JP2017080346A - Valve cap for retractor - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a valve cap for a retractor in which air tightness in a body cavity can be maintained even when a treatment instrument is moved horizontally.SOLUTION: A valve cap 1 for a retractor includes a canopy member 11 having flexibility, and a mounting member 13 continued downward from an outer edge of the canopy member 11 and mounted to an opening end 5 of the body cavity outside of a retractor 2 detained in incision W. The valve cap hermetically seals the body cavity along with the retractor 2. The canopy member 11 includes a through-hole 141 for vertically penetrating through the canopy member 11 and having a diameter larger than a treatment instrument F for inserting a treatment instrument F in the body cavity, and an extending part 142 continued to an intra-body cavity direction using a circumferential edge of the through-hole 141 as a base end. The extending part 142 has a small diameter part 147 having a diameter smaller than the diameter of the treatment instrument F over a predetermined length in an insertion direction.SELECTED DRAWING: Figure 5

Description

  The present invention relates to a retractor valve cap.

  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.

  The retractor normally connects a ring-shaped inner fixing member disposed inside the body cavity, a ring-shaped outer fixing member disposed outside the body cavity, the inner fixing member and the outer fixing member, And a cylindrical expansion member that expands the retracting portion. Various treatments can be performed by introducing the treatment tool into a body cavity from an opening formed by attaching the retractor to the retractor.

  Endoscopic surgery requires a stable and good surgical field of view in order to perform the treatment smoothly. In order to secure a surgical field of view, for example, a pneumoperitoneum method is widely used. The pneumoperitoneum is one of the expansion methods in laparoscopic surgery, and is a method of inflating the body cavity by injecting carbon dioxide gas into the body cavity to make a positive pressure.

  However, when the retractor is attached to the retracting portion, there is a problem that carbon dioxide gas escapes from the formed opening and the body cavity cannot be inflated. Accordingly, various retractor valve caps have been developed that can be attached to the retractor and allow a treatment tool to be introduced from an opening formed by the retractor and maintain the airtightness of the abdominal cavity.

  Conventionally, as a retractor valve cap, a plurality of port portions which are arranged on the body surface side of a retracting means for holding an incision wound in an open state and serve as insertion ports for medical treatment tools and endoscopes from outside the body into the body cavity The cap member is made of an elastic member, and the surface is formed with a plurality of indentations on the surface as a port portion, which is inclined with a diameter decreasing from the surface portion toward the bottom as a whole. Is known (see, for example, Patent Document 1). This conventional retractor valve cap is used by opening the recess by puncturing the treatment tool such as a trocar.

Japanese Patent No. 5475564

  However, in the conventional retractor valve cap, when the treatment instrument is moved in the horizontal direction with respect to the cap member, the opening deforms and expands, so that the gap between the opening and the treatment instrument is increased. Since a gap is generated and the inside of the body cavity communicates with the outside of the body cavity, there is a disadvantage that the airtightness inside the body cavity may not be maintained.

  An object of the present invention is to provide a retractor valve cap that can eliminate such inconveniences and maintain airtightness in a body cavity even when the treatment instrument is moved in the horizontal direction.

  In order to achieve such an object, a retractor valve cap of the present invention includes a flexible canopy member and an opening outside the body cavity of the retractor that is continuous downward from the outer edge of the canopy member and is placed in the incision. A retractor valve cap that hermetically seals the body cavity together with the retractor, wherein the canopy member penetrates the canopy member up and down, and the treatment tool is inserted into the body cavity. A through-hole having a diameter larger than that of the treatment instrument to be inserted therein, and an extending portion extending in the body cavity direction with a peripheral edge of the through-hole as a base end, and the extending portion has a predetermined length in the insertion direction. It has the small diameter part which is a smaller diameter than the diameter of the said treatment tool over length.

  The retractor valve cap of the present invention is attached to the open end of the retractor that is placed in the incision by an attaching member that continues downward from the outer edge of the canopy member. Can be sealed.

  When the treatment instrument is inserted into the body cavity from the through hole provided in the canopy member, the small diameter portion of the extending portion continuing from the through hole is smaller than the diameter of the treatment instrument, but has flexibility. By being bent and deformed, it tightly adheres to the treatment instrument.

  When this treatment tool is moved in a horizontal direction (for example, leftward) with respect to the canopy member, the through hole has a larger diameter than the treatment tool, and thus allows this movement. On the other hand, a part of one side (for example, the right side) of the small-diameter portion that is in close contact with the treatment instrument moves away from the treatment instrument, but the small-diameter portion is provided over a predetermined length in the insertion direction of the treatment instrument. It keeps airtight in other parts.

