Lacrimal sac incision

Abstract

A dacryocystorhinostomy knife (1) is used to insert into a patient's nasal cavity and cut open the dacryocystorhinostomy sac located inside the nasal cavity. The dacryocystorhinostomy knife (1) is configured such that a puncture blade (60) forms a puncture portion of the dacryocystorhinostomy sac, a first side blade (61) forms a first incision portion of the dacryocystorhinostomy sac, a second side blade (62) forms a second incision portion of the dacryocystorhinostomy sac, the blade (6) has a length dimension of approximately 4.0 mm to approximately 7.0 mm and a maximum width dimension of approximately 1.4 mm to approximately 2.0 mm, the puncture blade (60) has a cutting edge dimension of approximately 1.2 mm and a maximum width dimension of approximately 1.2 mm to approximately 1.5 mm, and the first side blade (61) and the second side blade (62) each have a cutting edge dimension of approximately 3.0 mm to approximately 5.0 mm.

Description

Technical Field

[0001] This invention relates to a rational structural technology for a lacrimal sac incision knife. Background Technology

[0002] As an example of surgical instruments for the head and neck, there are known structures for nasal scalpels that are inserted into the nasal cavity of a patient (e.g., Patent Document 1: WO2018 / 070409).

[0003] In this known nasal scalpel, as a structure useful for improving the operability of nasal surgery and avoiding interference between the nasal scalpel and instruments such as endoscopes used simultaneously, the following structure is adopted: a rod having a straight part and a curved part are connected to the handle part, and a blade is formed on the top side of the curved part.

[0004] In addition, among surgical procedures that involve inserting a scalpel into the patient's nasal cavity, there are procedures that are located in the border area between ophthalmology and otolaryngology, such as surgical treatment for nasolacrimal duct obstruction, in which a scalpel (and endoscope) is inserted through the nasal cavity via a bone window to approach the lacrimal sac, and then the lacrimal sac is cut open (dacryocystorhinostomy, hereinafter also referred to as "DCR method (especially called DCR intranasal method)).

[0005] In such cases, even if the surgical instruments of the aforementioned known nasal scalpels are well-suited for routine nasal surgeries, which are relatively wide surgical sites, they may not be suitable for ophthalmic surgeries, which are relatively narrow surgical sites.

[0006] That is, in cases where surgical approaches to ophthalmic diseases are attempted through the nasal cavity, such as the aforementioned DCR method, there is a need for further in-depth innovative ideas that differ from known nasal scalpels and are related to improving the operator's operability.

[0007] Existing technical documents

[0008] Patent documents

[0009] Patent Document 1: WO2018 / 070409 Summary of the Invention

[0010] The problem the invention aims to solve

[0011] The present invention was made in view of this, and its object is to provide a dacryocystorhinostomy knife structure that can further improve the operator's operability, especially when performing dacryocystorhinostomy using the intranasal approach.

[0012] Solution for solving the problem

[0013] The above problems are solved by the present invention.

[0014] In this invention, a dacryocystorhinostomy knife is constructed for insertion into a patient's nasal cavity and cutting open the lacrimal sac located on the inner side of the nasal cavity. The dacryocystorhinostomy knife has: a handle configured as an elongated body extending in a predetermined longitudinal direction, for the operator to hold; and a rod connected to the handle, which extends linearly throughout in the longitudinal direction. In this invention, by making the dacryocystorhinostomy knife extend linearly throughout in the longitudinal direction, reliable access to the lacrimal sac, which is an ophthalmic region, can be ensured. In particular, the rod extending linearly throughout in the longitudinal direction effectively reduces the risk of unexpected injury when entering the nasal cavity.

[0015] Furthermore, "extending in the longitudinal direction" appropriately includes forms that extend in a direction having a longitudinal component and slightly intersecting the longitudinal direction, or forms that include slight bends, steps, etc., and extend in a generally longitudinal direction. Similarly, "straight-lined" appropriately includes forms that extend in a direction slightly intersecting the longitudinal direction, or forms that include slight bends, steps, etc., and extend in a generally straight-lined manner. Additionally, "generally" also includes forms that generally, in their entirety, include regions intersecting the longitudinal direction or non-straight-lined regions in their parts.

[0016] The rod portion has: a base extending in the longitudinal direction; and a cutting edge extending in the longitudinal direction, wherein the cutting edge is connected to the base portion at its apex in the longitudinal direction.

