JP3228541B2 - Insufflation device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an insufflation device for injecting gas into an abdominal cavity to be treated and expanding the abdominal cavity in order to secure an observation field required for medical treatment in the abdominal cavity.

[0002]

2. Description of the Related Art Conventionally, when a medical treatment is performed in the abdominal cavity, for example, under endoscopic observation, a gas such as carbon dioxide is injected into the abdominal cavity to be treated to expand the intraperitoneal region and perform the intraperitoneal treatment. The necessary observation field of view is ensured so that the treatment procedure can be fully understood. For injecting gas into the abdominal cavity, an insufflation device that controls the pressure of a gas from a gas supply source such as a gas cylinder with a decompressor, a valve, or the like to maintain the inside of the abdominal cavity at a set pressure is used. This insufflation device usually has an insufflation tube inserted into the abdominal cavity to inject gas into the abdominal cavity, and a control device separate from the insufflation tube for performing gas pressure control and the like.

[0003] In such an insufflation apparatus, the pressure in the abdominal cavity is measured as needed in order to maintain the pressure in the abdominal cavity at a set pressure. In general, a pressure sensor is used for this measurement. This pressure sensor is arranged in an air supply line that leads into the abdominal cavity via an intraperitoneal tube, and this air supply line is usually provided on the control device side.

[0004]

In the above-mentioned conventional insufflation apparatus, the pressure in the abdominal cavity (static pressure state) is measured by a pressure sensor or the like provided in an air supply line. In the operation state of the gas in the above, the static pressure in the abdominal cavity could not be measured, so that the air supply had to be stopped frequently for the measurement of the intraperitoneal pressure.

[0005] Further, since the measurement of the intra-abdominal pressure is performed by regarding the pressure in the air supply duct leading to the abdominal cavity as the intra-abdominal pressure, the human body should not be subjected to excessive pressure due to erroneous data or malfunction. The air pressure is low (up to 50
mmHg). Therefore, set the air supply flow rate per unit time large (10 liters or more per minute)
And the prolonged insufflation time, that is, the treatment time.

[0006]

[0007] In addition to the above circumstances, the existing pneumoperitoneum
There is also a need for effective use of. The present invention has been made in view of the above circumstances, and has as its object, it is possible to measure the static pressure in the abdominal cavity without stopping the injection of gas into the abdominal cavity, the existing
It is an object of the present invention to provide a pneumoperitoneal device having good pneumoperitoneal efficiency, which can effectively use the pneumoperitoneum.

[0008]

In order to solve the above-mentioned problems, the present invention provides an insufflation device for expanding the inside of the abdominal cavity with a predetermined gas.
A gas supply source for supplying the gas;
One end is connected to the gas supply source, and
A connection conduit for guiding the gas, and a detachable connection at the other end of the connection conduit
Connected freely and inserted percutaneously into the abdominal cavity
And the gas guided by the connection conduit is introduced into the abdominal cavity.
A pneumoperitoneum to be infused; and
First measuring the pressure in the conduit of said gas injected by a pipe;
An abdominal pressure measuring means, provided on the pneumoperitoneum,
Second peritoneal pressure measuring means for measuring the pressure outside the conduit of the tube;
First measurement result measured by the first abdominal cavity pressure measuring means
And a second measurement measured by the second abdominal cavity pressure measuring means
A measurement result selecting means for selecting the measurement result;
Into the abdominal cavity based on the measurement result selected by the selection means.
Fluid control means for performing fluid control of the gas to be inputted.
It is characterized by having.

[0009]

A second abdominal cavity pressure measurement is performed by the measurement result selecting means.
If you select the second measurement result measured by the determination means,
, The static pressure of the injected gas can be measured. Also before
The first measurement result measured by the first abdominal cavity pressure measuring means and
Second measurement result measured by the second abdominal cavity pressure measuring means
(The first abdominal cavity pressure measuring means and the second
2) Switch one of the abdominal pressure measuring means to the use state)
When the second abdominal cavity pressure measuring means is used,
Since it is not necessary to set the barometric pressure to a low value,
High insufflation efficiency
It will be good. When the first abdominal cavity pressure measuring means is used
, Existing trocars can be used.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 5 show one embodiment of the present invention. The insufflation device 1 of the present embodiment includes a trocar 26 as an insufflation tube inserted percutaneously into the abdominal cavity, and an insufflation unit 3 for controlling gas pressure and the like, and a gas cylinder as a gas supply source. gas from 2 (e.g., CO ₂ gas) is intended to be implanted into the abdominal cavity through the distal end of the trocar 26 puncturing the abdominal cavity.

