JPH07265327A - Trocar tube - Google Patents

Abstract

PURPOSE:To enable the smooth puncture and certain fixing to the tissue of a living body and to widely ensure a region enabling observation or surgical treatment. CONSTITUTION:A trocar tube 1A has a tubular member 2 piercing the abdominal wall to be arranged and allowing the abdominal cavity to communicate with the outside of the body and the inside fixing means 3 fixing the tubular member 2 to the abnorminal wall on the side of the abdominal cavity. The inside fixing means 3 is constituted of three circular arc-shaped inside fixing members 31-33 arranged to the leading end of the tubular member 2 in a revolvable manner and the shaft members 34-36 performing the revolving operation of them. The inside fixing members 31-33 can take the first posture shown by a drawing constituting the annulus similar to the cross section of the tubular member 2 along the outer peripheral surface of the leading end part of the tubular member 2 and a second posture wherein one end parts of the fixing members are revolved around the center to allow the other end parts thereof to protrude outwardly.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a trocar tube mainly used for laparoscopic surgery.

[0002]

2. Description of the Related Art In recent years, for example, in excision of an appendix or gallbladder, laparoscopic surgery performed without laparotomy has attracted attention in place of conventional open surgery. In this laparoscopic surgery, multiple communication tubes called trocar tubes are inserted through the abdominal wall into the abdominal cavity, and the inside of the abdominal cavity is monitored by a small camera (endoscope) inserted from one trocar tube. While observing, forceps, scissors, scalpel inserted from other trocar tubes,
Various surgical procedures are performed in the abdominal cavity while observing the monitor image with an instrument such as a needle holder.

By the way, in such a laparoscopic surgery, in order to fix the trocar tube to the abdominal wall, the needle and the thread are inserted with the tip of the trocar tube protruding at least about 2 cm so as not to come off. Although it was performed by ligating using it, it takes time and time to fix it, and it is difficult to finely adjust the fixing angle and insertion depth of the trocar tube, which requires skill. A device having a fixing function has been developed (Japanese Utility Model Publication No. 58-54083, U.S. Pat. No. 5,147).
No. 316).

Among them, the trocar disclosed in Japanese Utility Model Publication No. 58-54083 has a forceps slidable in the axial direction on the outer peripheral surface of a trocar tube and holds the abdominal wall from the outside of the body. Although the trocar tube is fixed to the abdominal wall, the fixation is unstable because the trocar tube is fixed only outside the body, and in particular, the protruding length of the trocar tube tip into the abdominal cavity fluctuates. It has the drawback of being easy to do.

In the trocar shown in US Pat. No. 5,147,316, a balloon which is inflated by injecting gas is provided at the tip of the trocar tube, and the trocar tube has a base end side along the outer circumference of the trocar tube. A slidable contact member is provided, and the trocar tube is fixed by sandwiching the abdominal wall from the inside of the abdominal cavity and the outside of the body with the balloon and the contact member, respectively. However, in this trocar, since the portion where the balloon is installed is raised from the outer peripheral surface of the trocar tube and a step is formed, this step increases the resistance when the trocar tube is punctured or removed from the abdominal wall, In addition to being unable to perform smooth puncture and removal, the puncture hole in the abdominal wall is widened by the passage of the balloon during puncture of the trocar tube, so that there is a drawback that it cannot be firmly fixed.

Further, in each of the above-mentioned trocars, when the trocar tube is fixed to the abdominal wall, the tip portion thereof projects into the abdominal cavity by a predetermined length (2 cm or more). Therefore, when the endoscope is inserted, this projecting portion Has a drawback that a blind spot is generated and the field of view is narrowed. Further, when a device such as forceps is inserted, it hits the protruding portion and limits a region where surgical treatment can be performed.

Further, an omentum just below the abdominal wall (where the peritoneum stretches and is entangled with the internal tissues, and several layers further extend inside the abdominal cavity) covers the vicinity of the tip opening of the trocar tube, and In some cases, this may obstruct the field of view or interfere with the insertion or operation of instruments such as forceps.
In each of the above-mentioned trocars, the omentum cannot be removed from the vicinity of the opening of the tip of the trocar tube, so that a good field of view of the endoscope cannot be secured, and the operability of instruments such as forceps deteriorates. There is also a drawback of doing.

