JP2011229933A - Trocar set - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a trocar with an introducer sheath, eliminating the risk of a trocar needle mis-puncturing a front living body wall, excelling in operability in operation, and safe and easy to use.SOLUTION: The trocar needle 6 is regulated to be stored in a needle cover sleeve when not in use, and released from regulation by pressing a push button 4 with the fingertip when in use. Under pressure caused by puncture, the needle cover sleeve retreats into a position where the needle tip 6a of the trocar needle projects, and the retreat state is maintained. When the trocar needle reaches a body cavity and the pressure is reduced from the predetermined value, the needle cover sleeve is returns into a position where the trocar needle is stored, and the trocar needle 6 is stored in the needle cover sleeve. After puncture, the trocar is pulled out leaving the introducer sheath, and the introducer sheath is removed after inserting a catheter.

Description

The present invention relates to a trocar set that opens an insertion path for inserting a catheter into the abdominal cavity of a patient by endoscopic surgery or the like by puncturing the trocar needle. The present invention relates to a trocar set that eliminates the risk of accidental puncture of a living body wall and protects a practitioner by covering the needle tip after the trocar needle is pulled out from a patient's body.

In endoscopic surgery, inside the patient's abdominal cavity, esophagus, stomach, intestine, liver, spleen, pancreas, hernia, etc., guide wire, laparoscope (endoscope), forceps, scalpel (female), laser knife, etc. Remote surgery performed by inserting a surgical tool of this type reduces the scar size, reduces the possibility of wound infection, postoperative complications, intra-abdominal adhesion, etc., makes oral intake early, postoperative wound pain and abdominal wall The patient's dysfunction is reduced, and the hospitalization period is shortened to enable the patient to return to society early.

The tools used for these surgical operations are inserted into the abdominal cavity or the like through a catheter or trocar cannula tube (also referred to as a cannula) inserted from the patient's percutaneous into the abdominal cavity.

A catheter or trocar cannula tube is an injection path for injecting medicinal solution, nutrient solution, blood, etc. into the patient's body, or an infusion path for inflating the abdominal cavity by injecting carbon dioxide gas or air when using an endoscope Used as.

Also, catheters and trocar cannula tubes are used to discharge body fluids such as ascites to the outside, to discharge bleeding due to surgery to the outside, and to discharge gas and air that are no longer needed after injection during the aforementioned surgery. It is also used as a discharge path for exhausting gas generated in the abdominal cavity and a discharge path for discharging wastes and the like in the abdominal cavity. Many types of catheters are specialized in functioning as an injection path for injecting a chemical solution or a nutrient solution into a patient's body.

Since the catheter is a highly flexible resin tube, it cannot be inserted directly into the abdominal cavity. As a method for inserting a catheter into a patient's stomach or the like, conventionally, for example, a trocar is inserted into an introducer sheath (hereinafter abbreviated as a sheath) in which a T-shaped handle is formed at the rear end of a resin tube. (Hereinafter, referred to as a trocar set) was punctured into the abdominal cavity, after which only the trocar was pulled out, the catheter was inserted into the sheath left in the body, and then the sheath was removed.

A device (trocar catheter) in which a simpler tubular sheath (mantle catheter) and a trocar needle (metal needle) are combined is also known (see, for example, Patent Document 1).
A trocar catheter in which a trocar and a catheter are integrated is also disclosed (see, for example, Patent Document 2).

JP-A-10-151202 Japanese National Patent Publication No. 11-503643

However, since the trocar catheter described in Patent Document 1 always punctures the tip of the metal needle so as to protrude forward from the tip of the mantle catheter, the doctor can remove the front septum in the abdominal cavity during the operation. There was a risk of piercing. There is also a risk of infecting an infectious disease by accidentally puncturing a doctor or nurse's hand with a metal needle to which the patient's blood has adhered. For this reason, this type of instrument tends to be shunned.

