WO2014155743A1 - Pince - Google Patents

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Publication number
WO2014155743A1
WO2014155743A1 PCT/JP2013/059766 JP2013059766W WO2014155743A1 WO 2014155743 A1 WO2014155743 A1 WO 2014155743A1 JP 2013059766 W JP2013059766 W JP 2013059766W WO 2014155743 A1 WO2014155743 A1 WO 2014155743A1
Authority
WO
WIPO (PCT)
Prior art keywords
forceps
end side
bellows
advance
retreat
Prior art date
Application number
PCT/JP2013/059766
Other languages
English (en)
Japanese (ja)
Inventor
健嗣 川嶋
耕太郎 只野
大輔 原口
Original Assignee
国立大学法人 東京工業大学
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 国立大学法人 東京工業大学 filed Critical 国立大学法人 東京工業大学
Priority to PCT/JP2013/059766 priority Critical patent/WO2014155743A1/fr
Publication of WO2014155743A1 publication Critical patent/WO2014155743A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00539—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2931—Details of heads or jaws with releasable head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/305—Details of wrist mechanisms at distal ends of robotic arms
    • 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
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0813—Accessories designed for easy sterilising, i.e. re-usable

Definitions

  • a pair of forceps members are opened and closed by remote operation, thereby grasping an object to be grasped, peeling, cutting, grasping a biological tissue, and the like.
  • the present invention relates to a forceps used to perform the process.
  • a forceps that opens and closes by remote operation during a surgical operation and grips an object to be grasped has a forceps on a proximal end side of a pair of forceps members that are pivotally supported at a portion bent in a U shape.
  • the forceps member (gripper) at the tip of the forceps is driven to open and close to grasp the object to be grasped.
  • the conventional forceps uses a mechanism that opens and closes by pulling and rotating the proximal ends of the pair of forceps members with the wire, when grasping the object to be grasped, the forceps member and the wire Has a problem that it is difficult to obtain a large gripping force.
  • the forceps have a gripping force stronger than that of the wire-type forceps, for example, provided with a forceps (forceps portion) that is provided with a pneumatic cylinder and opens and closes a pair of forceps members using compressed air of the pneumatic cylinder.
  • a steering system having a haptic presentation function is known (see, for example, Patent Document 1).
  • FIG. 5 is a main part schematic perspective view showing the forceps disclosed in Patent Document 1.
  • FIG. 6 is a schematic cross-sectional view showing a main part of a forceps disclosed in Patent Document 1.
  • the conventional forceps A100 includes a pair of forceps with a forceps claw holding portion 200 interposed at a distal end portion of a rotatable rod-shaped forceps shaft 300.
  • a member 100 forceps claw
  • the forceps claw holding portion 200 has a proximal end portion rotatably connected to a distal end portion of a forceps shaft 300, and a pair of forceps members 100 are rotatably supported by the rotation shaft 400 at the distal end portion.
  • the forceps claw holder 200 moves forward by the compressed air supplied from the air pipe 220, and moves forward and backward by moving backward by the spring force of the compression coil spring 230, and the piston 240 can freely move back and forth.
  • the pneumatic cylinder 210 is composed of the cylinder 250 housed in the cylinder.
  • an O-ring 260 is fitted on the sliding outer peripheral portion, an automatic return compression coil spring 230 is inserted in the shaft portion, and a pair of links 500 are rotatably connected to the tip portion.
  • the piston 240 opens and closes the forceps member 100 via the link 500 by advancing and retracting with air pressure and spring force.
  • Each forceps member 100 is formed in a dogleg shape, and the bent central portion is pivotally supported by a pair of support pieces 252 extending from the cylinder 250 to the tip end side by the rotating shaft 400.
  • the forceps A100 grips an object to be grasped when air pressure is supplied to the cylinder chamber 270 of the pneumatic cylinder 210, the piston 240 advances, and the pair of forceps members 100 are closed via the link 500.
  • the forceps A100 releases the grasped object by closing the forceps member 100 via the link 500 when the compression coil spring 230 pushes the piston 240 back by the spring force.
  • the O-ring 260 of the seal portion fitted on the piston 240 is disposed in contact with the inner wall of the cylinder 250 and moves forward and backward together with the piston 240. For this reason, the O-ring 260 is moved when the piston 240 advances and retreats in the cylinder 250 when the cylinder region 280 on the cylinder chamber 270 side to which air pressure is supplied and the compression coil spring 230 that automatically returns the piston 240 expand and contract. It is divided into an air in / out area 290 through which air enters and exits.
  • the cylinder 250 of the forceps A100 has a structure in which the atmosphere enters and exits the atmosphere entry / exit region 290 in the cylinder 250 from the opening 251 of the cylinder 250 as the piston 240 moves forward and backward. For this reason, during surgery, body fluid and the like enter the atmosphere entry / exit region 290 in the cylinder 250 together with the atmosphere, and the O-ring 260 provided on the outer peripheral portion of the piston 240 moves forward and backward in the cylinder 250. There was a risk that body fluid would enter the inner cylinder region 280.
  • the cylinder 250, the O-ring 260, and the compression coil spring 230 also need to be cleaned and sterilized, and there is a problem that the cleaning and sterilization operations are indispensable and time-consuming.
  • the forceps A100 disclosed in Patent Document 1 uses the spring force of the compression coil spring 230 to drive the forceps member 100 in the opening direction.
