JP5926718B2 - Endoscopic surgical article cartridge and method for producing the same - Google Patents

Description

  The present invention relates to a surgical article cartridge that is inserted into a body cavity of a patient via a trocar in an endoscopic operation.

In endoscopic surgery, an absorbent cartridge that inhales blood and other body fluids in a patient's body cavity has been invented.
As disclosed in Patent Document 1, this cartridge includes an absorbent material that is inserted into a patient's body cavity through a trocar, and a cartridge tube that houses the absorbent material. The absorbent material is a strip-shaped gauze. The cartridge tube is filled with an absorbent material so that it can be pushed out, the outer diameter can be inserted into the trocar, and the inner diameter can be inserted by forceps. The strength enables the trocar body cavity inflation gas leak-proof valve to be pushed open. The cartridge tube has a funnel-shaped outer end, and the conical funnel-shaped end serves as an ingress stop against the outer end of the trocar. When the absorbent material is used, the cartridge tube is inserted into a trocar attached to the patient, forceps are inserted into the opening at the outer end, and the internal absorbent material is pushed out from the opening at the inner end to the body cavity with the forceps. An empty cartridge tube is extracted from the trocar.

  Moreover, the auxiliary component for trocars disclosed in Patent Document 2 stores the fabric in the auxiliary cylinder. In the auxiliary cylinder, the outer diameter of the front portion is made smaller than the inner diameter of the trocar, and the outer diameter of the rear portion is made larger than the inner diameter of the trocar. When the auxiliary cylinder has an outer diameter smaller than that of the rear part at the front part, the auxiliary cylinder is cut at the front part of the cylinder having the uniform outer diameter, and the cylinder wall of the cut part is overlapped. Alternatively, a slit is formed instead of the cut, and the gap between the slits is reduced. A conical intermediate portion is formed between the small-diameter front portion and the large-diameter rear portion. The conical intermediate part is an ingress stop against the outer end of the trocar. When the fabric is used, the auxiliary cylinder puts only the front side portion into the trocar. The fabric in the auxiliary cylinder is pushed into the abdominal cavity of the patient by pushing the tip of the forceps. The empty auxiliary cylinder is extracted from the trocar.

JP 2013-183751 A JP 2003-102738 A

[Task]
1. In the cartridge as described above, when the cartridge tube is inserted into the trocar, the entry stop hits the outer end of the trocar. Further, when the internal absorbent material is pushed out with forceps, a force in the extrusion direction is received from the absorbent material being extruded, and the ingress stop strongly hits the outer end of the trocar. Then, the cartridge tube entry stop has a conical shape or a tapered shape, and is firmly inserted into the outer end of the trocar and bites into the cartridge tube. The cartridge tube is difficult to extract from the trocar. For cartridges, I want to make it easier to pull the cartridge tube out of the trocar.

  In order to prevent the cartridge tube from biting into the trocar, it is conceivable that the cartridge tube is suddenly increased stepwise instead of gradually increasing the outer diameter at the entry stop position. However, it is difficult to easily manufacture a pipe having a two-step diameter in a step shape. The cartridge tube is disposable and must be inexpensive. It must be easy to make. Therefore, an extruded product of synthetic resin is used. For cartridges, I want to make a cartridge tube easily.

  Further, when the internal absorbent material is tightly fitted to the cartridge tube, the internal absorbent material is strongly pressed with the forceps when the absorbent material is pushed out with the forceps. Then, the outer end side portion of the cartridge tube receives a strong force that pushes out from the internal absorbent, and the forceps strongly rub the inner surface, which may damage the peripheral wall of the outer end side portion. When the outer end side portion of the cartridge tube is damaged, it becomes difficult to push out the absorbent material. With cartridges, I want to make it difficult to damage the outer end of the cartridge tube.

2. Surgical supplies that can be inserted into a patient's body cavity via a trocar include tuppel and gauze balls that are mainly used for tissue separation in addition to absorbent materials that are mainly used to absorb body fluid. There are various gauze and fabric products. I would like to make these cartridges easy to put in the body cavity.
Tuppel and gauze balls are gauze products made by rounding gauze into a spherical shape, an ellipsoidal shape, a cylindrical shape, or the like. Tuppel means a small one and gauze ball means a large one.