The gas cylinder 2 is connected via a connection chamber 14 to a pressure reducing section 4 of the insufflation unit 3 having a first pressure reducing valve (not shown). The pressure reducing unit 4 is connected to a pressure / flow control unit 6 via an internal conduit 16. The pressure and flow control unit 6 has a second pressure reducing valve (not shown), and can control the pressure and flow rate of the gas injected into the abdominal cavity. A trocar 26 is connected to the pressure / flow control unit 6 via an air supply line 18. The air supply line 18 and the trocar 26 are connected via a connector 29. Note that connectors 29, 29 for connecting the air supply line 18 and an electric line 28 described later to the trocar 26 are as shown in FIG.
(A), the air supply line 18 and the electric line 28 are provided as completely separate lines in the connector cable 21 (see FIG. 1 (b)). They are only shown with emphasis and are essentially the same (see FIG. 1B). The inside of the air supply line 18 communicates with the inside of the abdominal cavity through the trocar 26. In the middle of the air supply line 18, as a first abdominal cavity pressure measuring means for measuring the pressure in the air supply line 18 leading to the abdominal cavity. Pressure sensor 20 is provided.

A portion outside the conduit of the trocar 26 that does not directly come into contact with the working gas injected through the trocar 26, and is a distal end portion of the trocar 26 inserted into the abdominal cavity when gas is injected (hereinafter referred to as an insertion portion). .)
A pressure sensor 22 is provided as second abdominal pressure measuring means capable of measuring a static pressure in the abdominal cavity.
The pressure sensor 22 includes a connector 29 and an electric line 28.
Is connected to the sensor identification unit 10 of the pneumoperitoneum unit 3 and one input terminal of the sensor changeover switch 24. The output side of the pressure sensor 20 is connected to the other input terminal of the sensor changeover switch 24. The output terminal of the sensor changeover switch 24 is connected to the pressure control unit 12, and the pressure control unit 12 is connected to the pressure / flow control unit 6, thereby forming a feedback control circuit.

The sensor identification unit 10 is connected to a switching unit 8, and the switching unit 8 sends the pressure and flow rate of the gas to be injected into the abdominal cavity in accordance with the type of the pressure sensors 20 and 22. It has a signal line 5 for sending a signal to the pressure / flow rate control unit 6 and a signal line 7 for sending a signal to the sensor changeover switch 24 to switch the sensor input.

As shown in FIG. 1B, the trocar 2
A pressure sensor 22 is embedded in the insertion portion of the trocar 26, and the pressure sensing portion has an opening provided on the outer surface of the insertion portion of the trocar 26 as shown in an enlarged manner in FIG. Part 42
Exposed to the outside.

The pressure sensor 22 is connected via a wire 30 to an internal connector 32 as an electrical contact provided on a connector receiving portion 41 of the trocar 26. The connector 29 is provided with an internal connector 34 as an electric contact to which the electric line 28 is connected.
2 and 34 are electrically connected to each other by connecting the connector 29 to the connector receiving portion 41 of the trocar 26, whereby the pressure sensor 22 is connected to the electric cable 28 of the connector cable 21 via the electric line 28. The inside of the trocar 26 and the inside of the air supply line 18 communicate with each other while being connected to the system. In connection between the connector 29 and the connector receiving portion 41, the locking portions 38 and 40 having a tapered surface are locked.

The pressure sensor 22 may be provided at the hand side of the trocar 26, for example, near the connector receiving portion 41, as shown in FIG. In this case, the abdominal cavity pressure is applied to the pressure sensor 22 through the opening 42.
An intraperitoneal pressure introducing hole 46 leading to the inside is provided. In this configuration, it is not necessary to secure a space for disposing the pressure sensor 22 in the insertion portion of the trocar 26,
This is very advantageous in that the diameter of the piercing portion 6 can be made small and the burden on the patient and the like can be reduced. In addition, the abdominal pressure introduction hole 4
6 simply needs to transmit the abdominal pressure to the pressure sensor 22, and it is not necessary to reduce the pipeline resistance.
It may be a very small diameter or space.

