Forceps and forceps system

Abstract

To provide a pair of forceps that is easily used in an integrated manner with an endoscope.SOLUTION: A pair of forceps 1 includes: a forceps insertion part 21; and a treatment part 41 that is arranged in the forceps insertion part 21, projects further to a distal end side than the forceps insertion part 21, and performs a predetermined treatment. The forceps insertion part 21 includes: a large-diameter cylinder part 22 in which a portion of the treatment part 41 on a proximal end side is arranged therein; and a small-diameter cylinder part 24 which is arranged in the large-diameter cylinder part 22, and into which an endoscope insertion part 11 for observing the outside in the endoscope 10 can be inserted.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present disclosure relates to forceps and a forceps system.

Background Art

[0002] Conventionally, in the medical field, forceps of various shapes and sizes have been used for various purposes (see, for example, Patent Document 1). In particular, in recent years, minimally invasive endoscopic surgery and laparoscopic surgery have become mainstream in order to reduce the burden on the patient's body. Especially in digestive surgery, the number of conventional open surgeries has decreased significantly, and laparoscopic surgery accounts for about 70%. Laparoscopic surgery is performed by making several holes in the patient's abdomen through which a camera (main endoscope) and forceps are inserted.

[0003] Laparoscopic surgery has many advantages compared to conventional open surgery. Many advantages include fewer postoperative complications in patients, a smaller suture area, and the ability to significantly reduce the length of hospital stay. In addition, a doctor performing laparoscopic surgery does not need to maintain a forward-leaning position for a long time to look into the open abdomen during the operation. Furthermore, since the camera magnifies and displays the affected area on the monitor, the doctor can judge the condition of the affected area in detail and does not need to assume a painful forward-leaning position.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0005] In laparoscopic surgery, there are blind spots due to the camera. In order to reduce these blind spots, it has been considered to use an endoscope (sub-endoscope) together with the forceps used in laparoscopic surgery. However, the forceps of Patent Document 1 are difficult to use integrally with an endoscope.

[0006] The present disclosure has been made in view of such problems, and an object thereof is to provide forceps that are easy to use integrally with an endoscope and a forceps system including the forceps.

Means for Solving the Problems

[0007] In order to solve the above problems, the present invention proposes the following means. (1)Aspect 1 of the present disclosure includes a forceps insertion portion and a treatment portion that is disposed within the forceps insertion portion, protrudes beyond the distal end side of the forceps insertion portion, and performs a predetermined treatment. The forceps insertion portion includes a large-diameter cylindrical portion in which a proximal end side portion of the treatment portion is disposed inside, and a small-diameter cylindrical portion that is disposed within the large-diameter cylindrical portion and into which an endoscope insertion portion for observing the outside in the endoscope can be inserted.

[0008] In the present invention, for example, in laparoscopic surgery, the endoscope insertion portion of the endoscope is inserted into the small-diameter cylindrical portion of the forceps. In this state, while observing the outside of the endoscope insertion portion, such as the distal end side of the large-diameter cylindrical portion, with the endoscope insertion portion, the distal end side portion of the large-diameter cylindrical portion is inserted into the patient's abdomen. Then, a predetermined treatment is performed by the treatment portion. Since the endoscope insertion portion can be inserted into the small-diameter cylindrical portion, it is easy to insert the endoscope insertion portion into the forceps insertion portion, and the forceps can be easily used integrally with the endoscope.

[0009] (2)Aspect 2 of the present disclosure is the forceps according to (1), wherein the treatment portion has two gripping pieces that can be opened and closed with respect to each other, the distal end portions of the two gripping pieces open and close on a reference plane along the axis of the large-diameter cylindrical portion, and the entire opening at the distal end of the small-diameter cylindrical portion is disposed on either side orthogonal to the reference plane with respect to the reference plane. In this disclosure, the endoscope insertion portion observes the tip side of the large-diameter cylindrical portion through the opening of the small-diameter cylindrical portion. When performing a predetermined treatment by opening and closing the two gripping pieces, the entire opening is disposed on either side orthogonal to the reference plane, rather than the reference plane with respect to which the tip portions of the two gripping pieces open and close. Therefore, when observing through the opening by the endoscope insertion portion, it is possible to make it difficult for the tip portions of the two gripping pieces to obstruct the observation.

[0010] (3)Aspect 3 of the present disclosure may be the forceps according to (2), further comprising an opening / closing restricting portion that restricts the opening / closing range of the two gripping pieces. In this disclosure, for example, the opening / closing restricting portion can suppress excessive force from acting on the two gripping pieces that open and close, thereby preventing damage to the two gripping pieces.

