JPH05329164A - Apparatus for high speed pneumoperitoneum - Google Patents
Apparatus for high speed pneumoperitoneumInfo
- Publication number
- JPH05329164A JPH05329164A JP4139413A JP13941392A JPH05329164A JP H05329164 A JPH05329164 A JP H05329164A JP 4139413 A JP4139413 A JP 4139413A JP 13941392 A JP13941392 A JP 13941392A JP H05329164 A JPH05329164 A JP H05329164A
- Authority
- JP
- Japan
- Prior art keywords
- suction
- abdominal cavity
- smoke
- speed
- air supply
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Abstract
Description
【０００１】[0001]
【産業上の利用分野】本発明は、近年頻繁に行われるよ
うになってきた腹腔鏡下の外科手術において、術野を確
保するための高速気腹装置に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a high-speed pneumoperitoneum device for securing a surgical field in laparoscopic surgery which has been frequently performed in recent years.
【０００２】[0002]
【従来の技術】近年、開腹手術に代わって患者への侵襲
の少ない手術として、腹腔鏡下外科手術が増加してい
る。腹腔鏡下胆のう摘出手術（以下ラパコレと称する）
を例にとると、先ず患者の臍下部に気腹針を刺入し、こ
れに気腹チュ−ブを介して接続した気腹装置からＣＯ2
ガスを注入して腹腔を膨ませる。次に気腹針を抜き、同
じ穴から穴を拡張しつつ太径のトラカ−ルを刺入する。2. Description of the Related Art In recent years, laparoscopic surgery has been increasing as a surgery that is less invasive to patients instead of open surgery. Laparoscopic cholecystectomy (hereinafter referred to as Lapacore)
For example, first, a pneumoperitoneum needle is inserted into the lower navel of the patient, and CO 2 is emitted from the pneumoperitoneum device connected to the pneumoperitoneum via the pneumoperitoneum tube.
Inflate gas to inflate the abdominal cavity. Next, the pneumoperitoneum is pulled out, and a large diameter tracar is inserted while expanding the hole from the same hole.
【０００３】このトラカ−ルにＴＶカメラを装着した腹
腔鏡を挿入して、腹腔内を観察可能とする。その後、さ
らに２〜３本のトラカ−ルを観察下に刺入して手術の準
備が完了する。手術は常に腹腔鏡の観察下で、トラカ−
ルからハサミ、鉗子、電気メス、レ−ザ−、縫合具等を
挿入して行う。この間、気腹チュ−ブは腹腔鏡を挿入し
ているトラカ−ルの送気口に接続されており、漏れたガ
スを補って常に一定の腹腔圧を保つように、ＣＯ2 ガス
が腹腔内に送気される。A laparoscope equipped with a TV camera can be inserted into this tracar to observe the inside of the abdominal cavity. After that, a few more trawlers are inserted under observation to complete the preparation for surgery. Surgery should always be done under
Insert scissors, forceps, electric knife, laser, suturing tool, etc. During this period, the pneumoperitoneum tube is connected to the air supply port of the trawler into which the laparoscope is inserted, and CO 2 gas is intraperitoneally supplied so as to supplement the leaked gas and maintain a constant abdominal pressure. Be sent to.
【０００４】[0004]
【発明が解決しようとする課題】このようなラパコレ手
術において、胆管、胆のう動脈を露出させて結紮または
クリップした後、電気メスまたはレ−ザ−で胆管、胆の
う動脈を切断する際に、しばしば多量の煙が発生する。
この煙はＴＶモニタでの観察を阻げ、煙を排除するため
にはトラカ−ルの栓を開き、煙が晴れるのを待つ必要が
あり、手術を一時中断せざるおえないという問題があ
る。In such a rapa collection operation, when the bile duct and the gallbladder artery are exposed and ligated or clipped after the bile duct and the gallbladder artery are exposed, a large amount is often used when cutting the bile duct and the gallbladder artery with an electric knife or a laser. Smoke is generated.
This smoke obstructs the observation on the TV monitor, and in order to eliminate the smoke, it is necessary to open the stopper of the trawl and wait for the smoke to clear, which causes a problem that the operation must be temporarily stopped.
【０００５】また、特開昭６１−１４１３４０号公報、
特公平３−４９４８６、平３−４９４９０号公報等に開
示された吸引設備を利用して、短時間に煙を吸い出すこ
とも行われるが、煙と同時に気腹ガス（ＣＯ2 ガス）も
大量に吸引され、気腹速度が間に合わなくなって、患者
の腹腔がしぼみ、術野が確保できず、やはり手術が中断
することがある。これは、特に手術室に設けられた大容
量の吸引設備を用いた時によく発生している。Further, Japanese Patent Application Laid-Open No. 61-141340,
Smoke can be sucked out in a short time by using the suction equipment disclosed in Japanese Patent Publication No. 3-49486, Hei 3-49490, etc., but a large amount of insufflation gas (CO 2 gas) is also generated at the same time as the smoke. The patient may be aspirated and the pneumoperitoneum may not be in time, the abdominal cavity of the patient may be deflated, the operative field may not be secured, and the operation may be interrupted. This frequently occurs especially when a large-capacity suction equipment provided in an operating room is used.
