WO2019192067A1

WO2019192067A1 - Hand-held surgical instrument and use method therefor

Info

Publication number: WO2019192067A1
Application number: PCT/CN2018/089198
Authority: WO
Inventors: 朱莫恕
Original assignee: 成都五义医疗科技有限公司
Priority date: 2018-04-02
Filing date: 2018-05-31
Publication date: 2019-10-10

Abstract

Disclosed is a surgical instrument, comprising a distal operating head, a proximal grip, and an elongated rod extending therebetween; the grip comprises a front handle, a rear handle, and a grip rotation shaft connecting the front handle to the rear handle, the front handle and the rear handle being rotatable relative to the grip rotation shaft; the front handle comprises a front finger ring; the rear handle comprises a thumb ring; the thumb ring comprises an inner thumb ring curved surface and an outer thumb ring curved surface; a hang arm of the rear handle intersects with the outer thumb ring curved surface at a third transition region, and extends towards a region between the front handle and the rear handle without intersecting with the front handle; the hang arm of the rear handle is not in contact with any part of the front handle in the process of gripping the grip and acting.

Description

Surgical hand-held device and method of use thereof

Technical field

The invention relates to a minimally invasive surgical instrument, in particular to a laparoscopic surgical instrument.

Background technique

Surgical instruments have been around for hundreds of years. During surgery, doctors use different surgical instruments to perform tissue grasping, shearing, separation, coagulation, suture closure, etc. The surgical instruments have matured over hundreds of years. Endoscopic surgery has been clinically carried out for more than 30 years and is progressing rapidly. To put it simply, the endoscopic surgery, that is, the surgeon uses an extended surgical hand-held instrument to enter the patient through a natural cavity or a constructed puncture channel to complete tissue grasping, shearing, separation, coagulation, and suture closure.

Compared with traditional open surgery, the main advantage of laparoscopic surgery is that it can reduce pain and accelerate recovery for patients with small trauma. The operation of laparoscopic surgery is difficult and takes a long time. Usually, laparoscopic surgery takes 1 to 3 hours. Due to the limitations of the surgical space, surgeons often need to operate the device in difficult posture for a long time, which is prone to fatigue and even induces arthritis and periarthritis. Surgical hand-held instruments should be ergonomic and support a variety of gripping techniques to reduce extreme operating posture and reduce fatigue. In addition, in laparoscopic surgery, the surgeon cannot directly touch and sense the patient's tissues and organs, and the precise operation of the laparoscopic surgical instruments is particularly important due to the limitation of the surgical field of view.

When operating the same device, different surgeons, or the same surgeon, may have different methods of holding surgical instruments during different operations or during a specific operation in the same operation. Studies have shown that in laparoscopic surgery, the finger grip method pinch grip (or precision grip method) as shown in Figure 2 and the hand grasping method pam grip shown in Figure 3 (or called strong grip) The force grip is the most commonly used two methods.

Existing surgical hand-held instruments, such as laparoscopic surgical scissors, laparoscopic surgical forceps, laparoscopic surgical grasping forceps, etc., usually use a scissors-type handle, which can support a variety of gripping techniques. However, in the existing surgical hand-held instruments with scissors-type handles, almost all designs neglect the unique effects of the small fingers on the auxiliary balance and the auxiliary force, and the handling performance of such handles needs to be improved.

The invention proposes a novel handle for assisting balance and assisting force application with a small finger and a surgical hand-held instrument using the same. No surgical handpiece according to the present invention has been manufactured or used so far.

Summary of the invention

Accordingly, in order to solve the background problems, in one aspect of the invention, a surgical hand-held instrument is provided, comprising a distal working head, a proximal handle and an elongated stem extending therebetween; the handle comprising a front handle, a rear handle And a handle shaft connected thereto, and the front handle and the rear handle are rotatable relative to the handle shaft; the front handle includes a front finger loop, and the rear handle includes a thumb loop, wherein the thumb The ring includes a thumb inner ring surface and a thumb outer ring surface, and the rear handle cantilever intersects the thumb outer ring surface in the third transition region and extends toward the area between the front handle and the rear handle but does not intersect the front handle During the process of holding the handle and moving, the rear handle cantilever does not contact any position of the front handle.

In an optional technical solution, the position, shape and size of the rear handle cantilever are designed such that when the surgeon controls the handle by hand grasping, the rear handle cantilever can conveniently support the little finger to achieve auxiliary balance. And the function of assisting force.

