WO2020008530A1

WO2020008530A1 - Medical treatment tool

Info

Publication number: WO2020008530A1
Application number: PCT/JP2018/025220
Authority: WO
Inventors: 裕行高山
Original assignee: オリンパス株式会社
Priority date: 2018-07-03
Filing date: 2018-07-03
Publication date: 2020-01-09

Abstract

A medical treatment tool (1) provided with two jaws (2, 3) each having a longitudinal direction and being connected so as to be able to rotate about a rotation axis (A) orthogonal to the longitudinal direction, the jaws (2, 3) being provided with respective gripping surfaces (2a, 3a) caused to mutually approach or retreat in conjunction with rotation about the rotation axis (A), and at least one of the jaws (2, 3) being provided with a reduced-rigidity part (4) in which the flexural rigidity thereof about an axis parallel to the rotation axis (A) is reduced without a change in flexural rigidity about an axis thereof parallel to the longitudinal direction.

Description

Medical treatment tools

The present invention relates to a medical treatment tool.

2. Description of the Related Art There is known a treatment tool including a grip having a pair of jaws that are openably and closably connected (for example, see Patent Literature 1).
This treatment tool has a blade portion on one jaw, and a contact surface made of an elastic body for cutting the tissue between the jaw and the blade portion on the other jaw. By curving the surface, unevenness of the gripping force generated in the longitudinal direction of the blade portion is reduced.

JP-A-2004-180843

The treatment tool disclosed in Patent Literature 1 has a gripping force that is curved in the width direction of the blade portion, that is, in a direction perpendicular to the longitudinal axis of the blade portion, at each position along the longitudinal axis direction of the blade portion. Non-uniformity is suppressed. For this reason, the gripping force is dispersed in the short direction of the blade portion at each position of the blade portion, and it is necessary to supply a larger gripping force than when the contact surface is not formed of an elastic body. As a result, it is necessary to secure a strength capable of withstanding a large gripping force between the pair of jaws, and it is difficult to make the gripping portion longer or smaller in diameter.

An object of the present invention is to provide a medical treatment tool capable of making a grip portion longer and thinner and capable of gripping tissue with a uniform gripping force along a longitudinal direction of a jaw. And

One embodiment of the present invention includes two jaws each having a longitudinal direction and rotatably connected around a rotation axis orthogonal to the longitudinal direction, wherein each of the jaws responds to rotation about the rotation axis. A stiffness that includes gripping surfaces that are approached or separated from each other, and at least one of the jaws reduces bending stiffness about an axis parallel to the rotation axis without changing bending stiffness about an axis parallel to the longitudinal direction. It is a medical treatment tool provided with a lowering portion.

According to this aspect, the tissue is arranged between the gripping surfaces in a state in which the gripping surfaces of the two jaws are separated from each other, and the two jaws are rotated around the rotation axis and brought close to each other, whereby the tissue is gripped between the gripping surfaces. Can be gripped. Since the rigidity reducing portion provided on at least one jaw reduces the bending rigidity of the gripping surface, an uneven gripping force acts in the longitudinal direction of one jaw, and a moment about an axis parallel to the rotation axis is generated. When this occurs, the jaw is bent about an axis parallel to the rotation axis, so that excessive pressure can be prevented from acting on the tissue. Thereby, the tissue can be grasped uniformly along the longitudinal direction of the jaw.

In this case, unlike the conventional method in which the gripping force is dispersed by bending the receiving member about an axis parallel to the longitudinal direction, the gripping surface is bent about an axis parallel to the rotation axis orthogonal to the longitudinal direction. Therefore, dispersion of the gripping force around the axis parallel to the rotation axis is suppressed, and pressure can be efficiently applied to the tissue even with a small gripping force. As a result, it is not necessary to secure the strength of the jaws excessively, and the diameter and length of the jaws can be reduced.

