JPH08164144A - Implement for surgery - Google Patents

Abstract

PURPOSE: To change the direction of a surgical operation means at a steep angle and to perform a surgical treatment in an appropriate posture. CONSTITUTION: This implement 1 for surgery is a forceps used in the operation under laparoscope and is provided with a long-length hollow implement main body 2, a head part 3 rotatably provided on the tip part of the main body 2, the surgical operation means (forceps mechanism) 4 provided on the head part 3 for performing opening/closing or rotation operations and an operation part 5 provided on the base end side of the main body 2. Further, it is provided with a first transmission means for transmitting the rotation operation of a dial 52 in the manipulation part 5 and converting it into the rotation operation of the head part 3 and a second transmission means for transmitting the rotation operation of a movable handle 533 in the manipulation part 5 and converting it into the opening/closing or rotation operations of the surgical operation means 4 regardless of the posture (rotation angle) of the head part 3.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical instrument such as forceps and scissors, and more particularly to a surgical instrument suitable for use in laparoscopic surgery.

[0002]

2. Description of the Related Art A forceps having a structure in which a forceps mechanism provided at a distal end is remotely operated by an operating portion on a proximal end side is known (Japanese Utility Model Laid-Open No. 5-76413). This forceps has a forceps mechanism composed of a pair of claw members that can be opened and closed at the tip, and is rotated at a proximal end portion of a transmission shaft connected to the forceps mechanism in a direction toward and away from a fixed grip portion. A pawl operating means including a movable rotary grip portion is provided, and by rotating the rotary grip portion of the pawl operating means, the transmission rod built in the transmission shaft is pulled and moved in the longitudinal direction. The claw member is configured to open and close.

By the way, in recent years, in excision of the appendix or gallbladder, laparoscopic surgery performed without laparotomy has attracted attention in place of conventional open surgery. This laparoscopic surgery is shown in FIG.
As shown in FIG. 3, for example, four trocar tubes 107 are inserted into the abdominal cavity 101 through the abdominal wall 100, and a small camera (endoscope) 102 inserted through one of the trocar tubes 107 is used for the abdominal cavity. The inside of 101 is displayed on a monitor image 103, and while watching this monitor image 103, the forceps 104, the scissors 105 and the electric scalpel 106 respectively inserted through the other trocar tubes 107 are appropriately operated to perform a desired surgical procedure. It is performed in the abdominal cavity 101.

In such a laparoscopic surgery, the trocar tube 107, which is a straight tube, is penetrated and fixed to the abdominal wall 100, and the angle of the trocar tube 107 with respect to the abdominal wall 100 is also secured to protect the tissue of the penetrating portion. Forceps 104, scissors 105 and electrocautery 106 as they can hardly be changed
Each of them has a problem that the area in which a surgical operation can be performed is limited to a narrow area.

Therefore, as a method for solving the above problem,
For example, after inserting the forceps 104 into the trocar tube 107, bend or bend the vicinity of the tip of the long instrument main body (transmission shaft) 108 of the forceps 104 (shown by the alternate long and short dash line in FIG. 16) and combine it with the rotation of the forceps 104. Therefore, it has been proposed to expand the reach of the forceps mechanism at the tip.

However, according to this method, the bending angle when the long instrument body bends or curves cannot be made sufficiently large, and the distance from the bending point of the instrument body to the forceps mechanism at the tip is long. Therefore, when the forceps 104 are inserted into the trocar tube perpendicular to the organ surface 109, the grasping operation in a direction parallel to the organ surface 109 cannot be performed immediately below the trocar tube.

[0007]

SUMMARY OF THE INVENTION An object of the present invention is to provide a surgical instrument capable of performing a surgical procedure in a proper posture.

[0008]

These objects are achieved by the present invention described in (1) to (8) below.

