JPH09140717A - Internal organ holder for operation under endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To easily and safely hold/operate an internal organ defined as an object without damaging its mucous membrane. SOLUTION: A tube 20 having flexibility is loop-shaped, its terminal part is bonded with an inner tube top end part 61, an inner tube 60 is positioned inside the body of an outer tube 30, and a holding part 70 is bonded at the axially opposite side terminal part of inner tube top end part 61. Besides, the outer tube 30 also has an outer tube opening part 31 on the axially same side as the inner tube top end part 61, and a lock mechanism is bonded at the axially opposite side terminal part. The inner tube 60 and outer tube 30 can be axially slid, the positions of the inner tube 60 and outer tube 30 can be fixed and by sliding the inner tube 60, the tube 20 is pulled into the outer tube so that the diameter of loop can be continuously changed.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an instrument used for grasping and sealing organs, tissues or vessels in endoscopic surgery.

[0002]

2. Description of the Related Art In recent years, endoscopic surgery started with cholecystectomy, and its target area is now expanding rapidly. As one of them, splenectomy is indicated. In this operation method, the gripping means of the spleen during the operation is one of the points. In the conventional surgical method, the spleen was grasped using metal grasping forceps. This procedure always had a risk of bleeding because the mucosa of the spleen was very fragile. If you have bleeding during surgery, you have to move to open surgery,
There was a possibility that the advantage of minimally invasive endoscopic surgery could not be utilized.

[0003]

SUMMARY OF THE INVENTION The present invention has been made as a result of various studies in order to solve the above-mentioned problems of the conventional metal gripping forceps, and its purpose is a flexible tube. An object of the present invention is to provide an organ grasping tool constituted by.

[0004]

SUMMARY OF THE INVENTION According to the present invention, a flexible tube has a loop shape, and its end portion is joined to the inner pipe tip portion, and the inner pipe has an outer diameter larger than its outer diameter. A holding portion is located at the inner lumen of the pipe, and a holding portion is joined to the axially opposite end of the inner pipe tip, and the outer pipe also has an outer pipe opening on the same axial side as the inner pipe tip. However, a lock mechanism is joined to the end portion on the opposite side in the axial direction, and since the inner pipe and the outer pipe have a gap therebetween, they are slidable in the axial direction, and the lock mechanism causes the inner pipe and the outer pipe to slide. Since the position of the outer pipe can be fixed and the axial total length of the inner pipe is equal to or longer than the sum of the axial total length of the outer pipe and the axial total length of the locking mechanism, Sliding causes the tube to be drawn into the outer tube so that the diameter of the loop of the tube is continuous. A endoscopic surgical organ gripper, characterized in that the reduction.

[0005]

BEST MODE FOR CARRYING OUT THE INVENTION The present invention will now be described in detail with reference to the drawings, but this is one embodiment of the present invention and is not limited thereto. FIG. 1 is an external view of an organ grasping tool for endoscopic surgery according to the present invention. The main body of the organ grasping tool (10) for endoscopic surgery has the following structure. The flexible tube (20) has a loop shape, and its end is joined to the inner tube tip (61), and the inner tube (60) has an outer diameter (30) larger than its outer diameter. ), The holding portion (70) is joined to the axially opposite end of the inner tube tip (61), and the outer tube (30) is also connected to the inner tube tip (61). An outer pipe opening (31) is provided on the same side in the axial direction, a lock mechanism (55) is joined to the end portion on the opposite side in the axial direction, and the inner pipe (60) and the outer pipe (30) are interposed therebetween. Since it has a gap (62), it can slide in the axial direction, and the lock mechanism (55) can fix the position of the inner pipe (60) and the outer pipe (30), and the inner pipe can be fixed. Has a length in the axial direction equal to or longer than the sum of the length in the axial direction of the outer tube (30) and the length in the axial direction of the locking mechanism (55). Inner tube (60) the tube (20) by sliding the are drawn into the outer tube, the diameter of the thus loop continuously changes for.

The tube (20) used in the present invention
It is possible to use those having no lumen, those having a lumen, and those having a wire (22) in the lumen, but those having a wire (22) are particularly desirable. The lock mechanism (55) includes an inner screw mechanism (40), an outer screw mechanism (50), and an O-ring (41).
0) and the inner end (51) of the outer screw mechanism (50) changes, the inner diameter of the O-ring (41) housed between them is compressed / expanded, and the inner pipe (41) 6
0) is fixed / released. Note that the lock mechanism is not limited to this as long as the inner tube (60) is fixed / released.

