JP2011224258A - Forceps - Google Patents

Forceps Download PDF

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JP2011224258A
JP2011224258A JP2010098984A JP2010098984A JP2011224258A JP 2011224258 A JP2011224258 A JP 2011224258A JP 2010098984 A JP2010098984 A JP 2010098984A JP 2010098984 A JP2010098984 A JP 2010098984A JP 2011224258 A JP2011224258 A JP 2011224258A
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forceps
outer cylinder
core rod
handle
end portion
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Koichi Tsunoda
晃一 角田
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Japan Health Sciences Foundation
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Japan Health Sciences Foundation
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Abstract

PROBLEM TO BE SOLVED: To provide a forceps capable of easily and correctly indwelling only the temporal fascia into a pocket by using the single tool.SOLUTION: The forceps 1 includes an intra-body insertion portion 11 having a core bar 112 slidably inserted into an inner hole of an outer cylinder 111, and a grip portion 12 consisting of grips 121a and 121b coupled to ends of the outer cylinder 111 and the core bar 112, respectively. The grips 121a and 121b are rotated around a pivotally attaching portion 122 to make the front end 116 of the core bar 112 protrude from the front end of the outer cylinder 111, a minute object is placed on the planar front end 116 and transferred into a human body, and then, the front end 116 of the core bar 112 is stored in the front end of the outer cylinder 111. Thus, only the forceps 1 can be easily pulled out while the minute object is indwelled at a predetermined part in the body of a patient or a sick animal.

Description

本発明は、鉗子に関する。詳しくは、１つの器具で側頭筋膜のみをポケット内に簡便且つ正確に留置することが可能な鉗子に関するものである。   The present invention relates to forceps. More specifically, the present invention relates to a forceps capable of simply and accurately placing only the temporal fascia in a pocket with a single instrument.

声帯は、人間が他人とコミュニケーションを図り、人間社会を維持するために必須の感覚器の１つである。声帯は、喉頭の略中央の左右側壁から粘膜が盛り上がった上下２対のひだ状の***した下側部分にあり、筋肉、結合組織及び粘膜の三層構造からできている。この声帯の一側が、外傷、癌の手術、加齢、反回神経麻痺、喉頭麻痺等により、正中位（閉鎖位）への内転障害をきたし、或いは全体的に萎縮して声門閉鎖不全をきたすと、息漏れや嗄声（気息性嗄声）による音声障害のみならず、唾液の気管への垂れ込みによる誤嚥、更には息こらえが出来ないことによる身体能力の低下をも惹起し、その結果として、社会生活上におけるＱＯＬ（Ｑｕａｌｉｔｙ ｏｆ Ｌｉｆｅ）が著しく低下する。   The vocal cord is one of the sensory organs essential for humans to communicate with others and maintain human society. The vocal cords are located in the upper and lower two fold-like raised lower portions where the mucous membrane swells from the left and right side walls at the approximate center of the larynx, and are composed of a three-layer structure of muscle, connective tissue and mucous membrane. One side of this vocal cord may have a medial disorder (closed position) due to trauma, cancer surgery, aging, recurrent nerve palsy, laryngeal palsy, etc. As a result, not only speech disturbance due to breath leaks and hoarseness (breathing hoarseness), but also aspiration due to dripping saliva into the trachea, and also a decline in physical ability due to inability to hold the breath, as a result As a result, QOL (Quality of Life) in social life is significantly reduced.

そこで、本発明者は、上記の内転障害や声門閉鎖不全に対し、患者自身の側頭筋膜を声帯粘膜下に移植する「声帯内自家筋膜移植術（ＡＴＦＶ：Ａｕｔｏｌｏｇｏｕｓ Ｔｒａｎｓｐｌａｎｔａｔｉｏｎ ｏｆ Ｆａｓｃｉａ ｉｎｔｏ ｔｈｅ Ｖｏｃａｌ Ｆｏｌｄ）」を考案した（例えば、非特許文献１参照）。かかるＡＴＦＶは、声帯粘膜下に作成したポケット内に患者自身から採取した側頭筋膜を留置し、ポケットの入口を閉じて声帯を再生させる治療方法である。   Accordingly, the present inventor has developed “autologous transplantation of fascia into the ATFV: autologous fascia into the transplantation of the patient's own temporal fascia under the vocal cord mucosa. Vocal Fold) ”(for example, see Non-Patent Document 1). Such ATFV is a treatment method in which the temporal fascia collected from the patient itself is placed in a pocket created under the vocal cord mucosa, and the entrance of the pocket is closed to reproduce the vocal cord.

