Smoke and liquid discharge tube equipped with nozzle

Abstract

The purpose of the present invention is to provide a smoke and liquid discharge tube equipped with a nozzle, said tube enabling the position of a suction port to be adjusted on a forceps part such as an electrosurgical unit (forceps) and being capable of simultaneously suctioning and discharging both liquid and surgical smoke such as smoke or mist.　A smoke and liquid discharge tube equipped with a nozzle (1) according to the present invention comprises a tube body (2) in which a main lumen (3), which has open front and rear ends and into which a medical device is inserted and retained in the axial direction, and a suction lumen (5), which has open front and rear ends and is positioned inside in the axial direction, are formed in parallel. On the outer periphery of the front end of the tube body (2) where the suction lumen (5) is formed, a nozzle part (6) that has an arc-shaped cross section and protrudes and extends forward by a prescribed length from the front-end opening of the main lumen is formed so as to be bendable. A metal wire is embedded in the nozzle part, the metal wire bending the nozzle part and retaining the shape thereof. The front-end opening of the nozzle part is formed as a first liquid discharge port (8). A second liquid discharge port (10) that opens to communicate with the suction lumen is formed in the outward-facing peripheral wall of an axially intermediate part, and an exhaust port (11) that opens to communicate with the suction lumen is formed in the inward-facing peripheral wall near the front-end opening of the main lumen on the rear-end side of the nozzle part.

Description

Smoke and liquid drainage tube with nozzle

[0001] This invention relates to a smoke and liquid exhaust tube with a nozzle, and more specifically to a tube that can be attached to medical devices such as tiltable forceps or electrosurgical units (forceps) and can simultaneously aspirate and discharge both smoke and liquid.

[0002] In surgical treatment of cancer, it is essential to remove the organ in which the cancer has developed. Currently, many cancer removal surgeries are performed using laparoscopic techniques, where surgical instruments such as laparoscopes and forceps are inserted into the abdominal cavity via trocars to minimize invasiveness to the patient. Furthermore, when removing cancer, organs are fixed within the body cavity by membranes, so these tissues are cut to free the organ before the necessary portion is removed. At this time, it is extremely important to accurately visualize and dissect the boundary between the organ and the tissue in order to prevent damage to organs, blood vessels, nerves, etc.

[0003] In cases of advanced cancer, chemotherapy (anti-cancer drug treatment) or radiation therapy may be performed before surgery to shrink the tumor or reduce the recurrence rate. In patients who have undergone these treatments, tissue edema occurs, and when tissue is cut, a large amount of exudate is generated and accumulates in the area to be cut, making it difficult to visualize and accurately cut structures such as membrane boundaries, blood vessels, and nerves. Therefore, the risk of bleeding and nerve damage increases, and it may become difficult to perform surgery safely. In addition, if these fluids are present in the area to be cut, energy devices such as electrosurgical units cannot be used effectively, or the heat from the energy device causes the fluid to evaporate, generating smoke or mist, which obscures the endoscopic view and necessitates a temporary suspension of surgery. In particular, when bleeding occurs, hemostasis must be performed as quickly as possible, so careful handling is required to prevent smoke or other obstructions to the view. For this reason, surgeons use suction tubes (metal pipes) to aspirate and remove these fluids from the body.

[0004] In addition, in laparoscopic surgery, which is minimally invasive surgery, a trocar is placed in a small incision, and a linear surgical instrument is inserted through the trocar to perform the surgery. Therefore, depending on the surgical site, there are places where the instrument is difficult to reach. In such cases, in order to change the insertion direction of the instrument, the surgery is performed by inserting the instrument through another trocar.

[0005] Therefore, in recent years, in order to be able to access the surgical site without changing the insertion direction of the instrument, forceps with a tiltable tip for laparoscopic surgical instruments are being developed. Also, as one type of laparoscopic surgery, robot-assisted surgery using a surgical robot has been increasing. In a surgical robot, surgery is performed by attaching instruments such as an electric scalpel and forceps to the arm. This instrument also has a tiltable tip, enabling delicate movements. However, since a straight metal pipe is used for the suction tube, the tip cannot be tilted. Therefore, when using a suction tube together with an instrument whose tip tilts, when treating deep organs away from the trocar placement position, the suction tube cannot follow the tilting instrument, resulting in problems such as being unable to suck the stored liquid.

