JP2023003403A - Tissue recovering implement - Google Patents

Abstract

To provide a tissue recovering implement for taking a recovered tissue to the outside of the body from the inside of the body that can take a recovered tissue to the outside of the body more readily and reliably than before.SOLUTION: A tissue recovering implement 1 takes a recovered tissue to the outside of the body from the inside of the body. The tissue recovering implement 1 includes: a storage part 11b having an opening 12 on an upper end side and storing a recovered tissue therein; and a directivity volume reduction part 14 for reducing a content volume of the storage part 11b toward an upper end side from a lower end side to move the recovered tissue to the upper end side from the lower end side.SELECTED DRAWING: Figure 2

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a tissue recovery instrument for extracting a recovered tissue (specimen) from the body to the outside of the body in endoscopic surgery.

Endoscopic surgical procedures such as thoracoscopic surgery and laparoscopic surgery are surgical procedures performed by inserting treatment tools such as endoscopes and scalpels through incisions of several millimeters to several centimeters. Endoscopic surgery has a great advantage that the burden on the patient is small because the incision is small.
Tissue excised in the body by endoscopic surgery is placed in a tissue recovery bag in the body cavity, and pulled out of the body along with the bag through the incision. For the purpose of reducing problems caused by the resected diseased tissue coming into contact with healthy tissue, the resected tissue is placed in a bag and taken out.
Japanese Patent Application Laid-Open No. 2002-300001 discloses a conventional technique related to such a tissue collection bag.

U.S. Patent Application Publication No. 2012/0109144

When removing tissue from a bag for tissue collection, if the tissue is relatively large, pulling out the bag from a small incision requires a great deal of force or skill. There is a problem that it takes time.
On the other hand, in Patent Document 1, the bag is composed of a double layer of an outer bag 140 and an inner bag 110, and after putting a tissue in the inner bag 110, a space 150 between the inner bag 110 and the outer bag 140 is filled with tissue. There is a description of taking tissue out of the body by injecting a fluid and expelling it by inverting the inner bag 110 . According to the technique of Patent Document 1, the tissue can be taken out based on the pressure generated by injecting the fluid, so it is thought that the above problem can be reduced.
However, in the technique of Patent Document 1, the pressure generated when fluid is injected into the space 150 between the inner bag 110 and the outer bag 140 may act to close the opening of the inner bag 110 . In actual surgery, it is difficult for the bag to be arranged in the body cavity in an ideal arrangement as shown in FIGS. This is because the opening side of the inner bag 110 may be closed first. FIG. 25 shows a conceptual diagram of this state. As shown in FIG. 25, when the fluid F circulates to the opening side of the collected tissue Sp and the inner bag 110 is closed due to the pressure of the fluid F, the tissue Sp cannot be taken out successfully. There's a problem.

In view of the above points, the present invention provides a tissue recovery instrument for taking out a recovered tissue from the body to the outside of the body, which enables the recovery of the tissue to be taken out of the body more simply and more reliably. The purpose is to provide a tool for

(Configuration 1)
A tissue recovery instrument for taking out a recovered tissue from the body to the outside of the body, comprising: a storage part having an opening on one end side for storing the recovered tissue inside; a directional volume-reducing section that moves the collected tissue from the other end side to the one end side by reducing the internal volume of the storage section.

(Configuration 2)
a variable volume member for reducing the internal volume of the storage portion by increasing the volume of the directional volume reduction portion when the medium is introduced thereinto; and the medium introduced from the other end of the variable volume member. wherein the variable volume member has a medium movement resistance section that generates resistance against movement of the introduced medium introduced inside from the other end side to the one end side. , configuration 1.

(Composition 3)
The tissue recovery instrument according to configuration 2, wherein the variable volume member includes a plurality of partial variable volume members arranged in order from the other end side to the one end side of the storage section.

(Composition 4)
The tissue recovery according to configuration 3, wherein the medium movement resistance section is configured by a communicating section that allows the plurality of the partially variable volume members to communicate with each other, and that the communicating section that restricts the movement of the introduction medium. equipment.

(Composition 5)
The tissue recovery instrument according to configuration 3 or 4, wherein the medium movement resistance section is configured by the partially variable volume member being formed of an elastic member.

(Composition 6)
Configurations 3 to 5, wherein the partially variable volume member is an annular member along the outer periphery of the storage portion in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage portion. A tissue recovery instrument according to any one of the above.

(Composition 7)
The tissue recovery according to any one of configurations 3 to 5, wherein the partially variable volume member is divided into a plurality of parts in a cross-sectional view substantially perpendicular to an axis extending from the other end side to the one end side of the storage part. equipment.

(Composition 8)
The variable volume member is configured by a tubular spiral member spirally arranged from the other end side to the one end side, and the medium movement resistance section is configured based on friction loss caused by being a tubular member. The tissue retrieval instrument of configuration 2, wherein:

(Composition 9)
9. A tissue retrieval device according to configuration 8, wherein said tubular helical member is formed by a telescopic member, thereby increasing said friction loss.

(Configuration 10)
The variable volume member is configured by a tubular variable volume member arranged to extend from the other end side to the one end side, and the medium movement resistance is based on the friction loss caused by being a tubular member. 3. The tissue retrieval device of configuration 2, wherein the tissue retrieval device is configured with a section.

(Composition 11)
11. The tissue recovery instrument according to configuration 10, wherein a plurality of said tubular variable volume members are arranged.

(Composition 12)
12. The tissue recovery instrument according to configuration 11, comprising a medium introduction part for independently introducing the introduction medium to each of the plurality of tubular variable volume members.

(Composition 13)
13. A tissue retrieval device according to any of the configurations 10-12, wherein the friction loss is increased by the tubular variable volume member being formed by a telescopic member.

(Composition 14)
14. A tissue retrieval device according to any of the configurations 8-13, wherein the tubular helical member or the tubular variable volume member is provided with a valve that provides resistance to movement of the introduction medium.

(Composition 15)
The directional volume-reducing section includes a partially variable-volume member that increases in volume by introducing an introduction medium into the interior and reduces the internal volume of the storage section, and the partial variable-volume member reduces the internal volume of the storage section. The tissue recovery according to configuration 1, further comprising a plurality of medium introduction units arranged in order from the other end side to the one end side, and for individually introducing the introduction medium to each of the plurality of partial variable volume members. equipment.

(Composition 16)
16. The tissue recovery instrument according to configuration 15, wherein the medium introduction section introduces the introduction medium into the partially variable volume member in order from the other end side to the one end side.

(Composition 17)
16. The tissue recovery instrument according to configuration 15, wherein the introduction amount of the introduction medium per unit time into the partial variable volume member is larger on the other end side than on the one end side.

(Composition 18)
Configurations 15 to 17, wherein the partially variable volume member is an annular member along the outer periphery of the storage portion in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage portion. A tissue recovery instrument according to any one of the above.

(Composition 19)
18. The tissue recovery according to any one of configurations 15 to 17, wherein the partially variable volume member is divided into a plurality of parts in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage part. equipment.

(Configuration 20)
20. A tissue retrieval device according to any of configurations 15-19, wherein the partially variable volume member is formed by an elastic member.

(Composition 21)
The directional volume reduction unit includes a partially variable volume member that increases in volume when an introduction medium is introduced into the interior and reduces the internal volume of the storage unit,
At least one of the partial variable volume members is arranged on the other end side of the storage section, and the length of the partial variable volume member in the direction from the one end side to the other end side is the length of the storage section. The tissue recovery instrument according to Configuration 1, wherein the length in the direction from the one end side to the other end side is 4/5 or less.

(Composition 22)
22. The tissue recovery instrument according to configuration 21, wherein the partially variable volume member is divided into a plurality of parts in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage part.

(Composition 23)
The directional volume reduction section is configured by a flexible elongated member slidably wound around the outer periphery of the storage section, and one end of the flexible elongated member is located on the one end side of the storage section. The flexible elongated member is directly or indirectly fixed to a place where the flexible elongated member The tissue recovery instrument according to configuration 1, wherein the other end is pulled out to the one end side of the storage section.

(Composition 24)
The directional volume reduction section is composed of a flexible elongated member that is slidably wound around the outer periphery of the storage section, and a middle portion of the flexible elongated member is located on the one end side of the storage section. The flexible elongated member is directly or indirectly fixed to a place where the flexible elongated member The tissue recovery instrument according to configuration 1, wherein both ends are pulled out to the one end side of the storage section.

(Composition 25)
25. A tissue retrieval device according to configuration 23 or 24, wherein a plurality of said flexible elongate members are arranged.

(Composition 26)
26. The tissue retrieval device of configuration 25, wherein the inwardly drawn ends of the plurality of flexible elongate members are symmetrically arranged on the perimeter of the opening.

(Composition 27)
One end of the directional volume reduction section is directly or indirectly fixed to the storage section, wound around the outer periphery of the storage section, and the other end is pulled out to the one end side of the storage section. for tissue recovery according to configuration 1, wherein a plurality of flexible elongated members are arranged in order from the other end side to the one end side of the storage section. instrument.

