JP3614259B2

JP3614259B2 - Medical treatment insert

Info

Publication number: JP3614259B2
Application number: JP29033896A
Authority: JP
Inventors: 純一三浦; 文広海賀; 稔柴田
Original assignee: Sumitomo Bakelite Co Ltd
Current assignee: Sumitomo Bakelite Co Ltd
Priority date: 1996-10-31
Filing date: 1996-10-31
Publication date: 2005-01-26
Anticipated expiration: 2016-10-31
Also published as: JPH10127643A

Description

【０００１】
【発明の属する技術分野】
本発明は、内視鏡下手術において、気腹法を用いて、臓器を直接手で触れて処置するための処置挿入具に関するものである。
【０００２】
【従来の技術】
近年、低侵襲治療方法として、内視鏡下手術が広く施行されるようになってきた。内視鏡下手術は、主に腹部の諸臓器、例えば、胃、脾臓、腸、胆嚢等の手術を行う際、腹壁に炭酸ガスを注入することにより空間をつくり、そこへトラカール等の器具挿入用筒を複数本刺入し、これより挿入された内視鏡の視野を見ながら、種々の処置具を挿入し、手術をする方法である。従って、本法によると従来の開腹手術に比べ、切開創が極めて小さく、患者へのダメージが少ないというメリットがある。ここで、体内へ炭酸ガスを注入加圧し、腹腔内等に必要な空間を形成せしめることを、気腹法と称せられる。一方、炭酸ガスの注入を行わず、皮下へ鋼線等を刺し込んで腹壁を吊り上げる方法もあり、これを気腹法に対し、吊り上げ法と呼ばれる。現状では、手術のし易さなどから気腹法が多く使われている。しかしながら、こうした内視鏡下手術、特に、気腹法においては、内視鏡で映し出されたモニターの映像を見ながら、実際に手で触れて処置を行っているのではなく、トラカール等の挿入筒より鉗子類等を挿入しての遠隔操作で処置するために、処置や操作が難しかったり、時間がかかるという欠点があり、術者にとってはストレスの大きい術式であるといえる。また、万が一、術中に臓器や大血管を傷つけるような場合には、円筒状のトラカールしか処置ルートがないため、緊急のリカバリー処置が困難となる危険もある。特に、大血管を傷つけた場合、瞬時の内に大出血を引き起こし、最悪の結果となる可能性が高い。更に、癌組織を体外に摘出する際に、腹壁に癌組織が付着し、転移するという欠点もある。
【０００３】
【発明が解決しようとする問題】
本発明は、従来の内視鏡下手術における臓器処置のこのような欠点を解決するもので、その目的とするところは、気腹下で臓器処置を行う際に、直接手で臓器に触れ、確実、安全に短時間で処置でき、更に、気腹ガス漏れがなく、十分な視野の下で処置できることにある。
【０００４】
【課題を解決するための手段】
上記目的を達成するための本発明による医療用処置挿入具は、円筒状シート外周に隣接して、先端側に先バルーン、後端側に後バルーンを形成させ、該円筒状シートの該先バルーン下の周囲に、気液不透過性手袋の袖の部分を気密的に隣接させて付設し、更に、先端が該円筒状シートを通って該先バルーン内に連通した先枝チューブ、および先端部が該後バルーンに連通した後枝チューブより構成され、該先枝チューブと該後枝チューブの後端部には各々接続用コネクターを有する気液開閉装置を付設したことを構造上の特徴とする。
【０００５】
【発明の実施の形態】
以下図面を用いて本発明を詳細に説明する。図１は本発明による医療用処置挿入具の一実施例を示す図であり、図１（ａ）は外観図、（ｂ）は（ａ）の断面図である。図２は他の実施例を示す外観図であり、図３、図４は使用状態を示す概略図である。
【０００６】
本発明による医療用処置挿入具は、図１（ａ）のように、円筒状シート（３）外周に隣接して、先端側に先バルーン（１）、後端側に後バルーン（２）を形成させ、円筒状シート（３）外周の先端側に先バルーン（１）、後端側に後バルーン（２）を形成させ、該円筒状シート（３）の該先バルーン（１）下の周囲に、気液不透過性手袋（１４）の袖の部分を気密的に隣接させて付設し、更に、先端が該円筒状シート（３）を通って該先バルーン内（１）に連通した先枝チューブ（４）、および先端部が該後バルーン（２）に連通した後枝チューブ（５）より構成され、該先枝チューブ（４）と該後枝チューブ（５）の後端部には各々接続用コネクターを有する気液開閉装置を付設している。
【０００７】
