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WO2019116570A1 - Instrument de préhension médical - Google Patents

Instrument de préhension médical Download PDF

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Publication number
WO2019116570A1
WO2019116570A1 PCT/JP2017/045196 JP2017045196W WO2019116570A1 WO 2019116570 A1 WO2019116570 A1 WO 2019116570A1 JP 2017045196 W JP2017045196 W JP 2017045196W WO 2019116570 A1 WO2019116570 A1 WO 2019116570A1
Authority
WO
WIPO (PCT)
Prior art keywords
jaw
slit
movable
pair
pin
Prior art date
Application number
PCT/JP2017/045196
Other languages
English (en)
Japanese (ja)
Inventor
紀明 山中
Original Assignee
オリンパス株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2017/045196 priority Critical patent/WO2019116570A1/fr
Publication of WO2019116570A1 publication Critical patent/WO2019116570A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery

Definitions

  • the present invention relates to a medical grasper.
  • a medical clip using a parallel link is known as a mechanism for opening and closing a pair of jaws arranged parallel to each other (see, for example, Patent Document 1).
  • the pair of jaws translate in a direction approaching each other. Therefore, the living tissue can be grasped between the pair of jaws parallel to each other.
  • the present invention has been made in view of the above-described circumstances, and it is an object of the present invention to provide a medical grasper capable of grasping living tissue in parallel and obtaining good operability.
  • One aspect of the present invention is a base part connected to the tip of a long shaft part, a jaw part disposed adjacent to the base part in a direction intersecting the longitudinal direction of the shaft part, and the jaw part
  • An opening and closing mechanism for opening and closing the jaw part relative to the base part by swinging the tip end of the jaw part around the proximal end of the jaw part and translating the jaw part in the arrangement direction of the base part and the jaw part;
  • a driving force transmitting member for transmitting a driving force for opening and closing to the jaw part, wherein the opening and closing mechanism causes the tip of the jaw part to swing toward the base part in the closing operation of the jaw part.
  • a medical grasper that translates the jaw component towards the base component.
  • the opening / closing mechanism causes the tip of the jaw part to swing relative to the base part and subsequently translates the jaw part . Therefore, the living tissue can be grasped in parallel by the base part and the jaw part arranged parallel to each other. Also, in the open state, the jaw parts are arranged at an angle with respect to the base part such that the distal end opens wider than the proximal end. Therefore, better operability can be obtained in the open state as compared with the case where the jaw part is opened and closed only by translation (parallel movement).
  • the opening / closing mechanism is fixed to the slit formed in the base end of one of the base part and the jaw part and extending in the arrangement direction, and the other base end of the base part and the jaw part A movable pin movable in the slit, the slit being a rotation area in which the movable pin rotates in a plane of the arrangement direction by the driving force in the closing direction of the jaw part, and the closing direction of the jaw part And the translation region in which the movable pin translates in the arrangement direction by the driving force of
  • the translation of the jaw parts can be realized with an inexpensive configuration with a small number of parts as compared to parallel links.
  • the opening and closing mechanism includes a pair of movable pins arranged to be spaced apart from each other, and at least one of the pair of movable pins moves the rotation area to move the tip of the jaw part.
  • the jaw component may translate by oscillating and simultaneously moving both of the pair of movable pins in the translation region.
  • the translational region of the slit includes two repeating parts whose shapes, sizes and orientations are identical to each other, and the pair of movable pins have the same phase as the two repeating parts. It may be movable. A pair of movable pins in two repeated portions move along the same trajectory. Thereby, translation of a pair of movable pins is realizable by simple design of a slit.
