JP2552310B2 - Surgical resection instrument - Google Patents
Surgical resection instrumentInfo
- Publication number
- JP2552310B2 JP2552310B2 JP62305436A JP30543687A JP2552310B2 JP 2552310 B2 JP2552310 B2 JP 2552310B2 JP 62305436 A JP62305436 A JP 62305436A JP 30543687 A JP30543687 A JP 30543687A JP 2552310 B2 JP2552310 B2 JP 2552310B2
- Authority
- JP
- Japan
- Prior art keywords
- bending
- shape
- tube
- outer tube
- blade
- Prior art date
- Legal status (The legal status 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 status listed.)
- Expired - Fee Related
Links
- 238000002271 resection Methods 0.000 title description 3
- 238000005452 bending Methods 0.000 claims description 52
- 238000003780 insertion Methods 0.000 claims description 28
- 230000037431 insertion Effects 0.000 claims description 28
- 210000001519 tissue Anatomy 0.000 description 15
- 229910001285 shape-memory alloy Inorganic materials 0.000 description 14
- 208000027418 Wounds and injury Diseases 0.000 description 5
- 238000013459 approach Methods 0.000 description 4
- 238000012986 modification Methods 0.000 description 4
- 230000004048 modification Effects 0.000 description 4
- 229910001220 stainless steel Inorganic materials 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 210000000845 cartilage Anatomy 0.000 description 3
- 229920005989 resin Polymers 0.000 description 3
- 239000011347 resin Substances 0.000 description 3
- 239000010935 stainless steel Substances 0.000 description 3
- JOYRKODLDBILNP-UHFFFAOYSA-N Ethyl urethane Chemical compound CCOC(N)=O JOYRKODLDBILNP-UHFFFAOYSA-N 0.000 description 2
- 210000000988 bone and bone Anatomy 0.000 description 2
- 238000004891 communication Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 230000003287 optical effect Effects 0.000 description 2
- 230000002093 peripheral effect Effects 0.000 description 2
- 229920003002 synthetic resin Polymers 0.000 description 2
- 239000000057 synthetic resin Substances 0.000 description 2
- 206010002329 Aneurysm Diseases 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 208000025865 Ulcer Diseases 0.000 description 1
- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 210000001188 articular cartilage Anatomy 0.000 description 1
- 230000002457 bidirectional effect Effects 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 238000007599 discharging Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000003127 knee Anatomy 0.000 description 1
- 210000000629 knee joint Anatomy 0.000 description 1
- 230000005499 meniscus Effects 0.000 description 1
- 210000004417 patella Anatomy 0.000 description 1
- 230000009466 transformation Effects 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
- 231100000397 ulcer Toxicity 0.000 description 1
- 238000004804 winding Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320032—Details of the rotating or oscillating shaft, e.g. using a flexible shaft
Landscapes
- Surgical Instruments (AREA)
Description
【発明の詳細な説明】 ［産業上の利用分野］ 本発明は、切開することなく体腔外から体腔内、例え
ば膝等の関節腔内の軟骨（関節半月，関節軟骨），軟骨
瘤，種瘍等を切除し、体腔外に排出する外科用切除器具
に関するものである。DETAILED DESCRIPTION OF THE INVENTION [Industrial field of application] The present invention relates to cartilage (joint meniscus, articular cartilage), cartilage aneurysm, and seed ulcer from outside the body cavity to inside the body cavity without making an incision, for example, in a joint cavity such as the knee. The present invention relates to a surgical excision instrument for excising etc. and discharging it outside the body cavity.
［従来の技術と発明が解決しようとする問題点］ 従来、関節手術は、主として切開法（解放外科）によ
って行なわれていた。例えば、一般的な関節の手術にお
いては、膝蓋骨上の腫瘍を切除したり、膝関節から破損
した軟骨，骨等を切除すること等であるが、これらの手
術は、比較的大きな切開を必要としていた。このため、
切開による外傷を生じ、苦痛と運動制限とを伴い、完治
までに多くの時間を要するという欠点を有していた。[Problems to be Solved by Prior Art and Invention] Conventionally, joint surgery has been mainly performed by an incision method (open surgery). For example, in general joint surgery, tumors on the patella are excised, damaged cartilage, bone, etc. are excised from the knee joint, but these operations require relatively large incisions. I was there. For this reason,
The incision caused trauma, which was accompanied by pain and restriction of movement, and had the disadvantage that it took a lot of time to completely heal.
