[go: up one dir, main page]

WO2015146484A1 - Outil d'accès à une cavité corporelle - Google Patents

Outil d'accès à une cavité corporelle Download PDF

Info

Publication number
WO2015146484A1
WO2015146484A1 PCT/JP2015/055864 JP2015055864W WO2015146484A1 WO 2015146484 A1 WO2015146484 A1 WO 2015146484A1 JP 2015055864 W JP2015055864 W JP 2015055864W WO 2015146484 A1 WO2015146484 A1 WO 2015146484A1
Authority
WO
WIPO (PCT)
Prior art keywords
retractor
body cavity
retracting
annular member
treatment instrument
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2015/055864
Other languages
English (en)
Japanese (ja)
Inventor
秀司 北城
卓也 宮崎
慶弘 宮澤
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Top KK
Original Assignee
Top KK
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Top KK filed Critical Top KK
Priority to JP2016510172A priority Critical patent/JP6378318B2/ja
Publication of WO2015146484A1 publication Critical patent/WO2015146484A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/0293—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors with ring member to support retractor elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
    • A61B2017/3464—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals with means acting on inner surface of valve or seal for expanding or protecting, e.g. inner pivoting fingers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
    • A61B2017/3466—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals for simultaneous sealing of multiple instruments

Definitions

  • the present invention relates to a body cavity access device for introducing a treatment instrument that is attached to a retracted part when performing treatment while accessing the body cavity.
  • Patent Document 1 Japanese Patent Document 1
  • the retractor includes an inner annular member disposed in the body cavity, an outer annular member disposed outside the body, and the inner annular member fixed to one opening.
  • a flexible, tubular retractor member having an outer annular member fixed to the other opening.
  • the funnel-shaped treatment instrument introduction section functions as a protective lining and introduction path when the treatment instrument is introduced into the body cavity through the retractor.
  • a closure is attached to the outer annular member of the retractor attached to the retractor. Thereby, the opening part outside the body of the retracting member is closed.
  • the occlusion portion has an insertion portion for allowing the treatment tool to pass while maintaining the airtightness of the occlusion.
  • a retractor used in a body cavity access device one having a retractable member that can be wound with an outer annular member is known (for example, see Patent Document 2).
  • the retractor is wound around the outer annular member, thereby fixing the retractor to the retracted portion.
  • an inner annular member provided with a retractor having the inner annular member, the outer annular member, and the retracting member as described above, and a closing portion attached to the outer annular member, and disposed in the body cavity.
  • a string-like member for pulling out See, for example, Patent Document 3).
  • one end of the retracting member is fixed to the outer annular member, the intermediate portion is folded back with the inner annular member inside, and the other end is led out of the outer annular member. Therefore, the retracting member is doubled when mounted on the retracting portion. In this state, one end of the string-like member is fixed to the inner annular member, and extends from the outer peripheral side of the outer annular member to the outside of the retractor body through a doubled retracting member.
  • One end of the string-like member is fixed to the frame of the closing portion, and starting from this, the outside of the double retractable member passes while being folded back at the end on the inner annular member side, and the other end is the body of the retractor It may extend outward.
  • the end of the string-like member extending to the outside of the retractor is fixed to the ring member or is in a free state. By pulling up the extended end of the string-like member, the inner annular member can be taken out of the body cavity from the body cavity through the retracting portion.
  • the string-like member is led out through the inside of the treatment instrument introduction portion arranged inside the retracting member, but in that case, the string-like member passes between the treatment instrument introduction portion and the blocking portion or the outer annular member. Since the member is derived, there is a concern that the airtightness deteriorates similarly.
  • An object of the present invention is to provide a body cavity access device that can take out an inner annular member via a string-like member without causing deterioration of airtightness and damage of a retracted portion in view of the problems of the conventional technology. is there.
  • the body cavity access device of the present invention has an inner annular member disposed on the body cavity side of the retracting portion, an outer annular member disposed on the outer side of the retracting portion, and the inner annular member fixed to one opening,
  • a retractor having a flexible and tubular retractor member in which the outer annular member is fixed to the other opening, and inserted into the retractor mounted on the retractor, and into the body cavity of the treatment instrument
