Switchable laparoscopic surgical forceps

Abstract

To provide changeover type abdominoscope surgical forceps in which forceps to be used can be projected from a shaft and only the projected forceps can be operated by one handle.SOLUTION: Changeover type abdominoscope surgical forceps include: a body part (10) in which a plurality of forceps units (30) are projectably stored in an outer cover (10a); a handle part (20) that controls opening and closing of the forceps unit projecting from the outer cover; a connection component that connects the forceps unit and the handle part; and selection means (40) that causes one of the forceps units to project from the outer cover. The forceps unit includes: a forceps part (32), a load that drives the forceps part, a shaft storing a part of the forceps part and the load and provided with a load spring stopper therein, and a load spring that connects the load spring stopper and the load. One end of the connection component engages with another end of the load of the forceps unit selected by the selection means. The handle part is connected to another end of the connection component.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to forceps for use in laparoscopic surgery. [Background technology]

[0002] In recent years, laparoscopic surgery using an endoscope has been used as a surgical technique to minimize the burden on patients during medical treatment. It is particularly used in surgery on the digestive organs. In laparoscopic surgery, several holes are made in the abdomen and temporary ports called trocars are placed. An endoscope and surgical instruments are inserted into the abdominal cavity through the trocars to perform the surgery.

[0003] A trocar is a hole with a diameter of several tens of millimeters, so the shape of the instruments that can be inserted into it is also restricted. Patent Document 1 describes a typical forceps used in such laparoscopic surgery. Basically, this type of forceps has jaws that open and close at the end of a shaft incorporating a long, thin rod, and the rod is controlled by gripping and opening a handle. The shape resembles a handgun.

[0004] Since only a few trocars are provided, the amount of instruments that can be brought into the abdominal cavity through the trocars is also limited. Therefore, forceps that allow multiple forceps to be brought into the abdominal cavity from one trocar have been proposed.

[0005] Patent Document 2 shows a device in which two forceps are provided at the tip of one shaft, while Patent Document 3 discloses a device in which three forceps are provided at the tip of one shaft.

[0006] Patent document 4 proposes a switchable forceps in which forceps attached to the tip of a shaft are stored inside a cylindrical body and an operating lever located outside the cylindrical body is pushed out, causing the forceps to protrude from the tip of the cylindrical body and become operable. [Prior art documents] [Patent documents]

[0007] [Patent Document 1] Japanese Patent Application Publication No. 08-164144 [Patent Document 2] Special Publication No. 2014-512870 [Patent Document 3] Special Publication No. 08-502438 [Patent Document 4] JP 2018-064883 A Summary of the Invention [Problem to be solved by the invention]

[0008] As disclosed in Patent Documents 2 and 3, it is a useful idea to be able to bring multiple forceps into the abdominal cavity at once. As the surgery progresses, the type of forceps required changes. Therefore, it is necessary to change the forceps successively as the surgery progresses. However, changing the forceps increases the number of times the tip of the forceps is inserted and removed from the trocar, which is time-consuming and causes the surgery time to be longer.

[0009] However, as in Patent Documents 2 and 3, when multiple forceps protrude from one shaft into the abdominal cavity, it becomes difficult to tell which handle controls which forceps in the narrow field of view of the endoscope.In addition, there is a risk that forceps that are out of the field of view of the endoscope may touch unnecessary organs.

[0010] In this respect, Patent Document 4 solves the above problem by allowing only the tip of one forceps inserted from a trocar to be switched inside the abdominal cavity. However, the switching forceps in Patent Document 4 open and close the forceps by wire operation, so there is a possibility that play may occur between the movement of the forceps and the operating handle depending on the adjustment state of the wire. In addition, there is also a problem that the wire mechanism is difficult to disinfect. [Means for solving the problem]

[0011] The present invention has been conceived in view of the above problems, and provides a switchable forceps in which there is no play between the operating handle and the opening and closing of the forceps, the movement of the operating handle is always reflected in the opening and closing of the forceps, and further, which is easy to disinfect afterwards.

