WO2019146501A1 - Forceps - Google Patents
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- WO2019146501A1 WO2019146501A1 PCT/JP2019/001331 JP2019001331W WO2019146501A1 WO 2019146501 A1 WO2019146501 A1 WO 2019146501A1 JP 2019001331 W JP2019001331 W JP 2019001331W WO 2019146501 A1 WO2019146501 A1 WO 2019146501A1
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- 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
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- the present invention relates to forceps used in the medical field. Specifically, the present invention relates to forceps for sandwiching the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery in cardiac surgery.
- the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery with forceps.
- the aortic arch is curved to the left and back so as to surround the bifurcation of the pulmonary artery trunk and then descends, and from above the aortic arch, the brachiocephalic artery, left common carotid artery and left clavicle sequentially from the central side
- the lower arteries are bifurcated.
- the present invention has been made in view of the above circumstances, and collectively blocks and blocks three arteries, a brachiocephalic artery branching from the aortic arch, a left common carotid artery, and a left subclavian artery.
- the task is to provide forceps that can
- the present invention is a forceps for collectively sandwiching a brachiocephalic artery branching from an aortic arch, a left common carotid artery and a left subclavian artery, And a first arm and a second arm which are connected to each other via a pivot and rotatable about the pivot.
- the first arm has a first operation portion extending from the pivot portion to one side, and a first holding portion extending to the other side, and the second arm extends from the pivot portion to one side.
- a first holding portion capable of holding the thumb of the operator is formed at an end portion of the first operation portion, and another finger of the operator can be held at an end portion of the second operation portion.
- a second holding portion is formed,
- the first holding portion and the second holding portion are formed with inclined portions that are bent and extended obliquely to the first holding portion side as they extend from the pivot portion toward the tip end side, and In the vicinity of the tip of the inclined portion, a curved portion which protrudes in a direction substantially parallel to the axial direction by the support shaft portion is formed,
- the first holding unit and the second holding unit can be opened and closed by bringing the first holding unit and the second holding unit closer to or away from each other, and the first holding unit and the second holding unit can be operated.
- the brachiocephalic artery, the left common carotid artery and the left subclavian artery can be collectively held in the vicinity of the oppositely curved portions of the head.
- the brachiocephalic artery branching from the aortic arch, the left common carotid artery, and the three arteries of the left subclavian artery can be collectively pinched and blocked, a surgical field can be secured. Can reduce the burden on the operator.
- FIG. 3 It is the perspective view and the elements on larger scale which illustrate one embodiment of the forceps of the present invention.
- A is a front view illustrating an embodiment of a forceps of the present invention
- B is a side view illustrating an embodiment of a forceps of the present invention. It is the photograph which photographed the state which clamped the brachiocephalic artery which branches from the aortic arch, the left common carotid artery, and the left subclavian artery with forceps corresponding to this embodiment using the model near the aortic arch from the upper side. In the state shown in FIG. 3, it is a photograph taken from the side.
- the forceps of the present invention is for collectively sandwiching the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery.
- an embodiment of a forceps of the present invention will be described with reference to the drawings.
- FIG. 1 is a perspective view and a partially enlarged view illustrating an embodiment of a forceps of the present invention.
- FIG. 2 (A) is a front view illustrating one embodiment of a forceps of the present invention
- FIG. 2 (B) is a side view illustrating one embodiment of a forceps of the present invention.
- the forceps 1 includes a support shaft portion 2 and a first arm 3 and a second arm 4 connected to each other via the support shaft portion 2.
- a shaft (not shown) formed near the center of the second arm 4 is inserted into a shaft hole (not shown) formed near the center of the first arm 3.
- the first arm 3 and the second arm 4 are fixed in a freely swingable state about the support shaft portion 2.
- the structure of the support shaft portion 2 is not limited to such a form, and a well-known shaft structure can be adopted as appropriate.
- the first arm 3 has a first operation portion 5 extending from the support shaft portion 2 to one side and a first holding portion 6 extending to the other side.
- the second arm 4 has a second operation portion 7 extending from the support shaft portion 2 to one side and a second holding portion 8 extending to the other side.
- the first arm 3 and the second arm 4 intersect in a substantially X shape in the vicinity of the support shaft portion 2 and can freely rotate and slide around the support shaft portion 2 around the axial direction L.
- the material of the first arm 3 and the second arm 4 is not particularly limited.
- the first arm 3 and the second arm 4 may be alloy steel such as stainless steel, a known resin such as a polyamide resin, a polypropylene resin, a polycarbonate resin, a polycarbonate resin, an ABS resin, a polyethylene terephthalate resin, a polyethylene resin, or these resins Can be exemplified by those containing a reinforcing material such as glass fiber.
- the first arm 3 and the second arm 4 are preferably made of stainless steel.
- a substantially annular first holding portion 51 having a substantially circular opening 51 a is formed at an end portion of the first operation portion 5.
- the operator's thumb is inserted and held in the opening 51 a of the first holding portion 51.
- a substantially annular second holding portion 71 provided with a substantially circular opening 71a is formed at the end of the second operation portion 7.
- the operator's other finger (usually the middle finger or the like) is inserted and held in the opening 71 a of the second holding unit 71. That is, in the forceps 1 of this embodiment, at the time of surgery, the first operation unit 5 including the first holding unit 51 is normally located on the upper side, and the second operation unit 7 including the second holding unit 71 is Used in the lower position.
- the first operation unit 5 and the second operation unit 7 can be operated to approach or separate from each other. As exemplified by the arrows in FIG. 1, by operating the first operation unit 5 and the second operation unit 7 so as to approach each other, the opposing first holding unit 6 and the second holding unit 8 are closed. By sliding so as to move the first operation unit 5 and the second operation unit 7 away from each other, the first holding unit 6 and the second holding unit 8 can be opened (separate from each other) Slide in the direction).