Since the instrument described in Patent Document 2 punctures a trocar directly into a living tissue and uses it as a catheter, the trocar part is easily obstructed, and the rear end part is greatly bulged. As a result, a burden may be placed on the puncture site of the patient.

The present invention has been made to solve the above-mentioned problems, and there is no risk of piercing the front septum in the abdominal cavity. An object of the present invention is to provide a trocar set that can be punctured by mistake, does not impose a burden on a puncture site of a patient, is safe, easy to operate, and can perform a smooth and reliable operation. .

The trocar set of the present invention includes a trocar needle that protrudes inside one end of a housing and extends outward beyond the other end, a cylindrical needle cover sleeve that covers the trocar needle to the needle tip, and a needle cover An introducer sheath mounted on the outside of the sleeve, and a first spring that urges the needle cover sleeve in the direction of the needle tip of the trocar needle, and the needle cover sleeve has a pressure exceeding the urging force of the first spring. A trocar set in which the needle cover sleeve moves in the opposite direction to the tip of the trocar needle when added,
A push button provided on one surface of the housing, biased in a direction to be pushed back by a second spring, and having protrusions whose bottom surfaces are inclined on both side surfaces parallel to the trocar needle;
From the both ends in the horizontal direction of the flange surface provided at the rear end of the cylinder portion of the needle cover sleeve, it is provided in parallel with the trocar needle so as to sandwich both side surfaces of the push button and to be able to contact the protrusion. A pair of tongue pieces and a pair of protrusions provided by extending a part of each tongue piece downward;
A pair of guide plate portions provided from the inner side of one end of the housing to sandwich both outer side surfaces of the tongue piece, having elasticity, and having an upper plate portion, a lower plate portion, and a gap therebetween. ,
(A) Before use, the protrusion is held in the gap, abuts against the tongue piece connected to the needle cover sleeve, and the needle cover sleeve is restricted from moving in the direction opposite to the needle tip of the trocar needle. To prevent the needle tip of the needle from being exposed,
(B) In use, the push button is pressed against the urging force of the second spring, so that the lower plate portion is bent by the protrusion, and the protrusion is moved from the gap to the lower portion of the lower plate portion. The needle cover sleeve is allowed to move in the opposite direction to the needle tip of the trocar needle,
(C) In the state of (B), the tip of the needle cover sleeve is pressed against the patient's skin, pressure exceeding the biasing force of the first spring is applied to the needle cover sleeve, and the needle cover sleeve becomes the needle tip of the trocar needle. When the needle tip is exposed by moving in the opposite direction, the protrusion provided on the tongue curve curves the lower plate of the guide plate, and the protrusion moves from the lower plate to the lower edge of the tongue. Let
(D) When pressurization is continued until the trocar needle and introducer sheath reach the body cavity, and the trocar needle reaches the body cavity or the pressing force is decreased, and the pressure becomes lower than the biasing force of the first spring. The urging force of the first spring moves the needle cover sleeve to the needle tip of the trocar needle, covers the needle tip of the trocar needle, moves the tongue piece, and returns the protrusion to the gap of the guide plate part, Even after the trocar is pulled out with the introducer sheath remaining in the body cavity, the needle cover sleeve restricts the needle cover sleeve from moving in the direction opposite to the tip of the trocar needle. A stopper device for restricting exposure of the tip is provided.

The trocar set of the present invention is safe because the tip of the trocar needle is covered with the needle cover sleeve before use and the stopper is operated so that the needle cover sleeve does not move. In use, when the tip of the trocar is punctured into the living tissue together with the distal end of the sheath after releasing the lock, the needle cover sleeve that has covered the tip of the needle is retracted due to the pressure received from the living tissue. Therefore, there is no risk that the metal needle may be accidentally punctured by a doctor or nurse's hand, etc., and it is safe.

In the trocar set of the present invention, when the needle tip of the trocar needle penetrates the living tissue and reaches the body cavity, and the pressure received from the living tissue is reduced by the urging force of the first spring, the needle cover sleeve is attached to the trocar needle. Since it moves in the direction of the needle tip and covers the needle tip of the trocar needle, there is no risk of piercing the front septum in the abdominal cavity, and it is safe and easy to operate.