先バルーン（１）、および後バルーン（２）は、図１（ｂ）の断面図のように、ドーナツ状で中空の内腔を形成させたバルーンである。通常はブロー成形、ディップ成形、フィルム加工、回転成形などの中空成形等で作製される。それぞれが一体的に成形されても、当然ながら本特許範囲に含まれるものである。また、円筒状シート（３）と先バルーン（１）及び後バルーン（２）が貼り合わされたり、一体化させて形成したり、円筒状シート（３）を内筒とし、その外周に外筒として円筒状シートとを重ね合わせ、その先端部及び中央部で内外筒を接着して、先バルーン（１）と後バルーン（２）を形成させたものでも良い。先バルーン（１）、後バルーン（２）共に、バルーン肉厚は０．１〜２ｍｍ程度の薄肉が好ましく、特に先バルーン（１）は腹壁（７）の３〜１０ｃｍ程度の切開口より体内（６）に挿入するため、薄肉でかさばらない方が有利であり、バルーン内に空気を注入した場合でも、実使用の２倍以上の量を注入しても破裂しない程度の最低限の肉厚が好ましい。円筒状シート（３）の内径は、後バルーン（２）と先バルーン（１）内を通して手、腕（１５）を挿入して処置を行うため、手、腕（１５）が挿入できる程度の径が好ましく、６０〜９０ｍｍ程度が適当である。最外径は９０〜２００ｍｍ程度で、特に先バルーン（１）は体内（６）挿入時かさばらない程度の外径にするのが好ましい。バルーン材質については、例えば、軟質塩化ビニル樹脂、ポリウレタン樹脂、ポリエチレン樹脂、ポリプロピレン樹脂、ポリエステル樹脂、シリコーンゴム、天然ゴムのような適度な柔軟性をもつ材料が好ましいが必ずしもそのような材質に限定する必要はない。先バルーン（１）が空気を注入しない状態で、かさばらず切開口より体内（６）に簡単に挿入でき、体組織を傷つけない程度の柔軟性をもち、また、空気、あるいは水を注入した場合にも実使用の２倍以上の量を注入しても破裂しない程度の十分な破裂強度及び引裂強度をもつ材質を選択することが肝要である。
【０００８】
円筒状シート（３）は肉厚０．１〜２ｍｍの円筒状のシート部材であり、通常、インフレーション成形等で作製されるが特に、これに限定されない。使用上、そのシート内に手、腕（１５）を挿入し、また、切開口で固定されるため、材質は、かさばらず、適度な柔軟性をもつ材質がよく、例えば、軟質塩化ビニル樹脂、ポリウレタン樹脂、ポリエチレン樹脂、ポリプロピレン樹脂、ポリエステル樹脂、シリコーンゴム、天然ゴムのような材料が好ましい。また、内径も５０〜１００ｍｍ程度が適切である。そのシートの外周に、先バルーン（１）と後バルーン（２）を貼り合わせるが、先バルーン（１）と後バルーン（２）の間隔は患者の腹壁（７）の厚さに対応するもので通常１０〜１５ｍｍ程度であるが、特に個人差のある皮下脂肪層の厚みを考慮して５〜３０ｍｍの間で数種準備しておくのが好ましい。そのため、円筒状シート（３）長さは５〜２０ｃｍ程度が適切である。
【０００９】
図１（ａ）断面のように、先枝チューブ（４）は、先端部が円筒状シート（３）内を通って、先バルーン（１）内に開口し、後枝チューブ（５）は先端部が後バルーン（２）内に開口し、各々そこからバルーン部の後端側へ気液流通のために導き出されたチューブである。先枝チューブ（４）は先端部が円筒状シート（３）の内側あるいは外側のどちらを通っても、先バルーン（１）に開口していれば良い。また、先枝チューブ（４）及び後枝チューブ（５）は、図１（ａ）のように各々独立したチューブでも良いが、図２に示すようにバルーン後端部近傍は互いに一体化されたチューブで２つの流通路をもつ２腔チューブ（８）を用い、後方の位置に分岐部（９）を設けて枝分かれしても良い。材質としては、例えば、軟質塩化ビニル樹脂、ウレタン樹脂、シリコーンゴム、天然ゴムのような適度な柔軟性と硬度をもつ材料を使用し、押出成形された内径０．３〜３ｍｍ、肉厚０．３〜２ｍｍのチューブが好ましい。また、枝チューブ（４）（５）の長さは、術者が様々な処置具を使用するのに支障にならないように、３０〜３００ｍｍ程度が適当である。
【００１０】
更に、先枝チューブ（４）および後枝チューブ（５）の後端部には、それぞれ気液開閉装置（１０）（１１）であるコネクターを有する逆止弁、２方コック、もしくは３方コック等が連結されており一般的なバルーンの膨張注入器具である注射筒の着脱により、簡便に開閉できる構造となっている。また、枝チューブ（４）（５）と気液開閉装置（１０）（１１）の間にはパイロットバルーン（１２）（１３）が連結されても良く、この場合、パイロットバルーン（１２）（１３）は、バルーン部（１）（２）のバルーン膨張状況のモニターができるように、例えば、軟質塩化ビニル樹脂、ウレタン樹脂、シリコーンゴム、天然ゴム等の適度な柔軟性と弾力性を有する材料で成形されている。
【００１１】
手袋（１４）は腹壁（１６）の切開口より先バルーン（１）と一緒に体内（６）に挿入されるため、かさばらない方が有利であり、０．１〜２ｍｍ程度の肉薄のシートが好ましい。また、この仕様は気腹下で使用され、体内（６）の気密を保つため、手袋（１４）には気密性が必要であり、手袋（１４）は先バルーン（１）内壁外周、あるいは円筒状シート（３）下部に手袋（１４）の袖の部分を気密的に隣接させて使用される。手袋（１４）と円筒状シート（３）が貼り合わされたり、一体化されて形成しても良い。材質については、例えば、軟質塩化ビニル樹脂、ポリウレタン樹脂、ポリエチレン樹脂、ポリプロピレン樹脂、ポリエステル樹脂、シリコーンゴム、天然ゴムのような適度な柔軟性をもつ材料が好ましいが必ずしもこの限りでない。手袋（１４）が直接臓器に触れることがあるため、臓器に傷をつけず、また、通常の使用で裂けたり、穴が開いて気腹ガスが漏れない程度の引裂強度を持つ材質を選択することが肝要である。
