JPH11342107A - Medical peritoneoscope inserting mantle tube - Google Patents

Abstract

PROBLEM TO BE SOLVED: To simultaneously insert a plurality of treatment tools or endoscopes and minimize the number of mantle tubes used for a patient by mounting at least one valve member for interrupting the outside air on the rear end part of the mantle tube. SOLUTION: This medical peritoneoscope inserting mantle tube comprises a conduit 1 extending form the external side to the internal side, and a plurality of treatment tool inserting cavities 6 and 7. Sheets 2 and 3 are provided on the external side of the conduit 1. These sheets prevent aeroperitoneum gas from leaking from the internal cavity in the insertion of treatment tools or endoscopes to the treatment tool inserting cavities 6 and 7. The sheets 2 and 3, which have thin plate-like forms, are provided with slits. The slit has a cross or star form, for example, and two plates are used in lamination as occasion demands. The sheets 2, 3 have diameters desirably equal to or larger than the inner cavities of the treatment tool inserting cavities 6 and 7, and desirably fitted and adhered to the treatment tool inserting cavities 6 and 7 or adhered to the external surface of the conduit 1.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical abdominal cavity mainly for laparoscopic surgery, for maintaining airtightness even when inserted into a small incision opening and for inserting a plurality of treatment tools as well as an endoscope. The present invention relates to a mantle tube for inserting a mirror.

[0002]

2. Description of the Related Art In recent years, laparoscopic surgery has been rapidly spreading, and its indications are also expanding. Initially, this was started with relatively easy procedures such as laparoscopic cholecystectomy, but eventually the stomach and colon were partially resected, and common bile duct stones were removed by improving the surgeon's skills and equipment. Surgery that could only be done in the past is now being performed laparoscopically.

[0003] This is presumably because laparoscopic surgery does not make an incision, so that the time required for a patient to be discharged after surgery is short, and that the patient is also excellent in cosmetics in order to meet the needs of the patient. On the other hand, attempts have been made to reduce the number of inserted mantle tubes or to reduce the outer diameter of the mantle tube as much as possible due to cosmetic problems. This, on the other hand, degrades operability, which in turn leads to operator stress and erroneous operation.
The situation is not very advanced.

[0004] Since the wound is inconspicuous, a procedure for incising the umbilicus and inserting a large-sized mantle tube is often performed.
In this case, the postoperative wound is hidden well in the navel, so it is cosmetically very good, but on the other hand, the part is complicated, and the mantle tube inserted due to its extensibility Insufflation gas often leaks from the gap of the incision. Pneumoperitoneum gas is used to perform laparoscopic surgery.
There is carbon dioxide to the body and the pressure is about 3 ~ 2
It is about 0 mmHg. Because gas is being supplied,
The inside of the abdominal cavity is lifted in a tent shape, and the visual field is developed.

In order to prevent such insufflation gas leakage, a balloon catheter for medical use is disclosed in Japanese Utility Model Laid-Open No. 05-053651 as a balloon to be mounted on a conventionally used mantle tube. . According to the present invention, after the balloon catheter is attached to the mantle tube, the abdominal wall is sandwiched by a plurality of balloons, and the balloon is inflated to prevent insufflation gas from leaking. It also has the role of preventing the mantle tube from coming off the body wall.

However, the balloon catheter for medical use according to the present invention has an inner diameter so as to be in close contact with the mantle tube, so that there is a problem that it is often difficult to mount the balloon catheter on the mantle tube.

On the other hand, a trocar with a balloon for treatment after laparoscopic cholecystectomy disclosed in Japanese Patent Application Laid-Open No. 5-161657 is also disclosed. This was for the purpose of fixing a trocar (mantle tube) on the abdominal wall and preventing leakage of insufflation gas due to a gap with the incision. The trocar according to the present invention has excellent fixation on the abdominal wall and maintenance of airtightness, and has not encountered difficulty in mounting. However, on the other hand, since the valve is located at the distal end, bodily fluids may adhere and the valve may suddenly solidify. Also, since there is only one lumen, multiple treatment tools and endoscopes can be used simultaneously. Could not be inserted. Furthermore, when the gallbladder is removed from the abdominal cavity, in the conventional trocar, it was possible to store the gallbladder in the lumen and to lift the entire mantle tube out of the body. Therefore, the gallbladder could not be stored, which was inconvenient.

