Surgical instruments

Abstract

The surgical instrument 1 according to the present invention comprises: a treatment unit 10, the front end of which can be opened and closed; a rod-shaped rod-shaped body 100, to which the treatment unit 10 is connected; a fixed cylinder 20, to which the rear end side of the rod-shaped body 100 is rotatably engaged; a gripping portion 30, which is a portion gripped by a user and is integrally configured with the fixed cylinder 20; and a sliding handle mounted on the rod-shaped body 100. The surgical instrument 1 opens and closes the treatment unit 10 by moving the sliding handle 200 forward and backward, and rotates the treatment unit 10 by rotating the sliding handle 200. According to the surgical instrument 1 according to the present invention, compared with the existing surgical instruments, it is possible to more accurately perform fine surgical operations.

Description

Technical Field

[0001] The invention relates to a surgical instrument. Background Art

[0002] Conventionally, there are known gripping tools for gripping a micro object during surgery. As an example of the gripping tool, there is known a needle holder for gripping anastomotic needles (see, for example, Patent Document 1).

[0003] Although not shown in the figure, the needle holder as a surgical instrument described in Patent Document 1 (hereinafter referred to as the conventional surgical instrument) includes: a treatment tool including a holding portion, the holding portion being composed of a pair of clamping pieces whose front and rear ends are opened and closed with the axis as the center; a barrel including a rotating barrel portion having an opening and closing mechanism for opening and closing the front ends of the pair of clamping pieces and a rotating mechanism for rotatably supporting the treatment tool; and a grip including a trigger, the trigger being installed at a predetermined angle relative to the rotating barrel portion of the barrel and actuating the opening and closing mechanism. The conventional surgical instrument has a so-called normally closed structure in which the front end of the clamping portion is closed when the trigger is not pulled and the front end is opened when the trigger is pulled.

[0004] According to the surgical instrument of the prior art, the object can be clamped by pulling the trigger with the middle finger, bringing the clamping part close to the object, and then gradually withdrawing the pulling action of the middle finger to gradually return the trigger to the original position. In the state of clamping the object in this way, the rotating cylinder part is clamped with the index finger and thumb, and the clamped object can be rotated by rotating these two fingers in any direction. In this way, micro-operations such as imitating the bending of anastomotic needles to make needles can be performed.

[0005]

Prior technical literature

[0006] [Patent Document 1] Japanese Patent Application Publication No. 2019-25105

[0007] In plastic surgery and orthopedic surgery, since the above-mentioned operations are often performed at a relatively shallow position from the human body surface, existing surgical instruments can be effectively utilized even in operations involving minor operations such as lymphaticovenous anastomosis.

[0008] On the other hand, in operations such as neurosurgery, the operation is usually performed in a region that is relatively deep from the surface of the human body.

[0009] Fig. 9 This is a schematic diagram showing the situation when the existing surgical instrument 9 (needle holder) is used in a neurosurgery operation. Fig. 9As shown, a portion of the head HD of a human body (patient PA) is opened, and a surgical instrument 9 is inserted from above into a narrow and deep hole CA formed in the head HD. While the optical axis OA of the objective lens 910 of the microscope 900 is directed in a direction substantially the same as the insertion direction of the surgical instrument 9, surgery is performed while observing the microscope 900 and visually inspecting the surgical area near the front end of the surgical instrument 9.

[0010] In such neurosurgery, since the surgical instrument is inserted from above along the optical axis OA just below the microscope 900, the doctor DR operates the surgical instrument 9 with his wrist raised, in other words, with his hand easily shaking. In addition, since the handle of the surgical instrument 9 used in such neurosurgery (the barrel portion of the needle holder described in Patent Document 1) is relatively long, the shaking of the hand is easily magnified at the front end of the treatment tool.

[0011] In addition, the existing surgical instrument 9 uses the middle finger to operate the trigger to open and close the front end of the treatment tool as described above. Since the middle finger uses the muscles (tendons) shared with the index finger and the ring finger to move the fingers, it is said that it is not good at moving independently like the ring finger. If only the middle finger is allowed to move independently and finely, the operation as a whole is very strenuous because the muscles (tendons) widely distributed inside the hand are moved with delicate touches, and the palm and wrist, which are the basis of the fingertips for precise operations, are prone to shaking. Therefore, if the treatment tool is opened and closed with the existing surgical instrument 9, the front end is prone to shaking, which is not conducive to delicate operation techniques.

[0012] For reference, in the case of plastic surgery or orthopedic surgery, as described above, surgery is mostly performed at a relatively shallow position from the human body surface, so even if the existing surgical instrument 9 is used, the angle of the needle holder in the length direction can be set larger relative to the visual direction, and it is easier to ensure the visual field near the surgical area. In addition, due to the angle of the needle holder, the doctor can also fix the wrist near the armpit of the surgical area, so that the hand operation is in an environment where shaking is not easy to occur.

[0013] The present invention is proposed in view of the above situation, and an object of the present invention is to provide a surgical instrument that can perform more accurate surgery compared with existing surgical instruments. Summary of the invention

[0014] A surgical instrument according to one embodiment of the present invention comprises: a treatment unit, which is composed of a pair of treatment pieces whose front ends can be opened and closed; a rod-shaped rod-shaped body, to which the treatment unit is connected at the front end side and extends along a length direction line; a roughly cylindrical fixed barrel portion, which has a hole opening at the front end side, and the rear end side of the rod-shaped body is rotatably engaged with the inner wall of the hole with the length direction line as the center; and a holding portion, which is integrated with the fixed barrel portion as a part held by the user.

[0015] The surgical instrument further includes a sliding handle installed on the outer peripheral surface of the rod-shaped body, and the sliding handle can slide back and forth along the length direction line relative to the rod-shaped body (excluding the push rod) and can rotate around the length direction line. The pair of treatment plates of the treatment unit can be opened and closed by moving the sliding handle back and forth along the length direction line, and the treatment unit can be rotated around the length direction line by rotating the sliding handle around the length direction line.