[0011] (4)Aspect 4 of the present disclosure may be the forceps according to any one of (1) to (3), wherein the forceps insertion portion is disposed at an intermediate portion in the axial direction of the large-diameter cylindrical portion, and has a fixing portion that fixes the position of the small-diameter cylindrical portion with respect to the large-diameter cylindrical portion. In this disclosure, the fixing portion can hold the position of the small-diameter cylindrical portion with respect to the large-diameter cylindrical portion at a portion where the strength relatively decreases, namely, the intermediate portion in the axial direction.

[0012] (5)Aspect 5 of the present disclosure may be the forceps according to any one of (1) to (4), wherein the treatment portion extends along a treatment axis along the large-diameter cylindrical portion, and includes a rotation operation portion that rotates the treatment portion around the treatment axis. In this disclosure, by operating the rotation operation portion, for example, it is possible to change the orientation around the treatment axis for performing a predetermined treatment by the treatment portion without changing the orientation of the external visual field by the endoscope insertion portion.

[0013] (6)Aspect 6 of the present disclosure may be the forceps according to any one of (1) to (5), further comprising an attachment portion to which the endoscope main body of the endoscope is attached. In this disclosure, by attaching the endoscope body of the endoscope to the forceps with an attachment portion, an operator such as a doctor can operate the forceps and the endoscope body integrally.

[0014] (7)Aspect 7 of this disclosure may be the forceps according to any one of (1) to (6), comprising a rotation restricting portion that restricts the orientation of the endoscope insertion portion around the small-diameter axis of the small-diameter cylindrical portion. In this disclosure, the rotation restricting portion can suppress the rotation of the endoscope insertion portion around the small-diameter axis and the change in the orientation of the external visual field caused by the endoscope insertion portion.

[0015] (8)Aspect 8 of this disclosure may be the forceps according to any one of (1) to (7), comprising an insertion restricting portion that restricts the position of the endoscope insertion portion disposed within the small-diameter cylindrical portion in the direction of the small-diameter axis of the small-diameter cylindrical portion. In this disclosure, the insertion restricting portion can suppress the change in the position of the endoscope insertion portion in the direction of the small-diameter axis with respect to the small-diameter cylindrical portion.

[0016] (9)Aspect 7 of this disclosure is a forceps system comprising the forceps according to any one of (1) to (8) and the endoscope. In this disclosure, a forceps system can be configured using a forceps that is easy to use integrally with the endoscope.

Advantages of the Invention

[0017] In the forceps and the forceps system of this disclosure, it can be made easy to use integrally with the endoscope.

Brief Description of the Drawings

[0018]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Mode for Carrying Out the Invention

[0019] Hereinafter, an embodiment of the forceps and the forceps system according to the present invention will be described with reference to FIGS. 1 to 7. As shown in FIG. 1, the forceps system 1 of the present embodiment includes a sub-endoscope (endoscope) 10 and the forceps 20 of the present embodiment. The sub-endoscope 10 has an endoscope insertion portion 11, an endoscope main body 16, and a display portion (not shown). Hereinafter, the side of the endoscope insertion portion 11 with respect to the endoscope main body 16 (the side of the forceps insertion portion 21 with respect to the opening / closing operation portion 51 described later in the forceps 20) will be referred to as the distal end side. The side of the endoscope main body 16 with respect to the endoscope insertion portion 11 (the side of the opening / closing operation portion 51 with respect to the forceps insertion portion 21 described later in the forceps 20) will be referred to as the proximal end side.

[0020] For example, the endoscope insertion portion 11 has an outer sheath tube 12, a light projection portion 13, and an imaging portion 14. The outer sheath tube 12 is formed in a tubular shape and has flexibility. The light projection portion 13 and the imaging portion 14 are fixed inside the distal end portion of the outer sheath tube 12. The light projection portion 13 has an LED (Light Emitting Diode) or the like (not shown). The light projection portion 13 emits visible light toward the distal end side. A power supply line (not shown) is connected to the light projection portion 13. The power supply line extends toward the proximal end side through the inside of the outer sheath tube 12. A predetermined power is supplied to the light projection portion 13 through the power supply line.

[0021] The imaging unit 14 has a light receiving element such as a CMOS (Complementary Metal-Oxide-Semiconductor) not shown in the figure. The imaging unit 14 converts visible light reflected by an observation object such as a patient's tissue into an image. The imaging unit 14 converts this image into a signal. A signal line (not shown) is connected to the imaging unit 14. The signal line extends toward the proximal end through the outer sheath 12. The imaging unit 14 sends a signal through the signal line. As described above, the endoscope insertion portion 11 is a device for observing the outside of the endoscope insertion portion 11, such as the distal end side of the endoscope insertion portion 11.

