JP2008093407A - Organ traction device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an organ traction instrument which raises no fear of the damage of the internal organ when the internal organ is pulled in a direction outside the body in a manner to support the internal organ. <P>SOLUTION: This organ traction device includes a traction wire and a gripping section, and can grip the internal organ in a manner to surround the periphery of the internal organ or follow the periphery of the internal organ. Therefore, the internal organ traction device can pull the internal organ in a manner to support the internal organ unlike a conventional forceps which grips a part and pulls up the internal organ. Thus, a force which is applied to the internal organ is distributed, and fear for the damage of the internal organ is eliminated. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an organ traction tool that grips an organ such as the stomach, esophagus, large intestine, and the like and pulls it from outside the body when performing laparoscopic surgery.

  Conventionally, as an instrument for pulling an organ during endoscopic or laparoscopic surgery, it consists of a pair of pivotable levers, provided on one end side from the pivot point and on the other end A metal forceps having a grip portion is used (see, for example, Patent Document 1).

JP-A-9-285470

  When grasping a desired organ, the forceps as shown in the above-mentioned Patent Document 1 opens the grasping portion via the operation portion, then picks a part of the organ with the grasping portion, and pulls the organ up. . For this reason, the force at the time of organ pulling concentrates on the gripped part, and the organ may be damaged.

  Therefore, in view of the above situation, an object of the present invention is to provide an organ traction tool that does not cause damage to an organ when it is pulled outside the body to support the organ.

  An organ traction tool of the present invention is formed in an annular shape, and is provided with a flexible annular gripping portion that grips an organ, a traction line that pulls the annular gripping portion, and the annular gripping portion, and the traction line is hung A portion of the annular grasping portion provided with the hook member, and surrounding the organ so as to connect any portion of the annular grasping portion, and from the arbitrary portion to the annular grasping portion The annular gripping portion is wound around and fixed to the organ through the hook member in the ring, and the organ is pulled.

  According to the organ traction tool of the present invention, the organ can be grasped by winding and fixing the annular grasping portion around the organ. Then, by pulling the hook member provided in the annular gripping part from outside the body through the pulling line, the organ gripped by the annular gripping part can be pulled in the direction outside the body. This organ traction tool can be gripped so as to surround the periphery of the organ with an annular gripping portion, and can be pulled to support the organ.

  The organ traction tool of the present invention is formed in an annular shape, and is provided in the annular gripping portion, a flexible annular gripping portion that grips the organ, a traction line that pulls the annular gripping portion, and the traction line A connecting member to which one end of the connecting member is connected, and the other end of the pulling line located on the opposite side of the one end to which the connecting member is connected, and the traction is provided outside the body having the organ. A needle-like member for pulling out the other end of the wire, and surrounds the organ around the portion where the connection member of the annular gripping portion is provided and the arbitrary portion of the annular gripping portion. The annular gripping portion is wound around and fixed to the organ through the connecting member from the arbitrary position into the ring of the annular gripping portion, and the organ is pulled.

  According to the organ traction tool of the present invention, the organ can be grasped by winding and fixing the annular grasping portion around the organ. Then, with the needle-like member provided at the other end portion of the traction line, the other end portion of the traction line is pulled out of the body, and the connection member provided in the annular gripping portion is pulled from outside the body via the traction line. The organ grasped by the grasping unit can be pulled in the direction outside the body. This organ traction tool can be gripped so as to surround the periphery of the organ with an annular gripping portion, and can be pulled to support the organ.

  Further, the organ traction tool of the present invention is provided with a flexible gripping part for gripping an organ, one end of the gripping part, a traction line for pulling the gripping part, and one gripping part. Provided at the other end of the traction line located on the opposite side of the end, and formed in an annular shape, and a needle-like member for pulling out the other end of the traction line outside the body having the organ, An annular portion that is provided at the other end portion of the grasping portion located on the opposite side of the one end portion where the pulling line is provided, and through which the needle-like member and the pulling line are inserted; The needle-shaped member and the traction line are inserted into the ring of the annular portion, the gripping portion is wound around the organ and fixed, and the organ is pulled.

  According to this organ traction tool of the present invention, it is possible to wind and fix the gripping portion so as to place the organ inside the ring formed by inserting the needle-like member and the traction line through the annular portion, and to grip the organ. it can. Then, with the needle-like member provided at the other end of the traction line, the other end of the traction line can be pulled out of the body, and the gripping part can be pulled in the direction outside the body. The organ traction tool can be gripped so as to surround the periphery of the organ by the gripping portion, and can be pulled to support the organ.

  Still further, the organ traction tool of the present invention includes a flexible gripping part that grips an organ, two pulling lines that pull the gripping part at both ends of the gripping part, and the gripping part. Two needle-like members for pulling out the other end portion of the traction line provided on the other end portion of the two traction lines located on the opposite side of the one end portion, respectively, outside the body having the organ. And surrounding the organ so as to connect the two needle-like members, holding the organ with the gripping portion so as to support the organ, and pulling the organ.

