JPH0919433A - Subcutaneous tissue protector - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide subcutaneous protector for protecting a subcutaneous tissue to be treated during a treatment. SOLUTION: A subcutaneous protector 1 is composed of a body part 1a which can be inserted in a subcutaneous tissue so as to cover at least a part of the subcutaneous tissue for protecting the latter, and a guide means 6 for guiding a treating unit along the body part 1a while preventing the same from making contact with the subcutaneous tissue.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a subcutaneous tissue protector for protecting a target subcutaneous tissue from a treatment operation or the like.

[0002]

2. Description of the Related Art Conventionally, for example, when performing a blood vessel bypass operation on the heart, a saphenous vein existing in a body limb is collected and used as a bypass tube. When collecting the saphenous vein, it is first necessary to perform an operation of separating the saphenous vein from other tissues. The upper tissue of the saphenous vein has a structure in which a connective tissue covering the saphenous vein and fat and skin are sequentially laminated on the upper side thereof.

When the saphenous vein is extracted particularly endoscopically, the saphenous vein and other tissues including the connective tissue are largely separated from each other so that the saphenous vein and the connective tissue are separated from each other. The working space needed to collect the saphenous vein needs to be created. Further, in the formed working space, as a final step of the peeling work, a work of peeling and cutting the connective fabric that cannot be peeled off from the saphenous vein is also performed.

[0004]

When performing a procedure near the subcutaneous tissue such as a blood vessel or a nerve such as the above-mentioned peeling work or cutting work, the operator must avoid damaging the subcutaneous tissue. You need to be very careful.

However, in the peeling work or cutting work performed directly above the saphenous vein to be collected, there is a risk that the saphenous vein will be damaged by a treatment tool or the like during the work. The saphenous vein, which serves as a bypass tube in the heart, must be harvested without injury. This is not limited to the extraction of the saphenous vein, and the same applies when there is a tissue to be protected near the treatment work.

The present invention has been made in view of the above circumstances, and an object thereof is to provide a subcutaneous tissue protector capable of protecting a target subcutaneous tissue during a treatment operation. .

[0007]

In order to solve the above-mentioned problems, the subcutaneous tissue protector of the present invention is insertable into the subcutaneous tissue and covers at least a part of the subcutaneous tissue to protect it. And a guide means for guiding the device along the main body so as not to contact the subcutaneous tissue.

According to this structure, contact between the tissue and the treatment tool is positively prevented by the main body, and the treatment tool can be guided while the contact between the tissue and the treatment tool is prevented by the guide means.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 7 show a first embodiment of the present invention. As shown in FIG. 1A, the subcutaneous tissue protector 1 of the present embodiment is formed as a plate-shaped elongated member that can be inserted into the subcutaneous tissue and covers the subcutaneous tissue to be protected. It has a main body portion 1a having a width and a length that can be protected by. Further, an overhanging portion 1b that overhangs in the width direction is provided at the base end portion of the main body portion 1a. The overhanging portion 1b is overhanging with a width that cannot be inserted into the subcutaneous tissue from a skin cut portion of a treatment target portion of a living body described later.

Main body 1a for covering the subcutaneous tissue to be protected
The protective surface (lower surface in FIG. 1) 2 is formed as a smooth flat surface without irregularities. Further, a guide groove 6 for guiding the treatment tool is formed in the entire surface in the axial direction on a surface (upper surface in FIG. 1; hereinafter referred to as a guide surface) 4 opposite to the protective surface 2.

The tip of the main body 1a is tapered so that the main body 1a can be easily inserted into the subcutaneous tissue. Also, to avoid damaging the tissue,
The leading edge of the main body 1a is formed into a smooth blunt shape. In addition, a connection portion 7 that is detachably connectable to a treatment tool or the like is provided at the tip of the main body portion 1a.

