JP3354032B2 - Surgical forceps and ultrasonic coagulation and incision device - Google Patents
Surgical forceps and ultrasonic coagulation and incision deviceInfo
- Publication number
- JP3354032B2 JP3354032B2 JP08146995A JP8146995A JP3354032B2 JP 3354032 B2 JP3354032 B2 JP 3354032B2 JP 08146995 A JP08146995 A JP 08146995A JP 8146995 A JP8146995 A JP 8146995A JP 3354032 B2 JP3354032 B2 JP 3354032B2
- Authority
- JP
- Japan
- Prior art keywords
- support member
- ultrasonic
- insertion portion
- opening
- distal end
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
Description
【０００１】[0001]
【産業上の利用分野】本発明は、体腔内に挿入され、生
体組織を把持あるいは切除する外科用鉗子及び超音波凝
固切開装置に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical forceps inserted into a body cavity to grasp or resect living tissue and an ultrasonic forceps.
The present invention relates to a solid incision device .
【０００２】[0002]
【従来技術】近年、体腔内に細長の挿入部を挿入するこ
とにより、体腔内臓器などを観察したり、必要に応じて
内視鏡観察下で各種治療処置が行われている。2. Description of the Related Art In recent years, an elongated insertion portion has been inserted into a body cavity to observe organs in the body cavity, and various treatments have been performed under endoscopic observation as necessary.
【０００３】前記内視鏡観察下で治療処置を行う方法の
一つとして生体組織を吸着あるいは把持等する外科用鉗
子が種々提案されており、例えば吸着あるいは把持して
いる部材に超音波振動を加えて生体組織を切除あるいは
凝固などの処置を行うもの等が知られている。[0003] As one of the methods for performing a therapeutic treatment under the above-mentioned endoscopic observation, various surgical forceps for sucking or grasping a living tissue have been proposed. For example, ultrasonic vibration is applied to a member being sucked or grasped. In addition, there are known those which perform treatments such as excision or coagulation of living tissue.
【０００４】例えば、ＵＳＰ５３２２０５５号には、ハ
ウジングに搭載された超音波要素と、超音波振動を受け
取って振動する細長端を有する外科用刃と、外科用刃の
片側に沿いながら外科用刃に対置するシース先端部に設
けられた開閉自在なクランプ部と、このクランプ部と外
科用刃との間に組織を挟んで超音波要素からの超音波振
動を加えて切開あるいは凝固する超音波外科器具のため
のクランプ凝固装置及び切断システムが示されている。For example, US Pat. No. 5,322,055 discloses an ultrasonic element mounted on a housing, a surgical blade having an elongated end that receives and vibrates ultrasonic vibrations, and a surgical blade along one side of the surgical blade. An openable and closable clamp provided at the distal end of a sheath, and an ultrasonic surgical instrument which cuts or coagulates by applying ultrasonic vibration from an ultrasonic element with tissue interposed between the clamp and the surgical blade. A solidification device and a cutting system for the same are shown.
【０００５】また、特開平６−２２５８８６号公報に
は、全体が剛直な外套管と、この外套管内を挿通する内
套管とを備え、内套管内に設けられた内腔を挿通する２
本のリード線により内套管が軸方向に移動することによ
りリード線の先端が開閉し、リード線先端に挟まれた術
部に高周波電流を通電することで術部を焼灼する外科用
鉗子が示されている。Japanese Unexamined Patent Publication No. Hei 6-225886 discloses an outer tube which is entirely rigid and has an inner tube which penetrates the inner tube, and which penetrates a lumen provided in the inner tube.
Surgical forceps that cauterize the surgical site by applying high-frequency current to the surgical site sandwiched between the lead wires by opening and closing the distal end of the lead wire by axial movement of the inner tube by this lead wire It is shown.
【０００６】[0006]
【発明が解決しようとする課題】しかしながら、前記Ｕ
ＳＰ５３２２０５５号に示された超音波外科器具のため
のクランプ凝固装置及び切断システムでは、シースの先
端部に設けられている可動部であるクランプ部にシース
内を挿通する作動ロッドを接続して開閉動作が行なわれ
るようになっているため、シース内にクランプ部に接続
する作動ロッドを通すための細長穴を開けるなど構造が
複雑になり、使用後の洗滌が非常に難しく、感染症を防
止するためにはシースを使い捨てにしなければならな
い。However, the above U
In the clamp coagulation apparatus and cutting system for an ultrasonic surgical instrument disclosed in SP5322055, an opening / closing operation is performed by connecting an operating rod inserted through the sheath to a clamp portion which is a movable portion provided at the distal end of the sheath. In order to prevent infectious diseases, the structure becomes complicated, such as making an elongated hole for passing the operating rod connected to the clamp part in the sheath, and cleaning after use is extremely difficult. The sheath must be disposable.