【０００６】本発明は上記課題に着目してなされたもの
であり、その目的は術野を確保するために高速で腹腔内
の排煙を行っても、常に一定の腹腔圧を維持して安全に
手術が継続できる高速気腹装置を提供することにある。The present invention has been made in view of the above-mentioned problems, and its purpose is to maintain a constant abdominal pressure at all times even if smoke is rapidly exhausted in the abdominal cavity to secure the operative field. It is to provide a high-speed pneumoperitoneum device that can continue surgery.
【０００７】[0007]
【課題を解決するための手段及び作用】本発明の高速気
腹装置は、腹腔内で発生した煙を吸引する吸引手段と、
腹腔内へ送気する送気手段と、前記吸引手段の吸引開始
を検知する検知手段と、煙の吸引量または吸引速度を計
測する計測手段と、吸引開始と同時に前記計測手段の計
測値に従って腹腔内への送気量を増加させる手段と、腹
腔圧を常に監視することにより吸引量と送気量の少なく
とも一方を制御し、吸引速度と送気速度を均衡させる制
御手段とを有し、腹腔圧を設定圧に維持することを特徴
としている。The high-speed insufflation apparatus of the present invention comprises suction means for sucking smoke generated in the abdominal cavity,
Air supply means for supplying air into the abdominal cavity, detection means for detecting the start of suction of the suction means, measuring means for measuring the amount or rate of suction of smoke, and abdominal cavity according to the measurement value of the measuring means at the same time as the start of suction And a control unit for controlling at least one of the suction amount and the air supply amount by constantly monitoring the abdominal pressure to balance the suction speed and the air supply speed. The feature is that the pressure is maintained at the set pressure.
【０００８】従って本発明では、短時間で視野を確保す
るために高速で排煙を行うと同時に、送気流量を増加さ
せ、また腹腔圧を常に監視することにより吸引量と送気
量の少なくとも一方を制御し、常に排煙と送気を均衡さ
せながら腹腔圧を設定値に維持する。Therefore, according to the present invention, at the same time as smoke is exhausted at high speed to secure the field of view in a short time, at the same time the air supply flow rate is increased, and the abdominal pressure is constantly monitored so that at least the suction amount and the air supply amount can be reduced. One side is controlled, and the abdominal pressure is maintained at the set value while always balancing the smoke and air supply.
【０００９】[0009]
【実施例】以下図面を参照しながら本発明の実施例につ
いて説明する。Embodiments of the present invention will be described below with reference to the drawings.
【００１０】図１は、本発明の第１実施例に係わる高速
気腹装置の構成を示すと共に、気腹針による初期の気腹
が完了し、気腹針がトラカ−ルに変更され、本発明の高
速気腹装置が装着され、ＴＶモニタを観察しながら手術
を開始した状態を示している。FIG. 1 shows the structure of a high-speed pneumoperitoneum device according to a first embodiment of the present invention, in which the initial pneumoperitoneum by the pneumoperitoneum needle is completed and the pneumoperitoneum needle is changed to a trawl, The high-speed pneumoperitoneum device of the invention is attached, and the operation is started while observing the TV monitor.
【００１１】図１に示すように高速気腹装置には、腹腔
内へ送気する送気手段としてガスボンベ１が設けられ、
ガスボンベ１には、１次減圧器２、流量制御器３、流量
検知器４が順次接続され、さらに、バルブ６を介して送
気口７に接続されている。流量制御器３と流量検知器４
は制御部１５に電気的に接続されている。As shown in FIG. 1, the high-speed insufflation apparatus is provided with a gas cylinder 1 as an air supply means for supplying air into the abdominal cavity.
A primary pressure reducer 2, a flow rate controller 3, and a flow rate detector 4 are sequentially connected to the gas cylinder 1, and further connected to an air supply port 7 via a valve 6. Flow rate controller 3 and flow rate detector 4
Are electrically connected to the control unit 15.
【００１２】このように構成された送気経路は、ガスボ
ンベ１から高圧のＣＯ2 ガスを１次式減圧器２により減
圧し、流量制御器３で適性な流量（通常３■／ｍｉｎ）
が得られるように調節し、流量検知器４とバブル６を経
て送気口７にガスを送るようになっている。また、送気
口７は、送気チュ−ブ４０により患者９に刺入されたト
ラカ−ル８に接続されている。In the air supply path thus constructed, the high pressure CO 2 gas from the gas cylinder 1 is decompressed by the primary decompressor 2 and the flow controller 3 provides an appropriate flow rate (usually 3 s / min).
