Peeling suction pipe

Abstract

To provide a peeling suction pipe which can avoid interference with surrounding tissues and a medical device which is used in combination therewith, even in a surgery in which an introduction path to a surgery position is restricted, and operation can be facilitated.SOLUTION: A peeling suction pipe 1 comprises: a cylindrical nozzle 2; and a flexible tube 3 connected to the nozzle. On an outer peripheral face of the nozzle 2 or on a pole 203 erected from the outer peripheral face of the nozzle 2, as gripping stabilization means which can be gripped by a jaw of forceps, there are provided a clamp surface 25 facing the gripping surface of the jaw, and / or an engagement part for engaging the jaw. The nozzle 2 has a whole length of 30 mm or more and 60 mm or less. The engagement part is formed to incline a shaft of the forceps to an axis of the nozzle 2, by engagement with the jaw, and an inclination angle of the engagement part is preferably 5 degrees or more and 35 degrees or smaller.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] The present invention relates to a dissection and aspiration tube used for dissecting biological tissues and aspirating body fluids, cleaning fluids, etc. in surgical operations.

Background Art

[0002] Conventionally, in the field of medical aspiration tubes, there is known a technique of a dissection and aspiration tube that has a function of dissecting biological tissues in addition to the function of aspirating an object to be aspirated such as body fluids during surgery. For example, Patent Document 1 describes a dissection and aspiration tube having a rigid aspiration tube body, a handle that is connected to the aspiration tube body outside the body and is grasped by a surgeon, and an aspiration tube that communicates the lumen of the aspiration tube body through the handle.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] According to the dissection and aspiration tube of Patent Document 1, while bluntly dissecting by pressing the tip of the aspiration tube body against biological tissues, the dissected tissues, exuded body fluids, etc. can be aspirated and removed from the surgical field, and the surgery can be advanced efficiently. However, when the surgical site is deep inside the body and the distance from the body surface is long, or when inserting the dissection and aspiration tube through an insertion hole provided on the body surface such as in endoscopic surgery, in cases where the introduction path to the surgical site is restricted, the long, straight tubular aspiration tube body may interfere with the tissues around the surgical field and the medical instruments used in combination, and the dissection and aspiration operations may be difficult.

[0005] Therefore, an object of the present invention is to provide a dissection and aspiration tube that can be easily maneuvered, such as avoiding interference with surrounding tissues and medical instruments used in combination, even in surgeries where the introduction path to the surgical site is restricted.

Means for Solving the Problem

[0006] The peeling and suction tube of the present invention is composed of a cylindrical nozzle and a flexible tube connected to the nozzle, and a gripping stabilization means that can be clamped by the jaws of the forceps is provided on the outer peripheral surface of the nozzle or on a support column erected from the outer peripheral surface of the nozzle.

[0007] The peeling and suction tube is preferably configured or formed as follows. · The gripping stabilization means is a clamping surface facing the gripping surface of the jaws and / or an engaging portion for locking the jaws. · The engaging portion is formed so as to incline the shaft of the forceps with respect to the axis of the nozzle by engaging with the jaws, and the inclination angle is 5 degrees or more and 35 degrees or less. · The engaging portion is formed as a protrusion, and a plurality of the protrusions are provided, and each of the protrusions is formed in a different size. · The engaging portion is a ridge erected along the longitudinal direction of the nozzle. · The total length of the nozzle is 30 mm or more and 60 mm or less. · The peeling and suction tube is applied to robot-assisted endoscopic surgery.

[0008] (Function) According to the peeling and suction tube of the above means, it is composed of a cylindrical nozzle and a flexible tube connected to the nozzle, and a gripping stabilization means that can be clamped by the jaws of the forceps is formed on the outer peripheral surface of the nozzle or on a support column erected from the outer peripheral surface of the nozzle. Thus, the nozzle previously inserted into the surgical field can be gripped by the forceps by the surgeon and guided to a desired position, and while pressing the tip of the nozzle against the biological tissue and peeling it, it is possible to suck the peeled tissue, exuded body fluid, etc.

[0009] In addition, when the total length of the nozzle is 30 mm or more and 60 mm or less, it has a sufficient total length to form a nozzle tip portion used for the peeling operation, a gripping portion gripped by forceps, and a tube connection portion. Moreover, since the rigid nozzle is formed to be short, even in a narrow surgical field, peeling and suction operations can be performed while avoiding interference with surrounding tissues and medical instruments used in combination.