【００１２】
本発明による医療用処置挿入具の使用に当たっては、例えば、図３に示すように腹壁（７）の切開口から、先バルーン（１）を手で小さくし、体内（６）に挿入する。挿入後、気液開閉装置（１０）（１１）から、シリンジ等を用いて空気または水を注入することにより先バルーン（１）を膨張させる。ここで、この医療用処置挿入具を引いて腹壁（７）内側に先バルーン（１）を密着させた後、後バルーン（２）を同様にして体外で膨張させ、腹壁（７）を先バルーン（１）と後バルーン（２）の２つのバルーン膨張部で挟み込むようにして、気密的に医療用処置挿入具を体表に固定する。円筒状シート（３）及び手袋（１４）により、体内の気密が保たれ、手袋（１４）のシート１枚を介した状態で、体外と体内（６）の挿入路が通じ、手、腕（１５）を円筒状シート（３）に通して手袋（１４）に装着した後に手袋（１４）を介して手で直接、処置を行うことができる。
また、切除した臓器を手袋（１４）の中に入れ、ひっくり返して、体外に摘出することにより、腹壁に癌組織が付着せずに摘出が行うことが出来、癌組織の転移を予防することが出来る。
【００１３】
【発明の効果】
本発明の医療用処置挿入具は腹壁の切開口より挿入する時、かさばりがなく、また、バルーンの適度な柔軟性のため、安全に容易に挿入できる。また、２個のバルーン膨張部をもち、体内と体外表面でバルーンを膨張させることにより、切開口を体内外から挟み込むように固定でき、医療用処置挿入具を気密的に確実に固定することができる。バルーンが柔軟なため、小切開口についても損傷する恐れがない。膨張したバルーン内部で、体外と体内が通じるため、体外から体内に手を容易に挿入して直接手で臓器処置あるいは摘出を行え、確実、安全に短時間で処置することができる。また、膨張バルーンは操作角度に追随して自由に変形し、臓器処置を容易に行うことができる。更に、癌組織を体外に取り出すときにも腹壁に付着することがなく取り出すことが出来るため、転移の心配がない。気密性に関しても、円筒状シートの先バルーン下の周囲に気液不透過性の手袋を気密的に隣接させて付設することにより気腹ガス漏れがなく、十分な空間を体内に保て、良好な視野の下で安全、短時間で処置が行うことができ、内視鏡下手術で処置を行う場合、極めて有用である。
【図面の簡単な説明】
【図１】（ａ）気腹法で目的を達成するための本発明による医療用処置挿入具の一実施例を示す図である。
（ｂ）気腹法で目的を達成するための本発明による医療用処置挿入具の一実施例を示す断面図である。
【図２】気腹法で目的を達成するための本発明による医療用処置挿入具の他の実施例を示す図である。
【図３】本発明による医療用処置挿入具の使用状態を示す概略図である。
【図４】本発明による医療用処置挿入具の手を挿入したときの使用状態を示す概略図である。
【符号の説明】
１．先バルーン
２．後バルーン
３．円筒状シート
４．先枝チューブ
５．後枝チューブ
６．体内
７．腹壁
８．２腔チューブ
９．分岐部
１０．１１．気液開閉装置
１２．１３．パイロットバルーン
１４．手袋
１５．手、腕[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a treatment insertion tool for directly touching an organ with a hand by using a pneumoperitoneum in an endoscopic operation.
[0002]
[Prior art]
In recent years, endoscopic surgery has been widely performed as a minimally invasive treatment method. Endoscopic surgery mainly creates a space by injecting carbon dioxide into the abdominal wall when performing operations on various organs of the abdomen, such as the stomach, spleen, intestine, and gallbladder, and inserting instruments such as trocars there. In this method, a plurality of medical tubes are inserted, and