WO2019106737A1 - Medical gripping tool - Google Patents
Medical gripping tool Download PDFInfo
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- WO2019106737A1 WO2019106737A1 PCT/JP2017/042731 JP2017042731W WO2019106737A1 WO 2019106737 A1 WO2019106737 A1 WO 2019106737A1 JP 2017042731 W JP2017042731 W JP 2017042731W WO 2019106737 A1 WO2019106737 A1 WO 2019106737A1
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- piece
- gripping
- slit
- grip
- medical
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
Definitions
- the present invention relates to a medical grasper.
- Patent Literature 1 a medical grasper provided with a plurality of insulating protrusions that strike when closed on opposing surfaces of a pair of grasping pieces that are opened and closed by being mutually pivoted.
- Patent Literature 1 a medical grasper provided with a plurality of insulating protrusions that strike when closed on opposing surfaces of a pair of grasping pieces that are opened and closed by being mutually pivoted.
- Patent Literature 1 a medical grasper provided with a plurality of insulating protrusions that strike when closed on opposing surfaces of a pair of grasping pieces that are opened and closed by being mutually pivoted
- the gap size between gripping pieces may be varied depending on the type of tissue to be gripped and the type of treatment performed while gripping.
- the swing of the grasping pieces can not be stopped at a predetermined gap size until the projection butts, and only a single dimension gap is realized when the projection butts. There is a disadvantage that you can not do it.
- the present invention has been made in view of the above-described circumstances, and it is an object of the present invention to provide a medical grasper capable of stopping relative swing between grasping pieces with a plurality of predetermined gap sizes. There is.
- a pair of gripping pieces that are supported so as to be able to swing relative to a predetermined axis and that can be opened and closed;
- a power transmission unit for transmitting the driving force supplied by the operation unit to the holding piece, and one or more of the holding units disposed on one side of the holding unit with respect to the operation unit and between the maximum opening state and the closing state And an intermediate locking means for locking at a predetermined locking angle.
- the driving force supplied by the operation of the operation unit is transmitted to the gripping piece via the power transmission unit, and at least one of the gripping pieces is swung relative to the other, thereby causing the pair of The gripping piece is opened and closed.
- the object can be gripped between the pair of gripping pieces, or the gripped object can be released.
- the pair of gripping pieces are locked by the intermediate locking means at one or more locking angles intermediate between the maximum open state and the closed state. Thereby, relative swings of the gripping pieces can be stopped at a plurality of predetermined gap sizes.
- a bendable portion may be provided between the operation portion and the grip piece, and the intermediate locking means may be provided on one side of the bend from the bend portion.
- the locking angle of the pair of gripping pieces is fluctuated by the intermediate locking means provided on one gripping side of the curved portion. I do not have to do it. Thereby, a pair of holding pieces can be always locked at the same locking angle.
- the intermediate locking means may be provided on the grip piece. In this way, regardless of the form of the path from the operation portion to the gripping piece, the pair of gripping pieces can always be locked at the same locking angle.
- the intermediate locking unit may change the ratio of the amount of gripping force by the gripping piece to the amount of input force to the power transmission unit at the locking angle.
- the intermediate locking means includes a sliding portion that slides along with the swing of the grip piece
- the sliding resistance in the sliding portion may be changed at the locking angle. Good.
- the sliding portion in the longitudinal direction of the slit, is a slit provided in a pair of the holding pieces, and a driving force received in the slit and transmitted by the power transmission portion.
- a sliding pin may be provided, and a recess or a projection that changes the sliding resistance between the pin and the slit may be provided at an intermediate position in the length direction of at least one of the slits.
- the pin is a slit in the slit provided in the pair of gripping pieces along with the swinging. Slide along the length of the If the sliding surface of the slit with the pin is smooth, the sliding resistance does not change, but the sliding resistance changes if the pin reaches a recess or a protrusion provided at an intermediate position in the length direction. The change allows the operator to recognize that the locking angle has been reached.
- the intermediate locking means swings the gripping piece in the closing direction or swings the gripping piece in the opening direction, the gripping piece is locked It is also good.
- the intermediate locking means locks the swinging of the gripping piece, depending on the tissue to be gripped and the type of treatment performed while gripping.
- the treatment can be performed by locking at a plurality of appropriate locking angles.
- the intermediate locking means locks the swinging of the gripping piece, so that the gripping piece can be prevented from being opened too much at one time when the gripping piece is opened. .
- the pin slides and moves on the inner surface of the slit different in the width direction between swinging the gripping piece in the opening direction and swinging the gripping piece in the closing direction. It is also good.
- the intermediate locking means is provided on one of the inner surfaces in the width direction of the slit, whereby the gripping piece is engaged at a predetermined locking angle in either the opening operation or the closing operation. It can be operated smoothly without locking on the other.
- FIG. 1 shows the 1st slit of the holding part in the state of FIG. 3, a 2nd slit, and a pin. It is an enlarged view which shows the modification of the 2nd slit of FIG.
- FIG. 1 It is an enlarged view which shows the other modification of the 2nd slit of FIG.
- It is a modification of the medical grasper of Drawing 1 and is the elements on larger scale of the medical grasper provided with the middle stop means which holds on the way which makes the 2nd grasping piece move from the closed state to the maximum open state. is there.
- FIG. It is the elements on larger scale which show the modification provided with the amplification mechanism of the force of the medical grasper of FIG.
- FIG. 15 is a partially enlarged view showing an intermediate locked state of the medical grasper of FIG. 14; It is the elements on larger scale which show the closed state of the medical grasper of FIG. It is the elements on larger scale which show the maximum open state of the other modification of the medical grasper of FIG.
- FIG. 18 is a partially enlarged view showing an intermediate locked state of the medical grasper of FIG. 17; It is the elements on larger scale which show the middle locking state of the other modification of the medical grasper of FIG.
- the medical grasping tool 1 includes a long flexible insertion portion (curved portion) 2, a grasping portion 3 disposed at the tip of the insertion portion 2, and an insertion portion
- the control unit 4 includes an operation unit 4 disposed at the base end of the drive unit 2, a power transmission unit 5 for transmitting the driving force applied from the operation unit 4 to the grip unit 3, and an intermediate locking unit 6.
- the insertion portion 2 is a tube having at least one lumen penetrating in the longitudinal direction. When inserted into a body cavity, the insertion portion 2 is curved according to the shape of the body cavity by being inserted through a channel of an endoscope or an overtube, and the grasping portion 3 of the tip is disposed in the vicinity of the affected area It can be done.
- the gripping portion 3 is an inserting portion with respect to the first gripping piece (gripping piece) 7 fixed to the tip of the insertion portion 2 and the first gripping piece 7.
- a second grip piece (gripping piece) 8 swingably supported around a rocking axis (axis) A orthogonal to the longitudinal axis of 2 is provided.
- the pair of gripping pieces 7 and 8 are pivoted about the pivot axis A, so that the tip is separated as shown in FIG. 2 and the tip is brought into close contact as shown in FIG. It is made to be able to be opened and closed mutually between states.
- the gripping portion 3 is provided with a power conversion mechanism (sliding portion) 9 for converting the tension transmitted by the power transmission portion 5 to be described later into the swinging motion of the second gripping piece 8 to the first gripping piece 7. It is done.
- the power conversion mechanism 9 is provided in the linear first slit (slit) 10 provided in the first gripping piece 7 along the longitudinal direction of the insertion portion 2 and in the second gripping piece 8, and is provided in the first slit 10.
- a second slit (slit) 11 extending in a crossing direction, and a cylindrical pin 12 inserted at the intersection position of the first slit 10 and the second slit 11 and disposed parallel to the swing axis A There is.
- the operation unit 4 has any known structure operated by the operator, and supplies the force applied by the operator as a force along the longitudinal direction of the insertion unit 2 to the power transmission unit 5.
- the power transmission unit 5 includes a wire 13 which penetrates the inside of the lumen of the insertion unit 2 and connects the operation unit 4 and the grip unit 3. The force supplied from the operation unit 4 is transmitted as tension and transmitted to the gripping unit 3.
- the pin 12 constituting the power conversion mechanism 9 is fixed to the tip of the wire 13.
- the pin 12 By pulling the wire 13 proximally, when the pin 12 is pulled proximally by the tension transmitted by the wire 13, the pin 12 can be linearly moved proximally along the first slit 10. ing. Since the pin 12 is also inserted into the second slit 11, as the pin 12 moves, the crossing position of the first slit 10 and the second slit 11 moves, so that the second slit 11 is pushed by the pin 12 and shaken. As it rotates around the movement axis A, the second gripping piece 8 provided with the second slit 11 is made to swing around the swing axis A with respect to the first gripping piece 7.
