WO2020130551A1 - Appareil d'extraction de tissu - Google Patents

Appareil d'extraction de tissu Download PDF

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Publication number
WO2020130551A1
WO2020130551A1 PCT/KR2019/017840 KR2019017840W WO2020130551A1 WO 2020130551 A1 WO2020130551 A1 WO 2020130551A1 KR 2019017840 W KR2019017840 W KR 2019017840W WO 2020130551 A1 WO2020130551 A1 WO 2020130551A1
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WO
WIPO (PCT)
Prior art keywords
pouch
handle assembly
string
abdominal cavity
extraction device
Prior art date
Application number
PCT/KR2019/017840
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English (en)
Korean (ko)
Inventor
김진성
Original Assignee
김진성
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 김진성 filed Critical 김진성
Publication of WO2020130551A1 publication Critical patent/WO2020130551A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A61B10/0266—Pointed or sharp biopsy instruments means for severing sample

Definitions

  • the present invention relates to a device for excising human tissues excised from the abdominal cavity into the body during laparoscopic surgery, and more particularly, to a tissue extraction device that has been miniaturized so that it can be injected into the abdominal cavity using a 5 pie trocar.
  • Laparoscopic Surgery is a surgical method in which a surgical instrument is inserted into the abdominal cavity through several small incisions on the human body, and unlike conventional open surgery, it minimizes wounds caused by surgery and recovers patients. You can do it quickly. Such laparoscopic surgery is also referred to as minimally invasive surgery or endoscopic surgery.
  • Laparoscopic surgery is mainly used for surgery to remove and remove some or all of tissues or organs in the human body.
  • it is used in nephrectomy, cholecystectomy, duodenectomy, jejunectomy, myomectomy, and the scope of application is gradually expanding.
  • tissues' Human tissues or organs (hereinafter referred to as'tissues') that are excised in the process of laparoscopic surgery are stored in a translucent pouch made of synthetic resin and are excreted through the incision of the human body.
  • the pouch containing the tissue provides a function to prevent the resected tissue from infecting or damaging surrounding organs during the withdrawal process.
  • These pouches are referred to as “endo-bags” and “lap-bags”, and together with the instruments for manipulating them, form part of the tissue extraction device.
  • Trocar also known as a “trocar”
  • a trocar also known as a “trocar”
  • gas e.g., carbon dioxide
  • Trocar injects gas (e.g., carbon dioxide) into the abdomen to cause it to swell, thereby creating a space for surgical instruments to move and allowing the doctor to secure a field of view.
  • gas e.g., carbon dioxide
  • it provides a path for inserting various instruments for surgery, for example, endoscopy camera, scissors, forceps, stapler, and the like.
  • Trocar is used in various sizes depending on the type of surgery and purpose of use, and is classified into 5 pie and 10 pie according to its inner diameter.
  • the 5 pie trocar is a product for inserting surgical instruments about 5 mm in diameter into the abdominal cavity, and the inner diameter of the 5 pie trocar has a size of 5.6 to 6.0 mm.
  • the 10-pie trocar is a product for inserting surgical instruments of about 10 mm in diameter into the abdominal cavity, and the inner diameter of the 10-pie trocar has a size of 10.6 to 11.0 mm.
  • an incision formed in the human body for trocar insertion may leave a wound on the patient, which may be a factor in lengthening the recovery period after surgery, and may increase the risk of infection during surgery. Therefore, it is desirable to make the incision with the smallest number and as small as possible.
  • the tissue extraction device had an outer diameter of 10 mm, and it was difficult to minimize the wound after surgery because it was used with at least 10 pie trocars during laparoscopic surgery.
  • the present invention is to solve this problem, and an object of the present invention is to provide a tissue extraction device with a minimum diameter so that it can be used in a 5 pie trocar.
  • tissue extraction device that is easy to operate during laparoscopic surgery.
  • an object of the present invention is to provide a tissue extraction device having a simplified configuration and improved processability.
