JPH09276287A - Trocar and cannula - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a highly airtight trocar and cannula whose inside can easily and surely be washed. SOLUTION: In a trocar and cannula, which includes the main body of a trocar and cannula 10 having a tube inserted into a coelom to form a path for insertion of an instrument inserted into the coelom, a closing valve 14 opening and closing the path of insertion of the instrument inserted, and a chamber 11b which closes on contact with the closing valve to keep the inside and outside of the coelom airtight, the closing valve 14 and the chamber 11b are freely attached to and removed from each other, and when the trocar and cannula is mounted, the closing valve 14 is held energized toward the chamber 11b.

Description

Detailed Description of the Invention

[0001]

TECHNICAL FIELD The present invention relates to inserting into a body cavity,
The present invention relates to a tubular trocar mantle tube that forms an insertion path of an insertion device into a body cavity.

[0002]

2. Description of the Related Art In recent years, endoscopes have been widely used in surgical operations and the like. A typical example is laparoscopic cholecystectomy. The operation in laparoscopic surgery is to insufflate the abdominal cavity by insufflating gas such as carbon dioxide into the abdominal cavity, then puncture the abdominal cavity with a trocar mantle tube loaded with an inner needle, and then By removing the inner needle, a guide path for introducing an insertion instrument such as a laparoscope or a treatment instrument into the abdominal cavity is formed in the trocar outer tube.

This type of trocar outer tube is provided with a valve inside thereof for keeping airtightness so that insufflation gas does not leak from the abdominal cavity to the outside of the body. Since this valve has a function of keeping the guide passage in the trocar mantle airtight, many components such as a closing member, its supporting member and a biasing member are required, and as a result, the structure around the valve becomes complicated. There's a problem. Therefore, when the trocar mantle tube is cleaned after the operation, there arises a problem that the cleaning of the inside is troublesome.

As another prior art example, USP No. 5,22
No. 4,952 is available. In this prior art example, a valve having a closing member which is biased by a biasing member is provided in the trocar outer tube, but the member of this valve cannot be detached from the main body of the trocar outer tube. Also, a separate biasing member is required to bias the closure member. Further, since the members of this closing valve are attached to the main body side of the trocar outer tube in a non-detachable manner, it is very difficult to clean these members and their surroundings, and the assemblability of these members is also poor. .

In order to solve the problems of these prior art examples, a valve structure having a structure as described in JP-A-6-292678 is known. The valve structure known in this publication is of a type in which an occluding member made of an elastic material is biased by a pneumoperitoneum pressure to ensure airtightness. Further, the closing member is detachably attached to the trocar outer tube. It is also known that a cap for maintaining airtightness when a laparoscope or a treatment tool is inserted into the trocar outer sheath tube is provided at the proximal end of the trocar outer sheath tube.

[0006]

However, in the conventional trocar mantle tube, an attempt is made to urge the closing member by the abdominal pressure to secure the airtightness in the trocar mantle tube. Since the urging force to maintain the airtightness is not obtained, it is difficult to surely bring the closing member into contact with the abutting portion of the chamber, and the elastic portion of the closing member has a habit and the closing member is Since it does not come into contact with the whole, reliable closure becomes difficult.

On the other hand, if an urging member such as a spring is provided integrally with the occluding member to urge the occluding member, the internal structure of the trocar outer tube becomes complicated as described above.
Especially post-surgery cleaning work is troublesome.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a trocar mantle tube which can easily and reliably clean the inside of the trocar mantle tube and is highly airtight. It is in.

[0009]

SUMMARY OF THE INVENTION The present invention is directed to a body of a trocar mantle having a tubular sleeve that is inserted into a body cavity and forms an insertion path for the instrument to be inserted into the body cavity, and the insertion of the instrument. In a trocar mantle having a closing member that opens and closes a passage and a chamber that closes by contact with the closing member to ensure airtightness inside and outside the body cavity, the closing member and the chamber are detachably and attached. In the state, the blocking member is biased and held by the chamber. This makes it possible to provide a highly airtight trocar mantle tube in which the inside of the trocar mantle tube can be easily washed.

