JPS59186546A - Surgical incision instrument - Google Patents

Abstract

(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

【発明の詳細な説明】 ［発明の技術分野］ 本発明は、切開することなく、内視鏡等による観察のも
とに例えば膝関節腔内における滑膜組織とか繊維性組織
、あるいは軟骨等のけば立ち等を効率良く切削すると共
に、腔内から器具を引き出すことなく、切削した組織片
等を速やかに吸引除去できる外科用切除器具に関する。Detailed Description of the Invention [Technical Field of the Invention] The present invention is directed to the observation of synovial tissue, fibrous tissue, cartilage, etc. within a knee joint cavity without making an incision, under observation using an endoscope or the like. The present invention relates to a surgical resection instrument capable of efficiently cutting off fuzz, etc., and quickly suctioning off cut tissue pieces, etc., without pulling out the instrument from inside the cavity.

［発明の技術的背景とその問題点］ 数十年前から人体の関節は目視深針、つまり内視鏡を挿
入すれば、目視できることは知られていたが、関節手術
は主として切開法で行われていた。[Technical background of the invention and its problems] It has been known for several decades that the joints of the human body can be visually observed by inserting a deep visual needle, that is, an endoscope, but joint surgery is mainly performed by an open method. I was worried.

例えば、代表的な関節の手術は、膝蓋骨上の腫瘍を除去
したり、膝関節から破損した軟骨等を除去すること等で
あるが、大きな切開を必要としていた。このため、切開
による外傷、苦痛等が直るまでに多くの時間を要すると
いう欠点を有していた。For example, typical joint surgeries require large incisions, such as removing a tumor on the patella or removing damaged cartilage from the knee joint. For this reason, it has the disadvantage that it takes a long time to recover from the trauma, pain, etc. caused by the incision.

又、関節腔内の半月等の軟骨を切除しなければならない
場合のように、狭い腔内の組織片の切除ということは、
大きく切開しなければ殆んど行うことができなかった。In addition, when removing a piece of tissue within a narrow cavity, such as when cartilage such as a meniscus within a joint cavity must be removed,
Almost nothing could be done without making a large incision.

このため、近年、関節鏡の観察のもとで、切開しないで
、小さな穿刺孔を形成し、該穿刺孔に挿入されたプロー
ブを使用して手術する外科用切除器具が種々提案されて
いる。しかしながら例えば膝等の関節腔内における滑膜
繊維、繊維性組織とかひだ状の組織は、弾力性を有する
と共に、粘りがあるため、これら従来の切除器具では食
い付きが悪く、切除の際に逃げられてしまい、有効に切
除できるものが殆んどなかった。又、仮りに切除できて
も能率が悪いものであった。For this reason, in recent years, various surgical resection instruments have been proposed that form a small puncture hole without making an incision under arthroscopic observation and perform surgery using a probe inserted into the puncture hole. However, synovial fibers, fibrous tissues, and folded tissues in the joint cavity of the knee, for example, have elasticity and stickiness, so these conventional resection instruments have difficulty engaging and escape during resection. There was very little that could be effectively removed. Moreover, even if it could be excised, it would be inefficient.

［発明の目的］ 本発明は上述した点にかんがみてなされたもので、繊維
性組織等対象組織ｆ＼の狙撃が容易であると共に、食い
付きが良好で、しかも対象組織のみを切削して速やかに
排出できる外科用切除器具を提供することを目的とする
。[Object of the Invention] The present invention has been made in view of the above-mentioned points, and it is easy to target the target tissue f\ such as fibrous tissue, has good bite, and can quickly cut only the target tissue. The purpose of the present invention is to provide a surgical resection instrument that can be ejected in a timely manner.

［発明の概要］ 本発明は中空の管状部材に回転駆動される軸を収容し、
該軸の先端側に単数又は複数の刃を取付部材を介して取
付けると共に、前記刃の先端が臨む開口部を、切除用開
口窓を設けた凸面形状等の薄肉のカバ一部材で閉塞して
形成されている。[Summary of the Invention] The present invention accommodates a rotationally driven shaft in a hollow tubular member,
One or more blades are attached to the tip side of the shaft via a mounting member, and the opening where the tip of the blade faces is closed with a thin cover member having a convex shape or the like provided with an aperture for cutting. It is formed.

