WO1995029634A1 - Dispositif medical de palpation - Google Patents

Dispositif medical de palpation Download PDF

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Publication number
WO1995029634A1
WO1995029634A1 PCT/JP1995/000839 JP9500839W WO9529634A1 WO 1995029634 A1 WO1995029634 A1 WO 1995029634A1 JP 9500839 W JP9500839 W JP 9500839W WO 9529634 A1 WO9529634 A1 WO 9529634A1
Authority
WO
WIPO (PCT)
Prior art keywords
finger
sack
extension
palpation
recess
Prior art date
Application number
PCT/JP1995/000839
Other languages
English (en)
Japanese (ja)
Inventor
Hiroaki Nomori
Original Assignee
Hiroaki Nomori
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Hiroaki Nomori filed Critical Hiroaki Nomori
Priority to AU23527/95A priority Critical patent/AU2352795A/en
Publication of WO1995029634A1 publication Critical patent/WO1995029634A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B42/00—Surgical gloves; Finger-stalls specially adapted for surgery; Devices for handling or treatment thereof
    • A61B42/20—Finger-stalls specially adapted for surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A61B2017/00438—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping connectable to a finger
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3962—Markers, e.g. radio-opaque or breast lesions markers palpable

Definitions

  • the present invention relates to a medical instrument for palpation used for an operation under an endoscope, an operation in a narrow operation area, and the like, and more specifically, extends in a direction substantially extending a finger or a direction substantially parallel to a direction in which the finger is extended.
  • the present invention relates to a medical instrument for palpation having an extension.
  • Endoscopic surgery has advantages such as smaller surgical wounds and less burden on patients than ordinary open surgery.
  • the surgical site is visually recognized using, for example, a two-dimensional television screen having no perspective, and various forceps are used by using long forceps having a grip that can be grasped by hand. Was being treated.
  • this forceps can grasp an affected part or the like at the distal end, there is little sense of unity between the operator's hand or finger and the distal end of the forceps. For this reason, this forceps has a problem that operation requires skill.
  • an object of the present invention is to provide a surgical instrument which comes into contact with a sensitive part of an operator's finger, that is, a tip of an index finger, and has a great sense of unity with the operator's finger. Furthermore, an object of the present invention is to provide a surgical instrument capable of appropriately sensing the properties of the affected part such as hardness.
  • an object of the present invention is to provide a surgical instrument capable of performing various operations reliably by using various members provided at the distal end portion. Further, it is an object of the present invention to provide a surgical instrument which enables a surgical operation even in a narrow and deep surgical site.
  • a sack portion having a recess conforming to the outer shape of the finger, and an extension extending substantially in the direction of extension of the finger accommodated in the sac portion or in a direction substantially parallel to the extension direction of the finger, and connected to the sac portion.
  • a dent in the sack portion having a contact surface with which a tip of an index finger contacts.
  • the medical instrument for palpation of the present invention is a material which is soft enough to be partially or entirely deformed by pressing with a finger, that is, a soft material, or a material which is not easily deformed by pressing with a finger. It can be formed of a hard material, that is, a hard material.
  • the extension preferably has a length of 2 to 30 cm, particularly preferably 5 to 20 cm, and a thickness of 3 to 20 mm, preferably 8 to 20 cm. A value of 16 mm is particularly preferred.
  • a medical instrument for palpation 1 has a sack portion 2 having a recess conforming to the outer shape of the index finger, and an extension portion 4 connected to the sack portion 2.
  • the recess of the sack portion 2 has a concave contact surface 3 with which the tip of the index finger contacts.
  • the extension part 4 extends in the extension direction of the finger accommodated in the sack part 2 and has a tip part 6 for touching the affected part.
  • the sack portion 2 and the extension portion 4 are integrally formed of a hard material such as a hard plastic, a metal, or the like. It can also be formed of soft materials such as soft plastics such as vinyl chloride, natural rubber, and synthetic rubber.
  • the sack 2 covers the tip of the finger, extends beyond the first joint of the finger, and extends between the first and second joints. Accordingly, the finger is firmly fixed to the sack portion 2 by bending the finger at the first joint, and the extension portion 4 can be oriented in a desired direction by bending the finger at the second joint.
  • the medical instrument for palpation 10 according to the second embodiment of the present invention shown in FIG. 2 is particularly suitable for palpation, and has a sack portion 12 having a recess conforming to the outer shape of the index finger, and a sac portion 12. And an extension 14 connected thereto.
  • the sack portion 12 includes a hard portion 16 made of a hard material extending between the first and second joints of the finger, and a soft portion extending from the outside of the hard portion 16 to the vicinity of the base of the finger. Part 18.
