JP6543581B2 - Trocar - Google Patents

Description

  The present invention is a patent application that receives the application of Article 19 of the National Research Institute for Medical Research and Development, Japan Medical Research and Development Organization, "Medical-Industrial Cooperation Promotion Project Demonstration Project" commissioned research in FY 2015, The present invention relates to a trocar used for endoscopic surgery.

  In recent years, minimally invasive surgery such as laparoscopic surgery has been required in which an endoscope is inserted into the abdominal cavity in order to maintain and improve the quality of life (QOL) of a patient. In laparoscopic surgery, carbon dioxide gas is injected into the abdominal cavity to inflate the abdominal wall to secure space and visual field for the procedure. Then, a small hole is provided in the abdominal wall, and an instrument called trocar is inserted, and a surgical instrument such as an endoscope (CCD camera or the like) or forceps is inserted into the body from there, and an image displayed on the monitor by the endoscope It is common to perform surgery while observing the (1) and (2).

  In such conventional endoscopic surgery, since only one endoscope is inserted, the field of view is limited, and there is very little information that the operator can view and judge during the procedure. On the other hand, a wider field of view can be secured by additionally inserting an endoscope, but it is necessary to make a new hole in the body wall in order to insert the endoscope, which increases the burden on the patient. It will Then, the proposal which aimed at expansion of an observation visual field in laparoscopic surgery is made | formed by mounting a small camera in the trocar used for laparoscopic surgery (patent document 3).

That is, according to Patent Document 3, when inserting the trocar into the abdominal cavity, a mechanism for storing the camera in the trocar and deploying the camera outside the trocar is adopted when the tip of the trocar is inserted into the abdominal cavity. It is done.
However, since it is necessary to install a mechanism for operating storage and deployment of the camera in the trocar, there is a problem that the inner diameter and the outer shape of the trocar itself become large, and the burden on the patient becomes large.

JP, 2013-046789, A JP, 2006-167475, A JP, 2014-132979, A

  It is an object of the present invention to provide a trocar with a space-saving camera deployment mechanism.

The embodiment of the present invention for solving the above-mentioned subject has the following composition.
(1) A trocar including a pipe portion for inserting a medical instrument into the body and a head portion, wherein the pipe portion includes a pipe portion outer cylinder and a pipe portion inner cylinder, and the pipe portion outer cylinder is a metal The head portion includes a head portion outer cylinder and a head portion inner cylinder, the head portion outer cylinder is formed of resin, and the resin is provided at the rear end portion of the pipe portion outer cylinder. The rear end portion of the metal tube is covered to form a thick region integrally joined with the metal tube, and the head inner cylinder is integrally molded or integrally joined with the pipe inner cylinder. Torocar.
(2) The distal end of the pipe section inner cylinder has a camera section pivotally supported between the unfolded state pivoting out of the pipe section and the stored state retracted in the pipe section The pipe portion outer cylinder is externally slidably slidably on the upper portion of the pipe portion inner cylinder, and the camera portion is stored in the pipe portion while sliding toward the tip of the pipe portion (1 Trocar described in).
(3) The trocar according to (1) or (2), wherein a chamfered portion is formed at the tip of the thick region.
(4) The trocar according to any one of (1) to (3), wherein the surface of the pipe portion outer cylinder in contact with the thick region is roughened.
(5) The trocar according to any one of (1) to (4), wherein an anchor portion is formed at an end of the metal tube in the thick region.
(6) The trocar according to any one of (1) to (5), in which a corrugated region is formed on the outer peripheral surface of the pipe portion outer cylinder.
(7) The trocar according to any one of (1) to (6), wherein the medical device is inserted into the body through the pipe inner cylinder.

According to the present invention, since the pipe portion outer cylinder is formed of the metal tube, the pipe portion outer cylinder can be thinned. Therefore, by making the pipe portion of the trocar into a double structure of the pipe portion outer cylinder and the pipe portion inner cylinder, it is possible to prevent the inner diameter and the outer shape of the trocar itself from becoming large.
In addition, when the pipe portion outer cylinder is made to slide relative to the pipe portion inner cylinder, the pipe portion outer cylinder is made of a metal tube, so it has high strength and durability.
Furthermore, since a thick region integrally covered by a head outer cylinder made of resin is formed at the rear end of the pipe outer cylinder made of a metal tube, the pipe outer cylinder and the head are formed. The outer cylinder can be firmly joined and integrated.

