JP6412438B2 - Intubation forceps - Google Patents

Description

  The present invention relates to an instrument for inserting an intubation tube used in anesthesiology, respiratory medicine, otolaryngology, emergency medicine, or the like.

  Intubation tubes have been widely known as a patient airway securing device. This intubation tube is used, for example, in the anesthesiology area to secure the airway during general anesthesia or to ensure the airway of unconscious patients or patients with difficulty breathing, such as during emergency medical care. Yes. A Macintosh laryngoscope is widely used to insert it into the trachea.

  When using a Macintosh type of so-called direct-viewing laryngoscope to insert a tube under direct glottal viewing, it becomes impossible to intubate in cases where glottal observation is difficult, or esophageal intubation causes severe hypoxia and death. Many complications have been reported historically.

  Patent Document 1 describes a technique in which a guide that slides an intubation tube is inserted while being viewed with a small camera attached to the tip.

  On the other hand, conventionally, an intubation tube is inserted into the trachea using forceps. In this case, it is often performed using forceps. In Patent Document 2, a human body part such as the intestine is sandwiched between a pair of clamping parts, and an optimal surgical suture instrument or the like can be quickly selected from the length and thickness of the diameter of the human body part such as a flattened intestine. A graduated forceps is disclosed.

  When inserting an intubation tube into the trachea, Magille forceps having a donut-shaped ring at the tip of such forceps are often used.

JP 2007-144123 A JP 2010-29507 A

  Inserting an intubation tube while confirming the trachea using a camera as in Patent Document 1 is highly reliable. However, since it is a device that obtains a field of view indirectly through a camera, observation is hindered when the lens is clouded. Also, condensation is inevitable because the device is inserted into the oral cavity where water vapor is saturated at a temperature higher than room temperature. Furthermore, there exists a subject that the price of an apparatus is expensive.

  Inserting the intubation tube into the trachea using forceps, such as Magille forceps, has the advantage that it can be easily and quickly prepared, but requires skill in inserting the intubation tube into the trachea. Accordingly, problems such as inability to intubate or hypoxia due to esophageal intubation may occur.

  The present invention has been conceived in view of the above-mentioned problems, and provides an intubation assist forceps that can definitely guide an intubation tube to the trachea while being a simple forceps.

More specifically, the intubation assist forceps according to the present invention include:
In the middle of the body has a through hole for pivot support,
A wrist part following the through-hole on one end side from the through-hole, a handle part following the wrist part, and an operation part provided with a finger ring at the tip of the handle part;
On the other end side of the through-hole, there is a blade portion that continues to the through-hole, a neck portion that continues to the blade portion, and an action portion that is provided with an arrow-shaped gripping piece that has a tip portion in side view at the tip of the neck portion A pair of main bodies are forceps pivotally supported by connecting pins between the through holes,
From the plane when the connecting pin is viewed in the vertical direction, the neck is bent so that the tip of the gripping piece has an angle of 40 to 70 °,
The grip piece is provided with a tube guide groove having an angle of 90 ° or less with respect to the plane and an angle of 30 to 50 degrees with respect to a direction from the neck portion toward the grip piece. And

  An intubation assisting forceps according to the present invention is an instrument having a tube to be intubated into a patient's mouth and a bent portion provided to grasp and guide the distal end of the tube, and loosens a portion sandwiching the tube As a result, the intubation tube can be easily pushed forward, and the midline and the trachea entrance can be secured by the incision of the tip of the forceps into the esophageal entrance on both sides.

  In the intubation assist forceps according to the present invention, the forceps are made of metal or hard resin. By making it with metal, it can be reused by sterilization treatment, and it is economically useful. Moreover, by making it with a hard resin, it becomes possible not only to make a single-use article with a low unit price, but also to reduce the chance of nosocomial infections.

