JP2007068707A - Ultrasonic trocar - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ultrasonic trocar which is at a low cost, has a good inserting nature, and can easily and smoothly advance a surgical operation by smoothly detaining a sheath tube in the body wall. <P>SOLUTION: The ultrasonic trocar comprises an inner needle 2 which is stabbed in the body wall by the transmission of ultrasonic vibration, a protective sheath 5 which can move by covering the inner needle 2, the sheath tube 3 in which the inner needle 2 covered with the protective sheath 5 is inserted, and engagement groove portions 42 and 51 and an engagement nail portion 52 which are prepared in the inner needle 2 and the protective sheath 5 and keep the prong of the inner needle 2 fixed to the insertion part of the protective sheath 5 respectively in exposed state and retracted state. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an ultrasonic trocar that punctures a body wall while applying ultrasonic vibration to an inner needle inserted through an outer tube.

  2. Description of the Related Art A trocar is known in which a mantle tube that is inserted into a patient's body and used as a guide tube for an insertion device into a body cavity is punctured into the patient's body wall and placed in a state of being penetrated through the body wall.

  Generally, in a trocar, an inner needle that punctures through the abdominal wall and an outer tube having an insertion portion through which the inner needle is inserted are detachably combined, and in this combined state, the body wall is punctured, and the distal end of the outer tube Insert until is in the body cavity. Further, after inserting the trocar into the body cavity, the inner needle is removed from the outer tube, so that the outer tube is placed on the body wall, and the outer tube is used as an optical visual tube or a lesion for observing the lesion. It is used as a guide tube for a treatment tool or the like for performing the above procedure.

  As this type of trocar, for example, there is one shown in Japanese translations of PCT publication No. 2002-538879 (patent document 1). In the trocar of this patent document 1, the inner needle is provided with a pointed tip and a blade-like knife edge. In addition, a safety shield mechanism is incorporated so as to cover the puncture portion of the inner needle when the puncture portion of the inner needle penetrates the abdominal wall during the operation of puncturing the abdominal wall with the inner needle. When the puncture portion of the inner needle penetrates the abdominal cavity wall, the puncture portion of the inner needle is covered with the safety shield, so that the puncture portion of the inner needle hits a tissue such as a body organ and the body tissue is damaged. To prevent.

  The trocar of USP 6,656,198 specification (patent document 2) is provided with a separator in which an inner needle is combined with a non-pointed tip and a pair of blades, and penetrates the abdominal wall by screwing the inner needle. It is like that.

  Japanese Patent Laid-Open No. 2000-23991 (Patent Document 3) discloses an ultrasonic trocar that transmits ultrasonic vibrations to an inner needle that punctures the abdominal wall. With this ultrasonic trocar, it is possible to puncture with a relatively light force by inserting an ultrasonically vibrated inner needle into the abdominal wall. Further, the puncture portion of the inner needle is provided with two ridge lines at a position sandwiched between at least two curved surfaces and substantially symmetric with respect to the longitudinal central axis of the inner needle, and at least the tip portion and the outermost position of the ridge line The cutting edge part which cuts a biological tissue is formed in the largest external dimension part arrange | positioned in this.

Further, in the ultrasonic trocar disclosed in Japanese Patent Laid-Open No. 2002-85337 (Patent Document 4), the distal end portion of the inner needle is formed in a thin plate shape, and this inner needle closes the guide hole of the outer tube. It arrange | positions in the cover member which formed the slit in the front-end | tip part, and protrudes from the front-end | tip of a cover member through a slit.
JP-T-2002-538879 USP 6,656,198 Specification Japanese Patent Laid-Open No. 2000-23991 JP 2002-85337 A

  In the trocar shown in Japanese translations of PCT publication No. 2002-538879 gazette, it is the structure which incorporates a safety shield. For this reason, the structure of a trocar becomes complicated. Therefore, the number of parts of the trocar increases and the cost increases. Furthermore, the knife edge with a sharp tip of the inner needle has a problem that the knife edge becomes dull with each use and the sharpness is lowered. When the inner needle is not sharp, a large operating force is required when the puncture portion is pierced into the abdominal wall. When puncturing the puncture part into the abdominal wall by applying a large operating force, the tip of the puncture part hits the internal organ etc. due to the momentum when the puncture part penetrates the abdominal wall, and is difficult to avoid. Is required from the surgeon.