  • a funnel-shaped treatment instrument introduction section constituting an introduction path and an insertion section through which the treatment instrument is passed in an airtight state, and is attached to the outer annular member to block the retractor in an airtight manner
  • a gripping member that is gripped to pull out the inner annular member disposed on the body cavity side of the retracting portion, and one end is fixed to the inner annular member, and the other end is fixed to the gripping member
  • the retractor comprising a string-like member and attached to the retracting portion In a state where the treatment instrument introducing portion is inserted and the retractor is
  • the string-like member between the inner annular member of the retractor and the gripping member passes through the inside of the retracting member of the retractor, and the gripping member is the body.
  • a retractor is attached to the retracting portion in a state of being arranged on the outside.
  • the gripping member is disposed outside the body in the retractor.
  • the treatment instrument introducing portion is inserted into the retractor from the outside of the retractor body.
  • the string-like member is placed on the path from the grasping member to the inner annular member through the retractor and the treatment instrument introducing portion.
  • the closure part in which the treatment tool is disposed through the insertion part is attached to the outer annular member of the retractor while the distal end side of the treatment tool is inserted into the treatment tool introduction part. This completes the mounting of the body cavity access device to the retracted portion.
  • the gripping member is located in a portion where the airtightness is maintained by the closing, and the string-like member is connected to the retracting member and the treatment instrument introducing portion from the inner annular member. It arrange
  • the occlusion part is removed from the outer annular member together with the treatment instrument. Thereafter, the treatment instrument introducing portion is extracted from the retractor, and the gripping member is moved away from the retracting portion, whereby the inner annular member in the body cavity is pulled out of the body together with the retracting member via the string member.
  • the string-like member is located inside the retracting member and does not directly contact the retracting portion, so that the retracting portion is not damaged. Therefore, according to the present invention, it is possible to take out the inner annular member via the string-like member without causing deterioration of airtightness and damage to the wound portion.
  • the grasping member is disposed concentrically with the retracting portion on the outside of the retractor mounted on the retracting portion, and then inserted into the retractor and the retractor It may be comprised by the annular pulling member fixed by being pinched
  • the inner annular member when removing the body cavity access device, after removing the treatment instrument introducing portion from the retractor, the inner annular member is pulled out of the body by moving the handle member in a direction away from the retracting portion. Therefore, the inner annular member can be reliably taken out by the pulling member.
  • the gripping member may be constituted by the treatment instrument introducing portion, and the other end of the string-like member may be fixed to a portion outside the body of the treatment instrument introducing portion. According to this, since the treatment instrument introducing portion can be used as a grasping member, the configuration of the body cavity access device can be simplified.
  • the gripping member may be constituted by the outer annular member, and the other end of the string-like member may be fixed to the outer annular member. According to this, since the outer annular member can also be used as a gripping member, the configuration of the body cavity access device can be simplified.
  • the retractor is configured such that the inner annular member is disposed on the body cavity side of the retracting portion, and the outer annular member is disposed on the body outer side of the retracting portion, and the outer annular member is wound around the winding shaft.
  • the wound member is fixed to the wound part by winding a part of the wound member outside the body in one or the other winding direction, and the treatment instrument introducing part is arranged according to the winding direction. You may have the shape suitable for the shape which a member exhibits.
  • the treatment instrument introducing portion has a shape that matches the shape of the retractor corresponding to the winding direction of the retracting member, it is possible to arbitrarily select the winding direction of the retracting member or the shape of the retractor. it can.
  • FIG. 2 is a perspective cross-sectional view showing a state where the body cavity access device according to the first embodiment of the present invention is attached to a patient's wound part. It is sectional drawing which shows a mode when the retractor of the body cavity access device of FIG. 1 is mounted
  • FIG. 6 is a cross-sectional view showing a state where the retractor of the body cavity access device of FIG. 5 is attached to the retractor or when the retractor is removed from the retractor. It is sectional drawing which shows the state with which the body cavity access device concerning 4th Embodiment of this invention was mounted
