JPH05285158A - Tracheal device - Google Patents

Abstract

PURPOSE:To provide the tracheal which enables the easy insertion of even an implement having a bent insertion part and can reduce the size of its handle body. CONSTITUTION:This tracheal has a sheath pipe 12 for guiding the implement and a housing 14 communicated with the handle side end of this sheath pipe 12 and the handle body part 13 in which a valve for passing the above- mentioned implement into this housing 14 is built. The sheath pipe 12 and the housing 14 are constituted freely deformably according to the insertion of the curved insertion part of the implement.

Description

Detailed Description of the Invention

[0001]

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

[0002]

2. Description of the Related Art Conventionally, a trocar has been used for laparoscopic surgery such as excision of the gallbladder. However, 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 field of view of the laparoscope. Therefore, it is easy to get close to each other and concentrate on the region to be treated, which hinders visual field observation. In addition, it is in a fixed detention state that cannot avoid it.

If the insertion parts of these instruments are bent, it is possible to appropriately displace or retract the insertion parts of a plurality of instruments concentrated on the site to be treated so as to avoid vignetting of the visual field as much as possible. it can. Further, since the directionality with respect to the treatment target part can be given, the treatment operation ability is enhanced. As described above, if the treatment tool having the bent insertion portion can be used, complicated operation under the endoscope can be performed easily and accurately, and the treatment operation ability can be improved.

Here, in order to be able to insert a treatment instrument having a bent insertion portion, at least the outer tube 1 of the trocar must be made flexible as shown in FIG. Moreover, in order to smoothly pass the insertion portion 2 of the curved treatment instrument, the diameter of the insertion hole 4 in the hand portion (main body portion) 3 of the trocar must be increased. The built-in valve 5 also becomes large, and as a result, the length L and width D of the housing 6 of the proximal portion 3 become considerably large.

When actually using this, although a plurality of trocars are used at the same time, the enlarged hand parts 3 are likely to interfere with each other, and there is a disadvantage that they interfere with each other and interfere with the manipulation operation. Therefore, there is a limit in increasing the diameter of the insertion hole 4 in the proximal portion 3 of the trocar, and the curvature of the insertable treatment tool is limited.

The present invention has been made in view of the above problems, and an object of the present invention is to provide a trocar device capable of easily inserting a rigid instrument having a bent insertion portion and making the main body portion at hand compact. To provide.

[0009]

According to the present invention, a valve having an outer tube as an insertion portion and a housing connected to a proximal end portion of the outer tube and having a housing for passing the instrument therein is incorporated. In a trocar device including a hand body, at least the outer tube and the housing are configured to be deformable according to insertion of a curved insertion portion of an instrument to be inserted. According to this, it is possible to easily insert a rigid instrument whose insertion portion is bent and to make the main body portion at hand compact.

[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 comprises 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.
The housing 14 of the hand-held main body 13 is also made of a deformable elastic material.

The housing 14 is formed in a substantially cylindrical shape, one end of which is narrowed down, and the base end of the outer tube 12 is attached to this end. The other end side of the housing 14 is formed to be relatively wide, and a cap-shaped base 15 is detachably fitted to this opening end portion using, for example, a screw 17. And
Through the hole 18 of the mouthpiece 15, insertion parts of various instruments can be inserted.

A valve 20 for closing the opening of the hole 18 of the mouthpiece 15 is attached to the mouthpiece 15 by using the inner end surface portion thereof as a valve seat. The valve 20 has one end attached to a fulcrum 21 and is closed by its own elasticity. Alternatively, the valve 20 may be biased by a biasing member such as a spring (not shown). The valve 20 opens when pushed by an instrument inserted through the hole 18 of the mouthpiece 15, as shown in FIG. 1 (b).

An elastic cap 23 is attached to the end of the tubular mouth portion 22 of the mouthpiece 15 so as to be elastically fitted to and detachable from the end portion. Elastic cap 23 is trocar 1
A slit or small hole 24 is formed for hermetically inserting the insertion portion of various instruments used in FIG.

As the instrument used for the trocar 11, various instruments which have been used before can be cited. For example, like the forceps 25 which is a treatment instrument shown in FIG. A bent portion near the tip of the insertion portion 26 can also be used as described later.

Next, a case of performing, for example, a laparoscopic cholecystectomy using the trocar 11 will be described. In the procedure of puncturing the abdominal cavity with the trocar 11, the pneumoperitoneum is used for pneumoperitoneum, and an inner needle (not shown) is loaded to puncture the abdominal cavity with the trocar 11. Normally, a plurality of trocars 11 are used.

