JP6847854B2 - Trocar - Google Patents

Description

The present disclosure relates to trocars used in endoscopic surgery.

In recent years, minimally invasive surgery such as laparoscopic surgery in which an endoscope is inserted into the abdominal cavity is required to maintain and improve the QOL (quality of life) of patients. Laparoscopic surgery involves injecting carbon dioxide into the abdominal cavity to inflate the abdominal wall and provide space and field of view for the procedure. Then, a small hole is made in the abdominal wall, an instrument called a trocar is inserted, and a medical instrument such as an endoscope (CCD camera, etc.) or forceps is inserted into the patient's body, and the image displayed on the monitor by the endoscope. It is common to perform surgery while observing (Patent Documents 1 and 2).

The trocar is composed of a head portion and a pipe portion, and a trocar shaft inserted from the head portion and penetrating the pipe portion is attached. The trocar shaft has a puncture portion formed at the tip thereof for puncturing into the abdominal cavity through the body wall. The trocar shaft is pulled out of the trocar after being punctured into the abdominal cavity, leaving the trocar pipe in the abdominal cavity. In this state, carbon dioxide gas is injected into the abdominal cavity from the head of the trocar to inflate the abdominal wall.

Therefore, the head portion of the trocar is required to have high airtightness so that the injected gas does not escape. On the other hand, since the trocar also has a function of inserting a medical device such as forceps into the patient's body, it is necessary to maintain high airtightness even when the medical device is inserted.
Generally, a duckbill valve and other internal sealing parts are provided inside the trocar head to prevent the passage of ventilation gas, but they are highly airtight without interfering with the operation of medical equipment. Trocars with a structure are desired.

Japanese Unexamined Patent Publication No. 2013-046789 Japanese Unexamined Patent Publication No. 2006-167475

An object of the present disclosure are easy to manipulate for insertion and removal and medical instruments medical療器device, yet to provide a trocar having high airtight structure.

The trocar according to the embodiment of the present disclosure includes a pipe portion and a head portion for inserting a medical device into the body. The head portion covers the head portion main body communicating with the pipe portion, the airtight structure unit housed in the head portion main body, and the base end side of the head portion main body, and the medical instrument is inserted into the pipe portion via the airtight structure unit. It is provided with a plug member having an opening for the purpose. The airtight structure unit includes a sealing valve located on the pipe portion side, and a sealing unit that is interposed between the sealing valve and the plug member and is elastically sealed with the outer peripheral portion of the sealing valve.

According to the present disclosure, it is possible to prevent leakage of gas pressurized in the body cavity by the airtight structure unit and maintain airtightness when inserting / removing a medical device such as forceps from the opening of the plug member. it can. Further, the seal unit near the base end side (front side when viewed from the operator side) of the head portion body is interposed between the sealing valve and the plug member, and elastically seals with the outer peripheral portion of the sealing valve. Since it is positioned, the airtightness inside the head portion can be enhanced by easily ensuring the airtightness between the sealing valve and the sealing unit by attaching the plug member to the head portion main body.

It is a perspective view which shows the trocar of the camera unfolded state which concerns on one Embodiment of this disclosure. It is a side view of the trocar shown in FIG. It is sectional drawing of the trocar shown in FIG. It is a side view of the trocar shown in FIG. 1 in the camera retracted state. It is sectional drawing of the trocar shown in FIG. 1 in the camera retracted state. It is a side view of the trocar in the state where the trocar shaft is removed from the trocar shown in FIG. 2A. It is sectional drawing of the trocar in the state which removed the trocar shaft from the trocar shown in FIG. 2B. It is sectional drawing which shows the head part of the trocar. It is an exploded perspective view of the trocar which concerns on one Embodiment of this disclosure. It is an exploded perspective view of the airtight structure unit in one Embodiment of this disclosure. It is a breaking disassembled perspective view of FIG. It is a breaking perspective view which shows the assembled state of the airtight structure unit. FIG. 5 is a cross-sectional view showing a state in which the airtight structure unit shown in FIG. 9 is rotated by 90 °. It is a perspective view which shows the tip part of the trocar in the state which the camera part is deployed. It is sectional drawing which shows the tip part of the trocar in the state which the camera part is expanded. It is sectional drawing of the camera part. It is a perspective view which looked at the tip part of the trocar in the state of deploying the camera part from the operator side (front side). It is a perspective view for demonstrating the rotation mechanism of a camera part. It is a breaking perspective view which shows the structure of a camera part. It is sectional drawing of an optical system lens. It is sectional drawing which shows the operation of the pipe part outer cylinder in the camera retracted state. It is sectional drawing which shows the operation of the pipe part outer cylinder in the camera unfolded state. It is a schematic diagram for demonstrating the lock mechanism of a camera part by a trocar shaft. It is a schematic diagram for demonstrating the lock mechanism of a camera part by a trocar shaft. It is a perspective view which shows the form of a stopper member. It is a perspective view which shows the usage of the trocar. It is a perspective view which shows the usage of the trocar. It is a perspective view which shows the usage of the trocar. It is a perspective view which shows the usage of the trocar. It is explanatory drawing which shows the use state of a trocar. It is a perspective view which shows the trocar which concerns on other embodiment of this disclosure.

