Medical device

Abstract

A medical device (10) comprises: a first arm part (141) and second arm part (142) that are openably / closably supported at a tip end part (121) of a shaft (12); and a grasping part (18) that is provided at a base end part of the shaft (12). The grasping part (18) is provided with an operation part (20) for performing respective opening / closing operations of the first arm part (141) and the second arm part (142). The operation part (20) is connected to the first arm part (141) and the second arm part (142) by a first arm connection member (641) and a second arm connection member (642), respectively.

Description

Medical Device

[0001] The present disclosure relates to a medical device.

[0002] Japanese Unexamined Patent Application Publication No. 2023-73318 discloses a medical device for controlling the pulsation of the human heart. The medical device includes a set of arms attached to rails of a sternal retractor, and a set of contact portions provided respectively at tips of the set of arms. In thoracotomy, the set of contact portions is inserted into a living body through an opening, and ends of the set of contact portions are brought into contact with a surface of the heart, thereby controlling movement of the surface caused by heart pulsation.

[0003] Japanese Unexamined Patent Application Publication No. 2023-73318

[0004] In thoracotomy, in order to reduce the burden on a living body, a small opening is formed near an incision, a shaft is inserted into the living body through the opening, and a medical device is attached to a tip of the shaft. In this case, after inserting the shaft into the living body through the opening with a cap attached to the tip of the shaft, it is necessary to remove the cap inside the living body and attach the medical device (stabilizer) to the tip of the shaft.

[0005] However, removing the cap inside the living body and attaching the medical device to the tip of the shaft are complicated operations. Furthermore, there is a concern that after removing the cap inside the living body, the cap may be accidentally dropped into the living body (surgical field). In this case, an extra, originally unnecessary operation of recovering the dropped cap from the living body (surgical field) becomes mandatory.

[0006] An object of the present disclosure is to solve the above-described problem.

[0007] (1) An aspect of the present disclosure is a medical device for suppressing the movement of the surface of a living organ by contacting the organ of the living body, comprising: a shaft whose tip is inserted into the living body; a pair of arm portions provided on the tip of the shaft and supported by the shaft so as to be openable and closable; a support structure provided between the tip and the arm portions and movably supports the pair of arm portions with respect to the tip; a gripping portion provided on the base end of the shaft; and an operating portion provided on the gripping portion and performing opening and closing operations on each of at least one of the arm portions, wherein the operating portion is connected to the pair of arm portions by a pair of arm connecting members.

[0008] This medical device allows for easy insertion into the body with a pair of arms in a closed state, and by operating each arm individually within the body, it can effectively press against the surface of organs.

[0009] (2) In the medical device described in (1) above, the operating section is provided with a structural operating member that tilts the support structure in a direction intersecting the axis of the shaft, and the structural operating member and the support structure may be connected to each other by a structural connecting member.

[0010] This configuration allows for an effective change in the orientation of the pair of arms relative to the shaft.

[0011] (3) In the medical device described in (2) above, the operating section has a pair of arm operating members, and at least one of the arm operating members and the structural operating member may have a rotating member that is rotatably supported by the gripping section.

[0012] This configuration makes it easy for users to operate the control panel.

[0013] (4) In the medical device described in (3) above, the support structure is tiltably supported on the tip of the shaft by a first axis, and the pair of arm portions are supported on the support structure by a second axis, and the axial direction of the first axis and the axial direction of the second axis may intersect each other.

[0014] This configuration allows the pair of arms to tilt in a direction different from the opening and closing direction of the pair of arms, thereby enabling the arms to more effectively make close contact with the surface of the organ.

[0015] (5) In the medical device described in (3) or (4) above, the pair of arm operating members may be arranged in parallel in a direction intersecting the axial direction of the shaft.

[0016] This configuration effectively suppresses the amount of finger movement between the arm operating members when operating a pair of arm operating members.

[0017] (6) In the medical device described in any one of (2) to (5) above, the structural operating member may be arranged in the direction of the base end of the arm operating member in the gripping portion.

[0018] This configuration allows the user to intuitively recognize the structural operating member and the arm operating member in the gripping section.

[0019] According to this disclosure, the pair of arms can be easily inserted into a living body in a closed state, and by operating each arm individually within the living body, the surface of an organ can be effectively pressed.

[0020] Figure 1 is an explanatory diagram showing the usage state of a medical device according to an embodiment of the present invention. Figure 2 is an overall configuration diagram of the medical device. Figure 3 is a cross-sectional view of the medical device. Figure 4 is a perspective view showing the tip of the medical device. Figure 5 is a plan view showing the tip of the medical device. Figure 6 is a cross-sectional view of the tip of the medical device. Figure 7 is a cross-sectional view along the line VII-VII in Figure 6. Figure 8 is a cross-sectional view along the line VIII-VIII in Figure 6. Figure 9 is a cross-sectional view along the line IX-IX in Figure 2. Figure 10 is a cross-sectional view along the line X-X in Figure 2. Figure 11 is a cross-sectional view showing the base end of the medical device. Figure 12 is a cross-sectional view along the line XII-XII in Figure 8. Figure 13 is a plan view showing the open state of the first arm and the second arm. Figure 14 is a cross-sectional view along the line XIV-XIV in Figure 8. Figure 15 is a cross-sectional view along the line XV-XV in Figure 2. Figure 16 is a cross-sectional view showing the state in which the first arm and the second arm are tilted by the support structure.

