CN106456174B - Operation utensil and tissue cut off unit - Google Patents
Operation utensil and tissue cut off unit Download PDFInfo
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- CN106456174B CN106456174B CN201580029013.4A CN201580029013A CN106456174B CN 106456174 B CN106456174 B CN 106456174B CN 201580029013 A CN201580029013 A CN 201580029013A CN 106456174 B CN106456174 B CN 106456174B
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- axis body
- guide portion
- work department
- directed section
- blade
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- 210000000080 chela (arthropods) Anatomy 0.000 claims abstract description 78
- 238000003780 insertion Methods 0.000 claims abstract description 11
- 230000037431 insertion Effects 0.000 claims abstract description 11
- 238000010276 construction Methods 0.000 claims description 4
- 230000000694 effects Effects 0.000 description 7
- 238000010586 diagram Methods 0.000 description 5
- 230000007246 mechanism Effects 0.000 description 5
- 230000002093 peripheral effect Effects 0.000 description 5
- 230000005540 biological transmission Effects 0.000 description 4
- 230000009471 action Effects 0.000 description 3
- 230000008901 benefit Effects 0.000 description 3
- 239000000470 constituent Substances 0.000 description 3
- 238000000034 method Methods 0.000 description 3
- 238000004891 communication Methods 0.000 description 2
- 238000003825 pressing Methods 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 238000006467 substitution reaction Methods 0.000 description 2
- 241000208340 Araliaceae Species 0.000 description 1
- 235000005035 Panax pseudoginseng ssp. pseudoginseng Nutrition 0.000 description 1
- 235000003140 Panax quinquefolius Nutrition 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
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- 238000012217 deletion Methods 0.000 description 1
- 230000037430 deletion Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 235000008434 ginseng Nutrition 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
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- 238000000926 separation method Methods 0.000 description 1
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- 210000002784 stomach Anatomy 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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07221—Stapler heads curved
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07228—Arrangement of the staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
-
- 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
- A61B2017/2901—Details of shaft
- A61B2017/2905—Details of shaft flexible
-
- 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
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
- A61B2017/2937—Transmission of forces to jaw members camming or guiding means with flexible part
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (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
Operation utensil of the invention includes: insertion section；First pincers component and the second pincers component, with scheduled curved shape, and are arranged in the distal end section of the insertion section；Suturing part；Guide portion configures in at least either in the first pincers component and the second pincers component；Work department has by the axis body that the guide portion guides and can move and the blade that configuration positions away from and links with the axis body in the direction intersected from the axis body to the direction with the extension of the center line of the axis body；And operation lines, extend from the peri position end of the guide portion towards distal end section, turns back in the distal end section of the guide portion, extend towards the peri position end of the guide portion and be linked to the work department.
Description
Technical field
The present invention relates to a kind of operation utensils.The present invention is based on August 4th Japanese Patent Applications in Japanese publication in 2014
2014-158526 CLAIM OF PRIORITY, its contents are hereby incorporated herein by reference.
Background technique
In the past, there is known utensils that is a kind of while being sutured and cut off to bio-tissue.
For example, disclosing a kind of operation utensil in patent document 1,2 comprising be accommodated with the box of multiple bails, use
In the blade for cutting off bio-tissue and for bail to be hammered into tissue and cuts off the operation portion of tissue using blade.
In addition, Patent Document 2 discloses the operations that one kind can be such that blade moves along the box with curved shape
Use utensil.
Existing technical literature
Patent document
Patent document 1: Japanese Unexamined Patent Application Publication 2013-542004 bulletin
Patent document 2: Japanese Unexamined Patent Publication 8-289895 bulletin
Summary of the invention
Problems to be solved by the invention
In previous operation utensil, in the case where moving blade along the curved shape of box, if from blade
Peri position end side pushes blade to move it, then the launch direction that there is blade is unstable and the case where make blade hunting.If
Blade hunting, then the movement of blade has some setbacks, and cutting off for tissue becomes unstable.
The present invention is to complete in view of the situation, and its purpose is to provide a kind of in tissue during cutting off
Make the movement of blade smoothly operation utensil.
The solution to the problem
The operation utensil of first technical solution of the invention includes: insertion section, is inserted into internal；First pincers structure
Part and the second pincers component, with scheduled curved shape, and are arranged in hold tissue the amphi position end of the insertion section
Portion；Suturing part is used to hold by the first pincers component and the second pincers component the tissue that hold；Guide portion, edge
The scheduled curved shape formed, configure it is described first pincers component and it is described second pincers component at least either
On；Work department, have by the guide portion guides and can move axis body and configure from the axis body to the axis
The direction that the direction that the center line of body extends intersects positions away from and links with the blade of the axis body；And operation lines,
Extend from the peri position end of the guide portion towards distal end section, turns back in the distal end section of the guide portion, draw described in
The peri position end for leading portion extends and is linked to the work department.
The work is also possible in the operation utensil of the first technical solution using the second technical solution of the invention
Make portion and have to be sticked in the disk-shaped directed section that the guide portion and periphery supply the operation lines hooking, the axis body is with institute
The center line for stating axis body is fixed on the directed section by way of the center of the directed section.
Using third technical solution of the invention, in the operation utensil of the second technical solution, the directed section
Can the face of the side for being fixed with the axis body in the outer surface of the directed section there is sliding surface, which forms
For towards the curved of the axis body protrusion, the sliding surface and the guide portion point contact.
Using the 4th technical solution of the invention, in the operation utensil of the first technical solution, the blade can also be with
Centerline dip relative to the axis body.
Using the 5th technical solution of the invention, in the operation utensil of the first technical solution, the work department can also
To have a disk-shaped directed section for being sticked in the guide portion and periphery and supplying the operation lines hooking, the axis body can also be with
It positions away from the center from the directed section with the centerline parallel of the center line of the axis body and the directed section
The mode that ground extends is fixed on the directed section.
Using the 6th technical solution of the invention, in the operation utensil of the first technical solution, the work department can also
To have a disk-shaped directed section for being sticked in the guide portion and periphery and supplying the operation lines hooking, the axis body can also be with
It is rotated freely by the center and the axis body of the directed section relative to the directed section with the center line of the axis body
Mode be linked to the directed section.
Using the 7th technical solution of the invention, in the operation utensil of the first technical solution, the work department can also
With with chocking construction, the chocking construction can in order to limit the axis body relative to the guide portion rotate 180 ° or more and with
The guide portion abuts.
The effect of invention
According to the present invention, it is possible to provide a kind of in the movement for making blade during cutting off of tissue smoothly operation device
Tool.
Detailed description of the invention
Fig. 1 is the overall diagram of the operation utensil of the 1st embodiment of the invention.
