JPH08336543A - Enucleated organ chopper - Google Patents

Abstract

PURPOSE: To rapidly enucleate the enucleated organs chopped in the abdominal cavity outside the body without contamination. CONSTITUTION: Plural insertion holes 43 are formed in a head body 44 having flexibility and wire-shaped bodies 46 consisting of a superelastic alloy are inserted therein. Both ends of the respective wire-shaped bodies 46 are fixed to an operating member 47. The loop-like cutter parts 45 exposed outside from the respective insertion holes 43 are expanded uniformly to a prescribed shape by a superelastic effect when the operating membrane 47 is operated to be pressed into a sleeve 50. The enucleated organs are chopped at one time by the plural loop-like cutter parts 45 when the enucleated organs are housed into the expanded loop-like cutter parts 45 and the operating member 47 is drawn out of the sleeve 50.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention is used in endoscopic surgery such as laparoscopic surgery and thoracoscopic surgery to cut a part or all of an organ accompanied by a diseased tissue such as a malignant tumor in a patient. The present invention relates to an excised organ cutting device.

[0002]

2. Description of the Related Art In recent years, in order to achieve early social rehabilitation after surgery for a patient and early initiation of adjuvant therapy, treatment using an endoscope such as a laparoscope and a thoracoscope is performed as a less invasive surgery for the patient. Means are used. For example, in the field of urology, in order to remove highly solid organs such as the kidney and adrenal gland from the body, the organs released in the abdominal cavity are treated with a lapsac (Lapsac; trade name) or, for example, Japanese Patent Laid-Open No. -205786 Publication Laparoscopy (laparoscopic procedure: endoscopic surgery)
Put it in a bag and cut into small pieces.
It is taken out of the body through a 0 mm mantle tube. Especially when the target organ is accompanied by a neoplastic lesion, in order to determine the grade of malignancy of tumor cells, histological structure, and mode of tumor progression, the disease of the minced tissue pieces is determined. A physical search is required. That is, if renal cancer is taken as an example, it is difficult to make an appropriate diagnosis without waiting for a pathological search on the mode of tumor progression and the presence or absence of infiltration of cancer cells into the renal capsule. Therefore, the organs liberated in the abdominal cavity must be removed outside the body in a state where the pathological search is sufficiently possible.

A typical prior art excised organ mincing device is
This is shown in FIG. The excised organ 1 accompanied by the lesion liberated in the body by the above-mentioned laparoscopy is housed in the bag 5 inserted into the abdominal cavity 4 through the puncture opening 3 of the abdominal wall 2. The opening 6 of the bag 5 is pulled out from the puncture opening 3 to the outside of the body, and the guide tube 10 of the tissue slicing device 7, which is a device for slicing organs, is inserted through the opening 6 and the inside of the bag 5 is inserted. The excised organ 1 is cut into small pieces, and the finely cut tissues are suctioned and extracted outside the body. The tissue shredder 7 has a screw conveyor 9 having a sharp claw portion 8 formed at its tip, and the screw conveyor 9 is driven to rotate in a right cylindrical guide tube 10. The claw portion 8 prevents the bag 5 from being damaged and the tip portion 1 of the guide tube 10
It is formed so as to be retracted inward from 1.

When the excised organ 1 is carried out by using such a tissue shredder 7, the tip portion 11 of the guide tube 10 is pressed against the excised organ 1, and a part 12 of the raised organ in the tip portion 11 is pushed. Is cut by hooking with the claw portion 8, and the cut portion 12 is guided by the screw conveyor 9 to the guide tube 10
It is conveyed to the upper space 13 therein, sucked by the suction force guided to the suction port 14, and collected in a suction tank (not shown). Thus, in this prior art, the organ 1 collected in the bag 5 is cut into small pieces and taken out of the body.

In the prior art as described above, the excised organ 1 contained in the bag 5 is pressed against the tip 11 of the guide tube 10, and the part 12 of the raised organ in the tip 11 is cut into the claw portion 8. Since the finely sliced tissue pieces are hooked by, the finely sliced tissue pieces are uneven and small, and the cut surface is rough, and the tissue pieces are taken out in a state with poor reproducibility. Further, since the tip section 11 of the guide tube 10 is frequently pressed against the excised organ 1, the sectioning work is performed, so it is long to excise all solid organs such as the kidney and the liver into the body. There is a problem that the operation takes a long time and the operation is prolonged. Moreover, when the tip portion 11 of the guide tube 10 is pressed against the excised organ 1, lymphatic fluid secreted from a tumor of the excised organ 1 adheres to the surrounding normal tissue, or malignant tumor cells such as cancer cells There is also a possibility of dissemination by adhering to the normal tissue, and it becomes difficult to judge the degree of infiltration of the excised organ 1, etc., which causes inconvenience in performing a pathological search.