  • the rigid part 16 can be formed in various lengths, but by bending the finger at the first joint, the finger is firmly fixed in the recess of the rigid part 16 and the finger is bent at the second joint This preferably extends to between the first joint and the second joint so that the extension 14 can be oriented.
  • the soft part 18 is a species Mosquitoes that can be formed in various lengths, preferably have a length of at least the second joint so as not to come off from the finger, and particularly preferably have a length up to the base of the finger.
  • the hard portion 16 can be formed of, for example, hard plastic, metal, or the like.
  • the soft portion 18 preferably has flexibility and elasticity, and can be formed of, for example, a soft plastic such as vinyl chloride, natural rubber, or synthetic rubber.
  • the extension portion 14 is integrally formed of the same material as the hard portion 16 of the sack portion 12.
  • the extension portion 14 is, for example, in the shape of a round bar having a diameter of about 12 mm and a length of about 6 cm, and the tip end portion 20 is hemispherical.
  • This medical instrument for palpation 10 confirms the position of the affected part by touching the contact surface 13 formed on the inner surface of the sack part 12 with the tip of the index finger and touching the affected part with the hemispherical tip 20.
  • the properties of the affected part such as hardness, can be found by touching the finger.
  • the palpable medical device 30 according to the third embodiment shown in FIG. 3 is particularly suitable for palpation.
  • This medical instrument for palpation 30 includes a sack portion 32 having a recess matching the outer shape of a finger, and an extension portion 34 connected to the sack portion 32.
  • the sack portion 32 is entirely formed of a soft material and extends to the vicinity of the base of the finger.
  • the extension part 34 has a hard part 36 of a substantially quadrangular prism and a soft part 38 integrally formed of the same material as the sack part 32 which is a soft material.
  • the soft portion 38 partially surrounds and supports the substantially rectangular hard portion 36.
  • the distal end 40 of the extension portion 34 is formed by a flat surface at one end of the rectangular column of the hard portion 36.
  • the medical instrument for palpation 30 can touch the affected part at its distal end 40 which is a flat surface.
  • the flat part at the other end of the square part of the rigid part 3 6 A certain contact surface 33 is exposed in the recess of the sack portion 32 and can be touched with a finger, so that the properties of the affected area can be known well.
  • the medical instrument for palpation 50 is particularly suitable for palpation and ligation.
  • the medical instrument for palpation 50 is composed of a sack portion 52 having a contact surface 43 with which the tip of the forefinger comes into contact with a concave shape conforming to the outer shape of the index finger, and an extension connected to the sack portion 52. And 54, both of which are formed of a hard material.
  • the extension portion 54 of the medical device for palpation 50 is detachably connected to the first ID portion 56 integral with the sack portion 52 and the first portion 56 by, for example, a snap fit or a screw.
  • a second portion 58 is provided to the first ID portion 56 integral with the sack portion 52 and the first portion 56 by, for example, a snap fit or a screw.
  • the first portion 56 has a substantially cylindrical shape
  • the tip portion 60 has a substantially hemispherical shape.
  • This medical instrument for palpation 50 can be used for palpation when used with the second part 58 removed. Further, when used in this condition, the extension is short, which facilitates other is operative procedures.
  • a straight groove 64 is formed at the tip 62 of the second portion 58. When used with the second portion 58 attached, a suture can be inserted into the groove 62 at the time of knotting, and the knot can be easily moved to the knot portion.
  • FIG. 7 and 8 show a tip part 68 of the second part 202 in another embodiment that can be used in place of the second part 58.
  • FIG. The distal end portion 68 has a cross-shaped groove 70, and this groove 70 can be suitably used for moving a suture to a binding site.
  • a probe (not shown) for ultrasonic diagnosis or X-ray diagnosis may be provided at the distal end 62 of the second portion 58.
  • This probe uses ultrasonic It is made of a material that can be easily distinguished from tissues and other components during diagnosis or X-ray diagnosis.
  • the medical instrument for palpation 51 includes a sack portion 53 having a recess conforming to the outer shape of the index finger having a contact surface with which the tip of the index finger contacts, and an extension portion. 55, which are integrally formed of a hard material.
  • a linear groove 65 is formed at the distal end 63 of the extension 55 of the medical device 51.
  • the medical device 51 can be suitably used for palpation by touching the affected part with its distal end 63, and can be suitably used for closure by inserting a suture in the groove 65. Can be used.
  • the sack portion 53 extends beyond the second joint of the finger to the base of the finger. Therefore, the finger is firmly fixed to the sack portion by bending the finger at the first joint and the second joint, and the extension portion can be directed in a desired direction by bending the finger at the third joint.
  • the medical instrument for palpation 80 according to the sixth embodiment shown in FIG. 10 and FIG. 11 includes a sack portion 82 and an extension portion 84 which are particularly hardly detached from a finger.
  • the sack portion 82 of the medical instrument for palpation 80 includes a coarsely woven mesh-like net 86 and a sack member 88 of a hard material covering the net 86.
