U.S. patent number 3,791,387 [Application Number 05/338,174] was granted by the patent office on 1974-02-12 for forceps.
This patent grant is currently assigned to Olympus Optical Co., Ltd.. Invention is credited to Mitsuto Itoh.
United States Patent |
3,791,387 |
Itoh |
February 12, 1974 |
FORCEPS
Abstract
A forceps for use with an endoscope has a first or cutting wire
which extends in a loop from the distal end of the flexible
endoscope tube, whereas the two proximal ends may be shifted in the
tube by means of a control mechanism on the proximal tube end so as
to expand and contract the loop. A second wire has a distal end
pivotally attached to the loop, while its main portion passes
through the endoscope tube to a control device at the proximal end
of the tube which permits the second wire to be shifted
longitudinally in the tube, and thereby to be bulged out from the
loop for receiving a polyp or the like, and to be tightened about
the severed polyp for safely retracting the severed piece together
with the forceps.
Inventors: |
Itoh; Mitsuto (Tokyo,
JA) |
Assignee: |
Olympus Optical Co., Ltd.
(Tokyo, JA)
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Family
ID: |
26447805 |
Appl.
No.: |
05/338,174 |
Filed: |
March 5, 1973 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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203633 |
Dec 1, 1971 |
3739784 |
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Foreign Application Priority Data
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Dec 5, 1970 [JA] |
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45/107833 |
Dec 5, 1970 [JA] |
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45/107834 |
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Current U.S.
Class: |
606/113;
606/114 |
Current CPC
Class: |
A61B
17/32056 (20130101); A61B 17/29 (20130101); A61B
17/30 (20130101) |
Current International
Class: |
A61B
17/32 (20060101); A61B 17/28 (20060101); A61B
17/30 (20060101); A01b 001/06 (); A01b 017/00 ();
A01b 001/72 () |
Field of
Search: |
;128/306,309,320,356 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Medbery; Aldrich F.
Parent Case Text
This is a division of application Ser. No. 203,633, filed Dec. 1,
1971, now U.S. Pat. No. 3,739,784.
Claims
We claim:
1. A forceps for use with an endoscope comprising:
a. a flexible, elongated tube having a distal end portion and a
proximal end portion;
b. a first elongated wire having two branch portions and an arcuate
loop portion connecting said branch portions, said loop portion
projecting from said distal end portion, and said branch portions
extending from said loop portion toward said proximal end portion
and being movably received in said tube;
c. a second wire having a terminal portion pivotally secured to a
part of said loop portion remote from said distal end portion in a
direction away from said proximal end portion, said second wire
being movably received in said tube and extending from said
terminal portion toward said proximal end portion;
d. first control means on said proximal end portion and operatively
connected to said branch portions for shifting the same
longitudinally in said tube, whereby the loop defined by said loop
portion may be expanded and contracted, and a polyp captured in
said loop may be severed by contracting said loop; and
e. second control means on said proximal end portion and
operatively connected to said second wire for shifting the same
longitudinally in said tube to provide a means for securing a polyp
severed by said contracting loop portion for subsequent removal
with said forceps.
2. A forceps as set forth in claim 1, wherein said part of said
loop portion constitutes a bight portion having a smaller radius of
curvature than the remainder of said loop portion, said terminal
portion being pivotally secured to said bight portion.
3. A forceps as set forth in claim 1, further comprising a forked
connecting piece attached to said part of said loop portion and
defining a slot, said terminal portion being received in said slot,
and a pin member attached to said connecting piece, a portion of
said pin member being located in said slot and securing said
terminal portion to said connecting piece.
4. A forceps as set forth in claim 1, further comprising a first
eye on said part of said loop portion and a second eye on said
terminal portion of the second wire, said first and second eyes
being pivotally interengaged.
Description
BACKGROUND OF THE INVENTION
The present invention relates to a forceps for use with an
endoscope and, more particularly, to forceps capable of positively
capturing and severing a mass projecting into a body cavity such as
a polyp without destroying the tissue surrounding the polyp and
taking out the severed mass.
Heretofore, no effective forceps for use with an endoscope has been
developed for severing and taking out a projecting mass such as a
polyp growing in the stomach, gullet and the like of a living
body.
A prior art forceps of the type described above uses a loop of a
wire extending from the distal end portion of a forceps and the
projecting mass captured by the loop of the wire is severed by
pulling the branches of the wire extending from the loop and
extending through the elongated tube of the forceps rearwardly by
means of a control means in the proximal control portion of the
forceps so as to contract the loop to sever the projecting
mass.