[0012] More specifically, the switchable laparoscopic surgical forceps according to the present invention include: a main body portion in which a plurality of forceps units are housed within an outer cover in a protrudable manner; a handle portion protruding from the outer cover for controlling opening and closing of the forceps unit; a connecting part that connects the forceps unit and the handle portion; a selection means for causing one of the forceps units to project from the outer cover; The forceps unit includes: A forceps unit having a jaw that opens and closes and a link mechanism that opens and closes the jaw; a load having one end connected to the link mechanism and configured to drive the link mechanism; a shaft that houses the forceps portion and a part of the rod and has a rod spring stopper on its inner surface; a load spring connecting between the load spring stop and the other end of the load; One end of the connecting part is engaged with the other end of the rod of the forceps unit selected by the selection means and protruding from the outer cover, The handle portion is connected to the other end of the connecting part. 、 The selection means is A protruding shaft stopper provided on an outer surface of the shaft; A shaft holder provided inside the outer cover; a shaft spring provided between the shaft stopper and the shaft holder; A cylindrical rotary extrusion part is provided between the handle part and the shaft stopper, encases the shaft, and has one end cut obliquely. It is characterized by the fact that Effect of the Invention

[0013] The switchable laparoscopic surgical forceps of the present invention uses a rod-shaped connecting part as a part that transmits the operation of the handle part to the rod-shaped load that controls the opening and closing of the forceps, and the load is configured so that it is always biased by a load spring to open the forceps, so there is no play between the handle part and the opening and closing of the forceps, and the movement of the handle part can be directly reflected in the opening and closing of the forceps.

[0014] In addition, the selection means of the forceps unit is formed in a cylindrical shape that encases the forceps unit and is located near the handle portion, so that switching of the forceps unit does not take time and the switching means can be operated by feel without visually checking it.

[0015] In addition, since there are no parts that change shape other than the spring, there is no risk of missing any parts being disinfected when disassembling and disinfecting the device. [Brief description of the drawings]

[0016] [Figure 1] 1 is a diagram showing the appearance of switchable laparoscopic surgical forceps according to the present invention. FIG. [Diagram 2] FIG. 2 is a diagram showing a state in which an outer cover is removed from FIG. [Diagram 3] FIG. 2 is a diagram illustrating a rotary extrusion part. [Figure 4] FIG. 3 is a diagram showing a state in which a shaft holder and a rotary pusher part are further removed from FIG. 2. [Diagram 5] FIG. 2 is a diagram showing a configuration of a forceps unit. [Figure 6] FIG. 2 is a diagram showing a configuration of a main body part. [Figure 7] 13A and 13B are diagrams showing how the forceps units are replaced by rotating a rotary push-out part that constitutes the selection means. [Figure 8] 13A and 13B are diagrams illustrating a state in which the jaws of the forceps unit in the protruding state open and close when the handle portion is operated. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0017] The following describes the switchable laparoscopic surgical forceps according to the present invention with reference to the drawings. Note that the following description is an example of one embodiment of the present invention and an example, and the present invention is not limited to the following description. The following description can be modified without departing from the spirit of the present invention.

[0018] FIG. 1 shows an external view (FIG. 1(a)) and a partial perspective view (FIG. 1(b)) of switchable laparoscopic surgical forceps 1 according to the present invention. The switchable laparoscopic surgical forceps 1 is composed of a main body 10 and a handle 20. The main body 10 is covered with a cylindrical outer cover 10a. The main body 10 contains a plurality of forceps units 30 and a selection means 40 for selecting a forceps unit 30 to be protruded from the outer cover 10a among the plurality of forceps units 30. FIG. 1 shows a case in which two forceps units 30 are stored. Of course, three or more forceps units 30 may be stored.

