JP4253656B2 - Absorptive material for endoscopic surgery and its manufacturing method - Google Patents

Description

  The present invention relates to an absorbent material with an X-ray contrast thread used in endoscopic surgery, and relates to a woven gauze or nonwoven absorbent material that absorbs blood or other body fluids.

[Endoscopic surgery]
Endoscopic surgery uses gauze that absorbs bodily fluids, forceps that grip the gauze, trocar that passes forceps that grip the gauze, and the like in order to wipe blood or other body fluids in the body cavity. A trocar is a thin tube having a circular cross section and is inserted into a body cavity from outside the human body. The gauze with X-ray contrast thread is inserted into the body cavity with forceps through the trocar of the capillary tube, and is taken out of the human body from the body cavity.

  To describe the abdominal endoscopic operation in detail, the endoscope and trocar are inserted into different positions in the patient's abdomen. In the trocar, the distal end side is inserted into the abdomen of the patient, the distal end opening is disposed in the abdominal cavity, and the proximal end opening is disposed outside the abdomen. A forceps in which the gauze with an X-ray contrast thread is gripped by the grip portion at the tip is inserted into the trocar from the proximal end opening, and the forceps in the trocar are advanced. The gauze with an X-ray contrast thread protrudes from the opening of the tip of the trocar, enters the abdominal cavity, and is immersed in a body fluid such as blood flowing out into the abdominal cavity. Abdominal body fluid is absorbed by the gauze with X-ray contrast thread.

  Thereafter, the gauze with X-ray contrast thread that sucks in the body fluid of the abdominal cavity is grasped by the grasping portion of the forceps protruding from the opening of the distal end of the trocar while being viewed with the endoscope inserted into the abdominal cavity, and the forceps in the trocar are retracted. The gauze with X-ray contrast yarn containing the body fluid is drawn into the trocar from the opening of its tip. Next, the grasping forceps grasping the gauze with the X-ray contrast thread containing the body fluid is further retracted and extracted from the trocar. The gauze with X-ray contrast yarn containing the body fluid is drawn out from the inside of the trocar through its proximal end opening and taken out of the abdomen.

[Gauze with X-ray contrast yarn]
First prior art (Japanese Patent Laid-Open No. 2002-52038)
In the gauze with an X-ray contrast yarn for endoscopic surgery, an X-ray contrast yarn is woven as a warp yarn in a gauze of a woven cotton yarn. The gauze is cut into strips of dimensions that pass through the trocar. The X-ray contrast yarn is arranged along the long side direction at the center position in the short side direction of the gauze. In order to prevent the X-ray contrast yarn from falling off the gauze, the X-ray contrast yarn is a thermoplastic resin yarn, and one or several of the X-ray contrast yarns are heat-sealed to the gauze cotton yarn.

Second prior art (Japanese Patent Laid-Open No. 2002-238934)
For other gauze with X-ray contrast yarn for endoscopic surgery, non-woven fabric, X-ray contrast yarn, fiber sliver or woven gauze is supplied and stacked in a desired order on a belt conveyor, and the laminate is thickened. The laminated body is integrated by spraying water in the vertical direction to entangle the fibers. The laminate is cut into strips with dimensions that pass through the trocar. The X-ray contrast yarn is sandwiched between the nonwoven fabric on both sides of the laminate and the nonwoven fabric or the nonwoven fabric and gauze, and is disposed along the long side direction of the laminate.

Japanese Patent Laid-Open No. 2002-52038 JP 2002-238943 A

[Task]
When gauze for endoscopic surgery is immersed in a body fluid such as blood flowing into a body cavity, it absorbs the body fluid and becomes the same color as the body fluid, and also absorbs the body fluid and sinks into the body fluid. Then, the gauze with an X-ray contrast thread immersed in the body fluid of the body cavity is difficult to find with an endoscope inserted into the body cavity. The gauze with an X-ray contrast thread that cannot be seen with an endoscope is difficult to grasp with forceps. It is difficult to take it out of the body cavity. There is a high risk of leaving it in the body cavity.

  Endoscopic surgical gauze, especially woven gauze, when immersed in body fluids such as blood in a body cavity, absorbs body fluids, loses its waist, forms a complicated curve, and forms a lump. Then, it is almost impossible to find a position or a portion desired to be grasped with forceps from a gauze which is soaked in body fluid and formed into a lump with an endoscope inserted into a body cavity.

