JPH08173372A - Trocar - Google Patents

Abstract

PURPOSE: To provide a trocar capable of being hygienically fixed on an abdominal wall by providing a balloon on the outside wall of the tip of an outer mantle tube fixing tool freely slidably attached on the outside wall of the outer mantle tube in an endoscope of which lens cover soiled by body fluid is cleaned when observing a lesion using the endoscope contained in a trocar. CONSTITUTION: A fixing tool means comprising an anchor 9 and a lock screw 10 is provided to fix a lens cover on the tip of an inner mantle tube 2 of this trocar and an outer mantle tube 1 on the base end is equipped on this trocar, and a liquid cleaning means to clean the lens cover is provided on the tip opening of the outer mantle tube 1 and a means to intermittently inject liquid on the base end. A gap is formed between the outer mantle tube 1 and the inner mantle tube 2 and is used as a pass 12 for liquid to clean the lens cover. In this case, a balloon 8 is mounted on a suitable position of the outer mantle tube fixing tool. Thus, the outer mantle tube can be fixed on the abdominal wall by expanding the balloon 8 with fluid supplied from a fluid injection inlet 15.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a trocar used in laparoscopic surgery, and more particularly, when an endoscope is housed in a trocar to examine a diseased part in a body, a lens cover which is soiled with body fluid is washed. The present invention relates to a trocar for observing an affected part in the body.

[0002]

2. Description of the Related Art Conventionally, in intraperitoneal surgery, laparoscopic surgery has been performed in order to avoid wide skin incision. As a method for forming a fistula in laparoscopic surgery, there are a close method and an open method. The Cloze method introduces carbon dioxide gas into the abdominal cavity with a pneumoperitoneum to inflate the abdominal cavity. Insert the one marked with. In the open method, after a small incision is made in the skin, a blunt needle trocar is inserted, the inner needle is removed, the pneumoperitoneum is inserted from the outer cylinder, and an endoscope is inserted to perform a surgical procedure. In the case of the open method,
Since the fistula to the outside of the body is previously formed by the incision, it is possible to observe the affected part in the body by inserting the endoscope into the trocar-mantle tube. However, when a trocar-mantle tube is inserted into the abdominal cavity to examine a diseased part in the body, body fluid stains the lens cover of the mantle tube, so that it is not possible to observe a minute diseased part. Because of the image, I often had trouble with the diagnosis. As means for solving such a problem, Japanese Laid-Open Patent Publication No. 6-22902 discloses a laparoscope and a laparoscopic surgery method in which a fluid is passed through the tip to clean the tip.

[0003]

However, in such a laparoscope, in order to fix the laparoscope to the abdominal wall, a thread is hung on a suspension portion of the laparoscope and the thread is sewn and fixed to the abdominal wall.
Therefore, it is not only painful for the patient to sew the abdominal wall with a thread, but also has a problem in hygiene. The present invention has been made to solve the above problems, and an object of the present invention is to provide a trocar capable of hygienically fixing the trocar to the abdominal wall. Still another object of the present invention is to provide a trocar that is capable of continuously taking photographs and observing an affected area by thoroughly cleaning dirt on the lens cover with a liquid.

[0004]

Means for Solving the Problems That is, the present invention provides (1)
A lens cover at the tip and an inner tube provided with means for fixing the outer tube to the base end; and (2) a liquid washing means for inserting the inner tube and washing the lens cover at the tip opening, An outer tube having means for intermittently injecting liquid at the base end and means for fixing the inner tube, (3) in a gap between the outer wall of the inner tube and the inner wall of the outer tube. A trocar comprising a liquid passage for cleaning a lens cover provided therein, wherein the outer tube fixing tool slidable on the outer tube outer wall has a balloon provided on the outer wall on the front end side.

