JPH07178108A - Trocar tube - Google Patents

Abstract

PURPOSE:To provide a flexible trocar tube into which any curved instrument can be inserted, and having the tip which is not curled or crushed when inserted into the body wall. CONSTITUTION:A trocar tube comprises a tubular member 2 and a handy part 3, and the tubular member 2 comprises a main part 4 and a tip part 5. The main part 4 comprises a flexible member 6 and a stiffener 8 buried in the flexible member 6, and has a high longitudinal stiffness and flexibility. The tip part 5 comprises a hard member 7 joined to the flexible member 6 so as to have a resistance to compression at least in the longitudinal direction. The tip part 5 is tapered in outside diameter toward the tip so as to be easily inserted into the body cavity.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a trocar tube (trocar) used for inserting and removing surgical instruments such as an endoscope, forceps, and an electric scalpel into and from a body cavity during a body cavity endoscopic surgery.

[0002]

2. Description of the Related Art A trocar is a surgical instrument used to puncture a body wall and insert a surgical instrument such as an endoscope, forceps, and an electric scalpel into a body cavity. It consists of an obturator with a sharp tip. When using,
With the obturator inserted in the trocar tube, the tip of the obturator penetrates the body wall and punctures into the body cavity, and then only the obturator is removed leaving the trocar tube. This makes it possible to insert and remove an endoscope, forceps, electric knife, gas and the like into and from the body cavity.

Conventionally, this type of trocar tube has been constructed of a material having high rigidity and hardness such as metal such as stainless steel or hard plastic resin. However, in the trocar tube made of such a material, the instrument that can pass through the trocar tube is limited to the rod-shaped instrument having a diameter equal to or smaller than the inner diameter dimension of the trocar tube.

On the other hand, there has been considered a soft trocar tube which is made of a flexible material and is capable of passing a curved instrument, an instrument having a large-diameter joint, etc. 5-200041). This trocar tube has a reinforcing spring incorporated therein with a tightly wound coil, and is reinforced against kinking, crushing, shrinkage, and the like due to external force.

[0005]

However, in the soft trocar tube as described above, the wall thickness must be increased to some extent in order to obtain a certain degree of strength, and a considerable resistance is required when it is inserted into a body wall. Therefore, there is a problem that it hinders puncture. Further, in order to reduce this resistance, it is conceivable that the tip of the trocar tube is tapered so that the diameter becomes smaller (thinner) toward the tip. However, since the soft material is used, there is a problem in that the tip portion shrinks or curls. That is, the pressure applied from the body wall during puncture is applied in the longitudinal direction of the trocar tube,
In a trocar tube made of a soft material, the tip end thereof bends due to a force applied in the longitudinal direction, contracts without maintaining its rigid state, and is further curled.

The present invention has been made in view of such conventional problems, and an object of the present invention is to provide a trocar tube that maintains the flexibility of the tube and is easy to puncture.

[0007]

The above object is achieved by the present invention described in (1) below. Further, the following (2) to (10) are preferable.

(1) A trocar tube having a tubular member and a proximal portion connected to a proximal end of the tubular member, wherein the tubular member has at least a flexible main portion having high rigidity in a longitudinal direction, A trocar tube comprising: a tip portion having a compression resistance in a longitudinal direction.

(2) The trocar tube according to (1), wherein the tip portion has a diameter reduced toward the tip.

(3) The above-mentioned (1) or (2), wherein a spiral groove or protrusion is formed on the outer surface of the tip portion.
The trocar tube described in.

(4) The trocar tube according to any one of (1) to (3), wherein the inner surface and / or the outer surface of the tubular portion is lubricated.

(5) The trocar tube according to any one of the above (1) to (4), wherein the main portion is reinforced with a reinforcing material.

(6) The trocar tube according to the above (5), wherein a base end portion of the tip end portion is formed to be inclined outward and extends to a tip end position of the reinforcing member.

(7) The trocar tube according to any one of the above (1) to (6), wherein the tip portion is composed of a hard member joined to the main portion.

(8) The trocar tube according to any one of (1) to (6), wherein the main portion and the tip portion are integrally molded.

(9) The trocar tube according to any one of the above (1) to (6), wherein the tip portion is formed by arranging a coil body which is closely wound.