  • the compression coil spring 230 it is essential that the compression coil spring 230 be long and large.
  • the conventional forceps A100 has a problem that the entire drive unit becomes long and the size thereof is increased.
  • the forceps A100 compresses the compression coil spring 230 that presses these members when the components such as the forceps member 100, the link 500, and the piston 240 are connected and assembled by the rotating shaft 400, the connecting shaft 600, and the like. It is necessary to assemble in the state. For this reason, when assembling each member, each member must be assembled in a state in which a spring force is applied to each member, so that there is a problem that the workability of the assembling work is poor.
  • the present invention has been developed to solve the above-described problems, and an object of the present invention is to provide a compact forceps that can be easily cleaned and sterilized.
  • a forceps includes a first forceps member and a second forceps member that have a clip portion on a distal end side, a link portion on a proximal end side, and extend in a longitudinal direction, A support shaft disposed between the distal end side and the proximal end side of the first forceps member and the second forceps member and pivotally supporting the first forceps member and the second forceps member; A forceps comprising an advance / retreat member that opens and closes the first forceps member and the second forceps member by advancing and retreating, and an advance / retreat drive mechanism for advancing / retreating the advance / retreat member, wherein the advance / retreat member is inserted in a freely reciprocating manner.
  • a housing having a support piece for supporting the support shaft, and a detachably mounted on the base end side of the housing, and housing the advance / retreat drive mechanism with the housing, and the advance / retreat drive mechanism
  • the base end side is provided with a support base end side shaft member.
  • the forceps is provided with the first forceps member and the second forceps member by attaching the base end side shaft member to the base end side of the case in a detachable manner. It can be separated into two parts: a housing side which is an unclean part and a proximal end side shaft member which is a clean part in which the advance / retreat drive mechanism is housed. For this reason, when performing the cleaning operation and the sterilization operation, the casing side including the first forceps member and the second forceps member is shortened by separating the casing side from the proximal end side shaft member. And it becomes easy to perform sterilization processing work.
  • the inside of the storage space is exposed at the base end side shaft member side storing the advance / retreat drive mechanism by separating the housing side, it is easy to perform cleaning and sterilization operations. Since the forceps can be separated in this way, the forceps can be easily cleaned and sterilized, and can be efficiently cleaned and sterilized in a short time. Further, the forceps are removed from the base end side shaft member where the first forceps member and the second forceps member are located, and the case side is provided with the first forceps member and the second forceps member having various-shaped pinching portions. And can be easily replaced with a forceps having a clip portion suitable for various operations.
  • the forceps are suitable for use in tissue hemostasis, tissue grasping, suture grasping, etc., if, for example, the shape of the clamp is replaced with a shape such as a Kocher forceps or a needle-type forceps Can be.
  • the shape of the clamp is replaced with that of a Kelly forceps
  • the forceps has a shape suitable for grasping a blood vessel or hemostasis
  • the shape of the clamp is a cutting forceps
  • the shape is changed to the shape of the scissors forceps or the scissors blade forceps, it can be made suitable for use in cutting a wire or living tissue.
  • the present invention can significantly improve the operation of the forceps.
  • the advance / retreat drive mechanism preferably includes a bellows that expands and contracts by introducing and discharging fluid pressure supplied from a fluid pressure supply source to advance and retract the advance / retreat member.
  • the forceps has an advance / retreat drive mechanism provided with a bellows, so that compressed air is supplied to the bellows to expand the forceps so that the first forceps member and the second forceps member are interposed via the advance / retreat member.
  • the object to be grasped can be grasped by closing the sandwiching portion.
  • the forceps can be used as a pressing mechanism that does not require the piston, O-ring and compression coil spring used for the sliding portion of the conventional cylinder by arranging the bellows in the storage space. The space can be eliminated and the length of the drive part of the advance / retreat drive mechanism can be shortened, so that the size of the entire forceps can be reduced.
  • the bellows is made of a metal having a spring force that contracts to a natural length from an expanded state by introduction of fluid pressure supplied from the fluid pressure supply source.
  • the bellows has a spring force that contracts to a natural length from the expanded state due to the introduction of the fluid pressure supplied from the fluid pressure supply source.
  • the clamping part of a 1st forceps member and a 2nd forceps member can be closed. Then, by removing the supplied fluid pressure from the bellows, the bellows itself is brought into a contracted state due to the spring force returning to the natural length, and the advancement / retraction member is pulled back so that the sandwiching portion between the first forceps member and the second forceps member is removed. It can be automatically returned to the open position.
  • the bellows is made of a metal, so that it can be formed into a pleated bellows tube that is thinner than a resin bellows and can maintain a strong spring force over a long period of time.
  • the bellows and the advance / retreat member are connected by a detachable connecting portion.
  • the forceps has the bellows and the advancing / retreating member connected to each other by the detachable connecting portion, so that the advancing / retreating member that advances and retracts the first forceps member and the second forceps member to open / close the bellows is provided.
  • the forceps are cleaned and sterilized, it is only necessary to separate the side where the first forceps member, the second forceps member, and the advance / retreat member are cleaned and sterilized, thereby improving workability. it can.
  • the connecting portion is configured so that the advance / retreat member and the bellows are separated when the casing and the base end side shaft member are separated.
