JPH08266549A - Trocar sleeve pipe and trocar - Google Patents

Abstract

PURPOSE: To provide a trocar sleeve pipe which is low in invasion, is easy to be pricked, is low in production cost by forming a tubular member to a diameter smaller in its front end than in its base end in a natural state and separating at least one point of the tubular member and expanding the diameter at the front end at the time a desired long inserting object is inserted into the celom. CONSTITUTION: This trocar sleeve pipe 10 is composed of the tubular member 11 and a grip member 18 connected to the operator side part 13 at the base end of the tubular member 11. The tubular member 11 has the base end 13 and the front end 14 and is formed to an approximately conical shape smaller in the bore and outside diameter of the front end 14 than the bore and outside diameter of the base end 13 in matrrel state. The front end 14 of the tubular member 11 is so formed that its bore expands in compliance with the outside diameter of the trocar pipe for expansion. The front end side and shaft part are composed of rigid materials. The bore of the front end 14 is expandable by separating at least one point of the tubular member at the time of inserting a treating appliance or the like having an approximately uniform outside diameter into the internal cavity of the trocar sleeve pipe 10.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention is mainly used for inserting and removing instruments such as an endoscope, forceps, electric knife, laser knife, needle holder, scissors, etc. into a body cavity in body cavity endoscopic surgery. The present invention relates to a trocar, particularly a trocar outer tube.

[0002]

2. Description of the Related Art Recently, using a trocar (trocar),
Laparoscopic surgery is performed to perform cholecystectomy and intestinal anastomosis without laparotomy. This operation method has been attracting attention in recent years because it is a minimally invasive procedure that does not require laparotomy, has a small burden on the patient, and requires only a short hospital stay.

The trocar punctures and penetrates the body wall such as the abdominal wall to enter the body cavity through an endoscope, forceps, electric scalpel, laser scalpel,
It is a surgical instrument used to insert a surgical instrument such as a needle holder or scissors, and is generally composed of a tubular trocar outer tube and an inner trocar needle (obturator) having a sharp tip. At the time of use, with the trocar inner needle inserted into the inner cavity of the trocar outer cannula, the tip of the trocar inner needle penetrates the body wall to pierce into the body cavity, and then the trocar inner needle remains with the trocar inner needle remaining. It is fixed to the body wall by removing only the trocar mantle, and gas is injected into and removed from the body cavity through the fixed trocar mantle, and instruments such as endoscopes, forceps, electric scalpels, and needle holders are used. In and out.

Here, the conventional laparoscopic surgery will be described with reference to FIG. FIG. 9: is sectional drawing which shows the mode of the conventional laparoscopic surgery typically. In laparoscopic surgery, a pneumoperitoneum needle is punctured in the abdominal wall 100 and a gas such as CO ₂ is injected to inflate the abdominal cavity, or the abdominal wall 100 is punctured with a metal rod such as a wire. By the lifting method of pulling the metal rod upward with a wire and lifting the abdominal wall 100,
A surgical space is secured in the abdominal cavity 101. Then the abdominal wall 100
A small incision is made at a predetermined portion of the trocar, a trocar is punctured through the incision, an inner needle (not shown) of the trocar is removed, and the trocar outer tube 107 is fixed to the abdominal wall 100.
Then, the endoscope 10 such as a rigid endoscope or a flexible endoscope is passed through a passage (lumen) secured by the trocar outer tube 107.
2 is inserted into the abdominal cavity 101, and the inside of the abdominal cavity 101 is moved to the endoscope 10
While observing the monitor screen 103 photographed in 2, the trocars are punctured and fixed to other plural places in the same manner as described above, and the forceps 104, scissors 105, A long treatment instrument such as the electric knife 106 is inserted and appropriately operated to perform cholecystectomy or intestinal anastomosis.

Conventionally, this type of trocar has a problem that the body wall is greatly invaded during puncture because the outer diameter of the trocar is substantially constant over the entire length. In order to solve this problem, an expansion trocar having a small tip diameter and being used by expanding the inner diameter after puncture has been proposed (Japanese Patent Application No. 6-1577).
33, Japanese Patent Application No. 6-283142). According to such an expanded trocar, since the diameter of the tip of the trocar is small when puncturing the body wall, the invasion to the body wall is reduced,
With respect to these, there are still problems such as reduction in diameter, reduction in puncture resistance, further improvement in safety, and reduction in manufacturing cost.

[0006]

DISCLOSURE OF THE INVENTION An object of the present invention is to provide a trocar outer tube which is less invasive, easy to pierce, and inexpensive to manufacture in a trocar used by expanding the inner diameter of the tip after puncturing. To provide a trocar with.

[0007]

These objects are achieved by the present invention described in (1) to (7) below.

