JP2023182304A - Assisting tool for trocar - Google Patents

Abstract

To provide an assisting tool for a trocar which smoothly puts in and out an article through an inlet of a trocar.SOLUTION: An assisting tool 1 for a trocar putting in and out an article through an inlet 34 of a trocar 33 includes: a cylindrical assisting tool body 3 whose one end 4 can be inserted in the inlet 34; and a conical part 10 which is integrally coupled to the other end 5 of the assisting tool body 3 and whose opening area gradually increases in the direction in which it further extends from the other end 5. Thus, when cleaning an inside of the trocar, it is possible to bring a wiping-off part of a cleaning tool into contact with a valve member 36, a passage inner wall and the like in the trocar, to remove deposits such as blood dirt of a second valve member 36 in a valve 42, to facilitate cleaning, and to perform purification by inserting one end 4 of the assisting tool body through the inlet of the trocar and manually operating the cleaning tool to be inserted in the opening end 11.SELECTED DRAWING: Figure 11

Description

The present invention relates to an auxiliary tool for a trocar.

Laparoscopic surgery, which has been increasing in recent years in medical institutions, involves making a small hole in the abdomen, inserting a cylindrical medical device called a trocar, and inflating the abdomen with carbon dioxide gas supplied through the trocar's gas passage. The condition inside the abdominal cavity (operative field) is displayed on a monitor using an endoscope inserted through the trocar. The surgeon performs the surgery using surgical tools (forceps and scissors) inserted from other trocars while watching the monitor.

The trocar described in Patent Document 1 includes a conduit through which an instrument is inserted and an annular channel through which a liquid is introduced, and a single trocar is used to simultaneously insert an instrument and introduce a liquid.
The trocar spacer described in Patent Document 2 holds a surgical tool inserted into an arthroscopic surgical port and prevents the distal end of the surgical tool from wobbling.

JP2018-86168A Japanese Patent Application Publication No. 2016-104096

In general, a trocar has a passage through which surgical instruments, etc. are passed, and a gas supply passage that supplies carbon dioxide from the outside for pneumoperitoneum, and is equipped with a valve to prevent the supplied carbon dioxide from flowing backwards and leaking to the outside. There is.
In a structure equipped with a valve member that opens and closes a passage formed in the valve body in the trocar, the valve member creates resistance when items such as gauze are taken in and out at the entrance of the trocar's head, causing fat, blood, and body fluids to enter the passage. It is easy for dirt to adhere to it, making it difficult to put in and take out items, and it is easy to get clogged. Therefore, surgery may be hindered.
Furthermore, depending on the material of the valve member, it may be very difficult to take items in and out.

The present invention has been made in view of the above, and an object of the present invention is to provide an auxiliary tool for a trocar that facilitates the loading and unloading of articles from the entrance of the trocar.

The trocar auxiliary tool of the present invention is a trocar auxiliary tool for loading and unloading articles from the entrance (34) of the trocar (33), and has a cylindrical auxiliary tool main body (3) with one end (12) insertable into the entrance. ), and a conical part (6) connected to the other end (13) of the auxiliary tool main body, the opening area of which gradually increases in a direction further extending from the other end. Here, the term "articles" refers to tools used in surgery.

According to the trocar auxiliary tool of the present invention, when the trocar auxiliary tool is inserted from the entrance of the trocar, one end of the auxiliary tool main body pushes the trocar valve member radially outward to open the trocar valve, and the trocar valve is opened. This reduces resistance when loading and unloading items, allowing items to be loaded and unloaded smoothly.
The auxiliary device for a trocar of the present invention does not induce leakage of carbon dioxide gas when supplying carbon dioxide gas into the abdomen during laparoscopic surgery, nor does it impair airtightness when using the trocar.
According to the trocar auxiliary device of the present invention, the conical portion functions as a stopper at the opening of the trocar inlet to prevent the auxiliary device body from entering excessively into the trocar passage.

When cleaning the inside of the trocar, insert the one end of the auxiliary tool body from the entrance of the trocar, insert and operate the trocar cleaning tool disclosed in Utility Model Registration No. 3184175, for example, from the open end of the conical part. By bringing the wiping part of the cleaning tool into contact with the valve member, the inner wall of the passage, etc. inside the trocar, deposits on the valve member can be removed within the valve body, and cleaning can be promoted and purified.

