WO2012124595A1 - Applicator and application method - Google Patents

Abstract

An applicator (10) is provided with a syringe (applicator main body) (12), and a nozzle (14) having a nozzle head (78) that is provided at the tip of the nozzle. The nozzle (14) has a flexible nozzle tube (76), which has one end thereof connected to the syringe (12) side, and the other end thereof connected to the nozzle head (78). The direction of the nozzle head (78) is fixed by holding the nozzle head (78) by means of a forceps having a joint.

Description

Application tool and application method

The present invention relates to an applicator and an application method for applying a medicine to a target site by discharging a drug from a nozzle tip.

In recent years, an increasing number of robotic surgeries have been operated by operating a robot (medical support robot) equipped with forceps and a laparoscope (camera) at the tip of an arm by a remote operation by a doctor. At the time of robotic surgery, surgical instruments such as a laparoscope and forceps are introduced into the abdominal cavity through a trocar (trocar, tubular member) attached to an incision hole formed in the abdominal wall. Such a forceps has a high degree of freedom similar to that of a human wrist, and thus can approach a narrow space.

On the other hand, an adhesion preventing material is used to prevent adhesion between the incision and the surrounding tissue after laparotomy. As a method of applying an adhesion preventing material to a target site, there is a method in which an application tool having a nozzle at the tip is used, a nozzle is inserted into the abdominal cavity, and a liquid adhesion preventing material is ejected from the tip (for example, JP (See 2008-289617).

However, since the nozzle of the conventional applicator has a low degree of freedom of movement, the direction of the nozzle is limited, and it is difficult to accurately inject and apply the drug to the target site.

The present invention has been made in view of such problems, and an object thereof is to provide an applicator and an application method capable of reliably applying a drug to a target site.

In order to achieve the above object, the present invention provides an applicator that discharges a medicine and applies it to a target site, the applicator main body, and a nozzle that extends from the applicator main body and is provided with a nozzle head at the tip. The nozzle includes a flexible nozzle tube having one end connected to the applicator main body side and the other end connected to the nozzle head, and the nozzle head by a gripping tool having a joint. And the direction of the nozzle head is determined.

According to the present invention configured as described above, since the nozzle head is provided at the tip of the flexible nozzle tube, the nozzle head inserted into the abdominal cavity is provided with a degree of freedom similar to that of a human wrist. By grasping with a grasping tool (for example, forceps with a multi-degree-of-freedom joint), the nozzle can be oriented in an arbitrary direction and the medicine can be reliably applied to the target site.

In the above applicator, a plurality of protrusions may be provided on the outer peripheral surface of the body portion of the nozzle head.

According to the above configuration, when the body portion of the nozzle head is gripped, the plurality of protrusions provided on the outer peripheral portion of the nozzle head act as slip stoppers, so that the nozzle head is securely gripped by the gripping tool, Can be reliably applied to the target site. In addition, since the axis of the nozzle head and the gripping tool can be substantially aligned when gripped by the gripping tool, the trocar, which is an insertion port for inserting the gripping tool into the body while the nozzle head is gripped by the gripping tool Through, the nozzle can be smoothly inserted into the body.

In the applicator, a plate-like gripped portion extending in the longitudinal direction of the nozzle head may be provided on a side surface of the body portion of the nozzle head.

According to the above configuration, since the gripped portion is plate-shaped and provided on the side surface of the body portion of the nozzle head, the nozzle head can be gripped by various types of gripping tools. That is, without preparing a specific form of gripping tool, the plate-shaped gripped portion can be easily gripped from both sides and the nozzle head can be reliably oriented in any direction.

In the above applicator, a plurality of flow paths may be arranged in parallel in the nozzle tube.

According to the above configuration, the nozzle tube having a plurality of flow paths can have sufficient flexibility, and the nozzle head can be easily oriented in a desired direction by the gripping tool.