  In the trocar shown in US Pat. No. 6,656,198, the tip of the inner needle is blunt and the peritoneum is easily stretched and pushed in. As a result, the puncture part approaches or comes into contact with the internal organ. Since the tip of the inner needle easily damages the organ in the body cavity during the screwing operation, the operator is required to have a difficult technique to avoid it.

  The ultrasonic trocar disclosed in Japanese Patent Application Laid-Open No. 2000-23991 can puncture with a relatively light force. However, since the outer tube is inserted with the inner needle tip exposed in the abdominal cavity, At the same time, it is easy to damage organs in the body cavity at the tip of the inner needle, and thus a difficult technique to avoid it is required of the surgeon.

  In the ultrasonic trocar disclosed in Japanese Patent Laid-Open No. 2002-85337, since the cover member having the slit is provided, there is a problem that the configuration becomes complicated and the cost is increased. Further, when the abdominal wall is punctured, the distal end portion of the cover member becomes a resistance of the amount of insertion force, so that a large operating force is required. In such a case, since the tip of the puncture part hits the internal organ or the like due to the momentum when the puncture part penetrates the abdominal wall and is easily damaged, the operator is required to have a difficult technique to avoid it.

  The present invention has been made by paying attention to the above circumstances, and the object of the present invention is to facilitate the operation easily and smoothly by placing the mantle tube smoothly on the body wall with low cost and good insertability. It is to provide an ultrasonic trocar that can perform the above.

  According to the first aspect of the present invention, there is provided an inner needle that transmits ultrasonic vibrations to puncture a body wall, and a protective sheath that covers the insertion portion of the inner needle and is relatively movable with respect to the insertion portion of the inner needle. And an outer tube into which the inner needle covered with the protective sheath is inserted, and a state in which the distal end portion of the inner needle is exposed to the insertion portion of the protective sheath and stored in the inner needle and the protective sheath. It is the ultrasonic trocar characterized by including the latching means which each fixes in the state made.

  According to the first aspect of the present invention, the distal end portion of the inner needle is fixed while being exposed to the distal end of the insertion portion of the protective sheath during the puncturing operation using ultrasonic waves, and the outer tube is inserted into the body wall. During the operation, the distal end portion of the inner needle is fixed in a state of being accommodated with respect to the insertion portion of the protective sheath.

  The invention according to claim 2 covers the inner needle that is punctured into the body wall by transmitting ultrasonic vibration, and the inner needle insertion portion, and is movable relative to the inner needle insertion portion. A protective sheath, an outer tube into which the inner needle coated with the protective sheath is inserted, and a small-diameter puncture hole that is inserted between the outer tube and the inner needle and is drilled in the body wall by the inner needle A dilator having an expansion portion for extending the inner sheath and the inner needle and the protective sheath, and fixing the distal end portion of the inner needle in an exposed state and a retracted state with respect to the insertion portion of the protective sheath. An ultrasonic trocar comprising a stopping means.

  According to the second aspect of the present invention, the tip of the inner needle is fixed while being exposed to the tip of the insertion portion of the protective sheath during the puncturing operation using ultrasonic waves, and the puncture hole is expanded by the dilator. During the operation and the operation of inserting the outer tube into the body wall, the distal end portion of the inner needle is fixed in a state of being accommodated with respect to the insertion portion of the protective sheath.

  According to the ultrasonic trocar of the present invention, the expansion operation for expanding the diameter of the puncture hole formed in the patient's body wall by the dilator and the insertion operation for inserting the outer tube can be performed smoothly. Therefore, surgery can be performed easily and smoothly.

(First embodiment)
Hereinafter, a trocar system according to a first embodiment of the present invention will be described with reference to FIGS. 1 to 11.

  FIG. 1 schematically shows the overall configuration of the trocar system in the assembled state. The trocar system 1 is mainly provided with four components disassembled and shown in FIG. 2, that is, an inner needle 2, an outer tube 3, a dilator 4, and a protective sheath (guide member) 5. These components are used in the state shown in FIG. 3 shows the outer tube 3, FIG. 4 shows the dilator 4, and FIG. 5 shows the protective sheath 5 as a guide member.

  As shown in FIG. 2, the inner needle 2 has a substantially straight and long rod-like probe 6. The tip of the probe 6 is provided with a slightly sharp puncture needle 7 having a narrow tip. The portion of the puncture needle 7 is provided with two ridge lines that are sandwiched between two curved surfaces and are symmetric with respect to the longitudinal central axis of the inner needle 2. The cutting edge part which cuts a biological tissue is formed by the ridge line part.