  • the translational area of the slit may be linear. In this way, the translation of the movable pin can be realized by a simple linear translational region.
  • the pair of movable pins are arranged in the same slit in the extension direction of the slit, and the rotation area of the slit is translated from the swing operation side end of the jaw component of the slit
  • the movable portion has a wide portion provided at a position separated on the operation side and having a width larger than the outer diameter of the movable pin, and one movable pin on the translational operation side has the wide portion by the driving force in the closing direction.
  • the tip end portion of the jaw part may swing.
  • the pair of movable pins is rotated by the movement in the width direction of one of the movable pins in the wide portion. Thereby, the tip of the jaw part can be rocked.
  • the opening and closing mechanism has a pair of slits arranged in the longitudinal direction and into which the movable pin is inserted one by one, and the pair of slits have the same shape, size and direction. It is possible to have a certain translational region and a rotational region whose shape is different from each other. By doing so, the lengths of the individual slits in the arrangement direction of the base part and the jaw part can be shortened as compared with the case where the pair of movable pins move in the same slit.
  • the rotation area of the slit on the distal end side is an arc shape centering on the swing operation side end of the jaw component on the proximal end side
  • the driving force transmission member is The driving force may be applied to the jaw component at a position spaced apart from the movable pin in the proximal slit.
  • the movable pin in the slit on the distal end side may be a drive pin to which the drive force is applied from the drive force transmission member.
  • the medical grasping tool 1 is a treatment instrument such as grasping forceps or a clip that grasps a living tissue. As shown in FIG.
  • the medical grasper 1 has an elongated shaft (shaft part) 2 having a longitudinal axis A, a base (base part) 3 connected to the tip of the shaft 2, and a longitudinal axis A (Jaw component) 4 disposed adjacent to the base 3 in a direction orthogonal to the above, an opening / closing mechanism 5 for opening / closing the jaw 4 with respect to the base 3, and a drive for transmitting driving force for opening / closing to the jaw 4 And a force transmitting member 6 (see FIGS. 2A to 2D).
  • the arrangement direction of the base 3 and the jaws 4 is defined as the height direction
  • the base 3 side is defined as the lower side
  • the jaw 4 side is defined as the upper side.
  • a direction orthogonal to the longitudinal axis A and the height direction is defined as a width direction.
  • the base 3 is disposed side by side in the direction along the shaft 2 and the longitudinal axis A, and is fixed to the tip of the shaft 2.
  • the proximal end of the jaw 4 is connected to the proximal end of the base 3 via the opening and closing mechanism 5.
  • the base 3 and the jaw 4 have gripping surfaces 3a and 4a facing each other in the height direction and gripping a living tissue.
  • the base 3 has an axis connecting the front end and the base end of the base 3 and parallel to the gripping surface 3a.
  • the jaw 4 has an axis connecting the tip and the proximal end of the jaw 4 and parallel to the gripping surface 4a.
  • the opening / closing mechanism 5 has a single slit 7 formed at the base end of the base 3 and a pair of movable pins 8A fixed to the jaw 4 and movable in the slit 7 , 8B, and a drive pin 9 fixed to the jaw 4 on the more proximal side than the movable pins 8A, 8B and connecting the jaw 4 and the driving force transmission member 6.
  • the slits 7 open in the width direction and extend in the height direction.
  • the slit 7 is generally inclined with respect to the axis of the base 3 so as to be gradually displaced to the base end side from the upper end to the lower end.
  • the pair of movable pins 8A and 8B protrude in the width direction from the surface of the base end portion of the jaw 4 and are inserted in the width direction into the slit 7.
  • the pair of movable pins 8A and 8B are arranged in the height direction at intervals from each other, and are movable in the slit 7 between the upper end and the lower end.
