JP2000237200A - Tissue crushing device for laparoscopic surgery - Google Patents

Abstract

(57) [Summary] Tissue crushing for laparoscopic surgery, which can crush the tissue reliably, easily, and in a short time without damaging an organ bag or the like containing the tissue. Provide equipment. A crushable jaw (1) that can be opened and closed is provided at a front end, a gripping operation section (4) is provided at a rear end, and a connection section (5) having a connection mechanism that connects the crushing jaw (1) and the gripping operation section (4) is provided. While holding the gripping operation unit 4 with one hand, by operating the gripping operation unit 4, the tissue gripped by the crushing jaw 1 is crushed. Is provided with a relief convex / concave portion 2 for preventing escape when the grasped tissue is crushed, and / or at the tip of the crushed jaw, preventing escape when crushing the grasped tissue. To prevent escape.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laparoscopic operation and the like, in which tissue from which a part of a human body organ or the like has been resected is housed in an organ bag and then taken out of the operation hole together with the organ bag so that the tissue can be easily removed. The present invention relates to a tissue crushing device for crushing.

[0002]

2. Description of the Related Art In laparoscopic surgery, part or all of a human organ having a lesion, such as a malignant tumor, is excised as a tissue, and is temporarily removed so that the influence of the malignant tumor does not reach other portions. , Housed in an organ bag,
After a procedure such as sampling is performed, the organ bag together with the organ bag is taken out of the abdominal cavity through a treatment hole provided for laparoscopic surgery.

[0003] At this time, the size of the treatment hole is limited, and it may not be possible to remove the removed tissue contained in the organ bag to the outside of the abdominal cavity as it is. Therefore, it is necessary to crush the tissue in the organ bag so small that it can be taken out of the operation hole together with the organ bag.

FIG. 11 (a) is a front view showing an example of a conventional forceps used for crushing such a tissue, and FIG. 11 (b) is a detailed perspective view of a main part of a distal end thereof.

The forceps 110 includes a gripper 111 that opens and closes so as to grip the tissue, and a gripping operation unit 11 that grips the forceps 110 and opens and closes the gripper 111.
4. A connecting portion 115 having a built-in connecting mechanism for connecting the operating force of the grip portion 111 and the gripping operation portion 114. The connecting portion 115 is provided in the gripping operation portion 114, and the outer periphery of the ring portion is rotated to operate. , The grip portion 111, the connecting portion 115,
That is, the rotation means 117 that can rotate with respect to the grip operation unit 114 is provided on the grip operation unit 114 side.

As shown in FIG. 11 (b), in this example, the gripper 111 has a structure that opens and closes a gripper jaw 111a bent in an L-shape. In addition, a fine uneven surface 111b for preventing the gripped tissue from slipping is provided. To open and close the gripping jaw 111a of the gripper 111, apply up to four fingers other than the thumb of one hand to the gripping portion 114a of the gripping operation portion 114 of the forceps 110, and place the thumb in the ring hole of the operating portion 114b. Insert and operate your thumb.

[0007] However, such forceps 110
It is not a dedicated product for crushing tissue, but its gripping jaw 11
1a is also intended only to grasp the tissue,
No consideration was given to crushing the tissue, and its shape was not suitable for tissue crushing.

Further, since the grip operation section 114 is also operated with the thumb, it is not possible to apply much force, and there is no hindrance to grasping the tissue. Not suitable.

Further, in such a forceps 110, since the grip portion 111 can be completely closed, when used in an organ bag, the grip portion 111 is sandwiched between the grip jaws 11a of the grip portion 111. Part of the organ bag
It is damaged by the uneven surface 111b of the gripping jaw 111a and the like, and impairs the function of the organ back, which blocks the external influence such as an internal malignant tumor.

FIG. 12 is an explanatory view showing another example of the conventional tissue crushing method.

In this case, in order to crush the tissue, the operator's hand B is used as shown in the figure without using any special instrument.

FIG. 1 shows the state of the abdominal cavity H in a laparoscopic operation. A tissue A resected from a human body organ is already contained in an organ bag E in the abdominal cavity H. In this state, in order to take out the tissue A from the treatment hole J while being housed in the organ bag E, the index finger D of the operator's hand B is passed through the opening of the organ bag E looking through the treatment hole J, and the inside of the organ bag E is removed. The tissue A is pressed against the abdominal wall K with the index finger D via the organ bag E by applying to the tissue A.

Thus, in the case of a soft tissue,
The tissue can be crushed without difficulty, but in the case of hard, fibrous tissue, crushing was not easy and time-consuming.

Another method is disclosed in Japanese Patent Application Laid-Open No. 7-275.
253 and JP-A-8-257032, but these are merely similar to the forceps described above with reference to FIG. 11, and are suitable for grasping tissue. However, it is not suitable for crushing tissue. In addition, the irregularities provided on the gripping surfaces of these gripping portions also
Both are intended to prevent the tissue from slipping down when grasping the tissue, but not to crush the tissue.

[0015] The medical device described in Japanese Patent Publication No. 25733782 is also intended for grasping tissue, not for crushing tissue. Therefore, the end action means provided at the tip of the grip portion is also merely a stopper for the gripped tissue.

Further, a forceps and a cylindrical rotary blade which can be inserted through the forceps are used, and a protruding piece which comes into contact with the cylindrical rotary blade is erected at the tip of a grip portion of the forceps, and a tissue is placed on the grip portion. , Insert the cylindrical rotary blade, insert the tissue between the protruding piece and the cylindrical rotary blade, and use the protruding piece as a chopping board to cut the tissue using a tissue sampling and resecting device that cuts the tissue. Although a method of cutting the tissue can be considered, this tissue sampling and resection device is only for collecting tissue, not for crushing the tissue, and is inefficient and requires a long time as a tissue crushing instrument. Was.

