JP2017140287A - Trocar - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a trocar including a space-saving camera development mechanism.SOLUTION: A trocar 1 includes a pipe part 2 for inserting a medical instrument into a body. The pipe part 2 includes a pipe-part outer cylinder 21 and a pipe-part inner cylinder 22, and a camera part 5 formed at a notch part 6 at the tip end of the pipe-part inner cylinder 22, and journaled rotationally between a development state of rotationally turned outward the pipe part 2, and a storage part stored in the pipe part 2. The pipe-part outer cylinder 21 is externally inserted so as to be axially slidable on the pipe part inner cylinder 22 and stores the camera part 5 in the pipe part 2 with its sliding toward the tip end of the pipe part 2. The camera part 5 includes a U-shaped housing for covering the back face and both sides of a camera mount, and a chamfer part formed on the at least back face out of the back face and both side of the housing.SELECTED DRAWING: Figure 2

Description

  The present invention is a patent application subject to the application of the 19th Japan Medical Research and Development Organization, “Medical-Engineering Collaboration Promotion Project Demonstration Project” commissioned research, Article 19 of the Industrial Technology Strengthening Act, The present invention relates to a trocar used for endoscopic surgery.

  In recent years, in order to maintain and improve the quality of life (QOL) of patients, minimally invasive surgery such as laparoscopic surgery for inserting an endoscope into the abdominal cavity has been demanded. Laparoscopic surgery involves injecting carbon dioxide into the abdominal cavity to inflate the abdominal wall to ensure space and field of view for the procedure. Then, a small hole is made in the abdominal wall, a device called a trocar is inserted, a surgical instrument such as an endoscope (CCD camera, etc.) or forceps is inserted into the patient's body, and the image displayed on the monitor by the endoscope It is common to perform surgery while observing (Patent Documents 1 and 2).

  In such a conventional endoscopic surgical operation, since usually one endoscope is inserted, the visual field is limited, and there is very little information that an operator can judge by looking at the monitor during the procedure. On the other hand, it is possible to secure a wider field of view by additionally inserting an endoscope, but it is necessary to make a new hole in the body wall to insert the endoscope, which increases the burden on the patient. End up. Therefore, a proposal has been made with the aim of enlarging an observation field in laparoscopic surgery by attaching a small camera to a trocar used in laparoscopic surgery (Patent Document 3).

That is, Patent Document 3 adopts a mechanism for storing a camera in the trocar when the trocar is inserted into the abdominal cavity and deploying the camera outside the trocar when the distal end portion of the trocar is inserted into the abdominal cavity. Has been.
However, since a mechanism for operating the storing and unfolding of the camera needs to be installed in the trocar, there is a problem that the inner diameter and outer shape of the trocar itself are increased, which increases the burden on the patient.
Further, since the trocar shaft inserted into the abdominal cavity needs to be inserted and removed from the outer cylinder, a step corresponding to the thickness of the outer cylinder is formed, and insertion resistance is generated. Furthermore, when the camera is provided, there are many element parts such as a housing, and there is a problem that the step becomes larger.

JP 2013-046789 A JP 2006-167475 A JP 2014-132799 A

  An object of the present invention is to provide a trocar equipped with a space-saving camera deployment mechanism.

An embodiment of the present invention for solving the above problems has the following configuration.
(1) A trocar having a pipe part for inserting a medical instrument into the body, wherein the pipe part includes a pipe part outer cylinder and a pipe part inner cylinder, and a notch is provided at a tip of the pipe part inner cylinder. And having a camera portion pivotally supported between the unfolded state of rotating out of the pipe portion and the retracted state of being stored in the pipe portion in the notch portion, The pipe portion inner cylinder accommodates an elastic member that urges the camera portion in the unfolded state, and the pipe portion outer cylinder is extrapolated to be slidable in the axial direction on the pipe portion inner cylinder. The pipe part outer cylinder stores the camera part in the pipe part against the urging force of the elastic member while sliding toward the tip of the part, and the camera part includes a camera mount, a rear surface of the camera mount, and U-shaped covering both sides And at least the front end portion of the rear portion of the housing is exposed on the surface of the pipe portion, and at least the rear surface of the housing and the both side portions have a chamfered portion. A trocar characterized by being formed.
(2) Both ends of the camera unit are pivotally supported by the inner pipe of the pipe unit, and one end of the elastic member is connected to the pipe unit at a radially outward position from the pivot point to connect the camera unit to the pipe. The trocar according to (1), which is biased rearward.
(3) The trocar according to (1) or (2), wherein each front end surface of the pipe portion outer cylinder and the pipe portion inner cylinder is formed in a slope shape whose thickness increases toward the rear end.
(4) A trocar shaft is removably inserted into the pipe portion inner cylinder, and a substantially conical puncture portion protruding from a tip surface of the pipe portion inner cylinder is formed at the tip of the trocar shaft (1). The trocar in any one of-(3).
(5) The trocar according to any one of (1) to (4), wherein the medical instrument is inserted into the body through the pipe portion inner cylinder.
(6) A trocar having a pipe part for inserting a medical instrument into the body, wherein the pipe part has a notch at the tip, and the unfolded state rotates outside the pipe part in the notch And a storage state stored in the pipe portion, the camera portion is pivotally supported with an axis orthogonal to the major axis direction of the pipe portion as a rotation axis. An imaging unit provided with a means and a housing covering the imaging unit, wherein the camera unit is in a retracted state, and a chamfered part is formed at a boundary surface between the housing and the pipe unit. The characteristic trocar.

