JP2016013351A - Vitreous surgery instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide vitreous surgery instruments in which vitreous surgery can be performed efficiently and safely.SOLUTION: Vitreous surgery instruments 1 include a body 10 for supporting a pair of wire members 11, 11 and a moving body 20 having a pipe body 21 outwardly engaged with the pair of wire members 11, 11, in which the moving body 20 is movably configured along the pair of wire members 11, 11. The wire member 11 comprises energizable materials, in which a base end side is provided with a terminal section 11a and a tip side is provided with a gripper 11b of the high-resistance. The pipe body 21 comprises materials having electric insulation, in which a pair of accommodating routes for individually accommodating the pair of wire members 11, 11 is formed. The pipe body 21 is made to move forward in a tip direction, and thereby grippers 11b, 11b of the pair of wire members 11, 11 are brought into contact with each other.

Description

Translated fromJapanese

本発明は、硝子体手術器具に関する。  The present invention relates to a vitreous surgery instrument.

硝子体手術に使用される器具として、例えば特許文献１に開示された構成が知られている。図５に示すように、この手術器具５０は、本体把持部５１と、本体把持部５１に対して軸方向に移動自在に取り付けられたピストン部材５２と、ピストン部材５２に対して軸方向に延びるように固定された管状部材５３と、管状部材５３に挿通されて本体把持部５１に固定された芯部材５４と、芯部材５４を収容しつつピストン部材５２の先端側に軸方向に移動可能に取り付けられた補強部材５５と、補強部材５５をピストン部材５２の先端方向に付勢するばね部材５６とを備えている。本体把持部５１は、一対の板ばね部５１ａ，５１ａを備えており、補強部材５５の先端部を強膜等の眼の表面に押し当てた状態で板ばね部５１ａ，５１ａを押圧することにより、クランク５９，５９を介してピストン部材５２および管状部材５３が進出するように構成されている。  As an instrument used for vitreous surgery, for example, a configuration disclosed in Patent Document 1 is known. As shown in FIG. 5, thesurgical instrument 50 includes a mainbody gripping part 51, apiston member 52 attached to the mainbody gripping part 51 so as to be movable in the axial direction, and an axial direction extending with respect to thepiston member 52. Atubular member 53 fixed in this manner, acore member 54 inserted through thetubular member 53 and fixed to the mainbody gripping portion 51, and axially movable toward the distal end side of thepiston member 52 while accommodating thecore member 54. The attached reinforcingmember 55 and aspring member 56 that biases the reinforcingmember 55 toward the distal end of thepiston member 52 are provided. Themain body grip 51 includes a pair ofleaf springs 51a and 51a, and presses theleaf springs 51a and 51a in a state where the tip of the reinforcingmember 55 is pressed against the surface of the eye such as the sclera. Thepiston member 52 and thetubular member 53 are configured to advance through thecranks 59 and 59.

図６は、図５のＡ部拡大図である。図６に示すように、芯部材５４の先端部にはセッシ５４ａが設けられており、上述した板ばね部５１ａ，５１ａの操作により管状部材５３が進出すると、セッシ５４ａが狭まり網膜表面の組織等を剥ぎ取ることができる。  FIG. 6 is an enlarged view of part A in FIG. As shown in FIG. 6, thecore member 54 is provided with aseg 54a at the distal end thereof, and when thetubular member 53 is advanced by the operation of theleaf springs 51a and 51a described above, thesushi 54a narrows and the tissue on the surface of the retina, etc. Can be peeled off.

特開２００９−７２２２１号公報JP 2009-72221 A

ところが、上記従来の手術器具５０を用いた硝子体の手術においては、施術中に出血が生じた場合に、ジアテルミー器具等の他の手術器具を用いて止血を行う必要があり、施術が煩雑になり易いという問題があった。  However, in the vitreous surgery using the above-described conventionalsurgical instrument 50, if bleeding occurs during the procedure, it is necessary to stop hemostasis using another surgical instrument such as a diathermy instrument, and the procedure is complicated. There was a problem that it was easy to become.

そこで、本発明は、硝子体手術を安全に効率良く行うことができる硝子体手術器具の提供を目的とする。  Then, this invention aims at provision of the vitreous surgery instrument which can perform a vitreous surgery safely and efficiently.