(Composition 28)
The directional volume-reducing section has an intermediate portion directly or indirectly fixed to the storage section, is wound around the outer periphery of the storage section, and both ends are pulled out to the one end side of the storage section. The tissue recovery instrument according to configuration 1, wherein a plurality of flexible elongated members are arranged in order from the other end side to the one end side of the storage portion. .

(Composition 29)
29. The tissue retrieval device of configuration 27 or 28, wherein the one-end drawn ends of the plurality of flexible elongate members are symmetrically arranged on the perimeter of the opening.

(Configuration 30)
The directional volume reducing section comprises a flexible elongated member, one end of which is directly or indirectly fixed to the storage section and wound around the outer periphery of the storage section; A plurality of thin members are arranged in order from the other end side of the storage portion to the one end side, and the other end portion of the flexible long thin member arranged closest to the other end side of the storage portion. is pulled out to the one end side of the storage portion, and the other flexible long thin member is pulled out to the one end side of the storage portion. The ends are engaged so as to be slidable a predetermined distance and not slidable beyond the predetermined distance, the slidable distance of each said flexible elongate member being the distance of said housing. Configuration 1, wherein the flexible elongated member disposed on the other end side of the storage portion is configured to be longer than the flexible elongated member disposed on the one end side. tissue collection device.

(Composition 31)
23. The tissue recovery instrument according to any one of configurations 1 to 22, wherein at least part of the storage section is configured by the directional volume reduction section.

(Composition 32)
23. The tissue recovery instrument according to any one of configurations 1 to 22, which has an outer restraining body that suppresses an increase in the outer volume of the directional volume reduction section.

(Composition 33)
33. The structure according to any one of configurations 1 to 32, wherein a cross-sectional area substantially orthogonal to an axis extending from the one end side to the other end side of the storage portion decreases from the one end side to the other end side. recovery equipment.

(Composition 34)
34. The tissue recovery device according to any one of configurations 1 to 33, further comprising a display indicating an insertion position into the body when at least part of the tissue recovery device is inserted into the body.

(Composition 35)
35. The tissue recovery instrument according to any one of configurations 1 to 34, wherein the storage portion has a length of 25 cm or less in the direction from the one end side to the other end side.

According to the tissue recovery instrument of the present invention, by providing the directional volume reduction section for moving the recovered tissue to the opening, the recovered tissue can be extracted from the body more easily and more reliably. .

FIG. 1 is a diagram showing a tissue recovery instrument according to Embodiment 1 of the present invention; FIG. 2 is a cross-sectional view showing the tissue recovery instrument of Embodiment 1; FIG. 2 is a diagram showing the directional volume reducing section of Embodiment 1; Explanatory drawing for explaining the action of the tissue recovery instrument of the first embodiment. FIG. 4 is a diagram conceptually showing the tissue recovery instrument of Embodiment 2; FIG. 4 is a diagram conceptually showing another example of the tissue recovery instrument of Embodiment 2; The figure which shows the instrument for tissue collection|recovery of Embodiment 3 in cross section The figure which shows the directional volume reduction part of Embodiment 3. FIG. 11 is a diagram conceptually showing the tissue recovery instrument of Embodiment 4; FIG. 11 is a diagram conceptually showing the tissue recovery instrument of Embodiment 5; FIG. 11 is a diagram conceptually showing the tissue recovery instrument of Embodiment 6; FIG. 11 is a diagram conceptually showing the tissue recovery instrument of Embodiment 6; The figure which shows the instrument for tissue collection|recovery of Embodiment 7 in cross section The figure which shows the directional volume reduction part of Embodiment 7. Explanatory drawing for explaining the action of the tissue recovery instrument of Embodiment 7 FIG. 12 is a cross-sectional view showing another example of the tissue recovery instrument of Embodiment 7; The figure which shows another example of the directional volume reduction part of Embodiment 7. FIG. 11 is a diagram conceptually showing another example of the tissue recovery instrument of Embodiment 7; FIG. 11 is a diagram conceptually showing the tissue recovery instrument of Embodiment 8; FIG. 21 is a diagram conceptually showing the arrangement of flexible elongated members on the outer periphery of the opening of another example of the tissue recovery instrument of Embodiment 8; FIG. 11 is a diagram conceptually showing the tissue recovery instrument of Embodiment 9 FIG. 11 is a diagram conceptually showing the tissue recovery instrument of Embodiment 10 The figure which shows the tissue collection|recovery instrument of Embodiment 11 in cross section Explanatory drawing for explaining the action of the tissue recovery instrument of the eleventh embodiment. Explanatory drawing of a conventional tissue collection bag

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings. It should be noted that the following embodiment is one mode for embodying the present invention, and does not limit the scope of the present invention.

<Embodiment 1>
FIG. 1 is a view showing a tissue recovery instrument 1 of Embodiment 1 according to the present invention, and FIG. 2 is a cross-sectional view of the tissue recovery instrument 1. As shown in FIG.
The tissue recovery instrument 1 is a tissue recovery instrument used for extracting recovered tissue from the body to the outside of the body in thoracoscopic surgery, laparoscopic surgery, or the like. As its basic mode, the tissue recovery instrument 1 has an opening 12 on one end side (upper side in the figure), a storage part 11b for storing the recovered tissue inside, and the other end side (lower side in the figure). ) to move the collected tissue from the other end side to the one end side by reducing the internal volume of the storage portion 11b toward the one end side.
In the following description, the one end side where the opening 12 is located will be referred to as the "upper side" and the other end side as the "lower side".

The storage part 11b is a bag-shaped member having an opening 12 for storing the recovered tissue inside. As shown in FIG. constitutes As will be described later, the storage portion 11b is made of a member having flexibility because the internal volume of the storage portion 11b is reduced by being squeezed by the directional volume reduction portion. The flexible member may be structurally devised to provide flexibility, the physical properties of the material of the member may provide flexibility, or any combination thereof may be used. Structural devices are not particularly limited as long as they have expandability, and among them, a bellows structure is preferable. It should be noted that the storage portion 11b does not necessarily have to be folded with regularity. It may be arbitrarily folded depending on the crease. Soft synthetic resins with flexibility are preferred as materials having physical properties that provide flexibility, and urethane resin thin films are most preferred in terms of compatibility with the living body or excised organs (slipperiness, biocompatibility, etc.). However, the use of other synthetic resin thin films is not excluded as long as they are suitable for endoscopic surgery. Examples thereof include thermoplastic resins such as polyethylene, polyamide, ethylene-vinyl acetate copolymer, polyurethane and polypropylene, rubber-based materials such as silicone rubber, and other soft materials. As will be described below, the tissue recovery instrument 1 has the action of squeezing and moving the tissue to be recovered that is housed inside to the upper side. In order to facilitate the movement of the collected tissue, it is preferable to process the surface of the storage portion 11b or the like that comes into contact with the collected tissue so as to further improve the slipperiness with respect to the collected tissue. Such processing includes, for example, hydrophilic processing. That is, the water-soluble polymer is immobilized on the surface of the material. For example, there is a method in which radical active groups are introduced onto the material surface by γ-ray irradiation, ozone treatment, low-temperature plasma treatment, etc., and acrylamide or N-vinylpyrrolidone is surface-grafted. There is also a process of solvent-coating a water-soluble polymer. Specifically, the surface of the substrate is coated with a polyisocyanate compound, and a water-soluble polymer having active hydrogen is immobilized thereon by covalent bonding. Further, a coating process may be applied to coat with a fluorine-based resin, a silicon-based resin, or the like. Furthermore, the surface may be finely roughened. The fine structure may be random, or may be processed to impart directivity. As a process for imparting directivity, grooves may be cut from the other end side to the one end side, that is, parallel to the extruding direction of the organ.

In this embodiment, the storage portion 11b has an inverted conical shape. That is, it has a shape in which the cross-sectional area substantially orthogonal to the axis extending from the upper end side to the lower end side becomes smaller from the upper end side toward the lower end side.
The outer constraining body 11 a is arranged outside the directional volume reducing section 14 and prevents an increase in the external volume of the directional volume reducing section 14 . Therefore, it is desirable that the outer restraining body 11a is formed of a material that does not substantially expand and contract. A synthetic resin is preferably used for the non-shrinking member, and a urethane resin thin film is most preferable in terms of compatibility (slipperiness, biocompatibility, etc.) with a living body or an excised organ. The use of other synthetic resin thin films is not excluded as long as they are suitable for lower surgery. Examples thereof include thermoplastic resins such as polyethylene, polyamide, ethylene-vinyl acetate copolymer, polyurethane and polypropylene, rubber-based materials such as silicone rubber, and other soft materials. In addition, it is desirable that the outer restraining body 11a is made of a biocompatible member, and the housing portion 11b is also made of a biocompatible member.
In the tissue recovery instrument 1 of this embodiment, the outer restraining body 11a and the storage section 11b are integrally formed, and the bag section 11 is configured by folding the storage section 11b inside the outer restraining body 11a. It is
Of course, the outer restraining body 11a and the housing portion 11b may be formed separately.

