JP2018064883A - Switchable laparoscopic forceps - Google Patents

Abstract

A switchable laparoscopic forceps capable of projecting necessary forceps from a shaft and operating only the protruded forceps with a single handle. SOLUTION: A plurality of forceps units 30 housed in a cylindrical main body so as to be able to protrude and a handle portion 20 for controlling opening and closing of the forceps unit protruded from the cylindrical main body, the forceps unit including a jaw portion 32a. A forceps portion 32 having a link mechanism for opening and closing the jaw, a rod for driving the link mechanism, a shaft 36 for housing the forceps portion and a part of the rod, and a slit connecting member 38 fixed to the other end of the rod, And a switch spring having a load spring disposed between the shaft and the slit coupling member, and the handle portion being connected to a wire 52 engaged with a slit 38s of each slit coupling member via a wire pin 50. Laparoscopic forceps. [Selection] Figure 2

Description

  The present invention relates to a forceps used in laparoscopic surgery.

  In recent years, surgery for treatment has been performed with laparoscopic surgery using an endoscope as a technique for reducing the burden on the patient as much as possible. In particular, it is frequently used in surgery for digestive organs. In laparoscopic surgery, several holes are opened in the abdomen and temporary ports called trocars are provided. From this trocar, an endoscope and a surgical instrument are inserted into the abdominal cavity to perform surgery.

  Since the trocar is a hole with a diameter of several tens of millimeters, the shape of an instrument that can be inserted into the trocar is also limited. Patent Document 1 describes a typical forceps used in such laparoscopic surgery. Basically, this type of forceps is provided with a jaw that opens and closes at the end of a shaft incorporating an elongated rod, and the rod is controlled by opening the handle. The shape is similar to a handgun.

  Since the trocar is only provided in several places, the amount of instruments that can be brought into the abdominal cavity through the trocar is also limited. Therefore, forceps for bringing a plurality of forceps from one trocar into the abdominal cavity have also been proposed.

  Patent Document 2 shows that two forceps are provided at the tip of one shaft. Patent Document 3 discloses a device in which three forceps are provided at the tip of one shaft.

Japanese Patent Laid-Open No. 08-164144 Special table 2014-512870 gazette Japanese National Patent Publication No. 08-502438

  As disclosed in Patent Documents 2 and 3, it is a useful idea to bring a plurality of forceps into the abdominal cavity at a time. As the operation progresses, the type of forceps required changes. Therefore, it is necessary to sequentially replace the forceps as the operation progresses. However, exchanging the forceps increases the chances of inserting and removing the tip of the forceps from the trocar, which takes time and increases the operation time.

  However, as in Patent Documents 2 and 3, when a plurality of forceps protrude from the single shaft into the abdominal cavity, it is difficult to know which handle operates which forceps in a narrow endoscope field of view. In addition, forceps that are out of the field of view of the endoscope may touch unnecessary organs.

  The present invention has been conceived in view of the above problems, and a single shaft is provided with a plurality of forceps, and necessary forceps protrude from the shaft, and only the protruded forceps can be operated with one handle. A switchable laparoscopic forceps is provided.

More specifically, the switchable laparoscopic forceps (1) according to the present invention includes:
A plurality of forceps units (30) housed in a cylindrical body (10) in a projectable manner;
A handle portion (20) for controlling opening and closing of the forceps unit (30) projecting from the cylindrical body (10);
The forceps unit (30)
A forceps part (32) having a jaw part (32a) for opening and closing and a link mechanism (32b) for opening and closing the jaw part (32a);
A rod (40) having one end connected to the link mechanism (32b) and driving the link mechanism (32b);
A shaft (36) for housing a portion of the forceps portion (32) and the rod (40);
A slit coupling member (38) fixed to the other end (40b) of the rod (40);
A load spring (42) penetrating the rod (40) between the shaft (36) and the slit coupling member (38);
The handle portion (20) is connected to a wire (52) engaged with a slit (38s) of each slit connecting member (38) of the forceps unit (30) via a wire pin (50). It is characterized by. The rod (40) is not visible in the shaft (36) in FIGS. See FIG.