It is a trihedral view of the intubation assist forceps according to the present invention. It is an enlarged view of the top view of FIG. It is a partially expanded view of the side view of FIG. It is a side view of the intubation assistance forceps which concerns on this invention, and is explanatory drawing of the state which pinched | interposed the intubation tube at the front-end | tip and advanced to the hypopharynx. It is the figure which showed the relationship with the surrounding organ when the intubation assistance forceps which concern on this invention located the front-end | tip in the larynx part. It is explanatory drawing of the state which pushed the intubation tube into the trachea from FIG. 4, and ensured the airway. It is a side view showing embodiment using visualization devices, such as a camera, for intubation assistance forceps. It is a side view showing other embodiment using the intubation assistance forceps which concerns on this invention.

  The intubation assist 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.

  FIG. 1 shows a trihedral view of an intubation assist forceps according to the present invention. 1A is a plan view, FIG. 1B is a side view, and FIG. 1C is a front view. FIG. 2 shows an enlarged view of FIG. In the intubation assist forceps 1, a pair of main bodies 10 and 11 are pivotally supported by a connecting pin 9 with overlapping through holes 18 and 19 provided in the central part of the main body. 1 and 2, the through hole 18 of the main body 10 is not visible on the back side of the drawing.

  Referring to FIG. 2, the main bodies 10 and 11 are provided with wrist parts 12 and 13 and handle parts 14 and 15 on one end side with respect to the through holes 18 and 19. Finger rings 16 and 17 are provided at the tips of the handle portions 14 and 15. Therefore, the finger rings 16 and 17 are located at the tips on one end side of the main bodies 10 and 11.

  Blade portions 20 and 21 and neck portions 22 and 23 are provided on the other end side with respect to the through holes 18 and 19. Grip pieces 24 and 25 are provided at the tips of the neck portions 22 and 23. Therefore, the gripping pieces 24 and 25 are located at the distal ends on the other end sides of the main bodies 10 and 11.

  The handle portions 14 and 15, the wrist portions 12 and 13, the blade portions 20 and 21, and the neck portions 22 and 23 of the main bodies 10 and 11 may be mixed with different members. However, these are usually formed as a continuous body constituting the main bodies 10 and 11. Of course, the finger rings 16 and 17 and the grip pieces 24 and 25 may also be formed integrally with the main bodies 10 and 11.

  The side on which the wrist portions 12 and 13, the handle portions 14 and 15, and the finger rings 16 and 17 are provided is referred to as an operation portion 7. The side on which the blade portions 20 and 21, the neck portions 22 and 23, and the grip pieces 24 and 25 are provided is referred to as an action portion 8. Further, the intubation assist forceps 1 is manufactured for the right hand. Therefore, the thumb of the right hand is put into the finger ring 16 of the main body 10, and the other finger (for example, index finger) of the right hand is put into the finger ring 17 of the main body 11.

  Referring to FIG. 1B, the wrist parts 12, 13 and the blade parts 20, 21 are formed in the same plane when the connecting pin 9 is viewed in the vertical direction. In FIG. 1B, the plane is represented by a dotted line A (hereinafter, this plane is referred to as “plane A”), and the direction of the connecting pin 9 is represented by a dotted line B. On the other hand, referring to FIG. 1A, the wrist portions 12 and 13 and the blade portions 20 and 21 are in the same plane and are not linear but are provided with an angle θ. This angle θ is about 20 ° to 50 °, and 25 ° to 40 ° is easy to use.

  1B, the handle portions 14 and 15 and the neck portions 22 and 23 are bent in the vertical direction from the same plane (plane A) where the wrist portions 12 and 13 and the blade portions 20 and 21 are present. ing. The handle portions 14 and 15 and the neck portions 22 and 23 are bent in opposite directions with respect to the plane A.

  Further, the handle portion 14 and the handle portion 15 have different bending angles from the plane A. An angle θ2 of bending of the handle portion 14 of the main body 10 from the plane A is set to θ2, and a bending angle of the handle portion 15 of the main body 11 from the plane A is set to θ3. Then, θ2 is bent larger than θ3. This is because it is easier to operate with the thumb of the right hand. It is easy to use θ2 and θ3 between 20 ° and 70 °.

  Further, the grip pieces 24 and 25 and the neck portions 22 and 23 are inclined in the vertical direction from the plane A at an angle of θ4. The angle θ4 is suitably about 40 ° to 70 °. A movable mechanism may be provided for the angle θ4.

