JP5875898B2 - Endoscopic surgical absorbent cartridge - Google Patents

Description

  The present invention relates to an absorbent material that absorbs bodily fluids such as blood in a patient's body cavity during endoscopic surgery.

  In endoscopic surgery, a trocar is inserted into the body cavity from outside the body cavity of the patient through the cavity wall. In the trocar, the inner end side of the tip protrudes into the body cavity and the outer end side protrudes out of the body cavity. This trocar is a tube whose basic structure is a circular cross section.

  When wiping blood or other body fluids in a patient's body cavity, the body fluid absorbent is gripped by the gripping portion at the tip of the forceps shaft outside the body cavity. The gripping part that has gripped the absorbent material passes the trocar from the opening at the outer end to the opening at the inner end. The absorbent material is passed through the trocar and into the body cavity. In the body cavity, the absorbent material sucks body fluid such as blood. The absorbent that has inhaled the body fluid passes through the trocar and out of the body cavity.

The body cavity is filled with an inflation gas such as carbon dioxide through a trocar. The inflation gas keeps the body cavity inflated. This is to secure an operative field in the body cavity.
In the trocar, a branch pipe for injecting a body cavity inflation gas is connected to a main pipe that passes through a shaft portion of a forceps. In the main pipe, the branch pipe connecting portion is disposed on the outer end side, and a check valve is provided at the outer end side position of the branch pipe connecting portion. The check valve prevents the body cavity inflation gas from flowing out from the outer end opening of the main pipe. It is a leak-proof valve for body cavity inflation gas.

  As disclosed in Patent Document 1, the absorbent material is made of a woven gauze or a non-woven fabric in a strip shape and attached with an X-ray contrast yarn. The X-ray contrast yarn protrudes from the corner of the strip-shaped absorbent material.

Japanese Patent No. 4253656 JP 2005-296562 A

[Task]
When the trocar has a large diameter, a hole penetrating the cavity wall of the patient has a large diameter. Damage to the patient increases. Small diameter trocars have recently been used to reduce patient damage. Small diameter forceps are used for small diameter trocars. In the small-diameter forceps, the outer diameter of the shaft portion inserted into the small-diameter trocar is smaller than the inner diameter of the small-diameter trocar.

  The small diameter trocar is, for example, a 5 mm trocar. For the 5 mm trocar, forceps having an outer diameter of the shaft portion of 5 mm are used. The 5 mm trocar has an inner diameter of greater than 5 mm and 6 mm. The large diameter trocar includes a 10 mm trocar, a 12 mm trocar and a 16 mm trocar.

However, a small-diameter trocar cannot pass a large absorbent material. The absorbent material that can be passed becomes smaller. The small absorbent material has a small thickness and area, and absorbs less body fluid from the patient. Absorbents with a small amount of absorption increase the number of sheets used and increase the number of passes through a small diameter trocar. The trouble of wiping off body fluid increases.
In endoscopic surgery, the operation is interrupted while wiping off body fluids. As the number of bodily fluids increases, the number of surgical interruptions increases. The efficiency of surgery is not improved.
It is desirable that the absorbent material has a large amount of absorption and can pass through a small-diameter trocar.

[Observation]
When a forceps in a closed state that does not hold the absorbent material is inserted through the opening at the outer end of the trocar, the grip at the tip of the forceps shaft pushes the trocar check valve and the leakage valve for the body cavity inflation gas open. The forceps shaft passes through the leak-proof valve.

  When inserting the forceps holding the absorbent material into the trocar, the absorbent material is first put into the outer end opening of the trocar, and the absorbent material in the trocar is pushed with the forceps. A large absorbent material having a large amount of absorption is pushed by forceps and spreads radially in the trocar. However, when the large absorbent material hits the leak-proof valve, the leak-proof valve cannot be expanded and opened. This is because the absorbent material is woven gauze or non-woven fabric and is soft.

  In addition, when the gripping portion at the tip of the shaft portion of the forceps sandwiches the absorbent material with the gripping piece, the outer width or the outer diameter increases by the sandwiched thickness. When the outer diameter of the forceps gripping portion that has gripped the absorbent material is equal to or larger than the inner diameter of the trocar, the forceps cannot be inserted into the trocar.

[Idea]
1. Attention point When the trocar inserts a synthetic resin tube such as a straw for sucking a beverage through the outer end opening and pushes the leakage prevention valve at the end of the tube, the leakage prevention valve is expanded and opened. A synthetic resin tube such as a straw has the strength necessary to push open a leak-proof valve, unlike a woven gauze or non-woven fabric of an absorbent material.

