【発明の詳細な説明】［産業上の利用分野］本発明は、切間づることなく体腔外から体腔内、例えば
膝等の関節腔内の軟骨（関節半月、関節軟０）、軟骨瘤
、腫瘍等を切除し、体腔外に排出する外科用切除器具に
ｌ３１１するものである。Detailed Description of the Invention [Industrial Application Field] The present invention provides cartilage from outside the body cavity to within the body cavity, such as cartilage (articular meniscus, articular softness 0), chondrocele, It is used as a surgical resection instrument for excising tumors etc. and ejecting them out of the body cavity.
［従来の技術と発明が解決しようとする問題点］従来、
関節手術は、主として切開法（開放外科）によって行な
われていた。例えば、−殻内な関節の手術においては、
膝蓋骨上の腫瘍を切除したり、膝関節から破損した軟骨
、骨等を切除すること等であるが、これらの手術は、比
較的大きな切開を必要としていた。このため、切開によ
る外傷を生じ、名痛と運動制限とを伴い、完治までに多
くの時間を要するという欠点を有していた。[Problems to be solved by conventional techniques and inventions] Conventionally,
Joint surgery was primarily performed by incision (open surgery). For example, - In intrashell joint surgery,
These surgeries, such as removing tumors on the patella and removing damaged cartilage, bone, etc. from the knee joint, require relatively large incisions. As a result, the incision causes trauma, causing pain and restricted movement, and has the drawback of requiring a long time for complete recovery.
そこで近年、関節鏡（内視＃！１）の観察のもとで、関
節を切開しないで、この関節に小さな穿刺孔を形成し、
この穿刺孔に挿入部を挿入して手術する外科用切除器具
が提案されている。例えば、特開昭６１−１７０４４９
号公報では、硬性で直線的に伸びる外管内に、先端部に
切削部が設けられた硬性で直線的に伸びる内管を挿通し
た挿入部を右。Therefore, in recent years, under observation using an arthroscope (endoscopy #!1), a small puncture hole is made in this joint without incising the joint.
A surgical cutting instrument has been proposed that performs surgery by inserting an insertion portion into the puncture hole. For example, JP-A-61-170449
In the publication, an insertion section is shown in which a rigid, linearly extending inner tube with a cutting section at the tip is inserted into a rigid, linearly extending outer tube.
する外科用切除器具が開示されている。ところがこの硬
性で直線的に伸びる挿入部では１３１１節腔内で切除を
行う場合に、どうしても切除できない部位が発生づると
いう問題点があった。この問題に対処するために米国特
許ＵＳＰ４６４６７３８では、挿入部を形成する外管が
半硬性で、且つ、曲り癖のある外科用切除器具が開示さ
れている。しかしながら、この先行技術例では、挿入部
の先端側を任意の形状に曲げて使うのであるが、術中に
、体腔内、例えば関節腔に挿入する途中で骨等の硬い組
織に当たると挿入部の曲げ形状が変わり、挿入しにくか
ったり、場合によっては切除目的部位に到達できないと
いった問題点がある。A surgical cutting instrument is disclosed. However, with this rigid and linearly extending insertion section, there is a problem in that when resection is performed within the 1311 nodal cavity, there are areas that cannot be resected. To address this problem, US Pat. No. 4,646,738 discloses a surgical cutting instrument in which the outer tube forming the insertion portion is semi-rigid and has a tendency to bend. However, in this prior art example, the distal end of the insertion section is bent into an arbitrary shape, but during surgery, if it hits hard tissue such as bone while being inserted into a body cavity, for example a joint cavity, the insertion section will bend. There are problems in that the shape changes, making it difficult to insert, and in some cases, making it impossible to reach the target site.
そこで、本出願人は、特願昭６２− 号によって
、外管の先端側部位に固定湾曲部を設ける一方、内管の
少なくとも前記外管の固定湾曲部に対向した部位を可撓
性とし、且つ外管と内管とを本体に対し着脱自在にした
外科用切除器具を提案している。このｍ連技術によれば
、体腔内への挿入途中で挿入部の設定曲げ形状が硬い組
織等により変化されることがなく、又、対象組織へのア
プローチをし易い曲げ形状に挿入部が形成されているも
のを選定できる利点を有している。しかしながら、この
関連技術では、一部に固定湾曲部を有する外管に対して
内管を洗浄等で挿脱づるには、内管は可撓性を有する必
要があり、この内管を外管に挿入するとき固定湾曲部分
で内管が外管内壁に引っかかり挿入組付性が皿いといっ
た問題点が残っている。又、内管の先端側に設けられる
切刃は切除効率を上げる為には大きくするのが望ましい
が、その半面内管の外管への挿入組付性が悪くなるとい
った問題点がある。即ち、中途に固定湾曲部を有づる外
管内に内管を挿入組付けるとき、内管の切刃先端が湾曲
部を通過できるようにする必要があり、その為、内管先
端の切刃の大きさは制約されてしまっている。Therefore, in Japanese Patent Application No. 1983, the present applicant provided a fixed curved portion at the distal end portion of the outer tube, while at least a portion of the inner tube opposite to the fixed curved portion of the outer tube was made flexible. Furthermore, the present invention proposes a surgical cutting instrument in which the outer tube and the inner tube are detachable from the main body. According to this m-series technology, the set bending shape of the insertion section is not changed by hard tissue during insertion into the body cavity, and the insertion section is formed into a bending shape that makes it easy to approach the target tissue. It has the advantage of being able to choose what is available. However, in this related technology, in order to insert and remove the inner tube for cleaning etc. into the outer tube which has a fixed curved portion in part, the inner tube needs to be flexible, and the inner tube must be flexible. There remains the problem that the inner tube gets caught on the inner wall of the outer tube at the fixed curved portion when inserted into the tube, making insertion and assembly difficult. Further, although it is desirable that the cutting blade provided at the distal end of the inner tube be made larger in order to improve cutting efficiency, there is a problem in that the inserting and assembling of the inner tube into the outer tube becomes difficult. That is, when inserting and assembling the inner tube into an outer tube that has a fixed curved part in the middle, it is necessary to allow the tip of the cutting edge of the inner tube to pass through the curved part. Size is restricted.
