JP2003061971A - Trocar mantle tube - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a trocar mantle tube capable of being securely aligned with the center axis of an instrument by transmitting the force applied to the top of the instrument to the trocar mantle tube without damaging the top of the instrument when the instrument is inserted into the trocar mantle tube. SOLUTION: The trocar mantle tube has an inserting part 2 with a conduit piercing through a body wall for guiding an observation device or the treatment instrument into a body cavity, a holding part 3 mounted on the hand side of the inserting part 2, with an internal space 8 linked with the conduit, an opening part 9 mounted on the hand side of the holding part 3, linked with the internal space 8, and flapper valve 31 mounted between the internal space 8 and the opening part 9 for securing the air-tightness of the internal space 8. The trocar mantle tube has an open/close protection film 50 mounted on the hand side of the flapper valve 31 as a soft film-like member which can be opened and closed.

Description

Description: BACKGROUND OF THE INVENTION [0001] 1. Field of the Invention [0002] The present invention relates to an endoscope and a lesion for puncturing and penetrating a patient's body wall and inserting it into a body cavity to observe a lesion. The present invention relates to a trocar mantle tube used as a guide tube for inserting a treatment tool or the like for treating a part into a body cavity. 2. Description of the Related Art A conventional trocar jacket tube is disclosed in, for example, Japanese Utility Model Registration No. 2533624, Japanese Patent Laid-Open No. 2-658.
As disclosed in Japanese Patent Publication No. 54-54, a long insertion portion is provided, and a conduit for guiding instruments such as an optical viewing tube and a treatment tool into a body cavity is formed inside the insertion portion. When the trocar mantle tube is punctured and penetrated into the patient's skin, a sharp-pointed trocar inner needle is inserted and fixed in the duct to close the tip opening of the trocar mantle tube, Pierces and penetrates the skin of the patient with the sharp tip of the needle inside the trocar protruding from the skin. [0003] Further, a holding portion comprising a main body connected to the hand side of the insertion portion and a lid air-tightly and detachably connected to the main body is provided on the proximal side of the trocar outer tube. The lid has an opening for inserting instruments such as an optical sight tube and a treatment instrument, and an opening for inserting the instrument into the trocar mantle to keep the opening airtight when the instrument is inserted. An elastic cap is provided. [0004] A flap valve for ensuring airtightness of the opening when no instrument is introduced into the trocar mantle tube, and a packing for keeping airtight tightly on the flap valve are provided in the holding portion. . Further, the flap valve extends perpendicularly to the long axis of the trocar mantle tube, and can pivot around a rotation axis provided at a position eccentric to the long axis,
Normally, the spring is urged to a position to close the opening and pressed against the packing so as to keep airtight. The flap valve is connected via a small pin to an operation button projecting outward from the holding portion, and is opened / closed by operating the operation lever from outside to pivot the flap valve around a rotation axis. can do. [0006] However, during an operation, an operator often holds an optical viewing tube, a treatment tool, and the like in both hands. In addition, the trocar mantle tube often falls or leans on the patient's body by its own weight when no instrument or the like is introduced therein. Therefore, when inserting an instrument or the like into the trocar mantle pierced into the patient's body wall, the surgeon takes the tip of the instrument held in both hands to the opening of the trocar mantle, and places the trocar mantle tube at the tip of the instrument. And pushed into the mantle tube after the center axis of the mantle tube is aligned with the center axis of the instrument. However, when trying to raise the trocar mantle tube at the tip of the instrument, the tip of the instrument is pressed against the flap valve or the side wall in the body of the trocar mantle tube, and a force such as twisting or bending is applied. In addition, there is a possibility that the tip of a device such as an optical viewing tube or a treatment tool may be damaged or damaged. Further, when the flap valve of the trocar mantle tube is pushed open by the tip of the instrument to be advanced, and the tip of the instrument slides on the surface of the flap valve, the flap valve does not open and the tip of the instrument is moved. Often, it strikes against the side wall of the trocar mantle tube in front of the flap valve and gets stuck. For this reason, the operator must adjust the position of the distal end of the instrument again to capture and push open the flap valve at the distal end of the instrument, which is great for the operator who concentrates on the surgical operation. It can be stressful. Further, when the flap valve is made of a hard material such as a metal, the tip of the optical viewing tube may be damaged on the flap valve during the operation. The present invention has been made in view of the above circumstances, and an object of the present invention is to prevent the tip of an instrument from being damaged or damaged when the instrument is inserted into a trocar mantle tube. By transmitting the force applied to the tip to the trocar mantle tube, the alignment of the center axis of the trocar mantle tube and the instrument can be reliably performed, and the flap valve can be securely pushed open to facilitate use. Another object is to provide a safe trocar mantle. [0011] In order to achieve the above object, the present invention provides an insertion portion having a conduit penetrating a body wall and guiding an observation device or a treatment instrument into a body cavity, A holding portion provided on the hand side of the insertion portion and having an internal space communicating with the pipeline, an opening provided on the hand side of the holding portion and communicating with the internal space, the internal space and the opening portion And a trocar jacket tube having an on-off valve for ensuring airtightness of the internal space, wherein a flexible and openable and closable membrane member is provided near the on-off valve. The trocar can be easily opened and closed with the tip of the instrument near the opening / closing valve of the mantle tube, and the impact of the tip of the instrument hitting the opening / closing valve or the side wall of the mantle tube or being strongly rubbed is reduced. By providing a flexible film-shaped member for protecting the instrument, the tip of the instrument is protected and the force of the tip of the instrument is efficiently transmitted to the trocar mantle tube, and the trocar mantle tube can be easily raised. FIG. 1 and FIG. 2 show a first embodiment. FIG. 1 is a longitudinal side view of a trocar outer tube, and FIG.