(1) A long instrument body, a head portion provided at the tip of the instrument body so as to be rotatable about a rotation axis substantially orthogonal to the axis of the instrument body, and the head portion. A surgical operation means for performing opening / closing or rotating operation; and an operating portion provided on the proximal end side of the instrument body for remotely operating the rotation of the head portion and the operation of the surgical operating means, and the operating portion. And a first transmitting means for transmitting the operation of the head portion to convert into a rotational movement of the head portion, and an operation of the operating portion regardless of the posture of the head portion to open / close or rotate the surgical operating means. A second transmission means for converting into a dynamic movement.

(2) The first transmission means has a pair of first push rods, and the tips of both first push rods face each other through the shaft of the instrument body of the head portion. The surgical instrument according to (1) above, wherein the surgical instrument is rotatably supported by the pair to constitute a link mechanism.

(3) The operation section includes a rotation operation member,
The surgical instrument according to (2) above, further comprising: a conversion unit that converts a rotation operation of the rotation operation member into movements of the first push rods in a longitudinal direction and in opposite directions.

(4) The second transmission means is composed of at least one projecting contact point and a second push rod having a pressing surface for pressing and moving the contact point at the tip.
The surgical instrument according to any one of (1) to (3) above, wherein the surgical operation means is configured to operate by movement of the contact on the pressing surface.

(5) The surgical instrument according to (4), wherein the contact point is located on or near the axis of the rotating shaft.

(6) The rotation angle of the head is set,
The above (1) to (5) having an angle setting means for holding.
The surgical instrument according to any one of 1.

(7) The rotating shaft for rotating the head portion with respect to the instrument body is provided in the vicinity of the surgical operation means, according to any one of the above (1) to (6). Surgical instruments.

(8) The above-mentioned (1) to (7), wherein the head portion is rotatable by approximately 90 ° with respect to the instrument body.
The surgical instrument according to any one of 1.

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The surgical instrument of the present invention will be described below in detail with reference to the preferred embodiments shown in the accompanying drawings.

FIG. 1 is an overall side view showing an embodiment in which the surgical instrument of the present invention is applied to forceps, FIG. 2 and FIG.
4A and 4B are a plan view and a partial cross-sectional plan view showing the configuration near the distal end portion of the surgical instrument shown in FIG. 1, respectively.
FIG. 6 is a plan view and a partial cross-sectional plan view showing a state in which the head portion is at right angles to the axis of the instrument body, which is a configuration near the distal end portion of the surgical instrument shown in FIG. 1, respectively.
FIG. 8 is a side view and a partial cross-sectional side view, respectively, showing the configuration near the tip of the surgical instrument shown in FIG. 1, and FIG. 8 shows the configuration near the tip of the surgical instrument shown in FIG. FIG. 9 is a partial cross-sectional side view showing an opened state, and FIG. 9 shows a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. 1, in which the head portion is perpendicular to the axis of the instrument body and the forceps are opened. 10 is a partial sectional side view, FIG. 10 is a partial sectional side view showing a configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG. 1, and showing a state in which the head portion is perpendicular to the axis of the instrument main body, FIG. FIG. 12 and FIG. 13 are perspective views showing a configuration example of a dial in the present invention, and FIG. 14 and FIG. 14 are partial cross-sectional side views showing the configuration of an operating portion installed at the proximal end of the surgical instrument shown in FIG. 1, respectively. FIG. 15 is a partial cross-sectional side view showing the configuration of the tip portion of the operating portion. A.

In the following description, FIGS.
0, the right side in FIGS. 12 to 15 is called “proximal end”, the left side is called “distal end”, moving toward the distal end is called “forward”, and moving toward the proximal end is called “backward”.

The surgical instrument 1 of the present invention shown in FIG.
A forceps mainly used in laparoscopic surgery, which is a long instrument body 2, a head portion 3 provided at the tip of the instrument body 2, and an opening / closing or rotating operation provided on the head portion 3. A surgical operation means 4 for performing the operation, an operation portion 5 provided on the proximal end side of the instrument body 2, and a first transmission means for transmitting the operation of the operation portion 5 and converting the operation to the rotational movement of the head portion 3. And a second transmission means for transmitting the operation of the operation portion 5 and converting it into the opening / closing or the rotation operation of the surgical operation means 4 regardless of the posture (rotation angle) of the head portion 3.

