WO2015125826A1 - Medical collection bag - Google Patents

Abstract

Provided is a medical collection bag that is applicable to NOTES, and that is capable of forming a bag at a distal end into an intended state in accordance with proximal operations, even in a long, narrow, flexible tool that can be inserted into a forceps channel of a soft endoscope. This medical collection bag comprises: a bag (1) that expands and closes, and that has a through hole in the periphery of an opening; an elastic wire (2) that is inserted through the through hole in the bag, and that remembers the shape for expanding the opening; a flexible outer tube (3) that houses the bag and the elastic wire; a connection cable (4) that is made of a flexible metal stranded wire, is connected to the elastic wire, and slides inside the outer tube; an outer tube base (5) that is connected to the outer tube, and that serves as an operating section; a cable base body (6) that is movable in the axial direction, and that slides with the outer tube base which serves as the operating section of the connection cable; and a cable base ring (7) that is connected to the connection cable, and that is rotatably connected to the cable base body. The medical collection bag is formed such that the bag rotates in accordance with the rotating operation of the cable base ring (7).

Description

Medical collection bag

The present invention relates to a medical collection bag for storing an organ removed during surgery and taking it out of the body, particularly in a surgical operation using an endoscope.

In surgery performed from a small incision such as laparoscopic surgery, it is difficult to directly remove an organ or the like excised by surgery due to the limitation of the incision, and when removing it, a resection piece is placed in the body cavity. In order to prevent overflowing and splashing, a recovery bag has been used in which a cut piece is stored in a bag (bag) inserted into a body cavity through a trocar from outside the body and taken out from the body together with the bag.

As a collection bag for such a laparoscopic surgery, for example, the bag is pulled out to the outside of the sleeve through a through hole (trap portion) and an outer tube (long sleeve) bore provided around the bag opening. A series of fine yarns having a free end, a bag attached over the entire circumference of the trap portion, and means for pulling the free end of the fine yarn drawn out from the proximal end of the sleeve toward the front An instrument used through a trocar has been proposed in which the diameter of the trap portion is continuously narrowed by pulling the free end of the thin thread so that the bag opening can be closed continuously. (Patent Document 1)

In addition, surgical operations are in the flow of minimally invasive, from laparoscopic surgery to single-hole surgery, which is now widespread, and in some operations, there is no single wound on the body surface. Further, it has been developed into transluminal endoscopic surgery (NOTES) in which surgical operation is performed through a soft endoscope from a natural opening such as the mouth and anus.
Surgical instruments such as forceps used in this NOTES have many restrictions such as long insertion of a flexible endoscope through a limited number of forceps channels. Conventional instruments such as used medical collection bags cannot be used as they are.

Therefore, the present inventors applied NOTES as a medical collection bag applicable from the forceps channel of the endoscope, and a bag provided with a through hole around the opening, and the bag through the through hole of the bag. An elastic band for opening and closing; an outer tube that is housed at a distal end in a state where the bag and the elastic band are folded; and a proximal end of the bag, and is extended to the outside through a lumen of the outer tube. The bag and the elastic band are pushed out from the outer cylinder tube by expanding the bag by sliding in the outer cylinder tube, and the elastic band is pulled back into the outer cylinder tube and re-stored. A connection cable to be closed, an operation portion provided at the proximal end of the outer tube and the connection cable, and after the bag is pushed out from the outer tube, the opening of the bag can be freely expanded and closed from the outside. Possible re An instrument comprising an opening means, applied to the above application, the outer tube and the connecting cable have bendable flexibility, and the outer tube is adapted to a forceps channel and has an outer diameter of 1.4 mm. As described above, a device having a size of 5.5 mm or less is proposed. (Patent Document 2)

Japanese Patent Laid-Open No. 5-115493 JP 2013-208229 A

However, as described above, in order to insert the collection bag to the target site using the forceps channel of the flexible endoscope as a passage and deploy the bag, the instrument is required to be adapted and have a long and small diameter. In addition, there are many restrictions, such as the need to insert in a curved shape depending on the situation, and it is not easy to reflect the intended operation by the hand operation of the rear end base portion on the bag at the front end.
For example, the bag at the front end is not necessarily deployed with the opening, which is in a usable state at the stage of insertion, facing upward, and naturally the direction needs to be corrected after deployment. In addition, it may be necessary to adjust the opening direction depending on the situation of the operation.
In this case, for example, in the case of a collection bag for laparoscopic surgery as in Patent Document 1, the outer diameter of the instrument can be set to be relatively thick in accordance with the trocar serving as an insertion passage, There is no need to increase the length to the bag. Furthermore, the straight insertion makes it possible to apply a highly rigid (not necessarily required to be flexible) outer tube. For example, it is not difficult to change the direction of the bag without causing a twist or the like by rotating the entire instrument.