[0016] Effects of the Invention

[0017] The surgical instrument of the present invention can perform delicate surgery more accurately compared to conventional surgical instruments. BRIEF DESCRIPTION OF THE DRAWINGS

[0018] Figure 1 It is a perspective view of the surgical instrument 1 according to the first embodiment.

[0019] Figure 2 It is a cross-sectional view of the surgical instrument 1 according to the first embodiment.

[0020] Figure 3 It is a main part explanatory diagram for explaining the structure of the first connecting portion involved in the first embodiment.

[0021] Figure 4 This is a diagram for explaining the structure related to the second connection portion according to the first embodiment.

[0022] Figure 5 It is a perspective view of main parts for explaining the structure related to the second connecting portion according to the first embodiment.

[0023] Figure 6 This is a diagram for explaining the configuration related to the switching unit according to the first embodiment.

[0024] Figure 7 It is a perspective view for explaining a usage example of the surgical instrument 1 according to the first embodiment.

[0025] Figure 8 It is a perspective view of the surgical instrument 2 according to the second embodiment.

[0026] Fig. 9This is a schematic diagram showing a situation in which a conventional surgical instrument 9 is assumed to be used in a neurosurgery or the like. DETAILED DESCRIPTION

[0027] Hereinafter, embodiments of the surgical instrument of the present invention will be described with reference to the accompanying drawings. Each of the drawings is for illustration only and does not necessarily strictly reflect actual dimensions, proportions, etc. Figure 1 to Figure 7 Although the present invention is described in detail in the first embodiment, it is also described as a specific example of the present invention. Therefore, when describing a specific example related to the first embodiment, it is sometimes referred to as an "example".

[0028] [Implementation Method 1]

[0029] 1. Structure of the surgical instrument 1 according to the first embodiment

[0030] (1) Overview of surgical instruments

[0031] Figure 1 It is a perspective view of the surgical instrument 1 according to the first embodiment. Figure 2 FIG. 1 is a cross-sectional view of the surgical instrument 1 according to the first embodiment. In addition, the plane including the bending direction of the treatment sheets 11 and 12 and the longitudinal line LL does not necessarily coincide with the plane including the gripping portion 30 and the longitudinal line LL, but Figure 2 It is assumed that they are the same surface and are shown in the same figure.

[0032] like Figure 1 and Figure 2 As shown, the surgical instrument 1 involved in the first embodiment generally includes: a treatment unit 10, a rod-shaped body 100, a fixed cylinder 20, a gripping portion 30, and a sliding handle 200. In this specification, the "length direction line LL" refers to a line along the length direction of the rod-shaped body 100, and is an imaginary line constituting the central axis when the rod-shaped body 100 rotates. "Down" refers to the direction in which the gripping portion 30 protrudes from the length direction line LL of the rod-shaped body 100, and "up" refers to the direction opposite to "down". "Up" and "down" are for convenience of naming, and they are not necessarily consistent with the up and down directions along the vertical direction.

[0033] (2) Treatment unit 10

[0034] The treatment unit 10 is composed of a pair of treatment pieces 11 and 12 whose front ends can be opened and closed.

[0035] The treatment unit 10 can be divided into at least two pieces as long as the front end can be opened and closed by the opening and closing axis 19 (refer to Figure 2 ) as the center for opening and closing. This embodiment is described by taking a needle holder for holding anastomotic needle as an example.

[0036] In addition, the treatment unit 10 is not limited to a needle holder, and forceps for holding an object or scissors for cutting an object can also be preferably applied as the treatment unit 10. That is, the treatment unit 10 can be a needle holder, forceps, or pliers. The treatment unit 10 can also be scissors.

[0037] The front end of the treatment unit 10 in the first embodiment is located at a position radially away from the longitudinal direction line LL. In the embodiment, the front end side of the treatment sheets 11 and 12 is bent in a manner that gradually moves away from the longitudinal direction line LL as it moves from the opening and closing axis 19 toward the front end of the treatment sheets 11 and 12. However, this is not limited to such a manner. For example, the front end of the treatment unit 10 may also be extended from the treatment portion 11a, 12a "refer to the following Figure 6 (a)" is bent in the middle to form a substantially L-shape.

[0038] (3) Rod-shaped body 100

[0039] The rod-shaped body 100 refers to the overall rod-shaped member connected between the treatment unit 10 and the fixed cylinder 20 (described later) and extending along the length direction line LL. The rod-shaped body 100 includes a hollow tube 130 described later, a push rod 110 inserted in the inner side of the hollow tube 130, and a tube 140 connected to the outer peripheral surface of the hollow tube 130. The treatment unit 10 is connected to the front end side of the rod-shaped body 100, and the fixed cylinder 20 and the gripping part 30 described later are arranged on the rear end side. At the front end of the push rod 110, the treatment unit 10 is buckled by the flat plate 120, and the upper convex part (boss) 123 and the lower convex part 124 protruding from the flat plate 120, which will be described in detail later. In addition, on the inner side of the tube 140, a hollow member 150 that can advance and retreat along the length direction line LL and can rotate around the length direction line LL is arranged. The hollow member 150 can rotate in a manner such that the central axis thereof is aligned with the longitudinal line LL, and can move forward and backward along the longitudinal line LL.

[0040] In the present specification, “front end side” refers to the side where the treatment unit 10 is arranged with respect to the rod-shaped body 100 , and “rear end side” refers to the side where the fixed cylinder 20 is arranged with respect to the rod-shaped body 100 .

[0041] (4) Fixed cylinder 20

[0042] The fixed cylinder 20 is a substantially cylindrical portion having a hole 22 opened at the front end. A guide groove 24 cut along the circumferential direction is formed on the inner wall of the hole 22 (see Figure 2On the other hand, a flange portion 144 in a flange shape protruding from the longitudinal direction line LL to the radial direction RD is formed on the rear end side of the tube 140 constituting the rod-shaped body 100, and the flange portion 144 engages with the guide groove 24 of the fixed tube portion 20. In other words, the fixed tube portion 20 is a component formed after the rear end side of the rod-shaped body 100 (specifically, the rear end side of the tube 140) is rotatably engaged with the longitudinal direction line LL in the inner wall of the hole 22.