FIG. 3 is a diagram showing the directional volume reduction unit 14. As shown in FIG.
The directional volume reduction part 14 is a member that reduces the internal volume of the storage part 11b from the lower side toward the upper side by narrowing the storage part 11b from below.
The directional volume reduction portion 14 is a variable volume member that reduces the internal volume of the storage portion 11b by increasing its volume when an introduction medium such as a liquid is introduced thereinto. A plurality of partial variable volume members 141a to 141f are arranged in order from the side to the upper end.
The plurality of partially variable volume members 141a to 141f are communicated with each other by a communicating portion 142 so that the introduction medium can pass through them (see FIG. 2).
A medium introduction port 143, which is an introduction medium introduction port, is formed at the lower end portion of the directional volume reduction section 14, and is connected to a medium introduction section 131 for introducing the introduction medium. A hand pump 132 is connected to the medium introduction portion 131 .
The directional volume reduction section 14 is desirably made of a biocompatible member.

Each of the partial variable volume members 141a to 141f is a doughnut-shaped member arranged around the storage portion 11b. That is, it is an annular member along the outer periphery of the storage portion 11b in a cross-sectional view substantially perpendicular to the axis extending from the upper end side to the lower end side.
The directional volume reduction portion 14 has a shape that roughly follows the circumference of the storage portion 11b, and therefore each of the partial variable volume members 141a to 141f becomes smaller from the upper end side to the lower end side.
Each of the partial variable-volume members 141a to 141f of the present embodiment is formed of an elastic member, and has a doughnut-like shape whose volume is small when the introductory medium is not filled and whose volume increases when the introductory medium is filled. balloon.

The directional volume reduction section 14 has a medium movement resistance section that creates resistance against movement of an introduction medium such as a liquid introduced from the lower end side toward the upper end side.
In this embodiment, the medium movement resistance portion is configured by the partial variable volume members 141a to 141f made of an elastic member and the communication portion 142. FIG.
Since the partial variable volume members 141a to 141f form an elastic member, a predetermined pressure is required when increasing the volume of each of the partial variable volume members 141a to 141f. As a result, a larger friction loss is caused to the introduced medium circulating therein, and it functions as a medium movement resistance section. When the partial variable volume members 141a to 141f are made of elastic members, the partial variable volume members on the upper side may have a higher modulus of elasticity than that on the lower side. Different materials may be used to change the modulus of elasticity. For example, while using the same material, the partially variable volume member on the upper side may be made thicker.
In addition, the communicating portion 142 functions as a medium movement resistance portion by restricting the movement of the introduced medium by narrowing the channel or the like. In this embodiment, as shown in FIG. 2, the communicating portions 142 are arranged in a straight line in the vertical direction. By arranging it, the introduction medium may be made more difficult to move to the upper end side.

FIG. 4 is an explanatory diagram for explaining the action of the tissue recovery instrument 1. FIG.
BACKGROUND ART In thoracoscopic surgery, laparoscopic surgery, or the like, a tissue recovery instrument 1 is used to extract tissue such as a diseased organ excised inside the body to the outside of the body.
The tissue recovery instrument 1 is placed in a body cavity, and the recovered tissue Sp is placed in a bag (accommodating portion 11b). The introduction of the recovery bag into the body cavity and the putting of the recovered tissue into the recovery bag in the body cavity are performed in the same manner as in the conventional methods, such as using conventionally used instruments. Therefore, a detailed description is omitted here.
After the recovered tissue Sp is placed in the storage section 11b, the hand pump 132 is used to introduce the introduction medium through the medium introduction section 131 into the directional volume reduction section while the opening 12 is pulled out of the body surface S. Send to 14.
The introduced medium is introduced from the lower end side of the directional volume reduction section 14, and is resisted against upward movement by the function of the "medium movement resistance section" described above. That is, it is possible to prevent the introduction medium from immediately flowing into the upper end side partial variable volume member. Therefore, the introduction medium is introduced into each of the partial variable volume members 141a to 141f in order from the lower end side. As a result, as shown in FIG. 4, the partial variable volume members 141a to 141f expand in order from the lowermost partial variable volume member 141a toward the upper side.
Due to the expansion of the partial variable volume members 141a to 141f, the internal volume of the storage portion 11b is reduced, but due to the above, the internal volume is gradually reduced from the lower end side of the storage portion 11b to the upper end side so as to be squeezed up. It will be.
As a result, as shown in FIG. 4, the recovered tissue Sp in the storage portion 11b moves upward in a squeezed-up manner, and can be easily taken out of the body.
In the tissue recovery instrument 1 of this embodiment, since the outer restraining body 11a and the directional volume reducing portion 14 have an inverted conical shape, the internal volume of the storage portion 11b tends to decrease more quickly on the lower end side. It has become. As a result, the function of "squeeze up from the lower end side" described above can be exhibited more effectively.

As described above, according to the tissue recovery instrument 1 of the present embodiment, the recovered tissue can be extracted from the body more easily and more reliably.
As described using FIG. 25, in the case of the recovery bag of Patent Document 1, the fluid F circulates to the opening side of the recovery tissue Sp, and the inner bag 110 is closed based on the pressure of the fluid F. If the tissue Sp is taken out, there is a problem that the extraction of the tissue Sp does not go well.
On the other hand, according to the tissue recovery instrument 1, even in the posture shown in FIG. 25, the introduction medium is introduced in order from the partial variable volume member 141a to the partial variable volume member 141f. Extraction of the harvested tissue to the outside of the body can be performed immediately.

In addition to fluids such as liquids and gases, the introduction medium may be any medium that can be introduced into the variable volume member to increase its volume, such as powders, granules, and viscous bodies. can be done. By using materials such as powders, granules, and viscous materials that have greater frictional resistance than liquids and gases, it is possible to create resistance to the movement of the introduction medium from the other end side to the one end side. "It may be something that makes

In this embodiment, the partial variable volume member is formed of an elastic member, but the present invention is not limited to this. The partially variable volume member may be any member that increases its volume by introducing the introduction medium, and may be any stretchable stretchable member. That is, even if the member is completely non-stretchable, the volume can be increased by introducing the medium from the folded state (in this case, the "medium movement resistance section"). However, there is no problem if the function as a "medium movement resistance section" is obtained by a circulation section or the like). A synthetic resin is preferably used for the partially variable-volume member, and a urethane resin thin film is most preferable in terms of compatibility (slipperiness, biocompatibility, etc.) with a living body or an excised organ. The use of other synthetic resin thin films is not excluded as long as they are suitable for endoscopic surgery. Examples thereof include thermoplastic resins such as polyethylene, polyamide, ethylene-vinyl acetate copolymer, polyurethane and polypropylene, rubber-based materials such as silicone rubber, and other soft materials.
In this embodiment, six stages of partial variable volume members (partial variable volume members 141a to 141f) are taken as an example, but the number of stages of the partial variable volume members can be increased or decreased as appropriate. .

In this embodiment, the outer restraint body 11a is provided as an example, but the outer restraint body 11a is not essential. However, by providing the outer restraining body 11a, the expansion of the directional volume reducing portion 14 to the outside is restricted, and as a result, the internal volume of the storage portion 11b can be efficiently reduced, which is preferable.
Moreover, it is not necessary to provide the storage portion 11b separately from the directional volume reduction portion 14, either. For example, as can be understood from FIG. 3, the directional volume reduction section 14 itself can be made to function as a storage section, that is, the storage section can be configured by the directional volume reduction section. In this case, it is preferable that the directional volume-reducing portion, which is in contact with the recovered tissue, is processed to improve the above-described slipperiness.

In the present embodiment, a hand pump is used to feed the introduction medium, but the present invention is not limited to this, and any means capable of feeding the introduction medium, such as an electric pump or a syringe, can be used. (A suitable one may be selected according to the type of introduction medium).

As a "medium movement resistance part" that creates resistance against the movement of the introduction medium introduced from the lower end side to the upper end side, the introduction medium A valve may be provided to create resistance to movement of the For example, a valve is provided that is biased to block the flow path, and the pressure of the introduced medium must exceed the biasing force to prevent the introduced medium from moving past the valve.

<Embodiment 2>
FIG. 5 is a diagram conceptually showing the tissue recovery instrument 2 of Embodiment 2. As shown in FIG.
The basic concept of the tissue recovery instrument 2 of this embodiment is the same as that of the tissue recovery instrument 1 of Embodiment 1, and the introduction medium introduced from the lower end side moves toward the upper end side. By having the function of the "medium movement resistance section" that causes the storage section to "squeeze up from the lower end side".
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

The tissue recovery instrument 2 includes a bag portion 11 having an opening 12, which is composed of an outer restricting body 11a and a storage portion 11b, as in the first embodiment.
In this embodiment, a plurality of directional volume reduction sections 24-1 to 24-3 are arranged between the outer restraining body 11a and the storage section 11b.

Since each of the directional volume reduction units 24-1 to 24-3 has basically the same configuration, only the directional volume reduction unit 24-1 will be described here.
The directional volume reduction section 24-1 has a plurality of expansion sections 241a1 to 241d1 arranged in the vertical direction, as can be understood from the rightmost drawing in FIG. From 241a1 on the lower end side to 241d1 on the upper end side, the volume at the time of expansion increases. are communicated with each other in a passable manner.
An introduction section branched from the medium introduction section 131 is connected to the lower end side of the directional volume reduction section 24-1, and the introduction medium is introduced from the lower end side.
The inflatable portions 241a1 to 241d1 are balloons made of an elastic material, and the flow paths are narrowed at the communicating portions. These functions as a "medium movement resistance section" that creates resistance against the introduction medium introduced from the lower end side moving toward the upper end side. Therefore, the directional volume reduction section 24-1 can reduce the internal volume of the storage section 11b sequentially from the lower end side to the upper end side, and has the function of moving the recovered tissue from the lower end side to the upper end side.

