JP2020039531A - Intraperitoneal tissue traction suspension tool for laparoscopic surgery - Google Patents

Abstract

To provide a tool facilitating an operation performed by a surgeon by towing without damaging a peripheral tissue of a surgical site and widening a visual field in laparoscopic surgery.SOLUTION: A tool comprises: a surgical needle 1 which comprises a needle base part in which one end side of a needle body has a needle tip part, and the other end side has a thread attachment hole directed to an axial direction; a traction suspension thread 2 whose one end part is inserted into the hole and fixed and which is attached to the needle body and has a desired length; and a contact traction protective pad 3 which is fixed to the other end side of the thread and formed of a felt material or the like. The needle is implanted to a peripheral tissue of a surgical site and is penetrated, the needle is implanted to an abdominal wall and is penetrated, and the needle is pulled, the thread is towed in a state in which the pad contacts the tissue. Therefore the tissue is towed while protecting the tissue with the pad, so that the tissue can be suspended without being damaged and a visual field can be widened, thereby facilitating an operation performed by a surgeon.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an intra-abdominal tissue pulling and lifting device for laparoscopic surgery. More specifically, the present invention relates to a tissue pulling and lifting tool used for pulling and lifting a living tissue around a surgical site when performing a laparoscopic operation to widen a field of view.

  In laparoscopic (endoscopic) surgery, a desired number (for example, 4 to 5) of holes of, for example, about 5 mm to 12 mm are made without making a large incision in the abdomen, and a trocar (also referred to as a trocar or port) is made from the holes. Is inserted into the abdominal cavity. Next, a laparoscope (a type of endoscope) is inserted from one trocar, and the stomach, large intestine, kidney, spleen and other organs in the abdominal cavity are displayed on a monitor. Then, a desired forceps with scissors, an electric scalpel, tweezers, or the like is attached to the tip from another tracker, and the organ and the surrounding lymph nodes are removed while monitoring the monitor.

  In laparoscopic surgery, a method has been adopted in which carbon dioxide (gas) is injected into the abdominal cavity from the trocar to inflate the abdominal cavity so that the inside can be easily observed. Further, a method of pulling and lifting a patient's abdominal wall according to the physique and constitution of the patient, the type of operation, and the like has been adopted (for example, see Patent Documents 1 and 2).

  By the way, in the laparoscopic surgery, the treatment target site is often located at a position hidden under the internal organs of the patient. In this state, the surgical site is difficult to see, so that a trouble occurs such that the surgical operation cannot be performed smoothly and well. Therefore, in the above case, a method of winding a thread such as a suture around tissue such as the peritoneum or an organ around a surgical site, and pulling and lifting the thread to expand the field of view is generally adopted (conventional technique). . However, since the peritoneum and the like are particularly easy to tear, there is a risk that problems such as damage to the peritoneum and the like may occur according to the conventional technique.

JP-A-8-336539 JP-A-9-164143

  The present invention has been made in view of the above-mentioned circumstances, and solves the problems of the conventional technique, and pulls and lifts the tissue such as the peritoneum and organs around the surgical site without damaging the tissue, expanding the field of view. It is an object of the present invention to provide a technique for pulling and lifting tissue in an abdominal cavity for laparoscopic surgery that can easily perform an operation.

In order to achieve the above object, one invention (first invention) of the present invention is a tissue pulling and lifting system used to widen a field of view by pulling a tissue around a surgical site in an abdominal cavity when performing laparoscopic surgery. A tool,
A surgical needle having a needle tip for insertion formed at one end of the needle main body and a thread mounting hole provided in the other end of the needle main body in the axial direction;
A pulling and lifting thread of a desired length attached to the needle body with one end inserted and fixed in the thread mounting hole;
A contact traction protection pad fixedly provided on the other end side of the traction lifting yarn,
And characterized by comprising:

  According to the above configuration, a surgical needle is inserted into and penetrates the peritoneum and other desired tissues around the operation site, and the needle is inserted into a desired site of the abdominal wall to penetrate the abdominal wall. Then, by pulling the needle, the tissue is pulled and lifted while the protective pad is in contact with the tissue. As a result, the peritoneum and the like are towed while being protected by the pad, so that the peritoneum and the like can be lifted satisfactorily to widen the operative field (field of view) without damaging the peritoneum or the like, thereby making it possible to easily perform a surgical operation or the like. .

  Another invention (second invention) of the present invention is characterized in that the protective pad is made of a felt material.

  Still another invention (third invention) of the present invention is characterized in that the surgical needle is constituted by a straight needle.

  In the present invention, the “surgical needle” is used as a term meaning a “needle” for penetrating and penetrating tissue. In addition, the term “straight needle” is used as a term meaning a “needle” whose overall appearance is formed in a straight line.

  Still another invention (a fourth invention) of the present invention is characterized in that the traction yarn is constituted by a nylon-based yarn.

