JP2008006227A - Laparoscopic port - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a laparoscopic port and a wide angle assist monitor system for monitoring a state of the outside of a laparoscopic field of view in a laparoscopic operation to reduce the risk of damage to an organ or the like outside the laparoscopic field of view and performing the treatment quickly and accurately to reduce the entire time for the operation. <P>SOLUTION: The laparoscopic port is equipped with a port tube 11 having a lumen in which medical instruments such as forceps are inserted for communicating with the distal end to the proximal end and a means 12 which is provided along the direction of the external axis of the port tube 11 to house an area image sensor for wide-angle imaging. The wide angle assist monitor system comprises the laparoscopic port and the area image sensor housed in the area image sensor housing means 12 of the laparoscopic port. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a laparoport used for inserting medical devices such as an endoscope, forceps, and catheter in laparoscopic surgery, and more particularly, monitors a state outside the laparoscopic field in laparoscopic surgery. The present invention relates to a laparo port and a wide-angle assist monitor system that can reduce the risk of organ damage outside the field of view, thereby enabling quick and accurate treatment and shortening the entire operation time.

  Laparoscopic surgery is a method in which the state of the abdominal cavity is projected on a video screen with a laparoscope without performing a laparotomy, and the operation is performed using a special instrument while viewing this screen. In laparoscopic surgery, surgery is performed simply by opening several small holes of about 5 to 10 mm in the abdomen. A Rapalloport is installed in this small hole, and medical devices such as a laparoscope, forceps, and catheter are inserted to treat the affected area. A Rapalloport is a tube for facilitating access between the outside of the body and the abdominal cavity. Gas or liquid can be injected or extracted through this tube.

  The image displayed by the laparoscope is usually only the portion of the treatment field. Parts other than the treatment field cannot be seen at the same time. Therefore, the operator cannot perceive the danger that the medical device contacts other organs or the like while the medical device such as forceps is inserted into the treatment field through the rapalo port.

Patent Document 1 proposes a laparoscopic device for observing the abdominal cavity with a wide-angle visual field, visualizing the situation in the abdominal cavity, and providing information essential for the diagnosis and treatment of the operator. This laparoscopic device is a laparoscopic device composed of a cannula in which a light guide for guiding illumination light is arranged at the tip, and an endoscope that is inserted into the inner space of the cannula. The distal end portion of the inner space is sealed with a translucent member, and the endoscope has imaging means having a wide-angle lens at the distal end, and the endoscope is located in the inner space of the cannula. It is characterized in that it can be inserted and removed and the imaging means of the endoscope is installed so as to be close to the translucent member of the cannula. Although it becomes possible to observe the abdominal cavity at a wide angle by the laparoscopic device described in Patent Document 1, it is impossible to insert other medical equipment through the cannula while the laparoscope is inserted into the cannula. Another hole must be made in the abdomen and a cannula or the like inserted there.
JP-A-11-99855

  The object of the present invention is to monitor the state outside the laparoscopic field in laparoscopic surgery, reduce the risk of organ damage outside the field, and thereby perform the treatment quickly and accurately. It is an object of the present invention to provide a Rapallo port and a wide-angle assist monitor system that can shorten the entire time.

  As a result of intensive studies to solve the above problems, the present inventor has attached means for storing an area image sensor capable of wide-angle imaging outside a Rapallo port used for inserting medical devices such as forceps into the abdominal cavity, By storing an area image sensor such as a CCD image sensor in the storage means and installing it in a hole opened in the abdomen, the state outside the laparoscopic field is monitored, and the risk of organ damage outside the field is observed. It was found that the treatment can be performed quickly and accurately, and the overall operation time can be shortened. The present invention has been completed as a result of further studies based on these findings.

That is, the present invention is as follows.
(1) A Rapallo port comprising a port tube having a lumen (a) communicating from the distal end to the proximal end, and means for storing an area image sensor capable of wide-angle imaging.
(2) The Rapallo port according to (1), wherein the means for storing the area image sensor is a storage pipe having a lumen (b) attached along the outer axial direction of the port pipe.
(3) The rapalo port according to (1) or (2), wherein the port tube has a size that allows insertion of an endoscope, forceps, or catheter into the lumen (a).
(4) The Rapallo port according to any one of (1) to (3), wherein the means for accommodating the area image sensor can be drawn into the lumen (a) of the port tube from the outside of the port tube.

