JPH10127645A - Organ amputating device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To amputate an organ, etc., in a body into small pieces and to take it out from the body by providing an operating means for operating an organ inserting and holding means whose one tip is combined with the tip part of an amputating blade between a position deformed in the direction of separating from the amputating blade and a position facing along the cutting blade so as to amputate the organ. SOLUTION: The external shape of a thin and long cylindrical external body 1 is set to be in a size which can be inserted through an opening of a size allowing a finger to pass, and a cutter holder 2 and a frame holder 3 are freely slidably arranged within the body 1. Then a nearly ground-formed handle 4 is fixed at a projecting tip part on the side of the base tip of the holder 2, and the amputating blade 6 is fixed onto the axis line of the body 1 at the tip part of the holder 2. A spherical supporting part 9 is pivotally fixed to the tip part of this blade 6 with a pin 10, the tips of flexible thin plate frames 13 and 14 are respectively adhered to the groove 11 of the part 9 and the frames 13 and 14 are dislocated between a continuous line position and a chain line position to amputate the organ, etc., in the body to take it out from the body.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for cutting organs such as liver and kidney, which have been resected in endoscopic surgery, out of a small incision, and cutting the organs into slices in a patient's body. The present invention relates to an organ cutting device used for cutting.

[0002]

2. Description of the Related Art Endoscopic surgery is known as a surgical operation for cutting an organ such as a liver or kidney in a body cavity of a patient.

[0003] In endoscopic surgery, several openings are formed in the abdomen and chest of a patient so that fingers can pass through the openings, and endoscopes and treatment instruments are inserted through the openings to operate the endoscopes and treatment instruments. This is an operation to resect or reconstruct a patient's organ, and does not require a large incision.

[0004]

Although the treatment instrument used in the above-mentioned endoscopic surgery has a function of exfoliating and separating an organ, an organ cut off from a body wall by stopping a blood vessel is taken out of the body. It does not have the function of shredding organs for removal.

[0005] The present invention has been made in view of the above points, and it is an object of the present invention to provide an organ cutting apparatus which enables an organ or the like in a body to be cut into small pieces during operation and taken out of the body through an opening.

[0006]

An organ cutting apparatus according to the present invention comprises a cutting blade inserted into a human body through an opening provided in the human body, and a flexible material, one end of which is connected to a distal end of the cutting blade. Organ holding means, and a position where the organ holding means is bent in a direction away from the cutting blade so as to form a space for holding an organ to be cut between the blade part of the cutting blade and the cutting blade. Operating means for operating between a position along the cutting blade so as to cut the organ sandwiched between the cutting blade and the cutting blade. To be taken out.

An organ cutting apparatus according to the present invention comprises an elongated cylindrical outer body inserted into a human body through an opening provided in the human body, and a slidably provided base inside the cylindrical outer body, the base end of which is cylindrical. A first operating body projecting from a base end of the body, and a second operating body slidably provided in the first operating body inside the cylindrical outer body and having a base end side projecting outward from the base end of the first operating body. An operating body, a cutting blade fixed to the distal end of the first operating body so as to extend in the axial direction of the cylindrical outer body, and a slit having a slit through which the blade of the cutting blade passes, and one end connected to the distal end of the cutting blade. A flexible thin plate frame having the other end connected to the second operating body, and an organ to be cut held between the flexible thin frame and the cutting blade by sliding the second operating body forward. A space is formed, and the organ held between the flexible thin plate frames is cut by the cutting blade by sliding the second operating body backward. Is composed of a motion means, it excised organs such as small cut and at the time of surgery makes it possible to retrieve from the body through the opening.

According to the organ cutting apparatus of the present invention, a supporting portion is pivotally attached to the tip of a cutting blade, and one end of a thin plate frame is fixed to the supporting portion. Can be arranged in parallel.

[0009]

Embodiments of the present invention will be described below with reference to the drawings.

In FIGS. 1 and 2, reference numeral 1 denotes an elongated tubular outer body of an organ cutting apparatus made of stainless steel.
The cylindrical outer body 1 is set to have dimensions such that the outer shape thereof can be inserted into an opening having a size such that a finger provided on the abdomen or chest of a patient can pass therethrough in endoscopic surgery. ing. A cutter holder 2 and a frame holder 3 are slidably disposed inside the cylindrical outer body 1.

The cutter holder 2 is a rod having a rectangular cross section, and has a base end protruding from the base end of the cylindrical outer body 1.
A substantially gourd-shaped handle 4 is fixed to the protruding end. The distance from the base end surface of the cylindrical outer body 1 at the protruding end of the cutter holder 2 to the handle 4 is the sliding distance of the cutter holder 2. The handle 4 provided on the cutter holder 2 has a through hole 5 through which the frame holder 3 is inserted. A cutting blade 6 is fixed to the distal end portion of the cutter holder 2 so that the cutting blade 6 extends in the axial direction of the cylindrical outer body 1 with the blade portion facing upward.

