Medical device

Abstract

A first arm part (201) and a second arm part (202) of a medical device (10) have a first support part (241) and a second support part (242) that are supported by a shaft leading part (121). The first support part (241) and the second support part (242) have a first division surface (281) and a second division surface (282) that face each other and that are inclined with respect to the opening / closing direction of the first arm part (201) and the second arm part (202). In a state in which the first division surface (281) and the second division surface (282) are facing each other, the first support part (241) and the second support part (242) are openably / closably supported by the shaft leading part (121) of a shaft (12).

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 beating of a human heart. The medical device includes a pair of arms attached to rails of a sternum retractor, and a pair of contact portions provided respectively at the distal ends of the pair of arms. In thoracotomy, the pair of contact portions are inserted into a living body through an opening, and the distal ends of the pair of contact portions are brought into contact with the surface of the heart, thereby controlling the movement of the surface caused by the beating of the heart.

[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 the distal end of the shaft. In this case, after the shaft is inserted into the living body through the opening with a cap attached to the distal end of the shaft, it is necessary to remove the cap inside the living body and attach a medical device (stabilizer) to the distal end of the shaft.

[0005] However, removing the cap inside the living body and attaching the medical device to the distal end 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) must be performed.

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

[0007] (1) An aspect of the present disclosure is a medical device that suppresses 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; and a pair of arm portions provided at the tip of the shaft and supported by the shaft so as to be openable and closable, wherein each of the pair of arm portions comprises a support portion supported at the tip of the shaft and a suction portion extending toward the tip from each of the pair of support portions, wherein each of the pair of support portions faces each other and has a divided surface inclined with respect to the opening and closing direction of the arm portion, and the pair of support portions are supported by the tip of the shaft of the shaft so as to be openable and closable with a plurality of the divided surfaces facing each other.

[0008] This medical device allows for easy insertion of a pair of arms into the body while closed, and by moving the arms within the body, it can effectively press against the surface of organs.

[0009] (2) In the medical device described in (1) above, the pair of support parts may be provided with a biasing member that biases the pair of arm parts in a direction that causes the tips of the arm parts to move apart from each other.

[0010] This configuration allows the pair of arm sections to be easily opened by the biasing member.

[0011] (3) In the medical device described in (1) or (2) above, in the closed position where the tips of the pair of arm portions move toward each other, the pair of arm portions may overlap each other in a direction that intersects the extending direction of the arm portions and the opening and closing direction.

[0012] This configuration effectively reduces the width of the pair of arms when they are closed.

[0013] (4) In the medical device described in (3) above, each of the pair of support portions has a hemispherical portion that is convex in a direction away from the dividing surface, and the pair of support portions may be supported on the tip of the shaft in a state in which each of the pair of hemispherical portions is joined together to form a sphere.

[0014] This configuration allows for an effective change in the orientation of the pair of arms relative to the shaft.

[0015] (5) In the medical device described in (3) above, the suction portion comprises a tip arm portion having a contact surface that contacts the surface of the organ, and a base arm portion provided in the direction of the base end of the tip arm portion and connected to the support portion, wherein the base arm portion may be bent in the direction of extension of the tip arm portion.

[0016] This configuration allows the tips of a pair of arm sections to be effectively stacked vertically while the pair of support sections are supported by the shaft.

[0017] (6) In the medical device described in (5) above, the pair of base arm portions may have contact surfaces that come into contact with each other in the closed position.

[0018] This configuration allows the closed state of the pair of arms to be effectively maintained in the closed position.

[0019] (7) In the medical device described in (5) above, the proximal arm portion may be provided with a suction port that communicates with the suction hole of the contact surface and induces a negative pressure state.

[0020] This configuration allows the pair of arms to effectively adhere to the surface of the organ due to the negative pressure induced in the suction port and suction opening.

[0021] (8) In the medical device described in (5) above, the pair of arm portions comprises a first arm portion having a first support portion and a second arm portion having a second support portion, wherein in the closed position, the second arm portion is positioned closer to the surface of the organ than the first arm portion, and when the first arm portion and the second arm portion are opened from the closed position toward a direction

[0022] This configuration allows the contact surfaces of the first and second arms to be brought effectively closer to the surface of the organ by opening the arms.

[0023] (9) In the medical device described in (8) above, in the open position where the tip portions of the pair of arm portions are moved apart from each other, the contact surfaces of each of the pair of arm portions may be arranged to be substantially coplanar.

[0024] This configuration allows each contact surface of the pair of arms to be effectively brought into close contact with the surface of the organ.

[0025] According to this disclosure, a pair of arms can be easily inserted into a living body in a closed state, and by operating the arms within the living body, the surface of an organ can be effectively pressed.