- the intermediate locking means 6 is an inner surface on one side in the width direction, ie, a side on which the pin 12 is moved when the pin 12 is moved to the proximal side, at a substantially central position in the longitudinal direction of the second slit 11 It is comprised by providing the recessed part 14 in inner surface.
- the operator can sense the change in the operation unit 4. That is, the operator can maintain the angle of the second gripping piece 8 at the position where the change in the amount of gripping force is sensed, and realize an intermediate locking state between the maximum open state and the closed state. It can be done.
- the second grasping piece 8 is closed to the first grasping piece 7 as shown in FIG. It is inserted into the channel of the inserted endoscope or overtube, and is made to project from the tip opening of the channel so as to face the affected part.
- the operator operates the operation unit 4 to push the wire 13 to the tip end side, thereby applying the force to the first grip piece 7 as shown in FIG.
- the second gripping piece 8 is swung to the maximum open state.
- the second slit 11 whose crossing position with the first slit 10 is changed is the swing axis A
- the second gripping piece 8 is rotated about the swing axis A with respect to the first gripping piece 7 by rotating around.
- the pin 12 pushes the inner surface of the second slit 11 on the side where the recess 14 is not provided, the pin 12 does not engage with the recess 14 and is substantially constant along the straight inner surface.
- the second gripping piece 8 can be swung smoothly by the sliding resistance of
- the second gripping piece 8 is operated by operating the operation unit 4 and applying a force in a direction to pull the wire 13 proximally. 1) It is swung in the closing direction with respect to the gripping piece 7. And, as shown in FIG. 3, when the pin 12 is fitted into the recess 14, as shown in FIG. 6, the tangential direction and the movement of the pin 12 at the contact position between the pin 12 and the inner surface of the second slit 11 The angle ⁇ with the direction (that is, the longitudinal direction of the first slit 10) is sufficiently large as compared with the case where the position is other than the concave portion 14. That is, since the sliding resistance between the pin 12 and the second slit 11 rapidly increases at the position where the pin 12 fits in the recess 14, the swinging motion of the second gripping piece 8 with respect to the first gripping piece 7 Once locked.
- the treatment performed in a state in which the tissue is sandwiched between the pair of gripping pieces 7 and 8 is, for example, a treatment for coagulating the tissue by electric energy or the like
- the intermediate open state shown in FIG. It is also possible to set the gap between the two to be the optimal gap for solidification. Then, when the tissue is coagulated and then cut, the wire 13 is pulled by a further strong force, thereby disengaging the pin 12 from the state of being fitted in the concave portion 14 and as shown in FIG.
- the pieces 7, 8 can be brought close to the closed state to cut the tissue.
- the intermediate locking means 6 is provided not in the operation unit 4 but in the grip unit 3, the insertion unit between the grip unit 3 and the operation unit 4 Regardless of the shape of 2, there is an advantage that the intermediate locking angle can be maintained constant. That is, although the intermediate locking means 6 can be provided on the operation unit 4 side, in that case, there is a disadvantage that the intermediate locking angle changes due to the change of the path length of the wire 13 due to the shape of the insertion portion 2
- the medical grasper 1 according to the present embodiment does not have such a disadvantage, and the gap between the first grasping piece 7 and the second grasping piece 8 in the intermediate open state can be maintained constant.
- the sliding resistance between the pin 12 and the inner surface of the second slit 11 is rapidly changed.
- a convex portion 15 may be provided on the inner surface of the second slit 11. This likewise allows the sliding resistance to be rapidly changed to easily achieve an intermediate open position.
- the width of the second slit 11 is gradually expanded from the distal end side toward the proximal end side, The shape may be made to shrink.
- a recess 14 may be provided on the inner surface of the second slit 11 on the side to be pressed when the pin 12 is moved toward the tip end side.
- the pair of gripping pieces 7 and 8 can be prevented from being opened unintentionally and it is possible to prevent an open state when pulling out from the channel of the endoscope or the overtube. Can.
- the concave portion 14 or the convex portion 15 is provided in the second slit 11, but instead, the concave portion 14 or the convex portion 15 may be provided in the first slit 10.
- the case where the tip of the wire 13 is directly fixed to the pin 12 has been described, but instead, as shown in FIG. 16, 17 may be provided, and the wires 13a, 13b may be wound around these pulleys 16, 17.
- the wire 13 a whose tip is fixed to the insertion portion 2 or the first gripping piece 7 is wound around the pulley 16 provided on the pin 12 to swing the second gripping piece 8 in the closing direction.
- the pulling force of the pin 12 can be amplified to twice the tension to perform the closing operation with a smaller tension.
- the direction in which the second gripping piece 8 is opened by fixing the tip to the second gripping piece 8 and winding the wire 13 b wound around the pulley 16 of the pin 12 on the pulley 17 provided on the swinging axis A the pulling force of the pin 12 can be amplified to four times the tension to perform the opening operation with a smaller tension.
- the sliding resistance is changed by providing the concave portion 14 or the convex portion 15 in the second slit 11, as shown in FIGS. 12 and 13, the first gripping piece 7 and the second gripping piece 8 And a sliding portion 18 that starts contact near the intermediate locking angle to increase sliding resistance.
- the drive system in this case is not limited to the wire 13.
- the sliding portion 18 provided on the second grip piece 8 does not contact the first grip piece 7 at an angle between the maximum open state shown in FIG. 12 and the locked state shown in FIG.
- the dynamic resistance is maintained low, but from the locked state shown in FIG. 13 to the closed state, the sliding portion 18 contacts the first gripping piece 7 to make the first gripping piece 7 and the second gripping piece 8 Since the sliding resistance between them increases, the operator can sense the change and temporarily stop the operation in the locked state of FIG.
- a spring 20 is provided between the first gripping piece 7 and the second gripping piece 8 to start an elastic deformation by contacting in the vicinity of an intermediate locking angle. May be Also by this, the elastic deformation of the spring 20 is started in the intermediate locking state on the way from the maximum open state to the closed state, and the amount of operation force increases, so that the operator can recognize this state. .
- the shapes of the first gripping piece 7 and the second gripping piece 8 may be configured to form a certain gap in the intermediate locked state.
- the tissue can be sandwiched to a uniform thickness in the intermediate locked state, and uniform treatment can be performed in the case of coagulation or the like.
- the tissue can be easily cut by shearing at the time of transition to the closed state.
- magnets 21 and 22 are employed instead of the sliding portion 18 of FIGS. 12 and 13, and different magnetic poles are opposed to each other in an intermediate locked state.
- the magnets 21 and 22 may be fixed to the first grip piece 7 and the second grip piece 8.
- the magnetic attraction force generated by the magnets 21 and 22 is maximized in the intermediate locked state shown in FIG. 22. Therefore, the second gripping piece 8 can be arranged more reliably in the intermediate locked state. .
- the second grip piece 8 may be provided on the wire 13 for driving.
- the wire 13 is penetrated into the sleeve 23, and the friction coefficient of the inner surface of the sleeve 23 is larger on the proximal side (hatched portion in the figure) than on the distal side. You should do it.
- the sliding portion 18 fixed to the wire 13 reaches a region with a large coefficient of friction near the position where the second gripping piece 8 is in the intermediate locked state, After that, the amount of operation power to the closed state can be increased.
- a stopper 25 is provided on the first gripping piece 7 to abut the projection 24 provided on the second gripping piece 8.
- the stopper 25 may be made movable between a position where the projection 24 abuts and a position not in contact with the projection 24.
- the first gripping piece 7 is fixed to the tip end of the insertion portion 2 and the second gripping piece 8 is movably supported relative to the first gripping piece 7 by way of example.
- the present invention is not limited to this, and the present invention may be applied to the gripping portion 3 in which both the first gripping piece 7 and the second gripping piece 8 are swingably supported around the swing axis A.
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Abstract
The purpose of the present invention is to stop relative pivoting between gripping pieces at a predetermined plurality of gap dimensions. This medical gripping tool (1) is provided with: a pair of gripping pieces (7, 8) that can open and close and are supported to be relatively pivotable around a predetermined axis; an operating part (4) that supplies a drive force to cause at least one of the gripping pieces (7, 8) to pivot; a force transmission part (5) that transmits the drive force supplied by the operating part (4) to the gripping piece (8); and an intermediate locking means (6) that is disposed closer to the gripping pieces (7, 8) than the operating part (4), and causes the gripping piece (8) to be locked at one or more predetermined locking angles between a maximum open state and a closed state.
Description
本発明は、医療用把持具に関するものである。
The present invention relates to a medical grasper.
従来、相互に揺動させられることにより開閉される一対の把持片の対向面に、閉じられたときに突き当たる絶縁性の複数の突起を備える医療用把持具が知られている(例えば、特許文献1参照。)。
この医療用把持具では、閉じられたときに突起を突き当てることにより把持片間のギャップを規定し、封止する際の組織の厚さが薄くなりすぎないようにしている。 BACKGROUND Conventionally, there is known a medical grasper provided with a plurality of insulating protrusions that strike when closed on opposing surfaces of a pair of grasping pieces that are opened and closed by being mutually pivoted (for example, Patent Literature 1)).
