JP3312508B2 - Trocker - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a trocar used in laparoscopic surgery, and more particularly, to cleaning a lens cover contaminated with bodily fluids when an endoscope is housed in a trocar to examine an affected part in the body. The present invention relates to a trocar for observing an affected part in a body.

[0002]

2. Description of the Related Art Conventionally, in intra-abdominal surgery, laparoscopic surgery is performed in order to avoid a wide range of skin incisions. As a method of forming a fistula for laparoscopic surgery, there are a close method and an open method. In the close method, carbon dioxide gas is introduced into the abdominal cavity with an insufflation needle to inflate the abdominal cavity. When the insufflation is sufficient, the insufflation needle is changed to a pneumoperitoneum needle and a safety shield mechanism is attached to the inner needle of a large diameter (5-12 mm) trocar. Insert the one with. In the open method, after a small incision is made in the skin, a blunt-needle trocar is inserted, the inner needle is withdrawn, the stomach is insufflated from the outer cylinder, and an endoscope is inserted to perform a surgical procedure. In the case of the open method,
Since the fistula outside the body is previously formed by the incision, it is possible to observe the affected part in the body by inserting the endoscope into the trocar-mantle tube.

[0003]

However, when a trocar is inserted into the abdominal cavity to examine a diseased part of the body by inserting the trocar into the abdominal cavity, the body fluid stains the lens cover of the mantle tube, so that a precise observation of the diseased part is not possible. Diagnosis of the lens cover is also shown together with the affected part, so that it is often difficult to make a diagnosis. In addition, endoscopic observation is performed in the insufflated abdominal cavity, but if the observation time is prolonged, gas in the abdominal cavity may leak and it may not be possible to perform sufficient medical examination. Means for preventing gas leakage are required. SUMMARY OF THE INVENTION It is an object of the present invention to provide a trocar capable of continuously photographing by cleaning dirt on a lens cover with a liquid and observing an affected part. It is another object of the present invention to provide a trocar that prevents gas leakage in the abdominal cavity and allows sufficient endoscopic observation.

[0004]

Means for Solving the Problems That is, the present invention provides (1)
An inner tube having a lens cover at the distal end and a means for fixing the outer tube to the proximal end; (2) a liquid cleaning means for inserting the inner tube and cleaning the lens cover at the distal end opening; A means for intermittently injecting liquid into the base end and a means for fixing the means to the inner tube; and (3) a gap between the outer wall of the inner tube and the inner wall of the outer tube. A liquid passage for cleaning the provided lens cover, (4) means for flowing gas into the abdominal cavity provided on the outer wall of the mantle tube, means for preventing the gas from leaking from the abdominal cavity, and the mantle tube And a means for fixing the outer tube to the abdominal wall.

[0005] The present invention provides the trocar,
The means for fixing the inner tube and the outer tube has an external thread on the upper outer wall, an annular one end is fixed to the lower inner wall, and a cylindrical sheath-like body comprising a plurality of slits open at the other end. An upper portion is provided with a female screw which is screwed with the male screw to fasten the endoscope with the slit, and a foot portion of which is screwed with a female screw provided near the distal end opening of the outer tube to form an inner jacket. A trocar comprising a cylindrical body provided with a male screw for fixing a tube and a mantle tube. Further, the present invention provides the trocar,
The liquid cleaning unit is a trocar that cleans the lens cover by injecting liquid from the outer circumference to the inner circumference of an annular body having a plurality of holes in a circumferential surface. Still further, in the trocar according to the present invention, the means for intermittently injecting the liquid may include pressing a button of a plunger pushed up by a spring to connect a liquid inlet and a liquid passage provided on a side of the plunger. A shut-off valve separates the trocar from which liquid flows into the liquid passage from the liquid inlet.

Further, the present invention provides the above trocar,
The means for fixing the mantle tube to the abdominal wall is formed of a conical flexible resin layer having a gradually decreasing diameter at the distal end, and a plurality of annular ridges are provided on the outer surface thereof. A gas passage is formed in the gap with the flexible resin layer,
The distal end of the gap is a trocar which is opened and gas flows into the abdominal cavity. Furthermore, the present invention is the trocar - in, means for preventing means and said gas flowing the gas into the abdominal cavity to leak from the peritoneal cavity the trocar formed by providing a check valve in the inlet gas stream - a.

