JPS6115852Y2 - - Google Patents

Description

[Detailed description of the invention] The present invention drastically improves the structure of conventional clip forceps, makes the tip of the shaft rotatable, and attaches the gripping piece rotatably, increasing the degree of freedom in clipping. The present invention also relates to aneurysm clipping forceps that simplify the clipping operation.

In general, when performing brain surgery, for example, a basilar aneurysm is clipped, and a special clip supported by forceps has been used as the clipping means. As conventional clip forceps for supporting this type of clip, for example, those shown in FIGS. 1 and 2 are known. In Fig. 1, reference numeral 1 denotes a clip forceps, the upper ends of which are a pair of curved spring members 3a, 3b connected at their lower ends, are connected in a crossed manner by a pin P, and the tip thereof becomes a gripping part 7 for gripping the clip. It is something that Reference numeral 9a denotes an engaging hook portion provided on the inner surface of one curved spring member 3a, which engages with an engaged hook portion 9b provided on the inner surface of the other curved spring member 3b, thereby causing the curved spring member 3a, 3b is placed in a clip gripping state. In short, by manually operating the curved spring members 3a and 3b, that is, by pressing or releasing the operating section, the gripping section 7 is remotely opened and closed, and operations such as opening/closing, grasping, and releasing the clip are performed. This is what we do. The clip forceps 1 shown in FIG. 2 has the same structure and function as those shown in FIG. 1, except that the curved spring members 3a and 3b are bent at the center.

In such conventional clip forceps, the tip gripping part 7 can only be opened and closed, but cannot rotate at all, so it is difficult to insert deeply into the affected area or diagonally. The degree of freedom in clipping is extremely small, many types of clips are required, and the clipping operation itself is difficult. Moreover, the engaging hook portion 9a and the engaged hook portion 9b are easily destroyed by repeated use, and since the curved spring members 3a and 3b are pressed by hand, a delicate force is exerted by the spring action. death,
It is unsuitable for delicate operations such as brain surgery, as extra force is applied when releasing the clip, and the center portions of the curved spring members 3a and 3b are held in the hands for operation. First, there are many disadvantages in that the central curved portions of the curved spring members 3a, 3b become a great hindrance during brain surgery using a microscope.

Furthermore, clip forceps in which a gripping piece is rotatably attached to the gripping part 7 are also known (Utility Model No. 56-
53406) still uses the curved spring members 3a and 3b, so although the degree of freedom in clipping is greater than in the illustrated clip forceps, it is still impossible to rotate the gripping part 7,
The drawbacks of the prior art as described above have not been completely overcome.

This invention was made with attention to the above points,
A handle portion consisting of a pair of handle members, a shaft portion connected to the handle portion and having a rotatable tip portion, and a pair of handle portions provided at the tip of the shaft portion and opened and closed by operating the handle portion. A shaft main body integrally formed with one handle member, comprising a gripping portion consisting of a gripping member, and a pair of U-shaped gripping pieces rotatably attached to opposing surfaces of the gripping member. the shaft portion, a shaft movable portion slidably provided on the shaft main body portion, and a shaft rotation portion rotatably screwed to the tip of the shaft movable portion,
A large diameter threaded portion is formed at the tip of the shaft main body, a through hole is bored in the axial direction of the large diameter threaded portion, and a rod that can be inserted into the through hole is provided at the tip of the shaft movable portion. a small diameter threaded portion is formed at the tip of the rod;
The shaft rotating portion has a semi-cylindrical rotating main body integrally formed with one of the gripping members, and a large diameter cylindrical screw portion threaded on the inner surface is provided at the base end of the rotating main body. The large-diameter threaded portion is screwed into the large-diameter cylindrical threaded portion, a rotary movable portion is slidably provided on the upper surface of the rotating main body, and a small-diameter screw is provided at the base end of the rotary movable portion. A cylindrical threaded portion is provided, the small diameter threaded portion is screwed into the small diameter cylindrical threaded portion, a thin locking plate portion is formed at the base end of the other gripping member, and the locking plate The gripping member is rotatably engaged with the distal end of the rotary main body through the section, and the distal end of the rotatable movable section is also engaged with the locking plate, and the shaft movable section is always held forward. By fixing the spring piece that biases the direction to the handle member,
Instead of using the conventional curved spring member, the gripping operation is maintained by a spring piece fixed to the handle member, which eliminates the inconvenience during surgery due to the curved spring member and makes it possible to perform extremely stable clip gripping operation. It can be suitably used during brain surgery, simplifies the clipping operation, and greatly expands the degree of freedom in clipping by rotating the tip of the shaft and rotating the gripping piece.Furthermore, there are fewer types of clips than in the past. An object of the present invention is to provide aneurysm clipping forceps that are suitable for brain surgery that requires precise work, which uses a screw mechanism for the rotation mechanism of the upper shaft rotation part, eliminates any accidental movement of the shaft rotation part.