Japanese Patent Application Laid-Open No. HEI 5-115429 discloses a trocar / sleeve assembly in which a means for expanding the external dimensions is arranged at a part of the end.
The balloon can be fixed to the abdominal wall in the same manner as the above-mentioned balloon, and if an elastic coating such as latex is provided on the expanding means, airtightness equivalent to that of the balloon can be secured. However, also in this case, since there is only one lumen, a plurality of treatment tools and endoscopes could not be inserted at the same time.

Further, Japanese Patent Application Laid-Open No. Hei 6-327617 discloses a trocar having an outer tube and an inner needle removably inserted into the outer tube, wherein a channel is provided in the outer tube. Trocars are disclosed. It is an object of the present invention to provide a trocar capable of performing rapid hemostasis using a bioadhesive through a channel of a mantle tube in case of unexpected bleeding during endoscopic surgery. Therefore, since a bioadhesive is assumed only, a structure that allows various types of forceps to be inserted and removed from the sublumen, for example, there is no right-angled portion in the root, and a valve member for preventing insufficiency from dropping when inserting or removing The forceps and the like could not be inserted because the structure for providing the forceps was not considered.

Japanese Patent Application Laid-Open No. 7-265321 discloses an inserter configured to insert and fix a position of at least two surgical tools such as a surgical tool, an optical tool, and an implant. This device is mainly intended for thoracoscopic procedures that do not require pneumoperitoneum operation to secure the field of view, and it is possible to insert multiple forceps, but it is possible to perform surgery under pneumoperitoneum using a laparoscope. No consideration is given to a valve member or the like for preventing insufficiency, as in the case of performing the insufflation, and it is possible to use a lifting type without performing insufflation, but it is not possible to use the insufflation type. In addition, no airtight means such as a balloon is considered, and it is considered that operation under insufflation is difficult.

Furthermore, Japanese Patent Publication No. 10-502841 discloses a multi-port trocar having a plurality of working channels and a plurality of valves. This device is provided with a plurality of channels having a plurality of valves in a housing, so that forceps having different outer diameters can be separately inserted under pneumoperitoneum, and a plurality of forceps are simultaneously inserted to perform a treatment. It is also possible.
However, the working channel is supposed to be at the entrance, and since the actual forceps pass through separate channels and valve members and then join together in the housing and the cannula, for example, a laparoscopic and treatment forceps were inserted. In this case, it was considered that there was a danger that moving both the tools would cause partial contact and damage, or that they would not move due to touching.

[0012]

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and has been made as a result of various studies aimed at improving the performance of a mantle tube used in conventional laparoscopic surgery. Thus, not only can a plurality of treatment tools and endoscopes be inserted at the same time, but also the number of mantle tubes used for the patient can be reduced, and as a result, the patient can be rehabilitated to the early stage of society and the medical economy can be reduced. In addition, the purpose of the present invention is to provide a medical laparoscopic insertion mantle tube in which a cuff is attached in advance, thereby eliminating the need for mounting the cuff, ensuring sufficient fixation on the abdominal wall, and maintaining airtightness of insufflation gas. And

[0013]

That is, a first invention of the present invention is a cylindrical mantle tube having a plurality of lumens, and at least one valve member for shutting off outside air is mounted at a rear end thereof. This is a medical laparoscopic insertion mantle tube characterized by being carried out. Further, the second invention is directed to a conduit having a first valve member built-in portion and a plurality of independent lumens connected from the first end to the distal end, and a plurality of independent inner tubes built in the first valve member built-in portion. A first seal valve on the distal side and a second seal valve on the distal side corresponding to the cavity, further, an insufflation gas inlet attached to the first valve member built-in portion, a contractible and attachable to the conduit. A plurality of cuffs provided in the circumferential direction, a cuff inflation lumen connected directly to each of the plurality of cuffs, or a lumen for cuff inflation arranged in a conduit, and an inner cuff inflation tube and an outer cuff inflation tube connected thereto, respectively A medical laparoscope insertion mantle tube, further comprising a gas-liquid opening / closing device further connected to the medical tube.