[0026] Figure 1 is an explanatory diagram showing the usage state of a medical device according to an embodiment of this disclosure. Figure 2 is an overall configuration diagram of a medical device according to an embodiment of this disclosure. Figure 3 is a cross-sectional view showing the tip of the medical device. Figure 4 is a cross-sectional view showing the base end of the medical device. Figure 5 is a perspective view showing the tip of the medical device. Figure 6 is a front view showing the closed state of the first arm and the second arm. Figure 7 is an exploded perspective view of the first arm and the second arm. Figure 8 is a front view showing the open state of the first arm and the second arm. Figure 9 is a plan view of the first arm and the second arm shown in Figure 8. Figure 10 is a cross-sectional view along the line X-X in Figure 2. Figure 11 is a plan view of the first arm and the second arm viewed from the back. Figure 12 is a side view of the first arm and the second arm. Figure 13 is a plan view showing the tip of the medical device. Figure 14 is a side view of the first arm and the second arm shown in Figure 8. Figure 15 is a cross-sectional view of the base end when the first arm and the second arm are in the open position. Figure 16 is a perspective view of the tip of a medical device equipped with a modified support structure.

[0027] 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 the movement of the surface 301 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.

[0028] As shown in Figure 2, the medical device 10 comprises a shaft 12, a first arm portion 201 and a second arm portion 202, and an operating portion 22.

[0029] The shaft 12 has a tip 121 that is inserted into the living body P (see Figure 1). The shaft 12 comprises an outer rod 14, an inner rod 16, and a support structure 18.

[0030] As shown in Figure 3, the outer rod 14 is formed in a cylindrical shape having a lumen 231. The outer rod 14 has a tip opening 232 and a base opening 233 (see Figure 4). The tip opening 232 opens to the tip portion 141 of the outer rod 14. The tip opening 232 and the lumen 231 are in communication. As shown in Figure 4, the base opening 233 opens to the base end portion 142 of the outer rod 14.

[0031] The base end 142 of the outer rod 14 has an engagement groove 26. The engagement groove 26 is an annular groove formed on the outer circumferential surface of the outer rod 14. The operating part 22 is held on the shaft 12 via the engagement groove 26.

[0032] As shown in Figure 2, the inner rod 16 is inserted into the lumen 231 of the outer rod 14. The inner rod 16 and the outer rod 14 are relatively movable in the axial direction of the shaft 12. The inner rod 16's relative rotation to the outer rod 14 is restricted by a rotation prevention structure (not shown). That is, the inner rod 16 and the outer rod 14 are only relatively movable in the axial direction.

[0033] The tip portion 161 of the inner rod 16 is provided to protrude further forward than the tip portion 141 of the outer rod 14 (see Figure 5). As shown in Figure 4, the base end portion 162 of the inner rod 16 has a threaded portion 27. The threaded portion 27 has threads formed on its outer circumferential surface and extends in the axial direction.

[0034] As shown in Figure 5, the first arm portion 201 and the second arm portion 202 are provided on the shaft tip portion 121 of the shaft 12. Each of the first arm portion 201 and the second arm portion 202 is supported by the shaft 12 so as to be able to open and close. Figure 2 shows the closed position of the first arm portion 201 and the second arm portion 202, where the tip portions of the first arm portion 201 and the second arm portion 202 have moved toward each other. Hereinafter, the direction perpendicular to the extension direction and opening / closing direction of the first arm portion 201 and the second arm portion 202 will be referred to as the vertical direction.

[0035] As shown in Figure 6, in the closed position of the first arm portion 201 and the second arm portion 202, the tip of the first arm portion 201 and the tip of the second arm portion 202 overlap each other in the vertical direction. The following describes the case in which, in the closed position of the first arm portion 201 and the second arm portion 202, the tip of the second arm portion 202 is positioned lower than the tip of the first arm portion 201.

[0036] As shown in Figure 5, the first arm portion 201 comprises a first support portion 241 and a first suction portion 261.

[0037] The first support portion 241 is supported by the shaft tip portion 121 of the shaft 12. The first support portion 241 is provided in the direction of the base end of the first arm portion 201. The first support portion 241 is supported by the shaft 12 via the support structure 18.

[0038] As shown in Figure 7, the first support portion 241 has a first dividing surface 281, a hole 30, and a first hemispherical portion 321. As shown in Figure 3, the first dividing surface 281 faces the second support portion 242 of the second arm portion 202. As shown in Figure 8, the first dividing surface 281 is formed flat and inclined with respect to the opening and closing direction of the first arm portion 201. The opening and closing direction of the first arm portion 201 is the width direction (W direction) that intersects with the axial direction and vertical direction of the shaft 12. In a front view of the first arm portion 201, the first dividing surface 281 is inclined upward in the width direction from the first arm portion 201 toward the second arm portion 202.

[0039] As shown in Figure 3, the hole 30 extends in a vertical direction perpendicular to the extending direction of the first arm portion 201. The hole 30 opens into the first dividing surface 281. The first hemispherical portion 321 is formed in a convex shape in a direction away from the first dividing surface 281.

[0040] The first suction portion 261 attracts the heart 300 (see Figure 1). As shown in Figure 9, the first suction portion 261 extends from the tip of the first support portion 241 toward the tip. The first support portion 241 extends parallel to the shaft 12 toward the first suction portion 261 and may have a base end portion 451 (see Figure 7) of the first arm portion 201 that supports the first suction portion 261 with a surface that is bent outward in the width direction (W direction) intersecting the axial direction and vertical direction of the shaft 12.