An embodiment of the present invention is shown below in Figures 3 to 3 of the attached drawings.
This will be explained based on FIG.

In the figure, reference numeral 2 denotes an aneurysm clipping forceps according to the present invention, which includes a handle portion 4 provided at the proximal end, a shaft portion 6 connected to the handle portion 4, and a shaft portion 6 provided at the distal end of the shaft portion 6. It has a grip part 8. It serves as an operating section for remotely opening and closing the handle section 4 and the grip section 8, and is composed of a pair of handle members 4a and 4b each having a retaining ring 10 at the base end. The shaft portion 6 includes a shaft main body portion 6a integrally formed with one handle member 4a, a shaft movable portion 6b slidably provided on the shaft main body portion 6a, and the shaft main body portion 6.
a and a shaft rotating portion 6c rotatably screwed onto the tip of the shaft movable portion 6b.

At the tip of the other handle member 4b, a thin flat plate portion 12 is provided protruding from both sides with the same level difference. A small hole 14 is bored at the distal end of the flat plate part 12, and screw-like locking protrusions 16 are protruded from the top and bottom surfaces at the base end. The locking protrusion on the lower side (not shown) has a height flush with the surface of the handle member 4b, but the locking protrusion 1 on the upper side shown in the figure
6 protrudes to a position higher than the surface of the handle member 4b, and a wide head 16a is provided at its upper end.

Reference numeral 18 denotes a receiving step portion formed on the upper surface of the base end portion of the shaft main body portion 6a, and is engaged with a locking step portion 20 formed on the base end portion of the shaft movable portion 6b. 22
is a small hole bored in the locking step portion 20.

Reference numeral 24 denotes a receiving groove formed at the lower part of the base end of the shaft main body 6a, which is connected to the locking protrusion 16 of the handle member 4b.
is accepted.

Reference numeral 26 denotes a flat hole penetrated through the center in the thickness direction of the connecting portion between the shaft main body portion 6a and the handle member 4a, and 28 corresponds to the flat hole 26 and is inserted into the locking step portion 20 of the shaft movable portion 6b. This is a flat groove portion that opens downward.

Reference numeral 30 denotes an elastic, substantially square-shaped fastening member, with a locking pin 32 protruding from one end that penetrates into the small holes 14 and 22, and a central bent portion that locks into the locking protrusion 16. A locking groove 34 is formed therein, and a locking piece 36 that locks onto the inner surface of the shaft 5b of the handle member 4b projects from the other end.

To attach the handle member 4b, the flat plate portion 12
is inserted into the flat hole 26 and the flat groove portion 28, the small holes 14 and 22 are aligned, the locking pin 32 is inserted, the locking protrusion 16 locks the locking groove 34, and finally the locking piece 36 may be locked to the inner surface of the shaft 5b of the handle member 4b. The handle member 4b has a locking protrusion 16
If the handle member 4b is rotated using the fulcrum as a fulcrum and the handle member 4b is moved in the opening direction (solid arrow) as shown by the solid line and broken line arrow in FIG. If it moves in the closing direction (broken line arrow), the shaft movable part 6b will move forward.

Reference numeral 38 denotes a spring piece that always biases the shaft movable portion 6b in the forward direction, and the spring piece 38 is fixed with a screw 40 to the outer surface of the shaft 5a of the handle member 4a so that its tip comes into contact with the base end of the shaft movable portion 6b. There is.

A large-diameter threaded portion 42 is formed at the tip of the main shaft portion 6a, and a ring 44 is screwed onto the large-diameter threaded portion 42. A through hole 46 is bored in the axial direction of the large diameter threaded portion 42 . Reference numeral 46a denotes an insertion groove that is bored in the upper surface of the shaft main body portion 6a and communicates with the through hole 46. A rod 48 that can be inserted into the through hole 46 is protruded from the tip of the shaft movable portion 6b, and the tip of the rod 48 is threaded to form a small diameter threaded portion 50.

Reference numeral 52 designates a semi-cylindrical rotating main body constituting the shaft rotating section 6c, which is integrally formed with one gripping member 8a of the gripping section 8. Reference numeral 54 denotes a large-diameter cylindrical threaded portion formed at the base end of the rotating main body portion 52 and threaded on the inner surface, into which the large-diameter threaded portion 42 can be screwed. 56 is the rotating main body portion 42
It is a rotary movable part that is slidably provided on the upper surface, and the base end thereof is internally threaded, and the small diameter threaded part 50
A small-diameter cylindrical screw portion 58 into which the screw can be screwed is provided. Reference numeral 60 denotes a thin locking plate portion formed at the base end of the other gripping member 8b, through which the gripping member 8b is rotatably engaged with the distal end portion of the rotating main body portion 52. It is worn. Moreover, the rotary movable part 56
The distal end portion of the locking plate 60 is also locked to the locking plate portion 60. By configuring in this way, FIGS. 3 and 5
As shown by the solid line and broken line arrows in the figure, when the rotary movable part 56 is pulled rearward, the gripping member 8b moves upward and the gripping part 8 is released (solid line arrow), and the rotary movable part 56 is moved forward. When pressed, the gripping member 8b moves downward and the gripping portion 8 is closed (indicated by a broken line arrow).