(5) When an endoscope, forceps or catheter is inserted into the lumen (a) of the port tube, a means for accommodating the area image sensor that has been drawn into the lumen (a) of the port tube is located outside the port tube. The Rapallo port according to (4), which can be popped out.
(6) The Rapallo port according to any one of (1) to (5), wherein the area image sensor is a CCD image sensor or a CMOS image sensor.
(7) The Rapalloport according to any one of (1) to (6), wherein the distal end of the area image sensor storage means is made of a transparent member subjected to a hydrophilic treatment.
(8) The Rapalloport according to (7), wherein the hydrophilization treatment is a titanium oxide coating treatment.
(9) A wide-angle assist monitor system comprising the Rapallo port according to any one of (1) to (8) and an area image sensor housed in an area image sensor housing means of the Rapallo port.

  The Rapallo port of the present invention includes a port tube and a storage means, and an area image sensor can be stored in the storage means. When the Rapallo port is inserted into a hole formed in the abdominal wall and attached, medical devices such as an endoscope, forceps, and catheter can be inserted into the abdominal cavity through the port tube. The state outside the laparoscopic field can be monitored by the wide-angle visual field area image sensor stored in the storage means, thus avoiding contact with the organ while carrying the medical device from the rapalo port to the treatment field, and organ damage Therefore, the treatment can be performed quickly and accurately, and the entire operation time can be shortened.

  Exemplary embodiments of a Rapallo port of the present invention will be described below in detail with reference to the accompanying drawings. Note that the present invention is not limited to these embodiments.

(First embodiment)
FIG. 1 is a longitudinal sectional view (a state in which a laparoscope 14 is inserted) showing a Rapallo port 100 according to a first embodiment of the present invention.
The Rapallo port 100 of the first embodiment includes a port tube 11 having a lumen (a) communicating from a distal end to a proximal end, and means 12 for housing an area image sensor capable of wide-angle imaging.
This Rapallo port is penetrated through the abdominal wall to allow communication between the abdominal cavity and the outside of the body. Medical devices such as an endoscope, forceps, and catheter can be inserted into the abdominal cavity from outside the body through the lumen (a) in the port tube 11 of the Rapallo port.

  The port tube 11 is generally formed of resin, metal, or the like, but preferably has a structure that does not damage body tissue when inserted into the abdominal cavity. Further, the distal end of the distal end is obliquely cut in FIG. 1 so that the Rapalloport can be easily stuck into the abdominal wall when penetrating the abdominal wall. Alternatively, the dilator may be inserted into the lumen (a) of the rapalloport, and the rapalloport may be pierced into the abdominal wall while expanding the abdominal hole.

  A connector portion 16 is provided at the proximal end of the port tube 11. The connector portion 16 may be provided with a check valve (not shown) in a lumen that continues from the port pipe. This check valve can prevent fluid such as gas or liquid from flowing out of the abdominal cavity. The proximal end opening of the connector 16 can be closed with a cap stopper (not shown).

  The area image sensor storage means 12 is not particularly limited as long as it can store and hold the area image sensor. The area image sensor is a kind of solid-state imaging device, and a CCD (Charge Coupled Device) image sensor and a CMOS (Complementary Metal Oxide Semiconductor) image sensor are preferable. In particular, the area image sensor used in the present invention is preferably capable of wide-angle imaging. The area image sensor storage means may store an endoscope capable of wide-angle imaging.

  In FIG. 1, a storage tube 12 having a lumen (b) attached along the outer axial direction of the port tube 11 is shown. The opening at the distal end of the storage tube may be closed with a transparent member. A wide-angle lens is preferably used as the transparent member. The surface of the transparent member is preferably subjected to a hydrophilic treatment, particularly a titanium oxide coating treatment. By performing this hydrophilization treatment, it is possible to prevent the field of view from becoming clouded due to adhesion of water droplets or the like. Moreover, in order to remove the cloudiness of a visual field, it is preferable to provide a wiper and a fountain device. Further, an illumination (not shown) for illuminating the abdominal cavity and a light guide (not shown) for guiding light to the illumination may be provided at the tip of the storage tube 12 or the port tube 11. The inner surface of the storage tube 12 may be formed with a convex portion or a concave portion that can be unevenly fitted to the area image sensor so that the area image sensor is held firmly.

