TWI778570B - Surgical instrument - Google Patents

Abstract

The present invention discloses a surgical instrument comprising a first holding member, a sleeve member, a linkage member, a second holding member, a hook member and an opening/closing member. The second holding member is pivotally connected to the first holding member, and the linkage member is moved within the sleeve member to drive the opening/closing member moving relative to the hook member when the second holding member moves relative to the first holding member. The surgical instrument of the present disclosure can push surrounding soft tissues, blood vessels or nerves that have strayed into the hook member out of the hook member by the movement of the opening/closing member to avoid increasing a risk in damaging the surrounding soft tissues, blood vessels or nerves by the hook member during surgery.

Description

Surgical Instruments

The present disclosure relates to a surgical instrument, especially a surgical instrument used for minimally invasive tendon repair surgery.

With the advancement of science and technology, minimally invasive surgery has become the current trend of clinical medicine. It can effectively reduce the harm to the patient, and has the advantages of small wound, short recovery period, quick recovery, less muscle or nerve damage, low anesthesia risk, and short operation time. , low infection rate and other advantages.

In order to take advantage of the above-mentioned advantages, physicians have higher and higher requirements for surgical instruments used in minimally invasive surgery, and thus various surgical instruments have been developed, such as the suture holding device disclosed in Taiwan Patent No. M471856. , the suturing and clamping device disclosed in US Patent Application No. 20180116652, and the suture threader disclosed in Chinese Patent Application No. 106456155, etc., which can be used by physicians to easily clamp sutures for puncturing and suturing operations.

However, when the above-mentioned surgical instruments of the prior art are used in the minimally invasive surgery guided by ultrasound, such as the minimally invasive tendon repair surgery of the Achilles tendon, the movable mechanism to prevent the suture from falling off after the suture is pulled is still possible. The surrounding soft tissue, blood vessels or nerves are injured during operation. For example, in the suture clamping device disclosed in Taiwan New Patent No. M471856, when the first clamping part and the second clamping part are in a closed state, it may be pinched. Inadvertently enter the surrounding soft tissue, blood vessels or nerves of the suture holder during operation; and For example, in the suturing and clamping device disclosed in US Patent Application No. 20180116652, the two thread arms used to clamp the suture may also clamp the surrounding soft tissue, blood vessels or nerves when clamping the suture; For example, in the suture passer disclosed in Chinese Patent Application No. 106456155, when the suture coil sleeve is retracted, the hook end may also hook into the surrounding soft tissue, blood vessels or nerves.

Therefore, how to provide a surgical instrument that can solve the above problems is one of the problems to be solved urgently.

In order to solve the aforementioned problems, the present disclosure provides a surgical instrument, comprising: a first holding member; a sleeve member, one end of which is coupled to the first holding member; Two ends, wherein the first end is located in the first holding member; the second holding member is pivotally connected with the first holding member and coupled to the first end of the linking member, so as to be connected to the first holding member. When the two gripping members move relative to the first gripping member, the linkage member is moved in the sleeve member; the hook-shaped member includes an extension part and a bending part, and one end of the extension part is coupled to the sleeve part. At the other end, the bending portion extends and bends from the other end of the extending portion, wherein an opening is defined between the one end of the extending portion coupled to the sleeve member and the free end of the bending portion; and an opening and closing member , one end of which is pivotally connected to the extending portion and is connected to the second end of the linking member, so that when the linking member moves, the other end of the opening and closing member moves between the extending portion and the opening.

In at least one embodiment of the aforementioned surgical instrument, when the second holding member moves away from the first holding member, the opening and closing member moves toward the extension portion.

In at least one embodiment of the aforementioned surgical instrument, the extension portion further includes an accommodating space recessed in the extension portion for accommodating the opening and closing member.

In at least one embodiment of the aforementioned surgical instrument, when the second holding member moves in the direction of the first holding member, the opening and closing member moves toward the opening.

In at least one embodiment of the aforementioned surgical instrument, the opening and closing member moves toward the opening until one end of the opening and closing member abuts against the free end of the bending portion.

In at least one embodiment of the aforementioned surgical instrument, the opening and closing member includes an opening and closing portion and a pivot portion, the pivot portion is pivotally connected to the hook member, and the opening and closing portion is connected from the pivot portion along a tangent thereof. The direction extends and has a length that can abut the free end of the bent portion.

In at least one embodiment of the aforementioned surgical instrument, the linking member is pivotally connected at a position deviating from the position where the pivoting portion is pivotally connected to the hook-shaped member, so that when the linking member moves, the opening and closing portion is The rotation angle relative to the hook is in the range of 0 degrees to 40 degrees.