(10) A trocar tube assembly comprising the trocar tube according to any one of (1) to (9) above and a plug inserted into the trocar tube and inserted into a body cavity. A trocar tube assembly, wherein the tip portion of the trocar tube is tapered when the trocar tube is inserted into the trocar tube.

[0018]

In the trocar tube of the present invention, the main part of the tubular member is a flexible one having a high rigidity in the longitudinal direction, and is provided with a tip end portion having an anti-compression property in at least the longitudinal direction. Therefore, the main part of the tubular member can be deformed according to the shape of the device through which it passes, and the device can be easily taken in and out. On the other hand, the pressure received from the body wall at the time of puncturing is applied to the distal end portion of the tubular member in the longitudinal direction thereof, but the distal end portion has an anti-compression property with respect to the longitudinal direction, and should be deformed by contracting to this force. There is no. Therefore, even if the pressure from the body wall that is received during puncture is applied, the tip may be curled,
It can be reliably inserted into a body cavity without shrinking.

Further, by reducing the diameter of the tip portion toward the tip, puncture resistance is reduced. Further, by lubricating the inner surface and / or the outer surface of the tubular member, the puncture resistance of the trocar tube and the friction resistance when the instrument is taken in and out are reduced, and the trocar tube is punctured to the body wall and the instrument It becomes easy to put in and take out.

By reinforcing the main portion with a reinforcing material, it is possible to prevent the tubular member from being kinked, crushed or contracted by an external force. Further, the base end portion of the tip portion is formed so as to be inclined outward, and the tip end of the reinforcing material is prevented from being exposed from the outer surface of the tubular member by extending to the tip position of the reinforcing material. In addition, the rigidity gradually changes from the flexible main portion to the tip portion, and the occurrence of kinks at the boundary portion between the tip portion and the main portion is prevented.

Further, by forming a spiral groove or protrusion on the outer surface of the distal end, even if the trocar tube has a significantly high puncture resistance to the body wall due to, for example, the patient's body wall being thick, By screwing the trocar tube into the body wall while rotating, the trocar tube can be easily inserted into the body wall.

[0022]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The trocar tube of the present invention will be described in detail below with reference to the preferred structural example shown in the accompanying drawings. FIG. 1 shows the trocar tube of the present invention. The trocar tube 1 is a trocar tube having a tubular member 2 and a proximal portion 3 connected to the proximal end of the tubular member 2, and the tubular member 2 includes a flexible main portion 4 having high rigidity in the longitudinal direction. , And a tip portion 5 having a compression resistance at least in the longitudinal direction.

FIG. 2 is a longitudinal sectional view of the trocar tube of FIG. 1, and FIG. 3 is a transverse sectional view of a main part 4 of the trocar tube of FIG. The shape of the main portion 4 is substantially unchanged with respect to an external force applied in the longitudinal direction, has high rigidity so as to maintain a rigid state, and is flexible enough to be bent favorably with respect to bending force. In the illustrated example, the main portion 4 is composed of a tubular flexible member 6 having a constant inner diameter and outer diameter, and a reinforcing member 8.

As the constituent material of the member 6, for example, polyvinyl chloride, polyurethane, polyethylene, polyamide,
Examples of the flexible material include Teflon, polyester, synthetic rubber, ethylene-vinyl acetate copolymer, silicone rubber, and latex rubber.

As shown in FIGS. 2 to 3, a reinforcing member 8 is embedded inside the main portion 4. The reinforcing member 8 is formed of a wire rod having a relatively high bending elastic modulus in a lattice shape, and is tubular when the tubular member 2 is curved and when pressure from the body wall is applied to the tubular member 2. Member 2
It works to prevent the inner lumen from collapsing.

As the wire material constituting the reinforcing material 8, stainless steel, piano wire, metal material such as superelastic alloy, polyethylene, polypropylene, aromatic polyamide, aliphatic polyamide, polyarylate, polyester, polyimide, ABS resin, etc. A single wire, a fiber bundle, carbon fiber, etc. can be mentioned. The diameter of the wire rod is 0.05mm
It is preferably about 2 mm, more preferably about 0.1 mm to 0.5 mm, and is appropriately selected according to the size of the trocar tube. The cross-sectional shape of this wire rod is circular or elliptical as a standard, but may be rectangular such as square or rectangle.

