JPH10127643A - Medical treatment inserting tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To surely and safely execute organ treatment under pneumoperitoneum in short time by t branch tube making its tip communicate within a front balloon through a cylindrical sheet and a rear branch tube making its tip part communicate with a rear balloon through and attaching a glove for medical operation around the front balloon. SOLUTION: The front balloon 1 is formed on the front tip side of the outer periphery of the cylindrical sheet 3 and the rear balloon 2 is formed on a rear tip side, and the part of the sleeve of a gas-liquid impermeable glove 14 is air-tightly adjacently attached around under the tip balloon 1 of the sheet 3. The front branch tube 4 making its tip communicate with the inside of the balloon 1 through the cylindrical sheet 3 and the rear branch tube 5 making its tip communicate with the rear balloon 2 are provided. The gas-liquid opening and closing devices such as check valves, double-side cocks, etc., respectively provided with a connecting connector are provided at the rear tip parts of each tube 4 and 5. At the time of using, the front balloon 1 inserted in to a body 6 from the incision opening of an abdominal wall 7 of a patient is expanded and closely stuck to the inner side of the abdominal wall 7 and then organ treatment is executed through the use of the glove 14.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment insertion tool for performing treatment by directly touching an organ by an insufflation method in endoscopic surgery.

[0002]

2. Description of the Related Art In recent years, endoscopic surgery has been widely practiced as a minimally invasive treatment method. Endoscopic surgery is mainly used when performing operations on various organs of the abdomen, such as the stomach, spleen, intestine, and gallbladder, by creating a space by injecting carbon dioxide into the abdominal wall and inserting instruments such as trocars into it. This is a method in which a plurality of use tubes are inserted, and various treatment tools are inserted and surgery is performed while viewing the field of view of the endoscope inserted therefrom. Therefore, according to the present method, there is an advantage that the incision is extremely small and damage to the patient is small as compared with the conventional laparotomy. Here, injecting and pressurizing carbon dioxide into the body to form a necessary space in the abdominal cavity or the like is referred to as insufflation. On the other hand, there is also a method of suspending the abdominal wall by inserting a steel wire or the like under the skin without injecting carbon dioxide gas, and this is called a lifting method, as opposed to an insufflation method. At present, pneumoperitoneum is often used due to ease of operation. However,
In such endoscopic surgery, especially in the pneumoperitoneum method, the procedure is not performed by actually touching with the hand while watching the image of the monitor projected on the endoscope, but from the insertion tube such as a trocar. Since the treatment is performed by remote operation with the insertion of forceps and the like, the treatment and operation are difficult and it takes time, which is a stressful operation for the surgeon. Also, in the unlikely event that an organ or a large blood vessel is damaged during the operation, there is a risk that an emergency recovery procedure may be difficult because only a cylindrical trocar has a procedure. In particular, when a large blood vessel is injured, a large bleeding is caused in an instant, and the worst result is likely to occur. Furthermore, when the cancer tissue is removed from the body, there is a disadvantage that the cancer tissue adheres to the abdominal wall and metastasizes.

[0003]

SUMMARY OF THE INVENTION The present invention solves such a drawback of the conventional organ treatment in endoscopic surgery, and an object thereof is to perform organ treatment under insufflation. In addition, it is possible to perform treatment in a short time by touching the organ directly with a hand, reliably, safely, and without pneumoperitoneum gas leakage, and with a sufficient visual field.

[0004]

A medical treatment insert according to the present invention for achieving the above object has a front balloon formed on the front end side and a rear balloon formed on the rear end side adjacent to the outer periphery of the cylindrical sheet. A sleeve portion of a gas-liquid-impermeable glove is hermetically attached to a periphery of the cylindrical sheet below the tip balloon, and further, the leading end passes through the cylindrical sheet into the tip balloon. A gas-liquid opening / closing device having a connection connector is provided at the rear end of the front branch tube and the rear end of the rear branch tube. This is a structural feature.

