JP7801765B2 - Trocar auxiliary equipment - Google Patents

Description

The present invention relates to an auxiliary device for a trocar.

Laparoscopic surgery, which has become increasingly common in medical institutions in recent years, involves making a small hole in the abdomen, inserting a cylindrical medical device called a trocar, and inflating the abdomen with carbon dioxide gas supplied through the trocar's gas passage (pneumoperitoneum). An endoscope inserted through the trocar then displays the condition of the abdominal cavity (surgical field) on a monitor. While watching the monitor, the surgeon performs the surgery using surgical tools (forceps and scissors) inserted through another trocar.

The trocar described in Patent Document 1 includes a conduit through which an instrument is inserted and an annular flow path through which a liquid is introduced, and the single trocar allows for the insertion of the instrument and the introduction of the liquid simultaneously.
The trocar spacer described in Patent Document 2 holds a surgical instrument inserted into an endoscope surgical port and prevents the tip of the surgical instrument from shaking.

JP 2018-86168 A JP 2016-104096 A

Generally, a trocar has a passage for passing surgical instruments and a gas supply passage for supplying carbon dioxide gas from the outside for insufflation, and is equipped with a valve to prevent the supplied carbon dioxide gas from backflowing and leaking to the outside.
In a configuration in which a valve member is provided to open and close a passage formed in a valve body inside a trocar, the valve member acts as a resistance when inserting or removing items such as gauze at the entrance of the head of the trocar, making it easy for dirt such as grease, blood, and bodily fluids to adhere to the passage, making it difficult to insert or remove items and prone to clogging, which can interfere with surgery.
Furthermore, depending on the material of the valve member, it may be very difficult to insert or remove items.

The present invention was made in consideration of the above, and its purpose is to provide an auxiliary device for a trocar that makes it easier to put items in and take them out of the trocar's opening.

The trocar auxiliary device of the present invention is an auxiliary device for a trocar (33) for putting in and taking out an article from an entrance (34) of the trocar, and comprises a cylindrical auxiliary device main body (3) whose one end ( 12 ) can be inserted into the entrance, a conical part (10) connected to the other end ( 13 ) of the auxiliary device main body and whose opening area gradually increases in the direction of extension from the other end,
an opening (11) connected to the conical portion and through which the article can be put in and taken out ;
The opening has an annular flange (12) when viewed from above in the axial direction,
The annular flange has an outer wall that is a rounded curved surface that is seamless in the axial direction .
Here, the term "items" refers to tools and the like used in surgery.

With the trocar auxiliary device of the present invention, when the trocar auxiliary device is inserted through the entrance of the trocar, one end of the auxiliary device body pushes open the valve member of the trocar in the radially outward direction, opening the valve of the trocar, reducing resistance when inserting or removing items, and allowing items to be inserted or removed smoothly.
The auxiliary device for a trocar of the present invention does not induce leakage of carbon dioxide gas when carbon dioxide gas is supplied into the abdomen during laparoscopic surgery, nor does it impair the airtightness of the trocar when in use.
The auxiliary device for a trocar of the present invention is provided with a conical portion that functions as a stopper at the opening of the trocar inlet, preventing the auxiliary device body from entering excessively into the passage of the trocar.

When cleaning the inside of a trocar, insert the aforementioned one end of the auxiliary device body through the entrance of the trocar, and then insert and operate a trocar cleaning tool, such as that disclosed in Utility Model Registration No. 3184175, through the open end of the conical portion. This brings the wiping part of the cleaning tool into contact with the valve member and the inner wall of the passage inside the trocar, thereby removing any deposits on the valve member within the valve body, facilitating cleaning and purifying the valve.

FIG. 1 is a front view showing a trocar auxiliary device according to a first embodiment. FIG. 2 is a view taken in the direction of an arrow II in FIG. FIG. 3 is a view taken in the direction of an arrow III in FIG. 1 . 4 is a cross-sectional view taken along line IV-IV in FIG. 1; FIG. 1 is a perspective view showing a trocar auxiliary device according to a first embodiment. FIG. 2 is an explanatory diagram illustrating a state in which the trocar auxiliary device of the first embodiment is used. FIG. FIG. 8 is a view taken in the direction of arrow VIII in FIG. 7 . FIG. 1 is a schematic cross-sectional view showing a state in which the trocar auxiliary device of the first embodiment is attached to a trocar and in use. FIG. FIG. 1 is a schematic cross-sectional view showing a state in which the trocar auxiliary device of the first embodiment is used. FIG. 12 is a view taken in the direction of the arrow XII in FIG. FIG. 1 is a perspective view of the trocar auxiliary device of the first embodiment when used in a trocar and gauze is inserted.

