JP2012196373A - Puncturing and expanding instrument for medical treatment - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a puncturing and expanding instrument for medical treatment capable of preventing severe damages of a tissue and an organ from occurring even when a sudden change of resistance against penetration is generated, and to be able to execute an operation of an operator simply, in a short time and safely.SOLUTION: The puncturing and expanding instrument for medical treatment includes: a body surface fixing part, and a body surface puncturing and expanding outer cylinder. A movement amount regulating means for regulating the movement of the body surface puncturing and expanding outer cylinder in the puncturing direction is provided on at least one of the body surface fixing part and the body surface puncturing and expanding outer cylinder. As the movement amount of the body surface puncturing and expanding outer cylinder in the puncturing direction is regulated thereby, even when the sudden change of the resistance against the penetration is generated, it is safe as the body surface puncturing and expanding outer cylinder is not advanced more than a distance which has been already advanced.

Description

  The present invention relates to a medical puncture dilator.

  With the recent development of laparoscopic surgery, there is an increasing demand for trocars that are inserted into a patient's body and used as a guide tube for an insertion device into a body cavity. In addition, with the progress of an aging society, the demand for gastrostomy catheters is increasing. When these medical devices are used, they are punctured into a body wall and inserted into a body cavity, or are inserted after dilating a skin tissue that has been incised by a dilator. However, many current trocars and dilators have a risk of severe damage to internal organs and tissues due to sudden resistance changes during insertion operations. Therefore, medical puncture dilators such as highly safe trocars and dilators are desired.

  Patent Document 1 devises a surgical device in which a cutting tip can be positioned sufficiently away from vulnerable tissues. However, as the inventor himself states, no matter how careful the surgeon is during the penetration of a hole in body tissue, the sudden change in resistance to penetration is fast and difficult to predict. Even if the product of the present invention is used and the tissue is rarely damaged excessively by the blade, there is a risk of serious tissue or organ damage if excessive force is applied carelessly.

  In Patent Document 2, the guide member is detachably locked by a guide member locking mechanism of a handpiece including a vibrator that transmits ultrasonic vibration to the trocar inner needle, thereby disengaging the guide member and the trocar inner needle. The relative position can be fixed at the set position, and the outer tube can be easily inserted and placed in the body wall in a short time. In addition, the inner needle tip can be easily and stably inserted. A trocar that can be performed is proposed. However, in addition to the complexity and cost of the device, which is a problem in cost, there is a risk of serious tissue and organ damage if the surgeon is careless and put too much effort.

JP 2009-61279 A JP 2007-195998 A

  The present invention provides a medical puncture dilator that can prevent serious tissue and organ damage even if a sudden change in resistance to penetration occurs, and allows the operator's work to be performed easily in a short time and safely There is to be able to do it.

Such an object is achieved by the present invention described in the following (1) to (4).
(1) A medical puncture extension device including a body surface fixing portion and a body surface puncture extension outer cylinder, wherein at least one of the body surface fixation portion and the body surface puncture extension outer cylinder is provided with the body surface puncture extension outside A medical puncture expander, characterized in that movement amount restricting means for restricting movement of the tube in the puncture direction is provided.
(2) The medical puncture dilator according to (1), wherein the movement amount regulating means converts a force applied in a direction different from the puncture direction of the body surface puncture expansion outer cylinder into the puncture direction.
(3) The movement amount regulating means includes a screw-like portion formed on at least a part of the surface of the body surface puncture expansion outer cylinder, and a protrusion provided on the body surface fixing portion (1) or The medical puncture dilator according to (2).
(4) The movement amount regulating means includes ratchet teeth formed on at least a part of the surface of the body surface puncture expansion outer cylinder, and ratchet means provided on the body surface fixing part (1) or The medical puncture dilator according to (2).

