JPH01232949A - Surgical operation apparatus - Google Patents

Abstract

PURPOSE:To obtain the title apparatus capable of efficiently excising a part to be treated by certainly fixing a meniscus and performing treatment within a short time, by inserting a fixing jig and a treatment jig in the same puncture hole. CONSTITUTION:The leading end part of a vibration transmitting member 3 is set to a state of being retracted from grasping parts 27, 28 to insert a sheath 24 in a joint cavity and a meniscus 31 is grasped by the grasping parts 27, 28 by grasping finger hooking parts 13, 14. After the finger hooking parts 13, 14 are fixed, an ultrasonic suction apparatus 2 is moved fowardly. By this mechanism, the vibration transmitting part 3 protrudes from the grasping parts 27, 28 to be brought into contact with the meniscus 31. The vibration transmitting member 3 excises the meniscus 31 by vibration and the excised pieces are sucked from a suction passage not shown by a drawing to be discharged out of the joint cavity. Since the meniscus 31 is grasped to be exised by the vibration transmitting member 3, the meniscus 31 easy to move in the joint cavity can be excised. Further, the vibration transmitting member 31 is inserted through a grasping forceps 11, a puncture hole may be formed at one place and the pain of a patient can be retrieved.

Description

Detailed Description of the Invention [Industrial Application Field] The present invention is designed to detect cartilage, tumors, etc. in the body cavity from outside the body cavity, particularly in the joint cavity of the knee, etc. after being inserted into the body cavity and observed with an endoscope. The present invention relates to a surgical device capable of incising.

[Prior Art and Problems to be Solved by the Invention] Conventionally, joint surgery has been mainly performed by an incisional method (open surgery). For example, intrashell joint surgery, such as removing a tumor on the patella or excising damaged cartilage, bone, etc. from the knee joint, requires relatively large incisions.

Therefore, the incision causes trauma, which is accompanied by pain and restriction of movement, and has the disadvantage that it takes a long time to fully heal.

Therefore, in recent years, under observation using an arthroscope (endoscope), a small puncture hole is formed in the joint without making an incision, and a probe inserted into the puncture hole is used to perform surgery (closed surgery). A device to do this has been proposed.

Particularly, when resecting a damaged area of the meniscus, the site is observed with an endoscope, and the resection is performed by inserting a treatment instrument such as forceps or a power treatment instrument (shaper).

However, this method was inefficient because it required puncturing a fixation device and a treatment tool to fix the injured meniscus, and the meniscus moved within the joint cavity and the surface was prone to soaking. .

[Object of the Invention] The present invention has been made in view of the above-mentioned points, and it is possible to reliably fix the meniscus by puncturing a fixing device and a treatment device through the same puncture hole, thereby efficiently fixing the treatment area. can be removed,
Another object of the present invention is to provide a surgical operation device that can perform treatment in a short time.

[Means for Solving the Problems] A surgical device according to the present invention has an elongated insertion section inserted into a body cavity, and a gripping section provided at the tip of the insertion section for gripping an affected area. 1. Forceps, an insertion passage provided in the insertion portion of the grasping forceps, and a forceps that is slidably inserted through the insertion passage and provided in the front part of the ultrasonic suction device. A vibration transmitting member that protrudes from the grip portion and treats the affected area by vibration is provided.

[Function] According to the present invention, the grasping forceps having an elongated insertion section is provided with an insertion passage within the insertion section, and a grasping section for grasping the affected area is provided at the distal end of the grasping forceps. The affected area gripped by the gripping portion is excised by the distal end of the vibration transmission member inserted through the insertion passage.

[Example] Hereinafter, the present invention will be specifically explained with reference to the drawings.

1 to 10 show one embodiment of the present invention.

In FIG. 1, an ultrasonic suction device 2 constituting a surgical operation device 1 has an elongated tubular vibration transmitting member 3 in the front portion with a suction path formed therein, and a rear end of the vibration transmitting member 3. The vibrator section 6 is connected to the end side via the horn inside the horn cover 4.
It is connected to the.

A suction tube 8 connected to a suction lower communicating with the suction path and a cord 9 are provided on the rear end surface of the vibrator section 6.

The vibration transmitting member 3 is inserted from the rear end of the gripping forceps 11. The grasping forceps 11 includes an elongated insertion section 12 and a large-diameter operation section 16 provided with finger hooks 13 and 14 at the rear end of the insertion section 12.

In FIG.
A front operating member 17 is provided with the finger rest 14, and a rear operating member 18 is provided with the finger rest 14. An outer tube 19 inserted through a sheath 24 that forms the outer shell of the insertion section 12 is connected to the front end of the front operating member 17 . A continuous inner tube 21 is inserted rotatably in the circumferential direction. Furthermore, inside this inner tube 21, as mentioned above, the vibration transmission member 3 is installed.
is inserted through the insertion opening 22 while being kept watertight with a rubber cap 23.