［発明の実施例］ 以下、図面を参照して本発明を具体的に説明する。[Embodiments of the invention] Hereinafter, the present invention will be specifically described with reference to the drawings.

第１図ないし第４図は本発明の第１実施例に係り、第１
図は第１実施例の構造を示し、第２図は第１図の挿入部
先端側を拡大して示し、第３図は第２図の左側面図を示
し、第４図は第１実施例を用いて切除する様子を示す。FIGS. 1 to 4 relate to a first embodiment of the present invention.
The figure shows the structure of the first embodiment, FIG. 2 shows an enlarged view of the distal end of the insertion section in FIG. 1, FIG. 3 shows the left side view of FIG. 2, and FIG. 4 shows the structure of the first embodiment. An example is used to demonstrate how to perform resection.

これらの図において、第１実施例の（外科用）切除器具
１は、中空円管状の挿入部２の後端側を大径にして把持
部（操作部）３が形成されている。In these figures, the (surgical) resection instrument 1 of the first embodiment has a hollow circular tubular insertion section 2 with a large diameter at the rear end side, and a grip section (operation section) 3 is formed therein.

上記把持部３は、挿入部２の＠端側か、その前端内周に
嵌着される（把持部）本体４と、該本体４の後端側に螺
着されるモータハウジング５とから構成されている。こ
のモータハウジング５内には回転駆動手段としてのモー
タ６が収容されている。The grip part 3 is composed of a main body 4 (grip part) fitted on the @ end side of the insertion part 2 or the inner periphery of the front end thereof, and a motor housing 5 screwed onto the rear end side of the main body 4. has been done. A motor 6 serving as rotation driving means is accommodated within the motor housing 5.

一方、上記挿入部２内には円管の中心を通って回転動伝
達手段としての軸部材７が挿通され、該軸部材７の後端
は連結部材８を介し、モータハウジング５前枠のシール
機能を兼ねる軸受部５Ａで軸支された上記モータ６の回
転軸に連結され、該軸部材アの前端（先端）は略円板状
の（刃〉取付部材９に連結されている。上記連結部４’
Ａ’　８における連結は、例えばねじを螺着することに
よって、行われている。又、軸部材７の先端側は一部切
欠いた形状等にして、取付部材９の後面突部に形成した
凹部にスプリング１１を介装して嵌合収容されている。On the other hand, a shaft member 7 as a rotational motion transmitting means is inserted into the insertion portion 2 through the center of the circular tube, and the rear end of the shaft member 7 is connected to a seal of the front frame of the motor housing 5 via a connecting member 8. It is connected to the rotating shaft of the motor 6 which is supported by a bearing part 5A which also serves as a function, and the front end (tip) of the shaft member A is connected to a substantially disc-shaped (blade) mounting member 9.The above-mentioned connection Part 4'
The connection at A'8 is made, for example, by screwing. Further, the distal end side of the shaft member 7 is partially cut out, and a spring 11 is inserted and housed in a recess formed in the rear protrusion of the mounting member 9.

この取付部材９の前面側には略半径方向で、回転方向Ａ
に対し若干凹面状に湾曲した溝１２．１２（図示では一
方のみを示す）が形成されてそれぞれフ、レキシブルな
名刀１３の基部側が合溝１２に沿って湾曲して収容され
ている。On the front side of this mounting member 9, there is a direction of rotation A in the approximately radial direction.
Slightly concavely curved grooves 12 and 12 (only one of which is shown in the figure) are formed, and the base sides of flexible swords 13 are curved along the matching grooves 12 and housed therein.

上記合溝１２にそれぞれ刃１３を収容した取付部材９は
スプリング１１を介装して軸部材７の先端に取付けられ
、凸面状の薄肉部に半径方向に細長となる開口窓１４．
・・・、１４を形成した着脱自在のカバ一部材としての
蓋１５にて覆われている。The mounting member 9, which accommodates a blade 13 in each of the matching grooves 12, is attached to the tip of the shaft member 7 with a spring 11 interposed therebetween, and an opening window 14, which is elongated in the radial direction, is formed in a convex thin-walled portion.
..., 14, and is covered with a lid 15 as a removable cover member.