Furthermore, the trocar set of the present invention operates by automatically returning the stopper by moving the needle cover sleeve, so that the stopper operates even after the trocar is pulled out, and the trocar needle to which the patient's blood adheres can be removed by a doctor or nurse. There is no risk of accidental puncture of the teacher's hand, and it is safe.

In addition, the trocar set of the present invention generates a contact sound when the lock is released, when the needle cover sleeve moves and the stopper is started, and when the stopper is activated, so that the operation status of the stopper device can be confirmed. Therefore, smooth and reliable operation can be performed.

It is the perspective view which showed the trocar and sheath which concern on one Embodiment of this invention. It is a perspective view which shows the trocar set which attached the sheath to the trocar which concerns on other embodiment of this invention. It is a disassembled perspective view of the trocar which concerns on this invention. (A) is a top view of a housing, (b) is a cross-sectional view, (c) is an AA arrow sectional view in (b). (A) is a side view of a pushbutton, (b) is a front view. (A) is a partially broken perspective view of the needle cover sleeve, (b) is a plan view, and (c) is a rear view. (A) is the perspective view which looked at the front cover from diagonally back, (b) is a side view. It is a perspective view which shows the state in the middle of the assembly | attachment of the trocar. (A) is a perspective view showing the positional relationship between the needle cover sleeve and the front lid inside the housing, (b) is a vertical sectional view of the main part including the central axis of the needle cover sleeve, and (c) is the back surface. FIG. (A) is a horizontal sectional view including the center line of the trocar needle of the trocar in a state where the push button is not pushed, (b) is a vertical sectional view, and (c) is orthogonal to the trocar needle. It is sectional drawing in a surface. It is a perspective view which shows the positional relationship inside a trocar in the state in which the pushbutton is not pushed. It is a perspective view which shows the positional relationship inside a trocar in the state in which the pushbutton is pushed and the protrusion is moving. It is a perspective view which shows the positional relationship inside a trocar when a pushbutton is pushed and it will be in an OFF state. (A) is a horizontal sectional view including the central axis of the trocar needle of the trocar in the automatic return step, (b) is a vertical sectional view, and (c) is a transverse sectional view. It is the perspective view which partially broken and showed the trocar of the automatic reset process. (A) And (b) is the perspective view which showed the example which can confirm visually the state in which the pushbutton is pushing operation by the colored display. It is the perspective view which showed the example which can confirm the state in which the pushbutton is not pushed operation visually by a colored display. It is the perspective view which showed the example which set the position of the pushbutton higher than the surrounding surface. (A)-(e) is the figure which showed the introducer method using the trocar set of this embodiment in order.

Hereinafter, embodiments of the present invention will be described in detail.
A sheathed trocar (trocar set) used in the present invention is a device for inserting a surgical instrument, a catheter, or the like into a patient's abdominal cavity or the like in an operation under an endoscope. The trocar needle is inserted into the sheath and punctured into the abdominal cavity. After puncturing, only the trocar is pulled out, the catheter is inserted into the sheath left in the body, and then the sheath is removed. There are many.

The sheath is a plastic product having a “T” -shaped shape in which a plate-like gripping portion is provided at the rear end of the cylindrical portion, and the cylindrical portion is formed to be tearable in the long axis direction. preferable.

A trocar according to the present invention is a trocar needle that protrudes inside one end of a housing that can be held with one hand and extends outward beyond the other end, and a cylindrical needle cover that covers the trocar needle to the needle tip A sleeve and a first spring that urges the needle cover sleeve toward the tip of the trocar needle.

The trocar according to the present invention is a trocar in which the needle cover sleeve moves in the direction opposite to the needle tip of the trocar needle when a pressure exceeding the biasing force of the first spring is applied to the needle cover sleeve, and the needle A stopper device that restricts or allows the movement of the cover sleeve is provided.