Hereinafter, embodiments of the present disclosure will be described in detail with reference to the drawings.

<Overall structure of trocar>
FIG. 1 shows a trocar 1 according to an embodiment of the present disclosure. This trocar 1 is used, for example, in laparoscopic surgery, and is referred to as a pipe portion 2 located on the distal end side (distant position) when viewed in the direction of insertion during surgery and the operator side (hereinafter referred to as "front side"). It is composed of a head portion 3 at the position (may be).

The trocar 1 is equipped with a trocar shaft 4 that penetrates the pipe portion 2 from the head portion 3. The trocar shaft 4 has a puncture portion 4a formed at the tip thereof for puncturing into the abdominal cavity through the body wall, and a handle portion 4b formed at the rear end. The puncture portion 4a has a conical shape such that the tip thereof substantially matches the inner diameter of the pipe portion 2. The handle portion 4b is for the operator to perform an operation of inserting and removing the trocar shaft 4 into the trocar 1.

As shown in FIGS. 1 and 2A and 2B, the trocar 1 has a camera unit 5 as an imaging means attached to the tip of the pipe unit 2, and FIGS. 1 and 2A and 2B have the camera unit 5 expanded. Indicates the state. On the other hand, FIGS. 3A and 3B show a state in which the camera unit 5 is stored in the pipe unit 2. As shown in FIG. 3B, the tip portion 4c following the puncture portion 4a of the trocar shaft is formed in a columnar shape having substantially the same outer diameter as the inner diameter of the pipe portion, and in the retracted state of the camera portion 5, the camera portion 5 A notch 6 is formed in a part thereof in order to secure a storage space. The connecting portion 4d from the tip portion 4c to the handle portion 4b is formed to have a smaller outer diameter than the tip portion 4c. This structure is adopted because the tip portion 4c having a large outer diameter supports the tip of the pipe portion 2 provided with the camera portion 5 from the inside, thereby applying a large force when inserting the trocar 1. On the other hand, this is to ensure sufficient strength.
Incidentally, when the inner diameter of the pipe portion 2 is 12.7 mm, the outer diameter of the columnar tip portion 4c is preferably about 12.6 mm.

4A and 4B show the trocar 1 obtained by removing the trocar shaft 4 from the state shown in FIGS. 2A and 2B. As shown in FIG. 4B, the pipe portion 2 of the trocar 1 has a double structure including a pipe portion outer cylinder 21 and a pipe portion inner cylinder 22. The head portion 3 includes a head portion outer cylinder 31 formed integrally with the pipe portion outer cylinder 21, and a head portion inner cylinder 32 formed integrally with the pipe portion inner cylinder 22.
The pipe portion outer cylinder 21 and the head portion outer cylinder 31, and the pipe portion inner cylinder 22 and the head portion inner cylinder 32 may be integrally connected or connected.

<Head part>
Next, the structure of the head portion will be described. The head portion inner cylinder 32 includes an air supply tube 10 for sending a gas such as carbon dioxide gas or air into the abdominal cavity (see FIG. 1). The gas sent from the air supply tube 10 attached to the head inner cylinder 32 is sent into the abdominal cavity through the pipe inner cylinder 22 to pressurize the abdominal cavity.

As shown in FIGS. 5 and 6, the head portion 3 has a double structure including the head portion outer cylinder 31 and the head portion inner cylinder 32. Further, an airtight structure unit 44 is housed in the head inner cylinder 32, and in order to fix the airtight structure unit 44 at a predetermined position in the head inner cylinder 32, a plug is plugged on the base end side of the head inner cylinder 32. A member 40 is provided. The head portion outer cylinder 31 and the head portion inner cylinder 32 accommodating the airtight structure unit 44 constitute the head portion main body.
The plug member 40 has an opening 7 at the center for inserting the trocar shaft 4. In FIG. 5, the trocar shaft 4 is inserted into the opening 7, and the handle portion 4b is locked to the plug member 40. Then, after the trocar shaft 4 is pulled out, a medical instrument such as forceps (not shown, hereinafter may be referred to as a surgical instrument) can be inserted through the opening 7.
A connector portion 11 to which a flexible cable 28 (signal / power cable / FPC cable) extending from the camera portion 5 is connected is formed on the outer peripheral surface of the plug member 40.