various treatment tools are inserted while seeing the field of view of the endoscope inserted from the tube. Therefore, according to this method, there is an advantage that the incision is extremely small and the damage to the patient is small as compared with the conventional laparotomy. Here, injecting and pressurizing carbon dioxide into the body to form a necessary space in the abdominal cavity or the like is called a pneumoperitoneum method. On the other hand, there is also a method of lifting the abdominal wall by inserting a steel wire or the like under the skin without injecting carbon dioxide, which is called a lifting method as opposed to the pneumoperitoneum method. At present, the pneumoperitoneum method is often used because of the ease of surgery. However, in such endoscopic surgery, especially in the pneumoperitoneum method, the user does not actually perform the treatment by touching the hand while watching the monitor image projected by the endoscope, but inserts a trocar or the like. Since the treatment is performed remotely by inserting forceps or the like from the tube, there are disadvantages that treatment and operation are difficult and time consuming, and it can be said that this is a technique with great stress for the surgeon. In the unlikely event that an organ or a large blood vessel is injured during an operation, there is a risk that an emergency recovery procedure becomes difficult because only a cylindrical trocar has a treatment route. In particular, when a large blood vessel is injured, it is likely to cause major bleeding within an instant, resulting in the worst result. Furthermore, when the cancer tissue is removed from the body, the cancer tissue adheres to the abdominal wall and metastasizes.
[0003]
[Problems to be solved by the invention]
The present invention solves such drawbacks of organ treatment in conventional endoscopic surgery, the purpose of which is to touch the organ directly by hand when organ treatment under pneumoperitoneum, The treatment is reliable and safe in a short time, and there is no insufflation gas leakage and treatment can be performed under a sufficient field of view.