[0010] In addition, when the gripping stabilization means is a clamp surface facing the gripping surface of the jaw, the contact range with the gripping surface of the forceps can be widened compared to the cylindrical nozzle peripheral surface. Further, when the gripping stabilization means is an engaging portion that locks the jaw, when an external force is applied to the nozzle during a peeling operation or the like, the sliding of the jaw is suppressed, preventing the gripping from slipping. By these means, the fixation between the jaw and the nozzle becomes even more stable.

[0011] Furthermore, when the engaging portion is formed so as to incline the shaft of the forceps with respect to the axis of the nozzle by engaging with the jaw, since the shaft is obliquely arranged with respect to the tube connected coaxially with the nozzle, interference between the tube and the shaft during forceps operation can be avoided.

[0012] Furthermore, when the engaging portion is a protrusion, when being gripped by forceps having a cutout portion in the jaw, the protrusion can be fitted into the cutout portion, making the fixation of the nozzle even more stable. Also, when a plurality of protrusions are provided, the jaw can be sandwiched between the two protrusions to make the fixation of the nozzle even more stable. In addition, when each of the plurality of protrusions is formed in a different size, the protrusions can be fitted into the cutout portions of jaws having various shapes and sizes.

Advantages of the Invention

[0013] According to the above means, it is possible to provide a peeling and suction tube that is easy to handle, such as being able to perform operations while avoiding interference with surrounding tissues and medical instruments used in combination, even in surgeries where the introduction path to the surgical site is restricted.

Brief Description of the Drawings

[0014]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

Figure 11

Figure 12

Figure 13

Embodiments for Carrying Out the Invention

[0015] Hereinafter, the first embodiment of the peeling suction tube of the present invention will be described in detail with reference to the drawings. FIG. 1 is an overall view of the peeling suction tube of this embodiment. FIGS. 2 and 3 are explanatory diagrams of the nozzle portion, FIG. 2 is a perspective view, FIG. 3A is a side view, FIG. 3B is a front view, FIG. 3C is a top view, and FIG. 3D is a cross-sectional view taken along the α-α plane.

[0016] The peeling and suction tube 1 of the present embodiment is suitably used for endoscopic surgery, particularly robot-assisted endoscopic surgery (hereinafter referred to as robot surgery). However, the present invention does not specify the use of the peeling and suction tube, and it can also be used in all types of surgery including laparotomy. As shown in FIG. 1, the peeling and suction tube 1 includes a cylindrical nozzle 2 disposed in the body cavity and gripped by forceps for use in peeling and suction operations, a tube 3 connecting the nozzle 2 and a suction device outside the body, and an outer cylinder 4 disposed from the body surface into the body cavity and through which the tube 3 is inserted. The forceps used together with the peeling and suction tube of the present invention includes a jaw capable of opening and closing two opposing surfaces to clamp an object, and a straight tubular shaft connecting the jaw and a handle or a robot arm outside the body. In addition, the jaw has a type with a hollowed-out part and a solid type, and the gripping surface has a flat type and a corrugated type provided with continuous unevenness.

[0017] As shown in FIGS. 2 and 3, the nozzle 2 is formed in a short straight tubular shape, and includes a cylindrical portion 21 that presses the tip against the surgical site to perform peeling and suction operations, and a nozzle rear end portion 22 press-fitted into the tube 3. A gripping portion 23 gripped by forceps described later is formed on the outer peripheral surface of the rear end side of the cylindrical portion 21, and a side hole 24 that reduces the blockage of the opening during suction is formed near the tip of the cylindrical portion 21. In addition, the material of the nozzle 2 has rigidity that does not deform during the peeling operation, and a metal material or a rigid heat-resistant resin (stainless steel in this example) that is not easily melted or damaged even when gripped in a state where the forceps having an electric scalpel function generates heat is selected.

[0018] Regarding the size of the nozzle 2, the overall length is set to be 30 mm or more and 60 mm or less (40 mm in this example), which has a sufficient length to form the cylindrical portion 21, the rear end portion 22 of the nozzle, and the gripping portion 23, and is set so that it can be operated in a narrow surgical field such as the pelvic cavity while avoiding interference with surrounding tissues. Also, the length from the tip of the nozzle 2 to the tip of the gripping portion 23 is set to be 10 mm or more and 35 mm or less (13 mm in this example). By setting the length from the tip of the nozzle 2 to the tip of the gripping portion 23 in this way, the nozzle 2 will not be buried in the tissue during the peeling operation, and since it is not overly long, it is easy to handle and will not interfere with delicate peeling operations such as around nerves and blood vessels.