The directional volume reducing sections 24-2 and 3, which have the same configuration as the above-described directional volume reducing section 24-1, are arranged symmetrically along the outer circumference of the opening 12 when viewed from above, and are common to each other. An introduction medium is introduced by an introduction section branched from the medium introduction section 131 .
With this configuration, as can be understood from FIG. 5, when the introduction medium is introduced, the expansion section 241a1, the expansion section 241a2, and the expansion section 241a3 on the lower end side are expanded first, and then the expansion section 241b1, expansion section 241b1, and expansion section 241a3 are expanded. 241b2 and the expansion portion 241b3 are expanded, and the expansion progresses from the lower end side to the upper end side in sequence.
As a result, the internal volume of the storage portion 11b is gradually reduced from the lower end side of the storage portion 11b to the upper end side, and the recovered tissue Sp in the storage portion 11b is squeezed up and moved to the upper side. It is something that makes
As can be understood from the description, the basic concept of the tissue recovery instrument 2 is the same as that of the first embodiment. That is, the inflatable portions 241a1 to 241a3 can be collectively regarded as one partial variable volume member. Similarly, each of the expansion portions 241b1-3, expansion portions 241c1-3, and expansion portions 241d1-241d1 can be regarded as partial variable volume members, and a plurality of these partial variable volume members are arranged from the lower end to the upper end. , are mutually communicated by the communicating portion. From this point of view, in a cross-sectional view substantially perpendicular to the axis extending from the lower end side to the upper end side, the partial variable volume member of Embodiment 1 is divided into a plurality of parts to form the expansion portions 241a1 to 241a3. can be regarded as
As in the first embodiment, the number of stages of the partial variable volume member may be increased or decreased. Further, it is of course possible to increase or decrease the number of divisions in a cross-sectional view substantially perpendicular to the axis extending from the lower end side to the upper end side. That is, for example, only the directional volume reduction section 24-1 may be provided, or four or more directional volume reduction sections may be provided.

As described above, according to the tissue recovery instrument 2 of this embodiment, the same effects as those of the first embodiment can be obtained.
It should be noted that each inflatable portion constituting the partially variable volume member may be formed of any stretchable stretchable member, or may be formed of a completely non-stretchable member. It is the same as the first embodiment in that a valve may be provided to generate resistance to the movement of the .

In the tissue recovery instrument 2, the introduction medium is introduced into the directional volume reduction sections 24-1 to 24-3 by introduction sections branched from the common medium introduction section 131, but each of them is separately introduced. An introduction medium may be introduced.
FIG. 6 shows an example of such.
In the tissue recovery instrument 2-1 of FIG. 6, medium introduction sections 131-1 to 131-3 are provided individually for each of the directional volume reduction sections 24-1 to 24-3, and the other sections are for tissue recovery. Similar to instrument 2. Although omitted in the drawing, a hand pump or the like is provided so that the medium to be introduced can be individually fed to each of the medium introduction sections 131-1 to 131-3.
According to the tissue recovery instrument 2-1, the introduction medium can be individually fed into each of the directional volume reduction units 24-1 to 24-3. can also be used to move For example, by feeding the introduction medium only to the directional volume reduction section 24-1, it is possible to move the recovered tissue upward while gathering it rightward in FIG.

<Embodiment 3>
FIG. 7 is a cross-sectional view of the tissue recovery instrument 3 of Embodiment 3, and FIG. 8 is a view of a directional volume reduction section 34 of Embodiment 3. As shown in FIG.
The basic concept of the tissue recovery instrument 3 of the present embodiment is the same as that of the tissue recovery instrument 1 of Embodiment 1, and the introduction medium introduced from the lower end side moves toward the upper end side. By having the function of the "medium movement resistance section" that causes the storage section to "squeeze up from the lower end side".
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

The tissue recovery instrument 3 includes a bag portion 11 having an opening 12, which is composed of an outer restricting body 11a and a storage portion 11b, as in the first embodiment.
In the present embodiment, a directional volume reducing portion 34 configured by a tubular spiral member 341 spirally arranged from the lower end side to the upper end side is located between the outer restraining body 11a and the storage portion 11b. are distributed. The tubular helical member 341 is a variable-capacity member that increases in volume when an introduction medium is introduced thereinto and reduces the internal volume of the storage portion 11b.

As shown in FIG. 8, the directional volume reduction section 34 is configured by spirally arranging a tubular member formed of an elastic member (a tubular spiral member 341). 131 is connected.
Therefore, the introduction medium introduced by the medium introduction part 131 flows into the inside of the tubular spiral member 341 sequentially toward the upper side. At this time, friction loss occurs due to the introduction medium passing through the tubular member, and this friction loss is increased by the fact that the tubular member is an elastic member. The configuration that causes the friction loss functions as a "medium movement resistance section" that generates resistance against the introduction medium introduced from the lower end side moving toward the upper end side. Therefore, the directional volume reduction section 34 can reduce the internal volume of the storage section 11b sequentially from the lower end side to the upper end side, and has the function of moving the recovered tissue from the lower end side to the upper end side.

As described above, according to the tissue recovery instrument 3 of this embodiment, the same effects as those of the first embodiment can be obtained.
It should be noted that the tubular helical member that constitutes the directional volume reduction section may be formed of any stretchable stretchable member, or may be formed of a completely non-stretchable member. It is the same as the first embodiment in that a valve that creates resistance to the movement of the medium may be provided.

<Embodiment 4>
FIG. 9 is a diagram conceptually showing the tissue recovery instrument 4 of Embodiment 4. As shown in FIG.
The basic concept of the tissue recovery instrument 4 of this embodiment is the same as that of the tissue recovery instrument 1 of Embodiment 1, and the introduction medium introduced from the lower end side moves toward the upper end side. By having the function of the "medium movement resistance section" that causes the storage section to "squeeze up from the lower end side".
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

The tissue recovery instrument 4 includes a bag portion 11 having an opening 12, which is composed of an outer restricting body 11a and a storage portion 11b, as in the first embodiment.
In the present embodiment, a directional volume reduction section configured by a tubular variable volume member extending from the lower end side to the upper end side is arranged between the outer restraining body 11a and the storage section 11b. 44-1 to 44-3 are arranged. The directional volume reduction units 44-1 to 44-3 are variable volume members that increase in volume when the introduction medium is introduced thereinto and decrease the internal volume of the storage unit 11b.

Since each of the directional volume reduction units 44-1 to 44-3 has basically the same configuration, only the directional volume reduction unit 44-1 will be described here.
As shown in FIG. 9, the directional volume reduction section 44-1 is arranged such that a tubular member (tubular variable volume member) formed of an elastic member extends from the lower end side to the upper end side. , and an introduction section branched from the medium introduction section 131 is connected at its lower end.
Therefore, the introduction medium introduced by the introduction section branched from the medium introduction section 131 flows upward through the interior of the tubular variable volume member. At this time, friction loss occurs due to the introduction medium passing through the tubular member, and this friction loss is increased by the fact that the tubular member is an elastic member. The configuration that causes the friction loss functions as a "medium movement resistance section" that generates resistance against the introduction medium introduced from the lower end side moving toward the upper end side. Therefore, the directional volume reduction section 44-1 can sequentially reduce the internal volume of the storage section 11b from the lower end side to the upper end side, and has the function of moving the recovered tissue from the lower end side to the upper end side.

Directional volume-reducing sections 44-2 and 3 having the same configuration as the above-described directional volume-reducing section 44-1 are arranged symmetrically along the outer circumference of the opening 12 when viewed from above, and have a common An introduction medium is introduced by an introduction section branched from the medium introduction section 131 .
With this configuration, as can be understood from FIG. 9, when the introduction medium is introduced, the directional volume reduction sections 44-1 to 44-3 gradually expand from the lower end side.
As a result, the internal volume of the storage portion 11b is gradually reduced from the lower end side of the storage portion 11b to the upper end side, and the recovered tissue Sp in the storage portion 11b is squeezed up and moved to the upper side. It is something that makes

As described above, according to the tissue recovery instrument 4 of this embodiment, the same effects as those of the first embodiment can be obtained.
In addition, the directional volume reduction part (tubular variable volume member) may be formed of any stretchable stretchable member, or may be formed of a completely non-stretchable member, It is the same as the first embodiment in that a valve that creates resistance to the movement of the medium may be provided.
Further, it is of course possible to increase or decrease the number of directional volume reduction sections (tubular variable volume members) (the number of directional volume reduction sections may be one).

In the present embodiment, an introduction part branched from the common medium introduction part 131 introduces the introduction medium into the directional volume reduction parts 44-1 to 44-3 as an example. may be introduced.
In other words, independent medium introduction sections 131-1 to 131-3 may be provided for each of the directional volume reduction sections 44-1 to 44-3, based on the same concept as the tissue recovery instrument 2-1 described in FIG. .
With such a configuration, when moving the collected tissue, it can be used to move the collected tissue in the horizontal direction.

