JP2001025469A - Trocar mantle tube instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a trocar mantle tube instrument capable of realizing a smooth flow of operation by improving the operability in mounting the trocar instrument in the insertion portion of a trocar and locking the trocar, and maintaining the locking hard to release during the operation. SOLUTION: A lever 27 arranged in the peripheral portion of a sleeve 17 at the base thereof which the insertion portion 3 of a trocar 1 can pass through and rotatable along the central axial direction of the sleeve 17 around a rotating shaft 26 almost parallel with the axis orthogonal to the central axis of the sleeve 17 is provided. A locking mechanism section 19 that can be fixed to and released from the insertion portion 3 of the trocar 1 and is fixed to the insertion portion 3 of the trocar 1 by rotating the lever 27 to the user's hand side, is provided.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a trocar jacket for observing a lesion in a body cavity of a patient in an endoscopic surgical operation, and for guiding an optical visual tube for performing a treatment or a treatment tool. The present invention relates to a trocar mantle device that prevents the tube from easily falling out of the patient's skin during use.

[0002]

2. Description of the Related Art In general, a trocar is used as a guide tube for observing a lesion in a body cavity of a patient and performing a treatment in an endoscopic surgical operation, and for inserting a treatment tool into the body cavity. A mantle tube is used. The trocar mantle is inserted into the body cavity by puncturing the patient's skin. And
An optical viewing tube, a treatment tool, and the like are inserted into the trocar mantle tube, and the insertion into a body cavity is guided.

[0003] Devices have also been developed that combine with a trocar mantle tube to prevent the trocar mantle tube from easily falling out of the patient's skin during use. As this type of apparatus, for example, JP-A-6-285012 or U.S. Pat.
As disclosed in SP5, 217, 441, a gripping device that can be attached to and fixed to an insertion portion of a trocar mantle tube has been conventionally used.

The gripping device disclosed in Japanese Patent Application Laid-Open No. 6-285012 is provided with a fixing device for fixing the gripping device to the outer peripheral surface of the insertion portion of the trocar mantle tube. The fixing device is provided with a fixing screw extending in a direction perpendicular to the central axis of the trocar. Then, after the gripping device is mounted on the outer peripheral surface of the insertion portion of the trocar outer tube, the fixing screw of the fixing device is turned to tighten the trocar outer tube.

The stopping device disclosed in US Pat. No. 5,217,441 is provided with a first member on the distal end side and a second member on the proximal side which is screwed and fixed to the first member. Here, a plurality of grip fingers are provided on the hand side of the first member. Then, the second member is screwed into the first member by rotating the second member coaxially with the central axis of the insertion portion of the trocar mantle tube and screwing the plurality of grip fingers of the first member against the insertion portion of the trocar mantle tube. The structure is fixed to the trocar mantle tube.

Further, a conventional trocar jacket device is disclosed in Japanese Patent Application Laid-Open No. 6-285012, US Pat.
As disclosed in US Pat. No. 7,441,441, the tip of a gripping device or a stopping device has a shape obtained by cutting a cylinder vertically, and is provided with a tapered taper on the outer periphery of the tip. A convex locking rib is provided.

In order to push the gripping device or the stopping device into the patient's skin, the gripping device or the stopping device is advanced so as to slide outside the insertion portion of the mantle tube previously inserted into the patient's skin, so that the insertion portion of the mantle tube is removed. When the convex locking rib reaches the skin by pushing it between the patient's skins, the gripping device or the stopping device is rotated to screw the convex locking rib into the skin.

[0008]

However, the above-mentioned conventional structure has the following problems. In other words, the structure disclosed in Japanese Patent Laid-Open No. 6-285012 has a problem that the operator's hand turning the fixing screw of the fixing device hits the patient's body, making it difficult to rotate the fixing screw.

In the structure of US Pat. No. 5,217,441, the hand of the operator screwing the first member into the second member is difficult to operate by touching the trocar mantle tube, and the trocar mantle tube is fixed during the fixing operation by the stopping device. The tip of the trocar mantle may move within the patient's body cavity due to the wander. Therefore, in an extreme case, the tip of the trocar mantle tube may come into contact with an organ in a body cavity and damage the organ.

Usually, due to the processing of parts, the outer diameter of the insertion portion of the outer tube and the inner diameter of the trocar outer tube fixing device cannot be made exactly the same, and a gap always occurs between the two.

[0011] Furthermore, the skin is usually not greatly incised so as not to burden the patient, and therefore, even if the trocar mantle tube fixing device is slid and advanced over the insertion part of the mantle tube, The tapered edge at the tip of the trocar mantle tube fixing device abuts the skin all around, and often cannot be pushed further unless a large force is applied.

The present invention has been made in view of the above circumstances, and an object thereof is to improve the operability of mounting a trocar mantle tube device on an insertion portion of a trocar mantle tube and fixing the trocar mantle tube. It is an object of the present invention to provide a trocar mantle tube device which can realize a smooth flow of surgery, and which can be easily fixed during a surgery without being detached from the trocar mantle tube.

It is still another object of the present invention to provide a trocar mantle tube device which can easily and smoothly push the trocar mantle tube fixing device into a patient's skin with a small force.

