Source: https://patents.google.com/patent/JP5019108B2/en
Timestamp: 2019-10-15 05:17:05
Document Index: 704227025

Matched Legal Cases: ['art 22', 'art 14', 'art 36', 'art 36', 'art 22', 'art 12', 'art 20', 'art 66', 'art 22', 'art 14', 'art 22', 'art, 14', 'art, 16', 'art, 18', 'art, 20', 'art, 22', 'art, 24', 'art, 38', 'art, 40', 'art, 68']

JP5019108B2 - Treatment tool - Google Patents
JP5019108B2
JP5019108B2 JP2007135757A JP2007135757A JP5019108B2 JP 5019108 B2 JP5019108 B2 JP 5019108B2 JP 2007135757 A JP2007135757 A JP 2007135757A JP 2007135757 A JP2007135757 A JP 2007135757A JP 5019108 B2 JP5019108 B2 JP 5019108B2
JP2007135757A
JP2008289556A (en
2007-05-22 Application filed by オリンパス株式会社 filed Critical オリンパス株式会社
2007-05-22 Priority to JP2007135757A priority Critical patent/JP5019108B2/en
2008-12-04 Publication of JP2008289556A publication Critical patent/JP2008289556A/en
2012-09-05 Publication of JP5019108B2 publication Critical patent/JP5019108B2/en
The present invention relates to a treatment instrument that is inserted into a living body during a surgical operation to perform treatment.
In recent years, as a minimally invasive technique that does not require a large incision, endoscopic surgery is performed in which various treatments are performed in a body cavity by opening a hole in a body cavity wall such as an abdominal wall and inserting a treatment tool into the body cavity through the hole. It is getting done.
As a treatment tool used in such an endoscopic operation, a rigid treatment tool in which an insertion portion into a body cavity is formed by a hard tube, and a flexible tube as disclosed in Patent Document 1, for example, are used. Flexible treatment devices. When performing treatment in a deep part (such as the back of an organ) in a body cavity, the insertion part is adjusted in the vertical direction along the organ in the body cavity or by an operator's operation, while deforming its curved state Since it can be inserted into a body cavity, a flexible treatment instrument is generally used.
Japanese Utility Model Publication No. 5-15914
However, in the above-described flexible treatment tool, since the insertion portion is flexible, the treatment tool itself may move unintentionally from the treatment target site in the body cavity to be treated, or the treatment target site may be grasped, for example. However, there is a problem that the treatment tool itself moves and the target part cannot be moved even if it is moved.
The present invention has been made in view of the above points, and it is an object of the present invention to provide a treatment instrument that can be flexibly deformed and easily inserted into a living body and that does not move during treatment.
One aspect of the treatment tool of the present invention is:
A treatment unit for applying a predetermined treatment to the target organ in the body cavity;
A flexible tube portion provided with the treatment portion at the tip, and a switching tube portion capable of selectively switching between a soft state when inserted into the body cavity and a rigid state when applying the predetermined treatment to the organ within the body cavity An insertion portion comprising:
The switching tube portion is configured by connecting a treatment operation wire for operating the treatment portion and a bending wire for bending the flexible tube portion through a coil disposed in the switching tube portion. and said that you are.
According to the present invention, it is possible to provide a treatment tool that can be easily deformed and easily inserted into a living body and that does not move during treatment.
FIG. 1A is a diagram showing a configuration of a treatment instrument 10 according to an embodiment of the present invention, and FIG. 1B is a diagram showing a cross section of an insertion portion 14 of the treatment instrument 10 according to the present embodiment. FIG. 1C is a cross-sectional view taken along the line CC in FIG.