FIG. 5 is a perspective view of a trocar in a camera deployed state according to an embodiment of the present invention. (A), (b) is a side view of the trocar shown in FIG. 1, respectively, and its sectional drawing. (A), (b) is the side view in the camera storage state of the trocar shown in FIG. 1, respectively, and its sectional drawing. (A), (b) is respectively the side view and sectional drawing of the trocar in the state which removed the trocar shaft from the trocar shown in FIG. 2, (c), (d) is a perspective view, respectively. (A), (b) is respectively sectional drawing and the partial expanded sectional view which show the head part of trocar. It is an exploded perspective view of the trocar concerning one embodiment of the present invention. It is a disassembled perspective view of the airtight structure unit in one Embodiment of this invention. FIG. 8 is an exploded perspective view of FIG. 7; It is a broken perspective view which shows the assembled state of the airtight structure unit. It is sectional drawing which shows the state which rotated the airtight structure unit shown in FIG. 9 by 90 degrees. (A), (b) is a perspective view and sectional drawing which show the front-end | tip part of the trocar in a camera part unfolded state, respectively. It is a sectional view of a camera part. It is the perspective view which looked at the tip part of the trocar in a camera part unfolded state from the operator side (the near side). It is a perspective view for demonstrating the rotation mechanism of a camera part. (A), (b) is a cutaway perspective view and sectional drawing which each show the structure of a camera part. (A), (b) is sectional drawing which shows operation | movement of the pipe part outer cylinder in a camera storing state and an expansion | deployment state, respectively. (A), (b) is a schematic diagram for demonstrating the locking mechanism of the camera part by a trocar shaft. It is a perspective view which shows the form of a plug member. (A)-(d) is a perspective view which shows the usage method of a trocar. It is explanatory drawing which shows the use condition of a trocar. It is a perspective view showing the trocar concerning other embodiments of the present invention.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

<Overall structure of trocar>
FIG. 1 shows a trocar 1 according to an embodiment of the present invention. The trocar 1 is used, for example, for laparoscopic surgery, and is a pipe portion 2 on the distal end side (far end position) when viewed in the insertion direction at the time of operation, and an operator side (hereinafter referred to as “front side”) And the head portion 3 in the position of

  The trocar 1 is mounted with a trocar shaft 4 penetrating the pipe 2 from the head 3. The trocar shaft 4 is provided at its distal end with a puncturing portion 4a for puncturing the abdominal cavity through a body wall, and a handle portion 4b is formed at its rear end. The puncturing portion 4 a has a conical shape whose tip substantially matches the inner diameter of the pipe portion 2. The handle portion 4 b is for the operator to perform an operation of inserting and removing the trocar shaft 4 into and out of the trocar 1.

As shown in FIG. 1 and FIGS. 2 (a) and 2 (b), the trocar 1 has a camera 5 as an imaging means attached to the end of the pipe 2 as shown in FIGS. b) shows a state in which the camera unit 5 is expanded. On the other hand, FIGS. 3A and 3B show the camera unit 5 stored in the pipe unit 2. As shown in FIG. 3 (b), the tip 4 c following the puncture 4 a of the trocar shaft is formed in a columnar shape having an outer diameter substantially the same as the inner diameter of the pipe, and in the stored state of the camera 5 In order to secure the storage space of the part 5, the notch part 6 is formed in the part. The connecting portion 4d from the tip portion 4c to the handle portion 4b is formed to have a smaller outside diameter than the tip portion 4c. This structure is adopted by supporting the tip of the pipe portion 2 provided with the camera portion 5 from the inside by the tip portion 4c having a large outer diameter, thereby increasing the large force applied when the trocar 1 is inserted. This is to ensure sufficient strength.
Incidentally, when the inner diameter of the pipe portion 2 is 12.7 mm, the outer diameter of the columnar tip portion 4c is preferably about 12.6 mm.

FIGS. 4 (a) to 4 (d) show the trocar 1 in which the trocar shaft 4 is removed from the state shown in FIGS. 2 (a) and 2 (b). The pipe portion 2 of the trocar 1 has a double structure including a pipe portion outer cylinder 21 and a pipe portion inner cylinder 22 as shown in FIG. 4 (b). The pipe portion 2 includes a pipe portion outer cylinder 21 and a pipe portion inner cylinder 22. The pipe portion outer cylinder 21 is formed of a metal tube. The metal tube is made of, for example, a metal such as iron, copper, aluminum or an alloy thereof. Further, the head portion 3 includes a head portion outer cylinder 31 integrally formed with the pipe portion outer cylinder 21 and a head portion inner cylinder 32 integrally formed with the pipe portion inner cylinder 22.
The pipe inner cylinder 22 and the head inner cylinder 32 are integrally connected or joined. The pipe portion outer cylinder 21 and the head portion outer cylinder 31 may be integrally connected or joined.
By making the pipe portion outer cylinder 21 a metal tube, the thickness of the pipe portion 2 can be reduced. In addition, it is possible to make the corrugated region 90 for holding the trocar 1 described later off at the abdominal wall thinner and thinner.

