WO2015125826A1 - Sac de collecte médical - Google Patents

Sac de collecte médical Download PDF

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Publication number
WO2015125826A1
WO2015125826A1 PCT/JP2015/054447 JP2015054447W WO2015125826A1 WO 2015125826 A1 WO2015125826 A1 WO 2015125826A1 JP 2015054447 W JP2015054447 W JP 2015054447W WO 2015125826 A1 WO2015125826 A1 WO 2015125826A1
Authority
WO
WIPO (PCT)
Prior art keywords
bag
outer tube
cable
base
tube
Prior art date
Application number
PCT/JP2015/054447
Other languages
English (en)
Japanese (ja)
Inventor
清一 中島
吾妻　聖臣
秀憲 高木
瞬 新田
Original Assignee
国立大学法人大阪大学
株式会社八光
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 国立大学法人大阪大学, 株式会社八光 filed Critical 国立大学法人大阪大学
Priority to CN201580009368.7A priority Critical patent/CN106028955B/zh
Priority to JP2016504137A priority patent/JP6530370B2/ja
Publication of WO2015125826A1 publication Critical patent/WO2015125826A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00287—Bags for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2946—Locking means

Definitions

  • the present invention relates to a medical collection bag for storing an organ removed during surgery and taking it out of the body, particularly in a surgical operation using an endoscope.
  • a recovery bag In order to prevent overflowing and splashing, a recovery bag has been used in which a cut piece is stored in a bag (bag) inserted into a body cavity through a trocar from outside the body and taken out from the body together with the bag.
  • NOTES transluminal endoscopic surgery
  • the present inventors applied NOTES as a medical collection bag applicable from the forceps channel of the endoscope, and a bag provided with a through hole around the opening, and the bag through the through hole of the bag.
  • the bag and the elastic band are pushed out from the outer cylinder tube by expanding the bag by sliding in the outer cylinder tube, and the elastic band is pulled back into the outer cylinder tube and re-stored.
  • An instrument comprising an opening means, applied to the above application, the outer tube and the connecting cable have bendable flexibility, and the outer tube is adapted to a forceps channel and has an outer diameter of 1.4 mm. As described above, a device having a size of 5.5 mm or less is proposed. (Patent Document 2)
  • the instrument in order to insert the collection bag to the target site using the forceps channel of the flexible endoscope as a passage and deploy the bag, the instrument is required to be adapted and have a long and small diameter.
  • the bag at the front end is not necessarily deployed with the opening, which is in a usable state at the stage of insertion, facing upward, and naturally the direction needs to be corrected after deployment.
  • the outer diameter of the instrument can be set to be relatively thick in accordance with the trocar serving as an insertion passage, There is no need to increase the length to the bag.
  • the straight insertion makes it possible to apply a highly rigid (not necessarily required to be flexible) outer tube. For example, it is not difficult to change the direction of the bag without causing a twist or the like by rotating the entire instrument.
  • the instrument in order to bend and insert the thin long passage of the forceps channel of the flexible endoscope as in Patent Document 2 as in Patent Document 2, the instrument also has a long outer tube, a small diameter, and can be inserted. It is necessary to configure with flexibility. In this case, it is possible to operate by hand due to interference caused by contact with the forceps channel of the outer tube, torsion or expansion / contraction due to insufficient rigidity of the instrument, and hooking of the sliding part at the curved part. There is a concern that will not work well with the back of the tip.
  • the collection bag of the present invention is used for NOTES or the like that inserts the forceps channel of a flexible endoscope as a passage, and even if it is a long and thin instrument with flexibility that can be bent,
  • An object of the present invention is to provide a medical recovery bag that can be formed into an intended state following the hand operation of the front end bag and is excellent in usability.
  • the medical collection bag of the present invention has a through hole in the edge of the opening, a bag capable of opening and closing the opening, and a mode in which the opening is expanded in a natural state by being inserted into the through hole of the bag.
  • An elastic wire stored in the memory an outer tubular tube made of a long flexible resin tube and housed in the distal end in a state in which the bag and the elastic wire are reduced in diameter, and a tip portion near the elastic wire.
  • a connecting cable formed from a flexible metal stranded wire that retracts the elastic wire into the outer tube and re-stores it to close the bag; and a gripping unit and an operating unit connected to the proximal end of the outer tube And the proximal end of the connecting cable
  • a cable base that is connected and becomes a gripping part and an operation part.
  • the cable base slides with the outer tube pipe base and is relatively movable in the axial direction, and is connected to the connection cable.
  • the cable base ring and a cable base ring connected to be rotatable are configured such that the bag rotates following the rotation operation of the cable base ring.