The treatment instrument 10 according to the present embodiment includes a treatment unit 12, an insertion unit 14, an operation unit 16, and a fixing unit 18. Here, the treatment unit 12 is a member that applies a predetermined treatment to a target organ in a body cavity such as a bio-forceps. The insertion portion 14 includes a flexible tube portion 20 provided with the treatment portion 12 at the tip, and a switching tube portion 22 capable of selectively switching between a soft state and a hard state. The operation unit 16 is a member that is formed at a position that is disposed outside the body during the predetermined treatment and that operates the treatment unit 12. The fixing portion 18 is a member for fixing the treatment instrument 10 to a bed or the like.
The switching tube portion 22 is arranged so that a large number of switching tubes 24 functioning as joints are in continuous contact. In the switching pipes 24, one joint lock wire 26 fixed to the switching pipe 24, one end of which is arranged at the foremost end, communicates. The other end of the joint lock wire 26 is wound around a rotating member (not shown) that rotates in response to the rotation of the dial 28 provided in the operation unit 16. Is adjustable. That is, by rotating the dial 28 to the unlocking position, the tension of the joint lock wire 26 is loosened, the contact force between the switching pipes 24 is loosened, and the switching pipe part 22 of the insertion part 14 is in a soft state. The joint can move freely and can be in various curved states. On the other hand, by rotating the dial 28 to the lock fixing position, the tension of the joint lock wire 26 is increased, the contact force between the switching tubes 24 is increased, and the switching tube portion 22 of the insertion portion 14 is It becomes a hard state. That is, the joint is locked, and the curved state deformed in the soft state is maintained.
Further, four bending wires 30 and one tip opening / closing wire 32 are further communicated with each switching tube 24. In this case, as shown in FIG. 1C, the switching tube 24 is provided with a semicircular arc-shaped communication hole 34 so that the insertion portion 14 may be deformed into any curved state. Three of the four bending wires 30 and the tip opening / closing wire 32 are passed through the hole 34. A coil 40 and a coil 42 are arranged on the bending wire 30 and the tip opening / closing wire 32 so as to surround each of them. Since these coils 40 and 42 can be bent, even if the flexible tube portion 20 is bent, it can have the same shape. Therefore, when the wires 30 and 32 are contained in the coils 40 and 42, the portions of the wires 30 and 32 that are contained in the coils 40 and 42 are affected regardless of the bent shape of the flexible tube portion 20. There is nothing, and the flexible tube portion 20 can freely deform its curved state.
The flexible tube portion 20 includes a first movable portion 36 attached to the switching tube 24 disposed at the foremost position in the switching tube portion 22 of the insertion portion 14 so as to be swingable in the left-right direction, and the first movable portion 36. The second movable portion 38 is attached to the movable portion 36 so as to be able to swing in the vertical direction. Here, the tip opening / closing wire 32 and the four bending wires 30 are provided in the first movable portion 36, and the one tip opening / closing wire 32 and the four wires are provided in the second movable portion 38. Among the bending wires 30, two bending wires 30 involved in the movement of the second movable portion 38 are arranged.
Of the four bending wires 30 arranged in the first movable part 36, two opposing ones (not shown in FIG. 1B) are involved in the lateral swing of the first movable part 36, One end of the dial is fixed to the first movable portion 36, and the other end is wound around a rotating member (not shown) that rotates according to the rotation of the dial 44 provided in the operation unit 16. The tension can be adjusted by the operation of 44. The coil 40 surrounding the two bending wires 30 is fixed to the switching tube 24 arranged at the forefront. When the dial 44 is turned and the bending wire 30 is pulled, the first movable portion 36 moves left and right. Further, as shown in FIG. 1B, the other two opposing bending wires 30 are involved in the vertical swing of the second movable portion 38, and the tip thereof is fixed to the second movable portion 38. The other end is wound around a rotating member (not shown) that rotates according to the rotation of the dial 46 provided in the operation unit 16, and the tension can be adjusted by operating the dial 46. Yes. A coil 40 surrounding the two bending wires 30 is fixed to the first movable portion 36. Similarly to the first movable portion 36, the second movable portion 38 also moves up and down when the bending wire 30 is pulled.