  Therefore, according to the valve cap for a retractor of the present invention, the airtightness in the body cavity can be maintained even when the treatment instrument is moved in the horizontal direction.

  In the valve cap for a retractor according to the present invention, the extension portion has a slit portion that can be opened and closed to introduce a treatment instrument into a body cavity at a distal end portion, and the slit portion is not inserted into the treatment instrument. It is preferable that the opposing slit forming surfaces that form the slit portion are hermetically adhered to each other.

  According to this, when the treatment tool is not inserted, the opposing slit forming surfaces that form the slit portion are hermetically adhered to each other, so that the body cavity is inserted before and after the treatment tool is inserted. The inside airtightness can be maintained.

  In the retractor valve cap of the present invention, it is preferable that the retractor has a suspension portion that is continuous from the outer edge of the canopy member to the mounting member radially outward and has higher flexibility than the canopy member.

  According to this, when the treatment instrument is moved in the horizontal direction, the canopy member itself can follow the flexible suspension, so that the airtightness in the body cavity can be maintained.

Explanatory drawing which shows the mounting state of the valve cap for retractors of embodiment of this invention. The perspective view for explanation which shows the surface of the valve cap for retractors of the embodiment of the present invention. The perspective view for explanation which shows the back of the valve cap for retractors of the embodiment of the present invention. Explanatory drawing which shows the use condition of the valve cap for retractors of embodiment of this invention. The enlarged view which shows the insertion hole in the use condition of the valve cap for retractors of embodiment of this invention. Explanatory drawing which shows the modification of the valve cap for retractors of embodiment of this invention. Explanatory drawing which shows the modification of the through-hole in the valve cap for retractors of embodiment of this invention.

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

  A retractor valve cap (hereinafter referred to as a valve cap) 1 of the present embodiment, as shown in FIG. 1, in order to introduce a cylindrical treatment tool F such as forceps into the abdominal cavity in endoscopic surgery, The retractor 2 is attached to the incision W formed on the body wall B.

  The retractor 2 includes a cylindrical expansion member 3 that expands the incision W, an inner fixing ring 4 that is fixed to one end of the expansion member 3 and disposed inside the body cavity, and the other end of the expansion member 3. And an outer fixing ring 5 which is fixed and disposed outside the body cavity.

  The expansion member 3 is formed of an elastic thin film made of polyurethane, for example. The expansion member 3 has a diameter smaller than the diameters of the inner fixing ring 4 and the outer fixing ring 5 when the expansion member 3 is not extended.

  The inner fixing ring 4 is made of, for example, silicone rubber and has a substantially circular shape in cross section.

  The outer fixing ring 5 is made of, for example, silicone rubber and has a substantially rectangular shape in cross-sectional view along the axial direction. The outer fixing ring 5 can be adjusted to correspond to the thickness of the body wall B by shortening the length of the expanding member 3 by winding up the expanding member 3 with the outer fixing ring 5 as a central axis. .

  As shown in FIGS. 1 to 3, the valve cap 1 includes a disc-shaped canopy member 11, a suspension portion 12 that continues radially outward from the outer edge of the canopy member 11, and a downward direction from the outer edge of the suspension portion 12. And an attachment ring 13 for attaching the canopy member 11 to the outer fixing ring 5 of the retractor 2 in an airtight manner.

  In this embodiment, the canopy member 11, the suspension part 12, and the mounting ring 13 are integrally formed of a soft resin having flexibility. As the soft resin, for example, one resin selected from the group consisting of silicone rubber, polyurethane, and polyethylene can be used.

The canopy member 11 has a large-diameter insertion hole 14a at the center and six small-diameter insertion holes 14b around the insertion hole 14a. The large-diameter insertion hole 14a is suitable for use in, for example, a device trocar having a diameter of 12 mm in the treatment instrument F, and the small-diameter insertion hole 14b is
For example, it is suitable for use in inserting a device trocar having a diameter of 5 mm.

  The insertion holes 14 a and 14 b (hereinafter simply abbreviated as “insertion hole 14”) have a through hole 141 that penetrates the front and back of the canopy member 11. The through hole 141 is formed to have a diameter larger than the diameter of the treatment instrument F inserted into the body cavity, for example, a diameter in the range of 100 to 200% with respect to the diameter of the treatment instrument F. More preferably, the diameter of the treatment instrument F is preferably 120 to 180%.

  The insertion holes 14a and 14b have a projecting portion 142 whose diameter is gradually reduced in the body cavity direction with the peripheral edge of the through-hole 141 as a base end and is continuously closed.