That is, as shown in FIG. 2A, the cutter holder 2 slides forward until the handle 4 provided on the cutter holder 2 comes into contact with the base end surface of the cylindrical outer body 1, and the cutting blade provided on the cutter holder 2. 6 protrudes forward from the cylindrical outer body 1 by a distance slid forward of the cutter holder 2. Further, the cutting blade 6 provided on the cutter holder 2 moves in a direction of retracting inside the cylindrical outer body 1 by sliding backward in the cutter holder 2.

The frame holder 3 is shown in FIGS.
As shown in the figure, a semicircular portion 3a in contact with the inner surface of the cylindrical outer body 1
And a groove 7 for receiving the cutter holder 2 is formed in the plane of the semicircular portion 3a. The frame holder 3 slidably accommodates the cutter holder 2 in the groove 7,
The base end protrudes outward from a handle 4 provided on the cutter holder 2. A substantially U-shaped handle 8 is fixed to the protruding end of the frame holder 3. The frame holder 3 and the cutter holder 2 move integrally by engagement of an engaging means (not shown).

At the tip of the cutting blade 6 provided on the cutter holder 2, a spherical supporting portion 9 is pivotally mounted via a pin 10 so as to rotate in a vertical plane. This support 9
As shown in FIG. 3A, a groove 11 having an opening at one end and a screw hole 12 extending in a direction perpendicular to the groove 11 are provided. The cutting blade 6 as shown in FIG.
A flexible thin plate frame 13 having a slit 12 for passing the blade portion and a flat flexible thin plate frame 14 as shown in FIG. These flexible thin frames 13 and 14 can be formed from a flexible strip.

The flexible thin plate frame 13 is preferably
It is a thin stainless steel plate having a thickness of 4 mm and a width of 6 mm, and the width of the slit 12 is close to the width of the cutting blade 6, for example, 2.1 mm if the cutting blade 6 is 2 mm. As shown in FIG. 5, the flexible thin plate frame 13 has one hole 15 at one end and two holes 16 at the other end.

The flexible sheet frame 14 is preferably
It is a stainless steel plate having a thickness of 3 mm and a width of 6 mm, and has one hole 15a on one end and two holes 16a, 16a on the other end as shown in FIG. The hole 15a and the two holes 16a provided in the flexible thin frame 14 and the hole 15 and the two holes 16, 16 of the flexible thin frame 13 overlap the flexible thin frame 13 and the flexible thin frame 14. So that they will match when located.

A guide member 17 for guiding the cutting blade 6, the flexible thin frame 13 and the flexible thin frame 14 is fixed to the distal end of the cylindrical outer body 1. The guide member 17 has an opening through which the cutting blade 6 passes in the center, an opening through which the flexible thin plate frame 14 passes through the opening provided in the center on the cutting edge side of the cutting blade 6, and an opening provided in the center. An opening through which the flexible thin plate frame 13 passes is provided on the blade base side of the cutting blade 6.

As shown in FIG. 1, the flexible thin plate frame 13 and the flexible thin plate frame 14 are connected at one end to a support 9 pivotally attached to the tip of the cutting blade 6, and at the other end to a guide. Through an opening provided in the member 17, it is connected to a mounting portion 18 provided at the tip of the frame holder 3.

That is, the flexible thin plate frame 13 and the flexible thin plate frame 14 are inserted into the groove 11 of the support portion 9 by inserting the ends of the flexible thin plate frame 14 provided with the holes 15 and 15a on the upper side. It is fixed to the support part 9 by screws 19 screwed into the screw holes 12 of the part 9. Further, the other end of the flexible thin plate frame 13 is riveted to a lower portion of the mounting portion 18 of the frame holder 3 through an opening provided on the blade side of the cutting blade 6 from an opening of the guide member 17 through which the cutting blade 6 passes. The other end of the flexible thin plate frame 14 is riveted to the upper portion of the mounting portion 18 of the frame holder 3 through an opening provided on the cutting edge side of the cutting blade 6 from the opening through which the cutting blade 6 of the guide member 17 passes. It is fixed by.

As shown in FIG. 1, the flexible thin plate frame 13 is moved away from the cutting blade 6 so as to form a space for holding an organ to be cut between the cutting blade 6 and the cutting portion. It moves between positions (two-dot chain line) oriented along the cutting blade so that the organ held between the bent position (solid line position) and the cutting blade 6 is cut by the cutting blade.

Similarly, the flexible thin plate frame 14 arranged in parallel with the flexible thin plate frame 13 moves between a position shown by a solid line and a position shown by a two-dot chain line in FIG.

