WO2020008530A1 - Instrument de traitement médical - Google Patents

Instrument de traitement médical Download PDF

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Publication number
WO2020008530A1
WO2020008530A1 PCT/JP2018/025220 JP2018025220W WO2020008530A1 WO 2020008530 A1 WO2020008530 A1 WO 2020008530A1 JP 2018025220 W JP2018025220 W JP 2018025220W WO 2020008530 A1 WO2020008530 A1 WO 2020008530A1
Authority
WO
WIPO (PCT)
Prior art keywords
slit
medical treatment
longitudinal direction
treatment tool
gripping
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2018/025220
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English (en)
Japanese (ja)
Inventor
裕行 高山
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to PCT/JP2018/025220 priority Critical patent/WO2020008530A1/fr
Publication of WO2020008530A1 publication Critical patent/WO2020008530A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current

Definitions

  • the present invention relates to a medical treatment tool.
  • a treatment tool including a grip having a pair of jaws that are openably and closably connected (for example, see Patent Literature 1).
  • This treatment tool has a blade portion on one jaw, and a contact surface made of an elastic body for cutting the tissue between the jaw and the blade portion on the other jaw. By curving the surface, unevenness of the gripping force generated in the longitudinal direction of the blade portion is reduced.
  • the treatment tool disclosed in Patent Literature 1 has a gripping force that is curved in the width direction of the blade portion, that is, in a direction perpendicular to the longitudinal axis of the blade portion, at each position along the longitudinal axis direction of the blade portion. Non-uniformity is suppressed. For this reason, the gripping force is dispersed in the short direction of the blade portion at each position of the blade portion, and it is necessary to supply a larger gripping force than when the contact surface is not formed of an elastic body. As a result, it is necessary to secure a strength capable of withstanding a large gripping force between the pair of jaws, and it is difficult to make the gripping portion longer or smaller in diameter.
  • An object of the present invention is to provide a medical treatment tool capable of making a grip portion longer and thinner and capable of gripping tissue with a uniform gripping force along a longitudinal direction of a jaw.
  • One embodiment of the present invention includes two jaws each having a longitudinal direction and rotatably connected around a rotation axis orthogonal to the longitudinal direction, wherein each of the jaws responds to rotation about the rotation axis.
  • the tissue is arranged between the gripping surfaces in a state in which the gripping surfaces of the two jaws are separated from each other, and the two jaws are rotated around the rotation axis and brought close to each other, whereby the tissue is gripped between the gripping surfaces.
  • the gripping surface is bent about an axis parallel to the rotation axis orthogonal to the longitudinal direction. Therefore, dispersion of the gripping force around the axis parallel to the rotation axis is suppressed, and pressure can be efficiently applied to the tissue even with a small gripping force. As a result, it is not necessary to secure the strength of the jaws excessively, and the diameter and length of the jaws can be reduced.
  • the rigidity reduction portion may have a slit that penetrates the jaw in a direction parallel to the rotation axis and extends along the longitudinal direction.
  • a portion sandwiched between the slit and the gripping surface may be made of a member different from other portions of the jaw.
  • a reinforcing portion for increasing bending rigidity around an axis parallel to the longitudinal direction may be provided on an inner surface of the slit on the gripping surface side. According to this configuration, the bending around the axis parallel to the longitudinal direction of the grip surface can be more effectively suppressed by the reinforcing portion.
  • the width of the slit may be larger at the center than at the end in the longitudinal direction, With this configuration, the gripping surface can be largely bent at the center away from the longitudinal end of the jaw on which the biased gripping force acts, and the gripping force can be uniformly dispersed.
  • a distance from the inner surface of the slit on the gripping surface side to the gripping surface may gradually change along the longitudinal direction.
  • a high elastic member made of a material having higher elasticity than a portion sandwiched between the slit and the grip surface may be arranged in the slit.
  • the rigidity reducing portion may change the section modulus of the jaw along the longitudinal direction by depressing the gripping surface.
  • the gripping surface can be largely bent at a position apart from the longitudinal end of the jaw on which the biased gripping force acts, and the gripping force can be uniformly dispersed.
  • the present invention it is possible to lengthen the grip portion and reduce the diameter thereof, and it is possible to grip the tissue with a uniform gripping force along the longitudinal direction of the jaw.
