JP3158948U - Relief aid for endoscopic surgery - Google Patents

Abstract

An object of the present invention is to provide an exclusion assisting material that facilitates exclusion when a grasping forceps is used for organ exclusion in endoscopic surgery.
A flat bag that wraps the grasping portion 22 with the forceps open is formed of gauze. The gauze bag is configured to pass through the trocar in a folded state, and has a mouth 6 and an inside, and is configured to open the inside by inserting the gripping portion 22 of the forceps that has passed through the trocar from the mouth. did. The mouth portion of the bag was made narrower than the inside of the bag so that the gripping portion of the forceps opened inside the bag would not come out. The mouth portion of the bag is provided with a knob 7 on the outside, and is configured to pass through the trocar in a state where the knob is grasped with forceps. The bag had a trapezoidal outer shape with a narrow mouth side.
[Selection] Figure 9

Description

  The present invention relates to an exclusion technique for changing the position, posture, and shape of an obstructing organ in order to secure a surgical field and a visual field in endoscopic surgery.

  In endoscopic surgery, a plurality of trocars and forceps are prepared. A trocar is a thin tube. The forceps includes a treatment portion at one end of a shaft and an operation portion at the other end. The trocar is inserted into the body cavity of the patient, and the inner end is placed inside the body cavity and the outer end is placed outside the body cavity. The forceps are inserted into the outer end of the trocar, and the treatment portion is protruded from the inner end of the trocar. The operating portion is projected from the outer end of the trocar. This forceps operates the operation part outside the body cavity to operate the treatment part inside the body cavity.

  When changing the position, posture, and shape of an organ that interferes with surgery, a grasping forceps that grips the organ may be used without using a dedicated tool for exclusion.

  In the grasping forceps, a treatment part to be inserted into a body cavity is used as a grasping part. The gripping part is attached to the end of the shaft so that two gripping bars can be opened and closed. When the two gripping bars are opened by the operation unit, they are opened in a V shape. When the closing operation is performed, it is closed in an I shape. The two grasping rods open and close in the body cavity to grasp the organ.

  When this grasping forceps is used for organ exclusion, the two grasping rods of the grasping part are opened in a V shape within the body cavity. The open gripping part presses the V-shaped surface against the organ. The organ is pushed by the grasping part and changes its position, posture and shape.

JP 2002-360582 A

[Task]
As described above, when the grasping forceps are used to exclude an organ, the grasping portion may slip relative to the organ. If the gripping part slips, it is difficult to perform the exclusion.
In addition, the grip portion may injure the organ. Not benevolent to organs. Furthermore, the gripper does not absorb blood or other body fluids that interfere with the operation.

[Idea]
Such a problem is due to the fact that the grasping portion of the forceps is made of metal and the metal grasping portion comes into contact with the organ. Then, when using it for the exclusion, the forceps gripping part came up with gauze and came into contact with the organ through the gauze. Cotton fabric gauze is difficult to slide against organs and is difficult to damage organs and absorbs blood and other body fluids.
However, the gripping portion of the forceps does not pass through the trocar when it is opened and covered with gauze. Cannot be brought into the body cavity.

Therefore, it was decided to form a flat bag that wraps the gripping part with the open forceps with gauze. The gauze bag is made of foldable gauze and becomes foldable. This flat bag can pass through the trocar in a folded state.
The gauze bag is grasped with forceps, bent, passed through the trocar, and brought into the body cavity. Further, the grasping portion of another forceps is projected into the body cavity through another trocar.
In the body cavity, the gauze bag grasped with the forceps is unfolded from the folded state, and the grasping portion closed with the other forceps is inserted into the gauze bag. And the holding part of the forceps covered with the gauze bag is opened in the gauze bag. The forceps that have gripped the gauze bag open the grip and release the gauze bag. The forceps opened by putting the gripping part in a gauze bag are used for exclusion. The gauze bag serves as an exclusion aid.