In an optional technical solution, the position of the rear handle cantilever is in a relationship that the inner curved surface of the thumb defines a inner hole of the thumb circle, and the geometric center point of the inner hole of the thumb circle and the axis of the handle The geometric center point constitutes a third virtual straight line, and the geometric center point of the third transition region forms a fourth virtual straight line with the geometric center point of the handle rotating shaft, and the third virtual straight line and the fourth virtual straight line form an angle B, And 70 ° ≤ B ≤ 130 °.

In another optional technical solution, the thumb outer ring surface is provided with a plurality of second friction bumps along a third virtual straight line direction.

In yet another aspect of the invention, a hand grasping method for a surgical hand held device is as follows:

S1: the surgeon's palm is in close contact with the side of the handle, the thumb of the thumb is pressed against the opposite side of the handle, and the little finger is pressed against the rear handle cantilever to form a closed grip;

S2: the ring finger and the middle finger clamp the front handle and move to rotate the front handle around the handle shaft, and convert the movement of the front handle into the movement of the distal working head by the rod .

S2: the surgeon's ring finger passes through the front finger ring, wherein the finger is attached to the upper side of the outer ring curved surface, the movement causes the front handle to rotate about the handle rotating shaft, and the front portion is the front portion The movement of the handle is converted into the movement of the distal working head for vigorous operation.

In another aspect of the invention, a laparoscopic surgical instrument is provided comprising a distal working head, a proximal handle and an elongated stem extending therebetween; the handle comprising a front handle, a rear handle and a handle pivot coupled thereto And the front handle and the rear handle are rotatable relative to the handle shaft; the front handle includes a front finger loop, the rear handle includes a thumb loop, and the front finger ring includes an inner ring surface and an outer ring surface a first cantilever intersecting the outer ring surface intersecting the first transition region and extending away from the front finger ring, the second cantilever intersecting the outer ring surface at the second transition region and facing away from the front finger The direction of the circle extends, the first cantilever and the second cantilever do not intersect.

An optional technical solution, wherein the first cantilever and the second cantilever are positioned, shaped and dimensioned to facilitate the first cantilever and the second cantilever when the surgeon manipulates the handle by precise gripping Supporting its little finger to achieve the function of auxiliary balance and auxiliary force.

An optional technical solution, the position of the second cantilever is closer to the distal working head relative to the first cantilever, and the relative positions of the first cantilever and the second cantilever are in the following relationship: The geometric center point of the first transition region and the geometric center point of the handle shaft constitute a first virtual straight line, and the geometric center point of the second transition region and the geometric center point of the handle shaft constitute a second virtual straight line. The first virtual straight line and the second virtual straight line form an angle A, and 10° ≤ A ≤ 20°.

In an optional technical solution, the length of the second cantilever is smaller than the first cantilever.

In an optional technical solution, a plurality of first friction bumps are disposed at a position of the front end of the front handle and an edge of the outer ring curved surface facing the rotation axis of the handle.

In yet another aspect of the invention, a method for accurately holding a laparoscopic surgical instrument is as follows:

S1: the surgeon's ring finger passes through the front finger ring, wherein the finger is attached to the upper side of the outer ring curved surface, the little finger is pressed over the second cantilever, the ring finger, the middle finger and the little finger and the front handle Forming three support points between the triangles to control the balance of the handle without the involvement of the thumb;

S2: the thumb of the surgeon passes through the thumb loop, the moving thumb rotates the rear handle about the handle shaft, and the movement of the rear handle is converted into the distal working head by the rod motion.

DRAWINGS

In order to more fully understand the essence of the present invention, a detailed description will be made with reference to the accompanying drawings, in which:

1 is a schematic diagram of a prior art surgical hand-held device;

Figure 2 is a schematic view of the finger holding method shown in Figure 1;

Figure 3 is a schematic view of the hand holding method shown in Figure 2;

Figure 4 is a perspective view of the surgical hand-held instrument of the present invention;

Figure 5 is an enlarged schematic view of the front handle of the surgical hand-held instrument shown in Figure 4;

Figure 6 is an enlarged schematic view of the rear handle of the surgical hand-held instrument shown in Figure 4;

Figure 7 is another schematic view of the front handle and the rear handle shown in Figure 4;

Figure 8 is a schematic view of the operation of the surgical handpiece of the present invention in performing gallbladder surgery;

Figure 9 is a schematic view showing another operation of the surgical handpiece of the present invention for performing gallbladder surgery;

Figure 10 is a schematic view showing the finger holding method of the present invention;

Figure 11 is a schematic view showing the operation of the present invention using a finger grip method;

Figure 12 is a schematic view of the present invention using a hand grasping method;

Figure 13 is a schematic view of the present invention using a hand grasping method;

In all the views, the same reference numerals indicate equivalent parts or parts.

detailed description

Embodiments of the present invention are disclosed herein, but it should be understood that the disclosed embodiments are merely examples of the invention, which may be implemented in various ways. Therefore, the disclosure of the present invention is not to be construed as limiting, but as a basis

Referring to Figures 1-3, for convenience of description, one of the parties that is close to the operator is defined as the near end, and the party that is far from the operator is defined as the far end.

