TW201332508A - Needle unit - Google Patents

Abstract

A needle unit includes an outer cannula and an inner wire passing through a passageway thereof. The outer cannula is straight or curved, and the outer cannula has a piercing end and an open end connected to the passageway. The piercing end has a dull tip. An opening is disposed around the dull tip of the piercing end or at a top of the piecing end of the cannula. The inner wire has a threading part at an end thereof near an opening of the outer cannula. The threading part allows the suture thread passing through the threading part, and the inner wire is movable inwardly or outwardly via the opening. Therefore, the needle unit can be advantageous to tie the desired vessels or parenchyma of a liver in hepatic resection with less restriction.

Description

Socket set

The present invention relates to a trocar set for surgery, and more particularly to a trocar set for use in hepatectomy.

Successful hepatic resection procedures require skilled surgical techniques, remnant liver to have a safe volume, and reduce or eliminate unnecessary ischemia and reperfusion injuries. Skilled surgeons must work to reduce blood loss during the parenchyma division to stop bleeding or bile leakage from the liver surface and to maintain residual major blood vessels and the integrity of the tubing. If all of the above conditions are met, the surgery will of course be safe and save medical costs. Otherwise, it will take tedious postoperative care.

Liver resection often involves high-risk intraoperative or postoperative bleeding and postoperative liver failure. Although surgical techniques, equipment, and post-operative care have improved mortality, mortality has continued to decline. However, hepatic hemorrhage remains a key obstacle to overcome when performing parenchyma transection. In order to reduce bleeding during surgery, it is necessary to simultaneously control the inflow of blood and backflow of blood. Several known methods are currently available to control the total hepatic artery and portal vein at the hepatoduodenal ligament outside the liver (eg Pringle's maneuver), at the liver's hilar At individual segmental segmental branches of the blood vessel, intermittent or continuous means may be utilized to block influx of blood. Ischemia and reperfusion injury to the residual liver can be avoided by partially blocking individual blood inflows. Especially for cirrhotic liver, the key to preventing hepatic failure is to determine the appropriate ischemic time. As for the control of reflux blood, it can be achieved by the inferior vena cava exclusion (IVC exclusion) or individual hepatic vein occlusion. However, inferior vena cava blockage may compromise hemodynamic stability; therefore, fluids that exceed the load are used to block hemodynamic stability before blocking blood flow, and this increased fluid exacerbates postoperative recovery. burden.

In view of this, it is urgent to provide a surgical needle for the purpose of controlling the individual inflowing blood and returning blood in the liver (not at the hepatic portal), reducing intraoperative bleeding, and causing ischemia and reperfusion injury. The liver area is reduced to a smaller extent, thereby minimizing the risk of postoperative liver failure.

Accordingly, one aspect of the present invention is to provide a trocar set that includes an outer cannula body and an inner wire body disposed in an internal passage of the outer cannula body. The outer sleeve body is a straight tube or a curved tube, and the outer sleeve body has an internal passage, and the outer sleeve body further has a piercing end and an open end connecting the internal passage. The piercing end has a blunt end. The perforating end of the outer cannula body has an opening near the blunt end or at the piercing end. The inner wire body has a threading portion at one end of the opening adjacent to the outer sleeve body. At least one suture passes through the threading portion, and the inner thread body enters and exits through the opening. When the opening is directly disposed on the piercing end of the outer cannula body, the inner wire body can be connected with a plug as the piercing end. Therefore, when performing a partial organectomy operation, such as various liver resection operations, the use of the trocar group can facilitate the control of specific blood vessels of the organ.

According to the above aspect of the invention, a trocar set is proposed. In an embodiment, the trocar set includes an outer sleeve body and an inner wire body. The outer cannula body has an internal passageway disposed therein, and further the cannula body further includes at least an open end and a piercing end, and the piercing end has a blunt end. The puncture end is used to pierce the soft tissue or organ, and has an opening near the blunt end of the puncture end or at the end of the puncture end of the outer cannula body. The inner wire system is disposed in the inner passage of the outer casing body, and the inner wire body has a threading portion on or near one end of the opening adjacent to the outer casing body, wherein the inner wire body can enter and exit through the opening hole, and at least one suture thread Pass through the threading section. When the opening is directly provided on the end of the puncture end of the outer cannula body, the inner wire body can be connected with a plug as the piercing end.