[0006]

SUMMARY OF THE INVENTION Therefore, an object of the present invention is to remove an excised organ free in the body from the outside of the body in a state in which normal tissue is prevented from being contaminated with diseased tissue and a pathological search is possible. It is an object of the present invention to provide an excision organ slicing device capable of slicing into a size that can be taken out.

[0007]

According to the present invention, a plurality of insertion holes which are flexible and resistant to chemicals and which are inserted in the thickness direction at intervals in the longitudinal direction are formed and inserted into the abdominal cavity. It consists of a hollow head body, a substantially cylindrical guide tube to which one end of the head body in the longitudinal direction is fixed, and a superelastic alloy, and is inserted through each insertion hole of the head body, and a part between both ends is the head. A linear member exposed from the main body to the outside to form a plurality of loop-shaped cutter parts, and an operation member in which at least one end part of the linear member is fixed near one end part in the longitudinal direction inserted movably into the guide tube. An excised organ slicing device comprising: Further, according to the present invention, a spherical first guide surface and a truncated cone-shaped second guide surface extending from the first guide surface to the outer peripheral surface of the head body are formed at the other longitudinal end portion of the head body. It is characterized by being done. Further, the present invention is characterized in that a loop-shaped cutter portion of a linear body is fitted into the outer peripheral portion of the head body, and an arc-shaped groove extending between the insertion holes is formed. Furthermore, the present invention is characterized in that a portion near one longitudinal end of the operating member is inserted into the guide tube so as to be displaceable along the axis.
Further, the present invention is characterized in that the vicinity of one longitudinal end portion of the operating member is inserted into the guide tube so as to be rotatable around the axis. Further, the present invention, in the vicinity of one end in the longitudinal direction of a rod-shaped body having flexibility, heat resistance and chemical resistance, linear bodies made of a shape memory alloy are provided in a loop shape at intervals in the longitudinal direction, The linear body is subjected to shape memory processing so as to expand in a loop shape due to its temperature rise, and is electrically connected to the shape-memory processed linear body near the other end portion in the longitudinal direction of the rod-shaped body. It is an excised organ cutting device characterized by being provided with a connection terminal. Further, according to the present invention, an excised organ storage bag made of a soft synthetic resin having flexibility is wound in a rod shape in the vicinity of one end in the longitudinal direction of the rod-shaped body so as to surround the linear body. Is characterized by.

[0008]

According to the present invention, the guide tube is fixed to one end of the head body in the longitudinal direction, and the operation member is inserted into the guide tube so as to be displaceable in the axial direction of the guide tube or around the axial line. In the head body, a plurality of insertion holes that are inserted in the thickness direction are formed at intervals in the longitudinal direction of the head body. A linear body is inserted through each of the insertion holes, and both ends of the linear body are fixed near one longitudinal end of the operating member. The linear body is partially exposed to the outside of the guide cylinder from each insertion hole, and forms a plurality of loop cutter parts. By storing the excised organ inside such a loop-shaped cutter portion and operating the operating member in a direction in which each loop-shaped cutter portion shrinks, for example, by pulling, the inside of each loop-shaped cutter portion is incorporated. The enucleated excised organ can be cut at intervals substantially equal to the intervals of the respective insertion holes to divide it into a plurality of minced tissues at one time.

Since such a linear body is made of a superelastic alloy, a large external force is exerted on the linear body by operating the operating member, for example, a pulling force at the time of slicing an organ or a loop-shaped cutter portion at the time of insertion into the abdominal cavity. Even if the bending force is applied when it is contracted, there is no danger of permanent deformation occurring in the linear body, causing a so-called bending tendency, and always expanding in a loop with a constant elastic recovery force, or It can be reduced in shape. The plurality of loop-shaped cutter portions may be formed by spirally inserting a linear body into each insertion hole of the guide cylinder, and both end portions of the plurality of linear bodies may be formed from the respective insertion holes to the guide cylinder. It may be formed by being inserted into the inside.

Further, according to the invention, at the other longitudinal end of the head body, a spherical first guide surface and a second truncated cone shape extending from the first guide surface to the outer peripheral surface of the head body. A guide surface is formed. Accordingly, the other longitudinal end of the head body can be smoothly inserted into the abdominal cavity while being guided by the first and second guide surfaces, and can be moved in the abdominal cavity. Further, even when the head body is inserted into the abdominal cavity or the like, even if the head body is forcedly inserted, the safety can be improved without damaging an organ or the like.