このｍ１５の開口端内周には例えば雌ねじが形成され、
挿入部２先端に形成した雄ねじに螺着することによって
、スプリング１１によって若干前方に突出するよう付勢
された名刀１３における弧状の刃先が薄肉部内周面に当
接した状態で覆われている。For example, a female thread is formed on the inner periphery of the open end of this m15,
By screwing into the male thread formed at the tip of the insertion part 2, the arc-shaped cutting edge of the famous sword 13, which is urged to protrude slightly forward by the spring 11, is covered in a state in which it is in contact with the inner circumferential surface of the thin-walled part.

上記名刀１３の刃先は第３図に示すように回転方向△に
折り曲げられて、蓋１５の薄肉部内周面と、直角より小
さい鋭角となる状態で接し、薄肉部内周面に接する状態
で各月１３が回転駆動された際、開口窓１４．・・・、
１４から入り込んだ繊維状組織等を逃すことなく切除で
きるようになっている。The blade edge of the famous sword 13 is bent in the rotational direction △ as shown in FIG. 13 is rotated, the opening window 14. ...,
It is possible to cut out the fibrous tissue etc. that have entered from 14 without missing them.

又、上記取付部材９における谷溝１２に対し、回転方向
前方側に近接して切断した組織片の通路となる合孔１６
が形成されている。Further, a matching hole 16 is formed close to the front side in the rotational direction with respect to the valley groove 12 in the mounting member 9, and serves as a passage for the cut tissue piece.
is formed.

一方、把持部３の外周にあける例えば前端に近い部位に
モータ６に供給される電力をオンオフ制御できるスイッ
チ１７が取付けられ、又このスイッチ１７の取付は部位
と対向する反対側には挿入部２の中空路と連通ずる吸引
用口金１８が形成されている。On the other hand, a switch 17 that can control on/off the electric power supplied to the motor 6 is attached to the outer periphery of the gripping part 3, for example, in a part near the front end, and this switch 17 is installed on the opposite side of the insertion part 2 A suction mouthpiece 18 is formed which communicates with the hollow passage.

上記駆動用モータ６はモータハウジング５に収容接栓１
９でシールされ、コードカバー２０Ａ付きのコード２０
で電源２１（第４図参照）と接続されるようになってい
る。The drive motor 6 is housed in the motor housing 5 with a plug 1
Cord 20 sealed with 9 and with cord cover 20A
The power supply 21 (see FIG. 4) is connected to the power supply 21 (see FIG. 4).

このように構成された第１実施例の動作を以下に説明す
る。The operation of the first embodiment configured in this way will be described below.

第４図に示すように、第１実施例の切除器具１のコード
２０を電源２１に接続し、且つ吸引用口金１８にチュー
ブ２２を接続して吸引装置２３と連結し、図示しないス
イッチを操作すれば吸引可能となる状態に設定しておく
。しかして第４図に示すように目的とする部位、例えば
膝関節内で滑脱組織とか繊維性組織等の切除を行う場合
、膝部に第１実施例の先端側を挿入できる小孔をトラカ
ール等の穿刺操作等によって設け、挿入部２先端側を挿
入する。As shown in FIG. 4, the cord 20 of the cutting instrument 1 of the first embodiment is connected to the power source 21, and the tube 22 is connected to the suction cap 18 to connect it to the suction device 23, and a switch (not shown) is operated. Set it so that it can be sucked. However, as shown in FIG. 4, when resecting a target site such as a slipped tissue or fibrous tissue within a knee joint, a small hole into which the distal end of the first embodiment can be inserted is inserted into the knee using a trocar or the like. The insertion section 2 is provided by a puncturing operation, etc., and the distal end side of the insertion section 2 is inserted.

又、上記第１実施例の目的部位への挿入及び目的部位の
切除を観察しながら行えるように、関節鏡２４の照明及
び観察光学系が配設された関節鏡挿入部２４Ａをトラカ
ール等の穿刺操作によって導入し、関節鏡２４の接眼部
に眼を近接して、又は装着したテレビカメラ２５によっ
て、撮影した映像を表示するブラウン管等用いて形成し
た表示装置２６に関節腔内の様子及び第１実施例の先端
を観察できる状態にする。In addition, in order to perform insertion into the target site and resection of the target site in the first embodiment while observing, the arthroscope insertion section 24A, which is provided with the illumination and observation optical system of the arthroscope 24, is inserted into the trocar or the like by puncturing it. The image inside the joint cavity is displayed on a display device 26 formed using a cathode ray tube or the like, which displays images captured by the camera 25 when the eye is brought close to the eyepiece of the arthroscope 24 or by a television camera 25 attached. The tip of Example 1 is made observable.