  In the switching type laparoscopic forceps according to the present invention, a plurality of forceps units are arranged in the shaft, so that a plurality of forceps can be brought into the abdominal cavity from one trocar at a time. In addition, since only the forceps unit protruding from the shaft is operated with one handle at hand, there is no operation error.

  Also, if one forceps is allowed to protrude from the shaft, it is possible to avoid touching an organ that does not need to be touched by other forceps, and the risk of damaging the abdominal cavity becomes very low.

It is a figure which shows the external appearance of the switch-type laparoscopic forceps which concerns on this invention, and a cut cross section. It is a figure which shows the state except the main body of the switch-type laparoscopic forceps. It is the enlarged view of FIG. 2, Comprising: The perspective view from diagonally backward, and the perspective view from diagonally forward. It is a figure which shows the stopper provided in the main body exterior. It is a block diagram which shows the inside of the forceps unit part of the switch-type laparoscopic forceps. It is a figure which shows the internal structure of a wire switching member. It is a figure explaining operation | movement (how to use) of the switching type laparoscopic forceps.

  The switching type laparoscopic forceps according to the present invention will be described below with reference to the drawings and examples. The following description exemplifies an embodiment and an example of the present invention, and the present invention is not limited to the following description. The following description can be modified without departing from the spirit of the present invention.

<Overall configuration>
FIG. 1 shows an external view (FIG. 1 (a)) and a cut sectional view (FIG. 1 (b)) of a switch-type laparoscopic forceps 1 according to the present invention. In FIG. 1A as well, the handle portion 20 is excluded from the exterior. The switchable laparoscopic forceps 1 includes a main body 10 and a handle portion 20. The main body 10 has a cylindrical shape. A plurality of forceps units 30 are accommodated in the main body 10. FIG. 1 shows a case where two forceps units 30 are stored. Of course, three or more forceps units 30 may be accommodated.

  In the following description, the handle 20 side of the switchable laparoscopic forceps 1 is referred to as “rear”, and the opposite side is referred to as “front”. Further, in the two forceps units 30, the upper forceps unit 30 is referred to as “(A side) forceps unit 30A”, and the lower forceps unit 30 is referred to as “(B side) forceps unit 30B”. In addition, when distinguishing the forceps units 30 and the members constituting them, they are distinguished by adding “A” or “B” after the symbols of the respective members. Attached.

  Each forceps unit 30 is accommodated in the main body 10 in a state in which the direction of the forceps portion 32 and the axial direction are aligned and further aligned in the axial direction of the main body 10. In addition, an axis | shaft here means the centerline (rotation center) of the front-back direction of the main body 10 and the shaft 36 (after-mentioned).

  The handle portion 20 is provided with a thumb hole 21 and a lower finger hole 22. The lower finger hole 22 is fixed to the main body 10, and the thumb hole 21 is pivotally supported by a pivot 21 a provided in the handle portion 20, so that the main body 10 can be opened and closed around the pivot 21 a. Further, a ratchet 23 is disposed adjacent to the lower finger hole 22. The ratchet 23 locks the operation of the thumb hole 21.

  Each forceps unit 30 is provided with an operation lever 34 protruding from the main body 10. The operation lever 34 is for moving the forceps unit 30 in the axial direction (front-rear direction) within the main body 10. Further, a stopper 11 for fixing the position of the operation lever 34 is provided on the outer surface of the main body 10.

  When the operation lever 34 is pushed out toward the front end direction (forward) of the main body 10, the forceps portion 32 of the forceps unit 30 protrudes from the front end of the main body 10.

  FIG. 2 shows a state where the main body 10 is removed. The internal configuration of the forceps unit 30 will be described later with reference to FIG. In the forceps unit 30, an operation lever 34 is attached to a shaft 36 that is an exterior of the forceps unit 30. Therefore, when the operation lever 34 is moved forward, the forceps unit 30 is also moved in the axial direction (front and rear). FIG. 2 shows a state where the lower forceps unit 30B is pushed forward.

