JP7442909B2 - Cover and forceps device - Google Patents

Description

The present invention relates to a cover for a forceps device.

In recent years, medical treatments using robots (manipulators) have been proposed in order to reduce the burden on surgeons and save labor in medical facilities. In the field of surgery, proposals have been made regarding surgical manipulator systems in which a surgeon operates a remotely controllable surgical manipulator to treat a patient.

Various surgical tools are attached to the tip of a surgical manipulator, and forceps used to grasp human tissue during surgery are known as surgical tools. For example, Patent Document 1 discloses a cover for a surgical instrument, which is a cylindrical member that covers at least the periphery of the base of the surgical instrument.

JP 2019-195402 Publication

However, the surgical instrument cover described above is made of a flexible material such as rubber that can be used in endoscopic surgery. Therefore, when inserting and removing the surgical instrument through the trocar, the cover may get caught on the end of the trocar, and in some cases, the cover may come off from the surgical instrument.

The present invention has been made in view of these circumstances, and one exemplary purpose thereof is to provide a new technique that makes it difficult for a cover to come off from a surgical tool such as a forceps device.

In order to solve the above problems, a cover according to an aspect of the present invention is a cylindrical cover that is attached to a forceps device having a treatment section for treating a target, the first cover covering the distal end section including the treatment section. and a second covering part that covers the rear end side from the distal end part. Compared to the first covering part, the second covering part is configured to be less likely to deform when it gets caught on a trocar when inserting and removing the forceps device.

The second covering part, which is located closer to the base of the forceps device than the first covering part, is more likely to turn over than the first covering part when caught by the trocar. According to this aspect, since the second covering part has a structure that is less likely to deform compared to the first covering part, even if the second covering part of the cover gets caught on the trocar when inserting and removing the forceps device, , the cover becomes difficult to remove from the forceps device.

The first covering part may be made of butyl rubber or silicone rubber having a Shore A hardness of 40 to 60°, and the second covering part may be made of butyl rubber or silicone rubber having a Shore A hardness of 60 to 80°. As a result, the hardness of the first covering portion that covers the distal end portion including the treatment portion is relatively small, so that resistance to movement of the treatment portion due to the cover can be suppressed. On the other hand, since the hardness of the second covering part is relatively high, deformation of the second covering part when it gets caught on the trocar can be suppressed.

The first covering part is provided so that an annular small diameter part smaller than the diameter of the first covering part extends toward the rear end, and the second covering part is provided so as to cover the outer periphery of the small diameter part. may be provided. Thereby, the cover can be configured by attaching the second part having the second covering part to the first part having the first covering part. In this way, by combining multiple parts for each function, it is possible to create an appropriate cover for each type of forceps device to be attached or trocar to be used. Note that the diameter of the first covering part and the diameter of the second covering part are preferably substantially the same. In this case, a step is less likely to be formed at the boundary between the first covering part and the second covering part.

The second covering portion may be a region where a coating material is applied to a portion of the cover surface. Thereby, the second covering part can be easily formed on a part of the cover.

The coating material may include a glass-based coating material or an acrylic-based coating material. Thereby, the hardness of the second covering part can be increased.

An adhesive may be applied to the inner periphery of the second covering portion. This makes it difficult for the second covering to turn over even if the trocar gets caught on the cover.

The second covering part may be a region in which a part of the surface of the first covering part is thermally or chemically treated. Thereby, the second covering part having a different function and composition from the first covering part can be formed by simply preparing the first covering part without combining two parts or materials.

Another aspect of the invention is a forceps device. This forceps device includes a distal end having a treatment section for treating a target, a columnar component connected to the distal end, a pipe connected to a side of the columnar component opposite to the side connected to the distal end, and a distal end. and a cover that is attached from the columnar part to the columnar part.

According to this aspect, it is possible to realize a forceps device in which the cover is difficult to come off even if the second covering portion of the cover is caught on the trocar.

The distal end portion may have a joint portion for operating the treatment section. The joint portion is not covered with the second covering portion. Thereby, since the joint part is not covered with the second covering part which is less deformable than the first covering part, it is possible to suppress the operational resistance of the treatment section centering on the joint part.

Note that arbitrary combinations of the above-mentioned components and expressions of the present invention converted between methods, devices, systems, etc. are also effective as aspects of the present invention.

According to the present invention, the cover becomes difficult to come off from the forceps device.