[0008]

SUMMARY OF THE INVENTION It is an object of the present invention to provide a trocar tube which can be smoothly punctured into living tissue and can be reliably fixed, and which can secure a wide area for observation and surgical treatment. is there.

[0009]

These objects are achieved by the present invention described in (1) to (11) below.

(1) A trocar tube having a tubular member for penetrating a living tissue to communicate the inside and outside of the body cavity and an inner fixing means for fixing the tubular member inside the body cavity,
The inner fixing means is a plurality of inner fixing members rotatably installed with respect to the tubular member at the tip of the tubular member,
An operation member for rotating each inner fixing member, and by operating the operation member, each inner fixing member has a first posture along the peripheral surface of the distal end portion of the tubular member, and one end thereof. A trocar tube which is configured so as to be pivoted about a second position such that the other end thereof projects outward from the peripheral surface.

(2) The trocar tube according to (1), wherein each of the inner fixing members is configured to rotate independently.

(3) The trocar tube according to (1) or (2), wherein each inner fixing member is installed so as to be movable in the axial direction of the tubular member.

(4) The trocar tube according to the above (3), wherein each of the inner fixing members is configured to move independently.

(5) The trocar tube according to the above (3) or (4), which has a movement restricting means for restricting the movement of each of the inner fixing members with respect to the tubular member in at least one direction.

(6) The operating member is a shaft member installed inside the tube wall of the tubular member along the axial direction of the tubular member, and one end of the inner fixing member is fixed to the tip thereof. The trocar tube according to any one of (1) to (5).

(7) The trocar tube according to any one of the above (1) to (6), which has an outer fixing means for fixing the tubular member outside the body.

(8) An outer fixing means for fixing the tubular member outside the body, the outer fixing means including a holding member for holding the shaft member, and a holding operation means for giving a holding force to the holding member. The trocar tube according to (6) above, further comprising: an abutting member that is connected to the holding member and abuts against the body surface.

(9) The trocar tube according to (8), wherein the contact member is rotatably connected to the holding member.

(10) Each of the inner fixing members is the first
The trocar tube according to any one of the above (1) to (9), which has a shape that constitutes an annular ring that is close to the cross-section of the tubular member in the above posture.

(11) The trocar tube according to any one of the above (1) to (10), wherein the length of the tubular member is substantially equal to the thickness of the biological tissue penetrating therethrough.

[0021]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The trocar tube of the present invention will be described below in detail with reference to the preferred embodiments shown in the accompanying drawings.

FIG. 1 is a perspective view showing the overall structure of an embodiment of the trocar tube of the present invention, FIG. 2 is a perspective view showing the structure of the tip portion of the trocar tube shown in FIG. 1, and FIG. X-
It is an X-ray sectional view. In addition, in the following description, FIGS.
The upper side in the middle is called "proximal end", the lower side is called "distal end", moving to the distal end side is called "forward", and moving to the proximal end side is called "backward".

The illustrated trocar tube 1A is a trocar tube used for laparoscopic surgery, and is a tubular member that is installed so as to penetrate the abdominal wall 7 and allows the abdominal cavity 8 and the outside of the body 9 to communicate with each other through the lumen 23 thereof. 2 and an inner fixing means 3 for fixing the tubular member 2 to the abdominal wall 7 on the abdominal cavity 8 side.

The tubular member 2 has an outer diameter of, for example, 20 to 20.
The inner diameter is about 30 mm, for example, about 5 to 10 mm, and the length is about the thickness of the abdominal wall 7 to be punctured and fixed. In this case, it is preferable that the length of the tubular member 2 is slightly shorter than the thickness of the abdominal wall 7 so that the width that can be accommodated is widened.

As the constituent material of the tubular member 2, for example,
Hard materials such as polyethylene, polypropylene, acrylic resins and other hard resins, various ceramics, metal materials such as stainless steel and aluminum, and the like can be mentioned. In the illustrated configuration, the tubular member 2 is a straight pipe, but it may be curved beforehand as desired.