[0017] Similarly, the base and the blade are designed to extend in the longitudinal direction, thereby reliably ensuring the operator's operability and minimizing the patient's risk of injury as the procedure proceeds through the nasal cavity to the lacrimal sac.

[0018] The cutting edge has: a piercing blade formed at the top end of the longitudinal direction; and a first side blade and a second side blade, which are a pair of double-edged structures formed on both sides of a width direction defined as intersecting the longitudinal direction, the first side blade and the second side blade being connected to the piercing blade respectively.

[0019] "A pair" refers to a structure in which the first and second side blades are symmetrically shaped.

[0020] On the other hand, the puncture blade constitutes a lacrimal sac puncture section, which can puncture the lacrimal sac while the holding section is held by the surgeon. Typically, the puncture is performed by moving the lacrimal sac incision blade in the longitudinal direction. "Moving in the longitudinal direction" as used here broadly includes moving the lacrimal sac incision blade approximately in the longitudinal direction, and appropriately also includes moving it in a slightly inclined direction that includes the longitudinal component. Especially in surgical procedures approaching the lacrimal sac from the nasal cavity, surgical configurations where the lacrimal sac incision blade does not approach the lacrimal sac orthogonally are more common. Accordingly, the puncture blade of the present invention is preferably configured to be suitable for puncturing in an orthogonal or inclined manner relative to the lacrimal sac, and is widely applicable to various operation configurations such as moving the blade in the direction of the lacrimal sac surface to cut, or a composite operation configuration where it is inserted and cut while simultaneously being orthogonal or inclined. Furthermore, this does not preclude surgical procedures that involve using a puncture blade and performing only a simple incision (without puncture).

[0021] Furthermore, typically, the puncture blades are preferably configured as a pair of symmetrical structures, and are connected to the first and second side blades respectively. Additionally, by appropriately setting the angle between the puncture blades and the connection angles between the puncture blades and the first and second side blades, it is possible to form a pair of puncture blades and a pair of side blades (i.e., the first and second side blades) with blades facing different directions. Therefore, when cutting the lacrimal sac, the most suitable blade can be selected according to the complex shape of the lacrimal sac, improving the usability of the lacrimal sac incision knife.

[0022] One of the first and second side blades constitutes a first incision portion of the lacrimal sac. By moving the lacrimal sac incision blade to one side in the width direction, the first incision portion cuts the lacrimal sac along one side of its longitudinal extension. At this time, it is possible to suitably include both a form in which the lacrimal sac is cut using one of the first and second side blades without using the puncture blade, and a form in which the lacrimal sac is slightly punctured using the puncture blade (or the connection area with the puncture blade) while cutting using one of the first and second side blades.

[0023] Furthermore, the other of the first and second side blades constitutes a second incision section of the lacrimal sac. By moving the lacrimal sac incision blade to the opposite side in the width direction while maintaining the gripping part held by the surgeon, this second incision section cuts the lacrimal sac to the opposite side in the longitudinal extension direction of the lacrimal sac. In this case, it is appropriate to include both configurations where puncture blades are used simultaneously and configurations where puncture blades are not used simultaneously.

[0024] Typically, "one side" and "the other side" of the longitudinal extension of the lacrimal sac refer to the two directions that are 180 degrees apart, but can also include directions that intersect at angles other than 180 degrees.

[0025] Furthermore, for example, there are surgical methods that involve making multiple incisions that intersect the longitudinal extension of the lacrimal sac and separating the incision sites (this surgical method is also called "petal type" or "flap type" based on its incision shape).

[0026] Furthermore, regarding the direction, in the case of a single staged incision, various forms can be included, such as incisions in a curved or serrated manner. Moreover, as long as the longitudinal extension component of the lacrimal sac is included, forms that are incised in other directions can also be appropriately included.

[0027] "Maintaining the grip while the surgeon holds the suture" refers to the following state: when the surgeon cuts into the lacrimal sac to one side and the other side, there is no need to specifically change the grip on the suture, allowing the surgeon to maintain the grip while cutting. This eliminates the need to change the grip when changing the cutting direction after puncture (e.g., during a 180-degree turn), such as with a single-edged scalpel, thus improving operability in the ophthalmic region of the nasal cavity, which is a relatively narrow surgical area.