  A transducer 8 that generates ultrasonic vibrations is connected to the proximal end of the probe 6 via a horn (not shown). The ultrasonic vibration generated in the transducer 8 is amplified by the horn and then transmitted to the puncture needle 7 at the tip of the probe 6 through the probe 6. A connector portion 11 is provided at the base end portion of the transducer 8, and a connector 13 of the electric cable 12 shown in FIG. 1 connected to a power supply device (not shown) is detachably connected to the connector portion 11. It has become so.

  As shown in FIG. 3, the outer tube 3 is configured by detachably assembling an elongated insertion portion 14 and a connection unit 15 having a built-in valve. Here, a distal end inclined surface 14 a that is inclined obliquely with respect to a direction orthogonal to the center line direction of the insertion portion 14 is formed at the distal end portion of the insertion portion 14. In addition, the connection unit 15 is provided with an inlet port portion 16 located on the end face on the opposite side of the coupling portion between the cock 16 c and the insertion portion 14.

  As shown in FIG. 6, the inlet port portion 16 has a cylindrical inlet port body 16a. The inlet port body 16a is formed with a ring-shaped shoulder 16b protruding toward the inner side (back side) of the connection unit 15. A valve body 17 is disposed inside the connection unit 15. The valve body 17 constitutes an open / close valve that opens and closes in response to insertion of the dilator 4 and the like from the inlet port portion 16. The valve body 17 is provided with an expansion / contraction valve 17a and a check valve 17b formed of an elastic body. The expansion / contraction valve 17a has a small hole 17c centered on the center line of the inlet port portion 16. When an insertion tool is inserted into the valve body 17 from the inlet port portion 16, the circumference of the small hole 17c is reduced. The portion is pressed against the peripheral portion of the insertion instrument so as to ensure airtightness between the inlet port 16 and the insertion instrument. When the insertion device is not inserted, the check valve 17b ensures airtightness so that the gas from the abdominal cavity in the abdominal cavity does not leak from the insertion portion 14 side to the inlet port portion 16 side.

  As shown in FIG. 4, the dilator 4 is provided with a tubular elongated insertion portion 18 and a proximal side end portion 19 disposed at the proximal end portion of the insertion portion 18. The insertion portion 18 is formed with a small-diameter portion 20 having an outer diameter smaller than that of the front and rear end portions at an intermediate portion between the front and rear end portions. Both front and rear ends of the insertion portion 18 are set to have substantially the same diameter as the inner diameter of the insertion portion 14 of the outer tube 3. At the front end of the insertion portion 18, a straight pipe portion 21 having an outer diameter dimension substantially the same as the inner diameter dimension of the insertion portion 14 of the outer tube 3 is disposed. A substantially tapered conical puncture hole expanding portion 22 is disposed on the distal end side of the straight tube portion 21. A straight tubular bend preventing portion 23 extends from the distal end portion of the puncture hole expanding portion 22. A tip inclined surface 23 a that is inclined obliquely with respect to a direction orthogonal to the direction of the center line of the insertion portion 18 is formed at the tip portion of the bend preventing portion 23. As shown in FIG. 4, a thick-diameter portion 24 that is thicker than the thin-diameter portion 20 is formed at the rear end portion of the insertion portion 18.

  Then, as shown in FIG. 8, after the dilator 4 is inserted into the inlet port portion 16 of the mantle tube 3, the dilator 4 and the mantle tube 3 are assembled in a regular assembling position. 20 is brought into pressure contact with the expansion / contraction valve 17 a to ensure airtightness between the inlet port portion 16 and the dilator 4.

  Further, as shown in FIG. 7, on the outer peripheral surface of the large-diameter portion 24, the dilator 4 and the outer tube 3 are assembled in the regular assembly position, and the shoulder portion 16 b of the inlet port portion 16 in the outer tube 3. A click mechanism (locking means) 25 is disposed at a position corresponding to the inner peripheral edge. The click mechanism 25 is configured by disposing a C-ring 27 that is elastically deformable in the radial direction in the groove portion 26.

  Further, as shown in FIG. 7, a handle portion 29 on the hand side is formed in the dilator 4 at the proximal end portion of the large diameter portion 24. A ring-shaped fixing member 30 and a lock ring 31 are disposed on the outer end side of the handle portion 29. An index ring 32 is disposed between the fixing member 30 and the handle portion 29. The index ring 32 is made of a resin material. The indicator ring 32 is set to display the thickness of the dilator 4 in different colors, for example. Further, the index ring 32 is sandwiched between the fixing member 30 and the handle portion 29, and also serves as a sealing function between the fixing member 30 and the handle portion 29.