(1) A trocar mantle tube comprising a tubular member and a grip member connected to a proximal end portion of the tubular member, wherein the tubular member in a natural state has a diameter from a proximal end portion to a distal end portion. The trocar mantle tube is small in size, and when the desired elongated insert is inserted into the lumen, at least one portion of the tubular member is separated and the diameter of the distal end portion is expanded.

(2) The trocar mantle tube according to (1), wherein the distal end portion of the tubular member is made of a material that is softer than the portion other than the distal end portion of the tubular member.

(3) A trocar mantle tube comprising a tubular member and a grip member connected to the proximal end portion of the tubular member, wherein the tubular member in the natural state has a diameter from the proximal end portion to the distal end portion. Is small, and when a long insert is inserted into its lumen, the tubular member is deformed and the diameter of the distal end portion expands, and the distal end portion of the tubular member is the distal end portion of the tubular member. Trocar mantle characterized by being more flexible than other parts.

(4) The trocar outer tube according to any one of the above (1) to (3), wherein the tubular member is composed of a plurality of plate-like members which are connected in an annular shape and integrated.

(5) The trocar outer tube according to the above (4), wherein the tubular member is formed by adjoining at least base end portions of adjacent plate-like bodies by adhesion or fusion.

(6) A trocar outer tube according to any one of the above (1) to (5), and a trocar inner needle that is used by being inserted into the inner cavity of the tubular member of the trocar outer tube. Characterized trocar.

(7) The trocar according to (6) above, further comprising an expansion trocar tube for expanding the tubular member of the trocar outer tube.

[0015]

The tubular member of the trocar mantle tube of the present invention is constructed by connecting and integrating a plurality of plate-like bodies, so that a covering tube or the like is installed on the outer periphery in order to fix the separated plate-like bodies. There is no need, and thus a sufficient diameter reduction can be achieved.
As a result, the puncture resistance when puncturing a living body becomes smaller,
Less invasive.

Since the adjacent plate-like bodies are bonded to each other on the side surface on the base end side by adhesion or fusion, by inserting a long insert such as an expansion trocar tube,
The tubular member can be expanded easily and reliably.

Further, since the tip of the tubular member is made of a flexible material, it is possible to prevent the tip of the tubular member from damaging a living tissue such as an organ, which is highly safe. Further, since the adjacent plate-shaped bodies are separated from each other at their tip portions, it is easy to insert and remove the trocar inner needle having a tip outer diameter larger than the tip inner diameter of the trocar mantle tube before expansion.

[0018]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A trocar mantle tube of the present invention and a trocar equipped with the same will now be described in detail with reference to the preferred embodiments shown in the accompanying drawings.

FIG. 1 is a perspective view showing a natural state of a trocar mantle tube according to an embodiment of the present invention, and FIG. 2 is a line II- in FIG.
It is a II sectional view. As shown in FIG. 1, a trocar outer tube 10 of the present invention includes a tubular member 11 and a grip member 18 connected to a proximal end portion (hand side portion) 13 of the tubular member 11.
It consists of and.

The tubular member 11 has a proximal end portion 13 and a distal end portion 14, and in a natural state, has a diameter (inner diameter, outer diameter) of the distal end portion 14 that is larger than a diameter (inner diameter, outer diameter) of the proximal end portion 13. The smaller one has a substantially conical shape. In this embodiment, the tubular member 1
1 has a taper shape in which the outer diameter gradually decreases from the base end portion 13 toward the tip end portion 14. Here, the "natural state" means a state in which an external force is not applied to the tubular member 11.

The inner diameter of the tip portion 14 of the tubular member 11 is configured to expand in accordance with the outer diameter of the expansion trocar tube 50 described later. In addition, for example, when inserting a treatment instrument or the like having a substantially uniform outer diameter on the distal end side and the shaft portion such as forceps into the inner cavity 12 of the trocar mantle tube 10, the expansion trocar tube 50 described later is used. The inner diameter of the tip portion 14 of the trocar mantle tube 10 can be expanded without use.

As shown in FIG. 2, the tubular member 11 is composed of a plurality of elongated plate-like members 15 connected in an annular shape. Each plate-shaped body 15 has a trapezoidal shape in which the width on the base end side is larger than the width on the front end side. Each plate 15 is
It is composed of a tip portion 16 and a body portion 17, and the tip portion 16
Are made of a softer material than the main body 17.

Further, the adjacent plate-like bodies 15, especially the main body 1
The side surfaces of 7 are adhered or fused to each other, whereby the plate-like bodies 15 are connected and integrated to form the tubular member 11. In addition, it is preferable that the tip portions 16 of the plate-like bodies 15 are separated (have no binding force). Further, the main body portion 17 of each plate-shaped body 15 is not limited to being bonded or fused over its entire length, but may be partially bonded or fused.