Further, in the conventional instrument, it is not considered that the excised piece is stored in the body and the opening of the bag is closed, and then the opening of the bag is not reconsidered. Many cases cannot be applied to operations such as opening and closing the bag multiple times in the body, such as when it is desired to be stored in the bag, and even if applicable, operations from the outside cannot be performed, and operations are troublesome. It has become sloppy.

On the other hand, in order to bend and insert the thin long passage of the forceps channel of the flexible endoscope as in Patent Document 2 as in Patent Document 2, the instrument also has a long outer tube, a small diameter, and can be inserted. It is necessary to configure with flexibility. In this case, it is possible to operate by hand due to interference caused by contact with the forceps channel of the outer tube, torsion or expansion / contraction due to insufficient rigidity of the instrument, and hooking of the sliding part at the curved part. There is a concern that will not work well with the back of the tip.

Therefore, the collection bag of the present invention is used for NOTES or the like that inserts the forceps channel of a flexible endoscope as a passage, and even if it is a long and thin instrument with flexibility that can be bent, An object of the present invention is to provide a medical recovery bag that can be formed into an intended state following the hand operation of the front end bag and is excellent in usability.

The medical collection bag of the present invention has a through hole in the edge of the opening, a bag capable of opening and closing the opening, and a mode in which the opening is expanded in a natural state by being inserted into the through hole of the bag. An elastic wire stored in the memory, an outer tubular tube made of a long flexible resin tube and housed in the distal end in a state in which the bag and the elastic wire are reduced in diameter, and a tip portion near the elastic wire. Connected to the distal end, and extended to the outside through the lumen of the outer tube, and by sliding in the outer tube, the bag and the elastic wire are pushed out of the outer tube, and the bag is expanded, A connecting cable formed from a flexible metal stranded wire that retracts the elastic wire into the outer tube and re-stores it to close the bag; and a gripping unit and an operating unit connected to the proximal end of the outer tube And the proximal end of the connecting cable A cable base that is connected and becomes a gripping part and an operation part. The cable base slides with the outer tube pipe base and is relatively movable in the axial direction, and is connected to the connection cable. The cable base ring and a cable base ring connected to be rotatable are configured such that the bag rotates following the rotation operation of the cable base ring.

The outer tubular tube base is provided with a groove extending in the axial direction and a locking portion provided as a circumferential cut at the groove end, and the cable basic body has a protrusion that engages with the groove and the locking portion. One part or a plurality of parts on the same axis are formed, and the protrusion is engaged with the groove to slide to restrict the movement in the shaft and the rotation direction, and the protrusion is engaged with the locking part. The sliding was restricted.

The outer tube is formed with a length of 1000 mm or more and 1800 mm or less, and an outer diameter of 1.4 mm or more and 5.5 mm or less.

When the elastic wire is housed in the outer tube, the tip is located inside the outer tube, and when the elastic wire is returned to the outer tube after the bag is deployed, the tip of the elastic wire is It was assumed that the opening was in a sealed state with a purse-like shape by being positioned in the tube.

The bag was configured to be pushed out from the outer tube and deployed, closed once, then reopened by the operation from the outside, and further equipped with a means capable of being closed again.

The re-deployable means is formed by a string member having one end connected to the proximal end of the bag and the other end extending to the outside through the lumen of the outer tube. At that time, it is preferable that the proximal end portion of the string member is connected to the outer tube base.

Further, the another means that can be re-deployed is such that one end is connected to the proximal end of the bag, is passed through the lumen of the outer tube, and the other end is directly or directly at a site interlocked with the connection cable. It is indirectly connected, and part or all of it is formed including a spring-like elastic member. In this case, the re-expandable means is preferably formed by connecting a spring-like elastic member and a string member.