  • the forceps separates the forceps from the housing side and the base end side shaft member by separating the advancement / retraction member and the bellows together. Can be separated to the side.
  • the bellows has a bellows portion that can be expanded and contracted on an outer peripheral portion, and the bellows portion is disposed so as to be slidably in contact with an inner wall of the casing.
  • the bellows portion of the bellows is disposed so as to be slidably in close contact with the inner wall of the base end side shaft member.
  • the inner wall on the member side can be completely sealed. Therefore, foreign matter such as air, body fluid, blood, etc. can be prevented from entering the base end side shaft member, so that the inside of the base end side shaft member can always be kept clean. It is possible to eliminate the need for internal cleaning and sterilization.
  • the housing and the base end side shaft member have a threaded portion that is screwed together, and a packing is provided inside the threaded portion.
  • the forceps has a bellows that expands and contracts when the advancing / retreating member moves forward / backward by providing the packing in a portion where the casing and the proximal end side shaft member are connected to each other by the screw portion.
  • the packing does not move, a sealed state can be maintained, so that foreign matters such as blood and body fluid can be prevented from entering the proximal end side shaft member side of the packing. For this reason, when the base end side shaft member is cleaned and sterilized, it is unnecessary to clean and sterilize the part on the base end side shaft member side from the packing, and only the surface on the housing side is cleaned and sterilized. The work can be performed efficiently and easily.
  • a distal end portion is rotatably connected to the link portion, and a proximal end portion of the advance / retreat member It is preferable that a first link member and a second link member that are rotatably connected to the tip end portion are interposed.
  • the forceps is provided by the expansion of the bellows by providing the link mechanism including the first link member and the second link member between the first forceps member and the second forceps member and the advance / retreat member.
  • the gripping force for gripping the object to be gripped by opening and closing the pin is increased and stronger than the forceps without the link mechanism. A gripping force can be obtained.
  • the present invention can provide a forceps that is compact and easy to perform cleaning and sterilization operations.
  • the forceps has a shape suitable for the work by making the housing provided with the first forceps member and the second forceps member capable of gripping the object to be grasped detachable from the proximal end side shaft member. It can be easily replaced with a forceps having a pinch, and the operation of the forceps can be remarkably improved.
  • the support shaft 51 extends with the side where the first forceps member 1 and the second forceps member 2 are installed as the distal end side and the side where the bellows 62 is installed as the proximal end side.
  • the side is left and right.
  • the forceps A opens and closes the sandwiching portions 1 a and 2 a of the first forceps member 1 and the second forceps member 2 by remote operation during a surgical operation such as endoscopic surgery.
  • a surgical operation such as endoscopic surgery.
  • the forceps A can be used for grasping an object to be grasped by changing the shape of the sandwiching portion 1a of the first forceps member 1 and the second forceps member 2, and for cutting biological tissue.
  • the forceps A can be used as a tip mechanism of an arm of a surgery support robot.
  • a forceps A including the first forceps member 1 and the second forceps member 2 sandwiched between the first forceps member 1 and the second forceps member 2 will be described as an example.
  • the forceps A is capable of rotating the first forceps member 1 and the second forceps member 2 having the sandwiching portions 1 a and 2 a on the distal end side, and the first forceps member 1 and the second forceps member 2.
  • a support shaft 51 that supports the shaft, a link mechanism 3 connected to the proximal ends of the first forceps member 1 and the second forceps member 2, and an advance / retreat member 4 that drives the first forceps member 1 and the second forceps member 2 to open and close.
  • a fluid pressure supply source 61 that supplies fluid pressure to the mechanism 6, a control device 8 that drives and controls the fluid pressure supply source 61, and a power source 9 that supplies power to the fluid pressure supply source 61 and the control device 8 are provided. Yes.
  • the first forceps member 1 and the second forceps member 2 are gripping members called so-called needle holders suitable for gripping an object to be gripped such as a suture needle during surgery. , Composed of a metal member formed extending in the longitudinal direction.
  • the first forceps member 1 and the second forceps member 2 are used to hold ligation and anastomosis surgery, instruments for stopping blood flow, thin rubber tubes, soft plastic tubes, thin plates, and metal bars. Can also be used.
  • the first forceps member 1 and the second forceps member 2 have the sandwiching portions 1a and 2a on the distal end side, the link portions 1b and 2b on the proximal end side, and the support shaft 51 inserted in the substantially central portion. Shaft holes 1c and 2c are formed.
  • the first forceps member 1 and the second forceps member 2 are formed in a substantially line-symmetric shape, and the sandwiching portions 1a, 2a rotate in the opening / closing direction (arrow a, b direction) around the support shaft 51. Away and close.
  • the sandwiching portions 1a and 2a are portions for gripping an object to be gripped when rotated in the closing direction (arrow b direction) about the support shaft 51, and the gripping surface is formed in a substantially wave shape when viewed from the front. ing.
  • the sandwiching portions 1 a and 2 a are formed at the distal end side portion with respect to the support shaft 51 in the first forceps member 1 and the second forceps member 2.
  • the link portions 1b and 2b are portions on the proximal end side of the first forceps member 1 and the second forceps member 2, and the distal ends of the first link member 31 and the second link member 32 of the link mechanism 3 are freely rotatable.
  • a through hole for inserting the connecting pins 11 and 21 to be connected to is formed.
  • the first link member 31 is rotatably connected to the link portion 1b via a connecting pin 11.
