JPH08168465A - Trocar - Google Patents

Abstract

PURPOSE: To clean sufficiently contamination of a lens cover with a liq. by connecting a liq. outlet of a baloon with a liq. run-off tube extending from a liq. outlet of a liq. injecting tool consisting of a housing with an opening part. CONSTITUTION: A means for fixing a lens cover 6 on the apex of an inner covering tube and its base end fixed with an outer covering tube 1 is provided and, on the outer covering tube 1, a liq. cleaning means for inserting the inner covering tube 2 and for cleaning the lens cover 6 on the apex opening, a means 15 for injecting intermittently a liq. on the base end and a means for fixing with the inner covering tube 2, are provided. A gap is provided between the outer wall of the inner covering tube 2 and the inner wall of the outer covering tube 1 and a liq. path 12 for cleaning the lens cover 6 is provided. The liq. injecting opening 15 is connected with a liq. tube of a liq. injecting tool 70 with a baloon filled with a liq. to feed a liq. under pressurized condition for cleaning the lens cover 6 through a liq. path 12.

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, when an endoscope is housed in a trocar to examine a diseased part in a body, a lens cover which is soiled with body fluid is washed. The present invention relates to a trocar for observing an affected part in the body.

[0002]

2. Description of the Related Art Conventionally, in intraperitoneal surgery, laparoscopic surgery has been performed in order to avoid wide skin incision. As a method for forming a fistula in laparoscopic surgery, there are a close method and an open method. The Cloze method introduces carbon dioxide gas into the abdominal cavity with a pneumoperitoneum to inflate the abdominal cavity. Insert the one marked with. In the open method, after a small incision is made in the skin, a blunt needle trocar is inserted, the inner needle is removed, the pneumoperitoneum is inserted from the outer cylinder, and an endoscope is inserted to perform a surgical procedure. In the case of the open method,
Since the fistula to the outside of 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 a trocar-mantle tube is inserted into the abdominal cavity to examine a diseased part in the body, body fluid stains the lens cover of the mantle tube, so that it is not possible to observe a minute diseased part. Because of the image, I often had trouble with the diagnosis. As means for solving such a problem, Japanese Laid-Open Patent Publication No. 6-22902 discloses a laparoscope and a laparoscopic surgery method in which a fluid is passed through the tip to clean the tip.

[0003]

However, such a laparoscope has a drawback that the fluid cannot sufficiently clean the tip because the pressure of the fluid for cleaning the tip is small. In addition, endoscopic observation is performed in the abdominal cavity, but if the observation time is long, gas may leak inside the abdominal cavity and it may not be possible to perform a sufficient examination. There is a need for a means of preventing gas leaks. An object of the present invention is to provide a trocar capable of sufficiently cleaning dirt on the lens cover with a liquid and continuously taking photographs and observing an affected area. Another object of the present invention is to provide a trocar that prevents gas leakage in the abdominal cavity and enables sufficient endoscopic observation.

[0004]

Means for Solving the Problems That is, the present invention provides (1)
A lens cover at the tip and an inner tube provided with means for fixing the outer tube to the base end; and (2) a liquid washing means for inserting the inner tube and washing the lens cover at the tip opening, An outer tube having means for intermittently injecting liquid at the base end and means for fixing the inner tube, (3) in a gap between the outer wall of the inner tube and the inner wall of the outer tube. In a trocar comprising a liquid passage for cleaning the provided lens cover, a liquid injection port stores the liquid under pressure, and a balloon for discharging the liquid from the opening, and the balloon. A trocar connected to a liquid outflow tube extending from a liquid outflow port of a liquid injecting device, which comprises a housing which has a liquid outflow port which is housed and communicated with the opening in the opening.
Is. Further, in the trocar of the present invention, the trocar is slidable on the outer wall of the mantle tube, means for introducing gas into the abdominal cavity, means for preventing the gas from leaking from the abdominal cavity, and the mantle tube for the abdominal wall. And a means for fixing the trocar.