  • the wire net 86 can be formed of, for example, metal, hard plastic, or the like.
  • the wire net 86 in the right half of the wire net 86 in FIG. 10, the whole is exposed inside the recess of the sack member 88, but instead, the wire net 86 itself is So that the right half is all embedded in the sack member 8
  • the wire net 86 may be configured so that a part of the right half of the wire net 86 itself is embedded in the sack member 88 and another part is exposed inside the recess of the sack member 88.
  • the wire net 86 extends from the portion between the first and second joints of the finger at the left half of FIG. 10 to the root of the finger.
  • the wire net 86 allows the finger to be bent at the second joint, and secures the palpable medical device 80 to the finger, making it hard to come off.
  • the wire net 86 can be configured in the same manner as finger traction used when a finger is broken.
  • the extension 84 of this palpable medical device 80 has an opening 90 at the base end
  • FIG. 11 shows a state in which the covering member 94 and the sack member 88 have been removed from the medical instrument for palpation 80.
  • the opening 90 of the rod 92 is connected to the end of the wire forming the wire net 86, so that the rod 92 and the wire net 86 are is firmly connected.
  • the covering member 94 covering the rod 92 and the sack member 88 can be integrally formed of the same hard member, for example, a hard plastic or the like.
  • the tip portion 96 of the extension portion 84 is constituted by a large-diameter portion having a -shaped groove 98. This groove
  • the medical device 80 is also used for ligation as in the fourth embodiment.
  • the medical device 80 can be particularly preferably used for palpation.
  • the sack portion extends between the first joint and the second joint.
  • the finger can be firmly fixed to the sack portion by bending the finger at the first joint, and the extension portion can be oriented in a desired direction by bending the finger at the second joint.
  • the finger is firmly fixed to the sack by bending the finger at the first and second joints.
  • the extension can be oriented in a desired direction by bending the third joint at the third joint. Therefore, these medical instruments for palpation are mounted integrally with the finger, and can be suitably operated in an operation under an endoscope, an operation in a narrow operation area, and the like.
  • the palpation medical device 100 has a depression 106 formed in a shape matching the outer diameter of the index finger having a contact surface with which the tip of the index finger contacts. It has a sack portion 102 connected thereto and an extension portion 104 connected to the sack portion 102.
  • the sack portion 102 and the extension portion 104 are integrally formed of a hard material.
  • the recess 106 formed in the sack portion 102 has a length extending between the first joint and the second joint of the finger, and has a substantially U-shaped cross-sectional shape for accommodating a main part of the finger in cross section. Having. For example, three rubber rings 108 are arranged in the portion of the sack portion 102 where the recess 106 is formed.
  • the palpation medical device 100 is properly fixed to the finger by the rubber ring 108 only when the user inserts the finger into the recess 106, and the tip of the finger is The state in which it is in contact with the contact surface provided on the front surface is maintained.
  • the length of the recess 106 may be longer and configured to extend to the base of the finger.
  • a cross-section that does not have a bottom and is supported from both left and right sides may be used.
  • the finger 108 supports the finger from both the upper and lower sides.
  • the medical instrument for palpation 110 according to the eighth embodiment shown in FIG. 13 has a sucking portion 11 having a recess 1 16 formed similarly to the embodiment according to the seventh embodiment shown in FIG. 2 and extension 1 1 4, with two fasteners 1 18 instead of the rubber ring 108.
  • Each of the fasteners 118 includes, for example, two arms as illustrated. These arms are formed of a material, for example, a soft 10 metal, which can be easily deformed with a finger, for example, and maintained in that state.
  • the palpation medical device 1 10 is properly secured to the finger by spreading the fastener 1 1 8 and inserting the finger into the recess 1 1 6 and closing the fastener 1 1 8 Is maintained in contact with the contact surface provided on the front surface of the recess 1 16.
  • the medical instrument for palpation 120 according to the ninth embodiment shown in FIGS. 14 and 15 has a recess 1 26 having a shape corresponding to the outer diameter of the index finger. And an extension 1 2 4 connected to the sack 1 2 2
  • the sack portion 122 includes a tip portion 130 formed of a hard material 20 having a contact surface 1 28 with which the tip of a finger contacts, and a cylindrical portion formed of a cylindrical soft material.
  • the distal end portion 130 is formed of a hard material integrally with the extension portion 124.
  • the cylindrical portion 132 is formed of an elastic material, for example, silicone rubber having elasticity, and has a slit 134 extending to a substantially central portion in the longitudinal direction as illustrated.
  • the inner diameter of the cylindrical part 1 3 2 is Dimensions are slightly younger than the outer diameter of the user's finger and younger than the outer diameter of the tip 130. For this reason, as described below, the cylindrical portion 132 elastically supports the finger and the tip portion 130.
