Medical Instruments

Abstract

To provide a medical instrument capable of preferably performing both of a gripping operation and a peeling operation, and reducing a frequency of instrument replacement during treatment.SOLUTION: A medical instrument 1 comprises: a slender first member 10 having a gripping surface 12a; a slender second member 50 having a gripping surface; a first spring 71 whose front end part is fitted to the first member and which extends rearward; and a second spring 72 whose front end part is fitted to the second member and which extends rearward. The first member and the second member are formed of a conductor, and outer surfaces excluding a constant range from tip ends thereof are insulation-coated. The first member and the second member are coupled so as to relatively rotate in a state in which the gripping surfaces thereof face each other. In a state in which a rear end part of the first spring and a rear end part of the second spring contact, and the first spring and the second spring are not elastically deformed, the tip end of the first member and the tip end of the second member are separated.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to a medical instrument used in surgical procedures and the like. [Background technology]

[0002] Conventionally, during a surgical procedure, various biological tissues are grasped and dissected, both before reaching the target lesion and during treatment of the target lesion.

[0003] As a medical instrument for grasping, medical tweezers are known (see, for example, Patent Document 1). As a medical instrument for dissection, a medical dissector is known. In general, grasping and dissection are performed using different medical instruments, and therefore time is required to replace the medical instruments. In addition, grasping and dissection are both performed frequently, which is one of the factors that lengthen the surgery time. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Special Publication No. 6-6126 Summary of the Invention [Problem to be solved by the invention]

[0005] The tweezers described in Patent Document 1 have a generally V-shaped configuration in which one end of a pair of clamping pieces is connected to each other. Clamping surfaces provided at the other end of the tweezers are separated in the initial state, and when force is applied to the other end to bring the clamping surfaces closer together, and the force is then released, the elasticity of the clamping pieces causes the clamping surfaces to move in a direction away from each other. Although it is possible to utilize such a movement of the clamping surfaces for a dissection operation, this is not the intended use of tweezers and makes the operation difficult.

[0006] Additionally, in the field of neurosurgery, electricity is used for purposes such as stopping bleeding and checking brain function, but currently, specialized instruments are used for these purposes, which requires cumbersome replacement of medical instruments.

[0007] An object of the present invention is to provide a medical instrument that can suitably perform both a grasping operation and a dissection operation and can reduce the frequency of instrument replacement during treatment. [Means for solving the problem]

[0008] The present invention is a medical instrument comprising a first elongated member having a gripping surface, a second elongated member having a gripping surface, a first spring having a front end attached to the first member and extending rearward on the opposite side to the front where the gripping surface is located, and a second spring having a front end attached to the second member and extending rearward on the opposite side to the front where the gripping surface is located. The first member and the second member are formed of a conductor, and their outer surfaces, except for a certain range of 10 mm or less from the tip, are insulated. The first member and the second member are connected to each other so as to be capable of relative rotation with their gripping surfaces facing each other. A rear end portion of the first spring opposite to a front end portion thereof and a rear end portion of the second spring opposite to the front end portion thereof are in contact with each other, and in an initial shape in which the first spring and the second spring are not elastically deformed, a tip of the first member and a tip of the second member are spaced apart from each other. By rotating the first member and the second member relative to one another, the gripping surfaces of the first member and the second member can be both brought closer to each other than in the initial shape and moved farther apart from each other than in the initial shape. Effect of the Invention

[0009] According to the present invention, both the grasping operation and the dissection operation can be performed suitably, and the frequency of instrument replacement during treatment can be reduced. [Brief description of the drawings]

[0010] [Figure 1] 1 is a plan view of a medical device according to an embodiment of the present invention; [Diagram 2] FIG. [Diagram 3] 4A is a diagram showing an attachment portion of a first spring in a first member; FIG. [Figure 4] FIG. [Diagram 5] FIG. 2 is a cross-sectional view taken along line II in FIG. [Figure 6] FIG. 13 is a diagram showing an example of the medical device connected to a main body. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0011] An embodiment of the present invention will be described with reference to FIGS. Fig. 1 is a plan view showing a medical device 1 of this embodiment, and Fig. 2 is a left side view. As shown in Fig. 1, the medical device 1 has a basic configuration in which a thin, rod-like first member 10 and a second member 50 are rotatably connected to each other.