[0014]

According to a first aspect of the present invention, there is provided a trocar outer tube provided with a trocar outer tube main body having a port for inserting a treatment tool at a base end of an elongated tubular insertion portion. A trocar mantle tube device for fixing the trocar mantle tube at an arbitrary insertion position, the sleeve having at least one convex locking rib on an outer surface, and through which an insertion portion of the trocar mantle tube can be inserted; A lever disposed at an outer peripheral portion of the sleeve at a base end portion of the sleeve and rotatable in a central axis direction of the sleeve around a rotation axis substantially parallel to an axis orthogonal to the central axis of the sleeve; It is possible to fix and release the insertion part of the trocar mantle tube with the rotation operation of the lever, and when the lever is rotated to the hand side, it is fixed to the insertion part of the trocar mantle tube A trocar cannula device being characterized in that; and a locking mechanism. According to the first aspect of the present invention, when the trocar mantle tube is fixed at an arbitrary insertion position, the lever at the base end of the sleeve of the trocar mantle tube device mounted on the trocar mantle tube is rotated to the hand side. Then, the lock mechanism is operated to fix the trocar to the insertion portion of the mantle tube. This allows the trocar mantle tube to be quickly and reliably fixed after being inserted into the patient's body cavity, thereby preventing the tip of the trocar mantle tube located in the patient's body cavity from wobbling.

According to a second aspect of the present invention, there is provided a passage through which an insertion portion of a trocar mantle tube including a main body provided with a port for inserting a treatment tool and an elongated tubular insertion portion can be inserted, and at least one protrusion on the outer surface. In a trocar jacket device comprising a sleeve having a rib shape and a lock mechanism capable of being fixed and released at an arbitrary insertion position with respect to the insertion portion of the trocar jacket, a distal end of the sleeve extends in a distal direction. A trocar mantle tube device provided with at least one convex portion. According to the second aspect of the present invention, the convex portion at the distal end of the sleeve allows the trocar mantle tube fixing device to be easily and smoothly pressed into the patient's skin with a small force.

[0016]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS. 1 (A), 1 (B) to 3 (A) to 3 (E). FIGS. 1A and 1B show a trocar mantle tube 1.
1 shows a state in which the trocar inner needle 2 is assembled. Here, the trocar outer tube 1 is provided with a holding portion 4 on the proximal side at the base end of the elongated tubular insertion portion 3. As shown in FIG. 1B, the holding section 4 has a pipe 3 of the insertion section 3.
An internal space 5 communicating with the inside a is provided.

Further, a communication hole 6 communicating with the internal space 5 is provided at the proximal end of the holding portion 4. The communication hole 6 forms a port for inserting the trocar inner needle 2 or a treatment tool (not shown).

The holding part 4 on the hand side has a holding part main body 7.
And a lid portion 8 detachably connected to the holding portion main body 7. Here, a male screw portion 3b is formed at the proximal end of the insertion portion 3. Further, the holding unit body 7
The screw hole 9 screwed into the male screw 3b is provided at the tip of
Are formed. Then, the screw hole 9 of the holding part body 7
The external thread 3b at the proximal end of the insertion portion 3 is screwed into the connector 3 so that the proximal end of the insertion portion 3 and the holding portion main body 7 are detachably connected to each other.

The joint between the proximal end of the insertion portion 3 and the holding portion main body 7 is adjacent to the screwing portion between the screw hole 9 of the holding portion main body 7 and the male screw portion 3b of the insertion portion 3. An O-ring 10 made of an elastic material is provided. The O-ring 10 ensures airtightness between the insertion section 3 and the holding section 4.

A seal member 11 is attached to the communication hole 6 of the lid 8. The seal member 11 has an insertion hole 11a into which the trocar inner needle 2 or a treatment tool (not shown) is inserted.

The inner needle 2 is provided with an elongated needle portion 12 and a proximal end portion 13 disposed on the proximal side of the needle portion 12. Further, a sharp blade portion 14 is formed at the tip of the needle portion 12 of the inner needle 2. Then, when assembling the inner needle 2 to the trocar outer tube 1, the inner needle 2 is inserted from the insertion hole 11 a of the seal member 11. At this time, inner needle 2
Of the needle portion 12 reaches the inside of the conduit 3a of the insertion portion 3 through the internal space 5 of the holding portion 4, and the blade portion 14 at the distal end of the needle portion 12 extends forward from the distal end opening 3c of the insertion portion 3 of the trocar outer tube 1. The hand-side end portion 13 is fixed to the rear end of the holding portion 4 in a state of being extended and exposed.

An elastic ring 15 is incorporated inside the distal end opening 13a of the proximal end 13 of the inner needle 2. When the ring 15 is fitted into the groove 4 a on the outer periphery near the hand side of the holding portion 4, the blade portion 14 extending forward from the distal end opening 3 c of the trocar mantle tube 1.
Is fixed so that the amount of protrusion of the.

FIG. 2A shows a state in which the trocar mantle tube device 16 according to the present embodiment is mounted on the insertion portion 3 of the trocar mantle tube 1. The trocar mantle tube device 16 is provided with a substantially cylindrical sleeve 17 through which the insertion portion 3 of the trocar mantle tube 1 can be inserted. As shown in FIG. 2B, a tapered tapered portion 17a is formed at the tip of the sleeve 17. Further, a spiral thread (convex rib) 17b is provided on the outer peripheral surface of the sleeve 17 over substantially the entire length.

A flange 18 having a diameter larger than the outer diameter of the thread 17b is provided at the rear end of the sleeve 17. A fixing mechanism (lock mechanism) 19 is connected and fixed to the rear end of the flange 18.

The fixing mechanism 19 is provided with a substantially cylindrical base member 20. As shown in FIG. 3A, the base member 20 is formed with a slit 21 extending in a direction perpendicular to the central axis of the cylindrical portion. The base member 20 is provided with a cylindrical portion 22 which is connected and fixed to the inner peripheral surface of the flange 18 of the sleeve 17 on the tip end side of the sleeve 21.

Also, the slip 2 on the base member 20
As shown in FIG. 3 (B), a C-shaped cross-section 23 having a substantially C-shaped cross-section with a part of the circumference cut off is formed in the cylindrical portion on the rear side of 1. And the base member 20 is
The C-shaped cross-section 23 on the rear side of the slit 21 is bent and deformed by using the remaining portion of 1 as a hinge, and is movable.