The shaft rotating part 6c has a rod 48 inserted into the through hole 46, and a small diameter cylindrical threaded part 58 and a large diameter cylindrical threaded part 5 in the small diameter threaded part 50 and the large diameter threaded part 42 that protrude.
4 are connected to the shaft main body portion 6a and the shaft movable portion 6b by simultaneously screwing in the shaft rotating portion 6c, so that the shaft rotating portion 6c can be freely rotated by the screw mechanism. Therefore, although the shaft rotating portion 6c will rotate when turned by hand, it will not rotate unexpectedly unless force is applied.

Reference numerals 62a and 62b are U-shaped gripping pieces provided oppositely to each other at the tips of the gripping members 8a and 8b.
The protruding pins protruding from the gripping members 8a and 8b are inserted into and protruded from the insertion holes at the tips of the gripping members 8a and 8b, and are rotatably attached by caulking 66 on the outer surfaces of the protruding pins. The degree of rotation of the gripping pieces 62a and 62b can be adjusted by rotating them by hand, but it is important to adjust the degree of rotation so that they do not rotate accidentally unless force is applied, in order to prevent the gripped clip 67 from accidentally moving. It is. As a means for rotationally attaching the gripping pieces 62a, 62b, it is of course possible to employ known means such as screwing in addition to caulking means.

The clip 67 is for clipping basilar aneurysm A, etc., and is also called a mini clip, and has a pair of clip legs 68, 68;
An annular spring portion 70 for opening and closing is integrally formed by bending and forming a single elongated member. Reference numeral 72 designates a mini-ring loosely fitted to the intersection 74 connecting the clip legs 68, 68 and the annular spring 70. The clip legs 68, 68 are always urged to close by the spring action of the annular spring portion 70, but are opened when the annular spring portion 70 is pressed and clamped from both sides.

With the above configuration, as shown in FIG. 3, when the handle member 4b is pushed open in the direction of the solid line arrow, the shaft movable portion 6b and the rotary movable portion 56 are pulled rearward.
The gripping member 8b moves upward and the gripping portion 8 is opened. In this open state, the annular spring portion 7 of the clip 67
0 is positioned between the gripping pieces 62a, 62b and the handle member 4b is pulled in the closing direction, the shaft movable part 6b and the rotary movable part 56 move forward as shown by the broken line arrow, and the gripping member 8b moves downward to form an annular shape. Spring part 7
0 is pressed and clamped between the gripping pieces 62a and 62b, and is gripped by the clip forceps 2 with the clip legs 68 and 68 open (FIGS. 8 to 10). As shown in FIG. 11, this clip 67 in the open state is inserted into the affected area in order to clip the basilar aneurysm A, and the handle member 4b is opened again (solid arrow) to release the gripping part 8. Clip 67
are separated, and the clip legs 68, 68 are automatically closed by spring action to clip the basilar aneurysm A. Further, to release the clipping, the clip forceps 2 may be operated in the same manner to grasp and remove the clip 67 from the affected area. Clip 6
7 and attachment/detachment to the affected area are performed by remotely opening/closing the grip part 8 by operating the handle part 4, and the moving parts are the handle member 4b, the shaft movable part 6b, the rotating movable part 56, and the grip member 8b. Since the other parts do not move, the clip 66 can be operated in an extremely stable state, and can be suitably used when precise operation is required in a narrow space, such as during brain surgery. It is something. In addition, since the shaft rotating portion 6c can be rotated to any angle, it is easy to insert the clip in an oblique direction, and the gripping angle of the clip can also be changed freely by rotating the gripping pieces 62a and 62b (Figs. 8 to 10). figure). Furthermore, since the shaft rotating portion 6c and the gripped clip 67 can be rotated while the handle portion 4 is held in a fixed position, clipping in any direction is possible. In addition, since the handle portion 4 located below the linear shaft portion 6 can be used to open and close the grip portion 8, that is, perform clipping operations, the forceps 2 can be used in the field of view during brain surgery using a microscope. It has the advantage of not getting in the way.

