JP2004195037A

JP2004195037A - Insertion port of medical treatment instrument

Info

Publication number: JP2004195037A
Application number: JP2002369135A
Authority: JP
Inventors: Tadashi Kagaya; 正加賀谷; Masaru Maruyama; 勝丸山
Original assignee: Hakko Co Ltd
Current assignee: Hakko Co Ltd
Priority date: 2002-12-20
Filing date: 2002-12-20
Publication date: 2004-07-15

Abstract

<P>PROBLEM TO BE SOLVED: To provide an insertion port of a medical treatment instrument capable of moving the angle of a mounted treatment instrument largely without a large burden on a human body and safely treating a wide space inside the body cavity from a single incision. <P>SOLUTION: The insertion port 11 consists of a soft and flexible cylindrical port peripheral surface 11, an instrument holder part 12 with rigidity disposed at a proximal end of the port peripheral surface 11 and a mounting means 14 disposed at a distal end of the port peripheral surface for mounting an instrument such as a sheath tube to a body part. The insertion port 11 has such a function as the peripheral surface of the port 11 is flexibly bent according to the angle changing motion when a treatment instrument etc. is held by the instrument holder part 12 and the angle of the instrument is changed with the instrument holder part 12 and the mounting means 14 being fixed (without being deformed). An airtight valve 15 may be mounted inside the insertion port 11. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

【０００１】
【産業上の利用分野】
本発明は、主に内視鏡下外科手術のさいに、体腔内への内視鏡や処置器具の挿入通路となる外套管等において、処置器具類の出入り口となる挿入ポート部分に関する。
【０００２】
【従来の技術】
内視鏡下外科手術は、筒状の外套管を内針と共に経皮的に穿刺して、内針を抜去し、該外套管を通して体腔内に内視鏡や処置器具を挿入し、内視鏡画像を見ながら行う手術として発展してきたが、近年、この手術の適用の広がりや発達、また安全性、確実性が考慮さるなかで、体表に小切開を施し、この切開創を通してリング状などに形成された外套管の遠端側を体腔内に挿着し、体壁を開創した状態で体内外より挟持し、近端側に設けた挿入ポートから体腔内に処置器具を挿入して手術する、内視鏡下小切開手術が行われている。
【０００３】