According to the present invention, the deployment and storage of the camera unit is performed by the pipe unit outer cylinder slidably inserted with respect to the pipe unit inner cylinder, so that the camera unit can be expanded and stored without taking up a large space. It is. Therefore, the outer diameter of the trocar can be reduced and the inner diameter can be increased, and the downsizing of the trocar reduces the burden on the patient and does not hinder the insertion of a surgical instrument such as forceps into the body. .
Even if the trocar is removed from the body with the camera part deployed in the body, the camera part is rotated by an external force applied from the rear end side to the front end side in the axial direction of the pipe part during removal. It is safe because it is stored in the internal cylinder.
Furthermore, since the chamfered portion is formed on at least the back surface of the back surface and both side portions of the housing, insertion resistance into the abdominal cavity can be reduced and the burden on the patient can be reduced.

It is a perspective view which shows the trocar of the camera expansion | deployment state based on one Embodiment of this invention. (a), (b) is the side view of the trocar shown in FIG. 1, and its sectional drawing, respectively. (a), (b) is the side view in the camera storing state of the trocar shown in FIG. 1, respectively, and its sectional drawing. (a), (b) is the side view and sectional drawing of a trocar in the state which respectively extracted the trocar shaft from the trocar shown in FIG. It is sectional drawing which shows the head part of a trocar. It is a disassembled perspective view of the trocar which concerns on one Embodiment of this invention. It is a disassembled perspective view of the airtight structure unit in one Embodiment of this invention. FIG. 8 is a broken exploded perspective view of FIG. 7. It is a fractured perspective view which shows the assembly state of an airtight structure unit. It is sectional drawing which shows the state which rotated the airtight structure unit shown in FIG. 9 90 degrees. (a), (b) is the perspective view and sectional drawing which respectively show the front-end | tip part of the trocar in a camera part expansion | deployment state. It is sectional drawing of a camera part. It is the perspective view which looked at the front-end | tip part of the trocar in the camera part expansion | deployment state from the operator side (front side). It is a perspective view for demonstrating the rotation mechanism of a camera part. (a), (b) is the fracture | rupture perspective view and sectional drawing which respectively show the structure of a camera part. (a), (b) is sectional drawing which shows operation | movement of the pipe part outer cylinder in a camera retracted state and an unfolded state, respectively. (a), (b) is a schematic diagram for demonstrating the locking mechanism of the camera part by a trocar shaft. It is a perspective view which shows the form of a stopper member. (a)-(d) is a perspective view which shows the usage method of a trocar. It is explanatory drawing which shows the use condition of a trocar. It is a perspective view which shows the trocar which concerns on other embodiment of this invention.

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

<Overall structure of trocar>
FIG. 1 shows a trocar 1 according to an embodiment of the present invention. The trocar 1 is used in, for example, laparoscopic surgery, and includes a pipe portion 2 on the distal end side (distant position) when viewed in the direction of insertion at the time of surgery and an operator side (hereinafter referred to as “front side”). And the head portion 3 at the position of the case.

  A trocar shaft 4 penetrating the pipe portion 2 from the head portion 3 is attached to the trocar 1. The trocar shaft 4 has a puncture portion 4a for puncturing into the abdominal cavity through the body wall at the tip, and a handle portion 4b at the rear end. The puncture part 4a has a substantially conical shape whose tip substantially coincides with the inner diameter of the pipe part 2. The handle portion 4b is used by the operator to insert and remove the trocar shaft 4 from the trocar 1.

As shown in FIGS. 1, 2 (a) and 2 (b), the trocar 1 has a camera section 5 as an imaging means attached to the tip of a pipe section 2. b) shows a state in which the camera unit 5 is unfolded. On the other hand, FIGS. 3A and 3B show a state in which the camera unit 5 is stored in the pipe unit 2. As shown in FIG. 3 (b), the distal end portion 4 c following the puncture portion 4 a of the trocar shaft 4 is formed in a column shape having an outer diameter substantially the same as the inner diameter of the pipe portion 2, and the camera portion 5 is retracted. Then, in order to ensure the storage space of the camera part 5, the notch part 6 is formed in a part. And the connection part 4d from the front-end | tip part 4c to the handle | steering-wheel part 4b is formed smaller in outer diameter than the front-end | tip part 4c. This structure is adopted because of the large force applied when inserting the trocar 1 by supporting the tip of the pipe part 2 provided with the camera part 5 from the inside by the tip part 4c having a large outer diameter. This is for ensuring sufficient strength.
Incidentally, when the inner diameter of the pipe part 2 is 12.7 mm, the outer diameter of the columnar tip part 4 c is preferably about 12.6 mm.