  According to the organ traction tool of the present invention, the periphery of the organ is surrounded by connecting two needle-like members, and the organ is gripped by the gripping portion. Thereby, the organ can be grasped along the periphery of the organ by the grasping portion, and can be pulled so as to support the organ.

  Unlike the conventional forceps that picks up and pulls a part of an organ, the organ traction tool of the present invention can hold the organ so as to surround the organ or to support the organ. Can be towed. As a result, the force applied to the organ is dispersed and there is no risk of damage to the organ.

  Hereinafter, the organ traction tool of the present invention will be described in detail with reference to the drawings. It should be noted that the present invention is not limited to the following description, and can be appropriately changed without departing from the gist of the present invention.

[Embodiment 1]
FIG. 1 is a diagram showing an example of a main part of an organ traction tool described in Embodiment 1 of the present invention. The organ traction tool includes the annular gripping portion 10 and the hook member 20, and the traction line 60 is hung on the hook member 20 to pull the organ gripped by the annular gripping portion 10.

  As shown in FIGS. 1 and 2, the hook member 20 has a predetermined thickness with both end faces open, a cylindrical tubular member 23 having a predetermined inner diameter, and a hook portion 21 and a rod 25. It has been. The inner diameter of the cylindrical member 23 is not particularly limited, but is preferably large enough to accommodate the knot 15 of the annular grip 10 as will be described later. As a result, when the organ is gripped by the annular gripping part 10 and then pulled by the pulling line 60, it is not caught by another organ or tissue, and the knot 15 does not block the view of the endoscope or laparoscope.

  One end of the hanging portion 21 is provided on the side surface on the one end surface side of the cylindrical member 23. The hook 21 extends from one end surface of the connected cylindrical member 23 toward the outside of the cylindrical member 23, and has a shape that is bent so as to form a spiral at a predetermined position. is doing. That is, the hanging portion 21 has a hook shape.

  As will be described later, a pulling line 60 is hung on the hanging portion 21 from outside the body, and the organ gripped by the annular gripping portion 10 can be pulled. Therefore, even when the hanging portion 21 is pulled by the pulling wire 60, it is preferable that the hanging portion 21 has a material and a thickness having such a rigidity that the shape can be maintained.

  The rod body 25 has an inner side of the side surface on the other end surface side of the cylindrical member 23 or the other end surface so that the opening on the other end surface side located on the opposite side of the one end surface side provided with the hanging portion 21 is divided into two. It is attached to the side edge by bonding. More specifically, the rod body 25 passes through the center of the opening from the inner side of the side face on the other end face side or the other end face side, and passes through the opening to the inner side or the other end face of the other end face side on the opposite side. It is equipped so that it may hang over toward the edge of the side.

  At this time, the rod body 25 is provided to the cylindrical member 23 in a state where the rod body 25 is disposed in the ring of the annular gripping portion 10 described later. That is, the annular gripping portion 10 is provided on the hook member 20 while being hooked on the rod body 25. The rod body 25 is preferably formed of a material that does not bend when pulling an organ held by the annular holding portion 10. Moreover, it is preferable that the rod body 25 is provided without being detached from the cylindrical member 23.

  The overall size of the hook member 20 is not particularly limited. As will be described later, the hook member has a hook portion 21 in the ring of the annular gripping portion 10 after surrounding the organ. Any size that can pass 20 is sufficient.

  The annular gripping portion 10 provided with the hook member 20 is an annular member having a predetermined thickness, and is made of a member having flexibility and elasticity. As described above, the annular gripping part 10 is provided with the rod body 25 on the tubular member 23 in a state where the rod body 25 that divides the opening on the other end face side of the tubular member 23 into two is arranged in the ring. Thus, the hook member 20 is provided. Thereby, the annular gripping part 10 is put into the cylindrical member 23 from one opening among the openings on the other end face side of the cylindrical member 23 of the hook member 20 provided with the rod body 25, and the cylindrical member 23. It will be in the state where it came out via the other opening. That is, the annular gripping part 10 is inserted from one opening on the other end face side of the cylindrical member 23 provided with the rod body 25 toward the other opening, so that the rod body 25 is arranged in the ring of the annular gripping part 10. The hook member 20 is provided. Thereby, the annular gripping part 10 can reliably include the hook member 20 without being detached from the hook member 20.

  As shown in FIG. 1, the organ traction tool has a ring formed by the annular gripping portion 10 on the other end face side of the tubular member 23 of the hook member 20. The ring formed by the annular gripping portion 10 is curved in accordance with the shape of the organ provided with the organ traction tool. Specifically, the ring of the annular gripping portion 10 is curved in a horseshoe shape in which a portion in contact with the organ is warped when being wrapped around and fixed to the organ. As a result, as described later, the hook member 20 can be easily passed through the ring of the annular gripping portion 10 when being wrapped around and fixed to an organ. Therefore, it becomes easy to wrap around an organ and operability is improved.

  The length of the annular gripping part 10 is not particularly limited, but may be appropriately changed according to the organ to be gripped. The material of the annular gripping part 10 is not particularly limited, but it is a material having flexibility and elasticity, and an elastomer such as rubber or a thermoplastic elastomer can be used. As described above, the annular gripping portion 10 is formed of a material having flexibility and elasticity, so that the force applied to the contact portion with the organ is reduced as compared with the conventional metal forceps. Therefore, damage to organs can be prevented.

