JPH04336059A - Incision part opening instrument - Google Patents

Abstract

PURPOSE:To lighten an extraction part and its surroundings or the like so as to facilitate extraction of internal organs or the like by arranging holding levers, tubular unit protrusively provided from the point end of the holding lever and inserted into an incision part and a means for irradiating the front in an axial center direction of the tubular unit. CONSTITUTION:In the case of extracting operation for the gall, after the skin and subcutaneous fat are incised, a tubular unit 3 of an incision opening instrument is inserted into an incision part to open it. The small intestine 23 and large intestine 24 are forced aside to expose the gall 25 and also the lower of the tubular unit 3 is illuminated by a light source 8 and an optical fiber 7 to extract the gall 25. Here by forcing aside the small intestine 23 and large intestine 24 by the tubular unit 3, the forced aside small intestine 23 and large intestine 24 are prevented from returning to their original positions to cover the gall 25, so that extraction of the gall 25 is facilitated. By illuminating the lower side of the tubular unit 3 by the light source 8 and the optical fiber 7, the gall 25 and its surroundings are lightened to facilitate extraction of the gall 25.

Description

[Detailed description of the invention]

0001

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an incision opening instrument used in surgical operations.

0002

2. Description of the Related Art For example, in a gallbladder removal surgery, after the skin and subcutaneous fat are incised, an incision opening instrument 40 made of a bent wire is inserted into the incision, as shown in FIG. The incision is opened, and the small intestine 41 and large intestine 42 are pushed away using the opening instrument 40 to expose the gallbladder 43, and the gallbladder 43 is removed.

0003

[Problems to be Solved by the Invention] However, since the conventional opening device 40 is simply made by bending a wire rod, the small intestine 41 and the large intestine 42 that are pushed away by the opening device 40 are disposed of by the wire rod in the opening device 40. It invades the original place through the gap between the holes and comes to cover the gallbladder 43, and the gallbladder 4
There was a problem in that the extraction of item 3 could not be performed easily. Furthermore, during surgery, the operating area is illuminated with a surgical light, but since the gallbladder 43 is located relatively deep within the abdominal cavity, sufficient illumination is not possible, and improvements in this regard are also desired. Ta. An object of the present invention is to provide an incision opening instrument that can solve the above problems.

0004

[Means for Solving the Problems] In order to achieve the above object, the present invention is characterized by: a gripping lever; a cylindrical body protruding from the tip of the gripping lever and inserted into an incision; The present invention also includes an illumination means for illuminating the front side of the cylindrical body in the axial direction. In addition, the gripping levers are made into a pair and are pivotally connected so as to be freely openable and closable, and the cylindrical body is composed of a pair of divided bodies divided in the radial direction, and each divided body is fixed to the tip of each gripping lever. It may also be opened and closed by opening and closing both grip levers. Further, a spring may be interposed between both grip levers to bias both divided bodies in the closing direction. Furthermore, holding means may be provided for holding both halves in the open position. Further, the base side of the gripping lever may be bent with respect to the distal end side, and the base side may be located on the side opposite to the protruding direction of the cylindrical body than the distal end side. Furthermore, the gripping lever and the cylindrical body may be made of synthetic resin. Further, the cylindrical body may be made of metal, and the inner surface of the cylindrical body may be coated with rubber or synthetic resin. Furthermore, the cross section of the cylinder may be elliptical. Further, the illumination means may include an optical fiber embedded in the gripping lever and the cylinder, and a light source that illuminates through the optical fiber. Furthermore, the illumination means may include a planar light emitter that is provided on the inner surface of the cylindrical body and emits light when energized.

[0005]

[Operation] During surgery, the cylindrical body of the incision opening device allows
The incision is opened, internal organs, etc. are pushed away, and the front of the cylinder body in the axial direction is illuminated by the illumination means.

[0006]

[Embodiment] Hereinafter, a first embodiment of the present invention will be described based on the drawings of FIGS. It has a pair of left and right first and second divided bodies 4 and 5, a spring 6, an optical fiber 7, and a light source 8.

