JPH10127644A - Medical treatment insertion tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical treatment insertion tool by which an organ is directly touched with hands and surely and safely treated in a short time when performing treatment and extirpation by operation under endoscope. SOLUTION: Adjacently to the outer periphery of a cylindrical sheet 3, a preceding balloon 1 and a following balloon 2 are formed, at the rear end of the cylindrical sheet 3, a cylindrical sheet-shaped sleeve 16 is air-tightly adjacently added and further, a valve member 14 or a fastening member 15 are added for air-tightly closing a flow pass inside the sleeve 16. Concerning the respective balloons, gas/liquid opening/closing devices 10 and 11 are additionally provided at their rear end parts while communicating branch tubes 4 and 5.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment insertion tool for treating an organ by directly touching the organ using an insufflation method in endoscopic surgery.

[0002]

2. Description of the Related Art In recent years, endoscopic surgery has been widely practiced as a minimally invasive treatment method. Endoscopic surgery is mainly used when performing operations on various organs of the abdomen, such as the stomach, spleen, intestine, and gallbladder, by creating a space by injecting carbon dioxide into the abdominal wall and inserting instruments such as trocars into it. This is a method in which a plurality of use tubes are inserted, and various treatment tools are inserted and surgery is performed while viewing the field of view of the endoscope inserted therefrom. Therefore, according to the present method, there is an advantage that the incision is extremely small and damage to the patient is small as compared with the conventional laparotomy. Here, injecting and pressurizing carbon dioxide into the body to form a necessary space in the abdominal cavity or the like is referred to as insufflation. On the other hand, there is also a method of suspending the abdominal wall by inserting a steel wire or the like under the skin without injecting carbon dioxide gas, and this is called a lifting method, as opposed to an insufflation method. At present, pneumoperitoneum is often used due to ease of operation. However,
In such endoscopic surgery, especially in the pneumoperitoneum method, the procedure is not performed by actually touching with the hand while watching the image of the monitor projected on the endoscope, but from the insertion tube such as a trocar. Since the treatment is performed by remote operation with the insertion of forceps and the like, the treatment and operation are difficult and it takes time, which is a stressful operation for the surgeon. Also, in the unlikely event that an organ or a large blood vessel is damaged during the operation, there is a risk that an emergency recovery procedure may be difficult because only a cylindrical trocar has a procedure. In particular, when a large blood vessel is injured, a large bleeding is caused in an instant, and the worst result is likely to occur. Furthermore, when the cancer tissue is removed from the body, there is a disadvantage that the cancer tissue adheres to the abdominal wall and metastasizes.

[0003]

SUMMARY OF THE INVENTION The present invention solves such a drawback of the conventional organ treatment in endoscopic surgery, and an object thereof is to perform organ treatment under insufflation. In addition, it is possible to perform treatment in a short time by touching the organ directly with a hand, reliably, safely, and without pneumoperitoneum gas leakage, and with a sufficient visual field.

[0004]

A medical treatment insert according to the present invention for achieving the above object has a front balloon formed on the front end side and a rear balloon formed on the rear end side adjacent to the outer periphery of the cylindrical sheet. A rear end of the cylindrical seat is provided with a cylindrical sheet-shaped sleeve airtightly adjacent thereto, and a valve member for airtightly closing a flow passage in the sleeve or the sleeve is tightened to close the sleeve. A front end branch tube having a clamping member hermetically closing a flow passage therein in the sleeve or at the rear end of the sleeve, and further having a leading end communicating with the leading balloon through the cylindrical sheet into the leading balloon; and Is constituted by a rear branch tube communicating with the rear balloon, and a gas-liquid opening / closing device having a connector for connection is provided at a rear end of the front branch tube and a rear end of the rear branch tube. .

[0005]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below in detail with reference to the drawings. FIG. 1 is a view showing one embodiment of a medical treatment insert according to the present invention, wherein FIG. 1 (a) is an external view and FIG. 1 (b) is a sectional view of FIG. FIG. 2 is an external view showing another embodiment, and FIGS. 3 and 4 are schematic diagrams showing a use state.