The collection bag is inserted from a forceps channel of an endoscope and used together with an endoscope, for example, for use in NOTES.

According to the above means, since the bag, the elastic wire, the outer tube, and the connection cable, which are the insertion part to the forceps channel of the flexible endoscope, are all flexible, they are curved corresponding to the insertion path. In addition, since the outer tube and the connection cable can be easily reduced in diameter and length, the instrument can be applied to a procedure such as NOTES. In addition, the connecting cable is formed from a twisted metal wire with a good balance between flexibility and rigidity and excellent in torque characteristics. The connecting cable is rotatably connected to the cable base body and an elastic wire inserted through the through hole of the bag. By connecting to the cable base ring, the bag can be rotated following the rotation operation of the cable base ring that is a hand operation, and the opening is easily directed upward by hand operation after the bag is inserted. And can be turned in any direction during surgery. Further, since the connection cable passes through the inner tube and the lumen of the cable basic body and is connected to the cable base ring, it is not necessary to rotate the entire device when the bag is rotated.

In addition, since the outer tube tube base is provided with a groove and a locking portion, and the cable basic body is provided with a projection portion that engages with the groove, the operation in the axial direction and the rotational direction can be accurately performed when the bag is deployed and closed. Can be regulated. Furthermore, the structure of the elastic wire inserted without being fixed to the through hole of the bag and the tip of the elastic wire stored in the outer tube are positioned inside the outer tube so that the bag is sealed when the bag is closed. It can be made into a purse-like shape, and the collected excised pieces will not overflow or scatter.

Furthermore, by forming the length of the outer tube to 100 mm or more and 1800 mm or less, and forming the outer diameter to 1.4 mm or more and 5.5 mm or less, it is applied to NOTES and is, for example, equal in length from the oral cavity to the stomach interior. It can be applied to a case that needs to be inserted into a forceps channel of a thin flexible endoscope and can be operated without difficulty.

In addition, by providing means capable of re-deploying the opening of the bag by an external operation, the bag once closed in the body can be re-deployed without using other instruments such as forceps. it can. The redeployment means includes a string member extending from the proximal end of the bag to the outside, or a spring-like elastic member for connecting the proximal end of the bag and the connection cable, so that the outer tube base and the cable The opening of the bag can be opened and closed by the relative sliding movement of the operation portion made of the base, and the bag can be easily redeployed or reclosed from the outside.

As described above, the present invention is a long-thin and small-diameter instrument that can be bent and is a instrument that inserts a forceps channel of a flexible endoscope as a passage for uses such as NOTES. In addition, it is possible to provide a medical recovery bag excellent in usability, in which the front end bag can be formed in an intended state following the hand operation.

The whole block diagram which shows embodiment of the medical collection bag of this invention. The enlarged view which shows the front end side containing the bag of the said form, and a bag. The expanded sectional view which shows the base part of the said form. The block diagram which shows the connection with the outer cylinder pipe base and outer cylinder of the said form. The block diagram which shows the connection with the cable base and connection cable of the said form. The schematic diagram which shows the expansion | deployment and obstruction | occlusion state of the bag of the said form. The schematic diagram which shows the hand operation part of the said expansion | deployment and obstruction | occlusion state. The block diagram which shows the medical collection | recovery bag provided with the means which can be redeployed in another embodiment of this invention. Explanatory drawing which shows operation and operation | movement of the said form. The block diagram of the principal part which shows the means which can be re-deployed different from the said form.

Hereinafter, embodiments of the medical collection bag of the present invention will be described in detail with reference to the drawings.
FIG. 1 shows an overall configuration diagram of the present embodiment. The medical collection bag of this embodiment is applied to NOTES and inserted and operated from a forceps channel of a flexible endoscope. A tissue piece excised by surgery is accommodated in the bag, and the bag is closed outside the body. This is an organ recovery bag intended for recovery.
This collection bag is provided with a through hole 11 around a peripheral edge portion that becomes an opening, and a cut portion 12 is provided at one position of the through hole 11, and the opening expands and closes to store the tissue piece. The bag 1 is inserted into the bag 1 through the through hole 11 from the notch 12 of the bag 1 and the opening is expanded in a natural state (a state protruding from the outer tube) so as to maintain the expansion of the bag 1. An elastic wire 2 that is stored; an inner diameter that allows the bag 1 and the elastic wire 2 to be folded and thinned and accommodated at a distal end; and an outer diameter that can be inserted from a forceps channel of a flexible endoscope. An outer tube 3 made of a flexible resin tube formed longer than the channel, and connected to the proximal end of the elastic wire 2, extending to the cable base ring 7 through the lumen of the outer tube 3, Flexible metal twist sliding inside the outer tube 3 A connecting cable 4 comprising: an outer cylindrical tube base 5 which is connected to a proximal end of the outer cylindrical tube 3 and serves as a gripping part and an operating unit; and is inserted into the outer cylindrical tube base 5 and is slidable in the axial direction. The cable is basically composed of a cable basic body 6 serving as a gripping part and an operation part, and a cable base ring 7 that is connected to the proximal end of the connection cable 4 and rotatably connected to the cable basic body 6.

