JP3135161B2 - Trocar device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a trocar device for guiding an endoscope, a surgical instrument, and the like when an examination or an operation in the abdominal cavity or thoracic cavity is performed percutaneously using an endoscope.

[0002]

2. Description of the Related Art Conventionally, surgery such as removal of a gallbladder under a laparoscopic procedure using a trocar has been performed. However, an inner needle or a laparoscope inserted into an outer tube of the trocar, and furthermore, a procedure is performed. The tools and the like are all rigid and straight shapes, and the outer tube and the hand of the trocar are also made rigid.

[0003] When performing cholecystectomy under a laparoscope (Rapallo nanoscopic Kore cis Tech Tommy), rather than a treatment for the subject site in the body cavity from one direction, something present or instruments from a plurality of directions They are often used in combination with complicated operations.

[0004]

However, since the insertion portions of a plurality of instruments that are concentrated on the treatment target site in the body cavity are rigid and have a straight shape, they are located within the field of view of the laparoscope. , And tends to concentrate on the treatment target site and obstruct the visual field observation. In addition, it is in a fixed indwelling state that cannot be avoided.

[0005] If the insertion portions of these instruments are bent, the insertion portions of a plurality of instruments concentrated on the treatment target site are appropriately displaced or retracted so that the visual field is prevented from being blurred as much as possible. it can. In addition, since the degree of freedom in the direction with respect to the treatment target portion can be given, the treatment operation ability is enhanced. As described above, if a treatment tool with a bent insertion portion can be used, a complicated operation under an endoscope can be performed easily and accurately, and the treatment operation ability can be enhanced.

Here, in order to be able to insert a treatment instrument having a bent insertion portion, at least the outer tube 1 of the trocar must be flexible as shown in FIG. Moreover, in order to smoothly pass the insertion portion 2 of the bent treatment instrument, the diameter of the insertion hole 4 in the hand portion (main body portion) 3 of the trocar must be increased. The valve 5 to be incorporated becomes large, and as a result, both the length L and the width D of the housing 6 of the hand portion 3 become considerably large.

When the trocar is actually used, a plurality of trocars are used at the same time. For this reason, there is a limit in increasing the diameter of the insertion hole 4 in the hand portion 3 of the trocar, and the curvature of the insertable treatment tool is limited.

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide a trocar device capable of easily inserting a hard instrument having a bent insertion portion and making the main body of the trocar compact. To provide.

[0009]

According to the first aspect of the present invention, there is provided an outer tube as an insertion portion, a housing connected to the proximal end of the outer tube, and a device for passing an instrument through the housing. In a trocar device including a hand main body portion incorporating a valve for maintaining airtightness in a body cavity, at least the outer tube and the housing are deformable according to insertion of a curved insertion portion of the instrument to be inserted. It is characterized by having. The invention according to claim 2 is the trocar device according to claim 1, wherein the housing has a moving portion that is deformable in a radial direction at or near a base end of the housing, and the moving portion is the instrument. Has an opening into which the insertion portion can be inserted. The invention according to claim 3 is the trocar device according to claim 2,
The mouth has valve means for closing the mouth by its own elastic force. The invention according to a fourth aspect is the trocar device according to the second aspect, wherein the moving portion is a bellows cylindrical portion. ADVANTAGE OF THE INVENTION According to this invention, while being able to insert easily even the hard instrument by which the insertion part was bent, the compactness of the hand main-body part can be achieved.

[0010]

FIG. 1 shows a first embodiment of the present invention. FIG. 1A shows the appearance of the trocar 11.
The trocar 11 includes an outer tube 12 as an insertion portion and a main body portion 13 attached to one end of the outer tube 12. The mantle tube 12 is formed from a deformable elastic tube.
The housing 14 of the main body 13 is also made of a deformable elastic material.

The housing 14 is formed in a substantially cylindrical shape, one end of which is narrowed, and the base end of the outer tube 12 is attached to this end. The other end of the housing 14 is formed relatively wide, and a cap-shaped base 15 is detachably fitted to the opening end using, for example, a screw 17. And
Through the hole 18 of the base 15, insertion portions of various instruments can be inserted.

A valve 20 for closing the opening of the hole 18 of the base 15 is attached to the base 15 with the inner end face portion serving as a valve seat. The valve 20 has one end attached to a fulcrum 21 and is closed by its own elasticity. Further, the valve 20 may be urged to be closed by an urging member such as a spring (not shown). As shown in FIG. 1B, the valve 20 is opened when pressed by an instrument inserted through the hole 18 of the base 15.

