JPH07255735A - 外科用器具 - Google Patents

外科用器具

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Publication number
JPH07255735A
JPH07255735A JP6073969A JP7396994A JPH07255735A JP H07255735 A JPH07255735 A JP H07255735A JP 6073969 A JP6073969 A JP 6073969A JP 7396994 A JP7396994 A JP 7396994A JP H07255735 A JPH07255735 A JP H07255735A
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Japan
Prior art keywords
surgical
transmission member
handle
tip
instrument
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JP6073969A
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JP3421117B2 (ja
Inventor
Hirosada Hashimoto
大定 橋本
Takatomo Hisamatsu
孝知 久松
Itaru Okubo
到 大久保
雅博 ▲ぬで▼島
Masahiro Nudeshima
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Terumo Corp
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Terumo Corp
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Priority to JP07396994A priority Critical patent/JP3421117B2/ja
Priority to US08/405,786 priority patent/US5649955A/en
Priority to EP95103957A priority patent/EP0677275B1/en
Priority to DE69532486T priority patent/DE69532486T2/de
Publication of JPH07255735A publication Critical patent/JPH07255735A/ja
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Publication of JP3421117B2 publication Critical patent/JP3421117B2/ja
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Abstract

(57)【要約】 【構成】本発明の外科用器具１は、長尺な器具本体２
と、器具本体２の先端側に器具本体２に対し回転可能に
設置された先端部３と、器具本体２の基端側に設けられ
た操作部９と、先端部３と操作部９との間を接続する長
尺な伝達部材とを有する。先端部３には、固定挟持片４
１に対し可動挟持片４２が回動して開閉動作を行う外科
動作手段４が設置されている。器具本体２は、湾曲部２
３において屈曲または湾曲可能とされている。操作部９
の可動ハンドル９４を回動操作すると、伝達部材が移動
して外科動作手段４が開閉する。また、操作部９のノブ
９８を回転操作すると、伝達部材が回転して先端部３が
器具本体２に対し回転する。 【効果】器具本体の途中を屈曲または湾曲させた場合で
も、先端部の外科動作手段を、揺動することなく先端部
の軸を中心に回転することができる。