An outer tube 19 and an inner tube 21 protrude from the tip of the sheath 24.
form gripping portions 27 and 28 bent diagonally forward. This gripping portion 27 is provided at the tip of the outer tube 19, and the other gripping portion 28 is provided at the tip of the inner tube 21. That is, the grip section 27 is integrated with the front operating member 17 having the finger rest section 13, and the grip section 28 is integrated with the rear operation member 18 on the right side of the finger rest section 14.

As shown in FIG.
Two blade portions 29 and 29 are formed so as to protrude and retract further and become thinner toward the tip.

Note that the blade portions 29 and 29 may be formed so as to cut the tip of the vibration transmission member 3 into a figure 7 shape as shown in FIG.

The operation of the surgical operating device 1 configured as described above will be explained.

With the distal end of the vibration transmitting member 3 retracted from the gripping parts 27 and 28, the sheath 24 is inserted into the joint cavity as shown in FIG. Grip with gripping parts 27 and 28. The finger rest is part 13.
After fixing 14, move the ultrasonic suction device @2 forward. As a result, the vibration transmitting member 3 protrudes from the grip portions 27 and 28 and comes into contact with the meniscus 31. The vibration transmitting member 3 excises the meniscus 31 by vibration, and suctions the excised piece from a suction path (not shown) and discharges it outside the membrane.

In this embodiment, since the meniscus 31 is grasped and removed by the vibration transmitting member 3, the meniscus 31, which easily moves within the joint cavity, can be easily removed. Furthermore, since the vibration transmitting member 3 is inserted into the grasping forceps 11, only one puncture hole is required, and the pain of thinking can be alleviated.

Note that the fixture 32 may be inserted through the vibration transmitting member 3 as shown in FIGS. 8 to 10.

A suction conduit is provided in the ultrasonic suction device 2 in communication with a suction path 35 provided in the vibration transmission member 3. This suction conduit communicates with a suction port 33 provided at the rear end of the ultrasonic suction device 2, and a fixture 32 is inserted through this suction port 33 so as to be watertight with a rubber cap 34. ing. This fixture 32 includes a rod-shaped insertion portion 37 that is inserted into the suction channel, and a grip portion 38 that is connected to the rear end of the insertion portion 37 that protrudes rearward from the rear end of the ultrasonic suction device 2. It is equipped with At the tip of this insertion portion 37, sharply pointed blade portions 39 are provided at the front and obliquely rear sides.

The blade portion 39 of the fixture 32 configured as described above is retracted within the vibration transmission member 3 when inserted into a joint cavity, for example. The meniscus 31 in the joint cavity together with the vibration transmission member 3
It is inserted in a position facing the camera.

Grasp the grip part 38 of the fixture 32 and push it forward to make the blade part 39 protrude from the tip of the vibration transmission member 3 and puncture the meniscus 31. After puncturing, the grip portion 38 is pulled rearward so that the tip of the vibration transmission member 3 and the meniscus 31 come into contact. In this case, since the blade portion 39 is also provided diagonally rearward, the meniscus 31 and the insertion portion 37 do not separate, and the vibration transmission member 3 can be reliably brought into contact with the insertion portion 37 to perform resection. The cut piece is fixed to the fixing tool 32
can be discharged by removing it from the suction path 35.

[Effects of the Invention] As explained above, according to the present invention, by puncturing the fixing device and the treatment device through the same puncture hole, the meniscus can be reliably fixed and the treatment area can be resected efficiently and in a short time. It can be cured in time.

[Brief explanation of the drawing]

Figures 1 to 10 relate to one embodiment of the present invention;
The figure is an explanatory diagram of the entire surgical operation device, Figure 2 is a perspective view of the tip of the agitation transmission member, Figure 3 is a sectional view taken along the line A-A'' in Figure 1, and Figure 4 is a cross-sectional view of Figure 1. B-8 One direction arrow view, 5th
The figure is a partial sectional view of the operating section, Figure 6 is an explanatory diagram showing the operating state of the surgical operating device, Figure 7 is a perspective view of the tip of another vibration transmitting member, and Figure 8 is a view of the inside of the vibration transmitting member. FIG. 9 is an explanatory diagram of the fixing device to be inserted; FIG. 9 is an explanatory diagram of the tip of the fixing device; FIG.
The figure is an explanatory diagram of how the fixture is used. 1... Surgical operation device 2... Ultrasonic suction device 3.
...Vibration transmission member 11...Gripping forceps 12...Insertion part 27...Gripping part 28...Gripping part Fig. 5! i*7゜Figure 6

Claims (1)

[Scope of Claims] A grasping forceps having an elongated insertion section inserted into a body cavity, and a grasping section provided at the distal end of the insertion section for grasping the affected area; and a vibration transmission member that is slidably inserted through the insertion passage, is provided at the front part of the ultrasonic suction device, protrudes from the grip part, and treats the affected area by vibration. Characteristic surgical equipment.