According to an embodiment of the present invention, the outer sleeve body is a straight tube or is bent into a curved tube along a longitudinal length of the outer sleeve body with a continuous curvature, wherein the curvature is the central angle of the outer sleeve body except the sleeve body Length, this central angle is equal to or greater than 0 degrees and less than 180 degrees, and this length is from 101% to 250% of the average thickness of the human liver. In another example, the outer sleeve body is a straight tube or is bent into a curved tube at a chord angle, and the chord angle defined by the piercing end to the open end is equal to or greater than 0 degrees and less than 90. degree.

According to an embodiment of the invention, the opening is provided on one side of the outer sleeve body and adjacent to the blunt end. In another illustration, the opening is provided directly on the end of the piercing end of the outer cannula body. In the latter illustration, the threading portion may be an oval loop, a circular loop, a diamond loop, a U-shaped portion, or a hook. Alternatively, the elliptical ring body, the circular ring body or the rhombic ring body of the above-mentioned threading portion has a linear protrusion at the end adjacent to the opening of the outer sleeve body. The piercing end may be provided with a plug at one end of the linear protrusion as a blunt end, and the plug may cover the opening when the trocar group pierces the soft tissue or the organ.

According to another aspect of the present invention, a surgical trocar set for use in a hepatectomy is provided, comprising an outer cannula body, an inner wire body disposed in an inner passage of the outer cannula body, and an opening provided in the outer cannula body The grip of the end. The handle has a conduit for connection to the internal passage of the outer casing body such that the inner wire body is disposed in the conduit and the internal passage.

The trocar set of the present invention utilizes a cannula body other than a straight tube or an elbow. The threading portion of the inner wire body allows at least one suture to pass therethrough, and the inner wire body can enter and exit through the opening. As a result, the use of the trocar set of the present invention facilitates ligation of specific blood vessels of the organ during a partial organectomy procedure, such as a liver resection procedure.

It is to be understood that the foregoing general description,

As described above, the present invention provides a trocar set which is capable of effectively and easily ligating a specific blood vessel of an organ during a partial organectomy operation.

Nest structure

Please refer to FIG. 1A, which is a cross-sectional view showing a trocar set according to an embodiment of the present invention. In short, the trocar set 100 can include an outer sleeve body (hereinafter referred to as a straight tube type outer sleeve body 110a or a curved tube type outer sleeve body 110b) and an inner wire body 120. The straight tube type outer cannula body 110a or the curved tube type outer cannula body 110b has an inner passage 111 provided therein, and the outer sleeve body includes a piercing end 115 and an open end 113 connecting the inner passage 111. The piercing end 115 of the outer cannula body has a blunt end. In general, the puncture end 115 of the outer cannula body can be a blunt end to pierce a soft tissue or organ (e.g., the liver), and an opening 117 is formed adjacent the blunt end of the puncture end 115 of the outer cannula body or at the end of the puncture end 115. . The inner wire body 120 is disposed in the inner passage 111, and the inner wire body 120 has a threading portion 121 (for example, a ring body) on or near one end of the adjacent opening 117, wherein the inner wire body 120 can enter and exit through the opening 117, and at least A suture 130 passes through the threading portion 121.

For example, the opening 117 may be disposed on one side of the outer sleeve body (the straight tube type outer sleeve body 110a or the curved tube type outer sleeve body 110b) and adjacent to the blunt end of the piercing end 115 of the outer sleeve body, such as the 1A The figure shows. However, in another example, the opening 117 may be directly provided on the end of the puncture end of the outer sleeve body (the straight tube type outer sleeve body 110a' or the curved tube outer sleeve body 110b'), and in this illustration, the outer sleeve The tubular body (straight tubular outer cannula body 110a' or curved tubular outer cannula body 110b') does not have a blunt end, as shown in Fig. 1B. In this illustration, the threading portion 121 can be a ring or a hook. In the example in which the ring body is used as the threading portion 121, the threading portion 121 is more linear at the end of the opening 117 adjacent to the outer casing body (the straight tube type outer sleeve body 110a' or the curved tube outer sleeve body 110b'). Protrusion 123. The piercing end may be provided with a plug 150 at one end of the linear protrusion 123 as a blunt end as shown in FIG. 1A, and the plug 150 may cover the opening when the trocar set 100' pierces a soft tissue or an organ. 117. In other words, when the trocar set 100' pierces a soft tissue or organ, the plug 150 can serve as a blunt end for piercing a soft tissue or organ, and as a covering end covering the opening 117. Additionally, the plug 150 can be made of metal, plastic, or other material suitable for use with surgical instruments.

In one embodiment, the inner wire body 120 may be a metal wire, a plastic wire, or a metal wire coated with a polymer film, such as a metal wire coated with polytetrafluoroethylene (PTFE).

In one embodiment, the elbow-type outer cannula body 110b is bent into a curved tube at a tangent chord angle α, and the string-cutting angle is from the piercing end 115 of the outer cannula body (ie, above the opening 117) ) is defined to the open end 113 of the outer sleeve body as shown in Figure 1A. Alternatively, the elbow type outer cannula body 110b' can also be defined by the chord angle α from the opening 117 to the open end 113 of the outer sleeve body, as shown in Fig. 1B. The chord angle α defined from the opening 117 to the open end 113 of the outer sleeve body is equal to or greater than 0 degrees and less than 90 degrees.

In another embodiment, the outer sleeve body may be a straight tube type outer sleeve body 110a (or a straight tube type outer sleeve body 110a') or a curved tube type outer sleeve body 110b (or a curved tube type outer sleeve body 110b'). In an example, the curved outer sleeve body 110b (or the curved outer sleeve body 110b') can be bent into a curved tube along a longitudinal length ( 1 ) of the outer sleeve body, and the curvature is determined by (I) defined:

Outer casing body curvature = = (I)

In the above formula (I), this curvature can be directly defined by the reciprocal of the radius ( r ) of the outer casing body. The longitudinal full length ( 1 ) of the curved outer sleeve body 110b (or the curved outer sleeve body 110b') is defined by the product of its radius ( r ) and its central angle (θ). In other words, the curvature of the curved outer sleeve body 110b (or the curved outer sleeve body 110b') may be divided by its central angle (θ) by its longitudinal length ( 1 ). In one embodiment, the central angle (θ) of the curved outer sleeve body 110b (or the curved outer sleeve body 110b') is twice the tangent angle α, that is, 2α, and the central angle (θ) is equal to Or greater than 0 radians and less than 3.14 radians (ie 180 degrees).

The full length ( 1 ) of the straight tubular outer cannula body 110a (or the straight tubular outer cannula body 110a') may be from 101% to 250% of the average thickness of the human liver (for example, about 10 cm to 30 cm). The straight tube type outer sleeve body 110a (or the straight tube type outer sleeve body 110a') can be made of a conventional metal (for example, metal, metal alloy, stainless steel, etc.) or plastic, and the straight tube type outer sleeve body 110a (or a straight tube) The width w of the outer sleeve body 110a') or the curved outer sleeve body 110b (or the curved outer sleeve body 110b') is a syringe needle gauge No. 14 to 24 (ie, 2.108 mm to 0.559 mm). ). Similarly, the curved outer sleeve body 110b' of Fig. 1B can also be selectively bent along a longitudinal length ( l ) thereof into a curved tube with a continuous curvature, and the curvature can also be defined by the above formula (I).

Please refer to Figure 1C and Figure 1D. 1C and 1D are perspective views of a trocar set according to an embodiment of the present invention. The trocar set 100 can include an outer cannula body 110 and an inner wire body 120, while the trocar set 100' includes an outer cannula body 110' and an inner wire body 120 having a plug 150. The outer sleeve body 110 has an internal passage (not shown) disposed therein, and further the sleeve body further includes at least an open end 113 connecting the internal passage and the piercing end 115. The puncture end 115 of the outer cannula body has a blunt end to pierce soft tissue or an organ (eg, the liver). The piercing end 115 of the outer cannula body has an opening 117 in the vicinity thereof, wherein the opening 117 can be disposed on one side of the outer cannula body 115 and adjacent to the blunt end of the piercing end 115 (for example, the trocar set 100), or the opening 117 can be disposed directly on one end of the puncture end of the outer cannula body 110' (eg, trocar set 100'). One end of the inner wire body 120 has a threading portion 121, and the inner wire body 120 can enter and exit from the inner channel through the opening 117, and when the inner wire body 120 protrudes from the opening 117, at least one suture 130 can pass through the threading Part 121. However, the trocar set of FIG. 1C and FIG. 1D are merely exemplary here. It can be easily understood that the trocar set of other embodiments may also use a straight tube type outer sleeve body, but is not used to limit the request. Invention.

In other embodiments, the threading portion 121 of the trocar set 100' of FIG. 1C and FIG. 1D may be at the end of the opening 117 adjacent to the outer cannula body 110' at the end of the elliptical ring body, the circular ring body or the rhombic ring body. It has linear protrusions (not shown). In the foregoing illustration, the threading portion 121 of the various ring bodies of the trocar set 100' may be made of a metal material, and the width of the ring body is slightly larger than, equal to or smaller than the diameter of the opening 117, piercing in the trocar group. In the case of a soft tissue or organ, the threading portion 121 is maintained inside the opening 117 (not shown).

In an embodiment, a handle 130b (FIG. 1C) or a handle 130c (FIG. 1D) is further selectively disposed at the open end 113 of the outer sleeve body 110 or the outer sleeve body 110', wherein the handle 130b It is disposed vertically or obliquely at the open end 113 of the outer cannula body 110 or the outer cannula body 110', or the handle 130c extends in the same direction as the outer cannula body 110 or the outer cannula body 110'. Next, the grip portion 131b of the grip 130b of FIG. 1C or the grip portion 131c of the grip 130c of FIG. 1D has a pipe (not shown) for connecting to the outer sleeve body 110 or the outer sleeve body 110, respectively. The internal passage 111 allows the inner wire body 120 to pass from the opening 133b or the opening 133c to the opening 117 via the duct and the internal passage 111.

In another embodiment, the outer cannula body can be disposed in a hollow conduit of a laparoscopic surgical instrument. Please refer to Figure 2. 2 is a cross-sectional view showing a trocar set according to another embodiment of the present invention. A peritoneal puncture cannula 140 for laparoscopic surgery, such as a conventional trocar, has a hollow conduit 141 for receiving an outer cannula body 110 or an outer cannula body 110' such that it can be inserted through a peritoneal catheterization cannula The opening 145 enters and exits. In this illustration, a laparoscopic camera commonly used in the prior art can be independently provided in another cannula device (not shown).

In general, the length of the outer sleeve body 110 or the outer sleeve body 110' depends on actual needs, and the invention does not limit the range of lengths herein. For example, in the open abdomen surgery, when the outer cannula body 110 or the outer cannula body 110' is manually operated, the length of the outer cannula body 110 or the outer cannula body 110' can be the average thickness of the human liver. 101% to 250% (for example, about 10 cm to 30 cm). Alternatively, in the laparoscopic surgery, when the outer cannula body 110 or the outer cannula body 110' passes through the trocar port, the length of the outer cannula body 110 can exceed the hollow of the abdominal cavity piercing cannula in FIG. The length of the conduit 141 is, for example, about 50 cm.

Please refer to Figure 3. 3 is a schematic view showing an inner wire body according to an embodiment of the present invention. In an embodiment, the inner wire body 120 may be a metal wire, a plastic wire, or a metal wire coated with a polymer film, such as a metal wire coated with PTFE. The threading portion 121 of the inner wire body 120 may have various shapes such as an elliptical ring body (such as the ring body 121a and the ring body 121b), a circular ring body (such as the ring body 121c and the ring body 121d), or a diamond ring body (such as a ring). Body 121e and ring body 121f). In another embodiment, the threading portion 121 of the inner wire body 120 may be a U-shaped portion 121g. In still another embodiment, the threading portion 121 of the inner wire body 120 can be a hook body 121h.

Please refer to Figure 3. In another embodiment, the threading portion 121 has a linear protrusion at the end of the opening adjacent to the outer sleeve body (for example, the sleeve body 110a or the outer sleeve body 110b of FIG. 1B), for example, a linear protrusion of the ring body 121b. The object 123b, the linear protrusion 123d of the ring body 121d or the linear protrusion 123f of the ring body 121f. The linear protrusions exemplified herein facilitate the entry and exit of the inner wire body 120 through the opening. In other examples, one end of the linear protrusion 123b of the ring body 121b, the linear protrusion 123d of the ring body 121d or the linear protrusion 123f of the ring body 121f may be respectively provided with a plug 150 as a blunt end, and the plug 150 The above-described opening (e.g., opening 117 of Figure 1B) may be covered by a trocar set (e.g., trocar set 100 of Figure 1B or trocar set 100' of Figure 1B) when piercing a soft tissue or organ. Alternatively, the inner wire body 120 may have a hook-shaped hook body 121i, and a plug 150 is provided at an end of the opening adjacent to the outer sleeve body (for example, the sleeve body 110a or the outer sleeve body 110b of FIG. 1B). The hook body 121i can serve as a threading portion, and the plug 150 can serve as a blunt end. In this illustration, with or without the outer cannula body 110, the inner wire body 120 having the hook body 121i and the plug 150 itself can be used as a surgical needle.

The inner wire body 120 allows at least one suture 130 to pass through the threading portion 121 to ligate a specific blood vessel of the liver during a partial liver resection operation. In one embodiment, the suture 130 is a suture made of an absorbable or non-absorbable material commonly used in the prior art.

It is worth mentioning that the curved trocar group can effectively and easily ligature specific blood vessels of the organ compared to the straight tube trocar set. Please refer to Figure 4, which is based on the International Hepato-Pancreato-Biliary Association (IHPBA) in Brisbane's liver anatomy and resections (Brisbane Terminology of Liver Anatomy and Resections). Schematic diagram of segmental classification of the liver. The trocar set of the present invention can be applied to the first order, the second level, the third stage of the Glissonian pedicle of all the above sections of the liver. And the fourth stage of the blood vessel branch.

Application of trocar group

In performing, for example, a hepatectomy procedure, the trocar set can be applied as described below and in conjunction with Figure 1A and Figures 5A through 6B. During liver resection, intraoperative ultrasonography (not shown) or laparoscopic camera can be used to evaluate tumor size, location, hepatic vascular orientation, resection rate and determine the appropriate separation line. ). In order to explain in detail the operation of the trocar group, here, the lancet group 100 is used to perform the resection of the left hepatic lobe and the right hepatic lobe. However, it is to be understood that the following description is merely illustrative to provide a further explanation of the claimed invention.

1. Puncture the blood vessels from the bottom of the liver, especially the liver and blood vessels above the inferior vena cava

Please refer to Figures 1A, 5A and 5B. 5A and 5B are sagittal cross-sectional views of the left lobe of the liver according to an embodiment of the present invention. The anterior abdominal wall and chest wall 509 are raised after the necessary preoperative preparation. Using the cannula body 110b outside the trocar set 100, it passes through the lower surface 501 of the liver 500 [above the inferior venal cava (IVC) 503] along the path 511, and passes through the main supply blood vessel 507 (for example, Greeson's left liver) One side of the tubular structure, to the upper surface 505 of the liver 500, then the inner wire 120 of the trocar set 100 is removed outwardly from the opening 117 of the outer cannula body 110b, passing the first end of the suture 130 through The threading portion 121 of the inner wire body 120 of the trocar set 100.

Next, the outer cannula body 110b follows the same path 511, and the first end of the suture 130 is advanced from the upper surface 505 of the liver 500 back to the lower surface 501 of the liver 500, leaving the second end of the suture 130 on the upper surface of the liver 500. 505. The trocar set 100 then passes through the lower surface 501 of the liver 500 along path 513, through the other side of the primary supply vessel 507, to the upper surface 505 of the liver 500, and the first end of the suture 130 is brought to the upper surface 505 of the liver 500. . On the upper surface 505 of the liver 500, the distance between the path 511 and the path 513 is about 5 cm. Thereafter, the first end and the second end of the suture 130 on the upper surface 505 of the liver 500 are fastened to a knot 521 to control individual inflowing blood or returning blood to a particular blood vessel.

In other embodiments, the trocar set 100 may be reused in any of the above manners to form a row of intermittently interlocking sutures 521 along the inside of the separation line of the left lobe of the liver. As shown in Figure 5B. Then, there is no need to use Pringle's maneuver (completely block all inflowing blood outside the liver, including the total hepatic artery and hepatic portal vein) or any other method of blocking blood flow from the liver or returning blood. The left hepatic lobe can be directly isolated by scissors, electrocautery or by clamping and dividing with a Kelly clamp. Any tubular structure of significant size can be reinforced with suture ligation. After the above-described hepatectomy, the surface of the residual liver does not require the use of fibrin glue or collagen sheets. By convention, large diameter drains can be placed in the relevant sections if necessary.

When the ends of the suture 130 are on the same side and are fastened to each other, the suture 130 can be modified in any manner, whether it is on the upper surface 505 or the lower surface 501 of the liver 500. Thereafter, the liver tumor can be removed using a conventional method. After completion of the tumor resection, the knot 521 and the suture 130 may remain forever, or if it is necessary to restore the inflowing blood of the liver 500 and return blood, the knot 521 and the suture 130 may also be cut off.

When the gap between the upper surface 505 of the liver and the anterior abdominal wall and the chest wall 509 is too small, so that a straight needle (for example, the trocar set 100 having the straight tubular outer cannula 110a and the inner wire 120) is difficult to puncture from the liver surface The above method can also be applied to the right hepatectomy or various resection operations.

2. Puncture the liver from the surface of the liver (in the case of the inferior vena cava) or the bottom (the narrow space between the liver and the anterior abdominal wall and the chest wall)

Secondly, the hepatic blood vessels below the chest cavity or between the liver and the anterior abdominal wall have limited space, so that the conventional straight needle is difficult to reach. The trocar group of the present invention can also easily ligature the liver blood vessels in the above place.

Please refer to FIG. 1A, FIG. 6A and FIG. 6B. 6A is a side view showing the abdominal wall and the chest wall 509 and the right hepatic lobe below the diaphragm 602 according to another embodiment of the present invention, and FIG. 6B is a view showing the right lobe of the liver according to another embodiment of the present invention. Sagittal section view. For the same reason, after the necessary preoperative preparation, the front abdominal wall and the chest wall 509 are raised slightly. Using the cannula body 110b outside the trocar set 100, along the path 611, it is punctured from the top to the bottom in the manner of facing the retroperitoneal abdominal wall 623, passing through the upper surface 605 of the liver 600 and away from the 5A and the 5B below the vena cava 503, through the side that primarily supplies the blood vessel 607, to the lower surface 601 of the liver 600.

Next, the inner wire body 120 is removed outwardly from the opening 117 of the outer sleeve body 110b such that the first end of the suture thread 130 passes through the threading portion 121 of the inner wire body 120. Then, the outer cannula body 110b, along the same path 611, pulls the first end of the suture 130 from the lower surface 601 of the liver 600 to the upper surface 605 of the liver 600, leaving the first end of the suture 130 on the upper surface 605 of the liver 600. . Next, the trocar set 100 passes through the upper surface 605 of the liver 600 along the path 613, passes through the other side of the main supply blood vessel 607, to the lower surface 601 of the liver 600, and the threading portion 121 of the inner wire body 120 is taken from the outer cannula body 110b. The opening 117 is outwardly removed to obtain the second end of the suture 130. On the upper surface 605 of the liver 600, the distance between the path 611 and the path 613 is about 5 cm. Thereafter, the outer cannula body 110b, along the same path 613, pulls the first end of the suture 130 from the lower surface 601 of the liver 600 to the upper surface 605 of the liver 600, leaving the second end of the suture 130 on the upper surface 605 of the liver 600. . Subsequently, the first end and the second end of the suture 130 on the upper surface 605 of the liver 600 are fastened.

Alternatively, when the threading portion 121 of the inner wire body 120 is outwardly removed from the opening 117 of the outer sleeve body 110b, the first end of the suture thread 130 passes through the threading portion 121 of the inner wire body 120 of the trocar set 100, The inner wire body 120 is then moved inwardly until the end of the threading portion 121 is received in the opening 117. After being prepared, the cannula body 110b passes through the lower surface 601 of the liver 600 (away from or above the inferior vena cava 503) along the path 611, passing through the side that mainly supplies the blood vessel 607, from bottom to top. To the upper surface 605 of the liver 600, the first end of the suture 130 is left on the upper surface 605 of the liver 600. Next, the outer cannula body 110b passes through the upper surface 605 of the liver 600 along the same path 611 to the lower surface 601 of the liver 600.

After the threading portion 121 of the inner wire body 120 is outwardly removed from the opening 117 of the outer sleeve body 110b and the second end of the suture 130 is taken, the inner wire body 120 is moved inward until the end of the threading portion 121 is opened. 117. Upon completion, the trocar set 100 passes through the lower surface 601 of the liver 600 along path 613, through the other side of the primary supply vessel 607, to the upper surface 605 of the liver 600, and the second end of the suture 130 to the liver 600. Upper surface 605. The distance between the path 611 and the path 613 at the upper surface 605 is about 5 cm. Thereafter, the first end and the second end of the suture 130 on the upper surface 605 of the liver 600 are fastened to control individual inflowing blood or returning blood to a particular blood vessel.

In other embodiments, the trocar set 100 can be reused in any of the above manners to form a row of intermittent interlocking sutures along the inside of the separation line of the liver lobe or the section to be resected, similar to the 5B. The figure shows. Then, there is no need to use the Pringle technique or any other method of blocking blood flow from the liver or returning blood, directly separating the liver lobe or segment with scissors, electrocautery or clamp using a hemostat. Any tubular structure of significant size can be reinforced with suture ligation. After the above-described hepatectomy, the surface of the residual liver does not require the use of fibrin glue or collagen sheets. By convention, large diameter drains can be placed in the relevant sections if necessary.

It is worth noting that, compared with the long straight needle (or the trocar group 100 or the trocar group 100' having the straight tubular outer cannula body 110a and the inner wire body 120), the blood vessel is cut in the hepatectomy operation. The trocar set of the outer cannula body 110b and the inner wire body 120 can be effectively applied to the left hepatic lobe vascular ligation above the inferior vena cava, or the liver and the anterior abdominal wall and the thoracic cavity wall (Fig. 5A, Fig. 5B and Fig. 6B) 509), or the ligament of the liver (including the left hepatic lobe and the right lobe of the liver) in the stenotic space between the 5A, 5B, and 6B of the retroperitoneal peritoneum 623, but does not damage the inferior vena cava, does not cause Thoracotomy can be removed from excessively lifting the chest wall. For example, when the liver tumor is large, the space between the liver and the anterior abdominal wall and the chest wall is extremely limited, or the tumor is located above the inferior vena cava, so that the straight is straight. The needle is difficult to use.

Secondly, the trocar set of the present invention can be combined with a long straight needle and a trocar set 100 (or a trocar set 100') having a straight tubular outer cannula body 110a and an inner wire body 120 for ligation of liver blood vessels during hepatectomy. For example, a blood vessel above the inferior vena cava or at a narrow space between the liver and the anterior abdominal wall can be ligated using a trocar set 100 having an outer cannula body 110b and an inner wire body 120. As for the blood vessel away from the inferior vena cava, the long straight needle or the trocar set 100 having the straight tubular outer cannula body 110a and the inner wire body 120 can be ligated.

In addition, although the present invention is exemplified by the ligation of the blood vessels of the liver, the application of the trocar set of the present invention is described, but it is obvious to those skilled in the art that the present invention is not limited thereto, without departing from the invention. Within the spirit and scope, the trocar set of the present invention can also be applied to the ligation of blood vessels in other organs during a local excision operation. For example, the trocar set of the present invention can be applied to the treatment of female urinary incontinence. In this embodiment, the trocar set can be used to place a sling tape from the vagina to the connective tissue on both sides of the pubic bone, thereby suspending the urethra and providing support.

It can be seen from the above embodiments of the present invention that the trocar set of the present invention has the advantages of including an outer cannula body and an inner wire body disposed in the inner passage of the outer cannula body, which can be effectively and easily performed in a hepatectomy operation (for example, Zhang's operation method). Ligation of specific blood vessels, especially sections 4, 7, and 8 of the liver, left hepatic veins, or midhepatic veins, is difficult or even unlikely for a straight needle to ligature these specific blood vessels. In this way, the present invention can effectively overcome the limitations of the conventional straight needle application.

The present invention has been disclosed in the above embodiments, and is not intended to limit the present invention. Any one of ordinary skill in the art to which the present invention pertains can make various changes without departing from the spirit and scope of the invention. The scope of protection of the present invention is therefore defined by the scope of the appended claims.

100/100’. . . Socket set

110/110’/110a/110a’/110b/110b’. . . Outer casing body

111. . . Internal channel

113. . . Open end of outer casing body

115. . . Puncture end of outer cannula

117. . . Opening

120. . . Internal line body

121 threading department

121a/121b/121c/121d/121e/121f. . . Ring body

121g. . . U-shaped part

121h/121i. . . Hook body

123/123b/123d/123f. . . Linear protrusion

130. . . Suture

130b/130c. . . Grip

131b/131c. . . Grip

133b/133c. . . Opening

140. . . Abdominal puncture cannula for laparoscopic surgery

141. . . Hollow tube for abdominal puncture cannula

145. . . Opening of the abdominal puncture cannula

150. . . Plug

α. . . Chord angle

θ. . . Central angle

w . . . width

500. . . liver

501. . . lower surface

503. . . Inferior Vena

505. . . Upper surface

507. . . Main supply of blood vessels

509. . . Anterior abdominal wall and chest wall

511/513. . . path

521. . . Line knot

600. . . liver

601. . . lower surface

602. . . Diaphragm

605. . . Upper surface

607. . . Main supply of blood vessels

610. . . Rib skeleton

611/613. . . path

621. . . Thoracic posterior pleura

623. . . Peritoneal retroperitoneum

The above and other objects, features, advantages and embodiments of the present invention will become more apparent and understood.

1A and 1B are cross-sectional views showing a trocar set according to several embodiments of the present invention.

1C and 1D are perspective views showing a trocar set according to several embodiments of the present invention.

2 is a cross-sectional view showing a trocar set according to another embodiment of the present invention.

3 is a schematic view showing an inner wire body according to an embodiment of the present invention.

Figure 4 is a schematic diagram showing the classification of liver segments according to the terms of the 2000 International Hepatobiliary and Pancreatic Association (IHPBA) in Brisbane liver anatomy and surgical resection.

5A and 5B are sagittal cross-sectional views of the left lobe of the liver according to an embodiment of the present invention.

Figure 6A is a side elevational view of the rib cage and the right hepatic lobe below the diaphragm in accordance with another embodiment of the present invention.

Fig. 6B is a sagittal sectional view showing the right lobe of the liver according to another embodiment of the present invention.

100. . . Socket set

110a/110b. . . Outer casing body

111. . . Internal channel

113. . . Open end of outer casing body

115. . . Puncture end of outer cannula

117. . . Opening

120. . . Internal line body

121. . . Threading section

130. . . Suture

α. . . Chord angle

θ. . . Central angle

w . . . width

Claims (20)

A trocar set comprising: an outer sleeve body, wherein the outer sleeve body has an internal passageway disposed on the outer sleeve body, and the outer sleeve body further comprises at least: an open end connected to the internal passage; and a puncture An end, wherein the piercing end has a blunt end, the piercing end is for piercing a soft tissue or an organ, and the blunt end has an opening near the blunt end; and an inner wire body is disposed in the inner channel, and the inner wire body There is a threading portion adjacent one end of the opening, wherein the inner wire system enters and exits through the opening such that at least one suture passes through the threading portion. The trocar set according to claim 1, wherein the outer sleeve body is a straight tube. The trocar set according to claim 1, wherein the outer sleeve system is curved along a longitudinal length of one of the outer sleeve bodies by a curvature into a curved tube, the curvature being a central angle of the outer sleeve body divided by The longitudinal full length of the outer cannula body is equal to or greater than 0 degrees and less than 180 degrees, and the length is from 101% to 250% of the average thickness of a human liver. The trocar set according to claim 1, wherein the outer sleeve system is made of metal or plastic, and one of the outer sleeve bodies has a width of 2.108 mm to 0.559 mm. The trocar set according to claim 1, wherein the inner wire body is a metal wire, a plastic wire, or a metal wire coated with a polymer film. The trocar set of claim 1, wherein the suture is an absorbable suture or a non-absorbable suture. The trocar set according to claim 1, wherein the threading portion is an elliptical ring body, a circular ring body, a diamond ring body, a U-shaped portion or a hook body. The trocar set according to claim 7, wherein the elliptical ring body, the circular ring body or the rhombic ring body of the threading portion has a line shape at an end of the opening adjacent to the outer sleeve body. Protrusions. The trocar set according to claim 8, wherein the opening is provided on one side of the outer sleeve body and adjacent to the blunt end. The trocar set according to claim 8, wherein the opening is directly provided on one end of the piercing end of the outer sleeve body. The trocar set according to claim 10, wherein the piercing end is provided with a plug at one end of the linear protrusion as the blunt end, and the plug pierces the soft tissue in the trocar set or The organ is covered by the opening. The trocar set according to claim 10, wherein the elliptical ring body, the circular ring body or the diamond ring system is made of metal, and the elliptical ring body, the circular ring body or the diamond ring One of the widths of the body is greater than, equal to, or less than the diameter of the opening, and the threading portion is maintained inside the opening when the trocar group pierces the soft tissue or the organ. The trocar set according to claim 1, wherein a grip is further disposed at the open end of the outer sleeve body, and the handle has a pipe connected to the inner passage of the outer sleeve body, The inner wire body is disposed on the pipe and the inner passage. A trocar set comprising: an outer sleeve body, wherein the outer sleeve body is a straight tube or a curved tube, the outer sleeve body has an internal passageway disposed on the outer sleeve body, and the outer sleeve body further comprises at least: An open end connected to the internal passage; and a piercing end, wherein the piercing end has a blunt end for piercing a soft tissue or an organ, and the puncture end has an opening near the piercing end; and an internal line The body is disposed in the internal passage, and the inner wire body has a threading portion adjacent one end of the opening, wherein the inner wire system enters and exits through the opening, so that at least one suture passes through the threading portion. The trocar set according to claim 14, wherein the outer sleeve system is bent into a curved tube at a chord angle, and the chord angle defined by the piercing end to the open end is equal to or greater than 0. Degree is less than 90 degrees. The trocar set according to claim 14, wherein the threading portion is an elliptical ring body, a circular ring body, a diamond ring body, a U-shaped portion or a hook body. The trocar set according to claim 16, wherein the elliptical ring body, the circular ring body or the rhombic ring body of the threading portion has a line shape at an end of the opening adjacent to the outer sleeve body. Protrusions. The trocar set according to claim 17, wherein the opening is directly disposed on an end of the piercing end of the outer cannula body. The trocar set according to claim 18, wherein the piercing end is provided with a plug at one end of the linear protrusion as the blunt end, and the plug pierces the soft tissue in the trocar set or The organ is covered by the opening. The trocar set according to claim 19, wherein the elliptical ring body, the circular ring body or the diamond ring system is made of metal, and the elliptical ring body, the circular ring body or the diamond ring One of the widths of the body is greater than, equal to, or less than the diameter of the opening, and the threading portion is maintained inside the opening when the trocar group pierces the soft tissue or the organ.