JPH0618577B2 - Observation aid forceps - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial application] The present invention projects a linear or rod-shaped member that expands from a sheath to move the organ to a place where it can be easily observed or to prevent other organs from observing. The present invention relates to an observation assisting forceps as an assisting means for observation used for pulling the arm aside.

[Prior Art] In recent years, an endoscope has been widely used, which is capable of observing the inside of a body cavity without making an incision from the body surface by inserting an elongated insertion portion and performing a medical treatment with a treatment tool. It was

The endoscope is a flexible endoscope in which the insertion portion is flexible and is inserted from the oral cavity and the like, and the insertion portion is rigid and is rigidly inserted toward the observation target site in the body cavity by being guided by a puncture such as a trocar. There is an endoscope.

By the way, a rigid endoscope mainly used for abdominal observation,
In other words, in the laparoscope, when observing female organs such as the uterus, fallopian tubes, and ovaries in the abdominal cavity, it is necessary to move the organs to a location where they can be easily observed with forceps, a deep needle, or the like. For example, in order to observe the ovaries that are hidden behind the uterus and fallopian tubes, it is necessary to move the uterus and fallopian tubes aside. In this case, conventionally, as disclosed in Japanese Utility Model Application Laid-Open Nos. 57-193811 and 54-63992, the oviduct is grasped by using an ordinary grasping forceps and moved toward the side or a normal depth. He was holding the oviduct and uterus with a needle and moving them aside to observe.

[Problems to be Solved by the Invention] However, holding the oviduct unnecessarily with the grasping forceps as in the above-mentioned conventional example has a risk of damaging the oviduct and grasping a large organ such as the uterus. Actually it is impossible. Further, the deep needle is a mere rod-shaped sonde, and it is difficult to move a large organ such as the uterus to a desired place or keep the arm aside with only one deep needle.

The present invention has been made in view of the above points, and can easily move an organ in the abdominal cavity, such as the uterus, fallopian tube, and ovary, to a desired place with a single forceps, lift it, and pull it aside. An object of the present invention is to provide an observation assisting forceps that can be placed and can be smoothly observed and diagnosed in the abdominal cavity by a laparoscope.

[Means and Actions for Solving Problems] In the observation assisting forceps of the present invention, a hollow sheath, a shaft member inserted into the sheath, and a shaft member provided on the rear end side of the shaft member, and the shaft member is moved forward and backward. It consists of a movable operating means and a plurality of linear members provided on the front end side of the shaft member and biased so that the distal end side expands, and these linear members are projected from the distal end of the sheath. The organs and the like that obstruct the observation are reliably moved or held in a state of being set aside so that the desired site can be easily observed.

EXAMPLES The present invention will be specifically described below with reference to the drawings.

1 to 5 relate to a first embodiment of the present invention.
The drawing shows the tip end side of the first embodiment, FIG. 2 shows the entire first embodiment with the linear member accommodated therein, and FIG. 3 shows the first embodiment.
FIG. 4 shows a cross section taken along the line AA ′ in FIG. 4, FIG. 4 shows a first embodiment with a linear member protruding, and FIG. 5 shows a usage example of the first embodiment.

As shown in FIG. 2 or FIG. 4, in the observation assisting forceps 1 of the first embodiment, a thin shaft 3 having a small diameter is inserted into a slender, hollow sheath 2 so as to be able to move forward and backward. The rear end of the sheath 2 is joined to the operation section body 4. A set screw 5 is screwed into a screw hole extending from the upper side of the operation portion main body 4 to the hollow passage (of the operation portion main body 4), and a shaft 3 that can move back and forth in the hollow passage.
Can be fixed so that it will not move. Further, one end of a leaf spring 6 curved in a U shape, for example, is fixed to the lower side of the operation portion main body 4, and the other end of the leaf spring 6 is attached to the rear end of the shaft 3 to a leaf spring fixing member 7. It is attached to. The fixing member 7 is fixed to the rear end of the shaft 3 by joining or screwing the front end side through the through hole of the leaf spring 6 after passing through the through hole. Then, the shaft 3 is biased by the leaf spring 6 in the direction of moving backward. Also, at the front end of the shaft 3, there is a first
As shown in FIG. 3 to FIG.
The rear ends of the book wires 8, 8 and 8 are fixed by joining or the like,
A spherical member 9 is attached to the tip of each of the strands 8 so as not to damage an organ or the like. Therefore, the above-mentioned three linear or rod-shaped wires 8, 8 and 8 have a characteristic that the front end side expands in a fan shape in the same plane with respect to the rear end base (habit).
Is given. Therefore, when the shaft 3 is biased by the leaf spring 6 so as to move rearward, the three wires 8, 8, 8 are retracted (stored) in the sheath 2 as shown in FIG.
It is supposed to be done. Then, by gripping the U-shaped portion of the leaf spring 6 and bending the U-shaped portions in a direction in which both ends approach each other against the urging force, the shaft 3 is slid forward and the shaft 3 is slid forward. As shown in FIG. 1 or FIG. 1, the three strands 8, 8, 8 can be projected from the sheath 2. Since the three protruding wires are given the characteristic of expanding in a fan shape, these three wires 8, 8, 8 are in the same plane as shown in FIG. Then, it will spread out like a fan. By the expanded strands 8, 8, 8, it is possible to easily perform an operation such as pulling aside an organ that obstructs the observation at the time of the observation with the laparoscope. Also, shaft 3
Can be fixed with the set screw 5 of the operation portion main body 4, so that the protruding amount of the wires 8, 8, 8 (from the sheath 2) can be fixed to an arbitrary amount, and the fan formed by the wires 8, 8, 8 can be fixed. The size of can be set arbitrarily. Therefore, by setting the fan-shaped size variably according to the organ, it is possible to cope with organs of different sizes, and for a large uterus, the fan-shaped size should be as large as possible to enable stable organ operation. At the same time, for a small oviduct or the like, there is an effect that the operation range in a narrow abdominal cavity can be expanded by reducing the size of the fan shape. In particular, when adhesion occurs in the abdominal cavity, the operation in the state where the size of the fan is increased is often hindered, and it is very useful to fix and operate the state in which the size is decreased.