Fig. 2 is the schematic diagram for indicating the box portion of operation utensil of the 1st embodiment of the invention.
Fig. 3 is the cross-sectional view along the III-III line of Fig. 2.
Fig. 4 is the partial sectional view in the box portion of the 1st embodiment of the invention.
Fig. 5 is the perspective view for indicating the work department being arranged in the box portion of the 1st embodiment of the invention.
Fig. 6 is the side view of the work department of the 1st embodiment of the invention.
Fig. 7 is the perspective view for indicating the second pincers component in box portion of the 1st embodiment of the invention.
Fig. 8 is the cross-sectional view along the VIII-VIII line of Fig. 7.
Fig. 9 is the figure for the effect for illustrating the operation utensil of the 1st embodiment of the invention.
Figure 10 is the figure for the effect for illustrating the operation utensil of the 1st embodiment of the invention.
Figure 11 is the figure for the effect for illustrating the operation utensil of the 1st embodiment of the invention.
Figure 12 is the figure for the effect for illustrating the operation utensil of the 1st embodiment of the invention.
Figure 13 is the side view for indicating the work department of operation utensil of the 2nd embodiment of the invention.
Figure 14 is the side view for indicating the work department of operation utensil of the 3rd embodiment of the invention.
Figure 15 is the side view for indicating the work department of operation utensil of the 4th embodiment of the invention.
Figure 16 is the side view for indicating the work department of operation utensil of the 5th embodiment of the invention.
Figure 17 is the knot for indicating the first guide portion and the second guide portion of the operation utensil of the 5th embodiment of the invention
The cross-sectional view of structure is the figure for indicating section same as the III-III line of Fig. 2.
Figure 18 is the signal for indicating the work department and the first guide portion of operation utensil of the 6th embodiment of the invention
Figure.
Figure 19 is work department, the first guide portion and second for indicating the operation utensil of the 7th embodiment of the invention
The cross-sectional view of the structure of guide portion is the figure for indicating section same as the III-III line of Fig. 2.
Specific embodiment
(the 1st embodiment)
Illustrate the 1st embodiment of the invention.Fig. 1 is the overall diagram of the operation utensil 1 of present embodiment.Fig. 2 is table
The schematic diagram for showing the box portion of operation utensil 1 is the figure observed from the direction arrow A shown in FIG. 1.Fig. 3 is along Fig. 2
The cross-sectional view of III-III line.Fig. 4 is the partial sectional view in box portion, is the figure observed from the direction arrow B shown in FIG. 1.Fig. 5
It is the perspective view for indicating the work department being arranged in box portion.Fig. 6 is the side view of work department.Fig. 7 is the second pincers for indicating box portion
The perspective view of component.Fig. 8 is the cross-sectional view along the VIII-VIII line of Fig. 7.
The operation utensil 1 of present embodiment shown in FIG. 1 is to suture tissue each other, simultaneously using bail 27 (referring to Fig.1 2)
The medical apparatus that position after suture is cut off.Operation utensil 1 include be inserted into intracorporal insertion section 62 and with insertion
The operation portion 63 that portion 62 connects.Insertion section 62 includes box portion 2 and flexible pipe 61.Box portion 2 is filled with bail 27.Flexible pipe 61 and box
Portion 2 connects.
There is basic courses department 3, opening and closing link rod part 8, first to clamp component 10 and the second pincers component 50 in box portion 2.
As depicted in figs. 1 and 2, basic courses department 3 is the position for the substantially tubular for linking box portion 2 and flexible pipe 61.Basic courses department 3
Peri position end be fixed on the amphi position end of flexible pipe 61.The amphi position end and opening and closing link rod part 8 of basic courses department 3 and the second pincers component 50 connect
It connects.
Running through in the inside of basic courses department 3 has connecting elements 5.Connecting elements is made to the operation of operation portion 63 by user
5 movements.
Connecting elements 5 has the first connecting elements 6 and the second connecting elements 7 (operation lines).First connecting elements 6 be in order to
Make the first pincers component 10 relative to second pincers component 50 be opened and closed movement and be arranged.Second connecting elements 7 be in order to make after
State work department 31 movement and be arranged.
The peri position end of first connecting elements 6 extends to operation portion 63.The amphi position end of first connecting elements 6 is connected to opening and closing and connects
Bar portion 8.
It cuts off as shown in figure 4, the second connecting elements 7 has with connecting elements 7a and return connecting elements 7b.Cut off use
Connecting elements 7a is hung in aftermentioned band wheel portion 25.It cuts off and is inserted into aftermentioned first guide portion 24 with connecting elements 7a.It cuts off
Operation portion 63 is extended to the peri position end of connecting elements 7a.
As shown in figure 5, return is linked to work department 31 with the amphi position end of connecting elements 7b.In the present embodiment, it returns
The peri position end of aftermentioned axis body 32 is connected to the amphi position end of connecting elements 7b.Return is extended to the peri position end of connecting elements 7b
Operation portion 63.
Opening and closing link rod part 8 configures the inside of the distal part of basic courses department 3 shown in Fig. 2.Being opened and closed link rod part 8 has the
The movement of the first connecting elements 6 in the central axial direction of one connecting elements 6 is converted to moving openingly and closingly for the first pincers component 10
Link mechanism.
Insertion section 62 (referring to Fig.1) is arranged in hold tissue for Fig. 2, Fig. 3, the first pincers component 10 shown in Fig. 4
Distal end section.As shown in Fig. 2, the first pincers component 10 has scheduled curved shape.First pincers component 10 has base portion 11, bail
Holder 15, bail 27 and work department 31.
As shown in figure 3, base portion 11 has length axes, which is with the curved shape along the first pincers component 10
Shape, substantially rodlike or channel shape component.The communication path that base portion 11 has recess portion 12 and is connected to basic courses department 3
13.Recess portion 12 can store bail holder 15 and work department 31.Recess portion 12 holds face 51 towards the second of the second pincers component 50
Side opening.Bottom is formed with using cover 14 on recess portion 12.As shown in figure 4, the communication path 13 being connected to basic courses department 3 is for the
The perforative access of two connecting elements 7.
As shown in figure 3, bail holder 15 has keeping body portion 16, band wheel portion 25 and driver 26.
Keeping body portion 16 has first to hold face 17, incorporating section 18 and groove portion 22.First, which holds face 17, is holding tissue
In the case where contacted with tissue.Incorporating section 18 is accommodated with bail 27.Groove portion 22 holds 17 upper opening of face first.Keeping body portion 16
The recess portion 12 of base portion 11 is installed on the direction of the first holding face 17 from the exposure of base portion 11.