In the above aspect, the rigidity reduction portion may have a slit that penetrates the jaw in a direction parallel to the rotation axis and extends along the longitudinal direction.
With this configuration, when a gripping force acts on the gripping surface, the gripping surface is curved in a direction in which the slit is crushed, so that the gripping force is uniformly distributed. Since the slit penetrates in the direction parallel to the rotation axis, no bending moment acts on the grip surface around the axis parallel to the longitudinal direction, and the grip force is dispersed only by bending around the axis parallel to the rotation axis. be able to.

Further, in the above aspect, a portion sandwiched between the slit and the gripping surface may be made of a member different from other portions of the jaw.
With this configuration, a slit can be easily formed between the two members by fixing the jaws to a member that is swingably connected around the rotation axis.

Further, in the above aspect, a reinforcing portion for increasing bending rigidity around an axis parallel to the longitudinal direction may be provided on an inner surface of the slit on the gripping surface side.
According to this configuration, the bending around the axis parallel to the longitudinal direction of the grip surface can be more effectively suppressed by the reinforcing portion.

Further, in the above aspect, the width of the slit may be larger at the center than at the end in the longitudinal direction,
With this configuration, the gripping surface can be largely bent at the center away from the longitudinal end of the jaw on which the biased gripping force acts, and the gripping force can be uniformly dispersed.

Further, in the above aspect, a distance from the inner surface of the slit on the gripping surface side to the gripping surface may gradually change along the longitudinal direction.
With this configuration, the gripping force can be uniformly distributed.

Further, in the above aspect, a high elastic member made of a material having higher elasticity than a portion sandwiched between the slit and the grip surface may be arranged in the slit.
With this configuration, the displacement of the portion sandwiched between the slit and the gripping surface can be supported by the elastic force of the highly elastic member.

Further, in the above aspect, the rigidity reducing portion may change the section modulus of the jaw along the longitudinal direction by depressing the gripping surface.
With this configuration, the gripping surface can be largely bent at a position apart from the longitudinal end of the jaw on which the biased gripping force acts, and the gripping force can be uniformly dispersed.

According to the present invention, it is possible to lengthen the grip portion and reduce the diameter thereof, and it is possible to grip the tissue with a uniform gripping force along the longitudinal direction of the jaw.

It is a front view showing the tip part of the medical treatment instrument concerning one embodiment of the present invention. FIG. 2 is a front view showing a state where two jaws of the medical treatment tool in FIG. 1 are closed. FIG. 3 is a transverse sectional view showing a BB section of the medical treatment tool in FIG. 2. FIG. 2 is a front view showing a state where a gripping force is generated between two jaws of the medical treatment tool in FIG. 1. FIG. 5 is a transverse sectional view showing a CC section of the medical treatment tool in FIG. 4. FIG. 5 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the state of FIG. 4. It is a reference drawing showing the tip part of the conventional medical treatment instrument with a small gap size between grip surfaces. FIG. 8 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the medical treatment tool in FIG. 7. It is a reference drawing showing the tip part of the conventional medical treatment tool with a large gap size between the grip surfaces. FIG. 10 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the medical treatment tool in FIG. 9. FIG. 9 is a front view showing a first modification example in which the shape of the slit of the medical treatment tool in FIG. 1 is different. It is a front view which shows the 2nd modification from which the shape of the slit of the medical treatment tool of FIG. 1 differs. It is a front view showing the 3rd modification from which the shape of the slit of the medical treatment tool of Drawing 1 differs. It is a front view which shows the 4th modification from which the shape of the slit of the medical treatment tool of FIG. 1 differs. FIG. 15 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the medical treatment tool in FIG. 14. It is a front view which shows the 5th modification from which the shape of the slit of the medical treatment tool of FIG. 1 differs. FIG. 17 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the medical treatment tool in FIG. 16. It is a front view which shows the 6th modification from which the shape of the slit of the medical treatment tool of FIG. 1 differs. It is a front view which shows the 7th modification from which the shape of the slit of the medical treatment tool of FIG. 1 differs. FIG. 18 is a front view showing an eighth modification in which the slit of the medical treatment tool in FIG. 1 is filled with an elastic material. FIG. 15 is a front view showing a ninth modification example having a cover that covers an opening of a slit of the medical treatment tool in FIG. 1. It is a front view which shows the 10th modification which has the cover which covers the opening part of the slit of the medical treatment tool of FIG. FIG. 21 is a front view showing an eleventh modification in which a concave portion is provided on a grip surface instead of the slit of the medical treatment tool in FIG. FIG. 24 is a front view showing a twelfth modified example in which the concave portion of FIG. 23 is filled with a highly rigid material. It is a front view which shows the 13th modification which comprised the member containing the grip surface of the medical treatment tool of FIG. 1 by another member. FIG. 26 is a front view showing a fourteenth modification in which the shape of the slit in FIG. 25 is different. FIG. 26 is a front view showing a fifteenth modification in which the shape of the slit in FIG. 25 is different. FIG. 26 is a front view showing a sixteenth modification in which the shape of the slit in FIG. 25 is different. FIG. 29 is a front view showing a seventeenth modification in which a rib is provided on the inner surface of the slit of FIG. 28. It is a front view which shows the 18th modification which adopted the wiper jaw as the jaw of FIG.