[0007]

After a small incision is made on the skin of the abdominal wall, a blunt needle trocar is inserted and the inner needle is removed. Thereafter, the trocar of the present invention, in which the inner tube and the outer tube are fixed at the proximal ends, is inserted and fixed from the incision in the abdominal wall until the distal end opening of the gas inflow passage of the outer tube fixing device enters the abdominal cavity. Then, pressurized gas, particularly carbon dioxide, flows into the abdominal cavity from the gas inlet of the mantle tube fixture. The pressurized gas is prevented from leaking to the outside by the check valve. Thereafter, the endoscope is inserted into the lumen of the inner tube, and by pressing a plunger button provided at the proximal end of the outer tube, a liquid, for example, physiological saline is injected into the gap between the inner tube and the outer tube. Through the formed liquid passage, the lens cover is washed from the outside to the inside of the hole of the annular body provided at the end of the mantle tube. And before taking a picture with the endoscope, be sure to plunger
Button to clean the lens cover,
And then take a picture.

[0008]

DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below with reference to an embodiment. FIG. 1 is an explanatory view of a trocar according to the present invention, and FIG. 2 is a cross-sectional view of a base end portion of an inner tube before being fixed to a base end portion of an outer tube (reverse to FIG. 1).
An orientation), FIG. 3 is a sectional view of the liquid inlet of the mantle tube proximal end, FIG. 4 is a sectional view of the mantle tube fixture 5 present invention trocar - shows a cross-sectional view of the tip portion. In the figures, 1 is an outer tube, 2 is an inner tube, 3 is a proximal end of the outer tube, 4 is a proximal end of the inner tube, 5 is an outer tube fixing device, 6 is a lens cover, and 7 is an annular body.
(Annular slit) , 8 is a check valve, 9 is an anchor, 10 is a lock screw, 11 is a spring, 12 is a liquid passage, and 13 is a button.

FIG. 1 is an explanatory view of a trocar according to the present invention.
The inner tube 2 is provided with a lens cover 6 at the distal end and a means for fixing the outer tube 1 to the proximal end (see FIG. 2, right diagram) . The outer tube 1 has the inner tube 2 inserted therein, a liquid cleaning means for cleaning the lens cover 6 at the distal opening (see FIG. 5), and a means for intermittently injecting liquid at the proximal end (see FIG. 3). And means for fixing to the inner tube 2 are provided. A gap is provided between the outer wall of the inner tube 2 and the inner wall of the outer tube 1, and a liquid passage 12 for cleaning the lens cover 6 is provided.
In the middle of the outer wall of the outer tube 1, an outer tube fixing device 5 slidable on the outer wall of the outer tube is provided, and the outer tube is fixed to the abdominal wall.
Means are provided for flowing gas into the abdominal cavity and means for preventing the gas from leaking from the abdominal cavity (see FIG. 4) .

FIG. 2 is a sectional view of the trocar base end 3 of the trocar according to the present invention.
FIG . 1 is a cross-sectional view of the proximal end portion 4 of the inner tube (not shown) which is fixed thereto .
A male screw 18 is provided on the upper outer wall, an annular one end is fixed to the lower inner wall, and a cylindrical sheath 21 comprising a plurality of slits 17 having the other end opened (left figure) ) Is formed, and an endoscope is inserted into the lumen. And a sheath
When the body 21 is screwed into the female screw 19 formed on the upper part of the cylindrical body 22 , the endoscope clamped in the slit 17 of the sheath 21 is gradually tightened. The cylindrical body 22 has a female screw 19 formed on the upper part, and is screwed with the male screw 18 of the sheath 21 as described above. A male screw 20 is formed on the outer wall of the foot portion, and is screwed with a female screw (not shown) provided near the opening of the outer tube tip to fix the inner tube 2 and the outer tube 1 together.