The plate-like body 15 can be adhered to various adhesives such as acrylic adhesives, epoxy adhesives, rubber adhesives, silicone adhesives, polyurethane adhesives, polyester adhesives and polyamide adhesives. Adhesives or various solvents can be used. When the plate-shaped body 15 is fused, heat fusion, high frequency fusion, ultrasonic fusion, or the like can be performed. Such adhesion or fusion of the plate-like bodies 15 is preferably performed so that the plate-like bodies 15 can be easily separated from each other by inserting an expansion trocar tube 50 described later.

The material forming the main body portion 17 of the plate-like body 15 is not particularly limited as long as it is a material having a strength that can withstand the impact when puncturing the abdominal cavity or the pressure received from the body wall, but, for example, , Stainless steel, aluminum or aluminum alloys, elastic alloys, shape memory alloys, various metal materials, polyamide, polyvinyl chloride,
Examples thereof include various synthetic resin materials such as polycarbonate, ABS resin, polyethylene, polypropylene, polytetrafluoroethylene, and acrylic resin. Also,
Considering that an instrument such as an electric scalpel may be used, it is preferably composed of the synthetic resin material having an insulating property, and particularly preferably composed of polycarbonate, ABS resin or the like.

The material forming the tip portion 16 of the plate-like body 15 is preferably a softer material than the main body portion 17, and examples thereof include a super elastic alloy, soft polyvinyl chloride, ethylene-vinyl acetate copolymer, silicone rubber, Materials such as polyurethane may be mentioned.

In each plate member 15, the tip portion 16
And the main body 17 are joined by an adhesive (solvent),
Any method such as fusion bonding or integral molding such as two-color molding may be used. Also, the trocar mantle 1
In order to further reduce the puncture resistance of 0, the outer surface of the plate-shaped body 15 is preferably smoothed.

The thickness of the plate 15 depends on its constituent material, but is preferably about 0.05 to 3.0 mm, preferably 0.1 to 3.0 mm.
About 1.5 mm is more preferable. The plate body 15 has a wall thickness of 0.
If the thickness is less than 05 mm, the strength may be insufficient depending on the constituent material, and the pressure applied from the body wall during puncturing may not be able to be withstood.

The width of the tip of the tip portion 16 of the plate member 15 depends on the number of the plate members 15 constituting the tubular member 11, but for example, when the total number of the plate members 15 is about 6, 6.0
It is preferably about mm or less, more preferably about 4.0 mm or less, still more preferably about 1.5 mm. This width is 6.0 mm
When it exceeds, the inner diameter and the outer diameter of the tip portion 16 of the tubular member 11 increase, the resistance when puncturing the body wall increases, and puncturing may become difficult in some cases.

The width of the plate-shaped body 15 at the base end portion 13 depends on the number of the plate-shaped bodies 15 constituting the tubular member 11, but, for example, when the total number of the plate-shaped bodies 15 is about six. ,
It is preferably about 3.0 to 50 mm, more preferably about 5.0 to 20 mm, still more preferably about 6.0 mm. If this width is less than 3.0 mm, the strength of the tubular member 11 is weakened depending on the material of the plate member 15, and the tubular member 11 is deformed when the body wall is punctured, making it difficult to perform a piercing operation or It may be difficult to pass through. Further, if the width exceeds 50 mm, the outer diameter of the base end portion 13 of the tubular member 11 becomes large, the resistance at the time of puncturing the body wall becomes large, and it becomes difficult to pierce again.

The total number of the plate-like members 15 depends on the material and the thickness thereof, but is preferably about 4 to 50, more preferably about 6 to 12, and even more preferably about 6 to 8. The number is about one.

The inner diameter of the base end portion 13 of the tubular member 11 depends on the outer diameter of the instrument (treatment instrument, observation instrument, etc.) used,
The thickness is preferably about 4.0 to 50 mm, more preferably about 4.5 to 30 mm, even more preferably about 5.0 to 10 mm.
If the inner diameter of the proximal end portion 13 is less than 4.0 mm, the usable instruments (treatment instruments, observation instruments, etc.) will be limited, and if it exceeds 50 mm, the invasion to the patient at the time of puncture will increase. To do.

The inner diameter of the tip portion 14 of the tubular member 11 is 1.
It is preferably about 0 mm or more, more preferably about 1.5 mm. If this inner diameter is less than 1.0 mm,
It may be difficult to insert the expansion trocar tube 50 described later.