[0022] The endoscope main body 16 is connected to the proximal end portion of the outer sheath 12. A power supply line and a signal line are respectively connected to the endoscope main body 16. For example, the endoscope main body 16 supplies predetermined power to the power supply line and receives the signal sent by the imaging unit 14 from the signal line. The endoscope main body 16 appropriately processes the received signal for the display unit. The display unit has a liquid crystal panel and is connected to the endoscope main body 16. The display unit displays an image based on the appropriately processed signal. Next, the forceps 20 will be described.

[0023] The forceps 20 has a forceps insertion portion 21, a treatment portion 41, an opening / closing operation portion 51, an opening / closing restriction portion 56, and a rotation operation portion 61. As shown in FIGS. 1 and 2, the forceps insertion portion 21 has a large-diameter cylindrical portion 22, a fixing portion 23, a first small-diameter cylindrical portion (small-diameter cylindrical portion) 24, a second small-diameter cylindrical portion 25, and a bracket 26. As shown in FIG. 1, the large-diameter cylindrical portion 22 has a distal end cylindrical piece 30 and a proximal end cylindrical piece 31. The inner diameters of the distal end cylindrical piece 30 and the proximal end cylindrical piece 31 are equal to each other. The outer diameters of the distal end cylindrical piece 30 and the proximal end cylindrical piece 31 are equal to each other. The lengths of the distal end cylindrical piece 30 and the proximal end cylindrical piece 31 are equal to each other. The distal end cylindrical piece 30 and the proximal end cylindrical piece 31 are coaxially arranged. The distal end cylindrical piece 30 is arranged on the distal end side of the proximal end cylindrical piece 31. Note that the lengths of the distal end cylindrical piece 30 and the proximal end cylindrical piece 31 may be different from each other.

[0024] Hereinafter, the common axis (the axis of the large-diameter cylindrical portion 22) of the distal-end cylindrical piece 30 and the proximal-end cylindrical piece 31 is referred to as the axis O1. The direction orthogonal to the axis O1 is referred to as the radial direction, and the direction of orbiting around the axis O1 is referred to as the circumferential direction. A through-hole (not shown) penetrating in the radial direction is formed in the proximal-end cylindrical piece 31. The through-hole extends over a predetermined range in the circumferential direction.

[0025] As shown in FIGS. 1 and 2, the fixing portion 23 is formed in a disc shape having an outer diameter equal to the outer diameter of the distal-end cylindrical piece 30. The fixing portion 23 is disposed on the axis O1 between the distal-end cylindrical piece 30 and the proximal-end cylindrical piece 31. Through-holes 23a and 23b are formed in the fixing portion 23. The through-holes 23a and 23b penetrate the fixing portion 23 in the direction of the axis O1. For example, the through-holes 23a and 23b are arranged so as to sandwich the axis O1 in the radial direction. The fixing portion 23 is fixed to the distal-end cylindrical piece 30 and the proximal-end cylindrical piece 31 by welding. Note that the method of fixing the fixing portion 23 to the distal-end cylindrical piece 30 and the proximal-end cylindrical piece 31 is not limited to welding, and adhesion, pressure bonding, etc. may also be used. The fixing portion 23 is disposed at an intermediate portion in the direction of the axis O1 in the large-diameter cylindrical portion 22.

[0026] The first small-diameter cylindrical portion 24 and the second small-diameter cylindrical portion 25 are each formed in a tubular shape. The outer diameter of the first small-diameter cylindrical portion 24 and the outer diameter of the second small-diameter cylindrical portion 25 are smaller than the inner diameter of the distal-end cylindrical piece 30 and the inner diameter of the proximal-end cylindrical piece 31. The first small-diameter cylindrical portion 24 and the second small-diameter cylindrical portion 25 are disposed in the distal-end cylindrical piece 30 and the proximal-end cylindrical piece 31 of the large-diameter cylindrical portion 22. The first small-diameter cylindrical portion 24 is disposed in the through-hole 23a of the fixing portion 23. The second small-diameter cylindrical portion 25 is disposed in the through-hole 23b of the fixing portion 23. The fixing portion 23 fixes the positions of the first small-diameter cylindrical portion 24 and the second small-diameter cylindrical portion 25 with respect to the large-diameter cylindrical portion 22. As shown in FIG. 1, the bracket 26 has a flat plate portion 33 and a cylindrical portion 34. The flat plate portion 33 is formed in a disc shape and is disposed on the axis O1. The outer diameter of the flat plate portion 33 is equal to the outer diameter of the distal end cylindrical piece 30. Through holes 33a and 33b are formed in the flat plate portion 33 coaxially with the through holes 23a and 23b. The inner diameter of the through hole 33a is smaller than the inner diameter of the through hole 23a.

