JP2573138B2 - Internal organ pressing device used for abdominal wall lifting surgery - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an internal organ pressing device used for pressing an internal organ when performing an operation by lifting an abdominal wall.

[0002]

2. Description of the Related Art The abdominal wall lifting operation is used in operations such as incising the abdominal wall into small pieces to remove internal organs. This procedure does not make a large incision in the abdominal wall as in normal surgery. Several incisions are made in the abdominal wall. Laparoscopy through incised ostium
And surgical instruments are inserted into the abdominal cavity to perform surgery. In order to widen the abdominal cavity, several points on the abdominal wall are lifted to widen the space between the abdominal wall and the internal organs. However, depending on the patient's body type, the abdominal cavity cannot be widely opened while the abdominal wall is lifted. If the abdominal cavity is small, the part to be operated on cannot be seen sufficiently with a laparoscope inserted into the body. In addition, the surgical instrument cannot be inserted at an optimum position. When a patient having a narrow abdominal cavity lifts the abdominal wall, internal organs such as the intestine rise together with the abdominal wall. This condition is particularly prone to obese patients.

[0003] In order to prevent this adverse effect, a method is employed in which a stick is inserted into the abdominal cavity of the body through an incised small hole, and an internal organ such as an intestine that obstructs the operation is pressed by the stick. However,
The intestine cannot be sufficiently held down with a stick. that is,
This is because the internal organs cannot be pressed with a large area. Widening the tip of the rod can effectively press the intestine. However,
A wide-tip rod cannot be inserted into the abdominal cavity through a stoma incised in the abdominal wall. In order to insert a rod with a wide tip into the body, it is necessary to make a large incision in the abdominal wall, and the advantages of the abdominal wall lifting operation cannot be utilized. Abdominal wall lifting surgery is characterized by improving the time required for post-operative recovery by making a small incision in the abdominal wall. Thus, instruments used in surgery lifting the abdominal wall, the body belly from the stoma
It must be able to be inserted into the cavity .

In order to satisfy this, an internal organ pressing device shown in FIG. 1 has been developed. This internal organ pressing device is used in the state shown in FIG. In this internal organ pressing device, an elastic body is built in a pipe. When the elastic body is extruded from the pipe, it expands by its own elasticity. This internal organ pressing device is inserted into a body abdominal cavity through a small hole with the elastic body inserted into a pipe. After inserting the pipe, the elastic body is pushed out of the pipe and expanded, and the internal organs such as the intestine are pressed by the expanded elastic body.

[0005]

The internal organ pressing device shown in FIG. 1 can press the internal organ by an expanded elastic body. However, this device has the disadvantage that the internal organs cannot be pressed with sufficient pressure. This is because when the internal organs are strongly pressed, the elastic body is deformed. When the elastic body is hardened, the pressure for pressing the internal organs can be increased. However, a built-in pressing device having a built-in hard elastic body has a drawback that it cannot be smoothly inserted into a pipe. This is because the elastic body is deformed and inserted into the pipe.

[0006] The present invention has been developed for the purpose of further solving this drawback. An important object of the present invention, visceral be reliably pressed widely expanding the abdominal cavity and, moreover to provide a visceral pressing instrument for use in the abdominal wall lifting operation can be inserted into the abdominal cavity of the body through small holes in the abdominal wall.

[0007]

The visceral pressing device used in the abdominal wall lifting operation according to the present invention has the following configuration to achieve the above object. That is, the visceral pressing device of the present invention is an improved visceral pressing device that inserts through the small hole in which the abdominal wall 5 is cut out, presses the visceral organ 4, and expands the space between the visceral organ 4 and the abdominal wall 5. It is characterized by having all configurations. (A) The internal organ pressing device has a plurality of expanding rods 6 located at the middle and on both sides thereof . (B) The expanding rods 6 on both sides are openably and closably connected via a pin in the middle. (C) The expanding rods 6 on both sides are provided with finger holes 6A at the rear end so that the rear end can be operated from outside the body, and the distal end has a pressing portion 6B for pressing the internal organs 4. (D) The expanding rods 6 on both sides are bent in the middle so that the front end is expanded when the rear end is closed. (E) The expanding rods 6 on both sides have locking means 8 capable of locking the distal end in an expanded state. (F) The middle expanding rod 6 has a pressing portion 6B at the tip.
And protrudes more rearward than the pin 7. (G) The expanding rods 6 on both sides are opened,
Of the middle expansion rod 6
Is provided at a fixed position.

[0008]

[Action] Visceral pressing instrument for use in the abdominal wall lifting operation of the present invention, in the closed state of the tip portion as shown in FIG. 3, abdomen
It is inserted into the abdominal cavity 3 through a small hole in the wall 5. With the distal end portion inserted into the abdominal cavity 3, as shown in FIG.
To expand. The visceral organs 4 such as the intestine are pressed by the pressing portion 6B thus expanded. Expand the expanding rods 6 on both sides with the finger holes 6A.
When opened, the middle expansion rod 6 is
It is arranged in the middle of After the middle spreading rod 6
This is because the ends are sandwiched between the projections 9 of the expanding rods on both sides.
You.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. However, the embodiments described below are intended to exemplify a visceral pressing device for embodying the technical idea of the present invention, and the visceral pressing device of the present invention has the shape, structure,
The arrangement is not specified below. The internal organ pressing device of the present invention can be variously modified within the scope of the claims.