The total length of the tubular member 11 is preferably about 30 to 250 mm, more preferably about 50 to 200 mm, and 1
About 100 mm is more preferable. The total length of the tubular member 11 is 2
If it exceeds 50 mm, it may be difficult to operate instruments (treatment instruments, observation instruments, etc.). Tip 16 of plate-like body 15
The length is preferably about 0.5 to 30% of the total length of the tubular member 11, and more preferably about 1.0 to 15%.

In this embodiment, the tubular member 11 before expansion is used.
Are fixed by adhering or fusing to the side surfaces of the main body portions 17 of the adjacent plate-shaped bodies 15 and integrated, but in the present invention, the tubular member connects a plurality of plate-shaped bodies that are molded separately. It is not limited to what was done. For example, first, after forming a tubular member having a diameter gradually reduced toward the tip, a plurality of slits extending in the tube axis direction are formed on the outer peripheral surface and / or the inner peripheral surface thereof to form a thin wall portion, The plate-shaped bodies adjacent to each other may be connected by the thin portion. In this case, when an expansion trocar tube or the like to be described later is inserted into the tubular member, at least a part of the thin portion is broken, and the plate-shaped body is separated and expanded.

FIG. 3 is a partial sectional side view showing the structure of the grip member 18 of the trocar outer tube 10 according to the embodiment of the present invention. As shown in the figure, the grip member 18 is
Mainly, the outer wall portion 19 and an insertion port 2 which is opened at the base end of the outer wall portion 19 and into which an expansion trocar tube 50 described later is inserted.
0 and the engaging portion 21 for fixing the base end portion 13 of the tubular member 11
And a communication portion 23 that communicates with the inner cavity 12 of the tubular member 11. An engaging shaft 24 is provided on the engaging portion 21, and the proximal end of the plate-shaped body 15 of the tubular member 11 is fixed to the engaging shaft 24 so as to be wound around the engaging shaft 24.

The diameter of the insertion port 20 depends on the inner diameter of the tubular member 11, but is preferably 1.0 to 50 mm, and 1.5 to 30 mm.
mm is more preferable. If the diameter of the insertion port 20 is less than 1.0 mm, the instruments (treatment instruments, observation instruments, etc.) that can be used are limited, and if it exceeds 50 mm, the inner diameter of the tubular member 11 also increases, so that the puncture is performed. Occasionally, the invasion of the patient is increased.

Examples of the material forming the outer wall portion 19 of the grip member 18 include various metal materials such as stainless steel, aluminum or aluminum alloy, polyamide, polyvinyl chloride, polycarbonate, ABS resin,
Various synthetic resin materials such as polyethylene, polypropylene, polytetrafluoroethylene, and acrylic resin are preferable, and polycarbonate is particularly preferable.

Although not shown, in order to support the above-mentioned pneumoperitoneum method, in order to maintain the pneumoperitoneum pressure (the pressure of the gas injected into the abdominal cavity) near the insertion port 20 of the grip member 18. It is also possible to provide an airtight check valve.

In the trocar outer tube of the present invention, the tubular member has the same shape as described above in the natural state, but the treatment instrument and the elongated insert such as the expansion trocar tube 50 are inserted into the lumen thereof. In this case, for example, the plate-shaped members 15 or the joints between the plate-shaped members 15 are extended to deform the tubular member 11, and the diameter of the tip portion 14 of the tubular member 11 is expanded. Good. In this case, the tip portion 14 of the tubular member 11 is preferably made of a softer material than the portion (main body portion 17) other than the tip portion of the tubular member 11.

FIG. 4 is a perspective view showing the structure of the trocar according to the embodiment of the present invention, FIG. 5 is a longitudinal sectional view of the trocar shown in FIG. 4, and FIG. 6 is a trocar inner needle which constitutes the trocar of the present invention. It is a perspective view showing an example of composition. As shown in FIGS. 4 and 5, the trocar 1 of the present invention is composed of the trocar outer tube 10 described above and the trocar inner needle 40 that is used by being inserted into the inner cavity 12 of the tubular member 11.

As shown in FIG. 6, the trocar inner needle 40
Is composed of a shaft 41, a grip member 43 connected to a base end 42 of the shaft 41, and a head portion 45 formed at a tip end 44 of the shaft 41. Head part 4
5, a sharp puncture end (blade edge) 46 and a taper portion 47 located on the base end side thereof are formed. Further, a constricted portion 48 is formed at the boundary portion between the shaft 41 and the head portion 45. The shaft 41 and the head portion 45 are preferably integrally formed.

The shaft 41 has a taper shape in which the outer diameter gradually decreases from the base end 42 toward the tip end 44. In this case, as shown in FIG. 5, in the shaft 41, the outer peripheral surface of the shaft 41 contacts or approaches the inner peripheral surface of the tubular member 11 with the trocar inner needle 40 inserted in the trocar outer tube 10. It is preferably shaped.