Next, the airtight structure unit 44 will be described with reference to FIGS. 7 to 10.
As shown in FIGS. 7 and 8, the airtight structure unit 44 has a duck bill valve 8 on the tip side (far position) of the head portion inner cylinder 32, and further toward the front side (operator side) from the duck bill valve 8. It is composed of the arranged seal unit 60.
The duck bill valve 8 has a flange 8a on the outer peripheral surface. On the other hand, a step portion 50 to which the flange 8a abuts is formed on the inner peripheral surface of the head portion inner cylinder 32 to which the airtight structure unit 44 is mounted (see FIG. 6], and a recess is formed on the tip end side of the flange 8a. 51 is formed, while a convex portion 52 is formed in the stepped portion 50 corresponding to this. Therefore, when the airtight structure unit 44 including the duck bill valve 8 is mounted, the duck bill valve 8 is placed in a predetermined position. Positioning can be performed reliably. Note that the concave portion 51 and the convex portion 52 may be provided with only one or a plurality of each.
The seal unit 60 includes a seal holder 42, a dome-shaped seal fixing tip side mount 91, a dome-shaped seal 92, an airtight rubber cover 37 (airtight cover), and an airtight rubber cover 37 (airtight cover) in this order from the duck bill valve 8 toward the front side (operator side). A front mount 93 for fixing a dome-shaped seal is provided. The seal unit 60 is a seal structure for preventing leakage of the gas pressurized in the abdominal cavity by being in close contact with the surgical tool when the surgical tool is inserted and used. It is configured.

The duck bill valve 8 is a duck beak-shaped valve mechanism that separates the opening 7 from the inside of the pipe portion 2. As shown in FIG. 9, the duck bill valve 8 is closed in order to prevent leakage of the pressurized gas into the abdominal cavity before inserting the surgical instrument such as the trocar shaft 4 and forceps, and the trocar valve 8 is closed. The shaft 4 and the surgical tool are inserted into the pipe portion 2 so as to push open the opening / closing port 81. The duck bill valve 8 is formed of an elastomer material such as silicone rubber as an elastic material.
FIG. 10 shows the airtight structure unit 44 rotated by 90 ° from the state of FIG.

Returning to FIGS. 7 and 8, the seal unit 60 will be described. The seal holder 42 is formed of a resin material such as polycarbonate or acetal, and has a large diameter portion 42a that fits into a cylindrical portion 8b on the front side of the flange 8a of the duck bill valve 8 and a flange of the tip side mount 91 for fixing the dome-shaped seal. It is composed of a flat surface portion 42c provided with a small diameter portion 42b for positioning the portion 91b. The seal holder 42 functions as a holder for holding the airtight rubber cover 37, which will be described later.
The tip side mount 91 for fixing the dome-shaped seal is formed of polycarbonate resin or the like, and is composed of a peripheral wall portion 91a and a flange portion 91b that are fitted with the dome-shaped seal 92. ) Pin 91c is integrally formed.

The dome-shaped seal 92 is formed from an elastomer material such as silicone rubber as an elastic material, and is formed from a seal portion main body 92a and a flange portion 92b having an instrument insertion port 41 for inserting a trocar shaft 4 and other surgical tools. It is composed. The flange portion 92b is provided with a positioning hole 45 through which the pin 91c provided in the dome-shaped seal fixing tip side mount 91 is inserted.

The airtight rubber cover 37 is formed of an elastomer material such as silicone rubber as an elastic material, and has a function of connecting the duck bill valve 8 and the dome-shaped seal 92 and enhancing the airtightness between them. The airtight rubber cover 37 includes a tubular portion 37a, a first small diameter portion 37b provided on the tip side thereof, and a second small diameter portion 37c provided on the front side thereof, and the second small diameter portion 37c has a dome-shaped seal. The bellows portion 371 is formed so as to be able to follow the movement slide of 92. Further, a flat peripheral edge (flat portion) 37d is formed on the peripheral edge of the opening 39 on the inner diameter side of the bellows portion 37I provided in the second small diameter portion 37c, and a pin 91c is inserted through the peripheral edge portion (flat portion) 37d. A positioning hole 46 is formed.

The front mount 93 for fixing the dome-shaped seal is formed of a resin material such as polycarbonate or polyacetal, and is composed of a peripheral wall portion 93a and a flange portion 93b that are fitted with the dome-shaped seal 92. The flange portion 93b has a dome-shaped seal. A positioning hole 47 through which the pin 91c provided in the fixing tip side mount 91 is inserted is provided.

The assembled state of the airtight structure unit 44 is shown in FIGS. 9 and 10. In assembling, the flat surface portion 42c, flange portions 91b, 92b of each of the four parts of the dome-shaped seal fixing tip side mount 91, the dome-shaped seal 92, the airtight rubber cover 37, and the dome-shaped seal fixing front side mount 93. , 37d and 93b are overlapped, and the pin 91c provided on the tip side mount 91 is inserted into the holes 45, 46, 47 provided on the airtight rubber cover 37 and the front side mount 93 for fixing the dome-shaped seal in order (FIG. 7). See). Finally, after the tips of the pins 91c are integrated by caulking with heat, the far-position side edge 42d of the seal holding cover 42 is formed by the first small diameter portion 37b provided on the tip side of the airtight rubber cover 37. By holding, the seal unit 60 is assembled.
A protruding edge 93d extending toward the front side of the flat surface portion of the flange portion 93b is formed on the outer peripheral edge of the flange portion 93b of the front side mount 93 for fixing the dome-shaped seal. As shown in FIG. 9, the amount of protrusion of the protruding edge 93d may be such that the heat-caulked pin 91c is housed in the protruding edge 93d without protruding from the protruding edge 93d.
By superimposing the flange portions 91b, 92b, 37d and 93b and integrating the dome-shaped seal 92 in this way, the movement of the surgical instrument inserted into the instrument insertion port 41 of the dome-shaped seal 92 is interlocked with the movement of the surgical tool. The dome-shaped seal 92 acts on the bellows portion 371 provided on the airtight rubber cover 37, and the dome-shaped seal can be moved while maintaining the close contact state of the instrument insertion port 41.

Next, the first small diameter portion 37b provided on the tip end side of the airtight rubber cover 37 constituting the seal unit 60 is brought into close contact with the front surface of the flange portion 8a of the duck bill valve 8 to obtain the airtight structure unit 44. In this state, as shown in FIG. 6, the airtight structure unit 44 is inserted into the pipe inner cylinder 32, and the flange portion 8a of the duck bill valve 8 is locked to the step portion 32a formed on the inner surface of the pipe inner cylinder 32. Further, the plug member 40 is fitted to the pipe inner cylinder 32 from the front side.
At this time, the tip surface 40a (see FIG. 5) of the plug member 40 comes into contact with the protruding edge 93d of the front side mount 93 for fixing the dome-shaped seal. As shown in FIG. 9, this contact force was transmitted to the dome-shaped seal fixing tip-side mount 91 via the heat-caulked pin 91c, and further contacted with the dome-shaped seal fixing tip-side mount 91. It is transmitted to the first small diameter portion 37b provided on the tip side of the airtight rubber cover 37 via the tip side (far position side edge 42d) of the seal holder 42, and is transmitted to the front surface of the flange portion 8a of the duck bill valve 8. It is possible to bring it into contact with an airtight state.
As a result, the above four parts are integrally pressed against the flange portion 8a of the duck bill valve 8, so that the duck bill valve 8 and the dome-shaped seal 92 are connected in an airtight state.
In this embodiment, the airtight structure unit 44 adopts a structure in which the seal unit 60 and the duck building valve 8 are brought into close contact with each other, but it is of course possible to integrate the airtight structure unit 44 up to the duck building valve 8 by using the airtight rubber cover 37 of the seal unit 60. It is possible. That is, the airtight rubber cover 37 and the duck bill valve 8 may be joined or integrally molded.

<Camera part>
As will be described later, the camera unit 6 can be stored in the pipe unit 2 and is deployed outward from the outer peripheral surface of the pipe unit 2 in the abdominal cavity. 2 and 3 show the expanded state and the retracted state of the camera unit 5 in the trocar 1, respectively. 4A and 4B show a state in which the trocar shaft 4 is pulled out from the trocar 1 and the camera unit 5 is expanded.

11A and 11B are enlarged views of the tip portions of FIGS. 4A and 4B, and the camera unit 5 is in a state of being expanded outside the pipe unit 2. Both ends of the camera unit 5 are rotatably supported by the shaft so that the camera unit 5 can be accommodated in the tip notched portion 23 of the pipe portion inner cylinder 22. As a result, the camera unit 5 can freely rotate between the unfolded state in which the camera unit 5 rotates outside the pipe unit 2 so as to be photographable and the stored state stored in the pipe unit 2. As described above, since the camera unit 5 in the deployed state is located at the tip of the inner cylinder 22 of the pipe unit, the field of view is not obstructed by the pipe unit 2, and is suitable for photographing the surgical field.

That is, the camera unit 5 includes a substantially U-shaped housing 13 and a camera mount 17 attached to the front surface of the housing 13 (the inner bottom surface of the U-shape in the present embodiment). Lenses 14a, 14b, 14c, a light transmitting plate 15 for protecting an image sensor, and an image sensor 16 (CMOS or the like) are attached in this order along the transmission direction of the above. The lenses 14a, 14b, and 14c are laminated and arranged in the lens barrel 25. A flexi cable 28 is connected to the image sensor 16. The flexible cable 28 passes between the pipe portion outer cylinder 21 and the pipe portion inner cylinder 22, and gaps between the pipe portion outer cylinder 21 and the head portion outer cylinder 31 connected to the pipe portion inner cylinder 22 and the head portion inner cylinder 32, respectively. Through it, it is pulled out from the front single edge of the head portion outer cylinder 31 to the outside of the head portion 3, and is drawn into the connector portion 11 through an opening (not shown) formed on the surface of the connector portion 11 on the head portion 3 side. , Connected to a circuit board 100 (see FIG. 5), which will be described later. A translucent protective cover 18 is attached to the front surface of the lens 14a.
The lenses 14a, 14b, 14c and the protective light-transmitting plate 15 can be made of optical glass or optical resin, but it is desirable that the lenses 14a, 14b, 14c and the protective light-transmitting plate 15 be made of a resin material that can be manufactured at low cost and that can be easily formed into an aspherical surface.

A metal plate 19 (back plate) for reinforcing the image sensor is arranged on the back surface side of the flexible cable 28 connected to the image sensor 16. Since the metal plate 19 for reinforcing the image pickup sensor is directly mounted on the flexible cable 28, the flatness of the image pickup sensor 16 is maintained and the sensor is protected. As the reinforcing metal plate 19, it is preferable to use an aluminum plate that also has a heat dissipation effect of the image sensor 16. Then, the space between the reinforcing metal plate 19 and the housing 13 is sealed with a filler 19'such as a silicone material.

The housing 13 has a curved back surface portion 13a that is flush with the pipe portion inner cylinder 22 in the retracted state of the camera portion 5, and side surface portions 13b are formed on both side portions of the back surface portion 13a. Since the back surface portion 13a has a curved surface shape as described above, the pipe portion outer cylinder 21 can be smoothly slid when the camera portion 5 is retracted and unfolded. Further, in the deployed state of the camera unit 5, the lenses 14a, 14b, and 14c face the front of the pipe unit 2.

As shown in FIGS. 12 and 13, projecting portions 13c extending downward in the pipe portion inner cylinder 22 are formed on both side surface portions 13b and 13b of the housing 13, and each projecting portion 13c is formed with a projecting portion 13c. The shaft portion 20 is formed so as to project outwardly orthogonal to the axial direction of the pipe portion 2.
Then, as shown in FIGS. 11A and 11B and FIG. 13, the shaft portion 20 is inserted with an inclined groove 24 notched diagonally from both side portions of the tip notched portion 23 of the pipe portion inner cylinder 22 toward the front side. It is engaged with the inclined groove 24. The center of the shaft portion 20 is a shaft fulcrum S for rotating the camera portion 5. As a result, although it is compact, it is possible to secure a moment when the camera unit 5 is tilted by utilizing the pulling force of the coil spring 12 (elastic member) described later. Further, since the inclined groove 24 inclined as described above is adopted, the camera unit 5 can be easily attached.

As shown in FIG. 14, L-shaped portions 45 are projected downward on both sides of the bottom portion 13d of the housing 13, and a ring-shaped portion 12a at one end of the coil spring 12 is engaged with the L-shaped portion 45. It will be stopped. As shown in FIG. 13, the two coil springs 12 are housed in a recess 46 extending along the axial direction of the pipe portion 2 from the tip notched portion 23 of the pipe portion inner cylinder 22 to the front side (operator side). The ring-shaped portion 12b at the other end on the front side of the coil spring 12 is fixed in the concave groove 46.

One end (ring-shaped portion 12a) of the coil spring 12 is locked to the front side of the shaft portion 20 and to the radial outward position of the pipe portion 2 from the shaft portion 20. As a result, the camera unit 5 is urged toward the front side. As a result, the camera unit 5 rotates backward with the shaft fulcrum S as the center of rotation, and is in the deployed state.
Therefore, when the trocar 1 is pulled out from the body with the camera part 5 deployed in the body, the camera part 5 rotates in the axial direction of the pipe part 2 from the rear end side toward the tip side at the time of removal. It is safe because it is stored in the inner cylinder 22 of the pipe portion.
In particular, when an unexpectedly large force is applied to the camera portion 5 from the rear end side to the front end side, the L-shaped portion 45 and the ring-shaped portion 12a at one end of the coil spring 12 are configured to be disengaged. Since the shaft portion 20 is engaged with the inclined groove 24 of the inner cylinder 22 of the pipe portion, the shaft portion 20 can be disengaged so as to slide through the inclined groove 24, and the camera portion 5 can be disengaged. As a result, in an emergency or the like, the camera unit 5 can be separated from the trocar 1 without being damaged, the safety can be improved, and the risk of damage to the camera unit 5 can be reduced.
At this time, since the other end of the coil spring 12 is fixed, it does not fall into the abdominal cavity.

In the present embodiment, the image sensor 16 is directly mounted on the flexible cable 28 in order to make the camera unit 5 as small as possible. The mounting unit does not have a controller function for controlling the image pickup sensor 16, and controller functions such as clock control are arranged on the circuit board 100 (control means, see FIG. 5) provided in the head unit 3. ing. Therefore, the end of the flexible cable 28 directly mounted on the image pickup sensor 16 is connected to the circuit board 100 at the connector portion 11 of the head portion 3, and is connected to the external cable 102 (USB cable) soldered from the circuit board 100. The image signal is sent to the outside.

When the translucent protective cover 18 is formed of a transparent optical resin, as shown in FIGS. 15A and 15B, the inner surface adjacent to the lens 14a becomes a concave curved surface 181 to provide optical performance. Become. Therefore, since the translucent protective cover 18 itself exerts the function of a lens, the number of lenses to be used can be reduced, and the distance between the translucent protective cover 18 and the lenses 14a, 14b, 14c can be reduced. This makes it possible to make the camera unit 5 thinner and smaller. Further, it becomes possible to integrally mold a structure such as a peripheral wall, which will be described later.
Further, the translucent protective cover 18 has a peripheral wall 182, and a hole 26 is formed in the peripheral wall 182. On the other hand, the camera mount 17 has a claw portion 27 on the tip end side, and is integrated by engaging the claw portion 27 in the hole 26 when the translucent protective cover 18 is attached. At that time, in order to ensure waterproofness, a sealing material 29 such as rubber is fitted between the camera mount 17 and the translucent protective cover 18.

<Lock mechanism (1)>
Next, a locking mechanism for holding the camera unit 5 in the expanded state or the retracted state and preventing the camera unit 5 from inadvertently operating will be described. 16A and 16B show cross-sectional views of FIG. 3B showing the stored state and FIG. 2B showing the expanded state, respectively, rotated by 90 °.
As shown in FIGS. 16A and 16B, two recesses 30a and 30b are arranged side by side in the axial direction on the outer peripheral surface of the head portion inner cylinder 32 to which the pipe portion inner cylinder 22 is connected. On the other hand, a lock lever 34 having a claw-shaped convex portion 33 is attached to the head portion outer cylinder 31 to which the pipe portion outer cylinder 21 is connected.
A pair of recesses 30a and 30b and a lock lever 34 are provided at 180-degree symmetrical positions.
In the retracted state of the camera unit 5 (FIG. 16A), the convex portion 33 provided at the tip of the lock lever 34 is locked to the concave portion 30a on the tip side to lock the pipe portion outer cylinder 21. On the other hand, in the unfolded state of the camera unit 5 (FIG. 16B), the outer cylinder 21 of the pipe unit is locked by locking the recess 30b on the front side. These operations can be performed by the lock lever 34 extending outward from the head portion outer cylinder 31. That is, by pushing one end exposed to the outside of the lock lever 34 with a finger, the convex portion 33 provided at the other end of the lock lever 34 is rotated upward to be separated from the concave portion 30a or 30b, and the pipe is in this state. Slide the outer cylinder 21.

Further, the pipe portion outer cylinder 21 is formed to be shorter in length than the pipe portion inner cylinder 22. This is a state in which the camera unit 5 is expanded from the tip notch 23 of the pipe inner cylinder 22 to the outside of the pipe 2 (state in FIG. 16B), and the pipe outer cylinder 21 is located behind the camera unit 5. To do so.
Further, as shown in FIGS. 17A and 17B, a tubular sealing material 49 is interposed between the pipe portion outer cylinder 21 and the pipe portion inner cylinder 22. The tubular sealing material 49 is made of silicone rubber or the like, and is outerly mounted on the inner cylinder 22 of the pipe portion so as to sandwich the above-mentioned flexible cable 28. Even in the presence of the flexible cable 28, the outer cylinder 21 of the pipe portion 21 Can be slid while maintaining an airtight state. In addition, in order to reduce the friction coefficient of the tubular sealing material 49, the lubricating action may be ensured with an oil or fat that can be used for medical purposes such as silicone oil.

<Lock mechanism (2)>
Further, in the present embodiment, the camera unit 5 is locked by the trocar shaft 4 so that the camera unit 5 does not inadvertently expand in the retracted state of the camera unit 5. That is, as shown in FIG. 17A, when the camera unit 5 is stored in the notch 6 formed in the trocar shaft 4, the tip surface of the camera 5 is the tip wall portion 6 of the notch 6. It is prevented from rotating in contact with the camera. Therefore, the locked state can be reliably maintained in cooperation with the locking mechanism by the lock lever 34 described above.
On the other hand, in order to release the lock by the trocar shaft 4, as shown in FIG. 17B, it is easy to form a gap between the tip wall portion 6 of the trocar shaft 4 and the tip surface of the camera portion 5. The camera unit 5 can be expanded.

In order to lock and unlock the trocar shaft 4, as shown in FIG. 18, the camera unit storage position click groove 47a and the camera are located on the outer peripheral portion of the end surface of the plug member 40 located on the front side (operator side) of the trocar 1. The part development position click grooves 47b are arranged side by side with a predetermined feeling. When the trocar shaft 4 is inserted into the opening 7 of the stopper member 40 and the handle portion 4b is attached to the end surface of the stopper member 40, the protrusion provided on the handle portion 4b (shown in the figure) in the retracted state of the camera portion 5. Is engaged with the camera unit storage position click groove 47a. On the other hand, at the time of unfolding, the trocar shaft 4 is rotated by holding the handle portion 4b to engage the protrusion with the camera portion unfolding position click groove 47b. As a result, a gap D is formed between the tip wall portion 6 of the trocar shaft 4 and the tip surface of the camera portion 5 (see FIG. 19B), and the camera portion 5 can be expanded.
That is, since the camera unit deployment position click groove 47b has a deeper groove depth than the camera unit storage position click groove 47a, the trocar shaft 4 is moved toward the tip side, and a gap D is provided between the trocar shaft 4 and the tip surface of the camera unit 5. Can be formed.

Next, a method of using the trocar 1 according to the present embodiment will be described with reference to FIGS. 19A to 19D. First, in the initial state shown in FIG. 19A (the retracted state of the camera unit 5), the trocar shaft 4 is rotated from the camera unit storage position click groove 47a to the camera unit deployment position click groove 47b, and the tip wall portion of the trocar shaft 4 is rotated. A gap D is formed between the 6 and the front end surface of the camera unit 5 (FIG. 19B).

Then, as shown in FIG. 19C, the lock lever 34 of the pipe portion outer cylinder 21 is pushed to slide the pipe portion outer cylinder 21 toward the front side. As a result, the camera unit 5 is deployed by the urging force of the coil spring 12 (see FIG. 11), and the trocar shaft 4 can be pulled out.
In this state, as shown in FIG. 19D, the trocar shaft 4 is pulled out and can be used as a trocar port.

In actual use, in the initial state (camera unit 5 retracted state) shown in FIG. 19A, the puncture portion 4a formed at the tip of the trocar shaft 4 punctures the abdominal cavity through the body wall. Then, as described above, the camera unit 5 is deployed in the body wall 35, the trocar shaft 4 is pulled out from the trocar 1, and as shown in FIG. 20, the operation is performed while photographing the trunk 36 in the abdominal cavity.

Therefore, the surgeon can perform the operation by inserting forceps or the like (not shown) through the opening 7 of the trocar 1 while observing the image projected on the monitor (not shown), so that the field of view is expanded. However, the operation becomes easier and the safety of the operation is improved. In particular, since the camera unit 5 is provided at the tip of the pipe unit 2, there is an advantage that the field of view is not obstructed by the pipe unit 2 or the like.

<Other Embodiments>
In the above embodiment, the case where the camera unit 5 and the connector unit 11 are arranged on the same side with respect to the pipe unit 2 has been described, but the camera unit 5 and the connector unit 11 may be arranged at different positions. Good. For example, as shown in FIG. 21, the camera unit 5 and the connector unit 11 can be arranged at a position symmetrical with respect to the axial center of the pipe unit 2 or at a position in the vicinity thereof.
In this case, the external cable 102 during the operation can be arranged below the position of the operator's hand, and when the operator's hand touches the external cable 102, the camera unit 5 moves and rotates with the pipe unit 2 as the rotation axis. , The projected surgical field can be effectively prevented from rotating.
The positions of the camera unit 5 and the connector unit 11 should be arranged at positions different from the mounting positions of the camera unit in the circumferential direction of the head unit so that the operator's hand does not touch the external cable 102. For example, the connector portion 11 may be arranged at an angle of 90 ° or more from the camera portion 5 to the left and right with respect to the axis of the pipe portion 2.
Others are the same as those in the above embodiment.

Although Trocar 1 according to the embodiment of the present disclosure has been described above, the present disclosure is not limited to the above embodiment, and various improvements and improvements can be made within the scope of the claims. For example, in the above embodiment, the pin 91c is provided on the front end side mount 91 for fixing the dome type seal, and the positioning hole 47 through which the pin 91c is inserted is provided on the front side mount 93 for fixing the dome type seal. The front end side mount 91 may be provided with a positioning hole 47, and the front side mount 93 may be provided with a pin 91c. Others are the same as those in the above embodiment.
Further, the camera unit 5 may be provided with a lighting device so that the surgical field becomes bright. The trocar of the present disclosure can also be suitably used for endoscopic surgery in the thoracic cavity.

1 Trocar 2 Pipe part 3 Head part 4 Trocar shaft 4a Puncture part 4b Handle part 5 Camera part 6 Notch part 7 Opening part 8 Duck bill valve 10 Air supply pipe 11 Connector part 12 Coil spring (elastic member)
13 Housing 14a, 14b, 14c Lens 15 Image sensor protective cover 16 Image sensor 17 Camera mount 18 Translucent protective cover 19 Metal plate for reinforcing image sensor 20 Shaft 21 Pipe outer cylinder 22 Pipe inner cylinder 23 Tip notch 24 Inclined groove 25 Lens barrel 26 Hole 27 Claw 28 Flexible cable 29 Sealing material 30a, 30b Recessed 31 Head outer cylinder 32 Head inner cylinder 33 Convex 34 Lock lever 35 Body wall 37 Airtight rubber cover (airtight cover)
40 Plug member 42 Seal holder 44 Airtight structure unit 50 Step 51 Concave 52 Convex 60 Seal unit 91 Dome type seal fixing tip side mount 92 Dome type seal 93 Dome type seal fixing front side mount 100 Circuit board (control means)
102 Cable 371 Bellows

Claims (8)

A trocar equipped with a pipe part and a head part for inserting a medical device into the body.
The head portion
The head portion main body communicating with the pipe portion, the airtight structure unit housed in the head portion main body, and the airtight structure unit.
A plug member that covers the base end side of the head portion main body and has an opening for inserting the medical device into the pipe portion via an airtight structure unit is provided.
The airtight structure unit is
A sealing valve located on the pipe side and
An outer peripheral portion of the sealing valve and a sealing unit elastically sealed are provided between the sealing valve and the plug member.
The seal unit includes a dome-shaped seal fixing tip-side mount, a dome-shaped seal, and an airtight cover which are sequentially arranged from the sealing valve toward the base end side of the head portion main body.
A seal holder is arranged between the seal valve and the seal holder.
A trocar characterized in that the seal holder is included by a tubular portion of the airtight cover and a first small diameter portion provided on the pipe portion side of the tubular portion. The trocar according to claim 1, wherein the sealing valve is a duck bill valve made of an elastic member. The airtight cover, trocar according to claim 1 or 2, characterized in a Turkey which having a contact portion to the peripheral portion and the elastic contact of the sealing valve. The airtight cover is provided with the cylindrical portion, and the first small diameter portion provided on the pipe portion of the cylindrical portion, and a second small diameter portion provided on the opening side,
The trocar according to any one of claims 1 to 3, wherein a stretchable bellows portion is formed on the second small diameter portion, and a flat peripheral edge portion is formed on the inner diameter side of the bellows portion. The sealing unit, according to claim 1-4 which e Bei the operator during insertion direction seen the domed seal fixing tip side mount and the dome type seal fixing front mounted respectively disposed before and after the cover the airtight Trocar described in any of. The sealing unit, from said sealing valve toward the base end side of the head body said dome-type seal fixing tip side mount arranged in this order, the domed seal, cover and domed sealing fixing the airtight includes a front mount, trocar according to any one of請Motomeko 1-5 that are integrated at the periphery A pin is projected toward one of the flange portion of the dome-shaped seal fixing tip side mount and the flange portion of the dome-shaped seal fixing front side mount toward the other flange portion, and the other The flange has a hole for positioning,
Further, positioning holes are provided in the flange portion of the dome-shaped seal and the peripheral flat portion of the airtight cover.
The pin is inserted through the flange portion of the dome-shaped seal and the peripheral flat portion of the airtight cover, and is inserted into the positioning hole provided in the other flange portion, and the tip side mount for fixing the dome-shaped seal is inserted. the domed seal trocar of claim 6, said airtight cover and the dome type seal fixing front mount is fixed integrally. The head portion main body includes a head portion outer cylinder and a head portion inner cylinder.
The pipe portion includes a pipe portion outer cylinder integrated with the head portion outer cylinder and a pipe portion inner cylinder integrated with the head portion inner cylinder, and the pipe portion outer cylinder is axially on the pipe portion inner cylinder. It is extrapolated so that it can be slidable.
Any of claims 1 to 7, wherein the camera portion is rotatably supported in the inner cylinder of the pipe portion between a deployed state in which the camera portion rotates outside the pipe portion and a stored state in which the camera portion is stored in the pipe portion. Trocar described in the crab.

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