そこで近年、関節鏡（内視鏡）の観察のもとで、関節
を切開しないで、この関節に小さな穿刺孔を形成し、こ
の穿刺孔に挿入部を挿入して手術する外科用切除器具が
提案されている。例えば、特開昭61−170449号公報で
は、硬性で直線的に伸びる外管内に、先端部に切削部が
設けられた硬性で直線的に伸びる内管を挿通した挿入部
を有する外科用切除器具が開示されている。ところがこ
の硬性で直線的に伸びる挿入部では関節腔内で切除を行
う場合に、どうしても切除できない部位が発生するとい
う問題があった。この問題に対処するために米国特許US
P4646738では、挿入部を形成する外管が半硬性で、且つ
曲り癖のある外科用切除器具が開示されている。しかし
ながら、この先行技術例では、挿入部の先端側を任意の
形状に曲げて使うのであるが、術中に、体腔内、例えば
関節腔に挿入する途中で骨等の硬い組織に当たると挿入
部の曲げ形状が変わり挿入しにくかったり、場合によっ
ては切除目的部位に到達できないといった問題点があ
る。Therefore, in recent years, surgical resection instruments have been developed in which a small puncture hole is formed in the joint without incising the joint under the observation of an arthroscope (endoscope), and an insertion portion is inserted into the puncture hole to perform surgery. Proposed. For example, in Japanese Unexamined Patent Publication No. 61-170449, a surgical cutting instrument having a hard linearly extending outer tube and an insertion portion in which a hard linearly extending inner tube having a cutting portion at the tip is inserted. Is disclosed. However, this rigid and linearly extending insertion part has a problem in that when excision is performed within the joint cavity, there are some parts that cannot be excised. US patent US to address this issue
P4646738 discloses a surgical cutting instrument in which the outer tube forming the insertion portion is semi-rigid and has a bending tendency. However, in this prior art example, the distal end side of the insertion part is bent into an arbitrary shape and used, but if it hits a hard tissue such as a bone during the operation during insertion into a body cavity, for example, a joint cavity, the insertion part will bend. There are problems that the shape changes and it is difficult to insert it, and in some cases, the target site for resection cannot be reached.
本発明は、これらの事情に鑑みてなされたもので、体
腔内への挿入途中で挿入部の設定曲げ形状が硬い組織等
により変化されることがなく、又対象組織の切除時に挿
入部を該対象組織へアプローチし易い曲げ形状に曲げる
ことができ、さらには体腔内への挿入時に挿入部を挿入
し易い曲げ形状に曲げることができるようにした外科用
切除器具を提供することを目的としている。The present invention has been made in view of these circumstances, the set bending shape of the insertion portion is not changed by a hard tissue or the like during the insertion into the body cavity, and the insertion portion is removed when the target tissue is excised. An object of the present invention is to provide a surgical cutting instrument that can be bent into a bent shape that makes it easy to approach the target tissue, and can bend the insertion part into a bent shape that allows easy insertion when inserted into a body cavity. .
［問題点を解決するための手段及び作用］ 前記目的を達成するため本考案による外科用切除器具
は、挿入部の途中に所定曲げ形状に湾曲可能な湾曲部を
設ける一方、この湾曲部を手元側操作部の操作で直線状
から所定湾曲状態に変化させる湾曲作動手段を備えてい
る。[Means and Actions for Solving Problems] In order to achieve the above-mentioned object, the surgical cutting instrument according to the present invention is provided with a bending portion which can be bent into a predetermined bending shape in the middle of the insertion portion, and at the same time, this bending portion is at hand. A bending operation means for changing from a linear shape to a predetermined bending state by operating the side operation portion is provided.
この構成で、外管と内管とからなる挿入部の湾曲部
を、手元側操作部の操作によって直線状から所定湾曲状
態に変化させることが可能であり、挿入部を体腔内へ挿
入し易い曲げ形状に、又対象組織へアプローチし易い曲
げ形状に各々曲げ設定でき、さらにはこの設定された曲
げ形状を維持することが可能である。With this configuration, it is possible to change the curved portion of the insertion portion including the outer tube and the inner tube from the linear shape to the predetermined curved state by operating the proximal operation portion, and the insertion portion can be easily inserted into the body cavity. It is possible to set the bending shape to a bending shape or a bending shape that makes it easy to approach the target tissue, and it is possible to maintain the set bending shape.
［実施例］ 以下、図面を参照して本発明の実施例を具体的に説明
する。Embodiments Embodiments of the present invention will be specifically described below with reference to the drawings.