[0012] The first member 10 includes a rod-shaped main body portion 11, and a connecting portion 20 and a guide portion 25 provided on the main body portion 11. The main body portion 11 has a tip portion 12 that comes into contact with tissue during grasping and dissection, a base portion 14 on which a guide portion 25 is provided, and an intermediate portion 13 that connects the tip portion 12 and the base portion 14 . In the following description, the side where the tip portion 12 is located is defined as the front of the medical instrument 1, the side where the base portion 14 is located is defined as the rear of the medical instrument 1, and the front side of the paper surface of FIG.

[0013] The tip 12 is formed in a tapered shape that gradually becomes thinner as it approaches the tip. As shown in Figs. 1 and 2, the tip 12 has a gripping surface 12a that contacts tissue during gripping and a peeling surface 12b that contacts tissue during peeling. In the first member 10, the gripping surface 12a is formed on the side facing the second member 50, and the peeling surface 12b is formed on the side opposite the gripping surface in the first member 10. There is no particular restriction on the shape of the gripping surface 12a and the peeling surface 12b, but it is preferable that they are formed flat. If necessary, a non-slip function may be imparted to the gripping surface 12a or the peeling surface 12b by a known surface roughening treatment or the like.

[0014] The base end 14 is a portion that is gripped by a user, and has a semi-cylindrical shape with a diameter larger than that of the tip end 12. As a result, the base end 14 has a curved first outer circumferential surface and a substantially flat second outer circumferential surface. The cross-sectional shape of the front side of the base end 14 is formed so that the radius of curvature of the first outer peripheral surface in the longitudinal direction increases and decreases at a predetermined cycle. As a result, nodes 15 are formed at regular intervals on the first outer peripheral surface on the front side of the base end, as shown in Figures 1 and 2, giving it an appearance similar to bamboo.

[0015] The intermediate portion 13 is connected to the front end of the base end portion 14. As shown in FIG. 2, the intermediate portion 13 extends upward and forward from the connection portion with the base end portion 14 and is connected to the rear end of the tip portion 12. As a result, the rear end of the tip portion is located higher than the base end portion 14, and the longitudinal axis of the base end portion 14 and the longitudinal axis of the tip portion 12 are not parallel to each other. The tip of the tip portion 12 is located approximately on an extension of the longitudinal axis of the base end portion 14.

[0016] 1, the connecting portion 20 is provided at the longitudinal middle portion of the base end portion 14, and protrudes toward the second member 50. The connecting portion 20 is formed with a shaft hole 20a through which a rotating shaft member (described later) is inserted.

[0017] Guide portion 25 has a pair of guide members 26 and 27 provided at base end 14. In Fig. 1, guide member 27 overlaps with guide member 26 and is not visible. The pair of guide members 26, 27 protrude toward second member 50 substantially in parallel with each other with a predetermined gap therebetween.

[0018] The second member 50 has the same basic shape as the first member 10, and includes a distal end portion 12, an intermediate portion 13, and a proximal end portion 14. As shown in Fig. 1, the second member 50 also has a plurality of nodes 15. As shown in Fig. 1, the first member 10 and the second member 50 are disposed such that their gripping surfaces 12a face each other.

[0019] The connecting portion 21 formed on the second member 50 has a shape generally similar to that of the connecting portion 20 provided on the first member 10, and protrudes toward the first member 10. The details of the manner in which the first member 10 and the second member 50 are connected will be described later.

[0020] The second member 50 is provided with a guided portion 28. The shape of the guided portion 28 is generally similar to the guide members 26 and 27, and the guided portion 28 protrudes toward the first member 10 and enters between the pair of guide members 26, 27.

[0021] The medical device 1 is configured so as to allow current to flow through tissue in contact with the distal end portion 12. The configuration that allows current flow will be described below. The first member 10 and the second member 50 are formed of a conductive material, and their outer surfaces are insulated except for a certain length from the tip. The certain length can be, for example, about 5 to 10 mm. A first cord 61 is fixed to the base end 14 of the first member 10, and a second cord 62 is fixed to the base end 14 of the second member 50, with electrical connection secured. Fixing can be performed, for example, by a heat shrink tube. The first cord 61 and the second cord 62 are connected to a plug 63. This allows the medical device 1 to be connected to a main body, which will be described later, via the plug 63.

[0022] A first spring 71 and a second spring 72 are respectively attached to the first member 10 and the second member 50. The first spring 71 and the second spring 72 in this embodiment are strip-shaped members made of metal, but the shapes and materials of the first spring 71 and the second spring 72 can be appropriately determined in consideration of the amount of operating force, which will be described later, and the like.