[0027] The cylindrical portion 34 is formed in a cylindrical shape. The cylindrical portion 34 protrudes from the outer peripheral edge of the flat plate portion 33 toward the proximal end side. The cylindrical portion 34 is disposed on the distal end side of the distal end cylindrical piece 30 of the large-diameter cylindrical portion 22. A stepped portion (reference numeral omitted) that reduces in diameter toward the proximal end side is formed between the peripheral edge portion of the through hole 33b in the flat plate portion 33 and the cylindrical portion 34. The cylindrical portion 34 abuts against the distal end cylindrical piece 30 in the direction of the axis O1 and is fixed to each other by welding or the like.

[0028] The distal end of the first small-diameter cylindrical portion 24 contacts the flat plate portion 33 of the bracket 26 from the proximal end side of the flat plate portion 33. The space inside the first small-diameter cylindrical portion 24 communicates with the through hole 33a of the flat plate portion 33. The space inside the second small-diameter cylindrical portion 25 communicates with the through hole 33b of the flat plate portion 33. On the other hand, the distal end of the second small-diameter cylindrical portion 25 is separated from the flat plate portion 33 toward the proximal end side. The distal end of the first small-diameter cylindrical portion 24 is fixed to the flat plate portion 33 by welding or the like.

[0029] Here, a first axis (small-diameter axis) O4 that is the axis of the first small-diameter cylindrical portion 24 and a second axis O5 that is the axis of the second small-diameter cylindrical portion 25 are defined. A first reference plane S1 that includes the first axis O4 and the second axis O5 is defined. A direction that is along the first reference plane S1 and orthogonal to the axes O4 and O5 is defined as the orthogonal direction Z. Among the orthogonal directions Z, the side of the second axis O5 with respect to the first axis O4 is defined as the first side Z1. The side of the first axis O4 with respect to the second axis O5 is defined as the second side Z2.

[0030] A second reference plane (reference plane) S2 that is along the axis O1 and orthogonal to the first reference plane S1 is defined. Note that the second reference plane S2 may be a plane that is along the axis O1 and intersects the first reference plane S1. The forceps system 1 is used with the first reference plane S1 along the vertical direction. At this time, the first side Z1 is arranged to be upward. The endoscope insertion part 11 of the sub-endoscope 10 can be inserted into the first small-diameter cylindrical part 24. Note that the forceps 20 may have a base bracket that fixes the positions of the large-diameter cylindrical part 22, the first small-diameter cylindrical part 24, and the second small-diameter cylindrical part 25 on the proximal end side of the forceps insertion part 21.

[0031] As shown in FIGS. 1 and 3, the treatment part 41 has a known link structure. The treatment part 41 includes support members 42A and 42B, first swing members 43A and 43B, second swing members 44A and 44B, an operation member 45, and a connecting member 46 (see FIG. 4). As shown in FIG. 1, the support members 42A and 42B are formed in a rod shape and extend in the direction of the axis O1. The support member 42A is arranged on the first side Z1 rather than the support member 42B. A gap is formed between the support member 42A and the support member 42B. The proximal end portions of the support members 42A and 42B are fixed to the stepped portions of the bracket 26.

[0032] As shown in FIGS. 1 and 3, the first swing members 43A and 43B each extend in the direction of the axis O1 as a whole. The first swing members 43A and 43B are rotatable via first shaft members 48 provided at the proximal ends of each other. The first shaft member 48 extends in the orthogonal direction Z. Both ends of the first shaft member 48 in the orthogonal direction Z are supported by the distal end portions of the support members 42A and 42B. The portion of the first swing member 43A on the distal end side of the first shaft member 48 constitutes the gripping piece 49A. The portion of the first swing member 43B on the distal end side of the first shaft member 48 constitutes the gripping piece 49B. That is, the treatment part 41 has two gripping pieces 49A and 49B. The gripping pieces 49A and 49B can open while being separated from each other and can close while being in contact with each other. That is, the gripping pieces 49A and 49B can be opened and closed with respect to each other.

[0033] Here, for example, in the gripping pieces 49A and 49B, a range of (1 / 4) of the length in the direction of the axis O1 of the gripping pieces 49A and 49B from their respective tips is defined as the tip portions 49aA and 49aB of the gripping pieces 49A and 49B. A part of the gripping pieces 49A and 49B is formed in a curved shape. For this reason, in the gripping pieces 49A and 49B, the tip portions 49aA and 49aB are arranged in a shape that has moved to the tip side and the second side Z2 with respect to the base end portions. The tip portions 49aA and 49aB open and close on the second reference plane S2. The fact that the tip portions 49aA and 49aB open and close on the second reference plane S2 as mentioned here means that they open and close along the second reference plane S2 with any part of the tip portions 49aA and 49aB on the second reference plane S2.