  • the second link member 32 is rotatably connected to the link portion 2b via the connecting pin 21.
  • the shaft holes 1c and 2c are holes into which the substantially cylindrical support shaft 51 is rotatably inserted, and are disposed between the front end side and the base end side of the first forceps member 1 and the second forceps member 2. ing.
  • the support shaft 51 is a shaft bar member that rotatably supports the first forceps member 1 and the second forceps member 2 with respect to the housing 5 so as to be capable of opening and closing.
  • the support shaft 51 is inserted into the shaft holes 1c, 2c of the first forceps member 1 and the second forceps member 2, and a pair of support pieces 5b extending from the outer surface on the front end side of the housing 5 toward the front end. Both ends are held by 5b.
  • the link mechanism 3 is a transmission member that converts the linear motion of the advance / retreat member 4 into a rotational motion and transmits it to the first forceps member 1 and the second forceps member 2.
  • the link mechanism 3 includes, for example, the link portion 1b of the first forceps member 1, the link portion 2b of the second forceps member 2, the first link member 31, the second link member 32, and the first forceps member 1.
  • the connecting pin 11 that connects the link portion 1b and the first link member 31, the connecting pin 21 that connects the link portion 2b of the second forceps member 2 and the second link member 32, the first link member 31 and the second link member 21.
  • An advancing / retracting member connecting pin 33 that connects the link member 32 and the advancing / retreating member 4 is provided. That is, the link mechanism 3 is formed by connecting four link members to form a closed circuit, and is provided between the sandwiching portions 1 a and 2 a of the first forceps member 1 and the second forceps member 2 and the advance / retreat member 4. ing.
  • the link mechanism 3 includes a connecting pin 11 that connects the first link member 31 and the link portion 1 b, and a second link when the advancing / retreating member 4 is on the proximal end side by the spring force of the bellows 62.
  • the connecting pin 21 that connects the member 32 and the link portion 2b is moved in the direction of opening the sandwiching portions 1a and 2a of the first forceps member 1 and the second forceps member 2 toward the inner direction (arrow c direction) close to each other. Move.
  • the link mechanism 3 is connected to the first link member 31 and the link portion 1b as shown in FIG. 2 when the advance / retreat member 4 is pushed by the bellows 62 expanded by the fluid pressure and is on the tip side.
  • the pin 11 and the connecting pin 21 connecting the second link member 32 and the link portion 2b move away from each other in the outward direction (arrow d direction), and the pinching portion 1a of the first forceps member 1 and the second forceps member 2 is separated. , 2a is rotated in the closing direction.
  • the first link member 31 and the second link member 32 are formed of a flat plate-like member extending from the distal end side to the proximal end side, and are formed with holes for inserting the distal end side connection pins 21 and 22.
  • a hole for inserting the advancing / retracting member connecting pin 33 is formed on the part side.
  • the distal ends of the first link member 31 and the second link member 32 are rotatably connected to the link portions 1 b and 2 b at the base end portions of the first forceps member 1 and the second forceps member 2 by connecting pins 21 and 22.
  • the proximal end side is rotatably connected to the distal end portion of the advance / retreat member 4 by the advance / retreat member connection pin 33.
  • the advance / retreat member 4 is pushed and pulled by the advance / retreat drive mechanism 6 to move forward and backward, and opens and closes the first forceps member 1 and the second forceps member 2 via the link mechanism 3. It is a member to be driven, and is inserted into the housing 5 so as to freely advance and retract.
  • the advancing / retracting member 4 is formed with a hole for inserting the advancing / retracting member connecting pin 33 on the distal end side, and a connecting portion 4a connected to a connecting portion 62a formed at the center of the distal end portion of the bellows 62 is formed on the proximal end side. Has been.
  • the connecting portion 4a of the advancing / retracting member 4 and the connecting portion 62a of the bellows 62 may be any connecting means that can be connected to each other in a detachable manner.
  • the connecting portion 4a is composed of a male screw, Consisting of a female screw.
  • the housing 5 is a cylinder-shaped case body having a housing space 5a for housing the bellows 62 in a state where the bellows 62 can be expanded and contracted. As shown in FIG. It is formed to be separable from the 71 side.
  • the housing 5 is provided with an advancing / retracting member 4 at the front end side so as to freely advance and retract.
  • the housing 5 is integrally formed with support pieces 5 b and 5 b that support the support shaft 51 and a screw portion 5 c that is screwed into a screw portion 71 b formed at the sheath distal end portion 71.
  • the storage space 5 a is a hollow portion formed by the inner wall of the housing 5, the proximal end side shaft member 7, and the sheath distal end portion 71, and is formed in a substantially cylindrical shape.
  • the advancing / retracting member 4 inserted into the distal end portion so as to be able to advance and retract, a sheath distal end portion 71 detachably attached to the proximal end side, and a slidably inserted into the sheath distal end portion 71.
  • Bellows 62 a pipe 63 whose tip is joined to the bellows 62, a lid member 72 fitted into the opening 71a of the sheath tip 71, a packing 73 installed inside the lid member 72, and a housing 5 and a proximal end side shaft member 7 installed on the proximal end side.