  • the tissue extraction device for achieving the above object is a pouch for containing the abdominal abdominal tissue during laparoscopic surgery, a handle assembly for manipulating the position of the pouch in the abdominal cavity, and the pouch connected to the pouch A string used to withdraw the outside of the abdominal cavity, and a guide tube for storing the pouch and the handle assembly in order to guide the pouch and the handle assembly to be inserted into the abdominal cavity through a trocar for laparoscopic surgery.
  • the guide tube has an outer diameter of 5.5 mm or less, and the outer diameter of the handle assembly has a smaller size than the inner diameter of the guide tube.
  • the handle assembly supports an inlet portion of the pouch, an elastic member having a shape extended laterally to open the inlet portion of the pouch, and a handle bar for manipulating the position of the elastic member in the abdominal cavity.
  • a front cap for coupling the elastic member to the front end of the handle bar, and the front cap is assembled to the handle bar by a screw coupling method.
  • the handle bar has a hollow hollow rod shape, and the string extends from the annular portion of the pouch, and extends from the annular portion to penetrate the hollow interior of the handlebar. It has an extended portion.
  • the front cap includes a screw portion formed on an outer circumferential surface for coupling with the handle bar, and an outer circumferential surface groove portion recessed in the longitudinal direction of the outer circumferential surface to receive the extension portion of the string, and the extension portion of the string is the It is supported on the outer circumferential groove by a loose fitting method.
  • the handle assembly further includes a rear cap coupled to the rear end of the handle bar, and the rear cap is assembled to the handle bar by a screw coupling method, and the extension portion of the string is provided on an outer circumferential surface of the rear cap.
  • a draw groove for drawing out of the handle bar is formed, and the extension portion of the string is supported on the draw groove in a loose fitting manner.
  • an uneven portion for preventing slipping is formed on the outer peripheral surface of the rear cap.
  • the rear cap has a screw portion for screwing with the handle bar, and the rear cap has a length of 2 pitch or less so that it can be easily separated by a force applied in the lateral direction.
  • the elastic member is coupled through the center of the front cap, and a bent portion bent outward in the lateral direction is formed at the rear end of the elastic member so that the elastic member does not deviate from the front of the front cap.
  • the front end of the elastic member is formed to be rounded so as to be curved so as to prevent the pouch from being caught and damaged when the elastic member moves forward of the guide tube.
  • tissue extraction device for withdrawing the excised human tissue out of the abdominal cavity during laparoscopic surgery
  • the tissue extraction device is a pouch for containing the excised human tissue
  • the handle assembly for the operation of moving the pouch inside the abdominal cavity, and the pouch and the handle assembly through the trocar inserted into the abdominal cavity while receiving the front portion of the handle assembly in which the pouch and the pouch are combined therein
  • It includes a guide tube for guiding a portion of the front of the abdominal cavity to be introduced into the inside, and a string connected to the inlet of the pouch to pull the pouch from the outside of the abdominal cavity, wherein the pouch and the handle assembly are the guide tube In the inserted state, the outer diameter of the tissue extraction device is 5.5 mm or less.
  • the handle assembly has a shape extended in both directions in the absence of elastic deformation and supports an elastic member around the inlet of the pouch, a handle bar in which a part of the front is inserted into the abdominal cavity when used, and the elastic member It includes a front cap for coupling to the front end of the handle bar, and the handle bar has a hollow shape inside, and the string extends through the inside of the handle bar through an outer circumferential groove formed on the front circumferential surface of the front cap.
  • the handle assembly further includes a rear cap coupled to the rear end of the handle bar, and an outgoing groove for drawing the string is formed on an outer circumferential surface of the rear cap.
  • the string is configured to be coupled to the handle assembly in a loose fit manner, so that only the handle assembly can be removed while the pouch and the string are left in the abdominal cavity during laparoscopic surgery.
  • the outer diameter of the guide tube has a size of 5.5 mm or less, and the outer diameter of the handle assembly embedded in the guide tube has a smaller size than the inner diameter of the guide tube, and thus 5 pi trocar during laparoscopic surgery Can be used together. Therefore, in contrast to the conventional tissue extraction device used with 10 pie trocar, there is an advantage of minimizing wounds caused by surgery and enabling rapid recovery of patients.