FIG. 2 is a front view showing the trocar auxiliary tool of the first embodiment. FIG. 2 is a view taken in the direction of arrow II in FIG. 1; FIG. 2 is a view taken in the direction of arrow III in FIG. 1; FIG. 2 is a sectional view taken along the line IV-IV in FIG. 1. FIG. 1 is a perspective view showing a trocar auxiliary tool according to the first embodiment. FIG. 2 is an explanatory diagram illustrating the usage state of the trocar auxiliary tool of the first embodiment. A perspective view showing a trocar. VIII direction arrow view of FIG. Front view showing forceps. FIG. 2 is a schematic cross-sectional view showing a state in which the trocar auxiliary tool of the first embodiment is attached to a trocar. FIG. 2 is a schematic cross-sectional view showing how the trocar auxiliary tool of the first embodiment is used. The XII direction arrow view of FIG. FIG. 2 is a perspective view of the trocar auxiliary tool of the first embodiment when gauze is inserted into the trocar.

EMBODIMENT OF THE INVENTION Hereinafter, the auxiliary tool for trocars according to an embodiment of the present invention will be described based on the drawings.

(First embodiment)
A first embodiment of the present invention will be described based on FIGS. 1 to 13.

First, a trocar used as an auxiliary tool for a trocar will be explained based on FIGS. 6-8 and 10-13.
In laparoscopic surgery, as shown in FIG. 6, a small incision is made in the abdomen 8 of the human body 2, and a trocar 33 is inserted. Carbon dioxide gas is introduced through the gas pipe 44 of the trocar 33 to lift the abdominal wall away from the various organs. A laparoscope (not shown), forceps 37 (described later), etc. are passed through the entrance 34 of the trocar 33, and the surgery is performed while viewing the screen of the monitor 30.

As shown in FIGS. 7 and 8, the trocar 33 includes a head 40 and legs 50 connected to the head 40.
As shown in FIG. 10, the head 40 has an inlet 34 and a first valve member 35 inside a passage 43 of the valve body 42 connected to the inlet 34. The first valve member 35 has a fixed end fixed to the head case at its radially outer end, and a free end at its radially inner end. A second valve member 36 that opens and closes the passage 43 is provided on the outlet side of the first valve member 35 of the passage 43 . The second valve member 36 has a fixed end fixed to the head case at its radially outer end, and a free end at its radially inner end. The second valve member 36 has four flexible petals shaped like leaflets. The four valve pieces exert a biasing force on the article so as to push the article toward the center axis when the article is inserted from the inlet 34 side.

Further, as shown in FIG. 7, the head 40 has a gas pipe 44 through which gas such as carbon dioxide gas flows in from the outside. The internal passage of the gas pipe 44 communicates with the leg passage 51 on the leg 50 side of the second valve member 36 .
A passage 43 inside the head 40 communicates with a leg passage 51 inside the leg 50. Note that in FIGS. 10 to 13, the head 40 of the trocar 33 is shown, and the legs are not shown.
The first valve member 35 and the second valve member 36 are normally in a closed state, and can be changed to an open state by bending when an article is inserted into the head 40 from outside the inlet 34. .
Next, the auxiliary tool main body 3, which is inserted into the trocar through the entrance, will be explained.

The trocar auxiliary tool 1 shown in FIG. 5 of this embodiment is inserted into the entrance of the trocar 33.
As shown in FIG. 1, the trocar auxiliary tool 1 consists of an auxiliary tool main body 3 and a conical portion 10, and is formed, for example, by integral molding of resin.
The auxiliary tool main body 3 has a basic shape of a cylinder, and has a straight passage 6 with a constant inner diameter inside. One end 4 of the auxiliary tool main body 3 can be inserted into the entrance 34 of the trocar 33. The other end 5 of the auxiliary tool main body 3 is integrally connected to the conical part 10.

The outer diameter of the auxiliary tool main body 3 is smaller than the inner diameter of the inlet 34 of the trocar 33. The outer diameter of the auxiliary tool main body 3 is such that when the auxiliary tool main body 3 is inserted into the passage 43 of the trocar 33, it is possible to push out the first valve member 35 and the second valve member 36 of the trocar 33 to open the valve. It's the size. The length of the auxiliary tool body 3 in the longitudinal direction is such that the first valve member 35 and the second valve member 36 can be pushed open.

The conical portion 10 is continuously connected to the other end 5 of the auxiliary tool main body 3. The outer diameter of the conical part 10 is formed to gradually increase from the same outer diameter as the outer diameter of the auxiliary tool main body 3. A curved chamfer is formed at the open end 11 of the conical portion 10. The maximum outer diameter of the open end 11 of the conical portion 10 is such that it does not enter the inlet 34 of the trocar 33. The open end 11 of the conical portion 10 has a flange 12 having an annular curved surface. The open end 11 of the conical portion 10 has a curved flange formed in an annular shape.

