JP4917176B1 - Minimally invasive excisional tissue collection device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To minimize the invasion to a living body, enable the operation of recovering the excised tissue piece without interfering with the excision procedure of the living tissue, and efficiently excise the excised tissue piece without contaminating the surgical field due to the residual tissue piece. An ablation tissue collection device for removal is provided.
An excised tissue piece collection device 100 includes a distal end portion 110, a tube portion 120, and a hand operating mechanism 130, and can be introduced percutaneously into a surgical field in the same manner as a laparoscopic device. It has become. In the surgical field, the opening / closing mechanism of the distal end portion 110 expands the diameter and surface area of the wall surface structure 111 having a bellows structure or the like (cavity diameter expansion state). The side wall surface of the tip portion 110 is in a state of being greatly opened by folding the bellows structure (cavity deployed state). Tumors removed by the ablation device are successively taken into the cavity 112 inside the distal end portion 110. At an appropriate timing, the opening / closing mechanism closes the opening of the wall surface structure 111 and reduces the diameter (cavity reduced diameter closed state), and then transfers the tube structure 120 out of the body.
[Selection] Figure 5

Description

  The present invention relates to a resected tissue piece collection device for accessing a living body affected area through a percutaneous hole with minimal invasiveness and removing a resected tissue piece generated by a resection operation of a living tissue such as a tumor part.

  In laparoscopic surgery, a laparoscope is invaded through a small hole in the body without opening the laparoscope, and the state inside the abdominal cavity is displayed on a monitor, etc. This is a method of performing surgery on the affected area. In laparoscopic surgery, for example, surgery is performed by simply opening a few small percutaneous holes of about 5 to 10 mm in the abdomen. Therefore, the burden on the patient is small, the post-operative pain is small, and the period is short. Because of its rapid hospitalization, it is becoming a popular surgical method.

Conventionally, removal of excised tissue pieces such as the tumor part of the affected part caused by laparoscopic surgery has been performed by grasping and removing with a special small excision forceps inserted through the lumen of the laparoscope. If the tissue piece is large, it may be larger than the percutaneous hole made in the body, and the excised tissue piece cannot be easily removed as it is. In order to avoid such a situation, it is necessary to reduce the size of excision in advance and excise it into small pieces, or once excised tissue pieces need to be shredded again into small pieces with an electric knife or the like in the surgical field.
In this way, laparoscopic surgery is an excellent technique, but because it is not open, how to remove and collect excised tissue fragments produced by excision of living tissue such as the tumor part of the affected area is a problem. It becomes. In view of this, several methods have been proposed in the prior art as methods for removing excised tissue fragments produced by excision of living tissue.

  The first removal method is a tissue piece grasping and drawing method. This is a technique for efficiently and simultaneously performing grasping and drawing by the grasping unit and cutting of the tissue piece. An annular cutting member is provided around a small gripping part, and when the gripped part is pulled into the tube, it is cut with an annular blade provided in the tube port and pulled into the tube, and the tissue piece cut to the tube diameter Is known to be pulled out of the body as it is by the gripping part (special table 2001-513355).

  The second removal method is a tissue piece crushing suction method. In this method, the body fluid of the tissue piece is sucked by pushing the tube into the excised tissue piece generated by the excision operation of the living tissue. In recent years, a suction device for a laparoscope has been developed, whereby a biological tissue fluid is sucked from a tumor part of an affected part and the affected part is cleaned and disinfected. As a method of sucking a tissue piece, a method of sucking and transferring a liquid by applying a negative pressure to a pipe is known. In order to reduce the invasion to a living body, an extremely fine pipe is often used.

  In order to make it easy to suck the tissue piece, there is one in which the biological tissue piece is more finely crushed and sucked before the suction. For example, Japanese Patent Application Laid-Open No. 9-215747 discloses an ultrasonic suction apparatus having a probe that forms a suction path integrated with an ultrasonic transducer for outputting ultrasonic waves. A tip mechanism capable of crushing the living tissue by ultrasonic vibration is provided in the lumen in the vicinity of the tip of the probe to increase the removal efficiency when sucking and removing the living tissue.

  In addition, there is known an apparatus that crushes and removes a living tissue with a rotating screw blade instead of an ultrasonic vibrator. In Japanese translations of PCT publication No. 2002-539883, an ablation device including a cannula having a conical rotating body at the tip is proposed. The rotating body at the distal end is provided with a plurality of incisions for peeling off the tissue, and the peeled tissue is introduced into the lumen of the cannula from the incisions. The introduced tissue is transported in the lumen along the longitudinal direction of the cannula by an Archimedes screw interlocked with the suction mechanism.

Special table 2001-513355 JP-A-9-215747 JP-T-2002-539883

However, the conventional biological tissue removal method has the following problems.
The first tissue piece grasping and drawing method has a problem that it takes time to remove the tissue piece. In the conventional first method of grasping and pulling out a tissue piece, the amount of tissue piece that can be pulled out at a time is limited to the thin diameter of the lumen of the laparoscope, and can be pulled out little by little at the grasping portion. Therefore, it takes time to remove the tissue piece. In particular, when all of the tumor tissue cannot be excised at once, such as when the amount of excised tissue is large, it is necessary to perform a procedure to remove the excised tissue piece in parallel with the excision procedure. It is necessary to alternately perform the excision of the living tissue using an electric knife and the removal of the excised tissue piece using the grasping mechanism, and it takes time to remove the excised tissue piece, There was a situation where time was getting longer.

  In the second tissue piece crushing and sucking method, there is a problem that the biological tissue piece is easily clogged in the suction tube. Biological tissues are not limited to so-called smooth body fluids that have a low viscosity, but there are many highly viscous body fluids and massive tissue pieces. In the conventional suction method, tissues are in the middle of suctioning tissue such as tumor parts. The piece may be clogged, the suction force may be reduced, and the living tissue may not be completely aspirated and removed. For this reason, the suction must be repeated while lowering the viscosity by applying a cleaning solution, and eventually the time for sucking the tissue piece becomes long and the time for the entire operation becomes long.

  Further, the second tissue piece crushing and sucking method has a problem that the surgical field is soiled. As described above, in the conventional tissue fragment crushing suction method, the tissue piece is finely crushed and sucked so that the biological tissue piece is not clogged in the suction tube, but a high-speed rotating cutter or the like is provided for crushing the tissue piece. However, there are problems that tissue fragments are scattered, but tissue debris scatters and soils the surgical field. For this reason, it is unavoidable to perform a surgical procedure to remove the living tissue while cleaning the surgical field by applying a cleaning solution, resulting in a situation where the time for sucking the tissue piece becomes longer and the time for the entire operation becomes longer. It was.