  • the outer diameter of the handle assembly has a smaller size than the inner diameter of the guide tube, only the guide tube can be easily removed while leaving the handle assembly in the process of laparoscopic surgery, and a free space for manipulating the handle assembly in the trocar is secured. It has the advantage of easy operation for changing the pouch position.
  • the string is not tied to the handle assembly, and is loosely coupled to the handle assembly, there is an advantage that only the handle assembly can be easily removed while only the pouch and the string are left in the abdominal cavity.
  • front cap and the rear cap are configured to be assembled by a screwing method with respect to the handlebar, problems of long assembly time associated with the use of conventional adhesives, physical property deformation of the adhesive site material, and damage due to long-term storage, etc. There is a risk-free advantage.
  • FIG. 1 is a perspective view showing a tissue extraction device according to a preferred embodiment of the present invention.
  • FIG. 2 is an exploded perspective view showing a tissue extraction device according to an embodiment of the present invention.
  • Figure 3 is a side view showing a tissue extraction device according to a preferred embodiment of the present invention and a cross-sectional view accordingly.
  • FIGS. 4 and 5 are a plan view and a cross-sectional view showing a tissue extraction device according to an embodiment of the present invention.
  • 6 to 13 are views schematically showing a method of using a tissue extraction device according to a preferred embodiment of the present invention in laparoscopic surgery.
  • FIGS. 1 to 5 a tissue extraction apparatus according to a preferred embodiment of the present invention will be described with reference to FIGS. 1 to 5.
  • the tissue extraction device (1) includes a pouch (10) for containing the resected tissue in the human body during laparoscopic surgery.
  • the pouch 10 may be made of a biocompatible polymer material, for example, polyurethane, polyethylene, polypropylene, vinyl, latex, or the like.
  • the pouch 10 is manufactured in such a way that a film made of such a polymer resin is superimposed in two layers and the circumferential part is adhered or fused.
  • the pouch 10 is preferably made of transparent or translucent so that the inside is clearly visible.
  • the pouch 10 has an open inlet 11.
  • the tissue contained in the pouch 10 is introduced through the inlet 11.
  • a hollow rim portion 12 is formed around the inlet portion 11.
  • the hollow rim portion 12 forms an empty passage along the periphery of the inlet portion 11, into which the ring portion 21 and the elastic member 31 of the string 20 to be described later are inserted. .
  • the tissue extraction device 10 includes a string 20 connected to the pouch 10 and a handle assembly 30 for manipulating the position and movement of the pouch 10 in the abdominal cavity.
  • the string 20 is connected to the pouch 10 and is used for pulling the pouch 10 out of the abdominal cavity after surgery.
  • the string 20 may be made of a material such as cotton, nylon, silk, or synthetic resin.
  • the string 20 is made using a long strand of one strand, making a hollow ring knot at one end of the long thread, and penetrating the other end through the ring knot.
  • the ring part 21 forming one circle and the extension part 22 extending from the ring part 21 are constituted (see FIG. 2).
  • the ring portion 21 made in this way is embedded in the hollow rim portion 12 of the pouch 10, and when the user pulls the extension portion 22, the ring portion 21 shrinks and the opening portion 11 of the pouch 10 ) Is used in a closed way.
  • the handle assembly 30 is inserted into the hollow rim portion 12 of the pouch 10 to support the pouch 10 inlet 11 and a pair of elastic members (maintaining the open state of the inlet 11) 31), and a handle bar 33 in the form of a rod coupled to the elastic member 31.
  • the elastic member 31 has an extended shape that is spread laterally (see FIGS. 2 and 4).
  • a direction parallel to the handle bar 33 is called a longitudinal direction
  • a direction orthogonal to the longitudinal direction is called a lateral direction.
  • the end of the both ends of the handle bar 33 to which the elastic member 31 is coupled is referred to as a front end
  • the opposite end is referred to as a rear end.
  • the elastic member 31 is preferably made of a metal material that is elastically deformable while having a predetermined stiffness, and may be made of, for example, stainless steel, titanium, nitinol, or the like. In addition, it may be made of synthetic resin.