4 (a) and 4 (b) show the trocar 1 in which the trocar shaft 4 is removed from the state shown in FIGS. 2 (a) and 2 (b). The pipe part 2 of the trocar 1 has a double structure including a pipe part outer cylinder 21 and a pipe part inner cylinder 22 as shown in FIG. The head section 3 includes a head section outer cylinder 31 formed integrally with the pipe section outer cylinder 21 and a head section inner cylinder 32 formed integrally with the pipe section inner cylinder 22.
Each front end surface of the pipe part outer cylinder 21 and the pipe part inner cylinder 22 is formed in the shape of a slope whose thickness increases toward the rear end.
In addition, the pipe part outer cylinder 21 and the head part outer cylinder 31, and the pipe part inner cylinder 22 and the head part inner cylinder 32 may be integrally connected or connected.

<Head>
Next, the structure of the head part will be described. Returning to FIG. 1, the head portion inner cylinder 32 includes an air supply tube 10 that feeds a gas such as carbon dioxide or air into the abdominal cavity. The gas sent from the air supply tube 10 attached to the head portion inner cylinder 32 is sent into the abdominal cavity through the pipe portion inner cylinder 22, and the abdominal cavity is pressurized.

As shown in FIGS. 5 and 6, the head unit 3 includes the head unit outer cylinder 31 and the head unit inner cylinder 32, and further includes an airtight structure unit 44 accommodated in the head unit inner cylinder 32, and a front side unit 44. And a plug member 40 that closes the open end 48. The head portion outer cylinder 31 and the head portion inner cylinder 32 having the opening end 48 constitute a head portion main body.
The plug member 40 has an opening 7 through which the trocar shaft 4 is inserted at the center. In FIG. 5, the trocar shaft 4 is inserted into the opening 7, and the handle 4 b is locked to the plug member 40. Then, after the trocar shaft 4 is pulled out, a medical instrument such as forceps (not shown, hereinafter sometimes referred to as a surgical instrument) can be inserted from the opening 7.
A connector portion 11 to which a flexible cable 28 (signal / power cable / FPC cable) extending from the camera portion 5 is connected is formed on the outer peripheral surface of the plug member 40.

Next, the airtight structure unit 44 will be described with reference to FIGS.
As shown in FIGS. 7 and 8, the airtight structure unit 44 has a duckbill valve 8 on the distal end side (distant position) of the head portion inner cylinder 32, and further toward the front side (operator side) from the duckbill valve 8. And a seal unit 60 arranged in a row.
The duckbill valve 8 has a flange 8a on the outer peripheral surface. On the other hand, a step portion 50 with which the flange 8a abuts is formed on the inner peripheral surface of the head portion inner cylinder 32 to which the airtight structure unit 44 is mounted (see FIG. 6). On the other hand, corresponding to this, the step portion 50 is formed with a convex portion 52. Therefore, when the airtight structure unit 44 including the duckbill valve 8 is mounted, the duckbill valve 8 is surely placed in a predetermined position. In addition, the recessed part 51 and the convex part 52 may each be only one, and may be provided with two or more.
The seal unit 60 includes a seal retainer cover 42, a dome-type seal fixing tip side mount 91, a dome-type seal 92, an airtight rubber cover 37, and a dome-type seal fixing in order from the duckbill valve 8 toward the front side (operator side). A near-side mount 93 is provided. The seal unit 60 is a seal structure for preventing leakage of gas pressurized into the abdominal cavity by closely contacting the surgical instrument when the surgical instrument is inserted and used. It is configured.

The duckbill valve 8 is a duck mouth-shaped valve mechanism, and partitions the opening 7 and the inside of the pipe portion 2. As shown in FIG. 9, the duckbill valve 8 is closed to prevent leakage of gas pressurized into the abdominal cavity before the insertion of a surgical instrument such as the trocar shaft 4 or forceps. The shaft 4 and the surgical instrument are inserted into the pipe portion 2 so as to push open the opening / closing port 81. The duckbill valve 8 is formed from an elastomer material such as silicone rubber.
FIG. 10 shows the airtight structure unit 44 rotated by 90 ° from the state shown in FIG.

Returning to FIGS. 7 and 8, the seal unit 60 will be described. The seal retainer cover 42 is formed of a resin material such as polyacetal, and has a large-diameter portion 42a that fits into the cylindrical portion 8b on the front side of the flange 8a of the duckbill valve 8, and a flange portion of the dome-shaped seal fixing distal end side mount 91. It is comprised from the plane part 42c provided with the small diameter part 42b which positions 91b.
The dome-shaped seal fixing front end side mount 91 is formed of a polycarbonate resin or the like, and includes a peripheral wall portion 91a and a flange portion 91b that are fitted with the dome-shaped seal 92, and a plurality of flanges 91b (six in the figure). ) Pin 91c is integrally formed.