The first gripping lever 1 has a main body 10 that is elongated in the left-right direction and a ring-shaped flange 11 connected to the left end of the main body 10. The right side part is sloped upward to the right, and the right side part of the main body 10 is bent to have a steeper slope than the left side part, and is higher than the left side part. A pair of front and rear support portions 1 are provided on the lower left side of the main body 10.
2 is provided below, and an opening 13 that opens in the front-rear direction is formed from below in this support part 12, and the lower part of this opening 13 is narrower than the upper part. The lower surface of the flange portion 11 is stepped at the center in the left-right direction, and the left half thereof is thicker than the right half, and cutouts are provided in the front and rear portions of the stepped portion of the lower surface, respectively. A portion 14 is recessed from the right side.

The second gripping lever 2 has a main body 16 in the form of a plate that is elongated in the left-right direction, and a half-ring-shaped flange 17 connected to the left end of the main body 16. The left side portion of the main body 16 and the flange portion 17 are horizontal, but the right side portion of the main body 16 is sloped upward to the right and is higher than the left side portion. At the front and rear ends of the left end of the flange portion 17, protrusions 18 that protrude leftward are formed, respectively. Each protruding part 18 is inserted into each notch part 14 of the flange part 11 of the first gripping lever 1, and sandwiches each protruding part 18 and each protruding part 18 of the flange part 11 of the first gripping lever 1 in the front and back. By inserting the support shaft 19 through the portion, both the gripping levers 1 and 2 are pivotally connected to be able to open and close in the vertical direction.

The cross section of the cylindrical body 3 is an ellipse with the major axis in the left-right direction, and the two divided bodies 4 and 5 are formed by dividing the cylindrical body 3 in the major axis direction. The first divided body 4 is provided below the inner circumferential surface of the left half of the flange portion 11 of the first grip lever 1, and the second divided body 5 is provided below the inner circumferential surface of the flange portion 17 of the second grip lever 2. Each of the divided bodies 4 and 5 has a substantially U-shape when viewed from the side.

The first grip lever 1 and the first divided body 4 are integrally formed of hard synthetic resin, and the second grip lever 2 and the second divided body 5 are integrally formed of hard synthetic resin. The spring 6 is integrally formed of a relatively hard synthetic resin with elasticity, and has a bent plate shape that protrudes downward, and a shaft body 21 that protrudes forward and backward is formed at the left end of the spring 6. There is. Each shaft body 21 is pushed into the opening 13 of the support part 12 of the first gripping lever 1 from below through elastic deformation and is held in the upper part of the opening 13, whereby,
The spring 6 is swingably supported by the first gripping lever 1 , and its downwardly protruding midway portion in the left-right direction springs into contact with the main body 16 of the second gripping lever 2 . 2
is biased in the opening direction, and both divided bodies 4, 5 are biased in the closing direction.

The optical fiber 7 and the light source 8 constitute illumination means for illuminating the front of the cylinder 3 in the axial direction, that is, the downward direction. The optical fiber 7 is attached to each main body 10 of both gripping levers 1 and 2.
, 16 in the width direction, and the base side thereof is contained in the cord 22, and is extended to the outside from the base end of each main body 10, 11, and connected to the light source 8. ing. Further, on the tip end side of the optical fiber 7, both grip levers 1,
The optical fibers 7 are embedded in the respective flange portions 11 and 17 of the flange portions 11 and 17 in the radial direction in a parallel manner, and the optical fibers 7 are inserted into each of the two divided bodies 4 and 5 from positions equally distributed in the circumferential direction of the respective flange portions 11 and 17. is provided below and is exposed downward at the lower surface of each of the two divided bodies 4 and 5. A suitable lamp is used as the light source 8, and light from this light source passes through the optical fiber 7 and illuminates the lower part of the cylinder 3.

According to the embodiment configured as described above, in the case of gallbladder removal surgery, after incising the skin and subcutaneous fat, as shown in FIG. The incision is opened, the small intestine 23 and the large intestine 24 are pushed aside, and the gallbladder 25 is exposed. Further, the lower part of the cylindrical body 3 is illuminated by the light source 8 and the optical fiber 7, and the gallbladder 25 is removed. In the above case, a. The cylindrical body 3 allows the incision to be opened; and b. Since the small intestine 23 and large intestine 24 are pushed away by the cylinder 3, the small intestine 23 and large intestine 24 that have been pushed out do not return to their original places and cover the gallbladder 25, so that the gallbladder 25 can be easily removed. Further, since the lower part of the cylinder 3 is illuminated by the light source 8 and the optical fiber 7, the gallbladder 25 and its surroundings are bright and easy to see, making it easy to remove the gallbladder 25.