加我 君孝、外２名 編著、「新 臨床耳鼻咽喉科学 ＜５巻−基本手術手技＞」、中外医学社、ｐ．１７２−１７５Kimitaka Kaga, 2 authors, “New Clinical Otolaryngology <Volume 5-Basic Surgery Techniques>”, Chugai Medical Co., p. 172-175

かかるＡＴＦＶにおいては、テラメスや鈍針等の複数の器具と共に、先端が匙状や鉤状の喉頭手術用鉗子が用いられていたが、側頭筋膜は水分を含むと膨張してしまい、作成したポケット内に簡便且つ正確に押し込むことが困難であり、また、一度ポケット内に押し込んでも喉頭手術用鉗子を抜去しようとすると脱落してしまい、手技が煩雑で時間がかかるという問題があった。   In such an ATFV, a laryngeal surgical forceps having a scissors-like or scissor-like tip is used together with a plurality of instruments such as terames and blunt needles. However, the temporal fascia expands when it contains moisture. However, it is difficult to push it into the pocket easily and accurately, and even if it is once pushed into the pocket, if the forceps for laryngeal surgery are to be removed, it will fall off, and the procedure is complicated and takes time.

本発明は、上記従来技術の有する問題点に鑑みなされたものであり、その目的とするところは、１つの器具で側頭筋膜のみをポケット内に簡便且つ正確に留置することが可能な鉗子を提供することにある。   The present invention has been made in view of the above-described problems of the prior art, and an object thereof is a forceps capable of simply and accurately placing only the temporal fascia in a pocket with a single instrument. Is to provide.

本発明の上記目的は、下記の手段によって達成される。   The above object of the present invention is achieved by the following means.

（１）すなわち、本発明は、外筒と、前記外筒の内孔に挿通された芯棒と、を備え、前記芯棒の先端部が前記外筒の先端部から延出自在に構成されたことを特徴とする、鉗子である。   (1) That is, the present invention includes an outer cylinder and a core rod inserted through the inner hole of the outer cylinder, and the tip end portion of the core rod is configured to extend freely from the tip end portion of the outer cylinder. This is a forceps.

（２）本発明はまた、前記外筒の先端部近傍に屈曲部が設けられてなる、（１）に記載の鉗子である。   (2) The present invention also provides the forceps according to (1), wherein a bent portion is provided in the vicinity of the distal end portion of the outer cylinder.

（３）本発明はまた、前記芯棒は、前記屈曲部に挿通される部分が屈曲自在に構成されてなる、（２）に記載の鉗子である。   (3) The present invention is also the forceps according to (2), wherein the core rod is configured such that a portion inserted through the bent portion is bendable.

（４）本発明はまた、前記芯棒の先端部は、平板状、匙状又は鉤状に形成されてなる、（１）〜（３）の何れか１項に記載の鉗子である。   (4) The present invention also provides the forceps according to any one of (1) to (3), wherein a tip portion of the core rod is formed in a flat plate shape, a hook shape, or a hook shape.

（５）本発明はまた、前記外筒の末端部と連結された第１の柄と、前記芯棒の末端部と連結された第２の柄と、を備え、前記第１の柄と前記第２の柄の相対的変位に伴って前記芯棒の先端部が前記外筒の先端部から延出又は格納するように構成されてなる、（１）〜（４）の何れか１項に記載の鉗子である。   (5) The present invention also includes a first handle connected to the end portion of the outer cylinder, and a second handle connected to the end portion of the core rod, and the first handle and the In any one of (1) to (4), the distal end portion of the core rod extends or retracts from the distal end portion of the outer cylinder in accordance with the relative displacement of the second handle. The forceps described.

（６）本発明はまた、前記第１の柄と前記第２の柄は、互いに交差するように軸止されてなる、（５）に記載の鉗子である。   (6) The present invention also provides the forceps according to (5), wherein the first handle and the second handle are fixed so as to cross each other.

（７）本発明はまた、前記第１の柄は、前記外筒の末端部と着脱可能に連結され、前記第２の柄は、前記芯棒の末端部と着脱可能に連結されてなる、（５）又は（６）に記載の鉗子である。   (7) In the present invention, the first handle is detachably connected to the end portion of the outer cylinder, and the second handle is detachably connected to the end portion of the core rod. The forceps according to (5) or (6).

