JPH11299799A - Forceps - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide forceps whose cutting edge tip end becomes an acute angle against a flat object to be incised such as peritoneum and which can incise the object to be incised without slipping the cutting edge by rotating working members in the direction to close the working members. SOLUTION: These forceps are used together with an endoscope and has a pair of working members 4, 5 one or both of which rotate or move against the other to clamp and cut. Cutting edges 4a, 5a of the working members 4, 5 have tip end parts 4b, 5b which are in a right angle or an obtuse angle slightly over a right angle or an acute angle slightly under a right angle. When the working member 4, 5 are fully closed, the tip end of one cutting edge 4a is protruded in the opposite side of the other cutting edge 5.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to scissors forceps for incising tissue, for example, for use in endoscopic surgery.

[0002]

2. Description of the Related Art As forceps for grasping or incising tissue used in endoscopic surgery, see, for example,
Japanese Patent Publication No. 296619 and Japanese Patent Laid-Open Publication No. Hei 8-38495 are known. This forceps comprises a forceps body that can be opened and closed at a distal end thereof, a forceps body provided with an operation unit at a base end, and a driving member provided on the forceps body that moves back and forth by operating the operation unit to open and close the forceps unit. It is configured.

[0003] The forceps portion of the former forceps is constituted by a pair of forceps members that rotate about a pivot pin as a fulcrum, and the rear end of the forceps member and the driving member are connected by a link to reduce the amount of rotation. Regulating. Further, the latter forceps portion is formed by a pair of forceps members rotatable about a fulcrum pin, and a cam groove is provided at a rear end portion of the forceps member. An engagement pin is protruded from a distal end portion of the drive member driven forward and backward by the operation portion. The engagement pin is engaged with the cam groove, and the forceps member is pivotally supported by the forward and backward movement of the drive member. It can be opened and closed with a pin as a fulcrum.

FIG. 3 and FIG. 4 show scissors forceps used for endoscopic surgery and for peeling or incising tissue. FIG. 3 shows the whole of the endoscope forceps. The forceps includes an operation section 1, an insertion section 2 as a forceps body, and an operation section 3. The action section 1 includes a pair of forceps members 4 and 5 configured in a scissors shape, and an opening / closing mechanism 6 that opens and closes the forceps members 4 and 5.

[0005] The insertion section 2 comprises a tubular case 7 and a driving member 8 which is inserted into the inside thereof so as to be able to advance and retreat, and is connected to the opening / closing mechanism 6. The operation unit 3 includes a pair of handles 9 a and 9 b that are rotatable around a pivot pin 9 and a connecting member 10 that is connected to the driving member 8.

The forceps are inserted into a patient's abdominal cavity via a tracal or the like, and the operators open and close the handles 9a and 9b, thereby opening and closing the forceps members 4 and 5 of the forceps unit 1, thereby organs, An object such as a blood vessel or peritoneum can be cut, and when used as a peeling forceps, the handle 9
By opening and closing a and 9b, the action members 4 and 5 can be opened and closed to peel off the object.

The intermediate portion of the operating members 4 and 5 is rotatably supported by a pivot pin 12, and cutting edges 4a and 5a are formed on the distal ends of the operating members 4 and 5, respectively. ing. Cam grooves 4b and 5b are provided on the rear end side of the operation members 4 and 5, respectively. A connecting member 13 protrudes from the distal end of the driving member 8, and the connecting member 13 includes the cam groove 4.
A cam pin 14 that engages with d and 5d is provided.

Accordingly, by operating the handles 9a and 9b with fingers, the driving member 8 advances inside the sheath 7, and the connecting member 13 also moves to the distal end side. As the connecting member 13 moves forward, the cam pin 14 slides forward in the cam grooves 4d and 5d, and the action members 4 and 5 rotate in a direction in which they are relatively opened about the pivot pin 12 as a fulcrum.

When the driving member 8 is moved backward by the handles 9a and 9b, the connecting member 13 also moves to the rear end side, and the cam pin 14 slides rearward in the cam grooves 4d and db to actuate the operating members 4,5. Rotates about the pivot pin 12 in the closing direction.

[0010]

However, in the forceps constructed as described above, the distal end of the forceps when the working members 4 and 5 are closed has the center of curvature so that the normal tissue is not damaged. O (see FIG. 4) is formed on the arc surface 11. Therefore, when the operating members 4 and 5 are opened, the angle θ between the tangent line a of the circle and the extension line b of the cutting edges 4a and 5a is obtuse.