The gas is sent to the air supply port 7 through the flow rate detector 4 and the bubble 6 by adjusting the flow rate detector 4 and the bubble 6. Further, the air supply port 7 is connected to the tracar 8 inserted into the patient 9 by the air supply tube 40.
【００１３】バルブ６と送気口７との間の送気管路４２
には、圧力検知器５が設けられており、腹腔圧を常時モ
ニタすることができる。そして、圧力検知器５は制御部
１５に電気的に接続され、腹腔圧のモニタ結果は制御部
１５で判断され、設定値に達するまで又は下回った時に
はバブル６を開いてガスを注入し、設定値に達したとき
又は上回った時にはバブル６を閉じて送気を停止するよ
うになっている。つまり、バルブ６のオン・オフにより
腹腔圧を設定値に保つように制御される。An air supply line 42 between the valve 6 and the air supply port 7
Is equipped with a pressure detector 5 so that the abdominal pressure can be constantly monitored. Then, the pressure detector 5 is electrically connected to the control unit 15, and the monitoring result of the abdominal pressure is judged by the control unit 15, and the bubble 6 is opened to inject gas by setting until the set value is reached or falls below the set value. When the value is reached or exceeded, the bubble 6 is closed and the air supply is stopped. That is, the abdominal pressure is controlled to be kept at the set value by turning on / off the valve 6.
【００１４】一方、患者９に刺入された吸気トラカ−ル
１０は、吸気チュ−ブ４４を介して吸気口１１に接続さ
れ、吸気口１１は、フィルタ１２と流量検出器１３を介
して吸引ポンプ１４に接続されている。そして、流量検
出器１３と吸引ポンプ１４は、制御部１５に電気的に接
続されている。また、制御部１５にはフットスイッチ１
７が接続されている。On the other hand, the intake tractor 10 inserted into the patient 9 is connected to the intake port 11 via the intake tube 44, and the intake port 11 is sucked via the filter 12 and the flow rate detector 13. It is connected to the pump 14. The flow rate detector 13 and the suction pump 14 are electrically connected to the controller 15. In addition, the control unit 15 has a foot switch 1
7 is connected.
【００１５】次に、このように構成された高速気腹装置
の動作について説明する。Next, the operation of the high speed pneumoperitoneum device thus constructed will be described.
【００１６】腹腔内の手術が進行して胆のう切離や胆床
からの剥離の段階になると、電気メスやレ−ザ−が使用
され、腹腔内に煙が発生し、術者の観察視野が損なわれ
る。そこで、術者がフットスイッチ１７を踏むと、吸引
ポンプ１４が作動し、患者９の腹腔に刺入した吸気トラ
カ−ル１０、吸気チュ−ブ４４、吸気口１１を介して煙
がＣＯ2 ガスと共に吸引除去される。When the operation in the abdominal cavity progresses to the stage of dissection of the gallbladder and separation from the bile bed, an electric scalpel and a laser are used, smoke is generated in the abdominal cavity, and the operator's visual field of observation is changed. Be damaged. Then, when the operator steps on the foot switch 17, the suction pump 14 is activated, and smoke is emitted as CO 2 gas through the intake trawl 10, the intake tube 44, and the intake port 11 that are inserted into the abdominal cavity of the patient 9. Is sucked away together with.
【００１７】この煙は電気メスまたはレ−ザ−により焼
灼、蒸散した切離組織の一部であり、これに菌や癌組織
が付着しているという報告もあるので、外部への排出の
前にフィルタ１２を通して排出ガスを清浄化している。
そして、フィルタ１２を通過した煙は、流量検出器１３
と吸引ポンプ１４を通って、排気口１６から排気され
る。Since this smoke is a part of the cut tissue cauterized and evaporated by an electric knife or a laser, and it has been reported that bacteria and cancer tissues are attached to it, it is necessary to discharge the smoke to the outside. The exhaust gas is purified through the filter 12.
Then, the smoke that has passed through the filter 12 has a flow rate detector 13
Then, the gas is exhausted from the exhaust port 16 through the suction pump 14.
【００１８】排煙の流量は流量検出器１３により測定さ
れ、配管の詰りやチュ−ブ折れなどなく排出が行なわれ
ていると制御部１５で判断された場合には、流量制御器
３を高流量送気に切り換え、バルブ６を開いて送気が開
始され、腹腔圧が維持される。The flow rate of the flue gas is measured by the flow rate detector 13, and when it is determined by the control unit 15 that the exhaust is being performed without clogging of the pipe or breakage of the tube, the flow rate controller 3 is turned on. The flow rate is switched to the air supply, the valve 6 is opened to start the air supply, and the abdominal pressure is maintained.