【０００７】また、可動部であるクランプ部と外科用刃
部とが分離した構造であるため、術者は術前にクランプ
部と外科用刃部との位置決めを行なわなければならなか
った。さらに、一般的に内視鏡下外科手術に使用する処
置具は、３００mm以上の長さを必要とし、製作上長手方
向の長さに比較的大きな誤差が生じるため前記シースと
プローブとの間に長さの誤差が生じ、後端部で位置決め
を行っても先端部で大きなズレが生じるおそれがあるの
で、先端部側に新たな位置決め手段を設けなければなら
ず、構造がますます複雑になるという問題があった。In addition, since the clamp, which is a movable part, and the surgical blade are separated from each other, the operator must position the clamp and the surgical blade before the operation. Furthermore, a treatment tool generally used for endoscopic surgery requires a length of 300 mm or more, and a relatively large error occurs in the length in the longitudinal direction due to manufacturing. Length errors occur, and even if positioning is performed at the rear end, there is a possibility that a large deviation may occur at the front end, so new positioning means must be provided at the front end side, making the structure more complicated There was a problem.
【０００８】一方、前記特開平６−２２５８８６号公報
に示された外科用鉗子では、内套管が先端方向に移動す
ることにより把持部に設けられた傾斜部を押し閉じる機
構になっているが、内套管が前方に移動してくるため把
持範囲が把持前より小さくなってしまうため、１度把持
した組織を落とす可能性がある。On the other hand, the surgical forceps disclosed in the above-mentioned Japanese Patent Application Laid-Open No. 6-225886 has a mechanism in which the inner tube moves in the distal direction to push and close the inclined portion provided in the grip portion. Since the inner tube moves forward, the grasping range becomes smaller than before grasping, and there is a possibility that the tissue once grasped may be dropped.
【０００９】また、上記外科用鉗子の手元操作部では、
親指を動かす構造の方が先端のブレを押さえることがで
きるが、握る動作をすると支点を介するため作動棒ある
いは作動しースを後方に移動させることとなる。これは
把持部を開く方向なため、反親指側を動かす構造にする
か、支点を２つ設ける等の工夫が必要となる。In the above-mentioned operation part of the surgical forceps,
The structure that moves the thumb can suppress the blur at the tip, but when the user performs a grasping operation, the actuation rod or the actuation is moved rearward through the fulcrum. Since this is the direction in which the grip portion is opened, it is necessary to devise a structure that moves the side opposite to the thumb or to provide two fulcrums.
【００１０】さらに、上記外科用鉗子では、内套管が傾
斜部を押す構造のため、当然内套管を前方に引き抜くこ
とができない。従って、把持部と作動棒のユニットは、
内套管の前方より挿入することになる。しかし、把持部
を有する超音波切開凝固装置の場合、先端にシースを取
り付けることになるため上記従来例のように後方から傾
斜部を押すことはできない。Further, in the above-mentioned surgical forceps, since the inner tube pushes the inclined portion, the inner tube cannot naturally be pulled out forward. Therefore, the unit of the gripper and the operating rod is
It will be inserted from the front of the inner tube. However, in the case of an ultrasonic incision coagulation device having a grip portion, a sheath is attached to the tip, so that the inclined portion cannot be pushed from behind as in the above-described conventional example.
【００１１】さらにまた、把持部を開くための力は把持
部に設けた板バネによるとしているが、板バネを使用す
るとその弾性限界のため長さ方向を比較的長くとらなけ
ればならず、また、一般的な巻きバネと比較して復元耐
性が低い。さらに、両開き鉗子では把持部の開き角を十
分とることはできるが、片開きの場合十分な開き角を得
ることはできない。また、片開きで十分な開き角を得よ
うとすると板バネ長さを長くする必要があり大型化して
しまうという問題がある。Further, the force for opening the grip portion is based on the leaf spring provided on the grip portion. However, if a leaf spring is used, the length direction must be relatively long due to its elastic limit. , The restoration resistance is lower than that of a general wound spring. Further, with the double-opening forceps, it is possible to obtain a sufficient opening angle of the grip portion, but in the case of a single opening, it is not possible to obtain a sufficient opening angle. In addition, if an attempt is made to obtain a sufficient opening angle with one-sided opening, there is a problem that the length of the leaf spring needs to be increased and the size increases.
【００１２】本発明は上記事情に鑑みてなされたもので
あり、簡単な構成で、確実に生体組織を把持あるいは切
除することができ、操作性を向上させることのできる外
科用鉗子及び超音波凝固切開装置を提供することを目的
にしている。SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and has a simple configuration, a surgical forceps and an ultrasonic coagulation capable of reliably grasping or resecting a living tissue and improving operability. It is intended to provide a lancing device .
