JPH01232948A - Surgical excision forceps - Google Patents

Abstract

PURPOSE:To repeatedly perform excising operation by small force and to improve working efficiency, by constituting a surgical excision forceps by providing an ultrasonic oscillation means to the forceps on the rear part side thereof and transmitting the ultrasonic vibration from the ultrasonic oscillation means to a leading end excision part. CONSTITUTION:When excision work is performed by the surgical excision forceps 1 inserted in the body cavity along with a sheath and a hard endoscope, a movable handle 16 is closed with respect to a fixed handle 13 to revolve the end part of the movable handle 16 rearwardly around a pin 17. With this revolution, an operation rod 8 moves rearwardly and, with the rearward movement of said operation rod 8, a movable blade 7 is revolved in a closing direction around a pin 11 and the tissue in the body cavity is grasped by the fixed blade 6 and the movable blade 7. At this time, ultrasonic vibration is given to the fixed blade 6 and the movable blade 7 through a vibration transmitting member 2, and the fixed blade 6 and the movable blade 7 are subjected to ultrasonic vibration by said ultrasonic vibration to excise the grasped tissue in the body cavity.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to a rigid endoscope and surgical resection forceps that are inserted into a sheath or inserted into a body cavity as they are and used to resect tissue.

[Prior art and problems to be solved by the invention] In recent years, it has become possible to observe internal organs in a body cavity by inserting an elongated insertion section into a body cavity, and to insert a treatment instrument inserted into a treatment instrument channel as necessary. Endoscopes, which can be used to perform various therapeutic treatments, have become widely used, and various types of treatment instruments have been used to be inserted into the treatment instrument channel, depending on the affected area and purpose to which they are applied. In particular, surgical resection forceps are often used for resection of tissues within body cavities.

However, with conventional surgical resection forceps, tissue inside the body cavity was removed by operating the operating section using only hand force, which required a large amount of force during resection, and repeated resection operations could damage the surgeon's hands. The problem is that workers become fatigued and work efficiency deteriorates.

The present invention has been made in view of the above-mentioned circumstances, and an object of the present invention is to provide surgical cutting forceps that can repeatedly perform cutting operations with small force and have high working efficiency.

[Means and effects for solving the problem] In order to achieve the above object, the surgical cutting forceps according to the present invention is provided with an ultrasonic oscillation means on the rear side of the forceps, and the ultrasonic vibration from the ultrasonic oscillation means is transmitted to the tip of the forceps. It is configured to transmit the information to the resection site. With this configuration, the distal resection portion that grips the tissue within the body cavity is vibrated ultrasonically to perform resection.

[Example 1] Figs. 1 and 2 relate to the first embodiment of the present invention, in which Fig. 1 is a side view showing the surgical cutting forceps of the present invention, and Fig. 2 is a side view showing the surgical resection forceps of the present invention.
FIG. 3 is a side view showing a state in which the surgical cutting forceps shown in the figure are used by being inserted into a rigid endoscope inserted into a sheath, for example.

In FIG. 1, a surgical cutting forceps 1 includes a vibration transmitting member 2 formed in an elongated cylindrical shape, an ultrasonic transducer 3 provided on the rear side through which the vibration transmitting member 2 penetrates, and the ultrasonic transducer. 3 and an operating section 4 connected to the rear end of the vibration transmitting member 2.

A fixed blade 6 is provided at the tip of the vibration transmission member 2,
A movable blade 7 that grips tissue etc. together with the fixed blade 6 is attached to a bottle 9.
The movable blade 7 is pivotally supported to be openable and closable relative to the fixed blade 6, and the tip of an operating rod 8 is supported near the pivot of the movable blade 7.

The operation section 4 is connected to the vibration transmission member 2, and the finger rest is connected to the section 1.
2 and a movable handle 16 having a finger rest 14 at its end.
6 has its other end inserted into the fixed handle 13 and is rotatably supported by a pin 17 relative to the fixed handle 13.

At the end of the movable handle 16, the operating rod 8, which is inserted into the photographing and transmitting member 2, is rotatably supported by a pin 18 with respect to the movable handle 16. When rotated toward the fixed handle 13, the operating rod 8 moves backward within the vibration transmission member 2, and the movable blade 7
is now closed.

