WO2017119080A1 - Instrument de traitement endoscopique - Google Patents

Instrument de traitement endoscopique Download PDF

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Publication number
WO2017119080A1
WO2017119080A1 PCT/JP2016/050248 JP2016050248W WO2017119080A1 WO 2017119080 A1 WO2017119080 A1 WO 2017119080A1 JP 2016050248 W JP2016050248 W JP 2016050248W WO 2017119080 A1 WO2017119080 A1 WO 2017119080A1
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WO
WIPO (PCT)
Prior art keywords
operation wire
treatment
operation unit
main body
axis
Prior art date
Application number
PCT/JP2016/050248
Other languages
English (en)
Japanese (ja)
Inventor
和毅 炭山
恒哉 西村
創紀 滝野
Original Assignee
マルホ発條工業株式会社
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 マルホ発條工業株式会社 filed Critical マルホ発條工業株式会社
Priority to PCT/JP2016/050248 priority Critical patent/WO2017119080A1/fr
Publication of WO2017119080A1 publication Critical patent/WO2017119080A1/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

Definitions

  • the present invention relates to an endoscope treatment tool used for endoscopic surgery.
  • the endoscope treatment tool is connected to a distal treatment section (for example, forceps) having a treatment member for treating living tissue, an operation section operated by an operator, a distal treatment section, and an operation section.
  • a distal treatment section for example, forceps
  • the treatment instrument of this document includes a forceps having a pair of forceps pieces, an operation portion operated to rotate and open and close the pair of forceps pieces, and an operation wire connected to the forceps and the operation portion.
  • the operation unit includes a rotation operation ring. When the operator rotates the rotary operation ring, the operation wire is rotated around its axis integrally with the rotary operation ring. As a result, the pair of forceps pieces are rotated.
  • an operation grip and an operation handle are provided at the base end of the operation unit.
  • the operation grip and the operation handle are configured like a scissor grip.
  • finger holes are formed in each of the operation grip and the operation handle, and the operation handle is provided so as to be swingable with respect to the operation grip.
  • the operator passes a finger through each finger hole to grasp the operation grip and the operation handle, and when these are operated, the operation wire is moved forward and backward. As a result, the pair of forceps pieces are opened and closed.
  • the operability with one hand is poor in the arrangement of the rotating member, the operation grip and the operation handle in this document.
  • the rotary operation ring cannot be operated.
  • the conventional endoscope treatment tools including Patent Document 1 can cause the treatment member to perform both the treatment operation and the rotation by the operation of the operation unit. There wasn't.
  • the present invention has been made in view of the above circumstances, and an object of the present invention is to provide an endoscopic treatment tool having excellent operability with one hand of an operation unit.
  • the present invention provides a distal treatment section having a treatment member for treating living tissue; An operation unit operated by an operator; An operation wire connected to the distal treatment section and the operation section, The treatment member is operated to treat a living tissue when the operation wire is moved forward and backward by the operation unit, and is rotated when the operation wire is rotated around its axis by the operation unit.
  • the operation unit is An operating portion main body having a distal end, a proximal end, and a side surface extending between the distal end and the proximal end, the proximal end side of the side surface being configured as a gripping portion gripped by an operator;
  • a swing lever provided swingably on the side surface of the operation unit main body so as to approach and separate from the gripping unit;
  • a rotation member that is rotatably provided on the side surface of the operation unit main body and that can be operated from the side opposite to the side on which the swing lever is provided;
  • a transmission mechanism that moves the operation wire forward and backward when the rocking lever is swung, and rotates the operation wire around its axis when the rotating member is rotated. It is characterized by that.
  • the rotating member is A circumferential side around the axis of rotation; A plurality of recesses formed on the circumferential side surface at equiangular intervals around the rotation axis,
  • the operation unit is A protrusion that fits detachably in the recess; A positioning spring that biases the protrusion toward the circumferential side surface.
  • a through hole is formed in the rotating member so as to extend along the rotation axis of the rotating member;
  • the operation wire is inserted into the through hole so as to be in a straight line with the rotation axis,
  • the transmission mechanism is A rotation transmitting member disposed in the through hole so as to be movable along the through hole and rotating together with the rotating member, and attached to the operation wire;
  • a sliding member that is slidably provided on the operation unit main body so as to rotatably receive the operation wire about its axis and to move the operation wire forward and backward;
  • a connecting member that is connected to the swing lever and the sliding member, and interlocks the swing of the swing lever and the sliding of the sliding member;
  • the transmission mechanism is A return spring that biases the swing lever away from the gripping portion;
  • the operator can operate the rotating member with the hand holding the grip portion and the swing lever. Therefore, for the treatment operation and rotation of the treatment member, it is not necessary to change the way of holding the operation part once by removing the hand from the operation part and it is not necessary to use both hands.
  • FIG. 1 It is a figure which shows schematic structure of the treatment tool for endoscopes which concerns on one Embodiment of this invention. It is a perspective view which shows the forceps of an example of a front-end
  • an embodiment of an endoscope treatment tool (hereinafter simply referred to as a treatment tool) according to the present invention will be described with reference to the accompanying drawings.
  • the treatment instrument includes a distal treatment section 1 having a treatment member 2 for treating a living tissue, and an operation section 3 operated by an operator for the operation of the distal treatment section 1.
  • the treatment instrument further includes an operation wire 4 connected to the distal treatment section 1 and the operation section 3 and a sheath 5 connected to the distal treatment section 1 and the operation section 3.
  • the operation wire 4 has flexibility.
  • the operation wire 4 is inserted into the sheath 5 so as to be movable forward and backward and rotatable about its axis.
  • the operation wire 4 transmits the operation of the operation unit 3 to the distal treatment unit 1.
  • the operation wire 4 is moved back and forth with respect to the sheath 5 by the operation unit 3 and rotated around its axis.
  • the sheath 5 is also flexible.
  • the sheath 5 has a tube shape.
  • the treatment member 2 operates when the operation wire 4 is moved forward and backward by the operation unit 3 to treat the living tissue. Further, the treatment member 2 is rotated when the operation wire 4 is rotated around its axis by the operation unit 3.
