JPH06121768A - Medical auxiliary inserting tool - Google Patents

Abstract

PURPOSE:To provide a medical auxiliary inserting tool which can dispense with a casing to house an airtight valve in an airtight condition and by which assembling workability and cleaning ability can be improved in a simple structure. CONSTITUTION:An elastic valve seat 15 having an inserting hole 14 an inserting apparatus is inserted and an airtight valve 10 to open and close the inserting hole 14 of this elastic valve seat 15 are arranged in a base part 4 of an overcoat pipe 2 to insert and guide the inserting apparatus, and this airtight valve 10 is opened and closed outside of the elastic valve seat 15, and is arranged so as to be connected to/disconnected from the base part 4 of the overcoat pipe 2.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical insertion aid for inserting and guiding an insertion instrument such as a laparoscope or a treatment instrument that is percutaneously inserted into a body cavity.

[0002]

2. Description of the Related Art In recent years, surgery such as excision of the gallbladder under a laparoscope has been performed using a medical insertion aid (hereinafter referred to as a trocar). For example, Japanese Patent Laid-Open No. 2-20
As shown in Japanese Patent No. 6422, a trocar is composed of an inner needle and an outer tube, and an airtight holding member for keeping airtightness in the abdominal cavity is provided at the proximal portion of the outer tube.

In laparoscopic surgery, the abdominal wall is insufflated using a pneumoperitoneum needle. The outer tube of the trocar is inserted into the abdominal wall with the inner needle loaded and left there. 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. In addition, an elastic seal member is provided at the proximal portion of the trocar to prevent gas from escaping from the abdominal wall through the outer tube of the trocar.

The insertion portion of the laparoscope or the treatment instrument is hermetically inserted through the insertion hole of the elastic seal member. Also,
An airtight valve and a casing for accommodating the airtight valve are provided between the elastic seal member and the insertion portion of the outer tube in order to maintain airtightness when the laparoscope or the like is not inserted in the trocar outer tube.

[0005]

As described above, the conventional casing is large in size because it requires a space in which the airtight valve can be opened and closed. Also, a lever for manually opening and closing the airtight valve is provided on the outer surface of the casing, but since it is necessary to keep the airtightness of the connection between the lever and the airtight valve inside the casing, The structure of the airtight valve was complicated. Further, when the structure is complicated in this way, there are problems that the assembling becomes difficult and the cleaning property is poor.

The present invention has been made in view of the above circumstances, and an object thereof is to provide a medical insertion aid having a structurally simple structure and excellent in assemblability and cleanability.

[0007]

In order to achieve the above-mentioned object, the present invention has an elastic valve seat having an insertion hole for inserting an insertion instrument in the proximal portion of a mantle tube for inserting and guiding the insertion instrument, and this elasticity. In a medical insertion aid having an airtight valve that opens and closes an insertion hole of a valve seat, an airtight valve that opens and closes the insertion hole is provided outside the elastic valve seat.

When the airtight valve for opening and closing the insertion hole is provided on the outer side of the elastic valve seat, it is not necessary to provide a casing for accommodating the airtight valve at the proximal portion of the outer tube, and the elastic valve seat and the airtight valve are located outside. Therefore, the assembling and the cleaning can be facilitated.

[0009]

Embodiments of the present invention will be described below with reference to the drawings.

1 and 2 show a first embodiment of a trocar 1 as a medical insertion aid. The outer tube 2 of the trocar 1 is formed of a metal tube, a flexible portion 3 is provided at the tip end thereof, and a base portion 4 is provided at the proximal end of the outer tube 2.

A screw portion 5 is provided on the outer peripheral surface of the base portion 4, and a flange 6 is detachably screwed to the screw portion 5. A projecting portion 7 projecting upward is provided on a part of the flange 6.
An airtight valve 10 having a lever 9 is rotatably supported by a pivot pin 8 on the protrusion 7.

A torsion spring 11 is wound around the pivot pin 8, one end of the torsion spring 11 is inserted and fixed to the flange 6, and the other end abuts against the back surface of the airtight valve 10 and the airtight valve 10 is attached.
Is urged in the valve closing direction.

The through hole 12 of the base 4 is formed with a tapered surface 12a on the opening end side. Further, an elastic valve seat 15 having an insertion hole 14 into which the insertion portion 13a of the endoscope 13 can be inserted in an airtight state is attached to an end portion of the base portion 4. The elastic valve seat 15 is formed of an elastic member such as rubber, and the insertion hole 14 is hermetically closed by being joined to the airtight valve 10.