Further, the C-shaped cross section 2 of the base member 20
3 has a pair of ears 24 and 25 extending from both ends of the C-shape to the outside of the cylindrical portion. Each of the pair of ears 24 and 25 is provided with a cylindrical shaft 26 connecting the two.

A substantially U-shaped lever 27 is rotatably mounted on the shaft 26 as shown in FIG. 3 (C). The lever 27 has a pair of arms 27a and 27b.
Is provided. Here, each arm 27 of the lever 27
Reference numerals a and 27b are provided so as to sandwich the ears 24 and 25 therebetween. Then, a pair of screws 28a, 28b from the outside of each arm 27a, 27b
a, 27b are fixed to the shaft 26 in a state of being sandwiched therebetween. Thereby, the lever 27 is rotatable along the center axis direction of the sleeve 17 around the axis 26 substantially parallel to the axis orthogonal to the center axis of the sleeve 17.

Each arm 27a, 27 of the lever 27
The cam surface 3 is provided on the inner surface side of the attachment portion to the shaft 26 in FIG.
0 and 31 are provided respectively. Further, cam surfaces 32 and 33 are provided at positions corresponding to the cam surfaces 30 and 31 of the lever 27 on the outer surface side of the ear portions 24 and 25 of the base member 20, respectively. Here, on the respective cam surfaces 30, 31 of the lever 27, as shown in FIGS. 3 (D), (C), projecting portions 34, 35 project inward, respectively. Further, the cam surfaces 32, 25 of the ears 24, 25 of the base member 20,
33 are provided with convex portions 36 and 37 projecting outward.

When the lever 27 is rotated about the shaft 26 toward the distal end as shown by the arrow in FIG. 2B, each cam surface of the base member 20 is rotated as shown in FIG. The engagement between the projections 36, 37 of the levers 32, 33 and the projections 34, 35 of the cam surfaces 30, 31 of the lever 27 is released, and no force is applied to the ears 24, 25 of the base member 20. It is held in a state (unlocked state).

As shown by an arrow in FIG. 2 (A), when the lever 27 is rotated about the shaft 26 toward the hand side, as shown in FIG. 3 (E), each of the cam surfaces 32,
33, and each cam surface 30,
The projections 34 and 35 of the 31 simultaneously mesh with each other. At this time, since the positions of the arms 27a and 27b of the lever 27 in the axial direction of the shaft 26 are regulated by the screws 28a and 28b at both ends of the shaft 26, the protrusions of the cam surfaces 32 and 33 of the base member 20 are formed. When the protrusions 36 and 37 engage with the protrusions 34 and 35 of the cam surfaces 30 and 31 of the lever 27, respectively, the lugs 24 and 25 of the base member 20 move in the direction approaching each other. A force is applied to the ears 24 and 25. As a result, the C-shaped cross-section 23 of the base member 20 is elastically deformed in the direction in which the inner diameter dimension is reduced, so that the insertion portion 3 of the trocar mantle tube 1 inserted into the trocar mantle tube device 16 fixes this. The trocar mantle tube device 16 is fastened by the C-shaped section 23 of the mechanism portion 19.
Can be switched to a locked state fixed to the insertion portion 3 of the trocar mantle tube 1.

Accordingly, when the lever 27 is held in the unlocked state as shown by an arrow in FIG. 2B, the trocar mantle tube device 16 moves over the insertion portion 3 of the trocar mantle tube 1. 3 is held movably in the direction of the central axis, and the lever 27 is switched to a locked state as indicated by an arrow in FIG. 2 (A), so that it can be fixed at an arbitrary position.

The arms 27a, 27 of the lever 27
A substantially J-shaped bent portion 38 is formed in the middle of b.
When the fixing mechanism 19 is switched to the locked state by rotating the lever 27 toward the hand as shown by an arrow in FIG. 2A, the distal end of the lever 27 is inserted into the insertion portion 3 of the trocar mantle tube 1. Are set so as to be substantially parallel to the central axis.

An O-ring 39 is provided on the inner peripheral surface of the cylindrical portion 22 of the fixing mechanism 19. When the insertion portion 3 of the trocar mantle tube 1 is inserted into the inside of the trocar mantle tube device 16, the O-ring 39 inserts the insertion portion 3 of the trocar mantle tube 1 into the trocar mantle tube device 16.
It is designed to keep her tight.

Next, the operation of the above configuration will be described.
When using the trocar mantle tube device 16 of the present embodiment, the trocar mantle tube device 16 is attached to the insertion portion 3 of the trocar mantle tube 1 in advance. At this time, the trocar mantle tube device 16 is set in a state where the trocar mantle tube 16 is moved to the holding portion 4 side of the insertion portion 3 of the trocar mantle tube 1. continue,
With the inner needle 2 attached to the trocar mantle tube 1, the insertion portion 3 of the trocar mantle tube 1 is inserted into the body cavity from the skin of the patient.

After the insertion portion 3 of the trocar mantle tube 1 is inserted into the body cavity of the patient, the trocar mantle tube device 16
Is slid forward (toward the distal end) along the insertion portion 3 of the trocar mantle tube 1, and the trocar mantle tube device 16 is inserted into the skin from the tapered tapered portion 17a. At this time, the lever 27 of the fixing mechanism 19 of the trocar mantle tube device 16 is held in an unlocked state as shown by an arrow in FIG. 2B.

Further, after the tapered portion 17a of the trocar mantle tube device 16 is inserted into the skin, the thread 17b of the sleeve 17 of the trocar mantle tube device 16 is inserted into the skin while rotating the trocar mantle tube device 16. Screwed in. Then, after the thread 17b of the sleeve 17 is screwed into the skin and engaged with the skin, the lever 27 of the fixing mechanism 19 of the trocar mantle tube device 16 is turned on the shaft 26 as shown by an arrow in FIG. Rotate to the center as a center. As a result, as shown in FIG.
0, the convex portions 36, 37 of the respective cam surfaces 32, 33, and the lever 2
7 and the projections 34, 35 of the respective cam surfaces 30, 31 are simultaneously meshed.