[0004]
[Means for Solving the Problems]
In order to achieve the above object, a medical treatment insertion tool according to the present invention has a front balloon formed on the front end side and a rear balloon formed on the rear end side adjacent to the outer periphery of the cylindrical sheet, and the front balloon of the cylindrical sheet is formed. In the lower periphery, a sleeve portion of a gas-liquid impermeable glove is attached so as to be airtightly adjacent to each other, and a tip branch tube having a tip communicating with the inside of the tip balloon through the cylindrical sheet, and a tip portion Is composed of a rear branch tube communicating with the rear balloon, and a structural feature is that a gas-liquid opening / closing device having a connector for connection is provided at the rear ends of the front branch tube and the rear branch tube, respectively. .
[0005]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the present invention will be described in detail with reference to the drawings. FIG. 1 is a view showing an embodiment of a medical treatment insertion tool according to the present invention, FIG. 1 (a) is an external view, and FIG. 1 (b) is a cross-sectional view of FIG. FIG. 2 is an external view showing another embodiment, and FIGS. 3 and 4 are schematic views showing a use state.
[0006]
As shown in FIG. 1 (a), the medical treatment insertion tool according to the present invention has a front balloon (1) on the front end side and a rear balloon (2) on the rear end side, adjacent to the outer periphery of the cylindrical sheet (3). The front balloon (1) is formed on the front end side of the outer periphery of the cylindrical sheet (3), the rear balloon (2) is formed on the rear end side, and the cylindrical sheet (3) is surrounded around the front balloon (1). In addition, the sleeve portion of the gas-liquid impermeable glove (14) is attached so as to be airtightly adjacent to each other, and the tip communicates with the inside of the tip balloon (1) through the cylindrical sheet (3). A branch tube (4) and a rear branch tube (5) whose front end communicates with the rear balloon (2) are configured, and the front branch tube (4) and the rear branch tube (5) have rear ends. A gas-liquid switchgear having a connector for each connection is attached.
[0007]
The front balloon (1) and the rear balloon (2) are donut-shaped balloons having a hollow lumen as shown in the sectional view of FIG. 1 (b). Usually, it is produced by hollow molding such as blow molding, dip molding, film processing, and rotational molding. Even if they are integrally molded, they are naturally included in the scope of this patent. Further, the cylindrical sheet (3), the front balloon (1) and the rear balloon (2) are bonded together or formed integrally, or the cylindrical sheet (3) is used as an inner cylinder, and an outer cylinder is provided on the outer periphery thereof. The front balloon (1) and the rear balloon (2) may be formed by superimposing a cylindrical sheet and bonding the inner and outer cylinders at the front end and the center. Both the front balloon (1) and the rear balloon (2) preferably have a thin wall thickness of about 0.1 to 2 mm. In particular, the front balloon (1) has a body (from the incision of about 3 to 10 cm in the abdominal wall (7) ( 6) It is advantageous to be thin and not bulky because it is inserted into 6), and even if air is injected into the balloon, the minimum thickness is such that it will not rupture even if it is injected twice or more of the actual use. preferable. The inner diameter of the cylindrical sheet (3) is such that the hand and arm (15) can be inserted because the treatment is performed by inserting the hand and arm (15) through the rear balloon (2) and the front balloon (1). Is preferably about 60 to 90 mm. The outermost diameter is about 90 to 200 mm, and the tip balloon (1) preferably has an outer diameter that is not bulky when inserted into the body (6). As for the balloon material, for example, a material having appropriate flexibility such as soft vinyl chloride resin, polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber, and natural rubber is preferable, but it is not necessarily limited to such material. There is no need. When the tip balloon (1) does not inject air, it is not bulky and can be easily inserted into the body (6) through the incision, and has sufficient flexibility not to damage the body tissue, or when air or water is injected In addition, it is important to select a material having a sufficient burst strength and tear strength that does not rupture even when an amount more than twice that of actual use is injected.
