JP2015180328A - Medical device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical device capable of simply performing formation of a sheet-like member.SOLUTION: A medical device for inserting a sheet-like member S into the body comprises: a cylindrical member; an operating rod to be inserted into the cylindrical member movably in the axial direction and rotatably around the axis, the operating rod having a holding part for holding the sheet-like member at the tip side along the axial direction of the operating rod; and a winding member for taking up the sheet-like member. In the winding member is formed a hole at least one end of which opens in a surface of the winding member and an inner diameter of which is equal to or less than that of the cylindrical member. Also in the winding member is formed a slit which extends along an axis direction of the hole from the surface in which the one end of the hole opens, and which communicates with the hole.

Description

  The present invention relates to a medical instrument for inserting a sheet-like member into a body.

  Generally, after an operation is performed on an internal organ officer, the damaged portion of the internal organ officer is covered with a sheet-like adhesion preventing material in order to prevent adhesion between the damaged portion of the internal organ officer and the surrounding tissue. This adhesion prevention material is directly placed on the damaged part of an internal organ in the case of a laparotomy with a large incision, but in the case of endoscopic surgery with a small incision, for example, a medical treatment as proposed in Patent Document 1 It is placed on the damaged part of the internal organ using an instrument. This medical instrument includes an operation rod for holding the adhesion preventing material at the tip portion, and a cylindrical member inserted into the patient's body through the incision portion. And wrap it around the operating rod. And after inserting this operation rod in a cylindrical member and making it protrude from the front-end | tip of a cylindrical member, the adhesion prevention material wound around the operation rod is spread and arrange | positioned in the damaged part of an internal organ officer.

US Pat. No. 5,503,623

  However, each time the medical device as described above is placed on the damaged part, the medical device requires an operation of manually winding the adhesion preventing material around the operation rod and forming it into a shape that can be inserted into the tubular member. In particular, there is a problem that it is very troublesome when a plurality of anti-adhesive materials are arranged in the damaged part.

  Then, this invention makes it a subject to provide the medical device which can shape | mold a sheet-like member easily.

  A first medical device according to the present invention is made to solve the above-described problem, and is a medical device for inserting a sheet-like member into the body, and is movable in the axial direction with the tubular member. And an operation rod that is inserted into the cylindrical member so as to be rotatable about an axis, and has a holding portion that holds the sheet-like member along the axial direction of the operation rod on the distal end side; A winding member for winding the sheet-like member, wherein the winding member has a hole having at least one end opened on the surface of the winding member and an inner diameter that is equal to or smaller than the inner diameter of the cylindrical member. In addition, a slit is formed which extends along the axial direction of the hole from a surface where one end of the hole opens and communicates with the hole.

  When the first medical instrument is used, the sheet-like member is held by the holding portion so that the surface thereof is along the axial direction of the operating rod, and the operating rod is moved from one end side of the hole opened to the surface of the winding member. The sheet-like member is inserted into the slit while being inserted into the hole. When the operating rod is rotated around the axis in this state, the sheet-like member is drawn into the hole from the slit by the operating rod, and becomes a roll shape along the side surface of the hole having an inner diameter equal to or smaller than the inner diameter of the cylindrical member. Thus, according to the first medical instrument, the sheet-like member can be easily formed into a shape that can be accommodated in the cylindrical member.

A second medical instrument according to the present invention is made to solve the above-described problem, and is a medical instrument for inserting a sheet-like member into the body, and has a slit extending in the axial direction from the tip. A formed cylindrical member and an operation rod that is inserted into the cylindrical member so as to be movable in the axial direction and rotatable about the axis, and holds the sheet-shaped member along the axial direction of the operating rod And an operation rod having a holding portion on the distal end side.

  In the second medical instrument, after the holding portion of the operating rod protrudes from the tip of the cylindrical member and the sheet-like member is held by the holding portion so that the surface thereof is along the axial direction of the operating rod, the sheet-like member is The operating rod is moved to the rear end side so as to be inserted into the slit of the cylindrical member. When the operating rod is rotated around the axis, the sheet-like member is drawn into the cylindrical member from the slit by the operating rod, and is rolled and accommodated in the cylindrical member. Thus, according to the second medical instrument, the sheet-like member can be easily formed into a shape that can be accommodated in the cylindrical member.

