JP7285016B2 - Surgical instrument cover - Google Patents

Description

TECHNICAL FIELD The present invention relates to a cover for a surgical instrument that is attached to the distal end portion of a surgical instrument used in surgical operations and the like.

2. Description of the Related Art Conventionally, a forceps cover that is used by being attached to the distal end of a forceps is known (see, for example, Patent Document 1). By attaching the forceps cover to the distal end portion of the forceps, it is possible to prevent the grasped object grasped by the forceps from slipping or the like, and to reliably maintain the grasped state by the forceps.

By the way, in recent years, remote-controlled endoscopic surgical operations have been performed using surgical assistance robots such as Da Vinci manufactured by Intuitive Surgical. The surgical assistance robot has arms as surgical instruments for performing various tasks related to endoscopic surgery, and each arm has a gripping mechanism whose distal end is opened and closed by manipulation.

During surgery, the distal end of the arm is used to compress the surgical organ, protect the tissue, absorb blood, and so on. Attachment of the surgical instrument cover to the distal end of the arm is performed inside the patient's body. Then, for example, the tip of the arm fitted with a surgical instrument cover is used to hold an organ or the like around the tissue to be excised to secure the surgical field of the portion to be excised (exclude).

Japanese Patent No. 3114592

However, this type of surgical instrument cover has not been commercialized, and for example, a handmade surgical instrument cover made by manually forming a roll of gauze or the like is used. According to this, not only is it time-consuming to manufacture the cover for surgical instruments, but also there is a problem that the size of the roll-shaped gauze varies, making it impossible to obtain uniform quality. For this reason, in a hand-made surgical instrument cover made of rolled gauze, the shape of the opening for inserting the tip of the arm is not constant, and there is a risk that the operation of attaching the surgical instrument cover inside the patient's body cannot be performed smoothly. there were.

In view of the above points, it is an object of the present invention to provide a surgical instrument cover that facilitates insertion of a distal end portion of a surgical instrument.

In order to achieve such an object, the present invention provides a surgical instrument cover that can be inserted into the distal end portion of a surgical instrument, comprising a cover main body portion and a cover distal end portion connected to the distal end side of the cover main body portion. wherein the cover main body and the cover front end are formed by a first surface forming portion forming a first surface on the upper surface side and a second surface forming portion forming a second surface on the lower surface side The cover main body and the cover distal end have an inserting portion into which the distal end of a surgical instrument is inserted continuously from an opening on the base end side of the cover main body to the cover distal end. The opening of the inserting portion has a protruding portion that protrudes from the other part of the peripheral edge of the opening, and the protruding portion is located on the base end side of the second surface forming portion. It is provided and protrudes in a direction from the distal end side to the proximal end side from the first surface forming portion.

By providing the projecting portion in the opening, it becomes easy to insert the distal end portion of the surgical instrument into the insertion portion.

Further, in the present invention , a step is formed between the base end of the first surface forming portion forming the opening and the second surface forming portion due to the thickness thereof. .

Due to the step, the opening can be easily confirmed, and the insertion of the distal end portion of the surgical instrument is further facilitated.

Further, in the present invention, an X-ray contrast thread elongated in a direction along the edge of the opening is arranged on the projecting portion of the opening.

By providing the X-ray contrast thread on the projecting portion, it is possible to prevent the surgical instrument cover from remaining after surgery. By using a colored X-ray contrast thread, the opening can be easily confirmed. Furthermore, by using X-ray contrast thread with a relatively high rigidity, it is possible to impart hardness to the protruding portion, and even if a soft material is used for the cover main body and the cover tip, the protruding portion guides the It is possible to reliably insert the distal end of the surgical instrument into the insertion portion.

Moreover, in the present invention, the tip portion of the cover is formed in a tapered shape that gradually becomes smaller toward the tip.

By forming the distal end portion of the cover in a tapered shape, it is possible to secure the field of view (operative field) of the operator and improve workability (operability).