[0041] This structure makes it easier for the first contact surface 441 and the second contact surface 442 (described later) to come into contact without gaps and at an appropriate position in a direction perpendicular to the opening and closing direction of the first arm portion 201 when the first arm portion 201 and the second arm portion 202 are in a closed state. In addition, when the first suction portion 261 and the second suction portion 262 are in a closed structure, the base end portion 452 (see Figure 7) of the second arm portion 202 is shaped to easily come into contact with the inner surface of the tip portion 141 of the outer rod 14.

[0042] The first suction portion 261 includes a first distal arm portion 341 and a first proximal arm portion 361. The first distal arm portion 341 has a first contact surface 401 that abuts against the surface 301 of the heart 300 (see FIG. 8). The first contact surface 401 has a plurality of suction holes 42. The plurality of suction holes 42 are arranged along the longitudinal direction of the first suction portion 261.

[0043] The first proximal arm portion 361 is provided in the proximal direction of the first distal arm portion 341. The first proximal arm portion 361 is connected to the first support portion 241. The first proximal arm portion 361 is formed to be bent with respect to the extending direction of the first distal arm portion 341.

[0044] The first proximal arm portion 361 includes a first contact surface 441, a first suction port 461, and a first arm surface 471 (FIG. 12). The first contact surface 441 extends in a direction orthogonal to the opening / closing direction of the first arm portion 201. The first contact surface 441 may be a flat surface extending in the vertical direction of the first arm portion 201 (see FIG. 10).

[0045] The first suction port 461 opens at the proximal end of the first proximal arm portion 361. As shown in FIG. 11, the first suction port 461 communicates with the suction holes 42 of the first contact surface 401. A tube 48 connected to a suction source (not shown) is attached to the first suction port 461. Fluid is sucked from the first suction port 461 toward the suction source (not shown) through the tube 48 communicating with the suction source (not shown), inducing a negative pressure around the suction holes 42, whereby the first contact surface 401 can be suctioned to the surface 301 of the heart 300.

[0046] As shown in FIG. 12, the first arm surface 471 is a surface facing the surface 301 of the heart 300 in the living body P. The first arm surface 471 is provided in the proximal direction of the first contact surface 401. The first arm surface 471 is formed to be substantially flat along the extending direction of the first arm portion 201. The first arm surface 471 gently extends from the proximal end of the first contact surface 401 toward the proximal direction.

[0047] In the closed position of the first arm portion 201 and the second arm portion 202, the second arm portion 202 overlaps the first arm portion 201 in the vertical direction (see FIG. 6). When the first arm portion 201 and the second arm portion 202 in the closed position are inserted into the living body P, the second arm portion 202 is arranged closer to the surface 301 of the heart 300 than the first arm portion 201 is.

[0048] As shown in FIG. 5, the second arm portion 202 includes a second support portion 242 and a second suction portion 262.

[0049] The second support portion 242 is supported by the shaft distal end portion 121 of the shaft 12. The second support portion 242 is provided in the proximal direction of the second arm portion 202. The second support portion 242 is supported by the shaft 12 via the support structure 18.

[0050] The second support portion 242 has a second dividing surface 282. The second dividing surface 282 faces the first dividing surface 281 of the first arm portion 201. As shown in FIG. 8, the second dividing surface 282 is formed as a flat surface inclined with respect to the opening / closing direction of the second arm portion 202. The opening / closing direction of the second arm portion 202 is the width direction (W direction) intersecting the axial direction of the shaft 12 and the vertical direction. In a front view of the second arm portion 202, the second dividing surface 282 is inclined upward from the first arm portion 201 toward the second arm portion 202 in the width direction. The opening / closing direction of the second arm portion 202 is the width direction (W direction) intersecting the axial direction of the shaft 12 and the vertical direction. The first dividing surface 281 and the second dividing surface 282 are provided substantially parallel to each other.

[0051] As shown in FIG. 3, the second support portion 242 has a second hemispherical portion 322. The second hemispherical portion 322 is formed to protrude in a direction away from the second dividing surface 282.

[0052] By making the first dividing surface 281 and the second dividing surface 282 face each other in the vertical direction, the first support portion 241 and the second support portion 242 together form a spherical shape. In a state where the first hemispherical portion 321 and the second hemispherical portion 322 together form a spherical shape, the first support portion 241 and the second support portion 242 are supported by the shaft distal end portion 121 of the shaft 12.

[0053] As shown in Figure 7, the second support portion 242 further has a pivot shaft 33. The pivot shaft 33 is located in the center of the second dividing surface 282. The pivot shaft 33 protrudes from the second dividing surface 282 toward the first arm portion 201. The pivot shaft 33 is inserted into the hole 30 of the first support portion 241 at the base end of the first arm portion 201. The first arm portion 201 and the second arm portion 202 are rotatably supported relative to each other via the pivot shaft 33 (see Figure 3).