Further, according to the invention, an arcuate groove extending between the insertion holes is formed on the outer peripheral portion of the head body, and the linear loop-shaped cutter portion is fitted into the groove. As a result, the loop-shaped cutter portion is arranged radially inward of the outer peripheral surface of the head body. Therefore, the excised organ to be cut can be surely cut and divided.

Further, according to the present invention, linear bodies made of a shape memory alloy are provided in a loop shape in the vicinity of one end portion in the longitudinal direction of the rod-shaped body at intervals in the longitudinal direction. The linear body is subjected to shape memory treatment by heat treatment or the like, and the rod-shaped body is provided with a connection terminal electrically connected to the linear body. By applying a voltage to this connection terminal, the linear body undergoes phase transformation and can be expanded in a loop shape. By using the shape memory alloy that has been subjected to shape memory processing in this way, it is possible to rapidly expand a plurality of loop-shaped cutter parts to a predetermined size in the abdominal cavity during surgery,
It is possible to speed up the fine cutting work of the excised organ.

Further, according to the present invention, the linear body is surrounded by one end portion in the longitudinal direction of the rod-shaped body, that is, a portion where a plurality of loop-shaped cutter portions are formed, and a flexible soft material is provided. The extirpated organ storage bag made of the above synthetic resin is wound in a rod shape and attached. In this way, since the excised organ storage bag is wound around the guide tube in a rod shape, it can be easily inserted together with the guide tube into the abdominal cavity through the outer tube, and the elastic recovery force or shape memory effect of the superelastic alloy in the abdominal cavity. It becomes possible to enlarge by, and the excised organs can be taken into the enlarged loop-shaped cutter portion and quickly cut into small pieces. Such a fine cutting operation of the excised organ can be performed in the excised organ storage bag, which prevents the diseased tissue from adhering to and contaminating normal tissue other than the excised organ. Further, since the excised organ storage bag can be inserted into the abdominal cavity in a rod-shaped state and wrapped around the guide tube, it is not necessary to separately perform the guide tube insertion work and the excised organ storage bag insertion work. The operation time can be shortened by.

[0014]

1 is a cross-sectional view showing a state in which an excised organ cutting device 21 according to an embodiment of the present invention is inserted into the abdominal cavity.
FIG. 2 is a sectional view showing the internal structure of the excised organ cutting device 21 shown in FIG. 1. For example, in laparoscopic organ resection, when the excised organ 22 such as a non-functional kidney is excised and excised outside the body, the excised organ slicing apparatus 21 of this embodiment is used. First, as shown in FIG.
The process until the excised organ is stored in the excised organ storage bag 23 and the excised organ shredded organ 21 of this embodiment is inserted into the excised organ storage bag 23 will be described.

A plurality of puncture openings 25a, 25b, 25c are formed on the abdominal wall 24 at preselected positions. These puncture openings 25a to 25c make a transverse incision of about 1 cm in the skin, incis the anterior rectus abdominis muscle, and then divide the rectus abdominis muscle to reach the rectus abdominis muscle posterior sheath. About 1 cm on the anterior peritoneum on the back side
It is incised and formed by inserting the outer tubes 26a to 26c, and the muscle layer is not incised. Each of the puncture ports 25a to 25c formed in this way has the above-mentioned outer tube 26a to 26c.
Is placed, and an optical tube, forceps, abdominal scissors, a suction tube, etc. are inserted to release the excised organ 22, and the excised organ 22 is released. In the state shown in FIG. 1, for the sake of convenience of description, the three first to third mantle tubes 26a used for slicing the extracted organ 22 with the extracted organ 22 already stored in the storage bag 23 are provided. ~ 26c
Although only the subscripts a, b, and c are omitted in the generic name, in practice, in order to release the excised organ 22 as described above, for example, two positions on the midline of the clavicle, the front Normally, five mantle tubes 26 are used, such as two places on the axilla and one place just below the navel.
Shows only three of them.

When the excised organ 22 is released, the inner jacket 27 of the five outer tubes 26 is fitted with the thread 28 having a substantially C-shaped cross section divided in the circumferential direction. A space between the outer jacket 29 of the thread 28 and the inner jacket 27 of the outer tube 26 is closed by a cylindrical sealing sleeve 30 that is pre-mounted on the inner jacket 27 of each outer tube 26. Mantle 2 of thread 28
A pair of screw-engaging portions 31 projecting outward in the radial direction are integrally formed with the screw 9, and a thumbscrew 32 is screwed to each screw-engaging portion 31. By tightening the thumbscrew 32, the thread 2
The outer jacket 29 of FIG. 8 has a reduced diameter, and the sealing sleeve 30 is brought into close contact with the inner jacket 27 of the outer jacket tube 26 to block the leakage of carbon dioxide gas supplied into the abdominal cavity from a pneumoperitoneal device (not shown) to the outside of the body.
For example, 8 to 1 in the abdominal cavity while watching the patient's respiratory circulation
A constant pressure is maintained within a range of 4 mmHg to secure a working space in the abdominal cavity.