<Head part>
Next, the structure of the head unit will be described. Returning to FIG. 1, the head portion inner cylinder 32 is provided with a gas feed pipe 10 for feeding a gas such as carbon dioxide gas or air into the abdominal cavity. The gas fed from the air supply pipe 10 attached to the head portion inner cylinder 32 is fed into the abdominal cavity through the pipe portion inner cylinder 22 to pressurize the abdominal cavity.

As shown in FIGS. 5A and 6, the head unit 3 includes the head outer cylinder 31 and the head inner cylinder 32, and further includes an airtight structure unit 44 housed in the head inner cylinder 32; And a plug member 40 for closing the front open end 48. The head portion outer cylinder 31 and the head portion inner cylinder 32 having the opening end 48 constitute a head portion main body.
The head portion outer cylinder 31 of the head portion 3 is made of resin. Examples of this resin include polycarbonate resin, acrylic resin, polyacetal resin and the like.

As shown in FIG. 5 (b), the resin covers the rear end portion of the metal tube of the pipe portion outer cylinder 21 on the rear end portion (head portion 3 side) of the pipe portion outer cylinder 21 to form a metal tube A thick region 200 is formed integrally joined to the A chamfered portion 98 obtained by chamfering the boundary portion of the pipe portion outer cylinder 21 is provided at the tip of the thick region 200. The chamfered portion 98 is for reducing resistance and preventing damage when the trocar 1 is inserted into the abdomen. Further, since the chamfered portion 98 is formed by inclining the boundary portion between the pipe portion outer cylinder 21 and the head portion 3, it is possible to secure the thickness of the thick region 200 and secure the strength.
The thick region 200 is formed by forming the pipe portion outer cylinder 21 with a metal tube and then performing known insert molding on the resin-formed head portion 3.

The surface of the pipe portion outer cylinder 21 in contact with the thick region 200 is subjected to surface treatment such as surface roughening, surface roughening, etc. in order to increase the adhesiveness to the resin of the head portion 3 and to obtain sufficient adhesive strength. It may be done. For example, in the case of roughening, it is preferable that the arithmetic average surface roughness (Ra) be about 0.5 to 2.0 μm by a method known per se, such as sand blasting or chemical etching.
Further, in the thick region 200, an anchor portion 99 may be formed at the end of the metal tube of the pipe portion outer cylinder 21, as shown in FIG. 5 (b). The anchor portion 99 increases the diameter of the end of the metal tube of the pipe portion outer cylinder 21 to secure sufficient strength in the thick region 200 against axial movement. A plurality of anchor portions 99 can also be formed.

In the head portion 3, the plug member 40 has an opening 7 for inserting the trocar shaft 4 in the central portion. In FIG. 5A, the trocar shaft 4 is inserted into the opening 7, and the handle 4 b is engaged with the plug member 40. Then, after the trocar shaft 4 is pulled out, a medical instrument such as forceps (not shown, may be hereinafter referred to as a surgical tool) can be inserted from the opening 7.
A connector portion 11 to which a flexible cable 28 (signal / power cable / FPC cable) extending from the camera unit 5 is connected is formed on the outer peripheral surface of the plug member 40.

As shown in FIGS. 4A and 4C, a corrugated area 90 having a plurality of stepped portions 95 juxtaposed in the axial direction of the pipe portion is formed on the outer peripheral surface of the pipe portion outer cylinder 21. . Each stepped portion 95 has a rising surface facing the head portion 3 side, so when the trocar 1 is indwelled and held in the abdominal wall, the trocar 1 is carelessly pressed by the pressure of the gas pressed into the abdominal cavity It can prevent getting out. In addition, since each tapered portion 95 is formed with a tapered surface, it does not interfere with the insertion of the trocar 1 into the abdominal cavity. When the trocar 1 is pulled out, for example, it may be pulled out while rotating the trocar 1.
The corrugated region 90 is formed at least one place on one surface of the outer peripheral surface of the pipe portion outer cylinder 21, and is formed over the entire circumference of the pipe portion outer cylinder 21 if the thickness of the pipe portion outer cylinder 21 is secured. May be

Next, the airtight structure unit 44 will be described with reference to FIGS. 7 to 10.
As shown in FIGS. 7 and 8, the air-tight structure unit 44 has a duckbill valve 8 on the distal end side (distant position) of the head inner cylinder 32, and further, from the duckbill valve 8 toward the near side (operator side) And a seal unit 60 disposed in the same position.
The duckbill valve 8 has a flange 8a on the outer peripheral surface. On the other hand, on the inner peripheral surface of the head portion inner cylinder 32 to which the airtight structure unit 44 is attached, a step 50 to which the flange 8a abuts is formed (see FIG. 6). On the other hand, corresponding to this, convex part 52 is formed in step 50. Therefore, when mounting airtight structure unit 44 including duckbill valve 8, duckbill valve 8 is in a predetermined position. In addition, the number of the concave portions 51 and the convex portions 52 may be only one or plural.
The seal unit 60 includes, in order from the duckbill valve 8 toward the front side (the operator side), the seal presser cover 42, the tip side mount 91 for domed seal fixing, the domed seal 92, the air tight rubber cover 37 and the domed seal fixing A front side mount 93 is provided. The seal unit 60 is a seal structure for preventing the leakage of the pressurized gas in the abdominal cavity by bringing the surgical instrument into close contact with the surgical instrument when inserting and using the surgical instrument. It is configured.

