JP6892066B2 - Trocar with imaging function - Google Patents

Description

The present invention relates to a trocar with an imaging function, and more particularly to a trocar with an imaging function that is suitably used for observing an area between the surgical site and the body wall while being attached to the body wall.

During abdominal surgery, surgical instruments such as forceps and endoscopes are individually inserted into the patient's body cavity, and the surgery is performed while viewing the image of the surgical site captured by the camera at the tip of the endoscope. Surgery is being performed. At that time, surgical instruments such as forceps and an endoscope are inserted into the patient's body wall, specifically, through a trocar attached to a hole formed in the body wall into the patient's body cavity.

Such endoscopic surgery has the advantage that the incision range is smaller than that of conventional laparotomy, and the period required for postoperative recovery is shortened. On the other hand, there are also disadvantages such as a narrow field of view during surgery and restrictions on the operation of surgical instruments.

When the field of view during surgery is narrow, it is not possible to sufficiently observe the area other than the surgical site, so it is possible to check the bleeding site that occurred in an area different from the original work area (operative site) and to check for damaged instruments. There is a problem that it takes time to check a part of the surgery and the residue such as gauze.

As a means for solving the problem caused by such a narrow field of view, Patent Document 1 below discloses a configuration in which a camera capable of wide-angle imaging is arranged in a body cavity separately from an endoscopic camera.
FIG. 10 shows a specific example thereof. In the figure, 100 is an endoscopic camera for obtaining a magnified image of the surgical site (organ 110), and 103 is a small camera inserted into the body cavity for obtaining a wide-angle image. The camera 103 is connected to the tip of the needle 104 that has penetrated from the outside of the body into the body cavity via a connector portion 105, and by pulling up the portion (outside the body) of the needle 104 that is outside the body. , It enables desired wide-angle imaging for the surgical site.

Japanese Unexamined Patent Publication No. 2009-195521

However, in the one described in Patent Document 1, the imaging direction by the camera 103 is the axial direction (vertical direction in the drawing) of the support member (needle) 104 penetrating the body wall H, and the imaging is possible. The region is the range LA indicated by the dotted line hatching in FIG. Therefore, it is possible to widely observe the observation region (region LB surrounded by the alternate long and short dash line in the figure) whose imaging direction is substantially 90 ° different from that of the camera 103, that is, the region between the surgical site 110 and the body wall H. Can not.
Against the background of the above circumstances, it is an object of the present invention to provide a trocar with an imaging function capable of widely observing the area between the surgical site and the body wall while being mounted on the body wall. It was made as.

The one according to claim 1 is a tracker that is used while being attached to the body wall and guides the surgical instrument into the body cavity through the insertion hole formed inside, and penetrates the body wall to the body cavity. The guide tube has a tubular guide tube to be inserted inside, and a hand-side member having a diameter larger than that of the guide tube, which is formed on the hand side of the guide tube and is locked to the surface of the body wall. the side of the proximal member from the tip surface of the cylindrical wall and the guide tube, and a lens for condensing light from a subject to be located outside the viewing area of the guide tube, is focused by the lens An imaging means that receives light and converts it into an image signal, or a light receiving optical fiber that guides the light collected by the lens to the imaging means is provided, and the tip of the guide tube in the outer region of the guide tube. A region on the side of the hand side member with respect to the surface , and a region in a direction orthogonal to the axial direction of the guide tube starting from the imaging means or the light receiving optical fiber, or a region on the hand side member from the orthogonal direction. It is characterized in that the area on the side is configured so that an image can be taken.

The second aspect of the present invention further irradiates the observation region outside the guide tube with illumination light on the tubular wall of the guide tube and on the side of the hand side member with respect to the tip surface of the guide tube. It is characterized in that a light irradiation means is provided.

A third aspect of the present invention is the case where the image pickup means is provided on the tubular wall of the guide tube according to any one of the first and second claims, and the image pickup means is more than the axial intermediate position of the guide tube. It is characterized in that it is provided on the side of the hand side member.

A fourth aspect of the present invention is the case where the imaging means is provided on the tubular wall of the guide tube according to any one of claims 1 to 3, wherein a plurality of the imaging means are provided in the circumferential direction of the guide tube. It is characterized by being.

Claim 5 is a tracker that is used while being attached to a body wall and guides a surgical instrument into a body cavity through an insertion hole formed inside, and is inserted into the body cavity through the body wall. It has a tubular guide tube and a hand-side member having a diameter larger than that of the guide tube, which is formed on the hand side of the guide tube and is locked to the surface of the body wall. A lens that collects light from a subject located in an observation region outside the guide tube and an imaging means that receives the light collected by the lens and converts it into an image signal are provided, and the lens is provided. , It has a tubular shape, and is characterized in that it is arranged on the outside of the tubular wall so as to cover the imaging means.

As described above, the present invention provides a lens that collects light from a subject located in the observation area outside the guide tube on the tube wall of the tubular guide tube that penetrates the body wall and is inserted into the body cavity. It is characterized in that it is provided with an imaging means that receives the light collected by the lens and converts it into an image signal. According to the present invention, by providing a member for obtaining an observation image in the body cavity on the tubular wall of the guide tube, it is possible to observe the region between the surgical site and the body wall, which is separated from the surgical site. It is possible to easily confirm the bleeding site generated in such an area and the residue such as gauze.

Further, since the present invention adds an imaging function to the trocar conventionally used in endoscopic surgery, it is not necessary to provide a new wound (hole) on the body wall of the patient, which imposes a burden on the patient. It can be suppressed.
In the present invention, when the image pickup means is not provided on the tube wall of the guide tube, a light receiving optical fiber that guides the light collected by the lens to the image pickup means at a distant position is provided on the tube wall of the guide tube. Keep it.

In the present invention, further, by providing a light irradiation means for irradiating the observation area outside the guide tube with the illumination light on the tube wall of the guide tube, a clear observation image can be obtained (claim 2). ).

In the present invention, by providing the imaging means closer to the hand side member than the axially intermediate position of the guide tube, it is possible to easily observe an area near the body wall, which is difficult to observe with an endoscopic camera. (Claim 3).

In the present invention, by providing a plurality of imaging means in the circumferential direction of the guide tube, a wide range can be observed in the circumferential direction of the guide tube (claim 4).

In the present invention, the lens for condensing light can function as a protective cover for the imaging means by forming the lens into a tubular shape and arranging the lens on the outside of the cylinder wall so as to cover the imaging means (claim 5).

According to the present invention as described above, it is possible to provide a trocar with an imaging function capable of widely observing the area between the surgical site and the body wall while being mounted on the body wall.

It is a figure which showed the whole structure of the observation device in the body cavity using the trocar of one Embodiment of this invention. It is a figure which disassembled and showed the trocar of FIG. (A) is a sectional view taken along line III-III of FIG. (B) is an enlarged view of the recess and the peripheral portion of FIG. 3 (A). It is a figure which showed an example of the use mode of the trocar of the same embodiment. It is a figure which showed the modification of the trocar of the same embodiment. It is a figure which showed the base end side cylinder member of FIG. It is a figure which showed the main part of another embodiment of this invention. It is a figure which showed the main part of still another embodiment of this invention. It is a figure which showed the main part of still another embodiment of this invention. It is a figure which showed an example of the observation device in a conventional body cavity.

Next, an embodiment of the present invention will be described in detail with reference to the drawings.
FIG. 1 is a diagram showing a configuration of an observation device 10 for observing the inside of a body cavity using the trocar of the present embodiment. In the figure, 12 is a trocar, 16 is a control unit, and 18 is a monitor.
As will be described later, the trocar 12 of this example has an imaging function, and the obtained image signal is output to the control unit 16 through the code 19, and after being image-processed by the control unit 16, it is displayed on the monitor 18 as an observation image. Is displayed.

The trocar 12 is an insertion assisting tool used for inserting a surgical instrument into a patient's body cavity, and is a tubular guide tube 22 extending in the vertical direction in the drawing and a hand side (upper side in the drawing) of the guide tube 22. It has a hand-side member 24 having a diameter larger than that of the guide pipe 22 provided.
Inside the guide tube 22 and the hand side member 24, a penetrating insertion hole 25 for inserting a surgical instrument such as an endoscope is formed, and during endoscopic surgery, the trocar 12 is inserted into the body wall. The surgical instrument is inserted into the insertion hole 25 through the opening 26 of the hand side member 24 while being attached to the hole formed in H.

The large-diameter hand-side member 24 is composed of a first member 40 and a second member 42.
The first member 40 is a member located on the most hand side of the trocar 12, and as shown in FIG. 2, a through hole 25a forming a part of the insertion hole 25 is formed inside, and the hole 25a is formed on the upper end surface. The opening 26 is formed. A branch pipe 27 extending diagonally upward is formed on the side wall of the first member 40, and the tip opening of the branch pipe 27 communicates with the hole 25a.
Further, a cylindrical protrusion 41 projecting downward is formed on the lower end side of the first member 40.

The second member 42 is a member connected to the guide pipe 22, and the upper portion 43 has a large diameter and the lower portion 44 has a small diameter.
A recess 45 corresponding to the protrusion 41 of the first member 40 is formed inside the upper portion 43, and the protrusion 41 of the first member 40 is fitted into the recess 45 of the second member 42, and the first member 40 And the second member 42 are connected.
Inside the lower portion 44, a hole 25b forming a part of the insertion hole 25 is formed so as to open at the bottom surface of the recess 45.

An annular protrusion 46 is provided downward from the lower end surface of the lower portion 44 of the second member 42 in the drawing. The upper end 28a of the guide tube 22 (specifically, the base end side tubular member 28) described later is fitted inside the protrusion 46, and the upper end 48a of the lens 48 is fitted outside the protrusion 46. Members are connected and assembled. In this connecting portion, the outer diameter of the lower portion 44 is the same as the outer diameter of the upper end portion 48a of the lens 48 so that the outer peripheral surface of the lower portion 44 of the second member 42 and the outer peripheral surface of the upper end portion 48a of the lens 48 are flush with each other. It is a dimension.

The second member 42 is formed with an enlarged diameter portion whose outer diameter gradually increases from the lower portion 44 to the upper portion 43, and when the trocar 12 is attached to the hole formed in the body wall H, the enlarged diameter portion is formed. Locks to the surface of the body wall H to define the position of the trocar 12.

The guide tube 22 is a portion that penetrates the body wall H and is inserted into the body cavity when the trocar 12 is attached to the body wall H. As shown in FIG. 2, the proximal end side tubular member 28 and the distal end side tubular member 28 are inserted. It is composed of 29.

The tip side tubular member 29 is a member located on the most tip side of the trocar 12, and is a tubular member in which a through hole 25d forming a part of the insertion hole 25 is formed. An annular protrusion 29a protrudes upward in the axial direction from the upper end surface of the tip end side cylinder member 29 (end surface on the base end side cylinder member 28 side), and protrudes from the lower end portion 28b of the base end side cylinder member 28. By fitting the portion 29a inward, the proximal end side tubular member 28 and the distal end side tubular member 29 are integrally connected in the axial direction. The length of the tip-side tubular member 29 is appropriately determined so that the tip and movable portion of the surgical instrument such as an endoscope through which the inside is inserted protrude from the tip 29b of the guide tube 22 (tip-side tubular member 29). can do.

Further, the lower end portion 48b of the lens 48 is fitted to the outside of the protrusion 29a of the front end side cylinder member 29, and the front end side cylinder member 29 and the lens 48 are integrally connected in the axial direction. In this connecting portion, the outer diameter of the upper end portion of the distal end side tubular member 29 is the same as the outer diameter of the lower end portion 48b of the lens 48 so that the outer peripheral surface of the distal end side tubular member 29 and the outer peripheral surface of the lens 48 are flush with each other. It is a dimension.

The base end side tubular member 28 is a tubular member in which a through hole 25c forming a part of the insertion hole 25 is formed inside, and the central portion 28c is thicker than both end portions 28a and 28b in the axial direction. It is formed and the outer surface of the cylinder wall 31 has a barrel-like bulging shape.
In this example, the recess 30 is formed at the outermost bulging top of the central portion 28c of the proximal end side tubular member 28. As shown in FIG. 3A, the recesses 30 are formed at four locations at equal intervals (intervals of 90 °) in the circumferential direction, and each recess 30 has an opening outward in the radial direction. There is.

FIG. 3B is an enlarged view showing the cross-sectional shape of the recess 30. As shown in the figure, the cross section of the recess 30 has a trapezoidal shape that opens toward the outer peripheral surface side of the tubular wall 31, and the side wall 35 of the recess 30 is inclined with respect to the bottom surface 33 to form the recess 30. The opening area is formed so as to increase as the distance from the bottom surface 33 increases.

An image sensor 34 as an image pickup means is provided on the bottom surface 33 of the recess 30 with the light receiving surface facing outward (the opening side of the recess). The image sensor 34 is an image sensor equipped with an optical sensor such as a CCD (Charge Coupled Device) or CMOS (Complementary Metal Oxide Semiconductor), and receives light (reflected light) focused by the lens 48 and outputs it as an image signal. To do. In this example, the image sensor 34 is arranged so that the light receiving surface 34a of the image sensor 34 coincides with the image plane of the lens 48.

On the side wall 35 extending from the bottom surface 33 toward the opening, an LED 36 as a light irradiation means for irradiating the observation area outside the guide tube 22 with illumination light is arranged.
The shape of the base end side tubular member 28 is not limited to the shape of this example, and can be appropriately changed as long as the image sensor 34 and the LED 36 can be attached.

The LED 36 and the image sensor 34 are connected to the control unit 16 by a cord 19 (see FIG. 1) inserted through the inside of the trocar 12, and the LED 36 and the image sensor 34 are supplied with operating power via the cord 19. The image signal output from the image sensor 34 is sent to the control unit 16 via the code 19.

The lens 48 has a tubular shape and is arranged outside the LED 36 and the image sensor 34. As shown in FIG. 2, the cross-sectional shape of the lens 48 in the axial direction is a straight shape at both ends 48a and 48b, and a curved shape in which the center is bulged to the outermost side except for both ends, with reference to the axis. It has a rotationally symmetric shape. The inner surfaces of the upper end 48a and the lower end 48b of the lens 48 are formed in a stepped shape, and the upper end 48a and the lower end 48b are the protrusions 46 of the second member 42 and the protrusions of the tip side tubular member 29, respectively. The lens 48 is fitted to the portion 29a in an externally fitted state, and the lens 48 is assembled concentrically with the guide tube 22. Then, the light (reflected light of the illumination light emitted from the LED 36 in this example) from the subject located outside the lens 48 is focused based on the curvature of the lens 48 and guided to the light receiving surface of the image sensor 34. It is configured in.

The control unit 16 supplies power to the LED 36 and the image sensor 34 via the code 19, processes the image signal from the received image sensor 34, and displays the obtained image on the monitor 18. In this example, four images can be displayed on the monitor 18 based on the four image signals output from the trocar 12. Further, when the observation range of each image sensor 34 is 90 ° or more in the circumferential direction and a part of the observation range overlaps with each other in the adjacent image sensor 34, the four images are connected to each other and the guide tube 22 is connected. It is also possible to generate a composite image over a range of 360 ° in the circumferential direction and output it to the monitor 18.

FIG. 4 is a diagram showing an example of how to use the observation device in the body cavity using the trocar 12 of the present embodiment. In the figure, 52a and 52b are forceps, 54 is an endoscope for enlarging the surgical site and displaying it on an external monitor (not shown), and a camera 54a is provided at the tip. These forceps 52a, 52b and the endoscope 54 are inserted inside through the trocars 56, 12, 58 attached to the body wall H of the patient, respectively. Of these, the trocar 12 is a trocar having an imaging function.

In this example, since gas is sent into the body through any of the trocars, the body wall H expands outward, and a predetermined space is formed between the organ 60 serving as the surgical site and the body wall H. The surgeon operates the forceps 52a, 52b, etc. based on the magnified image of the organ 60 imaged by the endoscope 54 to perform the incision and suture work of the organ 60.
Then, in this example, by using the imaging function provided in the trocar 12, the observation image of the region LB between the organ 60 and the body wall H, which is difficult to confirm with the camera 54a of the endoscope, is displayed on the monitor 18 ( It can be displayed in (see FIG. 1).

In the present embodiment, the arrangement of the image pickup device 34 provided on the cylinder wall 31 of the guide tube 22 can be appropriately changed according to the region to be observed. FIGS. 5 and 6 show an example.
In this example, the image sensor 34 is provided in two stages above and below the axial direction of the proximal end side tubular member 28. As shown in FIG. 6, there are five recesses 30 in the circumferential direction (72) at positions on the base end side (upper side in the figure) of the central portion 28c of the tubular wall 31 in the drawing with respect to the outermost bulging top. Formed (at ° intervals). The recesses 30 formed on the base end side are opened diagonally upward in the drawing. Then, the image sensor 34 provided on the bottom surface of the recess 30 formed on the proximal end side can image the region of the outer region of the guide tube 22 near the back surface of the body wall H through the lens 48.

On the other hand, five recesses 30 are formed in the circumferential direction (at intervals of 72 °) at positions on the distal end side (lower side in the drawing) of the proximal end side tubular member 28 with respect to the top portion. The recesses 30 formed on the tip side are opened diagonally downward in the drawing. Then, the image sensor 34 provided on the bottom surface of the recess 30 formed on the tip side can take an image of the outer region of the guide tube 22, which is close to the surgical site, through the lens 48.
Therefore, according to the examples shown in FIGS. 5 and 6, the region outside the guide pipe 22 can be widely observed in the axial direction (vertical direction in the figure).

As described above, in the present embodiment, the region between the surgical site 60 and the body wall H, which is separated from the surgical site (organ 60), can be widely observed in the direction along the body wall H. It is possible to solve the problem caused by the difficulty in observing the area.
Further, since the present embodiment adds an imaging function to the conventionally used trocar, it is not necessary to provide a new wound (hole) on the body wall of the patient, and the burden on the patient can be suppressed. ..

In the present embodiment, the image sensor 34 is attached to the hand side member 24 side from the axially intermediate position of the guide tube 22, and the region near the body wall H, which is difficult to observe with the endoscopic camera, can be easily observed. Can be observed.

In the present embodiment, by providing a plurality of image pickup elements 34 in the circumferential direction of the guide tube 22, a wide range can be observed in the circumferential direction of the guide tube 22.

In the present embodiment, the lens 48 has a tubular shape, and the lens 48 is arranged outside the tubular wall 31 of the guide tube 22 so as to cover the LED 36 and the image sensor 34. Therefore, the lens 48 is arranged on the LED 36 and the image sensor 34. Can function as a protective cover against. Further, both ends 48a and 48b of the lens 48 are fitted and assembled with the protrusion 46 of the second member 42 and the protrusion 29a of the tip side cylinder member 29, respectively, and the lens provided with the LED 36 and the image sensor 34. It is possible to satisfactorily prevent the intrusion of liquid into the inner space of 48.

FIG. 7 is a diagram showing a main part of another embodiment of the present invention. In the figure, reference numeral 61 denotes a small camera provided with a lens 63 for condensing light and an image sensor 34 inside the housing, which is attached to a cylinder wall 31 of a guide tube 22B (specifically, a base end side cylinder member 28B). There is.
In this example, a part of the cylinder wall 31 of the base end side cylinder member 28B forms a bulging portion 64 that bulges outward in the radial direction, and is located at a position on the base end side (upper side in the drawing) from the top portion. Four recesses 65 are formed in the circumferential direction (at intervals of 90 °). The recesses 65 formed on the proximal end side are opened diagonally upward in the drawing. A camera 61 is attached to the recess 65 formed on the base end side so that the imaging direction is obliquely upward. As the camera 61, for example, a camera having a size of about 1 mm × 1 mm × 1.7 mm can be used. Further, the camera 61 is capable of capturing a range of a viewing angle of 90 °.

On the other hand, four recesses 65 are formed in the circumferential direction (at intervals of 90 °) at positions on the distal end side (lower side in the drawing) of the proximal end side tubular member 28B with respect to the top of the bulging portion 64. .. The recesses 65 formed on the tip side are opened diagonally downward in the drawing. A camera 61 is attached to the recess 65 formed on the tip side so that the imaging direction is obliquely downward.

Further, as shown in FIG. 7B, an LED 36 as a light irradiation means is attached to a position on the cylinder wall 31 different from the recess 65 in the circumferential direction so as to face the outside of the guide tube 22B. The LED 36 can irradiate the observation area outside the guide tube 22B within a range of an irradiation angle of 120 ° or more. If diffusion is required, a diffusion plate can be arranged in front of the LED 36. The camera 61 and the LED 36 are connected to the control unit 16 (see FIG. 1) by a cord (not shown).

Reference numeral 67 denotes a tubular transparent protective cover arranged on the outside of the camera 61 and the LED 36, and both ends thereof are formed on a protrusion 46 at the lower end of the hand side member 24 and a protrusion 29a at the upper end of the front end side tubular member 29. They are assembled concentrically with the guide pipe 22B in a state of being fitted on the outside. The transparent protective cover 67 has a spherical portion facing the camera 61, and also has a function as a lens that collects light from a subject located outside the guide tube 22B.

According to the present embodiment, the LED 36 irradiates the observation area outside the guide tube 22B with illumination light, and the light (reflected light) from the subject located in the observation area outside the guide tube 22B covers the transparent protective cover 67. It is transmitted and incident on the camera 61. Then, the light is collected by the lens 63 provided in the camera 61 and incident on the light receiving surface of the image sensor 34. The light incident on the image sensor 34 is converted into an image signal and output to an external control unit 16 (see FIG. 1). In the present embodiment, a plurality of cameras 61 whose imaging direction is obliquely upward and a camera 61 whose imaging direction is obliquely downward are respectively arranged in the circumferential direction of the guide tube 22B, and a wide area between the surgical site and the body wall is observed. be able to.
The surface of the base end side cylinder member 28B holding the camera 61 and the LED 36 can be blackened in order to suppress reflection on the surface. Further, in order to improve the mountability of the camera 61 and the LED 36, it is also possible to configure the base end side tubular member 28B so as to be rotatable in the axial direction at the top of the bulging portion 64.

FIG. 8 is a diagram showing a main part of still another embodiment of the present invention. In the figure, reference numeral 70 denotes a small camera, which includes a lens 63 for condensing light and an image sensor 34 inside the housing. Further, reference numeral 72 denotes a concave mirror that reflects light from a subject located in the observation region outside the guide tube 22C toward the camera 70.
In the trocar 12C of this example, the camera 70 and the concave mirror 72 are provided on the outer peripheral side of the guide tube 22C, specifically, the base end side tubular member 28C. The concave mirror 72 is located below the camera 70 in the drawing (the tip end side of the guide tube 22C), and the reflecting surface 72a is arranged so as to face the camera 70 side.
Reference numeral 74 denotes a substantially tubular transparent protective cover arranged on the outside of the camera 70 and the concave mirror 72, and both ends thereof are a protrusion 46 at the lower end of the hand side member 24 and a protrusion 29a at the upper end of the tip side cylinder member 29. It is assembled in a state where it is fitted on the outside.

According to this example, the light from the subject located in the observation area outside the guide tube 22C passes through the transparent protective cover 74 and is incident on the concave mirror 72. Further, the light incident on the concave mirror 72 is reflected by the reflecting surface 72a of the concave mirror 72 to the camera 70, collected by the lens 63 provided in the camera 70, and incident on the light receiving surface of the image sensor 34. .. Then, the light incident on the image sensor 34 is converted into an image signal and output to the external control unit 16 (see FIG. 1).
As described above, according to the present embodiment, the region between the surgical site and the body wall, particularly the region LB near the back side of the body wall H can be widely observed.
A plurality of concave mirrors 72 may be provided according to the number of attached cameras 70, or one ring-shaped concave mirror extending in the circumferential direction of the base end side tubular member 28C may be provided. is there.

FIG. 9 is a diagram showing a main part of still another embodiment of the present invention. In this example, the light source 76 of the illumination light and the image sensor 34 are arranged in the control unit 16D located at a position away from the tracker 12D, and the light from the light source 76 is guided by using the optical fiber 78 for projection. The light from the subject located in the observation area outside the guide tube 22D is guided to the image sensor 34 by using the light receiving optical fiber 80 while guiding the light to the observation area outside the 22D.

The light projecting optical fiber 78 is arranged from the light source 76 to the cylinder wall 31 of the guide tube 22D (specifically, the base end side tubular member 28D), and the end portion of the floodlight optical fiber 78 on the tubular wall 31 side is the guide tube 22D. It is arranged radially outward so as to face the outside of the. The light emitted from the light source 76 is collected by the lens 83 arranged between the light source 76 and the light projecting optical fiber 78, and is guided to the tube wall 31 of the guide tube 22D through the light projecting optical fiber 78. Then, the light emitted from the end of the light projecting optical fiber 78 on the cylinder wall 31 side is irradiated to the observation region outside the guide tube 22D through the irradiation lens 82. In this example, the light projection optical fiber 78 and the irradiation lens 82 form the light irradiation means.

The light receiving optical fiber 80 is arranged from the image sensor 34 to the cylinder wall 31 of the guide tube 22D, and the end portion of the light receiving optical fiber 80 on the cylinder wall 31 side faces outward in the radial direction so as to face the outside of the guide tube 22D. It is arranged. A lens 84 for condensing light is arranged at the end of the light receiving optical fiber 80 on the cylinder wall 31 side. According to this example, the light from the subject located in the observation region outside the guide tube 22D is guided by the lens 84 to the end face of the light receiving optical fiber 80 and emitted from the end face of the light receiving optical fiber 80 on the image sensor 34 side. To. A lens 85 that forms an image on the light receiving surface of the image sensor 34 is arranged between the light receiving optical fiber 80 and the image sensor 34, and the light emitted from the light receiving optical fiber 80 passes through the lens 85 and is the image sensor. It is incident on 34 and converted into an image signal.

As described above, when the image sensor 34 is not provided on the tube wall 31 of the guide tube 22D, the light receiving optical fiber 80 that guides the light collected by the lens 84 to the image sensor 34 is connected to the tube of the guide tube 22D. By providing it on the wall 31, the region LB between the surgical site and the body wall can be observed. Further, also in this example, by providing a plurality of light receiving optical fibers 80 in the circumferential direction or the vertical direction of the guide tube 22D, the outer region of the guide tube 22D can be observed over a wide range.

Although the embodiments of the present invention have been described in detail above, these are merely examples, and the present invention can be configured in a form in which various modifications are made without departing from the spirit of the present invention.

12, 12B, 12C, 12D Trocar 22, 22B, 22C, 22D Guide tube 24 Hand side member 25 Insertion hole 31 Tube wall 34 Image sensor (imaging means)
36 LED (light irradiation means)
48, 63, 84 Lens 78 Optical fiber for light projection (light irradiation means)
80 Optical fiber for light reception 82 Lens (light irradiation means)

Claims (5)

A trocar that is used while attached to the body wall and guides surgical instruments into the body cavity through an insertion hole formed inside.
A tubular guide tube that penetrates the body wall and is inserted into the body cavity, and a hand side member having a diameter larger than that of the guide tube that is formed on the hand side of the guide tube and is locked to the surface of the body wall. Have,
On the cylinder wall of the guide pipe and on the side of the hand side member with respect to the tip surface of the guide pipe.
A lens for condensing light from a subject to be located outside the viewing area of the guide tube,
An imaging means that receives the light focused by the lens and converts it into an image signal, or a light receiving optical fiber that guides the light focused by the lens to the imaging means.
Is provided,
In the outer region of the guide tube, a region closer to the hand side member than the tip surface of the guide tube , and a region in a direction orthogonal to the axial direction of the guide tube starting from the imaging means or the light receiving optical fiber. Alternatively, a trocar with an imaging function, characterized in that a region on the side of the hand side member with respect to the orthogonal direction is configured to be capable of imaging. In claim 1, further, a light irradiation means for irradiating an observation region outside the guide tube with illumination light is provided on the cylinder wall of the guide tube and on the side of the hand side member with respect to the tip surface of the guide tube. A trocar with an imaging function that is characterized by being In any one of claims 1 and 2, when the image pickup means is provided on the tubular wall of the guide tube, the image pickup means is closer to the hand side member than the axially intermediate position of the guide tube. A trocar with an imaging function, which is characterized by being installed in. According to any one of claims 1 to 3, the imaging means is provided on the tubular wall of the guide tube, and a plurality of the imaging means are provided in the circumferential direction of the guide tube. Trocar with imaging function. A trocar that is used while attached to the body wall and guides surgical instruments into the body cavity through an insertion hole formed inside.
A tubular guide tube that penetrates the body wall and is inserted into the body cavity, and a hand side member having a diameter larger than that of the guide tube that is formed on the hand side of the guide tube and is locked to the surface of the body wall. Have,
On the tube wall of the guide tube,
A lens that collects light from a subject located in the observation area outside the guide tube, and
An imaging means that receives the light collected by the lens and converts it into an image signal.
Is provided,
A trocar with an imaging function, wherein the lens has a tubular shape and is arranged outside the tubular wall so as to cover the imaging means.

Images