  A slit coupling member 38 is connected to a rod 40 (not visible in the shaft 36 in FIG. 2) disposed in the shaft 36 of the forceps unit 30. The slit connecting member 38 is a member in which a slit is formed in the longitudinal direction of the long member. As the long member, for example, a cylindrical shape, a strip shape, or a cubic shape can be suitably used.

  A wire pin 50 is engaged with the slit 38 s of the slit connecting member 38. A wire 52 attached to the wire pin 50 is connected to the thumb hole 21 of the handle portion 20 via a wire switching member 54.

  The wire switching member 54 and the handle part 20 are fixed. Further, the wire switching member 54 and the main body 10 (see FIG. 1) are also fixed. Then, by closing and opening the thumb hole 21 and the lower finger hole 22, the wire 52 is drawn or drawn out to the handle portion 20 side (rear side).

  The spring clamp 13 is fixed inside the main body 10. The spring clamp 13 is a wall material in which a hole (not shown) through which the shaft 36 passes is formed for each forceps unit 30. The spring clamp 13 is disposed between the operation lever 34 of the forceps unit 30 and the forceps portion 32 at the tip. Between the spring clamp 13 and the operation lever 34, a shaft spring 36s is disposed in a state where the shaft 36 of the forceps unit 30 is penetrated.

  A forceps holding plate 12 is disposed at the top of the main body 10. The forceps holding plate 12 forcibly closes the jaw portion 32 a of the forceps unit 30 when the forceps unit 30 is housed in the main body 10. Specifically, the forceps unit 32 of the forceps unit 30 is a plate in which a through hole is formed so that the jaw 32a can be passed in a closed state. The forceps holding plate 12 is fixed to the main body 10.

  FIG. 3 is an enlarged view of FIG. 2, and shows a perspective view obliquely from the rear (FIG. 3A) and a perspective view obliquely from the front (FIG. 3B). The operation lever 34 is fixed to the shaft 36. A slit coupling member 38 is fixed to a rod 40 (described in FIG. 5) at the end of the shaft 36 on the handle portion 20 side. The slit connecting member 38 is formed in an elongated member having substantially the same diameter as the shaft 36, and a slit 38s is formed in the length direction thereof.

  A wire 52 is connected to the wire pin 50 with the wire pin 50 inserted through the slit connecting member 38. That is, the wire pin 50 is disposed so as to be movable along the slit 38 s in the slit 38 s of the slit connecting member 38.

  In FIG. 3, in the upper forceps unit 30A (see FIG. 2), the wire pin 50A is located in the middle of the slit 38sA of the slit connecting member 38A. On the other hand, in the lower forceps unit 30B (see FIG. 2), the wire pin 50B is locked to the rear end of the slit 38sB of the slit connecting member 38B. The rear end of the slit connecting member 38 is referred to as a “locking end 38t”. In FIG. 3, only the locking end 38tA and the locking end 38tB are shown in FIG.

  The slit connecting member 38, the wire pin 50, and the wire 52 are provided for each forceps unit 30. And the wire 52 from each forceps unit 30 is put together by the wire switching member 54. In the wire switching member 54, all the wires 52 are combined into one and connected to the thumb hole 21 (see also FIGS. 1 and 2) (details of the wire switching member 54 will also be described later).

  FIG. 4 shows the stopper 11 provided outside the main body 10. 4A shows the forceps unit 30A (see FIG. 2) side, and FIG. 4B shows the forceps unit 30B (see FIG. 2) side. Assume that the forceps unit 30B side is pushed forward. The main body 10 is provided with a slit 10s. The operation lever 34 projects from the slit 10s to the outside of the main body 10, and is installed so as to be movable back and forth along the slit 10s.

  The stopper 11 is provided around the main body 10 at the slit 10s. Further, the stopper 11 is also cut off at a portion overlapping the slit 10s. Therefore, the operation lever 34 can be manually moved back and forth at the slit 10s and the overlapping portion of the slit 10s and the slit 11s.