本発明は、これらの事情に鑑みてなされたもので、体腔
内の挿入途中で挿入部の設定曲げ形状が硬い組織等によ
り変化されることがなく、又対象組織へのアプローチを
し易い固定曲げ形状に挿入部を設定できる上に、内管の
外管に対する組付性がよく、しかも内管及び外管を洗浄
し易く、さらには外管の湾曲部に対する挿通性に制約さ
れることなく内管の切刃を大きくすることが可能で切除
効率を向上できるようにした外科用切除器具を提供する
ことを目的としている。The present invention has been made in view of these circumstances, and is designed to prevent the set bending shape of the insertion section from being changed by hard tissue during insertion into a body cavity, and to provide a fixed bending shape that makes it easy to approach the target tissue. The insertion part can be set according to the shape, the inner tube can be easily assembled to the outer tube, the inner tube and the outer tube can be easily cleaned, and the inner tube can be easily inserted into the curved part of the outer tube without being restricted. It is an object of the present invention to provide a surgical resection instrument that can increase the cutting edge of a tube and improve the resection efficiency.
［問題点を解決するための手段及びその作用］前記目的
を達成するため本発明による外科用切除器具は、先端に
組織取込刃口を開口して先端部側に固定湾曲部を設けて
先端の刃口を所定角度に屈曲させた外管内に、前記刃口
に対向した切刃を設けた切刃部材を先端部に有する一方
、少なくとも固定湾曲部に対応した部位から前方を可撓
性に形成した内管を、軸回り回転自在に内装して挿入部
を構成する一方、前記内管先端の切刃部材を、内管が外
管に挿入組付けられた状態で外管先端側から着脱可能に
構成されている。[Means for Solving the Problems and Their Effects] In order to achieve the above object, the surgical cutting instrument according to the present invention has a tissue-taking opening at the tip and a fixed curved portion on the tip side. The outer tube has a cutting edge bent at a predetermined angle, and has a cutting blade member provided with a cutting edge facing the cutting edge at the tip, while at least the front part from the part corresponding to the fixed curved part is flexible. The formed inner tube is placed inside to be rotatable about the axis to form an insertion section, while the cutting blade member at the tip of the inner tube is attached and detached from the tip side of the outer tube with the inner tube inserted and assembled into the outer tube. configured to be possible.
この構成で、外管から内管を抜去するには、内管先端の
切刃部材を外管先端側から取り外した後に、内管を外管
の基部側から抜去する。又、内管を外管に挿入組付ける
には、切刃部材を外した状態の内管を外管の基部側から
挿入し、その後外管の先端側から切刃部材を組付ける。In this configuration, in order to remove the inner tube from the outer tube, the cutting blade member at the tip of the inner tube is removed from the tip side of the outer tube, and then the inner tube is removed from the base side of the outer tube. Further, in order to insert and assemble the inner tube into the outer tube, the inner tube with the cutting blade member removed is inserted from the base side of the outer tube, and then the cutting blade member is assembled from the distal end side of the outer tube.
［実施例］以下、図面を参照して本発明の実施例を具体的に説明す
る。[Example] Hereinafter, an example of the present invention will be specifically described with reference to the drawings.
第１図ないし第５図は本発明外科用切除器具の第１実施
例に係り、第１図は所面図、第２図は第１図のへ方向矢
視図、第３図は第１図のＤＩ−Ｉ線断面図、第４図は外
管の先端部を示す側面図、第５図は第４図のｖ−ｖ線断
面図である。1 to 5 relate to a first embodiment of the surgical cutting instrument of the present invention, in which FIG. 1 is a top view, FIG. 2 is a view taken in the direction of the arrow in FIG. 4 is a side view showing the tip of the outer tube, and FIG. 5 is a sectional view taken along the line v-v in FIG. 4.
