JP5669165B1 - Endoscopic surgical water supply / suction washing tube - Google Patents

Abstract

[PROBLEMS] To perform local cleaning for cleaning a part of the surgical field at the time of water supply and intraperitoneal cleaning for extensive cleaning of the abdominal cavity, without involving the abdominal tissue during aspiration, Provided is a water supply / suction washing tube for endoscopic surgery that can suck a washing liquid and the like without aspiration. A distal end portion of an outer cylinder is joined to one end of a hollow cylindrical tube portion in which a first hollow hole is formed. A plurality of first through holes 28 are formed in the distal end side region 28 s of the cylindrical portion 22, and a second through hole 29 is formed in the distal end portion 23. The inner cylinder 30 has a second hollow hole 32p formed therein, and one end 32t is opposed to the distal end portion 23 of the outer cylinder 20 with a gap therebetween, and is placed in the first hollow hole 22p of the outer cylinder 20. It arrange | positions and it can move along the 1st hollow hole 22p in the direction which leaves | separates from the position where the opening 32k approached the front-end | tip part 23 of the outer cylinder 20 most. Water can be fed and sucked through the second hollow hole 32p of the inner cylinder 30. [Selection] Figure 3

Description

  The present invention relates to a water supply / suction washing tube for endoscopic surgery, and more particularly, to a water supply / suction washing tube for endoscopic surgery capable of water supply and suction.

  2. Description of the Related Art Conventionally, there is a surgical cleaning tool capable of supplying a cleaning liquid for cleaning the inside of a body cavity and suctioning a liquid including a cleaning liquid, blood, a blood clot, and the like when performing a surgical operation on a body cavity of a patient. Proposed.

  For example, FIG. 16 is a cross-sectional view showing an example of a surgical cleaning tool. FIG. 16A is a cross-sectional view taken along the plane including the outer tube central axis and viewed from above. FIG. 16B is a cross-sectional view taken along the plane passing through A, B, C, and D in FIG. FIG.16 (c) is sectional drawing which follows the EE line | wire in FIG.16 (b). As shown in FIG. 16, in the insertion portion 2 to be inserted into the body cavity, the inner tube 5 is disposed inside the outer tube 4. Water supply uses the inside of the inner tube 5 as a flow channel, and suction uses the channel between the outer tube 4 and the inner tube 5 (see, for example, Patent Document 1).

Japanese Patent Laid-Open No. 10-193

  When performing endoscopic surgery, for example, in order to insert / remove the tube into / from a trocar unit provided on the abdominal wall, the outer diameter of the tube needs to be a predetermined value or less. However, if the double pipe structure is adopted and water flow and suction are performed through separate flow paths, the cross section required for each of water supply and suction is secured, and the outer diameter of the pipe is set to a predetermined value or less. It is extremely difficult. For this reason, in endoscopic surgery, the same tube is generally used for water supply of cleaning liquid and suction of cleaning liquid or the like (cleaning liquid, blood, body fluid, etc.).

  In endoscopic surgery, in order to maintain a clear view of the operative field, suction is frequently performed, and water is supplied and sucked as necessary. When water is supplied and sucked, there are local cleaning for cleaning a part of the surgical field and intraperitoneal cleaning for cleaning the abdominal cavity widely. In local cleaning, it is desirable that the cleaning solution is concentrated locally, and in intraperitoneal cleaning, it is desirable to spray the cleaning solution over a wide range in the surgical field. In addition, at the time of suction, regardless of the depth of the washing solution, the tissue in the abdominal cavity can be aspirated without being involved in the tube, and the abdominal gas can be inhaled while minimizing the suction of the abdominal gas in the abdominal cavity. desirable.

  For example, when the abdominal cavity washing liquid is aspirated, as shown in the explanatory diagram of FIG. 15, the tip 10 y side of the aspirating tube 10 x is inserted into the abdominal cavity and aspirated in the direction indicated by the arrow 90. At this time, while observing the image of the camera, the tip 10y of the suction tube 10x is disposed very close to the liquid surface 84s, and suction is performed so that the tip 10y of the suction tube 10x is not clogged with the intraabdominal tissue 86 such as the intestine or adipose tissue. While moving the tip 10y of the tube 10x, the liquid 84 such as the cleaning liquid is sucked. Such an operation requires skill. Further, from the distal end 10y of the suction tube 10x, not only the liquid 84 in the vicinity of the liquid surface 84s is sucked as indicated by an arrow 92, but also gas in the abdominal cavity is sucked as indicated by an arrow 94. For this reason, the efficiency of suction is poor and it takes time, and it is not possible to keep the stomach.

  In view of such circumstances, the present invention can perform local cleaning for cleaning a part of the operative field and intraperitoneal cleaning for widely cleaning the abdominal cavity during water supply, and involve the intra-abdominal tissue during suction. The present invention is intended to provide a water supply / suction washing tube for endoscopic surgery that is capable of sucking a washing solution without sucking pneumoperitone gas.

  In order to solve the above-described problems, the present invention provides a water supply / suction washing tube for endoscopic surgery configured as follows.