（８）本発明はまた、微小物を体内に移送及び留置するために用いることを特徴とする、（１）〜（７）の何れか１項に記載の鉗子である。   (8) The forceps according to any one of (1) to (7), wherein the present invention is used for transferring and placing a minute object in the body.

本発明の鉗子によれば、外筒と外筒の内孔に挿通された芯棒とを備え、芯棒の先端部が外筒の先端部から延出自在に構成されているので、芯棒の先端部を外筒の先端部から延出させて微小物を芯棒の先端部に載置して体内に移送し、次いで芯棒の先端部を外筒の先端部に格納させることにより、微小物を体内の所定部位に留置して鉗子のみを容易に抜去することができる。   According to the forceps of the present invention, the outer cylinder and the core rod inserted into the inner hole of the outer cylinder are provided, and the distal end portion of the core rod is configured to extend freely from the distal end portion of the outer cylinder. By extending the tip of the outer cylinder from the tip of the outer cylinder, placing a micro object on the tip of the core rod and transferring it into the body, and then storing the tip of the core rod in the tip of the outer cylinder, Only the forceps can be easily removed by placing a minute object at a predetermined site in the body.

また、本発明の鉗子によれば、外筒の先端部近傍に屈曲部が設けられているので、簡便且つ正確に鉗子の体内挿入部を体内に差し込み、更に先端部を所定部位に押し込むことができる。   Further, according to the forceps of the present invention, since the bent portion is provided in the vicinity of the distal end portion of the outer cylinder, the insertion portion of the forceps in the body can be easily and accurately inserted into the body, and the distal end portion can be further pushed into a predetermined site. it can.

また、本発明の鉗子によれば、芯棒の先端部が平板状、匙状又は鉤状に形成されているので、微小物を芯棒の先端部に載置し易く、また、微小物の芯棒の先端部からの落下を防止することができる。   In addition, according to the forceps of the present invention, since the tip of the core rod is formed in a flat plate shape, a bowl shape or a hook shape, it is easy to place a minute object on the tip of the core rod. The fall from the front-end | tip part of a core rod can be prevented.

また、本発明の鉗子によれば、外筒の末端部と連結された第１の柄と芯棒の末端部と連結された第２の柄とを備え、第１の柄と第２の柄が互いに交差するように軸止されているので、第１の柄と第２の柄を閉じた状態で把持することにより、外筒の先端部から芯棒の先端部を延出させた状態を容易に保持することができ、微小物を芯棒の先端部に載置した状態で落下させることなく体内の所望の部位に移送することができる。   According to the forceps of the present invention, the first handle and the second handle are provided with the first handle connected to the end portion of the outer cylinder and the second handle connected to the end portion of the core rod. Since the first handle and the second handle are held in a closed state, the tip of the core rod is extended from the tip of the outer cylinder. It can be easily held, and can be transferred to a desired site in the body without being dropped while being placed on the tip of the core rod.

更に、第１の柄は外筒の末端部と着脱可能に連結され、第２の柄は芯棒の末端部と着脱可能に連結されているので、鉗子から外筒や芯棒を容易に取り外すことができ、消毒や清掃等のメンテナンスしたり新品に交換したりすることができる。   Furthermore, since the first handle is detachably connected to the end of the outer cylinder and the second handle is detachably connected to the end of the core rod, the outer cylinder and the core rod can be easily removed from the forceps. It is possible to perform maintenance such as disinfection and cleaning, or exchange for a new one.

本発明の第１の実施形態にかかる鉗子の閉じた状態を示した概念図である。It is the conceptual diagram which showed the closed state of the forceps concerning the 1st Embodiment of this invention. 芯棒１１２の構成を説明するための概念図である。4 is a conceptual diagram for explaining a configuration of a core rod 112. FIG. （ａ）は、先端部１１６の構成を説明するための概念図であり、（ｂ）〜（ｇ）は、先端部１１６の応用例を示した概念図である。(A) is a conceptual diagram for demonstrating the structure of the front-end | tip part 116, (b)-(g) is a conceptual diagram which showed the example of application of the front-end | tip part 116. FIG. 鉗子１の開いた状態を示した概念図である。It is the conceptual diagram which showed the forceps 1 opened state. 本発明の第２の実施形態にかかる鉗子の開いた状態を示した概念図である。It is the conceptual diagram which showed the state which the forceps concerning the 2nd Embodiment of this invention opened.