  • FIG. 2 is a front view showing a state where two jaws of the medical treatment tool in FIG. 1 are closed.
  • FIG. 3 is a transverse sectional view showing a BB section of the medical treatment tool in FIG. 2.
  • FIG. 2 is a front view showing a state where a gripping force is generated between two jaws of the medical treatment tool in FIG. 1.
  • FIG. 5 is a transverse sectional view showing a CC section of the medical treatment tool in FIG. 4.
  • FIG. 5 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the state of FIG. 4.
  • FIG. 8 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the medical treatment tool in FIG. 7. It is a reference drawing showing the tip part of the conventional medical treatment tool with a large gap size between the grip surfaces.
  • FIG. 10 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the medical treatment tool in FIG. 9.
  • FIG. 9 is a front view showing a first modification example in which the shape of the slit of the medical treatment tool in FIG. 1 is different. It is a front view which shows the 2nd modification from which the shape of the slit of the medical treatment tool of FIG.
  • FIG. 1 differs. It is a front view showing the 3rd modification from which the shape of the slit of the medical treatment tool of Drawing 1 differs. It is a front view which shows the 4th modification from which the shape of the slit of the medical treatment tool of FIG. 1 differs.
  • FIG. 15 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the medical treatment tool in FIG. 14. It is a front view which shows the 5th modification from which the shape of the slit of the medical treatment tool of FIG. 1 differs.
  • FIG. 17 is a diagram showing a change according to a longitudinal position of a gripping force generated between two jaws in the medical treatment tool in FIG. 16.
  • FIG. 15 is a front view showing a ninth modification example having a cover that covers an opening of a slit of the medical treatment tool in FIG. 1. It is a front view which shows the 10th modification which has the cover which covers the opening part of the slit of the medical treatment tool of FIG. FIG.
  • FIG. 21 is a front view showing an eleventh modification in which a concave portion is provided on a grip surface instead of the slit of the medical treatment tool in FIG.
  • FIG. 24 is a front view showing a twelfth modified example in which the concave portion of FIG. 23 is filled with a highly rigid material. It is a front view which shows the 13th modification which comprised the member containing the grip surface of the medical treatment tool of FIG. 1 by another member.
  • FIG. 26 is a front view showing a fourteenth modification in which the shape of the slit in FIG. 25 is different.
  • FIG. 26 is a front view showing a fifteenth modification in which the shape of the slit in FIG. 25 is different.
  • FIG. 26 is a front view showing a sixteenth modification in which the shape of the slit in FIG. 25 is different.
  • FIG. 29 is a front view showing a seventeenth modification in which a rib is provided on the inner surface of the slit of FIG. 28. It is a front view which shows the 18th modification which adopted the wiper jaw as the jaw of FIG.
  • the medical treatment tool 1 is a grasping forceps including two jaws 2 and 3 that are swingably connected around a rotation axis A.
  • Each of the jaws 2 and 3 has a longitudinal direction in a direction orthogonal to the rotation axis A as shown in FIG. 2, and has a short direction in a direction parallel to the rotation axis A as shown in FIG. are doing.
  • the two jaws 2 and 3 have gripping surfaces 2a and 3a which are moved toward and away from each other when swung about the rotation axis A.
  • One jaw 2 is provided with a slit (stiffness reducing portion) 4 that penetrates in the short direction and extends in the long direction.
  • the slit 4 reduces the bending rigidity around the axis parallel to the short direction while maintaining the bending rigidity around the axis parallel to the longitudinal direction of the jaw 2 uniformly along the short direction.
  • the slit 4 has a constant opening width at a central portion in the longitudinal direction, and has a shape in which the opening width decreases toward both ends in the longitudinal direction.
  • the opening width of the slit 4 is reduced toward both ends in the longitudinal direction by the inclined surface 5 provided on the inner surface opposite to the grip surface 2a.
  • the slit 4 is formed parallel to the grip surface 2a and has a constant opening width.
  • the grip surfaces 110a, 120a of the pair of jaws 110, 120 are closed to a position where the grip surfaces 110a, 120a are parallel to each other.
  • the gripping pressure is highest at the longitudinal base ends of the gripping surfaces 110a and 120a as shown in FIG. Become. This is because the jaws 110, 120 that come into contact first are bent around an axis parallel to the short axis and escape, thereby suppressing an increase in contact pressure. As the displacement is limited, the gripping pressure increases.
  • the gripping surfaces are closed in a state where the gripping surfaces 210a, 220a of the pair of jaws 210, 220 are parallel to each other.
