JP2005137943A - Suction and releasing cap and forceps for endoscopic operation - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a suction and releasing cap and forceps for endoscopic operation which solve the problems that safe releasing cannot be performed, it clogs during sucking, or it is not easy to carry out releasing, suction, and washing because halation occurs when it is used for the endoscopic operation. <P>SOLUTION: In a suction and releasing cap for the endoscopic operation which consists of a flexible material, has one or more suction openings on a surface and a forceps loading slot at the end, and makes each suction opening communicate with the forceps loading slot, the cross-section area of each suction opening is not smaller than 0.5 mm<SP>2</SP>, and the color of the material has light absorbing characteristics. Also, a metal piece for high-frequency cauterization is prepared on the part of the surface of the suction and releasing cap for the endoscopic operation. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention mainly relates to suction of exudate, blood, mucus, physiological saline (hereinafter abbreviated as exudate, etc.) and detachment of tissues, mucous membranes, blood vessels and the like in endoscopic operations such as laparoscopic surgery and thoracoscopic surgery. The present invention relates to an endoscopic surgical suction peel cap and forceps used in the above.

  In recent years, endoscopic operations such as laparoscopic surgery and thoracoscopic surgery have rapidly spread and their indications are expanding. This initially started with relatively easy procedures such as laparoscopic cholecystectomy and thoracoscopic pneumothorax surgery, but eventually the partial removal of the stomach and large intestine, and the common bile duct stone This is because operations such as removal, thoracoscopic surgery for lung cancer and emphysema, which can only be performed by conventional laparotomy / thoracotomy, are being performed under laparoscopic / thoracoscopic operations.

  This is probably because the endoscopic operation did not make an incision, so that the patient's time to surgery was short and the cosmetics met the needs of the patient. On the other hand, since it is impossible for an operator to perform an operation with his / her finger under direct vision, various instruments have been developed to improve this.

  Examples of instruments that have been developed to perform the peeling operation include those in which a tip formed with a thermoplastic resin is attached to the tip as shown in Japanese Utility Model Laid-Open No. 1-138449, or Japanese Utility Model Laid-Open No. 5-88552. There are those composed of a porous member as shown. According to this, it was possible to exfoliate tissues, mucous membranes and blood vessels by providing some frictional portion at the tip, and it was also possible to suck in exudate and the like by having a suction function.

  However, such a peeling / suctioning forceps may be clogged because the hole diameter of the suction part is small. Further, when used under an endoscope, the light emitted from the endoscope may be reflected and difficult to see (hereinafter referred to as halation). In the unlikely event that the chip falls into the abdominal cavity or thoracic cavity, there is no way to search for it, so it must eventually be opened, which not only increases patient invasion, but also wastes time and operator effort. There was a thing.

  On the other hand, in order to further improve the peeling performance, a peeling forceps using a metal sphere having a rough surface structure has been developed (for example, Patent Document 1). This is because the metal surface is roughened and the peeling performance is considered to be good. On the other hand, because it is made of metal, in the unlikely event it is easy to damage blood vessels, etc., causing major bleeding, and surgery may be interrupted was there.

JP-A-7-67880

  The present invention has been made as a result of various studies with the aim of improving the performance of suction / peeling caps and forceps for endoscopic surgery used in conventional endoscopic surgery. In addition to safe peeling and suction without clogging of exudate, etc., it does not cause halation even when used in endoscopic surgery, and it imposes a visual burden on the operation of the operator. It can be reduced, and even if it falls into the abdominal cavity or thoracic cavity, it can be easily searched by X-rays, and therefore, safer and more reliable endoscopic surgery can be performed.

That is, the present invention is an endoscopic operation which is made of a flexible material, has one or more suction holes on the surface and a forceps insertion opening at the end, and each suction hole communicates with the forceps insertion opening. A suction peel cap for an endoscopic operation characterized in that the cross-sectional area of each suction hole is 0.5 mm ² or more and the material has a light-absorbing color. This is an endoscopic surgical suction / peeling cap characterized in that a metal piece for high-frequency cauterization is provided in a part thereof or it has radiopacity.

  According to the present invention, the results of various studies aimed at improving the performance of the aspirating / peeling cap for endoscopic surgery and forceps used in conventional endoscopic surgery include tissue, mucous membrane, blood vessel In addition to being able to perform good and safe exfoliation and suction without clogging of exudate, etc., it does not cause halation even when used in endoscopic surgery, and it is visually and visually operated by the operator. In addition, even if it falls into the abdominal cavity / thoracic cavity, it can be easily searched by X-rays, so that safer and more reliable endoscopic surgery can be performed.