第１図ないし第４図は本発明外科用切除器具の第１実
施例に係り、第１図は断面図、第２図は湾曲操作ノブ部
位を示す拡大断面図、第３図は湾曲操作ノブ部位の斜視
図、第４図は全体を示す側面図である。1 to 4 relate to a first embodiment of the surgical cutting instrument of the present invention. FIG. 1 is a sectional view, FIG. 2 is an enlarged sectional view showing a bending operation knob portion, and FIG. 3 is a bending operation knob. FIG. 4 is a perspective view of the part, and FIG. 4 is a side view showing the whole.
これらの図において、符号１は外科用切除器具で、手
元側の把持部を兼用した本体２と、この本体２から前方
へ延設されて体腔内、例えば関節腔内へ挿入される細長
な挿入部３とから構成されている。前記挿入部３は、開
口した基部を本体２の先端部に固定した外管４と、この
外管４内に軸回りに回動自在に内装された内管５とから
なり、前記外管４は有底状先端部近傍の側面に組織取込
刃口６を開口し、一方内管５は同様有底状先端部近傍で
外管４の組織取込刃口６と一致する位置に刃口７を開口
している。又、前記外管４は、基部側から先端側中途に
かけた、例えばステンレス等からなる直管部８と、この
直管部８の先端に連設された、例えば密巻きコイル，可
撓性合成樹脂チューブ（マルチゴアチューブ、ウレタン
チューブ等）よりなる湾曲部（図示例では密巻きコイ
ル）９と、この湾曲部９の先端に連設された組織取込刃
口６を有するステンレス等からなる先端構成部10とから
構成されている。又、内管５は、例えば、ステンレス鋼
線を３重にし、内層と外層とが同じ方向で、中間層が反
対方向に密巻きされた回転力を伝達できるフレキシブル
シャフト11と、このフレキシブルシャフト11の先端に連
設され前記刃口７を有するステンレス等からなる内刃部
材12とから構成され、外管４の湾曲部の直線状から所定
湾曲状態への変形に追従できるようになっている。前記
外管刃口６と内管刃口７は、内管５の回転によるこれら
刃口6,7同士の一致によって連通し、且つずれることに
よって閉塞されるようになっており、両刃口6,7の連通
開口時に組織に食い付き、閉塞時に切除，切削して切片
を内管刃口７内に取り込むようになっている。前記内管
５の内路は、外管刃口６と内管刃口７とに連通した切片
吸引路13となっていると共に、切片吸引装置を接続する
手元側本体２に連通している。In these drawings, reference numeral 1 is a surgical cutting instrument, which is a main body 2 that also serves as a grip portion on the proximal side, and a slender insertion that extends forward from the main body 2 and is inserted into a body cavity, for example, a joint cavity. And part 3. The insertion portion 3 is composed of an outer tube 4 having an open base fixed to the tip of the main body 2 and an inner tube 5 which is rotatably mounted in the outer tube 4 about an axis. Has a tissue intake blade opening 6 on the side surface near the bottomed tip, while the inner tube 5 also has a blade opening at a position near the bottomed tip and coincides with the tissue intake blade 6 of the outer tube 4. 7 is open. Further, the outer pipe 4 is a straight pipe portion 8 made of, for example, stainless steel, which extends from the base side to the middle of the front end side, and, for example, a tightly wound coil, which is continuously connected to the tip end of the straight pipe portion 8, a flexible composite. A bent portion (closely wound coil in the illustrated example) 9 made of a resin tube (multi-gore tube, urethane tube, etc.) and a tip made of stainless steel or the like having a tissue intake blade opening 6 connected to the tip of the bent portion 9 It is composed of a component 10. The inner pipe 5 is made of, for example, a triple layer of stainless steel wire, the inner layer and the outer layer are in the same direction, and the intermediate layer is tightly wound in the opposite direction. The inner blade member 12 is made of stainless steel or the like and is continuously provided at the distal end of the outer tube 4, and is capable of following the deformation of the curved portion of the outer tube 4 from the linear shape to the predetermined curved state. The outer pipe cutting edge 6 and the inner pipe cutting edge 7 communicate with each other by the rotation of the inner pipe 5 and are connected to each other by the coincidence of these cutting edges 6, 7 and are closed by the displacement. It bites into the tissue at the time of communication opening of 7, and cuts and cuts at the time of occlusion to take the slice into the inner tube blade 7. The inner passage of the inner pipe 5 serves as a section suction passage 13 that communicates with the outer tube blade 6 and the inner tube blade 7, and also communicates with the proximal body 2 that connects the section suction device.