[0014]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be specifically described below with reference to the drawings. FIG. 1A is a schematic view showing an embodiment of a laparoscopic insertion mantle according to the present invention, and FIG. 1B is a sectional view thereof. FIGS. 2A to 2F show an example of a combination of a plurality of treatment instrument insertion cavities. 3A to 3C are schematic diagrams illustrating an example of the slit shape of the sheet. FIG. 4 (a),
(B) is a schematic diagram showing an example of a flap shape. FIG.
(A) is a schematic diagram showing another embodiment of a medical laparoscopic insertion mantle according to the present invention, and FIG. 5 (b) is a sectional view thereof. FIG. 6 shows an example of attachment to the abdominal wall. FIG. 7 is a schematic view showing an embodiment for performing an operation. FIG. 8A is a schematic diagram showing another embodiment of a laparoscopic insertion mantle according to the present invention, and FIG. 8B is a sectional view thereof. FIG. 9 is a schematic view showing an example of the shape of the lid. FIG. 10A is a schematic view showing another embodiment of a medical laparoscopic insertion mantle according to the present invention, and FIG. 10B is a sectional view thereof. FIG.
(A) is a schematic diagram showing another embodiment of a medical laparoscopic insertion mantle according to the present invention, FIG. 11 (b) is a cross-sectional view thereof, and FIG. 11 (c) is another cross-sectional view. Is shown. FIG. 12 is a schematic view showing an example of the shape of the first seal valve.

An outer tube for medical laparoscope insertion according to the present invention comprises a conduit (1) extending from the outside of the body to the inside of the body, and a plurality of treatment instrument insertion cavities. The conduit (1) has a symmetrical shape such as a column, a regular hexagon, a regular octagon or the like in cross section, and an outer diameter of 1 mm to about 50 mm.

The conduit (1) is made of natural rubber, silicone rubber,
Flexible materials such as vinyl chloride resin, polyurethane resin, polyacetal resin or aluminum, stainless steel, titanium, carbon, polycarbonate resin,
It is made of a hard material such as polysulfone resin. The outer diameter of the conduit (1) is preferably φ1 to φ100 mm in consideration of the inner diameters of the treatment instrument insertion cavities (6) and (7). This is φ1
mm or less, there is no insertable treatment tool.
If the thickness is more than 00 mm, the invasion to the patient becomes large, and the usefulness is lost. The total length is desirably 5 to 30 cm. This is for obese people whose total length is less than 5 cm,
This is because there is a risk of being buried in the abdominal wall.
This is because if the length is longer than cm, the operability of the forceps deteriorates. The inner diameter of the treatment tool insertion lumen (6) (7) is φ0.4 to φ5
0 mm. This is because, when the inner diameter is 0.4 mm or less, there is no treatment tool to be inserted, and when the inner diameter is 50 mm or more, it is difficult to maintain airtightness of insufflation gas. Further, the combination of the plurality of treatment instrument insertion cavities (6) and (7) has the same diameter,
A combination of a large-diameter type and a small-diameter type can be considered, and an example of the combination is shown in FIG.

When a flexible material is used, it is reinforced by a spiral wire or the like along the axial direction of the conduit (1) in order to prevent the treatment instrument insertion cavities (6) and (7) from collapsing. Sometimes. The material of the wire is desirably stainless steel or the like, and the diameter is φ0.01 to
φ5 mm is desirable. This is because if the diameter is not more than 0.01 mm, the strength of the wire is insufficient, and if the diameter is not less than 5 mm, the lumen of the conduit (1) becomes narrow, and the usefulness is lost.