【００１３】[0013]
【課題を解決するための手段及び作用】請求項１の外科
用鉗子は、細長な挿入部を体腔内に挿入し、生体組織を
把持あるいは切除する外科用鉗子において、前記挿入部
の先端側で前記生体組織を把持あるいは切除するための
第１の支持部材と、前記挿入部の先端側で前記生体組織
を把持あるいは切除するための前記第１の支持部材と相
対した第２の支持部材と、前記挿入部の内側に配置され
るとともに、前期第１の支持部材の少なくとも一部を覆
い、前記挿入部の長手方向に移動することにより、少な
くとも前記第１の支持部材及び前記第２の支持部材の一
方を開閉させる開閉手段と、前記開閉手段を前記挿入部
の長手方向に移動させる操作手段とを備え、前記開閉手
段が前記操作手段により前記挿入部の基端側に移動した
ときに、少なくとも前記第１の支持部材及び前記第２の
支持部材の一方が他方に近接する方向に回動することを
特徴とする。請求項２の超音波凝固切開装置は、超音波
振動子と、前記超音波振動子から発生した超音波振動を
基端側から先端側に伝達する超音波伝達部材と、前記超
音波伝達部材を覆う挿入部とを有する超音波凝固切開装
置において、前記超音波伝達部材の先端部に設けられ、
前記挿入部の先端側で前記生体組織を把持あるいは凝固
／切除するための第１の支持部材と、前記挿入部の先端
側で前記生体組織を把持あるいは切除するための前記第
１の支持部材と相対した第２の支持部材と、前記挿入部
の内側に配置されるとともに、前記超音波伝達部材の少
なくとも一部を覆い、前記超音波伝達部材の長手方向に
移動することにより、前記第２の支持部材を開閉させる
開閉手段と、前記開閉手段を前記超音波伝達部材の長手
方向に移動させる操作手段とを備え、前記開閉手段が前
記操作手段により前記超音波伝達部材の基端側に移動し
たときに、前記第２の支持部材が前記第１の支持部材に
近接する方向に回動することを特徴とする。 Means and operation for solving the problems] surgery claim 1
A forceps is a surgical forceps that inserts an elongated insertion portion into a body cavity and grasps or cuts a living tissue, and a first support member for grasping or cutting the living tissue at the distal end side of the insertion portion. A second support member facing the first support member for grasping or resecting the living tissue at the distal end side of the insertion portion; and a second support member disposed inside the insertion portion.
Opening and closing means for covering at least a part of the first support member and moving in the longitudinal direction of the insertion portion to open and close at least one of the first support member and the second support member. Operating means for moving the opening / closing means in the longitudinal direction of the insertion portion, wherein when the opening / closing means is moved to the base end side of the insertion portion by the operation means, at least the first support member and the It is characterized in that one of the second support members rotates in a direction approaching the other. The ultrasonic coagulation and incision device according to claim 2 is an ultrasonic coagulation and incision device.
A vibrator, and ultrasonic vibration generated from the ultrasonic vibrator.
An ultrasonic transmission member for transmitting from the proximal end to the distal end;
Ultrasonic coagulation and incision device having an insertion portion covering an acoustic wave transmission member
In the arrangement, provided at the tip of the ultrasonic transmission member,
Hold or coagulate the living tissue at the distal end side of the insertion section
/ A first support member for resection, and a tip of the insertion portion
Side for grasping or resecting the living tissue at the side
A second support member facing the first support member, and the insertion portion
And a small number of the ultrasonic transmission members.
At least partially, in the longitudinal direction of the ultrasonic transmission member
Opening and closing the second support member by moving
Opening / closing means, and the opening / closing means,
Operating means for moving in the direction of
Moving to the proximal end side of the ultrasonic transmission member by the operating means;
When the second support member comes into contact with the first support member.
It is characterized in that it rotates in the approaching direction.
【００１４】[0014]
【実施例】以下、図面を参照して本発明の実施例を説明
する。Embodiments of the present invention will be described below with reference to the drawings.
【００１５】図１ないし図６は本発明の一実施例に係
り、図１は超音波切開凝固装置の概略構成を示す説明
図、図２は図１の超音波切開凝固装置の構成を示す分解
斜視図、図３は図１の超音波切開凝固装置の先端の構成
を示す断面図、図４は図１の超音波切開凝固装置の組立
を説明する説明図、図５は図１の超音波切開凝固装置の
先端部分の作用を説明する説明図、図６は図５のＡ−Ａ
線断面を示す断面図である。1 to 6 relate to an embodiment of the present invention. FIG. 1 is an explanatory view showing a schematic configuration of an ultrasonic incision coagulation apparatus, and FIG. 2 is an exploded view showing a configuration of the ultrasonic incision coagulation apparatus in FIG. 3 is a cross-sectional view showing the configuration of the distal end of the ultrasonic incision coagulation device of FIG. 1, FIG. 4 is an explanatory view for explaining the assembly of the ultrasonic incision coagulation device of FIG. 1, and FIG. 5 is the ultrasonic wave of FIG. FIG. 6 is an explanatory view for explaining the operation of the distal end portion of the incision coagulation device, and FIG.