The shaft 41, the head portion 45, and the grip member 43 are made of various metal materials such as stainless steel, aluminum or aluminum alloys, superelastic alloys, shape memory alloys, polyamide, and polychlorinated materials. Vinyl, polycarbonate, ABS resin,
Polyethylene, polypropylene, polytetrafluoroethylene, acrylic resin, polyether ketone (PE
Various synthetic resin materials such as K) and polyether ether ketone (PEEK) are preferable, and a hard material such as stainless steel is particularly preferable.

The total length of the shaft 41 is preferably about 40 to 300 mm, more preferably about 60 to 250 mm, and 1
About 50 mm is more preferable. The total length of the shaft 41 is 4
If it is less than 0 mm, the puncture end 46 may not protrude from the tip of the trocar mantle tube 10 depending on the total length of the tubular member 11. If it exceeds 300 mm, the trocar inner needle 40 is inserted into the abdominal cavity more than necessary. As a result, the possibility of damaging the storage device in the abdominal cavity increases.

The outer diameter of the shaft 41 near the base end 42 is a value adapted to the inner diameter of the base end portion 13 of the tubular member 11,
The thickness is preferably about 5.0 to 50 mm, more preferably about 6.0 to 30 mm, even more preferably about 7.5 mm.

The outer diameter of the tip end 44 of the shaft 41, that is, the outer diameter of the constricted portion 48, is the same as that of the tip end portion 1 of the tubular member 11.
It is a value suitable for the inner diameter of 4 and is preferably about 1.0 to 15 mm, more preferably about 1.0 to 10 mm, and 1.5 mm.
The degree is more preferable.

As shown in FIGS. 4 and 5, the trocar inner needle 40 is inserted into the inner cavity 12 of the tubular member 11 from the insertion port 20 of the trocar outer tube 10 grip member 18, and the tip surface of the grip member 43 is grip member. When approaching or abutting the base end surface of 18, the head portion 45 is in a state of protruding from the tip opening of the trocar outer tube 10. The tip of the body portion 17 of the plate-shaped body 15 constituting the trocar outer tube 10 before expansion, that is, the inner diameter at the boundary portion 151 between the body portion 17 and the tip portion 16 is equal to the maximum outer diameter of the head portion 45 of the trocar inner needle 40. At the tip 14 of the trocar mantle 10 which is approximately equal to or larger than the trocar mantle 10, the trocar inner needle 40 is attached to the trocar mantle 10 because the plates 15 are made of a flexible material and are separated from each other. Can be easily inserted.

The tip portion 14 of the trocar outer tube 10 is located at the constricted portion 48 of the trocar inner needle 40. At this time,
The outer diameter of the tip portion 14 of the trocar mantle tube 10 is substantially equal to or smaller than the maximum outer diameter of the head portion 45.
Therefore, in this state, the trocar 1 is easily pierced into the body wall. After piercing the trocar 1 into the body wall, only the trocar inner needle 40 is removed while leaving the trocar outer tube 10, but at this time, due to the tapered portion 47 of the trocar inner needle 40, the flexible tip of the trocar outer tube 10 is removed. Since the portion 14 is expanded, the trocar inner needle 40 can be smoothly removed. Furthermore, in the remaining trocar mantle tube 10,
A tubular member 1 is formed by inserting an expansion trocar tube 50 described later.
1 can be expanded, and instruments such as an endoscope, forceps, electric scalpel, needle holder, and scissors can be taken in and out through the abdominal cavity through the expansion trocar tube 50.

FIG. 7 is a perspective view showing a structural example of an expansion trocar tube for expanding the tubular member 11 of the trocar outer tube 10, and FIG. 8 is an expansion trocar tube 50 shown in FIG.
FIG. 3 is a perspective view showing a state in which is inserted into the trocar outer tube 10.

As shown in FIG. 7, the trocar tube 5 for expansion is used.
0 mainly comprises a tubular member 51 for inserting a treatment instrument, an observation instrument, etc. into the abdominal cavity, and a grip member 53 connected to a base end 52 of the tubular member 51.

The grip member 53 has an outer wall portion 54 similar to the outer wall portion 19 and has the insertion port 20 therein.
An insertion port and a communication part similar to the communication part 23 are formed. In addition, near the insertion opening of the grip member 53,
A check valve similar to that described above may be provided.

In the illustrated structural example, the inner diameter and outer diameter of the tubular member 51 are substantially constant over the entire length of the tubular member 51, but the present invention is not limited to this, and the inner diameter and outer diameter of the tubular member 51 are It may be gradually decreased in the tip direction.

The constituent material of the tubular member 51 may be the same as that of the tubular member 11, and the constituent material of the grip member 53 may be the same as that of the grip member 18.