After releasing the excised organ 22, the first mantle tube 26a into which the excision device shredder 21 is to be inserted is removed together with the sealing sleeve 30 (not shown) and left indwelling. The storage bag 23 wound in a rod shape is inserted into the abdominal cavity through the thread 28 (not shown) that is formed, and the storage bag 23 is expanded and expanded by forceps or the like.
The extracted organ 22 is accommodated. Next, the thread 28 that has passed through the storage bag 23 is removed, an annular balloon 33 is attached to the puncture opening 25a, and the opening 39 of the storage bag 23 is pulled out through the balloon 33 to the outside of the body. First
The outer tube 26a is inserted.

The known balloon 33 is made of a silicone resin and has two annular expanding / contracting portions 34a, 34b, and the annular expanding / contracting portions 34a, 34b are mounted so as to sandwich the abdominal wall 24. A connector 36, which communicates via a tube 35 and has a built-in check valve, is attached to each of the annular expansion / contraction parts 34a, 34b.
From the abdominal wall 2 by supplying air using, for example, a syringe of a syringe.
4 swells on both sides, and the puncture opening 25a is provided with the outer tube 26.
It is sealed in the state where a is inserted. The storage bag 23 has a plurality of (two in this embodiment) tubular portions 37 and 38, and each tubular portion 3
7 and 38 are inserted through the respective sleds 28 and drawn out of the body. The second and third outer jacket tubes 26 to which the sealing sleeves 30 are attached in advance are provided in the respective tubular portions 37 and 38.
b and 26c are inserted respectively.

After the opening 39 and the cylindrical portions 37, 38 of the storage bag 23 are pulled out of the body in this way, the laparoscope 41 is inserted into the third outer tube 26c, and the inside of the storage bag 23 is closed. Is visually confirmed through the laparoscope 41, and the state of the storage bag 23 is monitored by the image of the monitor television electrically connected to the laparoscope 41 through the cable, and the first outer tube is The excised organ cutting device 21 is inserted from 26a.

The excision organ cutting device 21 basically has flexibility and chemical resistance, and is a plurality (in this embodiment, in the present embodiment) inserted at regular intervals in the longitudinal direction toward the tip portion 42 in the thickness direction. A hollow head main body 44 in which 10 × 2 rows of insertion holes 43 are formed and a super elastic alloy, and each insertion hole 43 of the head main body 44 is inserted, and a part between both ends is formed in the head main body 44.
From the outside to form a plurality of loop-shaped cutter portions 45, and the linear body 46 near one end in the longitudinal direction.
The operation member 47 to which both ends are fixed, and the base end portion 48 of the head main body 44 is fitted to one end portion in the longitudinal direction, and the shaft portion 49 of the operation member 47 inserted from the other end portion in the longitudinal direction is an axis line. And a sleeve 50 that is a cylindrical guide tube that guides movably along the direction.

The sleeve 50 is made of a rigid synthetic resin. This synthetic resin is made of a fluororesin such as polytetrafluoroethylene (trade name: Teflon). Further, the operating member 47 has rigidity and has a structure in which a synthetic resin ring-shaped grip portion 51 is fixed to an end portion of a shaft portion 49 made of a stainless steel pipe. The tip portion 42 of the head main body 44 has a spherical first guide surface 54 and the first guide surface 54 in order to prevent the storage bag 23 from being damaged by force when being inserted into the abdominal cavity and damaging an organ or the like. A second truncated cone-shaped guide surface 56 is formed so as to extend from the surface 54 to the right cylindrical outer peripheral surface 55.

FIG. 3 is an enlarged sectional view taken along the line III-III in FIG. As described above, the head main body 44 is hollow and has the central hole 57.
A plurality of pairs of through holes 58, which communicate with 7, and are inserted in the thickness direction at 180 ° intervals in the circumferential direction, are formed at equal intervals in the axial direction. A right cylindrical metal fitting piece 59 is press-fitted or integrally molded into each through hole 58, and each insertion hole 43 is fitted by the inner peripheral surface of the fitting piece 59.
Is formed. As a metal material forming each fitting piece 59, stainless steel having excellent wear resistance, corrosion resistance and chemical resistance is preferably used.