The instrument main body 2 is a hollow elongated member having a space formed therein for accommodating push rods 71, 72, 8 and the like which will be described later. It is fixed.

The cross-sectional shape of the instrument body 2 is not particularly limited, and is, for example, a circle, an ellipse, a polygon, etc., but is preferably a circle. In this case, the outer diameter of the instrument body 2 is set so that it can be inserted into the trocar tube. Specifically, the outer diameter of the instrument body 2 is preferably about 5 to 18 mm.

In the illustrated construction, the instrument main body 2 has a linear shape in consideration of insertion into the trocar tube, but is not limited to this, and it may be curved or bent in a desired shape in advance. May be. Also, after inserting into the trocar tube,
The tip of the instrument body 2 may be curved or bent into a desired shape.

As shown in FIGS. 2 to 5, a head portion 3 is rotatably supported at the tip of the instrument body 2. The head unit 3 includes a holder 31, a rotary shaft 32 protruding vertically above and below the center of the holder 31, and a holder 3
1 and the shafts 33 and 34 provided upright on the base end side.

A pair of opposing tongues 21 are formed at the tip of the instrument body 2, and holes 22 are formed at the tip of each tongue 21. A rotary shaft 32 is inserted into each of the holes 22, so that the head portion 3 is rotatably supported between the tongue pieces 21. In addition, the maximum angle range in the rotation of the head portion 3 is the axis 25 of the instrument body 2.
Is about ± 90 °. The shafts 33 and 34 are formed on both sides of the head portion 3, that is, at positions (symmetrical) facing each other with the shaft 25 of the instrument body 2 in between.

In the instrument body 2, a pair of first push rods 71, 72 for rotating the head portion 3 and a second push rod 8 for opening / closing or rotating the surgical operating means 4. Are housed so as to be movable in their longitudinal direction. In this case, the first push rods 71, 7
2 are arranged to face each other via the shaft 25, and between the base end and the tip, the first push rod 71 is on the front side of the paper surface of FIG. 3, and the first push rod 72 is the back portion of the paper surface. Displaced to the side. The second push rod 8 is arranged at the center of the instrument body 2, that is, on the shaft 25.

The tips of the first push rods 71, 72 are
The holders 31 are rotatably supported by the shafts 33 and 34, respectively. As a result, a link mechanism is formed by both the first push rods 71 and 72 and the holder 31 that connects the tips of the first push rods 71 and 72. This link mechanism
It corresponds to the first transmission means.

The shafts 33 and 34, which are the connecting portions with the first push rods 71 and 72, are respectively attached to the holder 31.
Are provided on the upper surface (front side of the paper surface of FIG. 3) and the lower surface (back side of the paper surface of FIG. 3) of the first push rod when the head portion 3 rotates (bends) as shown in FIG. 71
And 72 are configured to not interfere.

At the tip of the second push rod 8,
As shown in FIGS. 7 to 9, a pair of upper and lower tapered pressing surfaces 81 is formed. On these pressing surfaces 81, a pair of contact points 4 provided at the base end of the surgical operation means 4 described later.
5 contact each other. The contact points 45 and the second push rod 8 constitute the second transmission means.

As shown in FIGS. 6-8, the surgical operating means 4
Is a forceps mechanism that can clamp living tissue,
The holder 31 includes a pair of movable holding pieces 41 and 42 rotatably supported by a shaft 43. The tip side of these movable sandwiching pieces 41, 42 constitutes a grip portion 44, and the inner joint surface thereof is formed with minute unevenness for preventing the gripping object from slipping.

On the base end side of the shafts 43 of the movable holding pieces 41, 42, protruding contact points 45 are formed so as to protrude inward. These contact points 45 have a hemispherical shape, and a part of the spherical surface is in contact with the pressing surface 81. Further, both contact points 45 are located on the axis of the rotary shaft 32 or in the vicinity thereof when the movable holding pieces 41, 42 are in the open state (when both contact points 45 are in contact with or approaching each other) (FIGS. 8 and 9). reference).

