JP2015097672A - Retractor - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a retractor, when an inner/outer periphery of a lateral annular member is reversed, capable of smoothly involving a sleeve.SOLUTION: A lateral annular member 2 of a retractor 1 comprises a first annular member 5 and a second annular member 6 that are formed of a same material into a same size and have flexibility, and is formed by joining the second annular member 6 in the inverted state to the inner periphery side of the first annular member 5 in the non-inverted state. The annular members are so configured that first holding power for holding the first state where the non-inverted first annular member 5 is located at the outside and the inverted-state second annular member 6 is located at the inside is equal to second holding power for holding a second state where the non-inverted second annular member 6 is located at the outside and the inverted-state first annular member 5 is located at the inside.

Description

  The present invention relates to a retractor for use in incision wound protection and protection.

  In order to introduce a cylindrical treatment instrument such as forceps into the abdominal cavity during endoscopic surgery and relatively small laparotomy, the retractor is mounted on a retractor formed on the body wall. A retractor is known for maintaining the open state of the retractor and protecting the retractable portion.

  In general, a retractor includes a cylindrical sleeve having flexibility, a body inner annular member to which a peripheral edge of the one end side opening is fixed so as to hold one end of the sleeve in an open state, and the sleeve The other end side of the other end side opening member, and the other end side opening portion is fixed to the outer ring member. The retractor is inserted from the retracted portion in a state where the body inner annular member is bent and deployed in the body, and then the body outer annular member is wound in the twisting direction outside the body, and the inner and outer circumferences of the body outer annular member Repeat to invert. Accordingly, the length of the sleeve is adjusted by winding the sleeve around the inner and outer circumferences of the outer annular member, and the open portion of the wound portion can be maintained by opening the middle portion of the sleeve.

  Conventionally, as a retractor, a body outer ring member is formed by joining thin annular webs in a state where two annular tubes in which both ends of each tube are thermally welded and joined in a ring shape are stacked vertically. (For example, refer to Patent Document 1).

2012-75927 gazette

  However, in the conventional retractor, when the inner and outer peripheries of the outer ring member are reversed, the outer ring member is distorted due to the influence of the force to return to the state before the reversal, and the sleeve cannot be smoothly wound. Sometimes.

  Further, in the conventional retractor, a bump-like trace is formed at the joint portion by heat welding, and the bump-like trace is exposed at the outermost peripheral portion and the innermost peripheral portion of the outer body annular member. For this reason, when the sleeve is wound by reversing the inner and outer circumferences of the outer ring member, the sleeve may be biased due to the bump-like traces, and the outer ring member may be distorted and the sleeve cannot be wound smoothly. is there.

  An object of the present invention is to provide a retractor that can eliminate the inconvenience and can smoothly wind the sleeve when the inner and outer circumferences of the outer ring member are reversed.

  In order to achieve this object, the present invention provides a cylindrical sleeve having flexibility, and a body inner side in which a peripheral edge of the one end side opening is fixed so as to hold one end side of the sleeve in an open state. The annular member and the peripheral edge of the opening on the other end side are fixed so as to hold the other end side of the sleeve in an open state, and the sleeve is twisted by repeatedly reversing the inner and outer circumferences by twisting. A retractor comprising a body outer annular member that can be wound and unwound, wherein the body outer annular member includes one or more non-inverted first annular members and one or more inverted second members. These annular members are arranged concentrically and joined together.

  In the retractor of the present invention, after the body inner annular member is bent and inserted from the retracting portion and deployed in the body, the body outer annular member is wound outside in the body in the twisting direction. Repeatedly reversing the inner and outer peripheries. As a result, the length of the sleeve is adjusted by winding the sleeve around the inner and outer circumferences of the outer body annular member, and the intermediate portion of the sleeve is opened to maintain the open state of the retracting portion.

  The outer body annular member is configured by concentrically arranging and joining one or more non-inverted first annular members and one or more inverted second annular members. Yes.