  • a body cavity access device 1 includes a retractor 5 that is provided on a body wall 2 of a patient and that maintains a retractor 4 that leads into the body cavity 3 in an open state.
  • the retractor 5 includes an inner annular member 9 disposed on the body cavity 3 side of the retracting portion 4, an outer annular member 10 disposed on the outer side of the retracting portion 4, and the inner annular member 9 fixed to one opening. And a flexible retracting member 11 having the outer annular member 10 fixed to the other opening.
  • the pulling member 8 functions as a gripping member that is gripped in order to pull out the inner annular member 9 disposed on the body cavity side of the retracting portion 4 to the outside of the body.
  • the outer annular member 10 and the inner annular member 9 are both elastically deformable by a predetermined external force, are circular in a free state, and typically have substantially the same diameter.
  • the retracting member 11 is formed of an elastic thin film made of polyurethane, for example.
  • the retracting member 11 has a cylindrical shape and has a diameter smaller than the outer diameter of the outer annular member 10 and the inner annular member 9.
  • the outer annular member 10 is made of, for example, silicone rubber and has a substantially rectangular cross-sectional shape.
  • the inner annular member 9 is made of, for example, silicone rubber and has a substantially circular cross-sectional shape.
  • the retractor 5 has the inner annular member 9 disposed on the body cavity side of the retracting portion 4 and the outer annular member 10 disposed on the body outer side of the retracting portion 4, and the retracting member 11 using the outer annular member 10 as a winding shaft. By winding a part of the outside of the body, the retractable member 11 can be attached to the retracting portion 4 while the substantial length of the retracting member 11 corresponds to the thickness of the body wall 2.
  • the blocking portion 7 includes a disc-shaped canopy member 12, a first film member 17 and a second film member 18 stacked on the front and back surfaces of the canopy member 12, and a first film member 17 and a second film member 18, respectively.
  • a mounting ring 13 for mounting the stacked canopy member 12 on the outer annular member 10 in an airtight manner is provided.
  • the canopy member 12 is made of a soft resin having flexibility, and is formed by laminating two sheet members (gel sheets) 14 a and 14 b having the same diameter as the inner diameter of the outer annular member 10.
  • the canopy member 12 may be composed of three or more sheet members.
  • the soft resin for example, silicone rubber, polyurethane, or polyethylene can be used.
  • the sheet members 14a and 14b are provided with a plurality of slit portions 16 penetrating in the thickness direction in order to introduce the columnar treatment instrument into the body cavity 3.
  • Each slit portion 16 of the sheet member 14a is orthogonal to the corresponding slit portion 16 of the sheet member 14b in a cross shape.
  • the first film member 17 and the second film member 18 are made of another soft resin that has elasticity and is slidable with respect to the soft resin constituting the sheet members 14a and 14b, and is larger than the diameter of the canopy member 12. Has a diameter.
  • this another soft resin for example, polyurethane, polyvinyl chloride, or polyethylene can be used.
  • the end portions of the first film member 17 and the second film member 18 are bonded to each other so as to sandwich the canopy member 12 therebetween.
  • the first film member 17 is provided with a circular hole 19 for allowing a treatment instrument passed through each slit portion 16 to pass through at a position overlapping the center position of each slit portion 16 of the sheet member 14a.
  • the circular hole 19 has a diameter in the range of 40 to 90% of the diameter of the treatment instrument.
  • the second film member 18 includes a slit portion 20 for passing a treatment instrument passed through each slit portion 16 at a position corresponding to each slit portion 16 of the sheet member 14b.
  • the slit portion 20 is orthogonal to the corresponding slit portion 16 of the sheet member 14 b and has the same length as the slit portion 16.
  • the circular hole 19 of the first membrane member 17, the slit portion 16 of the sheet members 14a and 14b, and the slit portion 20 of the second membrane member 18 constitute an insertion portion 21 through which the treatment instrument is passed while maintaining airtightness.
  • the mounting ring 13 is made of, for example, natural rubber or polyurethane, has a substantially U-shaped cross section, and can be mounted on the outer annular member 10 of the retractor 5.
  • the mounting ring 13 is bonded to the end portions of the first film member 17 and the second film member 18 so that the canopy member 12 is positioned outside the body of the outer annular member 10 when the mounting ring 13 is mounted on the outer annular member 10. .
  • the treatment instrument introducing unit 6 is inserted into the retractor 5 attached to the retracting unit 4 and constitutes an introduction path into the body cavity of the treatment instrument while protecting the retracting member 11.