  According to the present invention, since the amount of movement of the body surface puncture expansion outer cylinder in the puncture direction is regulated, even if a sudden change in resistance to penetration occurs, the distance between the surface puncture expansion outer cylinder already punctured However, it is safe because it does not progress. The body surface fixing part can be divided and removed, and the operation can be completed with a simple operation. According to the ratchet method, the puncture direction and the direction in which the force is applied are different, which is further safer. Since a complicated and expensive member such as an ultrasonic vibration transmission device is not required, a product can be provided at low cost.

It is a side view of the medical puncture dilator according to the first embodiment of the present invention. It is a perspective view of the body surface puncture expansion outer cylinder of the medical puncture expander according to the first embodiment of the present invention. It is a perspective view of the body surface fixing | fixed part of the medical puncture dilator which concerns on 1st embodiment of this invention. It is a side view which shows the ratchet mechanism of the medical puncture dilator which concerns on 2nd embodiment of this invention. It is a side view which shows the ratchet mechanism of the medical puncture dilator which concerns on 2nd embodiment of this invention. It is a side view which shows the front-end | tip part of the body surface puncture expansion tool of the medical puncture expansion tool which concerns on 2nd embodiment of this invention. It is a side view which shows the front-end | tip part of the body surface puncture expansion tool of the medical puncture expansion tool which concerns on 2nd embodiment of this invention.

Hereinafter, the medical puncture dilator of the present invention will be described in detail with reference to the drawings.

<First embodiment>
FIG. 1 is a side view of the medical puncture dilator according to the first embodiment. FIG. 2 is a perspective view of a body surface puncture expansion outer cylinder of the medical puncture expander according to the first embodiment. FIG. 3 is a perspective view of a body surface fixing portion of the medical puncture dilator according to the first embodiment.
As shown in FIG. 1, the medical puncture dilator 1 of the present embodiment includes a body surface fixing portion 2 and a body surface puncture expansion outer cylinder 3.

  The body surface fixing part 2 regulates insertion of the body surface puncture expansion outer cylinder 3 on the body surface. The body surface fixing part 2 has a hole 21 through which the body surface puncture expansion outer cylinder 3 passes. The shape of the body surface fixing portion 2 may be any shape as long as it can be fixed to the body surface and does not interfere with the operation. Examples of the shape of the body surface fixing portion 2 include a plate shape and a disk shape.

  The body surface fixing unit 2 may have any size as long as it does not interfere with the operation as described above. The dimensions of the body surface fixing part 2 are preferably about 3 to 6 cm on a side if it is a plate, and about 3 to 6 cm in diameter if it is a disk. If it is such a size, the body surface fixing | fixed part 2 can be more reliably fixed to a body surface, and it is preferable, without interfering with an operation. In addition, if the thickness is in the range of about 5 to 10 mm, it is preferable because it does not hinder the operation.

  Any material can be used for the body surface fixing portion 2 as long as it has an appropriate hardness. Examples of the material for the body surface fixing portion 2 include hard plastics such as polypropylene resin, polyethylene resin, and polycarbonate resin, soft plastics such as silicone resin, polyurethane resin, and soft polyvinyl chloride resin, stainless steel, and titanium. Metal etc. are mentioned. In particular, when soft plastic is used, it is preferable because it is flexible and easily fits on the body surface.

  The hole 21 is provided in the body surface fixing part 2. The position where the hole 21 is provided is not particularly limited, but is preferably near the center of the body surface fixing part 2 because the fixing property of the body surface fixing part 2 to the body surface is improved. The size of the hole 21 may be any size as long as the body surface puncture expansion outer cylinder 3 can be inserted, but due to the relationship with the protrusion 25 described later, the outer diameter of the body surface puncture expansion outer tube 3 On the other hand, it is desirable to design a larger size by about 0.1 to 1 mm.

  A protrusion 25 is attached to the hole 21. The protrusion 25 constitutes a movement amount regulating means together with a screw-like portion 33 formed on a part of the surface of the body surface puncture expansion outer cylinder 3 which will be described later. That is, the free movement of the body surface puncture expansion outer cylinder 3 in the puncture direction is restricted by the engagement between the protrusion 25 and the threaded portion 33.