Next, the case of performing an endoscopic saphenous vein sampling operation using the subcutaneous tissue protector 1 having the above-described configuration will be described. This surgical procedure is performed, for example, to collect and utilize a saphenous vein existing under the thigh as a bypass tube required when performing a blood vessel bypass operation on the heart. In this surgical procedure, it is important to collect the saphenous vein without damaging it, so that the subcutaneous tissue protector 1 of the present embodiment is indispensable.

First, as shown in FIG. 2, along the running of the saphenous vein 9 to be sampled, incisions are made at a plurality of locations on the thigh 8 to form skin incisions, and peeling forceps, etc. are formed at each skin incision. To expose the saphenous vein 9. The number of skin cuts is determined from the length of the saphenous vein 9 to be sampled and the length of the subcutaneous tissue protector 1. In the figure, for the sake of simplicity, two skin cutting portions 10 and 11 are shown.

Next, as shown in FIG. 3, the peeler 12 is inserted into the subcutaneous tissue from the skin cut portion 10 toward the skin cut portion 11. As shown in the figure, the tissue existing above the saphenous vein 9 has a structure in which the skin 15, the fat 16 and the connective tissue 17 are sequentially laminated, and the saphenous vein 9 which is the subcutaneous tissue to be protected is shown. And the connective weave 17 are inserted between the saphenous vein 9 and the connective weave 17 by the tip of the remover 12.
And peel off. This peeling work is performed while always checking the peeling condition by the endoscope 13 inserted in the peeler 12. At least the tip of the detacher 12 is made of a transparent material, and the saphenous vein 9 and a side branch (not shown) branching laterally from the saphenous vein 9 can be clearly observed by the endoscope 13. It is like this.

When the saphenous vein 9 extending from the skin-cutting portion 10 to the skin-cutting portion 11 and the connective fabric 17 are completely peeled off and the tip of the dissector 12 is projected from the skin-cutting portion 11 to the outside, this time, Connecting portion 20 at the base end portion of the stripper 12 protruding from the skin cutting portion 10
The connecting portion 7 of the subcutaneous tissue protector 1 is connected to. This connection may be a screw-in type as shown in FIG. 4A or a latch-engaging type as shown in FIG. 4B.

Next, with the connecting portion 20 of the subcutaneous tissue protector 1 connected to the connecting portion 20 at the proximal end of the detacher 12, the detacher 12 is pulled out from the subcutaneous tissue and the subcutaneous tissue protector 1 is turned down. It is drawn into the separation space between the existing vein 9 and the connective fabric 17. At this time, if the substantial cross-sectional area of the main body portion 1a of the subcutaneous tissue protector 1 is set to be equal to or less than the substantial cross-sectional area of the peeler 12, the subcutaneous tissue protector 1 can be easily provided between the saphenous vein 9 and the connective fabric 17. Can be inserted into.

FIG. 5 shows a state in which the subcutaneous tissue protector 1 is inserted between the saphenous vein 9 and the connective fabric 17 and placed in place of the peeling element 12. In this state, the stripper 12 is removed from the subcutaneous tissue protector 1, and the saphenous vein 9 is completely covered from above by the protective surface 2 of the main body 1a. Further, in this state, the overhanging portion 1b comes into contact with the skin cut portion 10 to prevent the subcutaneous tissue protector 1 from shifting toward the skin cut portion 11 side.

In this state, this time, as shown in FIG.
The distal end side of the guide rod 23 having the cavity forming tool 22 as a treatment tool connected to the proximal end is introduced from the skin cutting portion 10, and the guide rod 23 is inserted into the guide groove 6 of the main body portion 1a of the subcutaneous tissue protective device 1. Push along. When the tip side of the guide rod 23 protrudes from the cut portion 11, the guide rod 23 is pulled out from the cut portion 11 as it is, and the cavity creating tool 22 is drawn into the separation space between the saphenous vein 9 and the connective fabric 17. . At this time, as shown in FIG. 7, the cavity-creating tool 22 is pulled in while the projection 23 formed along the longitudinal direction on the lower surface thereof is guided by the guide groove 6. As a result, the detached state between the saphenous vein 9 and the connective tissue 17 is expanded by the expansion portion 22a of the cavity creating tool 22, and the treatment work is performed on the upper side of the saphenous vein 9, that is, the upper side of the subcutaneous tissue protector 1. A cavity of sufficient width is formed. In this case, since the saphenous vein 9 is protected by the subcutaneous tissue protector 1, the saphenous vein 9 is not damaged by the cavity creating operation by the cavity creating tool 22. In addition, an unevenness for finger hanging is formed on the outer peripheral surface of the tip end side of the guide rod 23 so that the operation of gripping and pulling the tip end side of the guide rod 23 can be easily performed without slipping.