In this medical grasper, when closed, the projection abuts to define the gap between the grasping pieces so that the thickness of tissue when sealed is not too thin.
この医療用把持具では、閉じられたときに突起を突き当てることにより把持片間のギャップを規定し、封止する際の組織の厚さが薄くなりすぎないようにしている。 BACKGROUND Conventionally, there is known a medical grasper provided with a plurality of insulating protrusions that strike when closed on opposing surfaces of a pair of grasping pieces that are opened and closed by being mutually pivoted (for example, Patent Literature 1)).
In this medical grasper, when closed, the projection abuts to define the gap between the grasping pieces so that the thickness of tissue when sealed is not too thin.
しかしながら、把持片間のギャップ寸法は、把持する組織や把持しながら行う処置の種類によって種々異ならせたい場合がある。特許文献1の医療用把持具では、突起が突き当たるまで把持片どうしの揺動を所定のギャップ寸法となる位置に停止させることはできず、突起を突き当てたときの単一寸法のギャップしか実現できないという不都合がある。
However, there are cases where the gap size between gripping pieces may be varied depending on the type of tissue to be gripped and the type of treatment performed while gripping. In the medical grasper of Patent Document 1, the swing of the grasping pieces can not be stopped at a predetermined gap size until the projection butts, and only a single dimension gap is realized when the projection butts. There is a disadvantage that you can not do it.
本発明は、上述した事情に鑑みてなされたものであって、所定の複数のギャップ寸法で把持片どうしの相対的な揺動を停止させることができる医療用把持具を提供することを目的としている。
The present invention has been made in view of the above-described circumstances, and it is an object of the present invention to provide a medical grasper capable of stopping relative swing between grasping pieces with a plurality of predetermined gap sizes. There is.
本発明の一態様は、所定の軸線回りに相対的に揺動可能に支持されて開閉可能な一対の把持片と、該把持片の少なくとも一方を揺動させる駆動力を供給する操作部と、該操作部により供給された駆動力を前記把持片に伝達する動力伝達部と、前記操作部よりも前記把持片側に配置され、前記把持片を最大開状態と閉状態との中間の1以上の所定の係止角度で係止させる中間係止手段とを備える医療用把持具である。
According to one aspect of the present invention, there is provided a pair of gripping pieces that are supported so as to be able to swing relative to a predetermined axis and that can be opened and closed; A power transmission unit for transmitting the driving force supplied by the operation unit to the holding piece, and one or more of the holding units disposed on one side of the holding unit with respect to the operation unit and between the maximum opening state and the closing state And an intermediate locking means for locking at a predetermined locking angle.
本態様によれば、操作部の操作により供給された駆動力が動力伝達部を介して把持片に伝達され、把持片の少なくとも一方が他方に対して相対的に揺動させられることにより一対の把持片が開閉される。これにより、対象物を一対の把持片の間に把持したり、把持していた対象物を解放したりすることができる。この場合において、一対の把持片は、最大開状態と閉状態との間の中間の1以上の係止角度で中間係止手段によって係止させられる。これにより、所定の複数のギャップ寸法で把持片どうしの相対的な揺動を停止させることができる。
According to this aspect, the driving force supplied by the operation of the operation unit is transmitted to the gripping piece via the power transmission unit, and at least one of the gripping pieces is swung relative to the other, thereby causing the pair of The gripping piece is opened and closed. Thus, the object can be gripped between the pair of gripping pieces, or the gripped object can be released. In this case, the pair of gripping pieces are locked by the intermediate locking means at one or more locking angles intermediate between the maximum open state and the closed state. Thereby, relative swings of the gripping pieces can be stopped at a plurality of predetermined gap sizes.
上記態様においては、前記操作部と前記把持片との間に湾曲可能な湾曲部を備え、前記中間係止手段が前記湾曲部より前記把持片側に設けられていてもよい。
このようにすることで、湾曲部を湾曲させることにより動力伝達部の経路長が変動しても湾曲部よりも把持片側に設けられた中間係止手段によって一対の把持片の係止角度を変動させずに済む。これにより、常に同一の係止角度で一対の把持片を係止させることができる。 In the above aspect, a bendable portion may be provided between the operation portion and the grip piece, and the intermediate locking means may be provided on one side of the bend from the bend portion.
In this way, even if the path length of the power transmission unit fluctuates by curving the curved portion, the locking angle of the pair of gripping pieces is fluctuated by the intermediate locking means provided on one gripping side of the curved portion. I do not have to do it. Thereby, a pair of holding pieces can be always locked at the same locking angle.
このようにすることで、湾曲部を湾曲させることにより動力伝達部の経路長が変動しても湾曲部よりも把持片側に設けられた中間係止手段によって一対の把持片の係止角度を変動させずに済む。これにより、常に同一の係止角度で一対の把持片を係止させることができる。 In the above aspect, a bendable portion may be provided between the operation portion and the grip piece, and the intermediate locking means may be provided on one side of the bend from the bend portion.
In this way, even if the path length of the power transmission unit fluctuates by curving the curved portion, the locking angle of the pair of gripping pieces is fluctuated by the intermediate locking means provided on one gripping side of the curved portion. I do not have to do it. Thereby, a pair of holding pieces can be always locked at the same locking angle.
また、上記態様においては、前記中間係止手段が前記把持片に設けられていてもよい。
このようにすることで、操作部から把持片に至る経路の形態にかかわらず、常に同一の係止角度で一対の把持片を係止させることができる。 In the above aspect, the intermediate locking means may be provided on the grip piece.
In this way, regardless of the form of the path from the operation portion to the gripping piece, the pair of gripping pieces can always be locked at the same locking angle.
このようにすることで、操作部から把持片に至る経路の形態にかかわらず、常に同一の係止角度で一対の把持片を係止させることができる。 In the above aspect, the intermediate locking means may be provided on the grip piece.
In this way, regardless of the form of the path from the operation portion to the gripping piece, the pair of gripping pieces can always be locked at the same locking angle.
また、上記態様においては、前記中間係止手段が、前記動力伝達部への入力力量に対する前記把持片による把持力量の割合を、前記係止角度において変化させてもよい。
このようにすることで、操作者が操作部を操作して動力伝達部への入力力量を加えていくと、一対の把持片が係止角度となった時点で把持力量が変化するので、その変化によって、係止角度となったことを操作者が認識することができる。 In the above aspect, the intermediate locking unit may change the ratio of the amount of gripping force by the gripping piece to the amount of input force to the power transmission unit at the locking angle.
By doing this, when the operator operates the operation unit and applies the input force amount to the power transmission unit, the grip force amount changes when the pair of holding pieces becomes the locking angle, so The change allows the operator to recognize that the locking angle has been reached.
このようにすることで、操作者が操作部を操作して動力伝達部への入力力量を加えていくと、一対の把持片が係止角度となった時点で把持力量が変化するので、その変化によって、係止角度となったことを操作者が認識することができる。 In the above aspect, the intermediate locking unit may change the ratio of the amount of gripping force by the gripping piece to the amount of input force to the power transmission unit at the locking angle.
By doing this, when the operator operates the operation unit and applies the input force amount to the power transmission unit, the grip force amount changes when the pair of holding pieces becomes the locking angle, so The change allows the operator to recognize that the locking angle has been reached.
また、上記態様においては、前記中間係止手段が、前記把持片の揺動に伴って摺動する摺動部を備え、該摺動部における摺動抵抗を前記係止角度において変化させてもよい。
このようにすることで、操作者が操作部を操作して一対の把持片を相対的に揺動させていくと、揺動に伴って摺動部が摺動し、一対の把持片が係止角度となった時点で摺動抵抗が変化するので、その変化によって、係止角度となったことを操作者が認識することができる。 Further, in the above aspect, even if the intermediate locking means includes a sliding portion that slides along with the swing of the grip piece, the sliding resistance in the sliding portion may be changed at the locking angle. Good.
By doing this, when the operator operates the operation unit and relatively swings the pair of gripping pieces, the sliding portion slides along with the swinging, and the pair of gripping pieces engage Since the sliding resistance changes when the stop angle is reached, the operator can recognize that the locking angle has been reached by the change.
このようにすることで、操作者が操作部を操作して一対の把持片を相対的に揺動させていくと、揺動に伴って摺動部が摺動し、一対の把持片が係止角度となった時点で摺動抵抗が変化するので、その変化によって、係止角度となったことを操作者が認識することができる。 Further, in the above aspect, even if the intermediate locking means includes a sliding portion that slides along with the swing of the grip piece, the sliding resistance in the sliding portion may be changed at the locking angle. Good.