Next, each part will be described in detail. FIG. 2 is an enlarged partial cross-sectional view of the distal end side including the bag in a state where A is in the state where the bag of the present embodiment is deployed, B is a bag viewed from the rear side, and FIG. 3 is a state in which A is deployed. The expanded sectional view of the base end side including the outer tube tube base and the cable base serving as the gripping part and the operation part, and B shows a part (rounded part) further enlarged. 4 shows a connection portion between the outer tube and the outer tube tube base, FIG. 5A shows a connection portion between the connection cable and the cable base, and B shows an enlarged partial sectional view of the cable base ring. ing.

The bag 1 for storing and recovering excision pieces such as organs is thin, flexible and does not specify a film-like sheet such as a polyolefin-based resin or a polyamide-based resin in consideration of strength that does not easily break and shape recoverability in a body cavity. It is formed in a bottomed bag having a shape, and is folded around one side of the edge that becomes the opening of the bag 1 and bonded or heat-welded to form an annular passage for inserting an elastic wire 2 to be described later The hole 11 was formed, and a cut portion 12 serving as an insertion port (extraction port) for the elastic wire 2 was provided at a position that would be the proximal end of the bag of the through hole 11. The size and shape of the bag 1 may be appropriately set according to the use. In this example, the bag 1 can be accommodated in the outer tube 3 to be described later in order to be applied to the NOTES which is the main use of the present invention. As the size that can be used without difficulty, the length in the longitudinal direction (axial direction) is 15 mm or more and 60 mm or less, the length in the short direction (width direction) is 15 mm or more and 40 mm or less, and the depth is 20 mm or less. The part was formed as a bowl with a bottom surface formed in a circle or ellipse. Moreover, it formed using the polyamide-type resin with a film thickness of 0.03 mm as a material.

The elastic wire 2 serving as an opening / closing means for maintaining and closing the bag 1 is inserted into the annular passage serving as a through hole 11 at the edge of the bag 1 without being fixed to the bag 1, Is pulled out from the notch 12 and connected to the distal end of the connection cable 4 to be described later via a tip bush 23. In addition, the elastic wire 2 is stored in a superelastic alloy (Ni in this example, Ni) in an annular shape (circular or elliptical shape in this example) when the bag 1 is opened when it is pushed out from the outer tube 3. -Ti alloy), but the tip portion is formed with a projecting portion 22 with the tip folded as a shape for achieving both folding when stored in the inner tube 3 and an annular shape when deployed. Composed. On the other hand, both ends, which are proximal ends following the annular shape, are linearly extended and, as described above, are connected to the distal end bush 23 by welding or the like, and are connected to the connection cable 3.

The outer tube 3 is applied to the NOTES, which is the object of this embodiment, and has a small surface friction resistance because it can be smoothly inserted into a bendable forceps channel having a small diameter and a long length of a flexible endoscope. It is made of a flexible resin tube such as fluororesin, and its size is compatible with general flexible endoscopes. In addition, considering the length to the surgical site and operability, the length is 1000 mm or more and 1800 mm. The outer diameter should be 1.4 mm or more and 5.5 mm or less (1.8 mm in this example) as appropriate for the inner diameter range (2.0 mm to 5.5 mm type) of a general flexible endoscope channel. (2.0 mm type) and 2.5 mm (2.8 mm type)).
Here, if the length is set to less than 100 mm, it cannot be adapted to the length of the flexible endoscope, and if it is longer than 1800 mm, the surplus portion becomes longer and the operability becomes worse, such as weakness. On the other hand, if the outer diameter of the outer tube 3 is set to be less than 1.4 mm, the inner diameter is naturally reduced, so that it becomes difficult to store the bag 1 having a size effective as an excision collecting tool. If the outer diameter is set to be larger than 5.5 mm, it cannot be inserted into the channel of the flexible endoscope and cannot be applied to NOTES.