The stopper device includes a stopper means for restricting the needle cover sleeve from moving in a direction opposite to the needle tip of the trocar needle, and an on state in which movement of the trocar needle is restricted to an off state in which movement is permitted. The input means for conversion, the stopper stopping means for maintaining the OFF state while applying the pressure exceeding the biasing force of the first spring in the OFF state to expose the tip of the trocar needle, the pressure is attenuated, It is preferable to include return means for returning the stopper means from the OFF state to the ON state when the needle cover sleeve moves in the direction of the needle tip of the trocar needle by the biasing force of one spring.
The present invention can be used with any structure as long as it is such a stopper device.

Hereinafter, an embodiment of the present invention will be described in detail with reference to the accompanying drawings. This description is for explaining the present invention, and is not intended to limit the technical scope of the present invention by this description. The present invention can be implemented with various modifications without departing from the technical scope. It is possible.

FIG. 1 is a perspective view showing a trocar and a sheath according to one embodiment of the present invention, and FIG. 2 is a perspective view showing a trocar set in which the trocar is attached to a sheath according to another embodiment of the present invention. is there.

As shown in FIG. 1, the trocar 2 includes a housing 3 that can be held with one hand, a trocar needle 6 that extends outward from the inside of the housing 3, and a trocar needle 6 that extends to the needle tip 6 a of the trocar needle 6. A needle cover sleeve 8 to be accommodated. Here, the direction of the needle tip 6a of the trocar needle 6 is defined as the front, and the opposite direction is defined as the rear.

In this embodiment, the needle cover sleeve 8 is formed of a transparent plastic through which the trocar needle 6 can be seen. However, whether the needle cover sleeve 8 is transparent and whether the material is plastic. Is not limited.

As shown in FIG. 2, the trocar set 1 is configured by inserting a trocar 2 into a sheath 10. The sheath 10 has a “T” shape in which plate-like gripping portions 10 b and 10 b are provided at the rear end of the cylindrical portion 10 a shorter than the needle cover sleeve 8, and the cylindrical portion 10 a extends in the long axis direction. It is preferably a plastic product formed to be tearable.

FIG. 3 is an exploded perspective view of the trocar according to the present invention.
As shown in FIG. 3, the trocar 2 has a cylindrical housing 3 with one end 3p sealed and the other end 3a open, a front lid 9 provided at the other end 3a of the housing 3, a push button 4, The assembled product includes a second spring 5 that urges the push button 4 in the push-back direction, a trocar needle 6, a needle cover sleeve 8, and a first spring 7 that urges the needle cover sleeve 8 forward. .

4A is a plan view of the housing, FIG. 4B is a cross-sectional view, and FIG. 4C is a cross-sectional view taken along the line AA in FIG.
4A to 4C, the housing 3 has a substantially rectangular or square cross section, and an opening 3b for holding a push button is provided on one surface thereof. Claw receiving openings 3c and 3c that engage with the front lid 9 are provided on the other end 3a side of the two faces facing each other across the opening 3b, and a low step portion 3r is provided between the one end 3p of the housing 3 and the opening 3b. The housing 3 is preferably provided with a trocar needle entry hole 3d at one end 3p. Here, the surface provided with the opening 3b for holding the push button is defined as the upper surface.

The interior of the housing 3 is a four-part holding piece 3e that surrounds and holds the rear end portion 6b of the trocar needle from the inner surface surrounding the trocar needle insertion hole 3d provided at one end 3p toward the other end 3a. A reinforcing rib 3m having a “T” -shaped cross section is formed in the center of the surface facing the opening 3b on the side of the one end 3p, and the lower end 3p on the two side surfaces facing the opening 3b. Two ribs 3n and 3n are preferably formed between the first end 3a and the other end 3a.

As shown in FIGS. 4B and 4C, the housing 3 is composed of an upper plate portion 3h and a lower plate portion 3k from one end 3p to the other end 3a, and the upper plate portion 3h and the lower plate portion 3k. A pair of guide plate portions 3s, 3s provided with a gap 3j is provided in slidable contact so as to sandwich the outer surface of the tongue pieces 8e, 8e.

