JPH06254042A - Insertion assisting means for medical treatment - Google Patents

Abstract

PURPOSE:To provide the insertion assisting means for medical treatment with a hermetic valve which can suppress the friction force on the outside surface of an insertion means for medical treatment. CONSTITUTION:This is insertion assisting means 1 for medical treatment provided with an elastic valve seat 7 having an introducing port 6 for introducing the insertion means 5 for medical treatment into a sleeve pipe 2 and the hermetic valve 9 for opening and closing this introducing port 6 in a hermetic state is provided with at least a rotating means 12 for rotating the insertion means 5 for medical treatment in the direction where the insertion means 5 for medical treatment is inserted and removed in the part of the hermetic valve in contact with the insertion means 5 for medical treatment at the time of inserting and removing the insertion means 5 for medical treatment.

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 guiding a medical insertion tool into a body cavity in an airtight state.

[0002]

2. Description of the Related Art In a recent laparoscopic surgery using a medical insertion aid (so-called trocar), first, the abdominal cavity to be treated is insufflated, and then the abdominal cavity is loaded with an inner needle. Insert the mantle of the trocar. After that, the inner needle is removed from the outer tube, and instead, for example, an endoscope as a medical insertion tool is inserted into the outer tube and introduced into the abdominal cavity.
In order to prevent gas from escaping from the abdominal cavity through the outer tube of the trocar at the time of this introduction, an elastic seal member having an inlet for introducing the endoscope into the outer tube is provided at the proximal portion of the trocar. .

Similarly, at the base of the trocar,
An airtight valve that can come into airtight contact with the elastic seal member as a valve seat is provided. This airtight valve prevents gas from coming out of the abdominal cavity through the mantle tube by making airtight contact with the endoscope when introducing the endoscope into the mantle tube, and when not introducing the endoscope into the mantle tube. The airtight contact with the elastic seal member closes the inlet of the elastic seal member.

In this structure, the airtight valve is biased by the spring member in the direction of closing the introduction port of the elastic seal member. Therefore, when the endoscope is introduced into the outer tube, the endoscope pushes the airtight valve against the urging force of the spring member, and in this state, the endoscope is inserted into the outer tube. Then, the angular contact surface of the airtight valve is strongly pressed against the outer surface of the endoscope by the biasing force of the spring member. This is also the case when the endoscope is removed from the mantle tube. That is, when the endoscope is inserted into or removed from the outer tube, a large frictional force acts between the contact surface of the airtight valve and the outer surface of the endoscope. Although the influence of this frictional force is small in a conventional rigid endoscope, in an endoscope having a flexible bending portion that is driven to bend, the bending portion is damaged by this frictional force, and as a result, the endoscope is Could leak water.

Therefore, as a countermeasure against such a situation, in US Pat. No. 4,233,982, the airtight valve is formed in a ball shape, and a contact surface between the endoscope and the airtight valve (hereinafter referred to as a ball valve) is smooth. I have to.

[0006]

However, US Pat. No. 4
No. 233,982 has a force generated by the spring member which is equal to that of the outer surface of the endoscope like the airtight valve having the above-mentioned angular contact surface.
Although it does not concentrate on the points, the outer surface of the endoscope and the ball valve eventually come into contact with each other over a wider surface, so that the biasing force of the spring member causes a wide area between the ball valve and the outer surface of the endoscope. It will act on the contact surface. Therefore, in a stationary state where the endoscope is simply inserted into the outer tube of the trocar, the contact pressure of the ball valve due to the spring member does not affect the endoscope so much, but the endoscope does not contact the outer tube. When you insert and remove
A large frictional force is generated on the wide contact surface between the ball valve and the outer surface of the endoscope.

Further, since the ball valve does not move except in the direction of opening and closing the inlet of the elastic seal member, the outer surface of the endoscope is always rubbed in the inserting / removing direction by the frictional force with the ball valve, and as a result, There is a risk that the particularly flexible curved portion of the endoscope may be damaged.

The present invention has been made in view of the above circumstances, and an object thereof is to provide a medical insertion assisting tool having an airtight valve capable of suppressing the frictional force to the outer surface of the medical insertion tool as much as possible. To provide.