A medical treatment tool 1 according to one embodiment of the present invention will be described below with reference to the drawings.
As shown in FIG. 1, the medical treatment tool 1 according to the present embodiment is a grasping forceps including two

jaws

2 and 3 that are swingably connected around a rotation axis A.

Each of the

jaws

2 and 3 has a longitudinal direction in a direction orthogonal to the rotation axis A as shown in FIG. 2, and has a short direction in a direction parallel to the rotation axis A as shown in FIG. are doing.
The two

jaws

2 and 3 have

gripping surfaces

2a and 3a which are moved toward and away from each other when swung about the rotation axis A. One jaw 2 is provided with a slit (stiffness reducing portion) 4 that penetrates in the short direction and extends in the long direction.

The slit 4 reduces the bending rigidity around the axis parallel to the short direction while maintaining the bending rigidity around the axis parallel to the longitudinal direction of the jaw 2 uniformly along the short direction.
In the example shown in FIGS. 1 and 2, the slit 4 has a constant opening width at a central portion in the longitudinal direction, and has a shape in which the opening width decreases toward both ends in the longitudinal direction. Specifically, the opening width of the slit 4 is reduced toward both ends in the longitudinal direction by the inclined surface 5 provided on the inner surface opposite to the grip surface 2a. In the short direction, as shown in FIG. 3, the slit 4 is formed parallel to the grip surface 2a and has a constant opening width.

The operation of the medical treatment instrument 1 according to the present embodiment configured as described above will be described below.
In the case of the conventional medical treatment tool 100 without the slit 4, as shown in FIG. 7, the grip surfaces 110a, 120a of the pair of

jaws

110, 120 are closed to a position where the grip surfaces 110a, 120a are parallel to each other. When the distance between the gaps 120a is relatively small, when the pair of

jaws

110 and 120 are further closed, the gripping pressure is highest at the longitudinal base ends of the

gripping surfaces

110a and 120a as shown in FIG. Become. This is because the

jaws

110, 120 that come into contact first are bent around an axis parallel to the short axis and escape, thereby suppressing an increase in contact pressure. As the displacement is limited, the gripping pressure increases.

In addition, in the case of the conventional medical treatment tool 200 having no slit 4, as shown in FIG. 9, the gripping surfaces are closed in a state where the gripping

surfaces

210a, 220a of the pair of

jaws

210, 220 are parallel to each other. When the distance between the

gaps

210a and 220a is relatively large, when the pair of

jaws

210 and 220 are further closed, as shown in FIG. 10, the gripping pressure becomes the highest at the longitudinal ends of the

gripping surfaces

210a and 220a. Get higher. This is because even if the

jaws

210 and 220 rotate, the base ends of the

jaws

210 and 220 do not come into contact with each other.