[0021] As shown in Figure 1, the medical device 10 according to this embodiment is a stabilizer that holds the heart 300 in a desired position by contacting the organs (e.g., heart 300) of the patient (hereinafter referred to as living organism P), and also suppresses movement of the surface of the heart 300. As shown in Figure 1, the tip of the medical device 10 is cut adjacent to the incision 302 of living organism P during thoracotomy (e.g., coronary artery bypass surgery), and is inserted into living organism P through an opening 304 that is smaller than the incision 302.

[0022] As shown in Figure 2, the medical device 10 comprises a shaft 12, a first arm portion 141 and a second arm portion 142, a support structure 16, a gripping portion 18, and an operating portion 20.

[0023] The shaft 12 has a tip portion 121 that is inserted into the living body P (see Figure 1). As shown in Figure 3, the shaft 12 is formed in a cylindrical shape with a lumen 122. The shaft 12 has a tip opening 123 (see Figure 6) and a base opening 124. The tip opening 123 opens at the tip of the shaft 12. The base opening 124 opens at the base of the shaft 12. The lumen 122 is in communication with each of the tip opening 123 and the base opening 124.

[0024] As shown in Figure 1, the first arm portion 141 and the second arm portion 142 are provided on the tip portion 121 of the shaft 12. Each of the first arm portion 141 and the second arm portion 142 is supported by the shaft 12 so as to be able to open and close. Figure 1 shows the first arm portion 141 and the second arm portion 142 in the open state.

[0025] As shown in Figure 4, each of the first arm portion 141 and the second arm portion 142 includes a suction portion 22 for adsorbing the heart 300 (see Figure 1) and a supported portion 24 supported by the support structure 16. In a plan view of the medical device 10 shown in Figure 5, the first arm portion 141 and the second arm portion 142 are symmetrical in shape and arranged symmetrically with respect to the axis of the shaft 12.

[0026] As shown in Figure 4, each suction portion 22 is provided at the tip of the first arm portion 141 and the second arm portion 142, respectively. Each suction portion 22 has a shape in which the width direction is shorter than the longitudinal direction. The suction portion 22 is formed to gradually widen from the base end to the tip. The suction portion 22 has a contact surface 221 that contacts the surface of the heart 300 (see Figure 1). The contact surface 221 is formed to be generally flat and has a plurality of suction ports 222. When the contact surface 221 contacts the heart 300 of the living organism P, it may be curved to conform to the shape of the heart 300.

[0027] Multiple suction ports 222 are arranged along the longitudinal direction of the adsorption unit 22. Each of the multiple suction ports 222 is connected to a suction source (not shown) via a tube 26 attached to the adsorption unit 22. Fluid is drawn in from each suction port 222 through the tube 26 communicating with the suction source, reducing the pressure in each suction port 222 and making the adsorption unit 22 capable of adsorption. Note that there may be only one suction port 222.

[0028] As shown in Figure 5, each supported portion 24 is provided at the base end of each suction portion 22. In a plan view of the medical device 10, each supported portion 24 is formed in a circular shape.

[0029] As shown in Figure 6, the supported portion 24 of the first arm portion 141 and the supported portion 24 of the second arm portion 142 are arranged in the vertical direction. The following describes the case in which the supported portion 24 of the first arm portion 141 is positioned below the supported portion 24 of the second arm portion 142.

[0030] Each supported portion 24 is provided with a first groove 28. Each first groove 28 is recessed radially from the outer circumferential surface of each supported portion 24. The first groove 28 is formed in an annular shape (see Figure 5). The first groove 28 has a first locking portion 30. The first locking portion 30 protrudes radially outward from the first groove 28. In the closed state, when the first arm portion 141 and the second arm portion 142 are rotated toward each other, the first locking portion 30 is positioned toward the tip.

[0031] As shown in Figure 4, the support structure 16 is provided at the tip 121 of the shaft 12. The support structure 16 is provided between the first arm portion 141 and the second arm portion 142 and the tip 121 of the shaft 12 (see Figure 5). The support structure 16 movably supports the first arm portion 141 and the second arm portion 142 with respect to the tip 121 of the shaft 12.

[0032] The support structure 16 comprises a base support member 161 and a tip support member 162.

[0033] As shown in Figure 7, the base support member 161 is provided at the tip portion 121 of the shaft 12. The base support member 161 has a base support body 32 and a pair of base support pieces 34. The base end of the base support body 32 is inserted into the tip opening 123 of the shaft 12 and closes the tip opening 123. The base end of the base support member 161 is fixed to the tip portion 121 of the shaft 12.

[0034] As shown in Figure 8, the base support body 32 has a pair of first arm holes 361, a pair of second arm holes 362, and a pair of structural holes 363.

[0035] The pair of first arm holes 361 penetrate the base support body 32 in the axial direction (see Figure 7). Each of the pair of first arm holes 361 is spaced apart from each other in the width direction of the base support member 161, which is perpendicular to the axial direction of the shaft 12. In the vertical direction of the medical device 10, the pair of first arm holes 361 are provided at the same height as the first groove 28 of the first arm portion 141 (see Figure 6). In the axial direction of the shaft 12, the first groove 28 of the first arm portion 141 is provided in the direction of the tip of the pair of first arm holes 361.

