JP6967208B1 - Exclusion body - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an excluding body which can easily support an organ only by an excluding body, is not easily deformed, and can improve work operability. SOLUTION: The exclusion body 100 includes an exclusion portion 1, a first pocket 3, and a support 5. The exclusion portion 1 is formed of a sponge and has a planar shape. The first pocket 3 is coupled to the surface of the exclusion portion 1 and the tip portion of the forceps 7 can be inserted. The support 5 is attached to the exclusion portion 1. [Selection diagram] FIG. 5

Description

The present disclosure relates to an exclusion body.

Multiple forceps are used in endoscopic surgery. Forceps are, for example, instruments used to grab and hold organs. However, organs that are not treated during surgery need to be protected or pushed up (excluded) during surgery. For that purpose, forceps called grasping forceps may be used instead of the special tool for exclusion.

When the gripping forceps are used for the exclusion of an organ, there is a problem that the gripping portion of the metal forceps slips on the organ and the gripping portion damages the organ. Therefore, from the viewpoint of solving such a problem, for example, in Utility Model Registration No. 3158948 (Patent Document 1), a bag made of gauze is used and a grip portion of forceps is wrapped in the bag. A technique for excluding organs by using it has been proposed.

Utility Model Registration No. 3158948 Gazette

However, it is difficult for the exclusion assisting material as the exclusion body disclosed in Utility Model Registration No. 3158948 to support the organ by the exclusion body alone when the forceps are removed from the gauze bag. Further, since the gauze exclusion body is easily deformed, the operability in the exclusion work may be deteriorated.

This disclosure has been made in view of the above issues. The purpose is to provide a repellent body that can easily support an organ only by a repellent body, is not easily deformed, and can improve operability.

Exclusion bodies according to the present disclosure include exclusion sections, pockets, and supports. The exclusion portion is formed of a sponge and is flat. The pocket is coupled to the surface of the exclusion section and the tip of the forceps can be inserted. The support is attached to the exclusion section. The pocket is wider at the end opposite the insertion slot than the width of the insertion slot into which forceps can be inserted.
Exclusion bodies according to the present disclosure include exclusion sections, pockets, and supports. The exclusion portion is formed of a sponge and is flat. The pocket is coupled to the surface of the exclusion section and the tip of the forceps can be inserted. The support is attached to the exclusion section.

According to the present disclosure, it is easy to support an organ only by a squeezing body, and it is possible to provide a squeezing body that is easily deformed and can improve operability.

It is a schematic diagram which shows the mode in which the tip portion of the forceps was inserted into the exclusion body of Embodiment 1. FIG. It is a schematic enlarged view of the tip portion of the forceps of FIG. It is the schematic which looked at the exclusion body of Embodiment 1 from the upper surface side. It is the schematic which looked at the exclusion body of Embodiment 1 from the lower surface side. It is a embodiment in which the tip portion of the forceps is inserted into the exclusion body of the first embodiment, and is a schematic view showing a portion such as a grip portion of the hidden forceps with a dotted line. It is a embodiment in which the tip portion of the forceps is inserted into the exclusion body of the second embodiment, and is a schematic view showing a portion such as a grip portion of the hidden forceps with a dotted line. It is a embodiment in which the tip portion of the forceps is inserted into the exclusion body of the third embodiment, and is a schematic view showing a portion such as a grip portion of the hidden forceps with a dotted line. It is a embodiment in which the tip portion of the forceps is inserted into the exclusion body of the fourth embodiment, and is a schematic view showing a portion such as a grip portion of the hidden forceps with a dotted line. It is a schematic diagram which shows the mode in which the tip part of the forceps was inserted into the exclusion body of Embodiment 5. It is the schematic which looked at the exclusion body of Embodiment 5 from the upper surface side. It is the schematic which looked at the exclusion body of Embodiment 5 from the lower surface side. It is a embodiment in which the tip portion of the forceps is inserted into the exclusion body of the fifth embodiment, and is a schematic view showing a portion such as a grip portion of the hidden forceps with a dotted line. It is the schematic which looked at the exclusion body of the 1st example of Embodiment 6 from the lower surface side. It is the schematic which looked at the exclusion body of the 2nd example of Embodiment 6 from the lower surface side. It is the schematic which looked at the exclusion body of the 1st example of Embodiment 7 from the lower surface side. It is the schematic which looked at the exclusion body of the 2nd example of Embodiment 7 from the lower surface side. It is the schematic which looked at the exclusion body of the 1st example of Embodiment 8 from the lower surface side. It is the schematic which looked at the exclusion body of the 1st example of Embodiment 8 from the upper surface side. It is a schematic diagram which shows the state of the exclusion part of the 1st example of Embodiment 8 before the joint part is formed. It is the schematic which looked at the exclusion body of the 2nd example of Embodiment 8 from the lower surface side. It is the schematic which looked at the exclusion body of the 3rd example of Embodiment 8 from the lower surface side. It is the schematic which looked at the exclusion body of the 3rd example of Embodiment 8 from the upper surface side. It is an embodiment in which the exclusion body of the first example of Embodiment 9 is fixed to the forceps, and is the schematic diagram which shows the part such as the grip part of the hidden forceps by the dotted line. It is an embodiment in which the exclusion body of the 2nd example of Embodiment 9 is fixed to the forceps, and is the schematic diagram which shows the part such as the grip part of the hidden forceps by the dotted line. It is an embodiment in which the exclusion body of the third example of Embodiment 9 is fixed to the forceps, and is the schematic diagram which shows the part such as the grip part of the hidden forceps by the dotted line. It is a schematic diagram which shows the mode that the exclusion body of Embodiment 10 was fixed to the forceps.

Hereinafter, each embodiment will be described with reference to the drawings.

