JP2003061970A - Trocar mantle tube - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a trocar mantle tube used for various operations from a simple short-time operation to a long-time complicated and difficult operation. SOLUTION: This trocar mantle tube is formed by an insert part 2 penetrating through the body wall to guide an observation device and a treatment tool in the body cavity, and a sleeve 20 removably and slidably mounted in the insert part 2 and having an outside diameter larger than that of the insert part 2. A plurality of flange parts 30 as projecting parts projected outward are provided on the outer peripheral surface of the insert part 2, and the sleeve 20 is provided with a sealing means for securing air-tightness between the sleeve 20 and the insert part 2, and a lock mechanism part 22 for locking the sleeve 20 to the insert part 2.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope for puncturing and penetrating a body wall of a patient, inserting the body wall into a body cavity, and observing a lesion, and a treatment tool for treating the lesion. The present invention relates to a trocar mantle tube which is used as a guide tube for inserting into a body cavity.

[0002]

2. Description of the Related Art Conventionally, a trocar as a guide for guiding an endoscope, a treatment tool and the like into a body cavity through a body wall of a patient is generally composed of an outer tube and an inner needle. With the inner needle inserted and fixed in the outer tube, pierce by severing the body wall with a sharp blade at the tip of the inner needle and pushing it open, or by incising the body wall beforehand with a scalpel, etc. It is introduced into the body cavity by a method such as inserting an outer tube and an inner needle through the portion.

After inserting the outer tube and the inner needle into the body cavity, the inner needle is pulled out from the outer tube to secure an insertion path for an endoscope, a treatment instrument and the like inside the outer tube.

At this time, in order to carry out observation and treatment inside the body cavity safely and reliably, the body cavity is expanded in advance by being filled with pneumoperitoneum gas. Then, in order to maintain airtightness so that insufflation gas does not leak from the body cavity through the trocar outer tube punctured / inserted in the body cavity, the outer tube is provided with a sealing means, and the inner needle is inserted from the outer tube. The sealing means is designed to automatically close when removed.

Here, if a force is applied to the mantle tube during observation or surgical operation, pneumoperitoneum gas leaks from the gap between the insertion part of the mantle tube and the hole formed in the body wall, or the mantle tube is inserted into the body wall. There is a problem that you can get out of it.

Therefore, for example, Japanese Patent Application No. 2001-065
As disclosed in Japanese Patent No. 546, a tapered conical sleeve is fixed to the insertion portion of the outer tube, the body wall near the hole and this sleeve are tied with a thread and squeezed, and the outer tube and the body wall are opened. Push the conical sleeve into the hole gap to close the gap,
Means were taken to ensure airtightness.

However, if it is known in advance that no force is applied to the mantle tube during observation or surgery, for example, if the operation is completed in a short time, or if a treatment tool is put in or taken out of the mantle tube. When the number of operations is small, or when only the treatment instrument having a small diameter is used in the outer tube, there are many cases where the above-mentioned conical sleeve is not necessary. Further, it is desirable not to use the conical sleeve for cosmetic purposes, especially when it is desired not to leave a large scar on the skin.

In such a case, for example, Japanese Patent Laid-Open No. 10-
As disclosed in Japanese Patent No. 759598, in order to fix the insertion part of the trocar to the skin without using a conical sleeve, the outer diameter of the insertion part of the conventional outer tube is approximately the same as the outer diameter of the insertion part of the conventional outer tube. There is a large number of steps having the same maximum outer diameter as the above.

By the way, as a specification generally desired for medical equipment, a more economical equipment with higher cost performance is desired. Therefore, for example, a device that can be repeatedly used and a multifunctional device that can be used in various ways using the same device are desired.

In the outer tube of Japanese Patent Application No. 2001-065546 mentioned above, a conical sleeve can be selectively attached to and detached from the insertion portion, but when the conical sleeve is assembled, the scar on the skin becomes large. In addition, since the conical sleeve is used together, the cost of surgery becomes high. On the other hand, if the conical sleeve is not used, the fixation of the mantle tube to the skin is unstable, which may impede the progress of the operation, which is a disadvantage.

The outer tube disclosed in Japanese Patent Laid-Open No. 10-759585 is expected to be fixed to the skin to some extent without using a conical sleeve, but, for example,
In cases such as long-term surgery or difficult surgery that requires complicated surgical operations using various instruments, the fixation to the skin may gradually loosen and become easier to pull out. In some cases, a conical sleeve is needed, so it could not be a general-purpose device that can be used for various operations.

The present invention has been made in view of the above circumstances, and its purpose is to provide an economical economical method that can be used for various operations ranging from simple or short-time operations to long-time complicated and difficult operations. To provide a trocar mantle.

[0013]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention provides an insertion portion which penetrates a body wall and guides an observation device or a treatment instrument into a body cavity, and an attachment / detachment / slide on / from the insertion portion. A trocar outer tube which is provided so as to include a sleeve having an outer diameter larger than that of the insertion portion is characterized in that a plurality of convex portions protruding outward are provided on an outer peripheral surface of the insertion portion.