  In the first and second medical devices, the holding portion may be formed in a bifurcated shape so as to sandwich the sheet-like member.

  In the first and second medical instruments, the holding unit may be formed in a sheet shape so that the sheet-like member is placed thereon. According to this configuration, when the sheet-like member is rolled, the holding portion is disposed outside the sheet-like member, so that the sheet-like member can be protected from body fluid or the like.

  In the first and second medical instruments, the operation rod can be configured such that the diameter of the distal end portion is equal to or larger than the inner diameter of the cylindrical member. According to this structure, since the front-end | tip of a cylindrical member can be sealed with the front-end | tip part of an operating rod, the sheet-like member accommodated in the cylindrical member can be protected from a bodily fluid etc.

  According to the present invention, the sheet-like member can be easily formed.

It is a top view of the medical instrument which concerns on 1st Embodiment of this invention. It is (a) top view and (b) partial side sectional view of a cylindrical member and an operation rod in a medical instrument concerning a 1st embodiment of the present invention. It is the (a) side view and (b) top view of the winding member in the medical device which concerns on 1st Embodiment of this invention. It is a top view of the board in the medical instrument concerning a 1st embodiment of the present invention. It is a top view which shows the usage method of the medical device which concerns on 1st Embodiment of this invention. It is a top view of the medical device which concerns on 2nd Embodiment of this invention. It is the (a) partial side view of the cylindrical member and operation rod in the medical device which concerns on 2nd Embodiment of this invention, (b) Front sectional drawing. It is a fragmentary top view of the operation rod in the medical instrument which concerns on the modification of the said 1st and 2nd embodiment.

  Hereinafter, embodiments of a medical device according to the present invention will be described with reference to the drawings.

(First embodiment)
As shown in FIG. 1, the medical device 100 according to the first embodiment includes a tubular member 1, an operation rod 2 inserted into the tubular member 1, and a winding member for winding up the sheet-like member S. 3 is provided.

  As shown in FIG. 2, the tubular member 1 is provided with a detachable plug body 4 at the rear end, and the plug body 4 has a through hole 41 into which the operation rod 2 is inserted. Yes. As shown in FIG. 2B, the through hole 41 has a large-diameter portion 411 that receives the cylindrical member 1 and the operating rod 2, and a small-diameter portion 412 that receives only the operating rod 2. A shoulder portion 413 is formed on which a stopper 23 of the operation rod 2 to be described later contacts. The plug 4 has a built-in spring (not shown) that suppresses the displacement of the operation rod 2 by pressing the inner wall thereof toward the operation rod 2.

  As shown in FIG. 1, the operating rod 2 is inserted into the cylindrical member 1 so as to be movable in the axial direction and rotatable around the axis, and has a diameter equal to or larger than the inner diameter of the cylindrical member 1 at the tip. A head 22 is provided. The head 22 preferably has a curved surface at the tip so as not to damage internal organs and the like. Further, as shown in FIG. 2A, the operation rod 2 is provided with a holding portion 21 that holds the sheet-like member S along the axial direction of the operation rod 2, and this holding portion 21. Is formed in a bifurcated shape with the rear end closed so that the sheet-like member S can be clamped. The length of the holding portion 21 in the axial direction can be, for example, 20 mm to 70 mm, although it depends on the size of the sheet-like member S to be sandwiched. In addition, it is preferable that the holding | maintenance part 21 is provided with the unevenness | corrugation in the surface so that the sheet-like member S can be hold | maintained reliably. As shown in FIGS. 2A and 2B, the operation rod 2 is provided with a stopper 23 at an intermediate portion, and this stopper 23 abuts against a shoulder 413 of the through hole 41 in the plug body 4. As a result, movement to the rear side is restricted. In addition, the operating rod 2 is provided with a grip portion 24 having a diameter larger than the small diameter portion 412 of the through hole 41 at the rear end portion, and the grip portion 24 abuts against the rear end of the plug body 4 to the front side. Movement is regulated.