As shown in Figures 1-3, in conjunction with the foregoing background, when performing a surgical procedure, particularly during laparoscopic surgery, when a cannula assembly (not shown) is inserted into place, various minimally invasive surgical instruments, such as surgical hand instruments, 10 can be inserted into the body cavity through the channel formed by the cannula assembly. One or more cannula assemblies may need to be used simultaneously during the procedure, and the surgical handpiece 10 is also configured to operate simultaneously according to one or more of the surgical procedures. 1 is a prior art surgical handpiece 10 comprising a distal working head 106, a proximal handle 11 and an elongated stem 105 extending therebetween; the handle including a front handle 101 and a rear handle 102 And a handle shaft 103 connected thereto, the front handle 101 and the rear handle 102 are rotatable relative to the handle shaft 103; the front handle 101 includes a front finger loop 110, and the rear handle 102 includes a thumb loop 120, A support arm 112 is disposed at the bottom of the front finger ring 111.

Current laparoscopic surgery usually includes gallbladder surgery, laparoscopic inguinal hernia repair, laparoscopic fundoplication, laparoscopic splenectomy, laparoscopic appendectomy, etc. The overall operation of laparoscopic surgery is difficult. Longer, the surgeon needs 1 to 3 hours of continuous surgery. In order to reduce the surgeon's long-term operation and operate the instrument in a difficult posture, the existing surgical hand-held instruments have a certain degree of ergonomics, can support a variety of gripping methods, and reduce the extreme operating posture and reduce fatigue to a certain extent. The finger grip method shown in Fig. 2 and the hand grip method shown in Fig. 3 are the two most commonly used techniques.

1 and 2 illustrate the state in which the surgeon uses a typical surgical hand-held instrument 10 (also referred to as a laparoscopic surgical instrument) to grasp the organ or grasp the tissue by finger grip: the surgeon's hand The ring finger passes through the front finger ring 111, wherein the finger is attached to the unlock trigger 115 on the upper side of the front finger ring 111, the inner side of the little finger is pressed over the support arm 112; the thumb passes through the thumb circle The 120-moving thumb rotates the rear handle 102 back and forth about the handle shaft 103, and the movement of the rear handle 102 is converted by the rod 105 into the movement of the distal working head 106.

1 and 3 illustrate the state in which the surgeon uses a typical surgical hand-held instrument 10 to grasp the organ or grasp the tissue in a hand-held manner: the palm of one hand of the surgeon is in close contact with the side of the handle 11. The thumb presses the opposite side of the handle 11 to clamp the rear handle 102 in the palm of the hand to form a U-shaped grip, the little finger of which is pressed over the support arm 112 of the front handle 101, and the ring finger passes through the front a finger loop 110, wherein the finger is attached to the unlock trigger 115 position on the upper side of the front finger loop 110, the movement causes the front handle 101 to rotate back and forth around the handle shaft 103, and the stem portion 105 will be rearward The movement of the handle 102 translates into the movement of the distal working head for vigorous operation. During this process, the rear handle 102 is clamped in the palm as a support, during the vigorous operation of the closing process (the front handle 101 is rotated proximally about the distal end of the handle shaft 103), due to the force direction (distal to the proximal direction) and the hand Mastering the opposite direction can achieve better exertion. However, if it is necessary to loosen and close again, the U-shaped grip of the palm is the same as the direction in which the hand is held. In this process, the clamping force of the thumb and the palm must be increased to ensure that the rear handle 102 of the handle 11 is not Displacement or loosening from the palm of the hand, since the entire surgical hand-held instrument 10 is primarily balanced by the clamping force of the thumb and palm, it is clear that this approach tends to cause fatigue throughout the palm. When switching the small force to perform the peeling action, it is necessary to quickly close and loosen the operation at this time. Generally, the little finger does not participate in the force, and the little finger is easy to cause the fatigue of the little finger due to the unsupported position being in the suspended state, thereby affecting the operation and the operation at the same time. The doctor's own finger joints bring damage and even induce arthritis and other risks.