[0028] Furthermore, when performing the aforementioned "petal-shaped" or "flap-shaped" incision on the lacrimal sac, the surgeon does not need to change the gripping hand each time, and can accurately and quickly perform multiple incisions in different directions. Therefore, the usability of the lacrimal sac incision knife is further improved.

[0029] Furthermore, in the dacryocystorhinostomy knife of the present invention, the specific dimensions of its structural elements are optimized according to the size of the dacryocystorhinostomy object. Generally, deviations in the size of the dacryocystorhinostomy due to individual patient differences are acknowledged, but in the present invention, size optimization that can reliably accommodate these differences is considered. Specifically, as follows.

[0030] The cutting edge has a length dimension of approximately 3.0 mm to approximately 10.0 mm in the longitudinal direction and a maximum width dimension of approximately 1.0 mm to approximately 2.0 mm in the width direction.

[0031] The piercing blade has a cutting edge size of approximately 1.0 mm to 4.0 mm in the longitudinal direction and a maximum width size of approximately 1.0 mm to approximately 2.0 mm in the width direction.

[0032] The first side blade and the second side blade each have a cutting edge size of approximately 2.0 mm to approximately 6.0 mm in the longitudinal direction.

[0033] Furthermore, as a preferred embodiment of the present invention, the lacrimal sac incision knife described above can be configured such that, in the longitudinal direction, the base has a length dimension approximately twice that of the cutting portion.

[0034] This ensures the operability of the lacrimal sac incision knife and improves the rigidity of the base.

[0035] Furthermore, as a preferred embodiment of the present invention, the lacrimal sac incision knife described above can be configured such that the rod portion has a length dimension of approximately 15.0 mm to approximately 50.0 mm in the longitudinal direction, and the base portion has a length dimension of approximately 5.0 mm to approximately 47.0 mm in the longitudinal direction.

[0036] Furthermore, as a preferred embodiment of the present invention, the lacrimal sac incision knife described above can be configured such that the width of the first side blade and the second side blade gradually narrows as they move toward the puncture blade.

[0037] With this design, the puncture and cutting capabilities of the dacryocystorhinostomy knife are further improved.

[0038] Furthermore, as a preferred embodiment of the present invention, the lacrimal sac incision knife described above can be configured such that the base is a wedge-shaped portion in which the thickness of the base gradually decreases toward the blade in the longitudinal direction, and in the blade, the region in which the first side blade and the second side blade are formed has a constant thickness in the longitudinal direction.

[0039] "Gradually" is a structure that is substantially equivalent to "in sequence", "step by step" or "gradually". In this invention, it appropriately includes not only a form that gradually decreases to the same degree as moving toward the cutting edge, but also a form that varies in the degree of decrease, or a form that gradually decreases only locally.

[0040] With this configuration, the base ensures a rigidity guarantee area for the dacryocystorhinostomy blade, and the cutting edge area where the first and second side blades are formed ensures a lacrimal sac cutting performance area with a thinner plate. Furthermore, the wedge-shaped connection, where the plate thickness gradually decreases from this rigidity guarantee area to the lacrimal sac cutting performance area, ensures smooth movement of the dacryocystorhinostomy blade into the nasal cavity.

[0041] Furthermore, as a preferred embodiment of the present invention, the aforementioned lacrimal sac incision knife can be configured such that the wedge-shaped portion has a length dimension of approximately 3.0 mm to approximately 7.0 mm in the longitudinal direction, and the plate thickness of the wedge-shaped portion gradually decreases from approximately 0.3 mm to approximately 0.15 mm while connecting with the cutting edge, and the forming regions of the first side blade and the second side blade of the cutting edge have a plate thickness of approximately 0.15 mm in the longitudinal direction.

[0042] Therefore, the rigid protection area and the lacrimal sac incision and elevation area mentioned above can be reasonably and specifically implemented respectively.

[0043] Furthermore, regarding the dimensions of the various structural elements of the aforementioned dacryocystorhinostomy knife, especially in order to effectively visualize the invention in actual product design, it is preferable to adopt typical values ​​such as those below. That is, the structure is set as follows:

[0044] The cutting edge has a length dimension of approximately 5.7 mm in the longitudinal direction and a maximum width dimension of approximately 1.7 mm in the width direction.

[0045] The piercing blade has a cutting edge size of approximately 1.2 mm in the longitudinal direction and a maximum width size of approximately 1.4 mm in the width direction.