It is sectional drawing which shows a line cross section.
【００１６】図１に示すように、外科用鉗子としての超
音波切開凝固装置１は、内部に超音波振動子を配設した
グリップ部２と、このグリップ部２に固定されている操
作部３（操作手段）と、前記グリップ部２の超音波振動
子に連結されて超音波振動を伝達する細長な超音波プロ
ーブ（以下プローブと略記）４と、このプローブ４を被
覆するシース５とで構成されている。なお、操作部３に
は後述する可動部を可動させるハンドピース３ａが設け
られている。As shown in FIG. 1, an ultrasonic incision coagulation device 1 as a surgical forceps has a grip portion 2 in which an ultrasonic vibrator is disposed, and an operation portion 3 fixed to the grip portion 2. (Operating means), an elongated ultrasonic probe (hereinafter abbreviated as a probe) 4 connected to the ultrasonic vibrator of the grip portion 2 and transmitting ultrasonic vibration, and a sheath 5 covering the probe 4. Have been. The operation section 3 is provided with a handpiece 3a for moving a movable section described later.
【００１７】図２及びプローブ４の先端断面である図３
に示すように、プローブ４の先端には組織を切除、凝固
するための固定刃を構成する振動伝達部１１（第１の支
持部材）が設けられ、振動伝達部１１に対向する可動刃
を構成する可動部１２（第２の支持部材）が設けられて
いる。そして、振動伝達部１１と可動部１２とは巻きバ
ネ１３を介して開閉する構成になっている。可動部１２
及び巻きバネ１３は金属あるいは樹脂等で形成されたピ
ン１４によりフッ素樹脂等などの摺動部材で形成された
ベース１５に回転可能に固定されており、ベース１５に
はプローブ４との連結部１６が設けられ、連結部１６は
プローブ４の細径部１７に固定することができるように
なっている。連結部１６とプローブ４の細径部１７との
固定方法は、スナップフィット方式やネジ固定プローブ
を分割して挟み込む方法等がある。また、プローブ４の
細径部１７には平面部１８が形成されており、可動部１
２と振動伝達部１１との位置固定ができるようになって
いる。FIG. 2 and FIG. 3 which is a cross section of the tip of the probe 4.
As shown in (1), a vibration transmitting portion 11 (first support member) constituting a fixed blade for cutting and coagulating tissue is provided at the tip of the probe 4, and a movable blade facing the vibration transmitting portion 11 is formed. The movable portion 12 (second support member) is provided. The vibration transmitting unit 11 and the movable unit 12 are configured to open and close via a wrapping spring 13. Movable part 12
The winding spring 13 is rotatably fixed to a base 15 formed of a sliding member such as a fluororesin by a pin 14 formed of a metal or a resin. Is provided, so that the connecting portion 16 can be fixed to the small-diameter portion 17 of the probe 4. As a method of fixing the connecting portion 16 and the small-diameter portion 17 of the probe 4, there are a snap-fit method, a method of dividing and pinching the screw fixing probe, and the like. Further, a flat portion 18 is formed on the small diameter portion 17 of the probe 4, and the movable portion 1 is formed.
2 and the vibration transmission unit 11 can be fixed in position.
【００１８】プローブ４の外周には、可動部１２を開閉
させるための内シース１９（開閉手段）が設けられてお
り、その先端にはフッ素樹脂等の摺動部材で作られた摺
動部２０が設けられている。また、摺動部２０には当接
部２１が設けられており、可動部１２に設けられた作用
部２２に当たるようになっている。なお、フッ素樹脂等
の摺動部材で作られた摺動部２０に代わりにプローブ４
に接する部分にフッ素樹脂コーティングを施して構成し
ても良い。An outer sheath 19 (opening / closing means) for opening and closing the movable portion 12 is provided on the outer periphery of the probe 4, and a sliding portion 20 made of a sliding member such as a fluororesin is provided at the tip thereof. Is provided. Further, the sliding portion 20 is provided with an abutting portion 21, which comes into contact with an action portion 22 provided on the movable portion 12. In addition, instead of the sliding portion 20 made of a sliding member such as fluororesin, the probe 4
May be configured by applying a fluororesin coating to a portion in contact with.
【００１９】図４に示すように、組立は、グリップ部２
から突出しているホーン３１にプローブ４を埋合後、シ
ース５をプローブ４の外周に挿入する。挿人後、シース
５の後端部に設けられたフランジ部３２に設けられた溝
３３に操作部３のハンドピース３ａに連結されたＵ字型
部３５に設けられた支持棒３６を可動的に組み合わせ
る。As shown in FIG.
