RETRACTOR
20230041137 · 2023-02-09
Assignee
- Mochida Pharmaceutical Co., Ltd. (Tokyo, JP)
- NATIONAL UNIVERSITY CORPORATION HOKKAIDO UNIVERSITY (Sapporo-shi, Hokkaido, JP)
Inventors
- Hitoshi MIZUNO (Tokyo, JP)
- Kuniyoshi MASUDA (Tokyo, JP)
- Masahiko KATAYAMA (Tokyo, JP)
- Tomokazu TAKAI (Tokyo, JP)
- Toshiya ENDO (Tokyo, JP)
- Norimasa Iwasaki (Hokkaido, JP)
- Tomohiro ONODERA (Hokkaido, JP)
- Koji IWASAKI (Hokkaido, JP)
Cpc classification
A61B17/0206
HUMAN NECESSITIES
International classification
Abstract
A retractor is provided that can form a joint cavity internal space for a field of view for an endoscope and practice of a treatment in a state where a wound area is spread. A retractor includes first arm portions 2 and 3 and a second arm portion 4 positioned between the first arm portions 2 and 3. The first arm portions 2 and 3 include first claw portions 12 and 13 to be hung on a wound area entrance edge. The second arm portion 4 includes a second claw portion 14 to be hung on the wound area entrance edge. When the first arm portions 2 and 3 and the second arm portion 4 are in a closed state, the first claw portions 12 and 13 and the second claw portion 14 overlap with each other.
Claims
1. A retractor for abutting a wound area entrance edge of an incised skin tissue and opening the wound area, the retractor comprising: a pair of first arm portions which are integrally coupled with each other on base end sides and extend toward tip ends; a single second arm portion which is positioned between the first arm portions, a base end side of the second arm portion being rotatably coupled with the first arm portions via a shaft portion, the second arm portion extending toward a tip end; and operation portions which perform opening and closing operations of the first arm portions and the second arm portion, where a state where the first arm portions and the second arm portion overlap with each other is set as a closed state, and a state where tip end sides of the first arm portions and of the second arm portion are separated from each other is set as an open state, wherein each of the first arm portions includes, in a tip end portion, a first claw portion which protrudes in an opening direction to be hung on the wound area entrance edge, the second arm portion includes, in a tip end portion, a second claw portion which protrudes in an opposite direction to the first claw portion to be hung on the wound area entrance edge, and when the first arm portions and the second arm portion are set to the closed state, the first claw portions and the second claw portion overlap with each other.
2. The retractor according to claim 1, wherein the first claw portions and the second claw portion are configured so that a thickness of each of the first claw portions is made smaller than a thickness of the second claw portion in a thickness direction in the closed state, where the thickness direction is a direction in which the first claw portions and the second claw portion overlap with each other in the closed state.
3. A retractor for abutting a wound area entrance edge of an incised skin tissue and opening the wound area, the retractor comprising: a plurality of first arm portions which are integrally coupled with each other on base end sides and extend toward tip ends; a plurality of second arm portions which are integrally coupled with each other on base end sides and are alternately arranged with the first arm portions, base end sides of the second arm portions being rotatably coupled with the first arm portions via a shaft portion, the second arm portions extending toward tip ends; and operation portions which perform opening and closing operations of the first arm portions and the second arm portions, where a state where the first arm portions and the second arm portions overlap with each other is set as a closed state and a state where tip end sides of the first arm portions and tip end sides of the second arm portions are separated from each other is set as an open state, wherein each of the first arm portions includes, in a tip end portion, a first claw portion which protrudes in an opening direction to be hung on the wound area entrance edge, each of the second arm portions includes, in a tip end portion, a second claw portion which protrudes in an opposite direction to the first claw portion to be hung on the wound area entrance edge, and when the first arm portions and the second arm portions are set to the closed state, the first claw portions and the second claw portions overlap with each other.
4. The retractor according to claim 3, wherein the first claw portions and the second claw portions are configured so that each thickness of at least a pair of claw portions which are positioned on outermost sides among the first claw portions and the second claw portions is smaller than each thickness of the other claw portions in a thickness direction in the closed state, where the thickness direction is a direction in which the first claw portions and the second claw portions overlap with each other in the closed state.
5. The retractor according to claim 1, wherein tip ends of the first claw portions and tip ends of the second claw portions are respectively directed in base end directions when the first arm portions and the second arm portion are in the open state compared to the closed state.
6. The retractor according to claim 1, further comprising an opening maintaining device for maintaining an opening between the first arm portions and the second arm portion at a desired position, wherein the opening maintaining device includes a locking member which extends in an opening-closing direction of a first operation rod portion and a second operation rod portion, a coupling portion which swingably couples the locking member with the first operation rod portion, a locking tooth which is provided on the second operation rod portion and is locked to the locking member in a releasable manner, and a finger handle portion which performs a swinging operation of the locking member.
7. The retractor according to claim 3, wherein tip ends of the first claw portions and tip ends of the second claw portions are respectively directed in base end directions when the first arm portions and the second arm portions are in the open state compared to the closed state.