【００１９】この間にも、圧力検知器５により腹腔圧が
モニタされ、送気量が多く腹腔圧が設定値より高くなる
とバルブ６を閉じ、吸引量が多く設定値より大巾に低く
なると、吸引ポンプ１４を停止または低流量運転に切り
換えて腹腔圧を一定に維持する。During this time, the abdominal pressure is monitored by the pressure detector 5, and the valve 6 is closed when the air supply amount is large and the abdominal pressure is higher than the set value, and when the suction amount is large and is much lower than the set value, the suction is performed. The pump 14 is stopped or switched to a low flow rate operation to maintain the abdominal pressure constant.
【００２０】本実施例の高速気腹装置では、以上のよう
にして高速で排煙を行い、短時間で術者の視野を回復し
ても、高速でＣＯ2 ガスが補充され腹腔圧は設定値に維
持される。さらに、排煙経路の流量をモニタして、詰ま
りなどにより排煙が停止し、または排煙量が少なく過送
気となって、腹腔圧が大巾に設定値を超える可能性があ
る場合には、送気を高速から低速に戻すなどの安全対策
をこうじることができる。In the high-speed pneumoperitoneum device of the present embodiment, CO 2 gas is replenished at high speed and the abdominal pressure is set even if the smoke is exhausted at high speed and the operator's visual field is restored in a short time as described above. Maintained at the value. Furthermore, if the flow rate of the smoke exhaust path is monitored and smoke is stopped due to clogging, or the amount of smoke exhausted is too small and there is a possibility that the abdominal pressure may greatly exceed the set value. Can take safety measures such as returning the air supply from high speed to low speed.
【００２１】図２は、本発明の第２実施例を示してい
る。FIG. 2 shows a second embodiment of the present invention.
【００２２】この実施例は、第１実施例の高速気腹装置
をより具体化したものであり、相違点のみについて説明
する。なお、第１実施例と同一の機能を有する部材には
同一の符号を付している。This embodiment is a more specific version of the high-speed insufflator of the first embodiment, and only the differences will be described. The members having the same functions as those in the first embodiment are designated by the same reference numerals.
【００２３】本実施例では、ガスボンベ１と１次減圧器
２とを接続している配管に、ガスボンベ１の残量を確認
するためのボンベ圧計１８が接続されている。そして、
１次減圧器２と２次減圧器２０の間には１次バルブ１９
が設けられ、万一の時にはＣＯ2 ガスの供給を遮断する
ようになっている。また、２次減圧器２０の後には２次
バルブ２１が設けられ、この送気経路の開閉を行う。さ
らに、２次バルブ２１は、流量計２２、流量調整器２
３、バルブ６を通って送気口７に連通している。送気口
７から吸気口１１までは第１実施例と同様に接続され
る。In this embodiment, a cylinder pressure gauge 18 for checking the remaining amount of the gas cylinder 1 is connected to the pipe connecting the gas cylinder 1 and the primary pressure reducer 2. And
A primary valve 19 is provided between the primary pressure reducer 2 and the secondary pressure reducer 20.
Is provided to shut off the supply of CO 2 gas in case of emergency. A secondary valve 21 is provided after the secondary decompressor 20 to open and close this air supply path. Further, the secondary valve 21 includes a flow meter 22 and a flow rate regulator 2
3, communicating with the air supply port 7 through the valve 6. The air supply port 7 to the air intake port 11 are connected in the same manner as in the first embodiment.
【００２４】２次減圧器２４、２次バルブ２５、流量計
２６、及び流量調整器２７で構成される第２の送気経路
は、上記第１の送気経路と対をなして平行に設けられ、
第１の送気経路が高流量経路、第２の経路が中・低流量
経路を構成し、２次バルブ２１と２次バルブ２５の選択
的な開閉により任意に選択することができる。The second air supply path composed of the secondary pressure reducer 24, the secondary valve 25, the flow meter 26, and the flow rate adjuster 27 is provided in parallel with the first air supply path as a pair. The
The first air supply path constitutes a high flow rate path and the second path constitutes a medium / low flow rate path, which can be arbitrarily selected by selectively opening and closing the secondary valve 21 and the secondary valve 25.
【００２５】一方、吸気経路におけるフィルタ１２に
は、孔の直径が０．２μｍ程度のメッシュフィルタ−が
用いられ、細菌類を完全に捕捉すると同時に、より大き
い煙粒子を捉え、排出ガスを清浄化することができる。On the other hand, as the filter 12 in the intake path, a mesh filter having a hole diameter of about 0.2 μm is used to completely capture bacteria and at the same time capture larger smoke particles to purify exhaust gas. can do.