  • the gripping pressure becomes the highest at the longitudinal ends of the gripping surfaces 210a and 220a. Get higher. This is because even if the jaws 210 and 220 rotate, the base ends of the jaws 210 and 220 do not come into contact with each other.
  • the provision of the slit 4 reduces the bending stiffness of the jaw 2 on the side where the slit 4 is provided around an axis parallel to the lateral direction. .
  • the gripping surface 2a of the jaw 2 is elastically deformed in the direction in which the slit 4 is crushed.
  • FIG. 6 an extreme increase in the gripping pressure at the base end in the longitudinal direction of the gripping surface 2a is suppressed.
  • the gripping surface 2a rotates around the axis parallel to the longitudinal direction. There is no bending, and the gripping pressure does not need to be dispersed in the short direction. As a result, pressure can be efficiently applied to the tissue even with a small gripping force, and the length of the jaws 2 and 3 can be increased, and the width and height can be reduced.
  • the slit 4 has a shape in which the opening width gradually decreases toward both ends in the longitudinal direction due to the inclined surface 5 provided on the inner surface opposite to the gripping surface 2a.
  • an inclined surface 5 may be provided on the inner surface on the gripping surface 2a side.
  • one inner surface of the slit 4 may be constituted by a cylindrical inner surface.
  • a slit 4 having a uniform opening width along the longitudinal direction may be employed. As a result, as shown in FIG. 15, an extreme increase in the gripping pressure at the base end in the longitudinal direction can be reduced. Further, instead of the slit 4 extending straight in the longitudinal direction, a curved slit 4 may be employed as shown in FIG. As a result, as shown in FIG. 17, an extreme increase in the gripping pressure at the base end in the longitudinal direction can be reduced.
  • the slit 4 is provided in one jaw 2, but the slit 4 may be provided in both jaws 2 and 3 instead. Further, in the above-described embodiment, the slit 4 whose both ends in the longitudinal direction are closed is exemplified. However, as shown in FIGS. 18 and 19, the slit 6 whose one end in the longitudinal direction is open is used instead. May be adopted.
  • the slit 4 provided in each of the above embodiments may be filled with a high elastic member 7 such as rubber having high elasticity. Thereby, it is possible to prevent tissue or the like from entering the slit 4. Further, as shown in FIGS. 21 and 22, a cover 8 may be provided at a position where both ends of the slit 4 are closed.
  • the slit 4 is employed as the stiffness reducing portion.
  • the gripping surface 2a of at least one jaw 2 is positioned at the middle position in the longitudinal direction.
  • the stiffness-reducing portion may be constituted by a concave portion 9 which is deeply recessed gradually toward both ends in the longitudinal direction.
  • the section modulus along the longitudinal direction of the jaw 2 changes, and the bending stiffness around the axis parallel to the rotation axis A decreases as the depression increases, so that the jaw 2 is bent when the tissue is pinched.
  • an extreme increase in the gripping pressure at the base ends of the jaws 2 and 3 or the distal ends of the jaws 2 and 3 can be suppressed.
  • the concave portion 9 may be filled with a high elastic member 10 having higher rigidity than rubber.
  • a portion disposed between the slit 4 and the grip surface 2a may be formed of a separate member. That is, one jaw 2 includes a jaw base 11 that is swingably connected to the other jaw 3 around the rotation axis A, and a gripping surface member 12 fixed to the jaw base 11 and forming a gripping surface 2a. It may be.
  • the slits 11 can be easily formed between the jaws 11 and 12 in a fixed state. Can be formed.
  • the gripping surface member 12 may be made of a material having high rigidity equivalent to that of the jaw base 11.
  • a reinforcing portion 13 such as a rib extending in the short direction may be provided on the inner surface of the slit 4 on the gripping surface 2a side.
  • one jaw 2 is supported on the other jaw 3 so as to be rotatable around a rotation axis A, and a jaw base 11 is supported on the tip of the jaw base 11 so as to be swingable.
  • a slit 15 may be provided in the wiper jaw part 14.
  • a single-opening type grasping forceps in which only one jaw 2 swings with respect to the other jaw 3 is exemplified, but instead, the present invention may be applied to a double-opening grasping forceps. . Further, the present invention may be applied to a gripping forceps of another type, for example, a type in which one jaw 2 translates with respect to the other jaw 3 and opens and closes.
  • the jaws 2 and 3 may be provided with a heater for heating the tissue at the time of cutting, or may be provided with an electrode for cauterizing and sealing the tissue. Further, instead of the heater, an ultrasonic transducer for supplying ultrasonic vibration to the tissue may be arranged.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Physics & Mathematics (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Ophthalmology & Optometry (AREA)
  • Surgical Instruments (AREA)

