surgical instruments

Abstract

To move a dural tube while protecting it without narrowing the field of view when an affected area is located below the dural tube during endoscopic spinal surgery for spinal canal stenosis, lumbar disc herniation, or the like. [Solution] A surgical instrument 1 used with an endoscope 100 to be inserted into the human body, characterized in that the surgical instrument 1 has a cylindrical body, a tubular body 2 through which the endoscope is inserted, and an extension portion 3 that extends from a portion of the circumferential direction of one end edge of the tubular body 2 in the direction in which the endoscope 100 is inserted.

Description

[Technical Field]

[0001] The present invention relates to an endoscopic surgical instrument. [Background technology]

[0002] In endoscopic spinal surgery for spinal stenosis, lumbar disc herniation, etc., an endoscopic device, such as that described in Patent Document 1, is used to drill a hole in the patient's body, insert a cylindrical retractor into the hole, and then insert an endoscope into the retractor to observe the surgical field, which will be the affected area, while the procedure is being performed. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Publication No. 2022-120383 Summary of the Invention [Problem to be solved by the invention]

[0004] However, to ensure minimal invasiveness, the hole drilled in the patient must be as small as possible, which inevitably narrows the field of view of the endoscope. In this state, if an affected area, such as an intervertebral disc compressing a nerve or a bony protrusion, is located ventral to the dural tube protecting the spinal cord, it becomes difficult to identify the affected area with the endoscope. Furthermore, if an instrument is used to move the dural tube to identify the affected area, the instrument further narrows the field of view and reduces operability, which presents a problem. Furthermore, because damage to the dural tube can cause serious symptoms, extreme care must be taken when moving the dural tube and after it has been moved to avoid damaging it.

[0005] The present invention has been devised in consideration of the above-mentioned problems, and relates to a surgical instrument that does not narrow the field of view and prevents deterioration of operability when moving tissue to expose the affected area. [Means for solving the problem]

[0006] The surgical instrument of the present invention is a surgical instrument used with an endoscope inserted into the human body, and is characterized by comprising a cylindrical tubular body through which the endoscope is inserted, and an extension portion extending from a portion of the circumference of one end edge of the tubular body in the direction in which the endoscope is inserted.

[0007] With this configuration, the surgical instrument of the present invention further includes an extension portion integrally formed with the tubular body through which the endoscope is inserted, allowing tissue to be moved using the extension portion without inserting any additional instruments. This prevents a narrowing of the field of view and a deterioration in operability. For example, in endoscopic spinal surgery, if an affected area, such as an intervertebral disc or bony protrusion compressing a nerve, is located ventral to the dural tube, the extension portion can be used to move the dural tube and expose the affected area. Furthermore, because the extension portion is positioned between the affected area and the dural tube, it protects the dural tube from instruments used to resect the affected area, preventing damage to important tissues such as the dural tube during surgery.

[0008] In one specific embodiment of the surgical instrument of the present invention, the extension portion is provided with at least one bending portion that bends so as to approach the endoscope.

[0009] With this configuration, the tissue (e.g., the dural tube) is positioned along the bending portion, so the distance and width of the tissue movement can be determined by the bending portion, making it possible to move the tissue according to the surgical site, surgical procedure, etc. [Effects of the Invention]

[0010] The surgical instrument of the present invention can move tissue without narrowing the field of view, keeping the surgical field wide and preventing deterioration of operability, and can also protect tissue during surgery. [Brief explanation of the drawings]

[0011] [Figure 1] 1 is a schematic view of a surgical instrument according to a first embodiment. [Figure 2] FIG. 2 is a plan view of the surgical instrument of the first embodiment. [Figure 3] FIG. 3 is a cross-sectional view of the surgical instrument of the first embodiment taken along line AA in FIG. 2. [Figure 4] FIG. 2 is a plan view showing an endoscope inserted into the surgical instrument of the first embodiment. [Figure 5] FIG. 5 is a schematic view of a surgical instrument according to a second embodiment. [Figure 6] FIG. 10 is a plan view of a surgical instrument according to a second embodiment. [Figure 7] 7 is a cross-sectional view of the surgical instrument of the second embodiment taken along line BB in FIG. 6. [Figure 8] FIG. 10 is a plan view showing an endoscope inserted into the surgical instrument of the second embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0012] The surgical instrument of this embodiment is used in endoscopic spinal surgery for spinal stenosis, lumbar disc herniation, etc. This embodiment assumes biportal endoscopic surgery in which two holes are made in the patient, and an endoscope is inserted into one hole and a surgical instrument is inserted into the other hole.

[0013] First Embodiment The surgical instrument of the first embodiment will be described in detail below with reference to the drawings.

[0014] As shown in Figures 1 to 4, the surgical instrument 1 of the first embodiment is a cylindrical body and includes a tubular body 2 through which an endoscope 100 is inserted, and an extension portion 3 that extends from a portion of the circumferential direction of one end edge of the tubular body 2 in the direction in which the endoscope 100 is inserted.