  The protruding part 142 has a slit part 143 at the tip part. The slit portion 143 can be formed by making a cut along the vertical direction in the protruding portion 142. The incision may be made in advance when the valve cap 1 is manufactured, or may be made with scissors forceps or the like immediately before mounting on the retractor 2. The diameter of the slit portion 143 is preferably smaller than the diameter of the treatment instrument F and is formed to have a length in the range of 50 to 100% with respect to the diameter of the treatment instrument F.

  The protruding portion 142 is provided with a stepped portion 144 on the outer periphery including the proximal end of the slit portion 143 as a mark of an end point for making a cut. The projecting portion 142 is formed as a thin portion 145 having a relatively thin portion on the distal end side and a thick portion 146 having a relatively thick portion on the proximal end side, with the step portion 144 as a boundary. 144 has a step shape.

  The shape of the stepped portion 144 is not limited to this, and may be another shape such as a groove portion or a ridge portion as long as it becomes a mark for making a cut.

  The slit part 143 is formed by making a cut in the axial direction with respect to the thin part 145.

  Since the thin portion 145 has flexibility, when the treatment instrument F is not inserted, the opposing slit forming surfaces forming the slit portion 143 are pressed against each other by their own elasticity and are tightly adhered.

  In the present embodiment, the insertion hole 14a and the plurality of insertion holes 14b are provided. However, only the insertion hole 14 into which the treatment instrument F is inserted can be cut and used.

  As shown in FIG. 5, the thick portion 146 is formed with a small diameter portion 147 provided in a range of a predetermined length L1 from the distal end to the proximal direction, and a large diameter portion 148 on the proximal end side from the small diameter portion 147. Has been. The small diameter portion 147 is preferably smaller than the diameter of the treatment instrument F and formed to have a length in the range of 50 to 100% with respect to the diameter of the treatment instrument F. Since the large diameter portion 148 is continuous with the small diameter portion 147 at the lower end and is continuous with the through hole 141 at the upper end, the large diameter portion 148 has a diameter equal to or larger than the small diameter portion 147 and equal to or smaller than the through hole 141.

  The suspension part 12 is formed thinner than the canopy member 11. The suspension part 12 is formed in a substantially U shape on the outer edge of the canopy member 11 in a cross-sectional view. The shape of the suspension part 12 is not limited to this, and may be a hollow convex part or a hollow concave part, and may be formed in a wave shape by providing a plurality.

  The mounting ring 13 has a substantially U shape in sectional view and can be mounted on the outer fixing ring 5 of the retractor 2.

  Next, the usage method of the valve cap 1 of this embodiment and the retractor 2 with which it is mounted will be described.

  First, as shown in FIG. 1, as a position for mounting the retractor 2, for example, an abdominal skin and peritoneum are incised to form an incision W as an incision. Next, the inner fixing ring 4 of the retractor 2 is inserted from the incision W in a bent state and deployed in the abdominal cavity. At this time, the outer fixing ring 5 of the retractor 2 is located outside the abdominal cavity.

  Next, the incision W is expanded in the radial direction by gripping the outer fixing ring 5 and rolling up the expansion member 3 around the outer fixing ring 5 while turning the outer fixing ring 5 radially inward. Thus, an opening having a desired diameter is formed, and the length of the expansion member 3 is made to correspond to the thickness of the body wall B.

  Next, the valve cap 1 is attached to the retractor 2 by covering the outer fixing ring 5 with the attachment ring 13. When the treatment instrument F is not inserted, the valve cap 1 attached to the retractor 2 in this way has a slit portion 143 that is elastically attached to each other so that the slit forming surfaces are tightly adhered to each other. Airtightness can be maintained.

  Next, the case where the treatment tool F is inserted into the valve cap 1 will be described with reference to FIGS. 4A and 5A.

  The treatment instrument F is inserted into the protruding portion 142 via the through hole 141 so as to be substantially perpendicular to the canopy member 11. Then, it is pushed by the treatment instrument F and the slit forming surface of the slit part 143 is deformed to be separated from each other, and the treatment instrument F protrudes from the slit part 143 and is introduced into the body cavity.

  At this time, since the protrusion 142 is extended by being made of a flexible soft resin, the treatment instrument F can be removed even if the small diameter portion 147 of the protrusion 142 has a diameter smaller than the diameter of the treatment instrument F. Can be inserted. The small diameter portion 147 covers the entire circumference of the outer peripheral surface of the treatment instrument F. Specifically, the inner periphery of the small-diameter portion 147 extends over a predetermined length L1 in the insertion direction, and an adhesion region 147a that tightly adheres to the entire circumference of the outer peripheral surface of the treatment instrument F is formed.

  As a result, the thick portion 146 is deformed into a so-called trumpet shape that is convex inward and gradually increases in diameter in a cross-sectional view.

