JPH05293112A - Tracheal - Google Patents

Abstract

PURPOSE:To provide the tracheal which enables the use of endoscopes and treating means having various outside diameters and can easily be handled. CONSTITUTION:This tracheal consists of a sheath pipe 12 and a hand side part 13 and has sealing members 15a, 15b, 15c having through holes 16a, 16b, 16c to be passed with the insertion part of an insertion means in this hand side part 13. The tracheal has plural sealing members 15a, 15b, 15c varying in the bores of these through holes 16a, 16b, 16c so that the sealing members 15a, 15b, 15c to be used are selectively used.

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 In recent years, laparoscopic surgery such as enucleation of the gallbladder has been performed using a trocar. In this laparoscopic operation, the abdominal cavity is insufflated using a pneumoperitoneum needle. The outer tube of the trocar is inserted into the abdominal wall with the inner needle loaded and placed. After this puncture, the inner needle is pulled out from the mantle tube and the laparoscope or the insertion portion of the treatment tool is inserted instead. Further, in order to prevent gas from escaping from the abdominal cavity through the outer tube of the trocar, an airtight valve is provided at the proximal portion of the trocar. It is designed to be inserted.

[0003]

In an operation using this type of trocar, various treatment tools having different outer diameters of the insertion portion must be used, and the insertion portion has the inner diameter of the through hole of the airtight valve. If it has a smaller outer diameter, the gas in the abdominal cavity escapes. Therefore, it is considered that an adapter (converter) having an airtight valve having a through hole smaller than the inner diameter of the through hole of the airtight valve is attached to the proximal portion to use the treatment tool.

However, in this operation under the endoscope, since the treatment instruments having different diameters of the insertion portion are frequently exchanged and taken in and out from the trocar, the attachment and detachment of the adapter are very troublesome. In addition, the adapter is easy to lose, and management is troublesome.

The present invention has been made in view of the above problems, and an object of the present invention is to provide a trocar which enables the use of endoscopes and treatment tools having various outer diameters and which is easy to handle. To do.

[0006]

A trocar according to the present invention comprises a sheath tube and a proximal portion, and a trocar comprising a sealing airtight valve having a hole through which an insertion portion of an insertion instrument is inserted in the proximal portion. It has a plurality of airtight valves each having a different inner diameter of the insertion hole, selects the airtight valve to be used, and inserts an instrument such as an endoscope or a treatment instrument through the airtight valve.

[0007]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIG. 1 shows a first embodiment of the present invention. The trocar 11 includes an outer tube 12 as an insertion portion and a hand portion (grip portion) 13 attached to one end thereof. The outer tube 12 may be formed of a deformable elastic tube, for example. In addition, a seal valve 14 for hermetically inserting the insertion portion of the instrument to be used is provided in the hand portion 13.

The seal valve 14 is formed by closely stacking three disk-shaped seal members 15a, 15b, 15c having the same outer diameter and thickness, and the seal members 15a, 15b, 15c slide in an airtight manner. It is like this. Each seal member 1
Through holes 16a, 16b, 16c having different diameters are formed in the central portions of 5a, 15b, 15c corresponding to the outer diameters of the insertion portions of instruments such as endoscopes and treatment tools to be inserted. The diameter of the through hole 16a of the uppermost seal member 15a is the smallest, and the diameters of the through holes 16a, 16b, 16c gradually increase in the order of the seal members 15a, 15b, 15c.

The bottom seal member 15c is the outer tube 12
It is attached and fixed to the proximal end of the, and the central axis of the through hole of the outer tube 12 and the central axis of the through hole 16c of the seal member 15c are aligned. Further, as shown in FIG. 1A, the central axes of the through holes 16a, 16b, 16c of the respective sealing members 15a, 15b, 15c in the aligned and stacked state are the same.
The diameter of the insertion hole of the outer tube 12 is larger than that of the through hole 16c having the maximum diameter.

Further, each seal member 15a, 15b, 15
c is rotatably provided via a pivot pin 17 penetrating the peripheral ends thereof. That is, the uppermost seal member 15a and the next seal member 15b can be rotated around the pivot pin 17 thereof to be retracted from the central axis position of the insertion hole of the outer tube 12. FIG. 1B shows a state in which the uppermost seal member 15a is rotated and retracted.

However, when the trocar 11 is used to perform, for example, laparoscopic cholecystectomy, it is usually performed as follows. First, the outer tube 1 of the trocar 11
Insert an inner needle (not shown) into 2. At this time, the seal member 15b having the largest through hole 16c is left and the other seal members 15a and 15b are retracted to insert the inner needle. Then, the mantle tube 12 is punctured into the abdominal cavity. 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 tool is appropriately inserted in place of the inner needle to perform the treatment.
16b, 16c are selected and through holes 16a,
The seal members 15a and 15b having 16b are retracted. Then, the remaining seal members 15a, 15b, 15c
Using the through holes 16a, 16b, 16c, the insertion portion of an instrument such as a laparoscope or a treatment tool is inserted to observe or treat the inside of the abdominal cavity.