It should be understood by those skilled in the art that in laparoscopic surgery, due to limitations of the surgical space, the surgeon often needs to operate the device in a difficult posture for a long time, the doctor is prone to fatigue, and even induces arthritis, shoulder inflammation and the like. Therefore, ergonomic or ergonomic hand-held instruments called Ergonomics can support a variety of gripping techniques, reducing extreme posture and reducing fatigue, especially important. There have been many published studies on human ergonomics related to laparoscopic surgery: representative studies include a review of the ergonomic issues published in Journal of Healthcare Engineering, Vol. 3, No. 4, pp. 587-603. In the laparoscopic operating rom, the human dysfunction of laparoscopic surgical instruments is detailed, and many other references in the literature also mention the human efficacy defects of laparoscopic instruments and their hazards, but no solution is given. Some of the human ergonomic evaluation measures are listed in the Technical report, new ergonomic design criteria for handles of laparoscopic dissection forceps, published in the Journal of laparoendoscopic & advanceive surgical techniques, 2001. However, the evaluation measures are limited to anthropometrics. Statistically calculated handle length dimensions, finger ring size design recommendations, and a rough way to evaluate the different grip experience of existing handles, however, no design recommendations or hints for functional performance are given.

Ergonomics is a very complex subject. According to the definition of the International Society of Ergonomics (IEA), ergonomics is a study of anatomy, physiology and psychology in a certain working environment. Various factors; the interaction between the researcher and the machine and the environment; the study of how to unify the issues of work efficiency, human health, safety and comfort at work, in family life and on vacation. There are few ergonomic application cases or related research disclosures on laparoscopic hand-held devices in the disclosed patent technology. The invention adopts ergonomic principles and uses experiments and statistics of comprehensive subjects such as anthropometry, biomechanics, time and work research. Research, proposed an ergonomic laparoscopic handheld device and its design method, use method.

4-7 detail the construction and composition of a surgical handpiece 20 (also referred to as a laparoscopic surgical instrument) in accordance with an embodiment of the present invention. A surgical hand tool 20 includes a distal working head 206, a proximal handle 21 and an elongated stem portion 205 extending therebetween; the handle 21 includes a front handle 201, a rear handle 202 and a handle pivot 203 coupled thereto And the front handle and the rear handle are rotatable relative to the handle shaft 203 for closing or loosening.

As shown in Figures 8-9, the surgical hand-held instrument 20 can be divided into a surgical scissors 20b with a scissors head 262 and a grasping forceps 20a with a fine-tooth straight-clamp head 261, depending on the configuration of the working head 206. The peeling pliers 20c of the clamp head 263 and the like. With the development of surgical hand-held devices, in order to meet different surgical needs, more and more different types of working heads 206 have appeared within the scope of the present invention, and are not enumerated here.

In a typical gallbladder surgery, the Galltmann's capsule 51 is formed as the initial part of the gallbladder neck 50 expands, and gallstones remain in the sac. Figure 4-5 shows one of the steps in gallbladder surgery: cholecystography, in order to The cystic duct 55 at the junction of the Hartmann capsule 51 and the gallbladder neck 50 and the gallbladder artery 54 (the gallbladder artery 54 is marked by the cystic duct 55) are completely free, showing a good surgical field, thereby ensuring subsequent safe cutting. The gallbladder artery 54 is prepared, and the gallbladder artery 54 must be first removed. The surgeon can operate one or more of the grasping forceps 20a with a finger grip or a hand grasping method, and the fine-toothed straight-clamp head 261 is closed to strongly pull the Hartmann capsule 51 toward the left side of the patient, and then hold it with fingers. The surgical scissors 20b is opened with a small force at the edge of the junction of the cystic ducts. The peritoneum is opened by the scissors head 262, and is cut away from the left side of the gallbladder triangle to expose the cystic duct 55 and the gallbladder artery 54. Careful, patient and precise operation is required to prevent the scissors head from cutting the cystic duct 55 and the gallbladder artery 54; then, using the finger to hold the stripping forceps 20c of the curved forceps head 263, the cystic duct 55 and the gallbladder artery 54 The circumference is completely free, so that it is convenient to follow the clip on the distal end and the proximal end of the gallbladder artery 55, respectively, and this process requires a large force to pull the Hartmann capsule 51 to the left side of the patient. It should be understood by those skilled in the art that in this process, both a continuous vigorous pulling operation and a precise and mere small force operation are required, and the switching of different instruments and techniques is involved, and the surgeon continues for a long time. During the operation, the fingers and the palms are in a state of intense work. On the one hand, the accuracy of the operation may be reduced, and on the other hand, the surgeon's own finger joints may be damaged, and even the risk of arthritis may be induced.

