JP2017202093A - Organ-sucking/holding device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an organ-sucking/holding device facilitating insertion into an incision opening or extraction from the incision opening, preventing a sucker from slipping out thereof, and reliably elevating and excluding even a soft and deformable organ.SOLUTION: An organ-sucking/holding device 1 includes: a suction tube body 2; and a plurality of suction cups 10a, 10b, and 10c for sucking an organ, at a front end of the tube body, and sucks an organ by suction force of the suction cups and holds it by elevating it. A dome-like member 8 for covering the plurality of suction cups from the backs thereof respectively with gaps formed between mutually adjacent suction cups respectively, is provided at the tube body in such a manner as to reduce the diameter thereof in the radial direction.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an organ suction gripper, and more particularly, to a technique for facilitating surgery by lifting and grasping the surface of an organ such as a lung when performing surgery with an endoscope, for example. It is.

  In a surgical operation, operations such as raising and excluding organs that obstruct the visual field are essential in order to facilitate the treatment of the affected area. In thoracotomy and abdominal surgery, instruments such as the surgeon's hands and surgical stabilizers are used to lift, but in endoscopic surgery, which is a minimally invasive procedure, a trocar is placed in a small incision, Since the surgical instrument is inserted through the large-sized instrument, the large instrument cannot be inserted into the body cavity, and is lifted using forceps or the like.

  By the way, the applicant has already put on the market a suction gripping tool used for endoscopic surgery, and the gripping tool lifts an organ with a single sucker, is large and heavy, and is soft and easily deformed. Etc., the sucker slipped and could not be raised.

  Therefore, the idea of using multiple suction cups to improve suction power was born, but based on this idea, a device related to a deformed suction cup with multiple legs on the suction cups used for cardiac surgery during thoracotomy Have also been proposed (Patent Documents 1 and 2). In these, the suction cup has a shape having a plurality of legs, which makes it easy to adsorb and grasp the heart wall.

  However, the suction cup of the device disclosed in Patent Document 1 has a plurality of legs, is arranged and supported in the shape of a starfish as a whole, and sucks and holds a heart having a certain degree of hardness. Although the device can be inserted into and removed from the incision without any problem, if a very soft organ, such as the lung, is sucked and grasped or lifted, the deformation of the lung between the legs of the suction cup increases, and the suction cup There was a problem that the suction force was reduced due to the gap between them, and could not follow the deformation of the lungs, and slipped off.

  In addition, a plurality of suction cups of the device disclosed in Patent Document 2 are configured such that a suction port and a suction hole are arranged in a straight line on the paddle, and the plurality of suction cups suck and hold the heart. Although it is possible to prevent slipping like the sucker of the device of Reference 1, there is a problem that the paddle is made of stainless steel and is hard and thus it is not easy to put it in and out of the device opening, and it is difficult to put it in and out. .

Japanese Patent No. 4406716 Japanese Patent No. 4556949

  Therefore, the present invention solves the conventional problems as described above, can be easily inserted into or removed from the cut opening, can prevent the suction cup from slipping, and is softly deformed. An object of the present invention is to provide an organ suction gripper that can reliably perform lifting and exclusion operations even in an easy organ.

  In order to solve the above-mentioned problems, the invention according to claim 1 is provided with a suction tube body, and a plurality of suction cups for organ suction are provided at the front end of the tube body, and the organ is sucked by the suction force of these suction cups. In the organ suction gripper for lifting and gripping, the tube body is provided with a dome-shaped member that covers the plurality of suction cups including the gap between the suction cups adjacent to the suction cups from the back so that the diameter can be reduced. It is characterized by being.

  According to a second aspect of the present invention, in the first aspect, the suction tube main body has a plurality of suction lumens formed in the axial direction, and the suction holes formed in the lumens and the suction cups communicate with each other through an airway tube. A metal guide tube is fitted and attached to the outer periphery of the main body.