  • the distal treatment section is, for example, a forceps 1 having a pair of forceps pieces 2 as operation members in FIG. 2C and 2D show a connection structure between the forceps 1, the operation wire 4 and the sheath 5, and one forceps piece 2 is omitted.
  • the forceps 1 is a base 6 attached to the distal end of the sheath 5 so as to be rotatable around the axis of the operation wire 4, and a support inserted into the base 6 so as to be able to move forward and backward and rotatable around the axis of the operation wire 4 together with the base 6 And a member 7.
  • the distal end of the operation wire 4 is connected to the support member 7.
  • the pair of forceps pieces 2 is connected to the support member 7 via the support shaft 8 at the base end, and opens and closes around the support shaft 8.
  • the pin 9 is supported by the base 6 and is inserted into a long hole 10 formed in the pair of forceps pieces 2.
  • the pair of forceps 2 When the operation wire 4 is rotated around the axis with respect to the sheath 5, the pair of forceps 2 is also rotated around the axis of the operation wire 4.
  • the pair of forceps pieces 2 When the operation wire 4 is retracted with respect to the sheath 5, the pair of forceps pieces 2 are closed (FIGS. 2B and 2D).
  • the pair of forceps pieces 2 opens (FIGS. 2A and 2C).
  • the pair of forceps pieces 2 can operate so as to grasp the living tissue by the forward and backward movement of the operation wire 4.
  • the tip treatment section is, for example, the snare 1 in FIG.
  • the snare 1 includes a loop-shaped snare wire 2 connected to the distal end of the operation wire 4 as a treatment member.
  • the snare wire 2 is also rotated about the axis of the operation wire 4.
  • the snare wire 2 is drawn into the sheath 5 and closed (FIG. 3B).
  • the snare wire 2 is pushed out of the sheath 5 and opened (FIG. 3A). In this way, the snare wire 2 can operate so as to excise the living tissue by the forward and backward movement of the operation wire 4.
  • the snare 1 may be a high frequency snare.
  • the distal treatment section is, for example, the hemostatic clip 1 shown in FIG.
  • the hemostatic clip 1 includes a clip body 2 as a treatment member.
  • An engagement ring 12 is provided on the proximal end side of the clip body 2.
  • the clip body 2 and the engagement ring 12 are integrally formed.
  • the hemostatic clip 1 is provided adjacent to the distal end of the sheath 5 and includes a cylindrical body 13 into which the clip body 2 and the engagement ring 12 are inserted.
  • the distal end of the operation wire 4 is formed as a hook 14 and is engaged with the engagement ring 12.
  • the clip body 2 When the operation wire 4 is rotated with respect to the sheath 5 around its axis, the clip body 2 is also rotated around the axis of the operation wire 4.
  • the clip body 2 When the operation wire 4 is retracted with respect to the sheath 5, the clip body 2 is drawn into the cylinder 13 and closed (FIGS. 4B and 4D).
  • the hook 14 is detached from the engagement ring 12, whereby the clip body 2 is detached from the operation wire 4 and the sheath 5 together with the cylindrical body 13 (FIGS. 4B and 4D). In this way, the clip body 2 can operate to stop hemostasis to the living tissue by the forward and backward movement of the operation wire 4.
  • the distal treatment section 1 is not limited to the examples shown in FIGS.
  • the operation unit 3 includes an operation unit main body 15.
  • the operation unit main body 15 has a distal end 16, a proximal end 17, and a side surface 18 extending between the distal end 16 and the proximal end 17 in the longitudinal direction X.
  • the base end 17 side of the side surface 18 is configured as a grip 19 that is gripped by an operator. Further, the proximal end sides of the operation wire 4 and the sheath 5 are inserted into the operation portion main body 15 along the longitudinal direction X from the distal end 16.
  • the operation unit 3 includes a swing lever 20 that is swingably provided on the side surface 18 of the operation unit main body 15 and a rotating member 21 that is rotatably provided on the side surface 18 of the operation unit main body 15. .
  • the swing lever 20 is operated by the operator for the advance / retreat movement of the operation wire 4, that is, for the treatment operation of the treatment member 2.
  • the rotating member 21 is operated by an operator for rotating the operating wire 4 around its axis, that is, for rotating the treatment member 2.
  • One end of the swing lever 20 is supported via a hinge 22 on the distal end 16 side with respect to the grip portion 19 of the operation portion main body 15. Thereby, the swing lever 20 can swing around an axis extending at right angles to the longitudinal direction X around the one end so as to approach and separate from the grip portion 19.
  • the swing lever 20 has a wave shape on the side opposite to the side facing the grip portion 19.
  • the finger of the operator who operates the swing lever 20 is adapted to fit in the waveform shape, so that the swing lever 20 can be easily gripped.
  • the rotating member 21 is disposed in a notch 23 formed in the side surface 18 and is located closer to the tip 16 side than the grip portion 19.
  • the rotating member 21 has a cylindrical shape, and is arranged so that the rotation axis at the center thereof is parallel to the longitudinal direction X. That is, the rotating member 21 can rotate around the rotation axis extending in the longitudinal direction X. Further, the rotating member 21 is located on the side surface 18 of the operation unit main body 15 on the opposite side (lower side in FIG. 1) to the side (lower side in FIG. 1) (upward side in FIG. 1). That is, the rotating member 21 can be operated from the side opposite to the side where the swing lever 20 is provided. Although the rotating member 21 is disposed in the notch 23, the rotating member 21 partially protrudes from the notch 23, so that the operator's finger can be easily applied to the rotating member 21.
  • the operation unit 3 includes a transmission mechanism 24 that moves the operation wire 4 forward and backward when the swing lever 20 is swung, and rotates the operation wire 4 around its axis when the rotating member 21 is rotated. ing.
  • the operation portion main body 15 is formed with an insertion hole 25 extending in the longitudinal direction X between the tip 16 and the notch 23.
  • the operation wire 4 and the sheath 5 are inserted into the insertion hole 25 from the tip 16 side.
  • the diameter of the insertion hole 25 on the notch 23 side is smaller than the diameter on the tip 16 side.
  • the base end of the sheath 5 is locked to the step generated by the difference in diameter of the insertion hole 25, and only the operation wire 4 is inserted into the notch 23.
  • a through hole 26 extending along the rotation axis C of the rotating member 21 (that is, along the longitudinal direction X) is formed.
  • the operation wire 4 is inserted into the through-hole 26 so as to be aligned with the rotation axis C.
  • the rotation transmission member 27 is disposed in the through hole 26.
  • the cross section of the through hole 26 is substantially rectangular.
  • the cross section of the rotation transmitting member 27 has a substantially rectangular shape corresponding to the cross section of the through hole 26. Therefore, the rotation transmission member 27 is movable along the through hole 26 and rotates around the rotation axis C together with the rotation member 21.