[0008]
The cylindrical sheet (3) is a cylindrical sheet member having a thickness of 0.1 to 2 mm, and is usually produced by inflation molding or the like, but is not particularly limited thereto. In use, since the hand and arm (15) are inserted into the sheet and fixed by the incision, the material is not bulky, and a material having an appropriate flexibility is good. For example, soft vinyl chloride resin, Materials such as polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber and natural rubber are preferred. Also, an inner diameter of about 50 to 100 mm is appropriate. The front balloon (1) and the rear balloon (2) are bonded to the outer periphery of the sheet. The distance between the front balloon (1) and the rear balloon (2) corresponds to the thickness of the patient's abdominal wall (7). Usually, the thickness is about 10 to 15 mm, but it is preferable to prepare several kinds in the range of 5 to 30 mm in consideration of the thickness of the subcutaneous fat layer having individual differences. Therefore, the length of the cylindrical sheet (3) is suitably about 5 to 20 cm.
[0009]
As shown in the cross section of FIG. 1 (a), the leading branch tube (4) has a distal end that passes through the cylindrical sheet (3) and opens into the leading balloon (1), and the rear branch tube (5) has a leading end. Each part is a tube that opens into the rear balloon (2) and is led from there for the gas-liquid flow to the rear end side of the balloon part. The leading branch tube (4) may be open to the leading balloon (1) regardless of whether the tip portion passes inside or outside of the cylindrical sheet (3). The front branch tube (4) and the rear branch tube (5) may be independent tubes as shown in FIG. 1 (a), but the vicinity of the balloon rear end is integrated with each other as shown in FIG. A two-lumen tube (8) having two flow paths in the tube may be used, and a branch portion (9) may be provided at a rear position to branch the tube. As a material, for example, a material having an appropriate flexibility and hardness such as soft vinyl chloride resin, urethane resin, silicone rubber, and natural rubber is used. A 3-2 mm tube is preferred. The length of the branch tubes (4) and (5) is suitably about 30 to 300 mm so as not to hinder the surgeon from using various treatment tools.
[0010]
Further, a check valve, a two-way cock, or a three-way cock having connectors that are gas-liquid opening / closing devices (10) and (11), respectively, at the rear ends of the front branch tube (4) and the rear branch tube (5). Are connected to each other, and can be easily opened and closed by attaching and detaching a syringe barrel which is a general balloon inflation and injection device. A pilot balloon (12) (13) may be connected between the branch tubes (4) (5) and the gas-liquid opening / closing devices (10) (11). In this case, the pilot balloons (12) (13) ) Is a material having appropriate flexibility and elasticity such as soft vinyl chloride resin, urethane resin, silicone rubber, natural rubber, etc., so that the balloon expansion status of the balloon portions (1) and (2) can be monitored. Molded.
[0011]
Since the glove (14) is inserted into the body (6) together with the balloon (1) beyond the incision of the abdominal wall (16), it is advantageous not to be bulky, and a thin sheet of about 0.1 to 2 mm is used. preferable. In addition, this specification is used under an insufflation, and in order to keep the body (6) airtight, the glove (14) needs to be airtight. The glove (14) is the outer periphery of the inner wall of the tip balloon (1) or a cylinder. The sleeve of the glove (14) is airtightly adjacent to the lower part of the sheet (3). The glove (14) and the cylindrical sheet (3) may be bonded together or formed integrally. As for the material, for example, a material having appropriate flexibility such as soft vinyl chloride resin, polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber, and natural rubber is preferable, but not necessarily limited thereto. Since the gloves (14) may touch the organs directly, select a material that does not damage the organs, and that has a tear strength that does not cause tearing during normal use, or that does not allow gas to escape from pneumoperitoneum. It is important.
[0012]
In using the medical treatment insertion tool according to the present invention, for example, as shown in FIG. 3, the tip balloon (1) is made small by hand from the incision in the abdominal wall (7) and inserted into the body (6). After the insertion, the front balloon (1) is inflated by injecting air or water from the gas-liquid opening and closing devices (10) and (11) using a syringe or the like. Here, after pulling this medical treatment insertion tool and bringing the front balloon (1) into close contact with the inside of the abdominal wall (7), the rear balloon (2) is inflated outside the body in the same manner, and the abdominal wall (7) is inflated to the front balloon. The medical treatment insertion tool is fixed to the body surface in an airtight manner so as to be sandwiched between two balloon inflating portions of (1) and the rear balloon (2). The cylindrical sheet (3) and the gloves (14) maintain the airtightness in the body, and the insertion path between the outside and the body (6) passes through one sheet of the glove (14), and the hand, arm ( After 15) is passed through the cylindrical sheet (3) and attached to the glove (14), the treatment can be performed directly by hand through the glove (14).