In addition, the bag 1 and the elastic wire 2 are inserted into the lumen of the distal end of the outer tube 3 in a wound or folded state, and the connection cable 4 described later is also inserted, so that the strength such as crushing is increased. It is desirable to ensure as large an inner diameter as possible without causing any problems. In this sense, it is recommended to use a fluororesin that is thin and has high strength. On the other hand, the end portion 33 of the proximal end is expanded in a taper shape, and the expanded portion is connected to the outer cylindrical tube base 31 described later with the connection cap 56 interposed therebetween. In order to prevent this from being bent and to improve the operability such as insertion into the forceps channel, and to ensure the connection with the outer tube tube base 5, the reinforcing tube 32 is externally provided about 100 mm from the base side to increase the rigidity. ing.

The connecting cable 4 has a length suitable for the outer tubular tube 3 by a twisted wire formed by twisting a plurality of fine metal wires such as stainless steel having appropriate flexibility and rigidity, and the inside of the outer tubular tube 3. Is formed by connecting the distal end to the end of the elastic wire 2 via the tip bush 23. On the other hand, the proximal end is connected to the cable base ring 7 which will be described later. However, the guide pipe 41 is externally provided about 240 mm from the proximal end side connecting portion which does not require flexibility to increase the rigidity in the axial direction. Operability in operation and rotation direction is improved.
And in addition to having both flexibility and rigidity as described above, this metal twisted wire has no expansion and contraction in the axial direction, is excellent in torque properties, and has a large surface area compared to metal wires and the like, Since the contact with the outer cylindrical tube 3 does not become a large surface contact, the outer cylindrical tube 3 has a small diameter, a long axis, and is curved in the middle due to good sliding and no strong frictional force in the outer cylindrical tube. Even in this case, following the relative movement in the axial direction between the outer tube tube base 5 and the cable basic body 6 described later and the rotation operation of the cable base ring 7, it is connected to the distal end. The elastic wire 2 (bag 1) can be rotated in the intended direction, and the protrusion and storage operations can be ensured.

The operation part of this collection bag is connected to the proximal end of the outer tube 3 and grips the outer tube tube base 5, and is connected to the proximal end of the connection cable 4 and grips and operates the basic cable body 6 and the cable base. The outer tube tube base 3 is a long tube body that is slidably inserted into the interior made of a resin molded product, and has a distal end portion of the outer tube tube 3 and A connection portion with the reinforcing tube 32 is formed, and a male screw 55 is formed, and a connecting cap 56 in which a female screw is formed sandwiching the expanded portion at the end of the outer tube 3 and the extended portion at the end of the reinforcing tube 32. Tightened and connected.
A groove 51 for sliding and sliding the cable basic body 6 in the axial direction is provided on the side surface, and the cable basic body 6 is slightly rotated and engaged with the rear end portion of the groove 51. It is formed with an engaging portion 52 that can be kept. Further, a notch 54 for passing through the groove 51 and a locking protrusion 63 of the cable basic body 6 which will be described later in communication with the groove 51 and a locking protrusion 63 necessary for the attachment to the outer tube 5. Is formed with an escape portion 53 for fitting into the locking portion 52.

The cable basic body 6 has a passage passing through the connection cable 4 and the guide pipe 41 inside, and serves as a slide portion 62 and an operation portion of a rod-like cylindrical body that is slidably inserted into the outer cylindrical tube 5. The holding portion 61 is formed of a holding portion 63, which is engaged with the groove 51 of the outer tube base 5 and slides in the axial direction at the front end portion of the slide portion 62. In addition, in this example, a plurality of guide protrusions 64 are provided on the same axis as the locking protrusion 63.
According to the above configuration, when the bag 1 is deployed from the outer tube 3 and the elastic wire 2 is stored (the bag 1 is closed), the locking protrusion 63 of the cable basic body 6 is formed along the groove 51 of the outer tube base 5. Therefore, the movement in the axial direction and the peripheral direction is restricted, and the locking projection 63 is engaged with the locking portion 52, so that the bag can be reliably kept closed and sealed.
Further, the grip portion 61 is provided with a cable base ring 7 which will be described later and a rotary slide receiving portion 65 which becomes a rotatable connection portion.

