JP2000166931A - Medical treating and inserting tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical treating and inserting tool by which a lesion is observed and additionally treated in re-pneumoperitoneum after putting an organ back into a body. SOLUTION: An outer baloon 2 is formed at a proximal end, and an inner baloon 3 is at a distal end to be adjacent to the outer periphery of a first cylindrical sheet 1 having an inserting port at the proximal end and an exit at the distal end. An outer baloon tube 4 whose distal end communicates with the outer baloon and an inner baloon tube 5 whose end communicates with the inner baloon through the first cylindrical sheet 1 are installed. An abdominal wall airtight device 8 installing gas- liquid opening/closing devices 6 which are respectively provided with a connector for connection at the rear ends of the outer baloon tube and the inner baloon tube is arranged, and a clamping member for clamping the second cylindrical sheet and airtightly closing the inner part of the second cylindrical sheet is arranged at the proximal end of the second cylindrical sheet 9 having the inserting port at the proximal end and the exist at the distal end. Then a sleeve 12 is also disposed, which is provided with a fixing member 11 connected to the outer baloon of the abdominal wall airtight device to close a part with the outer baloon at the distal end of the second cylindrical sheet.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic surgical operation, in which a surgeon inserts his or her hands and arms while maintaining insufficiency in the body and performs treatment while directly touching an organ.
A medical procedure for once releasing the insufflation and removing the organ from the body for treatment, or for returning the organ to the body and performing the insufflation operation again, confirming the affected area under an endoscope, and performing additional treatment The present invention relates to a tool insertion tool.

[0002]

2. Description of the Related Art In recent years, endoscopic surgery has been widely practiced as a method of minimally invasive surgery. Endoscopic surgery is mainly used when performing operations on various organs of the abdomen, such as the stomach, spleen, intestine, and gallbladder, by injecting carbon dioxide into the abdominal wall to form a treatment space, into which trocars and the like are placed. In this method, a plurality of mantle tubes for inserting a treatment instrument are inserted, an endoscope and a treatment tool are inserted, and surgery is performed by remote control while viewing an image viewed from the endoscope on a screen. Therefore, since the incision wound is smaller than that of the conventional laparotomy, the incision mark after the operation can be made small so as not to be conspicuous and is cosmetically effective. Therefore, there are great benefits for patients and hospitals.

On the other hand, an operator who actually performs an operation performs an operation by operating a plurality of treatment tools such as forceps by remote control while watching an image projected on an endoscope on a screen. Since it is not possible to actually touch the internal organs and the affected area by hand, it is necessary to perform a careful treatment, and the operator's stress is further increased especially in a long operation. In addition, if an organ or a blood vessel is injured during the operation, only treatment through the trocar can be performed, and in the worst case, it may be necessary to shift to open treatment. Furthermore, for example, when cancer tissue is taken out of the body during or after surgery, or when the operation is shifted to intraoperative laparotomy, the organ is taken out from the incision.At that time, there is a risk that the cancer tissue will adhere to the abdominal wall and metastasize. Was.

In order to solve these problems, a structure having an outer sleeve and two sealing means is used to enter the abdominal cavity through a small opening and form an airtight space in the outer sleeve using the two sealing means. The device is USP56
No. 40977. This device can perform treatment of internal organs in a state of insufficiency when the operator's hand and arm are inserted into the body through the device, and if the third sealing means is used, the arm is pulled out Even in this state, the airtightness of the sleeve and the body can be maintained. However, this device has a structure in which the sleeve part is adhered to the drape placed on the patient's body surface when the operator wants to pull out the internal organs from the body for treatment, so that the upper part can be separated from the adhesive part. Therefore, unless the drape is cut out and the entire device is once taken out or the sleeve portion is cut out, the organ cannot be taken out of the body and treated. If the device is taken out, cancer tissue may adhere to the abdominal wall. If the sleeve is cut off, insufflation may be performed again after the treatment outside the body, and observation and treatment cannot be performed in the abdominal cavity.

