JP2003135474A - Medical equipment and treatment tool for surgery - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical equipment which enables an operator to exactly make control with the lesser fatigue and pain of the operator and a treatment tool for surgery. SOLUTION: Contact areas of a finger hook 228 of a slider 222 and upper and lower finger hooks 229a and 229b of a control section 213 of a resect scopic apparatus 211 with the hands and fingers of the operator are provided with elastic members 230, 231 and 232, by which the burden of the hands and fingers of the operator in contact with the finger hook 228 of the slider 222 and the upper and lower finger hooks 229a and 229b is reduced.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical device and a surgical treatment tool used for surgery or endoscopic surgery.

[0002]

2. Description of the Related Art Generally, as a surgical treatment tool, there is a surgical scissor as disclosed in Japanese Examined Patent Publication No. 60-36293. This scissors for surgery is provided with two scissors pieces 1a and 1b as shown in FIG. The two scissors pieces 1a and 1b are rotatably connected by a fulcrum pin 2.

Further, the surgical scissors are provided with an operating portion 3 which is a handle on the base end side of the fulcrum pin 2. The operating portion 3 has an annular ring 4 for inserting fingers, which is integrally formed at the base ends of the scissors pieces 1a and 1b.
a and 4b are provided. Then, the operator operates the operation unit 3
With the fingers 5 inserted in the two rings 4a and 4b of
By opening / closing between the two rings 4a, 4b of the operating portion 3, the cutting blade portions (treatment portions) 6a, 6b at the tips of the scissors pieces 1a, 1b are opened / closed.

Further, Japanese Patent Laid-Open No. 4-246344 discloses a treatment tool used for endoscopic surgery. This treatment tool is provided with an insertion portion to be inserted into a living body, an operation portion arranged on the hand side of the insertion portion, and a treatment portion arranged on the distal end side of the insertion portion. Here, the operating portion is provided with a fixed handle and a movable handle rotatably connected to the fixed handle. Further, an annular ring for inserting fingers is formed integrally with the base end of each handle.

Further, the treatment section is provided with two treatment members which can be opened and closed. Further, inside the insertion portion, drive means for transmitting the operation of the movable handle of the operation portion to the treatment member and driving the treatment member is arranged. When the operator inserts the fingers into the two rings of the operation section and operates the movable handle of the operation section to open and close, the treatment member of the treatment section on the distal end side is opened and closed via the drive means. ing.

[0006]

In the case of the conventional construction described above, the operator moves from the hand 7 of the operator who uses the surgical scissors to the treatment target site 8 like the surgical scissors shown in FIG. Rings 4 of each scissors piece 1a, 1b on a plane including the central axis X
a and 4b are arranged. Therefore, for example, in FIG.
As shown in (A), when the surgical scissors approach the treatment target portion 8 from an oblique direction, the operator operates the surgical scissors or the like in an unnatural state with the wrist bent. The operator's fatigue and pain increase,
There is a problem that it becomes difficult to operate the correct treatment tool. The same applies to the treatment tool for endoscopic surgery disclosed in JP-A-4-246344.

The rings 4a, 4 of the scissors pieces 1a, 1b are also included.
b is formed of a metal material or a hard plastic material. Then, as shown in FIG. 22 (B), the inner peripheral surfaces 9 of the rings 4a, 4b that come into contact with the fingers 5 of the operator inserted into the rings 4a, 4b of the scissors pieces 1a, 1b.
Since the cross-sectional shape of the scissors is almost flat and the width of the rings 4a and 4b is also narrow, the scissors pieces 1a and 1b have the rings 4a and 4b.
There is a problem in that the edge portion of the inner peripheral surface 9 of b contacts the operator's finger 5 at an acute angle. Therefore, the rings 4a, 4 of the scissors pieces 1a, 1b can be operated by operating a treatment tool such as surgical scissors for a long time.
There is a risk that the operator's fingers 5 inserted in b will be hurt or the sensory disturbance will occur. In particular, surgical instruments are often used for a longer period of time than other instruments, such as scissors for stationery, and this problem is remarkable because the operation of applying force in both the opening and closing directions is frequently repeated. Appear in. Here, in particular, when the treatment instrument is opened, the thin parts such as the back and side of the operator's finger hit the rings 4a, 4b of the scissors pieces 1a, 1b, so that the nerve of the operator's finger is It is pressured and easily hurts.

Furthermore, the rings 4a of the scissors pieces 1a, 1b,
The operator's finger 5 inserted in the ring 4b is the ring 4a,
Since it is easy to slide along the inner peripheral surface 9 of 4b, there is a possibility that an erroneous operation of a treatment tool such as surgical scissors may occur, making it difficult to operate the treatment tool accurately.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a medical device and a surgical treatment tool that allow an operator to perform an accurate operation with less fatigue and pain.

[0010]

According to a first aspect of the present invention, in a medical device in which a surgical treatment tool and an endoscope are used in combination, the surgical treatment tool includes a main body of the surgical treatment tool. An operating portion on the proximal side disposed at the proximal end of the treatment instrument body, the operating portion including a first handle having a first finger contact element for applying a part of the operator's fingers, and the operator. A second handle having a second finger contact element for applying another finger to the other hand, and a connecting means for relatively movably connecting the first and second handles, and the treatment tool A treatment section disposed at the tip of the main body, wherein the treatment section has a movable element, and the movable element is operated in association with a relative movement operation between the first and second handles; Means for reducing the burden on the operator's fingers in contact with the first and second finger rest elements, Reducing means is provided at a contact portion of at least one of the first and second finger contact elements with a finger of the operator, and the endoscope operates the treatment section. It is a medical device having an observing means capable of observing. According to the first aspect of the present invention, the finger load reducing means having the above-described configuration makes it possible to reduce the load applied to the operator's fingers and wrist when operating the surgical treatment tool.

According to a second aspect of the present invention, there is provided an insertion portion which is provided in a surgical treatment tool and which can be inserted into a body cavity and which is constituted by a sheath, a main body portion which is provided at a proximal end portion of the insertion portion, and A guide shaft protruding from the base end, a movable element slidably provided on the guide shaft, and a distal end opening of the sheath provided inside the sheath of the insertion portion according to the forward / backward movement of the movable element. A treatment section that can be retracted from the inside, an endoscope provided inside the sheath for observing the inside of the body cavity from the sheath distal end opening, a first finger hook section provided at the main body section, and the movable element. Surgical treatment characterized in that it has a second finger-hanging portion provided on the upper surface and an elastic material provided so as to cover at least a part of the surface of the first finger-holding portion or the second finger-holding portion. It is a tool.

According to the second aspect of the present invention, the elastic material having the above-mentioned configuration causes a burden on an operator's finger or wrist when operating the first finger hooking portion and the second finger hooking portion of the surgical treatment tool. It is intended to be minor.

[0013]

BEST MODE FOR CARRYING OUT THE INVENTION A first embodiment of the present invention will be described below with reference to FIGS. Figure 1
(A), (B) shows the schematic structure of the treatment tool 11 for surgery of this Embodiment. The surgical treatment tool 11 of the present embodiment includes two forceps pieces 12 as shown in FIG.
a and 12b are provided. Two forceps pieces 12a, 1
2b are rotatably connected to each other by a fulcrum pin (connecting means) 13.

The surgical treatment instrument 11 is provided with an operating portion 14 which is a handle on the proximal end side of the fulcrum pin 13 and a treatment portion 15 on the distal end side of the fulcrum pin 13.

Here, one first forceps piece 12a is provided with a first handle element 16a arranged in the operating portion 14. An annular ring (first finger contact element) 17a for inserting fingers is integrally formed at the base end portion of the first handle element 16a. Similarly, the other second forceps piece 12b is provided with a second handle element 16b arranged in the operation portion 14. An annular ring (second finger contact element) 17b for inserting fingers is integrally formed at the base end of the second handle element 16b.

Further, in the treatment portion 15 of the surgical treatment instrument 11, an extended portion (movable element) 18 integrally extended to the tip end side of the first handle element 16a on the first forceps piece 12a side.
a and the second handle element 16 on the side of the second forceps piece 12b
Extension part (movable element) integrally extended to the tip side of b
18b are provided.

The treatment tool 11 of the present embodiment has a first
Of the handle element 16a and the second handle element 16b in the finger insertion ring 17a and the finger insertion ring 17b.
A finger burden reducing means 11A for reducing the burden on the operator's fingers coming into contact with b is provided. The finger load reducing means 11A is configured as follows. That is, the ring 17a of the first forceps piece 12a and the second forceps piece 12b.
As shown in FIG. 1 (A), the ring 17b has a central axis O connecting the operation portion 14 on the proximal side and the treatment portion 15 (the hand 19 of the operator using the surgical treatment instrument 11 of the present embodiment). Is arranged on a plane Z that is inclined at a predetermined inclination angle α with respect to the central axis O) from the treatment target site 20 to the treatment target site 20. The inclination angle α is set in the range of 50 ° to 70 °, and particularly in the present embodiment, the inclination angle α is set to about 60 °.

In addition, the ring 17a of the first forceps piece 12a
Is formed in a size large enough for the operator's thumb 21 to be inserted. Further, the ring 17b of the second forceps piece 12b
Is a single or multiple fingers 2 other than the operator's thumb 21.
2 is formed to be large enough to be inserted.

Further, the second forceps piece 12b of the present embodiment.
As shown in FIGS. 1 (B) and 1 (C), the first forceps piece 12 is
The slit 23 is formed in the connection part with a. The first forceps piece 12a is inserted into the slit 23 of the second forceps piece 12b.

Further, the fulcrum pin 13 is provided on the walls 24a and 24b on both sides of the slit 23 in the second forceps piece 12b.
Both ends of are fixed. The first forceps piece 12a is rotatably supported on the fulcrum pin 13 in a sliding state.

Further, as shown in FIG. 1C, the wall portions 24a on both sides of the slit 23 in the second forceps piece 12b,
On the inner surface of 24b, a sliding member 25 made of a resin material having a good sliding property such as PTFE is integrally provided. Further, a similar sliding member 26 is integrally formed on the sliding surface of the first forceps piece 12a with the walls 24a and 24b of the second forceps piece 12b and the sliding surface with the fulcrum pin 13. It is provided. Here, the dimensions of the sliding members 25 and 26 are set to have a dimensional relationship such that the clearance of each sliding portion is close to zero.