The loop-shaped cutter portion 4 of the linear member 46 is inserted into the central hole 57 of the head main body 44 through the insertion holes 43.
5, straight line portions 60a, 60b connected to both sides are inserted, and both end portions of the straight line portions 60a, 60b are located near one axial end of the shaft portion 49 of the operating member 47, and are denoted by reference numeral 61 (see FIG. 2).
It is fixed to the shaft portion 49 by caulking at the portion indicated by.

As the linear member 46, a thin metal wire made of a super elastic alloy having a diameter of 0.2 mm is used. Examples of the superelastic alloy include Ti-Ni alloy, Cu-Zn-Al alloy, Cu-Al-Ni alloy, and Cu-Cr-Ni alloy. In this embodiment, a Ti-Ni alloy is used. This superelastic alloy takes a martenside phase as an alloy crystal structure at a transformation temperature or lower, changes into an austenite phase at a transformation temperature or higher, and the deformation within a certain limit given when the martenside phase causes austenite by heating. It has a shape memory effect that completely recovers the initial shape when changing to a phase, and a pseudoelastic effect that the plastic deformation given during the austenite phase completely recovers the initial shape by removing the load. It is an alloy. The transformation temperature has a certain range, and the lower one is generally As.
The higher point is called the Af point, and by setting the Af point below room temperature or body temperature, it is possible to obtain the linear body having the pseudo-elastic effect used in this embodiment.

The storage bag 23 is not easily permeated by body fluids and cells, has electrical insulation properties, and is easily damaged by contact with a surgical instrument or a tensile force when the storage bag 23 is taken out of the body. Since it is necessary to have mechanical strength, etc., it is made of a low-density polyethylene film having a thickness of 0.01 to 0.2 mm that satisfies these conditions. The head body 44 is not limited to the synthetic resin having flexibility and chemical resistance, and may be a metal tightly wound spring, a bellows-shaped pipe, or a multi-joint structure.

FIG. 4 is a diagram for explaining the shredding operation of the excised organ 22 by the excised organ shredding device 21. Referring also to FIG. 1, the excised organ cutting operation is started in a state where the excised organ 22 is accommodated in the storage bag 23 and the excised organ cutting device 21 is not inserted into the first mantle tube 26a. To be done. First, as shown in FIG. 4A, the head body 4
Since it is necessary to reduce each loop-shaped cutter portion 45 exposed from 4 to the outside, the operation member 47 is attached to the sleeve 50.
In contrast, each loop-shaped cutter portion 45 is pulled out in the direction of the arrow A1 and is retracted along the outer peripheral surface of the head main body 44 as shown by the solid line in FIG.

In this state, the head main body 44 is inserted into the abdominal cavity from the first outer tube 26, and it is confirmed that all the loop-shaped cutter parts 45 are inserted into the storage bag 23.
As shown in (2), the operation member 47 is pressed in the arrow A2 direction to enlarge each loop-shaped cutter portion 45. At this time, the linear body 46 including the loop-shaped cutter portions 45 is
Since it is made of a super-elastic alloy, it expands from a diameter-reduced state as shown in FIG. 4 (1) to a uniform loop shape close to a circle (state shown by phantom line 45a in FIG. 3) due to its elastic recovery force. can do.

The enlarged loop-shaped cutter portion 45 is
It has a diameter of about 70 to 80 mm in order to secure a space in which the target excised organ 22 can be smoothly accommodated. In this state, the excised organ 22 is inserted into each loop-shaped cutter portion 45 by using forceps or the like inserted into the abdominal cavity through the second mantle tube 26b, and the excised organ 22 is completely cut into the loop-shaped cutter portion. 4 (3), the operating member 47 is pulled in the arrow A1 direction to reduce the diameter of each of the loop-shaped cutter portions 45 and the extracted organ 22 to each of the loops. It can be finely cut into a thickness corresponding to the interval between the blade-shaped cutter portions 45, for example, a thickness of about 5 mm. The minced tissue thus shredded is sucked by inserting the suction tube of the separately prepared suction device from the first outer tube 26a, and is collected in the suction device main body for pathological search. Be seen.

Since the excised organ 22 can be cut into a plurality of pieces by a single operation in this way, the time required for the cutting operation can be significantly shortened. Moreover, since the excised excised organ 22 is not subdivided into an irregular shape as in the conventional case, there is no possibility of inconvenience in performing a pathological search, and the excised organ 22 has flowed out from the tumor part in the excised organ 22. There is no risk of blood or secretions mixing with other normal tissues and adhering,
It is possible to remove all minced tissue without contamination.