[0005] In addition, with a basically similar structure, the sleeve and the abdominal wall fixing portion are separated, and a ring at the distal end of the sleeve,
A device to snap and fix the ring of the abdominal wall fixing part is U
It is disclosed in SP5813409. With this device, the sleeve and the abdominal wall fixing part can be separated, so the internal organs inside the body can be pulled out and treated while the sleeve part is removed, leaving the abdominal wall fixing part on the abdominal wall, so that cancer tissue may adhere to the incision. Instead, after the treatment is completed, the organ can be returned to the body, the sleeve can be fixed again, and observation and treatment can be performed under insufflation. However, it is difficult to fit the sleeve and the ring of the abdominal wall fixture over the entire circumference by snap, and if there is an insufficiently fitted portion, airtightness cannot be maintained.

[0006] The two USP related products are sold in the United States under the trade name PneumoSleeve. This is Adhesive Base, Protracto
r, Pneumo Sleep, Pneumo Do
me and the like. First, Adhesiv with adhesive applied to the back surface to create airtightness between the body surface and this device
e Base is attached to the periphery of the incision, the incision of the required size is made, the hand is inserted into the incision, the size of the incision is confirmed, and the flat ring made of two flexible elastic bodies and the flexible Protracto made of thin cylindrical sheet
The inner ring of r is bent and inserted into the body through the incision, and the length of the cylindrical sheet is adjusted to the thickness of the abdominal wall while twisting and winding up the outer ring. It serves as a wind protect to prevent incisions in the abdominal wall from adhering to cancerous tissue.

[0007] It is made of a flexible thin cylindrical upper sheet, one end of which is sealed except for a part where a finger of a hand can enter, and the other end of which has a grooved cylindrical shape so that it can be air-tightly connected to Adhesive Base. A ring is attached.
Pneumo Sleep has a structure that can be fitted to the convex portion on the inner periphery of the dhesive Base-like surface.
The ve is attached to the operator's arm, the fingers are protruded, and surgical gloves are worn thereon. This creates a tight seal between the surgeon's arm and the device.

[0008] Next, a grooved cylindrical ring of Pneumo Sleeve is fitted into the Adhesive Base, and Pneumo Sleep and Adhesive are inserted.
An airtightness between Bases can be formed, and an airtight space in the body and the sleeve can be formed therein. Also, Pne
Umo Sleepe is easy to pull Pneum by pulling the tab attached to the grooved cylindrical ring from the inside.
o In order to remove the sleep, it is also possible to once drop the pungent stomach and draw the organ out of the body to perform the operation. Furthermore, instead of Pneumo Sleepe, by inserting a PneumoDome formed of a slotted cylindrical opening with a valve, a grooved cylindrical ring, and a flexible thin sheet for inserting forceps, etc., the forceps can also be used from this route under pneumoperitoneum. It can be introduced.

[0009] However, Adhesive Base can be firmly fixed to the body surface, but causes long-term use of the skin, and Adhesive Base and Pneumo.
When the sleeve is fixed, the rings must be completely fitted over the entire circumference, and if any of the rings is not properly fitted, the operation cannot be continued because the airtight state cannot be maintained. In addition, Protractor adjusts the length of the cylindrical sheet to the thickness of the abdominal wall while twisting and winding up the outer ring many times, but if the sheet is not sufficiently wound up, it will be turned up when the organ is pulled out and cancer tissue will be turned up. It is conceivable that it becomes impossible to stop bleeding if it adheres or there is slight bleeding from the incision. Furthermore, the number of parts is large and the operation is complicated, resulting in an expensive configuration.

[0010] A similar device has recently been marketed in Japan under the trade name Handport. This is Retrac
tor Base, Sleep, Bracelet,
It consists of an Insufflation Cap. The Retractor Base consists of a grooved extracorporeal balloon, an intracorporeal ring, an airway tube and an insufflator, while the Slave has one end tapered and possibly an elastic ring member, and the other An elastic ring-shaped fixing member is attached to the end. Bracelet is large enough to be attached to the wrist and has one end broken so that the inner circumference can be adjusted by a stopper. In fact, if you use Retract
In Or Base, the body ring is inserted into the body through the incision, and the extracorporeal balloon is inflated using an air supply device and fixed to the abdominal wall.

Next, the surgeon puts a Bracelet on the wrist between the two gloves in advance under the glove in the case of one glove. As the hand is inserted into the sleeve, the end of the sleeve is narrowed down, and the elastic ring is fixed at the Bracelet portion and hermetically sealed. Next, the airtightness of the inside of the body and the inside of the sleeve is maintained by fitting the elastic ring-shaped fixing member of Sleep into the groove of the Retractor Base. Also, when returning from a procedure in which a hand has been inserted to a normal procedure, Re
Insufflation with one flexible thin cylindrical shape sealed to close the entrance of the tractor base and an elastic ring-shaped fixing member attached to the other
The Cap can be attached to an extracorporeal balloon of the Retractor Base.