As described above, the present invention includes a handle portion consisting of a pair of handle members, a shaft portion connected to the handle portion and having a rotatable tip portion, and a shaft portion provided at the tip of the shaft portion and having a rotatable tip portion. A gripping portion consisting of a pair of gripping members that can be opened and closed by operation, and a pair of U-shaped gripping pieces rotatably attached to opposing surfaces of the gripping members, one of which is a handle member; The shaft is comprised of an integrally formed shaft main body, a shaft movable part slidably provided on the shaft main body, and a shaft rotation part rotatably screwed onto the tip of the shaft movable part. A large diameter threaded portion is formed at the tip of the shaft main body, a through hole is bored in the axial direction of the large diameter threaded portion, and a through hole is formed at the tip of the shaft movable portion. A rod that can be inserted is provided protrudingly, a small diameter threaded portion is formed at the tip of the rod, and the shaft rotating portion has a semi-cylindrical rotating main body integrally formed with one of the gripping members. A large-diameter cylindrical threaded portion with a thread cut on the inner surface is formed at the base end of the rotating main body, and the large-diameter threaded portion is screwed into the large-diameter cylindrical threaded portion. A rotary movable part is slidably provided on the upper surface, a small diameter cylindrical threaded part is provided at the base end of the rotary movable part, and the small diameter threaded part is screwed into the small diameter cylindrical threaded part, A thin locking plate is formed at the base end of the other gripping member, and the gripping member is rotatably locked to the distal end of the rotating main body via the locking plate, and the rotation The distal end of the movable part is also engaged with the locking plate part, and the aneurysm clipping forceps have a spring piece fixed to the handle member that constantly biases the shaft movable part in the forward direction. Instead of using a curved spring member, the gripping action is maintained by a spring piece fixed to the handle member, which eliminates the inconvenience during surgery due to the curved spring member and makes it possible to perform an extremely stable clip gripping action. It can be used conveniently during surgery, and the clipping operation is simple.
In addition, the degree of freedom in clipping by rotating the tip of the shaft and the rotation of the gripping piece has been greatly expanded, and there are fewer types of clips than in the past. The purpose of the present invention is to provide aneurysm clipping forceps that are suitable for brain surgery that requires precise work and has no random movement of the rotating part.

[Brief explanation of the drawing]

1 and 2 are perspective views of conventional clip forceps, FIGS. 3 to 11 show an embodiment of the present invention, FIG. 3 is an overall side view, and FIG. 4 is a main feature of FIG. Fig. 5 is an exploded side view, Fig. 6 is a top view of the shaft main body, Fig. 7 is a bottom view of the shaft movable part, and Fig. 8 is an exploded side view.
10 to 10 are perspective explanatory views showing the state in which the clip is gripped and rotated, and FIG. 11 is a perspective view showing the state in which the clip forceps are used. 2: Clip forceps, 4: Handle portion, 6: Shaft portion, 8: Gripping portion, 8a, 8b: Grasping member, 62
a, 62b: gripping piece, 67: clip.

Claims (1)

[Scope of utility model registration request] A handle portion consisting of a pair of handle members, a shaft portion connected to the handle portion and having a rotatable tip portion, and a pair of handle portions provided at the tip of the shaft portion and opened and closed by operating the handle portion. A shaft main body integrally formed with one handle member, comprising a gripping portion consisting of a gripping member, and a pair of U-shaped gripping pieces rotatably attached to opposing surfaces of the gripping member. , a shaft movable part slidably provided on the shaft main body, and a shaft rotation part rotatably screwed onto the tip of the shaft movable part, and the shaft main body A large diameter threaded part is formed at the tip of the part, a through hole is bored in the axial direction of the large diameter threaded part, and a rod that can be inserted into the through hole is bored at the tip of the shaft movable part. , a small-diameter threaded portion is formed at the tip of the rod, and the shaft rotating portion has a semi-cylindrical rotating main body formed integrally with one gripping member, and the base of the rotating main body is formed integrally with one gripping member. A large diameter cylindrical threaded part with a thread cut on the inner surface is formed at the end, the large diameter threaded part is screwed into the large diameter cylindrical threaded part, and the rotary movable part is slid on the upper surface of the rotating main body. A small diameter cylindrical threaded portion is provided at the base end of the rotationally movable portion, the small diameter threaded portion is screwed into the small diameter cylindrical threaded portion, and the other grip member is provided with a small diameter threaded portion at the base end thereof. A thin locking plate portion is formed in the locking plate portion, and the gripping member is rotatably locked to the tip of the rotating main body portion via the locking plate portion, and the tip of the rotary movable portion is fixed to the tip of the rotating main body portion through the locking plate portion. 1. Aneurysm clipping forceps, characterized in that a spring piece is fixed to a handle member, the spring piece being fixed to the stop plate part and further urging the shaft movable part forward at all times.