FIG. 5 is a sectional view perpendicular to the axis showing an excised organ cutting device 21a according to another embodiment of the present invention. It should be noted that this embodiment is similar to the embodiment shown in FIGS. 1 to 4, and corresponding parts are designated by the same reference numerals. In this embodiment, each linear body 4
Both ends 64a and 64b of 6 are fixed to a flexible rotary shaft 65 connected to the operating member 47 by a known fixing means such as caulking. Rotating shaft 65 having flexibility
Alternatively, it may be realized by a twisted wire formed by bundling a plurality of element wires made of stainless steel. Such a rotating shaft 65
Further, both ends 64a, 64b of the plurality of linear bodies 46 are fixed at intervals in the longitudinal direction.

Therefore, when the operating member 47 is operated to rotate the rotary shaft 65 in the arrow B1 direction, both end portions 6
The loop-shaped cutter portion 45 connected to 4a and 64b is wound around the outer peripheral surface of the rotation shaft 65, and the loop-shaped cutter portion 45 can be reduced as shown by a virtual line 66. Further, by rotating the operating member 47 in the opposite direction, when the rotary shaft 65 is rotated in the direction of the arrow B2, the loop-shaped cutter portion 45 wound around the rotary shaft 65 as described above is inserted into each insertion. It is extruded to the outside through the hole 43 and can be expanded as shown by the solid line in FIG. 5 by the elastic recovery force of the linear body 46.

By using the excised organ slicing device 21a having such a structure, the operating member 47 can be rotated by the excised organ slicing device 2 of the embodiment shown in FIGS.
Compared to 1, less force is required for operation. In addition, in the above-described embodiment, when each of the loop-shaped cutter parts 45 digs in substantially parallel to the excised organ 22 when the operating member 47 is pulled, the contact area is large, whereas in the present embodiment, the loop-shaped cutter parts 45 are loop-shaped. The cutter unit 45 shrinks the excised organ 22 while shifting it in the axial direction so as to narrow it down.
5 can be bitten into the excised organ 22 with a slight force, and the force required for cutting can be reduced.

FIG. 6 is a sectional view showing a state in which the excised organ cutting device 21b of still another embodiment of the present invention is inserted into the abdominal cavity, and FIG. 7 is the excised organ cutting device 21b shown in FIG.
FIG. The parts corresponding to those in the above-mentioned embodiment are designated by the same reference numerals. The excised organ cutting device 21b of this embodiment has flexibility, heat resistance and chemical resistance, for example, in the vicinity of the tip of a hollow rod 68 having an outer diameter of about 2 to 3 mm or less, along the longitudinal direction thereof. A plurality of insertion holes 69 are formed alternately at equal intervals in an axially symmetrical manner, and each insertion hole has
For example, Au-Cd alloy, In-Tl alloy, Ti-Ni
A single linear body 70 made of an alloy and a shape memory alloy such as a Cu-Al alloy is spirally inserted. This shape memory alloy is, for example, an alloy that is shape-memory-treated by holding the above-mentioned superelastic alloy in a shape to be memorized, heating it to about 500 ° C. in an argon gas atmosphere or vacuum, and then rapidly cooling it. Say. One end 70a of the linear body 70 is fixed to the rod-shaped body 68 at the tip end side of the rod-shaped body 68, the other end 70b of the linear body 70 is inserted through the space in the rod-shaped body 68, and the rod-shaped body 68 is further inserted. The ring-shaped first operation member 71 connected to the
It extends from an opening formed in the vicinity of the grip portion 72 and is connected to the ring-shaped second grip portion 73. The first and second grips 72 and 73 are provided with first and second connection terminals 74 and 75, which are electrically connected to both ends of the linear body 70. By applying a voltage between the first and second connection terminals 74 and 75, the loop-shaped cutter portion 76 exposed to the outside from the rod-shaped body 68 of the linear body 70 is heated, and the heat generation effect of the wire itself causes the foregoing. By such heat treatment, the shape can be expanded into a loop shape close to the circular shape. In the vicinity of the tip of the rod-shaped body 68 over the range including the loop-shaped cutter portion 76, the extracted organ storage bag 123 made of the same material as the storage bag 23.
Is wound into a rod.