Next, the pressure / flow control unit 6 of the insufflation unit 3 will be described with reference to FIG. A first electromagnetic valve 54 is provided in the pressure and flow control unit 6. The first electromagnetic valve 54 has an internal conduit 16 connected to the pressure reducing unit 4.
Is connected. The internal conduit 16 is branched on the upstream side of the first electromagnetic valve 54, and the branch conduit 16 a is connected to the second electromagnetic valve 52 in the pressure and flow control unit 6. The first solenoid valve 54 is electrically connected to the switching unit 8, and the second solenoid valve 52 is also electrically connected to the switching unit 8 via the inverter 60. The signal causes either the first solenoid valve 54 or the second solenoid valve 52 to open.

Downstream of the first solenoid valve 54 is an internal line 1
A decompressor 56 for reducing the pressure of the gas to 50 mmHg is connected via 6. Further, a decompressor 58 for reducing the pressure of the gas to 200 mmHg is connected to the downstream side of the second solenoid valve 52 via the internal conduit 16a. Then, the conduits 16 and 16a extending from the decompressor 56 and the decompressor 58 merge, and the flow of gas from the internal conduit 16 to the air supply conduit 18 leading into the abdominal cavity is controlled downstream of the junction. A third solenoid valve 50 is provided. The third solenoid valve 50 is electrically connected to the pressure control unit 12, and its opening and closing operation is controlled by an electric signal from the pressure control unit 12.

Next, the sensor identification unit 10 and its peripheral circuits will be described with reference to FIG. As shown in FIG. 4A, the pressure sensor 22 includes an internal connector 32 provided at a connector receiving portion of the trocar 26 and an internal connector provided at a connector 29 of a connector cable 21 connected to the insufflation unit 3 side. The pressure control unit 12 and the sensor identification unit 10 are connected via the connector 34.

Each of the internal connectors 32 and 34 has four terminals. Two terminals 70c and 71d of the four terminals of the internal connector 32 are short-circuited, and these two terminals 70c and 71d are connected to the internal connectors 32 and 34, respectively.
When connecting the two, they are connected to two opposite terminals 76c and 76d on the internal connector 34 side. Two terminals 76
Among the terminals c and 76d, a terminal 76c is connected to the switching unit 8 via an inverter 79 provided in the sensor identification unit 10,
The other terminal 76d is connected to GND.

When connecting the internal connectors 32 and 34 to each other, the two remaining terminals 74a and 74b of the internal connector 32 are connected to two opposing terminals 76 on the internal connector 34 side.
a, 76b, whereby the pressure sensor 22
And the pressure controller 12 can be connected.

Therefore, when the internal connectors 32 and 34 are connected to each other, the input section of the inverter 79 of the sensor identification section 10 is short-circuited to GND.
The output of 9 becomes Hi level so that it can be recognized that the pressure sensor 22 is connected to the insufflation unit 3.

The pressure sensor 22 and the sensor identification unit 10
The connection with the pressure control unit 12 may be achieved by a configuration as shown in FIGS.

In the configuration shown in FIG. 4B, instead of short-circuiting between the two terminals 74c and 74d of the internal connector 32, the terminal 74c is connected to a communication control circuit 82 provided on the trocar 26 side. 74d is connected to GND. The internal connector 34 connected to the terminal 74c
Is connected to the communication control circuit 84 via the buffer 80 of the sensor identification unit 10. The other configuration is the same as that of FIG.

In this configuration, the communication between the trocar 26 and the insufflation unit 3 is performed by using the communication control circuits 82 and 84, so that the pressure sensor 22 is connected and the type of the trocar 26 (thickness of the trocar 26). Difference) can be known on the insufflation unit 3 side.

In the configuration shown in FIG. 4C, the pressure sensor 22 has a CPU with a communication function via a sensor amplifier 86.
88 A / D input terminals. Also, CPU
The communication terminal 88 is connected to the CPU 90 provided in, for example, the sensor identification unit 10 of the insufflation unit 3 via internal connectors 32 and 34 having the same configuration as that of FIG.

