JPH0819544A - Living body tissue storing bag - Google Patents

Abstract

PURPOSE:To obtain a living body tissue storing bag by which a taking out operation can be performed sefely and smoothly when a resected living body tissue in a living body is taken out in an subendoscopic surgery. CONSTITUTION:This living body tissue storing bag is a bag-shaped body provided with a thread inserting part 6 through which fastening thread 5 is inserted on the circumference rim of an opening part 4, and has a thin funnel-shape in which a body part 1 with substantially the same aperture as that of the opening part 4, a taper part 2 with gradual reducing diameter, and a tail part 3 whose outer diameter is 5-30mm are connected together. The tapering angle of the reducing diameter taper part 2 is preferably set in a range of 25-45 deg. in relation to the center axis.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a living tissue storing bag for medical treatment, which is used to remove living tissue from the body during endoscopic surgery.

[0002]

2. Description of the Related Art Endoscopic surgery is a surgical operation in which a medical instrument such as forceps is inserted from a trocar inserted into a puncture opening in a body wall and a procedure is performed while observing with an endoscope. Since it has less invasion to the body and has a shorter healing period, and has a slight scar, etc., it has been rapidly spread in recent years. However, this surgical procedure usually requires various medical procedures.
Since it is performed from a trocar of about 12 mm, a puncture opening, a small opening, etc., dedicated medical equipment will be prepared.

When removing a lesion or a tissue sample in the body by endoscopic surgery, a container used for accommodating the separated living tissue and pulling it out of the body is also an important medical instrument. is there. For example, when removing the gallbladder by laparoscopic cholecystectomy, the separated gallbladder is forcibly pulled out through the trocar puncture port, but if the gallbladder wall is exhausted due to inflammation or the like, it is pulled out. Occasionally, the tissue wall is damaged and the bile contained therein is scattered into the abdominal cavity. When such a phenomenon occurs, the risk of developing peritonitis increases. Also, in the case of calculus fullness or huge calculi, the calculus cannot be removed outside the body unless it is crushed before passing through the trocar puncture site, which makes the procedure complicated, and in the case of cancerous lesions, scattering or dislocation of cancer cells may occur. Extracorporeal removal should be done without damaging the tissue specimen to avoid it.
The biological tissue storage container is a medical device used to store the separated biological tissue and safely remove it outside the body.

Conventionally, a commercially available polyethylene bag or a parcel bag such as a condom has been used as a biological tissue storage container used in this type of endoscopic surgery, but thereafter, functions of operability and safety are provided. A special storage bag that is improved is being developed. For example, in U.S. Pat. No. 5,143,082, a loop-shaped thread passes through a thread passing portion around the bag opening and a hollow pipe, and the bag opening is closed by pulling the thread at the rear end of the hollow pipe. Is disclosed. According to this structure, the bag inserted through the trocar into the body can be guided from the outside to the arbitrary position by operating the hollow pipe, and the opening can be firmly closed. US Patent No. 5
No. 037379 discloses a bag having a high rupture strength in which a thread for closing the bag is passed through the mouth, and a tongue-like grip portion is provided so that the mouth can be easily grasped by forceps when the mouth is opened. A storage bag having a different structure has been proposed. Also in the United States
Product name "Pleat" in the Cabotmedical catalog
The storage bag structure of "man Sac" has a spindle-shaped bag made of semi-rigid plastic attached to the tip of the support operation rod, and an opening is installed diagonally on the hand side.
The material and the cut shape of the opening have a function of naturally opening when inserted into the body through the trocar and closing the opening when the living tissue is accommodated and drawn into the trocar.

[0005]

However, these living tissue storing bags according to the prior art have the main point of improvement in that the movement of the bag and the opening and closing of the opening can be easily performed by operating the member outside the body or the forceps inside the body. However, no consideration is given to safety and easiness when the biological tissue is stored and then pulled out of the body.