Next, the operation will be described.

In endoscopic surgery, an endoscope or a treatment instrument is inserted through an opening provided in the abdomen or chest of a patient, and the endoscope and the treatment instrument are operated to cut an organ such as a liver or a kidney. However, organs such as the liver and kidney that have been resected (organs that have stopped blood vessels and have been peeled off from the inner wall) cannot be taken out of the body through openings provided in the abdomen and chest as they are.

Therefore, the organ cutting device according to the present invention is used. In this organ cutting apparatus, most of the cutting blade 6 is located inside the cylindrical outer body 1 at the stage before use, and the distal end portion of the cutting blade 6 and the supporting portion 9 are moved from the distal end surface of the cylindrical outer body 1. It is in a protruding state. This is done by holding the tubular outer body 1 of the organ cutting apparatus with the left hand, holding the handle 8 provided on the frame holder 3 with the right hand, and pulling the handle 8 provided on the frame holder 3 in the direction of arrow B in FIG. It is done in.

Next, the tubular outer body 1 of the organ cutting apparatus is inserted into the body through openings provided in the abdomen and chest of the patient, with the side on which the support portion 9 is provided first. Since the outer diameter of the support portion 9 is spherical, other organs are not damaged when the cylindrical outer body 1 is inserted into the body.

Next, while looking at the endoscope, hold the tubular outer body 1 of the organ cutting apparatus with the left hand, hold the handle 8 provided on the frame holder 3 with the right hand, and hold the handle 8 provided on the frame holder 3 When pressed in the direction of arrow A in FIG. 1, the frame holder 3 and the cutter holder 2 move inside the cylindrical outer body 1, and the cutting blade 6 provided at the tip of the cutter holder 2, the flexible thin plate frame 13 and the flexible The thin plate frame 14 protrudes from the distal end surface of the cylindrical outer body 1. The protrusion of the cutting blade 6
The operation is performed until the handle 4 provided on the cutter holder 2 comes into contact with the base end surface of the cylindrical outer body 1.

When the handle 8 provided on the frame holder 3 is further pushed in the direction of arrow A, the flexible thin frame 13 and the flexible thin frame 14 provided on the frame holder 3 are further pushed out, and the flexible thin frame is pushed. 13 and the flexible thin plate frame 14 have a curved shape as shown by a solid line in FIG. That is, the flexible thin plate frame 13 takes a position bent in a direction away from the cutting blade, and the space 2 for holding the resected organ to be cut between the cutting blade and the blade portion of the cutting blade.
0 is formed.

Next, while looking at the endoscope, the organ, which has not been resected, is placed at a predetermined position in the space 20 formed between the flexible thin plate frame 13 and the blade of the cutting blade 6. Thereby, the cutting position of the organ after the resection is determined.

Once the cutting position of the organ is determined, the handle 4 provided on the cylindrical outer body 1 and the cutter holder 2 of the organ cutting device is held with the left hand, and the handle 8 provided on the frame holder 3 is held.
With the right hand and the handle 8 provided on the frame holder 3.
Is drawn in the direction of arrow B in FIG. In this case, by holding the handle 4 of the cutter holder 2 with the left hand, the cutting blade 6 is fixed at that position, and the flexible thin frame 13 and the flexible thin frame 14 provided on the frame holder 3
It is drawn into the inside of the cylindrical outer body 1, and at the same time, the support portion 9 pivotally attached to the tip of the cutting blade 6 also rotates in the direction of arrow C.

Thin frame 13 and flexible thin frame 1
4 is moved in a direction approaching the blade portion of the cutting blade 6 by the rotation of the support portion 9, and the end of the flexible thin plate frame 13 is cut by the opening of the guide member 17 through the opening through which the cutting blade 6 passes. 6
Is fixed to the lower portion of the mounting portion 18 of the frame holder 3 by riveting through an opening provided on the blade base side of the blade, so that the slit 12 of the flexible thin plate frame 13 passes through the blade portion of the cutting blade 6, The cutting blade 6 moves to a position behind the blade portion indicated by a dotted line in FIG. That is, the flexible thin plate frame 13 is moved to a position along the cutting blade 6. Thus, the organ held by the flexible thin plate frame 13 is pressed by the flexible thin plate frame 13 and cut off by the cutting blade 6. At this time, the thin plate frame 14
The thin plate frame 14 is also moved in the direction approaching the blade portion of the cutting blade 6, similarly to the thin plate frame 13, but the end of the thin plate frame 14 is provided on the cutting edge side of the cutting blade 6 from the opening of the guide member 17 through which the cutting blade 6 passes. Is fixed to the upper portion of the mounting portion 18 of the frame holder 3 by riveting through the opening, so that the thin plate frame 14 covers the blade portion of the cutting blade 6, whereby the blade portion of the cutting blade 6 is Will not damage.