The cable base ring 7 connects the connecting cable 4 and the guide pipe 41 to the cable connecting portion 71 on the distal end side by bonding or the like, and the rotating sliding receiving portion 65 and the rotating sliding portion of the cable basic body 6. In this example, the peg 73 is inserted into the rear end portion.
According to the above configuration, the connection cable 4 is connected to the cable base ring 7 and formed so as to be able to rotate and slide with the cable base body 6, without rotating the outer tube tube base 5 and the cable base body 6. The direction of the back can be changed only by rotating the cable base ring 7.

Next, the operation and operation of this embodiment will be described. FIG. 6 shows the state of the bag at each operation stage, in which A represents the pre-operation bag storage stage, B represents the bag deployment stage, and C represents the bag closure stage. FIG. 7 shows the state of the hand operating unit corresponding to each stage.

Before use and at the stage of insertion into the forceps channel of the flexible endoscope, the elastic wire 2 is squeezed linearly in the axial direction, and the bag 1 is wrapped around the elastic wire 2 and folded. Fully retracted at the distal end. (FIG. 6A) At that time, the locking protrusion 63 of the cable basic body 6 of the operating portion is located at the rearmost end of the groove 51 of the outer tube base 5, and the slide 62 portion of the cable base body 6 from the outer tube base 5. Is in a protruding state. (FIG. 7A)

The bag 1 and the elastic wire 2 protrude from the outer tube 3 by advancing the locking protrusion 63 of the cable basic body 6 to the outermost end of the groove 51 with respect to the outer tube tube base 5 from the storing stage, and the elastic wire The bag is developed by the elastic restoring force of 2. (Fig. 6B, Fig. 7B)

After the tissue is collected by the bag 1, only the elastic wire 2 is drawn into the outer tube 3 by retracting the locking protrusion 63 of the cable basic body 6 to the rear end of the groove 51 with respect to the outer tube base 5. The bag 1 is sealed and closed in a purse-like shape, and further, the bag 1 is slightly rotated to fit the locking protrusion 63 into the locking portion 52, so that this closed state is reliably maintained. (Fig. 6C, Fig. 7C)

FIG. 8 is a collection bag provided with means that can be re-deployed in another embodiment of the present invention, in which A indicates a tip portion and B indicates a hand operation portion. The re-deployable means of this example connects the distal end portion 81 of the thread to the proximal end of the bag, passes through the lumen of the outer tube 3 in parallel with the connection cable 4, and the other end (proximal position of the thread). The end portion 82) was formed by a thread 8 serving as a string member connected to the outer tube tube base 5.

The yarn 8 serving as the string member is made of a high-strength polyamide resin or metal wire having no stretchability (in this example, a polyamide resin yarn), and the yarn distal end portion 81 is tied to the proximal end of the bag 1 by ligation or the like. The thread proximal end 82 is connected to the outer tube base 5 through the lumen of the outer tube 3, and in this example, the thread take-out hole 57 is placed at an appropriate position on the outer tube base 5. The yarn proximal end portion 82 of the yarn 8 was taken out from the take-out hole 57, and fixed and connected by ligation or adhesion outside. Further, the thread 8 is set to a length that is positioned substantially at the distal end portion of the outer tube 3 when the bag 1 protrudes from the outer tube 3, and the length of the protruding portion of the bag 1 in the stored state before the bag 1 protrudes. The length (the slide length of the outer tube tube base 5 and the cable basic body 6) is accommodated in the outer tube 3 in a bent state and is fully stretched by the protrusion of the bag 1. Is set. As a result, the bag 1 can be reopened and reclosed by opening and closing the bag 1 from the external operation unit. The connecting means of the yarn end is not limited to this example, and the bag 1 is not moved from the distal end position of the outer tube 3 after the bag 1 protrudes from the outer tube 3. What is necessary is just to hold | maintain the thread | yarn distal end part 81 in a site | part. Further, when the thread 8 is taken out from the take-out hole 57 of the outer tube base 5, the end of the thread is not fixed by the take-out hole 57, and the protruding portion of the bag 1 (the amount bent in the outer tube) is lengthened. By projecting, the same re-deployment and re-occlusion effects as in this example can be obtained.