  A base ring 33 that is inserted into the lock ring 31 protrudes from the outer end portion of the fixing member 30. A guide pin 34 projects from the outer peripheral surface of the base ring 33 in the radial direction. A guide hole 35 into which the guide pin 34 is inserted extends in the lock ring 31 in the radial direction. A guide pin 34 is inserted into the guide hole 35 so as to be movable in the radial direction. A lock release button 36 is disposed on the outer peripheral surface of the lock ring 31 on the side opposite to the guide hole 35. A return spring 37 is incorporated in the lock release button 36. The lock ring 31 is held at a normal position shown in FIG. 9A by the spring force of the return spring 37.

  Further, as shown in FIG. 10A, a locking claw portion 31a that can be removably inserted into the center inner side of the pipe of the large diameter portion 24 in the dilator 4 protrudes from the outer end portion of the lock ring 31. It is installed. The lock ring 31 is in a locked position where the locking claw portion 31a held in the normal position shown in FIG. 9A is inserted to the center inside position of the pipe of the large diameter portion 24 in the dilator 4. So that it is held.

  Further, in the case of unlocking, the lock ring 31 is pushed in the radial direction along the guide pin 34 of the base ring 33 in accordance with the pushing operation of the unlocking button 36 as shown by an arrow in FIG. Then, the engaging claw portion 31a moves to the position where the pushing operation is performed to the position outside the center of the pipe of the large diameter portion 24 in the dilator 4, that is, the unlocking position.

  Further, as shown in FIG. 5A, the protective sheath 5 is provided with an elongated flexible straight pipe portion 39 and a handle portion 40 connected to a terminal portion on the proximal end side of the straight pipe portion 39. It has been. The straight pipe portion 39 is made of a flexible material having high heat resistance and high slipperiness, such as Teflon (registered trademark): PTFE (polytetrafluoroethylene), because of contact with the probe 6 that vibrates ultrasonically. Is formed. The inner diameter dimension of the straight tube portion 39 is set to be substantially the same as the outer diameter dimension of the puncture needle 7 of the inner needle 2. A positioning portion 39a is formed on the proximal end portion of the straight pipe portion 39. The positioning portion 39a is formed with a circumferential surface having substantially the same diameter as the inner diameter of the locking claw portion 31a of the dilator 4.

  As shown in FIG. 5A, the handle 40 of the protective sheath 5 has a large-diameter cylindrical body 41 inserted into the detachable part 9 on the proximal side of the inner needle 2 and a lock ring of the dilator 4. An elongated small-diameter cylindrical body 42 to be inserted into 31 is provided. On the outer peripheral surface of the large-diameter cylindrical body 41, a ring-shaped first engagement groove portion 43 and a second engagement groove portion 51 are formed at predetermined intervals in the axial direction. On the outer peripheral surface of the small-diameter cylindrical body 42, four ring-shaped third engaging groove portions 44 are arranged in parallel along the axial direction.

  In addition, a slit valve 45 is provided in the handle portion 40 of the protective sheath 5 to ensure airtightness inside the protective sheath 5. As shown in FIG. 5B, the slit valve 45 includes a disk-shaped base plate 46 formed of an elastic body, and a slit portion 47 that passes through the center of the base plate 46. When the inner needle 2 is inserted into the protective sheath 5, the inner needle 2 is inserted into the slit portion 47 of the slit valve 45 located on the proximal side of the protective sheath 5, and the peripheral portion of the slit portion 47 of the base plate 46 is located on the probe 6. It is in close contact with the outer peripheral surface so as to ensure airtightness inside the protective sheath 5.

  Then, as shown in FIG. 11A, when the inner needle 2 and the protective sheath 5 are assembled, the engaging claw portion 52 in the detachable portion 9 located on the hand side of the inner needle 2 is the first engagement. The inner needle 2 is held in the locked state engaged with the mating groove 43. Further, when the detachable button 10 is pushed in from this locked state, the engaging claw portion 52 is disengaged from the first engaging groove portion 43 of the protective sheath 5 and the locked state is released.

  In the unlocked state, the inner needle 2 can be moved in the axial direction with respect to the protective sheath 5. As shown in FIG. 11B, when the inner needle 2 is moved in the axial direction with respect to the protective sheath 5 in the unlocked state, the engaging claw portion 52 and the second engaging groove portion 51 of the protective sheath 5 The locked state is engaged and the inner needle 2 is held in that position. This ensures that the puncture needle 7 that is the distal end portion of the inner needle 2 is securely held in a state of being housed in the straight tube portion 39 of the protective sheath 5.