[0006] The medical treatment insertion tool according to the present invention is shown in FIG.
As shown in (a), adjacent to the outer periphery of the cylindrical sheet (3),
Front balloon (1) at the front end, rear balloon (2) at the rear end
And a rear end of the cylindrical sheet (3) is provided with a cylindrical sheet-shaped sleeve (16) airtightly adjacent thereto, and a flow passage in the sleeve (16) is airtightly closed. A valve member (14) or a tightening member (15) for tightening the sleeve (16) to hermetically close a flow passage in the sleeve (16) is provided in or after the sleeve (16). A fore-branch tube (4) attached to an end and having a leading end communicating with the inside of the leading balloon (1) through the cylindrical sheet (3); and a leading end portion of the trailing balloon (2).
The rear end of the leading branch tube (4) and the trailing end of the trailing tube (5) are provided with gas-liquid switching devices each having a connector for connection.

[0007] The front balloon (1) and the rear balloon (2) are donut-shaped hollow lumens as shown in the sectional view of FIG. 1 (b). Usually, it is produced by blow molding, dip molding, film processing, or hollow molding such as rotational molding. Even if each is integrally formed, it is naturally included in the scope of the present patent. Further, the cylindrical sheet (3) and the front balloon (1) and the rear balloon (2) may be bonded or integrated, or the cylindrical sheet (3) may be formed as an inner cylinder and the outer cylinder may be formed as an outer cylinder. A cylindrical sheet may be superimposed, and the inner and outer cylinders may be bonded at the tip and the center to form a front balloon (1) and a rear balloon (2). Balloon (1),
Both the rear balloon (2) and the balloon have a wall thickness of 0.1 to 2 mm.
In order to insert the tip balloon (1) into the body (6) through an incision of about 3 to 10 cm into the abdominal wall (7), it is advantageous that the balloon is thin and not bulky. Even in the case of injection, a minimum wall thickness that does not rupture even if the amount is twice or more than that of actual use is preferable. The inner diameter of the cylindrical sheet (3) is such that the hand and arm (17) are inserted through the rear balloon (2) and the front balloon (1) to perform the treatment, so that the hand and arm (17) can be inserted. Is preferable, and about 60 to 90 mm is appropriate. The outermost diameter is about 90 to 200 mm, and it is particularly preferable that the balloon (1) has an outer diameter that is not bulky when the body (6) is inserted. As the balloon material, for example, a material having appropriate flexibility such as a soft vinyl chloride resin, a polyurethane resin, a polyethylene resin, a polypropylene resin, a polyester resin, a silicone rubber, and a natural rubber is preferable, but is not necessarily limited to such a material. No need. When the balloon (1) does not inject air, it is not bulky, can be easily inserted into the body (6) through the incision, has enough flexibility not to damage body tissues, and when air or water is injected. In addition, it is important to select a material having a sufficient burst strength and a sufficient tear strength so that the material does not burst even if the amount is twice or more than that of the actual use.

The cylindrical sheet (3) has a thickness of 0.1 to 2 mm.
And is usually produced by inflation molding or the like, but is not particularly limited thereto. In use, the hand and arm (17) are inserted into the sheet and fixed by the incision. Therefore, the material is not bulky, and a material having appropriate flexibility is preferable. For example, soft vinyl chloride resin,
Materials such as polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber and natural rubber are preferred. The inner diameter is also 50-100mm
The degree is appropriate. The front balloon (1) and the rear balloon (2) are bonded to the outer periphery of the sheet, and the distance between the front balloon (1) and the rear balloon (2) is set to the abdominal wall (7) of the patient.
The thickness is usually about 10 to 15 mm corresponding to the thickness of the subcutaneous fat layer, which has individual differences.
It is preferable to prepare several types between 30 mm. Therefore, the length of the cylindrical sheet (3) is suitably about 5 to 20 cm.

As shown in the cross section of FIG. 1 (a), the leading branch tube (4) has a distal end portion that passes through the cylindrical sheet (3) and opens into the leading balloon (1), and the trailing branch tube (5). ) Are tubes each having a distal end opening into the rear balloon (2) and being led out therefrom to the rear end side of the balloon for gas-liquid circulation. Regardless of whether the distal end portion of the leading tube (4) passes through the inside or outside of the cylindrical sheet (3), it is sufficient that the leading end tube (4) is open to the leading balloon (1). Further, the leading branch tube (4) and the trailing branch tube (5) may be independent tubes as shown in FIG. 1 (a), but as shown in FIG. 2, the vicinity of the balloon rear end is integrated with each other. It is also possible to use a two-chamber tube (8) having two flow passages and provide a branch (9) at the rear position to branch the tube. As the material, for example, a material having an appropriate flexibility and hardness such as a soft vinyl chloride resin, a urethane resin, a silicone rubber, and a natural rubber is used.
m, a tube having a wall thickness of 0.3 to 2 mm is preferable. Also,
The length of the branch tubes (4) and (5) is set to 30 to 300 m so as not to hinder the operator from using various treatment tools.
About m is appropriate.