The distal ends of the inner tube 2 and the outer tube 1 thus fixed are provided with a lens cover 6 at the distal end of the inner tube 2 as shown in the sectional view of the distal end of the trocar of the present invention in FIG. At the tip of the mantle tube 1, an annular body 7 composed of a plurality of slits is provided. Between the wall of the outer tube 1 and the wall of the inner tube 2
There is a gap between them, and the liquid supplied from the liquid inlet 24
A liquid passage 12 is formed to pass through. Annular body 7 slit
One end of the opening communicates with the liquid passage 12 and the other end.
Is provided along the outer surface of the lens cover 6.
The liquid supplied from the liquid passage 12 passes through the slit of the annular body 7.
After that, the outer surface of the lens cover 6 is cleaned . Physiological saline is preferred as the liquid used.

A liquid inlet 24 is provided at the proximal end 3 of the mantle tube, and the liquid flows intermittently into the liquid passage 12 by pressing the button 13 as shown in the sectional view of FIG. ing. The button 13 is normally tensioned outward by the spring 11, and the liquid is closed by the seal member 25 and the valve 26. By pressing the button 13 in such a state, the shaft moves in the direction of the valve 26, and the cylindrical truncated cone is formed.
The valve 26, which has been sealed at the upper end of 27, moves in the direction of the larger diameter of the truncated cone 27, forming a gap between the valve 26 and the frustoconical cone 27 in contact. Then, the liquid flows from the gap to the liquid passage 12.
Then, the lens cover 6 is washed with the liquid.

FIG. 4 is a sectional view of the mantle tube fixture 5. The mantle tube fixing device 5 is a conical member for fixing the mantle tube 1,
The outer wall of the outer tube 1 is freely slid, and the outer tube 1 is fixed with the lock screw 10 so that the abdominal wall is at a desired position. The bottom of the mantle tube fixture 5 is provided with a conical anchor 9 for shielding a wound at a surgical site. A plurality of annular ridges 28 are provided on the outer wall of the anchor 9, and the anchor 9 is inserted into a wound formed in advance on the abdominal wall, and a boundary with the skin when the abdominal cavity is blocked by the trocar. become. There is a gap between the anchor 9 and the outer wall of the mantle tube 1 to form a gas passage 30 through which gas flows into the abdominal cavity. The distal end of the anchor 9 is open as a cylindrical tube, so that gas flows into the abdominal cavity. And an O-ring is on the upper end of anchor-9.
29 is provided to securely fix the anchor 9 to the outer wall of the mantle tube 1 and prevent gas from leaking from the upper end. The anchor 9 is made of a flexible resin. Examples of the flexible resin include thermoplastic resins such as polyvinyl chloride, polyethylene, polypropylene, polyester, polyamide, and acrylic resin, synthetic rubber, and natural rubber.

The gas inlet 30 is provided with a check valve 8 for preventing gas flowing into the abdominal cavity from flowing into the atmosphere but preventing gas from flowing from the abdominal cavity to the atmosphere. As the check valve, a duckbill type valve, umbrella valve, flap valve, poppet valve, ball valve or the like having a shape like a platypus beak is used. When the gas in the abdominal cavity is allowed to flow out after the operation, the check valve is opened with the thin tube so that the gas in the abdominal cavity flows out of the lumen of the thin tube. Carbon dioxide gas or the like is used as the gas. The gas enters the abdominal cavity through a gas passage 30 formed by a gap between the anchor 9 and the outer wall of the mantle tube 1.

Next, a method of operating the trocar according to the present invention will be described. After making a small incision in the skin of the abdominal wall, a blunt needle trocar
And remove the inner needle. Then, the inner tube 2 and the outer tube 1
The trocar of the present invention, which is fixed at the proximal end, is inserted from the incision in the abdominal wall until the distal end opening of the gas inflow passage of the mantle tube fixture enters the abdominal cavity. Then, pressurized gas flows into the abdominal cavity from the gas inlet 15 of the mantle tube fixture 5 at a low flow rate. After confirming that there is no abnormal increase in intraperitoneal pressure by palpation or percussion, switch to a high flow rate, and
mmHg. The pressurized gas is prevented from leaking to the outside by the check valve. Thereafter, the endoscope is inserted into the lumen of the inner tube 2, and a button provided at the proximal end of the outer tube 1 is inserted.
By pressing 13, the liquid passes through the liquid passage 12 formed in the gap between the inner tube 2 and the outer tube 1 and enters from the outside to the inside of the annular body 7 provided at the tip of the outer tube 1. Wash 6. Then, before taking a picture with the endoscope, be sure to press the button 13 to clean the lens cover 6 and remove the lens cover.
Take a picture after sharpening 6. When the gas in the abdominal cavity is allowed to flow out after the examination, a small-diameter tubular
The gas from the peritoneal cavity is allowed to flow out through the small-diameter tubular body by opening the check valve 8 by inserting the check valve from the position 15.