Fig.5 (a) is a side view of a pushbutton, (b) is a front view.
As shown in FIGS. 5 (a) and 5 (b), the push button 4 preferably has a prismatic shape in which an opening 4e through which the trocar needle 6 passes is formed in the lower part. It is preferable that the upper portion of the push button 4 is formed with an operation portion 4b having a quadrangular plan view and an upper surface formed with a low step portion 4c for facilitating pressing of the fingertip. Protrusions 4f and 4f whose bottom surfaces are inclined are formed at the lower portions of both side surfaces 4d and 4d of the push button 4 parallel to the trocar needle 6.

6A is a partially broken perspective view of the needle cover sleeve, FIG. 6B is a plan view, and FIG. 6C is a rear view.
As shown in FIGS. 6A to 6C, the needle cover sleeve 8 includes a cylindrical portion 8a into which the trocar needle 6 is inserted, an operation portion 8b provided to be connected to the rear end of the cylindrical portion 8a, Have

The operation portion 8b includes a flange surface 8c of the cylindrical portion 8a and a pair of tongue pieces 8e provided so as to be slidable so as to sandwich both side surfaces 4d and 4d of the push button 4 from both ends of the flange surface 8c in the horizontal direction. 8e, and each of the tongue pieces 8e, 8e extending downward and projecting outwardly therefrom are configured. It is preferable that the notches 8d and 8d are formed symmetrically in the lower part of the flange surface 8c.

FIG. 7A is a perspective view of the front lid as viewed obliquely from the rear, and FIG. 7B is a side view.
As shown in FIGS. 7A and 7B, the front lid 9 has a lid plate portion 9a provided with an opening 9b through which the needle cover sleeve 8 passes in the center. Claw portions 9c and 9c engaging with the claw receiving openings 3c formed in the housing 3 are erected rearward at two upper and lower portions, and are slidable to the outside of the tongue pieces 8e and 8e to the left and right of the opening 9b. It is preferable that upper guide portions 9d and 9d provided so as to be in contact with each other, and lower guide portions 9e and 9e to be inserted into the notched portions 8d and 8d of the flange surface 8c are provided below the lid plate portion 9a.

FIG. 8 is a perspective view showing a state where the trocar is being assembled.
As shown in FIG. 8, in assembling the trocar, it is preferable to attach the push button 4 to the upper surface of the housing 3 and hold the rear end portion of the trocar needle 6 at one end 3 p of the housing 3. Although not shown in FIG. 8, the trocar needle 6 is provided with a spring that biases the needle cover sleeve 8 forward.

With the tube cover 8a of the needle cover sleeve 8 fitted to the front cover 9, the trocar needle 6 is inserted into the needle cover sleeve 8, and the claw 9c of the front cover 9 and the claw opening 3c of the housing 3 When the two are fitted, the assembly of the trocar is completed.

FIG. 9A is a perspective view showing the positional relationship between the needle cover sleeve and the front lid inside the housing, FIG. 9B is a vertical sectional view of the main part including the central axis of the needle cover sleeve, and FIG. FIG.

As shown in FIGS. 9A to 9C, the tongue piece 8e of the needle cover sleeve 8 is supported on both sides by an upper guide portion 9d provided on the outside thereof, and a notch portion provided on the flange surface 8c. By inserting the lower guide portion 9e into 8d, the needle cover sleeve 8 can be held so as to be able to move forward and backward without rotating in the left-right direction.

FIG. 10A is a horizontal cross-sectional view including the center line of the trocar needle of the trocar in a state where the push button is not pushed, (b) is a vertical cross-sectional view, and (c) is a trocar needle. FIG. 11 is a perspective view showing a positional relationship inside the trocar when the push button is not pushed.