[0019] Also, the cylindrical portion 21 is set to have an inner diameter of 3 mm and an outer diameter of 5 mm in this example so as to have a lumen sufficient for suction and an outer diameter suitable for peeling. Furthermore, the outer diameter of the nozzle 2 consisting of the gripping portion 23 and the protrusion 26 described later is 4.5 mm or more and 5.8 mm or less (5.6 mm in this example), and the outer diameter of the connection portion between the rear end portion 22 of the nozzle and the tube 3 is also 5.8 mm or less, and it is set to be insertable into a 5 mm device port generally used in endoscopic surgery.

[0020] Also, as a means for stabilizing the gripping between the nozzle 2 and the forceps, the gripping portion 23 includes opposing clamp surfaces 25 that are clamped by the jaw 51 of the forceps 5 as shown in FIG. 4 described later, a protrusion 26 that protrudes from the clamp surface 25 and engages with the jaw 51, and a ridge 27 provided on the rear end side of the gripping portion 23. The size of the gripping portion 23 may be set to be clampable by the jaw 51. In this example, the axial length of the clamp surface 25 is 10 mm, and the radial length formed by the opposing clamp surfaces 25 is set to be 3.2 mm at the rear end and 4 mm at the front end, becoming thicker from the rear end to the front end. By setting the radial length to be larger toward the front end in this way, it conforms to the structure of a general forceps jaw, that is, a structure that opens and closes with a connecting portion provided at the rear end of the jaw as a fulcrum and opens wider toward the front end side, and the engagement is stabilized when the gripping portion 23 is clamped from the rear end side.

[0021] The protruding portions 26 are provided in two each on the respective two clamping surfaces 25, spaced apart in the axial direction of the nozzle 2, and are arranged such that the joe 51 can be engaged between the tip-side protruding portion 26a and the rear-end side protruding portion 26b. Further, the protruding portions 26 are formed so as to be inclined with respect to the axis of the nozzle 2 in the plane of the clamping surface 25. The inclination angle of the protruding portion 26 with respect to the axis of the nozzle 2 is preferably 5 degrees or more and 35 degrees or less, and is 30 degrees in this example. Further, the tip-side protruding portion 26a has an inclined side length of 2.5 mm and a width of 1.25 mm, and the rear-end side protruding portion 26b has an inclined side length of 4.9 mm and a width of 1.8 mm. The interval between the inclined sides of the tip-side protruding portion 26a and the rear-end side protruding portion 26b is formed to be 1.8 mm. The lengths and widths of these protruding portions 26 are set to be able to fit into the size of the cutout portion of the joe provided with the cutout portion.

[0022] Here, the gripping of the nozzle by the joe of the forceps will be described. By providing the peeling suction tube 1 of the present embodiment with the protruding portion 26 that engages with the joe 51 of the forceps 5, when an external force is applied to the nozzle 2 by a peeling operation or the like, the sliding between the joe 51 and the nozzle 2 is locked, and the fixing of the nozzle 2 and the forceps 5 is stabilized. FIGS. 4 and 5 are engagement state diagrams of forceps and a nozzle having different joe shapes, FIGS. 4A and 5 are side views, and FIG. 4B is a top view. As shown in FIG. 4, in the case of the joe 51 having the cutout portion 52 on the gripping surface, the rear-end side protruding portion 26b can be fitted into the inner surface of the cutout portion 52. Further, in the case of forceps with a small cutout portion 52, it can be fitted into the tip-side protruding portion 26a that is smaller than the rear-end side protruding portion 26b. In this way, the protruding portion 26 can be fitted into the cutout portions of joes of various sizes, and the fixing of the nozzle 2 and the forceps can be stabilized. Further, as shown in FIG. 5, when a plurality of protruding portions 26 are provided at intervals in the axial direction of the nozzle 2 and the joe 61 can be engaged between the tip-side protruding portion 26a and the rear-end side protruding portion 26b, the protruding portions 26 can sandwich both side surfaces of the joe 61, and the gripping of the nozzle 2 can be stabilized.

[0023] Furthermore, due to the inclination of the protrusion 26 with respect to the axis of the nozzle 2, the jaw 51 engaged with the protrusion 26 and the shaft 53 arranged coaxially with the jaw 51 are inclined with respect to the axis of the nozzle 2. Therefore, the tube 3 connected coaxially with the nozzle 2 and the shaft 53 are arranged obliquely, and interference between the tube 3 and the shaft 53 during forceps operation can be avoided. Furthermore, by limiting the inclination angle of the protrusion 26 with respect to the axis of the nozzle 2 to 5 degrees or more and 35 degrees or less, while suppressing interference between the forceps and the tube, since the angle between the axis of the forceps and the axis of the nozzle 2 is small, the peeling suction tube can be operated with an operation axis close to the operation of the forceps itself.