Description

【発明の詳細な説明】
【０００１】
【産業上の利用分野】本発明は、例えば鉗子、鋏のよう
な外科用器具、特に、腹腔鏡下手術に用いるのに好適な
外科用器具に関するものである。
【０００２】
【従来の技術】先端に設けられた鉗子機構を基端側の操
作部にて遠隔操作する構成の鉗子が知られている（実公
平２−４６３２７号）。この鉗子は、先端に開閉可能な
一対の把持部材(8a、8b) よりなる把持部（鉗子機構）を
有し、この把持部に連設された中空の軸部(6) の基端
に、一対のハンドル部材(4a、4b) よりなるハンドル部
(4)を設け、ハンドル部材(4b)を回動操作することによ
り、軸部に内蔵された軸芯部(12)が牽引されて長手方向
に移動し把持部材(8a、8b) が開閉するよう構成したもの
である。そして、軸部(6) は、ハンドル部(4) に対し回
転可能に取り付けられており、軸部(6) の基端部に形成
された突片(21)を操作して、軸部(6) およびその先端の
把持部(8) を回転する。これにより、生体組織を把持す
る方向を変えることができる。
【０００３】ところで、近年、虫垂や胆嚢の切除術等に
おいて、従来の開腹手術に代わり、非開腹で行う腹腔鏡
下手術が注目されている。この腹腔鏡下手術は、図１０
に示すように、腹壁１００を貫通して腹腔１０１内に例
えば４本のトロカール管１０７を挿入し、その内の１本
のトロカール管１０７を介して挿入した小型カメラ１０
２によって腹腔１０１内をモニター画像１０３に映し、
このモニター画像１０３を見ながら、他のトロカール管
１０７を介してそれぞれ挿入された鉗子１０４、鋏１０
５および電気メス１０６を適宜操作して、所望の外科的
処置を腹腔１０１内で行うものである。
【０００４】このような腹腔鏡下手術においては、直管
であるトロカール管１０７は、腹壁１００に貫通、固定
され、しかも、貫通部の組織保護のために、トロカール
管１０７の腹壁１００に対する角度もほとんど変更でき
ないため、鉗子１０４、鋏１０５および電気メス１０６
は、それぞれ、外科的処置の可能な領域が狭い範囲に限
定されてしまう。そのため、これを解決する方法とし
て、例えば、鉗子１０４をトロカール管１０７に挿入
後、鉗子１０４の長尺な器具本体（伝達軸）１０８の先
端付近を屈曲または湾曲させ（図１０中の一点鎖線）、
鉗子１０４の回転との組み合わせにより、先端の鉗子機
構が届く領域を拡大することが提案されている。
【０００５】しかしながら、前述した従来の鉗子では、
変形しない直線状の軸部(6) を前提とし、かつ、先端の
把持部(8) が軸部(6) と共に回転するため、軸部(6) を
屈曲または湾曲可能とした場合、次のような問題が生じ
る。
【０００６】すなわち、軸部(6) の途中を屈曲または湾
曲させた状態で軸部(6) を回転させると、先端の把持部
(8) は、湾曲部より基端側の軸を中心に揺動回転するの
で、外科的処置を施す目的部位から離脱してしまい、結
局、軸部(6) の湾曲部より先端側の部分においては、そ
の軸を中心にのみ回転させて生体組織を把持する方向を
変えることができない。
【０００７】また、軸部(6) の湾曲、非湾曲にかかわら
ず、生体組織を直接貫通して挿入する場合においては、
軸部(6) を回転させると、軸部(6) と接触する生体組織
が軸部(6) の外周面との間で摩擦を生じ、ねじれやひき
つりを生じたり、場合によっては損傷を受けたりするこ
とがある。
【０００８】
【発明が解決しようとする課題】本発明の目的は、長尺
な器具本体の途中を屈曲または湾曲させた場合でも、先
端部の外科動作手段を、揺動することなく先端部の軸を
中心に回転することができる外科用器具を提供すること
にある。
【０００９】
【課題を解決するための手段】このような目的は、下記
（１）〜（10）の本発明により達成される。
【００１０】（１） 長尺な器具本体と、該器具本体の
先端側に回転可能に設けられ、開閉または回動動作を行
う外科動作手段を備える先端部と、前記器具本体の基端
側に設けられ、前記外科動作手段を遠隔操作する操作部
と、該操作部での操作を前記先端部に伝達する少なくと
も１つの長尺な伝達部材とを有する外科用器具であっ
て、前記操作部は、前記伝達部材を介して前記外科動作
手段を作動させるハンドル部と、前記伝達部材を介して
前記先端部を前記器具本体に対し回転させる回転操作部
とを有することを特徴とする外科用器具。
【００１１】（２） 前記器具本体と前記先端部との接
合部は、先端部の回転方向に沿って形成された溝と該溝
内に挿入する隆起部とを有している上記（１）に記載の
外科用器具。
【００１２】（３） 前記伝達部材は、前記器具本体の
長手方向に移動可能な線状体を有するものである上記
（１）または（２）に記載の外科用器具。
【００１３】（４） 単一の伝達部材を有し、該伝達部
材により、前記外科動作手段の操作と、前記先端部の回
転操作とを兼用する上記（１）ないし（３）のいずれか
に記載の外科用器具。