The endoscopic surgical water supply / suction washing tube includes an outer cylinder, an inner cylinder, and a coaxial holding portion. The outer cylinder (a) has first and second openings at both ends, and a hollow cylindrical tube portion in which a first hollow hole communicating between the first and second openings is formed; (B) It is joined to the end of the said cylinder part, and the front-end | tip part which covers the said 1st opening is included. A plurality of first through holes communicating with the first hollow hole are formed in a distal end side region on the distal end side of the cylindrical portion. One or more second through-holes communicating with the first hollow hole are formed at the tip portion. The inner cylinder has (a) third and fourth openings at both ends, (b) a second hollow hole is formed to communicate between the third and fourth openings, and (c) the first 3 is disposed in the first hollow hole of the cylindrical portion of the outer cylinder so as to be opposed to the distal end portion of the outer cylinder with a space therebetween, and (d) the first It can move along the hollow hole. The coaxial holding portion is formed on one of the outer cylinder and the inner cylinder, abuts on the other of the outer cylinder and the inner cylinder, and the tip of the cylinder portion of the outer cylinder A side region and the third opening side of the inner cylinder are kept coaxial. The second hollow hole of the inner cylinder can be used as a flow path for water supply and suction, and at the time of water supply, the cleaning liquid supplied from the third opening of the inner cylinder is the first and second of the outer cylinder. The first through hole is discharged from at least the second through hole of the through hole of the outer cylinder, and at the time of suction, the first through the at least the second through hole of the first and second through holes of the outer cylinder. The liquid that has entered the hollow hole is sucked from the third opening of the inner cylinder.

  According to the said structure, water supply and suction can be performed by using the 2nd hollow hole of an inner cylinder as a flow path. Since the inner cylinder is disposed in the first hollow hole of the cylindrical portion of the outer cylinder and is movable along the first hollow hole, the position of the inner cylinder with respect to the outer cylinder is adjusted, and the distal end of the outer cylinder The interval between the portion and the third opening of the inner cylinder can be changed. Even if the position of the inner cylinder is adjusted with respect to the outer cylinder, the distal end side region of the cylindrical portion of the outer cylinder and the third opening side of the inner cylinder that are opposed to each other are kept coaxial by the coaxial holding portion. It is possible to prevent the suction state from becoming uneven or disturbing.

  According to the above configuration, when the distance between the distal end portion of the outer cylinder and the third opening of the inner cylinder is reduced during water supply, the cleaning liquid is mainly discharged from the second through hole. It can be performed. When the interval between the distal end portion of the outer cylinder and the third opening of the inner cylinder is increased during water supply, the cleaning liquid is discharged from the first and second through holes. be able to. If the third opening of the inner cylinder is below the liquid level at the time of suction, the cleaning liquid or the like can be sucked while keeping the stomach and the part of the first through hole is above the liquid level. And it does not involve the tissue in the abdominal cavity. When the distance between the tip of the outer cylinder and the third opening of the inner cylinder is small, the third opening approaches the second through hole of the tip of the outer cylinder, so suction from the tip of the outer cylinder is possible It is.

  Preferably, the outer diameter of the inner cylinder is smaller than the inner diameter of the inner peripheral surface of the cylinder portion of the outer cylinder forming the first hollow hole. The coaxial holding portion is formed on the inner cylinder, protrudes radially outward from the inner cylinder, and is adjacent to the distal end side region on the opposite side of the inner peripheral surface of the cylindrical portion of the outer cylinder from the distal end. The portion to be touched has an outer peripheral surface that is in contact with the entire periphery.

  In this case, it is easier to manufacture than the case where the coaxial holding portion is formed on the outer cylinder. Since the distance between the distal end side region of the cylindrical portion of the outer cylinder and the third opening side of the inner cylinder that is opposed to each other is kept constant by the coaxial holding portion, the water supply is performed even if the outer cylinder and the inner cylinder are repeatedly disassembled and assembled・ The state of suction is kept constant. In addition, it is possible to maintain a puffy stomach with a simple configuration. That is, the space between the inner cylinder and the outer cylinder is partitioned into a space on the distal end side and a space on the proximal end side by the coaxial holding portion, and the first and second through holes communicate only with the space on the distal end side. Therefore, even if the position of the inner cylinder is changed with respect to the outer cylinder, the insufficiency can be maintained.

  Preferably, a plurality of the second through holes are formed at the tip of the outer cylinder.

  In this case, the distance between the third opening of the inner cylinder and the distal end portion of the outer cylinder, and the arrangement position, shape, and size of the second through hole formed in the distal end portion of the outer cylinder are selected to locally. It is possible to feed the cleaning liquid and the cleaning liquid to a wide area. Further, suction from a local area can be performed by the second through hole at the tip of the outer cylinder, and suction from a deep part can be performed by the first and second through holes.

  Preferably, the outer diameter of the cylindrical portion of the outer cylinder is 3 mm or more and 7 mm or less.

  If the outer diameter of the cylindrical portion of the outer cylinder is 3 mm or more, more preferably 4 mm or more, water supply / suction through the second hollow hole of the inner cylinder is easy. If the outer diameter of the cylindrical portion of the outer cylinder is 7 mm or less, more preferably 6 mm or less, it can be inserted into a trocar unit generally used in endoscopic surgery.

  Preferably, the overall length of the cylindrical portion of the outer cylinder is 200 mm or more and 700 mm or less.