Further, there is a method of cutting tissue with forceps having a scissor-shaped tip. However, since the blade is exposed, there is a fear that the organ bag may be damaged, and the safety is reduced. There was a problem in point.

[0018]

SUMMARY OF THE INVENTION The present invention has been proposed in order to solve the above-mentioned problems, and it is possible to reliably and easily prevent damage to an organ bag or the like containing a tissue. Can crush tissue in a short time,
An object of the present invention is to provide a tissue crushing device used for laparoscopic surgery.

[0019]

A tissue crushing device for use in laparoscopic surgery according to claim 1 is an organ crushing device for use in laparoscopic surgery, comprising a collapsible jaw openable and closable at a distal end thereof. The rear end is provided with a gripping operation unit, and a coupling unit having a coupling mechanism for coupling the crushing jaw and the gripping operation unit is provided.The gripping operation unit is held with one hand, By operating the gripping operation section, the tissue gripped by the crushed jaw is crushed, and the crushed jaw is provided with an escape for preventing escape when the gripped tissue is crushed. The retaining projections and / or the distal end of the crushing jaw are provided with escape preventing projections for preventing escape when the grasped tissue is crushed.

This tissue crushing device is characterized in that it was first developed as a dedicated device for crushing tissue contained in an organ bag or the like. Therefore, it has a configuration similar to that of a conventional forceps, and in a laparoscopic operation, a distal end portion, a connecting portion, and a grip portion are used so as to be used by being inserted into an operation hole or a mantle tube provided in the operation hole. While having the holding operation part, the tip part thereof is provided with a collapsible jaw which can be opened and closed particularly for tissue crushing.

Since the crushing jaw is not for simply grasping the tissue but for crushing the tissue, the crushing jaw having a certain width so as not to hinder the insertion / removal through the treatment hole or the like is required. During this time, a part of the tissue is grasped and crushed. Therefore, since it is crushed in a wider area, it can be crushed efficiently and in a short time.

Also, if the gripping operation section for operating the crushing jaw is operated with a finger other than the thumb of one hand holding the device, more force can be applied than in the conventional thumb operation. And can be crushed easily and easily.

In order to prevent the tissue from escaping when the tissue is crushed by grasping and crushing the tissue, the tissue crushing device has a relief concave / convex portion on the crushing jaw or / and a tip of the crushing jaw. A relief protruding piece is provided on the front side.

In other words, when the tissue is grasped by the crushed jaw and the crushed jaw is closed to attempt to crush the grasped tissue, the grasped tissue is pressed by the crushing pressure. Try to escape in a more open direction. If this is left, the tissue will not be squashed properly. Therefore, in the right place of the crushed surface of this crushed jaw,
Escape-recess projections and depressions are provided, or escape-preventing projections for preventing the escape in the opening direction are provided at the tip of the crushed jaw.

Therefore, the crushing of the tissue by the crushing jaws can be performed more smoothly and without failure, and the crushing can be performed more easily and reliably.

Further, when both of the above-mentioned relief projections and recesses and the escape retaining projections are provided, the effect of preventing the escape is further enhanced.

Further, since the blade portion is not provided, the organ bag containing the tissue is not damaged and the safety is high.

According to a second aspect of the present invention, in the tissue crushing instrument used for laparoscopic surgery, in the first aspect, the relief projections and depressions provided on the crushing jaw are formed in a direction intersecting a tissue escape direction. It is characterized by being.

In this tissue crushing device, the relief projections and depressions have
It is formed in a direction intersecting the direction in which the tissue escapes, that is, in a direction intersecting the escape direction. Therefore, the escape projections and recesses allow the tissue grasped by the crushed jaw to be drawn into the crushed jaw as the tissue is sandwiched, so that the escape of the tissue is more effectively prevented.

The tissue crushing device used for laparoscopic surgery according to claim 3 is the device according to claim 1 or 2, wherein the relief projections and depressions of the crushed jaw are spike-shaped, and a plurality of projections are provided. It is characterized by comprising a concave portion into which the protruding portion is fitted or a receiving portion having a through hole.

This tissue crushing device is characterized in that the specific shape of the relief projections and depressions is defined as a spike-like projection and a corresponding recess or a receiving portion having a through hole.

Therefore, the escape of the grasped tissue can be prevented just like a spike.

The tissue crushing device used for laparoscopic surgery according to claim 4 is the device according to any one of claims 1 to 3, wherein the opposing crushing surfaces for crushing the tissue of the crushing jaw are planar. It is characterized in that it is formed in a convex and concave shape of a curved surface, a convex and concave shape of an acute angle, and the opposing portions of the crushed surface conform to each other's shape.

In this tissue crushing device, the shape of the crushing surface of the crushing jaw is specifically defined as a flat shape, a curved surface unevenness, or an acute angled unevenness. It is characterized in that opposing portions are provided so as to follow each other's shape, that is, a convex portion is provided with a concave portion and a concave portion is provided with a convex portion.

The tissue crushing device of the present invention does not cut the tissue into pieces in a tissue bag or the like, but crushes the tissue and accommodates it in the tissue bag. Since it is enough to be able to take out from it, it is sufficient that the opposing part has a shape that conforms to the opponent, and by doing so, the crushed surface becomes wider, It can be crushed efficiently.

Further, since the convex portions do not correspond to each other, it is possible to prevent a part of the organ bag from being caught and damaged between the convex portions. In combination, it can be better prevented.

Further, the crushed surface is basically sufficient to be a flat surface, but may be formed as an uneven surface as described above. In this case, the uneven surface has the role of crushing the tissue at the same time.
It also plays a role in preventing the escape of the organization.

