JP5414054B2 - drape - Google Patents

Description

  The present invention relates to a sheet-shaped drape that covers a patient in a procedure performed while injecting a perfusate into a resident hole that is a vagina or urethral hole of the patient.

  Conventionally, when medical treatment is performed in a medical facility such as an operating room or a ward, a drape that covers the body surface of a patient defined as an unclean area has been used. An opening is provided for exposure from the drape. For example, in the surgical cover cloth (draping) of Patent Document 1 used in obstetrics and gynecology, the cover cloth body has an opening corresponding to the surgical field (vagina) and water received under the opening. A pouch is provided. In addition, an adhesive covering piece that adheres to the patient is disposed in the opening, and a hole for operating a surgical instrument that is inserted into the vagina is formed in the adhesive covering piece. This prevents the perfusate injected into the vagina from leaking outside when performing hysteroscopic surgery.

JP 2009-118934 A

  However, in surgery for the patient's vagina, even if an adhesive cover piece is provided on the drape as in Patent Document 1, in practice, there is a gap between the periphery of the opening for inserting the instrument into the vagina and the patient. There will be a gap. In particular, it becomes difficult to make the adhesive covering piece adhere to the patient at the lower part of the edge of the opening in the crushed stone position (part on the rear side of the patient), and between the periphery of the opening of the drape and the patient. Perfusate will flow in.

  This invention is made | formed in view of the said subject, and aims at suppressing that a perfusate flows between the circumference | surroundings of the opening of a drape, and a patient.

  The invention according to claim 1 is a sheet-like drape that covers the patient in a treatment performed while injecting a perfusate into the resident hole, which is the vagina or urethral hole of the patient, A sheet-shaped drape body in which an opening for inserting a perforated liquid is inserted into the vagina from at least a lower part of the edge of the opening, thereby allowing the perfusate to flow out of the resident hole to the drape. And an insertion film leading to the main body.

  Invention of Claim 2 is the drape of Claim 1, Comprising: The said insertion film is a member different from the said drape main body, The edge part of the said insertion film is the said lower side of the said edge. In the vicinity of the site, the drape body is fixed to the surface opposite to the patient.

  The invention described in claim 3 is the drape according to claim 1 or 2, wherein the insertion film is bent in a direction away from the opening in a state before use.

  Invention of Claim 4 is the drape of Claim 1 or 2, Comprising: The said insertion film is inserted into the said vagina from the said lower part of the said edge, and the said drape is the said opening. The other two insertion films are further inserted into the vagina from both sides of the edge.

  The invention according to claim 5 is the drape according to claim 4, wherein each of the insertion film and the other two insertion films is bent in a direction away from the opening in a state before use. Yes.

  A sixth aspect of the present invention is the drape according to any one of the first to fifth aspects, further comprising a pouch attached on the drape main body and receiving the liquid flowing out from the opening.

  The invention according to claim 7 is the drape according to any one of claims 1 to 6, wherein the drape body is attached around the opening on a surface of the drape body facing the patient, It further includes an adhesive layer that adheres to the patient.

  ADVANTAGE OF THE INVENTION According to this invention, it can suppress that a perfusate flows between the circumference | surroundings of the opening of a drape, and a patient.

  In the invention of claim 2, the drape can be handled easily. In the inventions of claims 4 and 7, leakage of the perfusate can be further suppressed. In the invention of claim 6, the perfusate is Can be efficiently recovered.

It is a top view which shows a drape. It is a figure which shows the drape of a use condition. It is a figure which shows an opening peripheral part. It is a figure which shows the opening vicinity of the drape of a use condition. It is a perspective view which shows the other example of a drape. It is a figure which shows the further another example of a drape.

  FIG. 1 is a plan view showing a sheet-shaped drape 1 according to an embodiment of the present invention, and shows the drape 1 in a state before use. The drape 1 is positioned on the operating table in a supine position in an open leg posture with the knee bent (for so-called crushed stone position) during gynecological surgery (for example, excision using a hysteroscope (TCR)). ) Used to cover the patient.