以下、本発明の実施の形態を、図面を参照して詳細に説明する。   Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

図１は、本発明の第１の実施形態にかかる鉗子の閉じた状態を示した概念図である。図１に示すように、本実施形態に係る鉗子１は、側頭筋膜を声帯粘膜下に移植するための体内挿入部１１と、体内挿入部１１を開閉操作するための把持部１２とから構成されており、これらの部材は、ステンレス鋼、純チタン等の生体適合性を有する素材からできている。   FIG. 1 is a conceptual diagram showing a closed state of forceps according to the first embodiment of the present invention. As shown in FIG. 1, the forceps 1 according to this embodiment includes an in-vivo insertion portion 11 for transplanting the temporal fascia under the vocal cord mucosa, and a grasping portion 12 for opening and closing the in-vivo insertion portion 11. These members are made of a material having biocompatibility such as stainless steel and pure titanium.

体内挿入部１１は、外筒１１１と芯棒１１２とから構成されている。外筒１１１は、円管状の形状で、喉頭に挿入するのに十分な長さを有している。また、外筒１１１の先端部近傍は屈曲して構成されており（屈曲部１１３）、これにより、側頭筋膜を声帯粘膜下のポケット内に押し込み又は差し込み易くなっている。   The in-body insertion portion 11 is composed of an outer cylinder 111 and a core rod 112. The outer cylinder 111 has a circular tubular shape and is long enough to be inserted into the larynx. Further, the vicinity of the distal end portion of the outer cylinder 111 is bent (bent portion 113), which makes it easy to push or insert the temporal fascia into a pocket under the vocal cord mucosa.

一方、外筒１１１の内孔には、芯棒１１２が摺動自在に挿通されている。図２は、芯棒１１２の構成を説明するための概念図である。図２に示すように、芯棒１１２は、棒状の形状を有し、外筒１１１よりもやや長尺で、外筒１１１の先端部から芯棒１１２の先端が自在に延出できるようになっている。   On the other hand, a core rod 112 is slidably inserted into the inner hole of the outer cylinder 111. FIG. 2 is a conceptual diagram for explaining the configuration of the core rod 112. As shown in FIG. 2, the core rod 112 has a rod shape, is slightly longer than the outer cylinder 111, and the tip of the core rod 112 can freely extend from the distal end portion of the outer cylinder 111. ing.

芯棒１１２は、基部１１４と、屈曲部１１５と、先端部１１６とが順次連結されて構成されている。基部１１４は、把持部１２による変位を確実に屈曲部１１５や先端部１１６に伝達するために、適度な硬度を有し、伸縮性や可とう性を有しない素材からできている。また、屈曲部１１５は、外筒１１１の屈曲部１１３を摺動自在に挿通できるように、例えば、ワイヤー等の可とう性を有する素材又は構造からできている。図３（ａ）は、先端部１１６の構成を説明するための概念図である。図３（ａ）に示すように、先端部１１６は、平板状の形状を有しており、採取した側頭筋膜を先端部１１６上に載置することができるように構成されている。ただし、先端部１１６の形状は、これに限定されるものではなく、例えば、図３（ｂ）に示すような匙状や、図３（ｃ）に示すような鉤状であってもよいし、図３（ｄ）及び（ｅ）に示すような平板状の上面に複数の溝又は突起が形成されたものであってもよいし、図３（ｆ）に示すような波板状や、図３（ｇ）に示すような逆三角柱状の凹窩を有するものであってもよい。   The core rod 112 is configured by sequentially connecting a base portion 114, a bent portion 115, and a distal end portion 116. The base 114 is made of a material that has an appropriate hardness and does not have elasticity or flexibility in order to reliably transmit the displacement caused by the grip 12 to the bent portion 115 and the distal end portion 116. Further, the bent portion 115 is made of a material or a structure having flexibility such as a wire so that the bent portion 113 of the outer cylinder 111 can be slidably inserted. FIG. 3A is a conceptual diagram for explaining the configuration of the distal end portion 116. As shown in FIG. 3A, the distal end portion 116 has a flat plate shape, and is configured so that the collected temporal fascia can be placed on the distal end portion 116. However, the shape of the distal end portion 116 is not limited to this, and may be, for example, a bowl shape as shown in FIG. 3B or a bowl shape as shown in FIG. 3 (d) and (e) may be formed with a plurality of grooves or projections on a flat plate-like upper surface, or may be corrugated as shown in FIG. It may have an inverted triangular prism-shaped recess as shown in FIG.