The present invention also provides the above-mentioned trocar, wherein
A means for fixing the inner tube and the outer tube has a male screw on the upper outer wall,
The lower inner wall is provided with a cylindrical cap composed of a plurality of slits, one end of which is annular and one end of which is open, and the other end of which is open, and an upper part is provided with a female screw that is screwed with the male screw to fasten the inner tube with the slit. The foot of the trocar is a trocar comprising a female screw provided near the tip opening of the outer sheath tube and a cylindrical body provided with a male screw for fixing the inner sheath tube and the outer sheath tube.
Furthermore, the present invention provides the lens cover in the trocar.
The cleaning means is a trocar for cleaning the lens cover by injecting a liquid from the outer circumference to the inner circumference of the annular body having a plurality of holes on the circumferential surface. Furthermore, according to the present invention, in the trocar, the means for intermittently injecting the liquid pushes the button of the plunger pushed up by the spring, whereby the liquid inlet and the liquid passage provided on the side of the plunger are connected. The trocar is a trocar in which the shut-off valve is separated and liquid flows into the liquid passage from the liquid inlet.

The present invention also provides the above-mentioned trocar, wherein
The means for fixing the outer tube to the abdominal wall is composed of a conical flexible resin layer whose tip side diameter gradually decreases, and a plurality of annular projecting members are provided on the outer surface of the outer tube and the outer wall of the outer tube. A gas passage is formed in the gap with the flexible resin layer,
The tip of the gap is a trocar which is opened and gas is introduced into the abdominal cavity. Further, the present invention is the above trocar, wherein the means for introducing gas into the abdominal cavity and the means for preventing the gas from leaking from the abdominal cavity are provided with check valves at the gas inlets.

[0007]

[Function] After making a small incision on the skin of the abdominal wall, a blunt needle trocar is inserted and the inner needle is removed. After that, the trocar of the present invention in which the inner tube and the outer tube are fixed at their proximal ends is inserted and fixed from the incision in the abdominal wall until the tip opening of the gas inflow passage of the outer tube fixing device enters the abdominal cavity. Then, a pressurized gas, in particular carbon dioxide gas, flows into the abdominal cavity through the gas inlet of the mantle fixing device. Pressurized gas is prevented from leaking outside by a check valve. After that, 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 to remove the valve.
The liquid contained in the liquid container flows from the liquid injecting device through the liquid passage formed in the gap between the inner tube and the outer tube into the annular cover provided at the distal end of the outer tube from the outer side to the inner side. To wash. And before taking a picture with an endoscope, be sure to press the button on the plunger to wash the lens cover,
Take a picture after sharpening the lens cover.

[0008]

EXAMPLES An example 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 of the present invention, FIG. 2 is a cross-sectional view of the inner tube base end before being fixed to the outer tube base end, and FIG. 3 is a liquid flow of the outer tube base end. It is a sectional view of the entrance,
FIG. 4 is a sectional view of the outer tube fixing device, and FIG. 5 is the trocar of the present invention.
6 is a cross-sectional view of the tip of the balloon, FIG. 6 is a cross-sectional view of the balloon when the balloon is filled with liquid, and FIG. 7 is a connector of the liquid outflow tube of FIG. FIG. 8 is a sectional view of the par adapter, FIG. 8 is an explanatory view showing a state when the connector of FIG. 7 is inserted in the luer taper adapter, and FIG. And FIG. 10 is an explanatory view showing a state in which the syringe and the liquid injection device are not connected, and FIG. 10 is an explanatory view when the balloon is filled with the liquid. In the figure, 1 is an outer tube, 2 is an outer tube, 3 is a proximal end of the outer tube, 4 is a proximal end of the outer tube, 5 is a fixture for the outer tube, 6 is a lens cover, 7 is an annular body, and 8 is an inverted member. A stop valve, 9 is an anchor, 10 is a lock screw, 11 is a spring, 12 is a liquid passage, 13 is a button, 33 is a balloon, and 70 is a liquid injection device.

FIG. 1 is an explanatory view of the trocar of the present invention.
The inner tube 2 is provided with means for fixing the lens cover 6 at the tip and the outer tube 1 at the base 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 tip opening, a means for intermittently injecting a liquid at the base end, and a means for fixing the inner tube 2. 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. The liquid injection port 15 is connected to the liquid tube 62 of the liquid injection device 70 having the liquid-filled balloon 33 so that the liquid under pressure can wash the lens cover 6 through the liquid passage 12. Is supplied to. An outer tube fixing device 5 slidable on the outer tube outer wall is provided in the middle of the outer wall of the outer tube 1.
The mantle tube is fixed to the abdominal wall, and means for inflowing gas into the abdominal cavity and means for preventing the gas from leaking out of the abdominal cavity are provided. The mantle fixing device 5 can be used without being provided when the abdominal cavity is previously inflated with the pneumoperitoneum needle.