[0006] Therefore, the applicant previously proposed Patent No. 6869504 (Patent Document 1). This patent connects the port body and the electric scalpel mounting part with a connecting tube, enabling the dripping of irrigation fluid and the exhaust of mist. However, since the one in this Patent Document 1 was developed for an instrument whose tip of the electric scalpel mounting part does not tilt, when attached to an instrument whose tip tilts, it cannot follow the tilting of the instrument, resulting in a deviation between the direction of the tip of the electric scalpel mounting part and the direction of the tip of the instrument, and being unable to suck the drainage that leaks out and accumulates on the tip side of the instrument. Also, although the one in Patent Document 1 has a function of sucking mist from the suction port and exhausting (smoking), there was a problem that it does not have a drainage function and thus cannot process the stored leachate.

[0007] Japanese Patent No. 6869504 Gazette (Figs. 2, 6)

[0008] Therefore, the present invention aims to solve the aforementioned problems of the conventional methods and to provide a smoke and liquid exhaust tube with a nozzle that can simultaneously suction and discharge both surgical smoke such as smoke and mist, and liquid, even in endoscopic surgical instruments or robotic instruments with tilting tips, as the suction port can be adjusted in position to correspond to the tilting of the tip of an electrosurgical instrument (forceps), etc.

[0009] To solve the aforementioned problems, the invention described in claim 1 is a nozzle-equipped smoke and liquid exhaust tube used in laparoscopic surgery to simultaneously aspirate and discharge both surgical smoke such as smoke or mist and liquid, comprising a tube body having a main lumen with front and rear ends open and a suction lumen formed in parallel with a main lumen with front and rear ends open and a suction lumen formed in parallel with a main lumen with front and rear ends open and a suction lumen formed in parallel with a main lumen with front and rear ends open and a suction lumen formed in parallel with a main lumen with front ends open with front ends open with front ends open

[0010] The invention described in claim 2 is as described in claim 1, wherein the metal wire is provided on both sides of the suction lumen in the nozzle portion.

[0011] As described above, the present invention, according to claim 1, comprises a tube body having a main lumen with front and rear ends open and an axial interior into which the medical device is inserted and held, and a suction lumen with front and rear ends open and an axial interior formed in parallel. A nozzle portion with a circular arc cross-section is formed flexibly on the outer circumference of the front end where the suction lumen is formed, projecting forward by a predetermined length from the front end opening of the main lumen. A metal wire is embedded in the nozzle portion to bend and maintain its shape. The front end opening of the nozzle portion is formed as a first drain port, a second drain port is formed on the outward-facing circumferential wall of the axial middle portion and communicates with the suction lumen, and an exhaust port is formed on the inward-facing circumferential wall near the front end opening of the main lumen at the rear end of the nozzle portion and communicates with the suction lumen. Therefore, the tip of the nozzle portion can be adjusted via the metal wire to correspond to the tilting of the tip of an electrosurgical unit (forceps) or the like. As a result, the misalignment between the orientation of the tip of the electrosurgical unit attachment and the orientation of the instrument tip, as in the conventional method, is eliminated. Furthermore, it becomes possible to drain liquid from the first and second drain ports, and to exhaust smoke from the exhaust port.

[0012] According to the invention described in claim 2, since metal wires are provided on both sides of the suction lumen in the nozzle portion, the nozzle portion can be bent in a well-balanced manner.

[0013] This is a partially omitted front view of a nozzle-equipped smoke drain tube according to one embodiment of the present invention. This is an enlarged left side view of Figure 1. This is an enlarged end view along line A-A in Figure 1. This is an enlarged end view along line B-B in Figure 1. This is an enlarged end view along line C-C in Figure 1. This is an enlarged end view along line D-D in Figure 1. This is an enlarged end view along line E-E in Figure 1. This is a partially omitted cross-sectional view of a smoke drain tube. This is a partially enlarged cross-sectional view of the tip side of the smoke drain tube. This is a partially omitted plan view of a smoke drain tube. This is a partially omitted bottom view of the tip side of the smoke drain tube. This is a bottom view showing another embodiment in which a closing piece is used instead of the covering tube shown above. This is an enlarged end view along line F-F in Figure 12. This is an enlarged end view showing a modified example of the closing piece shown above. (A) to (D) are drawings for explaining the operation.