When the excised organ 22 is shredded using the excised organ shredding device 21b having such a structure,
As shown in FIG. 8 (1), first, the loop-shaped cutter portion 76 is expanded by heating by applying a voltage between the first and second connection terminals 24 and 25, whereby the excised organ storage bag 123 is opened, The extracted organ 22 is stored. Next, as shown in FIG. 8B, the opening 139 of the storage bag 23.
The closed string 77 inserted in the
The opening 139 is closed by using forceps or the like inserted from the outer tube 26a through which the rod-shaped body 68 of FIG.
3 is pulled in the direction of arrow C to cut out the excised organ 22. At this time, the excised organ 22 is not completely cut, and an uncut portion is left so that each finely cut tissue is partially connected. In this state, the first grip portion 72 is pulled in the direction of the arrow D, and as shown in FIG. 9, the excised organ 22 finely sliced through the mantle tube 26b is housed in the housing bag 123 while being kept in the mantle tube 26a.
It is extracted to the outside of the body via. After the excised organ 22 is finely cut, the application of voltage to the first and second connection terminals 74 and 75 is stopped so that the loop-shaped cutter portions 76 do not expand.

According to the excised organ slicing device 21b constituted by the thin rod-like body 68 and the operating member 71 as described above, the mantle tubes 26a to 26c are inserted into the abdominal wall 24 in order to insert the excised organ storage bag 123 into the abdominal cavity. Puncture openings 25a-25
It is not necessary to reattach the device after once removing it from c, and such a work process can be omitted to shorten the operation time.

As the rod-shaped member 68 having flexibility, heat resistance and chemical resistance, for example, a tube made of polytetrafluoroethylene can be preferably used. Further, as the operation member 71, for example, a stainless steel pipe can be used.

Further, although the linear body 70 is constructed to generate heat by being energized, as another embodiment of the present invention, a high frequency current is generated in the linear body 70 by high frequency and heat is generated by induction heating. May be configured to do so.

As still another embodiment of the present invention, FIGS.
In the embodiment shown in FIG. 9, when it is necessary to completely cut the excised organ 22 into small pieces, as shown in FIG. 10, they are provided on the outer peripheral portions of the head bodies 44 and 68 in axial symmetry. An arcuate groove 79 extending between each pair of insertion holes 43, 69 is formed for each loop-shaped cutter portion 45, and each loop-shaped cutter portion 45 of the linear body 46 is indicated by an imaginary line 81. It may be buried almost exactly when the expanded state is reduced as shown by the solid line. As a result, the excised organ 22 can be reliably divided into small pieces.

[0039]

As described above, according to the present invention, a linear body made of a superelastic material is inserted into the insertion hole of the guide cylinder to form a plurality of loop-shaped cutter portions, and the excised organ is once cut in the abdominal cavity. Since it is possible to cut into a plurality of pieces by the operation of, it is possible to remarkably reduce the time required for the cutting operation. Moreover, since the excised organs are shredded at once by multiple loop cutters, there is no risk that the diseased tissue or secretory fluid from the diseased tissue will adhere to normal tissue and stain it. It is possible to obtain finely chopped tissue of the excised organ suitable for.

Further, according to the present invention, since the head body is guided by the spherical first guide surface and the truncated cone second guide surface, the head body can be smoothly inserted into the abdominal cavity and moved in the abdominal cavity. You can Further, even if the forceful insertion is performed, the safety can be improved without damaging an organ or the like.

Further, according to the present invention, since the groove into which the linear loop-shaped cutter portion is fitted is formed in the outer peripheral portion of the head main body, the loop-shaped cutter portion has a radius larger than that of the outer peripheral surface of the head main body. By arranging inwardly in the direction, the excised organ to be cut can be reliably cut and divided.

Furthermore, according to the present invention, since the linear body is subjected to shape memory processing, it is possible to energize the linear body to expand a plurality of loop-shaped cutter portions at a time into a predetermined shape, which also enables Further, it is possible to shorten the time required to store the excised organ in the body, and to shorten the time required for the fine cutting work.

Further, according to the present invention, since the excised organ storage bag is wound around the portion of the guide tube where the plurality of insertion holes are formed in a rod shape, the excised organ cutting device is inserted into the abdominal cavity. At the same time, the excised organ storage bag can be inserted at the same time, and the storage bag can be unfolded and expanded with the expansion of each loop-shaped cutter portion of the linear body. Therefore, it is not necessary to insert the excised organ storage bag into the abdominal cavity separately from the excised organ shredding device, and it is possible to omit the work of deploying and expanding the accommodating bag in the abdominal cavity using forceps or the like. Further, it is possible to shorten the time required for finely cutting the excised organ and excising work.

[Brief description of drawings]

FIG. 1 is a cross-sectional view showing a usage state of an excised organ cutting device 21 according to an embodiment of the present invention.

FIG. 2 is a sectional view of the excised organ cutting device 21 shown in FIG.

FIG. 3 is an enlarged sectional view taken along the section line III-III in FIG.