[0034] As shown in FIG. 1, the tip of the second swing member 44A is rotatable with respect to a portion on the base end side of the first swing member 43A with respect to the first shaft member 48 via a second shaft member (not shown). The tip of the second swing member 44B is rotatable with respect to a portion on the base end side of the first swing member 43B with respect to the first shaft member 48 via a third shaft member (not shown). The operation member 45 is formed in a rod shape and extends in the direction of the axis O1. The base end side portion of the operation member 45 is disposed within the second small diameter cylinder portion 25. The tip of the operation member 45 is rotatable with respect to the base end side portions of the second swing member 44A and the second swing member 44B via a fourth shaft member (not shown).

[0035] As described above, the support members 42A and 42B and the base end side portions of the operation member 45 in the treatment portion 41 are disposed within the second small diameter cylinder portion 25 of the forceps insertion portion 21 (large diameter cylinder portion 22). The treatment portion 41 extends along a second axis O5 along the large diameter cylinder portion 22. In this example, the second axis O5 coincides with the treatment axis that is the axis of the treatment portion 41. The gripping pieces 49A and 49B protrude to the tip side of the forceps insertion portion 21 and perform predetermined treatments such as gripping the tissue of the patient. In the present embodiment, the opening 24a at the tip of the first small diameter cylinder portion 24 is disposed on the second reference plane S2.

[0036] As shown in FIG. 4, the connecting member 46 has a small-diameter portion 46a and a large-diameter portion 46b. The small-diameter portion 46a is formed in a rod shape and protrudes from the proximal end of the operation member 45 toward the proximal end side. The diameter of the small-diameter portion 46a is smaller than the diameter of the operation member 45. The large-diameter portion 46b is formed in a spherical shape and is provided at the proximal end of the small-diameter portion 46a. The diameter of the large-diameter portion 46b is larger than the diameter of the small-diameter portion 46a.

[0037] As shown in FIG. 1, the opening / closing operation portion 51 has an operation portion main body 52 and an opening / closing lever 53. The operation portion main body 52 is fixed to the proximal end portion of the proximal end cylinder piece 31 of the large-diameter cylinder portion 22. The operation portion main body 52 extends from the proximal end portion of the proximal end cylinder piece 31 toward the second side Z2. A first finger hole 52a is formed at the tip end portion where the operation portion main body 52 extends. The opening / closing lever 53 is disposed on the proximal end side of the operation portion main body 52 and extends in a direction between the proximal end side and the second side Z2.

[0038] An intermediate portion in the longitudinal direction of the opening / closing lever 53 is rotatably connected to the operation portion main body 52 by an opening / closing shaft member 54. The opening / closing shaft member 54 is provided at an intermediate portion in the orthogonal direction Z of the operation portion main body 52. The opening / closing lever 53 rotates on the first reference plane S1 with respect to the operation portion main body 52. A female screw 52b is formed in a portion of the operation portion main body 52 on the second side Z2 from the portion where the opening / closing shaft member 54 is provided. A second finger hole 53a is formed in a portion of the opening / closing lever 53 on the second side Z2. As shown in FIG. 4, a dovetail groove 53b is formed on a surface facing the tip end side in a portion of the opening / closing lever 53 on the first side Z1. The dovetail groove 53b extends along the portion of the opening / closing lever 53 on the first side Z1. The large-diameter portion 46b of the connecting member 46 is fitted into the dovetail groove 53b of the opening / closing lever 53. As shown in FIG. 1, a female screw 53c is formed in a portion of the opening / closing lever 53 on the first side Z1 from the portion where the opening / closing shaft member 54 is provided.

[0039] The opening / closing regulation unit 56 includes a first regulation unit 57 and a second regulation unit 58. In this example, screws are used for the first regulation unit 57 and the second regulation unit 58. The first regulation unit 57 is fitted into the female screw 52b. The first regulation unit 57 protrudes from the operation unit main body 52 toward the opening / closing lever 53 side (base end side). The second regulation unit 58 is fitted into the female screw 53c. The second regulation unit 58 protrudes from the opening / closing lever 53 toward the operation unit main body 52 side (tip end side). The protruding amounts of the regulation units 57 and 58 can be adjusted by adjusting the screw fitting positions. Note that the opening / closing regulation unit 56 may have only one of the first regulation unit 57 and the second regulation unit 58.

[0040] The rotation operation unit 61 is formed in a cylindrical shape and is externally fitted to the base end cylindrical piece 31 of the forceps insertion part 21. The rotation operation unit 61 is connected to the support members 42A and 42B of the treatment part 41 via a connection member (not shown) disposed in the through hole of the base end cylindrical piece 31. When the rotation operation unit 61 is rotated around the axis O1 with respect to the forceps insertion part 21, the treatment part 41 rotates around the second axis O5. When rotating the rotation operation unit 61, the rotation range around the axis O1 of the rotation operation unit 61 is regulated by the connection member being locked in the circumferential direction at the peripheral edge of the through hole in the base end cylindrical piece 31. Each component of the forceps 20 is formed of stainless steel or the like.