The movable holding pieces 41, 42 are always urged in the opening direction by urging means (not shown). Examples of the urging means include those utilizing a suction force or a repulsive force of various springs and magnets.

The length of the head portion 3 from the rotation axis to the instrument body 2 to the tip of the instrument, that is, the length from the center of the rotation axis 32 to the tip of the surgical operation means 4 is not particularly limited, but is, for example, 9 to 20 mm, It is preferably about 15 to 17 mm. With such a length, the direction of the surgical operation means 4 can be changed at a steep angle even immediately below the trocar tube, and the surgical procedure can be performed in an appropriate posture.

As shown in FIGS. 12 and 13, the instrument body 2
An operation unit 5 for remotely operating the rotating operation of the head unit 3 and the opening / closing of the surgical operation means 4 is provided on the proximal end side of the. The operation unit 5 includes an operation unit main body (casing) 51.
A dial 52 for rotating the head portion 3, a handle portion 53 for operating the surgical operating means 4, a ratchet release handle 54, and a ratchet 55. Further, the operation section 5 is provided with an angle setting means 6 for setting and holding the rotation angle of the head section 3.

The distal end of the operation portion main body 51 is connected and fixed to the base end of the instrument main body 2, and the bases of the first push rods 71 and 72 and the second push rod 8 inserted into the inside of the instrument main body 2. The end portion extends to the inside of the operation portion main body 51.

A dial (rotating operation member) 52 that rotates about the second push rod 8 as a rotation shaft is provided on the base end side of the first push rods 71 and 72. further,
A cam member 521 having a tapered cam surface 522 that is inclined at a predetermined angle with respect to the rotating shaft of the dial 52 is fixed to the surface of the dial 52 on the distal end side. The cam surface 522 is
For example, it is configured by a cut surface obtained by cutting the middle of the cylindrical body with a surface that is not parallel to the bottom surface.

On the other hand, a convex portion 73 for positioning the first push rod is formed on each of the base end portions of the first push rods 71 and 72, and both convex portions 73 are provided inside the operation portion main body 51. One end of each installed coil spring 56 in a compressed state is locked. As a result, the first push rods 71, 72 are biased toward the base end side by the elastic force of the coil spring 56, and their base ends are pressed against the cam surface 522. The cam member 521, both convex portions 73, and both coil springs 56 constitute a conversion unit that converts the rotational operation of the dial 52 into the movement of the second push rods 71 and 72 in the longitudinal direction and in the opposite directions. In addition, on the outer peripheral surface of the dial 52, minute ridges (knurls) for preventing slippage are formed.

When the dial 52 is rotated, the cam surface 522 also rotates at the same time, and one of the first push rods 71 and 72 whose base ends are in contact with the cam surface 522 is moved forward and the other is moved backward. As a result, the head portion 3 is rotated by the link mechanism at the tip portion of the instrument body 2.

Angle setting means 6 is provided on the base end side of the dial 52. The angle setting means 6 constitutes a click mechanism for rotating the dial 52.
A slider 61 slidable along the guide (not shown) in the longitudinal direction of the second push rod 8 by a small distance, a plunger 62 installed on the slider 61, and a slider 6
It is composed of a spring 63 for urging 1 toward the tip end, and a plurality of holes 64 formed in the base end surface of the dial 52 at equal intervals along the circumferential direction of the dial. The tip end of the plunger 62 is rounded and is selectively inserted into each hole 64 as the dial 52 rotates.

The slider 61 is urged by the spring 63 and pressed toward the tip end side, and the tip end of the plunger 62 abuts on the base end surface of the dial 52. However, when the dial 52 rotates, the plunger 62 and the hole 64 are separated from each other. When they match, the plunger 62 is inserted into the hole 64, whereby the rotation of the dial 52 is once stopped and the positioning is performed. When the rotation of the dial 52 is stopped, the first push rod 7
The movements of 1, 72 also stop, and the rotation angle of the head unit 3 is fixed. When the dial 52 is rotated again, the slider 61 moves toward the base end side against the biasing force of the spring 63, the plunger 62 comes out of the hole 64, and the dial 52 rotates until it is inserted into the next adjacent hole 64. To do. Thereafter, this operation is repeated.