(A) is a vertical sectional side view of a holding part, (b) is a cross-sectional view along AA line. As shown in FIGS. 1 and 2, the trocar mantle tube 1 includes an insertion portion 2 formed in a long tubular shape, and a holding portion 3 provided on the hand side of the insertion portion 2. The inner needle 4 detachably attached to the trocar outer tube 1 has a distal end portion formed as an elongated needle portion 5. A proximal portion of the inner needle 4 is formed with a cap-shaped inner needle main body 6 which is fitted to a part of the holding portion 3. The insertion portion 2 of the mantle tube 1 forms a conduit 7 whose both ends are open. The proximal side of the pipe 7 communicates with a space 8 formed inside the holding unit 3. An opening 9 communicating with the space 8 is formed at a proximal end of the holding unit 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 mantle 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 engaged with the proximal end of the holding portion 3. . In this mounting state, the blade portion 10 of the inner needle is positioned at a position protruding forward from the distal end opening 11 of the insertion portion 2. The dimensions of the outer tube 1 and the inner needle 4 are determined so as to achieve such a relationship. The inner needle main body 6 is provided with a seal fixing frame 42 described later.
It is formed in a cap shape so that it can be fitted to the outer periphery of the device, and has an opening 12 facing the front end side. Inner needle 4
An O-ring groove 15 is provided on the inner peripheral surface of the opening 12 of the inner needle main body 6 in order to fix the inner needle main body 6. An elastic O-ring 16 is fitted into the O-ring groove 15 and fixedly attached thereto. When the inner needle main body 6 is fitted into the seal fixing frame 42 of the holding portion 3, the O-ring 16 is fitted into the engaging groove 17 formed on the outer periphery of the seal fixing frame 42 near the hand side. I am trying to wear it. Thereby, the inner needle 4 can be fixed to the trocar mantle tube 1 so as not to rattle in the longitudinal direction. The holding section 3 has a main body 21 and a lid 22, and the front end portion of the main body 21 is inserted into the insertion section 2.
The insertion portion 2 and the main body portion 21 are detachably connected and fixed by being screwed into a screw 23 formed at the proximal end of the insertion portion 2. The connecting portion between the insertion portion 2 and the main body portion 21 has a screw 2
An O-ring 24 made of an elastic material is interposed adjacent to 3 to ensure airtightness between the insertion portion 2 and the main body 21. The lid 22 is detachably connected to and fixed to the main body 21 by attaching means described later. The main body 21 is provided with an insufflation gas inlet 26 communicating with the space 8 formed therein. Inside the lid portion 22, as an openable / closable sealing means, the inner hole (passage) is closed when the instrument is not inserted into the mantle tube 1 and the inner hole is opened when the instrument is inserted. Flap valve 31 is provided. Flap valve 3
1 is located at a position perpendicular to the long axis of the mantle tube 1 when closed, as shown in FIG. 2, and when opened, as shown in FIG. Move to a position that is approximately parallel. The flap valve 31 serves as a means for shutting off the space 8 of the holding portion 3 and the opening 9 communicating therewith to secure airtightness when a treatment tool or the like is not inserted into the mantle tube 1. is there. The flap valve 31 is rotatable about a rotation shaft 32 extending in a direction orthogonal to the long axis of the mantle tube 1. The flap valve 31 is a coil-shaped bias provided to surround the rotation shaft 32. It is elastically urged by a spring 33 to a closed position perpendicular to the long axis of the mantle tube 1. The flap valve 31 can be rotated by a push button 34 provided on the lid 22. The push button 34 is slidably provided on the side wall of the lid 22 in a direction orthogonal to the long axis of the mantle tube 1, is provided on the flap valve 31 at the tip of the push button 34, and is parallel to the rotary shaft 32. A groove 36 for receiving the drive shaft 35 is formed. Then, from the state shown in FIG.