Next, the operation of the above configuration will be described.
When the surgical treatment tool 11 according to the present embodiment is used, FIG.
As shown in (A), the ring 17a of the first forceps piece 12a.
The operator's thumb 21 is inserted into the second forceps piece 12b, and one or more fingers 22 other than the operator's thumb 21 are inserted into the ring 17b of the second forceps piece 12b. In this state, the first handle element 16a of the first forceps piece 12a and the second forceps piece 1
By performing an opening / closing operation with the second handle element 16b of 2b, the extension portions 18a, 18 of the treatment portion 15 at the distal end are
Opening and closing is performed between b. At this time, the first forceps piece 12a
The sliding surface between the second forceps piece 12b and the second forceps piece 12b and the sliding surface between the first forceps piece 12a and the fulcrum pin 13 are the sliding member 2
By 5,26, there is no play and it slides smoothly,
It is possible to smoothly open and close between the first forceps piece 12a and the second forceps piece 12b.

Therefore, the following effects can be obtained with the above-mentioned structure. That is, the ring 1 of the first forceps piece 12a
7a and the ring 17b of the second forceps piece 12b are shown in FIG.
As shown in (A), a central axis O connecting the operation section 14 on the proximal side and the treatment section 15 on the distal side (from the hand 19 of the operator using the surgical treatment instrument 11 of the present embodiment to the treatment target). Part 2
The first forceps piece is arranged on the plane Z inclined at a predetermined inclination angle α with respect to the central axis O) toward 0, and the inclination angle α is set to about 60 ° in the present embodiment. 12
The operator's thumb 21 and the second forceps piece 1 are attached to the ring 17a of a.
When a single or multiple fingers 22 other than the thumb 21 of the operator are inserted in the ring 17b of 2b and the operator opens and closes the operation unit 14 in a natural state, the treatment target site 20 is It is always located on the central axis of the operator's forearm (not shown). Therefore, the site to be treated 2
Even when approaching 0 from an oblique direction, the operator
Surgical treatment tool 11 in a natural state without bending the wrist
Since the operation can be performed, there is little effect on the operator's fatigue and pain even if the operation is performed for a long time, and there is an effect that an accurate operation can be performed.

Further, when the opening / closing operation is performed between the first handle element 16a of the first forceps piece 12a and the second handle element 16b of the second forceps piece 12b, the sliding member 2 is used.
5, 26, since the extended portions 18a, 18b of the treatment portion 15 can be smoothly opened and closed without rattling, it is possible to more accurately operate the surgical treatment instrument 11.

2 (A) and 2 (B) show the second embodiment of the present invention.
FIG. In the present embodiment, the present invention is applied to a surgical treatment tool 31 used for endoscopic surgery.

In the surgical treatment tool 31 of the present embodiment, an insertion portion 32 to be inserted into a living body through a trocar outer tube (not shown) and an operation portion on the proximal side connected to the proximal end portion of the insertion portion 32. And 33 are provided.

The insertion portion 32 has a tubular insertion tube 34.
Is provided. The insertion portion 32 is placed in the insertion tube 34.
The drive shaft 35 that is relatively moved in the axial direction of is inserted. Further, a treatment section 36 is arranged at the tip of the insertion section 32. The treatment section 36 is provided with a pair of gripping members (movable elements) 37, 37 that can be opened and closed. Here, the pair of gripping members 37, 37 are connected to the distal end portion of the drive shaft 35 via a drive mechanism (not shown) such as a cam mechanism. Then, with the forward / backward movement of the drive shaft 35, the gripping members 37, 37 of the treatment portion 36 are opened / closed via a drive mechanism.

In addition, the insertion portion 32 is attached to the operation portion 33 on the hand side.
An operation portion main body 38 for rotatably holding the base end portion of is provided. A fixed handle (first
Handle 39) is integrally formed. The fixed handle 39 is provided with an arm 40 extending substantially parallel to the central axis of the insertion portion 32.

Further, one end of a substantially L-shaped movable handle (second handle) 41 is rotatably connected to the fixed handle 39 via a fulcrum pin 42. The movable handle 41 includes a long arm-shaped handle body 43 extending substantially parallel to the central axis of the insertion portion 32, and the handle body 4
3 is provided with a short bent portion 44 that is bent substantially at a right angle from one end thereof. The free end of the bent portion 44 is rotatably connected to the fixed handle 39 via the fulcrum pin 42. The base end of the drive shaft 35 is connected to the bent portion 44 of the movable handle 41.

A ring (first finger contact element) 45 having a size into which an operator's thumb can be inserted is rotatably attached to the end of the arm 40 of the fixed handle 39 via a pin 46. It is connected. Further, at the end of the handle main body 43 of the movable handle 41, a ring (second finger contact element) 47 having a size into which a single finger or a plurality of fingers other than the operator's thumb can be inserted has a pin 48. It is rotatably connected via.

Here, the ring 45 of the fixed handle 39 and the ring 47 of the movable handle 41 are located on the proximal side, like the rings 17a and 17b of the first embodiment (see FIGS. 1A to 1C). A predetermined inclination angle with respect to a central axis O connecting the operation unit 33 and the treatment unit 36 (a central axis O extending from the hand of the operator who uses the surgical treatment instrument 31 of the present embodiment to the treatment target site) It is arranged on the plane Z inclined by α. The inclination angle α is set in the range of 50 ° to 70 °, and particularly in the present embodiment, the inclination angle α is set to about 60 °. Then, the fixed handle 39 having the above configuration
The support structure of the ring 45 and the ring 47 of the movable handle 41 configures the finger burden reducing means 31A of the treatment instrument 31 of the present embodiment that reduces the burden on the operator's fingers contacting the rings 45 and 47. .

Next, the operation of the above configuration will be described.
When the surgical treatment instrument 31 of the present embodiment is used, the operator's thumb is inserted into the ring 45 of the fixed handle 39, and one or more fingers other than the operator's thumb are inserted into the ring 47 of the movable handle 41. Is inserted. In this state, the movable handle 41 is rotated with respect to the fixed handle 39. At this time, the drive shaft 35 moves in the axial direction with respect to the insertion tube body 34 of the insertion portion 32 in accordance with the rotating operation of the movable handle 41, and the gripping member of the treatment portion 36 at the distal end of the insertion portion 32 via the drive mechanism. Opening and closing is performed between 37 and 37.

Therefore, the following effects are obtained with the above-mentioned structure. That is, the ring 45 of the fixed handle 39
Also, the ring 47 of the movable handle 41 has a central axis O connecting the operation portion 33 and the treatment portion 36 on the proximal side (from the hand of the operator who uses the surgical treatment instrument 31 of the present embodiment to the treatment target portion). The fixed handle 3 is arranged on the plane Z that is inclined at a predetermined inclination angle α with respect to the central axis O), and this inclination angle α is set to approximately 60 ° in the present embodiment.
With the operator's thumb inserted in the ring 45 of the reference numeral 9 and the operator's single or multiple fingers other than the operator's thumb inserted in the ring 47 of the movable handle 41, the operator can bend the wrist naturally. In this state, the surgical treatment instrument 31 can be operated. Therefore, even in this embodiment, the first
Similar to the embodiment described above, there is little fatigue and pain for the operator even in the operation for a long time, and there is an effect that an accurate operation can be performed.

Further, in the finger load reducing means 31A of the present embodiment, particularly, the ring 45 of the fixed handle 39 and the ring 47 of the movable handle 41 are pinned to the arm 40 of the fixed handle 39 and the handle body 43 of the movable handle 41. Since they are rotatably connected via 46 and 48 respectively, they follow the fingers of the operator inserted in the ring 45 of the fixed handle 39 and the ring 47 of the movable handle 41 during the opening / closing operation of the movable handle 41. Then, the ring 45 of the fixed handle 39 and the ring 47 of the movable handle 41 rotate via the pins 46 and 48, respectively. Therefore, there is an effect that the pain of each finger of the operator inserted in the ring 45 of the fixed handle 39 and the ring 47 of the movable handle 41 can be reduced.

Further, FIGS. 3A, 3B and 4
(A)-(C), (D)-(F) are the surgical treatment tools 31 used for endoscopic surgery of 2nd Embodiment (refer FIG. 2 (A), (B)). It shows a first modified example in which the configuration of the operation unit 33 is changed as follows. The operation unit 33
The configuration of the other parts is the surgical treatment tool 3 of the second embodiment.
This is the same as the first embodiment, and the same parts as those in the second embodiment are designated by the same reference numerals and the description thereof will be omitted.

That is, as shown in FIG. 3A, a fixed handle 51 bent in a direction substantially perpendicular to the central axis of the insertion portion 32 is provided on the operation portion 33 of the surgical treatment instrument 31 of the present modified example. It is formed integrally with 38. A movable handle 52 is attached to the fixed handle 51 as a fulcrum member (connecting means) 5.
3 is rotatably connected. The base end of the drive shaft 35 is connected to the head of the movable handle 52.

A ring-shaped finger insertion portion 54 for inserting a finger is formed at the end of the fixed handle 51.
As shown in FIG. 3 (B), a projection 55 is provided on the inner peripheral surface of the finger inserting portion 54 over the entire inner peripheral surface thereof.

Further, a ring-shaped finger insertion portion 56 for inserting a finger is also formed at the end of the movable handle 52. On the inner peripheral surface of the finger inserting portion 56, a protrusion 57 is provided so as to project over the entire inner peripheral surface.

The finger insertion portion 54 of the fixed handle 51
The shape of the inner peripheral surface of the finger insertion portion 56 of the movable handle 52 is symmetrical vertically and horizontally and front and rear. further,
The shape of the inner peripheral surface of the finger insertion portion 54 of the fixed handle 51,
The shape of the inner peripheral surface of the finger insertion portion 56 of the movable handle 52 is set to the same shape.

Further, the finger insertion portion 54 of the fixed handle 51
As shown in FIG. 3B, elastic rings (finger load reducing means) 58 made of an elastic material are detachably provided on the inner peripheral surfaces of the finger insertion portion 56 of the movable handle 52. On the outer peripheral surface of the elastic ring 58, the projections 55, 5 of the finger insertion portions 54, 56 of the handles 51, 52 are provided.
Engagement grooves 59 are formed to engage with and disengage with respect to 7.

Here, the elastic ring 58 is made of silicone rubber,
It is composed of synthetic rubber such as fluororubber, butyl rubber, ethylene propylene rubber, isoprene rubber, and butadiene rubber. The synthetic rubber is preferably antibacterial rubber. The width of the elastic ring 58 is preferably about 10 mm or more so that the contact area with the finger becomes large.