[0054] The second suction portion 262 adsorbs the heart 300 (see Figure 1). The second suction portion 262 extends from the tip of the second support portion 242 toward the tip. The second support portion 242 extends parallel to the shaft 12 toward the second suction portion 262 and may have a base end portion 452 of a second arm portion 202 that supports the first suction portion 261 with a surface that is bent outward in the width direction (W direction) intersecting the axial direction and vertical direction of the shaft 12.

[0055] This structure makes it easier for the first contact surface 441 and the second contact surface 442 (described later) to come into contact without gaps and at an appropriate position in a direction perpendicular to the opening and closing direction of the first arm portion 201 when the first arm portion 201 and the second arm portion 202 are in a closed state. In addition, when the first suction portion 261 and the second suction portion 262 are in a closed structure, the base end portion 452 of the second arm portion 202 is shaped to easily come into contact with the inner surface of the tip portion 141 of the outer rod 14.

[0056] As shown in Figure 9, the second suction portion 262 comprises a second tip arm portion 342 and a second base arm portion 362. The second tip arm portion 342 has a second contact surface 402 that contacts the surface 301 of the heart 300 (see Figure 8). The second contact surface 402 has a plurality of suction holes 42. The plurality of suction holes 42 are arranged along the longitudinal direction of the second suction portion 262.

[0057] The second base arm portion 362 is provided in the base direction of the second tip arm portion 342. The second base arm portion 362 is connected to the second support portion 242. The second base arm portion 362 is formed by bending with respect to the extending direction of the second tip arm portion 342.

[0058] The second base arm portion 362 includes a second contact surface 442, a second suction port 462, and a second arm surface 472. The second contact surface 442 is perpendicular to the opening and closing direction of the second arm portion 202. As shown in Figure 10, the second contact surface 442 is a flat surface extending in the vertical direction of the second arm portion 202. In the closed position of the first arm portion 201 and the second arm portion 202, the first contact surface 441 and the second contact surface 442 are in contact with each other.

[0059] The second suction port 462 opens at the base end of the second base arm portion 362. As shown in Figure 11, the second suction port 462 communicates with the suction hole 42 of the second contact surface 402. A tube 48 connected to a suction source (not shown) is attached to the second suction port 462. Fluid is drawn from the second suction port 462 toward the suction source (not shown) through the tube 48 communicating with the suction source (not shown), inducing a negative pressure state around the suction hole 42, which allows the second contact surface 402 to be attracted to the surface 301 of the heart 300.

[0060] As shown in Figure 12, the second arm surface 472 is the surface that faces the surface 301 of the heart 300 within the living body P. The second arm surface 472 is provided in the direction of the proximal end of the second contact surface 402. The second arm surface 472 is inclined upward toward the proximal end of the second arm portion 202. The inclination of the second arm surface 472 may be greater than that of the first arm surface 471. With this structure, when the first arm portion 201 and the second arm portion 202 are arranged to overlap in the vertical direction, there is less gap and the structure is easier to overlap in the vertical direction. Therefore, it is easier to insert the tip of the medical device 10 into the living body P.

[0061] As shown in Figure 9, each of the first adsorption portion 261 and the second adsorption portion 262 has a shape in which the width direction is shorter than the length direction. Each of the first adsorption portion 261 and the second adsorption portion 262 is formed to gradually widen from the base end to the tip. Note that there may be only one of the first suction port 461 and the second suction port 462.

[0062] As shown in Figure 7, the first support portion 241 and the second support portion 242 are further provided with a biasing member 50. The biasing member 50 biases the first arm portion 201 and the second arm portion 202 in a direction that causes the tip of the first arm portion 201 and the tip of the second arm portion 202 to move away from each other. The biasing member 50 is, for example, a torsion spring. However, the biasing member 50 is not limited to a torsion spring.

[0063] The biasing member 50 comprises a main body portion 501 around which a wire is wound, and a first end portion 502 and a second end portion 503 extending radially outward from the main body portion 501. As shown in Figure 9, the main body portion 501 is inserted through the support shaft 33 and provided between the first support portion 241 and the second support portion 242 (see Figure 3). The first end portion 502 engages with the first groove portion 381 of the first arm portion 201. The second end portion 503 engages with the second groove portion 382 of the second arm portion 202. The elastic force of the biasing member 50 biases the first base arm portion 361 of the first arm portion 201 and the second base arm portion 362 of the second arm portion 202 in a direction that separates them from each other (opening direction) with the support shaft 33 as the fulcrum. Furthermore, the mechanism is not limited to a biasing member, as long as it is a mechanism that can move the first arm portion 201 and the second arm portion 202 in a direction that separates them from each other. For example, a wire mechanism may be connected to each of the first arm portion 201 and the second arm portion 202 so as to be movable, and the opening and closing of each arm may be adjusted by rotating the wire winding structure.

[0064] In a plan view of the medical device 10, when the first arm portion 201 and the second arm portion 202 are in the open position (open state), the first arm portion 201 and the second arm portion 202 are arranged substantially symmetrically with respect to the axis of the shaft 12.