[0043] In the embodiment, the shape of the opening of the fixed cylinder 20 is substantially circular, but the shape does not need to be particularly limited to a substantially circular shape as long as the fixed cylinder 20 and the rod-shaped body 100 can finally rotate.

[0044] (5) Grip 30

[0045] The grip portion 30 is a portion that is integrally configured with the fixed cylinder 20 as a portion that the user of the surgical instrument 1 grips. In the first embodiment, the grip portion 30 protrudes from the longitudinal direction line LL in the radial direction RD. The fixed cylinder 20 and the grip portion 30 may be integrally formed (connected), or may be connected to each other as two separately formed components.

[0046] The grip portion 30 according to the first embodiment will be described in detail below. The grip portion 30 includes at least a finger hook portion 32 and a palm contact portion 34 .

[0047] The finger-hooking portion 32 includes a finger-hooking surface 32a on which the user's finger is hooked. The direction of the tangent line L1 of the finger-hooking surface 32a is set to intersect with the longitudinal line LL. In other words, the tangent line of the finger-hooking surface 32a is not parallel to the longitudinal line LL. In the embodiment, the tangent line of the finger-hooking surface 32a is orthogonal to the longitudinal line LL.

[0048] The finger hook portion 32 is disposed at a position offset by a predetermined dimension from the longitudinal line LL in the radial direction of the rod-shaped body 100 (see Figure 2 The offset amount can be set according to the size of the user's palm, etc., and is preferably set within a range of approximately 5 mm to 50 mm.

[0049] The finger buckle portion 32 is a portion where at least the middle finger of the user buckles. However, it is not limited to the middle finger, and the finger buckle portion 32 can also buckle the ring finger in addition to the middle finger. In this way, when using, by clamping and holding the middle finger and the ring finger and the palm, the grip portion 30 and the fixed cylinder portion 20, which are the basis for operating the surgical instrument 1, can be made more stable, thereby helping to achieve a more accurate technique (the method of use will be described later).

[0050] The palm contact portion 34 is a portion that contacts the palm of the user when the user holds the surgical instrument 1. The palm contact portion 34 is arranged on the rear end side when viewed from the finger hook portion 32. The shape of the palm contact portion 34 may be any appropriate shape, but in the embodiment, it is a shape obtained by making a rugby ball into a hemispherical shape (a shape similar to a PC mouse), and a long curved surface portion substantially parallel to the long axis thereof is arranged to contact as a palm contact surface 34a.

[0051] The palm contact portion 34 may be fixed relative to the finger hook portion 32 , but is preferably configured such that the distance between the palm contact portion 34 and the slide handle 200 (in the direction along the longitudinal line LL) is changeable.

[0052] In the embodiment, a stay 35 is connected to the side opposite to the palm contact surface 34a of the palm contact portion 34, and a stay hole 36a is provided on the rear end side of the grip portion middle portion 36 protruding from the finger hook portion 32, and the stay 35 is inserted into the stay hole 36a so as to be able to move forward and backward. By adopting such a structure, the distance between the palm contact portion 34 and the finger hook surface 32a can be changed, and finally the distance between the palm contact portion 34 and the slide handle 200 can be changed. In addition, in the present embodiment, the position of the palm contact portion 34 can be fixed by tightening the stop screw 37 at the stage of setting the distance.

[0053] As described above, since the distance between the palm contact portion 34 and the slide handle 200 can be changed, the user can adjust the state of easy grip according to the shape and size of the palm of the user, thereby achieving a more precise technique.

[0054] The palm contact portion 34 may be in the shape of an egg made into a hemispherical shape, or in the shape of a hemispherical shape obtained by dividing a sphere, or in the shape of a roughly plate-like shape such as the first to third bases of a baseball. When the palm contact portion 34 is in the shape of an egg made into a hemispherical shape (not shown), a stay 35 may be provided protruding from the back side of the protruding portion protruding toward the rear end. In this case, by rotating and fixing the stay 35 at an appropriate angle in the stay hole 36a, the size of the palm contact surface 34a portion in the palm area of ​​the user can be changed. In this way, the surgical instrument 1 can be more accurately grasped according to the shape and size of the user's palm.

[0055] (6) Sliding handle 200

[0056] The sliding handle 200 is a part for the user to operate the rotation and opening and closing of the front end of the treatment unit 10. The sliding handle 200 is installed on the outer peripheral surface 100a of the rod-shaped body 100. The sliding handle 200 can be installed in a manner that does not contact the outer peripheral surface 100a of the rod-shaped body 100, or it can be arranged in a radially outer side of the outer peripheral surface 100a in a slightly floating state without contacting the outer peripheral surface 100a. Such a form is also included in the category of "installation". The sliding handle 200 can be a structure that wraps the outer peripheral surface 100a of the rod-shaped body 100 about half a circle (embodiment), or it can be a structure that only covers a part like a commercially available sliding switch, or it can be a structure that is wrapped around approximately the entire circle / or completely the entire circle. In the case of being wrapped around approximately the entire circle / or completely the entire circle, it is a surgical instrument that can achieve that it is not easy to fall off from the sliding handle 200 even if the finger is rotated at a large angle.

[0057] The sliding handle 200 can slide forward and backward along the length direction line LL relative to the rod-shaped body 100 (here, the part excluding the push rod 110 (described later)) and rotate around the length direction line LL through the structure of the first connecting part 101, the second connecting part 102, etc. described later.

[0058] The rotation center axis of the slide handle 200 is coaxial with the center axis of the rod-shaped body 100 (at least a portion of the rod-shaped body 100 near the slide handle 200). The direction in which the slide handle 200 moves forward and backward is the same as the direction of the longitudinal line LL.

[0059] The slide handle 200 is operated by the user's thumb 81 and index finger 82 (refer to the following description) Figure 7 (b) Specifically, the sliding handle 200 is a part that is pinched by the belly of the thumb 81 and the belly of the index finger 82 and operated by the two fingers, but it also includes a usage method in which either the thumb 81 or the index finger 82 is mainly used for operation and the other is only used to rely on the handle. In addition, depending on the user, the usage method of only touching any one finger to operate is also included.