8. The retractor according to claim 3, further comprising an opening maintaining device for maintaining an opening between the first arm portions and the second arm portions at a desired position, wherein the opening maintaining device includes a locking member which extends in an opening-closing direction of a first operation rod portion and a second operation rod portion, a coupling portion which swingably couples the locking member with the first operation rod portion, a locking tooth which is provided on the second operation rod portion and is locked to the locking member in a releasable manner, and a finger handle portion which performs a swinging operation of the locking member.
9. A method for opening a wound area comprising: inserting the first claw portions and the second claw portion of the retractor of claim 1 into the wound; and then causing the first claw portions to move away from the second claw portion to open the wound.
10. A method for opening a wound area comprising: inserting the first claw portions and the second claw portions of the retractor of claim 3 into the wound; and then causing the first claw portions to move away from the second claw portions to open the wound.
Description
BRIEF DESCRIPTION OF DRAWINGS
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DESCRIPTION OF EMBODIMENTS
[0049] A first embodiment of the present invention will be described with reference to
[0050]
[0051] As illustrated in
[0052] On the opposite side to both of the first arm portions 2 and 3 via the shaft portion 5, a first operation rod portion 6 is provided, integrally with both of the first arm portions 2 and 3, to extend. A ring-shaped first finger handle portion 7 is provided on an end portion of the first operation rod portion 6.
[0053] On the opposite side to the second arm portion 4 via the shaft portion 5, a second operation rod portion 8 is provided, integrally with the second arm portion 4, to extend. A ring-shaped second finger handle portion 9 is provided on an end portion of the second operation rod portion 8.
[0054] Fingers are respectively hooked on the first finger handle portion 7 and the second finger handle portion 9, the first operation rod portion 6 and the second operation rod portion 8 are moved in directions in which those approach each other, and the first arm portions 2 and 3 and the second arm portion 4 are thereby moved via the shaft portion 5 in directions in which those are separated away from each other and are set to an open state as illustrated in
[0055] Note that the first operation rod portion 6 and first finger handle portion 7 and the second operation rod portion 8 and second finger handle portion 9 correspond to operation portions in the present invention.
[0056] Further, as an opening maintaining device for maintaining an open or closed state of the first arm portions 2 and 3 and the second arm portion 4, a first locking tooth portion 10 is provided on the first operation rod portion 6, and a second locking tooth portion 11 is provided on the second operation rod portion 8.
[0057] The first locking tooth portion 10 and the second locking tooth portion 11 are meshed with each other in a releasable manner and maintain an open state of the first arm portions 2 and 3 and the second arm portion 4 as illustrated in
[0058] Note that the opening maintaining device for maintaining an open state of the first arm portions 2 and 3 and the second arm portion 4 is not limited to a configuration in which the first locking tooth portion 10 of the first operation rod portion 6 and the second locking tooth portion 11 of the second operation rod portion 8 are meshed with each other.
[0059] As another opening maintaining device, for example, an opening maintaining device illustrated in
[0060] That is, as illustrated in
[0061] The locking member 101 is urged in a direction toward the locking teeth 111 by elasticity of the coupling portion 102. When an operation is made in a direction to close the first operation rod portion 6 and the second operation rod portion 8 (a direction to increase the opening between the first arm portions 2 and 3 and the second arm portion 4), the locking member 101 overcomes the locking teeth 111 in a bumping manner, and the opening between the first arm portions 2 and 3 and the second arm portion 4 is thereby maintained. Meanwhile, when an operation is made in a direction to open the first operation rod portion 6 and the second operation rod portion 8 (a direction to decrease the opening between the first arm portions 2 and 3 and the second arm portion 4), the locking member 101 is swung by hooking a finger on the finger handle portion 104, and locking of the locking member 101 to the locking teeth 111 can thereby be released.
[0062] As illustrated in
[0063] A second claw portion 14 is formed in a tip end portion of the second arm portion 4. The second claw portion 14 is provided to protrude with its tip end being directed in the opening direction. That is, the second claw portion 14 protrudes in the opposite direction to the first claw portions 12 and 13.
[0064] As illustrated in
[0065] In addition, as illustrated in
[0066] When the tip end portions are inserted into the wound area and the first arm portions 2 and 3 and the second arm portion 4 are opened, the first claw portions 12 and 13 and the second claw portion 14 become a hooked state where those are hooked on a wound area entrance edge. Then, in an open state, respective base end portions of the first claw portions 12 and 13 and the second claw portion 14 (boundary parts between the first arm portions 2 and 3 and the first claw portions 12 and 13 and a boundary part between the second arm portion 4 and the second claw portion 14) abut the wound area entrance edge, pull each other, and thereby sets the wound area to an opened state.
[0067] In this case, as
[0068] Further, as illustrated in
[0069] Further, when the first aim portions 2 and 3 and the second arm portion 4 are opened (separated away from each other), the tip end portions of the first arm portions 2 and 3 and the tip end portion of the second aim portion 4 respectively draw circular arc loci. Thus, the tip end of each of the claw portions 12, 13, and 14 in an open state is directed in a base end direction (upward in
[0070] In addition, as illustrated in
[0071] In order to pull up the retractor 1 which opens the wound area while the wound area is observed from above, it is desirable that the first finger handle portion 7 and the second finger handle portion 9 not be positioned right above the wound area. Meanwhile, in order to reduce loads applied to fingers by the first finger handle portion 7 and the second finger handle portion 9 when the retractor 1 is pulled up, it is desirable that a pulling-up direction generally agree with directions of the first arm portions 2 and 3 and the second arm portion 4. Furthermore, in order to realize both of visibility of the wound area and pulling-up operability as conditions which mutually conflict in such a manner, it is desirable that an angle of a bent part R of the arm portions 2, 3, and 4 (a depression angle of an extended line of insertion regions of the arm portions 2, 3, and 4 into the wound area with respect to an extended line of the operation rod portions 6 and 8 in a side view), which is illustrated in
[0072] Note that in order to further improve visibility of the wound area in an angle range of the above bent part R, although not illustrated, the operation rod portions 6 and 8 may be formed to have comparatively long dimensions. Alternatively, although not illustrated, the above-described bent part R may be formed into a crank shape in a side view, and extension directions of the arm portions 2, 3, and 4 may thereby be offset from directions in which the operation rod portions 6 and 8 extend.
[0073] Further, as illustrated in
[0074] The length of each of the claw portions corresponds to the relative relationship between a thickness of a skin tissue and a size of a small incision. A thickness of skin is in general 5 to 13 mm (epidermis+dermis: 1 to 4 mm and hypodermal tissue: 4 to 9 mm). The size of a small incision is 5 to 10 mm. A width of the wound area in an open state of the retractor 1, which is illustrated in
[0075] In addition, as illustrated in
[0076] Next, a second embodiment of the present invention will be described with reference to
[0077] As illustrated in
[0078] As illustrated in
[0079] In a closed state, the first claw portions 25 and 26 and the second claw portions 27 and 28 are alternately positioned, are superimposed on each other, and become a compactly gathered state.
[0080] In addition, as illustrated in
[0081] When the tip end portions are inserted into a wound area and the first arm portions 21 and 22 and the second arm portions 23 and 24 are opened, the first claw portions 25 and 26 and the second claw portions 27 and 28 become a hooked state where those are hooked on a wound area entrance edge. Then, as illustrated in
[0082] Furthermore, the retractor 20 is pulled up in a state where the first claw portions 25 and 26 and the second claw portions 27 and 28 are deeply hung on the wound area entrance edge, skin tissues around the wound area are thereby caused to follow the retractor 20, and a work space with a sufficient extent can be secured on the inside of skin tissues.
[0083] Further, as illustrated in
[0084] Further, as described above, the respective dimensions T3 of the first claw portion 25 and the second claw portion 28, which are positioned on the outside, in the thickness direction are smaller than respective dimensions T4 of the first claw portion 26 and the second claw portion 27, which are positioned on the inside, in the thickness direction (see
[0085] This will be described in detail with reference to
[0086] Here, when the claw portions are expanded and the areas in those expanded shapes are compared, as illustrated in
[0087] As described above, the retractor 20 of the second embodiment can comparatively widely stretch a wound area and can thus obtain high workability.
[0088] Further, also in the retractor 20 of the second embodiment, in order to certainly obtain the above effects, a length of each of the claw portions 25, 26, 27, and 28 is preferably 4 to 7 mm, and angles of the first claw portions 25 and 26 with respect to the first arm portions 21 and 22 and angles of the second claw portions 27 and 28 with respect to the second arm portions 23 and 24 are preferably set to 2° to 15°.
[0089] Note that in the second embodiment, the retractor 20 is raised which includes the two first arm portions 21 and 22 and the two second arm portions 23 and 24; however, the numbers of first arm portions and second arm portions are not limited to those, and it is possible to provide two or more first arm portions and two or more second arm portions.
[0090] Further, in the above embodiments, as illustrated in
[0091] As described in the foregoing, a work space with a sufficient extent can be secured on the inside of skin tissues by using the retractor of the present invention. A formulation for treating a focal area can be injected into the secured work space. The formulation for treating a focal area can be a formulation for caring damage to a cartilage of a joint of an articular cartilage or a base material for reproducing a defected cartilage (such as a sol composition of sodium alginate, see Japanese Patent No. 4740369), for example.
INDUSTRIAL APPLICABILITY
[0092] A retractor of the present invention has a configuration which can easily form a work space for arthroscopic surgery in a state where a wound area is spread and can thereby suitably be used as a medical tool.
REFERENCE SIGNS LIST
[0093] 1, 20 retractor [0094] 2, 3, 21, 22 first arm portion [0095] 4, 23, 24 second arm portion [0096] 12, 13, 25, 26 first claw portion [0097] 14, 27, 28 second claw portion [0098] 6 first operation rod portion (operation portion) [0099] 7 first finger handle portion (operation portion) [0100] 8 second operation rod portion (operation portion) [0101] 9 second finger handle portion (operation portion) [0102] 101 locking member [0103] 102 coupling portion [0104] 104 finger handle portion [0105] 111 locking teeth