As shown in FIGS. 10 (a) to 10 (c) and FIG. 11, the rear end portion 6b of the trocar needle 6 is preferably fixed to the housing by a four-piece holding piece 3e.
The trocar needle 6 is preferably in a state of being inserted into an opening 4e formed in the lower part of the push button 4. The push button 4 is biased upward by the second spring 5.

As shown in FIG. 10 (c), the tip of the protrusion 4f provided on the lower side wall of the push button 4 is fixed to the housing 3 in this state (on state). And in the gap 3j between the lower plate portions 3k. In the on state, the needle cover sleeve 8 is in a state of being urged forward by a first spring attached to the trocar needle 6, and the needle tip 6 a of the trocar needle 6 is in the cylinder portion 8 a of the needle cover sleeve 8. Is located.

In the ON state, the tongue piece 8e of the operation portion 8b provided at the rear end of the needle cover sleeve 8 abuts on the protrusion 4f provided on the push button 4, and the needle cover sleeve 8 moves backward. It is regulated. The protrusion 4f corresponds to the stopper means.

FIG. 12 is a perspective view showing the positional relationship inside the trocar when the push button is pushed and the protrusion is moving, and FIG. 13 is the inside of the trocar when the push button is pushed and turned off. It is a perspective view which shows these positional relationships.

As shown in FIG. 12, when the push button 4 is pushed down, the projections 4f and 4f provided on both side surfaces 4d and 4d of the push button 4 push and bend the lower plate portions 3k and 3k outward. When the push button 4 is pushed down to a position where the protrusions 4f and 4f exceed the lower plate portions 3k and 3k of the guide plate portion 3s, the lower plate portions 3k and 3k are elastically restored to their original shapes as shown in FIG. The protrusions 4f and 4f are held at positions where they contact the lower edges of the lower plate portions 3k and 3k, and the return of the push button 4 in the push-back direction is restricted. That is, the push button 4 is locked.

When the protrusions 4f and 4f move to a position where they contact the lower edges of the lower plate portions 3k and 3k, they do not contact the tongue pieces 8e and 8e of the needle cover sleeve 8, so that the needle cover sleeve 8 moves backward due to external pressure. It becomes possible (off state). The push button 4 corresponds to an input unit, and the guide plate portion 3s corresponds to a stopper stop unit.

When a pressure larger than the urging force of the first spring 7 is applied to the needle cover sleeve 8 in the off state, the needle cover sleeve 8 moves in the direction opposite to the needle tip 6a of the trocar needle 6 and the needle of the trocar needle 6 The tip 6 a is exposed from the tube portion 8 a of the needle cover sleeve 8.

14A is a horizontal sectional view including the central axis of the trocar needle of the trocar in the automatic return process, FIG. 14B is a vertical sectional view, FIG. 14C is a transverse sectional view, and FIG. It is the perspective view which partially broken and showed the trocar of the automatic reset process.
As shown in FIGS. 14A to 14C and FIG. 15, when the needle cover sleeve 8 is moved by receiving external pressure, the protrusions 8g and 8g of the needle cover sleeve 8 move the lower plate portions 3k and 3k outward. Push and bend.

As a result, the lower plates 3k and 3k are released from contact with the protrusions 4f and 4f on the push button 4 side, and the protrusions 4f and 4f are in contact with the lower side of the tongue pieces 8e and 8e of the needle cover sleeve 8, The return of the push button 4 is temporarily stopped at this position. At this time, a contact sound is generated in which the protrusion 4f contacts the tongue piece 8e.

In the state shown in FIGS. 14A to 14C and FIG. 15, when the applied pressure becomes smaller than the biasing force of the first spring 7 after the trocar 2 is inserted into the body cavity of the patient, The urging force moves the needle cover sleeve 8 in the direction of the needle tip 6a of the trocar needle 6 and moves to a position covering the needle tip 6a.