The duckbill valve 8 is a duck bill valve type valve mechanism and divides the opening 7 from the inside of the pipe portion 2. As shown in FIG. 9, the duckbill valve 8 is closed to prevent leakage of pressurized gas in the abdominal cavity in a state before inserting a trocar shaft 4 or a surgical instrument such as a forceps. The shaft 4 and the surgical instrument are inserted into the pipe section 2 so as to push open the opening / closing port 81. The duckbill valve 8 is formed of an elastomeric material such as silicone rubber.
FIG. 10 shows the airtight structure unit 44 rotated 90 degrees from the state of FIG.

Referring back to FIGS. 7 and 8, the seal unit 60 will be described. The seal presser cover 42 is formed of a resin material such as polyacetal, and has a large diameter portion 42a fitted to the cylindrical portion 8b on the near side of the flange 8a of the duckbill valve 8 and a flange portion of the dome side seal fixing distal end mount 91 A flat portion 42c is provided with a small diameter portion 42b for positioning 91b.
The dome-shaped seal fixing distal end mount 91 is formed of a polycarbonate resin or the like, and includes a peripheral wall portion 91a and a flange portion 91b fitted with the dome-shaped seal 92. A plurality of flange portions 91b (six in the figure) ) Are integrally formed.

  The dome-shaped seal 92 is formed of an elastomer material such as silicone rubber, and includes a seal main body 92a having a tool insertion opening 41 for inserting the trocar shaft 4 and other surgical instruments, and a flange 92b. The flange portion 92b is provided with a positioning hole 45 through which a pin 91c provided on the dome-shaped seal fixing distal end mount 91 is inserted.

  The airtight rubber cover 37 is formed of an elastomeric material such as silicone rubber, and has a function of connecting the duckbill valve 8 and the dome-shaped seal 92 to improve the airtightness therebetween. The air-tight rubber cover 37 includes a cylindrical portion 37a, a first small diameter portion 37b provided on the tip end side, and a second small diameter portion 37c provided on the front side, and a dome-shaped seal is provided on the second small diameter portion 37c. A bellows 371 is formed to be able to follow 92 slides. Further, a positioning hole 46 through which the pin 91c is inserted is formed in the peripheral portion (flat portion) 37d of the opening 39 in the second small diameter portion 37c.

  The dome-shaped seal fixing front side mount 93 is formed of a resin material such as polyacetal, and includes a peripheral wall 93a and a flange 93b fitted with the dome-shaped seal 92. The flange 93b is for fixing the dome-shaped seal A positioning hole 47 is provided through which a pin 91c provided on the distal end side mount 91 is inserted.

The assembled state of the airtight structure unit 44 is shown in FIG. 9 and FIG. In assembling, the flat portion 42c of each of the four parts of the dome-shaped seal fixing distal end mount 91, the dome-shaped seal 92, the air-tight rubber cover 37 and the dome-shaped seal fixing front side mount 93, flange portions 91b and 92b. 37d and 93d, and insert the pin 91c provided on the tip side mount 91 in order into the holes 45, 46, 47 provided on the air-tight rubber cover 37 and the front side mount 93 for dome-shaped seal fixing. Finally, after the tip of the pin 91c is integrated by heat caulking, the distal end side 42d of the seal pressing cover 42 is formed by the first small diameter portion 37b provided on the tip side of the airtight rubber cover 37. By holding, the seal unit 60 is assembled.
By thus overlapping the flange portions 91b, 92b, 37d and 93d and integrating the dome-shaped seal 92, in conjunction with the movement of the surgical instrument inserted into the instrument insertion port 41 of the dome-shaped seal 92, The dome-shaped seal 92 acts on the bellows portion 371 provided on the air-tightness rubber cover 37, and the dome-shaped seal can be moved while maintaining the tightness of the instrument insertion opening 41.