The present invention also provides the above-mentioned trocar, wherein
A means for fixing the inner tube and the outer tube has a male screw on the upper outer wall,
The lower inner wall is provided with a cylindrical cap composed of a plurality of slits, one end of which is annular and one end of which is open, and the other end of which is open, and an upper part is provided with a female screw that is screwed with the male screw to fasten the inner tube with the slit. The foot of the trocar is a trocar comprising a female screw provided near the tip opening of the outer sheath tube and a cylindrical body provided with a male screw for fixing the inner sheath tube and the outer sheath tube.
Furthermore, the present invention provides the lens cover in the trocar.
The cleaning means is a trocar for cleaning the lens cover by injecting a liquid from the outer circumference to the inner circumference of the annular body having a plurality of holes on the circumferential surface. Furthermore, according to the present invention, in the trocar, the means for intermittently injecting the liquid pushes the button of the plunger pushed up by the spring, whereby the liquid inlet and the liquid passage provided on the side of the plunger are connected. The trocar is a trocar in which the shut-off valve is separated and liquid flows into the liquid passage from the liquid inlet.

The present invention also provides the above-mentioned trocar, wherein
The outer tube fixing device is composed of a conical flexible resin layer whose diameter on the distal end side is gradually reduced, a plurality of annular ridges are provided on the outer surface thereof, and a cylindrical outer wall on the distal end side is provided with a bar. Is a trocar provided with a switch.

[0007]

[Function] After making a small incision on the skin of the abdominal wall, a blunt needle trocar is inserted and the inner needle is removed. After that, the trocar of the present invention in which the inner tube and the outer tube are fixed at their proximal ends is inserted through the incision in the abdominal wall until the balloon of the outer tube fixing tool completely enters the abdominal cavity, and then the balloon is inflated. Then, the mantle tube is fixed to the inner wall of the abdominal cavity. On the other hand, the trocar can be fixed from both sides of the abdominal wall by fixing the trocar with the lock screw of the conical outer tube fixing device on the outside. After that, the endoscope is inserted into the inner lumen of the inner tube, and the button of the plunger provided at the proximal end of the outer tube is pressed to remove the liquid contained in the balloon from the liquid injection device. Through the liquid passage formed in the gap between the outer tube and the outer tube, the lens cover is washed from the outside to the inside of the hole of the annular body provided at the tip of the outer tube. Before taking a picture with an endoscope, be sure to press the button on the plunger to clean the lens cover and make the lens cover clear before taking a picture.

[0008]

EXAMPLES An example of the present invention will be described below with reference to examples. FIG.
FIG. 2 is an explanatory view showing an example of the trocar of the present invention, FIG. 2 is a cross-sectional view of the inner tube base end before being fixed to the outer tube base end, and FIG. 3 is a liquid flow of the outer tube base end. It is a sectional view of the entrance,
FIG. 4 is a sectional view of the outer tube fixing device, and FIG. 5 is the trocar of the present invention.
3 is a cross-sectional view of the tip of FIG. In the figure, 1 is an outer tube, 2 is an inner tube,
Reference numeral 3 is a proximal end portion of the outer tube, 4 is a proximal end portion of the inner tube, 5 is a fixture for the outer tube, 6 is a lens cover, 7 is an annular body, 8 is a balloon, and 9 is a balloon.
Is an anchor, 10 is a lock screw, 11 is a spring, 12 is a liquid passage, and 13 is a button.

FIG. 1 is an explanatory view of the trocar of the present invention.
The inner tube 2 is provided with means for fixing the lens cover 6 at the tip and the outer tube 1 at the base end. The outer tube 2 is provided with a liquid cleaning means for inserting the inner tube 2 and cleaning the lens cover 6 at the tip opening, a means for intermittently injecting a liquid at the base end, and a means for fixing the inner tube 2. It becomes. A gap is provided between the outer wall of the inner tube 2 and the inner wall of the outer tube 1, and a liquid passage 12 for cleaning the lens cover 6 is provided. An outer tube fixing device 5 slidable on the outer wall of the outer tube is provided in the middle of the outer wall of the outer tube 1 to fix the outer tube to the abdominal wall from the outside. A balloon 8 is provided on the outer wall of the distal end of the outer tube fixing device 5. Balloon 8 is inserted into the abdominal cavity,
The outer tube is fixed to the abdominal wall from the inside by inflating with a pressurized fluid, and the outer tube is fixed from both sides of the abdominal wall.

FIG. 2 shows the trocar base 3 of the trocar of the present invention.
FIG. 4 is a cross-sectional view of the inner tube base end portion 4 fixedly attached to the upper outer wall of which a male screw 18 is provided, and a lower inner wall of which is formed into a cylindrical shape having a plurality of slits 17 having one end fixed and the other end open. The sheath 21 is formed, and the inner tube 2 is inserted into its inner cavity. And the sheath 21 having a male screw 18 has a female screw 19 at the top.
The inner tube 2 is clamped by the slit 17 of the sheath 21 and is gradually tightened. A male screw 20 is formed on the outer wall of the foot portion, and is screwed with a female screw (not shown) provided near the tip opening of the outer tube to fix the inner tube 2 and the outer tube 1 together.

The tips of the inner tube 2 and the outer tube 1 thus fixed are shown in the sectional view of the tip of the trocar of the present invention in FIG. A lens cover 6 is provided at the tip of the inner tube 2, and an annular slit 7 composed of a plurality of slits is provided at the tip of the outer tube 1. A cuff 14 is formed on the front surface of the annular slit 7 to prevent the annular slit 7 from directly colliding with body fluid. There is a gap between the wall of the outer tube 1 and the wall of the inner tube 2, and a liquid passage 12 through which the liquid supplied from the liquid inflow port 24 passes is formed. Liquid passage
The liquid supplied to 12 collides with the wall of the cuff 14 and flows from the outside of the annular body 7 into the inside of the annular body 7 to clean the outer surface of the lens cover 6, and the liquid stays in the body. Physiological saline is preferred as the liquid used.

A liquid inflow port 24 is provided at the base end portion 3 of the mantle tube, and as shown in the cross-sectional view of FIG. 3, when the button 13 is pushed, the liquid intermittently flows into the liquid passage 12. ing. The button 13 is normally tensioned outward by a spring 11 and the liquid is closed by a seal member 25 and a valve 26. By pressing the button 13 in such a state, the shaft shifts toward the valve 26 and the cylindrical truncated cone
The valve 26 that has been sealed at the upper end of 27 moves in the direction of the larger diameter of the truncated cone 27, and a gap is formed between the valve 26 and the truncated cone 27 that contacts. Then, as the liquid flows into the liquid passage 12 through the gap, the lens cover 6 is washed with the liquid.

FIG. 4 is a sectional view of the outer tube fixing device 5. The outer tube fixing device 5 is a conical member for fixing the outer tube 1,
The outer tube 1 is freely slid on the outer wall, and the outer tube 1 is fixed with a lock screw 10 so that the abdominal wall is located at a desired position. The bottom of the mantle tube fixing device 5 is provided with a conical anchor 9 that shields the incision in the surgical site. A plurality of annular projections 28 are formed on the outer wall of the anchor 9, and the boundary with the skin when the anchor 9 is inserted into the opening formed in the abdominal wall in advance to block the abdominal cavity with the trocar. become. The distal end of the outer tube fixing device 5 has a cylindrical shape, and the fluid passage 30 is provided along the inner wall of the conical member, and is a portion to be inserted into the abdominal cavity. Then, the balloon 8 is provided at an appropriate position, and the fluid supplied from the fluid inlet 15 expands the balloon 8, so that the outer tube 1 can be fixed to the abdominal wall from within the abdominal cavity. As the fluid, water, liquid such as physiological saline, air, gas such as carbon dioxide, etc. are used.

An O-ring is attached to the upper end of the anchor 9.
29 is provided to securely fix the anchor 9 to the outer wall of the outer tube 1 and prevent fluid from leaking from the upper end. The anchor 9 and the balloon 8 are made of flexible resin. As flexible resin, polyvinyl chloride, polyethylene, polypropylene, polyester, polyamide,
Examples thereof include thermoplastic resins such as acrylic resins, synthetic rubbers, natural rubbers and the like.

Next, a method of operating the trocar of the present invention will be described. After making a small incision in the skin of the abdominal wall, a blunt needle trocar
Insert and remove the inner needle. After filling the abdominal cavity with a gas, especially carbon dioxide gas, with the pneumoperitoneum, the trocar of the present invention, in which the inner tube 2 and the outer tube 1 are fixed at the proximal ends, is provided from the incision of the abdominal wall to the conical member of the outer tube fixing device. The outer tube 1 is positioned by tightening the outer tube fixing tool 5 with the roll screw 10 to insert the fluid into the protruding body 28, and the balloon 8 is inflated by injecting the fluid from the fluid injection port 15. The tube 1 is fixed to the abdominal wall. Then, the endoscope is inserted into the inner cavity of the inner tube 2 and the button 13 provided at the proximal end of the outer tube 1 is pressed to allow the liquid to pass through the liquid passage formed in the gap between the inner tube 2 and the outer tube 1. Through 12,
The lens cover 6 is washed from the outside to the inside of the annular body 7 provided at the tip of the outer tube 1. And before you take a picture with the endoscope, be sure to press button 13 to clean the lens cover 6,
Take a picture after clearing the lens cover 6.

[0016]

INDUSTRIAL APPLICABILITY The trocar of the present invention can fix the mantle tube from both sides of the abdominal wall without causing pain to the patient and can wash the lens cover in a stable state. The lens cover is washed cleanly, the inside of the body can be smoothly observed with the endoscope, and a photograph can be taken.

[Brief description of drawings]

FIG. 1 is an explanatory view of a trocar of the present invention.

FIG. 2 is a cross-sectional view of a proximal end portion of an inner sleeve fixed to a proximal end portion of an outer sheath tube.

FIG. 3 is a cross-sectional view of a liquid inlet at a base end portion of an outer tube.

FIG. 4 is a sectional view of the outer tube fixing device.

FIG. 5 is a sectional view of the tip of the trocar of the present invention.

[Explanation of symbols]

 1 Outer tube 2 Inner tube 3 Outer tube base end 4 Inner tube base end 5 Outer tube fixture 6 Lens cover 7 Annular body 8 Balloon 9 Anchor 10 Lock screw 11 Spring 12 Liquid passage 13 Button

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Hajime Tsujikawa 3-9-3 Honjo Nishi, Kita-ku, Osaka Nissho Inc. (72) Inventor Shoji Kawamoto 3-9-3 Honjo-nishi, Kita-ku, Osaka Nissho Co., Ltd.

Claims (5)

[Claims] (1) An inner tube having a lens cover at the tip and a means for fixing an outer tube at the base end, and (2) the inner tube is inserted and the lens cover is washed at the tip opening. A liquid cleaning means, an outer tube provided with means for intermittently injecting liquid at the base end and a means for fixing the inner tube, and (3) an outer wall of the inner tube and the outer tube. And a liquid passage for cleaning a lens cover provided in a gap between the outer wall of the outer tube and the inner wall of the outer wall of the outer tube. A trocar that has been created. 2. A cylindrical sheath-like body having a male screw on an upper outer wall and a lower inner wall having a plurality of slits, one end of which is fixed at one end and the other end of which is open, as means for fixing the inner and outer tubes. ,
A female screw is provided on the upper portion to be screwed with the male screw to fix the inner tube with the slit, and its foot portion is screwed with the female screw provided near the tip opening of the outer tube to form the inner tube. The trocar according to claim 1, comprising a cylindrical body provided with a male screw for fixing the outer tube. 3. The trocar according to claim 1 or 2, wherein the lens cover cleaning means cleans the lens cover by injecting a liquid from the outer circumference to the inner circumference of the annular body having a plurality of holes on the circumferential surface. 4. A valve for shutting off a liquid inlet and a liquid passage provided on a side portion of the plunger is separated by pushing a button of a plunger pushed up by a spring by means for intermittently injecting the liquid. The trocar according to claim 1, wherein the liquid flows into the liquid passage from the liquid inlet. 5. The outer tube fixing device is made of a conical flexible resin layer whose tip side diameter is gradually reduced, and a plurality of annular ridges are provided on the outer surface thereof, and the tip side cylindrical shape is provided. The trocar according to any one of claims 1 to 4, wherein the outer wall is provided with a balloon.