【００１４】（５） 前記操作部は、前記ハンドル部の
ハンドル操作を前記伝達部材の長手方向の移動に変換す
るとともに、前記回転操作部の操作により生じた回転力
を前記伝達部材に伝達する変換手段を有する上記（１）
ないし（４）のいずれかに記載の外科用器具。
【００１５】（６） 前記変換手段は、前記ハンドル部
のハンドル操作に伴って移動し、前記伝達部材を回転可
能に支持する支持部材と、前記回転操作部の操作により
生じた回転力を前記伝達部材に伝達する回転力伝達機構
とを有している上記（５）に記載の外科用器具。
【００１６】（７） 前記回転操作部は、前記伝達部材
の基端部に直接または間接的に接続されたノブで構成さ
れ、前記ハンドル部は、固定ハンドルと、該固定ハンド
ルに対し変位可能な可動ハンドルとで構成されている上
記（１）ないし（６）のいずれかに記載の外科用器具。
【００１７】（８） 前記外科動作手段は、その少なく
とも一方が駆動して開閉する一対の開閉部材で構成さ
れ、前記開閉部材を開く方向に付勢する付勢手段が設け
られている上記（１）ないし（７）のいずれかに記載の
外科用器具。
【００１８】（９） 前記付勢手段は、前記先端部また
はその近傍に設けられている上記（８）に記載の外科用
器具。
【００１９】（10） 前記器具本体は、屈曲または湾曲
可能である上記（１）ないし（９）のいずれかに記載の
外科用器具。
【００２０】
【実施例】以下、本発明の外科用器具を添付図面に示す
好適実施例に基づいて詳細に説明する。
【００２１】図１は、本発明の外科用器具を鉗子に適用
した場合の構成例を示す全体側面図、図２および図３
は、それぞれ、図１に示す外科用器具の先端部付近の構
成を拡大して示す部分断面側面図、図４および図５は、
それぞれ、図１に示す外科用器具の基端部付近の構成を
拡大して示す部分断面側面図、図６は、図２中のＡ−Ａ
線断面図、図７は、図５中のＢ−Ｂ線断面図である。な
お、以下の説明において、図１〜図５中の右側を基端、
左側を先端という。
【００２２】図１〜図７に示す本発明の外科用器具（鉗
子）１は、主に、腹腔鏡下手術において使用されるもの
であり、長尺な器具本体２と、器具本体２の先端側に設
けられた先端部３と、器具本体２の基端側に設けられた
操作部９と、先端部３と操作部９との間を接続する長尺
な伝達部材６とで構成されている。以下、これらの構成
要素について順次説明する。
【００２３】器具本体２は、内部に伝達部材６等を収納
し得る空間２１が形成された中空の長尺部材であり、そ
の先端には、先端部３と回転可能に連結される接合部７
を有している。また、器具本体２の基端は、後述する操
作部本体９１に連結されている。
【００２４】器具本体２の横断面形状は、例えば、円
形、楕円形、多角形等、特に限定されず、円形の場合、
その外径は、前記トロカール管１０７に挿入可能な程度
とされる。具体的には、器具本体２の外径は、５〜１８
mm程度とするのが好ましい。
【００２５】なお、図示の構成では、器具本体２は、ト
ロカール管１０７への挿入を考慮して、直線状をなして
いるが、これに限らず、所望の形状に予め湾曲または屈
曲したものであってもよい。
【００２６】また、後述するように、所望の形状に湾曲
変形可能な少なくとも１つの湾曲部２３を有するもので
あってもよい。このような構成とした場合には、外科動
作手段４による生体組織上の外科的処置の可能な領域が
拡大し、また、より適正な姿勢で外科的処置を行うこと
が可能となる。
【００２７】伝達部材６は、線状体６１と、該線状体６
１の基端側に連結された第１の連結部材６２と、線状体
６１の先端側に連結された棒状の第２の連結部材６３と
で構成されている。
【００２８】線状体６１としては、その全部または一部
が可撓性を有するもの（湾曲可能なもの）であるのが好
ましく、例えば、ステンレス鋼、タングステン、炭素
鋼、超弾性合金等よりなる金属線や、ポリアミド（全芳
香族系ポリアミド）、ポリエステル、超高分子量ポリエ
チレン、カーボン繊維等の比較的高張力に耐え得る高分
子材料よりなる繊維（以下、高張力繊維という）を素線
とするもの、あるいは、これらの素線のうちの任意のも
のの集合体またはその他の複合体を用いることができ
る。
【００２９】素線の集合体による線状体６１としては、
例えば、１本以上の前記素線（特に金属線）の外周に、
１本以上の同種または異種の素線を所定方向に巻きつけ
（例えばコイル状に）、さらにその外周に１本以上の同
種または異種の素線を前記と逆方向に巻きつけたものが
好適に使用される。このような線状体によれば、操作部
９における牽引操作に対する追従性に優れるとともに、
線状体６１を回転したときに、ねじれや曲げによる長さ
の変化（歪み）が抑制されるという利点がある。線状体
６１の外径は、特に限定されないが、本実施例の場合、
１．０〜２．５mm程度、特に１．０〜１．５mm程度とす
るのが好ましい。
【００３０】図６に示すように、第２の連結部材６３
は、その横断面形状が四角形をなし、一方、接合部７に