The ultrasonic vibrator 3 includes a piezoelectric vibrator 19 that generates ultrasonic vibrations in response to a drive signal, and a horn 21 that amplifies the ultrasonic vibrations generated by the piezoelectric vibrator 19 and transmits the amplified ultrasonic vibrations to the vibration transmission member 2. It is covered with a cover 22. In addition, the ultrasonic vibrator 3 is connected to the piezoelectric vibrator 19.
A cord 23 extending from the rear end is connected to a drive device (not shown) that generates a drive signal.

The surgical resection forceps 1 configured as described above is used, for example, with a sheath 26 and a rigid endoscope 1m27, as shown in FIG.

The sheath 26 includes an insertion portion 28 and a sheath body 29, and the sheath body 29 has a cap 3 having a cock 30.
1 is provided in a protruding manner so that perfusion fluid can flow into the sheath 26 through a tube (not shown). Further, an insertion passage (not shown) is formed from the rear end of the sheath body 29 to the front end of the insertion portion 28.

The sheath 26 configured as described above is inserted into the body cavity, and the insertion portion 33 of the rigid endoscope fi 27 is inserted into the sheath 26.

The rigid endoscope 127 includes an insertion section 33 and an insertion section 33.
A grip part 34 connected to the rear end, an eyepiece part 35 protruding from the side of the grip part 34, a connecting part 36 to which a light guide cable (not shown) is connected, and a connecting part 36 connected to the grip part 34. and an insertion port 37 into which forceps etc. are inserted.When forceps etc. are not inserted into the insertion port 37,
A cock 38 is provided for keeping it closed. Further, this insertion port 37 is provided with a rubber plug 39 that seals between the inserted surgical cutting forceps 1 and the vibration transmission member 2.

As described above, when performing a resection operation using the surgical resection forceps 1 inserted into a body cavity together with the sheath 26 and the rigid endoscope tlt 27, the end of the movable handle 16 is closed by closing the movable handle 16 with respect to the fixed handle 13. portion rotates rearward around the bin 17. Along with this rotation, the operating rod 8 also moves backward, and the operating rod 8
As the movable blade 7 moves rearward, the movable blade 7 rotates in the closing direction using the bottle 11 as a fulcrum, and the fixed blade 6 and the movable blade 7 grasp tissue in the body cavity. At this time, ultrasonic vibration is applied from the ultrasonic transducer 3 to the fixed blade 6 and the movable blade 7 via the imaging transmission member 2, and this ultrasonic vibration causes the fixed blade 6 and the movable blade 7 to receive ultrasonic waves. It vibrates and excises the grasped tissue inside the body cavity.

As described above, according to this embodiment, by grasping the tissue in the body cavity with the fixed blade 6 and the movable blade 7, the tissue in the body cavity can be excised by ultrasonic vibration, so that it can be efficiently and repeatedly excised with a small force. Able to perform work.

FIG. 3 is a side view of surgical cutting forceps according to a second embodiment of the present invention.

In this embodiment, a fixed blade 42 having a recess 41 is formed at the tip of the imaging transmission member, and together with the fixed blade 42, a movable blade 44 having a recess 43 for gripping and storing tissue, etc. is connected to the fixed blade by a pin 9. 42, and the tip of the operating rod 8 is supported near the pivot portion of the movable blade 44. It is rotatably connected to the operating rod 8 via.

Then, the recess 41 of the fixed blade 42 and the recess 4 of the movable blade 44
Reference numeral 3 is adapted to accommodate the tissue in the body cavity to be excised, and the other functions and effects of the structure 9 are the same as in the first embodiment.

4 and 5 relate to a third embodiment of the present invention, in which FIG. 4 is a side view of the surgical resection forceps incorporated into the sheath, and FIG. 5 is an enlarged sectional view of the tip of the surgical resection forceps. be.

In FIG. 4, the sheath 50 consists of an elongated insertion section 51 and a sheath body 52 connected to the rear of the insertion section 51, and an insertion passage 53 is provided from the tip of the insertion section 51 to the rear end of the sheath body 52. ing. Further, the sheath body 5
A cap 56 having a cock 54 is provided on the second side,
A tube (not shown) is connected to this mouthpiece 56, and irrigation fluid is introduced through the tube.

Furthermore, a finger rest part 57 is provided on the side of the sheath main body 52, facing the cap 56, and a cylindrical member 58 is provided at the center of the back surface of this finger rest part 57, projecting from the rear. .