本発明の前記目的は、一対の線状体を支持する本体と、一対の前記線状体に外嵌される管体を有する移動体とを備え、前記移動体を一対の前記線状体に沿って移動可能に構成された硝子体手術器具であって、前記線状体は、通電可能な材料からなり、基端側に端子部が設けられ、先端側に高抵抗の把持部が設けられており、前記管体は、電気絶縁性を有する材料からなり、一対の前記線状体を個別に収容する一対の収容路が形成されており、前記管体を先端方向に進出させることにより、一対の前記線状体の前記把持部同士が接触する硝子体手術器具により達成される。  The object of the present invention includes a main body that supports a pair of linear bodies, and a movable body having a tubular body that is fitted around the pair of linear bodies, and the movable bodies are combined into the pair of linear bodies. A vitreous surgery instrument configured to be movable along the wire body, wherein the linear body is made of a material that can be energized, a terminal portion is provided on the proximal end side, and a high-resistance gripping portion is provided on the distal end side. The tube body is made of a material having electrical insulation, and a pair of housing passages for individually housing the pair of linear bodies is formed, and by extending the tube body in the distal direction, This is achieved by a vitreous surgery instrument in which the gripping portions of the pair of linear bodies are in contact with each other.

この硝子体手術器具において、前記管体の先端面には、一対の前記線状体の間に介在される突部が設けられていることが好ましい。  In this vitreous surgery instrument, it is preferable that the distal end surface of the tubular body is provided with a protrusion interposed between the pair of linear bodies.

また、前記線状体は、可撓性を有し、先端側が湾曲形状に癖付けられていることが好ましく、前記把持部同士が接触した際に、前記管体の中心側において前記収容路の開口周縁と接触することが好ましい。  The linear body is preferably flexible and has a distal end that is brazed in a curved shape. When the gripping portions come into contact with each other, the linear body is provided with a central portion of the tubular body. It is preferable to contact the periphery of the opening.

本発明の硝子体手術器具によれば、硝子体手術を安全に効率良く行うことができる。  According to the vitreous surgery instrument of the present invention, vitreous surgery can be performed safely and efficiently.

本発明の一実施形態に係る硝子体手術器具の断面図である。It is sectional drawing of the vitreous surgery instrument which concerns on one Embodiment of this invention.図１に示す硝子体手術器具の要部拡大断面図である。It is a principal part expanded sectional view of the vitreous surgery instrument shown in FIG.図１に示す硝子体手術器具の使用状態を示す断面図である。It is sectional drawing which shows the use condition of the vitreous surgery instrument shown in FIG.図３に示す硝子体手術器具の要部拡大断面図である。It is a principal part expanded sectional view of the vitreous surgery instrument shown in FIG.従来の硝子体手術器具の断面図である。It is sectional drawing of the conventional vitreous surgery instrument.図５のＡ部拡大図である。It is the A section enlarged view of FIG.

以下、本発明の実施の形態について、添付図面を参照して説明する。図１は、本発明の一実施形態に係る硝子体手術器具の断面図である。図１に示すように、硝子体手術器具１は、本体１０および移動体２０を備えて構成されている。  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. FIG. 1 is a cross-sectional view of a vitreous surgery instrument according to an embodiment of the present invention. As shown in FIG. 1, the vitreous surgery instrument 1 includes amain body 10 and a movingbody 20.

本体１０は、支持部１２と、支持部１２の両側に設けられた操作部１３，１３とを備えており、互いに略平行に延びる一対の線状体１１，１１の基端側が支持部１２に固定されている。線状体１１は、通電可能な材料からなり、基端部に端子部１１ａを有する一方、先端に把持部１１ｂが設けられている。一対の線状体１１，１１の基端側には絶縁材１６が介在されている。  Themain body 10 includes asupport portion 12 andoperation portions 13 and 13 provided on both sides of thesupport portion 12, and the base end sides of the pair oflinear bodies 11 and 11 extending substantially in parallel with each other serve as thesupport portion 12. It is fixed. Thelinear body 11 is made of a material that can be energized, and has aterminal portion 11a at the base end portion, and agrip portion 11b at the tip end. Aninsulating material 16 is interposed on the base end side of the pair oflinear bodies 11, 11.

