JP3132629U - Retractor - Google Patents

Abstract

An object of the present invention is to provide a retractor in which an exclusion portion formed of a balloon is provided at the tip of a lot, and the rotation and lateral movement of the balloon with respect to the lot can be suppressed to stably exclude an organ.
A lot 1 in which a passage is formed from a fluid injection port 21 to a discharge port 131, a balloon 3 that can be inflated into a flat shape provided to cover a tip portion including the discharge port 131 of the lot 1, and the balloon 3, a fixing means for the lot 1, a movement preventing means 5 for restricting the movement of the balloon 3 in the front-rear and left-right directions relative to the lot 1, and a rotation prevention for restricting the twist of the balloon 3 around the lot 1. Means 61 is provided, and if necessary, slip prevention means formed by covering the surface of the balloon 3 with the nonwoven fabric 4 or the like is provided.
[Selection] Figure 1

Description

  The present invention relates to a retractor for excluding and holding an organ for the purpose of securing a surgical visual field, particularly during endoscopic surgery.

  In surgery, it is necessary to keep the organ in a desired position by maintaining the target organ within a good visual field in order to secure the operative field, or by excluding surrounding organs so as not to interfere with the operative field. In particular, in an endoscopic operation, this work is important because the visual field is limited along with the surgical space. In the past, a number of retraction devices (retractors) to which this endoscopic surgery is applied have been proposed. For example, the retraction device has a retraction portion made of a plurality of hard plates. When inserting and removing the body into the body, the plurality of plate materials are stacked into a small diameter, and can be inserted into and removed from the body cavity through a trocar or the like.In the body cavity, the plate material is opened in a fan shape by hand operation. There is an instrument that can be applied as an exclusion part having a certain area. (Patent Document 1, etc.)

However, in the case of a hard exclusion part as described above, depending on the organ, there is a problem that a mark may remain in the organ due to the exclusion. As a solution, the exclusion part is formed of a flexible material such as a balloon. A retractor was proposed. As this conventional example, for example, a strong lot having a through hole penetrating from a stop cock at the end portion to a hole portion at the tip portion, an inflatable balloon member covering the plurality of holes and the tip portion of the lot, And the balloon member has a relatively wide front surface and a relatively narrow cross-section when inflated, and is firmly fixed to the lot. (Patent Document 2)
JP-A-5-200040 JP-A-6-296700

According to the above-mentioned retractor device, an instrument can be inserted and removed from a trocar or a small incision by expansion and contraction of a balloon member so that it can be adapted for endoscopic surgery, and contact with an organ is soft. Because of the balloon member made of material, the risk of damaging fragile organs can be reduced.
However, the balloon member is firmly attached to the lot at multiple locations, and the balloon member expands and hardens due to fluid injection, but the flat balloon member rotates around the lot (twisting occurs) In addition, depending on how the balloon member is attached to the lot, there is no denying that the balloon may move back and forth, left and right, and laterally with respect to the lot. There is a problem that the holding becomes unstable.

  Therefore, an object of the present invention is to provide a retractor that can stably exclude an organ by effectively suppressing the rotation and lateral movement of a balloon relative to a lot during the exclusion of the organ.

The retractor of the present invention has a lot in which a passage is formed from an inlet to an outlet, provided with a fluid inlet and a gripping portion at a base end, and a fluid outlet at a tip.
A balloon that can be inflated into a flat shape by inserting and covering the tip including the discharge port of the lot;
Means for fixing the balloon to the lot, provided on the base side of the balloon;
Movable prevention means for restricting the movement of the balloon in the front / rear and left / right directions relative to the lot;
And a rotation preventing means for restricting the twisting of the balloon with the lot as an axis.

  As a specific means for preventing the movement, the front and back surfaces of the balloon are bonded to each other at a position facing the lot on the flat surface of the balloon in which the lot is inserted, and the lot is connected to the lot by the joint. The balloon was fixed and used as a means for preventing movement.