Then, the inner needle is pulled out from the trocar 11 and a laparoscope or a treatment tool is appropriately inserted in place of the inner needle to perform the treatment. For example, the forceps 2 shown in FIG. 1 (d).
It is also possible to easily use the insertion portion 26 in which the vicinity of the distal end portion is bent as shown in FIG. That is, it is inserted into the hole 18 of the base 15 through the slit or small hole 24 of the elastic cap 23, the valve 20 is pushed open, and the housing 14 is opened.
It is inserted into the outer tube 12 as an insertion portion through the inside.

When passing through the vicinity of the bent tip of the insertion portion 26, both the housing 14 and the mouthpiece 15 of the hand main body 13 are deformable as shown in FIG. 1 (b). Therefore, the curved insertion part 2
Each of them follows and bends in accordance with 6, and the bent insertion portion is easily inserted. Like this trocar 1
It is possible to smoothly insert the insertion portion 26, which has a curved portion by itself being curved. Therefore, it is not necessary to make the insertion hole and the valve in the hand-held main body 13 large, and therefore it is not necessary to make the housing 14 of the hand-held main body 13 of the trocar 11 large. As a result, the main body 1 at hand
Since the length and width of 3 are considerably small and can be made compact, the inconvenience that the main body parts 13 at hand are less likely to interfere with each other and interfere with each other to interfere with the manipulating operation can be avoided as much as possible. Of course, the curvature of the curved part of the insertion part of the insertable instrument is not limited, and the required curvature can be selected.

FIG. 1 (c) shows the field of view of the laparoscope when performing a cholecystectomy using three forceps 25 with the bending of the distal end portion of the insertion portion 26, and shows the target region. The treatment is performed from a plurality of directions using the three forceps 25, not from one direction. Since the plurality of mantle tubes 12 concentrated on the treatment target portion are bent, each insertion portion 26 is appropriately displaced or retracted from the concentrated portion to avoid the visual field from being obscured as much as possible. Moreover, since the orientation of the insertion portion 26 with respect to the treatment target portion can be freely changed, the treatment operation ability is enhanced. As described above, if the treatment tool having the bent insertion portion can be used, complicated operation under the endoscope can be performed easily and accurately, and the treatment operation ability can be improved.

2 to 4 show a second embodiment of the present invention. FIG. 2A shows the appearance of the trocar 31. The trocar 31 includes a portion of the outer tube 32 as an insertion portion and a hand body portion 33 connected to one end of the outer tube 32.
Consists of. The outer tube 32 and the main body 33 are integrally formed of a deformable elastic tube. A collar 34 is formed between the outer tube 32 and the main body section 33.

The outer tube 32 as an insertion portion is a hollow 35 having a circular cross section as shown in FIG.
As shown in FIG. 3B, the hand-held main body 33 is a hollow 36 having an oval cross-section, and the proximal end opening 3 of the hand-held main body 33 is formed.
Reference numeral 7 is a slit shape, which is normally closed airtightly.

Further, in the main body portion 33, the elastic tube constituting the housing thereof is curved in the major axis direction of the hollow 36, that is, in the flat direction, as shown in FIG. 2 (a). Thus, the hand-held main body portion 33 is bent in its major axis direction as a radial direction of curvature as a whole. Compared with the inner peripheral length of the hollow 35 of the outer tube 32, the hollow 3 of the hand body 33
The inner peripheral length of 6 is set to be long. In addition, the inner diameter of the hollow 35 of the outer tube 32 is D, and the hollow 36 of the hand body 33 is
The flat width at is d, and the flat width d is smaller than the inner diameter D.

Since the entire trocar 31 is integrally formed from the deformable elastic tube as described above, even if the insertion portion is a particularly bent instrument as described above, or even if the insertion portion is a straight instrument. It can be easily inserted. That is, since the hand main body 33 is curved in the long axis direction of the hollow 36 as shown in FIG. 2A, the curved portion of the insertion portion 38 of the instrument may be inserted substantially along the bend. Then, when inserting the straight part of the insertion part 38,
When the straight part of the insertion part 38 passes through the hand body part 33,
As shown in FIG. 2B, the bent main body portion 33 is passed while being deformed so as to be close to a straight line.

At this time, since the hollow 36 of the main body portion 33 is flat, the insertion portion 38 having a diameter smaller than the flat width d thereof.
In this case, the hollow main body 33 can be hermetically inserted. That is, as shown in FIG. 4 (a), the portion close to the outer tube 32 is in close contact with the wall surface on the right side, and as shown in FIG. 4 (b), the intermediate portion of the proximal body 33 is also in close contact with the wall surface. As shown in FIG. 6C, the proximal end opening 37 of the hand-held main body 33 has a slit shape and is hermetically closed by this, and at the same time, is closely attached to the left wall surface. Therefore, the insertion portion 38 of the device is
It adheres to its inner surface over the entire length of 3 and therefore
It can maintain high airtightness.

Then, a device having an insertion portion 38 having a diameter of D to D can be hermetically inserted. of course,
Even if the diameter is smaller than d, airtightness can be secured in the slit portion at the base end opening 37, so that it can be inserted while maintaining airtightness. Bent insertion part 3
When 8 passes through the outer tube 32, it can be bent and inserted according to the bending. Thus, the trocar 31 can also be used for laparoscopic cholecystectomy, as described above.

5 to 6 show a third embodiment of the present invention. The trocar 41 includes an outer tube 42 serving as an insertion section and a main body section 4 attached to one end of the outer tube 42.
3 and 3. The outer tube 42 is formed of a deformable elastic tube as in the above-described embodiment. Further, it has a thick-walled cylindrical housing 44 of the hand-held main body 43, and this housing 44 is also formed of a deformable elastic material.

The housing 44 has an outer tube 42 at one end thereof.
A tubular portion 45 to which the base end of is fitted is formed, and the outer tube 42 is attached thereto. A cap 46 is formed at the other end of the housing 44, and a bellows tubular cap 47 that can be deformed and bent is fitted to the cap 46. And
The cap 47 is formed with a mouth portion 48 into which the insertion portion of various instruments is inserted.

A valve 49 for closing the mouth portion 48 is attached to the mouth portion 48. This valve 49 has a fulcrum 50 at one end.
As a result, the opening of the mouth portion 48 is closed by its own elasticity. Of course, the valve 49 may be closed by an unillustrated biasing member such as a spring.
This valve opens when pushed by an instrument inserted through mouth 48.

In the trocar 41 having this structure, the outer tube 42 as an insertion portion and the housing 4 of the hand body portion 43
Since 4 and the cap 47 are configured to be elastically deformable, even an instrument such as an endoscope or a treatment instrument whose insertion portion is considerably bent can be easily inserted therethrough. Also,
The same effect as that of the above-described embodiment can be obtained.

FIG. 7 shows a fourth embodiment of the present invention. In the trocar 51, the outer tube 52 as an insertion portion and the housing 44 of the hand-held main body portion 53 connected to the outer tube 52 are formed of an elastic material that is both deformable, as in the first embodiment. A seal valve 57 made of an elastic tube material 56 is attached to a mouthpiece 55 attached to the other end of the housing 44. Seal valve 57
Is attached with one end thereof aligned with the insertion opening of the base 55. A slit-shaped closing portion 58 is formed at the other end of the elastic tube material 56.

Further, an elastic cap 59 made of rubber is provided on the base 55, and a slit or small hole 60 for hermetically inserting the insertion portion of various instruments to be used is formed in this. The length of the base 55 is considerably shorter than the length of the base 15 in the first embodiment described above, and is formed as short as possible.

FIG. 7B shows a normal state, and FIG. 7C shows a state in which the insertion portion 61 of the instrument is inserted. Also in the trocar 51 of this embodiment, the outer tube 52 as the insertion portion and the housing 44 of the hand main body portion 53 connected to the outer tube 52 are formed of a deformable elastic material as in the first embodiment. Therefore, it is possible to easily insert an instrument whose insertion portion 61 is curved. Further, since the elastic tube material is used for the valve means, the configuration can be simplified and the weight and size can be reduced in spite of the fact that an instrument having a curved insertion portion 61 can be inserted.

FIG. 8A shows a modified example of the seal valve 57, in which a seal portion 63 which is normally closed is formed in the middle portion of the elastic tube material 56 forming the seal valve 57. According to this, since there are cylindrical parts on both sides of the seal part 63,
For example, even with a treatment tool having a hook electrode, it is difficult for the hook electrode to be caught when pulling it out.

FIG. 8 (b) is also a modification of the seal valve 57, in which the elastic tube member 56 forming the seal valve 57 is sealed by constricting the outer tube side, that is, the intermediate portion biased to the inner end side. The part 64 is formed.

FIG. 9 shows still another modification of the seal valve 57, in which an intermediate portion of an elastic tube member 56 forming the seal valve 57 is sandwiched by a pair of elastic wires 65 to form a seal portion 66. .. Both ends of the pair of elastic wires 65 are supported by the housing 44 of the proximal body 53. The seal portion 66 is pushed open when the insertion portion of the instrument is inserted, and is inserted while maintaining a sealed state.

The present invention is not limited to the above-mentioned embodiments, but various 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.

[0036]

As described above, according to the present invention, it is possible to provide a trocar in which an instrument having a bent insertion portion can be easily inserted and the main body portion at hand can be made compact. Therefore, when actually using this, along with reducing the weight of each trocar, even if multiple trocars are used at the same time, the body part at hand can be configured small,
It is also possible to eliminate the inconvenience that the main body portions at hand are minimized to interfere with each other and interfere with each other when they hit each other. Further, the curvature of the insertion portion of the instrument used by inserting it through the trocar is not limited. In addition, it can be applied to various types of bends.

[Brief description of drawings]

FIG. 1 is an explanatory diagram showing a first embodiment of the present invention.

FIG. 2 is a sectional view showing a second embodiment of the present invention.

3A is a sectional view taken along line AA in FIG. 2A, FIG. 3B is a sectional view taken along line BB in FIG. 2A, and FIG. Sectional drawing which follows CC line in (a) of FIG.

4A is a sectional view taken along line AA in FIG. 2B, FIG. 4B is a sectional view taken along line BB in FIG. 2B, and FIG. Sectional drawing which follows CC line in (b) of FIG.

FIG. 5 is a perspective view showing a third embodiment of the present invention.

FIG. 6 is a sectional view showing a third embodiment of the present invention.

FIG. 7 is a side view showing a fourth embodiment of the present invention.

8A is a sectional view showing a modified example of the seal valve of the fourth embodiment, and FIG. 8B is a sectional view showing another modified example of the seal valve of the fourth embodiment.

FIG. 9 is a cross-sectional view showing a modified example of the seal valve of the fourth embodiment.

FIG. 10 is a sectional view showing a main part of a trocar for explaining a conventional problem.

[Explanation of symbols]

11 ... trocar, 12 ... mantle tube, 13 ... hand body part,
14 ... Housing, 31 ... Trocar, 32 ... Outer tube,
33 ... Hand body part, 41 ... Trocar, 42 ... Outer tube,
44 ... Housing, 55 ... Clasp.

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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 amended] Statement

[Name of item to be corrected] 0019

[Correction method] Change

[Correction content]

2 to 4 show a second embodiment of the present invention. FIG. 2A shows the trocar 31
A cross section is shown. The trocar 31 includes a portion of the outer tube 32 as an insertion portion and a hand body portion 33 connected to one end of the outer tube 32.
Consists of. The outer tube 32 and the main body 33 are integrally formed of a deformable elastic tube. A collar 34 is formed between the outer tube 32 and the main body section 33.

[Procedure 3]

[Document name to be amended] Statement

[Name of item to be corrected] 0023

[Correction method] Change

[Correction content]

At this time, since the hollow 36 of the main body portion 33 is flat, the insertion portion 38 having a diameter larger than the flat width d thereof.
In this case, the hollow main body 33 can be hermetically inserted. In other words, close contact with the right side of the wall in the portion close to the outer tube 32 as shown in in FIG. 4 (a), in the middle portion of the proximal body portion 33 as shown in FIG. (B), the upper
It is in close contact with the lower wall surface, and as shown in FIG. 7C, it has a slit-like shape at the proximal end opening 37 of the hand-held main body portion 33, which allows it to be airtightly closed, and at the same time, adheres to the left wall surface. ing. Therefore, the insertion portion 38 of the instrument is in close contact with the inner surface of the hand-held main body 33 over the entire length thereof, and therefore, high airtightness can be maintained.

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Tsuruo Hatori 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Akio Nakata 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Inventor, Tsukagoshi Isou 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Seiji Kuramoto 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical 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 Optical Co., Ltd. (72) Inventor Yasuhiko Omagari 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Gaku Kogyo Co., Ltd. (72) Kenji Yoshino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Keisuke Saito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd.

Claims (1)

[Claims] 1. A trocar device having an outer tube as an insertion portion, and a hand main body section having a housing connected to a proximal end portion of the outer tube and having a valve for passing the instrument through the housing incorporated therein. The trocar device according to claim 1, wherein at least the outer tube and the housing are configured to be deformable according to insertion of a curved insertion portion of an instrument to be inserted.