- a ratchet mechanism Y is provided on the end side of the first operation unit 5 and the second operation unit 7.
- the first operation unit 5 is provided with a downward facing sliding contact portion 52 projecting from an opposing surface (side surface) facing the second operating portion 7, and the downward facing sliding contact portion 52 is provided.
- the claw portion 52a is provided.
- the second operation portion 7 is provided with an upper surface sliding contact portion 72 projecting from an opposing surface (side surface) facing the first operation portion 5, and the upper surface sliding contact portion 72 has a projecting direction
- a wavelike stepped portion 72a having a sharp tip is provided.
- the claw portion 52a of the downward sliding contact portion 52 and the wavy step portion 72a of the upward sliding contact portion 72 can slide in the direction of each other in close proximity to each other, and the tip of the claw portion 52a By engaging with a part of the second control unit 7, it is possible to suppress movement of the first operation unit 5 and the second operation unit 7 in a direction away from each other. Therefore, by adjusting the engagement position of the claw portion 52a and the wavelike step portion 72a, the first sandwiching portion 6 and the second sandwiching portion 8 can be fixed in a state of being opened at a desired opening degree.
- the first holding portion 6 and the second holding portion 8 are formed in substantially the same shape. As illustrated in FIG. 2, in the closed state, the first holding unit 6 and the second holding unit 8 extend in a state in which the opposing surfaces are in contact with each other from the support shaft 2 side to the tip end side. In addition, a ridge T extending along the longitudinal direction is formed on the opposite surface of the first holding unit 6 facing the second holding unit 8, and a second holding unit 8 facing the first holding unit 6 is formed.
- the narrow groove M which extends along a longitudinal direction is formed in the opposite surface of. The ridge portion T and the narrow groove M are designed such that the first holding portion 6 and the second holding portion 8 fit with each other in the closed state.
- the artery can be stably held.
- lattice-like irregularities can be appropriately provided to the ridges T and the thin grooves M, whereby the artery can be designed to be held more stably.
- the first holding portion 6 and the second holding portion 8 smoothly curve toward the second holding portion 71 side (lower side in the use state of the forceps 1) as extending from the support shaft portion 2 toward the tip end side. Bulging portions 61 and 81 are formed.
- one end of the bulging portion 61, 81 is connected to the inclined portion 62, 82. That is, from bulging part 61, 81, it bends diagonally to the 1st holding part 51 side (upper side in the use condition of forceps 1) toward the tip side of the 1st clamping part 6 and the 2nd clamping part 8 further.
- the inclined portions 62 and 82 are formed.
- the angle of the inclined portions 62 and 82 can be designed as appropriate, but for example, it is preferable that the angle is inclined by about 15 ° to 60 ° with reference to the positions of the bulging portions 61 and 81.
- curved portions 63 and 83 are formed near the tip of the inclined portions 62 and 82 so as to curve and project in a direction substantially parallel to the axial direction L by the support shaft portion 2.
- the curved portions 63 and 83 are curved in a substantially semicircular shape toward the left side when viewed from the operator holding the forceps 1.
- the radius of curvature and the like of the curved portions 63 and 83 can be appropriately designed in consideration of the shape and the like of the aortic arch.
- FIGS. 3 and 4 One embodiment of a method of using the forceps of the present invention will be described using FIGS. 3 and 4 in addition to FIGS. 1 and 2.
- FIG. 3 shows a state in which the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery are held from above by the forceps 1 corresponding to this embodiment, using a model near the aortic arch It is a photograph.
- FIG. 4 is a photograph taken from the side in the state shown in FIG.
- the first holding portion 51 and the second holding portion 71 can be brought close to each other so that the first holding portion 6 and the second holding portion 8 are in the closed state.
- three arteries consisting of the brachiocephalic artery, the left common carotid artery and the left subclavian artery are collectively held between the opposing curved portions 63 and 83. can do. That is, the aortic arch is curved to the left and back to surround the bifurcated portion of the pulmonary artery trunk, and then has a shape that descends thereafter.
- the forceps 1 of this embodiment includes the first clamping portion 6 and the first clamping portion
- the inclined portions 62 and 82 are formed in the second holding portion 8, and the curved portions 63 and 83 are formed in the vicinity of the tips of the inclined portions 62 and 82. Therefore, the bending portions 63 and 83 of the first holding portion 6 and the second holding portion 8 are disposed along the alignment of the three arteries branching from the aortic arch without deforming the shape of the aortic arch, and the bending portion
- the vicinity of 63, 83 can block all three arteries stably and reliably and collectively. Therefore, since the surgical field is secured, the burden on the operator during surgery can be reduced.
- the anastomotic portion can be brought close to the contralateral blood vessel stump by only one operation, and the blood vessel anastomosis becomes easy. Furthermore, the formation of the bulging portions 61 and 81 in the first holding portion 6 and the second holding portion 8 makes it possible to block the three arteries more reliably.
- the present invention is a forceps 1 for collectively sandwiching the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery.
- a first arm 3 and a second arm 4 which are connected to each other via a pivot 2 and which can slide around the pivot 2 are provided.
- the first arm 3 has a first operation portion 5 extending to one side from the support shaft portion 2 and a first holding portion 6 extending to the other side, and the second arm 4 extends from the support shaft portion 2 to one side It has the extended 2nd operation part 7 and the 2nd holding part 8 extended to the other side.
- a first holding portion 51 capable of holding the thumb of the operator is formed at an end portion of the first operation portion 5, and another finger of the operator can be held at an end portion of the second operation portion 7.
- the second holding portion 71 is formed.
- the first holding portion 6 and the second holding portion 8 are formed with inclined portions 62 and 82 which are bent and extended obliquely toward the first holding portion 51 as they extend from the support shaft portion 2 toward the tip end side. And, in the vicinity of the tip of the inclined portions 62, 82, curved portions 63, 83 projecting in a direction substantially parallel to the axial direction L by the support shaft portion 2 are formed.