Bail holder 15 can be assembled and disassembled relative to base portion 11.For example, after being sutured using bail 27, it can be certainly
Base portion 11 is removed using the bail holder 15 finished.After being sutured using bail 27, finished by substitution use
Bail holder 15 and new bail holder 15 is mounted on base portion 11, can will use the operation device of present embodiment
The suture that tool 1 carries out carries out multiple.
First holding face 17 is to clamp component towards second in the state that keeping body portion 16 is installed on recess portion 12 of base portion 11
The second of 50 holds the face of face 51 (referring to Fig.1).
Incorporating section 18 can store bail 27 with the state that end holds face 51 towards second that is pierced into of bail 27.
As shown in figure 3, in the first holding face 17, the inside region of envelope that surround multiple incorporating sections 18 define benefit
The seam area SA of tissue is sutured with bail 27.In the state that bail 27 is accommodated in incorporating section 18, what is be truncated by groove portion 22
Bail column 19 (the first bail column 20, the second bail column 21) have been respectively constituted in two regions in keeping body portion 16.
First bail column 20 are made of the multiple bails 27 arranged along the direction that groove portion 22 extends.In the present embodiment,
First bail column 20 hold first and are equipped with two column or more on face 17 spaced apartly.
Second bail column 21 are made of the multiple bails 27 arranged along the direction that groove portion 22 extends.In the present embodiment,
Second bail column 21 hold first and are equipped with two column or more on face 17 spaced apartly.
Bail column 19 have around groove portion 22 as a result, to emit from the first pincers component 10 towards the second pincers component 50
Multiple bails 27.
As shown in figure 3, groove portion 22 is to be accommodated with the blade in such a way that the aftermentioned blade 39 of work department 31 can be retreated
39 linear slot.In the present embodiment, groove portion 22 is curvilinear.Groove portion 22 limits in the cutting off of tissue and cuts off line L (ginseng
According to Fig. 9, Figure 12).
Groove portion 22 has through hole 23 and the first guide portion 24.Through hole 23 holds 17 upper opening of face first.First draws
It leads portion 24 and perforation hole portion 23 is conjointly formed in keeping body portion 16.
Through hole 23 have the first wall surface 23a and the second wall surface 23b separated from each other and the first wall surface 23a of connection and
The bottom surface of second wall surface 23b.The bottom surface of groove portion 22 in present embodiment is made of a part of the inner surface of base portion 11.Separately
Outside, in the present embodiment, the intermediate region of the first pincers component 10 on the direction that groove portion 22 extends is in order to logical for work department 31
It crosses and is provided with gap between the first wall surface 23a and bottom surface, be provided with gap between the second wall surface 23b and bottom surface.
As shown in figure 3, the first wall surface 23a has the face intersected with the first holding face 17 in keeping body portion 16.First wall
The bottom that face 23a holds face 17 towards the recess portion 12 of base portion 11 from the first of keeping body portion 16 extends.First wall surface 23a is along base
The length axes direction in portion 11 extends.
As shown in figure 3, the second wall surface 23b is being had left and can lead to for the blade 39 of work department 31 from the first wall surface 23a
The face formed to the position for the distance crossed (comprising substantially parallel) parallel with the first wall surface 23a.Second wall surface 23b is and keeping body
First in portion 16 holds the face that face 17 intersects.Second wall surface 23b holds face 17 towards base portion 11 from the first of keeping body portion 16
Recess portion 12 bottom extend.Second wall surface 23b extends along the length axes direction of base portion 11.
As shown in Figure 3, Figure 4, the first guide portion 24 has width than between the first wall surface 23a and the second wall surface 23b
Every wide groove shape.First guide portion 24 extends along the curved shape of groove portion 22.The a pair being arranged in work department 31 is drawn
The first directed section 34 for leading portion 33 can be contacted with the first guide portion 24.
In the inside of the first guide portion 24 inserted with cutting off with connecting elements 7a.In the inside of the first guide portion 24, cut off
Extended along the first guide portion 24 from the peri position end of the first guide portion 24 towards distal end section with connecting elements 7a, is drawn first
It leads in the band wheel portion 25 of the distal end section in portion 24 and turns back, extend towards the peri position end of the first guide portion 24 and be linked to work department
31.In the present embodiment, it cuts off on the periphery for hanging over aftermentioned first directed section 34 with the amphi position end of connecting elements 7a.
Band wheel portion 25 shown in Fig. 4, which is hung with, to be cut off with connecting elements 7a, by rotate it is free in a manner of be linked to base portion 11.
Inside of the configuration of driver 26 shown in Fig. 3 in incorporating section 18.Driver 26 being capable of benefit in the inside of incorporating section 18
It is mobile with the cam part 37 of work department 31.That is, if driver 26 utilizes cam part 37 (referring to Fig. 5) towards the first of incorporating section 18
The opening of 17 side of holding face is mobile, then the linking part 30 for the opening pressing bail 27 that driver 26 holds 17 side of face towards first
(referring to Fig.1 2) release bail 27 from incorporating section 18.
Bail 27 has a pair of of the leg 28,29 (referring to Fig.1 2) for forming the piercing end that oriented tissue is pierced into and by a pair of of leg
The interconnected linking part 30 in portion 28,29.Bail 27 is by can deform and the higher wire rod of biocompatibility is bent
Being process shape is letter U shape (the letter U shape that all angles are right angle).About the shape of bail 27, properly selects and adopt
It is preferable with well known structure.
Fig. 3, Fig. 5, the configuration of work department shown in fig. 6 31 are in the inside of base portion 11.Work department 31 is in order to from incorporating section 18
It releases bail 27 and keeps driver 26 mobile, be arranged in order to cut off tissue after releasing bail 27.
As shown in Fig. 3, Fig. 5, Fig. 6, work department 31 has axis body 32, a pair of of directed section 33, cam part 37 and blade
39。
Axis body 32 is connected to the amphi position end of the second connecting elements 7 of connecting elements 5.Axis body 32 passes through the second connecting elements 7
It is moved along center axis thereof direction, it can be by the first guide portion 24 and what is be formed on aftermentioned second holding face 51 second draw
It leads portion 53 (referring to Fig. 7) guidance and moves.The center line C1 (referring to Fig. 6) of axis body 32 becomes the work department 31 of present embodiment
Rotation center.That is, in the present embodiment, energy while being supported on the first guide portion 24 and the second guide portion 53 of work department 31
It is enough as rotation center to be rotated in scheduled range using the center line C1 of axis body 32.The work department 31 of present embodiment can oneself
Turning range is that blade 39 contacts the state of the first wall surface 23a and blade 39 contacts between the state of the second wall surface 23b.In axis body 32
On a pair of of directed section 33, cam part 37 and blade 39 are installed.