[0014] The following description of an embodiment of a smoke exhaust tube with a nozzle will be given with reference to the drawings.

[0015] In Figures 1 to 8, 1 is a smoke and liquid exhaust tube with a nozzle, and this smoke and liquid exhaust tube 1 comprises a tube body 2 made of silicone rubber or the like, which is suitable for living organisms. The tube body 2 is integrally formed with a main body portion 2a with a circular cross-section and a main body portion 2b with an arc-shaped cross-section, which are parallel in the axial direction (Figures 1 and 5). The main body portion 2a has openings at the front and rear ends and a main lumen (cavity) 3 formed in the axial direction for inserting and holding medical instruments such as forceps. The main body portion 2b has openings at the front and rear ends and a suction lumen 5 formed in the axial direction. At the front end of the main body portion 2b where the suction lumen 5 is formed, a flat nozzle portion 6 is formed, which is integral with the front end of the main body portion 2b and extends horizontally forward for a predetermined length, as shown in Figure 1.

[0016] The nozzle section 6 is flexible, and a suction lumen 7 is formed axially inward in the nozzle section, communicating with the suction lumen 5 at its rear end opening, with the front end opening forming a drain port 8 (Figures 2 and 9). A drain port 10 is formed on the outward-facing circumferential wall in the axial middle section slightly behind the drain port 8, communicating with the suction lumen 7. Furthermore, an exhaust port 11 is formed on the inward-facing circumferential wall, further behind the drain port 10 and near the front end opening of the main lumen 3, communicating with the suction lumen 5. The exhaust port 11 and the drain port 10 are positioned opposite each other in the circumferential direction of the nozzle section 6. In the above, the outward-facing circumferential wall on which the drain port 10 is formed refers to the outer circumferential wall (upper wall) when viewed from the center of the main body section 2a of the tube body 2 shown in Figure 4, and similarly, the inward-facing circumferential wall on which the exhaust port 11 is formed refers to the inner circumferential wall (lower wall).

[0017] The drainage port 8 at the front end of the nozzle 6 is for aspirating fluids such as exudate and blood that have accumulated in the body during the procedure. The drainage port 11 in the middle is for aspirating fluids that seep out from the outside of the nozzle 6 (around the surgical site, etc.). In particular, when lifting tissue with forceps to secure a clear view of the treatment area, the tip of the nozzle 6 may not be positioned in the area where the exudate has accumulated, making efficient aspiration and drainage impossible. The drainage port 11 is provided to prevent this from happening.

[0018] The drain port 10 is located in the middle of the nozzle section 6, but it is more preferable to position it slightly towards the front, as shown in the figure. This is because when the nozzle section 6 is bent, it is more likely to be located in the reservoir where leachate and other liquids accumulate. The exhaust port 11 is located at the rear end of the nozzle section 6, but it is more preferable to position it directly above the source of surgical smoke, which is generated when liquid evaporates due to heat from an electrosurgical unit or the like, as this smoke is generated in large quantities from the pincers (base). The size of the exhaust port 11 is equal to the cross-sectional area of ​​the suction lumen 7 of the nozzle section 6 in order to maximize the exhaust flow velocity. If the size of the drain port 10 is too large, it will not be possible to drain liquid from the drain port 8, and if it is too small, it will not be possible to drain liquid from the drain port 10. Therefore, the size is set to be 1 / 2 to 1 / 3 the cross-sectional area of ​​the suction lumen 7, which is a size that satisfies both of these conditions.

[0019] A metal wire 13, such as stainless steel, is embedded between the nozzle portion 6 and the front end of the main body portion 2b (Figure 1). By grasping a portion of this metal wire with forceps inserted from another trocar and applying a predetermined force, the nozzle portion 6 can be bent to any angle. In other words, since the metal wire 13 is made of stainless steel or the like, it can maintain its shape and is thin enough to be bent by the forceps of a surgical robot. In this case, the metal wire 13 is provided on both sides of the suction lumen 7 in the nozzle portion 6, in order to bend the nozzle portion 6 in a balanced manner up, down, left, and right. However, providing it on both sides of the suction lumen 7 is just a preferred example, and other arrangements are also possible.