[0036] The pair of second arm holes 362 penetrate the base support body 32 in the axial direction (see Figure 6). Each of the pair of second arm holes 362 is spaced apart from each other in the width direction of the base support member 161. In the vertical direction of the medical device 10, the pair of second arm holes 362 are provided at the same height as the first groove 28 of the second arm portion 142 (see Figure 6). In the axial direction of the shaft 12, the first groove 28 of the second arm portion 142 is provided towards the tip of the pair of second arm holes 362. Each of the pair of second arm holes 362 is positioned above each of the pair of first arm holes 361.

[0037] The pair of structural holes 363 penetrate the base support body 32 in the axial direction (see Figure 6). Each of the pair of structural holes 363 is spaced apart from the other in the vertical direction of the base support body 32. In the axial direction of the shaft 12, the second groove 46 of the tip support member 162, which will be described later, is provided in the direction of the tips of the pair of structural holes 363 (see Figure 6).

[0038] As shown in Figure 7, a pair of base support pieces 34 are provided towards the tip of the base support body 32. Each of the pair of base support pieces 34 is symmetrical in shape and arranged symmetrically with respect to the axis of the shaft 12. The pair of base support pieces 34 are provided parallel to each other and spaced apart in the width direction perpendicular to the axis of the shaft 12 (see Figure 5). Each base support piece 34 protrudes from the base support body 32 toward the tip. Each base support piece 34 has a first shaft hole 38. Each first shaft hole 38 penetrates each base support piece 34 in the width direction. A first shaft 40 is inserted through each first shaft hole 38. The first shaft 40 is supported by the pair of base support pieces 34. The first shaft 40 is supported along the width direction by the pair of base support pieces 34.

[0039] As shown in Figure 4, the tip support member 162 is provided in the tip direction of the base support body 32 of the base support member 161. As shown in Figure 6, the tip support member 162 is tiltably supported relative to the tip portion 121 of the shaft 12 by a first axis 40 supported by the base support member 161. The tilting direction of the tip support member 162 is vertical around the first axis 40 (see Figure 16).

[0040] As shown in Figure 6, the tip support member 162 has a tip support body 42, a pair of tip support pieces 44, and a second groove 46.

[0041] The tip support body 42 is supported by the first shaft 40, through which the first shaft 40 is inserted, so as to be rotatable.

[0042] A pair of end support pieces 44 are provided at the tip of the end support body 42. Each end support piece 44 protrudes from the end support body 42 toward the tip. Each of the pair of end support pieces 44 is symmetrical in shape and symmetrically arranged with respect to the axis of the shaft 12. The pair of end support pieces 44 are provided parallel to each other and spaced apart in the vertical direction perpendicular to the axis and width direction of the shaft 12. Each end support piece 44 has a second shaft hole 48. Each second shaft hole 48 penetrates each end support piece 44 in the vertical direction. A second shaft 50 is inserted through each second shaft hole 48. The second shaft 50 is supported by the pair of end support pieces 44. The axial direction of the second shaft 50 and the axial direction of the first shaft 40 are perpendicular to each other.

[0043] The second shaft 50 penetrates the supported portions 24 of the first arm portion 141 and the second arm portion 142. The direction of penetration of the second shaft 50 is in the thickness direction of each supported portion 24. The first arm portion 141 and the second arm portion 142 are rotatably supported coaxially by the second shaft 50. Each of the first arm portion 141 and the second arm portion 142 is supported by the support structure 16 by the second shaft 50. The second shaft 50 supports each of the first arm portion 141 and the second arm portion 142 so that they can open and close relative to the support structure 16 (tip support member 162).

[0044] As shown in FIG. 6, the second groove portion 46 is recessed from the outer circumferential surface of the distal support body 42. The second groove portion 46 is formed in an annular shape. The second groove portion 46 has a second locking portion 52. The second locking portion 52 protrudes radially outward from the bottom of the second groove portion 46. In the closed state where the first arm portion 141 and the second arm portion 142 are rotated in a direction approaching each other, the second locking portion 52 is provided at a position facing the distal direction.

[0045] As shown in FIG. 3, the grip portion 18 is connected to the proximal end portion of the shaft 12. When a user uses the medical device 10, the user grips the grip portion 18.

[0046] The grip portion 18 includes a housing 181 formed in a cylindrical shape. In a plan view of the medical device 10, the housing 181 is, for example, elongated in the axial direction of the shaft 12 and formed in a shape that is short in the width direction orthogonal to the axial direction.

[0047] The proximal end portion of the shaft 12 is inserted into the distal end portion of the housing 181. The inside of the housing 181 and the inner lumen 122 of the shaft 12 communicate with each other via the proximal opening 124.

[0048] The operation surface of the housing 181 includes a first distal hole 541, a second distal hole 542, and a proximal hole 543. The first distal hole 541 and the second distal hole 542 open to the upper surface of the housing 181 (see FIGS. 9 and 10). Each of the first distal hole 541 and the second distal hole 542 is provided at the distal end portion of the housing 181. Each of the first distal hole 541 and the second distal hole 542 is formed to be elongated in the axial direction of the housing 181. The operation surface of the housing 181 is, for example, the surface that faces upward when the medical device 10 is in use.

