Surgical therapeutic instrument

• US 20030158576A1
• Filed: 02/14/2003
• Published: 08/21/2003
• Est. Priority Date: 02/15/2002
• Status: Active Grant

• Current Assignee: Olympus Corporation
• Original Assignee: Olympus Optical Corporation Limited (Olympus Corporation)
• Inventors: Nagase, Toru, Sasaki, Katsumi
• Granted Patent: US 7,494,499 B2
• Time in Patent Office: Days
• US Class Current: 606/205
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 2017/00424 ergonomic, e.g. fitting in fist
• CPC Class Codes: A61B 2017/2902 characterized by features of the actuating rod
• CPC Class Codes: A61B 2017/291 the position of the handle being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2919 details of linkages or pivot points
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2017/294 Connection of actuating rod to jaw, e.g. releasable

Abstract

The disclosed invention relates to an improvement in a surgical therapeutic instrument which includes an inserting part, a manipulating part, and a therapeutic part. In a link mechanism having a transmission shaft for transmitting a driving force applied to the manipulating part to the therapeutic part, the position of the transmission shaft is restricted, and a joint is provided in the transmission shaft to reduce the strain of the transmission shaft. A sheath is also provided in the inserting part to facilitate cleaning thereof. A mechanism is provided for immovably locking the movable portion. A circular arc centered about a turning shaft is introduced into the shape of the manipulating part to improve the manipulability thereof. Further, the structure of a gripping portion of the manipulating part is improved.

Claims

1. A surgical therapeutic instrument comprising:

an inserting part to be inserted into a body;

a therapeutic part provided on a distal tip of the inserting part and having a movable portion;

a manipulating part provided on a proximal side of the inserting part for manipulating the movable portion of the therapeutic-part;

a mechanical link mechanism having at least one transmission shaft for transmitting to the movable portion a driving force for manipulation applied at the manipulating part, the transmission shaft having a joint at an intermediate position; and

a position restricting member for restricting a position of the transmission shaft on a plane perpendicular to a longitudinal direction of the inserting part, in a predetermined portion of the transmission shaft.

2. A surgical therapeutic instrument according to claim 1, wherein the position restricting member restricts the position of the transmission shaft on a distal tip from a position of the joint.

3. A surgical therapeutic instrument according to claim 1, wherein the joint is movable about at least one axis.

4. A surgical therapeutic instrument according to claim 1, wherein the transmission shaft has rigidity on both sides of the joint.

5. A surgical therapeutic instrument according to claim 1, wherein the inserting part and therapeutic part are constructed to be passed through a trocar and inserted into a living body.

6. A surgical therapeutic instrument according to claim 1, wherein:

the movable portion of the therapeutic part is turnable and has an openable and closable gripping mechanism,

the manipulating part having an openable, closable and turnable structure,

the link mechanism having an opening and closing link mechanism having at least one transmission shaft and constructed to open and close the movable portion of the therapeutic part by opening and closing manipulations of the manipulating part, the link mechanism further having a turning link mechanism having at least two transmission shafts and constructed to open and close the movable portion of the therapeutic part by a turning manipulation of the manipulating part.

7. A surgical therapeutic instrument according to claim 6, wherein the at least one transmission shaft of the opening and closing link mechanism and the at least two transmission shafts of the turning link mechanism are supported in parallel with one another by the position restricting member.

8. A surgical therapeutic instrument comprising:

an inserting part to be inserted into a body;

a therapeutic part provided at a distal tip of the inserting part and constructed to be openable and closable and to be turnable about at least one axis;

a manipulating part provided in a proximal portion of the inserting part and constructed to be openable and closable and to be turnable about at least one axis;

a plurality of transmission shafts constructed to be movable back and forth and to constitute a portion of the inserting part, the plurality of transmission shafts interconnecting the manipulating part and the therapeutic part to transmit a manipulating force applied at the manipulating part to the therapeutic part;

a turning link mechanism including at least two of the plurality of transmission shafts, the therapeutic part and the manipulating part turning the therapeutic part in accordance with a turning manipulation of the manipulating part;

an opening and closing link mechanism including at least one of the plurality of transmission shafts, the therapeutic part and the manipulating part opening and closing the therapeutic part in accordance with opening and closing manipulations of the manipulating part;

a position restricting member provided in at least a portion of the inserting part to restrict a space between each of the plurality of transmission shafts; and

joints provided in intermediate portions of the respective plurality of transmission shafts and constructed to be turnable in at least one direction.

9. A surgical therapeutic instrument comprising:

an inserting part to be inserted into a body;

a therapeutic part provided on a distal tip of the inserting part and having a movable portion;

a manipulating part provided on a proximal side of the inserting part to manipulate the movable portion of the therapeutic part;

a mechanical link mechanism having at least one transmission shaft for transmitting to the movable portion a driving force for manipulation applied at the manipulating part, the transmission shaft being disposed to extend through the inserting part;

a supporting structure disposed in the inserting part for interconnecting the therapeutic part to the manipulating part; and

a sheath externally covering the supporting structure.