  As a specific means for preventing the rotation, a claw projecting toward the center of the balloon is provided along the lot inserted in the balloon so as to face the flat surface of the balloon across the lot. The balloon and the lot were sandwiched and fixed to form a rotation preventing means.

  Moreover, it is preferable that the surface of the balloon is provided with a slip prevention means. Specifically, the balloon is preferably covered with a nonwoven fabric.

(Function)
According to the retractor of this means, since the extruding part is a flat balloon, the balloon is folded during endoscopic surgery because it is inflated and contracted by injecting and discharging fluid to the balloon. It can be inserted into and removed from a trocar or small incision, and can be expanded in a body cavity to form a wide exclusion surface. In addition, the balloon material is flexible and the contact with the organ is soft, but a certain level of strength is obtained by injecting the fluid, so that the exclusion and retention can be stabilized, and a friendly exclusion that does not damage the organ. In addition, it is possible to maintain a balanced balance capable of achieving both reliable and stable exclusion.
Furthermore, this flexible and strong action makes it possible to use as a blunt tissue peeling device.
Further, the relative movement (displacement) between the lot and the balloon is suppressed by the lateral movement preventing means of the balloon, thereby enabling stable exclusion. For example, as a specific means, the position of the balloon with respect to the lot is fixed by the joint by providing a joint near the center of the flat surface of the balloon, the front and back surfaces being bonded to the opposite positions across the lot. The movement of the balloon in the front, rear, left, and right directions can be suppressed by suppressing the movement in cooperation with the means for fixing to the lot provided on the base side of the balloon.
In addition, the balloon rotation prevention means enables stable relieving because the balloon is difficult to twist with respect to the lot even in the case of strong or uneven relieving. For example, as a specific means, when a balloon and a lot are sandwiched and fixed from both sides by a claw protruding along the lot axis on the flat surface of the balloon, the outer diameter of the claw is not made larger than the lot (by this action, It is possible to insert and remove from the outer tube for endoscopes), the lot shaft part of the balloon is firmly held, and the side of the claw sandwiches the most proximal end of the side surface of the balloon inflating part to prevent twisting As a result, it is possible to suppress left-right rotation with respect to the lot axis.

  Further, if the surface of the balloon is made of a non-slip material such as a non-woven fabric, a stable retraction without slipping during organ retraction can be achieved.

  According to the present invention, due to the above-described configuration and operation, the balloon tends to rotate (rotate) with respect to the lot axis, moves back and forth and horizontally with respect to the lot (laterally movable), and further slides when organs are excluded. Therefore, it is possible to provide a retractor that can stably hold out an organ.

Hereinafter, an embodiment of the present invention will be described in detail with reference to the drawings.
FIG. 1 is an overall configuration diagram of a retractor showing an embodiment of the present invention, in which A is a front view, B is a side view, and FIG. 2 is a structural schematic diagram of its tip.
The retractor of the present example includes, on the base side, a fluid inlet 21 having a check valve (not shown) inside and a handle 2 serving as a gripping and operating portion, and a fluid outlet 131 at a tip portion. A lot 1 having a lumen as a fluid passage, a flatly inflatable balloon 3 fixed to the lot 1 by covering and covering the distal end side including the discharge port 131 of the lot 1, and the lot 1 and the balloon 3 are fixed, and the projection 3 is projected toward the center of the balloon flat surface 31 that prevents the balloon 3 from rotating with respect to the lot 1, and the projection 3 is sandwiched between the balloon 3 and the lot 1. A front end cover 6 provided and a surface of the balloon 3 which is basically configured from a nonwoven fabric 4 formed so as to cover the surface of the balloon 3 and which is provided opposite to the center of the balloon flat surface 31 with the lot 1 interposed therebetween. Bonding the back side 5 is inserted into a body cavity from a punctured trocar or small incision, mainly during endoscopic surgery, and grasps and excludes an organ to be operated or peripheral organs Therefore, it is an instrument used as a retractor for removing the tissue or a peeling device for peeling the tissue bluntly (protective).