[0010]

BEST MODE FOR CARRYING OUT THE INVENTION

<First Embodiment> A first embodiment of the present invention will be described with reference to FIGS. (Structure) As shown in FIGS. 1 and 2, the main body of the trocar mantle tube 10 according to the first embodiment is a base end side body 11.
And the distal end side body 12, and is configured to form an insertion path of the insertion instrument into the body cavity as a whole.

The base body 11 and the tip body 12 are provided.
Is detachably connected in a so-called bayonet type by a pin 11a provided on the base body 11 and a cam groove 12a provided on the body 12 on the tip side. Marks 11d and 12d are provided on the base end side main body 11 and the tip end side main body 12 to indicate their mounting completion positions. Furthermore, a packing 13 is provided near the connecting portion between the base body 11 and the tip body 12.
Is interposed, and the connecting portion of both connected by the packing 13 is hermetically sealed.

A chamber 11b is provided in the base body 11 and a closing valve 14 made of silicon rubber or the like is mounted in the chamber 11b. The shutoff valve 14 is provided at one end thereof with an attachment / detachment portion 14a which is slidably fitted into the groove portion 11c of the chamber 11b. The groove 11c is linearly formed in the direction perpendicular to the paper surface in FIG. The closing valve 14 is detachably attached to the chamber 11b by fitting the attachment / detachment portion 14a into the groove portion 11c.

The shutoff valve 14 comprises a detachable portion 14a for fitting into the groove portion 11c, and a disc-shaped valve portion 14c integrally connected to the detachable portion 14a via a hinge portion 14b. The closing valve 14 has a hinge portion 14b shown in FIG.
The chamber 11 is bent in the state indicated by the solid line in FIG.
It is fitted and fitted into the groove 11c of b. For this reason,
The valve portion 14c of the closing valve 14 is urged toward the opening edge 11d of the chamber 11b by the elastic restoring force of the hinge portion 14b and presses against the opening edge 11d, thereby sealing the opening of the chamber 11b in a closed state. .

The attachment / detachment portion 14a of the shutoff valve 14 is preferably formed of metal or hard plastic in order to improve slidability when it is attached / detached to / from the groove portion 11c of the chamber 11b.

An opening flange 11e is provided on the base body 11 and a cap 15 made of an elastic body having an insertion opening 15a is attached to the opening flange 11e as shown in FIG. There is. The cap 15 is detachably fitted by its own elasticity.

On the other hand, an insertion tool 16 having an outer diameter portion 16a which is inserted into the opening flange 11e and is tightly bound by the insertion opening 15a, and a base end side of the insertion tool 16 which is attached to the insertion tool 16 to insert the cap 15. Reducer 1 comprising a small cap 17 having an insertion opening 17a having a smaller diameter than the opening 15a
8 are prepared.

An outer diameter portion 1 is provided at the tip of the insertion tool 16.
A guide portion 16b having a smaller diameter than 6a is formed. The reducer 18 is the opening flange 1 of the base body 11 on the proximal side.
It is connected to the vicinity of 1e via a strap 19. The strap 19 is made of an elastic material such as silicone rubber and is detachably attached to both the base body 11 and the reducer 18.

A grip 20 for firmly gripping the trocar mantle tube 10 when puncturing / withdrawing it into the abdominal cavity is provided on the large-diameter hand-side operation portion of the tip side main body 12. An insertion portion sleeve 21 that is inserted into the abdominal cavity is connected to the distal end portion of the distal end main body 12.

(Operation) The main body of the trocar mantle tube 10 is
As described above, the trocar outer tube 11 is composed of the proximal body 11 and the distal body 12, and the proximal body 11 and the distal body 12 are detachably connected to each other in a bayonet manner. One-touch operation is possible, and compared with, for example, a screw-type connection method, there is no thread trough and the like, resulting in good post-operative cleanability.