おける凸部７２の中心部には、これと同形状の通路７３
が形成されている。第２の連結部材６３は、通路７３内
に挿通され、通路７３の内壁に沿って摺動する。そし
て、第２の連結部材６３の先端は、先端部３の内部に至
り、後述するスライダ４４の基端と連結または一体化さ
れている。
【００３１】なお、第２の連結部材６３の横断面形状
は、図示のごとき形状に限定されず、例えば、三角形、
六角形、半円形、一文字状、十文字状、Ｌ字状等の非円
形のように、通路７３に対し回転を阻止し得る任意の形
状とすることができる。
【００３２】第２の連結部材６３の構成材料としては、
例えば、アルミニウム、真鍮、銅、ステンレス鋼、タン
グステン、炭素鋼、超弾性合金等の金属材料、ポリカー
ボネート、ポリエチレン、ポリプロピレン、硬質ポリ塩
化ビニル、ポリエステル等の比較的硬質な樹脂または前
述した高張力繊維等を挙げることができる。
【００３３】図２および図３に示すように、先端部３に
は、外科動作手段４と、コイルバネ５よりなる付勢手段
とが設置されている。外科動作手段４は、生体組織を挟
持し得る鉗子機構を構成するもので、一方が駆動して開
閉する一対の開閉部材、すなわち、固定挟持片４１と、
該固定挟持片４１に対し回動する可動挟持片４２とを有
している。可動挟持片４２は、その基端部において、ピ
ン４５により先端部本体３１に対し回動可能に取り付け
られている。
【００３４】先端部本体３１の図２中下部には、切欠き
３２が形成されており、この切欠き３２内には、先端部
３の長手方向に摺動可能なスライダ４４が設置されてい
る。スライダ４４の先端部には、ピン４６が突設されて
おり、このピン４６は、可動挟持片４２の基端下部に形
成された長孔４３内に挿入されている。
【００３５】このような構成により、後述するハンドル
部９２のハンドル操作により伝達部材６が基端側へ牽引
されて、スライダ４４が切欠き３２内の基端側に位置す
るときには、固定挟持片４１および可動挟持片４２は閉
じているが（図２に示す状態）、後述するハンドル部９
２の握持力の緩和または除去により、伝達部材６が先端
側へ移動して、スライダ４４が切欠き３２内の先端側へ
移動すると、ピン４６が長孔４３の内周面を押圧し、可
動挟持片４２がピン４５を中心に回動して、可動挟持片
４２が開く（図３に示す状態）。なお、長孔４３を設け
ず、スライダ４４の移動に伴ってスライダ４４が歪み、
ピン４６の図２中上下方向の動きを吸収するような構成
であってもよい。
【００３６】先端部本体３１に形成された凹部３３およ
びスライダ４４に形成された凹部４７内には、コイルバ
ネ５が圧縮状態で収納されている。このコイルバネ５
は、その弾性力によりスライダ４４を先端方向へ付勢、
すなわち、可動挟持片４２を開く方向に付勢する付勢手
段である。このように、本実施例では、付勢手段である
コイルバネ５が先端部３に内蔵されているため、前述し
た従来の鉗子のように、ハンドル部９２に可動ハンドル
９４を開く方向に付勢する板バネ等を設ける必要がな
く、操作部９の構成が簡素化され、操作性が向上する。
【００３７】図２および図３に示すように、接合部７
は、器具本体２の空間２１に連通し、器具本体２の先端
面に解放する横断面が円形の凹部７１と、先端部本体３
１の基端に突出し、前記凹部７１に挿入される横断面が
円形の凸部７２とで構成されている。
【００３８】凸部７２の中心部には、第２の連結部材６
３の横断面形状とぼぼ同形状の通路７３が軸方向に形成
されている。この通路７３に第２の連結部材６３が挿通
され、伝達部材６の回転力が凸部７２および先端部本体
３１に伝達される。
【００３９】凹部７１の内周面には、軸方向に所定間隔
を隔てて、２つのリング状の溝７４が形成されている。
一方、凸部７２の外周面には、前記各溝７４に対応する
位置に２つのリング状の隆起部７５が周方向に沿って形
成されている。これらの隆起部７５は、それぞれ、対応
する溝７４内に挿入されている。なお、隆起部７５は、
連続したリング状のものに限らず、周方向に沿って間欠
的に設けられていてもよい。
【００４０】以上のような構成の接合部７により、先端
部３は、器具本体２に対し回転し得るが、軸方向へはほ
とんど移動することができない。これにより、先端部の
離脱やガタツキを防止することができる。
【００４１】なお、先端部３の回転抵抗を減少する回転
抵抗減少手段（図示せず）を設けることもできる。その
具体例としては、凹部７１と突部７２と間に、潤滑油等
の潤滑剤を介在させ、または、例えばポリテトラフルオ
ロエチレン、シリコーン、ポリエチレン、ポリアセター
ル、真鍮のような低摩擦材料の層を形成することが挙げ
られる。これにより、先端部３の回転をより円滑に行う
ことができる。
【００４２】図１、図４および図５に示すように、器具
本体２の基端側には、外科動作手段４の開閉を遠隔的に
操作する操作部９が設けられている。この操作部９は、
操作部本体９１に対し固定的または一体的に設けられた
