JP3024069U - Thoracoscopic insertion aid - Google Patents

Abstract

(57) 【Abstract】 PROBLEM TO BE SOLVED: Anti-thrombotic property, which does not stain the objective lens of the thoracoscope even if there is bleeding from the incision, and is flexible enough to follow the large bending of the thoracoscope. Providing a thoracoscopic insertion aid. SOLUTION: A hollow cylindrical auxiliary tool body 2 having front and rear ends opened and a rear end portion provided with a stopper portion 4 for preventing excessive entry.
And the inner needle 3 mounted in the auxiliary tool body 2, which is a thoracoscope insertion auxiliary tool 1 used to secure an insertion path during insertion of the thoracoscope. The entire body is made of a flexible and antithrombogenic material, and a balloon 5 which is inserted between the auxiliary tool body 2 and the stopper portion 4 and which sandwiches the chest is provided.

Description

[Detailed description of the device]

[0001]

[Technical field to which the device belongs]

 The present invention relates to a thoracoscopic insertion aid used to secure an insertion path when a thoracoscope is inserted in thoracic surgery, particularly in partial resection of the lung.

[0002]

[Prior art]

 With the recent development of surgical instruments such as endoscopes and laparoscopes, it has become possible to perform surgery even with unpredictably small incisions (openings, wounds). Similarly, with the development of a thoracoscope, partial lung resection can be performed without cutting the ribs as in the conventional case, the wound is small, and postoperative wound recovery is quick. As shown in FIG. 6, the auxiliary tool 01 currently used for securing the insertion path at the time of inserting the thoracoscope as described above has front and rear ends opened, and a stopper portion for preventing excessive entry at the rear end. 02 consists of a hard resin hollow tubular auxiliary tool body 03 integrally provided, and an inner needle 04 mounted in the main body, and is attached to the chest on the outer peripheral surface of the body 03 excluding the stopper section 02. A male screw 05 for screwing is provided.

[0003]

[Problems to be solved by the device]

 By the way, since the conventional assisting tool 01 is simple in structure as described above, bleeding from the incision often stains the objective lens of the thoracoscope when it is installed in the chest through the incision. As a result, the operative field (field of view) was narrowed or blocked, and surgery was interrupted and the objective lens had to be cleaned, resulting in a large loss of time. Also, since it is made of hard resin and is not flexible, it does not follow the attempt to bend the thoracoscope greatly, and in some cases it is necessary to newly provide an incision for insertion at another place. In addition, since it is not a material considering antithrombotic properties, when the assisting device 01 is removed during or after surgery, some cells are peeled together with the assisting device 01 due to the adhesion of cells inside the thrombus and the wound inside the wound. It sometimes spread. In addition, there are only two sizes, large and small, and it cannot be said that the size corresponds to the body shape of the patient (especially the thickness of subcutaneous fat). In the case of a patient with a particularly fat layer, a penetration path (insertion path) to the lungs can be secured. Without doing this, there were various problems that there was no choice but to perform a large-scale thoracotomy.

Therefore, the present invention solves the above-mentioned conventional problems and does not contaminate the objective lens of the thoracoscope even if there is bleeding from the incision, and can follow it even when the thoracoscope is largely bent. It is an object of the present invention to provide a thoracoscopic insertion assisting tool that is highly flexible, has antithrombotic properties, and can sufficiently support the body shape of a patient.

[0005]

[Means for Solving the Problems]

 In order to achieve the above object, the device of claim 1 is a hollow cylindrical auxiliary tool main body having front and rear ends opened and a rear end provided with a stopper portion for preventing excessive entry, and the main body of the auxiliary tool. A thoracoscopic insertion aid used to secure an insertion path during insertion of a thoracoscope, which consists of an inner needle attached to the At the front end of the main body, there is provided a balloon that inserts between the chest wall living tissue and the stopper portion. According to a second aspect of the invention, in the first aspect, the material is silicone rubber. Instead of the silicone rubber, an antithrombogenic soft resin may be used. According to a third aspect of the present invention, in the first or second aspect, the stopper portion is provided separately from the auxiliary tool body and is movable in the axial direction of the auxiliary tool body.

[0006]

[Embodiment of device]

 FIG. 1 is a vertical sectional front view of a thoracoscopic insertion assisting tool showing an embodiment of the present invention, and FIG. 2 is a sectional view taken along line AA of FIG. Reference numeral 1 denotes an auxiliary tool which is entirely made of a flexible antithrombogenic material such as silicone rubber, and has a hollow cylindrical auxiliary tool main body 2 having front and rear ends opened, and an inner needle 3 mounted in the main body. It consists of The main body 2 is integrally provided with a large-diameter over-entry prevention stopper portion 4 at its rear end portion and a balloon 5 at its front end portion. A balloon lumen 6 having one end opened to communicate with the balloon 5 is formed in the side wall of the main body 2 and in the stopper portion 4, and the other end opening portion of the lumen 6 has an air injection portion with one valve for balloon inflation. The other end opening of the branch tube 8 having 7 at one end is connected.

An outer surface of the front end of the main body 2 in front of the balloon 5 is formed as a tapered surface 9 which is inclined toward the front end opening. The tapered surface 9 is provided so that the step with the inner needle 3 can be made small so that the main body 2 can be easily inserted. The total length of the inner needle 3 is slightly longer than that of the main body 2, and a stopper portion 10 that comes into contact with the stopper portion 4 of the main body 2 is provided at the rear end portion. In the mounted state, the front end portion thereof projects from the front end opening portion of the main body 2, and the projecting portion 11 is formed in a rounded shape.