Further, preferably, the sleeve is provided with a sealing means for ensuring airtightness between the sleeve and the insertion portion and a locking means for locking the sleeve to the insertion portion, and the sleeve is adjacent to the insertion portion in the axial direction. It is characterized in that the interval between the matching convex portions is made smaller than the width of the sealing means and the locking means.

According to the above construction, even if the operation is performed for a short time or the sleeve is not used in order to minimize the scar, the plurality of convex portions provided on the outer peripheral surface of the insertion portion are in close contact with the body wall. The airtightness in the body cavity can be secured, and the insertion part can be prevented from coming off.

Further, when a sleeve is attached to the insertion part for a long-time operation or when a large number of treatment tools are used, since the sleeve is provided with a sealing means, a space between the insertion part and the sleeve is provided. Airtightness can be secured.

[0017]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings.

1 to 4 show a first embodiment, and FIG.
2 is a side view of the trocar mantle tube, FIG. 2 is a vertical side view of the same, FIG. 3 is a vertical side view of the sleeve, FIG. 4A is a side view of the insertion portion, and FIG. 4B is an enlarged side view of portion A. .

As shown in FIGS. 1 and 2, a trocar outer tube 1 (hereinafter, simply referred to as an outer tube) has an insertion portion 2 formed in an elongated tubular shape, and a holding portion provided on the proximal side of the insertion portion 2. 3 and 3. Further, the inner needle 4 detachably assembled to the outer tube 1 has a distal end side portion formed as an elongated needle portion 5. On the proximal side portion of the inner needle 4, a cap-shaped inner needle main body portion 6 to be fitted on a part of the holding portion 3 is formed.

The insertion portion 2 of the outer tube 1 forms a conduit 7 having both ends open. The proximal side of the pipeline 7 communicates with a space 8 formed inside the holding portion 3. An opening 9 communicating with the space 8 is formed at the proximal end of the holding portion 3.

On the other hand, a sharp blade portion 10 is formed at the tip of the needle portion 5 of the inner needle 4. When the inner needle 4 is inserted into the conduit 7 of the outer tube 1, the inner needle 4 is arranged from the conduit 7 into the space 8, and the inner needle main body 6 is fixedly attached to the proximal end of the holding portion 3. . In this mounted state, the blade portion 10 of the inner needle is positioned at a position projecting forward of the distal end opening portion 11 of the insertion portion 2. In order to achieve such a relationship, the outer tube 1
The dimensions of the inner needle 4 and the inner needle 4 are determined.

The holding part 3 is provided with an insufflation gas inlet 12 communicating with a space 8 formed therein. When the instrument is not inserted into the outer tube 1 inside the holding portion 3, its inner hole (passage) is closed, and when the instrument is inserted,
A flap valve 13 is provided as a seal means capable of opening and closing the inner hole thereof. The flap valve 13 is in a position perpendicular to the long axis of the outer tube 1 when closed, and in a position substantially parallel to the long axis of the outer tube 1 when opened, as shown in FIG. Can be moved to.

The flap valve 13 serves as a means for airtightly blocking between the space 8 of the holding portion 3 and the opening 9 communicating therewith when a treatment tool or the like is not inserted into the outer tube 1. is there. The flap valve 13 is rotatable about a rotary shaft 14 extending in a direction orthogonal to the long axis of the outer tube 1, and is normally provided with a coil-shaped biasing spring 15 provided so as to surround the rotary shaft 14. It is elastically biased to a closed position perpendicular to the long axis of the outer tube 1. The flap valve 13 can also be opened by rotating the push button 16 provided on the holding portion 3 by pushing it into the holding portion 3.

A substantially cylindrical sealing member 17 made of an elastic material is provided in the opening 9 at the proximal end of the holding portion 3. The opening end edge of the seal member 17 forms a ring-shaped seal portion 18 with which the back surface of the flap valve 13 can be intimately adhered to the entire circumference, and the proximal end is inserted with an instrument such as an optical tube or a treatment tool. An elastic film-like seal cap portion 19 that functions as a sealing means at this time is formed.

The seal portion 18 of the seal member 17 is in close contact with the flap valve 13 urged by the urging spring 15 when the inner needle 4 or an instrument such as forceps (not shown) is not inserted to maintain airtightness. . Further, the seal cap portion 19 of the seal member 17 is in close contact with the outer peripheral surfaces of the inner needle 4 and instruments (not shown) such as forceps when the instrument 8 is inserted into the space 8
Ensure airtightness between the outside and the outside.

Further, a sleeve 20 is detachably fitted to the insertion portion 2. As shown in FIG. 3, the sleeve 20 has a tapered portion 21 formed on the outer peripheral surface thereof, the outer diameter of which increases from the tip toward the hand. On the outer surface of the tapered portion 21, a plurality of conical portions 21a, 21b, 21c, 21d whose outer diameter increases from the tip toward the hand are provided.