[0023] 3 is a diagram showing an attachment portion of the first spring 71 in the first member 10. In this embodiment, the first spring 71 is fixed to an insulating member 73 attached to the inner surface on the tip side of the base end portion 14. The insulating member 73 is an insulator such as a fluororesin, and is fixed to the first member 10 with screws 74. Examples of fluororesin include polyether ether ketone (PEEK) and polytetrafluoroethylene (PTFE).

[0024] The front end of the first spring 71 is fixed to the insulating member 73 by a screw 75. The first spring 71 extends rearward and toward the second member 50 while gently curving. FIG. 4 shows a cross section of the attachment portion of the first spring 71. The screw 74 penetrates the insulating member 73 and engages with the first member 10, but the screw 75 does not penetrate the insulating member 73 and does not contact the first member 10. In this way, the first spring 71 is fixed to the first member 10 while ensuring a state of electrical non-connection with the first member 10. The attachment mode of the second spring 72 to the second member 50 is generally similar.

[0025] Due to the above-mentioned stretching, the first spring 71 and the second spring 72 are closer to each other as they approach the rear ends. The rear end of the first spring 71 is narrowed and enters between the rear ends of the bifurcated second spring 72 and crosses them. With this configuration, the first member 10 and the second member 50 are biased so that the rear end of the first spring 71 and the rear end of the second spring 72 come into contact and engage with each other, and the regions not covered with insulation, including the tips, are separated without contacting each other in the initial shape in which the first spring 71 and the second spring 72 are not elastically deformed. This biasing force is preferably set to a very small value, for example, about 0.1 Newton (N) to 1.0 N. The distance between the tips in the initial state can be changed by manually adjusting the bending of the first spring 71 and the second spring 72, for example.

[0026] Fig. 5 is a cross-sectional view taken along line II in Fig. 1. The connecting parts 20 and 21 are arranged so that their axial holes overlap, and an insulating first washer 81 is arranged between the connecting parts 20 and 21. A bolt (rotating shaft member) 82 made of an insulating material is passed through the overlapping axial hole and first washer 81 from the connecting part 21 side. A nut 84 made of an insulating material is screwed into the end of the bolt 82 protruding toward the connecting part 20 side, with an insulating second washer 83 sandwiched therebetween. With the above-described configuration, the first member 10 and the second member 50 are coupled to be relatively rotatable about the bolt 82 as a rotation axis, while being kept in an electrically non-connected state. The material of the insulating member at the connecting portion is preferably one that has a relatively high hardness and good slipperiness, such as a fluorine-based resin.

[0027] The operation of the medical device 1 of this embodiment configured as above during use will be described. First, the plug 63 of the medical device 1 is connected to a main body 100 that supplies current, as shown in Fig. 6. The main body 100 shown in Fig. 6 is connected to a foot switch 101 that controls on / off of the current supply, but this is just one example, and the specific mode of on / off control can be determined appropriately.

[0028] The user takes the medical instrument 1 in its initial shape in his / her dominant hand, and holds the first member 10 and the second member 50 in a desired manner. There is no particular restriction on how the medical instrument 1 may be held, but an example of a standard way of holding it is to hold the first member 10 between the thumb and index finger, and to lightly hold the second member 50 with the thumb, index finger, and middle finger. This is roughly the same as how chopsticks are held when eating in Japan.

[0029] When one of the first member 10 and the second member 50 is rotated relative to the other about the bolt 82 while holding the medical instrument 1, the pair of tip portions 12 move closer to and away from each other to open and close the medical instrument 1. As the medical instrument 1 is opened and closed, the gripping surface 12a and the peeling surface 12b also move closer to and away from each other.

[0030] During the gripping operation, the reaction force of the first spring 71 and the second spring 72 acts in a direction to separate the tip portions 12 of the first member 10 and the second member 50, but if the biasing forces of the first spring 71 and the second spring 72 are set to a very small value as described above, the reaction force that occurs is also very small. As a result, the effect of the reaction force that the gripping surface 12a receives from the gripped tissue or the like is significantly reduced, and the user can accurately grasp the properties, such as hardness, of the gripped tissue or the like and appropriately proceed with the procedure.