  When gauze for endoscopic surgery is taken out of the body cavity, it is squeezed with the trocar when it is grasped by the grasping part of the forceps protruding from the opening of the trocar in the state of sucking the body fluid in the body cavity and pulled into the trocar. A part of the sucked body fluid is squeezed out and returned to the body cavity. The amount of body fluid that returns to the body cavity varies depending on the position or part of the gauze picked up by the forceps. The smaller the amount of body fluid squeezed from the gauze and returning to the body cavity, the better the body fluid wiping efficiency.

[Idea and research]
1) In a gauze with an X-ray contrast yarn, a woven gauze or a non-woven fabric is an absorbent material, absorbs blood or other body fluid, becomes the same color as the body fluid, and loses waist. The X-ray contrast yarn is a synthetic resin yarn such as polyvinyl chloride, polypropylene or polyester containing a contrast agent barium sulfate. It is a thread that does not absorb bodily fluids such as blood, does not have the same color as bodily fluids, and does not lose its waist.

  However, in the first prior art, the X-ray contrast yarn is a warp of woven gauze and intersects with the weft. When the woven gauze absorbs a body fluid such as blood, the X-ray contrast yarn is hidden in the woven gauze having the same color as the body fluid. In the second prior art, the X-ray contrast yarn is covered with a woven gauze or a non-woven fabric. When the woven gauze or the nonwoven fabric absorbs the body fluid, the X-ray contrast yarn is hidden in the woven gauze or the nonwoven fabric having the same color as the body fluid. That is, the X-ray contrast yarn is hidden by the adjacent woven gauze or non-woven fabric.

Therefore, When mounting the X-ray opaque filament woven fabric gauze or non-woven absorbent material, X-ray opaque filament is, it was decided to protrude from the absorption material. Collision detection section of the X-ray opaque filament is positioned away from the absorbent material, even if the absorbent material becomes fluid absorbed by the body fluid of the same color, such as blood, found easily.

In attaching the X-ray contrast yarn to the absorbent material, the X-ray contrast yarn is sewn to the absorbent material as an upper thread or a lower thread of the sewing thread . This sewing operation can be performed with high efficiency using an industrial sewing machine.

  2) When wiping body fluids such as blood in a body cavity with gauze for endoscopic surgery, according to the study of the present inventor, the strip-shaped gauze grasps the central position in the long side direction or the short side direction with forceps. Then, when the trocar is pulled into the trocar from its distal end opening, when passing through the distal end opening of the trocar, the resistance is greatly squeezed and the body fluid sucked into the gauze is squeezed out and the amount returned to the body cavity increases. The amount of body fluid wiped off is reduced.

  On the other hand, a strip-shaped gauze can be squeezed strongly by holding the corner where the long and short sides intersect with forceps and pulling it into the trocar from the tip opening, reducing the resistance through the tip opening of the trocar. Therefore, the amount of body fluid squeezed from the gauze and the amount of body fluid returning to the body cavity are reduced. The amount of body fluid wiped off from the body cavity is increased.

  Therefore, when the strip-shaped gauze sucking the body fluid in the body cavity is taken out of the body cavity, the corners thereof are held with forceps.

  3) If a strip-shaped absorbent material into which body fluid such as blood in a body cavity has been sucked is grasped by a forceps, then a method of finding the corner of the absorbent material to be picked by the forceps becomes a problem.

X-ray opaque filament protruding from the absorbent material, as described above, even if the absorbent material absorbs body fluid, the because is easy to find, hitting the projects from absorption material, protruding from the corner portion of the absorption material It was decided.

Butt out of the X-ray contrast thread is to find easy, and go down the collision detection section, will reach the corner of the absorption material. That is, it is easy to find the corner of the absorbent material to be grasped with the forceps.

1) In an absorbent material for endoscopic surgery that has a strip shape that passes through a trocar by attaching an X-ray contrast thread that does not absorb blood or other body fluid to an absorbent material that absorbs blood or other body fluids .
X- ray contrast threads protrude from the corners of the absorbent material,
Absorbing material, the corners X-ray opaque filament is projected is grasped with forceps you characterized in that the arrangement passing through the trocar.
2) In the above-described absorbent material for endoscopic surgery,
The X-ray contrast yarn is characterized by protruding from the corners at both ends of the absorbing material.
3) In the above-mentioned absorbent material for endoscopic surgery,
The X-ray contrast yarn is attached to a diagonal position of the absorbing material.
4) In a method for manufacturing an endoscopic surgical absorbent material in a strip shape that passes through a trocar by attaching an X-ray contrast thread that does not absorb blood or other body fluid to the absorbent material that absorbs blood or other body fluid. ,
The X- ray contrast thread is sewn into the absorbent material as an upper thread or lower thread of the sewing thread, and protrudes from the corner of the absorbent material.
Absorbing material, the corners X-ray opaque filament is projected is grasped with forceps you characterized in that the structure to pass through the trocar.

In endoscopic surgical absorbent material, X-rays opaque filament which does not absorb blood or other body fluid is projected from the absorption material. The collision detection section is located away from the absorbent material, even if absorbent material to absorb body fluids, such as body cavity of blood, easy to wear look. That is, it is easy to find an absorbent material that has absorbed body fluid with an endoscope. The absorbent material is less likely to be left in the body cavity .

Furthermore, X-rays opaque filament protrudes from the corner of the absorption material. And go down the collision detection section, will reach the corner of the absorption material. Easy to find the corners of the absorption material. When the corner portion is gripped with forceps and the absorbent material that has absorbed the body fluid in the body cavity is drawn into the trocar, the body fluid is not squeezed strongly, the amount of body fluid squeezed out by the trocar is small, and the body fluid in the body cavity is wiped off. That is, the efficiency of wiping off body fluid from the body cavity is increased.

[First example (see FIGS. 1 to 3)]
As shown in FIG. 1 and FIG. 2, the absorbent material for endoscopic surgery of this example is sewn as a sewing thread with an X-ray contrast thread 5 as a sewing thread at the diagonal position of the elongated rectangular or strip-shaped absorbent material 1. Both ends of the X-ray contrast yarn 5 protrude from the corners of the strip-shaped absorbent material 1.

  The absorbent material 1 is a cotton fabric woven gauze 2 that absorbs blood or other body fluids. As shown in FIGS. 2 and 3, the rectangular woven gauze 2 is folded inward at three parallel fold line positions 3 to form a quadruple and elongated rectangle. As shown in FIGS. 1 and 2, the quadruple elongated rectangular woven gauze 2 is sewn with a cotton thread 4 along the peripheral four sides to integrate the quadruple woven gauze. The absorbent material 1 is dimensioned to pass through the trocar.

  In Example 1, the absorbent material 1 has a dimension of about 3 × 15 cm. The warp and weft yarns of the woven gauze 2 are 40th cotton yarns, and the yarn density is about 12 / cm.

  The X-ray contrast yarn 5 is a synthetic resin yarn that does not absorb blood or other body fluids. It is a thread made of polyvinyl chloride, polypropylene, polyester, or the like containing barium sulfate as a contrast agent. In an industrial straight-stitch sewing machine, the diagonal position of the strip-shaped absorbent material 1 is straight-stitched with the X-ray contrast thread 5 and the cotton thread 6 as the upper thread and lower thread of the sewing thread. When the X-ray contrast thread 5 sewn on the absorbent material 1 is cut, a non-sewn portion of the X-ray contrast thread 5 remains in the absorbent material 1. The non-sewn portions at both ends of the X-ray contrast thread 5 are projected from the corners of the strip-shaped absorbent material 1, respectively.

  In Example 1, the X-ray contrast yarn 5 is a yarn having no affinity for blood or other body fluids. This is a polypropylene thread containing the contrast agent barium sulfate. The thickness of the yarn 5 is 0.6 to 0.8 mm. The length of each end of the yarn 5 protruding from the corner of the absorbent material 1 is about 2 cm.

A trocar having an inner diameter of 10 mm or more is recommended for the absorbent material for endoscopic surgery in Example 1.
In endoscopic surgery, the absorbent materials 1 and 5 for endoscopic surgery are grasped with forceps, put into a body cavity through a trocar, and immersed in a body fluid such as blood flowing out into the body cavity. Thereafter, the absorbent material 1 that has absorbed the body fluid in the body cavity is grasped with forceps while drawing the end portion of the X-ray contrast thread 5 while being viewed with an endoscope, and is drawn into the trocar from its distal end opening. Then, the endoscopic surgical absorbent materials 1 and 5 have a small resistance to pass through the trocar tip opening and are not squeezed strongly. The amount of body fluid that is squeezed out of the absorbent material 1 and returns to the body cavity is small. The absorbent materials for endoscopic surgery 1 and 5 that have absorbed the body fluid are taken out of the human body from the trocar. Large amount of body fluid wiped off.