  • the treatment instrument introducing portion 6 has a funnel shape, and is adjacent to the cylindrical portion 22 that contacts the outlet side of the funnel, the conical portion 23 adjacent to the inlet side of the cylindrical portion 22, and the outer side of the conical portion 23. And an annular wall portion 24.
  • the treatment instrument introducing portion 6 has a shape and a size that are substantially contained in a space formed by the retractor 5 attached to the retracting portion 4 and the closing portion 7 that closes the retractor 5. Therefore, the annular wall 24 has a slightly smaller diameter and a slightly shorter axial length than the outer annular member 10 of the retractor 5.
  • the cylindrical portion 22 has an inner diameter that is slightly smaller than the diameter of the retractable portion 4 opened by the retractor 5, but larger than the outer diameter of the treatment instrument to be introduced. For example, it has an inner diameter that allows three treatment tools having a diameter of about 5 mm to pass through.
  • the length of the cylindrical portion 22 is approximately the same as the thickness of the body wall 2.
  • An elastic material such as polyurethane, polyvinyl chloride, or polyethylene is used as the material constituting the treatment instrument introduction unit 6.
  • one end of the string-like member T is fixed to the inner annular member 9 of the retractor 5, and the other end is fixed to the fixing portion 25 of the pulling member 8.
  • the retractor 5 is attached to the retractable portion 4 in a state in which the string-like member T passes through the inside of the retractor 5 and the handle member 8 is separated above the outer annular member 10.
  • the length of the string-like member T is shorter than the shortest possible length in the state where the handle member 8 is arranged as shown by the two-dot chain line in FIG. 2 with respect to the retractor 5 attached to the retracting portion 4. Is set to a length having a sufficient margin.
  • the retractor 5 when performing a surgical operation on a patient using the body cavity access device 1, first, the retractor 5 is attached to the retractable portion 4 provided in advance. That is, in a state where the string-like member T passes through the inside of the retractor 5 and the handle member 8 is separated above the outer annular member 10, the inner annular member 9 of the retractor 5 is bent and the body cavity 3 extends from the retracted portion 4. And inserted into the body cavity 3. Thereby, the inner side annular member 9 is arrange
  • the retracting member 11 is expanded in the radial direction to form an opening having a desired diameter.
  • the length of the retracting member 11 is made to correspond to the thickness of the body wall 2.
  • the handle member 8 is arranged inside the portion located outside the body of the retracting member 11 so as to be substantially concentric with the outer annular member 10 and the retracting portion 4. That is, the pulling member 8 is arranged at a position as shown by a two-dot chain line in FIG.
  • the treatment instrument introducing portion 6 is inserted into the retractor 5.
  • the cylindrical portion 22 of the treatment instrument introducing portion 6 is inserted into the opening formed by the retracting member 11.
  • the treatment instrument introduction unit 6 is in a state of being fitted (fit) to a region extending from the outside of the retractor 5 to the portion of the retracting unit 4.
  • the pulling member 8 is sandwiched and fixed between the retractor 5 and the treatment instrument introducing portion 6, and the string-like member T is introduced from the retractor 5 and the treatment instrument starting from the fixing portion 25 of the pulling member 8. It will be in the state arrange
  • the closed portion 7 in which a few treatment tools for surgery are arranged through the insertion portion 21 is attached to the outer annular member 10. That is, the closure 7 is attached to the retractor 5 by covering the outer annular member 10 with the attachment ring 13. This attachment is performed such that the distal end sides of the respective treatment instruments are bundled and the distal end side is introduced into the body cavity 3 from the cylindrical portion 22 of the treatment instrument introduction section 6.
  • the inside of the body cavity 3 is in an airtight state, and it becomes possible to perform an operation using each treatment instrument.
  • the string-like member T is located on the side of the body cavity 3 of the obstruction 7 as shown in FIG. 1, so that the airtight state of the body cavity 3 deteriorates due to the presence of the string-like member T as in the prior art. It is not.
  • the treatment tool introduction unit 6 prevents the wound member 11 and the wound part 4 from being damaged by the treatment tool.
  • the blocking portion 7 is removed from the outer annular member 10 together with the treatment instrument.
  • the treatment instrument introducing portion 6 is extracted from the retractor 5. Further, by moving the pulling member 8 in the direction away from the retracting portion 4, the inner annular member 9 is pulled out from the body cavity 3 together with the retracting member 11 via the string-like member T.
  • the treatment instrument introduction unit 6 since the treatment instrument introduction unit 6 is made of an elastic material, the treatment instrument introduction unit 6 can cope with external force with high followability.