Is pushed in the direction of the central axis of the mantle tube 1, and the push button 34
The end on the side of the flap valve 34 pushes the drive shaft 35 provided on the flap valve 31 in the direction of the central axis of the mantle tube 1 to oppose the urging force of the urging spring 33 to move the flap valve 34 to the rotating shaft 3.
2, the flap valve 31 can be moved to a position substantially parallel to the long axis of the mantle tube 1. A cylindrical seal receiving member 41 is coaxially provided at the proximal end of the lid 22. The seal fixing frame 42 is engaged with a hand edge of the seal receiving member 41. A substantially cylindrical seal member 4 made of an elastic material is provided between the seal receiving member 41 and the seal fixing frame 42.
3 is attached and fixed so as to be sandwiched. A ring-shaped sealing portion 44 is formed at the opening edge of the sealing member 43 on the front side of the flap valve 31 as a sealing means capable of closely adhering to the entire surface of the flap valve 31. The edge forms an elastic film-like seal cap portion 45 that functions as a means for inserting an instrument such as an optical viewing tube or a treatment tool. The seal member 43 is positioned and fixed at a position where the opening edge of the front end side of the seal portion 44 is exposed to the space 8. The back surface 31a of the flap valve 31 urged by the urging spring 33 is pressed tightly over the entire periphery of the opening edge of the seal portion 44 to ensure airtightness. That is, the flap valve 31
The seal portion 44 constitutes a seal valve that closes when instruments such as the inner needle 4 and forceps (not shown) are not inserted. A hole 47 communicating with the inner space 46 of the seal member 43 is provided at the center of the seal cap portion 45. When the flap valve 31 is pushed and opened against the urging force of the urging spring 33 by passing instruments such as the needle portion 5 of the inner needle 4 and forceps (not shown) through the hole 47, the internal space 46 of the seal member 43 passes through the gap. Although it communicates with the space 8, the outer periphery of the needle portion 5 of the inner needle 4 and the instrument such as forceps is in close contact with the sealing cap portion 45 and the opening edge of the hole 47, so that the airtightness between the internal space 46 and the outside is reduced. Secure. That is, the seal cap portion 45 constitutes a seal valve that closes when instruments such as the inner needle 4 and forceps (not shown) are inserted. An openable / closable protection film 50 as a film-like member is provided on the side of the seal cap portion 45 near the seal portion 44. The openable / closable protective film 50 is a thin disk made of an elastic member, and a part of its circumference is fixed to the seal member 43 via the connecting portion 51. Openable protective film 50
Is located on the front side of the flap valve 31, and FIG.
As shown in the figure, when the instrument is not inserted, it is substantially parallel to the flap valve 31, and when the instrument is inserted,
As shown in FIG. 1, it is deformed until it moves to a position where it is pushed and pushed open by the instrument. When an instrument such as an optical sight tube or a treatment tool is pushed from the tip side of the seal member 43 at hand and passed through the hole 47, the tip of the instrument hits the openable / closable protective film 50, and the impact when the instrument hits the same. Alleviate the
When the tip of the instrument is moved in the lateral direction, the tip of the instrument contacts the surface of the flap valve 31 or the side wall of the sealing member 43 via the open / close protective film 50 while keeping the tip of the instrument in close contact with the open / close protective film 50, and the tip of the instrument contacts the tip of the instrument. Communicate the applied force to the trocar tube 1
Can be moved laterally to raise the trocar mantle tube 1 on the patient's abdominal wall. Further, after the trocar mantle tube 1 is raised and positioned so that the central axis of the trocar mantle tube 1 and the central axis of the instrument substantially coincide with each other, when the tip of the instrument is advanced, the tip of the instrument can be opened and closed. With the film 50 still in contact,
It hits the surface of the flap valve 31 via the opening / closing protection film 50 and pushes the flap valve 31 open. Since the tip of the instrument is always covered with the soft opening / closing protective film 50, there is no risk of being damaged or damaged when the flap valve 31 is pushed open. FIGS. 3A and 3B show a second embodiment, in which FIG. 3A is a longitudinal sectional side view of a film-like member, and FIG. 3B is a sectional view taken along line BB. The film-like member 52 of the present embodiment is provided with one or a plurality of flexible restraining portions 53 that protrude inward from the seal cap 45 of the first embodiment. The trocar is then transmitted to the trocar jacket 1. FIG. 4 shows a third embodiment, and is a longitudinal sectional side view of a film-like member. In this embodiment, one or a plurality of concave portions 54 are provided on the back surface of the membrane member 52 of the second embodiment or the back surface of the flap valve 31 of the first embodiment. Is efficiently and reliably transmitted to the membrane member 52 and the flap valve 31. FIGS. 5 and 6 show a fourth embodiment. FIG. 5 (a) is a front view of a flap