Next, the operation of the above configuration will be described.
When using the surgical treatment tool 31 of this modification, the operator's thumb is inserted into the elastic ring 58 of the finger insertion portion 56 of the movable handle 52, and the operator is inserted into the elastic ring 58 of the finger insertion portion 54 of the fixed handle 51. The ring finger or middle finger of is inserted. In this state, the movable handle 52 is rotated with respect to the fixed handle 51. The drive shaft 35 moves in the axial direction with respect to the insertion tube body 34 of the insertion portion 32 in accordance with the rotating operation of the movable handle 52 at this time, and the gripping member of the treatment portion 36 at the distal end of the insertion portion 32 via the drive mechanism. Opening and closing is performed between 37 and 37.

Here, the finger insertion portion 5 of the movable handle 52.
6 and the elastic rings 58 of the finger insertion portions 54 of the fixed handle 51 are made of an elastic material, the elastic rings 58 are elastically deformed inward, and the protrusions of the finger insertion portions 54 and 56 of the handles 51 and 52 are projected. By engaging or disengaging between the portions 55 and 57 and the engaging groove 59 of each elastic ring 58, each elastic ring 58 has a finger insertion portion 56 of the movable handle 52 and a finger insertion portion 54 of the fixed handle 51.
Can be easily attached and detached.

Therefore, FIGS. 4A to 4C and 4D to
As shown in (F), by preparing in advance a plurality of elastic rings 58A to 58C each having a different inner peripheral surface size (inner diameter size), the operator can match the size of his / her fingers. The elastic rings 58A to 58C can be selected and used.

It is possible to prepare several kinds of elastic rings 58 having the same shape but different hardness, for example, those having a JIS hardness of 30 ° to 80 °. In addition, according to the size and hardness of the elastic rings 58, for example, by marking S, M, L or the like or changing the color, the user can easily make the elastic rings 58A to 58C. Can be identified. Furthermore, the elastic ring 58 is shown in FIG.
Instead of the elliptical shape shown in (C), a simple circular shape may be used. In this case, by attaching the elastic ring 58 to the finger insertion portions 54 and 56, the elastic ring 58
Transforms into an elliptical shape as shown in FIG.

Therefore, the following effects can be obtained with the above-mentioned structure. That is, since the elastic rings 58 of the finger insertion portion 56 of the movable handle 52 and the finger insertion portion 54 of the fixed handle 51 are formed of an elastic material, the finger insertion portion 56 of the movable handle 52 and the fixed handle 51 of the movable handle 52 can be operated even for a long time. The operator's fingers inserted in the finger insertion portion 54 do not hurt, and the operator's fatigue and pain can be reduced.

Further, since the operator can easily attach / detach and replace the elastic ring 58 of various sizes, shapes, and hardness according to his / her application or his / her preference, the operation of the surgical treatment tool 31 can be performed. And versatility are improved.

Further, when the elastic ring 58 is damaged, the initial operability can be easily restored by replacing only the damaged elastic ring 58, which is economically excellent.

FIG. 5 shows the second embodiment (FIG. 2).
(A), (B) reference) shows a second modified example of the surgical treatment tool 31. This modification is the first modification (see FIG. 3).
(A), (B) and FIGS. 4 (A) to (F)) are provided with a large number of minute protrusions 61 on the inner peripheral surface of the elastic ring 58.

Therefore, the elastic ring 58 of this modification is first
In the case of being used by attaching to the finger insertion portion 56 of the movable handle 52 and the finger insertion portion 54 of the fixed handle 51 of the modified example of FIG. It acts as a non-slip material that prevents the fingers from sliding on the surface. Therefore, by using the elastic ring 58 of the present modification, the operator's fingers do not slip on the inner peripheral surface of the elastic ring 58, so that the erroneous operation of the surgical treatment instrument 31 can be prevented.

In addition, the elastic ring 58 can be used for a long period of time.
If the protrusion 61 on the inner peripheral surface of the item is worn out, the initial operability can be easily restored by replacing only the elastic ring 58 with a new one.

FIGS. 6A to 6E show a third modification of the surgical treatment tool 31 of the second embodiment (see FIGS. 2A and 2B). . This modification is shown in FIG. 6C at the inner peripheral surface of the elastic ring 58 of the surgical treatment tool 31 of the first modification (see FIGS. 3A, 3B and 4A to 4F). 6D, inclined surfaces 71 that are inclined with respect to the central axis P of the elastic ring 58 are formed substantially parallel to each other on both left and right ends. The inner peripheral shape of the elastic ring 58 is the same as that of the finger insertion portion 155 of FIG. 16 and FIGS. 17A to 17D of a tenth modification described later.
It may be the same as the inner peripheral shape of the ring of 156.

Therefore, in the case of the above configuration, FIG.
As shown in (A) and (B), the elastic ring 5 of the present modified example.
8 is a finger insertion portion 56 of the movable handle 52 of the first modified example.
When used by being attached to the finger insertion portion 54 of the fixed handle 51, the operator's fingers 72 and 73 inserted in the elastic ring 58 and the inclined surface 71 of the inner peripheral surface of the elastic ring 58 are in contact with each other substantially in parallel. Therefore, when the surgical treatment instrument 31 is operated, the pressure applied to the fingers 72 and 73 of the operator is reduced.
Therefore, there is an effect that the operator's burden on the fingers 72 and 73 is lightened when operating the surgical treatment tool 31.

Although FIGS. 6A and 6B show the elastic ring 58 having a shape suitable for the operator to operate with the right hand, the elastic ring 58 is more elastic than the state shown in FIGS. 6A and 6B. With the ring 58 rotated 180 ° with respect to its central axis Q, the first
Of the modified example (see FIGS. 3A and 3B) of FIG.
The elastic ring 58 can be changed to a shape suitable for the operator to operate with the left hand by mounting the elastic ring 58 on the second finger insertion portion 56 and the finger insertion portion 54 of the fixed handle 51.

Further, FIGS. 7A and 7B show a fourth modification of the surgical treatment instrument 31 of the second embodiment (see FIGS. 2A and 2B). . In this modification, the configuration of the operation unit 33 of the first modification (see FIGS. 3A and 3B) is changed as follows. The configuration other than the operation unit 33 is the same as that of the surgical treatment tool 31 of the second embodiment, and here, the same parts as those of the second embodiment are designated by the same reference numerals and their description is omitted. Is omitted.

That is, as shown in FIG. 7 (A), the fixed handle 5 is provided on the operating portion 33 of the surgical treatment instrument 31 of this modification.
1, a substantially elliptical finger insertion hole portion 82 for inserting the operator's middle finger 81 and a substantially elliptical finger insertion hole portion 84 for inserting the operator's third finger 83 are formed.

At the end of the movable handle 52, a substantially elliptical ring 86 for inserting the thumb 85 of the operator is inserted.
Are provided integrally. Here, on the inner peripheral surface of the ring 86, an inclined surface 87 inclined with respect to the central axis R of the ring 86 is formed over the entire inner peripheral surface of the ring 86 as shown in FIG. 7B. ing.

In this modification, the inclination angle β of the inclined surface 87 with respect to the central axis R of the ring 86 of the movable handle 52 is set to about 20 °. Furthermore, fixed handle 5
A slanted surface 87 similar to the ring 86 of the movable handle 52 is also formed on the inner peripheral surfaces of the finger insertion hole portions 82 and 84 of the first finger insertion hole portion 8.
It is formed over the entire circumference of the inner peripheral surfaces of 2,84.

When the surgical treatment instrument 31 of this modification is used, the operator's thumb 85 is inserted into the ring 86 of the movable handle 52, and the operator's thumb 85 is inserted into one of the finger insertion hole portions 82 of the fixed handle 51. Middle finger 81, the other finger insertion hole 8
The operator's ring finger 83 is inserted into the inside of the position 4. In this state, the movable handle 52 is rotated with respect to the fixed handle 51. The drive shaft 35 moves in the axial direction with respect to the insertion tube body 34 of the insertion portion 32 in accordance with the rotating operation of the movable handle 52 at this time, and the gripping member of the treatment portion 36 at the distal end of the insertion portion 32 via the drive mechanism. Opening and closing is performed between 37 and 37.

Therefore, in the structure described above, an inclined surface 87 which is inclined with respect to the central axis R of the ring 86 is formed on the inner peripheral surface of the ring 86 of the movable handle 52, as shown in FIG. 6B. Since the inner surface of the ring 86 is formed over the entire circumference, the thumb 85 of the operator inserted into the ring 86 of the movable handle 52 is always the inclined surface 8 of the inner surface of the ring 86.
It touches almost parallel to 7. Therefore, the pressure applied to the thumb 85 of the operator during the operation of the surgical treatment tool 31 of this modification is reduced, and the burden on the thumb 85 of the operator during the operation of the surgical treatment tool 31 is reduced.

Further, the finger insertion hole portion 8 of the fixed handle 51
Since the inclined surfaces 87 similar to the ring 86 of the movable handle 52 are also formed on the inner peripheral surfaces of the reference numerals 2, 84, the middle finger 81 and the ring finger 83 of the operator, like the thumb 85, of the surgical treatment tool 31. The burden on operation is reduced. Therefore,
In this modified example, the load on each finger for operating the surgical treatment instrument 31 is reduced, so that the operator's fatigue and pain can be reduced.

FIG. 8 shows a second embodiment (FIG. 2).
(A), (B) reference) shows the 5th modification of the treatment tool 31 for surgery. This modification is the first modification (see FIG. 3).
The configuration of the operation unit 33 (see (A) and (B)) is changed as follows. The configuration of the parts other than the operation part 33 is the same as that of the surgical treatment tool 31 of the second embodiment,
Here, the same parts as those of the second embodiment are designated by the same reference numerals and the description thereof will be omitted.

That is, in the surgical treatment tool 31 of the present modification, as shown in FIG. 8, a handle body 91 integrally formed with the operation portion body 38 on the fixed handle 51 of the operation portion 33.
Further, a ring-shaped member 93 for inserting a finger is provided at the end of the handle body 91 so as to be rotatable about a rotary shaft 92.

Here, an engaging groove 94 is formed at the end of the handle body 91 of the fixed handle 51. A large-diameter hole 95 is formed at the inner end (upper end in FIG. 8) of the engaging groove 94.
Are formed.

Further, the ring-shaped member 93 is provided with a rotary shaft 92 projectingly engaged with the engaging groove 94 of the handle main body 91. A large diameter portion 96 to be inserted into the large diameter hole portion 95 of the handle body 91 is formed at the tip end portion of the rotating shaft 92.
The ring-shaped member 93 is rotatably connected to the end of the handle body 91 about the rotation shaft 92.