  When the dilator 4 and the protective sheath 5 are assembled, the spring force of the return spring 37 of the lock release button 36 causes the dilator 4 to move as shown in FIGS. 9 (A) and 10 (A). The locking claw 31a of the lock ring 31 engages with the third engagement groove 44 at any position of the protective sheath 5, and is held in a locked state. In this locked state, the lock ring 31 is engaged with the guide pin 34 of the base ring 33 by pushing the lock release button 36 in the direction indicated by the arrow in FIG. 9B against the spring force of the return spring 37. The locking claw 31a is released from the third engagement groove 44 of the protective sheath 5 and is unlocked (see FIG. 10B). In this unlocked state, the position of the tip of the inner needle 2 protruding from the tip of the outer tube 3 can be variably adjusted by moving the protective sheath 5 in the axial direction relative to the dilator 4 and selecting the position. .

  Next, the operation of the first embodiment will be described. When using this trocar system 1, as shown in FIG. 1, the inner needle 2, the outer tube 3, the dilator 4, and the protective sheath 5 are set in advance.

  In the assembling operation of the trocar system 1, first, as shown in FIG. 8, the insertion portion 18 of the dilator 4 is inserted into the inlet port portion 16 of the outer tube 3. At this time, the front end portion of the insertion portion 18 of the dilator 4 inserted into the inlet port portion 16 is pushed forward as a state in which the expansion and contraction valve 17a is expanded (see FIG. 6). For this reason, when the dilator 4 is inserted, the expansion / contraction valve 17a is pressed against the peripheral portion of the insertion portion 18 of the dilator 4 inserted into the valve body 17 from the inlet port portion 16, and the inlet port portion 16 and the die Airtightness with the insertion portion 18 of the lator 4 is ensured.

  Further, as shown in FIG. 8, the click mechanism 25 operates when the dilator 4 inserted into the outer tube 3 is moved to a proper assembly position between the dilator 4 and the outer tube 3. When the click mechanism 25 is operated, the C ring 27 is expanded and hooked on the inner peripheral edge of the shoulder portion 16b of the inlet port portion 16, and the hook mechanism of the click mechanism 25 operates in this hooked state. At this time, the dilator 4 and the outer tube 3 are detachably locked so that a click feeling is generated and at the same time the outer tube 3 is not detached from the dilator 4 with a light force.

  Further, when the dilator 4 is moved to the normal assembly position of the dilator 4 and the outer tube 3 shown in FIG. 8, the distal straight tube portion 21 of the dilator 4 is the inner peripheral surface of the distal portion of the outer tube 3. It is held in a state of sliding contact.

  Next, the inner needle 2 is inserted into the protective sheath 5. In this insertion operation, first, the inner needle 2 is inserted into the slit 47 in the slit valve 45 of the handle 40 in the protective sheath 5. At this time, the peripheral portion of the slit portion 47 of the base plate 46 is held in a state where it is pressed against the outer peripheral surface of the inner needle 2, thereby ensuring airtightness inside the protective sheath 5. Further, in a state in which the inner needle 2 is inserted into the protective sheath 5 to the proper insertion position, the engagement claw portion 52 of the inner needle 2 is engaged with the first engagement groove portion 43 of the protective sheath 5 in the locked state. Retained.

  Subsequently, an operation of inserting the inner needle 2 equipped with the protective sheath 5 into the tube of the dilator 4 is performed. In this operation, the inner needle 2 with the protective sheath 5 is inserted to an appropriate insertion position, and is positioned at any one of the four positions of the third engagement groove 44 of the small-diameter cylindrical body 42 of the protective sheath 5. The locking claw portion 31a of the lock ring 31 is selectively engaged. At this time, the locking claw 31 a of the lock ring 31 of the dilator 4 is engaged with the third engagement groove 44 at any position of the protective sheath 5 by the spring force of the return spring 37 of the lock release button 36. It is in a state and held in that position.

  As described above, the inner needle 2, the outer tube 3, the dilator 4, and the protective sheath 5 are set in an assembled state as shown in FIG.

  Next, when puncturing the patient's body wall with the trocar system 1, the puncture needle 7 of the inner needle 2 is punctured into the patient's body wall while applying ultrasonic vibration to the puncture needle 7 of the inner needle 2. An expansion operation for expanding the puncture hole by the dilator and an operation for inserting the outer tube 3 into the body wall are sequentially performed.