  In addition, surgical supplies that can be inserted into a patient's body cavity via a trocar include a retraction tool that changes the position of the organ. This is made of foamed synthetic resin such as sponge or cloth. We want to make sponge products and fabric products easy to put into the body cavity by using cartridges.

[Idea]
1. In manufacturing the cartridge tube, the “tube with one end expanded” can be easily manufactured. The production method is to extrude a synthetic resin cylinder having a uniform diameter. The synthetic resin cylinder heats and softens the end of one end, and presses a tapered mold to enlarge the end.
Therefore, in addition to the cartridge tube having a “tube with an enlarged one end”, an ingress prevention reinforcing tube is newly provided so that the ingress prevention reinforcing tube is also a “tube with an enlarged one end”.

  The ingress prevention reinforcing tube is fitted on the outer periphery of the uniform diameter portion of the cartridge tube, and the uniform diameter portion is disposed on the enlarged end side and the outer end side of the cartridge tube, and the enlarged end portion is disposed on the opposite side and the inner end side. The inner end side portion of the uniform diameter portion of the cartridge tube protrudes from the enlarged end portion of the ingress stop reinforcing tube. That is, the ingress prevention reinforcing tube is made shorter than the uniform diameter portion of the cartridge tube, and the uniform diameter portion is made thicker than that of the cartridge tube.

  In the cartridge tube with the entry preventing reinforcing tube, the inner end side portion and the protruding portion of the uniform diameter portion are inserted into the trocar. Then, the enlarged end portion of the ingress prevention reinforcing tube hits the outer end of the trocar, and the uniform diameter portion hits the enlarged end portion of the cartridge tube. The ingress stop reinforcing tube becomes the ingress stop of the cartridge tube. Since the enlarged end portion of the entry stop reinforcing tube is not tapered in the entry direction, it is difficult to bite into the trocar even if it is strongly applied to the outer end of the trocar. A cartridge tube with an ingress stop reinforcement tube is easy to extract from the trocar.

  Further, the cartridge tube is reinforced by covering the outer diameter side portion of the uniform diameter portion with the uniform diameter portion of the ingress prevention reinforcing tube. Even if the internal surgical supplies are strongly pressed with forceps, they are not easily damaged.

2. Examples of the surgical supplies to be packed in the cartridge tube include an absorbent material mainly used for sucking body fluids in the body cavity of a patient, Tuppel and gauze balls mainly used for tissue separation, and a retraction tool mainly used for repositioning an organ.
In the absorbent cartridge, the absorbent material of woven or non-woven gauze is folded or rolled into an elongated shape and inserted into a cartridge tube and packed.
In a Tuppel or gauze ball cartridge, a woven gauze or non-woven gauze tuppel or gauze ball is compressed into an elongated shape and inserted into a cartridge tube and packed.
In the cartridge of the pressure relief device, the pressure relief device made of sponge or cloth is compressed or folded into an elongated shape and inserted into the cartridge tube and packed.
As long as the surgical supplies to be packed in the cartridge tube have a shape and dimension that can be inserted into the cartridge tube, all of them are applicable regardless of uses such as body fluid suction, tissue peeling, and organ exclusion.