  • the outer tubular tube base is provided with a groove extending in the axial direction and a locking portion provided as a circumferential cut at the groove end, and the cable basic body has a protrusion that engages with the groove and the locking portion.
  • the protrusion is engaged with the groove to slide to restrict the movement in the shaft and the rotation direction, and the protrusion is engaged with the locking part. The sliding was restricted.
  • the outer tube is formed with a length of 1000 mm or more and 1800 mm or less, and an outer diameter of 1.4 mm or more and 5.5 mm or less.
  • the bag was configured to be pushed out from the outer tube and deployed, closed once, then reopened by the operation from the outside, and further equipped with a means capable of being closed again.
  • the re-deployable means is formed by a string member having one end connected to the proximal end of the bag and the other end extending to the outside through the lumen of the outer tube. At that time, it is preferable that the proximal end portion of the string member is connected to the outer tube base.
  • the another means that can be re-deployed is such that one end is connected to the proximal end of the bag, is passed through the lumen of the outer tube, and the other end is directly or directly at a site interlocked with the connection cable. It is indirectly connected, and part or all of it is formed including a spring-like elastic member.
  • the re-expandable means is preferably formed by connecting a spring-like elastic member and a string member.
  • the collection bag is inserted from a forceps channel of an endoscope and used together with an endoscope, for example, for use in NOTES.
  • the bag, the elastic wire, the outer tube, and the connection cable which are the insertion part to the forceps channel of the flexible endoscope, are all flexible, they are curved corresponding to the insertion path.
  • the outer tube and the connection cable can be easily reduced in diameter and length, the instrument can be applied to a procedure such as NOTES.
  • the connecting cable is formed from a twisted metal wire with a good balance between flexibility and rigidity and excellent in torque characteristics.
  • the connecting cable is rotatably connected to the cable base body and an elastic wire inserted through the through hole of the bag.
  • the bag By connecting to the cable base ring, the bag can be rotated following the rotation operation of the cable base ring that is a hand operation, and the opening is easily directed upward by hand operation after the bag is inserted. And can be turned in any direction during surgery. Further, since the connection cable passes through the inner tube and the lumen of the cable basic body and is connected to the cable base ring, it is not necessary to rotate the entire device when the bag is rotated.
  • the outer tube tube base is provided with a groove and a locking portion
  • the cable basic body is provided with a projection portion that engages with the groove
  • the operation in the axial direction and the rotational direction can be accurately performed when the bag is deployed and closed.
  • the structure of the elastic wire inserted without being fixed to the through hole of the bag and the tip of the elastic wire stored in the outer tube are positioned inside the outer tube so that the bag is sealed when the bag is closed. It can be made into a purse-like shape, and the collected excised pieces will not overflow or scatter.
  • the length of the outer tube is 100 mm or more and 1800 mm or less, and forming the outer diameter to 1.4 mm or more and 5.5 mm or less, it is applied to NOTES and is, for example, equal in length from the oral cavity to the stomach interior. It can be applied to a case that needs to be inserted into a forceps channel of a thin flexible endoscope and can be operated without difficulty.
  • FIG. 1 shows an overall configuration diagram of the present embodiment.
  • the medical collection bag of this embodiment is applied to NOTES and inserted and operated from a forceps channel of a flexible endoscope.
  • a tissue piece excised by surgery is accommodated in the bag, and the bag is closed outside the body.
  • This is an organ recovery bag intended for recovery.
  • This collection bag is provided with a through hole 11 around a peripheral edge portion that becomes an opening, and a cut portion 12 is provided at one position of the through hole 11, and the opening expands and closes to store the tissue piece.
  • the outer tube 3 is applied to the NOTES, which is the object of this embodiment, and has a small surface friction resistance because it can be smoothly inserted into a bendable forceps channel having a small diameter and a long length of a flexible endoscope. It is made of a flexible resin tube such as fluororesin, and its size is compatible with general flexible endoscopes. In addition, considering the length to the surgical site and operability, the length is 1000 mm or more and 1800 mm.
  • the outer diameter should be 1.4 mm or more and 5.5 mm or less (1.8 mm in this example) as appropriate for the inner diameter range (2.0 mm to 5.5 mm type) of a general flexible endoscope channel. (2.0 mm type) and 2.5 mm (2.8 mm type)).
