JPH0733771Y2 - Surgical cutting instrument - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial field of application] The present invention is used for spinal cord, chin and knee joints, brain surgery, etc.
The present invention relates to a surgical cutting instrument that cuts cartilage, tumor, etc. and discharges it outside the body.

[Prior Art] In recent years, for example, in joint surgery, a general incision method (open surgery) requires a relatively large incision, which causes trauma due to the incision and causes a lot of pain and movement limitation. Due to the drawback of requiring time, there is a surgical excision instrument that forms a small puncture hole without incising the joint under the observation of an arthroscope and inserts a treatment insertion portion into the puncture hole to perform an operation (closed surgery). It has been proposed (see JP-A-61-199848, etc.). Such a surgical cutting instrument is composed of an insertion portion having a cutting opening at the tip and a gripping portion, the diseased tissue is cut at the cutting opening of the insertion portion, and the cut tissue piece is formed in the insertion portion and the gripping portion. It is designed to be sucked out of the body along with the perfusate through the suction passage.

Further, USP 4,750,902 discloses that a tissue recovery container is provided in the middle of a suction path greatly separated from the instrument body, and a tissue piece collected in the tissue recovery container through the suction path is inspected. .

[Problems to be Solved by the Invention] However, in the one disclosed in the above-mentioned USP 4,750,902, since the tissue recovery container is provided in a portion largely separated from the instrument body, the operator cuts off the diseased tissue. In the meantime, in order to judge how much excision was done, it was necessary to look away from the surgical site and look at the tissue collection container. As described above, it is extremely dangerous to look away from the surgical site during the operation, and the tissue may be excessively resected or insufficiently resected.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a surgical excision instrument that allows a user to know at a glance how much the excised tissue piece has become.

[Means and Actions for Solving the Problems] In order to solve the above problems, the present invention has a suction passage that communicates with a suction source through an insertion portion and a grip portion, and the tip of the insertion portion through the suction passage. In a surgical cutting instrument for sucking a piece of tissue cut by a section, a tissue recovery container, at least a part of which is transparent, is exposed and detachably provided in the grip portion or the suction path immediately after the grip portion. According to this configuration,
The operator can visually observe the tissue collection container while observing the surgical site, and can recognize at a glance how much the excised tissue piece has become.

[Embodiment] A first embodiment of the present invention will be described below with reference to FIGS. 1 to 3.

FIG. 2 shows a surgical cutting instrument 1 of the present invention, which comprises a handpiece 2 on the proximal side and an elongated insertion part 3 extending on the distal side of the handpiece 2. The insertion portion 3 has a double pipe structure, the outer pipe 3a is fixed to the handpiece 2, and the inner pipe is rotated by a drive motor (not shown) incorporated in the handpiece 2. There is.
Further, cutting ports 4 are formed on the outer circumferences of the outer pipe 3a and the inner pipe, respectively. When the inner pipes are rotated, the cutting ports 4 are brought into contact with each other. Is designed to disconnect.

A suction mouthpiece 5 is projectingly provided at the rear end of the handpiece 2, and a tissue recovery container 7 is exposed to the suction mouthpiece 5 via a connecting tube 6 in front of the handpiece 2. It is detachably connected. As shown in FIG. 1, the tissue recovery container 7 has a container body 8 having a cylindrical shape with a bottom and formed entirely of a transparent member, and an opening portion of the container body 8 closed to be detachably screwed. A closed bottomed cylindrical lid portion 9 and a ring-shaped net holder 10 that is sandwiched between the rear end surface of the container body 8 and the inner bottom surface of the lid portion 9,
The net 11 attached to the tip opening of the net holder 10
The net 11 divides the inside of the tissue recovery container 7 into a first space 12 and a second space 13.
In addition, the inner peripheral surface of the container body 8 and the outer peripheral surface of the net holder 10,
Sealing O-rings 14 and 15 are mounted between the inner bottom surface of the lid 9 and the rear end surface of the net holder 10. Further, a first suction tube 16 is detachably connected to the lid portion 9, and the extending end of the first suction tube 16 has a third end.
As shown in the figure, it is connected to the first suction pipe 18 of the suction bottle 17. A second suction tube 21 having a switching cock 20 is connected midway to the second suction tube 19 of the suction bottle 17, and the extended end of the second suction tube 21 serves as a suction source (not shown). Connected to suction pump. Here, the inner tube of the insertion section 3, the handpiece 2, the tissue collection container 7, the first suction tube 16, the suction bottle 17, and the second suction tube 21 are in communication with each other, and the internal spaces of these sections are the insertion section. A suction path 22 is formed from the cutting port 3 of 3 to the suction pump. In addition, a power cord is provided at the end of the handpiece 2 through a snap 23.
24 is connected, and an extension end of the power cord 24 is connected to a power supply device 25 that applies a voltage to the inner tube driving motor built in the handpiece 2.