When a cavity of a predetermined size is formed above the saphenous vein 9 as described above, the subcutaneous tissue protector 1 from inside the subcutaneous tissue with the cavity secured by a cavity securing device (not shown).
Extract. Subsequently, the saphenous vein 9 is excised in the space in which the cavity is secured, and the saphenous vein 9 is collected from the skin incision.

As described above, the subcutaneous tissue protector 1 of the present embodiment has the protective surface 2 that covers and protects the subcutaneous tissue, so that the subcutaneous tissue is prevented from being damaged during various treatment operations. be able to. Therefore, when a subcutaneous tissue such as the saphenous vein 9 is collected, it can be collected without damaging it.

The subcutaneous tissue protector 1 has a guide rod 23.
Since it has the guide groove 6 for guiding the treatment tool such as the cavity preparation tool 22, the treatment tool can be easily inserted into the subcutaneous tissue.

Further, in the subcutaneous tissue protector 1, since the distal end side of the main body portion 1a is formed in a tapered shape, the main body portion 1a can be easily inserted into the subcutaneous tissue. Further, since the tip edge of the main body portion 1a is formed in a smooth blunt shape,
It does not damage the tissue when it is inserted into the subcutaneous tissue.

Further, since the main body 1a is provided at its tip with a connecting portion 7 which is detachably connectable to a treatment instrument or the like,
If the main body portion 1a is pulled by the treatment tool or the like to be connected, the main body portion 1a can be easily inserted into the subcutaneous tissue.

Further, since the base portion of the main body portion 1a is provided with the overhanging portion 1b protruding in the width direction, further insertion of the main body portion 1a into the subcutaneous tissue is prevented, and the extension portion 1b is extended. When the projecting portion 1b is brought into contact with the skin cut portion 10 or the like, the axial displacement of the subcutaneous tissue protective device 1 can be prevented. Further, since the overhanging portion 1b functions as a handle that can be gripped when the main body portion 1a is pulled out from the subcutaneous tissue, the pulling-out operation of the main body portion 1a becomes easy.

FIG. 8 shows a second embodiment of the present invention. An accommodation groove 25 for accommodating and protecting the subcutaneous tissue to be protected is formed in the protective surface 2 of the main body 1a of the subcutaneous tissue protector 1'of the present embodiment along the longitudinal direction. The other configuration is the same as that of the first embodiment.

According to this structure, as shown in FIG. 8, if the saphenous vein 9 to be protected, for example, is arranged to be accommodated in the accommodating groove 25, the saphenous vein 9 can be protected without being compressed. You can

FIG. 9 shows a third embodiment of the present invention. In the subcutaneous tissue protector 1 ″ of this embodiment, a protrusion 26 is formed on the protective surface 2 of the main body 1a along the longitudinal direction. The other configuration is almost the same as that of the first embodiment.

Subcutaneous tissue protector 1 ″ having such a configuration
For example, in the endoscopic saphenous vein collection operation shown in the first embodiment, the separation state between the saphenous vein 9 and the connective fabric 17 is gradually widened by a plurality of cavity creating tools 22 having different sizes. It will be beneficial in some cases. That is, when the detached state between the saphenous vein 9 and the connective tissue 17 becomes large, it becomes necessary to replace the subcutaneous tissue protector with a large one.