  • the cylindrical portion 22 of the treatment instrument introduction section 6 has a diameter that allows three treatment instruments to be passed together, for example, two bending forceps are introduced into the body cavity 3 as treatment instruments by the body cavity access instrument 1. Even so, it is possible to maintain a high degree of freedom in the insertion / extraction operation and the turning operation of each bending forceps.
  • the blocking part 7 can maintain airtightness even if a plurality of treatment tools are passed through the insertion part 21, it is not necessary to ensure airtightness by using a trocar check valve. For this reason, a treatment tool can be directly passed through the closing part 7 without using a trocar. Therefore, the operability is not deteriorated due to the mutual interference (fighting) of the trocar. Thereby, a some treatment tool can be arrange
  • the treatment instrument introduction section 6 is inserted into the retractor 5 before the closure section 7 is attached to the retractor 5, the treatment instrument is attached to the body cavity using a trocar even when a bending forceps is used as the treatment instrument.
  • the wound part 4 can be prevented from being damaged by the treatment tool.
  • damage of the retractable member 11 by a treatment tool can also be prevented.
  • such an effect can be obtained by a simple operation by simply inserting the treatment instrument introducing portion 6 into the retractor 5.
  • the treatment instrument introducing portion 6 that can be configured as an integrally molded product of an elastic material enables a very low cost.
  • the retracting portion 4 and the retracting member 11 can be protected.
  • the pulling member 8 used as a tab for pulling out the retracting member 11 together with the inner annular member 9 is fixed on the treatment instrument introducing portion 6 after being arranged on the retracting member 11, so that it is stable during the operation period. In this state, it can be left at the arrangement position.
  • the pulling member 8 is located outside the body in the retractor 5, and the string member T is treated from the inner annular member 9 to the retracting member 11. It arrange
  • the string-like member T is present inside the closure part 7 and the retractor 5, and is not led out from between the treatment instrument introduction part 6 and the closure part 7 or the outer annular member 10, The airtightness due to the blocking portion 7 is not impaired by the string member T.
  • FIG. 3 shows a body cavity access device according to the second embodiment of the present invention.
  • the same reference numerals are given to the same elements as those in FIG.
  • the winding direction of the retracting member 11 by the outer annular member 10 in the retractor 5 is opposite to the case of the body cavity access device 1 of FIG. 1.
  • the retracting member 11 of the retractor 5 has an isosceles triangular shape having a smaller apex angle than the case of FIG. 1 inside the outer annular member 10. A cross-sectional shape is formed.
  • the outer shape of the conical portion 28 in the treatment instrument introducing portion 27 of the body cavity access device 26 is a conical shape that matches the shape of the retracting member 11 having the cross-sectional shape.
  • the cylindrical portion 30 and the annular wall portion 29 adjacent to the conical portion 28 also have a shape and a size that match the shape of the retractor 5.
  • a pulling member 8 that is operated when the retractor 5 is removed from the retracting portion 4 is provided, and a string-like member T is provided between the pulling member 8 and the inner annular member 9.
  • the pulling member 8 is disposed in the retractor 5 in the same manner as described above, and is fixed by the treatment instrument introducing portion 6.
  • the cylindrical portion 30 of the treatment instrument introduction section 27 is slightly smaller than the diameter of the retractable section 4 opened by the retractor 5, but a treatment instrument having a diameter of about 5 [mm] is provided. It has a diameter that can be passed through all together. Therefore, as shown in FIG. 4, a plurality of bending forceps 31 is inserted into the body cavity as a treatment tool through the obstruction portion 7 and the treatment tool introduction portion 27 by the body cavity access device 26 attached to the retractable portion 4 and used. can do.
  • the degree of freedom of the insertion / extraction operation and the turning operation of each bending forceps 31 can be kept high.
  • the treatment instrument introducing portion 27 can prevent the bent portion of the bending forceps 31 from coming into contact with the retracting portion 4 and the retracting member 11 of the retractor 5 to cause damage.
  • the retracting member 11 of the retractor 5 can be wound up in the opposite direction to the case of the first embodiment.
  • FIG. 5 shows a body cavity access device according to a third embodiment of the present invention. 5, the same elements as those in FIG. 1 are denoted by the same reference numerals.
  • the treatment instrument introducing portion 6 is used as a grasping member that is grasped to pull out the inner annular member 9 disposed on the body cavity 3 side of the retracting portion 4 to the outside of the body.
  • one end of the string-like member T is fixed to the inner annular member 9, and the other end is fixed to a portion outside the body of the treatment instrument introducing portion 6 through the inside of the retracting member 11.