Furthermore, since the cylinder 3 is elliptical, the cylinder 3
Even a small incision can be made by rotating the
The inside of the gallbladder 25 can be seen clearly, and the gallbladder 25 can be easily removed. Furthermore, by closing both the gripping levers 1 and 2 and opening both the divided bodies 4 and 5, the incision can be opened more widely, and the small intestine 23 and the large intestine 24 can be further pushed away, and the gallbladder 25 and large intestine can be pushed away. The periphery of the gallbladder 25 can be exposed more widely, and the gallbladder 25 can be removed more easily. Also, since the spring 6 biases both the gripping levers 1 and 2 in the opening direction and biases both the divided bodies 4 and 5 in the closing direction, normally when both the divided bodies 4 and 5 are closed, ,
There is no need for the operator to take care to maintain the posture of the two divided bodies 4 and 5.

Furthermore, since the gripping levers 1 and 2 and the cylinder 3 are made of synthetic resin, when an electric scalpel is used to remove the gallbladder 25, the electric scalpel does not touch the gripping levers 1 and 2 and the cylinder 3. There is no risk of electrical leakage even if you accidentally touch it. Further, the right side portion of the first gripping lever 1 is steeply sloped, and the right side portion of the second gripping lever 2 is sloped upward to the right, respectively.
Since it is located higher than the left side, both grip levers 1,
Both grip levers 1
, 2 does not come into contact with the patient's abdomen 26, making it easier to operate the incision opening device.

FIG. 10 shows a second embodiment of the present invention, in which a planar light emitter 28 such as electroluminescence is provided on the inner surface of each of the divided bodies 4 and 5. , the electric wire 29 for energizing is attached to both gripping levers 1 and 2.
It is embedded in the main bodies 10, 16 and flange parts 11, 17 of.

FIG. 11 shows a third embodiment of the present invention, in which a pair of left and right support parts 31 are formed in an upwardly projecting shape at the right end of the main body 10 of the first gripping lever 1. , an opening 32 opening in the left-right direction is formed from above. The opening 32 is narrowed upward. Reference numeral 34 denotes a fixed piece having an arcuate shape, and a pair of shaft bodies 35 protruding left and right are formed at the base end thereof. Each shaft body 35 is inserted into the lower part of the opening 32 of each support part 31 through elastic deformation, and the fixing piece 34 is rotatably supported by the first gripping lever 1 . The fixing piece 34 has a U-shaped tip and is removably fitted onto the bodies 10 and 16 of the gripping levers 1 and 2 through elastic deformation, thereby placing the gripping levers 1 and 2 in the closed position. to hold. According to the third embodiment configured as described above, both the gripping levers 1 and 2 can be held in the closed position by the fixing piece 34, and both the divided bodies 4 and 5 can be held in the open position. 4 and 5 in the open position, there is no need for the operator to hold the gripping levers 1 and 2 in the closed position.

In the embodiment, a pair of gripping levers are used,
Although the cylindrical body is constructed from a pair of divided bodies, there are cases where the gripping lever is single and the cylindrical body is not divided as in the embodiment. Further, in the embodiment, the cross section of the cylinder is oval, but it may be circular. Furthermore, in the embodiment, the gripping lever and the cylinder were made of synthetic resin, but they could also be made of metal.
The inner surface of the cylindrical body, which may come into contact with the electric scalpel, may be coated with rubber or synthetic resin.