A pair of of directed section 33 is the component engaged with the first guide portion 24 and the second guide portion 53.In present embodiment
In, a pair of of directed section 33 has the first directed section 34 for engaging with the first guide portion 24 and engages with the second guide portion 53
Second directed section 35.
First directed section 34 is fixed in the both ends of axis body 32, configuration in one end of the first pincers 10 side of component.First
Directed section 34 is in the thickness direction thereof with the circular plate shape of center line.On the outer peripheral portion edge of the first directed section 34
Circumferentially extending be formed with the slot of the amphi position end for cutting off connecting elements 7a hooking.Cut off the amphi position end with connecting elements 7a
Part is hung on the first directed section 34 with ring-type.First directed section 34 is relative to the distal part cut off with connecting elements 7a
Rotation is freely.In the present embodiment, the center line of the first directed section 34 and the center line C1 of axis body 32 are coaxial.First is drawn
Leading portion 34 can rotate in the first guide portion 24 together with axis body 32.First directed section 34 is mounted on axis using screw 34a
On body 32.In addition, the first directed section 34 and axis body 32 can also be integrally formed.
Second directed section 35 is fixed in the both ends of axis body 32, configuration in one end of the second pincers 50 side of component.Second
Directed section 35 is in the thickness direction thereof with the circular plate shape of center line.In the present embodiment, the second directed section
The center line C1 of 35 center line and axis body 32 is coaxial.It second directed section 35 can be with axis body 32 together in the second guide portion 53
Interior rotation.Second directed section 35 is mounted on axis body 32 using screw 35a.In addition, the second directed section 35 and axis body 32
It can be integrally formed.
As shown in figs. 3 and 5, cam part 37 by relative to axis body 32 rotate it is free in a manner of be linked to axis body 32.Cam part
37 have the inclined inclined surface 38 of length axes relative to base portion 11.The inclined surface 38 of cam part 37 is in cam part 37 along base
Contiguously make driver 26 mobile with driver 26 when the length axes direction in portion 11 is mobile.The moving direction of cam part 37 is slot
The direction that portion 22 extends.
As shown in fig. 6, the configuration of blade 39 is in the side intersected from axis body 32 to the direction extended with the center line C1 of axis body 32
To positioning away from.Position of the blade 39 between the both ends of axis body 32 and axis body 32 link.Blade 39 has and axis body 32
The point of a knife 39a that center line C1 is extended parallel to.Point of a knife 39a is formed to cut off the sharp keen shape of the tissue of organism.Such as
Shown in Fig. 3, blade 39 by from the first holding face 17 towards second pincers 50 side of component it is outstanding in a manner of configure in groove portion 22.In benefit
When so that blade 39 is located at most peri position end side with the rotation of aftermentioned work department 31, blade 39, which is located at, leans on peri position end than cam part 37
Side.
Point of a knife 39a is located at the position separated from the center line C1 of axis body 32, and point of a knife 39a is towards axis body 32.Therefore, pass through
The tissue of organism touches point of a knife 39a, and the tissue that blade 39 can be pushed to blade 39 cuts off the peri position end side in direction and cuts
From tissue.When blade 39 is pushed by the tissue of organism, blade 39 is with the center line C1 (work of present embodiment of axis body 32
The rotation center in portion 31) centered on rotate.
In the present embodiment, when the first pincers component 10 and the second pincers component 50 are in the state of closure, at least the
Gap portion between one holding face 17 and the second holding face 51 is formed with point of a knife 39a.
The distal end section of insertion section 62 is arranged in hold tissue for Fig. 1, the second pincers component 50 shown in Fig. 7, this
Two pincers components 50 have the same scheduled curved shape with the first pincers component 10.Second pincers component 50 have be formed with it is multiple at
The second of shape bag 52 holds face 51.
Second holding face 51 is directed towards the face in the first holding face 17 of the first pincers component 10.It is opposite in the first pincers component 10
When the state that the second pincers component 50 is closed, the thickness with the tissue as suture object correspondingly sets the first pincers component in advance
The first of 10 holds face 17 and the second of the second pincers component 50 and holds the distance between face 51.The first of first pincers component 10 holds
Face 17 and the distance between the second holding face 51 of the second pincers component 50 are set to draw after the suture for having used bail 27
It acts the adhesion for becoming the tissue of suture object and is difficult to cause to become the distance of the excessive extruding of the tissue of suture object.
The forming bag 52 and the second guide portion 53 are formed on the second holding face 51.Second guide portion 53 can be for
Second directed section 35 enters and is upwardly formed longer in the length axes side of the second pincers component 50.
Forming bag 52 shown in Fig. 7 has to become the shape of suture tissue as shown in figure 12 and is used to make bail 27
Leg 28,29 is plastically deformed inclined-plane or flexure plane to guide leg 28,29.
As shown in figure 8, the second guide portion 53 has for the perforative opening portion 53a of axis body 32 shown in fig. 6 and width ratio
Opening portion 53a wide and the groove portion 53b slided for the second directed section 35.As shown in fig. 7, the second guide portion 53 be formed as along
The threadiness of the curved shape of groove portion 22 (referring to Fig. 2, Fig. 3).Groove portion is correspondingly suitably set with the shape of the second directed section 35
The shape of 53b is then preferable.
It is formed in the peri position part of the second guide portion 53 and is entered in the second guide portion 53 for the second directed section 35
Entrance 53c.Therefore, when being located at most peri position end side for groove portion 22 in work department 31, the second directed section 35 from second
Guide portion 53 is detached from.Thus, in the case where work department 31 is located at most peri position end side for groove portion 22, the first pincers component
10 and second pincers component 50 can not become using work department 31 link in the state of freely open closure.
In the present embodiment, seam is constituted using bail holder 15, bail 27, cam part 37 and the second pincers component 50
It is combined the suturing part 54 knitted (referring to Fig. 3).
As shown in Figure 1, flexible pipe 61 is elongated cylindrical member.In the inside of flexible pipe 61 through there is connecting elements 5 (the
One connecting elements 6 is cut off with connecting elements 7a and return connecting elements 7b).
The peri position end of the basic courses department 3 in box portion 2 is fixed in the amphi position end of flexible pipe 61.The peri position end of flexible pipe 61 is fixed on
On operation portion 63.
In addition it is also possible to be equipped on flexible pipe 61 for by well known observation device (such as endoscope) from operation portion 63
Side is directed to the pipeline of 2 side of box portion, and the observation device is for observing suture site.