According to a fifth aspect of the present invention, there is provided the tissue crushing instrument for use in laparoscopic surgery according to any one of the first to fourth aspects, wherein the crushing jaw does not completely crush the grasped tissue when closed. It is characterized in that a completely closed prevention means for forming a gap of the order is provided.

Since this tissue crushing device is provided with a means for completely closing the crushing jaw so as not to be completely closed, the organ bag should be attached to the crushing jaw during the crushing of the tissue. Even if a part of the body bag is caught, the organ bag is not damaged and the safety is high. Such safety is particularly important in laparoscopic surgery in which observation in an organ bag is not easy, and a tissue crushing instrument can be used with confidence. The tissue crushing instrument used for laparoscopic surgery according to claim 6, according to any one of claims 1 to 5,
The coupling mechanism is characterized in that, when the grip operation section is operated, the operation force is amplified as the crushed jaws are closed.

In this tissue crushing device, a link having a boosting function is provided in a connecting mechanism for connecting the gripping operation portion and the crushing jaw so that the operating force is amplified as the crushing jaw is closed. I have.

Therefore, in the open state, the crushing jaw opens and closes more in response to the operation of the gripping operation unit, while in the closed state, the crushing jaw opens and closes less in response to the operation of the gripping operation unit. In other words, a greater crushing pressure can be generated with less operating force, and tissue crushing can be performed more easily and with less force.

According to a seventh aspect of the present invention, in the tissue crushing instrument used for laparoscopic surgery, in any one of the first to sixth aspects, the crushing jaw is rotated by rotating means provided on the gripping operation part side. It is characterized by being movable.

In this tissue crushing device, a connecting mechanism for connecting the crushing jaw and the gripping operation portion is rotatable at a connecting portion that houses the crushing jaw, and is provided on the gripping operation portion side of the connecting portion. The pivoting means allows the crushing jaw to pivot with respect to the connecting portion, that is, the gripping operation portion.

Therefore, the opening / closing direction of the crushing jaw can be rotated in accordance with the posture of the tissue to be crushed, which is convenient for crushing.

[0045]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of a tissue crushing device according to the present invention will be described below with reference to the drawings.

FIG. 1 is a front view, partially in vertical section, showing an example of the tissue crushing device of the present invention. FIG.
(B) shows the crushed jaw opened. FIG.
(A), in order to make it easy to understand, the arrow A view showing the crushed jaw 1 viewed from the front and the arrow B view showing the crushed jaw 1 viewed from below are also shown.

The tissue crushing device 10 grips the crushing jaw 1 provided at the tip thereof, the relief concave / convex portion 2 and the relief retaining projection 3 provided on the crushing jaw 1, and the tissue crushing device 10. In addition, a gripping operation unit 4 for opening and closing the crushing jaw 1, a coupling unit 5 having a coupling mechanism for coupling the crushing jaw 1 and the gripping operation unit 4, and a connecting portion between the coupling unit 5 and the crushing jaw 1 Is provided with the full-close prevention means 6 provided in the first embodiment.

In this example, the crushing jaw 1 is composed of a fixed jaw 1a fixed to the connecting portion 5 and a movable jaw 1b supported by the open / close fulcrum g with respect to the fixed jaw 1a. It is a material that does not adversely affect human tissues in the abdominal cavity, such as an alloy or a stainless steel material, and is formed of a material that can be sterilized and disinfected by a method such as autograve sterilization.

The fixed jaw 1a of the crushing jaw 1 and the movable jaw 1b are respectively opposed to each other, that is, a crushing surface 11 for grasping the tissue between the surfaces and crushing the tissue.
a and 11b are configured so as to be as wide as possible within a range in which the crushed jaw 1 can pass through a treatment hole used in laparoscopic surgery or a mantle tube.

In this respect, the crushing jaw 1 of the tissue crushing instrument 10 is different from a conventional gripping portion of a forceps for gripping tissue, and thus the crushing jaw 1 has a crushing area as large as possible. , Crushing tissue more efficiently,
And it can be ensured.

The relief 2 is provided on the crushing jaw 1 to prevent escape when the grasped tissue is crushed. In this example, the projection 2 projects in the form of a spike provided on the movable jaw 1b. The plurality of protrusions 21 and the protrusions 2
1 includes a receiving portion 22 having a through hole provided in the fixed jaw 1a so as to fit therein. The direction in which the projecting portion 21 and the receiving portion are formed intersects in the direction in which the tissue escapes.

Further, in this example, the relief convex / concave portion 2 composed of the projecting portion 21 and the receiving portion 22 is provided on the crushing surfaces 11a and 11b of the crushing jaw 1 as shown in the arrow B view. , So as to be distributed over the entire surface.

The tissue gripped by the crushed jaw 1 is regulated by the spike-shaped protrusion 21 and the corresponding receiving portion 22 so as not to move laterally.
Even if the upper and lower crushing surfaces 11a and 11b are closed and the grasped tissue is crushed, the crushed surface 11a
It is possible to crush the grasped tissue reliably and without failure without escaping from the a and 11b. Further, since the direction in which the projecting portion 21 and the receiving portion 22 are formed intersects with the direction in which the tissue escapes, the effect of preventing this is great.

The escape-preventing projection 3 further provided on the crushing jaw 1 is provided for the same purpose as the escape-preventing concave / convex portion 2, and is provided upright at the tip of the fixed jaw 1a. As can be seen in the figure, in particular, the tissue gripped by the crushed jaw 1
It is prevented from escaping from the tip of the crushed jaw 1 which is the easiest to escape.