固定ハンドル９３と、該固定ハンドル９３に対し開閉
（回動）する可動ハンドル９４とで構成されるハンドル
部９２を有している。可動ハンドル９４は、その図中上
端部において、軸部材９５により操作部本体９１に対し
回動可能に取り付けられている。
【００４３】また、操作部本体９１の下部外面には、可
動ハンドル９４に係止してその回動範囲を規制するスト
ッパー９６が突出形成されている。これにより、ハンド
ル部９２に過度の握持力が加わることによる伝達部材６
の断線等を防止することができる。なお、固定ハンドル
９３と可動ハンドル９４の位置は、反対であってもよ
い。
【００４４】また、操作部９は、操作部本体９１の基端
側に、回転操作部９７を有する。この回転操作部９７
は、円盤状のノブ９８と、該ノブ９８を操作部本体９１
の基端に回転可能に支持する軸受９９で構成されてい
る。ノブ９８の外周には、その軸方向に沿って、滑り止
め用の凹凸９８１が形成されている。また、ノブ９８の
回転軸９８２は、基端側の円柱部９８３と、それより先
端側の角柱部８６１とで構成され、円柱部９８３におい
て軸受９９により支持されている。
【００４５】操作部本体９１の内部には、可動ハンドル
９４の回動を伝達部材６の長手方向の移動に変換すると
ともに、ノブ９８の回転操作により生じた回転力を伝達
部材６に伝達する変換手段８が設置されている。以下、
この変換手段８の構成について、図４、図５および図７
に基づき説明する。
【００４６】線状体６１の基端は、ピン６４により第１
の連結部材６２の先端部に固定されている。この第１の
連結部材６２は、その中心部に、ノブ９８の回転軸９８
２の角柱部８６１が挿入される横断面が四角形の通路８
６２が形成された円筒状の部材である。第１の連結部材
６２の基端には、後述する支持部材８１の基端面に係合
するリブ６２１が形成されている。
【００４７】変換手段８は、第１の連結部材６２を回転
可能に支持する支持部材８１と、ノブ９８の回転力を第
１の連結部材６２に伝達する回転力伝達機構８６とを有
している。
【００４８】支持部材８１は、第１の連結部材６２が挿
入される横断面が円形の貫通孔８１１を有している。支
持部材８１の図中下部には、長孔８３が形成された舌片
８２が突出形成されている。このような支持部材８１
は、操作部本体９１の内側に設けられたガイド部材８
７、８８により、伝達部材６の長手方向に摺動可能に支
持されている。舌片８２は、下方のガイド部材８８に形
成されたスリット８８１を貫通して下方へ突出してい
る。
【００４９】一方、可動ハンドル９４の上部には、操作
部本体９１の内部に挿入された突出片８４が形成され、
該突出片８４の上端部に立設されたピン８５が、前記舌
片８２の長孔８３に挿入されている。
【００５０】回転力伝達機構８６は、前記角柱部８６１
と、該角柱部８６１が挿入される通路８６２とで構成さ
れている。角柱部８６１は、通路８６２に対し、軸方向
には相対的に移動可能であるが、通路８６２内への挿入
深さにかかわらず、通路８６２に対し、回転することは
できない。従って、ノブ９８の回転力は、角柱部８６１
および通路８６２を介して第１の連結部材６２に伝達さ
れ、伝達部材６全体が回転する。
【００５１】なお、角柱部８６１の横断面形状は、図示
のものに限らず、例えば、三角形、六角形、半円形、一
文字状、十文字状、Ｌ字状等の非円形のように、通路８
６２に対し回転を阻止し得る任意の形状とすることがで
きる。
【００５２】また、回転力伝達機構８６としては、歯車
伝動機構、チェーン伝動機構、ベルト伝動機構（いずれ
も図示せず）を有するものであってもよい。例えば、こ
れらの伝動機構を用いて、回転操作部９７と先端部３と
の回転方向を逆としたり、変速したりすることもでき
る。
【００５３】以上のような外科用器具１では、外科動作
手段４の操作と先端部３の回転操作とを単一の伝達部材
６で兼用しているため、器具本体２内での伝達部材６の
設置スペースが小さくてよく、よって、器具本体をより
細くすることができるとともに、先端部３や操作部９の
構造も簡素化することができる。このようなことから、
本実施例の外科用器具１は、腹腔鏡下手術、脳外科手
術、胸腔鏡下手術、泌尿器科手術等に適している。
【００５４】次に、外科用器具１の作用について説明す
る。可動ハンドル９４が開いた状態（図１、図３および
図５に示す状態）から、ハンドル部９２を手で握り、可
動ハンドル９４を図１中の矢印で示す方向に回動させる
と、突出片８４が軸部材９５を中心に図中時計回りに回
動し、ピン８５が長孔８３の基端側内周面を押圧し、舌
片８２および支持部材８１がガイド部材８７、８８に沿
って基端側へ移動する（図４に示す状態）。支持部材８
１の基端には、リブ６２１が係合しているため、支持部
材８１の移動に伴って第１の連結部材６２も同方向に移
動し、伝達部材６が基端側へ牽引される。なお、支持部
材８１の基端方向への移動に伴い、角柱部８６１の先端
は、通路８６２内の比較的深部まで挿入される。