Similarly, the movable handle 52 also has a handle main body 97, and a rotary shaft 98 is provided at the end of the handle main body 97.
A ring-shaped member 99 for inserting fingers is provided which is rotatably connected around the center. The rotatable connecting mechanism between the handle main body 97 of the movable handle 52 and the ring-shaped member 99 has the same structure as that of the fixed handle 51 side, and the same parts are designated by the same reference numerals here. And its description is omitted.

Further, the ring-shaped member 9 of the fixed handle 51
3 and an inner peripheral surface of the ring-shaped member 99 of the movable handle 52, an inclined surface 87 similar to the ring 86 of the fourth modified example (see FIGS. 7A and 7B) is formed over the entire circumference. There is.

When the surgical treatment instrument 31 of this modification is used, the operator's thumb is inserted into the ring-shaped member 99 of the movable handle 52, and the operator's ring finger is inserted into the ring-shaped member 93 of the fixed handle 51. Alternatively, the middle finger is inserted. In this state, the movable handle 52 with respect to the fixed handle 51
Rotate. The drive shaft 35 moves in the axial direction with respect to the insertion tube body 34 of the insertion portion 32 in accordance with the rotating operation of the movable handle 52 at this time, and the gripping member of the treatment portion 36 at the distal end of the insertion portion 32 via the drive mechanism. Opening and closing is performed between 37 and 37.

Further, in the surgical treatment instrument 31 of the present modification, when the movable handle 52 is rotated, the ring-shaped member 99 follows the thumb of the operator inserted into the ring-shaped member 99 of the movable handle 52. While rotating about the rotation shaft 98 with respect to the main body 97, the fixed handle 51
The ring-shaped member 93 follows the ring finger or the middle finger of the operator inserted into the ring-shaped member 93 of the handle main body 9
It rotates about the rotating shaft 92 with respect to 1. At this time, since the large diameter portion 96 is formed at the tip of the rotary shafts 92 and 98, the ring-shaped member 93 of the fixed handle 51 and the ring-shaped member 99 of the movable handle 52 are rotated by the rotary shafts 92 and 9.
8 does not move in the axial direction.

Therefore, in the case of operating the surgical treatment instrument 31 in the above configuration, the ring-shaped member 93 of the fixed handle 51 and the ring-shaped member 99 of the movable handle 52 follow the inserted fingers. Since it pivots by rotating, the pain of each finger of the operator can be further reduced.

In the fifth modification of FIG. 8, the ring-shaped member 93 of the fixed handle 51 and the ring-shaped member 99 of the movable handle 52 are shaped so that the operator can operate them with his / her right hand. , The ring-shaped member 9 of the fixed handle 51
3 and the ring-shaped member 99 of the movable handle 52 from the state of FIG. 8 to the center line S of the rotating shaft 92 and the center line T of the rotating shaft 98.
By rotating each 180 degrees around
The ring-shaped member 93 of the fixed handle 51 and the ring-shaped member 99 of the movable handle 52 can be changed into a shape suitable for the operator to operate with the left hand. Therefore, the ring-shaped member 93 of the fixed handle 51 and the ring-shaped member 99 of the movable handle 52 are connected to the center line S of the rotating shaft 92 and the rotating shaft 9.
By rotating 180 degrees around the center line T of 8, the shape of the operation portion 33 suitable for operation with both left and right hands can be obtained.

FIG. 9 shows the second embodiment (FIG. 2).
It is a figure which shows the 6th modification of the surgical treatment tool 31 of (A), (B) reference. This modification is the first modification (see FIG. 3).
The configuration of the operation unit 33 (see (A) and (B)) is changed as follows. The configuration of the parts other than the operation part 33 is the same as that of the surgical treatment tool 31 of the second embodiment,
Here, the same parts as those of the second embodiment are designated by the same reference numerals and the description thereof will be omitted.

That is, in the surgical treatment tool 31 of the present modification, as shown in FIG. 9, two arms 101, which are expanded in a substantially V shape, are formed on a fixed handle 51 integrally formed with the operation section main body 38. 102 (lower first arm 101 and upper second arm 102) are provided. here,
The opening angle between the two arms 101, 102 is about 110 °.
It is set to a degree. Furthermore, each arm 101, 10
An annular ring 103, 104 for inserting fingers is provided at the end of 2.
Are provided integrally with each other.

The movable handle 52, which is rotatably connected to the fixed handle 51 by a fulcrum member 53, has two arms 105 and 106 (third lower arm 105) which are similarly expanded into a substantially V shape. And the upper fourth arm 10
6) is provided. Here, the two arms 105,
The opening angle between 106 is set to about 110 °. Further, annular rings 107 and 108 for inserting fingers are integrally provided at the ends of the arms 105 and 106, respectively.

Further, the fixed handle 51 is formed with a slit 109 for inserting the movable handle 52 at a connecting portion between the two arms 101 and 102. Then, with one arm (third arm) 105 of the movable handle 52 extending between the two arms 101 and 102 of the fixed handle 51 through the slit 109, the movable handle 52 is a fulcrum on the fixed handle 51. It is rotatably connected by a member 53. In this case, 2 of the fixed handle 51
One arm (third arm) 105 of the movable handle 52 is located at an intermediate position between the angles formed by the two arms 101 and 102.
Are set to be placed. That is, the angle formed between the first arm 101 of the fixed handle 51 and the third arm 105 of the movable handle 52, the movable handle 5
Angle formed between the third arm 105 of No. 2 and the second arm 102 of the fixed handle 51, the second of the fixed handle 51
Arm 102 and fourth arm 10 of movable handle 52
The arrangement of the movable handle 52 is set so that the angles formed by the movable handle 52 and 6 are the same.

Further, the third arm 1 of the movable handle 52
In the slit 109 of the fixed handle 51 into which 05 is inserted, a sufficient space for inserting a cleaning brush (not shown) is secured.

When the surgical treatment instrument 31 of this modification is used, the two arms 101, 10 of the fixed handle 51 are used.
The two rings 103 and 104 and the rings 107 and 108 of the two arms 105 and 106 of the movable handle 52 are selectively used by the operator depending on the situation. That is, a first combination using the ring 103 of the first arm 101 of the fixed handle 51 and the ring 107 of the third arm 105 of the movable handle 52, or the ring 107 of the third arm 105 of the movable handle 52. A second combination using the ring 104 of the second arm 102 of the fixed handle 51, or the ring 104 of the second arm 102 of the fixed handle 51 and the fourth of the movable handle 52.
Any one of the third combinations using the ring 108 of the arm 106 of FIG.

Then, the movable handle 52 is rotated around the fulcrum member 53 with respect to the fixed handle 51 by any one of the first to third combinations, so that the movable handle 52 is rotated at this time. The drive shaft 35 moves in the axial direction with respect to the insertion tube body 34 of the insertion portion 32 in accordance with the dynamic operation, and the opening / closing drive is performed between the gripping members 37, 37 of the treatment portion 36 at the distal end of the insertion portion 32 via the drive mechanism. It

When the operator opens and closes the hand,
Normally, the closing operation can generate a larger amount of force than the opening operation. Therefore, a first combination using the ring 103 of the first arm 101 of the fixed handle 51 and the ring 107 of the third arm 105 of the movable handle 52, and the ring 104 of the second arm 102 of the fixed handle 51. When operating in a third combination using the ring 108 of the fourth arm 106 of the moveable handle 52,
A large amount of force can be generated in the direction in which the drive shaft 35 is retracted.

On the contrary, the third arm 1 of the movable handle 52
When operating with the second combination using the ring 107 of 05 and the ring 104 of the second arm 102 of the fixed handle 51, a large amount of force can be generated in the direction of advancing the drive shaft 35.

Therefore, in the above structure, the ring 10 of the two arms 101 and 102 of the fixed handle 51 is arranged.
3, 104 and the two arms 10 of the movable handle 52
5 and 106 of the ring 107, 108 is a surgical treatment tool 3
Since the operator can selectively and properly use the item 1 (angle with the insertion portion 32, power, etc.) according to the situation in which the item 1 is used, the operability of the surgical treatment tool 31 is improved.

During the operation, the operator holds the fixed handle 51
Ring 103 and movable handle 5 of the first arm 101 of
When the surgical treatment instrument 31 operated in the first combination using the ring 107 of the second arm 105 of No. 2 is handed over to another person (an assistant, etc.), the other person does not move the fixed handle 51 first. Ring 104 and movable handle 52 of the second arm 102
By inserting fingers into the ring 108 of the fourth arm 106, the surgical treatment instrument 31 can be delivered without interrupting the operation of the surgical treatment instrument 31. Therefore, the operation time can be shortened.

Furthermore, the fixed handle 5 has a simple structure and the third arm 105 of the movable handle 52 is inserted.
The slit 109 of No. 1 has a sufficient space for a cleaning brush (not shown) to be inserted therethrough, and thus has the effect of improving the cleaning property.

FIGS. 10 to 12 show a seventh embodiment of the surgical treatment instrument 31 of the second embodiment (see FIGS. 2A and 2B).
It shows a modified example of. In this modification, the configuration of the operation unit 33 of the first modification (see FIGS. 3A and 3B) is changed as follows. The configuration other than the operation unit 33 is the same as that of the surgical treatment tool 31 of the second embodiment, and here, the same parts as those of the second embodiment are designated by the same reference numerals and their description is omitted. Is omitted.

That is, in the surgical treatment tool 31 of this modification, as shown in FIG. 10, the first arm 111 extending to the lower side of the operating portion main body 38 is attached to the fixed handle 51 integrally formed with the operating portion main body 38. And a second arm 112 extending above the operation portion main body 38.

The movable handle 52 rotatably connected to the fixed handle 51 by a fulcrum member 53 has a third arm 113 extending below the fulcrum member 53 and a fourth arm 113 extending above the fulcrum member 53. An arm 114 is provided.

Further, connecting portions 115 having the same shape are provided on the tip end sides of the first and second arms 111 and 112 of the fixed handle 51 and the third and fourth arms 113 and 114 of the movable handle 52. Has been. These connections 1
As shown in FIG. 11 and FIG.
6 and the hole portion 1 formed in the axial center portion of the male screw portion 116.
And 17 are provided. A flat surface for positioning is formed on one side surface of the inner peripheral surface of the hole 117.

Further, the first arm 1 of the fixed handle 51
A ring-shaped member 118 is detachably connected to the connecting portion 115 of 11. The ring-shaped member 118 is provided with a connecting arm 119 and a finger-inserting ring 120 integrally formed at the base end of the connecting arm 119.