  If the total length of the cylindrical portion of the outer cylinder is 2000 mm or more, more preferably 300 mm or more, the distal end reaches the desired position during the operation. Moreover, it can be sucked in a state of being deeply inserted into the liquid. If the overall length of the cylindrical portion of the outer cylinder is 700 mm or less, more preferably 500 mm or less, the operation is easy.

  Preferably, the length of the tip and the tip side region is 80 mm or more and 150 mm or less.

  If the length of the distal end side region is 80 mm or more, it is easy to prevent a part of the abdominal tissue from being involved by exposing a part of the first through-holes above the liquid surface during intraperitoneal washing. If the length of the distal end side region is 150 mm or less, it is easy to keep all the first through holes in the abdominal cavity and keep the pneumoperitoneum.

  The water supply / suction washing tube for endoscopic surgery of the present invention is capable of local washing for intensively washing the local area and intraperitoneal washing for spraying the washing solution over a wide area and washing the abdominal cavity during water feeding. At the time of aspiration, it is possible to aspirate the washing liquid and the like without involving the intra-abdominal tissue and aspiration gas.

FIG. 1 is an assembly view of a water supply / suction washing tube for endoscopic surgery. Example 1 FIG. 2 is an exploded view of a water supply / suction washing tube for endoscopic surgery. Example 1 FIG. 3 is a cross-sectional view of an essential part of the distal end side of the water / suction washing tube for endoscopic surgery in an assembled state. Example 1 FIG. 4 is a cross-sectional view of the main part of the proximal end side of the endoscope operation water supply / suction washing tube in an assembled state. Example 1 FIG. 5 is an explanatory view of the use state of the water / suction washing tube for endoscopic surgery. Example 1 FIG. 6 is an explanatory diagram of a use state of the water / suction washing tube for endoscopic surgery. Example 1 FIG. 7 is a cross-sectional view of the main part of the inner cylinder. Example 1 FIG. 8 is a cross-sectional view of the main part of the inner cylinder. Example 1 FIG. 9 is a cross-sectional view of the main part of the inner cylinder. Example 1 FIG. 10 is an explanatory diagram of the inner cylinder and the outer cylinder. Example 1 FIG. 11 is an explanatory view of a water supply / suction washing tube for endoscopic surgery. (Example 2) FIG. 12 is a cross-sectional view of the coaxial holding portion. (Modification 1) FIG. 13 is an explanatory diagram of the concept of the present invention. (Explanation example 1) FIG. 14 is an explanatory diagram of a water supply state. (Example 1, Comparative Example 1) FIG. 15 is an explanatory diagram of suction of the cleaning liquid and the like. (Comparative Example 2) FIG. 16 is a sectional view of a water supply / suction washing tube for endoscopic surgery. (Conventional example 1)

  Hereinafter, embodiments of the present invention will be described with reference to FIGS.

  First, the concept of the water / suction washing tube for endoscopic surgery of the present invention will be described with reference to FIG. FIG. 13 is an explanatory diagram of the concept of the water / suction washing tube for endoscopic surgery of the present invention.

  As shown in FIG. 13A, the endoscopic surgical water supply / suction washing tube of the present invention includes a cylindrical outer cylinder 20c having a closed tip 20v. The outer cylinder 20c is formed with a large number of holes 20k like a gold handle. When the outer cylinder 20c is partially submerged in the liquid 84, the liquid 84 flows into the outer cylinder 20c, and the height of the liquid surface 84s is the same inside and outside the outer cylinder 20c. In order to suck the liquid 84 inside the outer cylinder 20c, as shown in FIG. 13B, an inner cylinder 30c having openings formed at both ends like a straw is inserted into the outer cylinder 20c. The liquid 84 inside 20c is sucked from one opening 30v of the inner cylinder 30c.

  In a state where the outer cylinder 20c is submerged in the liquid 84 halfway, even if suction is performed from one opening 30v of the inner cylinder 30c, no pressure difference occurs between the inside and outside of the outer cylinder 20c. Therefore, even if there is an intra-abdominal tissue such as an intestine or a fatty tissue outside the outer cylinder 20c, it is not adsorbed by the outer cylinder 20c. Therefore, when the liquid inside the outer cylinder 20c is reduced by the suction from the inner cylinder 30c, the liquid 84 outside the outer cylinder 20c flows into the outer cylinder 20c, and the suction can be continued.

  The outer cylinder 20c needs to be inserted into the body via the trocar unit inserted into the abdominal wall and moved to the desired position in the body on the distal end 20v side.

  <Example 1> A water supply / suction washing tube 10 for endoscopic surgery of Example 1 will be described with reference to FIGS. 1 to 10 and FIG.

  FIG. 1 is an assembly view of a water supply / suction washing tube 10 for endoscopic surgery. FIG. 2 is an exploded view of the water / suction washing tube 10 for endoscopic surgery. As shown in FIGS. 1 and 2, the endoscopic surgical water supply / suction washing tube 10 includes an outer cylinder 20 and an inner cylinder 30. The outer cylinder 20 is an elongated rod-like member, and a first connection portion 24 in which a female screw 26 is formed is coupled to a proximal end. The inner cylinder 30 is an elongated rod-like member, and a second connection portion 34 having a male screw 36 is coupled to the proximal end. The outer cylinder 20 and the inner cylinder 30 are manufactured using metals, such as stainless steel and titanium, for example.