【００２６】また、流量検出器１３と吸引ポンプ１４と
の間の管路には、第１吸引バルブ２８が設けられ、この
管路から分岐されて大気中に開口する分岐管路３０に
は、第２吸引バルブ２９が設けられている。そして、第
１吸引バルブ２８を開閉することにより排煙のオン・オ
フが制御できるようになっている。つまり、第２吸引バ
ルブ２９は、第１吸引バルブ２８と相補的に動作し、第
１吸引バルブ２８が開いて排煙している時には閉じ、第
１吸引バルブ２８が閉じると開いて大気に開放している
開口から空気を吸引する。この第２吸引バルブ２９は、
第１吸引バルブ２８を閉じると吸引ポンプ１４の騒音が
増大するので、この騒音を低減させるために設けられて
いる。A first suction valve 28 is provided in the conduit between the flow rate detector 13 and the suction pump 14, and a branch conduit 30 branching from this conduit opens into the atmosphere. A second suction valve 29 is provided. Then, by opening / closing the first suction valve 28, it is possible to control the on / off of the smoke exhaust. That is, the second suction valve 29 operates complementarily to the first suction valve 28, and is closed when the first suction valve 28 is open and smoke is discharged, and is opened when the first suction valve 28 is closed and opened to the atmosphere. Suction air through the opening. This second suction valve 29 is
Since the noise of the suction pump 14 increases when the first suction valve 28 is closed, it is provided to reduce this noise.
【００２７】なお、吸引ポンプ１４や上記各バルブは、
駆動回路３１を介して制御部１５に接続されている。The suction pump 14 and the above valves are
It is connected to the control unit 15 via the drive circuit 31.
【００２８】本実施例でも第１実施例と同様に、高速で
排煙を行って短時間で術野を回復しても、高速でＣＯ2
ガスが補充されて腹腔圧は設定値に維持される。In this embodiment, as in the first embodiment, even if smoke is discharged at high speed and the operative field is restored in a short time, CO 2 is discharged at high speed.
Gas is replenished to maintain the abdominal pressure at the set value.
【００２９】なお、第１及び第２吸引バルブ２８，２９
にはピンチバルブを用いてもよい。この場合、排煙経路
はピンチバルブで排煙チュ−ブの一部を挟んで開閉され
るので、吸引バルブ内が排煙に曝されないという長所が
あり、また、病院設備として建物内に備っている所謂
「壁吸引」や別途所有の吸引器等の吸引手段を選ばない
という利点もある。Incidentally, the first and second suction valves 28, 29
A pinch valve may be used for this. In this case, since the smoke exhaust path is opened and closed with a pinch valve sandwiching a part of the smoke exhaust tube, there is an advantage that the inside of the suction valve is not exposed to smoke exhaust. There is also an advantage that a so-called “wall suction” that is used or a suction device such as a separately owned suction device is not selected.
【００３０】また、第２実施例の吸引ポンプをオン・オ
フ制御するだけでなく、吸引力の制御が可能なポンプを
用いれば、第１及び第２の吸引バルブは省略してもよ
い。The first and second suction valves may be omitted if a pump capable of controlling the suction force in addition to the on / off control of the suction pump of the second embodiment is used.
【００３１】さらに、流量検出器はオリフィスとその両
端圧力の差を計測する手段で構成してもよい。また、送
気流量は２次減圧器の設定値を変えてもよく、同様に流
量制御器の制御値を変えてもよい。Further, the flow rate detector may be composed of an orifice and a means for measuring the difference between the pressures at both ends of the orifice. Further, the set value of the secondary pressure reducer may be changed for the air supply flow rate, and similarly, the control value of the flow rate controller may be changed.
【００３２】次に、第２実施例に係わる高速気腹装置の
他の制御方法について、図２を参照しながら説明する。Next, another control method of the high-speed pneumoperitoneum device according to the second embodiment will be described with reference to FIG.
【００３３】手術中に電気メスやレ−ザ−を使用すると
煙が発生する。そこで、術者がフットスイッチ１７を踏
むと、制御部１５は排煙動作を開始する。そして、バル
ブ６及び２次バルブ２１を開き、高流量経路を経由して
ＣＯ2 ガスが送気される。同時に、第１吸引バルブ２８
が開き、第２吸引バルブ２９が閉じ、ＣＯ2 ガスと共に
煙が吸引される。また、送気と吸引の開始と同時に、流
量検出器１３及び流量計２２がそれぞれ送気量、吸引量
を測定する。If an electric knife or laser is used during surgery, smoke will be generated. Therefore, when the operator steps on the foot switch 17, the control unit 15 starts the smoke discharging operation. Then, the valve 6 and the secondary valve 21 are opened, and CO 2 gas is sent through the high flow rate path. At the same time, the first suction valve 28
Is opened, the second suction valve 29 is closed, and smoke is sucked together with CO 2 gas. Simultaneously with the start of air supply and suction, the flow rate detector 13 and the flow meter 22 measure the air supply amount and the suction amount, respectively.