At the end of the cylindrical mouth portion 22 of the base 15, an elastic cap 23 which is elastically fitted and detachably attached is attached. The elastic cap 23 is the trocar 1
A slit or small hole 24 for airtightly inserting the insertion portion of various instruments used in 1 is formed.

The instrument used for the trocar 11 may be any of various instruments which have been used in the past. For example, as shown in FIG. A bent portion near the distal end of the insertion portion 26 can also be used as described later.

Next, a description will be given of a case where a laparoscopic cholecystectomy is performed using the trocar 11, for example. The technique of puncturing the trocar 11 into the abdominal cavity is the same as in the conventional method, in which the trocar 11 is insufflated using an insufflation needle, and the inner needle (not shown) is loaded to puncture the trocar 11 into the abdominal cavity. Usually, a plurality of trocars 11 are used.

Then, the inner needle is withdrawn from the trocar 11, and a laparoscopic device or a treatment tool is inserted as needed to perform the treatment. For example, the forceps 2 shown in FIG.
As shown in FIG. 5, one having a bent portion near the distal end of the insertion portion 26 can be easily used. That is, the valve 20 is inserted into the hole 18 of the base 15 through the slit or the small hole 24 of the elastic cap 23 to open and close the valve 20.
It is inserted into the mantle tube 12 as an insertion part through the inside.

As shown in FIG. 1B, the housing 14 and the base 15 of the main body 13 are both deformable when passing near the bent end of the insertion portion 26. Therefore, the curved insertion portion 2
Each of them follows and curves according to 6, and the curved insertion portion is easily inserted. In this way, trocar 1
The insertion part 26 having a curved portion by itself can be smoothly inserted. For this reason, the insertion hole and the valve in the hand main body 13 do not need to be enlarged, and therefore, it is not necessary to enlarge the housing 14 of the hand main body 13 of the trocar 11. As a result, the main body 1
Since both the length and the width of the trocars 3 are considerably small and can be made compact, when using a plurality of trocars 11 at the same time, the inconvenience that the hand main body portions 13 hardly interfere with each other and hinder the manipulation operation can be avoided as much as possible. Of course, the required curvature can be selected without limiting the curvature of the curved portion of the insertion portion of the insertable device.

FIG. 1C shows the field of view of a laparoscope when a cholecystectomy is performed using three forceps 25 having a bent portion near the distal end of the insertion portion 26. The operation is performed not from one direction but from a plurality of directions using three forceps 25. Since the plurality of mantle tubes 12 converging on the treatment target site are bent, each insertion portion 26 is appropriately displaced or retracted from the converging site, thereby avoiding blurring the visual field as much as possible. In addition, since the directionality of the insertion portion 26 with respect to the treatment target portion can be freely changed, the treatment operation ability is enhanced. As described above, if a treatment tool with a bent insertion portion can be used, a complicated operation under an endoscope can be performed easily and accurately, and the treatment operation ability can be enhanced.

FIGS. 2 to 4 show a second embodiment of the present invention. FIG. 2A shows the trocar 31.
3 shows a cross section . The trocar 31 includes a mantle tube 32 as an insertion portion and a hand main body portion 33 connected to one end of the mantle tube 32.
Consists of The mantle tube 32 and the main body 33 are integrally formed from a deformable elastic tube. A flange 34 is formed between the outer tube 32 and the main body 33.

The outer tube 32 as an insertion portion is a hollow 35 having a circular cross section as shown in FIG.
As shown in FIG. 3B, the hand main body 33 is a hollow 36 having an oval cross section.
Reference numeral 7 denotes a slit, which is usually airtightly closed.

Further, the elastic tube itself constituting the housing of the hand main body 33 is curved in the long axis direction of the hollow 36, that is, in a flat direction, as shown in FIG. Thus, the hand main body 33 is bent as a whole in the major axis direction as a radial direction of curvature. Compared to the inner peripheral length of the hollow 35 of the mantle tube 32, the hollow 3
The inner peripheral length of No. 6 is set long. The inner diameter of the hollow 35 of the mantle tube 32 is D, and the hollow 36 of the
Is flat width d, and flat width d is smaller than inner diameter D.

As described above, since the entire trocar 31 is integrally formed from the deformable elastic tube, even if the insertion portion is particularly bent as described above, even if the insertion portion is straight, the insertion portion may be straight. It can be easily inserted. That is, since the hand main body 33 is curved in the long axis direction of the hollow 36 as shown in FIG. 2A, the curved portion of the insertion portion 38 of the device may be inserted substantially along the curve. However, when inserting the straight portion of the insertion portion 38,
When the straight portion of the insertion portion 38 passes through the main body portion 33 at hand,
As shown in FIG. 2 (b), it passes through the bent main body portion 33 while being deformed so as to be close to a straight line.