[0024] Note that the peeling suction tube 1 of the present embodiment is configured to include the clamp surface 25 and the protrusion 26, but it may also be configured to include either the clamp surface 25 or the protrusion 26. When only the protrusion 26 is provided, the protrusion is provided on the cylindrical outer peripheral surface of the nozzle 2.

[0025] The protrusions 27 are erected along the longitudinal direction on the peripheral surface on the rear end side of the gripping portion 23. In this example, four protrusions are provided at equal intervals in the circumferential direction. Among them, the short protrusion 27a formed on the rear end side of the protrusion 26 has an axial length of 3.4 mm, a width and a height of 0.5 mm, and the tip portion in the axial direction is inclined at 30 degrees with respect to the axis and formed parallel to the rear end side protrusion 26b, and the interval from the rear end side protrusion 26b is set to 1.5 mm. Also, the long protrusion 27b provided at a position rotated 90 degrees in the circumferential direction from the formation surface of the protrusion 26 has an axial length of 3.4 mm, a semi-circular cross-section with a radius of 0.5 mm on the rear end side in the circumferential direction, and extends to the tip side in the axial direction.

[0026] FIG. 6 is a diagram showing the engagement state between the jaw 71 of the forceps 7 and the ridge 27 of the nozzle 2. FIG. 6A is a side view, and FIGS. 6B is a cross-sectional view taken along the line α-α. If the ridge 27 is erected along the longitudinal direction on the outer peripheral surface of the nozzle 2, when the nozzle 2 is gripped from the side by the jaw 71 having the corrugated portion 72 on the gripping surface, the corrugated portion 72 and the ridge 27 (the short ridge 27a in this example) are engaged, and the gripping becomes stable. Therefore, for example, in a temporary gripping operation such as when moving the position of the nozzle 2 in the surgical field, the nozzle 2 can be prevented from falling off. Further, if the ridges 27 are provided in a plurality in the circumferential direction as in this example, it becomes easy to engage the corrugated portion 72 with the ridges 27.

[0027] As shown in FIG. 1, one end of the tube 3 is connected to the rear end portion 22 of the nozzle, and the other end is connected to a suction device (not shown) outside the body. The tube 3 has flexibility to be easily bent by an external force and returns to a substantially straight tube shape when the external force is removed. In this example, the tube 3 is formed of a silicone resin imparted with the above performance. Also, the size of the tube 3 is set to an inner diameter sufficient for suction and a wall thickness that is not easily kinked even when bent. In this example, the inner diameter is 3 mm and the outer diameter is 5 mm. Further, the length of the tube 3 is preferably 1000 mm to 3000 mm, which is a sufficient length not to interfere with the operation by the forceps 5 from the patient's body cavity to the suction device. In this example, the length is set to 1500 mm.

[0028] If the tube 3 has flexibility to be easily bent by an external force and returns to a substantially straight tube shape when the external force is removed, the tube 3 is less likely to develop a bending habit in the packaged state or the like, so that it is easy to guide it to a desired position. As a result, there is less interference between the forceps and the tube 3, and the operability is improved. Also, since the tube 3 is flexible, when the operation is interrupted and the nozzle 2 is moved from the surgical field and held in the body cavity, a flexible tube 3 is pulled out outside the body, so that the operation at hand is not obstructed. Further, stable holding can be achieved by fixing the tube at an appropriate position outside the body. Furthermore, since the silicone resin also has excellent heat resistance, even if the forceps with an electric scalpel function accidentally come into contact with the tube 3 in a heated state, the risk of melting or damage can be reduced.

[0029] In addition, a branch pipe may be provided on the outer side of the body of the tube 3 and branched into a suction tube and a water supply tube to add a water supply function for washing the surgical field. Furthermore, known flow path blocking mechanisms and flow rate adjusting mechanisms such as clamps and side holes may be provided in these tubes.

[0030] Also, when applying the peeling suction tube 1 of the present embodiment to endoscopic surgery, the outer cylinder 4 is used. As shown in FIG. 1, the outer cylinder 4 is a cylinder through which the tube 3 is inserted, and is composed of an outer cylinder tube 41, an outer cylinder base 42, and an outer cylinder valve 43. The outer cylinder tube 41 is a rigid tube that guides the insertion of the tube 3 into the body cavity. In this example, it is formed of stainless steel and is set to have an outer diameter of 5.8 mm, an inner diameter of 5.3 mm, and a length of 150 mm, which can be inserted through a 5 mm device port.