【００３４】この制御方法は、ここでもし吸引経路に詰
まり、チュ−ブ折れまたはチュ−ブ外れが発生し、吸引
経路にガスが流れない場合には、直ちに排煙動作を停止
し、通常の送気動作を行うように切換えることを特徴と
している。In this control method, if the suction passage is clogged, the tube is broken or the tube is disengaged, and the gas does not flow in the suction passage, the smoke exhausting operation is immediately stopped and the normal operation is performed. The feature is that switching is performed so as to perform an air feeding operation.
【００３５】また、この制御方法では、図３のタイムチ
ャ−トに示すように、送気と吸引の開始後、一定短時
間、例えば０．２５秒が経過後、送気と吸引を停止し、
圧力検知器５により腹腔圧を測定する。ここで、短時間
の送気と吸引を行うのは、送気流量と吸引流量の差を測
定し、これらの差に応じて、送気量と吸引量のバランス
のとれた送気と吸引時間を決定するためである。Further, in this control method, as shown in the time chart of FIG. 3, the air supply and the suction are stopped after a predetermined short time, for example, 0.25 seconds has elapsed after the start of the air supply and the suction.
The pressure detector 5 measures the abdominal pressure. Here, short-time air supply and suction is performed by measuring the difference between the air supply flow rate and the suction flow rate, and according to the difference, the air supply and suction time in which the air supply amount and the suction amount are balanced. This is to determine.
【００３６】吸引量が大きい場合には送気時間を長く、
また、送気量が大きい場合には吸引時間を長くして再び
送気と吸引を行う。それと同時に腹腔圧をモニタし、腹
腔圧が低下した場合には送気時間を長くして設定値を維
持する。一方、腹腔圧が設定値を越えた場合には送気時
間を短くする。When the suction amount is large, the air feeding time is long,
When the amount of air supplied is large, the suction time is lengthened and the air is supplied and sucked again. At the same time, the abdominal pressure is monitored, and when the abdominal pressure decreases, the air supply time is lengthened to maintain the set value. On the other hand, when the abdominal pressure exceeds the set value, the insufflation time is shortened.
【００３７】このように送気と吸引時間を調整するが、
いずれの時間も、ある一定値、例えば３秒を越えないよ
うに設定する。これは、長時間連続した送気と吸引を行
うと、腹腔過圧や腹腔圧減少による危険性が増すからで
ある。このような送気と吸引による排煙動作をフットス
イッチが踏まれている間、繰り返し行う。The air supply and suction times are adjusted in this way,
Any time is set so as not to exceed a certain fixed value, for example, 3 seconds. This is because performing continuous air supply and suction for a long time increases the risk of abdominal pressure or abdominal pressure reduction. The smoke exhausting operation by the air supply and the suction is repeatedly performed while the foot switch is depressed.
【００３８】この制御方法では、排煙を開始しても管路
の詰まりやチュ−ブの折れ等により、吸引量が上昇しな
い時は、直ちに排煙動作を停止して通常の送気動作を行
うので、より安全性が向上する。According to this control method, if the suction amount does not increase due to the clogging of the pipe line, the tube being broken, etc. even if the smoke emission is started, the smoke emission operation is immediately stopped and the normal air supply operation is performed. Because it does, the safety is improved.
【００３９】また、送気が間に合わず、排煙し過ぎによ
り腹腔圧が維持できない時は、排煙を停止し、腹腔圧の
回復を待って再度排煙動作を行うこともできる。If the abdominal pressure cannot be maintained because the air is not supplied in time and the smoke is exhausted too much, the smoke exhaust may be stopped, the abdominal pressure may be recovered, and the smoke exhaust operation may be performed again.
【００４０】図４は上記第２実施例の変形例を示し、こ
の変形例は第２実施例の構成を一部変更して具体化した
ものである。FIG. 4 shows a modification of the second embodiment, which is a modification of the second embodiment and is embodied.
【００４１】この変形例では、図４（ａ）に示すよう
に、設定値の異なる２つの２次減圧器２０，２４を通る
送気経路を３つの切換弁５０，５２，５４により切換え
ることにより、例えば１６■／ｍｉｎの高流量経路Ａ、
例えば８■／ｍｉｎの中流量経路Ｂ、例えば１■／ｍｉ
ｎの低流量経路Ｃのいずれにも接続できるようになって
いる。In this modification, as shown in FIG. 4 (a), by switching the air supply path passing through the two secondary pressure reducers 20, 24 having different set values by the three switching valves 50, 52, 54. , For example, a high flow rate path A of 16 ■ / min,
For example, a medium flow path B of 8 ■ / min, for example, 1 ■ / mi
It can be connected to any of the n low flow paths C.
【００４２】また、送気経路にはタンク５６を備えた２
つの別経路が設けられ、さらに、洗浄用コネクタ５８に
接続される洗浄経路も設けられている。この洗浄経路に
は、生理食塩水の入った容器６０とバルブ６２と２次減
圧器６４が設けられている。一方、図４（ｂ）に示す吸
引経路については、第１及び第２吸引バルブ２８，２９
が三方弁６６に置換えられているが、その他の構成は第
２実施例と同様である。A tank 56 is provided in the air supply path.