As described above, the escape preventing means may be provided with both the escape preventing concave / convex portion 2 and the escape preventing protrusion 3, or may be provided with only one of them.

The gripping operation section 4 has an operation section 41 rotatably supported by a fixed fulcrum d provided at an appropriate position of the connecting section 5 and a grip fixed to the rear end of the connecting section 5. The operation unit 41 includes a finger stopper 41a that enables the operation unit 41 to rotate in both directions.

When grasping the tissue crushing device 10, the thumb side of one hand is applied to the grasping portion 42, and the operating portion 41
The grip operation unit 4 is gripped so that the index finger is applied to the upper part of the finger stopper 41a and the remaining fingers are applied to the lower part. At this time, the palm of the hand that has been grasped has a shape that just wraps around the grasping section 42, and the operating section 41 is moved to 3 to 3 except for the thumb.
With four fingers, it can be operated in a more powerful manner.

Therefore, the tissue can be crushed more strongly than the crushing of the tissue using forceps based on the thumb operation as described in the conventional example.

The operating section 41 of the gripping operation section 4 is provided with a fulcrum b connected to a connecting mechanism 51 built in the connecting section 5.

The connecting portion 5 is a cylindrical body and includes a front cylinder 5a fixedly supporting the fixed jaw 1a and a rear cylinder 5b of a cylindrical body removably inserted and fixed to the front cylinder 5a. When both are fitted and fixed, a predetermined inner space 5c is formed inside. Further, the grip section 42 of the grip operation section 4 is fixed to the rear cylinder 5b.

The connecting mechanism 51 built in this connecting portion is
A front link plate 51a linked at a fulcrum f to the movable jaw 1b of the crushing jaw 1 is linked at a fulcrum e to the front link plate 51a, and is fixed to the rear end of the rear cylinder 5b from the front cylinder 5a of the connecting portion 51. A connecting shaft 51b penetrating to the grip portion 42,
The connecting shaft 52b is inserted into a portion corresponding to the inner space 5c of the connecting portion 51 of the connecting portion 51, and the connecting shaft 52b is moved forward (to the left in FIG.
A spring 51c biasing the movable jaw 1a (in a direction in which the movable jaw 1a is opened), and a grip portion 42 fixed to the rear end of the rear cylinder 5b of the connecting shaft 52b.
Tube 51d detachably inserted and fixed to the rear end exposed from the rear, a rear link plate for linking a fulcrum c provided on the link tube 51d and a fulcrum b of the operation unit 41 of the gripping operation unit 4. 51f.

According to such a coupling mechanism, when the operation unit 4 of the gripping operation unit 4 is operated rightward (counterclockwise) in the figure, that is, close to the gripping unit 42, the operating force is reduced. Support point b, rear link plate 51f, support point c, link cylinder 5
1d, the connecting shaft 51b, the fulcrum e, the front link plate 51a, and the fulcrum f are linked, and the movable jaw 1b is rotated in the closing direction about its opening and closing fulcrum g, finally as shown in FIG. It becomes a state.

Conversely, when the operation unit 4 of the gripping operation unit 4 is operated to the left (clockwise) in the figure, that is, away from the gripping unit 42 (in this case, as described above, the connecting shaft 51b is connected). Is biased by the spring 51c in the direction in which the movable jaw 1a is opened. Therefore, only by removing the force of the finger applied to the operating unit 4, the operating unit 41 is moved in that direction by the biasing force. ), By the same link transmission of the connecting mechanism 51, the movable jaw 1b is moved around its open / close fulcrum g.
It is rotated in the opening direction, and finally comes to a state as shown in FIG.

In this way, the gripping operation section 4 can be gripped with one hand, and the crushed jaw 1 can be opened and closed more powerfully and easily with fingers other than the thumb of the gripped one hand.

Here, the fully closed prevention means 6 is provided with a crushed surface 11b of the movable jaw 1b, which opens and closes and pivots about an opening and closing fulcrum f, inside the front cylinder 5a of the connecting portion 5 in the form of a so-called stopper pin. As shown in FIG. 1A, when the back 1ba comes into contact with the fully closed prevention means 6, the fixed jaw 1 is provided.
a of the movable jaw 1b with respect to the crushed surface 11a
However, the gap is formed so that the grasped tissue is not completely crushed.

In this way, even if a part of the organ bag is pinched by the crushed jaw 1 while the tissue is being crushed, the organ bag is not damaged. High safety. Such safety can be intraperitoneal,
In laparoscopic surgery where observation inside the organ bag is not easy,
Of particular importance, the tissue crushing device can be used with confidence.

In the tissue crushing instrument 10 having such a structure, the tissue grasped by the relief projections 2 and the relief projections 3 can be more efficiently formed by the crushing jaws 1 having the wide crushing surfaces 11a and 11b. The tissue can be reliably crushed without escaping. Also, with the gripping operation unit 4, with one hand gripped,
It can be operated with stronger force and is suitable for use in laparoscopic surgery.

The point a corresponds to the operation section 41 of the grip operation section 4.
The center point of the lower part of the neck forming the finger stopper 41a, and the point h is the crushed surface 1 of the movable jaw 1b of the crushed jaw 1.
1b shows the tip portion, and each of these points
Along with the other lower-case notation points b to g shown in the figure,
It will be described later for use in describing the amplifying operation of the connecting mechanism 51 of the connecting portion 5.

FIGS. 2A and 2B are front views of a main part of a partial longitudinal section showing various examples of relief projections and depressions provided on the crushing jaw of the tissue crushing device of the present invention. FIG. b) is an unevenly distributed type, (c) is a vertical type, (d) is a non-uniform projection type, and FIG. 3 shows various other examples of relief projections and depressions provided on the crushing jaw of the tissue crushing device of the present invention. (A) is a pointed type, (b) is a prismatic type, (c) is a non-penetrating type, and (d) is a bent protruding type.