  That is, after the inner needle 2 is punctured into the body wall of the patient, the engaging claw portion 52 is pushed into the attaching / detaching button 10 on the attaching / detaching portion 9 of the inner needle 2 so that the engaging claw portion 52 is the first engaging groove portion of the protective sheath 5. 43 is released and the locked state of the inner needle 2 is released.

  Subsequently, when the inner needle 2 is slid toward the proximal side with respect to the protective sheath 5, the engaging claw portion 52 engages with the second engaging groove portion 51 of the protective sheath 5, and enters a locked state. Thereby, the puncture needle 7 which is the distal end portion of the inner needle 2 is reliably held in a state of being accommodated in the straight tube portion 39 of the protective sheath 5.

  Subsequently, in a state where the puncture needle 7 is housed in the protective sheath 5, the outer tube 3 and the dilator 4 are pushed in while expanding the puncture hole of the body wall with the protective sheath 5 as an axis. The insertion part 14 is inserted into the abdominal wall.

  Further, after the outer tube 3 is inserted, the inner needle 2, the protective sheath 5, and the dilator 4 are removed from the outer tube 3. As a result, the outer tube 3 is placed in the abdominal wall.

  The configuration described above has the following effects. First, in the trocar system of the present embodiment, the inner needle 2 and the protective sheath 5 can be locked by the lock mechanism in the indwelling state in which the puncture needle 7 is housed in the protective sheath 5. It is possible to prevent the protective sheath 5 from being deformed during an operation of expanding the diameter of the protective sheath 5 or the like. At the same time, since the tip of the puncture needle 7 is covered by the protective sheath 5, there is no risk of damaging the internal organs by the puncture needle 7, and operations such as expansion and insertion of the outer tube 3 are easier than before.

  In FIG. 11, when a biasing means such as a spring is provided inside the attaching / detaching portion 9 of the inner needle 2 and the lock button 10 is released by pressing the attaching / detaching button 10, the protective sheath 5 is moved to the inner needle by the biasing force of the biasing means. 2 and move away from the first engagement groove 43 so that the engagement claw 52 automatically engages with the second engagement groove 51. In this case, the relationship between the inner needle 2 and the protective sheath 5 is such that the puncture needle 7 is housed in the protective sheath 5 and is automatically locked at that position, so that the operation is further facilitated.

(Second Embodiment)
FIG. 12 shows a trocar system according to a second embodiment of the present invention. In this embodiment, the configuration of the trocar system 1 of the first embodiment (see FIGS. 1 to 11) described above is changed as follows.

  That is, in this embodiment, the outer tube 103 having a diameter smaller than that of the outer tube 3 of the first embodiment is used in combination with the inner needle 2 and the protective sheath 5. In this case, the inner needle 2 to which the protective sheath 5 is connected is directly inserted into the outer tube 103 without using the dilator 4 of the first embodiment.

  Here, since the outer tube 103 is a combination that does not involve the dilator 4, it does not have means for engaging with the protective sheath 5. And the front-end | tip of the positioning part 39a of the handle part 40 of the protective sheath 5 and the base end part of the connection unit 115 contact | abut. Therefore, as in the case of the first embodiment described above, the protruding amount of the puncture needle 7 of the inner needle 2 from the dilator 4 cannot be adjusted stepwise.

  In the present embodiment, the clamp mechanism 201 is provided in a portion where the outer tube 103 having the insertion portion 114 is connected to the connection unit 115. The clamp mechanism 201 includes a protective sheath contact member 203 and a slide member 204 inside a housing 202, and the slide member 204 is illustrated by an operation button 205 provided to be exposed to the outside from the housing 202. It can be moved in the front-rear direction indicated by the arrow 12 (B).

  The protective sheath contact member 203 and the slide member 204 have surfaces that are inclined and contact each other, and both surfaces that are in contact are always joined together, and the operation button 205 is pushed in the direction indicated by the arrow in FIG. When operated so as to slide, the protective sheath contact member 203 moves relatively in the vertical direction and presses and fixes the outside of the straight pipe portion 39 of the protective sheath 5.

  Next, the operation of the second embodiment will be described. When the trocar system 1 of this embodiment is used, as shown in FIG. 12, the inner needle 2, the protective sheath 5, and the outer tube 103 are used in an assembled state in advance.