FIG. 3 shows an example of a use state, in which the surgical cutting instrument 1 is guided to a target site in a body cavity, for example, an intervertebral disc 28 via an optical tube 26 and a trocar outer tube 27. That is, the optical tube 26
Includes an illumination optical system such as an optical fiber and an observation optical system such as a relay lens (none of which is shown), and the illumination optical system is optically connected to the light source device 30 via a light guide cable 29. The observation optical system is optically connected to the eyepiece unit 31. A VT camera 32 is set in the eyepiece unit 31, and an image captured by the TV camera 32 is displayed on the TV monitor 34 via the camera controller 33. Further, the trocar outer tube 27 is attached to the outer periphery of the distal end portion of the optical tube 26, and the finger hook portion 35,
A water delivery cap 36 is provided. A water supply bottle 38 is connected to the water supply mouthpiece 36 via a water supply tube 37.
The perfusate 39 in 38 is discharged from the distal end to the surgical site through the liquid supply path between the water supply tube 37, the trocar outer tube 27 and the optical tube 26.

In such a configuration, in order to excise the diseased tissue of the intervertebral disc 28, the operator grasps the finger hook portion 35 of the trocar mantle tube 27 and the handpiece 2 of the surgical cutting instrument 1 to insert the surgical cutting instrument 1 The section 3 is inserted into the optical tube 26 and the trocar outer tube 27, and the insertion section 3 is guided to the intervertebral disc 28 by forming the insertion puncture hole 41 in the living body 40 by the puncture scanning of the trocar outer tube 27. Then, while observing the intervertebral disc 28 and the distal end portion of the insertion portion 3 with the TV monitor 34, the cutting opening 4 at the distal end of the insertion portion 3 is brought into contact with the diseased tissue, and the motor is driven in this state to drive the inner tube of the insertion portion 3. By rotating, the diseased tissue that has taken in the cutting opening 4 is cut. At this time, the water bottle 38 should be placed on the surgical site.
The perfusate 39 from the above is supplied, and the perfusate 39 mixes with the excised tissue fragment by the suction action of the water supply pump and flows through the suction passage 22. The perfusion solution 39 and the tissue piece are collected in the tissue recovery container 7 provided in the suction passage 22 immediately after the handpiece 2.
In the process of passing through the tissue, the tissue piece is removed from the net 11 of the tissue recovery container 7.
As a result, only the perfusate 39 passes through the net 11, so that the tissue pieces cut at the tip of the insertion portion 3 are accumulated in the first space 12 of the tissue recovery container 7. The perfusate 39 flowing through the tissue collection container 7 is guided to the suction bottle 17 and collected therein.

In this manner, since the container body 8 of the tissue recovery container 7 is transparent, the operator can visually recognize the tissue pieces accumulated in the first space 12 from the outside. Since it was installed immediately after the handpiece 2 that the operator holds,
While observing the surgical site on the TV monitor 34, the tissue recovery container 7 can be visually observed at the same time, and the size of the excised tissue piece can be seen at a glance. The same can be said when the eyepiece 31 is directly observed without using the TV monitor 34. In this way, since it is possible to perform the excision of the diseased tissue while visually observing the amount of the excised tissue piece, it is possible to prevent even the normal tissue from being cut, or it is possible to prevent the diseased tissue from being insufficiently excised, Surgery can be performed safely, reliably and stably.

4 and 5 show a second embodiment of the present invention.