The tubular member 2 is made of, for example, soft polyvinyl chloride, polyurethane, polyethylene, polyester, polytetrafluoroethylene, polyamide, ethylene-vinyl acetate copolymer (EVA), various synthetic rubbers such as silicone rubber and latex rubber, The tubular member 2 may be made of a material having flexibility such as a superelastic alloy so that the tubular member 2 can be bent and deformed.

When the tubular member 2 is made of a flexible material, the rod of the instrument to be inserted into the inner cavity 23 of the tubular member 2 is curved to the tubular member 2 such as a super elastic alloy or a rubber material having a relatively high rigidity. It is preferable that it is configured so as to be bendable along it, which allows such an instrument to be easily inserted into the lumen 23 of the tubular member 2 and is preferable.

A plurality of inner fixing means 3 (3 in FIG. 3) are rotatably installed with respect to the tubular member 2 at the tip of the tubular member 2.
Individual) inner fixing members 31, 32 and 33, and shaft members 34, 35 and 36 which are operation members for rotating these.

As shown in FIG. 3, the shaft members 34, 35 and 36 are inserted in the tube wall 21 of the tubular member 2 in the axial direction of the tubular member 2, preferably at equal intervals. And
One ends of the corresponding inner fixing members 31, 32 and 33 are fixed to the tips of the shaft members 34, 35 and 36, respectively. The base end portions of the shaft members 34 to 36 respectively project from the base end of the tubular member 2 by a predetermined length, and when these are rotated, the corresponding inner fixing members 31 to 33 rotate.

The inner fixing members 31 to 33 are tubular members 2
Posture (the state shown in FIG. 1) along the outer peripheral surface of the tip of the
And a second posture (a state shown in FIG. 2) in which the one end (the shaft members 34 to 36) is rotated and the other end is projected outward of the outer peripheral surface. In this case, each of the inner fixing members 31 to 33 has an arc shape, and when they are in the first posture, they form an annular ring that approximates the cross section of the tubular member 2. Thereby, the puncture operation of the abdominal wall 7 of the trocar tube 2, the endoscope for the lumen 23 of the tubular member 2,
Instruments such as forceps, scissors, a scalpel, and a needle holder can be smoothly inserted. Moreover, when each of the inner fixing members 31 to 33 takes the second posture, each of the inner fixing members 3 will be described later.
1-33 can abut the inner surface 10 of the abdominal wall 7 to fix the trocar tube 1A inside the abdominal cavity 8.

It should be noted that each of the inner fixing members 31 to 33 has a first
It is possible to adopt an intermediate posture between the above posture and the second posture, that is, to rotate at an arbitrary angle with respect to the radius of the tubular member 2.

Further, by moving the shaft members 34 to 36 forward and backward with respect to the tubular member 2, the inner fixing members 31 to 31 are
The 33 can be moved in the axial direction of the tubular member 2 regardless of its posture. In this case, each inner fixing member 31-
The rotation of 33 and the movement in the axial direction may each be performed independently or in conjunction with each other, but in the case of the present embodiment, in order to have a wide degree of freedom of adjustment regarding the fixed posture and the like, The rotation and the axial movement of the inner fixing members 31 to 33 can be performed independently. In the example shown in FIG. 2, the inner fixing member 33 of the inner fixing members 31 to 33 in the second posture.
Moves forward and separates from the tip surface 22 of the tubular member 2, and the other inner fixing members 31, 32 are in contact with the tip surface 22.

The rotation and axial movement of the inner fixing members 31 to 33 are performed to fix the tubular member 3 to the abdominal wall 7 from the abdominal cavity 8 side, as described later, and the inner surface of the abdominal wall 7. This is done in order to eliminate the harmful effects due to the large nets near 10 being pushed away and eliminated.

The number of the inner fixing members 31 to 33 and the shaft members 34 to 36 installed is not limited to three as shown in the figure. Further, the number of inner fixing members and the number of shaft members may be different. For example, the configuration may be such that four inner fixing members whose rotation centers are gear-connected to each other are simultaneously rotated by one shaft member.

FIG. 4 is a perspective view showing the overall construction of another embodiment of the trocar tube of the present invention, and FIG. 5 shows the construction of the base end portion of the trocar tube shown in FIG. 6 is an exploded perspective view showing the structure of the outer fixing means, and FIG. 7 is a perspective view showing the structure of the outer fixing means. In the following description, the upper side in FIGS. 4 and 5 is referred to as the “proximal end” and the lower side is referred to as the “distal end”. Moving to the distal end side is “forward” and moving to the proximal end side is “toward”. Retreat ".

In the trocar tube 1B, the tubular member 2 is attached to the outside of the body 9
The trocar tube 1 </ b> A is the same as the trocar tube 1 </ b> A except that it has an outer fixing means 4 that is fixed on the side. Hereinafter, this outer fixing means 4
The configuration of will be described.

The outer fixing means 4 is mainly composed of the shaft members 34, 3
Clamping members 41, 42 and 43 for clamping 5 and 36 respectively, clamping operation means 44, 45 and 46 for imparting a clamping force to these clamping members 41 to 43, and clamping members 41 to 43, respectively. It is composed of contact members 47, 48 and 49 that contact the body surface 11. The sandwiching member 41 corresponding to each of the shaft members 34 to 36
To 43, clamping operation means 44 to 46, and abutting member 47 to
Since 49 has the same configuration, respectively, the sandwiching member 41, the sandwiching operation means 44, and the contact member 47 will be representatively described below.

As shown in FIGS. 6 and 7, the holding member 4
Reference numeral 1 denotes a base portion 50 and a shaft member 3 which is erected from the base portion 50.
It is composed of a pair of sandwiching pieces 51 for sandwiching 4 and a pair of outer frames 52 located outside both sandwiching pieces 51. In this case, the sandwiching piece 51 and the outer frame 52 are installed with a wedge-shaped gap therebetween. Further, the base 50 is formed with a pair of openings 53 through which a head 58 described later can be inserted.

As shown in FIGS. 5 and 7, the contact member 4
Reference numeral 7 denotes a plate-shaped member, which is rotatably connected to the base portion 50 of the holding member 41 by a hinge 60. The hinge 60 is not shown in FIG.

The clamping operation means 44 includes a pressing rod 54 bent in a U-shape and a screw shaft 55 located inside thereof.
It consists of and. The pressing rod 54 penetrates from one end to the other end of the contact member 47, and heads 58 are formed at both ends protruding from the contact member 47.

The threaded shaft 55 has a threaded portion 56 on the outer periphery of which a spiral thread is formed, and is rotatably supported at the central portion of the pressing rod 54 at a portion adjacent to the threaded portion 56. In addition, the screw portion 56 is screwed into the screw hole 59 formed in the contact member 47. Shaft with screw 55
A knob 57 for rotationally operating the threaded shaft 55 is fixed to an end portion on the opposite side of the threaded portion 56 of the.

Next, the operation of the outer fixing means 4 will be described. When the outer fixing means 4 is not operated, as shown in FIG. 5, the contact member 47 is clamped by the rotation of the hinge 60.
Bend against. In this case, since both clamping pieces 51 of the clamping member 41 do not clamp the shaft member 34 or clamp it loosely, the clamping member 41 can easily slide the outer peripheral surface of the shaft member 34 along the axial direction. In this way, the contact member 4
Bending 7 prevents the operation of the trocar tube 1 from being hindered, and enables compact storage.

When the trocar tube 1 is fixed to the abdominal wall 7 from the outside 9 side, as shown in FIGS. 4, 6 and 7.
First, the bent contact member 47 is rotated to extend in a horizontal state, and the holding member 41 is slid with respect to the shaft member 34 and moved in the distal direction to move the contact member 47 to the body surface 11. Abut.

Next, the knob 57 is operated to rotate the screw shaft 55 in a predetermined direction. As a result, the threaded shaft 55 is screwed into the inner part of the screw hole 59, and the pressing rod 54 is moved to the knob 5.
It is pressed by 7 and moves to the holding member 41 side. As a result of this movement, the two heads 58 that have passed through the opening 53 are separated from each other by the holding piece 51.
And the outer frame 52. This gap is the head 5
8 is gradually narrowed in the forward direction, so that as the head portion 58 moves forward, the head portion 58 comes into contact with the outer surface of the sandwiching piece 51 and the inner surface of the outer frame 52 to try to widen the gap between them. To do. As a result, the two gripping pieces 51 are pressed by the head portions 58 in a direction in which the gripping pieces 51 approach each other, and clamp the shaft member 34. Further, in this state, the pressing rod 54 is opened by the opening 53.
Since the contact member 47 is inserted inside, the contact member 47 cannot be bent with respect to the holding member 41 even when receiving a reaction force from the body surface 11, and is in a horizontal state (a state substantially parallel to the body surface 11). Is maintained.