Therefore, for example, even if the operating members 4 and 5 are opened and the distal ends of the operating members 4 and 5 are pressed against a flat surface such as the object c such as the peritoneum or the like and the incision is made, the operating member 4 The circular arc surface 11 at the tip end of each of the working members 4 and 5 comes into contact, and when the working members 4 and 5 are closed, they slide with respect to the object c and cannot be cut. In other words, it is necessary to perform a complicated operation in which the target object c is gripped by using another gripping forceps and incised by the action members 4 and 5 in a state of being pulled toward the user.

[0012] Some scissors forceps have a very sharp blade called a micro-scissor. As shown in FIG. 5, a pair of action members 15 and 16 are pivotally supported by a pivot pin 17. The action members 15 and 16 are formed such that the tips are formed at acute angles, and the cutting edges 15a and 16a are formed at the side edges facing each other.

However, in order to manufacture this micro-scissor, the working members 15 and 16 which have been independently processed are caulked by the pivot pin 17 to thereby obtain the working member 1.
When assembling 5 and 16 and closing the working members 15 and 16,
It is necessary to assemble in a state where the sharp edges of the tips overlap each other, but it is difficult to adjust the sharp edges, and the sharp edges of the tips are not completely closed and two sharp edges protrude, or the cutting edges 15a and 16a are too closed. Is the peak portion 1 of the other working members 15 and 16
Cutting blades 15a, 1 including tip portions protruding from 5b, 16b
6a may protrude and damage normal tissue during handling.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances. It is an object of the present invention to make it possible to easily make an incision without slipping the tip of a cutting blade even in a planar tissue, and to provide a pair of cutting blades. An object of the present invention is to provide a scissors forceps which can easily process and assemble the end portions of the scissors.

[0015]

According to the present invention, in order to achieve the above object, in scissors forceps used with an endoscope, both or one of them is rotated or moved relative to the other to shear the object. Having a pair of action members, each of the action members has a sharp angle tip slightly below a right angle or a right angle or an obtuse angle slightly above a right angle, and when fully closed,
It is characterized in that the tip of one working member projects to the opposite side of the other working member.

When the pair of action members are opened, the tip of the action member becomes an acute angle with respect to the planar incision target, and the action member can be cut without slipping with respect to the incision target. Since it protrudes to the opposite side, processing and assembling for matching the tips are not required.

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, embodiments of the present invention will be described with reference to the drawings. 1A and 1B show the first embodiment, in which FIG. 1A shows the operation members 4, 5 in a fully closed state, and FIG. 1B shows the operation members 4, 5 in a fully open state. Cutting edges 4a and 5a are provided at the side edges of the working members 4 and 5 facing each other, that is, at the portions that overlap first when closed. The distal ends 4b and 5b of the individual working members 4 and 5 are formed on an arc surface 20 having a pivot pin 12 that supports the working members 4 and 5 as the center of the radius of curvature.

Then, the angle θ of the tip of each of the cutting blades 4a, 5a
Is formed at 75 ° to 105 °, preferably 79 ° to 95 °. Therefore, when the operating members 4 and 5 are closed, the distal end portions 4b and 5b overlap, but one of the operating members 4 and 5 is closed.
The tip 4b (5b) of (5) is the other working member 5 (4).
On the opposite side of the tip 5b (4b), that is, the peak portion 4c (5b).
c) slightly projecting from c).

According to the scissors forceps constructed as described above, when the pair of operating members 4 and 5 are closed, one of the operating members 4 and 5 is closed.
The tip 4b (5b) of (5) is the other working member 5 (4).
Protrudes from the opposite side of the tip 5b (4b), but the amount of protrusion is small, and there is no danger of scratching even if it comes into contact with tissue. When the pair of action members 4 and 5 are opened,
For example, the tips of the cutting blades 4a and 5a become acute angles with respect to the object c for planar incision such as the peritoneum, and are rotated in the closing direction of the action members 4 and 5 so that the cutting edge 4
a, 5a can be opened without slipping.

FIG. 2 shows a second embodiment. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. In this embodiment, a micro scissor is shown, (a) shows the action members 4 and 5 in a fully closed state, and (b) shows the action members 4 and 5 in a fully open state. Opposing side edges of the working members 4, 5;
That is, the cutting edges 4a and 5a are provided in the portion that overlaps first when closed. In addition, the tip portions 4b and 5b of the individual working members 4 and 5 are formed on an inclined surface 21 whose surface crossing the extending direction of the cutting blades 4a and 5a is inclined with respect to the longitudinal axis of the insertion portion. .