さらに、生理的食塩水を制御された水圧で、給永源２７
から穿刺した給水管２８を経て関節内に供給できる状態
にする。In addition, physiological saline is supplied to the source 27 with controlled water pressure.
The water can be supplied into the joint through the water supply pipe 28 punctured from the hole.

このように設定した状態で、照明光源３１の照明光によ
って関節鏡２３の挿入部２４内を挿通されたライトガイ
ドを経て照明された関節腔内を術者は表示装置２６で観
察しながら、第１実施例の切除器具１の先端側を脛骨３
２と大腿骨３３との間に挿入し、その周辺にある切除部
位となる繊維性組織等に挿入部２先端側の蓋１５の凸面
を当接させる。（第３図においては、膝部の一部を切欠
いて示しである。）。With these settings, the operator uses the display device 26 to observe the interior of the joint cavity, which is illuminated by the illumination light from the illumination light source 31 through the light guide inserted through the insertion section 24 of the arthroscope 23. The tip side of the resection instrument 1 of the first embodiment is attached to the tibia 3.
2 and the femur 33, and the convex surface of the lid 15 on the distal end side of the insertion section 2 is brought into contact with fibrous tissue or the like that will be the resection site around the insertion section 2. (In FIG. 3, a part of the knee part is cut away.)

しかして、スイッチ１７を押圧する等してオンしてモー
タ６を回転駆動すると共に、吸引装置２３の図示しない
スイッチを操作（上記スイッチ１７と連動するスイッチ
でも良い。）して吸引動作を働かせる。すると、上記蓋
１５に当接された組織における開口窓１４．・・・、１
４に入り込んだひだ状等の組織は、凸面状薄肉部内周面
にに当接して回転駆動される各月１３の刃先で効率良く
切断される。Then, the switch 17 is turned on by pressing the switch 17, etc. to rotationally drive the motor 6, and a switch (not shown) of the suction device 23 is operated (a switch that is linked to the switch 17 described above may also be used) to perform the suction operation. Then, the opening window 14 in the tissue abutted against the lid 15. ..., 1
The fold-like structure that has entered the grooves 4 is efficiently cut by the cutting edge of each lug 13 that comes into contact with the inner circumferential surface of the convex thin-walled portion and is driven to rotate.

つまり、各月１３は各開口窓１４から入り込んだ組織の
側部側に刃先が向くためと、各月１３が半径方向に対し
凹面状に湾曲して取付けであるため、回転の際組織が半
径方向外側に逃げられることなく能率良く切断される。In other words, because the cutting edge of each moon 13 is directed toward the side of the tissue that has entered through each opening window 14, and because each moon 13 is attached with a concave curve in the radial direction, the tissue radially changes when rotated. Cuts efficiently without escaping in the outside direction.

又、切断された組織片は、合孔１６を通って潅流液と共
に挿入部２の中空路を通り手元側に吸引され、さらに口
金１８に接続したチューブ２２を経て吸引装置２３側に
吸引排出され、必要に応じて該吸引装置２３内（又は外
）のフィルタ等によって組織片と潅流液とは分離できる
。Further, the cut tissue piece passes through the joint hole 16, passes through the hollow passage of the insertion section 2 together with the irrigation fluid, is suctioned to the proximal side, and is further suctioned and discharged to the suction device 23 side through the tube 22 connected to the mouthpiece 18. If necessary, tissue pieces and perfusion fluid can be separated by a filter inside (or outside) the suction device 23.

このように簡単な構造の第１実施例によって、繊維状組
Ｒ等は能率良く切断及び吸引除去できる。With the first embodiment having such a simple structure, the fibrous set R and the like can be efficiently cut and removed by suction.

引き続いて切断する場合には先端側を移動させたり、回
転したりして開口窓１４．・・・、１４の位置を変えれ
ば良い。この実施例によれば凸面に当接される側の繊維
のみの組織等が切削されるので、狙撃性が良好なものと
なる。又、開口窓１４．・・・。When cutting is to be continued, the tip side is moved or rotated to open the opening window 14. ..., just change the position of 14. According to this embodiment, only the tissue of the fibers on the side that comes into contact with the convex surface is cut, so that the shooting performance is improved. Also, the opening window 14. ....

