Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
  • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
  • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
  • A61B17/062—Needle manipulators
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/28—Surgical forceps
  • A61B17/29—Forceps for use in minimally invasive surgery
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/28—Surgical forceps
  • A61B17/29—Forceps for use in minimally invasive surgery
  • A61B17/2909—Handles

Definitions

• Patent Document 1 discloses a pliers-type needle holder
• Patent Documents 2 and 3 disclose a scissors-type medical instrument and surgical forceps, respectively.
• the present invention aims to solve the above problems and provide a surgical instrument that makes the clamping portion of the surgical instrument less likely to vibrate, thereby improving operability.
• the surgical instrument of the present invention is a surgical instrument for clamping an object, and is characterized in that it has a main body that extends in one direction, a clamping section that is provided at the tip of the main body and can clamp an object, a contact section that is provided at the base end of the main body, an opening/closing mechanism that opens and closes the clamping section, and a support section that extends in one direction, and the main body and the support section are connected and fixed so that they intersect in a roughly cross shape.
• a surgical instrument for clamping an object comprises a main body extending in one direction, a clamping section provided at the tip of the main body and capable of clamping an object, a contact section provided at the base end of the main body, an opening/closing mechanism for opening and closing the clamping section, and a support section extending in one direction.
• the main body and the support section are connected and fixed so that they intersect in a roughly cross shape.
• the longitudinal direction of the surgical instrument is parallel to or approaches parallel to the longitudinal direction of the forearm of the hand grasping the surgical instrument, and the clamping section is positioned on or approaches an axis extending along the longitudinal direction of the forearm. Therefore, compared to pliers- or scissors-shaped surgical instruments, swinging of the clamping section can be prevented or reduced even when the wrist of the hand grasping the surgical instrument rotates around the axis.
• the opening and closing mechanism has an operating unit that is connected to the main body and rotates about an axis perpendicular to the longitudinal direction of the main body, reciprocating between the distal end and proximal end in the longitudinal direction of the main body.
• the opening and closing mechanism has an operating unit that is connected to the main body and rotates about an axis perpendicular to the longitudinal direction of the main body and reciprocates between the distal end and proximal end in the longitudinal direction of the main body, thereby suppressing vibration of the clamping portion caused by the reciprocating movement of the operating unit compared to when the operating unit reciprocates in a direction intersecting the longitudinal direction of the main body.
• the opening/closing mechanism opens the clamping portion when the operating unit is rotated toward the tip end of the main body, and closes the clamping portion when the operating unit is rotated toward the base end of the main body.
• the opening/closing mechanism opens the clamping portion when the operating unit is rotated toward the tip end of the main body, and closes the clamping portion when the operating unit is rotated toward the base end of the main body.
• the clamping portion closes, making it easier to maintain the clamping portion in a closed state compared to when the clamping portion closes when the fingers are straightened and the operating unit is rotated toward the tip end of the main body.
• the locking mechanism holds the operating part of the opening/closing mechanism in a rotated state toward the base end of the main body, and then releases that hold.
• the locking mechanism can hold the operating part of the opening/closing function in a rotated state toward the base end of the main body, and then release that hold, thereby keeping the clamping part closed without continuously applying force to the operating part.
• the support portion is composed of two parts, a first support portion and a second support portion, and that the first support portion and the second support portion are arranged at a distance in the longitudinal direction of the main body.
• the support portion is composed of two parts, a first support portion and a second support portion, and that the first support portion and the second support portion are arranged at a distance in the longitudinal direction of the main body. This increases the number of points that can be supported by the hand compared to when the support portion is composed of a single part, thereby enabling the surgical instrument to be grasped more stably.
• the surgical instrument further has a connecting portion, and is configured so that the connecting portion and the abutting portion can be connected sequentially to the base end of the main body, or the abutting portion can be directly connected to the base end of the main body without using the connecting portion.
• the main body and the abutment portion are integrally formed. According to this invention, by integrally forming the main body and the abutment portion, it is possible to prevent the abutment portion from becoming detached from the main body and falling into the patient's body during surgery.
• the present invention has the excellent effect of making the clamping portion of a surgical instrument less likely to vibrate.
• FIG. 1A is a schematic front view showing an open state of the opening/closing mechanism of the present embodiment
• FIG. 1B is a schematic front view showing a closed state of the opening/closing mechanism.
• 1A is a schematic diagram showing a state in which the surgical instrument of this embodiment is gripped
• FIG. 1B is a schematic diagram showing a state in which the wrist is rotated while gripping the surgical instrument.