After the probe 4 is embedded in the horn 31 protruding from the probe 4, the sheath 5 is inserted into the outer periphery of the probe 4. After the insertion, the support rod 36 provided on the U-shaped part 35 connected to the handpiece 3a of the operation part 3 is movable into the groove 33 provided on the flange part 32 provided on the rear end of the sheath 5. Combine with.
【００２０】次に、このように構成された本実施例の作
用について説明する。Next, the operation of the embodiment constructed as described above will be described.
【００２１】図５及び図５のＡ−Ａ断面である図６に示
すように、操作部３を操作することにより内シース１９
が軸方向に前後する。内シース１９が後方に動いた場
合、当接部２１が作用部２２に当たり、ピン１４を中心
に可動部１２を回転させ閉じることとなる。また、内シ
ース１９が前方に動くと可動部１２は巻きバネ１３の力
で再び開く。グリップ部２内部の超音波振動子より発生
した超音波振動はプローブ４に伝わり振動伝達部１１に
伝達される。可動部１２が閉したとき、可動部１２と振
動伝達部１１との間に挟まれた組織は振動伝達部１１が
超音波振動することにより発生する摩擦熱により，焼灼
される。As shown in FIG. 5 and FIG. 6, which is a cross section taken along line AA of FIG.
Move back and forth in the axial direction. When the inner sheath 19 moves rearward, the contact portion 21 contacts the action portion 22 and the movable portion 12 is rotated about the pin 14 and closed. When the inner sheath 19 moves forward, the movable portion 12 is opened again by the force of the helical spring 13. Ultrasonic vibration generated by the ultrasonic vibrator in the grip 2 is transmitted to the probe 4 and transmitted to the vibration transmitting unit 11. When the movable section 12 is closed, the tissue sandwiched between the movable section 12 and the vibration transmitting section 11 is cauterized by frictional heat generated by the vibration transmitting section 11 being ultrasonically vibrated.
【００２２】プローブ４に伝達された超音波は振動伝達
部１１に伝達されるため、プローブ４に接触しているも
のとの間では超音波振動による摩擦熱が発生することと
なるが本実施例においては、プローブ４と接触している
部分は摺動部材で形成されたベース１５のみであり、摂
動による摩擦熱は発生しにくい。そのため正常組織に熱
の影響を与えることはない。また、プローブ４が削れる
などの不具合もなくなり、耐性が向上する。さらに、振
動による金属同士の接触による異音の発生の防止効果も
ある。また、フッ素樹脂コーティングなどを使用すれば
さらに小型化、簡素化などを図ることが可能となる。ベ
ース１５により内シース１９とプローブの位置決めをす
るためプローブと内シース１９との接触を防止し発熱の
防止、耐久性の向上ができる。Since the ultrasonic wave transmitted to the probe 4 is transmitted to the vibration transmitting unit 11, frictional heat is generated between the ultrasonic wave transmitted to the probe 4 and the one in contact with the probe 4 by the ultrasonic vibration. In the above, only the base 15 formed of a sliding member is in contact with the probe 4, and frictional heat due to perturbation is unlikely to be generated. Therefore, there is no influence of heat on the normal tissue. In addition, there is no problem such as the probe 4 being scraped, and the durability is improved. Further, there is an effect of preventing generation of abnormal noise due to contact between metals due to vibration. Further, if a fluororesin coating or the like is used, further downsizing and simplification can be achieved. The positioning of the probe with the inner sheath 19 by the base 15 prevents contact between the probe and the inner sheath 19, thereby preventing heat generation and improving durability.
【００２３】このように本実施例によれば、焼灼の間、
組織は可動部１２によって挟まれているため滑り落ちる
ことはなく、確実に焼灼される。また、巻きバネ１３を
使用することにより、可動部１２の開き角を大きくとる
ことができ、さらに先端部の開閉部を小型化でき、また
開閉動作の耐久性をアップできる。Thus, according to the present embodiment, during cauterization,
Since the tissue is sandwiched between the movable parts 12, it does not slide down and is cauterized reliably. Further, by using the coil spring 13, the opening angle of the movable portion 12 can be increased, the opening / closing portion at the distal end can be reduced in size, and the durability of the opening / closing operation can be improved.
【００２４】内シース１９を後方に移動して可動部１２
を閉じる機構なため、プローブ４を操作部３のハンドピ
ース３ａに固定した後、シース５を取り付けることがで
きるため、組立・分解が容易となる。また構造が簡単な
ため洗條性が向上し、操作部の機構も簡素化され、可動
部１２を閉じた時の把持範囲が小さくなることがない。The inner sheath 19 is moved backward to move the movable portion 12
, The sheath 5 can be attached after the probe 4 is fixed to the handpiece 3a of the operation unit 3, so that assembly and disassembly become easy. Further, since the structure is simple, the washing property is improved, the mechanism of the operation unit is simplified, and the gripping range when the movable unit 12 is closed is not reduced.