[0046] The first and second side blades each have a cutting edge size of approximately 4.5 mm in the longitudinal direction.

[0047] The rod portion has a length dimension of approximately 17.3 mm in the longitudinal direction.

[0048] The base has a length dimension of approximately 11.6 mm in the longitudinal direction.

[0049] The wedge-shaped portion has a length dimension of approximately 5 mm in the longitudinal direction.

[0050] The thickness of the wedge-shaped portion gradually decreases from approximately 0.3 mm to approximately 0.15 mm and connects to the cutting edge, wherein the forming regions of the first side blade and the second side blade of the cutting edge have a thickness of approximately 0.15 mm in the longitudinal direction.

[0051] According to the present invention, a reasonable structural technology for a lacrimal sac incision knife is provided. Detailed Implementation

[0052] (Embodiments of the present invention)

[0053] based on Figures 1-12 The embodiments of the present invention will be described.

[0054] In the diagram, Figures 1 to 8 The structure of the lacrimal sac incision knife 1 of this embodiment is shown. Figures 9-12 An outline of the surgical procedure using the lacrimal sac incision knife 1 is shown.

[0055] Regarding the structure of the lacrimal sac incision knife 1

[0056] Figure 1 , Figure 2 These are top views and front views that represent the overall structure.

[0057] Figure 3 , Figure 4 This is a schematic top view showing the structure of the top area.

[0058] Figure 5 , Figure 6 These are schematic front views and sectional views illustrating the structure of the top area.

[0059] Figure 7 This is a schematic top view showing the dimensions and structure of the cutting edge.

[0060] Figure 8 It is a schematic front sectional view showing the size structure of the top area.

[0061] (Definitions of direction, etc.)

[0062] exist Figures 1 to 8 For ease of explanation, the longitudinal direction of the lacrimal sac incision 1 is defined as L, the anterior longitudinal direction as LF, the posterior longitudinal direction as LB, and the width direction as W. Figure 1 , Figure 3 The top side of the paper is defined as the width in the right direction (WR), and the bottom side of the paper is defined as the width in the left direction (WL). Figure 2 , Figure 5 , Figure 6 In the diagram, the vertical direction on the paper is defined as the vertical direction V.

[0063] (Overall structure of the lacrimal sac incision knife 1)

[0064] like Figure 1 , Figure 2 As shown, the lacrimal sac incision knife 1 of this embodiment is mainly composed of a holding part 2 and a rod part 3, which are respectively configured as longitudinal bodies extending in the longitudinal direction L, and is also configured as a longitudinal body extending in the longitudinal direction L as a whole.

[0065] In this embodiment, the gripping part 2 is made of resin, and the rod part 3 is made of metal.

[0066] (Structure of rod 3)

[0067] like Figure 3As shown, the rod 3 is configured with a base 4 and a blade 6 as a cutting component as the main body. The base 4 is connected to the longitudinal front direction LF relative to the gripping part 2 for the practitioner (not shown for convenience). The blade 6 is connected to the longitudinal front direction LF of the base 4.

[0068] (Structure of base 4)

[0069] like Figure 3 As shown, the base 4 has a substantially constant width dimension in the width direction (see below). Figure 7 The figure reference numeral W3 is used, and a stepped portion 5 is formed in the middle region of the base 4. Furthermore, especially as shown in the attached figure... Figure 6 The diagram shows in detail that a wedge-shaped portion 41 is formed in the vertical direction V from the step portion 5 to the blade portion 6, with the plate thickness gradually decreasing towards the longitudinal forward direction LF. In this embodiment, the wedge-shaped portion is formed such that it has a larger reduction ratio near the step portion 5, and a relatively small and approximately constant plate thickness reduction ratio in the region separating from the step portion 5 and towards the blade portion 6.

[0070] (Structure of blade 6)

[0071] like Figure 4 As shown, the cutting edge 6 has: a piercing blade 60 formed at the topmost region in the longitudinal front direction LF; and a pair of first side blades 61 and second side blades 62 formed in the width right direction WR and width left direction WL of the cutting edge 6, respectively, and the piercing blade 60 is formed continuously in the longitudinal rear direction LB relative to the piercing blade 60.

[0072] like Figure 7 As shown in detail, in the longitudinal direction L, the cutting edge 6 has a length dimension of L1, the piercing blade 60 has a length dimension of L2, and the first side blade 61 and the second side blade 62 each have a length dimension of L3. In other words, they are configured with a relationship of L1 = L2 + L3.