  According to a third aspect of the present invention, in the first aspect, the suction tube main body has a plurality of suction lumens formed in the axial direction, and the suction holes formed in the lumens and the suction cups communicate with each other through an airway tube. A metal guide tube that is detachably attached to the outer periphery of the main body from the rear end side is provided.

  According to a fourth aspect of the present invention, in any one of the first to third aspects, a substantially cylindrical reinforcing member is provided at a front end portion of the suction tube body, and a dome-shaped member is provided on the reinforcing member. According to a fifth aspect of the present invention, in the fourth aspect, the auxiliary member has an outer diameter on one end side that is a front end side of the suction tube body larger than an outer diameter on the other end side, and an outer peripheral surface gradually increases from one end to the other end. It has a small diameter and is formed in a substantially cylindrical shape having a predetermined thickness with both ends open.

  According to a sixth aspect of the present invention, in any one of the first to fifth aspects, the dome-shaped member is a circular and bowl-shaped top plate made of a flexible material such as resin or rubber.

  A seventh aspect of the present invention provides the suction cup according to any one of the first to sixth aspects, wherein the line connecting the centers of the suction cups forms an equilateral triangle on the mounting portion provided on the inner surface side of the top plate. It consists of three suction cups arranged. An eighth aspect of the present invention is that, in any one of the first to seventh aspects, the suction cup and the dome-shaped member have a central axis parallel to the central axis of the tube body.

  The present invention is as described above, and according to the first aspect of the present invention, the dome-shaped member that covers the plurality of suction cups including the gap between the suction cups adjacent from the rear of the suction cups can be reduced in diameter. Since it is provided in the tube main body, it is easy to insert the organ suction gripper into the incision opening or to remove it from the incision opening due to the reduced diameter of the dome-shaped member. In addition, since the gap between adjacent suction cups is covered with a dome-like member, the suction cup behavior of the organ suction gripper is stable, there is no air leakage from the gap between the organ and the suction cup, and the suction force does not decrease Therefore, it is possible to prevent the slipper from slipping out, and to perform lifting and exclusion operations reliably even in a soft and easily deformable organ.

  According to the second aspect of the present invention, since the metal guide tube is fitted and attached to the outer periphery of the suction tube main body, the tube main body is prevented from being kinked by the guide tube, and a large organ is pulled. Even when performing, it is possible to perform a treatment that makes it possible. According to the invention described in claim 3, in addition to the effects similar to those of the invention described in claim 2, even when it is desired to use the organ suction gripper from the direction where the trocar is placed, This can be done by inserting the guide tube into the tube body once pulled out of the trocar. Therefore, the access direction of a surgical instrument such as an electric scalpel can be set not only from a trocar but also from an incision, and the selection range is widened and can be selectively used, which is highly convenient.

  According to the fourth aspect of the present invention, the front end of the tube body is reinforced by the reinforcing member, and the dome member attached thereto is firmly supported. According to the fifth aspect of the present invention, the reinforcing member has a substantially cylindrical shape, so that attachment is facilitated. According to the invention described in claim 6, since the dome-shaped member is formed of a circular bowl-shaped top plate made of a flexible material such as resin or rubber, it is easy to handle and the top plate of the suction cup Can be installed smoothly. According to the invention described in claim 7, it is possible to arrange the three suction cups in a balanced manner, and the suction force can be equalized. According to the invention described in claim 8, the suction cup and the dome-shaped member can be attached to the tube main body in the same direction, so that the efficiency of the installation work is improved and the workability of the production is improved. Can do.

It is a front view of a part omitted of the organ aspiration grasping tool according to the first embodiment of the present invention. It is sectional drawing of a part abbreviation same as the above. FIG. 3 is an enlarged left side view of FIG. 2. It is an expanded sectional view which follows the AA line of FIG. It is an expanded sectional view which follows the BB line of FIG. It is operation | movement explanatory drawing explaining the usage example same as the above. It is operation | movement explanatory drawing same as the above. It is operation | movement explanatory drawing same as the above. It is a disassembled front view of a part of the organ aspiration gripping tool according to the second embodiment of the present invention. It is operation | movement explanatory drawing explaining the usage example same as the above. It is operation | movement explanatory drawing same as the above. It is operation | movement explanatory drawing same as the above. It is operation | movement explanatory drawing same as the above. It is operation | movement explanatory drawing same as the above. It is operation | movement explanatory drawing same as the above.