  In FIG. 1, the lumen (b) extends to the connector portion 16. A cord for transmitting an image signal of the area image sensor through the lumen (b) extends to the outside and can be connected to a signal processing device or an image output device (not shown). In FIG. 1, the image signal is transmitted by a code (wired), but the area image sensor is provided with a wireless transmission system, the signal processing device or the image output device is provided with a wireless reception system, and the image of the area image sensor is provided. The signal may be transmitted to the image output device wirelessly.

  The area image sensor storage means may be configured to detachably store the area image sensor. By allowing the area image sensor to be removed from the storage means, the rapalo port and the area image sensor can be cleaned separately, and when either the rapalo port or the area image sensor fails, only the one that has failed If it is replaced, it is economical.

  In the Rapallo port of the first embodiment, the laparoscope 14 is inserted through the port tube 11. The condition of the treatment field can be observed with this laparoscope. Then, with the area image sensor capable of wide-angle imaging that is stored in the storage means of the first embodiment, it is possible to observe a region that is out of the field of view of the laparoscope, that is, a region from the rapaloport to the treatment field. Thus, the wide-angle assist monitor system for assisting the main monitor by the laparoscope can be configured by the raparo port and the area image sensor of the present invention.

(Second embodiment)
FIG. 2 is a longitudinal cross-sectional view (a state where the forceps 15 are inserted) showing a Rapallo port 200 according to the second embodiment of the present invention.
The Rapallo port 200 of the second embodiment includes a port tube 21 having a lumen (a) communicating from the distal end to the proximal end, and means 22 for housing an area image sensor capable of wide-angle imaging. The port tube 21 is the same as the port tube 11 of the first embodiment except that it has a lumen (a) and a lumen (b).
In the Rapallo port of the second embodiment, an area image sensor capable of wide-angle imaging can be stored in a storage tube 22 having a lumen (b) integrated with a port tube 21. The specifications of other components such as the storage tube and area image sensor are the same as those in the first embodiment.

  In the Rapallo port of the second embodiment shown in FIG. 2, the forceps 15 are inserted through the port tube 21. Then, while the treatment field is monitored with a laparoscope inserted from another port, the affected part or the like can be treated with the forceps 15. Furthermore, the area image sensor that is out of the field of view of the laparoscope and that is out of the field of view of the laparoscope can be observed by the area image sensor accommodated in the storage means 22 of the Laparo port according to the second embodiment. Therefore, it is possible to avoid the risk that the forceps inserted from the Rapallo port come into contact with the body tissue and cause damage. Thus, the wide-angle assist monitor system for assisting the main monitor by the laparoscope can be configured by the raparo port and the area image sensor of the present invention.

(Third embodiment)
FIG. 3 shows a longitudinal sectional view (a state in which a laparoscope starts to be inserted from a connector portion) showing a Laparo port 300 according to a third embodiment of the present invention. FIG. 4 shows a longitudinal sectional view (a state in which the laparoscope is completely inserted through the rapalloport) showing the rapalloport 300 of the third embodiment according to the present invention. FIG. 5 is a cross-sectional view of a Lapalo port 300 according to a third embodiment of the present invention.
The Rapallo port 300 of the third embodiment includes a port tube 31 having a lumen (a) communicating from the distal end to the proximal end, and means 32 for storing an area image sensor capable of wide-angle imaging.
The port pipe 31 is the same as the port pipe 11 of the first embodiment, except that there is a part for drawing the area image sensor storage means 32.

  In the Rapallo port of the third embodiment, as shown in FIG. 5A, the means 32 for accommodating the area image sensor can be drawn into the lumen (a) of the port pipe from the outside of the port pipe 31. When a medical device such as an endoscope, forceps, or catheter is inserted through the lumen (a) of the port tube, means 32 for receiving the area image sensor that has been drawn into the lumen (a) of the port tube is provided by the port tube 31. (Fig. 5 (2)). Specifically, a part of the tube wall of the port tube 31 is open, and the edge of the opening and the outside of the tube wall of the storage tube 32 which is a means for storing the area image sensor are a hinge or it. It is connected by an equivalent means. Normally, the storage tube 32 is drawn into the lumen (a) of the port tube 31 as shown in FIG.