That is, since the shape of the conventional storage bag is a spindle shape, a square shape, or a simple bag shape of an inverted trapezoid having a slightly larger opening side, the bag having the living tissue stored and the opening closed is about 10 mm in diameter. When the bag is pulled out from the trocar puncture port, the contents move to the bag terminal side due to the compression action, and as a result, the outer diameter of the bag locally bulges and it becomes impossible to pass through. For this reason, the operator is unavoidably forced to crush the contents with the bag mouth exposed to the outside of the body and suck a part or all of the contents, and then pull out the entire bag, or incise the puncture opening of the trocar. Since it is necessary to take measures such as increasing the caliber and then pulling it out, there is a problem that the operation is prolonged and the patient is excessively invaded.

The present invention has been made as a result of extensive studies in order to solve the above-mentioned problems in the conventional structure. The object of the present invention is to store the living tissue cut from the body during endoscopic surgery. Another object of the present invention is to provide a living tissue storing bag that can safely and smoothly complete the extraction operation when the body is pulled out of the body through the trocar puncture opening.

[0008]

A living tissue storing bag according to the present invention for achieving the above object is a bag-like body having a threading portion into which a fastening thread is inserted at the periphery of the opening, The structural feature is that it has a thin drawing shape in which a main body portion having substantially the same diameter, a taper portion having a reduced diameter, and a tail portion having an outer diameter of 5 to 30 mm are connected.

In the living tissue storing bag of the present invention, the taper angle of the taper portion having a reduced diameter is 25 to 4 with respect to the central axis.
It is preferably in the range of 5 °.

[0010]

The bag for accommodating biological tissue according to the present invention is provided with a threading portion in which a fastening thread is inserted at the peripheral edge of the opening, a main body having substantially the same diameter as the processed portion, a reduced taper portion and an outer portion. Diameter 5
It is configured in the form of a thin squeeze in which the tail portion of 30 mm is sequentially connected. Of these, the main body portion has an internal volume that reliably stores the biological tissue cut off in the body, and by operating the fastening thread inserted into the threading section after storage with forceps or the like,
The opening is tightly closed. Therefore, it becomes possible to easily store the separated living tissue in isolation without causing a phenomenon of scattering or leaking inside the body cavity. The bag after storage passes through the puncture port with a thin trocar from the closed opening side and is pulled out of the body.However, when the bag is pulled out, the compression action applied to the bag by pressing the puncture port causes the biological tissue to contract in the reduced diameter taper part in the subsequent stage. It smoothly moves while deforming and / or aligning with the tail part. The smooth rearward movement of the contents skillfully alleviates the unevenness of the internal pressure of the bag, eliminates the problem of being unable to pull out due to the local expansion and bulging that has occurred in the storage bag of the conventional structure, and excessive internal pressure due to compression. It works effectively to prevent serious accidents where the bag bursts when rising. When removing a large stone in the gallbladder, it is necessary to crush the stone in the main body with the opening exposed from the trocar to the outside of the body, but the crushed stone moves smoothly to the tail and deposits. To do.

The outer diameter of the tail portion is in the range of 5 to 30 mm, which is usually adapted to the diameter of the trocar puncture opening formed in the body wall, and the outer diameter range of the trocar conforms to the trocar diameter of the patient. By selecting so, it is not necessary to perform excessive invasion such as incision expansion during extraction. Further, the taper angle of the reduced diameter tapered portion is 25 to 4 with respect to the central axis.
Designing within a range of 5 ° is preferable for smooth rear movement of the contents.

[0012] In combination with the above-mentioned operations, it becomes possible to reliably store the living tissue separated from the body in the endoscopic surgical operation, and always proceed the extraction operation safely and smoothly.

[0013]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described in detail below with reference to an embodiment shown in the drawings. However, the present invention is not limited to this embodiment.