The following describes an auxiliary device for a trocar according to an embodiment of the present invention, with reference to the drawings.

(First embodiment)
A first embodiment of the present invention will be described with reference to FIGS. 1 to 13. FIG.

First, the trocar used as the trocar auxiliary device will be described with reference to FIGS. 6-8 and 10-13.
In laparoscopic surgery, as shown in Figure 6, a small incision is made in the abdomen 8 of the human body 2 and a trocar 33 is inserted. Carbon dioxide gas is introduced through a gas pipe 44 of the trocar 33, and the abdominal wall is lifted from various organs. A laparoscope (not shown), forceps 37 (described later), and other instruments are passed through an inlet 34 of the trocar 33, and surgery is performed while watching the screen of a monitor 30.

As shown in FIGS. 7 and 8, the trocar 33 comprises a head portion 40 and legs 50 connected to the head portion 40 .
As shown in Figure 10, the head 40 has an inlet 34, and a first valve member 35 is located inside a passage 43 of a valve body 42 connected to the inlet 34. The first valve member 35 has a fixed end at its radially outer side that is fixed to the head case and a free end at its radially inner side. A second valve member 36 that opens and closes the passage 43 is provided on the outlet side of the first valve member 35. The second valve member 36 has a fixed end at its radially outer side that is fixed to the head case and a free end at its radially inner side. The second valve member 36 has four flexible petal-shaped leaflets. When an article is inserted from the inlet 34 side, the four leaflets apply a biasing force to the article so as to push the article toward the central axis.

7, the head portion 40 has a gas pipe 44 through which gas such as carbon dioxide flows in from the outside. The internal passage of the gas pipe 44 communicates with a leg passage 51 on the leg portion 50 side of the second valve member 36.
The passage 43 inside the head portion 40 communicates with the leg passage 51 inside the leg portion 50. In Figures 10 to 13, the head portion 40 of the trocar 33 is shown, and the legs are not shown.
The first valve member 35 and the second valve member 36 are normally in a closed state, and can be changed to an open state by bending when an article is inserted into the head portion 40 from the outside of the inlet 34 .
Next, the assisting device main body 3, which is inserted through the entrance of the trocar, will be described.

The trocar auxiliary device 1 of this embodiment shown in FIG. 5 is inserted into the entrance of the trocar 33.
As shown in FIG. 1, the trocar auxiliary device 1 comprises an auxiliary device main body 3 and a conical portion 10, and is formed by integral molding of resin, for example.
The assisting device main body 3 has a cylindrical basic shape and has a straight passage 6 with a constant inner diameter inside. One end 4 of the assisting device main body 3 can be inserted into the inlet 34 of the trocar 33. The other end 5 of the assisting device main body 3 is integrally connected to the conical portion 10.

The outer diameter of the auxiliary device main body 3 is smaller than the inner diameter of the inlet 34 of the trocar 33. The outer diameter of the auxiliary device main body 3 is large enough to push out the first valve member 35 and second valve member 36 of the trocar 33 when the auxiliary device main body 3 is inserted into the passage 43 of the trocar 33, thereby opening the valves. The longitudinal length of the auxiliary device main body 3 is long enough to push open the first valve member 35 and second valve member 36.

The conical portion 10 is continuously connected to the other end 5 of the assistive device main body 3. The outer diameter of the conical portion 10 is formed so that it gradually increases from the outer diameter of the assistive device main body 3. A curved chamfer is formed at the open end 11 of the conical portion 10. The maximum outer diameter of the open end 11 of the conical portion 10 is large enough so that it will not enter the entrance 34 of the trocar 33. The open end 11 of the conical portion 10 has a flange 12 with a curved surface formed in an annular shape. The open end 11 of the conical portion 10 has a curved flange formed in an annular shape.