- first holding portion 51 and the second holding portion 71 By making the first holding portion 51 and the second holding portion 71 approach or separate from each other, opening and closing operations of the first holding portion 6 and the second holding portion 8 are possible, and the first holding portion 6 and the second holding portion
- the brachiocephalic artery, the left common carotid artery and the left subclavian artery can be collectively held in the vicinity of the eight opposing curved portions 63 and 83.
- the first holding portion 6 and the second holding portion 8 are provided with bulging portions 61 and 81 that are curved and expanded toward the second holding portion 71 on the support shaft portion 2 side, It is preferable that one end of the bulging portion 61, 81 and the inclined portion 62, 82 be connected.
- the forceps of the present invention is not limited to the above embodiments.
Abstract
The forceps (1) have: at a first gripping part and a second gripping part, inclined sections 63, 82 which obliquely curve towards a first holding part 51 while extending from a support shaft part 2 to the distal end side; and, near the distal ends of the inclined parts 63, 82, curved sections 63, 83 which project in a direction substantially parallel to the axial direction L of the support shaft part 2.
Description
本発明は、医療分野で使用されるに鉗子に関する。具体的には、心臓外科手術において、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈を挟むための鉗子に関する。
The present invention relates to forceps used in the medical field. Specifically, the present invention relates to forceps for sandwiching the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery in cardiac surgery.
従来より、手術用の鉗子として、止血、生体組織の把持や採取、切開部分やその周囲の消毒などの目的に応じて種々の形態のものが知られている（例えば、特許文献１など）。また、血管をつかんだり止血したりするための鉗子として、先端がやや湾曲している形状に形成された血管鉗子（ケリー鉗子などと呼ばれる）も広く使用されている。
Conventionally, various forms of forceps for surgery are known according to purposes such as hemostasis, grasping and collection of a living tissue, and disinfection of an incision portion and its surroundings (for example, Patent Document 1). In addition, as a forceps for grasping a blood vessel or for stopping bleeding, a blood vessel forceps (referred to as kelly forceps or the like) formed in a shape with a slightly curved tip is widely used.
一方で、特に微細な外科手術においては、血管をきわめて狭い特定の環境下で挟む必要がたびたび生じる。
On the other hand, particularly in fine surgery, it is often necessary to pinch the blood vessel in a very narrow and specific environment.
具体的には、例えば、心臓外科手術においては、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈を鉗子で挟んで遮断する必要が生じる場合がある。大動脈弓は、肺動脈幹の分岐部を囲むように左方向へ背側に湾曲し、その後下行する形状を有し、大動脈弓上方からは中枢側から順に腕頭動脈、左総頸動脈および左鎖骨下動脈が分岐している。
Specifically, for example, in cardiac surgery, it may be necessary to clamp and block the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery with forceps. The aortic arch is curved to the left and back so as to surround the bifurcation of the pulmonary artery trunk and then descends, and from above the aortic arch, the brachiocephalic artery, left common carotid artery and left clavicle sequentially from the central side The lower arteries are bifurcated.
しかしながら、従来のような血管鉗子を使用する場合、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈の３本の動脈を１つの血管鉗子で挟むことは困難であるため、３本の動脈のそれぞれを別個の血管鉗子で遮断しているのが実際である。この場合、手術野の確保が難しくなり、手術が非常に煩雑になるため、術者の負担が大きいという問題があった。
本発明は、以上のような事情に鑑みてなされたものであり、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈の３本の動脈を一括して挟んで遮断することができる鉗子を提供することを課題としている。 However, when using conventional blood vessel forceps, it is difficult to clamp three arteries of the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery with one blood vessel forceps. In fact, each of the three arteries is blocked by a separate blood vessel. In this case, it is difficult to secure a surgical field and the operation becomes very complicated, which causes a problem that the burden on the operator is large.
The present invention has been made in view of the above circumstances, and collectively blocks and blocks three arteries, a brachiocephalic artery branching from the aortic arch, a left common carotid artery, and a left subclavian artery. The task is to provide forceps that can
本発明は、以上のような事情に鑑みてなされたものであり、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈の３本の動脈を一括して挟んで遮断することができる鉗子を提供することを課題としている。 However, when using conventional blood vessel forceps, it is difficult to clamp three arteries of the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery with one blood vessel forceps. In fact, each of the three arteries is blocked by a separate blood vessel. In this case, it is difficult to secure a surgical field and the operation becomes very complicated, which causes a problem that the burden on the operator is large.
The present invention has been made in view of the above circumstances, and collectively blocks and blocks three arteries, a brachiocephalic artery branching from the aortic arch, a left common carotid artery, and a left subclavian artery. The task is to provide forceps that can
上記の課題を解決するため、本発明は、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈を一括して挟むための鉗子であって、
支軸部を介して互いに連結され、その支軸部の周りを回転摺動自在な第１アームおよび第２アームを備え、
前記第１アームは、前記支軸部から一方側に延びる第１操作部と、他方側に延びる第１挟持部とを有し、前記第２アームは、前記支軸部から一方側に延びる第２操作部と、他方側に延びる第２挟持部とを有し、
前記第１操作部の端部には、術者の親指を保持可能な第１保持部が形成されており、前記第２操作部の端部には、術者の他の指を保持可能な第２保持部が形成されており、
前記第１挟持部および前記第２挟持部には、前記支軸部から先端側に向かって延びるにしたがって前記第１保持部側に斜めに屈曲して延びる傾斜部が形成されており、かつ、前記傾斜部の先端付近には、前記支軸部による軸方向と略平行な方向に向かって突出する湾曲部が形成されており、
前記第１保持部と前記第２保持部とを互いに接近または離間させることで、前記第１挟持部および前記第２挟持部の開閉操作が可能であり、前記第１挟持部および前記第２挟持部の対向する前記湾曲部付近の間に、腕頭動脈、左総頸動脈および左鎖骨下動脈が一括して挟持可能とされていることを特徴としている。 In order to solve the above problems, the present invention is a forceps for collectively sandwiching a brachiocephalic artery branching from an aortic arch, a left common carotid artery and a left subclavian artery,
And a first arm and a second arm which are connected to each other via a pivot and rotatable about the pivot.