[0065] As shown in Figure 8, in the open position of the first arm portion 201 and the second arm portion 202, where the tip of the first arm portion 201 and the tip of the second arm portion 202 are moved in a direction (W direction) away from each other, the first contact surface 401 of the first arm portion 201 and the second contact surface 402 of the second arm portion 202 are arranged to be substantially on the same plane when viewed from the axial direction of the shaft 12.

[0066] As shown in Figure 5, the support structure 18 is provided on the tip portion 161 of the inner rod 16. The support structure 18 supports the first arm portion 201 and the second arm portion 202 so that they can be opened and closed, and has a cylindrical collet portion 52. The collet portion 52 is formed in a cylindrical shape. The tip of the collet portion 52 opens toward the tip.

[0067] The collet portion 52 has a housing portion 54 and a plurality of slits 56. The housing portion 54 is provided inside the collet portion 52. The housing portion 54 houses the first support portion 241 of the first arm portion 201 and the second support portion 242 of the second arm portion 202. Specifically, the first hemispherical portion 321 of the first arm portion 201 and the second hemispherical portion 322 of the second arm portion 202 are combined to form a spherical shape, and the first support portion 241 and the second support portion 242 are housed in the housing portion 54 of the collet portion 52. The opening area at the tip of the collet portion 52 is smaller than the diameter of the spherical first hemispherical portion 321 and the second hemispherical portion 322.

[0068] With the first support portion 241 and the second support portion 242 housed in the housing portion 54, each of the first arm portion 201 and the second arm portion 202 is rotatably supported with respect to the support structure 18. The first arm portion 201 and the second arm portion 202 do not detach from the collet portion 52 toward the tip.

[0069] As shown in Figure 13, in the closed position of the first arm portion 201 and the second arm portion 202, the base end portion 451 of the first arm portion 201 and the base end portion 452 of the second arm portion 202 abut against the inner surface of the tip portion 141 of the outer rod 14, thereby holding the first arm portion 201 and the second arm portion 202 in the closed position.

[0070] As shown in Figure 5, the slit 56 opens onto the tip surface of the collet portion 52 (inner rod 16). As shown in Figure 3, the slit 56 extends from the tip of the inner rod 16 towards the base end. The slit 56 penetrates the circumferential wall of the inner rod 16 in the thickness direction. Multiple slits 56 are provided spaced apart in the circumferential direction of the inner rod 16.

[0071] As shown in Figure 14, the outer diameter of the collet portion 52 is larger than the diameter of the tip opening 232 of the outer rod 14. The collet portion 52 is formed to be retractable via a plurality of slits 56.

[0072] As shown in Figure 2, the operating part 22 is provided at the base end of the shaft 12. The operating part 22 moves the inner rod 16 axially relative to the outer rod 14. As shown in Figure 4, the operating part 22 has a handle 58. The handle 58 is cylindrical and covers the base end 142 of the outer rod 14. The base end opening 233 of the outer rod 14 is covered by the handle 58.

[0073] The handle 58 comprises an engaging portion 581 and a meshing portion 582. The engaging portion 581 is provided at the tip of the handle 58. The engaging portion 581 protrudes radially inward from the tip of the handle 58. The engaging portion 581 is formed in an annular shape and engages with the engaging groove 26 of the outer rod 14. The handle 58 is rotatably supported on the base end 142 of the outer rod 14.

[0074] The meshing portion 582 is formed inside the handle 58. The threaded portion 27 of the inner rod 16 engages with the meshing portion 582. The meshing portion 582 extends in the axial direction of the handle 58. The meshing of the threaded portion 27 and the meshing portion 582 causes the inner rod 16 to move along the axial direction when the handle 58 is rotated. When the handle 58 is rotated in the first direction relative to the outer rod 14, the inner rod 16 moves relative to the outer rod 14 toward the tip. The tip portion 161 of the inner rod 16 protrudes toward the tip beyond the tip portion 141 of the outer rod 14 (see Figure 14). At this time, the first arm portion 201 and the second arm portion 202 are in an open position with a predetermined angle of separation (see Figure 9).

[0075] When the handle 58 is rotated relative to the outer rod 14 in a second direction opposite to the first direction, the inner rod 16 moves relative to the outer rod 14 toward its base end. The tip 161 of the inner rod 16 is accommodated by the tip 141 of the outer rod 14 through the tip opening 232 (see Figure 3).

[0076] As a result, the collet portion 52 of the support structure 18 is housed in the tip opening 232 of the outer rod 14. At this time, the collet portion 52 is pushed radially inward by the inner surface of the outer rod 14 and its diameter is reduced through the slit 56. The inner circumferential surface of the reduced-diameter collet portion 52 supports the first support portion 241 of the first arm portion 201 and the second support portion 242 of the second arm portion 202 in a state where they are pushed toward each other. The rotational movement of the first arm portion 201 and the second arm portion 202 relative to the support structure 18 is restricted, resulting in a locked state. The tip of the first arm portion 201 and the tip of the second arm portion 202 are in a closed position where they overlap each other in the vertical direction (see Figure 3).