このような小切開を施しての内視鏡下外科手術に使用する外套管としては、例えば、特開２００２−２８１６３のような切開創保持器具が開示されている。これは、対向配置した体表側リング及び可撓性の体腔内挿入側リングに筒状の弾性部材の両端部を拡張させて固定することにより鼓型に形成され、該体表側リングと体腔内挿入側リングで切開創を開創状態に挟む保持具本体と、該保持具本体の体表側リングに接合手段を介して脱着自在に取り付けられた他種類のプレート部材により基本構成されており、本発明の適用となる処置器具の挿入ポート部に関しては、他の外套管においても一般的と考えられる挿入ポート部として、該明細書中に、プレート部材に気腹手術のさいに気密を維持する弁を複数設けた多弁プレートが開示されている。この多弁プレートの挿入ポート部は、プレート台と一体化された弁基部（ハウジング）内に、気密弁（クロス弁と開口弁の組み合わせ）を備えて構成されている。また、別の外套管における一般的な処置器具の挿入ポートも、基本的にはハウジング内に器具を保持する保持部や気密弁を有して構成されている。
【０００４】
【発明が解決しようとする課題】
しかし、前記した従来の外套管等の挿入ポートでは、挿入ポートに処置器具を挿着して、処置器具の角度を動かした場合、ハウジング（弁基部）や気密弁により処置器具の動作の範囲が規正されてしまうため、安全に外部から操作できる体腔内の範囲は限られたものとなり、広範に処置を行いたい場合は不便で、最悪の場合、処置の必要な部位に処置器具が到達できず、別のルート（切開創）を設ける必要が生じる事態となる可能性も孕んでいる。一方、人体は柔軟であるため、これを無理に大きく動かすことも可能ではあるが、外套管全体が動いてしまうため、該外套管の動作に追従して動く腹壁（切開創）に無理を強いることになり、また外套管全体と腹壁及び処置器具類の相対的位置がずれることで、腹壁固定部からの気腹ガスの漏れ、処置器具挿入部となる保持部の変形による気腹ガスの漏れなどが危惧されることから、結果、患者へ負担を増す事態となり、低侵襲といった内視鏡下手術の主旨から外れたものになってしまうことも考えられる。
【０００５】
そこで本発明は、処置器具等を挿入ポートに装着した状態で、人体に無理なく処置器具等の角度を大きく動かすことができ、一つの切開創から体腔内の広範囲な空間を安全に処置することができる使用勝手に優れた、医療用処置器具の挿入ポートを提供することを課題とした。
【０００６】
【課題を解決するための手段】
本発明の医療用処置器具挿入ポートは、柔軟で屈曲自在な可撓性樹脂により形成する筒状のポート周面と、該ポート周面の近端部に設ける、剛性を有する可撓性樹脂より形成する器具保持部と、前記ポート周面の遠端部に設ける、外套管等の本体部への装着手段より構成し、前記器具保持部に、前記挿入ポートの内腔と連通する挿入孔を設け、該挿入孔の孔面と当接させて処置器具等を保持して該処置器具等の角度を変更するさい、前記器具保持部と器具等の当接部、及び、前記装着手段は固定されたまま（形状が変形することがなく）、前記ポート周面が、変更動作に追従して自在な屈曲を可能とする機能を備えた挿入ポートとした。
【０００７】
また、前記挿入ポートは内部に、前記したポート周面の自在な屈曲を妨げない弾性を有する気密弁を設けて構成した。例えば、前記器具保持部より連接一体化され、挿入ポート周面に囲繞されるダックビル弁等で有ればよい。
【０００８】
更に、前記挿入ポート周面を形成する柔軟で屈曲自在な可撓性樹脂は、ゴム弾性を有するシート状樹脂より形成すると一層良い。
【０００９】
前記剛性を有する器具保持部と、柔軟なポート周面との硬軟を変化させる手段として、異なる硬度を有する同じ樹脂、または、異なった樹脂により各々を形成する手段を用いる。
【００１０】
また、前記剛性を有する器具保持部と、柔軟な挿入ポート周面との硬軟を変化させる別の手段として、同じ材料の樹脂を異なった厚さで形成する手段を用いる。尚、該手段あるいは、前段の手段のいずれを選択するかは、状況に応じより利点の多い方を選択すれば良く、また器具保持部に補強材を用いるなどの別の手段によっても同一の作用が得られれば良い。
【００１１】
【作用】
本手段によれば、挿入ポートに挿着した処置器具は、器具保持部と処置器具の接触部及び外套管本体部への装着手段が固定されたまま、かつ、外套管全体（人体への装着部を含む）を動かすことなく、柔軟なポート周面のみが自在に屈曲し、体腔に対する処置器具の角度が大きく自在に変えられるため、体腔内の広範囲な部分に、人体や器具に無理なく処置器具先端の操作部分を到達させることができる。
【００１２】