The first arm has a first operation portion extending from the pivot portion to one side, and a first holding portion extending to the other side, and the second arm extends from the pivot portion to one side. 2 operation unit and a second holding unit extending to the other side,
A first holding portion capable of holding the thumb of the operator is formed at an end portion of the first operation portion, and another finger of the operator can be held at an end portion of the second operation portion. A second holding portion is formed,
The first holding portion and the second holding portion are formed with inclined portions that are bent and extended obliquely to the first holding portion side as they extend from the pivot portion toward the tip end side, and In the vicinity of the tip of the inclined portion, a curved portion which protrudes in a direction substantially parallel to the axial direction by the support shaft portion is formed,
The first holding unit and the second holding unit can be opened and closed by bringing the first holding unit and the second holding unit closer to or away from each other, and the first holding unit and the second holding unit can be operated. The brachiocephalic artery, the left common carotid artery and the left subclavian artery can be collectively held in the vicinity of the oppositely curved portions of the head.
支軸部を介して互いに連結され、その支軸部の周りを回転摺動自在な第１アームおよび第２アームを備え、
前記第１アームは、前記支軸部から一方側に延びる第１操作部と、他方側に延びる第１挟持部とを有し、前記第２アームは、前記支軸部から一方側に延びる第２操作部と、他方側に延びる第２挟持部とを有し、
前記第１操作部の端部には、術者の親指を保持可能な第１保持部が形成されており、前記第２操作部の端部には、術者の他の指を保持可能な第２保持部が形成されており、
前記第１挟持部および前記第２挟持部には、前記支軸部から先端側に向かって延びるにしたがって前記第１保持部側に斜めに屈曲して延びる傾斜部が形成されており、かつ、前記傾斜部の先端付近には、前記支軸部による軸方向と略平行な方向に向かって突出する湾曲部が形成されており、
前記第１保持部と前記第２保持部とを互いに接近または離間させることで、前記第１挟持部および前記第２挟持部の開閉操作が可能であり、前記第１挟持部および前記第２挟持部の対向する前記湾曲部付近の間に、腕頭動脈、左総頸動脈および左鎖骨下動脈が一括して挟持可能とされていることを特徴としている。 In order to solve the above problems, the present invention is a forceps for collectively sandwiching a brachiocephalic artery branching from an aortic arch, a left common carotid artery and a left subclavian artery,
And a first arm and a second arm which are connected to each other via a pivot and rotatable about the pivot.
The first arm has a first operation portion extending from the pivot portion to one side, and a first holding portion extending to the other side, and the second arm extends from the pivot portion to one side. 2 operation unit and a second holding unit extending to the other side,
A first holding portion capable of holding the thumb of the operator is formed at an end portion of the first operation portion, and another finger of the operator can be held at an end portion of the second operation portion. A second holding portion is formed,
The first holding portion and the second holding portion are formed with inclined portions that are bent and extended obliquely to the first holding portion side as they extend from the pivot portion toward the tip end side, and In the vicinity of the tip of the inclined portion, a curved portion which protrudes in a direction substantially parallel to the axial direction by the support shaft portion is formed,
The first holding unit and the second holding unit can be opened and closed by bringing the first holding unit and the second holding unit closer to or away from each other, and the first holding unit and the second holding unit can be operated. The brachiocephalic artery, the left common carotid artery and the left subclavian artery can be collectively held in the vicinity of the oppositely curved portions of the head.
本発明の鉗子によれば、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈の３本の動脈を一括して挟んで遮断することができるため、手術野を確保することができ、術者の負担を軽減することができる。
According to the forceps of the present invention, since the brachiocephalic artery branching from the aortic arch, the left common carotid artery, and the three arteries of the left subclavian artery can be collectively pinched and blocked, a surgical field can be secured. Can reduce the burden on the operator.
本発明の鉗子は、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈を一括して挟むためのものである。以下、本発明の鉗子の一実施形態について図面とともに説明する。
The forceps of the present invention is for collectively sandwiching the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery. Hereinafter, an embodiment of a forceps of the present invention will be described with reference to the drawings.
図１は、本発明の鉗子の一実施形態を例示した斜視図および部分拡大図である。図２（Ａ）は、本発明の鉗子の一実施形態を例示した正面図であり、図２（Ｂ）は、本発明の鉗子の一実施形態を例示した側面図である。
FIG. 1 is a perspective view and a partially enlarged view illustrating an embodiment of a forceps of the present invention. FIG. 2 (A) is a front view illustrating one embodiment of a forceps of the present invention, and FIG. 2 (B) is a side view illustrating one embodiment of a forceps of the present invention.
鉗子１は、支軸部２と、この支軸部２を介して互いに連結された第１アーム３および第２アーム４を備えている。
The forceps 1 includes a support shaft portion 2 and a first arm 3 and a second arm 4 connected to each other via the support shaft portion 2.
支軸部２は、第１のアーム３の中央付近に形成された軸孔（図示していない）に第２のアーム４の中央付近に形成された軸部（図示していない）が挿入され、第１アーム３および第２アーム４が支軸部２を中心に揺動自在な状態で固定されている。支軸部２の構造は、このような形態に限定されず、周知の軸構造を適宜採用することができる。
In the spindle 2, a shaft (not shown) formed near the center of the second arm 4 is inserted into a shaft hole (not shown) formed near the center of the first arm 3. The first arm 3 and the second arm 4 are fixed in a freely swingable state about the support shaft portion 2. The structure of the support shaft portion 2 is not limited to such a form, and a well-known shaft structure can be adopted as appropriate.