[0005]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below in detail with reference to the drawings. FIG. 1 is a view showing one embodiment of a medical treatment insert according to the present invention, wherein FIG. 1 (a) is an external view and FIG. 1 (b) is a sectional view of FIG. FIG. 2 is an external view showing another embodiment, and FIGS. 3 and 4 are schematic diagrams showing a use state.

[0006] The medical treatment insertion tool according to the present invention is shown in FIG.
As shown in (a), adjacent to the outer periphery of the cylindrical sheet (3),
Front balloon (1) at the front end, rear balloon (2) at the rear end
And a front balloon (1) is formed on the front end side of the outer periphery of the cylindrical sheet (3), and a rear balloon (2) is formed on the rear end side of the cylindrical sheet (3) under the front balloon (1). Around,
A forearm tube having a sleeve portion of a gas-liquid impermeable glove (14) airtightly adjoined and further having a leading end communicating with the inside of the tip balloon (1) through the cylindrical sheet (3). (4) and a rear branch tube (5) having a distal end communicating with the rear balloon (2). The rear branch tube (5) is connected to the front branch tube (4) and the rear end of the rear branch tube (5), respectively. A gas-liquid switchgear with a connector is provided.

[0007] The front balloon (1) and the rear balloon (2) are donut-shaped hollow lumens as shown in the sectional view of FIG. 1 (b). Usually, it is produced by blow molding, dip molding, film processing, or hollow molding such as rotational molding. Even if each is integrally formed, it is naturally included in the scope of the present patent. Further, the cylindrical sheet (3) and the front balloon (1) and the rear balloon (2) are bonded or formed integrally, or the cylindrical sheet (3) is formed as an inner cylinder and the outer cylinder is formed as an outer cylinder on its outer periphery. A cylindrical sheet may be superimposed, and the inner and outer cylinders may be bonded at the tip and the center to form a front balloon (1) and a rear balloon (2). Balloon (1),
Both the rear balloon (2) and the balloon have a wall thickness of 0.1 to 2 mm.
In order to insert the tip balloon (1) into the body (6) through an incision of about 3 to 10 cm into the abdominal wall (7), it is advantageous that the balloon is thin and not bulky. Even in the case of injection, a minimum wall thickness that does not rupture even if the amount is twice or more than that of actual use is preferable. The inside diameter of the cylindrical sheet (3) is such that the hand and arm (15) are inserted through the rear balloon (2) and the front balloon (1) to perform the treatment, so that the hand and arm (15) can be inserted. Is preferable, and about 60 to 90 mm is appropriate. The outermost diameter is about 90 to 200 mm, and it is particularly preferable that the balloon (1) has an outer diameter that is not bulky when the body (6) is inserted. As the balloon material, for example, a material having appropriate flexibility such as a soft vinyl chloride resin, a polyurethane resin, a polyethylene resin, a polypropylene resin, a polyester resin, a silicone rubber, and a natural rubber is preferable, but is not necessarily limited to such a material. No need. When the balloon (1) does not inject air, it is not bulky, can be easily inserted into the body (6) through the incision, has enough flexibility not to damage body tissues, and when air or water is injected. In addition, it is important to select a material having a sufficient burst strength and a sufficient tear strength so that the material does not burst even if the amount is twice or more than that of the actual use.

The cylindrical sheet (3) has a thickness of 0.1 to 2 mm.
And is usually produced by inflation molding or the like, but is not particularly limited thereto. In use, the hand and the arm (15) are inserted into the sheet and fixed by the incision. Therefore, the material is not bulky, and a material having appropriate flexibility is preferable. For example, soft vinyl chloride resin,
Materials such as polyurethane resin, polyethylene resin, polypropylene resin, polyester resin, silicone rubber and natural rubber are preferred. The inner diameter is also 50-100mm
The degree is appropriate. The front balloon (1) and the rear balloon (2) are bonded to the outer periphery of the sheet, and the distance between the front balloon (1) and the rear balloon (2) is set to the abdominal wall (7) of the patient.
The thickness is usually about 10 to 15 mm corresponding to the thickness of the subcutaneous fat layer, which has individual differences.
It is preferable to prepare several types between 30 mm. Therefore, the length of the cylindrical sheet (3) is suitably about 5 to 20 cm.

