JP2003325659A - Drainage apparatus for laparoscopic operation - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a drainage apparatus for laparoscopic operation allowing an inserting operation to be easily and surely performed when a drainage catheter is retained in a ductus cysticus during a laparoscopic surgery. <P>SOLUTION: This drainage apparatus for laparoscopic operation comprises an outer tube having a flexible tube with a tip part curved in J-shape, an outer tube guide pipe allowed to be inserted into and extractable from the bore of the outer tube, an inside needle allowed to be inserted into and extractable from the bore of the outer tube guide pipe and having an edge thereon, and a direct-operation part having an outer tube base, an outer tube guide pipe base, and an inside needle base fitted to the rear end parts thereof. The apparatus further comprises a piercing kit allowing the tip part of the outer tube to be varied in shape from the J-shape in the range of a linear shape depending on the depth of the insertion of the outer tube guide pipe when the outer tube guide pipe is inserted into the outer tube, a catheter allowed to be inserted into the bore part of the outer tube guide pipe and having an opening at the tip portion, an adapter detachable from the catherter and closable and openable the bore passage of the catherter, and a check valve connected to the outer tube guide pipe and closing the bore passage. <P>COPYRIGHT: (C)2004,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a catheter for draining bile and a device for inserting the catheter after laparoscopic surgery for choledocholithography or after performing a lithotripsy with a transgallbladder duct. And a drainage instrument for laparoscopic surgery.

[0002]

2. Description of the Related Art With the development of laparoscopic surgery, laparoscopic surgery has been introduced as a contraindicated treatment of common bile duct stones. Among these, when the common bile duct is sutured for a period after the operation of the common bile duct, or after the stone is cut through the transgallbladder, the internal pressure of the common bile duct is increased by the bile after the operation. For the purpose of prevention and prevention of bile leakage, it is general to indwell a small-diameter tube called C tube for draining the bile into the common bile duct through the transcholecystic duct. Conventionally, as a gallbladder canal drainage tube suitable for this procedure, there is a drainage tube for endoscopic surgery of Patent 3209896. This has an opening and multiple side holes in the tip and its vicinity that communicate with the lumen, the outer diameter of the entire tube is almost the same and there is no step, and the tube lumen is airtightly closed at the rear end. A drainage tube composed of a flexible tube having a sealing portion for sealing, and a connection connector fitted after cutting the rear end sealing portion of the tube, and an instrument for inserting the tube into the gallbladder duct. It is used together with a double needle consisting of a puncture needle and an outer tube.

For example, when this tube is used for laparoscopic common bile duct lithotripsy, first, the double needle is inserted through the abdominal incision, the tip is introduced into the gallbladder duct, and only the puncture needle is removed to remove the outer cylinder. Place the tube. Next, the tube is introduced through the opening of the outer tube, but at this time the rear end of the tube is sealed to prevent the peritoneal gas in the abdominal cavity from being released outside the body through the lumen of the tube. There is. Place the tube in the gallbladder duct using the outer tubular tube as a guide, remove the outer tubular tube, put an elastic suture on the outside of the gallbladder tube where the tube is inserted, and apply a clip while pulling strongly to prevent the tube from coming off. Fix and put on. After that, the sealing portion at the rear end of the tube is cut, a connector is connected, and bile drainage is performed. Also, when the tube is no longer needed, when the tube is removed from the outside of the body, the elastic suture around the gallbladder duct voluntarily blocks the opening of the gallbladder duct, so no treatment is required after the operation. .

[0004]

However, in these conventional instruments, while the tube and the outer tube are made of resin and are soft and have a linear shape, from the gallbladder tube into which the tube is actually inserted to the common bile tube. The path is not a straight line, but it is bent, and since the insertion operation is a remote operation using laparoscopic forceps, etc., the outer tube is inserted into the gallbladder tube and the outer tube is used as a guide. When the catheter is inserted into the gallbladder duct or the common bile duct, the insertion operation is often difficult because the tube or the outer tubular tube is bent or is caught at the bent portion of the gallbladder duct or the like.

Therefore, it is an object of the present invention to provide a drainage instrument for laparoscopic surgery which is easy and reliable to insert when a drainage catheter is placed in the gallbladder duct during laparoscopic surgery.