As shown in FIG. 1, the auxiliary tool 1 having the above-described structure generally has a body 2 having an overall length L of 40 mm, an outer diameter D of 16 mm, an inner diameter d of 13 mm, and a stopper portion. The outer diameter D'of No. 4 is about 30 mm.

The operation will be described with reference to FIG. 3. First, as a pre-operation, an incision is made by a scalpel in the chest 15 between the ribs until the lungs are reached. Next, the auxiliary tool 1 with the inner needle 3 attached inside the main body 2 is inserted while the balloon 5 is contracted so that the protruding portion 11 of the inner needle 3 pushes open the incision, and the stopper 4 is placed on the chest. Insert it until it cannot be inserted because it hits the outer skin of 15. Then, the balloon 5 comes to be located in the lung. Then, the inner needle 3 is pulled out and removed, and air is injected from an injector (not shown) attached to the air injection part 7 to inflate the balloon 5. Let Due to the expansion of the balloon 5, the chest 15 is sandwiched and fixed by the balloon 5 and the stopper portion 4. Then, under this fixed state, for example, as shown in FIG. 4, a thoracoscope 12 with forceps is inserted into the lung from inside the main body 2 and an operation portion 13 is grasped at the distal end so as to perform a fork-shaped knob at the tip. The surgery is performed by opening and closing the part 14 and picking up the affected lung cells.

At the time of the above, since the assisting tool 1 is fixed by the balloon 5 and the stopper portion 4, there is no accident of coming off. Moreover, since the balloon 5 on the lung side plays a role of stopping bleeding from bleeding from the incision and the bleeding does not flow to the front end opening side of the main body 2, the objective lens of the thoracoscope 12 is not contaminated during the operation. . Therefore, it is expected that the operation time can be shortened as compared with the conventional case. Further, since the assisting tool 1 is entirely made of a flexible material, it is possible to follow the thoracoscope 12 even when it is largely bent. Furthermore, after the operation is completed, the balloon 5 can be easily removed by deflating the balloon 5, and since the material that does not cause thrombus is used, the postoperative recovery is quick.

FIG. 4 shows an example in which a cut portion 16 is formed at the rear end portion of the main body 2 to facilitate insertion of the thoracoscope 12. Other configurations are the same as those in the above-mentioned embodiment.

FIG. 5 shows another embodiment. This auxiliary tool 21 has a stopper portion 24 provided separately from the auxiliary tool main body 22 and is movable in the axial direction of the main body 22. That is, the stopper 24 has a shaft hole 25 at the center thereof which is loosely fitted in the main body 22, and is divided into a plurality of parts in the circumferential direction at the periphery of the shaft hole, and the outer surface faces the tip side. A claw portion 26 having a slightly smaller diameter is provided so as to be elastically deformable in the radial direction, and a common male screw 27 is formed on the outer surface of the claw portion 26. A nut 29 as a tightening member having a female screw 28 formed on the inner surface is screwed into the male screw 27 of the claw portion 26, and the claw portion 26 is elastically displaced inward by tightening the claw portion 26 by screwing. Then, it can be pressed against the outer surface of the main body 22 and fixed at that position. Although not shown, the outer surface of the nut 29 is knurled so that it will not slip when screwed. Other configurations are the same as those in the above-mentioned embodiment. If such an assisting tool 21 is used, it is possible to sufficiently cope with the fat layer of the chest 15 even if there is some individual difference.

[0013]

[Effect of device]

 According to the invention of claims 1 and 2, the entire body is made of a flexible antithrombogenic material as described above, and the chest is inserted between the front end of the main body of the assisting tool and the stopper. Since it is provided with a tube, even if there is bleeding from the incision, the balloon does not stop bleeding and the objective lens of the thoracoscope is not contaminated. Also, since it is highly flexible, it can follow the thoracoscope even when it is largely bent. In addition, since an anti-thrombogenic material is used, when the assisting device is pulled out as in the past, some cells are peeled off together with the assisting device due to the adhesion of cells inside the thrombus and the wound is widened. There is no such thing as going to sleep. According to the third aspect of the invention, since the stopper portion is movable in the axial direction of the main body of the auxiliary tool, there is an excellent effect that it can sufficiently cope with the body shape of the patient.

[Brief description of drawings]

FIG. 1 is a vertical cross-sectional front view of a thoracoscopic insertion aid showing an embodiment of the present invention.

FIG. 2 is a sectional view taken along line AA of FIG.

FIG. 3 is an operation explanatory view.

FIG. 4 is a vertical cross-sectional front view of essential parts showing a modified example of the auxiliary tool body.

FIG. 5 is a vertical sectional front view of a thoracoscopic insertion aid according to another embodiment.

FIG. 6 is a front view of a left half section showing a conventional auxiliary tool.

[Explanation of symbols]

 1 Thoracoscope insertion aid 2 Auxiliary body 3 Inner needle 4 Stopper part 5 Balloon 12 Thoracoscope with forceps 21 Thoracoscope insertion aid 22 Auxiliary device body 24 Stopper part 25 Shaft hole 26 Claw 29 Nut

Claims (3)

[Scope of utility model registration request] 1. A hollow cylindrical auxiliary tool body having front and rear ends opened and a rear end portion provided with an over-entry preventing stopper portion,
A thoracoscopic insertion aid used to secure an insertion path during insertion of a thoracoscope, which is composed of a flexible antithrombotic material A thoracoscopic insertion aid, characterized in that a balloon for sandwiching the chest inserted between the assist tool body and the stopper is provided at the front end of the assist tool body. 2. The material is silicone rubber.
A thoracoscopic insertion aid as described. 3. The thoracoscope insertion assisting tool according to claim 1, wherein the stopper portion is provided separately from the assisting tool body and is movable in the axial direction of the assisting tool body.