By doing this, when the operator operates the operation unit and relatively swings the pair of gripping pieces, the sliding portion slides along with the swinging, and the pair of gripping pieces engage Since the sliding resistance changes when the stop angle is reached, the operator can recognize that the locking angle has been reached by the change.
また、上記態様においては、前記摺動部が、一対の前記把持片に設けられたスリットと、該スリット内に収容され前記動力伝達部により伝達された駆動力により、前記スリットの長さ方向に摺動させられるピンとを備え、少なくとも一方の前記スリットの前記長さ方向の途中位置に、前記ピンと前記スリットとの摺動抵抗を変化させる凹部または凸部を備えていてもよい。
Further, in the above aspect, in the longitudinal direction of the slit, the sliding portion is a slit provided in a pair of the holding pieces, and a driving force received in the slit and transmitted by the power transmission portion. A sliding pin may be provided, and a recess or a projection that changes the sliding resistance between the pin and the slit may be provided at an intermediate position in the length direction of at least one of the slits.
このようにすることで、操作者が操作部を操作して一対の把持片を相対的に揺動させていくと、揺動に伴って一対の把持片に設けられたスリット内においてピンがスリットの長さ方向に摺動させられる。スリットのピンとの摺動面が滑らかであれば、摺動抵抗は変化しないが、長さ方向の途中位置に備えられた凹部または凸部にピンが差し掛かると摺動抵抗が変化するので、その変化によって、係止角度となったことを操作者が認識することができる。
In this way, when the operator operates the operation unit to swing the pair of gripping pieces relative to each other, the pin is a slit in the slit provided in the pair of gripping pieces along with the swinging. Slide along the length of the If the sliding surface of the slit with the pin is smooth, the sliding resistance does not change, but the sliding resistance changes if the pin reaches a recess or a protrusion provided at an intermediate position in the length direction. The change allows the operator to recognize that the locking angle has been reached.
また、上記態様においては、前記中間係止手段が、前記把持片を閉じる方向に揺動させるとき、または前記把持片を開く方向に揺動させるときのいずれかにおいて前記把持片を係止させてもよい。
このようにすることで、把持片を閉じる方向に揺動させたときに中間係止手段が把持片の揺動を係止することにより、把持する組織や把持しながら行う処置の種類に応じて複数の適正な係止角度で係止させて処置を行うことができる。また、把持片を開く方向に揺動させたときに中間係止手段が把持片の揺動を係止することにより、把持片を開く際に、一度に大きく開きすぎないようにすることができる。 Further, in the above aspect, when the intermediate locking means swings the gripping piece in the closing direction or swings the gripping piece in the opening direction, the gripping piece is locked It is also good.
In this way, when the gripping piece is swung in the closing direction, the intermediate locking means locks the swinging of the gripping piece, depending on the tissue to be gripped and the type of treatment performed while gripping. The treatment can be performed by locking at a plurality of appropriate locking angles. In addition, when the gripping piece is swung in the opening direction, the intermediate locking means locks the swinging of the gripping piece, so that the gripping piece can be prevented from being opened too much at one time when the gripping piece is opened. .
このようにすることで、把持片を閉じる方向に揺動させたときに中間係止手段が把持片の揺動を係止することにより、把持する組織や把持しながら行う処置の種類に応じて複数の適正な係止角度で係止させて処置を行うことができる。また、把持片を開く方向に揺動させたときに中間係止手段が把持片の揺動を係止することにより、把持片を開く際に、一度に大きく開きすぎないようにすることができる。 Further, in the above aspect, when the intermediate locking means swings the gripping piece in the closing direction or swings the gripping piece in the opening direction, the gripping piece is locked It is also good.
In this way, when the gripping piece is swung in the closing direction, the intermediate locking means locks the swinging of the gripping piece, depending on the tissue to be gripped and the type of treatment performed while gripping. The treatment can be performed by locking at a plurality of appropriate locking angles. In addition, when the gripping piece is swung in the opening direction, the intermediate locking means locks the swinging of the gripping piece, so that the gripping piece can be prevented from being opened too much at one time when the gripping piece is opened. .
また、上記態様においては、前記把持片を開く方向に揺動させるときと、閉じる方向に揺動させるときとで、前記ピンが、前記スリットの幅方向の異なる内面を摺動して移動してもよい。
このようにすることで、スリットの幅方向のいずれか一方の内面に中間係止手段を設けておくことにより、開動作または閉動作のいずれか一方において、把持片を所定の係止角度で係止させ、他方において係止することなく滑らかに動作させることができる。 In the above aspect, the pin slides and moves on the inner surface of the slit different in the width direction between swinging the gripping piece in the opening direction and swinging the gripping piece in the closing direction. It is also good.
In this manner, the intermediate locking means is provided on one of the inner surfaces in the width direction of the slit, whereby the gripping piece is engaged at a predetermined locking angle in either the opening operation or the closing operation. It can be operated smoothly without locking on the other.
このようにすることで、スリットの幅方向のいずれか一方の内面に中間係止手段を設けておくことにより、開動作または閉動作のいずれか一方において、把持片を所定の係止角度で係止させ、他方において係止することなく滑らかに動作させることができる。 In the above aspect, the pin slides and moves on the inner surface of the slit different in the width direction between swinging the gripping piece in the opening direction and swinging the gripping piece in the closing direction. It is also good.
In this manner, the intermediate locking means is provided on one of the inner surfaces in the width direction of the slit, whereby the gripping piece is engaged at a predetermined locking angle in either the opening operation or the closing operation. It can be operated smoothly without locking on the other.
本発明によれば、所定の複数のギャップ寸法で把持片どうしの相対的な揺動を停止させることができるという効果を奏する。
According to the present invention, there is an effect that it is possible to stop relative swing of the gripping pieces with a predetermined plurality of gap sizes.
本発明の一実施形態に係る医療用把持具1について、図面を参照して以下に説明する。
本実施形態に係る医療用把持具1は、図1に示されるように、長尺の軟性の挿入部(湾曲部)2、該挿入部2の先端に配置された把持部3と、挿入部2の基端に配置された操作部4と、操作部4において加えた駆動力を把持部3に伝達する動力伝達部5と、中間係止手段6とを備えている。 A medical grasper 1 according to an embodiment of the present invention will be described below with reference to the drawings.
As shown in FIG. 1, the medical grasping tool 1 according to the present embodiment includes a long flexible insertion portion (curved portion) 2, a graspingportion 3 disposed at the tip of the insertion portion 2, and an insertion portion The control unit 4 includes an operation unit 4 disposed at the base end of the drive unit 2, a power transmission unit 5 for transmitting the driving force applied from the operation unit 4 to the grip unit 3, and an intermediate locking unit 6.
本実施形態に係る医療用把持具1は、図1に示されるように、長尺の軟性の挿入部(湾曲部)2、該挿入部2の先端に配置された把持部3と、挿入部2の基端に配置された操作部4と、操作部4において加えた駆動力を把持部3に伝達する動力伝達部5と、中間係止手段6とを備えている。 A medical grasper 1 according to an embodiment of the present invention will be described below with reference to the drawings.
As shown in FIG. 1, the medical grasping tool 1 according to the present embodiment includes a long flexible insertion portion (curved portion) 2, a grasping
挿入部2は、長手方向に貫通する少なくとも1つのルーメンを有するチューブである。体腔内に挿入される際に、内視鏡あるいはオーバーチューブのチャネルを介して挿入されることにより、挿入部2を体腔の形状に倣って湾曲させ、先端の把持部3を患部近傍に配置することができるようになっている。
The insertion portion 2 is a tube having at least one lumen penetrating in the longitudinal direction. When inserted into a body cavity, the insertion portion 2 is curved according to the shape of the body cavity by being inserted through a channel of an endoscope or an overtube, and the grasping portion 3 of the tip is disposed in the vicinity of the affected area It can be done.
把持部3は、例えば、図2から図5に示されるように、挿入部2の先端に固定された第1把持片(把持片)7と、該第1把持片7に対して、挿入部2の長手軸に直交する揺動軸線(軸線)A回りに揺動可能に支持された第2把持片(把持片)8とを備えている。これら一対の把持片7,8は揺動軸線A回りに揺動させられることにより、図2のように先端を離間させた最大開状態と、図4に示されるように先端を密着させた閉状態との間で相互に開閉させられるようになっている。
For example, as shown in FIG. 2 to FIG. 5, the gripping portion 3 is an inserting portion with respect to the first gripping piece (gripping piece) 7 fixed to the tip of the insertion portion 2 and the first gripping piece 7. A second grip piece (gripping piece) 8 swingably supported around a rocking axis (axis) A orthogonal to the longitudinal axis of 2 is provided. The pair of gripping pieces 7 and 8 are pivoted about the pivot axis A, so that the tip is separated as shown in FIG. 2 and the tip is brought into close contact as shown in FIG. It is made to be able to be opened and closed mutually between states.