However, it is difficult to operate the Bracelet under the surgical glove in the manner of forming the sealing means on the wrist side, and the elastic ring-shaped fixing member of Sleep is arranged airtight with the Bracelet. Operation is also difficult. Especially for wrists with thin wrists
May be wrinkled when tightened, and the airtightness may not be maintained. Also, if Bracelet does not fit the size of the wrist, it cannot be used. Also, Ins
The operation of the UF cap has to be done once when moving to a normal procedure, which complicates the operation. R
Since the extractor base has a structure in which the abdominal wall is sandwiched between the body ring and the extracorporeal balloon, the width corresponding to a patient having a difference in the thickness of the abdominal wall is smaller than the aforementioned pneumo sleeve.

Japanese Patent Laid-Open No. 10-108868 discloses a valve and a valve-equipped trocar jacket which can prevent the insufflation gas from leaking from the abdominal cavity irrespective of the type of forceps to be used without using an adapter. It is disclosed in the gazette. This valve has a flexible cylindrical seat between two rings,
By twisting the two rings in opposite directions, it is possible to insert forceps or arms having different outer diameters to perform treatment inside the body. However, in this method, since the forceps and the like are fixed while being squeezed by the valve, there is a disadvantage that it is difficult to move forward and backward. Also,
When the arm is inserted, the thickness of the arm is changed particularly by the forward and backward movement, so that it becomes more difficult to maintain airtightness in some cases, and it is necessary to adjust the throttle of the valve.

An apparatus for forming two balloons on the outer periphery of a cylindrical sheet and fixing the balloon to the abdominal wall is disclosed in Japanese Patent Laid-Open No. 10-12 / 1998.
No. 7642, Japanese Patent Application Laid-Open No. 10-127644, and Japanese Patent Application Laid-Open No. 10-127644. Japanese Patent Application Laid-Open No. 10-127742 cannot operate under pneumoperitoneum.
In Japanese Patent No. 27644, operation can be performed under insufflation, but gas-liquid impermeable gloves and a sleeve are not detachable, and internal organs are temporarily pulled out of the body for treatment. In this case, gas-liquid-impermeable gloves and sleeves have to be cut off or the device itself has to be removed from the abdominal wall.

[0015]

SUMMARY OF THE INVENTION The present invention solves such a drawback of the conventional endoscopic surgery, and its object is to provide a method for performing organ treatment under pneumoperitoneum. The organs can be directly touched by hand, and safe and reliable treatment can be performed in a short time without leaking pneumoperitoneum gas.If further treatment is necessary outside the body, stop pneumoperitoneum and leave the infection prevention device inside. The organ is taken out of the patient, the treatment is performed, the organ is returned to the body again, and the affected part can be observed and additional treatment can be performed under re-inflation.

[0016]

SUMMARY OF THE INVENTION The present invention comprises an outer balloon at a proximal end adjacent to the outer periphery of a first cylindrical sheet having an insertion port at a proximal end and an outlet at a distal end. Forming an inner balloon at the distal end, a tube for the outer balloon having a distal end communicating with the outer balloon, and a tube for the inner balloon having a distal end communicating with the inner balloon through the cylindrical sheet. At the rear end of the balloon tube and the inner balloon tube, an abdominal wall airtight device provided with a gas-liquid opening / closing device having a connector for connection, and a second cylinder having an insertion port at the proximal end and an outlet at the distal end. At the proximal end of the cylindrical sheet, a second cylindrical sheet is fastened, and a fastening member for closing the inside of the second cylindrical sheet airtightly is provided. Further, at the distal end of the second cylindrical sheet, an abdominal wall is provided. Equipped with a fixing member that can be airtightly connected to the outer balloon of the airtight device. A medical treatment insertion tool, characterized in that it consists of the sleeve.