  • the elastic member 31 has a pair of left and right symmetrical shapes.
  • the elastic member 31 forms a circular or elliptical shape extending from side to side.
  • a pair of elastic members 31 is coupled to the handlebar 33 at its rear end.
  • the handle bar 33 has a hollow hollow pipe shape.
  • the handle bar 33 is used to move the pouch 10 to a desired position by a user holding and moving during surgery.
  • the handle bar 33 is preferably made of a material having predetermined rigidity and elasticity so that the elastic member 31 can be supported and moved with sufficient force, for example, a metal such as stainless steel, aluminum alloy, or synthetic resin material. Can be manufactured as.
  • the front end cap 32 and the rear cap 34, which prevent it, are coupled to both open ends of the handle bar 33.
  • the front cap 32 is coupled to the front end of the handle bar 33 by a screw coupling method, and for this purpose, a thread portion 32a forming a male screw is formed on the outer circumferential surface of the front cap 32. It is formed, and a thread portion 33a forming a female screw is formed on the inner circumferential surface of the front end of the handle bar 33.
  • the rear end of the elastic member 31 is coupled through the center hole 32b formed in the front-rear direction from the center of the front cap 32 (see FIG. 5).
  • a bending part 31a bent outward in the lateral direction is formed at the rear end of the elastic member 31.
  • the front cap 32 can be made of plastic injection. In this case, it is preferable to integrally process the elastic member 31 and the front cap 32 by an insert molding method. By doing so, a separate assembly process for coupling the elastic member 31 to the front cap 32 can be omitted.
  • the extension portion 22 of the string 20 extends outwardly through the hollow portion 33c inside the handlebar 33.
  • the front cap 32 is formed with an outer circumferential groove 32c forming a passage through which the extension 22 passes.
  • the outer circumferential groove 32c is formed in a straight line in the front-rear direction over the entire length of the front cap 32 (see FIG. 4).
  • the outer peripheral surface groove portion 32c is also formed in the thread portion 32a.
  • the string 20 is not tightly fixed on the outer circumferential groove 32c and is slidably supported loosely (hereinafter referred to as a "loose fitting method"). That is, the string 20 can be easily separated from the groove 32c without the user's effort.
  • the rear cap 34 is coupled to the rear end of the handlebar 33.
  • a thread portion 34a forming a male screw is formed in front of the rear cap 34, and a thread portion 33b forming a female screw is formed on the inner circumferential surface of the rear end of the handle bar 33.
  • a withdrawal groove 34b forming a passage through is formed (see FIG. 4).
  • the string 20 is not tightly fixed on the withdrawal groove 34b, but is supported in a slidably loose fit manner.
  • the rear cap 34 is configured to be easily detachable from the handle bar 33. Since the rear cap 34 is screwed to the handle bar 33, it can be separated from the handle bar 33 by rotation in the unlocking direction. It is preferable that the length La of the threaded portion 34a is short to a length within twice the thread pitch (see FIG. 3) so that it can be easily separated by one or two rotations (see FIG. 3). On the outer circumferential surface of the rear cap 34, an uneven portion 34c (see FIG. 1) for preventing slipping with a finger is formed and provides a function of increasing friction. In addition, since the threaded portion 34a of the rear cap 34 has a short length, it can be easily separated by an external force applied in the lateral direction.
  • the tissue extraction device 1 includes a guide tube 40.
  • the guide tube 40 guides the aforementioned pouch 10 and handle assembly 30 to be inserted into the abdominal cavity through a trocar.
  • the elastic member 31 of the pouch 10 and the handle assembly 30 is stored in the guide tube 40 in a folded state, and is exposed and used outside during surgery.
  • the guide tube 40 has a length of about 30 cm (centimeter), but may be longer or shorter depending on the application.
  • the handlebar 33 has a length of about 40 cm (centimeter), but it can also vary depending on the specification.
  • the guide tube 40 is preferably made of a biocompatible material as an element whose front end is inserted into the abdominal cavity during a surgical procedure, and may be made of metal or plastic resin. As the metal, stainless steel, aluminum alloy, or the like can be used.