Then, the angle θ of the tip of each of the cutting blades 4a, 5a
Is formed at 75 ° to 105 °, preferably 79 ° to 95 °. Therefore, when the operating members 4 and 5 are closed, the distal end portions 4b and 5b overlap, but one of the operating members 4 and 5 is closed.
The tip 4b (5b) of (5) is the other working member 5 (4).
On the opposite side of the tip 5b (4b), that is, the peak portion 4c (5b).
c) slightly projecting from c).

According to the scissors forceps constructed as described above, when the pair of operating members 4 and 5 are closed, one of the operating members 4 is closed.
The tip 4b (5b) of (5) is the other working member 5 (4).
Projecting from the opposite side of the tip 5b (4b), but the amount of projection is small, and there is no danger of scratching even if it comes into contact with tissue. When the pair of action members 4 and 5 are opened,
For example, a cutting blade 4 for a planar incision target A such as the peritoneum.
The cutting edges 4a and 5a become acute angles, and rotate in the closing direction of the action members 4 and 5, so that the cutting blade 4 is cut with respect to the cutting target c.
a, 5a can be opened without slipping. In addition, the slope 21
Is not limited to a plane, and may be a gentle curved surface.

According to the above configuration, the following configuration is obtained. (Supplementary Note 1) In a pair of scissors forceps used with an endoscope, both or one of them has a pair of action members for turning or moving with respect to a counterpart to shear an object, and each of the action members has a right angle or a right angle. It has an acute angle slightly exceeding an obtuse angle or slightly less than a right angle, and when fully closed, the distal end of one operating member projects to the opposite side of the other operating member.

(Supplementary Note 2) The scissors forceps according to Supplementary Note 1, wherein the angle of the tip of each of the action members is 79 ° to 95 °. (Supplementary Note 3) The shape of the surface intersecting with the extension direction of each of the cutting blades is
2. The scissors forceps according to claim 1, wherein the scissors have an arc surface centered on the center of rotation of each cutting blade.

(Supplementary note 4) The scissors according to Supplementary note 1, wherein the shape of the surface intersecting with the extending direction of each of the cutting blades is a flat surface or a gentle curved surface with respect to the longitudinal axis of the insertion portion. forceps.

According to the configuration described above, when the pair of operating members are closed, the distal end of one operating member projects from the side opposite to the distal end of the other operating member. This eliminates the need for processing, and provides an effect that the assembling work can be provided simply and at low cost. Further, the protrusion amount is small, and there is no fear of damaging even if it comes into contact with tissue. Further, when the pair of operating members are opened, the tip of the cutting blade becomes an acute angle with respect to a planar incision target such as the peritoneum, and the cutting blade is rotated with respect to the incision target by rotating in a direction to close the operation member. There is an effect that the incision can be made without slipping.

On the other hand, there has been known a tissue sampling tool which is inserted into a body cavity through a treatment tool channel of an endoscope to sample a diseased tissue. As this tissue sampling tool, for example,
As shown in Japanese Patent Application Laid-Open No. 3-98790, a connecting member is provided at the distal end of an insertion portion formed of a close-wound coil, and a cytodiagnosis brush is rotatably attached to the connecting member via a pivot pin. An operation wire is connected to the cytodiagnosis brush, and the operation wire is inserted through the insertion portion and connected to the hand operation portion.

As shown in FIG. 14, a cup-shaped tissue sampling tool 30 is conventionally known. In the cup-shaped tissue sampling tool 30, a bent receiving member 32 is provided at a distal end of an insertion portion 31 formed of a close-wound coil, and a distal cup member 34 is rotatable on the bent receiving member 32 via a pivot pin 33. Attached to. An operation wire 35 is connected to the distal end cup member 34, and the operation wire 35 is inserted through the insertion portion 31 and connected to a hand operation portion.

Then, the cup-shaped tissue sampling tool 30
As shown in FIG. 15, the treatment instrument channel 37 of the endoscope 36
Through the distal end portion of the endoscope insertion portion 38, and the diseased tissue can be collected by the distal end cup member 34.

However, the operation wire 3 is not
If the distal end cup member 34 is bent by pulling the tip 5 around the pivot pin 33, the operation wire 35 is bent. If the operation wire 35 has a bending habit, it is difficult to finely adjust the bending, and there is a problem that it is difficult to selectively insert the bending into the bronchus. Further, if the operation wire 35 is weakened so that the operation wire 35 is unlikely to bend, there is a problem that the force is weakly transmitted when the operation of returning the bending is performed, and it is difficult to finely adjust the bending.

The operating wire 35 is pushed back to make the tip cup member 34 straight from the bent state. However, since the operating wire 35 can be pushed further from the straightened tip cup member 34, as shown in FIG. Then, the tip cup member 34 warps. If the warp occurs, as shown in FIG. 16, even if it is inserted into the bronchus d and is to be inserted in the direction of I, it will hit the bifurcation e and will be inserted in the unintended direction of H. Further, as shown in FIG. 15, after the affected tissue f is collected, the cup-shaped tissue collecting tool 30 is withdrawn from the treatment tool channel 37.
At this time, the warped tip cup member 34 is inserted into the endoscope insertion portion 38.
However, there is a disadvantage that the affected tissue f collected by the impact falls on the distal end surface of the device.

FIGS. 6 to 11 show a third embodiment of the present invention, which shows a tissue collecting tool which has solved the above-mentioned problems.
An insertion portion 42 composed of a close-wound coil is connected to the operation portion main body 41, and a break prevention member 43 is provided at this connection portion. As shown in FIG. 10, a regulating guide member 44 having a cylindrical guide hole 44a having a circular cross section is attached to the distal end of the insertion portion 42, and the upper and lower portions of the regulating guide member 44 extend in the axial direction. A slit 45 is provided.

A connection pin 46 is provided on the distal end side of the regulating guide member 44 in a direction orthogonal to the axial direction. The upper end of the proximal end of the distal end cup member 47 is pivotally supported on the connection pin 46 so as to be vertically rotatable. Have been. The distal end of the link member 48 is connected to the lower portion of the proximal end of the distal cup member 47 by a connection pin 49, and the rear end of the link member 48 is connected to a connection pin 50.
Is connected to a sliding member 51 which is slidably inserted into the regulating guide member 44. The sliding member 51 has a cylindrical sliding portion 51a inserted into the guide hole 44a, and the sliding portion 51 is provided with a slot 51b into which the link member 48 is inserted. The sliding member 51 is connected to a distal end of an operation wire 52 that is inserted into the insertion portion 42 so as to be able to advance and retreat.

The operation wire 52 is inserted into the insertion portion 42 and a slider member 53 is provided on the operation portion main body 41 so as to be able to advance and retreat.
It is connected to. Note that a finger hook 54 is provided on the operation unit main body 41.

Therefore, when the slider member 53 is slid forward, the sliding member 51 is moved through the operation wire 52.
Moves forward while being guided by the regulating guide member 44, and presses the tip cup member 47 in the clockwise direction via the link member 48. Therefore, the tip cup member 47 rotates clockwise about the pivot pin 46 as a fulcrum. The tip cup member 47 is in a straight state.

When the slider member 53 is slid rearward, the sliding member 51 retreats while being guided by the regulating guide member 44 via the operation wire 52, and the link member 4 is moved.
Since the tip cup member 47 is pulled in the counterclockwise direction via the pin 8, the tip cup member 47 pivots counterclockwise around the pivot pin 46, and the tip cup member 47 pivots downward.

As described above, since the guide hole 44a is provided in the regulating guide member 44 so that the sliding member 51 moves only in the thrust direction, the sliding member 51 does not become inclined with respect to the sliding direction. Therefore, the distal cup member 47 does not warp upward, and the distal cup member 47 is in a straight state. When the distal cup member 47 is inserted into the bronchus d, the distal cup member 47 is inserted in an intended direction without hitting the branch portion e. can do.

FIGS. 12 and 13 show a fourth embodiment, which is a modification of the regulating guide member. A guide hole 55a having a rectangular cross section is provided in the cylindrical restriction guide member 55, and slits 56 are provided in upper and lower portions of the restriction guide member 55 along the axial direction. The guide hole 5
5a is a sliding member 57 having a rectangular sliding portion 57a.
Are slidably inserted in the front-rear direction, and the sliding portion 57a is provided with a slit portion 58 into which the link member 48 is inserted. Therefore, the same functions and effects as those of the third embodiment can be obtained.

According to the above configuration, the following configuration is obtained. (Supplementary Note 5) Insertion portion, operation wire inserted through this insertion portion so as to be able to advance and retreat, a sliding member provided at the distal end of the operation wire, and this sliding member is rotatable via a link mechanism. And a regulating guide member provided at the distal end of the insertion portion for guiding the sliding member so as to be movable only in the thrust direction.

(Supplementary note 6) The tissue sampling tool according to supplementary note 5, wherein the regulating guide member has a guide hole having a circular cross section for guiding a cylindrical sliding portion of the sliding member only in the thrust direction. .