  The endoscopic surgical water supply / suction washing tube 10 is inserted from the proximal end side of the outer cylinder 20 into the outer cylinder 20 at the distal end 32t side of the inner cylinder 30 and is connected to the female screw 26 of the first connecting portion 24 and The first state in which the inner cylinder 30 is inserted into the outer cylinder 20 most deeply and the outer cylinder 20 and the inner cylinder 30 are coupled to each other by screwing the male thread 36 of the two connecting portions 34 to the end. Can be used in Alternatively, the outer cylinder 20 and the inner cylinder 30 can be used in a relatively moved state. That is, the second state in which the internal thread 26 of the first connection portion 24 and the external thread 36 of the second connection portion 34 are screwed together or loosened, or the first connection portion 24. Although the internal thread 26 and the external thread 36 of the second connection portion 34 are released, the third end state in which the tip 32t side of the inner cylinder 30 is inserted into the outer cylinder 20 is achieved. The distance between the distal end portion 23 of the outer cylinder 20 and the distal end 32t of the inner cylinder 30 (that is, a third opening 32k described later) can be changed.

  FIG. 3 is a cross-sectional view of the main part on the distal end 10t side of the endoscope operation water supply / suction washing tube 10 in an assembled state. As shown in FIGS. 1 to 3, the outer cylinder 20 includes a cylinder part 22 and a tip part 23. The cylindrical portion 22 has a hollow cylindrical shape, has openings (that is, first and second openings) at both ends, and is formed with a first hollow hole 22p that communicates between the openings at both ends. The tip portion 23 is joined to one end of the cylindrical portion 22 and covers the opening 22k (that is, the first opening) at one end of the cylindrical portion 22. A plurality of first through holes 28 communicating with the first hollow hole 22p of the cylindrical portion 22 are formed in the distal end side region 28s on the distal end portion 23 side of the cylindrical portion 22. A second through hole 29 that communicates with the first hollow hole 22 p of the cylindrical portion 22 is formed in the distal end portion 23. The number of the second through holes 29 may be one or two or more.

  The inner cylinder 30 has openings (that is, third and fourth openings) at both ends, a second hollow hole 32p communicating between the openings at both ends is formed, and a third hollow 32p at one end 32t of the inner cylinder 30 is formed. It arrange | positions in the 1st hollow hole 22p of the outer cylinder 20 so that the opening 32k may provide a space | interval with the front-end | tip part 23 of the outer cylinder 20, and may oppose. Specifically, the inner cylinder 30 has a main body part 32 that extends with a space between the inner peripheral surface 22b of the cylindrical part 22 of the outer cylinder 20 that forms the first hollow hole 22p, and a diameter larger than that of the main body part 32. And a coaxial holding portion 38 protruding outward in the direction. The inner cylinder 30 is movable along the first hollow hole 22p in a direction approaching or moving away from the distal end portion 23 of the outer cylinder 20.

  The outer peripheral surface 38k of the coaxial holding portion 38 is opposite to the tip portion 23 even when the inner tube 30 moves along the first hollow hole 22p in a direction approaching or leaving the tip portion 23 of the outer cylinder 20. , The inner peripheral surface 22b of the cylindrical portion 22 of the outer cylinder 20 adjacent to the distal end side region 28s is in contact with the entire circumference. A space between the outer cylinder 20 and the inner cylinder 30 is divided into a space 40 on the distal end side and a space 42 on the proximal end side by the coaxial holding portion 38.

  The internal thread 26 of the first connecting portion 24 and the external thread 36 of the second connecting portion 34 are screwed together to the end, and the inner cylinder 30 is inserted deepest into the outer cylinder 20, and the outer cylinder 20 and the inner cylinder 30 are inserted. Are coupled to each other, the third opening 32k of the one end 32t of the inner cylinder 30 is closest to the tip 23 of the outer cylinder 20. At this time, the outer peripheral surface 38k of the coaxial holding portion 38 is closest to the distal end side region 28s.

  The coaxial holding part 38 is a hollow cylindrical member that is slightly larger than the main body part 32 along the outer peripheral surface 32a of the hollow cylindrical main body part 32 of the inner cylinder 30 as shown in the sectional view of the main part of FIG. 38s is disposed and fixed by brazing 38t or the like. Alternatively, as shown in the cross-sectional view of the main part in FIG. 8, the main body 32 and the coaxial holding portion 38 a are integrally formed by partially changing the diameter of the hollow cylindrical main body 32 of the inner cylinder 30. If the coaxial holding part is formed in the inner cylinder 30, it is easier to manufacture than the case where the coaxial holding part is formed in the outer cylinder as in Modification 1 described later.

  FIG. 4 is a cross-sectional view of an essential part of the proximal end side of the endoscope operation water supply / suction washing tube 10 in an assembled state. As shown in FIG. 4, the first connecting portion 24 has a first hole 25 communicating with the first hollow hole 22 p of the cylindrical portion 22, and a female screw 26 is formed along the first hole 25. Has been. The second connecting portion 34 of the inner cylinder 30 is formed with a male screw 36 that is screwed into the female screw 26 of the first connecting portion 24 on the main body portion 32 side of the inner cylinder 30. The second connection portion 34 has a second hole 35 communicating with the second hollow hole 32 p of the main body portion 32, and a pipe connection member is provided on the opposite side of the main body portion 32 along the second hole 35. A screw 38 is formed.

