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WO2012056769A1 - Instrument de microchirurgie médicale - Google Patents

Instrument de microchirurgie médicale Download PDF

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Publication number
WO2012056769A1
WO2012056769A1 PCT/JP2011/065283 JP2011065283W WO2012056769A1 WO 2012056769 A1 WO2012056769 A1 WO 2012056769A1 JP 2011065283 W JP2011065283 W JP 2011065283W WO 2012056769 A1 WO2012056769 A1 WO 2012056769A1
Authority
WO
WIPO (PCT)
Prior art keywords
arm
medical
support member
arms
pair
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2011/065283
Other languages
English (en)
Japanese (ja)
Inventor
内久 松村
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2012056769A1 publication Critical patent/WO2012056769A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/128—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord for applying or removing clamps or clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/2812—Surgical forceps with a single pivotal connection
    • A61B17/2841—Handles
    • 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
    • A61B17/2909—Handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/30—Surgical pincettes, i.e. surgical tweezers without pivotal connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A61B17/1227—Spring clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0042—Surgical instruments, devices or methods with special provisions for gripping

Definitions

  • the present invention relates to a medical micro-surgical instrument for performing an operation with emphasis on delicate movement and feeling of a fingertip under a microscope.
  • the term "medical use” here refers not only to pure medical treatment for human beings but also to biological experiments on experimental animals and tissues.
  • microsurgery Performing advanced surgery under a surgical microscope is called microscopic surgery or microsurgery.
  • precise exfoliation, incision, hemostasis, microvascular anastomosis, and the like are performed using a surgical microscope at a magnification of 3 to 20 times.
  • Such surgery spans areas such as neurosurgery, plastic surgery, orthopedic surgery, and transplantation surgery.
  • microvascular anastomosis a fine blood vessel anastomosis technique with a blood vessel diameter of about 0.3 to 2.0 mm
  • lymphedema Surgery such as lymphatic venule anastomosis and vascular anastomosis for organ transplantation.
  • cerebral aneurysm clipping is also performed under a surgical microscope.
  • a pair of elastic arms are provided to face each other, and the tip ends thereof are provided so as to be openable / closable. Also, there is a part that is integrated on the rear side, and a grip part that grips the rear part of the pair of arms with a fingertip, and the grip part is provided so that the distance between the pair of arms can be approached and separated.
  • the pair of arms has elasticity, and a desired operation can be performed by finely adjusting the gripping force against the elasticity.
  • Patent Document 1 Prior art documents were investigated. As a result, the medical tip opening / closing device described above was found to be provided with a recess having a size that allows the abdomen of the finger to enter the gripping portion of the tweezers.
  • Patent Document 1 does not affect the patentability of the present application.
  • Non-Patent Document 1 two cases in which the support member protrudes from the arm have been discovered as medical tip opening / closing devices that are different in shape from the application of the present application but are similar in shape.
  • Non-Patent Document 1 These are not used under a surgical microscope, nor are they gripped with the fingertips, but are medical tip opening / closing devices that can be grasped firmly with the palm of your hand. I use it. Therefore, Non-Patent Document 1 also does not affect the patentability of the present application in which the delicate movement of the fingertip is a problem.
  • microtweezers are usually held in a way called a pen holder method. That is, it is a holding method that supports the lower side of the end portions of the pair of arms near the base of the index finger while attaching the tip of the thumb and the tips of the index and middle fingers to the surface of the pair of arms. In such a way of holding, it is in contact with the pair of arms at four points.
  • the reason why such a problem occurs is that the holding of (1) and the opening / closing movement of (2) are performed only by holding the fingertip with the thumb and index finger.
  • the holding of (1) is important in order to prevent the risk of damage to biological tissue (such as the brain) due to the fall of the instrument.
  • the opening / closing movement of (2) is closely related to the surgical result. If the burden on the fingertips, particularly the thumb, can be reduced in the holding of (1), the fingertips, especially the thumb feeling and fingertip movements can be concentrated in the opening / closing movement of (2). As a result, it is presumed that good surgical results can be obtained.
  • the present invention was created in view of the above circumstances, and its purpose is to reduce the burden of the thumb in holding (1) on the medical tip opening / closing device as much as possible, In particular, it should be possible to concentrate the thumb sensation and fingertip movement.