• 1A is a schematic diagram showing an operation of closing the clamping portions of the surgical instrument of the present embodiment
• FIG. 1B is a schematic diagram showing an operation of opening the clamping portions of the surgical instrument.
• the direction indicated by the arrow Up is the upper side (the upper left side of the paper in Figures 1 and 8-9, the left side of the paper in Figures 2-3 and 10, the upper side of the paper in Figures 4-5, the front side of the paper in Figure 6, and the back side of the paper in Figure 7).
• the direction indicated by the arrow Dw is the lower side (the lower right side of the paper in Figures 1 and 8-9, the right side of the paper in Figures 2-3 and 10, the lower side of the paper in Figures 4-5, the back side of the paper in Figure 6, and the front side of the paper in Figure 7).
• the opening/closing mechanism 30 has an operating unit 31, a shaft 32, and a joint 33.
• This operating unit 31 is T-shaped, and a semi-cylindrical finger rest 31b is connected and fixed perpendicular to one end of an arm 31a extending in one direction.
• the other end of the arm 31a forms the tip of the operating unit 31, and is rotatably connected to the middle part of the main body 10 by a pin P2.
• This pin P2 is cylindrical and extends in a direction perpendicular to the longitudinal direction of the main body 10.
• the shaft 32 is a rod-shaped member that extends in one direction.
• the shaft 32 is housed in the main body 10 from the bottom, as indicated by the arrow Dw, in the middle portion of the main body 10. Therefore, the shaft 32 extends in the longitudinal direction, just like the main body 10.
• the joint 33 is housed in the main body 10 from the top. In this state, the joint 33, shaft 32, and operating unit 31 are sequentially arranged in a line in the longitudinal direction from the tip end to the base end.
• the joint 33 and shaft 32 are rotatably connected by pin P3.
• the shaft 32 and operating unit 31 are rotatably connected by pin P4.
• These pins P3 and P4 are cylindrical and extend in a direction perpendicular to the longitudinal direction of the main body 10. In the illustrated example, the pins P3 and P4 extend in the width direction. Therefore, the joint 33, shaft 32, and operating unit 31 are each rotatable around an axis that extends in the width direction.
• pins P3 and P4 abut against the base ends of the elongated holes 10p and 10q, respectively, stopping the rotation of the operating unit 31, and when the clamping unit 20 closes, pins P3 and P4 abut against the tip ends of the elongated holes 10p and 10q, respectively, stopping the rotation of the operating unit 31.
• pins P3 and P4 and elongated holes 10p and 10q define the rotation range of the operating unit 31, preventing damage to the clamping unit 20 and operating unit 31.
• the opening/closing mechanism 30 is provided with a locking mechanism 60.
• This locking mechanism 60 has a locking member 61, an opening 62, and a narrow portion 63.
• This locking member 61 is a rod-shaped member that extends in one direction, with a hook Hk provided at one end and connected and fixed to the main body 10 so as to protrude from the outer periphery of the main body 10.
• the locking member 61 is located on the base end 10b side of the main body 10, protruding diagonally upward from the outer periphery of the main body 10 toward the tip, and the hook Hk is provided at the tip (upper end) of the locking member 61.
• the opening 62 is a through-hole formed in the operating unit 31, and penetrates the operating unit 31 in the vertical direction from the bottom surface to the top surface. In other words, it penetrates from the side of the operating unit 31 facing the main body 10 to the opposite side of the main body 10 in a direction intersecting the longitudinal direction of the main body 10.
• This opening 62 is configured to allow the tip of the locking member 62 to be inserted through it. Therefore, when the operating unit 31 rotates towards the base end, the tip of the locking member 61 is inserted through the opening 62.
• the narrow portion 63 is a small-diameter portion and is configured to be elastically deformable. This narrow portion 63 is provided in the middle part of the arm portion 31a of the operating unit 31.
• the opening 62 is provided on the finger rest portion 31b side of the arm portion 31a. In other words, the opening 62 is positioned closer to the finger rest portion 31b than the narrow portion 63. Therefore, the opening 62 is configured to be able to move slightly in the width direction due to elastic deformation of the narrow portion 63.
• the tip of the locking member 61 is inserted into the opening 62, and the hook Hk protrudes toward the opposite side (top side) of the operating part 31 facing the main body 10.