[0060] The surface of the slide handle 200 is provided with a wavy concave-convex portion for anti-slip. In addition, it is preferred to provide a position mark 205 on the surface 200a of the slide handle 200. The position mark 205 may be any structure as long as it can serve as a mark of the position and posture when the user touches it. In the embodiment, the position mark 205 protrudes in a manner that is one level higher than the wavy concave-convex portion (see the following description). Figure 3 ). However, it is not limited thereto, and on the contrary, it can also be composed of a recessed portion, or a hole, etc.

[0061] By providing the position mark 205 on the slide handle 200, the user can use the position mark 205 as a reference to operate while recognizing the relative position relationship of the slide handle, etc., thereby operating more accurately.

[0062] The surgical instrument 1 according to the first embodiment includes: a treatment unit 10, a rod-shaped body 100, a fixed cylinder 20, and a gripping portion 30, and further includes a sliding handle 200 installed on the outer peripheral surface 100a of the rod-shaped body 100, which is slidable along the longitudinal line LL relative to the rod-shaped body 100 and rotated around the longitudinal line LL. In the surgical instrument 1, the pair of treatment pieces 11 and 12 of the treatment unit 10 are opened and closed by moving the sliding handle 200 forward and backward along the longitudinal line LL, and the treatment unit 10 is rotated around the longitudinal line LL by rotating the sliding handle 200 around the longitudinal line LL. In this embodiment, when the sliding handle 200 is moved forward in the direction of the thick arrow F, the pair of treatment pieces 11 and 12 are opened in the direction of the thick arrow O in conjunction with it, and when the sliding handle 200 is moved back in the direction of the thick arrow B, the pair of treatment pieces 11 and 12 are closed in the direction of the thick arrow C in conjunction with it. In addition, when the sliding handle 200 is rotated in the R direction, the treatment unit 10 as a whole is rotated in the direction of the thick arrow R in conjunction with it, and when the sliding handle 200 is rotated in the L direction, the treatment unit 10 as a whole is rotated in the direction of the thick arrow L in conjunction with it (refer to Figure 1 ).

[0063] The following description will continue with a focus on the implementation of the above-mentioned specific structure.

[0064] (7) First connecting portion 101

[0065] As described above, the rod-shaped body 100 includes the push rod 110 to which the treatment unit 10 is connected at the front end. The "push rod 110" has a function of not only pushing the plate 120 (described later) toward the front end but also pulling it toward the rear end.

[0066] The surgical instrument 1 includes a first connection portion 101 . The first connection portion 101 connects the slide handle 200 and the push rod 110 , and converts the forward and backward movement of the slide handle 200 into the forward and backward movement of the push rod 110 .

[0067] Figure 3 1 is a diagram for explaining the main parts of the structure related to the first connecting portion 101 of the first embodiment. Figure 3 (a) is an exploded view of the main parts when a part of the surgical instrument 1 is viewed from obliquely below. The figure shows a state where the slide handle 200 is removed from the cylinder 140, and the screw 194 for fixing the slide handle 200 is omitted from the figure. Figure 3 (b) is related to Figure 3(a) is a cross-sectional view of the push rod 110 corresponding to the area surrounded by the dotted line a.

[0068] like Figure 3 As shown, the slide handle 200 is in the shape of a semi-cylindrical cylinder roughly cut in half along the axial direction, and a claw 210 is provided inside the semi-cylindrical cylinder. The claw 210 protrudes from the edge position of the front end side of the slide handle 200 in the direction of the rotation axis (the length direction line LL in the installed state) when the slide handle 200 is rotated. The front end 212 of the claw 210 is in the shape of an arc in accordance with the peripheral shape of the guide groove 105 (described later), and when the slide handle 200 is rotated, the front end 212 slides while being guided along the periphery of the guide groove 105 (described later).

[0069] The position where the thrust direction (the direction along the longitudinal line LL) of the claw 210 is provided is not limited to the edge on the front end side, and may be arranged at a middle position between the front end side and the rear end side of the slide handle 200 .

[0070] On the other hand, inside the rod-shaped body 100, the push rod 110 is accommodated in the internal space of the hollow tube 130, the cylinder 140 and other components. Figure 3 In (a), the push rod 110 can be slightly visually seen through the slit 142 of the barrel 140. Figure 3 As shown in the cross-sectional view of FIG. 1 (b), a guide groove 105 is formed on the rear end side of the push rod 110 (see also FIG. Figure 2 The guide groove 105 of the push rod is formed along the circumferential direction by a groove with a smaller diameter than other parts, and the front end portion 212 of the claw 210 of the sliding handle falls into the guide groove 105 and engages with the guide groove 105 .

[0071] The cylinder 140 is provided with a slit 142. When the slide handle 200 is assembled to the push rod 110 through the slit 142, the front end 212 of the claw 210 of the slide handle is engaged with and connected to the guide groove 105 of the push rod 110. In this state, when the slide handle 200 is moved forward and backward along the thrust direction, the front end 212 of the claw 210 pushes the inner walls 105a and 105b of the guide groove 105 (see FIG. Figure 3 (b)), thereby, the push rod 110 as a whole also moves forward and backward along the thrust direction.

[0072] As described above, it can be understood that the first connection portion 101 is constituted by the front end portion 212 of the claw 210 of the slide handle and the guide groove 105 of the push rod 110 .

[0073] (8) Second connecting portion 102

[0074] Figure 4 1 is a diagram for explaining the structure of the second connecting portion 102 according to the first embodiment. Figure 4(a) is a cross-sectional view for explaining the fixing portion 107 of the rod-shaped body 100 that fixes the opening and closing shaft 19. Figure 4 (b) Yes Figure 4 (a) BB cross-sectional view. Figure 5 1 is a perspective view of the main parts for explaining the structure related to the second connecting portion 102 according to the first embodiment. Figure 5 In the figure, the end side of the rod-shaped body 100 that is closer to the middle part, the fixed cylinder 20, the gripping part 30 and the like are omitted. The figure also shows the state after the hollow member 150 and the sliding handle 200 are removed from the cylinder 140.