線状体１１は、全体として可撓性を有しており、把持部１１ｂ以外の部分が、銅などの電気抵抗率が低い金属材料から形成されている。把持部１１ｂは、線状体１１の他の部分よりも電気抵抗率が高い高抵抗金属材料（例えば、タングステン、コバルト、ニッケル、鉄、白金、クロム、チタンや、これらの合金等）により形成されている。一対の線状体１１，１１は、通常の状態で把持部１１ｂ，１１ｂ同士の間に隙間が生じるように、先端側が互いに離隔する方向に湾曲形状となるよう癖付けされている。高抵抗の把持部１１ｂは、例えば、全体が高抵抗の金属材料により形成された線状体１１の先端部以外を、低抵抗の金属材料からなるめっき膜等で被覆して形成することもできる。  Thelinear body 11 has flexibility as a whole, and a portion other than thegrip portion 11b is formed from a metal material having a low electrical resistivity such as copper. Thegrip portion 11b is formed of a high-resistance metal material (for example, tungsten, cobalt, nickel, iron, platinum, chromium, titanium, or an alloy thereof) having a higher electrical resistivity than other portions of thelinear body 11. ing. The pair oflinear bodies 11 and 11 are brazed so as to have a curved shape in a direction in which the distal ends are separated from each other so that a gap is generated between thegripping portions 11b and 11b in a normal state. The high-resistance gripping portion 11b can be formed, for example, by covering the tip of thelinear body 11 formed entirely of a high-resistance metal material with a plating film or the like made of a low-resistance metal material. .

支持部１２および操作部１３，１３は、合成樹脂材料等により一体成形することができ、支持部１２に対して操作部１３，１３の先端側を撓み変形可能に構成されている。操作部１３，１３の先端側は、両端が回動可能なアーム１４，１４を介して移動体２０に連結されている。支持部１２の先端側には受け部１５が支持されており、受け部１５は、移動体２０を移動可能に保持する。  Thesupport portion 12 and theoperation portions 13 and 13 can be integrally formed of a synthetic resin material or the like, and are configured such that the distal ends of theoperation portions 13 and 13 can be bent and deformed with respect to thesupport portion 12. The distal ends of theoperation units 13 and 13 are connected to the movingbody 20 viaarms 14 and 14 that can turn both ends. A receivingportion 15 is supported on the distal end side of thesupport portion 12, and thereceiving portion 15 holds themovable body 20 so as to be movable.

移動体２０は、ブロック状の基体２１に管体２２が固定されており、管体２２が一対の線状体１１，１１に外嵌されている。管体２２は、合成樹脂パイプ等の電気絶縁性材料からなる直管状の部材であり、一対の線状体１１，１１の端子部１１ａ，１１ａと把持部１１ｂ，１１ｂとの間で、一対の線状体１１，１１に沿って移動可能とされている。基体２１の先端側には、管体２２に外嵌される管状の補強部材２３が、基体２１に対して移動可能に支持されている。補強部材２３は、ばね部材２４によって先端方向に付勢される。  In the movingbody 20, atubular body 22 is fixed to a block-shaped base body 21, and thetubular body 22 is externally fitted to the pair oflinear bodies 11 and 11. Thetubular body 22 is a straight tubular member made of an electrically insulating material such as a synthetic resin pipe, and a pair oflinear bodies 11, 11 between theterminal portions 11a, 11a and thegripping portions 11b, 11b. It can be moved along thelinear bodies 11. On the distal end side of thebase body 21, a tubular reinforcingmember 23 fitted on thetube body 22 is supported so as to be movable with respect to thebase body 21. The reinforcingmember 23 is urged in the distal direction by thespring member 24.

図２は、図１に示す硝子体手術器具１の要部拡大断面図である。図１および図２に示すように、管体２２には、軸線を挟むようにして一対の収容路２２ｂ，２２ｂが長手方向に形成されており、それぞれの収容路２２ｂ，２２ｂに線状体１１，１１が個別に収容されている。また、管体２２の先端面における一対の収容路２２ｂ，２２ｂの間には、一対の線状体１１，１１の間に介在されるように突部２２ａが設けられている。  FIG. 2 is an enlarged cross-sectional view of a main part of the vitreous surgery instrument 1 shown in FIG. As shown in FIGS. 1 and 2, thetube body 22 is formed with a pair of receivingpassages 22 b and 22 b in the longitudinal direction so as to sandwich the axis, and thelinear bodies 11 and 11 are formed in the respectivereceiving passages 22 b and 22 b. Are individually housed. Further, aprotrusion 22 a is provided between the pair ofaccommodating passages 22 b and 22 b on the distal end surface of thetube body 22 so as to be interposed between the pair oflinear bodies 11 and 11.