[0016]

The present invention trocar according to the present invention - is intraperitoneal gas inlet and lens cover - since the cleaning can be done in one instrument, trocar - no gas leak abdominal cavity after insertion into the abdominal cavity, smooth You can observe the inside of the body with an endoscope and take a picture.

[Brief description of the drawings]

FIG. 1 is an explanatory diagram of a trocar according to the present invention.

FIG. 2 is a cross-sectional view of the proximal end of the inner tube fixed to the proximal end of the outer tube.
It is .

FIG. 3 is a cross-sectional view of a liquid inlet at a proximal end portion of a mantle tube.

FIG. 4 is a sectional view of a mantle tube fixture.

FIG. 5 is a sectional view of the tip of the trocar of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Outer tube 2 Inner tube 3 Outer tube base end 4 Inner tube base 5 Outer tube fixing device 6 Lens cover 7 Annular body 8 Check valve 9 Anchor 10 Lock screw 11 Spring 12 Liquid passage 13 Button

────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Shoji Kawamoto 3-9-3 Honjo Nishi, Kita-ku, Osaka City Examiner, Nissho Co., Ltd. Examiner Hiroshi Kadota (56) References JP-A-5-269079 (JP, A) JP-A-6-285012 (JP, A) JP-A-3-198829 (JP, A) JP-A-6-81501 (JP, U) JP-A 57-87715 (JP, U) JP-A-2 -17105 (JP, U) JP 6-17711 (JP, U) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 1/00-1/32

Claims (6)

(57) [Claims] 1. An inner tube having a lens cover provided at a distal end thereof and a means for fixing an outer tube at a proximal end thereof, and (2) washing the lens cover at a distal end opening by inserting the inner tube therein. (3) an outer tube provided with a means for intermittently injecting a liquid into the base end and a means for fixing the inner tube to the inner tube; and (3) an outer wall of the inner tube and the outer tube. A liquid passage for cleaning a lens cover provided in a gap between the inner wall of the outer tube and (4) means for flowing gas into an abdominal cavity provided on an outer wall of the mantle tube, and a means for allowing the gas to leak from the abdominal cavity. And a means for fixing the mantle tube to the abdominal wall, the trocar being slidable on the mantle tube outer wall. 2. A means for fixing an inner tube and an outer tube has a male screw on an upper outer wall, an annular one end is fixed to a lower inner wall, and a plurality of slits open at the other end. And a female screw which is screwed with the male screw at the upper portion to fasten the endoscope with the slit is provided, and its foot is screwed with a female screw provided near the distal end opening of the mantle tube. 2. The trocar according to claim 1, comprising a cylindrical body provided with a male screw for fixing the inner tube and the outer tube. 3. A liquid washing means , wherein a liquid is injected from an outer periphery to an inner periphery of an annular body having a plurality of holes in a circumferential surface,
3. The trocar according to claim 1, which cleans the lens cover. 4. A means for intermittently injecting a liquid includes pressing a button of a plunger pushed up by a spring to separate a valve for shutting off a liquid inlet and a liquid passage provided on a side of the plunger. 4. The trocar according to claim 1, wherein the liquid flows into the liquid passage from the liquid inlet. 5. The means for fixing the mantle tube to the abdominal wall is made of a conical flexible resin layer whose diameter on the tip side is gradually reduced, and a plurality of annular ridges are provided on the outer surface thereof. The gas passage is formed in a gap between the outer wall of the mantle tube and the flexible resin layer, and the tip of the gap is opened to allow gas to flow into the abdominal cavity. Trocker. 6. The trocar according to claim 1, wherein the means for flowing gas into the abdominal cavity and the means for preventing the gas from leaking from the abdominal cavity are provided with a check valve at the gas inflow port. .