Hereinafter, an organ suction gripping tool according to an embodiment will be described with reference to the drawings.
<First Embodiment>

  1 to 5, reference numeral 1 denotes a suction gripping tool for organs such as lungs. The suction gripping tool 1 includes a suction tube body 2. The tube body 2 is a three-lumen type tube in which three suction lumens 3a, 3b, 3c are formed in the axial direction. A guide tube 5 is fitted and inserted into the tube main body 2 over a predetermined length from the vicinity of the front end, for example, about 30 cm, so as to cover the outer peripheral surface thereof. The guide tube 5 is made of a metal pipe. A metal pipe is used as the guide tube 5 so that the tube main body 2 is inserted into the lumen of the pipe so that the soft tube main body 2 is not kinked during use. It is. That is, when the organ is towed, kinking of the tube body 2 is prevented, and a large organ can be pulled. The outer peripheral surface of the guide tube 5 is covered with a covering tube 6. The reason why the outer peripheral surface of the guide tube 5 is covered with the covering tube 6 is mainly to prevent the living tissue from being damaged by the guide tube 5 in use.

  A reinforcing member 7 is provided at the front end of the tube body 2. As shown in enlarged detail in FIG. 4, the reinforcing member 7 has an outer diameter on one end side that is the front end side of the tube body 2 larger than the outer diameter on the other end side, and the outer peripheral surface gradually decreases in diameter from one end to the other end. It is formed in a substantially cylindrical shape with a predetermined thickness with both ends open, and reinforces a suction cup portion composed of a suction cup and a top plate, which will be described later, and a connecting portion of the guide tube 5, and is inserted into the tube body 2. The front end of the guide tube 5 is fitted and attached.

  A top plate 8 as a dome-like member is attached to the front end portion of the reinforcing member 7 with the central hole portion fitted to one end of the reinforcing member 7. A plurality of (three in this embodiment) suction cups 10a, 10b, and 10c are arranged on the inner surface side of the top plate 8 at equal intervals in the circumferential direction as viewed from the side (FIG. 3). It is attached. That is, the suction cups 10a, 10b, and 10c are arranged so that a line connecting the centers of the suction cups forms an equilateral triangle. As described above, the top plate 8 is disposed so as to cover the suction cups 10a, 10b, and 10c from the curved back thereof, and the degree of coverage can be seen from the back side of FIG. 10a, 10b, 10c is configured such that the outer peripheral edge is located at a position where a part of the outer peripheral edge can be seen. With such a position form, suction by the suction cups 10a, 10b, and 10c can be effectively performed without any trouble, and the diameter reduction can be performed without adversely affecting the suction cups.

  A large number of small protrusions 11 are provided on the inner surfaces of the respective suction cups 10a, 10b, and 10c to increase the suction force, and suction holes 12 are formed near the center of the bottom. One end of each is communicated and connected. The other end of the airway tube 13 is connected to the lumens 3 a, 3 b, 3 c of the tube body 2 through one end opening of the reinforcing member 7. As described above, the small protrusion 11 has a role of preventing the suction hole 12 from being blocked by the biological tissue adsorbed by the small protrusion, in addition to increasing the adsorption force. The small protrusions 11 may be formed by attaching a mesh made of polyester fiber or the like separately. Such small protrusions 11 can prevent the suction area from decreasing, and the suction force in the suction cups 10a, 10b, 10c can be increased.