  • a pair of elastically deformable arms are provided opposite to each other, and their front end portions are provided so as to be openable and closable, and are integrated on the rear side of the front end portions, and the rear portions of the pair of arms are gripped by a fingertip. It is assumed that the grasping portion is a medical microsurgical instrument in which the gap between the pair of arms can be approached and separated.
  • the grip portion of one arm is provided with a support member on the surface side, and the support member can be sandwiched between the index finger and the middle finger, and is separated from the other arm. It protrudes in the direction.
  • the invention of the present application is as follows if its application is clarified. That is, as in the invention of claim 2, the surgical instrument is held under a microscope with a tweezer, a needle holder, a scissors blade, a clip forceps, a bipolar coagulation hemostasis lever and other fingertips.
  • the shape of the support member is not limited, but it is desirable that the support member is easily sandwiched between the index finger and the middle finger. That is, as in the third aspect of the invention, the support member has a rod shape, the thickness is smaller than the thickness of the finger, and the protruding length from the arm is equal to or greater than the thickness of the finger.
  • the support member may be provided so as not to be detachable from the arm. However, if the position of the support member can be changed, the usability is improved. That is, as in the invention of claim 4, the support member is detachably provided on the arm, the attachment / detachment connecting portion is provided on the arm, the connected portion is provided on the support member, and the arm operation portion is provided with its longitudinal The connected parts are provided at intervals along the direction, and the connected parts with respect to the connecting parts are provided so as to be selectable.
  • the support member is detachably attached to the arm, the attachment / detachment connecting portion is provided on the arm, the connected portion is provided on the support member, and the connected portion is provided on the pair of arms. It is provided in each operation part, and it is provided so that a to-be-connected part to a connection part can be selected.
  • connection structure of the connecting part and the connected part does not matter.
  • the connecting portion is a male screw and the connected portion is a female screw hole.
  • the surgeon can stably hold the medical microsurgical instrument by holding the supporting member protruding from one arm between the index finger and the middle finger. Therefore, the surgeon can concentrate on the opening / closing movement of the tip part with the thumb feeling and fingertip movement pushing the other arm. As a result, it is possible to drastically reduce the tremor of the surgeon, etc., perform precise surgical operations under a microscope, and expect good surgical results.
  • the ability to hold the medical microsurgical instrument stably and stably enables more accurate fingertip movement, especially when using a hand opposite to the dominant hand or a person who has little experience with surgery. I can expect.
  • the surgeon can easily hold the support member between the index finger and the middle finger.
  • the support member can be attached to and detached from the arm and the attachment location can be selected, the operator can change the position of the support member and the usability is improved.
  • the support member is sandwiched between the index finger and the middle finger of the gripped hand, even when gripped by either the right hand or the left hand. be able to.
  • the connected portion is a female screw hole, the connected portion does not protrude from the surface of the arm. Therefore, the connected portion to which the connecting portion is not attached is not disturbed when the grip portion is gripped by the fingertip, and is easy to use.
  • FIG. 1 It is a perspective view which shows the use condition of 1st embodiment in the medical microsurgical instrument of this invention. It is a disassembled perspective view which shows 1st embodiment in the medical microsurgical instrument of this invention. It is a perspective view which shows 2nd embodiment in the medical microsurgical instrument of this invention. It is a perspective view including a partially enlarged front view showing a third embodiment of the medical microsurgical instrument of the present invention. It is an excerpt of a catalog showing a conventional Hakuba cervical spreader. It is an excerpt of a catalog showing a conventional steele Ruskin round chisel forceps.
  • the micro tweezers 1 includes a pair of arms 2 and 3 and a support member 4 detachably attached to one arm 2.
  • Each arm 2, 3 is a thin plate (plate spring) that can be elastically deformed, and is curved in the thickness direction.
  • the pair of arms 2 and 3 are provided to face each other, and are integrated at the end portions of each other, and at portions other than the end portions (portions on the tip side with respect to the end portions), they are outside each other. Curved and thereby spaced apart.
  • interval which is spaced apart approaches by gripping a pair of arms 2 and 3 with a fingertip against elasticity (force of a leaf
  • the grip portions 21 and 31 gripped by the fingertips in this way are the rear portions of the pair of arms 2 and 3.