  • the jaw 4 is supported by the base 3 so as to be able to open and close with respect to the base 3 by the pair of movable pins 8A and 8B inserted into the slit 7.
  • the width of the slit 7 in the direction orthogonal to the extending direction is slightly larger than the outer diameter of each movable pin 8A, 8B, and in the slit 7, the pair of movable pins 8A, 8B is only in the extending direction of the slit 7. It can be arranged.
  • the movement path of the pair of movable pins 8A and 8B with respect to the base 3 is defined by the shape of the slit 7.
  • a drive unit (not shown) that generates a drive force for opening and closing the jaws 4 is connected.
  • the drive unit may be a manual type that generates a driving force by the operation of the operator, or may be an electric type that generates a driving force by an electric motor.
  • the driving unit generates a pressing force as a driving force for moving the jaw 4 in the opening direction, and generates a pulling force F as a driving force for moving the jaw 4 in the closing direction.
  • the driving force transmitting member 6 includes a link 6 a connected to the jaw 4.
  • the distal end portion of the link 6 a is connected to a proximal end portion of the jaw 4 by a drive pin 9 so as to be swingable about a swing axis extending in the width direction.
  • the proximal end of the link 6a is connected to the drive via another member disposed in the shaft 2, for example, another link.
  • FIGS. 2A to 2D show the process of closing the jaw 4.
  • the closing motion of the jaw 4 is the downward swing of the tip of the jaw 4 with respect to the base 3 from the open position to the mid position, and the base 3 from the mid position to the closed position.
  • the shape of the slit 7 and the relative position of the pair of movable pins 8A, 8B are designed so as to be performed in two stages of downward translation of the jaw 4 with respect to.
  • the gripping surface 4a In the open position, as shown in FIG. 2A, the gripping surface 4a is disposed at a position separated from the gripping surface 3a, and the axis of the jaw 4 is disposed at an angle to the axis of the base 3 .
  • the middle position is a position where the gripping surface 4a is disposed at a position separated from the gripping surface 3a and the axis of the jaw 4 is parallel to the axis of the base 3, as shown in FIG. 2C.
  • the gripping surface 4a In the closed position, as shown in FIG. 2D, the gripping surface 4a is in contact with the gripping surface 3a, and the axis of the jaw 4 is parallel to the axis of the base 3.
  • the slit 7 swings the distal end of the jaw 4 about the base end of the jaw 4 in a vertical plane along a curved locus of the movable pins 8A and 8B.
  • the curved area 7A has a center of curvature on the proximal side of the slit 7 and has a substantially arc shape that is convex on the distal side.
  • the linear region 7B has a linear shape that is gradually displaced toward the base end side from the upper end to the lower end of the linear region 7B.
  • the lower end of the curved area 7A and the upper end of the straight area 7B are smoothly continuous with each other.
  • the inclination of the straight line connecting the centers of the pair of movable pins 8A and 8B with respect to the axis of the jaw 4 is equal to the inclination of the linear area 7B with respect to the axis of the base 3.
  • the axis of the jaw 4 is parallel to the axis of the base 3 when both movable pins 8A, 8B are arranged in the linear region 7B.
  • both movable pins 8A and 8B move in the linear region 7B, the inclination of the straight line connecting the centers of the pair of movable pins 8A and 8B with respect to the axis of the base 3 is maintained constant.
  • the jaws 4 are vertically translated with respect to the base 3 while the axes of the jaws 4 are parallel to each other.
  • the medical grasper 1 configured as described above will be described.
  • a pressing force is applied from the driving force transmitting member 6 to the driving pin 9 .
  • the pair of movable pins 8A and 8B move in the slit 7 from the lower end to the upper end, and the jaw 4 moves in the opening direction.
  • a traction force F is applied to the driving pin 9 from the driving force transmission member 6.
  • the jaws 4 move in the closing direction by the pair of movable pins 8A, 8B moving in the slit 7 from the upper end to the lower end by the pulling force F.