  The top plate 8 has an outer diameter of about 50 mm and is made of a flexible and easily deformable material such as resin or rubber together with the suction cups 10a, 10b, and 10c, and forms a cavity with a recess on the inner surface side that is the suction cup mounting side. However, it is formed in a circular shape having a bowl-shaped bulge so that the void can be crushed. The top plate 8 covers the suction cups 10a, 10b, and 10c including gaps between the suction cups 10a and 10b adjacent to each other in the circumferential direction from behind, the suction cups 10b and 10c, and the suction cups 10c and 10a. Thus, the diameter can be reduced. For this reason, in use, the suction gripper 1 can be inserted into the slit opening, which is the insertion point, and can be removed without any trouble.

  The suction cups 10a, 10b, and 10c have an outer diameter of about 2 cm, and suck, hold, move, and fix an organ by applying a negative pressure of 20 to 50 cmHg from an aspirator (not shown) as a suction source. Is possible. The central axes of the suction cups 10 a, 10 b, and 10 c and the central axis of the top plate 8 are both parallel to the central axes of the tube body 2 and the guide tube 5.

  A short tube 14 of 1 lumen type is connected to the rear end portion of the tube body 2 which is longer than the guide tube 5 by a predetermined length (for example, about 10 cm) by communicating the suction lumen with the suction lumens 3a, 3b, 3c. Yes. In use, the tube 14 is connected to a connection connector 15 and a guide rod (not shown) connected to the suction device. 2 and 4, only the suction cup 10a is shown, and the suction cups 10b and 10c are omitted.

  Next, a usage method will be described with reference to FIGS. First, the reference numerals of each part indicated by alphabet letters in each figure will be described. A and B are trocars placed in a small incision, C is an abdominal wall, D is a lung as an example of an organ, E is an endoscope, F Is a small opening, G is an electric knife, and H is a forceps.

  In use, the trocars A and B are inserted into the abdominal wall C and inserted toward the lung D in the body cavity as shown in FIGS. In addition, the endoscope E is inserted into one of the trocars A, and the suction gripper 1 reaches the middle of the suction gripping tool 1 from the small opening F formed in the abdominal wall C to a size of about 40 to 50 mm. Insert to position. At the time of this insertion, the cutting opening F is about 40 to 50 mm and the top plate 8 is about 50 mm. Therefore, the outer peripheral edge of the top plate 8 is caught by the cutting opening F of the abdominal wall C as it is, and the insertion is predicted to be hindered. However, since the top plate 8 can be reduced in diameter together with the suction cups 10a, 10b, and 10c, the insertion can be easily performed, and there is no trouble like the conventional one.

  Then, the insertion of the suction gripper 1 is advanced, and when the suction cups 10a, 10b, and 10c are guided to the position where the suction is easy to suck the lung D as shown in FIG. When negative pressure is applied by operating an aspirator (not shown) to be connected, the suction cups 10a, 10b, and 10c suck the soft surface of the lung D as shown in FIG. In this sucking and gripping state, the suction hole 12 is not blocked by the small protrusions 11, so that a good suction state is maintained. Further, the suction cups 10a, 10b, 10c are covered with the dome-shaped top plate 8 between the suction cups 10a and 10b adjacent in the circumferential direction, between the suction cups 10b and 10c, and between the suction cups 10c and 10a. The lungs can be prevented from being deformed, and air suction from the gaps does not occur and the suction force does not decrease. Therefore, the suction cups 10a, 10b, and 10c do not slip out as in the conventional case. Therefore, the back side of the lung D, for example, the affected part is observed with the endoscope E by pulling back the suction gripping tool 1 in the state of being sucked by the suction cups 10a, 10b, and 10c and adjusting the insertion degree. It is brought to a possible position, and under the observation by the endoscope, an operation such as excision on the affected part is performed with an electric knife G inserted from another trocar B.