The CPU 90 may be connected to all control means, display means, input means, drive means, etc. in the insufflation unit 3 so that the CPU 90 controls all functions in the insufflation unit 3. .

In this configuration, when the internal connectors 32 and 34 are connected, the CPU 88 sends a signal to the communication line to notify the CPU 90 of the connection of the pressure sensor 22 and the type of the trocar 26. Specifically, first, the pressure sensor 22 converts the pressure in the body cavity into an electric signal, and this electric signal is amplified by the sensor amplifier 86 and then input to an A / D input terminal of the CPU 88 to be converted into a digital value. You.
The CPU 88 transmits individual data such as the connection of the pressure sensor 22, the type of the trocar 26, and the pressure in the body cavity to the CPU 90 periodically or when a change occurs in the body cavity pressure. In the case of this configuration, the information of the pressure sensor 22 is transmitted to the insufflation unit 3 by the communication system.
Abnormal operation does not occur using incorrect data.

Each CPU described above is a one-chip CP.
U is mounted on the trocar 26 together with various sensors.

In addition to the above configuration, a temperature sensor, a humidity sensor, or the like may be provided at another A / D input terminal of the CPU 88 so that data such as body temperature and humidity in a body cavity can be transmitted in the same manner. Further, the intra-abdominal pressure may be displayed on the trocar 26 using an LCD.

The configuration shown in FIG. 4D is such that information from the pressure sensor 22 is transmitted to the unit 3 by optical communication. That is, the communication terminal output of the CPU 88 is connected to the input terminal of the driver 92,
The output of the driver 92 is connected to the LED 94.
An optical fiber 96 is provided so as to face the light emitting portion of the LED 94, and the other end of the optical fiber 96 faces a light incident surface of the phototransistor 98. Phototransistor 9
The output of 8 is connected to the communication input terminal of the CPU 90 via the buffer amplifier 99.

In this configuration, the light emission of the LED 94 is controlled by the communication output of the CPU 88 via the driver 92, and the communication data is converted into an optical signal. Optical fiber 96
Communication data transmitted as an optical signal through the inside enters the phototransistor 98, returns to an electric signal again, and is input to the communication input terminal of the CPU 90 via the buffer amplifier 99. In the case of this configuration, since light is used for communication means,
It is strong against noise radiated from external devices such as an X-ray device and an electric scalpel in the operating room, and can expect a stable operation.

The communication lines in FIGS. 4A to 4C have been described as a model of one-way communication from the trocar 26 side to the insufflation unit 3 side. It is desirable to adopt a configuration according to the situation, such as inquiring from the three sides, instructing the operation pressure of the relief mechanism of the trocar 26 described later, or sending an alarm to the trocar 26 side. Of course, half-duplex or full-duplex communication is also possible, and the form of communication is not limited.

On the hand side of the trocar 26, a relief valve 100 as shown in FIG. The relief valve 100 is provided in the housing 1
A diaphragm 104 and a spring 106 are arranged in the inside of the trocar 26, and the diaphragm 104 is urged by the spring 106 in a direction to close an internal conduit of the trocar 26.

The control for maintaining the intraperitoneal pressure at the set value is usually performed in the insufflation unit 3. However, when the treatment instrument 108 such as a laser scalpel is inserted into the internal conduit of the trocar 26 and used, For example, CO ₂ gas for cooling may be released into the abdominal cavity, or a doctor may press the inflated abdomen, so that the pressure in the abdominal cavity may be higher than a set value.

In such a case, the pressure in the abdominal cavity pushes up the diaphragm 104 of the relief valve 100 against the urging force of the spring 106 and the opening 102 of the housing 102.
Excess gas is released to outside. When the pressure in the abdominal cavity returns to or below the set value, the urging force of the spring 106 overcomes the pressure in the abdominal cavity, the diaphragm 104 again closes the internal conduit of the trocar 26, and the gas discharge is stopped. In this way, the relief valve 100 is automatically opened even in the event that the intra-abdominal pressure becomes abnormally high, so that the danger to the patient when the pressure is exceeded can be immediately prevented. Conversely, by providing the relief valve 100, it can be said that safe high-pressure air supply and large-volume air supply can be achieved.