[0006]

A drainage instrument for laparoscopic surgery according to the present invention comprises an outer cylinder made of a flexible tube having a J-shaped curved distal end, and a hard tube which can be inserted into and removed from the inner cavity of the outer cylinder. An outer cylinder guide tube made of a pipe, an inner needle made of a rod-shaped body that can be inserted into and removed from the inner cavity of the outer cylinder guide tube, and has a cutting edge at the tip, and the rear ends of the outer cylinder, the outer cylinder guide tube, and the inner needle. When the outer cylinder guide tube is inserted into the outer cylinder, the outer cylinder base, the outer cylinder guide tube base and the inner needle base are provided at the distal end of the outer cylinder. Depending on the insertion depth of the tube guide tube, a puncture kit capable of changing the shape from a curved J shape to a straight line shape corrected by the outer tube guide tube, and the puncture kit that can be inserted into the inner cavity of the outer tube guide tube A catheter having an opening at the tip and / or a side hole on the side surface near the tip Detachable to a rear end portion or the middle portion of the catheter, and was configured to have a closed and openable adapter inner luminal path of the catheter.

In addition to the above construction, the catheter can be inserted into the inner cavity, and the outer cylinder guide tube base can be detachably attached to the rear end portion thereof, and after the inner needle is pulled out, the catheter is connected to the rear end portion. The non-return valve for closing the inner passage of the outer cylinder guide tube is provided.

The tip of the catheter is bent into a J shape in advance to have a curved shape.

The tip of the catheter has a tapered shape.

The outer cylinder and / or the catheter is formed of a fluororesin such as tetrafluoroethylene which is relatively hard among flexible resins. Further, the catheter was provided with a scale and an X-ray impermeable property as required.

The outer cylinder base and the outer cylinder guide tube base of the hand-operated portion are formed as slidable cylindrical members arranged concentrically, and the outer cylinder base and the outer cylinder guide tube base are slidable on each other. A structure in which a projection formed on the other side of the sliding surface is engaged with a longitudinal moving groove formed on one of the moving surfaces and circumferential fixed grooves provided at both ends and an intermediate portion of the moving groove. When the protrusion is engaged with the fixed groove, the movement of the outer cylinder base and the outer cylinder guide base in the longitudinal direction is restricted. It was configured.

[0012]

According to the puncture kit of the drainage instrument for laparoscopic surgery of this structure, the outer cylinder guide tube made of a hard pipe is provided in the curved portion of the outer cylinder made of a flexible resin formed in a J shape. By inserting (advancing), the flexible outer cylinder is straightened by the hard pipe to gradually reduce the curvature, and becomes linear when the distal end is inserted. On the other hand, if the outer cylinder guide tube is removed (retracted) from the outer cylinder while it is inserted, the flexible outer cylinder will not be affected by the hard pipe, and the bending will be gradually deepened, and the tip of the outer cylinder guide tube will be deepened. When it reaches the straight portion (non-curved portion) of the outer cylinder, the shape returns to the pre-bent J-shape. Therefore, the shape can be changed in the linear range from the J-shape depending on the insertion depth of the outer cylinder guide tube into the outer cylinder. It is possible to puncture the body cavity with a straight line that is easy to puncture, and when inserting into the gallbladder duct in the abdominal cavity, select a curved shape that is easy to insert and that matches the shape along the long axis of the gallbladder duct. It can be operated. In addition to forming the outer cylinder with a fluororesin, which is a relatively hard and flexible resin, a hard outer cylinder guide tube is inserted in the inner cavity of the outer cylinder. It becomes an outer cylinder, and when it is inserted into the gallbladder duct, which is a remote control,
It is possible to eliminate a cause that hinders insertion such as bending or breaking of the outer cylinder, and improve followability to a hand operation. Further, by providing a removable adapter to the catheter that can close and open the lumen passage of the catheter, the passage can be closed during the laparoscopic insertion procedure of the catheter so that the catheter can be opened from the rear end opening of the catheter. It is possible to prevent the leakage of pneumoperitoneum, and after operation, drain the bile by opening the passage or removing the adapter.Furthermore, when injecting a contrast agent etc. using the catheter as a passage during surgery etc. If the rear end of the adapter is made into a luer taper, it can be used as it is as the injection port for the chemical solution.