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be specifically described below with reference to the drawings. 1 and 2 show a medical treatment insert according to an embodiment of the present invention. FIG. 1 is an external view, and FIG. 2 is a sectional view of FIG. 3 and 4 show a medical treatment insert according to another embodiment of the present invention. FIG.
FIG. 4 is a sectional view of FIG. FIG. 5 shows the shape of the sleeve of the medical treatment insertion tool according to one embodiment of the present invention.
6 to 9 are schematic views showing the method of use, FIG. 6 shows a state in which the abdominal wall airtight device is fixed to the abdominal wall, FIG. 7 shows a state in which the operator's hand is inserted into the sleeve to make it airtight, and FIG. FIG. 9 is a diagram showing a state in which the airtight device and the sleeve are connected and insufflated, and FIG. 9 shows a state in which the arm is pulled out by fastening the sleeve with the second fastening member.

A medical treatment insert according to the present invention, as shown in FIG. 1, has a proximal end adjacent to the outer periphery of a first cylindrical sheet (1) having an insertion port at a proximal end and an outlet at a distal end. An outer balloon (2) is formed at the end, an inner balloon (3) is formed at the distal end, a tube (4) for an outer balloon having a distal end communicating with the outer balloon (2), and a first cylindrical sheet at the distal end. An inner balloon tube (5) connected to the inner balloon (3) through (1) is provided, and further connected to the outer balloon tube (4) and the rear end of the inner balloon tube (5), respectively. Abdominal wall airtight device (8) provided with gas-liquid opening / closing devices (6) and (7) having connectors for use, and a second cylindrical sheet (9) having an insertion port at a proximal end and an outlet at a distal end. To the proximal end of the second cylindrical sheet (9), to hermetically close the inside of the second cylindrical sheet (9) A fastening member (10) is attached, and further, the distal end of the second cylindrical sheet (9) is connected to the outer balloon (2) of the abdominal wall airtight device (8), and the space between the outer balloon (2) and the outer balloon (2) is established. It consists of a sleeve (12) with a fixing member (11) which closes hermetically.

Among the members constituting the abdominal wall airtight device (8), the first cylindrical sheet (1) is a cylindrical sheet member having a thickness of 0.1 to 2 mm, and is usually formed by inflation molding or heat treatment. It is produced by sheet processing such as welding, but is not particularly limited. At the time of use, it is inserted and fixed at the incision, and the operator's arm enters and exits the sheet many times, so a material that is not bulky and has moderate flexibility is good so as not to interfere with insertion, for example, soft chloride Materials such as vinyl resin, polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber, and natural rubber are preferred. Further, the inner diameter is appropriately about 50 to 100 mm because the arm of the operator needs to pass through.

Outer balloon (2) and inner balloon (3)
Is a balloon in which a hollow lumen is formed in a donut shape as shown in the sectional view of FIG. Usually, it is produced by hollow molding such as blow molding, dip molding and rotational molding, or sheet processing such as heat welding, but is not particularly limited. Both the outer balloon (2) and the inner balloon (3) have a balloon thickness of 0.
The inner wall of the outer balloon (2) and the inner balloon need to have an inner diameter that does not interfere with the arm of the surgeon many times.
About 00 mm is appropriate. The outer diameter of the outer balloon (2) is slightly larger than that of the inner balloon (3) and is preferably about 90 to 200 mm in order to secure fixation. A minimum outer diameter that does not obstruct the visual field below is preferable.
mm is appropriate.

The material of the balloon is a soft vinyl chloride resin,
Materials having appropriate flexibility such as polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber, natural rubber, and the like are preferable. The inner balloon (3) can be easily inserted into the body through the incision without being bulky without injecting fluid such as air, and has enough flexibility not to damage organs, and more than twice as much air or water as in actual use. It is important to select a material having a sufficient rupture strength and tensile strength that does not rupture even when the material is injected.

The outer balloon tube (4) and the inner balloon tube (5) are extruded and have an inner diameter of 0.3 to 3 m.
m, the thickness is 0.3 to 2 mm, and the length is appropriately about 50 to 300 mm from the first cylindrical sheet so as not to hinder the operator from using various treatment tools. . It is preferable to use a material having appropriate flexibility and hardness, such as a soft vinyl chloride resin, urethane resin, silicone rubber, and natural rubber.