  First, an operation of inserting the inner needle 2 into the protective sheath 5 is performed. When the inner needle 2 is inserted, the inner needle 2 is inserted into the slit 47 of the slit valve 45 of the handle 40 in the protective sheath 5. At this time, the peripheral portion of the slit portion 47 of the base plate 46 is held in a state where it is pressed against the outer peripheral surface of the inner needle 2, thereby ensuring airtightness inside the protective sheath 5.

  Furthermore, with the inner needle 2 inserted to the proper insertion position, the engagement claw 52 of the inner needle 2 is engaged with the first engagement groove 43 of the protective sheath 5 and is held in a locked state.

  Subsequently, an operation of inserting the inner needle 2 fitted with the protective sheath 5 into the tube of the outer tube 103 is performed. Here, the outer tube 103 is fixed to the protective sheath 5 by operating the operation button 205 of the outer tube 103 at an arbitrary position of the straight tube portion 39 in the protective sheath 5.

  Subsequently, ultrasonic vibration is applied to the puncture needle 7 of the inner needle 2 of the trocar system 1 to puncture the patient's body wall, and then the outer tube 103 is inserted into the body wall sequentially.

  First, after puncturing the patient's body wall, the engaging claw portion 52 is disengaged from the first engaging groove portion 43 of the protective sheath 5 by pushing the attaching / detaching button 10 on the attaching / detaching portion 9 of the inner needle 2. , Release the lock.

  Subsequently, the inner needle 2 is slid with respect to the protective sheath 5 and locked in a state where the engaging claw 52 is engaged with the second engaging groove 51 of the protective sheath 5. As a result, the puncture needle 7 which is the distal end portion of the inner needle 2 is held in a state of being accommodated in the straight tube portion 39 of the protective sheath 5.

  Subsequently, the outer tube 3 is inserted into the abdominal wall by pushing the outer tube 103 around the protective sheath 5 while the puncture needle 7 is housed in the protective sheath 5.

  Further, after the outer tube 3 is inserted, the inner needle 2 and the protective sheath 5 are removed from the outer tube 103.

  According to the structure of this embodiment, there exist the following effects. That is, in the trocar system of the present embodiment, a lock mechanism is provided that locks the inner needle 2 and the protective sheath 5 while the puncture needle 7 is housed in the protective sheath 5. This prevents the protective sheath 5 from being deformed during the operation of inserting the outer tube 103, and at the same time, since the tip is covered by the protective sheath 5, there is no risk of damaging the internal organs by the puncture needle 7. In comparison, the operation of inserting the outer tube 103 becomes easier.

  Further, the outer tube 103 can be fixed at an arbitrary position of the straight tube portion 39. For this reason, the protrusion amount from the front-end | tip part 114a of the outer tube 103 of the puncture needle 7 can be adjusted according to the thickness of a patient's body wall. As a result, when the inner needle 2 penetrates the abdominal wall when puncturing with ultrasonic waves, the distal end portion 114a of the outer tube 103 serves as a stopper that comes into contact with the abdominal wall, so that puncturing can be performed more safely.

  The clamp mechanism as described above may be externally assembled to the outer tube 103 so that it can be removed after the puncturing operation. This method can be applied without changing the structure of the current outer tube.

(Third embodiment)
13 (A) and 13 (B) show a trocar system according to a third embodiment of the present invention. In this embodiment, the configuration of the trocar system 1 of the second embodiment (see FIG. 12) is changed as follows.

  That is, in this embodiment, it is configured to be used in combination with the clamp member 301 that clamps the straight pipe portion 39 of the protective sheath 5. As shown in FIG. 13B, the clamp member 301 is composed of a fulcrum 302, a gripping part 303, an operation part 304, and a spring 305. By operating the operation part 204 in the direction of the arrow in the figure, the gripping part The tip opening 306 of 303 opens. An elastic member 307 is disposed on the inner gripping surface of the gripping portion 303.

  Next, the operation of the above configuration will be described. When using the trocar system 1 of this embodiment, it is used in the state where the inner needle 2, the protective sheath 5, and the outer tube 103 are assembled in advance. Here, the clamp member 301 is clamped at an arbitrary position of the straight pipe portion 39 in the protective sheath 5. Subsequently, the ultrasonic vibration is actuated on the puncture needle 7 of the inner needle 2 of the trocar system 1 to puncture the patient's body wall, and then the outer tube 103 is inserted into the body wall in sequence.