  The dome-shaped seal 92 is formed of an elastomer material such as silicone rubber, and includes a seal portion main body 92a having an instrument insertion port 41 for inserting the trocar shaft 4 and other surgical tools, and a flange portion 92b. The flange portion 92b is provided with a positioning hole 45 through which a pin 91c provided on the dome-shaped seal fixing front end side mount 91 is inserted.

  The airtight rubber cover 37 is formed of an elastomer material such as silicone rubber, and has a function of connecting the duckbill valve 8 and the dome-shaped seal 92 to improve airtightness therebetween. The airtight rubber cover 37 includes a cylindrical portion 37a, a first small-diameter portion 37b provided on the front end side thereof, and a second small-diameter portion 37c provided on the near side, and the second small-diameter portion 37c includes a dome-shaped seal. A bellows portion 371 is formed so as to follow the 92 slides. In addition, a positioning hole 46 through which the pin 91c is inserted is formed in the peripheral portion (flat portion) 37d of the opening 39 in the second small diameter portion 37c.

  The front mount 93 for fixing the dome-shaped seal is made of a resin material such as polyacetal, and includes a peripheral wall portion 93a and a flange portion 93b that are fitted to the dome-shaped seal 92. A positioning hole 47 through which a pin 91c provided on the distal end side mount 91 is inserted is provided.

The assembled state of the airtight structure unit 44 is shown in FIGS. In assembling, the flat part 42c and the flange parts 91b and 92b of each of the four parts of the dome type seal fixing front end mount 91, the dome type seal 92, the airtight rubber cover 37 and the dome type seal fixing front side mount 93 are provided. , 37d and 93d are overlapped, and the pin 91c provided on the front end side mount 91 is inserted through holes 45, 46, 47 provided in the airtight rubber cover 37 and the front side mount 93 for fixing the dome-shaped seal in order. Finally, the tip end of the pin 91c is integrated by caulking with heat, and then the distal end edge 42d of the seal pressing cover 42 is held by the first small diameter portion 37b provided on the tip end side of the airtight rubber cover 37. Thus, the seal unit 60 is assembled.
Thus, by overlapping the flange portions 91b, 92b, 37d and 93d and integrating the dome-shaped seal 92, in conjunction with the movement of the surgical instrument inserted into the instrument insertion port 41 of the dome-shaped seal 92, The dome-shaped seal 92 acts on the bellows portion 371 provided on the airtight rubber cover 37, and the dome-shaped seal can be moved while maintaining the close contact state of the instrument insertion port 41.

Next, an airtight structure unit 44 is obtained by bringing the first small-diameter portion 37 b provided on the front end side of the airtight rubber cover 37 constituting the seal unit 60 into close contact with the front surface of the flange portion 8 a of the duckbill valve 8. In this state, as shown in FIG. 6, the airtight structure unit 44 is inserted into the pipe inner cylinder 32, and the flange portion 8 a of the duckbill valve 8 is locked to the step portion 32 a formed on the inner surface of the pipe inner cylinder 32. Further, the plug member 40 is fitted into the pipe inner cylinder 32 from the front side.
The four parts are integrally pressed against the flange portion 8a of the duckbill valve 8 so that the duckbill valve 8 and the dome-shaped seal 92 are connected in an airtight state.
In this embodiment, a structure in which the hermetic structure unit 44 is in close contact with the seal unit 60 and the duckbill valve 8 is adopted, but it is of course possible to integrate up to the duckbill valve 8 using the airtight rubber cover 37 of the seal unit 60. Is possible. That is, the airtight rubber cover 37 and the duckbill valve 8 may be joined or integrally formed.

<Camera part>
As will be described later, the camera unit 6 can be stored in the pipe unit 2 and is deployed outward from the outer peripheral surface of the pipe unit 2 within the abdominal cavity. 2 and 3 show the unfolded state and the retracted state of the camera unit 5 in the trocar 1, respectively. 4A and 4B show a state where the trocar shaft 4 is extracted from the trocar 1 and the camera unit 5 is unfolded.

  11 (a) and 11 (b) are enlarged views of the tip portions of FIGS. 4 (a) and 4 (b), and the camera unit 5 is unfolded outside the pipe unit 2. FIG. The camera unit 5 is pivotally supported at both ends so that the camera unit 5 can be accommodated in the tip notch portion 23 of the pipe portion inner cylinder 22. As a result, the camera unit 5 can freely rotate between the unfolded state in which the camera unit 5 can be photographed outside the pipe unit 2 and the stored state stored in the pipe unit 2. As described above, the unfolded camera unit 5 is located at the distal end portion of the pipe portion inner cylinder 22, so that the field of view is not obstructed by the pipe portion 2, and is suitable for photographing the surgical field.

That is, the camera unit 5 includes a substantially U-shaped housing 13 and a camera mount 17 attached to the front surface of the housing 13 (in this embodiment, a U-shaped inner bottom surface). Lenses 14a, 14b, and 14c, an imaging sensor protecting translucent plate 15, and an imaging sensor 16 (such as a CMOS) are attached in order along the transmission direction. The lenses 14 a, 14 b and 14 c are stacked in the lens barrel 25. A flexible cable 28 is connected to the image sensor 16. The flexible cable 28 passes between the pipe part outer cylinder 21 and the pipe part inner cylinder 22, and passes through the gap between the pipe part outer cylinder 21 and the head part outer cylinder 31 and the head part inner cylinder 32 connected to the pipe part inner cylinder 22, respectively. Then, it is drawn out from the front side single edge of the head part outer cylinder 31 to the outside of the head part 3 and drawn into the connector part 11 through an opening (not shown) formed in the surface of the connector part 11 on the head part 3 side. The circuit board 100 (see FIG. 5), which will be described later, is connected. A translucent protective cover 18 is attached to the front surface of the lens 14a.
The lenses 14a, 14b, and 14c and the protective translucent plate 15 can be made of optical glass or optical resin, but it is desirable that the lenses 14a, 14b, and 14c be made of a resin material that can be manufactured at low cost and can be easily aspherically molded.

  An imaging sensor reinforcing metal plate 19 (back plate) is disposed on the back side of the flexible cable 28 connected to the imaging sensor 16. This imaging sensor reinforcing metal plate 19 is mounted directly on the flexible cable 28, so that the planarity of the imaging sensor 16 is maintained and the sensor is protected. As the reinforcing metal plate 19, it is preferable to use an aluminum plate that also has a heat dissipation effect of the image sensor 16. The reinforcing metal plate 19 and the housing 13 are sealed with a filler 19 'such as a silicone material.

The housing 13 has a curved back surface portion 13 a that is flush with the pipe portion outer cylinder 21 when the camera portion 5 is stored. Side portions 13b are formed on both sides of the back portion 13a. Since the back surface portion 13a is curved, the pipe portion outer cylinder 21 can be smoothly slid when the camera portion 5 is stored and deployed. In the unfolded state of the camera unit 5, the lenses 14 a, 14 b, and 14 c face the front of the pipe unit 2, and at least the tip of the back surface unit 13 a of the housing 13 is exposed on the surface of the pipe unit 2.
A chamfered portion 130 is formed on at least the rear surface portion 13a of the rear surface portion 13a and both side portions 13b of the housing 13, and the pipe between the trocar shaft 4 and the rear surface portion 13a of the housing 13 is formed by the chamfered portion 130. The step corresponding to the thickness of the external cylinder 22 is eliminated, and the resistance when the trocar 1 is inserted into the abdominal cavity of the patient is reduced. When the camera unit 5 is housed, it is preferable that the distal end surface of the chamfered portion 130 of the housing 13 and the distal end wall portion 4a of the trocar shaft 4 are continuous without a gap. The chamfered portion 130 is inclined from the back surface portion 13b toward the distal end direction of the camera portion 5, and the inclination angle can be set to any angle as long as the insertion resistance can be reduced. In the present invention, an inclination of about 25 degrees with respect to the major axis direction of the pipe portion is provided, but if the inclination angle is 20 to 45 °, smooth insertion can be performed.

As shown in FIGS. 12 and 13, on both side surface portions 13 b and 13 b of the housing 13, a protruding portion 13 c extending downward in the pipe inner cylinder 22 is formed at the lower end portion, and each protruding portion 13 c includes The shaft portion 20 is formed so as to protrude outwardly perpendicular to the axial direction of the pipe portion 2.
As shown in FIGS. 11A, 11B and 13, the shaft portion 20 has an inclined groove 24 that is cut obliquely from both side portions of the tip notch portion 23 of the pipe portion inner cylinder 22 toward the front side. Is engaged with the inclined groove 24. The center of the shaft portion 20 is a shaft fulcrum S for rotating the camera portion 5. Thereby, although it is compact, the moment at the time of raising / lowering the camera part 5 using the pulling force of the coil spring 12 (elastic member) mentioned later is securable. Further, since the inclined groove 24 inclined as described above is employed, the camera unit 5 can be easily mounted.

  As shown in FIG. 14, L-shaped portions 45 project downward from both sides of the bottom portion 13 d of the housing 13, and the L-shaped portion 45 is associated with the ring-shaped portion 12 a at one end of the coil spring 12. Stopped. As shown in FIG. 13, the two coil springs 12 are accommodated in a concave groove 46 that extends from the front end notch portion 23 of the pipe portion inner cylinder 22 to the front side (operator side) along the axial direction of the pipe portion 2. The ring-shaped part 12 b at the other end on the near side of the coil spring 12 is fixed in the groove 46.