【００２５】なお、上記実施例では、外科用鉗子として
超音波切開凝固装置を例に説明したが、これに限らず、
例えば高周波電流による焼灼装置や患部組織を把持する
把持鉗子等の外科用鉗子にも適用できることは言うまで
もない。In the above embodiment, an ultrasonic incision coagulation device has been described as an example of the surgical forceps. However, the present invention is not limited to this.
For example, it is needless to say that the present invention can be applied to a surgical forceps such as a cautery device using a high-frequency current or a grasping forceps for grasping an affected tissue.
【００２６】［付記］ （付記項１） 細長な挿入部を体腔内に挿入し、生体組
織を把持あるいは切除する外科用鉗子において、前記挿
入部の先端に前記生体組織を把持あるいは切除するため
の第１の支持部材と、前記挿入部の先端に前記生体組織
を把持あるいは切除するための前記第１の支持部材と相
対した第２の支持部材と、前記第１の支持部材及び前記
第２の支持部材を覆い、前記挿入部の長手方向に移動す
ることにより、少なくとも前記第１の支持部材及び前記
第２の支持部材の一方を開閉させる開閉手段と、前記開
閉手段を前記挿入部の長手方向に移動させる操作手段と
を備え、前記開閉手段が前記操作手段により前記挿入部
の基端側に移動したときに、少なくとも前記第１の支持
部材及び前記第２の支持部材の一方が他方に近接する方
向に回動することを特徴とした外科用鉗子。[Supplementary note] (Supplementary note 1) In a surgical forceps for inserting a slender insertion portion into a body cavity and grasping or resecting a living tissue, a distal end of the insertion portion is used for grasping or resecting the living tissue. A first support member, a second support member at a distal end of the insertion portion, which is opposed to the first support member for gripping or resecting the living tissue, the first support member, and the second support member. Opening and closing means for covering at least one of the first support member and the second support member by covering the support member and moving in the longitudinal direction of the insertion portion; Operating means for moving the opening / closing means to the proximal end side of the insertion portion by the operating means, at least one of the first support member and the second support member comes close to the other. You Forceps were characterized by pivoting in the direction.
【００２７】（付記項２） 前記開閉手段は、開閉を補
助する開閉補助手段（巻きバネ１３）を有することを特
徴とする付記項１に記載の外科用鉗子。(Additional Item 2) The surgical forceps according to Additional Item 1, wherein the opening / closing means has opening / closing assisting means (winding spring 13) for assisting opening / closing.
【００２８】（付記項３） 前記第１の支持部材及び前
記第２の支持部材を回転支持する回転支持手段（ピン１
４）を有することを特徴とする付記項１に記載の外科用
鉗子。(Appendix 3) Rotation support means (pin 1) for rotatably supporting the first support member and the second support member.
Item 4. The surgical forceps according to item 1, wherein item 4) is provided.
【００２９】（付記項４） 前記第１の支持部材及び前
記第２の支持部材を回転支持する回転支持手段（ピン１
４）を有し、前記開閉補助手段は、前記回転支持手段に
より固定されていることを特徴とする付記項２に記載の
外科用鉗子。(Additional Item 4) Rotation support means (pin 1) for rotatably supporting the first support member and the second support member.
4. The surgical forceps according to claim 2, wherein 4) and the opening and closing assisting means is fixed by the rotation supporting means.
【００３０】（付記項５） 前記開閉手段の先端部には
凸部が設けられ、前記凸部は、前記第１の支持部材に設
けられた作用部を押すことで、前記第１の支持部材を閉
じることを特徴とする付記項１に記載の外科用鉗子。(Supplementary note 5) A convex portion is provided at a tip end of the opening / closing means, and the convex portion presses an action portion provided on the first support member, thereby causing the first support member to press. The surgical forceps according to claim 1, wherein the surgical forceps are closed.
【００３１】（付記項６） 前記開閉手段と前記第１の
支持部材及び前記第２の支持部材の接触部とは、摺動部
材で形成されていることを特徴とする付記項１に記載の
外科用鉗子。(Additional Item 6) The additional member according to the additional item 1, wherein the opening / closing means and a contact portion between the first support member and the second support member are formed of a sliding member. Surgical forceps.
【００３２】（付記項７） 前記第１の支持部材は、基
端で超音波発振源と連結され、前記超音波発振源からの
超音波を伝達することのできる部材で形成されているこ
とを特徴とする付記項１に記載の外科用鉗子。(Appendix 7) The first support member is connected to an ultrasonic oscillation source at a base end and is formed of a member capable of transmitting ultrasonic waves from the ultrasonic oscillation source. The surgical forceps according to claim 1, characterized in that:
【００３３】[0033]
【発明の効果】以上説明したように本発明によれば 、
簡単な構成で、確実に生体組織を把持あるいは切除し、
操作性を向上させることができるという効果がある。As described above , according to the present invention ,
In easy single configuration to grip or cut reliably biological tissue,
There is an effect that operability can be improved.