Next, each component will be described in detail.
In the lot 1, the pipe 11, the bush 14, the tip pipe 12, and the tip tube 13 are connected from the handle side to the tip side, and each lumen is configured as a fluid passage.
The pipe 11 is made of a stainless steel pipe, and has an outer diameter (5 mm in this example) that can be inserted into a trocar so as to be applicable to endoscopic surgery, and a length sufficient for remote operation from outside the body (this book). In the example, the base end portion is bonded to the handle 2 described later, and the distal end portion is bonded to the bush 14 described later.
The distal end pipe 12 is a portion inserted into the balloon 3 to be described later, so that it can be inserted into the trocar, etc., and is formed from a stainless steel pipe (in this example, 1.8 mm) having a smaller diameter than the pipe 11. The end side is connected to the bush 14 and the tip side is connected to the tip tube 13.
The bush 14 is a connector for connecting the pipe 11 having a different diameter and the distal end pipe 12 and is formed of an unspecified resin. As in the previous operation, the distal end pipe 12 is connected to the distal end side and the pipe 11 is connected to the proximal end side. Become.
The tip tube 13 is the most advanced part of the lot 1 and is made of a relatively hard material such as a fluorine resin tube having the same outer diameter (1.8 mm in this example) as that of the tip pipe. Connected to the part. The tip is made of resin to prevent the balloon 3 from being damaged by the tip, which is a concern with metal pipes, etc. Further, a side hole (discharge port 131) is provided at the tip and a handle described later. This is a discharge port for the fluid injected from the second fluid injection port 21.

  The handle 2 serves as an operation gripping part of the retractor, and may have any form as long as it can be easily gripped. Further, the handle is provided with a fluid inlet 21 having a female luer taper to which a general syringe can be connected for injecting fluid into the balloon, and the fluid inlet prevents the backflow of fluid from the balloon. A known check valve (not shown) is provided.

FIG. 3 shows a configuration diagram of the balloon of this example.
The balloon 3 is formed by welding two sheets made of, for example, polyurethane resin having relatively high strength over the entire circumference except for the lot insertion port 33 for inserting the lot 1. Can be expanded into a flat shape having a flat surface 31, and the shape and size are not specified, but in this example, it is connected to the lot 1 on the exclusion surface of a wide droplet shape. As a whole, it is formed as a wide rice paddle shape with a tail portion 32, and the size when expanded can be inserted into a trocar etc. The thickness was about 40 mm and the thickness was about 15 mm.
Further, the entire surface of the balloon 3 is covered with a non-woven fabric 4 serving as a slip prevention means when grasping an organ or the like, and further, substantially the central portion of a balloon flat surface 31 formed by the balloon 3 and the non-woven fabric 4. Thus, the joining portion 5 is formed by welding and fixing the front and back surfaces of the balloon flat surface 31 at positions facing the tip pipe 12 or the tip tube 13 of the lot 1.

The front end cover 6 is for fixing the lot 1 and the balloon 3 (hereinafter, including the nonwoven fabric 4) and for restricting the movement of the lot 1 and the balloon 3 in the twisting direction. Is formed as a shape obtained by dividing a cylindrical body, which is molded from ABS resin, and has an outer diameter substantially equal to that of the pipe 11 of the lot 1 into two substantially symmetrically in the longitudinal direction. 3 is sandwiched and attached from the front end of the bush 14 to immediately before the balloon inflating portion, and is fixed by adhering the cover joining portion 62. In addition, when the two members are joined to each other, a protrusion claw 61 that is positioned on the side of the balloon flat surface 31 is formed on the distal end portion. When viewed from the side of the balloon 3, a concave groove 63 is formed. Has been configured.