As shown in Figures 4-5 and 7, the front handle 201 includes a front finger loop 210 and a front handle body 207 extending from the front finger loop 210 toward the handle shaft 203 and defining the front handle 201 to rotate about the handle pivot 203. The front finger ring 210 includes an inner ring curved surface 218 and an outer ring curved surface 219. The shape of the inner curve surface 223 of the thumb is generally approximately circular in order to match the fingers during operation. The front end side of the front handle body 207 is provided with a middle finger curved surface 272 for facilitating the placement of the middle finger, and the middle finger curved surface 272 extends toward the handle rotating shaft 203 and is further provided with an index finger curved surface 273. The first proximal end position 271 of the front handle body 207 and the edge intersecting the outer ring curved surface 219 are disposed with a plurality of first frictional protrusions 215 in the direction of the handle shaft 203. The first frictional protrusion 215 can effectively increase the friction between the finger and the contact thereof. The force, in turn, drives the front handle body 207 to perform a rotational motion.

The front handle 201 further includes a first cantilever 211 and a second cantilever 213. The first cantilever 211 intersects the outer ring curved surface 219 in the first transition region 212 and extends in a direction away from the front finger ring 210, and at the same time, in order to fit the little finger shape, the concave arc is disposed in the distal direction of the opening. Shaped cantilever. The second cantilever 213 intersects the outer ring curved surface 219 in the second transition region 214 and extends in a direction away from the front finger ring 210, and at the same time, in order to cooperate with the little finger shape and different operation methods and force situations, the second cantilever 213 The cantilever 213 is configured as a cantilevered arcuate cantilever that opens toward the proximal direction. The top ends of the first cantilever 211 and the second cantilever 213 are each provided with a circular arc transition. The first cantilever 211 and the second cantilever 213 do not intersect, and the first cantilever 211 extension line direction and the second cantilever 213 extension line direction are the same or larger than the distance between the extension lines. The first cantilever 211 extends substantially in line with the central line of the middle finger curved surface 272 and the index finger curved surface 273, and an extension of the first cantilever 211 and the first proximal end position 271 of the front handle body 207.

An optional technical solution, the position of the second cantilever 213 is closer to the distal working head 206 relative to the first cantilever 211, and the relative positions of the first cantilever 211 and the second cantilever 213 are in accordance with the lower position. The relationship between the geometric center point of the first transition region 212 and the geometric center point of the handle shaft 203 constitutes a first virtual line 1000, the geometric center point of the second transition region 214 and the geometry of the handle shaft 203 The center point constitutes a second virtual straight line 2000, and the first virtual straight line 1000 and the second virtual straight line 2000 form an angle A, and 10° ≤ A ≤ 20°. When the angle A is less than 10 degrees or greater than 20 degrees, the distance between the two is too close or too far, which may affect the normal operation of the first cantilever 211 and the second cantilever 213 of the little finger and the switching of the little finger in both. In order to adapt to the hand shape of different surgeons, the position of the second cantilever 213 is not less than 15 mm with respect to the position of the first cantilever 211. At the same time, it is convenient for the little finger to switch without being blocked. The length of the second cantilever is smaller than the first cantilever. Generally, the length of the second cantilever ranges from 8 mm to 15 mm, and the length of the first cantilever is between 15 and 30 mm. It should be understood by those skilled in the art that the length, position and dimensional relationship between the first cantilever 211 and the second cantilever 213 can be variously combined, but in any case, the basic idea is that the small thumb can be conveniently supported. The function of balance and force is the scope of protection of the present invention. Briefly, its function is to enable the little finger to be supported, to relax the little finger to rest, and to use the little finger to achieve balance with other fingers. And the function of force.

As shown in FIGS. 4 and 6-7, the rear handle 202 includes a thumb loop 220 and a rear handle body 227 that extends from the thumb loop 220 toward the handle pivot 203 and defines a rear handle 202 that rotates about the handle pivot 203. The thumb circle 220 includes a thumb inner ring surface 223 and a thumb outer ring surface 224. The shape of the thumb inner ring surface 223 is generally elliptical in shape to match the thumb during operation, and may also be approximately circular. The loop surface 223 encloses a thumb loop inner bore 226 that defines a thumb loop 220 that accommodates the thumb. The rear handle 202 further includes a rear handle cantilever 221 that intersects the thumb outer ring curved surface 224 at a third transition region 222 and extends toward a region between the front handle 201 and the rear handle 202 but When the front handle 201 is not intersected, and the handle 21 is held and moved, the rear handle cantilever 221 does not have any position with the front handle 201 regardless of the finger grip method and the hand grasping method. contact.