  • the other end of the string-like member T is fixed to the fixing portion 25 of the annular wall portion 24.
  • the length of the string-like member T is such that the other end is fixed from the portion of the inner annular member 9 to which one end is fixed in a state where the treatment instrument introducing portion 6 is inserted into the retractor 5 attached to the retracting portion 4.
  • the length is set to have a sufficient margin than the shortest length of the annular wall portion 24 reaching the fixed portion 25.
  • the string-like member T passes through the inside of the retracting member 11 to the fixing portion 25 of the treatment instrument introducing portion 6. It will be in the extended state. Therefore, most of the string-like member T is in a state of being sandwiched between the retracting member 11 and the treatment instrument introducing portion 6.
  • the treatment instrument introducing portion 6 is extracted from the retractor 5, and further moved away from the retracting portion 4, thereby the string-like member T is removed.
  • the inner annular member 9 is pulled out from the body cavity 3 together with the retracting member 11.
  • the retracting portion 4 is not damaged by the string-like member T.
  • the treatment instrument introduction unit 6 can be used as a grasping member, the configuration of the body cavity access device 32 can be simplified. Other points are the same as those in the first embodiment of FIG.
  • FIG. 7 shows a body cavity access device according to the fourth embodiment of the present invention.
  • the same elements as those in FIG. 3 or FIG. the winding direction of the retracting member 11 by the outer annular member 10 in the retractor 5 is opposite to the case of the body cavity access device 32 of FIG. 5.
  • the retracting member 11 of the retractor 5 has an isosceles triangular shape having a smaller apex angle than that of FIG. A cross-sectional shape is formed.
  • the outer shape of the conical portion 28 in the treatment instrument introducing portion 27 of the body cavity access device 33 is a conical shape that matches the shape of the retracting member 11 having the cross-sectional shape.
  • the cylindrical portion 30 adjacent to the conical portion 28 and the fixing portion 25 of the annular wall portion 29 also have a shape and dimensions that match the shape of the retractor 5.
  • Other points of the body cavity access device 33 are the same as those of the body cavity access device 32 of FIG.
  • a treatment instrument introducing portion having a shape suitable for the shape of the retractor corresponding to the winding direction of the retractable member can be employed. . Therefore, it is possible to select the desired winding direction of the retracting member or the shape of the retractor with emphasis on either the winding direction of the retracting member or the shape of the retractor.
  • FIG. 8 shows a body cavity access device according to the fifth embodiment of the present invention.
  • the same elements as those in FIG. 1 are denoted by the same reference numerals.
  • the outer annular member 10 is used as a gripping member that is gripped in order to pull out the inner annular member 9 disposed on the body cavity 3 side of the retractable portion 4 to the outside of the body.
  • one end of the string-like member T is fixed to the inner annular member 9, and the other end is fixed to the fixing portion 25 of the outer annular member 10 through the inside of the retracting member 11.
  • the length of the string-like member T is such that the other end is fixed from the portion of the inner annular member 9 to which one end is fixed in a state where the treatment instrument introducing portion 6 is inserted into the retractor 5 attached to the retracting portion 4.
  • the outer annular member 10 is set to a length that has a sufficient margin than the shortest length to the fixed portion 25 of the outer annular member 10.
  • the inner annular member 9 is disposed on the body cavity 3 side of the retractor 4, and the retractor 11 is wound around the outer annular member 10 as an axis.
  • the string-like member T is also wound up by the outer annular member 10 from the fixed portion 25 side. Thereby, the remaining portion of the string-like member T that has not been wound is in a state of extending to the inner annular member 9 through the inside of the retracting member 11.
  • the string-like member T is not led out of the body cavity access device 34 through the space between the retractor 5 and the occlusion portion 7 in a state where the body cavity access device 34 is attached to the retractable portion 4.
  • the airtightness of the body cavity access device 34 due to the occlusion portion 7 does not deteriorate.
  • the outer annular member 10 can be used as a gripping member, the configuration of the body cavity access device 34 can be simplified. Other points are the same as those in the first embodiment of FIG.
  • the retractor may not be of a type in which a part of the retracting member is wound up by the outer annular member as long as the closing part and the treatment instrument introducing part can be attached.
  • the pulling member does not need to be completely closed in a ring shape, and a part thereof may be open. Further, the pulling member does not need to be a perfect circle, and may be a polygonal shape or an elliptical shape.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Devices For Opening Bottles Or Cans (AREA)