[0073] On the other hand, such as Figure 7 As shown, the puncture blade 60 has a width dimension of W1 in the width direction W. In addition, the first side blade 61 and the second side blade 62 span across the two and have a width dimension of W1 in the area connected with the puncture blade 60, and have a width dimension of W2 in the area connected with the base 4.

[0074] In this embodiment, a structure in which W1 < W2 is adopted.

[0075] Furthermore, the relationship of this size ratio can also be such that W1 = W2 or W1 > W2.

[0076] In addition, the first side blade 61 and the second side blade 62 are configured to have a conical shape in which the width dimension gradually increases from the width dimension region (i.e., the narrower region) of the front side W1 to the width dimension region (i.e., the wider region) of the rear side W2.

[0077] By employing these structures, the puncture or incision of the lacrimal sac is improved by utilizing the narrower puncture blade 60 and the narrower apical regions of the first side blade 61 and the second side blade 62 during the dacryocystorhinostomy described later. Furthermore, the puncture and incision capabilities of the first side blade 61 and the second side blade 62, which are tapered and become wider as they move toward the longitudinal posterior direction LB, are further enhanced.

[0078] Furthermore, in this embodiment, the width dimension W2 related to the first side blade 61 and the second side blade 62 is larger than the width dimension W3 of the base 4. That is, a structure is adopted in which the first side blade 61 and the second side blade 62 protrude slightly wider than the base 4 in the width direction W. This further improves the puncture and incision properties when performing the dacryocystorhinostomy described later.

[0079] Furthermore, for this width dimension, a structure in which W2 = W3 or W2 < W3 can also be adopted.

[0080] (Regarding the dimensions of each part)

[0081] For the specific dimensional values ​​of each structural element of the dacryocystorhinostomy blade 1, such as Figure 3 , Figure 7 , Figure 8 As shown, the settings are as follows (unit: mm).

[0082] The blade 6 is configured to have a length dimension L1 of approximately 5.7 mm in the longitudinal direction L and a maximum width dimension W2 of approximately 1.7 mm in the width direction W.

[0083] The piercing blade 60 is configured to have a cutting edge size L2 of approximately 1.2 mm in the longitudinal direction L and a maximum width size W1 of approximately 1.4 mm in the width direction W.

[0084] The first side blade 61 and the second side blade 62 are each configured to have a cutting edge size L3 of approximately 4.5 mm in the longitudinal direction L, and a minimum width size of approximately 1.4 mm (connected to the piercing blade 60) and a maximum width size of approximately 1.7 mm in the width direction W. In other words, the maximum width size W2 of the first side blade 61 and the second side blade 62 (approximately 1.7 mm in this embodiment) defines the maximum size of the cutting edge 6.

[0085] In addition, such as Figure 3 As shown, the base 4 has a length dimension LB of approximately twice the length of the blade 6 in the longitudinal direction L, that is, approximately 11.6 mm, and a width dimension W3 of 1.4 mm to 2.0 mm.

[0086] In addition, such as Figure 3 As shown, the rod 3 has a length dimension LS of approximately 17.3 mm in the longitudinal direction.

[0087] In addition, such as Figure 8 As shown, the wedge-shaped portion 41 is configured to have a length dimension LT of approximately 5 mm in the longitudinal direction L. Furthermore, the thickness of the wedge-shaped portion 41 gradually decreases from approximately 0.3 mm (the maximum thickness TH2) to approximately 0.15 mm (the minimum thickness TH1), and it is connected to the cutting edge 6. And, as... Figure 8 As shown, the forming region L1 of the cutting edge 6, the first side blade 61 and the second side blade 62 are configured to have a plate thickness TH1 of approximately 0.15 mm in the longitudinal direction L.

[0088] Next, using the lacrimal sac incision knife 1 as described in this embodiment, referring to... Figures 9-12 A specific example of dacryocystorhinostomy will be described. In this embodiment, dacryocystorhinostomy (DCR method) is used as an example to illustrate the surgical procedure of treating nasolacrimal duct obstruction by applying the dacryocystorhinostomy knife 1 to the dacryocystorhinostomy via the nasal cavity and bone window.