At this time, each arm 27a of the lever 27,
Since the position of the shaft 26 in the axial direction is regulated by the screws 28a and 28b at both ends of the shaft 26b, the convex portions 36 and 37 of the cam surfaces 32 and 33 of the base member 20 and the cams of the lever 27 When the projections 34 and 35 of the surfaces 30 and 31 are engaged with each other, the ears 24 and 2 of the base member 20 are engaged.
The ears 2 are moved so that the distance between them moves toward each other.
Force is applied to 4,25. As a result, the C-shaped cross-section 23 of the base member 20 is elastically deformed in the direction in which the inner diameter dimension is reduced, so that the insertion portion 3 of the trocar mantle tube 1 inserted into the trocar mantle tube device 16 fixes this. The mechanism section 19 is tightened by the C-shaped section 23 and switched to the locked state, and the trocar mantle tube device 16 is fixed to the insertion portion 3 of the trocar mantle tube 1.

Therefore, the above configuration has the following effects. That is, in the present embodiment, when the trocar mantle tube 1 is fixed at an arbitrary insertion position, the lever 27 at the base end of the sleeve 17 of the trocar mantle tube device 16 mounted on the trocar mantle tube 1 is rotated to the hand side. Thus, the fixing mechanism 19 can be operated to be fixed to the insertion portion 3 of the trocar mantle tube 1. Therefore, when rotating the lever 27 of the trocar mantle tube device 16 toward the hand, the operator's hand hits the patient's body or the surgeon's hand hits the trocar mantle tube 1 to operate the lever 27 as in the related art. Since there is no possibility that the operation will be difficult, the trocar mantle tube device 16 can be mounted and fixed to the insertion portion 3 of the trocar mantle tube 1 to improve the workability of the operation, thereby realizing a smooth operation flow, and during the operation. The lock of the trocar mantle tube device 16 is not easily released, and the lock can be reliably maintained.

Further, after inserting the trocar mantle tube device 16 into the patient's body cavity, the trocar mantle tube 1 can be quickly and reliably fixed without fluctuating the tip position of the trocar mantle tube 1 located in the patient's body cavity. Therefore, it is possible to prevent the biological tissue in the body cavity from being damaged.

FIGS. 4A and 4B and FIG.
(A) and (B) show a second embodiment of the present invention. This embodiment is similar to the first embodiment (FIG. 1).
(A), (B) to FIG. 3 (A) to (E) (see FIGS. 3A to 3E).

That is, in the present embodiment, the first trocar tube device 16 is provided at the distal end of the sleeve 17 of the trocar tube device 16.
In this embodiment, a plurality of blade portions 41 are juxtaposed along a circumferential direction on a tapered tapered portion 17a similar to the embodiment. Here, each blade portion 41 has a tip ridge line 42 and both side ridge lines 4.
An edge is formed on each of 3a and 43b. Note that each edge may be subjected to a blade processing.

FIG. 5A is a view of the sleeve 17 of the trocar mantle tube device 16 viewed from the distal end side. As shown in FIG. 5 (A), the tip ridge line 42 of each blade portion 41 is shifted from the position of the inner peripheral surface 17c of the sleeve 17 to the sleeve 1
7 extend in the direction of the center and are offset.

Therefore, in the present embodiment, since the plurality of blades 41 are provided at the tip of the sleeve 17 of the trocar mantle tube device 16, the trocar mantle tube device 16 is slid forward on the insertion portion 3 of the trocar mantle tube 1. Then, when rotated, it becomes easy for each blade portion 41 to enter the gap between the skin and the insertion portion 3 of the trocar mantle tube 1.

Further, when the tip of the sleeve 17 is inserted into the patient's skin, the blades 41 are caught on the patient's skin, so that the trocar can be easily screwed into the patient's skin using the caught as a foothold. There is an effect.

Further, as shown in FIG.
The tip ridge line 42 extends from the position of the inner peripheral surface 17c of the sleeve 17 toward the center of the sleeve 17 and is disposed so as to be offset, as shown in FIG. 5 (B). Insertion part 3 of trocar mantle tube 1 inside
When the combination is performed, the tip ridge line 42 of each blade portion 41 can be securely brought into close contact with the outer peripheral surface of the insertion portion 3 of the mantle tube 1.

FIGS. 6A and 6B show the trocar jacket device 16 of the second embodiment (see FIGS. 4A and 5B and FIGS. 5A and 5B). It shows a first modification. In this modification, a slit 51 extending in the circumferential direction is provided at the base of one or more blades 41 provided at the tip of the sleeve 17 as shown in FIG. 6B, and as shown in FIG. The side ridge line 43a of the blade portion 41 is extended from the position of the inner peripheral surface 17c of the sleeve 17 toward the center of the sleeve 17, and is arranged to be offset.

FIG. 7 shows a second embodiment (FIG. 4).
(A), (B) and FIGS. 5 (A), (B) (see FIGS. 5 (A), 5 (B)) show a second modification of the trocar mantle tube device 16. In this modification, a thread 17b on the outer peripheral surface of the sleeve 17 is used.
Is extended to the same position as the tip position of the tip taper portion 17a of the sleeve 17.

The same effects as those of the trocar mantle tube device 16 of the second embodiment can be obtained in the first and second modifications of the trocar mantle tube device 16 of the second embodiment.