また、図１において、把持部１２は、略真直な平板構造の柄１２１ａ及び１２１ｂとから構成され、これらは互いに交差した状態で枢着部１２２回りに回動自在に軸止されている。また、柄１２１ａ及び１２１ｂの先端部は、それぞれ螺子１２３ａ及び１２３ｂにより、外筒１１１及び芯棒１１２の末端部と着脱自在に連結されている。このような構成にすることにより、把持部１２から体内挿入部１１を容易に脱着することができるので、各部材の消毒を簡易且つ迅速に行うことができ、また、１つの部材が破損したとしても破損部材のみを新品に交換することができる。更に、柄１２１ａ及び１２１ｂの末端部には、指を入れて鉗子１を把持するための指孔１２４ａ及び１２４ｂが、それぞれ形成されている。   Moreover, in FIG. 1, the holding part 12 is comprised from the pattern 121a and 121b of a substantially straight flat plate structure, and these are pivotally fixed around the pivoting part 122 in the state which mutually cross | intersected. Moreover, the front-end | tip part of the handles 121a and 121b is detachably connected with the terminal part of the outer cylinder 111 and the core rod 112 by the screws 123a and 123b, respectively. By adopting such a configuration, the in-vivo insertion portion 11 can be easily detached from the grasping portion 12, so that each member can be sterilized easily and quickly, and one member is damaged. Also, only damaged members can be replaced with new ones. Furthermore, finger holes 124a and 124b for inserting fingers and holding the forceps 1 are formed at the ends of the handles 121a and 121b, respectively.

かかる構成により、鉗子１は、指孔１２４ａ及び１２４ｂにそれぞれ指を入れて、柄１２１ａ及び１２１ｂを枢着部１２２回りに回動させて閉じると、柄１２１ａ及び１２１ｂの両先端部が閉じて、外筒１１１の先端部から芯棒１１２の先端部１１６が延出される。   With this configuration, when the forceps 1 puts fingers into the finger holes 124a and 124b and rotates the handles 121a and 121b around the pivoting portion 122 and closes them, both ends of the handles 121a and 121b are closed. A distal end portion 116 of the core rod 112 extends from the distal end portion of the outer cylinder 111.

また、図４は、鉗子１の開いた状態を示した概念図である。図４に示すように、指孔１２４ａ及び１２４ｂにそれぞれ指を入れて、柄１２１ａ及び１２１ｂを枢着部１２２回りに回動させて開くと、柄１２１ａ及び１２１ｂの両先端部が開いて、外筒１１１の内孔に先端部１１６が格納される。   FIG. 4 is a conceptual diagram showing a state in which the forceps 1 is opened. As shown in FIG. 4, when the fingers are inserted into the finger holes 124a and 124b, and the handles 121a and 121b are rotated around the pivoting portion 122 to open, both ends of the handles 121a and 121b are opened. The tip end portion 116 is stored in the inner hole of the cylinder 111.

次に、本実施形態に係る鉗子１の使用方法について、声帯内自家筋膜移植術（ＡＴＦＶ）を例に挙げて説明する。   Next, a method for using the forceps 1 according to the present embodiment will be described by taking an intrafascia autologous fascia grafting (ATFV) as an example.

まず、声帯上面外側に、声帯に平行にして前から後へ粘膜切開を入れ、テラメスや一般的な鉗子等を用いて声門下へ剥離を進める。次いで、声帯の溝病変まで剥離を進めて、声帯粘膜に穿孔をきたさぬように声帯の形に添って溝を粘膜に付けるように、声帯靱帯又は粘膜下組織より剥離する。なお、剥離が難しい場合には、メスや鋏等で切離する。次いで、剥離を溝に対して平行にして声門下方向に３ｍｍ程まで進めてポケットを作成する。最後に、消毒した紙を作成したポケット内に挿入して、かかるポケットの大きさに合うように紙をトリミングする。   First, a mucosal incision is made from the front to the back in parallel with the vocal cords on the upper surface of the vocal cords, and peeling is advanced below the glottis using a terames or general forceps. Next, peeling is advanced to the groove lesion of the vocal cord, and the groove is peeled from the vocal fold ligament or submucosa so that the groove is attached to the mucous membrane along the shape of the vocal cord so as not to perforate the vocal cord mucosa. If peeling is difficult, cut it off with a knife or scissors. Next, peeling is performed in parallel to the groove and advanced to about 3 mm in the subglottic direction to create a pocket. Finally, the sterilized paper is inserted into the created pocket and the paper is trimmed to fit the pocket size.