In at least one embodiment of the aforementioned surgical instrument, a connecting member is further included between the linking member and the pivoting portion, and two ends of the connecting member are pivotally connected to the linking member and pivotally connected to the pivoting portion away from the pivoting portion, respectively. the position of the hook-shaped piece, so that the linking piece is maintained parallel to the axial direction of the sleeve piece.

According to at least one embodiment of the foregoing surgical instrument, the first holding member includes a first buckle portion having a first tooth portion, the second holding member includes a second buckle portion having a second tooth portion, and wherein , when the second holding member moves toward the direction of the first holding member, the second tooth portion of the second buckle portion can be relatively fastened to the first tooth portion of the first buckle portion.

In at least one embodiment of the aforementioned surgical instrument, the included angle between the hook member and the sleeve member is in the range of 135 degrees to 225 degrees.

In at least one embodiment of the aforementioned surgical instrument, the included angle between the sleeve member and the first holding member is in the range of 135 degrees to 225 degrees.

In at least one embodiment of the aforementioned surgical instrument, the first holding member and the second holding member are made of medical plastic, the sleeve member is made of medical plastic or medical stainless steel, and the hook-shaped member is made of medical plastic. And the material of the opening and closing piece is medical stainless steel, and the material of the connecting piece is medical stainless steel.

In at least one embodiment of the aforementioned surgical instrument, the linking member is a long rod, a wire or a spring.

With the surgical instrument of the present disclosure, when the first holding member and the second holding member move relative to each other, the opening and closing member can move between the extension portion and the opening, so that the opening and closing member can be used after the hook-shaped member hooks the suture. When the opening and closing parts close the opening, not only the sutures will not fall off, but also the surrounding soft tissue, blood vessels or nerves that have accidentally entered the opening will be pushed out of the opening when the opening and closing parts close the opening. Therefore, the surgical instrument of the present disclosure does not have the problem of damaging surrounding soft tissues, blood vessels or nerves in the prior art, and has the advantages of short postoperative recovery time, low infection rate, small wound, short operation time, and short time for doctors to learn and other effects.

1: Surgical instruments

11: The first grip

12: Second grip

13: casing parts

14: Linkage

141: First End

142: Second End

15: Hooks

151: Extensions

152: Bending part

1522: Free End

153: accommodating space

154: Opening

16: Opening and closing pieces

161: Opening and closing department

162:Pivot part

17: Connectors

18: The first buckle

181: First tooth

19: The second buckle

191: Second tooth

θ: angle

θ 1, θ 2: included angle

FIG. 1A is an overall schematic diagram of the disclosed surgical instrument in a first operating state.

FIG. 1B is a schematic cross-sectional view of FIG. 1A .

FIG. 2A is an overall schematic diagram of the disclosed surgical instrument in a second operating state.

FIG. 2B is a schematic cross-sectional view of FIG. 2A .

FIG. 3 is a schematic diagram of another embodiment of the first holding member and the second holding member of the disclosed surgical instrument.

4A and 4B are schematic views of other embodiments of the hook-shaped portion of the disclosed surgical instrument.

5A and 5B are schematic views of other embodiments of the sleeve member in the disclosed surgical instrument.

FIG. 6 is a schematic view of the operation of the opening and closing elements of the disclosed surgical instrument.

FIG. 7 is an overall schematic view of another embodiment of the disclosed surgical instrument.

The following specific embodiments are used to illustrate the implementation of the present disclosure, and those skilled in the art can easily understand other advantages and effects of the present disclosure from the content disclosed in this specification, and can also use other different specific embodiments. be implemented or applied.

The surgical instruments of the present disclosure can be used in minimally invasive surgery, especially tendon repair surgery, such as Achilles tendon, rotator cuff, quadriceps, etc. Not limited to this. In addition, the surgical instrument of the present disclosure can be matched with imaging equipment such as ultrasound, endoscope, etc., but is not limited to this, so as to assist the physician in accurately locating the wound.

Please refer to FIG. 1A and FIG. 1B at the same time, which show an overall schematic diagram and a cross-sectional schematic diagram of the surgical instrument 1 of the present disclosure when it is in a first operating state. The surgical instrument 1 of the present disclosure includes a first holding member 11 , a second holding member 12 , a sleeve member 13 , a linking member 14 , a hook member 15 and an opening and closing member 16 . One end of the sleeve member 13 is coupled to the first holding member 11 . The linking member 14 is disposed in the sleeve member 13 and has a first end 141 and a second end 142 , wherein the first end 141 is located in the first holding member 11 .