Then, the first small diameter portion 37b provided on the tip end side of the air-tightness rubber cover 37 constituting the seal unit 60 is brought into close contact with the front side surface of the flange portion 8a of the duckbill valve 8 to obtain the airtight structure unit 44. In this state, as shown in FIG. 6, the airtight structure unit 44 is inserted into the pipe inner cylinder 32, and the flange portion 8a of the duckbill valve 8 is engaged with the step 32a formed on the inner surface of the pipe inner cylinder 32. Further, the plug member 40 is fitted to the pipe inner cylinder 32 from the front side.
Thus, the four components are integrally pressed against the flange portion 8a of the duckbill valve 8, whereby the duckbill valve 8 and the dome-shaped seal 92 are connected in an airtight state.
In this embodiment, although the airtight structure unit 44 adopts a structure in which the seal unit 60 and the duckbill valve 8 are in close contact with each other, it is of course possible to integrate up to the duckbill valve 8 using the airtight rubber cover 37 of the seal unit 60. It is possible. That is, the airtight rubber cover 37 and the duckbill valve 8 may be joined or integrally formed.

<Camera section>
The camera unit 6 can be stored in the pipe unit 2 as described later, and is deployed outward from the outer peripheral surface of the pipe unit 2 in the abdominal cavity. 2 and 3 show the unfolded state and the retracted state of the camera unit 5 in the trocar 1, respectively. FIGS. 4A and 4B show a state in which the trocar shaft 4 is removed from the trocar 1 and the camera unit 5 is expanded.

  11 (a) and 11 (b) are enlarged views of the tip of FIGS. 4 (a) and 4 (b), and the camera unit 5 is in a state of being developed outside the pipe unit 2. FIG. Both ends of the camera unit 5 are rotatably supported so as to be accommodated in the end notch 23 of the pipe unit inner cylinder 22. Thus, the camera unit 5 can freely pivot between the unfolded state in which the camera unit 5 pivots outside the pipe unit 2 so as to be capable of photographing and the storage state accommodated in the pipe unit 2. As described above, since the camera unit 5 in the unfolded state is located at the front end of the pipe inner cylinder 22, the pipe unit 2 does not block the field of view, so that it is suitable for photographing the surgical field.

That is, the camera unit 5 includes a substantially U-shaped housing 13 and a camera mount 17 attached to a front surface (in the embodiment, a U-shaped inner bottom surface) of the housing 13. The lenses 14a, 14b and 14c, the light transmission plate 15 for protecting the image sensor, and the image sensor 16 (such as CMOS) are attached in order along the transmission direction of the image sensor. The lenses 14 a, 14 b and 14 c are arranged in layers in the lens barrel 25. The flexible cable 28 is connected to the imaging sensor 16. The flexible cable 28 passes between the pipe portion outer cylinder 21 and the pipe portion inner cylinder 22, and the gap between the head portion outer cylinder 31 and the head portion inner cylinder 32 connected to the pipe portion outer cylinder 21 and the pipe portion inner cylinder 22 respectively It is pulled out to the outside of the head portion 3 from the front single edge of the head portion outer cylinder 31 and pulled into the connector portion 11 from an opening (not shown) formed in the surface of the connector portion 11 on the head portion 3 side. , And is connected to a circuit board 100 (see FIG. 5) described later. In addition, a translucent protective cover 18 is attached to the front of the lens 14a.
The lenses 14a, 14b, 14c and the protective translucent plate 15 can be made of optical glass or optical resin, but it is desirable to be made of a resin material that can be manufactured inexpensively or that is easy to form an aspheric surface.

  On the back side of the flexible cable 28 connected to the imaging sensor 16, a metal plate 19 (back plate) for reinforcing the imaging sensor is disposed. Since the imaging sensor reinforcing metal plate 19 is directly mounted on the flexible cable 28, the planarity of the imaging sensor 16 is maintained to protect the sensor. As the imaging sensor reinforcing metal plate 19, it is preferable to use an aluminum plate which also has a heat radiation effect of the imaging sensor 16. The space between the image sensor reinforcing metal plate 19 and the housing 13 is sealed with a filler 19 ′ such as a silicone material, for example.

  The housing 13 has a curved back surface 13a which is flush with the pipe inner cylinder 22 when the camera 5 is stored, and side surfaces 13b are formed on both sides of the back surface 13a. Since the back surface portion 13a is curved as described above, the pipe portion outer cylinder 21 can be smoothly slid when the camera portion 5 is stored and deployed. Further, in the unfolded state of the camera unit 5, the lenses 14 a, 14 b and 14 c face the front of the pipe unit 2.