  As shown in FIG. 1, the drape 1 includes a sheet-like drape main body 11 that covers a patient, and a medical pouch 2 that is fixed to the drape main body 11 with a double-sided tape or the like. The drape body 11 includes a drape sheet 12 that covers almost the entire body of the patient, and the drape sheet 12 formed of a water-repellent material exposes the vagina that is the patient's surgical site (ie, surgical field). A rectangular member (hereinafter referred to as “opening peripheral portion”) 121 in which an elliptical opening 122 is formed is provided. The opening peripheral part 121 is formed of a hydrophilic material (it can also be regarded as a water-absorbing material), and blood or the like scattered from the surgical field during surgery is prevented from spreading from the opening peripheral part 121 to the outside.

  An adhesive layer 123 is attached to the periphery of the opening 122 on the surface of the opening periphery 121 facing the patient (that is, the surface facing the patient when the drape 1 is used, hereinafter referred to as “dirty surface”). When the drape 1 is used, the adhesive layer 123 adheres the entire periphery of the opening 122 of the opening peripheral portion 121 and the entire periphery of the patient's surgical field. Actually, the opening peripheral portion 121 is adhered on the surface of the drape sheet 12 facing outward when the drape 1 is used (that is, the surface facing the operator side when used, and hereinafter referred to as “clean surface”). The drape sheet 12 is provided with an opening (not shown) for avoiding interference with the opening 122 and the adhesive layer 123. Since the double structure of the sheet is formed by the drape sheet 12 and the opening peripheral portion 121 around the opening 122, the strength of the drape 1 around the opening 122 is improved.

  On the clean surface of the drape sheet 12, two cord holders 14 are attached to the opposite side of the opening peripheral portion 121 from the pouch 2. One end of the cord holder 14 is fixed to the drape sheet 12. A pair of hook-and-loop fasteners are attached in the vicinity of the free end and the fixed end, and various cords and tubes (for example, a perfusate supply tube) used in the operation are bundled by the cord holder 14. In addition, in the free end part of the cord holder 14, the surface fastener is provided in the position slightly away from the front-end | tip, and the said front-end | tip vicinity becomes a knob part which an operator hold | grips when the code holder 14 is attached or detached. Yes.

  Further, the drape sheet 12 is formed with a slit 124 extending from the vicinity of the opening peripheral portion 121 toward one edge (the lower edge in FIG. 1). The drape sheet 12 is formed of, for example, a nonwoven fabric (spun lace, SMS (spunbond / meltblown / spunbond), etc.).

  FIG. 2 is a diagram showing the drape 1 in use. During surgery using the drape 1, a perfusion solution such as physiological saline is continuously or intermittently injected into the patient's operative field through the opening 122, and the pouch 2 shown in FIGS. It is a so-called water-receiving bag that receives the liquid flowing out from 122 (mainly perfusate, including blood and body fluid). The pouch 2 is a part 21 provided with a liquid receiving port 201 for receiving liquid from the operative field (a part disposed on the upper side when the drape 1 is used, hereinafter referred to as “upper part 21”), and an upper part. The lower part 22 which is attached to the lower end part of 21 and forms a flow path narrower than the liquid receiving port 201 is provided. In the pouch 2, the liquid received at the liquid receiving port 201 is guided to the lower part 22 and is discharged from the liquid discharging port 202 provided at the lower end of the lower part 22. The drain port 202 is provided with a substantially cylindrical conduit portion 23 (see FIG. 2) that protrudes outward (that is, downward). The drain port 202 is a pump that sucks liquid through the conduit portion 23, or the like. Connected to the suction mechanism.

  As shown in FIG. 1, in the drape 1, a part of the edge of the liquid receiving port 201 in the upper part 21 is sandwiched between the end part on the slit 124 side of the opening peripheral part 121 and the drape sheet 12, and both. By sticking, the pouch 2 is attached on the drape main body 11. Further, an elastic member 24 extending in the left-right direction in FIG. 1 is provided at a portion of the edge of the upper portion 21 opposite to the portion attached to the drape main body 11. The elastic member 24 protrudes from both lateral ends of the upper portion 21, and ring-shaped portions (hereinafter referred to as “ring portions”) 241 are provided at both ends of the elastic member 24.

