JPH05285157A - Tracheal - Google Patents

Abstract

PURPOSE:To provide the tracheal which enables the easy insertion of even an implement having a bent insertion part and can simplify its sealing part. CONSTITUTION:An sheath pipe 12 is constituted of a tube freely deformable corresponding to the insertion of the curved insertion part of the implement to be inserted therein and is provided with a clip 18 which crushes the sheath pipe 12 and provides hermeticity in the sheath pipe 12 in the state of removing the implement from the sheath pipe 12. This sheath pipe 12 is crushed by this clip 18 in the state of removing the implement from the sheath pipe 12, by which the sheath pipe 12 is provided with the hermeticity.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a trocar for guiding an endoscope, surgical instrument or the like when performing percutaneous examination or surgery in the abdominal cavity or thoracic cavity.

[0002]

2. Description of the Related Art Conventionally, a trocar has been used to perform a laparoscopic operation such as excision of the gallbladder. An inner needle or laparoscope inserted into the outer tube of the trocar, and further treatment. All the tools and the like are hard and have a straight shape, and the outer tube and the proximal portion of the trocar are also made to be hard.

By the way, when performing cholecystectomy (laparoscopic cholecystomy) under the laparoscope, the treatment of the target site in the body cavity is performed from a plurality of directions rather than from one direction. Often combined with complicated operations.

[0004]

However, since the insertion portions of the plurality of instruments concentrated on the treatment target site in the body cavity are rigid and have a straight shape, they are in the laparoscopic field of view. They tend to get close to each other and concentrate on the site to be treated, which is an obstacle to visual field observation. In addition, it is in a fixed indwelling state that cannot be avoided.

If the insertion portions of these instruments are bent, the insertion portions of the plurality of instruments concentrated on the treatment target area are appropriately displaced or retracted, and the laparoscopic field of view is obscured. Can be avoided as much as possible. Further, since the directionality with respect to the treatment target part can be given, the treatment operation ability is enhanced. As described above, if a rigid treatment tool having a bent insertion portion can be used, complicated surgery under the endoscope can be performed easily and accurately, and the treatment operation ability can be improved.

However, with the conventional trocar, it has been impossible to insert a rigid endoscope having a curved insertion portion or a treatment tool. Especially, in the trocar, since the seal valve is incorporated in the proximal portion, the construction of the valve mechanism that allows the insertion part with the bend to be inserted is rather complicated or highly accurate. In addition, the width and length of the insertion passages in the vicinity must be increased. Therefore, the hand portion of the trocar accordingly becomes considerably large and heavy, which hinders the operability.

In addition, when actually used, a plurality of trocars are used at the same time, but the enlarged hand parts are likely to interfere with each other, and there is a disadvantage that they interfere with each other and interfere with the manual operation. Therefore, there is a limit to increase the diameter of the insertion hole in the proximal portion of the trocar, and there is a problem that the size and type of the curvature of the treatment instrument that can be inserted are limited.

The present invention has been made in view of the above-mentioned problems, and an object thereof is to easily insert an instrument having a bent insertion portion and to simplify the sealing means when the instrument is removed. It is to provide a trocar that can be achieved.

[0009]

In the trocar of the present invention, at least an outer tube as an insertion portion is constituted by a tube which is deformable according to the insertion of a curved insertion portion of an instrument to be inserted therethrough, Clip means is provided for crushing the outer tube with the device removed from the outer tube to make the outer tube airtight. With the device removed from the mantle tube, the mantle tube is crushed by the clip means to make the mantle tube airtight.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIG. 1 shows a first embodiment of the present invention. FIG. 1A shows the appearance of the trocar 11.
The trocar 11 includes an outer tube 12 as an insertion section and a hand body section 13 attached to one end of the outer tube 12. The outer tube 12 is formed of a deformable elastic tube. Further, the hand-held main body portion 13 is formed by attaching the seal portion 15 via the base 14. Alternatively, the outer tube 12 and the base 14 may be integrally formed of an elastic tube that is deformable. The seal portion 15 of the hand body portion 13 is for hermetically inserting the insertion portion of the instrument to be inserted into the mouthpiece 14. The outer periphery of the base 14 projects like a brim.