Abstract

La présente invention se rapporte à un outil d'accès (1) à une cavité corporelle, comprenant un écarteur (5), une partie d'introduction d'instrument (6) en forme d'entonnoir et une partie de fermeture (7). L'écarteur (5) comprend en outre un élément en forme d'anneau (9) du côté interne qu'il faut positionner à l'intérieur d'une cavité corporelle (3), et un élément en forme d'anneau (10) du côté externe qu'il faut positionner à l'extérieur du corps. Les deux éléments (9, 10) sont couplés au moyen d'un élément de rétraction (11) cylindrique flexible. L'élément de rétraction (11) traverse une paroi corporelle (2). La partie d'introduction d'instrument (6) est insérée dans l'écarteur (5). La partie de fermeture (7) est montée sur l'élément en forme d'anneau (10) du côté externe. La partie de fermeture comprend en outre une partie d'insertion (21). L'instrument doit être inséré dans la cavité corporelle (3), en passant à travers la partie d'insertion (21) et la partie d'introduction d'instrument (6). Un élément de poignée (8) est positionné à l'extérieur du corps et à l'intérieur de l'écarteur (5). L'élément de poignée (8) interne et l'élément en forme d'anneau (9) du côté interne sont couplés au moyen d'un élément en forme de filetage (T). Après une opération, il est possible, en tirant vers le haut sur l'élément de poignée (8), de retirer de la cavité corporelle (3) l'élément en forme d'anneau (9) du côté interne.
PCT/JP2015/055864 2014-03-27 2015-02-27 Outil d'accès à une cavité corporelle Ceased WO2015146484A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2016510172A JP6378318B2 (ja) 2014-03-27 2015-02-27 体腔アクセス器具