FIG. 2 is a front view of the forceps device according to the present embodiment. FIGS. 2(a) to 2(b) are schematic diagrams for explaining how the joint cover comes off from the base cap. FIG. 2 is a perspective view of a cover according to the present embodiment. FIG. 4 is a longitudinal cross-sectional view showing a main part of the cover shown in FIG. 3; FIG. 6 is an enlarged view of the vicinity of a second covering portion in the forceps device according to the present embodiment. FIG. 7 is a longitudinal cross-sectional view showing essential parts of a cover according to a first modified example of the present embodiment. It is a longitudinal cross-sectional view showing the main part of the cover concerning the 2nd modification of this embodiment. It is a longitudinal cross-sectional view showing the principal part of the cover concerning the 3rd modification of this embodiment. It is a longitudinal cross-sectional view showing the principal part of the cover concerning the 4th modification of this embodiment.

DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below based on embodiments and with reference to the drawings. Identical or equivalent components, members, and processes shown in each drawing are designated by the same reference numerals, and redundant explanations will be omitted as appropriate. Furthermore, the embodiments are illustrative rather than limiting the invention, and all features and combinations thereof described in the embodiments are not necessarily essential to the invention.

(forceps device)
FIG. 1 is a front view of a forceps device according to this embodiment. A medical forceps device 10 shown in FIG. 1 includes a pair of gripping parts 12a and 12b, a support body 14 that holds the pair of gripping parts 12a and 12b, and a first rotating shaft that rotatably supports the support body 14. 16, a base component 18 that holds the first rotating shaft 16, four guide pulleys (not shown) arranged coaxially with the first rotating shaft 16, and coaxially with the pair of gripping parts 12a and 12b. The four jaw pulleys 20 to be held, the four wires 22 hung between the four guide pulleys and the four jaw pulleys 20, and the two wires 22 for rotating the support body 14 around the first rotation axis 16. The main wire 24 is provided.

The base component 18 is connected to the tip side of a base cap 26, which is a columnar component. The rear end side of the base cap 26 is connected to a pipe 28. The forceps device 10 according to the present embodiment is covered with a cylindrical joint cover 30 from the support body 14 to the rear end of the base cap 26. This makes it difficult for foreign objects to enter gaps between parts such as wires and pulleys during surgery. Further, in the case of a forceps device of the type that applies electricity to the gripping portions 12a and 12b to stop bleeding in the patient's tissue, a joint cover 30 having insulating properties is used.

The base cap 26 is a cylindrical (column-shaped) resin component made of engineering plastic or the like. This makes it possible to achieve both component strength and insulation. Specifically, materials such as PEEK (polyetheretherketone) and PEI (polyetherimide) are used, but are not limited to these.

The material used for the pipe 28 is, for example, CFRP (carbon fiber reinforced plastic) or GFRP (glass fiber reinforced plastic). The joint cover 30 is preferably made of a material with high insulation properties and excellent flexibility, such as butyl rubber or silicone rubber.

As described above, the forceps device 10 according to the present embodiment includes a distal end portion 31 having gripping portions 12a and 12b as a treatment section for treating a surgical object, a base cap 26 connected to the distal end portion 31, and a base cap 26 connected to the distal end portion 31. It includes a pipe 28 connected to the side of the cap 26 opposite to the side connected to the tip 31, and a joint cover 30 attached from the tip 31 to the base cap 26.

FIGS. 2(a) to 2(b) are schematic diagrams for explaining how the joint cover comes off from the base cap. The forceps device 10 is inserted into a patient's body via a trocar 32 during laparoscopic surgery. The inserted forceps device 10 may tilt or slide inside the patient's body. Therefore, a portion of the joint cover 30 (FIG. 2(a)) caught on the end 32a of the trocar 32 lifts up from the recess 26a of the base cap 26 when the forceps device 10 moves in the direction to remove it from the trocar 32 (FIG. 2(a)). 2(b)). Therefore, the contact area between the joint cover 30 and the recess 26a of the base cap 26 is reduced, and the friction is reduced, making it easier for the joint cover 30 to come off.

If force is further applied to the joint cover 30 from the trocar 32 in this state, there is a possibility that the joint cover 30 will eventually fall off from the forceps device 10. Therefore, the forceps device 10 according to the present embodiment employs a configuration in which the joint cover 30 is not easily deformed when the end portion 32a of the trocar 32 is caught on the joint cover 30.