The outer wall of the conical portion 10 is conical in shape. When the trocar is not in use, for example, when cleaning the trocar, the head portion 40 and the leg portion 50 are disassembled. When the assisting device main body 3 is inserted through the inlet 34 of the head portion 40 and passes through the first valve member 35, if the assisting device main body 3 is further inserted, one end 4 of the assisting device main body 3 will reach the second valve member 36, opening the second valve member 36.
The internal passage 13 of the conical portion 10 communicates with the passage 6 of the assisting device main body 3. The inner wall of the conical portion 10 that forms the internal passage 13 expands toward the open end 11 so that the inner diameter increases.
The inner diameters of the passage 6 and the inner passage 13 are large enough to allow forceps and gauze to pass through.

An example of the trocar 33 used in the trocar auxiliary device 1 will be described.
6 to 8, in laparoscopic surgery, a small incision is made in the abdomen and a trocar 33 is inserted. Carbon dioxide gas is introduced through a gas tube 44 of the trocar 33, and the abdominal wall is lifted from various organs. A laparoscope, forceps 37, and other instruments (not shown) are passed through the trocar 33, and surgery is performed while watching a monitor screen.

How to use the trocar auxiliary device 1 will now be described.
(1) Regarding condition 1 (cleaning the trocar with cleaning tools)
The lens of an endoscopic camera becomes dirty due to the adhesion of oil, blood, and bodily fluids scattered during surgery, obstructing the surgeon's view. For this reason, the endoscopic camera must be removed from the body several times during surgery to clean the lens.
Meanwhile, inside the trocar 33, dirt such as oil, blood, and bodily fluids from the patient's body easily adheres to the second valve member 36 and the passages through the passage 51 in the leg section 50 and the passage 43 in the head section 40. If dirt remains inside the trocar, it will re-adhere when the endoscopic camera is reinserted after being removed outside the body. This requires the lens to be wiped repeatedly, interrupting the surgery and extending the surgery time. Therefore, the auxiliary tool main body 3 is inserted through the inlet 34 of the trocar 33, and a cleaning tool (not shown, for example, the cleaning tool disclosed in Utility Model Registration No. 3184175) is inserted into the passage 6, and the inside of the trocar 33 is cleaned with its wiping portion by operating the cleaning tool.

The insertion length of the auxiliary tool body inserted through the entrance 34 of the trocar 33 can be adjusted as needed when operating the cleaning tool. By manually adjusting the insertion length, the efficiency of cleaning the inside of the trocar can be improved and the operability of the cleaning tool can be enhanced.
Furthermore, during surgery, the auxiliary tool for a trocar 1 can be used to easily remove dirt from the lens of an endoscope camera outside the body, while also cleaning the inside of the trocar.
Therefore, when the cleaned endoscopic camera is reinserted into the body, it can be inserted through the cleaned trocar and operated appropriately. Therefore, in combination with the cleaning tool inside the trocar, it can be used as an auxiliary cleaning tool to improve the operability and functionality of the cleaning tool.

(2) Regarding use state 2 (removal of forceps, gauze, etc.)
This section explains how to use the trocar auxiliary tool 1, which is used to remove forceps 37 or gauze from inside the body. The trocar auxiliary tool 1 is inserted into the entrance 34 of the trocar 33, and the forceps 37 or gauze is removed to the outside of the body through the passage 6 of the auxiliary tool 1. The auxiliary tool main body 3 pushes open the first valve member 35 and second valve member 36 inside the trocar 33 to secure the passage 6, thereby avoiding problems such as being caught by the valve members and allowing the gauze or other items inside the body to be smoothly removed from the body to the outside. At this time, the supply of carbon dioxide gas or the like to the body is controlled by a gas supply device (not shown).

(3) Regarding use state 3 (use of the biological tissue collection device)
When a biological tissue collection device (not shown) is inserted into the body through a trocar, the catheter of the biological tissue collection device is inserted through the passage 6 of the auxiliary tool 1, whereby the biological tissue is excised at the tip of the biological tissue collection device, the excised tissue is captured, and the excised tissue is removed to the outside of the body by the biological tissue collection device through the passage 6 of the auxiliary tool 1. At this time, because a passage is secured inside the trocar, it is possible to eliminate factors inside the trocar that may hinder the removal of items such as the biological tissue collection device, and items can be smoothly inserted and removed between the inside and outside of the body.

(Other embodiments)
In the above embodiment, a trocar 33 using the trocar auxiliary device 1 was used, but the shape and configuration of a trocar that can use the trocar auxiliary device of the present invention is not limited to the above.