The first cylindrical sheet (1), the outer balloon (2), and the inner balloon (3) may be formed by bonding each other after forming each member, or by integrally forming each member. Sheet (1) is used as an inner cylinder, another cylindrical sheet is superimposed on the outer circumference as an outer cylinder, and the inner and outer cylinders are adhered at the leading end and the center of the outer sheet, thereby forming an outer balloon (2) and an inner balloon (3). May be formed. The distal end of the outer balloon tube (4) opens into the outer balloon, and the distal end of the inner balloon tube (5) opens into the inner balloon (3). Ports (13) and (14) attached to the balloon may be connected directly to the balloon.
And may be connected via a connection.

Also, the inner balloon tube (5) is formed with a loop immediately after coming out of the inner balloon (3) so as not to be broken or hindered when being fixed to the abdominal wall, and a part of the tube is formed into a first part. The cylindrical sheet (1) may be bonded and fixed to the wall surface. Also, the outer balloon tube (4) loops out toward the lumen of the first cylindrical sheet (1) once after coming out of the outer balloon (2) so as not to be in the way when the sleeve (12) is covered. In some cases, the tube may be formed so as to penetrate from the inner wall of the first cylindrical sheet (1) to the outer wall side so that the tube can be taken out of the body. In addition, the outer balloon tube (4) and the inner balloon tube (5) may be independent tubes, respectively. In the vicinity of the rear end of the balloon, a two-chamber tube having two flow passages integrated with each other is used. It may be used, and a branch may be provided at a rear position to branch.

Further, at the rear ends of the outer balloon tube (4) and the inner balloon tube (5), check valves having connectors as gas-liquid opening / closing devices (6) and (7) are provided, respectively. A one-way cock, a three-way cock, or the like is connected, and has a structure that can be easily opened and closed by attaching and detaching an injection cylinder, which is a general balloon inflation and injection device. Also,
Between the outer balloon tube (4), the inner balloon tube (5) and the gas-liquid opening / closing device (6), (7), pilot balloons (15), (16) are connected to both or only one of them. In this case, the pilot balloons (15) and (16) may be made of, for example, a soft vinyl chloride resin, a urethane resin, a silicone rubber, or a natural rubber so that the state of balloon inflation of the balloon portions (2) and (3) can be monitored. It is formed of a material having appropriate flexibility and elasticity such as rubber.

Next, among the members constituting the sleeve (12), the second cylindrical sheet (9) has a thickness of 0.03 to 2 mm.
And is usually produced by sheet processing such as inflation molding or heat welding. In use, the operator's hand is inserted and removed many times, or it moves intricately with the hand in, so a material with moderate flexibility is good without being bulky so as not to interfere with movement, for example, Materials such as soft vinyl chloride resin, polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber, and natural rubber are preferred. Further, the inner diameter is appropriately about 70 to 200 mm because the arm of the operator needs to pass through and move around, and the length is appropriately about 50 to 300 mm.

The tightening member (10) is a member that hermetically closes the inside of the sleeve when the operator's hand or arm is inserted, and can be freely expanded and contracted without excessively pressing the hand or arm. ,
Any elastic member that can be properly tightened may be used. For example,
A rubber-based material such as silicone rubber or natural rubber alone, or a rubber-based material such as a wristband worn by athletes on a wrist, etc. may be wrapped with a thread or cloth, or moderately flexible on the wrist It is possible to form a molded product having flexibility and a length adjustable from a soft vinyl chloride resin, a polyurethane resin, a polyethylene resin, a polypropylene resin, a polyester resin, or the like, and to form the inner surface with a rubber-based member.
Further, a string-like structure for manually binding the second cylindrical sheet (9) may be used. Further, as shown in FIG. 4 (b), the surgeon wears surgical rubber gloves (17) in double to increase the airtightness of the tightening portion, and tightens the tightening member (10).
By inserting the hand (18) into the garment and folding the upper glove end (17) over the fastening member (10), higher airtightness can be obtained.

The fixing member (11) is connected to the outer balloon (2) of the abdominal wall airtight device (8) at the distal end of the second cylindrical sheet (9), so that the space between the outer balloon (2) and the outer balloon (2) is airtight. It is a closed object and is usually formed by injection molding or compression molding into a ring shape, or by processing an extruded tube member into a ring shape. The material is a material having appropriate flexibility and elasticity, and soft vinyl chloride resin, polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber, natural rubber, nitrile rubber and the like can be used. As a structure, a single ring-shaped member may be used as shown in FIGS.
As shown in FIG. 4, a third cylindrical sheet (1
9) may be placed, and the outer balloon (2) of the abdominal wall airtight device (8) may be formed so as to be wrapped by the third cylindrical sheet (19).