Further, since the hinge portion 14b of the closing valve 14 is bent when it is attached to the chamber 11b, the valve portion 14c is elastically restored by the closing valve 14 itself.
Is always urged toward the opening edge 11d of the chamber 11b. Therefore, the above-mentioned prior art (JP-A-6-29) is used.
It is possible to obtain higher airtightness than that of the trocar mantle tube of Japanese Patent No. 2678). Further, the closure valve 1
Since 4 is a simple plate-shaped valve, its molding and the like are extremely easy and can be manufactured at low cost.

Further, since the reducer 18 is prepared, it is possible to prevent leakage of pneumoperitoneum gas even when using an insertion instrument having a diameter smaller than that of the insertion instrument normally used. Since the guide 16b is provided on the insertion tool 16 of the reducer 18, the reducer 18 can be smoothly inserted into the proximal body 11.

Since the strap 19 is detachably attached to both the base body 11 and the reducer 18, the reducer 18 can be detached and used when the reducer 18 is not needed. If the reducer 18 or the strap 19 is damaged, only those parts can be replaced. In addition, since it can be disassembled, it goes without saying that it has good post-operative cleaning properties.

Further, since the grip 20 is provided on the distal end side body 12, the gripping property of the trocar mantle tube 10 is improved, and hence the operability of the trocar mantle tube 10 is improved, so that the trocar mantle tube 10 is more safely abdominal cavity. Can be inserted inside.

(Effect) Hinge portion 14b of the shutoff valve 14
By mounting in a bent state in the chamber 11b, high airtightness can be obtained without using a biasing member, and since the structure is simple, disassembly and cleaning after use are easy. Moreover, since the reducer 18 is detachably provided to the trocar mantle tube 10, it is possible to provide a trocar mantle tube which is convenient in use and has good cleanability.

<Second Embodiment> A second embodiment of the present invention will be described with reference to FIGS. (Structure) As shown in FIG. 3, the main body of the trocar mantle tube 31 according to the second embodiment is mainly composed of a proximal end side main body 32 and a distal end side main body 33, and the insertion of the insertion device into the body cavity as a whole. Is configured to form a passage.

The proximal body 32 and the distal body 33 are connected by a male screw 32a provided at the distal end of the proximal body 32 and a female screw 33a provided at the proximal end of the distal body 33, It is also removable.
A packing 34 is provided in the vicinity of the connecting portion between the proximal end side main body 32 and the distal end side main body 3, and the packing 34 seals the connecting portion between the both in an airtight state. In addition,
The connecting portion between the base end side body 32 and the tip end side body 33 is formed in the large-diameter hand operation portion 31 a of the trocar outer tube 31.

An opening flange 32b is provided at the base end of the base end side body 32, and the opening flange 32b is made of an elastic body cap 35 having an insertion opening 35a.
Is applied by utilizing its elasticity. Further, a chamber 36 in which a distal end side edge 36a is obliquely formed in the base end side main body 32, and a closing member fitted so as to surround the chamber 36 and detachably attached to the chamber 36 37 and a biasing member 38 that is fitted around the closing member 37 and is detachably attached to the closing member 37.

The closing member 37 has a fixed wall 37a for tightening and fitting the chamber 36, and the chamber 3
6, a closing valve 37b that comes into contact with the edge 36a formed at the tip of the entire circumference of the edge 36a, and the closing valve 37b and the edge 3a.
The seal portion 37c is provided at a position where the 6a abuts, and is formed in a thin protruding wall shape, and the hinge portion 37d that serves as a fulcrum when the closing valve 37b opens and closes. Fixed wall 3
A convex portion 37e is provided on the inner surface of 7a, and the convex portion 37e is fitted into and engaged with a concave groove 36b provided on the outer peripheral surface of the chamber 36, whereby the fixed wall 37 is formed.
Position a is fixed to the chamber 36. In addition, the fixed wall 37a, the closing valve 37b, the seal portion 3
7c and the hinge portion 37d are integrally formed of an elastic material such as silicon rubber.