Here, the same reference numerals are given to the parts already described, and the repeated description will be omitted.

The tissue crushing device according to the present invention is characterized in that, when crushing, the tissue grasped by the crushing chin is prevented from escaping by escaping protrusions and depressions.
The aspect of the escape preventing convex and concave portions is not limited to the one described in FIG.

FIG. 2A shows an upside-down type, that is, a projection 21 is provided on a fixed jaw 1b, and a receiving portion 22 is
2 shows the one provided in b.

FIG. 2 (b) shows an uneven distribution type, in which the relief convex / concave portion 2 composed of the protruding portion 21 and the receiving portion 22 is fitted to the crushed jaw 1.
Are provided only in the vicinity of the tip, and are not provided so as to be dispersed throughout.

FIG. 2 (c) shows a vertical type, that is, a part of the projection 21 is provided on the movable jaw 1b, a part of the projection 21 is provided on the fixed jaw 1a, and the receiving part 22 is also fixed so as to correspond thereto. The jaw 1a and the movable jaw 1b are shown.

FIG. 2D shows a non-uniform projecting type in which the length of the projecting portion 21 becomes longer toward the tip of the movable jaw 1b. In this way, when the user first grasps the crushed jaw 1 and tries to prevent the tissue from escaping, the projecting portions 21 are sequentially arranged from the tip end having the largest opening.
Can come into contact with the tissue and can be prevented from escaping, so that the escaping effect is more reliably exhibited.

FIG. 3A shows a pointed type, and the protrusion 21
The tip of is sharpened. This makes it easier to penetrate the tissue.

FIG. 3B shows a prism type. Projection 2
The shape of 1 may be not only a columnar shape but also a prismatic shape as described above, and its cross-sectional shape is not limited as long as it exhibits an escape preventing effect.

FIG. 3 (c) shows a non-penetrating type,
Are constituted by concave portions that do not penetrate.

FIG. 3D shows a bending projection type, in which the projection 2
1 is bent so as to draw a curve centered on the curvature of the opening / closing fulcrum g of the movable jaw 1b provided with the movable jaw 1b.
2 also has a shape corresponding to it.

In this manner, the closing direction of the movable jaw 1b, that is, the direction in which the tissue is crushed, and the direction in which the protruding portion 21 bites into the tissue are just orthogonal to each other, and from the open state to the closed state. Evenly, the trapped tissue is prevented from escaping.

Further, in this case, the bending degree of the protruding portion is further set to the opening / closing fulcrum g side, and the more the movable jaw 1b is closed, the more the grasped tissue becomes. You may make it be pushed in the direction.

FIGS. 4A and 4B are main part front views showing various examples of the crushed surface of the crushed jaw of the present invention. FIG. 4A is a closed state of an acute-angled uneven type, and FIG. , (C)
Is a closed state of the curved surface type, and (d) is an open state of the curved surface type.

Further, FIG. 4 (a) also shows a view of the crushing surface 11c of the crushing jaw 1 viewed from right above, which is viewed from an arrow C, for easy understanding.

In FIG. 1, the crushing surfaces 11a and 11b of the crushing jaw 1 are shown.
Has shown a planar shape, but is not limited to this, and is not limited to a planar shape as long as it has an effect of crushing the tissue. For example, the shape shown in FIG. There is.

FIGS. 4 (a) and 4 (b) show a fixed jaw 1c and a movable jaw 1d having crushed surfaces 11c and 11d of an acute angled type.
And (c) and (d) show a crushed surface 1 of a curved uneven type.
A fixed jaw 1e and a movable jaw 1f having 1e and 11f are shown.

The uneven crushed surfaces 11c, 11d,
11e and 11f are not provided so that the convex portion and the convex portion and the concave portion and the concave portion correspond to each other, but are provided so that the concave portion corresponds to the convex portion and the convex portion corresponds to the concave portion. Have been.

What is different is that the tissue crushing device 10 of the present invention
Then, instead of chopping the tissue apart in a tissue bag, etc., if the tissue can be crushed and stored in the tissue bag, it can be removed from the treatment hole etc. It is enough if the opposing part is shaped along the opponent,
Also, by doing so, the crushed surface becomes wider, and crushing can be performed more efficiently.

Further, since the projections and the projections do not correspond to each other, it is possible to prevent a part of the organ bag from being caught and damaged between the projections by the above-described full-closure preventing means 6 (FIG. Combined with 1), it can be better prevented.

Further, when the crushed surface is formed as an uneven surface as described above, it can play a role of crushing the tissue as well as a role of preventing the escape of the tissue. Therefore, in this case, as a positive escape prevention means, as shown in the figure,
It is enough to use the escape stopper 3 provided at the tip of the crushing jaw 1 only.
The effect of the escape can be exhibited.

FIGS. 5A and 5B are main part front views showing another example of the crushed surface of the crushed jaw of the present invention. FIG. 5A shows a closed state and FIG. 5B shows an opened state.

The crushing jaw 1 is composed of a fixed jaw 1g having curved rugged surfaces 11g and 11h, and a movable jaw 11h. The crushing surfaces 11g and 11h are convex without conforming to the shape of the other party. The part and the convex part, and the concave part and the concave part are arranged so as to correspond to each other.

Although the crushing effect of such a crushing jaw is inferior to that of the crushing jaw described with reference to FIG. 4, it is sufficiently durable in actual use.

FIGS. 6A and 6B are main part front views showing another example of the crushed jaw of the present invention, wherein FIG. 6A is a closed state and FIG. 6B is an opened state.