Further, in this specification, in order to make it easy to understand the claims, the numbers corresponding to the members shown in the embodiments are referred to as "claims", "actions", and "actions". In the column of "Means for solving the problem". However, the members shown in the claims are
It is by no means specific to the members of the embodiment.

The internal organ pressing device used in the abdominal wall lifting operation shown in FIGS. 3 and 4 includes three expanding rods 6. 3
The book expanding rod 6 is connected via a pin 7 so as to be freely opened and closed. The two expanding rods 6 have finger holes 6A similar to scissors at their rear ends so that the distal ends can be inserted into the abdominal cavity 3 and expanded. Expanding rod 6 provided with finger hole 6A
As shown in FIG. 4, when the rear end is closed, the front end is bent in the middle so that the front end can be expanded, and the whole is in a “U” shape. Further, the expanding rod 6 has, for example, an elongated shape with a total length of 20 to 50 cm so as to penetrate the small hole of the abdominal wall 5 and insert the pressing portion 6B at the distal end into a predetermined position of the abdominal cavity 3. The pressing portion 6B of the expanding rod 6
The tip is curved so that the internal organs 4 can be pressed reliably. Further, although not shown, the pressing portion 6B can be curved into a shape that can effectively press the internal organs 4.

As shown in FIG. 4, the expanding rod 6 presses the internal organ 4 in a state where the pressing portion 6B is expanded, and thus has a locking means 8 which can lock in this state. The locking means 8 of the internal organ pressing device shown in FIGS. 3 and 4 fixes the arch-shaped ratchet arm 8A to one of the expanding rods 6, and is hooked on the other expanding rod 6 by the unevenness of the ratchet arm 8A. The hook 8B is fixed.

The ratchet arm 8A is located at the rear end of the expanding rod 6, and extends inward from the finger hole 6A and is provided in an arch shape. The ratchet arm 8A is shown in FIG.
As shown in FIG. 3 (cross-sectional view taken along the line AA in FIG. 3), one side is provided with saw-toothed irregularities. The hook 8B fixed to the other expanding rod 6 moves along the unevenness of the ratchet arm 8A. The hook 8B has a hook-like surface that moves along the irregularities of the ratchet arm 8A, the surface being moved by the irregularities. The locking means 8 shown in FIG.
The structure is such that it can easily move in the direction of closing A (direction indicated by arrow A in the figure), but cannot easily move in the direction of opening finger hole 6A (direction indicated by arrow B in the figure). Therefore, the locking means 8 having this structure is capable of easily moving in the opening direction of the pressing portion 6B of the expanding rod 6 (in order to close the pressing portion 6B, it is necessary to separate the hook 8B from the irregularities of the ratchet arm 8A). In order to separate the hook 8B from the irregularities of the ratchet arm 8A, the rear end of the expanding rod 6 is moved in the direction indicated by the arrow C in FIG.

Further, the internal organ pressing device shown in FIGS. 3 and 4 has an intermediate expanding rod 6, and when the expanding rod 6 is opened, the internal organ 4 is pressed by the three expanding rods 6. be able to. Therefore, there is a feature that the internal organ 4 can be pressed with a wider area. The middle expanding rod 6 has the pressing portion 6B at the front end having the same length as the expanding rods 6 on both sides, and the rear end is shortened.

When the pressing portion 6B is expanded as shown in FIG. 4, the intermediate expanding rod 6 is located at an intermediate position between the expanding rods 6 on both sides, and as shown in FIG. Is designed to be parallel to the expanding rods 6 on both sides in the closed state. In order to open and close the pressing portion 6B, the expanding rod 6 has a unique structure. The intermediate expanding rod 6 is held at a fixed position by the convex portions 9 provided on the expanding rods 6 on both sides. In the state shown in FIG. 4 in which the pressing portion 6B is expanded, the rear end of the intermediate expanding rod 6 is sandwiched between the expanding rods 6 on both sides by a convex portion 9 provided at the rear end of the pin 7 than the pin 7. In the state shown in FIG. 3 in which the pressing portion 6B is closed, the intermediate expanding rod 6 is clamped by the convex portion 9 provided at the tip of the pin 7.