The relief valve provided on the hand side of the trocar 26 may be a solenoid valve 115 as shown in FIG. In this case, the solenoid valve 115 is electrically connected to the insufflation unit 3 via the electric line 110.

In the above-described spring-operated relief valve 100, the opening pressure thereof is determined by the elastic coefficient of the spring 106.
For example, when 30 mmHg is used as the release pressure, the pressure is not released unless the intraperitoneal pressure exceeds 30 mmHg,
As in this configuration, the relief valve is connected to the solenoid valve 1
If it is 15, the opening operation can be controlled by a signal from the insufflation unit 3, so that the opening pressure can be set arbitrarily and the operability is improved. For example, when the set pressure is 8 mmHg, 9 mmHg, and when the set pressure is 20 mmHg, 22 mmHg.
The valve 115 can be opened at an arbitrary value slightly higher than the set pressure, for example, by setting the opening pressure to g.

As described above, the provision of the relief valve on the trocar 26 allows the stomach to be insufflated in a short time and recovers the rapid decrease in the abdominal cavity pressure caused by the operation of the suction device or the like in a short time. Even when gas is injected into the abdominal cavity at a stretch by increasing the air supply pressure, it is very effective in that it can be safely inflated without overpressurizing the abdominal cavity.

Next, the operation of the insufflation device 1 described above will be described. As shown in FIG. 1, gas (for example, CO ₂ gas) from a gas cylinder 2 supplied at a pressure of several tens of atmospheres
Is first reduced to 1/10 or less by the pressure reducing unit 4. When the internal connectors 32 and 34 are connected to each other, the sensor identification unit 10 detects the connection with the pressure sensor 22 and the switching unit 8
, The first solenoid valve 54 in the pressure and flow control unit 6 is closed, and the second solenoid valve 52 is opened.

The CO ₂ gas decompressed by the decompression unit 4 is reduced by the decompressor 58 in the pressure and flow control unit 6 so that a pressure that is safe for the patient and a flow rate that does not hinder the progress of the operation can be obtained (in this case, 200 mmHg). ). 200
The CO ₂ gas reduced to mmHg is injected into the abdominal cavity of the human body through the air supply line 18 and the trocar 26. The situation where the pressure in the abdominal cavity is increasing is determined by the pressure sensor 22.
And the information is transmitted to the pressure control unit 12 as an electric signal. The pressure control unit 12 receives the electric signal and opens the third solenoid valve 50 in the pressure / flow control unit 6 until the pressure in the abdominal cavity reaches a set pressure (for example, 8 mmHg). When the pressure in the abdominal cavity reaches the set pressure, the third solenoid valve 50 in the pressure / flow control unit 6 is closed via the pressure sensor 22 and the pressure control unit 12, and the air supply to the abdominal cavity is stopped.

Thereafter, when CO ₂ gas leaks from the abdominal cavity due to handling of surgical instruments during the operation and the pressure in the abdominal cavity decreases, the pressure control unit 12 constantly monitors the output of the pressure sensor 22. A signal urging additional air supply is sent to the pressure and flow control unit 6. As a result, the third solenoid valve 50 is opened again to supply air into the abdominal cavity, and the abdominal cavity pressure is constantly maintained at the set pressure.

When a trocar having no pressure sensor 22 is used, the same control as described above is performed using the output of the pressure sensor 20 provided in the air supply line of the insufflation unit 3. Since the insufflation pressure acts directly on the pressure sensor 20 as dynamic pressure, when the intraperitoneal pressure is measured by the pressure sensor 22, the insufflation is temporarily interrupted and the inside of the insufflation duct 18 is moved into the abdominal cavity. It is necessary to perform the operation in a static pressure state in which communication is performed. After the measurement of the intraperitoneal pressure, if the pressure in the abdominal cavity has not reached the set pressure, the third solenoid valve 50 is opened via the pressure control unit 12, and air is supplied to the abdominal cavity again. As described above, when the pressure in the abdominal cavity is controlled using the pressure sensor 20, the air supply and the measurement of the abdominal cavity pressure are alternately repeated. The pressure sensor 20
Is measuring the intraperitoneal pressure on the delivery side, for example, the line resistance changes due to clogging or breakage in the air supply line 18, and the pressure sensor 20 detects the intraperitoneal pressure as a value lower than the actual pressure. In such a case, the CO ₂ gas is pushed into the abdominal cavity beyond the set pressure, which is dangerous. However, in this embodiment, in order to avoid this danger, when the sensor identification unit 10 recognizes the connection with the pressure sensor 20 (correctly, when the connection with the pressure sensor 22 is not recognized), the switching is always performed. The first electromagnetic valve 54 of the pressure / flow control unit 6 is opened via the unit 8, and the second electromagnetic valve 52 is closed. That is, air can be sent at a low pressure of 50 mmHg.