[0031] The outer cylinder base 42 is a connecting member between the rear end of the outer cylinder tube 41 and the outer cylinder valve 43. In this example, it is formed of an ABS resin, which is a rigid resin that can be adhered to the outer cylinder tube 41 and press-fitted into the outer cylinder valve 43. Also, by setting the outer cylinder base 42 to be equal to or larger than the inner diameter of the 5 mm device port (17 mm in this example), the entire outer cylinder 4 cannot enter the body cavity.

[0032] The outer cylinder valve 43 is formed in a cylindrical cap shape from an elastically deformable resin (silicone resin in this example), and the rear end of the outer cylinder base 42 is fitted and connected to the inner surface of the cylindrical portion. Also, the upper flat surface is in a thin sheet shape (1 mm thick in this example), and an insertion hole is formed coaxially with the outer cylinder tube 41. The inner diameter of the insertion hole is set to be in close contact with the tube 3 (4.6 mm in this example) to prevent the gas filled in the body cavity for ensuring the surgical field during endoscopic surgery from leaking from the gap between the tube 3 and the outer cylinder 4.

[0033] Generally, a highly airtight valve is provided for the port of the 5 mm device. If the tube 3 is brought into direct contact with the valve, it will cause frictional resistance, which will hinder the peeling and suction operations, etc. Moreover, the valve may be curled, resulting in gas leakage. In particular, when the tube 3 is formed of silicone resin as in this example, the frictional resistance is greater than that of other flexible resin materials. Therefore, the configuration is such that the tube 3 is inserted through the outer cylinder 4 inserted into the port of the 5 mm device, and an outer cylinder valve 43 of a size suitable for the tube 3 is provided, thereby reducing the frictional resistance when inserting and removing the tube 3 and enabling safe peeling, suction operations, etc.

[0034] According to the peeling and suction tube 1 of the present embodiment, it is composed of a cylindrical nozzle 2 and a flexible tube 3 connected to the nozzle 2. On the outer peripheral surface of the nozzle 2, a clamp surface 25 and a protrusion 26 are formed as gripping stabilization means that can be clamped by the jaws of forceps, so that the nozzle 2 previously inserted into the surgical field can be gripped by the forceps and guided to a desired position. While pressing the tip of the nozzle 2 against the biological tissue for peeling, it is possible to suck the peeled tissue, exuded body fluid, etc.

[0035] Also, due to the inclination of the protrusion 26 with respect to the axis of the nozzle 2, the jaw 51 engaged with the protrusion 26 and the shaft 53 arranged in the coaxial direction with the jaw 51 are inclined with respect to the axis of the nozzle 2. Therefore, the tube 3 connected coaxially with the nozzle 2 and the shaft 53 are arranged obliquely, and interference between the tube 3 and the shaft 53 during forceps operation can be avoided. Furthermore, by limiting the inclination angle of the protrusion 26 with respect to the axis of the nozzle 2 to 5 degrees or more and 35 degrees or less, while suppressing the interference between the forceps 5 and the tube 3, since the angle between the axis of the forceps and the axis of the nozzle is small, the peeling and suction tube can be operated with an operation axis close to the operation of the forceps itself.

[0036] Also, by leaving the nozzle 2 and the tube 3 in the surgical field and continuously applying suction, it is possible to exhaust the surgical smoke generated when using an energy device such as an electric scalpel. In addition, the operation of pressing the nozzle 2 against the tissue may be used for displacement (temporarily pushing out and removing objects such as organs and tumors that obstruct the surgical field from the surgical field), etc., and is not limited to the tissue peeling use described above.

[0037] Figures 7 to 13 show another embodiment of the present invention, all of which relate to the means for stabilizing the grip of the nozzle of the peeling suction tube. Since the respective dimensions and components in these embodiments are basically the same as those in the first embodiment, the description of the same parts will be omitted and mainly the different parts will be described.

[0038] Figure 7 is a detailed view of the nozzle of the peeling suction tube in the second embodiment of the present invention, Figure 7A is a side view, Figure 7B is a top view, and Figure 7C is a cross-sectional view taken along the line α-α. In this embodiment, a groove portion 28 is provided in the gripping portion 23 on the outer peripheral surface of the nozzle 2. The groove portion 28 is formed on two opposing surfaces of the outer peripheral surface of the nozzle 2 so that the jaws of the forceps can be fitted, and a tip-side groove portion 28a and a rear-end-side groove portion 28b are arranged on each surface at intervals in the axial direction.