Further, the present invention is an application method for applying a drug to a target site by discharging a drug, wherein the applicator main body is disposed outside a closed space where the target site exists, and a nozzle tube is disposed on the applicator main body. A nozzle head connected to the nozzle head in the closed space, a step of gripping the nozzle head with a gripper whose tip direction can be freely changed, and the nozzle held in the closed space And a step of adjusting the orientation of the head so as to direct the target portion.

According to the above application method, the nozzle head inserted into the closed space is gripped with a gripping tool having the same degree of freedom as a human wrist, so that the nozzle head can be oriented in an arbitrary direction, It can be reliably applied to the site.

According to the applicator and the application method according to the present invention, the nozzle head provided at the tip of the flexible nozzle tube is gripped by the gripper and the direction of the nozzle head is determined by the gripper. The drug can be reliably applied.

It is a partially-omission perspective view of the applicator according to one embodiment of the present invention. It is a perspective view which shows the structure of the nozzle head of the applicator shown in FIG. It is a longitudinal cross-sectional view of the nozzle head of the applicator shown in FIG. 4A is a cross-sectional view of the nozzle tube along the line IVA-IVA in FIG. 3, FIG. 4B is a cross-sectional view of the nozzle tube according to the first modification, and FIG. 4C is a second modification. It is a cross-sectional view of the nozzle tube concerning. FIG. 5A is a perspective view showing a state in which the nozzle head is gripped with forceps, and FIG. 5B is a schematic illustration showing a state in which the anti-adhesive material is sprayed by directing the nozzle head toward the target site with the forceps in the abdominal cavity. FIG. It is a perspective view of the nozzle head which concerns on a modification. FIG. 7A is a schematic explanatory view showing a state where the nozzle head according to the modified example is directed to the target site by forceps in the abdominal cavity and the adhesion preventing material is sprayed, and FIG. 7B is a nozzle according to the modified example with the forceps. It is a perspective view which shows the state which hold | gripped the head.

Hereinafter, preferred embodiments of the applicator and the application method according to the present invention will be described with reference to the accompanying drawings.

First, the configuration of the applicator will be described with reference to FIGS. 1 to 4C. 1 is a partially omitted perspective view of an applicator 10 according to an embodiment, FIG. 2 is a perspective view showing a configuration of a nozzle head 78 that is a component of the applicator 10, and FIG. 4A is a longitudinal sectional view of the head 78, FIG. 4A is a transverse sectional view of a nozzle tube 76 that is a component of the applicator 10, and FIGS. 4B and 4C are transverse sectional views of nozzle tubes 76a and 76b according to modifications. FIG.

The applicator 10 applies two kinds of liquids having different liquid compositions (hereinafter, for convenience of explanation, the two kinds of liquids are referred to as “first liquid L1” and “second liquid L2”), respectively. A syringe (applicator main body) 12 in which a first syringe (supply means) 12a and a second syringe (supply means) 12b are integrally connected in parallel is connected to each tip of the syringe 12. By this, it is a spray type device provided with the nozzle 14 which injects the 1st liquid L1 and the 2nd liquid L2 with which it fills in the syringe 12 to application object.

In the applicator 10, for example, during a laparoscopic operation, the nozzle 14 is inserted into the abdominal cavity, and the first and second liquids L1 and L2 having different liquid compositions supplied from the syringe 12 are mixed in the nozzle 14. On the other hand, it is used as a medical instrument for applying a drug solution, which is a mixture thereof, to an organ, an abdominal wall or the like.

The syringe 12 includes a first syringe 12a and a second syringe 12b that respectively correspond to the first and second liquids L1 and L2 that are mixed and ejected by the nozzle 14, and the first liquid L1 is supplied to the first syringe 12a. The second syringe 12b is filled and filled with the second liquid L2. In the case of the present embodiment, the first syringe 12a and the second syringe 12b have substantially the same configuration except that their outer diameters and excluded volumes are different. The second syringe 12b will be described with reference to the reference numerals (numbers) of the corresponding components of the first syringe 12a, and detailed description thereof will be omitted. Of course, you may comprise the 1st syringe 12a and the 2nd syringe 12b with the same diameter.