An example of use of the first embodiment configured as described above will be described below with reference to FIG.

FIG. 5 shows the abdominal cavity 11 of a female, and the ovary 13 is seen with a laparoscope 12.
It shows how to observe the above.

The laparoscope 12 allows the abdominal cavity 11 to pass through the first trocar 14.
Inserted inside. Then, the observation assisting forceps 1 of the first embodiment is inserted into the abdominal cavity 11 through the second trocar 15 in a state in which the wires 8, 8, 8 are stored in the sheath 2. When observing the ovary 13, if the uterus 16 or the fallopian tube 17 interferes with the observation, the axis 3 is moved forward, and the uterus 16 is expanded by the fan-shaped wires 8, 8, 8.
It is also possible to easily avoid the oviduct 17 aside and hold it as it is, or place the object to be observed on the fan-shaped wires 8, 8 and 8 to lift it and set it in an easily observable state. In these cases, by fixing the shaft 3 with the set screw 5, the fan-shaped size can be variably set according to the organ to be handled, and it is possible to widely deal with the organs having different sizes.
Further, since the spherical member 9 is provided at the tip of each wire 8,
It is possible to prevent the organ from being damaged even if the tip of the wire 8 is pressed.

FIG. 5 shows a state in which the oviduct 17 is kept away from the side of the observation visual field by the fan-shaped wires 8, 8 and 8, and the ovaries 13 are held so that the ovaries 13 can be observed. .

FIG. 6 shows the tip side of the second embodiment of the present invention.

In this second embodiment, six strands 21, 21, ..., 21 are attached to the front end of the shaft 3 of the first embodiment. Like the first embodiment, these strands 21, 21, ..., 21 are given a habit of spreading in a fan shape on substantially the same plane when they are projected from the sheath 2. In the second embodiment, since the interval between the adjacent strands 21 and 21 is narrow, when dealing with a relatively thin or small organ such as an oviduct, the organ is the strand 2.
It is possible to prevent falling between 1, 21, ..., 21, and it is easy to perform a moving operation or the like for easy observation.

FIG. 7 shows the tip side of the third embodiment of the present invention.

In this third embodiment, four strands of wire 31, 3 are provided on the front end side of the shaft 3.
1, 31, 31 are attached. These strands 31, 3
1, 31, 31 are designed to have a characteristic of expanding so that their front end sides are arranged in parallel on substantially the same plane.

In this way, a plurality of strands may be spread within a certain range on substantially the same plane, and a shape other than a fan shape may be used.

FIG. 8 shows a fourth embodiment of the present invention.

The observation assisting forceps 41 of the fourth embodiment has a ratchet fixing means instead of the set screw 5 of the first embodiment.

That is, the shaft 42 is inserted inside the sheath 2, and the shaft 4
Wedge-shaped notches 43, 43, 43 are provided at several places (three places in this example) on the lower side near the rear end of the No. 2.

On the other hand, a pin 45 is projectingly provided on a portion of the operation portion main body 44 facing the shaft 42, the pin 45 is passed through a through hole of a locking member 46, and the locking member 46 is rotatably supported. is doing. One end of the locking member 46 is brought into contact with the operation portion main body 44 by the coil spring 47 provided around the pin 45, and the locking member 46 is pressed at the other end ( The locking member 46 is urged clockwise (clockwise) about the pin 45. Thus, the upper end of the locking member 46 is provided with a first claw portion 48 that engages with the notch 43, and a second claw portion is formed in the front direction orthogonal to the first claw portion 48. A portion 49 is provided so as to project. The second claw portion 49 abuts on the cutout surface 51 of the operation portion main body 44 so that the rotational movement thereof is restricted. The trigger portion 52 is formed in the lower portion of the locking member 46 pivotally supported by the pin 45.