The outer wall of the conical portion 10 has a conical shape. When the trocar is not in use, for example, when cleaning the trocar, for example, the head 40 and the legs 50 are disassembled. When the auxiliary tool main body 3 is inserted from the entrance 34 of the head 40 and the first valve member 35 is inserted, the one end 4 of the auxiliary tool main body 3 is inserted into the second valve member 36. and opens the second valve member 36.
The internal passage 13 of the conical part 10 communicates with the passage 6 of the auxiliary tool main body 3. The inner wall of the conical portion 10 forming the internal passage 13 expands toward the open end 11 so that its inner diameter becomes larger.
The inner diameters of the passage 6 and the internal passage 13 are large enough to allow forceps and gauze to pass through them.

An example of the trocar 33 used in the trocar auxiliary tool 1 will be explained.
As shown in FIGS. 6 to 8, in laparoscopic surgery, a small incision is made in the abdomen and a trocar 33 is inserted. Carbon dioxide gas is introduced through the gas pipe 44 of the trocar 33 to lift the abdominal wall away from the various organs. A laparoscope, forceps 37, etc. (not shown) are passed through the trocar 33, and the surgery is performed while looking at a monitor screen.

How to use the trocar aid 1 will be explained.
(1) Regarding usage condition 1 (cleaning with trocar cleaning tools)
The lenses of endoscopic cameras become dirty due to adhesion of oil, blood, and body fluids scattered during surgery, which obstructs the surgeon's view. For this reason, the endoscopic camera is removed from the body many times during surgery to clean the lens.
On the other hand, inside the trocar 33, dirt such as fat, blood, and body fluids in the patient's body tends to adhere to the second valve member 36 and the inside of the passage through the passage 51 of the leg portion 50 and the passage 43 of the head 40. If there is dirt left inside the trocar, the dirt will re-adhere when the endoscopic camera is reinserted after being removed outside the body, resulting in the lens having to be wiped many times during surgery. This will cause the surgery to be interrupted and the surgery time will be extended. Therefore, the auxiliary tool main body 3 is inserted through the entrance 34 of the trocar 33, a cleaning tool (not shown) (for example, the cleaning tool disclosed in Utility Model Registration No. 3184175) is inserted into the passage 6, and the cleaning tool is operated to wipe. Clean the inside of the trocar 33 with the handle.

The insertion length of the auxiliary tool body inserted through the entrance 34 of the trocar 33 can be adjusted as appropriate when operating the cleaning tool. By manually adjusting the insertion length, cleaning efficiency inside the trocar can be improved and the operability of the cleaning tool can be improved.
Further, during surgery, dirt on the lens of the endoscope camera, etc. can be removed outside the body, and on the other hand, the inside of the trocar can be easily cleaned using the trocar auxiliary tool 1.
Therefore, when the cleaned endoscopic camera is inserted into the body again, the cleaned endoscopic camera can be inserted through the inside of the trocar and the endoscopic camera can be operated appropriately. Therefore, in combination with the cleaning tool inside the trocar, the operability and functionality of the cleaning tool can be improved as an auxiliary tool for the cleaning tool.

(2) Regarding usage condition 2 (removal of forceps, gauze, etc.)
How to use the trocar auxiliary tool 1 used when removing forceps 37 or gauze from the body will be explained. With the trocar auxiliary tool 1 inserted into the entrance 34 of the trocar 33, the forceps 37 or gauze are taken out of the body through the passage 6 of the trocar 1. Since the auxiliary device main body 3 pushes open the first valve member 35 and the second valve member 36 inside the trocar 33 to secure the passage 6, troubles such as getting caught by the valve members are avoided, and gauze and other articles inside the body are avoided. can be smoothly removed from the body to the outside. At this time, the supply of carbon dioxide and the like into the body is controlled by a gas supply device (not shown).

(3) Regarding usage condition 3 (use of biological tissue collection device)
When a biological tissue collection device (not shown) is inserted into the body through a trocar, the catheter of the biological tissue device is inserted into the passage 6 of the auxiliary device 1, and the biological tissue is excised with the distal end of the biological tissue collection device. is captured, and the excised tissue is taken out of the body through the passage 6 of the auxiliary tool 1 using a biological tissue collection device. At this time, since a passage is secured inside the trocar, it is possible to eliminate elements that prevent the extraction of articles such as a biological tissue collection device inside the trocar, and it is possible to smoothly take articles in and out between the inside and outside of the body.