  In addition, the outer diameter or the outer width of the gripping portion at the distal end of the shaft portion of the forceps does not increase if the absorbent material is pushed in a closed state without grasping the absorbent material. When the forceps shaft is inserted into the trocar, a gap is formed between the inner peripheral surface of the trocar and the outer periphery of the forceps shaft.

2. Cartridge tube A tube such as a synthetic resin tube is used as a cartridge for the absorbent material.
The cartridge tube is filled with an absorbent material so that the absorbent material can be extruded. The outer diameter is a dimension that can be inserted into the trocar. The strength should be such that the trocar check valve and leak-proof valve can be pushed open. The inner diameter is dimensioned to allow insertion of forceps.
During use of the absorbent material, the cartridge tube is inserted into the trocar through the opening at the outer end. Then, the cartridge tube pushes and opens the trocar leakage prevention valve, and penetrates the leakage prevention valve in the open state. Next, forceps are inserted into the cartridge tube from the outer end opening. The absorbent material in the cartridge tube is pushed forward with forceps. The absorbent material is pushed out from the inner end opening of the cartridge tube. Moreover, it extrudes from the inner end opening of the trocar.
Even if the absorbent material has a large amount of absorption, the absorbent material can pass a small-diameter trocar.

3. The outer end of the cartridge tube The outer end of the cartridge tube is expanded in a funnel shape.
Then, the outer end portion of the cartridge tube has a funnel shape, so that forceps can be easily inserted into the opening at the outer end.
Further, when the cartridge tube is inserted into the trocar, the outer end of the large diameter hits the outer end of the trocar and the insertion is stopped. Furthermore, even if the cartridge tube is pushed forward with the advancing absorbent when the absorbent material inside is pushed out, the outer end of the large diameter hits the outer end of the trocar and the advancement is stopped. The outer end of the large diameter is the entry stop.
After the cartridge tube is emptied by extruding the absorbent material, the large-diameter funnel-shaped outer end portion remains outside the trocar. Grasp the funnel-shaped outer end and pull it out of the trocar. When the outer end of the cartridge tube enters the trocar, it becomes difficult to remove the cartridge tube from the trocar.

4). The length of the cartridge tube The cartridge tube has such a length that the inner end does not protrude from the inner end opening of the trocar when the funnel-shaped outer end hits the outer end of the trocar and is blocked.
If the inner end of the cartridge tube protrudes from the inner end opening of the trocar, the inner end can injure the patient's body cavity.

5). Absorbent shape The absorbent material is strip-shaped.
Since the cartridge tube has an elongated inside, it is easy to accommodate a strip-shaped absorbent material.

1. It consists of an absorbent material that enters the patient's body cavity through a trocar in endoscopic surgery and a cartridge tube that stuffs the absorbent material ,
Cartridges tube inserted into the trocar, inserting a forceps into the opening of the outer end, the absorbent cartridge extruding absorbent packed inside from the opening of the inner end with forceps,
The cartridge tube is a tube with a circular cross section of synthetic resin, the outer end of the tube is expanded in a funnel shape, the portions other than the funnel-shaped outer end of the tube are the same diameter portion, and the absorbent material is packed into the same diameter portion. And
An absorbent cartridge for an endoscopic operation, wherein the same diameter portion is configured to be inserted into the trocar, and the funnel-shaped end portion is applied to the outer end of the trocar to prevent entry .
2. In the above-mentioned 1 absorbent cartridge for an endoscopic operation,
The absorbent material is characterized by being made of woven gauze or non-woven fabric which absorbs blood and other body fluids in the body cavity .
3. In the above-mentioned 1 absorbent cartridge for an endoscopic operation,
The absorbent material is characterized by being a woven gauze laminate in which woven gauze is laminated .
4). In the above 1, 2, or 3 absorbent cartridge for endoscopic surgery,
The absorbent material has a strip shape.
5). In the absorbent cartridge for an endoscopic operation according to any one of 1 to 4,
The absorbent material is characterized by attaching an X-ray contrast yarn.
6). In the above-mentioned 4 absorbent cartridge for endoscopic surgery,
The strip-shaped absorbent material is characterized in that an X-ray contrast yarn is attached and the X-ray contrast yarn protrudes from a corner.
7). In the absorbent cartridge for an endoscopic operation according to any one of 1 to 6,
The trocar is characterized by an inner diameter of 6 mm or less.
8). In the absorbent cartridge for an endoscopic operation according to any one of 1 to 7,
The trocar is a 5 mm trocar.