次に、鼓膜形成術に準じた視野又は術野で、周囲の結合組織を十分に付けて、厚めに耳の側頭筋膜を採取する。次いで、採取した側頭筋膜を圧迫して伸ばし、水分を十分に除去して乾燥させる。最後に、トリミングした紙を乾燥させた側頭筋膜にあてがい、かかる紙の大きさに合わせて側頭筋膜をトリミングする。   Next, in the visual field or operative field according to tympanic membrane surgery, the surrounding connective tissue is sufficiently attached, and the temporal temporal fascia of the ear is collected thickly. Next, the collected temporal fascia is compressed and stretched to sufficiently remove water and dry. Finally, the trimmed paper is applied to the dried temporal fascia, and the temporal fascia is trimmed according to the size of the paper.

次に、鉗子１の指孔１２４ａ及び１２４ｂにそれぞれ指を入れて、柄１２１ａ及び１２１ｂを枢着部１２２回りに回動させて閉じ、外筒１１１の先端部から芯棒１１２の先端部１１６を延出する。次いで、先端部１１６上にトリミング済みの側頭筋膜を載置し、この状態を保持したまま鉗子１の体内挿入部１１を患者の喉頭に差し込み、更に先端部１１６をポケット内に押し込む。次いで、柄１２１ａ及び１２１ｂを枢着部１２２回りに回動させて開き、外筒１１１の内孔に先端部１１６を格納して側頭筋膜をポケット内に留置し、体内挿入部１１のみを患者の喉頭から抜去する。次いで、他の鉗子等の器具を用いて留置した側頭筋膜をポケット全体に行き渡るように調節して声帯の形を整えると共に、ポケット内の死腔を取り除く。最後に、縫合して又はフィブリン糊で覆って切開創を塞ぎ、手術を終了する。   Next, fingers are put into the finger holes 124 a and 124 b of the forceps 1, and the handles 121 a and 121 b are turned around the pivoting portion 122 to close, and the distal end portion 116 of the core rod 112 is closed from the distal end portion of the outer cylinder 111. Extend. Next, the trimmed temporal fascia is placed on the distal end portion 116, and the internal insertion portion 11 of the forceps 1 is inserted into the patient's larynx while maintaining this state, and the distal end portion 116 is further pushed into the pocket. Next, the handles 121a and 121b are opened by pivoting around the pivot portion 122, the distal end portion 116 is stored in the inner hole of the outer cylinder 111, the temporal fascia is placed in the pocket, and only the insertion portion 11 is inserted. Remove from patient's larynx. Next, the temporal fascia placed using another instrument such as forceps is adjusted so as to spread over the entire pocket to adjust the shape of the vocal cords, and the dead space in the pocket is removed. Finally, the incision is closed with sutures or covered with fibrin glue and the operation is terminated.

このように、鉗子１は、柄１２１ａ及び１２１ｂを閉じ、外筒１１１の先端部から芯棒１１２の先端部１１６を延出させ、先端部１１６上にトリミング済みの側頭筋膜を載置し、この状態を保持したまま鉗子１の体内挿入部１１を患者の喉頭に差し込み、更に先端部１１６をポケット内に押し込むことができるので、これらの作業中に側頭筋膜が落下することがない。また、外筒１１１の内孔に先端部１１６を格納して側頭筋膜をポケット内に留置する際に柄１２１ａ及び１２１ｂを開くので、側頭筋膜をポケットから脱落させずに体内挿入部１１のみを患者の喉頭から容易に抜去することができる。従って、鉗子１を用いれば、ＡＴＦＶにおいて、簡便且つ正確に側頭筋膜を声帯粘膜下のポケットへ留置することができ、また、体内挿入部１１のみをポケットから容易に抜去することができる。   In this way, the forceps 1 closes the handles 121a and 121b, extends the distal end portion 116 of the core rod 112 from the distal end portion of the outer cylinder 111, and places the trimmed temporal fascia on the distal end portion 116. Since this state is maintained, the insertion part 11 of the forceps 1 can be inserted into the larynx of the patient and the distal end part 116 can be pushed into the pocket, so that the temporal fascia does not fall during these operations. . Further, when the distal end portion 116 is stored in the inner hole of the outer cylinder 111 and the temporal fascia is placed in the pocket, the handles 121a and 121b are opened, so that the temporal fascia is not dropped from the pocket and inserted into the body. Only 11 can be easily removed from the patient's larynx. Therefore, by using the forceps 1, the temporal fascia can be simply and accurately placed in the pocket below the vocal cord mucosa in the ATFV, and only the body insertion portion 11 can be easily removed from the pocket.