Therefore, even if a laparoscope or a treatment tool having various diameters is arbitrarily selected, the seal member 15 having the diameter is selected.
Since a, 15b, and 15c can be selected and used, escape of gas in the abdominal cavity can be prevented. In this case, it is not necessary to attach and detach the adapter, and the adapter can be easily switched, and the handling is easy. Also, the adapter is easy to manage without being lost.

FIG. 2 shows a second embodiment of the present invention. This trocar 11 is also the outer tube 1 as an insertion portion.
2 and a hand portion (grip portion) 13 attached to one end thereof. Further, the outer tube 12 may be formed of a deformable elastic tube, for example. A seal valve 14 for hermetically inserting the insertion portion of the instrument to be used is provided in the hand portion 13.

The seal valve 14 of this embodiment is constructed as follows. First, the body frame 21 of the hand portion 13 is formed in a U shape when viewed from the side. A circumferential portion of a disc-shaped seal member 23 is fitted in the groove portion 22 of the main body frame 21, and the center of the seal member 23 is pivotally attached to the main body frame 21. Then, one circumference of the seal member 23 is closely interposed between the open end of the outer tube 12 and the inner open end of the insertion port tube 24. Open end of mantle tube 12 and insertion port tube 2
A plurality of through holes 2 having different diameters corresponding to the outer diameter of the insertion portion of the endoscope or the treatment tool are provided in the peripheral portion closely intervening with the inward opening end of 4.
6a, 26b, 26c, ... Are formed.

The through hole 26a having the largest diameter is formed in accordance with the insertion portion of the inner needle or the thickest instrument to be used, and the insertion port tube 24 is also formed to have the same diameter as that. .. of the other through holes 26b, 26c, ... These through holes 26a, 26b, 26c, ...
By rotating the seal member 23, the outer tube 1
The opening end of 2 and the inner opening end of the insertion port tube 24,
It is designed to communicate in an airtight manner.

By rotating the seal member 23, the operator selects the through holes 26a, 26b, 26c, ... According to the diameter of the insertion portion of the instrument to be used, and inserts the outer tube 12 into the outer tube 12. The mouth tube 24 can be communicated in an airtight manner. Therefore, as in the case of the above-mentioned embodiment, the through holes 26a,
Since it is possible to select 26b, 26c, ..., Airtightness can be maintained without being too loose or too tight. According to this configuration, since the single sealing member 23 is sufficient, the operation is easy.

FIG. 3 shows a third embodiment of the present invention. The trocar 11 is a modified example of the seal valve in the second embodiment described above, and in this case, the seal member 33 is linearly slidable with respect to the main body frame 32 of the hand portion 13 instead of being rotated. It was installed in. The seal member 33 is formed with a plurality of through holes 34a, 34b, 34c, ... As described above, each having a different diameter corresponding to the outer diameter of the insertion portion of an instrument such as an endoscope or a treatment instrument. By positioning the selected through holes 34a, 34b, 34c, ... Between the open end of the outer tube 12 and the inner open end of the insertion tube 24, the outer tube 12 and the insertion tube 24 are air-tightly communicated with each other. To do. Others are as described above.

FIG. 4 shows a fourth embodiment of the present invention. This trocar 41 is also the outer tube 1 as the insertion portion.
2 and a hand portion (grasping portion) 13 attached to one end of this. The body frame 42 of the proximal portion 13 is formed in a box shape communicating with the opening at the proximal end of the outer tube 12, and has a relatively large diameter through hole 43 on the proximal end surface facing the open end of the outer tube 12. The first airtight valve 44 is provided.

Further, a second airtight valve 45 fitted to the first airtight valve 44 is provided, and the second airtight valve 45 is provided.
The inner diameter of the through hole 46 is smaller than that of the through hole 43.
The second airtight valve 45 is connected to the main body frame 42 via an elastically deformable strip 47. The second airtight valve 45 can be selectively attached to the first airtight valve 44 for use. Further, on the side surface of the main body frame 42 on the side to which the second airtight valve 45 is attached, a locking tool 48 for fitting and locking the through hole 46 of the second airtight valve 45 is provided.

Therefore, as shown in FIG. 4, when the second airtight valve 45 is removed from the first airtight valve 44, the insertion port becomes the size of the through hole 43 of the first airtight valve 44, The opening can be enlarged. Further, if the second airtight valve 45 is attached to the first airtight valve 44, the insertion port becomes the size of the through hole 46 of the second airtight valve 45, and the opening can be made small. When the second airtight valve 45 is not used, the through hole 46 can be attached to the locking tool 48 and held on the side surface of the main body frame 42.