The total length of the tubular member 51 of the expansion trocar tube 50 is preferably about 40 to 300 mm, and 60 to 250.
mm is more preferable, and 130 mm is further preferable. If the total length of the tubular member 51 is less than 40 mm, it may not be possible to penetrate the thickened body wall, and if it exceeds 300 mm, it may be difficult to operate instruments (treatment instruments, observation instruments, etc.).

The inner diameter of the expansion trocar tube 50 varies depending on the outer diameter of the instrument used (treatment instrument, observation instrument, etc.), but is preferably about 2.0 to 49 mm, more preferably about 3.0 to 30 mm, It is more preferably about 3.0 to 20 mm. If the inner diameter of the tubular member 51 is less than 2.0 mm, the instruments (treatment instruments, observation instruments, etc.) that can be used are limited, and if it exceeds 49 mm, the invasion to the patient increases.

The wall thickness of the tubular member 51 of the expansion trocar tube 50 depends on the instrument used (treatment instrument, observation instrument, etc.).
It is preferably 0.05 to 2.0 mm, preferably 0.1 to 1.5 mm, and 0.5 to 1.0, though it depends on the conditions.
mm is more preferred.

The tubular member 51 of the expansion trocar tube 50 is inserted into the lumen 12 of the tubular member 11 through the insertion port 20 of the grip member 18 of the trocar outer tube 10.
When the tip end surface of the grip member 53 approaches or comes into contact with the base end surface of the grip member 18, the tubular member 51 pushes the tubular member 11 apart as shown in FIG. The bonded or fused portion is broken, the plate-like bodies 15 are separated from each other, and the trocar mantle tube 10 is expanded. The trocar of the present invention may be configured by the trocar outer tube 10 described above, the trocar inner needle 40, and the expansion trocar tube 50.

Next, an example of how to use the trocar 1 as described above will be described. First, the grip member 18 of the trocar mantle tube 10 is fixed with one hand, and the grip member 43 of the trocar inner needle 40 is pressed with the other hand to insert the trocar inside the tubular member 11 of the trocar mantle tube 10. The needle 40 is inserted from the tip side. As a result, as shown in FIGS. 4 and 5, the trocar 1 is in a state in which the head portion 45 of the inner needle trocar 40 projects from the distal end portion 14 of the trocar outer tube 10 to the distal end side.

At this time, the tip portions 16 of the plate members 15 are flexible and separated from each other, and the tip of the main body portion 17 of the plate member 15, that is, the inner diameter of the tubular member 11 at the boundary portion 151. Is approximately equal to or larger than the maximum outer diameter of the head portion 45, so that the trocar inner needle 40 can be easily inserted and the head portion 45 can be projected.

Since the tip portion 16 of the plate-like body 15 has a certain degree of flexibility and elasticity, after the trocar inner needle 40 is inserted, the outer diameter of the tip portion 14 of the trocar outer sheath tube 10 is the head portion 45. Is approximately equal to or smaller than the maximum outer diameter of.

Next, the trocar 1 is attached to the trocar inner needle 40.
The body wall is pierced by the piercing end 46 of the above and inserted into the body cavity.
At this time, as described above, since the distal end portion 14 of the trocar outer sheath tube 10 is housed in the constricted portion 48 of the trocar inner needle 40, it is difficult to receive resistance from the body wall during penetration,
Therefore, it is possible to pierce with a small puncture resistance.

Then, the grip member 43 is pulled in the proximal direction while the trocar outer tube 10 is left, and the trocar inner needle 40 is removed from the trocar outer tube 10. On this occasion,
Since the tip portion 14 of the trocar outer tube 10 is expanded by the tapered portion 47 of the trocar inner needle 40, the head portion 45 can easily pass through the tubular member 11, and therefore the trocar inner needle 40 can be extracted. Can be done easily.

Subsequently, the grip member 53 is pressed against the trocar mantle tube 10 in a state of being pierced through the body wall, and the expansion trocar tube 50 is inserted from the distal end side of the tubular member 51. As a result, the tubular member 51 spreads out the tubular member 11, and each plate-shaped body 15 forming the tubular member 11 is expanded.
The bonded or fused portion of the plate is broken, the plate-like bodies 15 are separated from each other, and the trocar outer tube 10 is expanded.

In this state, instruments such as an endoscope, forceps, electric scalpel, needle holder, scissors, etc. can be taken in and out of the body cavity (abdominal cavity, thoracic cavity, etc.) through the lumen 55 of the expansion trocar tube 50. it can.

The tip portion 14 of the trocar mantle tube 10
Since it is made of a flexible material, it does not damage the internal organs or other tissues by the tip portion 14 after being inserted into the body cavity.