[0015] The tubular body 2 is inserted into a hole provided in the patient, and in this embodiment, is inserted into a hole through which the endoscope 100 is inserted. The tubular body 2 has an extension 3 at one end and a knob 4 on the circumferential surface of the other end. The knob 4 is used to secure the surgical instrument 1 of this embodiment to the outer sheath of the endoscope 100. One end of the tubular body 2, together with an insertion aid (not shown) disposed in its internal space 2a, is inserted into the patient's body through the hole through which the endoscope 100 is inserted, and the other end provided with the knob 4 is disposed outside the body. Once insertion into the hole through the patient's body is complete, the insertion aid is removed, leaving the internal space 2a empty, and the endoscope 100 is inserted into this internal space 2a.

[0016] The extension portion 3 extends in one direction (the direction in which the endoscope 100 is inserted) from a portion of the circumferential direction of one end edge of the tubular body 2 that is inserted into the patient's body, and extends parallel to the extension direction of the tubular body 2. As a result, as shown in the cross section of Figure 3, the tip of the extension portion 3 has an inclined cut surface shape obtained by cutting one end of the tube at an angle. This extension portion 3 is configured to be integrated with the tubular body 2, but may also be made of a material different from that of the tubular body 2 (for example, a translucent member).

[0017] The surgical instrument 1 of the first embodiment configured as described above is inserted into the hole through which the endoscope 100 is inserted. At this time, if the affected area to be excised is on the back side of the tissue (for example, in this embodiment, a hole is made in the patient's back to perform the surgery, but the affected area is on the ventral side and cannot be seen from the back side due to the dural tube), the extension portion 3 can be used to press and move the tissue (in this embodiment, the dural tube) to expose the affected area. Therefore, when the endoscope 100 is inserted into the internal space 2a of the tubular body 2, the surgeon can confirm that the affected area is exposed, allowing the surgeon to easily perform the surgery even in endoscopic surgery with a narrow field of view.

[0018] Furthermore, since there is no need to use a separate instrument as in the past, it is possible to prevent the surgical field from being further narrowed by a separate instrument placed solely for moving the dural tube. In addition, since the dural tube protects the spinal cord and cauda equina, accidental damage to it can result in serious after-effects. However, with the surgical instrument 1 of this embodiment, the extension portion 3 is placed between the affected area and the dural tube, allowing surgery to be performed while the dural tube is protected.

[0019] Second Embodiment The surgical instrument 10 of the second embodiment will be described in detail below with reference to the drawings. Note that the same parts as those of the surgical instrument 1 of the first embodiment are given the same reference numerals and descriptions thereof will be omitted.

[0020] 5 to 8, the surgical instrument 10 of the second embodiment includes a tubular body 2 and an extension portion 11. The extension portion 11 of the second embodiment extends in one direction (the direction in which the endoscope 100 is inserted) from a portion of the circumferential direction of one end edge of the tubular body 2 that is inserted into the patient's body, and is provided with at least one bending portion 12 that bends so as to approach the endoscope 100.

[0021] In this embodiment, the liquid extension portion 11 extends from a portion of the circumference of one end edge of the tubular body 2, bends to approach the endoscope 100, and has a bending portion 12 that extends parallel to the extension direction of the tubular body 2 after bending.

[0022] The bending portion 12 is bent by 4 mm relative to the 8 mm outer diameter of the tubular body 2 so as to be close to the endoscope 100. The bending width and bending position of the bending portion 12 can be changed as appropriate. Also, a plurality of bending portions 12 may be provided.

[0023] In the surgical instrument 10 of the second embodiment, the bending shape of the bending portion 12 presses along the tissue (the dural tube in this embodiment), so the traction force for moving the dural tube can be determined by the bending width of the bending portion 12. For example, with the surgical instrument 10 of this embodiment, the bending portion 12 bends 4 mm so as to approach the endoscope 100, so surgery can be performed with the dural tube moved 4 mm, making it possible to move the dural tube while suppressing the force pulling on the dural tube to some extent.

[0024] The present invention is not limited to the above-described embodiments.

[0025] For example, although this embodiment is intended for use in endoscopic spinal surgery for spinal stenosis, lumbar disc herniation, etc., the surgical instrument of this invention can be used in any surgery that uses an endoscope.

[0026] Furthermore, the surgical instruments of the present invention may be configured to be reusable or disposable.

[0027] The surgical instrument of the present invention can be implemented in various forms with various improvements, modifications, or variations based on the knowledge of those skilled in the art, without departing from the spirit of the instrument. [Explanation of symbols]

[0028] 1, 10...Surgical instruments 2. Tube body 2a...interior space 3, 11...extension part 4 Knob 12. Bend 100 Endoscope

Claims

1. A surgical instrument used in an endoscope inserted into the human body, a tubular body through which the endoscope is inserted; a tubular body having a distal end and a distal end, the distal end of which extends from a circumferential portion of the distal end of the tubular body toward the distal end of the surgical instrument;

2. 2. The surgical instrument according to claim 1, wherein the extension portion has at least one bending portion that bends so as to approach the endoscope.

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