[0089] (Structure of the surgical site)

[0090] exist Figure 9 The diagram schematically illustrates the outline of the eye and nose regions of patient P, the subject of this surgical procedure. In the eye P1 and nose P2 regions of patient P, the nasal cavity P4, which serves as the internal space of the nose, extends from the nostril P3, which is an opening to the outside, along the nasal cavity extension direction P4L. Furthermore, on the inner side of this nasal cavity P4 (in... Figure 9 (The middle section is above), the lacrimal sac R4 and the nasal cavity P4 are positioned close together with the bone window P5 between them. In addition, the bone window P5 is formed in advance using a drill or the like, but the fenestration method itself is a well-known technique, so detailed explanation is omitted.

[0091] (Structure of the ophthalmic region)

[0092] On the other hand, the lacrimal gland R1 is connected to the patient P's eye P1, and it is connected to the lacrimal sac R4 via the lacrimal punctum R2 and a pair of lacrimal canaliculi R3, and it is connected to the nasal cavity P4 via the nasolacrimal duct R6. Thus, tears are transported to the nasal cavity P4 via the lacrimal gland R1, eye P1, lacrimal punctum R2, lacrimal canaliculi R3, lacrimal sac R4, and nasolacrimal duct R6.

[0093] (Overview of DCR method)

[0094] In the aforementioned DCR method (DCR intranasal method), typically, as an example of a treatment for nasolacrimal duct obstruction, an incision is performed on the dacryocystorhinostomy R4. While the surgeon holds the holding part 2 (the holding position is omitted for convenience), ... Figure 9 In this embodiment, the lacrimal sac incision knife 1 is inserted into the nasal cavity P4 through the nostril P3 along with the endoscope, and then enters medially in a manner roughly along the extension direction of the nasal cavity P4L, reaching the lacrimal sac R4 via the bone window P5. Furthermore, for convenience, the illustration of the endoscope is omitted.

[0095] The lacrimal sac R4 has a longitudinal shape with a long axis and a short axis. Although there are individual differences, its longitudinal extension dimension (the longitudinal direction of the lacrimal sac R4) is approximately 6.0 mm to 15.5 mm.

[0096] (Approaching the lacrimal sac R4)

[0097] Then, as Figure 10 As shown, the lacrimal sac incision knife 1 is moved along the longitudinal direction L, so that the puncture blade 60 of the lacrimal sac incision knife 1 approaches the surgical site R5 (i.e., the lacrimal sac R4) in a roughly central incision area R5S. However, in actual surgery, there may be cases where the lacrimal sac incision knife 1 does not approach the lacrimal sac R4 orthogonally; however, in this embodiment, for ease of explanation, an orthogonal approach shape is illustrated.

[0098] (Incision on the longitudinal side of the lacrimal sac R4)

[0099] Next, as Figure 11 As shown, the lacrimal sac incision knife 1 is directed towards R5L1, which is the longitudinal direction of the lacrimal sac R4. Figure 11 The surgeon moves the blade 1 to the right (in the middle direction) and uses the first side blade 61 to cut the lacrimal sac R4. That is, the first side blade 61 forms the first incision of the lacrimal sac. At this time, the surgeon can maintain the holding position when the lacrimal sac incision knife 1 is close to the lacrimal sac (without changing the grip) while performing the cutting operation of the first side blade 61.

[0100] (Incision on the opposite side of the lacrimal sac R4 in the longitudinal direction)

[0101] Next, as Figure 12 As shown, the lacrimal sac incision knife 1 is directed towards R5L2 on the opposite side of the longitudinal direction of the lacrimal sac R4 ( Figure 12The surgeon moves the blade to the left (in the left direction) and uses the second blade 62 to further cut the lacrimal sac R4. That is, the second blade 62 forms the second incision of the lacrimal sac. At this time, the surgeon can maintain the holding position of the lacrimal sac incision knife 1 when cutting in the R5L1 direction with the first blade 61 (without changing the grip) while performing the cutting operation with the second blade 62.

[0102] That is, in the lacrimal sac incision knife 1 of this embodiment, the first side blade 61 and the second side blade 62 are configured as a pair of double-edged structures, and a structure in which both are continuously formed with the puncture blade 60 is adopted, so that the operator can maintain the gripping part 2 (see reference 2). Figure 1 In other words, the lacrimal sac incision knife 1 is flipped over without changing the gripping method of the gripping part 2 each time the operation is switched, so as to cut the lacrimal sac R4 in the left and right directions (i.e., the longitudinal direction R5L1, R5L2 of the lacrimal sac R4).