[Second Example (see FIGS. 4 to 6)]
As shown in FIG. 4 and FIG. 5, the absorbent material for endoscopic surgery in this example is sewn with a X-ray contrast thread 5 as a sewing thread at the diagonal position of the rectangular or strip-shaped absorbent material 11, Both ends of the line contrast yarn 5 protrude from the corners of the strip-shaped absorbent material 11.

  The absorbent material 11 is a cotton fabric gauze 12 that absorbs blood or other body fluids. As shown in FIGS. 5 and 6, the rectangular woven gauze 12 is folded in two at a fold line position 13 at the center position, folded inward at three parallel fold line positions 14, and eight-folded. It is in the shape. As shown in FIGS. 4 and 5, the eight-fold rectangular woven gauze 2 is sewn with a cotton thread 15 along the four sides of the periphery to integrate the eight-fold woven gauze. The absorbent material 11 is dimensioned to pass through the trocar.

  In Example 2, the absorbent material 11 has a dimension of about 5 × 7.5 cm. The warp and weft yarns of the woven gauze 12 are 40th cotton yarns, and the yarn density is about 12 / cm.

  The X-ray contrast yarn 5 is a synthetic resin yarn that does not absorb blood or other body fluids and has no affinity for body fluids. It is a thread made of polyvinyl chloride, polypropylene, polyester, or the like containing barium sulfate as a contrast agent. The same as in the first example.

A trocar having an inner diameter of 10 mm or more is recommended as the absorbent material for endoscopic surgery in Example 2.
In endoscopic surgery, the absorbent materials 11 and 5 for endoscopic surgery are the same as in the first example, while the absorbent material 11 absorbs bodily fluids such as blood in a body cavity, and then looks through the endoscope. Then, the corner of the absorbent material 11 from which the end of the X-ray contrast thread 5 protrudes is grasped with forceps and is taken out of the human body through the trocar. Large amount of body fluid wiped off.

[Experimental example (see FIGS. 7 and 8)]
The absorbent material for endoscopic surgery is pulled from the opening of the distal end of the X-ray contrast yarn into the synthetic resin tube that looks like a trocar by pulling the protruding end portion of the X-ray contrast yarn at a constant speed. At that time, the maximum value of the pulling force of the absorbent material is measured. Its maximum tensile force is proportional to the resistance through the trocar tip opening. It is inferred to be inversely proportional to the amount of body fluid squeezed from the absorbent material.

  As shown schematically in FIG. 7 (a), the endoscopic surgical absorbent materials 1 and 5 of Example 1 are immersed in physiological saline p that looks like blood in a body cavity or other body fluid. The absorbent material 1 absorbs physiological saline p. The physiological saline p has a concentration of 0.9%. The end of the X-ray contrast yarn 5 protruding from the corner of the absorbent material 1 is connected to one end of the string r. The other end of the string r is connected to the winding mechanism of the tensile tester e through a synthetic resin tube t having an inner diameter of 9 mm, which looks like a trocar. The tensile tester e operates and pulls the string r at a constant speed of 30 cm / min. Record the maximum value of tensile force.

  As shown schematically in FIG. 7B, the endoscopic surgical absorbent material of the comparative example has diagonal positions corresponding to the attachment position of the X-ray contrast yarn 5 in the endoscopic surgical absorbent material of Example 1. To the middle position in the short side direction. The absorption material of the comparative example also records the maximum value of the tensile force under the same conditions as those of Example 1.

  The absorbent material 1 of Example 1 and the comparative example is a quadruple woven gauze as described in the first example of the embodiment, and has a rectangular shape of 3 × 15 cm.

  For the absorbent materials 1 and 5 of Example 1 and the absorbent material of the comparative example, the maximum value of the tensile force was measured 5 times. For the five measured values, an average value and a standard deviation were calculated. The result is as shown in FIG. For the absorbent material of Example 1, the maximum tensile force has an average value of 0.87 [N] and a standard deviation of 0.13. For the absorbent material of the comparative example, the maximum tensile force has an average value of 2.0 [N] and a standard deviation of 0.16. Therefore, the absorbent material of Example 1 has a maximum tensile force less than half that of the comparative example, and the resistance to pass through the tip opening of the synthetic resin tube t is very small.