  If the storage tube 32 is drawn into the lumen (a) as described above when the Rapallo port is passed through the abdominal wall, the storage tube 31 does not get in the way when penetrating the abdominal wall, and the Rapallo port can be easily penetrated into the abdominal wall. Become. After penetrating and attaching to the abdominal wall, a medical device is inserted from the connector part of the Rapallo port as shown in FIG. In the Rapallo port of the third embodiment, the proximal end of the storage tube 32 is cut obliquely. Therefore, when the medical device pushes the obliquely cut portion, the storage tube 32 is driven out and the medical device is In the completely inserted state (FIG. 4), the storage tube 32 protrudes outside the port tube 31. Further, by using an elastic body for the hinge or an equivalent means, when the inserted medical device is pulled out from the Rapallo port after the operation, the storage tube 32 automatically lumens the port tube 31 by the force of the elastic body. If it is pulled in, the Rapallo port can be extracted without the storage tube 32 being caught by the abdominal wall. The specifications of other components such as the area image sensor are the same as those in the first embodiment.

  In the Laparo port 300 of the third embodiment, a laparoscope or the like can be inserted into the port tube 31. The condition of the treatment field can be observed with this laparoscope. Then, similarly to the Laparo port of the first embodiment, a wide-angle assist monitor system that assists the main monitor with a laparoscope can be configured.

(Fourth embodiment)
FIG. 6 is a longitudinal sectional view showing a Rapallo port 400 according to the fourth embodiment of the present invention.
The Rapallo port 400 of the fourth embodiment can transmit the image signal of the area image sensor to an external signal processing device or image output device (not shown) by the signal processing system 40 and the wireless transmission system 41. Yes. Other configurations are the same as the Rapallo port of the second embodiment.
In the Laparo port 400 of the fourth embodiment, a laparoscope or the like can be inserted into the port tube 21. The condition of the treatment field can be observed with this laparoscope. Then, similarly to the Laparo port of the second embodiment, a wide-angle assist monitor system that assists the main monitor with a laparoscope can be configured.

It is a longitudinal cross-sectional view (state which penetrated the laparoscope) of the Rapallo port 100 of 1st embodiment which concerns on this invention. It is a longitudinal cross-sectional view (state which penetrated forceps) of the Rapallo port 200 of 2nd embodiment which concerns on this invention. It is a longitudinal cross-sectional view (The state which started insertion of the laparoscope) of the Rapallo port 300 of 3rd embodiment which concerns on this invention. It is a longitudinal cross-sectional view (state which penetrated the laparoscope) of the Rapallo port 300 of 3rd embodiment which concerns on this invention. A cross-sectional view of a Rapallo port 300 according to the third embodiment of the present invention ((1) shows a state in which the area image sensor storage means 32 is pulled into the port pipe 31, and (2) shows that the area image sensor storage means 32 is in the port pipe) 31). It is a longitudinal cross-sectional view which shows the Rapallo port 400 of 4th embodiment which concerns on this invention.

Explanation of symbols

11, 21, 31: Port tubes 12, 22, 32: Area image sensor storage means 13: Area image sensor 14: Laparoscope 15: Forceps 40: Signal processing system 41: Wireless transmission system

Claims (9)

  A Rapallo port comprising a port tube having a lumen (a) communicating from the distal end to the proximal end, and means for housing an area image sensor capable of wide-angle imaging.   The Rapallo port according to claim 1, wherein the means for storing the area image sensor is a storage pipe having a lumen (b) attached along the outer axial direction of the port pipe.   The Rapalloport according to claim 1 or 2, wherein the port tube has a size capable of inserting an endoscope, forceps, or catheter into the lumen (a).   The Rapallo port according to any one of claims 1 to 3, wherein the means for accommodating the area image sensor can be drawn into the lumen (a) of the port tube from the outside of the port tube.   When an endoscope, forceps, or catheter is inserted through the lumen (a) of the port tube, the means for accommodating the area image sensor that has been drawn into the lumen (a) of the port tube is allowed to jump out of the port tube. The Rapallo port according to claim 4, wherein   The Rapalloport according to any one of claims 1 to 5, wherein the area image sensor is a CCD image sensor or a CMOS image sensor.   The rapalloport according to any one of claims 1 to 6, wherein a distal end of the area image sensor storage means is constituted by a transparent member subjected to a hydrophilic treatment.   The rapalloport according to claim 7, wherein the hydrophilization treatment is a titanium oxide coating treatment. A wide-angle assist monitor system comprising the Rapallo port according to claim 1 and an area image sensor housed in an area image sensor housing means of the Rapallo port.

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