• the narrow portion 63 elastically deforms and the opening 62 moves slightly widthwise, causing the hook Hk to engage with the edge of the opening 62 or to be released from engagement. This allows the locking mechanism 60 to hold the operating part 31 toward the base end or release the hold, and to hold the clamping part 20 in a closed state or release the hold.
• the abutment portion 40 has a hemispherical portion 40b at one end of a shaft portion 40a that extends in one direction.
• This shaft portion 40a has an outer diameter that is the same as the outer diameter of the main body 10, and the hemispherical portion 40b has a hemispherical convex curved surface with an outer diameter larger than the outer diameter of the main body 10.
• An anti-slip feature is formed on this hemispherical portion 40b. In the illustrated example, this anti-slip feature is a number of concentric circular bumps.
• the shaft 40a of the abutment portion 40 is detachably connected to the base end 10b of the main body 10 via the connecting portion 70, and the hemispherical portion 40b of the abutment portion 40 is disposed at the end (base end) of the surgical instrument 100 on the base end side in the longitudinal direction. That is, the connecting portion 70 and the abutment portion 40 are sequentially connected to the base end 10b of the main body 10, and the surgical instrument 100 extends in the longitudinal direction.
• the base end 10b of the main body 10, the connecting portion 70, and the shaft 40a of the abutment portion 40 are each threadedly connected.
• the base end 10b of the main body 10, the connecting portion 70, and the tip end (other end) of the shaft 40a of the abutment portion 40 each have an outer periphery that is hexagonal in plan view. This allows them to be firmly fastened and easily separated from the connected state using a tool such as a wrench.
• the shaft 40a of the abutment portion 40 is configured to be connectable to the base end 10b of the main body 10, and is also configured to be connectable to the connecting portion 70. That is, as shown in the example, the connecting portion 70 and the abutment portion 40 can be connected sequentially to the base end 10b of the main body 10, or the abutment portion 40 can be connected directly to the base end 10b of the main body 10 without using the connecting portion 70. This allows the surgical instrument 100 to be adjusted in length and extension.
• the connecting portion 70 is a cylindrical member with an outer diameter that is the same as the outer diameter of the main body 10. One end of this connecting portion is configured to be connectable to the base end portion 10b of the main body 10, and the other end is configured to be connectable to the shaft portion 40a of the abutment portion 40.
• the support part 50 is composed of two members, a first support part 51 and a second support part 52.
• the first support part 51 and the second support part 52 are rod-shaped members that extend in one direction and are connected and fixed to the main body 10 so as to intersect the longitudinal direction of the main body 10.
• the first support part 51 and the second support part 52 are arranged with a gap between them in the longitudinal direction of the main body 10.
• the first support part 51 is arranged in the middle part of the main body 10 so that a finger can be hooked onto it.
• the second support part 52 is arranged on the side of the base end part 10b of the main body 10 so that it can be placed between the fingers.
• the first support part 51 is arranged between the operating part 31 and the locking member 61 on the main body 10.
• the first support part 51 is connected at its longitudinal middle portion to the main body 10, with one part 51a and the other part 51b of the first support part 51 extending out on either side of the main body 10.
• One end of the second support part 52 is connected to the main body 10 and extends out in one direction from the main body 10.
• one part 51a of the first support part 51 extends diagonally downward from the main body 10 towards the front side as indicated by arrow Fr
• the other part 51b extends diagonally upward from the main body 10 towards the rear side as indicated by arrow Bk.
• the second support part extends diagonally upward from the main body 10 towards the rear side.
• one portion 51a of the first support portion 51 has a recess R1 extending in its longitudinal direction.
• the second support portion 52 has a recess R2 extending in its longitudinal direction. This reduces the thickness of the first support portion 51 and the second support portion 52, resulting in a reduction in weight.
• a notch Sp is formed in the other part 51b of the first support part 51.
• This notch Sp is curved in a roughly U-shape and is configured so that a finger can be inserted into it. Therefore, by inserting the index finger into the notch Sp and placing the middle finger on the part of the other part 51b opposite the notch Sp, the other part 51b of the first support part 51 can be held between the index finger and middle finger.
• Figure 11(a) is a schematic diagram showing the state in which the surgical instrument of this embodiment is being held.
• Figure 11(b) is a schematic diagram showing the state in which the wrist is rotated while holding the surgical instrument of this embodiment.
• the surgical instrument 100 has the clamping portion 20, main body 10, connecting portion 70, and abutting portion 40 arranged sequentially in one direction and extending in the longitudinal direction, and the first support portion 51 is connected and fixed to the middle part of the main body 10 so as to extend in a direction intersecting the longitudinal direction, giving the surgical instrument 100 an approximately cross shape.