One end (ring-shaped portion 12 a) of the coil spring 12 is locked on the front side of the shaft portion 20 and at a radially outward position of the pipe portion 2 from the shaft portion 20. Thereby, the camera part 5 is urged | biased to the near side. As a result, the camera unit 5 rotates rearward with the pivot point S as the rotation center, and is in a deployed state.
Therefore, when the trocar 1 is pulled out from the body while the camera unit 5 is deployed in the body, the camera unit 5 is rotated by an external force applied from the rear end side to the front end side in the axial direction of the pipe portion 2 at the time of removal. Since it is stored in the pipe portion inner cylinder 22, it is safe.
In particular, when a large force that is not assumed from the rear end side to the front end side acts on the camera unit 5, the L-shaped portion 45 and the ring-shaped portion 12a at one end of the coil spring 12 are disengaged from each other. Since the shaft portion 20 is engaged with the inclined groove 24 of the pipe portion inner cylinder 22, the shaft portion 20 can be detached so as to slide along the inclined groove 24, and the camera portion 5 can be detached. Accordingly, in an emergency or the like, the camera unit 5 can be detached from the trocar 1 without damaging it, so that safety can be improved and the risk of damaging the camera unit 5 can be reduced.
At this time, since the other end of the coil spring 12 is fixed, it does not fall into the abdominal cavity.

  In the present embodiment, the image sensor 16 is directly mounted on the flexible cable 28 in order to reduce the size of the camera unit 5 as much as possible. This mounting unit does not have a controller function for controlling the image sensor 16, and controller functions such as clock control are arranged on the circuit board 100 (control means, see FIG. 5) provided in the head unit 3. The Therefore, the end portion of the flexible cable 28 directly mounted on the imaging sensor 16 is connected to the circuit board 100 at the connector portion 11 of the head portion 3, and is connected to the external cable 102 (USB cable) soldered from the circuit board 100. The image signal is sent to the outside.

When the translucent protective cover 18 is formed from a transparent optical resin, the inner surface adjacent to the lens 14a becomes a concave curved surface 181 as shown in FIGS. It becomes possible to make it. Therefore, since the translucent protective cover 18 itself exhibits the function of a lens, the number of lenses to be used can be reduced, and the distance between the translucent protective cover 18 and the lenses 14a, 14b, and 14c can be reduced. Thus, the camera unit 5 can be reduced in thickness and size. In addition, a structure such as a peripheral wall described later can be integrally formed.
The translucent protective cover 18 has a peripheral wall 182, and a hole 26 is formed in the peripheral wall 182. On the other hand, the camera mount 17 has a claw portion 27 on the distal end side, and is integrated by locking the claw portion 27 in the hole 26 when the translucent protective cover 18 is attached. At that time, a sealing material 29 such as rubber is fitted between the camera mount 17 and the translucent protective cover 18 in order to ensure waterproofness.

<Lock mechanism (1)>
Next, a lock mechanism for holding the camera unit 5 in the unfolded state or the stored state and preventing the camera unit 5 from inadvertently operating will be described. 16 (a) and 16 (b) show cross-sectional views obtained by rotating the cross-sectional views of FIG. 3 (b) showing the retracted state and FIG. 2 (b) showing the unfolded state by 90 °, respectively.
As shown in FIGS. 16A and 16B, two concave portions 30a and 30b are arranged in parallel in the axial direction on the outer peripheral surface of the head inner cylinder 32 to which the pipe inner cylinder 22 is connected. On the other hand, a lock lever 34 having a claw-like convex portion 33 is attached to the head portion outer tube 31 to which the pipe portion outer tube 21 is connected.
The recesses 30a and 30b and the lock lever 34 are provided as a pair at positions symmetrical to 180 degrees.
In the retracted state of the camera unit 5 (FIG. 16A), the convex portion 33 provided at the tip of the lock lever 34 is engaged with the concave portion 30a on the tip side to lock the pipe portion outer cylinder 21. . On the other hand, in the unfolded state of the camera part 5 (FIG. 16B), the pipe part outer cylinder 21 is locked by engaging with the concave part 30b on the front side. These operations can be performed by the lock lever 34 extending from the head portion outer cylinder 31 to the outside. That is, when one end exposed to the outside of the lock lever 34 is pushed with a finger, the convex portion 33 provided at the other end of the lock lever 34 is rotated upward to be detached from the concave portion 30a or 30b. The external cylinder 21 is slid.