Further, a connecting member 121 is integrally fixed to the tip of the connecting arm 119. The connecting member 121 is provided with a rod-shaped member 122 and a female screw member 123.

Here, the base end portion of the rod-shaped member 122 is fitted into the hole portion 119a formed at the tip end portion of the connecting arm 119 and is integrally fixed. Further, the rod-shaped member 12
The tip of 2 is projected to the outside of the hole 119a of the connecting arm 119. Then, a large diameter portion 124 for preventing the female screw member 123 from coming off is provided on the protruding portion of the rod member 122,
Engagement protrusion 12 inserted into the hole 117 of the connecting portion 115
And 5 are formed.

Further, the female screw member 123 has a connecting portion 115.
A female screw portion 126 screwed to the male screw portion 116 and a ring-shaped small-diameter portion 127 having a smaller diameter than the large-diameter portion 124 of the rod-shaped member 122 are formed. The female screw member 123 is held rotatably along the rod member 122 and movable in the axial direction of the rod member 122. The large-diameter portion 124 of the rod member 122 restricts the range of movement of the female screw member 123 in the axial direction of the rod member 122.

Also, the third arm 1 of the movable handle 52
The ring-shaped member 118 is also detachably connected to the connection portion 115 of the reference numeral 13 similarly to the connection portion 115 of the first arm 111 of the fixed handle 51. Since the structure of the ring-shaped member 118 connected to the third arm 113 of the movable handle 52 is the same as the ring-shaped member 118 connected to the first arm 111 of the fixed handle 51, its description will be given here. Omit it.

Also, the second arm 1 of the fixed handle 51
If necessary, the connection portion 115 of the first arm 111 of the fixed handle 51 and the connection portion 115 of the fourth arm 114 of the movable handle 52 and the connection portion 115 of the third arm 113 of the movable handle 52 may be connected. The ring-shaped members 118 removed from the portion 115 are detachably connected to each other.

Then, when the surgical treatment tool 31 of this modification is used, as shown in FIGS. 10 and 11, the respective connecting portions 115 of the first arm 111 of the fixed handle 51 and the third arm 113 of the movable handle 52. The ring-shaped member 11
8 is a first state in which they are detachably connected, or a ring-shaped member 118 removed from each connecting portion 115 of the first arm 111 of the fixed handle 51 and the third arm 113 of the movable handle 52. 10, each connecting portion 115 of the second arm 112 of the fixed handle 51 and the fourth arm 114 of the movable handle 52 is indicated by a phantom line.
The surgical treatment instrument 31 is used in either of the second states, which are detachably connected to each other.

Here, the engaging protrusion 125 of the ring-shaped member 118 is inserted into the hole 117 of each connecting portion 115 of the first arm 111 of the fixed handle 51 and the third arm 113 of the movable handle 52. Then, the male screw portion 116 of each connecting portion 115 is connected to the female screw member 123 of the ring-shaped member 118.
By rotating the screw in the screwing direction, the ring is attached to each connecting portion 115 of the first arm 111 of the fixed handle 51 and the third arm 113 of the movable handle 52 as in the first state shown in FIGS. 10 and 11. The strip-shaped members 118 are detachably connected to each other.

In this state, the ring-shaped member 118 of the third arm 113 of the movable handle 52 is operated by the operator's finger.
The movable handle 52 to the fixed handle 51.
By rotating the fulcrum member 53 in the clockwise direction in FIGS. 10 and 11 with respect to the fulcrum member 53, the drive shaft 35 is rotated by the rotating operation of the movable handle 52 at this time. To retreat in the axial direction. That is, a large amount of force can be generated in the direction in which the drive shaft 35 is retracted. At this time, the gripping members 37, 37 of the treatment section 36 at the distal end of the insertion section 32 are driven to be closed or opened via the drive mechanism.

Further, from the male screw portion 116 of each connecting portion 115 of the first arm 111 of the fixed handle 51 and the third arm 113 of the movable handle 52 shown in FIGS. 10 and 11 to the ring-shaped member 118. Female screw member 1
23 is rotated in the opposite direction to the screwing direction, and the engaging projection 125 is pulled out from the inside of the hole 117 of the connecting portion 115, whereby the first arm 111 and the movable handle 52 of the fixed handle 51 in the first state. The ring-shaped member 118 can be detached from each connection portion 115 of the third arm 113 of FIG.

Further, the engaging protrusion of the ring-shaped member 118 removed here is inserted into the hole 117 of each connecting portion 115 of the second arm 112 of the fixed handle 51 and the fourth arm 114 of the movable handle 52. With the inserted 125, the female screw member 123 of the ring-shaped member 118 is rotated in the screwing direction to the male screw portion 116 of each connection portion 115 to fix it as in the second state shown by the phantom line in FIG. A ring-shaped member 118 is detachably connected to each connecting portion 115 of the second arm 112 of the handle 51 and the fourth arm 114 of the movable handle 52.

In this state, the ring-shaped member 118 of the fourth arm 114 of the movable handle 52 is operated by the operator's fingers.
By performing the closing operation of the above, the movable handle 52 can be rotated in the counterclockwise direction in FIGS. 10 and 11 about the fulcrum member 53 with respect to the fixed handle 51.
Since the drive shaft 35 can be moved forward in the axial direction with respect to the insertion tube body 34 of the insertion portion 32 in accordance with the rotating operation of the movable handle 52 at this time, a large amount of force is generated in the direction in which the drive shaft 35 is moved forward. be able to. At this time, the drive mechanism is used to open or close between the grasping members 37, 37 of the treatment portion 36 at the distal end of the insertion portion 32.

Therefore, in the structure described above, the fixed handle 51 is provided with the first arm 111 extending below the operating portion main body 38 and the second arm 112 extending above the operating portion main body 38. The movable handle 52 is provided with a third arm 113 that extends below the fulcrum member 53 and a fourth arm 114 that extends above the fulcrum member 53, and as shown in FIG. 10 and FIG. 1
The arm 111 and the third handle 113 of the movable handle 52 in the first state in which the ring-shaped members 118 are detachably connected to the respective connection portions 115, or the first arm 111 and the movable handle 52 of the fixed handle 51. The ring-shaped member 118 removed from the respective connection portions 115 of the third arm 113 of the second arm 112 of the fixed handle 51 and the fourth arm 114 of the movable handle 52 are indicated by phantom lines in FIG. Since the surgical treatment instrument 31 can be used in any one of the second states detachably connected to each of the connection portions 115, the operation portion 33 can be selectively used according to the situation of use. Therefore, there is an effect that the operability of the surgical treatment instrument 31 is improved.

FIG. 13 shows a first modification (FIG. 3).
(A), (B) refer to another modified example. In this modification, the configuration of the operation unit 33 of the first modification is changed as follows. The configuration other than the operation unit 33 is the same as that of the surgical treatment tool 31 of the second embodiment, and the same parts as those of the second embodiment are designated by the same reference numerals and the description thereof will be omitted. Is omitted.

That is, in the present modification, the finger insertion portions 54,
56 is a notch 54a formed by notching a part of the circumference of the ring,
56a are formed respectively. Then, elastic rings 58 are mounted in the rings of the substantially C-shaped finger insertion portions 54 and 56, respectively.

Therefore, in this modified example, the finger insertion portions 54, 5
6 has notches 54a, 5 formed by notching a part of the circumference of the ring.
Since the respective 6a are formed, when the operating portion 33 is operated in the opening direction, the elastic ring 58 can be deformed to a greater extent at the notches 54a and 56a.
Therefore, the pain of the fingers when operating the operation unit 33 in the opening direction can be reduced more effectively.

Further, FIG. 14 shows a second embodiment (FIG. 2).
It is a figure which shows the 8th modification of the surgical treatment tool 31 of (A), (B) reference. This modification is the first modification (see FIG. 3).
The configuration of the operation unit 33 (see (A) and (B)) is changed as follows. The configuration of the parts other than the operation part 33 is the same as that of the surgical treatment tool 31 of the second embodiment,
Here, the same parts as those of the second embodiment are designated by the same reference numerals and the description thereof will be omitted.

That is, in the surgical treatment tool 31 of the present modification, the lower portion of the fixed handle 51 and the movable handle 52 has a thinner portion 131a, 1 than the upper portion.
31b are provided respectively, and elastic members (finger load reducing means) 13 in a state of covering the outer surfaces of the thin portions 131a and 131b.
2a and 132b are attached. Here, the thin portion 131a of the fixed handle 51 is formed on the ring of the finger insertion portion 54 of the fixed handle 51 and the vicinity thereof. Further, the thin portion 131b of the movable handle 52 is formed on the ring of the finger insertion portion 56 of the movable handle 52 and its vicinity. The elastic members 132 a and 132 b are the thin-walled portions 131 of the fixed handle 51 and the movable handle 52.
The outer surfaces of a and 131b are integrally formed and fixed, for example, by insert molding.

Therefore, in the structure described above, the finger insertion portions 54 of the fixed handle 51 and the movable handle 52,
Not only inside the ring 56, but also outside the rings of the finger insertion portions 54 and 56 and the entire outer surface in the vicinity thereof, the elastic member 1
Since 32a and 132b are attached, the fingers that are not inserted into the rings of the finger insertion portions 54 and 56 of the fixed handle 51 and the movable handle 52, for example, the ring finger of the finger insertion portion 54 of the fixed handle 51 on the front side. When inserting, the middle finger arranged outside the ring of the finger inserting portion 54,
It also has the effect of not hurt the little finger. Therefore, it is possible to reduce operator fatigue and pain.

Further, FIGS. 15A to 15C show a surgical treatment instrument 31 of the second embodiment (see FIGS. 2A and 2B).
It shows a ninth modified example of. In this modification, the configuration of the operation unit 33 of the first modification (see FIGS. 3A and 3B) is changed as follows. The configuration other than the operation unit 33 is the same as that of the surgical treatment tool 31 of the second embodiment, and here, the same parts as those of the second embodiment are designated by the same reference numerals and their description is omitted. Is omitted.

That is, the operating portion 33 of the surgical treatment instrument 31 of this modification is provided with a fixed handle 141 having a smaller bending angle with respect to the central axis of the insertion portion 32 than the fixed handle 51 of the first modification. . This fixed handle 141
A movable handle 142 is rotatably connected by a fulcrum member 143. Head 1 of this movable handle 142
A base end of the drive shaft 35 is connected to the drive shaft 44.