[0031] With the tissue to be peeled in contact with one of the pair of peeling surfaces 12b, the first member 10 and the second member 50 can be rotated relative to each other so that the tip portions 12 move apart, thereby moving the tissue to be peeled. During the dissection operation, when the tip 12 is moved away from the rear end of the first spring 71 by a predetermined distance or more, the rear end of the first spring 71 and the rear end of the second spring 72 are separated from each other, and the biasing force of the first spring 71 and the second spring 72 does not act on the first member 10 and the second member 50. In this state, the user can feel only the reaction force from the tissue through the medical instrument 1, so that the user can accurately grasp the properties of the tissue to be dissected, such as hardness, and the state of the tissue, such as the degree of adhesion, and can proceed with the procedure appropriately. When the biasing force generated by the first spring 71 and the second spring 72 is set to be sufficiently small, the biasing force has almost no effect on the reaction force from the tissue, so that the user can accurately grasp the properties and state of the tissue even when the rear end of the first spring 71 and the rear end of the second spring 72 are not separated from each other.

[0032] When the user steps on the foot switch 101 while the tip of the first member 10 and the tip of the second member 50 are in contact with tissue, current is supplied from the main body 100 to the medical instrument 1, allowing current to flow between the tip of the first member 10 and the tip of the second member 50. If the current supplied from the main body 100 is a high-frequency current, the medical instrument 1 can coagulate tissue with the current to stop bleeding or cauterize it. When the medical instrument 1 is used in the field of brain surgery, the presence or absence of function of a specific part of the brain can be confirmed by applying electrical stimulation to the specific part of the brain by changing the current supplied from the main body 100. Therefore, brain mapping using this can contribute to preserving brain function by appropriately setting the treatment range. The current can be changed by changing the settings or replacing the main unit.

[0033] As described above, according to the medical instrument 1 of this embodiment, even a minute reaction force from the tissue to be operated can be sensed in detail by the hand holding the medical instrument 1, and both the grasping operation and the dissection operation can be suitably performed with an appropriate amount of force using the medical instrument 1. Furthermore, hemostasis by applying electricity and confirmation of brain function can be performed without changing to a dedicated instrument that has been used conventionally. This significantly reduces the frequency of instrument replacement during treatment, greatly contributing to shortening treatment time and reducing the burden on the patient. In particular, in the field of neurosurgery, the properties and condition of tissues, etc. are judged based on slight differences in the reaction force received from the tissue, and the magnitude of the force applied to the tissue is finely adjusted based on this judgment to perform the procedure, so the benefits of the above configuration are extremely significant.

[0034] Furthermore, since the guided portion 28 is disposed between the pair of guide members 26, 27, the first member 10 and the second member 50 rotate relatively while being guided by the guide portion 25. Furthermore, the first spring 71 and the second spring 72 that apply a biasing force to the first member 10 and the second member 50 are not directly connected, so that the rear ends of the two engaged springs can move relative to each other. Therefore, regardless of the state of the first spring 71 and the second spring 72, no force is generated that moves the tips of the first member 10 and the second member 50 in the longitudinal direction of the first member 10 and the second member 50.

[0035] With the above-mentioned configuration, even if the dimension of the tip of the tip portion 12 in the direction perpendicular to the longitudinal direction is as thin as 1 mm or less, the tip is unlikely to slip during gripping. Therefore, even small objects can be gripped reliably. Furthermore, even if the rear ends of the first spring 71 and the second spring 72 separate and disengage during the peeling operation, the guided portion 28 remains positioned between the pair of guide members 26, 27, so that the rear ends of the first spring 71 and the second spring 72 easily re-engage when the first member 10 and the second member 50 approach each other again. This advantageously achieves both prevention of tip slippage and smooth opening and closing operations.

[0036] Furthermore, since the intermediate portion 13 has a shape having a plurality of joints 15, the user can hold the medical instrument 1 by hooking his / her fingers on an appropriate joint according to the size of his / her hand, the length of his / her fingers, etc. Therefore, the medical instrument 1 can be configured to be non-slip and easy to use for a wide range of users.

[0037] In the initial shape of the medical instrument 1, the tip ends of the first member 10 and the second member 50 are kept apart by the first spring 71 and the second spring 72. This makes it possible to preferably prevent the tip ends from accidentally coming into contact with each other during use of the medical instrument 1, thereby preventing an electrical short circuit from occurring.