Specific examples of the trocar outer tube of the present invention and the trocar having the same will be described below.

Example 1 A trocar of the present invention having a trocar outer tube, a trocar inner needle, and an expanding trocar tube having the structures shown in FIGS. 1 to 7 was manufactured. The conditions of this trocar are as follows.

1. Trocar outer tube [Plate body body] Material: Polyethylene Base width: 6.0 mm Thickness: 0.5 mm

[Tip of plate-like body] Constituent material: ethylene-vinyl acetate copolymer Width of tip: 1.5 mm Thickness: 0.5 mm

[Tubular member] The six plate-like members were used to manufacture as follows. Inner diameter of tip: 1.6 mm Inner diameter of base: 7.6 mm Outer diameter of tip: 3.0 mm Outer diameter of base: 9.0 mm Total length: 100 mm

Adjacent side faces of the plate-shaped body main body were bonded and fixed with an acrylic adhesive.

[Outer Wall of Grip Member] Constituent Material: Polycarbonate

2. Trocar inner needle [Shaft] Composition material: Stainless steel (SUS304) Outer diameter of the tip (constriction): 1.5 mm Outer diameter of the base: 7.5 mm Total length: 140 mm

[Head] Constituent material: Stainless steel (SUS304) Overall length: 10 mm Maximum outer diameter: 3.2 mm

[Outer Wall of Grip Member] Material of Construction: Stainless Steel (SUS304)

3. Expansion trocar tube [tubular member] Material: Polycarbonate Inner diameter: 3.0mm Outer diameter: 4.0mm Thickness: 0.5mm Total length: 130mm

[Outer Wall of Grip Member] Constituent Material: Polycarbonate

(Example 2) In the same trocar as in Example 1, the inner diameter and outer diameter of the tubular member of the expansion trocar tube were changed as follows.

[Tube member of expansion trocar tube] Constituent material: same as in Example 1 inner diameter: 4.5 mm outer diameter: 5.5 mm wall thickness: 0.5 mm total length: same as in Example 1

(Example 3) In the same trocar as in Example 1, the inner diameter and outer diameter of the tubular member of the expansion trocar tube were changed as follows.

[Tubular member of trocar tube for expansion] Constituent material: the same as in Example 1 Inner diameter: 6.0 mm Outer diameter: 7.0 mm Wall thickness: 0.5 mm Overall length: Same as in Example 1

<Experiment> Using the trocars of Examples 1 to 3 above, an intestinal anastomosis of an experimental animal (mongrel dog) was performed.

First, after general anesthesia was given to the experimental animal, carbon dioxide gas was injected into the abdominal cavity to perform pneumoperitoneum. Then, using a conventionally used trocar, the trocar mantle was punctured by a conventional method and inserted into the abdominal cavity. A rigid endoscope (endoscope) was inserted through the trocar mantle so that images taken by the rigid endoscope could be monitored by CRT.

Next, using the trocar of Example 1, the trocar inner needle was inserted into the trocar mantle tube, and the puncture end of the trocar inner needle was projected from the tip of the trocar mantle tube, and the trocar was used to test the experimental animal. After piercing the abdominal wall and inserting into the abdominal cavity, only the trocar inner needle was removed while leaving the trocar outer tube. Then, the tip portion of the expansion trocar tube of Example 1 is inserted into the remaining trocar outer tube, and the grip member of the expansion trocar tube is pressed to expand the tubular member of the trocar outer tube. A trocar tube for expansion was inserted into the abdominal cavity. In this state,
A small spatula forceps with an outer diameter of 2.0 mm was inserted into the abdominal cavity through the expansion trocar tube and used.

Thereafter, the expansion trocar tube of Example 1 is removed, the expansion trocar tube of Example 2 is inserted into the trocar mantle tube, and a laser knife having an outer diameter of 4.0 mm is inserted through the expansion trocar tube. It was inserted into the abdominal cavity and used.

Further, the expansion trocar tube of Example 2 is removed, the expansion trocar tube of Example 3 is inserted into the trocar mantle tube, and forceps having an outer diameter of 5.0 mm and a forceps having an outer diameter of 5.0 mm are inserted through the expansion trocar tube. A needle holder having an outer diameter of 5.0 mm was sequentially inserted into the abdominal cavity and used.

In the above experiments, in the trocars of Examples 1 to 3, the trocar mantle tube with the trocar inner needle inserted should be pierced into the abdominal wall smoothly with a small piercing resistance and smoothly. I was able to. In addition, the expansion of the tubular member of the trocar mantle tube by the expansion trocar tube can be easily and reliably performed with a slight force.
The use of instruments such as forceps and needle holders did not cause any problems.