A ring-shaped finger insertion portion 145 for inserting a finger is formed at the end of the fixed handle 141. Furthermore, a ring-shaped finger insertion portion 146 for inserting a finger is also formed at the end of the movable handle 142.

Elastic rings 147 are detachably or integrally provided on the inner peripheral surfaces of the finger inserting portions 145, 146 over the entire inner peripheral surfaces thereof. Here, a concave engagement groove 148 is formed on the outer peripheral surface of each elastic ring 147 as shown in FIG. The elastic rings 147 are fixed to the finger insertion portions 145, 146 with the engagement grooves 148 of the elastic rings 147 engaged with the inner peripheral surfaces of the finger insertion portions 145, 146.

Further, as shown in FIG. 15B, a tapered inclined surface 149 is provided symmetrically in the vicinity of the finger insertion portion 145 of the fixed handle 141. Further, similar inclined surfaces 149 are also provided symmetrically in the vicinity of the finger insertion portion 146 of the movable handle 142.
In this modification, the opening angle α between the left and right inclined surfaces 149 is α.
Is set to about 40 °.

Further, an abutting portion 150 for restricting the movable range of the movable handle 142 in the closing direction is provided near the center of the fulcrum member 143 in the fixed handle 141 and the movable handle 142.

Therefore, in the above-mentioned structure, when the surgical treatment instrument 31 is used, the user puts his thumb in the ring of the finger insertion portion 146 of the movable handle 142, and the finger insertion portion of the fixed handle 141 on the front side. For example, when the ring finger is placed in the ring 145, the inclined surface 149 of the fixed handle 141 is shaped to fit the middle finger of the user.

Here, since the movable handle 142 is also provided with a similar inclined surface 149, the user changes the way of holding the surgical treatment instrument 31 and, as shown by the phantom line in FIG. When the user puts his thumb in the ring of the finger insertion portion 145 of the fixed handle 141 and puts the ring finger in the ring of the finger insertion portion 146 of the movable handle 142, the inclined surface 149 of the movable handle 142 is Fits the middle finger of the user.

Further, since the inclined surface 149 has a bilaterally symmetrical shape, the user can use either the left or right hand of the surgical treatment instrument 3.
Even if 1 is operated, the same operability can be obtained. As a result, even when the operator holds the surgical treatment tool 31 in various ways, the operator's fingers are not hurt, and the operator's fatigue and pain can be reduced.

In addition, FIGS. 16 and 17A to 17D.
Shows a tenth modified example of the surgical treatment tool 31 of the second embodiment (see FIGS. 2A and 2B). In this modification, the configuration of the operation unit 33 of the first modification (see FIGS. 3A and 3B) is changed as follows. The configuration other than the operation unit 33 is the same as that of the surgical treatment tool 31 of the second embodiment, and the same parts as those of the second embodiment are designated by the same reference numerals and the description thereof will be omitted. Is omitted.

That is, the operation portion 33 of the surgical treatment instrument 31 of the present modification is provided with the fixed handle 151 which is bent substantially at right angles to the central axis of the insertion portion 32. The movable handle 152 is attached to the fixed handle 151 as the fulcrum member 1.
It is rotatably connected by 53. The base end of the drive shaft 35 is connected to the head 154 of the movable handle 152.

A ring-shaped finger insertion portion 155 for inserting a finger is formed at the end of the fixed handle 151. Furthermore, a ring-shaped finger insertion portion 156 for inserting a finger is also formed at the end of the movable handle 152.

In this modification, the opening angle between the center line O1 of the ring of the finger insertion portion 155 of the fixed handle 151 and the center axis O2 of the fixed handle 151 in the bending direction with respect to the center axis of the insertion portion 32. α is set to about 36 °. Further, the opening angle β between the center line O3 of the ring of the finger insertion portion 156 of the movable handle 152 and the center axis O4 of the movable handle 152 is set to about 9 °.

Further, the finger insertion portion 1 of the fixed handle 151.
On the inner peripheral surface of the ring 55, two inclined surfaces 157 having a substantially V-shaped cross section, which are arranged on the left end side of FIG. 17A which is a cross section taken along the line AA of FIG. A circular surface 158 having a substantially semicircular cross section disposed on the right end side in the drawing,
The flat surface portion 159 shown in FIG. 17B, which is a cross section taken along the line BB of FIG. 16, is formed, and the flat portions 159 are smoothly connected to each other.

Further, on the inner peripheral surface of the ring of the finger insertion portion 156 of the movable handle 152, the cross-sectional shape arranged on the left end side of FIG. 17C, which is a cross section taken along the line CC of FIG. 16, is substantially formed. A semicircular circular surface 160, a flat surface portion 161 arranged on the right end side in the figure, and a flat surface part 161 arranged on the left end side in FIG. Two inclined surfaces 162 having a substantially V-shaped cross section, and two inclined surfaces 163 having a substantially V-shaped cross section disposed on the right end side in the figure.
And are formed, and they are connected smoothly.

The inner peripheral surfaces of the rings of the finger insertion portions 155 and 156 are bilaterally symmetrical. Further, in the vicinity of the fulcrum member 153 in the movable handle 152,
As shown in FIG. 16, a protrusion 164 is provided so as to protrude outward.

When the user holds and fixes the operating portion 33 when using the surgical treatment tool 31 of this modified example, the fixed handle 151 and the movable handle 152 are oblique to the rings of the finger insertion portions 155, 156. The finger inserted in the ring is the circular surface 1 and the inclined surface 157 of the ring of the finger insertion portion 155.
58 and the inclined surfaces 162 and 163 of the finger insertion part 156, respectively.

When the movable handle 152 is opened with respect to the fixed handle 151, the fixed handle 15 is opened.
1 and the finger insertion portions 155, 1 of the movable handle 152.
The back and side portions of the finger inserted in the ring 56 are the plane portion 159 of the ring of the finger insertion portion 155 and the finger insertion portion 15.
Each of the six flat portions 161 hits.

Further, when the movable handle 152 is closed with respect to the fixed handle 151, the fixed handle 1
51 and each finger insertion portion 155 of the movable handle 152.
The abdomen of the finger inserted in the ring of 156 is the finger insertion part 15
The ring-shaped surface 158 of the ring No. 5 and the ring-shaped surface 160 of the ring of the finger insertion portion 156 are contacted.

Therefore, in the above-mentioned structure, the user operates either the left or right hand to open or close the movable handle 152 with respect to the fixed handle 151 of the operation unit 33.
Even when holding and fixing 3, the fingers and the fixed handle 15
1 and the finger insertion portions 155, 1 of the movable handle 152.
Since the contact area of 56 with the ring can be always ensured to be sufficiently large, there is an effect that fingers are not hurt.

Further, since the protruding portion 164 is provided so as to project outward in the vicinity of the fulcrum member 153 of the movable handle 152, the user inserts the finger of the movable handle 152 into the finger as shown by the phantom line in FIG. It can also be held by removing the thumb from the ring of the portion 156.

FIG. 18 shows a third embodiment of the present invention. In this embodiment, the ultrasonic probe 17 is used.
The present invention is applied to 1. In the ultrasonic probe 171 of the present embodiment, an elongated insertion portion 172 that is inserted into a living body through a trocar outer tube (not shown) and an operation portion 173 on the proximal side connected to the proximal end portion of the insertion portion 172.
And are provided.

A distal treatment section 174 is provided on the distal side of the insertion section 172. The distal treatment section 174 is provided with fixed teeth 175 and movable teeth 176. The base end portion of the movable tooth 176 is rotatably connected to the tip end portion of the insertion portion 172.

Further, the fixed handle 17 is attached to the operating portion 173.
7 and a fulcrum member 178 for the fixed handle 177.
And a movable handle 179 that is rotatably connected by the. Further, an ultrasonic transducer 180 is provided on the rear end side above the fixed handle 177. Then, the ultrasonic vibration generated from the ultrasonic transducer 180 is transmitted to the distal treatment section 174 of the ultrasonic probe 171 via a vibration transmission member (not shown) arranged in the insertion section 172.

A drive shaft (not shown) for driving the movable teeth 176 is provided in the insertion portion 172. The drive shaft connecting portion 181 fixed to the upper end of the movable handle 179 is connected to the base end portion of the drive shaft. Then, as the movable handle 179 is rotated around the fulcrum member 178 with respect to the fixed handle 177, the drive shaft is axially advanced and retracted in the insertion portion 172 through the drive shaft connecting portion 181 with the opening / closing operation of the movable handle 179. The movable teeth 176 are driven and opened / closed with respect to the fixed teeth 175 with the movement of the drive shaft.

Further, a substantially slotted finger insertion portion 182 is provided at the lower portion of the fixed handle 177. An elastic ring 183 is detachably or integrally provided inside the finger insertion portion 182.

Further, a substantially elliptical finger insertion portion 184 is provided below the movable handle 179. An elastic ring 185 is detachably or integrally provided inside the finger inserting portion 184.

A rotary operation knob 186 is provided at the connecting portion between the insertion portion 172 and the operation portion 173. The operation portion 17 is operated by operating the rotation operation knob 186.
3, the insertion portion 172 is rotationally driven around the axis.

Next, the operation of the above configuration will be described.
When the surgical treatment instrument 31 of the present embodiment is used, the movable handle 179 is rotated to operate the drive shaft connecting portion 1.
The drive shaft in the insertion portion 172 moves back and forth via 81, and the movable tooth 176 is opened and closed with respect to the fixed tooth 175.

The ultrasonic vibration generated by the ultrasonic transducer 180 is transmitted through a vibration transmission member (not shown) provided in the insertion portion 172 to the distal treatment portion 17 of the ultrasonic probe 171.
It is transmitted to 4. That is, by operating the movable handle 179,
The ultrasonic probe 1 applies ultrasonic vibrations while holding a living tissue (not shown) between the movable teeth 176 and the fixed teeth 175.
The movable tooth 1 is transmitted to the distal treatment section 174 of the movable tooth 71.
It is possible to treat the living tissue or the like grasped between the 76 and the fixed tooth 175.

Therefore, in the structure described above, the finger insertion portion 182 of the movable handle 179 and the fixed handle 1 are provided.
Since the elastic rings 183 and 185 made of an elastic material are attached to the finger insertion portion 184 of the 77, the finger insertion portion of the movable handle 179 can be operated even for a long time operation as in the first modification of the second embodiment. 182 and fixed handle 1
The fingers of the operator inserted into the finger insertion portion 184 of 77 do not hurt, and the operator's fatigue and pain can be reduced.