[0019] In the following description, the handle portion 20 side of the switchable laparoscopic surgical forceps 1 will be referred to as the "rear" and the opposite side will be referred to as the "front". In addition, of the two forceps units 30, the upper forceps unit 30 will be referred to as the "(A-side) forceps unit 30A" and the lower forceps unit 30 will be referred to as the "(B-side) forceps unit 30B". In addition, when distinguishing between the forceps units 30 and the members that constitute them, the letters "A" or "B" will be added after the reference numerals of the respective members to distinguish them, and when no particular distinction is made, only the reference numerals will be added. In addition, "one end" refers to the end on the front side, and "the other end" refers to the end on the rear side.

[0020] Each forceps unit 30 is stored in the outer cover 10a with its axial direction aligned with the direction of the forceps portion 32 and with the axial direction aligned with the main body portion 10. Note that the axis here refers to the center line (center of rotation) in the front-rear direction of the outer cover 10a and a shaft 34 (described later).

[0021] The handle portion 20 is provided with an operating lever 21 with a thumb hole 21a and a grip portion 22 with a lower finger hole 22a. The grip portion 22 is fixed to a base plate forming the handle portion 20. The operating lever 21 is pivoted by a pivot 21b provided on the handle portion 20, and can be swung around the pivot 21b with respect to the base plate of the handle portion 20. By swinging the operating lever 21, the jaw portion 32a of the forceps portion 32 protruding from the outer cover 10a opens and closes. In addition, a ratchet 23 is disposed adjacent to the grip portion 22. The ratchet 23 locks the movement of the operating lever 21. The operating lever 21 is biased away from the grip portion 22 by a spring (not shown). If the ratchet 23 does not lock the movement of the operating lever 21, the operating lever 21 opens in a direction away from the grip portion 22. In other words, when the ratchet 23 is released, the operating lever 21 opens and the jaw portion 32a opens.

[0022] Between the handle portion 20 and the main body portion 10, an operation surface 40a of a selection means 40 for switching the forceps unit 30 to be protruded from the outer cover 10a of the main body portion 10 is exposed (FIG. 1(b)). By rotating this operation surface 40a, the forceps unit 30 protruding from the outer cover 10a is switched. Here, switching means that, assuming that the protruding forceps unit 30 is forceps unit 30A, the forceps unit 30A is stored in the main body portion 10 and instead, the forceps unit 30B protrudes from the outer cover 10a. Note that after the forceps unit 30A is once stored in the outer cover 10a, the forceps unit 30B may be protruded by another operation.

[0023] FIG. 2(a) shows the state without the outer cover 10a. When the outer cover 10a is removed, the rotating push-out part 40b constituting the selection means 40, the shaft holder 13, and two sets of forceps units 30 are revealed. FIG. 2(b) shows the state with the shaft holder 13 and the rotating push-out part 40b split. The shaft holder 13 engages with a specific location on the inner wall of the outer cover 10a and is fixed at a predetermined position on the outer cover 10a. A cylindrical outer cover fixing part 10b with a two-tiered outer wall is fixed to the front end of the handle part 20. The outer cover 10a is connected to the handle part 20 via the outer cover fixing part 10b, so that the switchable laparoscopic surgical forceps 1 is integrated with the main body part 10 and the handle part 20.

[0024] The selection means 40 is formed by a rotary push-out part 40b, a shaft stopper 34a provided on the forceps unit 30, a shaft holder 13 that determines the relative positions of the forceps unit 30 and the outer cover 10a, and a shaft spring 42 provided between the shaft stopper 34a and the rear end of the shaft holder 13. At this time, the rotary push-out part 40b is sandwiched between the outer cover fixing part 10b and the shaft stopper 34a.