  • This medical instrument for palpation 120 is fitted by inserting the distal end 13 05 as shown in FIG. 15 into the cylindrical portion 13 2 and inserting the finger into the cylindrical portion 13 2 by the user.
  • the medical device for palpation 120 is appropriately fixed to the finger by the cylindrical portion 132, and the tip of the finger is kept in contact with the contact surface 128 provided on the front surface of the recess 126. You.
  • the length of the cylindrical portion 132 elastically supporting the finger can be adjusted.
  • the slit 13 4 formed in the cylindrical portion 13 2 extends linearly.
  • a curved slit, a zigzag slit, or the like may be formed. .
  • a palpable medical device 140 according to the tenth embodiment according to FIG. 16 is connected to a sack portion 144 having a recess 144 for receiving the tip of a forefinger, and a sack portion 142.
  • the sack portion 144 and the extension portion 144 are integrally formed of a hard material.
  • the extension part 144 has a main part 144 having a substantially circular cross section and a hemispherical tip part 144.
  • the sack portion 144 is formed thicker than the extension portion 144.
  • the medical instrument for palpation 140 can be supported by the finger and the palm in a state where the tip of the index finger is recessed and is in contact with the contact surface 148 provided on the front surface of the index finger.
  • the main portion 144 of the extension portion 144 has a constant cross-sectional shape, but the cross-section of a portion about 1 to 3 in front is reduced, and The feel can also be improved.
  • the length of the sack portion 142 is shortened.
  • the sack portion 142 is further provided with a recess for accommodating the tips of the thumb and the middle finger, and the medical instrument for palpation 140 is held with the thumb, index finger and ring finger. It can be configured to hold.
  • the palpation medical device 150 according to the first embodiment according to FIG. 17 comprises a sack part 152 with a recess 156 for receiving the index finger, and an extension connected to the sack part 152 And a part 154.
  • the sack portion 152 and the extension portion 154 are integrally formed of a hard material.
  • the recess 156 has a length capable of accommodating the index finger over its entire length 10 as shown, and has a contact surface 158 on the front surface with which the tip of the index finger contacts.
  • the recess 156 is formed to a depth that accommodates only a part of the index finger, but may be formed to have a depth that accommodates most of the index finger in cross section.
  • This palpation medical device 150 is a device in which the user accommodates the index finger in the recess 156, and the tip of the index finger is placed in front of the recess 156 by the thumb and the middle finger. 8 can be supported in contact with it.
  • the medical instrument for palpation 160 according to the first embodiment shown in FIG. 18 is different from the medical instrument for palpation 150 according to the first embodiment shown in FIG.
  • the difference is that it has two protrusions 165 and 167 on the side of 2102, but the others are formed similarly.
  • the user puts the index finger in the recess 166, hooks the thumb and middle finger on the protrusions 165 and 167, respectively, and the tip of the index finger is recessed. 6 Contacted with contact surface 1 6 8 provided on the front of 6 In state, can be supported.
  • the palpable medical device 170 according to the thirteenth embodiment shown in FIG. 19 is the same as the palpable medical device 150 according to the first embodiment shown in FIG. With the difference that it has a handle 1 75 which extends downward at the bottom of the
  • the user holds the index finger in the recess 176, grips the handle 175 with the thumb, middle finger, ring finger, and little finger, and the tip of the index finger faces the front of the recess 176. It can be supported in contact with the contact surface 1778 provided on the surface.
  • the palpable medical device 180 according to the fourteenth embodiment shown in FIGS. 20 and 21 has a sack 182 and an extension 184.
  • This medical instrument for palpation 180 has a sack portion 182 having a recess 186 for accommodating the tip of the index finger, and an extension portion 184 connected to the sack portion 182.
  • the sack portion 182 and the extension portion 184 are integrally formed of a hard material.
  • the extension portion 184 of the medical instrument for palpation 180 according to this embodiment extends in a direction substantially parallel to the extension direction of the finger accommodated in the sack portion 182.
  • the sack portion 18 2 extends in the longitudinal direction of the dome portion 190 forming the recess 1 86, the arch portion 19 2 supporting the first joint portion of the index finger, and the tip portion 18 4 Handle 1 94.
  • This medical instrument for palpation 180 inserts the index finger into the arch part 192 and the dome part 190 as shown in Fig. 20 and grasps the handle 1994 with the finger and palm.
  • the state in which the tip of the index finger is in contact with the contact surface provided on the front surface of the recess 186 is maintained.
  • the extension is made of, for example, a hard material
  • This extension can be formed of, for example, a soft metal material that can be easily bent with a finger, for example, and can maintain the bent state.
  • extension in two parts and connect them with pins.
  • the strength of the connection is such that the strong force of the hand changes the angle of these two parts, but not the weak force.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgical Instruments (AREA)
  • Laser Surgery Devices (AREA)