As the form of the reinforcing member 8, in addition to the lattice-like braid as shown, a coil for spirally winding the inside of the main portion 4 and a plurality of annular members are predetermined in the longitudinal direction of the main portion 4. A configuration in which the main body 4 and the plurality of rods are arranged in parallel with each other in the longitudinal direction of the main body 4 are arranged with a distance.
It may be arranged such that they are spaced apart by a predetermined angle in the circumferential direction. Among them, if the braided structure as shown in the drawing is used, it is possible to exert a sufficient reinforcing effect without increasing the wall thickness and the outer diameter of the tubular member 2 by using a wire having a small diameter.

2 and 3, the member 6 is made of a single resin, but the present invention is not limited to this. For example, as shown in FIG. 4, the inner layer sandwiching the reinforcing material 8 is sandwiched. You may comprise by two layers of 61 and the outer layer 62. Further, in FIG. 4, the inner layer 61 and the outer layer 62 are each composed of a single layer, but each of these layers may be composed of a plurality of layers. When such a plurality of layers are used, the constituent material of each layer may be the same or different.

The tip portion 5 shown in FIG. 1 and FIG. 2 has a hard member 7 obtained by molding a material having high rigidity secured to the tip of the main portion 4 by, for example, adhesion with an adhesive, fusion, or welding. It is configured by joining to. Hard member 7
As the constituent material of, for example, stainless steel, metal materials such as superelastic alloys, polyacetal, aromatic polyamido,
Aliphatic polyamide, acrylic resin, polycarbonate,
Resin materials such as polyvinyl chloride, Teflon, polyethylene, polypropylene, polystyrene, polyurethane, etc.
A relatively hard material can be used.

The outer surface of the tip portion 5 is formed smoothly so that the body wall is not damaged when it is inserted into the body wall and the insertion is easy. Moreover, it is preferable that the outer diameter of the tip portion 5 is reduced toward the tip. As a result, the puncture resistance at the time of inserting into the body wall is reduced, and reliable insertion is possible. Note that, in FIG. 2, the outer diameter of the tip portion 2 changes toward the tip at a constant reduction rate, but as shown in FIG.
A configuration that changes stepwise or a configuration that changes with a certain curvature, as shown in FIGS.

As shown in FIGS. 2 and 5, the base end portion of the tip end portion 5 has a shape inclined toward the outside of the tubular member 2 and is formed so as to extend to the tip end position of the reinforcing member 8. Is preferred. As a result, the base end portion of the distal end portion 5 covers the distal end portion of the reinforcing material 8 from the outside, so that the distal end of the reinforcing material 8 can be prevented from being exposed on the outer surface of the tubular member 2.
Further, due to the inclined shape, the rigidity of the base end portion of the tip end portion 5 gradually decreases toward the base end thereof, and thus it is possible to prevent the occurrence of a kink at the boundary with the main portion 4.

Further, it is preferable that a spiral groove or a convex portion is formed on the outer surface of the tip portion 5. Thereby, even if the puncture resistance at the time of inserting the trocar tube 1 into the body wall is extremely high due to, for example, the thick body wall,
By pushing the trocar tube 1 while rotating it, it is easy to puncture the body wall by a screw action.

In the present invention, the main portion 4 and the tip portion 5 are
Not only what is made integral by the above-mentioned joining etc., but also after being integrally molded, post-processing to make only the tip end highly rigid,
Alternatively, it may be formed by softening except the tip portion. Specifically, the tubular member 2 is molded with a flexible resin material, and then, for example, cross-linking by radiation or ultraviolet irradiation,
Only the tip portion of the tubular member 2 is hardened by a method of reducing the plasticizer content, a method of depositing or adsorbing metal molecules, or the like, or conversely, the tubular member 2 is molded with a hard resin material, and thereafter, Examples include a method of softening by impregnating a portion other than the tip with a plasticizer. If the main part 4 and the tip part 5 are formed in this way, there is no step between the main part 4 and the tip part 5, and when the trocar tube is punctured into the body wall, the step damages the body wall. The puncture can be performed smoothly without fear.