  • the operation wire 4 is inserted through the rotation transmission member 27.
  • the rotation transmission member 27 is attached to the operation wire 4. Therefore, the rotation transmitting member 27 rotates around the rotation axis C integrally with the operation wire 4 and the rotation member 21 and moves in the longitudinal direction X integrally with the operation wire 4. .
  • a sliding member 28 for moving the operation wire 4 forward and backward is provided on the base end 17 side of the operation unit main body 15 so as to be slidable.
  • a slide hole 29 extending in the longitudinal direction X and opening at the base end 17 is formed on the base end 17 side of the operation unit main body 15. The sliding member 28 is inserted into the sliding hole 29 and is slidable in the longitudinal direction X.
  • the operation wire 4 that has passed through the rotating member 21 is inserted into the sliding member 28 while extending in the longitudinal direction X.
  • the support member 30 is disposed in the sliding member 28, and the operation wire 4 is attached to the support member 30. Thereby, when the sliding member 28 is slid along the longitudinal direction X, the operation wire 4 is moved forward and backward.
  • the sliding member 28 receives the operation wire 4 so as to be rotatable around its axis. This is achieved by attaching the operation wire 4 to the support member 30 in the sliding member 28 so as to be rotatable about its axis. Thereby, the rotation of the operation wire 4 by the rotation of the rotating member 21 is ensured.
  • a connecting member 31 is provided for interlocking the swing of the swing lever 20 and the slide of the slide member 28.
  • the connecting member 31 has a substantially square shape.
  • One end of the connecting member 31 is attached to the central portion of the swing lever 20 via a hinge (not shown), and the other end of the connecting member 31 is at the base end of the sliding member 28 protruding from the sliding hole 29. It is attached via a hinge (not shown).
  • a return spring 32 is provided for biasing the swing lever 20 in a direction away from the grip portion 19.
  • An accommodation hole 33 is formed between the notch 23 and the sliding hole 29 of the operation unit main body 15.
  • the return spring 32 is disposed across the accommodation hole 33 and the through hole 26 of the rotating member 21, and urges the rotation transmitting member 27 toward the tip 16, thereby urging the operation wire 4 to advance. is doing.
  • the biasing force of the return spring 32 is transmitted to the swing lever 20 via the sliding member 28 and the connecting member 31, and the swing lever 20 is biased in a direction away from the gripping portion 19 as shown in FIG. .
  • the operator can swing the swing lever 20 close to the grip portion 19 against the urging force of the return spring 32 by grasping the grip portion 19 and the swing lever 20 with one hand.
  • the swing lever 20 is swung in this way, as shown in FIG. 6, the sliding member 28 is slid by the connecting member 31 in conjunction with the swing of the swing lever 20, and the operation wire 4 and It is retracted together with the rotation transmitting member 27.
  • the operation wire 4 is moved back and forth, and thereby the treatment member 2 is operated so as to treat the living tissue.
  • the rotation transmitting member 27 moves along the through hole 26 as the swing lever 20 swings, but does not come out of the through hole 26. That is, the rotation transmitting member 27 is always located in the through hole 26 regardless of the position of the swing lever 20 and rotates together with the rotating member 21. Therefore, both the rotation of the treatment member 2 by the operation of the rotation member 21 and the treatment operation of the treatment member 2 by the swing lever 20 are always guaranteed.
  • the operator places the palm on the gripping part 19 and places at least one of the index finger, middle finger, ring finger, and little finger on the swing lever 20.
  • the grip portion 19 and the swing lever 20 can be gripped.
  • the operator can swing the swing lever 20 by grasping them. Further, the operator can place his / her thumb on the rotating member 21 and can rotate the rotating member 21.
  • the treatment operation and rotation of the treatment member 2 it is not necessary to change the way of holding the operation unit 3 by once releasing the hand from the operation unit 3, and it is not necessary to use both hands. That is, the treatment operation and rotation of the treatment member 2 can be simplified with one hand. Further, simultaneous treatment operation and rotation of the treatment member 2 can be easily performed with one hand.
  • the operability with one hand of the operation unit 3 is very high.
  • the swing lever 20 automatically returns from the state shown in FIG. 6 to the state shown in FIG. ing.
  • FIG. 8 is a perspective view partially showing an internal structure of the operation unit main body 15. Illustration of a part of the configuration of the operation wire 4 and the like is omitted.
  • a plurality of concave portions 34 are formed at equal angular intervals (for example, intervals of 20 degrees) around the rotation axis C on the circumferential side surface around the rotation axis C of the rotation member 21. .
  • Each recess 34 extends along the rotation axis C.
  • a positioning member 35 is disposed in the operation unit main body 15 adjacent to the circumferential side surface of the rotating member 21.
  • the positioning member 35 is inserted into a pin 36 provided in the operation unit main body 15 and extending in a direction orthogonal to the rotation axis C, and is rotatable around the pin 36.
  • the protrusion 37 is provided so as to protrude from the positioning member 35 toward the circumferential side surface at a position offset in one direction along the rotation axis C from the pin 36.
  • the protrusion 37 is detachably fitted to the recess 34.
  • a positioning spring 38 for urging the protrusion 37 toward the circumferential side surface is provided in the operation unit main body 15.
  • the positioning spring 38 is offset from the pin 36 along the rotation axis C in the other direction.
  • the positioning member 35 is urged in one direction of rotation around the pin 36 by the positioning spring 38, whereby the protrusion 37 is urged to the circumferential side surface.
  • the protrusion 37 is fitted in the recess 34 in such a state that it is biased by the positioning spring 38 in this way. Thereby, the rotating member 21 is positioned.
  • the protrusion 37 resists the biasing force of the positioning spring 38 and the next adjacent recess 34. Get on the convex part between.
  • the protrusion 37 is fitted into the next concave portion 34 by the urging force of the positioning spring 38, and the state shown in FIG. 8A is obtained.
  • the protrusion 37 is separated from the concave portion 34 against the urging force of the positioning spring 38, and then fitted into the next concave portion 34 by the urging force, so that a click feeling can be given to the operator.
  • the rotating member 21 can be rotated at a predetermined angle and positioned at the rotated position. That is, the treatment member 2 can be accurately rotated at a predetermined angle and held at the rotated position. Thus, accurate rotation of the treatment member 2 is realized.
  • the operability of the operation unit 3 related to the rotation of the treatment member 2 is further improved by the configuration that gives the operator a click feeling.