In other words, the exclusion assisting material is a gauze and constitutes a flat bag that wraps the gripping part where the forceps are opened. The gauze bag is configured to pass through the trocar in a folded state. Further, the gauze bag has a mouth and an inside, and is configured so that the gripping portion closed by the forceps that has passed through the trocar is inserted from the mouth and opened inside.
Moreover, the exclusion assisting material makes the mouth of the bag narrower than the inside of the bag. The gripping part of the forceps opened inside the bag is not pulled out.
Further, the exclusion assisting material is provided with a knob on the outside of the mouth of the bag. It is configured to pass through the trocar in a state where the knob is grasped with forceps. When the mouth portion of the bag is grasped with forceps, it becomes difficult to insert the grasping portion of the forceps.
Moreover, the exclusion assisting material makes the outer shape of the bag a trapezoidal shape with a narrow mouth side. The outer portion of the mouth portion is smaller than that of the rectangular shape. The outer part may hang down during retraction. There are fewer parts that sag during the exclusion and obstruct the operative field and visual field.
Further, the exclusion assisting material shifts one of the edge of the front side gauze and the edge of the back side gauze in the insertion direction from the other in the mouth portion of the bag. It becomes easy to insert the grasping portion of the forceps.
The exclusion assisting material is attached with an X-ray contrast yarn. Easy to find when left in the body cavity.

1) Use gauze to form a flat bag that wraps the gripping part where the forceps are opened,
The gauze bag is configured to pass through the trocar in a folded state, has a mouth and an interior, and is configured to open the inside by inserting the closed gripping portion of the forceps that has passed through the trocar from the mouth. Relief aid for endoscopic surgery characterized by
2) In the above-mentioned exclusion auxiliary material,
The mouth portion of the bag is narrower than the inside of the bag so that the gripping portion of the forceps opened inside the bag cannot be pulled out.
3) In the above-mentioned exclusion auxiliary material,
The mouth portion of the bag is characterized in that a knob portion is provided on the outside, and the knob portion is configured to pass through the trocar while being gripped with forceps.
4) In the above-mentioned exclusion auxiliary material,
The bag is characterized in that the outer shape is trapezoidal on the mouth side.
5) In the above-mentioned exclusion auxiliary material,
The mouth portion of the bag is characterized in that one of the edge of the front side gauze and the edge of the back side gauze is shifted in the insertion direction from the other.
6) In the above-mentioned exclusion auxiliary material,
The bag is characterized by an X-ray contrast thread.

  The exclusion assisting material facilitates exclusion when the grasping forceps are used for organ exclusion in endoscopic surgery.

The front view of the exclusion auxiliary material for endoscopic surgery in the 1st example of embodiment of this invention. The rear view of the exclusion assisting material for the same endoscopic surgery. The conceptual diagram which shows the folding structure of the gauze in the AA line cross section of FIG. The conceptual diagram which shows the folding structure of the gauze in the BB line cross section of FIG. The figure which shows the 1st process of folding the gauze of the same pressure exclusion auxiliary material. The figure which shows the 2nd process of the folding. The figure which shows the 3rd process of the folding. The figure which shows the 4th process of the folding. The front view which shows the usage method of the same pressure exclusion auxiliary material. The front view of the exclusion auxiliary material for endoscopic surgery in the 2nd example of embodiment. The conceptual diagram which shows the folding structure of the gauze in the CC sectional view of FIG.

[First example (see FIGS. 1 to 9)]
As shown in FIGS. 1 to 4, the exclusion assisting material for endoscopic surgery of this example has a front side gauze 1 and a back side gauze 2 overlapped. The gauze 1 and 2 on both sides are each trapezoidal. The trapezoidal gauze 1, 2 has a left edge and a right edge inclined in a C shape, an upper edge and a lower edge are parallel, and an upper edge is shorter than a lower edge. The height in the vertical direction is longer than the width in the horizontal direction.

  The front-side gauze 1 and the back-side gauze 2 are connected at the lower edge with the lower edge being a fold of the gauze. The gauze 1 and 2 on both sides are formed into bags by sewing both left and right sides into a C shape with a thread. The portion between the left side seam 3 and the right side seam 4 of the C-shape is the interior 5 of the bag. The upper end of the inside 5 of the bag is the mouth 6 of the bag. The bags of gauze 1 and 2 are made flat and bendable.

