JP3336597B2 - 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In the open method, after a small incision is made in the skin, a blunt-needle trocar is inserted, the inner needle is withdrawn, the stomach is insufflated from the outer cylinder, and an endoscope is inserted to perform a surgical procedure.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. However, when the trocar is inserted into the abdominal cavity to examine the affected part in the abdominal cavity, since the body fluid stains the lens cover of the mantle tube, it is impossible to observe the affected part in detail, and especially when taking a photograph, the dirt on the lens cover is also removed together with the affected part. It was often troublesome to diagnose because it was reflected. As means for solving such a problem, Japanese Patent Laying-Open No. 6-22902 discloses a laparoscopic method and a laparoscopic surgical method for cleaning a distal tip by flowing a fluid through the distal tip.

[0003]

However, in order to fix the laparoscope to the abdominal wall, such a laparoscope is fixed by suspending a thread on a suspension portion of the laparoscope and sewing the thread to the abdominal wall.
Therefore, when sewing with a thread on the abdominal wall, the patient is not only painful but also has a problem in hygiene. The present invention has been made to solve such a problem, and an object of the present invention is to provide a trocar that can hygienically fix the trocar to an abdominal wall. Still another object of the present invention is to provide a trocar capable of sufficiently taking a photograph of a lens cover by washing the dirt with a liquid and continuously taking a photograph or observing an affected part.

[0004]

That is, the present invention provides: (1) an inner tube having a lens cover provided at the distal end and a means for fixing the outer tube to the proximal end; and (2) an inner tube having an inner tube. An annular body having a plurality of holes for cleaning the lens cover is provided on the outer surface of the lens cover provided at the front end opening, and a liquid is injected from the outer circumference to the inner circumference of the annular body to cover the lens cover. (3) an outer tube provided with a means for intermittently injecting a liquid into a base end, and a means for fixing the inner tube, and (3) an outer wall of the inner tube. A liquid passage for cleaning a lens cover provided in a gap between the inner wall of the outer tube, and (4) the outer wall of the outer tube has a tip side diameter gradually reduced.
The conical mantle fixing device made of flexible resin
And a plurality of annular protrusions are provided on the outer surface of the mantle fixture.
A striated body is formed on the cylindrical outer wall on the tip side of the mantle fixture.
Is a trocar provided with a balloon.

[0005] The present invention provides the trocar,
A means for fixing the inner tube and the outer tube has a male screw 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 having the other end opened, A female screw is provided at the upper part to screw the male screw and fasten the inner tube with the slit, and its foot is screwed with a female screw provided near the opening of the outer tube tip to form the inner tube. And a cylindrical body provided with a male screw for fixing the mantle tube.

Further, the present invention provides the above trocar,
The means for intermittently injecting liquid presses a button of a plunger provided at the proximal end of the mantle tube, thereby separating a valve for shutting off a liquid inlet and a liquid passage provided at the side of the plunger. , A trocar in which liquid flows into the liquid passage from the liquid inlet.

[0007]

After a small incision is made in 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 through the incision in the abdominal wall until the balloon of the outer tube fixing device is completely inserted into the abdominal cavity, and then the balloon is expanded. Then, the mantle tube is fixed on the inner wall of the abdominal cavity. On the other hand, the trocar can be fixed from both sides of the abdominal wall by fixing the trocar with the lock screw of the conical mantle tube fixture on the outside. Thereafter, the endoscope is inserted into the inner lumen of the inner tube and the button of the plunger provided at the proximal end of the outer tube is pressed, whereby the liquid contained in the balloon is released from the liquid injection device through the inner tube. Through the liquid passage formed in the gap between the outer tube and the outer tube, the lens cover enters from the outside of the hole of the annular body provided at the distal end of the outer tube to clean the lens cover. Before taking a picture with the endoscope, be sure to press the button of the plunger to clean the lens cover and to make the lens cover clear before taking a picture.

