JPH05317326A - Transfixing needle - Google Patents

Abstract

PURPOSE:To provide a transfixing needle used to safely insert a tracheal into an abdominal cavity. CONSTITUTION:A transfixing needle 1 having a needle body 14 transfixed to an organism wall into an organism is provided with a cutting edge 22 provided on the needle body 14 and capable of selecting the cutting position state cutting the organism wall expansively from the outer periphery of the needle body 14 and the noncutting position state retreated from the cutting position state and operating means 14, 10a selectively operating the cutting edge 22 in either position state.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a puncture needle such as a pneumoperitoneum needle, a Menghini needle, a Silberman needle or the like which is pierced into a living body wall and inserted into the living body.

[0002]

2. Description of the Related Art Conventionally, various needles such as a pneumoperitoneum needle, a Menghini needle, and a Silberman needle have been known as puncture needles which are pierced into a living body wall and inserted into a living body. These puncture needles pierce the needle body into the living body wall and insert it into the living body,
It is used to inject and administer gas or drug solution into the living body through the inner hole of the needle body.

Of the puncture needles, the pneumoperitoneum needle is used, for example, to inject a gas such as carbon dioxide into the abdominal cavity to be expanded during medical treatment under endoscopic observation to expand the abdominal region. It is used to secure an observation visual field necessary for intraperitoneal treatment, or is used together with a trocar as a guide member for guiding a medical instrument such as an endoscope or a treatment instrument into the abdominal cavity.

When the pneumoperitoneum needle is used with a trocar, it is used as follows, for example.
That is, first, the needle body of the pneumoperitoneum needle is pierced into the abdominal wall to be inserted into the abdominal cavity, gas is injected into the abdominal cavity through the inner hole of the needle body to expand the abdominal cavity, and a cavity is formed in the abdominal cavity. To do.
Then, after removing the pneumoperitoneum needle from the abdominal cavity, this time, the trocar is introduced into the abdominal cavity while incising the abdominal wall with the trocar. At this time, the cavity prevents the trocar from accidentally incising an organ or the like in the abdominal cavity.
In this way, when the trocar is introduced into the abdominal cavity,
The endoscope and the like are introduced into the abdominal cavity through the trocar.

[0005]

By the way, incision of the abdominal wall by a trocar requires a considerable amount of puncture force. However, when the trocar is completely punctured into the abdominal cavity, the puncture resistance suddenly disappears. Therefore, despite the presence of the hollow portion, the trocar may be forced into the abdominal cavity deeply. In such a case, the organ in the abdominal cavity may be damaged by the trocar, causing great pain to the patient. These risks are especially great with thick trocars.

The present invention has been made in view of the above circumstances, and an object thereof is to provide a puncture needle used for safely inserting a trocar into the abdominal cavity.

[0007]

In order to solve the above problems, the present invention relates to a puncture needle having a needle body which is pierced into a living body wall and inserted into a living body, the needle body being provided in the needle body. An incision position state in which the living body wall is incised to spread out from the outer periphery of the body and a non-incision position state retracted from the incision position state, and an operating means for selectively operating the incision blade in any one of the position states. It is equipped with and.

[0008]

With the above structure, the living body wall into which the needle is inserted,
Since the incision blade can be incised to the extent that the trocar can be inserted, it is not necessary to puncture or expand the living body wall by the trocar when inserting the trocar.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 3 show a first embodiment of the present invention. As shown in FIG. 1, the puncture needle 1 of the present embodiment
Is formed as a pneumoperitoneum, and has a needle body 14 pierced into a living body wall and inserted into a living body, a body portion 2 provided at a base end portion of the needle body 14, and a base end of the body portion 2. And an air feeding cock 4 provided on the side.

The needle body 14 is composed of a needle tube 16 as an outer tube and an inner tube 15 which is inserted into the needle tube 16 so as to be able to advance and retreat and can be projected and retracted from the tip of the needle tube 16. The inner tube 15 is a coil spring described later. It is always urged by 6 so as to protrude from the tip of the needle tube 16. The needle tube 16 is in the shape of a hollow tube whose tip is needle-shaped and has an opening, and the proximal end of the needle tube 16 is fitted into the main body 2. This body 2
Has a hollow portion 2a that communicates with the hollow tube portion of the needle tube 16, is open on the rear end face side, and has an internal thread portion 2 on the inner surface.
b is formed. Further, the holding member 8 has a through hole 8c in the center, and a male screw portion 8b formed on the outer peripheral surface of the holding member 8 is screwed into the female screw portion 2b.

