JPS6126380B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to an improvement in a quarrying mirror for extracting and recovering stones in organs such as the kidney or bladder.

Conventionally, this type of quarrying mirror has been constructed by having an endoscope removably inserted into a tubular member that is equipped with forceps having an observation site at the tip and a forceps operating mechanism at the rear end. . The method of using the quarry mirror is, for example, during surgery, by inserting the viewing tube from the body cavity and sending forceps to organs such as the kidneys or bladder, and using the forceps to extract stones while observing the inside of the organ.
It is now being collected.

However, the tip of the endoscope is fixedly positioned at the observation position behind the forceps, and the stone located in front of the forceps is observed through the observation site when the forceps are closed.
During stone extraction, the stone located in front of the forceps is observed through the open lumen of the forceps, which creates the problem that the observation field of view is obstructed by the forceps when the forceps are opened, making it impossible to adequately observe the stone inside the organ. , there is a risk that quarrying cannot be performed reliably due to oversights in observation.

This invention was made in view of the above-mentioned circumstances, and its purpose is to sufficiently secure the observation field of view of the endoscope during the forceps opening operation without being damaged by the forceps, and to ensure that a sufficient amount of stone can be detected. It is an object of the present invention to provide a stone quarrying mirror that enables observation and reliable quarrying of stones without overlooking anything.

An embodiment of the present invention will be described below with reference to FIG. In the figure, 1 is the hand part of the quarrying mirror, and on the distal end side of the hand part 1, a main pipe 2, which is a plastically deformable tubular member, is bent at approximately 90 degrees. It constitutes a viewing tube part insertion port 4 that communicates with the inner cavity 3 shown in FIG. 4 provided in FIG. A viewing tube section 6 of a fiberscope 5, which is an endoscope, can be inserted along this viewing tube section insertion opening 4. This fiber scope 5 will be explained later. And the above main manager 2
Forceps 7 are provided at the tip. As shown in FIG. 3, this forceps 7 has a movable forceps piece 10 rotatably supported on a fixed forceps piece 8 via a pin 9, and when the fixed forceps piece 8 and the movable forceps piece 10 are closed, each Engaging teeth 11 provided on the fixed forceps piece 8 and the movable forceps piece 10
......, 12...... is now able to bite. Note that reference numeral 13 is an oblique through-hole provided at the center of the movable forceps piece 10 in the width direction, and forms an observation range from the rear observation site. The fixed forceps piece 8 of the forceps 7 configured in this way is attached to the distal end surface of the main tube 2, and the insertion port 14 provided in the fixed forceps piece 8 is made to face the endoscope insertion port 4. . In addition,
The tip opening of the insertion port 14 faces the oblique through hole 3 when the forceps 7 are closed.

Further, a guide pipe 15 is fixed to the outer circumferential surface of the main pipe 2 along the axial direction, and its base end is connected to the hand portion 1 in the same way as the main pipe 2. A wire insertion port 17 is formed inside the guide pipe 15 and communicates with a lumen 16 provided in the hand portion 1 and shown in FIG. An operating wire 18 is inserted along this wire insertion port 17, and its insertion end is connected to a pin 20 pivotally supported by the movable forceps piece 10 via a joint 19. Further, the rear end of the operating wire 18 is connected to an operating rod 2 which is fitted into the inner cavity 16 so as to be freely retractable as shown in FIG.
1, and as the operating rod 21 moves forward and backward, the movable forceps piece 10 can be rotated about the pin 9 as a fulcrum. In addition, 2
2 is an O-ring for airtightness and watertightness. A forceps operating mechanism 23 that moves the operating rod 21 forward and backward
is provided on the rear end side of the hand portion 1. The forceps operating mechanism 23 is configured with a fixed operating lever 24 and a movable operating lever 25 in the shape of scissors, and the tip of the fixed operating lever 24 is fixed to the hand portion 1. In addition, the movable operation lever 2
A cutout groove 26 is cut in the tip of the lever 5, and the operating rod 21 is removably inserted into the cutout groove 26 as shown in FIG. In order to fix the operating rod 21, a large diameter portion 27 is provided at the end corresponding to the top of the operating rod 21, and a leaf spring 28 is provided on the distal end side of the movable operating lever 24 in a state of single support. 27 is elastically held between the tip of the movable operating lever 24 and the free end of the leaf spring 28. By opening and closing the movable operating lever 25, the operating rod 21 moves forward and backward, allowing the forceps 7 to be opened and closed. In addition, the surplus operating amount required for the opening operation after the forceps 7 is completely opened can be absorbed by the protrusion of the large diameter portion 27 that resists the elastic force of the leaf spring 28. It does not cause any heavy load.

Next, the fiberscope 5 will be explained.
As shown in FIG. 2, the fiberscope 5 is constructed by connecting a hard part 30 and a soft part 31, which make up the visual tube part 6, to an eyepiece part 29 along the axial direction. These hard portions 30 and soft portions 3
1 is provided with an observation optical system and an illumination optical system made of optical fibers (not shown), so that the front of the flexible part 31 can be visually observed from the eyepiece part 29. Note that 32 is a universal cord that guides light to the illumination optical system. Further, the base side of the visual tube section 6 is curved to make it easier for the operator to view from the eyepiece section 29.

An actuating plate 35 having a groove 34 is movably provided on the rigid portion 30 of the fiberscope 5 configured as described above, and is fixed with a fixing screw 36. That is, the required length of the viewing tube section 6 can be adjusted by operating the fixing screw 36 of the operating rod 35.