[0009]

In order to solve the above problems, the present invention provides an elastic valve seat having an introduction port for introducing a medical insertion tool into an outer tube, and the introduction port in an airtight state. In a medical insertion aid provided with an airtight valve that opens and closes, at least the insertion / removal direction of the medical insertion tool at the site of the airtight valve that contacts the medical insertion tool when the medical insertion tool is inserted or removed. It is provided with a rotating means for rotating.
As a result, the frictional force generated between the airtight valve and the outer surface of the medical insertion tool becomes extremely small.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 shows a first embodiment of the present invention. As shown in (a) of FIG. 1, a trocar 1 as a medical insertion aid of the present embodiment is a guide tube for guiding an endoscope 5 (see (c) of FIG. 1) which is a medical insertion tool. Box-shaped casing part 2 adhered and fixed to the base ends of 2a and the guide tube 2a
It is configured by arranging an airtight valve 9 in the casing portion 2b of the outer tube 2 formed by b. A flexible tube 3 is connected and fixed to the tip of the guide tube 2a.

An opening 4 is provided at the base end surface of the casing portion 2b so as to communicate with the outer tube 2. The opening 4 serves as a valve seat having an inlet 6 through which an endoscope 5 can be inserted in an airtight state. A substantially ring-shaped elastic member 7 is fitted. The inner surface of the elastic member 7 forming the introduction port 6 is formed in a tapered shape, and the inner diameter thereof gradually decreases toward the inside. The inner surface of the inner end of the elastic member 7 forming the minimum diameter portion can be brought into airtight contact with the outer surface of the endoscope 5 inserted through the introduction port 6.

The airtight valve 9 provided inside the casing portion 2b is rotatably supported at one end by a first shaft member 8 which is attached and fixed to the casing portion 2b.
A spring member 10 is arranged around the first shaft member 8. One end of the spring member 10 abuts on the inner wall 30 of the casing portion 2b, and the other end of the spring member 10 abuts on the back surface 9a of the airtight valve 9 to urge the airtight valve 9 against the elastic member 7. ing.

A convex portion 11 is provided on the surface of the airtight valve 9 which receives the biasing force of the spring member 10. The convex portion 11 is always in contact with the elastic member 7 in the airtight state by the biasing force of the spring member 10. ing.

A second shaft member 12 is provided at the free end of the airtight valve 9 in parallel with the first shaft member 8. A cylindrical member 13 is rotatably supported on the second shaft member 12 in a state capable of abutting on the outer surface of the endoscope 5 introduced into the outer tube 2 through the introduction port 6.

Next, the operation of the trocar 1 having the above structure will be described. First, the operator inserts an inner needle (not shown) into the introduction port 6
When inserted from, the airtight valve 9 is pushed by this inner needle and pivots around the first shaft member 8 toward the tip side of the trocar 1. When the inner needle is further inserted, the outer peripheral surface of the inner needle contacts the cylindrical member 13, and the cylindrical member 13 rotates about the second shaft member 12 as the inner needle is inserted.

Then, the trocar 1 with the inner needle inserted is punctured into the abdominal cavity. After that, when the inner needle is removed from the trocar 1, the airtight valve 9 is reversed to the inlet 6 side by the biasing force of the spring member 10 and abuts the elastic member 7 again, and the inlet 6 becomes airtight. Next, as shown in FIG. 1C, the endoscope is inserted into the outer tube 2 through the introduction port 6 in the same manner as the inner needle. With the endoscope 5 thus inserted,
Similar to when the inner needle is inserted / removed, for example, the outer peripheral surface 5a of the distal end curved portion of the endoscope 5 and the cylindrical member 13 are in contact with each other, and the cylindrical member 13 is attached to the shaft member 12 as the endoscope 5 is inserted / removed. Rotate around.

As described above, in the trocar 1 having the above-described structure, the cylindrical member 13 of the airtight valve 9 that contacts the outer peripheral surface of the endoscope 5 rotates when the endoscope 5 is inserted or removed, as the endoscope 5 moves forward or backward. In other words, since the endoscope 5 and the airtight valve 9 are in contact with each other in a rotating state, the friction between the outer peripheral surface of the endoscope 5 and the airtight valve 9 is small, and the airtight valve 9 and the endoscope 5 have a small friction. It is possible to avoid a situation where the outer surface rubs against each other and the outer peripheral surface 5a of the flexible tip curved portion is damaged.

FIG. 2 shows a second embodiment of the present invention. In this embodiment, the convex portion 1 provided on the surface of the airtight valve 9
A concave portion 14 having a depth equal to or larger than the radius of the cylindrical member 13 is provided at the apex portion of 1. A cylindrical member 13 supported by a shaft member 12 fixed to the convex portion 11 is rotatably provided in the concave portion 14. This cylindrical member 13 is
The convex portion 11 has a diameter and an axial length that are within the diameter of the introduction port 6 in a state of being in contact with the elastic member 7. The rest of the configuration is the same as in the first embodiment.