[0008]

EXAMPLES Examples of the present invention will be described below with reference to examples. FIG.
FIG. 2 is an explanatory view showing an example of the trocar according to the present invention. FIG. 2 is a sectional view of the base end of the inner tube before being fixed to the base end of the outer tube. FIG. It is a cross-sectional view of the entrance,
FIG. 4 is a cross-sectional view of the mantle tube fixture, and FIG.
It is sectional drawing of the front-end | tip of. In the figure, 1 is an outer tube, 2 is an inner tube,
Reference numeral 3 denotes a base end of the mantle tube, 4 denotes a base end of the mantle tube, 5 denotes a mantle tube fixture, 6 denotes a lens cover, 7 denotes an annular body, 8 denotes a balloon, 9
Indicates an anchor, 10 indicates a lock screw, 11 indicates a spring, 12 indicates a liquid passage, and 13 indicates a button.

FIG. 1 is an explanatory view of a trocar according to the present invention.
The inner tube 2 is provided with means for fixing the lens cover 6 at the distal end and the outer tube 1 at the proximal end. The outer tube 2 is provided with a liquid cleaning means for inserting the inner tube 2 and cleaning the lens cover 6 at the opening at the distal end, a means for intermittently injecting a liquid at the base end, and a means for fixing the inner tube 2 to the inner end. It becomes. 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. An outer tube fixing device 5 slidable on the outer wall of the outer tube is provided in the middle of the outer wall of the outer tube 1, and fixes the outer tube to the abdominal wall from the outside. A balloon 8 is provided on the outer wall of the distal end of the mantle tube fixture 5. Balloon 8 is inserted into the abdominal cavity,
The mantle tube is secured to the abdominal wall from the inside by inflation with pressurized fluid, and the mantle tube is secured from both sides of the abdominal wall.

FIG. 2 is a sectional view of the trocar base end 3 of the trocar according to the present invention.
FIG. 4 is a cross-sectional view of the inner tube base end portion 4 which is fixed to the outer tube. A male screw 18 is provided on the upper outer wall, and a cylindrical shape including a plurality of slits 17 having an annular one end fixed and the other end open on the lower inner wall. Is formed, and the inner tube 2 is inserted into its inner cavity. The sheath 21 having the male screw 18 has a female screw 19
The screw is screwed together with the cylindrical body 22 having the cylindrical body 22, and the inner tube 2 is clamped by the slit 17 of the sheath body 21 and gradually tightened. 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 shown in the sectional view of the distal end of the trocar of the present invention in FIG. The distal end of the inner tube 2 is provided with a lens cover 6, and the outer end of the outer tube 1 is provided with an annular slit 7 composed of a plurality of slits. On the front surface of the annular slit 7, a cuff 14 for preventing the annular slit 7 from directly colliding with a body fluid is formed. There is a gap between the wall of the outer tube 1 and the wall of the inner tube 2 to form a liquid passage 12 through which the liquid supplied from the liquid inlet 24 passes. Liquid passage
The liquid supplied to 12 collides with the wall of the cuff 14 and flows from the outside of the annular body 7 to the inside of the annular body 7 to clean the outer surface of the lens cover 6, and the liquid stays in the body. Physiological saline is preferred as the liquid used.

A liquid inlet 24 is provided at the proximal end portion 3 of the mantle tube. As shown in the sectional view of FIG. 3, when the button 13 is pressed, the liquid flows intermittently into the liquid passage 12. ing. The button 13 is normally tensioned outward by the spring 11, and the liquid is closed by the sealing member 25 and the valve 26. By pressing the button 13 in such a state, the plunger 31 moves in the direction of the valve 26, and the valve 26 sealed at the upper end of the cylindrical truncated cone 27 moves in the direction of the larger diameter of the truncated cone 27. Then, it moves in the direction of the larger diameter of the truncated cone 27 which contacts the valve 26, and a gap is formed between the truncated cone 27 and the valve 26. Then, the liquid flows into the liquid passage 12 from the gap, whereby 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 the incision at the surgical site. A plurality of annular ridges 28 are formed on the outer wall of the anchor 9, and the anchor 9 is inserted into an opening formed in advance in the abdominal wall to cut off the abdominal cavity with a trocar. become. The distal end of the mantle tube fixture 5 has a cylindrical shape, is provided with a fluid passage 30 along the inner wall of the conical member, and is a portion inserted into the abdominal cavity. The balloon 8 is provided at an appropriate position, and the fluid supplied from the fluid injection port 15 expands the balloon 8 so that the mantle tube 1 can be fixed to the abdominal wall from within the abdominal cavity. As the fluid, liquids such as water and physiological saline, air, and gases such as carbon dioxide are used.