An optional technical solution, the position of the rear handle cantilever 221 is in a relationship that the thumb inner ring curved surface 223 defines a thumb circle inner hole 226, and the geometric center point of the thumb circle inner hole 226 is The geometric center point of the handle shaft 203 constitutes a third virtual line 3000, and the geometric center point of the third transition area 222 and the geometric center point of the handle shaft 203 form a fourth virtual line 4000, the third virtual line 3000 and The fourth virtual straight line 4000 constitutes an angle B, and 70° ≤ B ≤ 130°. In order to conform to ergonomics, when it is less than 70 degrees or greater than 130 degrees, it is not suitable for flexible pressing of the little finger when grasping the method by hand. The rear handle cantilever 221 is mainly applied to the hand grasping method. When the surgeon's palm is in close contact with the side of the handle 21, the thumb presses the opposite side of the handle 21 to clamp the rear handle 102 in the palm of the hand. A U-shaped clamping, at which point the little finger can be pressed against the rear handle cantilever 221 to form a closed grip. When the tissue or organ needs to be vigorously pulled, the rear handle 202 can be more firmly clamped on the one hand. The fixed end maintains the balance of the entire handle 21, and the other aspect can prevent the handle 21 from being loosened or slid out from the proximal end to the distal end of the palm, effectively reducing the force of the palm grip and assisting the fixation. When less force is required to pull the tissue or organ, when the handle 21 is released, the little finger can form a closed grip together with the palm to assist the fixation. When the force is closed, the little finger can relax the little finger by the rear handle cantilever 221 To make it rest.

In another optional technical solution, the thumb outer ring surface 224 is provided with a plurality of second friction bumps 225 along the third virtual straight line 3000, and the second friction bumps 225 can be effectively increased when the hand grasping method is adopted. The friction between the palm and the palm of the hand ensures that the rear handle 202 is more firmly held in the palm of the hand, preventing slipping or even slipping out of the palm.

As shown in Figures 10-11 in conjunction with Figure 4, in order to alleviate finger fatigue and provide operational precision during long-term operation by the surgeon, the present invention is based on a new finger grip method for laparoscopic surgical instruments. The first cantilever 211 and the second cantilever 213 are positioned, shaped and dimensioned such that when the surgeon manipulates the handle 21 by finger holding, the first cantilever 211 and the second cantilever 213 can conveniently support the handle The little finger reaches the function of auxiliary balance and auxiliary force. For ease of discussion, in conjunction with Figures 8 and 9, a typical gallbladder surgery is exemplified in which there is a large amount of peeling or separation and clipping operations, such as the peritoneum around the gallbladder artery 54 and the cystic duct 55. The cutting operation and the separation of the two are performed, and the peeling operation is performed. In the process of performing the peeling or separation of the cystic duct 55 and the cutting of the peritoneum 52, the specific operation is as follows when a small force is used in conjunction with the finger grip method:

S1: the surgeon's ring finger passes through the front finger ring 210, wherein the finger is attached to the middle finger curved surface 272 on the upper side of the outer ring curved surface 219, and the little finger is pressed on the second cantilever 213. The ring finger, the middle finger and the little finger form a triangular support point with the force point 1 of the front handle, thereby controlling the balance of the handle 21 without the participation of the thumb;

S2: the thumb of the surgeon passes through the thumb loop 220, the thumb is rotated to rotate the rear handle 202 around the handle shaft 203, and the movement of the rear handle 202 is converted into the far side by the rod 205 The movement of the end working head 206.

In this process, it is necessary to perform the closing and opening operations for a long time to realize the separation and peeling operation of the tissue. The front handle 201 forms a triangular shape between the middle finger and the little finger and the force point 1 of the front handle due to the ring finger. The support points make the front handle 201 as a fixed end more balanced and stable. The little finger serves to assist the ring finger and the middle finger to balance the front handle 201. At the same time, since the little finger and the ring finger and the middle finger work together, the clamping force of the ring finger and the middle finger on the front finger ring 210 can be effectively reduced, and the ring finger and the middle finger can be relaxed. The role. In addition, since the little finger is pressed against the second cantilever 213 during the operation of the small force, the little finger itself also plays a relaxing and relaxing effect without prolonged lifting or bending (in the case of orchids), avoiding excessive fatigue of the little finger.