Three separate paths are provided, and a cleaning path connected to the cleaning connector 58 is also provided. A container 60 containing physiological saline, a valve 62, and a secondary decompressor 64 are provided in this cleaning path. On the other hand, regarding the suction path shown in FIG. 4B, the first and second suction valves 28, 29 are provided.
Is replaced with a three-way valve 66, but the other structure is the same as that of the second embodiment.
【００４３】本変形例では、３つの流量の異なる送気経
路Ａ，Ｂ，Ｃが設けられているので、より正確な流量調
整が可能となる。なお、その他の作用効果は上記第２実
施例と同様である。In this modified example, three air supply paths A, B, C having different flow rates are provided, so that more accurate flow rate adjustment is possible. The other operational effects are similar to those of the second embodiment.
【００４４】[0044]
【発明の効果】以上説明したように本発明の高速気腹装
置では、高速で排煙を行って短時間で腹腔内の視野を回
復させる場合でも、供給されるガスの流量が増して速や
かに補充され、また、腹腔圧を常に監視することにより
吸引量と送気量の少なくとも一方を制御し、常に排煙と
送気を均衡させながら腹腔圧を設定値に維持することが
できる。従って、安全に腹腔内の手術を行うことができ
る。As described above, according to the high-speed insufflation apparatus of the present invention, even when smoke is exhausted at high speed to restore the visual field in the abdominal cavity in a short time, the flow rate of the supplied gas is increased and the gas is rapidly supplied. It is replenished, and at least one of the suction amount and the air supply amount is controlled by constantly monitoring the abdominal pressure, and the abdominal pressure can be maintained at the set value while always balancing smoke emission and air supply. Therefore, it is possible to safely perform an intraperitoneal operation.
【図１】本発明の第１実施例に係わる高速気腹装置のブ
ロック図である。FIG. 1 is a block diagram of a high-speed pneumoperitoneum device according to a first embodiment of the present invention.
【図２】本発明の第２実施例に係わる高速気腹装置のブ
ロック図である。FIG. 2 is a block diagram of a high-speed pneumoperitoneum device according to a second embodiment of the present invention.
【図３】上記第２実施例に係わる高速気腹装置の他の制
御方法を示すタイミングチャ−トである。FIG. 3 is a timing chart showing another control method of the high-speed pneumoperitoneum device according to the second embodiment.
【図４】上記第２実施例の変形例を示す配管図である。FIG. 4 is a piping diagram showing a modified example of the second embodiment.
１…ガスボンベ（送気手段）、３…流量制御器（送気量
増加手段）、５…圧力検知器、１３…流量検出器（検知
手段、計測手段）、１４…吸引ポンプ（吸引手段）、１
５…制御部（制御手段）。DESCRIPTION OF SYMBOLS 1 ... Gas cylinder (air supply means), 3 ... Flow rate controller (air supply amount increasing means), 5 ... Pressure detector, 13 ... Flow rate detector (detection means, measuring means), 14 ... Suction pump (suction means), 1
5 ... Control unit (control means).
───────────────────────────────────────────────────── フロントページの続き (72)発明者 柳川 裕 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 (72)発明者 碓氷 健夫 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Yutaka Yanagawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Takeo Usui 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.
Claims (1)
と、腹腔内へ送気する送気手段と、前記吸引手段の吸引
開始を検知する検知手段と、煙の吸引量または吸引速度
を計測する計測手段と、吸引開始と同時に前記計測手段
の計測値に従って腹腔内への送気量を増加させる手段
と、腹腔圧を常に監視することにより吸引量と送気量の
少なくとも一方を制御し、吸引速度と送気速度を均衡さ
せる制御手段とを有し、腹腔圧を設定圧に維持すること
を特徴とする高速気腹装置。1. A suction means for sucking smoke generated in the abdominal cavity, an air feeding means for feeding air into the abdominal cavity, a detection means for detecting the suction start of the suction means, and a smoke suction amount or suction speed. Measuring means for measuring, means for increasing the insufflation amount into the abdominal cavity according to the measurement value of the insulting simultaneously with the start of suction, and controlling at least one of the inhalation amount and the insufflation amount by constantly monitoring the abdominal pressure. A high-speed pneumoperitoneum device having a control means for balancing the suction speed and the insufflation speed, and maintaining the abdominal pressure at a set pressure.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP13941392A JP3236067B2 (en) | 1992-05-29 | 1992-05-29 | Insufflation device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP13941392A JP3236067B2 (en) | 1992-05-29 | 1992-05-29 | Insufflation device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH05329164A true JPH05329164A (en) | 1993-12-14 |
