JP2017140288A - 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, and a head part 3. The pipe part 2 includes a pipe-part outer cylinder 21 and a pipe-part inner cylinder 22, and the pipe-part outer cylinder 21 is composed of a metal tube. The head part 3 includes a head-part outer cylinder 31 and a head-part inner cylinder 32, and the head-part outer cylinder 31 is composed of a resin. A thick-wall area 200 in which the resin covers over the rear end part of the metal tube and is integrally joined with the metal tube is formed at a rear end of the pipe-part outer cylinder 21. The head-part inner cylinder 32 is integrally molded or integrally joined with the pipe-part inner cylinder 22.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.

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 comprising a pipe part for inserting a medical instrument into the body and a head part, wherein the pipe part includes a pipe part outer cylinder and a pipe part inner cylinder, and the pipe part outer cylinder is made of metal. The head part includes a head part outer cylinder and a head part inner cylinder, the head part outer cylinder is made of resin, and the resin is formed at the rear end of the pipe part outer cylinder. A thick region is formed which covers the rear end portion of the metal tube and is integrally joined to the metal tube, and the head portion inner cylinder is formed integrally with or joined to the pipe portion inner cylinder. And trocar.
(2) At the tip of the pipe part inner cylinder, there is a camera part pivotally supported between the unfolded state rotating outside the pipe part and the retracted state stored in the pipe part. The pipe portion outer cylinder is inserted so as to be slidable in the axial direction on the pipe portion inner cylinder, and the camera portion is stored in the pipe portion while being slid toward the tip of the pipe portion (1 ) Trocar as described in.
(3) The trocar according to (1) or (2), wherein a chamfered portion is formed at a tip of the thick region.
(4) The trocar according to any one of (1) to (3), wherein a surface of the pipe portion outer cylinder that is in contact with the thick region is roughened.
(5) The trocar according to any one of (1) to (4), wherein an anchor portion is formed at an end of the metal tube in the thick region.
(6) The trocar according to any one of (1) to (5), wherein a corrugated region is formed on an outer peripheral surface of the pipe portion outer cylinder.
(7) The trocar according to any one of (1) to (6), wherein the medical instrument is inserted into the body through the pipe portion inner cylinder.

According to the present invention, since the pipe part outer cylinder is made of a metal tube, the pipe part outer cylinder can be thinned. Therefore, by making the pipe part of the trocar a double structure of the pipe part outer cylinder and the pipe part inner cylinder, it is possible to prevent the inner diameter and the outer shape of the trocar itself from increasing.
Moreover, when sliding a pipe part outer cylinder with respect to a pipe part inner cylinder, since the pipe part outer cylinder is comprised from the metal tube, it has high intensity | strength and durability.
Furthermore, since the pipe portion outer cylinder and the head portion are formed at the rear end portion of the pipe portion outer tube made of a metal tube, the head portion outer tube made of resin is covered and integrally joined. The outer cylinder can be firmly joined and integrated.

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 of the trocar in the state which extracted the trocar shaft from the trocar shown in FIG. 2, respectively, and its sectional drawing, (c), (d) is a perspective view, respectively. (A), (b) is sectional drawing and the partial expanded sectional view which respectively show 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 show the structure of a camera part, respectively. (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 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 unit 5 as an imaging means attached to the tip of a pipe unit 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 tip portion 4c following the trocar shaft puncture portion 4a is formed in a column shape having an outer diameter substantially the same as the inner diameter of the pipe portion. In order to secure a storage space for the part 5, a notch part 6 is formed in a part thereof. 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) to 4 (d) 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 pipe part 2 includes a pipe part outer cylinder 21 and a pipe part inner cylinder 22, and the pipe part outer cylinder 21 is made of a metal tube. This metal tube is made of, for example, a metal such as iron, copper, or aluminum, or an alloy thereof. The head unit 3 includes a head unit outer cylinder 31 formed integrally with the pipe unit outer cylinder 21 and a head unit inner cylinder 32 formed integrally with the pipe unit inner cylinder 22.
The pipe part inner cylinder 22 and the head part inner cylinder 32 are integrally connected or joined. In addition, the pipe part outer cylinder 21 and the head part outer cylinder 31 may also be integrally connected or joined.
By making the pipe part outer cylinder 21 into a metal tube, the thickness of the pipe part 2 can be reduced. Further, the corrugated region 90 for retaining the trocar 1 described later on the abdominal wall can be made thinner.

<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. 5A and 6, the head unit 3 includes the above-described head unit outer cylinder 31 and the head unit inner cylinder 32, and further, an airtight structure unit 44 accommodated in the head unit inner cylinder 32, And a plug member 40 that closes the opening end 48 on the front side. The head portion outer cylinder 31 and the head portion inner cylinder 32 having the opening end 48 constitute a head portion main body.
As for the head part 3, the head part outer cylinder 31 is comprised from resin. Examples of this resin include polycarbonate resin, acrylic resin, polyacetal resin, and the like.

As shown in FIG. 5 (b), the resin covers the rear end of the pipe portion outer cylinder 21 at the rear end portion (head portion 3 side) of the pipe portion outer cylinder 21, and the metal tube A thick region 200 is formed which is integrally joined together. A chamfered portion 98 obtained by chamfering the boundary portion of the pipe portion outer cylinder 21 is provided at the distal end portion of the thick region 200. The chamfered portion 98 is for reducing resistance and preventing damage when the trocar 1 is inserted into the abdomen. Further, since the chamfered portion 98 is formed by inclining the boundary portion between the pipe portion outer cylinder 21 and the head portion 3, the thickness of the thick region 200 can be secured and the strength can be secured.
The thick region 200 is formed by performing known insert molding on the resin molded head portion 3 after the pipe outer cylinder 21 is molded with a metal tube.

The surface of the pipe outer cylinder 21 in contact with the thick region 200 is subjected to surface treatment such as roughening or uneven processing in order to improve the adhesion of the head portion 3 to the resin and obtain sufficient adhesive strength. May be. For example, when the rough surface treatment is performed, the arithmetic average surface roughness (Ra) is preferably about 0.5 to 2.0 μm by a publicly known method such as sandblasting or chemical etching.
In the thick region 200, an anchor portion 99 may be formed at the end of the metal tube of the pipe portion outer cylinder 21, as shown in FIG. This anchor part 99 is for enlarging the diameter of the end of the metal tube of the pipe part outer cylinder 21 to ensure sufficient strength in the thick region 200 against the movement in the axial direction. A plurality of the anchor portions 99 can be formed.

In the head portion 3, the plug member 40 has an opening 7 through which the trocar shaft 4 is inserted in the center portion. In FIG. 5 (a), the trocar shaft 4 is inserted into the opening 7, and the handle 4 b is locked to the plug member 40. 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.

As shown in FIGS. 4A and 4C, a corrugated region 90 having a plurality of step portions 95 arranged in parallel in the axial direction of the pipe portion is formed on the outer peripheral surface of the pipe portion outer cylinder 21. . Since each step portion 95 has a rising surface facing the head portion 3 side, when the trocar 1 is placed and held on the abdominal wall, the trocar 1 is inadvertently caused by the pressure of gas injected into the abdominal cavity. It can be prevented from coming off. Further, since each step portion 95 has a tapered surface, insertion of the trocar 1 into the abdominal cavity is not hindered. When the trocar 1 is pulled out, for example, the trocar 1 may be pulled out while rotating.
The corrugated region 90 is formed at least on one surface of the outer peripheral surface of the pipe portion outer cylinder 21, and is formed over the entire circumference of the pipe portion outer cylinder 21 if the thickness of the pipe portion outer cylinder 21 is ensured. May be.

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 attached (see FIG. 6). 51, on the other hand, correspondingly, 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 brought into 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 far side edge 42d of the seal pressing cover 42 is attached to the first small diameter portion 37b provided on the tip end side of the airtight rubber cover 37. By holding, 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.
As a result, the four components are integrally pressed against the flange portion 8a of the duckbill valve 8, whereby 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.

  FIGS. 11A and 11B are enlarged views of the tip portions of FIGS. 4A and 4B, and the camera unit 5 is unfolded outside the pipe unit 2. 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 imaging sensor reinforcing metal plate 19, it is preferable to use an aluminum plate that also has a heat dissipation effect of the imaging sensor 16. The space between the image sensor reinforcing metal plate 19 and the housing 13 is sealed with a filler 19 'such as a silicone material.

  The housing 13 has a curved back surface portion 13a that is flush with the pipe portion inner cylinder 22 in the retracted state of the camera portion 5, and side surface portions 13b are formed on both sides of the back surface portion 13a. Since the back surface portion 13a has a curved surface as described above, the pipe portion outer cylinder 21 can be smoothly slid when the camera portion 5 is stored and deployed. Further, 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.

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.
Then, as shown in FIGS. 11A, 11B and 13, the shaft portion 20 is inclined so as to be obliquely cut from both side portions of the tip notch portion 23 of the pipe portion inner cylinder 22 toward the front side. The groove 24 is inserted and 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 imaging sensor 16 is directly mounted on the flexible cable 28 in order to make the camera unit 5 as small as possible. The 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. ing. 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 of 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) are 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 portion outer cylinder 21 is formed to be shorter than the pipe portion 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.
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.

<Other embodiments>
In the above 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. The trocar of the present invention can also 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 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 Tip notch portion 24 Inclined 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 Sealing rubber cover 40 Plug member 42 Seal pressing cover 44 Airtight structure unit 50 Step 51 Recess 52 Protrusion 60 Seal unit 90 Wave area 91 Dome-type seal fixing tip side mount 92 Dome-type seal 93 Dome-type seal fixing front-side mount 95 Step 98 Chamfer 99 Anchor part 100 Circuit board (control means)
102 Cable 200 Thick region 371 Bellows

Claims (7)

A trocar comprising a pipe part for inserting a medical instrument into the body and a head part,
The pipe part includes a pipe part outer cylinder and a pipe part inner cylinder, and the pipe part outer cylinder is made of a metal tube,
The head part includes a head part outer cylinder and a head part inner cylinder, the head part outer cylinder is made of a resin, and the resin is placed at a rear end part of the metal tube at a rear end part of the pipe part outer cylinder. A thick region that is integrally joined to the metal tube is formed.
A trocar characterized in that the inner cylinder of the head part is molded or integrally joined to the inner cylinder of the pipe part. At the tip of the pipe portion inner cylinder, there is a camera portion pivotally supported between a deployed state that rotates outside the pipe portion and a retracted state that is stored in the pipe portion,
The pipe part outer cylinder is extrapolated so as to be slidable in the axial direction on the pipe part inner cylinder, and the camera part is stored in the pipe part in a state of sliding toward the tip of the pipe part. The described trocar.   The trocar according to claim 1, wherein a chamfered portion is formed at a tip portion of the thick region.   The trocar in any one of Claims 1-3 by which the surface of the said pipe part outer cylinder which contacts the said thickness area | region is roughened.   The trocar according to any one of claims 1 to 4, wherein an anchor portion is formed at an end of the metal tube in the thick region.   The trocar according to claim 1, wherein a corrugated region is formed on an outer peripheral surface of the pipe portion outer cylinder.   The trocar according to any one of claims 1 to 6, wherein the medical instrument is inserted into the body through the pipe portion inner cylinder.