(Embodiment 1)
FIG. 1 is an overall schematic view of the exclusion body of the first embodiment and the forceps inserted therein. FIG. 2 is a schematic enlarged view of the tip of the forceps of FIG. FIG. 3 is a schematic view of the exclusion body of the first embodiment as viewed from the upper surface side. FIG. 4 is a schematic view of the exclusion body of the first embodiment as viewed from the lower surface side. FIG. 5 is a schematic view in which the tip end portion of the forceps is inserted into the exclusion body of the first embodiment, and a portion such as a grip portion of the hidden forceps is shown by a dotted line.

With reference to FIG. 1, the exclusion body 100 of the present embodiment is a member called a retractive membrane. The exclusion body 100 can insert the tip of the forceps 7. The forceps 7 is an instrument used for endoscopic surgery. The forceps 7 is, for example, a gripping forceps, and mainly includes an insertion portion 70 and a grip portion 71. The insertion portion 70 is a rod-shaped portion that is inserted into the body during surgery. A grip portion 71 is provided at the tip of the forceps 7. The grip portion 71 is a portion that grips an organ or the like during surgery. Here, as will be described later, the grip portion 71 is a portion inserted into the pocket of the exclusion body 100. With reference to FIG. 2, the grip portion 71 is arranged so that two metal members have a V-shape, and by changing the angle between the two members, the object may or may not be gripped. Can be adjusted.

With reference to FIGS. 3, 4 and 5, the exclusion body 100 includes an exclusion section 1, a first pocket 3, a second pocket 4, and a support 5. The exclusion unit 1 has a planar shape. The exclusion portion 1 has, for example, a shape in which four corners of a quadrangle having a shape close to a rhombus are chamfered, but the exclusion portion 1 is not limited to this. The exclusion portion 1 is a thin sheet-like member formed of a sponge. Among them, the exclusion portion 1 may be formed of, for example, a cellulose sponge. The exclusion unit 1 has two surfaces, an upper surface 11 and a lower surface 12 on the opposite side thereof. The upper surface 11 faces upward in FIG. 1 and is a surface on the side that can be visually recognized by the doctor performing the operation. The lower surface 12 is a surface that faces downward and is in direct contact with the organ to be protected.

As shown in FIGS. 3 and 5, the first pocket 3 is coupled to the upper surface 11 of the exclusion section 1. The first pocket 3 has an insertion slot 31 and an end portion 32 on the opposite side thereof. That is, both the insertion slot 31 and the end portion 32 are the outer edges of the first pocket 3. The end portion 32 faces the insertion slot 31 and is the farthest portion from the insertion slot 31. The first pocket 3 is bonded to the upper surface 11 which is a part of the surface of the exclusion portion 1 at the coupling portion 30 formed in the region slightly inside the outer edge adjacent to the outer edge thereof. However, the first pocket 3 may be coupled to the lower surface 12 which is a part of the surface of the exclusion portion 1. The joint portion 30 is not formed in the region adjacent to the insertion port 31, that is, on the insertion port 31 side. This is because the forceps 7 are inserted into the gap between the first pocket 3 and the exclusion portion 1 from the insertion port 31. The first pocket 3 is preferably formed of a sponge as in the exclusion portion 1, and may be formed of a cellulose sponge. However, the first pocket 3 may be made of a material different from the material of the exclusion portion 1, and may be made of, for example, plastic. The first pocket 3, which is one of the pockets, can insert the tip end portion of the forceps 7, that is, the grip portion 71. The tip portion here may include both the grip portion 71 and a partial region of the insertion portion 70 adjacent thereto. Further, the fact that the tip of the forceps 7 can be inserted into the first pocket 3 means that the tip of the forceps 7 is sandwiched between the first pocket 3 and the exclusion portion 1 (for example, the upper surface 11) to which the first pocket 3 is connected. It means that it can be inserted into the area.

As shown in FIG. 4, the second pocket 4 is coupled to the lower surface 12 of the exclusion portion 1. The second pocket 4 has, for example, a rectangular planar shape extending in the vertical direction of FIGS. 3 to 5. The second pocket 4 is bonded to the lower surface 12 which is a part of the surface of the exclusion portion 1 at the coupling portion 40 formed in the region slightly inside the outer edge adjacent to the outside thereof. However, particularly when the first pocket 3 is coupled to the lower surface 12, the second pocket 4 may be coupled to the upper surface 11 which is a part of the surface of the exclusion portion 1. That is, the connecting portion 40 of the second pocket 4 is a region adjacent to the other three sides, excluding the short side region 40a adjacent to one of the pair of short sides of the outer edges of the four sides of the rectangle of the second pocket 4. It is preferably formed in. In this case, the coupling portion 40 is not formed in the short side region 40a, and the support 5 is not coupled to the exclusion portion 1.

The support 5 has, for example, a rectangular, thin plate-like planar shape extending in the vertical direction of FIGS. 3 to 5. The support 5 is preferably made of plastic. However, the present invention is not limited to this, and the support 5 may be made of, for example, a sponge.

The support 5 is housed in the second pocket 4. By inserting the support 5 into the second pocket 4, the support 5 is housed in the second pocket 4. Here, the fact that the support 5 is housed in the second pocket 4 means that the support 5 is arranged between the second pocket 4 and the exclusion portion 1 (for example, the lower surface 12) to which the support 5 is connected. do. Alternatively, the support 5 may be embedded inside the exclusion portion 1. Further, the support 5 may be directly connected to the lower surface 12 (or the upper surface 11) of the exclusion portion 1. That is, the support 5 may be sewn to the lower surface 12 or the like, or may be adhered to the lower surface 12 or the like by an adhesive means other than the sewn. As described above, it is assumed that the support 5 is housed in the second pocket 4, embedded inside the exclusion portion 1, and directly coupled to the exclusion portion 1. Will be done. It is expressed here that the support 5 is attached to the exclusion portion 1 in combination with these three ways. Further, even when the support 5 is restrained by the exclusion portion 1 by some method other than both of them, it is expressed here that the support 5 is attached to the exclusion portion 1.