The crushing jaw 1 has a crushing jaw 1 composed of a fixed jaw 1e having crushing surfaces 11e and 11f of curved surface irregularities, a movable jaw 1f, and a receiving portion 22 provided on the fixed jaw 1e. , A relief projection 2 formed by a projection 21 provided on the movable jaw 11f.

As described above, the uneven type crushed surface 11
While e and 11f crush the tissue and play the role of preventing the crushed tissue from escaping, the provision of the relief ridges and depressions 2 can further reliably crush the tissue.

FIGS. 7A and 7B are front views of a main part showing various examples of escape preventing projections of the crushed jaw of the present invention. FIG. 7A shows a closed state of one side type, and FIG. 7B shows an open state of one side type. State,
(C) is a state in which both types of closed states are viewed from the front,
(D) is a closed state of both types, and (e) is an open state of both types.

In this example, the crushing jaw 1 provided with a relief projection / recess 2 composed of a projecting portion 21 and a receiving portion 22 is further provided with escape retaining projections 3A, 3B at its tip. 7 is the same as that of FIG.
The movable jaw 1b of the crushed jaw 1 is provided with a retaining projection 3A. FIGS. 7C, 7D and 7E show the fixed jaw 1a of the crushed jaw 1.
And the movable jaws 1b are provided with escape stopper projections 3Ba, 3Bb.
Is provided.

In the case where the escape preventing projections are provided vertically, FIG.
As shown in (c), the upper and lower escape projections 3Ba, 3B
b must be provided so as not to interfere with each other.

As described above, by providing both the relief projections and depressions and the escape retaining projections, the escape of the tissue at the time of crushing can be more reliably prevented.

FIG. 8 is a front view of a main part of a partial vertical section showing an example of a double-opening type of a crushing jaw of the tissue crushing device of the present invention.
(A) is a closed state, (b) is an open state.

Until now, one of the crushed jaws 1 was fixed,
Although only the other is movable, the effect of the crushed jaw of the present invention is exhibited even if both are opened and closed. The crushed jaw 1A shown here is an example of such a double opening.

In the crushed jaw 1A, the two jaws constituting the crushed jaw 1A are respectively constituted by movable jaws 1g and 1h which are pivotally opened and closed about an opening and closing fulcrum i by operating the gripping operation section 4. , Respectively, a flat crushed surface 11g,
11h, a receiving portion 22 is provided on one movable jaw 1g, and a protrusion 21 is provided on the other movable jaw 1h,
The protrusion 21 and the receiving portion 22 constitute the relief convex / concave portion 2. The relief concave / convex portion 2 is provided in a direction intersecting the direction in which the tissue escapes, preferably in a direction substantially orthogonal to the escape direction.

The movable jaws 1g and 1h are respectively
Each has a fulcrum j and k, and is connected to the connecting shaft 51b via the front link plates 51ab and 51aa by the fulcrums j and k, similarly to the case of the above-mentioned one movable crushing jaw. It can be opened and closed by the grip operation unit 4 via the connection mechanism, and can crush the grasped tissue.

Reference numeral 6A denotes a fully closed preventing means similar to the fully closed preventing means 6 provided on the crushing jaw 1 of FIG. 1, and here, the crushing surface of the movable jaw 1g which opens and closes and rotates about the opening and closing fulcrum i. 11g is provided as a projection on the back which is a point symmetrical part,
As shown in FIG. 8 (a), when the fully closed prevention means 6A comes into contact with the front link plate 51aa, the movable jaws 1g, 1h
A gap is formed between the opposing crushing surfaces 11g and h to such an extent that the grasped tissue is not completely crushed.

The various types of crushing surfaces, various types of relief projections and depressions, and various types of relief projections described above are not limited to the combinations described above.
Each of them can be freely selected and combined, and in that case, the effects of each can be synergistically exhibited.

FIGS. 9A and 9B are conceptual diagrams schematically illustrating the connection mechanism of the tissue crushing device of the present invention. FIG. 9A shows a state in which the crushing jaws are closed, and FIG. 9B shows a state in which the crushing jaws are open.

This figure schematically illustrates how the relative relationship between the points a to h relating to the coupling mechanism 51 shown in FIGS. 1A and 1B changes. 3 shows how the point h at the tip of the movable jaw 1b of the crushing jaw 1 moves in response to the movement of the point a by the operation of the operation unit 41 of the gripping operation unit 4 of FIG.

In FIG. 9 (a), the positions of these points a to h when the crushing jaw 1 is most closed are indicated by a suffix 0, and when the operating section 41 is operated in the opening direction by a rotation angle of 10 degrees. Is indicated by subscript 1. On the other hand, in FIG.
The positions of the points a to h when the crushing jaw 1 is opened most are indicated by the subscript 9, and then the operation unit 41 is rotated by a rotation angle of 10 degrees.
The position when operated in the closing direction is indicated by a subscript 8.

In the figure, the opening / closing fulcrum g of the crushed jaw 1 is shown.
And the fixed fulcrum d of the operation unit 4 is always fixed in position.
Since the position does not change, no subscript is added. Further, a straight line connecting the fulcrums e and c schematically shows the connecting shaft 51b of FIG. 1, and the shaft 51b is accommodated in the connecting portion 5 and slides only in the front-rear direction.

Thus, while maintaining the relative relationship of FIG. 1, as shown in FIG. 9A, the point a of the operation section 41 is changed from the fully closed point a0 to a point a1 of 10 degrees in the opening direction. Is operated, the point h0 of the tip of the movable jaw 1b rotates only about 31 degrees to the point h1, but the point a of the operation unit 41 is changed from the fully open point a9 to a point a8 of 10 degrees in the closing direction. It can be seen that the point h9 at the tip of the movable jaw 1b rotates about 47 degrees to the point h8 when the operation is performed.