  • the support pieces 5b and 5b are tongue-like portions protruding from the housing 5 toward the front end side, and the first link member 31 and the second link member 32 to which the advance / retreat member 4 and the link mechanism 3 are connected. Is supported with a support shaft 51 interposed therebetween. Therefore, as shown in FIG. 3, when the housing 5 is separated from the sheath distal end portion 71, the housing 5, the support shaft 51, the first link member 31 and the second link member 32, and the first link member 31. And the 2nd link member 32, the connection pins 11 and 21, the advance / retreat member connection pin 33, and the advance / retreat member 4 form one forceps gripper part.
  • the screw portion 5 c is formed of a female screw that is screwed into a screw portion 71 b that is a male screw of the sheath distal end portion 71.
  • the screw parts 5c and 71b are formed at the same pitch as the pitches of the male screw part and the female screw part that form the connecting parts 4a and 62a of the advance / retreat member 4 and the bellows 62, and rotate the housing 5 with respect to the sheath tip part 71. If moved, the two parts can be screwed together to be connected or separated.
  • the sheath distal end portion 71 is a case half that forms one case body that houses the advance / retreat driving mechanism 6 with the housing 5, and is formed in a cylindrical shape, for example.
  • an opening 71a into which the lid member 72 is fitted is formed at the proximal end portion, and the screw portion 71b is formed at the distal end portion.
  • a bellows 62 is accommodated in the sheath distal end portion 71 so as to be freely stretchable.
  • a lid member 72 is joined to the inner edge, and a bellows 62 is provided in the lid member 72 with a packing 73 interposed.
  • the screw part 71b is a part that is detachably screwed into the screw part 5c of the housing 5, and is made of, for example, a male screw. As long as the screw part 71b and the screw part 5c are screwed together, any of them may be a male screw or a female screw.
  • the lid member 72 is made of a metal plate member provided in close contact with the opening 71a of the sheath distal end portion 71, and an installation hole for inserting the pipe 63 is formed in the central portion.
  • the lid member 72 is interposed between the packing 73 made of a soft member and the proximal end side shaft member 7.
  • the lid member 72 may be formed integrally with the sheath distal end portion 71.
  • the packing 73 is made of a rubber disk-like member in which an installation hole for inserting the pipe 63 is formed at the center, and the outer peripheral part is in close contact with the inner wall of the sheath distal end 71 and the central part is in close contact with the pipe 63. Is installed.
  • the proximal-side shaft member 7 is a forceps holding member that is installed and protected so as to cover the pipe 63 and supports the forceps A, and is, for example, a sheath made of a pipe-shaped member that can be bent.
  • the proximal end side shaft member 7 is adjacent to the proximal end side surface of the sheath distal end portion 71 at the distal end side, and is connected to the fluid pressure supply source 61 at the proximal end side.
  • the advance / retreat drive mechanism 6 is a drive device that drives the advance / retreat member 4 to advance / retreat, and generates a fluid pressure to supply the fluid pressure into the bellows 62, and a fluid pressure supply
  • a control device 8 that controls driving of the source 61, a power source 9 that supplies power to the fluid pressure supply source 61 and the control device 8, a bellows 62 that moves the advance / retreat member 4 forward and backward, and a fluid generated by the fluid pressure supply source 61
  • the advance / retreat drive mechanism 6 is provided on the proximal end side of the advance / retreat member 4 with the link mechanism 3 and the advance / retreat member 4 interposed between the distal first forceps member 1 and the second forceps member 2.
  • the fluid pressure supply source 61 is a device that generates fluid pressure and supplies the fluid pressure to the bellows 62, and includes, for example, a compressor that generates compressed air.
  • the fluid pressure supply source 61 only needs to generate fluid pressure such as compressed air or hydraulic pressure.
  • the fluid pressure supply source 61 may be a hydraulic pump that generates hydraulic pressure.
  • the fluid pressure supply source 61 a case where the fluid pressure generated by the fluid pressure supply source 61 is compressed air generated by a compressor will be described as an example.
  • the fluid pressure supply source 61 is composed of a compressor that generates compressed air, and when gripping an object to be gripped by the forceps A, the fluid pressure supply source 61 supplies the compressed air into the bellows 62 via the pipe 63 and expands in the distal direction. Thus, the advance / retreat member 4 is advanced. Further, the fluid pressure supply source 61 is configured so that the supplied compressed air is returned from the bellows 62 when the object to be grasped is released by the forceps A.
  • the bellows 62 expands when the compressed air (fluid pressure) supplied from the fluid pressure supply source 61 is introduced and functions as a pressing mechanism that moves the advance / retreat member 4 forward. If the supply of compressed air introduced into the bellows 62 is stopped, the contraction is automatically caused by the spring force to return to the original shape, the compressed air is discharged, and the advance / retreat member 4 is moved back to the original position. Acts as a pull-back mechanism.
  • the bellows 62 includes the connecting portion 62a, a hollow portion 62b into which compressed air supplied from the fluid pressure supply source 61 is introduced, an entrance / exit portion 62c through which the compressed air enters and exits, a bellows portion 62d formed in a bellows shape, Is formed of a thin metal having a spring force that contracts from the expanded state.
  • the bellows 62 is made of, for example, a brass metal, a nickel metal, or a metal plated with gold.
  • the bellows 62 is housed in the housing space 5a of the housing 5 so as to be stretchable.
  • the connecting portion 62a is a portion formed on the distal end surface of the bellows 62 and detachably attached to the connecting portion 4a of the advance / retreat member 4, and is formed in, for example, a female screw shape.