  • the jaw 4 operates in two steps in accordance with the curved area 7 ⁇ / b> A and the linear area 7 ⁇ / b> B of the slit 7. That is, in the first stage of the closing operation, when the pair of movable pins 8A and 8B move in the curved area 7A, the tip end of the jaw 4 swings around the base end of the jaw 4 and the jaw 4 opens. Move from position to halfway position. At the final stage of the subsequent closing operation, the pair of movable pins 8A and 8B moves the linear region 7B to maintain the axis of the base 3 and the axis of the jaw 4 parallel to each other.
  • the jaws 4 are arranged parallel to the base 3 in the middle of the closing operation, after which the jaws 4 translate relative to the base 3.
  • the living tissue can be grasped by the base 3 and the jaws 4 parallel to each other.
  • translation of the jaw 4 can be realized with a simple structure of only the slit 7 formed in the base 3 and the two movable pins 8A and 8B fixed to the jaw 4.
  • the proximal end of the jaw 4 is also connected to the base 3 so that the jaw 4 opens at an angle to the base 3.
  • the distal end side of the jaw 4 is configured to open largely, so that the narrow jaw of the medical grasper 1 in the open state is compared with a structure in which the entire jaw 4 is translated upward in relation to the base 3.
  • the operability in space can be improved.
  • both movable pins 8A and 8B are stably pressed against the inner surface on one side of the slit 7 so that rattling of the jaw 4 is suppressed.
  • the drive pin 9 is disposed. Specifically, as shown in FIG. 3, when the pair of movable pins 8A and 8B and the drive pin 9 are projected in the direction of the pulling force F, a pair of movable surfaces is projected on the projection plane P intersecting the direction of the pulling force F.
  • the drive pin 9 is disposed with respect to the pair of movable pins 8A and 8B so that the projection point Q3 of the drive pin 9 internally divides the line connecting the projection points Q1 and Q2 of the pins 8A and 8B.
  • the relationship between the reaction force that the pins 8A and 8B receive from the inner surface of the slit 7 and the pulling force F from the drive pin 9 becomes opposite directions around the pin 8A and around the pin 8B. It is possible to suppress rattling of the pins 8A and 8B.
  • the link 6a is used as a member for transmitting the driving force to the drive pin 9, but the configuration of the driving force transmission member 6 is not limited to this. Any other member that can transmit along the direction may be used.
  • the driving force transmitting member 6 may be a rod-like or columnar member disposed in the direction along the longitudinal axis A, as shown in FIGS. 4A to 4C.
  • the distal end portion of the driving force transmitting member 6 is provided with a hole 6b in which the driving pin 9 can move in the height direction, thereby allowing movement of the driving pin 9 in association with swinging and translation of the jaw 4 It is supposed to be.
  • the translational area of the slit 7 for translating the jaws 4 consists of the linear area 7B, but instead, as shown in FIGS. 5A to 5C, the translational areas are mutually different. , And have two repeated portions (translational regions) 7C whose shape, size and orientation are identical to each other.
  • the upper movable pin 8A disposed in the upper repeat portion 7C and the lower movable pin 8B disposed in the lower repeat portion 7C move the repeat portion 7C in the same phase.
  • the centers of the pair of movable pins 8A and 8B with respect to the axis of the base 3 are connected.
  • the inclination of the straight line is maintained constant, and the pair of movable pins 8A and 8B translate. Therefore, the jaw 4 can be translated by the movement of the pair of movable pins 8A, 8B of the repeated portion 7C.
  • the drive pin 9 is provided separately from the pair of movable pins 8A and 8B, but instead, one of the pair of movable pins 8A and 8B is connected to the driving force transmission member 6 It may be In the example of FIGS. 6A to 6C, the lower movable pin 8B is connected to the driving force transmission member 6.
  • the pair of movable pins 8A and 8B also function as a drive pin receiving the drive force from the drive force transmission member 6, the number of parts of the open / close mechanism 5 can be reduced and the longitudinal axis A Can be shortened along the
