• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:

    公开号:DK152997A
    申请号:DK152997
    申请日:1997-12-23
    公开日:1998-08-12
    发明作者:Ouchi Teruo
    申请人:Asahi Optical Co Ltd；
    IPC主号:
    专利说明:

    The invention relates to a surgical stripper which can be inserted into a trocart for use in endoscope observation to strip an internal part of the body cavity from surrounding connective tissue, in recent years, surgery under observation in endoscope has been widely used for various medical and surgical treatments. , such as gallbladder removal, since surgery under observation in the endoscope can be performed without a large incision. Surgery under observation in the endoscope is typically done by inserting several thin and tubular trocars into which surgical instruments and an endoscope are inserted through the body wall. As one of the surgical instruments, a hook-shaped or spatula-shaped high-frequency stripping cang is used to strip or remove the surrounding connective tissue from the internal organ or equivalent, which is the target of surgery, by collecting the surrounding connective tissue and supplying high-frequency current to and through the tissue thus collected. Such a hook-shaped or spatula-shaped high frequency stripping rod is shown, for example, in ILLUSTRATED HANDBOOK OF LAPAROSCOPIC & THORACOSCOPIC SURGERY "and" SURGICAL LAPAROSCOPY11. However, the use of high frequency stripping pliers requires the physician to have hands and experience since a so-called accidental injury such as cutting and bleeding can be caused if a high frequency current is applied in the event that the pliers negatively touch the gallbladder, the gallbladder artery or the like. Since the physician usually operates the high-frequency stripping rod while viewing a TV monitor displaying a two-dimensional image obtained with a rigid endoscope or electronic endoscope, the physician must judge the depth of direction through his hand craft and experience.
    Thus, it is an object of the invention to provide a surgical stripper which is adapted to be inserted into a trocar map for use under observation in an endoscope and which can safely strip the surrounding connective tissue from an internal organ or the like.
    To achieve this object, the invention provides a surgical stripper for use in endoscopic observation, which is intended to be inserted into a trocart for stripping the surrounding connective tissue from an internal organ or similarly within the body cavity. of the insertion portion, and a handle is connected to the base portion of the insertion portion.
    It is preferred that the insert portion has a diameter equal to or less than 12 mm and a length equal to or less than 500 mm. It is further preferred that the insertion member has a diameter equal to or greater than 5 mm and has a length equal to or greater than 250 mm.
    An aperture used for at least either suction of a liquid or equivalent from a body 3 cavity or injection of a liquid into the body cavity may be provided at the low end of the insertion portion. In this case, the aperture is formed in a place which is surrounded by the bristles. The aperture may be formed at a location outside the bristled area so that the aperture points forward.
    In addition, control means may be provided at the handle for controlling at least either suction treatment or water supply treatment via the orifice.
    A portion on which the bristles are disposed may be removable from the distal end of the insertion portion.
    Further, several elements may be provided which have bristles arranged in various shapes so that they may optionally be attached to the distal end of the insertion portion.
    The bristles may be placed on a J-shaped bar or on an elliptically bent bar. Further, the bristles may be disposed on an outer end of the distal end of the insertion portion.
    Since the insertion portion adapted to be inserted into the trocar map is shaped such that the bristles are disposed at the distal end of the insertion portion, it is possible to safely strip the surrounding connective tissue from the internal organ or correspondingly into body cavity under observation in the endoscope. to scrub it with the bristles.
    In addition, it is easily possible to eliminate a stain due to bleeding or the like on the part to be stripped, in case the suction and / or fluid supply opening is provided at the distal end of the insertion portion, thus ensuring a clear field of view for observation through endoscope
    In addition, in the case where an element to which bristles.e are placed is removably attached to the distal end of the insertion part, it is possible to facilitate washing and replacement of the bristles. Further, if several elements equipped with bristles of various shapes, which are selectively fastenable on the distal end of the insertion portion, it is possible to select a suitable one of the number of elements depending on the location where it is to be used.
    The present disclosure relates to the technique contained in Japanese Patent Application No. POS-344771 filed there. December 25, 1397, which application is hereby incorporated by reference in its entirety.