It can be seen from the figure that such a relationship is amplified at both ends.
When the gripping operation unit 4 and the crushing jaw 1 are connected using the, the crushing jaw 1 rotates smaller with respect to the movement of the operation unit 41 as the crushing jaw 1 is closed, and conversely, As the operation unit 41 is fully opened, the crushing jaw 1 rotates more in response to the movement of the operation unit 41.

In this manner, in the open state where no force is applied, the crushing jaw 1 is rotated more quickly, and in the closed state where a force is applied, the operating force of the operating section 41 is further amplified and the crushing jaw 1 is increased.
The crushing jaw 1 can be opened and closed in an ideal manner, which is suitable for crushing tissue.

FIG. 10 is a partial longitudinal sectional front view showing another example of the tissue crushing device of the present invention.

In the tissue crushing instrument 10A, the opening / closing structure of the crushing jaw 1 is the same as that shown in FIG.
Is rotatably supported with respect to the connecting portion 5, and the rear end of the connecting portion is provided with a rotating means 7 for rotating the crushing jaw 1.

In the tissue crushing instrument 10A, the front tube 5d of the connecting portion 5 for fixedly supporting the crushing jaw 1 is connected to the rear tube 5d.
e, and is rotatably inserted into the front cylinder 5d.
A connecting bearing 51g, which is connected to the front link plate 51a, slides back and forth in the front tube 5d, and co-rotates with the front tube 5d, is accommodated therein.
The head 51ha of the connecting shaft 51h that connects the connecting bearing 51g and the rear link cylinder 51d to the receiving hole 51ga.
Are rotatably accommodated so as to transmit a sliding force.

At the rear end of the rear cylinder 5e of the connecting portion 5, a ring portion 42a of the gripping operation portion 42 is fixed.
A rotation ring 71 is rotatably inserted into 2 a, and a rotation cylinder 72 connecting the rotation ring 71 and a front cylinder of the connecting portion 5.
Are housed in the rear cylinder 5e. Therefore, when the rotating ring 71 is rotated, the rear cylinder 5e
The front tube 5d rotates, and accordingly, the front tube 5d is rotated.
The crushing jaw 1 fixed to d rotates.

Therefore, the gripping operation section 4 can be gripped with one hand, and the rotating ring 71 can be rotated with the thumb while holding the gripping operation section 4 with the thumb. Can be rotated with respect to the gripping operation unit 4.

Thus, according to the tissue crushing instrument 10A, the effect of the above-described tissue crushing instrument 10 is exhibited, and
Since the crushing jaw 1 can be rotated with respect to the gripping operation unit 4 in a gripping state, the opening and closing direction of the crushing jaw can be adjusted according to the posture of the tissue to be crushed, which is convenient for crushing. It is.

If all of the exposed corners of the tissue crushing device described above are carefully chamfered, even if they come into contact with an organ bag or the like to be crushed,
The contact partner will not be damaged.

[0120]

According to the first aspect of the present invention, the tissue crushing instrument used for laparoscopic surgery has a dedicated crushing jaw, so that the tissue can be crushed efficiently and in a short time.

Further, when the tissue is grasped and crushed, the relief ridges and / or projections for preventing the tissue from escaping are provided. Thus, the operation is performed smoothly and without failure, and crushing can be performed more easily and reliably.

Further, since the blade portion is not provided, the organ bag containing the tissue is not damaged and the safety is high.

According to the tissue crushing instrument used for laparoscopic surgery according to the second aspect, in addition to the effect of the tissue crushing instrument used for the laparoscopic surgery according to the first aspect, the relief projections and recesses allow the tissue to escape. Since it is formed in a direction intersecting the direction, the escape projections and depressions sandwich the tissue gripped by the crushed jaws, and more effectively prevent the escape of the tissue.

According to the tissue crushing instrument used for laparoscopic surgery according to the third aspect, in addition to the effect of the tissue crushing instrument used for the laparoscopic surgery according to the first or second aspect, the relief projections and recesses are provided. Since it is configured as a spike-shaped protruding portion and a concave portion corresponding to the spike-shaped protruding portion, or a receiving portion having a through hole, it is possible to prevent escape of the grasped tissue just like a spike.

According to the tissue crushing instrument used for laparoscopic surgery according to the fourth aspect, in addition to the effect of the tissue crushing instrument used for the laparoscopic surgery according to any one of the first to third aspects, the crushing jaw can be used. The crushed surfaces are respectively flat, curved and uneven, and sharp and rugged, and the opposing portions of the crushed surfaces are formed so as to conform to each other's shape. The convex part and the convex part do not correspond to each other, so that a part of the organ bag is caught and damaged between the convex parts. Together, they can be better prevented.

Further, the uneven crushed surface plays the role of crushing the tissue as well as the role of preventing the tissue from escaping.

According to the tissue crushing instrument used for laparoscopic surgery according to claim 5, in addition to the effect of the tissue crushing instrument used for laparoscopic surgery according to any one of claims 1 to 4, the crushing jaw can be reduced. In addition, when closed, the device is provided with a fully closed preventing means that forms a gap that does not completely crush the grasped tissue. Even when a part of the bag is pinched, the organ bag is not damaged and the safety is high.

According to the tissue crushing instrument used for laparoscopic surgery according to claim 6, in addition to the effect of the tissue crushing instrument used for laparoscopic surgery according to any one of claims 1 to 5, the connecting mechanism is When the gripping operation part is operated, the operation force is amplified as the crushing jaws are closed, so that the tissue can be crushed more easily and with less force, and the tissue crushing can be performed. Suitable for.