[0049] As shown in FIG. 2, in the width direction orthogonal to the axial direction of the housing 181, the first distal hole 541 is arranged on one side in the width direction of the center line of the housing 181, and the second distal hole 542 is arranged on the other side in the width direction of the center line of the housing 181. In the width direction orthogonal to the axial direction of the shaft 12, the first distal hole 541 and the second distal hole 542 are arranged in parallel. Note that the first distal hole 541 and the second distal hole 542 do not need to be arranged in parallel in the width direction. For example, the first distal hole 541 and the second distal hole 542 may be arranged offset in the axial direction of the housing 181 without being arranged in parallel.

[0050] The first tip hole 541 is inclined with respect to the axial direction of the shaft 12 so as to extend outward in the width direction (one direction of width) toward the tip. The second tip hole 542 is inclined with respect to the axial direction of the shaft 12 so as to extend outward in the width direction (the other direction of width) toward the tip. The first tip hole 541 and the second tip hole 542 are arranged symmetrically with respect to the center line of the housing 181.

[0051] The base end of the first tip hole 541 and the base end of the second tip hole 542 are closest in the width direction, while the tip of the first tip hole 541 and the tip of the second tip hole 542 are farthest apart in the width direction.

[0052] Furthermore, the first tip hole 541 and the second tip hole 542 are not limited to being formed at an inclination with respect to the axial direction of the shaft 12 or housing 181. For example, at least one of the first tip hole 541 and the second tip hole 542 may be parallel to the axial direction of the shaft 12 or housing 181.

[0053] The base end hole 543 is provided in the base end direction of the first tip hole 541 and the second tip hole 542. The base end hole 543 extends along the axial direction of the shaft 12 or housing 181. In a plan view of the housing 181, the base end hole 543 is positioned on the axis of the shaft 12 or housing 181.

[0054] The operating unit 20 is provided on the gripping unit 18. The operating unit 20 performs the opening and closing operation and the tilting operation of the first arm unit 141 and the second arm unit 142, respectively. Alternatively, the operating unit 20 may be configured to perform at least one of the opening and closing operation and the tilting operation of the first arm unit 141 and the second arm unit 142, respectively.

[0055] As shown in Figure 11, the operating unit 20 comprises a first arm operating member 201, a second arm operating member 202, and a structural operating member 203. Each of the first arm operating member 201, the second arm operating member 202, and the structural operating member 203 is a rotatable wheel-shaped operating member.

[0056] The first arm operating member 201 opens and closes the first arm portion 141. As shown in Figure 9, the first arm operating member 201 includes a first rotating member 561. The first rotating member 561 is rotatably supported by the housing 181 of the gripping portion 18. The first rotating member 561 includes a rotating body portion 58 and a rotating shaft 60.

[0057] The rotating body portion 58 is formed in a circular shape having a predetermined width in the axial direction. The rotating body portion 58 is housed inside the housing 181, and a part of its outer circumference 581 is inserted into the first tip hole 541. A part of the outer circumference 581 of the first rotating member 561 is exposed to the outside of the housing 181. A part of the first rotating member 561 protrudes from the upper surface of the housing 181 in an operable manner.

[0058] As shown in Figure 11, the first arm operating member 201 is inclined to be outward in the width direction (one side in the width direction) toward the tip direction with respect to the axial direction of the housing 181.

[0059] As shown in Figure 9, the outer circumferential surface of the rotating body 58 has a plurality of recesses 62 that are recessed radially inward. Each of the plurality of recesses 62 extends in the axial direction of the rotating body 58. The plurality of recesses 62 are spaced apart from each other along the circumferential direction of the rotating body 58.

[0060] As shown in Figure 11, the rotating shaft 60 is provided at the axial center of the rotating body 58 and protrudes in the axial direction of the rotating body 58. The rotating shaft 60 is rotatably supported by the shaft support portion 182 inside the housing 181.

[0061] The first arm operating member 201 is connected to the first arm portion 141 by the first arm connecting member 641.

[0062] The first arm connecting member 641 consists of a first linear member 661. The first linear member 661 is, for example, a wire made of metal. However, the first linear member 661 is not limited to metal; any material with sufficient strength and flexibility may be used, and an appropriate design is applied. The same applies to the linear members described herein. The first linear member 661 is formed in a loop shape. The first linear member 661 connects the first arm portion 141 and the first arm operating member 201 through the lumen 122 of the shaft 12. The first linear member 661 is provided in an elongated length along the axial direction of the shaft 12.

[0063] As shown in Figure 12, the first linear member 661 comprises a first tip 681, a first base 682 (see Figure 11), and a pair of first intermediate portions 683.

[0064] The first tip 681 of the first linear member 661 protrudes from the tip opening 123 of the shaft 12 toward the tip. The first tip 681 is inserted into the first groove 28 of the first arm portion 141 from the tip direction of the supported portion 24. The first tip 681 is fixed to the supported portion 24 by the first locking portion 30.

[0065] As shown in Figure 9, the first base end 682 is connected to the first arm operating member 201 inside the housing 181. The first base end 682 is fixed to the rotation axis 60 of the first rotating member 561.

[0066] As shown in Figure 12, the pair of first intermediate sections 683 are housed in the lumen 122 of the shaft 12. As shown in Figure 8, each of the pair of first intermediate sections 683 is inserted through each of the first arm holes 361 of the base support member 161. Each of the pair of first intermediate sections 683 is spaced apart in the width direction in the lumen 122 of the shaft 12.

[0067] By rotating the first arm operating member 201, the supported portion 24 of the first arm portion 141 rotates around the second axis 50 by the first arm connecting member 641. Specifically, by rotating the first arm operating member 201 toward the tip, the first linear member 661 rotates in the first direction in a plan view. The first arm portion 141, to which the tip of the first linear member 661 is fixed, rotates around the second axis 50 as a pivot point and opens. At this time, as shown in Figure 13, the maximum angle θ1 of the first arm portion 141 with respect to the axis of the shaft 12 is, for example, 60°. The maximum angle θ1 of the first arm portion 141 with respect to the axis of the shaft 12 may be less than 60° or 61° or more.

[0068] By rotating the first arm operating member 201 toward the base end, the first linear member 661 rotates in the second direction in a plan view. The first arm portion 141, to which the first tip 681 of the first linear member 661 is fixed, rotates in the opposite direction with the second axis 50 as the pivot point, thereby performing a closing operation.

[0069] The second arm operating member 202 opens and closes the second arm portion 142. As shown in Figure 10, the second arm operating member 202 includes a second rotating member 562. The second rotating member 562 is rotatably supported by the housing 181 of the gripping portion 18. The second rotating member 562 includes a rotating body portion 58 and a rotating shaft 60. Note that the rotating body portion 58 and rotating shaft 60 of the second rotating member 562 are the same as the rotating body portion 58 and rotating shaft 60 of the first rotating member 561, so they are given the same reference numerals and a detailed explanation is omitted.

[0070] The second rotating member 562 has a portion of its outer circumference 581 inserted into the second tip hole 542. A portion of the outer circumference 581 of the second rotating member 562 is exposed to the outside of the housing 181. A portion of the second rotating member 562 protrudes from the top surface of the housing 181 in an operable manner. The rotating shaft 60 is rotatably supported by the shaft support portion 182 inside the housing 181 (see Figure 11).

[0071] As shown in Figure 11, the second arm operating member 202 is inclined outward in the width direction (in the other direction in the width direction) toward the tip direction with respect to the axial direction of the housing 181. The base end of the first arm operating member 201 and the base end of the second arm operating member 202 are closest in the width direction, and the tip of the first arm operating member 201 and the tip of the second arm operating member 202 are furthest apart in the width direction.

[0072] The first arm operating member 201 and the second arm operating member 202 are arranged in parallel in the width direction perpendicular to the axial direction of the shaft 12. However, the first arm operating member 201 and the second arm operating member 202 do not necessarily have to be arranged in parallel in the width direction. For example, the first arm operating member 201 and the second arm operating member 202 may be arranged offset from each other in the axial direction of the housing 181 instead of being arranged in parallel.

[0073] The second arm operating member 202 is connected to the second arm portion 142 by a second arm connecting member 642. The second arm connecting member 642 consists of a second linear member 662. The second linear member 662 is, for example, a wire made of metal or the like. However, the second linear member 662 is not limited to a wire made of metal or the like. The second linear member 662 is formed in a loop shape. The second linear member 662 connects the second arm portion 142 and the second arm operating member 202 through the lumen 122 of the shaft 12. The second linear member 662 is provided in an elongated length along the axial direction of the shaft 12.

[0074] As shown in Figure 14, the second linear member 662 comprises a second tip 701, a second base 702 (see Figure 11), and a pair of second intermediate portions 703.

[0075] The second tip 701 of the second linear member 662 protrudes from the tip opening 123 of the shaft 12 toward the tip. The second tip 701 is inserted into the first groove 28 of the second arm portion 142 from the tip direction of the supported portion 24. The second tip 701 is fixed to the supported portion 24 of the second arm portion 142 by the first locking portion 30.

[0076] As shown in Figure 11, the second base end 702 is connected to the second arm operating member 202 inside the housing 181. The second base end 702 is fixed to the rotation axis 60 of the second rotating member 562 (see Figure 10).

[0077] The pair of second intermediate sections 703 are housed in the lumen 122 of the shaft 12. As shown in Figure 8, each of the pair of second intermediate sections 703 is inserted through each of the second arm holes 362 of the base support member 161. Each of the pair of second intermediate sections 703 is spaced apart in the width direction in the lumen 122 of the shaft 12. In the lumen 122 of the shaft 12, each second intermediate section 703 is positioned above each first intermediate section 683.

[0078] By rotating the second arm operating member 202, the supported portion 24 of the second arm portion 142 rotates around the second axis 50 by the second arm connecting member 642. Specifically, by rotating the second arm operating member 202 toward the tip, the second linear member 662 rotates in the first direction in a plan view. The second arm portion 142, to which the second tip 701 of the second linear member 662 is fixed, rotates around the second axis 50 as a pivot point and opens.

[0079] In this case, as shown in Figure 13, the maximum angle θ2 of the second arm portion 142 with respect to the axis of the shaft 12 is, for example, 60°. The maximum angle θ2 of the second arm portion 142 with respect to the axis of the shaft 12 may be less than 60° or 61° or more. The maximum angle θ1 of the first arm portion 141 and the maximum angle θ2 of the second arm portion 142 may be the same, or they may be different from each other.