FIG. 3 is a perspective view of the cover according to this embodiment. FIG. 4 is a longitudinal cross-sectional view showing essential parts of the cover shown in FIG. 3. FIG. The joint cover 30 according to the present embodiment is a cylindrical cover that is attached to a forceps device having gripping parts 12a and 12b for treating a target. The joint cover 30 has a first covering part 30a that covers the distal end part 31, and a second covering part 30b that covers the rear end side of the distal end part 31. The second covering part 30b is configured to be less likely to deform when it gets caught on the trocar 32 when inserting and removing the forceps device 10, compared to the first covering part 30a. Here, "hard to deform" means not only that the material of the second covering part 30b is harder than the material of the first covering part 30a (the Young's modulus and the elastic modulus are larger), but also that the material of the second covering part 30b This also includes a case where the structure is made more rigid than the first covering part 30a by adjusting the shape and size of the first covering part 30a.

Normally, the second covering part 30b, which is located closer to the base of the forceps device 10 (on the pipe 28 side) than the first covering part 30a, is more likely to turn over when caught by the trocar 32 than the first covering part 30a. Therefore, the second covering part 30b according to the present embodiment is configured to have a higher Shore A hardness than the first covering part 30a. Specifically, the first covering part 30a is made of butyl rubber or silicone rubber with a Shore A hardness of 40 to 60 degrees, and the second covering part 30b is made of butyl rubber or silicone rubber with a Shore A hardness of 60 to 80 degrees. It is. Note that the first covering part 30a and the second covering part 30b only need to contain butyl rubber or silicone rubber, and it is more preferable that they contain it as a main component, and may contain other components.

As a result, the hardness of the first covering portion 30a that covers the tip portion 31 including the gripping portions 12a, 12b is relatively small, so that resistance to movement of the gripping portions 12a, 12b by the joint cover 30 can be suppressed. On the other hand, since the hardness of the second covering part 30b is relatively high, when the second covering part 30b is caught on the trocar 32, a part of the joint cover 30 may be deformed as shown in FIG. 2(b). This makes it difficult for curling to occur. As a result, even if the second covering portion 30b of the joint cover 30 is caught on the trocar 32 when inserting and removing the forceps device 10, the joint cover 30 is difficult to be removed from the forceps device 10.

Note that the joint cover 30 according to the present embodiment is provided with a deformation suppressing member 36 as an annular convex portion on the back surface, which is less likely to deform than the joint cover 30. Here, "hard to deform" means not only when the material of the deformation suppressing member 36 is harder than the material of the joint cover 30 (when the Young's modulus or elastic modulus is larger) but also when the shape of the deformation suppressing member 36 is hard to deform. This also includes a case where the joint cover 30 has a structure with higher rigidity than the joint cover 30 by adjusting its size. In such a case, the joint cover 30 whose back surface is partially supported by the deformation suppressing member 36 is less likely to deform than the joint cover 30 alone. Note that in the joint cover 30 according to the present embodiment, the deformation suppressing member 36 is not necessarily essential. Further, the second covering portion 30b and the deformation suppressing member 36 may be integrally made of the same material.

FIG. 5 is an enlarged view of the vicinity of the second covering part in the forceps device according to the present embodiment. As shown in FIGS. 3 to 5, the first covering part 30a and the second covering part 30b according to this embodiment are cylindrical or ring-shaped members. Thereby, deformation of the joint cover 30 by the abutting trocar 32 can be suppressed no matter where the contact position P where the trocar 32 and the forceps device 10 come into contact is at any position in the circumferential direction of the second covering portion 30b.

Further, as shown in FIG. 5, the base cap 26 has an annular recess 26a formed on its outer periphery. The deformation suppressing member 36 described above has a shape that fits into the recess 26a. In this way, the deformation suppressing member 36, which is less deformable than the joint cover 30, is fitted into the annular recess 26a formed on the outer periphery of the base cap 26, so that the joint cover 30 as shown in FIG. Part of the base cap 26 is prevented from deforming and rising from the recess 26a of the base cap 26.

Furthermore, since the joint cover 30 is difficult to lift up, the state in which the deformation suppressing member 36 fitted in the recess 26a of the base cap 26 is caught on the step 26c is maintained. In other words, the joint cover 30 provided with the deformation suppressing member 36 becomes difficult to come off from the base cap 26.

Further, in the joint cover 30 according to the present embodiment, a portion 30d of the back surface of the first covering portion 30a that covers the tip portion 31 is not covered with the deformation suppressing member 36. Even if the end 32a of the trocar 32 bites into the front end side of the joint cover 30 whose back surface is not covered with the deformation suppressing member 36, the joint cover 30 at the front end 31 is difficult to bend (hard to deform), so the first covering part A material having relatively lower hardness than the second covering portion 30b can be used for the second covering portion 30a.