[0075] like Figure 4 and Figure 5 As shown, the surgical instrument 1 includes a second connecting portion 102 (reference numeral 102). Figure 5 ).

[0076] The second coupling portion 102 couples the slide handle 200 to “the fixing portion 107 of the rod-shaped body 100 for fixing the opening and closing axis 19 of the treatment unit 10 ” and converts the rotation of the slide handle 200 into the rotation of the treatment unit 10 .

[0077] The fixing portion 107 of the rod-shaped body 100 for fixing the opening and closing axis 19 of the treatment unit 10 may be composed of any member as long as it can fix the opening and closing axis 19. Figure 4 As shown in (a), the "fixing portion 107 of the rod-shaped body 100 for fixing the opening and closing axis 19" is composed of: a treatment unit base 135 supporting the opening and closing axis 19 from the front end side, a hollow tube 130 connected to the treatment unit base 135 at the front end, and a tube 140 in which the hollow tube 130 is embedded inside and connected to the hollow tube 130 by a screw 192.

[0078] like Figure 5 As shown, a snap-fitting convex strip portion 230 is provided on the inner side of the sliding handle 200, which protrudes from the inner wall toward the central axis of rotation and is in the shape of a long strip. An inner groove 230a is also provided near the center of the snap-fitting convex strip portion 230. On the other hand, a snap-fitting groove 154 is provided on the outer side of the hollow member 150. An inner protrusion 154a having the shape of the inner groove 230a is also provided near the center of the snap-fitting groove 154. Therefore, when the surgical instrument 1 is assembled, the snap-fitting convex strip portion 230 of the sliding handle 200 passes over the slit 142 of the cylinder 140 and snaps into the snap-fitting groove 154 of the hollow member 150 (see also Figure 4 (b)).

[0079] In addition, the sliding handle 200 is secured by screws 194 (in Figure 5 The outer surface of the hollow member 150 is fixedly secured to the threaded hole 156 of the hollow member 150 via the slit 142 of the cylinder 140 (not shown).

[0080] According to the above structure, the sliding handle 200 will not fall off from the rod-shaped body 100.

[0081] For reference, since the claw 210 of the slide handle passes through a portion of the cutout 152 of the hollow member 150 , it does not interfere with the hollow member 150 .

[0082] Due to the above structure, when the sliding handle 200 is rotated, the side surface 230b of the engaging convex strip portion 230 of the sliding handle 200 abuts against the inner wall 142a of the slit 142 of the tube 140, and the tube 140 as a whole is rotated in a manner of pressing the inner wall 142a (see Figure 4 (b) and Figure 5 As described above, the cylinder 140 constitutes a part of the "fixing portion 107 of the rod-shaped body 100 for fixing the opening and closing shaft 19", and is indirectly connected to the opening and closing shaft 19 to form a whole. Therefore, by rotating the cylinder 140, the opening and closing shaft 19 rotates, and further rotates the treatment unit 10 whose front end is opened and closed around the opening and closing shaft 19.

[0083] As can be seen from the above, the second connection portion 102 is formed by the engaging protruding strip 230 (more specifically, the side surface 230 b ) of the slide handle and the slit 142 (more specifically, the inner wall 142 a of the slit).

[0084] (9) Open / Close Conversion Unit 103

[0085] The surgical instrument 1 includes an opening / closing conversion unit 103 . The opening / closing conversion unit 103 is used to convert the forward and backward movement of the push rod 110 into the opening and closing of the treatment unit 10 .

[0086] Figure 6 1 is a structural diagram of the switching converter 103 of the first embodiment. Figure 6 (a) is an exploded view of the opening and closing conversion unit 103, Figure 6 (b) is a plan view of the opening and closing switching section 103 when the treatment unit 10 is opened. Figure 6 (c) is a plan view showing the treatment unit 10 when it is closed.

[0087] like Figure 6 As shown in (a), the treatment unit 10 is composed of a pair of treatment sheets consisting of a treatment sheet 11 and a treatment sheet 12.

[0088] Each of the treatment sheets 11 and 12 is formed with an axial hole 11c and 12c, respectively. Each of the treatment sheets 11 and 12 has a treatment portion 11a and 12a at the front end side of the axial hole 11c and 12c, and an operation portion 11b and 12b at the rear end side of the axial hole 11c and 12c, respectively. The pair of treatment sheets 11 and 12 are combined by an opening and closing axis 19 that is commonly embedded in the axial holes 11c and 12c of the respective treatment sheets 11 and 12. In the first embodiment, the opening and closing axis 19 is composed of a pin 18 and a pin cap 18a.

[0089] In addition, each of the operation portions 11b and 12b is formed with a predetermined angle θ1 or θ2 (see FIG. 1 ) with respect to the longitudinal line LL when the treatment unit 10 is in the closed state. Figure 6 The cam grooves 11d and 12d of (c) are preferably provided at angles θ1 and θ2 defined here, respectively, in the range of about 1° to 5°. For example, the range of 2° to 3° is more preferred.

[0090] On the other hand, a flat plate 120 is disposed at the front end of the push rod 110. The flat plate 120 is provided with an upper convex portion 123 on a first surface 121, and a lower convex portion 124 on a second surface 122 opposite to the first surface 121. When viewed from above, the upper convex portion 123 and the lower convex portion 124 are disposed at the same position. However, the present invention is not limited to this form.

[0091] As described above, the upper convex portion 123 engages with the cam groove 11 d of one treatment piece 11 , and the lower convex portion 124 engages with the cam groove 12 d of the other treatment piece 12 .

[0092] In such a structure, Figure 6 As shown in (b), when the push rod 110 is advanced, the upper convex portion 123 and the lower convex portion 124 of the plate 120 are located at the intersection of the cam grooves 11d and 12d having a predetermined angle, that is, at the front end side of the cam grooves 11d and 12d. At this time, the front end side of the operating parts 11b and 12b is opened with the opening and closing shaft 19 as the center.