<Embodiment 5>
FIG. 10 is a diagram conceptually showing the tissue recovery instrument 5 of Embodiment 5. As shown in FIG.
The tissue recovery instrument 5 of the present embodiment includes partially variable volume members 54-1 to 54-3 that increase the volume by introducing an introduction medium into the interior and decrease the internal volume of the storage portion 11b. A plurality of members 54-1 to 54-3 are arranged in order from the lower end side to the upper end side of the storage portion 11b. In addition, medium introduction sections 131-1 to 131-3 are provided for individually introducing the introduction medium to the partial variable volume members 54-1 to 54-3. Although omitted in the drawing, a pump or the like is provided so that the introduction medium can be individually fed to each of the medium introduction sections 131-1 to 131-3.
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

Each of the partial variable volume members 54-1 to 54-3 is a doughnut-shaped member formed of an elastic member and arranged around the storage portion 11b. That is, it is an annular member along the outer periphery of the storage portion 11b in a cross-sectional view substantially perpendicular to the axis extending from the upper end side to the lower end side.

In the tissue recovery instrument 5, as shown in FIG. 10, the introduction medium is introduced in order from the partial variable volume member 54-1 on the lower end side to the partial variable volume member 54-3 on the upper end side. , the partial variable volume member expands in order.
As a result, the internal volume of the storage portion 11b is gradually reduced from the lower end side of the storage portion 11b to the upper end side so as to be squeezed up, and the recovered tissue Sp in the storage portion 11b is squeezed up and the upper portion of the storage portion 11b is squeezed up. It moves to the side.

As described above, according to the tissue recovery instrument 5 of the present embodiment, the recovered tissue can be extracted from the body more easily and more reliably.
As in the first embodiment, the partially variable volume member may be formed of any stretchable stretchable member or may be formed of a completely non-stretchable member.
Also, it is of course possible to increase or decrease the number of partial variable volume members. For example, it is possible to set the number of stages of the partial variable volume member to one. As an example corresponding to this, Embodiment 11 will be described later.

The method of sequentially introducing the introduction medium into each of the partial variable volume members 54-1 to 54-3 is similar to manually operating hand pumps or the like connected to each of the medium introduction sections 131-1 to 131-3 in order. Alternatively, the operation of an electric pump or the like may be automatically controlled.
When the operation of an electric pump or the like is to be automatically controlled, the amount of introduction medium corresponding to the capacities of the partial variable volume members 54-1 to 54-3 can be supplied in order from the lower end side partial variable volume member. good. Alternatively, a pressure gauge may be provided to supply the introduction medium until a predetermined pressure is reached, and when the predetermined pressure is reached, the supply to the next (upper side) partial variable volume member may be started. The introduction timing of the introduction medium to each partial variable volume member may partially overlap.

In introducing the introduction medium into each of the partial variable volume members 54-1 to 54-3, the introduction amount per unit time may be larger on the lower end side than on the upper end side.
For example, even if introduction of medium to be introduced into each of the partial variable volume members 54-1 to 54-3 is started at the same time, by increasing the introduction amount per unit time on the lower end side compared to the upper end side, the storage portion This provides the effect of squeezing up from the lower end side of 11b. In addition, by forming the storage portion into an inverted conical shape, the capacity of the lower end side becomes smaller than that of the upper end side. , the effect of squeezing up from the lower end side of the storage portion 11b can be obtained.

<Embodiment 6>
FIG. 11 is a diagram conceptually showing the tissue recovery instrument 6 of Embodiment 6. As shown in FIG.
The basic concept of the tissue recovery instrument 6 of this embodiment is the same as that of the tissue recovery instrument 5 of Embodiment 5, and the partially variable volume members 64-1 to 64-4 extend from the lower end side to the upper end side of the storage portion 11b. By sequentially introducing the introduction medium from the lower end side to each of the partial variable volume members 64-1 to 64-4, the storage portion 11b is squeezed up from the lower end side and sequentially moved to the upper end side. The inner volume of the storage portion 11b is reduced, and the recovered tissue Sp in the storage portion 11b is moved upward.
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

In the tissue recovery instrument 6, each of the partial variable volume members 64-1 to 64-4 is divided into a plurality of parts in a cross-sectional view substantially perpendicular to the axis extending from the lower end side to the upper end side. This embodiment differs from the fifth embodiment in that medium introduction portions are provided individually for the inflatable bodies.

Since each of the partial variable volume members 64-1 to 64-4 has basically the same concept, the partial variable volume member 64-4 on the upper end side will be explained here.
The partially variable volume member 64-4 is composed of expansion bodies 64-4a to 64-c formed of elastic members, and a medium introduction part 131-4a for individually introducing the introduction medium into each of the expansion bodies 64-4a to 64-4c. ~c are provided.

According to the tissue recovery instrument 6, as can be understood from FIG. 12, similarly to the fifth embodiment, the inner volume of the storage portion 11b is gradually increased from the lower end side of the storage portion 11b to the upper end side. It is possible to move the recovered tissue in the storage portion 11b upward.
In addition, since the introduction medium can be individually introduced into any inflatable body, it is possible to guide the recovered tissue in the storage portion 11b in any direction.
As in the first embodiment, each inflatable body constituting the partially variable volume member may be made of any stretchable stretchable member or may be formed of a completely non-stretchable member.
Further, it is of course possible to increase or decrease the number of the partial variable volume members or to increase or decrease the number of expansion bodies constituting the partial variable volume members.
Also, the method of introducing the introduction medium into each inflatable body may be either manual or automatic, and in the case of automatic, it may be based on flow control, pressure control, etc., as in the fifth embodiment.

<Embodiment 7>
FIG. 13 is a cross-sectional view of the tissue recovery instrument 7 of Embodiment 7, and FIG. 14 is a view of a directional volume reduction section 74 of Embodiment 7. As shown in FIG.
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

The tissue recovery instrument 7 includes a bag portion 11 having an opening 12, which is composed of an outer restraining body 11a and a storage portion 11b, as in the first embodiment.
In this embodiment, a directional volume reducing portion 74 is provided between the outer restraining body 11a and the storage portion 11b.
As shown in FIG. 14, the directional volume reduction section 74 includes a flexible elongated member (string member 741 in this embodiment) slidably wound around the outer periphery of the storage section 11b. One end of the string member 741 is directly or indirectly fixed to a point 744 on the upper end side, and the string member 741 is wound around the outer periphery of the storage portion 11b from the upper end side to the lower end side. is pulled out from the upper end side of the storage portion 11b.
The directional volume reduction section 74 includes string insertion members 743a to 743f for holding the “wound” arrangement of the string member 741. As shown in FIG. Each of the string insertion members 743a to 743f has basically the same configuration, and is a flexible ring-shaped and band-shaped member having an insertion portion through which the string member 741 is slidably inserted on the outer circumference. ing. The insertion portion is formed around the outer periphery of the ring, and the entrance and exit of the string member 741 to the insertion portion are formed at locations where the cord insertion members 743a to 743f are oriented substantially in the same direction. The string member 741 exiting from the exit of the string insertion member enters from the entrance of the lower string insertion member, and the string member 741 that goes around the string insertion member and exits from the exit passes through the lower string insertion member. The configuration of entering from the entrance of the insertion member is repeated. The uppermost string insertion member 743f has no entrance, and one end of the string member 741 is fixed at a point 744. As shown in FIG. The string member 741 coming out of the outlet 745 of the lowermost string insertion member 743a is pulled out from the upper end side of the storage portion 11b, and a handle 772 is fastened to the end thereof (see FIG. 13).

FIG. 15 is an explanatory diagram for explaining the action of the tissue recovery instrument 7. FIG.
After putting the recovered tissue Sp into the storage part 11b, pulling the string member 741 with the handle 772 in a state in which the opening 12 is pulled out of the body surface S, the string member 741 is pulled in order from the string insertion member 743a on the lower end side. A contraction-like action occurs. A tensile force generated by pulling the handle 772 causes the string member 741 to slide against each of the string passing members 743a to 743f, contracting each string passing member. The action of contracting sequentially from 743a works.
Specifically, since the string member 741 is wound around the outer periphery of the storage portion 11b from the upper end side to the lower end side, it is not pulled from the lower end side. Become. Here, if the handle 772 side of the string member 741 is the base end side and the point 744 side is the distal end side, the sliding string member 741 receives frictional resistance over its path, so the tensile force is applied to the proximal end side. Attenuation is small, but the sliding path length becomes longer toward the tip side, and the attenuation due to frictional resistance increases accordingly, so the tensile force becomes weaker toward the tip side. Therefore, a stronger tensile force acts on the cord insertion member on the lower end side, and the action of contraction works in order from the cord insertion member 743a on the lower end side.
By this action, as shown in FIG. 15, an action is generated in which the string insertion member 743a on the lower end side is tightened in order to the string insertion member 743f on the upper end side, thereby squeezing from the lower end side of the storage portion 11b. The internal volume of the storage portion 11b is gradually decreased toward the upper end side in an upward manner, and the collected tissue Sp in the storage portion 11b can be moved upward.