Others are almost the same as those in the first embodiment.

In the fourth embodiment thus configured, when the shaft 42 is projected forward against the biasing force of the leaf spring 6, the first claw portion 48 of the locking member 44 causes the notches 43, 43, It fits in one of 43. When the claw 48 fits into the notch 43, the shaft 42
The second claw portion 49 of the locking member 46 abuts the main body 44 even if the force pushing out the front is released, and the shaft 42 is fixed by the locking member 46. In this way, in the fourth embodiment, the wire rods 8, 8,
8 can be fixed stepwise in a state where it is expanded into a fan shape of a certain size.

The lock is released by the ratchet mechanism by pulling the trigger portion 52 of the locking member 46 toward the operator's side.

The effects of the fourth embodiment are almost the same as those of the first embodiment.

FIG. 9 shows the storage state of the wires in the fifth embodiment of the present invention.

In the first embodiment shown in FIG. 1, the wires 8, 8, 8 are accommodated side by side on the same plane in the sheath 2, whereas in the fifth embodiment, the inner peripheral wall surface of the sheath 2 is It is accommodated so that the strands 8 are positioned at the vertices of an equilateral triangle without being regulated and aligned in the same plane, and on the other hand, when the regulation is released and the strands are expanded, the strands are expanded in the same plane. . Others are the same as those in the first embodiment.

In each of the above embodiments, a key or a pin may be provided on the shaft 3 so that the movable shaft 3 does not rotate, and a key groove may be provided on the sheath 2 or the operation section body 4 on the other side.

In each of the above embodiments, the shaft side is slidable with respect to the sheath, but the shaft may be fixed so that the sheath side can be slid.

Further, in each of the above-described embodiments, the strands of wire are expanded in the same plane as the surface formed by the U-shaped portion of the leaf spring, but the present invention is not limited to this example, and the U-shaped portion of the leaf spring is formed. The expansion may be performed in a plane perpendicular to the plane.

Further, although the strands are expanded in the same plane in each of the above-mentioned embodiments, the present invention is not limited to this example, and may be expanded in a curved surface such as a conical surface or a cylindrical surface. Further, a linear or rod-shaped member may be used instead of the strand. The present invention can be used not only for assisting observation but also for assisting treatment, for example.

[Effects of the Invention] As described above, according to the present invention, a plurality of strands having a characteristic of expanding on the same plane or the like can be moved forward and backward from the sheath. With a simple operation even for organs of different sizes, it is possible to set aside an organ that interferes with observation or set an organ that is desired to be observed in a state where it is easy to observe.

[Brief description of drawings]

1 to 5 relate to a first embodiment of the present invention.
FIG. 2 is an enlarged cross-sectional view showing the tip end side of the first embodiment in an expanded state, and FIG. 2 is a cross-sectional view showing the entire first embodiment with the tip end side wire accommodated in a sheath, FIG. 3 is a sectional view taken along the line AA ′ in FIG. 1, FIG. 4 is a sectional view showing the first embodiment in a state where the tip end side wire is projected, and FIG. 5 is the use of the first embodiment. FIG. 6 is an explanatory view showing an example, FIG. 6 is a sectional view showing a tip side of a second embodiment of the present invention, FIG. 7 is a sectional view showing a tip side of a third embodiment of the present invention, and FIG. FIG. 9 is a sectional view showing a fourth embodiment of the present invention, and FIG. 9 is a sectional view showing an accommodating portion of a wire in a fifth embodiment of the present invention. 1 ... Observation assisting forceps, 2 ... Sheath 3 ... Axis, 4 ... Operation part main body 5 ... Set screw, 6 ... Leaf spring 8 ... Element wire, 9 ... Spherical member

Continuation of the front page (56) Reference JP-A-57-157101 (JP, A) JP-A-58-81021 (JP, A) JP-A-57-39303 (JP, A) JP-A-57-22734 (JP , A) Actually open 54-63992 (JP, U) Actually open 57-193811 (JP, U) Actually open 60-4489 (JP, Y2) US Patent 4204548 (US, A)

Claims (1)

[Claims] 1. A hollow sheath, a shaft member inserted into the sheath, an operating portion formed on a rear end side of the shaft member, and a moving operation means for the shaft member, and the moving operation. Fixing means formed on the means for fixing the shaft member at an arbitrary position, and a rear end base portion attached to the front end side of the shaft member so that the tip end side expands in a fan shape. An observation assisting forceps comprising: a plurality of linear members, and an observation assisting piece having a spherical member attached to the tip of each linear member.