Further, as shown in FIGS. 3 to 5, the contrast medium 6 may be further provided. Similar to the support 5, the contrast medium 6 has, for example, a rectangular, thin plate-like planar shape extending in the vertical direction of FIGS. 3 to 5. The contrast medium 6 is made of, for example, a material in which barium sulfate and a styrene-based elastomer are mixed. Even if the contrast medium 6 forgets to take out the exclusion part 1 out of the patient's body cavity after the operation, the exclusion part 1 remains in the patient's body cavity by confirming it when the inside of the patient's body cavity is examined by X-ray after the operation. It is a member for preventing the patient from being left unattended. This also applies to each subsequent embodiment.

After the support 5 and the contrast medium 6 are housed in the second pocket 4, the joint portion 40 may or may be formed in the short side region 40a as well as the other three sides of the second pocket 4. It does not have to be. This also applies to each subsequent embodiment. Further, in FIG. 3 and the like, the support 5 is housed in the second pocket 4 so as to be arranged on the upper surface 11 side of the contrast medium 6, but the present invention is not limited to this. The contrast medium 6 may be housed in the second pocket 4 so as to be arranged on the upper surface 11 side of the support 5.

The connecting portions 30 and 40 may be, for example, a sutured portion, or may be adhered by an adhesive means other than the suture. Since the joint portion 30 is a suture portion in FIGS. 3 to 5, the joint portion 30 is also visible on the lower surface 12 opposite to the upper surface 11 to which the first pocket 3 of FIG. 4 is bonded. Since the joint portion 40 is a suture portion in FIGS. 3 to 5, the joint portion 40 is also visible on the upper surface 11 opposite to the lower surface 12 to which the support 5 of FIG. 4 is bonded. The connecting portion 30 may not be formed in the region overlapping the second pocket 4 and the support 5.

In FIGS. 3 and 5, the tip of the forceps 7 is inserted into the first pocket 3. The support 5 extends in a direction intersecting the extending direction of the forceps 7 inserted into the first pocket 3. That is, in FIGS. 3 and 5, the forceps 7 inserted into the first pocket 3 extend in the left-right direction, while the support 5 extends in the up-down direction. In other words, the direction connecting the insertion slot 31 and the end portion 32 and the direction in which the support 5 extends intersect with each other (for example, they are substantially perpendicular to each other).

It is preferable that the mark M is provided in the region adjacent to the end portion of the support 5 in the extending direction. Specifically, it is a region adjacent to the extending direction of the support 5, that is, the upper and lower ends in the vertical direction of FIGS. 3 to 5 (on the extension line of the support 5), for example, the exclusion portion 1. It is preferable that a visible mark M is formed in a part of the region on the upper surface 11. More specifically, the mark M overlaps with an extension portion of the second pocket 4 adjacent to the vertical end of FIGS. 3 to 5, which is the extending direction of the second pocket 4 for accommodating the support 5, for example. It is preferably formed in the region of the upper surface 11 of the exclusion portion 1. However, the mark M may be formed on a part of the surface of the second pocket 4 adjacent to the extending end of the support 5, that is, on the surface of the extending end of the second pocket 4. The mark M may be colored in a color different from the color of the support 5. Alternatively, the mark M may be formed as a portion of the support 5 having a concave shape or a convex shape with respect to the other portion.

As shown in FIG. 3, it is preferable that the width W2 of the end portion 32 opposite to the insertion port 31 is wider in the first pocket 3 than the width W1 of the insertion port 31 into which the forceps 7 can be inserted. More specifically, for example, it is preferable that the width W2 is twice or more larger than the width W1. Among them, it is more preferable that the width W2 is three times or more larger than the width W1. In order to obtain such a shape, the first pocket 3 extends in a plan view along the grip portion 71 in a state where the pair of grip portions 71 of the forceps 7 inserted therein are open to each other. It has a pair of width expansion portions 33 as outer edges. The width expansion portion 33 extends at an angle inclined in both the vertical direction and the horizontal direction in FIG. 3, for example, in a straight line or in a curved shape close to a straight line. In FIGS. 3 to 5, the outer edge of the first pocket 3 is formed by the insertion port 31, the end portion 32, and the width expansion portion 33. The width expansion portion 33 of FIGS. 3 to 5 connects one end of the insertion port 31 and one end of the end 32 in the extending direction of the support 5. Therefore, the entire outer edge of the first pocket 3 has a planar shape close to a fan shape. The width expansion portion 33 of FIGS. 3 to 5 connects the other end portion of the insertion port 31 and the other end portion of the end portion 32 in the extending direction of the support 5.

The insertion port 31 of the first pocket 3 extends linearly in a plan view. On the other hand, it is preferable that the end portion 32 of the first pocket 3 has a convex shape protruding to the side opposite to the insertion port 31. That is, the end portion 32 has a convex shape that curves toward the outside of the first pocket 3 so as to be separated from the insertion opening 31 in the left-right direction of FIGS. 3 to 5 connecting the end portion 32 and the insertion opening 31. doing. This convex shape may be arcuate or elliptical, or may be a curve different from arcuate or elliptical.

The method of using the exclusion body 100 at the time of endoscopic surgery is as follows. First, a hole for inserting the forceps 7 into the patient's body cavity is formed in the patient's abdomen. Next, the exclusion body 100 is wound so that, for example, the left-right direction (direction connecting the end portion 32 and the insertion port 31) of FIGS. 3 to 5 intersecting the extending direction of the support 5 is the circumferential direction. .. The rolled exclusion body 100 is inserted into the body cavity through a hole formed in the patient's abdomen. The wound exclusion body 100 is spread in the patient's body cavity.

The grip portion 71 of the forceps 7, that is, for example, a part of the grip portion 71 and the insertion portion 70 is inserted into the first pocket 3 of the exclusion body 100. Since the grip portion 71 is expanded inside the first pocket 3, the grip portion 71 of the forceps 7 cannot be removed from the first pocket 3. Therefore, the exclusion body 100 is fixed to the forceps 7. The untreated organ around the organ to be treated in the operation is protected by being covered with the exclusion body 100 fixed to the forceps 7. Alternatively, the untreated organ is pressurized from below by the exclusion body 100 fixed to the forceps 7 and pushed up. After the operation is completed, the forceps 7 and the exclusion body 100 are taken out of the body cavity. At this time, the mark M provided on the exclusion body 100 is confirmed. A plurality of holes are formed in the abdomen of the patient. Using an endoscope inserted through the hole, the position of the mark M in the body cavity and in the body cavity is visually confirmed. For example, this mark M is grasped by the grip portion 71 of the forceps 7 and is taken out of the body cavity from the above hole.