The first syringe 12a includes an outer cylinder (cylinder) 20a having a reduced-diameter flow port (discharge port) 18a provided at the tip, a gasket 22a that can be slid in a liquid-tight manner within the outer cylinder 20a, and a gasket 22a. And a pusher (plunger rod) 24a that moves in the axial direction of 20a. The circulation port 18a is an opening for allowing the liquid to flow inside and outside the outer cylinder 20a, and is a tapered tapered protrusion protruding from the front end surface of the outer cylinder 20a.

A thin plate oval flange 26 is formed on the outer periphery of the base end edge of the outer cylinder 20a so as to put an index finger, a middle finger or the like when the operator operates the pusher 24a. The flange 26 is formed by the second syringe 12b. Is formed integrally with the outer periphery of the base end edge of the outer cylinder 20b. A guide member 28 that guides the forward and backward movement of the pushers 24a and 24b is fitted into the proximal end side opening of each of the outer cylinders 20a and 20b. You may provide the scale (not shown) which shows a liquid quantity in the outer peripheral surface of the outer cylinder 20a (20b).

The material of the outer cylinder 20a (20b) is not particularly limited. For example, polyvinyl chloride, polyethylene, polypropylene, cyclic polyolefin, polystyrene, poly- (4-methylpentene-1), polycarbonate, acrylic resin, acrylonitrile-butadiene Resin such as styrene copolymer, polyester such as polyethylene terephthalate, polyethylene naphthalate, butadiene-styrene copolymer, polyamide (for example, nylon 6, nylon 6,6, nylon 6,10, nylon 12) may be used. However, considering ease of molding and low water vapor permeability, polypropylene, cyclic polyolefin, polyester, and the like are preferable. In addition, it is preferable that the outer cylinder 20a is transparent or semi-transparent in order to ensure internal visibility.

The pusher 24a is a long rod whose cross section orthogonal to the axial direction is formed in a cross shape, and a cross-shaped guide hole (not shown) penetrating the first syringe 12a side of the guide member 28 in the axial direction. Is inserted. Similarly, the pusher 24b is inserted through a cross-shaped guide hole (not shown) that penetrates the second syringe 12b side of the guide member 28 in the axial direction.

The bases of the pushers 24a and 24b are integrally connected by a bridge 24c, and are configured in a substantially U shape as a whole. That is, the advance / retreat operation of the pushers 24a, 24b is integrated by a common operation portion (operation disk) 24d provided in the bridge 24c. The material of the pusher 24a (24b) may be the same as that of the outer cylinder 20a described above. However, in order to improve the visibility in the transparent outer cylinder 20a, it is preferable that the material is non-transparent.

The gasket 22a is formed of, for example, an elastic material, and is a piston that can be liquid-tightly slidable in close contact with the inner peripheral surface of the outer cylinder 20a by being connected to the tip of the pusher 24a. The gasket 22a can suck and fill the liquid from the flow port 18a into the chamber formed on the tip side, and can push the filled liquid from the flow port 18a.

The material of the gasket 22a (22b) is not particularly limited. For example, various rubber materials such as natural rubber, butyl rubber, isoprene rubber, butadiene rubber, styrene-butadiene rubber, silicone rubber, polyurethane, polyester, polyamide It is preferable to use elastic materials such as various thermoplastic elastomers such as olefins and styrenes, or mixtures thereof.

The 2nd syringe 12b is the structure substantially the same as the above-mentioned 1st syringe 12a, is equipped with the distribution port 18b, the outer cylinder 20b, the gasket 22b, and the pusher 24b, and the flange 26 and the guide member 28 are made into 1st. It is shared with the syringe 12a.

The first syringe 12 a and the second syringe 12 b are connected at the base end side by a flange 26, and a portion from the center to the tip end is connected by a flat plate-like connecting portion 30. The connecting portion 30 is provided with a hook member 34 constituting an engagement mechanism (lock mechanism) 32 that locks and unlocks the nozzle 14 when the nozzle 14 is attached to and detached from the syringe 12. The engagement mechanism 32 includes a hook member 34 and a claw member 36 on the nozzle 14 side with which the hook member 34 is engaged.