At the upper end of the anchor 9, an O-ring 29
Are provided to securely fix the anchor 9 to the outer wall of the mantle tube 1 and to prevent fluid from leaking from the upper end. The anchor 9 and the balloon 8 are made of a flexible resin.
As the flexible resin, polyvinyl chloride, polyethylene,
Examples thereof include thermoplastic resins such as polypropylene, polyester, polyamide, and acrylic resin, synthetic rubber, and natural rubber. FIG. 5 is a sectional view of the tip of the trocar of the present invention.
is there. A lens cover 6 is provided at the tip of the inner tube 2, and
An annular body 7 having a plurality of holes is fixed to the tip of the sleeve 1
It is provided fixed with the tool 14. Inner tube 2 and outer tube 1
The liquid sent from the liquid passage 12 formed in the gap,
From the outside of the annular body 7 provided at the tip of the mantle tube 1 to the inside
And clean the lens cover 6 .

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. After filling the inside of the abdominal cavity with a gas, in particular, carbon dioxide, with a pneumoperitoneal needle, the trocar of the present invention, in which the inner tube 2 and the outer tube 1 are fixed at the proximal end, is used to cut the conical member of the outer tube fixing device from the incision in the abdominal wall. The sheath 8 is inserted to the ridges 28, the mantle tube fixing device 5 is fastened with the roll screw 10, the mantle tube 1 is positioned, and the balloon 8 is inflated by injecting a fluid from the fluid injection port 15 to expand the sheath. Tube 1 is fixed to the abdominal wall. Then, the endoscope is inserted into the inner lumen of the inner tube 2 and a button 13 provided at the base end of the outer tube 1 is pressed, whereby a liquid is formed in a gap between the inner tube 2 and the outer tube 1. Through 12,
The lens cover 6 is cleaned by entering the annular body 7 provided at the tip of the outer tube 1 from outside to inside. And before taking a picture with the endoscope, be sure to press the button 13 to clean the lens cover 6,
Take a picture after clearing the lens cover 6.

[0016]

According to the trocar of the present invention, the mantle tube can be fixed from both sides of the abdominal wall without causing pain to the patient, and the lens cover can be washed in a stable state. Then, the lens cover is cleaned cleanly, the inside of the body can be smoothly observed with an endoscope, and a photograph can be taken.

[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 an inner tube proximal end fixed to an outer tube proximal end;

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

FIG. 4 is a cross-sectional view of the 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 end 5 Outer tube fixing device 6 Lens cover 7 Annular body 8 Balloon 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-shi Nissho Co., Ltd. (56) References JP-A-3-37030 (JP, A) JP-A-6-22902 (JP, A) JP-A-6-189893 (JP, A) JP-A-6-54798 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 1 / 00-1/32 A61B 17/34

Claims (3)

(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) a lens provided at an opening of a distal end by inserting the inner tube therein. A liquid cleaning means provided with an annular body having a plurality of holes for cleaning the lens cover on an outer surface of the cover, wherein a liquid is injected from an outer periphery of the annular body toward an inner periphery to wash the lens cover; A means for intermittently injecting a liquid into the proximal end, a mantle tube provided with means for fixing the mantle tube, and a liquid passage for cleaning a lens cover provided in the gap, (4) the in the mantle tube outer wall is gradually reduced distal end diameter
The conical mantle fixture made of flexible resin
And a plurality of annular protrusions are provided on the outer surface of the jacket fixture.
A striated body is formed on the cylindrical outer wall on the tip side of the mantle fixture.
Is a trocar equipped with a balloon. 2. A means for fixing an inner tube and an outer tube having a male screw on an upper outer wall, an annular one end fixed to a lower inner wall, and a cylindrical slit comprising a plurality of slits open at the other end. A sheath-like body and an internal thread provided on an upper portion thereof to be screwed with the male thread to fasten the inner tube with the slit are provided, and a foot portion thereof is screwed with a female screw provided near an opening of the outer tube tip. 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 means for intermittently injecting liquid is provided by depressing 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. 3. The trocar according to claim 1, wherein the liquid flows into the liquid passage from the liquid inlet.