  The annular gripping portion 10 is formed by pulling out the annular gripping portion 10 from the opening of the cylindrical member 23 on the side where the hook portion 21 of the hook member 20 provided is provided, and forming a knot 15 as shown in FIG. it can. By changing the position of the knot 15, the size of the ring of the annular grip 10 can be changed. Thereby, according to the magnitude | size of the organ to hold | grip, the position of the knot 15 can be changed and the magnitude | size of the ring of the annular holding part 10 can be changed.

  At this time, it is preferable that the knot 15 to be formed has a size that fits inside the cylindrical member 23. As a result, when the organ is gripped by the annular gripping part 10 and then pulled by the pulling line 60, it is not caught by another organ or tissue, and the knot 15 does not block the view of the endoscope or laparoscope.

  The pulling wire 60 is a member having a predetermined length and having linear flexibility such as a thread made of nylon or the like. The pulling line 60 is introduced into the body after the annular gripping part 10 grips the organ, and is folded in two so that an arbitrary point is a bending point and is folded back at the bending point. The inflection point is hung. The traction line 60 hung on the hanging portion 21 is pulled in the direction outside the body, and the organ can be pulled through the annular gripping portion 10. The traction line 60 is not particularly limited as long as it does not break when the organ is pulled. Also, the thickness and length of the organ are appropriately changed according to the organ to be pulled and the inner diameter of the elastomer needle when introduced into the body, and are not particularly limited as long as the organ can be pulled in the direction outside the body.

  When pulling an organ with the organ traction tool of the first embodiment, it is necessary to grip the organ with the annular gripping portion 10. Hereinafter, a method of grasping an organ with the annular grasping portion 10 in the organ traction tool will be described with reference to FIGS. 4 to 6. Here, the intestinal tract 50 is described as an example of an organ to be grasped, but the present invention is not limited to this.

  As shown in FIG. 4, the organ traction tool of the first embodiment first connects a portion where the hook member 20 is provided and an arbitrary portion of the annular gripping portion 10 when pulling an organ such as the intestinal tract 50. Thus, the periphery of the intestinal tract 50 is surrounded by the annular gripping part 10. At this time, it arrange | positions in the position where the location where the hook member 20 is equipped, ie, the vicinity of the knot 15 inside the cylindrical member 23, is not made to contact the location which the intestinal tract 50 grasps.

  Then, the hook member 20 is passed through the ring of the annular gripping portion 10 from an arbitrary position of the annular gripping portion 10 and is wound around the intestinal tract 50 as shown in FIG. In this way, two rings are formed by passing the annular gripping part 10 from an arbitrary place, and the intestinal tract 50 is inserted inside the rings. By pulling the hook member 20 away from the intestinal tract 50, the size of the two rings is reduced and fixed to the intestinal tract 50. That is, since the annular gripping portion 10 is deformed along the shape of the intestinal tract 50, the intestinal tract 50 is not greatly deformed. In addition, by gripping the intestinal tract 50 not along a part of the intestinal tract 50 but by gripping it along the intestinal tract 50, it is possible to pull the intestinal tract 50 so as to support it.

  Organs such as the intestinal tract 50 include a mesentery (not shown) so as to cover the aorta and blood vessels that connect the aorta to the organs such as the intestinal tract 50. When the intestinal tract 50 is pulled with the organ traction tool of the first embodiment, the mesentery near the grasped intestinal tract 50 is incised so as not to incise blood vessels inside the mesentery. Thereby, the organ traction tool described in the first embodiment can be fixed to the intestinal tract 50 as described above.

  As shown in FIG. 6, the annular gripping part 10 wound around the intestinal tract 50 widens the interval between the two formed rings and fixes it to the intestinal tract 50. As described above, by widening the interval and fixing to the intestinal tract 50, the force of pulling away from the intestinal tract 50 by the traction line of the hook member 20, that is, the force pulling in the direction outside the body is transmitted to a wider range of the intestinal tract 50. Therefore, the intestinal tract 50 in a wider range can be pulled, and the field of view of the endoscope and laparoscope can be sufficiently secured. In addition, the bowing of the intestinal tract 50 generated by traction becomes gentle, and the influence on the intestinal tract 50 can be reduced.

  The organ retractor according to Embodiment 1 is introduced into the body in the same manner as an endoscope or a laparoscope. As shown in FIG. 7, the organ traction tool according to the first embodiment is configured such that the hook member 20 has an annular gripping portion through a hole (port 70) of about 1 cm to 2 cm that is opened in the abdomen 69 of the patient when performing laparoscopic surgery. It is introduced to enter the body before 10. Further, in order to pull the organ traction tool, one or a plurality of elastomer needles 71 having a diameter of about 1 mm are punctured at an arbitrary position of the abdomen 69 where the port 70 is formed. The introduced organ traction tool is held using forceps or the like while being observed by a laparoscope (not shown) introduced from another port (not shown). Then, as shown in FIGS. 5 and 6, the annular gripping portion 10 is fixed so as to wrap around the intestinal tract 50, and the intestinal tract 50 can be gripped.