In this structure, since the endoscope 5 and the cylindrical member 13 are in contact with each other from the time when the endoscope 5 is inserted into the outer tube 2 through the introduction port 6, the endoscope 5 is attached to the distal end surface of the endoscope 5. Also, damage by the airtight valve 9 can be prevented.

FIG. 3 shows a third embodiment of the present invention. In this embodiment, a holding member 16 formed in a shape that can be fitted to the inner surface of the recess 14 is fixed to the recess 14 of the airtight valve 9 of the second embodiment by screws or adhesives, and the inside of the holding member 16 is fixed. The airtight valve 9 is configured by arranging the spherical member 15 rotatably in the.

The outer portion of the inner surface of the pressing member 16 has a taper portion 16a formed in a tapered shape so that the inner diameter of the pressing member 16 gradually becomes smaller toward the outer side (the surface side of the convex portion 11). Has become. The spherical member 15 arranged inside the pressing member 16 has a diameter substantially the same as the axial length of the pressing member 16 and has a diameter larger than the minimum diameter of the taper portion 16a, thus ensuring a rotatable state. While recessing 14
It does not fall out of the room. The rest of the configuration is the same as in the second embodiment. With this configuration as well, it is possible to obtain the same effects as those of the above-described respective embodiments.

FIG. 4 shows a fourth embodiment of the present invention. The trocar 17 of this embodiment is a trumpet valve trocar having a trumpet-shaped outer shape. Figure 4
As shown in (a) of FIG.
A guide tube 2a for guiding the endoscope 5 and a valve tube 2c integrally formed on the proximal side of the guide tube 2a so as to intersect with the guide tube 2a. A trumpet valve type airtight valve 19 is slidably accommodated in the valve tube 2c.

A button 21 is provided at one end of the trumpet valve type airtight valve 19. Further, one end of a compression spring 22 is attached to the other end of the trumpet valve type airtight valve 19. The other end of the compression spring 22 is in contact with the inner wall 31 on one end side of the valve pipe 2c, and the compression spring 22 is urged in a state in which the trumpet valve type airtight valve 19 is abutted against the inner wall 32 on the other end side of the valve pipe 2c. is doing.

Body 2 of the trumpet valve type airtight valve 19
3 is provided with an opening 24 through which the endoscope 5 can be inserted.
Then, the trumpet valve type airtight valve 19 has an inner wall 32 on the other end side of the valve tube 2c by the urging force of the compression spring 22.
In the standby state, the body portion 23 closes the conduit of the guide tube 2a in an airtight state, and when the button 21 is pushed in, the opening 14 of the guide tube 2a opens. The introduction port 6 and the guide tube 2a are communicated with each other so as to coincide with the pipeline, and the introduction port 6 is opened with respect to the guide tube 2a.

A cylindrical member 13 is rotatably provided on the inner wall of the opening 24 on the compression spring 22 side by the shaft member 12. Further, the introduction port 6 of the elastic member 7 has an inner diameter such that the inner surface of the elastic member 7 forming the introduction port 6 can come into contact with the outer surface of the endoscope 5 inserted through the introduction port 6 in an airtight state.

Next, the operation of the trocar 17 having the above structure will be described. First, as shown in FIG. 4 (c), the endoscope 5 is pushed with the button 21 pushed in so that the opening 24 of the airtight valve 19 of the rumpet valve is aligned with the guide tube 2a.
Is introduced into the outer tube 2 through the introduction port 6. When the finger is released from the button 21, the trumpet valve type airtight valve 19 receives the biasing force of the compression spring 22 and tries to move in the direction of closing the guide tube 2a. Therefore, the cylindrical member 13 provided in the opening 24 of the trumpet valve type airtight valve 19 presses against the outer surface of the endoscope 5. When the endoscope 5 is inserted and removed in this state, the cylindrical member 13 pressed against the endoscope 5 rotates around the shaft member 12 as the endoscope 5 moves.

FIG. 5 shows a fifth embodiment of the present invention. The trocar of this embodiment is different only in the configuration of the trumpet valve type airtight valve 19 in the fourth embodiment,
The other structure is the same as that of the fourth embodiment. As shown in the figure, a ring-shaped pressing member 16 is fixed to the opening 24 of the trumpet valve type airtight valve 19 by screws or adhesion.

A taper portion 16a is provided on the outer side of the inner surface of the pressing member 16 so that the inner diameter of the pressing member 16 gradually decreases toward the outer side (the surface side of the convex portion 11). In addition, inside the pressing member 16, the pressing member 1
6 has a diameter substantially the same as the axial length of 6 and has a tapered portion 16a.
A sphere member 15 having a diameter larger than the minimum diameter is rotatably provided. With this configuration, the same operational effect as that of the fourth embodiment can be obtained.