[0018]

[Effects of the Invention] As detailed above, according to the present invention,
During surgery, the cylindrical body of the incision opening device allows the incision to be opened easily and the internal organs, etc. to be easily pushed away. , the internal organs can be easily removed without having to return to the original location and cover the removed area. In addition, since the illumination means for illuminating the axially forward part of the cylindrical body is provided, the extraction portion and its surroundings in the axial direction of the cylindrical body are bright and easy to see, making it easier to remove internal organs. Further, according to claim 2, by opening both the divided bodies constituting the cylindrical body,
The incision can be opened more widely, the internal organs, etc. can be pushed away to a larger extent, the extraction area and its surroundings, etc. can be exposed more widely, and the internal organs can be removed more easily.

Furthermore, according to claim 3, since both the divided bodies are biased in the closing direction by the spring, the operator does not have to maintain the posture of both divided bodies during normal times when both divided bodies are closed. There is no need to consider it. Further, according to claim 4, since both the divided bodies can be held in the open position by the holding means, there is no need for the operator to hold both the divided bodies in the open position. Furthermore, claim 5
According to , the base side of the gripping lever is bent with respect to the distal end side, so that the base side is located in the opposite direction to the protruding direction of the cylinder body than the distal end side, so that the gripping lever can be opened. In both the normal state and the closed state, the hands holding both gripping levers do not come into contact with the patient's abdomen, etc., making it easy to operate the incision opening device. Also, claim 6 or 7
According to , when an electric scalpel is used in surgery, there is no or little risk of electrical leakage even if the electric scalpel comes into contact with an incision opening instrument. Furthermore, according to claim 8, since the cylindrical body is elliptical, by rotating the opening instrument, even a small incision can be seen in a large area, and internal organs etc. can be easily removed.

[Brief explanation of drawings]

FIG. 1 is a perspective view showing a first embodiment of the present invention.

FIG. 2 is a front view of the same.

FIG. 3 is a front view showing the same operating state.

FIG. 4 is an exploded perspective view of the same part.

FIG. 5 is an enlarged view of the same part.

FIG. 6 is a sectional view taken along the line AA in FIG. 5;

7 is a sectional view taken along the line BB in FIG. 2; FIG.

8 is a sectional view taken along the line CC in FIG. 7. FIG.

9 is a sectional view taken along the line DD in FIG. 8; FIG.

FIG. 10 is a sectional view of essential parts showing a second embodiment of the present invention.

FIG. 11 is a sectional view of essential parts showing a third embodiment of the present invention.

FIG. 12 is a perspective view showing a conventional example.

[Explanation of symbols]

1 First gripping lever 2 Second gripping lever 3 Cylindrical body 4 First division body 5 Second division body 6 Spring 7 Optical fiber 8 Light source 28 Planar light emitter 34 Fixed piece

Claims (10)

[Claims] 1. An incision comprising a gripping lever, a cylindrical body protruding from the tip of the gripping lever and inserted into the incision, and illumination means for illuminating the front side of the cylindrical body in the axial direction. Part opening equipment. Claim 2: A pair of gripping levers are pivotally connected to each other so as to be freely openable and closable, and the cylindrical body is composed of a pair of divided bodies divided in the radial direction, and each divided body is attached to the tip of each gripping lever. The incision opening device according to claim 1, which is fixedly installed and is opened and closed by opening and closing both gripping levers. 3. The incision opening device according to claim 2, wherein a spring is interposed between both the grip levers to bias both the divided bodies in a closing direction. 4. The incision opening device according to claim 2, further comprising a holding means for holding both the divided bodies in an open position. 5. Any one of claims 1 to 4, wherein the base side of the gripping lever is bent with respect to the tip side, and the base side is located on the side opposite to the protruding direction of the cylinder body than the tip side. The incision opening device described in . 6. The incision opening device according to claim 1, wherein the gripping lever and the cylindrical body are made of synthetic resin. 7. The incision opening device according to claim 1, wherein the cylindrical body is made of metal, and the inner surface of the cylindrical body is coated with rubber or synthetic resin. 8. The incision opening instrument according to claim 1, wherein the cylindrical body has an elliptical cross section. 9. The incision opening instrument according to claim 1, wherein the illumination means includes an optical fiber embedded in the gripping lever and the cylindrical body, and a light source that illuminates through the optical fiber. 10. The incision opening instrument according to claim 1, wherein the illumination means includes a planar light emitter that is provided on the inner surface of the cylindrical body and emits light when energized.