FIG. 2 shows the trocar base 3 of the trocar of the present invention.
FIG. 4 is a cross-sectional view of the inner tube base end portion 4 fixedly attached to the upper outer wall of which a male screw 18 is provided, and a lower inner wall of which is formed into a cylindrical shape having a plurality of slits 17 having one end fixed and the other end open. The sheath 21 is formed, and the inner tube 2 is inserted into its inner cavity. Then, as the inner tube 2 is screwed into the female screw 19 formed on the upper portion of the cylindrical body 22, the inner tube 2 held between the slits 17 of the sheath 21 is gradually tightened. The cylindrical body 22 has an internal thread 19 formed on the upper portion thereof, and as described above, the sheath 21
It is designed to be screwed with the male screw 18 of. 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 tip opening of the outer tube to fix the inner tube 2 and the outer tube 1 together.

As shown in the sectional view of the tip of the trocar of the present invention in FIG. 5, the tips of the inner tube 2 and the outer tube 1 fixed in this way are provided with a lens cover 6 at the tip. The outer tube 1 is provided at its front end with an annular slit 7 composed of a plurality of slits. A cuff 14 is formed on the front surface of the annular slit 7 to prevent the annular slit 7 from directly colliding with body fluid. There is a gap between the wall of the outer tube 1 and the wall of the inner tube 2, and a liquid passage 12 through which the liquid supplied from the liquid inflow port 24 passes is formed. The liquid supplied to the liquid passage 12 collides with the wall of the cuff 14 and flows from the outside of the annular body 7 into 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 inflow port 24 is provided at the base end portion 3 of the mantle tube, and as shown in the cross-sectional view of FIG. 3, when the button 13 is pushed, the liquid intermittently flows into the liquid passage 12. ing. The button 13 is normally tensioned outward by a spring 11 and the liquid is closed by a seal member 25 and a valve 26. By pressing the button 13 in such a state, the shaft shifts toward the valve 26 and the cylindrical truncated cone
The valve 26 that has been sealed at the upper end of 27 moves in the direction of the larger diameter of the truncated cone 27, and a gap is formed between the valve 26 and the truncated cone 27 that contacts. Then, as the liquid flows into the liquid passage 12 through the gap, the lens cover 6 is washed with the liquid.

FIG. 6 is a cross-sectional view of a liquid injection device 70 showing an example when the balloon 33 is filled with liquid.
Reference numeral 33 denotes a portion for containing the liquid and a drive portion for moving the liquid to the liquid inlet, and the rod-shaped inner shaft 31
And a cylindrical outer shaft 32 that is slidably mounted on the inner shaft 31.
And a balun 33 provided outside of these shafts, and an inner bearing 34 formed integrally with the inner shaft 31. An umbrella-shaped member 35 is fixed to one end of the outer shaft 32, which is an end opposite to the side covered by the inner shaft 31.

The balloon 33 has a cylindrical shape, a spherical shape, and a flat shape in which the edges of two sheets are sealed, and both of them are covered so as to cover the inner shaft 31 and the outer shaft 32. It is provided outside the shaft, one end of which is fixed to the inner shaft 31 and the other end of which is fixed to the outer shaft 32 in an airtight manner by seal means 36 such as an O-ring. The balloon 33 can be used in various sizes and wall thicknesses depending on the amount of drug solution to be injected into the patient, the time of injection, etc., and is not particularly limited in the present invention. The balloon 33 is expanded by being filled with liquid, and the cylindrical balloon has a structure capable of expanding not only in the radial direction but also in the longitudinal direction.