An inner tube 15 having an air supply port 20 as an air outlet is formed in a hollow side wall of the needle tube 16 so as to be able to move forward and backward. The rear end portion of the inner pipe 15 is internally fitted to the front end portion of the air supply pipe 3, whereby the tube hole 15a of the inner pipe 15 and the air supply hole 3a of the air supply pipe 3 are in communication with each other. At the tip of the inner tube 15, a plug 19 that closes the tip opening of the inner tube 15 is attached.

The air supply pipe 3 is inserted into the through hole 8c of the holding member 8 so as to be able to advance and retract in a liquid-tight manner. A locking member 5 is screwed onto the outer circumference of the air supply pipe 3 on the distal end side. Furthermore, the air pipe 3
The a communicates with the air feeding cock 4 provided on the rear end side.

A coil spring 6 as an urging means is interposed between the locking member 5 and the holding member 8 in the cavity 2a of the main body 2. Coil spring 6
Is provided in a state of being wound around the outer circumference of the air supply tube 3, and applies a biasing force in a direction in which the plug 19 of the inner tube 15 projects from the tip opening of the needle tube 16.

A positioning pin 7 is provided on the outer periphery of the air supply pipe 3 on the rear end side. The positioning pin 7 is slidably engaged with a groove 8a axially provided on the inner peripheral surface of the through hole 8c of the holding member 8. Further, due to this engagement, the positioning pin 7 slides only along the groove 8a, so that the air supply pipe 3 and the inner pipe 15 connected to the air supply pipe 3 are moved forward and backward in a state in which the circumferential position is restricted. Sliding and inner tube 1
The air supply port 20 of 5 is positioned in the circumferential direction. In the normal state shown in FIG. 1, the tip of the inner tube 15 is projected from the tip of the needle tube 16 by the biasing force of the coil spring 6, and the air supply port 20 is positioned in the circumferential direction and the needle of the needle tube 16 is positioned. It is exposed from the front opening.

A slide tube 24 having two cutting blades 22 is slidably fitted around the outer periphery of the needle tube 16. The slide tube 24, together with the knob 10 described later, constitutes an operating means for selectively operating the cutting blade 22 in the cutting position state and the non-cutting position state. The cutting blade 22 is provided on the outer peripheral portion of the slide tube 24, and expands in a "V" shape outward in the radial direction of the slide tube 24. The two cutting blades 22 are provided symmetrically with respect to the axis of the slide tube 24, and by fixing both ends thereof near both ends of the slide tube 24, they extend over substantially the entire length of the slide tube 24. ..

Further, at the base end of the slide tube 7, two knobs 10 are provided so as to project outward in the radial direction. These two knob portions 10 extend in directions opposite to each other, and their tips have a pair of covers 12, 12 described later.
Projecting outward. A grip portion 10a is provided at the tip of each knob portion 10.

Further, the cutting blade 22 provided on the slide tube 24 can be retracted and accommodated in the space sandwiched by the pair of covers 12, 12 attached to the tip of the main body 2. There is.

The covers 12, 12 extend radially outward from both end edges of the spherical portion 12a, which surrounds the needle body 14 from the outer periphery, and a cutting blade which is retracted toward the hand side by the forward / backward operation of the slide tube 24. The flat cover portion 12b protects 22 from the outside. Further, knob stoppers 21 that connect the covers 12 and 12 to each other are provided on the inner surfaces of the front end portions of the covers 12 and 12 at two upper and lower positions. When the slide pipe 24 is slid forward by the knob portion 10, The knob portion 10 abuts on the knob stopper 21 and regulates the movement of the slide tube 24 in the axial direction.

Next, a case where the abdominal wall is incised by using the puncture needle 1 having the above-mentioned structure will be described. Non-cutting position state in which the cutting blade 22 is housed in the cover 12 (see (a) of FIG. 3)
Then, when the stopper 19 of the inner tube 15 located at the tip of the needle body 14 of the puncture needle 1 is pressed against the abdominal wall, the inner tube 15 is pushed into the needle tube 16 against the biasing force of the coil spring, and The needle tip pierces the abdominal cavity wall and is inserted into the abdominal cavity. At this time, the air supply port 20 of the inner tube 15 is housed inside the needle tube 16.