【図１】本発明の一実施例に係る超音波切開凝固装置の
概略構成を示す説明図FIG. 1 is an explanatory diagram showing a schematic configuration of an ultrasonic incision coagulation apparatus according to one embodiment of the present invention.
【図２】図１の超音波切開凝固装置の構成を示す分解斜
視図FIG. 2 is an exploded perspective view showing the configuration of the ultrasonic incision coagulation apparatus shown in FIG. 1;
【図３】図１の超音波切開凝固装置の先端の構成を示す
断面図FIG. 3 is a cross-sectional view showing a configuration of a distal end of the ultrasonic incision coagulation apparatus of FIG. 1;
【図４】図１の超音波切開凝固装置の組立を説明する説
明図FIG. 4 is an explanatory view for explaining assembly of the ultrasonic incision coagulation apparatus of FIG. 1;
【図５】図１の超音波切開凝固装置の先端部分の作用を
説明する説明図FIG. 5 is an explanatory view for explaining the operation of the distal end portion of the ultrasonic incision coagulation apparatus of FIG. 1;
【図６】図５のＡ−Ａ線断面を示す断面図FIG. 6 is a sectional view showing a section taken along line AA of FIG. 5;
１…超音波切開凝固装置 ２…グリップ部 ３…操作部 ３ａ…ハンドピース ４…超音波プローブ ５…シース １１…振動伝達部 １２…可動部 １３…巻きバネ １４…ピン １５…ベース １６…連結部 １７…細径部 １８…平面部 １９…内シース ２０…摺動部 ２１…当接部 ２２…作用部 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic incision coagulation apparatus 2 ... Grip part 3 ... Operation part 3a ... Hand piece 4 ... Ultrasonic probe 5 ... Sheath 11 ... Vibration transmission part 12 ... Movable part 13 ... Winding spring 14 ... Pin 15 ... Base 16 ... Connection part 17 ... Small diameter part 18 ... Flat part 19 ... Inner sheath 20 ... Sliding part 21 ... Contact part 22 ... Working part
フロントページの続き (58)調査した分野(Int.Cl.7，ＤＢ名) A61B 17/28 310 A61B 18/00 Continuation of front page (58) Field surveyed (Int. Cl. 7 , DB name) A61B 17/28 310 A61B 18/00
Claims (3)
織を把持あるいは切除する外科用鉗子において、 前記挿入部の先端側で前記生体組織を把持あるいは切除
するための第１の支持部材と、 前記挿入部の先端側で前記生体組織を把持あるいは切除
するための前記第１の支持部材と相対した第２の支持部
材と、前記挿入部の内側に配置されるとともに、前期第１の支
持部材の少なくとも一部 を覆い、前記挿入部の長手方向
に移動することにより、少なくとも前記第１の支持部材
及び前記第２の支持部材の一方を開閉させる開閉手段
と、 前記開閉手段を前記挿入部の長手方向に移動させる操作
手段とを備え、 前記開閉手段が前記操作手段により前記挿入部の基端側
に移動したときに、少なくとも前記第１の支持部材及び
前記第２の支持部材の一方が他方に近接する方向に回動
することを特徴とする外科用鉗子。1. A surgical forceps for inserting an elongated insertion portion into a body cavity to grasp or cut a living tissue , wherein a first support member for grasping or cutting the living tissue at a distal end side of the insertion portion. And a second support member facing the first support member for grasping or resecting the living tissue at the distal end side of the insertion portion; and a second support member disposed inside the insertion portion, Branch
Opening and closing means for covering at least a part of the holding member and moving in the longitudinal direction of the insertion portion to open and close at least one of the first support member and the second support member; Operating means for moving in the longitudinal direction of the portion, wherein at least one of the first support member and the second support member when the opening / closing means is moved to the proximal end side of the insertion portion by the operating means. The surgical forceps rotate in a direction approaching the other.
発生した超音波振動を基端側から先端側に伝達する超音
波伝達部材と、前記超音波伝達部材を覆う挿入部とを有
する超音波凝固切開装置において、 前記超音波伝達部材の先端部に設けられ、前記挿入部の
先端側で前記生体組織を把持あるいは凝固／切除するた
めの第１の支持部材と、 前記挿入部の先端側で前記生体組織を把持あるいは切除
するための前記第１の支持部材と相対した第２の支持部
材と、 前記挿入部の内側に配置されるとともに、前記超音波伝
達部材の少なくとも一部を覆い、前記超音波伝達部材の
長手方向に移動することにより、前記第２の支持部材を
開閉させる開閉手段と、 前記開閉手段を前記超音波伝達部材の長手方向に移動さ
せる操作手段とを備え、 前記開閉手段が前記操作手段により前記超音波伝達部材
の基端側に移動したときに、前記第２の支持部材が前記
第１の支持部材に近接する方向に回動することを特徴と
する超音波凝固切開装置。 2. An ultrasonic vibrator and said ultrasonic vibrator
Ultrasonic that transmits the generated ultrasonic vibration from the proximal end to the distal end
A wave transmitting member, and an insertion portion covering the ultrasonic transmitting member.