図５は、第２の実施形態にかかる鉗子を開いた状態を示した概念図である。図５に示すように、鉗子２は、略くの字状に屈曲した平板構造の把持部２２の構造以外は鉗子１と同一である。把持部２２は、柄２２１ａ及び２２１ｂとから構成され、これらの一部が互いに重なった状態で枢着部２２２回りに回動自在に軸止されている。また、柄２２１ａ及び２２１ｂの先端部は、それぞれ螺子２２３ｂ及び２２３ａにより、芯棒２１２及び外筒２１１の末端部と着脱自在に連結されている。更に、柄２２１ａ及び２２１ｂの末端部には、指を入れて鉗子２を把持するための指孔２２４ａ及び２２４ｂが、それぞれ形成されている。   FIG. 5 is a conceptual diagram showing a state in which the forceps according to the second embodiment are opened. As shown in FIG. 5, the forceps 2 is the same as the forceps 1 except for the structure of the grip portion 22 having a flat plate structure bent in a substantially square shape. The gripping part 22 is composed of handles 221a and 221b, and is pivotally supported around the pivotal attachment part 222 in a state in which some of these grips overlap each other. The tips of the handles 221a and 221b are detachably connected to the core rod 212 and the end of the outer cylinder 211 by screws 223b and 223a, respectively. Furthermore, finger holes 224a and 224b for inserting fingers and holding the forceps 2 are formed at the end portions of the handles 221a and 221b, respectively.

かかる構成により、鉗子２は、指孔２２４ａ及び２２４ｂにそれぞれ指を入れて、柄２２１ａ及び２２１ｂを枢着部２２２回りに回動させて開くと、柄２２１ａ及び２２１ｂの両先端部が閉じて、外筒２１１の先端部から芯棒２１２の先端部２１６が延出される。一方、指孔２２４ａ及び２２４ｂにそれぞれ指を入れて、柄２２１ａ及び２２１ｂを枢着部２２２回りに回動させて閉じると、柄２２１ａ及び２２１ｂの両先端部が開いて、外筒２１１の内孔に先端部２１６が格納される。   With such a configuration, when the forceps 2 is opened by putting fingers into the finger holes 224a and 224b and rotating the handles 221a and 221b around the pivoting portion 222, both ends of the handles 221a and 221b are closed. A distal end portion 216 of the core rod 212 extends from the distal end portion of the outer cylinder 211. On the other hand, when the fingers are inserted into the finger holes 224a and 224b and the handles 221a and 221b are rotated and closed around the pivoting portion 222, both ends of the handles 221a and 221b are opened, and the inner hole of the outer cylinder 211 is opened. The tip portion 216 is stored in the.

なお、本発明の鉗子は、上記した実施形態に限定されるものではなく、本発明の要旨を逸脱しない範囲内において種々変更を加え得ることは勿論である。   Note that the forceps of the present invention is not limited to the above-described embodiment, and it is needless to say that various modifications can be made without departing from the gist of the present invention.

上述したように、本発明の鉗子は、芯棒の先端部を外筒の先端部から延出させて微小物を芯棒の先端部に載置して体内に移送し、次いで芯棒の先端部を外筒の先端部に格納させることにより、微小物を患者や患畜等の体内の所定部位に留置して鉗子のみを容易に抜去することができるので、側頭筋膜、骨髄、筋肉、脂肪、粘膜、結合組織、血管壁、軟骨、軟骨膜等の組織、臓器の一部、培養細胞等の微小物、及び人工物や培養組織等に細胞や薬剤ホルモン等を付着添付せしめた微小物を、体内に移送及び留置するための鉗子として利用した場合極めて有用である。   As described above, the forceps of the present invention allows the tip of the core rod to extend from the tip of the outer cylinder, places a micro object on the tip of the core rod, and transfers it to the body, and then the tip of the core rod. By storing the part in the distal end of the outer cylinder, it is possible to leave a minute object at a predetermined site in the body of a patient or patient and easily remove only the forceps, so that the temporal fascia, bone marrow, muscle, Fat, mucous membrane, connective tissue, blood vessel wall, cartilage, part of organ, parts of organ, minute things such as cultured cells, and minute things with cells and drug hormones attached and attached to artificial or cultured tissues Is extremely useful when used as forceps for transporting and placing in the body.