  • this metal twisted wire has no expansion and contraction in the axial direction, is excellent in torque properties, and has a large surface area compared to metal wires and the like, Since the contact with the outer cylindrical tube 3 does not become a large surface contact, the outer cylindrical tube 3 has a small diameter, a long axis, and is curved in the middle due to good sliding and no strong frictional force in the outer cylindrical tube. Even in this case, following the relative movement in the axial direction between the outer tube tube base 5 and the cable basic body 6 described later and the rotation operation of the cable base ring 7, it is connected to the distal end.
  • the elastic wire 2 (bag 1) can be rotated in the intended direction, and the protrusion and storage operations can be ensured.
  • the operation part of this collection bag is connected to the proximal end of the outer tube 3 and grips the outer tube tube base 5, and is connected to the proximal end of the connection cable 4 and grips and operates the basic cable body 6 and the cable base.
  • the outer tube tube base 3 is a long tube body that is slidably inserted into the interior made of a resin molded product, and has a distal end portion of the outer tube tube 3 and A connection portion with the reinforcing tube 32 is formed, and a male screw 55 is formed, and a connecting cap 56 in which a female screw is formed sandwiching the expanded portion at the end of the outer tube 3 and the extended portion at the end of the reinforcing tube 32. Tightened and connected.
  • a groove 51 for sliding and sliding the cable basic body 6 in the axial direction is provided on the side surface, and the cable basic body 6 is slightly rotated and engaged with the rear end portion of the groove 51. It is formed with an engaging portion 52 that can be kept. Further, a notch 54 for passing through the groove 51 and a locking protrusion 63 of the cable basic body 6 which will be described later in communication with the groove 51 and a locking protrusion 63 necessary for the attachment to the outer tube 5. Is formed with an escape portion 53 for fitting into the locking portion 52.
  • the cable basic body 6 has a passage passing through the connection cable 4 and the guide pipe 41 inside, and serves as a slide portion 62 and an operation portion of a rod-like cylindrical body that is slidably inserted into the outer cylindrical tube 5.
  • the holding portion 61 is formed of a holding portion 63, which is engaged with the groove 51 of the outer tube base 5 and slides in the axial direction at the front end portion of the slide portion 62.
  • a plurality of guide protrusions 64 are provided on the same axis as the locking protrusion 63.
  • the grip portion 61 is provided with a cable base ring 7 which will be described later and a rotary slide receiving portion 65 which becomes a rotatable connection portion.
  • the cable base ring 7 connects the connecting cable 4 and the guide pipe 41 to the cable connecting portion 71 on the distal end side by bonding or the like, and the rotating sliding receiving portion 65 and the rotating sliding portion of the cable basic body 6.
  • the peg 73 is inserted into the rear end portion.
  • the connection cable 4 is connected to the cable base ring 7 and formed so as to be able to rotate and slide with the cable base body 6, without rotating the outer tube tube base 5 and the cable base body 6. The direction of the back can be changed only by rotating the cable base ring 7.
  • FIG. 6 shows the state of the bag at each operation stage, in which A represents the pre-operation bag storage stage, B represents the bag deployment stage, and C represents the bag closure stage.
  • FIG. 7 shows the state of the hand operating unit corresponding to each stage.
  • the bag 1 and the elastic wire 2 protrude from the outer tube 3 by advancing the locking protrusion 63 of the cable basic body 6 to the outermost end of the groove 51 with respect to the outer tube tube base 5 from the storing stage, and the elastic wire
  • the bag is developed by the elastic restoring force of 2.
  • FIG. 8 is a collection bag provided with means that can be re-deployed in another embodiment of the present invention, in which A indicates a tip portion and B indicates a hand operation portion.
  • the re-deployable means of this example connects the distal end portion 81 of the thread to the proximal end of the bag, passes through the lumen of the outer tube 3 in parallel with the connection cable 4, and the other end (proximal position of the thread).
  • the end portion 82) was formed by a thread 8 serving as a string member connected to the outer tube tube base 5.
  • the yarn 8 serving as the string member is made of a high-strength polyamide resin or metal wire having no stretchability (in this example, a polyamide resin yarn), and the yarn distal end portion 81 is tied to the proximal end of the bag 1 by ligation or the like.
  • the thread proximal end 82 is connected to the outer tube base 5 through the lumen of the outer tube 3, and in this example, the thread take-out hole 57 is placed at an appropriate position on the outer tube base 5.
  • the yarn proximal end portion 82 of the yarn 8 was taken out from the take-out hole 57, and fixed and connected by ligation or adhesion outside.
  • the thread 8 is set to a length that is positioned substantially at the distal end portion of the outer tube 3 when the bag 1 protrudes from the outer tube 3, and the length of the protruding portion of the bag 1 in the stored state before the bag 1 protrudes.