前記本体２は外科用切除器具１を外科医等の術者が手
にもって操作する部分であり、前記内管５を回転駆動す
る駆動部分等を収納するハウジング14と、前記内管５の
吸引路13に連通した空洞15を有して切片吸引装置に接続
される吸引管口金16を取付けた前部ハウジング17とから
構成されている。この前部ハウジング17は、例えば螺合
手段にてハウジング14に着脱自在に螺着連結されてい
る。また、この前部ハウジング17は、前部内周に雌ねじ
を有して湾曲操作ノブ用軸受パイプ18を螺合し、該軸受
パイプ18を介して外管４を連設している。この軸受パイ
プ18は、第３図に示すようにその外周軸方向にスライド
溝19を有し、この溝19内に摺動体20が摺動自在に係入さ
れている一方、この摺動体20の外周には雄ねじ21が刻設
され、さらに操作ワイヤ22の一端が止着されている。
又、前記軸受パイプ18にはリング状の湾曲操作ノブ23が
外装されている一方、この湾曲操作ノブ23は内周に雌ね
じ24aを有して前記摺動体20の雄ねじ21に螺合してお
り、該ノブ23の時計方向、反時計方向への回動により、
摺動体20を軸方向前後に摺動するようになっている。こ
の前後動する摺動体20に一端を止着した操作ワイヤ22
は、刃口６側位置の先端構成部10の基部に止着され、湾
曲操作ノブ23の回動による摺動体20の後方への摺動によ
って操作ワイヤ22を牽引して、例えば先端構成部10の刃
口６側を内側して湾曲部９を湾曲させ、且つ摺動体20の
前方への摺動によって操作ワイヤ22を弛緩して湾曲部９
を自身の弾性復元力によって直線状に復元させるように
なっている。又、湾曲操作ノブ23の所定回動による摺動
体20の後退量及び操作ワイヤ22の牽引量によって、湾曲
部９の湾曲角を設定可能であり、且つこのときの湾曲操
作ノブ23を例えば止めねじ24等の固定手段により固定す
ることにより、湾曲部９の設定湾曲状態を維持すること
ができるようになっている。尚、この止めねじ24等の固
定手段は、省略することも可能である。The main body 2 is a portion where an operator such as a surgeon manually operates the surgical cutting instrument 1, and a housing 14 for housing a drive portion for rotationally driving the inner tube 5 and a suction path for the inner tube 5. The front housing 17 is provided with a suction pipe cap 16 having a cavity 15 communicating with 13 and connected to a section suction device. The front housing 17 is detachably screwed to the housing 14 by, for example, screwing means. Further, the front housing 17 has a female screw on the inner circumference of the front portion, and a bending operation knob bearing pipe 18 is screwed into the front housing 17, and the outer pipe 4 is continuously provided via the bearing pipe 18. As shown in FIG. 3, the bearing pipe 18 has a slide groove 19 in the outer peripheral axial direction, and a sliding body 20 is slidably engaged in the groove 19, while the sliding body 20 A male screw 21 is engraved on the outer circumference, and one end of an operation wire 22 is further fixed.
A ring-shaped bending operation knob 23 is externally mounted on the bearing pipe 18, and the bending operation knob 23 has an internal thread 24a on its inner circumference and is screwed to the external thread 21 of the sliding body 20. , By turning the knob 23 clockwise or counterclockwise,
The sliding body 20 is adapted to slide back and forth in the axial direction. An operation wire 22 having one end fixed to the sliding body 20 that moves back and forth.
Is fixed to the base of the tip forming portion 10 at the position of the blade opening 6 and the operation wire 22 is pulled by sliding the sliding body 20 rearward by the turning of the bending operation knob 23, for example, the tip forming portion 10 The bending portion 9 is bent with the blade opening 6 side of the bending portion 9 inward, and the operating wire 22 is loosened by sliding the sliding body 20 forward.
Is to be linearly restored by its own elastic restoring force. Further, the bending angle of the bending portion 9 can be set by the retreat amount of the sliding body 20 and the pulling amount of the operation wire 22 by the predetermined rotation of the bending operation knob 23. By fixing with a fixing means such as 24, the set bending state of the bending portion 9 can be maintained. The fixing means such as the set screw 24 can be omitted.
