Medical treatment instrument

• US 6,099,537 A
• Filed: 02/25/1997
• Issued: 08/08/2000
• Est. Priority Date: 02/26/1996
• Status: Expired due to Fees

• Current Assignee: Olympus Optical Company Ltd. (Olympus Corporation)
• Original Assignee: Olympus Optical Company Ltd. (Olympus Corporation)
• Inventors: Uchiyama, Naoki, Shimizu, Yoshihito, Nagamizu, Hiroyuki, Oaki, Yoshinao, Nishigaki, Shinichi, Sugai, Toshiya, Shibata, Norikiyo, Tsuruta, Minoru, Suzuta, Toshihiko
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Shai, Daphna
• Application Number:
  US08/805,556
• Time in Patent Office: 1,260 Days
• Field of Search: 606/143, 606/167, 606/170, 606/205, 606/206, 606/208, 606/139
• US Class Current: 606/143
• CPC Class Codes: A61B 17/0684 having a forming anvil staying above the tissue during stapling
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/00464 for use with different instruments

Abstract

A medical treatment instrument is provided with a treatment section for treating issue, an insertion section which has at one end the treatment section, and an operating section which is provided at the other end of the insertion section, operates the treatment section, and has a fixed portion and a movable portion. The treatment section is actuated by pivoting the movable portion with respect to the fixed portion. The medical treatment instrument is further provided with an actuating main body and a cover. The cover is displaceable between a first position in which the medical treatment instrument is used and a second position in which the inside of the operating section is uncovered.

Claims

1. A medical treatment instrument comprising:

a treatment section for treating tissue;

an insertion section which has at one end the treatment section;

an operating section provided at the other end of the insertion section for operating the treatment section, the operating section comprising a fixed portion and a movable portion, with the treatment section being operated by operating the movable portion with respect to the fixed portion; and

a drive mechanism disposed within the operating section for driving the treatment section in response to the operation of the operating section, and the operating section further comprising a main body and a cover which is displaceable between a first position in which the medical treatment instrument is used and a second position in which the inside of the operating section including the drive mechanism is uncovered.

2. The medical treatment instrument as defined in claim 1, wherein an engaging portion between the insertion section and the operating section is sheathed with the cover.

3. The medical treatment instrument as defined in claim 2, wherein the engaging portion between the insertion section and the operating section is defined by the main body and the cover of the operating section.

4. The medical treatment instrument as defined in claim 1, wherein the inside of the operating section is sealed from outside by closing the cover.

5. The medical treatment instrument as defined in claim 1, wherein the cover serves as a part of the operating section when being closed.

6. The medical treatment instrument as defined in claim 5, wherein an engaging section disposed in the insertion section removably engages with an engaging section of the operating section.

7. The medical treatment instrument as defined in claim 1, wherein a degree of opening of the cover is substantially set so as to permit sufficient washing of the inside of the operating section.

8. The medical treatment instrument as defined in claim 1, wherein the cover is disposed on the operating section in a position opposite to the movable portion.

9. The medical treatment instrument as defined in claim 1, wherein the treatment section, the insertion section, and the operating section can be separated from each other and reassembled into one piece.

10. The medical treatment instrument as defined in claim 1, wherein the insertion section is detachable from the operating section.

11. The medical treatment instrument as defined in claim 9, wherein the operating section, the insertion section, and the treatment section are respectively selected from an operating unit including a plurality of types of operating section, a sheath unit including a plurality of types of sheath, and a treatment unit including a plurality of types of treatment section, and the thus-selected operating section, insertion section, and treatment section are combined together.

12. The medical treatment instrument as defined in claim 11, wherein the treatment unit is a forceps unit comprising various types of forceps such as dissection type forceps grip-type forceps and scissors forceps.

13. The medical treatment instrument as defined in claim 11, wherein the treatment unit is an applier unit including various types of applier such as a clip unit and a stapler unit.

14. The medical treatment instrument as defined in claim 11, wherein the treatment unit is a suturing and purse string unit comprising various units such as a cartridge unit, a jaws unit, and an anvil unit.

15. The medical treatment instrument as defined in claim 11, wherein the treatment unit comprises various units such as a forceps unit, a tip unit, and a probe unit.

16. The medical treatment instrument as defined in claim 9, wherein the insertion section and the treatment section are replaceable in the form of a cartridge.

17. The medical treatment instrument as defined in claim 16, wherein the insertion section can be detached from the operating section by opening the cover, and the insertion section can be attached to the operating section by closing the cover.

18. The medical treatment instrument as defined in claim 16, wherein the insertion section is rotatable with respect to the operating section.

19. The medical treatment instrument as defined in claim 18, wherein the insertion section is restricted with respect to the movable section of the operating section in a longitudinal direction thereof by engaging with the operating section.