これらの図において、符号１は外羊４用切除器具で、手
元側の把持部を兼用した本体２と、この本体２から前方
へ延設されて体腔内、例えば関節腔内へ挿入される細長
な挿入部３とから構成されている。前記挿入部３は、間
口した基部を本体２の先端部に固定される外管４と、こ
の外管４内に軸回りに回動自在に内装される内管５とか
ら構成されている。そして、この外管４は、例えばステ
ンレス等からなり、図示例では先端に組織取込刃口６を
開口する一方、先端の刃口６を組織にアプローチし易い
よう例えば３０度位の角度に屈曲する固定湾曲部７を先
端部側に形成している。一方、内管５は、密答きコイル
、可撓性合成樹脂チューブ（マルチゴアヂューブ、ウレ
タンチューブ等）よりなり、その先端に切刃部材８を固
定している。In these figures, reference numeral 1 denotes a resection instrument for external sheep 4, which includes a main body 2 that also serves as a grip on the proximal side, and a slender member that extends forward from the main body 2 and is inserted into a body cavity, for example, a joint cavity. It is composed of an insertion section 3. The insertion section 3 is composed of an outer tube 4 whose open base is fixed to the distal end of the main body 2, and an inner tube 5 housed within the outer tube 4 so as to be rotatable about an axis. The outer tube 4 is made of, for example, stainless steel, and in the illustrated example, has a tissue-taking opening 6 at its tip, and is bent at an angle of, for example, about 30 degrees to make it easier to approach the tissue. A fixed curved portion 7 is formed on the distal end side. On the other hand, the inner tube 5 is made of a tightly coiled coil or a flexible synthetic resin tube (multi-gore tube, urethane tube, etc.), and has a cutting blade member 8 fixed to its tip.
この切刃部材８には切刃８ａ側から内管５内に連通する
連通孔８ｂが形成されており、外管４の組織取込刃口６
がこの連通孔８ｂを経て内管５内に連通している。この
内管５の内路は、切片吸引通路９となっていると共に、
切片吸引装置を接続する手元側本体２に連通している。This cutting blade member 8 is formed with a communication hole 8b that communicates from the cutting blade 8a side into the inner tube 5, and a tissue intake opening 6 of the outer tube 4 is formed.
communicates with the inside of the inner tube 5 via this communication hole 8b. The inner path of this inner tube 5 serves as a section suction passage 9, and
It communicates with the proximal main body 2 to which the section suction device is connected.
前記外管４の先端部に有する組織取込刃口６は、外管４
の先端に対し着脱自在とした先端構成部材１０の先端部
に形成されている。この先端構成部材１０は中途内周か
ら後端にかけ還拡径部１１が形成され、この拡径部１１
の後部に′雌ねじを形成しており、外管４先端部のやや
小径とした外周に形成した雄ねじに螺合して、外管４の
先端部に着脱自在に取付けられるようになっている。一
方、内管５先端の切刃部材８は、内管５に対しむ脱自在
どなっている。この切刃部材８は、その外周に前記先端
構成部材１０の拡径部１１に係合可能な外径の７ランジ
１２を有して、先端構成部材１０の拡径部１１に後端開
口から係合挿入され、フランジ１２の先端面を拡径部１
１先端の段部１１ａに当接するようになっている。又、
内管５は先端に環状のコネクタ１３を固定しており、結
局館記先喘（８成部［１０の拡径部１１にフランジ１２
を係合挿入した切刃部材８は、該先端構成部材１０を外
管４に螺合固定したとき、７ランジ１２の先端部が拡径
部１１の段部１１ａに当接し、後端面がコネクタ１３に
当接して位置決めされ、且つ切刃部材８の（１２端に形
成したキー８Ｃがコネクタ１３内に嵌入固定されるよう
になっている。The tissue intake opening 6 provided at the distal end of the outer tube 4 is
It is formed at the distal end of the distal end component 10 which is removably attached to the distal end. This tip constituent member 10 has a return enlarged diameter portion 11 formed from the inner circumference midway to the rear end, and this enlarged diameter portion 11
A female thread is formed at the rear of the outer tube 4, and the outer tube 4 can be removably attached to the tip of the outer tube 4 by screwing into a male screw formed on the slightly smaller diameter outer periphery of the tip of the outer tube 4. On the other hand, the cutting blade member 8 at the tip of the inner tube 5 is removable from the inner tube 5. This cutting blade member 8 has a seven flange 12 on its outer periphery with an outer diameter capable of engaging with the enlarged diameter portion 11 of the tip component 10, and connects to the enlarged diameter portion 11 of the tip component 10 from the rear end opening. The distal end surface of the flange 12 is inserted into the enlarged diameter portion 1.
It comes into contact with a stepped portion 11a at one end. or,
An annular connector 13 is fixed to the tip of the inner tube 5, and a flange 12 is attached to the enlarged diameter portion 11 of the 8-part part [10].