  In addition, in the prior art, there are some devices that integrate a resecting apparatus that performs excision work of living tissue and a recovery apparatus that performs excision work of a excised tissue piece. However, there is a problem that the work efficiency is reduced. . Although there is a merit that access to the affected area is only one route, during the actual operation, the removal of the excised tissue fragment tends to interfere with the excision of the tissue fragment such as a tumor, and the work efficiency is lowered. There were often things.

  The present invention solves the above-mentioned problem, enables the operation of recovering the excised tissue piece without affecting the excision procedure of the biological tissue using an electric knife while keeping the invasion to the living body small, and It is an object of the present invention to provide an excised tissue piece collection device that can efficiently remove a large amount of excised tissue pieces without contaminating the operative field due to residual tissue pieces.

  In order to solve the above-mentioned problems, the excised tissue piece collection device of the present invention is a excised tissue piece collection device that can be percutaneously introduced to the surgical field of the tissue excision site, and approaches the surgical field of the tissue excision site. A distal portion that forms a cavity for taking in the excised tissue piece in the surgical field, and is connected to the distal portion, the distal portion is introduced from outside the patient's body to the surgical field, and the distal portion is withdrawn after surgery. A tube portion and a hand operation mechanism that is connected to the tube portion and allows operation by an operator, the distal end portion includes an opening / closing mechanism, and the side wall surface of the distal end portion remains open until the surgical field is approached. An excised tissue piece collecting device, wherein the distal end portion can be deformed in a closed cavity closed state and a cavity deployed state in which the side wall surface of the distal end portion is largely opened after approaching the surgical field.

With the above configuration, since the distal end portion of the excised tissue piece collection device of the present invention has an opening / closing mechanism, the diameter of the distal end portion is minimally invasive until the distal end approaches the surgical field such as tumor resection. The diameter of the tube portion is initially reduced, and after reaching the operative field, the cavity at the distal end portion can be expanded greatly in order to increase the working efficiency.
In addition, with the above configuration, the excised tissue piece collection device of the present invention can be configured independently of the excision surgery device that performs excision surgery. Incorporated into the cavity at the distal end of the excised tissue piece collection device of the invention, can be collected outside the body through the tube, and the excision operation of the biological tissue and the excised tissue piece collection work can be performed independently and in parallel It becomes possible. Since the excised tissue piece such as a tumor generated during the excision surgery may be taken into the side cavity, the recovery operation can be performed without bringing the excised tissue piece such as the tumor or body fluid into contact with other normal tissues.

In the configuration of the excised tissue piece collection apparatus of the present invention described above, the opening / closing mechanism of the distal end portion has a diameter expanding function of expanding and expanding the side wall surface of the distal end portion, and the cavity by the opening / closing mechanism of the distal end portion It is preferable that the unfolded state is a state in which a part of the side wall surface is opened and greatly opened in a state where the diameter of the distal end portion is expanded.
If it is the above-mentioned configuration, a part of the wall surface of the tip is not opened like a lid, but the side wall surface is cut open and expanded, so the area of the cavity as a container for taking in the excised tissue piece is large growing.

Here, as means for realizing the diameter expanding function of the side wall surface of the tip portion, for example, there is a means that the side wall surface of the tip portion has a bellows structure and the side wall surface is expanded and contracted using the bellows structure. In addition, the bellows structure includes an outer bellows structure on the outer wall surface side of the tip portion and an inner bellows structure on the inner wall surface side of the tip portion, depending on the difference in expansion and contraction of the outer bellows structure and the inner bellows structure. It is also possible to adjust the diameter expansion function of the opening / closing mechanism at the tip.
As means for expanding and contracting the bellows structure, for example, there is a balloon control means based on air injection / discharge control with respect to the bellows structure. In addition, there is a wire driving means using a wire incorporated in the bellows structure.

  As described above, the wall structure at the tip has a bellows function, the side wall of the tip has an open / close joint, and the side walls joined at the open / close joint are unbonded. If it has a structure that can be separated, the cavity developed state by the opening / closing mechanism of the distal end portion is the bellows structure of the side wall surface where the distal end portion is joined from the enlarged diameter state by the opening / closing joining portion. Can be separated and folded to a large opening.

Further, in order to further open the opening, the side wall surface of the front end portion has an open / close joint, and the open / close state has a joint state in which the side wall surfaces joined at the open / close joint portion are joined to each other, and an open and separated state. In the cavity deployment state by the opening / closing mechanism of the distal end portion, the opening / closing structure joined by the opening / closing joint portion is opened from the expanded diameter state, and the bellows structure is folded to open the side It is preferable that the wall surfaces are separated from each other and the opening is greatly opened.
With the above configuration, since the side wall surface is cut open and expanded in the expanded state where the wall surface of the distal end portion is expanded, the opening is further increased and the area of the cavity as a container for taking in the excised tissue piece Becomes even larger.

Further, in order to further open the opening, at least one hinge structure for changing the angle of the side wall surface is provided in a part of the side wall surface of the tip portion, and in the cavity deployment state by the opening / closing mechanism of the tip portion, By opening the open / close structure joined at the open / close joint from the enlarged diameter state of the distal end, changing the angle of the side wall surface by the one or more hinge structures, and separating the side wall surface by a double door It is preferable to have a large opening.
With the above configuration, since the wall surface of the distal end portion is expanded, the side wall surface is opened to the outside with a hinge, so that the opening is further increased, and a device for taking in the excised tissue piece The cavity area is further increased.

Next, the distal end opening / closing mechanism expands the side wall surface of the distal end portion by expanding and contracting the diameter by the diameter expanding function, and the distal end portion remains in a state where the side wall surface of the distal end portion is extended. It is preferable to make it possible to make the cavity expanded diameter closed state in which the wall surface of the portion is closed.
During the recovery operation of the excised tissue piece via the tube part, it is preferable to close the cavity so that the residue of the tissue piece does not leak from the tip part. The residue of the piece does not leak from the tip. In addition, since a large lump of excised tissue piece may be taken into the distal end portion when the excised tissue piece is taken in, it is possible to achieve a cavity expanded closed state in which the diameter of the cavity closed state is closed as it is in a larger expanded state.

Next, recovery of the tissue piece taken into the tip will be described.
There are two ways to recover the tissue piece taken into the tip.
The first is a collection method in which tissue pieces such as cancer are collected without being crushed so as to be sent for pathological examination. That is, the collection is aimed at taking out the tissue piece as it is with as little burden on the patient as possible.
The second is a method of crushing a tissue piece such as cancer to make it smaller and recovering it from the body. That is, this is a recovery method in which the tissue piece is taken out of the body with as little burden on the patient as possible.