The second cylindrical sheet (9), the fastening member (10) and the fixing member (11) have a fastening member (10) at the proximal end of the second cylindrical sheet (9) and a distal end. A sealing member (11) is formed so as to enclose the fixing member (11), or attached to the inner surface of the second cylindrical sheet (9),
It can be attached to the end of the second cylindrical sheet (9). Further, the inner diameter of the portion on the fixing member side of the second cylindrical sheet (9) is substantially the same as the inner diameter of the outer balloon (2) of the abdominal wall airtight device (8) as shown in FIG. Sometimes.

Further, the second tightening member (20) is attached to the outer balloon tube (4) or the like, and when the operator's hand (18) is pulled out of the sleeve (12), the sleeve (20) is kept airtight. Used to tighten 12). Usually, it is formed by injection molding into a shape that can sandwich and fix the sleeve (12), and a plurality of ribs are formed as necessary. The material is preferably a material that is hard and can be fixed firmly, and may be formed of a metal such as hard vinyl chloride resin, polycarbonate resin, polyacetal resin, polysulfone resin, or stainless steel.

In using the medical insert according to the present invention, for example, as shown in FIG. 6, the inner balloon (3) of the abdominal wall airtight device (8) is made smaller by hand through an incision in the abdominal wall.
Insert into the body. After the insertion, the inner balloon (3) is inflated by injecting air or water from the gas-liquid opening / closing device (7) using a syringe or the like. Here, after pulling this medical treatment insertion tool to bring the inner balloon (3) into close contact with the inside of the abdominal wall, the outer balloon (2) is similarly expanded outside the body,
The abdominal wall is airtightly fixed to the body surface so as to be sandwiched between the inner balloon (3) and the outer balloon (2).

Next, as shown in FIG. 7, two surgical gloves (17) are attached to the surgeon's hand (18), and a sleeve (12) is attached.
The hand (18) is inserted into the tightening member (10), and one end of the outer side of the surgical glove (17) is bent so as to cover the tightening member (10) sufficiently to be airtight. Let Further, as shown in FIG. 8, the other fixing member (11) is put on the outer balloon (2) of the abdominal wall airtight device (8) so that the outer balloon (2) and the fixing member (11) are airtight. . As a result, the inside of the medical treatment insertion tool and the inside of the medical treatment insertion tool are air-tight, and an operation using a hand in the abdominal cavity can be performed while maintaining the air-tightness. Further, when it is desired to remove the organ or temporarily remove the hand while maintaining the insufflation, as shown in FIG. 9, the second fastening member (20) is used for the sleeve (1).
By tightening 2), the hand (18) can be pulled out while maintaining hunger. If the insufflation is to be stopped and the organ is to be taken out from the opening for treatment, the insufflation may be dropped and the sleeve (12) may be removed from the abdominal wall airtight device (8).

[0033]

The abdominal wall airtightness device of the medical treatment insertion device of the present invention has no bulk when inserted through an incision in the abdominal wall, and can be safely and easily inserted because of the appropriate flexibility of the balloon. . In addition, it has two balloon inflation parts, and by inflating the balloon on the inside and outside of the body, the incision can be fixed so as to be sandwiched from inside and outside the body. It can be securely fixed in an airtight manner. Further, since the balloon is flexible, there is no possibility that the small opening is damaged. Further, the sleeve is configured so as to maintain the airtightness between the operator's hand and the sleeve by a tightening member on the proximal end side, and furthermore, the operator wears two surgical gloves and ends the upper one of them. A higher airtightness can be obtained by covering the tightening member with. The distal end side of the sleeve is configured so as to keep the outer balloon and the fixing member airtight by a fixing member, and is simple and reliable without using an adhesive or the like and without being partially worn out. Just cover the balloon. The hand can be easily inserted into the body from outside the body and the organ can be directly treated or removed by hand.
It can be treated safely and in a short time.