Next, the operation of the trocar 1 constructed as described above will be described. When the operator pushes down the lever 9 with a finger, the airtight valve 10 pivots outward around the pivot pin 8, and the airtight valve 10 separates from the elastic valve seat 15 and the insertion hole 14
Opens. Although not shown, an inner needle is inserted into the outer tube 2 and punctured into the abdominal cavity that is insufflated in the same manner as the normal trocar 1.
When the inner needle is removed and the lever 9 is released, the airtight valve 10 contacts the elastic valve seat 15 by the biasing force of the torsion spring 11, and the insertion hole 14 is closed in an airtight state.

Then, similarly to the insertion of the inner needle, the lever 9 is pushed down, the airtight valve 10 is rotated, and the insertion portion 13a of the endoscope 13 is inserted with the insertion hole 14 opened. In this case, the inner peripheral surface of the insertion hole 14 is kept in close contact with the outer peripheral surface of the insertion portion 13a in an airtight state, and it is possible to prevent the pneumoperitoneum gas from leaking to the outside.

When the observation and treatment with the endoscope 13 are completed, the lever 9 is operated again to open the airtight valve 10, the insertion portion 13a is removed, and the lever 9 is released. The elastic force is applied to the elastic valve seat 15 to close the insertion hole 14 and keep the airtight state.

When the trocar 1 is washed after observation and treatment, the airtight valve 10 can be removed from the base 4 by removing the flange 6 from the base 4,
Ultrasonic cleaning can be performed with the trocar 1 and the airtight valve 10 separated.

As described above, since the airtight valve 10 opens in front of the operator, that is, in the direction in which the endoscope 13 is pulled out, the outer tube 2
Even if the endoscope 13 is inadvertently pulled out from the inside, the end portion of the airtight valve 10 rarely scratches the insertion portion 13a of the endoscope 13. Further, since the distal end portion of the outer tube 2 is the soft portion 3, even if the endoscope with a curved tip is inserted, the distal end of the outer tube 2 does not damage the curved portion of the endoscope and the handling is easy. Is.

FIG. 3 shows a second embodiment, and 16 is a protective tube which can be inserted into the trocar 1. The protection tube 16 has an outer tube 17 longer than the entire length of the trocar 1. An airtight valve 10 similar to that of the first embodiment is provided in the mouthpiece portion 4 at the proximal portion of the outer tube 17, and the flexible portion 1 is provided at the tip.
8 are provided. Reference numeral 19 is a trocar 1 valve.

Therefore, like the normal trocar 1, the abdominal cavity is punctured. After removing the inner needle, the protection tube 16 is inserted into the trocar 1. Protection tube 16
When the base portion 4 of the trocar 1 is inserted until it comes into contact with the base end portion of the trocar 1, the flexible portion 18 at the tip of the outer tube 17 is inserted into the trocar 1.
Protrudes from the tip of. In this state, the protection tube 16
The insertion portion 22 of the endoscope 21 having the curved portion 20 at the distal end thereof
Even if is inserted, the bending portion 20 does not interfere with the tip of the trocar 1, and the bending portion 20 can be prevented from being damaged.

[0021]

As described above, according to the present invention, by providing the airtight valve on the outside of the elastic valve seat provided at the proximal portion of the outer tube, the casing for housing the airtight valve in an airtight state becomes unnecessary. In addition, the structure is simple, and the assembling workability and the cleaning performance can be improved.

[Brief description of drawings]

FIG. 1 is a vertical sectional side view of a trocar according to a first embodiment of the present invention.

FIG. 2 is a vertical cross-sectional side view showing a state in which an insertion portion of the endoscope is inserted in the trocar of the embodiment.

FIG. 3 is a perspective view of a trocar according to a second embodiment of the present invention in use.

[Explanation of symbols]

1 ... trocar, 2 ... outer tube, 10 ... airtight valve, 14 ... insertion hole, 15 ... elastic valve seat.

Claims (1)

[Claims] 1. A medical insertion aid provided with an elastic valve seat having an insertion hole for inserting the insertion instrument in a proximal portion of a mantle tube for guiding insertion of the insertion instrument, and an airtight valve for opening and closing the insertion hole of the elastic valve cushion. A medical insertion assisting tool, wherein an airtight valve for opening and closing the insertion hole is provided outside the elastic valve seat.