The outer shaft 32 follows the movement of the balloon 33 and
It moves in the axial direction using 31 as a guide. Its position and bar
Since the relationship with the amount of liquid remaining in the container 33 is constant, the outflow amount of liquid can be confirmed by providing a scale on the inner shaft 31 or the housing 37. If necessary, a water pressure resistant filter 38 is provided at one end of the outer shaft 32 and at the end opposite to the side covered by the inner shaft 31. The water pressure resistant filter 38 is a member that plays a role of expelling the air remaining in the balloon 33 to the outside at the time of liquid injection, and may be made of polyester, fluororesin or a laminate of these. it can.

The balloon 33 is made of an elastic material, which is made of silicone rubber, butyl rubber, acrylonitrile butadiene rubber, butadiene rubber, isoprene rubber,
Urethane rubber, styrene butadiene rubber, perprene,
Elastic polymers such as Kraton rubber or natural rubber, mixtures of these polymers, or processed substances obtained by removing additives of these substances and then adding harmless antioxidants to the human body,
Alternatively, laminate can be used.

An inner bearing 34 is integrally formed with the inner shaft 31 at one end of the inner shaft 31 opposite to the outer shaft 32 exterior side. The inner bearing 34 is a short cylindrical member, and a chemical solution inflow / outflow port is formed at the end portion on the inner shaft 31 side. The liquid outflow port communicates with the liquid flow path 43 of the housing 37 through the inside of the inner bearing 34. The housing 37 prevents the ball 33 from being damaged by touching an external sharp object, and also protects the ball 33 from external damage in the event of liquid leakage from the ball 33 due to defects such as pinholes in the ball itself. It has a function of sealing the liquid so that the liquid does not scatter. Air vent window 40 at appropriate location on housing 37
It is preferable that the window 40 is provided with a hydrophobic filter 41 through which air can pass but liquid cannot pass.

One end surface of the housing 37 is closed by a cap 42, and a liquid is injected into the central portion of the cap 42 into the balloon 33 or the liquid is injected from the balloon 33 to a predetermined position. A liquid channel 43, which serves as a liquid channel at that time, is formed. The liquid flow path 43 is provided with a duckbill type check valve 44, a fixed disk 45 and a seal means 46 from the side of the balloon 33 as shown in FIGS. The duckbill type check valve 44 has a valve closed end shaped like a duckbill's beak, and allows the liquid to flow into the balloon 33, but blocks the flow in the opposite direction. ing. As the check valve 44, an umbrella valve, a flap valve, a poppet valve, a ball valve, and the like can be used in addition to the duck bill type valve, and these valve materials include fluororesin, nylon, polyolefin, and poly-olefin. Examples thereof include vinyl chloride, polycarbonate and silicone resin. The fixed disk 45 supports the substrate of the check valve 44, and has an opening 47 formed at the center for inflow and outflow of liquid. The opening 47 also serves as a liquid outflow portion and a liquid inflow portion.

In FIG. 7, an O-ring as a sealing means 46 is disposed in an annular recess 48 formed by a lock adapter 49 which is a connecting tool and a fixed disk 45.
The inner diameter of the O-ring is the same as or smaller than the outer diameter of the communication pipe, so that the sealing property when the communication pipe 64 is inserted into the liquid flow path 43 is enhanced. The inner surface of the lock adapter 49 is a luer taper
It is a substantially cylindrical connection tool formed into a shape. The lock adapter 49 is fitted in a recess 50 formed in the cap 42. A screw portion 51 for connecting the liquid outflow tube 62 is formed on the outer periphery of the end portion of the lock adapter 49. As shown in FIGS. 9 and 10, the inflow of the liquid into the balloon 33 is performed by inserting the needle base 53 of the syringe 52 of the syringe into the liquid flow path 43, and the outer periphery of the needle base 53 of the syringe 52 is locked with the lock adapter. It is carried out by fitting it on the inner surface of the luer taper shape of 49 and screwing it with the lock adapter 49. 9 and 10, the needle base 53 of the syringe 52 is formed so as to be screwed with the lock adapter-49. However, the outer periphery of the needle base 53 of the syringe 52 is shaped like a luer taper of the lock adapter-49. The liquid may flow into the balloon while pressing it against the inner peripheral surface of. At this time, the needle base 53 is on the inlet side of the check valve 44, and its length is within the range that does not reach the check valve 44, and when the liquid is filled into the balloon, the liquid flows out on the side of the liquid outflow tube 62. To prevent backflow.