By the way, the insufflation pressure is closely related to the insufflation flow rate. If the insufflation pressure is reduced, the insufflation flow rate cannot be increased, and the operability of the operator is reduced due to an increase in insufflation time. Invite. That is, the safety of the patient and the operability of the operator are opposite to each other.

However, as described above, the pressure sensor 2
In the case of using 2, since the static pressure in the abdominal cavity can be constantly measured without stopping the infusion of the gas into the abdominal cavity, the insufflation pressure is increased by 200 mmHg,
It allows for early insufficiency. Of course, since the static pressure in the abdominal cavity is always measured, even if air is supplied at a high pressure of 200 mmHg, it is safe because the pressure control unit 12 constantly monitors the pressure change.

As described above, the insufflation device 1 according to the present embodiment can reliably and accurately measure the static pressure in the abdominal cavity without stopping the injection of gas into the abdominal cavity. Good insufficiency can be achieved. In addition, since the use state of the pressure sensors 20 and 22 can be switched by the switching operation of the switching unit 8 through the sensor identification unit 10, the existing insufflation tube can be used effectively.
That is, when the pressure sensor 22 is used,
It is not necessary to set the
The airflow can be set large, and the insufflation efficiency is good.
Become. When the pressure sensor 20 is used, the existing
Trocars can be used.

By the way, various means can be considered to detect the abnormal high pressure in the abdominal cavity as soon as possible and to deal with it immediately to avoid the danger to the patient. For example, the means shown in FIG. Punctures 4-5 trocars 26 into the patient 139, inserts the scope 125 into the abdominal cavity through one trocar 26, and inserts the treatment tools 130, 131, 132 into the abdominal cavity through the other trocar 26. Is what you do. TV on scope 125
A camera 126 is connected, and a captured image signal is transmitted to a TV monitor 124 via a TV camera control device 122.
It is projected to. Scope 12 to send light into the abdominal cavity
5, a fiber cable 127 connected to the light source device 120 is connected.

Normally, the set pressure of the abdominal cavity is about 10 mmHg, and does not exceed 20 mmHg. However, the air pressure (outlet pressure) of the insufflation device 1 is usually 50 mmHg,
If this is directly applied to the abdominal cavity, it poses a great danger to the patient.

Therefore, in this configuration, at least two of the four trocars 26 are provided with a spring-type relief valve 135, and the set pressure of each spring is made different. For example, one relief valve 13
5 is set to 30 mmHg, and others are set to 50 mmHg. In this way, even if the inside of the abdominal cavity is overpressurized during a normal operation, first, the relief valve 135 with the set pressure of 30 mmHg is opened to prevent the set pressure from being exceeded. Further, when the pressure inside the abdominal cavity becomes abnormally high due to any cause, the relief valve 135 having the set pressure of 50 mmHg is opened to rapidly release the gas to the atmosphere, thereby reducing the pressure.

The relief valve 135 may be an electromagnetic valve. In this case, the pressure is maintained by one solenoid valve near the set value, and when suddenly high pressure is applied, the other solenoid valves are simultaneously opened. You just have to select

FIG. 6B shows a trocar 26 with a solenoid valve provided with a first element 148 (for reception, for example, a phototransistor) used for transmission or reception is inserted into the abdomen 149 of the patient. It is entered. At least one of the trocars 26 is connected to the air supply conduit 18 connected to the insufflation device 1. An antenna 145 is provided above a bed (not shown) on which the patient lies.
45 includes a plurality of second elements 1 used for transmission or reception.
42 (for transmission, for example, an LED) is provided.
The second elements 142 are connected to the insufflation device 1 via signal lines 140, respectively.