Therefore, for example, when the subcutaneous tissue protector 1 is to be replaced with a subcutaneous tissue protector 1 ″ having a wider width than that, as shown in FIG. With the projection 26 of the subcutaneous tissue protector 1 ″ engaged, move the subcutaneous tissue protector 1 ″ along the guide surface 4 of the subcutaneous tissue protector 1 until it completely overlaps the subcutaneous tissue protector 1. Just do it. As a result, the subcutaneous tissue protector 1 ″ is placed on the subcutaneous tissue protector 1 so as to be embedded in the connective fabric 17. When the subcutaneous tissue protector 1 is pulled out in this state, the subcutaneous tissue protector 1 ″ is replaced with the subcutaneous tissue protector 1.

11 to 14 show a fourth embodiment of the present invention. As shown in (a) of FIG. 11, the subcutaneous tissue protector 40 of the present embodiment is formed as a substantially rod-shaped elongated member that can be inserted into the subcutaneous tissue, and at least one of the subcutaneous tissues to be protected. It has a body portion 40a having a width and a length that can cover and protect the portion. An operation rod 40b having a diameter smaller than that of the main body 40a is connected to the base end of the main body 40a.

As shown in FIG. 11B, the body portion 40a of the subcutaneous tissue protector 40 has a substantially flat cross section. Body 40 in contact with the subcutaneous tissue to be protected
An accommodating groove 47 for accommodating and protecting subcutaneous tissue is formed on the protective surface 42 of a over its entire length. In addition, a guide groove 46 for guiding the treatment tool is formed in the guide surface 44 on the side opposite to the protective surface 42 along the longitudinal direction. Both ends of the guide groove 46 are terminated by walls, and the groove wall 30 on the distal end side restricts the protrusion of the treatment instrument guided along the guide groove 46 toward the distal end. The guide groove 46 may be formed over the entire length of the main body 40a.

The tip side of the main body portion 40a is designed so that the main body portion 40a can be easily inserted into the subcutaneous tissue and the subcutaneous tissue to be protected can be easily separated from other subcutaneous tissue. Is formed in a tapered shape.
Further, the tip edge of the body portion 40a is formed into a smooth blunt shape so as not to damage the tissue.

Next, a case of performing an endoscopic saphenous vein collection operation using the subcutaneous tissue protector 40 having the above-described configuration will be described with reference to FIGS. 12 to 14. First, the first
A cavity of a predetermined size is formed on the upper side of the saphenous vein 9 by the same operation as described in the above embodiment, and this cavity is secured by the dome-shaped cavity retainer 39. This state is shown in FIG. In the space secured by the cavity securing device 39, the saphenous vein 9 is exposed while being partially covered with the connective fabric 17. This is because the peeler 12 may pass through the connecting weave 17 during the peeling work by the peeler 12. In the figure, 19 is a side branch that branches off from the saphenous vein 9.

In such a state, it is necessary to remove the connective fabric 17 which is a membranous tissue from the saphenous vein 9 with scissors forceps or the like. Therefore, first, the subcutaneous tissue protector 40 is introduced from the skin cutting portion 10 into the space secured by the cavity securing tool 39. Then, as shown by the arrow in the drawing, the subcutaneous tissue protector 40 is pushed toward between the unseparated connective fabric 17 and the saphenous vein 9 (see (b) of FIG. 12).
It should be noted that this work is performed under observation with an endoscope (not shown) introduced into the cavity securing device 39.

Then, as shown in FIG. 13, the subcutaneous tissue protector 40 is inserted between the unseparated connective fabric 17 and the saphenous vein 9 to separate the tissues 9 and 17 from each other. This time,
Subcutaneous tissue protector 4 such that the saphenous vein 9 extends along the accommodation groove 47.
Insert 0. 13B shows a vertical cross section at that time, and FIG. 13C shows a horizontal cross section. At this time, the blade of the scissors forceps 38 is inserted along the guide groove 46.