The handle portion 53 is a fixed handle 532 fixedly or integrally provided with the operation portion main body 51.
And a movable handle 533 that opens and closes (rotates) with respect to the fixed handle 532. Movable handle 53
Reference numeral 3 is rotatably attached to the operation portion main body 51 by a shaft member 531 and is biased clockwise in FIG. 12 by a torsion spring 536 so that the handle is always kept open. Further, a long hole 534 and a ratchet engaging claw 535 are formed at the upper end of the movable handle 533 in FIGS. 12 and 13.

A pin 82 formed at the base end of the second push rod 8 is inserted into the elongated hole 534. Further, the claw 535 is inserted into a ratchet hole 551 formed in the ratchet 55 described later.

The ratchet 55 has the functions of restricting the rotation of the movable handle 533, and setting and holding the rotation angle, that is, the opening degree (grasping force) of the movable holding pieces 41, 42 as desired. The ratchet 55 is composed of a T-shaped plate piece, and is attached to the operation portion main body 51 so as to be displaceable in the direction perpendicular to the paper surface of FIG.

Further, the ratchet 55 has a ratchet hole portion 551 composed of a set of a plurality of grooves arranged along the movement trajectory of the claw 535 when the movable handle 533 is rotated.
Are formed. The ratchet 55 has the claw 53.
The biasing member (not shown) such as a spring is constantly biased toward the rear side of the paper surface of FIG. 12 so that 5 is inserted into the groove of the ratchet hole 551.

In the vicinity of the tip side of the ratchet 55,
The ratchet release handle 54 is rotatably supported by the shaft 541 with respect to the operation portion main body 51. The ratchet release handle 54 is shown in FIG.
2 It is biased in the clockwise direction.

A taper surface 542 is formed in the middle of the ratchet release handle 54 so that the height (the thickness in the direction perpendicular to the paper surface of FIG. 12) gradually increases toward the base end side. 12 is rotated counterclockwise in FIG. 12, the tapered surface 542 presses the tip of the ratchet 55 and displaces the ratchet 55 to the front side of the paper surface.
As a result, the pawl 535 is disengaged from the ratchet hole 551, and the movable handle 533 can freely rotate. Next, the operation of the surgical instrument 1 will be described.

[1] Rotating Operation of Head Unit 3 As shown in FIGS. 14 and 15, for example, when the dial 52 is rotated in a predetermined direction by the index finger of the hand holding the handle unit 53, the dial 52 is rotated in accordance with the rotation angle. The abutting positions of the base ends of the first push rods 71, 72 on the cam surface 522 change. Along with this, the first push rods 71 and 72 move in opposite directions to each other in the longitudinal direction of the instrument body 2.

The rotation angle of the dial 52 is set and held by inserting the tip of the plunger 62 into the hole 64. Therefore, the positions of the first push rods 71 and 72 in the longitudinal direction and the rotation of the head portion 3 are set. The moving angle is also set and held.

When the first push rod 71 is moved forward and the first push rod 72 is moved backward as shown in FIG. 14 by rotating the dial 52, the distal end portion of the instrument main body 2 is shown in FIG. As shown in FIG. 5, the displacement of the shafts 33 and 34 in the link mechanism causes the head unit 3 to rotate clockwise. In this case, the maximum rotation angle of the head portion 3 is set so that the angle formed by the center line 46 of the surgical operation means 4 and the shaft 25 is about + 90 °.

Further, by rotating the dial 52, the first push rod 71 is retracted as shown in FIG.
When the first push rod 72 advances, the head portion 3 rotates counterclockwise at the tip portion of the instrument body 2 contrary to the above. In this case, the maximum rotation angle of the head portion 3 is set so that the angle formed by the center line 46 of the surgical operation means 4 and the shaft 25 is about −90 °.