In this configuration, when the pressure in the abdominal cavity 149 becomes abnormally high while the CO ₂ gas is being injected into the abdominal cavity 149 from the side of the insufflator 1 via the air supply line 18, 1 detects a pressure abnormality in the abdominal cavity 149 and detects a signal line 140.
To the second element 142 via the. This signal is
The first element 1 of each trocar 26
48. When the first element 148 receives this signal, the solenoid valve in the trocar 26 opens and C
O ₂ gas is released to the atmosphere to reduce the pressure in the abdominal cavity 149.
Thereafter, when the pressure returns to the safe pressure or lower or the set pressure or lower, the insufflation device 1 stops signal transmission. This closes the solenoid valve in the trocar 26.

In this configuration, the first element 1
48 and the second element 142 can be respectively transmitted and received (for example, a phototransistor and an LED are provided as a pair), and a pressure sensor or the like is provided on the trocar 26 in addition to a solenoid valve, so that pressure data transmission / reception is made wireless. It is possible to do. Further, only one of the plurality of trocars 26 is provided with a pressure sensor and a transmitting element, the other trocars 26 are provided with a solenoid valve and a receiving element, and the antenna 145 is provided with respective elements for transmitting and receiving. There are various possibilities.

As described above, the wireless use of the pressure sensor signal and the solenoid valve drive signal is very advantageous in terms of hygiene and efficiency during an operation in which various treatment tools are scattered on the abdomen of a patient. Becomes Further, since the transmitting / receiving element is provided above the bed, even if many doctors surround the patient, there is no problem in transmitting / receiving signals. Further, if the battery built in the trocar 26 is a solar cell, and the antenna 145 having the transmitting / receiving element is also used as an operating light above the bed,
The light energy can be received to generate electric power. Although the above-mentioned signal transmission and reception is based on an optical signal, the optical signal may be a modulated signal. Further, it may be a radio frequency signal or an ultrasonic signal.

FIG. 7A shows CO ₂
The CO ₂ gas from the gas cylinder 2 is reduced to an appropriate pressure by the insufflation device 152, and the reduced CO ₂ gas can be injected into the body through the electromagnetic valve 158 and the trocar 26. The air supply line 18 branches on the way, and is connected to the suction unit 154 via the electromagnetic valve 160. The signal of the pressure sensor 22 of the trocar 26 is connected to the control unit 156. The control unit 156 also controls the insufflation device 15
2 and a suction unit 154 are connected to these via signal lines so as to be controlled as necessary. Also, the solenoid valves 158, 1
A control unit 156 is provided so as to be capable of independently controlling the drive.
It is connected to the.

In this configuration, when the pressure in the abdominal cavity becomes higher than the set pressure, the control unit 156 detects the signal of the pressure sensor 22 and closes the solenoid valve 158 to stop insufflation. Driving part 154, C in the abdominal cavity
O ₂ gas is sucked. When the pressure in the body cavity falls rapidly below the set pressure or below the safe pressure by sucking CO ₂ gas in the abdominal cavity, the control unit 156 detects this and stops the suction unit 154, and at the same time, closes the electromagnetic valve 160, In this configuration in which the solenoid valve 158 is opened again to start insufflation, the patient can be protected from danger due to high pressure. The pressure sensor 20 (see FIG. 1) provided in the air supply line 18 may be used for measuring the pressure in the abdominal cavity. Also,
A separate suction line may be provided and connected to the trocar 26 without branching the air supply line 18 on the way.

FIG. 7B shows an air supply line 18.
And the suction line 161 are connected to different trocars 26, 26 (both are inserted into the same abdominal cavity region). The suction pipe 161 branches on the way, and the pressure sensor 20 is provided at the branch. The output of the pressure sensor 20 is connected to the control unit 156.

When insufflation is started in the same manner as in FIG. 7A, when the abdominal pressure rises abnormally, the controller 1
The solenoid valve 158 is closed by 56 and the solenoid valve 16 is closed.
Opening 0, the suction unit 154 is driven to lower the abdominal pressure.