Such a mark M is provided in a region adjacent to the extending end of the support 5 (for example, an extending region of the second pocket 4 adjacent to the outside of the extending end of the second pocket 4). ing. By wrapping the exclusion body 100 around the forceps 7 again while grasping the portion of the mark M, it is possible to suppress damage to the exclusion body 100 when the exclusion body 100 is pulled out of the body cavity. Further, by pulling out while grasping the mark M, the tip portions of the exclusion body 100 and the forceps 7 can be smoothly pulled out from the body cavity.

Next, the action and effect of the exclusion body 100 of the present embodiment will be described. The exclusion body 100 according to the present embodiment includes an exclusion portion 1, a first pocket 3 which is a pocket, and a support 5. The exclusion portion 1 is formed of a sponge and is a flat member. The first pocket 3 is coupled to, for example, the upper surface 11 which is the surface of the exclusion portion 1, and a grip portion 71 at the tip of the forceps 7 can be inserted. The support 5 is attached to the exclusion portion 1.

The support 5 is mounted on the upper surface 11 which is the surface of the exclusion portion 1. As a result, even when the forceps 7 are removed from the first pocket 3, the effect of supporting the organ, protecting the organ, and pushing up the organ with the exclusion body 100 alone can be sufficiently obtained. If the support 5 is made of plastic, for example, it is harder and less likely to be deformed than the exclusion portion 1. Therefore, the entire exclusion body 100 having the support 5 is not easily deformed, the work of excluding the organ with the forceps 7 becomes easy, and the operability of the exclusion body 100 in the work can be improved. By excluding an organ by the exclusion body 100 provided with the support 5, the organ can be reliably excluded and supported in a safe place.

If the exclusion portion 1 is formed by a sponge, it expands when it absorbs water in the body cavity. This water is sucked by, for example, a tube pressed against the exclusion portion 1. Therefore, the volume of the once expanded exclusion portion 1 contracts. This makes it easy to remove the exclusion unit 1 from the body cavity after the treatment is completed.

In the exclusion body 100 of the present embodiment, the support 5 may extend in a direction intersecting the extending direction of the forceps 7 inserted in the first pocket 3. As a result, the operation of pushing up (pushing up) the organ by the forceps 7 can be easily performed as compared with the support 5 which extends long along the extending direction of the forceps 7 inserted into the first pocket 3, for example. Further, when the support 5 intersects in the extending direction of the forceps 7, the support 5 and the forceps 7 form a two-dimensional plane. This plane enhances the function of pushing up the organ as the exclusion body 100, and enhances the rigidity of the exclusion body 100. Therefore, the organ can be stably excluded with a stronger force. Further, with this configuration, the forceps 7 are more strongly fixed to the exclusion body 100.

In the exclusion body 100 of the present embodiment, even if the width W2 of the end portion 32 opposite to the insertion port 31 is wider in the first pocket 3 than the width W1 of the insertion port 31 into which the forceps 7 can be inserted. good. By doing so, the angle between the two metal materials constituting the grip portion 71 of the forceps 7 can be easily adjusted in the first pocket 3. Therefore, the exclusion of the organ by the grip portion 71 can be performed more easily.

In the exclusion body 100 of the present embodiment, the end portion 32 of the first pocket 3 may be curved so as to form a convex shape protruding to the side opposite to the insertion port 31. As a result, for example, the distance from the tip of the grip portion 71 of the forceps 7 opened in the first pocket 3 to the end portion 32 is shorter than in the case where the end portion 32 is linear like the insertion slot 31. Therefore, the forceps 7 can easily apply a pressing force for exclusion to the organ side as compared with the case where the end portion 32 is linear like the insertion port 31.

If the exclusion portion 1, the first pocket 3 and the support 5 are too thin, the function as the exclusion body 100 is impaired. Further, if these are too thick, the exclusion body 100 swells excessively in the body cavity, and even if it absorbs water, it does not become small, and it becomes difficult to pull out the exclusion body 100 from the body cavity after use. Therefore, by setting the thickness of each part to an appropriate thickness, the function as the exclusion body 100 can be enhanced.

In the exclusion body 100 of the present embodiment, it is preferable that the length of the support 5 extending in the vertical direction of FIGS. 3 to 5 is 80% or more of the dimension of the exclusion portion 1 in the vertical direction. That is, in the exclusion body 100, the dimension of the support 5 in the direction intersecting the insertion port 31 and the end portion 32 in FIGS. 3 to 5 is 80, which is the length of the diagonal line extending the exclusion portion 1 in the same direction. It is preferable to have a length of% or more. In this way, the effect of supporting the organ by the support 5 is further enhanced. This is because the support 5 has a sufficient length. The extending length of the support 5 is more preferably 90% or more of the dimension of the exclusion portion 1 in the extending direction of the support 5.

In the exclusion body 100 of the present embodiment, it is preferable that the support 5 is arranged at a position where the support 5 passes through the center of gravity G of the entire exclusion body 100. In this way, the effect of supporting the organ by the support 5 is further enhanced.

In addition, the exclusion body 100 of the present embodiment preferably has the following characteristics. The convex apex of the end portion 32 of the first pocket 3 in FIG. 3 and the exclusion portion (closest to the end portion 32 facing the end portion 32) in the left-right direction in which the forceps 7 inserted into the first pocket 3 extend from the apex. It is preferable that the distance W3 to the outer edge of 1 is as short as possible. The convex apex of the end portion 32 is the central portion of the convex shape of the end portion 32 in the vertical direction in which the support 5 extends, and the end portion 32 is the most protruding portion on the left side of FIG. Specifically, for example, in the vertical direction in which the support 5 extends from the width expansion portion 33 of the first pocket 3 in the central portion in the left-right direction of either the support 5 in FIG. 3 and the second pocket 4 in which the support 5 is housed. W3 is preferably shorter than W4, where W4 is the distance to the outer edge of the exclusion section 1 (closest to this facing the width expansion section 33) for (the direction in which the forceps 7 extend in the left-right direction). .. By doing so, since neither the support 5 nor the forceps 7 is arranged and only the exclusion portion 1 is present, the region that is easily deformed and the organ is difficult to be excluded is reduced, and the workability of the exclusion body 100 is improved. Can be improved.

Further, the exclusion body 100 of the present embodiment of the present embodiment has diagonal dimensions of the exclusion portion 1 with respect to the extending direction of the support 5 (the direction intersecting the direction connecting the end portion 32 and the insertion port 31). Is longer than the diagonal dimension of the exclusion portion 1 in the direction intersecting it, that is, in the direction connecting the end portion 32 and the insertion port 31, and in the extending direction of the inserted forceps 7. Such a configuration may be used.

(Embodiment 2)
FIG. 6 is a schematic view in which the tip end portion of the forceps is inserted into the exclusion body of the second embodiment, and a portion such as a grip portion of the hidden forceps is shown by a dotted line. With reference to FIG. 6, this corresponds to FIG. 5 in Embodiment 1. Since the exclusion body 100 of the present embodiment has the same configuration as that of the exclusion body 100 of the first embodiment, the same components are designated by the same reference numerals, and the characteristics, actions and effects are the same. I will not repeat the explanation as long as possible. However, in the exclusion body 100 of the present embodiment, the end portion 32 extends linearly in a plan view, similarly to the insertion port 31. That is, both the end portion 32 and the insertion port 31 extend in the vertical direction in which the support 5 extends (the direction intersecting the direction connecting the end portion 32 and the insertion port 31). Since the end portion 32 is linear, as shown in FIG. 6, the outer edge of the first pocket 3 is located between the end portion 32 and the width expansion portion 33 in the left-right direction connecting the end portion 32 and the insertion port 31. It may have an intervening portion 34 extending to. Such a configuration may be used. The exclusion body 100 having the end portion 32 having such a configuration can be processed by sewing or the like at the joint portion 30 as compared with the exclusion body 100 of the first embodiment (FIG. 3) in which the end portion 32 has a curved shape. It is easy to work and has an effect.

(Embodiment 3)
FIG. 7 is a schematic view in which the tip end portion of the forceps is inserted into the exclusion body of the third embodiment, and a portion such as a grip portion of the hidden forceps is shown by a dotted line. With reference to FIG. 7, this corresponds to FIG. 5 in Embodiment 1. Since the exclusion body 100 of the present embodiment has the same configuration as that of the exclusion body 100 of the first embodiment, the same components are designated by the same reference numerals, and the characteristics, actions and effects are the same. I will not repeat the explanation as long as possible. However, in the exclusion body 100 of the present embodiment, the joint portion 30 between the first pocket 3 and the exclusion portion 1 is not only in the region adjacent to the outer edge of the first pocket 3, but also in the region adjacent to the outer edge in a plan view. Is also formed in the inner region. The inner joint portion 30 has, for example, a portion along each of the pair of width expansion portions 33 of the first pocket 3 having a planar shape close to a fan shape, and a portion along the curved end portion 32. These form a planar shape close to a fan shape. However, the inner joint portion 30 does not have to have a planar shape close to a fan shape (a shape that forms a circular fan shape), and for example, a part of the fan shape is formed (a part is missing without rotating). ) It may be a straight line or a curved line. A pair of regions is formed between a portion extending along the width expansion portion 33 of the outer coupling portion 30 and a portion extending along the width expansion portion 33 of the inner coupling portion 30. When the forceps 7 are inserted into the first pocket 3, each of the pair of regions accommodates each of the pair of grips 71 in the open state. Such a configuration may be used. The exclusion body 100 having two joint portions 30 closed in this way on the outside and inside can more stably store the grip portion 71 in the first pocket 3.

(Embodiment 4)
FIG. 8 is a schematic view in which the tip end portion of the forceps is inserted into the exclusion body of the fourth embodiment, and a portion such as a grip portion of the hidden forceps is shown by a dotted line. With reference to FIG. 8, this corresponds to FIG. 5 in Embodiment 1. Since the exclusion body 100 of the present embodiment has the same configuration as that of the exclusion body 100 of the first embodiment, the same components are designated by the same reference numerals, and the characteristics, actions and effects are the same. I will not repeat the explanation as long as possible. However, in the exclusion body 100 of the present embodiment, the diagonal dimension of the exclusion portion 1 with respect to the extending direction of the support 5 (the direction intersecting the direction connecting the end portion 32 and the insertion port 31) intersects the direction. That is, it is shorter than the diagonal dimension of the exclusion portion 1 in the direction connecting the end portion 32 and the insertion port 31 and in the extending direction of the inserted forceps 7. Such a configuration may be used.

(Embodiment 5)
FIG. 9 is a schematic view showing a mode in which the tip end portion of the forceps is inserted into the exclusion body of the fifth embodiment. FIG. 10 is a schematic view of the exclusion body of the fifth embodiment as viewed from the upper surface side. FIG. 11 is a schematic view of the exclusion body of the fifth embodiment as viewed from the lower surface side. FIG. 12 is a schematic view in which the tip end portion of the forceps is inserted into the exclusion body of the fifth embodiment, and a portion such as a grip portion of the hidden forceps is shown by a dotted line. 9, FIG. 10, FIG. 11, and FIG. 12 correspond to FIGS. 1, 3, 4, and 5 in the first embodiment with reference to FIGS. 9 to 12. Since the exclusion body 100 of the present embodiment has the same configuration as that of the exclusion body 100 of the first embodiment, the same components are designated by the same reference numerals, and the characteristics, actions and effects are the same. I will not repeat the explanation as long as possible. However, in the exclusion body 100 of the present embodiment, the support 5 extends in the direction along the extending direction of the forceps 7 inserted into the first pocket 3. That is, in FIGS. 10 and 12, the direction in which the forceps 7 inserted into the first pocket 3 extends and the direction in which the support 5 (the second pocket 4 in which the support 5 is housed) extends substantially coincides with each other. In other words, the direction connecting the insertion slot 31 and the end portion 32 and the direction in which the support 5 (second pocket 4) extends are substantially the same (for example, substantially parallel to each other). In FIGS. 10 and 11, the joint portion 30 is not formed in the region surrounded by the joint portion 30 having a planar shape close to a fan shape, that is, the region inside the joint portion 30 adjacent to the outer edge of the first pocket 3. By doing so, the area in which the grip portion 71 can be inserted can be widened in the first pocket 3, and the work efficiency can be improved.

The exclusion body 100 of the present embodiment is a direction in which the support 5 (second pocket 4) intersects in the extending direction and the direction in which the end portion 32 and the insertion port 31 intersect. The diagonal dimension may be shorter in the extending direction of the support 5 (the direction connecting the end portion 32 and the insertion port 31) and shorter than the diagonal dimension of the exclusion portion 1 in the extending direction of the inserted forceps 7. ..

The exclusion body 100 having a feature that the extending direction of the support 5 is along the extending direction of the forceps 7 is the first embodiment (FIG. 3) in which the extending direction of the support 5 intersects with the extending direction of the inserted forceps 7. Compared with the exclusion body 100, the shape is maintained more stably and the effect of enhancing the exclusion effect is exhibited.

(Embodiment 6)
FIG. 13 is a schematic view of the exclusion body of the first example of the sixth embodiment as viewed from the lower surface side. FIG. 14 is a schematic view of the exclusion body of the second example of the sixth embodiment as viewed from the lower surface side. With reference to FIGS. 13 and 14, these correspond to FIGS. 4 and 11, respectively. Since the exclusion body 100 of the present embodiment has the same configuration as the exclusion body 100 of the first and fifth embodiments, the same components are designated by the same reference numerals, and the characteristics, actions and effects are the same. As long as it is, the explanation will not be repeated. However, the exclusion body 100 of the present embodiment has a planar shape close to a fan shape so that the outer edge of the exclusion portion 1 is approximately along the outer edge of the first pocket 3 and the joint portion 30. That is, the outer edge of the exclusion portion 1 has a curved outer edge at least in a part thereof, similarly to the first pocket 3 and the joint portion 30. In this respect, FIGS. 13 and 14 have a shape in which the outer edge of the exclusion portion 1 is rectangular, particularly a chamfer is formed at each corner of a rhombus, and the outer edges are all linear. Has different characteristics.

The magnitude relationship between the vertical direction and the horizontal direction of the exclusion portion 1 in FIG. 13 is the same as the magnitude relationship between the vertical direction and the horizontal direction of the exclusion portion 1 in FIG. Further, the magnitude relationship between the vertical direction and the horizontal direction of the exclusion portion 1 in FIG. 14 is the same as the magnitude relationship between the vertical direction and the horizontal direction of the exclusion portion 1 in FIG. 10 (FIG. 11). Such a configuration may be used. In the exclusion body 100 having such a shape as the outer edge, the outer edge of the exclusion body 100 is rounded as compared with the exclusion body 100 having a linear outer edge as in the first and fifth embodiments, for example. Therefore, according to the present embodiment, the distance between the first pocket 3 and the outer periphery of the exclusion portion 1 can be shortened as compared with the exclusion portion 1 having a linear outer edge. Therefore, since the distance between the first pocket 3 and the outer circumference of the exclusion portion 1 is long, it is possible to suppress a problem that the grip portion 71 of the forceps 7 is difficult to apply a force to the outer circumference of the exclusion portion 1.

(Embodiment 7)
FIG. 15 is a schematic view of the exclusion body of the first example of the seventh embodiment as viewed from the lower surface side. FIG. 16 is a schematic view of the exclusion body of the second example of the seventh embodiment as viewed from the lower surface side. With reference to FIGS. 15 and 16, these correspond to FIGS. 4 and 11, respectively. Since the exclusion body 100 of the present embodiment has the same configuration as the exclusion body 100 of the first and fifth embodiments, the same components are designated by the same reference numerals, and the characteristics, actions and effects are the same. As long as it is, the explanation will not be repeated. However, in the exclusion body 100 of the present embodiment, the planar shape of the outer edge of the rectangle forming the second pocket 4 is rounded in an arc shape at each corner portion. In this respect, the exclusion body 100 of the present embodiment has a shape different from that of the second pockets 4 of the first to sixth embodiments, in which the corners are formed in a straight line so as to be substantially at right angles. .. Such a configuration may be used. Alternatively, the outer edge of the second pocket 4 may be curved so that, for example, the entire width direction of one and the other end in the extending direction forms a semicircular shape. By doing so, it is possible to suppress the problem that the support 5 is peeled off from the exclusion portion 1. Further, by rounding the corners of the second pocket 4, the risk that the corners of the second pocket 4 may damage the patient's organs can be reduced.

As with the second pocket 4, the support 5 may also have a rectangular outer edge having a planar shape formed into a circular arc shape at each corner.

(Embodiment 8)
Further, the following modification examples are also conceivable. FIG. 17 is a schematic view of the exclusion body of the first example of the eighth embodiment as viewed from the lower surface side. FIG. 18 is a schematic view of the exclusion body of the first example of the eighth embodiment as viewed from the upper surface side. With reference to FIGS. 17 and 18, these correspond to FIGS. 4 and 3, respectively, in Embodiment 1. Since the exclusion body 100 of the first example of the present embodiment has the same configuration as the exclusion body 100 of the first embodiment in general, the same components are designated by the same reference numerals, features, effects, and the like. Do not repeat the explanation as long as they are the same. However, in the exclusion body 100 of the present embodiment, the outer edge of the exclusion portion 1 has a shape including a curved line as in the sixth embodiment (FIG. 13). However, the shape of the outer edge of the exclusion portion 1 of the present embodiment is different from that of FIG. 13 of the sixth embodiment. Specifically, the shape of the outer edge of the exclusion portion 1 of the first example of the present embodiment is closer to the outer edge shape of the first pocket 3 than the outer edge of the exclusion portion 1 of FIG. The outer edges of the exclusion portions 1 in FIGS. 17 and 18 include a first region extending straight in the left-right direction and a second region extending in the left-right direction from both ends thereof toward the lower side of the figure in the same manner as the first pocket 3. It has a third region extending in the vertical direction in the figure so that the width becomes constant, and a fourth region extending along the curved shape of the first pocket 3 so as to make one round from both ends thereof. In FIGS. 17 and 18, the outer edge of the exclusion portion 1 is formed in the order of a first region, a second region, a third region, and a fourth region from the upper side to the lower side, and is circulated by these regions. Only the fourth region is curved, and the first, second, and third regions are linear.

In FIGS. 17 and 18, the connecting portion 30 of the first pocket 3 is formed in a straight line as compared with each of the other embodiments described above. Such an embodiment may be used, but the present invention is not limited to this, and the coupling portion 30 having the same shape as that of each of the other embodiments may be formed in this embodiment. Further, the connecting portion 30 is not formed in the region overlapping the second pocket 4 and the support 5. The coupling portion 30 may be formed in this way.

FIG. 19 is a schematic view showing a state of the exclusion portion of the first example of the eighth embodiment before the joint portion is formed. That is, FIG. 19 shows the manufacturing process of the exclusion unit 1. With reference to FIG. 19, the exclusion unit 1 of the present embodiment initially has a planar bottom surface 12 and an upper surface region shown in FIGS. 17 and 18, and a pocket forming region 14 extending from the lower surface 12 and the upper surface thereof. Is formed like this. The pocket forming region 14 is a region that should eventually become the second pocket 4. Therefore, the pocket forming region 14 has a rectangular planar shape like the second pocket 4. The exclusion portion 1 is bent at the boundary between the pocket forming region 14 and the lower surface 12 so that, for example, the pocket forming region 14 can come into contact with the lower surface 12. In this state, the support 5 and the contrast medium 6 are sandwiched between the pocket forming region 14 and the lower surface 12. Then, as in the first embodiment, the regions adjacent to at least three of the four sides of the rectangle of the pocket forming region 14 are sutured or the like. As a result, a connecting portion 40 that connects the pocket forming region 14 and the lower surface 12 is formed, and the pocket forming region 14 becomes the second pocket 4. The short side region 40a (see FIG. 3) in which the connecting portion 40 is not formed is preferably a portion adjacent to one side of the second pocket 4 formed by the bent region. However, it is not limited to this.

The method of forming the second pocket 4 by bending and stitching a part of the material as shown in FIG. 19 may be similarly applied in each of the above embodiments and the following examples. However, conversely, also in each example of the present embodiment, as shown in FIGS. 3 to 5, the second pocket 4 is prepared as a separate member from the exclusion portion 1, and this is coupled to the exclusion portion 1. May be good.

FIG. 20 is a schematic view of the exclusion portion of the second example of the eighth embodiment as viewed from the lower surface side. With reference to FIG. 20, the exclusion body 100 has almost the same configuration as that of the first example of FIG. However, the shape of the outer edge of the exclusion portion 1 in FIG. 20 is different from the shape of the outer edge of the exclusion portion 1 in FIG. 17, especially in the above-mentioned fourth region. Specifically, in the fourth region, the central portion extends substantially linearly in the left-right direction, except that the left-right end portions in the drawing have a slightly curved shape. It may have such a shape.

FIG. 21 is a schematic view of the exclusion body of the third example of the eighth embodiment as viewed from the lower surface side. FIG. 22 is a schematic view of the exclusion body of the third example of the eighth embodiment as viewed from the upper surface side. With reference to FIGS. 21 and 22, these correspond to FIGS. 11 and 10, respectively, in embodiment 5. Since the exclusion body 100 of the first example of the present embodiment has the same configuration as the exclusion body 100 of the first embodiment in general, the same components are designated by the same reference numerals, features, effects, and the like. Do not repeat the explanation as long as they are the same. However, in the exclusion body 100 of the present embodiment, the shape of the outer edge of the exclusion portion 1 is substantially the same as the shape of the outer edge of the first pocket 3. That is, the outer edge of the exclusion portion 1 in FIGS. 21 and 22 has a fifth region extending straight in the left-right direction and a sixth region extending in the left-right direction from both ends thereof toward the lower side of the figure in the same manner as the first pocket 3. And a seventh region extending along the curved shape of the first pocket 3 so as to make one round of the outer edge so as to form a region in which the outer edge is closed from both ends thereof. In FIGS. 21 and 22, the outer edge of the exclusion portion 1 is formed in the order of a fifth region, a sixth region, and a seventh region from the upper side to the lower side, and is circulated by these regions. Only the 7th region is curved, and the 5th and 6th regions are linear.

(Embodiment 9)
In each of the above embodiments, the grip portion 71 or the like, which is the tip of the forceps 7, is inserted into the first pocket 3, and the pair of grip portions 71 are opened to each other in the first pocket 3. It has become. Therefore, the tip of the forceps 7 inserted into the first pocket 3 cannot be removed from the first pocket 3, and the exclusion body 100 is fixed to the forceps 7. However, the mode of fixing the exclusion body 100 to the forceps 7 is not limited to this.

FIG. 23 is a schematic view in which the exclusion body of the first example of the ninth embodiment is fixed to the forceps, and a portion such as a grip portion of the hidden forceps is shown by a dotted line. With reference to FIG. 23, here, for example, the first pocket 3 of the exclusion body 100 shown in FIG. 5 of the first embodiment has an aspect of being gripped by a pair of grip portions 71 of the forceps 7. In FIG. 23, the support 5 extends in a direction intersecting the extending direction of the forceps 7. One of the pair of grips 71 is arranged so as to come into contact with the first pocket 3 from above. The other of the pair of grips 71 is inserted into the first pocket 3 from the insertion port 31 (sandwiched between the first pocket 3 and the upper surface 11 of the exclusion portion 1). As a result, the pair of grips 71 sandwich the first pocket 3.

FIG. 24 is a schematic view in which the exclusion body of the second example of the ninth embodiment is fixed to the forceps, and a portion such as a grip portion of the hidden forceps is shown by a dotted line. With reference to FIG. 24, here, for example, both the first pocket 3 and the exclusion portion 1 of the exclusion body 100 shown in FIG. 5 of the first embodiment are gripped by a pair of grip portions 71 of the forceps 7. Shows. In FIG. 24, the support 5 extends in a direction intersecting the extending direction of the forceps 7. One of the pair of grips 71 is arranged so as to come into contact with the first pocket 3 from above. The other of the pair of grips 71 is arranged so as to be in contact with the lower surface 12 of the exclusion section 1. As a result, the pair of grip portions 71 sandwich both the first pocket 3 and the exclusion portion 1.

FIG. 25 is a schematic view in which the exclusion body of the third example of the ninth embodiment is fixed to the forceps, and a portion such as a grip portion of the hidden forceps is shown by a dotted line. With reference to FIG. 25, here, for example, the support 5 of the exclusion body 100 shown in FIG. 4 of the first embodiment is grasped by a pair of grip portions 71 of the forceps 7. In FIG. 25, the support 5 extends in the direction along the extending direction of the forceps 7. However, if possible, the forceps 7 may extend in a direction intersecting the extending direction of the support 5, and the grip portion 71 of the forceps 7 may grip the support 5. One of the pair of grips 71 is arranged so as to come into contact with the second pocket 4 for accommodating the support 5 from above. The other of the pair of grips 71 is inserted into the second pocket 4 from the insertion slot (sandwiched between the second pocket 4 and the upper surface 11 of the exclusion section 1). As a result, the pair of grips 71 sandwich the second pocket 4 and the support 5. The pair of grip portions 71 may sandwich the second pocket 4, the support 5, and the exclusion portion 1.

As shown in FIGS. 23 to 25, in each of the examples in the present embodiment, the pair of gripping portions 71 of the forceps 7 is a part of the exclusion body 100, particularly the exclusion portion 1 or a member fixed thereto. I'm grabbing it. As a result, the exclusion body 100 is fixed to the forceps 7. In such an embodiment, the exclusion body 100 may be fixed to the forceps 7, and in this case as well, a pair of grip portions 71 opened in the first pocket 3 are housed as in the first to eighth embodiments. Similarly, the exclusion effect of the organ by the exclusion body 100 is enhanced. It should be noted that FIGS. 23 to 25 show an example in which the exclusion body 100 of the first embodiment is used as an example, but the exclusion body 100 of each of the other embodiments 2 to 8 described above is the same as that of the present embodiment. It may be fixed by forceps 7.

(Embodiment 10)
FIG. 26 is a schematic view showing an embodiment in which the exclusion body of the tenth embodiment is fixed to forceps. With reference to FIG. 26, for example, the suction beak tube 80 of the laparoscope is inserted into the exclusion body 100 shown in FIGS. 3 to 5 of the first embodiment. The suction beak tube 80 has an elongated metal tube 81. The suction beak tube 80 may be inserted into the whole including the first pocket 3, the exclusion portion 1, the support 5, and the like of the exclusion body 100, and may be arranged so as to substantially penetrate the entire exclusion body 100. Alternatively, the suction beak tube 80 penetrates only the first pocket 3 of the exclusion body 100, and the tip end portion of the metal tube is housed in the space portion between the first pocket 3 and the exclusion portion 1. May be good. In any case, one end of the tube 81 constituting the suction beak tube 80 and a region adjacent thereto are arranged so as to be inserted into the exclusion body 100.

As a result, the suction beak tube 80 can absorb the water contained in the exclusion body 100 from the tube 81. From the viewpoint of absorbing the water contained in the entire exclusion body 100, the suction beak tube 80 may be arranged so as to pierce an arbitrary position of the exclusion body 100 as shown in FIG. 26. The entire exclusion body 100 of the present embodiment used in this way is used as a filter. Note that FIG. 26 shows an example in which the exclusion body 100 of FIG. 1 is used as an example, but the exclusion body 100 of the other embodiment (Example) described above is provided by the suction beak tube 80 as in the present embodiment. It may be a suction mode.

The features described in each of the above-described embodiments (each example included in the embodiment) may be applied so as to be appropriately combined within a technically consistent range.

It should be considered that the embodiments disclosed this time are exemplary in all respects and not restrictive. The scope of the present invention is shown by the scope of claims rather than the above description, and is intended to include all modifications within the meaning and scope equivalent to the scope of claims.

1 Exclusion part, 3 1st pocket, 4th 2nd pocket, 5 support, 7 forceps, 11 upper surface, 12 lower surface, 14 pocket forming area, 30, 40 joint part, 31 insertion port, 32 end part, 33 width expansion part , 34 Intervening part, 40a Short side area, 70 Insertion part, 71 Grip part, 100 Exhaust body, 80 Suction tube, G center of gravity, M mark.

Claims (4)

A flat exclusion section formed by a sponge,
A pocket that is coupled to the surface of the exclusion portion and into which the tip of the forceps can be inserted.
With a support attached to the exclusion section ,
The pocket is a repellent body in which the width of the end opposite to the insertion slot is wider than the width of the insertion slot into which the forceps can be inserted. The exclusion body according to claim 1 , wherein the end portion is curved so as to form a convex shape protruding to the opposite side of the insertion port. The exclusion body according to claim 1 or 2 , wherein the support extends in a direction intersecting the extending direction of the forceps inserted into the pocket. The exclusion body according to any one of claims 1 to 3, wherein a mark is provided in a region adjacent to an end portion in the extending direction of the support.

Images