  • the connecting portion 62a and the connecting portion 4a of the advance / retreat member 4 are configured such that the advance / retreat member 4 and the bellows 62 are separated when the screw portion 5c of the housing 5 and the screw portion 71b of the sheath distal end portion 71 are separated. It is configured.
  • the connecting portions 4a and 62a and the screw portions 5c and 71b are formed with screws having the same pitch so that they can be separated and connected simultaneously when the housing 5 is rotated with respect to the sheath tip portion 71.
  • the hollow part 62b is formed in the bellows part 62d that expands and contracts, and is formed so that the volume increases and decreases by moving in and out of the hollow part 62b to advance and retract the position of the connecting part 62a.
  • the inlet / outlet portion 62 c is a hole to which the distal end portion of the pipe 63 is externally fitted and joined, and is formed in the central portion on the proximal end side of the bellows 62.
  • the bellows portion 62d is a bellows-like portion formed on the outer peripheral portion of the bellows 62 and is a portion that can be expanded and contracted.
  • the bellows part 62d is slid in close contact with the inner wall of the housing 5 and the role of an expansion / contraction part that expands and contracts in the direction of the distal end part and the base end part, the role of a spring member that pulls back the advance / retreat member 4 connected to the connection part 62a. It fulfills the function of a moving sealing material.
  • the bellows portion 62d is telescopically fitted into the sheath distal end 71 side in the storage space 5a, and when the bellows 62 expands and contracts, the entire outer peripheral portion of the bellows portion 62d slides on the inner wall of the housing 5. It is inserted into the storage space 5a so as to be closely movable.
  • the pipe 63 has a proximal end supplied to a fluid pressure supply source 61 and a distal end connected to a bellows 62.
  • the pipe 63 is made of, for example, a tube that can be bent and deformed.
  • the control device 8 is a device that controls the opening and closing of the forceps A by controlling the supply of compressed air from the fluid pressure supply source 61 to the bellows 62 and the release of the compressed air in the bellows 62.
  • the control device 8 includes, for example, a compressed air supply electromagnetic valve (not shown) provided in the fluid pressure supply source 61, and a compressed air discharge electromagnetic valve (not shown) that discharges the compressed air in the bellows 62. , Control.
  • the power source 9 includes a household power source or a storage battery, and is electrically connected to the fluid pressure supply source 61 and the control device 8.
  • the advance / retreat member 4 connected to the bellows 62 pulls the first link member 31 and the second link member 32 to the proximal end side (arrow e direction side) via the advance / retreat member connection pin 33, and the first forceps member
  • the first and second forceps members 2 are rotated in the direction in which the link portions 1b and 2b are close to each other (arrow c direction). For this reason, when not in use, the forceps A is in an expanded state in which the sandwiched portions 1a and 2a release an object to be grasped such as a suture needle rotated in the opening direction (arrow a direction).
  • the advancing / retracting member 4 presses the first link member 31 and the second link member 32 toward the distal end side (arrow f direction side) via the advancing / retracting member connecting pin 33, so that the first forceps member 1 and the second forceps member 2 are pressed.
  • the link parts 1b and 2b are rotated in a direction away from each other (arrow d direction). For this reason, the forceps A is rotated in the direction in which the sandwiching portions 1a and 2a are closed (in the direction of the arrow b) to hold the object to be grasped.
  • the rotation of the forceps A in the closing direction (arrow b direction) stops when the sandwiching portions 1a and 2a grip the object to be gripped or when the sandwiching portions 1a and 2a are in contact with each other.
  • the outer peripheral portion of the bellows portion 62d slidably contacts the inner wall surface of the housing 5, and the inner wall surface on the distal end side sends compressed air in the hollow portion 62b to the pipe 63 side (arrow g direction side). Extrude into.
  • the fluid pressure supply source 61 sucks the compressed air of the bellows 62 by having the spring force for returning the bellows 62 and the function as a sealing material that is in close contact with the inner wall surface of the housing 5.
  • the structure of the forceps A is simplified and the length in the advancing / retreating direction is shortened and made compact by eliminating suction force, the spring member that pushes back the bellows 62, and the arrangement of the seal member on the outer periphery of the bellows 62. Can do.
  • the bellows 62 has a large number of bellows portions 62d in close contact with the inner wall surface of the housing 5 in the housing 5, even if foreign matter such as blood enters the storage space 5a, the bellows 62 Intrusion into the sheath distal end 71 closer to the proximal end than the distal end face of 62 can be prevented. For this reason, it is not necessary to perform the cleaning process and the sterilization process after using the forceps A in the sheath distal end portion 71.
  • the advance / retreat member 4 is pulled by the bellows 62 and linearly moves to the base end side, and the first link member 31 and the second link member 32 are moved to the base end side (arrow e direction side) via the advance / retreat member connecting pin 33. Withdrawn, the first forceps member 1 and the second forceps member 2 are rotated in the direction in which the link portions 1b and 2b are close to each other (arrow c direction). In the forceps A, the sandwiching portions 1a and 2a are rotated in the opening direction (arrow a direction) to release the object to be grasped.
  • the forceps A rotates the first forceps member 1 and the second forceps member 2 via the first link member 31 and the second link member 32 by the advancement / retraction member 4 pushing and pulling the link mechanism 3.
