JPH03143437A - Surgical ablation tool - Google Patents

Abstract

PURPOSE:To use a cutter as two cutters, to shorten an operational time and to attempt to improve efficiency by making two blade shapes formed with an inner blade and an outer blade different each other. CONSTITUTION:When an inner tube 22 is rotated and driven in the clockwise direction by controlling a foot switch 18, an outer blade 28 and the second blade 37 with a sawtooth-shape cooperatively perform cutting of a diseased part. Cutting of a diseased part suitable to a cutting blade shape formed with the second blade 37 having a sawtooth-shape and the outer blade 28 is thereby performed. As the first blade 36 having a circular arc-shape and the second blade 37 having a sawtooth-shape are provided on an inner blade 33, it is possible to cut two diseased parts with different shapes by changing the rotating direction of the inner tube 22. It is therefore unnecessary to exchange the inner tube 22 in accordance with a cutting part as in the conventional case resulting in shortening of the operational time.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a surgical resection instrument for puncturing into a joint cavity or the like to resect a diseased part.

[Prior art and problems to be solved by the invention] Conventionally,
Joint surgery was primarily performed using the open method. For example, a typical joint surgery is on the patella! There are methods such as removing a 1ffi tumor or removing damaged cartilage from a knee joint, but they require a large incision. Therefore, it has the disadvantage that it takes a long time to completely heal due to the trauma and pain caused by the incision.

In addition, it is not suitable for resecting tissue in a narrow cavity, such as cartilage such as a meniscus in a joint cavity, or a site with a medial joint.

For this reason, in recent years, a small puncture hole is made without making an incision under close observation with an arthroscope, a probe is inserted into the puncture hole, and the resection part (the area to be resected with a trowel) is inserted at the tip of the probe. Surgical cutting instruments have been proposed for cutting.

The surgical cutting instrument described above is generally depicted as shown in FIGS. 17-21.

In Fig. 17, the surgical resection instrument is detachably attached to the wooden Buddhist temple (not shown).
have. The outer tube 2 is formed into an elongated tube shape,
An outer cutter 5 is provided at the tip. As shown in FIG. 18, the peripheral wall of the outer cutter 5 is provided with an opening 4 having a quadrilateral shape when viewed from the radial direction.

An outer cutting edge 6 is provided on the inner ridge line that constitutes the four sides of this opening 4.
．． 6, . . . are formed, and a pair of outer cutting edges 6.6 that coincide with the axial direction of the outer tube 2 have the same cutting edge shape.

The inner tube 3 is inserted through the outer tube 2 and has an inner cutter 9 at its tip. The inner cutter 9 is provided with an opening 7 in a quadrilateral shape when viewed from the radial direction, as shown in FIG. 19, at a position corresponding to the opening 4. The outer ridgeline forming the four sides of this opening 7 has inner cutting edges 8.8, .
. . are formed, and the inner cutting edges 8.8, .

When the surgical cutting instrument 1 configured as described above is in use, the cutting edge shape formed by the outer cutting edge 6 and the inner cutting edge 8 at a3 is the second one.
0 J5 J, and as shown in Fig. 21.

Note that FIG. 20(b) is the A-A' direction I of FIG. 20(a).
i′J1, Fig. 21(b) f, A in Fig. 21(a)
FIG.

The cutting edge shape created by the outer cutting edge 6 and the inner cutting edge 8 (also when the inner tube 3 is rotated clockwise as shown in Fig. 2O and when the inner tube 3 is rotated counterclockwise as shown in Fig. 21) (The shapes of the pair of outer cutting edges 6.6 that face each other are the same, and the shapes of the corresponding pair of inner cutting edges 8.8) are the same, so the outer cutting edges 6 The shape of the cutting edge formed by the inner cutting edge 8 is exactly the same i, only that the cutting edge is reversed lj.

Furthermore, in the technique disclosed in Japanese Patent Application Laid-Open No. 55-1163346, the outer cutter and the inner cutter (both cutting edges have the same shape), and the same thing as above can be said.

The fact that the shape of the cutting edge during forward rotation and reverse rotation is exactly the same as in the prior art described above inevitably limits the object to be resected.

On the other hand, the cutter for surgical material cutting instruments is 1f! It is well known that the same type of cutter is not perfect and cannot remove all tissues, so if the cutter you are using is not suitable for the tissue to be removed during tissue resection, it is recommended that you replace the cutter. It had been lost.