  Then, the pulling wire 60 introduced so as to be folded in two and leave both ends outside the body is introduced from the elastane needle 71 punctured at an arbitrary position. As shown in FIG. 8, the traction line 60 is hung on the hanging portion 21 of the hook member 20, and the intestinal tract 50 is pulled in the direction outside the body. Accordingly, it is not necessary to introduce a plurality of forceps to pull the intestinal tract 50, and the organ can be pulled with one instrument. Note that the organ traction tool may be pulled not only from the elastane needle 71 but also from the port 70 by introducing the traction line 60.

  As described above, the organ traction tool of Embodiment 1 can grip the organ by wrapping and fixing the annular gripping portion 10 around the organ. Then, by pulling the hook member 20 provided in the annular gripping part 10 from outside the body via the pulling line 60, the organ gripped by the annular gripping part 10 can be pulled in the direction outside the body.

  And unlike the conventional forceps which picks up and pulls a part of the organ, the organ traction tool of Embodiment 1 supports the organ by winding the annular gripping part 10 around the organ so as to follow the shape of the organ. In addition, the organ can be pulled in the direction outside the body. Therefore, the force applied to the organ during organ traction is dispersed, and there is no risk of damage to the organ.

  Further, since the annular gripping portion is flexible, the annular gripping portion is deformed according to the shape of the organ, and the organ is not greatly deformed. Further, the annular gripping portion 10 is fixed to the organ so as to widen the interval between the two rings formed when gripping the organ, and the organ is gripped by the annular gripping portion 10 so that a wider range of organs is pulled. The organ can be pulled with a single instrument, and the field of view of the endoscope or laparoscope can be sufficiently secured.

  Although the annular gripping portion of the organ traction tool of Embodiment 1 is formed of an annular member having flexibility and elasticity, the present invention is not limited to this. For example, the annular gripping part may be composed of a single elongated flexible and elastic member. In this case, one end of the annular gripping portion is passed through one of the openings on the other end face side of the cylindrical member 23 divided into two by the rod 25, and the other end of the annular gripping portion is annular It is passed through an opening on the other end face side different from the opening on the other end face side through which the one end of the gripping part is passed.

  Then, one end and the other end of the annular gripping part pass through the inside of the cylindrical member 23 and the outside of the cylindrical member 23 from the opening on the one end surface side of the cylindrical member 23 provided with the hanging part 21. To be issued. And an elongate member becomes cyclic | annular by forming a knot in the part protruded outside from the opening by the side of the one end surface of the cylindrical member 23 of a cyclic | annular holding part. By forming the knot, the rod body 25 of the hook member 20 is disposed in the ring of the annular gripping portion 10, and the hook member 20 is provided in the annular gripping portion 10. The size of the ring of the annular gripping portion can be adjusted by changing the position of the knot.

  The rod body 25 provided in the hook member 20 of the organ traction tool of Embodiment 1 may be provided detachably. Thereby, it is also possible to change the size of the ring of the annular grasping part 10 according to the organ to be grasped.

[Embodiment 2]
In the organ traction tool described in the second embodiment, instead of the hook portion of the hook member of the organ traction tool described in the first embodiment, a tubular member is directly provided with a traction line. FIG. 9 is a diagram illustrating an example of an organ traction tool according to the second embodiment.

  The organ traction tool described in the second embodiment has an annular gripping part 10, a connection member 22, a traction line 61, and a needle-like member 62. The connecting member 22 of the organ traction tool is provided with the rod body 25 described in the first embodiment on the cylindrical member 23 having both end surfaces opened as described in the first embodiment.

  The rod body 25 has an inner side or the other end surface of the side surface on the other end surface side of the cylindrical member 23 so that the opening on the other end surface side located on the opposite side to the one end surface side provided with the pulling portion 61 is divided into two. It is attached to the side edge by bonding. More specifically, the rod body 25 passes through the center of the opening from the inner side of the side face on the other end face side or the other end face side, and passes through the opening to the inner side or the other end face of the other end face side on the opposite side. It is equipped so that it may hang over toward the edge of the side.

  As in the first embodiment, the annular gripping portion 10 is configured such that the rod body 25 is disposed on the tubular member 23 in a state in which the rod body 25 that divides the opening on the other end surface side of the tubular member 23 into two is arranged in the ring. The connection member 22 is provided by being provided. As a result, the annular gripping portion 10 is inserted into the cylindrical member 23 from one of the openings on the other end face side of the cylindrical member 23 of the connecting member 22 provided with the rod body 25. It will be in the state where it came out via the other opening. That is, the annular gripping part 10 is inserted from one opening on the other end face side of the cylindrical member 23 provided with the rod body 25 toward the other opening, so that the rod body 25 is arranged in the ring of the annular gripping part 10. In addition, a connecting member 22 is provided. Thereby, the annular gripping part 10 can reliably include the connection member 22 without being detached from the connection member 22.