Subcutaneous tissue protector 40 allows tissues 9, 17
When the comrades are separated to some extent, as shown in FIG. 14, the blade of the scissors forceps 38 is pushed along the guide groove 46 to position the connecting weave 17 between the upper blade and the lower blade. Then, in this state, the connecting weave 17 is cut. Do this work with the saphenous vein 9
Repeat until the entire length of is exposed.

When the full length of the saphenous vein 9 is exposed, the side branch is clipped and cut, the saphenous vein 9 is excised, and then the saphenous vein 9 is taken out through the cut-out portion. As described above, the subcutaneous tissue protector 40 of the present embodiment is
Since the protective surface 42 is provided to cover and protect the subcutaneous tissue, it is possible to prevent the subcutaneous tissue from being damaged during various treatment operations. That is, for example, directly using the scissors forceps 3
If 8 is introduced along the saphenous vein 9 and the connective tissue 17 is cut, the saphenous vein 9 may be damaged by the scissors forceps 38, but the saphenous vein is protected by the protective surface 42 as in the present embodiment. If 9 is protected, the scissors forceps 38 can be guided along the guide groove 46 without damaging the saphenous vein 9 to cut the connective fabric 17.

Further, the subcutaneous tissue protector 40 of the present embodiment
Since the saphenous vein 9 to be protected, for example, can be accommodated in the accommodating groove 47, the saphenous vein 9 can be protected without being pressed.

The subcutaneous tissue protector 40 comprises a body portion 40.
Since the tip side of a is formed in a tapered shape,
The main body portion 40a can be easily inserted into the subcutaneous tissue, and the tissues can be easily separated from each other. Further, at this time, since the tip edge of the main body portion 40a is formed in a smooth and blunt shape, the saphenous vein 9 to be protected, for example, is not damaged during peeling.

FIG. 15 shows a fifth embodiment of the present invention. This embodiment is the same as the fourth embodiment except that the tip of the main body 40a is directed upward. With such a tip shape, the upper tissue can be peeled off by scooping up the lower tissue.

FIG. 16 shows a sixth embodiment of the present invention. The subcutaneous tissue protector 50 of the present embodiment is formed as a long tubular member. As shown, the subcutaneous tissue protector 50 has a hole 5 through which the insertion portion 55a of the endoscope 55 can be inserted.
Two. The tip of the hole 52 is closed, and the base end of the hole 52 is open.

The subcutaneous tissue protector 50 is made of a transparent material over its entire length and can be observed by an endoscope 55 inserted in the hole 52. Also,
The subcutaneous tissue protector 50 is formed with a guide groove 51 for guiding the treatment tool and the like over the entire length thereof.

The tip of the subcutaneous tissue protector 50 can be easily inserted into the subcutaneous tissue, and the subcutaneous tissue to be protected and other subcutaneous tissues can be easily separated. It is formed in a tapered shape. Also,
The leading edge of the subcutaneous tissue protector 50 is formed into a smooth blunt shape so as not to damage the tissue.

With the subcutaneous tissue protector 50 having such a structure, the treatment can be performed while observing by inserting the insertion portion 55a of the endoscope 55 into the hole 52 through the opening at the proximal end. For example, while the scissors forceps are guided along the guide groove 51 and treated, the state can be observed with the endoscope 55.

The subcutaneous tissue protector 50 prevents contact between the treatment instrument and the subcutaneous tissue to be protected, that is,
Since the subcutaneous tissue protector 50 itself protects the underlying subcutaneous tissue, the subcutaneous tissue is not damaged by the treatment tool during a procedure such as a peeling operation.

17 to 18 show a seventh embodiment of the present invention. As shown in FIG. 17, the subcutaneous tissue protector 60 of the present embodiment is formed as a long tubular member. As illustrated, the subcutaneous tissue protector 60 has a hole 62 through which a treatment tool 65 such as scissors forceps can be inserted. The tip of the hole 62 is closed, and the base end of the hole 62 is open. An opening 61 is formed at the tip of the subcutaneous tissue protector 60 to open the hole 62 to the outside. This opening 6
1 is set to a size that does not interfere with the operation of the forceps portion 66 of the scissors forceps 65, for example.