[0077] The medical device 10 is used as follows:

[0078] As shown in Figure 2, the medical device 10 before use (initial state) is in a closed state (closed position) where the inner rod 16 moves relative to the outer rod 14 in the direction of the base end, and the tip of the first arm portion 201 and the tip of the second arm portion 202 are locked in a direction approaching each other. In other words, in the initial state, the rotational movement of the first arm portion 201 and the second arm portion 202 is prevented by the reduced diameter collet portion 52, and they are maintained in the closed position.

[0079] 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 body P. After the tip of the medical device 10 has been inserted to the desired position of the heart 300 (organ) within the living body P, the user operates the control unit 22.

[0080] Specifically, by rotating the handle 58 of the operating unit 22 in the first direction relative to the shaft 12, as shown in Figure 15, the inner rod 16 moves toward the tip relative to the outer rod 14 as the handle 58 rotates. As shown in Figure 14, the tip 161 of the inner rod 16 protrudes toward the tip further than the tip 141 of the outer rod 14, thereby releasing the radially inward pressure on the collet portion 52 of the support structure 18.

[0081] As a result, the collet portion 52 expands radially outward, releasing the lock on the rotational movement of the first arm portion 201 and the second arm portion 202 caused by the collet portion 52. The first arm portion 201 and the second arm portion 202 become rotatable relative to the tip of the shaft 12 via the support structure 18. As the collet portion 52 expands, the pressure that brings the first support portion 241 and the second support portion 242 closer together is released. The first support portion 241 and the second support portion 242 become relative to each other and can move.

[0082] The biasing force of the biasing member 50 biases the tip of the first arm portion 201 and the tip of the second arm portion 202 in a direction that moves them apart from each other. As a result, the first arm portion 201 and the second arm portion 202 rotate from the closed position so that the tip of the first arm portion 201 and the tip of the second arm portion 202 move apart from each other with the support shaft 33 as the pivot point (see Figure 9).

[0083] As shown in Figure 9, the first arm portion 201 and the second arm portion 202 are in an open position, separated by a predetermined angle. In a plan view of the medical device 10, in the open position, the first arm portion 201 and the second arm portion 202 open in a V-shape such that the distance between them increases toward the tip.

[0084] At this time, the support shaft 33 is inclined with respect to a direction perpendicular to the surface 301 of the heart 300, and the first dividing surface 281 and the second dividing surface 282 are inclined with respect to the opening and closing direction of the first arm portion 201 and the second arm portion 202. Specifically, the surface formed by the two inclined surfaces is inclined such that, in the closed position, the opening direction of the upper overlapping first arm portion 201 is downward, and the opening direction of the lower overlapping second arm portion 202 is upward. In the front-rear direction as well, the tip is inclined downward and the base is inclined upward. Therefore, as shown in Figure 6, when the first arm portion 201 and the second arm portion 202 open from the closed position, the first arm portion 201 moves along a trajectory that approaches the surface 301 of the heart 300 in a slightly downward direction (R1 direction), with the first support portion 241 as the pivot point. The second arm portion 202 moves along a trajectory that is slightly upward (in the R2 direction) away from the surface 301 of the heart 300, with the second support portion 242 as the pivot point. As shown in Figure 8, in a front view of the medical device 10, the first contact surface 401 of the first arm portion 201 and the second contact surface 402 of the second arm portion 202 are arranged to be substantially on the same plane in the open position.

[0085] In other words, the first arm portion 201, which is positioned above in the closed position, is rotated diagonally downwards via the first and second dividing surfaces 281 and 282 so as to face the heart 300, and the second arm portion 202, which is positioned below, is rotated diagonally upwards via the first and second dividing surfaces 281 and 282 so as to move away from the heart 300. As a result, the first arm portion 201 and the second arm portion 202, which are positioned eccentrically in the vertical direction in the closed position, are positioned to be aligned with the surface 301 of the heart 300 in the open position.

[0086] The user moves the shaft 12 and tilts the first arm portion 201 and the second arm portion 202 so that they are aligned with the surface 301 of the heart 300, and then brings the contact surfaces of the suction portions of the first arm portion 201 and the second arm portion 202 into contact with the surface 301 of the heart 300. At this time, with the first arm portion 201 and the second arm portion 202 kept in the open position, the first support portion 241 and the second support portion 242 may be rotatable relative to the shaft 12. This allows the angle between the shaft 12 and the contact surface to be adjusted so that the first arm portion 201 and the second arm portion 202 can be brought into contact with the appropriate position on the heart 300. Such rotation may be performed by rotating with a finger or an instrument, or a rotation mechanism may be provided.

[0087] After the first arm portion 201 and the second arm portion 202 are brought into contact with the surface 301 of the heart 300, a suction source (not shown) induces a negative pressure state around the first suction port 461 of the first arm portion 201 and the second suction port 462 of the second arm portion 202 through a tube 48. The first suction portion 261 of the first arm portion 201 and the second suction portion 262 of the second arm portion 202 suction the surface 301 of the heart 300. At the tip of the medical device 10, the movement of the surface 301 of the heart 300 due to pulsation is suppressed.