Further, as the tip portion 5 in the present invention, as shown in FIG. 6, a coil body 70 of tight winding is arranged on the tip portion of the tubular member 2 which is formed flexibly, and by this coil body 70, a tubular body is formed. A configuration may be adopted in which the tip of the member 2 is not substantially contracted in the longitudinal direction. Even with such a configuration, similarly to the case where only the tip portion 5 is made highly rigid by the above-mentioned hard member 7 or the post-treatment, the tip portion has a compressive property at least in the longitudinal direction.

As the arrangement of the coil body 70, the coil body 70 is embedded in the tubular member 2 as shown in the drawing, and the coil body 70 is housed in the inner cavity of the tubular member 2 along the inner peripheral surface thereof.
The both ends of the coil body 70 may be fixed to the tubular member 2 by adhesion, fusion, welding, or the like, and the shrinkage of the tubular member 4 in the longitudinal direction may be restricted. Further, as the constituent material of the coil body 70, for example, the same material as the above-mentioned reinforcing material 8 can be cited.

In order to improve the puncture resistance of the trocar tube 1 and the operability of instruments and the like to be inserted into the inner cavity of the trocar tube 1, the inner and outer surfaces of the flexible main portion 4 and the tip portion 5 have friction resistance and sliding. It is preferable to perform a lubrication process to reduce resistance. As an example of such a lubrication treatment, depending on the material of the tubular member 2, the sliding surface is smoothed, a lubricant such as silicone, a maleic anhydride-based hydrophilic polymer, or a Teflon-based low friction is used. Examples include coating materials and the like. Further, in the inner cavity of the trocar tube 1, it is possible to improve the operability by reducing the contact area with the instruments to be inserted by making fine irregularities on the surface.

The proximal portion 3 is joined to the proximal end of the tubular member 2, and as shown in FIG. 2, an instrument insertion port 31 communicating with the inner cavity of the tubular member 2 is provided inside thereof. The hand portion 3 is formed in a shape that is easy to grasp when the operator punctures the body wall with a trocar tube or after inserting the instrument into the trocar tube 1.

The hand portion 3 is provided with an inlet 32 for injecting gas for inflating the inside of the body cavity, which can be closed by a plug (not shown). In addition, a rubber check valve 9 made of rubber having a cross-shaped cut (not shown) is provided at the instrument insertion port 31 in order to prevent the gas in the body cavity from leaking. The injection port 32 and the check valve 9 are not necessary when the operating space is secured by the lifting method.

The trocar tube of the present invention preferably has an effective insertion length of about 50 to 200 mm and an outer diameter of 3 to.
It is preferably about 30 mm. Effective insertion length is 50
If the length is shorter than mm, the operability is poor, and there is a possibility that it may come off from the body wall during the operation. If the length is longer than 200 mm, the inserted instrument may not reach the target site, or the trocar tube may damage the internal organs. If the outer diameter of the trocar tube is smaller than 3 mm, the instruments that can be inserted are limited, and
If it is larger than mm, the patient is more invasive.

Further, the length of the tip portion 5 is made relatively short so as not to impair the flexibility of the main portion 4, specifically, 1 to 20.
The thickness is preferably about mm, more preferably about 1 to 5 mm.

FIG. 6 is a vertical sectional view of the trocar assembly in which the plug 10 is inserted in the trocar tube 1. The obturator 10 comprises a puncture needle 11, an obturator grip 12, and a protective sleeve 13. Normally, the puncture needle 11 is fixed to an obturator grip 14 and is covered with a slidable protective sleeve 13. Even in this state, the tip of the trocar tube 1 is
The outer surface has a tapered shape, which reduces puncture resistance when piercing the body wall, and makes puncturing easy and reliable.

At the time of piercing the body wall, the body wall is punctured with the obturator 10 inserted in the trocar tube 1 as shown in FIG.
At that time, the protective sleeve 13 is pushed by the body wall and retracts,
The puncture needle 11 is exposed to puncture the body wall. At this time, if the puncture resistance at the time of insertion is extremely high, the trocar assembly is rotated and pushed in to proceed with insertion into the body wall. If a spiral groove or a convex portion is formed on the outer surface of the tip portion 5, the trocar tube 1 can be punctured more favorably by a screw action.