また、挿入ポートに弾性を有する気密弁を内包すると、前段の作用を大きく損なうことなく気腹手術に適応した挿入ポートとすることが可能で、更に前記ポート周面を弾性を有する柔軟な可撓性樹脂で形成することで屈曲と共に、伸縮も可能となり更に前記作用を助長させることができる。
【００１３】
更に、ポート周面と器具保持部の硬軟を変化させる手段として、異なる硬度の材料を使用すれば、硬度を自由に選択できることで、器具保持部には保持に十分な剛性を持たせ、挿入ポートには屈曲自在な適度な柔軟性を持たせることが容易にでき、前記作用をより確実にすることが期待できる。
一方、前記変化の手段として、同一材料で厚さを変える手段を用いると、挿入ポート全体を一体的に形成することが可能となり製造コストを押さえることが期待できる。
【００１４】
【発明の実施の形態】
本発明の実施の形態の一例を図面を用いて詳細に説明する。
【００１５】
図１は、本発明の実施の形態の一例を示す構成図で、外套管に装着した状態を示すものである。挿入ポート１は、処置器具等の通路となる柔軟な円筒状のポート周面１１と、該ポート周面１１の近端側に連設され、処置器具類を挿入し、かつ保持するための円形の挿通孔１３を設けた、器具を保持可能な剛性を有する器具保持部１２と、前記ポート周面１１の遠端側に連設される、後記する外套管２の上リング２１に装着される外套管装着部１４及び、前記器具保持部１２より連接され、挿入ポート周面１１に囲繞され、挿入ポート１に内包される気密弁１５より構成される。一方外套管２は、特定するものではないが実施の一例として、挿入ポート１を装着可能な通孔を有したプレート状の、体壁に装着したさい体表側に置かれる上リング２１と、体腔内に挿入され、前記上リング２１と体壁を挟持して切開創を保持する下リング２３と、円筒状の弾性を有する樹脂を上リング２１と下リング２３に両端部を拡張して固定し、切開創との接触部となり開創状態を維持する弾性部材２２より構成される。ここで、外套管２に設ける挿入ポート１は一つであってもかまわないが、一つの場合は、前記した従来技術の特開２０００−２８１６３の弁プレートであっても類似の作用を生じるため、挿入ポート１複数を一つの外套管２に設けるものであると、本発明特有の特長が際立つものとなりより効果的である。
【００１６】
図２は、本実施の形態の一例の挿入ポート１を示す断面図で、ポート周面１１は、医療用であるため毒性のない、屈曲自在な柔軟で弾性を有する樹脂であれば特定するものではないが、本例においては肉薄のシリコーンゴムを円筒状に形成して用い、その外径や高さは使用状況により選択されるものであるが、自在に屈曲できる作用を十分に発揮するためには内部空間１６を広くとると効果的であり、該外径や高さはスペースとの関係で可能な範囲で大きく取るように配慮されるものである。尚、本例及び明細書のポート周面１１は、円筒状としたが断面が八の字型に広がったもの等を含めたものを指しており、該八の字形状であると更に効果的となる可能性もある。
【００１７】
器具保持部１２は、毒性のない、処置器具を保持する十分な剛性を有する可撓性樹脂で有れば特定するものではないが、本例においては前記ポート周面１１と同一のシリコーンゴムを肉厚とし、前記した処置器具類の挿入口となる挿入孔１３を設けて、挿入ポート周面１１と一体成型して形成した。
また、挿入孔１３は処置器具類の出入り口と共に、該処置器具類を気密的に保持するものであるため、弾性部材を用い、孔径を挿入する処置器具より僅かに小さな外径とすることで、挿入時は、弾性により処置器具により押し広げられて挿入可能で、使用時は、処置器具を挿入孔１３の孔面が締め付けることにより気密的な保持を確実なものとしている。
尚、前記したとおりこの器具保持部１２は挿入ポート１１と別の材料、あるいは同じ材料を硬度を変えて用いても良いが、その場合は、自在に硬度を選択できる利点があるが、２部品を別に成形し組み合わせる必要がありコスト高となる可能性があるは前述の通りである。
【００１８】
外套管装着部１４は、外套管２へ挿入ポート１を取り付け一体化するためのもので、確実に装着されるものであればどのような手段を採ることも可能であるが、本例においては、該外套管挿着部１４をポート周面１１の遠端側に、該ポート周面１１の外周側にリング状に突起させ、シリコーンゴムにより一体成形して連設し、外套管２の上リング２１に設ける円形状の溝２４に該外套管挿着部１４を挿着して取り付けられる。尚、更に確実な装着あるいは気密維持のためには、挿着部に可撓性のＯリング（図示しない）等の装着補助具を取り付け固定する手段を用いると一層効果的となる。