[0093] Then, if Figure 6 As shown in (c), when the push rod 110 is moved backward, the upper convex part 123 and the lower convex part 124 are located at the intersection of the cam grooves 11d and 12d having a predetermined angle, that is, at the rear end side of the cam grooves 11d and 12d. At this time, the front end side of the operating parts 11b and 12b is closed with the opening and closing axis 19 as the center. In terms of dynamic description, by moving the slide handle 200 backward, the positions of the upper convex part 123 and the lower convex part 124 move along the cam grooves 11d and 12d, and accordingly, the front ends of the treatment parts 11a and 12a are transferred from the open state to the closed state.

[0094] Based on the above, it can be seen that the opening and closing conversion part 103 is composed of the flat plate 120, the upper protrusion 123 and the lower protrusion 124 formed on the flat plate 120, the cam grooves 11d and 12d engaged with these protrusions, and a pair of handling pieces with cam grooves 11d and 12d of the operating part.

[0095] Since the surgical instrument 1 adopts the structure as described above, the pair of treatment plates 11 and 12 of the treatment unit 10 are opened and closed by moving the sliding handle 200 forward and backward along the longitudinal direction line LL, and the treatment unit 10 is rotated around the longitudinal direction line LL by rotating the sliding handle 200 around the longitudinal direction line LL.

[0096] In the first embodiment, since the predetermined angles θ1, θ2 and lengths of the cam grooves 11d, 12d are appropriately set, when the operation parts 11b, 12b and the plate 120 of the treatment unit 10 are observed in a plane cut perpendicular to the longitudinal direction line LL, Figure 6 (b) indicates the width W1old and is provided inside the outer diameter OD of the hollow tube 130 for accommodating the push rod 110 .

[0097] In the first embodiment, a hole (not shown) centered on the longitudinal line LL may be provided at the rear end of the fixed cylinder 20 and communicated with the hole 22 opened toward the front end. By adopting this structure, the internal cleaning can be easily performed as described in Patent Document 1.

[0098] 2. Usage examples and effects of the surgical instrument 1 according to the first embodiment

[0099] The first embodiment relates to a surgical instrument 1 suitable for use in surgical operations, such as brain surgery.

[0100] (1) Example of use of surgical instrument 1

[0101] Figure 7 It is a perspective view for explaining a usage example of the surgical instrument 1 according to the first embodiment.

[0102] in, Figure 7 (a) is a diagram showing the first step of starting to hold the surgical instrument 1. Figure 7 (b) is a diagram showing the second step of moving the sliding handle 200 forward and backward and rotating. Figure 7 2 shows an example in which the surgical instrument 1 is held by the right hand, but the relationship is opposite when it is held by the left hand.

[0103] First, if Figure 7As shown in (a), the palm contact portion 34 disposed on the rear end side of the surgical instrument 1 is brought into contact with the user's right palm 86. On this basis, the middle finger 83 is placed on the finger hook portion 32 (finger hook surface 32a). For example, when the palm contact surface 34a is brought into contact with the vicinity of the center of the palm between the fingertip ball 88 and the thumb ball 87, the palm contact surface 34 is sandwiched by the fingertip ball 88 and the thumb ball 87, so that the surgical instrument 1 can be stably grasped (first step).

[0104] Next, the user's thumb 81 and index finger 82 are brought into contact with the slide handle 200, and the slide handle 200 is grasped in a manner of being sandwiched between the thumb 81 and index finger 82. At this time, it is preferred that the thumb 81 and / or index finger 82 also contact the position mark 205 (not shown) so that the positional relationship after grasping can be understood.

[0105] On this basis, the front end of the treatment unit 10 is opened and closed by moving the slide handle 200 forward and backward along the longitudinal line LL using the thumb 81 and the index finger 82, or the entire treatment unit 10 is rotated by rotating the slide handle 200 around the longitudinal line LL. In this way, the user (doctor) can perform the desired technique through the treatment unit 10 on the front end side by operating only with the thumb 81 and the index finger 82.

[0106] (2) Effect of surgical instrument 1

[0107] (2-1) As mentioned above, the middle finger 83 is not suitable for precise operation. In order to open and close the treatment unit using the existing surgical instrument 9, the middle finger 83 will involuntarily exert force when performing precise operation, causing the palm 86 and wrist 89, which are the basis of the operation, to shake. In particular, when using a long surgical instrument with a large rod-shaped body, the shaking of the hand will be magnified at the front end of the treatment unit, thereby damaging the delicate operation technique.

[0108] The structure of the surgical instrument 1 according to the first embodiment is as follows: the sliding handle 200 is mounted on the outer peripheral surface 100a of the rod-shaped body 100, and the sliding handle 200 slides forward and backward along the longitudinal direction line LL relative to the rod-shaped body 100, and can rotate around the longitudinal direction line LL. In addition, by moving the sliding handle 200 forward and backward along the longitudinal direction line LL, the pair of treatment pieces 11 and 12 of the treatment unit 10 are opened and closed, and by rotating the sliding handle 200 around the longitudinal direction line LL, the treatment unit 10 rotates around the longitudinal direction line LL.

[0109] Therefore, if Figure 7As shown in (b), the user pinches the sliding handle 200 by the thumb 81 and the index finger 82, and by rotating the thumb 81 and the index finger 82, not only can the treatment unit 10 be rotated, but also the treatment unit 10 can be opened and closed by moving the thumb 81 and the index finger 82 forward and backward.

[0110] That is, since the treatment unit 10 can be opened and closed without using the middle finger 83 , there is no shaking of the palm 86 and the wrist 89 due to the movement of the middle finger 83 .

[0111] For reference, the thumb 81 and the index finger 82 can perform precise movements without exerting force compared to the middle finger 83 due to the formation structure of muscles (tendons). The surgical instrument 1 according to the first embodiment can open and close / rotate the treatment unit 10 only by the thumb 81 and the index finger 82 that can perform precise movements without exerting force, so the user can accurately and finely operate the treatment unit 10 by operating the slide handle 200.