10. A surgical therapeutic instrument according to claim 9, wherein the sheath is removable.

11. A surgical therapeutic instrument according to claim 10, wherein the sheath has a bayonet connector for removably attaching the sheath to the therapeutic part.

12. A surgical therapeutic instrument according to claim 10, wherein when the sheath is removed, the at least one transmission shaft is exposed.

13. A surgical therapeutic instrument according to claim 12, wherein the supporting structure has a groove in which the at least one transmission shaft is disposed.

14. A surgical therapeutic instrument according to claim 9, wherein the sheath is cylindrical.

15. A surgical therapeutic instrument according to claim 9, wherein a main material of the supporting structure is a metal.

16. A surgical therapeutic instrument according to claim 15, wherein the metal is stainless steel.

17. A surgical therapeutic instrument according to claim 15, wherein metal is titanium or an alloy thereof.

18. A surgical therapeutic instrument according to claim 9, wherein a main material of the supporting structure is a resin.

19. A surgical therapeutic instrument according to claim 18, wherein the resin is polyetherketone.

20. A surgical therapeutic instrument according to claim 18, wherein the resin is polyphenylsulfone.

21. A surgical therapeutic instrument according to claim 9, wherein:

the movable portion of the therapeutic part is turnable and has an openable and closable gripping mechanism,

the manipulating part having an openable, closable and turnable structure,

the link mechanism having an opening and closing link mechanism having at least one transmission shaft and constructed to open and close the movable portion of the therapeutic part by manipulations for opening and closing the manipulating part, the link mechanism further having a turning link mechanism having at least two transmission shafts and constructed to turn the movable portion of the therapeutic part by a turning manipulation of the manipulating part.

22. A surgical therapeutic instrument comprising:

an inserting part to be inserted into a body;

a therapeutic part provided at a distal tip of the inserting part and constructed to be openable and closable and to be turnable about at least one axis;

a manipulating part provided in a proximal portion of the inserting part and constructed to be openable and closable and to be turnable about at least one axis;

a plurality of transmission shafts constructed to be movable back and forth and to constitute a portion of the inserting part, the plurality of transmission shafts interconnecting the manipulating part and the therapeutic part to transmit a manipulating force applied at the manipulating part to the therapeutic part;

a turning link mechanism including at least two of the plurality of transmission shafts, the therapeutic part and the manipulating part turning the therapeutic part in accordance with a turning manipulation of the manipulating part; and

an opening and closing link mechanism including at least one of the plurality of transmission shafts, the therapeutic part and the manipulating part opening and closing the therapeutic part in accordance with opening and closing manipulations of the manipulating part, wherein

the inserting part having a supporting structure for supporting the transmission shafts along the longitudinal direction thereof, the inserting part further having a removable sheath for externally covering the transmission shafts and the supporting structure.

23. A surgical therapeutic instrument comprising:

an inserting part to be inserted into a body;

a therapeutic part provided on a distal tip of the inserting part and having a movable portion;

a manipulating part provided on a proximal side of the inserting part for manipulating the movable portion of the therapeutic part;

a link mechanism for transmitting to the movable portion a driving force for manipulation applied at the manipulating part; and

a fixing mechanism for locking the movable portion of the therapeutic part to make the movable portion immovable.

24. A surgical therapeutic instrument according to claim 23, wherein at least a portion of the fixing mechanism is provided in the manipulating part.

25. A surgical therapeutic instrument according to claim 23, wherein the fixing mechanism has a plurality of fixed positions.

26. A surgical therapeutic instrument according to claim 23, wherein the fixing mechanism is constructed to be able to be manipulated with one hand with which to manipulate the manipulating part.

27. A surgical therapeutic instrument according to claim 23, wherein the fixing mechanism has a mechanical engagement mechanism using concave and convex portions.

28. A surgical therapeutic instrument according to claim 23, wherein the fixing mechanism is disposed on an prolonged line of an external shape of an opening and closing handle provided in the manipulating part.

29. A surgical therapeutic instrument according to claim 23, wherein:

the movable portion of the therapeutic part is turnable and has an openable and closable gripping mechanism,

the manipulating part having an openable, closable and turnable structure,

the link mechanism having an opening and closing link mechanism for opening and closing the movable portion of the therapeutic part by opening and closing manipulations of the manipulating part, the link mechanism further having a turning link mechanism for turning the movable portion of the therapeutic part by a turning manipulation of the manipulating part,

the fixing mechanism locking at least one of the opening and closing and turning manipulations.

30. A surgical therapeutic instrument comprising

an inserting part to be inserted into a body;

a therapeutic part provided at a distal tip of the inserting part and constructed to be openable and closable and to be turnable in at least two planes;

a manipulating part provided in a proximal portion of the inserting part and constructed to be openable and closable and to be turnable in at least two planes;

a driving part for interconnecting the manipulating part and the therapeutic part and for transmitting a manipulating force of the manipulating part to the therapeutic part for actuating the therapeutic part; and

a turn restricting part for restricting a manipulation of the manipulating part in at least one plane by concave-and-convex engagement between a proximal side of the inserting part and the manipulating part,

switching means for switching between a first state in which a turn of each of the manipulating part and the therapeutic part is allowed in at least two planes, and a second state in which a turn of each of the manipulating part and the therapeutic part is restricted in at least one plane by the turn restricting part.