In an intermediate state (basic state) between the state shown in FIG. 14 and the state shown in FIG. 15, that is, in the state where the positions of both base ends of the first push rods 71 and 72 in the longitudinal direction coincide, the state shown in FIG. As shown, the head portion 3 faces the same direction as the instrument body 2 (the center line 46 and the axis 25 coincide).

[2] Opening / closing operation of surgical operating means 4 As shown in FIGS. 8 and 13, from the state in which the movable handle 533 is opened and the movable holding pieces 41, 42 are opened, the handle portion 53 is grasped by the hand and torsion is applied. The movable handle 533 is rotated counterclockwise in FIG. 13 against the biasing force of the spring 536 (state shown by a dotted line in FIG. 13). As a result, the edge portion of the elongated hole 534 formed at the end portion of the movable handle 533 presses the pin 82 toward the tip end, and the second push rod 8
Moves forward. By the forward movement of the second push rod 8,
As shown in FIG. 6 and FIG. 7, the pressing surface 81 at the tip of the second push rod 8 presses the corresponding contact point 45, and both contact points 45 move along the pressing surface 81 in the direction away from each other. Accordingly, the movable holding pieces 41, 42 are closed, and the surgical operation is performed.

Along with the rotation of the movable handle 533, the claw 535 formed at the end of the movable handle 533.
Are sequentially inserted into the respective grooves of the ratchet hole 551, and when the rotation of the movable handle 533 is stopped, they are fitted into a predetermined groove and are prohibited from moving in the opposite direction. That is, rotation of the movable holding pieces 41, 42 in the opening direction is prohibited.

At this time, for example, the ratchet release handle 54 is shown in FIG. 1 with the index finger of the hand holding the handle portion 53.
When it is rotated counterclockwise in 2, the tapered surface 542 presses the tip of the ratchet 55, displaces the ratchet 55 to the front side of the paper surface, and the pawl 535 is disengaged from the ratchet hole 551. As a result, the regulation of the rotation of the movable handle 533 is released, and when the gripping force of the handle portion 53 is reduced, the biasing force of the torsion spring 536 causes the movable handle 53 to move.
3 rotates clockwise and returns to the original open state. Along with this, the second push rod 8 retracts, and the pressing of the contact 45 by the pressing surface 81 is released, so that the movable holding pieces 41, 42 are opened again by the action of the biasing means (not shown).

As described above, the opening / closing of the movable holding pieces 41, 42 is interlocked with the opening / closing operation of the movable handle 533.
The opening degree (grip force) of both the movable holding pieces 41, 42 corresponds to the opening degree of the fixed handle 532 and the movable handle 533.

[3] Opening / closing operation of the surgical operation means 4 when the head portion 3 is bent FIG. 9 and FIG. 10 respectively show the head portion 3 shown in FIG.
FIG. 3 is a partial cross-sectional side view of the surgical operating means in an open state and a closed state, as seen from the direction of arrow A in the state in which is rotated + 90 °.

As described above, both contact points 45 have a hemispherical shape, and they are located on the axis of the rotary shaft 32 when the movable holding pieces 41, 42 are in the open state. 9 is bent with respect to the instrument body 2 as shown in FIG.
As shown in, the positional relationship between both pressing surfaces 81 and the corresponding contact points 45 does not change. Therefore, in this state, when the movable handle 533 is rotated to move the second push rod 8 forward in the same manner as described above, as shown in FIG. 10, both contacts 45 move on the pressing surface 81 in the directions away from each other. Then, along with this, the movable holding pieces 41, 42 are closed, and the surgical operation is performed. The movable handle 533 is rotated in the opposite direction to the second direction.
The same applies to the case where the push rod 8 is retracted and the movable holding pieces 41 and 42 are opened.

The opening / closing operation of the movable holding pieces 41, 42 as described above is performed by the rotation angle of the head portion 3, that is, the surgical operation means 4.
It can be performed regardless of the direction, and its operability and responsiveness are constant.