  An absorbent material with a large amount of absorption can be passed through a small-diameter trocar.

The front view of the packaging state of the absorbent material cartridge for endoscopic surgery in the 1st example of embodiment of this invention. The front view of the absorbent material cartridge for surgery under the same endoscope. FIG. 3 is a sectional view taken along line AA in FIG. 2. The front view of the cartridge pipe | tube of the absorber cartridge for the same endoscopic surgery. BB sectional drawing of FIG. The front view of the absorber of the absorber cartridge for the same endoscopic surgery. The CC sectional view taken on the line of FIG. The figure which shows the manufacturing process of the absorber. The front view of the trocar which uses the absorber cartridge for surgery under the same endoscope. The front view of the state which inserted the absorbent material cartridge for surgery under the same endoscope into the trocar. The front view of the state which inserted the forceps into the absorbent material cartridge for surgery under the endoscope and pushed out the absorbent material. The figure which shows the manufacture process of the absorber of the absorber cartridge for endoscopic surgery in the 2nd example of embodiment.

[First example (see FIGS. 1 to 11)]
〔Overview〕
The absorbent cartridges 2, 3, and 6 for endoscopic surgery of this example are packaged in a packaging bag 1 and sterilized before use as shown in FIG.
The absorbent cartridges 2, 3, 6 for endoscopic surgery shown in FIGS. 2 and 3 are attached to the cartridge tubes 2, 3 shown in FIGS. 4 and 5 with the X-ray contrast thread 7 shown in FIGS. 6 and 7. The absorbent material 6 is packed. The absorbent 6 with the X-ray contrast yarn 7 is manufactured through the process shown in FIG.
The cartridges 2, 3, 6 of this example are used in the trocars 21, 22 shown in FIG. As shown in FIG. 10, the cartridge tubes 2 and 3 are inserted into the main tube 21 of the trocar. Next, as shown in FIG. 11, the forceps 26 are inserted into the cartridge tubes 2 and 3, and the absorbent material 6 is pushed out by the forceps 26.

[Cartridge tube]
As shown in FIGS. 4 and 5, the cartridge tubes 2 and 3 are tubes having a circular cross section. The outer end 2 of the tube expands in a funnel shape. The portions other than the funnel-shaped outer end portion 2 of the tube have the same diameter portion 3. The same diameter portion 3 has an outer diameter that can be inserted into the trocar main pipe 21. The inner diameter is such that the forceps 26 can be inserted. The length is shorter than the main 21 of the trocar. The strength is set to such a value that the trocar check valve and leak check valve 23 can be pushed open. The funnel-shaped outer end portion 2 is configured to prevent entry into contact with the outer end of the trocar main pipe 21.
In the embodiment, the same diameter portion 3 has an outer diameter of 5.5 to 6 mm, an inner diameter of 5.1 to 5.5 mm, and a length of about 100 mm. The material is a synthetic resin such as polypropylene, polyethylene or PET.

[Absorbent]
As shown in FIGS. 6 and 7, the absorbent 6 is formed by folding gauze and sewing it into a strip shape. The strip-shaped absorbent material 6 has X-ray contrast threads 7 attached to diagonal positions on one side. Both ends of the X-ray contrast yarn 7 protrude from the corners of the absorbent material 6.

The material of the absorbent material 6 is cotton yarn woven gauze. As shown in the first step on the left side of the upper stage of FIG. 8, the woven gauze 11 is formed in a horizontally long rectangular shape, and the left and right side portions are folded to the same side at the fold line position 12 to be doubled. As shown in the second step on the right side of the upper stage in FIG. In this vertically long rectangular woven gauze, the upper and lower side portions are folded to the same side at the folding line position 12 to be quadruple. As shown in the third step on the right side of the middle stage in FIG. In this horizontally long rectangular woven gauze, the lower half is folded at the fold line position 12 to make 8 layers. As shown in the fourth step on the left side of the middle stage in FIG. 8, a horizontally long rectangular shape and a strip shape are formed. This strip-shaped woven gauze is sewn with a cotton thread 13 along the left and right sides and the upper side, as shown in the fifth step on the left side of the lower part of FIG. A laminate of strip-shaped woven gauze. As shown in the sixth step on the right side of the lower stage of FIG. 8, the strip-shaped woven fabric gauze laminate and absorbent material 6 are sewn with X-ray contrast threads 7 at diagonal positions on one side. Both ends of the X-ray contrast yarn 7 protrude from the corners of the absorbent material 6.
In the embodiment, the absorbent material 6 in which the woven gauze 11 is laminated eight times has a size of 25 × 75 mm. The single woven gauze 11 serving as the absorbent material has a size of 100 × 150 mm as shown in the first step on the left side of the upper stage of FIG. The warp and weft yarns are 40th cotton yarn. The yarn density is about 12 / cm.