Abstract

Dispositif médical de palpation servant d'instrument chirurgical pour des opérations endoscopiques et des opérations sur une zone restreinte. Le dispositif comporte une partie de calage présentant un évidement épousant le contour d'un doigt, ainsi qu'une extension sensiblement parallèle au sens d'allongement du doigt prenant appui dans l'évidement, ou sensiblement parallèle au sens d'extension du doigt et reliée à la partie de calage. L'évidement dans la partie de calage présente une surface de contact avec laquelle l'extrémité de l'index vient en contact.
PCT/JP1995/000839 1994-04-28 1995-04-27 Dispositif medical de palpation WO1995029634A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU23527/95A AU2352795A (en) 1994-04-28 1995-04-27 Medical device for palpation

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP6111930A JPH1133030A (ja) 1994-04-28 1994-04-28 エンドフインガ
JP6/111930 1994-04-28

Publications (1)

Publication Number Publication Date
WO1995029634A1 true WO1995029634A1 (fr) 1995-11-09

Family

ID=14573699

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP1995/000839 WO1995029634A1 (fr) 1994-04-28 1995-04-27 Dispositif medical de palpation

Country Status (3)

Country Link
JP (1) JPH1133030A (fr)
AU (1) AU2352795A (fr)
WO (1) WO1995029634A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1853178A1 (fr) * 2005-03-03 2007-11-14 Aceris Innovation & Production AB Dispositif sanitaire pour l elimination des points noirs et boutons

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP6466886B2 (ja) * 2016-08-05 2019-02-06 株式会社 型善 手術用指先延長具

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH031850A (ja) * 1989-05-31 1991-01-08 Fujitsu Ltd 体腔内超音波探触子

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH031850A (ja) * 1989-05-31 1991-01-08 Fujitsu Ltd 体腔内超音波探触子

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1853178A1 (fr) * 2005-03-03 2007-11-14 Aceris Innovation & Production AB Dispositif sanitaire pour l elimination des points noirs et boutons
EP1853178A4 (fr) * 2005-03-03 2014-12-31 Aceris Innovation & Production Ab Dispositif sanitaire pour l elimination des points noirs et boutons

Also Published As

Publication number Publication date
AU2352795A (en) 1995-11-29
JPH1133030A (ja) 1999-02-09

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