At this time, since the hollow 36 of the hand main body 33 is flat, the insertion portion 38 having a diameter larger than the flat width d is used.
Then, it can be airtightly inserted into the hollow 36 of the hand main body 33. In other words, close contact with the right side of the wall in the portion close to the outer tube 32 as shown in in FIG. 4 (a), in the middle portion of the proximal body portion 33 as shown in FIG. (B), the upper
It is in close contact with the lower wall surface and has a slit shape at the base end opening 37 of the main body 33 as shown in FIG. ing. Therefore, the insertion portion 38 of the instrument is in close contact with the inner surface of the hand main body 33 over the entire length thereof, so that high airtightness can be maintained.

An instrument having an insertion portion 38 having a diameter from D to d can be hermetically inserted. of course,
Even if the diameter is smaller than d, airtightness at the slit portion is ensured at the base end opening 37, so that it can be inserted while maintaining airtightness. Instrument insertion section 3
When the tube 8 passes through the mantle tube 32, the tube 8 can be bent and inserted according to the bending. Thus, the trocar 31 can also be used, for example, for laparoscopic cholecystectomy, as described above.

FIGS. 5 and 6 show a third embodiment of the present invention. The trocar 41 has a mantle tube 42 as an insertion portion and a main body portion 4 attached to one end of the mantle tube 42.
3 The mantle tube 42 is formed of a deformable elastic tube as in the above-described embodiment. In addition, it has a thick cylindrical housing 44 of the hand main body 43, and this housing 44 is also formed of a deformable elastic material.

The housing 44 has a mantle tube 42 at one end thereof.
Is formed, and the outer tube 42 is attached to the cylindrical portion 45. A base 46 is formed at the other end of the housing 44, and a bellows-shaped cylindrical cap 47 that can be deformed and bent is fitted to the base 46. And
The cap 47 has an opening 48 into which insertion portions of various instruments are inserted.

The mouth 48 is provided with a valve 49 for closing the mouth. This valve 49 is connected at one end to a fulcrum 50.
The opening of the mouth portion 48 is closed by its own elasticity. Of course, the valve 49 may be closed by a biasing member such as a spring (not shown).
This valve opens when pushed by an instrument inserted through the mouth 48.

In the trocar 41 having this configuration, the outer tube 42 as an insertion portion and the housing 4 of the main body 43 at hand are provided.
Since the 4 and the cap 47 are configured to be elastically deformable, even an instrument such as an endoscope or a treatment tool having a considerably bent insertion portion can be easily inserted therethrough. Also,
The same operation and effect as those of the above embodiment can be obtained.

FIG. 7 shows a fourth embodiment of the present invention. In the trocar 51, as in the first embodiment described above, the outer tube 52 as an insertion portion and the housing 44 of the hand main body 53 connected to the outer tube 52 are formed of an elastic material that can be deformed together. Further, a seal valve 57 made of an elastic tube material 56 is attached to a base 55 attached to the other end of the housing 44. Seal valve 57
Is attached with one end thereof aligned with the insertion opening of the base 55. The other end of the elastic tube member 56 is formed with a slit-shaped closing portion 58.

Further, the base 55 is provided with an elastic cap 59 made of rubber, which is formed with a slit or a small hole 60 for airtightly inserting the insertion portion of various instruments to be used. The length of the base 55 is considerably shorter than the length of the base 15 in the above-described first embodiment, and is formed as short as possible.

FIG. 7B shows a normal state, and FIG. 7C shows a state in which the insertion portion 61 of the instrument is inserted. In the trocar 51 of this embodiment, as in the first embodiment described above, the outer tube 52 as an insertion portion and the housing 44 of the hand main body 53 connected to the outer tube 52 are formed of an elastic material that can be deformed together. Therefore, the instrument whose insertion portion 61 is curved can be easily inserted. Further, since the elastic tube material is used for the valve means, the configuration can be simplified and the weight and size can be reduced despite the fact that the insertion section 61 can insert a curved instrument.

FIG. 8A shows a modified example of the seal valve 57 in which a seal portion 63 which is normally closed is formed in an intermediate portion of an elastic tube member 56 forming the seal valve 57. According to this, since there are cylindrical portions on both sides of the seal portion 63,
For example, even with a treatment tool having a hook electrode, it is difficult for the hook electrode to be caught when it is pulled out.

FIG. 8 (b) shows a modification of the seal valve 57, in which an intermediate portion of the elastic tube member 56, which is formed on the outer tube side, that is, the inner end side, is narrowed. The portion 64 is formed.

FIG. 9 shows still another modification of the seal valve 57 in which an intermediate portion of an elastic tube member 56 forming the seal valve 57 is sandwiched by a pair of elastic wires 65 to form a seal portion 66. . Both ends of the pair of elastic wires 65 are supported by the housing 44 of the main body 53 at hand. The seal portion 66 is pushed open when the insertion portion of the instrument is inserted, and is inserted while maintaining the sealed state.

The present invention is not limited to the embodiment described above, and various other modifications can be made without departing from the gist of the present invention. Various instruments such as an endoscope, various treatment tools, and a catheter can be used as the instrument. In addition, the technique field to which the present invention is applied is not limited to, for example, examination and surgery of the abdominal cavity and thoracic cavity, but can be applied to general procedures using a trocar.

[0036]

As described above, according to the present invention, it is possible to provide a trocar which can easily insert a device having a bent insertion portion and can reduce the size of the main body at hand. Therefore, when this is actually used, the weight of each trocar can be reduced, and even if a plurality of trocars are used at the same time, the hand main body can be configured to be small,
Interference between the hand main bodies can be minimized, and the inconvenience that they interfere with each other and hinder the manipulation operation can be solved. Further, the curvature of the insertion portion of the instrument used by being inserted into the trocar is not limited. In addition, the present invention can be applied to various types of bends.

[Brief description of the drawings]

FIG. 1 is an explanatory view showing a first embodiment of the present invention.

FIG. 2 is a sectional view showing a second embodiment of the present invention.

3A is a cross-sectional view taken along line AA in FIG. 2A, FIG. 3B is a cross-sectional view taken along line BB in FIG. 2A, and FIG. Sectional drawing which follows the CC line | wire in (a) of FIG.

4A is a cross-sectional view taken along the line AA in FIG. 2B, FIG. 4B is a cross-sectional view taken along the line BB in FIG. 2B, and FIG. Sectional drawing which follows the CC line | wire in (b) of FIG.

FIG. 5 is a perspective view showing a third embodiment of the present invention.

FIG. 6 is a sectional view showing a third embodiment of the present invention.

FIG. 7 is a side view showing a fourth embodiment of the present invention.

FIG. 8A is a sectional view showing a modified example of the seal valve of the fourth embodiment, and FIG. 8B is a sectional view showing another modified example of the seal valve of the fourth embodiment.

FIG. 9 is a sectional view showing a modified example of the seal valve of the fourth embodiment.

FIG. 10 is a cross-sectional view showing a main part of a trocar for explaining a conventional problem.

[Explanation of symbols]

11: trocar, 12: mantle tube, 13: body part at hand,
14 ... housing, 31 ... trocar, 32 ... mantle tube,
33: body part at hand, 41: trocar, 42: mantle tube,
44 ... housing, 55 ... base.

──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Tsuruo Hatori 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Industrial Co., Ltd. (72) Akio Nakata 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Co., Ltd. (72) Inventor Tsuyoshi Tsukagoshi 2-43-2, Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Co., Ltd. Seiji Kuramoto 2-43-2, Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Co., Ltd. (72) Shuichi Kimura, Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Co., Ltd. Minoru Tsuruta 2-43-2, Hatagaya, Shibuya-ku, Tokyo (72) Inventor Yasuhiko Omagari 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus Hikari (72) Inventor Kenji Yoshino 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus Optical Industry Co., Ltd. (72) Inventor Keisuke Saito 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus (56) Reference US Pat. No. 4,978,334 (US, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 17/34 A61B 1/00

Claims (4)

(57) [Claims] 1. A main body incorporating an outer tube as an insertion portion, a housing connected to a proximal end of the outer tube, and a valve for passing an instrument through the housing and maintaining airtightness in a body cavity. A trocar device comprising: a trocar device, wherein at least the outer tube and the housing are deformable according to insertion of a curved insertion portion of the instrument to be inserted. 2. The trocar device according to claim 1, wherein a proximal end or a vicinity of the proximal end of the housing has a radially deformable moving portion, and the moving portion is an insertion portion of the instrument. With a mouth that can be inserted. 3. The trocar device according to claim 2, wherein the mouth has valve means capable of closing the mouth by its own elastic force. 4. The trocar device according to claim 2, wherein said moving portion is a bellows cylindrical portion.