If a removable check valve is provided at the rear end of the outer cylinder guide tube base, the puncture kit is pierced into the abdominal cavity, the inner needle is removed, and then the inner needle base is replaced to connect the outer needle guide tube to the outside. By closing the lumen passage of the tube guide tube, it is possible to prevent the leakage of pneumoperitoneum gas in the abdominal cavity during the catheter insertion and indwelling operations. Further, the check valve prevents leakage of pneumoperitoneum gas from the abdominal cavity side as described above, but has a structure in which a catheter can be inserted from the outside of the body through the lumen of the check valve to form an outer cylinder. Since the catheter can be inserted while it is attached to the guide tube, leakage of pneumoperitoneum gas from the gap between the outer tube guide tube and the catheter during the catheter insertion operation can be minimized.

When the distal end of the catheter is bent into a J shape in advance to have a curved shape, the long axis of the gallbladder duct is inserted when the catheter is inserted from the gallbladder duct into the common bile duct using the outer tube and the outer tube guide tube as a guide. It can be inserted naturally along the curved path of the transition from the bile duct to the common bile duct, and the tip is not caught. Further, when the distal end portion of the catheter is formed into a tapered shape, it can be further prevented from being caught when it is inserted into the gallbladder duct or the common bile duct, and the insertion operation of the outer tube and the outer tube guide tube into the inner cavity can be performed. Can be smooth.

Since the outer cylinder and the catheter are made of a fluororesin such as tetrafluoroethylene which is relatively hard among the flexible resins, the rigidity of the outer cylinder and the catheter becomes strong. Even if the operation is performed, it is possible to eliminate the cause of the insertion of the outer cylinder and the catheter into the gallbladder duct, such as breakage and stiffness, which may be a problem.

The outer cylinder base and the outer cylinder guide tube base of the hand operation section are slidably arranged on concentric circles, and a moving groove (longitudinal direction) is provided in one of the sliding surfaces of the outer cylinder base and the outer cylinder guide tube base. And a plurality of fixed grooves (circumferential direction) are formed, and a protrusion that engages with the movable groove and the fixed groove is formed on the other sliding surface, and the protrusion moves in the longitudinal direction within the range of the movable groove to fix the protrusion. When the groove is rotated in the circumferential direction and engaged with the groove, the movement in the longitudinal direction is restricted, so that the insertion depth of the outer cylinder guide tube into the outer cylinder inner cavity, that is, the curvature of the outer cylinder. The shape (or linear shape) can be adjusted by the operation unit at hand.

[0017]

BEST MODE FOR CARRYING OUT THE INVENTION An example of an embodiment of the present invention will be described in detail with reference to the drawings.