  Hereinafter, the present invention will be described in detail with reference to the drawings. FIG. 1A is a schematic view showing an embodiment of an endoscopic surgical suction peeling cap according to the present invention, FIG. 1B is a sectional view thereof, and FIG. 1C is a sectional view in which metal pieces are combined. Indicates. FIG. 2A is a schematic diagram showing an example in combination with a linear suction / cleaning forceps, and FIG. 2B is a schematic diagram showing an example in combination with a bent suction / cleaning forceps. FIG. 3A is a schematic diagram showing a state where an operation is performed and blood vessels are peeled off, and FIGS. 3B and 3C are schematic diagrams showing the positional relationship between the position of the suction hole and the exudate.

  The suction peeling cap (1) for endoscopic surgery according to the present invention comprises one or more suction holes (2) and a forceps insertion opening (3). (FIG. 1 (a)) Endoscopic suction / peeling cap (1) The tip can be spherical, oval, tetrahedral, hexahedral, octahedral, dodecahedron, conical, etc. Spherical shapes are more desirable due to molding problems. The outer diameter varies depending on the operator's preference, but is preferably φ3 to φ30 mm when used through a trocar. One or more suction holes (2) communicate with the forceps insertion opening (3), respectively, and are sucked by suction / washing forceps or the like to which exudate is connected. The cross-section of the suction hole (2) can be circular, elliptical, triangular, quadrangular, hexagonal, etc., but a circular shape is preferable from the viewpoint of usability and workability.

The cross-sectional area of the suction hole (2) is desirably 0.5 mm ² or more, and if it is less than 0.5 mm ² , there is a risk of clogging due to blood clots, tissue fragments, and the like. By providing one or more suction holes (2), even if one suction hole (2) is blocked, it is possible to continuously suck because there is another suction hole (2). . The upper limit of the cross-sectional area of the suction hole (2) varies depending on the outer diameter of the distal end portion of the suction peeling cap (1) for endoscopic surgery, but generally has a size up to 50% of the outer diameter. Beyond that, durability is significantly reduced. In a single suction hole (2), blood clots and tissue fragments in the blocked portion may not be removed due to continuous suction, but it is also possible to avoid such a situation.

  The position and number of the suction holes (2) are arbitrary and are selected depending on the application. For example, the suction hole (2) is provided in the hemisphere of the sphere, and the remaining hemisphere is not provided with the suction hole (2) and is used as the surface for the peeling operation. The suction hole (2) is preferably located at the lowermost part when used by being attached to the suction / washing forceps. In the linear suction / washing forceps, the opposite side of the forceps insertion port (3) is provided, and in the bent suction / washing forceps, the suction / washing forceps are positioned according to the bending state. This makes it easier for the suction hole (2) to reach the bottom of the pool of leachate or the like during use. By pulling, more effective suction can be performed. (FIGS. 4B and 4C)

  The shape of the forceps insertion opening (3) is determined by the cross-sectional shape of the attached suction / washing forceps, but a circular shape is more preferable because it can be attached to a general suction / washing forceps. The inner diameter is arbitrary, but is generally φ2 to φ27 mm. A sleeve (4) is provided to make the attachment to the suction / washing forceps more robust. The length of the sleeve (4) is arbitrary, but 5 to 40 mm is desirable. If it is less than 5 mm, it may fall off from the suction / washing forceps, and if it exceeds 40 mm, it may be difficult to attach to the suction / washing forceps. There is.

  The endoscopic surgical peeling suction cap (1) is made of a flexible resin such as vinyl chloride resin, polyurethane resin, polyethylene resin, polypropylene resin, silicone rubber or elastomer. Some are made of a single resin, and some are made of a plurality of resins. Silicone rubber is preferable from the viewpoints of biological safety, release performance, processability, and the like. In order to be able to search with X-rays in the event that it falls off, breaks and remains in the abdominal cavity or chest cavity, it may be a radiopaque material mixed with bismuth oxide, basic bismuth, barium sulfide, etc. More desirable.

  Colors that reflect light such as transparent and white cause halation and hinder surgery, so colors that absorb light such as gray, black, brown, blue, and dark green are desirable. Gray and black are more desirable from the viewpoint of cost. A certain degree of hardness is required for performing sufficient peeling operation of tissues, mucous membranes and blood vessels, and not damaging or bleeding, and 40 to 80 degrees for Shore A, more preferably 60 to 70 degrees. Thereby, it has moderate softness | flexibility and peeling performance.