[0112] As described above, according to the surgical instrument 1 of the first embodiment, even if the treatment unit 10 is located relatively far from the hand, the object can be accurately and precisely gripped, pinched, and rotated. Compared with the conventional surgical instruments, it can perform fine techniques (surgery) more accurately.

[0113] (2-2) In the surgical instrument 1 according to the first embodiment, the finger hook portion 32 is arranged as the grip portion 30 at a position offset from the longitudinal direction line LL in the radial direction of the rod-shaped body 100, and the finger hook portion 34 is arranged on the rear end side when viewed from the finger hook portion 32. With this structure, the user (doctor) can place the palm 86 on the palm contact portion 34 and the middle finger 83 on the finger hook portion 32, thereby stably holding the surgical instrument 1. By stably holding the surgical instrument 1, the operation can be performed with less shaking.

[0114] (2-3) It is also easy to perform very delicate techniques such as holding the anastomosis needle and inserting the needle into the object to be sutured along the curve of the anastomosis needle. In addition, according to the surgical instrument 1, since the user's operating object is reduced to only the sliding handle 200, it is also easy to open and close and rotate the treatment unit 10 at the same time, for example, it is also easy to close / open the front end of the treatment unit 10 while twisting it.

[0115] In addition, in the conventional surgical instrument 9, the degree of opening and closing is determined by the angle of the trigger, and it is generally difficult to control the angle of the trigger. In contrast, in the surgical instrument 1 according to the first embodiment, since the degree of opening and closing of the treatment unit 10 is determined by the position on one axis (long side direction line), it is easy to make fine adjustments to the opening and closing, and the feeling of clamping the object is more intuitive and easy to understand.

[0116] (2-4) In the conventional surgical instrument 9, in order to accommodate the leaf spring, etc., it is necessary to ensure that the outer diameter of the rod-shaped body 100 (hollow tube 130, etc.) corresponds to the leaf spring. On the other hand, the surgical instrument 1 according to the first embodiment has an opening and closing conversion portion 103 that allows the convex portion to engage with the cam grooves 11d and 12d, and the operating portions 11b and 12b of the treatment unit 10 and the flat plate 120 are arranged on the inner side of the outer diameter of the hollow tube 130 for accommodating the push rod 110 (see Figure 6 (b)).

[0117] Therefore, the surgical instrument 1 according to the first embodiment can be easily designed to have a thinner outer diameter of the rod-shaped body 100 than the conventional surgical instrument 9. Fig. 9 In the neurosurgery shown in the figure, when the front end of the treatment unit 10 is observed with a microscope 900, the rod-shaped body 100 is difficult to prevent from obstructing the field of vision. That is, it is a structure that makes it easy to secure the surgical area even in a narrow and deep area.

[0118] (2-5) The front end of the treatment unit 10 is located radially away from the longitudinal line LL. For example, the front end of the treatment sheets 11 and 12 is curved so as to be away from the longitudinal line LL as it moves toward the front end of the treatment sheets 11 and 12. Fig. 9 In the case of a neurosurgery or the like, even when the user (doctor) observes from a shallow angle relative to the longitudinal direction line LL of the surgical instrument 1 (rod-shaped body 100), it is easy to include the narrow and deep portion located at the front end side in the field of vision. Therefore, the surgery can be performed more accurately.

[0119] [Implementation Method 2]

[0120] Figure 8 2 is a perspective view of a surgical instrument 2 according to Embodiment 2. The same components as those in Embodiment 1 in terms of basic structure and features are denoted by the same reference numerals as those in Embodiment 1, and description thereof is omitted.

[0121] The surgical instrument 2 according to the second embodiment basically has the same structure as the surgical instrument 1 according to the first embodiment, but is different from the surgical instrument 1 according to the first embodiment in the structure of the grip portion. That is, the grip portion 30' of the surgical instrument 2 is provided with a palm contact portion 34' at the rear end side of the fixed cylinder portion 20', and does not have a finger hook portion 32 like the grip portion 30 according to the first embodiment (see FIG. Figure 8 In addition, the palm contact portion 34' may be directly connected to the fixed cylinder portion 20', or may be connected to the fixed cylinder portion 20' via a stay similar to the palm contact portion 34 of the first embodiment.

[0122] Of course, in the surgical instrument 2, similarly to the surgical instrument 1 according to the first embodiment, the treatment unit 10 is rotated by rotating the slide handle 200, and the front end (a pair of treatment pieces 11, 12) of the treatment unit 10 is opened and closed by moving the slide handle 200 forward and backward.

[0123] Since the surgical instrument 2 according to the second embodiment has substantially the same structure as the surgical instrument 1 according to the first embodiment except for the structure of the gripping portion, the surgical instrument 2 also has the same effects as the surgical instrument 1 according to the first embodiment.

[0124] As mentioned above, although the present invention has been described based on the above-mentioned embodiments, the present invention is not limited to the above-mentioned embodiments, and can be implemented in various forms within the scope of the concept, and for example, the following modifications are also possible.

[0125] (1) In the above embodiment, although the front end side of the treatment sheet 11, 12 is bent as an example, the present invention is not limited to this. For example, the treatment sheet 11, 12 may also be a so-called straight-line treatment sheet extending along the length direction line LL on the entire treatment portion 11a, 12a. In this case, since the front end of the treatment sheet 11, 12 is located on the same axis as the axis of the operating slide handle 200, it can be easily aligned with the part to be treated, for example.

[0126] (2) In the above-mentioned embodiments, the opening and closing conversion part 103 adopts the cam groove and the convex part, but the present invention is not limited to this. For example, the opening and closing conversion part 103 may be formed by making the push rod contact the joint of the operation part of a pair of treatment pieces and then applying the restoring force from the outside of the operation part by a leaf spring, as in the conventional surgical instrument 9 (the needle holder described in Patent Document 1).