FIGS. 8A to 8C show the third embodiment of the present invention.
1 shows an embodiment of the present invention. This embodiment is similar to the first embodiment (FIGS. 1A, 1B to 3A).
The configuration of the trocar mantle tube device 16 of (E) is modified as follows.

That is, in this embodiment, a double-structured sleeve 71 is provided in place of the sleeve 17 of the first embodiment. Double structure sleeve 7 of the present embodiment
1 is provided with an inner sleeve 72 and an outer sleeve 73 disposed outside the inner sleeve 72.
Here, the tip of the inner sleeve 72 extends forward from the tip of the outer sleeve 73. And the inner sleeve 7
2 is provided so as to be slidable in the axial direction with respect to the outer sleeve 73 and rotatable.

A spiral thread (convex rib) 74 is provided on the outer peripheral surface of the outer sleeve 73 over substantially the entire length. Further, a proximal end 75 is provided at the proximal end of the outer sleeve 73.

The rear end of the inner sleeve 72 is provided with a proximal end 76 including a fixing mechanism (not shown). Further, a large-diameter flange 77 is provided at the tip of the inner sleeve 72. A tapered tapered portion 78 is provided on the outer peripheral surface of the flange 77.

A cylindrical rubber ring 79 made of an elastic material is provided between the front end of the outer sleeve 73 and the rear end of the flange 77. As shown in FIG. 8B, the outer diameter of the rubber ring 79 is substantially the same as the outer diameter of the outer sleeve 73. Then, as shown in FIG.
Is slid forward, the rubber ring 79 is compressed in the direction of the central axis and expands outward.

Next, the operation of the above configuration will be described.
When using the double-layered sleeve 71 of the present embodiment, the trocar mantle tube device 16 is stabbed into the patient's skin as in the first embodiment, and the double-layered sleeve 7 of the present embodiment is used.
After penetrating 1 into the body cavity, the outer sleeve 73 is slid forward with respect to the inner sleeve 72. As a result, the rubber ring 79 at the tip of the outer sleeve 73 is moved to the position shown in FIG.
The extension is performed as shown in FIG.

Therefore, the above configuration has the following effects. That is, in the present embodiment, after the double-layered sleeve 71 is penetrated into the body cavity,
By sliding the outer sleeve 73 forward with respect to 2, the rubber ring 79 at the tip of the outer sleeve 73 is expanded as shown in FIG. 8C. There is an effect that the mantle tube device 16 is more difficult to come off.

Further, in the present embodiment, the inner sleeve 72
The outer sleeve 73 can be rotated while the inner sleeve 72 is fixed to the insertion portion 3 of the trocar outer tube 1 by a fixing mechanism (not shown) in the proximal end portion 76 at the rear end of the trocar outer tube device. There is an effect that the fixing operation of 16 is further facilitated.

FIGS. 9A to 9D show the double structure sleeve 7 of the trocar mantle tube device 16 according to the third embodiment.
13 shows a modification of the first embodiment. In this modified example, the outer sleeve 73 with respect to the inner sleeve 72 of the double structure sleeve 71
The outer sleeve 73 is rotatably provided with respect to the inner sleeve 72.

As shown in FIG. 9B, the rubber ring 79 sandwiched between the flange 77 at the tip of the inner sleeve 72 and the tip of the outer sleeve 73 has a lengthwise and widthwise shape on the inner peripheral surface side. An oval hole 81 having a different shape is formed. Further, on the outer peripheral surface of the distal end portion of the inner sleeve 72, a similar oval deformed portion 82 corresponding to the oval hole portion 81 of the rubber ring 79 is formed.

Next, the operation of the above configuration will be described.
In the present embodiment, as shown in FIG.
In the case where the position of the oval hole portion 9 of the 9 and the position of the oval deformed portion 82 of the inner sleeve 72 coincide with each other, as shown in FIG. Is maintained in a state substantially the same as the outer diameter of the outer sleeve 73.

When the outer sleeve 73 is rotated by 90 degrees with respect to the inner sleeve 72, the short axis of the oval hole 81 of the rubber ring 79 is changed to the irregular shape of the inner sleeve 72 as shown in FIG. The state is switched to a state where the long axis of the portion 82 is engaged. In this state, the rubber ring 79 can be pushed outward to expand the rubber ring 79 as shown in FIG. 9C. Therefore, the same effects as those of the third embodiment can be obtained in this modification.

FIGS. 10A to 10D and FIG.
Shows a fourth embodiment of the present invention. The present embodiment is a trocar having a trocar outer tube device main body 91 shown in FIG. 10C and an inner needle portion 100 shown in FIG. An outer tube device 92 is provided.

Here, a trocar outer tube device main body 91 is provided with a holding portion 94 on the proximal side at the base end of a sleeve portion 93 which is an elongated tubular insertion portion. The holding section 94 is provided with a fixing mechanism (not shown).

On the outer peripheral surface of the sleeve portion 93, a plurality of ring-shaped grooves 95 are juxtaposed at intervals along the center axis direction. Further, an expansion ring 96 made of an elastic body is fitted in each ring-shaped groove 95.

As shown in FIG. 10D, the expansion ring 96 has one or more, in this embodiment, two inner projections 97a projecting from the inner peripheral surface of a substantially circular ring main body 97. . A through hole 98 penetrating in the central axis direction is provided in a portion near the outer peripheral surface of the inner projection 97a. Further, a bridge portion 99 provided in the ring-shaped groove 95 of the sleeve portion 93 passes through the through hole 98. Here, the through hole 98 is sufficiently large with respect to the bridge portion 99, and the inner protrusion 97a of the expansion ring 96 can be moved in the radial direction.

The inner needle portion 100 shown in FIG. 10A is inserted into the trocar outer tube device main body 91 so as to be freely inserted and removed. Two engaging grooves 101 extending in the same direction as the central axis are formed on the outer peripheral surface of the inner needle portion 100. These engagement grooves 101 are arranged at positions corresponding to the inner protrusions 97a of the expansion ring 96 as shown in FIG. Further, a sharp blade 102 is formed at the tip of the inner needle 100.