Abstract

Un instrument de traitement médical (1) comprend deux mâchoires (2, 3) présentant chacune une direction longitudinale et reliées de façon à pouvoir tourner autour d'un axe de rotation (A) orthogonal à la direction longitudinale, les mâchoires (2, 3) étant pourvues de surfaces de préhension respectives (2a, 3a) amenées à s'approcher ou à se rétracter mutuellement conjointement avec la rotation autour de l'axe de rotation (A), et au moins une des mâchoires (2, 3) étant pourvue d'une partie à rigidité réduite (4), sa rigidité à la flexion autour d'un axe parallèle à l'axe de rotation (A) étant réduite sans changement de rigidité à la flexion autour d'un axe de celle-ci parallèle à la direction longitudinale.
PCT/JP2018/025220 2018-07-03 2018-07-03 Instrument de traitement médical Ceased WO2020008530A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2018/025220 WO2020008530A1 (fr) 2018-07-03 2018-07-03 Instrument de traitement médical

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2018/025220 WO2020008530A1 (fr) 2018-07-03 2018-07-03 Instrument de traitement médical

Publications (1)

Publication Number Publication Date
WO2020008530A1 true WO2020008530A1 (fr) 2020-01-09

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Family Applications (1)

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PCT/JP2018/025220 Ceased WO2020008530A1 (fr) 2018-07-03 2018-07-03 Instrument de traitement médical

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WO (1) WO2020008530A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2021152753A1 (fr) * 2020-01-29 2021-08-05 オリンパス株式会社 Instrument de traitement et procédé de fabrication d'un instrument de traitement
WO2021181438A1 (fr) * 2020-03-09 2021-09-16 オリンパス株式会社 Dispositif de préhension de tissu et procédé de commande de dispositif de préhension de tissu
JP2022047656A (ja) * 2020-09-14 2022-03-25 株式会社Ｌａｋｅ・Ｅ２ 内視鏡用処置具

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0998978A (ja) * 1995-10-06 1997-04-15 Olympus Optical Co Ltd 医療器具
JP2010082180A (ja) * 2008-09-30 2010-04-15 Kitakyushu Foundation For The Advancement Of Industry Science & Technology 挟持装置
US20100160940A1 (en) * 2007-06-26 2010-06-24 Aesculap Ag Surgical Instrument
US20110213409A1 (en) * 2010-02-25 2011-09-01 Martin Leonhard Medical instrument
JP2011525125A (ja) * 2008-06-16 2011-09-15 ボストン サイエンティフィック サイムド，インコーポレイテッド 解剖学的構造へアクセスするための方法およびデバイス
US20150164526A1 (en) * 2012-06-25 2015-06-18 Olympus Winter & Ibe Gmbh Gripping instrument
US20150257776A1 (en) * 2014-03-13 2015-09-17 Lsi Solutions, Inc. Surgical clamp and clamp jaw

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0998978A (ja) * 1995-10-06 1997-04-15 Olympus Optical Co Ltd 医療器具
US20100160940A1 (en) * 2007-06-26 2010-06-24 Aesculap Ag Surgical Instrument
JP2011525125A (ja) * 2008-06-16 2011-09-15 ボストン サイエンティフィック サイムド，インコーポレイテッド 解剖学的構造へアクセスするための方法およびデバイス
JP2010082180A (ja) * 2008-09-30 2010-04-15 Kitakyushu Foundation For The Advancement Of Industry Science & Technology 挟持装置
US20110213409A1 (en) * 2010-02-25 2011-09-01 Martin Leonhard Medical instrument
US20150164526A1 (en) * 2012-06-25 2015-06-18 Olympus Winter & Ibe Gmbh Gripping instrument
US20150257776A1 (en) * 2014-03-13 2015-09-17 Lsi Solutions, Inc. Surgical clamp and clamp jaw

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2021152753A1 (fr) * 2020-01-29 2021-08-05 オリンパス株式会社 Instrument de traitement et procédé de fabrication d'un instrument de traitement
US11974766B2 (en) 2020-01-29 2024-05-07 Olympus Corporation Treatment tool and method of manufacturing treatment tool
WO2021181438A1 (fr) * 2020-03-09 2021-09-16 オリンパス株式会社 Dispositif de préhension de tissu et procédé de commande de dispositif de préhension de tissu
JPWO2021181438A1 (fr) * 2020-03-09 2021-09-16
JP7349555B2 (ja) 2020-03-09 2023-09-22 オリンパス株式会社 医療デバイス、医療デバイスの制御方法および制御装置
JP2022047656A (ja) * 2020-09-14 2022-03-25 株式会社Ｌａｋｅ・Ｅ２ 内視鏡用処置具
JP7482592B2 (ja) 2020-09-14 2024-05-14 レイクＲ＆Ｄ株式会社 内視鏡用処置具

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