FIG. 4 is a view for explaining the slicing operation of the excised organ 22 by the excised organ slicing apparatus 21, and FIG. 4 (1) shows a state when the excised organ slicing apparatus 21 is inserted into the abdominal cavity. FIG. 4 (2) shows a loop-shaped cutter portion 45 in the abdominal cavity.
FIG. 4 is a diagram showing a state in which the excised organ 22 is enlarged and inserted, and FIG. 4C is a diagram showing a state in which the accommodated excised organ 22 is finely cut by the loop-shaped cutter portion 45.

FIG. 5 is an excised organ cutting device 21a according to another embodiment of the present invention.
FIG. 6 is a cross-sectional view perpendicular to the axis.

FIG. 6 is a cross-sectional view showing a usage state of the excised organ cutting device 21b according to still another embodiment of the present invention.

7 is a front view of the excised organ cutting device 21b shown in FIG.

FIG. 8 is an excised organ cutting device 2 shown in FIGS. 6 and 7.
FIG. 9B is a view showing a chopping operation of the excised organ 22 by 1b, and FIG. 8 (1) is an enlarged view of the loop-shaped cutter portion 76 and the storage bag 2
8 is a view showing a state in which 3 is opened, and FIG. 8 (2) is a state in which the excised organ 22 is stored in the opened loop-shaped cutter portion 76 and the storage bag 23, and the opening 39 of the storage bag 23 is closed. FIG.

FIG. 9 is an excised organ cutting device 2 shown in FIGS. 6 and 7.
It is a figure which shows the state which takes out the excised organ 22 finely chopped by 1b with the storage bag 23 out of the body.

FIG. 10 is an enlarged cross-sectional view of a part of a head main body 44 showing still another embodiment of the present invention.

FIG. 11 is a cross-sectional view showing a state in which the excised organ 1 is shredded by a typical prior art tissue shredder 7.

[Explanation of symbols]

 21,21a, 21b Excised organ slicing device 22 Excised organ 23,123 Excised organ storage bag 24 Abdominal wall 25a-25c Puncture port 26a-26c Mantle tube 28 Thread 30 Sealing sleeve 33 Balloon 39,139 Opening 41 Laparoscope 42 Tip Part 43,69 Insertion hole 44 Head main body 45,76 Loop cutter 46,70 Linear body 47,71 Operation member 68 Rod-shaped body 74,75 Connection terminal

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Toshiro Terachi 54 Shogoin Kawaramachi, Sakyo-ku, Kyoto City, Kyoto Prefecture (72) Inventor Ryuichiro Shinseki 680 Higashihaman-cho, Fushimi-ku, Kyoto City Kyoto Prefecture Morita Manufacturing Co., Ltd.

Claims (7)

[Claims] 1. A hollow head main body having flexibility and chemical resistance, having a plurality of insertion holes formed at intervals in the longitudinal direction to be inserted in the thickness direction and inserted into the abdominal cavity, and a head main body. It is made of a super-elastic alloy and has a substantially cylindrical guide tube to which one end in the longitudinal direction of the head is fixed, and is inserted through each insertion hole of the head body. A linear body forming a loop-shaped cutter portion, and an operation member having at least one end portion fixed to the linear body in the vicinity of one longitudinal end portion movably inserted into the guide tube. Excising organ cutting device. 2. The other end portion in the longitudinal direction of the head body is
The excised organ cutting device according to claim 1, wherein a spherical first guide surface and a truncated cone-shaped second guide surface extending from the first guide surface to the outer peripheral surface of the head body are formed. . 3. The head body has an outer peripheral portion in which a loop-shaped cutter portion of a linear body is fitted and an arc-shaped groove extending between the insertion holes is formed. 2. The excised organ cutting device described in 2. 4. The vicinity of one longitudinal end of the operating member is
2. The excised organ cutting device according to claim 1, wherein the device is inserted into the guide tube so as to be displaceable along the axis. 5. The vicinity of one longitudinal end of the operating member is
The excised organ cutting device according to claim 1, which is inserted into the guide tube so as to be rotatable about its axis. 6. A rod-shaped body having flexibility, heat resistance, and chemical resistance is provided in the vicinity of one longitudinal end portion thereof with linear bodies made of a shape memory alloy in a loop shape at intervals in the longitudinal direction. The linear body is subjected to shape memory processing so as to expand in a loop due to its temperature rise, and electrically connected to the shape-memory processed linear body in the vicinity of the other longitudinal end of the rod-shaped body. An excised organ cutting device, which is provided with a connection terminal. 7. The vicinity of one longitudinal end of the rod-shaped body,
7. The excised organ shredding device according to claim 6, wherein the excised organ storage bag made of a soft synthetic resin having flexibility is wound around the linear body in a rod shape.