    FIG. Figure 1 is a side view of a surgical stripper for use in endoscope observation; 2 is a schematic view illustrating a surgical device on endoacopic observation, in which the stripper shown in FIG. i is used, fig. 3 is a plan view of the stripper shown in FIG. 1, FIG. 4 is a side sectional view of the distal end of the stripper shown in FIG. 1, FIG. Figure 5 is a sectional view from below of the distal end of the stripper shown in Figure 1; 6 is a perspective view showing the stripper of FIG. 1 in use; FIG. 7 is a side sectional view of the distal end of another stripper; FIG. 8 is a sectional view from below of the distal end of the stripper shown in FIG. 7, FIG. 9 is a side view of the stripper shown in FIG. 7, wherein is. control valve is shown as a sectional view, fig. 10 is a sectional view of the control valve in a suction condition; FIG. 1 is a sectional side view of the control valve in a water supply condition; FIG. 12 is a side sectional view of the distal end of a third stripper; FIG. 13 is a side sectional view of the distal end of a fourth stripper; FIG. 14 is a side sectional view of a control valve in a fifth stripper; FIG. 15 is a perspective view of the distal end of a sixth stripper; FIG. 16 is a perspective view of the distal end of a seventh stripper in use; FIG. 17 is a side view of the distal end of an eighth stripper; FIG. 18 is a side view of the distal end of a ninth stripper; FIG. 19 is a perspective exploded view of the distal end of the stripper of FIG. l.
    Pig. 2 shows an arrangement of surgical instruments under observation in the endoscope. Reference numeral 1 corresponds to a trocart which is pierced or traversed through the body wall 100 from the outside so that the distal end thereof reaches the inside of the body cavity.
    The trocart 1 is a tube with a collar at its proximal end (actuating end or end located externally when the trocart is inserted into the body cavity}. In the case shown in Fig. 2, four trocars 1 are used.
    An endoscope 2 is inserted into a first trocart 1, which makes it possible to observe the surgical area within the body cavity from the outside of the body.
    In this case, a rigid endoscope is used as the endoscope 2, and is inserted into the trocart 1. An image taken by a TV camera attached to an ocular is processed in the video processor so that an image observed in the endoscope appears on the TV monitor. 4. Reference numeral 5 corresponds to a pneumoperitoneum, for supplying air into the body cavity through a duct in the endoscope.
    A high frequency treatment tool S, for cutting or the like within the body cavity, is introduced into another trocart 1. An electrical surgical unit 7 is connected to a high frequency treatment tool 6 and constitutes a power source thereof. The suction device 8 and the water supply device 9 are connected to the high frequency tool s for performing suction and water supply via the high frequency tool 6.
    A suture clip device 10 or similar is inserted in a third trocart in which device can be remotely controlled from the outside of the body for sewing an area cut by the high frequency tool 6.
    A stripper 20 is inserted into a fourth trocart 1 The stripper 20 has an insertion portion 21 intended to be inserted into the trocart 1 on the distal end of which bristles 22 are disposed and to whose proximal end a handle 23 is connected. The stripper 20 may be designed to have a suction function and a water supply function, in which case the suction device β and the water supply unit 9 are connected to the stripper 20.
    FIG. 1 and FIG. 2 is a side view and a plan view, respectively, of the stripper 20. The insertion portion 21 is arranged such that a brush rod 24, on which bristles 22 are applied, is removably attached to the tip of the connecting rod 25. Nylon or the like is used as material for the bristles 22. The bristles 22 extend from the brush rod 24 in one direction {in the downward direction in FIG. 3). The brush rod 24 is bent at a portion 24a such that a horizontal portion of the brush rod 24 is set in a direction opposite to a direction in which the brush heads 22 extend from the brush rod 24.
    The outer diameter of the insert portion 21 is set to be equal to or less than 12 mm even at the largest portion, taking into account the inner diameter of the trocart 1. It is preferred that the outer diameter of the insert portion 21 be equal to or greater than ca. 5 mm, taking into account strength and practicality.
    The length L of the insertion portion 21 is preferably approx. 300 mm for use in an internal chest operation. For an internal abdominal operation, the length L is preferably not more than 500 mm. 250 mm, taking into account the length and so on of the trocart 1.