  The traction line 61 is a member having a predetermined length and having flexibility such as a thread made of nylon or the like, like the traction line of the first embodiment. The traction line 61 is provided on the side surface on the one end surface side of the cylindrical member 23 located on the opposite side to the other end surface side on which the rod body 25 is provided. The traction line 61 is not particularly limited as long as it does not break when the organ is pulled. Further, the thickness and length of the organ are appropriately changed depending on the organ to be pulled, and are not particularly limited as long as the organ can be pulled in the direction outside the body.

  The needle-like member 62 is a needle made of metal or hard resin having one end tapered. The needle-like member 62 is connected to the traction line 61 at the other end which is not tapered. The needle-like member 62 is tapered at one end, so that the needle-like member 62 can be pulled out from the inside of the abdomen toward the outside of the body, and the annular gripper 10 can be pulled out. After grasping the organ, the other end side of the traction line 61 can be pulled out of the body. As a result, the other end side of the traction line 61 can be brought out of the body, and by pulling the traction line 61, the organ grasped by the annular grasping portion 10 can be pulled.

  Such an organ traction tool according to the second embodiment has the same annular gripping portion 10 as in the first embodiment, and thus, as in the first embodiment, the organ traction tool is introduced into the body to grip the organ. Can tow the organs. Hereinafter, the traction of the organ will be described. Here, the intestinal tract 50 is described as an example of an organ to be grasped, but the present invention is not limited to this.

  FIG. 10 is a diagram illustrating a state in which the intestinal tract is pulled by the organ traction tool according to the second embodiment. The organ retractor of the second embodiment is introduced into the body through the port 70 as in the first embodiment. The organ traction tool can hold the intestinal tract 50 by fixing the annular gripping portion 10 around the intestinal tract 50 in the same manner as in the first embodiment.

  After the intestinal tract 50 is gripped by the annular gripping portion 10, forceps or the like are inserted into the body via the port 70 or a port (not shown) to grip the needle-like member 62. Then, one end of the needle-like member 62 having a tapered shape is inserted so as to penetrate the abdomen 69 from the inside of the body. After the insertion, the one tip of the needle-like member 62 exposed outside the body is taken out from the skin of the abdomen 69. As a result, as shown in FIG. 10, the other end of the traction line 61 to which the tubular member 23 is not connected is pulled out of the body. By pulling the pulled pulling line 61, the organ gripped by the annular gripping portion 10 can be pulled in the direction outside the body.

  Thus, unlike the conventional forceps that picks up and pulls a part of the organ, the organ traction tool of Embodiment 2 is wound around the organ so that the annular gripping part 10 follows the shape of the organ. The organ can be pulled out of the body to support it. Therefore, the force applied to the organ during organ traction is dispersed, and there is no risk of damage to the organ.

  Further, by providing the needle-like member 62 on the pulling line 61, the organ can be pulled in the direction outside the body without using the elastane needle. Then, the direction in which the organ is pulled can be easily changed by pulling back the needle-like member 62 in the direction of the body and inserting the needle-like member 62 so as to penetrate another part.

[Embodiment 3]
In the organ traction tool described in the third embodiment, instead of the organ traction tool connecting member and the annular gripping portion described in the second embodiment, a gripping portion that is not directly annular is provided on the traction line. FIG. 11 is a diagram illustrating an example of an organ traction tool according to the third embodiment.

  The organ traction tool described in the third embodiment includes a traction line 61, a needle-like member 62, a gripping part 16, and an annular part 17. One end portion of the gripping portion 16 is connected to one end portion of the traction line 61 that is not connected to the needle-like member 62 described in the second embodiment.

  The gripping portion 16 is made of, for example, a rubber member having a predetermined thickness and having flexibility and elasticity. One end of the grip 16 is connected to the traction line 61. And the annular part 17 is connected to the other end part of the holding part 16 located on the opposite side to the one end part connected to the traction line 61. The cross-sectional shape of the grasping portion 16 of the organ traction tool may be circular or elliptical.

  The traction line 61 is a member having a predetermined length and having flexibility such as a thread made of nylon or the like, like the traction line of the second embodiment. One end of the traction line 61 is connected to one end of the grip 16. The traction line 61 is not particularly limited as long as it does not break when the organ is pulled. Further, the thickness and length of the organ are appropriately changed depending on the organ to be pulled, and are not particularly limited as long as the organ can be pulled in the direction outside the body.

  The needle-like member 62 is a needle made of metal, hard resin, or the like having one end tapered like the needle-like member of the second embodiment. The other end of the needle-like member 62 that is not tapered is connected to the other end of the traction line 61 located on the opposite side of the one end connected to the grip 16. The needle-like member 62 has one end tapered so that the needle-like member 62 can be pulled out from the inside of the abdomen toward the outside of the body, and the inserted needle-like member 62 can be pulled out. After gripping, the other end side of the traction line 61 can be pulled out of the body. Thereby, the other end side of the traction line 61 can be brought out of the body, and by pulling both of the traction lines 61, the organ grasped by the grasping portion 16 can be pulled.