| JP3236067B2 JP3236067B2 (en) | 2001-12-04 |
Family
ID=15244657
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP13941392A Expired - Fee Related JP3236067B2 (en) | 1992-05-29 | 1992-05-29 | Insufflation device |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP3236067B2 (en) |
Cited By (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006043130A (en) * | 2004-08-04 | 2006-02-16 | Olympus Corp | Endoscope system |
| JP2006181108A (en) * | 2004-12-27 | 2006-07-13 | Olympus Corp | Gas insufflator |
| JP2009534092A (en) * | 2006-04-20 | 2009-09-24 | アイ．シー． メディカル， インコーポレイテッド | Automatic smoke evacuator and air delivery system for surgical procedures |
| JP2014523268A (en) * | 2011-05-27 | 2014-09-11 | アレクサンダー ヘッツェル | Laparoscopic surgical device |
| WO2015019695A1 (en) * | 2013-08-06 | 2015-02-12 | オリンパスメディカルシステムズ株式会社 | Pneumoperitoneum apparatus |
| CN108634999A (en) * | 2018-07-16 | 2018-10-12 | 鹰利视医疗科技有限公司 | A kind of pneumoperitoneum apparatus with smoke removing function |
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| WO2019187189A1 (en) * | 2018-03-26 | 2019-10-03 | オリンパス株式会社 | Pneumoperitoneum device |
| JP2020512924A (en) * | 2017-04-10 | 2020-04-30 | ユー．エス． パテント イノベーションズ エルエルシーＵ．Ｓ． Ｐａｔｅｎｔ Ｉｎｎｏｖａｔｉｏｎｓ Ｌｌｃ | Electrosurgical gas control module |
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1992
- 1992-05-29 JP JP13941392A patent/JP3236067B2/en not_active Expired - Fee Related
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006043130A (en) * | 2004-08-04 | 2006-02-16 | Olympus Corp | Endoscope system |
| JP2006181108A (en) * | 2004-12-27 | 2006-07-13 | Olympus Corp | Gas insufflator |
| JP2009534092A (en) * | 2006-04-20 | 2009-09-24 | アイ．シー． メディカル， インコーポレイテッド | Automatic smoke evacuator and air delivery system for surgical procedures |
| JP2012139519A (en) * | 2006-04-20 | 2012-07-26 | Ic Medical Inc | Automatic smoke evacuator and insufflation system for surgical procedures |
| JP2014523268A (en) * | 2011-05-27 | 2014-09-11 | アレクサンダー ヘッツェル | Laparoscopic surgical device |
| EP3009077A4 (en) * | 2013-08-06 | 2017-02-15 | Olympus Corporation | Pneumoperitoneum apparatus |
| JP5830625B2 (en) * | 2013-08-06 | 2015-12-09 | オリンパス株式会社 | Pneumoperitoneum |
| CN105431093A (en) * | 2013-08-06 | 2016-03-23 | 奥林巴斯株式会社 | Pneumoperitoneum apparatus |
| WO2015019695A1 (en) * | 2013-08-06 | 2015-02-12 | オリンパスメディカルシステムズ株式会社 | Pneumoperitoneum apparatus |
| JP2021121341A (en) * | 2016-11-14 | 2021-08-26 | コンメッド コーポレーション | Multimodal surgical gas delivery system configured to maintain stable body cavity pressure when suction is used in body cavity |
| JP2020512924A (en) * | 2017-04-10 | 2020-04-30 | ユー．エス． パテント イノベーションズ エルエルシーＵ．Ｓ． Ｐａｔｅｎｔ Ｉｎｎｏｖａｔｉｏｎｓ Ｌｌｃ | Electrosurgical gas control module |
| WO2019187189A1 (en) * | 2018-03-26 | 2019-10-03 | オリンパス株式会社 | Pneumoperitoneum device |
| JPWO2019187189A1 (en) * | 2018-03-26 | 2021-02-12 | オリンパス株式会社 | How to adjust pneumoperitoneum and body cavity pressure |
| US11534561B2 (en) | 2018-03-26 | 2022-12-27 | Olympus Corporation | Insufflation device and method of adjusting intra-abdominal pressure |
| CN108634999A (en) * | 2018-07-16 | 2018-10-12 | 鹰利视医疗科技有限公司 | A kind of pneumoperitoneum apparatus with smoke removing function |
| CN108634999B (en) * | 2018-07-16 | 2023-08-11 | 鹰利视医疗科技有限公司 | Pneumoperitoneum machine with smoke removing function |
| CN109077757A (en) * | 2018-09-15 | 2018-12-25 | 山西省人民医院 | A kind of pneumoperitoneum control device and method that endoscope-assistant surgery uses |
| CN109077757B (en) * | 2018-09-15 | 2020-07-14 | 山西省人民医院 | Pneumoperitoneum control device and method for endoscopic surgery |
| WO2021240976A1 (en) | 2020-05-26 | 2021-12-02 | 忠明 江藤 | Gas-discharging device and gas-discharging system |
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