[0039] In this example, the gripping portion 23 has an outer diameter of 5.6 mm and an inner diameter of 3 mm, similar to the first embodiment, and the depth of the groove portion 28 is 0.8 mm. Further, the inclination angle of the groove portion 28 with respect to the axis of the nozzle 2 is 30 degrees, the width of the tip-side groove portion 28a is 1.8 mm, the width of the rear-end-side groove portion 28b is 2.6 mm, and the interval between the inclined sides of the tip-side groove portion 28a and the rear-end-side groove portion 28b is 1.8 mm.

[0040] As shown in Figure 8, by fitting the jaws 61 of the forceps 6 into the rear-end-side groove portion 28b, the sliding between the jaws and the nozzle when an external force is applied to the nozzle during the peeling operation or the like is locked, and the fixation of the nozzle 2 and the forceps 5 is stabilized. Further, since the widths of the tip-side groove portion 28a and the rear-end-side groove portion 28b are different, by selecting and fitting the groove portion 28 that matches the size of the jaws, jaws of various sizes can be stably fixed.

[0041] In addition, Figure 9 is a perspective view of the nozzle of the peeling suction tube in the third embodiment of the present invention. In this embodiment, the material of the nozzle 2 is stainless steel as in the first embodiment, and the gripping portion 23 on the outer peripheral surface of the nozzle 2 is formed in a cylindrical shape continuous with the cylindrical portion 21, and a rough surface 29 is formed on the outer peripheral surface. The rough surface 29 is formed so as to increase the frictional resistance with the jaw of the pliers to be engaged and suppress the sliding during the peeling operation, and is processed by an arbitrary method such as cutting or sandblasting.

[0042] In addition, in this embodiment, the gripping stability is achieved by making the gripping portion 23 a rough surface. For example, the gripping portion 23 may be formed of an elastic deformable rubber material or the like, and when gripped by the pliers, the gripping portion 23 deforms so as to conform to the shape of the gripping surface of the jaw, thereby increasing the frictional resistance. Furthermore, the material of the gripping portion 23 is preferably a heat-resistant material (such as silicone rubber) with little risk of melting or damage even when gripped in a state where the pliers having an electrocautery function are heated.

[0043] Next, the peeling suction tube in the fourth embodiment of the present invention will be described. In the previous embodiments, it was assumed that the insertion into the 5 mm device port generally used in endoscopic surgery was considered, but this embodiment is set to be applicable to the 12 mm device port. FIGS. 10 and 11 are explanatory views of the peeling suction tube in the fourth embodiment of the present invention, FIG. 10 is a perspective view, FIG. 11A is a side view, and FIG. 11B is a top view. In this embodiment, the clamp surface 205 that can be clamped by the pliers is formed as a support column 203 standing on the outer peripheral surface of the nozzle 20.

[0044] The size of the nozzle 20 is set such that the overall length is 51 mm, the length from the tip of the nozzle 20 to the tip of the support column 203 is 23 mm, the inner diameter of the cylindrical portion 201 is 4 mm, and the outer diameter is 6 mm. Further, the maximum radial width formed by the cylindrical portion 201 and the support column 203 is 12 mm or less (11.8 mm in this example), and the outer diameter of the connection portion between the nozzle rear end portion 202 and the tube 30 is also 12 mm or less.

[0045] Further, the support column 203 is in a flat plate shape that stands upright along the longitudinal direction on the outer peripheral surface of the cylindrical portion 201, and the plate surface of the support column 203 serves as the clamping surface 205. Further, as shown in FIG. 12 to be described later, both sides of the clamping surface 205 are provided with two protrusions 206 arranged in a manner of sandwiching the side surface of the jaw 51 from both sides. The upper end side of the support column 203 is the upper protrusion 206a, and the cylindrical portion 201 side is the lower protrusion 206b. The protrusion 206 is inclined with respect to the axis of the nozzle 20 and is formed to be higher toward the rear end side.