As shown in FIG. 7, one end of the connector portion 60 has a length which allows the check valve 44 to be pushed open when it is connected to the lock adapter 49 so as to communicate with the inside of the balloon 33. A pipe 64 is provided. The communication pipe 64 can be made of a synthetic resin such as polycarbonate, polyvinyl chloride, or polyolefin, or a metal such as stainless steel. The communication pipe 64 is fixed to the inner peripheral surface of the connector portion 60. The length of the protruding portion of the communication pipe 64 is set to such a length that the duckbill type check valve 44 can be expanded when the connector portion 60 and the lock adapter 49 are connected as shown in FIG. ing. As a result, the non-return effect of the check valve 44 is forcibly released, and the valve can be removed without using the injection needle.
The liquid filled in the container 33 can be discharged. The threaded portion 65 on the connector portion 60 side is threadedly engaged with the threaded portion 51 formed on the lock adapter 49, so that the ball 33 and the liquid outflow tube.
Connection with 62 is made. This connection may be made by fitting other than screwing.

FIG. 4 is a sectional view of the outer tube fixing device 5. The outer tube fixing device 5 is a conical member for fixing the outer tube 1,
The outer tube 1 is freely slid on the outer wall, and the outer tube 1 is fixed with a lock screw 10 so that the abdominal wall is located at a desired position. The bottom of the mantle tube fixing device 5 is provided with a conical anchor 9 that shields the wound at the surgical site. A plurality of annular protrusions 28 are provided on the outer wall of the anchor 9, and the anchor 9 is inserted into the wound formed in the abdominal wall in advance to form a boundary with the skin when blocking the abdominal cavity with the trocar. Become. Anchor-9 and mantle 1
There is a gap between the outer wall and the outer wall and forms a gas passage 30 through which gas flows into the abdominal cavity. The tip of the anchor 9 is opened as a cylindrical tube so that gas can flow into the abdominal cavity. And at the top of the anchor-9, the O-ring 29
Is provided to securely fix the anchor 9 to the outer wall of the outer 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, natural rubber and the like.

A check valve 8 is provided at the gas inlet 30 to prevent gas from flowing into the atmosphere from the abdominal cavity while flowing in gas entering the abdominal cavity. As the check valve, a duck bill type valve having a shape like a duckbill's beak, an umbrella valve, a flap valve, a poppet valve, a ball valve, or the like is used. When the gas in the abdominal cavity is to be discharged after the operation, the check valve is opened with a thin tube so that the gas in the abdominal cavity is discharged from the lumen of the thin tube. Carbon dioxide or the like is used as the gas. Gas enters the abdominal cavity through the gas passage 30 formed by the gap between the anchor 9 and the outer wall of the outer tube 1.

Next, a method of operating the trocar of the present invention will be described. After making a small incision in the skin of the abdominal wall, a blunt needle trocar
Insert and remove the inner needle. After that, the trocar of the present invention in which the inner tube 2 and the outer tube 1 are fixed at their proximal ends is inserted from the incision in the abdominal wall until the tip opening of the gas inflow passage of the outer tube fixing device enters the abdominal cavity. Next, the gas inlet 15 of the mantle fixing device 5
At first, the pressurized gas flows into the abdominal cavity at a low flow rate. After checking by palpation or percussion that there is no abnormal increase in intraabdominal pressure, switch to a high flow rate so that the intraabdominal pressure becomes 10 to 15 mmHg. Pressurized gas is prevented from leaking outside by a check valve. After that, the endoscope is inserted into the inner cavity of the inner tube 2 and the button 13 provided at the proximal end of the outer tube 1 is pressed to allow the liquid in the balloon 33 to be separated from the inner tube 2 and the outer tube 1. The lens cover 6 is washed from the outer side to the inner side of the annular body 7 provided at the tip of the outer tube 1 through the liquid passage 12 formed in. And before taking a picture with the endoscope, be sure to press the button 13 to wash the lens cover 6 and
Take a picture after sharpening. When the gas in the abdominal cavity is to be discharged after the inspection, use a small-diameter tubular body for gas inlet 15
And the valve of the check valve 8 is opened to allow gas in the abdominal cavity to flow out through the thin tubular body.