  Yet another invention (fifth invention) of the present invention is a method of pulling and lifting tissue in an abdominal cavity for laparoscopic surgery, using any one of the first to fourth pulling and lifting tools, It is characterized in that the tissue surrounding the operation site is pulled and lifted.

  According to the present invention, in laparoscopic surgery, the laparoscopic surgery can be performed by pulling and lifting the tissue such as the peritoneum and organs around the operation site without damaging the tissue, expanding the field of view, and enabling the operation to be performed easily and smoothly. It is possible to provide a surgical intraperitoneal tissue traction lifting tool and a traction lifting method.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an explanatory perspective view schematically showing a configuration of an intra-abdominal tissue pulling and lifting tool for laparoscopic surgery according to one embodiment of the present invention. FIG. 2 is an enlarged view showing a part of the traction lifting tool of FIG. 1, wherein FIG. 1 (a) is an explanatory sectional view showing a proximal end side of a needle main body of a surgical needle, and FIG. It is explanatory drawing which shows the structure of the state in which the thread for pulling and lifting was fixed and attached to the thread attachment hole on the base end side. FIG. 3 (a) is an enlarged perspective view showing an abutting traction protection pad employed in the traction lifting tool of FIG. 1, and FIG. 3 (b) shows a state where the pad is attached to the traction lifting thread. FIG. 3 is an explanatory diagram showing a configuration. FIG. 2 is an explanatory view illustrating an example of a state in which a tissue in an abdominal cavity is lifted by using the pulling and lifting tool of FIG. 1.

  Hereinafter, an example of an embodiment of the present invention will be described with reference to the drawings.

  1 to 4 show one embodiment of the present invention.

  As shown in FIGS. 1 to 3, a laparoscopic surgery intra-abdominal tissue pulling and lifting tool 100 of the present embodiment includes a surgical needle 1, a pulling and lifting thread 2, and a contact and pulling protection pad 3. Prepare.

  The surgical needle 1 of the present embodiment is constituted by a straight needle. In the present embodiment, a straight needle (straight round needle) in which the cross-sectional shape of the tip of the needle is circular or substantially elliptical is employed.

  The surgical needle 1 includes an insertion needle tip 12 (tip of a needle) formed on one end of a body 11 (body) of the needle body 10 and another end of the body 11 (the tip of the needle body). And a needle base 13 formed at the base end). The surgical needle 1 also has a thread mounting hole 14 for thread mounting provided in the needle base 13 in the axial direction of the needle body 10. The pulling and hanging thread 2 is fixedly attached by inserting one end into the thread attachment hole 14 and caulking or the like. This will be further described later.

  As the material of the needle main body 10, a round bar-shaped needle material such as austenitic stainless steel (for example, SUS304) or other stainless steel can be used. The length of the needle main body 10 (the dimension from the distal end to the proximal end of the needle main body) is not particularly limited, but may be, for example, a length formed from about 30 mm to about 60 mm.

  The thickness of the body 11 of the needle body 10 is not particularly limited, but may be formed, for example, to a diameter of about 0.5 mm to about 1.2 mm. However, it is not limited to the above range.

  The needle tip 12 of the needle main body 10 is formed of a tapered portion that gradually tapers (diameter or cross-sectional area is reduced) in the direction of the tip, and a tip of the insertion portion is formed at the tip of the tapered portion. The needle body is formed in a straight line.

  The material of the pulling and hanging thread 2 is not particularly limited, but for example, a thread made of synthetic fiber such as nylon or polypropylene can be used. In the present embodiment, a nylon thread (nylon thread) is employed.

  The thickness and length of the yarn 2 are not particularly limited. For example, a yarn having a diameter of about 0.2 mm to about 0.5 mm and a length of about 30 cm to about 60 cm can be employed. However, it is not limited to the above range.

  The thread 2 is attached to the needle body 10 with one end inserted into the thread mounting hole 14 of the needle body and fixed by swaging or the like.

  The contact traction protection pad 3 is fixedly attached to the other end of the lifting yarn 2 by binding or other desired means. When the thread 2 pulls the peritoneum and other tissues, the protective pad 3 is brought into contact with the tissues to pull while protecting the tissues such as the peritoneum.

  The constituent material of the protective pad 3 is not particularly limited, but is preferably made of a flexible material in order to impart the above-mentioned effects. The protection pad 3 of the present embodiment is made of a felt material.

  Although the size and shape of the protective pad 3 are not particularly limited, a substantially circular small mat having a diameter of about 8 mm to about 10 mm and a thickness of about 1.0 mm to about 1.2 mm. It is formed in a shape. In addition, the constituent material, shape, size, etc. of the protection pad 3 are disclosed as an example, and are not limited to the above.

