JP6380937B2 - Tissue resection tool - Google Patents

Description

  The present invention relates to a tissue excision instrument for excising biological tissue.

  As a tool for excising tissue, for example, a cutting device disclosed in Patent Document 1 is known. As shown in FIG. 7, in the cutting device 50, a spiral knife 52 is rotatably accommodated inside a cylindrical outer member 51. A cutting edge 53 that is inclined with respect to the axis is formed at the tip of the outer member 51, and a part of the spiral knife 52 is exposed to the outside through the cutting edge 53.

  In the cutting device 50 having such a configuration, the spiral knife 52 cuts into the tissue and cuts by rotating the spiral knife 52 while pressing the distal end against the target tissue. The cut tissue is conveyed along the spiral groove 54 of the spiral knife 52 and is divided into pieces by the cutting edge 53. The segment is guided along the spiral groove 54 into the outer member 51 and sucked into the hollow interior of the spiral knife 52.

JP 2010-240467 A

  In order to remove the target tissue, the conventional cutting device 50 performs the excision work while changing the direction and the inclination angle of the outer member 51 with the tip pressed against the tissue. There is a room for improvement in this respect because it is likely that displacement due to slippage easily occurs between the tissue surface.

  Then, this invention aims at provision of the tissue excision instrument which can excise a desired biological tissue easily and correctly.

In order to achieve the above object, the device according to the present invention is:
An outer cylinder in which an opening having an arc-shaped cross section is formed on the outer peripheral surface of the tip, and the tip of the opening is connected to a disk-shaped lid that closes the tip ;
Inside the outer cylinder , a shaft body rotatably inserted toward the tip ,
A conveying member that is provided in a spiral shape on the outer peripheral surface of the shaft body and that cuts the surrounding tissue while the edge is exposed from the opening, and simultaneously conveys the cut surrounding tissue toward the root portion of the shaft body; ,
With
Some of the lid portion has a plane perpendicular to the axis of the outer cylinder, a tissue ablation instrument that constitutes the surrounding tissue engageable with the locking piece.

In the tissue excision instrument, it is preferable that a gap is formed between the distal end of the transport member and the lid so that the tissue that engages with the locking piece does not interfere with the transport member .

  ADVANTAGE OF THE INVENTION According to this invention, the tissue excision instrument which can excise a desired biological tissue easily and correctly can be provided.

It is a perspective view of the tissue excision instrument concerning one embodiment of the present invention. It is sectional drawing of the tissue excision instrument shown in FIG. It is a principal part expanded sectional view of FIG. It is a principal part end view of FIG. FIG. 5 is an enlarged cross-sectional view of another main part of FIG. 2. It is a principal part expanded sectional view of the tissue excision instrument concerning other embodiments of the present invention. It is a principal part perspective view of the conventional tissue excision instrument.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. FIG. 1 is a perspective view of a tissue excision instrument according to an embodiment of the present invention. As shown in FIG. 1, the tissue excision instrument 1 includes a hollow outer cylinder 10 that extends linearly, and a main body 20 that is fixed to a proximal end portion of the outer cylinder 10. A conveying member to be described later is provided. The main body 20 has a gripping portion 21 formed in a constricted shape at the center in the axial direction, and a practitioner can perform work by gripping the gripping portion 21 with a fingertip. A suction part 22 is provided on the proximal end side of the main body 20, and the suction part 22 is connected to a vacuum suction source (not shown) such as a vacuum pump during use.

  FIG. 2 is a cross-sectional view of the tissue resection instrument shown in FIG. 3 is an enlarged cross-sectional view of the distal end portion of the outer cylinder 10 shown in FIG. 2, and FIG. 4 is an end view of the distal end portion of the outer cylinder 10. As shown in FIGS. 2 and 3, an opening 11 is formed on the outer peripheral surface of the distal end portion of the outer cylinder 10. The opening surface of the opening portion 11 is inclined with respect to the axis L of the outer cylinder 10, and the distal end portion 11 a of the opening portion 11 is connected to a disc-shaped lid portion 12 that closes the distal end of the outer cylinder 10. Yes. As shown in FIGS. 3 and 4, the lid portion 12 has substantially the same diameter as the outer diameter of the outer cylinder 10, and a portion protruding from the connecting portion 11 a to the opening portion 11 toward the tip of the opening portion 11 The engaging piece 12a is engageable.