  The annular portion 17 is a ring formed by a linear flexible member such as a thread made of nylon or the like, and connected by connecting both ends thereof to the other end portion of the gripping portion 16. . The ring diameter of the annular portion 17 is not particularly limited as long as it has a size that allows the needle-like member 62, the traction line 61, and the gripping portion 16 to be inserted therethrough.

  When an organ is pulled with the organ traction tool of the third embodiment, it is necessary to hold the organ with the holding unit 16. Hereinafter, a method of grasping an organ with the grasping portion 16 in the organ traction tool will be described with reference to FIGS. 12 and 13. Here, the intestinal tract 50 is described as an example of an organ to be grasped, but the present invention is not limited to this.

  As shown in FIG. 12, in the organ traction tool of the third embodiment, when pulling an organ such as the intestinal tract 50, first, the gripping portion 16 is arranged so that both ends of the gripping portion 16 do not contact the intestinal tract 50. . At this time, the needle-like member 62 penetrates the intestinal tract membrane of the intestinal tract 50 so as not to damage blood vessels in the mesentery (not shown). Then, the needle-like member 62 is inserted into the ring of the annular portion 17, and the gripping portion 16 is wound around the intestinal tract 50 and fixed so as to follow the periphery of the intestinal tract 50 as shown in FIG. 13. That is, the gripping part 16 grips the intestinal tract 50 together with a mesentery (not shown). As a result, the grip 16 is deformed along the shape of the intestinal tract 50 so that the intestinal tract 50 is not significantly deformed. In addition, by gripping the intestinal tract 50 so as to be held along the intestinal tract 50, the intestinal tract 50 can be pulled so as to be supported.

  FIG. 14 is a diagram illustrating a state in which the intestinal tract is pulled by the organ traction tool according to the third embodiment. The organ retractor of the third embodiment is introduced into the body via the port 70 as in the second embodiment. Then, the organ traction tool is fixed so that the gripping portion 16 wraps around the intestinal tract 50 as shown in FIGS. 12 and 13, and can grip the intestinal tract 50.

  After the intestinal tract 50 is gripped by the gripping portion 16, forceps and the like are inserted into the body via the port 70 and a port (not shown) to grip the needle-like member 62. Then, one end of the needle-like member 62 having a tapered shape is inserted so as to penetrate the abdomen 69 from the inside of the body. After the insertion, the one tip of the needle-like member 62 exposed outside the body is taken out from the skin of the abdomen 69. Accordingly, as shown in FIG. 14, the other end portion of the traction line 61 that is not connected to the grip portion 16 is pulled out of the body. By pulling the pulled pulling line 61, the organ gripped by the gripping part 16 can be pulled in the direction outside the body.

  Thus, unlike the conventional forceps that picks up and pulls a part of the organ, the organ traction tool of the third embodiment is wound around the organ so that the shape of the organ follows the shape of the organ. It can be pulled out of the body to support it. Therefore, the force applied to the organ during organ traction is dispersed, and there is no risk of damage to the organ. Further, the structure is simple, and the grasping portion 16 can be easily wound around the organ.

  Further, by providing the needle-like member 62 on the pulling line 61, the organ can be pulled in the direction outside the body without using the elastane needle. Then, the direction in which the organ is pulled can be easily changed by pulling back the needle-like member 62 in the direction of the body and inserting the needle-like member 62 so as to penetrate another part.

[Embodiment 4]
The organ traction tool described in the fourth embodiment is provided with a traction line including a needle-like member in place of the annular portion of the organ traction tool described in the third embodiment. FIG. 15 is a diagram illustrating an example of an organ traction tool according to the fourth embodiment.

The organ traction tool described in the fourth embodiment includes traction lines 61 and 63, needle-like members 62 and 64, and a grip portion 18.

  The gripping portion 18 is formed of a member having an elliptical cross-sectional shape as shown in FIG. 16 and having a predetermined thickness. The gripping part 18 is composed of, for example, a rubber core material 180 having an elliptical shape and a sheet material 181 made of cloth such as gauze covering the core material 180, and has flexibility and elasticity. The cross-sectional shape of the grip portion 18 is an example, and may be circular. The sheet material 181 does not need to cover the entire core material 180. For example, the end portion of the core material 180 may be exposed. In addition, the sheet material 181 is not limited, but it is preferable to use a sheet material such as a gauze that has an uneven surface, for example, which generates a frictional force with an organ to be grasped.

  One end of the grip 18 is connected to the traction line 61 described in the third embodiment. Then, a traction line 63 similar to the traction line 61 is connected to the other end of the grip portion 16 located on the side opposite to the one end connected to the traction line 61. Specifically, both ends of the core member 180 and the traction wires 61 and 63 are connected.

  The traction lines 61 and 63 are members having a predetermined length as in the traction line of the third embodiment and having flexibility such as a thread made of nylon or the like. One end of the traction line 61 is connected to one end of the grip portion 18. Further, the traction line 63 is connected at one end to the other end of the grip portion 18 located on the opposite side of the one end to which the traction line 61 is connected. The traction lines 61 and 63 are not particularly limited as long as they do not break when the organ is pulled. Further, the thickness and length of the organ are appropriately changed depending on the organ to be pulled, and are not particularly limited as long as the organ can be pulled in the direction outside the body.