The surgical resection forceps 60 includes a vibration transmission member 61 that is inserted into the insertion passage 53 of the sheath 50 so as to be freely advanced and retracted, an ultrasonic transducer 62 that is connected to the rear end of the imaging transmission member 61, and an ultrasonic transducer. It consists of a suction cap 63 connected to the rear end of the mover 62. A tube 64 is attached to the suction cap 63.
This tube 64 is connected to a suction device (not shown).

The ultrasonic vibrator 62 includes a piezoelectric sensor 67 that generates ultrasonic vibrations in response to a drive signal, and a horn that amplifies the ultrasonic wave generated from the piezoelectric vibrator 67 and transmits it to the vibration transmission member 61. 66 and covered with a cover 68. Further, a cord 69 connected to the piezoelectric vibrator 67 and extending from the rear end of the ultrasonic vibrator 62 is connected to a drive device (not shown) that generates a drive signal. Further, the ultrasonic transducer 62 is provided with a protruding handle 72 having a finger rest 71, and the cylindrical member 58 of the sheath body 52 is inserted into a hole 73 formed in the center of the handle 72. A spring 74 is mounted on the cylindrical member 58.

As shown in FIG. 5, the tip of the vibration transmitting member 61 forms a suction lower part on the side of the tip, and a movable blade 77 is rotatably provided on a pin 78. Furthermore, the tip and movable blade 77 are provided with protrusions 79 and 80, and both ends of a spring 81 fitted into the pin 78 are hooked to these protrusions 79 and 80. The movable blade 77 is moved by this spring 81.
The lower suction is biased in the direction of closing.

Further, an operating wire 82 is connected to the end of the movable blade 77, and the operating wire 82 is inserted through a suction path 83 formed in communication with the vibration transmitting member 61 and the ultrasonic vibrator 62. , is connected to a control lever 84 of the ultrasonic transducer 62, and by rotating the control lever 84 counterclockwise, the control wire 82 is pulled rearward. By pulling this operating wire 82 backward, the movable blade 77 rotates clockwise around the bin 78 and is separated.
By returning the operating lever 84 to its original position, the movable blade 7
It is closed by the bias of a spring 81 hooked on a protrusion 80 of 7.

Surgical resection forceps 60 of this embodiment with the above configuration
For example, the insertion portion 51 of the sheath 50 is inserted into the knee joint by a puncturing operation such as a trocar, and the surgical resection forceps 60 are inserted.
The vibration transmitting member 61 is inserted through the knee joint, and the distal end of the vibration transmitting member 61 is brought into contact with a meniscus or the like in the knee joint. Then, the meniscus or the like is attracted to the suction lower roller at the tip of the vibration transmitting member 61 by the suction force of a suction device (not shown), and the meniscus or the like is gripped by the suction lower roller and the movable blade 77. At this time, ultrasonic vibration is applied to the movable blade 77 by the ultrasonic vibrator 62, and the meniscus is resected by the ultrasonic vibration of the movable blade 77. Then, the excised meniscus is suctioned into the suction path 83 of the imaging transmission member 61, and is discharged through the suction path 83 into a discharge container (not shown) connected to the tube 64 connected to the suction cap 63. be done.

According to this embodiment, tissue such as a meniscus can be removed by adsorbing it to the tip of the vibration transmitting member 61 having the movable blade 77 and the suction roller, so efficient removal can be performed with a small force. The excised tissue can be sucked into the suction path 83 of the imaging transmission member 61 and discharged.

[Effects of the Invention] As explained above, according to the present invention, ultrasonic waves are transmitted by the ultrasonic vibrator to the blade gripping tissue, etc., so that cutting can be performed efficiently and repeatedly with a small force. It has the effect of being able to.

[Brief explanation of the drawing]

1 and 2 relate to a first embodiment of the present invention, FIG. 1 is a side view showing the surgical cutting forceps of the present invention, and FIG.
FIG. 3 is a side view showing a state in which the surgical resection forceps shown in the figure are used by being inserted into a rigid endoscope inserted into a sheath; FIG. 4 and 5 relate to the third embodiment of the present invention, FIG. 4 is a side view of the surgical resection forceps incorporated in the sheath, and FIG. 5 is a side view of the tip of the surgical resection forceps. It is an enlarged sectional view.

Claims (1)

[Claims] In surgical resection forceps with a movable blade at the distal resection part,
1. A surgical resection forceps, characterized in that an ultrasonic oscillation means is provided on the rear side, and ultrasonic vibrations from the ultrasonic oscillation means are transmitted to a distal resection portion.