JP2002224129A - Trocar fixing tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a trocar fixing tool with which it is possible to decrease number of parts of a trocar body and to make the structure simple and to reduce cost related to the trocar and to minimize wound to a human body. SOLUTION: A fixing tool on the celom side for fixing the trocar on the body wall is provided and it has a constitution in which an anti-falling means 1 being freely removably mounted on the outer peripheral part of a trocar tube and an operating means 3 with which the anti-falling means can be operated from the extracorporeal part are provided.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a body cavity side fixing means for holding a trocar tube serving as a passage for inserting an endoscope and forceps into a body cavity in a body wall in an endoscopic surgical operation. And a trocar fixture.

[0002]

2. Description of the Related Art In endoscopic surgery, a tubular body having a base called a trocar is attached to a body wall as a passage for inserting surgical instruments such as an endoscope and forceps into a body cavity. However, it is necessary to fix the contact part with the body wall so that it does not come off or shift during the operation, and in many trocars, fixing means for the body surface side and body cavity side are provided separately from the trocar tube This uses a means for holding and fixing the body wall. And as a conventional body cavity side fixing means by this means, after inserting the trocar tube inside the body cavity, such as a balloon, on the outer peripheral surface near the tip of the trocar tube itself, expand this fixing means, In general, a fixing means provided with a mechanism capable of fixing the trocar tube from the inside of the body cavity during the operation and releasing the trocar tube after use to remove the expansion is used.

As another means, for example, Japanese Patent Laid-Open No.
A stopper of a retaining member, which is constituted by a stopper, a loop serving as a distal end of the stopper, and a handle serving as a base end of the stopper, provided on an outer peripheral portion of the outer tube (trocar tube) such as 163577, is attached to the outer tube. At a position deviated from the center axis, the handle is rotated by a handle about an axis parallel to the longitudinal direction of the mantle tube, so that a loop provided at the distal end portion protrudes outward from the mantle tube to serve as fixing means. Or a plurality of inner fixing members rotatably provided at the tip of a trocar and an operating member for operating the fixing members as disclosed in JP-A-7-265327, and the operating member is turned from outside the body. There is disclosed an example in which a fixing member protrudes outward from an outer peripheral surface of a trocar by performing a moving operation and serves as fixing means.

[0004]

Any of these conventional means can be used without any serious problem when examined from the functional aspect of fixing the trocar tube to the body wall. It is provided on the trocar body, and this fixing means is required to be as small as possible with the outer diameter of the trocar tube when inserting it into the body wall, while when fixing it inside the body as a stopper Therefore, it is necessary to provide a structure such as expanding the body after insertion into the body cavity, increasing the number of parts of the trocar body, complicating the configuration, and complicating the manufacturing process such as attaching the fixing means to the trocar. Therefore, it becomes one of the most troublesome and costly members in the manufacture of trocars, and as a result, there is a problem that the equipment is expensive. Further, as described above, these fixing means are made to have as small a step as possible, but it is unavoidable to increase the outer diameter of the trocar tube, and the attachment of these fixing means increases the wound of the patient. There is also a problem.

In the case where a balloon is used as the fixing means, it is often a disposable product due to the problem of the durability of the balloon, and even if another conventional fixing means is used, a complicated structure is required. Therefore, there is also a problem that the operation is unnecessary and the possibility of breakage is high, and the shape becomes complicated, so that cleaning after use becomes troublesome and the cost increases for the user.

In view of the above problems, the present invention can reduce the number of parts of the trocar body and can have a simple structure, and both the manufacturer and the user can reduce the cost related to the trocar, Another object of the present invention is to provide a trocar fixing device that does not enlarge the wound of a patient by the fixing device.

[0007]

A trocar fixing device of the present invention is a fixing device on the side of a body cavity for fixing a trocar to a human body, and a retaining device detachably attached to an outer peripheral portion of a trocar tube. The retaining means comprises operating means operable from outside the body, and is configured as a separate member from the trocar tube.

The retaining means comprises a ring of a flexible rubber elastic member having an inner diameter compatible with the outer diameter of the trocar tube.

The retaining means has a structure in which, after the trocar is inserted into the body, the trocar can be inserted into or removed from the body through the trocar lumen.

[0010] In consideration of the ease of insertion into the trocar tube inside the body cavity, the ring of the retaining means has an inner diameter at one end that is compatible with the outer diameter of the trocar tube, and the other side is slightly larger. Preferably, it is formed.

The operating means for operating the retaining means from outside of the body is such that one or more of the retaining means is locked with a thread, the end of the thread is extended and placed outside the body, and Or an operating means is attached to the end of the thread.

As operating means attached to the end of the yarn,
An operating ring is locked to the thread to form an operating section.

Each of the retaining means and the operating means has both a function of being detachably mounted on the outer periphery of the trocar tube and a function of operating the retaining means from outside the body. Can be used both as the retaining means and the operating means.