[0046] The size of the support column 203 may be set such that it can be clamped by the jaw 51. In this example, the length of the support column 203 in the axial direction is 19 mm at the bottom, 9 mm at the upper end, and the maximum height from the outer peripheral surface of the cylindrical portion 201 is 4.9 mm. Also, the thickness of the support column 203 is set to be 0.8 mm at the rear end and 1.3 mm at the front end, becoming thicker from the rear end to the front end. Also, the size of the protrusion 206 in this example is such that the upper protrusion 206a has a length of 9 mm and a width of 1.3 mm, and the thickness is 2.6 mm at the rear end and 4 mm at the front end, being formed to be thicker from the rear end to the front end. Also, the lower protrusion 206b has a thickness of 4 mm. Also, the inclination angle of the protrusion 206 with respect to the axis of the nozzle 2 is preferably 5 degrees or more and 35 degrees or less, and more preferably 20 degrees or less. In this example, the upper protrusion 206a is 12 degrees and the lower protrusion 206b is 9 degrees.

[0047] Here, the engagement state between the protrusion 206 and the jaw of the pliers will be described. FIGS. 12 and 13 are engagement state diagrams of pliers with different jaw shapes and the nozzle 20, FIGS. 12A and 13 are side views, and FIG. 12B is a top view. As shown in FIG. 12, in the case of the jaw 51 having the cutout portion 52 on the gripping surface, the upper protrusion 206a can be fitted to both side surfaces in the longitudinal direction of the cutout portion 52. In such an engagement state, the lower protrusion 206b does not have to be formed. Also, as shown in FIG. 13, when the jaw 61 is thin, it can be fitted between the upper protrusion 206a and the lower protrusion 206b. Further, by setting the inclination of the upper protrusion 206a to be larger than that of the lower protrusion 206b as in this example, the interval between the two protrusions becomes narrower at the tip side, so that it becomes easier to engage with a tapered jaw.

[0048] Note that, as for the entire peeling suction tube, the outer diameter of the nozzle may be set to be large for the purpose of increasing the contact area with the biological tissue during the peeling operation or widening the suction flow path. However, in the first to third embodiments described above, since the outer peripheral surface of the nozzle is gripped by the jaw of the forceps, the outer diameter of the nozzle needs to be equal to or less than the opening width of the combined jaws. On the other hand, when formed as a support column 203 that erects the clamp surface 205 on the outer peripheral surface of the nozzle 20 as in this embodiment, even when the outer diameter of the cylindrical portion 201 is set to be equal to or larger than the opening width of the jaws, the nozzle can be gripped by the forceps, and it is possible to cope with a larger nozzle outer diameter. Further, by providing the protrusion 206 on the clamp surface 205, when an external force is applied to the nozzle 2 due to a peeling operation or the like, the sliding between the jaw 51 and the nozzle 20 is locked, and the gripping becomes more stable.

[0049] Also, the size of the tube 30 is set to an inner diameter of 4 mm and an outer diameter of 7 mm in this example so as to have an inner diameter sufficient for suction and a wall thickness that is not easily kinked even when bent. The length of the tube 3 was set to 1500 mm. Also, since the outer cylinder 40 is composed of the same components and materials as in the first embodiment, the illustration is omitted. The outer cylinder tube 401 is set to an outer diameter of 10 mm, an inner diameter of 9 mm, and a length of 150 mm that can be inserted through a 12 mm device port. By setting the outer diameter of the outer cylinder base 402 to be equal to or larger than the inner diameter of the 12 mm device port (17 mm in this example), the entire outer cylinder 40 does not enter the body cavity. Further, the upper flat surface of the outer cylinder valve 403 is set to a thickness of 1 mm, and the inner diameter of the insertion hole is set to 6.5 mm to prevent the gas filled in the body cavity for ensuring the surgical field of view in endoscopic surgery from leaking from the gap between the tube 30 and the outer cylinder 40.

[0050] The peeling and suction tube of the present invention is formed in a configuration that is particularly suitable for robotic surgery, including the first to fourth embodiments described above, and particularly remarkable effects are expected when combined with robotic forceps used in robotic surgery.

[0051] Here, the application of the peeling and suction tube of the present invention to robotic surgery will be described. In robotic surgery, generally, robotic forceps are used for peeling and a dedicated rigid suction tube is used for suction, and they are respectively attached to different robotic arms and used. However, due to the limitation of the number of robotic arms, depending on the surgery, it is necessary to replace the device when switching operations due to insufficient number of robotic arms. Since this replacement work is done manually by the assistant, there is a problem that the surgery is temporarily interrupted. To solve this problem, in some cases, a method is adopted in which the assistant manually operates a straight tubular rigid suction tube inserted into the body cavity from a separate route. However, in this suction tube, when the surgical site is deep inside the body or the surgical field is narrow, etc., interference with surrounding tissues and auxiliary instruments is likely to occur in cases where the introduction route is restricted, and the operation may be difficult. Also, this method is difficult to coordinate among surgeons, and the position and timing of suction by the assistant may deviate from the requirements of the robotic operator, and an optimal peeling and suction tube for robotic surgery has been demanded.