[0041] For example, the operator holds the opening / closing operation unit 51 of the forceps 20 by hand. At this time, the middle finger is inserted into the first finger hole 52a of the operation unit main body 52, and the thumb is inserted into the second finger hole 53a of the opening / closing lever 53. When the operator grips the opening / closing operation unit 51, the finger holes 52a and 53a approach each other, and the first restricting unit 57 contacts the opening / closing lever 53 from the tip side of the opening / closing lever 53. The operation member 45 moves toward the proximal end side with respect to the forceps insertion part 21, and the tip parts 49aA and 49aB of the gripping pieces 49A and 49B contact each other, and the two gripping pieces 49A and 49B close. At this time, within the dovetail groove 53b of the opening / closing lever 53, the large-diameter part 46b of the connecting member 46 moves along the dovetail groove 53b. On the other hand, when the operator opens the opening / closing operation unit 51, the finger holes 52a and 53a move apart from each other, and the second restricting unit 58 contacts the operation unit main body 52 from the proximal end side of the operation unit main body 52. The operation member 45 moves toward the distal end side with respect to the forceps insertion part 21, and the tip parts 49aA and 49aB of the gripping pieces 49A and 49B move apart from each other, and the two gripping pieces 49A and 49B open.

[0042] As described above, the first restricting unit 57 and the second restricting unit 58 included in the opening / closing restricting unit 56 restrict the opening / closing range of the gripping pieces 49A and 49B (the range from the angle formed by the gripping pieces 49A and 49B when the gripping pieces 49A and 49B are closed to the angle formed by the gripping pieces 49A and 49B when the gripping pieces 49A and 49B are open).

[0043] For example, the outer diameter of the large-diameter cylindrical part 22 is 5 mm, and the length of the large-diameter cylindrical part 22 is about 30 cm to 40 cm. In the forceps insertion part 21, the first small-diameter cylindrical part 24 and the second small-diameter cylindrical part 25 are arranged within the large-diameter cylindrical part 22.

[0044] Next, the operation of the forceps system 1 configured as described above will be described. For example, in laparoscopic surgery, the endoscope insertion part 11 of the sub-endoscope 10 is inserted into the first small-diameter cylindrical part 24 of the forceps 20. When inserting the endoscope insertion part 11 into the first small-diameter cylindrical part 24, it is preferable to align the tip of the endoscope insertion part 11 with the tip of the forceps insertion part 21. In addition, when inserting the endoscope insertion part 11 into the first small-diameter cylindrical part 24, the tip of the endoscope insertion part 11 may be arranged on the proximal end side rather than the tip of the forceps insertion part 21. The endoscope insertion part 11 of the sub-endoscope 10 can be freely attached to and detached from the forceps 20.

[0045] As shown in FIG. 5, for example, holes (not shown) are formed in the umbilicus P5 of the patient P and the portions P6 on the sides of the umbilicus P5. Trocars 100 and 101 are respectively attached to these holes. Through the trocar 100, the main endoscope 105 is inserted into the abdomen P7. Through the trocar 101, the forceps insertion part 21 of the forceps system 1 is inserted into the abdomen P7. The image acquired by the main endoscope 105 is appropriately displayed. The image acquired by the sub-endoscope 10 is displayed on the display unit. Carbon dioxide gas is injected into the abdomen P7 through the trocars 100 and 101 to inflate the abdomen P7.

[0046] In this state, while observing the tip side of the large-diameter cylinder part 22 through the endoscope insertion part 11, the operator inserts the tip side part of the large-diameter cylinder part 22 into the abdomen P7 of the patient P through the trocar 101. Then, a predetermined treatment is performed by the treatment part 41. Parts that are difficult to observe with the main endoscope 105, such as the dead angles of the main endoscope 105, can be observed with the sub-endoscope 10. Since the endoscope insertion part 11 can be inserted into the first small-diameter cylinder part 24, it is easy to insert the endoscope insertion part 11 into the forceps insertion part 21 and easy to use the forceps 20 integrally with the sub-endoscope 10.

[0047] Since the sub-endoscope 10 and the forceps 20 can be managed separately from each other, for example, only the forceps 20 can be easily stored, cleaned, and sterilized. Since the forceps 20 are non-active medical devices, they are also consumables. Therefore, when the movement of the forceps 20 deteriorates, it is necessary to replace the forceps 20. On the other hand, since the sub-endoscope 10 has no movable parts, it is durable and does not need to be replaced.