By such an operation, as shown in FIG. 8, the trocar tube 1 punctured in the abdominal wall 7 has the inner fixing members 31 to 33 in the second posture and the contact members 4 in the horizontal state.
7 to 49, they are fixed so as to sandwich the abdominal wall 7 from the inner surface 10 of the abdominal wall 7 and the body surface 11, respectively. Therefore, the trocar tube 1B is securely and firmly fixed to the abdominal wall 7.

In the state where the holding member 41 holds the shaft member 34, when the holding member 41 comes into contact with the base end face 24 of the tubular member 2, the inner fixing member 31 cannot move any further. This prevents the inner fixing member 31 from advancing more than necessary and releasing or relaxing the fixation on the abdominal cavity 8 side. In this way, the sandwiching members 41 to 43 are at least 1 with respect to the tubular member 2 of each inner fixing member 31 to 33.
It constitutes a movement regulation means for regulating the movement in the direction.

Further, in the case of the trocar tube 1A having no outer fixing means 4, as the movement restricting means, for example, the outer peripheral surfaces of the shaft members 34 to 36 are provided with a concavo-convex structure or ratchet mechanism which gives sliding resistance. Alternatively, a configuration in which a locking member is provided may be used. Such movement restricting means may restrict both the forward movement and the backward movement of the inner fixing members 31 to 33 with respect to the tubular member 2.

Although not shown, the contact member 47 is shown in FIG.
A biasing means for biasing in the bending direction may be provided as shown in FIG. Examples of the biasing means include springs such as a coil spring and a torsion spring installed near the hinge 60.

Although not shown, in order to prevent the holding member 41 from coming off the shaft member 34 easily, the shaft member 3
It is also possible to provide a stopper on 4 or the like. As this stopper, for example, a protrusion protruding to the outer periphery of the shaft member 34 can be cited.

The number of sandwiching members, abutting members, etc. constituting the outer fixing means 4 is not limited to three as shown in the drawing, and may be different from the number of shaft members. Also,
When the tubular member 2 longer than the thickness of the abdominal wall 7 is used, the outer fixing means 4 may be attached to the outer periphery of the tubular member 2.

Next, the method of use and operation of the trocar tube 1B of the present invention will be described.

[1] The inner fixing members 31 to 33 of the inner fixing means 3 are set to the first posture shown in FIG. 1, and the abutting members 47 to 49 of the outer fixing means 4 are bent to make them as shown in FIG.
The state shown in is set.

[2] A predetermined portion of the body surface 11 is incised.

[3] An inner cylindrical needle (not shown) is inserted into the inner cavity of the tubular member 2, and the distal end of the inner cylindrical needle is projected from the distal end opening of the tubular member 2. 7 is punctured in a direction substantially perpendicular to 7, and the inside of the abdominal wall 7 is gradually advanced. At this time, the inner fixing members 31 to 33 are
Since it is in the first posture and is along the outer peripheral surface of the tubular member 2 (the surfaces are substantially the same without any step), the puncture can be performed smoothly without increasing the puncture resistance and the puncture hole can be widened. In addition, the inner surface of the puncture hole is not damaged.

[4] The distal end surface 22 of the tubular member 2 passes through the inside of the abdominal wall 7, that is, the subcutaneous fat tissue, connective tissue, fascia, muscular layer, and peritoneum in order and substantially coincides with the inner surface 10 of the abdominal wall 7. When the position is reached, the advance of the trocar tube 1 is stopped and the inner cylinder needle is pulled out.

[5] A part of the omentum (not shown) may overlap with the tip of the trocar tube 1, obstructing the field of view of the endoscope, or obstructing the insertion and operation of instruments such as forceps. In this case, at least one of the shaft members 34 to 36 is operated to rotate and / or advance the corresponding inner fixing members 31 to 33 to push away the omentum overlapping with the tip of the trocar tube 1.

[6] Rotate the shaft members 34 to 36 to move the inner fixing members 31 to 33 of the inner fixing means 3 to the position shown in FIG.
And the second posture shown in FIG. As a result, FIG.
As shown in, each of the inner fixing members 31 to 33 is locked to the inner surface 10 of the abdominal wall 7, and the trocar tube 1B is fixed on the abdominal cavity 8 side. The inner fixing members 31 to 33 are the inner surface 10 of the abdominal wall 7.
Since it is locked to the trocar tube, even if the tip of the tubular member 2 does not project as in the conventional trocar tube, the tip of the tubular member 2 is not buried in the peritoneum, muscle layer, or the like forming the abdominal wall 7.

[7] As described above, the outer fixing means 4
While rotating each of the contact members 47 to 49 of FIG.
Move them forward and press them against the body surface 11. At this time,
Adjusting the degree of pressing of the abutting members 47 to 49 on the body surface 11 respectively, adjusting the angle of the trocar tube 1B with respect to the abdominal wall 7, and orienting the trocar tube 1B toward the intended surgical field in the abdominal cavity 8. You can also

[8] As described above, the clamping operation means 4
To operate the corresponding shaft member 3 in each of the holding members 41 to 43.
Hold 4 to 36. As a result, as shown in FIG.
The contact members 47 to 49 are fixed to the shaft members 34 to 36, and the trocar tube 1B is also fixed to the outside of the body 9 side.

In this state, when an endoscope (not shown) is inserted into the inner cavity 23 of the tubular member 2 from the outside 9 side for observation,
Wide field of view not only in the front but also in the side. That is,
The distal end surface 22 of the tubular member 2 is substantially flush with the inner surface 10 of the abdominal wall 7, and is located between the adjacent rotation centers of the inner fixing members 31 to 33 (each having an opening angle of slightly less than 120 °). A visual field along 10 can be secured. Also, when a surgical procedure is performed on the operative field by inserting an instrument such as forceps into the inner cavity 23 of the tubular member 2, the movable range is wide and the area where the surgical procedure can be performed is similarly set. Can be widely secured.

[9] After the operation, the clamping operation means 4 is operated in the opposite direction to release the clamping of the clamping members 41 to 43, and the contact members 47 to 49 are bent again, so that the outer fixing means 4 is released. Release the fixation by. Further, the shaft member 3
4 to 36 are rotated in the opposite direction to the above and returned to the first posture.

[10] Pull out the trocar tube 1B to the outside of the body 9 side. Also in this case, since the inner fixing members 31 to 33 are in the first posture, they can be smoothly extracted without increasing the removal resistance, and the inner surface of the puncture hole or the like is not damaged.

[11] As shown in FIG. 9, when the tubular member 2 is pierced obliquely into the abdominal wall 7, the distal end surface 22 of the tubular member 2 is projected from the inner surface 10 of the abdominal wall 7 to the abdominal cavity 8 side. The inner surface 1 of the abdominal wall 7 is advanced by advancing a part of the inner fixing members 31 to 33 (the inner fixing member 31 in the case shown) without advancing.
Abut 0 and fix. Thus, even when the trocar tube is pierced obliquely into the abdominal wall 7, the trocar tube can be securely and firmly fixed.

The trocar tube of the present invention has been described above based on the respective structural examples shown in the drawings. However, the present invention is not limited to these, and for example, the structure of the tubular member, the inner fixing means, the outer fixing means, etc. Each can be replaced by any one having a similar function. For example, the length of the tubular member 2 is
It may be longer than the thickness of the abdominal wall 7 (for example, about 4 to 6 cm).

In the present invention, the outer fixing means may or may not be installed. However, when the outer fixing means is not installed, the movement restricting means as described above, for example, the shaft members 34 to 36 are tubular members. Clamping member 41 to be fixed to 2
A clip such as 43 is preferably provided.

Further, the tubular member 2 longer than the thickness of the abdominal wall 7
In the case of providing the outer fixing means 4 as shown in the drawing, a groove or slit (not shown) extending along the axial direction is formed in the tube wall 21 of the tubular member 2 to expose the respective shaft members 34 to 36. , Holding member 41 to the inside of the groove or slit
It can be configured such that 43 can move. Also,
In the present invention, the operation member is not limited to the shaft member as illustrated, but may be, for example, a wire that is pulled to rotate each inner fixing member.

In each of the illustrated embodiments, the laparoscopic surgery by the lifting method is assumed, but the trocar tube of the present invention is not limited to this, and is used for the laparoscopic surgery by the pneumoperitoneum method. But it's okay. In this case, a check valve or the like (not shown) capable of sealing the inner cavity 23 may be installed at the proximal end of the tubular member 2 so that the gas injected into the abdominal cavity 8 is not discharged. it can.

The trocar tube of the present invention is not limited to that used for laparoscopic surgery, and can be applied to, for example, thoracoscopic surgery, brain surgery, and other operations.

[0069]

As described above, according to the trocar tube of the present invention, the tubular member penetrating the living tissue can be fixed inside the body cavity, and further inside and outside the body cavity. Be made sure and strong. In particular, when each inner fixing member is configured to be independently movable in the axial direction, the fixing can be reliably and firmly performed according to the puncture angle of the trocar tube with respect to the biological tissue.

Further, since the outer peripheral surface of the distal end portion of the tubular member does not have a raised portion such as a step, the trocar tube can be smoothly punctured and removed without increasing resistance. Further, when fixing the trocar tube to the abdominal wall or the like, the tip portion can be fixed without protruding into the abdominal cavity, so that when the endoscope is inserted, a wide field of view is secured, and forceps or the like is used. When the instrument of (1) is inserted, a wide area for surgical treatment can be secured.

Since the omentum near the inner surface of the abdominal wall can be removed from the tip opening of the trocar tube by using the inner fixing means, the field of view of the endoscope is improved, and
It is possible to smoothly insert and operate instruments such as forceps.
In addition, each inner fixing member can be independently rotated and / or
Alternatively, when it is configured to be movable, the fixed conditions such as the posture of the trocar tube can be set more finely,
The operation of removing the omentum becomes even easier.

[Brief description of drawings]

FIG. 1 is a perspective view showing an embodiment of a trocar tube of the present invention.

FIG. 2 is a perspective view showing a configuration of a tip portion of the trocar tube shown in FIG.

FIG. 3 is a sectional view taken along line XX in FIG.

FIG. 4 is a perspective view showing another embodiment of the trocar tube of the present invention.

5 is a perspective view showing a configuration of a tip portion of the trocar tube shown in FIG.

FIG. 6 is an exploded perspective view showing the configuration of an outer fixing means.

FIG. 7 is a perspective view showing a configuration of an outer fixing means.

FIG. 8 is a longitudinal sectional view showing a state in which the trocar tube of the present invention is fixed to the abdominal wall.

FIG. 9 is a longitudinal sectional view showing a state in which the trocar tube of the present invention is fixed to the abdominal wall.

[Explanation of symbols]

 1A, 1B Trocar tube 2 Tubular member 21 Tube wall 22 Tip surface 23 Lumen 24 Base end surface 3 Inner fixing means 31, 32, 33 Inner fixing members 34, 35, 36 Shaft member 4 Outer fixing means 41, 42, 43 Clamping member 44, 45, 46 Clamping operation means 47, 48, 49 Abutting member 50 Base 51 Clamping piece 52 Outer frame 53 Opening 54 Push rod 55 Screw shaft 56 Screw part 57 Knob 58 Head 59 Screw hole 60 Hinge 7 Abdominal wall 8 Abdominal cavity 9 outside body 10 inside surface 11 body surface

Claims (1)

[Claims] 1. A trocar tube having a tubular member that penetrates a biological tissue to communicate the inside and outside of a body cavity with an inner fixing means that fixes the tubular member inside the body cavity, wherein the inner fixing means comprises: A plurality of inner fixing members rotatably installed with respect to the tubular member at the tip of the tubular member,
An operating member for rotating each of the inner fixing members, and by operating the operating member, each of the inner fixing members has a first posture along the peripheral surface of the distal end portion of the tubular member, and one end thereof. A trocar tube which is configured so as to be pivoted about a second position such that the other end thereof projects outward from the peripheral surface.