Further, the rear ends of the leading branch tube (4) and the trailing branch tube (5) have gas-liquid opening / closing devices (1), respectively.
0) A check valve having a connector as described in (11), a two-way cock, a three-way cock, or the like is connected, and a structure that can be easily opened and closed by attaching and detaching a syringe which is a general balloon inflation and injection device. Has become. Further, pilot balloons (12) and (13) may be connected between the branch tubes (4) and (5) and the gas-liquid switching devices (10) and (11). In this case, the pilot balloons (12) and (13) )
Is molded from a material having appropriate flexibility and elasticity, such as a soft vinyl chloride resin, urethane resin, silicone rubber, or natural rubber, so that the balloon inflation status of the balloon portions (1) and (2) can be monitored. Have been.

The sleeve (16) is airtightly attached to the rear end of the cylindrical sheet (3) and has a thickness of 0.1 to 2 m.
m is a cylindrical sheet member. Since the inside of the sleeve (16) only needs to be kept airtight, the sleeve (16) and the cylindrical sheet (3) may be laminated or integrated. Usually, it is produced by inflation molding or the like, but is not particularly limited to this. In use, hands in the sheet,
In order to insert the arm (17), the inner diameter is preferably about 70 to 200 mm, and the material is preferably a material having appropriate flexibility.
For example, materials such as soft vinyl chloride resin, polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber, and natural rubber are preferable. The appropriate length is about 50 mm to 300 mm, but the cylindrical sheet (3) should be fixed with the upper arm so that there is no insufflation gas even when the treatment is performed by moving the hand and arm (17). The length of the cylindrical sheet (3) should be as long as the upper arm.

The valve member (14) or the tightening member (1)
5) is provided inside the sleeve (16) and at the rear end to hermetically close the flow passage in the sleeve (16). Since the hand and the arm (17) are inserted into the sleeve (3) when used, the valve member (14) is a valve that can maintain airtightness even when the hand is inserted or removed as shown in FIG. The slit valve (14) with a slit in it, or when the hand is inserted, the valve at the entrance has a shape with a hole with a diameter so that it can be kept in close contact with the arm and keep airtight. Is folded into the cylindrical sheet (3), and when the hand is not inserted, the positive valve of the insufflation gas in the body (6) causes the back valve to close the inlet valve, as in a one-valve type (14)-. Is preferable. The material is preferably a material having appropriate flexibility and elasticity, such as silicone rubber, natural rubber, and butyl rubber. Since the valve at the back of the one-valve type (14)-in FIG. 1 (c) only needs to close the valve at the inlet, a film sheet made of synthetic resin may be used. The tightening member (15) is made of, for example, silicone rubber so that the inside of the sleeve (16) is closed and the airtightness is maintained by tightening the tightening member (15) regardless of whether the hand is inserted or not. ,
A material having an appropriate elasticity such as natural rubber is preferable. Further, a string-like structure in which the cylindrical sheet is manually bound may be used. In the case of these structures, in practical use, ie,
It is better to fix the sleeve (16) at the upper arm so that there is no insufflation gas even when the treatment is performed by moving the hand or the arm, and the length of the sleeve (16) is up to the upper arm.
4) Or, the fastening member is preferably arranged at the rear end of the sleeve (16). In addition, more sleeve (16)
It is more preferable that a plurality of valve members (14), a plurality of fastening members (15), or a combination of both are provided and provided at a plurality of locations so as to keep the inside airtight. In particular, a combination in which the valve member (14) is provided at one or two locations or the fastening member (15) is provided at one or two locations in combination is preferable in consideration of use and airtightness.