In addition, by putting the excised organ in a glove (14), turning it over and removing it from the body, it can be excised without cancerous tissue adhering to the abdominal wall, and prevent cancerous tissue metastasis. I can do it.
[0013]
【The invention's effect】
The medical treatment insertion tool of the present invention is not bulky when inserted through the incision in the abdominal wall, and can be safely and easily inserted due to the appropriate flexibility of the balloon. In addition, by having two balloon inflating parts and inflating the balloon between the inside and outside of the body, the incision can be fixed so as to be sandwiched from inside and outside, and the medical treatment insertion tool can be fixed in an airtight and reliable manner. it can. Because the balloon is flexible, there is no risk of damage to the slit opening. Since the inside of the inflated balloon communicates between the outside of the body and the inside of the body, a hand can be easily inserted into the body from outside the body, and the organ treatment or extraction can be performed directly by hand, so that treatment can be performed reliably and safely in a short time. Further, the inflatable balloon can be freely deformed following the operation angle, and organ treatment can be easily performed. Furthermore, when cancer tissue is taken out of the body, it can be taken out without adhering to the abdominal wall, so there is no worry of metastasis. Regarding airtightness, gas-liquid impervious gloves are attached adjacent to the bottom of the balloon at the end of the cylindrical sheet in an airtight manner to prevent gas leakage due to gastrointestinal gas. It is possible to perform treatment safely and in a short time under a clear visual field, and is extremely useful when performing treatment by endoscopic surgery.
[Brief description of the drawings]
FIG. 1A is a diagram showing an embodiment of a medical treatment insertion tool according to the present invention for achieving an object by a pneumoperitoneum method.
(B) It is sectional drawing which shows one Example of the medical treatment insertion tool by this invention for achieving an objective by the pneumoperitoneum method.
FIG. 2 is a view showing another embodiment of the medical treatment insertion tool according to the present invention for achieving the object by the pneumoperitoneum method.
FIG. 3 is a schematic view showing a use state of the medical treatment insertion tool according to the present invention.
FIG. 4 is a schematic view showing a use state when a hand of the medical treatment insertion tool according to the present invention is inserted.
[Explanation of symbols]
1. Point balloon 2. Rear balloon 3. Cylindrical sheet 4. 4. Branch tube 5. 5. Rear branch tube Inside the body 7. Abdominal wall 8.2 lumen tube 9. Branch 10.11. Gas-liquid switchgear 12.13. Pilot balloon 14. Gloves 15. Hands, arms

Claims

Adjacent to the outer periphery of the cylindrical sheet, a front balloon is formed on the front end side and a rear balloon is formed on the rear end side, and a sleeve portion of a gas-liquid impermeable glove is sealed around the cylindrical sheet below the front balloon. And a tip branch tube having a tip communicating with the inside of the tip balloon through the cylindrical sheet, and a tip branch tube having a tip portion communicating with the back balloon. A medical treatment insertion tool characterized in that a gas-liquid switching device having a connector for connection is attached to the rear end of the tube and the rear branch tube.

The medical treatment insertion tool according to claim 1, wherein the cylindrical sheet and a gas-liquid impermeable glove are bonded to each other.

The medical treatment insertion tool according to claim 1, wherein the cylindrical sheet, the front balloon and the rear balloon are bonded together.

2. The medical device according to claim 1, wherein a cylindrical sheet is used as an inner cylinder, and a cylindrical sheet as an outer cylinder is superposed on the outer periphery of the cylindrical sheet, and the inner and outer cylinders are bonded to each other at the front end portion and the center portion to form a front balloon and a rear balloon. Treatment inserter.

The medical treatment insertion tool according to claim 1, wherein the length of the cylindrical sheet is 5 to 20 cm and the inner diameter of the cylindrical sheet is 5 to 10 cm.