The peri position end of flexible pipe 61 is arranged in operation portion 63.Operation portion 63 is to be carried out making the first pincers component by user
10 and second clamp 50 on-off action of component or bail 27 are mounted on tissue and then cuts off the operation of tissue and is arranged.Behaviour
The shape for making portion 63 be can be held by operator it is substantially rodlike.
Operation portion 63 includes shell 64, crooked knob 65, opening and closing knob 66 and bar 67, transmission mechanism (not shown).Shell
Body 64 be it is substantially rodlike, inside it have space.Crooked knob 65 is arranged to make 61 flexure operation of flexible pipe.It opens
Knob 66 and bar 67 are closed in order to act connecting elements 5 and is configured to be exposed to the outside of shell 64.Transmission mechanism is in shell 64
Inside be connected to connecting elements 5.
Crooked knob 65 is the angle (not shown) for extending to operation portion 63 from the amphi position end of flexible pipe 61 by drawing
Degree operation lines and make the component of 61 flexure operation of flexible pipe.Crooked knob 65 can be rotated relative to the shell 64 of operation portion 63,
Or it can be fixed by such a way that arbitrary position is not rotated relative to shell 64.
Opening and closing knob 66 is the component for moving forward and backward the first connecting elements 6 along its centerline direction.It is opened and closed knob
66 can rotate relative to the shell 64 of operation portion 63, or can with arbitrary position not relative to shell 64 rotate
Mode is fixed.
By operator's controlled opening/closing knob 66, transmission mechanism (not shown) will be opened and closed the operation strength of knob 66 as making
First connecting elements 6 is transmitted to the first connecting elements 6 along the strength that its centerline direction moves forward and backward.
Bar 67 is the component for moving forward and backward the second connecting elements 7 along its centerline direction.Bar 67 can be relative to
The shell 64 of operation portion 63 is swung, or can be fixed by such a way that arbitrary position is not swung relative to shell 64.
By operator's operating stick 67, transmission mechanism (not shown) is using the operation strength of bar 67 as making the second connecting elements
7 are transmitted to the second connecting elements 7 along the strength that its centerline direction moves forward and backward.In the present embodiment, make bar 67 to pre-
When a fixed direction is swung, cut off with connecting elements 7a by proximally side-lining, make bar 67 along with described scheduled one
When contrary direction is swung, return is drawn with connecting elements 7b by proximally end side.
It is interconnected in box portion 2 via work department 31 in addition, cutting off with connecting elements 7a and return connecting elements 7b.
Therefore, when cutting off with connecting elements 7a by the proximally end side traction of bar 67, return is mobile to amphi position end side with connecting elements 7b,
Return with connecting elements 7b by bar 67 proximally end side is drawn when, cut off mobile to amphi position end side with connecting elements 7a.
Then, illustrate the effect of the operation utensil of present embodiment.Fig. 9~Figure 12 is for illustrating present embodiment
The figure of the effect of operation utensil 1.
Operation is as shown in Figure 3 to be accommodated with bail 27 in incorporating section 18 and cam part 37 and blade 39 with utensil 1
What the state near the peri position end of base portion 11 prepared.At this point, the configuration of a pair of of directed section 33 of work department 31 is in the first guidance
Near portion 24 and the peri position end of the second guide portion 53.
Operation passes through the naturally open of patient, patient such as the mouth for being formed in patient using well known gimmick with utensil 1
The small cut-away portions of stomach wall etc. be directed into disposition object position.
As shown in figure 9, the first pincers component 10 and the second pincers of the distal end section of the insertion section 62 of operation utensil 1 is arranged in
Component 50 correspondingly holds work with the operation of the opening and closing knob 66 (referring to Fig.1) of operation portion 63 under laparoscope (not shown) monitoring
For the tissue for cutting off object.
It is held by the first pincers component 10 as shown in Figure 9 and the second pincers component 50 as the tissue for cutting off object, for cutting
Line L is cut off from object tissue restriction.User is by being fixed on shell 64 for opening and closing knob 66 shown in FIG. 1, thus in such as Fig. 9
Shown first pincers component 10 and the second component 50, pincers fix the first pincers component 10 relative to the second pincers in the state of hold tissue
The position of component 50.
User acts bar 67 after opening and closing knob 66 shown in FIG. 1 is fixed on shell 64, makes to cut off with connection
Proximally end side is mobile by component 7a.Being moved to cutting off for peri position end side is made with connecting elements 7a using band wheel portion 25 shown in Fig. 4
Lead reversion, to keep work department 31 mobile to amphi position end side.Work department 31 makes 37 He of Fig. 3 and cam part shown in fig. 5
Blade 39 is mobile to amphi position end side.Drive shown in Fig. 3 is boosted using to the inclined surface 38 of the mobile cam part 37 in amphi position end side
Dynamic device 26.Driver 26 shown in Fig. 3 by the inclined surface 38 of work department 31 by being boosted, to release bail 27 from incorporating section 18
So that the piercing terminal spine of bail 27 enters tissue.
If further releasing bail 27 from incorporating section 18, the leg 28,29 of bail 27 is connected to forming bag 52 (referring to figure
7).Forming bag 52 makes the leg 28,29 of bail 27 to the scheduled shape distortion of suture tissue as shown in figure 12.Bail 27 is adjoint
Cam part 37 movement from first pincers component 10 proximal side successively emitted towards far side from incorporating section 18.This
Sample, suturing part 54 shown in Fig. 3 carry out the tissue that hold by the first pincers component 10 and the second component 50, pincers using bail 27
Suture.
Work department 31 can be moved using the second connecting elements 7 along groove portion 22.The proximal side configured in cam part 37
Blade 39 (referring to Fig. 5, Fig. 6) uses connecting elements 7a to draw by being cut off, so that the first bail column 20 and the second bail be arranged
It is used as between 21 and is moved along groove portion 22 with cutting off line L (referring to Fig. 9, Figure 12).It is cut off in work department 31 with connecting elements 7a
Draw during cutting off the tissue of organism, point of a knife 39a is pushed by tissue, work department 31 with a pair of of directed section 33 respectively
Center line rotated for rotation center.At this point, as shown in Figure 10 and Figure 11, the point of a knife 39a of blade 39 does not touch groove portion 22
Any one of first wall surface 23a and the second wall surface 23b make axis body 32 with a pair of of directed section 33 using the rotation of work department 31
Respective center line rotates for rotation center, and blade 39 is rotated around axis body 32.Make blade 39 to work using the rotation of blade 39
The front side (proximal side of groove portion 22) made on the moving direction in portion 31 is mobile, and the direction of point of a knife 39a, which becomes, to be cut off with connection
Lead of the component 7a to work department 31.That is, cutting off tissue with connecting elements 7a traction work department 31 utilizing to cut off
In the process, point of a knife 39a direction cuts off the lead with connecting elements 7a to work department 31.At this point, point of a knife 39a is towards curved
The tangential direction of groove portion 22.