When the distal end component 10 is screwed and fixed to the outer tube 4, the distal end of the seven flange 12 comes into contact with the step 11a of the enlarged diameter section 11, and the rear end surface of the cutting blade member 8 engages with and inserts into the connector. 13, and a key 8C formed at the end (12) of the cutting blade member 8 is fitted and fixed into the connector 13.
前記本体２は外科用切除器具１を外科医等の術者が手に
もって操作する部分であり、前記内管５を回転駆動する
駆動部分等を収納づるハウジング１４と、前記外管４の
吸引通路９に連通した空洞１５を右して切片吸引装置に
接続される吸引管口金１６を取付けた前部ハウジング１
７とから構成されている。この前部ハウジング１７は、
例えば螺合手段にてハウジング１４に着脱自在に螺着連
結されている。また、この前部ハウジング１７は前方に
環状の固定部１８を延設し、且つ、その内周軸方向に溝
部１９を形成している。一方、外管４の１．４部外周に
は、前方にフランジ２０を有するスリーブ２１が嵌合さ
れていると共に、スリーブ２１外周にピン２２を植立し
ている。そして、前記ピン２２を溝部１９内に係入した
状態でスリーブ２１を嵌合した外管４基部を固定部１８
内に挿入し、且つ、固定ねじ体２３を固定部１８外因に
螺合して着脱自在に外管４の基部を固定している。The main body 2 is a part of the surgical resection instrument 1 that is held and operated by an operator such as a surgeon, and includes a housing 14 that houses a driving part that rotationally drives the inner tube 5, and a suction passage of the outer tube 4. The front housing 1 has a suction tube mouthpiece 16 connected to a section suction device on the right side of the cavity 15 communicating with the section suction device 9.
It consists of 7. This front housing 17 is
For example, it is removably screwed to the housing 14 by screwing means. Further, this front housing 17 has an annular fixing part 18 extending in the front thereof, and a groove part 19 is formed in the inner circumferential axis direction thereof. On the other hand, a sleeve 21 having a flange 20 at the front is fitted onto the 1.4 part outer periphery of the outer tube 4, and a pin 22 is installed on the outer periphery of the sleeve 21. Then, with the pin 22 engaged in the groove 19, the base of the outer tube 4 fitted with the sleeve 21 is attached to the fixing part 18.
The fixing screw body 23 is screwed onto the external part of the fixing part 18 to removably fix the base of the outer tube 4.
前記ハ「フランジ１４の後部には、駆動部分としてのモ
ータ２４が内装され、このモータ２４の前方に突出した
モータ軸２５には雄スプライン２６が固定されている。A motor 24 as a driving portion is installed in the rear of the flange 14, and a male spline 26 is fixed to a motor shaft 25 that projects forward of the motor 24.
一方、このモータ２４の前方には、出力軸２７が回転自
在に、且つ軸方向に摺動可能に軸受りされていると共に
、この後部に雌スプライン２８が形成され、この雌スプ
ライン２８が前記雄スプライン２６に噛合している。前
記出力軸２７は、前記ハウジング１４の空洞１５内に突
出し、この突出部に内管５の後端部に設けられた接続部
材２９が連結されている。この接続部材２９には、前記
吸引路９と連通する窓部３０が外周に設けられている。On the other hand, an output shaft 27 is rotatably and slidably supported in the axial direction at the front of the motor 24, and a female spline 28 is formed at the rear of the motor 24. It meshes with the spline 26. The output shaft 27 protrudes into the cavity 15 of the housing 14, and a connecting member 29 provided at the rear end of the inner tube 5 is connected to this protrusion. A window 30 communicating with the suction path 9 is provided on the outer periphery of the connecting member 29 .
このような構成では、内管５を外管４内に挿入組イ］け
るには、内管５先端の切刃部材８を該内管５から外した
状態で外管４の基部開口から挿入する。その後、外管４
から取外された先端構成部材１ｏの拡径部１１内に、後
端開口からフランジ１２を係合させて切刃部材８を挿入
づる。この状態で、先端構成部材１ｏを外管４の先端部
に螺合して固定ηることにより、切刃部材８はそのフラ
ンジ１２の先端面を段部１１ａに当接し、後端面を内管
５のコネクタ１３に当接して前段が位置決めされ、且つ
キー８Ｃをコネクタ１３に嵌入固定して、内管５の先端
部に組付けられ、内管５の回転力が伝達可能となる。In such a configuration, in order to insert and assemble the inner tube 5 into the outer tube 4, the cutting blade member 8 at the tip of the inner tube 5 is removed from the inner tube 5, and then inserted from the base opening of the outer tube 4. do. After that, outer tube 4
The cutting blade member 8 is inserted into the enlarged diameter portion 11 of the distal end component 1o that has been removed from the rear end by engaging the flange 12 from the rear end opening. In this state, by screwing and fixing the tip component 1o to the tip of the outer tube 4, the cutting blade member 8 brings the tip surface of its flange 12 into contact with the stepped portion 11a, and the rear end surface of the cutting blade member 8 into contact with the step portion 11a. The front stage is positioned by contacting the connector 13 of the inner tube 5, and the key 8C is fitted and fixed into the connector 13, and is assembled to the tip of the inner tube 5, so that the rotational force of the inner tube 5 can be transmitted.