[0080] By rotating the second arm operating member 202 toward the base end, the second linear member 662 rotates in the second direction in a plan view. The second arm portion 142, to which the second tip 701 of the second linear member 662 is fixed, rotates in the opposite direction with the second axis 50 as the pivot point, thereby performing a closing operation.

[0081] The structural operating member 203 tilts the support structure 16 in a direction intersecting the axis of the shaft 12. As shown in Figure 11, in the gripping portion 18, the structural operating member 203 is positioned towards the base end of the first arm operating member 201 and the second arm operating member 202, respectively.

[0082] As shown in Figure 15, the structural operating member 203 includes a third rotating member 563. The third rotating member 563 is rotatably supported by the housing 181 of the gripping portion 18. The third rotating member 563 includes a rotating body portion 58 and a rotating shaft 60. Note that the third rotating member 563 of the structural operating member 203 is the same as the first rotating member 561 of the first arm operating member 201 and the second rotating member 562 of the second arm operating member 202, so the same reference numerals are used and a detailed explanation is omitted.

[0083] The third rotating member 563 has a portion of its outer circumference 581 inserted into the base end hole 543. A portion of the outer circumference 581 of the third rotating member 563 is exposed to the outside of the housing 181. A portion of the third rotating member 563 protrudes operably from the upper surface of the housing 181. The rotating shaft 60 is rotatably supported by the shaft support portion 182 inside the housing 181 (see Figure 11).

[0084] As shown in Figure 2, the structural operating member 203 is arranged along the axial direction of the housing 181. In plan view, the structural operating member 203 is positioned on the axis of the housing 181.

[0085] As shown in Figure 6, the structural operating member 203 is connected to the support structure 16 by a structural connecting member 643. The structural connecting member 643 consists of a third linear member 663. The third linear member 663 is, for example, a wire made of metal or the like. However, the third linear member 663 is not limited to a wire made of metal or the like. The third linear member 663 is formed in a loop shape. The third linear member 663 connects the tip support member 162 of the support structure 16 and the structural operating member 203 through the lumen 122 of the shaft 12.

[0086] The third linear member 663 is provided in an elongated manner along the axial direction of the shaft 12. The third linear member 663 comprises a third tip 721, a third base 722 (see Figure 11), and a pair of third intermediate portions 723.

[0087] The third tip 721 protrudes toward the tip from the tip opening 123 of the shaft 12. The third tip 721 is inserted into the second groove 46 of the tip support member 162. The third tip 721 is fixed to the tip support body 42 of the tip support member 162 by the second locking portion 52.

[0088] The third base end 722 is connected to the structural operating member 203 inside the housing 181 (see Figure 15). The third base end 722 is fixed to the rotation axis 60 of the third rotating member 563.

[0089] As shown in Figures 8 and 11, the pair of third intermediate sections 723 are housed in the lumen 122 of the shaft 12. Each of the pair of third intermediate sections 723 is inserted through each of the structural holes 363 of the base support body 32. Each of the pair of third intermediate sections 723 is spaced apart vertically in the lumen 122 of the shaft 12. In plan view, each third intermediate section 723 is positioned on the axis of the shaft 12 (see Figure 7).

[0090] By rotating the structural operating member 203, the tip support member 162 of the support structure 16 rotates around the first axis 40 by the structural connecting member 643, as shown in Figure 16.

[0091] Specifically, by rotating the structural operating member 203 toward the tip, the third linear member 663 rotates in a third direction in a side view of the medical device 10. The tip support member 162 to which the third tip 721 of the third linear member 663 is fixed tilts downward around the first axis 40 as a pivot point. The third direction is the direction in which the upper third intermediate portion 723 moves toward the tip, and the lower third intermediate portion 723 moves toward the base end. By rotating the structural operating member 203 toward the base end, the third linear member 663 rotates in a fourth direction in a side view. The fourth direction is the direction in which the upper third intermediate portion 723 moves toward the base end, and the lower third intermediate portion 723 moves toward the tip. The tip support member 162 to which the third tip 721 of the third linear member 663 is fixed tilts upward around the first axis 40 as a pivot point.

[0092] The medical device 10 is used as follows:

[0093] Before use, the medical device 10 (initial state) is in a closed state, with the tips of the first arm portion 141 and the second arm portion 142 rotated toward each other, with the second axis 50 supported by the support structure 16 acting as a fulcrum (see Figure 2). At this time, the first arm operating member 201 and the second arm operating member 202 are positioned toward their base ends.

[0094] First, as shown in Figure 1, the tip of the medical device 10 is inserted through an opening 304 made adjacent to the incision 302 of the living organism P. After the tip of the medical device 10 has been inserted to the desired position of the heart 300 (organ) within the living organism P, the user operates the operating unit 20 while holding the gripping unit 18.

[0095] Specifically, the user rotates the first arm operating member 201 and the second arm operating member 202 toward the tip using the fingers that are gripping the gripping portion 18. At this time, the user can touch the base end of the first arm operating member 201 and the base end of the second arm operating member 202 with the same finger (for example, the thumb), and operate the base end of the first arm operating member 201 and the second arm operating member 202 simultaneously with one finger.