In this embodiment, the tissue recovery container 7 and the power cord 24 are integrally fixed by a substantially S-shaped holder 45, and other configurations and operations are similar to those of the first embodiment. By fixing the tissue collection container 7 and the power cord 24 in this manner, the removable tissue collection container 7 becomes stable and the operability is improved.

FIG. 6 shows a third embodiment of the present invention.

In this embodiment, the connection tube 6 and the container body 8 of the tissue recovery container 7 are integrally formed. The connection tube 6 is made of a soft material, and the suction mouthpiece 5 of the handpiece 2
It is directly attached to and detached from. Other configurations and operations are similar to those of the first embodiment, but in this case, it contributes to reduction of the number of parts, simplification of the system, and cost reduction.

FIG. 7 shows a fourth embodiment of the present invention.

In this embodiment, the tissue recovery container 7 is provided inside the handpiece 2. That is, the accommodation chamber 46 is formed in a part of the outer periphery of the handpiece 2, and the accommodation chamber 46 is provided with the first embodiment in the middle of the pipe 47 that connects the inner pipe of the insertion portion 3 and the suction cap 5. Similarly, the tissue recovery container 7 in which the container body 8 is formed of a transparent member is attached and is closed by the transparent lid 48 of the storage chamber 46. That is, the tissue recovery container 7 is exposed through the transparent lid 48 of the handpiece 2. Note that the other configurations and operations are the same as those in the first embodiment, but in this case, the operability can be improved by attaching / detaching the tissue recovery container 7 to / from the handpiece 2 in a cassette manner. it can.

The present invention is not limited to the above embodiments, and for example, not only the container body 8 of the tissue recovery container 7 but also the connection tube 6, the container body 8, the net holder 10 and the lid 9 are all formed of transparent members. You may do it. Alternatively, the container body 8 may be formed of an opaque member, and a transparent window may be formed on a part of the outer periphery thereof. Further, a scale for indicating the amount of collected tissue pieces may be engraved on the outer peripheral portion of the container body 8.

[Effects of the Invention] As described above, according to the surgical cutting instrument of the present invention, since the tissue recovery container is provided in the grasping portion for grasping by the operator or in the suction path immediately after that, the operator observes the operation site. However, the tissue collection container can be visually checked at the same time, and the size of the excised tissue piece can be seen at a glance. Therefore, the lesioned tissue can be excised while easily visually recognizing the amount of excised tissue piece, and the surgery can be performed safely and surely and stably.

[Brief description of drawings]

1 to 3 show a first embodiment of the present invention, FIG. 1 is an enlarged side view of a part of a surgical cutting instrument showing a main portion in section, and FIG. 2 is a surgical cutting instrument. Fig. 3 is a side view of Fig. 3, Fig. 3 is a system view showing a state of use, Figs. 4 and 5 show a second embodiment of the present invention, and Fig. 4 is an enlarged side view of a part of a surgical cutting instrument, FIG. 5 is a view seen from the direction A in FIG. 4, and FIG. 6 is an enlarged sectional view of an essential part showing a third embodiment of the present invention.
FIG. 7 is a side view of a surgical cutting instrument showing a fourth embodiment of the present invention. 2 ... Handpiece, 3 ... Insertion part, 7 ... Tissue recovery container, 22
… Suction path.

 ─────────────────────────────────────────────────── ─── Continued Front Page (72) Inventor Tetsumaru Kubota 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Genji Ogawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Inventor Toshiki Terayama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Takeaki Nakamura 2-43 Hatagaya, Shibuya-ku, Tokyo No. 2 Olympus Optical Co., Ltd. (72) Creator Yoshian Aoki 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (56) Reference JP-A-63-73948 (JP, A) ) JP-A-61-206435 (JP, A)

Claims (1)

[Scope of utility model registration request] 1. A surgical cutting instrument having a suction passage communicating with a suction source through an insertion portion and a gripping portion, and sucking a tissue piece cut at a distal end portion of the insertion portion through the suction passage. Alternatively, a surgical cutting instrument characterized in that a tissue recovery container, at least a part of which is transparent, is exposed in a suction path immediately after that and is detachably provided.