  As shown in FIG. 3A and FIG. 4, the winding member 3 has a pair of plate bodies 32 formed with recesses 321 extending in the axial direction, and a pair of recesses 321 are opposed to each other. The holes 31 are formed by overlapping the plate bodies 32. An inclined surface 322 is provided at the front end portion of each plate 32, so that the front end portion of the hole 31 is tapered so that the sheet-like member S can be easily received. The inner diameter of the hole 31 may be not more than the inner diameter of the cylindrical member 1 and has a size that can receive the operation rod 2, and can be, for example, 1 mm to 9 mm. Further, as shown in FIGS. 3A and 3B, the winding member 3 has a spacer 33 disposed between the pair of plate bodies 32 at the rear end thereof, and a pair of plate bodies 32 and The spacer 33 is fixed by a fastening member 34, whereby a slit 35 that extends from the distal end surface of the winding member 3 in the axial direction of the hole 31 and communicates with the hole 31 is formed. The dimensions of the slit 35 are not particularly limited. For example, the length in the axial direction is 30 mm to 90 mm, the length in the width direction is 10 mm to 60 mm, and the length in the height direction is 1 mm to 9 mm. Can do.

  Examples of the sheet-like member S include an anti-adhesion material for protecting the damaged part of the internal organ officer caused by the operation and preventing the adhesion between the damaged portion of the internal organ officer and the surrounding tissue. The material is usually made of a material that dissolves and is absorbed by the body after a certain period of time. The material for the adhesion preventing material is not particularly limited, and examples thereof include oxidized cellulose, hyaluronic acid, polylactic acid, trehalose, collagen, and hydrogel.

  Next, a method of using the medical instrument 100 configured as described above will be described with reference to FIG. In the following description, the left side in FIG. 5 is referred to as the front or front, and the right side is referred to as the rear.

First, the holding part 24 of the operating rod 2 is pushed forward, and the holding part 21 is protruded from the tip of the cylindrical member 1. After inserting the protruding holding portion 21 into the hole 31 from the rear end side of the winding member 3,
Further, the holding part 24 is pushed forward to cause the holding part 21 to protrude from the tip of the winding member 3, and the sheet-like member S is held between the holding part 21 (FIG. 5A). At this time, the front end of the cylindrical member 1 is preferably brought into contact with the rear end of the winding member 3.

  Next, the grip portion 24 is pulled backward to insert the sheet-like member S into the slit 35, and in this state, the operation rod 2 is rotated around the axis (FIG. 5B). Thereby, the sheet-like member S is drawn into the hole 31 from the slit 35 by the operation rod 2 and becomes a roll shape along the inner surface of the hole 31. Thereafter, the grip portion 24 is pulled rearward to accommodate the roll-shaped sheet member S together with the holding portion 21 in the cylindrical member 1, and the tip of the cylindrical member 1 is sealed by the head portion 22 (FIG. 5C). ).

  When the sheet-like member S is an adhesion preventing material, the tubular member 1 containing the sheet-like member S in this way is used as follows. That is, this cylindrical member 1 is inserted into the body through an incision on the surface of the patient's body, and the tip thereof reaches the vicinity of the damaged portion of the internal organ officer after the operation. Then, the grip portion 24 is pushed forward, and the holding portion 21 together with the sheet-like member S is projected from the tip of the tubular member 1. Thereby, the roll-shaped sheet-like member S is spread and the sheet-like member S can be arrange | positioned in a damaged part.

  As described above, in the medical instrument 100 according to the first embodiment, the operation rod 2 is inserted into the hole 31 of the winding member 3 so that the sheet-like member S is inserted into the slit 35, and the operation rod 2 is moved around the axis. Since the sheet-like member S is wound up along the side surface of the hole 31 only by rotating it, there is no need to perform a troublesome work such as winding the sheet-like member S around the operation rod 2 by hand. In addition, the medical device 100 according to the present embodiment is configured such that the slit 35 is provided in the winding member 3 separate from the cylindrical member 1 and the tip of the cylindrical member 1 can be sealed with the head 22. When the cylindrical member 1 is inserted into the body, it is possible to prevent the sheet-like member S in the cylindrical member 1 from becoming wet with body fluids and being unusable.

  In the first embodiment, the front end side of the slit 35 of the winding member 3 is open. However, if the sheet-like member S held by the holding portion 21 can be inserted, the rear end side is open. Alternatively, both the front and rear ends may be opened.