[0024]

Since the trocar of the present invention cleans the lens cover by using a liquid in a sufficiently pressurized state, the lens cover is cleanly cleaned, and the inside of the body is smoothly observed by the endoscope.
And you can take a picture.

[Brief description of drawings]

FIG. 1 is an explanatory view of a trocar of the present invention.

FIG. 2 is a cross-sectional view of a proximal end portion of an inner sleeve fixed to a proximal end portion of an outer sheath tube.

FIG. 3 is a cross-sectional view of a liquid inlet at a base end portion of an outer tube.

FIG. 4 is a sectional view of the outer tube fixing device.

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

FIG. 6 is a cross-sectional view of a balloon portion when the balloon is filled with a liquid.

7 is a sectional view of the connector of the liquid outflow tube of FIG. 6 and the luer taper-like adapter of the liquid injection device.

8 is an explanatory view showing a state when the connector of FIG. 7 is inserted into a luer taper-shaped adapter.

FIG. 9 is an explanatory diagram when injecting the liquid in the syringe into the balloon, and is an explanatory diagram showing a state in which the syringe and the liquid injection device are not connected, and FIG.

FIG. 10 is an explanatory diagram when the liquid is filled from the syringe into the balloon.

[Explanation of symbols]

 1 Outer tube 2 Inner tube 3 Outer tube base end 4 Inner tube base end 5 Outer tube fixer 6 Lens cover 7 Annular body 8 Check valve 9 Anchor 10 Lock screw 11 Spring 12 Liquid passage 13 Button 33 Ball- 70 Liquid injection device

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Hajime Tsujikawa 3-9-3 Honjo Nishi, Kita-ku, Osaka Nissho Inc. (72) Inventor Shoji Kawamoto 3-9-3 Honjo-nishi, Kita-ku, Osaka Nissho Co., Ltd.

Claims (7)

[Claims] (1) An inner tube having a lens cover at the tip and a means for fixing an outer tube at the base end, and (2) the inner tube is inserted and the lens cover is washed at the tip opening. A liquid cleaning means, an outer tube provided with means for intermittently injecting liquid at the base end and a means for fixing the inner tube, and (3) an outer wall of the inner tube and the outer tube. In a trocar consisting of a liquid passage for cleaning the lens cover provided in the gap between the inner wall and the inner wall, the liquid injection port stores the liquid under pressure and the liquid flows out from the opening. And a liquid outflow tube extending from the liquid outflow port of the liquid injecting device, which comprises a housing for accommodating the balloon and having a liquid outflow port communicating with the opening at the opening. 2. An outer wall of the outer tube is slidable,
The trocar according to claim 1, comprising means for introducing gas into the abdominal cavity, means for preventing the gas from leaking from the abdominal cavity, and means for fixing the outer tube to the abdominal wall. 3. A cylindrical sheath-like body having a male screw on the upper outer wall, and a lower inner wall having a plurality of slits with one end fixed and the other end open, as means for fixing the inner and outer tubes. ,
A female screw is provided on the upper portion to be screwed with the male screw to fix the inner tube with the slit, and its foot portion is screwed with the female screw provided near the tip opening of the outer tube to form the inner tube. 3. The trocar according to claim 1, comprising a cylindrical body provided with a male screw for fixing the outer tube. 4. The lens cover cleaning means cleans the lens cover by injecting a liquid from the outer circumference to the inner circumference of an annular body having a plurality of holes on its circumferential surface. Trocar. 5. A valve for disconnecting a liquid inlet and a liquid passage provided on a side portion of the plunger is separated by pressing a button of a plunger pushed up by a spring by means for intermittently injecting the liquid. The trocar according to claim 1, wherein the liquid flows into the liquid passage from the liquid inlet. 6. The means for fixing the mantle tube to the abdominal wall comprises a conical flexible resin layer whose tip side diameter gradually decreases,
A plurality of annular ridges are provided on the outer surface of the outer tube, and a gas passage is formed in the gap between the outer wall of the outer tube and the flexible resin layer. The tip of the gap is opened to the abdominal cavity. The trocar according to any one of claims 1 to 5, wherein gas is introduced. 7. The trocar according to any one of claims 1 to 6, wherein a check valve is provided at a gas inlet port of the means for introducing gas into the abdominal cavity and the means for preventing the gas from leaking out of the abdominal cavity. -.