上記の構成を備える硝子体手術器具１は、一対の線状体１１，１１の端子部１１ａ，１１ａを、電源３０に接続して使用することができる。この硝子体手術器具１をセッシとして使用する場合には、一対の線状体１１，１１への通電は不要であるため、スイッチ３２はオフの状態にしておくことで上述した従来の手術器具５０（図４参照）と同様に使用することができる。すなわち、補強部材２３の先端を眼の表面Ｓに当接させて管体２２を眼内に挿入し、図３に示すように、操作部１３，１３を矢示方向に押圧して、管体２２を一対の線状体１１，１１に沿って先端方向に移動させることにより、一対の線状体１１，１１の把持部１１ｂ，１１ｂが互いに近接して閉じた状態になる。こうして、例えば網膜上の増殖膜等の組織を把持して、剥離除去することができる。把持部１１ｂ，１１ｂが閉じた状態においては、図４に示すように、線状体１１と収容路２２ｂの開口周縁との接触部ｃが、管体２２の中心側に位置することが好ましく、この接触部ｃから先端側の把持部１１ｂの弾性力を利用して、組織等を確実に把持することができる。操作部１３，１３の押圧力を緩めると、ばね部材２４の付勢力によって管体２２は後退し、把持部１１ｂ，１１ｂの間を拡げることができる。  The vitreous surgery instrument 1 having the above-described configuration can be used by connecting theterminal portions 11 a and 11 a of the pair oflinear bodies 11 and 11 to thepower supply 30. When this vitreous surgical instrument 1 is used as a set, it is not necessary to energize the pair oflinear bodies 11, 11, so that the conventionalsurgical instrument 50 described above is kept by turning off theswitch 32. (See FIG. 4). That is, the distal end of the reinforcingmember 23 is brought into contact with the surface S of the eye, and thetubular body 22 is inserted into the eye, and theoperating portions 13 and 13 are pressed in the direction of the arrow as shown in FIG. By moving 22 in the distal direction along the pair oflinear bodies 11, 11, thegrip portions 11b, 11b of the pair oflinear bodies 11, 11 are close to each other and closed. Thus, for example, a tissue such as a proliferation film on the retina can be grasped and removed. In the state where thegripping portions 11b and 11b are closed, as shown in FIG. 4, it is preferable that the contact portion c between thelinear body 11 and the opening periphery of theaccommodation path 22b is located on the center side of thetubular body 22, The tissue or the like can be reliably gripped by utilizing the elastic force of thegrip portion 11b on the distal end side from the contact portion c. When the pressing force of theoperation portions 13 and 13 is loosened, thetubular body 22 is retracted by the biasing force of thespring member 24, and the space between thegrip portions 11b and 11b can be expanded.

硝子体手術器具１を用いた施術中に止血が必要になった場合には、スイッチ３２をオン状態にした後、操作部１３，１３を押圧して把持部１１ｂ，１１ｂ同士を接触させる。これにより、把持部１１ｂ，１１ｂ間が導通して一対の線状体１１，１１に電流が流れ、主として高抵抗の把持部１１ｂ，１１ｂにおいて発熱する。この把持部１１ｂ、１１ｂを出血部位に押し当てることにより、組織を凝固させて止血することができる。管体２２の先端面には、本実施形態のように、一対の線状体１１，１１の間に介在される突部２２ａを設けることが好ましく、操作部１３，１３を操作しない状態での把持部１１ｂ，１１ｂ間の導通を確実に防止することができる。止血の終了後は、スイッチ３２をオフにして、把持部１１ｂ，１１ｂの放熱後に硝子体手術器具１を再びセッシとして使用することができる。  When hemostasis is required during the treatment using the vitreous surgery instrument 1, after theswitch 32 is turned on, theoperation portions 13 and 13 are pressed to bring thegrip portions 11b and 11b into contact with each other. Thereby, thegripping portions 11b and 11b are electrically connected to each other, a current flows through the pair oflinear bodies 11 and 11, and heat is generated mainly in the high-resistance gripping portions 11b and 11b. By pressing the grippingportions 11b and 11b against the bleeding site, the tissue can be coagulated and hemostasis can be performed. As in the present embodiment, it is preferable to provide aprotrusion 22a interposed between the pair oflinear bodies 11 and 11 on the distal end surface of thetube body 22 in a state where theoperation sections 13 and 13 are not operated. It is possible to reliably prevent conduction between the grippingportions 11b and 11b. After the hemostasis is finished, theswitch 32 is turned off, and the vitreous surgery instrument 1 can be used again as a set after the heat radiation of thegripping portions 11b and 11b.