前記ハウジング14の後部には、駆動部分としてのモー
タ25が内装され、このモータ25の前方に突出したモータ
軸26には雄スプライン27が固定されている。一方、この
モータ25の前方には、出力軸28が回転自在に、且つ軸方
向摺動可能に軸受けされていると共に、この後部に雌ス
プライン29が形成され、この雌スプライン29が前記雄ス
プライン27に噛合している。前記出力軸28は、前記ハウ
ジング14の空洞15内に突出し、この突出部にフレキシブ
ルシャフト11の後端部が嵌入固定されたスリーブ31が連
結されている。このスリーブ31には前記吸引路13と連通
する窓部32が外周に設けられている。A motor 25 as a driving portion is mounted inside the rear portion of the housing 14, and a male spline 27 is fixed to a motor shaft 26 projecting forward of the motor 25. On the other hand, in front of the motor 25, an output shaft 28 is rotatably and axially slidably supported, and a female spline 29 is formed at the rear portion of the output shaft 28. The female spline 29 is connected to the male spline 27. Meshes with. The output shaft 28 projects into the cavity 15 of the housing 14, and a sleeve 31 to which the rear end of the flexible shaft 11 is fitted and fixed is connected to this projection. A window portion 32 communicating with the suction passage 13 is provided on the outer circumference of the sleeve 31.
前記吸引管口金16は、前記ハウジング14の空洞15と連
通状態で取付けられている。この吸引管口金16は、その
入口部分の開口面積を大きく取れるようにハウジング14
の軸方向に対して後方に傾斜させている。また、この吸
引管口金16を取付けた前部ハウジング17は、前方に細径
になるようなテーパ状に形成されており、吸引管口金16
の開口面積を大きくしている。The suction pipe ferrule 16 is mounted in communication with the cavity 15 of the housing 14. This suction pipe mouthpiece 16 has a housing 14 that allows a large opening area at the inlet portion.
Is inclined rearward with respect to the axial direction of. Further, the front housing 17 to which the suction pipe mouthpiece 16 is attached is formed in a taper shape so that the diameter becomes smaller toward the front.
The opening area of is increased.
このような構成では、挿入部３は外管４の先端側に配
設した湾曲部９を、手元側の湾曲操作ノブ23の回動によ
る摺動体20の軸方向進退により、操作ワイヤ22を牽引，
弛緩して直線状から所定角度の湾曲状態に設定でき、且
つこの設定形状は、湾曲操作ノブ23の回転を、例えば止
ねじ24により固定することによって保持することができ
る。したがって、挿入部３は該挿入部３を体腔内、例え
ば関節腔内へ挿入し易い形状に操作ノブ23を回動操作す
ることによって設定でき、又組織を切除，切削するとき
には先端部の刃口6,7を対象組織にアプローチし易い形
状に設定できる。With such a configuration, the insertion portion 3 pulls the bending portion 9 disposed on the distal end side of the outer tube 4 to pull the operation wire 22 by moving the bending operation knob 23 on the proximal side forward and backward in the axial direction of the sliding body 20. ，
It can be relaxed and set to a curved state of a predetermined angle from a straight line shape, and this set shape can be held by fixing the rotation of the bending operation knob 23 by, for example, a set screw 24. Therefore, the insertion section 3 can be set by rotating the operation knob 23 into a shape that allows the insertion section 3 to be easily inserted into a body cavity, for example, a joint cavity, and when cutting or cutting tissue, the cutting edge of the tip portion. 6 and 7 can be set in a shape that makes it easy to approach the target tissue.
第５図及び第６図は本発明の第２実施例に係り、第５
図は挿入部を構成する内管の先端部側を示す断面説明
図、第６図は第５図のＶ−Ｖ線断面図である。FIG. 5 and FIG. 6 relate to the second embodiment of the present invention.
FIG. 6 is a cross-sectional explanatory view showing the distal end side of the inner tube forming the insertion portion, and FIG. 6 is a cross-sectional view taken along the line VV of FIG.