As described above, according to the tissue recovery instrument 7 of the present embodiment, the recovered tissue can be extracted from the body more easily and more reliably.
In the present embodiment, a cord member is used as an example of the flexible elongated member, but the present invention is not limited to this, and may be, for example, a band-like or belt-like member, which is flexible. Any member having properties can be used. In addition, as described in the following embodiments, a plurality of flexible elongated members may be provided.
Further, in the present embodiment, six stages of the string passing members (string passing members 743a to 743f) are taken as an example, but the number of stages of the string passing members can be increased or decreased as appropriate.
In this embodiment, the outer restraint body 11a is provided as an example, but the outer restraint body 11a is not essential.
Moreover, it is not necessary to provide the storage portion 11b separately from the directional volume reduction portion 14, either. For example, as can be understood from FIG. 14, the directional volume reduction section 74 itself can function as a storage section, that is, the storage section can be configured by the directional volume reduction section.

In this embodiment, the ring-shaped string insertion members are arranged one above the other. However, as shown in FIGS. 16 and 17, a spiral string insertion member may be provided.
FIG. 16 is a cross-sectional view of a tissue recovery instrument 7-1, which is another example of the tissue recovery instrument, and FIG. 1 is a diagram showing FIG.
The tissue recovery instrument 7-1 has the same configuration as the tissue recovery instrument 7 except for the directional volume reducing portion 74-1.
The directional volume reduction section 74-1 has a string insertion member 743-1 for holding the “wound” arrangement of the string member 741. As shown in FIG. The string insertion member 743-1 is a flexible belt-like member spirally wound around the storage portion 11b, and has an insertion portion through which the string member 741 is slidably inserted on the outer periphery. are doing.
The string member 741 is directly or indirectly fixed at a point 744 on the upper end side, and is spirally wound through the insertion portion toward the lower end side. 11b is pulled out from the upper end side.
The tissue recovery instrument 7-1 having this configuration can obtain the same effects as the tissue recovery instrument 7. FIG.

In this embodiment, the flexible elongated member is helically wound, but the present invention is not limited to this. For example, as shown in FIG. The flexible elongated member may be wound around the outer periphery of the storage portion from the upper end side to the lower end side.
FIG. 18 is a diagram conceptually showing a tissue recovery instrument 7-2, which is another example of the tissue recovery instrument.
The tissue recovery instrument 7-2 is similar to the tissue recovery instrument 7 in that the string member 741 is arranged so as to be wound around the outer periphery of the storage portion 11b from the upper end side to the lower end side. However, the method of winding the string member 741 is different.
In the tissue recovery instrument 7-2, one end of the string member 741 is fixed at a point 744 on the upper end side, and the string member 741 is wound around the outer periphery of the storage portion 11b from the upper end side toward the lower end side. However, the winding direction is reversed in the middle. More specifically, the winding direction of the string member 741 is reversed between an insertion portion 741a and an insertion portion 741b which are fixed to the storage portion 11b and through which the string member 741 is slidably inserted in the vertical direction. Further, the string member 741 protruding from the insertion portion 741c provided on the lower end side is pulled out from the upper end side of the storage portion 11b.
As is clear from the example of FIG. 18, the string insertion member that covers the entire outer side of the storage portion 11b as shown in FIGS. 14 and 17 is not necessarily required. Any member that can appropriately maintain the arrangement state of the string member 741 may be used. However, by providing the band-like string insertion member as shown in FIGS. 14 and 17, it is possible to obtain the effect of preventing the pressure on the storage portion 11b caused by tightening by the string member from being localized. .

<Embodiment 8>
FIG. 19 is a diagram conceptually showing the tissue recovery instrument 8 of Embodiment 8. As shown in FIG.
In the tissue recovery instrument 8, a flexible elongated member is wound around the outer periphery of the storage portion from the upper end side to the lower end side, thereby squeezing the storage portion from the lower end side to the upper end side in order. This is the same as Embodiment 7 in that the internal volume of the storage portion is reduced and the recovered tissue in the storage portion is moved upward.
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

In the tissue recovery instrument 8, the directional volume reducing portion is configured by a flexible elongated member (string member 841 in this embodiment) that is directly or indirectly fixed to a point 844 whose middle portion is the upper end side. ing. The string member 841 is wound around the outer periphery of the storage portion 11b from the upper end side to the lower end side, and both ends 846-1 and 846-2 of the string member 841 are pulled out to the upper end side of the storage portion 11b.
Although not shown in the drawings, a string insertion member or the like is appropriately provided so that the arrangement state of the string member 841 can be appropriately maintained.

The tissue recovery instrument 8 of this embodiment can obtain the same effects as those of the seventh embodiment.
Regarding the flexible elongated member, the point that any flexible member such as a band or belt can be used and the number of times of winding can be increased or decreased are the same as in the seventh embodiment. is similar to

A plurality of flexible elongated members may be provided, in which case the ends of the flexible elongated members drawn to the upper end side are arranged symmetrically on the outer periphery of the opening 12. It is better to
FIG. 20 conceptually shows a state in which such a tissue recovery instrument 8-1 is viewed from above.
The tissue recovery instrument 8-1 includes a string member 841a having the same configuration as the string member 841 described above with respect to the tissue recovery instrument 8, and having the same configuration as the string member 841, the tissue recovery instrument 8-1 is oriented 180° with respect to the string member 841a. A string member 841b is provided that is arranged in a rotated state. With this configuration, as shown in FIG. 20, both ends 846-1a and 846-2a of the string member 841a and both ends 846-1b and 846-2b of the string member 841b are symmetrical on the outer periphery of the opening 12. are strategically placed.
According to the tissue recovery instrument 8-1, since the ends of the plurality of string members are symmetrically arranged on the outer periphery of the opening, the force applied to the tissue recovery instrument when the string members are pulled is reduced. It is preferable in that it can be equalized.

<Embodiment 9>
FIG. 21 is a diagram conceptually showing the tissue recovery instrument 9 of the ninth embodiment.
The tissue recovery instrument 9 is a flexible elongated member whose intermediate portion is directly or indirectly fixed to the storage portion 11b, wound around the outer periphery of the storage portion 11b, and both ends are pulled out to the upper end side. (In this embodiment, string members 941a and 941b) are provided, and the string members 941a and 941b are arranged in order from the lower end side to the upper end side. The configuration constitutes a directional volume reduction section.
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

The string member 941a and the string member 941b have the same concept as the string member 841 of the eighth embodiment, and are wound around the outer periphery of the storage portion 11b from the upper end side to the lower end side. 1a, 946-2a and both end portions 946-1b, 946-2b are pulled out to the upper end side of the storage portion 11b.
Although not shown in the drawings, a string insertion member or the like is appropriately provided so that the arrangement state of each string member can be appropriately maintained.

In the tissue recovery instrument 9, both ends 946-1b and 946-2b of the string member 941b on the lower end side are pulled first, and then both ends 946-1b and 946-2b of the string member 941a on the upper end side are pulled. By pulling, the internal volume of the storage portion 11b is gradually reduced from the lower end side of the storage portion 11b to the upper end side by squeezing up, and the recovered tissue in the storage portion 11b is moved upward. can be done.
Regarding the flexible elongated member, the point that any flexible member such as a band or belt can be used and the number of times of winding can be increased or decreased are the same as in the seventh embodiment. is similar to
In addition, although the case where the flexible elongated members arranged in the vertical direction are arranged in two stages is taken as an example here, it is a matter of course that the flexible elongated members may be arranged in three stages or more.

In the present embodiment, as an example of the flexible elongated members arranged in the vertical direction, those having the same concept as the string member 841 of the eighth embodiment are used, but any flexible elongated members described in the seventh and subsequent embodiments may be used. Any combination of materials can be arranged in the vertical direction.

Alternatively, as described with reference to FIG. 20, after arranging a plurality of flexible elongated members, the end portions of the flexible elongated members may be arranged symmetrically on the outer periphery of the opening. good.

<Embodiment 10>
FIG. 22 is a diagram conceptually showing the tissue recovery instrument 10 of the tenth embodiment.
In the tissue recovery instrument 10, one end thereof is directly or indirectly fixed to the storage portion 11b, and a flexible elongated member (string members 1041a and 1041b in this embodiment) is wound around the outer periphery of the storage portion 11b. , 1041c), and a plurality of string members 1041a, 1041b, and 1041c are arranged in order from the lower end side to the upper end side of the storage portion 11b.

One end of the cord member 1041a, which is the lowest end, is fixed to the storage portion 11b at a point 1044a, and after being wound around the storage portion 11b, the other end is pulled out to the upper end side of the storage portion 11b. .
In addition, the locking portion 1047a is fixed to the string member 1041a at a position above the winding position of the string member 1041c, which is the uppermost end.

One end of the string member 1041b is fixed to the storage portion 11b at a point 1044b, and the storage portion 11b is wound around the storage portion 11b. are non-slidably engaged.
More specifically, a ring member 1048b is formed at the other end of the string member 1041b, and the string member 1041a is inserted through the ring member 1048b. The inner diameter of the ring member 1048b is equal to or greater than the diameter of the string member 1041a and smaller than the outer diameter of the locking portion 1047a. That is, the string member 1041a is slidable with respect to the ring member 1048b, but cannot pass through the engaging portion 1047a. It is engaged so that it is slidable only over a predetermined distance and is not slidable over a predetermined distance.