  • the elastic member 31 When the elastic member 31 is stored in the guide tube 40 together with the pouch 10, the elastic member 31 is elastically deformed along the longitudinal direction and stored in a folded state.
  • the front end of the elastic member 31 has a smooth curved shape without an angled corner (see enlarged portion “A” in FIG. 1). That is, the front end of the elastic member 31 has a rounded shape. This is to prevent the pouch 10 from being torn or damaged while the elastic member 31 stored in the guide tube 40 is pushed forward and moved.
  • the tissue extraction device 1 according to the present invention, the guide tube 40, the outer diameter (Da) has a size of 5.5mm or less, so that it can be inserted into the abdominal cavity through a 5 pie trocar, preferably Has a size of 5.0 to 5.5 mm. Since the pouch 10 and the handle assembly 30 are stored in the guide tube 40 and stored, the overall outer diameter of the tissue extraction device 1 is determined by the outer diameter Da of the guide tube 40.
  • the outer diameter Dc of the handle assembly 30 is smaller than the inner diameter Db of the guide tube 40 so that the handle assembly 30 can be embedded in the guide tube 40.
  • the outer diameter (Dc) of the handle assembly 30 is the outermost diameter of the rest of the elements except the elastic member 31, that is, the cross section of the front cap 32, the handle bar 33, and the rear cap 34 Means
  • the outer diameter Dc of the handle assembly 30 may be 4.5 mm.
  • the tissue extraction device 1 can be used for laparoscopic surgery using a 5 pi trocar.
  • the overall outer diameter Dc of the handle assembly 30 is smaller than the inner diameter Db of the guide tube 40, only the guide tube 40 can be easily separated from the handle assembly 40.
  • a trocar T is inserted into the abdomen of the surgical target site as shown in FIG.
  • the abdomen is inflated with carbon dioxide gas injected through the trocar, and the trocar (T) is used as a passage for various surgical instruments.
  • the tissue extraction device 1 of the present invention has a size of 5.5 mm or less in diameter over the entire length, so a trocar (T) for inputting the tissue extraction device 1 may also have a size of 5 pi.
  • the tissue extraction device 1 of the present invention can also be injected into the abdomen through the 5 pi trocar, thus minimizing wounds after surgery and recovering patients. It can be effective to do it quickly.
  • Other surgical instruments such as forceps (F) and endoscopic cameras (not shown), may also be inserted into the abdomen during laparoscopic surgery.
  • the tissue extraction device 1 of the present invention is injected into the abdominal cavity through a trocar T as shown in FIG. 7.
  • the guide tube 40 is introduced into the abdominal cavity through a trocar in a state in which the pouch 10 and the handle assembly 30 are embedded.
  • the handle assembly 30 is pushed forward with respect to the guide tube 40 so that the front end portion of the handle assembly 30 is pushed out of the guide tube 40. That is, the pouch 10 and the elastic member 31 are pushed out in front of the guide tube 40.
  • the elastic member 31 is extended in the lateral direction by the inherent restoring force, and accordingly, the inlet portion 11 of the pouch 10 is also opened.
  • the elastic member 31 supports the inlet 11 so that the pouch 10 remains open.
  • the guide tube 40 is removed from the trocar (T). Since the outer diameter of the handlebar 33 and the rear cap 34 has a smaller size than the inner diameter of the guide tube 40, the handle assembly 30 can be removed by pulling out only the guide tube 40 while leaving the handle assembly intact. As the guide tube 40 is removed, a space that can flow around the handle bar 33 is secured, and it becomes easier to operate the handle assembly 30 to adjust the position of the pouch 10. In some cases, the next step may be performed without the guide tube 40 being removed.
  • the human tissue (O) resected in the surgical process is placed in the pouch 10 using other surgical instruments inserted into the abdominal cavity, such as forceps.