The urging member 38 is a spring support member 38a for tightening and fitting the fixed wall 37a, and the closing valve 3
The spring 38b is fixed to the spring support member 38a so as to bias the spring 7b toward the edge 36a. In the biasing member 38, the spring support member 38a and the spring 38b may be integrally provided.

The distal end side portion of the distal end side main body 33 is composed of an insertion portion sleeve 39 that is inserted into the abdominal cavity, and guides an insertion instrument 42 inserted therein as shown in FIG. 4 into the abdominal cavity. Has become. An air supply hole 39a for transmitting pneumoperitoneum gas is provided near the tip of the sleeve 39, and a tip 40 is provided at the tip of the sleeve 39. Although the tip of the tip 40 is formed obliquely,
The edge of the opening 40a of the tip 40 is formed as a non-edge. Therefore, the wall thickness of the tip 40 is larger than that of the sleeve 39, and the inner diameter of the tip 40 is smaller than that of the sleeve 39 by the thickness thereof.

An air supply mouthpiece 41 is provided on the side surface portion of the proximal end portion of the main body 33. An insufflation tube (not shown) is connected to the insufflation mouthpiece 41, and insufflation gas is supplied into the abdominal cavity from an insufflation unit (not shown) via the insufflation tube.

(Operation) FIG. 3 shows a state of the trocar outer tube 31 when the insertion instrument 42 is not inserted. At this time, the thin convex wall-shaped seal portion 37c provided on the closing valve 37b is in contact with the edge 36a formed at the tip of the chamber 36 over the entire circumference thereof. Further, the closing valve 37b is completely sealed by being biased by the spring 38b so that the seal portion 37c elastically deforms and comes into close contact with the edge 36a. As a result, the cap 35 side portion and the insertion distal end side portion are airtightly shut off, so that leakage of the insufflation gas fed from the air feeding mouthpiece 41 is prevented. Therefore, when the insertion device 42 is not inserted, the pneumoperitoneum gas does not leak out of the body, and the abdominal cavity can be kept in an insufflated state.

On the other hand, FIG. 4 shows a trocar outer tube 31 having an insertion instrument 4 such as a trocar inner needle, an endoscope or a treatment instrument.
2 shows a state when 2 is inserted. In this way, when the insertion device 42 is inserted into the trocar outer tube 31,
The insertion instrument 42 pushes the closing valve 37b against the biasing force of the elasticity of the hinge portion 37d and the elasticity of the spring 38b. Then, the closing valve 37b bends around the hinge portion 37d as a fulcrum, so that the insertion instrument 42 can be inserted into the trocar outer tube 31 without damaging the closing valve 37b.

Each main body 3 of the trocar outer tube 31
Since a space is provided in 2, 33 to allow the closing valve 37b and the spring 38b to move, when the insertion instrument 42 is inserted, the opening peripheral edge of the insertion opening 35a of the cap 35 contacts the outer peripheral surface of the insertion instrument 42. , As it is tied up as it is, it prevents the peritoneal gas from leaking out of the abdominal cavity from this part. Therefore, even if the insertion instrument 42 is not inserted and the airtightness is not maintained by the closing member 37, the abdominal cavity can be kept in the pneumoperitoneum state without leaking the pneumoperitoneum gas out of the body by the cap 35.

As described above, since the inner diameter of the tip 40 is smaller than the inner diameter of the sleeve 39, when the insertion instrument 42 having an outer diameter substantially the same as the inner diameter of the tip 40 is inserted, the tip tip 40 and the tip tip 40 have an outer diameter between them. There is a possibility that the pneumoperitoneum gas cannot be sufficiently supplied into the abdominal cavity due to the small clearance. It passes through the inner circumference of 39 and flows into the abdominal cavity from an air supply hole 39a provided in the vicinity of the tip of the sleeve 39 to secure the supply of pneumoperitoneum gas.