１４から入り込む組織片は細いことと、各刃１３かフレ
キシブルであるので、切削の際、刃先が摩耗したり、損
傷される虞れが少く、長寿命のものとなる。Since the tissue pieces entering from 14 are thin and each blade 13 is flexible, there is little risk of the blade edge being worn or damaged during cutting, resulting in a long life.

又、仮りに刃１３が損傷しても交換は容易であり、替刃
も低コストで実現できる。又、刃先に細かい組織片が付
着しても、Ｍ２Ｓを外すことによって容易に除去あるい
は洗浄できる。Furthermore, even if the blade 13 is damaged, it can be easily replaced, and replacement blades can be realized at low cost. Furthermore, even if fine tissue particles adhere to the blade edge, they can be easily removed or cleaned by removing the M2S.

第５図は本発明の第２実施例における蓋４１を示す。FIG. 5 shows a lid 41 in a second embodiment of the invention.

この実施例における蓋４１においては異る大きさの開口
窓４２，４２，４２，４２　：４３，４．３゜４３；４
４，４４がそれぞれ形成されており、切除されるべき組
織片の大きさを選ぶことができるようになっている。又
、最初大きな開口窓４４゜４４で切除し、その後車さい
開口窓４２等を用いて仕上げを行うこともできる。又、
小さい開口窓４２等を用いて切除すれば、必要以上に大
きな組織を切除してしまうこともないという利点を有す
る。In the lid 41 in this embodiment, opening windows 42, 42, 42, 42: 43, 4.3° 43; 4 of different sizes are provided.
4 and 44, respectively, so that the size of the tissue piece to be excised can be selected. Alternatively, it is also possible to first cut out the large aperture 44° 44, and then finish using the wheel sill aperture 42 or the like. or,
Excision using a small opening window 42 or the like has the advantage that an unnecessarily large tissue will not be excised.

第６図及び第７図は本発明の第３実施例を示し、第６図
は挿入部先端側を示し、第７図は名刀の取付構造を拡大
して示す側面図である。6 and 7 show a third embodiment of the present invention, FIG. 6 shows the distal end side of the insertion part, and FIG. 7 is an enlarged side view showing the mounting structure of the famous sword.

第６図に示すように第３実施例の切除器具５１における
挿入部５２の先端側は側部側に円状の開口部が形成され
ている。この挿入部５２内には軸部材５３が挿通され該
軸部材５３の先端にはマイク歯車５４が開口部の中心後
方に位置するように固定されている。このマイク歯車５
４に歯合するマイク歯車５５を後端側に取付けた取付部
材５６の前面にはそれぞれ溝５７を形成して名刀５８の
基部側が収容しである。この実施例においては台溝５７
の奥に例えば第７図に示すように満５７の長手方向に四
角形状の凹部が形成され、折り曲げられた名刀５８の基
部が収容されると共に、その内側に長手方向の両側から
切り込みを設ける等して長手方向両端で拡開する弾性力
を示す板ばね５９が介装され、名刀５８の刃先が各渦５
７から突出する方向に付勢されて収容されている。As shown in FIG. 6, a circular opening is formed on the side of the distal end of the insertion section 52 in the cutting instrument 51 of the third embodiment. A shaft member 53 is inserted into the insertion portion 52, and a microphone gear 54 is fixed to the tip of the shaft member 53 so as to be located behind the center of the opening. This microphone gear 5
A groove 57 is formed on the front surface of each mounting member 56 to which a microphone gear 55 that meshes with the microphone gear 55 is attached to the rear end side, and the base side of the famous sword 58 is accommodated therein. In this embodiment, the trapezoid 57
For example, as shown in FIG. 7, a rectangular recess is formed in the longitudinal direction of the mantle 57 in the depths thereof, and the bent base of the famous sword 58 is accommodated therein, and cuts are provided inside the recess from both sides in the longitudinal direction. A leaf spring 59 exhibiting an elastic force that expands at both ends in the longitudinal direction is interposed, and the blade edge of the famous sword 58 is inserted into each vortex 5.
It is biased in a direction protruding from 7 and accommodated.