The hook member 34 includes a main body portion 38 and a thin plate-like elastic piece (elastic body) 40 extending obliquely downward from the base end of the main body portion 38. In the main body 38, pins 42 and 42 projecting from both side surfaces in the width direction are pivotally supported with respect to the pair of support members 44 and 44, thereby being swingable. The elastic piece 40 is a leaf spring-like member that is curved toward the inner surface side, and whose end is landed on the connecting portion 30 and is slidable on the connecting portion 30, and the main body with the pin 42 as a rotation axis. The tip of the part is biased in the direction of swinging downward.

In such a syringe 12, the 1st liquid L1 with which the 1st syringe 12a is filled, and the 2nd liquid L2 with which the 2nd syringe 12b is filled depend on the use of the said applicator 10, an intended purpose, etc. For example, when used for administration of a biological tissue adhesive, one of the liquid and the liquid is a liquid containing thrombin (solution, etc.) and the other is a liquid containing fibrinogen (solution, etc.) ). Further, for example, when the applicator 10 is used for administration of an adhesion preventing material, one of the liquid and the liquid is a liquid (solution or the like) containing carboxymethyldextrin modified with a succinimidyl group, and the other is hydrogen phosphate. The liquid (solution etc.) containing disodium can be mentioned.

¡The liquid and liquid in such a combination are altered, that is, gelled (solidified) when they are mixed. By gelling, for example, a liquid medicine (a mixture, a mixed solution) in which a liquid and a liquid are mixed can be reliably retained in an applied biological tissue (target site). The function as an adhesion preventing material can be surely exhibited. Of course, the liquid and the kind and combination of the liquid are not limited to those exemplified above.

The cylinder 86 shown as one configuration example of the gas supply source is filled with a high-pressure (compressed) sterile gas G (hereinafter simply referred to as “gas G”) in its internal space, and the gas G is applied to the cylinder 86. It can be supplied (sent) to the tool 10 (nozzle 14). For example, carbon dioxide may be used as the gas G. The cylinder 86 is provided with an openable / closable valve (cock) 87 for controlling supply / stop of supply of the gas G to the applicator 10. When the applicator 10 is used, the valve 87 is opened.

The nozzle 14 constitutes the base end portion of the nozzle 14 and is connected to the tip end of the syringe 12, the nozzle tube 76 extending from the tip end of the nozzle base portion 74, and the tip end of the nozzle tube 76. And a nozzle head 78 provided.

The nozzle base 74 is a member made of, for example, a metal material or a resin material, and has a substantially triangular shape that is tapered in a plan view. An opening 74a through which the nozzle tube 76 is inserted is formed at the tip, and the base end thereof is formed. This is a box-shaped member in which a rectangular opening (not shown) is formed so that the flow path member 64 can be projected and retracted.

Inside the nozzle base 74, a flow path member 64 capable of moving back and forth is provided. Connection ports 62 a and 62 b into which the respective flow ports 18 a and 18 b of the syringe 12 are fitted are formed on the base end surface of the flow path member 64. An outlet port 67 into which the base end portion of the nozzle base portion 74 is inserted and connected protrudes from the front end surface of the flow path member 64, and a gas into which the tube 86a from the cylinder 86 is inserted and connected to the lower surface. A port (not shown) is provided.

The nozzle tube 76 is composed of a soft material, an elastic material, etc., and is easily deformed by applying an external force. As shown in FIG. 1, the nozzle tube 76 extends from an opening 74a provided at the tip of the nozzle base 74, A nozzle head 78 is connected to the tip. The length of the nozzle tube 76 is set to about 300 to 400 mm, for example.

As shown in FIG. 4A, which is a cross-sectional view taken along the line IVA-IVA in FIG. 3, the first liquid flow path 91 for flowing the first liquid L1 supplied from the first syringe 12a through the nozzle tube 76. And a second liquid channel 92 for flowing the second liquid L2 supplied from the second syringe 12b, and a gas channel 93 for flowing the gas G supplied from the cylinder 86 are provided.