The pipe outer cylinder 21 is formed to be shorter than the pipe inner cylinder 22. This is a state in which the camera unit 5 is deployed out of the pipe part 2 from the tip notch part 23 of the pipe part inner cylinder 22 (the state of FIG. 16B), and the pipe part outer cylinder 21 is behind the camera part 5. This is because it is located in the area.
Also, as shown in FIGS. 17A and 17B, a tubular seal material 49 is interposed between the pipe portion outer cylinder 21 and the pipe portion inner cylinder 22. The tubular sealing material 49 is formed of silicone rubber or the like, and is sheathed on the pipe portion inner cylinder 22 so as to sandwich the above-described flexible cable 28, and even in the presence of the flexible cable 28, the pipe portion outer cylinder 21. Can be slid while maintaining an airtight state. In addition, in order to reduce the friction coefficient of the tube-shaped sealing material 49, you may make it ensure a lubrication effect | action with the oils and fats which can be used for medical uses, such as silicone oil.

<Lock mechanism (2)>
In the present embodiment, the camera unit 5 is locked by the trocar shaft 4 so that the camera unit 5 is not unintentionally deployed when the camera unit 5 is stored. That is, as shown in FIG. 17A, in the state in which the camera unit 5 is stored in the notch 6 formed in the trocar shaft 4, the tip surface of the camera 5 is the tip of the notch 6. It is prevented from rotating while abutting against the wall 6a. Therefore, the lock state can be reliably maintained in cooperation with the lock mechanism by the lock lever 34 described above. At this time, the back surface portion 13a of the housing 13 continues to be inclined at the chamfered portion 130 from the puncture portion 4a.
On the other hand, in order to release the lock by the trocar shaft 4, as shown in FIG. 17B, a gap is formed between the tip wall portion 6 a of the trocar shaft 4 and the tip surface of the camera portion 5. The camera unit 5 can be easily deployed.

In order to perform locking and releasing by the trocar shaft 4, as shown in FIG. 18, a camera portion storage position click groove 47a and a camera are provided on the outer peripheral portion of the end surface of the plug member 40 located on the front side (operator side) of the trocar 1. Partial development position click grooves 47b are juxtaposed in a predetermined sense. When the trocar shaft 4 is inserted into the opening 7 of the plug member 40 and the handle portion 4b is attached to the end face of the plug member 40, the projection (not shown) provided on the handle portion 4b is shown in the retracted state of the camera unit 5. Is engaged with the camera portion storage position click groove 47a. On the other hand, at the time of deployment, the trocar shaft 4 is rotated by holding the handle portion 4b to engage the protrusion with the camera portion deployment position click groove 47b. Thereby, a gap D is formed between the distal end wall portion 6a of the trocar shaft 4 and the distal end surface of the camera portion 5 (see FIG. 19B), and the camera portion 5 can be deployed.
That is, since the camera portion unfolding position click groove 47b is deeper than the camera portion storage position click groove 47a, the trocar shaft 4 is moved to the tip side and the gap D is formed between the camera portion 5 and the tip surface. Can be formed.

  Next, the usage method of the trocar 1 which concerns on this embodiment is demonstrated based on Fig.19 (a)-(d). First, in the initial state shown in FIG. 19A (the storage state of the camera unit 5), the trocar shaft 4 is rotated from the camera unit storage position click groove 47a to the camera unit deployment position click groove 47b. A gap D is formed between the front end wall 6a and the front end surface of the camera unit 5 (FIG. 19B).

Next, as shown in FIG. 19C, the lock lever 34 of the pipe portion outer cylinder 21 is pushed, and the pipe portion outer cylinder 21 is slid forward. Thereby, the camera unit 5 is developed by the urging force of the coil spring 12 (see FIG. 11), and the trocar shaft 4 can be pulled out.
In this state, as shown in FIG. 19D, the trocar shaft 4 can be pulled out and used as a trocar port.

  In actual use, in the initial state (stored state of the camera unit 5) shown in FIG. 19A, the puncture portion 4a formed at the tip of the trocar shaft 4 is punctured into the abdominal cavity through the body wall. Next, as described above, the camera unit 5 is deployed in the body wall 35, the trocar shaft 4 is extracted from the trocar 1, and surgery is performed while photographing the affected part 36 in the abdominal cavity as shown in FIG.

  Therefore, the surgeon can insert a forceps or the like (not shown) from the opening 7 of the trocar 1 while looking at the image displayed on the monitor (not shown), so that the field of view is enlarged. In addition, the operation becomes easier and the safety of the operation is improved. In particular, since the camera unit 5 is provided at the tip of the pipe unit 2, there is an advantage that the visual field is not obstructed by the pipe unit 2 or the like.

  Further, when the camera unit 5 is in the retracted state, at least the back surface part 13a of the back surface part 13a and both side parts 13b of the housing 13 is continuous with the chamfered part 130 and the puncture part 4a of the trocar shaft 4, so that the trocar 1 The resistance at the time of insertion is reduced as the shape of the tip, and it can be smoothly inserted into the abdominal cavity (inside the body).