FIG. 1 is a perspective explanatory view showing the entire structure of a living tissue storing bag according to the present invention. Reference numeral 1 is a main body portion, 2 is a taper portion having a reduced diameter, 3 is a tail portion, and each portion is integrally connected. And has a narrowed shape. The storage bag is, for example, a single-layer or multi-layer film of thermoplastic resin such as polyethylene, polyamide, ethylene-vinyl acetate copolymer, polyurethane, polypropylene, etc., rubber-based sheets such as silicone rubber, natural rubber, etc. Can be made of various materials that are cross-coated with
There is no particular limitation on the material.

However, since the storage bag itself is inserted through a small-diameter trocar and operations such as opening and moving are performed inside the body cavity, it is thin so as to have a minimum necessary volume when folded or rolled. It must have wall thickness (0.01 to 0.20 mm) and flexibility and recoverability. Further, when the living tissue is stored and passed through the trocar puncture port, it has material strength and joint strength that do not cause rupture or extreme deformation due to increase in internal pressure, and it was stored when viewed directly with an endoscope. It is preferably transparent so that the state of the contents can be easily confirmed. Furthermore, in order to improve the openability of the storage bag, it is necessary to use a material that does not adhere to the bag-shaped body due to sterilization and sterilization treatment before use. It is desirable to perform uneven processing or emboss processing. The preferred bag has a tensile rupture strength of 0.2 kg or more including the joint portion. For example, a polyamide resin single-layer film (thickness: 0.05 mm) or an ethylene-vinyl acetate copolymer resin film (thickness: 0.1 mm). ), The bag formed by high-frequency welding of the peripheral joints satisfies this requirement. The bag-like body is formed by stacking resin films and heat-sealing or high-frequency-welding the peripheral portion, or by forming the raw material into an integral bag-like body using blow molding, compression molding, injection molding, dipping molding, or the like. Etc., an appropriate method can be adopted.

The body portion 1 is a portion having a relatively large inner volume having substantially the same diameter as the opening portion 4, and a threading portion 6 for inserting the fastening thread 5 is formed on the peripheral edge of the opening portion 4. ing. The internal volume of the main body 1 is designed to be a size that can be easily housed in consideration of the shape and size of the target dissected organ tissue. Further, it is preferable to partially attach a gripping margin 7 to the end portion of the opening 4 for facilitating the gripping operation at the time of opening. The threading portion 6 may have any structure as long as the opening 4 can be reliably closed when the inserted fastening thread 5 is pulled, and for example, a method of folding back and joining bag materials, a method of attaching a tubular member, It can be formed by an appropriate means such as a method of forming a plurality of threading holes arranged at equal intervals. Of these, the method of folding back and joining the bag material is most preferable in that the opening 4 can be reinforced and the opening operation becomes easy. It is desirable that the fastening thread 5 has a tensile strength that is not easily deformed and broken in a pulling stage, has a good sliding property with the threading portion 6, and is a flexible thin thread. For example, a polyamide resin thread is preferably used. The fastening thread 5 can also be configured by being connected to various members such as a support operation member, a ligation fixing member, and an opening assisting member, which are not shown in the figure, if necessary.

The reduced-diameter taper portion 2 is a funnel-shaped portion for connecting the wide-diameter main body portion 1 and the small-diameter tail portion 3 to each other. The reduced-diameter taper portion 2 is designed to have a curved inner surface so that the contents of the stored living tissue can be smoothly moved to the tail portion 3, and the taper angle is 25 to the center axis.
It is preferably formed in the range of 45 °. Further, it is a preferable embodiment that the connecting portion between the main body 1 and the tail portion 3 is designed so as not to have a corner.

The tail portion 3 is a portion to be filled with contents by moving the reduced diameter taper portion 2 from the main body portion 1 when it finally passes through the trocar puncture opening, and is usually a trocar formed on a body wall. It is formed in an outer diameter range of 5 to 12 mm, which is equivalent to the diameter of the puncture opening. The shape is substantially straight, has a length that can secure an internal volume that can sufficiently store the tissue that is difficult to deform contained in the contents, and the sealing tip does not damage the organ in the body cavity It is preferably designed to have a rounded shape.