第１アーム３は、支軸部２から一方側に延びる第１操作部５と、他方側に延びる第１挟持部６とを有している。第２アーム４は、支軸部２から一方側に延びる第２操作部７と、他方側に延びる第２挟持部８とを有している。
The first arm 3 has a first operation portion 5 extending from the support shaft portion 2 to one side and a first holding portion 6 extending to the other side. The second arm 4 has a second operation portion 7 extending from the support shaft portion 2 to one side and a second holding portion 8 extending to the other side.
第１アーム３および第２アーム４は、支軸部２付近で略Ｘ字状に交差しているとともに、支軸部２の周りを、軸方向Ｌを中心に回転摺動自在である。
The first arm 3 and the second arm 4 intersect in a substantially X shape in the vicinity of the support shaft portion 2 and can freely rotate and slide around the support shaft portion 2 around the axial direction L.
第１アーム３および第２アーム４の材料は特に限定されない。例えば、第１アーム３および第２アーム４は、ステンレス鋼などの合金鋼や、リアミド樹脂、ポリプロピレン樹脂、ポリカーボネート樹脂、ＡＢＳ樹脂、ポリエチレンテレフタレート樹脂、ポリエチレン樹脂等の公知の樹脂、または、これらの樹脂にガラス繊維等の補強材を含有させたものなどを例示することができる。なかでも、第１アーム３および第２アーム４は、ステンレス鋼で構成されていることが好ましい。
The material of the first arm 3 and the second arm 4 is not particularly limited. For example, the first arm 3 and the second arm 4 may be alloy steel such as stainless steel, a known resin such as a polyamide resin, a polypropylene resin, a polycarbonate resin, a polycarbonate resin, an ABS resin, a polyethylene terephthalate resin, a polyethylene resin, or these resins Can be exemplified by those containing a reinforcing material such as glass fiber. Among them, the first arm 3 and the second arm 4 are preferably made of stainless steel.
第１操作部５の端部には、略円形状の開口部５１aを備えた略円環状の第１保持部５１が形成されている。第１保持部５１の開口部５１aには、術者の親指が挿入されて保持される。また、第２操作部７の端部には、略円形状の開口部７１aを備えた略円環状の第２保持部７１が形成されている。第２保持部７１の開口部７１aには、術者の他の指（通常は中指等）が挿入されて保持される。すなわち、この実施形態の鉗子１は、手術時においては、通常、第１保持部５１を備えた第１操作部５が上側に位置し、第２保持部７１を備えた第２操作部７が下側に位置した状態で使用される。
A substantially annular first holding portion 51 having a substantially circular opening 51 a is formed at an end portion of the first operation portion 5. The operator's thumb is inserted and held in the opening 51 a of the first holding portion 51. Further, at the end of the second operation portion 7, a substantially annular second holding portion 71 provided with a substantially circular opening 71a is formed. The operator's other finger (usually the middle finger or the like) is inserted and held in the opening 71 a of the second holding unit 71. That is, in the forceps 1 of this embodiment, at the time of surgery, the first operation unit 5 including the first holding unit 51 is normally located on the upper side, and the second operation unit 7 including the second holding unit 71 is Used in the lower position.
第１操作部５と第２操作部７は、互いに接近または離間するように操作することができる。図１の矢印に例示したように、第１操作部５と第２操作部７を互いに接近するように操作することで、対向する第１挟持部６と第２挟持部８とが閉鎖状態に近づくように摺動し、第１操作部５と第２操作部７を互いに離間するように操作することで、第１挟持部６と第２挟持部８とが開放されるように（互いに離れる方向に）摺動する。
The first operation unit 5 and the second operation unit 7 can be operated to approach or separate from each other. As exemplified by the arrows in FIG. 1, by operating the first operation unit 5 and the second operation unit 7 so as to approach each other, the opposing first holding unit 6 and the second holding unit 8 are closed. By sliding so as to move the first operation unit 5 and the second operation unit 7 away from each other, the first holding unit 6 and the second holding unit 8 can be opened (separate from each other) Slide in the direction).
また、第１操作部５と第２操作部７とには、端部側にラチェット機構Ｙが設けられている。具体的には、第１操作部５には、第２操作部７と対向する対向面（側面）から突出する下向摺接部５２が設けられており、この下向摺接部５２には、爪部５２aが設けられている。また、第２操作部７には、第１操作部５と対向する対向面（側面）から突出する上向摺接部７２が設けられており、この上向摺接部７２には、突出方向に沿って連続し、先端が鋭角な波状段部７２aが設けられている。下向摺接部５２の爪部５２aと上向摺接部７２の波状段部７２aは、互いに近接対峙した状態で互いの方向に摺動可能であり、爪部５２aの先端を波状段部７２aの一部分に係合させることで、第１操作部５と第２操作部７とが互いに離間する方向へ動くのを抑制することができる。したがって、爪部５２aと波状段部７２aの係合位置を調整することで、第１挟持部６と第２挟持部８とが所望の開度で開放された状態で固定することができる。
Further, a ratchet mechanism Y is provided on the end side of the first operation unit 5 and the second operation unit 7. Specifically, the first operation unit 5 is provided with a downward facing sliding contact portion 52 projecting from an opposing surface (side surface) facing the second operating portion 7, and the downward facing sliding contact portion 52 is provided. , The claw portion 52a is provided. Further, the second operation portion 7 is provided with an upper surface sliding contact portion 72 projecting from an opposing surface (side surface) facing the first operation portion 5, and the upper surface sliding contact portion 72 has a projecting direction A wavelike stepped portion 72a having a sharp tip is provided. The claw portion 52a of the downward sliding contact portion 52 and the wavy step portion 72a of the upward sliding contact portion 72 can slide in the direction of each other in close proximity to each other, and the tip of the claw portion 52a By engaging with a part of the second control unit 7, it is possible to suppress movement of the first operation unit 5 and the second operation unit 7 in a direction away from each other. Therefore, by adjusting the engagement position of the claw portion 52a and the wavelike step portion 72a, the first sandwiching portion 6 and the second sandwiching portion 8 can be fixed in a state of being opened at a desired opening degree.