The first liquid channel 91, the second liquid channel 92, and the gas channel 93 are formed to penetrate in parallel along the extending direction of the nozzle tube 76, and are arranged in parallel as shown in FIG. 4A. ing. In other words, the first liquid channel 91, the second liquid channel 92, and the gas channel 93 are arranged so as to be aligned in the same straight line in the cross section of the nozzle tube 76.

The nozzle tube 76 having such a flow path can be manufactured by, for example, integrating three independent flexible tubes by heat welding or the like. In the case where the first liquid channel 91, the second liquid channel 92, and the gas channel 93 are arranged in parallel like the nozzle tube 76, the nozzle tube 76 can have sufficient flexibility. .

The present invention is not limited to the configuration of the nozzle tube 76 shown in FIG. 4A, and the first liquid channel 91, the second liquid channel 92, and the gas channel 93 are not limited to the nozzle tube 76a shown in FIG. 4B. You may arrange | position in three dimensions rather than parallel, ie, the position corresponded to each vertex of a triangle. Further, as in the nozzle tube 76b shown in FIG. 4C, the inner tubes 95, 96, and 97 that are independent from each other may be collectively inserted into the outer tube 98.

As shown in FIG. 2, the nozzle head 78 has a cylindrical outer shape, and has an injection port 72 that opens at the tip wall portion 79. The tip of the junction pipe 58 is connected to the injection port 72. The ejection port 72 is an opening for discharging the mixture of the first liquid L1, the second liquid L2, and the gas G mixed in the junction pipe 58. The constituent material of the nozzle head 78 is not particularly limited. For example, the same constituent material as that of the nozzle base 74 can be used.

The nozzle head 78 has a body part 100 and a head part 102 that is provided with an enlarged diameter at the tip of the body part 100. The ejection port 72 is formed on the tip wall surface of the head unit 102. A plurality of protrusions 104 are provided on the outer peripheral surface of the body portion 100 at intervals in the longitudinal direction of the nozzle 14. In the illustrated configuration example, each protrusion 104 extends in the circumferential direction along the outer periphery of the nozzle 14 in a range of less than one round. Further, in the illustrated configuration example, the protrusions 104 are arranged at locations opposite to each other with respect to the center line (axis line) of the nozzle 14. These protrusions 104 act as a slip stopper when the body portion 100 of the nozzle 14 is gripped by a gripping tool (for example, forceps). In addition, although the illustrated protrusion 104 has a rib shape, the shape is not limited to this, and for example, a knurling provided on the outer periphery of the body portion 100 may be used.

As shown in FIG. 3, the first and second liquid flow paths 91, 92 extend in the tip direction in the nozzle tube 76, and then merge with each other in a merging pipe 58 disposed in the nozzle head 78. The The liquid flow paths of the nozzles 14 are integrally joined together at the base end of the merge pipe 58 so that the first liquid L1 and the second liquid L2 can be mixed uniformly and reliably. It has become.

The gas flow path 93 is not connected to the merging pipe 58, and instead communicates with the space inside the nozzle head 78 and outside the merging pipe 58. As a result, the gas G from the gas cylinder is introduced into the space between the nozzle head 78 and the junction pipe 58 through the gas flow path 93. In addition, the base end of the nozzle head 78 is prevented so that the gas G introduced into the space between the nozzle head 78 and the junction pipe 58 does not leak from between the nozzle head 78 and the nozzle tube 76 to the outside of the nozzle head 78. Is in close contact with the outer surface of the nozzle tube 76. A sealing material may be provided between the inner surface of the proximal end of the nozzle head 78 and the nozzle tube 76.