However, changing the cutter prolongs the surgical time, increases the psychological pain of the surgical procedure, and reduces the efficiency of the surgical procedure.

The present invention has been made in view of the above-mentioned circumstances, and an object of the present invention is to shorten the surgical time and provide an efficient surgical cutting instrument.

[Means for Solving the Problems] In order to achieve the above object, the surgical cutting instrument of the present invention has an opening near the tip, and a pair of outer blades facing each other ψ are provided at the periphery of the opening. It is equipped with an outer tubular member and an inner tubular member having a pair of inner cutters 41 provided opposite to each other, which are inserted into the outer tubular member and rotated to cut out the resection site together with the outer cutter. In the case where the two cutting edges formed by the outer cutter and inner cutter are
It was designed to make it happen.

[Operation] The shape of one cutting edge formed by the outer and inner blades of the surgical resection instrument configured as described above is different from the shape of the other cutting edge formed by the outer and inner blades, and the shape of the cutting edge formed by the outer and inner blades is different from each other. The direction of rotation of the inner tubular member is changed according to the shape of the cutting blade, and the resection region is cut out using one of the suitable cutting blade shapes.

[Example] Hereinafter, the present invention will be specifically explained with reference to the drawings.

Figures 1 to 6 relate to the first embodiment of the present invention.
The figure is a perspective view explaining the shape of the outer blade, FIG. 2 is a perspective view explaining the shape of the inner blade, and FIG.
FIG. 4 is an explanatory diagram of the outer tube with the inner tube inserted through it, FIG. 5 is an explanatory diagram of the shape of the cutting blade, and FIG. 6 is an explanatory diagram of the shape of the cutting blade.

In FIG. 3, the surgical resection instrument 11 has a long insertion section 12
A large-diameter main body 13 is connected to the proximal end of the main body 13 . The proximal end of the main body 13 is connected to a suction device 19, which is connected to a suction tube 14 for suctioning and discharging the resected piece, and a control unit 16, which supplies power to a motor (not shown) built into the main body 13. A power cord 17 is attached for this purpose. A foot switch 18 is connected to the control unit 16 so that the surgeon can control the surgical cutting instrument 11 with his/her foot.

In FIG. 4, the insertion section 12 is composed of an outer tube 21 as an outer tubular member and an inner tube 22 rotatably inserted into the outer tube 21. The outer tube 21 includes an outer vibrator 20 made of stainless steel, and a connecting flange 23 connected to the main body 13 is fitted into the proximal end of the outer vibrator 20. ), and two pins 24 and 24 for connecting to the main body 13 in the radial direction are screwed into the vicinity of the middle of the outer peripheral wall of the connecting flange 23.

An outer cutter 26 machined from stainless steel is fitted into the tip of the outer vibrator 20 and fixed by laser welding. As shown in FIG. 1, the outer cutter 26 has a cylindrical shape and has a closed end, and has an opening 27 formed in a quadrilateral shape (when viewed from the radial direction) on the outer peripheral wall surface. The inner edge of the opening 27 forms a quadrilateral and the outer tube 21
The two sides that coincide in the axial direction form a pair of outer cutting edges 28.28.

A connecting sleeve 29 is provided at the proximal end of the inner tube 22 and is connected to a motor (not shown) housed in the main body 13 and receives rotational driving force from the motor. An inner vibrator 30 made of stainless steel is inserted into the inner vibrator 1fl-1. 6j Connection sleeve 2
A suction hole 32 that communicates with a suction path 31 formed inside the inner pipe 30 is provided at the proximal end of the pipe 90 . In addition, 1) an inner cutter 33 protruding from stainless steel is fitted into the tip of the inner pipe 30, and is fixed by laser welding. The inner cutter 33 is shown in the second figure.
; It has a cylindrical shape and its tip is closed, and the outer cutter 26
An opening 34 is provided at a position corresponding to the opening 27 provided in the opening 27 . An arc-shaped first cutting edge 36 is provided at one portion of the outer ridgeline of the opening 34 that substantially coincides with the axial direction of the inner tube 22, and a saw-blade-shaped second cutting edge is provided at the other portion. A cutting edge 37 is formed respectively.

The operation of the surgical cutting instrument 11 configured as described above will be explained next.

When the outer tube 21 containing the inner tube 22 is connected to the main body, the motor (not shown) built in the main body 13 is connected to the connecting sleeve 29.
It is connected to the inner tube 22 via.