【００１９】
気密弁１４は挿入ポート１に内包され、処置器具を装着して操作するさいにポート周面１１の自在な屈曲を妨げないことが重要な条件となり、確実な気密性に加え、該挿入ポート１の内腔の空間１６を大きく占有しないもの、そして挿入ポート周面１１と同様な柔軟性を有するものが選択される。本例においては、器具保持部１２に連接しポート周面１１に囲繞される、シリコーンゴムにより挿入ポート１全体を一体成型で形成した公知のダックビル弁として構成した。尚、ダックビル弁については一般的であるため説明を省略するが、前記条件を考慮して機能面に支障がない範囲で極力小さく形成される。
この気密弁１４と器具保持部１２の挿入孔１３により、処置器具類を挿入した状態では挿入孔１３により、一方、処置器具類が挿入されない状態では気密弁１４により体腔内の気密は維持されている。
尚、気密弁１４はダックビル弁の他スリット弁、クロス弁、フラップ弁などを上記条件に適合するように用いることもでき、更に気腹の維持が必要ない場合や重要でない場合、あるいは、処置器具を常に挿着した状態で使用する場合などでは気密弁自体を設けなくても良い。
また、本例は機能とコストのバランスを考慮して全ての部位を一体成形で形成したが、機能面を最優先して各部を最適材料で各々成形しても良い。
【００２０】
図３は、本実施の形態の一例の挿入ポートに処置器具を挿着した状態（Ａ）、及び挿入ポートが屈曲した状態（Ｂ）を示す断面の模式図で、処置器具３を挿入ポート１より体腔内に挿入すると、処置器具３と器具保持部１２の挿入孔１３孔面が当接され器具が支持され（図Ａ）、この状態で処置器具３の体腔に対する角度を変えると（図Ｂ）、前記した処置器具３は、挿入孔１３の当接部に支持され器具保持部１２への固定を維持し、かつ器具保持部１２も変形することなく形状を維持した状態を保ち、更に、前記した外套管装着部１４も固定されたまま形状を維持するため、外套管２全体が変形することなく元の人体装着状態を維持して、挿入ポート周面１１のみが屈曲または／かつ伸縮して、処置器具３の角度の変化に対応した曲がった状態となっている。これにより、本発明の最大の特徴である前記作用となる人体や器具類に負担を掛けることなく、気密を維持したまま処置器具３を体腔に対して大きく角度を変えて動かすことが可能となっている。
【００２１】
【発明の効果】
本発明の外套管ポートによれば、前記した作用により、一つの外套管（一カ所の創）より人体や外套管等の器具類に無理なく体腔内の広い範囲に処置器具類の操作部が到達することができ、広範への処置が可能となるため、結果として、内視鏡下外科手術における患者の負担を少なくすることができる。また、前記、広範な処置部に処置器具を到達させる操作が無理なく、自在にできる作用により、取り回しが良く使い勝手に優れた器具となり術者への負担も小さくすることができる。更に、この作用により、これまで内視鏡下手術では困難とされる広範な手術部位への適用が可能となることが考えられ、内視鏡下外科手術の適用の可能性を広げることができる。
【図面の簡単な説明】
【図１】発明の実施の形態の一例を示す構成図であって、被装着体となる外套管を含む全体図
【図２】発明の実施の形態の一例を示す断面図
【図３】発明の実施の形態の一例をであって、処置具を装着した状態の断面を示す模式図
【符号の説明】
１．挿入ポート
１１．挿入ポート周面
１２．器具保持部
１３．挿入孔
１４．外套管装着部
１５．気密弁
１６．空間
２．外套管
２１．上リング
２２．弾性部材
２３．下リング
２４．溝
３．処置器具[0001]
[Industrial applications]
The present invention relates to an insertion port portion serving as an entrance / exit for treatment instruments in an outer tube or the like serving as an insertion passage for an endoscope or a treatment instrument into a body cavity mainly during endoscopic surgery.