As shown in FIG. 12-13 in conjunction with FIG. 4, in order to reduce the surgeon's long-term vigorous operation and different situations, and to reduce the difficulty of the operation, the present invention also proposes a new hand grasping method for the laparoscopic surgical instrument. The position, shape and size of the rear handle cantilever 221 are designed such that when the surgeon manipulates the handle 21 by hand grasping, the rear handle cantilever 221 can conveniently support the little finger to achieve auxiliary balance and auxiliary force application. Features. For convenience of discussion, as shown in FIG. 8 and FIG. 9, a typical gallbladder operation is also taken as an example. In order to obtain a good surgical field and to perform peeling or separation, it is necessary to carry out stretching at different positions for a long time. The operation, for example, the cutting operation of the peritoneum around the gallbladder artery 54 and the cystic duct 55 and the separation of the two, and the peeling operation, it is necessary to use a plurality of grasping pliers 20a to pull the Hartmann capsule 51 to facilitate the peeling operation. In the process of implementing the pulling operation, when using the hand to grasp the holding method, the specific operations are as follows:

As shown in FIG. 13, when a small force pulling operation is required or a quick closing and opening peeling operation is required, the surgeon's palm is in close contact with the side of the handle 21, and the thumb is pressed against the opposite side of the handle 21, the little finger Pressed on the rear handle cantilever 221, the middle finger fits over the first proximal end position 271 of the front handle body 207, the ring finger and the middle finger clamp the front handle 201 and move to surround the front handle 201 The handle shaft 203 rotates back and forth, and the movement of the front handle 201 is converted by the rod 206 into the movement of the distal working head 206.

During this process, the surgeon's palm is in close contact with the side of the handle 21, and the thumb presses the opposite side of the handle 21 to clamp the rear handle 102 in the palm, and the little finger presses the rear handle cantilever 221 to form a closed grip. The state ensures that the rear handle 202 as the fixed end is in a firm equilibrium state when the force is closed or the handle 21 is opened. At this time, the rear handle arm 221 functions to assist balance and limit the sliding of the handle 102. In this method, since the rear handle 202 plays a stable supporting role, the middle finger clamps the front handle 201 together with the ring finger, and the front handle 201 can be quickly rotated back and forth around the handle rotating shaft 203 by using a rapid ejection mode. The working head 206 is quickly closed or opened. At the same time, since the middle finger is in contact with a plurality of first friction bumps 215 disposed along the edge of the outer ring surface 219 facing the handle shaft 203, the first friction bump 215 can effectively increase the friction between the middle finger and the contact thereof, thereby effectively preventing slippage. The phenomenon, in turn, drives the front handle body 207 to perform a rotational motion. It should be understood by those skilled in the art that if the little finger does not have the support of the rear handle cantilever 221, and the middle finger clamps the front handle 201 together with the ring finger for rapid ejection mode, the little finger will involuntarily follow the ring finger to move. It is necessary to increase the clamping force of the palm to the rear handle 202 to ensure the stability of the handle 21, which will inevitably affect the accuracy of the entire operation, and on the other hand, the fatigue of the little finger.

As shown in FIG. 13, when a large force pulling operation is required, the surgeon's palm is in close contact with the side of the handle 21, the thumb is pressed against the opposite side of the handle 21, and the little finger is pressed against the rear handle cantilever 221 Forming a closed gripping state, the ring finger passes through the front finger ring 210, wherein the middle finger curved surface 272 is attached to the upper side of the outer ring curved surface 219, and the movement causes the front handle 201 to surround the handle rotating shaft 203. Rotation, and the movement of the front handle 201 is converted by the rod 206 into the movement of the distal working head, achieving vigorous operation.

In this method, since the rear handle 202 is in a closed clamping state under the auxiliary force of the rear handle cantilever 221, the balance handle 21 can be stabilized, and the middle finger and the ring finger and the index finger are also used together. Make great efforts.

The above two hand grasping methods are performed on the rear handle cantilever 221 by the little finger, so that the rear handle 202 becomes a stable fixed end, and can be vigorously pulled or pulled and opened with a small force according to different needs of the operation. The method of switching such as peeling can effectively improve the accuracy of surgery, reduce the operation time, and reduce the fatigue of the palms and fingers.