  The stopper 11 is provided with a stopper piece 11a that can slide in a direction perpendicular to the slit 11s. Further, the sliding range of the stopper piece 11a can be slid to a position where the slit 11s of the stopper 11 is closed. In other words, the stopper piece 11a can move in the circumferential direction of the main body 10 within the stopper 11, and is provided to be slidable from a position at which the slit 11s is completely opened to a position at which the slit 11s is closed.

  When the forceps unit 30 is housed in the main body 10, as shown in FIG. 4A, the operation lever 34A is positioned behind the stopper piece 11a. On the other hand, when the forceps unit 30 protrudes from the main body 10 as shown in FIG. 4B, the operation lever 34B is positioned in front of the stop piece 11a. When the stopper 11a is slid at each location to close the slit 11s, the operation lever 34 does not move in the front-rear direction from that position.

  FIG. 5 is a configuration diagram that makes it easier to see the internal configuration of the forceps unit 30 portion of the switchable laparoscopic forceps 1 in FIGS. 1 and 2. 5A and 5B show the forceps unit 30 alone, and FIG. 5C shows a state where the two forceps units 30 are housed in the main body 10.

  With reference to FIG. 5A, the forceps unit 30 includes a forceps portion 32, a rod 40, a shaft 36, a load spring 42, and a slit connecting member 38.

  The forceps 32 has a pair of jaws 32a coupled to a link mechanism 32b. The configuration of the pair of jaws 32a and the link mechanism 32b may be a known configuration. The rod 40 drives the link mechanism 32b. The rod 40 is a long rod-shaped member, and has rigidity in the length direction. In other words, if one end is pushed and moved, the other end is moved by the length of which one end is pushed without bending in the middle.

  A link mechanism 32 b is connected to one end 40 a of the rod 40. On the other hand, a slit coupling member 38 is coupled to the other end 40 b of the rod 40.

  The link mechanism 32b is configured to open the jaw 32a when the rod 40 is pushed in and close the jaw 32a when the rod 40 is pulled out. FIG. 5A shows a state where the rod 40 is pulled out with respect to the shaft 36, and FIG. 5B shows a state where the rod 40 is pushed into the shaft 36.

  Since the slit connecting member 38 is coupled to the other end 40 b of the rod 40, the jaw 32 a is opened when the slit connecting member 38 is pushed into the shaft 36, and the slit connecting member 38 is pulled out from the shaft 36. It can be said that the jaw portion 32a is closed when it is pushed.

  The movement distance of the rod 40 necessary for opening / closing the jaw portion 32a is referred to as an opening / closing length 40L. Since the jaw portion 32a and the rod 40 are connected by the link mechanism 32b, the jaw portion 32a is opened and closed by pushing and pulling the rod 40. Conversely, when the open jaw 32a is forcibly closed, the rod 40 is pushed backward by an opening / closing length of 40L.

  The link mechanism 32 b and the rod 40 are covered with a shaft 36. However, at least the jaw portion 32 a is disposed outside the shaft 36. The link mechanism 32b is fixed to the shaft 36.

  Further, the slit coupling member 38 is disposed such that at least the slits 38 s of the slit coupling member 38 are outside the shaft 36. The slit connecting member 38 is not fixed to the shaft 36. 1-3, this shaft 36 is visible, and the rod 40 is in the shaft 36 and is not visible. The shaft 36 is a cylindrical member. It is preferable to form a cylindrical shape that is easy to manufacture.

  A load spring clamp 36a is provided on the inner surface of the shaft 36 on the slit connecting member 38 side. The load spring 42 extends through the rod 40 and connects the load spring clamp 36 a and the slit connecting member 38. Then, the load spring 42 is urged in the contracting direction with the rod 40 pushed into the link mechanism 32b.