    FIG. 4 and FIG. 5 is a side sectional view and a planar sectional view, respectively, of the insertion portion 21. Brushes 22 are circularly shaped: as shown in Fig. 5, when viewed in a direction from the distal end of bristles 22 * Brushing rod 24 is inserted into a slot 28 formed at the upper end of the connecting rod 25. As shown in FIG. 19, the gap 29 is formed at least in an area where the brush rod 24 is to be inserted.
    Two pins 26 disposed on the tie rod 25 to cross the slot 26 engage with recesses in the slot 27 which are formed axially on the brush rod 24. The foremost pin 26 abuts the foremost recess, which recess constitutes an axial end. of the slit. 27, so that too long insertion of the brush rod 24 into the connecting tube 25 is avoided. As shown in FIG. 4, the thickness of the brush rod 24 in the longitudinal direction of the pin 26 is equal to or slightly less than the thickness of the slot 29. Further as shown in FIG. 5, the slot 28 extends (passes) across the full width of the connecting rod 25 in a direction perpendicular to both the longitudinal direction of the pin 26 and the longitudinal direction of the connecting rod 25, and the width of the brush rod 24 is equal to the width of the connecting rod 25 (the slot 28). .
    According to this, the brush rod 24 is usually attached to the upper end of the connecting rod 25, but the brush rod 24 can be removed from the connecting rods. 25 if the brush rod 24 is forcefully pulled forward while the connecting rod 25 is gripped. This removable design facilitates washing and replacement of the brush rod 24 and facilitates the optional replacement of brush bars which have bristles arranged in various shapes.
    The stripper 20 so formed is used as shown in FIG. 6 by pressing the tip of the bristles 22 against the surrounding tissue 101, such as the bile duct or bile artery, and the stripper. 20 is moved back and forth along its axis as shown by arrow A,
    The surface of the bile duct and the bile artery is hard because, for example, the artery has a three-layer structure consisting of an inner membrane, an intermediate membrane and an outer membrane. In contrast, the surrounding tissue is relatively soft and is not covered by the outer membrane. Therefore, the surrounding tissue can easily strip off by scrubbing it with the bristles 22, while the outer membrane of the bile duct or bile artery does not break, even if scrubbed with the bristles 22. It is the same with other internal organs.
    As bristles 22 is a nylon hair having a diameter of approx. 0.05 mm to approx. 0.1 ir.m desirable when the object to be stripped of surrounding tissue is a blood vessel or tube of approx. 2 mm. A nylon hair with a diameter of approx. C, 1 rr.m to approx. 0.3 mm is desirable when the object to be stripped of surrounding tissue is a blood vessel or tube of approx. 3 mir ,.
    FIG. 7 and Fig. Θ are a side sectional view and a sectional view, respectively, of an insertion portion 21 of another stripper. An opening 31 for suction and water supply is formed centrally in the area where bristles are placed.
    A passage 33 is formed along the central axis of the connecting rod 25 throughout the length of the torque connecting rod 25. The rear half of the brush rod 24 is removably inserted into the upper end of the passage 33, a pin 26 disposed on the connecting rod 25, extending across the passage 33 cr in engagement with the slot 27 formed on the brush rod 24 similar to the previous stripper shown in FIG. b. That is, pin 26 engages a recess formed as an axial end of slot 27.
    A connecting bore 32 is formed behind the opening 31 and connected to the opening 31 for suction and water supply, and the opening 31 is connected to the passage 33 in the connecting rod 25 via the connecting bore 32.
    As shown in FIG. 9, a syr valve 40 is provided in a handle 23 connected to the proximal end of the connecting rod 25. A guide piston 42 is inserted into a cylinder 41 perpendicular to the connection S3 the plunger 25 and the handle 23 so that it is reciprocated along the axis. thereof.
    One end of the passage 33 passing through the connecting rod 25 opens into the middle portion of the cylinder 41. A suction passage 43 and a water supply passage 44 open into the cylinder 41 on the opposite side relative to the opening of the passage 33. The suction passage 43 is connected to the suction device S via a suction pipe 45, and the water supply passage 44 is connected to the water supply device 9 via ct water supply pipe 46.
    In the guide piston 42, two circumferential grooves 48 and 49 are spaced apart within the cylinder 41. Several O-rings, not shown, are arranged on the guide piston 42 for sealing purposes.