As shown in FIG. 12 and FIG. 13, projections 13 c extending downward in the pipe portion inner cylinder 22 are respectively formed at the lower end portions of both side surface portions 13 b and 13 b of the housing 13. The shaft portion 20 is formed so as to protrude outward in a direction perpendicular to the axial direction of the pipe portion 2.
And, as shown in FIGS. 11 (a), (b) and FIG. 13, the shaft portion 20 is inclined obliquely toward the front side from the both sides of the front end notch portion 23 of the pipe portion inner cylinder 22. The groove 24 is inserted and engaged with the inclined groove 24. The center of the shaft portion 20 serves as a shaft fulcrum S for rotating the camera unit 5. Thereby, although it is compact, the moment at the time of raising and lowering the camera part 5 can be ensured using the pulling force of the coil spring 12 (elastic member) mentioned later. Moreover, since the inclined groove 24 which inclined as mentioned above is employ | adopted, mounting | wearing of the camera part 5 is easy.

  As shown in FIG. 14, L-shaped portions 45 are respectively protruded downward on both sides of the bottom portion 13 d of the housing 13, and a ring-shaped portion 12 a at one end of the coil spring 12 is engaged with the L-shaped portion 45. It is stopped. As shown in FIG. 13, the two coil springs 12 are accommodated in a recessed groove 46 extending along the axial direction of the pipe portion 2 on the near side (the operator side) from the tip end notch 23 of the pipe portion inner cylinder 22. The ring-shaped portion 12 b at the other front end of the coil spring 12 is fixed in the recessed groove 46.

One end (ring-shaped portion 12 a) of the coil spring 12 is locked on the near side of the shaft portion 20 and at the radially outward position of the pipe portion 2 from the shaft portion 20. Thereby, the camera unit 5 is biased to the front side. As a result, the camera unit 5 pivots rearward with the pivot point S as the pivot center, and is in the unfolded state.
Therefore, when the trocar 1 is pulled out of the body in a state in which the camera unit 5 is deployed in the body, the camera unit 5 is rotated by an external force applied in the axial direction of the pipe portion 2 from the rear end side toward the tip end It is safe because it is stored in the pipe inner cylinder 22.
In particular, the L-shaped portion 45 and the ring-shaped portion 12a at one end of the coil spring 12 are configured to be disengaged when a large force not assumed is applied to the camera portion 5 from the rear end side toward the front end side. Since the shaft portion 20 is engaged with the inclined groove 24 of the pipe portion inner cylinder 22, the shaft portion 20 can slide off the inclined groove 24 to release the camera unit 5. As a result, in an emergency or the like, the camera unit 5 can be detached from the trocar 1 without damage, and safety can be enhanced and the risk of breakage of the camera unit 5 can be reduced.
At this time, since the coil spring 12 is fixed at the other end, it does not fall into the abdominal cavity.

  In the present embodiment, in order to make the camera unit 5 as small as possible, the imaging sensor 16 is directly mounted on the flexible cable 28. The mounting unit does not have a controller function for controlling the imaging sensor 16, and a controller function such as clock control is disposed on the circuit board 100 (control means, see FIG. 5) provided in the head unit 3. ing. Therefore, the end portion of the flexible cable 28 directly mounted on the imaging sensor 16 is connected to the circuit board 100 at the connector portion 11 of the head portion 3, and the external cable 102 (USB cable) soldered from the circuit board 100 Thus, the image signal is transmitted to the outside.

When the light-transmissive protective cover 18 is formed of a transparent optical resin, as shown in FIGS. 15A and 15B, the inner surface adjacent to the lens 14a has a concave surface 181 and has optical performance. It is possible to Therefore, since the translucent protective cover 18 itself exerts the function of a lens, the number of lenses to be used can be reduced, and the distance between the translucent protective cover 18 and the lenses 14a, 14b and 14c can also be reduced. This makes it possible to make the camera unit 5 thinner and smaller. Moreover, it becomes possible to integrally mold the structure of the peripheral wall etc. mentioned later.
In addition, the translucent protective cover 18 has a peripheral wall 182, and a hole 26 is formed in the peripheral wall 182. On the other hand, the camera mount 17 has a claw 27 on the tip end side, and is integrated by the claw 27 being engaged with the hole 26 when the translucent protective cover 18 is attached. At this time, in order to ensure waterproofness, a sealing material 29 such as rubber is fitted between the camera mount 17 and the translucent protective cover 18.

<Lock mechanism (1)>
Next, a lock mechanism for holding the camera unit 5 in the expanded or stored state and preventing the camera unit 5 from operating inadvertently will be described. 16 (a) and 16 (b) show cross-sectional views obtained by rotating the respective cross-sectional views of FIG. 3 (b) showing the storage state and FIG. 2 (b) showing the expanded state by 90 °.
As shown in FIGS. 16A and 16B, on the outer peripheral surface of the head portion inner cylinder 32 to which the pipe portion inner cylinder 22 is connected, two concave portions 30a and 30b are provided in parallel in the axial direction. On the other hand, a lock lever 34 having a claw-like convex portion 33 is attached to the head portion outer cylinder 31 to which the pipe portion outer cylinder 21 is connected.
The concave portions 30a and 30b and the lock lever 34 are provided in a pair at symmetrical positions of 180 degrees.
In the stored state of the camera unit 5 (FIG. 16A), the convex portion 33 provided at the tip of the lock lever 34 is locked to the concave portion 30a on the tip side to lock the pipe portion outer cylinder 21 . On the other hand, in the unfolded state of the camera unit 5 (FIG. 16 (b)), the pipe portion outer cylinder 21 is locked by being locked to the recess 30b on the front side. These operations can be performed by a lock lever 34 extending from the head portion outer cylinder 31 to the outside. That is, by pushing one end of the lock lever 34 exposed to the outside with a finger, the convex portion 33 provided at the other end of the lock lever 34 is pivoted upward to be separated from the concave portion 30a or 30b. The outer sleeve 21 is slid.