FIG. 19 shows a fourth embodiment of the present invention. The treatment instrument 191 of the present embodiment is provided with an elongated insertion portion 192 and a proximal side operation portion 193 connected to the proximal end portion of the insertion portion 192.

A distal treatment section 194 is provided on the distal side of the insertion section 192. The distal treatment section 194 is provided with a pair of gripping members 195a and 195b.
Further, the insertion portion 192 is provided with a fixed sheath 196 and a movable sheath 197 which is movable in the axial direction with respect to the fixed sheath 196. Furthermore, the movable sheath 197
A knife 198 is provided at the tip of the.

Further, the operating portion 193 is provided with a holding portion 199 held by an operator by hand, a trigger 200 connected to the movable sheath 197, and a knife lever 201 connected to the knife 198.

Further, the holding portion 199 and the trigger 200
As shown in FIG. 19, the knife lever 201 is provided with elastic members 202, 20 at the portions that come into contact with the operator's hand.
3, 204 are provided integrally or detachably.

The gripping members 195a and 195b are insulated from each other, and the gripping members 195a and 195b are insulated from each other.
Two high-frequency connection pins 205 for supplying a high-frequency current to 5b are provided on the rear end side of the operating portion 193.

When the treatment tool 191 of this embodiment is used, the trigger 20 is held while the user holds the holding portion 199 of the operating portion 193 as shown by the phantom line in FIG.
By pulling 0 toward the front side, the movable sheath 197 moves to the distal end side, the gripping members 195a and 195b are closed, and a living tissue or the like (not shown) is gripped.

Here, a high-frequency current is passed through the holding members 195a, 195b via the high-frequency connecting pin 205 to cauterize the living tissue held by the holding members 195a, 195b. Further, by rotating the knife lever 201 and moving the knife 198 to the tip side, the gripping member 19
The living tissue grasped by 5a and 195b is cut.

Therefore, in the structure described above, the elastic members 20 are respectively provided in the holding portion 199, the trigger 200, and the portion of the knife lever 201 which comes into contact with the operator's hand.
Since 2, 203, and 204 are attached, when the user operates the operation unit 193 when using the treatment tool 191 according to the present embodiment, the holding unit 199 of the operation unit 193 and the holding unit 199 of the operator's fingers and palm are used. , Trigger 200 and knife lever 20
The part in contact with 1 does not hurt, and the operator's fatigue and pain can be reduced.

Further, the elastic members 202, 203, 204
Plays a role of preventing the operator's fingers and palm from slipping, so that the holding property of the operating portion 193 and the reliability of the operation are improved.

FIG. 20 shows the fifth embodiment of the present invention. In this embodiment, the present invention is applied to the resectoscope device 211. The resectoscope device 211 of the present embodiment is a thin tubular sheath 212.
And an operating portion 213 provided at the rear end of this sheath 212
And an optical tube 214 and an electrode device 215 which are inserted into the sheath 212 from the operating portion 213. A loop-shaped tip electrode 215a serving as a current-carrying portion is provided at the tip of the electrode device 215.

The sheath 212 is provided with an insertion portion 216 to be inserted into the body cavity through the urethra and a main body portion 217 connected to the rear end of the insertion portion 216. The main body 217 is provided with a water supply port 218 for supplying the perfusate to the affected area. A cock 219 for opening and closing is provided in the middle of the water supply port 218.

The operation section 213 is provided with an operation section main body 220 which is detachably connected to the rear end of the sheath 212. The guide shaft 22 is provided at the rear end of the operation portion main body 220.
1 is projected. Further, a slider 222 is slidably held on the guide shaft 221.

Further, the slider 222 is provided with a holding portion 223 for holding the electrode device 215 and an energizing portion 224 for supplying a high frequency current to the electrode device 215, respectively. The energizing part 224 is connected to a connector 225 provided on the slider 222. Furthermore, the connector 22
A power cord of a high frequency power supply device (not shown) is connected to 5.

Further, one end side of a fixed arm 226 is fixed to the lower surface of the slider 222. The other end of the fixed arm 226 is bent downward in a substantially L shape. Further, a ring-shaped finger hook 228 on which the user's thumb is hooked via a support shaft 227 is provided on the L-shaped bent portion of the fixed arm 226 so as to be rotatable around the axis X in FIG. There is.

Further, the operation section main body 220 is provided with a lever-shaped upper finger hook 229a extending upward and a lever-shaped lower finger hook 229b extending downward. Then, one end of a substantially U-shaped plate spring member 239 is fixed to the lower finger hook 229b. The other end of the leaf spring member 239 is fixed to the lower surface of the slider 222 together with the fixed arm 226. Then, the user's thumb is inserted into the finger hook 228 of the slider 222, and fingers other than the thumb are placed on the upper and lower finger hooks 229 of the operation unit main body 220.
a, 229b, the front and rear finger hooks 229a, 229b and 228 resist the spring force of the leaf spring member 239.
By performing the operation of reducing the interval between the sliders 2,
22 can be slid forward. As a result, the tip electrode 215a of the electrode device 215 projects from the tip of the sheath 212.

In addition, the finger-holding portions 22 above and below the operating portion 213.
9a, 229b and the finger hook 228 of the slider 222
The elastic members 230, 2 are attached to the parts that come into contact with the operator's fingers.
31 and 232 are provided integrally or detachably.

A stopper 233 is provided at the rear end of the guide shaft 221. The stopper 233 prevents the slider 222 from coming off the guide shaft 221. The inside of the guide shaft 221 has a hollow structure, and the optical tube 214 is inserted into the sheath 212 through the guide shaft 221.

Further, a sheath 212 is attached to the optical tube 214.
An insertion portion 234 to be inserted therein and an eyepiece portion 235 provided at the rear end of the insertion portion 234 are provided. A light guide connector 236 is provided near the eyepiece 235.

The electrode device 215 has a tip electrode 215a.
A current-carrying member (wire) (not shown) that conducts high-frequency current to
And an insulating member 237 that covers the current-carrying member. The electrode device 215 is provided with a stabilizer 238 for positioning the tip of the optical tube 214 at the center of the tip electrode 215a.

When the resectoscope device 211 of this embodiment is used, the sheath 212 is inserted into the body cavity through the urethra. Subsequently, while observing the inside of the body cavity with the optical scope 214, the upper and lower finger hooks 229 of the operation section main body 220 are observed.
When the operator's fingers are respectively put on a and 229b and the finger-holding portion 228 of the slider 222 and the slider 222 is slid forward, the tip electrode 215a of the electrode device 215 projects from the tip of the sheath 212. Where connector 2
36, current-carrying part 224, and current-carrying member (wire) not shown
By passing a high-frequency current through the tip electrode 215a via the electrode, the affected area in contact with the tip electrode 215a, for example, the enlarged prostate is excised.

Therefore, in the above-described structure, the elastic members 230, 231, 232 are respectively provided on the upper and lower finger hooks 229a, 229b of the operation section 213 and the finger hooks 228 of the slider 222 which come into contact with the operator's fingers. Since it is provided, the operator can operate the upper and lower finger hooks 229a and 229b of the operation unit 213 and the finger hook 2 of the slider 222.
When operating 28, the operator's fingers are placed on the elastic members 230,
231, 232 can be contacted. for that reason,
The operator's fingers are the finger hooks 229 above and below the operation unit 213.
a, 229b and the finger hook 228 of the slider 222 do not come into direct contact with each other, the upper and lower finger hooks 229a and 229b of the operation unit 213 and the part of the finger which is in contact with the finger hook 228 of the slider 222 do not hurt, The operator's fatigue and pain can be reduced. Further, the elastic member 23
Since 0, 231, 232 play a role of preventing the operator's fingers from slipping, there is an effect that the holding property of the operation unit 213 and the certainty of the operation are improved.

FIG. 21 shows a sixth embodiment of the present invention. This embodiment is shown in FIG.
The surgical treatment tool 31 and the endoscope 241 shown in (B) are used in combination. Here, a hollow tubular trocar mantle tube 242, 2 is previously formed on the patient's skin, fascia, or the like.
43 is punctured, penetrates the patient's skin and fascia, and the tip thereof is inserted into the body cavity 244.

Then, the operator inserts the surgical treatment instrument 31 and the distal end of the endoscope 241 into the inside of the body cavity 244 from the outside of the body cavity of the patient through the hollow portions of the trocar outer tubes 242 and 243 as shown in FIG. To do. In this state, the surgical treatment instrument 3 is used while observing the inside of the body cavity 244 of the patient with the endoscope 241.
By operating the operation unit 33 of No. 1 and driving the treatment unit 36 at the distal end, the tissue in the body cavity is treated.

The present invention is not limited to the above-mentioned embodiments, and it goes without saying that various modifications can be made without departing from the gist of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. Note (Supplementary Note 1) In the surgical treatment tool, a main body of the surgical treatment tool, a hand side operation unit disposed at a proximal end portion of the treatment tool main body, and the operation unit is a part of an operator. A first handle provided with a first finger-applying element for applying a finger, a second handle having a second finger-applying element for applying another finger of the operator, and the first and second handles A treatment section disposed at the distal end of the treatment instrument main body, the treatment section having a movable element, and the first and second connection sections. When the movable element is operated in association with the relative movement operation between the handles,
Means for reducing the burden on the operator's fingers in contact with the second finger rest element, the finger burden reducing means being the first and second
Provided at a contact portion of at least one of the finger contact elements with the operator's finger, and the surgical treatment tool.

(Additional Item 2) The additional item, wherein the connecting means of the treatment instrument has a rotation fulcrum for relatively rotatably connecting the first handle and the second handle. The surgical treatment tool of 1.

(Additional Item 3) The connecting means has a connecting portion for relatively slidably connecting the first handle and the second handle along the axial direction of the treatment instrument body. The surgical treatment instrument according to appendix 1.

(Additional Item 4) The surgical treatment instrument according to Additional Item 1, wherein at least one of the first and second finger contact elements has a ring-shaped member into which an operator's finger is inserted.

(Additional Item 5) The surgical treatment instrument according to Additional Item 1, wherein the finger burden reducing means is a contact member made of an elastic material.

(Additional Item 6) The surgical treatment tool according to Additional Item 5, wherein the elastic material of the contact member is silicon rubber.

(Additional Item 7) The surgical treatment instrument according to Additional Item 5, wherein the contact member is attachable to and detachable from at least one of the first and second finger contact elements.

(Additional Item 8) A plurality of projections are formed on the contact member, and these projections prevent the fingers of the operator from sliding on the contact member. The surgical treatment instrument according to appendix 5.