  The above configuration has the following effects. That is, in the trocar system of this embodiment, since the clamp member 301 can be fixed at an arbitrary position of the straight tube portion 39, the lengths of the puncture needle 7 and the clamp member 301 according to the thickness of the body wall of the patient. Can be adjusted. Thereby, when the inner needle 2 penetrates through the abdominal wall when puncturing with ultrasonic waves, the clamp member 301 acts as a stopper that abuts against the abdominal wall, so that the amount of puncture can be regulated.

  In addition, this invention is not limited to the thing of each embodiment mentioned above. Of course, various modifications can be made without departing from the scope of the present invention.

  The present invention is effective in a technical field for manufacturing a trocar and a technical field using a trocar.

A side view showing the whole trocar system concerning a 1st embodiment. The side view which shows the state which decomposed | disassembled the trocar system which concerns on 1st Embodiment according to the instrument similarly. The side view of the mantle tube of the trocar system similarly concerning 1st Embodiment. The side view of the dilator of the trocar system which similarly concerns on 1st Embodiment. The protection sheath of the trocar system similarly concerning 1st Embodiment is similarly shown, Comprising: (A) is a side view of the protection sheath which makes the upper half a cross section, (B) is a front view of the rear-end part of a protection sheath. Similarly, the side view which makes the upper half of the outer tube of the trocar system concerning 1st Embodiment a cross section. The dilator of the trocar system similarly concerning 1st Embodiment is also shown, Comprising: (A) is a side view of the dilator which makes an upper half and a rear-end part a cross section, (B) is 7B part of (A) The longitudinal cross-sectional view which expands and shows, (C) is sectional drawing of the part which follows the 7C-7C line | wire of (A). The side view which makes the upper half and the rear-end part the state which combined the dilator and mantle tube of the trocar system which concerns on 1st Embodiment similarly, and makes it a cross section. Similarly, the operation of the unlocking button between the dilator and the mantle tube of the trocar system according to the first embodiment will be described, and (A) shows a normal assembly position between the dilator and the mantle tube. The longitudinal cross-sectional view of the principal part which shows the locked state, (B) is the longitudinal cross-sectional view of the principal part which shows the pushing-in operation state of a lock release button. FIG. 9 is a view for explaining the operation of the unlock button between the dilator and the mantle tube of the trocar system according to the first embodiment, and FIG. 9 (A) is a front view showing the state of FIG. ) Is a front view showing the state of FIG. Similarly, the longitudinal cross-sectional view of the principal part which shows the engagement state of the dilator of the trocar system which concerns on 1st Embodiment, and the inner peripheral part of the inlet port part of a mantle tube. (A) is a side view which shows the decomposition | disassembly state of the trocar system concerning 2nd Embodiment, (B) is an expanded side view which cuts and shows the upper half of the clamp mechanism part. (A) is a side view of the state which clamped the protective sheath of the trocar system concerning a 3rd embodiment with a clamp mechanism, (b) is a front view of the clamp mechanism.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Trocar system 2 ... Inner needle 3 ... Outer tube 4 ... Dilator 5 ... Protective sheath 43 ... 1st engagement groove part 51 ... 2nd engagement groove part 52 ... Engagement claw part

Claims (3)

An inner needle that transmits ultrasonic vibrations and punctures the body wall;
A protective sheath that covers the insertion portion of the inner needle and is movable relative to the insertion portion of the inner needle;
An outer tube into which the inner needle covered with the protective sheath is inserted;
Locking means provided on the inner needle and the protective sheath, for fixing the distal end portion of the inner needle in an exposed state and a retracted state with respect to the insertion portion of the protective sheath;
An ultrasonic trocar comprising: An inner needle that transmits ultrasonic vibrations and punctures the body wall;
A protective sheath that covers the insertion portion of the inner needle and is movable relative to the insertion portion of the inner needle;
An outer tube into which the inner needle covered with the protective sheath is inserted;
A dilator having an expansion portion that is inserted between the outer tube and the inner needle and expands a small-diameter puncture hole formed in the body wall by the inner needle;
Locking means provided on the inner needle and the protective sheath, for fixing the distal end portion of the inner needle in an exposed state and a retracted state with respect to the insertion portion of the protective sheath;
An ultrasonic trocar comprising: A means for urging the inner needle in a direction to be retracted with respect to the protective sheath, and the fixation by the locking means is released in a state where the distal end portion of the inner needle is exposed to the insertion portion of the protective sheath; The ultrasonic trocar according to claim 1 or 2, wherein the tip of the inner needle is automatically housed in the protective sheath.

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