  Although not shown, an operation unit is attached to the pipe connection female screw 38 of the endoscope operation water supply / suction cleaning tube 10 in the assembled state, and a cleaning solution bag, a suction device, etc. are connected to the operation unit using a tube. In this state, the cleaning liquid is fed and the cleaning liquid is sucked. The operation unit includes an operation button, a water supply valve connected to the cleaning solution bag, a suction valve connected to a vacuum device, a check valve, and the like. The flow path connected to the suction cleaning tube 10 is switched. The operation unit may include a lever or the like instead of the operation button.

  Next, how to use the water / suction washing tube 10 for endoscopic surgery will be described with reference to FIGS. FIG. 5 and FIG. 6 are explanatory diagrams showing the usage state of the water / suction washing tube 10 for endoscopic surgery.

  For example, as shown in FIG. 5, the endoscopic surgical water supply / suction washing tube 10 is inserted into the trocar unit 50 inserted into the abdominal wall 80 and the distal end 10t side of the endoscopic surgical water supply / suction washing tube 10 is inserted. The tip 10t side is used in a state where it reaches the abdominal cavity 82.

  When washing the abdominal cavity 82, the water supply button of the operation unit is operated. By this operation, the water supply valve of the operation unit connected to the cleaning liquid bag is opened, and the cleaning liquid in the cleaning bag allows the third opening 32k (one end 32t of the inner cylinder 30 of the endoscope operation water supply / suction cleaning pipe 10). 3) to the inside of the outer cylinder 20. The cleaning liquid supplied into the outer cylinder 20 is fed into the abdominal cavity from the through holes 28 and 29 of the outer cylinder 20. As a result, water can be supplied to a desired site and washed.

  In the first state in which the internal thread 26 of the first connection portion 24 and the external thread 36 of the second connection portion 34 are screwed together to the end, the distal end portion 23 of the outer cylinder 20 and the distal end of the inner cylinder 30 during water feeding. The distance between the second opening 32k and the third opening 32k is the smallest, and as shown in the explanatory view of FIG. 14A, the cleaning liquid 72 mainly passes through the second through-hole formed in the distal end portion 23 of the outer cylinder 20. It is discharged, and a proper amount of water can be locally delivered to perform local cleaning.

  In the second state where the screw connection between the outer cylinder 20 and the inner cylinder 30 is loosened, or in the third state where the screw connection between the outer cylinder 20 and the inner cylinder 30 is released and the inner cylinder 30 is slightly removed from the outer cylinder 20, The distance between the distal end portion 23 of the outer cylinder 20 and the third opening 32k of the distal end 32t of the inner cylinder 30 is increased, and formed in the cylindrical portion 22 and the distal end portion 23 of the outer cylinder 20, as shown in FIG. The cleaning liquids 74 and 76 are discharged from the first and second through holes. In this case, it is possible to carry out intraperitoneal washing by supplying washing liquids 74 and 76 over a wide range.

  When aspirating the washing liquid or the like in the abdominal cavity 82, the suction button of the operation unit is operated. By this operation, the suction valve of the operation unit connected to the suction device is opened, and the liquid 84 such as the cleaning liquid is sucked from the third opening 32k of the one end 32t of the inner cylinder 30 by the suction pressure by the suction device.

  In the intraperitoneal cleaning shown in FIG. 5, a liquid 84 such as a cleaning liquid around the outer cylinder 20 passes from the first and second through holes 28 and 29 of the outer cylinder 20 to the space 40 on the distal end side in the outer cylinder 20. Enters, is sucked from the third opening 32k of the one end 32t of the main body portion 32 of the inner cylinder 30, flows toward the base end through the second hollow hole 32p of the main body portion 32 of the inner cylinder 30, and passes through the operation unit. To be recovered.

  In a state in which a part of the first through hole 28 is exposed above the liquid level 84s, the inside and outside of the outer cylinder 20 communicate with each other through the through hole 28 above the liquid level 84s, and even if the suction is performed, the outer cylinder 20 Since the inside does not become a negative pressure, even if there is an intraabdominal tissue 86 such as an intestine or an adipose tissue around the outer cylinder 20, the intraabdominal tissue 86 is not adsorbed by the through holes 28 and 29. That is, the through holes 28 and 29 are not blocked. Therefore, when the liquid inside the outer cylinder 20 (that is, in the space 40 on the front end side) is reduced by the suction from the third opening 32k of the one end 32t of the inner cylinder 30, the liquid outside the outer cylinder 20 is removed from the outer cylinder 20. It can flow into the interior and continue suction.

  In addition, when the distal end 10t side of the endoscopic surgical water supply / suction washing tube 10 is sufficiently immersed in the liquid, the third opening 32k of the one end 32t of the inner cylinder 30 is disposed below the liquid level 84s. Therefore, the gas existing above the liquid level 84s is not sucked. That is, if the first opening 32k of the inner cylinder 32t and the third opening 32k are below the liquid level at the time of suction, even if a part of the first through-hole 28 is above the liquid level 84s, the pneumoconiency is maintained. In addition, it is possible to perform suction of a cleaning liquid or the like without involving the tissue in the cavity. Therefore, it can suck | inhale efficiently.

  In the first state where the outer cylinder and the inner cylinder are screwed together to the end, the distance between the tip of the outer cylinder and the third opening of the inner cylinder is the smallest, and the third opening of the inner cylinder is the outer cylinder. It is closest to the second through hole at the tip, and suction from the tip of the outer cylinder is possible. Therefore, it is easy to suck the liquid 84 such as the cleaning liquid without leaving it. Furthermore, as shown in the explanatory diagram of FIG. 6, local suction can be performed from the distal end 10 t of the water / suction washing tube 10 for endoscopic surgery during surgery. That is, as shown by an arrow 89 in FIG. 6A, the distal end 10t of the endoscopic surgical water supply / suction washing tube 10 is brought close to the liquid 88 such as blood, and the distal end 10t as shown in FIG. 6B. The liquid 88 can be aspirated from.

  As described above, the endoscopic surgical water supply / suction washing tube 10 can easily and quickly suck the washing liquid while keeping the pneumothorax, and can supply the washing liquid and the suction from the tip. Is possible.

  The endoscope operation water supply / suction washing tube 10 uses the second hollow hole 32p of the main body 32 of the inner cylinder 30 for both water supply and suction. In this way, by making the water supply flow path and the suction flow path common, the outer diameter of the tube of the endoscopic surgical water supply / suction washing pipe 10 is compared with the case where the water supply flow path and the suction flow path are separately provided, that is, The outer diameter of the cylindrical portion 22 of the outer cylinder 20 (the diameter of the outer peripheral surface 22a of the cylindrical portion 22) is reduced, and the inner diameter of the main body portion 32 of the inner cylinder 30 (the diameter of the inner peripheral surface 32b of the main body portion 32) is increased. Can do.

  The thickness of the main body portion 32 of the inner cylinder 30 in order to reduce the outer diameter of the cylindrical portion 22 of the outer cylinder 20 of the water supply / suction washing tube 10 for endoscopic surgery, while ensuring a cross-section of the flow path for water supply / suction. When the height is reduced, the rigidity of the main body portion 32 is lowered and the body portion 32 is easily deformed. If the main body portion 32 is deformed when the endoscope operation water supply / suction washing tube 10 is assembled, the tip of the inner cylinder with respect to the outer cylinder 20 is left as it is, for example, as shown in the explanatory view of FIG. As shown by the broken line on the 32t side, the water supply / suction strength varies depending on the position in the circumferential direction, and the operability is deteriorated.

  When the coaxial holding portion 38 is provided, the distance between the distal end side region 28s of the cylindrical portion 22 of the outer cylinder 20 and the one end 32t side of the inner cylinder 30 (that is, the third opening 32k side) is kept constant. . Therefore, even if the disassembly / assembly of the outer cylinder 20 and the inner cylinder 30 is repeated, the water supply / suction state is kept constant.

  Water supply and suction are performed only in the space 40 on the distal end side defined by the coaxial holding portion 38 in the space between the inner cylinder 30 and the outer cylinder 20, and coaxial with the space 42 on the proximal end side. Water supply and suction are blocked by the holding portion 38. Therefore, water supply and suction can be performed efficiently, and operability is good. That is, if there is no coaxial holding portion 38, a liquid such as a cleaning liquid may enter the base end side of the space between the inner cylinder 30 and the outer cylinder 20, or the liquid that has entered may flow backward. When the holding portion 38 is provided, such a phenomenon does not occur, so that operability is good.

  Further, even if the position of the inner cylinder 30 is changed with respect to the outer cylinder 20, the outer peripheral surface 38k of the coaxial holding portion 38 is outside on the proximal side with respect to the distal end side region 28s where the first through hole 28 is formed. Since it contacts the inner peripheral surface 22b of the cylinder part 22 of the cylinder 20 over the entire circumference, it is possible to keep the stomach.

  Note that the outer peripheral surface 38k of the coaxial holding portion 38 is formed in the cylinder of the outer cylinder 20 even if the inner cylinder 30 moves along the first hollow hole 22p in a direction approaching or moving away from the distal end portion 23 of the outer cylinder 20. Although it is preferable to contact the inner peripheral surface 22b of the part 22 over the whole periphery, it is not restricted to this. For example, the outer peripheral surface 38 k of the coaxial holding portion 38 is not in the outer cylinder 20 only in the first state, that is, when the third opening 32 k of the main body portion 32 of the inner cylinder 30 is closest to the distal end portion 23 of the outer cylinder 20. You may make it contact the inner peripheral surface 22b of the cylinder part 22 over a perimeter. In this case, if it is a 1st state, puffiness can be maintained.

  Furthermore, for example, a coaxial holding portion 38b shown in the cross-sectional view of the main part in FIG. In this case, it is possible to form a coaxial holding portion in the inner cylinder 30 so as to face the distal end side region 28s of the cylindrical portion 22 of the outer cylinder 20, but in order to keep the stomach, the distal end side region 28s. It is necessary to separately provide a configuration for keeping the stomach in the proximal end side.

  The outer diameter of the cylindrical portion 22 of the outer cylinder 20 is preferably 3 mm or more and 7 mm or less. If the outer diameter of the cylindrical portion 22 of the outer cylinder 20 is 7 mm or less, more preferably 6 mm or less, it can be inserted into a trocar unit generally used in endoscopic surgery. If the outer diameter of the cylindrical portion 22 of the outer cylinder 20 is 3 mm or more, more preferably 4 mm or more, water supply / suction through the second hollow hole 32p of the inner cylinder 30 is easy.