[0025] FIG. 3(a) shows the rotary pusher part 40b placed vertically. Therefore, the front-to-back direction is the up-to-down direction in FIG. 3. The rotary pusher part 40b is a cylindrical part with one end cut off at an angle. Therefore, the edge position of the opening on one end side differs in the front-to-back direction. In other words, the opening on one end side has a leading edge (referred to as "leading edge 40c") and a rearmost edge (referred to as "rear edge 40d"). An operating surface 40a is formed at the rear end of the rotary pusher part 40b (the bottom end in FIG. 3).

[0026] In this description, since two forceps units 30 are attached, the rear end edge 40d on which the shaft stopper 34a is hooked may be one location. However, as shown in Fig. 3(b), by making the rear end edge 40d a fixed area on which multiple shaft stoppers 34a can be hooked and leaving the leading edge 40c at one location, it is possible to push one shaft stopper 34a forward from the multiple shaft stoppers 34a.

[0027] 3(b), for example, a point Ssp is provided on the rear end edge 40d to allow two shaft stoppers 34a to be hooked. When combined with the leading edge 40c, one of the three forceps units 30 can be pushed out.

[0028] 2, the rotary push-out part 40b is rotatably fitted to the outer cover fixing part 10b. The operation surface 40a of the rotary push-out part 40b (which is also the operation surface of the selection means 40) is provided on the side surface of the other end side.

[0029] An edge on one end side of the rotary push-out part 40b abuts against the shaft stopper 34a. The shaft stopper 34a is constantly biased backward by a shaft spring 42 arranged between the rotary push-out part 40b and the shaft holder 13. Therefore, when the rotary push-out part 40b is rotated, one of the shaft stoppers 34a moves backward along the edge between the leading edge 40c and the rear edge 40d, and the other shaft stopper 34a is pushed forward. In this manner, the selection means 40 switches the internal forceps unit 30.

[0030] 4 shows the state without the shaft holder 13 and the rotary pusher part 40b. At one end of the forceps unit 30, there are arranged two sets of a forceps part 32 having an opening and closing jaw part 32a, a rod 36 for controlling the opening and closing of the jaw part 32a, and a shaft 34 covering the rod 36. One end of the shaft 34 starts immediately behind the forceps part 32. The other end of the shaft 34 extends to a shaft stopper 34a. The rod 36 extends rearward beyond the shaft stopper 34a.

[0031] The other end of the rod 36 engages with the connecting part 50 when the forceps unit 30 is projected forward from the outer cover 10a. The connecting part 50 has a flange 50a with a through hole 50ah formed therein fixed to one end of a rod 50b with the opening of the through hole 50ah facing forward and backward. The other end of the connecting part 50 is pivotally supported by the operating lever 21 of the handle portion 20. By swinging the operating lever 21, the connecting part 50 is pulled backward. The connecting part 50 is made of metal or resin, and can transmit a force applied in the length direction with almost no bending.

[0032] The rods 36 of the two forceps units 30 are inserted into the through-holes 50ah of the flanges 50a. The other end of the rods 36 has a hook end 36c larger than the through-hole 50ah of the flanges 50a. When the forceps units 30 are pushed forward and the hook end 36c hooks into the through-hole 50ah of the flanges 50a, the operating lever 21 is operated to pull the connecting part 50 backward, and the rods 36 are also pulled backward.

[0033] 5(a), the forceps unit 30 will be described in more detail. The forceps unit 30 is composed of a forceps portion 32, a load 36, a shaft 34, and a load spring 38.

[0034] The forceps section 32 has a pair of jaws 32a connected to a link mechanism 32b. The configuration of the pair of jaws 32a and the link mechanism 32b may be a known configuration. The link mechanism 32b is driven by a load 36. The load 36 is a long rod-shaped member that has rigidity in the length direction. In other words, when one end is pushed and moved, the other end moves the distance the one end is pushed without bending along the way.

[0035] The link mechanism 32b is connected to one end 36a of the load 36. Meanwhile, a hook end 36c is formed at the other end 36b of the load 36. The hook end 36c has a terminal shape with a diameter larger than the through hole 50ah of the flange 50a of the connecting part 50 (see FIG. 4(b)). The hook end 36c can be suitably formed by a method such as threading a screw having a head diameter larger than the through hole 50ah into the other end 36b of the load 36, or cutting an external thread into the other end 36b of the load 36 and screwing a nut larger than the through hole 50ah.