Further, the pipe portion outer cylinder 21 is formed to have a length shorter than that of the pipe portion inner cylinder 22. This is because the pipe portion outer cylinder 21 is located rearward of the camera portion 5 in a state where the camera portion 5 is expanded out of the pipe portion 2 from the tip end notch 23 of the pipe portion inner cylinder 22 (the state of FIG. 16B). In order to be located in
Further, as shown in FIGS. 17A and 17B, a tube-shaped sealing material 49 is interposed between the pipe portion outer cylinder 21 and the pipe portion inner cylinder 22. The tube-shaped sealing material 49 is formed of silicone rubber or the like, and is encased on the pipe portion inner cylinder 22 so as to sandwich the flexible cable 28 described above, and even in the presence of the flexible cable 28, the pipe portion outer cylinder 21 is Can be slid while maintaining the air tightness. In order to reduce the coefficient of friction of the tubular sealing material 49, the lubricating action may be ensured by fats and oils usable as medical applications such as silicone oil.

<Lock mechanism (2)>
Further, in the present embodiment, in the stored state of the camera unit 5, the camera unit 5 is locked by the trocar shaft 4 so that the camera unit 5 is not deployed carelessly. That is, as shown in FIG. 17A, in the state where the camera unit 5 is stored in the notch 6 formed in the trocar shaft 4, the tip end face of the camera unit 5 is the tip of the notch 6. It is prevented from rotating in contact with the wall 6a. Therefore, in cooperation with the lock mechanism by the lock lever 34 described above, the locked state can be reliably maintained.
On the other hand, in order to release the lock by the trocar shaft 4, as shown in FIG. 17 (b), if a gap is formed between the end wall 6a of the trocar shaft 4 and the end face of the camera unit 5. The camera unit 5 can be easily deployed.

In order to lock and release by the trocar shaft 4, as shown in FIG. 18, a camera storage position click groove 47a and a camera on the end face outer peripheral portion of the plug member 40 located on the front side (operator side) of the trocar 1 The partial development position click grooves 47b are arranged in parallel in a predetermined sense. When the trocar shaft 4 is inserted into the opening 7 of the plug member 40 and the handle 4b is attached to the end face of the plug member 40, the protrusion provided on the handle 4b (shown in FIG. ) Is engaged with the camera unit storage position click groove 47a. On the other hand, at the time of deployment, the trocar shaft 4 is rotated by holding the handle portion 4b, and the projection is engaged with the camera portion deployment position click groove 47b. Thus, a gap D is formed between the end wall 6a of the trocar shaft 4 and the end surface of the camera unit 5 (see FIG. 19B), so that the camera unit 5 can be deployed.
That is, since the camera portion development position click groove 47b is deeper than the camera portion storage position click groove 47a, the trocar shaft 4 is moved to the tip side, and a gap D is formed between the camera portion 5 and the tip surface. Can be formed.

  Next, the usage method of the trocar 1 which concerns on this embodiment is demonstrated based on FIG.19 (a)-(d). First, in the initial state (stored state of the camera unit 5) shown in FIG. 19A, the trocar shaft 4 is rotated from the camera unit storage position click groove 47a to the camera unit development position click groove 47b. A gap D is formed between the end wall 6a and the end surface of the camera unit 5 (FIG. 19 (b)).

Next, as shown in FIG. 19C, the lock lever 34 of the pipe portion outer cylinder 21 is pushed to slide the pipe portion outer cylinder 21 to the front side. As a result, the camera unit 5 is developed by the biasing force of the coil spring 12 (see FIG. 11), and the trocar shaft 4 can be pulled out.
In this state, as shown in FIG. 19 (d), the trocar shaft 4 is pulled out to be used as a trocar port.

  In actual use, the abdominal cavity is punctured through the body wall with the puncture part 4a formed at the tip of the trocar shaft 4 in the initial state (storage state of the camera part 5) shown in FIG. 19 (a). Next, the camera unit 5 is deployed in the body wall 35 as described above, the trocar shaft 4 is removed from the trocar 1, and as shown in FIG. 20, surgery is performed while imaging the affected area 36 in the abdominal cavity.