  The needle-like members 62 and 64 are needles made of metal, hard resin, or the like whose one end is tapered like the needle-like member of the third embodiment. The other end portions of the needle-like members 62 and 64 that are not tapered are respectively connected to the other end portions of the traction lines 61 and 63 that are located on the opposite side of the one end portion connected to the grip portion 18. ing. The needle-like members 62 and 64 have one end tapered so that the needle-like members 62 and 64 can be pulled out from the inside of the abdomen toward the outside of the body, After grasping the organ with the part 18, the other end side of the traction lines 61 and 63 can be pulled out of the body. Thereby, the other end side of the traction lines 61 and 63 can be taken out of the body, and the organ grasped by the grasping portion 18 can be pulled by pulling both of the traction lines 61 and 63.

  When an organ is pulled with the organ traction tool of the fourth embodiment, it is necessary to hold the organ with the holding unit 18. Hereinafter, a method of grasping an organ with the grasping portion 18 in the organ traction tool will be described with reference to FIG. Here, the uterus 51 is described as an example of an organ to be grasped, but the present invention is not limited to this.

  In the organ traction tool of the fourth embodiment, for example, when an organ such as the uterus 51 is to be pulled, first, the uterus 51 is connected by the grip portion 18 and the two pull lines 61 and 63 so as to connect the two needle-like members 62 and 64. Surround the surroundings. Around the uterus 51, there is a mesentery 52 having blood vessels connected to the uterus as shown in FIG. When the uterus 51 is surrounded by the grip portion 18 and the two traction lines 61 and 63 so as to connect the two needle-like members 62 and 64, the needle-like members 62 and 64 are pierced through the uterine membrane 52. The position where the needle-like members 62 and 64 penetrate the endometrium 52 is such that the uterus 51 exists on a straight line connecting the positions, that is, the position where the uterus 51 can be sandwiched between the needle-like members 62 and 64. In this position, blood vessels passing through the endometrium 52 are not damaged. The uterus 51 is surrounded by the gripping portion 18 and the two pulling lines 61 and 63 formed by penetrating the needle-like members 62 and 64 at such positions and connecting the two needle-like members 62 and 64. Can do.

  After surrounding the uterus 51, the needle-like members 62 and 64 are pulled so that the gripping portion 18 is brought into contact with the uterus 51, whereby the gripping portion 18 can grip the uterus 51. As a result, the gripping portion 18 is deformed along the shape of the uterus 51 so that the uterus 51 is not greatly deformed. In addition, by gripping the uterus 51 so as to be held along the uterus 51, the uterus 51 can be pulled to support the uterus 51.

  FIG. 18 is a diagram showing a state where the uterus is pulled by the organ traction tool of the fourth embodiment. Similar to the third embodiment, the organ traction tool of the fourth embodiment is introduced into the body through a port (not shown). Then, as shown in FIG. 17, the organ traction tool can grip the uterus 51 along the periphery of the uterus 51 by the grip portion 18.

  After grasping the uterus 51 with the grasping portion 18, forceps and the like are inserted into the body through a port (not shown) and the like, and the needle-like members 62 and 64 are separately grasped. Then, one end of each of the needle-like members 62 and 64 that is tapered is inserted so as to penetrate the abdomen 69 from the inside of the body. After the insertion, one end of the needle-like members 62 and 64 exposed to the outside of the body is taken out from the skin of the abdomen 69. Thereby, as shown in FIG. 18, the other end portion of the traction lines 61 and 63 that is not connected to the grip portion 18 is pulled out of the body. By pulling the drawn tow lines 61 and 63, the organ gripped by the grip portion 18 can be pulled in the direction outside the body.

  As described above, the organ traction tool according to the fourth embodiment is different from the conventional forceps that picks up and pulls a part of the organ, and grips the organ so that the gripping part 18 follows the periphery of the organ. It can be pulled out of the body to support it. Therefore, the force applied to the organ during organ traction is dispersed, and there is no risk of damage to the organ. Even when there is no gap around which the grasping portion 18 is wound, the organ can be pulled in a desired direction.

  In addition, by providing a sheet material 181 such as gauze that covers the periphery of the core material 180 of the grasping portion 18, a frictional force is generated between the organ and the sheet material 181. The gripping part 18 can be securely gripped without slipping out.