    Both ends of the guide plunger 42 extend beyond the cylinder 41. Animal buttons 51 and 52 are attached to the respective projecting ends. Reference numerals 53 and 54 correspond to compression-screw springs for return stroke. Reference numerals 55 and 56 correspond to the washers for the springs.
    Reference numeral 60 corresponds to a pawl mechanism provided to stop the temple 4 2 being controlled in the condition shown in FIG. 9, wherein the control valve 40 is closed. This mechanism is designed such that a ball pressurized by a spring engages a v-foxed groove formed in the guide piston 42.
    The control valve 40 so formed is operated such that if the first control button 51 is pressed in the bottom as shown in FIG. 10, the suction passage 43 is connected to the passage 33 via the first annular groove 48 to enable the suction from the opening 31 to be disposed at the distal end of the insertion portion 21.
    If the second control button 52 is pressed in the bottom, as shown in Fig. 11, then the water supply passage 44 will be connected to the passage 33 via the second circumferential groove 49 to allow water to be supplied from the opening 31 located at the distal end of the insertion portion 21 .
    According to this, blood flowing from the capillary vessels and so on is easily sucked and removed during the stripping operation with the insertion portion 21 so as to ensure an excellent field of view during the endoscopic observation.
    In addition, since bristles 22 are disposed around aperture 31 for suction and water supply, blood vessels and internal organs will not be drawn directly into aperture 31, although the eye force is ator, and therefore suction treatment can be performed easily and safely.
    Hair part which is to be stripped cannot be seen due to bleeding and so on which obstructs a field of vision in the endoscopic observation, the part can be washed by water supplied from the opening 31 and then the dirty liquid after washing can be removed by suction.
    Pig. 12 shows the distal end of yet another stripper 20, where the brush rod 24 and the connecting rod 25 are connected via threaded engagement to facilitate removal and replacement of the brush rod 24.
    FIG. 13 shows the distal end of yet another stripper 2Q, in which the opening 31 for suction and water supply is formed at the surface of the brush rod 24, on the portion not provided with bristles 22, thereby providing water directly and strongly to the a sick part to wash it when, for example, there is severe bleeding. The suction can also be performed quickly.
    Fig. 14 shows another bull event 11 in 40, where the change between the suction mode and the waterfox sewing condition occurs in one movement, i.e. by pressing the guide pin 42 into the cylinder 41.
    The control valve 40 shown in FIG. 14 is formed such that the suction tube 45 is connected to one end of the cylinder 41, and is. ventilation opening 61 is drilled in the ceraxial axis of the temple 42 which projects from the other end of the cylinder 41 so as to pass through, plunger 42.
    Therefore, the suction device 8 is free of high load, although the suction device a is always activated for suction through the suction tube 45, because the surrounding air can be sucked through the vent opening 61, the first annular groove 48, for connecting the suction tube 45 with the passage 33 down ventilation opening 61.
    In order to return the piston 42 to the stand-by position, a first return spring 53a with a small spring force and a second return spring 53b with a large spring force with a disc 55 are mounted in series on the control valve 40 in series.
    Therefore, when the guide pin 42 is pressed into the cylinder 41 within the range where the first return spring 53a can compress, the water supply tube 46 and the passage 33 are interconnected through the second annular groove 49 to establish the water supply state.
    When the guide plunger 42 is further pressed into the interval where the second return spring 53b can also be compressed, provided that the vent opening 61 is closed with a fingertip, the suction tube 45 and the passage 33 are interconnected through the first annular groove 48 to establish suction mode.
    The supply of bristles is not limited to the strippers described above, that is, various bristles can be used according to the condition of the part to be stripped.
    For example, bristles 22 may be disposed in a long area as shown in Fig. 15 when stripper 20 is applied to a large arela. The bristles may also be radially disposed in a J-shaped bar as shown in FIG. 1, and the brush rod 24 is then preferably moved in the lateral direction shown by arrow B when a portion facing away from the stripper 20 is to strip.
    When a small portion is stripped, as shown in FIG. 1 "7, the bristles may be placed radially on the tip of the brush rod 24 and a portion to be stripped may be struck by the tip. When a deep stripping is required, as shown in FIG. 18, the bristles may be radially disposed on an elliptically bent rod. .