[0088] After the thoracotomy of the living organism P is completed, the medical device 10 is removed from the living organism P. The drive of the suction source communicating with the first suction part 261 and the second suction part 262 is stopped, and the negative pressure state is released. Then, by rotating the handle 58 of the operating part 22 in the second direction, the inner rod 16 moves relative to the outer rod 14 in the proximal end direction (see Figure 4). As the inner rod 16 moves in the proximal end direction, the first arm part 201 and the second arm part 202 move toward the tip part 141 of the outer rod 14.

[0089] As the inner rod 16 moves, the collet portion 52 moves from the tip opening 232 of the outer rod 14 into the lumen 231, causing the collet portion 52 to shrink in diameter through the slit 56. Then, the base end 451 of the first arm portion 201 and the base end 452 of the second arm portion 202 come into contact with the tip 141 of the outer rod 14 and are inserted into the lumen 231, causing the first arm portion 201 and the second arm portion 202 to rotate toward each other with the pivot shaft 33 as the fulcrum, against the biasing force of the biasing member 50.

[0090] As a result, the first arm portion 201 and the second arm portion 202 are closed, as shown in Figure 2.

[0091] As shown in Figure 13, the tip 161 of the inner rod 16 is housed in the tip 141 of the outer rod 14, thereby locking the rotational and opening / closing movements of the first arm portion 201 and the second arm portion 202 relative to the shaft 12.

[0092] Then, with the first arm portion 201 and the second arm portion 202 closed, the tip of the medical device 10 is withdrawn to the outside of the living body P through the opening 304. However, the configuration is not limited to closing the first arm portion 201 and the second arm portion 202 by rotating the inner rod 16 in the second direction and moving it towards the base end when locking. For example, the first arm portion 201 and the second arm portion 202 may be closed by the user holding them between their fingers inside the living body P, and then the first arm portion 201 and the second arm portion 202 may be withdrawn through the opening 304.

[0093] This embodiment provides the following effects.

[0094] As shown in Figure 8, each of the first arm portion 201 and the second arm portion 202 includes a first support portion 241 and a second support portion 242 that are supported on the shaft tip portion 121. Each of the first support portion 241 and the second support portion 242 has a first dividing surface 281 and a second dividing surface 282 that face each other and are inclined with respect to the opening and closing direction of the first arm portion 201 and the second arm portion 202. With the first dividing surface 281 and the second dividing surface 282 facing each other, the first support portion 241 and the second support portion 242 are supported on the shaft tip portion 121 of the shaft 12 so as to be able to open and close.

[0095] With this medical device 10, the first arm portion 201 and the second arm portion 202 can be easily inserted into the living body P in a closed state, and by operating the first arm portion 201 and the second arm portion 202 within the living body P, the surface 301 of the heart 300 can be effectively pressed.

[0096] As shown in Figure 9, the first support portion 241 and the second support portion 242 are equipped with biasing members 50 that bias the first arm portion 201 and the second arm portion 202 in a direction that causes the tips of the first arm portion 201 and the second arm portion 202 to move away from each other.

[0097] With this configuration, the biasing member 50 makes it easy to open the first arm portion 201 and the second arm portion 202.

[0098] As shown in Figure 6, in the closed position of the first arm portion 201 and the second arm portion 202, the first arm portion 201 and the second arm portion 202 overlap each other in the vertical direction.

[0099] This configuration effectively suppresses the width of the first arm portion 201 and the second arm portion 202 during their closing operation.

[0100] As shown in Figure 3, the first support portion 241 and the second support portion 242 each have a first hemispherical portion 321 and a second hemispherical portion 322, which are formed in a convex shape in a direction away from the first dividing surface 281 and the second dividing surface 282. With the first hemispherical portion 321 and the second hemispherical portion 322 together forming a sphere, the first support portion 241 and the second support portion 242 are supported on the shaft tip portion 121.

[0101] This configuration allows for an effective change in the orientation of the first arm portion 201 and the second arm portion 202 relative to the shaft 12.

[0102] As shown in Figure 5, the first suction portion 261 comprises a first tip arm portion 341 that abuts against the surface 301 of the heart 300, and a first base arm portion 361 that is provided in the base direction of the first tip arm portion 341 and connected to the first support portion 241. The first base arm portion 361 is formed by bending with respect to the extending direction of the first tip arm portion 341. The second suction portion 262 comprises a second tip arm portion 342 that abuts against the surface 301 of the heart 300, and a second base arm portion 362 that is provided in the base direction of the second tip arm portion 342 and connected to the second support portion 242. The second base arm portion 362 is formed by bending with respect to the extending direction of the second tip arm portion 342.

[0103] With this configuration, the tips of the first arm portion 201 and the second arm portion 202 can be effectively stacked vertically while the first support portion 241 and the second support portion 242 are supported by the shaft 12.

[0104] As shown in Figure 10, the first base arm portion 361 of the first suction portion 261 and the second base arm portion 362 of the second suction portion 262 have a first contact surface 441 and a second contact surface 442 that are in contact with each other in the closed position.

[0105] With this configuration, the closed state of the first arm portion 201 and the second arm portion 202 can be effectively maintained in the closed position.