  FIG. 3 is a view showing the opening periphery 121, and the lower side of FIG. 3 corresponds to the lower side of the drape 1 in the use state of FIG. As shown in FIG. 3, on the clean surface of the opening peripheral portion 121 around the opening 122, there are three films formed of polyethylene, urethane or the like (a film inserted into the patient's vagina as will be described later). Therefore, hereinafter, it is referred to as “insert film”.) 31, 32, 33 are provided. Specifically, the first insertion film 31 is provided on the periphery of the opening 121 near the lower part of the edge of the opening 122 (that is, between the opening 122 and the pouch 2 in FIG. Second and third insertion films 32 and 33 are provided in the vicinity of portions on both sides of the edge (that is, portions approximately along the vertical direction in use).

  Each insertion film 31 to 33 is substantially rectangular, and one end portion 311, 321, 331 in the longitudinal direction is fixed on the clean surface of the peripheral portion 121 of the opening by a double-sided tape, a hot melt adhesive, or the like. Further, the insertion films 31 to 33 are folded in parallel to the short side at a position close to the opening 122, and the free ends 312, 322, and 332 opposite to the fixed ends 311, 321, and 331 are The opening peripheral portion 121 is disposed at a position that does not overlap with the opening 122 when viewed from a direction perpendicular to the opening peripheral portion 121 in a state before being stretched flat. Thus, in the state before use, the insertion films 31 to 33 are bent in a direction away from the opening 122 on the clean surface side of the opening peripheral portion 121. In addition, the corner | angular part of the free end parts 312,322,332 of the 1st thru | or 3rd insertion films 31-33 is rounded.

  In the present embodiment, the length of the opening 122 in the longitudinal direction of FIG. 3 is 80 millimeters (mm), the width of the opening 122 in the lateral direction of FIG. 3 is 50 mm, and the longitudinal direction of the first insertion film 31 and The horizontal lengths are 120 mm and 60 mm, and the vertical and horizontal lengths of the second and third insertion films 32 and 33 are 90 mm and 120 mm. The distance between the lower part of the edge of the opening 122 and the fold line of the first insertion film 31 is 5 mm, and the second or third insertion adjacent to the part of the side of the edge of the opening 122 and the part. The distance between the folds of the films 32 and 33 is 10 mm. Each of the insertion films 31 to 33 has a size and an arrangement so as to cover the entire opening 122 when it is overlapped with the opening 122.

  When the drape 1 of FIG. 1 is used, the slits 124 of the drape body 11 are opened to the left and right, and both legs of the patient in an open leg posture with the knees bent by the left and right sides of the slit 124 of the drape sheet 12. Is covered. At this time, as described above, the unclean surface of the drape main body 11 faces the patient, and the clean surface faces the opposite side of the patient. An opening 122 is arranged in the patient's vagina, and the adhesive layer 123 adheres the periphery of the opening 122 of the opening peripheral portion 121 to the periphery of the patient's vagina. At this time, since the insertion films 31 to 33 are bent in a direction away from the opening 122, the patient's body surface can be observed through the opening 122, and the arrangement of the opening 122 with respect to the patient's vagina is easy. Done.

  As shown in FIG. 2, the pouch 2 is disposed between the legs of the patient with the liquid receiving port 201 facing upward at the lower side of the opening 122, and at both ends of the elastic member 24 protruding left and right from the upper part 21. The ring portions 241 are respectively hooked on the two cord holders 14. The liquid receiving port 201 may be widened by applying the ring part 241 to a part ahead of the ankles on both sides of the patient (for example, a part near the arch).

  Moreover, the 1st insertion film 31 is inserted in the vagina, and the clearance gap between the site | part below the edge of the opening 122, and the site | part below the patient's vagina is obstruct | occluded. Subsequently, the second and third insertion films 32 and 33 are inserted into the vagina, and the gap between the side portion of the edge of the opening 122 and the side portion of the patient's vagina facing this portion is provided. Is blocked. Then, as shown in FIG. 4, an instrument 9 such as a cusco (colposcope) is inserted into the vagina, and the vagina exposed from the opening 122 of the drape 1 while continuously or intermittently injecting a perfusion solution such as physiological saline. Is operated on. Liquid such as perfusate flowing out from the vagina is guided onto the clean surface of the drape body 11 by the first to third insertion films 31 to 33 inserted between the instrument 9 and the vagina wall (see FIG. 2). Then, it flows into the pouch 2 through the liquid receiving port 201 and is sucked and discarded by the suction mechanism connected to the conduit portion 23.