One end of the distal end opening / closing wire 32 is connected to the rear end of the treatment section 12, and the other end is connected to a slider 48 provided in the operation section 16. By pulling / pushing the slider 48, the treatment portion distal end 50 can be opened and closed. The coil 42 surrounding the distal end opening / closing wire 32 is fixed to the distal end side with respect to the second movable portion 38.
FIG. 2 is a diagram illustrating a usage state of the treatment instrument 10 according to the present embodiment.
That is, when the treatment target site of the target organ 52 is treated with the treatment instrument 10 according to the present embodiment, the switching tube of the insertion portion 14 is inserted through the trocar 56 that is inserted and fixed in the hole formed in the body wall 54. Inserting the treatment instrument 10 with the portion 22 in a soft state (unlocked state) into the body cavity 58 and observing with the camera 62 provided at the distal end of the endoscope 60 inserted through another trocar 56, The treatment unit 12 is set as a treatment target region of the target organ 52. Thereafter, the switching tube portion 22 of the insertion portion 14 is set in a rigid state (locked). Thereby, the position of the switching pipe part 22 which became the rigid state is fixed.
As described above, since the switching tube portion 22 is in a soft state when inserted into the living body, the inserting portion 14 can be easily inserted into the living body. In addition, in the case of using an insertion portion that is in a soft state as a whole, the operator's operation causes the proximal side of the insertion portion to move, resulting in the position and posture of the insertion portion (treatment portion) as desired by the operator. Difficult to operate. However, if the flexible tube portion 20 and the switching tube portion 22 are provided in the insertion portion 14 as in the present embodiment, and the switching tube portion 22 is in a rigid state at the time of treatment, the treatment portion 12 moves unintentionally at the time of treatment. There is no end. In addition, when an insertion portion that is entirely rigid is used, it is difficult to operate the treatment portion to a position and posture desired by the operator. However, according to this one embodiment, even if the switching tube portion 22 is in a rigid state, the flexible tube portion 20 is attached to the switching tube portion 22 by including the flexible tube portion 20. The position and posture of the treatment section 12 can be freely changed with coordinates based on the portion, and the operability of the treatment section 12 is improved. Further, for example, the treatment target part of the target organ 52 is grasped by the treatment part 12 and the direction of the flexible tube part 20 is adjusted, so that the treatment target part can be moved.
Here, with reference to FIG. 3A thru | or FIG. 3C further, the insertion method in the body cavity 58 of the treatment tool 10 which concerns on this one embodiment is demonstrated.
That is, as shown in FIG. 3A, an endoscope 64 different from the endoscope 60 is used. The endoscope insertion portion 66 of the endoscope 64 communicates between a portion outside the body when the endoscope insertion portion 66 is inserted into the body cavity 58 and the distal end of the endoscope insertion portion 66. A forceps channel for inserting a biological forceps or the like is provided. Then, the front end 70 of the guide wire 68 is inserted from the insertion port 72 of the forceps channel, passes through the forceps channel in the endoscope insertion portion 66, exits from the discharge port 74 at the tip, and is inserted into the endoscope. Along the outside of the portion 66, it is returned to the temporary fixing portion 76 in the vicinity of the insertion opening 72 and temporarily fixed with a tape or the like. After preparing the guide wire 68 in this way, a hole formed in the body wall 54 in addition to the trocar 56 for inserting the treatment instrument 10 and the trocar 56 for inserting the endoscope 60. Then, the endoscope 64 is inserted into the body cavity 58 through the trocar 56.
If the endoscope insertion portion 66 is inserted until the temporary fixing portion 76 is in the vicinity of the trocar 56, the guide wire 68 is temporarily fixed with the tape or the like as shown by an arrow (1) in FIG. 3B. It cancels | releases and the endoscope insertion part 66 is further inserted. As a result, the front end 70 of the guide wire 68 is dropped from the trocar 56 into the body cavity 58 as indicated by the arrow (2) in FIG. 3B. Then, the insertion portion 14 of the treatment instrument 10 according to the present embodiment is inserted into the body cavity 58 via the trocar 56 (at this time, the switching tube portion 22 may be in either a soft state or a hard state) While observing with the camera 62 of the endoscope 60, the front end 70 of the guide wire 68 is shown by the treatment portion distal end 50 of the treatment portion 12 provided at the distal end of the insertion portion 14 as shown by an arrow (3) in FIG. 3B. Grab the vicinity.