  The conveying member 30 is provided in a spiral shape on the outer peripheral surface of the shaft body 31, and an edge portion 30a for cutting tissue is formed on the outer edge. The edge portion 30 a is exposed at the distal end side from the opening portion 11, and cuts the tissue by the rotation of the conveying member 30. The conveying member 30 has substantially the same axial length as the outer cylinder 10 to be inserted, and conveys the tissue taken into the outer cylinder 10 from the opening 11 toward the proximal end side. A gap is formed between the tip of the transport member 30 and the lid 12 so that the tissue that engages with the locking piece 12 a does not interfere with the transport member 30.

  As shown in FIG. 2, the main body 20 includes a storage chamber 24 that stores the tissue transferred by the transfer member 30, and a rotation chamber 25 that is disposed on the proximal end side of the storage chamber 24. The storage chamber 24 and the rotation chamber 25 are separated by a partition wall 28. The shaft body 31 that supports the conveying member 30 in the outer cylinder 10 has a proximal end extending to the rotation chamber 25 through the storage chamber 24 and is rotatably supported by a bearing 27. An impeller 26 fixed to the shaft body 31 is disposed in the rotation chamber 25 and communicates with the outside through the suction part 22 and the introduction part 23. The material of the outer cylinder 10 and the shaft body 31 is not particularly limited, but is preferably a high-rigidity material that does not easily bend. For example, fine ceramics such as zirconia, cemented carbides such as tungsten carbide, and metal materials such as stainless steel Can be mentioned.

  The suction part 22 is connected to one end side of a tube-like suction flow path 40 disposed inside the main body 20. The other end side of the suction channel 40 extends to the vicinity of the proximal end side of the outer cylinder 10 facing the storage chamber 24. The suction flow path 40 communicates with the rotation chamber 25 via a large number of vent holes 42, and vacuum suction from the suction portion 22 introduces outside air from the introduction portion 23 to generate an air flow in the rotation chamber 25. The impeller 26 rotates together with the shaft body 31.

  FIG. 5 is an enlarged cross-sectional view of the proximal end portion of the outer cylinder 10 shown in FIG. As shown in FIGS. 2 and 5, a large number of vent holes 41 are formed at the tip of the suction flow path 40, and vacuum is sucked from the suction portion 22, so that the storage chamber 24 becomes negative pressure and the outer cylinder 10. A tissue or the like is aspirated from the opening 11 of the tube. The vent hole 41 is preferably sized so that gas can pass therethrough but tissue transferred to the storage chamber 24 cannot pass through. For example, a vent film can be used. Note that an auxiliary introduction part 21a communicating with the outside is formed in the grip part 21 of the main body 20, and the auxiliary introduction part 21a is closed with a finger or the like during treatment.

  In the tissue excision instrument 1 having the above-described configuration, by operating a vacuum source connected to the suction unit 22, suction force acts on the opening 11 of the outer cylinder 10, and the transport member 30 rotates. Therefore, by pressing the tip of the outer cylinder 10 against the tissue, the tissue is drawn into the outer cylinder 10 from the opening 11, and the tissue is divided by the rotation of the conveying member 30 in this state. The divided tissue is taken into the outer cylinder 10 from the opening 11, transported toward the proximal end side by the transport member 30, and stored in the storage chamber 24. In the transport member 30 of the present embodiment, the edge portion 30a is formed entirely along the outer edge, and the inner peripheral surface of the outer tube 10 and the edge portion 30a are also conveyed while the tissue is transported inside the outer tube 10. Since the tissue can be divided by the gap, the tissue can be subdivided and reliably conveyed. However, the edge portion 30 a can be formed only in a portion where the conveying member 30 is exposed from the opening portion 11.