<Other embodiments>
In the above-described embodiment, the case where the camera unit 5 and the connector unit 11 are arranged on the same side with respect to the pipe unit 2 has been described, but the camera unit 5 and the connector unit 11 may be arranged at different positions. Good. For example, as shown in FIG. 21, the camera unit 5 and the connector unit 11 can be arranged in a symmetrical position with respect to the axis of the pipe unit 2 or in the vicinity thereof.
In this case, the external cable 102 during the operation can be arranged below the position of the operator's hand, and when the operator's hand touches the external cable 102, the camera unit 5 moves and rotates around the pipe unit 2 as the rotation axis. It is possible to effectively prevent the projected surgical field from rotating.
The positions of the camera unit 5 and the connector unit 11 may be arranged at positions different from the mounting position of the camera unit in the circumferential direction of the head unit so that the operator's hand does not touch the external cable 102. For example, the connector part 11 may be disposed at an angle of 90 ° or more from the camera part 5 with respect to the axial center of the pipe part 2.
Others are the same as the said embodiment.

  As mentioned above, although the trocar 1 which concerns on embodiment of this invention was demonstrated, this invention is not limited to the said embodiment, A various improvement and improvement are possible. For example, an illuminating device may be provided in the camera unit 5 to brighten the surgical field. In addition, the trocar 1 of the present invention can be suitably used for endoscopic surgery in the thoracic cavity.

DESCRIPTION OF SYMBOLS 1 Trocar 2 Pipe part 3 Head part 4 Trocar shaft 4a Puncture part 4b Handle part 5 Camera part 6 Notch part 7 Opening part 8 Duck bill valve 10 Air supply pipe 11 Connector part 12 Coil spring (elastic member)
13 Housing 13a Back surface portion 13b Both side portions 14a, 14b, 14c Lens 15 Imaging sensor protective cover 16 Imaging sensor 17 Camera mount 18 Translucent protective cover 19 Imaging sensor reinforcing metal plate 20 Shaft portion 21 Pipe portion outer cylinder 22 Pipe portion inner cylinder 23 Notch portion 24 Tip groove 25 Lens barrel 26 Hole 27 Claw portion 28 Flexible cable 29 Sealing material 30a, 30b Recess 31 Head portion outer cylinder 32 Head portion inner tube 33 Convex portion 34 Lock lever 35 Body wall 37 Airtight rubber cover 40 Plug member 42 Seal retainer cover 44 Airtight structure unit 50 Step 51 Recess 52 Protrusion 60 Seal unit 91 Front side mount 92 for fixing the dome type seal Dome type seal 93 Front side mount 100 for fixing the dome type seal Circuit board (control means)
102 Cable 130 Chamfered portion 371 Bellows portion

Claims (6)

A trocar having a pipe part for inserting a medical instrument into the body,
The pipe part includes a pipe part outer cylinder and a pipe part inner cylinder,
There is a notch at the tip of the pipe portion inner cylinder, and a shaft is freely pivoted between the unfolded state of rotating outside the pipe portion and the retracted state of being stored in the pipe portion. Has a supported camera part,
The pipe portion inner cylinder accommodates an elastic member that urges the camera portion to a deployed state,
The pipe part outer cylinder is inserted so as to be slidable in the axial direction on the pipe part inner cylinder, and the pipe part outer cylinder resists the urging force of the elastic member while sliding toward the tip of the pipe part. While storing the camera part in the pipe part,
The camera unit includes a camera mount and a U-shaped housing that covers the back surface and both sides of the camera mount. When the camera unit is in a developed state, at least a tip of the back surface of the housing is a pipe unit. A trocar characterized by being exposed on the surface and having a chamfered portion formed on at least the back surface of the back surface and both side portions of the housing.   Both ends of the camera part are pivotally supported by the inner cylinder of the pipe part, and one end of the elastic member is connected at a radially outward position of the pipe part from the pivot point, so that the camera part is located behind the pipe part. The trocar of claim 1 being biased.   3. The trocar according to claim 1, wherein each front end surface of the pipe portion outer cylinder and the pipe portion inner cylinder is formed in a slope shape whose thickness increases toward the rear end.   The trocar shaft is removably inserted into the pipe portion inner cylinder, and a substantially conical puncture portion protruding from the distal end surface of the pipe portion inner cylinder is formed at the tip of the trocar shaft. The trocar according to any one.   The trocar according to any one of claims 1 to 4, wherein the medical instrument is inserted into the body through the pipe portion inner cylinder. A trocar having a pipe part for inserting a medical instrument into the body,
The pipe portion has a notch at the tip, and in the notch, there is a long axis direction of the pipe portion between an unfolded state that rotates outside the pipe portion and a retracted state that is stored in the pipe portion. It has a camera part that is pivotally supported around a direct axis as a rotation axis,
The camera unit includes an imaging unit provided with optical means and a housing that covers the imaging unit. When the camera unit is in a retracted state, a chamfered portion is provided at a boundary surface between the housing and the pipe unit. Trocar characterized by being formed.