  • the link mechanism 3 amplifies the opening / closing force of the sandwiching portions 1a, 2a, and can exert a strong gripping force. For this reason, the forceps A can firmly grasp the object to be grasped by the sandwiching portions 1a and 2a and can release it securely.
  • the proximal shaft member 7 side separated from the housing 5 constitutes a clean part because the inside of the sheath distal end 71 prevents entry of foreign substances such as body fluids and blood by the bellows 62. It is only necessary to perform cleaning and sterilization treatment only on the front end surface, and the cleaning and sterilization treatment operations are easy to perform. That is, the housing 5 side is an unclean part because blood or the like adheres when an object to be grasped such as a suture needle is grasped. For this reason, it is only necessary to clean and sterilize only the surface of the casing 5 side on the sheath distal end 71 side of the clean section separated from the casing 5 side of the unclean section.
  • the forceps A when replacing the forceps housing> Moreover, if the forceps A is exchanged for another type on the housing 5 side, the forceps A can be easily exchanged for one suitable for various operations. For this reason, the forceps A can be used for various operations such as an instrument for stopping blood flow, a thin rubber tube, a soft plastic tube, and a work for gripping and fixing a thin plate in a wide range. It is.
  • FIG. 4 is a schematic cross-sectional view of a main part showing a modification of the forceps according to the embodiment of the present invention.
  • the case 5 and the sheath tip 71 are described as being detachable, but the case 5A of the forceps A1 is shown in FIG.
  • the shape is not particularly limited as long as it has a storage space 5Aa for storing the bellows 62, a threaded portion 5Ac, and a support piece 5Ab, and the advance / retreat member 4 can be freely advanced and retracted.
  • the housing 5 ⁇ / b> A is detachably screwed with a screw portion 5 ⁇ / b> Ac formed at the proximal end portion to a screw portion 7 ⁇ / b> Aa formed at the distal end portion of the proximal end side shaft member 7 ⁇ / b> A (sheath). It doesn't matter if you do. Further, when the screw portion 5Ac of the housing 5A and the screw portion 7Aa formed at the end portion of the base end side shaft member 7A are screwed into or detached from the housing 5A, the housing 5A A locking hole 5Ae for engaging a tool or the like for rotating the tool may be formed.
  • the housing 5A extends the position of the screw portion 5Ac to the base end side to a position where the screw portion 7Aa formed at the tip end portion of the base end side shaft member 7A is screwed.
  • a plurality of locking holes 5Ae are formed at a plurality of locations to engage with convex portions (not shown) of the tool for attaching / detaching the housing.
  • the base end side shaft member 7A is made of, for example, a substantially pipe-shaped member that can be bent.
  • a screw portion 7Aa made of a male screw that is screwed into a screw portion 5Ac made of a female screw is formed outside the tip portion.
  • a recess 7Ab for installing the lid member 72 and the packing 73 is formed inside the tip.
  • the lid member 72 and the packing 73 may be omitted.
  • the case 5A side can be attached to and detached from the base end side shaft member 7A side at any time.
  • the cleaning and sterilization work on the housing 5A side can be easily performed.
  • the packing 73 is disposed in close contact with the inside of the threaded portions 5Ac and 7Aa on the base end side shaft member 7A side, only the surface of the bellows 62 may be cleaned and sterilized. Work can be done easily.
  • the forceps A1 of the modified example of the present invention also has the advance / retreat drive mechanism 6 provided with the bellows 62 as in the above-described embodiment, whereby the entire apparatus can be reduced in size and the structure can be simplified.
  • the piping 63 which sends compressed air to the bottom face part of the bellows 62 is connected, the advancing / retreating drive mechanism 6 may use what used the wire etc. which can push the piping 63.
  • the bellows 62 is expanded by the fluid pressure supplied from the fluid pressure supply source 61 to press the advance / retreat member 4, and the advance / retreat member 4 is returned to the original by the spring force of the bellows 62.
  • the advance / retreat drive mechanism 6 is not limited to this.
  • the advancing / retreating drive mechanism 6 may have any function as long as it can perform a reciprocating motion that moves the advancing / retreating member 4 forward and backwards to the distal end side, and may have another configuration.
  • the advancing / retracting drive mechanism 6 may be, for example, a rod-shaped member that is advanced and retracted by a motor gear mechanism, a rack of a rack and pinion mechanism, a reciprocating slider link mechanism, or the like.
  • the bellows 62 has been described by taking a metal one as an example, but may be made of a resin.
  • connection parts 4a and 62a can be connected and isolate
  • the connecting portions 4a and 62a and the screw portions 5c and 71b may be provided with a locking portion on one side and an engaging portion detachably attached to the locking portion on the other side.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Ophthalmology & Optometry (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)
  • Surgical Instruments (AREA)

Abstract

La présente invention vise à proposer une pince, qui est compacte et peut être facilement lavée et stérilisée. Cette pince (A) comprend : un premier élément de pince (1) et un second élément de pince (2) ayant des parties tenaille (1a, 2a) sur le côté d'extrémité distale, et ayant des parties liaison (1b, 2b) sur le côté d'extrémité de base ; un pivot (53) situé entre le côté d'extrémité distale et le côté d'extrémité de base du premier élément de pince (1) et du second élément de pince (2) pour faire pivoter le premier élément de pince (1) et le second élément de pince (2) ; un élément d'avancement/rétraction (4) pour faire avancer ou rétracter le premier élément de pince (1) et un second élément de pince (2), et actionner ainsi leur ouverture ou fermeture ; et un mécanisme d'actionnement d'avancement/rétraction (6) pour faire avancer ou rétracter l'élément d'avancement/rétraction (4). La pince (A) comprend également un boîtier (5) ayant des éléments de support (5b, 5b) pour soutenir le pivot (53), et un élément de tige côté extrémité de base (71) installé amovible sur le côté d'extrémité de base du boîtier (5) pour soutenir le côté d'extrémité de base du mécanisme d'actionnement d'avancement/rétraction (6).