[0036] The link mechanism 32b is configured to open the jaws 32a when the load 36 is pushed in and close the jaws 32a when the load 36 is pulled out. Fig. 5(a) shows a state in which the load 36 is pulled out relative to the shaft 34 by operating the handle portion 20 (see Fig. 1(a)), and Fig. 5(b) shows a state in which the load 36 is pushed into the shaft 34.

[0037] The travel distance of the rod 36 required to open and close the jaw 32a is called the opening / closing length 36L. The jaw 32a and the rod 36 are connected by a link mechanism 32b, so the jaw 32a opens and closes by pushing in and pulling out the rod 36. Conversely, when the open jaw 32a is forcibly closed, the rod 36 is pushed backward by the opening / closing length 36L.

[0038] The link mechanism 32b and the load 36 are covered by the shaft 34. However, at least the jaw portion 32a is disposed outside the shaft 34. The link mechanism 32b is fixed relative to the shaft 34.

[0039] A load spring stopper 36a for stopping one end of a load spring 38 is fixed to the load 36 within a shaft stopper 34a provided at the other end of the shaft 34. The load spring 38 receives the other end of the load spring 38 inside the shaft stopper 34a. One end of the load spring 38 is also received by the load spring stopper 36a. Therefore, the load 36 is always biased forward relative to the shaft 34.

[0040] 6 is a schematic diagram of the main body 10. Two sets of forceps units 30 are arranged inside the outer cover 10a, and one of them is protruding from the outer cover 10a by the selection means 40. Specifically, the tip edge 40c of the selection means 40 protrudes the shaft stopper 34aB of the forceps unit 30B forward, causing the forceps portion 32B of the forceps unit 30B to protrude from the tip of the outer cover 10a.

[0041] At this time, the jaws 32aA of the forceps unit 30A housed inside the outer cover 10a (main body 10) are forcibly restricted to a closed state only in the opening diameter of the forceps pressing plate 14. That is, the jaws 32aA (jaws 32aA) are more open than the state in which they are closed by operating the handle 20 as described below. The forceps pressing plate 14 is disposed at the tip of the outer cover 10a (the side from which the forceps unit 30 protrudes). The front side of the shaft spring 42 is restricted by the rear end of the shaft holder 13.

[0042] FIG. 7(a) shows the forceps unit 30B of the forceps unit 30 housed in the outer cover 10a in a protruding state. The forceps unit 30A is housed in the outer cover 10a. The forceps pressing plate 14 is disposed at the tip of the outer cover 10a, and as described above, the jaw 32aA of the housed forceps unit 30A is forcibly closed. Also, the shaft spring 42B on the forceps unit 30B side is compressed, pushing the forceps unit 30B backward against the shaft holder 13. The tip edge 40c of the rotary push-out part 40b abuts against the shaft stopper 34aB of the forceps unit 30B, thereby holding the forceps unit 30B in the protruding position.

[0043] The load spring 38B disposed in the shaft stop 34aB is biased in a direction extending between the load spring stop 36dB fixed to the load 36B and the shaft stop 34aB. As a result, the load 36B is biased forward relative to the shaft 34B. The load 36B then pushes the link mechanism 32bB forward, and the jaws 32aB are maintained in an open state.

[0044] Next, the rotary push-out part 40b is rotated (FIG. 7(b)). The shaft stopper 34aB of the forceps unit 30B retracts the edge of the rotary push-out part 40b toward the rear end edge 40d due to the bias of the shaft spring 42B. Meanwhile, the shaft stopper 34aA of the forceps unit 30A is pushed out against the bias of the shaft spring 42A toward the front end edge 40c of the rotary push-out part 40b.