The fiberscope 5 is removably inserted into the viewing tube insertion port 4, and is moved forward and backward by the endoscope forward and backward operation mechanism 37 provided in the hand portion 1. That is, the forward/backward movement mechanism 37 is constructed by installing the actuating plate 35 on a holding seat at the free end of a coil spring 38 attached to the open end of the inner cavity 3 of the hand portion 1, and
is held elastically. And when holding this,
As shown in FIG.
The fiberscope 5 is positioned at a rear observation position 13a, so that a sufficient observation field range of the fiberscope 5 can be secured when the forceps 7 are closed.

When the fiberscope 5 is held, the groove 34 of the actuation plate 35 is slidably engaged with the shaft of the actuation rod 21 as shown in FIG. I am doing it. At the same time, it also prevents the fiberscope 5 from rotating.

In addition, 39 is a cap for liquid feeding and suction connected to the inner cavity 3 of the hand part 1, and this is used to send liquid etc. into the body cavity through the spaced part of the optic tube part insertion port 4, or to suction. It is something to do.

Further, 40 is an O-ring that maintains airtightness and watertightness when the fiberscope 5 is attached.

Therefore, when attempting to extract a stone in the kidney during surgery using a stone quarry mirror configured as described above, first remove the forceps 7 and the main tube 2 from the surgical site in the state shown in Fig. 1. Insert into body cavity. Then, while observing the inside of the body cavity through the eyepiece 29, the forceps 7 are sent into the kidney. After this,
If a stone is confirmed in this state, the operation parts 24a, 25b of the movable and fixed operation levers 24, 25
Move along the opening direction. Then, as a result of this moving operation, the operating rod 21 is moved forward, and the movable forceps piece 10 is gradually opened. When the tip of the movable operating lever 25 is in contact with the actuating plate 35 as shown in FIG. 7b, the movable operating lever 25 is fully opened as shown in FIG. 7a. Subsequently, further operation parts 24a, 25
By moving the lever a, the actuating plate 35 is pressed along the axial direction of the actuating rod 21, as shown in FIG. 8b, and the fiberscope 5 is moved forward. Then, as shown in FIG. 8a, the distal end of the visual tube section 6 gradually protrudes forward from the inner cavity of the forceps 7 in the fully opened state. Furthermore, if the forward movement of the distal end of the optic tube section 6 reaches the apex, which is the forward observation position 13b, the observation field range of the fiberscope 5 can be sufficiently secured without being damaged by the forceps 7 when the forceps are operated. .

Thereafter, the stone is thoroughly checked and the stone is grasped with the forceps 7 to extract the stone.

Note that during stone extraction, the distal end of the optic tube section 6 moves back due to the elastic force of the coil spring 38 in synchronization with the closure of the forceps 7, so that the stone and the distal end of the optic tube section 6 do not come into contact with each other. There is no damage to the visual tube section 6.

In this way, since the tip of the fiberscope 5 is positioned at the observation position 13b in front of the forceps 7 when the forceps 7 are opened, the observation field range of the fiberscope 5 when the forceps 7 is activated can be controlled by the forceps 7. It can be secured sufficiently without being damaged.

Therefore, the stone can be sufficiently observed, and the stone can be reliably quarried without overlooking anything.

In the above-mentioned embodiment, a tubular member curved at an angle of 90° was used; however, the present invention is not limited to this. For example, the tubular member may be curved at an angle of 60° to 150° depending on the position and shape of the affected area within the body cavity. A tubular member may also be used.

As explained above, according to the present invention, an endoscope advancement/retraction operation mechanism for advancing and retracting the endoscope is provided, and this advancement/retraction operation mechanism is linked with a forceps operation mechanism provided on a tubular member, so that when the forceps are opened, Since the tip of the endoscope, which was located at the rear observation position near the forceps, is made to protrude in front of the forceps and positioned at the front observation position, the observation field range of the fiberscope can be controlled by the forceps, especially when the forceps are opened. It can be secured sufficiently without being damaged.

Therefore, the stone can be sufficiently observed, and the stone can be reliably extracted without any oversight.

[Brief explanation of the drawing]

The drawings show one embodiment of the present invention; FIG. 1 is an overall front view of a quarrying mirror, FIG. 2 is an overall front view of an endoscope, FIG. 3 is a partially enlarged front sectional view showing forceps, and FIG.
The figure is a partially enlarged side cross-sectional view showing the forceps operating mechanism.
The figure is an arrow view along the line from Fig. 1, and Fig. 6 is a view along the line from Fig. 1.
7a and 7b are partial state diagrams showing the operating state of the forceps operating mechanism when the forceps are opened and the operating state of the forceps in that operating state. FIG. 8a , b are partial state diagrams showing the operating state of the forceps operating mechanism when the tip of the endoscope protrudes during the forceps opening operation, and the operating state of the forceps in that operating state. 2... Tubular member, 5... Fiber scope (endoscope), 7... Forceps, 13a... Back observation position, 13b... Front observation position, 23... Forceps operating mechanism, 37... Holding mechanism.

Claims (1)

[Claims] 1. Consists of a tubular member that is equipped with forceps at the tip and a forceps operating mechanism that opens and closes the forceps at the rear end, into which an endoscope is inserted in a movable manner and which guides the tip of the endoscope to the vicinity of the forceps. The quarrying mirror is provided with an endoscope forward/backward operating mechanism that works in conjunction with the forceps operating mechanism, and this forward/backward operating mechanism works in conjunction with the forceps operating mechanism to move the tip of the endoscope to a backward observation position near the forceps when the forceps are closed. A quarrying mirror characterized in that when the forceps are opened, the endoscope is moved forward and its tip is positioned at a front observation position.