The tube wall of the merge tube 58 is formed of a gas permeable membrane through which the gas G can pass and liquid cannot pass. Therefore, the merging pipe 58 has a large number of pores (not shown) penetrating inside and outside the pipe wall in order to form the gas permeable membrane. Thus, the merge pipe 58 that functions as a gas permeable membrane is impermeable (water repellency) to the liquids L1 and L2, that is, has hydrophobicity.

Since the merging pipe 58 is thus configured, the gas G flowing through the gas flow path 93 passes through the tube wall of the merging pipe 58 and flows into the merging pipe 58. Thereby, the liquid mixture of the 1st liquid L1 and the 2nd liquid L2 which distribute | circulates the confluence | merging pipe | tube 58 is atomized by being injected from the injection port 72 with the gas G which flows in from the circumference | surroundings.

When the applicator 10 configured as described above is used, a finger (for example, an index finger and a middle finger) is hung on the left and right sides of the flange 26, another finger (for example, a thumb) is hung on the operation unit, and the operation unit 24d is mounted on the flange. When the pressing operation is performed on the 26th side, the first liquid L1 in the first syringe 12a and the second liquid L2 in the second syringe 12b are supplied into the nozzle base 74 through the flow path member 64. Then, the first liquid L1 and the second liquid L2 are mixed with the gas G supplied from the cylinder 86 in the merging pipe 58 and are sprayed from an injection port 72 provided at the tip of the nozzle 14 to form a mist. And uniformly applied to the target site (affected area).

The applicator according to the present embodiment is basically configured as described above, and the operation and effect thereof will be described next.

In laparoscopic surgery, an anti-adhesive material is applied to a target site in the abdominal cavity using the applicator 10 as follows. First, as shown in FIG. 5A, the nozzle head 78 is gripped by the forceps 110 as a gripping tool. At this time, as shown in FIG. 5A, the forceps 110 and the nozzle head 78 are held by the forceps 110 so that the forceps 110 and the nozzle head 78 are aligned in a substantially straight line. In the case of this embodiment, since the plurality of protrusions 104 provided on the outer periphery of the body portion 100 of the nozzle head 78 act as a slip stopper, the nozzle head 78 can be reliably gripped by the forceps 110.

The forceps 110 has a gripper 112 composed of a pair of gripper members 112a and 112b at the tip of the shaft 113, and a posture changing mechanism having three operation axes for causing the gripper 112 to roll, pitch and yaw with respect to the shaft 113. (Wrist part) 114 is provided. For this reason, the forceps 110 is configured such that the orientation of the gripper 112 can be freely changed.

The forceps 110 that holds the nozzle head 78 may be attached to the tip of the arm of the surgery support robot, or may be directly operated by a human surgeon. The forceps 110 may be a medical manipulator configured to perform any or all of opening / closing and posture changing operations of the gripper 112 at the distal end by driving one or a plurality of motors.

Once the nozzle head 78 is gripped by the forceps 110, the nozzle head 78 and the forceps 110 are then inserted into the abdominal cavity 119 through a trocar 120 attached to an incision hole formed in the abdominal wall 118 of the patient, as shown in FIG. 5B. At this time, the passage cross-sectional area of the nozzle head 78 and the forceps 110 can be reduced by inserting the nozzle head 78 and the forceps 110 into the abdominal cavity 119 in the state shown in FIG. The head 78 and forceps 110 can be smoothly introduced into the abdominal cavity 119.

When the nozzle head 78 and the forceps 110 are introduced into the abdominal cavity 119, the posture changing mechanism 114 of the forceps 110 is operated to direct the nozzle head 78 toward the target site. Since the nozzle head 78 is provided at the tip of the flexible nozzle tube 76, the gripper 112 moves only by changing the direction of the gripper 112 of the forceps 110 while holding the nozzle head 78 with the forceps 110. Following this, the nozzle head 78 also moves integrally, and its direction can be easily changed. Therefore, the nozzle head 78 can be easily oriented in an arbitrary direction.