【００５５】伝達部材６が基端側へ牽引されると、これ
に伴い、スライダ４４がコイルバネ５の付勢力に抗して
切欠き３２内で基端側に移動し、ピン４６が長孔４３の
基端側内周面を押圧し、可動挟持片４２がピン４５を中
心に図２中反時計回りに回動して、可動挟持片４２が閉
じる（図２に示す状態）。
【００５６】ハンドル部９２を握っていた手を離すかま
たは握持力をゆるめると、コイルバネ５の付勢力により
スライダ４４が切欠き３２内で先端側に移動し、ピン４
６が長孔４３の先端側内周面を押圧し、可動挟持片４２
がピン４５を中心に図３中時計回りに回動して、可動挟
持片４２が開く（図３に示す状態）。
【００５７】スライダ４４の先端方向への移動に伴い、
伝達部材６も同方向に移動する。これにより、伝達部材
６の基端部においては、リブ６２１が支持部材８１を押
圧し、支持部材８１および舌片８２がガイド部材８７、
８８に沿って先端側へ移動する。これにより、長孔８３
の基端側内周面がピン８５を押圧し、突出片８４および
可動ハンドル９４が軸部材９５を中心に図５中時計回り
に回動し、可動ハンドルは、元の開いた状態（図５に示
す状態）に復帰する。なお、支持部材８１の先端方向へ
の移動に伴い、角柱部８６１の先端は、通路８６２内の
長手方向中央付近まで移動する。
【００５８】このように、可動挟持片４２の開閉は、可
動ハンドル９４の開閉に連動しており、固定挟持片４１
および可動挟持片４２の開度（把持力）は、固定ハンド
ル９３および可動ハンドル９４の開度（握持力）に対応
している。
【００５９】可動挟持片４２の開閉（開度）にかかわら
ず、ノブ９８を回転すると、その回転力は、回転軸９８
３の角柱部８６１、通路８６２、第１の連結部材６２、
線状体６１、第２の連結部材６３、通路７３、凸部７２
および先端部本体３１に順次伝達され、先端部３が回転
する。ノブ９８の回転方向は、先端部３の回転方向に一
致している。
【００６０】なお、外科動作手段４の開閉動作および先
端部３の回転動作は、器具本体２の直線状態、屈曲また
は湾曲状態のいずれにおいても可能である。特に、本発
明の外科用器具１では、器具本体２が屈曲または湾曲し
た状態（図１中の一点鎖線で示す状態）であっても、湾
曲部２３は回転せず、先端部３のみが回転するため、回
転に伴って先端部３が湾曲部２３より基端側の軸を中心
に揺動することがない。従って、外科動作手段４の外科
的処置を施す目的部位への接近状態を維持したまま外科
動作手段４の姿勢（生体組織を把持する方向）を変える
ことができる。
【００６１】図８は、本発明の外科用器具の先端部付近
の他の構成例を示す部分断面側面図である。同図に示す
外科用器具は、可動挟持片４２を開く方向に付勢する付
勢手段が、先端部３の近傍に設けられた構成のものであ
る。
【００６２】すなわち、器具本体２の接合部７の基端側
に隣接する位置には、空間２１が拡径した拡径部２２が
形成されており、該拡径部２２内には、前記と同様のコ
イルバネ５が収納されている。拡径部２２内において、
第２の連結部材６３は、コイルバネ５の内側に挿通され
ており、連結部材６３のコイルバネ５より先端側には、
円盤状の鍔部６５が固着または一体形成されている。圧
縮状態のコイルバネ５は、その基端が拡径部２２の基端
面に、その先端が鍔部６５に当接しており、第２の連結
部材６３を先端方向へ付勢する。
【００６３】図９は、器具本体２の湾曲部２３の構成例
を部分的に示す分解斜視図である。同図に示すように、
湾曲部２３は、相互に回動し得る複数の節輪環２４を接
合したものである。なお、図９では、３個の節輪環２４
が示されているが、節輪環２４の設置数はこれに限定さ
れず、例えば、４〜３０個程度であってもよい。
【００６４】各節輪環２４の一方の面には、節輪環２４
の中心を介して対向する一対のＶ字状の溝２５が形成さ
れ、他方の面には、節輪環２４の中心を介して対向する
一対の半円柱状の突部２６が前記溝２５と９０°ずれた
位置に形成されている。
【００６５】隣接する節輪環２４同士は、それらの溝２
５同士が互いに９０°ずれた姿勢で配置され、一方の節
輪環２４の両突部２６が他方の節輪環２４の対応する両
溝２５内に挿入されるようにして各節輪環２４を接合す
る。
【００６６】また、各節輪環２４の両溝２５および両突
部２６の位置には、それぞれ、貫通孔２７が形成されて
おり、必要に応じ、４本の柔軟な線材２８を各節輪環２
４の対応する貫通孔２７にそれぞれ挿通することによ
り、各節輪環２４を集合させることができる。
【００６７】突部２６が溝２５に挿入された状態では、
隣接する節輪環２４の間には隙間が形成されるため、突
部２６が溝２５内で回動することができ、これにより、
隣接する節輪環２４同士が回動する。隣接する１組の節
輪環２４同士の回動角度は、僅かであるが、その角度が
複数組の節輪環２４について累積すると、湾曲部全体と
して所望の湾曲（例えば８０〜１２０°程度）が得られ
る。また、この実施例では、湾曲可能な方向は、器具本
体２の横断面上で上下左右の４方向である。なお、図示