  As described above, in the drape 1 of FIG. 1, the insertion films 31 to 33 are provided around the opening 122 for inserting the instrument 9 into the patient's vagina, and the perfusion solution is injected into the vagina. During the operation, the insertion films 31 to 33 are inserted between the device 9 and the vagina wall from the lower part and both sides of the edge of the opening 122, so that the perfusate flowing out from the vagina is draped. It is guided onto the clean surface of the main body 11. Thereby, it is possible to suppress the perfusate from flowing (leaking) between the periphery of the opening 122 of the drape 1 and the site around the patient's vagina (that is, the dirty surface side of the drape main body 11).

  Further, on the unclean surface of the drape main body 11, by providing an adhesive layer 123 that adheres the periphery of the opening 122 and the site around the patient's vagina, leakage of the perfusate can be further suppressed, and the drape main body 11 can be suppressed. By providing the pouch 2 that receives the liquid flowing out from the opening 122, the perfusate can be efficiently collected.

  As another example of the drape 1, the first to third insertion films may be provided as members independent of the drape body 11 (members not fixed to the drape body 11). In this case, after covering the patient with the drape 1 and arranging the opening 122 in the vagina of the patient, a part of each of the first to third insertion films is sequentially inserted into the vagina. In this way, the first to third insertion films are inserted between the device 9 and the vaginal wall from the lower side and both sides of the edge of the opening 122, so that the area around the opening 122 of the drape 1 and the patient are inserted. It is possible to prevent the perfusate from flowing into. However, in order to facilitate the handling of the drape 1, as in the drape 1 of FIG. 1, the end portions of the first to third insertion films 31 to 33 are located below the edge of the opening 122 and on both sides. It is preferable to be fixed to the clean surface of the drape body 11 near the site.

  FIG. 5 is a perspective view showing another example of the drape, and shows only the vicinity of the opening 122 in an enlarged manner. Further, FIG. 5 shows a state when the drape is used. In the drape shown in FIG. 5, the insertion film 34 curved so that the cross-sectional shape parallel to the surface including the edge of the opening 122 is U-shaped in the state where the opening peripheral portion 121 is flattened is The unit 121 is provided. At the end of the insertion film 34 on the opening 122 side, a fixing portion 341 that is fixed on the clean surface of the opening peripheral portion 121 and near the lower portion and the both sides of the edge of the opening 122 is provided. In a state before the drape is used, the insertion film 34 protrudes toward the clean surface side of the opening peripheral portion 121. At the time of use, the base of the insertion film 34 is bent, and as shown in FIG. Then, it is inserted into the vagina so as to protrude from the lower part of the edge of the opening 122 and the parts on both sides to the unclean surface side. Even in the drape of FIG. 5, the insertion film 34 is inserted between the instrument and the patient's vagina wall in the use state, thereby suppressing the perfusion fluid from flowing between the periphery of the opening 122 and the patient. Can do.

  Although the embodiments of the present invention have been described above, the present invention is not limited to the above-described embodiments, and various modifications can be made.

  In the drape 1 of FIG. 2, the second and third insertion films 32 and 33 provided in the vicinity of portions on both sides of the edge of the opening 122 may be omitted. Even in this case, the vicinity of the lower part of the edge of the opening 122 where the perfusate easily flows and the patient are blocked by the first insertion film 31 provided in the vicinity of the part, and the leakage of the perfusate is suppressed. Thus, from the viewpoint of suppressing the perfusate from flowing between the periphery of the opening 122 of the drape 1 and the patient, at least the lower part of the edge of the opening 122 between the device 9 and the vaginal wall. It is important that the insertion film is inserted. In this case, the width of the insertion film is preferably not less than the width of the opening 122 (not more than twice the width), and the length of the insertion film is preferably not less than 20 mm (150 mm or less). However, in order to further suppress leakage of the perfusate, it is preferable that the first to third insertion films 31 to 33 are inserted between the instrument 9 and the vagina wall.