1. Consists of surgical supplies, cartridge tubes, and entry-stop reinforcement tubes that enter the patient's body cavity through trocars under endoscopic surgery,
Each of the cartridge tube and the ingress prevention reinforcing tube is a tube having an enlarged one end portion, and has an equal diameter portion and an enlarged end portion,
The cartridge tube allows the uniform diameter part to be inserted into the trocar, allows insertion of forceps from the enlarged end part to the uniform diameter part, is filled with surgical supplies, and is configured to push out the surgical supplies from the inner end with forceps,
The ingress prevention reinforcing tube is fitted on the outer periphery of the uniform diameter portion of the cartridge tube, the uniform diameter portion is arranged on the enlarged end side of the cartridge tube, and the enlarged end portion is arranged on the opposite side. The outer end side portion of the cartridge tube is covered, and the inner end side portion of the uniform diameter portion of the cartridge tube protrudes from the enlarged end portion,
When a cartridge tube with an entry prevention reinforcement tube is inserted into the trocar at the inner end side of the uniform diameter portion, the enlargement end of the entry prevention reinforcement tube contacts the outer end of the trocar, and the equal diameter portion is the enlarged end of the cartridge tube. Endoscopic surgical product cartridge, wherein the cartridge tube is configured to stop entering the cartridge tube.
2. In the above-mentioned 1 absorbent cartridge for an endoscopic operation,
The surgical supplies shall be an absorbent material mainly used to absorb body fluid in the patient's body cavity, a tuppel or gauze ball mainly used for tissue separation, or a retraction tool mainly used to reposition the organ. Features.
3. The absorbent material cartridge for endoscopic surgery on SL 2,
The absorbent material is characterized by laminating woven or non-woven gauze .
4). In the above 1, 2, or 3 absorbent cartridge for endoscopic surgery,
The surgical supplies are characterized in that they contain X-ray contrast threads.
5. In the absorbent cartridge for an endoscopic operation according to any one of 1 to 4,
The trocar is characterized by an inner diameter of 6 mm or less.
6). A method for producing an endoscopic surgical product cartridge according to any one of 1 to 5 ,
A tube of an enlarged end portion of the cartridge tube, the tube having an enlarged end portion of the entrance stop reinforcing tube, respectively, extruding the synthetic resin tube of uniform diameter, and soften the end portion of the one end of the synthetic resin tube production method of endoscopic surgical items cartridge it characterized by expanding against the mold Te.

  The cartridge tube with the entry prevention reinforcing tube is difficult to bite into the trocar and is easily extracted from the trocar. Moreover, even if the internal surgical supplies are strongly pressed with forceps, they are not easily damaged. Easy to make.

1 is a front view of an endoscopic surgical product cartridge according to an embodiment of the present invention. FIG. 2 is an enlarged sectional view taken along line AA in FIG. 1. FIG. 3 is an enlarged cross-sectional view taken along line BB in FIG. The front view of the cartridge pipe | tube of the same endoscopic operation goods cartridge. The CC sectional view enlarged view of FIG. The front view of the approach prevention reinforcement pipe | tube of the endoscopic operation goods cartridge. FIG. 7 is an enlarged sectional view taken along line D-D in FIG. 6. The figure which shows the manufacturing process of the absorbent material of the surgical supplies of the same endoscopic surgical supply cartridge. The front view of the trocar which uses the endoscopic operation goods cartridge. The front view which shows the state which inserted the endoscopic operation goods cartridge in the trocar.

〔Overview〕
As shown in FIGS. 1 to 3, the endoscopic surgical product cartridge 1 of the present example includes cartridge tubes 2 and 3, ingress prevention reinforcing tubes 4 and 5, and surgical product gauze products 6 and 7.

  As shown in FIGS. 4 and 5, the cartridge pipes 2 and 3 are pipes having one end portion enlarged, and have a uniform diameter portion 2 and an enlarged end portion 3. As shown in FIGS. 6 and 7, the ingress stop reinforcing pipes 4 and 5 are also pipes having one end portion enlarged, and have a uniform diameter portion 4 and an enlarged end portion 5. The ingress prevention reinforcing tubes 4 and 5 are shorter than the uniform diameter portion 2 of the cartridge tube, and the uniform diameter portion 4 is thicker than the uniform diameter portion 2 of the cartridge tube.

  As shown in FIGS. 1 to 3, the cartridge tubes 2, 3 are filled with gauze products 6, 7, and are fitted with ingress prevention reinforcing tubes 4, 5 on the outer periphery of the uniform diameter portion 2. The ingress stop reinforcing pipes 4 and 5 are arranged with the uniform diameter part 4 on the enlarged end 3 side and the outer end side of the cartridge pipe, and the enlarged end part 5 on the opposite side and the inner end side. The uniform diameter portion 4 of the ingress stop reinforcing tube covers and reinforces the outer end side portion of the uniform diameter portion 2 of the cartridge tube. The inner end side portion of the uniform diameter portion 2 of the cartridge tube protrudes from the enlarged end portion 5 of the ingress stop reinforcing tube.

  The gauze products 6 and 7 of the surgical supplies are made of an absorbent material 6 with an X-ray contrast thread 7 mainly used for sucking fluid in the body cavity of the patient. This is manufactured through the process shown in FIG.

  As shown in FIG. 9, the trocars 21 and 22 are connected to a passage tube 21 through which forceps are passed and an infusion tube 22 for inflating a body cavity. The passage pipe 21 has an injection pipe 22 connecting portion disposed on the outer end side, and a check valve 23 is provided at an outer end side position of the injection pipe 22 connecting portion. The check valve 23 is a leak valve for the body cavity inflation gas. The injection tube 22 is provided with an on-off valve 24 in the middle.

  When the cartridge 1 is used, as shown in FIG. 10, the cartridge pipes 2 and 3 with the entry preventing reinforcing pipes 4 and 5 are the inner end side portion of the uniform diameter portion 2, and the protruding portion is outside the trocar passage pipe 21. Insert it at the end. Then, the inner end side portion of the uniform diameter portion 2 of the cartridge pipe enters the passage pipe 21, penetrates the leakage prevention valve 23 of the passage pipe 21, and penetrates the injection pipe 22 connection portion of the passage pipe 21. The entry stop reinforcing pipes 4 and 5 stop the entry of the cartridge pipes 2 and 3 when the enlarged end part 5 hits the outer end of the passage pipe 21 of the trocar and the uniform diameter part 4 hits the enlarged end part 3 of the cartridge pipe. Next, the forceps 26 are inserted into the enlarged end 3 of the cartridge tube, and the internal gauze products 6 and 7 are pushed out from the inner end of the uniform diameter portion 2 of the cartridge tube with the forceps 26. The gauze products 6, 7 enter the patient's body cavity through the trocar passage tube 21.

[Cartridge tube and entry stop reinforcement tube]
Each of the cartridge tubes 2 and 3 and the ingress prevention reinforcing tubes 4 and 5 is formed by extruding a synthetic resin cylinder having an equal diameter with a circular cross section, and heats and softens one end of the synthetic resin cylinder. The mold is pressed against the part, and the end is enlarged in a funnel shape. The synthetic resin is made thermoplastic. Examples include polypropylene, polyethylene, and PET.

  The uniform diameter portion 2 of the cartridge tube has an outer diameter that can be inserted into the trocar passage tube 21 and an inner diameter that can be inserted into the forceps 26. The length is set so that it does not protrude from the inner end of the trocar passage tube 21 when it is inserted into the trocar passage tube 21 and stopped by the entry prevention reinforcing tubes 4 and 5. The strength is set to such a value that the trocar check valve and leak check valve 23 can be pushed open.

  The ingress prevention reinforcing tubes 4 and 5 have the equal diameter portion 4 having the same or substantially the same inner diameter as the outer diameter of the uniform diameter portion 2 of the cartridge tube. The maximum diameter of the enlarged end 5 is larger than the inner diameter of the outer end of the trocar passage tube 21 and smaller than the outer diameter. The length is a little less than half of the uniform diameter portion 2 of the cartridge tube. The strength is set to a value that can prevent the cartridge tubes 2 and 3 from entering and reinforce the inner end side portion of the uniform diameter portion 2 of the cartridge tube.

  In the embodiment, the cartridge tubes 2 and 3 are made of polypropylene as the material thermoplastic synthetic resin and have a total length of about 100 mm. The uniform diameter portion 2 has an outer diameter of 5.5 to 6 mm and an inner diameter of 5.1 to 5.5 mm. The ingress stop reinforcing pipes 4 and 5 are made of polypropylene as a thermoplastic synthetic resin, and have a total length of about 40 mm. The enlarged end 5 has a maximum diameter of about 10 mm.

[Gauze products for surgical supplies]
As shown in FIG. 8, the absorbent material 6 with the X-ray contrast yarn 7 of the gauze product is folded and sewn into a slender shape.
The gauze 11 as the material of the absorbent material 6 is a woven fabric of cotton yarn. As shown in the first step at the uppermost stage in FIG. 8, the gauze 11 is formed into a horizontally long rectangular shape, and the left and right side portions are bent to the same side at the vertical fold line position 12. Slightly overlap the left and right bent pieces. As shown in the second step of FIG. 8, a horizontally long rectangular shape with the length in the left-right direction being slightly less than half is formed. This horizontally long rectangular gauze sews the X-ray contrast thread 7 at the diagonal position of the lower half of the surface on the bent side. Next, the lower half is bent at the horizontal folding line position 13. The X-ray contrast thread 7 is sandwiched inside. As shown in the third step of FIG. 8, the length in the vertical direction is halved and the X-ray contrast yarn 7 is arranged in a horizontally long rectangle. This horizontally long rectangular gauze is sewn with a cotton thread 14 along the left side, the right side, and the top side as shown in the fourth step of FIG. Sew together the laminated gauze. A strip-shaped gauze laminate containing the X-ray contrast yarn 7 is formed. As shown in the fifth step at the bottom of FIG. 8, the absorbent material 6 for gauze incorporating the X-ray contrast yarn 7 is folded at approximately the center position in the vertical direction to be folded in two. The cartridge tubes 2 and 3 are packed in the folded state.

  Since the X-ray contrast thread 7 is built in the absorbent material 6, it is difficult for the absorbent material 6 to fall off when the absorbent material 6 is used in a patient's body cavity or taken out of the body cavity.

  In the embodiment, the absorbent material 6 in which the woven gauze 11 is laminated has a size of 25 × 150 mm. In the folded state, it is about 25 × 75 mm. The warp and weft of the woven fabric are 40th cotton yarn. The yarn density is about 12 / cm.

〔cartridge〕
The cartridge 1 contains an absorbent material 6 with an X-ray contrast yarn 7 of gauze product packed in a uniform diameter portion 2 of the cartridge tube. The absorbent 6 can be pushed out with forceps 26.
The cartridge 1 is sealed in a packaging bag and sterilized. At the time of use, the packaging bag is opened and the cartridge 1 is taken out.

[Trocar]
In the embodiment, the trocars 21 and 22 are 5 mm trocars. The passage tube 21 having a circular cross section has an outer diameter of about 20 mm, 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 the endoscopic operation, the trocar passage tube 21 is inserted from the outside of the body cavity of the patient into the body cavity through the cavity wall. The trocar passage tube 21 projects from the inner end side of the tip into the body cavity and from the outer end side to the outside of the body cavity. The body cavity is filled with inflation gas.

  When the absorbent material 6 with the X-ray contrast yarn 7 of the gauze product is used, the cartridge 1 is taken out from the packaging bag. The cartridge 1 grips the enlarged end 3 of the cartridge tube, and inserts the uniform diameter portion 2 into the outer end of the trocar passage tube 21 as shown in FIG. Then, the inner end side portion of the uniform diameter portion 2 of the cartridge pipe enters the passage pipe 21, opens the leakage prevention valve 23 of the passage pipe 21 to open, and penetrates the leakage prevention valve 23 in the opened state. Moreover, it penetrates through the injection pipe 22 connecting portion of the passage pipe 21. The entry stop reinforcing pipes 4 and 5 stop the entry of the cartridge pipes 2 and 3 when the enlarged end part 5 hits the outer end of the passage pipe 21 of the trocar and the uniform diameter part 4 hits the enlarged end part 3 of the cartridge pipe. In this state, the inner end of the uniform diameter portion 2 of the cartridge tube does not protrude from the inner end of the trocar passage tube 21. Next, the forceps 26 is inserted into the enlarged end portion 3 of the cartridge tube, and the gauze products 6 and 7 inside the forceps 26 are pushed out from the inner end of the uniform diameter portion 2 of the cartridge tube to the passage tube 21 of the trocar. Further, it is pushed out of the inner end of the trocar passage tube 21 into the patient's body cavity.

  In the cartridge tubes 2 and 3, even if the internal gauze products 6 and 7 are strongly pressed with the forceps 26, the outer end side portion of the uniform diameter portion 2 is hardly damaged. The outer end side portion of the uniform diameter portion 2 is covered and reinforced by the uniform diameter portion 4 of the ingress stop reinforcing pipe.

  Even when the enlarged end portion 5 strongly hits the outer end of the trocar passage tube 21, the ingress stop reinforcement tubes 4 and 5 do not bite into the trocar passage tube 21. The enlarged end portion 5 has a tapered shape and is not a tapered shape. The cartridge tubes 2 and 3 with the entry stop reinforcing tubes 4 and 5 are easily extracted from the trocar passage tube 21.

  After the gauze products 6, 7 are pushed out, the empty cartridge tubes 2, 3 with the entry prevention reinforcing tubes 4, 5 grip the enlarged end 3 of the cartridge tube and pull it out from the trocar passage tube 21. The trocar leakage valve 23 then closes.

[Modification]
The present invention is not limited to the above embodiment. The following modifications are exemplified.
1. In the above-described embodiment, the surgical article is the absorbent material 6 mainly used for sucking the body fluid in the body cavity of the patient, but is a tuppel or gauze ball mainly used for tissue peeling. Or other gauze products or cloth products.
2. In the above embodiment, the surgical article is the absorbent material 6, but it is a retraction tool mainly used for changing the position of the organ. Or other sponge products or cloth products.
3. In the above embodiment, the surgical article contains the X-ray contrast thread 7 but is attached to the outer surface. Alternatively, no X-ray contrast thread is attached.
4). In the above embodiment, the gauze product of the surgical article is made of the woven gauze 11 but is made of a non-woven gauze.
5. In the above embodiment, the trocar is a trocar having a 5 mm trocar and an inner diameter of 6 mm, but a trocar having an inner diameter of less than 6 mm, for example, a 3 mm trocar.

DESCRIPTION OF SYMBOLS 1 Endoscopic surgical article cartridge 2, 3 Cartridge pipe | tube 2 Equal diameter part of cartridge pipe | tube 3 Enlarged end part 4 of cartridge pipe | tube 5, Reinforcement reinforcement pipe | tube 4 Equal diameter part of entry prevention reinforcement pipe | tube 5 Expansion of entry prevention reinforcement pipe Ends 6, 7 Gauze product, surgical article 6 Absorbent, gauze product 7 X-ray contrast yarn 11 Woven gauze 12 Vertical fold line position 13 Horizontal fold line position 14 Cotton thread 21, 22 Trocar 21 Trocar passage tube 22 Trocar body cavity inflation gas injection tube 23 Check valve, body cavity inflation gas leakage valve 24 Injection tube opening / closing valve 26 Forceps

Claims (6)

Consists of surgical supplies, cartridge tubes, and entry-stop reinforcement tubes that enter the patient's body cavity through trocars under endoscopic surgery,
Each of the cartridge tube and the ingress prevention reinforcing tube is a tube having an enlarged one end portion, and has an equal diameter portion and an enlarged end portion,
The cartridge tube allows the uniform diameter part to be inserted into the trocar, allows insertion of forceps from the enlarged end part to the uniform diameter part, is filled with surgical supplies, and is configured to push out the surgical supplies from the inner end with forceps,
The ingress prevention reinforcing tube is fitted on the outer periphery of the uniform diameter portion of the cartridge tube, the uniform diameter portion is arranged on the enlarged end side of the cartridge tube, and the enlarged end portion is arranged on the opposite side. The outer end side portion of the cartridge tube is covered, and the inner end side portion of the uniform diameter portion of the cartridge tube protrudes from the enlarged end portion,
When a cartridge tube with an entry prevention reinforcement tube is inserted into the trocar at the inner end side of the uniform diameter portion, the enlargement end of the entry prevention reinforcement tube contacts the outer end of the trocar, and the equal diameter portion is the enlarged end of the cartridge tube. Endoscopic surgical product cartridge, wherein the cartridge tube is configured to stop entering the cartridge tube.   The surgical supplies shall be an absorbent material mainly used to absorb body fluid in the patient's body cavity, a tuppel or gauze ball mainly used for tissue separation, or a retraction tool mainly used to reposition the organ. The endoscopic surgical product cartridge according to claim 1, wherein: The endoscopic surgical product cartridge according to claim 2 , wherein the absorbent material is laminated with woven fabric or nonwoven fabric gauze .   The endoscopic surgical product cartridge according to claim 1, 2 or 3, wherein the surgical product contains an X-ray contrast thread.   The endoscopic surgical product cartridge according to any one of claims 1 to 4, wherein the trocar has an inner diameter of 6 mm or less. A method for producing the endoscopic surgical product cartridge according to any one of claims 1 to 5,
A tube of an enlarged end portion of the cartridge tube, the tube having an enlarged end portion of the entrance stop reinforcing tube, respectively, extruding the synthetic resin tube of uniform diameter, and soften the end portion of the one end of the synthetic resin tube manufacturing method of an endoscope surgery supplies cartridge you characterized by expanding against the mold Te.

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