  • the shape of the slit 7 is as shown in FIGS. 7A and 7B in order to move the pair of movable pins 8A and 8B smoothly in the slit 7 by the driving force.
  • it is preferably designed to always satisfy the following conditions. ⁇ ⁇ 90 °, ⁇ ⁇ 90 °, ⁇ ⁇ 90 ° ⁇ is an angle formed by the tangential direction of the slit 7 at the position of the drive pin 8A or 8B and the direction of the driving force applied to the drive pin 8A or 8B.
  • ⁇ is an angle formed by a line connecting the centers of the pair of movable pins 8A and 8B and the tangential direction of the slit 7 at the position of one of the movable pins 8A.
  • ⁇ is an angle formed by a line connecting the centers of the pair of movable pins 8A and 8B and the tangential direction of the slit 7 at the position of the other movable pin 8B.
  • the two slits 71 and 72 are arranged in a direction along the axis of the base 3. Therefore, the pair of movable pins 8A, 8B are arranged with a distance corresponding to the distance between the two slits 71, 72 mutually spaced.
  • the slit 71 on the tip end side includes a rotation area 71A on the upper end side and a translation area 71B on the lower end side.
  • the slit 72 on the base end side comprises a rotation area 72A on the upper end side and a translation area 72B on the lower end side.
  • the translation regions 71B and 72B are identical in shape, size and orientation to each other.
  • the translation regions 71B and 72B may be substantially arc-shaped as shown in FIGS. 10A and 10B, or linear as shown in FIG. 10C.
  • the rotation areas 71A and 72A are different in shape from each other.
  • a drive pin different from the movable pin 8B in the proximal slit 72 is provided.
  • the drive pin may be a pin different from the pair of movable pins 8A and 8B, or may be the movable pin 8A in the slit 71 on the tip side.
  • the rotational moment acting on the movable pin 8B can be further increased by applying the driving force to the drive pin at a position away from the movable pin 8B.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un instrument de préhension médical, pourvu : d'une base (3) et d'une mâchoire (4) qui sont disposées adjacentes l'une à l'autre ; d'un mécanisme d'ouverture/fermeture (5) qui ouvre et ferme la mâchoire (4) par rapport à la base (3) au moyen de l'extrémité distale de la mâchoire (4) pivotant autour de l'extrémité proximale de celle-ci et de la mâchoire (4) effectuant une translation dans la direction dans laquelle la base (3) et la mâchoire (4) sont agencées ; et un élément de transmission de force d'entraînement (6) qui transmet une force d'entraînement d'ouverture/fermeture à la mâchoire (4). Dans l'opération de fermeture de la mâchoire (4), le mécanisme d'ouverture/fermeture (5) amène l'extrémité distale de la mâchoire (4) à pivoter vers la base (3) puis la mâchoire (4) à se déplacer en translation vers la base (3).
PCT/JP2017/045196 2017-12-15 2017-12-15 Instrument de préhension médical WO2019116570A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/045196 WO2019116570A1 (fr) 2017-12-15 2017-12-15 Instrument de préhension médical

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/045196 WO2019116570A1 (fr) 2017-12-15 2017-12-15 Instrument de préhension médical

Publications (1)

Publication Number Publication Date
WO2019116570A1 true WO2019116570A1 (fr) 2019-06-20

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ID=66820213

Family Applications (1)

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PCT/JP2017/045196 WO2019116570A1 (fr) 2017-12-15 2017-12-15 Instrument de préhension médical

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WO (1) WO2019116570A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5431674A (en) * 1993-09-07 1995-07-11 Pa Consulting Group Compound motion cutting device
JPH08196540A (ja) * 1995-01-30 1996-08-06 Olympus Optical Co Ltd 把持鉗子
US20120022584A1 (en) * 2010-07-23 2012-01-26 Stephen Donnigan Jaw Movement Mechanism and Method for a Surgical Tool

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5431674A (en) * 1993-09-07 1995-07-11 Pa Consulting Group Compound motion cutting device
JPH08196540A (ja) * 1995-01-30 1996-08-06 Olympus Optical Co Ltd 把持鉗子
US20120022584A1 (en) * 2010-07-23 2012-01-26 Stephen Donnigan Jaw Movement Mechanism and Method for a Surgical Tool

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