[0127] (3) In the above-mentioned embodiments, although the opening and closing degree of the treatment unit 10 is maintained in this state when the forward and backward movement of the sliding handle 200 is stopped, that is, a surgical instrument capable of full manual operation is described as an example, the present invention is not limited to this, and a surgical instrument capable of semi-manual and semi-automatic operation may also be used. For example, a predetermined spring (such as a coil spring, etc.) that engages the push rod 110 may be arranged inside the hollow tube 130. Under the elastic force of the spring, when the user releases the finger from the sliding handle 200, the push rod 110, the sliding handle 200, the plate 120, etc. automatically advance to the front end, and the front end of the treatment unit 10 is automatically closed. On the contrary, the push rod 110, etc. may similarly automatically retreat to the rear end side, and the front end of the treatment unit 10 is automatically opened.

[0128]

Explanation of symbols

[0129] 1, 2, 9…surgical instrument; 10…treatment unit; 11, 12…treatment sheet; 11a, 12a…treatment portion; 11b, 12b…operation portion; 11c, 12c…axial hole; 11d, 12d…cam groove; 18…pin; 18a…pin cap; 19…opening and closing axis; 20, 20'…fixed cylinder; 22…(fixed cylinder) hole; 24…(fixed cylinder) guide groove; 30, 30'…grip portion; 32…finger buckle portion; 32a…finger buckle surface; 34, 34' ...palm contact portion; 34a...palm contact surface; 35...stay; 36...middle portion of grip portion; 36a...stay hole; 37...fastening screw; 81...thumb; 82...index finger; 83...middle finger; 86...palm; 87...thumb ball; 88...fingertip ball; 89...wrist; 100...rod-shaped body; 100a...outer peripheral surface (of rod-shaped body); 101...first connecting portion; 102...second connecting portion; 103...opening and closing conversion portion; 105...guide groove (formed on push rod); 105a, 105b ...inner wall (of the guide groove); 107 ...fixing portion of the rod-shaped body for fixing the opening and closing axis; 110 ...push rod; 120 ...flat plate; 121 ...first surface; 122 ...second surface; 123 ...upper convex portion; 124 ...lower convex portion; 130 ...hollow tube; 135 ...disposal unit base; 140 ...barrel; 142 ...slit (of the barrel); 142a ...inner wall (of the slit); 144 ...flange (of the barrel); 150 ...hollow member; 152 ...incision (of the hollow member); 152a ...incision) Inner wall; 154… (engaging groove of hollow member); 154a… inner protrusion, 156… threaded hole of hollow member; 192, 194… screws; 200… sliding handle; 200a… surface of sliding handle; 205… position mark; 210… claw; 212… front end (of claw); 213… side (of claw); 230… engaging ridge; 230a… inner groove; 230b… side (of engaging ridge); 254… engaging groove; 900… microscope; 910… objective lens.

Claims

1. A surgical instrument, comprising: The treatment unit is composed of a pair of treatment pieces whose front ends can be opened and closed; a rod-shaped rod-shaped body, to which the treatment unit is connected at the front end side and extends along the length direction line; a cylindrical fixed barrel portion, which has a hole opened at the front end side, and the rear end side of the rod-shaped body is rotatably engaged with the inner wall of the hole with the length direction line as the center; and a grip portion, which is a part gripped by a user and is integrally configured with the fixed barrel portion, characterized in that: further comprising a sliding handle mounted on the outer peripheral surface of the rod-shaped body, The sliding handle can slide back and forth along the length direction line relative to the rod-shaped body and can rotate around the length direction line. The pair of treatment pieces of the treatment unit are opened and closed by moving the slide handle forward and backward along the longitudinal direction line, and the treatment unit is rotated around the longitudinal direction line by rotating the slide handle around the longitudinal direction line. The sliding handle is operated by the user's thumb and index finger. The holding portion is formed to protrude from the longitudinal direction line in the radial direction of the rod-shaped body. The holding portion has: a finger buckle portion, the finger buckle portion comprising a finger buckle surface for buckling a user's finger, wherein a tangent line of the finger buckle surface is set in a direction intersecting the longitudinal direction line, and the finger buckle portion is arranged at a position offset from the longitudinal direction line toward the radial direction; and The palm contact portion is disposed on the rear end side when viewed from the finger latch portion, and the finger latch portion is a portion where at least the middle finger of the user latches.

2. The surgical instrument according to claim 1, Features: The rod-shaped body includes a push rod, and the treatment unit is engaged at the front end of the push rod. The surgical instrument comprises: A first connecting portion, used to connect the sliding handle and the push rod, and convert the forward and backward movement of the sliding handle into the forward and backward movement of the push rod; A second connecting portion for connecting the slide handle and "the fixing portion of the rod-shaped body for fixing the opening and closing axis of the treatment unit" and converting the rotation of the slide handle into the rotation of the treatment unit; and The opening and closing conversion part is used to convert the forward and backward movement of the push rod into the opening and closing of the treatment unit.

3. The surgical instrument according to claim 2, characterized in that: in, An axial hole is formed on each treatment piece, and each treatment piece has a treatment portion closer to the front end side than the axial hole and an operating portion closer to the rear end side than the axial hole. The pair of treatment pieces are connected by the opening and closing shafts that are commonly inserted into the axial holes of each treatment piece. A cam groove having a predetermined angle relative to the longitudinal direction line when the treatment unit is closed is formed on each of the operation parts. A flat plate is provided at the front end of the push rod, an upper convex portion is provided on a first surface of the flat plate, and a lower convex portion is provided on a second surface which is opposite to the first surface. The upper convex portion is engaged with the cam groove of one of the disposal pieces, and the lower convex portion is engaged with the cam groove of the other disposal piece. When viewed in a cross section perpendicular to the longitudinal direction line, the operation portion and the plate of the treatment unit are housed inside an outer diameter of the hollow tube for housing the plunger.

4. The surgical instrument according to any one of claims 1 to 3, characterized in that: in, Position marks are provided on the surface of the sliding handle.

5. The surgical instrument according to any one of claims 1 to 3, characterized in that: in, The distance between the palm contact portion and the sliding handle can be changed.

6. The surgical instrument according to any one of claims 1 to 3, characterized in that: in, The front end of the treatment unit is located away from the longitudinal direction line in the radial direction.

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