Further, since the edge of the opening 40a of the tip 40 is formed as a non-edge, for example, the insertion tool 42
For example, when an endoscope having a curved portion in the insertion portion is used, even if the endoscope is accidentally pulled out from the trocar outer tube 31 while the curved portion of the endoscope is bent, the distal end tip 40 is flexible such as rubber covering the curved portion. There is no need to worry about damaging the parts.

When the trocar outer tube 31 is washed after the operation, first, the base body 32 and the tip body 33 are attached to the male screw 32.
The packing 34 is removed by disassembling it with "a" and the female screw 33a as a boundary. Next, the biasing member 38 is removed from the base body 32, and then the closing member 37 is removed (see FIG. 5). At this time, as shown in FIG. 5, the biasing member 38 holds the spring support member 38a, and the closing member 37 holds the fixed wall 37a, so that these members can be easily removed. Finally, the cap 35 is removed from the base body 32. As described above, since the trocar mantle tube 31 can disassemble each component, it is possible to completely clean all the components, and it is easy to clean.
It is possible to prevent the occurrence of infectious diseases caused by poor cleaning.

(Effect) According to this embodiment, since the closing member 37 is detachably held so as to be urged toward the chamber 36, the inside of the trocar outer tube 31 can be easily and completely cleaned. Moreover, it is possible to provide the trocar outer tube 31 having high airtightness.

<Third Embodiment> A third embodiment of the present invention will be described with reference to FIGS. 6 to 7. (Structure) Since the third embodiment has the same structure as the second embodiment described above, only different structures will be described. The same structures will be denoted by the same reference numerals and the description thereof will be omitted.

As shown in FIG. 6, the closing member 37 is integrally constituted by a fixed wall 37a, a closing valve 37b, a seal portion 37c, and a hinge portion 37d made of a spring material. The fixed wall 37a, the closing valve 37b, and the seal portion 37c are made of an elastic material such as silicon rubber as in the first embodiment.

The hinge portion 37d of the closing member 37 is also provided.
Is made of a spring material, by which the fixed wall 37a and the closing valve 37b are connected and the closing member 37 is integrally provided. Therefore, in the third embodiment, the attachment shown in the second embodiment is provided. The biasing member 38 is excluded from the configuration.

(Operation) FIG. 6 shows a state when the insertion device 42 is not inserted into the trocar outer tube 31. At this time, the thin wall-shaped seal portion 37c provided in the closing valve 37b is provided with the edge 36a formed at the tip of the chamber 36.
Against the entire circumference. Further, when the closing valve 37b is biased by the hinge portion 37d made of a spring material, the seal portion 37c elastically deforms and comes into close contact with the edge 36a.

FIG. 7 shows a state in which the insertion device 42 is inserted into the trocar outer tube 31. Insertion tool 42
Is inserted into the trocar outer tube 31, the insertion tool 42 pushes the closing valve 37b against the biasing force of the hinge portion 37d made of a spring material. Then, since the opening / closing valve 37b is bent around the hinge portion 37d as a fulcrum, the insertion instrument 42 does not damage the closing valve 37b and the insertion device 42 does not damage the trocar outer tube 31.
Can be inserted in.

Since the other construction is the same as that of the second embodiment, the trocar mantle tube 31 can disassemble the respective constituent parts, so that it is possible to completely clean all the respective constituent parts, which is accompanied by poor cleaning. The fact that the occurrence of infectious diseases can be easily prevented is the same as in the second embodiment described above.

(Effects) In addition to the effects of the second embodiment,
The hinge portion 37d of the closing member 37 is integrally provided with the fixed wall 37a, the closing valve 37b, and the sealing portion 37c using a spring material, so that the biasing member 38 shown in the second embodiment can be provided. Since it can be omitted, the cleaning work can be simplified and the manufacturing cost can be reduced with the reduction in the number of components.

Further, since the biasing member 38 is omitted, when the insertion tool 42 is inserted into the trocar outer tube 31, a space for moving the spring 38b is provided in the trocar outer tube main body 32, 33. Since it is not necessary to provide the main body 32, 33 of the trocar outer tube 31, the main body 32, 33 can be made smaller. This allows the surgeon to insert the insertion tool 42.
The operability is improved, and surgery can be performed quickly.