  • the length (the slide length of the outer tube tube base 5 and the cable basic body 6) is accommodated in the outer tube 3 in a bent state and is fully stretched by the protrusion of the bag 1. Is set.
  • the bag 1 can be reopened and reclosed by opening and closing the bag 1 from the external operation unit.
  • the connecting means of the yarn end is not limited to this example, and the bag 1 is not moved from the distal end position of the outer tube 3 after the bag 1 protrudes from the outer tube 3.
  • FIG. 9 is a schematic diagram showing the operation and operation of the present embodiment, in which A is when the bag is stored before use, B is when the bag is deployed, C is when the bag is closed, and D is when the bag is redeployed. Since the basic operation and operation of this embodiment are the same as those of the above-described embodiment, only the yarn 8 of the re-deployment means and the re-deployment are added. Before use, the thread 8 is accommodated in the inner tube 3 in a state where the length of the bag protruding (the length of the slide between the outer tube tube base 5 and the cable basic body 6) is bent (FIG. A).
  • the bag 1 is recovered from the body together with the flexible endoscope in this state.
  • the elastic wire 2 is moved forward by moving the cable basic body 6 forward relative to the outer tube base 3 again. Protrudes from the outer tube 3, while the proximal end (thread 8) of the bag does not change position so that the bag 1 is naturally redeployed with the opening of the elastic wire 2 (FIG. D).
  • FIG. 10 shows the main components of an example using a spring-like elastic member as another embodiment of the re-deployable means of the present invention, and A is a state where the spring-like elastic member is contracted (before use) , And a state where the bag is unfolded) and a state where B is stretched (a state where the bag is closed).
  • the re-deployable means of this example uses a spring 9 in a natural state made of metal as a spring-like elastic member, and one end (proximal end) of the spring 9 is interlocked with the connection cable 4.
  • the same thread as that of the above-described embodiment is connected to the proximal end of the bag 1, parallel to the connection cable 4, and through the lumens of the outer tube 3 and the outer tube base 5.
  • the spring 9 is provided so as to cover the outer periphery of the connection cable 4, and the distal end is connected to the thread 8 and the proximal end is connected to the guide pipe 41 that covers and reinforces the outer periphery of the connection cable 4. ing.
  • the guide pipe 41 since the guide pipe 41 is connected to the cable base ring 7 together with the connection cable 4, the guide pipe 41 moves in conjunction with the connection cable 4.
  • the thread distal end portion 81 of the re-deployable means is at the proximal end of the bag 1,
  • the proximal end is connected and set to a non-sliding position interlocked with the outer tube 3 such as the outer tube 3 or the outer tube tube base 5, and can be re-deployed when a spring-like contraction member (for example, the spring 9) is used.
  • the distal end portion 81 of the thread is connected to the proximal end of the bag 1, and the proximal end portion is set to a sliding position interlocking with the connection cable 4 such as the connection cable 4, the guide pipe 41, or the cable base ring 7. Is done. According to this, the bag 1 once closed can be re-deployed and re-closed only by the sliding operation of the outer tube tube base 5 and the cable basic body 6 of the hand operation section.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un sac de collecte médical qui est applicable à la chirurgie endoscopique transluminale par orifice naturel (NOTES), et qui peut former un sac au niveau d'une extrémité distale dans un état souhaité, conformément à des opérations proximales, même dans un outil flexible étroit long qui peut être inséré dans un canal de forceps d'un endoscope souple. Ce sac de collecte médical comprend : un sac (1) qui se dilate et se ferme, et qui a un trou traversant dans la périphérie d'une ouverture ; un fil élastique (2) qui est inséré à travers le trou traversant dans le sac, et qui mémorise la forme pour dilater l'ouverture ; un tube externe flexible (3) qui loge le sac et le fil élastique ; un câble de raccordement (4) qui est constitué d'un fil multibrin métallique flexible, est relié au fil élastique et coulisse à l'intérieur du tube externe ; une base de tube externe (5) qui est reliée au tube externe, et qui sert de section d'actionnement ; un corps de base de câble (6) qui est mobile dans la direction axiale, et qui coulisse avec la base de tube externe qui sert de section d'actionnement du câble de raccordement ; et une bague de base de câble (7) qui est reliée au câble de raccordement, et qui est reliée de façon rotative au corps de base de câble. Le sac de collecte médical est formé de telle sorte que le sac tourne en fonction de l'opération de rotation de la bague de base de câble (7).
PCT/JP2015/054447 2014-02-18 2015-02-18 Sac de collecte médical WO2015125826A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CN201580009368.7A CN106028955B (zh) 2014-02-18 2015-02-18 医疗用回收袋
JP2016504137A JP6530370B2 (ja) 2014-02-18 2015-02-18 医療用回収バッグ