A string member 1041c on the upper side of the string member 1041b has one end fixed to the storage portion 11b at a point 1044c, and after being wound around the storage portion 11b, the other end is positioned at a predetermined distance from the string member 1041a. They are engaged so as to be slidable and not slidable over a predetermined distance.
More specifically, a ring member 1048c is formed at the other end of the string member 1041c, and the string member 1041a is inserted through the ring member 1048c. The inner diameter of the ring member 1048c is equal to or greater than the diameter of the string member 1041a and smaller than the outer diameter of the locking portion 1047a (or the ring member 1048b). That is, the string member 1041a is slidable with respect to the ring member 1048c, but the locking portion 1047a (or the ring member 1048b) cannot pass through. It engages with 1041a so that it can slide by a predetermined distance and cannot slide over a predetermined distance.

The slidable distance L1 of the flexible elongate member 1041a is configured to be longer than the slidable distance L2 of the flexible elongate member 1041b. The slidable distance L2 of flexible elongate member 1041b is configured to be longer than the slidable distance L3 of flexible elongate member 1041c.
Although not shown in the drawings, a string insertion member or the like is appropriately provided so that the arrangement state of each string member can be appropriately maintained.

The tissue recovery instrument 10 of the present embodiment has a directional volume reducing portion formed by the configuration described above.
It should be noted that the same reference numerals are used for the same configuration as in the first embodiment, and the description here is simplified or omitted.

In the tissue recovery instrument 10, when the other end of the string member 1041a pulled out to the upper end side of the storage portion 11b is pulled, the diameter of the string member 1041a wound around the storage portion 11b is first reduced, The storage portion 11b is tightened at that portion. At this time, as the string member 1041a is pulled, the locking portion 1047a also moves upward. No tensile force occurs.
After that, when the engaging portion 1047a comes into contact with the ring member 1048b, the ring member 1048b is also pulled upward. As a result, the diameter of the string member 1041b wound around the storage portion 11b is reduced, and the storage portion 11b is tightened at that portion.
After that, when the locking portion 1047a (or the ring member 1048b) comes into contact with the ring member 1048c, the ring member 1048c is also pulled upward. As a result, the diameter of the string member 1041c wound around the storage portion 11b is reduced, and the storage portion 11b is tightened at that portion.

As can be understood from the above description, according to the tissue recovery instrument 10, the internal volume of the storage portion 11b is gradually reduced from the lower end side of the storage portion 11b toward the upper end side by squeezing it upward. The collected tissue inside can be moved to the upper side.
As for the flexible elongated member, it is the same as in the seventh embodiment in that any flexible member such as a band or belt can be used.
Also, in this example, the flexible elongated members arranged in the vertical direction are arranged in three stages, but it is of course possible to arrange them in two stages or four or more stages.

<Embodiment 11>
FIG. 23 is a cross-sectional view of the tissue recovery instrument 15 of Embodiment 11. As shown in FIG. 24A and 24B are explanatory diagrams for explaining the action of the tissue recovery instrument 15. FIG.
The tissue recovery instrument 15 of the present embodiment includes partially variable volume members 154-1 and 2 that increase the volume by introducing an introduction medium into the interior and decrease the internal volume of the storage portion 11b. Volume members 154-1 and 154-2 are arranged on the lower end side of the storage portion 11b. The medium introduction part 131 and the hand pump 132 for introducing the introduction medium have the same concepts as those in the first embodiment (the same reference numerals are used for the same configurations as in the first embodiment, and simplified or omitted).

Since the partial variable volume members 154-1 and 154-2 basically have the same configuration (symmetrical configuration), the partial variable volume member 154-1 will be mainly described here.
The partially variable volume member 154-1 is arranged along the inner peripheral surface of the storage portion 11b on the lower end side of the storage portion 11b. The partial variable volume member 154-1 of this embodiment extends over approximately half of the inner circumference of the storage portion 11b in a cross-sectional view substantially perpendicular to the axis extending from the upper end side to the lower end side (the partial variable volume member 154-1). -2 exists in the remaining half circumference).
Further, as shown in FIG. 24, the vertical length L1 of the partial variable volume members 154-1, 2 is larger than the maximum dimension L2 of the recovered tissue Sp assumed to be recovered by the tissue recovery instrument 15. short. In addition, the vertical length L1 of the partial variable volume members 154-1 and 2 is 4/5 or less (for example, 2/3 or less, or 1/2 or less, or 1/3 or less).
As shown in FIG. 24, the partial variable volume members 154-1 and 154-2 are mainly positioned on the lower side with respect to the collected tissue Sp stored in the storage section 11b. In addition, the “recovery tissue expected to be recovered by the tissue recovery instrument” is appropriately determined based on the specifications and design concept of each tissue recovery instrument at the time of commercialization.
According to the tissue recovery instrument 15 having the above configuration, as shown in FIG. 24, the volume of the partially variable volume members 154-1 and 154-2 is increased by introducing the introduction medium, and the internal volume of the storage portion 11b is increased. When (the space in which the recovered tissue Sp can exist) is reduced, the recovered tissue Sp is squeezed up and moved upward.

As described above, according to the tissue recovery instrument 15 of this embodiment, the same effects as those of the first embodiment can be obtained.
As in the first embodiment, the partially variable volume member may be formed of any stretchable stretchable member or may be formed of a completely non-stretchable member.
Also, the number of divisions of the partial variable volume member (the number of divisions in a cross-sectional view substantially perpendicular to the axis extending from the upper end side to the lower end side (2 in this embodiment)) may of course be increased or decreased. When the partial variable volume member is divided, it is not always necessary to provide the partial variable volume member continuously on the inner peripheral surface of the storage portion 11b, and for example, it may be intermittently provided.
In addition, the partial variable volume member and the storage section may be separately formed and combined (bonded together, etc.), or integrally formed (for example, the partial variable volume member may be integrally formed as part of the housing).

Also, the method of introducing the introduction medium into the partial variable volume member may be either manual or automatic, and in the case of automatic, it may be based on flow control, pressure control, etc., as in the fifth embodiment.
In the present embodiment, the introduction medium is introduced into the partial variable volume members 154-1 and 154-2 by the introduction section branched from the common medium introduction section 131, but the introduction medium is individually introduced to each of them. You may make it introduce.

As described above in each embodiment, according to the tissue recovery instrument of each embodiment, by providing the directional volume reduction section for moving the recovered tissue to the opening, the recovered tissue can be recovered more easily and more reliably. can be taken out of the body.
For example, when removing lung lobes in thoracoscopic surgery, it may be necessary to pull out the tissue collection bag containing the lung lobes from between the ribs, but the bag containing the lung lobes is caught on the ribs and cannot be pulled out. Or, at this time, the intercostal nerve was sometimes compressed. If the intercostal nerve is compressed during surgery, it may cause postoperative pain, which poses a problem of increasing the burden on the patient.
According to the tissue recovery instrument of each embodiment, the recovered tissue in the storage part can be moved upward and taken out, so that such problems can be reduced, which is very useful. be.

Note that the tissue recovery instrument of each embodiment may be provided with a display that serves as an index of the insertion position into the body when the tissue recovery instrument is inserted into the body.
For example, a mark M may be attached to the location indicated by the arrow in FIG. The display M can use any notation that functions as an index, for example, a reference line, an arrow, a character, etc., or a color-coded display (for example, different colors above and below the position of M). There may be. Also, it may be one that displays a step-by-step index (for example, one that marks a plurality of reference lines or a memory).
Additionally, indicia may be provided to indicate where the variable volume member is formed. As described in each of the above embodiments, the variable volume member increases in volume, and it is preferable not to place it at the location of the incision. This is to reduce the effect of expanding the incision when the variable volume member expands. Therefore, it is recommended to provide an indication that the position and range where the variable volume member is formed can be easily recognized from the outside (for example, it may be a warning indication such as "Be sure to insert into the body up to this position"). can be

In the tissue recovery instrument of each embodiment, the length of the storage portion in the vertical direction (direction from one end to the other end) (for example, length L3 in FIG. 24) is 25 cm, considering the limitation of the space in the thoracic cavity. It is preferably 20 cm or less, more preferably 20 cm or less. In addition, the length in the vertical direction (direction from one end to the other end) of the directional volume reduction portion (or the partial variable volume member) is the length in the vertical direction (direction from one end to the other end) of the storage portion (for example, , 1/3 to 4/5 of the length L3) in FIG.

A string may be arranged along the edge of the opening of the storage section, and a mechanism may be provided in which the opening is closed like a purse when the string is pulled. At this time, a limiting member (predetermined opening maintaining member) may be provided to prevent the opening from becoming smaller than a certain size. For example, a stopper that physically prevents the string from being pulled more than a certain amount may be placed in the middle of the string or at an arbitrary location on the edge of the storage section (opening) where the string is arranged. good. Alternatively, a ring-shaped part may be arranged in the opening so that the opening does not become smaller than a certain size.