  By winding the body outer ring member in the first state with the first side surface as the inner circumferential surface and the second side surface as the outer circumferential surface, the inner and outer circumferences of the body outer ring member are reversed, A transition is made to the second state in which the side surface is the inner peripheral surface and the first side surface is the outer peripheral surface. That is, when transitioning from the first state to the second state, one annular member transitions from the non-inverted state to the inverted state, and the other annular member transitions from the inverted state to the non-inverted state.

  At this time, the force to return to the non-inverted state of one annular member is canceled by the force to shift to the inverted state of the other annular member, so that the first state is smoothly shifted to the second state. It is possible to prevent the outer annular member from being distorted.

  In the retractor of the present invention, the outer annular member is formed by concentrically arranging and joining the first annular member and the second annular member. As described above, the joint portion is not exposed at the outermost peripheral portion and the innermost peripheral portion of the outer body annular member. Therefore, when the inner and outer circumferences of the outer ring member are reversed, it is possible to prevent the sleeve ring from being biased and distorting the outer ring member.

  As described above, according to the retractor of the present invention, the sleeve can be smoothly wound when the inner and outer circumferences of the outer annular member are reversed.

  In the retractor of the present invention, the body outer annular member has a first holding force for holding a first state in which the first side surface is an inner peripheral surface and the second side surface is an outer peripheral surface; The second holding force that holds the second state in which the inner and outer peripheries of the outer ring member in the above state are reversed and the second side surface is the inner peripheral surface and the first side surface is the outer peripheral surface is substantially It is preferable that it is comprised so that it may become equal to.

  When the body-side annular member is in a first state in which the first side surface is the inner peripheral surface and the second side surface is the outer peripheral surface, a first holding force for maintaining the first state is working. Yes. In addition, since the second annular member is in the inverted state, a first restoring force caused by the force of the second annular member returning to the original non-inverted state is applied to the body-side annular member. . When the first holding force exceeds the first restoring force, the body-side annular member can hold the first state.

  Next, by winding the outer ring member in the first state with a torsional force exceeding the first holding force, the inner and outer circumferences of the outer ring member are inverted, and the second side surface is A transition is made to the second state in which the inner peripheral surface is used and the first side surface is the outer peripheral surface. At this time, the first annular member is in an inverted state, and the second annular member is in a non-inverted state.

  At this time, the body outer annular member is applied with a second holding force for maintaining the second state. Further, since the first annular member is in the inverted state, a second restoring force due to the force of the first annular member returning to the original non-inverted state is applied to the body-side annular member. . When the second holding force exceeds the second restoring force, the body-side annular member can hold the second state.

  The body-side annular member is configured such that the first holding force and the second holding force are substantially equal. Therefore, the body-side annular member in the first state is the first Except when wound with a torsional force exceeding the holding force, the first state can be maintained, and the body-side annular member in the second state is twisted exceeding the second holding force. The second state can be maintained except when wound by force.

  Therefore, according to the retractor of the present invention, when the inner and outer circumferences of the outer annular member are reversed, the outer annular member can be reliably prevented from being distorted.

  In the retractor of the present invention, the outer annular member is composed of a first annular member and a second annular member that are made of the same material and have the same dimensions and are flexible. It is preferable that a second annular member in an inverted state is joined to the inner peripheral side of the annular member.

  If the first state is when the first annular member in the non-inverted state is located outside and the second annular member in the inverted state is located inside, the second state is the second in the non-inverted state. The annular member is positioned outside, and the inverted first annular member is positioned inside.

  At this time, since the first annular member and the second annular member have the same material and the same dimensions, they can be regarded as substantially the same member. For this reason, in the body outer annular member in the first state, the first restoring force caused by the force of the second annular member located inside and inverted to return to the original non-inverted state, In the body outer annular member in the state 2, the second restoring force caused by the force of the first annular member located inside and reversed to return to the original non-reversed state can be made equal. . As a result, in the body outer annular member, the first holding force for maintaining the first state and the second holding force for maintaining the second state can be made equal.