Further, the inflation balloon is freely deformed according to the operation angle, so that organ treatment can be easily performed. Further, the second tightening member can be temporarily attached to the sleeve and the hand can be pulled out while maintaining insufficiency. Also,
Release the insufflation, remove the sleeve, remove the abdominal wall airtight device on the abdominal wall, pull the organ out of the body, perform treatment outside the body, and also prevent cancer tissue from adhering to the abdominal wall when removing the organ, No worries about metastasis. There is no gas leak under pneumoperitoneum, a sufficient treatment space can be kept in the body, treatment can be performed safely and in a short time with good vision, and it is necessary to remove only the sleeve without removing the entire device in case of emergency such as bleeding In the case of performing a particularly long-term treatment in endoscopically assisted surgery, there are effects such as safety of the procedure, reduction of the postoperative recovery period of the patient, and reduction of the operator's stress, Extremely useful.

[Brief description of the drawings]

FIG. 1 is a view showing the appearance of the structure of a medical treatment insert according to one embodiment of the present invention.

FIG. 2 is a diagram showing a cross section of the structure of the medical treatment insertion tool according to one embodiment of the present invention.

FIG. 3 is a view showing the appearance of the structure of a medical treatment insert according to another embodiment of the present invention.

FIG. 4 is a diagram showing a cross section of the structure of a medical treatment insert according to another embodiment of the present invention.

FIG. 5 is a view showing a shape of a sleeve of the medical treatment insertion tool according to one embodiment of the present invention.

FIG. 6 is a schematic view showing a state in which an abdominal wall airtight device is fixed to an abdominal wall in an example of a method of using the medical treatment insertion tool according to an embodiment of the present invention.

FIG. 7 is a schematic diagram showing an airtight state by inserting an operator's hand into a sleeve in an example of a method of using the medical treatment insertion tool according to one embodiment of the present invention.

FIG. 8 is a schematic view showing an example of a method of using the medical treatment insertion tool according to an embodiment of the present invention, showing a state in which an abdominal wall airtight device and a sleeve are connected and insufflated.

FIG. 9 is a schematic view showing a state where a sleeve is fastened by a second fastening member and an arm is pulled out in an example of a method of using the medical treatment insertion tool according to an embodiment of the present invention.

[Explanation of symbols]

 1. First cylindrical sheet 2. Outer balloon 3. Inner balloon 4. Tube for outer balloon 5. Tube for inner balloon 6. Gas-liquid switchgear 7. 7. Gas-liquid switchgear 8. Abdominal wall airtight device Second cylindrical sheet 10. Tightening member 11. Fixing member 12. Sleeve 13. Port 14. Port 15. Pilot balloon 16. Pilot balloon 17. Surgical rubber gloves 18. Hand 19. Third cylindrical sheet 20. Second fastening member

Claims (5)

[Claims] Forming an outer balloon at a proximal end adjacent an outer periphery of a first cylindrical sheet having an insertion port at a proximal end and an outlet at a distal end, and an inner balloon at a distal end; An outer balloon tube having a distal end communicating with the outer balloon, and an inner balloon tube having a distal end communicating with the inner balloon through a cylindrical sheet are further provided. Further, the outer balloon tube and the rear end of the inner balloon tube are provided. An abdominal wall airtight device provided with a gas-liquid opening and closing device each having a connector for connection, an insertion port at the proximal end, a second cylindrical sheet having an outlet at the distal end, a second Tightening the cylindrical sheet, a fastening member for airtightly closing the inside of the second cylindrical sheet is additionally provided,
A medical treatment insertion tool comprising a sleeve provided at a distal end of a second cylindrical sheet with a fixing member capable of airtightly connecting to an outer balloon of an abdominal wall airtight device. 2. A second tightening member for tightening a second cylindrical sheet of a sleeve to maintain airtightness in order to maintain airtightness when an operator's arm is pulled out from the tightening member of the sleeve. The medical treatment insert according to any one of the preceding claims. 3. The medical treatment insertion tool according to claim 1, wherein the inner diameter of a portion of the sleeve on the fixing member side of the second cylindrical sheet is substantially the same as the inner diameter of the outer balloon. 4. The medical treatment insertion tool according to claim 1, wherein the fixing portion of the sleeve comprises a ring-shaped flexible member. 5. The fixing device according to claim 1, wherein the third cylindrical sheet is placed between the two ring-shaped flexible members at the fixing portion of the sleeve so as to wrap the outer balloon. Medical procedure insert.