FIG. 1 is an overall configuration diagram of a drainage instrument for laparoscopic surgery showing an example of an embodiment of the present invention. When a drainage catheter is inserted into a gallbladder duct and left in place, a body cavity is punctured and the catheter A puncture kit 1 that serves as an insertion guide (passage), and is inserted into the gallbladder duct by passing through the puncture kit 1;
Basically, a catheter 2 used for the purpose of indwelling and biliary drainage (injecting a drug solution such as a contrast agent if necessary), and an adapter 3 connected to the rear end of the catheter 2 and capable of occluding the lumen of the catheter 2. Composed. Puncture kit 1
Will be described later in detail, the outer cylinder 11, the outer cylinder guide tube 13, the inner needle 15, and the outer cylinder base 12, the outer cylinder guide base 14, and the inner needle base 16 connected to the respective base end portions of the outer cylinder 11, An outer cylinder guide tube 13 is inserted into the inner cavity of 11, and an inner needle 15 is inserted into the inner cavity of the outer cylinder guide tube 13, and an outer cylinder base 12 and an outer cylinder guide base 14, and an outer cylinder guide base 14 and an inner needle base 16 are attached. Engaged and connected to form a unit. (In addition, in order to clarify the configuration in the drawing,
The state where the inner needle is pulled out is shown, but the inner needle base 16 is naturally connected to the rear end of the outer cylinder guide tube base 14 at the time of puncturing. ) The catheter 2 has an outer diameter (4 Fr., 950 mm in this example) that can be inserted into the inner cavity of the outer cylinder guide tube 13 and an inner diameter (0.8 mm in this example) into which a guide wire can be inserted.
A tube formed of tetrafluoroethylene resin having an inner diameter) into which the guide wire can be inserted. For the purpose of bile drainage and the like, an opening 21 at the tip end communicating with the lumen and
By forming a plurality of side holes 22 on the side surface near the tip,
Further, in order to facilitate insertion into the gallbladder canal, the tip portion has a curved shape 23 that is bent in a J shape in advance, and the tip portion is formed as a tapered taper shape 24. Further, if necessary, a scale 25 for confirming the insertion depth into the body cavity or the gallbladder duct, and an X-ray non-transparency for confirming the placement position may be provided. The adapter 3 is detachably attached to the rear end portion or the middle portion of the catheter 2 and can close and open the lumen passage of the catheter. In this example, the adapter body 31, the tightening ring 32, and the lock ring 33 are provided. The adapter body 31 and the lock ring 33 are made of a hard resin, and the screw portion of the rear end portion of the adapter body 31 and the screw portion of the front end portion of the lock ring 33 are connected and used integrally, while the tightening ring 32 is It has rubber elasticity, is formed in a ring shape with a through hole for inserting a catheter in the center, and is mounted so as to be sandwiched inside the adapter body 31 and the lock ring 33. By tightening the screw part of the adapter body 31 and the screw part of the lock ring 33 strongly, With the ring 32 is crushed by reducing the inner diameter of the through hole has a structure to increase the diameter of that in the through hole to loosen the tightening. With this, when the catheter 2 is inserted into the through hole, the through hole is tightened by tightening the lock ring 33 to a certain extent so that the catheter 2 is connected and fixed, and by further tightening, the through hole is further tightened and the lumen of the catheter 2 is closed. Conversely, by loosening this, the through hole is opened and the catheter lumen is opened, and by further loosening it is possible to remove it from the catheter. Naturally, during insertion of the catheter 2 into the gallbladder duct during operation, it is tightened and occluded, and it is loosened during drainage after the operation.
Alternatively, the catheter lumen passage is opened and the catheter lumen passage is opened. Further, if the lock cap 34 is connected to the rear end of the lock ring 33, the catheter lumen passage can be closed more reliably. Further, the rear end portion of the lock ring 33 is formed as a female luer taper, and can be used as it is as a drug solution injection port when injecting a drug solution such as a contrast agent during surgery.