    Further, the bristles 22 can be vibrated in the same way as with an electric toothbrush.
    权利要求:
    Claims (16)
    [1]
    A surgical stripper which may be inserted into a trocar for use in endoscope observation for stripping a predetermined internal body cavity space from surrounding connective tissue, characterized by an elongated insertion portion, bristles disposed on a distal end of the insertion portion, and a handles located in a proximal end portion of the insertion portion.
    [2]
    Surgical stripper according to claim 1, characterized in that the insertion portion has a diameter equal to or greater than 5 mm and less than 12 mm.
    [3]
    Surgical stripper according to claim 2, characterized in that the insertion portion has a length equal to or longer than 250 mm and shorter than 500 mm.
    [4]
    Surgical stripper according to claim 1, characterized in that the bristles are arranged in circular form. from the distal part of the bristles.
    [5]
    Surgical stripper according to claim 4, characterized in that it further comprises an opening at the distal end of the insertion portion, which opening is in communication with the proximal end portion of the insertion portion.
    [6]
    Surgical stripper according to claim 5, characterized in that the opening is encircled by the bristles.
    [7]
    Surgical stripper according to claim 5, characterized in that the opening is forward and is placed outside the area provided with bristles.
    [8]
    Surgical stripper according to claim 6, characterized in further comprising means arranged on said handle and arranged to connect the opening down either a suction wedge or are. source of water.
    [9]
    Surgical stripper according to claim 1, characterized in that the distal end of the insertion member comprises a first element on which the stock facial hairs are arranged and a second element on which the first element is removably supported.
    [10]
    Surgical stripper according to claim 9, characterized by further comprising a third element on which bristles are arranged in a second form, said third element being connectable to said second element instead of the first element.
    [11]
    Surgical stripper according to claim 1, characterized in that the dislocated end of the insertion member is connected to a J-shaped rod.
    [12]
    Surgical stripper according to claim 1, characterized in that the distal end of the insertion part is formed into an elliptically bent rod.
    [13]
    Surgical stripper according to claim 1, characterized in that the bristles extend radially from an upper end of the distal end of the insertion part
    [14]
    Surgical stripper according to claim 7r, further comprising means disposed on said handle to provide connection between the opening of at least either a suction source or a water supply source.
    [15]
    15- Surgical stripper as claimed in claim, characterized in that the bristles are made of nylon.
    [16]
    The surgical stripper of claim 1, characterized in that the bristles are located in an elongated region the length of which is greater than the width. InternatPatent-Bureau fj. / i / / 7,
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    同族专利:
    公开号 | 公开日
    JPH10179594A|1998-07-07|
    GB2320683A|1998-07-01|
    GB9727223D0|1998-02-25|
    DE19757676A1|1998-07-16|
    GB2320683A8|1998-10-15|
    引用文献:
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    WO2003100307A1|2002-05-24|2003-12-04|Bindesboel Tommy|Support beam comprising at least one longitudinal profile which profile forms a longitudinal passage|DE4125806C2|1991-08-03|1993-06-17|Richard Wolf Gmbh, 7134 Knittlingen, De|US6371934B1|1997-08-06|2002-04-16|C. R. Bard, Inc.|Irrigation system and tip with debrider|
    US20050171467A1|2004-01-30|2005-08-04|Jaime Landman|Multiple function surgical device|
    CN100376217C|2006-03-31|2008-03-26|暨南大学|Subcutaneous separation stick for endoscopic thyroid surgery|
    CN100376218C|2006-03-31|2008-03-26|暨南大学|Muscle separation device for endoscopic thyroid surgery|
    EP2851031B1|2012-05-14|2017-07-12|National University Corporation Shiga University OF Medical Science|Organ resection tool|
    JP2016077646A|2014-10-17|2016-05-16|高周波熱錬株式会社|Organ separation operation tool|
    CN110141302B|2019-06-05|2020-05-29|青岛市黄岛区中心医院|Gout crystallization clearing device|
    法律状态:
    2001-07-30| AHB| Application shelved due to non-payment|
    优先权:
    申请号 | 申请日 | 专利标题
    JP8344771A|JPH10179594A|1996-12-25|1996-12-25|Exfoliation tool for operation under observation with endoscope|
    JP34477196|1996-12-25|
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