  The total length of the cylindrical portion 22 of the outer cylinder 20 is preferably 200 mm or more and 700 mm or less. If the total length of the cylindrical portion 22 of the outer cylinder 20 is 200 mm or more, more preferably 300 mm or more, the distal end side of the outer cylinder 20 reaches a desired position during the operation. Further, suction can be performed with the distal end side of the outer cylinder 20 inserted deeply into the liquid. If the total length of the cylindrical portion 22 of the outer cylinder 20 is 700 mm or less, more preferably 500 mm or less, operations such as movement of the distal end side of the outer cylinder 20 are easy.

  In the first state in which the outer cylinder and the inner cylinder are screwed to the end, the distance between the tip 32t of the inner cylinder 30 and the tip 23 of the outer cylinder 20 is, for example, 10.0 mm or less and 1.0 mm or more. preferable.

  The distance between the inner peripheral surface 22b of the cylindrical portion 22 of the outer cylinder 20 and the outer peripheral surface 32a of the main body portion 32 of the inner cylinder 30 is preferably 0.2 mm or more and 1.0 mm or less. If it is 0.2 mm or more, the cleaning liquid can sufficiently flow into the space between the inner peripheral surface 22 b of the cylindrical portion 22 of the outer cylinder 20 and the outer peripheral surface 32 a of the main body portion 32 of the inner cylinder 30. If it is 1.0 mm or less, the inner diameter of the second hollow hole 32p of the main body 32 of the inner cylinder 30 can be sufficiently secured.

  The shape, size, and arrangement of the first and second through-holes 28 and 29 are such that water can be fed in a desired manner so that a washing solution or the like flows during suction and prevents or suppresses passage of tissue in the abdominal cavity. Just choose. For example, the first and second through holes 28 and 29 can be round holes having a diameter of about 1 mm.

  The length of the distal end portion and the distal end side region 28s (that is, the axis from the distal end 10t of the outer cylinder 20 to the most proximal end side of the first through hole 28 closest to the proximal end, as indicated by reference numeral L2 in FIG. The direction distance) is preferably 80 mm or more and 150 mm or less. If the length of the distal end side region is 80 mm or more, it is easy to prevent some of the intraperitoneal tissue from getting involved by exposing some of the first through holes 28 above the liquid level during intraperitoneal washing. . If the length of the distal end side region is 150 mm or less, it is easy to keep all the first through holes 28 in the abdominal cavity and keep the pneumoperitoneum.

  <Example 2> A water supply / suction washing tube 10a for endoscopic surgery of Example 2 will be described with reference to FIG. Below, the same code | symbol is used for the component similar to Example 1, and a different point from Example 1 is mainly demonstrated.

  FIG. 11A is an explanatory view of the front end portion 23 of the outer cylinder 20 as viewed from the front. FIG. 11B is an explanatory diagram of the outer cylinder 20. FIG. 11C is an explanatory diagram of the inner cylinder 30. FIG. 11D is an explanatory view showing an assembled state of the outer cylinder 20 and the inner cylinder 30.

  As shown in FIGS. 11C and 11D, the inner cylinder 30 having the coaxial holding portion 38 is disposed inside the outer cylinder 20. As shown in FIG. 11 (b), first through holes 28 are formed on the distal end portion 23 side of the cylindrical portion 22 of the outer cylinder 20 every 60 ° in the circumferential direction. As shown in FIGS. 11A and 11B, the distal end portion 23 of the outer cylinder 20 of the endoscopic surgical water supply / suction washing tube 10a has an axisymmetric curved surface and has a plurality of second penetrations. A hole 29 is formed.

  When the cleaning liquid is discharged at an appropriate pressure from the third opening 32 k at the tip 32 t of the inner cylinder 30, the cleaning liquid is jetted from the second through hole 29 of the tip portion 23 of the outer cylinder 20. At this time, the cleaning liquid is sprayed in a conical shape from the second through hole 29 formed in the distal end portion 23 of the outer cylinder 20. The spread of the injection varies depending on, for example, the curved shape of the distal end portion 23 of the outer cylinder 20 and the position and shape of the second through hole 29.

  As shown in FIG. 11 (d), the first through hole 28 formed in the cylindrical portion 22 of the outer cylinder 20 is formed so that the cleaning liquid is jetted only from the distal end portion 23 of the outer cylinder 20. Formed at a predetermined distance L1 or more from the distal end 20t to the proximal end side. In this case, if the distance separating the distal end 32t of the inner cylinder 30 from the distal end 10t of the outer cylinder 20 toward the proximal end is L0, it is preferable to satisfy L0 ≦ L1. In addition, the form of water supply is various dimensions shown in FIG. 11, that is, between L 0, L 1, the proximal end of the distal end region where the first through hole 28 is formed, and the distal end 10 t of the outer cylinder 20. The distance L2, the outer diameter D0 of the cylindrical portion 22 of the outer cylinder 20, the outer diameter D1 of the main body 32 of the inner cylinder 30, and the number and arrangement of the second through holes 29 formed in the distal end portion 23 of the outer cylinder 20. The shape can be selected according to the curved shape of the distal end portion 23 of the outer cylinder 20.

  The endoscopic surgical water supply / suction washing tube 10a according to the second embodiment, like the endoscopic surgical water feeding / suction washing tube 10 according to the first embodiment, can easily suck the cleaning liquid and the like while keeping the pneumothorax, It can be performed in a short time, and the cleaning liquid can be fed and sucked.

  <Modification 1> FIG. 12 is a cross-sectional view of a main part of the coaxial holders 27a and 27b of Modification 1. As shown in FIG. 12, the coaxial holding portions 27 a and 27 b may be formed not on the inner cylinder 30 but on the outer cylinder 20.

  That is, as shown in FIG. 12 (a), a hollow cylindrical member 27s that is slightly smaller than the cylindrical portion 22 is disposed along the inner peripheral surface 22b of the hollow cylindrical cylindrical portion 22 of the outer cylinder 20. The coaxial holding portion 27a may be formed on the outer cylinder 20 by fixing with the attachment 27t or the like. Alternatively, as shown in FIG. 12B, the coaxial holding portion 27 b is formed integrally with the cylindrical portion 22 of the outer cylinder 20 by partially reducing the diameter of the hollow cylindrical cylindrical portion 22 of the outer cylinder 20. May be. The coaxial holding portions 27a and 27b may be formed over the entire circumference in the circumferential direction, or may be formed at a plurality of locations with intervals in the circumferential direction.

  <Summary> The water supply / suction washing tube for endoscopic surgery according to the present invention described above includes a local washing for intensively washing the local area and a peritoneal cavity for washing the abdominal cavity by spraying a washing solution over a wide area during water feeding. Internal cleaning is possible, and at the time of suction, the cleaning liquid or the like can be sucked without involving the intra-abdominal tissue and without sucking the pneumoperitoneum gas.

  The present invention is not limited to the above embodiment, and can be implemented with various modifications.

  For example, the configuration in which the inner cylinder is movably disposed in the outer cylinder so that the distance between the tip of the outer cylinder and the third opening of the inner cylinder can be changed is not limited to the above embodiment. What is necessary is just to comprise suitably. The first and second through holes are not limited to a circular shape, and may have various shapes such as an ellipse, a triangle, and a rectangle.

  Further, the coaxial holding portion can be formed on both the inner cylinder and the outer cylinder.

10, 10a Endoscopic water supply / suction washing tube 20, 20c Outer tube 22 Tube portion 22p First hollow hole 23 Tip portion 27a, 27b Coaxial holding portion 28 First through hole 28s Tip side region 29 Second Through hole 30, 30c Inner cylinder 30v Opening (third opening)
32 Main body portion 32k Third opening 32p Second hollow hole 38, 38a, 38b Coaxial holding portion 38k Outer peripheral surface

Claims (6)

A water supply / suction washing tube for endoscopic surgery capable of water supply and suction,
A hollow cylindrical tube portion having first and second openings at both ends and formed with a first hollow hole communicating between the first and second openings, and joined to one end of the tube portion A plurality of first through holes communicating with the first hollow hole are formed in a distal end side region on the distal end side of the cylindrical portion, and the distal end portion is formed. And an outer cylinder in which one or two or more second through holes communicating with the first hollow hole are formed,
A second hollow hole having third and fourth openings at both ends and communicating between the third and fourth openings is formed, and the third opening is between the tip of the outer cylinder. An inner cylinder that is disposed in the first hollow hole of the cylindrical portion of the outer cylinder so as to be opposed to the outer cylinder and is movable along the first hollow hole,
It is formed in any one of the outer cylinder and the inner cylinder, abuts against the other of the outer cylinder and the inner cylinder, and the distal end side region of the cylinder portion of the outer cylinder and the inner cylinder A coaxial holding portion that keeps the third opening side of the coaxial coaxial;
Equipped with a,
Using the second hollow hole of the inner cylinder as a flow path, water can be fed and sucked,
At the time of water supply, the cleaning liquid supplied from the third opening of the inner cylinder is discharged from at least the second through hole of the first and second through holes of the outer cylinder,
At the time of suction, the liquid that has entered the first hollow hole of the outer cylinder from at least the second through hole of the first and second through holes of the outer cylinder is allowed to flow into the third cylinder of the inner cylinder. A water supply / suction washing tube for endoscopic surgery characterized by suction from an opening . The outer diameter of the inner cylinder is smaller than the inner diameter of the inner peripheral surface of the cylinder portion of the outer cylinder forming the first hollow hole,
The coaxial holding portion is formed in the inner cylinder, and is in contact with a portion adjacent to the distal end side region on the opposite side of the distal end portion of the inner peripheral surface of the cylindrical portion of the outer cylinder over the entire circumference. The water supply / suction washing tube for endoscopic surgery according to claim 1, further comprising an outer peripheral surface.   The water supply / suction washing tube for endoscopic surgery according to claim 1, wherein a plurality of the second through holes are formed at the distal end portion of the outer cylinder.   The water supply / suction washing tube for endoscopic surgery according to any one of claims 1 to 3, wherein an outer diameter of the tube portion of the outer tube is 3 mm or more and 7 mm or less.   The water supply / suction washing tube for endoscopic surgery according to any one of claims 1 to 4, wherein the overall length of the tube portion of the outer tube is 200 mm or more and 700 mm or less.   The water supply / suction washing tube for endoscopic surgery according to any one of claims 1 to 5, wherein a length of the distal end portion and the distal end side region is 80 mm or more and 150 mm or less. .

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