Sheets (2) and (3) provided on the outside of the body of the conduit (1) are used for introducing a treatment tool or an endoscope into the treatment tool insertion cavity (6) or (7). To prevent leakage. The sheets (2) and (3) are thin and have slits. The shape of the slit is, for example, a cross shape, a star shape, or the like, and in some cases, two plates may be used in an overlapping manner. An example is shown in FIG. In this case, the directions of the crosses are shifted by 45 degrees and overlapped. It is desirable that the material of the sheet has flexibility, for example,
Examples include natural rubber, silicone rubber, vinyl chloride resin, polyurethane resin, and SEBS resin.

The outer diameter of the sheets (2) and (3) is desirably the same as or larger than the inner diameter of the treatment instrument insertion cavities (6) and (7), and is fitted into the treatment instrument insertion cavities (6) and (7). It is desirable to adhere or adhere to the exterior surface of the conduit (1). The thickness of the sheets (2) and (3) is 0.1 to
About 10 mm is appropriate. This is because if it is 0.1 mm or less, it cannot withstand the pressure of the insufflation gas, and if it is 10 mm or more, the frictional resistance at the time of inserting the treatment tool becomes large, and it becomes difficult to insert it. The width of the slit varies depending on the treatment instrument or endoscope to be inserted, but is suitably 0.3 to 50 mm, and preferably ± 5 mm of the diameter of the treatment instrument or endoscope used. This is 0.
If it is less than 3 mm, it is difficult to insert the treatment tool,
If it is not less than mm, it becomes larger than the treatment instrument insertion cavities (6) and (7), and is not practical.

FIG. 4 shows another form of the sheets (2) and (3).
A one-way flap (11) as shown in FIG. Since the flap (11) does not open to the outside of the body but moves only to the inside of the body, when the treatment tool or the endoscope is not in the valve, the flap (11) has a positive pressure due to the insufflation pressure of the inside of the body. (11) is pushed outward and closed. Flap (1
Because 1) is closed, insufflation pressure does not escape from the body. That is, the flap (11) is closed, and the treatment tool insertion cavities (6) and (7) are not released to the outside of the mantle tube. On the other hand, the flap (1
1) is pushed inside the body and is introduced inside the body. At that time, the insufflation gas does not leak because the flap (11) and the treatment tool or endoscope are in close contact with each other.

The material of the flap (11) is not particularly limited as long as it has flexibility. For example, natural rubber, silicone rubber, vinyl chloride resin, polyurethane resin and the like can be used. Silicone rubber is more preferred from the viewpoint of maintaining airtightness. In addition, hard materials such as aluminum, stainless steel, titanium, carbon, polycarbonate resin, polysulfone resin, and the like, and natural rubber, silicone rubber, vinyl chloride resin, polyurethane resin, and the like, which have a flexible surface. Those with surface bonding can also be used. It is also preferable to provide a spring at the hinge (12) of the flap (11). This allows the flap (11) to return more quickly when the treatment tool or endoscope is withdrawn from the treatment tool insertion cavity, and causes less insufflation when the flap (11) is closed. There is an advantage.

As another form of the sheets (2) and (3), lids (13) and (14) as shown in FIGS. Lid (13) (1) provided outside the body of conduit (1)
4) Prevents insufflation gas from leaking from the lumen when inserting a treatment instrument or an endoscope into the treatment instrument insertion lumens (6) and (7).
The lids (13) and (14) have substantially the same cross-sectional shape as the treatment tool insertion cavities (6) and (7). Lid (13)
The total length of (14) is preferably 5 to 50 mm.
This is because if it is less than 5 mm, insufflation gas may leak,
This is because if it is 50 mm or more, it becomes difficult to detach. Lid (1
3) FIG. 9 shows an example of the shape of (14). In this case, the intraluminal insertion portion is substantially the same as the cross-sectional shape of the treatment instrument insertion cavity,
It is preferable that the portion of the grip allowance is one to two times as large as that. This is because if it is less than 1 time, it is difficult to grasp it, and there is a problem in insertability, and if it is more than 2 times, it may interfere with other lids. It is also preferable to provide a connecting cord between the grip margin and the conduit (1). This is the lid (13) (1
The material of 4) is preferably a material having flexibility, for example, natural rubber, silicone rubber, vinyl chloride resin, polyurethane resin and the like.