[0002]
[Prior art]
Endoscopic surgery involves percutaneously puncturing a tubular mantle with an inner needle, removing the inner needle, inserting an endoscope or treatment instrument into the body cavity through the mantle, and performing endoscopic surgery. Although it has been developed as an operation performed while viewing a mirror image, in recent years, given the spread and development of this operation, as well as safety and certainty, a small incision is made on the body surface and a ring-shaped incision is made through this incision. Insert the treatment instrument into the body cavity through the insertion port provided on the near end side by inserting the distal end side of the mantle tube formed in the body cavity into the body cavity, holding the body wall in a retracted state, and holding it from outside the body. Endoscopic small incision surgery is being performed.
[0003]
As a mantle tube used for endoscopic surgery after making such a small incision, for example, an incision holding device as disclosed in JP-A-2002-28163 is disclosed. This is formed in a drum shape by expanding and fixing both ends of the cylindrical elastic member to the body surface side ring and the flexible body cavity insertion side ring which are arranged opposite to each other, and the body surface side ring is inserted into the body cavity. It is basically composed of a holder main body that sandwiches an incision in a wounded state with a side ring, and another type of plate member detachably attached to a body surface side ring of the holder main body via a joining means. Regarding the insertion port portion of the treatment instrument to be applied, as the insertion port portion which is considered to be common also in other mantle tubes, a plurality of valves for maintaining the airtightness during the pneumoperitoneum operation in the plate member are described in the specification. A multi-valve plate provided is disclosed. The insertion port portion of this multi-valve plate is provided with an airtight valve (a combination of a cross valve and an opening valve) in a valve base (housing) integrated with the plate base. Further, the insertion port of a general treatment instrument in another mantle tube is basically configured to have a holding portion for holding the instrument in the housing and an airtight valve.
[0004]
[Problems to be solved by the invention]
However, in the above-described conventional insertion port such as a mantle tube, when the treatment instrument is inserted into the insertion port and the angle of the treatment instrument is moved, the operation range of the treatment instrument is limited by the housing (valve base) and the airtight valve. Because of the restriction, the range of the body cavity that can be safely operated from the outside is limited, and it is inconvenient if a wide range of treatment is desired, and in the worst case, the treatment instrument cannot reach the site requiring treatment. However, there is a possibility that another route (incision wound) needs to be provided. On the other hand, since the human body is flexible, it is possible to forcibly move it. However, since the entire mantle tube moves, the abdominal wall (incision wound) that moves following the operation of the mantle tube is forced. In addition, since the relative positions of the entire mantle tube and the abdominal wall and the treatment instruments are shifted, insufflation gas leaks from the abdominal wall fixing portion, and insufflation gas leak due to deformation of the holding portion serving as the treatment instrument insertion portion. As a result, the burden on the patient may be increased, which may depart from the purpose of endoscopic surgery such as minimally invasive.
[0005]
Therefore, the present invention is capable of moving the angle of the treatment instrument or the like to a large extent without any difficulty on the human body while the treatment instrument or the like is attached to the insertion port, and safely treating a wide space in the body cavity from one incision. An object of the present invention is to provide a medical treatment instrument insertion port which is excellent in usability and can be used.
[0006]
[Means for Solving the Problems]
The medical treatment instrument insertion port of the present invention comprises a cylindrical port peripheral surface formed of a flexible and bendable flexible resin, and a rigid flexible resin provided at a near end of the port peripheral surface. An instrument holding portion to be formed, provided at a far end of the port peripheral surface, and configured to be attached to a main body portion such as an outer tube, and the instrument holding portion has an insertion hole communicating with a lumen of the insertion port. When the angle of the treatment instrument or the like is changed by holding the treatment instrument or the like by contacting with the hole surface of the insertion hole and changing the angle of the treatment instrument or the like, the contact portion between the instrument holding portion and the instrument or the like and the mounting means are fixed. The insertion port is provided with a function of allowing the port peripheral surface to freely bend following the change operation (without deforming the shape).
[0007]
Further, the insertion port is provided with an airtight valve having elasticity which does not prevent free bending of the peripheral surface of the port. For example, it may be a duck bill valve or the like that is connected and integrated from the instrument holding portion and is surrounded by the insertion port peripheral surface.
[0008]
Further, it is more preferable that the flexible resin that is flexible and bendable forming the peripheral surface of the insertion port is formed of a sheet-like resin having rubber elasticity.
[0009]
As means for changing the hardness between the rigid instrument holding portion and the flexible port peripheral surface, means for forming each of the same resin having different hardness or different resin is used.
[0010]
As another means for changing the hardness of the rigid instrument holding part and the peripheral surface of the flexible insertion port, means for forming resins of the same material with different thicknesses is used. It should be noted that which means or the former means should be selected, depending on the situation, the one having more advantages may be selected, and the same effect can be obtained by another means such as using a reinforcing material for the instrument holding portion. Should be obtained.
[0011]
[Action]
According to this means, the treatment instrument inserted into the insertion port can be used with the instrument holding portion and the contact portion between the treatment instrument and the attachment means to the mantle tube main body fixed, and the entire mantle tube (attachment to the human body) can be performed. Part), and only the flexible port peripheral surface bends freely and the angle of the treatment instrument with respect to the body cavity can be changed freely. The operating part at the tip of the instrument can be reached.
[0012]
In addition, if an elastic airtight valve is included in the insertion port, it is possible to make the insertion port suitable for pneumoperitoneum surgery without significantly impairing the operation of the previous step, and furthermore, the port peripheral surface is made of a flexible flexible material having elasticity. By forming the conductive resin, it is possible to expand and contract as well as to bend, which can further promote the above-mentioned action.
[0013]
Further, if materials having different hardnesses are used as means for changing the hardness of the port peripheral surface and the instrument holding portion, the hardness can be freely selected, so that the instrument holding portion has sufficient rigidity for holding, and the insertion port It is possible to easily provide a suitable flexibility to bend, and it can be expected that the above-mentioned action is further ensured.
On the other hand, if a means for changing the thickness of the same material is used as the means for changing, it is possible to integrally form the entire insertion port, which can be expected to reduce the manufacturing cost.
[0014]
BEST MODE FOR CARRYING OUT THE INVENTION
An example of an embodiment of the present invention will be described in detail with reference to the drawings.
[0015]
FIG. 1 is a configuration diagram showing an example of an embodiment of the present invention, and shows a state where it is mounted on a mantle tube. The insertion port 1 is connected to a flexible cylindrical port peripheral surface 11 serving as a passage for a treatment instrument or the like and a proximal end side of the port peripheral surface 11, and is circular for inserting and holding treatment instruments. An instrument holding portion 12 having a rigidity capable of holding an instrument and having an insertion hole 13 is mounted on an upper ring 21 of an outer tube 2 described later, which is provided continuously on the far end side of the port peripheral surface 11. It is composed of an outer tube mounting portion 14 and an airtight valve 15 which is connected to the device holding portion 12, is surrounded by the insertion port peripheral surface 11, and is included in the insertion port 1. On the other hand, the mantle tube 2 includes, for example, a plate-shaped upper ring 21 having a through hole through which the insertion port 1 can be mounted, the upper ring 21 being placed on the front side of a body wall when the body tube is mounted, and a body cavity. A lower ring 23 inserted into the upper ring 21 and holding the incision by sandwiching the upper ring 21 with the body wall, and a resin having a cylindrical elasticity is fixed to the upper ring 21 and the lower ring 23 by expanding both ends thereof. The elastic member 22 serves as a contact portion with the incision and maintains the wound state. Here, the insertion port 1 provided in the mantle tube 2 may be one, but in the case of one, even if the valve plate of the above-mentioned prior art JP-A-2000-28163 produces a similar effect. In the case where a plurality of insertion ports 1 are provided in one mantle tube 2, the unique features of the present invention stand out and are more effective.
[0016]
FIG. 2 is a cross-sectional view illustrating the insertion port 1 according to an example of the present embodiment. The port peripheral surface 11 is a non-toxic, flexible, flexible and elastic resin specified for medical use. Although it is not, in this example, a thin silicone rubber is formed into a cylindrical shape and used, and its outer diameter and height are selected according to the use condition, but in order to sufficiently exert the function of freely bending. It is effective to make the internal space 16 wider, and the outer diameter and the height are considered to be as large as possible in relation to the space. In addition, the port peripheral surface 11 in this example and the specification refers to a shape including a cylindrical shape but a cross-sectional shape spreading in an eight-shape and the like, and the eight-shape is more effective. It is possible that
[0017]
The instrument holding portion 12 is not specified as long as it is a non-toxic, flexible resin having sufficient rigidity to hold the treatment instrument, but in this example, the same silicone rubber as the port peripheral surface 11 is used. It was made thicker, provided with an insertion hole 13 serving as an insertion port for the above-mentioned treatment instruments, and integrally molded with the insertion port peripheral surface 11.
In addition, since the insertion hole 13 is for holding the treatment instruments airtight together with the entrance and exit of the treatment instruments, by using an elastic member, the outer diameter is slightly smaller than that of the treatment instrument into which the hole is inserted. At the time of insertion, the treatment instrument can be inserted by being expanded by elasticity by elasticity, and at the time of use, the treatment instrument is secured in an airtight manner by tightening the hole surface of the insertion hole 13.
As described above, the instrument holding portion 12 may be made of a different material from the insertion port 11 or the same material with a different hardness. In this case, there is an advantage that the hardness can be freely selected. Need to be separately formed and combined, which may increase the cost as described above.
[0018]
The mantle tube mounting part 14 is for attaching the insertion port 1 to the mantle tube 2 and integrating it, and any means can be adopted as long as it can be securely mounted. The outer tube insertion portion 14 is formed in a ring shape on the far end of the port peripheral surface 11 and on the outer peripheral side of the port peripheral surface 11, and is integrally formed with silicone rubber so as to be continuously connected. The outer tube insertion portion 14 is inserted and attached to a circular groove 24 provided in the ring 21. For more secure mounting or airtight maintenance, it is more effective to use means for attaching and fixing a mounting aid such as a flexible O-ring (not shown) to the insertion portion.
[0019]
The airtight valve 14 is included in the insertion port 1, and it is important that the flexible operation of the port peripheral surface 11 is not prevented when the treatment instrument is mounted and operated. One that does not occupy much of the lumen space 16 and one that has the same flexibility as the insertion port peripheral surface 11 is selected. In the present embodiment, a known duckbill valve is formed by integrally molding the entire insertion port 1 by silicone rubber, which is connected to the instrument holding portion 12 and is surrounded by the port peripheral surface 11. The duckbill valve is generally used and therefore will not be described. However, the duckbill valve is formed as small as possible in consideration of the above conditions as long as the function is not hindered.
With the airtight valve 14 and the insertion hole 13 of the instrument holding part 12, the airtightness in the body cavity is maintained by the insertion hole 13 when the treatment instrument is inserted, and by the airtight valve 14 when the treatment instrument is not inserted. I have.
In addition, the airtight valve 14 can use a slit valve, a cross valve, a flap valve or the like in addition to a duckbill valve so as to meet the above conditions. Further, when maintenance of insufflation is not necessary or important, or when a treatment instrument is used. In the case where the airtight valve is always used, the airtight valve itself may not be provided.
Further, in this example, all parts are formed by integral molding in consideration of the balance between function and cost. However, each part may be molded with an optimum material with the highest priority on the functional surface.
[0020]
FIG. 3 is a schematic cross-sectional view showing a state (A) in which the treatment instrument is inserted into the insertion port according to an example of the present embodiment and a state (B) in which the insertion port is bent. When the treatment instrument 3 is further inserted into the body cavity, the treatment instrument 3 and the insertion hole 13 of the instrument holding portion 12 are brought into contact with each other to support the instrument (FIG. A). When the angle of the treatment instrument 3 with respect to the body cavity is changed in this state (FIG. B) ), The treatment instrument 3 is supported by the contact portion of the insertion hole 13, maintains the fixation to the instrument holding portion 12, and maintains the shape of the instrument holding portion 12 without being deformed. In order to maintain the shape of the above-mentioned outer tube mounting portion 14 while being fixed, only the insertion port peripheral surface 11 bends and / or expands and contracts while maintaining the original human body mounted state without deforming the entire outer tube 2. And bent according to the change in the angle of the treatment instrument 3 It has been on purpose. This makes it possible to move the treatment instrument 3 at a large angle with respect to the body cavity while maintaining airtightness, without imposing a burden on the human body and instruments that have the above-described function, which is the greatest feature of the present invention. ing.
[0021]
【The invention's effect】
According to the mantle tube port of the present invention, due to the above-described action, the operation unit of the treatment instrument can be easily spread over a wide range within the body cavity from one mantle tube (one wound) to instruments such as the human body and the mantle tube. As a result, the burden on the patient during endoscopic surgery can be reduced. In addition, the operation of allowing the treatment instrument to reach the wide range of treatment units without difficulty and freely can be achieved, so that the instrument is easy to handle and easy to use, and the burden on the operator can be reduced. In addition, it is considered that this action can be applied to a wide range of surgical sites that have been difficult to perform with endoscopic surgery, thereby expanding the possibility of applying endoscopic surgery. .
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing an example of an embodiment of the present invention, and is an overall view including an outer tube to be a mounted body. FIG. 2 is a cross-sectional view showing an example of an embodiment of the invention. FIG. 1 is a schematic view showing a cross section of a state in which a treatment tool is mounted according to an embodiment of the present invention.
1. Insertion port 11. 11. Insert port peripheral surface Instrument holding part 13. Insertion hole 14. Mantle tube mounting part 15. Airtight valve 16. Space2. Mantle tube 21. Upper ring 22. Elastic member 23. Lower ring 24. Groove 3. Treatment instrument

Claims

In an insertion port such as an outer tube, which serves as an entrance / exit of an endoscope or a treatment instrument, a cylindrical port peripheral surface formed of a flexible and bendable flexible resin,
An instrument holding portion formed of a flexible resin having rigidity, provided at a near end portion of the port peripheral surface,
An insertion port for a medical treatment instrument, comprising: means for attaching to a main body such as a mantle tube provided at a far end of the port peripheral surface.

The instrument holding section is provided with an insertion hole communicating with the lumen of the insertion port. 2. The port peripheral surface can freely bend following the changing operation while the contact portion between the device holding portion and the device or the like and the mounting means are fixed (without being deformed). Insertion port for medical treatment instruments.

3. The insertion port of the medical treatment instrument according to claim 1, further comprising an elastic airtight valve included in the insertion port.

4. The insertion port for a medical treatment instrument according to claim 1, wherein the flexible resin that forms the peripheral surface of the port is formed of a sheet-like resin having rubber elasticity.

5. The insertion port for a medical treatment instrument according to claim 1, wherein the rigid instrument holding portion and the flexible port peripheral surface are formed of the same or different resins having different hardness.

The insertion port for a medical treatment instrument according to any one of claims 1 to 4, wherein the rigid instrument holding portion and the flexible port peripheral surface are formed of resin of the same material with different thicknesses.