FIG. 2 is a block diagram of the puncture kit 1 of the present embodiment, which is divided into an outer cylinder portion (FIG. A), an outer cylinder guide portion (FIG. B), and an inner needle portion (FIG. C). Show. The outer cylinder part A is
The outer cylinder 11 and the outer cylinder base 12 are connected at the base end portion of the outer cylinder 11, the outer cylinder 11 is formed of tetrafluoroethylene resin, and the distal end portion is curved in a J shape in advance.
Formed as. The outer cylinder base 12 is a resin molded product, the inner surface of which communicates with the inner cavity of the outer cylinder 11, and the inner surface serves as a sliding surface with respect to the outer cylinder guide tube base 14, and the sliding surface extends in the longitudinal direction. The movable groove 121, and fixed grooves 122a, 122b, and 122c are provided in the circumferential direction of both ends and an intermediate portion of the movable groove 121 so as to be engaged with a protrusion 141 of an outer cylinder guide tube base 14 described later. It In the outer cylinder guide portion B, an outer cylinder guide tube 13 and an outer cylinder guide tube base 14 are connected at the base end portion of the outer cylinder guide tube 13, and the outer cylinder guide tube 13 is made of a stainless pipe.
The edge of the cut surface of the tip portion is polished. The outer cylinder guide tube base 14 is a resin molded product, the inner surface of which is communicated with the inner cavity of the outer cylinder guide tube 13, and the outer surface of the outer cylinder guide tube 12 is a sliding surface with which the projection 141 is formed. The outer cylinder base 1 described above is provided.
The two moving grooves 121 and the fixed grooves 122a, b, and c are configured to be engaged with each other. Also, the outer cylinder guide tube base 1
The rear end portion 4 of 4 has a female luer taper,
If necessary, it can also be used as an injection port for injecting a drug solution or the like. Further, by removing the inner needle 15 and connecting a separately provided check valve 17 to the rear end portion 142 of the outer cylinder guide base. It is possible to maintain the closed state of the inner cavity of the outer cylinder guide tube 13 even after the inner needle 15 is removed, and the intraoperative puncture kit 1 is punctured into the body cavity, and after the inner needle 15 is removed, the catheter 2 is inserted,
By connecting the check valve 17 until the indwelling, it is possible to prevent the leakage of the insufflation gas. The check valve 17 of the present embodiment has a diameter capable of inserting the connecting ring 171 that can be connected to the outer cylinder guide tube base 14 on the front end side and the catheter 2 on the rear end side and maintaining airtightness when the catheter 2 is attached. And a rubber elastic member 172 provided with a through hole, and the check valve 1 is inserted into the through hole of the rubber elastic member 172 by inserting the catheter 2 whose lumen is blocked by the adapter 3 described above.
When 7 is connected to the rear end portion 142 of the outer cylinder guide tube base 14, the inner cavity of the outer cylinder guide tube 13 is closed to maintain pneumoperitoneum. Further, as the check valve 17, in addition to the above configuration, a known check valve mechanism such as a duck bill valve or a cross slit valve may be provided inside. In that case, the catheter 2 may not be inserted. The blockage of the inner cavity of the outer cylinder guide tube 13 can be maintained. Inner needle C
Is formed by connecting an inner needle 15 and an inner needle base 16 at a proximal end portion of the inner needle 15, the inner needle 15 is made of a stainless wire, and a distal end portion thereof is provided with a sharp cutting edge 151 for puncturing into the abdominal cavity. Configured. The inner needle base 16 is made of a resin molded product and is formed so as to be connectable to the rear end portion 142 of the outer cylinder guide tube base 14.

FIG. 3 shows the outer cylinder base and the outer cylinder guide tube base of the hand-operated portion of the present embodiment, wherein the inner surface of the outer cylinder base 12 and the outer surface of the outer cylinder guide tube base 14 serve as sliding surfaces and slide with each other. The outer cylinder base 1 is configured as a cylindrical member movably arranged on concentric circles.
2, a moving groove 121 is provided in the longitudinal direction, and a fixed groove 12 is provided at both ends of the moving groove 121 and at one intermediate portion in the circumferential direction.
2a, b, c are formed, and on the other hand, a protrusion 141 that engages with the moving groove 121 and the fixed groove 122 is provided on the sliding surface of the outer cylinder base 12 and the outer cylinder guide tube. Group 1
4 is relatively slidable within the range of movement by the moving groove 121 and the protrusion 141, and when the protrusion 142 is rotated in the circumferential direction to engage with the fixed groove 122, the outer cylinder base 12 and the outer cylinder are The guide tube base 14 has a configuration in which movement in the longitudinal direction is restricted. By setting the relative positions of the moving groove 121 (fixed groove 122) of the outer cylinder 12 and the protrusion 141 of the outer cylinder guide tube base 14 by this, the insertion depth of the outer cylinder guide tube 13 into the inner cavity of the outer cylinder 11 is set. That is, the curved shape (or linear shape) of the outer cylinder 11 can be adjusted by the hand operation unit. In addition, in the present embodiment, since the fixing grooves are provided at the above-mentioned three places, the tip shape of the outer cylinder 11 is correspondingly linear, and the shape is J
3 of curved shape curved in shape and curved shape in the middle
The form can be selected.