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2014028531 2014-02-18
JP2014-028531 2014-02-18

Publications (1)

Publication Number Publication Date
WO2015125826A1 true WO2015125826A1 (fr) 2015-08-27

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2015/054447 WO2015125826A1 (fr) 2014-02-18 2015-02-18 Sac de collecte médical

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Country Link
JP (1) JP6530370B2 (fr)
CN (1) CN106028955B (fr)
WO (1) WO2015125826A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105816207A (zh) * 2016-05-19 2016-08-03 武汉百格资产管理有限公司 一种袋口结构及采用该袋口结构的腹腔镜取物袋
CN114302683A (zh) * 2019-10-24 2022-04-08 奥林巴斯株式会社 内窥镜用持针器及缝合针的操作方法

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112165912B (zh) * 2018-06-15 2024-05-17 奥林巴斯株式会社 医疗用处置器具

Citations (3)

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Publication number Priority date Publication date Assignee Title
JPH09534A (ja) * 1995-06-19 1997-01-07 Asahi Optical Co Ltd 内視鏡用バスケット型把持具
JP2010099477A (ja) * 2008-10-23 2010-05-06 Tyco Healthcare Group Lp 外科手術用回収装置
JP2013208229A (ja) * 2012-03-30 2013-10-10 Hakko Co Ltd 医療用回収バッグ

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JP3417778B2 (ja) * 1997-01-17 2003-06-16 ペンタックス株式会社 内視鏡用処置具
US8021372B2 (en) * 2001-07-05 2011-09-20 Annex Medical, Inc. Medical retrieval device with independent rotational means
CA2836948C (fr) * 2004-08-09 2015-10-27 Tyco Healthcare Group Lp Appareil medical d'application sur la peau
CN101589943B (zh) * 2008-05-30 2011-03-30 普威国际有限公司 可分离式组织取物袋装置
CN203122579U (zh) * 2013-03-18 2013-08-14 黄英 一种腹腔镜取物器

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH09534A (ja) * 1995-06-19 1997-01-07 Asahi Optical Co Ltd 内視鏡用バスケット型把持具
JP2010099477A (ja) * 2008-10-23 2010-05-06 Tyco Healthcare Group Lp 外科手術用回収装置
JP2013208229A (ja) * 2012-03-30 2013-10-10 Hakko Co Ltd 医療用回収バッグ

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105816207A (zh) * 2016-05-19 2016-08-03 武汉百格资产管理有限公司 一种袋口结构及采用该袋口结构的腹腔镜取物袋
CN114302683A (zh) * 2019-10-24 2022-04-08 奥林巴斯株式会社 内窥镜用持针器及缝合针的操作方法
CN114302683B (zh) * 2019-10-24 2024-04-26 奥林巴斯株式会社 内窥镜用持针器及缝合针的操作方法

Also Published As

Publication number Publication date
CN106028955A (zh) 2016-10-12
JPWO2015125826A1 (ja) 2017-03-30
JP6530370B2 (ja) 2019-06-12
CN106028955B (zh) 2019-05-14

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