The surgical instrument of the present invention has been described above with reference to the illustrated embodiments, but the present invention is not limited to these. For example, the surgical operation means 4 is configured by a pair of opening / closing members, one of which is opened and closed by being driven, that is, a fixed sandwiching piece and a movable sandwiching piece that rotates with respect to the fixed sandwiching piece. Good. Further, the structure is not limited to the rotation, and for example, the structure may be such that the structure is moved in parallel to open and close. Further, one member may be configured to rotate, such as a bow forceps, an electric knife, and an ultrasonic knife.
Further, the first transmission means and the second transmission means are not limited to the illustrated configurations, and for example, a pair of pulling wires may be used instead of the pair of first push rods.

The type of surgical instrument of the present invention is not limited to forceps, and may be, for example, scissors, a ligature device, a needle holder, or a knife such as an electric knife, an ultrasonic knife, or a laser knife. Also, its application is not limited to that used for laparoscopic surgery,
For example, it can be applied to other operations such as brain surgery, thoracoscopic surgery, and urological surgery.

[0061]

As described above, according to the surgical instrument of the present invention, the operability of the turning operation of the head portion and the driving operation of the surgical operation means is excellent, and particularly, the posture (rotation of the head portion The surgical operation means can be opened and closed or rotated by the same operation regardless of the movement angle.

From the above, when the surgical instrument of the present invention is used for laparoscopic surgery, for example, even when the surgical instrument is inserted perpendicularly or at a steep angle to the organ surface, it is parallel to the organ surface. It becomes possible to perform a surgical operation in a direction (for example, grasping biological tissue with forceps), and since the area in which the surgical procedure can be performed is expanded, the operability in the operation is significantly improved and the operation time is increased. Can be shortened.

Further, the first transmission means has a pair of first push rods, and the tips of both the first push rods are rotatably supported at the positions of the head portion facing each other via the shaft of the instrument body. In particular, when the link mechanism is configured, the operating unit includes the rotation operating member and the converting unit that converts the rotation operation of the rotation operating member into the movements of the first push rods in the longitudinal direction and in the opposite directions. In the case of including, the head portion can be easily and surely rotated.

The second transmitting means is composed of a protrusion-shaped contact, particularly a hemispherical contact, and a second push rod having a pressing surface for pressing and moving the contact at the tip, and the surgical operating means is the above-mentioned. When configured to operate by movement of the contact point on the pressing surface, the contact point and the second push rod are surely brought into contact with each other regardless of the postures of the head portion and the surgical operation means, And point contact is possible.

Further, when the contact point is located on or near the axis of the rotary shaft of the head portion with respect to the instrument body, the opening / closing or rotating operation of the surgical operating means can be surely performed regardless of the posture of the head portion. It can be carried out.

Further, in the case of having the angle setting means for setting and holding the rotation angle of the head portion, the operability of the surgical instrument is further improved. When the rotation axis of the head part with respect to the instrument body is provided near the surgical operation means,
In particular, when the head portion can rotate about 90 ° with respect to the instrument body, the direction of the surgical operation means can be changed at a steep angle, and the surgical procedure can be performed reliably and in an appropriate posture. .

[Brief description of drawings]

FIG. 1 is an overall side view showing an embodiment when the surgical instrument of the present invention is applied to forceps.

FIG. 2 is a plan view showing a configuration near a distal end portion of the surgical instrument shown in FIG.

FIG. 3 is a partial cross-sectional plan view showing the configuration in the vicinity of the distal end portion of the surgical instrument shown in FIG.

FIG. 4 is a plan view showing a configuration near a distal end portion of the surgical instrument shown in FIG. 1 and showing a state in which a head portion is bent at a right angle to an axis of an instrument body.

5 is a partial cross-sectional plan view showing a configuration near the distal end portion of the surgical instrument shown in FIG. 1 and showing a state in which the head portion is bent at a right angle to the axis of the instrument body. FIG.

FIG. 6 is a side view showing the configuration near the distal end portion of the surgical instrument shown in FIG.

7 is a partial cross-sectional side view showing the configuration near the distal end portion of the surgical instrument shown in FIG.

8 is a partial cross-sectional side view showing a configuration near the distal end portion of the surgical instrument shown in FIG. 1 and showing a state in which forceps are opened. FIG.