In this way, the endoscope insertion portion 66 is further inserted while observing with the camera 62 of the endoscope 60 with the guide wire 68 held by the treatment portion 12, and the distal end of the endoscope insertion portion 66 is targeted. Move to the treatment target site of the organ 52. And if it moved to that position, the switching pipe part 22 will be switched to a soft state, and the guide wire 68 will be pulled from the insertion opening 72 side of a forceps channel as shown by the arrow in FIG. 3C (A). Then, as shown by an arrow in FIG. 3C (B), the treatment portion 12 of the treatment instrument 10 holding the vicinity of the front end 70 of the guide wire 68 is pulled as the guide wire 68 moves, and the endoscope is inserted. It moves to the vicinity of the discharge port 74 of the forceps channel at the tip of the portion 66, that is, to the vicinity of the treatment target site of the target organ 52. When this state is observed with the camera 62 of the endoscope 60 and the treatment section 12 of the treatment instrument 10 is reached at a desired position, the switching tube section 22 is switched to the rigid state and the treatment section distal end 50 is opened. As a result, the holding of the guide wire 68 is released. Then, the guide wire 68 is further pulled and removed from the forceps channel of the endoscope 64. The endoscope 64 may be pulled out in the same manner, or the position of the endoscope 64 may be further adjusted and used for treatment or observation of the surgical field.
As described above, the treatment instrument 10 according to the present embodiment has the flexible tube portion 20 that is an active movable portion that can be operated by the operator from outside the body, and the passive movable device that can selectively switch between the soft state and the hard state. Since it has the insertion part 14 provided with the switching tube part 22 which is a part, it can be set as the treatment tool 10 which can be easily inserted into the living body by being deformed flexibly and does not move during treatment.
As mentioned above, although this invention was demonstrated based on one Embodiment, this invention is not limited to embodiment mentioned above, Of course, a various deformation | transformation and application are possible within the range of the summary of this invention. is there.
(1) a treatment unit for applying a predetermined treatment to a target organ in a body cavity;
A flexible tube portion provided with the treatment portion at the tip, and an insertion portion including a switching tube portion capable of selectively switching between a soft state and a hard state;
A treatment instrument comprising:
(Correspondence with embodiment)
In one embodiment, the body cavity 58 is the body cavity, the target organ 52 is the target organ, the treatment section 12 is the treatment section, the soft tube section 20 is the soft tube section, and the switching tube section 22 is the switching tube section. Further, the insertion portion 14 corresponds to the insertion portion, and the treatment instrument 10 corresponds to the treatment instrument.
According to the treatment instrument described in (1), since the treatment portion always has a flexible tube portion formed at the tip and a switching tube portion that takes both hardness and flexibility, the treatment portion is flexibly deformed into the living body. Thus, it is possible to provide a treatment instrument that can be easily inserted and does not move during treatment.
(2) The switching tube portion of the insertion portion is in a soft state when inserted into the body cavity, and in a rigid state when the predetermined treatment is applied to the organ in the body cavity (1) ).
According to the treatment instrument described in (2), the switching tube portion of the insertion portion becomes soft when inserted into a body cavity and becomes rigid when treated, so that treatment can be easily performed at a place other than the treatment site nearest to the insertion hole into the body cavity. .
(3) It further includes an operation unit for operating the treatment unit, which is formed at a position arranged outside the body during the predetermined treatment.
The treatment instrument according to (1), wherein the operation unit includes a selection unit for switching and selecting the soft state and the hard state of the switching tube unit of the insertion unit.