また、把持部3には、後述する動力伝達部5により伝達されてきた張力を第2把持片8の第1把持片7に対する揺動動作に変換する動力変換機構(摺動部)9が設けられている。動力変換機構9は、第1把持片7に挿入部2の長手方向に沿って設けられた直線状の第1スリット(スリット)10と、第2把持片8に設けられ、第1スリット10に交差する方向に延びる第2スリット(スリット)11と、これら第1スリット10および第2スリット11の交差位置に挿入され、揺動軸線Aに平行に配置される円柱状のピン12とを備えている。
In addition, the gripping portion 3 is provided with a power conversion mechanism (sliding portion) 9 for converting the tension transmitted by the power transmission portion 5 to be described later into the swinging motion of the second gripping piece 8 to the first gripping piece 7. It is done. The power conversion mechanism 9 is provided in the linear first slit (slit) 10 provided in the first gripping piece 7 along the longitudinal direction of the insertion portion 2 and in the second gripping piece 8, and is provided in the first slit 10. A second slit (slit) 11 extending in a crossing direction, and a cylindrical pin 12 inserted at the intersection position of the first slit 10 and the second slit 11 and disposed parallel to the swing axis A There is.
操作部4は、操作者により操作される任意の公知の構造を有し、操作者の加える力を挿入部2の長手方向に沿う力として動力伝達部5に供給するようになっている。
動力伝達部5は、挿入部2のルーメン内を貫通して操作部4と把持部3とを連結するワイヤ13を備えている。操作部4において供給した力を張力として伝達し、把持部3に伝達するようになっている。ワイヤ13の先端には動力変換機構9を構成しているピン12が固定されている。 Theoperation unit 4 has any known structure operated by the operator, and supplies the force applied by the operator as a force along the longitudinal direction of the insertion unit 2 to the power transmission unit 5.
Thepower transmission unit 5 includes a wire 13 which penetrates the inside of the lumen of the insertion unit 2 and connects the operation unit 4 and the grip unit 3. The force supplied from the operation unit 4 is transmitted as tension and transmitted to the gripping unit 3. The pin 12 constituting the power conversion mechanism 9 is fixed to the tip of the wire 13.
動力伝達部5は、挿入部2のルーメン内を貫通して操作部4と把持部3とを連結するワイヤ13を備えている。操作部4において供給した力を張力として伝達し、把持部3に伝達するようになっている。ワイヤ13の先端には動力変換機構9を構成しているピン12が固定されている。 The
The
ワイヤ13を基端側に牽引することにより、ワイヤ13により伝達した張力によってピン12を基端側に牽引すると、ピン12が第1スリット10に沿って基端側に直線移動させられるようになっている。ピン12は第2スリット11にも挿入されているので、ピン12が移動すると第1スリット10と第2スリット11との交差位置が移動する結果、第2スリット11がピン12に押されて揺動軸線A回りに回転するので、第2スリット11が設けられている第2把持片8が第1把持片7に対して揺動軸線A回りに揺動させられるようになっている。
By pulling the wire 13 proximally, when the pin 12 is pulled proximally by the tension transmitted by the wire 13, the pin 12 can be linearly moved proximally along the first slit 10. ing. Since the pin 12 is also inserted into the second slit 11, as the pin 12 moves, the crossing position of the first slit 10 and the second slit 11 moves, so that the second slit 11 is pushed by the pin 12 and shaken. As it rotates around the movement axis A, the second gripping piece 8 provided with the second slit 11 is made to swing around the swing axis A with respect to the first gripping piece 7.
本実施形態において中間係止手段6は、第2スリット11の長手方向の略中央位置に、幅方向の一側の内面、すなわち、ピン12が基端側に移動させられる際に接触する側の内面に凹部14を設けることにより構成されている。図2に示されるように第1把持片7に対して第2把持片8が開かれた最大開状態から図4に示される閉状態まで、第2把持片8を揺動させる場合には、ピン12は凹部14が設けられている側の内面に押し付けられて移動し、その途中で、図3に示されるように、第2スリット11に設けられている凹部14内に嵌まるようになっている。
In the present embodiment, the intermediate locking means 6 is an inner surface on one side in the width direction, ie, a side on which the pin 12 is moved when the pin 12 is moved to the proximal side, at a substantially central position in the longitudinal direction of the second slit 11 It is comprised by providing the recessed part 14 in inner surface. When swinging the second grip piece 8 from the maximum open state in which the second grip piece 8 is opened relative to the first grip piece 7 as shown in FIG. 2 to the closed state shown in FIG. The pin 12 is pressed against the inner surface of the side where the recess 14 is provided to move, and in the middle thereof is fitted into the recess 14 provided in the second slit 11 as shown in FIG. 3. ing.
このとき、ピン12が第2スリット11の直線状の内面を押しているときには、両者間の摺動抵抗はほぼ一定、あるいは滑らかに変化するが、ピン12が凹部14に入る瞬間、ピン12と第2スリット11の内面との接触圧力が急激に低下した後、凹部14に嵌まった状態で直線状の内面との摺動抵抗より大きな値まで上昇するようになっている。
At this time, when the pin 12 is pushing the linear inner surface of the second slit 11, the sliding resistance between the two changes substantially constant or smoothly, but at the moment when the pin 12 enters the recess 14, the pin 12 and the After the contact pressure with the inner surface of the two slits 11 drops sharply, it is made to rise to a value larger than the sliding resistance with the linear inner surface in a state of being fitted in the recess 14.
これにより、操作部4において操作者が動力伝達部5に一定の力を入力して第2把持片8を揺動させていても、ピン12が凹部14に一致する位置で把持力量が変化するので、操作者はその変化を操作部4において感知することができるようになっている。すなわち、操作者は、把持力量の変化を感知した位置に第2把持片8の角度を維持することができ、最大開状態と閉状態との間に中間的な係止状態を実現することができるようになっている。
Thereby, even if the operator inputs a constant force to the power transmission unit 5 in the operation unit 4 and swings the second gripping piece 8, the amount of gripping force changes at the position where the pin 12 matches the recess 14 Therefore, the operator can sense the change in the operation unit 4. That is, the operator can maintain the angle of the second gripping piece 8 at the position where the change in the amount of gripping force is sensed, and realize an intermediate locking state between the maximum open state and the closed state. It can be done.
このように構成された本実施形態に係る医療用把持具1の作用について以下に説明する。
本実施形態に係る医療用把持具1を用いて患部の組織を把持するには、図4に示されるように第1把持片7に対して第2把持片8を閉じた状態として、体内に挿入された内視鏡あるいはオーバーチューブのチャネル内に挿入していき、チャネルの先端開口から突出させて、患部に対向配置させる。 The operation of the medical grasper 1 according to the present embodiment configured as described above will be described below.
In order to grasp the tissue of the affected area using the medical grasping tool 1 according to the present embodiment, the secondgrasping piece 8 is closed to the first grasping piece 7 as shown in FIG. It is inserted into the channel of the inserted endoscope or overtube, and is made to project from the tip opening of the channel so as to face the affected part.
本実施形態に係る医療用把持具1を用いて患部の組織を把持するには、図4に示されるように第1把持片7に対して第2把持片8を閉じた状態として、体内に挿入された内視鏡あるいはオーバーチューブのチャネル内に挿入していき、チャネルの先端開口から突出させて、患部に対向配置させる。 The operation of the medical grasper 1 according to the present embodiment configured as described above will be described below.
In order to grasp the tissue of the affected area using the medical grasping tool 1 according to the present embodiment, the second
この状態で、図5に示されるように、操作者が操作部4を操作してワイヤ13を先端側に押し出す力を加えることにより、図2に示されるように、第1把持片7に対して第2把持片8を最大開状態まで揺動させる。
このとき、ワイヤ13の先端に取り付けられたピン12が第1スリット10内を先端に向かって移動する結果、第1スリット10との交差位置が変化させられた第2スリット11が揺動軸線A回りに回転して、第2把持片8が第1把持片7に対して揺動軸線A回りに回転させられる。 In this state, as shown in FIG. 5, the operator operates theoperation unit 4 to push the wire 13 to the tip end side, thereby applying the force to the first grip piece 7 as shown in FIG. The second gripping piece 8 is swung to the maximum open state.
At this time, as a result of thepin 12 attached to the tip of the wire 13 moving toward the tip in the first slit 10, the second slit 11 whose crossing position with the first slit 10 is changed is the swing axis A The second gripping piece 8 is rotated about the swing axis A with respect to the first gripping piece 7 by rotating around.