  The protrusion 25 may be configured integrally with the body surface fixing unit 2 or may be configured as a separate body. When configured as a separate body, the protrusion 25 can be made of the same material as the material mentioned in the body surface fixing portion 2 described above. In this case, the protrusion 25 is fixed to the body surface fixing part 2 by bonding or by being partially inserted.

  The size of the protruding portion 25 can be adjusted as appropriate depending on the height of the screw of the screw-like portion 33. If the protrusion 25 is excessively long, the strength may be insufficient with respect to the force applied to the body surface puncture expansion outer cylinder 3 and the puncture resistance. Therefore, the size of the protrusion 25 is preferably about 0.25 to 1 mm.

  It is desirable to attach anti-slip means (not shown) to the body surface installation surface of the body surface fixing part 2. Examples of the anti-slip means include uneven processing on the surface and attachment of an adhesive substance.

  The body surface fixing part 2 is preferably designed so that it can be removed when the puncture expansion operation is completed. Although the structure can be separated into two parts and can be removed, as shown in FIG. 3, a fixed part where the claw 22 and the concave part 23 are engaged and a movable fixed part 24 are attached so that the operation can be easily removed after the operation is completed. It is desirable to make it.

  The body surface puncture expansion outer cylinder 3 punctures the body surface and pierces and expands the body wall. In the present embodiment, as shown in FIG. 2, the body surface puncture expansion outer cylinder 3 has a substantially cylindrical main body 31 and a tapered insertion portion 32 provided at the tip of the main body 31.

  Any material can be used for the body surface puncture expansion outer cylinder 3 as long as it is a biocompatible material. Examples of the material for the body surface puncture expansion outer cylinder 3 include tetrafluoroethylene / hexafluoropropylene copolymer (FEP), hard plastic such as nylon resin and polyethylene resin, stainless steel, and metal such as titanium. It is done. In consideration of manufacturing cost and puncture resistance, FEP resin having good slipperiness is preferable.

  The size of the body surface puncture expansion outer cylinder 3 is appropriately set depending on the operation to be performed. For example, when used as a dilator, the length is preferably about 10 to 30 cm and the outer diameter is preferably about 1.5 to 15 mm. Moreover, if the length of the insertion part 32 is about 5-30 mm, since safer puncture is possible, it is preferable.

  Moreover, the body surface puncture expansion outer cylinder 3 may be provided with a lumen. Such a lumen is used to insert a guide wire in the dilator. Moreover, in a trocar, it is used in order to arrange | position a puncture part.

  The body surface puncture expansion outer cylinder 3 has a threaded portion 33 formed on at least a part of its surface. As described above, the screw-like portion 33 constitutes a movement amount regulating means together with the protruding portion 25. The screw-shaped part 33 should just be formed in at least one part of the surface of the body surface puncture expansion outer cylinder, and may be formed in the whole. Preferably, the threaded portion 33 is preferably formed from about 1 to 15 cm from the tip of the main body 31.

  The screw-like portion 33 may be formed so as to protrude from the main body 31 or may be formed so as to be depressed. When the screw-like portion 33 is formed so as to protrude from the main body 31, the height of the screw-like portion 33 is appropriately adjusted according to the length of the protruding portion 25. Since the body surface puncture expansion outer cylinder 3 is inserted into the body by rotating itself, it is desirable that the height of the screw-like portion 33 is not excessively high. Therefore, the height of the screw-like portion 33 is preferably about 0.2 to 1 mm. If the height of the screw-like portion 33 is about this level, puncture can be performed more safely even by a puncture expansion operation.

  Further, when the threaded portion 33 is formed to be depressed with respect to the main body 31, the depth of the threaded portion 33 is appropriately adjusted according to the length of the protruding portion 25. Since the body surface puncture expansion outer cylinder 3 is inserted into the body by rotating itself, it is desirable that the depth of the screw-like portion 33 is not excessively deep. Therefore, it is preferable that the depth of the screw-shaped part 33 is about 0.2-1 mm. If the depth of the screw-shaped part 33 is this level, it can puncture more safely also by puncture expansion operation.