• FIG. 12(a) is a schematic diagram showing the operation of closing the clamping portion of the surgical instrument of this embodiment.
• FIG. 12(b) is a schematic diagram showing the operation of opening the clamping portion of the surgical instrument of this embodiment.
• the surgical instrument 100 configured as described above is grasped by abutting the contact portion 40 against the palm Pa, hooking fingers F4-F5 (ring finger and little finger) on one portion 51a of the first support portion 51, pinching the other portion 51b of the first support portion 51 between fingers F2 (index finger) and F3 (middle finger), and positioning the second support portion 52 between fingers F1 (thumb) and F2.
• bending and straightening finger F1 causes the operating portion 31 to reciprocate between the distal end and proximal end in the longitudinal direction of the surgical instrument 100, thereby opening and closing the clamping portion 20.
• the surgical instrument 100 has the clamping portion 20, main body 10, connecting portion 70, and abutting portion 40 sequentially connected in one direction and extending in the longitudinal direction, and the first support portion 51 is connected and fixed to the middle portion of the main body 10 and extends in a direction intersecting the longitudinal direction of the surgical instrument 100.
• the surgical instrument 100 has a generally cross shape, so that the abutting portion 40 is brought into contact with the palm of the hand and fingers F1-F4 are hooked onto the first support portion 51 to grasp the surgical instrument 100.
• the longitudinal direction of the surgical instrument 100 becomes parallel or approaches parallelism with the longitudinal direction of the forearm Ar, and the clamping portion 20 is positioned on or approaches the axis Oa that extends along the longitudinal direction of the forearm Ar.
• vibration of the clamping portion 20 can be prevented or reduced even when the wrist of the hand holding the surgical instrument 100 rotates around the axis Oa (see Figure 11 (b)), and the surgical instrument 100 can be easily operated while viewing an endoscopic image.
• the operating unit 31 of the opening/closing mechanism 30 is connected to the main body and rotates about an axis perpendicular to the longitudinal direction of the main body 10, reciprocating between the distal end and proximal end in the longitudinal direction of the main body 10.
• the reciprocating direction of the operating unit 31 is the same as the longitudinal direction of the surgical instrument 100. Therefore, compared to when the reciprocating direction of the operating unit 31 differs from the longitudinal direction of the surgical instrument 100, the vibration of the clamping unit 20 caused by the reciprocating movement of the operating unit 31 can be sufficiently suppressed by the hand gripping the surgical instrument 100.
• the opening/closing mechanism 30 is provided with a locking mechanism 60, which can hold the clamping unit 20 in a closed state or release the hold. This allows the clamping unit 20 to be held in a closed state without continuously applying force to the operating unit 31, and allows the clamping unit 20 to hold an object such as a needle, thereby improving the operability of the surgical instrument 100.
• the locking mechanism 60 has a locking member 61, an opening 62, and a narrow portion 63.
• the locking member 61 is equipped with a hook Hk at its tip and is connected and fixed to the main body 10.
• the opening 62 and narrow portion 63 are provided in the arm portion 31a of the operating unit 31.
• the opening 62 penetrates the arm portion 31a.
• the narrow portion 63 is an elastically deformable small-diameter portion.
• the surgical instrument of this embodiment is not limited to the example shown in the illustrations above, and various modifications can of course be made without departing from the spirit of the present invention.
• the support portion 50 of this embodiment is composed of two portions, a first support portion 51 and a second support portion 52, but the support member 50 may be composed of a single first support portion 51, or may be composed of three or more portions.
• the surgical instrument 100 is configured to be adjustable in length and retraction in the longitudinal direction by sequentially connecting the connecting portion 70 and the abutting portion 40 to the base end 10b of the main body 10 using a screw connection, or by directly connecting the abutting portion 40 to the base end 10b of the main body 10.
• the connection method is not limited to screw connection, and a hook-and-loop connection or the like may also be used.
• the main body 10 and the abutting portion 40 may also be connected to each other in a telescopic manner, without using the connecting portion 70, or by a mechanism such as a slide mechanism or turnbuckle, allowing for extension and retraction.

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• Biomedical Technology (AREA)
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• Engineering & Computer Science (AREA)
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  • 2024-02-15 KR KR1020247036649A patent/KR20250126603A/ko active Pending
  • 2024-02-15 WO PCT/JP2024/005235 patent/WO2025173162A1/ja active Pending
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