  The inside 5 of the bag has a trapezoidal shape with a narrow opening 6 side. The bag mouth 6 is narrower in the left-right direction than the bag interior 5. The outer shape of the bag is a trapezoidal shape on the mouth 6 side.

  The mouth portion 6 of the bag has the upper edge of the front side gauze 1 shifted from the upper edge of the back side gauze 2 in the insertion direction. At the mouth portion 6 of the bag, the upper end portion of the inner surface of the back side gauze 2 is exposed on the front side.

  A portion between the left edge of the gauze 1 and 2 on both sides and the left stitch 3 is a knob 7. A portion between the right edge of the gauze 1 and 2 on both sides and the right seam 4 is also a knob 7. That is, the knob portions 7 are provided on the left and right outer sides of the mouth portion 6 of the bag. The knob portion 7 is elongated along the seams 3 and 4 and narrows in the left-right direction as it approaches the lower edge.

  An X-ray contrast yarn 8 is sewn to the stitch 4 on the right side of the front gauze 1 with a cotton yarn.

  This exclusion assisting material is made by using a gauze of a cotton fabric as a raw material, and undergoes a gauze cutting process, a folding process, and a sewing process.

  As shown in FIG. 5, the raw material gauze 11 is cut into an elongated rectangular shape. The rectangular gauze 11 is folded substantially in half by folding approximately half on one end side and approximately half on the other end side on the same side at the fold line 12 of the transverse line. Then, as shown in FIG. 6, the gauze 11 is in a state where the double portion on one end side and the double portion on the other end side are connected by a single portion.

  Next, the double part on the one end side of the rectangular shape folds the left and right sides on the same side along the hatched folding line 13. The double part on one end side is trapezoidal. In addition, the left and right side portions of the double portion on the other end side are also folded on the same side along the oblique folding lines 13. The double part on the other end side is also trapezoidal. Then, as shown in FIG. 7, the trapezoidal portion that becomes the front-side gauze 1 and the trapezoidal portion that becomes the back-side gauze 2 are connected at the bottom of the trapezoidal shape.

  Next, the trapezoidal portions on both sides are folded at a fold line 14 of a transverse line at the base position to be almost folded in half. Then, as shown in FIG. 8, the trapezoidal front side gauze 1 and the back side gauze 2 overlap. The front-side gauze 1 and the back-side gauze 2 in which the gauze 11 is doubled are connected at the lower edge where the gauze 11 is in a single layer. The upper edge of the front side gauze 1 is located slightly below the upper edge of the back side gauze 2.

  The front-side gauze 1 and the back-side gauze 2 that are overlapped in this way are sewn together with cotton thread to produce bags. An X-ray contrast thread 8 is sewn with a cotton thread to the right stitch 4 of the front gauze 1.

  In the embodiment, the exclusion assisting material has a vertical height of about 5 cm and a horizontal width of about 4 cm. The inner diameter of the trocar through which it can pass is about 10 mm or more.

  When the exclusion assisting material of this example is used in an endoscopic operation, the gripping portion 7 on one side of the exclusion assisting material is grasped by the grasping portion 21 of the forceps for bringing in. At this time, as shown in FIG. 9 (1), the forceps gripping portion 21 is substantially aligned with the insertion direction of the bag mouth 6, and the wide portion of the knob 7 and the portion of the bag mouth 6 side are arranged. grab. This exclusion assisting material is bent and wound around the grasping portion 21 of the forceps to form an elongated shape. In that state, the trocar is passed and brought into the patient's body cavity. Then, the exclusion assisting material is expanded from the bent state by an elastic force and restored to a flat state. On the other hand, through another trocar, the other forceps and the gripping portion 22 of the forceps for exclusion are protruded into the body cavity.

