JP2013252218A - Laparoscope device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a laparoscope device enabling an operator to guide a soft laparoscope device inserted through a trocar with his/her intention at a stable posture without causing unwanted warpage in an abdominal cavity.SOLUTION: A laparoscope device includes an inner-outer dual cylinder consisting of an inner cylinder 21 for allowing a soft laparoscope 10 to be inserted and an outer cylinder 22 in a trocar 20. The inner-outer dual cylinder can expand and contract in a contracted state where the inner cylinder 21 enters the outer cylinder 22 and an expanded state where the inner cylinder 21 protrudes from the tip of the outer cylinder 22 to the front thereof. The inner-outer dual cylinder is equipped with a spring 23 for urging the dual cylinder from an expanded state to a contracted state. A base end portion 14 of a bending portion 12 of the soft laparoscope 10 is equipped with an expansion engaging portion 15 which is engaged with the inner cylinder 21 (23) when the base end portion 14 of the bending portion 12 is positioned at the distal end position 31 of the inner cylinder 21 and expands the dual cylinder against the urging force of the spring 23.

Description

  The present invention relates to a laparoscopic device.

  In a laparoscopic device, a rigid laparoscope is generally passed through a trocar (also called “trocar”) and guided from outside the body into the abdominal cavity. Are also starting to be widely used.

  In such a flexible laparoscope, generally, a bending portion that is bent by remote control from the proximal end side of the flexible tube is connected to the distal end of the flexible tube, and an observation window is disposed at the most distal portion of the bending portion. The structure is provided (for example, patent document 1).

JP 2003-265402 A

  The flexible laparoscope allows the surgeon to bend the curved part formed on the front side of the insertion part protruding into the abdominal cavity from the tip of the trocar in the desired direction and approach freely to the target affected part What can be done is a great advantage over rigid laparoscopes.

  However, for example, as shown in FIG. 9, when a portion of the flexible laparoscope 90 near the distal end of the flexible tube 91 is projected from the distal end of the trocar 80, the flexible tube 91 is loosened within the abdominal cavity, thereby causing an observation window or the like. In some cases, the distal end surface 92 on which is placed cannot be brought closer to the target affected area 100 as expected. Such a situation is more likely to occur as the protruding length of the flexible tube 91 from the tip of the trocar 80 increases. Reference numeral 93 denotes a bending portion that is bent by a remote operation from the proximal end side of the flexible tube 91.

  Although not shown, even when a treatment tool protruding from the tip of a flexible laparoscope is pressed against the target affected area, the soft part is bent due to the repulsive force, and the treatment tool is targeted with sufficient force. It may be difficult to press against the affected area.

  The present invention has been made in view of such circumstances, and guides the flexible laparoscope passed through the trocar so as to follow the operator's intention in a stable posture without causing unnecessary slack in the abdominal cavity. It is an object of the present invention to provide a laparoscopic device that can be used.

  In order to achieve the above object, the laparoscopic device according to the present invention has a bending portion connected to the distal end of the flexible tube by a remote operation from the proximal end side of the flexible tube, and is observed on the most distal side of the bending portion. A laparoscopic device comprising a soft laparoscope with a window and a trocar for inserting and guiding the soft laparoscope from outside the body into the abdominal cavity, and an inner tube and an outer tube for passing the soft laparoscope through the trocar The inner and outer double cylinders can be expanded and contracted between a shortened state in which the inner cylinder enters the outer cylinder and an extended state in which the inner cylinder projects forward from the tip of the outer cylinder. A spring for biasing the inner and outer double tubes from the extended state to the shortened state is provided, and the proximal end portion of the bending portion of the flexible laparoscope is near the distal end position of the inner tube. Engage with the inner cylinder when it is in the extension, and extend the double cylinder against the urging force of the spring. Engaging portion is provided.

  The inner cylinder is formed so that the inner diameter in the vicinity of the most distal part is narrower than the inner diameter of the other part of the inner cylinder, and the extension engaging part comes into contact with the step formed in the inner diameter changing part from the rear. Also good. Moreover, the sealing member which seals between the front-end | tip parts of an inner cylinder and the base end part of a curved part may be provided.

  According to the present invention, the flexible tube of the soft laparoscope is in the inner tube by the double tube constituting the trocar for passing the soft laparoscope extending corresponding to the pushing operation of the soft laparoscope And can be guided in the abdominal cavity so as to meet the operator's intention in a stable posture without causing unnecessary slack.

1 is a configuration diagram of a laparoscopic apparatus according to a first embodiment of the present invention. It is side surface sectional drawing of the shortened state of the laparoscopic apparatus which concerns on 1st Example of this invention. It is side surface sectional drawing of the expansion | extension state of the laparoscopic apparatus which concerns on 1st Example of this invention. It is a schematic diagram of the use condition of the laparoscopic device concerning the 1st example of the present invention. It is side surface sectional drawing of the trocar which concerns on the 2nd Example of this invention. It is a perspective view of the trocar which concerns on the 2nd Example of this invention. It is side surface sectional drawing of the trocar which concerns on the 3rd Example of this invention. It is a perspective view of the trocar which concerns on the 3rd Example of this invention. It is a schematic diagram of the use condition of the conventional laparoscopic device.

Hereinafter, a first embodiment of the present invention will be described with reference to the drawings.
A reference numeral 10 shown in FIG. 1 is a soft laparoscope, which is known for a proximal end portion (not shown) (not shown) of a flexible tube 11 which is freely bent and has a length of several tens of centimeters. Are connected to each other.

  The distal end of the flexible tube 11 is connected to a bending portion 12 that can be bent at an arbitrary angle in an arbitrary direction by a remote operation from the operation portion. An observation window, an illumination window, and the like are arranged on the distal end surface 13a.

  The outer peripheral surface of the connecting ring 14 provided at the base end of the bending portion 12 for connecting the flexible tube 11 and the bending portion 12 is a smooth circumferential surface. A flange-like stopper ring 15 is formed at a position adjacent to the connecting ring 14 on the flexible tube 11 side so as to protrude with a larger diameter than any of the curved portion 12 and the tip component portion 13 in front of it. Yes.

  Reference numeral 20 denotes a trocar for guiding the insertion portion of the flexible laparoscope 10 from outside the body into the abdominal cavity. The trocar 20 is provided with an inner / outer double cylinder including an inner cylinder 21 and an outer cylinder 22 through which the insertion portion (that is, the flexible tube 11, the bending portion 12, and the distal end constituting portion 13) of the flexible laparoscope 10 is passed. Yes.

  The inner and outer double cylinders have a shortened state shown in FIGS. 1 and 2 in which the inner cylinder 21 and the outer cylinder 22 slide relative to each other in the axial direction so that the inner cylinder 21 enters the outer cylinder 22; The inner cylinder 21 can expand and contract between the extended state shown in FIG. 3 that protrudes forward from the tip of the outer cylinder 22. A compression coil spring 23 that urges the inner and outer double cylinders from the extended state to the shortened state is disposed between the inner cylinder 21 and the outer cylinder 22.

  The compression coil spring 23 is disposed in a space between the outer peripheral surface of the inner cylinder 21 and the inner peripheral surface of the outer cylinder 22, the proximal end abuts on a step formed in the inner cylinder 21, and the distal end side is the outer cylinder. 22 is in contact with the stepped portion formed at 22.

  As shown in FIG. 1, a mouth seal member 26 is disposed in the mouth tube portion 24 formed at the base end portion of the outer tube 22. The mouth seal member 26 is formed in a tapered shape with an elastic rubber material or the like. The seal hole 27 formed in the center of the mouth seal member 26 is closed when the soft laparoscope 10 is not passed, and when the soft laparoscope 10 is passed as shown in FIGS. It is elastically deformed in a state where it is pushed open.

  An insertion port 29 through which the insertion portion of the flexible laparoscope 10 passes smoothly is formed at the center portion of the lid body 28 that is detachably attached to the inlet opening portion of the mouth tube portion 24 together with the mouth seal member 26. When taking out a large body tissue through the internal space of the trocar 20, the lid body 28 is removed together with the mouth seal member 26.

  A distal end opening hole 31 into which the connecting ring 14 of the flexible laparoscope 10 is fitted is formed at the most distal portion of the inner cylinder 21. The inner diameter of the tip opening hole 31 is narrower than any other part of the inner cylinder 21. An O-ring 32 is mounted on the inner peripheral surface of the tip opening hole 31 as a seal member for sealing between the outer peripheral surface of the connecting ring 14.

  Reference numeral 33 denotes a stopper step portion with which the stopper ring 15 of the soft laparoscope 10 abuts when the insertion portion of the flexible laparoscope 10 is passed through the inner cylinder 21. Is formed.

  When the stopper ring 15 abuts against the stopper step portion 33, the insertion portion of the flexible laparoscope 10 cannot be inserted any more into the inner cylinder 21, and the entire bending portion 12 is moved forward from the tip of the inner cylinder 21. Protruding state. Since the stopper ring 15 abuts against the stopper step 33, the flexible tube 11 of the flexible laparoscope 10 does not protrude forward from the inner tube 21 at all.

  2 and 3 show a state in which the insertion portion of the flexible laparoscope 10 is inserted into the trocar 20, and FIG. 2 shows that the entire inner cylinder 21 through which the insertion portion of the flexible laparoscope 10 is inserted is the outer cylinder 22. 3 shows a shortened state entering the inside, and FIG. 3 shows an extended state in which the inner cylinder 21 protrudes to the maximum from the front end of the outer cylinder 22.

  As described above, when the proximal end portion of the bending portion 12 of the flexible laparoscope 10 is in the vicinity of the distal end position of the inner cylinder 21 (that is, when the connecting ring 14 is in the vicinity of the distal end opening hole 31), the soft laparoscope 10 is flexible. The stopper ring 15 of the laparoscope 10 is engaged with the stopper step portion 33 of the inner cylinder 21. In addition, the space between the distal end portion of the inner cylinder 21 and the connecting ring 14 of the flexible laparoscope 10 is sealed with an O-ring 32.

  Then, by operating the insertion portion of the flexible laparoscope 10 into the trocar 20, as shown in FIG. 3, the double tubes 21 and 22 do not protrude the flexible tube 11 from the tip of the inner tube 21. Can be extended against the urging force of the compression coil spring 23. Therefore, it can be said that the stopper ring 15 is an extension engagement portion that engages with the stopper step portion 33 so as to extend the double cylinders 21 and 22.

  FIG. 4 schematically shows the usage state of the laparoscopic apparatus of the above embodiment. The trocar 20 is inserted into the abdominal cavity from the hole formed in the body surface wall 101, and the insertion portion of the flexible laparoscope 10 is passed through the trocar 20. A rigid treatment instrument 110 such as a grasping forceps for lifting an organ (for example, gallbladder) 102 is inserted into the abdominal cavity through the treatment instrument trocar 120.

  Even when the insertion portion of the flexible laparoscope 10 is inserted into the trocar 20, when the double cylinders 21 and 22 of the trocar 20 are still in a shortened state, the tip configuration of the flexible laparoscope 10 is shown by the two-dot chain line. The part 13 ′ is located away from the target affected part 100.

  Therefore, when the flexible tube 11 is pushed into the trocar 20 from the hand side so that the inner tube 21 protrudes from the tip of the outer tube 22 of the trocar 20, the flexible tube 11 is moved to the inner side as shown by the solid line. The bending portion 12 can be advanced without sagging the flexible tube 11 while being held in the cylinder 21.

  As a result, the flexible laparoscope 10 is guided in the abdominal cavity so as to follow the operator's intention in a stable posture, and the distal end surface 13a of the distal end constituting part 13 is brought close to the target affected part 100 to perform good endoscopic observation. It can be carried out.

  In addition, this invention is not limited to the said Example, For example, what kind of thing may be sufficient as the structure of the base end side part of the double cylinders 21 and 22. FIG. 6 and 7 show the trocar 20 of the second embodiment of the present invention, and FIGS. 8 and 9 show the trocar 20 of the third embodiment.

  In both of these, the seal member is omitted from the base end side of the double cylinders 21 and 22, and only the removable cap 35 is provided. Reference numeral 36 denotes a collar that protrudes in a bowl shape in order to stabilize the posture during operation, and fixes the base end portions of the inner cylinder 21 and the outer cylinder 22 to each other. The configuration of the tip side of the trocar 20 of the second and third embodiments is the same as that of the first embodiment.

DESCRIPTION OF SYMBOLS 10 Flexible laparoscope 11 Flexible tube 12 Bending part 13a Tip surface 14 Connection ring 15 Stopper ring (extension engagement part)
20 Trocar 21 Inner cylinder 22 Outer cylinder 21, 22 Double cylinder 23 Compression coil spring 32 O-ring (seal member)
33 Stopper step

Claims (3)

A flexible laparoscope in which a bending portion that is bent by remote operation from the proximal end side of the flexible tube is connected to a distal end of the flexible tube, and an observation window is disposed on the most distal side of the bending portion; and the flexible laparoscope In a laparoscopic device provided with a trocar for guiding the insertion into the abdominal cavity from outside the body,
The trocar is provided with an inner and outer double cylinder consisting of an inner cylinder and an outer cylinder for passing the flexible laparoscope,
The inner and outer double cylinders are extendable between a shortened state in which the inner cylinder has entered the outer cylinder and an extended state in which the inner cylinder protrudes forward from the front end of the outer cylinder. A spring for urging the heavy cylinder from the extended state side to the shortened state;
The proximal end portion of the bending portion of the flexible laparoscope is engaged with the inner tube when the proximal end portion of the bending portion is near the distal end position of the inner tube, and the double tube is attached to the spring. A laparoscopic device, characterized in that an extension engaging portion that extends against a force is provided.   2. The inner cylinder is formed such that an inner diameter in the vicinity of the most distal portion thereof is narrower than an inner diameter of another portion of the inner cylinder, and an extension engaging portion abuts against a step portion formed in the inner diameter changing portion from behind. The laparoscopic device as described.   The laparoscopic device according to claim 1 or 2, wherein a seal member that seals a gap between the distal end portion of the inner cylinder and the proximal end portion of the curved portion is provided.

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