[0014] As a structure in which the retaining means and the operating means can be used together, a retaining ring as described above is attached to both ends of the yarn, and one unspecified ring is a retaining ring and the other is a retaining ring. It is used as an operation ring, and each ring is configured to have the function of the ring of the retaining means and the operation ring.

The two rings serving both as the retaining means and the operating means have at least different inner diameters.

(Operation) When the trocar fixing device is used, the trocar main body does not need the body wall fixing means on the side of the body cavity, which is one of the most troublesome members in manufacturing the trocar. It is sufficient to have an inner needle for inserting the outer tube, an inner needle for inserting the outer tube, a base for the outer tube, a gas leakage prevention valve mechanism provided on the base, and a body wall fixing means on the body surface side. be able to.

Further, since there is no need to provide a body wall fixing means in the body cavity around the outer periphery of the trocar tube, it is not necessary to increase the outer diameter of the trocar tube, and it is possible to minimize the wound on the human body.

Further, if the retaining means and the operating means are configured to be able to be used together, either side may be used as the retaining means, and if each is set to have a different inner diameter, two types of trocars having an outer diameter can be used. A compatible trocar fixing device that can be used can be obtained.

[0019]

An embodiment of the trocar fixing device of the present invention will be described in detail with reference to the drawings.

(Embodiment 1) FIG. 1 shows Embodiment 1 of a trocar fixing device of the present invention. The retaining ring 1 serving as retaining means for fixing the trocar from the inside of the body cavity is a ring-shaped molded member that uses silicone rubber as a flexible elastic body and has an inner diameter adapted to the outer diameter of the corresponding trocar tube 4. The thread 2 for forming and connecting the retaining means and the operating means uses a polyamide resin thread as a resin having a small diameter and a necessary and sufficient strength, and the operating ring 3 serving as operating means for operating the retaining means from outside the body is It was formed as a resin-made ring-shaped molded product. In addition, the ring shape of the retaining ring 1 may be a mere ring shape having a circular cross section, or a contact area with the body cavity side contact portion by making the cross section elliptical for more secure body wall fixing. In addition, considering the ease of insertion into the trocar tube 4 inside the body cavity, the inner diameter at one end is set to a diameter compatible with the outer diameter of the trocar tube, and the other side is slightly larger. The shape may be large.

The trocar fixing device of the first embodiment is constituted by connecting the retaining ring 1 and the operating ring 3 of the above-mentioned components with a thread 2. More specifically, the retaining ring is formed with one end of the thread 2 being two. The two ends 21 are symmetrical with each other, while the other end is one, and is fixed to the gripping ring 3 at one point 23. The structure was summarized as follows.

FIG. 2 shows a state in which the trocar fixing device of the present invention is attached to a trocar attached to the body wall, and a portion near the distal end of the trocar tube 4 attached to the body wall 7 near the body cavity 8. The body wall 7 and the trocar tube 4 are fixed by holding the contact portion with a retaining ring 1 and holding the contact portion of the body surface 9 with the body surface side fixing means 6 that does not specify the contact portion as necessary.

FIG. 3 is a schematic view showing a method of mounting the trocar fixing device of the present invention on a trocar tube and fixing it on a body wall. (A) As a preparation prior to puncturing and attaching the trocar tube 4 to the body wall 7, the retaining ring 1 is crushed and deformed into an elliptical shape so that the lumen of the trocar tube 4 can be smoothly inserted, and the forceps 10 and the like are deformed. The trocar tube 4 is inserted from the distal end side of the trocar tube 4, taken out of the trocar from the base end portion, and the thread 2 penetrates into the lumen of the trocar tube 4. (B) Insert the inner needle 5 into the lumen of the trocar tube 4 through which the thread 2 of the previous stage has penetrated, and set it as the trocar needle to complete the preparation. (C) The trocar needle at the previous stage is punctured into the body wall 7, an appropriate amount is inserted into the body cavity and attached, the inner needle 5 is removed, and the retaining ring 1 is removed using forceps or the like in the same manner as in the step (a). Is deformed and inserted into the lumen from the proximal end of the trocar tube 4. (D) Further, the retaining ring 1 is pushed into the lumen of the trocar tube 4 by the forceps 10 or the like, and is pushed completely into the body cavity from the tip of the trocar tube. The retaining ring 1 pushed into the body cavity returns to its original circular shape by elasticity. (E) The retaining ring 1 extruded into the body cavity of the previous stage,
While watching the image of the laparoscope, the operator remotely controls the trocar tube 4 via the grip ring 3 or the thread 2 serving as a hand operation unit, and mounts the trocar tube 4 on the outer periphery. At this time, if necessary, if the operation is assisted by using forceps or the like inserted into the body cavity from the trocar tube 4 or another path, the trocar can be easily mounted. (F) When the retaining ring 1 is attached to the outer peripheral portion of the trocar tube 4, the grip ring 3 or the thread 2 at hand is pulled, and the retaining ring 1 is located at an appropriate position of the trocar tube 4, that is, the retaining ring 1 is located inside the body cavity. Adjustment is performed so that the trocar fixing device of the present embodiment is set to a position where the trocar fixing device is brought into contact with the body wall.