されていないが、各節輪環２４の外周を、例えば、弾性
または可撓性を有する材料で構成された層で被覆するこ
ともできる。
【００６８】このような湾曲部２３は、例えば線材２８
の牽引により能動的に屈曲または湾曲するものでも、外
部より応力を加えられて受動的に屈曲または湾曲するも
のでもよい。さらに、湾曲方向やその数（自由度）も特
に限定されない。
【００６９】また、湾曲部２３の構成は、図示のものに
限定されず、例えば、蛇腹管や可撓性チューブを有する
構成であってもよい。さらには、器具本体を先端部側の
硬管と基端部側の硬管とで構成し、両硬管同士を１本ま
たは複数本の軸により回動可能に接続することで屈曲さ
せる構成としてもよい。
【００７０】以上、本発明の外科用器具を図示の各実施
例について説明したが、本発明は、これらに限定される
ものではない。例えば、付勢手段は、コイルバネ５に限
らず、例えば、トーションバネ、板バネ等の他の形態の
バネや、ゴムのような弾性材料、あるいは永久磁石、電
磁石を用いることができる。また、このような付勢手段
は、操作部９に設けられていてもよい。
【００７１】また、接合部７、変換手段８、操作部９の
構成も、それぞれ、図示のものに限定されない。また、
本発明において、外科動作手段は、双方が回動する一対
の開閉部材で構成されたものであってもよい。また、回
動に限らず、例えば、平行移動して開閉する構成のもの
でもよい。さらには、例えばおじぎ鉗子、電気メス、超
音波メスのように、一つの部材が回動する構成のもので
あってもよい。
【００７２】本発明の外科用器具の種類は、鉗子に限ら
ず、例えば、鋏、結紮器、持針器や、電気メス、超音波
メス、レーザメス等のメスであってもよい。また、その
用途も、腹腔鏡下手術に使用されるものに限定されな
い。
【００７３】
【発明の効果】以上述べたように、本発明の外科用器具
によれば、器具本体に対し先端部が回転するため、器具
本体の途中を屈曲または湾曲させた場合でも、外科動作
手段を、揺動することなく先端部の軸を中心に回転する
ことができる。従って、外科動作手段の外科的処置を施
す目的部位への接近状態を維持したまま、外科動作手段
の姿勢をより適した姿勢に変えることができる。
【００７４】また、外科動作手段の操作と先端部の回転
操作とを単一の伝達部材で兼用した場合には、伝達部材
の設置スペースをとらず、器具本体等をより細くするこ
とができる。また、器具本体を屈曲または湾曲可能とし
た場合には、外科的処置の可能な領域が拡大し、また、
より適正な姿勢で外科的処置を行うことが可能となる。
【図面の簡単な説明】
【図１】本発明の外科用器具の構成例を示す全体側面図
である。
【図２】図１に示す外科用器具の先端部付近の構成を拡
大して示す部分断面側面図である。
【図３】図１に示す外科用器具の先端部付近の構成を拡
大して示す部分断面側面図である。
【図４】図１に示す外科用器具の基端部付近の構成を拡
大して示す部分断面側面図である。
【図５】図１に示す外科用器具の基端部付近の構成を拡
大して示す部分断面側面図である。
【図６】図２中のＡ−Ａ線での断面図である。
【図７】図５中のＢ−Ｂ線での断面図である。
【図８】本発明の外科用器具の先端部付近の他の構成例
を示す部分断面側面図である。
【図９】本発明における器具本体の湾曲部の構成例を示
す分解斜視図である。
【図１０】腹腔鏡下手術の状態を示す断面図である。
【符号の説明】
１ 外科用器具 ２ 器具本体 ２１ 空間 ２２ 拡径部 ２３ 湾曲部 ２４ 節輪環 ２５ 溝 ２６ 突部 ２７ 貫通孔 ２８ 線材 ３ 先端部 ３１ 先端部本体 ３２ 切欠き ３３ 凹部 ４ 外科動作手段 ４１ 固定挟持片 ４２ 可動挟持片 ４３ 長孔 ４４ スライダ ４５、４６ ピン ４７ 凹部 ５ コイルバネ ６ 伝達部材 ６１ 線状体 ６２ 第１の連結部材 ６３ 第２の連結部材 ６４ ピン ６５ 鍔部 ７ 接合部 ７１ 凹部 ７２ 凸部 ７３ 通路 ７４ 溝 ７５ 隆起部 ８ 変換手段 ８１ 支持部材 ８１１ 貫通孔 ８２ 舌片 ８３ 長孔 ８４ 突出片 ８５ ピン ８６ 回転力伝達機構 ８６１ 角柱部 ８６２ 通路 ８７、８８ ガイド部材 ８８１ スリット ９ 操作部 ９１ 操作部本体 ９２ ハンドル部 ９３ 固定ハンドル ９４ 可動ハンドル ９５ 軸部材 ９６ ストッパー ９７ 回転操作部 ９８ ノブ ９８１ 凹凸 ９８２ 回転軸 ９８３ 円柱部 ９９ 軸受 １００ 腹壁 １０１ 腹腔 １０２ 小型カメラ １０３ モニター画像 １０４ 鉗子 １０５ 鋏 １０６ 電気メス １０７ トロカール管 １０８ 器具本体
───────────────────────────────────────────────────── フロントページの続き (72)発明者 大久保 到 神奈川県足柄上郡中井町井ノ口1500番地 テルモ株式会社内 (72)発明者 ▲ぬで▼島 雅博 神奈川県足柄上郡中井町井ノ口1500番地 テルモ株式会社内