第１挟持部６および第２挟持部８は、略同形状に形成されている。図２に例示したように、第１挟持部６および第２挟持部８は、閉鎖状態では、支軸部２側から先端側に亘って互いの対向面が当接した状態で延びている。また、第２挟持部８と対向する第１挟持部６の対向面には、長手方向に沿って延びる突条部Ｔが形成されており、第１挟持部６と対向する第２挟持部８の対向面には、長手方向に沿って延びる細溝Ｍが形成されている。突条部Ｔと細溝Ｍは、第１挟持部６と第２挟持部８とが閉鎖状態において互いに嵌合するように設計されている。第１挟持部６と第２挟持部８とが突条部Ｔと細溝Ｍを備えていることで、動脈を安定して挟持することができる。また、突条部Ｔと細溝Ｍには、例えば、格子状の凹凸などを適宜付与することができ、これによって、より安定に動脈が挟持されるように設計することができる。
The first holding portion 6 and the second holding portion 8 are formed in substantially the same shape. As illustrated in FIG. 2, in the closed state, the first holding unit 6 and the second holding unit 8 extend in a state in which the opposing surfaces are in contact with each other from the support shaft 2 side to the tip end side. In addition, a ridge T extending along the longitudinal direction is formed on the opposite surface of the first holding unit 6 facing the second holding unit 8, and a second holding unit 8 facing the first holding unit 6 is formed. The narrow groove M which extends along a longitudinal direction is formed in the opposite surface of. The ridge portion T and the narrow groove M are designed such that the first holding portion 6 and the second holding portion 8 fit with each other in the closed state. Since the first holding portion 6 and the second holding portion 8 are provided with the ridge portion T and the narrow groove M, the artery can be stably held. In addition, for example, lattice-like irregularities can be appropriately provided to the ridges T and the thin grooves M, whereby the artery can be designed to be held more stably.
第１挟持部６および第２挟持部８は、支軸部２から先端側に向かって延びるにしたがって、第２保持部７１側（鉗子１の使用状態における下側）に向かって滑らかに湾曲して膨らむ膨出部６１,８１が形成されている。
The first holding portion 6 and the second holding portion 8 smoothly curve toward the second holding portion 71 side (lower side in the use state of the forceps 1) as extending from the support shaft portion 2 toward the tip end side. Bulging portions 61 and 81 are formed.
また、膨出部６１,８１の一端と傾斜部６２,８２とが接続している。すなわち、膨出部６１,８１からは、さらに第１挟持部６および第２挟持部８の先端側に向かって、第１保持部５１側（鉗子１の使用状態における上側）に斜めに屈曲する傾斜部６２,８２が形成されている。傾斜部６２,８２の角度は適宜設計することができるが、例えば、膨出部６１,８１の位置を基準にして、１５°～６０°程度傾斜していることが好ましい。
Further, one end of the bulging portion 61, 81 is connected to the inclined portion 62, 82. That is, from bulging part 61, 81, it bends diagonally to the 1st holding part 51 side (upper side in the use condition of forceps 1) toward the tip side of the 1st clamping part 6 and the 2nd clamping part 8 further. The inclined portions 62 and 82 are formed. The angle of the inclined portions 62 and 82 can be designed as appropriate, but for example, it is preferable that the angle is inclined by about 15 ° to 60 ° with reference to the positions of the bulging portions 61 and 81.
そして、傾斜部６２,８２は、その先端付近に、支軸部２による軸方向Ｌと略平行な方向に向かって湾曲して突出する湾曲部６３,８３が形成されている。この実施形態の鉗子１では、湾曲部６３,８３は、鉗子１を保持した術者から見て、左側に向かって略半円形状に湾曲している。湾曲部６３,８３の曲率半径などは、大動脈弓の形態等を考慮して適宜設計することができる。
Further, curved portions 63 and 83 are formed near the tip of the inclined portions 62 and 82 so as to curve and project in a direction substantially parallel to the axial direction L by the support shaft portion 2. In the forceps 1 of this embodiment, the curved portions 63 and 83 are curved in a substantially semicircular shape toward the left side when viewed from the operator holding the forceps 1. The radius of curvature and the like of the curved portions 63 and 83 can be appropriately designed in consideration of the shape and the like of the aortic arch.
図１および図２に加え、図３および図４を用いて、本発明の鉗子の使用方法の一実施形態について説明する。
One embodiment of a method of using the forceps of the present invention will be described using FIGS. 3 and 4 in addition to FIGS. 1 and 2.
図３は、大動脈弓付近の模型を用いて、この実施形態に対応する鉗子１によって、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈を挟持した状態を上方から写した写真である。図４は、図３に示した状態において、側方から写した写真である。
FIG. 3 shows a state in which the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery are held from above by the forceps 1 corresponding to this embodiment, using a model near the aortic arch It is a photograph. FIG. 4 is a photograph taken from the side in the state shown in FIG.