At the base end of the sleeve 20, there is provided a lock mechanism portion 22 as a locking means for fixing the sleeve 20 to the insertion portion 2 of the outer tube 1. Further, the sleeve 20 is provided with a through hole 23 having an inner diameter slightly larger than the outer diameter of the insertion portion 2 of the outer tube 1 from the tip to the hand,
A seal made of an elastic member as a sealing means for closely contacting the outer periphery of the insertion portion 2 of the outer tube 1 with a part of the through hole 23 and maintaining airtightness between the insertion portion 2 of the outer tube 1 and the sleeve 20. A ring 24 is provided.

Here, the width of the lock mechanism portion 22 in the longitudinal direction of the sleeve 20 = W ₁ and the width of the seal ring 24 = W ₂ . Further, a lock lever 25 is provided above the lock mechanism portion 22, and the sleeve 20 can be locked movably and immovably with respect to the insertion portion 2 by operating the lock lever 25. .

Furthermore, the insertion portion 2 of the outer tube 1 is shown in FIG.
As shown in (a), the outer peripheral surface of the insertion portion 2 is provided with a large number of flange portions 30 as convex portions protruding outward, and the outer diameter φd ₂ of the flange portion 30 is equal to the tip of the insertion portion 2. It is larger than the outer diameter φd _{1 of the} portion.

Further, as shown in FIG. 4 (b), each franc
The juncture portion 30 is directed toward the tip of the cylindrical portion 32 and the insertion portion 2.
It has a tapered portion 33, and the outer diameter of the cylindrical portion 32 is
φd _TwoHas become. Furthermore, the distance W between the cylindrical parts 32
₀Is the width W of the lock mechanism portion 22 of the sleeve 20.
₁And the width W of the seal ring 24_TwoFormed smaller than
Has been done.

According to the trocar outer tube 1 constructed as described above, the trocar 1 is provided on the outer peripheral surface of the insertion portion 2 even if the operation is performed for a short time or the sleeve 20 is not used in order to minimize scars. Further, a large number of flange portions 30 are in close contact with the body wall, airtightness in the body cavity can be secured, and the insertion portion 2 can be prevented from coming off.

When the sleeve 20 is attached to the insertion portion 2 for a long-time operation or when a large number of treatment tools are used, the sleeve 20 is fixed to the body wall with a thread or the like. Since the seal ring 24 is provided, the airtightness between the insertion portion 2 and the sleeve 20 can be secured.

Further, the sleeve 20 is fitted to the insertion portion 2.
When, the interval W between the cylindrical portions 32₀Of the lock mechanism unit 22
Width W₁Since the sleeve 20 is smaller than the insertion portion 2,
It can be locked securely in any place. Well
Also, the distance W between the cylindrical portions 32₀ Is the width W of the seal ring 24
_TwoSince the sleeve 20 is smaller than the
Airtightness can be surely secured even in places.

[0034]

As described above, according to the present invention, even if a sleeve is not used in order to perform surgery for a short time or to minimize scars, a plurality of inserts provided on the outer peripheral surface of the insertion portion can be used. The convex portion is in close contact with the body wall, airtightness in the body cavity can be secured, and the insertion portion can be prevented from coming off. In addition, when a sleeve is attached to the insertion part for long-term surgery or when a large number of treatment tools are used, a sealing means is provided on the sleeve, so that airtightness is secured between the insertion part and the sleeve. it can.

Therefore, there is an effect that it can be used in various operations, from simple and short-time operations to long-time complicated and difficult operations.

[Brief description of drawings]

FIG. 1 is a side view of a trocar mantle tube showing a first embodiment of the present invention.

FIG. 2 is a vertical sectional side view of the trocar outer tube of the same embodiment.

FIG. 3 is a vertical sectional side view of the sleeve of the same embodiment.

FIG. 4 shows the same embodiment, (a) is a side view of an insertion portion,
(B) is the side view which expanded the A section.

[Explanation of symbols]

1. Trocar mantle 2 ... insertion part 20 ... Sleeve 22 ... Lock mechanism section (locking means) 24 ... Seal ring (sealing means) 30 ... Flange (convex)

Claims (2)

[Claims] 1. An insertion part for penetrating a body wall to guide an observation device or a treatment instrument into a body cavity, and a sleeve detachably and slidably provided on the insertion part and having an outer diameter larger than that of the insertion part. The trocar outer tube according to claim 1, wherein the outer peripheral surface of the insertion portion is provided with a plurality of protrusions protruding outward. 2. The sleeve is provided with a sealing means for ensuring airtightness between the sleeve and the insertion portion and a locking means for locking the sleeve to the insertion portion, and a convex portion adjacent to the insertion portion in the axial direction. The trocar outer tube according to claim 1, wherein the interval between the two is smaller than the width of the sealing means and the locking means.