  • three connected portions (female screw holes) 22 are formed in the grip portion 21 of one arm 2 at intervals along the longitudinal direction thereof.
  • the female screw hole 22 penetrates in the thickness direction.
  • a support member 4 is selectively and detachably attached to the female screw holes 22.
  • the support member 4 has a rod shape and is provided with a connecting portion (male screw 41) at one end thereof.
  • the support member 4 attached to one arm 2 protrudes in a direction away from the other arm 3.
  • the support member 4 has a columnar shape, and the optimum projection length is 2 to 3 cm and 2.5 cm. Further, the thickness is narrower than that of a human finger, more specifically, it is narrower than the plate width of the arm 2, and the specific value is a diameter of 2 to 5 mm or 3 mm.
  • the micro tweezers 1 described above are used as shown in FIG. While holding the end portions of the arms 2 and 3 of the micro tweezers 1 on the upper side of the base of the index finger, the support member 4 is sandwiched between the first joint of the index finger and the middle finger, and the fingertip of the middle finger is gripped by the arm 2 on the back side in the figure
  • the micro tweezers 1 can be held by pressing against the surface of the portion 21. If it does so, the adjustment of the force which presses a thumb with respect to the holding part 31 of the arm 3 on the near side in the figure can be assigned only to the delicate opening / closing movement with respect to the tip parts of the pair of arms 2 and 3.
  • the distance between the pair of arms 2 and 3 approaches and separates, and the tip portion can be opened and closed.
  • the surgeon may change the mounting position of the support member 4 with respect to one arm 2 according to his / her preference.
  • FIG. 3 shows a bionet-type needle holder 11 for deep operation as a second embodiment of the medical microsurgical instrument of the present invention.
  • a support member 4 is attached to the arm 2 on the right hand side.
  • Female screw holes 22 and 32 are respectively provided in the gripping portions 21 and 31 of the pair of arms 2 and 3 so that the support member 4 can be attached to both the right and left arms 2 and 3.
  • the needle holder 11 also has a support member 4 detachably attached to one arm 2 in the same manner as the microtweezers 1 of the previous example.
  • the position where the pair of arms 2 and 3 are integrated is provided not only at the end portions of each other but also slightly behind the tip portion.
  • the pair of arms 2 and 3 intersect each other slightly behind the tip, and the shaft 5 is attached to the intersecting portion.
  • tip part opens and closes centering on the axis
  • Non-slip irregularities are formed on the surfaces of the grip portions 21 and 31.
  • the arms 2 and 3 are thinner at the rear portions than the grip portions 21 and 31, and these portions are elastically deformable portions (plate springs).
  • FIG. 4 shows a bionet-type clip forceps 12 for deep operation as a third embodiment of the medical microsurgical instrument of the present invention.
  • the clip forceps 12 has the same opening / closing structure as the needle holder 11 of the second embodiment.
  • arc-shaped depressions 23 and 33 are provided on the opposing surfaces of the tip portions of the pair of arms 2 and 3, respectively.
  • claw pieces 24 and 34 protrude from opposite surfaces of the rear portions of the pair of arms 2 and 3, respectively.
  • the clip 6 gripped by the clip forceps 12 forms a circular loop portion 61 by bending one metal spring, and leg portions 62 and 63 extend from both ends of the loop portion 61, respectively.
  • the pair of leg portions 62 and 63 intersect at a position slightly away from the loop portion 61 and usually overlap in parallel from the intersecting portion to the tip due to the spring property.
  • the tip portions of the pair of arms 2 and 3 are in an open state, the interval between the opposing depressions 23 and 33 is widened, and the loop portion 61 is released between the two.
  • the pair of legs 62 and 63 are closed, for example, a cerebral aneurysm is sandwiched, and hemostasis / treatment is completed. Thereafter, the operator moves the clip forceps 12 and leaves the clip 6 in the brain.
  • FIG. 4 are not limited to the tweezers 1, the needle holder 11, and the clip forceps 12, and the usage method of the medical micro surgical instrument is the same. That is, the method of use projects from one arm 2 between two of the four fingers other than the thumb in one hand (more preferably, between the index and middle fingers of one hand (between the first joints depending on the surgeon)).
  • the medical micro surgical instrument is held, and the force applied to press the thumb of the same hand against the grip portion 31 of the other arm 3 is delicately applied to the distal ends of the pair of arms 2 and 3. It can be assigned only to opening and closing movements.
  • the medical microsurgical instrument is not limited to the tweezers 1, the needle holder 11, and the clip forceps 12, but may be a surgical instrument under a microscope that is gripped by a cutting blade, a bipolar coagulation hemostatic hemostasis, or other fingertips (not shown). . Further, as described in the section of means for solving the problem, it is possible to appropriately change the shape and the like within a range not changing the gist of the present invention.