[0048] The forceps 20 have an opening / closing restriction part 56. Therefore, it is possible to prevent excessive force from acting on the gripping pieces 49A and 49B that open and close, and prevent the gripping pieces 49A and 49B from being damaged. The forceps 20 have a fixing part 23. The fixing part 23 can hold the position of the first small-diameter cylinder part 24 with respect to the large-diameter cylinder part 22 at a portion in the middle part in the direction of the axis O1 where the strength is relatively reduced.

[0049] The forceps 20 has a rotation operation part 61. Therefore, by operating the rotation operation part 61, for example, without changing the orientation around the first axis O4 of the tip-side visual field by the endoscope insertion part 11, the orientation around the second axis O5 for performing a predetermined treatment by the treatment part 41 can be changed. Also, in the forceps system 1 of the present embodiment, the forceps system can be configured using the forceps 20 that is easy to use integrally with the sub-endoscope 10.

[0050] The configuration of the forceps system of the present embodiment can be variously modified as described below. In the forceps system 2 of the first modification example shown in FIG. 6, in each configuration of the forceps system 1 of the present embodiment, a forceps 70 is provided instead of the forceps 20. The forceps 70 has a mounting part 71 in addition to each configuration of the forceps 20. For example, the mounting part 71 extends in the direction of the axis O1 and is formed in a U shape in which the first side Z1 opens when viewed in the direction of the axis O1. For example, the mounting part 71 is attached to the forceps insertion part 21. When the endoscope main body 16 of the sub-endoscope 10 is disposed in the mounting part 71, the endoscope main body 16 is attached to the mounting part 71.

[0051] In the forceps system 2 of the first modification example configured as described above, by attaching the endoscope main body 16 of the sub-endoscope 10 to the forceps 70 by the attachment part 71, an operator such as a doctor can operate the forceps 70 and the endoscope main body 16 integrally.

[0052] In the forceps system of the second modification example, the entire opening 24a of the first small-diameter cylindrical part 24 is disposed on either side (the first side Z1 or the second side Z2) orthogonal to the second reference plane S2 rather than on the second reference plane S2. In the forceps system of the second modification example, the endoscope insertion portion 11 observes the tip side of the large-diameter cylindrical portion 22 through the opening 24a of the first small-diameter cylindrical portion 24. When performing a predetermined treatment by opening and closing the gripping pieces 49A and 49B, the entire opening 24a is disposed on either side orthogonal to the second reference plane S2, rather than on the second reference plane S2 where the tip portions 49aA and 49aB of the gripping pieces 49A and 49B open and close. Therefore, when observing through the opening 24a with the endoscope insertion portion 11, it is possible to make it difficult for the tip portions 49aA and 49aB of the gripping pieces 49A and 49B to obstruct the observation.

[0053] The forceps system 3 of the third modification example shown in FIG. 7 includes a sub-endoscope 150 and the forceps 160 of the present embodiment. For example, on the outer peripheral surface of the endoscope insertion portion 11 of the sub-endoscope 150, a ridge 151 protruding outward from the endoscope insertion portion 11 is formed. The ridge 151 extends along the endoscope insertion portion 11. In the portion of the first small-diameter cylindrical portion 161 of the forceps 160 into which the endoscope insertion portion 11 is inserted, a small-diameter hole 162 and a large-diameter hole 163 are respectively formed. The inner diameter of the small-diameter hole 162 is smaller than the inner diameter of the large-diameter hole 163. The large-diameter hole 163 is disposed on the proximal end side of the small-diameter hole 162. On the inner peripheral surface of the small-diameter hole 162, a key groove (not shown) that fits with the ridge 151 of the endoscope insertion portion 11 is formed. The key groove extends along the first axis O4 of the first small-diameter cylindrical portion 161. Note that the ridge 151 and the key groove constitute a rotation restricting portion 170 that restricts the orientation of the endoscope insertion portion 11 around the first axis O4.

[0054] On the inner peripheral surface of the proximal end side portion of the large-diameter hole 163, a female screw 163a is formed. A cylindrical pressing member 164 is disposed inside the distal end side portion of the large-diameter hole 163. For example, the pressing member 164 can be formed of synthetic rubber or the like.

[0055] A fixing member 165 is fitted into the female screw 163a of the first small-diameter cylindrical portion 161. Note that the large-diameter hole 163, the pressing member 164, and the fixing member 165 of the first small-diameter cylindrical portion 161 constitute an insertion restricting portion 171. The fixing member 165 has a cylindrical portion 166 and a flange portion 167. On the outer peripheral surface of the tip-side portion of the cylindrical portion 166, a male screw 166a that fits with the female screw 163a is formed. The flange portion 167 protrudes outward from the base-end side portion of the cylindrical portion 166. For example, the fixing member 165 is formed of stainless steel or the like.