In this way, the organs in the body that have been cut into small pieces are taken out of the body through the opening, and are used as specimens as needed.

When a malignant cancer cell or the like is contained in an organ after resection, a bag made of synthetic resin is used to prevent the malignant cancer cell body from adhering to other tissues and metastasizing. Put through the opening, house the organ that has been resected in this bag,
The organ contained in the bag is cut in the bag.

In the above-described embodiment, the cutting blade is disposed so as to be able to advance and retreat to the elongated cylindrical outer body. May be moved.

Further, if the flexible thin plate frame is not provided with a slit and the flexible thin frame is pressed against the blade portion of the cutting blade, the organ sandwiched between the flexible thin frame is pushed off by the cutting blade. be able to.

In the above embodiment, the organ cutting in the endoscopic operation has been described. However, it is needless to say that the present invention can be used in other surgical operations.

[0036]

As described above, according to the present invention, organs in the body that cannot be seen directly can be cut small by simple operation, and the cut small organs can be taken out of the body through the opening.

[Brief description of the drawings]

FIG. 1 is a side view showing a cross section of a part of an organ cutting apparatus according to the present invention.

FIG. 2 shows the use state of the organ cutting device according to the present invention,
(A) is a side view, (B) is a plan view.

FIGS. 3A and 3B are views showing a part of a support section in cross section, wherein FIG. 3A is a side view and FIG. 3B is a plan view.

FIG. 4 is a sectional view taken along the line IV-IV in FIG. 1;

FIG. 5 is a view showing a flexible thin plate frame having a slit.

FIG. 6 is a view showing a flexible thin plate frame without slits.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Slender cylindrical outer body 2 Cutter holder (1st operating body) 3 Frame holder (2nd operating body) 4 Handle 6 Cutting blade 9 Support part 12 Slit 13 Flexible thin plate frame (organ pinching means) 14 Flexible thin plate frame

Continued on the front page (72) Inventor Toshio Kishida 594-14, Kamihiroya, Tsurugashima-shi, Saitama (72) Inventor Hideaki Iwano 5-3-25 Koyama, Higashikurume-shi, Tokyo Bonnar Nishihara 102

Claims (10)

[Claims] 1. A cutting blade inserted into a human body through an opening provided in the human body, an organ holding means formed of a flexible material, one end of which is connected to a tip of the cutting blade, and the organ holding means. The cutting blade cuts the organ held between the cutting blade and the position bent in a direction away from the cutting blade so as to form a space for holding the organ to be cut between the cutting blade and the cutting blade. Operating means for operating between a position oriented along the cutting blade to perform the operation. 2. The organ cutting apparatus according to claim 1, wherein the organ holding means has a flexible thin plate frame. 3. The organ cutting apparatus according to claim 2, wherein the flexible thin plate frame has a slit through which the blade portion of the cutting blade passes. 4. The organ cutting apparatus according to claim 1, wherein a supporting portion is pivotally attached to a tip portion of the cutting blade, and one end of the organ holding means is fixed to the supporting portion. 5. The organ cutting apparatus according to claim 4, wherein the support is a sphere. 6. An elongated cylindrical outer body inserted into a human body through an opening provided in the human body, and a base end side slidably provided inside the cylindrical outer body and protruding from a base end of the cylindrical outer body. A first operating body which is provided inside the cylindrical outer body and slidably provided on the first operating body, and a second operating body whose base end projects outward from a base end of the first operating body; A cutting blade fixed to the distal end of the operating body so as to extend in the axial direction of the cylindrical outer body, a slit having a slit through which the blade of the cutting blade passes, one end connected to the distal end of the cutting blade, and the other end connected to the second end; A flexible thin plate frame connected to the operating body, and a space for holding an organ to be cut between the flexible thin plate frame and the cutting blade by sliding the second operating body forward; (2) an operating means for cutting an organ held by the flexible thin plate frame by a cutting blade by sliding the operating body backward. Apparatus. 7. The organ cutting apparatus according to claim 6, wherein a support portion is pivotally attached to a distal end portion of the cutting blade, and one end of a flexible thin plate frame is fixed to the support portion. 8. The organ cutting apparatus according to claim 7, wherein the support is a sphere. 9. A flexible thin plate frame having no slit is arranged in parallel on a flexible thin plate frame having a slit, one end of the flexible thin frame is connected to the tip of a cutting blade, and the other end is connected to a second end. The organ cutting device according to claim 6, wherein the organ cutting device is connected to an operating body. 10. A flexible thin plate frame having no slit,
One end is connected to a support pivotally attached to the cutting blade, and the other end is connected to the second
The organ cutting device according to claim 7, wherein the organ cutting device is connected to an operating body.