  Further, in the first embodiment, the hole 31 penetrates the winding member 3 and both ends thereof are open on the surface of the winding member 3, but at least one end is open on the surface of the winding member 3. That's fine. When only one end of the hole 31 of the winding member 3 is opened on the surface of the winding member 3, the slit 35 is configured to extend along the axial direction of the hole 31 from this surface.

  Moreover, in the said 1st Embodiment, although the winding member 3 was comprised from the two plate bodies 32 of another body, these two plate bodies 32 can also be formed integrally, Furthermore, it is cylindrical. It can also be made into various shapes such as a disk shape.

(Second Embodiment)
As shown in FIGS. 6 and 7, the medical device 200 according to the second embodiment does not include the winding member 3 as in the first embodiment, and the axial direction from the front end on both side surfaces of the tubular member 10. A slit 350 extending along the line is formed. Since other configurations are the same as those in the first embodiment, description thereof is omitted.

In use, the medical instrument 200 causes the holding portion 21 of the operation rod 2 to protrude from the tip of the cylindrical member 10 and causes the holding portion 21 to sandwich the sheet-like member S. Thereafter, the grip portion 24 is pulled rearward, and the sheet-like member S is inserted into the slit 350 and the holding portion 21 is moved to the cylindrical member 10.
Housed inside. When the operating rod 2 is rotated around the axis in this state, the sheet-like member S is drawn into the cylindrical member 10 from the slit 350 by the operating rod 2 and is accommodated in the cylindrical member 10 in a roll shape. .

  As described above, the medical device 200 according to the second embodiment simply inserts the sheet-like member S held by the holding portion 21 into the slit 350 of the cylindrical member 10 and rotates the operation rod 2 around the axis. Since the sheet-like member S is wound up along the side surface of the tubular member 10, the sheet-like member S can be easily formed and accommodated in the tubular member 10.

  As mentioned above, although embodiment of this invention was described, this invention is not limited to these, A various change is possible unless it deviates from the meaning of this invention. For example, in the first and second embodiments, two slits 35 and 350 are provided, but the present invention is not limited to this, and it is sufficient that at least one slit is provided.

  Further, in the first and second embodiments, the holding portion 21 of the operating rod 2 is formed in a bifurcated shape with the rear end closed, but is not limited to this as long as the sheet-like member S can be held, For example, it may be a bifurcated shape with the front end or the front and rear ends closed. Moreover, as shown in FIG. 8, the holding | maintenance part 210 may be formed in the sheet form so that the sheet-like member S can be mounted, and in this case, in order to insert and hold the sheet-like member S The pocket portion 2101 is preferably provided. According to this structure, since the holding | maintenance part 210 is wound up with the sheet-like member S so that it may be located in the outer side of the sheet-like member S, the sheet-like member S can be protected from a bodily fluid etc.

DESCRIPTION OF SYMBOLS 100,200 Medical instrument 1,10 Tubular member 2 Operation rod 21,210 Holding part 3 Winding member 31 Hole 35,350 Slit S Sheet-like member

Claims (5)

A medical instrument for inserting a sheet-like member into the body,
A tubular member;
An operating rod that is inserted into the cylindrical member so as to be movable in the axial direction and rotatable about the axis, and has a holding portion that holds the sheet-like member along the axial direction of the operating rod on the distal end side. The operating rod;
A winding member for winding the sheet-like member;
With
The winding member has at least one end opened on the surface of the winding member, and a hole having an inner diameter equal to or smaller than the inner diameter of the cylindrical member. A medical instrument in which a slit extending along the axial direction and communicating with the hole is formed. A medical instrument for inserting a sheet-like member into the body,
A cylindrical member formed with a slit extending along the axial direction from the tip;
An operating rod that is inserted into the cylindrical member so as to be movable in the axial direction and rotatable about the axis, and has a holding portion that holds the sheet-like member along the axial direction of the operating rod on the distal end side. The operating rod;
A medical device comprising:   The medical device according to claim 1 or 2, wherein the holding portion is formed in a bifurcated shape so as to sandwich the sheet-like member.   The medical device according to claim 1, wherein the holding portion is formed in a sheet shape so that the sheet-like member is placed thereon.   The medical instrument according to any one of claims 1 to 4, wherein a diameter of a distal end portion of the operation rod is equal to or larger than an inner diameter of the cylindrical member.