このように、本実施形態の硝子体手術器具１は、従来のセッシと同様に組織の剥離除去等に使用することができるだけでなく、組織の剥離等に伴い止血が必要になった場合には、管体２２を眼内から引き抜くことなく、一対の線状体１１，１１に通電して把持部１１ｂ，１１ｂを発熱させることにより、組織をピンポイントで熱凝固させることができるので、硝子体手術の安全性・作業性を向上させることができる。  Thus, the vitreous surgery instrument 1 of the present embodiment can be used not only for tissue exfoliation and the like as in the case of the conventional setushi, but also when hemostasis is required due to tissue exfoliation or the like. Since the tissue can be thermally coagulated pinpointly by energizing the pair oflinear bodies 11 and 11 to generate heat by pulling thetube body 22 out of the eye, the vitreous body Surgery safety and workability can be improved.

以上、本発明の一実施形態について詳述したが、本発明の硝子体手術器具は、必ずしも本実施形態の構成に限定されるものではなく、例えば、補強部材を備えない従来のセッシにも適用可能である。  As mentioned above, although one Embodiment of this invention was explained in full detail, the vitreous surgery instrument of this invention is not necessarily limited to the structure of this embodiment, For example, it applies also to the conventional setushi which is not provided with a reinforcement member. Is possible.

１ 硝子体手術器具
１０ 本体
１１ 線状体
１１ａ 端子部
１１ｂ 把持部
１３ 操作部
２０ 移動体
２２ 管体
２２ａ 突部
２２ｂ 収容路DESCRIPTION OF SYMBOLS 1 Vitreous bodysurgical instrument 10Main body 11Linear body 11aTerminal part 11b Grasppart 13Operation part 20Moving body 22Tubular body22a Protrusion part 22b Accommodation path

Claims (3)

Translated fromJapanese

一対の線状体を支持する本体と、
一対の前記線状体に外嵌される管体を有する移動体とを備え、
前記移動体を一対の前記線状体に沿って移動可能に構成された硝子体手術器具であって、
前記線状体は、通電可能な材料からなり、基端側に端子部が設けられ、先端側に高抵抗の把持部が設けられており、
前記管体は、電気絶縁性を有する材料からなり、一対の前記線状体を個別に収容する一対の収容路が形成されており、
前記管体を先端方向に進出させることにより、一対の前記線状体の前記把持部同士が接触する硝子体手術器具。A main body supporting a pair of linear bodies;
A moving body having a tubular body fitted around the pair of linear bodies,
A vitreous surgery instrument configured to be movable along the pair of linear bodies,
The linear body is made of a material that can be energized, a terminal portion is provided on the proximal end side, and a high resistance gripping portion is provided on the distal end side,
The tubular body is made of a material having electrical insulation, and a pair of housing paths for individually housing the pair of linear bodies are formed.
A vitreous surgery instrument in which the gripping portions of the pair of linear bodies come into contact with each other by advancing the tubular body in the distal direction. 前記管体の先端面には、一対の前記線状体の間に介在される突部が設けられている請求項１に記載の硝子体手術器具。  The vitreous surgery instrument according to claim 1, wherein a projecting portion interposed between the pair of linear bodies is provided on a distal end surface of the tubular body. 前記線状体は、可撓性を有し、先端側が湾曲形状に癖付けられており、前記把持部同士が接触した際に、前記管体の中心側において前記収容路の開口周縁と接触する請求項１または２に記載の硝子体手術器具。  The linear body has flexibility, and the tip end side is brazed in a curved shape, and when the gripping portions come into contact with each other, the linear body comes into contact with the peripheral edge of the opening of the accommodation path on the center side of the tubular body. The vitreous surgery instrument according to claim 1 or 2.

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