In this configuration, unlike the configuration shown in FIG. 7A, air supply and suction can be performed at the same time.
The smoke generated by the laser or electric scalpel can be discharged while maintaining the intraperitoneal pressure. Further, in order to measure the static pressure in the abdominal cavity, it is necessary to stop the suction function. This can be achieved by closing the electromagnetic valve 160. When the suction operation is performed with the electromagnetic valve 160 opened, the performance of the suction function can be monitored because the pressure sensor 20 measures the suction dynamic pressure. Therefore, the patient can be protected from the danger of high pressure, and the reliability of the device can be increased. In this configuration, without preparing two trocars 26,
One that can connect both the air supply line and the suction line may be prepared. Further, an air supply pipe and a suction pipe may be combined into a single polymerization tube, which may be connected to one trocar.

[0060]

As described above, the insufflation device of the present invention
Of the gas provided in the connecting line and injected through the pneumoperitoneum
First abdominal cavity pressure measuring means for measuring the pressure in the conduit;
A second measuring means for measuring the pressure outside the duct of the pneumoperitoneum
Abdominal cavity pressure measuring means and the first abdominal cavity pressure measuring means
The first measurement result is measured by the second abdominal cavity pressure measuring means.
Measurement result selecting means for selecting the second measurement result obtained;
To stop gas injection into the abdominal cavity.
Reliably and accurately measures static pressure in the abdominal cavity
Can be selected by the measurement result selecting means.
The air injected into the abdominal cavity based on the measurement results obtained.
Because it is designed to control body fluids, existing
The abdominal canal can be used effectively, thereby improving insufflation efficiency.

[Brief description of the drawings]

1A is a circuit diagram of an insufflation device showing an embodiment of the present invention, FIG. 1B is a cross-sectional view showing details of a connection between an insufflation tube (trocar) and an insufflation unit, and FIG. () Is a cross-sectional view showing the configuration near the pressure sensor.

FIG. 2 is a cross-sectional view showing a modified example of a connecting portion between a pneumoperitoneal tube (trocar) and a pneumoperitoneum unit.

FIG. 3 is an internal circuit diagram of a pressure and flow control unit.

FIG. 4 is a circuit configuration diagram near a connector portion in a connection portion between a pneumoperitoneum tube (trocar) and a pneumoperitoneum unit.

5A is a cross-sectional view of a trocar having a spring type relief valve, and FIG. 5B is a cross-sectional view of a trocar having an electromagnetic type relief valve.

FIG. 6 is a schematic configuration diagram showing an example of danger prevention means using an insufflation device.

FIG. 7 is a schematic configuration diagram showing another example of danger prevention means using an insufflation device.

[Explanation of symbols]

1 ... insufflation device, 6 ... sending pressure flow rate control unit (fluid control means),
8 switching unit (measurement result selection means), 10 sensor identification unit, 12 pressure control unit (fluid control means), 18 air supply line (connection line), 20 pressure sensor (first abdominal cavity pressure measurement) Means), 22 ... pressure sensor (second abdominal pressure measuring means),
26 ... trocar.

──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Hiroshi Yanagawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Takeo Usui 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Inventor Shiro Bito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (56) References JP-A-63-164931 (JP, A) 1-314548 (JP, A) U.S. Pat. No. 4,027,872 (US, A) U.S. Pat. No. 3,982,533 (US, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 1/00-1/32

Claims (1)

(57) [Claims] An insufflation device for expanding the inside of the abdominal cavity with a predetermined gas.
In, a gas supply source for supplying the gas , one end is connected to the gas supply source, from the gas supply source
A connection conduit for guiding the gas, and detachably connected to the other end of the connection conduit,
Percutaneously inserted into the abdominal cavity and guided through the connecting conduit
A gastrointestinal tube for injecting the gas into the abdominal cavity, the gas being provided in the connection conduit, and infused with the gastrointestinal tube
First peritoneal pressure measuring means for measuring pressure in a gas conduit
If the gas provided in the belly tube, measuring the pressure in the conduit outside of the pneumoperitoneum tube
A second abdominal pressure measuring means for determining, and a first measurement result measured by the first abdominal pressure measuring means
And a second measurement measured by the second abdominal cavity pressure measuring means
Results and measuring result selection means for selecting and, based on the measurement result selected by the measurement result selection unit,
A flow for performing fluid control of the gas injected into the abdominal cavity
An insufflation device comprising: body control means .