It is a figure which shows an example of the organ traction tool of Embodiment 1 of this invention. It is a figure which shows the structure of a hook member in the organ traction tool of Embodiment 1 of this invention. It is a figure which shows the state which formed the knot in the cyclic | annular holding part of the organ traction tool of Embodiment 1 of this invention. It is a figure which shows the process of enclosing the circumference | surroundings of the organ traction tool of Embodiment 1 of this invention. It is a figure which shows the state which wound the organ traction tool of Embodiment 1 of this invention around the organ, and was fixed. It is a figure which shows the state which expanded the space | interval of the cyclic | annular holding part of the organ traction tool of Embodiment 1 of this invention. It is a figure which shows the state which introduces the organ traction tool of Embodiment 1 of this invention into a body. It is a figure which shows the state which pulls an organ with the organ traction tool of Embodiment 1 of this invention. It is a figure which shows an example of the organ traction tool of Embodiment 2 of this invention. It is a figure which shows the state which pulls an organ with the organ traction tool of Embodiment 2 of this invention. It is a figure which shows an example of the organ traction tool of Embodiment 3 of this invention. It is a figure which shows the process of enclosing the circumference | surroundings of the organ traction tool of Embodiment 3 of this invention. It is a figure which shows the state which wound the organ traction tool of Embodiment 3 of this invention around the organ, and was fixed. It is a figure which shows the state which pulls an organ with the organ traction tool of Embodiment 3 of this invention. It is a figure which shows an example of the organ traction tool of Embodiment 4 of this invention. It is A-A 'sectional drawing of FIG. It is a figure which shows the state which equips an organ with the organ traction tool of Embodiment 4 of this invention toward the abdomen side from the back part side. It is a figure which shows the state which pulls an organ with the organ traction tool of Embodiment 4 of this invention.

Explanation of symbols

10, 26 Annular gripping parts 16, 18 Grasping part 180 Core material 181 Sheet material 20 Hook member 21 Hooking part 22 Connecting member 23 Cylindrical member 25 Rod body 17 Annular part 61, 63 Tow line 62, 64 Needle-like member

Claims (9)

A flexible annular grasping part formed in an annular shape for grasping an organ;
A towing line for towing the annular gripping portion;
A hook member that is provided in the annular gripping part and hangs the traction line;
The hook member of the annular grasping portion is surrounded by the place where the hook member is provided, and an arbitrary portion of the annular grasping portion is connected, and the hook member is inserted into the ring of the annular grasping portion from the arbitrary portion. An organ traction tool characterized in that the annular gripping part is wound around and fixed to the organ through and pulled through the organ. The hook member is
A cylindrical tubular member having both end faces open;
A hanging portion for hanging the traction line provided on the side surface on the one end surface side of the cylindrical member,
On the inside of the side surface on the other end surface side of the tubular member so that the opening on the other end surface side of the tubular member located on the opposite side to the one end surface side provided with the hanging portion is divided into two. A rod body provided,
The annular gripping portion is inserted from one opening on the other end face side of the cylindrical member provided with the rod body toward the other opening, and the rod body is disposed in the ring of the annular gripping portion. The organ traction tool according to claim 1, further comprising the hook member. The annular gripping part is knotted by being tied on the other end face side of the cylindrical member provided with the rod,
The organ traction tool according to claim 2, wherein the knot of the annular gripping part is stored inside the cylindrical member.   2. The organ traction tool according to claim 1, wherein the annular gripping portion is curved in a horseshoe shape in which a portion that comes into contact with the organ is bent when being wound around and fixed to the organ. A flexible annular grasping part formed in an annular shape for grasping an organ;
A towing line for towing the annular gripping portion;
A connecting member provided in the annular gripping part, to which one end of the traction line is connected;
A needle-like member that is provided at the other end of the traction line that is located on the opposite side of the one end to which the connection member is connected, and for pulling out the other end of the traction line outside the body having the organ. And
The connection member of the annular grasping portion is surrounded by the place where the connection member is provided, and an arbitrary portion of the annular grasping portion is connected to the periphery of the organ, and the connection member enters the ring of the annular grasping portion from the arbitrary place. An organ traction tool characterized in that the annular gripping portion is wound around and fixed to the organ and the organ is pulled. The connecting member is
Cylindrical cylindrical members having both end faces opened and one end of the traction line connected to the side face on one end face side;
A rod provided on the inner side of the other end surface side of the cylindrical member so as to divide the opening on the other end surface side of the cylindrical member located on the side opposite to the one end surface side where the traction line is provided. Having a body,
The annular gripping portion is inserted from one opening on the other end surface side of the cylindrical member provided with the rod body toward the other opening, and the rod body is disposed in the ring of the annular gripping portion. The organ traction tool according to claim 5, further comprising the connection member. A flexible gripping part for gripping an organ;
A traction line that is provided at one end of the grip portion and pulls the grip portion;
A needle-like member for pulling out the other end of the traction line to the outside of the body having the organ; ,
An annular portion that is formed in an annular shape and is provided at the other end portion of the grip portion that is located on the opposite side of the one end portion provided with the traction line;
Surrounding the organ with the grasping portion, inserting the needle-like member and the traction line into the ring of the annular portion, wrapping and fixing the grasping portion around the organ, and pulling the organ An organ traction tool. A flexible gripping part for gripping an organ;
Two pulling lines provided at both ends of the gripping part to pull the gripping part;
2 for pulling out the other end portion of the traction line to the outside of the body having the organ, provided at the other end portion of the two traction lines located on the opposite side of the one end portion where the grip portion is provided. Two needle-like members,
An organ traction tool that surrounds the organ so as to connect the two needle-like members, holds the organ by the gripping portion so as to support the organ, and pulls the organ.   The organ traction tool according to claim 8, wherein the grasping portion includes a core material and a sheet material that covers the core material.