20. The medical treatment instrument as defined in claim 18, further comprising an operation rod disposed in the insertion section for driving the treatment section, the operation rod comprising a ball portion disposed at the end of the insertion section where the operating section is provided, the ball portion engaging slidably and rotatably with a groove formed in the operating section.

21. The medical treatment instrument as defined in claim 20, wherein a sealing member is disposed between the operation rod and rear of the insertion section.

22. The medical treatment instrument as defined in claim 16, wherein the insertion section is covered with a sheath.

23. The medical treatment instrument as defined in claim 22, wherein the treatment section and the insertion section comprise respective one of an attachment claw and an engaging part for coupling to each other.

24. The medical treatment instrument as defined in claim 16, wherein the insertion section is divided into an upper insert member and a lower insert member.

25. The medical treatment instrument as defined in claim 24, wherein at least one of the upper and lower insert members is formed from substantially transparent material.

26. The medical treatment instrument as defined in claim 16, wherein a sealing member is disposed between the inside of the insertion section and the treatment section.

27. The medical treatment instrument as defined in claim 16, wherein a packing member is disposed between the insertion section and the operating section and between the operating section and the cover.

28. The medical treatment instrument as defined in claim 16, wherein the insertion section has a circular cross section.

29. The medical treatment instrument as defined in claim 1, wherein a suturing and ligating element is loaded in the treatment section.

30. The medical treatment instrument as defined in claim 29, wherein the insertion section comprises a cartridge suturing and ligating instrument.

31. The medical treatment instrument as defined in claim 29, wherein the suturing and ligating element is substantially U-shaped in its initial state and comprises a base and two parallel legs extending from the base at right angles, and the surfaces of the two legs which face each other come into at least partial contact with each other after the suturing and ligating element has been clinched.

32. The medical treatment instrument as defined in claim 31, further comprising:

at least one holding member for holding the suturing and ligating element; and

a pusher for deforming the suturing and ligating element to shape desiredly by urging the base while sandwiching the suturing and ligating element between the pusher and the holding member.

33. The medical treatment instrument as defined in claim 29, wherein the suturin and ligating element comprises legs and a joint for connecting together the legs, and the legs cross each other when the suturing and ligating element is in its initial state but are clinched after having been released from the crossed state when the suturing and ligating element is deformed.

34. The medical treatment instrument as defined in claim 29, wherein the suturing and ligating element is substantially U-shaped in its initial state and comprises a base and two parallel legs extending from the base at right angles, and a space is formed in the vicinity of the base after the two legs have been clinched.

35. The medical treatment instrument as defined in claim 29, wherein the staples are stored and ejected in an inclined orientation.

36. The medical treatment instrument as defined in claim 35, wherein a tapered surface is formed at the front end of the treatment section, and an opening is formed in the tapered surface for supplying the suturing and ligating element at an angle with respect to the longitudinal direction of the insert.

37. The medical treatment instrument as defined in claim 1, wherein the cover rotates around a hinge attached to the operating section.

38. The medical treatment instrument as defined in claim 37, wherein the cover is openable and closeable around a hinge provided behind the cover.

39. The medical treatment instrument as defined in claim 37, wherein the hinge is provided along one side of the cover, and the cover becomes open around the hinge.

40. The medical treatment instrument as defined in claim 1, wherein the treatment section includes forceps having jaws.

41. The medical treatment instrument as defined in claim 40, wherein the operating section comprises a live pin electrically connected to the jaws.

42. The medical treatment instrument as defined in claim 1, wherein the treatment section has a storage member, and a plurality of suturing and ligating elements are loaded in the storage member.

43. The medical treatment instrument as defined in claim 42, wherein the treatment section is replaceable with a cartridge.

44. The medical treatment instrument as defined in claim 1, wherein the insertion section and the treatment section are integrated into one piece.

45. The medical treatment instrument as defined in claim 1, wherein the cover engages with the operating section in a slidable manner.

46. The medical treatment instrument as defined in claim 1, wherein the drive mechanism comprises:

a pivotal arm formed in the movable portion of the operating section;

a first treatment section drive member;

a first actuation member engaging with the pivotal arm and actuating the first treatment drive member;

a first gear formed in the first actuating member;

a second gear fixed on the operating section;

a second actuation member having a third gear which engages with the second gear; and

a second treatment section drive member driven by the second actuation member.

47. The medical treatment instrument as defined in claim 1, wherein the treatment section comprises an automatic suturing instrument.

48. The medical treatment instrument as defined in claim 47, wherein the automatic suturing instrument comprises a cartridge housing a plurality of staples for suturing purposes, and an anvil for clinching the staples.

49. The medical treatment instrument as defined in claim 48, wherein a close lever for closing the anvil with the respect to the cartridge and a release button for releasing the close lever are provided on the operating section.

50. The medical treatment instrument as defined in claim 48, wherein the treatment section comprises an excising member which travels along a slide path, and a switch for switching the excising member between a position where it can excise tissue and a position where it cannot excise the tissue.