Specifically, the preferred bag size in the case of storing an isolated gallbladder organ containing a large calculus or a filled calculus by laparoscopic cholecystectomy is that the main body 1 has an outer diameter of 40 to 70.
The effective length is 40 to 110 mm, the diameter is 30 to 80 mm when the taper angle of the taper portion 2 is 30 °, and the outer diameter is 10 to 22 mm and the length is 80 to 200 mm.

In the illustrated embodiment, the main body 1 has a straight shape with the same inner diameter, but if the mouth has substantially the same diameter as the opening 4, the main body is gently reduced in diameter. Even if the shape connected to the taper portion 2 or the shape of the main body portion is similar to that of the taper portion 2 having a reduced diameter, as long as the functionally accommodated contents smoothly move to the tail portion 3, Included in the configuration.

Next, a method of using the living tissue storing bag according to the present invention will be described by taking laparoscopic cholecystectomy as an example. First, the gallbladder duct is clipped closed while laparoscopically monitoring, and the excised gallbladder is dissected from the liver bed. Then, insert a folded biological tissue storage bag from a trocar having a diameter of 10 mm installed in advance at the puncture opening for treatment, grasp the bag by inserting grasping forceps from the diagonally formed trocar,
It is introduced into the abdominal cavity. The main body 1 is held by the forceps, the gripping margin 7 is pinched by another forceps, and the opening 4 is opened. Grasping the dissected gallbladder with the forceps holding the main body 1, and opening the main body 1 through the opening 4.
To store. Subsequently, the thread passing portion 6 is held by the forceps, the fastening thread 5 is picked up by another forceps, and the opening portion 4 is surely closed by pulling out the fastening thread 5 from the thread passing portion 6.

A forceps is inserted from a trocar (umbilical part) serving as an extraction port, the end of the fastening thread 5 is picked, the threading portion 6 is drawn into the trocar, and then the opening 4 is guided outside the body together with the trocar. . The opening 4 exposed outside the body is opened, and a treatment tool such as forceps is inserted into the inside of the main body 1 located inside the body to break the gallbladder and crush the calculus. Then, when the gallbladder is taken out from the opening 4, the crushed calculi move through the tapering portion 2 of reduced diameter to the tail portion 3 and settle down, and fill this portion to form a rod-like shape. In this state, when the opening 4 is grasped and pulled out from the trocar puncture opening, the whole body tissue storage bag can be smoothly extracted without any trouble.

[0023]

As described above, by using the living tissue storing bag of the present invention, it is possible to securely store living tissue of an affected area that has been cut off during endoscopic surgery, and always remove it safely and promptly outside the body. It will be possible. Therefore, the operation time can be shortened and unnecessary invasive burden on the patient can be prevented. Further, since the living tissue storage bag according to the present invention is structurally simple, it can be mass-produced at low cost.

[Brief description of drawings]

FIG. 1 is an overall perspective explanatory view showing an embodiment of a biological tissue storage bag according to the present invention.

[Explanation of symbols]

 1 Body 2 Reduced-diameter taper 3 Tail 4 Opening 5 Fastening thread 6 Threading section 7 Gripping allowance

Claims (2)

[Claims] 1. A bag-shaped body having a threading portion in which a fastening thread is inserted at a peripheral edge of an opening, the main body having substantially the same diameter as the opening, a taper portion having a reduced diameter, and an outer diameter of 5 to 5. A living tissue storing bag having a thin drawing shape in which a tail portion of 30 mm is connected. 2. The biological tissue storage bag according to claim 1, wherein the taper angle of the taper portion with a reduced diameter is in the range of 25 to 45 ° with respect to the central axis.