[0089]

As described above, according to the trocar mantle tube and the trocar of the present invention, the distal end portion of the tubular member of the trocar mantle tube is smaller in diameter than the base end portion when puncturing a living body, and The diameter of the tubular member can be reduced, so that the puncture resistance at the time of puncturing a living body is reduced, the trocar mantle tube can be easily pierced, and the invasiveness is reduced.

In particular, when the tubular member of the trocar outer tube is formed by connecting and integrating a plurality of plate-shaped members in an annular shape, a covering tube or the like is attached to the outer periphery to fix the separated plate-shaped members. Therefore, the diameter can be sufficiently reduced, and the above effect can be more remarkably exhibited.

Further, the tubular member of the trocar outer tube is
When at least the base end portions of the adjacent plate-like bodies are connected by adhesion or fusion, the plate-like bodies are easily and reliably separated from each other when the tubular member is expanded, and the plate-like bodies are expanded with a slight force. In addition, the tubular member can be easily manufactured, and the manufacturing cost can be reduced.

When the distal end of the tubular member is made of a softer material than the other parts, the insertion of the trocar inner needle,
The removal can be easily performed, and the tip of the tubular member is prevented from damaging the living tissue such as the organ, which further enhances the safety.

Particularly, when adjacent plate-shaped bodies are separated from each other at their tip portions, a trocar inner needle having a tip outer diameter larger than the tip inner diameter of the trocar outer tube before expansion can be easily inserted and removed. can do. Therefore, the invasion during puncture is further reduced.

[Brief description of drawings]

FIG. 1 is a perspective view showing a natural state of a trocar mantle tube according to an embodiment of the present invention.

FIG. 2 is a sectional view taken along line II-II in FIG.

FIG. 3 is a partial cross-sectional side view showing the configuration of a grip member of the trocar outer tube shown in FIG.

FIG. 4 is a perspective view showing a configuration of a trocar according to an embodiment of the present invention.

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

FIG. 6 is a perspective view showing a configuration example of a trocar inner needle that constitutes the trocar of the present invention.

FIG. 7 is a perspective view showing a configuration example of an expansion trocar tube for expanding the tubular member of the trocar outer tube.

FIG. 8 is a perspective view showing a state in which the expansion trocar tube shown in FIG. 7 is inserted into a trocar outer tube.

FIG. 9 is a cross-sectional view schematically showing a state of conventional laparoscopic surgery.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Trocar 10 Trocar outer tube 11 Tubular member 12 Lumen 13 Base end part 14 Tip part 15 Plate-like body 151 Boundary part 16 Tip part 17 Main body part 18 Grip member 19 Outer wall part 20 Insertion port 21 Engaging part 23 Communication part 24 Engagement Joint shaft 40 Trocar inner needle 41 Shaft 42 Base end 43 Grip member 44 Tip 45 Head part 46 Puncture end 47 Tapered part 48 Constricted part 50 Expansion trocar tube 51 Tubular member 52 Base end 53 Grip member 54 Outer wall part 55 Inner cavity 100 Abdominal wall 101 abdominal cavity 102 endoscope 103 monitor screen 104 forceps 105 scissors 106 electric scalpel 107 trocar mantle

Claims (7)

[Claims] 1. A trocar outer tube comprising a tubular member and a grip member connected to a proximal end portion of the tubular member, wherein the tubular member has a distal end portion having a diameter smaller than that of the proximal end portion in a natural state. A trocar mantle tube which is small and characterized in that, when a desired elongated insert is inserted into the lumen thereof, at least one portion of the tubular member is separated to expand the diameter of the distal end portion. 2. The trocar mantle tube according to claim 1, wherein the distal end portion of the tubular member is made of a material softer than the portion other than the distal end portion of the tubular member. 3. A trocar mantle tube comprising a tubular member and a grip member connected to a proximal end portion of the tubular member, wherein the tubular member has a diameter of a distal end portion from a proximal end portion in a natural state. It is small, and when a long insert is inserted into its inner cavity, the tubular member deforms and the diameter of the distal end portion expands, and the distal end portion of the tubular member is other than the distal end portion of the tubular member. Trocar mantle characterized by being more flexible than the part of the. 4. The trocar mantle tube according to claim 1, wherein the tubular member is composed of a plurality of plate-like members that are integrally connected by being annularly connected. 5. The trocar outer tube according to claim 4, wherein the tubular member is formed by adjoining at least base end portions of adjacent plate-like bodies by adhesion or fusion. 6. A trocar having a trocar outer tube according to any one of claims 1 to 5, and a trocar inner needle used by being inserted into an inner cavity of the tubular member of the trocar outer tube. . 7. The expansion trocar tube for expanding the tubular member of the trocar mantle tube.
Trocar as described in.