[0106] As shown in Figure 11, the first base arm portion 361 of the first suction portion 261 is provided with a first suction port 461 that communicates with the suction hole 42 of the first contact surface 401 and induces a negative pressure state. The second base arm portion 362 of the second suction portion 262 is provided with a second suction port 462 that communicates with the suction hole 42 of the second contact surface 402 and induces a negative pressure state.

[0107] With this configuration, the negative pressure state induced by the first suction port 461 and the second suction port 462 respectively allows the first arm portion 201 and the second arm portion 202 to be effectively brought into close contact with the surface 301 of the heart 300 (organ).

[0108] As shown in Figure 6, the device comprises a first arm portion 201 having a first support portion 241 and a second arm portion 202 having a second support portion 242. In the closed position, the second arm portion 202 is positioned closer to the surface 301 of the heart 300 than the first arm portion 201. When the first arm portion 201 and the second arm portion 202 open from the closed position, the first arm portion 201 moves along a trajectory toward the surface 301 of the heart 300 with the first support portion 241 as a pivot point, and the second arm portion 202 moves along a trajectory toward the surface 301 of the heart 300 with the second support portion 242 as a pivot point.

[0109] With this configuration, by opening the first arm portion 201 and the second arm portion 202, the first contact surface 401 of the first arm portion 201 and the second contact surface 402 of the second arm portion 202 can be effectively brought closer to the surface 301 of the heart 300.

[0110] As shown in Figure 8, in the open position of the first arm portion 201 and the second arm portion 202, the first contact surface 401 of the first arm portion 201 and the second contact surface 402 of the second arm portion 202 are arranged to be substantially on the same plane.

[0111] With this configuration, the first contact surface 401 of the first arm portion 201 and the second contact surface 402 of the second arm portion 202 can be effectively brought into close contact with the surface 301 of the heart 300.

[0112] The medical device 10 is not limited to having a support structure 18 having a collet portion 52. As shown in Figure 16, it may also have a support structure 18A having a plurality of hook portions 60. The plurality of hook portions 60 are provided on the tip portion 161 of the inner rod 16A. The plurality of hook portions 60 are spaced apart from each other along the circumferential direction of the inner rod 16A. The tip of each hook portion 60 is provided with a claw portion 62 that protrudes radially inward. Each claw portion 62 can hold the first support portion 241 and the second support portion 242 housed in the housing portion 54.

[0113] When the inner rod 16A moves toward the base end relative to the outer rod 14, each hook portion 60 elastically deforms radially inward. The first support portion 241 and the second support portion 242 are held by the elastically deformed hook portions 60.

[0114] As the inner rod 16A moves toward the tip relative to the outer rod 14, and each hook portion 60 protrudes toward the tip of the outer rod 14, the first support portion 241 and the second support portion 242 are rotatably held by the hook portions 60 which have expanded radially outward.

[0115] 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; and a pair of arm portions provided at the tip of the shaft and supported by the shaft so as to be openable and closable, wherein each of the pair of arm portions comprises: a support portion supported at the tip of the shaft; and a suction portion extending toward the tip from each of the pair of support portions, wherein each of the pair of support portions has a dividing surface that faces each other and is inclined with respect to the opening and closing direction of the arm portion, and the pair of support portions are supported by the tip of the shaft so as to be openable and closable with a plurality of the dividing surfaces facing each other.

2. A medical device according to claim 1, wherein the pair of support portions are equipped with biasing members that bias the pair of arm portions in a direction that causes the tips of the arm portions to move apart from each other.

3. A medical device according to claim 1 or 2, wherein in a closed position where the tips of a pair of arm portions move toward each other, the pair of arm portions overlap each other in a direction intersecting the extending direction of the arm portions and the opening and closing direction.

4. A medical device according to claim 3, wherein each of the pair of support portions has a hemispherical portion formed in a convex shape toward a direction away from the dividing surface, and the pair of support portions are supported at the tip of the shaft when the two hemispherical portions are joined together to form a sphere.

5. A medical device according to claim 3, wherein the suction portion comprises: a tip arm portion having a contact surface that contacts the surface of the organ; and a base arm portion provided in the direction of the base end of the tip arm portion and connected to the support portion, wherein the base arm portion is formed by bending with respect to the extending direction of the tip arm portion.

6. A medical device according to claim 5, wherein the pair of base arm portions have contact surfaces that come into contact with each other in the closed position.

7. A medical device according to claim 5, wherein the base arm portion is provided with a suction port that communicates with a suction hole in the contact surface and induces a negative pressure state.

8. A medical device according to claim 5, wherein the pair of arm portions comprises: a first arm portion having a first support portion; and a second arm portion having a second support portion, wherein in the closed position, the second arm portion is positioned closer to the surface of the organ than the first arm portion; and when the first arm portion and the second arm portion are opened from the closed position toward a direction 9. A medical device according to claim 8, wherein in an open position where the tip portions of a pair of arms are moved apart from each other, the contact surfaces of each of the pair of arms are arranged to be substantially coplanar.

Images