[0020] An axial slit 15 is formed along almost its entire length on the peripheral wall of the main body portion 2a on the side facing the main lumen 3 (Figures 5 and 11). This causes the main body portion 2a containing the main lumen 3 to open at the slit 15, allowing forceps and other instruments with a larger outer diameter than the main lumen 3 to be accepted.

[0021] At the front end of the main body 2a, an expandable covering tube 16 is provided so as to wrap around the outer circumference of the main body 2a from below. The covering tube 16 suppresses the degree to which the slit 15 at the tip opens when forceps or the like with an outer diameter larger than that of the main lumen 3 are received, thereby enabling effective holding of forceps or the like (Figure 4). At the rear end of the tube body 2, a non-expandable fixing tube 17 is provided so as to wrap around the outer circumference of the tube body 2 (main body 2b and main body 2a) from above (Figure 6). The fixing tube 17 is for maintaining the shape of the main lumen 3 and prevents forceps or the like received in the main lumen 3 from coming out of the slit 15.

[0022] A suction tube 18, which communicates with the suction lumen 5, is connected to the rear end of the tube body 2, and a connector 19, which connects to a suction device (not shown), is provided at the other end of the suction tube 18 (Figure 1).

[0023] Figures 12 and 13 show another embodiment in which the covering tube 16 is replaced by an expandable closing piece 21 that closes the slit 15 at the front end of the main body portion 2a. The closing piece 21 is made of a highly expandable material, such as silicone rubber, and has the function of closing a portion of the slit 15. It is provided along the line of the slit 15 so as to form the peripheral wall of the front end of the main body portion 2a where the slit 15 is formed. As a result, the tube body 2 has a structure in which the slit 15 does not open at the closing piece 21, and while it expands and contracts to accept forceps or the like to be inserted, after acceptance it can hold the forceps or the like in a fixed state, preventing it from becoming impossible to hold.

[0024] Moreover, as is clear from the figure, the closing piece 21 is provided with equal wall thickness so that it is embedded in a portion of the cut-out section that sandwiches the slit 15. Therefore, not only the inner surface but also the outer surface is smooth, and thus insertion into a trocar or the like is smooth, resulting in good insertability.

[0025] Figure 14 shows a modified example of the closing piece 21. In this example, the slit 15 is formed until it reaches the front end opening of the main body 2a, and a closing piece 22 made of a highly elastic material is attached to the inner circumferential surface of the front end of the main body 2a where the slit is formed, at the same position as the closing piece 21. The closing piece 22 in this modified example has the same function as the closing piece 21. In this case, it can be added after the tube body 2 with the slit has been formed, making it easier to install than the closing piece 21. Figure 7 shows 23, which is a hole-filling member for the suction lumen 5.

[0026] Next, the method of use will be explained with reference to Figure 15. In the figure, F represents an electrosurgical unit as an instrument. As shown in Figure 15(A), the exhaust smoke and drainage tube 1 with a nozzle is attached to the electrosurgical unit F with the nozzle portion 6 unbent and inserted into the body, after which the nozzle portion 6 is bent to a predetermined angle. There are two methods for this bending: one is to bend the nozzle portion 6 using forceps inserted through another port after insertion into the body, and the other is to bend the nozzle portion 6 to the desired shape with fingers, etc., before insertion into the body. However, if the bending angle of the nozzle portion 6 is too large, it will not be possible to insert it into the port lumen, so it is common to bend the nozzle portion 6 using forceps inserted through another port after insertion, and this method is widely used. This embodiment also adopts this method.

[0027] Furthermore, when bending the nozzle portion 6, if the tubular nozzle portion 6 has a circular cross-section, it cannot follow the shape of the metal wire 13. For this reason, the nozzle portion 6 has an elliptical cross-section. In addition, by embedding the metal wire 13 on both sides in the direction of the major axis of the ellipse, rotational misalignment between the nozzle portion 6 and the metal wire 13 when bending the nozzle portion 6 is prevented.

[0028] Figures 15(B), (C), and (D) are illustrative diagrams showing the bending changes of the nozzle portion 6. (B) shows the state in which the tip of the nozzle portion 6 is bent in the same direction as the downward movement of the scissors of the electrosurgical unit F (relatively strong curvature). (C) shows the state in which the tip of the nozzle portion 6 is bent slightly upward horizontally when the scissors are facing straight (relatively weak curvature). (D) shows the state in which the tip of the nozzle portion 6 is bent slightly upward curvature when the scissors are facing straight.

[0029] In this way, the nozzle section 6 can be bent at various angles via the metal wire 13. Moreover, since the metal wire 13 is embedded in almost the entire surface of the nozzle section 6, it is possible to bend the nozzle section 6 evenly in all directions, such as up, down, left, right, or in two stages.

[0030] As described above, by using the nozzle-equipped smoke and liquid exhaust tube 1, the tip of the nozzle section 6 can be made to follow the changes in the tip of the electrosurgical unit F, so that liquid generated during surgery can be guided from the drainage port 8 to the suction lumens 7 and 5 and drained from the suction tube 18. Even if the liquid is above the nozzle section 6, the drainage port 10 can receive the liquid and guide it from the suction lumen 7 to the suction lumen 5, and drain it from the suction tube 18. In addition, mist and other substances generated by the use of the electrosurgical unit F can be guided from the exhaust port 11 to the suction lumens 7 and 5 and exhausted from the suction tube 18. Therefore, it becomes possible to process exhaust gases that were not possible with conventional methods.

[0031] As described above, the nozzle section 6 can be changed according to the direction of the tip of the electrosurgical scalpel F by bending the metal wire 13. This eliminates the problem of not being able to follow the tilting of the instrument (forceps) with a tilting tip, as in the conventional design, and thus being unable to suction the drainage fluid that seeps out and accumulates at the tip of the instrument. Moreover, drainage is possible not only from the drainage port 8 at the front end of the nozzle 6, but also from the drainage port 10 located in the middle in the axial direction, thus improving drainage efficiency. Furthermore, smoke and mist generated near the scissors body of the electrosurgical scalpel F can be exhausted from the exhaust port 11, improving smoke exhaust efficiency compared to the conventional design.

[0032] It should be noted that the configuration of the nozzle portion 6 shown in the embodiment is merely a preferred example, and does not preclude other modifications regarding its shape and detailed configuration. Furthermore, the components of the tube body 2, such as the main body portions 2a and 2b, are also merely examples, and may have shapes and structures other than those shown. Additionally, the shape and number of the drain port 10 and exhaust port 11 are arbitrary, and their design can be modified as appropriate during implementation without altering the overall essence.

[0033] 1. Smoke and liquid drainage tube with nozzle 2. Tube body 2a, 2b Main body section 3. Main lumen (hollow section) 5, 7. Suction lumen 6. Nozzle section 8, 10. Drainage port 11. Exhaust port 13. Metal wire 15. Axial slit 16. Covering tube 17. Fixing tube 18. Suction tube 19. Connector 21, 22. Closing piece F. Electrosurgical unit

Claims

1. A nozzle-equipped smoke and liquid exhaust tube used for simultaneously aspirating and discharging both surgical smoke, such as smoke or mist, and liquid in laparoscopic surgery, comprising a tube body having a main lumen with openings at both front and rear ends and an axial interior into which the medical device is inserted and held, and a suction lumen with openings at both front and rear ends and an axial interior arranged in parallel, wherein a bendable nozzle portion with an arc-shaped cross-section is formed on the outer circumference of the front end where the suction lumen is formed, projecting forward by a predetermined length from the front end opening of the main lumen, a metal wire is embedded in the nozzle portion to maintain its shape by bending the nozzle portion, the front end opening of the nozzle portion is formed as a first drainage port, a second drainage port is formed on the outward-facing circumferential wall of the axial middle portion and is in communication with the suction lumen, and an exhaust port is formed on the inward-facing circumferential wall near the front end opening of the main lumen on the rear end side of the nozzle portion and is in communication with the suction lumen.

2. The nozzle-equipped exhaust tube with a metal wire provided on both sides of the suction lumen in the nozzle portion, as described in claim 1.

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