  Next, the case where the treatment instrument F inserted into the valve cap 1 is moved in the horizontal direction and leftward in FIGS. 4B and 5B will be described as an example with reference to FIGS. 4B and 5B.

  Since the through hole 141 has a larger diameter than the treatment tool F, the treatment tool F can move horizontally within the range of the inner diameter of the through hole 141.

  As shown in FIG. 5B, when the treatment instrument F is moved to the left, an adhesion region 147b is formed on the left side of the thick portion 146. The close contact region 147b is in close contact with the outer peripheral surface of the treatment instrument F over a range L2 longer than the length L1 in the insertion direction of the small diameter portion 147. The close contact region 147b is formed in a certain range from the entire small diameter portion 147 and the tip of the large diameter portion 148 in the insertion direction.

  On the other hand, an adhesion region 147c is formed on the right side of the thick portion 146. The close contact region 147c is in close contact with the outer peripheral surface of the treatment instrument F over a range L3 shorter than the length L1 in the insertion direction of the small diameter portion 147. The close contact region 147c is formed in a part of the small diameter portion 147.

  The right side of the thick portion 146 will be described. When the treatment instrument F is moved in the left direction, the small diameter portion 147 forming the contact region 147a expands by being made of a flexible soft resin. A part of the base end side of 147 is deformed and peeled from the treatment instrument F, and the other part of the distal end side of the small diameter part 147 is kept in close contact with the outer peripheral surface of the treatment instrument F. Region 147c is formed.

  As a result, the inner circumference including the close contact region 147b and the close contact region 147c of the thick portion 146 is in airtight contact with the entire outer periphery of the treatment instrument F, thereby preventing communication between the body cavity and the outside of the body cavity. be able to.

  Therefore, according to the valve cap 1 of the present embodiment, the airtightness in the body cavity can be maintained even when the treatment instrument F is moved in the horizontal direction. Of course, according to the valve cap 1 of the present embodiment, if the movement includes a component in the horizontal direction, for example, even when the treatment instrument is inclined with respect to the insertion direction, the airtightness in the body cavity Sex can be maintained.

  As shown in FIG. 4B, when the treatment instrument F is moved in the left direction, the suspension portion 12 is made of a soft resin having flexibility and is formed thinner than the canopy member 11, and therefore the left suspension portion. 12 is deformed so as to be bent, and the right suspension portion 12 is deformed so as to expand. As a result, the suspension part 12 swings the canopy member 11 in the horizontal direction with respect to the mounting ring 13.

  Therefore, according to the valve cap 1 of the present embodiment, the canopy member 11 itself also swings, so that the airtightness in the body cavity can be maintained even if the treatment instrument F is moved in the horizontal direction.

  In the valve cap 1 of the present embodiment, the canopy member 11 has seven insertion holes 14, but may be one, or 19 or more as shown in FIG. 6.

  Further, in the valve cap 1 of the present embodiment, the through hole 141 is formed in an annular ridge shape on the surface side of the canopy member 11, and the strength is improved. However, as shown in FIG. In this case, it may be formed into a hollow convex shape so as to be more flexible and easy to extend.

DESCRIPTION OF SYMBOLS 1 ... Valve cap for retractors, 2 ... Retractor, 5 ... Opening end part (outside fixing ring) outside body cavity, 11 ... Canopy member, 12 ... Suspension part, 13 ... Mounting member, 141 ... Through-hole, 142 ... Extension Part (protrusion part), 143 ... slit part, 147 ... small diameter part, W ... incision, F ... treatment instrument.

Claims (3)

A flexible canopy member, and a mounting member attached to the opening end of the retractor wound outside the body cavity, which is continuous from the outer edge of the canopy member, and is placed in the incision. A retractor valve cap that hermetically seals,
The canopy member passes through the canopy member up and down and continues in the body cavity direction with a larger diameter through-hole than the treatment tool for inserting the treatment tool into the body cavity and a peripheral edge of the through-hole as a base end With an extension part,
The extension portion has a small-diameter portion that is smaller in diameter than the diameter of the treatment instrument over a predetermined length in the insertion direction. The retractor valve cap according to claim 1,
The extension part has a slit part that can be freely opened and closed to introduce a treatment tool into the body cavity at the tip part,
The retractor valve cap according to claim 1, wherein when the treatment tool is not inserted, the slit-forming surfaces facing each other that form the slit portion are tightly adhered to each other. A retractor valve cap according to claim 1 or 2,
A retractor valve cap comprising a suspension portion that is continuous from the outer edge of the canopy member to the mounting member radially outward and has higher flexibility than the canopy member.