上記軸部材５３の先端側のマイク歯車５４に歯合させた
取付部材５６に取付けた刃５８．５８は、凸面状の薄肉
部を形成した蓋６０によって覆われている。The blades 58 and 58 attached to the attachment member 56 meshed with the microphone gear 54 on the distal end side of the shaft member 53 are covered by a lid 60 having a convex thin wall portion.

この第３実施例によれは、挿入方向の側面側における滑
脱組織、繊維性組織、軟骨等の【プば立ち等を効率良く
切削除去できる。According to the third embodiment, it is possible to efficiently cut and remove protrusions such as slipped tissue, fibrous tissue, cartilage, etc. on the side surface side in the insertion direction.

尚、上述の各実施例を組合わせたものも本発明の範ちゅ
うに入ることは明らかである。例えば、第１実施例にお
いて、第３実施例における刃５８の取付構造を適用する
等できる。It is clear that combinations of the above embodiments also fall within the scope of the present invention. For example, in the first embodiment, the mounting structure of the blade 58 in the third embodiment can be applied.

又、本発明は開口窓が図示した開口窓１４，４２．４３
．４４に限定されるもので、なく、刃１３゜５８と反対
側に弧状となる形状にしたり、円状。Further, the present invention is applicable to the opening windows 14, 42, 43 shown in the drawings.
．． The shape is not limited to 44, but may be arcuate on the opposite side of the blade 13°58, or circular.

長円状、正方形状その他の形状でも良い。又、取付部材
９，５６等に形成される孔１６の形状及びその個数も上
述のものに限定されるものでないし、刃の個数もさらに
多数設けたものも、１個のものについても本発明のは範
ちゅうに入るものである。It may be oval, square or other shape. Further, the shape and number of holes 16 formed in the mounting members 9, 56, etc. are not limited to those described above, and the present invention also applies to those with a larger number of blades or those with one blade. falls within this category.

さらに、刃１３．５８の形状は、刃先が凸面状薄肉部内
周に当接するか、殆んど接触する状態で回転駆動される
状態であれば良く、凸面をより突出させたり、あるいは
殆んど平面状に近いものであっても良い。Furthermore, the shape of the blade 13.58 may be such that the cutting edge contacts or almost contacts the inner periphery of the convex thin wall part and is rotated, and the convex surface is made to protrude more or It may be nearly flat.

尚、開口窓の形状を（多数の）小孔にした場合等におい
ては、第１実施例で述べたように湾曲させなくても切削
可能であり、この場合には半径方向への直線状の溝で充
分なものとなる。このようにすれば、溝の加工が容易で
ある。In addition, when the shape of the opening window is made into (many) small holes, it is possible to cut it without curving it as described in the first embodiment. The groove will be sufficient. This makes it easy to process the grooves.

又、第３実施例における挿入部５２は円管状のものに限
定されるものでないし、回転動の伝達手段としての軸部
材７．５３は細径の円柱状のものに限定されるものでな
い。Furthermore, the insertion portion 52 in the third embodiment is not limited to a cylindrical shape, and the shaft member 7.53 serving as a rotational motion transmission means is not limited to a small diameter cylindrical shape.

又、第３実施例における軸部材５３と取付部材５６との
噛合は、１体１で回転を直角に伝達するマイク歯車５４
．５５に限らず、適当な回転比で伝達するかさ歯車等で
も良い。又、第１実施例のように挿入部２前方とか、第
３実施例のように挿入部５２に対し、直角方向の側部側
を切削できるようにするものに限らず、斜め前方とか斜
め後方側等を（適当な歯車等を用いることによって）切
削除去できる構造とすることもできる。Further, the engagement between the shaft member 53 and the mounting member 56 in the third embodiment is such that the microphone gear 54 transmits rotation at right angles in one body 1.
．． The rotation speed is not limited to 55, but a bevel gear or the like that transmits transmission at an appropriate rotation ratio may be used. In addition, the cutting is not limited to the front side of the insertion section 2 as in the first embodiment or the side part in the perpendicular direction to the insertion section 52 as in the third embodiment; It is also possible to have a structure in which the sides etc. can be cut and removed (by using suitable gears etc.).