Further, the distal end portion of the subcutaneous tissue protector 60 can be easily inserted into the subcutaneous tissue, and the subcutaneous tissue to be protected and other subcutaneous tissues can be easily separated. It is formed in a tapered shape. Also,
The distal edge of the subcutaneous tissue protector 60 is formed into a smooth blunt shape so as not to damage the tissue.

When the subcutaneous tissue protector 60 having such a structure is used, first, as shown in FIG. 18, for example, the scissors forceps 6 is inserted from the proximal end opening of the subcutaneous tissue protector 60 into the hole 62.
5 is inserted and the forceps part 66 is positioned in the opening 61. Then, as shown in FIG. 19, the pair of blades 66 of the forceps portion 66.
With the a and 66b opened, the subcutaneous tissue protector 60 is inserted, for example, between the saphenous vein 9 and the connective fabric 17 to be peeled off, and the connective fabric 17 is cut with the blades 66a and 66b in a state where it is separated to some extent. To do.

As described above, in the subcutaneous tissue protector 60 of this embodiment, the treatment tool 65 is housed in the hole 62, and only the forceps 66 involved in the treatment is exposed from the opening 61. Compared with the case where the treatment tool is guided by the guide groove, contact between the tissue to be protected and the treatment tool 65 can be reliably prevented.

By the way, according to the embodiment described above, the following configuration can be obtained. 1. In the treatment of subcutaneous tissue, the body has a main body that is inserted from the skin cut portion and is placed on the target subcutaneous tissue, and a guide groove for guiding the treatment tool is formed on the upper surface of the main body along the longitudinal axis. A subcutaneous tissue protector characterized by:

2. The said main-body part is formed in the length which covers the subcutaneous tissue for treatment (protection) fully, The subcutaneous tissue protection tool of Claim 1 characterized by the above-mentioned. 3. 3. The subcutaneous tissue protector according to claim 2, wherein the length of the main body portion is set to be at least the length between the skin cut portions.

4. 4. The subcutaneous tissue protector according to any one of claims 1 to 3, wherein the main body portion has a recess for accommodating the tissue to be protected on the surface (lower surface) on the subcutaneous tissue side.

5. The subcutaneous tissue protector according to any one of items 1 to 4, wherein the main body portion is provided with a traction means. 6. 6. The subcutaneous tissue protector according to item 5, wherein the pulling means is detachable.

7. 6. The subcutaneous tissue protector according to claim 1, wherein at least a part of the main body has a large width. 8. 8. The subcutaneous tissue protector according to claim 7, wherein at least one end of the main body has a width larger than the width of the insertion-side cut end.

9. The insertion-side tip of the main body is tapered so that it can be easily inserted, and the distal end is formed to be blunt. The subcutaneous tissue protector described.

10. 10. The subcutaneous tissue protector according to any one of items 1 to 9, wherein the guide groove ends with a wall in the vicinity of the distal end portion on the insertion side. 11. The subcutaneous tissue protector according to any one of items 1 to 10, wherein the main body is plate-shaped.

12. 12. The subcutaneous tissue protector according to any one of items 1 to 11, wherein the main body is transparent. 13. 12. The subcutaneous tissue protector according to any one of items 1 to 11, wherein the main body has a cavity capable of containing an endoscope and is transparent.

14. 13. The cross-sectional area of the main body is equal to or smaller than the cross-sectional area of a treatment tool (such as a stripper) inserted into the body in front of the main body, according to any one of items 1 to 12. Subcutaneous tissue protector.