PCT/JP2013/059766 2013-03-29 2013-03-29 Pince WO2014155743A1 (fr)

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Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102015204486A1 (de) * 2015-03-12 2016-09-15 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Chirurgisches Instrument
DE102015212358A1 (de) * 2015-07-01 2017-01-05 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Zweiteiliges Instrument mit Schnellkupplung
CN108078609A (zh) * 2016-11-21 2018-05-29 张小彤 用于盲肠手术的夹持装置
JP2018102823A (ja) * 2016-12-28 2018-07-05 川崎重工業株式会社 ロボット鉗子
WO2018197935A1 (fr) * 2017-04-28 2018-11-01 Saxena Kuldeep Kuldeep Système automatisé d'écartement de pince
WO2020052345A1 (fr) * 2018-09-11 2020-03-19 南微医学科技股份有限公司 Pince à tissu pour tube digestif
CN111096774A (zh) * 2020-02-25 2020-05-05 杨锐 一种微创外科组织夹钳
WO2022250002A1 (fr) * 2021-05-25 2022-12-01 清明 本間 Instrument de traitement endoscopique
WO2023186807A3 (fr) * 2022-04-01 2023-11-09 Tuebingen Scientific Medical Gmbh Dispositif d'entraînement pneumatique pour mouvement de translation et/ou de rotation

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JPH05208014A (ja) * 1991-04-10 1993-08-20 Olympus Optical Co Ltd 処置具
JPH06343643A (ja) * 1993-06-08 1994-12-20 Olympus Optical Co Ltd 処置具
JP2005261734A (ja) * 2004-03-19 2005-09-29 Olympus Corp 内視鏡用処置具及び内視鏡処置システム
US20080276746A1 (en) * 2007-05-11 2008-11-13 Deutsches Zentrum Fuer Luft- Und Raumfahrt E.V. Surgical robotic system
JP2009195351A (ja) * 2008-02-20 2009-09-03 Hoya Corp 内視鏡用鉗子
JP2010069302A (ja) * 2008-09-16 2010-04-02 Tyco Healthcare Group Lp 外科手術用器具を関節運動させる際に流体を満たした可撓性の管を使用して力を伝達する方法

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Publication number Priority date Publication date Assignee Title
JPH05208014A (ja) * 1991-04-10 1993-08-20 Olympus Optical Co Ltd 処置具
JPH06343643A (ja) * 1993-06-08 1994-12-20 Olympus Optical Co Ltd 処置具
JP2005261734A (ja) * 2004-03-19 2005-09-29 Olympus Corp 内視鏡用処置具及び内視鏡処置システム
US20080276746A1 (en) * 2007-05-11 2008-11-13 Deutsches Zentrum Fuer Luft- Und Raumfahrt E.V. Surgical robotic system
JP2009195351A (ja) * 2008-02-20 2009-09-03 Hoya Corp 内視鏡用鉗子
JP2010069302A (ja) * 2008-09-16 2010-04-02 Tyco Healthcare Group Lp 外科手術用器具を関節運動させる際に流体を満たした可撓性の管を使用して力を伝達する方法

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102015204486B4 (de) 2015-03-12 2022-08-04 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Chirurgisches Instrument
DE102015204486A1 (de) * 2015-03-12 2016-09-15 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Chirurgisches Instrument
DE102015212358A1 (de) * 2015-07-01 2017-01-05 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Zweiteiliges Instrument mit Schnellkupplung
CN108078609A (zh) * 2016-11-21 2018-05-29 张小彤 用于盲肠手术的夹持装置
JP2018102823A (ja) * 2016-12-28 2018-07-05 川崎重工業株式会社 ロボット鉗子
WO2018123755A1 (fr) * 2016-12-28 2018-07-05 川崎重工業株式会社 Pince de robot
WO2018197935A1 (fr) * 2017-04-28 2018-11-01 Saxena Kuldeep Kuldeep Système automatisé d'écartement de pince
ES2689340R1 (es) * 2017-04-28 2019-02-07 Kuldeep Saxena Sistema de expansion de forceps automatizado
WO2020052345A1 (fr) * 2018-09-11 2020-03-19 南微医学科技股份有限公司 Pince à tissu pour tube digestif
CN111096774A (zh) * 2020-02-25 2020-05-05 杨锐 一种微创外科组织夹钳
WO2022250002A1 (fr) * 2021-05-25 2022-12-01 清明 本間 Instrument de traitement endoscopique
JP7492085B2 (ja) 2021-05-25 2024-05-28 清明 本間 内視鏡用処置具
WO2023186807A3 (fr) * 2022-04-01 2023-11-09 Tuebingen Scientific Medical Gmbh Dispositif d'entraînement pneumatique pour mouvement de translation et/ou de rotation

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