Note that, as shown in FIG. 1, the distal end portion 31 according to the present embodiment has a first rotating shaft 16 that serves as a joint when the entire gripping portions 12a and 12b, which are treatment portions, is bent. A second rotating shaft 38 is provided, which serves as a joint when opening and closing the sections 12a and 12b. The joint portion of the joint cover 30 according to this embodiment is not covered with the second covering portion 30b. If the joint part is covered with the second covering part 30b made of a material that is less deformable than the first covering part 30a, the movement of the joint part will be hindered. Therefore, since the joint part according to the present embodiment is not covered with the second covering part 30b which is less deformable compared to the first covering part 30a, the gripping parts 12a and 12b around the joint part are Operational resistance can be suppressed.

Next, the diameter and length of each part will be explained. The diameter d1 of the pipe-side end surface 30c of the joint cover 30 according to this embodiment is set within a range of 8.4±1.5 mm. Further, the thickness of the joint cover 30 is set within a range of 0.5±0.3 mm. The diameter d2 of the deformation suppressing member 36 is set within a range of 7.8±1.5 mm. Further, the thickness of the deformation suppressing member 36 is set within a range of 0.5±0.3 mm. Further, the end surface 30c of the joint cover 30 is preferably covered by the end surface 28a of the pipe 28. Further, the diameter d4 of the pipe 28 is set within a range of 8.4±1.5 mm.

The joint cover 30 has a diameter d1 smaller than the inner diameter d5 of the trocar into which the forceps device 10 is inserted. Thereby, the forceps device 10 can change its posture inside the trocar 32. The inner diameter d5 according to this embodiment is set in the range of 10 to 15 mm, and the effective length L2 of the trocar 32 is set in the range of 30 to 100 mm. The surface material of the trocar 32 is, for example, resin such as polycarbonate or polyolefin, or metal such as stainless steel.

If the diameter d1 of the joint cover 30 is too large, the change in the posture of the forceps device 10 with respect to the trocar 32 will become small. On the other hand, if the diameter d1 is too small, the inclination α of the trocar 32 with respect to the forceps device 10 tends to become large, and the bite (contact load) of the end 32a of the trocar 32 into the joint cover 30 at the contact position P becomes large. Therefore, the diameter d1 of the joint cover 30, the inner diameter d5 and the effective length L2 of the trocar 32 are adjusted so that the maximum value of the inclination α is within the range of 15±5° with respect to the trocar 32 into which the forceps device 10 is inserted and removed. It is a good idea to set the size.

The base cap 26 according to the present embodiment has a through hole 26b through which the wires 22 and 24 that open, close, and bend the gripping parts 12a and 12b, which are treatment parts, pass. Further, the length L1 of the recess 26a provided in the portion covered by the second covering portion 30b of the base cap 26 is in the range of 7.0±3 mm, and the diameter d6 of the small diameter portion of the recess 26a is in the range of 7.0±3 mm. It is set within the range of 7.2±1.5mm. Further, the diameter d7 of the large diameter portion of the base cap 26 is set within a range of 7.8±1.5 mm.

Note that the deformation suppressing member 36 is preferably made of a material with high rigidity and surface sliding properties, such as PE (polyethylene), PP (polypropylene), PPS (polyphenylene sulfide), PEEK (polyetheretherketone), PEI (polyethylene), etc. It is preferable that it is formed from a resin material containing at least one selected from the group consisting of (etherimide) and PSU (polysulfone). Thereby, the fitability of the joint cover 30 made of a relatively soft material is not impaired, and deformation of the joint cover 30 due to biting of the trocar 32 after being fitted can be suppressed.

(First modification)
FIG. 6 is a longitudinal cross-sectional view showing essential parts of a cover according to a first modification of the present embodiment. The first covering part 40a in the joint cover 40 according to the first modification is provided such that an annular small diameter part 40c having a diameter d3 smaller than the diameter d1' of the first covering part extends toward the rear end side. There is. The second covering portion 40b is provided to cover the outer periphery of the small diameter portion 40c. Thereby, the joint cover 40 can be configured by attaching the second part 44 having the second covering part 40b to the first part 42 having the first covering part 40a.

In this way, by combining a plurality of parts for each function, an appropriate joint cover 40 can be manufactured for each type of forceps device 10 to be attached or trocar 32 to be used. Note that the joint cover 40 may be produced by two-color molding instead of combining a plurality of parts. Further, it is preferable that the diameter d1' of the first covering part 40a and the diameter d1 of the second covering part 40b are substantially the same. In this case, a step is less likely to be formed at the boundary 46 between the first covering part 40a and the second covering part 40b.