又、外管４から内管５を洗浄等のために後人するには、
まず、先端構成部材１０を外管４の先端部から取り外し
て、切刃部材８のキー８Ｃを内管５のコネクタ１３から
引き抜き、該切刃部材８を外管４の先端側から取り外１
゜その後、内管５を外管４の基部側間口から扱去する。Also, in order to remove the inner tube 5 from the outer tube 4 for cleaning etc.
First, remove the tip component 10 from the tip of the outer tube 4, pull out the key 8C of the cutting blade member 8 from the connector 13 of the inner tube 5, and remove the cutting blade member 8 from the tip side of the outer tube 4.
゜Then, the inner tube 5 is handled and removed from the base side opening of the outer tube 4.
このように、内管５先喘の切刃部材８を外管４の先端側
から着脱づるため、この外管４の先端部側には固定湾曲
部７が形成されているが、内管５の内装、組み付けを容
易に行なえ、しかも内管５及び外管４が簡単に分解でき
るため、洗浄に優れている。又、内管５の切刃８ａが外
管４の湾曲部７に対する挿通性に全く制約されることが
なく、従って切刃８ａを大きくすることが可能である。In this way, in order to attach and detach the cutting blade member 8 at the tip of the inner tube 5 from the distal end side of the outer tube 4, the fixed curved portion 7 is formed at the distal end side of the outer tube 4. The inner tube 5 and the outer tube 4 can be easily disassembled, making it easy to clean. In addition, the cutting edge 8a of the inner tube 5 is not restricted at all by the ability to pass through the curved portion 7 of the outer tube 4, and therefore it is possible to increase the size of the cutting edge 8a.
更に、内管５を外管に組付けた状態で切刃部材８の交換
を行うことが可能である。ざらに又、前記のように挿入
部２先端部は湾曲部７の存在によって組織にアプローチ
し易い角度で屈曲しているため、先端の組織取込刃口６
を組織ヘアブローチし易い。Furthermore, it is possible to replace the cutting blade member 8 while the inner tube 5 is assembled to the outer tube. In addition, as mentioned above, the distal end of the insertion section 2 is bent at an angle that makes it easy to approach the tissue due to the presence of the curved section 7, so the tissue taking in opening 6 at the distal end
The tissue hair broach is easy to make.
第６図及び第７図は本発明第１実施例の変形例を示す要
部断面図である。これら変形例は、内管５を形成づる密
巻コイルの各コイル素線５ａの隙間に組織片、汚物等が
詰まり易く、その洗浄、除去が困難である為、第６図に
示すように各コイル素線５ａの隙間にテフロン等の合成
樹脂５ｂを充填し、又は第７図に示づように合成樹脂層
５Ｃ中に密巻コイルの素線５ａを埋設したものである。6 and 7 are sectional views of essential parts showing a modification of the first embodiment of the present invention. In these modified examples, the gaps between the coil wires 5a of the tightly wound coil forming the inner tube 5 are easily clogged with tissue particles, dirt, etc., and cleaning and removal thereof is difficult. The gap between the coil wires 5a is filled with a synthetic resin 5b such as Teflon, or the wires 5a of the tightly wound coil are buried in a synthetic resin layer 5C as shown in FIG.
第８図は本発明第１実施例の更に他の変形例を示す断面
図である。この変形例は切刃８ａの摩耗を防止して切れ
味の低下を妨ぐと共に、回転する切刃部材８のジャーナ
ル部８ｄ、このジャーナル部８ｄを軸受づる外管４の先
端構成部１０の摩耗を防止して摩耗によるガタをなくす
よう切刃部材８及び先端構成部材１゛０をセラミックス
で成形したものである。尚、図示例では切刃部材８の後
部キー８０を内管５先端に直接嵌入し、内管に固定した
ソケットを省略した例を示している。FIG. 8 is a sectional view showing still another modification of the first embodiment of the present invention. This modification prevents wear of the cutting blade 8a and prevents deterioration of sharpness, and also prevents wear of the journal portion 8d of the rotating cutting blade member 8 and the tip component 10 of the outer tube 4 that bears this journal portion 8d. The cutting blade member 8 and tip component member 1'0 are molded from ceramics to prevent looseness due to wear. In the illustrated example, the rear key 80 of the cutting blade member 8 is directly inserted into the tip of the inner tube 5, and the socket fixed to the inner tube is omitted.
第９図は本発明の第２実施例を示１断面図である。FIG. 9 is a sectional view showing a second embodiment of the present invention.
この実施例は、第１実施例にお１ノるコネクタ１３と切
刃部材８との間に緩衝用のコイルスプリング３１を介装
したものである。その為、コイルスプリング３１を受け
ることができるようにコネクタ１３を先端有底状に形成
すると共に、切刃部材８のキー８０はコネクタ１３の有
底先端面に形成したキー溝３２に嵌入されている。この
実施例は切刃部材８が内管５のコネクタ１３との間で緩
衝できる以外は、第１実施例と同じである。In this embodiment, a buffer coil spring 31 is interposed between the connector 13 and the cutting blade member 8, which are the same as in the first embodiment. Therefore, the connector 13 is formed to have a bottomed end so that it can receive the coil spring 31, and the key 80 of the cutting blade member 8 is fitted into the keyway 32 formed in the bottomed end surface of the connector 13. There is. This embodiment is the same as the first embodiment except that the cutting blade member 8 can be buffered between the connector 13 of the inner tube 5.
第１０図ないし第１２図は本発明の第３実施例に係り、
第１０図は切刃部材を外した状態の挿入部先端を示す要
部切欠き側面図、第１１図は切刃部材に固定される磁石
を示す斜視図、第１２図は内管先端に固定される磁石を
示す斜視図である。10 to 12 relate to the third embodiment of the present invention,
Figure 10 is a cutaway side view of the main part showing the tip of the insertion tube with the cutting blade removed, Figure 11 is a perspective view showing the magnet fixed to the cutting blade, and Figure 12 is fixed to the tip of the inner tube. It is a perspective view showing a magnet.
この実施例は、磁石の吸着力で切刃部材８を内管５に着
脱自在に装着するもので、切刃部材８の後部には係入キ
ー３３を有するリング状の磁石３４が固定されている一
方、内管５の先端には係合凹部３５を右するリング状の
磁石３６が固定され、両磁石３４．３６の対向面は吸着
力が作用するよう異極同士が配置されている。この実施
例によれば、切刃部材８を外管４の先端側から内管５に
対し脱着するのに外管４の先端部を先端構成部材として
分離するよう構成し、且つ切刃部材８を押える段部等の
構成の必要がない。その他の作用効果、及び構成は第１
実施例とほぼ同様である。In this embodiment, the cutting blade member 8 is detachably attached to the inner tube 5 by the attraction force of the magnet, and a ring-shaped magnet 34 having an engagement key 33 is fixed to the rear part of the cutting blade member 8. On the other hand, a ring-shaped magnet 36 is fixed to the distal end of the inner tube 5 to the right of the engagement recess 35, and the opposing surfaces of both magnets 34 and 36 are arranged with different polarities so that an attractive force acts on them. According to this embodiment, when the cutting blade member 8 is attached to and detached from the inner tube 5 from the distal end side of the outer tube 4, the distal end of the outer tube 4 is separated as a tip constituent member, and the cutting blade member 8 There is no need for a structure such as a stepped section to hold down the material. Other effects and configuration are the first
This is almost the same as the example.
第１３図及び第１４図は、他の実施例に係り、第１３図
は挿入部先端側を示す断面図、第１４図ハｍ １３図（
７） Ｘ ＩＶ −Ｘ ＴＶ Ｉ断面図である。13 and 14 relate to other embodiments, in which FIG. 13 is a sectional view showing the distal end side of the insertion section, and FIG.
7) It is a sectional view taken along the line XIV-XTVI.
この実施例は、内管の内部を吸引通路とすると、この通
路の径は小さくせざるを得ないので、及び内管５の内路
を吸引通路とＪると該内管５が密巻きコイルで形成され
ているとき、コイル素線の隙間に切片等が詰まるので、
外管４の外周に、例えば二本の切片吸引路３７を形成し
、この通路３７と切刃部材８部位とを連通孔３８で連通
させている。尚、連通孔３８後部側の切刃部材８と外管
４内周との間にはシール部材３９が介装されている。In this embodiment, if the inside of the inner tube is used as a suction passage, the diameter of this passage must be made small. When the coil is formed with
For example, two section suction passages 37 are formed on the outer periphery of the outer tube 4, and the passages 37 and the portion of the cutting blade member 8 are communicated through a communication hole 38. Note that a seal member 39 is interposed between the cutting blade member 8 on the rear side of the communication hole 38 and the inner periphery of the outer tube 4.
第１５図は第１３図の変形例の他の例を示寸断面図で、
外管４の外周側に断面楕円形の外管二重管部４０を形成
し、外管４で二重管部４０の短径部を閉塞し、両回弧部
側に吸引通路４１を形成している。FIG. 15 is a sectional view showing another example of the modification of FIG. 13.
An outer tube double tube part 40 having an oval cross section is formed on the outer circumferential side of the outer tube 4, the short diameter part of the double tube part 40 is closed with the outer tube 4, and a suction passage 41 is formed on both arcuate part sides. are doing.
第１６図及び第１７図は更に他の実施例に係り、第１６
図は挿入部の断面図、第１７図は挿入部の側面図である
。FIG. 16 and FIG. 17 relate to still another embodiment, and FIG.
The figure is a sectional view of the insertion part, and FIG. 17 is a side view of the insertion part.
この実施例は、切刃５１を回転駆動するフレキシブルシ
ャフト５２を、先端に外刃５４が設けられた外管５３内
に組込んで外科用切除器具の挿入部５５を構成するもの
において、該挿入部５５の先端部に観察手段５６／照明
手段５７を配設して、体腔内を観察／照明しながら、組
織の切除を行えるにうにしたものである。In this embodiment, a flexible shaft 52 for rotationally driving a cutting blade 51 is incorporated into an outer tube 53 having an outer cutter 54 at its tip to constitute an insertion section 55 of a surgical cutting instrument. An observation means 56/illumination means 57 is disposed at the distal end of the section 55 so that tissue can be excised while observing/illuminating the inside of the body cavity.
前記観察手段５６としては、対物レンズ５８の結像位置
に固体撮像素子５９を配設し、光学像を光電変換して信
号クープル６０にて電気信号として取り出し、ビデオブ
ロセッザ等を経て表示装置に表示するもの、及び対物レ
ンズ５８の結像位置にオプティカルファイバーバンドル
からなるイメージガイドの端面を配置し、このイメージ
ガイドを接眼部にまで延設したものがある。又、照明手
段５７としては、外部の光源からの照明光を伝送でるイ
メージガイド、ＬＥＤ、ランプ等が用いられる。As the observation means 56, a solid-state image pickup device 59 is disposed at the imaging position of the objective lens 58, photoelectrically converts the optical image, extracts it as an electric signal at the signal coupler 60, and sends it to a display device via a video processor or the like. There is also one in which the end face of an image guide made of an optical fiber bundle is arranged at the imaging position of the objective lens 58, and this image guide is extended to the eyepiece. Further, as the illumination means 57, an image guide, an LED, a lamp, etc. that can transmit illumination light from an external light source is used.
尚、本発明において、外管の刃口の形状、及び切刃部材
の切刃の形状は必要に応じて種々形成して用いられる。In the present invention, the shape of the cutting edge of the outer tube and the shape of the cutting edge of the cutting blade member may be formed in various shapes as necessary.
又、内管は少なくとも外管の湾曲部相当部位から前方が
フレキシブルであればよい。Further, the inner tube only needs to be flexible at least in the front from the portion corresponding to the curved portion of the outer tube.
［発明の効果］以上説明したように本発明によれば、体腔内への挿入途
中で挿入部の設定曲げ形状が硬い組織等により変化され
ることがなく、又、対象組織へのアブローヂをし易い固
定曲げ形状に挿入部を設定できる上に、内管の外管に対
する組付性がよく、しかも内管及び外管を洗浄し易く、
ざらには外管の前記湾曲部に対する挿通性に制約される
ことなく内管の切刃を大きくでき、切除効率を向上でき
る効果がある。[Effects of the Invention] As explained above, according to the present invention, the preset bending shape of the insertion portion is not changed by hard tissue or the like during insertion into a body cavity, and ablation to the target tissue is prevented. The insertion part can be set in a fixed bending shape that is easy to bend, the inner tube can be easily assembled to the outer tube, and the inner tube and outer tube are easy to clean.
In general, the cutting edge of the inner tube can be made larger without being restricted by the ability of the outer tube to pass through the curved portion, which has the effect of improving cutting efficiency.
第１図ないし第５図は本発明外科用切除器具の第１実施
例に係り、第１図は断面図、第２図は第１図のへ方向矢
視図、第３図は第１図の■−■線断面図、第４図は外管
の先端部を示１゛側面図、第５図は第４図のｖ−ｖ線断
面図、第６図及び第７図は第１実施例の内管の変形例を
示す要部拡大新面図、第８図は第１実施例の外管先端部
と切刃部材の変形例を示す断面図、第９図は第２実施例
を示す挿入部先端部を示す断面図、第１０図ないし第１
２図は本発明第３実施例に係り、第１０図は挿入部先端
側を示す要部切欠き側面図、第１１図及び第１２図は各
々磁石を示す斜視図、第１３図及び第１４図は他の実施
例に係り、第１３図は挿入部の先端側を示す断面図、第
１４図は第１３図のＸｒＶ−ＸＩＶ線断面図、第１５図
は第１４図の変形例を示づ断面図、第１６図及び第１７
図は更に他の実施例に係り、第１６図は挿入部の断面図
、第１７図は側面図である。２・・・本体 ３・・・挿入部４・・・外
管 ５・・・内管６・・・刃口
７・・・固定湾曲部８・・・切刃部材 １
０・・・先端構成部材１３・・・コネクタ第４図 第５図第６図 第７図工＝＝＝ 助言槌第１０図第１３図ｊｕＶ ５ソ第１４図 第１５図口第１６図第１７図手続ネ市正書（自発）昭和６３年１月２８日特り′Ｆ庁長官 小川 ｊ（Ｓ 夫 殿
ら）、１１、事件の表示 昭和６２年特許
願第３０５４３７号２、発明の名称 外科用切除器
具３、補正をする者事件との関係 特許出願人代表者 下 山 敏 部４、代理人５、補正命令の日イ］ （自 発）６、補正の対象 明細占の「特許請求の範囲」の欄
７、補正の内容 別紙の通り１、特許請求の範囲を次のとおりに補正しまづ゛。1 to 5 relate to a first embodiment of the surgical cutting instrument of the present invention, in which FIG. 1 is a sectional view, FIG. 2 is a view taken in the direction of the arrow in FIG. 1, and FIG. Fig. 4 is a side view showing the tip of the outer tube, Fig. 5 is a sectional view taken along line v-v in Fig. 4, and Figs. 6 and 7 are views of the first implementation. FIG. 8 is a cross-sectional view showing a modification of the outer tube tip and cutting blade member of the first embodiment. FIG. 9 is a cross-sectional view of the second embodiment. 10 to 1 are cross-sectional views showing the distal end of the insertion portion shown in FIG.