In one embodiment, the operation unit 16 corresponds to the operation unit, and the dial 28 corresponds to the selection unit.
According to the treatment instrument described in (3), since the selection unit for switching is outside the body, operability is good.
(4) The treatment instrument according to (3), wherein the operation unit further includes a posture operation unit for manipulating the posture of the flexible tube portion.
In one embodiment, the dials 44 and 46 correspond to the posture operation unit.
According to the treatment instrument described in (4), the posture of the flexible tube portion can be freely adjusted, and the treatment portion can be set as the treatment target portion of the target organ.
FIG. 1A is a diagram illustrating a configuration of a treatment instrument according to an embodiment of the present invention, and FIG. 1B is a diagram illustrating a cross section of an insertion portion of the treatment instrument according to the present embodiment. FIG. 1C is a cross-sectional view taken along the line CC in FIG. FIG. 2 is a diagram illustrating a usage state of the treatment tool according to the embodiment. It is a figure for demonstrating the insertion method in the body cavity of the treatment tool which concerns on one Embodiment. It is a figure for demonstrating the insertion method in the body cavity of the treatment tool which concerns on one Embodiment. It is a figure for demonstrating the insertion method in the body cavity of the treatment tool which concerns on one Embodiment.
DESCRIPTION OF SYMBOLS 10 ... Treatment tool, 12 ... Treatment part, 14 ... Insertion part, 16 ... Operation part, 18 ... Fixing part, 20 ... Flexible pipe part, 22 ... Switching pipe part, 24 ... Switching pipe, 26 ... Joint lock wire, 28, 44, 46 ... dial, 30 ... bending wire, 32 ... tip opening / closing wire, 34 ... communication hole, 36 ... first movable part, 38 ... second movable part, 40, 42 ... coil, 48 ... slider, 50 ... treatment part Tip, 52 ... target organ, 54 ... body wall, 56 ... trocar, 58 ... body cavity, 60, 64 ... endoscope, 62 ... camera, 66 ... endoscope insertion part, 68 ... guide wire, 70 ... front end, 72 ... insertion port, 74 ... discharge port, 76 ... temporary fixing part.
The switching tube portion is configured by connecting a treatment operation wire for operating the treatment portion and a bending wire for bending the flexible tube portion through a coil disposed in the switching tube portion. treatment tool, characterized in that there.
Further comprising an operation part for operating the treatment part formed at a position arranged outside the body during the predetermined treatment;
The treatment tool according to claim 1, wherein the operation unit includes a selection unit for switching and selecting the soft state and the hard state of the switching tube unit of the insertion unit.
The treatment instrument according to claim 2 , wherein the operation unit further includes a posture operation unit for manipulating the posture of the flexible tube portion.
JP2007135757A 2007-05-22 2007-05-22 Treatment tool Active JP5019108B2 (en)
JP2007135757A JP5019108B2 (en) 2007-05-22 2007-05-22 Treatment tool
PCT/JP2008/059148 WO2008143218A1 (en) 2007-05-22 2008-05-19 Treatment device
US12/603,004 US8864749B2 (en) 2007-05-22 2009-10-21 Surgical instrument
JP2008289556A JP2008289556A (en) 2008-12-04
JP5019108B2 true JP5019108B2 (en) 2012-09-05
ID=40031915
JP2007135757A Active JP5019108B2 (en) 2007-05-22 2007-05-22 Treatment tool
US (1) US8864749B2 (en)
JP (1) JP5019108B2 (en)
WO (1) WO2008143218A1 (en)
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2007-05-22 JP JP2007135757A patent/JP5019108B2/en active Active
2008-05-19 WO PCT/JP2008/059148 patent/WO2008143218A1/en active Application Filing
2009-10-21 US US12/603,004 patent/US8864749B2/en active Active
US20100042077A1 (en) 2010-02-18
WO2008143218A1 (en) 2008-11-27
US8864749B2 (en) 2014-10-21
JP2008289556A (en) 2008-12-04