[0038] Furthermore, since the longitudinal axis of the base end 14 held by the user is not parallel to the longitudinal axis of the tip end 12 that comes close to and comes into contact with tissue, the hand of the user holding the base end 14 is not positioned on the extension of the axis of the tip end 12. This makes it difficult for the user's hand to enter the field of view of the user who is visualizing the tip, and prevents the user from being unable to confirm the position of the tip due to the hand. This effect is particularly noticeable in the field of brain surgery, where procedures are often performed under a microscope, and is extremely useful, for example, when performing procedures deep in the brain.

[0039] The opening and closing action of the medical instrument of the present invention is similar to that of chopsticks used in Japan for eating, etc., so users living in Japan can use it without feeling uncomfortable, as the action is roughly the same as chopsticks they are accustomed to using. Now that chopsticks are used worldwide due to the spread of Japanese food, etc., it is expected that even more users will be able to use the medical instrument of the present invention without feeling uncomfortable.

[0040] The above-mentioned manner in which the medical instrument 1 is held is merely an example, and does not limit the manner in which the medical instrument 1 is used. Just as chopsticks are held in various ways in Japan and around the world, a user can hold the medical instrument 1 in a manner that is easy for him or her to use, and rotate the first member 10 and the second member 50 relative to each other to perform grasping and peeling operations.

[0041] Although one embodiment of the present invention has been described above, the technical scope of the present invention is not limited to the above embodiment, and it is possible to combine components of different embodiments, make various changes to each component, or delete the components without departing from the spirit of the present invention.

[0042] The material of the medical device of the present invention is not particularly limited as long as it is an electrically conductive conductor, but from the viewpoints of biocompatibility and resistance to sterilization treatment, titanium, stainless steel, and the like are preferred. In addition, in the present invention, it is not essential that the longitudinal axis of the distal end and the longitudinal axis of the proximal end of the first and second members are non-parallel, and the distal end and the proximal end may be arranged coaxially and linearly. In this case, the medical instrument does not need to have an intermediate portion. When the first and second members are linear, the above-mentioned advantages are reduced, but other effects are enjoyed in relatively shallow areas, and the procedure can be performed well.

[0043] In the present invention, the first spring and the second spring may be formed of a material other than metal, for example, a resin, etc. In this case, even if the first spring and the second spring are engaged with each other, the first member and the second member are not electrically connected, so the first spring and the second spring may be attached directly to the first member and the second member without an insulating member. Furthermore, in the initial shape, it is not essential that the rear end portion of the first spring and the rear end portion of the second spring are engaged with each other, and they may simply be in contact with each other.

[0044] The application field of the medical instrument of the present invention is not limited to the above-mentioned brain surgery field. Even in other fields, by performing the grasping operation and the dissection operation with one medical instrument, it can contribute to shortening the operation time and reducing the burden on the patient. [Explanation of symbols]

[0045] 1 Medical equipment 10 First member 12 Tip 13 Middle section 14 Proximal end 12a Gripping surface 50 Second member 71 First Spring 72 Second Spring 73 Insulating materials 82 Bolt (rotating shaft member)

Claims

1. an elongated first member having a gripping surface; a second elongated member having a gripping surface; A first spring having a front end attached to the first member and extending rearward opposite the front where the gripping surface is located; A second spring having a front end attached to the second member and extending rearward opposite the front where the gripping surface is located; Equipped with the first member and the second member are made of a conductor, and their outer surfaces except for a certain range of 10 mm or less from the tip are insulated; The first member and the second member are connected to each other so as to be relatively rotatable with their gripping surfaces facing each other, a rear end of the first spring opposite to the front end and a rear end of the second spring opposite to the front end are in contact with each other, and in an initial shape in which the first spring and the second spring are not elastically deformed, a tip of the first member and a tip of the second member are spaced apart, and it is possible to both bring the gripping surface of the first member and the gripping surface of the second member closer to each other than in the initial shape and move them farther apart from each other than in the initial shape by rotating the first member and the second member relatively. Medical instruments.

2. A pivot member made of an insulator is passed through a connecting portion between the first member and the second member, and the first member and the second member are connected to each other so as to be relatively rotatable about the pivot member. The medical device of claim 1 .

3. the first spring and the second spring are made of metal and are attached to the first member and the second member, respectively, via an insulating member; The medical device according to claim 1 or 2.

4. The first member and the second member are A tip portion including the tip; A base end portion that is gripped by a user; an intermediate portion connecting the distal end portion and the proximal end portion; The longitudinal axis of the distal end portion and the longitudinal axis of the proximal end portion are non-parallel. A medical device according to any one of claims 1 to 3.

Images