  After the operation, when the operation of the suction device is stopped and the suction gripping of the surface of the lung D by the suction cups 10a, 10b, and 10c is stopped, the lung D returns to the original position where the affected part becomes the back side. At the same time, the suction gripping tool 1 is pulled out from the cut opening F. At this time, if the top plate 8 is hard and flat, it is caught by the cut opening F in the abdominal wall C, but it is difficult to remove it. Since 8 is made of a soft dome-like material as described above, the suction cups 10a, 10b, and 10c can be easily removed with a reduced diameter to reduce resistance. Further, with this suction gripping tool 1, it is possible to perform an operation of excluding (pushing) an organ, and the top plate 8 is dome-shaped and has no corners, so that it is possible to prevent damaging the living tissue when excluding it. it can.

  As described above, if the suction gripping tool 1 is used, the dome-shaped top plate 8 can be reduced in diameter, so that insertion into and removal from the small opening F can be performed smoothly and easily without any problem. be able to. In addition, since the suction force by the suction cups 10a, 10b, and 10c does not decrease, the suction cups 10a, 10b, and 10c can be prevented from slipping, and even the soft and easily deformable organs can be lifted and removed reliably. Can do. In addition, since the top plate 8 is dome-shaped and has no corners, it is possible to prevent the living tissue from being damaged when being evacuated.

<Second Embodiment>
In FIG. 9, reference numeral 21 denotes an organ suction gripping tool according to the second embodiment. This organ suction gripping tool 21 is different from the organ suction gripping tool 1 of the first embodiment in that a guide tube 25 is separated from the organ suction gripping tool 1. However, the basic configuration is different, and the other configurations are almost the same. For this reason, the same reference numerals are given to the same components, and detailed description thereof will be omitted.

  That is, the organ suction gripper 21 includes a guide tube 25 that is inserted into the tube main body 2 from the rear end side as a separate body, and pulls out the rear end of the tube main body 2 previously inserted into the body cavity to the outside. It is configured to be detachably attached by being inserted from the pulled rear end. In addition, also in the case of this guide tube 25, it is preferable to coat the outer peripheral surface with a tube similar to the coated tube 6 of the guide tube 5.

  Next, a usage method will be described with reference to FIGS. In use, as shown in FIG. 10, the tube body 2 without the guide tube 25 is inserted into the body cavity from the front end side where the suction cups 10a, 10b, 10c are located through the small opening F. In this case, as shown in FIG. 11, the tube body 2 is inserted so as to completely fit in the body cavity up to the rear end. Thereafter, the rear end of the tube body 2 is clamped with forceps H inserted from the trocar B as shown in FIG. 12, and the rear end side is pulled out of the trocar B from the body as shown in FIG. Thereafter, as shown in FIG. 14, the guide tube 25 is inserted from the rear end of the drawn tube body 2, and the guide tube 25 and the guide tube 25 are inserted into the body cavity from the trocar B.

  Then, the insertion of the suction gripper 21 is advanced, and when the suction cups 10a, 10b, 10c are guided to a position where the suction is easy to suck the lung D by approaching the lung D as shown in FIG. When a suction device (not shown) is connected to the connector 14 at the rear end of the guide tube 5 and a negative pressure is applied by operating the suction device (not shown), a suction cup 10a, 10b and 10c can suck the surface of the lung D and bring the back side of the lung D, for example, to the position where the affected part can be observed with the endoscope E. Under the observation with the endoscope, An operation such as excision of the affected area is performed with the electric knife G inserted through the incision F.

  In this embodiment, a guide rod (not shown) may be attached and attached to the rear end of the tube body 2 before insertion into the body cavity so that the tube body 2 can be easily pulled out of the body from the rear end. . As a result, it is possible to pull out the guide rod instead of the rear end of the tube main body 2 when it is pinched with the forceps H, so that the pull-out becomes easy.