Since the resistance from the abdominal wall disappears after penetrating the body wall, the protective sleeve 13 is pushed by the spring 14 installed in the obturator grip 12, and the puncture needle 11 is again provided.
Cover. The protective sleeve 13 can prevent the puncture needle 11 from damaging internal organs such as the intestine. At this time, since the distal end portion of the tubular member 2 of the trocar tube 1 is a highly rigid distal end portion, the distal end portion is not curled or crushed at the time of body wall puncture, and the puncture can be performed smoothly. it can.

After that, the plug 11 is pulled out, gas is sent into the body cavity from the remaining inlet 32 of the trocar tube 1 to inflate the body cavity, and then the inlet 32 is plugged.
The device is inserted into the body through the lumen of the trocar tube 1.
At this time, even when an instrument having a curved shape or an instrument having a large-diameter joint is desired to be inserted into the trocar tube and used, since the main part 3 of the tubular member 2 is flexible, it is curved according to the shape of the instrument. It can be extended or expanded to allow the insertion of such devices.

[0045]

EXAMPLES Next, specific examples of the trocar tube of the present invention will be described. Example 1 A trocar tube having the structure shown in FIGS. 1 to 3 was manufactured. The conditions of this trocar tube are as follows.

<Tip> Material: Nylon Tip outer diameter: 6 mm Base end outer diameter: 8 mm Tip inner diameter: 5 mm Total length: 5 mm Shape: As shown in FIG.

<Main part> Material: Thermoplastic polyurethane Outer diameter: 8 mm Inner diameter: 5 mm Total length: 100 mm Surface treatment: None

<Reinforcing Member> Structure: Braid as shown in FIG. 16-piece set (8 right-handed and 8 left-handed). Material: Stainless Steel Wire diameter: Round wire with φ0.1 mm Outer diameter: 7 mm End treatment: Welding process Total length: 100 mm

<Hand> Material: Nylon

<Backflow prevention valve> Material: Silicone rubber Thickness: 1 mm

When the trocar tube was punctured into the abdominal wall of a dog using a plug having the structure shown in FIG. 6, the trocar tube penetrated the body wall together with the plug without crushing the tip or kinking. Successfully inserted into the body cavity.

After that, the plug was pulled out, and after the operation space was secured by the lifting method, a forceps with an outer diameter of 5 mm bent at a position of 5 cm from the tip was inserted into the lumen of the remaining trocar tube. The main part of the tube was curved according to the bending structure of the forceps, and the forceps could be successfully inserted into the body cavity.

[0053]

As described above, the trocar tube of the present invention has the tubular member and the proximal portion connected to the proximal end of the tubular member, and the tubular member has high rigidity in the longitudinal direction. It is characterized by a flexible main part and at least a tip end that has anti-compression property in the longitudinal direction, so that it can be deformed according to the shape of the instrument to be inserted and received at the time of insertion. The tip does not shrink or curl up due to pressure, and can be reliably inserted into the body cavity.

[Brief description of drawings]

FIG. 1 is a perspective view showing a configuration example of a trocar tube of the present invention.

FIG. 2 is a vertical cross-sectional view of the trocar tube shown in FIG.

3 is a cross-sectional view of the trocar tube shown in FIG.

FIG. 4 is a cross-sectional view showing another configuration example of the main part of the trocar tube of the present invention.

FIG. 5 is a vertical cross-sectional view showing another configuration example of the tip portion of the trocar tube of the present invention.

FIG. 6 is a vertical cross-sectional view showing another configuration example of the distal end portion of the trocar tube of the present invention.

FIG. 7 is a vertical cross-sectional view showing a trocar tube assembly in which a plug is inserted in the trocar tube of the present invention.

[Explanation of symbols]

 1 Trocar tube 2 Tubular member 3 Hand part 4 Main part 5 Tip part

Claims (1)

[Claims] 1. A trocar tube having a tubular member and a proximal portion connected to a proximal end of the tubular member, wherein the tubular member has a flexible main portion having high rigidity in a longitudinal direction and at least a longitudinal portion. A trocar tube characterized by comprising a tip portion having a compression resistance against a direction.