Further, a clip means is attached to the outer periphery of the outer tube 12 for crushing the outer tube 12 with the insertion portion of the instrument inserted therein to maintain airtightness. In the clip means in this embodiment, as shown in FIG. 1, the middle of the elastic wire 16 is bent, the middle portions of both ends thereof are crossed, and the knob portion 1 is provided at each end.
The clip 18 is formed by forming 7,17.

The clip 18 is configured such that the outer tube 12 is inserted from the intermediate bent portion 19 into the loop portion 21 in the intermediate portions 20 at both ends. The loop portion 21 of the clip 18 crushes the outer tube 12 to keep airtightness. FIG. 1 shows a state in which the outer tube 12 of the trocar 11 is crushed by the clip 18 with the device removed, and the outer tube 12 at this time maintains airtightness.

When laparoscopic cholecystectomy is performed using the trocar 11, for example, it is performed as follows.
First, an inner needle is inserted into the outer tube 12 of the trocar 11 to puncture the abdominal cavity. In this procedure, the pneumoperitoneum is used for pneumoperitoneum as in the conventional method, and then the trocar 11 is inserted into the abdominal cavity. Usually, a plurality of trocars 11 are used. In addition, at the time of this puncturing, the clip 18 may be attached to the outer circumference of the outer tube 12 in advance.

Then, the inner needle is removed from the trocar 11 and a laparoscope, a treatment instrument or the like is appropriately inserted in place of the inner needle to perform the treatment. The clip 18 is used until the inner needle is removed and the instrument is inserted instead. The outer tube 12 is crushed to close the inside. In addition, when the clip 18 is attached, the clip 18 can be loosened and the operation can be performed directly. Further, by newly mounting the clip 18 on the outer circumference of the outer tube 12, the outer tube 12 is crushed and the inside thereof is closed.

By the way, since at least the outer tube 12 of the trocar 11 is deformable and flexible, there is a bend in the insertion portion of an instrument to be inserted therethrough, for example, a laparoscope (hard endoscope) or a rigid treatment instrument. Also, it can be easily inserted. Since the outer tube 12 is deformed following the curved insertion portion of the instrument to be inserted, it can be easily inserted even if the insertion portion is bent like a forceps shown in FIG. 2 described later, for example. Further, when the clip 18 is always attached and placed, the clip 18 can be loosened and another device can be replaced with the outer tube 12.

FIG. 2 shows a modification of the clip according to the second embodiment of the present invention. The trocar 11 is the same as that of the above-mentioned embodiment. In the clip 25 of this embodiment, a pair of elastic plate members 26, 26 are joined together and the corresponding ends thereof are pivotally attached.

The elastic plate-like members 26, 26 usually have a function as a clip for closing in a direction in which the elastic plate-like members 26 are joined to each other. When both ends are crushed in the longitudinal direction, the elastic plate-like members are crushed. 26, 26 can be elastically pushed open. The clip 25 can be used for the trocar 11 as in the above-described embodiment.

When the inner needle or instrument is removed from the outer tube 12 of the trocar 11, the outer tube 12 is pinched by a clip 25 and crushed to close it.
Further, for example, when the clip 25 is left attached, the elastic plate members 26, 26 are elastically pushed open only when the insertion portion 27 of the forceps is inserted or pulled out. If the base 14 is sandwiched, the insertion / removal passage can be secured.

FIGS. 3 and 4 relate to a third embodiment of the present invention, in which the trocar 11 and the clip 18 are constructed in the same manner as in the first embodiment described above, but this is the outer tube. The outer circumference of 12 has a sliding cylinder 28 that is slidable in the axial direction, and a clip 18 is attached to this. The sliding cylinder 28 has an opening 29 for exposing the knob portions 17, 17 to the outside. And according to this, the position of the clip 18 can be changed by changing the position of the sliding cylinder 28.

A hooking portion for holding the clip 18 in the opened state may be provided on the sliding cylinder 28. Also,
A hole (not shown) for inserting and hooking the intermediate bent portion 19 of the clip 18 is formed, and the intermediate bent portion 19 is formed therein.
You may insert and hook.

FIG. 5 shows a fourth embodiment of the present invention, in which an outer tube 12 as an insertion portion of a trocar 11 and a main body portion 13 connected to the outer tube 12 are integrally formed from a deformable elastic tube. A seal portion 31 that elastically seals is provided in the middle of the hand body portion 13. As it is,
It can be used as a soft trocar, but can also be used in combination with the above-mentioned clip.

Incidentally, FIG. 6 shows a modified example thereof, in that the outer tube 12 as an insertion portion and the main body portion 13 connected to the outer tube 12 are integrally formed from a deformable elastic tube. 5 is the same as that shown in FIG. 5, except that a sealing portion for elastically sealing is not provided in the middle of the cylindrical main body portion 13 over its entire length. However, the above-mentioned clip 25 shown in FIGS. 6 (b) and 6 (c) is attached in the middle of the main body portion 13 to be opened, and the portion is used and sealed as needed. ..

The present invention is not limited to the above-mentioned embodiment, and various other modifications can be made without departing from the scope of the invention. Various instruments such as an endoscope, various treatment tools, and catheters can be considered as instruments used for this. Further, the technique field to which this is applied is not limited to, for example, inspection and surgery in the abdominal cavity and thoracic cavity, but can be applied to general techniques using a trocar.

[0024]

As described above, according to the trocar of the present invention, even a bent instrument can be easily inserted, and
The seal portion can be simplified. Therefore, when this is actually used, the weight of each trocar can be reduced, and even if a plurality of trocars are used at the same time, the hands and the like can be made small, and the interference between the hands can be minimized so that they are mutually It is also possible to eliminate the inconvenience of hitting each other and interfering with the procedure. Further, the curvature of the insertion portion of the instrument used by inserting it through the trocar is not limited.

[Brief description of drawings]

FIG. 1 is a perspective view showing a trocar according to a first embodiment of the present invention.

FIG. 2 is a perspective view showing a trocar according to a second embodiment of the present invention.

FIG. 3 is a sectional view showing a trocar according to a third embodiment of the present invention.

4 is a cross-sectional view taken along the line AA in FIG.

FIG. 5 is a sectional view showing a trocar according to a fourth embodiment of the present invention.

FIG. 6 is an explanatory diagram showing a modification of the fourth embodiment of the present invention.

[Explanation of symbols]

11 ... trocar, 12 ... mantle tube, 13 ... hand body part,
18 ... clip, 25 ... clip.

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[Procedure amendment]

[Submission date] July 17, 1992

[Procedure Amendment 1]

[Document name to be amended] Statement

[Name of item to be corrected] 0003

[Correction method] Change

[Correction content]

[0003] When performing cholecystectomy under a laparoscope (Rapallo nanoscopic Kore cis Tech Tommy), rather than a treatment for the subject site in the body cavity from one direction, something present or instruments from a plurality of directions Often used to combine complex operations.

[Procedure Amendment 2]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 4

[Correction method] Change

[Correction content]

[Figure 4]

Front Page Continuation (72) Inventor Tsuruo Hatori 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Akio Nakata 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industrial Co., Ltd. (72) Inventor, Tsukagoshi Iso 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Seiji Kuramoto 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optics Kogyo Co., Ltd. (72) Inventor Shuichi Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Minor Tsuruta 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optics Kogyo Co., Ltd. (72) Inventor Shiro Bito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd. (72) Kenji Yoshino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd. (72) Inventor Keisuke Saito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. An outer tube serving as at least an insertion portion is composed of a tube that is deformable in response to insertion of a curved insertion portion of an instrument inserted therethrough, and the insertion portion of the instrument is removed from the outer tube. A trocar comprising clip means for squeezing the outer tube in a state to make the outer tube airtight.