  With respect to the absorbent materials 11 and 5 of Example 2 and the absorbent material of the comparative example, an attempt was made to measure the maximum tensile force. However, the absorbent material of Example 2 passed through the synthetic resin tube t, but the absorbent material of the comparative example could not pass through because it was difficult to enter the synthetic resin tube t.

  As described in the second example of the embodiment, the absorbent material 11 of Example 2 and the comparative example is an eight-fold woven gauze having a rectangular shape of 5 × 7.5 cm.

[Modification]
1) In the first example and the second example of the embodiment, the position where the end portion of the X-ray contrast yarn 5 protrudes from the absorbent materials 1 and 11 is two, but it is one, three, or four. .
2) In the first example and the second example of the embodiment, the two corners of the absorbing materials 1 and 11 from which both ends of the X-ray contrast yarn 5 protrude are diagonal positions of the absorbing materials 1 and 11. The both ends of the long sides of the absorbent materials 1 and 11 are positioned. Or, it is set to both end positions of the short side.
3) In the first example and the second example of the embodiment, when attaching the X-ray contrast thread 5 to the absorbent materials 1 and 11, the X-ray contrast thread 5 is sewn as a top thread or a lower thread of the sewing thread. The X-ray contrast thread is sewn with a sewing thread. Alternatively, an X-ray contrast yarn is welded. Alternatively, the X-ray contrast yarn is woven as warp or weft.
4) In the first example and the second example of the embodiment, the absorbent materials 1 and 11 have a laminated structure of 4 layers and 8 layers by folding the woven gauze 2 and 12 into 4 or 8 layers. A sheet of woven gauze is not folded, but is cut into strips of dimensions that pass through the trocar to form a single non-laminated structure.
5) In the first example and the second example of the embodiment, the absorbent materials 1 and 11 are composed of woven gauze 2 and 12, but are composed of a nonwoven fabric that absorbs blood or other body fluids.

  INDUSTRIAL APPLICABILITY The present invention is an absorbent material with an X-ray contrast yarn used in endoscopic surgery, and is used for a woven cloth gauze or a non-woven cloth absorbent material.

The front view of the absorption material for endoscopic surgery in the 1st example of embodiment of this invention. FIG. 2 is a schematic end view taken along line AA in FIG. 1. Development view of the woven gauze made of the same absorbent material. The front view of the absorption material for endoscopic surgery in the 2nd example of embodiment. FIG. 5 is a schematic end view taken along the line BB in FIG. 4. Development view of the woven gauze made of the same absorbent material. It is a schematic diagram of the condition which measures the tension | pulling force which draws an absorption material in a pipe | tube, (a) shows the condition about an Example, (b) shows the condition about a comparative example. The graph which shows the measurement result of maximum tensile force.

Explanation of symbols

1 Absorbing material
2 Woven gauze of cotton yarn
3 Folding line position
4 Cotton yarn
5 X-ray contrast yarn
6 Cotton yarn
11 Absorbing material
12 Woven gauze of cotton yarn
13, 14 Folding line position
15 Cotton yarn
p physiological saline
r string
t Synthetic resin pipe
e Tensile tester

Claims (4)

In an absorbent material for endoscopic surgery that is attached to an absorbent material that absorbs blood or other bodily fluids, is attached with an X-ray contrast thread that does not absorb blood or other bodily fluids, and has a strip shape that passes through a trocar .
X- ray contrast threads protrude from the corners of the absorbent material,
An absorbent material for endoscopic surgery characterized in that the absorbing material is configured to pass through the trocar by grasping the corner from which the X-ray contrast thread protrudes with forceps. The absorbent material for endoscopic surgery according to claim 1, wherein the X-ray contrast yarn protrudes from corners at both ends of the absorbent material. The absorbent material for endoscopic surgery according to claim 1 or 2, wherein the X-ray contrast yarn is attached at a diagonal position of the absorbent material. In a method for manufacturing an absorbent material for endoscopic surgery in a strip shape that passes through a trocar by attaching an X-ray contrast thread that does not absorb blood or other body fluid to an absorbent material that absorbs blood or other body fluid ,
The X- ray contrast thread is sewn into the absorbent material as an upper thread or lower thread of the sewing thread, and protrudes from the corner of the absorbent material.
A method for producing an absorbent material for endoscopic surgery, characterized in that the absorbent material is configured such that a corner portion from which an X-ray contrast thread protrudes is grasped with forceps and passes through a trocar.

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