[0103] Moreover, such as Figure 6 As shown, in the lacrimal sac incision knife 1 of this embodiment, a wedge-shaped portion 41 is formed in the vertical direction V from the step portion 5 to the blade portion 6, with the plate thickness gradually decreasing as it moves toward the longitudinal front direction LF.

[0104] And, as Figure 8 As shown, a rigidity-ensuring region A (plate thickness TH2) with a relatively thick plate is provided for the base 4. On the other hand, a lacrimal sac cutting capability-enhancing region B with a thinner plate thickness, designated as TH1, is provided for the blade 6. Furthermore, a wedge-shaped portion 41, whose plate thickness gradually decreases from the rigidity-ensuring region A to the lacrimal sac cutting capability-enhancing region B, is used to ensure that the lacrimal sac incision knife 1 can enter the nasal cavity P4 (see reference). Figure 9 The smoothness of the situation.

[0105] In addition, a structure is adopted in which a piercing blade 60, a first side blade 61, and a second side blade 62 form a continuous blade assembly facing different directions (see reference). Figure 7 Therefore, from the approach to the lacrimal sac R4 described above until the incision is completed, the surgery can be performed while appropriately selecting the most suitable blade from the blade groups facing different directions. Thus, the complex shape of the lacrimal sac can be properly addressed, and the usability of the lacrimal sac incision knife 1 is further improved.

[0106] Furthermore, in this embodiment, the surgery was performed by bringing the lacrimal sac incision knife 1 close to the lacrimal sac R4, and the operation was performed in the order of cutting with the first side blade 61 followed by cutting with the second side blade. However, the use of the lacrimal sac incision knife 1 of the present invention is not limited to this.

[0107] For example, using the first side blade 61, the lacrimal sac R4 is cut several times in multiple directions, including the longitudinal R5L1 component, and the cut lacrimal sac R4 is slightly separated. Next, using the second side blade 62, the lacrimal sac R4 is cut several times in multiple directions, including the longitudinal R5L2 component, and the cut lacrimal sac R4 is slightly separated. Thus, it is possible to better adopt a surgical approach that cuts the lacrimal sac R4 in a flower-like shape ("petal-like" or "flap-like").

[0108] In addition, for example, it is also possible to adopt a shape that cuts along the lacrimal sac surface after puncturing the lacrimal sac R4 with the puncture blade 60.

[0109] According to the above embodiments, a structural technology for a dacryocystorhinostomy knife 1 that helps improve the operability of the surgeon is provided. Attached Figure Description

[0110] Figure 1 This is a top view showing the overall structure of the lacrimal sac incision knife 1 according to an embodiment of the present invention.

[0111] Figure 2 This is a front view showing the overall structure of the lacrimal sac incision knife 1 according to an embodiment of the present invention.

[0112] Figure 3 This is a schematic top view showing the structure of the tip region of the lacrimal sac incision knife 1.

[0113] Figure 4 Is with Figure 3 Similarly, a schematic top view showing the structure of the tip region of the lacrimal sac incision knife 1.

[0114] Figure 5 This is a schematic front view showing the structure of the tip region of the lacrimal sac incision knife 1.

[0115] Figure 6 This is a schematic cross-sectional view showing the structure of the tip region of the lacrimal sac incision knife 1.

[0116] Figure 7 This is a schematic top view showing the structure of the blade 6 of the lacrimal sac incision knife 1.

[0117] Figure 8 This is a schematic cross-sectional view showing the structure of the tip region of the lacrimal sac incision knife 1.

[0118] Figure 9 This is a schematic diagram showing the structure of the eye and nose region of the patient P, who is the subject of the surgery performed by the dacryocystorhinostomy knife 1 in this embodiment.

[0119] Figure 10This is a schematic diagram showing the state (close) of the lacrimal sac incision knife 1 applied to the lacrimal sac R4, which is the surgical site R5.

[0120] Figure 11 This is a schematic diagram showing the incision shape of the lacrimal sac R4.

[0121] Figure 12 This is a schematic diagram showing the incision morphology of the lacrimal sac R4.