First, as a structure suitable for the first tissue piece recovery method, in the excised tissue piece recovery apparatus of the present invention, the opening / closing mechanism of the tip portion stops the diameter expansion function and contracts the side wall surface by contraction. There is a structure having a function of reducing the diameter.
With the above-described configuration, the distal end portion is changed from the cavity diameter-enlarged closed state to the reduced diameter state, and the distal end portion is connected to the patient via the tube portion while the excised tissue piece is stored in the cavity of the distal end portion. It can be pulled out of the body and the excised tissue piece can be taken out.

Next, as a structure suitable for the second tissue piece recovery method, the tube portion has a lumen that conducts from the surgical field to the outside of the patient's body, is connected to the tube portion, and negative pressure is applied to the lumen. There is a structure in which the excised tissue piece taken into the distal end portion can be transferred through the lumen by the negative pressure applied to the lumen by the pressure adjusting device. .
Depending on the magnitude of the negative pressure and the hardness and elasticity of the tissue piece, the tissue piece can be recovered outside the body via a tube so that it is crushed by the negative pressure and sucked into the lumen.

In addition, it is preferable to provide a device for crushing the excised tissue piece that crushes the excised tissue piece taken into the cavity of the distal end portion so that the excised tissue piece is finely crushed and easily transported.
By providing the crushing device as in the above configuration, some of the excised tissue pieces taken into the cavity of the tip may be a large mass of excised tissue pieces. Can be crushed.
However, it is preferable that the excised tissue piece crushing device has a size and a structure that can be operated in the state in which the cavity diameter is expanded and closed so that the crushing residue is not scattered in the surgical field. Even in the case of a large lump of excised tissue, the cavity can be crushed with the diameter expanded and closed, and the crushed residue is not scattered into the operative field.

  In addition, as a means for transferring the excised tissue piece in the tube portion, a grasping / drawing means that is inserted into the lumen and pulled out using a grasping mechanism having a grasping portion at the tip can be applied.

According to the excised tissue piece collection device of the present invention, the diameter of the tip portion and the diameter of the tube portion are initially small to allow the patient to approach the operative field with minimal invasiveness to the patient. In order to increase the working efficiency, the cavity at the tip can be expanded greatly.
In addition, according to the excised tissue piece collection device of the present invention, the excised tissue piece generated during the excision surgery using the excision surgery device can be configured independently of the excision surgery device for performing excision surgery. Incorporated to be placed on the distal end of the excised tissue piece recovery device, and can be collected outside the body through the tube, and the excision of living tissue and the excised tissue piece can be performed independently and in parallel. It becomes possible.
Further, according to the excised tissue piece collection apparatus of the present invention, the distal end portion is made into a cavity diameter-enlarged state to facilitate the collection of the tissue piece. After making the diameter small, the tube part can be pulled out together with the distal end part, and the tissue piece can be collected and sent for pathological examination without crushing the tissue piece and placing a burden on the patient.
Further, according to the resected tissue piece collecting apparatus of the present invention, some of the resected tissue pieces taken into the cavity at the tip may be a large lump of resected tissue pieces, but while crushing the tissue pieces with negative pressure, Alternatively, the mass of the excised tissue piece can be collected by sucking it out from the lumen of the tube part while crushing the tissue piece with a crushing device.

  Hereinafter, embodiments of the excised tissue piece collection device of the present invention will be described with reference to the drawings. However, it goes without saying that the scope of the present invention is not limited to the specific application, shape, number, number, etc. shown in the following examples.

  In order to approach the surgical field such as tumor resection with minimal invasiveness to the patient, the excised tissue piece collection device of the present invention is initially reduced in the diameter of the tip and the diameter of the tube, and after reaching the surgical field Is a state in which the cavity at the tip portion is greatly expanded in order to improve the working efficiency. In a state where the cavity of the distal end portion is greatly expanded, by providing it in an independent form beside the resection device such as an electric knife, the resection tissue piece collection device of the present invention is configured independently from the resection operation device for performing resection surgery, The operation of excising the living tissue with an electric knife and the operation of collecting the excised tissue piece by the excised tissue piece collecting apparatus of the present invention can be performed independently and in parallel. In other words, the excision tissue pieces generated during the excision surgery using the excision surgery device may be taken into the cavity at the tip of the excision tissue piece collection device next to each other. The work efficiency is improved by executing the recovery operation without bringing the body fluid into contact with other normal tissues.

In addition, in the example of the first embodiment, the collected excised tissue pieces are collected with the function of removing the taken excised tissue pieces as they are because the excised tissue pieces such as cancer cells are used for pathological examination. . Here, in order to place a large burden on the patient if the tip portion is pulled out with a large diameter when taken out, the first embodiment has a function of reducing the tip portion as much as possible and pulls the tip portion out of the body. Pull out after reducing the diameter so as not to crush the excised tissue piece previously taken. That is, in the first embodiment, as the transfer means of the excised tissue piece taken into the cavity 112, a means for pulling out the distal end portion 110 together with the tube portion 120 is employed as will be described later.
A method for sucking out the excised tissue piece from the tube while being crushed by negative pressure will be described in Example 2, and a method for crushing the excised tissue piece by the excised tissue piece crushing device 115 and sucking it out from the tube will be explained in Example 3.

The example of the excisional tissue piece collection | recovery apparatus of this invention concerning Example 1 is shown.
FIG. 1 is a diagram illustrating a configuration example of the excised tissue piece collection device 100 according to the first embodiment.
As illustrated in FIG. 1, the excised tissue piece collection apparatus 100 according to the first embodiment includes a distal end portion 110, a tube portion 120, and a hand operation mechanism 130. Note that the resected tissue piece collection device 100 can be percutaneously introduced into the surgical field at the tissue resection site in the same manner as a laparoscopic device that has been widely used as a medical device in recent years. In addition, illustration is abbreviate | omitted about the structure required in order to introduce percutaneously to the operative field of a tissue excision site | part.

The distal end portion 110 corresponds to the distal end portion of the excised tissue piece collection device 100 and is a site that is percutaneously introduced to the surgical field of the tissue excision site.
The tip portion 110 has an opening / closing function, a diameter expansion function, and a diameter reduction function, and can take, for example, four states: a cavity closed state, a cavity diameter expanded state, a cavity diameter expanded closed state, and a cavity diameter reduced state. Until the approach to the operative field, the side wall surface of the distal end portion 110 is closed and the cavity is closed with a small diameter. After the approach to the operative field, the distal end portion is expanded and the side wall surface is opened widely to insert the excised tissue piece. Cavity diameter expansion deployment state that makes it easy to perform, cavity diameter expansion closed state where the open / close joint is closed with the excised tissue piece inserted, cavity shrinkage that closes the open / close joint with the excised tissue piece inserted and shrinks Take diameter state. Each of these states will be described later.
As shown in FIG. 1, the distal end portion 110 includes a wall surface structure 111, a cavity 112, and an opening / closing joint portion 113.