Next, the operation of the above configuration will be described.
In the present embodiment, the inner needle portion 100 is pushed into the trocar outer tube device main body 91 in a state where the positions of the two engagement grooves 101 of the inner needle portion 100 are aligned with the positions of the inner protrusions 97a of the expansion ring 96. As a result, the two inner protrusions 97a of the expansion ring 96 are connected to the two engagement grooves 1 of the inner needle portion 100.
01, the expansion ring 96 is not expanded, and the outer diameter of the expansion ring 96 is kept substantially the same as the outer diameter of the sleeve portion 93.

After penetrating the skin of the patient with the inner needle portion 100 attached to the trocar outer tube device main body 91, the inner needle portion 100 is removed from the trocar outer tube device main body 91. In this state, as shown in FIG. 11, a trocar mantle tube 104 having a cylindrical insertion portion 103 having an outer diameter substantially the same as the inner diameter of the sleeve portion 93 of the trocar mantle tube device main body 91 is inserted. Press At this time, the insertion portion 1 of the trocar 104
03, the inner projection 97a of the extension ring 96
Is pushed outward. Therefore, the outer peripheral portion of the expansion ring 96 expands outward and protrudes outward beyond the sleeve portion 93.

Therefore, in the above configuration, after the inner needle portion 100 is assembled to the trocar outer tube device main body 91 and the patient's skin is pierced, the inner needle 100 is inserted into the trocar outer tube device main body 91. Part 100 and trocar mantle tube 10
The expansion ring 96 is expanded simply by replacing the expansion ring 4, and an effect of retaining the expansion ring 96 is obtained.

Further, by providing a seal valve on the trocar outer tube device main body 91, gas leakage can be prevented when the inner needle portion 100 and the trocar outer tube 104 are exchanged.

Further, by hooking the large-diameter flange portion at the distal end of the sleeve portion 93 of the trocar mantle tube device main body 91 inside the patient's skin, a greater retaining effect can be obtained. In addition, by providing a guide portion near the inner needle portion 100, the inner needle portion 100 and the trocar outer tube 10 are provided.
This has the effect that the exchange work with the No. 4 can be performed quickly.

FIG. 12 shows a first modification of the fourth embodiment. In this modification, the holding portion 94 on the hand side of the trocar mantle tube device main body 91 of the fourth embodiment is used.
Valve that closes and keeps airtight when nothing is put in
05 is provided.

FIG. 13 shows a second modification of the main body of the trocar mantle tube device according to the fourth embodiment. In this modified example, a flange portion 121 larger than the outer diameter when the expansion ring 96 is expanded is provided at the tip of the trocar outer tube device main body 91 of the fourth embodiment.

FIGS. 14A and 14B show a third modification of the fourth embodiment. In this modification, the extension portion 13 having the guide portion 131 on the proximal side of the inner needle portion 100 of the trocar outer tube device body 91 of the fourth embodiment is used.
2 is provided. The outer diameter of the guide portion 131 is set to be substantially the same as the inner diameter of the insertion portion 103 of the trocar outer tube 104. Then, FIG. 14 (B)
As shown in FIG.
Is inserted along the guide surface of the guide part 131 of the extension part 132 so that the trocar mantle tube 104 can be easily inserted.

FIG. 15 shows a fifth embodiment of the present invention. In this embodiment, a trocar mantle tube device 143 including a trocar mantle tube device main body 141 and a retaining member 142 is provided.

The trocar outer tube device main body 141 of this embodiment is provided with a hand-side thread hooking portion 145 at the base end of the sleeve portion 144. The thread hooking section 145 has a thread locking slit 146 formed therein.

Further, the retaining member 142 is composed of a hard rod member 147 longer than the diameter of the sleeve portion 144 of the trocar outer tube device main body 141, and a sufficiently long thread 148 fixed to the rod member 147. . Here, obtuse chamfers 147a are formed at both ends of the rod member 147. Then, the thread 148 of the retaining member 142
Are locked in a state of being sandwiched between the thread locking slits 146 of the thread hooking portion 145.

Next, the operation of the above configuration will be described.
In the present embodiment, after the sleeve portion 144 of the trocar mantle tube device main body 141 penetrates the skin of the patient, the rod member 147 is dropped into the body cavity through the sleeve portion 144. Then, after fixing the rod member 147 at a position substantially perpendicular to the central axis of the sleeve part 144, the thread 148 fixed to the rod member 147 is inserted into the thread locking slit 146 of the thread hooking part 145. Fix it.

Therefore, the above configuration has the following effects. That is, in this embodiment, since the retaining member 142 can be disassembled with respect to the trocar mantle tube device main body 141, the structure of the trocar mantle tube device main body 141 is simplified. Also, the retaining member 142 has an extremely simple structure, and has an effect that it can be manufactured at low cost.

Further, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Additional Item 1) An inner diameter through which an insertion portion of a trocar mantle tube including a main body provided with a port for inserting a treatment tool and an elongated tubular insertion portion can be inserted, and at least one convex rib on an outer surface. In a trocar mantle tube device comprising a sleeve having a lock mechanism capable of being fixed and released with respect to the insertion portion of the trocar mantle tube, a lever for operating the lock mechanism is rotatable in the longitudinal axis direction of the sleeve, A trocar mantle tube device characterized in that when the lever is rotated to the hand side, fixing is activated.

(Additional Item 2) A passage through which an insertion portion of a trocar mantle tube including a main body provided with a port for inserting a treatment tool and an elongated tubular insertion portion can be inserted, and at least one convex shape on the outer surface. A trocar jacket device comprising a sleeve having ribs and a lock mechanism capable of being fixed and released at an arbitrary insertion position with respect to the insertion portion of the trocar jacket. A trocar mantle tube device provided with at least one shape portion.