  In the transport member 30 of the present embodiment, the helical pitch is constant, but the distal end side may be a narrow pitch in order to facilitate the tissue cutting in the opening 11. Further, in order to facilitate the conveyance of the tissue in the outer cylinder 10, the proximal end side of the conveyance member 30 can be widened. In order to reliably prevent clogging of the tissue in the outer cylinder 10, the transport member 30 may be non-axial, and the shaft body 31 may be connected to the proximal end portion of the transport member 30.

  Further, the conveying member 30 of the present embodiment is configured so that the edge portion 30a exposed from the opening portion 11 protrudes outward from the opening surface of the opening portion 11, thereby reliably cutting the tissue. Since the tissue to be cut is drawn into the outer cylinder 10 by suction from the opening 11, the edge portion 30 a exposed from the opening 30 a may not protrude from the opening surface of the opening 11.

  In the tissue excision instrument 1 of the present embodiment, the outer cylinder 10 is provided with a locking piece 12a that is connected to the distal end portion 11a of the opening 11 and can be engaged with the tissue. By burying the locking piece 12a, it is possible to maintain a state in which the distal end position of the outer cylinder 10 is fixed even when the direction and the inclination angle of the outer cylinder 10 are changed during the excision work. Therefore, desired tissue can be excised easily and accurately.

  Further, as in the present embodiment, by providing the locking piece 12a at the tip 11a of the opening 11 whose opening surface is inclined with respect to the axis L of the outer cylinder 10, the protruding length of the locking piece 12a is easy. The locking piece 12a can be reliably buried in the tissue. However, the shape of the opening 11 is not limited to that of the present embodiment, and various modifications can be made depending on the application. For example, when the tissue excision instrument 1 is used for excision of a tumor, as shown in FIG. 6, the shape of the opening 11 is made to have a circular arc shape so that most of the surface of the tumor fits in the opening 11. May be.

  The protruding direction of the locking piece 12a is not particularly limited as long as it can be reliably engaged with the tissue. However, as shown in FIG. 3, the axis of the opening 11 along the plane orthogonal to the axis L of the outer cylinder 10 is used. It is preferable that the locking piece 12a protrudes forward in the L direction. According to this configuration, the opening 11 can be easily opposed to the tissue to be excised while the locking piece 12a is buried in the tissue, and workability can be improved.

  The locking piece 12a having the configuration shown in FIG. 3 is easily formed by cutting out a part of the outer peripheral surface of the outer cylinder 10 so as to leave the lid portion away from the covered outer cylinder 10. Can do. Further, the locking piece 12a formed in this way is excellent in strength because the base portion is wide.

DESCRIPTION OF SYMBOLS 1 Tissue excision instrument 10 Outer cylinder 11 Opening part 11a Tip part 12 Lid part 12a Locking piece 20 Main body 21 Holding part 30 Conveying member 30a Edge part

Claims (2)

An outer cylinder in which an opening having an arc-shaped cross section is formed on the outer peripheral surface of the tip, and the tip of the opening is connected to a disk-shaped lid that closes the tip ;
Inside the outer cylinder , a shaft body rotatably inserted toward the tip ,
A conveying member that is provided in a spiral shape on the outer peripheral surface of the shaft body and that cuts the surrounding tissue while the edge is exposed from the opening, and simultaneously conveys the cut surrounding tissue toward the root portion of the shaft body; ,
With
A tissue excision instrument in which a part of the lid portion has a flat surface perpendicular to the axis of the outer cylinder and constitutes a locking piece that can be engaged with the surrounding tissue . The tissue excision instrument according to claim 1, wherein a gap is formed between the distal end of the transport member and the lid so that the tissue engaged with the locking piece does not interfere with the transport member.