According to the medical treatment tool 1 according to the present embodiment, the provision of the slit 4 reduces the bending stiffness of the jaw 2 on the side where the slit 4 is provided around an axis parallel to the lateral direction. . Thus, as shown in FIGS. 4 and 5, even if the

gripping surfaces

2a and 3a come into contact with each other and the gripping pressure increases, the gripping surface 2a of the jaw 2 is elastically deformed in the direction in which the slit 4 is crushed. As shown in FIG. 6, an extreme increase in the gripping pressure at the base end in the longitudinal direction of the gripping surface 2a is suppressed.

And in this case, since the slit 4 maintains the bending rigidity around the axis parallel to the longitudinal direction of the gripping surface 2a along the short direction constant, the gripping surface 2a rotates around the axis parallel to the longitudinal direction. There is no bending, and the gripping pressure does not need to be dispersed in the short direction. As a result, pressure can be efficiently applied to the tissue even with a small gripping force, and the length of the

jaws

2 and 3 can be increased, and the width and height can be reduced.

In the present embodiment, the slit 4 has a shape in which the opening width gradually decreases toward both ends in the longitudinal direction due to the inclined surface 5 provided on the inner surface opposite to the gripping surface 2a. Instead, as shown in FIG. 11, an inclined surface 5 may be provided on the inner surface on the gripping surface 2a side. Further, as shown in FIGS. 12 and 13, one inner surface of the slit 4 may be constituted by a cylindrical inner surface.

Further, as shown in FIG. 14, a slit 4 having a uniform opening width along the longitudinal direction may be employed. As a result, as shown in FIG. 15, an extreme increase in the gripping pressure at the base end in the longitudinal direction can be reduced.
Further, instead of the slit 4 extending straight in the longitudinal direction, a curved slit 4 may be employed as shown in FIG. As a result, as shown in FIG. 17, an extreme increase in the gripping pressure at the base end in the longitudinal direction can be reduced.

Further, in the above embodiment, the slit 4 is provided in one jaw 2, but the slit 4 may be provided in both

jaws

2 and 3 instead.
Further, in the above-described embodiment, the slit 4 whose both ends in the longitudinal direction are closed is exemplified. However, as shown in FIGS. 18 and 19, the slit 6 whose one end in the longitudinal direction is open is used instead. May be adopted.

When the distance between the

gripping surfaces

2a and 3a is relatively narrow when the

gripping surfaces

2a and 3a are parallel to each other, by opening the base end side of the slit 6 as shown in FIG. In addition, an extreme increase in the gripping pressure generated at the base end can be suppressed.
When the distance between the

gripping surfaces

2a and 3a is relatively small when the

gripping surfaces

2a and 3a are parallel to each other, the distal end side of the slit 6 should be opened as shown in FIG. Thereby, it is possible to suppress an extreme increase in the gripping pressure generated at the tip.

As the rigidity reducing portion, as shown in FIG. 20, the slit 4 provided in each of the above embodiments may be filled with a high elastic member 7 such as rubber having high elasticity. Thereby, it is possible to prevent tissue or the like from entering the slit 4. Further, as shown in FIGS. 21 and 22, a cover 8 may be provided at a position where both ends of the slit 4 are closed.

Further, in the present embodiment, the slit 4 is employed as the stiffness reducing portion. Instead, as shown in FIG. 23, the gripping surface 2a of at least one jaw 2 is positioned at the middle position in the longitudinal direction. The stiffness-reducing portion may be constituted by a concave portion 9 which is deeply recessed gradually toward both ends in the longitudinal direction. Also in this case, the section modulus along the longitudinal direction of the jaw 2 changes, and the bending stiffness around the axis parallel to the rotation axis A decreases as the depression increases, so that the jaw 2 is bent when the tissue is pinched. Thus, an extreme increase in the gripping pressure at the base ends of the

jaws

2 and 3 or the distal ends of the

jaws

2 and 3 can be suppressed.

In this case, as shown in FIG. 24, the concave portion 9 may be filled with a high elastic member 10 having higher rigidity than rubber.
Further, in each of the above embodiments, as shown in FIGS. 25 to 28, a portion disposed between the slit 4 and the grip surface 2a may be formed of a separate member. That is, one jaw 2 includes a jaw base 11 that is swingably connected to the other jaw 3 around the rotation axis A, and a gripping surface member 12 fixed to the jaw base 11 and forming a gripping surface 2a. It may be.

In this case, by providing the concave portion 9 on one of the surfaces of the jaw base 11 and the gripping surface member 12 facing each other, the slits 11 can be easily formed between the

jaws

11 and 12 in a fixed state. Can be formed. The gripping surface member 12 may be made of a material having high rigidity equivalent to that of the jaw base 11.

As shown in FIG. 29, a reinforcing portion 13 such as a rib extending in the short direction may be provided on the inner surface of the slit 4 on the gripping surface 2a side. Thus, even if the gripping surface member 12 is made of a material having low rigidity, the bending of the gripping surface 2a around the longitudinal axis can be suppressed, and the gripping pressure can be prevented from being dispersed.

As shown in FIG. 30, one jaw 2 is supported on the other jaw 3 so as to be rotatable around a rotation axis A, and a jaw base 11 is supported on the tip of the jaw base 11 so as to be swingable. And a slit 15 may be provided in the wiper jaw part 14.
Further, in the above-described embodiment, a single-opening type grasping forceps in which only one jaw 2 swings with respect to the other jaw 3 is exemplified, but instead, the present invention may be applied to a double-opening grasping forceps. . Further, the present invention may be applied to a gripping forceps of another type, for example, a type in which one jaw 2 translates with respect to the other jaw 3 and opens and closes.

ヒータ Further, the

jaws

2 and 3 may be provided with a heater for heating the tissue at the time of cutting, or may be provided with an electrode for cauterizing and sealing the tissue. Further, instead of the heater, an ultrasonic transducer for supplying ultrasonic vibration to the tissue may be arranged.

Reference Signs List 1

medical treatment tool

2, 3

jaw

2a,

3a gripping surface

4, 6, 15 slit (stiffness reduced part)
7,10 High elasticity member 9 Recess (reduced rigidity)
13 Reinforcement A Rotation axis

Claims

Comprising two jaws each having a longitudinal direction and rotatably connected about a rotation axis orthogonal to the longitudinal direction,
Each of the jaws has a gripping surface which is moved toward or away from each other according to rotation about the rotation axis,
A medical treatment tool, wherein at least one of the jaws is provided with a rigidity reducing portion that reduces bending rigidity around an axis parallel to the rotation axis without changing bending rigidity around an axis parallel to the longitudinal direction. .
The medical treatment tool according to claim 1, wherein the rigidity reducing portion has a slit that penetrates the jaw in a direction parallel to the rotation axis and extends along the longitudinal direction.
The medical treatment tool according to claim 2, wherein a portion sandwiched between the slit and the gripping surface is made of a member different from other portions of the jaw.
4. The medical treatment tool according to claim 2, wherein a reinforcing portion that increases bending rigidity around an axis parallel to the longitudinal direction is provided on an inner surface of the slit on the gripping surface side. 5.
The medical treatment tool according to any one of claims 2 to 4, wherein the width of the slit is larger at the center than at the end in the longitudinal direction.
The medical treatment tool according to any one of claims 2 to 5, wherein a distance from the inner surface of the slit on the gripping surface side to the gripping surface gradually changes along the longitudinal direction.
The medical treatment tool according to any one of claims 2 to 6, wherein a high elastic member made of a material having higher elasticity than a portion sandwiched between the slit and the grip surface is disposed in the slit. .
The medical treatment device according to claim 1, wherein the rigidity reducing portion changes the section modulus of the jaw along the longitudinal direction by denting the gripping surface.