(Additional Item 3) An inner diameter through which an insertion portion of a trocar mantle tube including a main body provided with a port for inserting a treatment tool and an elongated tubular insertion portion can be inserted, and at least one convex shape on the outer surface. In a trocar mantle tube device comprising a sleeve having ribs and a lock mechanism capable of being fixed and released with respect to the insertion portion of the trocar mantle tube, an elastic body provided near the tip of the sleeve and capable of expanding and contracting in a radial direction is provided. And a control member for controlling expansion and contraction of the elastic body.

(Additional Item 4) In the additional item 1, the lock mechanism is an elastic ring having a slit extending in the axial direction, and the lock mechanism is fixed to the insertion portion of the trocar outer tube by reducing the inner diameter of the ring. Characteristic trocar mantle tube device.

(Additional Item 5) The trocar outer tube device according to Additional Item 1, wherein the lever is substantially parallel to the longitudinal axis of the sleeve when the lever is moved toward the hand side.

(Additional Item 6) The trocar outer tube device according to Additional Item 1, wherein the convex rib is a spiral convex portion.

(Additional Item 7) The trocar outer tube device according to Additional Item 2, wherein an edge is provided at a leading edge and / or a side edge of the convex portion.

(Additional Item 8) The trocar outer tube device according to additional item 2, wherein a tip and / or a side surface of the convex portion is inclined to a diameter smaller than an inner diameter of the passage.

(Prior Art of Supplementary Items 1 to 8)
In order to guide an optical sight tube or a treatment tool for performing observation or treatment of a lesion in a patient's body cavity in endoscopic surgery, insert the patient's skin into the body cavity by puncturing it,
The present invention relates to a device for combining with a trocar mantle tube used as a guide tube for insertion into a body cavity so that the trocar mantle tube does not easily come out of the patient's skin during use.

Conventionally, JP-A-6-285012 and US Pat.
As disclosed in P5217441, a gripping device that can be attached to and fixed to an insertion portion of a trocar mantle tube has been used.

Further, after the stopping device disclosed in US Pat. No. 5,217,441 is attached to the insertion portion of the trocar mantle tube, the second member on the hand side is rotated coaxially with the longitudinal axis of the trocar mantle tube insertion portion and screwed into the stopper member. A plurality of gripping fingers provided on the proximal side of the first member are pressed against the insertion portion of the trocar mantle tube and fixed to the trocar mantle tube.

Further, a conventional trocar mantle tube device is disclosed in JP-A-6-285012, US Pat.
As disclosed in US Pat. No. 7,441,441, the tip of a gripping device or a stopping device has a shape obtained by cutting a cylinder vertically, and is provided with a tapered taper on the outer periphery of the tip. A convex locking rib is provided.

In order to push the gripping device or the stopping device into the patient's skin, the gripping device or the stopping device is advanced so as to slide outside the insertion portion of the mantle tube previously inserted into the patient's skin. When the convex locking rib reaches the skin by pushing it between the patient's skins, the gripping device or the stopping device is rotated to screw the convex locking rib into the skin.

(Problems to be Solved by Additional Items 1 to 8)
However, the gripping device disclosed in Japanese Patent Application Laid-Open No. 6-285012 is mounted on the outer periphery of the insertion portion of the trocar outer tube by turning a screw provided in a direction perpendicular to the longitudinal axis of the trocar after mounting on the trocar outer tube. In this structure, the hand of the operator turning the screw hits the patient's body, making the operation difficult.

In the structure of US Pat. No. 5,217,441, the operator's hand screwing the first member into the second member is difficult to operate by hitting the trocar mantle tube, causing the trocar mantle tube to fluctuate. There was also a risk that the tip of the tube would move and damage the organ.

Normally, the outer diameter of the insertion portion of the outer tube and the inner diameter of the trocar outer tube fixing device cannot be made exactly the same due to the processing of the parts, and a gap always occurs between the two.

Furthermore, the skin is not usually greatly incised so as not to burden the patient. Therefore, even if the trocar mantle tube fixing device is slid and advanced over the insertion part of the mantle tube, The tapered edge at the tip of the trocar mantle tube fixing device abuts the skin all around, and often cannot be pushed further unless a large force is applied.

(Objects of Supplementary Items 1 to 8) An object of the present invention is to improve the operation of attaching and fixing the trocar mantle tube device to the insertion portion of the trocar mantle tube to realize a smooth operation flow, and to perform the operation during the operation. It is another object of the present invention to prevent the trocar mantle tube device from being easily fixed, and to surely maintain the fixing.

Further, the tip of the trocar mantle tube located in the patient's body cavity fluctuates and damages the tissue in the body cavity by enabling the trocar mantle device to be quickly and securely fixed after being inserted into the patient's body cavity. The purpose is to prevent danger.

Still another object of the present invention is to provide a trocar mantle tube device which can easily and smoothly push the trocar mantle tube fixing device into the skin of a patient with a small force.

(Effects of Additional Items 1 to 8) According to the present invention, a trocar mantle tube device is attached to an insertion portion of a trocar mantle tube.
The operation of fixing is improved to realize a smooth operation flow, and the lock of the trocar mantle tube device is hard to be released during the operation, so that the lock can be reliably maintained.

Further, by enabling the trocar mantle tube device to be quickly and securely fixed after being inserted into the patient's body cavity, the tip position of the trocar mantle tube located in the patient's body cavity does not shift, and the tissue in the body cavity can be removed. This has the effect of preventing damage.

Furthermore, according to the present invention, the trocar mantle tube fixing device can be easily and smoothly pushed into the patient's skin with a small force.