  The intra-abdominal tissue pulling and lifting tool 100 for laparoscopic surgery of the present embodiment has the above configuration. As a result, the surgical needle 1 is inserted into the peritoneum or other desired living tissue to penetrate it, and by pulling the needle 1, the tissue is pulled while the protective pad is in contact with the tissue. Therefore, the peritoneum and the like are towed while being protected by the pad, so that the peritoneum and the like can be lifted well without damage to the peritoneum and the like, and the field of view can be widened, so that operations such as a surgical operation can be easily performed.

  Next, an example of a tissue pulling and lifting method performed by using the pulling and lifting tool 100 of the present embodiment will be described with reference to FIG. FIG. 4 is an explanatory view showing an example of a state in which a tissue in an abdominal cavity is lifted by using the pulling and lifting tool.

  In FIG. 4, reference numeral 4 denotes an abdomen (transverse view of the abdomen), 40 denotes an abdominal wall, 41 denotes an abdominal cavity, 42 denotes a spine, 43 denotes a peritoneum and various organs (living tissues) in the abdominal cavity, and 44 denotes an abdominal cavity through a hole formed in the abdominal wall. A desired number of trocars 45 inserted into the inside of the trocar 45 indicate scissors, an electric scalpel, tweezers, or other desired instruments attached to the tip, and forceps inserted from the trocar 44. In addition, only a part of the intraperitoneal organ, the trocar, the forceps, and the like are exemplarily described.

  The tissue pulling and lifting tool 100 is placed in the abdominal cavity 41 through the trocar 44 or the like. A forceps having a needle holding device attached to the tip is inserted into the abdominal cavity 41 from a desired trocar, and the surgical needle 1 is inserted into the peritoneum and other desired tissues 43 around the operation target site while monitoring the monitor to penetrate. At the same time, the needle 1 is inserted into a desired portion of the abdominal wall 40 to penetrate the abdominal wall.

  Next, by pulling the thread 2 with the needle 1, the tissue is pulled by the thread 2 and lifted with the protection pad 3 in contact with the tissue 43. As a result, the peritoneum and the like are towed while being protected by the pad 3, so that the peritoneum and the like can be lifted well and the field of view can be widened without damaging the peritoneum and the like. The tip side of the thread 2 or the needle 1 is fixed in a desired fixing means (not shown) while maintaining the above state.

  After the above operation is completed, an operation such as a surgical operation at a target operation site is performed while monitoring the monitor. Then, after the operation or the like is completed, the protruding portion of the thread 2 is cut off from the abdominal wall, and the pad 3 and the thread 2 in the abdominal cavity are taken out of the abdomen from a desired portion of the abdominal wall together with the removed organ and the like. Thereafter, a post-treatment similar to the conventional one is performed. According to the present embodiment, in a laparoscopic operation, a laparoscopic operation that can be pulled and lifted without damaging tissues such as the peritoneum and organs in the vicinity of the operation site, expanding the field of view, and making it possible to easily perform an operation or the like. An intra-abdominal tissue traction and lifting technique for surgery can be provided.

  The present invention is also applicable to “thoracoscopic surgery”.

  In addition, the above-described embodiment is disclosed as an example, and the present invention is not limited to the above-described embodiment, and can be arbitrarily changed without departing from the technical idea described in the claims. is there.

DESCRIPTION OF SYMBOLS 1 Surgical needle 2 Pulling and lifting thread 3 Contacting and pulling protection pad 4 Abdomen 10 Needle body 11 Body 12 Needle tip 13 Needle base 14 Thread mounting hole 40 Abdominal wall 41 Abdominal cavity 42 Spine 43 Tissue 44 Trocker 45 Forceps

Claims (5)

When performing laparoscopic surgery, a tissue pulling lifting tool used to pull the surrounding tissue of the surgical site in the abdominal cavity to expand the field of view,
A surgical needle having a needle tip for insertion formed at one end of the needle main body and a thread mounting hole provided in the other end of the needle main body in the axial direction;
A pulling and lifting thread of a desired length attached to the needle body with one end inserted and fixed in the thread mounting hole;
A contact traction protection pad fixedly provided on the other end side of the traction lifting yarn,
And a tool for pulling and lifting intra-abdominal tissue for laparoscopic surgery.   The tool for pulling and lifting tissue in a peritoneal cavity for laparoscopic surgery according to claim 1, wherein the protective pad is made of a felt material.   The laparoscopic tissue intraperitoneal tissue pulling and lifting tool according to claim 1, wherein the surgical needle is a straight needle.   2. The tool for lifting a tissue in an abdominal cavity for laparoscopic surgery according to claim 1, wherein the pulling and lifting thread is made of a nylon-based thread.   A method for pulling and lifting tissue in an abdominal cavity for laparoscopic surgery, comprising pulling and lifting tissue around a surgical site by using the pulling and lifting tool according to any one of claims 1 to 4.

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