The wall surface structure 111 is a member that forms the wall surface of the distal end portion 110, and is a hollow cylinder in this configuration example. In the configuration of the first embodiment, the wall surface structure 111 of the distal end portion 110 is an example having a bellows structure. That is, the diameter expanding function and the diameter decreasing function of the opening / closing mechanism of the distal end portion 110 are such that the wall surface structure 111 extends by expanding the bellows structure and the side wall surface structure 111 contracts by folding the bellows structure. It has become.
In this configuration example, the bellows structure includes an outer bellows structure 111a on the outer wall surface side of the tip portion 110 and an inner bellows structure 111b on the inner wall surface side of the tip portion 110, and the expansion and contraction of the outer bellows structure 111a and the inner bellows structure are provided. The diameter-expanding function and the diameter-reducing function of the opening / closing mechanism of the distal end portion 110 are adjusted according to the difference in expansion / contraction magnitude of 111b. This diameter expansion operation and diameter reduction operation will be described in detail later.

  The cavity 112 is a space or region formed by being surrounded by the wall surface structure 111, and is a space for taking in the excised tissue piece. As will be described later, the volume of the cavity 112 can be expanded by the opening / closing mechanism to greatly expand the diameter, or can be closed to decrease the diameter.

The open / close joint 113 is a joint that can be opened and closed provided in parallel to the axis of the wall surface structure 111, and can join the cut portion and the cut. In this configuration example, as shown in FIG. 3 to be described later, the door is opened to the left and right in parallel with the axis, or is joined and closed from the left and right as shown in FIG. Although it does not specifically limit as a structure of joining, In this example, it is the system joined so that the other edge may bite with respect to one edge. In addition, a so-called zipper method may be used.
As described above, the distal end portion 110 can be opened and closed at a part of the opening / closing joint portion 113 of the wall structure 111 and has a deployment function and a closing function. Further, by expanding and contracting the outer bellows structure 111a and the inner bellows structure 111b, the structure can be deformed into a diameter-expanded state in which the diameter is increased and a diameter-reduced state in which the diameter is contracted.

  The tube portion 120 is a member that is connected to the distal end portion 110, introduces the distal end portion from outside the patient's body to the surgical field, and pulls out the distal end portion after the operation. It is a flexible hollow tubular structure and is preferably a member that conducts from the surgical field to the outside of the patient's body in a state where the distal end portion 110 approaches the surgical field. The tube portion 120 is provided with a bending control mechanism such as a wire, and bends from the percutaneous hole while freely changing the advancing direction by operating the bending control mechanism by the hand operation mechanism 130 like a general endoscope. You can proceed until you reach the operative field. An example in which the lumen of the tube portion 120 is used as a transfer path for the excised tissue piece will be described in the second and subsequent embodiments.

  The hand operating mechanism 130 is a portion where the operator performs a braking operation of the distal end portion 110 and a braking operation of the tube portion 120, and a wire pulling mechanism, a pump operating mechanism, and the like corresponding to the mechanisms of the distal end portion 110 and the tube portion 120. Electrical circuit devices etc. are included. Here, the detailed structure is not shown.

Hereinafter, the concept of changing the cavity space by developing, closing, expanding, and contracting the wall surface structure 111 of the tip 110 will be described.
In FIG. 1, the open / close joint 113 of the wall surface structure 111 of the tip 110 is in a closed state. In the present invention, the state in which the wall structure 111 circulates or is folded is referred to as a “cavity closed state”. The cavity closed state is a state in which the inner cavity 112 is surrounded by the wall surface structure 111 of the distal end portion 110 and the cavity 112 cannot be approached from the outside. Moreover, it exists in the diameter-reduced state in which it is in a so-called contracted state and the diameter is small.

Next, the diameter expansion function of the wall surface structure 111 of the front end portion 110 will be described in detail.
FIG. 2 is a diagram schematically showing, in a side cross-section, a change from a state in which the bellows structure of the wall surface structure 111 of the tip part 110 is folded to a developed state.

  FIG. 2A is a side cross-section of the distal end portion 110 in the basic posture. The bellows structure is in a folded state and the wall surface is in a contracted state. The state of FIG. 2A is the “cavity closed state” described above, and the internal cavity 112 is surrounded by the wall surface structure 111 and cannot be directly approached from the surroundings.

  On the other hand, FIG. 2B is a side cross-section of the tip portion 110 in an expanded state, and the bellows structure is in a developed state and the wall surface is in an expanded state. For example, the outer bellows structure 111a is greatly expanded as compared with the inner bellows structure 111b, and the inner bellows structure 111b is elongated relatively small, so that the circular shape in the expanded state of FIG. 2B is obtained. The state shown in FIG. 2B is a state in which the wall surface is closed while being in the expanded diameter state. Therefore, in the present invention, this state is referred to as a “cavity expanded diameter closed state”. The internal cavity 112 is still surrounded by the wall structure 111 and cannot be approached directly from the surroundings. However, it can be seen that the volume of the cavity 112 is larger than that in FIG.

  As shown in FIG. 2, the opening / closing mechanism of the distal end portion 110 expands and contracts the bellows structure of the wall surface structure 111 to increase the diameter itself, and the cavity deployment state of the distal end portion 110 is simply the distal end portion. Since the slit line is opened left and right after expanding the diameter and extending the side wall surface, the space formed is larger than the space formed by opening the slit line of the opening / closing joint 113 of 110 to the left and right. Yes.

  When the distal end portion 110 is provided with this diameter expansion function, when the distal end portion 110 is percutaneously invaded into the living body, the distal end portion 110 is reduced in diameter to reduce the percutaneous hole and penetrate the patient for approach. While the space is reduced and the load on the patient is kept small, the diameter can be increased during the recovery operation for recovering the excised tissue piece, and a merit that a large cavity serving as a space for the recovery operation can be secured. In other words, the tip of the tip can be deformed in a “cavity closed state” where the tip wall is closed until the operative field is approached, and after the approach to the operative field, the “cavity unfolded state” is opened with the tip wall being largely open. It has a simple structure.

  The means for controlling the expansion and contraction of the bellows structure of the wall surface structure 111 is not particularly limited. For example, it may be a balloon control means by air injection / discharge control with respect to the bellows structure of the wall structure 111, or a wire drive means by a wire incorporated in the bellows structure.