FIG. 9 is a schematic diagram showing the operation and operation of the present embodiment, in which A is when the bag is stored before use, B is when the bag is deployed, C is when the bag is closed, and D is when the bag is redeployed. Since the basic operation and operation of this embodiment are the same as those of the above-described embodiment, only the yarn 8 of the re-deployment means and the re-deployment are added. Before use, the thread 8 is accommodated in the inner tube 3 in a state where the length of the bag protruding (the length of the slide between the outer tube tube base 5 and the cable basic body 6) is bent (FIG. A). ), When the cable basic body 6 is advanced and the bag 1 protrudes from the outer tube 5 and is deployed, the distal end portion 81 of the yarn connected to the proximal end of the bag 1 is positioned substantially at the tip of the outer tube 3. The thread 8 is in a tensioned state in the inner tube 3 (FIG. B). Then, when the cable basic body 6 is retracted and the bag 1 is closed after the tissue is recovered, the elastic wire 2 returns to the outer tube 3 but the thread 8 is connected to the proximal end of the protruding bag 1. Without returning, the position of the thread distal end portion 81 which is the connecting portion is also kept fully stretched without changing (FIG. C).

Usually, the bag 1 is recovered from the body together with the flexible endoscope in this state. However, when the bag 1 is redeployed for some reason, the elastic wire 2 is moved forward by moving the cable basic body 6 forward relative to the outer tube base 3 again. Protrudes from the outer tube 3, while the proximal end (thread 8) of the bag does not change position so that the bag 1 is naturally redeployed with the opening of the elastic wire 2 (FIG. D).

FIG. 10 shows the main components of an example using a spring-like elastic member as another embodiment of the re-deployable means of the present invention, and A is a state where the spring-like elastic member is contracted (before use) , And a state where the bag is unfolded) and a state where B is stretched (a state where the bag is closed). The re-deployable means of this example uses a spring 9 in a natural state made of metal as a spring-like elastic member, and one end (proximal end) of the spring 9 is interlocked with the connection cable 4. The distal end of the spring 9 is connected to the distal end of the guide pipe 41 that covers the cable 4, and the one end (yarn proximal end 82) of the high-strength resin thread 8 such as a metal wire or polyamide resin. The thread 8 and the spring 9 were formed in series, with the thread distal end 81 of the thread 8 connected to the proximal end of the bag 1.

As the thread 8 of the present embodiment, the same thread as that of the above-described embodiment is connected to the proximal end of the bag 1, parallel to the connection cable 4, and through the lumens of the outer tube 3 and the outer tube base 5. Connected to the distal end of the street spring 9. The spring 9 is provided so as to cover the outer periphery of the connection cable 4, and the distal end is connected to the thread 8 and the proximal end is connected to the guide pipe 41 that covers and reinforces the outer periphery of the connection cable 4. ing. Here, since the guide pipe 41 is connected to the cable base ring 7 together with the connection cable 4, the guide pipe 41 moves in conjunction with the connection cable 4.

Since the basic operation and operation of this embodiment are the same as those of the above-described embodiment, only the operation of the spring 9 of the re-deployable means will be described. When the bag 1 is accommodated in the outer tube 3 before use, the spring 9 is in a naturally contracted state (FIG. A), and the yarn 8 is in a tensioned state, unlike the above-described form. It has become. Next, when the cable basic body 6 is advanced and the bag 1 is projected and deployed, the thread 8 and the spring 9 are also slid as they are, and the spring 9 does not change from the contracted state. When the cable basic body 6 is pulled back and the bag 1 is closed, the distal end portion 81 of the yarn connected to the bag 1 stays at the tip of the outer tube 3 and the connecting cable 4 moves backward, so that the spring 9 is extended. This extended state can be maintained by engaging the locking protrusions 63 of the cable basic body 6 with the locking portions 52 of the outer tube tube base 5 (FIG. B).

When the bag 1 is re-deployed from the above state, the engagement protrusion 63 is disengaged, and the cable basic body 6 is slid forward, so that the restoring force of the spring 9 restores the original contracted state (FIG. A). Returning, the bag 1 is re-deployed by the elastic wire protruding without changing the position of the thread 8.