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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 concerne un instrument de traitement endoscopique comprenant une partie d'actionnement qui est facile à actionner à une main. La partie d'actionnement 3 comprend un corps principal 15 de partie d'actionnement ayant une extrémité distale 16, une extrémité proximale 17 et une surface latérale 18 s'étendant entre l'extrémité distale 16 et l'extrémité proximale 17, le côté de l'extrémité proximale 17 de la surface latérale 18 étant conçu pour servir de partie de préhension 19 qu'un opérateur saisit. La partie d'actionnement 3 comprend en outre : un levier oscillant 20 qui est disposé oscillant sur la surface latérale 18 du corps principal 15 de la partie d'actionnement de façon à se rapprocher et à s'éloigner de la partie de préhension 19 ; un élément tournant 21 qui est disposé rotatif sur la surface latérale 18 du corps principal 15 de la partie d'actionnement et peut être actionné depuis un côté opposé au côté de la surface latérale 18 sur laquelle est disposé le levier oscillant 20 ; et un mécanisme de transmission 24 qui déplace un fil d'actionnement 4 vers l'avant et vers l'arrière lorsque le levier oscillant 20 oscille, et fait tourner le fil d'actionnement 4 autour de son axe lorsque l'élément tournant 21 tourne.
PCT/JP2016/050248 2016-01-06 2016-01-06 Instrument de traitement endoscopique WO2017119080A1 (fr)