9 is a partial cross-sectional side view showing a configuration near the distal end portion of the surgical instrument shown in FIG. 1, showing a state in which the head portion is bent at right angles to the axis of the instrument body and the forceps are opened.

10 is a partial cross-sectional side view showing a configuration near the distal end portion of the surgical instrument shown in FIG. 1 and showing a state in which the head portion is bent at a right angle to the axis of the instrument main body.

FIG. 11 is a perspective view showing a configuration example of a dial according to the present invention.

FIG. 12 is a partial cross-sectional side view showing the configuration of an operation unit installed at the proximal end of the surgical instrument shown in FIG.

FIG. 13 is a partial cross-sectional side view showing an operating state of the handle portion in the operation portion installed at the base end portion of the surgical instrument shown in FIG. 1.

14 is a partial cross-sectional side view showing the configuration of the distal end portion of the operation portion shown in FIG.

15 is a partial cross-sectional side view showing the configuration of the distal end portion of the operation portion shown in FIG.

FIG. 16 is a cross-sectional view schematically showing a state of laparoscopic surgery.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Surgical instrument (forceps) 2 Instrument main body 21 Tongue piece 22 Hole 25 Shaft 3 Head part 31 Holder 32 Rotating shaft 33, 34 Shaft 4 Surgical operation means 41, 42 Movable clamping piece 43 Shaft 44 Grasping part 45 Contact point 46 Center line 5 Operation part 51 Operation part body 52 Dial 521 Cam member 522 Cam surface 53 Handle part 531 Shaft member 532 Fixed handle 533 Movable handle 534 Long hole 535 Claw 536 Torsion spring 54 Ratchet release handle 541 Shaft 542 Tapered surface 543 Spring 55 Ratchet 551 Ratchet Hole 56 Spring 6 Angle setting means 61 Slider 62 Plunger 63 Spring 64 Hole 71, 72 First push rod 73 Convex portion 8 Second push rod 81 Pressing surface 82 Pin 100 Abdominal wall 101 Abdominal wall 102 Small camera 103 Moni Over image 104 Forceps 105 scissors 106 electric knife 107 trocar tube 108 instrument body 109 organ surface

Claims (8)

[Claims] 1. A long instrument body, a head portion provided at a tip portion of the instrument body so as to be rotatable about a rotation axis substantially orthogonal to an axis of the instrument body, and the head portion. A surgical operation means for performing opening / closing or rotating operation; an operating portion provided on the proximal end side of the instrument body for remotely operating the rotation of the head portion and the operation of the surgical operating means; First transmitting means for transmitting an operation and converting it into a rotational movement of the head portion, and transmitting / closing an operation at the operating portion regardless of the posture of the head portion to open / close or rotate the surgical operating means. Surgical instrument for converting into motion. 2. The first transmission means has a pair of first push rods, and the tip ends of both the first push rods are located at positions facing each other of the head portion via the shaft of the instrument body. The surgical instrument according to claim 1, wherein the surgical instrument is rotatably supported to form a link mechanism. 3. The operation section includes a rotation operation member, and a conversion means for converting a rotation operation of the rotation operation member into movements of the first push rods in the longitudinal direction and in the opposite directions to each other. The surgical instrument according to. 4. The second transmission means includes at least one protrusion-shaped contact point and a second push rod having a pressing surface for pressing and moving the contact point at a tip thereof, and the surgical operation means includes: The surgical instrument according to any one of claims 1 to 3, wherein the surgical instrument is configured to operate by movement of the contact on the pressing surface. 5. The surgical instrument according to claim 4, wherein the contact point is located on or near an axis of the rotating shaft. 6. The surgical instrument according to claim 1, further comprising angle setting means for setting and holding a rotation angle of the head portion. 7. The surgical instrument according to claim 1, wherein the rotating shaft for rotating the head portion with respect to the instrument body is provided in the vicinity of the surgical operation means. 8. The surgical instrument according to any one of claims 1 to 7, wherein the head portion is rotatable about 90 ° with respect to the instrument body.