In at least one embodiment of the present disclosure, the sleeve member 13 can be a hollow tubular body, and the linkage member 14 can be a long rod accommodated in the tubular body of the sleeve member 13 . In some embodiments, the linking member 14 may be a flexible or rigid wire, and may also be a flexible or rigid spring, but the present disclosure is not limited thereto.

In at least one embodiment of the present disclosure, the second holding member 12 is pivotally connected in the first holding member 11 and coupled to the first end 141 of the connecting member 14, so that the second holding member 12 is relative to the first holding member 11. When the first holding member 11 moves, the linking member 14 can be moved back and forth in the sleeve member 13 by the driving of the second holding member 12 .

As shown in FIG. 1B , the hook member 15 includes an extension portion 151 , a bent portion 152 and an accommodating space 153 , and an end of the extension portion 151 is coupled to an end of the sleeve member 13 away from the first holding member 11 . Bending part 152 extends from the other end of the extension portion 151 to the free end 1522, and is bent inward toward the axis extending in the length direction of the linking member 14 (for example, the free end 1522 of the bending portion 152 may face the end of the first holding member 11). The end of the surgical instrument 1 away from the first holding member 11 and the second holding member 12 is blunt as a whole, so as to avoid the possibility of pushing the surgical instrument 1 between tissues during the operation. Puncture damage inflicted.

In at least one embodiment of the present disclosure, an opening 154 is defined between one end of the extending portion 151 coupled to the sleeve member 13 and the free end 1522 of the bending portion 152 , as shown in FIGS. 2A and 2B .

In at least one embodiment of the present disclosure, one end of the opening and closing member 16 is pivotally connected to the extending portion 151 and the second end 142 of the connecting member 14 . Please refer to FIG. 2A and FIG. 2B together, which show an overall schematic diagram and a cross-sectional schematic diagram of the surgical instrument 1 of the present disclosure in the second operating state. In FIGS. 1A and 1B , one end of the opening and closing member 16 abuts against the free end 1522 of the bending portion 152 . When the second holding member 12 moves away from the first holding member 11 , as shown in FIG. 2A and FIG. 2B , the opening and closing member 16 will move toward the extending portion 151 . In this state, if the second holding member 12 moves in the direction of the first holding member 11, the opening and closing member 16 will move toward the opening 154, as shown in FIG. 1A and FIG. 1B .

In at least one embodiment of the present disclosure, when the opening and closing member 16 moves toward the extending portion 151 , the opening and closing member 16 can be moved into the accommodating space 153 in the extending portion 151 to accommodate the opening and closing member 16 . When the opening and closing member 16 moves toward the opening 154 , the opening and closing member 16 can move to abut against the free end 1522 of the bending portion 152 until the opening 154 is in a closed state. In addition, the movement of the opening and closing member 16 is achieved through the movement of the linking member 14 . In other words, through the movement of the second holding member 12 relative to the first holding member 11 , the linking member 14 is linked to drive the opening and closing member 16 to move between the extension portion 151 and the opening 154 .

In at least one embodiment of the present disclosure, please refer to FIG. 6 at the same time, the opening and closing member 16 may include an opening and closing portion 161 and a pivoting portion 162, the pivoting portion 162 is pivotally connected to the hook member 15, and the opening and closing portion 161 is automatically The pivoting portion 162 extends along its tangential direction, and has a length to abut against the free end 1522 of the bent portion 152, so that the pivoting When the portion 162 rotates relative to the hook member 15 , the opening and closing member 16 can move between the accommodating space 153 and the opening 154 until it abuts the inner side of the free end 1522 of the bent portion 152 .

In order to achieve the purpose of rotating the pivot portion 162 relative to the hook member 15 , the link member 14 can be pivoted at a position offset from the position where the pivot portion 162 is pivoted to the hook member 15 . Specifically, the pivoting portion 162 may have an approximate circular shape, the opening and closing portion 161 may extend along the tangential direction at one end of the circular diameter, and the pivotal position of the linking member 14 may be set at a different diameter than the circular diameter. The position of the other end where the opening and closing portion 161 extends, but the present disclosure is not limited thereto.

In at least one embodiment of the present disclosure, the movement of the link member 14 can be controlled by pivoting the link member 14 to the position of the hook member 15 , and the opening and closing portion 161 has a certain range of rotation angle relative to the hook member 15 . , in the present disclosure, the rotation angle θ can be in the range of 0 degrees to 40 degrees, such as 0 degrees to 35 degrees, 0 degrees to 32 degrees, 0 degrees to 30 degrees, 0 degrees to 27 degrees, or 0 degrees to 25 degrees within the scope of this disclosure, but this disclosure is not limited thereto.

In some embodiments of the present disclosure, as shown in FIG. 2B and FIG. 6 , a connecting member 17 may be further included between the linking member 14 and the pivoting portion 162 , and two ends of the connecting member 17 are pivotally connected to the linking member 14 and at The position where the offset pivot portion 162 is pivoted to the hook member 15 . The connecting member 17 is mainly used to provide a buffer, so that the linking member 14 can be maintained in the axial direction parallel to the length of the sleeve member 13, without causing the end of the linking member 14 to be bent or deformed in order to be pivoted on the pivot portion 162, In turn, the movement of the linkage member 14 in the sleeve member 13 is hindered.

In at least one embodiment of the present disclosure, please refer to FIG. 3 , the first holding member 11 includes a first buckle portion 18 , the second holding member 12 includes a second buckle portion 19 , and the first buckle portion 18 is provided with a The first tooth portion 181 is provided with a second tooth portion 191 on the second buckle portion 19 . When the second holding member 12 moves in the direction of the first holding member 11 , the second holding member 12 and the first holding member can be fixed by the second tooth portion 191 and the first tooth portion 181 being fastened. 11 relative position.

In some embodiments of the present disclosure, as shown in FIG. 4A and FIG. 4B , the included angle between the hook member 15 and the sleeve member 13 may not be limited to 180 degrees, for example, the included angle θ1 may be 135 degrees, 140 degrees, 145 degrees, 150 degrees, 155 degrees, 160 degrees, 165 degrees, 170 degrees or 175 degrees, or the included angle θ2 can be 185 degrees, 190 degrees, 195 degrees, 200 degrees, 205 degrees, 210 degrees, 215 degrees, 220 degrees or 225 degrees Spend. In addition, as shown in FIG. 5A and FIG. 5B , the included angle between the sleeve member 13 and the first holding member 11 may not be limited to 180 degrees, for example, the included angle θ 1 may be 135 degrees, 140 degrees, 145 degrees, 150 degrees, 155 degrees degrees, 160 degrees, 165 degrees, 170 degrees or 175 degrees, or the included angle θ 2 can be 185 degrees, 190 degrees, 195 degrees, 200 degrees, 205 degrees, 210 degrees, 215 degrees, 220 degrees or 225 degrees. It should be noted that the angles in the present disclosure are not limited to the above, such as the included angles θ1 and θ2 between the hook member 15 and the sleeve member 13 and the included angles between the sleeve member 13 and the first holding member 11 θ 1 and θ 2 have different designs depending on the actual operation site.

In at least one embodiment of the present disclosure, the material of the first holding member 11 and the second holding member 12 can be medical plastic, the material of the sleeve member can be medical plastic or medical stainless steel, and the first holding member 11 and the second holding member 12 can be made of medical plastic. The part 11 or the second holding part 12 can be two mutually combined shells (for example, they can be combined together by screws made of medical steel) and equipped with a ring-shaped ring structure for fingers to hold, or as shown in the figure. As shown in FIG. 1A to FIG. 2B , the shape of a scissors handle pivoted only at one end is shown, but the present disclosure is not limited to this.

In at least one embodiment of the present disclosure, the material of the hook member 15 and the opening and closing member 16 may be medical stainless steel, and the linking member 14 may also be medical stainless steel, but the present disclosure is not limited thereto.

Please refer to FIG. 7 , which is an overall schematic diagram of another embodiment of the disclosed surgical instrument. The difference between this embodiment and the previous embodiment lies in the design of the first holding member 11 and the second holding member 12 . The following only The differences are described, and the same technical content will not be repeated here.

In this embodiment, the lengths of the first holding member 11 and the second holding member 12 may be longer than the lengths of the first holding member 11 and the second holding member 12 in FIG. 1A , so as to be ergonomic, Easier to operate do. In addition, the ring-shaped annular structure for holding fingers in the first holding member 11 and the second holding member 12 may specifically be an oval shape, which is different from the circular shape presented by the ring-shaped annular structure in FIG. 1A , but the present disclosure Not limited to this.

With the surgical instrument of the present disclosure, when the first holding member and the second holding member are relatively moved, the opening and closing member can move between the extension portion and the opening, so that the opening and closing member can be used after the hook-shaped member hooks the suture. piece to close the opening. When the surgical instrument of the present disclosure is matched with an ultrasonic imaging device, since the ultrasonic image cannot clearly identify the tissue, the surgical instrument of the present disclosure can not only prevent the sutures from falling off during the operation, but also can When the closing piece closes the opening, the surrounding soft tissue, blood vessels or nerves that have accidentally entered the opening will be pushed out of the opening. Therefore, the surgical instrument of the present disclosure does not have the problem of damaging surrounding soft tissues, blood vessels or nerves in the prior art, and has the advantages of short postoperative recovery time, low infection rate, small wound, short operation time, and short time for doctors to learn and other effects. The surgical instruments disclosed in this disclosure do not necessarily need to be equipped with ultrasonic imaging equipment. Even with an endoscope, etc., they can help doctors reduce accidental injury to the surrounding soft tissue, blood vessels, or nerves when the surrounding soft tissue, blood vessels, or nerves can be seen at the surgical site. nerve opportunity.

The above-mentioned embodiments are only illustrative of the technical principles, features and effects of the present disclosure, and are not intended to limit the scope of the present disclosure. Modifications and changes in form. However, any equivalent modifications and changes made by using the teaching content of the present disclosure should still be covered by the following patent application scope, and the protection scope of the present disclosure should be as listed in the following application patent scope.

1: Surgical instruments

11: The first grip

12: Second grip

13: casing parts

14: Linkage

141: First End

142: Second End

15: Hooks

151: Extensions

152: Bending part

1522: Free End

153: accommodating space

16: Opening and closing pieces

161: Opening and closing department

162:Pivot part

17: Connectors

Claims (13)

A surgical instrument, comprising: a first holding member; a sleeve member, one end of which is coupled to the first holding member; a linking member disposed in the sleeve member and having a first end and a second end, wherein the first The end is located in the first holding member; the second holding member is pivotally connected with the first holding member and coupled to the first end of the linking member, so that the second holding member is relative to the first holding member. When a holding member moves, the linkage member is moved in the sleeve member; the hook-shaped member includes an extension part and a bending part, one end of the extension part is coupled to the other end of the sleeve part, and the bending part is The other end of the extension portion extends and is bent inward toward the direction of the first holding member, wherein an opening is defined between the end of the extension portion coupled to the sleeve member and the free end of the bending portion; and One end of the opening and closing member is pivotally connected to the extending portion and connected to the second end of the linking member, so that when the linking member moves, the other end of the opening and closing member moves between the extending portion and the opening. The surgical instrument according to claim 1, wherein when the second holding member moves away from the first holding member, the opening and closing member moves toward the extension portion. The surgical instrument according to claim 2, wherein the extension part further comprises an accommodating space recessed in the extension part for accommodating the opening and closing member. The surgical instrument according to claim 1, wherein when the second holding member moves in the direction of the first holding member, the opening and closing member moves toward the opening. The surgical instrument of claim 4, wherein the opening and closing member moves toward the opening until one end of the opening and closing member abuts against the free end of the bending portion. The surgical instrument according to claim 1, wherein the opening and closing member comprises an opening and closing portion and a pivot portion, the pivot portion is pivotally connected to the hook member, and the opening and closing portion is connected from the pivot portion along a tangent thereof The direction extends and has a length that can abut the free end of the bent portion. The surgical instrument as claimed in claim 6, wherein the linking member is pivotally connected at a position deviating from the position where the pivoting portion is pivotally connected to the hook-shaped member, so that when the linking member moves, the opening and closing portion is The rotation angle relative to the hook is in the range of 0 degrees to 40 degrees. The surgical instrument according to claim 7, wherein a connecting member is further included between the linking member and the pivoting portion, and two ends of the connecting member are pivotally connected to the linking member and pivotally connected to the pivoting portion away from the pivoting portion, respectively. the position of the hook-shaped piece, so that the linking piece is maintained parallel to the axial direction of the sleeve piece. The surgical instrument of claim 1, wherein the first holding member includes a first buckle portion having a first tooth portion, the second holding member includes a second buckle portion having a second tooth portion, and wherein , when the second holding member moves toward the direction of the first holding member, the second tooth portion of the second buckle portion can be relatively fastened to the first tooth portion of the first buckle portion. The surgical instrument according to claim 1, wherein the included angle between the hook member and the sleeve member is in the range of 135 degrees to 225 degrees. The surgical instrument of claim 1, wherein the included angle between the sleeve member and the first holding member is in the range of 135 degrees to 225 degrees. The surgical instrument according to claim 1, wherein the material of the first holding member and the second holding member is medical plastic, the material of the sleeve member is medical plastic or medical stainless steel, and the hook-shaped member is made of medical plastic. And the material of the opening and closing piece is medical stainless steel, and the material of the connecting piece is medical stainless steel. The surgical instrument according to claim 1, wherein the linking member is a long rod, a wire or a spring.

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