このとき、ワイヤ13の先端に取り付けられたピン12が第1スリット10内を先端に向かって移動する結果、第1スリット10との交差位置が変化させられた第2スリット11が揺動軸線A回りに回転して、第2把持片8が第1把持片7に対して揺動軸線A回りに回転させられる。 In this state, as shown in FIG. 5, the operator operates the
At this time, as a result of the
そして、この開動作においては、ピン12は第2スリット11の凹部14が設けられていない側の内面を押すので、ピン12が凹部14に係合することなく、真っ直ぐな内面に沿ってほぼ一定の摺動抵抗で滑らかに第2把持片8を揺動させることができる。
And in this opening operation, since the pin 12 pushes the inner surface of the second slit 11 on the side where the recess 14 is not provided, the pin 12 does not engage with the recess 14 and is substantially constant along the straight inner surface. The second gripping piece 8 can be swung smoothly by the sliding resistance of
図2に示されるように最大開状態となった後には、操作者が操作部4を操作してワイヤ13を基端側に牽引する方向に力を加えることにより、第2把持片8は第1把持片7に対して閉じる方向に揺動させられる。そして、図3に示されるように、ピン12が凹部14に嵌まる位置では、図6に示されるように、ピン12と第2スリット11の内面との接触位置における接線方向とピン12の移動方向(すなわち、第1スリット10の長手方向)とのなす角度θは、凹部14以外の位置おける場合と比較して、十分に大きくなる。すなわち、ピン12が凹部14に嵌まる位置において、ピン12と第2スリット11との間の摺動抵抗が急激に増大するので、第1把持片7に対する第2把持片8の揺動動作が一旦係止される。
As shown in FIG. 2, after the operator is in the maximum open state, the second gripping piece 8 is operated by operating the operation unit 4 and applying a force in a direction to pull the wire 13 proximally. 1) It is swung in the closing direction with respect to the gripping piece 7. And, as shown in FIG. 3, when the pin 12 is fitted into the recess 14, as shown in FIG. 6, the tangential direction and the movement of the pin 12 at the contact position between the pin 12 and the inner surface of the second slit 11 The angle θ with the direction (that is, the longitudinal direction of the first slit 10) is sufficiently large as compared with the case where the position is other than the concave portion 14. That is, since the sliding resistance between the pin 12 and the second slit 11 rapidly increases at the position where the pin 12 fits in the recess 14, the swinging motion of the second gripping piece 8 with respect to the first gripping piece 7 Once locked.
これにより、図3に示される中間の開状態を達成することができるという利点がある。例えば、比較的薄い組織を把持する場合には、図4に示されるような閉状態に近い状態において把持する必要があるが、比較的厚い組織を把持する場合には図3に示されるような中間の開状態において把持することが好ましい場合がある。このような場合に図4に示される閉状態まで一対の把持片7,8を閉じてしまうと、組織に過大な負担がかかる不都合がある。
This has the advantage that the intermediate open state shown in FIG. 3 can be achieved. For example, when grasping relatively thin tissue, it is necessary to grasp in a close state as shown in FIG. 4, but when grasping relatively thick tissue, as shown in FIG. It may be preferable to grip in the intermediate open state. In such a case, if the pair of gripping pieces 7 and 8 are closed until the closed state shown in FIG. 4, there is a disadvantage that the tissue is excessively burdened.
また、一対の把持片7,8によって組織を挟んだ状態で行われる処置が、例えば、電気エネルギ等により組織を凝固させる処置である場合には、図3に示される中間の開状態となるときに両者間の隙間が凝固に最適な隙間となるように設定することもできる。そして、組織を凝固した後に切断する際には、ワイヤ13をさらに強い力で牽引することにより、凹部14に嵌まった状態からピン12を離脱させて図4に示されるように、一対の把持片7,8を閉状態に近づけて組織を切断することができる。
In addition, when the treatment performed in a state in which the tissue is sandwiched between the pair of gripping pieces 7 and 8 is, for example, a treatment for coagulating the tissue by electric energy or the like, the intermediate open state shown in FIG. It is also possible to set the gap between the two to be the optimal gap for solidification. Then, when the tissue is coagulated and then cut, the wire 13 is pulled by a further strong force, thereby disengaging the pin 12 from the state of being fitted in the concave portion 14 and as shown in FIG. The pieces 7, 8 can be brought close to the closed state to cut the tissue.
特に、ピン12が押し付けられる第2スリット11の内面に凹部14を設けることにより、両者間の接触圧力が、一旦急激に低下させられた後に急激に増大させられる。その結果、接触圧力の変化による摺動抵抗の急激な変化を操作部4側においてクリック感として操作者が検知し易くすることができるという利点もある。
In particular, by providing the recess 14 on the inner surface of the second slit 11 against which the pin 12 is pressed, the contact pressure between the two is rapidly increased and then sharply increased. As a result, there is also an advantage that the operator can easily detect an abrupt change in sliding resistance due to a change in contact pressure as a click on the operation unit 4 side.
また、本実施形態に係る医療用把持具1によれば、中間係止手段6が操作部4ではなく把持部3に設けられているので、把持部3と操作部4との間の挿入部2の形状に関わらず、中間の係止角度を一定に維持することができるという利点がある。すなわち、中間係止手段6を操作部4側に設けることもできるが、その場合、挿入部2の形状によるワイヤ13の経路長変動により、中間の係止角度が変動してしまう不都合があるが、本実施形態に係る医療用把持具1によればそのような不都合はなく、中間の開状態における第1把持片7と第2把持片8との隙間を一定に維持することができる。
Further, according to the medical gripping tool 1 according to the present embodiment, since the intermediate locking means 6 is provided not in the operation unit 4 but in the grip unit 3, the insertion unit between the grip unit 3 and the operation unit 4 Regardless of the shape of 2, there is an advantage that the intermediate locking angle can be maintained constant. That is, although the intermediate locking means 6 can be provided on the operation unit 4 side, in that case, there is a disadvantage that the intermediate locking angle changes due to the change of the path length of the wire 13 due to the shape of the insertion portion 2 The medical grasper 1 according to the present embodiment does not have such a disadvantage, and the gap between the first grasping piece 7 and the second grasping piece 8 in the intermediate open state can be maintained constant.
なお、本実施形態においては、第2スリット11の内面の一部に凹部14を設けることにより、ピン12と第2スリット11の内面との間の摺動抵抗を急激に変化させることとしたが、これに代えて、図7に示されるように、第2スリット11の内面に凸部15を設けることにしてもよい。これによっても同様に、摺動抵抗を急激に変化させて、中間の開位置を容易に達成することができる。
また、第2スリット11の内面の部分的な凹部14に代えて、図8に示されるように、第2スリット11の幅を先端側から基端側に向かって徐々に広げ、途中の段差によって、収縮させる形状にしてもよい。 In the present embodiment, by providing therecess 14 in a part of the inner surface of the second slit 11, the sliding resistance between the pin 12 and the inner surface of the second slit 11 is rapidly changed. Instead of this, as shown in FIG. 7, a convex portion 15 may be provided on the inner surface of the second slit 11. This likewise allows the sliding resistance to be rapidly changed to easily achieve an intermediate open position.
Further, instead of thepartial recess 14 on the inner surface of the second slit 11, as shown in FIG. 8, the width of the second slit 11 is gradually expanded from the distal end side toward the proximal end side, The shape may be made to shrink.
また、第2スリット11の内面の部分的な凹部14に代えて、図8に示されるように、第2スリット11の幅を先端側から基端側に向かって徐々に広げ、途中の段差によって、収縮させる形状にしてもよい。 In the present embodiment, by providing the
Further, instead of the
また、図9に示されるように、ピン12が先端側に向かって移動させられる際に押し付けられる側の第2スリット11の内面に、凹部14が設けられていてもよい。この場合には、第1把持片7に対して第2把持片8を閉状態から開状態に揺動させる途中で、第2把持片8の揺動を一時的に係止させることができる。これにより、一対の把持片7,8が意図せず開かれ過ぎないようにすることができ、内視鏡やオーバーチューブのチャネルから引き抜く際に、開いた状態となっていることを防止することができる。
Further, as shown in FIG. 9, a recess 14 may be provided on the inner surface of the second slit 11 on the side to be pressed when the pin 12 is moved toward the tip end side. In this case, it is possible to temporarily lock the swing of the second grip piece 8 while swinging the second grip piece 8 from the closed state to the open state with respect to the first grip piece 7. As a result, the pair of gripping pieces 7 and 8 can be prevented from being opened unintentionally and it is possible to prevent an open state when pulling out from the channel of the endoscope or the overtube. Can.