(Embodiment 2) FIG. 4 shows Embodiment 2 of the trocar fixing device of the present invention, and shows an example in which the retaining means and the operating means are also used. A retaining ring / operating ring (hereinafter, dual-purpose ring A) 11 and a second retaining / operating ring (hereinafter, dual-purpose ring B) 12, which serve as retaining / operating means, are flexible. Silicone rubber is used as an elastic body, and the inner diameter is 5 mm for 10 mm, which is the general outer diameter of the trocar tube 4.
In order to obtain a size suitable for use, the dual-purpose ring A11 is formed as a ring-shaped molded member with the dual-purpose ring A11 being about 10 mm and the dual-purpose ring B12 being about 5 mm. It was formed using a polyamide resin yarn as the resin to have. Of course, when a trocar for 5 mm is used, the dual use ring B12 is used as a retaining ring, and the dual use ring A11 is used as an operation ring.

The trocar fixing device according to the second embodiment is configured by connecting a dual-purpose ring A11 and a dual-purpose ring B12 with a thread 2. More specifically, the two threads 2 and two are symmetrical at two points 21 where the dual-purpose ring A11 is symmetric. And the other end is locked at two points 23 that are symmetrical to the dual-purpose ring B12. Example 2
The method of mounting on the trocar tube and fixing on the body wall are the same as those described in the first embodiment.

[0026]

According to the present invention, it is not necessary to provide a body cavity side fixing means for fixing the body wall to the trocar body, so that a trocar having a simple structure may be prepared, and the trocar fixing device of the present invention is also provided. Combined with the simple structure having only a small number of components consisting of only the elastic member ring and the thread, the cost of the trocar device for the manufacturer can be significantly reduced as compared with the related art. it can. In addition, this simple structure minimizes damage and malfunction, and in case of damage, the main unit and fixture are separate parts so they can be replaced separately, and maintenance after use such as cleaning is easy. Therefore, the cost can be reduced for the user, and the overall cost of the trocar can be reduced.

Further, since there is no need to provide a body surface fixing means in the body cavity on the outer periphery of the trocar tube main body, there is no need to increase the outer diameter of the trocar tube, and it is possible to minimize invasion to the patient. The trocar fixing device with less number can be provided.

[Brief description of the drawings]

FIG. 1 is a configuration diagram of a trocar fixing device according to a first embodiment of the present invention.

FIG. 2 is a schematic diagram showing a state in which the trocar fixing device is attached to a trocar tube and fixed to a body wall.

FIG. 3 is an explanatory view showing a method of mounting the trocar fixing device on a trocar tube.

FIG. 4 is a configuration diagram of a trocar fixing device according to a second embodiment of the present invention.

[Explanation of symbols]

 1. Retaining ring 2. Thread 3 Operation ring 4. Trocar tube 5. 6. Needle in trocar Body wall 11. Combined ring A 12. Combined ring B

Claims (9)

[Claims] 1. A body cavity side fixing device for fixing a trocar tube to a body wall in an endoscopic surgical operation, wherein the stopper device is detachably attached to an outer peripheral portion of the trocar tube, and the stopper device. A trocar fixing device, comprising: operating means capable of operating from outside the body. 2. The trocar fixing device according to claim 1, wherein said retaining means comprises a ring of a flexible rubber elastic member. 3. The trocar fixing device according to claim 1, wherein said retaining means is insertable into a trocar lumen. 4. The trocar fixing device according to claim 2, wherein the ring of the retaining means according to claim 2 is formed such that an inner diameter of one end of the ring is larger than that of the other end. 5. The operating means according to claim 1, wherein said retaining means can be operated from outside the body by locking one or more of the retaining means with a thread and extending the end of the thread to operate the retaining means. The trocar fixing device according to any one of claims 1 to 4, wherein the trocar fixing portion is provided as a part or an operation means is attached to an end of the thread. 6. The trocar fixing device according to claim 5, wherein the operating means attached to the end of the yarn is an operating ring. 7. The retaining means and the operating means according to claim 1,
7. The device according to claim 1, wherein each of the means has a function of being detachably attached to the outer peripheral portion of the trocar tube, and a function of operating the retaining means from the outside of the body. Trocar fixture. 8. The retaining means and the operating means having both a function of being detachably mounted on the outer peripheral portion of the trocar tube and a function of operating the retaining means from outside the body. 8. The trocar fixing device according to claim 7, wherein the trocar fixing device comprises a ring of a stopping means, and each means can be used in combination. 9. The trocar fixing device according to claim 8, wherein each ring serving also as said retaining means and operating means has a different ring diameter.