Using cut off draw work department 31 with connecting elements 7a during, point of a knife 39a is to from shown in Fig. 3 first
The mode that the direction of wall surface 23a, the second wall surface 23b separation is dragged by axis body 32 is mobile, thus be not easy to bite the first wall surface 23a,
Second wall surface 23b.
Tissue is cut off in order from the position sutured by bail 27 using blade 39.Blade 39 is by the first pincers component 10
Tissue is cut off in the seam area SA in second pincers 50 tissues that hold of component.
The suture carried out using bail 27 and using blade 39 carry out cut off end after, user release fixed part
70 pairs of fixing for bar 69 and make the first pincers component 10 relative to second pincers component 50 open.The first pincers 10 He of component is released as a result,
The holding of second 50 pairs of component tissues of pincers.
In addition, as needed, making return connecting elements 7b proximally side movement and acting bar 67, work can be made
It is mobile to the peri position end side of groove portion 22 to make portion 31.When work department 31 is in the peri position end of groove portion 22, being able to carry out will sent out
Penetrate the operation that the bail holder 15 emptying later of bail 27 is changed to new bail holder 15.
In the case where the operation using present embodiment is repeatedly disposed with utensil 1, bail 27 can transmitted
It is changed to new bail holder 15 later and continues to suture and cut off.
In the past, tissue was being cut off by pushing the blade for the tissue for cutting off organism that the point of a knife of blade is made to bite tissue
In utensil, there is a possibility that blade hunting when releasing tissue from the proximal side of blade.In particular, being cut along curved
In the case where offline release blade, the hunting of blade, needs the direction of travel towards blade to adjust to blade in order to prevent
Apply the direction of pressing force.
In contrast, there is blade with connecting elements 7a traction using cutting off using the operation utensil 1 of present embodiment
39 work department 31, thus the point of a knife 39a of blade 39 in the tangential direction of groove portion 22 towards the far side of groove portion 22, therefore,
Blade 39 is not susceptible to hunting, and blade 39 can be moved swimmingly, and tissue cuts off stabilization.
(the 2nd embodiment)
Then, illustrate the 2nd embodiment of the invention.In addition, in each embodiment described below, to the 1st
Illustrate that the same constituent element of the constituent element finished marks appended drawing reference identical with the 1st embodiment in embodiment, saves
Slightly repeat description.Figure 13 is to indicate the operation of the present embodiment side view of the work department of utensil 1A.
As shown in figure 13, have in blade 39A relative in axis body 32 in the operation of present embodiment in utensil 1A
The point of a knife 39aA this point that heart line C1 obliquely extends is different.
Point of a knife 39aA is formed along the straight line that the center line C1 with axis body 32 intersects.Half in the overall length of point of a knife 39aA with
On towards axis body 32 center line C1.
In the present embodiment, point of a knife 39aA extends along the inclined direction of direction of travel relative to point of a knife 39aA.Cause
This, can utilize the power lighter than the point of a knife 39a illustrated in the 1st embodiment to cut off the tissue of organism.
(the 3rd embodiment)
Then, illustrate the 3rd embodiment of the invention.Figure 14 is the work for indicating the operation utensil 1B of present embodiment
The side view in portion.
As shown in figure 14, the work department that the operation utensil 1B of present embodiment has and illustrates in the 1st embodiment
The different work department 31B of 31 structures and substitute the work department 31 illustrated in the 1st embodiment.
Work department 31B be fixed with axis body 32B in the position relative to the respective centerline offset in a pair of of directed section 33 and
On this point of substituting axis body 32 illustrated in the 1st embodiment is different with the structure of the 1st embodiment.
In the present embodiment, work department 31B is rotated centered on the respective center line C2 in a pair of of directed section 33.Axis
Body 32B is guided using the respective center line C2 in a pair of of directed section 33 as the rotation of rotation center, with a pair using work department 31B
The respective center line C2 in portion 33 rotates for rotation center.
It is equipped with the blade 39B for cutting off the tissue of organism in a same manner as in the first embodiment on axis body 32B.Blade 39B
With extending with the respective centerline parallel in a pair of of directed section 33 and towards the respective center line in a pair of of directed section 33
Point of a knife 39aB.
In the present embodiment, work department 31B can also be moved using the second connecting elements 7 along groove portion 22.It is working
Portion 31B cut off drawn with connecting elements 7a and during cutting off the tissue of organism, in a same manner as in the first embodiment, tissue
Point of a knife 39aB, work department 31B is pushed as rotation center to rotate using the respective center line in a pair of of directed section 33.Then, axis body
32B as rotation center is rotated using the respective center line in a pair of of directed section 33, and blade 39B is respective with a pair of of directed section 33
It is rotated centered on center line.Front side (proximal side of groove portion 22) of the blade 39 on the moving direction of work department 31B is mobile.
During utilization cuts off and drawn work department 31B with connecting elements 7a and cut off tissue, point of a knife 39aB direction is cut
From the lead with connecting elements 7a to work department 31B.At this point, tangential direction of the point of a knife 39aB towards curved groove portion 22.
Thus, same as the 1st embodiment in the present embodiment, blade 39B, which remains, not to be connect with groove portion 22 yet
It contacts to earth and is guided by the first guide portion 24 and the second guide portion 53, therefore, swimmingly moved in blade 39B during cutting off of tissue
It is dynamic.
(the 4th embodiment)
Then, illustrate the 4th embodiment of the invention.Figure 15 is the work department for indicating the operation utensil of present embodiment
The cross-sectional view of 31C.
As shown in figure 15, in the present embodiment, have different from 31 structure of work department illustrated in the 1st embodiment
Work department 31C and substitute the work department 31 illustrated in the 1st embodiment.
Work department 31C by axis body 32 relative to a pair of of directed section 33 rotate it is free in a manner of so that axis body 32 is linked to one
On this point to directed section 33 and the structure of the 1st embodiment are different.
That is, in the present embodiment, there is bearing 34c between the first directed section 34 and axis body 32 and between the
Bearing 35c between two directed sections 35 and axis body 32.
In the present embodiment, other than work department 31C is rotated integrally, axis body 32 is also relative to the first directed section 34
It is rotated with the second directed section 35, so that blade 39 can also rotate.Thus, in the present embodiment, it can utilize more real than the 1st
Applying the light power of mode rotates blade 39.
(the 5th embodiment)
Then, illustrate the 5th embodiment of the invention.Figure 16 is the work department for indicating the operation utensil of present embodiment
The side view of 31D.Figure 17 is the knot for indicating the first guide portion 24 and the second guide portion 53 of the operation utensil of present embodiment
The cross-sectional view of structure is the figure for indicating section same as the III-III line of Fig. 2.
As shown in Figure 16 and Figure 17, in the present embodiment, have and the work department 31 that illustrates in the 1st embodiment
The different work department 31D of structure and substitute the work department 31 illustrated in the 1st embodiment.
Work department 31D has a pair of of (the first directed section directed section 33D for being formed as curved surface towards the face of 32 side of axis body
34D, the second directed section 35D) and a pair of of directed section 33 of the 1st embodiment of substitution.
In first directed section 34D, the curved of 32 protrusion of axis body is formed towards (in this reality towards the face of 32 side of axis body
It is hemispherical for applying in mode), become the sliding surface with 24 point contact of the first guide portion towards the face of 32 side of axis body.
In second directed section 35D, the curved of 32 protrusion of axis body is formed towards (in this reality towards the face of 32 side of axis body
It is hemispherical for applying in mode), become the sliding surface with 53 point contact of the second guide portion towards the face of 32 side of axis body.
In addition, in the present embodiment, the first guide portion 24 and the second guide portion 53 are respectively with the inclination of letter V shape
Inclined-plane 24D, 53D.First directed section 34D and the second directed section 35D and inclined-plane 24D and inclined-plane 53D point contact.
First directed section 34D and the second directed section 35D is even if the inclined feelings of rotation center in work department 31D
Under condition also with 53 point contact of the first guide portion 24 and the second guide portion.Therefore, compared with the work department 31 of the 1st embodiment,
Have the work department 31D of a pair of of directed section 33D of present embodiment work department 31D in the state of rotation center inclination to be led
Resistance to sliding when drawing is smaller, and the tissue of organism can be cut off using lighter power.
(the 6th embodiment)
Then, illustrate the 6th embodiment of the invention.Figure 18 is the work department for indicating the operation utensil of present embodiment
The schematic diagram of 31E and the first guide portion 24.
As shown in figure 18, in the present embodiment, have with the structure of the work department 31 illustrated in the 1st embodiment not
With work department 31E and substitute the work department 31 illustrated in the 1st embodiment.
Work department 31E has the first directed section 34E of oval template and substitutes the first directed section of the 1st embodiment
34。
First directed section 34E has the long axis bigger than the width w1 of the first guide portion 24 and wider than the first guide portion 24
Spend the slightly smaller short axle of w1.
In the present embodiment, when assembling first clamps component 10, to enter the first guidance in the first directed section 34E
Blade 39 is located at the mode assembly working portion 31E that proximal side is leaned on than axis body 32 when portion 24.Therefore, the rotatable model of work department 31E
It encloses in the range of be limited in the first directed section 34E and can be rotated in the first guide portion 24.By by the first directed section
34E constitute chocking construction abutted with the first guide portion 24 limit axis body 32 relative to the first guide portion 24 rotation 180 ° with
On.
In the present embodiment, blade 39 is prevented to be moved to than axis body 32 by far side using the first directed section 34E.Cause
This, the point of a knife 39a of blade 39 is always towards substantially amphi position end side.Therefore, it can prevent to cut off in utilization and be led with connecting elements 7a
The opposite side of point of a knife 39a when drawing work department 31E in blade 39 is encountered tissue and can not be cut off.
In the present embodiment, it is possible to have the second directed section (not shown) of oval template and substitute the 1st and implement
Second directed section 35 of mode.
(the 7th embodiment)
Then, illustrate the 7th embodiment of the invention.Figure 19 is the work department for indicating the operation utensil of present embodiment
The cross-sectional view of the structure of 31F, the first guide portion 24F and the second guide portion 53F is to indicate same as the III-III line of Fig. 2
The figure in section.
As shown in Figure 10, in the present embodiment, have and the first guide portion 24 for illustrating in the 1st embodiment and the
What the structure of two guide portions 53 the first different guide portion 24F and the second guide portion 53F and substituting illustrated in the 1st embodiment
First guide portion 24 and the second guide portion 53.In addition, in the present embodiment, the work for having and illustrating in the 1st embodiment
Make the different work department 31F of structure in portion 31 and substitutes the work department 31 illustrated in the 1st embodiment.
First guide portion 24F has the mutually different wall portion of height in the inner circumferential side of the curved shape of groove portion 22 and peripheral side
24Fa and wall portion 24Fb.
Second guide portion 53F has the mutually different wall portion of height in the inner circumferential side of the curved shape of groove portion 22 and peripheral side
53Fa and wall portion 53Fb.
Work department 31F has a pair of of the directed section 33F being made of the first directed section 34F and the second directed section 35F
And substitute a pair of of the directed section 33 illustrated in the 1st embodiment.
In the first inside rotating member 40 and first that first directed section 34F is rotated with respect to axis body 32
Side rotating member 40 is coaxial and is linked to the first outside rotating member 41 of the first inside rotating member 40 and implements with the 1st
Mode is similarly coupled to cut off the band wheel plate 42 with connecting elements 7a.
First inside rotating member 40 and the first outside rotating member 41 can be in rotation with the center line C1 of axis body 32
Heart relative rotation.
First inside rotating member 40 can be with curved shape in wall portion 24Fa and wall portion 24Fb, as groove portion 22
The wall portion 24Fa of inner circumferential side is abutted.
First outside rotating member 41 can be with curved shape in wall portion 24Fa and wall portion 24Fb, as groove portion 22
The wall portion 24Fb of peripheral side is abutted.
The second inside rotating member 43 that second directed section 35F is rotated with respect to axis body 32 and with second in
Side rotating member 43 is coaxial and is linked to the second outside rotating member 44 of the second inside rotating member 43.
Second inside rotating member 43 and the second outside rotating member 44 can be in rotation with the center line C1 of axis body 32
Heart relative rotation.
Second inside rotating member 43 can be with curved shape in wall portion 53Fa and wall portion 53Fb, as groove portion 22
The wall portion 53Fa of inner circumferential side is abutted.
Second outside rotating member 44 can be with curved shape in wall portion 53Fa and wall portion 53Fb, as groove portion 22
The wall portion 53Fb of peripheral side is abutted.
In the present embodiment, when using the first guide portion 24F and the second guide portion 53F guidance work department 31F, first
Inside rotating member 40 and the first outside rotating member 41 being capable of mutual phase reversal, the second inside rotating member 43 and the second outer sidespins
Turning component 44 being capable of mutual phase reversal.