After that, when the needle tip of the needle tube 16 reaches the inside of the abdominal cavity by breaking the abdominal wall, the pressing force of the inner tube 15 pressed by the abdominal wall is released, and the tip end of the needle tube 16 is urged by the urging force of the coil spring. Stick out from. At this time, the air supply port 20 of the inner tube 15 is also exposed from the needle tube 16. It should be noted that a thin object such as the needle body 14 has a very small puncture resistance, and therefore there is little possibility that the needle body 14 is too deeply inserted into the abdominal cavity.

In this state, gas is supplied from an air supply device (not shown) connected to the air supply cock. The gas supplied from the air supply device is supplied to the air supply hole 3a of the air supply pipe 3 and the inner pipe 1
The gas is discharged from the air supply port 20 through the tube hole 15a of No. 5, and the abdominal cavity is sufficiently expanded.

With the pneumoperitoneum in which the abdominal cavity is fully expanded, this time, the grip 10a of the knob 10 is gripped and the knob 10 is pushed forward. As a result, the slide tube 2
4 moves forward, and the cutting blade 22 is in the cutting position state exposed from the cover 12 (see FIG. 3B). Then, the slide tube 24 is further advanced by the knob portion 10,
The cutting blade 22 is pressed against the abdominal wall to incise the abdominal wall.
In this case, since the abdominal cavity is in a sufficient pneumoperitoneum state, the cutting blade 22 does not accidentally incise an organ in the abdominal cavity.

When the abdominal wall is incised by the cutting blade 22 to such an extent that the trocar can be easily inserted, the puncture needle 1 is removed from the abdominal cavity, and the trocar is inserted into the abdominal cavity through the incision. At this time, it is preferable to use a trocar having a blunt tip. This allows the trocar to be safely inserted into the abdominal cavity.

As described above, the puncture needle 1 of this embodiment
Does not need to puncture or expand the abdominal wall with the trocar when inserting the trocar, because the abdominal wall into which the needle body 14 is inserted is incised by the cutting blade 22 to the extent that the trocar can be inserted. Therefore, it is possible to safely insert the trocar into the abdominal cavity without rushing the trocar into the abdominal cavity and damaging the organ.

FIG. 4 shows a second embodiment of the present invention. The puncture needle 30 of this embodiment is one in which a high-frequency cauterizing current can be passed through the incision blade 22, and other configurations are substantially the same as those of the first embodiment. The same members as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted.

The puncture needle 30 has a power cord connecting portion 32 at one end of the knob portion 10 for moving the slide tube 24 forward and backward.
Is attached. The power cord connecting portion 32 can be connected to a power cord (not shown) that is connected to a power source portion (not shown) that supplies a high frequency cauterizing current.
A power supply member 34 that is electrically connected to the cutting blade 22 is connected to the power cord connecting portion 32. As a result, the high frequency cauterizing current supplied from the power supply unit can be supplied to the cutting blade 22 via the power supply cord connecting unit 32 and the conductive member 34.

In the above structure, if the power cord is connected to the power cord connecting portion 32 and the cutting blade 22 is exposed from the cover 12 while the high frequency cauterizing current is passed, the abdominal cavity can be operated by the same operation as in the first embodiment. A high frequency incision can be made in the wall. Therefore, the puncture needle 30 of the present embodiment also has the same effect as that of the first embodiment, and since the cutting blade 22 functions as an electric knife, the abdominal wall can be cut more easily and bleeding can be prevented.

FIG. 5 shows a third embodiment of the present invention. A block member 43 as a wire operating means is slidably fitted around the outer periphery of the needle tube 16 of the puncture needle 40 of this embodiment. To the block member 43, a power cord connecting portion 42 and two conductive wires 45 as the cutting blade 22 electrically connected to the power cord connecting portion 42 are attached. The power cord connecting portion 42 is adapted to be connectable to a power cord (not shown) connected to a power source portion (not shown) which supplies a high frequency cauterizing current, and the high frequency power supplied from the power source portion via the power cord. A cauterizing current can be applied to the conductive wire 45.