FIG. 4 shows the shape change state of the tip of the outer cylinder of this embodiment, where A is a straight line state, C is a preformed J-shaped curved state, and B is a curved state at the intermediate portion. As described above, the shape can be changed depending on the relative position of the outer cylinder base 12 and the outer cylinder guide tube base 14 of the hand operation unit 10 (the insertion depth of the outer cylinder guide tube 13 into the outer cylinder 11). In this state, the protrusion 141 of the outer cylinder guide base tube 14 is at the position of the fixed groove 122a on the tip side of the moving groove 121 of the outer cylinder base 12,
Since the tip of the outer tube guide tube 13 made of a hard pipe projects from the tip of the outer tube 11 made of a flexible resin, the outer tube 1
Reference numeral 1 is straightened by the outer cylinder guide tube 13. This linear shape is effective when puncturing a body cavity, and the inner needle 15 is attached in this form, but of course the inner needle 1
The tip portion 5 is configured to project the blade edge 151 from the tip of the outer cylinder guide tube. On the other hand, in the state of FIG. C, the protrusion 141 of the outer cylinder guide tube base 14 is located at the fixed groove 122c on the rear end side of the moving groove 121 of the outer cylinder base 12, and the outer cylinder guide tube 1
Since the tip of 3 is located in the straight portion outside the curved portion of the inner tube 12, the tip of the outer tube 11 is not influenced by the outer tube guide tube 13 and has a curved shape that is bent in a J shape in advance. There is. In the state of FIG. B, the protrusion 141 of the outer cylinder guide tube base 14 is in the fixed groove 122b located in the middle portion of the moving groove 121 of the outer cylinder base 12 in the middle between FIG. A and FIG.
Since the tip of is located in the middle of the curved portion of the inner tube 12,
It has a curved shape intermediate between the previously formed curved line and the straight line. As described above, these curved shapes are the external cylinder 1 to the gallbladder duct.
A shape effective for inserting the tip 1 and the catheter 2 is selected and used according to the path of the gallbladder duct.

Next, a method of using the present device in laparoscopic choledochotomy will be briefly described. It should be noted that the description shows an example of use of the present device that is assumed, and does not describe an actual procedure. After completing a series of lithotomy and closure of the common bile duct, 1. Under the laparoscope, an incision is made in the gallbladder duct, and the linear puncture kit 1 is punctured from outside the body toward the incised gallbladder duct. 2. Only the inner needle 15 is removed, and the check valve 17 in which the catheter 2 whose passage is blocked by the adapter 3 is inserted is connected to the outer cylinder guide tube base 14 so that the pneumoperitoneum can be maintained.
The outer cylinder 11 is positioned along the long axis of the gallbladder canal, and the outer cylinder 11 is fixed so that the outer cylinder 11 is curved according to the shape of the gallbladder canal by manual operation and is closely attached to the incision of the gallbladder canal. 3. Catheter 2 using the lumen of puncture kit 1 as a guide
Is inserted through the gallbladder duct to the common bile duct. When the gallbladder tube is thin and difficult to insert, a 0.8 mm guide wire (not shown) is inserted first, and then the catheter 2 is inserted. 4. After insertion, leave catheter 2 and puncture kit 1
After that, the gallbladder duct and the catheter 2 are ligated with an elastic suture and drainage is performed in the same manner as in the conventional method described above.

[0023]

According to the drainage instrument for laparoscopic surgery of the present invention, the shape of the tip of the outer cylinder of the puncture kit can be varied in the range from J-shaped to linear, and when puncturing, puncturing is performed. It is easy to insert into the gallbladder duct in the abdominal cavity, and when it is inserted into the gallbladder duct, it is possible to select and operate a curved shape that is easy to insert according to the shape along the long axis of the gallbladder duct. By having a curved shape that naturally follows the insertion passage of the common bile duct, even when the laparoscopic remote operation is performed, when the outer cylinder or catheter is inserted into the gallbladder duct or the like, the outer cylinder or catheter is caught or It is possible to prevent bending and enable smooth and easy placement.
Further, if the tip of the catheter is tapered, smoother insertion becomes possible.

Further, the outer cylinder and the catheter are made of a relatively hard fluororesin such as tetrafluoroethylene and the hard outer cylinder guide tube is inserted into the inner cavity of the outer cylinder, so that the body becomes strong and the abdominal cavity is improved. Even with remote operation under a mirror, when inserting an outer cylinder or catheter into the gallbladder duct, etc., it is possible to eliminate the cause of obstacles such as bending of the outer cylinder or catheter, and to operate at hand. Faithful transmission to the tip of the outer cylinder enables smooth and reliable insertion.