(Other embodiments)
In the above embodiment, the trocar 33 using the trocar auxiliary tool 1 was used, but the form and configuration of the trocar that can use the trocar auxiliary tool of the present invention is not limited to the above.

The form or structure of a trocar that can use the trocar auxiliary tool of the present invention may include not only a first valve member and a second valve member, but also a form having only one of the valve members. . The number of valve members a trocar has does not affect the scope of application of the trocar aid of the present invention.

As described above, the present invention is not limited to the above-described embodiments, and can be implemented in various forms without departing from the gist thereof.
The trocar auxiliary device of the present invention may include an opening (11) connected to the conical portion and through which the article can be taken in and taken out. This makes it easier to insert items such as surgical instruments through the enlarged opening of the conical portion. The inserted article is guided by the conical inner wall surface and is easily guided smoothly into the passage of the auxiliary device main body.

The trocar auxiliary tool of the present invention can have a flange having an annular opening. According to this, it has high strength, is hard to break, and is hard to deform, so it is stable to put in and take out articles.
Since the flange forming the opening has a curved surface, it is difficult for the article to be caught when inserted through the entrance of the trocar, and it is safe when it comes into contact with the article.
In the trocar auxiliary tool of the present invention, the opening area of the opening can be larger than the opening area of the one end. It is easy to insert items such as surgical instruments through the large opening. The inserted article is guided by the conical inner wall surface and easily guided into the passage of the auxiliary device main body. Therefore, communication between the inside of the abdomen and the outside for loading and unloading articles becomes easier.

A trocar using the trocar aid of the present invention generally has a head (40) having the entrance and a cylindrical leg (50) connected to the head. Here,
The head includes a passageway (43) that communicates with the inlet, a first valve member (35) that opens and closes the passageway, a second valve member (36) provided on the outlet side of the first valve member, and the first valve member (35) that opens and closes the passageway. A gas pipe (44) to which gas can be supplied from the outside may be provided on the outlet side of the two-valve member. The leg may have a leg passageway (51) communicating with the passageway.

Of course, the outer diameter and longitudinal length of the auxiliary tool body, the inner diameter of the passage, the inner diameter and outer diameter of the conical part, etc. can be changed.
During surgery, by supplying carbon dioxide gas to the abdomen of the human body through a gas pipe, the surgical field within the abdomen is secured and fire is prevented, allowing the surgery to proceed smoothly.
In a trocar using the trocar auxiliary tool of the present invention, it is preferable that the inner diameter of the entrance of the trocar is smaller than the maximum outer diameter of the conical part.

1 Auxiliary equipment for trocars,
3 Auxiliary device body,
4 One end,
6 aisle,
10 conical part,
11 open end,
12 flange,
13 internal passage;
14 Inner wall surface,
33 Trocker,
34 Entrance,
35 first valve member,
36 second valve member,
40 head,
43 aisle,
44 gas pipe,
50 legs,
51 Leg passage.

Claims (7)

A trocar aid for loading and unloading articles from the entrance (34) of the trocar (33),
a cylindrical auxiliary device main body (3) with one end (4) insertable into the inlet;
An auxiliary tool for a trocar, comprising: a conical part (10) connected to the other end (5) of the auxiliary tool main body, and in which the opening area of the internal passage 13 gradually increases in a direction extending further from the other end. The trocar auxiliary tool according to claim 1, further comprising an opening (11) connected to the conical part and through which the article can be taken in and taken out. A trocar aid according to claim 2, wherein the opening has an annular flange (12). The trocar auxiliary tool according to claim 3, wherein the flange has a curved surface. The trocar auxiliary tool according to claim 1 or 2, wherein the opening area of the opening is larger than the opening area of the one end. The trocar has a head (40) having the inlet, and a cylindrical leg (50) connected to the head,
The head includes a passageway (43) that communicates with the inlet, a first valve member (35) that opens and closes the passageway, a second valve member (36) provided on the outlet side of the first valve member, and the first valve member (35) that opens and closes the passageway. It has a gas pipe (44) capable of supplying gas from the outside on the outlet side of the two-valve member,
The trocar auxiliary tool according to claim 1, wherein the leg has a leg passageway (51) communicating with the passageway. The trocar auxiliary tool according to claim 1, wherein the inner diameter of the inlet of the trocar is smaller than the maximum outer diameter of the conical portion.

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