[0103]

According to the present invention, the outer periphery of the sleeve at the base end of the sleeve into which the insertion portion of the trocar mantle tube can be inserted is arranged around a rotation axis substantially parallel to an axis orthogonal to the center axis of the sleeve. The lever is rotatable along the center axis direction of the trocar, and can be fixed and released from the insertion part of the trocar mantle tube by the rotation of this lever. Since the lock mechanism fixed to the insertion part of the mantle tube was provided,
The trocar mantle tube device is attached to the insertion portion of the trocar mantle tube, improving the operability of fixing the trocar mantle tube, realizing a smooth operation flow, and fixing the trocar mantle tube during the operation. Is not easily detached, and the fixing can be reliably maintained.

Further, according to the present invention, it becomes possible to easily and smoothly push the trocar mantle tube fixing device into the patient's skin with a small force.

[Brief description of the drawings]

FIG. 1 shows a first embodiment of the present invention;
(A) is a side view which shows the state which attached the trocar inner needle to the trocar outer tube, (B) is the same longitudinal cross-sectional view.

FIG. 2A is a side view showing a state where the trocar mantle tube device according to the first embodiment is mounted on an insertion portion of the trocar mantle tube, and FIG. 2B is a side view of the trocar mantle tube device.

3A is a longitudinal sectional view showing a trocar mantle tube device according to the first embodiment, FIG. 3B is a sectional view taken along line AA of FIG. 3A, and FIG. (D) is a schematic configuration diagram showing a state in which the protrusion between each cam surface of the base member and the protrusion of each cam surface of the lever is disengaged, and (E) is a base view. The schematic block diagram which shows the state in which the convex part of each cam surface of a member and the convex part of each cam surface of a lever are engaged.

FIG. 4 shows a second embodiment of the present invention.
(A) is a side view of the trocar mantle tube device, and (B) is a plan view showing a fixing mechanism on the hand side of the trocar mantle tube device.

FIG. 5A is a plan view showing a state in which the sleeve of the trocar mantle tube device according to the second embodiment is viewed from the distal end side;
(B) is a longitudinal sectional view of a main part showing a state where the trocar mantle tube device according to the second embodiment is assembled to an insertion portion of the trocar mantle tube.

FIG. 6 is a plan view showing a first modified example of the trocar mantle tube device according to the second embodiment, in which (A) shows a state in which the sleeve of the trocar mantle tube device is viewed from the distal end side;
(B) is a side view which shows the front-end | tip part of the sleeve of the trocar mantle tube apparatus.

FIG. 7 is a side view showing a second modified example of the trocar mantle tube device according to the second embodiment.

FIG. 8 shows a third embodiment of the present invention,
(A) is a side view of the trocar mantle tube device, (B) is a longitudinal sectional view enlarging a portion C of (A), and (C) is a side view showing a state where the sleeve is slid forward with respect to the inner sleeve. .

9A and 9B show a first modified example of the trocar mantle tube device according to the third embodiment, wherein FIG. 9A is a side view of the trocar mantle tube device, and FIG. 9B is a line D1-D1 of FIG. Sectional view,
(C) is a side view showing a state where the sleeve is rotated by 90 degrees with respect to the inner sleeve, and (D) is a cross-sectional view taken along line D2-D2 of (C).

FIG. 10 shows a fourth embodiment of the present invention.
(A) is a longitudinal sectional view of the inner needle portion of the trocar mantle tube device,
(B) is a cross-sectional view of the inner needle portion, (C) is a vertical cross-sectional view of the main body of the trocar outer tube device, and (D) is a cross-sectional view of the expansion ring of the main body.

FIG. 11 is a longitudinal sectional view showing a state where the trocar mantle tube is pushed into the main body.

FIG. 12 is a longitudinal sectional view showing a first modified example of the main body of the trocar mantle tube device according to the fourth embodiment.

FIG. 13 is a longitudinal sectional view showing a second modification of the main body of the trocar mantle tube device according to the fourth embodiment.

FIG. 14A is a longitudinal sectional view of an inner needle portion of a trocar mantle tube showing a third modification of the fourth embodiment, and FIG. 14B is a longitudinal sectional view showing an attached state of a trocar mantle tube device. .

FIG. 15 is a longitudinal sectional view of a main part showing a fifth embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Trocker outer tube 3 Insertion part 6 Communication hole (port) 17b Thread (convex rib) 17 Sleeve 19 Fixing mechanism (Locking mechanism) 26 Rotating shaft 27 Lever

Claims (2)

[Claims] 1. A trocar mantle tube provided with a trocar mantle tube main body provided with a port for inserting a treatment tool at a base end of an elongated tubular insertion portion, and the trocar mantle tube is placed at an arbitrary insertion position. A trocar mantle tube device having at least one convex locking rib on an outer surface,
A sleeve through which an insertion portion of the trocar mantle tube can be inserted, and a sleeve disposed at an outer peripheral portion of the sleeve at a base end of the sleeve, the rotation center being substantially parallel to an axis orthogonal to a center axis of the sleeve. A lever rotatable in the direction of the central axis of the sleeve; and a rotation operation of the lever, which can be fixed and released with respect to the insertion portion of the trocar mantle tube. When the lever is rotated to the hand side, the trocar mantle is rotated. A trocar mantle tube device comprising: a lock mechanism fixed to an insertion portion of a tube. 2. A passage through which an insertion portion of a trocar mantle tube comprising a main body provided with a port for inserting a treatment tool and an elongated tubular insertion portion, and at least one convex rib on an outer surface are provided. A trocar jacket device comprising a sleeve having a lock mechanism capable of being fixed and released at an arbitrary insertion position with respect to the insertion portion of the trocar jacket tube. A trocar mantle tube device provided with at least one.