[Supplementary Notes] A body of a trocar outer tube having a tubular sleeve that is inserted into a body cavity and forms an insertion path of an insertion device into the body cavity, a closing member that opens and closes the insertion path of the insertion device, and the closing member. In a trocar mantle having a chamber that is closed by the contact of to secure airtightness inside and outside the body cavity,
A trocar outer tube, wherein the closing member and the chamber are detachable, and the closing member is biased and held by the chamber in a mounted state.

2. The trocar outer tube according to appendix 1, wherein the closing member has a bent portion that is held in the chamber in a bent state. 3. The trocar outer tube according to claim 2, wherein the bent portion is formed of an elastic member, and the elastic force presses the valve portion of the closing member against the chamber. 4. The trocar outer tube according to Additional Items 2 and 3, wherein the closing member and the bent portion are the same member and integrated.

5. The trocar outer tube according to any one of claims 1 to 4, further comprising a biasing member that biases the closing member in a direction of coming into contact with the chamber and enhances airtightness in the closed state. 6. The trocar outer tube according to Additional Item 5, wherein the urging member is detachable from the chamber.

7. In the trocar outer tube according to Supplementary Note 1, the closing member includes a fixing portion that engages with the main body of the trocar outer tube, and a closing valve that abuts the edge formed at the tip of the chamber over the entire circumference. A trocar mantle tube comprising a hinge portion serving as a fulcrum when the closing valve is opened and closed by inserting and removing the insertion instrument, and at least the hinge portion is formed of a spring material. 8. The trocar outer tube according to any one of Supplementary Notes 1 to 7, wherein the closing member is formed of an elastic material.

9. The trocar mantle tube according to any one of Supplementary Notes 1 to 8, wherein a seal portion is formed integrally with the closure member at a position where the closure member and the chamber contact each other.

[0052]

As described above, according to the present invention, the closing member and the chamber are detachably attached, and in the mounted state, the closing member is biased and held by the chamber. Therefore, it is possible to provide a trocar mantle tube which is easy to clean the inside of the trocar mantle tube and has high airtightness.

[Brief description of drawings]

FIG. 1 is an exploded view showing a proximal portion of a trocar outer tube according to a first embodiment.

FIG. 2 is an explanatory view showing a cross section of a proximal portion of the trocar mantle tube according to the first embodiment.

FIG. 3 is a vertical sectional view of a trocar mantle tube according to a second embodiment.

FIG. 4 is a vertical cross-sectional view of a trocar outer tube when an insertion member is inserted into the trocar outer tube according to the second embodiment.

FIG. 5 is a perspective view showing appearances of a proximal end side main body, a closing member, and a biasing member of the trocar outer tube according to the second embodiment.

FIG. 6 is a vertical sectional view of a trocar mantle tube according to a third embodiment.

FIG. 7 is a vertical cross-sectional view of the trocar outer tube when an insertion member is inserted into the trocar outer tube according to the third embodiment.

[Explanation of symbols]

Reference numeral 10 ... Trocar outer tube, 11 ... Base body, 12 ... Tip body, 11a ... Pin, 11b ... Chamber, 11c
... groove part, 11d ... opening edge, 14 ... closing valve, 14a ... attaching / detaching part, 14b ... hinge part, 14c ... valve part, 18 ... reducer.

Claims (1)

[Claims] 1. A main body of a trocar outer tube having a tubular sleeve inserted into a body cavity and forming an insertion path of an insertion instrument into the body cavity, and a closing member for opening and closing the insertion channel of the insertion instrument. A trocar outer tube having a chamber that closes by contact with the closing member to ensure airtightness inside and outside the body cavity, wherein the closing member and the chamber are detachable, and when the wearing member is attached, the closing member is A trocar outer tube that is held by being biased to a chamber.