  The grip pieces 24 and 25 have a substantially arrowhead shape in a side view (see FIG. 1B). However, as shown in a plan view (FIG. 1 (a)) and a front view (FIG. 1 (c)), the neck portions 22 and 23 are thicker. The thickness is stacked on the side (inside) where the grip pieces 24 and 25 are opposed. The grip pieces 24 and 25 are rounded as a whole. In particular, the tip portions 24a and 25a of the grip pieces 24 and 25 are rounded. This is because the tip portions 24a and 25a are smoothly pushed from the hard palate to the hypopharynx.

  FIG. 3 shows an enlarged view of FIG. The gripping pieces 24, 25 have tip portions 24 a, 25 a formed in the extending direction C of the neck portions 22, 23. On the other hand, tube guide grooves 28 and 29 are provided on the inner side of the gripping pieces 24 and 25 further downward from the extending direction C by 40 ° ± 10 °. The tube guide grooves 28 and 29 cannot have an angle with respect to the plane A larger than 90 °.

  The intubation tube 90 is sandwiched between the tube guide grooves 28 and 29, and the intubation tube is pushed up to the hypopharynx 106. Further, the intubation tube 90 can be inserted into the trachea 102 while the intubation assisting forceps 1 is inserted by slightly loosening the grip of the intubation tube 90. Therefore, it is desirable that the space formed by the tube guide grooves 28 and 29 when the intubation assisting forceps 1 is closed is slightly smaller than the outer diameter of the intubation tube 90.

  FIG. 4 is a side cross-sectional view showing a state where the intubation assisting forceps 1 is used. A user (not shown) holds the intubation assisting forceps 1 by putting the thumb of the right hand into the finger ring 16 and the other finger (for example, the middle finger) of the right hand into the finger ring 17. Then, the user grasps the intubation tube 90 with the grasping pieces 24 and 25 and approaches from the parietal side. And the front-end | tip parts 24a and 25a of the holding | grip pieces 24 and 25 are advanced from the patient's mouth 100 to the hypopharynx 106.

  FIG. 5 is a view showing a relationship with surrounding organs when the distal end portions 24a and 25a are positioned in the larynx. In this figure, the intubation tube 90 is not described. The intubation tube 90 is gripped between the tube guide grooves 28 and 29. The user tries to insert the intubation tube 90 into the entrance of the trachea 102 at the back of the pharyngeal cap 103 while holding the tongue base 104 with the necks 22 and 23.

  When the distal end portions 24a and 25a of the intubation assisting forceps 1 are inserted into the esophageal entrance portion 101, the gripping pieces 24 and 25 are fixed at the median position. The trachea 102 located at the center of the median position coincides with the space formed by the left and right tube guide grooves 28 and 29.

  That is, the intubation tube 90 is clamped by the gripping pieces 24 and 25, and the distal end portions 24a and 25a of the gripping pieces 24 and 25 are pushed from the patient's mouth 100 toward the hard palate 105 (see FIG. 4), and the hypopharynx 106 ( 4), the tip of the intubation tube 90 sandwiched between the gripping pieces 24 and 25 is located at the entrance of the trachea 102.

  FIG. 6 shows a state in which the grasping pieces 24 and 25 are loosened while the intubation support forceps 1 are inserted, and the intubation tube 90 is pushed into the trachea 102 to secure the airway. The position of the intubation tube 90 at the entrance of the trachea 102 is regulated by the tube guide grooves 28 and 29 of the grip pieces 24 and 25. Therefore, the tip of the intubation tube 90 is fed into the trachea 102 by pushing the intubation tube 90 toward the hard palate 105 from the lower jaw side.

  As described above, the intubation assist forceps 1 according to the present invention is inserted into the esophageal entrance 101 while the distal ends 24a and 25a of the gripping pieces 24 and 25 are gripping the distal end of the intubation tube 90. The distal end can be positioned at the entrance of the trachea 102, and the intubation tube 90 can be reliably inserted into the trachea 102. Further, the intubation assist forceps 1 pushes the oral cavity along the hard palate 105, so that the distal end portions 24a and 25a naturally intrude into the esophageal entrance 101. Therefore, no special skill is required when inserting the intubation tube 90 into the trachea 102.

  FIG. 7 is a view showing a state in which a visualization device 95 such as a video endoscope system is inserted into the lumen of the intubation tube 90 and the intubation assist forceps 1 is used. In this way, by using the visualization device 95 in combination, the intubation tube 90 can be inserted while confirming the inlet portion of the trachea 102, and the operation can be performed more safely.

  FIG. 8 shows the intubation support forceps 2 in which the tube guide grooves 28 and 29 in the grip pieces 24 and 25 of the intubation support forceps 1 are extended from the rear neck portions 22 and 23 to the blade portions 20 and 21.

  The portions extending from the neck portions 22 and 23 to the blade portions 20 and 21 are referred to as intubation tube guides 30 and 31. The intubation tube guides 30 and 31 are grooves formed inside the neck portions 22 and 23 and the blade portions 20 and 21 continuously to the tube guide grooves 28 and 29.

  Furthermore, the diameter of the space formed by the intubation tube guides 30 and 31 when the intubation assist forceps 2 is closed forms a space having a larger diameter than the tube guide grooves 28 and 29. This is because when the intubation support forceps 2 is slightly opened and the intubation tube 90 is inserted into the trachea 102, the intubation tube 90 is not caught in the space formed by the intubation tube guides 30 and 31.

  In addition, the neck parts 22 and 23 in which the intubation tube guides 30 and 31 are formed and the blade parts 20 and 21 are thicker than the grip pieces 24 and 25 or more.

  In addition, the shapes of the distal end portions 24 a and 25 a of the grip pieces 24 and 25 are the same as those of the intubation assist forceps 1. Therefore, when the intubation assisting forceps 2 are pushed forward along the hard palate 105, the distal end portions 24 a and 25 a are invaded into the esophageal entrance portion 101.

  The intubation support forceps 2 secures the path of the intubation tube 90 up to the blade portions 20 and 21 with the intubation tube guides 30 and 31. Therefore, when the intubation tube 90 is inserted into the trachea 102, the tube can be reliably inserted into the trachea 102 by being pushed along the tube guide grooves 28 and 29 without being advanced while being in contact with the hard palate 105. Is done.

  The intubation support forceps according to the present invention can be suitably used when an insertion tube is inserted into the trachea and an airway is secured.

DESCRIPTION OF SYMBOLS 1 Intubation assistance forceps 2 Intubation assistance forceps 7 Operation part 8 Action part 9 Connecting pin 10,11 Main body 12,13 Wrist part 14,15 Handle part 16,17 Finger ring 18,19 Through-hole 20,21 Blade part 22,23 Neck part 24 , 25 Grip pieces 24a, 25a Tip portion 28, 29 Tube guide groove 30, 31 Intubation tube guide 90 Intubation tube 95 Visualization device 100 Patient's mouth 101 Esophageal entrance portion 102 Trachea 103 Pharyngeal cap 104 Tongue root 105 Hard palate 106 Lower pharynx

Claims (4)

In the middle of the body has a through hole for pivot support,
A wrist part following the through-hole on one end side from the through-hole, a handle part following the wrist part, and an operation part provided with a finger ring at the tip of the handle part;
On the other end side of the through-hole, there is a blade portion that continues to the through-hole, a neck portion that continues to the blade portion, and an action portion that is provided with an arrow-shaped gripping piece that has a tip portion in side view at the tip of the neck portion A pair of main bodies are forceps pivotally supported by connecting pins between the through holes,
From the plane when the connecting pin is viewed in the vertical direction, the neck is bent so that the tip of the gripping piece has an angle of 40 to 70 °,
The grip piece is provided with a tube guide groove having an angle of 90 ° or less with respect to the plane and an angle of 30 to 50 degrees with respect to a direction from the neck portion toward the grip piece. Intubation assist forceps.   The intubation assist forceps according to claim 1, wherein the main body is made of metal or hard resin.   The intubation assistance forceps according to claim 1, wherein the grip piece is thicker than the neck.   The intubation assist forceps according to claim 1, wherein an intubation tube guide that is continuous with the tube guide groove is formed from the neck portion to the blade portion.