FIG. 5 shows a modification in which, in addition to the second airtight valve 45, a third airtight valve 50 having through holes 49 of different diameters is provided. The third airtight valve 50 is also connected to the body frame 42 via the strip 51. In this case 3 with different diameters
The one through hole 43, 46, 49 can be selected and used according to the instrument to be used. For other details, refer to the examples described above.

The through hole in each of the above-described embodiments may be a slit-like hole, which is airtight when not inserted into the hole, which is more airtight when the device is taken in and out. Convenient because it is retained.

FIG. 6 shows a fifth embodiment of the present invention. This trocar 61 also includes a soft outer tube 12 as an insertion portion and a hand portion (grip portion) 1 attached to one end thereof.
3, the main body frame 62 of the hand portion 13 is the outer tube 12
It is formed in a box shape that communicates with the opening at the proximal end. The main body frame 62 is formed in a tent shape from the left and right side wall portions 63a and 63b facing the open end of the outer tube 12 and the soft wall portions 64a and 64b closing the front and rear. Each of the wall portions 63a, 63b, 64a, 64b is made of a flexible airtight film, and the first airtight valve 65 is provided on one of the wall portions 63a, 63b on the left and right side surfaces of the mountain, and the other is provided with the first airtight valve 65. Two airtight valves 66 are provided. The diameter of the through hole 67 of the first airtight valve 65 and the diameter of the through hole 68 of the second airtight valve 66 are different.
The through holes 67 and 68 are elastic slits.

A relatively large insertion opening 70 facing the open end of the outer tube 12 is formed on the upper surface wall 69 of the main body frame 62, and the insertion opening 70 has one of the wall portions 63a, 63b.
Is folded and joined to the upper wall 69, the first airtight valve 65 or the second airtight valve 66 provided therein is fitted. It should be noted that FIG. 6C shows a state in which the first airtight valve 65 is fitted into the insertion port 70.

Then, in a normal state not used, FIG.
As shown by, the left and right walls 63a and 63b rise, and the first airtight valve 65 and the second airtight valve 66 are closed.
Further, when inserting and using the inner needle or the thick instrument 71, the first airtight valve 65 having the through hole 67 having a large inner diameter is fitted into the insertion opening 70 as shown in FIG. 6C. Then, the through hole 67 is used. Further, when the thin instrument 71 is inserted and used, the second airtight valve 66 having the through hole 68 having a small inner diameter is fitted into the insertion opening 70 and mounted, and the through hole 68 is used. Note that other methods of use can be general or as described above.

When an endoscope or a treatment instrument having a curved insertion portion is used, it is used in the state shown in FIG. The first airtight valve 6 whose axial direction is different from that of the insertion port 70 of the handle portion 13
Since the fifth airtight valve 66 and the second airtight valve 66 are provided, the through hole 67 or the through hole 68 having different axial directions can be used for inserting and removing from the diagonal direction without difficulty. Since the outer tube 12 is also flexible, it can be easily inserted into the outer tube 12 from the body frame 62. Therefore, the insertion opening 70 and the airtight valves 65 and 66 are not damaged.

FIG. 7 shows a modification of the fifth embodiment, in which a third airtight valve 73 is provided on the front wall 64a and a fourth airtight valve 74 is provided on the rear wall 64b. The through holes 75 and 76 are provided to each other and the airtight valves 65 and 66 described above.
The through holes 67 and 68 have different diameters. FIG. 7B shows an example in which one of them is selected and used. according to this,
The selection of the diameter is increased, and the optimum one can be selected from more different diameters. That is, compatibility can be improved.

FIG. 8 shows a further modification of the fifth embodiment, in which a wall portion 77 made of an elastic film attached to the main body frame 62 is formed into a spherical dome shape, and the wall portion 77 is connected to the wall portion 77. A plurality of airtight valves 78 having different hole diameters are provided.

9 and 10 are trocars 80 considered in parallel with the present invention. The trocar 80 comprises an outer tube 81 as a flexible insertion section and a hand grip section 82 attached to one end of the outer tube 81. The hand-holding portion 82 has a main body frame 83 formed in a tubular shape with a bottom portion closed, and an outer tube 81 is connected to the bottom wall portion. End plate 84 of body frame 83
A valve member 85 is provided so as to penetrate therethrough and be capable of protruding and retracting.
The valve member 85 is formed of an elastic material in a tubular shape, and has an inner end opened and an outer end closed. Further, flanges 86 and 87 are formed on the outer circumferences of the inner and outer ends, respectively. The body frame 83 of the hand grip 82 may be rigid, but may be curved laterally to some extent.