  Therefore, the operator can perform surgery by inserting forceps or the like (not shown) from the opening 7 of the trocar 1 while looking at an image displayed on a monitor (not shown), so the field of view is enlarged. Operation is facilitated and the safety of the operation is also improved. In particular, since the camera unit 5 is provided at the tip of the pipe unit 2, there is an advantage that the field of view is not disturbed by the pipe unit 2 or the like.

Other Embodiments
Although the case where the camera unit 5 and the connector unit 11 are disposed on the same side with respect to the pipe unit 2 has been described in the above embodiment, even if the camera unit 5 and the connector unit 11 are disposed at different positions. Good. For example, as shown in FIG. 21, it is also possible to arrange the camera unit 5 and the connector unit 11 at symmetrical positions with respect to the axial center of the pipe unit 2 or in the vicinity thereof.
In this case, the external cable 102 during operation can be disposed below the position of the operator's hand, and when the operator's hand touches the external cable 102, the camera unit 5 moves and the pipe unit 2 rotates. It can effectively prevent the projected surgical field from rotating.
The positions of the camera unit 5 and the connector unit 11 are arranged at positions different from the mounting position of the camera unit in the circumferential direction of the head unit so that the operator's hand does not touch the external cable 102. For example, the connector unit 11 may be disposed at an angle of 90 ° or more with respect to the axial center of the pipe unit 2 from the camera unit 5 on the left and right, respectively.
Others are the same as the above embodiment.

  As mentioned above, although the trocar 1 which concerns on embodiment of this invention was demonstrated, this invention is not limited to the said embodiment, A various improvement and improvement are possible. For example, a lighting device may be provided in the camera unit 5 to make the operative field bright. The trocar of the present invention can also be suitably used for endoscopic surgery in the thoracic cavity.

DESCRIPTION OF SYMBOLS 1 trocar 2 pipe part 3 head part 4 trocar shaft 4a puncture part 4b handle part 5 camera part 6 notch part 7 opening part 8 duckbill valve 10 air pipe 11 connector part 12 coil spring (elastic member)
13 Housing 14a, 14b, 14c Lens 15 Image sensor protection cover 16 Image sensor 17 Camera mount 18 Translucent protection cover 19 Image sensor reinforcing metal plate 20 Shaft portion 21 Pipe portion outer cylinder 22 Pipe portion inner cylinder 23 Tip notch 24 Inclined groove 25 Lens barrel 26 Hole 27 Claw 28 Flexible cable 29 Sealing material 30a, 30b Recess 31 Head part outer cylinder 32 Head part inner cylinder 33 Convex part 34 Lock lever 35 Body wall 37 Airtight rubber cover 40 Plug member 42 Seal presser cover 44 Airtight Structure Unit 50 Step 51 Concave 52 Convex 60 Seal Unit 90 Corrugated Region 91 Tip Mount 92 for Domed Seal Fixing Dome Type Seal 93 Domed Seal 93 for Domed Seal Fixation 95 Step 98 98 Chamfer 99 99 Anchor Part 100 Circuit board (control means)
102 cable 200 thick area 371 serpentine

Claims (7)

A trocar comprising a pipe portion for inserting a medical instrument into the body and a head portion,
The pipe portion includes a pipe portion outer cylinder and a pipe portion inner cylinder, and the pipe portion outer cylinder is formed of a metal tube,
The head portion includes a head portion outer cylinder and a head portion inner cylinder, the head portion outer cylinder is made of resin, and the resin is a rear end portion of the metal tube at a rear end portion of the pipe portion outer cylinder. To form a thick region integrally joined with the metal tube,
A trocar characterized in that the head inner cylinder is integrally molded or integrally joined with the pipe inner cylinder. The distal end of the pipe inner tube has a camera portion pivotally supported between a deployed state in which it is pivoted out of the pipe portion and a stored state in which it is stored in the pipe portion,
The pipe section outer cylinder is externally slidably slidably in the axial direction on the pipe section inner cylinder, and the camera section is stored in the pipe section while sliding toward the tip of the pipe section. Described trocar.   The trocar according to claim 1, wherein a chamfered portion is formed at an end of the thick region.   The trocar according to any one of claims 1 to 3, wherein a surface of the pipe portion outer cylinder in contact with the thick region is roughened.   The trocar according to any one of claims 1 to 4, wherein an anchor portion is formed at an end of the metal tube in the thick region.   The trocar according to any one of claims 1 to 5, wherein a corrugated region is formed on the outer peripheral surface of the pipe portion outer cylinder.   The trocar according to any one of claims 1 to 6, wherein the medical device is inserted into the body through the pipe inner cylinder.