When only the string-like member (for example, the thread 8) is used as the re-deployable means as in the above embodiment, the thread distal end portion 81 of the re-deployable means is at the proximal end of the bag 1, The proximal end is connected and set to a non-sliding position interlocked with the outer tube 3 such as the outer tube 3 or the outer tube tube base 5, and can be re-deployed when a spring-like contraction member (for example, the spring 9) is used. The distal end portion 81 of the thread is connected to the proximal end of the bag 1, and the proximal end portion is set to a sliding position interlocking with the connection cable 4 such as the connection cable 4, the guide pipe 41, or the cable base ring 7. Is done. According to this, the bag 1 once closed can be re-deployed and re-closed only by the sliding operation of the outer tube tube base 5 and the cable basic body 6 of the hand operation section.

1. Bag 11. Through hole 12. Cut section Elastic wire 21. Opening expansion part 22. Projection 23. Tip bush 3. Outer tube 31. Proximal end 32. Reinforcing tube 33. Proximal end 4. Connection cable 41. Guide pipe 5. Outer tube tube base 51. Groove 52. Locking part 54. Slit 55. Cap connection part 56. Connection cap 57. Thread take-out hole 6. Cable basic body 61. Gripping part 62. Slide sliding part 63. Locking projection 64. Guide protrusion 65. Ring receiver 7. Cable base ring 71. Cable connection 72. Rotating sliding part 73. Pegs 8. Thread 81. Yarn distal end 82. 8. Proximal end of thread Spring

Claims (11)

A bag provided with a through hole at the edge of the opening, and capable of opening and closing the opening;
An elastic wire that is inserted into the through-hole of the bag and stored in a manner to expand the opening in a natural state;
An outer tubular tube made of a long flexible resin tube and housed in the distal end in a state in which the bag and the elastic wire are reduced in diameter,
A connecting cable formed of a flexible metal stranded wire that slides in the outer tube, the tip portion being connected to the proximal end of the elastic wire and extending to the outside through the lumen of the outer tube;
An outer tube tube base connected to the proximal end of the outer tube and serving as a gripping part and an operation unit;
A cable base that is connected to the proximal end of the connection cable and serves as a gripping part and an operation part,
The cable base is composed of a cable basic body that slides in the axial direction by sliding with the outer tube tube base, and a cable base ring that is connected to the connection cable and is rotatably connected to the cable basic body.
A medical collection bag, wherein the bag rotates following the rotation of the cable base ring. The outer tube tube base is provided with a groove extending in the axial direction and a locking portion provided as a circumferential cut at the end of the groove, while the cable basic body is provided with the groove and the locking portion. The medical recovery bag according to claim 1, wherein one or a plurality of engaging protrusions are formed on the same axis. The medical recovery bag according to any one of claims 1 to 2, wherein the outer tube is formed to have a length of 1000 mm or more and 1800 mm or less. The medical recovery bag according to any one of claims 1 to 3, wherein the outer tube is formed with an outer diameter of 1.4 mm or more and 5.5 mm or less. The medical collection bag according to any one of claims 1 to 4, wherein the elastic wire is housed in an outer tube, and a tip is located inside the outer tube. The medical collection bag according to any one of claims 1 to 5, further comprising means for extruding and expanding the bag from the outer tube and temporarily reopening the bag from the outside. 7. The medical device according to claim 6, wherein the re-deployable means is formed of a string member having one end connected to the proximal end of the bag and the other end extending to the outside through the lumen of the outer tube. Collection bag. The medical recovery bag according to claim 7, wherein a proximal end portion of the string member is connected to the outer tube base. The re-deployable means has one end connected to the proximal end of the bag, passed through the lumen of the outer tube, and the other end connected directly or indirectly to a portion interlocked with the connection cable. The medical collection bag according to claim 6, wherein the medical collection bag is formed so as to include a spring-like elastic member in a part or all thereof. The medical recovery bag according to claim 9, wherein the re-deployable means is formed by connecting the spring-like elastic member and a string member. The medical collection bag according to any one of claims 1 to 10, wherein the collection bag is inserted from a forceps channel or the like of an endoscope and used together with the endoscope.

Images