The tip of the conductive wire 45 has a needle tube 16
Is fixed to the outer peripheral surface of the distal end of the needle, and the conductive wire 45
Is held in a non-incision position where it extends linearly along the outer peripheral surface of the needle tube 16 (see FIG. 5A). Further, if the block member 4 is moved forward, the conductive wire 45 can be opened in a state of being expanded outward in the radial direction of the needle body 16 as shown in FIG. 5B. The other structure is the same as that of the first embodiment.

Therefore, in the puncture needle 40 having the above-mentioned structure, in the non-incision position state in which the conductive wire 45 is linearly extended,
If the needle body 14 is inserted into the abdominal cavity and the abdominal cavity is insufflated by the same operation as in the first embodiment, and the conductive wire 45 is expanded to the outside by advancing the block member 43, the abdominal cavity is incised by high frequency. The same effect as that of the second embodiment can be obtained.

6 and 7 show a fourth embodiment of the present invention. As shown in FIG. 6, the puncture needle 50 of the present embodiment includes a hollow needle tube 56 and a grip portion 54 provided on the proximal side of the needle tube 56. A pair of cutting blades 58, 58 are provided near the tip of the needle tube 56 so as to be openable and closable by an opening / closing mechanism described later.

The grip portion 54 has a guide hole 54a communicating with the inner hole of the needle tube 56, and one lever 52 is inserted from this guide hole 54a to the inner hole of the needle tube 56. The lever 52 has a guide wire insertion hole 52a into which a guide wire 72 (or a guide rod) described later can be inserted.

The opening / closing mechanism for opening / closing the cutting blade 58 is as shown in FIG. That is, a pair of pins 63, 63 protruding outward in the radial direction are provided at the tip of the lever 52 located in the inner hole of the needle tube 56. The pair of pins 63, 63 are provided symmetrically with respect to the axis of the lever 52, and project in opposite directions.

The pair of cutting blades 58, 58 are rotatably attached to the needle tube 56 by support pins 55, 55. Extension portions 58a and 58a extending in the width direction of the cutting blade 58 are formed at the tip ends of the cutting blades 58 and 58, respectively. The extension portions 58a, 58a have pins 63, 6
3 are formed with slits 61, 61, and by pulling the lever 52 upward from the inner hole of the needle tube 56 in the figure, the pins 63, 63 move along the slits 61, 61, and the cutting blade 58, 58 is rotated around the support pins 55, 55 as a rotation axis so as to open and spread from the outer periphery of the needle tube 56 (incision position state). Also, lever 5
In the non-cutting position state in which 2 is pushed into the inner hole of the needle tube 56, the cutting blades 58, 58 are housed in a housing groove 59 formed near the tip of the needle tube 56. In this case, the cutting blade 5
The outer surfaces of 8, 58 and the outer surface of the needle tube 56 are substantially flush with each other.

Next, the operation of the puncture needle 50 having the above structure will be described with reference to FIG. First, similarly to the first embodiment, the needle tube 56 is pierced into the abdominal wall 70 to insert the needle tube 56 into the abdominal cavity ((a) of FIG. 8). Next, the lever 52 is pulled up to open the incision blade 58, and the guide wire 72 is inserted into the abdominal cavity through the guide wire insertion hole 52a of the lever 52 ((b) of FIG. 8). After inserting the guide wire 72 into the abdominal cavity, guide the needle tube 56 along the guide wire 72.
The abdominal wall 70 by the incision blade 58 while removing the abdominal cavity from the inside of the abdominal cavity.
Is cut to the extent that the trocar 75 can be easily inserted ((c) of FIG. 8). Then, the trocar 75 is inserted into the abdominal cavity through the incision 74 using the guide wire 72 left in the abdominal cavity as a guide ((d) of FIG. 8). As described above, the puncture needle 50 of this embodiment also has the same effects as those of the above embodiments.

In the puncture needle 50 having the above structure,
The cutting blade 58 may be used as a stopper when the trocar 75 is inserted. That is, the puncture needle 80 shown in FIG. 9 is one in which the cutting blade 58 is formed as a mere stopper arm 86, and the other configurations are the same as those of the puncture needle 50.