(Supplementary Note 7) The tissue collection tool according to Supplementary Note 5, wherein the regulating guide member has a guide hole having a rectangular cross section for guiding a rectangular sliding portion of the sliding member only in the thrust direction. .

[0042]

As described above, according to the present invention, when the pair of operating members are closed, the distal end of one operating member projects from the side opposite to the distal end of the other operating member. In addition, there is no need to perform processing for matching the tip portions, and there is an effect that the assembling operation can be provided simply and at low cost. Further, the protrusion amount is small, and there is no fear of damaging even if it comes into contact with tissue. Further, when the pair of operating members are opened, the tip of the cutting blade becomes an acute angle with respect to a planar incision target such as the peritoneum, and the cutting blade is rotated with respect to the incision target by rotating in a direction to close the operation member. There is an effect that the incision can be made without slipping.

[Brief description of the drawings]

FIG. 1 shows a distal end portion of a scissors forceps according to a first embodiment of the present invention, wherein (a) is a side view in a closed state, and (b) is a side view in an open state.

FIGS. 2A and 2B show a distal end portion of a scissors forceps according to a second embodiment of the present invention, wherein FIG. 2A is a side view in a closed state, and FIG. 2B is a side view in an open state.

FIG. 3 is a side view showing the entire configuration of a conventional scissors forceps.

4A and 4B show a tip portion of the conventional scissors forceps, in which FIG. 4A is a side view in a closed state, and FIG. 4B is a side view in an open state.

5A and 5B show the tip of another conventional scissors forceps, wherein FIG. 5A is a side view in a closed state, and FIG. 5B is a side view in an open state.

FIG. 6 is a side view showing the overall configuration of a tissue sampling tool according to a third embodiment of the present invention.

FIG. 7 is a vertical side view of the tip of the tissue sampling tool of the embodiment.

FIG. 8 is a vertical cross-sectional view of the distal end portion of the tissue sampling tool of the embodiment.

FIG. 9 is a vertical cross-sectional side view showing a state where the distal end cup member of the embodiment is bent.

FIG. 10 is an exemplary perspective view showing a regulation guide member according to the embodiment;

FIG. 11 is an exemplary perspective view showing a sliding member according to the embodiment;

FIG. 12 is a perspective view showing a regulation guide member according to a fourth embodiment of the present invention.

FIG. 13 is an exemplary perspective view showing a sliding member according to the embodiment;

FIG. 14 is a longitudinal sectional side view of a tip portion of a conventional tissue sampling tool.

FIG. 15 is a partially cutaway side view showing a state in which the conventional tissue sampling tool is inserted into an endoscope.

FIG. 16 is a view showing a state in which a conventional tissue sampling tool is inserted into a bronchus.

[Explanation of symbols]

 4, 5: Working member 4a, 5a: Cutting blade 4b, 5b: Tip

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[Procedure amendment]

[Submission date] June 11, 1998

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0004

[Correction method] Change

[Correction contents]

FIG. 3 and FIG. 4 show scissors forceps used for endoscopic surgery and for peeling or incising tissue. FIG. 3 shows the whole of the endoscope forceps. The forceps includes an operation section 1, an insertion section 2 as a forceps body, and an operation section 3. Working portion 1, a pair of work that is configured to scissors-like
And an opening / closing mechanism 6 for opening and closing the action members 4 and 5.

[Procedure amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0006

[Correction method] Change

[Correction contents]

[0006] Then, the forceps is Toraka - via Le like is inserted into the abdominal cavity of the patient, and the opening and closing action members 4 of the working portion 1 by the handle 9a, 9b and surgeon to open and close, organ, An object such as a blood vessel or peritoneum can be cut, and when used as a peeling forceps, the handle 9
By opening and closing a and 9b, the action members 4 and 5 can be opened and closed to peel off the object.

[Procedure amendment 4]

[Document name to be amended] Drawing

[Correction target item name] Fig. 1

[Correction method] Change

[Correction contents]

FIG.

[Procedure amendment 5]

[Document name to be amended] Drawing

[Correction target item name] Fig. 4

[Correction method] Change

[Correction contents]

FIG. 4

Claims (1)

[Claims] 1. A scissors forceps for use with an endoscope, wherein both or one of the forceps has a pair of action members for rotating or moving with respect to a counterpart to shear an object, and each of the action members has a right angle or a right angle. Scissors forceps having an acute angle slightly exceeding the obtuse angle or slightly less than the right angle, and wherein when fully closed, the distal end of one operating member projects to the opposite side of the other operating member. .