The peeling cap (1) for endoscopic surgery according to the present invention is used by a doctor by attaching it to his / her favorite suction forceps or suction / washing forceps. May be provided. (Fig. 2 (a), (b))
As a result, it can be used as a peeling / suctioning forceps or a peeling / suction / washing forceps, respectively, so that a doctor can perform a treatment more quickly and the usefulness increases.

  Also, it may be used in combination with a suction forceps having a high-frequency cauterization function or suction / washing forceps. At this time, a metal piece (10) for high frequency separation / cauterization is provided on a part of the surface of the peeling cap (1) for endoscopic surgery, and a suction forceps having a high frequency separation / cauterization function, By using the suction / washing forceps cutting / cauterizing part electrically connected, the part of the peeling cap for endoscopic surgery (1) has a cutting / cauterizing function. Usefulness increases. By positioning the metal piece (10) on the forceps insertion opening side (3), unintentional disconnection / cauterization is prevented from occurring during energization. When separating the mucous membrane, etc., place the separated mucosa on the side of the forceps insertion port (3) of the exfoliating suction cap (1) for endoscopic surgery. It prevents the unintentional detachment and cauterization of the tissue in contact with the distal end side, and safely detaches the mucous membrane. (Fig. 1 (c))

  Further, a bent tip may be used to improve operability. The angle depends on the operator's preference, but 45-60 degrees is generally used. In this case, the position of the suction hole (2) is set to the deepest position when the operator uses it. (Fig. 2 (b), Fig. 3 (c))

  Next, a method for performing an actual operation using the peeling suction cap (1) for endoscopic surgery according to the present invention will be described with reference to FIG. 3 to clarify the effect of the present invention.

  First, the peeling suction cap (1) for endoscopic surgery is attached to the tip of the suction / washing forceps (5). Since it has a sleeve (4), it is difficult to drop off. Connect the suction / washing forceps (5) to an aspirator or a physiological saline for washing (not shown), and confirm that suction and washing can be performed. Next, suction / washing forceps are introduced into the patient's abdominal cavity (7) / thoracic cavity through an incision (6) or trocar on the patient's abdominal / chest wall. Since the outer diameter is φ3 to φ30 mm, it can be used through a trocar.

To perform the peeling operation, the peeling suction cap for endoscopic surgery (1) is positioned in the vicinity of the mucous membrane (8) and operated so as to stroke the peeling site. Since it is made of silicone rubber and has a hardness of 60 to 70 degrees, it can be operated in a friendly manner without damaging tissues and blood vessels. There is also little risk of bleeding. (Fig. 3 (a))
The washing / suction operation can be easily performed with suction / washing forceps. Physiological saline is poured into the abdominal cavity and thoracic cavity with suction and washing forceps, and the exudate (9) is aspirated. Since there are one or more suction holes (2) and 0.5 mm ² or more each, suction and cleaning can be easily performed, and there is no possibility of clogging. (Fig. 3 (b), (c))

  Moreover, since it is a light-absorbing color when performing an operation in endoscopic surgery, halation does not occur and the operator's visual field is not hindered. Even if it falls off or breaks, it has X-ray opacity, so it is easy to search by X-ray.

It is the schematic which shows one Example of the suction peeling cap for endoscopic surgery by this invention. It is the schematic which shows the state which mounted | wore the suction / washing forceps with the suction peeling cap for endoscopic surgery by this invention. It is the schematic which shows the Example which peels, wash | cleans, and suction | inhalation using the suction peeling cap for endoscopic surgery by this invention.

Explanation of symbols

1. 1. Endoscopic suction / peeling cap 2. Suction hole Forceps insertion port Sleeve 5 5. Suction / cleaning forceps Incision 7. 7. Intraperitoneal Mucosa 9. 9. Leachate etc. Metal piece

Claims (4)

In an endoscopic surgical suction peeling cap that is made of a flexible material, has one or more suction holes on the surface and a forceps insertion opening at the end, and each suction hole communicates with the forceps insertion opening. A suction peel cap for endoscopic surgery, wherein the cross-sectional area of each suction hole is 0.5 mm ² or more, and the material is a light-absorbing color.   The suction peeling cap for endoscopic surgery according to claim 1 or 2, wherein a metal piece for high-frequency cauterization is provided on a part of the surface of the suction peeling cap for endoscopic surgery.   The suction / peeling cap for endoscopic surgery according to claim 1, wherein the suction / peeling cap for endoscopic surgery has radiopacity. An endoscopic surgical forceps comprising a suction forceps or a suction / washing forceps attached to the forceps insertion port of the endoscopic surgical suction peel cap according to any one of claims 1 to 3.