As shown in the cross section of FIG. 1 (a), the leading branch tube (4) has a distal end portion that passes through the cylindrical sheet (3) and opens into the leading balloon (1), and the trailing branch tube (5). ) Are tubes each having a distal end opening into the rear balloon (2) and being led out therefrom to the rear end side of the balloon for gas-liquid circulation. Regardless of whether the distal end portion of the leading tube (4) passes through the inside or outside of the cylindrical sheet (3), it is sufficient that the leading end tube (4) is open to the leading balloon (1). Further, the leading branch tube (4) and the trailing branch tube (5) may be independent tubes as shown in FIG. 1 (a), but as shown in FIG. 2, the vicinity of the balloon rear end is integrated with each other. It is also possible to use a two-chamber tube (8) having two flow passages and provide a branch (9) at the rear position to branch the tube. As the material, for example, a material having an appropriate flexibility and hardness such as a soft vinyl chloride resin, a urethane resin, a silicone rubber, and a natural rubber is used.
m, a tube having a wall thickness of 0.3 to 2 mm is preferable. Also,
The length of the branch tubes (4) and (5) is set to 30 to 300 m so as not to hinder the operator from using various treatment tools.
About m is appropriate.

Further, the rear ends of the leading branch tube (4) and the trailing branch tube (5) have gas-liquid opening / closing devices (1), respectively.
0) A check valve having a connector as described in (11), a two-way cock, a three-way cock, or the like is connected, and a structure that can be easily opened and closed by attaching and detaching a syringe which is a general balloon inflation and injection device. Has become. Further, pilot balloons (12) and (13) may be connected between the branch tubes (4) and (5) and the gas-liquid switching devices (10) and (11). In this case, the pilot balloons (12) and (13) )
Is molded from a material having appropriate flexibility and elasticity, such as a soft vinyl chloride resin, urethane resin, silicone rubber, or natural rubber, so that the balloon inflation status of the balloon portions (1) and (2) can be monitored. Have been.

Since the glove (14) is inserted into the body (6) together with the balloon (1) beyond the incision in the abdominal wall (16), it is advantageous that the glove is not bulky, and it is as thin as about 0.1 to 2 mm. Sheets are preferred. In addition, this specification is used under the stomach and gloves (14) to keep the body (6) airtight.
The glove (14) is used with the sleeve portion of the glove (14) air-tightly adjacent to the inner wall of the balloon (1) or the lower part of the cylindrical sheet (3). The glove (14) and the cylindrical sheet (3) may be laminated or integrated. For material,
For example, a material having appropriate flexibility such as a soft vinyl chloride resin, a polyurethane resin, a polyethylene resin, a polypropylene resin, a polyester resin, a silicone rubber, and a natural rubber is preferable, but not necessarily limited thereto. Since the gloves (14) may come into direct contact with the organ, select a material that does not damage the organ, and has a tearing strength such that the glove (14) does not tear or puncture due to normal use and does not leak gas. It is important.

In using the medical treatment insertion tool according to the present invention, for example, as shown in FIG. 3, the balloon (1) is made smaller by hand through an incision in the abdominal wall (7), and the body (6) is cut.
Insert After the insertion, the balloon (1) is inflated by injecting air or water from the gas-liquid opening / closing device (10) (11) using a syringe or the like. Here, after pulling this medical treatment insertion tool and bringing the front balloon (1) into close contact with the inside of the abdominal wall (7), the rear balloon (2) is similarly expanded outside the body, and the abdominal wall (7) is inflated outside the body. The medical treatment insertion tool is airtightly fixed to the body surface so as to be sandwiched between two balloon inflatable portions of (1) and the rear balloon (2). The airtightness in the body is maintained by the cylindrical sheet (3) and the gloves (14), and the gloves (14) pass through one sheet.
The insertion path between the outside of the body and the inside of the body (6) communicates, the hand and the arm (15) are passed through the cylindrical sheet (3) and attached to the glove (14), and then the treatment is performed directly by hand through the glove (14). be able to. In addition, by putting the resected organ in gloves (14), turning it over, and removing it outside the body, it can be removed without attaching cancerous tissue to the abdominal wall, and preventing metastasis of cancerous tissue. Can be done.

[0013]

The medical treatment insert of the present invention has no bulk when inserted through an incision in the abdominal wall, and can be safely and easily inserted because of the appropriate flexibility of the balloon. Also,
By having two balloon inflatable portions and inflating the balloon on the inside and outside of the body, the incision can be fixed so as to be sandwiched from inside and outside the body, and the medical treatment insertion tool can be securely fixed in an airtight manner. Because the balloon is flexible, there is no risk of damage to the small opening. Since the inside of the inflated balloon communicates with the outside of the body, the hand can be easily inserted into the body from outside the body, and the organ can be directly treated or extracted by hand, and the treatment can be performed reliably, safely, and in a short time. Further, the inflation balloon is freely deformed according to the operation angle, so that organ treatment can be easily performed. Furthermore, even when the cancer tissue is taken out of the body, it can be taken out without adhering to the abdominal wall, so that there is no fear of metastasis. As for airtightness, gas-liquid-impermeable gloves are provided airtightly adjacent to the cylindrical sheet below the tip of the balloon, so that there is no insufflation gas leak, sufficient space can be kept in the body, and good The procedure can be performed safely and in a short time under a wide field of view, and is extremely useful when performing the procedure by endoscopic surgery.

[Brief description of the drawings]

FIG. 1 (a) is a view showing one embodiment of a medical treatment insert according to the present invention for achieving an object by an insufflation method. (B) It is sectional drawing which shows one Example of the medical treatment insertion tool by this invention for achieving the objective by the insufflation method.

FIG. 2 is a view showing another embodiment of the medical treatment insertion tool according to the present invention for achieving the purpose of insufflation.

FIG. 3 is a schematic view showing a use state of the medical treatment insertion tool according to the present invention.

FIG. 4 is a schematic view showing a use state when a hand of the medical treatment insertion tool according to the present invention is inserted.

[Explanation of symbols]

 1. Tip balloon 2. Rear balloon 3. 3. cylindrical sheet Branch tube 5. Rear branch tube 6. Inside the body 7. 8. Abdominal wall 8.2 cavity tube Branch 10.11. Gas-liquid switching device 12.13. Pilot balloon 14. Gloves 15. Hands, arms

Claims (5)

[Claims] 1. A front balloon is formed on the front end side and a rear balloon is formed on the rear end side adjacent to the outer periphery of the cylindrical sheet, and a gas-liquid impermeable glove is formed around the cylindrical sheet below the front balloon. A sleeve portion is provided so as to be airtightly adjacent to the sleeve portion, and further comprises a front branch tube having a leading end communicating with the front balloon through the cylindrical sheet and a rear branch tube having a leading end communicating with the rear balloon. A medical treatment insert, wherein a gas-liquid opening / closing device having a connector for connection is provided at a rear end portion of each of the leading branch tube and the trailing branch tube. 2. The medical treatment insert according to claim 1, wherein the cylindrical sheet and the gas-liquid impermeable glove are bonded to each other. 3. The medical treatment insertion tool according to claim 1, wherein the cylindrical sheet, the front balloon, and the rear balloon are bonded to each other. 4. An inner cylinder is used as a cylindrical sheet, and a cylindrical sheet is superimposed on an outer cylinder as an outer cylinder, and the inner and outer cylinders are adhered at a tip portion and a central portion to form a front balloon and a rear balloon. The medical treatment insert according to claim 1. 5. The medical treatment insert according to claim 1, wherein the length of the cylindrical sheet is 5 to 20 cm and the inner diameter of the cylindrical sheet is 5 to 10 cm.