  Further, the insertion film may be attached on the clean surface of the drape main body 11 with a double-sided tape or the like immediately before the operation, and a pair of surface fasteners or the like are provided on the end of the insertion film and the clean surface of the drape main body 11. The insertion film and the drape body 11 may be detachable.

  The insertion film does not necessarily need to be a separate member from the drape main body 11. For example, as shown in FIG. 6, when forming the opening 122a in the opening peripheral portion 121a, the insertion film is substantially U-shaped inverted in the vertical direction. A cut line (continuous cut line) is formed, and the root of the part surrounded by the cut line is bent along a line connecting both ends of the cut line. Thereby, the said site | part becomes the insertion film 35, and a cut and a crease | fold become the edge of the opening 122a. Thus, even in the drape in which the insertion film 35 is formed integrally with the drape main body 11 (the opening peripheral portion 121a thereof), the insertion film 35 is inserted between the device 9 and the vagina wall, thereby opening the opening. It is possible to prevent the perfusate from flowing between the periphery of 122a and the patient. 6 is bent in a direction away from the opening 122a on the clean surface side before use, and is bent on the unclean surface side during use so that it is between the device 9 and the vagina wall. By being inserted, it is possible to easily arrange the opening 122a with respect to the patient's vagina immediately before the insertion film 35 is inserted into the vagina.

  As described above, in the drape 1, since the gap between at least the lower part of the edges of the openings 122 and 122 a and the patient is blocked by the insertion film, it is injected into the patient's vagina during the operation. The adhesive layer 123 can be omitted depending on the flow rate of the perfusate to be used. Alternatively, the pouch 2 may be omitted, and a liquid recovery container or the like may be disposed below the openings 122 and 122a of the drape 1.

  The shape of the openings 122 and 122a is not limited to an ellipse, and may be various shapes such as a circle and a rectangle. Moreover, the drape main body 11 does not necessarily need to be formed with a nonwoven fabric, for example, may be formed with a plastic film.

  The drape 1 may be used in a treatment (for example, transurethral resection (TUR)) performed while injecting a perfusate into the urethral hole. That is, the drape 1 can be used in a treatment performed while injecting a perfusate into a resident hole that is a vagina or a urethral hole of a female patient. In the drape 1, an opening for inserting a bipolar (female), an endoscopic camera, a catheter or the like into a permanent hole is provided, and an insertion film is inserted into the vagina from at least a lower part of the edge of the opening. By being inserted, the perfusate is suppressed from flowing between the periphery of the opening and the patient. The configurations in the above-described embodiments and modifications may be combined as appropriate as long as they do not contradict each other.

DESCRIPTION OF SYMBOLS 1 Drape 2 Pouch 9 Apparatus 11 Drape main body 31-35 Insertion film 122,122a Opening 123 Adhesive layer 311,321,331 End part 341 Fixing part

Claims (7)

A sheet-like drape covering the patient in a procedure performed while injecting a perfusate into a resident hole that is a vagina or urethral hole of the patient,
A sheet-shaped drape body in which an opening for inserting an instrument into the permanent hole is formed;
An insertion film that guides the perfusate flowing out of the permanent hole onto the drape body by being inserted into the vagina from at least the lower part of the edge of the opening;
A drape characterized by comprising. A drape according to claim 1, wherein
The insertion film is a member different from the drape body, and an end of the insertion film is fixed to the surface of the drape body opposite to the patient in the vicinity of the lower portion of the edge. A drape characterized by that. A drape according to claim 1 or 2,
The drape characterized by the said insertion film being bent in the direction away from the said opening in the state before use. A drape according to claim 1 or 2,
The insertion film is inserted into the vagina from the lower part of the edge;
The drape further comprises two other insertion films that are inserted into the vagina from both sides of the edge of the opening. A drape according to claim 4, wherein
A drape, wherein each of the insertion film and the other two insertion films is bent in a direction away from the opening in a state before use. A drape according to any of claims 1 to 5,
The drape further comprising a pouch attached on the drape body and receiving the liquid flowing out from the opening. A drape according to any of claims 1 to 6,
The drape further comprising an adhesive layer attached to the periphery of the opening on a surface of the drape main body facing the patient and sticking the periphery of the opening and the patient.

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