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

Abstract

La présente invention concerne un instrument de microchirurgie médicale ayant des extrémités qui peuvent être ouvertes et fermées l'une par rapport à l'autre. L'instrument de microchirurgie médicale est constitué d'une paire de bras élastiquement déformables qui se trouvent l'un en face de l'autre, la paire de bras ayant des extrémités qui peuvent être ouvertes et fermées l'une par rapport à l'autre, la paire de bras ne formant qu'une seule partie à une position à l'arrière des extrémités, la paire de bras ayant des parties arrières adaptées à servir de sections de préhension destinées à être saisies par le bout des doigts, l'espace entre les bras de la paire de bras au niveau des sections de préhension étant configuré de manière à ce que les sections de préhension puissent s'approcher et s'éloigner l'une de l'autre. L'instrument de microchirurgie médicale est caractérisé en ce qu'un élément de support est fourni sur le côté de la surface avant de la section de préhension de l'un des bras, l'élément de support pouvant être saisi entre l'index et le majeur, l'élément de support se projetant dans la direction dans laquelle l'élément de support se sépare de l'autre bras.
PCT/JP2011/065283 2010-10-26 2011-07-04 Instrument de microchirurgie médicale Ceased WO2012056769A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2010-239842 2010-10-26
JP2010239842A JP4734469B1 (ja) 2010-10-26 2010-10-26 医療用マイクロ手術器具

Publications (1)

Publication Number Publication Date
WO2012056769A1 true WO2012056769A1 (fr) 2012-05-03

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PCT/JP2011/065283 Ceased WO2012056769A1 (fr) 2010-10-26 2011-07-04 Instrument de microchirurgie médicale

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JP (1) JP4734469B1 (fr)
WO (1) WO2012056769A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2014117438A (ja) * 2012-12-17 2014-06-30 Shoichi Nakamura 外科手術用器具

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP5824182B1 (ja) 2015-06-29 2015-11-25 ジャスト株式会社 把持具の把持面のめっき処理方法及び把持具
JP7540686B2 (ja) * 2020-02-25 2024-08-27 国立研究開発法人情報通信研究機構 先合いばさみ
JP7627018B2 (ja) * 2020-08-26 2025-02-05 国立大学法人金沢大学 医療用器具
CN112451046B (zh) * 2020-11-13 2025-07-15 佛山市中医院 一种造痿口专用显微镊

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2685880A (en) * 1952-09-19 1954-08-10 Curutchet Pedro Domingo Compass-forceps for surgery and the like
JPS58140055U (ja) * 1982-03-11 1983-09-20 久井　宗裕 止め具付ピンセツト
JPS63108374U (fr) * 1986-12-30 1988-07-13
JPH08945U (ja) * 1993-12-28 1996-06-11 清 松尾 手術用器具の落下防止ホルダ
JPH0975361A (ja) * 1995-09-14 1997-03-25 Mizuho Ika Kogyo Kk 医療用鋼製器具
US20040145201A1 (en) * 2003-01-24 2004-07-29 Cho Yong Hoon Padded tweezers

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2685880A (en) * 1952-09-19 1954-08-10 Curutchet Pedro Domingo Compass-forceps for surgery and the like
JPS58140055U (ja) * 1982-03-11 1983-09-20 久井　宗裕 止め具付ピンセツト
JPS63108374U (fr) * 1986-12-30 1988-07-13
JPH08945U (ja) * 1993-12-28 1996-06-11 清 松尾 手術用器具の落下防止ホルダ
JPH0975361A (ja) * 1995-09-14 1997-03-25 Mizuho Ika Kogyo Kk 医療用鋼製器具
US20040145201A1 (en) * 2003-01-24 2004-07-29 Cho Yong Hoon Padded tweezers

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2014117438A (ja) * 2012-12-17 2014-06-30 Shoichi Nakamura 外科手術用器具

Also Published As

Publication number Publication date
JP2012090724A (ja) 2012-05-17
JP4734469B1 (ja) 2011-07-27

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