尚、駆動装置としてのモータ６は手元側把持部３に収容
しなければならないものでなく、外部に設け、フレキシ
ブルシャフト等を介して把持部等において、軸部材７，
５３と連結するよう構成することもできる。Incidentally, the motor 6 as a drive device does not have to be housed in the hand-side grip part 3, but is provided externally and is connected to the shaft member 7, etc. in the grip part via a flexible shaft or the like.
It can also be configured to be connected to 53.

［発明の効果］ 以上述べたように本発明によれば、中空の挿入部内に回
転駆動される軸部材を収容し、該軸部材の先端側に取付
部材を介して刃を取付（プると共に、該刃の先端側刃先
が臨む開口部を薄肉で開口窓を設けたカバ一部材で該薄
肉の内周面に刃先が略当接する状態で閉塞し、且つ手元
側以降の吸引手段で挿入部の中空路を経て切断した組織
片等を吸引除去できるようにしであるので、滑膜繊紺と
か繊維性組織等あるいは軟骨のけば立ち等を、狙撃性が
良好で、効率良く切削し、且つ吸引排出できる。[Effects of the Invention] As described above, according to the present invention, a rotatably driven shaft member is housed in a hollow insertion portion, and a blade is attached to the distal end side of the shaft member via an attachment member (while being pulled). , the opening where the distal cutting edge of the blade faces is closed with a thin-walled cover member provided with an opening window with the cutting edge substantially in contact with the inner circumferential surface of the thin-walled cover, and the insertion portion is removed by suction means from the proximal side onwards. Since the cut tissue pieces can be removed by suction through the hollow passage, synovial fibers, fibrous tissues, cartilage fuzz, etc. can be cut efficiently with good targeting ability. Can be suctioned and discharged.

又、刃が損傷したり、摩耗することが少く長寿命である
。さらに構造か簡単であり、低コストで製造できる。又
、刃先に細かい組織片が付着しても、蓋を取り外して簡
単に除去できる。In addition, the blade is less likely to be damaged or worn out and has a long life. Furthermore, it has a simple structure and can be manufactured at low cost. Furthermore, even if small pieces of tissue adhere to the blade edge, they can be easily removed by removing the lid.

【図面の簡単な説明】[Brief explanation of the drawing]

第１図ないし第４図は本発明の第１実施例に係り、第１
図は第１実施例の全体の構造を一部切欠いて示す正面図
、第２図は第１図の先端側を一部切欠いて拡大して示す
正面図、第３図は第２図の側面図、第４図は第１実施例
を用いて切除する様子を−示す説明図、第５図は本発明
の第２実施例における蓋に形成した開口窓を示す側面図
、第６図及び第７図は本発明の第３実施例に係り、第６
図は第３実施例の挿入部先端側を示す断面図、第７図は
取付部材に刃が取付けられる構造を拡大して示す側面図
である。 １．５１・・・切除器具　　２，５２・・・挿入部３・
・・把持部　　　　　　　　　６・・・モータ７．５３
・・・軸部材　　　９．５６・・・取付部材１１・・・
スプリング　　１２．５７・・・溝１３．５８・・・刃 １４．４２，４３．４４・・・開口窓 １５．６０・・・蓋　　　　　　１６・・・孔１７・・
・スイッチ　　　　　　Ｉ８・・・吸引用口金２４・・
・関節鏡 ２５・・・テレビカメラ　　　　２６・・・表示装置５
４．５５・・・マイク歯車 ５つ・・・板ばね 第５図 第６図 第７図 第１頁の続き ０発　明　者　松尾和正 東京都渋谷区幡ケ谷二丁目４３番 ２号才リンパス光学工業株式会 社内 ０発　明　者　水元９秀 東京都渋谷区幡ケ谷二丁目４３番 ２号才リンパス光学工業株式会 社内 ０発　明　者　加藤正彦 東京都渋谷区幡ケ谷二丁目４３番 ２号才リンパス光学工業株式会 社内 ■発　明　者　萩野忠夫 東京都渋谷区幡ケ谷二丁目４３番 ２号才リンパス光学工業株式会 社内FIGS. 1 to 4 relate to a first embodiment of the present invention.
The figure is a partially cutaway front view of the entire structure of the first embodiment, FIG. 2 is a partially cutaway, enlarged front view of the tip side of FIG. 1, and FIG. Figure 4 is an explanatory view showing how cutting is performed using the first embodiment, Figure 5 is a side view showing the opening window formed in the lid in the second embodiment of the present invention, and Figures 6 and 4 are explanatory diagrams showing the state of cutting using the first embodiment. FIG. 7 relates to the third embodiment of the present invention, and the sixth embodiment
The figure is a sectional view showing the distal end side of the insertion portion of the third embodiment, and FIG. 7 is an enlarged side view showing the structure in which the blade is attached to the attachment member. 1.51... Resection instrument 2,52... Insertion section 3.
・Gripping part 6...Motor 7.53
...Shaft member 9.56...Mounting member 11...
Spring 12.57... Groove 13.58... Blade 14.42, 43.44... Opening window 15.60... Lid 16... Hole 17...
・Switch I8...Suction cap 24...
・Arthroscope 25...TV camera 26...Display device 5
4.55 ... 5 microphone gears ... leaf spring Figure 5 Figure 6 Figure 7 Figure 7 Continued from page 1 0 Inventor Kazumasa Matsuo 2-43-2 Hatagaya, Shibuya-ku, Tokyo Lymphus Optical Industry Inventor: Mizumoto 9Hide, 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inventor: Masahiko Kato, 2-43-2, Hatagaya, Shibuya-ku, Tokyo Inventor: Masahiko Kato Inventor Tadao Hagino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Incorporated within Lymphus Optical Industry Co., Ltd.