FIG. 6 shows a sixth embodiment of the present invention. The trocar 40 of this embodiment includes the outer tube 2 having the same structure as that of the first embodiment. A shaft member 8 is provided inside the casing 2 b, and a spring member 10 is arranged around the shaft member 8. One end of the spring member 10 is in contact with the inner wall 30 of the casing portion 2b. A ball member 15 is arranged at the other end of the spring member 10 so as to be rotatable and contact the elastic member 7 in an airtight state by the biasing force of the spring member 10.

In the above structure, first, when the operator inserts an inner needle (not shown) through the introduction port 6, the spherical member 15 pushed by the inner needle counters the biasing force of the spring member 10 and the trocar 40.
Move to the tip side of. Further, at this time, the spherical member 15 rotates in accordance with the movement of the pressing inner needle. Trocar 4
When the inner needle is removed after puncturing 0 into the abdominal cavity, the ball member 15
Is again brought into contact with the elastic member 7 in an airtight state by the biasing force of the spring member 10. Next, similarly to the inner needle, the endoscope is inserted into the outer tube 2 through the introduction port 6. As in the case of inserting and removing the inner needle, when the endoscope 5 is inserted, the curved outer peripheral surface 5a of the endoscope 5 and the spherical member 15 are in contact with each other by the biasing force of the spring member 10. A ball member 15 along with the insertion / removal operation of the mirror 5
Rotates. In this configuration, the spherical member 15 that presses against the outer circumference of the endoscope 5 also serves as an airtight valve, so that the structure is simple and easy to assemble.

When a flexible endoscope is percutaneously inserted into the common bile duct or the like, the insertion portion is weak, and the distal end of the flexible endoscope may be directly pressed against the hole formed in the common bile duct for insertion. Because it is difficult, the operator pushes the flexible endoscope into the common bile duct while grasping the tip of the flexible endoscope with the metal grasping tool, but at this time, the curved portion of the tip of the flexible endoscope is broken by the metal grasping tool. In order to prevent this from happening, it is advisable to provide a metal portion that can be gripped by the gripping tool in the middle of the curved portion.

[0032]

As described above, in the medical insertion assisting tool of the present invention, when the medical insertion tool is inserted and removed, the medical insertion tool and the airtight valve come into contact with each other in a rotating state. The frictional force generated between the medical insert and the outer surface is minimized.
Therefore, the medical insertion tool is not damaged by friction with the airtight valve. As a result, the operator does not have to be careful when inserting / removing the medical insertion tool into / from the medical insertion aid, which allows the operator to concentrate on the operation and is safe for the patient.

[Brief description of drawings]

1A is a sectional view of a trocar showing a first embodiment of the present invention, FIG. 1B is a perspective view of an airtight valve provided in the trocar of FIG. 1A, and FIG. It is sectional drawing which shows a mode that an endoscope is penetrated in a trocar.

2A is a plan view of an airtight valve provided in a trocar according to a second embodiment of the present invention, and FIG. 2B is a side sectional view of the airtight valve of FIG. 2A.

FIG. 3 is a side sectional view of an airtight valve provided in a trocar showing a third embodiment of the present invention.

4A is a cross-sectional view of a trocar showing a fourth embodiment of the present invention, FIG. 4B is a perspective view of an airtight valve provided on the trocar of FIG. 4A, and FIG. It is sectional drawing which shows a mode that an endoscope is penetrated in a trocar.

5A is a side sectional view of an airtight valve provided in a trocar according to a fifth embodiment of the present invention, and FIG. 5B is a perspective view of the airtight valve of FIG.

FIG. 6A is a sectional view of a trocar showing a sixth embodiment of the present invention, and FIG. 6B is a sectional view showing how an endoscope is inserted into the trocar of FIG.

[Explanation of symbols]

1, 17, 40 ... trocar (medical insertion aid), 2
... Outer tube, 5 ... Endoscope (medical insert), 7 ... Elastic member (elastic valve seat), 9, 15, 19 ... Airtight valve, 13 ... Cylindrical member (rotating means), 15 ... Ball member (rotating) means).

Claims (1)

[Claims] 1. A medical insertion aid comprising an elastic valve seat having an inlet for introducing the medical insert into the outer tube and an airtight valve for opening and closing the inlet in an airtight state, wherein A medical insertion assisting tool, wherein at least a rotating means for rotating in the insertion / removal direction of the medical insertion tool is provided at a portion of the airtight valve that comes into contact with the medical insertion tool when inserting / removing the insertion tool. .