  Therefore, the slit connecting member 38 is attracted toward the shaft 36 unless a force is applied in the front-rear direction. As a result, the rod 40 pushes the link mechanism 32b against the shaft 36, and the jaw portion 32a is maintained in an open state. That is, the forceps unit 30 is set in a normally open state.

  Since the rod 40 always pushes in the link mechanism 32b, when the slit connecting member 38 is pulled rearward with respect to the shaft 36, the rod 40 pulls out the link mechanism 32b, and as a result, the jaw portion 32a is closed. When the rearward pulling of the slit connecting member 38 is released, the slit connecting member 38 is pulled back to the shaft 36 side, and the rod 40 pushes the link mechanism 32b. As a result, the jaw 32a opens.

  That is, the rod 40 can be pulled out or pushed in by applying or releasing a backward force to the slit connecting member 38. As a result, the jaw 32a can be opened and closed by applying or releasing a backward force to the slit connecting member 38.

  In the present embodiment, the forceps unit 30 having such a configuration is housed in the two-unit body 10. The main body 10 is provided with a spring clamp 13. The shaft spring 36 s is disposed between the spring clamp 13 and the operation lever 34 in a state of penetrating each forceps unit 30.

  FIG. 6 shows the internal structure of the wire switching member 54. The wire switching member 54 has a wire inlet 54a side and a wire outlet 54b side. The wire inlet 54a side is disposed on the slit connecting member 38 side, and the wire outlet 54b side is disposed on the handle portion 20 side (see FIG. 3).

  On the wire inlet 54a side, the wire 52A from the upper forceps unit 30A and the wire 52B from the lower forceps unit 30B are inserted. Inside each wire, rotatable wire rolls 55aA, 55bA, 55aB, 55bB arranged in parallel are arranged for each wire.

  And each wire 52 is made to hold on the mutual wire roll 55, and is pulled out from the wire exit 54b side. That is, on the wire outlet 54b side, the wires 52 for each forceps unit 30 are combined into one. The collected wire 52 is connected to the thumb hole 21 of the handle portion 20.

  Thus, even if the wire 52 moves back and forth by passing the wire 52 between the rotatable wire rolls 55 parallel to each other, the wires 52 can be prevented from being entangled with each other.

  The operation of the switchable laparoscopic forceps 1 having the above configuration will be described. Please refer to FIG. The switchable laparoscopic forceps 1 has a main body 10 inserted into a body through a trocar (not shown). At this time, the operation lever 34 is located outside the trocar.

  The operator selects the A-side forceps unit 30A or the B-side forceps unit 30B as necessary. The operator pushes the operation lever 34 of the forceps unit 30 on the selected side forward and fixes it with the stopper 11 (see FIG. 1). This state is shown in FIG.

  In FIG. 7A, it is assumed that the lower forceps unit 30B of the two forceps units 30 is in a selected state. At this time, in the A-side forceps unit 30A, the jaw portion 32aA is regulated by the forceps holding plate 12 in a closed state. The load spring 42A adjusted to the normally open state is extended by an opening / closing length of 40L (see FIG. 5).

  In other words, the load spring 42A exerts a force to return the slit coupling member 38A to the shaft 36A side. Further, in the slit 38sA of the slit connecting member 38A, the wire pin 50A is located at a point far from the locking end 38tA of the slit 38sA.

  Reference is made to FIG. When operated to open the thumb hole 21 of the handle portion 20 in this state, the wire 52A is pulled toward the handle portion 20 side. However, since the wire pin 50A does not rest on the engaging end 38tA of the slit 38sA of the slit connecting member 38A, it only slides in the slit 38sA. That is, the rod 40A does not move, and the jaw portion 32aA does not open / close.

  On the other hand, in the B-side forceps unit 30B, the operation lever 34B is pushed forward. By the pushing operation of the forceps unit 30B, the forceps 32, which is the tip of the forceps unit 30B, protrudes from the main body 10, and the restriction from the forceps pressing plate 12 is released. Therefore, the load spring 42B can return to the normal state, and pulls the rod 40B back to the fixed position with respect to the shaft 36B. As a result, the jaw 32aB opens. Further, the wire pin 50B moves to the locking end 38tB of the slit 38sB of the slit connecting member 38B.