Next, an example of operation of the medical puncture dilator 1 of the first embodiment will be described.
The surgeon places the body surface fixing part 2 on the body surface. At this time, the position where puncture is desired is positioned so as to be the center of the hole 21. When the guide wire is already placed, the guide wire is positioned at the center. Next, the body surface puncture expansion outer cylinder 3 is inserted into the hole 21. By rotating the body surface puncture expansion outer cylinder 3, the body surface puncture expansion outer cylinder 3 advances in the puncture direction.

  Even if the surgeon excessively applies force in the puncture direction or a sudden change in resistance due to penetration occurs, the body surface fixing portion 2 is in contact with the body surface, resulting in a large resistance in the puncture direction. Therefore, the body surface puncture expansion outer cylinder 3 does not advance in the puncture direction more than intended. In addition, the surgeon is safer because it applies force in the rotational direction, not the direction in which the body surface puncture expansion outer cylinder 3 is inserted.

<Second embodiment>
Next, a second embodiment of the present invention will be described.
In the following, the second embodiment will be described, but the difference from the first embodiment will be mainly described, and the description of the same matters will be omitted.

  4 and 5 are side views showing the ratchet mechanism of the medical puncture dilator 1 according to the second embodiment. 6 and 7 are side views showing the distal end portion of the body surface puncture expansion outer cylinder 3 of the medical puncture expander 1 according to the second embodiment.

  In the second embodiment, the configuration of the movement amount regulating means is different from that of the first embodiment. The movement amount regulating means of the second embodiment has ratchet teeth 34 formed on at least a part of the surface of the body surface puncture expansion outer cylinder 3 and ratchet means 4 provided on the body surface fixing part 2.

  The ratchet teeth 34 are formed on at least a part of the surface of the body surface puncture expansion outer cylinder 3. As shown in FIG. 6, the ratchet tooth portion 34 has a shape in which a plurality of substantially tapered truncated cones are connected.

  As shown in FIG. 4, the ratchet means 4 includes a lever 41, a lever fixing part 42, a locking member 43, a locking member movable fixing part 44, a locking member resistance means 45, and a locking member resistance means fixing part 46. .

  The lever 41 is movably attached to the lever fixing portion 42. One end of the lever 41 is engaged with the ratchet tooth portion 34 of the body surface puncture expansion outer cylinder 3. When the operator pulls up the other end of the lever 41, one end of the lever 41 is engaged with the body surface puncture expansion outer cylinder 3 as described above, so that the body surface puncture expansion outer cylinder 3 is inserted into the body. It is desirable to design the dimensions of the lever 41 so that the ratchet tooth portion 34 of the body surface puncture expansion outer cylinder 3 is inserted into the inside of the body by one pulling operation of the lever 41.

  The lever fixing portion 42 is attached to the body surface fixing portion 2. The means for attaching the lever 41 is not particularly limited, but a bearing penetrating the lever 41 as shown in FIG. 4 may be attached and a shaft may be attached to the lever fixing portion 42.

  The locking member 43 is movably attached to the body surface fixing portion 2. An elastic part may be attached and molded integrally with the body surface fixing part 2. One end of the locking member 43 is locked to the ratchet tooth portion 34 of the body surface puncture expansion outer cylinder 3 and restricts the moving direction of the body surface puncture expansion outer cylinder 3. By restricting the moving direction, the body surface puncture expansion outer cylinder 3 is prevented from moving in the direction opposite to the body when the lever 41 is pushed to the body surface side.

  In FIG. 4, the locking member 43 is slidably attached by a locking member fixing shaft attached to the lever fixing portion 42 and a sliding slit attached to the locking member 43.