この実施例は、内管５を可撓性チューブ、例えばマル
チゴアチューブ，ウレタンチューブ等の合成樹脂チュー
ブで形成すると共に、この内管５の先端部側を湾曲部40
とし、この湾曲部40を湾曲動作させるのに形状記憶合金
（又は樹脂）41を用いたものである。この場合、内管５
の湾曲部９と一致する外管４位置は、第１実施例と同様
密巻コイル，樹脂等により湾曲部９が形成されている。
図示例では形状記憶状態（湾曲角度）が各々異なる形状
記憶合金41が４本用いられ、いずれも一方向性のもので
あって湾曲部40の内周軸方向に添設されて、通電するこ
とによる発熱で変態するようになっている。前記形状記
憶合金41のうち１本41aは変態して例えば30度湾曲し、
他の１本41bは変態して例えば45度湾曲し、さらに他の
１本41cは変態して60度湾曲し、残りの１本41cは変態し
て湾曲状態から直線状態に復帰させるようになってい
る。尚、前記変態することにより湾曲する形状記憶合金
41a,41b,41cへの通電発熱を中止することにより、湾曲
部40（及び外管４の湾曲部の）の弾性復元力で該湾曲部
40が直線状に復帰するようにすれば直線状にするための
形状記憶合金41dは不要となる。尚又、図示例では形状
記憶合金４を湾曲部40の内周に添設しているが、湾曲部
40内に埋設しても、或は外周に添設してもよい。又、こ
の実施例においては、各形状記憶合金41a〜ｄへの通電
のON,OFF用スイッチは、図示しないが手元側本体に配設
される。更に、実施例では湾曲部40を内管５に設けてい
るが、第１実施例と同様外管４のみに設け、この外管４
の湾曲部９に形状記憶合金41を配設してもよい。In this embodiment, the inner tube 5 is formed of a flexible tube, for example, a synthetic resin tube such as a multi-gore tube or a urethane tube, and the distal end side of the inner tube 5 is bent to a curved portion 40.
The shape memory alloy (or resin) 41 is used for bending the bending portion 40. In this case, the inner pipe 5
At the position of the outer tube 4 which coincides with the curved portion 9 of the above, the curved portion 9 is formed by a close-wound coil, resin or the like as in the first embodiment.
In the illustrated example, four shape memory alloys 41 each having a different shape memory state (bending angle) are used, and all of them are unidirectional and are attached along the inner peripheral axial direction of the bending portion 40 to energize them. It is supposed to be transformed by the heat generated by. One of the shape memory alloys 41a is transformed and bent, for example, 30 degrees,
The other one 41b transforms and bends, for example, 45 degrees, the other one 41c transforms and bends 60 degrees, and the remaining one 41c transforms and returns from the bent state to the straight state. ing. In addition, a shape memory alloy that bends by the transformation
By stopping the heating by energization to 41a, 41b, 41c, the elastic restoring force of the bending portion 40 (and the bending portion of the outer tube 4) causes the bending portion 40 to move.
If the linear shape 40 is restored, the shape memory alloy 41d for linearizing the shape becomes unnecessary. Further, in the illustrated example, the shape memory alloy 4 is attached to the inner circumference of the bending portion 40, but
It may be embedded in 40 or may be attached to the outer periphery. Further, in this embodiment, the ON / OFF switch for energizing each of the shape memory alloys 41a to 41d is provided on the hand side main body although not shown. Further, although the curved portion 40 is provided on the inner pipe 5 in the embodiment, it is provided only on the outer pipe 4 as in the first embodiment.
The shape memory alloy 41 may be arranged on the curved portion 9 of the above.
第７図本発明の第２実施例における変形例である。こ
の変形例は、形状記憶合金42として二方向性のものを用
い、且つ湾曲部40の横断面周回状に多数埋設している。
図示例では形状記憶合金42aが例えば80度,42bが70度,42
cが60度,42bが50度,42eが40度,42fが30度,42gが20度42h
が10度通電による発熱で湾曲するようになっている。FIG. 7 is a modification of the second embodiment of the present invention. In this modification, a bidirectional alloy is used as the shape memory alloy 42, and a large number of the shape memory alloys 42 are embedded in a circumferential section of the curved portion 40.
In the illustrated example, the shape memory alloy 42a is, for example, 80 degrees, 42b is 70 degrees, 42
c is 60 degrees, 42b is 50 degrees, 42e is 40 degrees, 42f is 30 degrees, 42g is 20 degrees 42h
Is bent by heat generated by energizing 10 degrees.
第８図は本発明第２実施例の更に他の変形例を示す説
明図で、形状記憶合金43をコイルばね状に形成して、各
形状記憶合金43a,43b,43cの長さ、或は巻き方を変える
ことで湾曲角度を変えるものである。FIG. 8 is an explanatory view showing still another modified example of the second embodiment of the present invention, in which the shape memory alloy 43 is formed into a coil spring shape and the length of each shape memory alloy 43a, 43b, 43c, or The bending angle is changed by changing the winding method.
尚、本発明の実施例では、内管のフレキシブルシャフ
トを密巻きコイルにて形成しているが、これに代えて可
撓性の合成樹脂チューブを用いてもよく、又外管の湾曲
部と対峙した内管部位のみ可撓性とし他は硬性部材で形
成してもよい。In the embodiment of the present invention, the flexible shaft of the inner tube is formed by the tightly wound coil, but a flexible synthetic resin tube may be used instead of the flexible shaft, and the curved portion of the outer tube may be used. The inner tube portion facing each other may be made flexible and the other may be made of a hard member.
尚、本発明において外管，内管の刃口の形状、及びそ
の位置は図示例に限ることなく必要に応じて種々形成さ
れる。In the present invention, the shapes and positions of the blade openings of the outer tube and the inner tube are not limited to those shown in the drawings, but may be variously formed as needed.
［発明の効果］ 以上説明したように本発明によれば、体腔内への挿入
途中で挿入部の設定曲げ形状が硬い組織等により変化さ
れることがなく、又対象組織の切除時に刃口を該対象組
織へアプローチし易い曲げ形状に設定でき、さらには体
腔内への挿入時に挿入部を挿入し易い曲げ形状に設定で
きる効果がある。[Effects of the Invention] As described above, according to the present invention, the set bending shape of the insertion portion is not changed by the hard tissue or the like during the insertion into the body cavity, and the cutting edge is cut when the target tissue is excised. There is an effect that it is possible to set a bending shape that makes it easy to approach the target tissue, and further to set a bending shape that makes it easy to insert the insertion portion when inserting it into the body cavity.
第１図ないし第４図は本発明外科用切除器具の第１実施
例に係り、第１図は断面図、第２図は湾曲操作ノブ部位
を示す拡大断面図、第３図は湾曲操作ノブ部位の斜視
図、第４図は全体を示す斜視図、第５図及び第６図は本
発明の第２実施例に係り、第５図は挿入部を構成する内
管の先端側を示す断面説明図、第６図は第５図のＶ−Ｖ
線断面図、第７図は第２実施例の変形例を示す断面説明
図、第８図は第２実施例の更に他の変形例を示す断面説
明図である。 ２……本体、３……挿入部 ４……外管、５……内管 ６……組織取込刃口 ７……刃口、９……湾曲部 13……吸引路 18……湾曲操作ノブ用軸受パイプ 19……スライド溝 20……摺動体、22……操作ワイヤ 23……湾曲操作ノブ 40……湾曲部 42,43……形状記憶合金1 to 4 relate to a first embodiment of the surgical cutting instrument of the present invention. FIG. 1 is a sectional view, FIG. 2 is an enlarged sectional view showing a bending operation knob portion, and FIG. 3 is a bending operation knob. FIG. 4 is a perspective view of the part, FIG. 4 is a perspective view showing the whole, FIGS. 5 and 6 are related to a second embodiment of the present invention, and FIG. 5 is a cross section showing the distal end side of the inner tube constituting the insertion portion. Explanatory drawing, FIG. 6 is VV of FIG.
FIG. 7 is a sectional explanatory view showing a modification of the second embodiment, and FIG. 8 is a sectional explanatory view showing still another modification of the second embodiment. 2 ... Main body, 3 ... Insertion part 4 ... Outer tube, 5 ... Inner tube 6 ... Tissue intake blade opening 7 ... Blade opening, 9 ... Bending portion 13 ... Suction path 18 ... Bending operation Bearing pipe for knob 19 …… Slide groove 20 …… Sliding body, 22 …… Operating wire 23 …… Bending operation knob 40 …… Bending section 42,43 …… Shape memory alloy
フロントページの続き (72)発明者 楠 博幸 東京都渋谷区幡ケ谷２丁目43番２号 オ リンパス光学工業株式会社内 (72)発明者 渋谷 正造 東京都渋谷区幡ケ谷２丁目43番２号 オ リンパス光学工業株式会社内 (72)発明者 萩野 忠夫 東京都渋谷区幡ケ谷２丁目43番２号 オ リンパス光学工業株式会社内 (56)参考文献 特開 平１−119241（ＪＰ，Ａ) 特開 昭61−265134（ＪＰ，Ａ) 特開 昭63−288150（ＪＰ，Ａ)Front page continuation (72) Inventor Hiroyuki Kusunoki 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Shozo Shibuya 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optics Kogyo Co., Ltd. (72) Inventor Tadao Hagino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (56) Reference JP-A-1-119241 (JP, A) JP-A 61- 265134 (JP, A) JP-A-63-288150 (JP, A)
Claims (1)
内に、該外管の刃口に対峙した切り刃を有する内管を移
動可能に内装して挿入部を構成し、この内管の内路を前
記外管の組織取込刃口に連通した吸引路とすると共に、
前記挿入部の途中に所定曲げ形状に湾曲可能な湾曲部を
設ける一方、この湾曲部を手元側操作部の操作で直線状
から所定湾曲角に湾曲させる湾曲作動手段を備えたこと
を特徴とする外科用切除器具。1. An insertion part is constructed by movably incorporating an inner tube having a cutting blade facing the blade of the outer tube into a slender outer tube having a tissue intake blade at its tip. With the inner path of the inner tube as a suction path communicating with the tissue intake blade of the outer tube,