Many different embodiments and examples of the invention have been shown and described. One of ordinary skill in the art can make adaptations to the methods and apparatus by appropriate modifications without departing from the scope of the invention. Several corrections have been mentioned, and other modifications are also conceivable to those skilled in the art. Therefore, the scope of the invention should be construed in the appended claims and the claims

Claims

A surgical instrument includes a distal working head, a proximal handle and an elongated stem extending therebetween; the handle includes a front handle, a rear handle and a handle pivot coupled thereto, and the front handle and the rear handle are Rotating movement with respect to the handle shaft; the front handle includes a front finger loop, and the rear handle includes a thumb loop, wherein the thumb loop includes a thumb inner ring surface and a thumb outer ring surface, and the rear handle cantilever The thumb outer ring surface intersects the third transition region and extends toward the area between the front handle and the rear handle but does not intersect the front handle, and during the process of holding the handle and moving, the rear The handle cantilever does not contact any position of the front handle.
The surgical instrument of claim 1 wherein said rear handle cantilever is positioned, contoured and dimensioned to facilitate said rear handle cantilever when the surgeon manipulates said handle by hand grasping Supports its little finger to achieve the function of auxiliary balance and auxiliary force.
The surgical instrument according to claim 1, wherein the position of the rear handle cantilever is in a relationship that the curved inner curve of the thumb defines an inner hole of the thumb circle, and a geometric center point of the inner hole of the thumb circle Forming a third virtual straight line with a geometric center point of the handle shaft, wherein a geometric center point of the third transition region and a geometric center point of the handle shaft constitute a fourth virtual straight line, the third virtual straight line and the fourth virtual line The straight line forms an angle B and 70° ≤ B ≤ 130°.
The surgical instrument according to claim 3, wherein said thumb outer ring surface is provided with a plurality of second friction bumps along a third virtual straight line direction.
A hand grasping method for a surgical instrument according to any of claims 1-3 is as follows:

S1: the surgeon's palm is in close contact with the side of the handle, the thumb of the thumb is pressed against the opposite side of the handle, and the little finger is pressed against the rear handle cantilever to form a closed grip;

S2: the ring finger and the middle finger clamp the front handle and move to rotate the front handle around the handle shaft, and convert the movement of the front handle into the movement of the distal working head by the rod .
A hand grasping method for a surgical instrument according to any of claims 1-3 is as follows:

S1: the surgeon's palm is in close contact with the side of the handle, the thumb of the thumb is pressed against the opposite side of the handle, and the little finger is pressed against the rear handle cantilever to form a closed grip;

S2: the surgeon's ring finger passes through the front finger ring, wherein the finger is attached to the upper side of the outer ring curved surface, the movement causes the front handle to rotate about the handle rotating shaft, and the front portion is the front portion The movement of the handle is converted into the movement of the distal working head for vigorous operation.
A laparoscopic surgical instrument includes a distal working head, a proximal handle and an elongated stem extending therebetween; the handle includes a front handle, a rear handle and a handle pivot coupled thereto, and the front handle and the rear handle Rotating movement relative to the handle shaft; the front handle includes a front finger loop, and the rear handle includes a thumb loop, wherein the front finger ring includes an inner ring surface and an outer ring surface, and the first cantilever The outer ring surface intersects the first transition region and extends toward a direction away from the front finger ring, and the second cantilever intersects the outer ring surface at a second transition region and extends toward a direction away from the front finger ring. The first cantilever and the second cantilever do not intersect.
A laparoscopic surgical instrument according to claim 7 wherein said first cantilever and said second cantilever are positioned, shaped and dimensioned such that when the surgeon manipulates said handle by finger grip, said A cantilever and a second cantilever can conveniently support the little finger to achieve the functions of auxiliary balance and auxiliary force application.
The laparoscopic surgical instrument of claim 8 wherein said second cantilever is positioned closer to said distal working head relative to said first cantilever and said first cantilever and said second cantilever are opposite The position is in accordance with the relationship that the geometric center point of the first transition region and the geometric center point of the handle shaft constitute a first virtual straight line, and the geometric center point of the second transition region and the geometric center of the handle shaft The dots constitute a second virtual straight line, and the first virtual straight line and the second virtual straight line form an angle A, and 10° ≤ A ≤ 20°.
The laparoscopic surgical instrument of claim 9 wherein said second cantilever has a length that is less than said first cantilever.
The endoscopic surgical instrument according to claim 7, wherein a plurality of first frictional bumps are provided at a position of the proximal end of the front handle and an edge of the outer ring curved surface that faces the direction of the shaft of the handle.
A finger gripping method for a laparoscopic surgical instrument according to any of claims 7-11, characterized in that:

S1: the surgeon's ring finger passes through the front finger ring, wherein the finger is attached to the upper side of the outer ring curved surface, the little finger is pressed over the second cantilever, the ring finger, the middle finger and the little finger and the front handle Forming three support points between the triangles to control the balance of the handle without the involvement of the thumb;

S2: the thumb of the surgeon passes through the thumb loop, the moving thumb rotates the rear handle about the handle shaft, and the movement of the rear handle is converted into the distal working head by the rod motion.