The present invention relates to biopsy forceps.
Conventionally, biopsy forceps have been known, in which a scissors-shaped forceps cup is provided on a distal side of a shaft portion having flexibility and an operation portion for the forceps cup is provided on a proximal side of the shaft portion (see Patent Document 1).
In a case where the forceps cup of the biopsy forceps is guided to an examination area, a practitioner performs such a process with reference to an X-ray transmission image obtained using a contrast agent. However, there is a problem that even by the process with reference to the X-ray transmission image obtained using the contrast agent, it is difficult, depending on the morphology of a patient's heart, to cause a tip end of the forceps cup to point in an intended direction to collect a tissue from an intended area.
An object of the present invention is to provide biopsy forceps capable of causing a tip end of a forceps cup to point in an intended direction.
A first aspect of the invention relates to biopsy forceps including a forceps portion having an openable forceps cup, a bendable portion that is provided with the forceps portion at a tip end and is bendable, an operation portion that is operable to open and close the forceps cup and bend the bendable portion, a shaft portion coupled to the bendable portion and the operation portion, a first operation member that is inserted into the shaft portion and opens or closes the forceps cup in conjunction with operation of the operation portion, a second operation member that is inserted into the shaft portion and bends the bendable portion in conjunction with operation of the operation portion, and a contrast agent supply pipe that is inserted into the shaft portion and has a distal-side end portion opening at the forceps portion and a proximal-side end portion opening at the operation portion.
In the above-described aspect of the invention, the distal-side end portion of the contrast agent supply pipe may open at a position not interfering with the forceps cup of the forceps portion.
In the above-described aspect of the invention, the bendable portion may include a plurality of movable pieces that moves in conjunction with the second operation member, the operation portion may include an operation member that is operable to move the second operation member forward or backward, and the plurality of movable pieces may bring the bendable portion into a bent state or a straight state in conjunction with forward/backward movement of the second operation member by operation of the operation member.
According to the biopsy forceps of the present invention, the tip end of the forceps cup can point in the intended direction.
Hereinafter, an embodiment of the present invention will be described. Note that the drawings attached to the present specification are all schematic views, and for the sake of easy understanding, etc., the shape, scale, aspect ratio, etc. of each component are changed or exaggerated from actual shape, scale, aspect ratio, etc. Moreover, in the drawings, hatching for showing the section of each member is omitted as necessary. In the present specification, etc., terms specifying shapes, geometric conditions, and the degrees thereof, such as terms “parallel”, “perpendicular”, and “direction”, include not only exact meanings of these terms, but also ranges which can be taken as substantially parallel, substantially perpendicular, etc. and ranges which can be taken as being substantially in intended directions.
As shown in
The forceps portion 10 is a component provided closest to the distal side (the X1-side) of the biopsy forceps 1. As shown in
As shown in
Note that the same configuration as that of a forceps portion of general conventional biopsy forceps is applicable to the forceps portion 10 of the biopsy forceps 1 of the present embodiment. That is, the link mechanism 102 of the forceps portion 10 is not limited to the example described in the present embodiment, and various link mechanisms are applicable. The forceps cup 101 is not limited to the example of the present embodiment as long as the tissue of the examination area can be collected, and a forceps cup in any shape may be employed.
The forceps operation wire (a first operation member) 104 is an elongated member that is inserted into the shaft portion 40 (described later) and opens or closes the forceps cup 101 in conjunction with operation of the operation portion 30. The forceps operation wire 104 is, for example, made of stainless steel (SUS). As described above, the distal-side (X1-side) end portion of the forceps operation wire 104 is coupled to an end portion of the link mechanism 102. A proximal-side (X2-side) end portion of the forceps operation wire 104 penetrates the bendable portion 20 and the shaft portion 40, and is joined to a slider 302 (described later) of the operation portion 30.