1. . . Tissue Recovery Instruments 11a. . . Outer Constraint 11b. . . Storage part 12 . . . opening 131 . . . Medium introduction part 14 . . . Directional volume reduction section 141a-141f. . . Partial variable volume member 142 . . . Communication part (medium movement resistance part)
341. . . Tubular spiral member 44-1 to 44-3. . . Directional volume reduction section (tubular variable volume member)
741. . . String member (flexible elongated member)
S. . . body surface Sp. . . Collected tissue 100 . . . Conventional tissue collection bag (Patent Document 1) 110 . . . Inner bag of conventional tissue collection bag (Patent Document 1) 140 . . . Outer bag of conventional tissue collection bag (Patent Document 1) 150 . . . Space in a conventional tissue collection bag (Patent Document 1)
F. . . Fluid introduced into a conventional tissue collection bag (Patent Document 1)

Claims (39)

A tissue recovery instrument for extracting recovered tissue from the body to the outside of the body,
a storage unit having an opening on one end side and storing the recovered tissue therein;
a directional volume reduction unit that moves the collected tissue from the other end side to the one end side by reducing the internal volume of the storage unit from the other end side toward the one end side;
A tissue retrieval device comprising: The directional volume reduction unit is
a variable-capacity member that increases in volume by introducing an introduction medium into the interior and reduces the internal volume of the storage unit;
a medium introduction section for introducing the introduction medium from the other end side of the variable volume member;
with
2. The tissue recovery instrument according to claim 1, wherein said variable volume member has a medium movement resistance section that produces resistance against movement of said introduced medium introduced inside from said other end side to said one end side. . 3. The tissue recovery instrument according to claim 2, wherein the variable volume member comprises a plurality of partial variable volume members arranged in order from the other end side to the one end side of the storage section. 4. The tissue according to claim 3, wherein the medium movement resistance section is configured by a communication section that allows the plurality of partially variable volume members to communicate with each other, and that the communication section restricts movement of the introduction medium. recovery equipment. 4. The tissue recovery instrument according to claim 3, wherein the medium movement resistance portion is configured by forming the partially variable volume member with an expandable member. 4. The partially variable volume member according to claim 3, wherein the member is an annular member along the outer circumference of the storage portion in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage portion. tissue collection device. 4. The tissue recovery instrument according to claim 3, wherein the partially variable volume member is divided into a plurality of pieces in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage portion. The variable volume member is configured by a tubular spiral member spirally arranged from the other end side to the one end side, and the medium movement resistance section is configured based on friction loss caused by being a tubular member. 3. The tissue retrieval instrument of claim 2, wherein the tissue retrieval instrument is a 9. The tissue retrieval device of claim 8, wherein said tubular helical member is formed by a telescopic member to increase said friction loss. 9. The tissue retrieval device of claim 8, wherein the tubular helical member is provided with a valve that provides resistance to movement of the introduction medium. The variable volume member is configured by a tubular variable volume member arranged to extend from the other end side to the one end side, and the medium movement resistance is based on the friction loss caused by being a tubular member. 3. The tissue retrieval device of claim 2, wherein the tissue retrieval device comprises a section. 12. The tissue recovery instrument according to claim 11, wherein a plurality of said tubular variable volume members are arranged. 13. The tissue recovery instrument according to claim 12, comprising a medium introduction part for independently introducing the introduction medium into each of the plurality of tubular variable volume members. 12. The tissue retrieval device according to claim 11, wherein said tubular variable volume member is formed by an extendable member, thereby increasing said friction loss. 12. The tissue retrieval device of claim 11, wherein the tubular variable volume member is provided with a valve that provides resistance to movement of the introduction medium. The directional volume reduction unit includes a partially variable volume member that increases in volume when an introduction medium is introduced into the interior and reduces the internal volume of the storage unit,
A plurality of the partially variable volume members are arranged in order from the other end side of the storage portion to the one end side,
2. The tissue recovery instrument according to claim 1, comprising a medium introduction part for individually introducing the introduction medium into each of the plurality of partial variable volume members. 17. The tissue recovery instrument according to claim 16, wherein the medium introduction section introduces the introduction medium into the partially variable volume member in order from the other end side to the one end side. 17. The tissue recovery instrument according to claim 16, wherein the introduction amount of the introduction medium per unit time into the partially variable volume member is larger at the other end side than at the one end side. 17. The partially variable volume member according to claim 16, wherein the member is an annular member along the outer periphery of the storage portion in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage portion. tissue collection device. 17. The tissue recovery instrument according to claim 16, wherein the partially variable volume member is divided into a plurality of pieces in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage section. 17. The tissue retrieval device of Claim 16, wherein said partially variable volume member is formed by an elastic member. The directional volume reduction unit includes a partially variable volume member that increases in volume when an introduction medium is introduced into the interior and reduces the internal volume of the storage unit,
At least one of the partial variable volume members is arranged on the other end side of the storage section, and the length of the partial variable volume member in the direction from the one end side to the other end side is the length of the storage section. 2. The tissue recovery instrument according to claim 1, wherein the length in the direction from said one end side to said other end side is 4/5 or less. 23. The tissue recovery instrument according to claim 22, wherein the partially variable volume member is divided into a plurality of pieces in a cross-sectional view substantially orthogonal to an axis extending from the other end side to the one end side of the storage section. the directional volume reducing portion is configured by a flexible elongated member slidably wound around the outer circumference of the storage portion;
One end of the flexible elongated member is directly or indirectly fixed to a location on the one end side of the storage section, and the flexible elongated member extends from the one end side to the other end of the storage section. 2. The tissue recovery instrument according to claim 1, wherein the flexible elongated member is wound toward one end, and the other end of the flexible elongated member is pulled out to the one end of the storage portion. 25. The tissue retrieval device of Claim 24, wherein a plurality of said flexible elongate members are arranged. 26. The tissue retrieval device of claim 25, wherein the ends of the plurality of flexible elongate members that are drawn toward the one end side are symmetrically arranged on the circumference of the opening. the directional volume reducing portion is configured by a flexible elongated member slidably wound around the outer circumference of the storage portion;
A middle portion of the flexible elongated member is directly or indirectly fixed to a location on the one end side of the storage portion, and the flexible elongated member extends from the one end side of the storage portion to the other side. 2. The tissue recovery instrument according to claim 1, wherein the flexible elongated member is wound toward the ends, and both ends of the flexible elongate member are pulled out to the one end side of the storage portion. 28. The tissue retrieval device of claim 27, wherein a plurality of said flexible elongate members are arranged. 29. The tissue retrieval device of claim 28, wherein the ends of the plurality of flexible elongate members that are drawn toward the one end side are symmetrically arranged on the perimeter of the opening. The directional volume reduction unit is
A flexible elongated piece, one end of which is directly or indirectly fixed to the storage portion, wound around the outer circumference of the storage portion, and the other end of which is pulled out toward the one end of the storage portion. with materials,
2. The tissue recovery instrument according to claim 1, wherein a plurality of said flexible elongated members are arranged in order from said other end side of said storage portion to said one end side thereof. 31. The tissue retrieval device of claim 30, wherein the ends of the plurality of flexible elongate members that are drawn toward the one end are symmetrically arranged on the circumference of the opening. The directional volume reduction unit is
A flexible elongated member whose middle part is directly or indirectly fixed to the storage part, is wound around the outer periphery of the storage part, and has both ends pulled out to the one end side of the storage part. with
2. The tissue recovery instrument according to claim 1, wherein a plurality of said flexible elongated members are arranged in order from said other end side of said storage portion to said one end side thereof. 33. The tissue retrieval device of claim 32, wherein the ends of the plurality of flexible elongate members that are drawn toward the one end are symmetrically arranged on the circumference of the opening. The directional volume reduction section comprises a flexible elongated member, one end of which is directly or indirectly fixed to the storage section and wound around the outer periphery of the storage section,
A plurality of the flexible elongated members are arranged in order from the other end side of the storage portion to the one end side thereof,
the other end of the flexible elongated member arranged closest to the other end of the storage portion is pulled out toward the one end of the storage portion;
The other end of the other flexible elongated member is slidable by a predetermined distance with respect to the flexible elongated member drawn out to the one end side of the storage section, and is slidable by a predetermined distance or more. non-slidably engaged such that said slidable distance of each said flexible elongate member extends to said flexible elongate member disposed at said one end of said housing; 2. The tissue recovery instrument according to claim 1, wherein said flexible elongated member disposed on said other end side of said storage portion is configured to be longer than said other end. 24. The tissue recovery instrument according to any one of claims 1 to 23, wherein at least part of said storage portion is constituted by said directional volume reduction portion. 24. The tissue recovery instrument according to any one of claims 1 to 23, comprising an outer restraining body that suppresses an increase in the outer volume of said directional volume reducing portion. 35. The storage portion according to any one of claims 1 to 34, wherein a cross-sectional area substantially perpendicular to an axis extending from the one end side to the other end side of the storage portion decreases from the one end side toward the other end side. Instruments for tissue collection. 35. The tissue recovery device according to any one of claims 1 to 34, comprising a display indicating an insertion position into the body when at least part of the tissue recovery device is inserted into the body. 35. The tissue recovery instrument according to any one of claims 1 to 34, wherein the length of said storage portion in the direction from said one end side to said other end side is 25 cm or less.

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