Next, FIG. 3 is a diagram illustrating a state in which the wall surface structure 111 of the distal end portion 110 opens the open / close joint portion 113 and expands left and right.
FIG. 3A shows a side cross section of the distal end portion 110 in the expanded state, which is the “cavity expanded diameter closed state”, as in FIG.
On the other hand, FIG. 3B shows a state in which the upper part of the wall surface structure 111 is greatly expanded by opening the cut line of the opening / closing joint 113 left and right from the “cavity diameter enlarged closed state” of FIG. It is a figure. As shown in FIG. 3 (b), the open / close joint 113 is opened when the tip 110 is in the expanded state, the bellows structure of the upper portion of the wall surface structure 111 is folded, and the bellows of the lower portion of the wall surface structure 111 is folded. By leaving the structure as it is, the opening is in a largely open state. Thus, the state where the side wall surface of the tip portion 110 is largely opened by the opening / closing mechanism of the tip portion 110 is the “cavity developed state”.
As will be described later, the wall surface of the distal end portion 110 is greatly opened, and the work becomes easier when taking the excised tissue piece into the cavity 112.

Next, FIG. 4 is a diagram illustrating a state in which the wall surface structure 111 of the distal end portion 110 is further opened and expanded to the left and right as compared with the configuration of FIG.
FIG. 4A shows a side cross section of the distal end portion 110 in a state where the diameter is expanded, which is a “cavity developed state”, as in FIG. 3B.

  On the other hand, FIG. 4B is a diagram showing a state in which the upper cut line is further opened to the left and right and further expanded from the “cavity developed state” of FIG. The wall structure of the tip portion 110 is provided with a hinge structure 114 that changes the angle of the side wall surface at least one place, in this example, one place on the left and right sides. As shown in FIG. By changing the angle of the left and right side wall surfaces with the hinge portion 1114 from the diameter-expanded state 110, the left and right sides are further separated by a so-called double door opening, and a large opening state is obtained. The angle is changed by the hinge portion 1114 and the outer bellows structure 111a of the wall surface structure 111 is slightly contracted together. The work area of the cavity 112 in the “cavity unfolded state” shown in FIG. 4 can be secured more widely than that in FIG.

  By the deformation of the tip portion 110 as described above, the basic posture can be changed from the “cavity closed state” to the “cavity deployed state”.

  FIG. 5 is a diagram simply showing a state in which the basic posture shown in FIG. 1 is changed from the “cavity closed state” to the “cavity deployed state”. As shown in FIG. 5, the cavity 112 of the distal end portion 110 is in a state where the cavity 112 is greatly opened in the operative field, so that it can be accessed from the surroundings through the opening. It is in a state where the excised tissue piece excised by (1) can be inserted. In the “cavity deployed state”, the cavity 112 can be accessed from the surgical field. That is, in the cavity deployment state, the wall surface structure 111 of the distal end portion 110 provides an area for temporarily storing the excised tissue piece like a kind of vessel or dish.

  In the example of FIG. 5, the development of the wall surface structure 111 of the cylindrical tip portion 110 is such that an opening / closing joint portion parallel to the axis is provided on the side wall surface of the tip portion 110, and the opening / closing joint portion is the center. 5 is an example in which the side wall surface is cut open in the left-right direction (circular direction of the shaft) and expanded widely, but various shapes are possible as the cut-off shape of the opening / closing joint portion of the side wall surface of the tip portion, as shown in FIG. It is not limited to.

Next, the insertion of the excised tissue piece into the excised tissue piece collection device 100 of the present invention by the operator during the operation will be described.
FIG. 6 is a diagram schematically showing the concept of access to the affected part of the excised tissue piece collection device 100 of the present invention and the excision device 200 for excising a tissue piece such as an electric knife. The excised tissue piece collection device 100, the excision device 200, and the affected part 300 such as a tumor of the present invention are also shown in a simplified manner.
In the example of FIG. 6, the excised tissue piece collection device 100 has an independent configuration different from the excision device 200 that excises a tissue piece such as an electric knife, and in this example, the approach to the surgical field where the affected area is located is also different. It is a route and a percutaneous hole is also provided separately.

  Thus, by making the excision tissue piece collection | recovery apparatus 100 different from the excision apparatus 200, both apparatus can be operated freely separately and the freedom degree of operativity increases. In addition, the practitioner can concentrate on excision of the affected part 300 using the excision apparatus 200, while the excision of the excised tissue piece is collected by the practitioner of the excised tissue piece collection apparatus 100. Work efficiency is also improved.

FIG. 7 is a diagram illustrating a state in which a practitioner operating the resecting apparatus 200 is throwing the excised tissue piece 310 of the affected part 300 into the cavity 112 of the excised tissue piece collecting apparatus 100. FIG. 7 also shows the excised tissue piece collection device 100, the excision device 200, and the excised tissue piece 310 such as a tumor in a simplified manner.
As shown in FIG. 7, the distal end portion 110 of the excised tissue piece collection device 100 is in the “cavity deployment state”, the upper portion is open, and the excision device 200 is excised from the opening into the cavity 112 such as a tumor. The piece 310 can be inserted. The laparoscopic excision device 200 has a grasping mechanism at the tip, and is often burned off by electricity or laser while picking up a tissue piece such as a tumor, and the excision beside it while holding the excised tissue piece. The excisional tissue piece can be moved into the cavity 112 of the tissue piece collecting apparatus 100 and can be put into the cavity 112 by releasing the grip.

This operation is similar to an operation in which a practitioner places a tissue piece cut with a scalpel on a side tray or the like in a laparotomy, and the operator of the resecting apparatus 200 performs his or her resection efficiently. it can.
On the other hand, the practitioner of the excised tissue piece collection device 100 can concentrate on the work of successively treating the excised tissue pieces 310 that are introduced into the cavity 112 and transferring them to the outside of the patient through the tube 120. .

Next, transfer of the excised tissue piece 310 by the excised tissue piece collection apparatus 100 will be described.
In the first embodiment, an example will be described in which the excised tissue piece 310 is transferred by a method of collecting the excised tissue piece 310 as it is for use in pathological examination without crushing.
The excised tissue piece collection device 100 closes the wall structure that has been in the “cavity developed state” at an appropriate timing in the collection operation of the excised tissue piece 310, and as shown in FIG. “Closed”. As shown in FIG. 8, in the “cavity enlarged diameter closed state”, the excised tissue piece 310 is incorporated inside, but the distal end portion 110 is enlarged in diameter and the volume of the cavity 112 is increased. The wall surface of the wall surface structure 111 can be joined in a state in which the tissue piece 310 is taken into the cavity, and a “cavity diameter expansion closed state” can be obtained.

However, when the excised tissue piece 310 that is so large that it cannot be brought into the cavity expanded diameter closed state is put into the cavity 112 in the cavity expanded state, the excised tissue piece 310 is recovered as it is without closing the wall surface structure 111. This does not exclude the operation.
Next, the “cavity reduced diameter closed state” will be described. In the first embodiment, the excised tissue piece 310 is collected as it is for pathological examination without being crushed. However, the diameter is large in the “cavity enlarged diameter closed state”, and pulling out as it is increases the burden on the patient. Therefore, in the first embodiment, a device is devised to shrink the diameter as small as possible without crushing the excised tissue piece 310.

FIG. 9 shows a state in which the distal end portion 110 is deformed from the “cavity enlarged diameter closed state” to the “cavity reduced diameter closed state”.
When returning from the “cavity enlarged diameter closed state” to the “cavity closed state”, the wall structure 111 was stretched with a bellows structure. In the case of a balloon system using air, the pump is operated to remove the air. The bellows structure is folded and contracted. In the case of the wire system, the bellows structure is folded by operating the wire and contracted. In the “cavity enlarged diameter closed state” in FIG. 9A, the diameter of the path is larger than the path through which the distal end portion 110 is accessed to the operative field, and if the distal end portion 110 is pulled out in this state, the living body may be damaged. Therefore, as shown in FIG. 9B, if the bellows structure of the distal end portion 110 is folded into the “cavity reduced diameter closed state”, the diameter becomes smaller, and the distal end when the excised tissue piece collection device 100 is pulled out of the body is reduced. The trouble that the part 110 can be used does not occur, and the excised tissue piece collection device 100 can be smoothly pulled out of the body without applying a load to the patient's body. In addition, since the excision tissue piece 310 is contained inside the distal end portion 110, there is a case where a part of the trunk portion remains in a slightly swollen state without returning to the “cavity closed state” in FIG. .

FIG. 10 is a diagram illustrating an entire state in which the distal end portion 110 in the “cavity diameter expansion closed state” is in the “cavity diameter diameter closed state”. The excised tissue piece collection device 100 and the excised tissue piece 310 of the present invention are shown in a simplified manner. As shown in FIG. 10A, when the tip portion 110 in the “cavity diameter expansion closed state” is in the “cavity diameter reduction closed state” as shown in FIG. Although it is in an inflated state, it can be seen that it is easier to pull out the entire tip 110 than in the “cavity enlarged diameter closed state” in FIG.
By pulling out the tube portion 120 together with the distal end portion 110 in the “cavity reduced diameter closed state” in FIG. 10B, the excised tissue pieces stored in the cavity 112 of the distal end portion 110 can be directly taken out of the body.

  As described above, according to the excised tissue piece collection device 100 of the present invention according to the first embodiment, the distal end diameter and the tube portion are reduced until the patient approaches the surgical field such as tumor excision with minimal invasiveness. In order to increase the work efficiency after reaching the operative field, the work efficiency can be improved with the distal end portion of the cavity being greatly expanded. Further, according to the excised tissue piece collection device 100, the excised tissue piece taken into the cavity at the distal end can be collected outside the body without being brought into contact with other normal tissues.

Next, an excised tissue piece collection apparatus 100a according to Example 2 will be described.
The resected tissue piece collecting apparatus 100a according to the second embodiment is similar to the wall surface structure 111 of the first embodiment with respect to the wall surface structure 111 of the distal end portion 110a, but transfers the resected tissue piece 310 taken into the distal end portion 110a. Means are different. In the recovery and transfer of the excised tissue piece 310 according to the second embodiment, negative pressure is applied to the excised tissue piece 310 and sucked toward the lumen of the tube 120, and the excised tissue piece 310 is sucked out of the body while being crushed. It is collected and transferred.

  When the excised tissue piece 310 is collected, when the excised tissue piece 310 is sent to a pathological examination, the excised tissue piece 310 needs to be taken out without being crushed. The excised tissue piece 310 is recovered and transferred by pulling out the entire portion 110a. However, when the excised tissue piece 310 does not need to be used for pathological examination, the excised tissue piece 310 may be finely crushed and taken out. Therefore, in this second embodiment, a negative pressure is applied to the lumen of the tube portion 120 by a pump or the like to the communicating tube portion 120 to suck the excised tissue piece 310 toward the lumen of the tube portion 120, If the excised tissue piece 310 is soft and easily crushed, the excised tissue piece 310 is collected and transported outside the body while crushing the excised tissue piece 310 as if the gel-like substance is sucked out with a straw. When the excision tissue piece 310 is large, there is a problem that the lumen is clogged. However, when the excision tissue piece 310 is finer than the lumen diameter of the tube part 120 or when the excision tissue piece 310 is soft and finely crushed by the negative pressure suction process, suction means Is a means of transferring the excised tissue piece 310 out of the body very efficiently.

  FIG. 11 is a diagram showing a state of transfer of the excised tissue piece 310 through the tube portion 120 using suction means as transfer means. The excised tissue piece collection device 100a and the excised tissue piece 310 of the second embodiment are simply shown. As shown in FIG. 10, the excised tissue pieces 310 in the cavity 112 in the “cavity diameter expansion closed state” are sucked one after another and discharged to the tray outside the body through the tube part 120.

  Since the excised tissue piece 310 has already been sucked out of the body when the excised tissue piece collection device 100a of the second embodiment is collected outside the body, as shown in FIG. It can be returned to the “closed state” and can be easily pulled out of the body together with the tube portion 120.

  As described above, according to the excised tissue piece collection device 100a of the present invention according to the second embodiment, after the excised tissue piece 310 is taken in the surgical field, negative pressure is applied to the lumen of the pipe portion 120 to Aspiration can be performed toward the lumen, and the excised tissue piece 310 can be crushed and aspirated / collected / transferred outside the body, thereby improving work efficiency.

Next, an excised tissue piece collection apparatus 100b according to Example 3 will be described.
The resected tissue piece collecting apparatus 100b according to the third embodiment is similar to the wall surface structure 111 of the first embodiment with respect to the wall surface structure 111 of the distal end portion 110b, but a resected tissue piece crushing device 115 is provided in the cavity 112. It is a configuration example. When the excised tissue piece 310 is collected and transferred, the excised tissue piece 310 is crushed by the excised tissue piece crushing device 115 to be finely divided and collected and transferred outside the body.

  Similarly to the case of the second embodiment, in the case where the excised tissue piece 310 does not need to be used for pathological examination, the lumen of the tube portion 120 can be obtained by a pump or the like when the excised tissue piece 310 may be finely crushed and taken out. The ablated tissue piece 310 may be sucked toward the lumen of the tube part 120 and collected / transferred by applying negative pressure to the tube part 120. However, if the ablated tissue piece 310 is not easily crushed, The negative pressure to be given will increase. Therefore, in the third embodiment, the excision tissue fragment crushing device 115 is used to assist the recovery and transfer outside the body while crushing the excision tissue fragment 310.

FIG. 13 is a diagram illustrating a configuration example of the excised tissue piece collection device 100b according to the third embodiment.
The excised tissue fragmentation device 115 incorporated in the tip 110b is shown schematically. The structure of the excised tissue piece crushing device 115 is, for example, a rotary cutter with a cutting edge. In the configuration example of the third embodiment, the excised tissue piece 310 is a biaxial rotating body provided with a cutter on a cylindrical surface. It is an example of being finely cut by a rotating body that rotates on a shaft. In addition, there is a crushing device that irradiates an excised tissue piece with ultrasonic waves and pulverizes it finely.

  Here, when the excised tissue piece crushing device 115 is operated, the tissue pieces of the excised tissue piece 310 are mechanically crushed finely, and thus cell debris and body fluid may be scattered around. In order to prevent this inconvenience, in the recovery operation of the excised tissue piece 310, the wall structure 111 that has been in the “cavity expanded state” is closed at an appropriate timing, and then the excised tissue piece is put into the “cavity expanded diameter closed state”. The crushing device 115 is operated. In addition, it is preferable that the size, structure, and arrangement of the excised tissue piece crushing device 115 be operable in a state in which the cavity enlarged diameter is closed after taking the excised tissue piece 310 into the cavity 112.

14A is a diagram simply showing the internal structure of the tip 110b in the “cavity closed state”, and FIG. 14B simply shows the internal structure of the tip 110b in the “cavity enlarged diameter closed state”. It is a figure.
FIG. 15A is a diagram simply showing the internal structure of the tip portion 110b in the “cavity deployed state”, and FIG. 15B is a view of the tip portion 110b in the “cavity deployed state” further deployed using a hinge. It is the figure which showed the internal structure simply.
As shown in FIG. 14B, if the wall surface structure 111 is closed and the cavity is enlarged, the excision tissue fragment crushing device 115 is operated and the excision tissue fragment 310 is crushed. It is possible to prevent crushing residues from splashing around.

  FIG. 16 is a diagram illustrating a state in which the excised tissue piece crushing device 115 is operated in the cavity 112 to crush the excised tissue piece 310 in the “cavity diameter expansion closed state”. As shown in FIG. 16 (a), the diameter of the excised tissue piece 310 is larger than the diameter of the tube portion 120 before the excision tissue piece 310 is crushed by the excised tissue piece crushing device 115. Cannot be transferred from 120. However, as shown in FIG. 16 (b), if the tissue piece of the excised tissue piece 310 is finely crushed by the excised tissue piece crushing device 115, the diameter of the excised tissue piece 310 becomes smaller than the diameter of the tube portion 120. The transfer work using the unit 120 is facilitated.

Next, transfer of the excised tissue piece 310 through the tube part 120 will be described.
In the third embodiment, the excised tissue piece 310 is crushed by the excised tissue piece crushing device 115, so that the negative pressure is applied to the lumen of the pipe portion 120 to remove the excised tissue piece 310 via the pipe portion 120. Transport outside the body.

FIG. 17 is a view showing a state of transfer of the excised tissue piece 310 through the tube portion 120 using suction means as transfer means. The excised tissue piece collection device 100b and the excised tissue piece 310 of the third embodiment are simply shown. As shown in FIG. 17, the excised tissue pieces 310 in the cavity 112 in the “cavity diameter expansion closed state” are sucked one after another and discharged to the tray outside the body through the tube part 120.
Note that, when the excised tissue piece collection device 100a according to the third embodiment is collected outside the body, the excised tissue piece 310 has already been sucked out of the body, so that the distal end portion 110 is shown in FIG. The “cavity closed state” can be returned to, and the tube portion 120 can be easily pulled out of the body.

  As described above, according to the excised tissue piece collecting device 100b of the present invention according to the third embodiment, the excised tissue piece crushing device 115 is provided, so that the excised tissue piece crushing device 115 collects the excised tissue piece 310 when the excised tissue piece 310 is collected and transferred. The pieces 310 can be crushed and made finer, and recovered and transported outside the body.

  Note that gripping / drawing means can be applied instead of means for applying a negative pressure to the inner space of the pipe portion 120. That is, the grasping device 121 having a grasping portion at the tip is inserted into the lumen of the tube portion 120, and the excision tissue piece 310 grasped by the grasping portion using the grasping device 121 is pulled out of the body. For example, this means is an effective means in the case of a surgical field environment where the suction means cannot be used. Further, the suction means is an effective means for pulling out the excised tissue piece 310 that is highly likely to be clogged in the tube portion 120.

  FIG. 19 is a diagram showing a state of transfer of the excised tissue piece 310 through the tube portion 120 using the gripping and pulling means as the transferring means. The excised tissue piece collection device 100 and the excised tissue piece 310 of the present invention are shown in a simplified manner. As shown in FIG. 19, the excised tissue pieces 310 in the cavity 112 in the “cavity diameter-enlarged closed state” are successively pulled out through the tube part 120 while being gripped by the gripping device 121 and discharged to the tray outside the body. Has been.

  As mentioned above, although preferred embodiment of this invention was illustrated and demonstrated, this invention can be widely applied as a collection | recovery apparatus of a resected tissue piece in the medical field, and does not deviate from the technical scope of this invention. It will be understood that various modifications are possible.

It is a figure which shows the structural example of the excised tissue piece collection | recovery apparatus 100 of this invention concerning Example 1. FIG. It is the figure which showed typically the change from the state by which the bellows structure of the wall surface structure 111 of the front-end | tip part 110 was folded to the state expand | deployed in the side cross section. It is a figure which shows a mode that the wall surface structure 111 of the front-end | tip part 110 opened the opening-and-closing junction part 113, and expand | deployed right and left. It is a figure which shows a mode that the wall surface structure 111 of the front-end | tip part 110 was further opened rather than the structure of FIG. It is a figure which shows simply a mode that it changed from the "cavity closed state" which is the basic attitude | position shown in FIG. 1 to the "cavity expansion | deployment state". It is a figure which shows typically the concept of the access to the human body affected part of the excision tissue piece collection | recovery apparatus 100 of this invention and the excision apparatus 200 which excises tissue pieces, such as an electric knife. FIG. 5 is a diagram showing a state where a practitioner operating the resecting apparatus 200 is throwing the excised tissue piece 310 of the affected part 300 into the cavity 112 of the excised tissue piece collecting apparatus 100. It is a figure which shows the "cavity diameter expansion closed state" which closed the opening with the side wall surface of the wall surface structure 111 of the front-end | tip part 110 expanded in diameter. It is a figure which shows a mode that the front-end | tip part 110 deform | transforms from a "cavity diameter expansion closed state" to a "cavity diameter reduction closed state". It is a figure which shows the whole mode which made the front-end | tip part 110 in a "cavity diameter expansion closed state" the "cavity diameter diameter closed state". It is a figure which shows the mode of the transfer of the excision tissue piece 310 via the pipe part 120 which used the suction means as a transfer means. It is a figure which shows a mode that the tube | pipe part 120 is pulled out with the front-end | tip part 110, and the excision tissue piece collection | recovery apparatus 100 is collect | recovered out of the body. It is a figure which shows one structural example of the excisional tissue piece collection | recovery apparatus 100b concerning the present Example 3. FIG. It is the figure which showed simply the internal structure of the front-end | tip part 110b in a "cavity closed state", and the internal structure of the front-end | tip part 110b in a "cavity diameter expansion closed state". It is the figure which showed simply the internal structure of the front-end | tip part 110b in a "cavity expansion | deployment state", and the internal structure of the front-end | tip part 110b in the "cavity expansion | deployment state" using a hinge. FIG. 4 is a diagram showing a state in which the excised tissue piece crushing device 115 is operated in the cavity 112 to crush the excised tissue piece 310 in the “cavity diameter enlarged closed state”. It is a figure which shows the mode of the transfer of the excision tissue piece 310 via the pipe part 120 which used the suction means as a transfer means. It is a figure which shows a mode that the tube | pipe part 120 is pulled out with the front-end | tip part 110, and the excision tissue piece collection | recovery apparatus 100 is collect | recovered out of the body. It is a figure which shows the mode of the transfer of the excision tissue piece 310 through the pipe part 120 using the grasping | pulling extraction means as a transfer means.

DESCRIPTION OF SYMBOLS 100 Excision | tissue tissue piece collection | recovery apparatus 110 Tip part 111 Wall surface structure 112 Cavity 113 Excision tissue piece crushing apparatus 120 Pipe part 130 Hand operation mechanism 200 Excision apparatus 300 Living body tissue 310

Claims (11)

An excised tissue piece collection device that can be transcutaneously introduced to the surgical field at the tissue excision site,
Approaching the surgical field at the tissue excision site and forming a cavity for taking the excised tissue piece in the surgical field;
A tube portion connected to the distal end portion, introducing the distal end portion from outside the patient's body to the surgical field, and pulling out the distal end portion after surgery;
A hand operation mechanism connected to the tube portion and enabling operation by an operator;
The distal end portion has an opening / closing mechanism, and has a diameter expansion function for expanding the diameter of the side wall surface of the distal end portion,
Cavity closed side wall surface is closed up to the tip approaches the operating field is the tip, the tip portion after the approach to the operating field is expanded by the diameter expansion capabilities, the side wall surface of that one The distal end portion of the distal end portion is maintained in a state where the side wall surface of the distal end portion is extended from the cavity expanded state in which the portion is greatly opened and the cavity expanded state in which the side wall surface of the distal end portion is expanded and contracted by the diameter expanding function. An excised tissue piece collection device that enables deformation of the distal end portion in a closed-cavity-diameter closed state with a wall surface closed .   The tip opening / closing mechanism has a diameter reducing function that stops the diameter expansion function and contracts the side wall surface to reduce the diameter, and the tip part is changed from the cavity enlarged diameter closed state to the diameter reduced state, and the tip part 2. The excised tissue piece according to claim 1, wherein the excised tissue piece can be taken out by pulling the distal end portion out of the patient's body through the tube while the excised tissue piece is stored in the cavity of the patient. Recovery device. One or more hinge structures that change the angle of the side wall surface are provided in a part of the side wall surface of the tip part,
In the cavity deployment state by the opening / closing mechanism of the tip portion, the opening / closing structure joined by the opening / closing joint portion is opened from the diameter-expanded state, and the side wall surface is opened by the one or more hinge structures. The resected tissue piece collecting apparatus according to claim 1 or 2, wherein the cut tissue piece is in a state of being largely opened by changing the angle and separating the side wall surface by a double door.   The side wall surface of the tip portion has a bellows structure, and the diameter increasing function provided in the opening / closing mechanism of the tip portion utilizes expansion / contraction of the side wall surface using the bellows structure. The excised tissue piece collection device according to claim 1.   The bellows structure comprises an outer bellows structure on the outer wall surface side of the tip portion and an inner bellows structure on the inner wall surface side of the tip portion, and the expansion and contraction of the outer bellows structure and the extension and contraction size of the inner bellows structure The excised tissue piece collection device according to claim 4, wherein the diameter expanding function of the opening / closing mechanism at the distal end is adjusted by the difference.   6. The excised tissue piece collection device according to claim 4 or 5, wherein the means for controlling expansion and contraction of the bellows structure by the opening / closing mechanism of the tip is balloon control means by air injection / discharge control with respect to the bellows structure.   The excised tissue piece collection according to any one of claims 4 to 6, wherein the means for controlling expansion and contraction of the bellows structure by the opening / closing mechanism at the tip is wire driving means by a wire incorporated in the bellows structure. apparatus. The side wall surface of the tip has an open / close joint, and includes an open / close structure having a joined state in which the side wall surfaces joined at the open / close joint are joined to each other, and an open and separated state.
In the cavity deployment state by the opening / closing mechanism of the tip part, the side wall surfaces are separated from each other by opening the opening / closing structure where the tip part is joined by the opening / closing joint part from the expanded state and folding the bellows structure. The excised tissue piece collection apparatus according to any one of claims 4 to 7, wherein the opening is in a state where the opening is largely open. The tube has a lumen leading from the surgical field to the patient's body,
A pressure adjusting device connected to the tube portion and applying a negative pressure to the lumen;
The excisional tissue piece according to any one of claims 1 to 8, wherein the excisional tissue piece taken into the distal end portion can be transferred through the lumen by a negative pressure applied to the lumen by the pressure adjusting device. Recovery device. A resection tissue piece crushing device for crushing a resection tissue piece taken into the cavity of the tip,
The excised tissue piece collection device according to any one of claims 1 to 8, wherein the excised tissue piece is finely crushed to facilitate transport.   The excised tissue according to any one of claims 1 to 8, wherein the means for transferring the excised tissue piece in the tube portion is a grasping / drawing means for pulling out using a grasping mechanism having a grasping portion at a distal end passed through the tube portion. Piece collection device.

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