As described later, when the practitioner operates the slider 302 of the operation portion 30 to move the forceps operation wire 104 forward to the distal side, the forceps cup 101 is brought into the open state as shown in
The bendable portion 20 is a portion that is bendable with a later-described mechanism and is displaceable to the bent state or the straight state. As shown in
As shown in
The bending operation wire (a second operation member) 204 is a member that is inserted into the shaft portion 40 and brings the bendable portion 20 into the bent state or the straight state in conjunction with operation of the operation portion 30. The bending operation wire 204 is, for example, made of stainless steel (SUS). The distal-side (X1-side) end portion of the bending operation wire 204 is, as described above, joined to the first through-hole 202 of the leading movable piece 201. A proximal-side (X2-side) end portion of the bending operation wire 204 penetrates the shaft portion 40, and is joined to the dial 303 (described later) of the operation portion 30.
The second through-hole 203 is a circular hole into which an elastic wire 205 is to be inserted. The elastic wire 205 is a member made of a metal material having a high elasticity. For example, a hyperelastic material such as shape-memory alloy can be used for the elastic wire 205. The elastic wire 205 of the present embodiment is normally in a straight state, and when external force acts thereon, deforms in the direction of such external force. The elastic wire 205 has such properties that when the external force no longer acts on the elastic wire 205, the elastic wire 205 returns to the original straight state. Note that the elastic wire 205 of the present embodiment is formed of a member having a circular section, but may be formed of a member having a rectangular section, for example. The elastic wire 205 is joined to the second through-holes 203 of all the movable pieces 201.
As described later, when the practitioner operates the dial 303 of the operation portion 30 to move the bending operation wire 204 forward to the distal side, the bendable portion 20 is brought into the straight state by elastic force of the elastic wire 205 as shown in
The operation portion 30 is a portion that is operable to open and close the forceps cup 101 (the forceps portion 10) and bend the bendable portion 20. As shown in
The practitioner grips the operation portion 30 by inserting one's thumb into the holding ring 304 of the operation portion 30 and inserting one's index and middle fingers into two rings of the slider 302, and in this state, can move the slider 302 along the X-direction relative to a reference point which is the holding ring 304. When the practitioner moves the slider 302 to the X1-side to move the forceps operation wire 104 forward to the distal side, the forceps cup 101 (the forceps portion 10) is brought into the open state. When the practitioner moves the slider 302 to the X2-side to move the forceps operation wire 104 backward to the proximal side, the forceps cup 101 is brought into the closed state.
By rotating the dial 303 of the operation portion 30, the practitioner can displace the bendable portion 20 (see
Next, configurations of other portions of the operation portion 30 will be described. As shown in
The forceps operation wire 104 is inserted into the forceps operation wire guide coil 105 (see
The bending operation wire 204 is inserted into the bending operation wire guide coil 206 (see
The liquid feeding tube (a contrast agent supply pipe) 310 is a tubular member that supplies the contrast agent to the forceps portion 10. The liquid feeding tube 310 is, for example, formed of a PEEK tube. The liquid feeding tube 310 is inserted into the shaft portion 40 (described later). The distal-side (X1-side) end portion of the liquid feeding tube 310 opens at the forceps portion 10 (the holding portion 103) as shown in
The shaft portion 40 is a tubular member formed of a coil spring (not shown) wound in a spiral shape. A distal-side (X1-side) end portion of the shaft portion 40 is connected to the bendable portion 20 as shown in
Next, steps of collecting the tissue of the examination area by the biopsy forceps 1 of the present embodiment configured as described above will be described.
First, a guide sheath (not shown) is inserted into the right femoral vein 61 of a patient. The guide sheath is a tubular member for guiding, e.g., the guiding catheter into the body. Subsequently, the guide wire and the guiding catheter (not shown) are inserted into the guide sheath, and the guiding catheter is guided to the vicinity of the inferior vena cava by the leading guide wire. Then, the contrast agent is released through a clearance between the guide wire and the guiding catheter, and the guide wire and the guiding catheter are guided to the right atrium 62 while an X-ray transmission image obtained using the contrast agent is being checked. Next, the guide wire is pulled out of the guiding catheter, and an angiographic catheter (not shown) is inserted into the guiding catheter. Then, while the contrast agent is being released from the angiographic catheter, the angiographic catheter is guided to the right ventricle 63 of the heart 60.