Therefore, as shown in FIGS. 3 and 4, the expanding rods 6 on both sides are provided with a convex portion 9 for holding the intermediate expanding rod 6 therebetween. The intermediate expanding rod 6 is connected between the expanding rods 6 on both sides so as to be opened and closed with a pin 7 in a state of being stacked. Therefore, the expanding rods 6 on both sides are provided with the convex portions 9 protruding toward the intermediate expanding rod 6. The convex portion 9 presses the side surface of the intermediate expanding rod 6 laminated therebetween and holds it at the position shown in FIGS. On both sides of the intermediate expanding rod 6, concave portions 10 are provided at portions guiding the convex portions 9. The protruding portion 9 has a projecting height equal to or less than the height of the intermediate expanding rod 6 so that the expanding rod 6 is not in contact with another expanding rod 6 in a parallel state. However, the concave portion 1 in which the convex portion 9 is higher than the intermediate expanding rod 6 and the convex portion 9 is inserted into the other expanding rod 6.
Needless to say, 0 can be provided.

In the internal organ pressing device shown in FIGS. 3 and 4 , one intermediate expanding rod 6 is disposed between the expanding rods 6 on both sides. The number of intermediate expanding rods 6 is not limited to one, and a plurality of intermediate expanding rods 6 can be provided. The internal organ pressing device provided with a plurality of intermediate expanding rods 6 has the pressing portion 6B expanded as shown in FIG. 4, and the intermediate expanding rods 6 are arranged at equal intervals between the expanding rods 6 on both sides. The connecting portion of the pin 7 is bent or straight so as to be disposed.

[0018]

Visceral pressing tool to be used for abdominal wall lifting operation of the present invention according to the present invention can be inserted from the small holes were dissected abdominal wall into the abdominal cavity of the body, moreover, it is reliably pressed visceral gut such in the abdominal cavity, the abdominal cavity There is a feature that can be widely spread. This is because the internal organ pressing device of the present invention connects a plurality of expanding rods with pins so as to be openable like scissors.
When inserting into the abdominal wall, the pressing part of the expanding rod is parallel and inserted into the abdominal cavity from a small hole, and in the inserted state, the pressing part at the tip of the expanding rod is expanded, and the internal organs are spread over a wide area. Can be pressed. In particular, even when the pressing portion is expanded, the width of the connecting portion of the pin does not increase, and the small hole in the abdominal wall does not increase. The visceral organ pressing device of the present invention can push down the visceral organ with a strong pressure and widen the abdominal cavity , because the pressing portion can be strengthened. That is, the internal organ pressing device of the present invention does not need to elastically expand the pressing portion as in the related art, and has a feature that the strong pressing portion can reliably expand the pressing portion.

Further, the internal organ pressing device of the present invention is
Despite the extremely simple construction, both sides are widened
Open the rod with a finger hole and place the middle expansion rod in place.
There is a feature that can be set. It pin the expanding rod on both sides
With a structure that can be opened like a pair of scissors.
The rear end of the middle expansion rod to the rear end beyond the pin.
Then, clamp this protruding part between the protruding parts of the expanding rods on both sides.
This is because the intermediate expanding rod is disposed at a fixed position.
The internal organ pressing device of the present invention having this structure has the entire structure.
Simplifies the construction, the expansion rod on both sides and the intermediate expansion rod
And spread them out exactly to the specified interval,
Has the advantage of being able to press the internal organs securely with the
You.

[Brief description of the drawings]

FIG. 1 is a cross-sectional view showing a use state of a conventional internal organ pressing device .

FIG. 2 is a perspective view showing an example of the internal organ pressing device shown in FIG.

FIG. 3 is a plan view of an internal organ pressing device showing one embodiment of the present invention.

FIG. 4 is a plan view showing a state where a pressing portion of the internal organ pressing device shown in FIG. 3 is expanded.

FIG. 5 is a sectional view taken along line AA of the internal organ pressing device shown in FIG. 3;

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Pipe 2 ... Elastic body 3 ... Abdominal cavity 4 ... Internal organs 5 ... Abdominal wall 6 ... Expanding rod 6A ... Finger hole 6B ... Pressing part 7 ... Pin 8 ... Locking means 8A ... Ratchet arm 8B ... Hooking tool 9 ... Convex part 10 ... Recess

Claims (1)

(57) [Claims] A visceral pressing device which inserts through an incision in the abdominal wall (5) to press the internal organs (4) and expands between the internal organs (4) and the abdominal wall (5). A visceral pressing device for use in an abdominal wall lifting operation, characterized by having the following configuration. (A) The visceral pressing device has a plurality of expanding rods (6) located in the middle and on both sides thereof . (B) The expanding rod (6) is openably and closably connected via a pin (7) in the middle. (C) The expanding rods (6) on both sides have finger holes (6A) at the rear end.
Has a pressing portion (6B) at the tip. (D) The expanding rods (6) on both sides are closed at the rear end.
In addition, the middle is bent so that the tip is in an expanded state. (E) The expanding rods (6) on both sides have locking means (8) that can lock the expanded ends . (F) The intermediate expanding rod (6) has a pressing portion (6
B) and protrudes rearward from the pin (7). (G) With the expanding rods (6) on both sides open,
Hold the rear end of the middle expansion rod (6), and
It has a projection (9) for positioning the rod (6) in place.