Claims (1)

    【特許請求の範囲】
  1. 【請求項１】 長尺な器具本体と、該器具本体の先端側
    に回転可能に設けられ、開閉または回動動作を行う外科
    動作手段を備える先端部と、前記器具本体の基端側に設
    けられ、前記外科動作手段を遠隔操作する操作部と、該
    操作部での操作を前記先端部に伝達する少なくとも１つ
    の長尺な伝達部材とを有する外科用器具であって、 前記操作部は、前記伝達部材を介して前記外科動作手段
    を作動させるハンドル部と、前記伝達部材を介して前記
    先端部を前記器具本体に対し回転させる回転操作部とを
    有することを特徴とする外科用器具。
JP07396994A 1994-03-17 1994-03-17 外科用器具 Expired - Lifetime JP3421117B2 (ja)

Priority Applications (4)

Application Number Priority Date Filing Date Title
JP07396994A JP3421117B2 (ja) 1994-03-17 1994-03-17 外科用器具
US08/405,786 US5649955A (en) 1994-03-17 1995-03-17 Surgical instrument
EP95103957A EP0677275B1 (en) 1994-03-17 1995-03-17 Surgical instrument
DE69532486T DE69532486T2 (de) 1994-03-17 1995-03-17 Chirurgisches Instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP07396994A JP3421117B2 (ja) 1994-03-17 1994-03-17 外科用器具

Publications (2)

Publication Number Publication Date
JPH07255735A true JPH07255735A (ja) 1995-10-09
JP3421117B2 JP3421117B2 (ja) 2003-06-30

Family

ID=13533424

Family Applications (1)

Application Number Title Priority Date Filing Date
JP07396994A Expired - Lifetime JP3421117B2 (ja) 1994-03-17 1994-03-17 外科用器具

Country Status (1)

Country Link
JP (1) JP3421117B2 (ja)

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