[0096] When the first arm operating member 201 is rotated toward the tip, the first linear member 661 fixed to the rotation shaft 60 rotates in the first direction. As the first linear member 661 rotates in the first direction, the first arm portion 141 to which the first tip 681 is fixed rotates away from the axis of the shaft 12, with the second shaft 50 as the pivot point.

[0097] When the second arm operating member 202 is rotated toward the tip, the second linear member 662 fixed to the rotation axis 60 rotates in the first direction. As the second linear member 662 rotates in the first direction, the second arm portion 142, to which the second tip 701 is fixed, rotates away from the axis of the shaft 12 with the second axis 50 as the pivot point. As a result, the tip of the first arm portion 141 and the tip of the second arm portion 142 rotate toward each other. The first arm portion 141 and the second arm portion 142 open to each other at a predetermined angle (see Figure 1). As shown in Figure 13, in a plan view of the medical device 10, the first arm portion 141 and the second arm portion 142 open in a V shape such that the distance between them increases toward the tip.

[0098] The opening degree (angle with respect to the axis of the shaft 12) of the first arm portion 141 and the second arm portion 142 can be adjusted by the amount of rotation of the first arm operating member 201 and the second arm operating member 202 toward the tip. For example, when the amount of rotation of the first arm operating member 201 and the second arm operating member 202 is at its maximum, each of the first arm portion 141 and the second arm portion 142 rotates to its maximum angle (for example, 60°).

[0099] Furthermore, it is possible to open the first arm portion 141 and the second arm portion 142 at different opening angles. In this case, the amount of rotation of the first arm operating member 201 toward the tip and the amount of rotation of the second arm operating member 202 toward the tip are changed. For example, if the opening angle of the second arm portion 142 is to be greater than the opening angle of the first arm portion 141, the amount of rotation of the second arm operating member 202 is increased relative to the amount of rotation of the first arm operating member 201. If the opening angle of the first arm portion 141 is to be greater than the opening angle of the second arm portion 142, the amount of rotation of the first arm operating member 201 is increased relative to the amount of rotation of the second arm operating member 202.

[0100] Next, the user tilts the open first arm portion 141 and the second arm portion 142 relative to the shaft 12 so that they are aligned with the surface of the heart 300 within the living body P, and brings the first arm portion 141 and the second arm portion 142 into contact with the surface of the heart 300.

[0101] Specifically, the desired location on the heart 300 is identified, and the structural operating member 203 is operated. The following describes the case in which the first arm portion 141 and the second arm portion 142 are tilted upward with respect to the tip portion 121 of the shaft 12. With the user holding the gripping portion 18, the structural operating member 203 is rotated toward the base end with the fingers. As the third rotating member 563 rotates toward the base end, the third linear member 663 fixed to the rotation axis 60 rotates in the fourth direction. As the third linear member 663 rotates in the fourth direction, as shown in Figure 16, the tip support member 162 to which the third tip 721 is fixed tilts upward with the first axis 40 as the pivot point.

[0102] Together with the tip support member 162, the first arm portion 141 and the second arm portion 142 tilt upward relative to the tip portion 121 of the shaft 12. The amount of vertical tilt of the first arm portion 141 and the second arm portion 142 relative to the tip portion 121 of the shaft 12 (the inclination angle with respect to the axial direction of the shaft 12) can be adjusted by the amount of rotation of the third rotating member 563.

[0103] Furthermore, when tilting the first arm portion 141 and the second arm portion 142 downward with respect to the tip portion 121 of the shaft 12, the structural operating member 203 is rotated toward the tip.

[0104] The user operates the structural operating member 203 to tilt the first arm portion 141 and the second arm portion 142 so as to follow the surface of the heart 300, and then brings the contact surfaces 221 of the suction portions 22 of the first arm portion 141 and the second arm portion 142 into contact with the surface of the heart 300.

[0105] After the first arm portion 141 and the second arm portion 142 are brought into contact with the surface of the heart 300, fluid around the suction ports 222 of the first arm portion 141 and the second arm portion 142 is drawn in by a suction source (not shown) through a tube 26. A negative pressure state is induced around the suction ports 222, causing the suction portions 22 of the first arm portion 141 and the second arm portion 142 to draw in the surface of the heart 300. At the tip of the medical device 10, the movement of the surface of the heart 300 due to pulsation is suppressed.

[0106] After the thoracotomy of the living organism P is completed, the medical device 10 is removed from the living organism P. After the suction source connected to the suction unit 22 is stopped and the suction state of the suction unit 22 is released, the structural operating member 203 of the operating unit 20 is rotated toward the tip, causing the third linear member 663 to rotate in the third direction, and the tip support member 162, the first arm unit 141, and the second arm unit 142 to tilt downward as a single unit. In a side view, the tip support member 162, the first arm unit 141, and the second arm unit 142 are arranged linearly in the axial direction of the shaft 12 (see the dashed line shape in Figure 16). Next, the first arm operating member 201 and the second arm operating member 202 are each rotated toward the base end.

[0107] As the first arm operating member 201 rotates, the first linear member 661 fixed to the rotation shaft 60 rotates in a second direction opposite to the direction during the opening operation. As the first linear member 661 rotates in the second direction, the supported portion 24 of the first arm portion 141 rotates toward the second arm portion 142. As a result, with the second shaft 50 as the pivot point, the tip of the first arm portion 141 rotates toward the axis of the shaft 12.