According to the tissue crushing instrument used in laparoscopic surgery according to claim 7, in addition to the effect of the tissue crushing instrument used in laparoscopic surgery according to any one of claims 1 to 6, the crushing jaw is The opening / closing direction of the crushing jaw can be turned in accordance with the posture of the tissue to be crushed because the turning means provided on the gripping operation unit side enables the turning. It is.

[Brief description of the drawings]

FIG. 1 is a front view of a partially longitudinal section showing an example of a tissue crushing device of the present invention, wherein (a) shows a crushed jaw closed and (b) shows a crushed jaw opened.

FIGS. 2A and 2B are front views of a main part of a partial vertical cross section showing various examples of relief projections and depressions provided on a crushing jaw of the tissue crushing device of the present invention, wherein FIG. Eccentric type,
(C) is a vertical type, (d) is an uneven projection type

FIGS. 3A and 3B are front views of a main part of a partial longitudinal section showing various other examples of the relief projections and depressions provided on the crushing jaw of the tissue crushing device of the present invention, wherein FIG. Is a prism type,
(C) is a non-penetrating type, (d) is a bending protrusion type

FIG. 4 is a front view of a main part showing various examples of a crushed surface of a crushed jaw according to the present invention, wherein FIG.
(B) is an open state of the acute angled type, (c) is a closed state of the curved type, and (d) is an open state of the curved type.

FIGS. 5A and 5B are front views of essential parts showing another example of the crushed surface of the crushed jaw of the present invention, wherein FIG.

FIG. 6 is a front view of a relevant part showing another example of the crushing jaw of the present invention.
(A) is closed, (b) is open

FIGS. 7A and 7B are front views of a main part showing various examples of escape preventing projections of the crushed jaw of the present invention, wherein FIG.
(B) is the open state of one type, (c) is the closed state of both types viewed from the front, (d) is the closed state of both types, and (e) is the open state of both types.

FIGS. 8A and 8B are partial longitudinal sectional front views showing an example of a double-opening type of a crushing jaw of the tissue crushing device of the present invention, wherein FIG. 8A is a closed state, and FIG.

FIG. 9 is a conceptual diagram schematically illustrating a connection mechanism of the tissue crushing device of the present invention, wherein (a) shows a state in which a crushing jaw is closed,
(B) is open

FIG. 10 is a front view of a partial longitudinal section showing another example of the tissue crushing device of the present invention.

FIG. 11 (a) is a front view showing an example of a conventional forceps used also for crushing tissue, and FIG. 11 (b) is a detailed perspective view of a main part of a distal end thereof.

FIG. 12 is an explanatory view showing another example of the tissue crushing conventionally used.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Crushing jaw 2 Relief convex / concave part 21 Protrusion part 22 Receiving part 3 Relief retaining protrusion 4 Grip operation part 5 Connecting part 51 Connecting mechanism 6 Fully closed prevention means 7 Rotating means 10 Organ crushing device A Tissue C Hand C Thumb D Pointing finger E Organ storage bag H Abdominal cavity J Treatment hole K Abdominal wall

 ──────────────────────────────────────────────────続 き Continuation of the front page (71) Applicant 000138185 Morita Manufacturing Co., Ltd. Person Toshiro Terachi 54, Shogoin Kawaharamachi, Sakyo-ku, Kyoto-shi, Kyoto (72) Inventor Ryuichiro Shinseki 680, Higashihama-machi, Fushimi-ku, Kyoto-shi Inside Morita Manufacturing Co., Ltd. 680 Minamicho F-term in Morita Manufacturing Co., Ltd. (reference) 4C060 EE21 FF12 GG22 GG23 GG24 MM26

Claims (7)

[Claims] An apparatus for crushing an organ used in laparoscopic surgery, comprising: a crushable jaw openable and closable at a distal end; a gripping operation unit at a rear end; A coupling portion having a coupling mechanism for coupling, the tissue grasped by the crushed jaw is pushed by operating the gripping operation portion while holding the gripping operation portion with one hand. In addition to the crushing configuration, the crushing jaw is provided with a relief concave / convex portion for preventing escape when the grasped tissue is crushed, and / or the tip of the crushing jaw is gripped. A tissue crushing instrument used for laparoscopic surgery, which is provided with an escape stop projection for preventing escape when crushing tissue. 2. The tissue crushing instrument for use in laparoscopic surgery according to claim 1, wherein the relief projections and depressions provided on the crushing jaw are formed in a direction intersecting with a tissue escape direction. . 3. The crushing jaw according to claim 1, wherein the relief projections and depressions of the crushed jaw include a plurality of projections projecting in a spike shape and a receiving portion having a depression or a through hole into which the projections fit. A tissue crushing device for laparoscopic surgery, which is constituted. 4. The crushing jaw according to claim 1, wherein opposing crushing surfaces for crushing the tissue of the crushing jaw are:
Each used for laparoscopic surgery, characterized in that the flat surface, the curved surface unevenness, the acute angled unevenness, and the opposing portions of the crushed surface are formed so as to conform to the shape of each other. Tissue crushing device. 5. The crushing jaw according to any one of claims 1 to 4, wherein the crushing jaw is provided with a completely closing prevention means for forming a gap which does not completely crush the grasped tissue when closed. A tissue crushing device characterized by the above-mentioned. 6. The connecting mechanism according to claim 1, wherein the operating force of the connecting mechanism is amplified as the crushing jaws are closed when the gripping operation section is operated. A tissue crushing device for use in laparoscopic surgery. 7. The laparoscopic surgery according to claim 1, wherein the crushing jaw is rotatable by a rotating means provided on the gripping operation unit side. Tissue crushing device used for