This valve member 85 has an inner flange 86.
The coil spring 88 is interposed between the end plate 84 and the end plate 84, and is biased so as to be drawn inward. Then, by pulling the outer flange 87, the valve member 85 can be pulled out. Further, the side wall of the valve member 85 exposed when pulled out has an airtight valve 8 formed of a slit.
9 is formed. That is, the airtight valve 89 is provided at a position different from the axial direction of the outer tube 81.

However, the trocar 80 can also be used in an endoscope or a treatment instrument in which the insertion portion 90 is curved. That is, when inserting the bent insertion portion 90, as shown in FIG. 9, the valve member 85 is pulled up to expose the airtight valve 89 to the outside. Then, as shown in FIG. 10, the insertion portion 90 of the instrument to be used is inserted into the airtight valve 89 from the side, and the flexible outer tube 8 is inserted from the inner cavity of the valve member 85.
Insert in 1. For this reason, it is possible to easily insert and remove even with a curved endoscope or a treatment instrument, and the instrument is not damaged.

FIG. 11 is another trocar 91 studied in parallel with the present invention. The trocar 91 is composed of an outer tube 92 as a flexible insertion section and an insertion mouthpiece 93 as a hand-holding section attached to one end of the outer tube 92. This base 93
A first seal member 96 having a through hole 95 at a portion of the insertion port 94 thereof and a rubber sheet 9 having a half-moon shape.
A second seal member 98 composed of 7a and 97b is arranged coaxially.

Then, normally, the sheets 97a and 97b of the second seal member 98 have their leading end portions overlapped with each other as shown in FIGS. 11 (a) and 11 (b). Therefore, the first
Even if the through hole 95 of the seal member 96 is open, the insertion port 94 is sealed.

Further, as shown in FIG. 11C, when the insertion portion 99 of the instrument to be used is inserted into the insertion opening 94,
Sheet 97 of second sealing member 98 overlapping
a and 97b are pushed in and inserted. Further, it can be inserted into the soft outer tube 92 by penetrating the through hole 95 of the first seal member 96.

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.

[0037]

INDUSTRIAL APPLICABILITY As described above, the present invention is applied to a trocar having a sealable airtight valve which is composed of an outer tube and a proximal portion and has a hole through which the insertion portion of an insertion instrument is inserted. Having a plurality of airtight valves with different inner diameters of the holes and selecting and using the airtight valve to be used, it is possible to use endoscopes and treatment instruments of various outer diameters in an airtight manner, and furthermore, The sealing valve is easy to select and can be used easily. Easy to manage because you don't need to use an adapter and you don't lose it.

[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 a perspective view showing a trocar according to a third embodiment of the present invention.

4A is a perspective view showing a trocar according to a fourth embodiment of the present invention, and FIG. 4B is a sectional view of the trocar.

5A is a perspective view showing a trocar showing a modified example of the fourth embodiment of the present invention, and FIG. 5B is a sectional view of the trocar.

6A is a perspective view showing a trocar according to a fifth embodiment of the present invention, FIG. 6B is a sectional view of the trocar, FIG.
(C) is a cross-sectional view of the trocar in use.

FIG. 7A is a perspective view of a trocar showing a modified example of the fifth embodiment of the present invention, and FIG. 7B is a perspective view of the trocar when the trocar is in use.

FIG. 8 is a perspective view of a trocar showing another modification of the fifth embodiment of the present invention.

9A is a perspective view of a trocar examined in parallel with the present invention, and FIG. 9B is a sectional view thereof.

FIG. 10 is a sectional view of the trocar in use.

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

[Explanation of symbols]

11 ... Trocar, 12 ... Outer tube, 13 ... Hand part, 14
... Seal valve, 15a, 15b, 15c ... Seal member, 1
6a, 16b, 16c ... through hole, 23 ... sealing member, 26
a, 26b, 26c ... through hole, 33 ... sealing member, 34
a, 34b, 34c ... through hole, 43 ... through hole, 44 ... first airtight valve, 45 ... second airtight valve, 46 ... through hole, 49 ... through hole, 65 ... first airtight valve, 66 ... Second airtight valve, 67 ...
Through hole, 68 ... Through hole, 75, 76 ... Through hole, 78 ... Airtight valve.

 ─────────────────────────────────────────────────── ─── 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 Seiji Kuramoto 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Shuichi Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Minor Tsuruta 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 comprising a sealable airtight valve having an outer tube and a proximal portion, the proximal portion having a hole through which an insertion portion of an insertion instrument is inserted, and a plurality of airtight holes each having a different insertion hole inner diameter. A trocar having a valve, wherein an airtight valve to be used is selected and an instrument is inserted using the valve.