31. A surgical therapeutic instrument according to claim 30, further comprising a manipulating lever for manipulating the turn restricting part, the manipulating lever being provided at a position where the manipulating lever can be manipulated with a finger of a hand with which to manipulate the manipulating part.

32. A surgical therapeutic instrument comprising:

an inserting part to be inserted into a body;

a therapeutic part provided at a distal tip of the inserting part and constructed to be turnable about at least one axis, the therapeutic part having an external shape containing a substantially circular-arc-shaped portion substantially centered about a center of turning of the therapeutic part;

a manipulating part provided at a proximal end of the inserting part and constructed to be turnable with respect to-the inserting part; and

a turning link mechanism for turning the therapeutic part in accordance with a turning manipulation of the manipulating part.

33. A surgical therapeutic instrument according to claim 32, wherein the manipulating part has a gripping portion turnable in one plane about a turning shaft provided at the proximal end of the inserting part, the gripping portion having an external shape, a portion of which forms a circular arc when the external shape is projected on the plane, a center of the circular arc substantially coinciding with the turning shaft.

34. A surgical therapeutic instrument according to claim 32, wherein the manipulating part has gripping portion having a first portion and a second portion, the first portion is turnable in a first plane about a first turning shaft provided at the proximal end of the inserting part, and a second portion is turnable in a second plane about a second turning shaft provided at the proximal end of the inserting part, in a second plane perpendicular to the first plane,

the first portion having an external shape, a portion of which forms a first circular arc when the external shape is projected on the plane,

the second portion having an external shape, a portion of which forms a second circular arc when the external shape is projected on the plane,

a center of the first circular arc substantially coinciding with the first turning shaft, and a center of the second circular arc substantially coinciding with the second turning shaft.

35. A surgical therapeutic instrument according to claim 32, wherein at least one of a diameter and a long diameter of the first circular arc is set to not greater than about 100 mm.

36. A surgical therapeutic instrument according to claim 32, wherein the manipulating part has a leg portion disposed to extend beyond the circular arc-shaped portion.

37. A surgical therapeutic instrument according to claim 32, wherein when the therapeutic part is directed to a first direction with respect to an axis of the inserting part, the manipulating part is directed to a second direction which is opposite to the first direction with respect to the axis of the inserting part,

the manipulating part having a shape capable of being held from at least the first direction and the second direction.

38. A surgical therapeutic instrument comprising:

an inserting part to be inserted into a body;

a therapeutic part provided on a distal tip of the inserting part;

a gripping portion provided in the therapeutic part and having a pair of therapeutic halves capable of being opened and closed about a turning shaft;

gripping surfaces respectively formed on each of the pair of therapeutic halves which are constructed to be opposed to each other when the gripping portion is in a closed state, and not to be parallel to the turning shaft; and

a manipulating part provided on a proximal side of the inserting part to manipulate the gripping portion.

39. A surgical therapeutic instrument according to claim 38, wherein one of the pair of therapeutic halves having a concave portion in its gripping surface, the other of the pair of therapeutic halves having a convex portion to be accommodated in the concave portion when the gripping portion is in the closed state.

40. A surgical therapeutic instrument according to claim 39, wherein a height of a wall portion surrounding the concave portion is partly reduced.

41. A method of manipulating a surgical therapeutic instrument, comprising:

manipulating a manipulating part to transmit a driving force to a transmission shaft;

changing a direction of the transmission shaft to a restricted direction by a joint provided in the transmission shaft;

transmitting the driving force to a therapeutic part through the transmission shaft which direction is changed in the restricted direction; and

moving a movable portion of the therapeutic part by the transmitted driving force.

42. A method of manipulating a surgical therapeutic instrument, comprising, during cleaning of an inserting part of the surgical therapeutic instrument:

removing a sheath disposed to cover the inserting part, and exposing an inside transmission shaft;

cleaning the transmission shaft; and

attaching the sheath to the inserting part after the cleaning step.

43. A method of manipulating a surgical therapeutic instrument, comprising the steps of:

activating a fixing mechanism to make a movable portion of a therapeutic part immovable;

inserting the surgical therapeutic instrument into a living body;

deactivating the fixing mechanism and performing a surgical procedure; and

activating the fixing mechanism; and

withdrawing the surgical therapeutic instrument from the living body.

44. A method of manipulating a surgical therapeutic instrument, comprising the steps of:

holding a manipulating part having a turning shaft about which the manipulating part rotates, the manipulating part having an external shape, a portion of which has a substantially circular arc shape centered about the turning shaft, the manipulating part being held in one hand with a thumb thereof contacting the portion having the circular arc shape; and

reversing the surgical therapeutic instrument in a vertical direction, and holding the manipulating part in the one hand while contacting a root portion of a palm corresponding to the thumb to the portion having the circular arc shape.