[0122] Explanation of reference numerals in the attached figures

[0123] 1. Dacryocystorhinostomy blade; 2. Handling part; 3. Rod part; 4. Base; 41. Wedge-shaped part; 5. Step part; 6. Blade part; 60. Puncture blade; 61. First side blade; 62. Second side blade; L. Longitudinal direction; LF. Anterior direction of longitudinal direction; LB. Posterior direction of longitudinal direction; W. Width direction; WR. Right side direction of width; WL. Left side direction of width; V. Inverting direction; P. Patient; P1. Eye; P2. Nose; P3. Nose; P4. Nasal cavity; P4L. Direction of nasal cavity extension; P5. Bone window; R1. Lacrimal gland; R2. Lacrimal punctum; R3. Lacrimal canaliculus; R4. Lacrimal sac; R5. Surgical site; R5S. Incision area; R5L1. First longitudinal direction of lacrimal sac; R5L2. Second longitudinal direction of lacrimal sac; R6. Nasolacrimal duct.

Claims

1. A dacryocystorhinostomy knife for inserting into a patient's nasal cavity and cutting open the lacrimal sac located medially within the nasal cavity, characterized in that, The lacrimal sac incision knife is configured as follows: This lacrimal sac incision knife has the following features: The gripping part is configured as an elongated body extending in a predetermined longitudinal direction, and the gripping part is for the practitioner to hold; and The rod portion is connected to the grip portion, and the rod portion extends in a straight line throughout the longitudinal direction. The rod portion has: The base, which extends in the longitudinal direction; as well as A cutting edge extends in the longitudinal direction, and the cutting edge is connected to the base at its apex in the longitudinal direction. The cutting edge has: A piercing blade, formed at the tip side in the longitudinal direction; as well as The first and second side blades are a pair of double-edged structures formed on both sides of a width direction defined as intersecting the longitudinal direction. The first and second side blades are respectively connected to the piercing blade. The puncture blade forms a dacryocystorhinostomy puncture section, which can puncture the dacryocystorhinostomy sac while the holding section is held by the surgeon. One of the first side blades and the second side blade constitutes the first incision portion of the lacrimal sac. By moving the lacrimal sac incision blade to one side in the width direction, the first incision portion of the lacrimal sac cuts the lacrimal sac to one side in the longitudinal extension direction of the lacrimal sac. The first side blade and the other of the second side blades constitute the second incision section of the lacrimal sac. By moving the lacrimal sac incision blade to the other side in the width direction while maintaining the holding part in the state of being held by the surgeon, the second incision section of the lacrimal sac cuts the lacrimal sac to the other side in the longitudinal extension direction of the lacrimal sac. The cutting edge has a length dimension of 3.0 mm to 10.0 mm in the longitudinal direction and a maximum width dimension of 1.0 mm to 2.0 mm in the width direction. The piercing blade has a cutting edge size of 1.0 to 4.0 mm in the longitudinal direction and a maximum width size of 1.0 mm to 2.0 mm in the width direction. The first side blade and the second side blade each have a cutting edge size of 2.0 mm to 6.0 mm in the longitudinal direction. The dacryocystorhinostomy blade is configured such that the base is a wedge-shaped portion in which the plate thickness gradually decreases towards the cutting edge in the longitudinal direction, and in the cutting edge, the region where the first side blade and the second side blade are formed has a constant plate thickness in the longitudinal direction. The wedge-shaped portion has a length dimension of 3.0 mm to 7.0 mm in the longitudinal direction, and the plate thickness of the wedge-shaped portion gradually decreases from 0.3 mm to 0.15 mm to connect with the cutting edge. The forming areas of the first side blade and the second side blade of the cutting edge have a plate thickness of 0.15 mm in the longitudinal direction.

2. The lacrimal sac incision knife according to claim 1, characterized in that, The lacrimal sac incision knife is configured such that, in the longitudinal direction, the base has a length dimension twice that of the cutting edge.

3. The lacrimal sac incision knife according to claim 1 or 2, characterized in that, The lacrimal sac incision knife is configured as follows: The rod portion has a length dimension of 15.0 mm to 50.0 mm in the longitudinal direction. The base has a length dimension of 5.0 mm to 47.0 mm in the longitudinal direction.

4. The lacrimal sac incision knife according to claim 1 or 2, characterized in that, The lacrimal sac incision knife is configured such that the width of the first side blade and the second side blade gradually narrows as they move toward the puncture blade.

5. The lacrimal sac incision knife according to claim 3, characterized in that, The lacrimal sac incision knife is configured such that the width of the first side blade and the second side blade gradually narrows as they move toward the puncture blade.

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