  The locking member 43 is preferably provided with a locking member resistance means 45. In FIG. 4, by attaching a spring to the locking member 43, it is possible to firmly lock the ratchet tooth portion 34 of the body surface puncture expansion outer cylinder 3.

  The locking member resistance means 45 is attached without being detached from the body surface fixing portion 2 by the engaging member resistance means fixing portion 46.

  As shown in FIGS. 4 to 7, a ratchet tooth portion 34 is attached to the outer surface of the body surface puncture expansion outer cylinder 3. The ratchet teeth 34 may be provided 360 degrees in the circumferential direction as shown in FIG. 6, but since the body surface puncture expansion outer cylinder 3 is used without rotation, the circumferential direction as shown in FIG. On the other hand, a ratchet tooth portion 34 may be provided in part.

Next, an example of operation of the medical puncture dilator 1 of the second embodiment will be described.
The operator places the body surface fixing part 2 on the body surface, and at this time, positions the position where puncture is desired to be the center of the hole 21. When the guide wire is already placed, the guide wire is positioned at the center. Next, the body surface puncture expansion outer cylinder 3 is inserted into the hole 21 until the first-stage ratchet tooth portion 34 engages with the stopper 47. When the surgeon pulls up the lever 41, the ratchet tooth portion 34 advances in the puncture direction. Since the stopper 47 is movably engaged, the stopper 47 moves according to the shape of the ratchet tooth portion 34. It is desirable to design the length of the lever 41 so that the lifting operation of the lever 41 advances one distance of the ratchet tooth portion 34. The surgeon pushes the lever 41 again. At this time, the ratchet teeth portion 34 of the body surface puncture expansion outer cylinder 3 is engaged with the stopper 47 of the body surface fixing portion 2 and therefore does not move in the direction opposite to the puncture direction.

  Even if a force is excessively applied in the puncture direction or a sudden change in resistance due to penetration occurs, the body surface fixing part 2 is in contact with the body surface, resulting in a large resistance in the puncture direction. The front puncture expansion outer cylinder 3 does not advance in the puncture direction more than intended. In addition, the surgeon is safer because a force is applied in the direction opposite to the direction in which the body surface puncture expansion outer cylinder 3 is inserted.

  The movement amount regulating means of the present invention is preferably configured to convert a force applied in a direction different from the puncturing direction of the body surface puncture expansion outer cylinder 3 into the puncturing direction. As an example of such a configuration, the ratchet structure has been described in the second embodiment. However, the present invention is not limited to this, and any configuration can be used as long as it has the same effect.

DESCRIPTION OF SYMBOLS 1 Medical puncture dilator 2 Body surface fixing | fixed part 21 Hole part 22 Claw 23 Recessed part 24 Movable fixed part 25 Projection part 3 Body surface puncture expansion outer cylinder 31 Main body 32 Insertion part 33 Screw-shaped part 34 Ratchet tooth part 4 Ratchet means 41 Lever 42 Lever fixing portion 43 Locking member 44 Locking member movable fixing portion 45 Locking member resistance means 46 Locking member resistance means fixing portion 47 Stopper

Claims (4)

A medical puncture dilator comprising a body surface fixing part and a body surface puncture expansion outer cylinder,
At least one of the body surface fixing portion and the body surface puncture expansion outer cylinder is provided with a movement amount restricting means for restricting movement of the body surface puncture expansion outer cylinder in the puncture direction. Puncture dilator.   The medical puncture dilator according to claim 1, wherein the movement amount regulating means converts a force applied in a direction different from the puncture direction of the body surface puncture expansion outer cylinder into the puncture direction.   The said movement amount control means has a screw-shaped part formed in at least one part of the surface of the said body surface puncture expansion outer cylinder, and the projection part provided in the said body surface fixing | fixed part. Medical puncture dilator.   The said movement amount control means has a ratchet tooth part formed in at least one part of the surface of the said body surface puncture expansion outer cylinder, and a ratchet means provided in the said body surface fixing | fixed part. Medical puncture dilator.

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