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2014066446 2014-03-27
JP2014-066446 2014-03-27

Publications (1)

Publication Number Publication Date
WO2015146484A1 true WO2015146484A1 (fr) 2015-10-01

Family

ID=54195015

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2015/055864 Ceased WO2015146484A1 (fr) 2014-03-27 2015-02-27 Outil d'accès à une cavité corporelle

Country Status (3)

Country Link
JP (1) JP6378318B2 (fr)
TW (1) TWI641356B (fr)
WO (1) WO2015146484A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2017209190A (ja) * 2016-05-23 2017-11-30 秀司 北城 体腔アクセス器具

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU195088U1 (ru) * 2019-08-07 2020-01-15 Борис Михайлович Белик Устройство для расширения хирургического доступа

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060149137A1 (en) * 2005-01-05 2006-07-06 Applied Medical Resources Corporation Easily placeable and removable wound retractor
JP2009501045A (ja) * 2005-07-15 2009-01-15 アトロポス・リミテッド 創傷レトラクタ
JP2010207579A (ja) * 2009-03-06 2010-09-24 Ethicon Endo Surgery Inc 所定の運動領域内のシール運動を与える外科用アクセス装置及び方法
JP2011509767A (ja) * 2008-01-22 2011-03-31 アプライド メディカル リソーシーズ コーポレイション 手術器具アクセスデバイス

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2013530736A (ja) * 2010-05-19 2013-08-01 ナム ソ、オ 手術道具ガイダー及び手術道具ガイダー用保護キャップ
TWI531350B (zh) * 2012-01-31 2016-05-01 住友電木股份有限公司 醫療用處置用具

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060149137A1 (en) * 2005-01-05 2006-07-06 Applied Medical Resources Corporation Easily placeable and removable wound retractor
JP2009501045A (ja) * 2005-07-15 2009-01-15 アトロポス・リミテッド 創傷レトラクタ
JP2011509767A (ja) * 2008-01-22 2011-03-31 アプライド メディカル リソーシーズ コーポレイション 手術器具アクセスデバイス
JP2010207579A (ja) * 2009-03-06 2010-09-24 Ethicon Endo Surgery Inc 所定の運動領域内のシール運動を与える外科用アクセス装置及び方法

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2017209190A (ja) * 2016-05-23 2017-11-30 秀司 北城 体腔アクセス器具

Also Published As

Publication number Publication date
JP6378318B2 (ja) 2018-08-22
TWI641356B (zh) 2018-11-21
TW201544068A (zh) 2015-12-01
JPWO2015146484A1 (ja) 2017-04-13

Similar Documents

Publication Publication Date Title
US10201371B2 (en) Surgical device
JP5213948B2 (ja) 内視鏡／腹腔鏡導入スリーブ
EP2468192A1 (fr) Rétracteur chirurgical doté d'un anneau de duromètre variable
US7850602B2 (en) System and method for removing a protective cover from a medical instrument
JP2009501045A (ja) 創傷レトラクタ
JP2012130677A (ja) 自己展開の体の開口部プロテクタ
US20130012770A1 (en) Combined retractor and endoscope system
US11992184B2 (en) Surgical robotic access system for irregularly shaped robotic actuators and associated robotic surgical instruments
JP6378318B2 (ja) 体腔アクセス器具
JP4082952B2 (ja) 医療用処置用具
JP6618187B2 (ja) 体腔アクセス器具
JP4134161B2 (ja) 医療用処置用具
EP2884919A2 (fr) Dispositif chirurgical
JP5813849B2 (ja) 医療用処置具の挿入器具
JP5813848B2 (ja) 医療用処置具の挿入器具
JP6678894B2 (ja) 開創器用バルブキャップ
JP5683855B2 (ja) 医療用処置具の挿入器具

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 15767823

Country of ref document: EP

Kind code of ref document: A1

ENP Entry into the national phase

Ref document number: 2016510172

Country of ref document: JP

Kind code of ref document: A

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 15767823

Country of ref document: EP

Kind code of ref document: A1