  Reference is made to FIG. When the thumb hole 21 of the handle portion 20 is opened in this state, the wire 52B is pulled toward the handle portion 20 side. Then, the wire pin 50B of the B-side forceps unit 30B pulls the slit connecting member 38B toward the handle portion 20 side. The rod 40B connected to the slit connecting member 38B moves to the handle portion 20 side. As a result, the jaw 32aB is closed. At this time, the load spring 42B is extended, and an urging force to return the slit coupling member 38B to the front side works.

  When the thumb hole 21 is returned to the original position, the slit connecting member 38B returns to the tip side in accordance with the urging of the load spring 42B. The rod 40B also returns at the same time. As a result, the jaw 32aB opens. In this way, the jaw portion 32aB is opened and closed by the opening and closing operation of the thumb hole 21.

  On the other hand, since the A-side forceps unit 30A is in the storage position of the main body 10, even if the wire pin 50A moves back and forth by opening / closing the thumb hole 21 of the handle portion 20, it moves in the slit 38sA of the slit connecting member 38A. Just opening and closing the jaw 32aA is not performed.

  When replacing the forceps unit 30, the operation lever 34 </ b> B is operated to house the B-side forceps unit 30 </ b> B in the main body 10. Thereafter, the operation lever 34A is operated to push the A-side forceps unit 30A forward. By this pushing operation, the A-side forceps unit 30A can open and close the jaw portion 32aA by opening and closing the handle portion 20.

  As described above, in the switchable laparoscopic forceps 1 according to the present invention, only the forceps unit 30 pushed forward (projected) by the operation lever 34 responds to the opening / closing of the thumb hole 21 of the handle portion 20. The jaw portion 32a is opened and closed.

  The switch-type laparoscopic forceps according to the present invention can be suitably used for laparoscopic surgery using an endoscope.

DESCRIPTION OF SYMBOLS 1 Switch-type laparoscopic forceps 10 Main body 10s Slit 11 Stopper 11s Slit 11a Stopping piece 12 Forceps pressing plate 13 Spring clamp 20 Handle part 21 Thumb hole 22 Lower finger hole 21a Axis 30 Forceps unit 32 Forceps part 32a Jaw part 32b Link mechanism 34 Operation lever 36 Shaft 38 Slit connecting member 38s Slit 40 Rod 40a One end 40b Other end 40L Opening / closing length 42 Load spring 50 Wire pin 52 Wire 36s Shaft spring 36a Load spring clamp 38t Locking end 54 Wire switching member 54a Wire inlet 54b Wire Outlet 55 wire roll

Claims (4)

A plurality of forceps units housed in a cylindrical body so as to protrude;
A handle portion for controlling the opening and closing of the forceps unit projecting from the cylindrical body;
The forceps unit is
A forceps part having a jaw part for opening and closing and a link mechanism for opening and closing the jaw part;
One end is connected to the link mechanism, and the rod drives the link mechanism;
A shaft that houses part of the forceps part and the rod;
A slit coupling member fixed to the other end of the rod;
A load spring penetrating the rod between the shaft and the slit coupling member;
The switchable laparoscopic forceps, wherein the handle portion is connected to a wire engaged with a slit of each slit connecting member of the forceps unit via a wire pin. An operation lever protruding from the cylindrical body is fixed to the shaft,
A spring clamp is fixed inside the cylindrical body,
The switchable laparoscopic forceps according to claim 1, wherein a shaft spring is disposed between the spring clamp and the operation lever.     The switchable laparoscopic forceps according to claim 1, wherein a forceps pressing plate that forcibly closes the jaw is disposed at a front portion of the cylindrical main body. Arranged between the tubular body and the handle part;
The switching type according to any one of claims 1 to 3, further comprising a wire switching member that bundles the wires of each forceps unit into a bundle after passing between a pair of parallel wire rolls. Laparoscopic forceps.