In the ultrasonic coagulation and incision device to be provided, the ultrasonic transmission member is provided at the distal end of the ultrasonic transmission member,
For grasping or coagulating / excising the living tissue at the distal end side
A first support member for grasping or resecting the living tissue at the distal end side of the insertion portion
A second support portion facing the first support member for performing
Material and the ultrasonic transmission
At least a portion of the ultrasonic transmission member,
By moving the second support member in the longitudinal direction,
Opening and closing means for opening and closing, and moving the opening and closing means in the longitudinal direction of the ultrasonic transmission member.
Operating means for causing the ultrasonic transmission member to be opened and closed by the operating means.
When the second support member moves to the base end side of the
Characterized in that it rotates in a direction approaching the first support member.
Ultrasonic coagulation and incision device.
回転支持手段により回動することを特徴とする請求項２
に記載の超音波凝固切開装置。 3. The second support member supports rotation.
3. The rotation by means of a rotation support means.
The ultrasonic coagulation and incision apparatus according to claim 1.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP08146995A JP3354032B2 (en) | 1995-04-06 | 1995-04-06 | Surgical forceps and ultrasonic coagulation and incision device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP08146995A JP3354032B2 (en) | 1995-04-06 | 1995-04-06 | Surgical forceps and ultrasonic coagulation and incision device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH08275948A JPH08275948A (en) | 1996-10-22 |
| JP3354032B2 true JP3354032B2 (en) | 2002-12-09 |
Family
ID=13747271
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP08146995A Expired - Fee Related JP3354032B2 (en) | 1995-04-06 | 1995-04-06 | Surgical forceps and ultrasonic coagulation and incision device |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP3354032B2 (en) |
Families Citing this family (17)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA2213948C (en) | 1996-09-19 | 2006-06-06 | United States Surgical Corporation | Ultrasonic dissector |
| US5944737A (en) * | 1997-10-10 | 1999-08-31 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having improved waveguide support member |
| AU6357298A (en) | 1997-04-28 | 1998-10-29 | Ethicon Endo-Surgery, Inc. | Methods and devices for controlling the vibration of ultrasonic transmission components |
| US5954736A (en) * | 1997-10-10 | 1999-09-21 | Ethicon Endo-Surgery, Inc. | Coagulator apparatus having indexed rotational positioning |
| US5893835A (en) * | 1997-10-10 | 1999-04-13 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having dual rotational positioning |
| US5980510A (en) * | 1997-10-10 | 1999-11-09 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having improved clamp arm pivot mount |
| US5947984A (en) * | 1997-10-10 | 1999-09-07 | Ethicon Endo-Surger, Inc. | Ultrasonic clamp coagulator apparatus having force limiting clamping mechanism |
| US6068647A (en) * | 1997-10-10 | 2000-05-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having improved clamp arm tissue pad |
| US5873873A (en) * | 1997-10-10 | 1999-02-23 | Ethicon Endo-Surgery, Inc. | Ultrasonic clamp coagulator apparatus having improved clamp mechanism |
| DE19806718A1 (en) * | 1998-02-18 | 1999-08-26 | Storz Endoskop Gmbh | System for treating of body tissue using ultrasound with generator and unit transmitting ultrasound on tissue and hollow probe |
| US20030171747A1 (en) | 1999-01-25 | 2003-09-11 | Olympus Optical Co., Ltd. | Medical treatment instrument |
| GB2355661A (en) * | 1999-09-17 | 2001-05-02 | Michael John Radley Young | Ultrasonic surgical tool |
| JP2003093402A (en) * | 2002-07-25 | 2003-04-02 | Olympus Optical Co Ltd | Operation apparatus |
| US8574252B2 (en) | 2006-06-01 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Ultrasonic blade support |
| USD767353S1 (en) | 2007-05-22 | 2016-09-27 | Ethicon Endo-Surgery, Llc | Torque wrench for ultrasonic instrument |
| JP5312868B2 (en) * | 2008-08-01 | 2013-10-09 | オリンパスメディカルシステムズ株式会社 | Endoscopic treatment tool |
| CN104523312B (en) * | 2015-01-30 | 2016-08-24 | 陈裕生 | A kind of execution head of straight line closed cutter |
-
1995
- 1995-04-06 JP JP08146995A patent/JP3354032B2/en not_active Expired - Fee Related
Also Published As
| Publication number | Publication date |
|---|---|
| JPH08275948A (en) | 1996-10-22 |
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