〔cartridge〕
As shown in FIGS. 2 and 3, the absorbent cartridges 2, 3, 6 for endoscopic surgery are filled with the absorbent 6 in the same diameter portion 3 of the cartridge tubes 2, 3, and the absorbent 6 in the cartridge tube is The forceps 26 can be pushed out. As shown in FIG. 1, the cartridges 2, 3, and 6 are packaged in a sterilization packaging bag 1 and sterilized.

[Trocar]
As shown in FIG. 9, the trocar connects a branch pipe 22 for injecting a body cavity inflation gas to a main pipe 21 having a circular cross section through which forceps 26 are passed. The main pipe 21 has a branch pipe connection portion disposed on the outer end side, and a check valve 23 is provided at the outer end side position of the branch pipe connection portion. The check valve 23 prevents the body cavity inflation gas from flowing out from the outer end opening of the main pipe 21. It is a leak-proof valve for body cavity inflation gas. The branch pipe 22 is provided with an on-off valve 24 in the middle.
In the example, the trocar is a 5 mm trocar. The main pipe has an inner diameter of 6 mm and a length of about 150 mm. The forceps 26 used for the 5 mm trocar has an outer diameter of the shaft portion of 5 mm.

[How to use the cartridge]
In an endoscopic operation, the main tube 21 of the trocar is inserted into the body cavity from outside the body cavity of the patient through the cavity wall. The main tube 21 of the trocar protrudes from the inner end side of the tip into the body cavity and the outer end side out of the body cavity.
When using the absorbent material 6, the absorbent cartridges 2, 3, 6 for endoscopic surgery are removed from the packaging bag 1. The cartridges 2, 3 and 6 grip the funnel-shaped outer end 2 of the cartridge tube, and, as shown in FIG. 10, insert the same diameter portion 3 into the main tube 21 of the trocar from the outer end opening. Then, the same diameter portion 3 of the cartridge tube pushes and opens the trocar leakage prevention valve 23 and penetrates the leakage prevention valve 23 in the opened state.
Next, as shown in FIG. 11, the shaft portion of the forceps 26 is inserted into the cartridge tubes 2 and 3 from the outer end opening. The absorbent 6 in the same diameter part 3 of the cartridge tube is pushed forward by the forceps 26 and advanced. The absorbent 6 is pushed out from the inner end opening of the same diameter portion 3 of the cartridge tube to the main tube 21 of the trocar. Further, the trocar is pushed out from the inner end opening of the main pipe 21 into the body cavity of the patient.

When the insertion length of the cartridge tubes 2 and 3 into the trocar main tube 21 is substantially the same as the length of the same diameter portion 3, the large-diameter funnel-shaped outer end portion 2 is formed at the outer end of the trocar main tube 21. The insertion is stopped. Further, the cartridge pipes 2 and 3 are positioned so that the large-diameter funnel-shaped outer end portion 2 contacts the outer end of the trocar main pipe 21, and the inner ends do not protrude from the inner end opening of the trocar main pipe 21.
Furthermore, even when the cartridge pipes 2 and 3 are pushed forward with the advancing absorbent material 6 when the internal absorbent material 6 is pushed out, the large-diameter funnel-shaped outer end portion 2 hits the outer end of the trocar main pipe 21. The advance is stopped. The large-diameter funnel-shaped outer end portion 2 remains outside the trocar main pipe 21.
After the pushing out of the absorbent 6, the emptied cartridge tubes 2 and 3 are pulled out from the trocar main tube 21 by grasping the funnel-shaped outer end portion 2 that is outside the trocar main tube 21. The trocar leakage valve 23 then closes.
In the embodiment, the absorbent material 6 with the 25 × 75 mm X-ray contrast yarn 7 obtained by folding the 100 × 150 mm woven gauze 11 into eight layers passes through the 5 mm trocar. Compared to the case where the cartridge tubes 2 and 3 are not used, the absorbent material that can pass through the 5 mm trocar has a volume or absorption amount approximately three times that of the absorbent material.