[0052] On the other hand, the robotic forceps used in robotic surgery have a wide range of motion due to having multiple axes of motion and can perform precise operations. To conform to this characteristic, the peeling and suction tube of this embodiment is composed of a short nozzle and a flexible tube, and gripping stabilization means that can be clamped by the jaw of the robotic forceps is formed on the outer peripheral surface of the nozzle or on a support standing from the outer peripheral surface of the nozzle.

[0053] When the peeling and suction tube of the present invention is combined with the aforementioned robotic forceps, the peeling and suction tube can flexibly follow the movement of the robotic forceps, and even in cases where the introduction route of the medical instrument is restricted, it becomes easy to perform the peeling and suction operation while avoiding interference with surrounding tissues and auxiliary instruments. In addition, the dissection and aspiration tube of the present invention has functions of dissection and aspiration, and can be introduced into the body cavity through an insertion route different from that of the robotic forceps. Therefore, since the robotic arm is not occupied by dissection and aspiration, it is not necessary to replace the device on the robotic arm, and temporary interruption of the surgery can be eliminated. Furthermore, since the dissection and aspiration operation can be performed only by the robotic operator, the accuracy and efficiency of the surgery can be improved without being troubled by cooperation with the assistant.

[0054] As described above, the embodiments of the present invention have been described. However, the embodiments of the present invention are not limited to the above embodiments, and various modifications and implementations are possible. For example, the clamp surface and the engaging portion, which are the means for stabilizing the grip of the dissection and aspiration tube of the present invention, may be formed on both the outer peripheral surface of the nozzle and the support column erected from the outer peripheral surface of the nozzle. In addition, some of the components of the above embodiments may be omitted or modified.

Description of Reference Numerals

[0055] 1. Dissection and aspiration tube 2, 20. Nozzle 21, 201. Cylindrical portion 22, 202. Rear end portion of nozzle 23. Gripping portion 203. Support column 24, 204. Side hole 25, 205. Clamp surface 26, 206. Protrusion 26a. Front end side protrusion 206a. Upper side protrusion 26b. Rear end side protrusion 206b. Lower side protrusion 27. Ridge 27a. Short ridge 27b. Long ridge 28. Groove portion 28a. Front end side groove portion 28b. Rear end side groove portion 29. Rough surface 3, 30. Tube 4, 40. Outer cylinder 41, 401. Outer cylinder tube 42, 402. Outer cylinder base 43, 403. Outer cylinder valve 5, 6, 7. Pliers 51, 61, 71. Joe 52. Core removal part 53. Shaft 72. Corrugated part

Claims

1. A dissection and aspiration tube that is grasped by forceps to perform dissection of biological tissue and aspiration of body fluids, etc., comprising a cylindrical nozzle and a flexible tube connected to the nozzle, and a dissection and aspiration tube provided with gripping stabilization means that can be clamped by the jaws of the forceps on the outer peripheral surface of the nozzle or on a support standing upright from the outer peripheral surface of the nozzle.

2. The dissection and aspiration tube according to Claim 1, wherein the gripping stabilization means is a clamping surface facing the gripping surface of the jaw and / or an engaging portion for locking the jaw.

3. The dissection and aspiration tube according to Claim 2, wherein the engaging portion is formed so as to incline the shaft of the forceps with respect to the axis of the nozzle by engagement with the jaw.

4. The dissection and aspiration tube according to Claim 3, wherein the inclination angle of the engaging portion is 5 degrees or more and 35 degrees or less.

5. The dissection and aspiration tube according to Claim 2, wherein the engaging portion is formed as a protrusion.

6. The dissection and aspiration tube according to Claim 5, wherein a plurality of the protrusions are provided.

7. The dissection and aspiration tube according to Claim 6, wherein each of the plurality of protrusions is formed in a different size.

8. The dissection and aspiration tube according to Claim 2, wherein the engaging portion is a ridge standing upright along the longitudinal direction of the nozzle.

9. The dissection and aspiration tube according to any one of Claims 1 to 8, wherein the total length of the nozzle is 30 mm or more and 60 mm or less.

10. The dissection and aspiration tube according to Claim 9, which is applied to robot-assisted endoscopic surgery.

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