(Second modification)
FIG. 7 is a longitudinal cross-sectional view showing essential parts of a cover according to a second modification of the present embodiment. In the joint cover 48 according to the second modification, a region (second covering section 48b) coated with a coating material is provided on a part of the surface 48c on the rear end side of the first covering section 48a. Thereby, the second covering portion 48b can be easily formed on a part of the joint cover 48. The coating material according to this embodiment may contain a glass-based coating material or an acrylic-based coating material. Thereby, the hardness of the second covering portion 48b can be increased. Note that the deformation suppressing member 36 may be provided on the back side of the first covering part 48a at a position facing the second covering part 48b.

(Third modification)
FIG. 8 is a longitudinal cross-sectional view showing essential parts of a cover according to a third modification of the present embodiment. The joint cover 50 according to the third modification includes a region (second covering section 50b) coated with the adhesive 51 on the inner periphery 50c on the rear end side of the first covering section 50a. There is. Thereby, even if the trocar 32 gets caught on the joint cover 50, the second covering portion 50b is less likely to turn over.

(Fourth modification)
FIG. 9 is a longitudinal cross-sectional view showing the main parts of a cover according to a fourth modification of the present embodiment. In the joint cover 52 according to the fourth modification, a part of the surface 52c of the first covering part 52a is provided with a thermally or chemically treated area (second covering part 52b). . Thereby, the second covering part 52b having a different function and composition from the first covering part 52a can be formed by simply preparing the first covering part 52a without combining two parts or materials. Here, the thermal treatment includes treatments such as hardening and baking. Further, the chemical treatment includes a treatment of exposing the material to a predetermined atmosphere (a gas atmosphere containing a large amount of a predetermined element) and a treatment of applying a chemical in order to change the composition of the material constituting the joint cover.

Although the present invention has been described above with reference to the above-described embodiments, the present invention is not limited to the above-described embodiments, and may also be applied to combinations or substitutions of the configurations of the embodiments as appropriate. It is included in the present invention. Furthermore, it is possible to appropriately rearrange the combinations and order of processing in the embodiments based on the knowledge of those skilled in the art, and to make various modifications to the embodiments, such as various design changes. Such embodiments may also be included within the scope of the present invention.

The present invention makes it difficult for the cover to come off from the forceps device.

Reference Signs List 10 forceps device, 12a gripping portion, 14 support body, 16 first rotating shaft, 18 base component, 26 base cap, 26a recess, 26b through hole, 26c step, 28 pipe, 28a end surface, 30 joint cover, 30a first 30b second covering part, 31 tip part, 32 trocar, 32a end part, 38 second rotating shaft.

Claims (7)

A cylindrical cover attached to a forceps device having a treatment section for treating a target,
a first covering portion that covers the distal end portion including the treatment portion;
a second covering part that covers the rear end side from the tip part,
Compared to the first covering part, the second covering part is configured to be difficult to deform when caught by a trocar when inserting and removing the forceps device,
The second covering part is an area where a coating material is applied to a part of the cover surface,
The cover is characterized in that the coating material contains a glass-based coating material or an acrylic-based coating material . The first covering portion is made of butyl rubber or silicone rubber with a Shore A hardness of 40 to 60°,
The cover according to claim 1, wherein the second covering portion is made of butyl rubber or silicone rubber having a Shore A hardness of 60 to 80°. The first covering part is provided such that an annular small diameter part smaller than the diameter of the first covering part extends toward the rear end side,
The cover according to claim 1 or 2, wherein the second covering portion is provided so as to cover an outer periphery of the small diameter portion. A cylindrical cover attached to a forceps device having a treatment section for treating a target,
a first covering portion that covers the distal end portion including the treatment portion;
a second covering part that covers the rear end side from the tip part,
Compared to the first covering part, the second covering part is configured to be difficult to deform when caught by a trocar when inserting and removing the forceps device,
The cover is characterized in that the second covering portion has an adhesive coated on its inner periphery. 2. The cover according to claim 1, wherein the second covering part is a region in which a part of the surface of the first covering part is thermally or chemically treated. a distal end portion having a treatment section for treating a target;
a columnar component connected to the tip;
a pipe connected to a side of the columnar component opposite to the side connected to the tip;
The cover according to any one of claims 1 to 5, which is attached from the tip end to the columnar component;
A forceps device comprising: The distal end portion has a joint portion for operating the treatment portion,
The forceps device according to claim 6, wherein the joint portion is not covered with the second covering portion.

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