In such a forceps, a wire having a relatively large diameter must
be used for forming the loop in order to avoid breaking the wire
during the repeated use of the forceps. The large diameter
interferes with the severing performance of the wire, and the
tissue surrounding the projecting mass may be damaged.
Further, it has been very difficult to withdraw the severed mass of
the polyp because of the peristaltic movement of organ through
which the severed mass must be withdrawn.
SUMMARY OF THE INVENTION
The object of the present invention is to provide a forceps for use
with an endoscope capable of positively capturing, severing a
projecting mass such as a polyp growing in a body cavity and
withdrawing the severed mass without destroying the tissue
surrounding the projecting mass to be severed.
The above object is achieved in accordance with the present
invention by the provision of a forceps having a proximal control
portion, a distal end portion and an elongated flexible tube
connecting the distal end portion to the proximal control portion,
the forceps being provided with a first wire forming a loop
projecting from the distal end portion and having two branches
which extend from the loop through the flexible tube, a second wire
extending through the flexible tube, its distal end being pivotally
connected to the distal end of the loop of the first wire, a first
control means provided in the proximal control portion, the
proximal ends of the branches of the first wire being connected to
the first control means so that the loop is enlarged when the first
wire is pushed forwardly while the loop is contracted to sever a
projecting mass captured in the loop when the first wire is pulled
rearwardly, and a second control means provided in the proximal
control portion, the proximal end of the second wire being
connected to the second control means in such a manner that the
severed mass is captured by the second wire, when the same is
pulled rearwardly.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is an enlarged side view showing the distal end portion of a
prior art forceps for use with an endoscope;
FIGS. 2 to 12 are fragmentary views showing the first embodiment of
the forceps constructed in accordance with the present invention,
FIG. 2 showing a distal end portion in magnified scale, FIG. 3
being the longitudinal sectional view taken along line A--A in FIG.
2, FIG. 4 being the cross-section taken along line B--B in FIG. 2,
FIG. 5 showing the proximal control portion of the forceps in
elevational section, FIGS. 6 to 9 show various steps of operation
of the forceps of FIG. 3, while FIGS. 10 to 12 show the devices of
in FIGS. 7 to 9, respectively, in section on the line C--C;
FIGS. 13 to 17 show a modification of the forceps sown in FIGS. 2
to 12, FIG. 13 being a top plan view of the distal end portion,
FIG. 14 being a longitudinal sectional view taken along line D--D
in FIG. 13, FIG. 15 being a cross-sectional view taken along line
E--E in FIG. 13, FIG. 16 being a longitudinal sectional view
similar to FIG. 14 but showing a mass capture by the wire while
FIG. 17 is a cross-sectional view taken along line F--F in FIG.
16;
FIGS. 18 to 21 show a further modification of the forceps shown in
FIGS. 2 to 12, FIG. 18 being a top plan view of the distal end
portion, FIG. 19 being a sectional view taken along line G--G in
FIG. 18, FIG. 20 being a cross-sectional view taken along line H--H
in FIG. 18, while FIG. 21 is a view similar to FIG. 19 but showing
a different operating condition of the forceps;
FIGS. 22 to 26 illustrate a still further modification of the
forceps shown in FIGS. 2 to 12, FIG. 22 being a top plan view of
the distal end portion, FIG. 23 being a sectional view taken along
line I--I in FIG. 22, FIG. 24 being a cross-sectional view taken
along line J--J in FIG. 22, FIG. 25 being a sectional view similar
to FIG. 23 but showing a mass captured between the distal end
portion and the wire, while FIG. 26 is a cross-sectional view taken
along line K--K in FIG. 25;
FIG. 27 is a schematic perspective view of the distal end portion
of the second embodiment of the forceps of the present
invention;
FIG. 28 is a fragmentary plan view of the device of FIG. 27;
FIG. 29 is a perspective view of the device of FIG. 28;
FIG. 30 is a fragmentary view on a larger scale of an element of
the forceps of FIG. 27;
FIG. 31 is a front view of the element of FIG. 30;
FIGS. 32 is a fragmentary side view showing the proximal control
portion of the forceps of FIG. 27;
FIGS. 33 to 35 are views to illustrate sequential operating steps
of the forceps of FIG. 27;
FIGS. 36 and 37 show a modification of the device of FIG. 28 in top
plan view and side-elevational section respectively; and
FIG. 38 is a fragmentary view of a further modification of the
device of FIG. 29.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to FIG. 1 showing a prior art forceps, a wire 2 is
shown to form a loop extending from the distal end portion 1 of the
forceps which is connected to a proximal control portion (not
shown) by an elongated flexible tube a portion of which is shown
connected to the distal end portion 1. Two branches of the wire 2
extending from the loop extend through the distal end portion 1 and
the elongated flexible tube and the proximal ends of the branches
are connected to a control means (not shown) provided in the
proximal control portion so that the wire 2 is pushed forwardly and
pull backwardly by the operation of the control means. In
operation, the wire 2 is pushed forwardly after the distal end
portion 1 is inserted into a body cavity so that the loop of the
wire 2 is enlarged to capture a projecting mass 3 such as a polyp.
Then the wire 2 is pulled rearwardly by the operation of the
control means, thereby contacting the loop to sever the projecting
mass 3. In such a forceps, the wire 2 is turned back upon itself
during the operation of the forceps to form a node 2', and tends to
be broken at the node 2' as the operation of the forceps is
repeated.
FIGS. 2 to 12 show first embodiment of the forceps of the present
invention. The forceps shown comprises a distal tubular end portion
11 and a proximal tubular control portion 12 connected to the
distal end portion 11 by an elongated flexible tube 13 made of a
closely wound helical coil.
The distal end 11 carries a pair of parallel legs 16 extending
forwardly of the distal end portion 11 and separated from each
other by a slot or elongated recess 15.
The end wall 11' of the distal end portion 11 is formed with a
central hole through which a wire 14 shiftably extends into the
bore of the tube 13. The forward end of the wire 14 is secured to a
connecting piece 19 by means of solder 19a, the connecting piece 19
being in turn rotatably mounted on a pin 18 secured to the legs 16
and extending in the slot 15 laterally thereto. The longitudinal
end portion of the wire 14 seen in FIG. 2 is thus limited in its
longitudinal movement while being capable of pivotal movement about
an axis transverse of the elongation of the slot 15.
The rearward end of the wire 14 extends outwardly of the
cylindrical portion of the proximal control portion 12 through an
elongated slot 12a formed in the cylindrical portion and secured by
solder 20a to an operating or central ring 20 slidably mounted on
the cylindrical portion as so that the wire 14 is pushed forwardly
or pulled rearwardly by the operation of the operating ring 20.
Thus, when the wire 14 is pushed forwardly, the forward portion of
the flexible wire 14 between the connecting piece 19 and the end
wall 11' is bent outward of the open side of the slot 15 to form a
loop 24 between the wire 14 and the legs 16 in which a projecting
mass 3 is easily captured. When the wire 14 is pulled rearwardly,
the loop is contracted so that the wire 14 moves into the slot 15
in tensioned state.
At least one leg 16 has a sharp, longitudinal cutting edge 17, and
the width of the slot 15 between the wall faces of the legs 16 is
made slightly greater than the diameter of the wire 14 permitting
the same to easily move into the slot 15 while the close contact of
cutting edge 17 with the wire 14 is insured.
Thus, the projecting mass 3 captured in the loop 24 is easily and
efficiently severed by the cutting edge 17 when the wire 14 is
pulled rearwardly by the operating ring 20 without damage to tissue
surrounding the projecting mass 3. The thus severed mass 3 is
positively held in the slot 15 by means of the tensioned wire
14.
Pin 21 extending between the legs 16 in the slot 15 serves to
prevent the wire 14 from buckling in the direction opposite to that
shown in the figures so that the loop of the wire 14 is positively
formed at the side where the cutting edge 17 is formed in the leg
16.
In the drawings, the slot 15 is shown as extending from one
peripheral surface to the diametrically opposite peripheral
surface, however, the slot 15 may be partly closed by a
longitudinal bottom surface.
FIGS. 13 to 17 show a modification of the forceps shown in FIG. 2.
The forceps of FIGS. 13 to 17 is substantially similar to that
shown in FIG. 2 except that a shallow, concave receptacle 15' is
formed in the face of one of the legs directed toward the slot 15
and the cutting edge 17 on the other leg 16. The bottom wall of the
receptacle is obliquely inclined relative to the slot 15.
The operation of the forceps of FIG. 13 is similar to that of FIG.
2, except that the severed projecting mass 3 is more safely held in
the slot 15 by virtue of the provision of the receptacle 15' as
shown in FIG. 17.
FIG. 18 to 21 show a further modification of the forceps of FIG. 2.
In this embodiment, one end of an arm member 22 having a cutting
edge 22' is swingably mounted on the pin 18 and the free end of the
more rigid member 22 is pivotally connected to the forward end of
the wire 14 so that the member 22 is swung out of the open side of
the slot 15 when the wire 14 is pushed forwardly while the member
22 is moved into the slot 15 when the wire 14 is pulled rearwardly.
The width of the member 22 is made slightly smaller than the width
of the slot 15 for free swinging movement of the member 22 into and
out of the slot 15 while the cutting edge 22' of the member
shearingly cooperates with the cutting edge 17 of the leg 16 when
the member 22 is swung into the slot 15.
The operation of the embodiment of FIG. 18 is substantially similar
to that of FIG. 2.
FIGS. 22 to 26 show a further modification of the forceps of FIG.
2.
This embodiment is substantially similar to that of FIG. 2 except
that a surface 23a is formed in either one of the outer surfaces of
the legs 16 merging with the longitudinal edge thereof so as to
form a sharp cutting edge 23 as shown in FIG. 24. Thus, the
projecting mass 3 captured between the wire 14 and the legs 16 can
be most efficiently severed by the cutting edge 23 cooperating with
the tensioned wire 14.
FIGS. 27 to 32 show a forceps of the present invention which
comprises a first wire 104 forming a loop extending from the distal
end portion 107 with the branches or the portions of the wire 104
extending from the respective ends of the loop through the flexible
tube 13 toward the proximal control portion 12. The ends of the
branches of the wire 104 pass through an elongated slot (not shown)
formed in a cylindrical guide tube 111 and are connected to a first
operating or control ring 112 slidably guided on the cylindrical
guide tube 111 so that the wire 104 is pushed forwardly to enlarge
the loop or pulled rearwardly to contract the loop by the operation
of the operating ring 112. The loop of the wire 104 serves to
capture the projecting mass and sever the same when the loop is
contracted.
A second wire 105 extends through the flexible tube 13, and an eye
106 provided at its distal end is pivotably connected to a bight
past 104a of reduced radius of curvature formed at the distal end
of the loop of the wire 104 while the rearward end of the wire 105
passes through the elongated slot in the cylindrical guide tube 111
and is connected to a second operating ring 113 slidably guided on
the cylindrical guide tube 111 so that, when the operating ring 113
is actuated, the wire 105 is pushed forwardly to form a loop
between the eye 106 and the distal end portion 107 or is pulled
rearwardly to contract the loop. The second wire 105 serves to
positively hold the severed projecting mass. Stationary stop rings
114 are secured to the cylindrical guide tube 111 of the proximal
control portion 12 so that the stroke of each of the operating
rings 112, 113 is appropriately limited. The stop rings 114 may be
adjustable, to suit the conditions under which the operation is to
be carried out.
As is shown in FIG. 31, a hole 109 formed in the end wall of the
distal end portion 107 is used to slidably pass therethrough the
second wire 105 while the elongated hole 108 is used for slidably
passing therethrough the branches of the wire 104 extending from
the loop of the wire 104.
FIGS. 33 to 35 show the manner how a polyp projecting from an inner
wall of a living body is captured and severed by the forceps of
FIG. 27.
First, the first and second wires 104, 105 are pushed forwardly by
the operation of the operating rings 112, 113 after the distal end
portion 107 is inserted together with the endoscope into a body
cavity so as to capture the projecting mass within the loop of the
wire 104 and in the loop of the wire 105 as shown in FIG. 33 which
the projecting mass is observed through the optical system of the
endoscope, not shown. Then, the operation ring 112 is manually
moved rearwardly to pull the wire 104 so as to contract the loop of
the wire 104 thereby severing the projecting mass captured therein.
At the same time or after the operation of the first operating ring
112, the second operating ring 113 is moved rearwardly to contract
the loop of the wire 105 so that the severed projecting mass is
positively held by wire 105 as shown in FIG. 35.
FIGS. 36 and 37 show a modification of the connection of the wire
104 with the wire 105. The two leg ends of a forked connecting
piece 116 having a slot 117 are attached to respective distal end
portions of the wire 104. A pin 118 is secured to the piece 116
extending laterally of the slot 115 and a pivot piece 117 connected
to the distal end of the wire 105 is pivotally mounted on the pin
118 in the slot 115. The operation of the embodiment is similar to
that shown in FIG. 28.
FIG. 38 shows a further modification of the connection between the
wires 104 and 105. In this embodiment, an eye 119 is provided at
the distal end of the loop formed by the wire 104 and the eye 119
is pivotally engaged with the eye 106 of the wire 105.
* * * * *