At the same time, the tongue pieces 8e, 8e that have been in contact with the protrusions 4f, 4f at the bottom of the push button 4 are also moved forward, so that the contact with the protrusions 4f, 4f on the lower side of the tongue pieces 8e, 8e is released, The push button 4 is returned to the original position by the urging force of the second spring, the rear ends of the tongue pieces 8e, 8e and the projections 4f, 4f are in contact with each other, and the movement of the needle cover sleeve 8 in the backward direction is restricted. Return to (ON state). At this time, the push button 4 comes into contact with the housing 3 and a contact sound is generated. The protrusion 8g and the second spring correspond to the return means.

FIGS. 16A and 16B are perspective views showing an example in which the state in which the push button is pressed can be visually confirmed by colored display.
As shown in FIG. 16A, a colored display 20 such as red or green is displayed on the front wall of the push button holding hole formed in the housing 3.
For this reason, as shown in FIG. 16B, when the push button 4 is in a sunk position, the colored display 20 can be visually confirmed.

On the other hand, in FIG. 17, the same colored display 20 is displayed on the side wall of the push button 4, for example, the rear surface. it can.

FIG. 18 is a perspective view showing an example in which the position of the push button is set higher than the surrounding surface.
As shown in FIG. 18, when the push button 4 is at least in the non-push operation position, the push button 4 can be operated further if the height that the push button 4 protrudes from the surrounding surface is maintained. This is preferable because it becomes easy and it can be confirmed whether or not the push button 4 has returned to the original height position with the touch of the fingertip or palm and visual observation.

(how to use)
FIGS. 19A to 19E are diagrams sequentially illustrating the introducer method using the trocar set of the present invention.
In FIGS. 19A to 19C, in order to show the usage of the trocar set 1 of the present invention in an easy-to-understand manner, a doctor's hand with the housing 3 and the sheath 10 is not drawn. Use it with the palm of one hand.

As shown in FIG. 19 (a), first, the push button 4 of the trocar 2 is pushed at the lower position until it is locked, and the restriction of the movement of the needle cover sleeve 8 to the rear of the trocar needle is released. In this state, when the distal end portion 8f of the needle cover sleeve 8 is strongly pressed against the percutaneous puncture portion 50 of the patient, the needle cover sleeve 8 receives a strong pressure from the living tissue.

For this reason, as shown in FIG. 19 (b), the tip of the needle cover sleeve is retracted against the urging force of the first spring 7 (not shown) and the needle tip 6a protrudes, and the needle tip 6a Punctures into the patient's sebum 51.

When the needle cover sleeve 8 is moved in a direction opposite to the needle tip 6a of the trocar needle 6 with a pressure exceeding the urging force of the first spring 7, as shown in FIGS. The protrusion 4f is moved from below the lower plate portion 3k to the lower edge of the tongue piece 8e.

As shown in FIG. 19C, for example, when the needle tip 6a of the trocar needle 6 passes through the stomach wall 52 and reaches the intragastric cavity 53, the distal end portion 8f of the needle cover sleeve 8 is sebum 51, stomach wall 52 or the like. No pressure is received from the living tissue, and the pressure becomes smaller than the biasing force of the first spring 7.

For this reason, the needle cover sleeve 8 receiving the urging force of the first spring returns to the position where it covers the needle tip 6a of the trocar needle 6, so that the needle tip 6a does not puncture the front gastric wall 52 further. .

The pressure decreases below the urging force of the first spring 7, and the urging force of the first spring 7 moves the needle cover sleeve 8 to the needle tip 6 a of the trocar needle 6 to cover the needle tip 6 a of the trocar needle 6, The protrusion 4f is returned to the gap 3j to return the off state to the on state.
Thereafter, the entire trocar 2 is pulled out while leaving the sheath 10 punctured.

The sheath 10 in the state of being punctured into the living tissue serves as an insertion passage for allowing the distal end portion of the catheter 30 to be inserted into the intragastric cavity 53 as shown in FIG.
After inserting the catheter 30 through the intragastric cavity 53, as shown in FIG. 19 (e), the sheath 10 is pulled out from the living tissue, and by operating the fingertip having the grasping portions 10b and 10b which are grasping portions, It is torn longitudinally and removed.