A bending portion capable of bending into a predetermined bending shape is provided in the middle of the insertion portion, and a bending operation means for bending the bending portion from a linear shape to a predetermined bending angle by an operation of a proximal side operation portion is provided. Surgical cutting instrument.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP62305436A JP2552310B2 (en) | 1987-12-02 | 1987-12-02 | Surgical resection instrument |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP62305436A JP2552310B2 (en) | 1987-12-02 | 1987-12-02 | Surgical resection instrument |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH01146538A JPH01146538A (en) | 1989-06-08 |
| JP2552310B2 true JP2552310B2 (en) | 1996-11-13 |
Family
ID=17945115
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP62305436A Expired - Fee Related JP2552310B2 (en) | 1987-12-02 | 1987-12-02 | Surgical resection instrument |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP2552310B2 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2002515793A (en) * | 1996-10-23 | 2002-05-28 | オーレイテック インターヴェンションズ インコーポレイテッド | Method and apparatus for treating an intervertebral disc |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP3530894B2 (en) * | 1994-09-13 | 2004-05-24 | 日清丸紅飼料株式会社 | Ovariectomy device for mammals |
| JP3530895B2 (en) * | 1996-06-18 | 2004-05-24 | 日清丸紅飼料株式会社 | Ovariectomy device for mammals |
-
1987
- 1987-12-02 JP JP62305436A patent/JP2552310B2/en not_active Expired - Fee Related
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2002515793A (en) * | 1996-10-23 | 2002-05-28 | オーレイテック インターヴェンションズ インコーポレイテッド | Method and apparatus for treating an intervertebral disc |
Also Published As
| Publication number | Publication date |
|---|---|
| JPH01146538A (en) | 1989-06-08 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| EP1406544B1 (en) | Non-circular resection device and endoscope | |
| US5282821A (en) | Adjustable surgical instrument | |
| US7766904B2 (en) | Adjustable laser probe for use in vitreoretinal surgery | |
| US5643303A (en) | Flexible surgical instrument | |
| US8657840B2 (en) | Surgical instrument with distal suction capability | |
| US5601583A (en) | Surgical instrument | |
| EP2908742B1 (en) | Retrieval basket apparatus | |
| US5358508A (en) | Laparoscopic device | |
| US20230240769A1 (en) | Insertion methods for robotic surgical devices | |
| CN105816220B (en) | The rigid sheath of surgical tool | |
| US20110098709A1 (en) | Mechanical cavity-creation surgical device and methods and kits for using such devices | |
| US20050234481A1 (en) | Suture cutting device | |
| US10702285B2 (en) | Method and apparatus for performing minimally invasive arthroscopic procedures | |
| AU2002318451A1 (en) | Non-circular resection device and endoscope | |
| JPS6349125A (en) | Guide pipe for endoscope | |
| JP2006518261A (en) | Driving force transmission along a bending instrument | |
| JPH02206452A (en) | Method and intrument for removing affected tissue from body blood | |
| JP2009189808A (en) | Surgical instrument | |
| JPH0340615B2 (en) | ||
| JP2552310B2 (en) | Surgical resection instrument | |
| JP7434322B2 (en) | Device with integrated imaging and irrigation mechanism | |
| JPH06503238A (en) | Surgical instruments for material removal | |
| US20160106300A1 (en) | Flexible Endoscopic Exoskeleton Surgical System | |
| JP2510227B2 (en) | Surgical resection instrument | |
| EP0926992B1 (en) | Flexible surgical instrument |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| LAPS | Cancellation because of no payment of annual fees |