The material of the tube (20) is extruded from a flexible synthetic resin such as soft vinyl chloride resin, silicone rubber or polyurethane elastomer. This keeps the shape of the tube when bent,
It is necessary to have elasticity that does not allow the lumen to collapse, and flexibility that does not damage the living body. The size is not particularly limited, but normally, the outer diameter is 0.5 to 10 mm and the inner diameter is 0.
2 to 8 mm and a loop diameter of 30 to 500 mm are suitable.

The tube lumen (21) has a wire (2
2), the wire (22) allows the tube (20) to have an appropriate hardness, which improves the operability. Furthermore, it is possible to prevent accidents caused by cutting the tube (20). Suitable materials for the wire (22) are, for example, stainless steel, tungsten steel, etc., and more preferably, twisted wires of stainless wire.

The wire (22) communicates with the inner lumen of the inner tube (60) through the inner lumen of the tube (20), and extends in parallel with the holding portion (70) through the inner lumen of the inner tube (60). In the holding portion (70), the wires (22) pass through the wire holes (72) one by one, and the two wires are collectively fixed by the wire fixture (23). This prevents the wire (22) from falling off. In addition, a sealant (71) is enclosed in the wire fixture enclosure,
The wire (22) is prevented from being exposed to the outside.

The inner pipe (60) has a tube (20) at the inner pipe front end (61) and is joined to the holding portion (70) at its axially opposite end (73). The outer tube (3
0) has an inner tube (60) in its lumen and an outer tube opening (31)
The tube (20) or inner tube (60) protrudes from the
An axially opposite end (44) is axially joined to the internal screw mechanism (40).

The material of the inner pipe (60) and the outer pipe (30) is, for example, extruded synthetic resin having inflexibility such as hard vinyl chloride resin, acrylonitrile-butadiene-styrene resin, aluminum, stainless steel, etc. It is a tubular processed product of the above metal, and must have such strength that it does not bend or bend when it is grasped and rotated by an organ, or when pulled.
In addition, the size is not particularly limited, but in the inner pipe, the outer diameter is usually 1 to 25 mm, the inner diameter is 0.5 to 24 mm, the total length is 50 to 800 mm, and the outer pipe is 2 to 30 m.
m, an inner diameter of 1.5 to 28 mm, and a total length of 50 to 800 mm are suitable.

The internal threaded mechanism (40) has an externally threaded groove (42) which mates with the internally threaded groove (52) of the external threaded mechanism (50). Internal screw mechanism (40)
Upper end (43) of the screw and the inner end (51) of the external screw mechanism (50)
Is continuously variable and the O-ring (41) is located between them.

The internal screw mechanism (40) and the external screw mechanism (5
As the material of 0), for example, a material obtained by injection molding a synthetic resin having no flexibility such as a hard vinyl chloride resin, acrylonitrile / butadiene / styrene resin, or a processed product of a metal material such as aluminum or stainless steel is preferable.
The material of the O-ring (41) is preferably a synthetic resin having flexibility such as hard vinyl chloride resin, silicone rubber, polyurethane elastomer, natural rubber.

Next, a method of using the organ grasping tool for endoscopic surgery according to the present invention will be described. First, the main gripping tool is introduced into the body cavity from a trocar (not shown) for endoscopic surgery. At the time of introduction, the inner tube (60) is pulled and the loop diameter of the tube (20) is minimized to facilitate the introduction.

After the gripping tool is introduced, the inner tube (60) is pushed into the outer tube opening (31) side so that the loop diameter of the tube (20) becomes the maximum diameter. The target organ (80) is introduced into the loop, the inner tube (60) is pulled toward you, and the tube (2
The diameter of 0) is set to an appropriate size. The outer screw mechanism (50) is tightened, the inner tube (60) is locked, and the intended treatment is performed. To release the organ, the external screw mechanism (50) is loosened and the inner tube (60) is returned.

Next, another method of using the endoscopic surgical organ grasping tool of the present invention will be described. This gripping tool is introduced into the body cavity in the same manner as described above, and the target organ / vessel (8
1) is made into a U shape and introduced into the loop, and the inner pipe (20)
Draw as much as possible to the extent that it does not damage the organ / vessel (81). Target organs / vessels (81)
Can be temporarily sealed.

Another example of the organ grasping tool (11) for endoscopic surgery according to the present invention will be shown. Here, the spring (90) is located between the external screw mechanism (50) and the holding part (70). The inner diameter of the spring (90) must be larger than the inner pipe (60) and smaller than the outer diameter of the outer screw mechanism (50) and the holding portion (70). By this spring (90), the lock mechanism (55)
It becomes possible to temporarily fix the organ without fixing it.

[0018]

The organ gripping tool for endoscopic surgery according to the present invention has a tube having a loop shape, the inner diameter of which changes continuously, and a lock mechanism for fixing the inner diameter. Therefore, grasping and operation can be performed easily and safely without damaging the mucous membrane of the target organ.

[Brief description of the drawings]

FIG. 1 is an external view of an endoscopic surgical organ grasper according to an embodiment of the present invention.

FIG. 2 shows a sectional shape of a tube. FIG. 1 is an enlarged vertical sectional view taken along line 1-1 ′ of FIG.

FIG. 3 shows a cross-sectional shape of a tip portion of an outer tube. 2- of FIG.
2'is an enlarged vertical sectional view.

FIG. 4 shows a sectional shape of a rear end portion of the outer tube. 3-of FIG.
3'is an enlarged vertical sectional view.

FIG. 5 shows a sectional shape of a lock mechanism. 4-4 'in FIG.
An enlarged vertical sectional view of a line.

FIG. 6 shows a sectional shape of a holding portion. FIG. 5 is an enlarged vertical sectional view taken along line 5-5 ′ of FIG. 1.

FIG. 7 shows a sectional shape of a lock mechanism. 4-4 'in FIG.
The expanded horizontal sectional view of a line.

FIG. 8 shows a sectional shape of a holding portion. FIG. 5 is an enlarged horizontal sectional view taken along line 5-5 ′ of FIG. 1.

FIG. 9 is a schematic diagram showing an example of usage. A state in which a loop of a tube is hooked to grasp an organ is shown.

FIG. 10 is a schematic diagram showing an example of usage. FIG. 9 shows a state in which the holder is pulled, the loop of the tube is reduced, and the organ is grasped.

FIG. 11 is a schematic diagram showing an example of usage. A state in which a tube loop is hooked to seal an organ / vessel is shown.

FIG. 12 is a schematic diagram showing an example of usage. FIG. 11 shows a state in which the holder is pulled, the loop of the tube is made smaller, and the organ / vessel is sealed.

FIG. 13 is an external view of an organ grasping tool for endoscopic surgery, which is another embodiment of the present invention.

[Explanation of symbols]

 1, 1'tube cross section 2, 2'outer tube tip cross section 3, 3'outer tube rear end cross section 4, 4'lock mechanism cross section 5, 5'holding section cross section 10, 11 organ grip for endoscopic surgery Tool 20 Tube 21 Tube lumen 22 Wire 23 Wire fixing tool 30 Outer tube 31 Outer tube opening 40 Inner screw mechanism 41 O-ring 42 Male screw groove 43 Upper end 44 Axial opposite side end 50 Outer screw mechanism 51 Inner end 52 Female thread groove 55 Lock mechanism 60 Inner tube 61 Inner tube tip 62 Gap 70 Holding part 71 Sealant 72 Wire hole 73 Axial opposite end 80 Organ 81 Organ / vascular 90 Spring

Claims (3)

[Claims] 1. A flexible tube has a loop shape, the end of which is joined to the inner tube tip, and the inner tube is located in the inner lumen of the outer tube having an inner diameter larger than the outer diameter thereof. A holding portion is joined to the axially opposite end of the inner pipe tip, and the outer pipe also has an outer pipe opening on the same axial side as the inner pipe tip, and the axially opposite end thereof. A lock mechanism is joined to the part,
Since the inner pipe and the outer pipe have a gap therebetween, they can be slid in the axial direction, and the positions of the inner pipe and the outer pipe can be fixed by the locking mechanism, and the shaft of the inner pipe can be fixed. The total length in the axial direction is equal to or longer than the sum of the total axial length of the outer tube and the total axial length of the locking mechanism, the sliding of the inner tube causes the tube to be drawn into the outer tube, and An organ grasping tool for endoscopic surgery, characterized in that the diameter of the loop of the tube changes continuously. 2. The organ grasping tool for endoscopic surgery according to claim 1, wherein a flexible wire is built in the tube lumen. 3. A spring having an inner diameter smaller than an outer diameter of the lock mechanism and the holding portion and larger than an inner diameter of the inner tube is coaxially provided between the lock mechanism and the holding portion. Or the organ gripping tool for endoscopic surgery according to 2