[0025] Laparoscopic choledocholithotomy can be treated in a one-stage manner, and compared with performing lithotripsy with endoscopic retrograde cholangiopancreatography before and after laparoscopic cholecystectomy, shortening the hospital stay, etc. Although it is a surgery with many advantages, it is thought that the reason why it does not spread so much is that the operation of inserting the bile drainage tube was complicated in addition to the operation of the lithotomy and suturing operation of the common bile duct incision. With the drainage device of the present invention, one problem will be solved, and it is expected that this surgical method will be further spread in the future, and for the patient,
Further, it is possible to provide a drainage instrument for laparoscopic surgery that enables a surgeon to perform a better surgical procedure.

[Brief description of drawings]

FIG. 1 is an overall configuration diagram of a drainage instrument for laparoscopic surgery showing an embodiment of the present invention.

FIG. 2 is a configuration diagram of each part of the puncture kit of the device (outer cylinder, outer cylinder guide tube, inner needle).

FIG. 3 is an enlarged view showing an outer cylinder base and an outer cylinder guide base of a hand operation part of the puncture kit.

FIG. 4 is an explanatory view showing a state in which the shape of the tip of the outer cylinder of the device is changed.

[Explanation of symbols]

1. Puncture kit 10. Hand control unit 11. Outer cylinder 111. Curved part 12. Outer cylinder base 121. Moving groove 122. Fixed groove 13. Outer cylinder guide tube 14. Guide tube base 141. Protrusion 142. (Guide tube base) Rear end 15. Inner needle 151. Cutting edge 16. Inner needle base 17. Check valve 171. Connection ring 172. Rubber elastic member 2. catheter 21. Tip opening 22. Side hall 23. Curved part 24. Tip taper part (tapered part) 25. scale 3. adapter 31. Adapter body 32. Tightening ring 33. Lock ring 34. Lock cap

Claims (6)

[Claims] 1. An outer cylinder made of a flexible tube whose tip is curved in a J shape, an outer cylinder guide tube made of a hard pipe that can be inserted into and removed from an inner cavity of the outer cylinder, and an inner cylinder of the outer cylinder guide tube. An inner needle that is a rod-shaped body that can be inserted into and removed from the cavity and has a cutting edge at the tip, and an outer cylinder base, an outer cylinder guide pipe base, and an inner cylinder that are provided at the rear ends of the outer cylinder, the outer cylinder guide tube, and the inner needle. When the outer cylinder guide tube is inserted into the outer cylinder, the distal end portion of the outer cylinder has a range from a J shape to a straight shape depending on the insertion depth of the outer cylinder guide tube. Puncture kit whose shape can be changed, a catheter which can be inserted into the inner cavity of the outer cylinder guide tube and has an opening at the tip and / or a side hole on the side surface near the tip, and a rear end or a middle portion of the catheter. Detachable from the catheter and capable of closing and opening the lumen passage of the catheter. A drainage instrument for laparoscopic surgery, characterized by having a adaptor. 2. In addition to the structure of claim 1, the inside of the outer cylinder guide tube can be inserted into the inner cylinder of the outer cylinder guide tube by inserting and detaching the catheter into the rear end of the outer cylinder guide tube base. The laparoscopic surgical drainage device according to claim 1, further comprising a check valve for closing the cavity passage. 3. The drainage instrument for laparoscopic surgery according to claim 1, wherein the distal end portion of the catheter is curved in a J shape. 4. The drainage instrument for laparoscopic surgery according to claim 1, wherein a distal end portion of the catheter has a tapered taper shape. 5. The drainage instrument for laparoscopic surgery according to claim 1, wherein the outer cylinder and / or the catheter is made of a fluororesin such as tetrafluoroethylene. 6. The outer cylinder base and the outer cylinder guide tube base of the hand-operated portion are configured as cylindrical members slidably arranged on concentric circles, and the outer cylinder base and the outer cylinder guide tube base are both The longitudinal movement groove formed on one of the sliding surfaces and the circumferential fixed grooves provided at both ends and the intermediate portion of the movement groove are engaged with the protrusions formed on the other sliding surface. When the protrusion has a configuration and relatively moves within the movement range of the protrusion of the movement groove and the protrusion is engaged with the fixed groove, movement of the outer cylinder base and the outer cylinder guide base in the longitudinal direction is restricted. The drainage instrument for laparoscopic surgery according to any one of claims 1 to 5, having the above-mentioned configuration.