As still another embodiment, FIG.
As shown in (b), a first valve member built-in portion (15) is provided at the proximal end of the conduit (1), and the first seal valve (16) (1) is provided.
7) The second seal valves (18) and (19) may be incorporated. The first seal valves (16) and (17) may be formed of a sheet as shown in FIG. 12, and may have a structure that hermetically seals them when an endoscope or a treatment tool is inserted. The thickness is suitably about 0.1 to 10 mm, and the inner diameter is suitably 0.3 to 50 mm according to the outer diameter of the treatment tool or the like. The material of the first seal valve is desirably flexible, and for example, natural rubber, silicone rubber, vinyl chloride resin, urethane resin, SEBS resin and the like are suitable. The second seal valves (18) and (19) may be in the form of a slitted sheet shown in FIG. 3 or a flap shape shown in FIG. When the endoscope or the treatment tool is pulled out, the stomach does not fall, and any structure that can maintain airtightness can be used. Also,
As another form of the valve member built-in portion, in order to improve operability so that the treatment tool does not hit during operation, the valve is branched into a conduit (1) as shown in FIG. A second conduit (23) is provided, and a second valve member built-in portion (24) is formed at a proximal end thereof, and the first seal valve and the second seal valve are provided therein. Is also good.
At this time, if the second conduit (23) is arranged at an angle perpendicular to the conduit (1), it becomes difficult or impossible to insert the treatment tool. An angle of about 5 to 30 degrees is good. The material of the first and second valve member built-in portions is not limited as long as it is a slightly hard resin such as a vinyl chloride resin, a polycarbonate resin, and a polysulfone resin. The material of the second conduit (23) is the same as that of the conduit (1).

Next, a description will be given with reference to FIG. This shows an example of a medical laparoscopic insertion mantle. Here the extracorporeal cuff (4) and the extracorporeal cuff (5) are each arranged in series on the conduit (1). The shape of the cuff usually has a spherical shape or a donut shape, and may be provided uniformly in the circumferential direction. In this case, the cuff can be inflated and deflated by a gas, a liquid, or the like through the outside-body cuff inflating pilot balloon (8) and the inside-body cuff inflating pilot balloon (9). The outer and inner cuffs have a maximum diameter of φ10 to φ when inflated.
It is desirable that the diameter at the time of contraction be approximately the same as the outer diameter of the conduit (1).

As the material of the cuffs (4) and (5), materials having flexibility such as natural rubber, silicone rubber, soft vinyl chloride resin and polyethylene terephthalate resin are desirable. The wall thickness is desirably 0.01 mm to 5 mm from the viewpoint of expansion characteristics and internal pressure during expansion. Further, the width of the cuffs (4) and (5) in the axial direction is desirably 5 to 50 mm, and the interval between the inner cuff (5) and the outer cuff (4) is desirably 3 to 50 mm. Further, the cuffs (4) and (5) have a withstand voltage of at least 0.5.
It is desirably at least kg / cm ² .

Since the inside cuff (5) and the outside cuff (4) have an interval, the abdominal wall is sandwiched therebetween and both cuffs are inflated to prevent leakage of insufflation gas. Before use, the cuffs (4) and (5) are contracted, the outer diameter of which is almost the same as the outer diameter of the conduit (1), and the incision is slightly larger than the diameter of the conduit (1) on the abdominal wall. A medical laparoscopic mantle according to the present invention is introduced into the body. When only the inside cuff (5) is completely housed in the body, first, gas or fluid is injected from the inside cuff inflating pilot balloon (9) equipped with a gas-liquid opening / closing device such as a one-way valve. Inflate (5). This acts as an anchor and prevents the conduit (1) from falling out of the abdominal wall. Subsequently, a gas or a fluid is similarly injected from the external balloon cuff inflating pilot balloon (8) provided with the gas-liquid opening / closing device, and the external body cuff (4) is also inflated. As a result, the two cuffs (4) and (5) come into close contact with the body wall, and leakage of insufflation gas from inside the body is prevented.

The gas injected into the cuffs (4) and (5) is preferably an inert gas such as air, carbon dioxide, or nitrogen.
This is to prevent an accident such as an explosion if gas leaks from the cuffs (4) and (5). Further, as the liquid, sterilized distilled water, physiological saline and the like can be considered, and sterilized distilled water is preferable. This is because there is no danger of contamination or infection in the event that the cuff leaks, and there is no danger of sticking due to the lack of solubility even when stored for a long time. Injecting air is easier, but on the other hand, injecting sterile distilled water is heavier and may be desirable in terms of stability. Which one to select depends on the needs of the surgeon.

The insufflation gas inlet (1) provided on the outside of the body
0) makes it possible to supply gas for insufflation of the abdominal cavity, which is convenient because there is no need to insert a pneumoperitoneum needle, etc. There is an advantage that it can be reduced. The insufflation gas inlet (10) is desirably provided with a gas-liquid opening / closing device such as a two-way cock to prevent leakage.

Next, a method of performing an actual operation using the medical laparoscopic insertion mantle according to the present invention will be described with reference to FIGS. 6 and 7 to clarify the effects of the present invention. First, a patient's umbilicus is grasped with forceps, and a small incision is made in the vicinity with a scalpel. The medical laparoscopic insertion mantle according to the present invention is inserted from the small incision site, and the inside cuff (5) is inflated. Subsequently, the external cuff (4) is inflated while the conduit (1) is pulled toward the user. This fixes the conduit (1). (FIG. 6)

Subsequently, the endoscope is inserted into the treatment instrument insertion cavity (large) (6) of the conduit (1), and insufflation gas is injected. As a result, the abdominal cavity is lifted in a dome shape, and a visual field (operating field) is secured. Subsequently, one to three conventional trocars are inserted into appropriate positions on the abdominal wall. Through these trocars, forceps, suction cannula, electric scalpel, ultrasonic scalpel, laser scalpel, etc. are introduced into the abdominal cavity to perform necessary treatment. In addition, since these treatment tools can be inserted into the treatment tool insertion cavity (small) (7) of the mantle tube (1) for medical laparoscopic insertion according to the present invention, the number of trocars is smaller than that of a normal treatment. Can be reduced. (FIG. 7) This also reduces the number of injuries to the patient and thus leads to a better prognosis for the patient. At the time of withdrawal, the cuff on the tip side can be withdrawn to facilitate removal.

[0031]

According to the present invention, not only can a plurality of treatment tools and endoscopes be inserted at the same time, but also the number of trauma tubes used for the patient can be reduced, so that the number of wounds on the patient can be reduced. Early return of the patient to the society and a reduction effect on the medical economy can be obtained. In addition, the time and labor required for attaching the cuff can be reduced, and the operation time can be shortened because reliable airtightness can be maintained.

[Brief description of the drawings]

FIG. 1 is a schematic view showing an embodiment of a medical laparoscopic insertion mantle according to the present invention.

FIG. 2 is a schematic view showing an example of a combination of a plurality of treatment instrument insertion cavities.

FIG. 3 is a schematic view showing an example of a slit shape on a sheet.

FIG. 4 is a schematic view showing an example of a flap shape.

FIG. 5 is a schematic view showing another embodiment of a medical laparoscopic insertion mantle according to the present invention.

FIG. 6 is a schematic view showing an example in which a medical laparoscope insertion mantle tube according to the present invention is mounted on an abdominal wall.

FIG. 7 is a schematic view showing an example of performing an operation using a medical laparoscopic insertion mantle according to the present invention.

FIG. 8 is a schematic view showing another embodiment of a medical laparoscopic insertion mantle according to the present invention.

FIG. 9 is a schematic view showing an example of a shape of a lid.

FIG. 10 is a schematic view showing another embodiment of a medical laparoscopic insertion mantle according to the present invention.

FIG. 11 is a schematic view showing another embodiment of a medical laparoscopic insertion mantle according to the present invention.

FIG. 12 is a schematic view showing an example of a shape of a first seal valve.

[Explanation of symbols]

 1. Conduit 2. Sheet (Large) 3. Sheet (small) 4. Extracorporeal cuff Internal cuff 6. 6. Treatment tool insertion cavity (large) 7. Treatment tool insertion cavity (small) 8. Pilot balloon for external cuff inflation Pilot balloon for inflation of inside cuff 10. 10. Insufflation gas inlet Flap 12. Hinge 13. Lid (large) Lid (small) 15. First valve member built-in portion 16. First seal valve (large) 17. 17. First seal valve (small) Second seal valve (large) 19. Second seal valve (small) 20. Outer cuff inflation tube 21. Inner cuff inflation tube 22. Gas-liquid opening / closing device 23. Second conduit 24. Second valve member built-in part

Claims (13)

[Claims] 1. A tubular mantle tube having a plurality of lumens, and a valve member for shutting off outside air is provided at a rear end of each of the lumens.
An outer tube for medical laparoscopic insertion, wherein at least one is mounted. 2. The outer tube for medical laparoscope insertion according to claim 1, wherein the valve member is a sheet made of a flexible material, and the sheet has a thin slit in the center. 3. The valve member according to claim 1, wherein the valve member is a detachable lid.
A laparoscopic tube for medical laparoscopic insertion according to the above. 4. The outer tube for medical laparoscope insertion according to claim 1, wherein the valve member is a flap that bends only in the distal direction. 5. The mantle tube according to claim 1, wherein one or more cuffs that can be contracted along the axial direction of the mantle tube are provided in the circumferential direction of the mantle tube.
5. The mantle tube for inserting a medical laparoscope according to any one of items 4 to 4. 6. A conduit having a first valve member built-in portion and a plurality of independent lumens connected to the first valve member built-in portion from a distal end to a distal end, and a plurality of independent lumens built in the first valve member built-in portion. A first seal valve on the distal end side and a second seal valve on the distal end side, furthermore, an insufflation gas inlet attached to the first valve member built-in portion, and a contractible circular attached to the conduit. A plurality of cuffs provided in the circumferential direction, directly connected to each of the plurality of cuffs, or a lumen for cuff inflation arranged in a conduit, and an inner cuff inflation tube and an outer cuff inflation tube connected to it, and An outer tube for medical laparoscope insertion, further comprising a gas-liquid opening / closing device connected thereto. 7. A second conduit branched and connected obliquely to at least one of a plurality of lumens from near a proximal end of the conduit, and a second valve member built-in portion is provided at the proximal end thereof. 7. The outer tube for medical laparoscope insertion according to claim 6, wherein a first seal valve is attached to a distal end side of the second valve member built-in portion, and a second seal valve is attached to a distal end side. 8. The cuff is molded from a flexible material into an inflated shape, and by injecting a fluid into the cuff, the cuff is inflated to a molded state and the fluid is drawn from the cuff. 8. The medical laparoscopic insertion device according to claim 5, wherein the cuff has an outer diameter substantially equal to the outer diameter of the shaft of the mantle tube, and the pressure resistance of the cuff is at least 0.5 kg / cm ² or more. Mantle tube. 9. The sheath tube for medical laparoscopic insertion according to claim 1, wherein a spiral wire for preventing collapse of the lumen is built in the guide tube of the sheath tube. 10. The outer tube for medical laparoscopic insertion according to claim 1, wherein the inner lumen has two lumens. 11. The method according to claim 5, wherein two cuffs are provided.
11. A mantle tube for inserting a medical laparoscopic device according to any one of items 10. 12. An endoscope is inserted into one lumen, and flexible forceps are inserted into another lumen.
12. The mantle tube for inserting a medical laparoscope according to any one of items 11 to 11. 13. The outer tube for medical laparoscope insertion according to claim 12, wherein the flexible forceps has a function of grasping, cauterizing, and cutting off a tissue or an object.