  In the body cavity, as shown in FIG. 9 (2), the gripping portion with the exclusion forceps closed from the mouth portion 6 of the relief assisting material gripped by the holding forceps gripping portion 21 to the inside 5 of the bag. 22 is inserted. Next, as shown in FIG. 9 (3), the grasping portion 22 of the forceps for exclusion covered with the bag of the exclusion assisting material is opened inside the bag 5. The gripping part 21 of the forceps for bringing in is opened and the exclusion assisting material is released. The forceps for exclusion press the grasping portion 22 in an open state wrapped with an exclusion assisting material against the organ, and exclude the organ. The organ is in contact with the front side gauze 1 or the back side gauze 2 of the exclusion assisting material. The exclusion assisting material is difficult to slide with respect to the organ, hardly damages the organ, and absorbs blood and other body fluids.

  The gripping portion 22 of the forceps for exclusion is the inside 5 of the bag of the exclusion assisting material, and when the two gripping bars are opened in a V shape, the ends of both gripping bars are in contact with the left and right ends of the bottom of the interior 5 of the bag. In the forceps for exclusion, the exclusion assisting material does not fall off while the grip portion 22 is opened.

  After completion of the exclusion, the grasping portion of the forceps for removal is brought into the body cavity through the trocar. In the body cavity, the grasping portion of the removal forceps grasps the exclusion assisting material covering the grasping portion 22 of the exclusion forceps. The grasping portion 22 of the forceps for exclusion is closed in an I-shape inside the bag 5 of the exclusion assisting material. The exclusion assisting material is extracted from the gripping portion 22 closed with the forceps for exclusion. The grasping portion of the forceps for taking out makes the grasping exclusion assisting material bend and takes it out of the body cavity through the trocar.

[Second example (see FIGS. 10 and 11)]
As shown in FIG. 10 and FIG. 11, the exclusion assisting material for endoscopic surgery of this example is configured such that the front side gauze 1 and the back side gauze 2 are different gauze.

  The trapezoidal front side gauze 1 and the back side gauze 2 are not connected to each other at the lower edge, and are sewn together with a cotton thread 31 along the lower edge. A seam 31 appears at the lower end in parallel with the lower edge.

  Other points are the same as in the first example. Parts similar to those in the first example are denoted by the same reference numerals as those in the first example.

[Modification]
1) In the above-described embodiment, the front side gauze 1 and the back side gauze 2 of the exclusion assisting material are double and quadruple, but are single or triple.
2) In the above embodiment, the knobs 7 are provided on both the left and right sides of the mouth part 6 of the bag, but are provided only on the left side or the right side of the mouth part 6 of the bag.
3) In the above-described embodiment, the X-ray contrast thread 8 is attached to the stitch 4 on the right side of the front side gauze 1, but is attached to other positions of the front side gauze 1. Or attach to the back gauze 2.

DESCRIPTION OF SYMBOLS 1 Front side gauze 2 Back side gauze 3 Left side stitch 4 Right side seam 5 Bag interior 6 Bag mouth part 7 Knob part 8 X-ray contrast thread 11 Raw material gauze 12 Cross line fold line 13 Diagonal line fold line 14 Folding line of transverse line 21 Grasping part 22 for bringing in forceps Grasping part 31 of forceps for extruding Cotton thread, seam

Claims (6)

With gauze, make up a flat bag that wraps around the open gripping part of the forceps,
The gauze bag is configured to pass through the trocar in a folded state, has a mouth and an interior, and is configured to open the inside by inserting the closed gripping portion of the forceps that has passed through the trocar from the mouth. Relief aid for endoscopic surgery characterized by   2. The exclusion assist for endoscopic surgery according to claim 1, wherein the mouth portion of the bag is narrower than the inside of the bag so that the gripping portion of the forceps opened inside the bag does not come out. Wood.   The mouth portion of the bag is configured to pass through the trocar in a state where a knob portion is provided on the outer side and the knob portion is gripped by forceps. Exclusion aid.   The exclusion assisting material for endoscopic surgery according to claim 1, 2, or 3, wherein the bag has a trapezoidal outer shape with a narrow mouth side.   5. The exclusion assist for endoscopic surgery according to any one of claims 1 to 4, wherein one of the front gauze edge and the back gauze edge is shifted from the other in the insertion direction of the mouth of the bag. Wood.   The exclusion assisting material for endoscopic surgery according to any one of claims 1 to 5, wherein the bag is provided with an X-ray contrast yarn.

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