Figure 2 relates to the third embodiment of the present invention, Figure 10 is a cutaway side view of the main part showing the distal end side of the insertion section, Figures 11 and 12 are perspective views showing the magnet, and Figures 13 and 14. The figures relate to other embodiments; FIG. 13 is a sectional view showing the distal end side of the insertion section, FIG. 14 is a sectional view taken along the line XrV-XIV in FIG. 13, and FIG. 15 is a modification of FIG. 14. Cross-sectional view, Figures 16 and 17
The figures relate to still another embodiment, with FIG. 16 being a sectional view of the insertion portion, and FIG. 17 being a side view. 2...Main body 3...Insertion part 4...Outer tube 5...Inner tube 6...Blade mouth
7... Fixed curved part 8... Cutting blade member 1
0...Tip component 13...Connector Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. === Advice hammer Fig. 10 Fig. 13 juV 5 Seo Fig. 14 Fig. 15 Mouth Fig. 16 Fig. 17 Illustrated Procedures City Authorization (Spontaneous) January 28, 1986 Special Office Commissioner Ogawa J (Mr. S. Husband)
et al.), 11. Indication of the case Patent Application No. 305437 of 1988 2, Title of the invention Surgical resection instrument 3, Relationship with the person making the amendment case Patent applicant representative Satoshi Shimoyama Department 4, Agent 5, Date of amendment order] (Volunteer) 6. Subject of amendment Column 7 of "Claims" in the detailed description Contents of amendment As shown in the attached document 1, the scope of claims has been amended as follows.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP62305437AJP2510227B2 (en) | 1987-12-02 | 1987-12-02 | Surgical resection instrument |
| DE19883828478DE3828478C2 (en) | 1987-10-30 | 1988-08-22 | Surgical resection device |
| US08/237,832US5529580A (en) | 1987-10-30 | 1994-05-04 | Surgical resecting tool |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP62305437AJP2510227B2 (en) | 1987-12-02 | 1987-12-02 | Surgical resection instrument |
| Publication Number | Publication Date |
|---|---|
| JPH01146541Atrue JPH01146541A (en) | 1989-06-08 |
| JP2510227B2 JP2510227B2 (en) | 1996-06-26 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP62305437AExpired - LifetimeJP2510227B2 (en) | 1987-10-30 | 1987-12-02 | Surgical resection instrument |
| Country | Link |
|---|---|
| JP (1) | JP2510227B2 (en) |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8097167B2 (en) | 2006-01-18 | 2012-01-17 | Basf Se | Concentration of suspensions |
| JP2015014288A (en)* | 2014-07-09 | 2015-01-22 | セイコーエプソン株式会社 | Fluid ejection unit and medical device |
| US9433434B2 (en) | 2010-10-12 | 2016-09-06 | Seiko Epson Corporation | Fluid ejection device and medical instrument |
| JP2019529041A (en)* | 2016-09-20 | 2019-10-17 | ジャーメイン、アーロン | Arthroscopy apparatus and method |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4445509A (en)* | 1982-02-04 | 1984-05-01 | Auth David C | Method and apparatus for removal of enclosed abnormal deposits |
| US4646738A (en)* | 1985-12-05 | 1987-03-03 | Concept, Inc. | Rotary surgical tool |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4445509A (en)* | 1982-02-04 | 1984-05-01 | Auth David C | Method and apparatus for removal of enclosed abnormal deposits |
| US4646738A (en)* | 1985-12-05 | 1987-03-03 | Concept, Inc. | Rotary surgical tool |
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8097167B2 (en) | 2006-01-18 | 2012-01-17 | Basf Se | Concentration of suspensions |
| US8506822B2 (en) | 2006-01-18 | 2013-08-13 | Basf Se | Concentration of suspensions |
| US9433434B2 (en) | 2010-10-12 | 2016-09-06 | Seiko Epson Corporation | Fluid ejection device and medical instrument |
| JP2015014288A (en)* | 2014-07-09 | 2015-01-22 | セイコーエプソン株式会社 | Fluid ejection unit and medical device |
| JP2019529041A (en)* | 2016-09-20 | 2019-10-17 | ジャーメイン、アーロン | Arthroscopy apparatus and method |
| Publication number | Publication date |
|---|---|
| JP2510227B2 (en) | 1996-06-26 |
| Publication | Publication Date | Title |
|---|---|---|
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