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PCT/JP2016/050248 WO2017119080A1 (fr) 2016-01-06 2016-01-06 Instrument de traitement endoscopique

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PCT/JP2016/050248 WO2017119080A1 (fr) 2016-01-06 2016-01-06 Instrument de traitement endoscopique

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114096208A (zh) * 2019-07-08 2022-02-25 奥林巴斯株式会社 内窥镜用处置器具

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08164144A (ja) * 1994-12-15 1996-06-25 Terumo Corp 外科用器具
JP2008086778A (ja) * 2006-10-02 2008-04-17 Tyco Healthcare Group Lp 内視鏡的な外科用クリップアプライヤ
JP2010099460A (ja) * 2008-09-11 2010-05-06 Tyco Healthcare Group Lp 腹腔鏡器具および関連手術方法
JP2011239975A (ja) * 2010-05-19 2011-12-01 Adachi Kogyo:Kk 内視鏡外科手術用鉗子
US20120109186A1 (en) * 2010-10-29 2012-05-03 Parrott David A Articulating laparoscopic surgical instruments
JP2015080556A (ja) * 2013-10-22 2015-04-27 株式会社スズキプレシオン 高機能手術デバイス

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08164144A (ja) * 1994-12-15 1996-06-25 Terumo Corp 外科用器具
JP2008086778A (ja) * 2006-10-02 2008-04-17 Tyco Healthcare Group Lp 内視鏡的な外科用クリップアプライヤ
JP2010099460A (ja) * 2008-09-11 2010-05-06 Tyco Healthcare Group Lp 腹腔鏡器具および関連手術方法
JP2011239975A (ja) * 2010-05-19 2011-12-01 Adachi Kogyo:Kk 内視鏡外科手術用鉗子
US20120109186A1 (en) * 2010-10-29 2012-05-03 Parrott David A Articulating laparoscopic surgical instruments
JP2015080556A (ja) * 2013-10-22 2015-04-27 株式会社スズキプレシオン 高機能手術デバイス

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114096208A (zh) * 2019-07-08 2022-02-25 奥林巴斯株式会社 内窥镜用处置器具

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