Next, the angiographic catheter is pulled out of the guiding catheter, and the biopsy forceps 1 are inserted into the guiding catheter. Then, the biopsy forceps 1 are guided into the right ventricle 63 of the heart 60 as shown in
After having guided the biopsy forceps 1 into the right ventricle 63, the practitioner operates the slider 302 of the operation portion 30 to bring the forceps cup 101 (the forceps portion 10) into the open state. Then, while the contrast agent is being released from the tip end of the forceps portion 10, the forceps portion 10 is guided to the examination area. The practitioner checks an X-ray transmission image obtained using the released contrast agent so that the tip end of the forceps portion 10 can point in an intended direction. For example, as shown in
According to the biopsy forceps 1 of the present embodiment as described above, the contrast agent can be released from the tip end of the forceps portion 10, and therefore, the practitioner can cause the tip end of the forceps portion 10 to point in the intended direction while checking the X-ray transmission image obtained using the released contrast agent.
Note that a child's heart has a small muscle thickness, and for this reason, there is a probability that if a tissue is erroneously collected from an unintended area, the heart is pierced with a hole and an accident such as blood leakage is caused. However, according to the biopsy forceps 1 of the present embodiment, the contrast agent can be released from the tip end of the forceps portion 10, and therefore, the practitioner can easily grasp the direction of the tip end of the forceps portion 10 with reference to the X-ray transmission image. Accordingly, the practitioner can avoid an area with a relatively-small muscle thickness and collect a tissue from an area with a relatively-large muscle thickness, and therefore, can avoid the above-described accident. According to the biopsy forceps 1 of the present embodiment, the dial 303 of the operation portion 30 is operated so that the bendable portion 20 joined to the forceps portion 10 can be brought into the bent state or the straight state. Thus, the forceps portion 10 can more smoothly pass through a blood vessel or an organ. Moreover, the amount of rotation of the dial 303 is adjusted so that the forceps portion 10 can point in a desired direction. Thus, the forceps portion 10 can be more accurately guided to the examination area.
In the biopsy forceps 1 of the present embodiment, the distal-side end portion of the liquid feeding tube 310 opens at the position not interfering with the forceps cup 101. Thus, interference of the liquid feeding tube 310 with operation of the forceps cup 101 and contact of the liquid feeding tube 310 with the collected tissue can be reduced. Moreover, the contrast agent can be released in the direction in which the forceps portion 10 points.
In the biopsy forceps 1 of the present embodiment, the bendable portion 20 includes the plurality of movable pieces 201 that move in conjunction with the bending operation wire 204. The plurality of movable pieces 201 brings the bendable portion 20 into the bent state or the straight state in conjunction with forward/backward movement of the bending operation wire 204 by operation of the dial 303 provided at the operation portion 30. Thus, according to the amount of operation of the dial 303, the bent state of the bendable portion 20 can be more finely adjusted.
The embodiment of the present disclosure has been described above, but the present disclosure is not limited to the above-described embodiment. Various modifications and changes can be made as in later-described modifications, and are included in the technical scope of the present disclosure. The advantageous effects described in the embodiment are merely the list of most suitable effects of the present disclosure, and are not limited to those described in the embodiment. Note that the above-described embodiment and the later-described modifications may be used in combination as necessary, but detailed description thereof will be omitted.
The operation portion 30 may include two bending operation wires 204. In this case, each of distal-side end portions of the two bending operation wires 204 is joined to the leading movable piece 201. With this configuration, the plurality of movable pieces 201 can displace the bendable portion 20 to the bent state or the straight state in conjunction with forward/backward movement of the two bending operation wires 204. The plurality of movable pieces 201 may be coupled to each other. The shapes of the plurality of movable pieces 201 may be the same as each other, or be different from each other according to an area in the longitudinal direction. Further, the drum 307 that moves the bending operation wire 204 forward or backward may be provided with a lock mechanism, or the dial 303 may be provided with, e.g., a lever.
In the operation portion 30, the mechanism that moves the bending operation wire 204 forward or backward is not limited to the slider 302 shown in
Number | Date | Country | Kind |
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2020-139123 | Aug 2020 | JP | national |
Filing Document | Filing Date | Country | Kind |
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PCT/JP2021/028292 | 7/30/2021 | WO |