[0045] When the shaft stopper 34aA of the forceps unit 30A is pushed out to the leading edge 40c of the rotary pusher part 40b, the hook end 36cA at the other end of the rod 36A engages with the flange 50a of the connecting part 50. Since the operating lever 21 (see Figs. 1 and 2) is biased in the opening direction by a spring (not shown), the flange 50a of the connecting part 50 advances to the forwardmost position when the ratchet 23 is released. The jaw 32aA of the forceps unit 30A is open because the load spring 38A biases the rod 36A forward relative to the shaft 34A.

[0046] FIG. 8 shows the principle of the opening and closing operation of the forceps unit 32 by operating the handle portion 20 (see FIG. 1(a)). See FIG. 8(b). When the handle portion 20 is operated, the connecting part 50 is pulled backward, and the engaged rod 36A is also pulled backward. As a result, the jaw portion 32aA closes. In this movement, if the engaging portion between the flange 50a of the connecting part 50 and the rod 36A is securely engaged when the forceps unit 30A is pushed out by the rotary push-out part 40b, the movement of the operating lever 21 is transmitted through the connecting part 50, the rod 36A, the link mechanism 32bA, and the jaw portion 32aA. Therefore, the movement of the operating lever 21 is transmitted almost directly to the jaw portion 32aA, and there is almost no play in operation.

[0047] In addition, since the load spring stopper 36dA fixed to the load 36A moves backward while the shaft 34A does not move, the load spring 38A biases the contracted load 36A forward. As a result, when the force is released from the operating lever 21 of the handle portion 20, the load 36A moves forward and the jaw portion 32aA opens. [Industrial Applicability]

[0048] The switchable forceps for laparoscopic surgery according to the present invention can be suitably used in laparoscopic surgery using an endoscope. [Explanation of symbols]

[0049] 1 Switchable laparoscopic surgical forceps 10 Main body 10a Outer cover 10b Outer cover fixing parts 13 Shaft holder 14 Forceps holder 20 Handle 21 Operating lever 21a Thumb hole 21b Axis 22 Grip 22a Lower finger hole 23 Ratchet 30 Forceps unit 32 Forceps 32a Jaw 32b Link mechanism 34a Shaft stopper 34 Shaft 36 Road 36a (One end of the road) 36b (the other end of the road) 36c (Road) Hanging End 36d Opening length 36L Load spring stop 38 Road Spring 40 Selection Method 40a Operation surface 40b Rotary extrusion parts 40c Tip Edge 40d rear edge 42 Shaft spring 50 Connecting parts 50b Rod 50a flange 50ah through hole

Claims

1. a main body portion in which a plurality of forceps units are housed within an outer cover in a protrudable manner; a handle portion protruding from the outer cover for controlling opening and closing of the forceps unit; a connecting part that connects the forceps unit and the handle portion; a selection means for projecting one of the forceps units from the outer cover; The forceps unit includes: A forceps unit having a jaw that opens and closes and a link mechanism that opens and closes the jaw; a load having one end connected to the link mechanism and configured to drive the link mechanism; a shaft that houses the forceps portion and a part of the rod and has a rod spring stopper on its inner surface; a load spring connecting between the load spring stop and the other end of the load; One end of the connecting part is engaged with the other end of the rod of the forceps unit selected by the selection means and protruding from the outer cover, The handle portion is connected to the other end of the connecting part, The selection means is A protruding shaft stopper provided on an outer surface of the shaft; A shaft holder provided inside the outer cover; a shaft spring provided between the shaft stopper and the shaft holder; A switchable laparoscopic surgical forceps, characterized in that it is composed of a cylindrical rotating extrusion part that is provided between the handle portion and the shaft stopper, wraps around the shaft, and has one end cut at an angle.

2. 2. The switchable laparoscopic surgical forceps according to claim 1, wherein a forceps pressing plate for forcibly closing the jaws is disposed at a front portion of the outer cover.

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