また、本実施形態においては、凹部14あるいは凸部15が1個だけ設けられている場合について例示したが、これに代えて、図10に示されるように2個以上設けられていてもよい。
また、本実施形態においては、第2スリット11に凹部14または凸部15を設けることとしたが、これに代えて第1スリット10に凹部14または凸部15を設けてもよい。 Moreover, in this embodiment, although illustrated about the case where only the recessedpart 14 or the convex part 15 is provided, it may replace with this and may be provided 2 or more, as FIG. 10 shows.
Further, in the present embodiment, theconcave portion 14 or the convex portion 15 is provided in the second slit 11, but instead, the concave portion 14 or the convex portion 15 may be provided in the first slit 10.
また、本実施形態においては、第2スリット11に凹部14または凸部15を設けることとしたが、これに代えて第1スリット10に凹部14または凸部15を設けてもよい。 Moreover, in this embodiment, although illustrated about the case where only the recessed
Further, in the present embodiment, the
また、本実施形態においては、ワイヤ13の先端をピン12に直接固定する場合について説明したが、これに代えて、図11に示されるように、ピン12および揺動軸線Aに回転可能にプーリ16,17を設け、これらのプーリ16,17にワイヤ13a,13bを巻き掛けることにしてもよい。図11に示す例では、ピン12に設けたプーリ16には、先端を挿入部2あるいは第1把持片7に固定したワイヤ13aを巻き掛けることにより、第2把持片8を閉じる方向に揺動させる際にピン12の牽引力を張力の2倍に増幅して、より小さい張力で閉動作を行うことができる。
Also, in the present embodiment, the case where the tip of the wire 13 is directly fixed to the pin 12 has been described, but instead, as shown in FIG. 16, 17 may be provided, and the wires 13a, 13b may be wound around these pulleys 16, 17. In the example shown in FIG. 11, the wire 13 a whose tip is fixed to the insertion portion 2 or the first gripping piece 7 is wound around the pulley 16 provided on the pin 12 to swing the second gripping piece 8 in the closing direction. In this case, the pulling force of the pin 12 can be amplified to twice the tension to perform the closing operation with a smaller tension.
また、揺動軸線Aに設けたプーリ17には、先端を第2把持片8に固定し、ピン12のプーリ16に巻き掛けたワイヤ13bを巻き掛けることにより、第2把持片8を開く方向に揺動させる際にピン12の牽引力を張力の4倍に増幅して、より小さい張力で開動作を行うことができる。
Further, the direction in which the second gripping piece 8 is opened by fixing the tip to the second gripping piece 8 and winding the wire 13 b wound around the pulley 16 of the pin 12 on the pulley 17 provided on the swinging axis A During the swinging operation, the pulling force of the pin 12 can be amplified to four times the tension to perform the opening operation with a smaller tension.
また、第2スリット11に凹部14または凸部15を設けることで摺動抵抗を変化させることとしたが、図12および図13に示されるように、第1把持片7と第2把持片8との間に、中間の係止角度近傍で接触を開始して摺動抵抗を増大させる摺動部18を備えることにしてもよい。この場合の駆動方式はワイヤ13に限られない。図12に示される最大開状態から図13に示される係止状態までの間の角度では第2把持片8に設けられた摺動部18は第1把持片7に接触しておらず、摺動抵抗は低く維持されているが、図13に示される係止状態から閉状態までは摺動部18が第1把持片7に接触することにより第1把持片7と第2把持片8との間の摺動抵抗が増大するので、操作者がその変化を感知して図13の係止状態において一旦操作を停止することができる。
Further, although the sliding resistance is changed by providing the concave portion 14 or the convex portion 15 in the second slit 11, as shown in FIGS. 12 and 13, the first gripping piece 7 and the second gripping piece 8 And a sliding portion 18 that starts contact near the intermediate locking angle to increase sliding resistance. The drive system in this case is not limited to the wire 13. The sliding portion 18 provided on the second grip piece 8 does not contact the first grip piece 7 at an angle between the maximum open state shown in FIG. 12 and the locked state shown in FIG. The dynamic resistance is maintained low, but from the locked state shown in FIG. 13 to the closed state, the sliding portion 18 contacts the first gripping piece 7 to make the first gripping piece 7 and the second gripping piece 8 Since the sliding resistance between them increases, the operator can sense the change and temporarily stop the operation in the locked state of FIG.
また、図14から図16に示されるように、第2把持片8に固定されたプーリ19に巻き掛けたワイヤ13を牽引して第2把持片8を閉じる場合に、非円形のプーリ19を用いることにしてもよい。これにより、同じ張力で牽引していても、図15に示される角度において発生するモーメントを図14および図16に示される最大開状態および閉状態と比較して小さくすることができる。すなわち、図15の中間の係止状態において必要な操作力量が増大するので、操作者にこの状態を認識させることができる。
Further, as shown in FIGS. 14 to 16, when pulling the wire 13 wound around the pulley 19 fixed to the second grip piece 8 to close the second grip piece 8, the non-circular pulley 19 is used. You may use it. This makes it possible to reduce the moment generated at the angle shown in FIG. 15 as compared to the maximum open and close states shown in FIGS. 14 and 16 even when pulling with the same tension. That is, since the amount of operation force required in the intermediate locked state of FIG. 15 increases, the operator can be made aware of this state.
また、図17および図18に示されるように、第1把持片7と第2把持片8との間に、中間の係止角度近傍で接触して弾性変形を開始するバネ20を備えることにしてもよい。これによっても、最大開状態から閉状態に向かう途中の中間の係止状態においてバネ20の弾性変形が開始されることにより、操作力量が増大するので、操作者にこの状態を認識させることができる。
Further, as shown in FIGS. 17 and 18, a spring 20 is provided between the first gripping piece 7 and the second gripping piece 8 to start an elastic deformation by contacting in the vicinity of an intermediate locking angle. May be Also by this, the elastic deformation of the spring 20 is started in the intermediate locking state on the way from the maximum open state to the closed state, and the amount of operation force increases, so that the operator can recognize this state. .
また、図19に示されるように、第1把持片7および第2把持片8の形状が、中間の係止状態において、一定のギャップを形成するように構成されていてもよい。例えば、中間の係止状態において組織を均一な厚さに挟むことができ、凝固等の場合に均一な処置を行うことができる。そして、この場合には、図20に示されるように、閉状態に移行する際に剪断によって組織を容易に切断することができる。
Further, as shown in FIG. 19, the shapes of the first gripping piece 7 and the second gripping piece 8 may be configured to form a certain gap in the intermediate locked state. For example, the tissue can be sandwiched to a uniform thickness in the intermediate locked state, and uniform treatment can be performed in the case of coagulation or the like. And, in this case, as shown in FIG. 20, the tissue can be easily cut by shearing at the time of transition to the closed state.
また、図12および図13の摺動部18に代えて、図21および図22に示されるように、磁石21,22を採用し、中間の係止状態において、異なる磁極が対向するように第1把持片7および第2把持片8に磁石21,22を固定してもよい。これにより、図22に示される中間の係止状態において磁石21,22により発生する磁気吸引力が最も大きくなるので、中間の係止状態に第2把持片8をより確実に配置することができる。
Further, as shown in FIGS. 21 and 22, magnets 21 and 22 are employed instead of the sliding portion 18 of FIGS. 12 and 13, and different magnetic poles are opposed to each other in an intermediate locked state. The magnets 21 and 22 may be fixed to the first grip piece 7 and the second grip piece 8. Thus, the magnetic attraction force generated by the magnets 21 and 22 is maximized in the intermediate locked state shown in FIG. 22. Therefore, the second gripping piece 8 can be arranged more reliably in the intermediate locked state. .
また、摺動部18を第2把持片8に設けることに代えて、第2把持片8を駆動するワイヤ13に設けることにしてもよい。この場合に、図23および図24に示されるように、ワイヤ13をスリーブ23内に貫通させておき、スリーブ23内面の摩擦係数を先端側よりも基端側(図中、斜線部)で大きくしておけばよい。これにより、図24に示されるように、第2把持片8が中間の係止状態となる位置近傍で、ワイヤ13に固定された摺動部18が摩擦係数の大きな領域に差し掛かることとなり、それ以降、閉状態までの操作力量を増大させることができる。
Further, instead of providing the sliding portion 18 on the second grip piece 8, the second grip piece 8 may be provided on the wire 13 for driving. In this case, as shown in FIGS. 23 and 24, the wire 13 is penetrated into the sleeve 23, and the friction coefficient of the inner surface of the sleeve 23 is larger on the proximal side (hatched portion in the figure) than on the distal side. You should do it. As a result, as shown in FIG. 24, the sliding portion 18 fixed to the wire 13 reaches a region with a large coefficient of friction near the position where the second gripping piece 8 is in the intermediate locked state, After that, the amount of operation power to the closed state can be increased.