With this construction, the needle tube 56 is pierced into the abdominal wall 70 in the same manner as in the fourth embodiment, and the needle tube 56 is inserted into the abdominal cavity ((a) of FIG. 9). Next, the lever 52 is pulled up to open the arm 86 ((b) of FIG. 9), and the lever 5
The trocar 90 is punctured in the abdominal wall using 2 as a guide (FIG. 9C) (FIG. 9D). In this case, lever 5
The arm 86 is pressed against the inner surface of the abdominal wall in a state in which 2 is pulled up so that a wide space is formed between the abdominal wall and the abdominal organ.

According to such a method, since the abdominal wall is pulled up by the arm 86, a wide space is created between the abdominal wall and the abdominal organ, and the arm 86 stops the trocar 90 even when the trocar 90 passes through the abdominal wall. Therefore, even if the trocar 90 has momentum at the time of puncturing, the trocar 90 does not penetrate deep into the abdominal cavity to damage the organ.

Although the puncture needle has been described as a pneumoperitoneum needle in each of the above embodiments, it goes without saying that the structure of the present invention can be applied to biopsy needles such as a Silberman needle and a Mengini needle.

[0040]

As described above, the needle of the present invention is
Since the living body wall into which the needle body is inserted can be incised by the cutting blade to the extent that the trocar can be inserted, it is not necessary to puncture or expand the living body wall with the trocar when inserting the trocar. Therefore, it is possible to safely insert the trocar into the living body without rushing the trocar into the inside of the living body and damaging the organ with the trocar.

[Brief description of drawings]

FIG. 1 is a side sectional view of a puncture needle showing a first embodiment of the present invention.

FIG. 2 is a sectional view taken along the line AA of FIG.

3A is a side view of the puncture needle of FIG. 1 in a non-incision position state, and FIG. 3B is a side view of the puncture needle of FIG. 1 in an incision position state.

4A is a side view of the puncture needle in a non-incision position state showing a second embodiment of the present invention, FIG. 4B is a sectional view taken along line BB of FIG. 4A, and FIG. It is a side view of a puncture needle in an incision position state.

FIG. 5A is a side view of a puncture needle in a non-incision position state showing a third embodiment of the present invention, and FIG. 5B is a side view of the puncture needle in an incision position state.

FIG. 6A is a schematic view of a puncture needle in a non-incision position state showing a fourth embodiment of the present invention, and FIG. 6B is a schematic view of the puncture needle in an incision position state.

7 (a) is a sectional view of a main part of the puncture needle of FIG. 6, and FIG. 7 (b) is a sectional view taken along line CC of FIG.

FIG. 8 is an explanatory view showing a usage mode of the puncture needle of FIG.

FIG. 9 is an explanatory diagram showing a usage pattern of a puncture needle according to a modification of the present invention.

[Explanation of symbols]

1, 30, 40, 50 ... Puncture needle, 14 ... Needle body, 22, 4
5, 58 ... Cutting blade, 24 ... Slide member (operating means),
43 ... Block member (operating means), 52 ... Lever (operating means).

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[Procedure amendment]

[Submission date] January 22, 1993

[Procedure Amendment 1]

[Document name to be amended] Statement

[Name of item to be corrected] 0002

[Correction method] Change

[Correction content]

[0002] Conventionally, various needles such as a pneumoperitoneum needle, a Menghini needle, and a Silberman needle are known as puncture needles that are pierced into a living body wall and inserted into a living body. These puncture needles pierce the living body wall with the needle body and pierce into the living body, and inject gas or drug solution into the living body through the inner hole of the needle body.
Used to do or have a biopsy .

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0016

[Correction method] Change

[Correction content]

Further, at the base end of the slide tube 24 , two knobs 10 are provided so as to project outward in the radial direction. These two knob portions 10 extend in directions opposite to each other, and their tip ends have a pair of covers 12, 1 described later.
It projects to the outside of 2. A grip portion 10a is provided at the tip of each knob portion 10.

[Procedure 3]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 4

[Correction method] Change

[Correction content]

[Figure 4]

 ─────────────────────────────────────────────────── ─── Continuation of front page (72) Inventor Seiji Kuramoto 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Minor Tsuruta 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.

Claims (1)

[Claims] 1. A puncture needle having a needle body that is pierced into a living body wall and inserted into a living body, wherein an incision position state in which the living body wall is incised by expanding the outer periphery of the needle body and cutting the living body wall, and A puncture needle comprising: an incision blade that is selectable from a non-incision position state retracted from the incision position state, and an operating unit that selectively operates the incision blade state to any one of the above-mentioned position states.