In using the medical treatment insertion tool according to the present invention, for example, as shown in FIG. 3, the tip of the balloon (1) is reduced by hand through the incision in the abdominal wall (7), and the body (6) is inserted.
Insert After the insertion, the balloon (1) is inflated by injecting air or water from the gas-liquid opening / closing device (10) (11) using a syringe or the like. Here, after pulling this medical treatment insertion tool and bringing the front balloon (1) into close contact with the inside of the abdominal wall (7), the rear balloon (2) is similarly expanded outside the body, and the abdominal wall (7) is inflated outside the body. The medical treatment insert is airtightly fixed to the body surface so as to be sandwiched between the two balloon inflated portions of (1) and the rear balloon (2).
The inside and outside of the body (6) communicate with each other through the cylindrical sheet (3) and the sleeve (16) inside the rear balloon (2), the front balloon (1), and the hand from the sleeve (16) and the cylindrical sheet (3). The treatment is performed directly by inserting the arm (17).

[0014]

The medical treatment insert of the present invention has no bulk when inserted through an incision in the abdominal wall, and can be safely and easily inserted because of the appropriate flexibility of the balloon. Also,
By having two balloon inflatable portions and inflating the balloon on the inside and outside of the body, the incision can be fixed so as to be sandwiched from inside and outside the body, and the medical treatment insertion tool can be securely fixed in an airtight manner. Because the balloon is flexible, there is no risk of damage to the small opening. Since the inside of the inflated balloon communicates with the outside of the body, the hand can be easily inserted into the body from outside the body, and the organ can be directly treated or extracted by hand, and the treatment can be performed reliably, safely, and in a short time. Further, the inflation balloon is freely deformed according to the operation angle, so that organ treatment can be easily performed. Furthermore, even when the cancer tissue is taken out of the body, it can be taken out without adhering to the abdominal wall, so that there is no fear of metastasis. Regarding the airtightness, by attaching a valve member or a tightening member to the rear end of the cylindrical seat, there is no insufflation gas leak, a sufficient space can be maintained inside the body, and treatment can be performed safely and in a short time with a good view. This is extremely useful when performing a procedure by endoscopic surgery.

[Brief description of the drawings]

FIG. 1 (a) is a view showing one embodiment of a medical treatment insert according to the present invention for achieving an object by an insufflation method. (B) It is sectional drawing which shows one Example of the medical treatment insertion tool by this invention for achieving the objective by the insufflation method.

FIG. 2 is a view showing another embodiment of the medical treatment insertion tool according to the present invention for achieving the purpose of insufflation.

FIG. 3 is a schematic view showing a use state of the medical treatment insertion tool according to the present invention.

FIG. 4 is a schematic view showing a use state when a hand of the medical treatment insertion tool according to the present invention is inserted.

[Explanation of symbols]

 1. Tip balloon 2. Rear balloon 3. 3. cylindrical sheet Branch tube 5. Rear branch tube 6. Inside the body 7. 8. Abdominal wall 8.2 cavity tube Branch 10.11. Gas-liquid switching device 12.13. Pilot balloon 14. Valve member 15. Tightening member 16. Sleeve 17. Hands, arms

Claims (6)

[Claims] 1. A front balloon is formed on the front end side and a rear balloon is formed on the rear end side adjacent to the outer periphery of the cylindrical sheet, and the rear end of the cylindrical sheet is airtightly adjacent to the cylindrical sheet sleeve. And a valve member for airtightly closing the flow passage in the sleeve or a tightening member for tightening the sleeve to airtightly close the flow passage in the sleeve in the sleeve or at the rear end of the sleeve. A front branch tube having a distal end communicating with the front balloon through the cylindrical sheet, and a rear branch tube having a distal end communicating with the rear balloon. A medical treatment insertion tool, wherein a gas-liquid opening / closing device having a connection connector is provided at a rear end of the branch tube. 2. The medical treatment insertion tool according to claim 1, wherein the sleeve and the cylindrical sheet are attached to each other. 3. The medical treatment insertion tool according to claim 1, wherein the cylindrical sheet, the front balloon, and the rear balloon are bonded to each other. 4. An inner cylinder is used as a cylindrical sheet, and a cylindrical sheet is superimposed on an outer cylinder as an outer cylinder, and the inner and outer cylinders are adhered at a tip portion and a central portion to form a front balloon and a rear balloon. The medical treatment insert according to claim 1. 5. A valve member is provided within the sleeve and at the rear end thereof.
The medical treatment insertion tool according to claim 1, wherein the medical treatment insertion tool is provided at 1 to 5 locations or at 1 to 5 locations by combining the fastening members. 6. The length of the sleeve is 5 to 30 cm, the length of the cylindrical sheet is 5 to 20 cm, and the inner diameter of the cylindrical sheet is 5 to 6.
The medical treatment insert according to claim 1, which is 10 cm.