  Further, when the body-side annular member is in the first state, the non-inverted first annular member is positioned outside the inverted second annular member, so that the second annular member is non-inverted. The first restoring force due to the force that tries to return to the inverted state does not exceed the force that the first annular member tries to maintain the non-inverted state. Thereby, the 1st holding force can always exceed the 1st restoring force, and the body outside annular member in the 1st state can hold the state certainly.

  In addition, when the body outer annular member is in the second state, the non-inverted second annular member is positioned outside the inverted first annular member, so that the first annular member is not in the non-inverted state. The first restoring force caused by the force that tries to return to the inverted state does not exceed the force that the second annular member tries to maintain the non-inverted state. Thereby, the 2nd holding force can always exceed the 2nd restoring force, and the body outside annular member in the 2nd state can hold the state certainly.

  Therefore, according to the retractor including the outer annular member made of the first material and the second annular member having the same material and the same dimensions, the distortion generated when the outer annular member is inverted is further reduced. It can be surely prevented.

The perspective view which shows the retractor of embodiment of this invention. It is sectional drawing which shows the use condition of the retractor of embodiment of this invention, Fig.2 (a) shows the state which pushed the body inner ring member into the body cavity, FIG.2 (b) shows the 1st of the body outer ring member. The state of 1 is shown. It is sectional drawing which shows the use condition of the retractor of embodiment of this invention, Fig.3 (a) shows the 2nd state of a body outer side annular member, and shows the completion state of length adjustment of a sleeve.

  Next, embodiments of the present invention will be described in more detail with reference to the accompanying drawings.

  The retractor 1 of the present embodiment shown in FIG. 1 includes an outer body annular member 2 and an inner body annular member 3 at both ends in the axial direction, and an outer periphery of the body outer ring member 2 and the inner body annular member 3 at the opening peripheral edges at both ends in the axial direction. And a flexible sleeve 4 fixed to the periphery or the periphery.

  Both the body outer ring member 2 and the body inner ring member 3 are elastically deformable by a predetermined external force, and are circular in a free state. Typically, the body outer ring member 2 and the body inner ring member 3 are formed. Are circular with the same diameter.

  The body-side annular member 2 is composed of a first annular member 5 and a second annular member 6 having the same material and the same dimensions and having flexibility. The body-side annular member 2 is provided with a second annular member 6 in an inverted state on the inner peripheral side of the first annular member 5 in a non-inverted state, and the inner peripheral surface of the first annular member 5 is connected to the second peripheral member. It is formed by joining the outer peripheral surface of the annular member 6.

  The cross sections of the first annular member 5 and the second annular member 6 are substantially rectangular with chamfered corners. The first annular member 5 and the second annular member 6 are formed by filling a mold with a resin such as isoprene rubber, silicone rubber, polyurethane, or elastomer and then curing the resin. You may form by cut | disconnecting the tubular body which consists of resin in the direction orthogonal to an axial direction. Moreover, the said joining can be performed by adhesion | attachment which used welding and an adhesive agent, for example.

  In the present specification, in the first annular member 5 and the second annular member 6, a surface corresponding to the outer peripheral surface of the resin molded body cured by the mold or the tubular body is located on the outer peripheral surface. In addition, a state where a surface corresponding to the inner peripheral surface of the resin molded body or the tubular body is located on the inner peripheral surface is referred to as a “non-inverted state”. Moreover, in the 1st annular member 5 and the 2nd annular member 6, while the surface equivalent to the internal peripheral surface of the said resin molding or the said tubular body is located in the outer peripheral surface, the said resin molding is carried out in the internal peripheral surface. A state where a surface corresponding to the outer peripheral surface of the body or the tubular body is located is referred to as a “reversed state”.

  The body inner annular member 3 is composed of one member, and the shape of the cross section in the direction perpendicular to the annular axis is typically circular.

  The flexible sleeve 4 is configured such that the outer peripheral member on the outer annular member 2 side is outside the body by repeating reversal in one direction or the other of the inner and outer periphery of the outer annular member 2 around the annular axis of the outer annular member 2. The annular member 2 is wound or unwound. The flexible sleeve 4 is typically made of a thin material that is transparent and easy to wind and unwind around the outer annular member 2 and is strong. The axial length between the outer annular member 2 and the inner annular member 3 can be adjusted by increasing or decreasing the amount of winding of the outer annular member 2.

  Next, with reference to FIG.2 and FIG.3, the process at the time of setting the retractor 1 to a test subject's abdominal wall 10 is demonstrated. After forming the wound 15 on the abdominal wall 10 of the subject, the operator stands the body inner annular member 3 vertically with respect to the surface 11 of the abdominal wall 10 as shown in FIG. 15 and pushed into the body cavity 14.

  When the insertion of the body inner annular member 3 into the body cavity 14 is completed, next, as shown in FIG. 2 (b), the body outer annular member 2 is lifted up a little to open the opening surface of the body inner annular member 3 to the abdominal wall 10. Along the back surface 12. As a result, the body outer annular member 2 and the body inner annular member 3 are both substantially parallel to the abdominal wall 10 and return to a circular shape by elastic restoring force.

  Next, the surgeon grasps the outer body annular member 2 with both hands at two positions at both ends of a predetermined diameter, and at the two positions, as shown in FIGS. 2B and 3A, Twists are performed in opposite torsional directions so that the inner and outer peripheries are repeatedly inverted around the annular axis of the annular member 2. As a result, the flexible sleeve 4 is wound around the body outer annular member 2 at the end on the body outer annular member 2 side, the axial length of the flexible sleeve 4 is reduced, and the body outer annular member 2 is reduced. And the length between the body inner annular member 3 is reduced.

  When the axial length of the flexible sleeve 4 is approximately equal to the thickness of the abdominal wall 10, the surgeon finishes adjusting the length of the flexible sleeve 4, and as shown in FIG. The outer annular member 2 is placed (set) on the surface 11 of the subject's abdominal wall 10. The body outer ring member 2 and the body inner ring member 3 are in close contact with the front surface 11 and the back surface 12 of the abdominal wall 10, respectively, and the flexible sleeve 4 expands in the radial direction, so that the wound 15 is expanded in a circular shape.

  When the body outer annular member 2 is wound, the first annular member 5 in the non-inverted state is positioned outside and the second annular member 6 in the inverted state is positioned inside “the first state The state where the second annular member 6 in the non-inverted state is located outside and the state where the first annular member 5 in the inverted state is located inside is referred to as a “second state”.

  First, when the body-side annular member 2 is in the first state, a first holding force that tries to hold the first state is working. The body outer annular member 2 in the first state is subjected to a first restoring force due to the force of the inverted second annular member 6 returning to the original non-inverted state. At this time, since the non-inverted first annular member 5 is located outside the inverted second annular member 6, the second annular member 6 is caused by a force of returning to the non-inverted state. The first restoring force does not exceed the force with which the first annular member 5 tries to maintain the non-inverted state. Thus, the first holding force can always exceed the first restoring force, and the body-side annular member 2 in the first state can reliably hold the state.

  Next, by winding the body outer ring member 2 in the first state with a torsional force exceeding the first holding force, the inner and outer circumferences of the body outer ring member 2 are reversed, and the body outer ring member 2 is in the non-reversed state. The second annular member 6 is located outside, and the first annular member 5 in the inverted state shifts to the second state located inside.

  When the body-side annular member 2 is in the second state, a second holding force that tries to hold the second state is working. The body outer annular member 2 in the second state is subjected to a second restoring force due to the force of the inverted first annular member 5 returning to the original non-inverted state. At this time, since the non-inverted second annular member 6 is positioned outside the inverted first annular member 5, the first annular member 5 is caused by a force of returning to the non-inverted state. The second restoring force does not exceed the force with which the second annular member 6 tries to maintain the non-inverted state. Thereby, the 2nd holding force can always exceed the 2nd restoring force, and body outside annular member 2 in the 2nd state can hold the state certainly.

  Further, the first annular member 5 and the second annular member 6 constituting the body outer annular member 2 are made of the same material and have the same dimensions, so that the first holding force and the second holding force are always equal. Become. Thereby, the body outer side annular member 2 in a 1st state can hold | maintain a 1st state, and the body outer side annular member 2 in a 2nd state can hold | maintain a 2nd state.

  As described above, according to the retractor 1 of the present embodiment, the outer annular member 2 can be prevented from being distorted due to the influence of the restoring force when the inner and outer circumferences of the outer annular member 2 are reversed.

  Furthermore, since the inner peripheral surface of the first annular member 5 and the outer peripheral surface of the second annular member 6 are joined to the outer annular member 2, both ends of the joined portion are the upper surfaces of the outer annular member 2. And although it exposes to a lower surface, a junction part is not exposed to the outermost peripheral part and innermost peripheral part of a body outer side annular member like the conventional retractor. Therefore, when the flexible sleeve 4 is wound by reversing the inner and outer circumferences of the outer annular member 2, it is possible to prevent the outer annular member 2 from being distorted due to a bias in the flexible sleeve 4.

  From the above, according to the retractor 1 of the present embodiment, the flexible sleeve 4 can be smoothly wound when the inner and outer circumferences of the outer annular member 2 are reversed.

  Moreover, according to the retractor 1 of this embodiment, since the bias of the flexible sleeve 4 and the distortion of the outer body annular member 2 can be prevented as described above, the airtightness in the body cavity is maintained. When the reducer is attached to the outer body annular member 2, an unnecessary gap is not formed between the reducer and the outer body annular member 2, and airtightness can be reliably maintained.

  In the present embodiment, a case has been described in which the body-side annular member 2 is composed of one first annular member 5 and one second annular member 6 having the same material and the same dimensions. It is not limited. The body-side annular member has one or more non-inverted first annular members and one or more inverted second annular members concentrically arranged to join the first state. It is sufficient if the first holding force to be held and the second holding force to hold the second state are substantially equal. At this time, the first annular member and the second annular member may not be the same material, the same size, and the same shape.

  Further, instead of joining the first annular member and the second annular member by welding or adhesion, a convex portion and a concave portion are provided on each joint surface, and the convex portion and the concave portion are fitted to each other. You may make it join.

    DESCRIPTION OF SYMBOLS 1 ... Retractor, 2 ... Body outside annular member, 3 ... Body inside annular member, 4 ... Sleeve, 5 ... 1st annular member, 6 ... 2nd annular member

Claims (3)

A cylindrical sleeve having flexibility;
A body inner annular member to which a peripheral edge of the one end side opening is fixed so as to hold one end side of the sleeve in an open state;
The peripheral edge of the opening on the other end is fixed so as to hold the other end of the sleeve in an open state, and the sleeve is wound in the twisting direction by repeatedly reversing the inner and outer periphery by twisting; In a retractor comprising an unrollable body outer annular member,
The body-side annular member is formed by concentrically arranging and joining one or more non-inverted first annular members and one or more inverted second annular members. The retractor. The retractor of claim 1.
The body-side annular member has a first holding force for holding a first state in which the first side surface is an inner peripheral surface and the second side surface is an outer peripheral surface, and the body-side annular member in the first state. The second holding force that holds the second state in which the inner and outer peripheries are reversed and the second side face is the inner peripheral face and the first side face is the outer peripheral face is substantially equal. A retractor characterized by that. The retractor according to claim 1 or claim 2,
The outer body annular member is composed of a first annular member and a second annular member having the same material and the same dimensions and having flexibility, and on the inner peripheral side of the first annular member in a non-inverted state, A retractor formed by joining a second annular member in an inverted state.

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