この実施形態の鉗子１では、第１保持部５１と第２保持部７１とを互いに接近させることで、第１挟持部６と第２挟持部８が閉鎖状態になるように近づけることができる。これによって、図３、図４に示したように、対向する湾曲部６３,８３同士の間に、腕頭動脈、左総頸動脈および左鎖骨下動脈からなる３本の動脈を一括して挟持することができる。すなわち、大動脈弓は、肺動脈幹の分岐部を囲むように左方向へ背側に湾曲し、その後下行する形状を有しているが、この実施形態の鉗子１は、第１挟持部６および第２挟持部８に傾斜部６２,８２が形成されており、かつ、その傾斜部６２,８２の先端付近に湾曲部６３,８３が形成されている。このため、大動脈弓の形態を変形させることなく、大動脈弓から分岐する３本の動脈の並びに沿って、第１挟持部６および第２挟持部８の湾曲部６３,８３を配置させ、湾曲部６３,８３付近によって３本の動脈を安定かつ確実に挟んで一括して遮断することができる。したがって、手術野が確保されるため、手術における術者の負担を軽減することができる。また、この実施形態の鉗子１によれば、例えば、一つの操作のみで吻合部を対側血管断端と近接させることができるようになり、血管吻合も容易となる。さらに、第１挟持部６および第２挟持部８に膨出部６１,８１が形成されていることで、より確実に３本の動脈を一括して遮断することができる。
In the forceps 1 of this embodiment, the first holding portion 51 and the second holding portion 71 can be brought close to each other so that the first holding portion 6 and the second holding portion 8 are in the closed state. Thereby, as shown in FIG. 3 and FIG. 4, three arteries consisting of the brachiocephalic artery, the left common carotid artery and the left subclavian artery are collectively held between the opposing curved portions 63 and 83. can do. That is, the aortic arch is curved to the left and back to surround the bifurcated portion of the pulmonary artery trunk, and then has a shape that descends thereafter. The forceps 1 of this embodiment includes the first clamping portion 6 and the first clamping portion The inclined portions 62 and 82 are formed in the second holding portion 8, and the curved portions 63 and 83 are formed in the vicinity of the tips of the inclined portions 62 and 82. Therefore, the bending portions 63 and 83 of the first holding portion 6 and the second holding portion 8 are disposed along the alignment of the three arteries branching from the aortic arch without deforming the shape of the aortic arch, and the bending portion The vicinity of 63, 83 can block all three arteries stably and reliably and collectively. Therefore, since the surgical field is secured, the burden on the operator during surgery can be reduced. Moreover, according to the forceps 1 of this embodiment, for example, the anastomotic portion can be brought close to the contralateral blood vessel stump by only one operation, and the blood vessel anastomosis becomes easy. Furthermore, the formation of the bulging portions 61 and 81 in the first holding portion 6 and the second holding portion 8 makes it possible to block the three arteries more reliably.
本発明は、大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈を一括して挟むための鉗子１である。支軸部２を介して互いに連結され、その支軸部２の周りを摺動自在な第１アーム３および第２アーム４を備えている。第１アーム３は、支軸部２から一方側に延びる第１操作部５と、他方側に延びる第１挟持部６とを有し、第２アーム４は、支軸部２から一方側に延びる第２操作部７と、他方側に延びる第２挟持部８とを有している。第１操作部５の端部には、術者の親指を保持可能な第１保持部５１が形成されており、第２操作部７の端部には、術者の他の指を保持可能な第２保持部７１が形成されている。第１挟持部６および第２挟持部８には、支軸部２から先端側に向かって延びるにしたがって第１保持部５１側に斜めに屈曲して延びる傾斜部６２,８２が形成されており、かつ、傾斜部６２,８２の先端付近には、支軸部２による軸方向Ｌと略平行な方向に向かって突出する湾曲部６３,８３が形成されている。第１保持部５１と第２保持部７１とを互いに接近または離間させることで、第１挟持部６および第２挟持部８の開閉操作が可能であり、第１挟持部６および第２挟持部８の対向する湾曲部６３,８３付近の間に、腕頭動脈、左総頸動脈および左鎖骨下動脈が一括して挟持可能とされている。
The present invention is a forceps 1 for collectively sandwiching the brachiocephalic artery branching from the aortic arch, the left common carotid artery and the left subclavian artery. A first arm 3 and a second arm 4 which are connected to each other via a pivot 2 and which can slide around the pivot 2 are provided. The first arm 3 has a first operation portion 5 extending to one side from the support shaft portion 2 and a first holding portion 6 extending to the other side, and the second arm 4 extends from the support shaft portion 2 to one side It has the extended 2nd operation part 7 and the 2nd holding part 8 extended to the other side. A first holding portion 51 capable of holding the thumb of the operator is formed at an end portion of the first operation portion 5, and another finger of the operator can be held at an end portion of the second operation portion 7. The second holding portion 71 is formed. The first holding portion 6 and the second holding portion 8 are formed with inclined portions 62 and 82 which are bent and extended obliquely toward the first holding portion 51 as they extend from the support shaft portion 2 toward the tip end side. And, in the vicinity of the tip of the inclined portions 62, 82, curved portions 63, 83 projecting in a direction substantially parallel to the axial direction L by the support shaft portion 2 are formed. By making the first holding portion 51 and the second holding portion 71 approach or separate from each other, opening and closing operations of the first holding portion 6 and the second holding portion 8 are possible, and the first holding portion 6 and the second holding portion The brachiocephalic artery, the left common carotid artery and the left subclavian artery can be collectively held in the vicinity of the eight opposing curved portions 63 and 83.
この鉗子では、第１挟持部６および第２挟持部８には、支軸部２側に、第２保持部７１側に向かって湾曲して膨らむ膨出部６１,８１が形成されており、この膨出部６１,８１の一端と傾斜部６２,８２とが接続していることが好ましい。
In this forceps, the first holding portion 6 and the second holding portion 8 are provided with bulging portions 61 and 81 that are curved and expanded toward the second holding portion 71 on the support shaft portion 2 side, It is preferable that one end of the bulging portion 61, 81 and the inclined portion 62, 82 be connected.
本発明の鉗子は、以上の実施形態に限定されることはない。
The forceps of the present invention is not limited to the above embodiments.