  If the suction gripping tool 21 as described above is used, the dome-shaped top plate 8 can be reduced in diameter, and therefore can be easily inserted into and removed from the small opening F without any trouble. At the same time, the suction cups 10a, 10b, and 10c are prevented from slipping, and even the soft and easily deformable organ can be surely operated for raising and excluding. In addition, since the top plate 8 has a dome shape and no corners, it is possible to expect the same effects as the suction gripping tool 1 such as preventing the living tissue from being damaged when being evacuated. In addition, according to this embodiment, since the guide tube 5 is integrally attached like the suction gripping tool 1 of the first embodiment, not only from the small opening F but also from the trocar. Can be used. Therefore, the access direction of the electric knife G can be set not only from the trocar B but also from the small opening F, and the selection range is widened.

  As described above, if the suction gripping tool 1 of the first embodiment and the suction gripping tool 21 of the second embodiment are prepared, the access direction of the electric knife G is changed from the trocar B or small. It can be selected and used arbitrarily from the incision F.

  In each of the above embodiments, the members other than the guide tubes 5 and 25, including the suction tube main body 2, the reinforcing member 7, the suction cups 10a, 10b, 10c, and the top plate 8, are PP, PE, PU, nylon. It is made of a flexible material such as a thermoplastic resin such as silicone rubber, and other materials that are used in medical devices and can be used as long as they are also suitable for living tissue. . The guide tubes 5 and 25 may be any material that has rigidity such as metal and is used in medical devices.

  The top plate 8 shown in each of the above embodiments is merely a preferred example of a dome-shaped member, and does not exclude other modifications. Further, other members such as the reinforcing member 7 are merely shown as an example, and of course, shapes and structures other than those illustrated may be used. It goes without saying that the design and the like of the present invention can be arbitrarily changed and modified within the scope of the claims.

1,21 Suction gripping tool 2 Suction tube body 3a, 3b, 3c Suction lumen 5,25 Guide tube 7 Reinforcing member 8 Top plate (dome-shaped member)
10a, 10b, 10c Suction cup 11 Small protrusion 12 Suction hole 13 Airway tube 15 Connector A, B Trocar C Abdominal wall D Lung (organ)
E Endoscope F Small opening G Electric knife H Forceps

Claims (8)

In the organ suction gripper for providing an aspiration tube body, a plurality of suction cups for organ suction are provided at the front end portion of the tube body, and sucking an organ by the suction force of these suction cups and raising and holding it,
An organ suction gripping tool, wherein a dome-shaped member that covers the plurality of suction cups including a gap between the suction cups adjacent to the plurality of suction cups from behind is provided on the tube main body so as to be able to reduce the diameter.   The suction tube body is formed with a plurality of suction lumens in the axial direction, these lumens and the suction holes formed in each suction cup communicate with each other through an airway tube, and a metal guide tube is fitted and attached to the outer periphery of the tube body The organ suction gripping tool according to claim 1.   The suction tube main body is formed with a plurality of suction lumens in the axial direction, these lumens and suction holes formed in each suction cup communicate with each other through the airway tube, and are further detachable by being inserted into the outer periphery of the tube main body from the rear end side The organ suction gripping tool according to claim 1, further comprising a metal guide tube to be attached.   The organ suction grasping tool according to any one of claims 1 to 3, wherein a substantially cylindrical reinforcing member is provided at a front end portion of the suction tube main body, and a dome-like member is provided on the reinforcing member.   The auxiliary member has an outer diameter of one end side which is the front end side of the suction tube main body, which is larger than the outer diameter of the other end side, the outer peripheral surface gradually decreases in diameter from one end to the other end, and has a predetermined thickness with both ends opened. The organ aspiration grasping tool according to claim 4, which is formed in a cylindrical shape.   The organ suction-holding tool according to any one of claims 1 to 5, wherein the dome-shaped member is formed of a circular bowl-shaped top plate made of a flexible material such as resin or rubber.   The suction cup is composed of three suction cups arranged on an attachment portion provided on the inner surface side of the top plate so that a line connecting the centers of the suction cups forms an equilateral triangle. Organ suction gripper.   The organ suction gripper according to any one of claims 1 to 7, wherein the suction cup and the dome-shaped member have a central axis parallel to the central axis of the tube body.

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