1 Trocar with sheath (trocar set)
2 trocar 3 housing 3a other end 3b opening 3c claw receiving port 3d trocar needle insertion hole 3e holding piece 3h upper plate portion 3j gap 3k lower plate portion 3m reinforcing rib 3n rib 3p one end 3r lower step portion 3s guide plate portion 4 push button 4b Operation part 4c Low step part 4d Both sides 4e Opening 4f Protrusion 5 Second spring 6 Trocar needle 6a Needle tip 6b Rear end part 7 First spring 8 Needle cover sleeve 8a Tube part 8b Operation part 8c Flange surface 8d Notch part 8e Tongue piece 8f Tip 8g Projection 9 Front cover 9a Cover plate 9b Opening 9c Claw 9d Upper guide 9e Lower guide 10 Sheath (Introducer sheath)
DESCRIPTION OF SYMBOLS 10a Tube part 10b Gripping part 20 Color display 30 Catheter 50 Percutaneous puncture part 51 Sebum 52 Gastric wall 53 Gastric cavity

Claims (1)

A trocar needle that protrudes from the inside of one end of the housing and extends outward beyond the other end, a cylindrical needle cover sleeve that covers the trocar needle to the tip of the needle, and an outer side of the needle cover sleeve An introducer sheath, and a first spring that urges the needle cover sleeve in the direction of the needle tip of the trocar needle, and a pressure exceeding the urging force of the first spring is applied to the needle cover sleeve. A trocar set in which the needle cover sleeve moves in a direction opposite to the needle tip of the trocar needle,
A push button provided on one surface of the housing, biased in a direction to be pushed back by a second spring, and having protrusions whose bottom surfaces are inclined on both side surfaces parallel to the trocar needle;
From both ends in the horizontal direction of the flange surface provided at the rear end portion of the cylinder portion of the needle cover sleeve, it can be in contact with the protrusions so as to sandwich both side surfaces of the push button in parallel with the trocar needle. A pair of tongue pieces provided on the pair, and a pair of protrusions provided by extending a part of each tongue piece downward,
A pair of guide plate portions that are provided so as to sandwich both outer side surfaces of the tongue piece from the inside of one end of the housing, have elasticity, and include an upper plate portion, a lower plate portion, and a gap therebetween. Have
(A) Before use, the protrusion is held in the gap, contacts the tongue piece connected to the needle cover sleeve, and the needle cover sleeve moves in the direction opposite to the needle tip of the trocar needle. Regulate to prevent the tip of the trocar needle from being exposed,
(B) In use, the lower plate portion is bent by the protrusion by pressing the push button against the urging force of the second spring, and the protrusion is moved from the gap to the lower plate portion. The needle cover sleeve is allowed to move in a direction opposite to the needle tip of the trocar needle, releasing the contact between the protrusion and the tongue piece,
(C) In the state of (B), the tip of the needle cover sleeve is pressed against the patient's skin, and a pressure exceeding the urging force of the first spring is applied to the needle cover sleeve so that the needle cover sleeve When the needle tip is exposed by moving in a direction opposite to the needle tip of the trocar needle, the protrusion provided on the tongue piece curves the lower plate portion of the guide plate portion, and the protrusion is moved to the lower plate. Moved from below the lower part to the lower edge of the tongue,
(D) Further, pressurization is continued until the trocar needle and the introducer sheath reach the body cavity, and the trocar needle reaches the body cavity or the pressing force is decreased, so that the pressure is lower than the biasing force of the first spring. The needle cover sleeve is moved to the needle tip of the trocar needle by the biasing force of the first spring to cover the needle tip of the trocar needle, the tongue piece is moved, and the protrusion Is returned to the gap of the guide plate portion and brought into contact with the tongue piece to restrict the needle cover sleeve from moving in the direction opposite to the needle tip of the trocar needle, and the introducer sheath A trocar set comprising a stopper device for restricting exposure of the needle tip of the trocar needle even after the trocar is pulled out while remaining in the body cavity.

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