When adjustment is made so that the direction of the nozzle head 78 is directed to the target site, the operation unit 24d (see FIG. 1) is pressed toward the distal end side, and the adhesion preventing material M is discharged from the distal end of the nozzle head 78. Thereby, the adhesion prevention material M can be reliably apply | coated to the target site | part. The nozzle head 78 is introduced into the abdominal cavity 119 through a trocar 122 (indicated by a phantom line in FIG. 5B) different from the trocar 120 through which the forceps 110 is inserted, and the nozzle head 78 is gripped by the forceps 110 in the abdominal cavity 119. May be. In this case, the nozzle head 78 is introduced into the abdominal cavity 119 through the trocar 120 using an appropriate insertion tool (an instrument different from the forceps 110), and the nozzle head 78 is inserted between the forceps 110 and the insertion tool in the abdominal cavity 119. 78 is delivered and the nozzle head 78 is gripped by the forceps 110.

According to the applicator 10 according to the present embodiment described above, since the nozzle head 78 is provided at the tip of the flexible nozzle tube 76, the nozzle 14 inserted into the abdominal cavity 119 is connected to a human wrist. By gripping with the forceps 110 having a degree of freedom, the nozzle 14 can be oriented in an arbitrary direction, and the adhesion preventing material M can be reliably applied to the target site.

Further, according to the applicator 10, when the body portion 100 of the nozzle head 78 is gripped, the plurality of protrusions 104 provided on the outer peripheral portion of the nozzle head 78 act as slip stoppers, so that the forceps 110 that is a gripping tool. Thus, the nozzle head 78 can be securely gripped and the adhesion preventing material M can be reliably applied to the target site.

As described above, when the nozzle head 78 provided with the plurality of protrusions 104 on the outer peripheral portion of the body portion 100 is gripped by the forceps, the nozzle head 78 and the forceps 110 are arranged in a substantially straight line. Accordingly, the nozzle head 78 can be smoothly inserted into the body through the trocar 120 which is an insertion port for inserting the forceps 110 into the body while the nozzle head 78 is held by the forceps 110.

Furthermore, in the case of the applicator 10 according to the present embodiment, the nozzle tube 76 is provided with a plurality of flow paths (a first liquid flow path 91, a second liquid flow path 92, and a gas flow path 93) arranged in parallel. Therefore, the nozzle tube 76 having a plurality of flow paths can be provided with sufficient flexibility, and the forceps 110 can easily direct the nozzle head 78 in a desired direction. Can be applied more reliably.

In the nozzle head 78 shown in FIG. 2 and the like, a plurality of protrusions 104 are provided on the outer peripheral surface of the body portion 100. However, like the nozzle head 130 according to the modification shown in FIG. A plate-like gripped portion 132 extending in the longitudinal direction of the nozzle head 78 may be provided. The gripped portion 132 is a portion that is gripped by the gripping tool, and is formed to protrude outward (radially outward) from the body portion 100. The gripped portion 132 of the illustrated configuration example has a substantially rectangular shape in plan view.

A plurality of ribs 134 extending in the short direction of the gripped portion 132 are formed on one surface and the other surface of the gripped portion 132 so as to protrude at intervals in the longitudinal direction of the gripped portion 132. . These ribs 134 act as anti-slip when the nozzle head 130 is gripped by a gripping tool.

Next, with reference to FIGS. 7A and 7B, a method of applying the adhesion preventing material M to a target site in the abdominal cavity 119 using the applicator 10 provided with the nozzle head 130 in laparoscopic surgery will be described.

As shown in FIG. 7A, the forceps 110 is inserted into the abdominal cavity 119 through the trocar 120 attached to the incision hole formed in the abdominal wall 118 of the patient. In addition, in parallel with the insertion of the forceps 110 into the abdominal cavity 119, or before or after the insertion of the forceps 110 into the abdominal cavity 119, an appropriate insertion tool (not shown) (an instrument different from the forceps 110) is used. The nozzle head 130 is introduced into the abdominal cavity 119 through the trocar 120.