After that, control Fu 1-Switch 18! 20, the inner tube 22 is rotated clockwise, for example, as shown in FIG.

Then, the arcuate first cutting edge 36 of the inner tube 122 and the outer cutting edge 28 come together to shear the affected area.

As a result, the affected area is cut in a manner suitable for the shape of the cutting blade formed by the arcuate first cutting blade 36 and the outer cutting blade 28.

In addition, when the foot switch 18 is controlled to rotate the sea urchin inner tube 22 in the 0151 direction as shown in FIG.
and a saw-blade-shaped second cutting blade 37 to shear the affected area. This creates a saw-like second cutting edge 37 and an outer cutting edge 2.
The affected area is cut according to the shape of the cutting blade formed by 8 and 8.

In this embodiment, one inner blade 33 has an arc-shaped first cutting edge 36.
and a saw-like second cutting edge 37, the inner tube 2
By changing the rotation direction of 2, two V-shaped affected areas can be excised. Therefore, there is no need to replace the inner tube 22 depending on the resection site as in the past.
It is possible to reduce the surgical time.

In addition, one cutter can remove the same amount of tissue as two conventional cutters, so instead of two conventional cutters, one
Books can make you feel better.

Furthermore, by shortening the surgical time, physical and mental pain to the patient is reduced.

Further, since the rotation direction of the inner tube 22 is controlled by the foot switch 18, the operation is easy.

Figures 7 to 11 relate to the second embodiment of the present invention, in which Figure 7 is an explanatory diagram of the outer tube with the inner tube inserted through it, and Figure 8 (a diagonal diagram illustrating the outer blade shape). , 9F/1 is a perspective view illustrating the inner blade shape, FIG. 10 is an explanatory diagram of the cutting edge shape, and FIG. 11 is an explanatory diagram of the cutting blade shape.

Note that FIG. 10(b) shows an arrow view in the /\A' direction of FIG. 10(a), and FIG. 11(b) shows an arrow view in the AΔ' direction of FIG. 11(a).

This embodiment is the same as the first embodiment except that the outer cutter 41 and the inner cutter 46 have a cutting edge shape of 74.

The outer cutter 41 of this embodiment has a pick-up-shaped opening 43 extending from the closed end surface to the outer circumferential wall surface, and an outer cutting edge 44 is formed on the inner ridgeline of the opening 43. In addition, a gap 47 is formed in the inner cutter 46 from the closed end surface to the outer peripheral wall surface, and the outer ridgeline of the opening 47 is a part that substantially coincides with the axial direction J of the inner tube 22. A cutting edge 48 having a circular arc shape (!1'!1) is provided at a portion thereof, and a second cutting edge 7'I9 having a saw blade shape is provided at the other portion.

The other configurations are the same as in the first embodiment.

In this embodiment, as in the first embodiment, by changing the direction of rotation of the inner tube 22 as shown in FIG. 10IJ';A and FIG.

Other functions and effects are similar to those of the first embodiment.

Figure 12 Jj top and Figure 16 relate to the third embodiment of the present invention, Figure 1''12 is an explanatory diagram of the outer tube with the inner tube passed through, and Figure 13 is a perspective view explaining the outer blade shape. Figure 14 is a perspective view illustrating the shape of the inner blade, and Figure 15 is an explanatory diagram of the shape of the cutting edge.
FIG. 16 is an explanatory diagram of the shape of the cutting edge.

In addition, Fig. 15(b) shows the direction 'A' in Fig. 15<a),
FIG. 16(b) (FIG. 16(b) is a view taken along the arrow A-A'' in FIG. 16(a).

Although each of the above embodiments differs in the cutting edge shape of the opposing portion of the inner cutter 33.4G, in this embodiment the outer cutter 51
The shape of the cutting edge at the opposing portion is y.

In this embodiment, an opening 52 is formed on the outer peripheral wall surface of the outer cutter 51 ().
I'm here. The inner ridgeline of the opening 52 and the outer tube 2
A first cutting edge 53 in the shape of a saw blade is provided at one portion that substantially coincides with the axial direction of the blade 1, and a second cutting blade 54 in the shape of a straight line is provided at the other portion.

Further, an opening 57 is provided in a portion of the inner cutter 56 corresponding to the opening 52 provided in the outer cutter 51, and the outer ridgeline of the opening 57 extends in the axial direction of the inner tube 22. A pair of straight cutting edges 58, 58 are provided at substantially coincident locations.