[0059]

As described above, according to the subcutaneous tissue protector of the present invention, contact between the tissue and the treatment tool is positively prevented by the main body portion, and contact between the tissue and the treatment tool is provided by the guide means. It is possible to guide the treatment tool while preventing it.
Therefore, the treatment work can be safely performed in the vicinity of the subcutaneous tissue without damaging the subcutaneous tissue.

[Brief description of the drawings]

FIG. 1A is a perspective view of a subcutaneous tissue protector according to a first embodiment of the present invention, and FIG. 1B is a cross-sectional view taken along the line AA of FIG.

FIG. 2 is a plan view showing a state in which a skin cut is provided on a thigh.

FIG. 3 is a cross-sectional view showing how the subcutaneous tissue protector of FIG. 1 is inserted into subcutaneous tissue.

FIG. 4 is a perspective view showing a connection mode between a subcutaneous tissue protection tool and a treatment tool.

FIG. 5 is a perspective view showing a state in which a subcutaneous tissue protector is inserted between skin cut portions.

FIG. 6 is a plan view showing a state in which the cavity creating tool is inserted between the skin incisions where the subcutaneous tissue protecting tool is placed.

FIG. 7 is a cross-sectional view of the subcutaneous tissue in which the subcutaneous tissue protector and the cavity creating tool are inserted.

FIG. 8 is a cross-sectional view of a subcutaneous tissue in which a subcutaneous tissue protector and a cavity creating tool according to a second embodiment of the present invention are inserted.

9A is a front view of a subcutaneous tissue protector according to a third embodiment of the present invention, FIG. 9B is a side view of the subcutaneous tissue protector, and FIG. 9C is a lower surface of the subcutaneous tissue protector. It is a figure.

FIG. 10 is a perspective view showing how the subcutaneous tissue protection device of FIG. 9 is replaced with another subcutaneous tissue protection device placed inside the body.

11A is a perspective view of a subcutaneous tissue protector according to a fourth embodiment of the present invention, FIG. 11B is a sectional view taken along line BB of FIG. 11A, and FIG. It is a sectional side view of a protector.

12 (a) is a view showing a state in which the subcutaneous tissue protector of FIG. 11 is inserted between a saphenous vein and a connective tissue, and FIG. 12 (b) is a side sectional view of FIG.

13 (a) is a view showing a state in which the saphenous vein and the connective tissue are separated using the subcutaneous tissue protector of FIG. 11, (b) is a side sectional view of (a), and (c) is ( It is sectional drawing which follows CC line of b).

14 (a) is a diagram showing a state in which the connective fabric is cut using the scissors forceps guided by the subcutaneous tissue protector of FIG. 11, and FIG. 14 (b) is a side sectional view of FIG.

FIG. 15 is a side sectional view of a subcutaneous tissue protector according to a fifth embodiment of the present invention.

16A is a perspective view of a subcutaneous tissue protector according to a sixth embodiment of the present invention, FIG. 16B is a cross-sectional view of the subcutaneous tissue protector, and FIG. 16C is a perspective view of the subcutaneous tissue protector. FIG.

FIG. 17 is a perspective view of a subcutaneous tissue protector according to a seventh embodiment of the present invention.

FIG. 18 shows a state in which a treatment tool is inserted through the subcutaneous tissue protector of FIG. 17, (a) is a horizontal sectional view, (b) is a longitudinal side sectional view, and (c) is a plan view.

FIG. 19 is a diagram showing a state in which a connective fabric is cut using the subcutaneous tissue protector and the treatment tool of FIG. 17;

[Explanation of symbols]

1, 1 ′, 1 ″, 40, 50, 60 ... Subcutaneous tissue protector, 1 a, 40 a ... Main body part, 6, 46, 51 ... Guide groove (guide means), 62 ... Hole (guide means).

Claims (1)

[Claims] 1. A body part that can be inserted into subcutaneous tissue and covers at least a part of the subcutaneous tissue to protect it, and a guide means that guides the treatment tool along the body part so as not to contact the subcutaneous tissue. A subcutaneous tissue protector comprising: