TWI641356B - Body cavity pick and place device - Google Patents
Body cavity pick and place device Download PDFInfo
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- TWI641356B TWI641356B TW104106497A TW104106497A TWI641356B TW I641356 B TWI641356 B TW I641356B TW 104106497 A TW104106497 A TW 104106497A TW 104106497 A TW104106497 A TW 104106497A TW I641356 B TWI641356 B TW I641356B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
- A61B2017/3464—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals with means acting on inner surface of valve or seal for expanding or protecting, e.g. inner pivoting fingers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
- A61B2017/3466—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals for simultaneous sealing of multiple instruments
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
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- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Devices For Opening Bottles Or Cans (AREA)
Abstract
本發明提供一種可在不造成氣密性之劣化或開創部之損傷下,經由繩狀部件取出內側環狀部件之體腔取放器具。 The present invention provides a body cavity pick-and-place device that can take out an inner annular member via a string member without causing deterioration of airtightness or damage to the wound portion.
本發明體腔取放器具(1)具備:於開創部件(11)之兩端具有內側環狀部件(9)及外側環狀部件(10)之開創器(5);插入開創器(5)內之處置具導入部(6);將開創器(5)氣密地封塞之封塞部(7);位於被封塞之開創器(5)內之體外側之拉手部件(8);以及自處置具導入部(6)或外側環狀部件(10),經由開創部件(11)與處置具導入部(6)之間而到達內側環狀部件(9)之繩狀部件(T)。 The body cavity pick-and-place device (1) of the present invention comprises: a starter (5) having an inner annular member (9) and an outer annular member (10) at both ends of the priming member (11); and insertion into the creator (5) a disposal device introduction portion (6); a closure portion (7) that hermetically seals the opener (5); a handle member (8) located outside the body in the plugged opener (5); The self-disposing tool introduction portion (6) or the outer annular member (10) reaches the string-shaped member (T) of the inner annular member (9) via the break member (11) and the treatment instrument introduction portion (6).
Description
本發明有關一種於進入體腔內進行處置時,裝設於開創部之供處置具導入用之體腔取放器具。 The present invention relates to a body cavity pick-and-place device for introducing a disposal tool installed in a creating portion when being disposed in a body cavity.
迄今為止,作為此類之體腔取放器具,已有一種具備:用以將開創部設成敞開狀態之開創器、以及插入開創器內之漏斗狀之處置具導入部者,業已為人所知(例如參見專利文獻1)。 As a body cavity pick-and-place device of this type, it has been known that a starter for opening the opening portion and a funnel-shaped treatment tool introducing portion for inserting the starter are known. (See, for example, Patent Document 1).
專利文獻1所記載之體腔取放器具中,開創器具備:配置於體腔內之內側環狀部件、配置於體外側之外側環狀部件、以及一方之開口部固定有該內側環狀部件而另一方之開口部固定有該外側環狀部件之可撓性筒狀開創部件。 In the body cavity pick-and-place device of the patent document 1, the opener includes an inner annular member disposed in the body cavity, an annular member disposed outside the body outer side, and one of the opening portions fixed to the inner annular member. A flexible tubular opening member of the outer annular member is fixed to one of the openings.
漏斗狀之處置具導入部係作為通過開創器將處置具導入體腔內時之保護襯筒及導入路徑發揮機能。安裝於開創部之開創器的外側環狀部件處安裝有封塞部。藉此,開創部件之體外側的開口部將被封塞。封塞部具有可在維持此一封塞之氣密性下令處置具通過之插通部。 The funnel-shaped treatment tool introduction portion functions as a protective liner and an introduction path when the treatment tool is introduced into the body cavity by the opener. A plug portion is attached to the outer annular member of the starter installed in the starter. Thereby, the opening portion outside the body of the initiating member is sealed. The closure portion has an insertion portion through which the disposal device can be passed while maintaining the airtightness of the one plug.
又,作為體腔取放器具中所使用之開創器,也已為人 所知的還有一種具有可以外側環狀部件捲取之開創部件者(例如,參見專利文獻2)。於所述之該開創器中,於內側環狀部件配置於體腔內後,係以外側環狀部件捲取開創部件,藉此開創器被固定於開創部。 Moreover, as a pioneer used in body cavity pick-and-place appliances, it has also been There is also known a pioneering member having a windable outer ring member (for example, see Patent Document 2). In the above-described starter, after the inner annular member is disposed in the body cavity, the opening member is wound by the outer annular member, whereby the opener is fixed to the creating portion.
另一方面,作為體腔取放器具,具備包括上述般之內側環狀部件、外側環狀部件及開創部件之開創器、以及安裝於外側環狀部件之封塞部,且具備用以拉出配置於體腔內之內側環狀部件之繩狀部件者,也已為人所知(例如,參見專利文獻3)。 On the other hand, the body cavity pick-and-place device includes a starter including the inner annular member, the outer annular member, and the starter member, and a plug portion attached to the outer annular member, and is provided with a pull-out portion. A rope-like member of the inner annular member in the body cavity is also known (for example, see Patent Document 3).
專利文獻3之體腔取放器具中,開創部件係以一端固定於外側環狀部件,其中間部係以內側環狀部件為內側而折返,且另一端係被導出至外側環狀部件之外側。因此,開創部件在裝設於開創部之狀態下,乃成為二重狀。於此一狀態下,繩狀部件其一端係固定於內側環狀部件,並自該處而始經過形成二重狀之開創部件之間,且自外側環狀部件之外周側延伸至開創器之體外側。 In the body cavity pick-and-place device of Patent Document 3, the starter member is fixed to the outer annular member at one end, and the intermediate portion thereof is folded back inside the inner annular member, and the other end is led out to the outer side of the outer annular member. Therefore, the wound-opening member is in a double shape in the state of being installed in the start-up portion. In this state, the rope member is fixed at one end to the inner annular member, and from there to pass between the double-shaped breaking members, and extends from the outer peripheral side of the outer annular member to the opener. Outside the body.
繩狀部件,其一端係固定於封塞部之框架,以此為起點,而在於內側環狀部件側之端部處折返下通過二重之開創部件之外側,其另一端側也有延伸至開創器之體外側之情況。延伸至開創器之體外側之繩狀部件之端部,係固定於環部件,或被設為自由狀態。藉由提拉繩狀部件之延伸出之端部,可通過開創部將內側環狀部件自體腔內朝體外取出。 The rope-like member has one end fixed to the frame of the sealing portion as a starting point, and the end portion on the side of the inner annular member is folded back to pass through the outer side of the double-opening member, and the other end side thereof also extends to the creation. The outside of the body of the device. The end of the string member extending to the outside of the body of the opener is fixed to the ring member or set to a free state. By lifting the end portion of the string member, the inner annular member can be taken out of the body cavity from the body cavity through the opening portion.
[專利文獻1]日本特開2010-207579號公報 [Patent Document 1] Japanese Patent Laid-Open Publication No. 2010-207579
[專利文獻2]日本特開2013-55993號公報 [Patent Document 2] Japanese Patent Laid-Open Publication No. 2013-55993
[專利文獻3]日本特表2009-501045號公報 [Patent Document 3] Japanese Patent Publication No. 2009-501045
上述專利文獻1之體腔取放器具、或是於其中應用專利文獻2之開創器者亦然,可想像的是,宜採用如專利文獻3中所述般之繩狀部件,而可將內側環狀部件自體腔內容易地取出。 The body cavity pick-and-place device of the above-mentioned Patent Document 1, or the inventor in which the patent document 2 is applied, is also conceivable, and it is conceivable to adopt a rope-like member as described in Patent Document 3, and the inner ring can be used. The component is easily removed from the body cavity.
此一情況下,專利文獻1或2之開創器之開創部件,並非如專利文獻3之開創部件般之折疊為二重者,因此當將體腔取放器具裝設於開創部時,繩狀部件會經由開創部件之外側或內側被導出至開創部之上方。繩狀部件經由開創部件之外側被導出之情況下,繩狀部件係與開創部直接接觸。因此,將內側環狀部件以繩狀部件拉出時,因繩狀部件之故而有對開創部造成損傷之虞。 In this case, the pioneering component of the opener of Patent Document 1 or 2 is not folded as a double member as the pioneering component of Patent Document 3, so when the body cavity pick-and-place device is installed in the start-up portion, the string member It will be exported to the top of the creating part via the outside or inside of the creating part. When the string member is led out through the outer side of the tapping member, the string member is in direct contact with the creating portion. Therefore, when the inner annular member is pulled out by the string member, the wound portion is damaged by the string member.
另一方面,繩狀部件經由開創部件之內側導出之情況下,係通過固定於開創部件的體外側端部之外側環狀部件與封塞部之間而導出繩狀部件,因此封塞部所達成之氣密性有劣化之虞。 On the other hand, when the string member is led out through the inside of the tapping member, the string member is guided by being fixed between the outer ring side member and the plug portion of the body outer end portion of the tapping member, so that the plug portion is The airtightness achieved is degraded.
經由配置於開創部件之內側之處置具導入部的內側將繩狀部件導出此擧也曾為人所考慮,此一情況下亦然,由 於係通過處置具導入部與封塞部或外側環狀部件之間導出繩狀部件,因此同樣有氣密性劣化之懸念。 It has also been considered that the rope member is led out via the inside of the treatment tool introduction portion disposed inside the priming member, and in this case, Since the string member is led out between the treatment instrument introduction portion and the closure portion or the outer annular member, there is also a suspense in which the airtightness is deteriorated.
本發明係有鑑如此般之先前技術之課題開發而成者,其目的係在提供一種可在不造成氣密性之劣化或開創部之損傷下,經由繩狀部件將內側環狀部件取出之體腔取放器具。 The present invention has been developed in view of the problems of the prior art, and the object thereof is to provide an inner annular member which can be taken out via a string member without causing deterioration of airtightness or damage of the creating portion. Body cavity pick and place device.
本發明之體腔取放器具,其特徵為:此體腔取放器具具備:開創器,其具有配置於開創部之體腔側之內側環狀部件、配置於該開創部之體外側之外側環狀部件、及該內側環狀部件固定於一方開口部且該外側環狀部件固定於另一方開口部之可撓性筒狀開創部件;漏斗狀之處置具導入部,其插入於安裝在上述開創部之上述開創器,且構成處置具之朝體腔內之導入路徑;封塞部,其具有供上述處置具於保持氣密之狀態下通過之插通部,且安裝於上述外側環狀部件而將上述開創器氣密狀封塞;把持部件,其可經把持而用以將配置於上述開創部之體腔側之上述內側環狀部件拉出體外;以及繩狀部件,其一端固定於上述內側環狀部件,另一端固定於上述把持部件;於上述處置具導入部插入於裝設在上述開創部之上述開創器、且上述開創器由上述封塞部封塞之狀態下,上述把持部件係位於上述開創器內之體外側,且上述繩狀部件係配置成自上述內側環狀部件經由上述開創部件與上述處置具導入部之間而到達 上述把持部件。 A body cavity pick-and-place device according to the present invention is characterized in that the body cavity pick-and-place device includes an opener having an inner annular member disposed on a body cavity side of the creating portion and an outer annular member disposed outside the body of the creating portion And a flexible tubular opening member in which the inner annular member is fixed to one opening and the outer annular member is fixed to the other opening; and a funnel-shaped disposal tool introduction portion is inserted into the opening portion The ejector is configured to form an introduction path in the body cavity of the treatment tool, and the occlusion portion has an insertion portion through which the treatment tool passes in a state of being kept airtight, and is attached to the outer annular member to a primer-sealing sealing device; the holding member is configured to pull the inner annular member disposed on the body cavity side of the creating portion to be pulled out of the body; and the string member has one end fixed to the inner ring shape The other end of the member is fixed to the gripping member, and the handle introduction portion is inserted into the ejector provided in the priming portion, and the ejector is sealed by the sealing portion Under the above-described holding member positioned to create lines within the outer body, a string-like member and said line arranged from said annular member via the inner member and the disposition created between the lead portion and reaches with The above holding member.
本發明中,於將體腔取放器具裝設於開創部時,首先,開創器之內側環狀部件與把持部件之間之繩狀部件係通過開創器之開創部件的內側,於把持部件配置於體外側之狀態下,將開創器裝設於開創部。此時,把持部件係配置於開創器內之體外側。而後,將處置具導入部自開創器之體外側插入開創器內。 In the present invention, when the body cavity pick-and-place device is attached to the start-up portion, first, the string-like member between the inner annular member and the grip member of the opener passes through the inner side of the starter member of the opener, and the grip member is disposed on the grip member. In the state of the outside of the body, the starter is installed in the starter. At this time, the grip member is disposed outside the body in the starter. Then, the treatment introducer is inserted into the opener from the outside of the body of the opener.
藉此,繩狀部件係成為配置於自把持部件經由開創器與處置具導入部之間而到達內側環狀部件之路徑上。其次,將配置成處置具已通過插通部之封塞部,於一面將處置具之前端側插入處置具導入部下,予以安裝於開創器之外側環狀部件。藉此,體腔取放器具之對於開創部之裝設終了。 Thereby, the string member is disposed on the path from the grip member to the inner annular member via the starter and the treatment instrument introduction portion. Next, the disposal device has been placed in the plugging portion through which the insertion portion has passed, and the front end side of the treatment tool is inserted into the treatment instrument introduction portion on one side, and is attached to the outer ring member of the opener. Thereby, the installation of the body cavity pick-and-place device for the start-up portion is completed.
其間,於開創器由封塞部封塞之狀態下,把持部件係位於因該封塞而保持氣密之部分,且繩狀部件係配置成自內側環狀部件經由開創部件與處置具導入部之間而到達把持部件。因此,繩狀部件不會經由外側環狀部件與封塞部之間被導出至開創器之外側。因此,於封塞部將開創器封塞之狀態下,不會有對於體腔側之外部氣密性發生劣化之情事。 In the meantime, in a state where the starter is closed by the sealing portion, the grip member is located at a portion that is kept airtight by the plugging, and the string member is disposed from the inner annular member via the opening member and the treatment instrument introduction portion. Arrived between the gripping parts. Therefore, the string member is not led out to the outside of the starter via the outer annular member and the plug portion. Therefore, in the state where the plugging device is closed by the plugging portion, there is no possibility that the external airtightness on the body cavity side is deteriorated.
自開創部卸除體腔取放器具時,首先係與處置具一起將封塞部自外側環狀部件卸除。而後,將處置具導入部自開創器拔除,再藉由將把持部件移動於自開創部遠離之方向,經由繩狀部件將體腔內之內側環狀部件與開創部件一 起拉出體外。 When the body cavity pick-and-place device is removed from the invasive portion, the plugging portion is first removed from the outer annular member together with the disposal tool. Then, the treatment device introduction portion is removed from the ejector, and the inner annular member and the priming member in the body cavity are separated by the rope member by moving the grasping member in a direction away from the priming portion. Pull out of the body.
此時,繩狀部件係位於開創部件之內側,並無與開創部直接接觸之情事,不會對開創部造成損傷。因此,根據本發明,可在不造成氣密性之劣化或開創部之損傷下,經由繩狀部件取出內側環狀部件。 At this time, the string member is located inside the pioneering member, and there is no direct contact with the creating portion, and the wound portion is not damaged. Therefore, according to the present invention, the inner annular member can be taken out via the string member without causing deterioration of the airtightness or damage of the breaking portion.
本發明中,上述把持部件可由環狀拉手部件所構成;該環狀拉手部件係在上述處置具導入部與該開創器之上述開創部件之間被夾著而固定,該處置具導入部係於裝設在上述開創部之上述開創器之體外側與開創部配置成同心狀,而後插入該開創器。 In the present invention, the grip member may be constituted by an annular handle member that is sandwiched and fixed between the treatment tool introduction portion and the priming member of the ejector, and the treatment instrument introduction portion is attached to The outside of the body of the above-mentioned starter installed in the above-mentioned creating portion is arranged concentrically with the creating portion, and then inserted into the opener.
此一情況下,於將體腔取放器具卸除之際,在將處置具導入部自開創器拔除後,將拉手部件移動於自開創部遠離之方向,藉而內側環狀部件被拉出體外。因此,可以拉手部件確實將內側環狀部件取出。 In this case, when the body cavity pick-and-place device is removed, after the treatment tool introduction portion is removed from the ejector, the handle member is moved away from the priming portion, and the inner annular member is pulled out of the body. . Therefore, the inner ring member can be taken out by the handle member.
本發明中,上述把持部件可由上述處置具導入部構成,上述繩狀部件之另一端可固定於該處置具導入部之體外側之部分。據此,也可將處置具導入部作為把持部件利用,因此可使體腔取放器具之構成簡便化。 In the present invention, the grip member may be configured by the treatment instrument introduction portion, and the other end of the string member may be fixed to a portion outside the body of the treatment instrument introduction portion. According to this, since the treatment instrument introduction portion can be used as the grasping member, the configuration of the body cavity pick-and-place device can be simplified.
本發明中,上述把持部件可由上述外側環狀部件構成,上述繩狀部件之另一端可固定於該外側環狀部件。據此,也可將外側環狀部件作為把持部件利用,因此可使體腔取放器具之構成簡便化。 In the invention, the grip member may be constituted by the outer annular member, and the other end of the string member may be fixed to the outer annular member. According to this, since the outer annular member can be used as the grip member, the configuration of the body cavity pick-and-place device can be simplified.
本發明中,上述開創器於上述內側環狀部件配置於上述開創部之體腔側、且上述外側環狀部件配置於上述開創 部之體外側之狀態下,係以上述外側環狀部件為捲取軸而於一方或另一方之捲取方向將上述開創部件之體外側的一部分捲取,而固定於上述開創部;上述處置具導入部具有適配於對應上述捲取方向而上述開創部件呈現之形狀的形狀。 In the above invention, the inner ring member is disposed on the body cavity side of the opening portion, and the outer annular member is disposed in the above-mentioned creation In the state of the outer side of the body, the outer annular member is a take-up shaft, and a part of the outer side of the wound member is taken up in one or the other winding direction, and is fixed to the creating portion; The lead-in portion has a shape adapted to correspond to the above-described winding direction and the shape of the above-described tapping member.
據此,由於處置具導入部具有與開創部件之捲取方向對應之開創器之形狀適配之形狀,因此可任意選擇開創部件之捲取方向或開創器之形狀。 According to this, since the treatment instrument introduction portion has a shape adapted to the shape of the starter corresponding to the winding direction of the priming member, the winding direction of the tampering member or the shape of the creator can be arbitrarily selected.
1,26、32、33、34‧‧‧體腔取放器具 1,26,32,33,34‧‧‧ body cavity pick and place apparatus
3‧‧‧體腔 3‧‧‧ body cavity
4‧‧‧開創部 4‧‧‧Creation Department
5‧‧‧開創器 5‧‧‧Creator
6‧‧‧處置具導入部(把持部件) 6‧‧‧Disposal device introduction unit (holding unit)
7‧‧‧封塞部 7‧‧‧Department
8‧‧‧拉手部件(把持部件) 8‧‧‧ handle parts (holding parts)
9‧‧‧內側環狀部件 9‧‧‧Inside ring parts
10‧‧‧外側環狀部件(把持部件) 10‧‧‧Outer annular parts (holding parts)
11‧‧‧開創部件 11‧‧‧Creating components
T‧‧‧繩狀部件 T‧‧‧ropod parts
第1圖係表示本發明第1實施方式之體腔取放器具裝設於患者之開創部的狀態之斜視剖視圖。 Fig. 1 is a perspective cross-sectional view showing a state in which a body cavity grasping device according to a first embodiment of the present invention is attached to a wound opening portion of a patient.
第2圖係表示第1圖之體腔取放器具之開創器裝設於開創部時或將開創器自開創部卸除時之態樣之剖視圖。 Fig. 2 is a cross-sectional view showing a state in which the starter of the body cavity pick-and-place device of Fig. 1 is attached to the starter portion or when the starter is removed from the starter portion.
第3圖係表示本發明第2實施方式之體腔取放器具裝設於患者之開創部的狀態之剖視圖。 Fig. 3 is a cross-sectional view showing a state in which a body cavity grasping and detaching device according to a second embodiment of the present invention is attached to a wound opening portion of a patient.
第4圖係表示經由第3圖之體腔取放器具使用彎嘴鉗的態樣之剖視圖。 Fig. 4 is a cross-sectional view showing a state in which a curved nose pliers is used via the body cavity pick-and-place device of Fig. 3.
第5圖係表示本發明第3實施方式之體腔取放器具裝設於患者之開創部的狀態之斜視剖視圖。 Fig. 5 is a perspective cross-sectional view showing a state in which a body cavity grasping and dispensing device according to a third embodiment of the present invention is attached to a wound opening portion of a patient.
第6圖係表示第5圖之體腔取放器具之開創器裝設於開創部時或將開創器自開創部卸除時之態樣之剖視圖。 Fig. 6 is a cross-sectional view showing the state in which the starter of the body cavity pick-and-place device of Fig. 5 is installed at the start-up portion or when the starter is removed from the start-up portion.
第7圖係表示本發明第4實施方式之體腔取放器具裝設於患者之開創部的狀態之剖視圖。 Fig. 7 is a cross-sectional view showing a state in which a body cavity grasping and dispensing device according to a fourth embodiment of the present invention is attached to a wound opening portion of a patient.
第8圖係表示本發明第5實施方式之體腔取放器具裝設於患者之開創部的狀態之斜視剖視圖。 Fig. 8 is a perspective cross-sectional view showing a state in which a body cavity grasping and dispensing device according to a fifth embodiment of the present invention is attached to a wound opening portion of a patient.
以下,茲以圖面說明本發明之實施方式。如第1圖所示,有關第1實施方式之體腔取放器具1,其具備:設於患者之體壁2且將通至體腔3內之開創部4維持於敞開狀態之開創器5、插入於開創器5內之處置具導入部6、用以將開創器5於體外側予以封塞之封塞部7、以及將開創器5自開創部4卸除時供操作之拉手部件8。 Hereinafter, embodiments of the present invention will be described with reference to the drawings. As shown in Fig. 1, the body cavity grasping device 1 according to the first embodiment includes a starter 5 that is provided in the body wall 2 of the patient and that maintains the opening portion 4 that has passed into the body cavity 3 in an open state, and is inserted. The treatment tool introduction portion 6 in the ejector 5, the closure portion 7 for sealing the ejector 5 on the outside of the body, and the handle member 8 for operation when the ejector 5 is detached from the erecting portion 4.
開創器5具有:配置於開創部4之體腔3側之內側環狀部件9、配置於開創部4之體外側之外側環狀部件10、以及一方之開口部固定有內側環狀部件9而令一方開口部固定有外側環狀部件10之可撓性開創部件11。拉手部件8係作為用以將開創部4之配置於體腔側的內側環狀部件9拉出體外時供把持之把持部件發揮機能。 The opener 5 has an inner annular member 9 disposed on the side of the body cavity 3 of the priming portion 4, an outer annular member 10 disposed outside the body of the blasting portion 4, and an inner annular member 9 fixed to one opening. The flexible opening member 11 of the outer annular member 10 is fixed to one opening. The handle member 8 functions as a grip member for gripping when the inner annular member 9 disposed on the body cavity side of the creation portion 4 is pulled out of the body.
外側環狀部件10及內側環狀部件9,均係可由特定之外力彈性變形自如,自由狀態下係呈圓形,典型上具有大致相同之直徑。開創部件11,例如係由包含聚胺基甲酸酯之具有彈性之薄膜所形成。 Both the outer annular member 10 and the inner annular member 9 are elastically deformable by a specific external force, and are circular in a free state, and typically have substantially the same diameter. The initiating member 11 is formed, for example, of an elastic film comprising a polyurethane.
開創器5未裝設於開創部4之狀態下,開創部件11具有筒狀之形態,且具有較外側環狀部件10及內側環狀部件9之外徑為小之直徑。 The ejector 5 is not attached to the blasting portion 4, and the blasting member 11 has a tubular shape and has a smaller outer diameter than the outer annular member 10 and the inner annular member 9.
外側環狀部件10,例如含有矽酮橡膠,具有大致長 方形之剖面形狀。內側環狀部件9,例如含有矽酮橡膠,具有大致圓形之剖面形狀。開創器5,於內側環狀部件9配置於開創部4之體腔側、外側環狀部件10配置於開創部4之體外側之狀態下,藉由以外側環狀部件10為捲取軸而將開創部件11之體外側之一部分捲取,可於使開創部件11之實質長度與體壁2之厚度對應下,將其裝設於開創部4。 The outer annular member 10, for example, contains an anthrone rubber and has a substantially long length Square profile shape. The inner annular member 9 contains, for example, an anthrone rubber and has a substantially circular cross-sectional shape. In the opener 5, the inner annular member 9 is disposed on the body cavity side of the priming portion 4, and the outer annular member 10 is disposed outside the body of the creator 4, and the outer annular member 10 is used as the take-up shaft. One portion of the outer side of the body of the invasive member 11 is taken up, and the substantial length of the breaking member 11 is attached to the opening portion 4 in accordance with the thickness of the body wall 2.
封塞部7具備:圓盤狀之頂蓋部件12、分別積層於頂蓋部件12之表面及裏面之第1膜部件17及第2膜部件18、以及用以將積層有第1膜部件17及第2膜部件18之頂蓋部件12氣密地裝設於外側環狀部件10之裝設環13。 The sealing portion 7 includes a disk-shaped top cover member 12, a first film member 17 and a second film member 18 which are laminated on the surface and the inside of the top cover member 12, and a first film member 17 for laminating the laminate. The top cover member 12 of the second film member 18 is airtightly attached to the attachment ring 13 of the outer annular member 10.
頂蓋部件12含有具可撓性之軟質樹脂,其係將具有與外側環狀部件10之內徑同程度之直徑的2片片體部件(凝膠片)14a及14b積層而形成。頂蓋部件12可由3片以上之片體部件構成。作為軟質樹脂,例如可使用矽酮橡膠、聚胺基甲酸酯、或聚乙烯。 The top cover member 12 includes a flexible flexible resin which is formed by laminating two sheet member members (gel sheets) 14a and 14b having the same diameter as the inner diameter of the outer annular member 10. The top cover member 12 can be composed of three or more sheet members. As the soft resin, for example, an anthrone rubber, a polyurethane, or a polyethylene can be used.
片體部件14a及14b,為了將圓柱狀之處置具導入體腔3內,於複數個部位具有貫通厚度方向之槽隙部16。片體部件14a之各槽隙部16係與片體部件14b之對應之槽隙部16成十字正交。 The sheet members 14a and 14b have a groove portion 16 penetrating in the thickness direction at a plurality of portions in order to introduce the cylindrical treatment tool into the body cavity 3. Each of the slot portions 16 of the sheet member 14a is cross-orthogonal with the corresponding slot portion 16 of the sheet member 14b.
第1膜部件17及第2膜部件18,含有具伸縮性且相對構成片體部件14a及14b之軟質樹脂具有滑動性之他種軟質樹脂,具有較頂蓋部件12之直徑為大之直徑。作為 該別種軟質樹脂,例如可使用聚胺基甲酸酯、聚氯乙烯、或聚乙烯。第1膜部件17及第2膜部件18,係以其間夾持頂蓋部件12之方式以其端部彼此接著。 The first film member 17 and the second film member 18 contain a soft resin which is stretchable and has a slidability with respect to the soft resin constituting the sheet members 14a and 14b, and has a diameter larger than the diameter of the top cover member 12. As As the other soft resin, for example, polyurethane, polyvinyl chloride, or polyethylene can be used. The first film member 17 and the second film member 18 are joined to each other with their end portions so as to sandwich the top cover member 12 therebetween.
第1膜部件17,於與片體部件14a之各槽隙部16的中心位置重疊之位置處,具有用以使通經各槽隙部16之處置具通過之圓孔19。圓孔19具有處置具之直徑的40~90%之範圍之直徑。 The first film member 17 has a circular hole 19 through which the treatment tool passing through each of the slit portions 16 passes at a position overlapping the center position of each of the slit portions 16 of the sheet member 14a. The circular hole 19 has a diameter in the range of 40 to 90% of the diameter of the treatment tool.
第2膜部件18,於與片體部件14b之各槽隙部16對應之位置處,具有用以使通經各槽隙部16之處置具通過之槽隙部20。槽隙部20係與對應於片體部件14b之槽隙部16正交,具有與槽隙部16同程度之長度。 The second film member 18 has a slit portion 20 for passing the treatment tool passing through each of the slit portions 16 at a position corresponding to each of the slit portions 16 of the sheet member 14b. The slot portion 20 is orthogonal to the slot portion 16 corresponding to the sheet member 14b and has the same length as the slot portion 16.
藉由第1膜部件17之圓孔19、片體部件14a及14b之槽隙部16、及第2膜部件18之槽隙部20,構成可在維持氣密性下供處置具通過之插通部21。 The circular hole 19 of the first film member 17, the slot portion 16 of the sheet members 14a and 14b, and the slot portion 20 of the second film member 18 constitute a socket through which the disposal tool can be passed while maintaining airtightness. Passing 21.
裝設環13,例如含有天然橡膠或聚胺基甲酸酯,剖面大致為U字形,其可供裝設於開創器5之外側環狀部件10。裝設環13裝設於外側環狀部件10時,係以使頂蓋部件12位於外側環狀部件10之體外側的方式接著第1膜部件17及第2膜部件18之端部。 The mounting ring 13, for example, contains natural rubber or polyurethane, and has a substantially U-shaped cross section, which can be mounted on the outer ring member 10 on the outer side of the opener 5. When the mounting ring 13 is attached to the outer annular member 10, the end portions of the first film member 17 and the second film member 18 are attached so that the top cover member 12 is positioned outside the body of the outer annular member 10.
處置具導入部6係插入於裝設在開創部4之開創器5內,除供保護開創部件11外,又構成處置具之朝體腔內之導入路徑。處置具導入部6具有漏斗狀之形狀,具有相當於漏斗之出口側之筒狀部22、與筒狀部22之入口側鄰接之圓錐部23、以及與圓錐部23之體外側鄰接之環狀壁 部24。 The treatment instrument introduction portion 6 is inserted into the ejector 5 installed in the nucleus portion 4, and in addition to the protection initiation member 11, constitutes an introduction path in the body cavity of the treatment tool. The treatment instrument introduction portion 6 has a funnel shape, and has a tubular portion 22 corresponding to the outlet side of the funnel, a conical portion 23 adjacent to the inlet side of the tubular portion 22, and a ring adjacent to the outer side of the body portion of the conical portion 23. wall Department 24.
處置具導入部6具有大致可納入裝設於開創部4之開創器5及將其封塞之封塞部7所形成之空間內的形狀及尺寸。因此,環狀壁部24具有較開創器5之外側環狀部件10稍小之直徑及稍短之軸向長度。 The treatment instrument introduction portion 6 has a shape and a size that can be substantially included in the space formed by the starter 5 installed in the creation portion 4 and the closure portion 7 that is sealed. Therefore, the annular wall portion 24 has a slightly smaller diameter and a shorter axial length than the outer annular member 10 of the opener 5.
筒狀部22具有較開創器5所敞開之開創部4之直徑稍小、但較導入之處置具之外徑為大之內徑。例如具有可供直徑5〔mm〕左右之處置具3支集體通過之內徑。筒狀部22之長度係與體壁2之厚度為同程度。作為構成處置具導入部6之素材,可使用聚胺基甲酸酯、聚氯乙烯、聚乙烯等之彈性素材。 The tubular portion 22 has an inner diameter which is slightly smaller than the diameter of the opening portion 4 to which the opener 5 is opened, but which is larger than the outer diameter of the introduced treatment tool. For example, it has an inner diameter through which three sets of disposal tools having a diameter of about 5 [mm] can pass collectively. The length of the tubular portion 22 is the same as the thickness of the body wall 2. As the material constituting the treatment tool introduction portion 6, an elastic material such as polyurethane, polyvinyl chloride or polyethylene can be used.
如第2圖所示,繩狀部件T係以其一端固定於開創器5之內側環狀部件9,以其另一端固定於拉手部件8之固定部25。而且,相對開創部4之開創器5之裝設,係於繩狀部件T通過開創器5之內側、且拉手部件8離開至外側環狀部件10之上方之狀態下進行。 As shown in Fig. 2, the string member T is fixed to the inner annular member 9 of the opener 5 at one end thereof, and is fixed to the fixing portion 25 of the handle member 8 at the other end. Further, the installation of the opener 5 with respect to the creating portion 4 is performed in a state where the string member T passes through the inside of the opener 5 and the tab member 8 is separated from the outer annular member 10.
繩狀部件T之長度係設定為:於相對裝設於開創部4之開創器5,拉手部件8如第2圖中兩點鏈線所示般之配置的狀態下,較可採取之最短長度具有充分餘裕之長度。 The length of the string member T is set to be the shortest length that can be taken in the state in which the handle member 8 is disposed opposite to the starter 5 of the starter portion 4 and the handle member 8 is arranged as shown by the two-dot chain line in FIG. Has a sufficient margin.
於此一構成中,於使用體腔取放器具1為患者進行手術時,首先係於預設之開創部4裝設開創器5。即,於繩狀部件T通過開創器5之內側,且拉手部件8離開至外側環狀部件10之上方的狀態下,將開創器5之內側環狀部件9撓曲並自開創部4插入體腔3內,並於體腔3內展開 之。藉此,內側環狀部件9將會配置於開創部4之體腔3側,而開創器5之外側環狀部件10將會成為位於體外側之狀態。 In this configuration, when the patient is operated using the body cavity grasping and dispensing device 1, the starter 5 is first attached to the predetermined opening portion 4. That is, when the string member T passes the inside of the opener 5 and the tab member 8 is separated from above the outer annular member 10, the inner annular member 9 of the opener 5 is flexed and inserted into the body cavity from the priming portion 4. 3, and expand in the body cavity 3 It. Thereby, the inner annular member 9 is disposed on the side of the body cavity 3 of the rupture portion 4, and the outer annular member 10 of the ejector 5 is placed outside the body.
然後,把持著外側環狀部件10,將外側環狀部件10作為軸而捲取開創部件11,藉而將開創部件11於徑向擴張而形成具有所期望大小之直徑的開口部,且使開創部件11之長度與體壁2之厚度對應。藉此,開創器5之裝設終了,而成為第2圖所示般之狀態。 Then, the outer annular member 10 is gripped, and the opening member 11 is wound around the outer annular member 10 as a shaft, whereby the opening member 11 is radially expanded to form an opening having a diameter of a desired size, and the opening is made. The length of the member 11 corresponds to the thickness of the body wall 2. Thereby, the installation of the starter 5 is completed, and it is in the state shown in FIG.
其次,於開創部件11之位於體外側的部分之內側,以與外側環狀部件10或開創部4大致同心之方式配置拉手部件8。亦即,拉手部件8於第2圖中係配置於如兩點鏈線所示般之位置。 Next, the handle member 8 is disposed on the inner side of the portion of the opening member 11 located outside the body so as to be substantially concentric with the outer annular member 10 or the opening portion 4. That is, the handle member 8 is disposed at a position as shown by the two-dot chain line in Fig. 2 .
而後,將處置具導入部6插入開創器5。此時,開創部件11處所形成之開口部內係插入有處置具導入部6之筒狀部22。藉此,處置具導入部6係成為適於(fit)自開創器5之體外側到達開創部4之部分的區域之狀態。又,拉手部件8係夾於開創器5與處置具導入部6之間而被固定,繩狀部件T係以拉手部件8之固定部25為起點而成為通過開創器5與處置具導入部6之間,再通過開創器5之內側而到達內側環狀部件9之路徑上的狀態。 Then, the treatment instrument introduction portion 6 is inserted into the ejector 5 . At this time, the tubular portion 22 of the treatment instrument introduction portion 6 is inserted into the opening formed in the initiation member 11. Thereby, the treatment instrument introduction portion 6 is in a state suitable for fitting a region from the outside of the body of the creator 5 to the portion of the nucleus portion 4. Further, the handle member 8 is fixed between the starter 5 and the treatment instrument introduction portion 6, and the string member T is passed through the opener 5 and the treatment instrument introduction portion 6 from the fixing portion 25 of the handle member 8. The state between the inner ring member 9 and the inner annular member 9 is reached again through the inner side of the opener 5.
其次,將配置成手術用之2、3支處置具通經其插通部21之封塞部7,安裝於外側環狀部件10。亦即,藉由以裝設環13覆蓋外側環狀部件10,可將封塞部7裝設於開創器5。此一裝設,係以將各處置具之前端側束集並自 處置具導入部6之筒狀部22使該前端側導入體腔3內之方式進行。 Next, the two or three treatment tools arranged for surgery are passed through the closure portion 7 of the insertion portion 21, and are attached to the outer annular member 10. That is, the plugging portion 7 can be attached to the starter 5 by covering the outer annular member 10 with the mounting ring 13. This installation is to bundle the front end sides of each disposal tool and The tubular portion 22 of the treatment instrument introduction portion 6 is introduced into the body cavity 3 so that the distal end side is introduced into the body cavity 3.
藉此,體腔3內成為氣密狀態,而成為可進行使用各處置具之手術的狀態。手術進行之期間,繩狀部件T係如第1圖所示位於封塞部7之體腔3側,因此不會有先前般之因繩狀部件T之存在使得體腔3之氣密狀態劣化之顧慮。又,此一期間,藉由處置具導入部6可防止處置具所造成之開創部件11或開創部4之損傷。 Thereby, the inside of the body cavity 3 is in an airtight state, and it is in a state in which the operation using each treatment tool can be performed. During the operation, the string member T is located on the side of the body cavity 3 of the sealing portion 7 as shown in Fig. 1, so that there is no fear that the airtight state of the body cavity 3 is deteriorated due to the presence of the string member T. . Moreover, in this period, damage to the rupturing member 11 or the rupturing portion 4 caused by the treatment tool can be prevented by the treatment instrument introduction portion 6.
手術完了,於將體腔取放器具1自開創部4卸除時,首先係將封塞部7與處置具一起自外側環狀部件10卸除。其後,將處置具導入部6自開創器5拔除。然後,藉由將拉手部件8自開創部4朝遠離之方向移動,而經由繩狀部件T將內側環狀部件9與開創部件11一起自體腔3內拉出。 When the surgery is completed, when the body cavity pick-and-place device 1 is removed from the creator 4, the plugging portion 7 is first removed from the outer ring member 10 together with the disposal tool. Thereafter, the treatment instrument introduction unit 6 is removed from the ejector 5 . Then, by moving the handle member 8 away from the erecting portion 4, the inner annular member 9 and the priming member 11 are pulled out from the body cavity 3 via the string member T.
此時,由於繩狀部件T經常位於開創部件11之內側,因此繩狀部件T不會使開創部4受到損傷。於內側環狀部件9之卸除一終結,則體腔取放器具1之卸除終了。 At this time, since the string member T is often located inside the crevice member 11, the string member T does not damage the crevice portion 4. After the removal of the inner annular member 9 is terminated, the removal of the body cavity pick-and-place device 1 is completed.
根據本實施方式,由於處置具導入部6係由彈性素材所構成,因此處置具導入部6相對外力可以高追隨性對應。又,由於處置具導入部6之筒狀部22具有可使處置具3支集體通過之直徑,因此利用體腔取放器具1即使作為處置具將例如2支彎嘴鉗導入至體腔3內,仍可高度維持各彎嘴鉗之插拔動作或旋迴動作之自由度。 According to the present embodiment, since the treatment instrument introduction portion 6 is composed of elastic material, the treatment instrument introduction portion 6 can correspond to the external force with high followability. Further, since the tubular portion 22 of the treatment instrument introduction portion 6 has a diameter through which the treatment tool 3 can collectively pass, the body cavity grasping device 1 can introduce, for example, two curved nose pliers into the body cavity 3 as a treatment tool. The degree of freedom of the insertion and extraction or the rotation of each curved nose pliers can be highly maintained.
又,封塞部7由於即便是經由其插通部21而有複數 支處置具通過時仍可維持氣密性,並無利用套管之止回閥而確保氣密性之必要。因此,可無須經由套管而直接將處置具通入封塞部7內。是以,不會招致源於套管之相互干擾(糾葛)的操作性之惡化。藉此,可經由封塞部7而令複數之處置具接近配置,可提昇處置具之操作性。 Further, the plugging portion 7 has plural numbers even through the insertion portion 21 thereof. The airtightness can still be maintained when the support device passes, and it is not necessary to use the check valve of the casing to ensure airtightness. Therefore, the treatment tool can be directly introduced into the closure portion 7 without the need for a cannula. Therefore, the deterioration of the operability due to the mutual interference (entanglement) of the casing is not caused. Thereby, a plurality of disposal tools can be arranged close to each other via the sealing portion 7, and the operability of the treatment tool can be improved.
又,由於係在將封塞部7裝設於開創器5之前將處置具導入部6插入開創器5,因此即便是作為處置具使用彎嘴鉗之情況,與利用套管將處置具插入體腔3內之情況相同,可防止處置具所造成之開創部4之損傷。又,也可防止處置具所造成之開創部件11之損傷。又,如此般之效果,可僅藉由將處置具導入部6插入開創器5之簡單操作而獲得。 Further, since the treatment instrument introduction portion 6 is inserted into the ejector 5 before the closure portion 7 is attached to the ejector 5, even if the bending tool is used as the treatment tool, the treatment tool is inserted into the body cavity using the cannula. The same is true in the case of 3, which prevents damage to the creating portion 4 caused by the disposal tool. Moreover, damage to the rupturing member 11 caused by the treatment tool can also be prevented. Moreover, such an effect can be obtained only by a simple operation of inserting the treatment instrument introduction portion 6 into the ejector 5.
又,此時,與利用複數個由若干種類之素材或零件所構成之可撓性套管的情況相較,藉由可以彈性素材之一體成形品所構成之處置具導入部6,可以極低之成本保護開創部4或開創部件11。 Further, in this case, compared with the case where a plurality of flexible sleeves composed of a plurality of types of materials or components are used, the treatment instrument introduction portion 6 which can be formed of one of the elastic material can be extremely low. The cost protection creation 4 or the creation of the component 11.
此外,用以將開創部件11與內側環狀部件9一起拉出之作為拉環而供利用之拉手部件8,於配置於開創部件11上後係由處置具導入部6所固定,因此於手術期間中,可以安定之狀態預先予以留置於其配置位置。 In addition, the handle member 8 which is used as a pull tab for pulling the priming member 11 together with the inner annular member 9 is fixed by the treatment tool introduction portion 6 after being placed on the erecting member 11, and thus is operated by surgery. During the period, the state of stability can be reserved in advance in its configuration position.
另,於體腔取放器具1裝設於開創部4之狀態下,拉手部件8係位於開創器5內之體外側,且繩狀部件T係配置成自內側環狀部件9經過開創部件11與處置具導入部6之間而到達拉手部件8。因此,繩狀部件T係存在於封 塞部7及開創器5之內側,不會從處置具導入部6與封塞部7或外側環狀部件10之間導出至外部,因此封塞部7所達成之氣密性不會由繩狀部件T損害。 Further, in a state in which the body cavity pick-and-place device 1 is attached to the start-up portion 4, the handle member 8 is located outside the body in the starter 5, and the string member T is disposed from the inner ring member 9 through the start-up member 11 and The handle introduction portion 6 is passed between the handle portions 6 and reaches the handle member 8. Therefore, the rope component T is present in the seal Since the inside of the plug portion 7 and the starter 5 is not led out from between the treatment instrument introduction portion 6 and the closure portion 7 or the outer annular member 10, the airtightness achieved by the closure portion 7 is not caused by the rope. The component T is damaged.
第3圖係表示本發明第2實施方式之體腔取放器具。第3圖中,針對與第1圖中之構成要件相同之構成要件係標示以相同之符號。此一體腔取放器具26中,與第1圖之體腔取放器具1之情況相較,於開創器5之外側環狀部件10所為之開創部件11的捲取方向係成相反。因此,於體腔取放器具26裝設於開創部4之狀態下,開創器5之開創部件11於外側環狀部件10之內側,係形成較第1圖之情況頂角較小之等腰三角形之剖面形狀。 Fig. 3 is a view showing a body cavity pick-and-place device according to a second embodiment of the present invention. In the third embodiment, the same constituent elements as those in the first embodiment are denoted by the same reference numerals. In the integrated cavity pick-and-place tool 26, the winding direction of the tapping member 11 which is the outer ring member 10 of the opener 5 is reversed as compared with the case of the body cavity pick-and-place tool 1 of Fig. 1. Therefore, in the state in which the body cavity pick-and-place device 26 is attached to the creating portion 4, the creating member 11 of the opener 5 is formed inside the outer annular member 10, and an isosceles triangle having a smaller vertex angle than that of the first drawing is formed. The shape of the section.
因此,體腔取放器具26之處置具導入部27的圓錐部28之外形,係形成為適配於具有上述剖面形狀之開創部件11之形狀般之圓錐狀者。又,與圓錐部28鄰接之筒狀部30及環狀壁部29亦具有適配於開創器5之形狀之形狀及尺寸。 Therefore, the conical portion 28 of the treatment instrument introduction portion 27 of the body cavity pick-and-place device 26 has an outer shape and is formed into a conical shape that is adapted to the shape of the fracture member 11 having the above-described cross-sectional shape. Further, the tubular portion 30 and the annular wall portion 29 adjacent to the conical portion 28 also have a shape and a size adapted to the shape of the opener 5.
本實施方式之狀況亦然,設有將開創器5自開創部4卸除時供操作之拉手部件8,且拉手部件8與內側環狀部件9之間設有繩狀部件T。拉手部件8與上述相同係配置於開創器5內,而由處置具導入部6固定。 Also in the present embodiment, a handle member 8 for operating when the starter 5 is removed from the erecting portion 4 is provided, and a string member T is provided between the tab member 8 and the inner annular member 9. The handle member 8 is disposed in the ejector 5 in the same manner as described above, and is fixed by the treatment instrument introduction portion 6.
又,本實施方式之情況亦然,處置具導入部27之筒狀部30具有較開創器5所敞開之開創部4之直徑稍小之具有可供直徑5〔mm〕左右之處置具3支集體通過之內徑。因此,如第4圖所示,藉由裝設於開創部4之體腔取 放器具26,經由封塞部7及處置具導入部27,可將作為處置具之複數之彎嘴鉗31插入至體腔內使用。 Further, in the case of the present embodiment, the tubular portion 30 of the treatment instrument introduction portion 27 has a treatment tool having a diameter of about 5 [mm] which is slightly smaller than the diameter of the opening portion 4 to which the opener 5 is opened. The inner diameter of the collective passage. Therefore, as shown in FIG. 4, it is taken by the body cavity installed in the creating part 4. The ejector 26 can insert a plurality of curved nose pliers 31 as a treatment tool into the body cavity via the occlusion portion 7 and the treatment instrument introduction portion 27.
此一情況亦然,可高度地保持各彎嘴鉗31之插拔操作或旋廻操作之自由度。又,此時,可藉由處置具導入部27而防止彎嘴鉗31之彎曲部與開創部4或開創器5之開創部件11接觸所造成之對其等之損傷。 Also in this case, the degree of freedom in the insertion/removal operation or the twisting operation of each of the curved nose pliers 31 can be highly maintained. Further, at this time, it is possible to prevent the bending portion of the curved nose pliers 31 from coming into contact with the breaking member 4 or the breaking member 11 of the starter 5 by the treatment tool introduction portion 27, thereby causing damage thereto.
體腔取放器具26之其他各點係與第1圖及第2圖之體腔取放器具1之情況相同,可獲得與第1實施方式之情況相同之效果。又,根據本實施方式,可將開創器5之開創部件11捲取於與第1實施方式之情況相反之方向。 The other points of the body cavity pick-and-place device 26 are the same as those of the body cavity pick-and-place device 1 of Figs. 1 and 2, and the same effects as in the case of the first embodiment can be obtained. Moreover, according to the present embodiment, the rupturing member 11 of the ejector 5 can be wound in the opposite direction to the case of the first embodiment.
第5圖係表示本發明第3實施方式之體腔取放器具。第5圖中,針對與第1圖中之構成要件相同之構成要件係標記以相同之符號。此一體腔取放器具32中,作為將配置於開創部4之體腔3側之內側環狀部件9拉出體外而經把持之把持部件,係使用處置具導入部6。 Fig. 5 is a view showing a body cavity pick-and-place device according to a third embodiment of the present invention. In the fifth drawing, the same constituent elements as those in the first embodiment are denoted by the same reference numerals. In the integrated cavity pick-and-place device 32, the handle introduction portion 6 is used as a grip member that pulls the inner annular member 9 disposed on the body cavity 3 side of the priming portion 4 and grips it.
如第6圖所示,繩狀部件T係以其一端固定於內側環狀部件9,以其另一端經由開創部件11之內側而固定於處置具導入部6之體外側之部分。本實施方式中,繩狀部件T之另一端係固定於環狀壁部24之固定部25。繩狀部件T之長度係設定為:於裝設於開創部4之開創器5內插入處置具導入部6之狀態下,較自一端固定於內側環狀部件9之部分至另一端固定於環狀壁部24之固定部25的最短之長度,具有充分餘裕之長度。 As shown in Fig. 6, the string member T is fixed to the inner annular member 9 at one end thereof, and the other end thereof is fixed to the outer side of the body of the treatment instrument introduction portion 6 via the inner side of the ejector member 11. In the present embodiment, the other end of the string member T is fixed to the fixing portion 25 of the annular wall portion 24. The length of the string-shaped member T is set to be fixed to the ring from the one end fixed to the inner annular member 9 to the other end in a state in which the treatment tool introduction portion 6 is inserted into the starter 5 of the opening portion 4. The shortest length of the fixing portion 25 of the wall portion 24 has a sufficient margin.
於將體腔取放器具32裝設於開創部4之際,於將處 置具導入部6插入開創器5時,繩狀部件T係經由開創部件11之內側而成為延伸至處置具導入部6之固定部25之狀態。因此,繩狀部件T之大部分,係成為夾於開創部件11與處置具導入部6之間之狀態。 When the body cavity pick-and-place device 32 is installed in the start-up portion 4, at the place where When the device introduction portion 6 is inserted into the ejector 5, the string member T is in a state of extending to the fixing portion 25 of the treatment instrument introduction portion 6 via the inside of the tamping member 11. Therefore, most of the string member T is sandwiched between the ripper member 11 and the treatment instrument introduction portion 6.
於將體腔取放器具32自開創部4卸除時,如第6圖所示,藉由將處置具導入部6自開創器5拔除,並進一步朝自開創部4離開之方向移動,可經由繩狀部件T將內側環狀部件9與開創部件11一起自體腔3內拉出。此時,由於繩狀部件T經常位於開創部件11之內側,因此繩狀部件T不會使開創部4受到損傷。 When the body cavity pick-and-place tool 32 is removed from the erecting unit 4, as shown in Fig. 6, by removing the treatment instrument introduction unit 6 from the ejector 5 and further moving away from the erecting unit 4, it is possible to The string member T pulls the inner annular member 9 together with the tapping member 11 from the body cavity 3. At this time, since the string member T is often located inside the crevice member 11, the string member T does not damage the crevice portion 4.
又,繩狀部件T於處置具導入部6插入開創器5內之狀態下,內側環狀部件9側之一部分係位於開創部件11之內側,而其他部分係位於開創部件11與處置具導入部6之間。即,封塞部7處於將開創器5封塞之狀態下,繩狀部件T不會經由開創器5與封塞部7之間而導出至體腔取放器具32之外側,因此封塞部7所達成之體腔取放器具32之氣密性不會劣化。 Further, in a state where the cord-shaped member T is inserted into the introducer 5 in the state in which the treatment instrument introduction portion 6 is inserted, one portion of the inner annular member 9 side is located inside the crevice member 11, and the other portion is located at the erecting member 11 and the treatment instrument introduction portion. Between 6. That is, in the state in which the plugging portion 7 is closed by the ejector 5, the string member T is not guided to the outside of the body cavity accommodating device 32 via the gap between the ejector 5 and the occluding portion 7, and therefore the damming portion 7 is closed. The airtightness of the body cavity pick-and-place device 32 achieved does not deteriorate.
根據本實施方式,可將處置具導入部6亦作為把持部件利用,因此可使體腔取放器具32之構成簡便化。至於其他各點係與第1圖之第1實施方式之情況相同。 According to the present embodiment, since the treatment instrument introduction portion 6 can also be used as the grasping member, the configuration of the body cavity pick-and-place device 32 can be simplified. The other points are the same as those in the first embodiment of Fig. 1 .
第7圖係表示本發明第4實施方式之體腔取放器具。第7圖中,針對與第3圖或第5圖中之構成要件相同之構成要件係標記以相同之符號。此一體腔取放器具33中,與第5圖之體腔取放器具32之情況相較,在開創器5之 外側環狀部件10所為之開創部件11的捲取方向係成相反。因此,於體腔取放器具33裝設於開創部4之狀態下,開創器5之開創部件11於外側環狀部件10之內側,係形成較第1圖之情況頂角較小之等腰三角形之剖面形狀。 Fig. 7 is a view showing a body cavity pick-and-place device according to a fourth embodiment of the present invention. In the seventh drawing, the same constituent elements as those in the third or fifth drawing are denoted by the same reference numerals. In the one-piece cavity pick-and-place device 33, compared with the case of the body cavity pick-and-place device 32 of FIG. 5, in the opener 5 The winding direction of the tapping member 11 for the outer annular member 10 is reversed. Therefore, in the state in which the body cavity pick-and-place device 33 is attached to the start-up portion 4, the tapping member 11 of the opener 5 is formed inside the outer ring-shaped member 10, and an isosceles triangle having a smaller vertex angle than that of the first figure is formed. The shape of the section.
因此,體腔取放器具33之處置具導入部27的圓錐部28之外形,係成適配於具有上述剖面形狀之開創部件11之形狀般之圓錐狀者。又,與圓錐部28鄰接之筒狀部30及環狀壁部29之固定部25亦具有適配於開創器5之形狀之形狀及尺寸。體腔取放器具33之其他各點,係與第5圖之體腔取放器具32之情況相同。 Therefore, the conical portion 28 of the treatment instrument introduction portion 27 of the body cavity grasping device 33 has an outer shape and is shaped like a conical shape having the shape of the fracture member 11 having the above-described cross-sectional shape. Further, the tubular portion 30 adjacent to the conical portion 28 and the fixing portion 25 of the annular wall portion 29 also have a shape and a size adapted to the shape of the opener 5. The other points of the body cavity pick-and-place device 33 are the same as those of the body cavity pick-and-place device 32 of Fig. 5.
根據本實施方式,與第5圖之實施方式一併考慮,可發現作為處置具導入部,可採用具有適配於與開創部件之捲取方向對應的開創器之形狀的形狀者。因此,可重視開創部件之捲取方向或開創器之形狀之任一者,而選擇所期望之開創部件之捲取方向或是開創器之形狀。 According to the present embodiment, in consideration of the embodiment of Fig. 5, it has been found that as the treatment tool introduction portion, a shape having a shape adapted to the shape of the opener corresponding to the winding direction of the priming member can be employed. Therefore, it is possible to select any one of the winding direction of the component or the shape of the starter, and select the winding direction of the desired component or the shape of the starter.
第8圖係表示本發明第5實施方式之體腔取放器具。第8圖中,針對與第1圖中之構成要件相同之構成要件係標記以相同之符號。此一體腔取放器具34中,為了將開創部4之體腔3側所配置之內側環狀部件9拉出體外而被把持之把持部件,係使用外側環狀部件10。 Fig. 8 is a view showing a body cavity pick-and-place device according to a fifth embodiment of the present invention. In the eighth embodiment, the same constituent elements as those in the first embodiment are denoted by the same reference numerals. In the integrated cavity pick-and-place tool 34, the outer annular member 10 is used to pull the inner annular member 9 disposed on the side of the body cavity 3 of the opening portion 4 and pull the outer annular member 9 to be gripped.
如第8圖所示,繩狀部件T係以一端固定於內側環狀部件9,以另一端經由開創部件11之內側而固定於外側環狀部件10之固定部25。繩狀部件T之長度係設定為: 於處置具導入部6插入裝設於開創部4之開創器5之狀態下,較一端固定於內側環狀部件9之部分至另一端固定於外側環狀部件10之固定部25的最短長度,具有充分餘裕之長度。 As shown in Fig. 8, the string member T is fixed to the inner annular member 9 at one end, and is fixed to the fixing portion 25 of the outer annular member 10 via the inner side of the ejector member 11 at the other end. The length of the string member T is set to: The shortest length of the fixing portion 25 that is fixed to the inner annular member 9 from one end to the other end is fixed to the fixing portion 25 of the outer annular member 10 in a state in which the treatment instrument introduction portion 6 is inserted into the starter 5 attached to the opening portion 4. Has a sufficient margin.
為了將體腔取放器具34安裝而於開創部4裝設開創器5之際,內側環狀部件9係配置於開創部4之體腔3側,而以外側環狀部件10為軸,開創部件11乃經捲取。與此相伴,繩狀部件T亦係自固定部25側由外側環狀部件10所捲取。藉此,繩狀部件T之未被捲取之殘餘部分,係成為經由開創部件11之內側延伸至內側環狀部件9之狀態。 When the body cavity pick-and-place tool 34 is attached and the starter 5 is attached to the starter 4, the inner annular member 9 is disposed on the body cavity 3 side of the fringe portion 4, and the outer annular member 10 is used as an axis to open the component 11 It was taken up. Along with this, the string member T is also taken up from the outer annular member 10 from the side of the fixing portion 25. Thereby, the remaining portion of the string member T that has not been wound up is in a state of extending to the inner annular member 9 via the inner side of the tapping member 11.
而後,若裝設於開創部4之開創器5中插入處置具導入部6,則繩狀部件T之未被捲取之殘餘部分除了內側環狀部件9側之一部分以外,其大部分係成為由開創器5之開創部件11與處置具導入部6之間夾著之狀態。 Then, when the treatment tool introduction portion 6 is inserted into the ejector 5 of the erecting portion 4, the remaining portion of the string-shaped member T that has not been wound is replaced by a portion other than the inner annular member 9 side. The state between the opening member 11 of the starter 5 and the treatment instrument introduction portion 6 is sandwiched.
為了卸除體腔取放器具34而自開創部4拔除開創器5時,以上述外側環狀部件10為軸之開創部件11之捲取獲得解除,與此相伴,繩狀部件T也沿開創部件11之內側成為延伸之狀態。而後,藉由令外側環狀部件10移動於自開創部4離開之方向,可經由繩狀部件T將內側環狀部件9與開創部件11一起自體腔3內拉出。此時,由於繩狀部件T經常位於開創部件11之內側,因此繩狀部件T不會使開創部4受到損傷。 When the opener 5 is removed from the erecting portion 4 in order to remove the body cavity accommodating device 34, the winding of the creator 11 with the outer annular member 10 as the axis is released, and the string member T is also along the starting member. The inner side of 11 becomes an extended state. Then, by moving the outer annular member 10 in the direction away from the blasting portion 4, the inner annular member 9 and the priming member 11 can be pulled out from the body cavity 3 via the string member T. At this time, since the string member T is often located inside the crevice member 11, the string member T does not damage the crevice portion 4.
又,繩狀部件T於體腔取放器具34裝設於開創部4 之狀態下,不會經由開創器5與封塞部7之間導出至體腔取放器具34之外側,因此封塞部7所達成之體腔取放器具34之氣密性不會劣化。 Moreover, the string member T is mounted on the opening portion 4 in the body cavity pick-and-place device 34. In this state, the outside of the body cavity pick-and-place device 34 is not guided between the starter 5 and the plugging portion 7, and therefore the airtightness of the body cavity pick-and-place device 34 achieved by the plugging portion 7 is not deteriorated.
根據本實施方式,外側環狀部件10亦可作為把持部件利用,因此可將體腔取放器具34之構成簡便化。至於其他各點,係與第1圖之第1實施方式之情況相同。 According to the present embodiment, since the outer annular member 10 can also be used as a grip member, the configuration of the body cavity pick-and-place tool 34 can be simplified. The other points are the same as those in the first embodiment of Fig. 1 .
以上,係就本發明之實施方式進行說明,然本發明不受實施方式之限定。例如,開創器只要是可供安裝封塞部及處置具導入部者即可,非為以外側環狀部件將開創部件之一部分捲取之形式者也可。 The embodiments of the present invention have been described above, but the present invention is not limited by the embodiments. For example, the starter may be any one that can be attached to the plugging portion and the treatment instrument introduction portion, and may be a form in which the outer annular member is partially wound up.
又,拉手部件並無完全閉合成環狀之必要,也可部分開放。另,拉手部件並無正圓之必要,也可為多角形或橢圓形者。 Moreover, the handle member is not completely closed into a ring shape, and may be partially opened. In addition, the handle parts are not necessary for a perfect circle, and may also be polygonal or elliptical.
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US20100228094A1 (en) * | 2009-03-06 | 2010-09-09 | Ethicon Endo-Surgery, Inc. | Surgical access devices and methods providing seal movement in predefined movement regions |
TW201330819A (en) * | 2012-01-31 | 2013-08-01 | Sumitomo Bakelite Co | Medical treatment instrument |
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US8021296B2 (en) * | 1999-12-01 | 2011-09-20 | Atropos Limited | Wound retractor |
US20060149137A1 (en) * | 2005-01-05 | 2006-07-06 | Applied Medical Resources Corporation | Easily placeable and removable wound retractor |
EP2237815B1 (en) * | 2008-01-22 | 2020-08-19 | Applied Medical Resources Corporation | Surgical instrument access device |
EP2572664A1 (en) * | 2010-05-19 | 2013-03-27 | O Nam Seo | Surgical instrument guide and protection cap for such a surgical instrument guide |
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US20100228094A1 (en) * | 2009-03-06 | 2010-09-09 | Ethicon Endo-Surgery, Inc. | Surgical access devices and methods providing seal movement in predefined movement regions |
TW201330819A (en) * | 2012-01-31 | 2013-08-01 | Sumitomo Bakelite Co | Medical treatment instrument |
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