[Second Example (see FIG. 12)]
The absorbent material cartridge for endoscopic surgery of this example changes the configuration of the absorbent material 6 with the X-ray contrast yarn 7 in the first example.
As shown in the first step of the uppermost stage in FIG. 12, the woven gauze 31 that is the material of the absorbent material 6 is formed into an elongated rectangular shape in the left-right direction, and the left and right side portions are folded to the same side at the folding line position 32. Duplicate. As shown in the second step of FIG. 12, a horizontally long rectangular shape with the left-right direction halved is formed. In this horizontally long rectangular woven gauze, the lower half is folded at the fold line position 32 to be quadruple. As shown in the third step of FIG. 12, a vertically long rectangular shape and a strip shape are formed in which the vertical direction is halved. As shown in the fourth step of FIG. 12, this strip-shaped woven gauze is sewn with a cotton thread 33 along the left and right sides and the upper side, and a four-fold woven gauze is sewn together. A laminate of strip-shaped woven gauze. As shown in the fifth step of FIG. 12, the strip-shaped woven fabric gauze laminate and absorbent material 6 are sewn with X-ray contrast threads 7 at diagonal positions on one side. Both ends of the X-ray contrast yarn 7 protrude from the corners of the absorbent material 6.
The absorbent material 6 with the X-ray contrast yarn 7 is folded in half at the center in the left-right direction, as shown in the sixth step at the bottom of FIG. In this folded state, the cartridge tubes 2 and 3 are packed and can be pushed out by the forceps 26.

In the embodiment, the absorbent material 6 in which the woven gauze 31 is laminated four times has a size of 25 × 150 mm. In the folded state, it is 25 × 75 mm. The single woven gauze 31 has a size of 50 × 300 mm as shown in the uppermost first step of FIG. The warp and weft yarns are 40th cotton yarn. The yarn density is about 12 / cm. The woven gauze 31 has the same volume as the woven gauze 11 in the first example.
The other points are the same as in the first example.

[Modification]
1 . In the above embodiment, the absorbent material 6 is the woven gauze 11 or 31, but it is a non-woven fabric that absorbs blood and other body fluids in the body cavity.
2 . In the above embodiment, the trocars 21 and 22 are 5 mm trocars and trocars having an inner diameter of 6 mm, but trocars having an inner diameter of less than 6 mm.

1 packaging bag, sterilization packaging bag 2, 3, 6 Endoscopic absorbent cartridge, cartridge 2, 3 cartridge tube 2 outer end, funnel-shaped outer end, ingress stop 3 same diameter part 6 absorbent, Laminated fabric gauze laminate 7 X-ray contrast yarn 11 Woven fabric gauze 12 Folding line position 13 Cotton yarn 21, 22 Trocar 21 Main tube 22 Branch tube 23 Check valve, leakage valve, gas leakage valve 24 for body cavity expansion Open / close valve 26 Forceps 31 Woven gauze 32 Folding line position 33 Cotton thread

Claims (8)

It consists of an absorbent material that enters the patient's body cavity through a trocar during endoscopic surgery, and a cartridge tube that stuffs the absorbent material .
Cartridges tube inserted into the trocar, inserting a forceps into the opening of the outer end, the absorbent cartridge extruding absorbent packed inside from the opening of the inner end with forceps,
The cartridge tube is a tube with a circular cross section of synthetic resin, the outer end of the tube is expanded in a funnel shape, the portions other than the funnel-shaped outer end of the tube are the same diameter portion, and the absorbent material is packed into the same diameter portion. And
An absorbent cartridge for an endoscopic operation, wherein the same diameter portion is configured to be inserted into the trocar, and the funnel-shaped end portion is applied to the outer end of the trocar to prevent entry . The absorbent cartridge for an endoscopic operation according to claim 1, wherein the absorbent material is a woven gauze or a non-woven fabric that absorbs blood and other body fluids in the body cavity . The absorbent material cartridge for an endoscopic operation according to claim 1 , wherein the absorbent material is a woven fabric gauze laminate in which woven fabric gauze is laminated .   The absorbent material cartridge for endoscopic surgery according to claim 1, 2 or 3, wherein the absorbent material has a strip shape.   The absorbent material cartridge for an endoscopic operation according to any one of claims 1 to 4, wherein the absorbent material is attached with an X-ray contrast thread.   5. The absorbent cartridge for an endoscopic operation according to claim 4, wherein the strip-shaped absorbent material is attached with an X-ray contrast thread and protrudes from the corner.   The absorbent cartridge for an endoscopic operation according to any one of claims 1 to 6, wherein the trocar has an inner diameter of 6 mm or less.   The absorbent cartridge for an endoscopic operation according to claim 1, wherein the trocar is a 5 mm trocar.

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