Claims (1)

【特許請求の範囲】 （１）中空の挿入部に回転動の伝達部材を挿通し、該伝
達部材の先端側に単数又は複数の刃を取付部材を介して
取付けると共に、前記刃の先端が臨む挿入部先端側の開
口部を、開口窓を設けた薄肉のカバ一部材で着脱自在に
閉塞し、手元側把持部に収容した、又は外部に配設した
回転駆動装置によって、前記刃を伝達部材を介して回転
駆動可能とすると共に、切削した組織片等を挿入部の中
空部を通して外部の吸引装置側に吸引排出可能にしたこ
とを特徴とする外科用切除器具。 く２）前記開口部は、挿入部の軸方向に開口するよう形
成したことを特徴とする特許請求の範囲第１項記載の外
科用切除器具。 （３）前記開口部は、挿入部の軸方向と直角方向ないし
は斜め前方に開口するよう形成したことを特徴とする特
許請求の範囲第１項記載の外科用切除器具。 （４）前記刃は、開口部から突出する向きに付勢して刃
先がカバ一部材内周面に当接するよう取付けたことを特
徴とする特許請求の範囲第１項記載の外科用切除器具。 （５）前記刃は、回転駆動される方向に刃先側を折り曲
げた形状に成型したことを特徴とする特許請求の範囲第
１項記載の外科用切除器具。 （６）前記カバ一部材は、開口窓が形成された薄肉の部
分を凸面状ないしは平面状に成型したことを特徴とする
特許請求の範囲第１項記載の外科用切除器具。[Scope of Claims] (1) A rotary motion transmission member is inserted into the hollow insertion portion, and one or more blades are attached to the distal end side of the transmission member via a mounting member, and the distal ends of the blades face. The opening on the distal end side of the insertion part is removably closed with a thin cover member provided with an opening window, and the blade is moved to the transmission member by a rotary drive device housed in the proximal grip part or disposed externally. What is claimed is: 1. A surgical resection instrument characterized in that it is rotatably driven through the insertion section, and that cut tissue pieces, etc., can be suctioned and discharged to an external suction device through a hollow section of the insertion section. 2) The surgical cutting instrument according to claim 1, wherein the opening is formed to open in the axial direction of the insertion section. (3) The surgical cutting instrument according to claim 1, wherein the opening is formed to open in a direction perpendicular to the axial direction of the insertion section or diagonally forward. (4) The surgical cutting instrument according to claim 1, wherein the blade is attached such that the blade is urged in a direction protruding from the opening and the blade edge comes into contact with the inner circumferential surface of the cover member. . (5) The surgical cutting instrument according to claim 1, wherein the blade is formed in a shape in which the cutting edge side is bent in the direction in which the blade is rotationally driven. (6) The surgical cutting instrument according to claim 1, wherein the cover member has a thin portion formed with an opening window formed into a convex or planar shape.