１ 鉗子
２ 支軸部
３ 第１アーム
４ 第２アーム
５ 第１操作部
５１ 第１保持部
６ 第１挟持部
６１ 膨出部
６２ 傾斜部
６３ 湾曲部
７ 第２操作部
７１ 第２保持部
８ 第２挟持部
８１ 膨出部
８２ 傾斜部
８３ 湾曲部Reference Signs List 1 forceps 2 support shaft portion 3 first arm 4 second arm 5 first operation portion 51 first holding portion 6 first gripping portion 61 bulging portion 62 inclined portion 63 curved portion 7 second operation portion 71 second holding portion 8 Second holding portion 81 Bulging portion 82 Sloped portion 83 Curved portion
２ 支軸部
３ 第１アーム
４ 第２アーム
５ 第１操作部
５１ 第１保持部
６ 第１挟持部
６１ 膨出部
６２ 傾斜部
６３ 湾曲部
７ 第２操作部
７１ 第２保持部
８ 第２挟持部
８１ 膨出部
８２ 傾斜部
８３ 湾曲部
Claims (2)
- 大動脈弓から分岐する腕頭動脈、左総頸動脈および左鎖骨下動脈を一括して挟むための鉗子であって、
支軸部を介して互いに連結され、その支軸部の周りを回転摺動自在な第１アームおよび第２アームを備え、
前記第１アームは、前記支軸部から一方側に延びる第１操作部と、他方側に延びる第１挟持部とを有し、前記第２アームは、前記支軸部から一方側に延びる第２操作部と、他方側に延びる第２挟持部とを有し、
前記第１操作部の端部には、術者の親指を保持可能な第１保持部が形成されており、前記第２操作部の端部には、術者の他の指を保持可能な第２保持部が形成されており、
前記第１挟持部および前記第２挟持部には、前記支軸部から先端側に向かって延びるにしたがって前記第１保持部側に斜めに屈曲して延びる傾斜部が形成されており、かつ、この傾斜部の先端付近には、前記支軸部による軸方向と略平行な方向に向かって突出する湾曲部が形成されており、
前記第１保持部と前記第２保持部とを互いに接近または離間させることで、前記第１挟持部および前記第２挟持部の開閉操作が可能であり、前記第１挟持部および前記第２挟持部の対向する前記湾曲部付近の間に、腕頭動脈、左総頸動脈および左鎖骨下動脈が一括して挟持可能とされていることを特徴とする鉗子。 Forceps for collectively sandwiching the brachiocephalic artery, left common carotid artery and left subclavian artery branching from the aortic arch,
And a first arm and a second arm which are connected to each other via a pivot and rotatable about the pivot.
The first arm has a first operation portion extending from the pivot portion to one side, and a first holding portion extending to the other side, and the second arm extends from the pivot portion to one side. 2 operation unit and a second holding unit extending to the other side,
A first holding portion capable of holding the thumb of the operator is formed at an end portion of the first operation portion, and another finger of the operator can be held at an end portion of the second operation portion. A second holding portion is formed,
The first holding portion and the second holding portion are formed with inclined portions that are bent and extended obliquely to the first holding portion side as they extend from the pivot portion toward the tip end side, and In the vicinity of the tip end of this inclined portion, a curved portion which protrudes in a direction substantially parallel to the axial direction by the support shaft portion is formed,
The first holding unit and the second holding unit can be opened and closed by bringing the first holding unit and the second holding unit closer to or away from each other, and the first holding unit and the second holding unit can be operated. A forceps characterized in that the brachiocephalic artery, the left common carotid artery and the left subclavian artery can be collectively held in the vicinity of the oppositely facing curved parts of the part. - 前記第１挟持部および前記第２挟持部には、前記支軸部側に、前記第２保持部側に向かって湾曲して膨らむ膨出部が形成されており、この膨出部の一端と前記傾斜部とが接続していることを特徴とする請求項１の鉗子。 In the first holding portion and the second holding portion, a bulging portion that curves and bulges toward the second holding portion side is formed on the support shaft portion side, and one end of the bulging portion The insulator according to claim 1, wherein the inclined portion is connected.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2018011288A JP2019126637A (en) | 2018-01-26 | 2018-01-26 | forceps |
| JP2018-011288 | 2018-05-23 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2019146501A1 true WO2019146501A1 (en) | 2019-08-01 |
Family
ID=67395381
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/JP2019/001331 WO2019146501A1 (en) | 2018-01-26 | 2019-01-17 | Forceps |
Country Status (2)
| Country | Link |
|---|---|
| JP (1) | JP2019126637A (en) |
| WO (1) | WO2019146501A1 (en) |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS5151181Y2 (en) * | 1973-11-22 | 1976-12-08 | ||
| JPS5331889U (en) * | 1976-08-24 | 1978-03-18 | ||
| US4226240A (en) * | 1979-05-30 | 1980-10-07 | Walker Jr William E | Surgical foreceps |
| US20080300622A1 (en) * | 2007-05-29 | 2008-12-04 | Lin Xu | Atraumatic Hemostatic Clamp |
-
2018
- 2018-01-26 JP JP2018011288A patent/JP2019126637A/en active Pending
-
2019
- 2019-01-17 WO PCT/JP2019/001331 patent/WO2019146501A1/en active Application Filing
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS5151181Y2 (en) * | 1973-11-22 | 1976-12-08 | ||
| JPS5331889U (en) * | 1976-08-24 | 1978-03-18 | ||
| US4226240A (en) * | 1979-05-30 | 1980-10-07 | Walker Jr William E | Surgical foreceps |
| US20080300622A1 (en) * | 2007-05-29 | 2008-12-04 | Lin Xu | Atraumatic Hemostatic Clamp |
Also Published As
| Publication number | Publication date |
|---|---|
| JP2019126637A (en) | 2019-08-01 |
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