(Additional Item 9) At least one of the first and second finger contact elements has a ring-shaped member for inserting a finger of an operator, and the finger load reducing means has at least an inner circumference of the ring-shaped member. The surgical treatment instrument according to appendix 1, further comprising a contact member formed on the surface and made of an elastic material.

(Additional Item 10) The surgical treatment instrument according to Additional Item 9, wherein the connecting means has a rotation fulcrum that connects the first and second handles so as to be relatively rotatable.

(Additional Item 11) The treatment instrument main body is a tubular insertion portion that connects the treatment portion and the operation portion, and is inserted into the insertion portion to transmit the operation force of the operation portion to the treatment portion. The surgical treatment tool according to appendix 10, further comprising a drive shaft.

(Additional Item 12) The surgical treatment instrument according to Additional Item 11, wherein the contact member is detachable from the ring-shaped member.

(Supplementary Note 13) The treatment tool body includes a tubular insertion portion that connects the treatment portion and the operation portion, a drive shaft that is inserted into the insertion portion, and the drive shaft is an operation force of the operation portion. Is further transmitted to the treatment portion, and the surgical treatment tool according to additional item 1, further comprising:

(Additional Item 14) One of the first and second handles is fixed to the treatment instrument body, and the other is supported so as to be movable relative to the fixed handle. The surgical treatment instrument according to appendix 1.

(Additional Item 15) At least one of the first finger contact element and the second finger contact element has a ring-shaped member into which a part of fingers of the operator is inserted, and the connecting means is the first finger contact element. The handle has a rotation fulcrum for relatively rotatably connecting the first handle and the second handle, and the finger burden reducing means is an inclined surface inclined with respect to the central axis of the ring-shaped member. The surface is provided on at least a part of the inner peripheral surface side of the ring-shaped member, and the surgical treatment tool according to Additional Item 1, wherein:

(Additional Item 16) The ring-shaped member is rotatably connected about a rotation shaft extending along the central axis direction of the first handle or the second handle. The surgical treatment tool according to appendix 15, wherein.

(Additional Item 17) Each of the first finger contact element and the second finger contact element has a ring-shaped member into which a part of fingers of the operator is inserted, and the connecting means is the first handle. Has a rotation fulcrum that relatively rotatably connects the first handle and the second handle, and the finger load reducing means includes the ring-shaped members of the first and second finger contact elements with the treatment instrument body. The surgical treatment instrument according to appendix 1, wherein the surgical treatment instrument is arranged on a plane inclined at an inclination angle in the range of 50 ° to 70 ° with respect to the central axis of the item.

(Additional Item 18) At least one of the ring-shaped members of the first and second finger contact elements is rotatably attached to the terminal portion of the first handle or the second handle. The surgical treatment tool according to appendix 17, which is connected.

(Additional Item 19) At least one of the ring-shaped members of the first and second finger contact elements has a large-diameter opening into which a plurality of fingers of an operator can be inserted. The surgical treatment instrument according to the additional item 17, which is a feature.

(Additional Item 20) In a medical device in which a surgical treatment tool and an endoscope are used in combination, the surgical treatment tool includes a main body of the surgical treatment tool and a base end portion of the treatment tool main body. An operating part on the hand side disposed on the first handle, the operating part including a first handle having a first finger contact element for applying a part of fingers of an operator, and a second handle for applying another finger of the operator. A second handle having a finger rest element, and the first and second handles
And a treatment section disposed at a distal end portion of the treatment instrument body, the treatment section having a movable element. When the movable element is operated in association with the relative movement operation between the two handles, a means for reducing the burden on the operator's fingers coming into contact with the first and second finger rest elements, and the finger burden Reducing means is provided at a contact portion of at least one of the first and second finger contact elements with a finger of the operator, and the endoscope operates the treatment section. It has an observation means capable of observing.

[0181]

According to the present invention, the operator who makes contact with the first and second finger contact elements at the contact portion of the operator's finger on at least one of the first and second finger contact elements. Since the means for reducing the burden on the fingers of the operator is provided, the operator's fatigue and pain are reduced, and accurate operation can be performed.

[Brief description of drawings]

FIG. 1 shows a first embodiment of the present invention,
(A) is a side view of the surgical treatment tool, (B) is a plan view of the same,
1C is a cross-sectional view taken along the line CC of FIG.

FIG. 2 shows a second embodiment of the present invention,
2A is a side view of the surgical treatment tool, and FIG. 2B is a sectional view taken along the line BB of FIG.

FIG. 3 shows a first modification of the surgical treatment tool according to the second embodiment, in which (A) is a side view of the surgical treatment tool;
3B is a cross-sectional view taken along the line BB of FIG.

FIG. 4 shows elastic rings of three finger insertion portions of different sizes, which are arranged in the operation portion of the surgical treatment tool of the first modified example, and (A) is a plane of the first elastic ring. Figure,
4B is a plan view of the second elastic ring, FIG. 4C is a plan view of the third elastic ring, FIG. 4D is a sectional view taken along the line DD of FIG. 4A, and FIG. 4B is a sectional view taken along line EE in FIG. 4B, and FIG. 4F is a sectional view taken along line FF in FIG.

5A and 5B show a second modification of the surgical treatment tool according to the second embodiment, where FIG. 5A is a plan view of an elastic ring of a finger insertion part, and FIG. 5B is a plan view of FIG. 5A. Sectional drawing of the BB line.

6A and 6B show a third modified example of the surgical treatment tool according to the second embodiment, where FIG. 6A is a side view of the operating portion, and FIG. 6B is a line BB in FIG. 6A. Sectional view, (C) is a side view showing the elastic ring of the finger insertion part, (D) is a sectional view taken along the line DD of FIG. 6C, and (E) is a sectional view taken along the line EE of FIG. 6C. Fig.

7A and 7B show a fourth modified example of the surgical treatment tool according to the second embodiment, where FIG. 7A is a side view of an operating portion of the surgical treatment tool, and FIG. BB line sectional drawing.

FIG. 8 is a side view of an operation portion of a fifth modified example of the surgical treatment tool according to the second embodiment.

FIG. 9 is a side view of an operation portion of a sixth modified example of the surgical treatment tool according to the second embodiment.

FIG. 10 is a side view of an operating portion of a seventh modified example of the surgical treatment tool according to the second embodiment.

FIG. 11 is a side view showing a partial cross section of an operation portion of a seventh modified example.

FIG. 12 is a side view showing, in a partial cross section, a connecting portion between a replacement ring of an operating portion and a handle body of a seventh modified example.

FIG. 13 is a side view of an operation unit showing still another modification of the first modification of the second embodiment.

FIG. 14 is a side view showing an operation section of an eighth modified example of the surgical treatment tool according to the second embodiment in a partial cross section.

15A and 15B show a ninth modification of the surgical treatment tool according to the second embodiment, wherein FIG. 15A is a side view of the operation portion, and FIG.
Is a cross-sectional view taken along line BB of FIG. 15A, and (C) is C- of FIG. 15A.
C line sectional drawing.

FIG. 16 is a tenth embodiment of the surgical treatment tool according to the second embodiment.
The side view which shows the operation part of the modification of FIG.

17 (A) is a cross-sectional view taken along the line AA of FIG. 16, (B).
16 is a sectional view taken along the line BB of FIG. 16, (C) is a sectional view taken along the line CC of FIG. 16, and (D) is a sectional view taken along the line DD of FIG.

FIG. 18 is a side view showing a surgical treatment tool according to a third embodiment of the present invention.

FIG. 19 is a side view showing the surgical treatment tool according to the fourth embodiment of the present invention.

FIG. 20 is a vertical sectional view showing a surgical treatment tool according to a fifth embodiment of the present invention.

FIG. 21 is a schematic configuration diagram showing a treatment state in which the surgical treatment tool according to the sixth embodiment of the present invention and an endoscope are used in combination.

FIG. 22 shows a conventional example, (A) is a side view showing a usage state of surgical scissors, and (B) is a sectional view taken along line BB of (A).

[Explanation of symbols]

211 Resectoscope Device (Surgical Treatment Tool) 213 Operation Section 214 Optical Tube (Endoscope) 215 Electrode Device 215a Tip Electrode (Treatment Section) 222 Slider (Movable Element) 228 Finger Hooking Section (Second Handle) 229a, 229b Upper and lower finger hooks (first handle) 230, 231, 232 Elastic member (finger load reducing means) 239 Leaf spring member (connecting means)

   ─────────────────────────────────────────────────── ─── Continued front page    (72) Inventor Akira Shiga             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. (72) Inventor Katsumi Sasaki             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. (72) Inventor Toshihiko Hashiguchi             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. F-term (reference) 4C060 GG24 GG30 KK03 KK14 KK17                       MM24                 4C061 AA00 BB01 CC00 DD00 GG15                       HH56

Claims (2)

[Claims] 1. In a medical device in which a surgical treatment tool and an endoscope are used in combination, the surgical treatment tool is disposed on a main body of the surgical treatment tool and a base end portion of the treatment tool main body. The operation part on the proximal side, which is provided with a first handle having a first finger contact element for applying a part of the operator's fingers, and a second finger contact for applying the other finger of the operator. A second handle having an element, and a connecting means for connecting the first and second handles so as to be relatively movable.
And a treatment section disposed at the distal end of the treatment instrument main body, and the treatment section has a movable element, and the movable element is operated in association with a relative movement operation between the first and second handles. ,
And means for reducing the burden on the operator's fingers that come into contact with the first and second finger rest elements, the finger burden reducing means being provided in at least one of the first and second finger rest elements. It is provided in the contact portion with the operator's finger,
And a medical device having an observation means capable of observing the operation of the treatment section. 2. An insertion portion which is provided in a surgical treatment instrument and which can be inserted into a body cavity and which is constituted by a sheath, a main body portion which is provided at a proximal end portion of the insertion portion, and a proximal end portion of the main body portion. A guide shaft that is provided, a movable element that is slidably provided on the guide shaft, and a movable element that is provided inside the sheath of the insertion portion and can be projected and retracted from the distal end opening of the sheath according to the forward and backward movement of the movable element A treatment section, an endoscope provided inside the sheath for observing the inside of a body cavity from the sheath distal end opening, a first finger hook section provided on the main body section, and a first finger placement section provided on the movable element. A surgical treatment tool, comprising: two finger-hooking portions; and an elastic material provided so as to cover at least a part of the surface of the first finger-hooking portion or the second finger-hooking portion.