Therefore, a pair of of directed section 33F can be rolled relative to the first guide portion 24F and the second guide portion 53F, resistance at this time
Power becomes the rolling friction smaller than sliding friction.As a result, work department 31F and its blade 39 are swimmingly advanced along groove portion 22.
More than, embodiments of the present invention are described in detail by reference to the accompanying drawing, but specific structure is not limited to the reality
Mode is applied, also comprising not departing from the design alteration etc. in the range of purport of the invention.
For example, instantiating the soft operation utensil 1 for having flexible pipe 61, but can also in each embodiment
Flexible pipe 61 is substituted to be equipped with the axis of hardness.
In each embodiment, illustrating opens the first pincers component 10 and the second pincers component 50 using opening and closing knob 66
The example of movement is closed, but is also configured to carry out the on-off action in box portion 2 using a movement and by the blade of work department 31
39 cut off tissue.Such as also it is configured to the work when keeping work department 31 mobile to the far side in box portion 2 using bar 67
First pincers component 10 of the connection of portion 31 and second clamps component 50 and keeps the first pincers component 10 mobile to the second pincers 50 side of component.This
In the case of, the on-off action in box portion 2 can be carried out and by the blade 39 of work department 31 using the movement carried out using bar 67
Tissue is cut off.
It this concludes the description of the embodiments of the present invention, but technical scope of the invention is not limited to the embodiment party
Formula can change the combination of the constituent element of each embodiment or to each structure without departing from the spirit and scope of the invention
Apply various changes or deletion at element.The present invention is not illustrated to limit by above-mentioned.
Industrial availability
It is capable of providing a kind of in the movement for making blade during cutting off of tissue smoothly operation utensil.
Description of symbols
1,1A, 1B, operation utensil；7, the second connecting elements (operation lines)；10, the first pincers component；24,24F, first are drawn
Lead portion (guide portion)；31,31B, 31C, 31D, 31E, 31F, work department；32,32B, axis body；33,33D, 33F, a pair are guided
Portion；34,34D, 34F, the first directed section；35,35D, 35F, the second directed section；34E, the first directed section (stop knot
Structure)；39,39A, 39B, blade；50, the second pincers component；53,53F, the second guide portion (guide portion)；54, suturing part；62, it is inserted into
Portion.
Claims (10)
1. a kind of operation utensil, wherein
The operation includes: with utensil
Insertion section is inserted into internal；
First pincers component and the second pincers component, with scheduled curved shape, and described insert are arranged in hold tissue
Enter the distal end section in portion；
Guide portion is formed along the scheduled curved shape, and configuration is in the first pincers component and the second pincers component
In at least either on；And
Work department is guided and can be moved by the guide portion,
The work department includes
Axis body is set to the work department, which, which has from the first pincers component towards described second, clamps what component extended
Center line, the axis body can be rotated around with the rotation axis of the centerline parallel；And
Blade is being positioned away from from the rotation axis to the direction intersected with the rotation axis with towards the rotation
The mode of axis is linked to the axis body, which can rotate around the rotation axis.
2. operation utensil according to claim 1, wherein
The operation utensil also has operation lines, which extends from the peri position end of the guide portion towards distal end section,
It turns back in the distal end section of the guide portion, extends towards the peri position end of the guide portion and be linked to the work department.
3. operation utensil according to claim 1, wherein
The operation utensil also has suturing part, and the suturing part is for suturing by the first pincers component and the second pincers component
The tissue that hold.
4. operation utensil according to claim 2, wherein
The work department, which has, is sticked in the disk-shaped directed section that the guide portion and periphery supply the operation lines hooking,
The axis body is fixed on the directed section in such a way that the center line of the axis body is by the center of the directed section.
5. operation utensil according to claim 4, wherein
The face of the side that is fixed with the axis body of the directed section in the outer surface of the directed section has sliding surface,
The sliding surface is formed towards the curved of the axis body protrusion, the sliding surface and the guide portion point contact.
6. operation utensil according to claim 2, wherein
Centerline dip of the blade relative to the axis body.
7. operation utensil according to claim 2, wherein
The work department, which has, is sticked in the disk-shaped directed section that the guide portion and periphery supply the operation lines hooking,
The axis body positions away from the center from the directed section with the center line of the axis body and the directed section
Centerline parallel the mode that extends be fixed on the directed section.
8. operation utensil according to claim 2, wherein
The work department, which has, is sticked in the disk-shaped directed section that the guide portion and periphery supply the operation lines hooking,
The axis body is drawn by the center and the axis body of the directed section relative to described with the center line of the axis body
It leads portion's free mode of rotation and is linked to the directed section.
9. operation utensil according to claim 2, wherein
The work department has chocking construction, which can rotate to limit the axis body relative to the guide portion
180 ° or more and abutted with the guide portion.
10. a kind of tissue cuts off unit, wherein
The tissue cuts off unit and includes
Work department can be moved along the scheduled curved shape of the pincers component with scheduled curved shape,
The work department includes
Axis body is set to the work department；And
Blade links with the axis body,
The axis body and the blade can be rotated around the rotation axis of the centerline parallel with the axis body,
Blade configuration is positioned away from from the rotation axis to the direction intersected with the rotation axis, with towards institute
The mode for stating rotation axis is linked to the axis body.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2014-158526 | 2014-08-04 | ||
| JP2014158526 | 2014-08-04 | ||
| PCT/JP2015/064309 WO2016021268A1 (en) | 2014-08-04 | 2015-05-19 | Surgical instrument |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN106456174A CN106456174A (en) | 2017-02-22 |
| CN106456174B true CN106456174B (en) | 2019-08-23 |
Family
ID=55263547
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201580029013.4A Active CN106456174B (en) | 2014-08-04 | 2015-05-19 | Operation utensil and tissue cut off unit |
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| US (1) | US9913641B2 (en) |
| EP (1) | EP3178411B1 (en) |
| JP (1) | JP6006460B2 (en) |
| CN (1) | CN106456174B (en) |
| WO (1) | WO2016021268A1 (en) |
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- 2015-05-19 CN CN201580029013.4A patent/CN106456174B/en active Active
- 2015-05-19 JP JP2016527470A patent/JP6006460B2/en active Active
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Also Published As
| Publication number | Publication date |
|---|---|
| WO2016021268A1 (en) | 2016-02-11 |
| US20170079645A1 (en) | 2017-03-23 |
| JPWO2016021268A1 (en) | 2017-04-27 |
| CN106456174A (en) | 2017-02-22 |
| EP3178411A1 (en) | 2017-06-14 |
| US9913641B2 (en) | 2018-03-13 |
| EP3178411A4 (en) | 2018-03-21 |
| JP6006460B2 (en) | 2016-10-12 |
| EP3178411B1 (en) | 2023-12-20 |
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