  • the handle assembly 30 Prior to drawing out the pouch 10 containing human tissue to the outside of the abdominal cavity, as shown in FIG. 11, only the handle assembly 30 is first taken out of the trocar T. Only the pouch 10 and the string 20 remain in the abdominal cavity. The rear end of the extension portion 22 of the string 20 forms a free end without any knots, and the extension portion 22 passes through the hollow portion of the handle bar 33 while the front cap 32 and the rear cap 34 ), the string 20 can be easily separated from the handle assembly 30. If the handle assembly 30 is not first removed while the human tissue to be extracted is contained in the pouch 10, the inlet 11 of the pouch 10 is in an open state, and there is a fear that human tissue O may escape. There is a fear that the pouch 10 is torn due to the weight of the pouch 10 containing the human tissue O. Therefore, when the human tissue O to be extracted is contained in the pouch 10, it is preferable to separate the handle assembly 30 immediately.
  • the string 20 is pulled so that the hook 21 is closed, thereby closing the pouch 10 inlet 11, and removing the trocar from the abdominal cavity. Then, the string 20 is pulled again, and the pouch 10 is taken out of the abdominal cavity (see FIG. 13).
  • the outer diameter of the guide tube 40 has a size of 5.5 mm or less, and the outer diameter of the handle assembly 30 embedded in the guide tube 40 Since it has a smaller size than the inner diameter of the guide tube 40, it can be used with a 5 pi trocar during laparoscopic surgery. Therefore, in contrast to the conventional tissue extraction device used with 10 pie trocar, there is an advantage of minimizing wounds caused by surgery and enabling rapid recovery of patients.
  • the outer diameter of the handle assembly 30 has a smaller size than the inner diameter of the guide tube 40, only the guide tube 40 can be easily removed while leaving the handle assembly 30 in the process of laparoscopic surgery, and within the trocar. In the free space to operate the handle assembly 30 is secured, there is an advantage in that the operation for changing the position of the pouch 10 is easy.
  • the string of the present invention is not tied to the handle assembly 30, but is loosely coupled to the handle assembly 30, so that only the pouch 10 and the string 20 are left in the abdominal cavity. There is an advantage that only (30) can be easily removed.
  • the front cap 32 and the rear cap 34 are configured to be assembled by a screwing method with respect to the handle bar 33 constituting the handle assembly 30, which has been involved in the use of conventional adhesives. It has the advantage of not having the problem of long-time assembly time, property deformation of the bonding material, and damage due to long-term storage.
  • the tissue extraction device according to the present invention can be widely used in the medical device field.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • Animal Behavior & Ethology (AREA)
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Abstract

La présente invention concerne un appareil de collecte de tissus humains excisés dans la cavité abdominale durant la chirurgie laparoscopique et l'extraction des tissus vers l'extérieur d'un corps et, particulièrement, un appareil d'extraction de tissu qui est miniaturisé afin d'être introduit dans la cavité abdominale en utilisant un trocart de 5 pi. L'appareil d'extraction de tissu selon la présente invention comprend une poche, un ensemble poignée, et un tube de guidage, et présente un diamètre externe global de 5,5 mm ou moins.
PCT/KR2019/017840 2018-12-19 2019-12-16 Appareil d'extraction de tissu WO2020130551A1 (fr)

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KR101968479B1 (ko) * 2018-12-19 2019-08-13 김진성 조직 적출 장치
KR102308127B1 (ko) * 2019-09-24 2021-10-01 (주)코업 수술용 파우치 어셈블리
CN116807727B (zh) * 2023-08-29 2023-11-21 上海宇度医学科技股份有限公司 一种妇产科医师用临床取环器

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JP2015163238A (ja) * 2009-10-09 2015-09-10 アプライド メディカル リソーシーズ コーポレイション 単孔式腹腔鏡下組織回収システム
KR20110086219A (ko) * 2010-01-22 2011-07-28 (주)선메딕스 보호커버를 구비한 복강경 수술에 사용되는 엔도백
KR20150109179A (ko) * 2014-03-19 2015-10-01 권병수 복강경 수술용 엔도파우치 및 단일공 복강경 수술용 엔도파우치 조립체
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KR101968479B1 (ko) * 2018-12-19 2019-08-13 김진성 조직 적출 장치

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