Further, the cover main body portion and the cover tip portion have a first surface forming portion forming a first surface and a second surface forming portion forming a second surface on the opposite side of the first surface forming portion. It is characterized by being joined by sewing.

Since the first surface forming portion and the second surface forming portion are joined by sewing, the joint portion does not harden as compared with, for example, heat sealing or ultrasonic bonding, and the cover main body portion and the cover tip end are not hardened. The flexibility of the part can be secured.

1 is a plan view showing a surgical instrument cover according to one embodiment of the present invention; FIG. FIG. 2 is a cross-sectional explanatory view of the surgical instrument cover of FIG. 1 taken along the line II-II. FIG. 2 is a cross-sectional explanatory view showing a usage state of the surgical instrument cover of the present embodiment. Explanatory drawing which shows the manufacturing process of the cover for surgical instruments of this embodiment. FIG. 5 is an explanatory view showing the manufacturing process following FIG. 4;

One embodiment of the present invention will be described based on the drawings. A surgical instrument cover 1 (hereinafter referred to as cover 1) of the present embodiment includes a cover main body portion 2 and a cover distal end portion 3, as shown in FIG. The cover distal end portion 3 is provided continuously on the distal end side of the cover main body portion 2 , and the cover main body portion 2 is provided with an overhanging portion 4 on the proximal end side thereof.

The cover main body portion 2 and the cover tip portion 3 have a first surface forming portion 5 forming a first surface on the upper surface side in the drawing and a second surface forming portion 6 forming a second surface on the lower surface side in the drawing. formed by The protruding portion 4 is provided on the proximal end side of the second surface forming portion 6 and protrudes outward (that is, in the direction from the distal end side to the proximal end side) from the first surface forming portion 5 .

It is preferable that the cover distal end portion 3 is formed in a tapered shape so that the width dimension gradually decreases toward the distal end side.

As shown in FIG. 2 , an inserting portion 7 is formed inside the cover 1 between the first surface forming portion 5 and the second surface forming portion 6 . As shown in FIG. 3, an arm distal end portion A of a surgical assistance robot, which is a surgical instrument, is inserted into the insertion portion 7 .

As shown in FIG. 2, the inserting portion 7 is opened by an opening 8 located at the proximal end of the first surface forming portion 5 . A step 9 is formed between the base end of the first surface forming portion 5 forming the opening 8 and the second surface forming portion 6 due to its thickness.

As described above, since the projecting portion 4 is provided, the arm distal end portion A can be smoothly guided to the opening portion 8 and can be easily inserted into the insertion portion 7 . At this time, the visibility of the opening 8 is good due to the step 9, and the work of inserting the arm distal end portion A is facilitated.

The first surface forming portion 5 and the second surface forming portion 6 of the cover 1, which will be described later in detail, are formed by sewing and cutting from one sheet or laminated sheet-like materials. Therefore, a sewn portion 10 (see FIG. 1) is formed on the peripheral edge of the cover 1 to join the first surface forming portion 5 and the second surface forming portion 6 together.

By joining the first surface forming portion 5 and the second surface forming portion 6 of the cover 1 by sewing, it is possible to obtain higher flexibility than, for example, fusion bonding using heat or ultrasonic waves.

In the present embodiment, a long-fiber nonwoven fabric such as Bemliese (registered trademark) is used as the material of the cover 1, but the material is not limited to this, and a material capable of absorbing blood and exudates and preventing damage to organs and the like can be used. It is preferable to adopt

In addition, in the present embodiment, cotton thread (100% cotton) is used as the sewing thread forming the sewing portion 10, but the present invention is not limited to this. It is preferable to use a material.

The step 9 can be formed by thickening the sheet that is the material of the cover 1 . To this end, it is conceivable to increase the thickness of the sheet material itself. However, since this reduces the flexibility of the material of the cover 1, it is preferable to obtain the thickness by stacking a plurality of sheet materials. By superimposing the sheet material, the step 9 can be formed without impairing the flexibility of the cover 1 .

A long X-ray contrast thread 11 is arranged in the width direction (the direction along the edge of the opening 8) of the projecting portion 4. As shown in FIG. As a result, it is possible to prevent the cover 1 from remaining in the body after surgery. By arranging the X-ray contrast thread 11 on the projecting portion 4, the projecting portion 4 becomes harder than the other portions. As a result, a difference in rigidity is generated in the opening 8, and the cover 1 can be easily inserted into the arm distal end portion A. As shown in FIG. Further, as shown in FIG. 3 , when one side of the arm distal end portion A is inserted into the cover 1 , it is positioned on the side that sandwiches the first surface forming portion 5 , thereby extending from the second surface forming portion 6 . A projecting portion 4 is positioned outside the arm distal end portion A. As shown in FIG. As a result, since the arm distal end portion A does not sandwich the projecting portion 4, damage to the X-ray contrast thread 11 and breakage of the X-ray contrast thread 11 can be prevented.

By using a colored material such as black as the X-ray contrast thread 11, the visibility of the overhanging portion 4 with an endoscope is increased, and the operation of inserting the arm distal end portion A into the insertion portion 7 becomes easier. Become.

In this embodiment, a monofilament made by mixing polystyrene with barium sulfate is used as the X-ray contrast thread 11 arranged on the projecting portion 4 of the cover 1, but the present invention is not limited to this. Also, the X-ray contrast thread 11 may not be provided.

An example of specific dimensions of each part of the cover 1 is 20 mm in width, 35 mm in length, 30 mm in length of the fitting portion 7, and 14 mm in diameter of the opening 8. As shown in FIG. However, it is needless to say that these dimensions are appropriately changed according to the dimensions and shape of the arm distal end portion A of the surgical assistance robot.

Next, a method for manufacturing the cover 1 of this embodiment will be described with reference to FIGS. 4 and 5. FIG. First, as shown in FIG. 4A, a predetermined distance (in this embodiment, the is about 36 mm), the X-ray contrast thread 11 is staggered using a zigzag sewing machine (not shown) and heat-sealed (X-ray contrast thread stitching and welding step).

When the X-ray contrast thread 11 is sewn by lockstitching or the like, the X-ray contrast thread 11 may be punctured by the sewing needle, and the X-ray contrast thread 11 may be torn or cut. On the other hand, by adopting the zigzag stitch, damage to the X-ray contrast thread 11 can be prevented.

In addition, if the X-ray contrast thread 11 is only provided by zigzag stitching, when the cover 1 is used as the cover 1, the cover 1 becomes wet, or a part of the X-ray contrast thread 11 is subjected to a large load. In addition, the X-ray contrast thread 11 may come off. Therefore, by heat-welding the X-ray contrast thread 11 after zigzag stitching, it is possible to prevent the X-ray contrast thread 11 from unintentionally coming off and to fix it securely.

It should be noted that it is also possible to fix only by thermal welding without zigzag stitching. Since zigzag stitching is not used, one process can be reduced. As a welding method, ultrasonic bonding may be used instead of thermal welding.

Next, the base cloth W provided with the X-ray contrast thread 11 is overlaid with other two base cloths having the same shape. As a polymerization method, there is a method of arranging the base cloth W provided with the X-ray contrast thread 11 on the upper side, the middle side, and the lower side.

When arranged on the upper side, the X-ray contrast thread 11 is covered with the two base fabrics in the process of folding the base fabric, so that the X-ray contrast thread 11 is not directly exposed. When arranged on the lower side, the X-ray contrast thread 11 is positioned on the outer side, so the position of the X-ray contrast thread 11 is easily recognized, and the visibility of the projecting portion 4 is increased. When placed on the middle side, it has the characteristics of both when placed on the upper side and when placed on the lower side.

Although any arrangement method may be used, the base fabric W thus superimposed will be treated as a single base fabric W hereinafter. Although the base cloth W in this embodiment is made by superposing three sheets, the number of sheets to be superimposed is not limited to this, and may be three or more. may be In addition, in the explanatory diagrams of FIGS. 2 and 3, for the sake of convenience, a one-sheet configuration is shown.

As shown in FIGS. 4A to 4C, the base cloth W is folded (base cloth folding step). That is, it is valley-folded at predetermined upper and lower folding positions t and d indicated by two-dot chain lines, which are imaginary lines in FIG. , and is valley-folded at the abutting position (in this embodiment, the position 35 mm from the upper edge) where the upper and lower sides are folded back. As a result, the oblong shape shown in FIG. 4C is obtained.

Subsequently, as shown in FIG. 5A, sewing is performed for each cover 1 shape (sewing process). At this time, a longitudinal sewn portion 10a extending from the cover main body portion 2 to the cover tip portion 3 and a transverse sewn portion 10b passing through the projecting portion 4 along the opening 8 are continuously formed. Of these, the longitudinal sewn portion 10a is double sewn by performing backstitches to turn back at the front end side of the front end portion 3 of the cover. The laterally sewn portion 10b is sewn in a single layer so as to connect the longitudinally sewn portions 10a on the protruding portion 4 side.

After that, as shown in FIG. 5B, punch cutting is performed at a predetermined cutting position c (indicated by a two-dot chain line that is a virtual line) corresponding to the shape of the cover 1 (cutting step). As a result, a plurality of individual covers 1 are manufactured as shown in FIG.

According to the above method, a plurality of covers 1 can be efficiently manufactured, and the covers 1 of constant quality can be obtained. Moreover, according to the above-described method, by double stitching the longitudinal sewn portion 10a by backstitching, fraying and loosening are prevented, and the cover 1 attached to the tip portion A of the arm is prevented from accidentally falling off. can.

In addition, according to the above method, the sewing position and the cutting interval can be appropriately set according to the desired shape, so that the degree of freedom in designing the cover 1 is high. It becomes extremely easy.

Note that the dimensions and materials of each part shown in the above description are not limited to these. Further, it goes without saying that the cover of the present invention is not limited to the manufacturing method described above, and can be manufactured using other appropriate methods.

A... arm tip (tip of surgical instrument), 1... cover for surgical instrument, 2... cover main body, 3... cover tip, 8... opening, 7... insertion part, 4... projecting part, 9 ... Step, 11 ... X-ray contrast thread, 5 ... First surface constituent part, 6 ... Second surface constituent part, 10 ... Sewing part.

Claims (5)

A cover for a surgical instrument that can be inserted into the distal end of a surgical instrument,
comprising a cover main body and a cover distal end connected to the distal end of the cover main body,
The cover main body portion and the cover tip portion are formed by a first surface forming portion forming a first surface on the upper surface side and a second surface forming portion forming a second surface on the lower surface side,
The cover main body and the cover distal end are provided with an insertion portion into which a distal end of a surgical instrument is inserted continuously from an opening on the base end side of the cover main body to the cover distal end. ,
The opening of the inserting portion has a protruding portion that protrudes from the other part of the peripheral edge of the opening, and the protruding portion is provided on the base end side of the second surface forming portion so that the A cover for a surgical instrument, characterized in that it protrudes in a direction from the distal side toward the proximal side from the first surface forming portion. 2. The operation according to claim 1, wherein a step is formed between the proximal end of the first surface forming portion forming the opening and the second surface forming portion due to the thickness thereof. Instrument cover. 3. The cover for a surgical instrument according to claim 1, wherein an X-ray contrast thread elongated in a direction along the edge of the opening is arranged on the projecting portion of the opening. . The cover for a surgical instrument according to any one of claims 1 to 3, wherein the distal end portion of the cover is formed in a tapered shape that gradually becomes smaller toward the distal end. In the cover main body and the cover tip, a first surface forming portion forming a first surface and a second surface forming portion forming a second surface on the opposite side of the first surface forming portion are sewn together. The surgical instrument cover according to any one of claims 1 to 4, characterized in that it is joined.

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