When the forceps 110 and the nozzle head 130 are introduced into the abdominal cavity 119, the nozzle head 130 is transferred between the forceps 110 and the insertion tool, and the nozzle head 130 is gripped by the forceps 110. At this time, as shown in FIG. 7B, the gripper 112 is sandwiched from both sides by the gripper 112, whereby the nozzle head 130 can be firmly held. In addition, since the ribs 134 provided on both surfaces of the gripped portion 132 act as a slip stopper, the nozzle head 130 can be securely gripped by the forceps 110.

When the nozzle head 130 is gripped by the forceps 110, the posture changing mechanism 114 of the forceps 110 is operated to direct the nozzle head 130 toward the target site. At this time, since the nozzle head 130 is provided at the tip of the nozzle tube 76, the gripper 112 can follow the movement of the gripper 112 only by changing the direction of the gripper 112 of the forceps 110 while holding the nozzle head 130 with the forceps 110. Thus, the nozzle head 130 also moves integrally and its direction can be easily changed. Therefore, the nozzle head 130 can be easily oriented in an arbitrary direction.

When adjustment is made so that the orientation of the nozzle head 130 is directed to the target site, the operation prevention unit 24d (see FIG. 1) is pressed toward the distal end side to discharge the adhesion preventing material M from the distal end of the nozzle head 130. Thereby, the adhesion prevention material M can be reliably apply | coated to the target site | part.

When the trocar 120 has a size that allows the forceps 110 that holds the nozzle head 130 to be inserted, the nozzle head 130 and the forceps 110 are trocared after the nozzle head 130 is gripped by the forceps 110 as shown in FIG. 7B. It may be introduced into the abdominal cavity 119 through 120. In this case, since it is not necessary to transfer the nozzle head 130 between the forceps 110 and the insertion tool, the procedure time required for applying the adhesion preventing material M can be shortened.

As will be understood from the above description, the following application method can be implemented by using the applicator 10 according to the present invention. That is, in the application method, the applicator main body (syringe 12) is disposed outside the closed space (inside the abdominal cavity 119) where the target site exists, while the nozzle connected to the applicator main body via the nozzle tube 76. A step of disposing the head 78 (130) in the closed space; a step of gripping the nozzle head 78 (130) with a gripper (forceps 110) capable of freely changing the direction of the tip; Adjusting the orientation of the gripped nozzle head 78 (130) so as to be directed to the target portion.

In the above description, the present invention has been described with reference to preferred embodiments. However, the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the scope of the present invention. Needless to say.

Claims (5)

An applicator (10) for discharging a medicine and applying it to a target site,
An applicator body (12);
A nozzle (14) extending from the applicator body (12) and provided with a nozzle head (78, 130) at the tip,
The nozzle (14) has a flexible nozzle tube (76, 76a, 76b) having one end connected to the applicator main body (12) side and the other end connected to the nozzle head (78, 130). Have
The nozzle head (78, 130) is gripped by a gripping tool having a joint, and the direction of the nozzle head (78, 130) is determined.
An applicator (10) characterized in that. The applicator (10) according to claim 1, wherein
A plurality of protrusions (104) are provided on the outer peripheral surface of the body portion of the nozzle head (78).
An applicator (10) characterized in that. The applicator (10) according to claim 1, wherein
A plate-like gripped portion (132) extending in the longitudinal direction of the nozzle head (130) is provided on a side surface of the body portion of the nozzle head (130).
An applicator (10) characterized in that. The applicator (10) according to claim 1, wherein
In the nozzle tube (76, 76a, 76b), a plurality of flow paths (91, 92, 93) are arranged in parallel.
An applicator (10) characterized in that. An application method in which a drug is discharged and applied to a target site,
A nozzle connected to the applicator main body (12) via nozzle tubes (76, 76a, 76b) while disposing the applicator main body (12) outside the closed space (119) where the target site exists. Arranging the heads (78, 130) in the closed space (119);
Gripping the nozzle head (78, 130) with a gripper that can freely change the orientation of the tip;
Adjusting the orientation of the gripped nozzle head (78, 130) in the closed space (119) so as to be directed to a target site.
The coating method characterized by the above-mentioned.

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