The shape or configuration of a trocar that can use the trocar auxiliary device of the present invention does not necessarily have to have a first valve member and a second valve member, but may also have only one of the valve members. The number of valve members a trocar has does not affect the scope of application of the trocar auxiliary device of the present invention.

As described above, the present invention is not limited to the above-described embodiment, and can be implemented in various forms without departing from the spirit and scope of the present invention.
The trocar auxiliary device of the present invention can have an opening (11) connected to the conical portion and through which the item can be inserted and removed. This makes it easy to insert items such as surgical instruments through the enlarged opening of the conical portion. The inserted items are guided by the conical inner wall surface and easily led into the passage of the auxiliary device body.

The opening of the trocar auxiliary device of the present invention can be configured as an annular flange, which is strong and resistant to breakage and deformation, allowing for stable insertion and removal of items.
The flange forming the opening has a curved surface, so that when an article is inserted through the entrance of the trocar, it is unlikely to get caught and is safe when it comes into contact with the opening.
In the trocar auxiliary device of the present invention, the opening area of the opening can be made larger than the opening area of the one end. Surgical instruments and other items can be easily inserted through the large opening. The inserted items are guided by the conical inner wall surface, facilitating smooth introduction into the passageway of the auxiliary device body. This facilitates the transfer of items between the inside and outside of the abdomen.

A trocar using the trocar auxiliary device of the present invention generally has a head portion (40) having the inlet and a cylindrical leg portion (50) connected to the head portion.
The head may have a passage (43) communicating with the inlet, a first valve member (35) for opening and closing the passage, a second valve member (36) provided on the outlet side of the first valve member, and a gas pipe (44) through which gas can be supplied from the outside to the outlet side of the second valve member. The leg may have a leg passage (51) communicating with the passage.

Of course, the outer diameter and longitudinal length of the auxiliary tool body, the inner diameter of the passage, the inner diameter and outer diameter of the conical portion, etc. can be changed.
During surgery, carbon dioxide gas is supplied to the abdomen through a gas tube, ensuring a clear surgical field within the abdomen and preventing fire, allowing the surgery to proceed smoothly.
In a trocar using the trocar auxiliary device of the present invention, the inner diameter of the trocar entrance is preferably smaller than the maximum outer diameter of the conical portion.

1. Trocar auxiliary equipment,
3. Auxiliary device body,
4 One end,
6 aisles,
10 conical portion,
11 Open end,
12 flange,
13 internal passage;
14 inner wall surface,
33 Trocar,
34 Entrance,
35 first valve member,
36 second valve member,
40 head,
43 aisle,
44 gas pipes,
50 legs,
51 Leg passage.

Claims (5)

An auxiliary tool for a trocar (33) for putting in and taking out an article from an entrance (34) of the trocar,
A cylindrical auxiliary tool body (3) whose one end (4) can be inserted into and removed from the inlet;
a conical portion (10) connected to the other end (5) of the auxiliary tool body, the opening area of the internal passage (13) gradually increasing in the direction extending from the other end;
an opening (11) connected to the conical portion and through which the article can be put in and taken out ;
The opening has an annular flange (12) when viewed from above in the axial direction,
An auxiliary device for a trocar, wherein the outer wall of the annular flange is a rounded curved surface that is seamless in the axial direction . 2. The auxiliary device for a trocar according to claim 1, wherein the trocar (33) has a valve body therein capable of connecting and disconnecting the intracorporeal space and the extracorporeal space, and when the auxiliary device main body is inserted, the inlet and outlet of the valve body are connected, and when the auxiliary device main body is removed, the inlet and outlet of the valve body are blocked. 3. The auxiliary device for a trocar according to claim 1, wherein the opening area of the internal passage of the conical portion is larger than the opening area of the one end. The trocar has a head portion (40) having the inlet and a tubular leg portion (50) connected to the head portion,
The head portion includes a passage (43) communicating with the inlet, a first valve member (35) for opening and closing the passage, and a valve member (35) for opening and closing the passage.
a second valve member (36) provided on the outlet side of the first valve member, and a gas pipe (44) through which gas can be supplied from the outside at the outlet side of the second valve member,
3. An auxiliary device for a trocar according to claim 1 or 2 , wherein the leg has a leg passage (51) communicating with the passage. 3. An auxiliary device for a trocar according to claim 1, wherein the inner diameter of the inlet of the trocar is smaller than the maximum outer diameter of the conical portion.