１、２・・・鉗子
１１、２１・・・体内挿入部
１１１、２１１・・・外筒
１１２、２１２・・・芯棒
１１３、１１５、２１３、２１５・・・屈曲部
１１４、２１４・・・基部
１１６、２１６・・・先端部
１２、２２・・・把持部
１２１ａ、１２１ｂ、２２１ａ、２２１ｂ・・・柄
１２２、２２２・・・枢着部
１２３ａ、１２３ｂ、２２３ａ、２２３ｂ・・・螺子
１２４ａ、１２４ｂ、２２４ａ、２２４ｂ・・・指孔 1, 2... Forceps 11, 21... Internal insertion part 111, 211 .. Outer cylinder 112, 212... Core rod 113, 115, 213, 215. Base part 116, 216 ... Tip part 12, 22 ... Grasping part 121a, 121b, 221a, 221b ... Handle 122, 222 ... Pivoting part 123a, 123b, 223a, 223b ... Screw 124a, 124b, 224a, 224b ... finger holes

Claims (8)

外筒と、
前記外筒の内孔に挿通された芯棒と、
を備え、
前記芯棒の先端部が前記外筒の先端部から延出自在に構成されたことを特徴とする、鉗子。 An outer cylinder,
A core rod inserted through the inner hole of the outer cylinder;
With
A forceps characterized in that a tip end portion of the core rod is configured to be freely extendable from a tip end portion of the outer cylinder. 前記外筒の先端部近傍に屈曲部が設けられてなる、請求項１に記載の鉗子。   The forceps according to claim 1, wherein a bent portion is provided in the vicinity of a distal end portion of the outer cylinder. 前記芯棒は、前記屈曲部に挿通される部分が屈曲自在に構成されてなる、請求項２に記載の鉗子。   The forceps according to claim 2, wherein the core bar is configured such that a portion inserted through the bent portion is freely bendable. 前記芯棒の先端部は、平板状、匙状又は鉤状に形成されてなる、請求項１〜３の何れか１項に記載の鉗子。   The forceps according to any one of claims 1 to 3, wherein a tip portion of the core rod is formed in a flat plate shape, a hook shape, or a hook shape. 前記外筒の末端部と連結された第１の柄と、
前記芯棒の末端部と連結された第２の柄と、
を備え、
前記第１の柄と前記第２の柄の相対的変位に伴って前記芯棒の先端部が前記外筒の先端部から延出又は格納するように構成されてなる、請求項１〜４の何れか１項に記載の鉗子。 A first handle connected to the end of the outer cylinder;
A second handle connected to the end of the core rod;
With
The tip of the core rod is configured to extend or retract from the tip of the outer cylinder with relative displacement of the first handle and the second handle. The forceps according to any one of claims. 前記第１の柄と前記第２の柄は、互いに交差するように軸止されてなる、請求項５に記載の鉗子。   The forceps according to claim 5, wherein the first handle and the second handle are fixed so as to cross each other. 前記第１の柄は、前記外筒の末端部と着脱可能に連結され、前記第２の柄は、前記芯棒の末端部と着脱可能に連結されてなる、請求項５又は６に記載の鉗子。   7. The first handle according to claim 5 or 6, wherein the first handle is detachably connected to a terminal portion of the outer cylinder, and the second handle is detachably connected to a terminal portion of the core rod. forceps. 微小物を体内に移送及び留置するために用いることを特徴とする、請求項１〜７の何れか１項に記載の鉗子。   The forceps according to any one of claims 1 to 7, wherein the forceps are used for transferring and placing minute objects in the body.
JP2010098984A 2010-04-22 2010-04-22 Forceps Withdrawn JP2011224258A (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102011087659A1 (en) 2010-12-03 2012-06-06 Ngk Spark Plug Co., Ltd. Method for forming a conductor pattern

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102011087659A1 (en) 2010-12-03 2012-06-06 Ngk Spark Plug Co., Ltd. Method for forming a conductor pattern

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