また、図12および図13の摺動部18に代えて、図25から図27に示されるように、第2把持片8に設けた突起24を突き当てるストッパ25を第1把持片7に設けるとともに、突起24が突き当たる位置と突起24と接触しない位置との間でストッパ25を移動可能にすることにしてもよい。
これにより、図25の最大開状態から閉状態に向かう途中で、図26に示されるように突起24をストッパ25に突き当てることにより、中間の係止状態に、より確実に第2把持片8を係止させることができる。そして、さらに閉状態に向かう際には、図27に示されるように、ストッパ25を突起24と接触しない位置まで退避させることにより、第2把持片8を閉状態まで移動させることが可能となる。 Further, instead of the slidingportion 18 of FIGS. 12 and 13, as shown in FIGS. 25 to 27, a stopper 25 is provided on the first gripping piece 7 to abut the projection 24 provided on the second gripping piece 8. In addition, the stopper 25 may be made movable between a position where the projection 24 abuts and a position not in contact with the projection 24.
Thereby, on the way from the maximum open state to the closed state in FIG. 25, thesecond holding piece 8 is more reliably engaged in the intermediate locked state by abutting the projection 24 against the stopper 25 as shown in FIG. Can be locked. Then, when going further to the closed state, as shown in FIG. 27, it is possible to move the second grip piece 8 to the closed state by retracting the stopper 25 to a position not in contact with the projection 24. .
これにより、図25の最大開状態から閉状態に向かう途中で、図26に示されるように突起24をストッパ25に突き当てることにより、中間の係止状態に、より確実に第2把持片8を係止させることができる。そして、さらに閉状態に向かう際には、図27に示されるように、ストッパ25を突起24と接触しない位置まで退避させることにより、第2把持片8を閉状態まで移動させることが可能となる。 Further, instead of the sliding
Thereby, on the way from the maximum open state to the closed state in FIG. 25, the
また、本実施形態においては、第1把持片7が挿入部2の先端に固定され、第2把持片8が第1把持片7に対して揺動可能に支持されている把持部3を例示したが、これに限定されるものではなく、第1把持片7および第2把持片8の両方が揺動軸線A回りに揺動可能に支持されている把持部3に適用してもよい。
Further, in the present embodiment, the first gripping piece 7 is fixed to the tip end of the insertion portion 2 and the second gripping piece 8 is movably supported relative to the first gripping piece 7 by way of example. However, the present invention is not limited to this, and the present invention may be applied to the gripping portion 3 in which both the first gripping piece 7 and the second gripping piece 8 are swingably supported around the swing axis A.
1 医療用把持具
2 挿入部(湾曲部)
4 操作部
5 動力伝達部
6 中間係止手段
7 第1把持片(把持片)
8 第2把持片(把持片)
9 動力変換機構(摺動部)
10 第1スリット(スリット)
11 第2スリット(スリット)
12 ピン
14 凹部
15 凸部
18 摺動部
A 揺動軸線(軸線) 1Medical grasper 2 Insertion part (curved part)
4operation unit 5 power transmission unit 6 intermediate locking means 7 first gripping piece (gripping piece)
8 Second gripping piece (gripping piece)
9 Power conversion mechanism (sliding part)
10 1st slit (slit)
11 Second slit (slit)
12Pin 14 Recess 15 Protrusion 18 Slider A Swing axis (axis)
2 挿入部(湾曲部)
4 操作部
5 動力伝達部
6 中間係止手段
7 第1把持片(把持片)
8 第2把持片(把持片)
9 動力変換機構(摺動部)
10 第1スリット(スリット)
11 第2スリット(スリット)
12 ピン
14 凹部
15 凸部
18 摺動部
A 揺動軸線(軸線) 1
4
8 Second gripping piece (gripping piece)
9 Power conversion mechanism (sliding part)
10 1st slit (slit)
11 Second slit (slit)
12
Claims (8)
- 所定の軸線回りに相対的に揺動可能に支持されて開閉可能な一対の把持片と、
該把持片の少なくとも一方を揺動させる駆動力を供給する操作部と、
該操作部により供給された駆動力を前記把持片に伝達する動力伝達部と、
前記操作部よりも前記把持片側に配置され、前記把持片を最大開状態と閉状態との中間の1以上の所定の係止角度で係止させる中間係止手段とを備える医療用把持具。 A pair of grasping pieces that are supported so as to be relatively pivotable about a predetermined axis and can be opened and closed;
An operation unit for supplying a driving force for swinging at least one of the grip pieces;
A power transmission unit for transmitting the driving force supplied by the operation unit to the gripping piece;
A medical grasper comprising: an intermediate locking means disposed on the one side of the grip than the operation portion and locking the grip piece at one or more predetermined locking angles between the maximum open state and the closed state. - 前記操作部と前記把持片との間に湾曲可能な湾曲部を備え、
前記中間係止手段が前記湾曲部より前記把持片側に設けられている請求項1に記載の医療用把持具。 A bendable portion bendable between the operation portion and the gripping piece;
The medical grasper according to claim 1, wherein the intermediate locking means is provided on one side of the curved portion from the curved portion. - 前記中間係止手段が前記把持片に設けられている請求項1または請求項2に記載の医療用把持具。 The medical grasper according to claim 1 or 2, wherein the intermediate locking means is provided on the grasping piece.
- 前記中間係止手段が、前記動力伝達部への入力力量に対する前記把持片による把持力量の割合を、前記係止角度において変化させる請求項1から請求項3のいずれかに記載の医療用把持具。 The medical grasper according to any one of claims 1 to 3, wherein the intermediate locking means changes the ratio of the amount of gripping force by the gripping piece to the amount of input force to the power transmission unit at the locking angle. .
- 前記中間係止手段が、前記把持片の揺動に伴って摺動する摺動部を備え、該摺動部における摺動抵抗を前記係止角度において変化させる請求項4に記載の医療用把持具。 The medical grip according to claim 4, wherein the intermediate locking means comprises a sliding portion sliding along with the swing of the grip piece, and changing the sliding resistance in the sliding portion at the locking angle. Equipment.
- 前記摺動部が、一対の前記把持片に設けられたスリットと、該スリット内に収容され前記動力伝達部により伝達された駆動力により、前記スリットの長さ方向に摺動させられるピンとを備え、少なくとも一方の前記スリットの前記長さ方向の途中位置に、前記ピンと前記スリットとの摺動抵抗を変化させる凹部または凸部を備える請求項5に記載の医療用把持具。 The sliding portion includes a slit provided in a pair of the holding pieces, and a pin which is accommodated in the slit and is slid in the longitudinal direction of the slit by a driving force transmitted by the power transmission portion. The medical grasper according to claim 5, further comprising a concave portion or a convex portion which changes a sliding resistance between the pin and the slit at an intermediate position in the length direction of at least one of the slits.
- 前記中間係止手段が、前記把持片を閉じる方向に揺動させるとき、または前記把持片を開く方向に揺動させるときのいずれかにおいて前記把持片を係止させる請求項1から請求項6のいずれかに記載の医療用把持具。 The said intermediate locking means locks the said holding piece, either, when rock | fluctuating the holding | grip piece in the direction to close, or when rocking the holding | grip piece in the opening direction. The medical grasper according to any one.
- 前記把持片を開く方向に揺動させるときと、閉じる方向に揺動させるときとで、前記ピンが、前記スリットの幅方向の異なる内面を摺動して移動する請求項6に記載の医療用把持具。 7. The medical device according to claim 6, wherein the pin slides and moves on the inner surface of the slit different in the width direction between the time of swinging the gripping piece in the direction to open and the time of swinging in the direction of closing. Gripping tool.
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PCT/JP2017/042731 WO2019106737A1 (en) | 2017-11-29 | 2017-11-29 | Medical gripping tool |
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PCT/JP2017/042731 WO2019106737A1 (en) | 2017-11-29 | 2017-11-29 | Medical gripping tool |
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WO2013140648A1 (en) * | 2012-03-21 | 2013-09-26 | オリンパスメディカルシステムズ株式会社 | Endoscopic treatment instrument |
WO2014185515A1 (en) * | 2013-05-17 | 2014-11-20 | オリンパスメディカルシステムズ株式会社 | Endoscope treatment tool |
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JP2011251122A (en) * | 2010-06-02 | 2011-12-15 | Tyco Healthcare Group Lp | Apparatus for performing electrosurgical procedure |
US20120022584A1 (en) * | 2010-07-23 | 2012-01-26 | Stephen Donnigan | Jaw Movement Mechanism and Method for a Surgical Tool |
US20120289999A1 (en) * | 2011-05-11 | 2012-11-15 | Timothy Graham Frank | Medical Instrument For Grasping An Object, In Particular A Needle Holder |
WO2013140648A1 (en) * | 2012-03-21 | 2013-09-26 | オリンパスメディカルシステムズ株式会社 | Endoscopic treatment instrument |
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