valve, FIG. 5 (b) is a sectional view taken along line CC, and FIGS. 6 (a) and 6 (b). It is a front view which shows the modification of a flap valve. As shown in FIG. 5, a plurality of grooves 57 are provided on the back face 55a of the flap valve 55 in a direction orthogonal to the rotation center 56 of the flap valve 55. The groove 57 prevents the instrument from slipping in the axial direction (lateral direction) of the rotation center 56 when the tip of the instrument hits the flap valve 55. As shown in FIGS. 6A and 6B, a plurality of concentric grooves 58 and spiral grooves 59 may be provided on the back surface 55a of the flap valve 55. The same effect can be obtained by providing a large number of dot-shaped convex portions on the back surface 55a of the optical disk. According to the above embodiments, the following configuration is obtained. (Supplementary Note 1) An insertion portion having a conduit that penetrates the body wall and guides an observation device or a treatment instrument into a body cavity, and an inner portion provided near the insertion portion and communicating with the conduit. A holding portion having a space, provided on the hand side of the holding portion,
In a trocar outer tube having an opening communicating with the internal space and an opening / closing valve provided between the internal space and the opening to ensure airtightness of the internal space, a flexible and openable / closable membrane is provided at a hand side of the opening / closing valve. A trocar mantle tube provided with a shape member. (Supplementary Note 2) In Supplementary Note 1, a seal means may be provided in the opening to be in close contact with the outer periphery of the observation device or the treatment instrument to ensure airtightness, and the membrane member and the seal means may be integrally formed. A trocar mantle tube characterized by the following. (Supplementary Note 3) In the supplementary note 1, a protection member may be provided on the surface or near the hand of the on-off valve to protect the tip of an observation device or a treatment instrument from directly contacting the on-off valve. Trocker mantle tube. (Supplementary Note 4) The trocar according to supplementary note 1, wherein a member is provided on the surface or near the hand of the on-off valve to restrict the lateral movement of the tip of the observation device or the treatment instrument. Mantle tube. (Supplementary note 5) The trocar outer tube according to Supplementary note 3, wherein one or a plurality of grooves parallel to the opening / closing direction of the on-off valve are provided on the surface on the hand side of the on-off valve. (Supplementary note 6) The trocar outer tube according to Supplementary note 3, wherein one or more concentric or spiral grooves are provided on the proximal surface of the on-off valve. (Supplementary note 7) The trocar outer tube according to Supplementary note 3, wherein one or a plurality of recesses are provided in a surface on the hand side of the on-off valve. (Supplementary note 8) The trocar outer tube according to supplementary note 3, wherein a member having a larger coefficient of friction than a surface of the on-off valve is provided on a surface on a hand side of the on-off valve. As described above, according to the present invention, a flexible and freely openable and closable membrane member is provided on the hand side of the on-off valve for ensuring the airtightness of the internal space of the holding portion. When the instrument is inserted into the trocar mantle, the force applied to the instrument tip is reliably transmitted to the trocar mantle without damaging the instrument tip, ensuring that the center axis of the instrument is aligned with the trocar mantle tube. In addition, the operability can be improved because the flap valve can be reliably pushed open.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a longitudinal sectional side view of a trocar mantle tube showing a first embodiment of the present invention. FIGS. 2A and 2B show a holding unit of the embodiment, wherein FIG. 2A is a longitudinal sectional side view, and FIG. 3A and 3B show a second embodiment of the present invention, wherein FIG. 3A is a longitudinal side view of a film-like member, and FIG. 3B is a cross-sectional view taken along line BB. FIG. 4 is a longitudinal sectional side view of a film-like member showing a second embodiment of the present invention. FIGS. 5A and 5B show a fourth embodiment of the present invention, wherein FIG. 5A is a front view of a flap valve, and FIG. 5B is a cross-sectional view taken along line CC. FIGS. 6A and 6B are front views showing modified examples of the flap valve. [Description of Signs] 1 ... Trocar mantle tube 2 ... Insertion part 3 ... Holding part 8 ... Internal space 9 ... Opening part 31 ... Flap valve (open / close valve) 50 ... Open / close protective film (film-like member)

Claims (1)

Claims: 1. An insertion section having a conduit that penetrates a body wall and guides an observation device or a treatment instrument into a body cavity, and an insertion section provided on a hand side of the insertion section, A holding portion having an internal space communicating with the opening portion, an opening provided on the hand side of the holding portion and communicating with the internal space, an opening / closing valve provided between the internal space and the opening portion to ensure airtightness of the internal space And a flexible and openable and closable membrane member is provided on the hand side of the on-off valve.