Next, the fixing means for the lot 1 and the balloon 3 in this example will be described.
First, the lot 1 is inserted to the tip of the balloon 3 from the lot insertion port 33 of the balloon tail 32, and a part or all of the balloon tail 32 is covered and contracted and fixed by the shrink tube 7. Hold securely to 1.
Further, the above-described bifurcated tip cover 6 is attached to the outer layer of the shrinkable tube 7 so as to sandwich the lot 1 and the balloon 3, and the cover joining portion 62 is bonded and integrated and fixed. At that time, the projection claw portion 61 is located on the balloon flat surface 31 side, and is attached so as to project along the axis of the lot 1.

According to the present example, the fixing of the lot 1 and the balloon 3 is performed by fixing at the two locations of fixing by the contraction tube 7 and the tip cover 6 at the base including the balloon tail portion 32 and fixing by the joint portion 5 sandwiching the lot on the tip side. Due to the action of securely fixing the relative position, it is possible to effectively prevent lateral movement from front to back and from side to side.
In addition, the projection claw 61 sandwiches and holds the lot shaft between the balloon 3 on the flat surface of the balloon, and the side base end of the balloon inflating portion is sandwiched in the concave groove 63, and the side of the projection claw 61 By suppressing the twisting in the rotation direction, the rotation can be effectively prevented.
It should be noted that the actions for the lateral movement prevention means and the rotation prevention means described above are symbolic, and each means, including the specific means described above, independently embodies each action. However, it is considered that the fixing means, the lateral movement preventing means, and the rotation preventing means provided at the base cooperate to prevent lateral movement or rotation.

Next, an example of use of this example will be briefly described.
The preferred use example of this example is the exclusion of organs such as the intestine in endoscopic surgery, or blunt dissection. First, the diameter is reduced by, for example, winding the balloon around a lot while no fluid is injected into the balloon. In this state, it is inserted into the body cavity through a trocar or small incision, and when the balloon part is inserted into the body cavity, it is used by inflating the balloon into a flat shape by injecting air or the like from the fluid inlet. The
In addition, a thin-walled cylindrical reducer made of resin or the like is provided on the outer layer of the balloon 1 that has been gathered into lots 1 and small diameters in advance, and is inserted into the body cavity through a trocar or the like in this state, and the reducer in the body cavity. It is also possible to use the balloon 3 by pulling it forward.

1 is an overall configuration diagram showing an embodiment of the present invention. The structure schematic diagram which shows the front-end | tip part of this Embodiment. The block diagram which shows the balloon of this Embodiment.

Explanation of symbols

1. Lot 11. Pipe 12. Tip pipe 13. Tip tube 131. Fluid discharge port 14. Bush 2. Handle 21. 2. Fluid inlet Balloon 31. Balloon flat surface 32. Balloon tail 4. Nonwoven fabric Joint part 6. Tip cover 61. Protrusion claw 62. Cover joint 63. Groove 7. Shrink tube

Claims (5)

A lot in which a passage is formed from an inlet to an outlet, with a fluid inlet and a grip at the base end and a fluid outlet at the tip;
A balloon that can be inflated into a flat shape by inserting and covering the tip including the discharge port of the lot;
Means for fixing the balloon to the lot, provided on the base side of the balloon;
Movable prevention means for restricting the movement of the balloon in the front / rear and left / right directions relative to the lot;
A retractor comprising rotation preventing means for restricting twisting of the balloon with the lot as an axis.   2. The retractor according to claim 1, wherein the movement preventing means is provided with a joint portion formed by adhering the front and back surfaces of the balloon at a position facing the lot on the flat surface of the balloon in which the lot is inserted.   The rotation preventing means is provided with a claw projecting toward the center of the balloon along the lot inserted in the balloon so as to face the flat surface of the balloon across the lot. The retractor according to claim 1, wherein the retractor is sandwiched.   The retractor according to any one of claims 1 to 3, wherein a surface of the balloon includes a slip prevention means.   The retractor according to claim 4, wherein the slip prevention means is formed by covering a balloon with a nonwoven fabric.

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