51. The medical treatment instrument as defined in claim 50, wherein the insertion section is provided with an insertion section sheath having a hole therein, and the cartridge has a removal button which fits into the hole.

52. The medical treatment instrument as defined in claim 1, wherein the treatment section comprises a cartridge housing therein a plurality of staples for anastomosing and an anastomosing instrument having an anvil for deforming the staples.

53. The medical treatment instrument as defined in claim 52, wherein a gap control knob for opening and closing the anvil with respect to the cartridge is disposed in the rear of the fixed portion of the operating section.

54. The medical treatment instrument as defined in claim 53, wherein the drive mechanism is housed in the fixed portion.

55. The medical treatment instrument as defined in claim 1, wherein the treatment section comprises an ultrasonic clotting and incising instrument for clotting and incising tissue by ultrasonic vibrations.

56. The medical treatment instrument as defined in claim 55, wherein the treatment section comprises a tip for affording ultrasonic vibrations to tissue, and jaws which is freely openable and closeable with respect to the tip.

57. The medical treatment instrument as defined in claim 56, wherein the operating section houses an ultrasonic transducer.

58. The medical treatment instrument as defined in claim 1, wherein the treatment section is provided with a first treatment member and a second treatment member, and the drive mechanism comprises a first treatment section drive member and a second treatment section drive member, both of which are manually operated.

59. The medical treatment instrument as defined in claim 58, wherein the treatment section has jaws, and wherein the drive mechanism comprises a spring-thrust clip feed member which is operated together with the movable portion of the operating section and is connected to a pusher, and a spring-thrust jaws closing member which is operated together with the movable portion of the operating section and is connected to the jaws of the treatment section.

60. The medical treatment instrument as defined in claim 58, wherein the second treatment section drive member is arranged in line with the first treatment section drive member, the movable portion of the operating section drives the first treatment section drive member, the drive mechanism comprising a flange formed in the movable portion of the operating section in a slidable manner, and an engaging section engaging with the flange and driving the second treatment section drive member.

61. The medical treatment instrument as defined in claim 58, wherein the first and second treatment section drive members are rotatably connected to the operating section in a slidable manner, and the drive mechanism comprises a first spring for connecting together the first and second treatment section drive members, and a second spring for connecting together the second treatment section drive member and a distal end of the operating section, and wherein the spring constant of the first spring is smaller than that of the second spring.

62. The medical treatment instrument as defined in claim 58, wherein the second treatment member comprises jaws which are normally stored in a sheath and project from the sheath only when the medical treatment instrument is used.

63. The medical treatment instrument as defined in claim 58, further comprising a spring for normally thrusting the second treatment section drive member forwardly, a sheath interposed between the treatment section and the insertion section, the sheath attaching to the first treatment member and housing the first treatment section drive member, a drive pin which is provided in the sheath and is connected to the first treatment section drive member, and a cam mechanism which is formed as a result of engagement of one end of the first treatment section with the drive pin.

64. The medical treatment instrument as defined in claim 48, further comprising a first handle for closing the anvil with respect to the cartridge and a second handle for ejecting the staples, said first and second handles being disposed in front-rear direction of the fixed portion of the operating section.

65. The medical treatment instrument as defined in claim 1, further comprising a first sealing member disposed in the area where the insertion section comes into contact with the operating section, a second sealing member disposed in the area where the operating section main body comes into contact with the cover, and a third sealing member disposed in the area between the fixed portion and the movable portion of the operating section.

66. The medical treatment instrument as defined in claim 65, wherein the first, second, and third sealing members are made of insulating material.

67. The medical treatment instrument as defined in claim 63, wherein the third sealing member is a membrane.

68. A medical treatment instrument comprising:

an insertion section;

a treatment section for treating tissue, the treatment section being at one end of the insertion section;

an operating section disposed at the other end of the insertion section for operating the treatment section, said operating section comprising a fixed portion and a movable portion, the treatment section being operated by moving the movable portion of said operating section relative to the fixed portion of said operating section, and said operating section further comprising a main body and a cover body; and

a drive mechanism disposed within said operating section for driving the treatment section in response to the operation of said operating section, and the cover body is opened relative to the main body or removed from the main body to completely expose the inside of said operating section and the drive mechanism for cleaning and sterilizing.

69. A medical treatment instrument comprising:

an insertion section;

a treatment section for treating tissue, the treatment section being at one end of the insertion section; and

an operating section disposed at the other end of the insertion section and being connected to a connecting portion that extends through the insertion section for operating the treatment section, said operating section comprising a fixed portion and a movable portion, the treatment section being operated by moving the movable portion of said operating section relative to the fixed portion of said operating section, and said operating section further comprising a main body and a cover body, wherein the cover body is opened relative to the main body or removed from the main body to completely expose the connection of said operating section and said connecting portion for cleaning and sterilizing.