[0108] As the second arm operating member 202 rotates, the second linear member 662 fixed to the rotation shaft 60 rotates in a second direction opposite to the direction during the opening operation. As the second linear member 662 rotates in the second direction, the supported portion 24 of the second arm portion 142 rotates toward the first arm portion 141. Using the second shaft 50 as a pivot point, the tip of the second arm portion 142 rotates toward the axis of the shaft 12.

[0109] As a result, the tip of the first arm portion 141 and the tip of the second arm portion 142 rotate in a direction that brings them closer together, and the first arm portion 141 and the second arm portion 142 close together (see Figure 2).

[0110] With the first arm portion 141 and the second arm portion 142 closed, the tip of the medical device 10 is withdrawn from the living body P through the opening 304.

[0111] This embodiment provides the following effects.

[0112] As shown in Figure 3, the medical device 10 includes a first arm portion 141 and a second arm portion 142 that are openable and closable and supported at the tip portion 121 of the shaft 12. The gripping portion 18 includes an operating unit 20 that performs the opening and closing operations of the first arm portion 141 and the second arm portion 142, respectively. The operating unit 20 is connected to the first arm portion 141 and the second arm portion 142 by a first arm operating member 201 and a second arm operating member 202, respectively.

[0113] This medical device 10 can be easily inserted into a living organism P with the first arm portion 141 and the second arm portion 142 closed, and the surface of an organ (heart 300) can be effectively pressed by operating the first arm portion 141 and the second arm portion 142 individually within the living organism P.

[0114] The operating unit 20 includes a structural operating member 203 that tilts the support structure 16 in a direction intersecting the axis of the shaft 12. The structural operating member 203 and the support structure 16 are connected to each other by a structural connecting member 643.

[0115] This configuration allows for an effective change in the orientation of the first arm portion 141 and the second arm portion 142 relative to the shaft 12.

[0116] The first arm operating member 201 and the second arm operating member 202 each have a first rotating member 561 and a second rotating member 562, respectively, which are rotatably supported by the gripping portion 18. The structural operating member 203 has a third rotating member 563, which is rotatably supported by the gripping portion 18.

[0117] This configuration makes it easy for the user to operate the control unit 20.

[0118] As shown in Figure 6, the support structure 16 is tiltably supported on the tip 121 of the shaft 12 by the first shaft 40, and the first arm portion 141 and the second arm portion 142 are supported on the support structure 16 by the second shaft 50. The axial direction of the first shaft 40 and the axial direction of the second shaft 50 intersect in different directions.

[0119] This configuration allows the first arm portion 141 and the second arm portion 142 to be tilted in a direction different from the opening and closing direction of the first arm portion 141 and the second arm portion 142, thereby enabling them to be more effectively brought into close contact with the surface of the heart 300 (organ).

[0120] As shown in Figure 2, the first arm operating member 201 and the second arm operating member 202 are arranged in parallel in a direction that intersects with the axial direction of the shaft 12.

[0121] This configuration effectively suppresses the amount of finger movement between the first arm operating member 201 and the second arm operating member 202 when operating the first arm operating member 201 and the second arm operating member 202.

[0122] In the gripping portion 18, the structural operating member 203 is positioned in the direction of the base end of the first arm operating member 201 and the second arm operating member 202.

[0123] This configuration allows the user to intuitively recognize the structural operating member 203, the first arm operating member 201, and the second arm operating member 202 in the gripping section 18.

[0124] While this disclosure has been described in detail, it is not limited to the individual embodiments described above. These embodiments can be added, replaced, modified, partially deleted, etc., in any way that does not depart from the gist of this disclosure or from the intent of this disclosure derived from the claims and their equivalents. These embodiments can also be implemented in combination. For example, the order of operations and processes in the embodiments described above are given as examples only and are not limited thereto. The same applies when numerical values ​​or mathematical formulas are used in the description of the embodiments described above.

Claims

1. A medical device for suppressing the movement of the surface of a living organ by contacting the organ, comprising: a shaft whose tip is inserted into the living body; a pair of arm portions provided at the tip of the shaft and supported by the shaft so as to be openable and closable; a support structure provided between the tip and the arm portions and movably supports the pair of arm portions with respect to the tip; a gripping portion provided at the base end of the shaft; and an operating portion provided at the gripping portion for performing opening and closing operations on each of at least one of the arm portions, wherein the operating portion is connected to the pair of arm portions by a pair of arm connecting members.

2. A medical device according to claim 1, wherein the operating section includes a structural operating member that tilts the support structure in a direction intersecting the axis of the shaft, and the structural operating member and the support structure are connected to each other by a structural connecting member.

3. A medical device according to claim 2, wherein the operating section has a pair of arm operating members, and at least one of the arm operating members and the structural operating member has a rotating member that is rotatably supported by the gripping section.

4. A medical device according to claim 3, wherein the support structure is tiltably supported at the tip of the shaft by a first axis, and a pair of arm portions are supported by the support structure by a second axis, and the axial direction of the first axis and the axial direction of the second axis intersect each other.

5. A medical device according to claim 4, wherein the pair of arm operating members are arranged in parallel in a direction intersecting the axial direction of the shaft.

6. A medical device according to claim 3 or 5, wherein the structural operating member is positioned in the direction of the base end of the arm operating member in the gripping portion.

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