The other configurations are the same as in the first embodiment.

In this embodiment, when the inner cutter 56 rotates in the 34 direction, the saw-like first cutting edge 5 of the outer cutter 51 rotates as shown in FIG.
3 and the linear cutting edge 58 of the inner blade 56 work together to cut the affected area, and when the cut is rotated counterclockwise, the linear second cutting edge 54 of the outer blade 51 and the inner blade 156 cut the affected part. The linear cutting blade 58 cooperates to cut out the affected area.

Other functions and effects are similar to those of the first embodiment.

Note that the shape of the inner cutter and the outer cutter (not limited to the shapes explained in the first to third embodiments, but any shape that allows the inner cutter and the outer cutter to cut η at the same time of 1jA) may be used. In other words, in a conventionally known surgical cutting instrument, the distal end of the insertion section, the outer or inner cutter, or the first cutter, each having a different shape, can be used. This can be done by adding a cutting blade and a second cutting blade.

In addition, in the example, it was stated that the inner blade and the inner vibrator J3 and the outer blade and the outer vibrator were fixed by welding. Furthermore, it is also possible to integrally mold the connecting flange and the outer pipe, the connecting sleeve and the inner vibe are not limited to bonding, for example, by soldering or Relief welding is also good.

In addition, if the wood is suitable for forming the cutting edge for both the outer and inner blades, it must be stainless steel (for example, ceramics, titanium, etc. may be used).

[Effects of the Invention] As explained above, according to the present invention, the shapes of the two cutting edges formed by the inner cutter and the outer cutter are made different from each other, so that a single wood cutter can be used as a cutter for two pieces. This can shorten surgical time and improve efficiency.

[Brief explanation of the drawing]

Figures 1 to 6 relate to the first embodiment of the present invention.
The figure is a perspective view explaining the shape of the outer blade, Figure 2 is a perspective view explaining the shape of the inner blade, Figure 3 is the configuration of the surgical cutting instrument: 32 clear view, and Figure 4 is the state where the inner tube has been passed through. Explanatory diagram of the outer tube of
The figure is an explanatory diagram of the cutting blade shape, FIG. 6 is an explanatory diagram of the cutting blade shape, and FIGS. 7 to 11 relate to the second embodiment of the present invention.
The figure is an explanatory view of the outer tube with the inner tube inserted through it, Figure 8 is a perspective view explaining the outer blade shape, Figure 9 is a perspective view explaining the inner blade shape, and Figure 10 is an explanation of the cutting blade shape. Fig. 11 is an explanatory diagram of the shape of the cutting blade from Fig. 1, Fig. 12 and Fig. 16 are related to the third embodiment of tJ Kikomei, and Fig. 12 is an explanatory diagram of the outer tube in a state where the inner tube has been pushed through; Figure 13 is a perspective view illustrating the shape of the outer blade;
Figure 4 is a perspective view explaining the shape of the inner blade, Figure 16 (illustration of the shape of the cutting edge, Figure 17).
Figures 1 to 21 relate to the conventional example; FIG. 17 is an explanatory diagram of the outer tube with the inner tube inserted through it; FIG. 18 is a perspective view illustrating the shape of the outer blade; and FIG. 19 is the shape of the inner blade. A perspective view to explain,
FIG. 20 is an explanatory diagram of the shape of the cutting blade, and FIG. 21 is an explanatory diagram of the shape of the cutting blade. 11... External oblique resection instrument 12... Insertion section 21.
...Outer tube 22...Inner tube 26...Outer blade 27...Opening 28...Outer cutting edge
33... Inner blade 34... Between [1 part 36... First cutting blade/second cutting blade Figure 2 (a) Figure 5 (b) Figure 8 Figure 9 Figure 10 (0) Figure 10 (b) Figure 12 Figure 13 Figure 14 Figure 17 Old figure Figure 19

Claims (1)

[Claims] An outer tubular member having an opening near its tip and a pair of outer blades facing each other provided at the peripheral edge of the opening, and a part to be cut together with the outer blades by being inserted into the outer tubular member and rotated. A surgical cutting instrument comprising an inner tubular member having a pair of inner blades provided opposite each other for cutting, wherein the shapes of two cutting edges formed by the outer blade and the inner blade are different from each other. A surgical resection instrument characterized by: