JPH05293111A - Tracheal - Google Patents

Abstract

PURPOSE:To provide the tracheal which can easily be inserted even by an implement having a bent insertion part and can simplify a sealing valve to be provided in its hand side part. CONSTITUTION:A sheath pipe 12 of the tracheal 11 is constituted of a tube which is freely deformable according to the insertion of the curved insertion part of the implement to be inserted therein and further, the sealing valve is provided by forming a valve hole with a cylindrical elastic tube 17. A constricted part 21 is formed in this tube by deforming the tube. A means for opening and closing the valve hole by changing the sectional area of this constricted part 21 and a means for operating the opening and closing means are provided.

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. It is easy to get close to each other and concentrate on the region to be treated to disturb the visual field observation. In addition, it is in a fixed indwelling state that cannot be avoided.

If the insertion parts of the instruments are bent, the insertion parts of the plurality of instruments concentrated on the site to be treated are appropriately displaced or retracted so that the field of view of the laparoscope is reduced. You can avoid being caught as much as possible. Also,
Since the directionality with respect to the treatment target portion 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 of the present invention is to provide a trocar capable of easily inserting an instrument having a bent insertion portion and simplifying a seal valve provided at the proximal portion thereof. To provide.

[0009]

A trocar according to the present invention is a trocar in which a proximal portion having a sealing valve is continuously provided at a proximal end of an outer tube serving as an insertion portion, the outer tube being inserted through the proximal portion. Consists of a tube that is deformable according to the insertion of the curved insertion part of the instrument,
The seal valve is formed by forming a valve hole with a tubular elastic membrane member, deforms the tubular elastic membrane member to form a constricted portion, and changes the cross-sectional area of the constricted portion to cause the valve It comprises means for opening and closing the hole and means for operating this opening and closing means.

The instrument is inserted through an outer tube made of a deformable tube through a valve hole formed by a cylindrical elastic film member. Since they are soft, they can be easily inserted even if the insert is bent.

[0011]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIG. 1 shows a first embodiment of the present invention. FIG. 1 shows the appearance of the trocar 11. The trocar 11 includes an outer tube 12 as an insertion section and a hand section 13 attached to one end of the outer tube 12. The outer tube 12 is formed of a deformable elastic tube. Also, the hand part 1
A seal valve 14 for inserting the insertion portion of the instrument to be used and closing the passage portion is incorporated in the reference numeral 3.

The seal valve 14 is a deformable thin film between a hollow ring-shaped end frame 15 fixedly attached to the proximal end of the outer tube 12 and an operating member 16 which is also formed in a hollow ring shape. The tubular elastic tube 17 is coaxially installed, and the tubular elastic tube 17 is the outer tube 12
Is formed in a cylindrical shape having a diameter as large as possible so that the valve hole is sufficiently larger than the hollow hole. A mesh 18 for deformation restriction is attached to the film portion of the tubular elastic tube 17.

Furthermore, the fixed end frame 15 and the operating member 1
6, and an elastic coil member 19 composed of an equal-diameter coil coaxially arranged around the tubular elastic tube 17.
Has been erected. The elastic coil member 19 urges the tubular elastic tube 17 in the axially extending direction to form a constricted portion 21 in the elastic tube 17 as shown in FIG. Close the valve hole. That is, the valve hole formed by the elastic tube 17 normally closes the narrowed portion 21 by narrowing it by the urging force of the elastic coil member 19, and closes the constricted portion 21, while operating toward the fixed end frame 15. If you bring 16 closer,
As shown in FIG. 1B, the constricted portion 21 is expanded in the middle of the elastic tube 17 to open the valve hole. This constitutes the means for opening and closing the valve hole and the opening and closing operation means.

When laparoscopic cholecystectomy is performed using this trocar 11, the procedure is usually as follows. First, the seal valve 14 at the proximal portion 13 of the trocar 11 is opened, and the inner needle is inserted to the outer tube 12. When the operating member 16 is opened, a constricted portion 21 is formed in the elastic tube 17 by the urging force of the elastic coil member 19 and pushes against the peripheral surface of the inner needle to close it. In this state, the abdominal cavity is punctured. This procedure is performed after pneumoperitoneum using a pneumoperitoneum as in the previous method. Usually, a plurality of trocars 11 are often used.

Then, the inner needle is pulled out from the trocar 11 and a laparoscope or a treatment instrument or the like is appropriately inserted in place of the inner needle to perform the treatment. Open a hole.

By the way, the trocar 11 includes the outer tube 12 and the tubular elastic tube 1 in the proximal portion 13.
Since 7 is deformable and flexible, a device to be inserted through it,
For example, even if the insertion portion of a laparoscope (hard endoscope) or a rigid treatment instrument has a bent portion, it can be easily inserted. FIG. 1A shows the state, in which the forceps 23 having a bent part in the insertion part 22 is inserted.

That is, the outer tube 12 and the tubular elastic tube 17 are deformed following the curved insertion portion of the instrument to be inserted, and moreover, since the elastic tube 17 has a relatively large inner cavity, it is bent. Insertion part 2 of forceps 23
Even 2 can be easily inserted.

A trocar of this type may have the following structure. That is, the valve hole is formed by the above-mentioned cylindrical elastic tube 17 provided between the end frame 15 and the operation member 16, and the valve hole is opened in the natural state. By pulling the operating member 16 in a direction away from it, a cylindrical elastic tube 1
It is a system of operating so as to close the valve hole by narrowing down the intermediate portion of 7.

FIG. 2 shows a second embodiment of the present invention. The elastic coil member 19 having a small diameter in the middle part and a large diameter in both ends is tightly wound around the outer circumference of a tubular elastic tube 17 made of a deformable thin film forming the seal valve 14. The member 19 is the end frame 1
5 and the operation member 16 are installed. And
Normally, as shown in FIG. 2B, the intermediate portion of the tubular elastic tube 17 is narrowed and closed by the urging force of the elastic coil member 19. The other structure is the same as that of the above-mentioned embodiment.

When the operating member 16 is rotated against the biasing force of the elastic coil member 19 as shown by the arrow in FIG. 2A, the elastic coil member 19 is loosely wound, and the elastic tube is wound. The constricted portion 21 of 17 spreads outward and expands into a cylindrical shape of equal diameter as much as possible, so that the valve hole formed of the elastic tube 17 can be opened. Therefore, the elastic tube 17 closed by the biasing force of the elastic coil member 19
The valve hole can be selectively opened by the operating member 16. Further, it is not necessary to attach the above-mentioned deformation regulating net to the film portion of the elastic tube 17.

FIG. 3 shows a third embodiment of the present invention. In this embodiment, a plurality of rod-shaped elastic members 25 are installed between the end frame 15 and the operating member 16 instead of the elastic coil member 19 in the trocar 11 of the first embodiment. It should be noted that the film portion of the elastic tube 17 does not have to be provided with the above-mentioned deformation regulating net.

In a natural state, the elastic tube 17 forming the valve hole 27 by the rod-shaped elastic member 25.
Is held in a twisted state as shown in FIG. 3 (a), and the valve hole is in a closed state. In this state, each rod-shaped elastic member 25 is oriented parallel to its axial direction.

Further, knobs 26 are provided so as to project on the corresponding side surfaces of the end frame 15 and the operating member 16. The operation member 16 can be rotated with one hand by putting a finger on both the knobs 26. The other structure is the same as that of the trocar 11 of the first embodiment described above.

In the natural standing state shown in FIG. 3A, the elastic tube 17 is twisted by the urging force of the elastic member 25 to close the valve hole. Elastic member 2
If the operating member 16 is rotated against the biasing force of 5,
As shown in FIG. 3A, the elastic tube 17 is untwisted and the valve hole 27 is opened. The ones shown in FIGS. 4-12 are for other trocars studied in parallel with those of the present invention.

The trocar 30 shown in FIG. 4 is a flexible outer tube 3.
1 and a grip portion 32 as a hand portion. The grip portion 32 includes a support cylinder 35 that fixedly holds a ring (donut) -shaped elastic member 34 for sealing in a housing 33 thereof.
Is provided. A holding plate 37 having the insertion opening 36 is attached to the end of the support tube 35 on the insertion opening 36 side.

The sealing elastic member 34 has a flat peripheral surface to be joined to the inner surface of the support cylinder 35, but the sealing passage 3 is provided.
On the side where 8 is formed, the cross-sectional shape is a smooth curved surface 39 as shown in FIG.
In the normal natural state, the two closely contact each other near the central axis of the insertion passage 38 to close the insertion passage 38.

When the inner needle 40 is inserted into the insertion passage 38, the sealing elastic member 34 is elastically expanded as shown by the dotted line in FIG. 4 (a), and the inner needle 40 is hermetically sealed. Insert into. In this way, the treatment instrument 4 is inserted into the insertion passage 38.
The insertion part of 1 can be taken in and out. Further, since the surface of the sealing elastic member 34 forming the insertion passage 38 is a curved surface 39 that gently protrudes, even if the treatment tool 41 is a hook-shaped forceps or the like, FIG. It can be put in and taken out of the insertion passage 38 without being caught as shown in FIG. Therefore, it is possible to avoid breaking the valve portion during insertion and removal.

Instead of the sealing elastic member 34 of this example, a gel-like material may be filled in the support cylinder 35. Further, instead of the gel-like one, the support cylinder 35 may be filled with a water-containing resinous one.

The trocar 42 shown in FIG. 5 has a valve housing 44 attached to the proximal end of a deformable and flexible outer tube 43 to form a proximal portion 45. The housing 44 has a narrow distal end and a proximal end. A sealable valve 49 is incorporated which engages a plurality of so-called curved ball-shaped elastic concentrators 47 which are thicker on the side and wholly bent, to close the insertion passage 48 of the proximal portion 45. That is, as shown in FIG.
Four concentrators 47 are arranged point-symmetrically about the axis of the trocar 42 in the housing 44 of No. 5, and are pivotally supported on the inner surface of the operation ring 50 rotatably provided on the outer periphery of the housing 44.

Grooves 5 are formed in the middle of each concentrator 47.
1 is formed to be long from the base end side toward the tip end side, and a pin 52 fixedly provided on the housing 46 is penetrated through the groove hole 51.

However, when the operation ring 50 is rotated, each focusing element 47 is pulled in its rotating direction, and at this time, the pin 52 in the groove hole 51 relatively moves from the base end side to the tip end side. Therefore, each focusing element 47 is rotated as shown in FIG.
Open 8. Further, when the operation ring 50 is rotated in the opposite direction, the insertion passage 48 is closed. That is, the operation ring 50
The insertion passage 48 can be opened and closed by rotating.

Since the concentrator 47 is made of a rubber material such as silicon rubber, airtightness can be obtained. However, since it is difficult to obtain the slidability with the inner surface of the housing 46,
As shown in (d) of FIG. 3, a resin plate 5 having good slipperiness on one surface thereof
It is good to paste 3.

In FIG. 6A, a tubular elastic member 55 is used to form the insertion passage of the proximal portion.
5 is an example in which the inlet end portion of No. 5 is bent inward to form the seal portion 56. Further, FIG. 6B shows an example of a valve that opens and closes the inlet portion of the insertion passage in the proximal portion, and is formed by stacking two rotatable discs 58 each having a slit 57, and By rotating the disk 58, the slits 57 are overlapped or intersected with each other to adjust the opening amount of the insertion passage from the sealed state to the maximum opening amount.

FIG. 7 shows an example in which the sealing elastic member 34 in FIG. 4 described above is replaced with a balloon 61 having a ring shape. A part of the balloon 61 is fitted in a chamber 62 formed in the housing 33. The other portion protrudes so as to close the insertion passage 38 and closes the insertion passage 38. Also in this case, since the surface of the balloon 61 is the curved surface 39 that gently protrudes, even if the treatment tool 41 is, for example, a hook-shaped forceps, it is not caught in the insertion passage 38, Never put it in or out. Therefore, it is possible to avoid breaking the valve portion during insertion and removal.

FIGS. 8 and 9 show another trocar 70, which comprises a flexible outer tube 71 and a grip portion 72 as a proximal portion. A balloon 75 having a ring (donut) shape formed in a housing 73 of the grip portion 72 and thus forming an insertion passage 74 is arranged. The balloon 75 is filled with a fluid such as gas or liquid. Further, the balloon 75 is communicated with a bellows-shaped chamber member 76 filled with the fluid. A pushing operation member 77 is attached to the chamber member 76. The push-in operation member 77 has a locking recess 78, which is provided when the push-in operation member 77 is pushed in.
The locking projection 79 formed on the above is locked, and the pushing operation member 77 is held in the pushed state.

When the pushing operation member 77 is pushed in, the chamber member 76 is crushed as shown in FIG.
As a result of the fluid inside the balloon 75 being pushed into the balloon 75, the balloon 75 greatly expands inward and closes the insertion passage 74. Further, as shown in FIG. 8, the insertion passage 74 can be opened by pulling out the pushing operation member 77.

FIG. 10 shows a modification of the means for locking the pushing operation member 77 in the trocar 70. That is, the pushing operation member 77 is formed in a lever shape, the hook portion 81 is formed at one end of the pushing operation member 77, and the locking projection 82 is formed on the housing 73 side correspondingly. When this is used, the lever-like push-in operation member 77 can be pushed in like the above to inflate the balloon 75.

By locking the hook 81 to the locking projection 82, it can be held in the pushed-in state as shown in FIG. 10 (b). The push-in operation member 77 is engaged with and disengaged from the protrusion 82 by the chamber member 76.
It can be performed by displacing it by using the elasticity of. Further, as shown in FIG. 10D, the lever-shaped pushing operation member 77 may be rotated to engage and disengage.

FIG. 11 shows another trocar 85. As described above, the trocar 85 includes the flexible outer tube 86 and the grip portion 87 serving as a proximal portion, and is formed in the housing 88 of the grip portion 87 in a ring (donut) shape so that the insertion passage 89 is formed. The balloon 90 to be formed is arranged.

Further, the balloon 90 communicates with a ventilation passage 91 formed in the soft outer tube 86 to reach the tip thereof. Then, when the outer tube 86 is punctured into the abdominal cavity, the pressure in the abdominal cavity is transmitted to the balloon 90 through the air passage 91, and the balloon 90 is inflated.
Thereby, the insertion portion is sealed, and the insertion portion of the inserted instrument is tightened and sealed.

FIG. 12 shows the housing 8 of the grip portion 87.
8 shows a modified example in which a balloon receiving frame 95 is formed in 8, and the ventilation path 91 is formed by partially utilizing the inside of the housing 88 thereof.

By the way, any of the above-mentioned trocars using a balloon as the sealing means is not limited to the diameter of the insertion portion of the instrument to be inserted therethrough, but is applicable to various diameters. That is, scopes, forceps, etc. having different diameters can be used. In addition, a bent insertion portion can be easily inserted. Since the outer tube is also flexible, a bent instrument can be easily inserted.

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.

[0044]

As described above, according to the trocar of the present invention, an instrument having a bent insertion portion can be easily inserted and used, and the seal valve provided at the proximal portion can be simplified.

[Brief description of drawings]

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

2A is a perspective view showing a trocar according to a second embodiment of the present invention, and FIG. 2B is a sectional view of the trocar.

FIG. 3 is an explanatory diagram showing a trocar according to a third embodiment of the present invention.

FIG. 4 is a cross-sectional view of another trocar studied in parallel with that of the present invention.

FIG. 5 is a cross-sectional view of another trocar studied in parallel with that of the present invention.

FIG. 6A is a cross-sectional view of a main portion of a seal portion at a proximal portion of a trocar, and FIG. 6B is a perspective view of a main portion of another seal portion.

FIG. 7 is a cross-sectional view of yet another trocar studied in parallel with that of the present invention.

FIG. 8 is a cross-sectional view of yet another trocar studied in parallel with that of the present invention.

FIG. 9 is a sectional view of the trocar.

FIG. 10 is an explanatory view of still another trocar studied in parallel with that of the present invention.

FIG. 11 is a cross-sectional view of yet another trocar studied in parallel with that of the present invention.

FIG. 12 is a cross-sectional view of yet another trocar studied in parallel with that of the present invention.

[Explanation of symbols]

11 ... Trocar, 12 ... Outer tube, 13 ... Hand part, 14
... Seal valve, 16 ... Operation member, 17 ... Elastic tube,
19 ... Elastic coil member, 21 ... Constricted portion.

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[Procedure amendment]

[Submission date] July 17, 1992

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0009

[Correction method] Change

[Correction content]

[0009]

A trocar according to the present invention is a trocar in which a proximal end having a sealing valve is connected to a proximal end of an outer tube as an insertion portion, and the outer tube is inserted into the trocar. It is composed of a tube that is deformable according to the insertion of a curved insertion portion of the instrument, and further, the seal valve is formed by forming a valve hole with a tubular elastic membrane member, and the tubular elastic membrane member is It is provided with means for deforming and forming a constricted portion in the deformed portion, and for opening and closing the valve hole according to a change in the cross-sectional area of the constricted portion, and means for operating the opening / closing means.

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0035

[Correction method] Change

[Correction content]

FIGS. 8 and 9 show another trocar 70, which comprises a flexible outer tube 71 and a grip portion 72 as a proximal portion. Gripper 72 is in its housing 73, is formed in a ring (donut) shape, a balloon 75 that forms the insertion passage 74 thereby
There is. The balloon 75 is filled with a fluid such as gas or liquid, and the balloon 75 is further communicated with a bellows-shaped chamber member 76 filled with the fluid. A pushing operation member 77 is attached to the chamber member 76. The pushing operation member 77 has a locking recess 78,
When the pushing operation member 77 is pushed in, the locking projection 79 formed on the housing 73 is locked, and the pushing operation member 77 is held in the pushed state.

[Procedure 3]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 10

[Correction method] Change

[Correction content]

[Figure 10]

[Procedure amendment 4]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 11

[Correction method] Change

[Correction content]

FIG. 11

[Procedure Amendment 5]

[Document name to be corrected] Drawing

[Correction target item name] Figure 12

[Correction method] Change

[Correction content]

[Fig. 12]

 ─────────────────────────────────────────────────── ─── Continued Front Page (72) Inventor Nobuhiko Washizuka 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (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 Co., Ltd. (72) Inventor Tsukagoshi Iso 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Shiro Bito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Shuichi Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Industry Co., Ltd. (72) Inventor Seiji Kuramoto 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd. (72) Inventor 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 Industry Co., Ltd.

Claims (1)

[Claims] 1. A trocar in which a proximal portion having a seal valve is continuously provided at a proximal end of an outer tube serving as an insertion portion, wherein the outer tube is responsive to insertion of a curved insertion portion of an instrument to be inserted therethrough. The seal valve is formed of a deformable tube, and further, the seal valve is formed by forming a valve hole with a cylindrical elastic film member, and the cylindrical elastic film member is deformed to form a constricted portion, A trocar comprising a means for opening and closing the valve hole according to a change in the cross-sectional area of the constricted portion and a means for operating the opening / closing means.