[0056] The endoscope insertion portion 11 is disposed in the cylindrical hole of the cylindrical portion 166 of the fixing member 165, in the cylindrical hole of the pressing member 164, and in the small-diameter hole 162 of the first small-diameter cylindrical portion 161, respectively. When the fixing member 165 that fits with the female screw 163a of the first small-diameter cylindrical portion 161 compresses the pressing member 164 in the direction of the first axis O4, the inner diameter of the pressing member 164 becomes smaller, and the pressing member 164 presses the endoscope insertion portion 11 from the outside over the entire circumference. Therefore, the position of the endoscope insertion portion 11 disposed in the first small-diameter cylindrical portion 161 in the direction of the first axis O4 is restricted.

[0057] In the forceps system 3 of the third modification configured as described above, the rotation restricting portion 170 can suppress the endoscope insertion portion 11 from rotating around the first axis O4 and changing the direction of the external visual field by the endoscope insertion portion 11. Also, the insertion restricting portion 171 can suppress a change in the position of the endoscope insertion portion 11 in the direction of the first axis O4 with respect to the first small-diameter cylindrical portion 161. Note that the forceps system 3 may include only one of the rotation restricting portion 170 and the insertion restricting portion 171.

[0058] As described above, although one embodiment and modifications of the present invention have been described in detail with reference to the drawings, the specific configuration is not limited to this embodiment, and changes, combinations, deletions, etc. of the configuration within the scope not departing from the gist of the present invention are also included. For example, in the above embodiment and modifications, the forceps 20, 70, 160 may not have at least one of the opening / closing restricting portion 56 and the rotation operation portion 61. The forceps insertion portion 21 may not have at least one of the fixing portion 23, the second small-diameter cylindrical portion 25, and the bracket 26. When the forceps 20, 70, 160 do not have the second small-diameter cylindrical portion 25, the positions of the operating members 45 with respect to the large-diameter cylindrical portion 22 may be held by both brackets 26 of the forceps insertion portion 21.

Explanation of Reference Numerals

[0059] 1, 2, 3 Forceps system 10, 150 Sub-endoscope (endoscope) 11 Endoscope insertion portion 20, 70, 160 Forceps 21 Forceps insertion portion 22 Large-diameter cylindrical portion 23 Fixed portion 24, 161 First small-diameter cylindrical portion (small-diameter cylindrical portion) 24a Opening 41 Treatment portion 49A, 49B Gripping pieces 56 Opening / closing restricting portion 61 Rotation operation portion 71 Mounting portion 170 Rotation restricting portion 171 Insertion restricting portion O1 Axis O4 First axis (small-diameter axis) O5 Second axis (treatment axis) S2 Second reference plane (reference plane)

Claims

1. A forceps insertion part, A treatment part which is arranged inside the forceps insertion part, protrudes beyond the tip side of the forceps insertion part, and performs a predetermined treatment, and is provided with, The forceps insertion part, A large-diameter cylindrical part in which the proximal-side part of the treatment part is arranged inside, A small-diameter cylindrical part which is arranged inside the large-diameter cylindrical part and into which an endoscope insertion part for observing the outside in the endoscope can be inserted, Forceps having.

2. The treatment part has two gripping pieces that can be opened and closed with respect to each other, The tip parts of the two gripping pieces open and close on a reference plane along the axis of the large-diameter cylindrical part, The entire opening at the tip of the small-diameter cylindrical part is arranged on either side orthogonal to the reference plane rather than the reference plane. The forceps according to claim 1.

3. The forceps according to claim 2, further comprising an opening / closing regulation part for regulating the opening / closing range of the two gripping pieces.

4. The forceps insertion part is arranged at an intermediate part in the axial direction of the large-diameter cylindrical part in the large-diameter cylindrical part and has a fixing part for fixing the position of the small-diameter cylindrical part with respect to the large-diameter cylindrical part. The forceps according to claim 1 or 2.

5. The treatment part extends along a treatment axis along the large-diameter cylindrical part, The forceps according to claim 1 or 2, further comprising a rotation operation part for rotating the treatment part around the treatment axis.

6. The forceps according to claim 1 or 2, further comprising a mounting part to which an endoscope main body of the endoscope is mounted.

7. The forceps according to claim 1 or 2, further comprising a rotation regulation part for regulating the orientation of the endoscope insertion part around the small-diameter axis of the small-diameter cylindrical part.

8. The forceps according to claim 1 or 2, further comprising an insertion restricting portion that restricts the position of the endoscope insertion portion disposed within the small-diameter cylinder portion in the small-diameter axis direction of the small-diameter cylinder portion.

9. The forceps according to claim 1 or 2, and the endoscope, and a forceps system comprising the same.

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