Inserter for medical treatment tool

Abstract

To provide an inserter for a medical treatment tool capable of introducing plural treatment tools of various sizes without the need for a complex mechanism.SOLUTION: An inserter 1 for a medical treatment tool of the present invention is worn on a body-surface side of wound retractor means attached to an opening of a human body and is capable of setting ports through which medical treatment tools are inserted. The inserter 1 includes a dome body 10 made of an elastic member, a mounting portion 40 for the wound retractor means, and port-setting portions 30 defined as ranges in which the ports can be set by puncture penetration without providing advance through-holes or slits into a body cavity, the port-setting portions 30 being provided in plurality on the dome body 10. The port-setting portions 30 are provided such that at least one is provided on the upper side of the dome body 10 and the plurality of them is provided on the peripheral surface on the lower side of the dome body 10, and it is preferable that the port-setting portion 30 provided on the upper side is formed to have a larger area than the port-setting portions provided at other positions.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present invention relates to an insertion device for introducing a medical treatment tool into a body cavity during endoscopic surgery, and more particularly to an insertion device for a medical treatment tool that allows multiple treatment tools to be applied through a single incision. [Background technology]

[0002] In conventional general endoscopic surgery, multiple ports for inserting treatment instruments are drilled on the body surface as passages into the body cavity, and treatment instruments are inserted through each of these ports to proceed with the surgery. However, because this surgery requires multiple incisions, a less invasive technique called single-port endoscopic surgery is now being applied, in which a single small incision (about 2 cm) is made in an area such as the navel where scarring is less noticeable, a tubular retractor is attached to the incision and holds the wound open using the tension of an elastic member, and multiple treatment instruments are inserted through multiple access routes provided in an insertion device that covers the body surface side of the retractor, allowing all surgical operations to be performed.

[0003] As insertion instruments applicable to this surgery, there have been proposed a single-port laparoscopic surgery device (Patent Document 1) that has a substantially hemispherical dome body made of an extensible resin material, a connection means for connecting to a retractor provided at the bottom of the dome body, and multiple port portions provided on the dome body, with the port portions provided with notches that can be opened by pressing, and a medical instrument (Patent Document 2) that has a flexible balloon with a valved opening whose opening diameter can be adjusted. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] International Publication No. 2014 / 104373 [Patent Document 2] U.S. Patent No. 5,480,410 Summary of the Invention [Problem to be solved by the invention]

[0005] With this type of instrument, during endoscopic surgery, multiple treatment tools can be introduced into the body cavity through a single incision without making multiple incisions, making it possible to perform minimally invasive surgery that places less strain on the human body.

[0006] However, the instrument in Patent Document 1 has a configuration in which the port portion has a notch that can be opened by pressing, and when a treatment tool thinner than the appropriate size is inserted, a gap is created in the opening. Therefore, in laparoscopic surgery, in which the body cavity is inflated with carbon dioxide gas to secure the surgical field, there is a concern that gas leakage from the gap will narrow the surgical field and make surgical operations difficult, and therefore the thickness of the treatment tool that can be used is limited. In contrast, the instrument in Patent Document 2 has a valved opening whose opening diameter can be adjusted, making it possible to accommodate treatment tools of various thicknesses. However, the valved opening is configured with a pair of rings on both ends of an elastic tube, and the opening diameter is adjusted by twisting the elastic tube by rotating the rings circumferentially, which results in a complex expansion / contraction mechanism and high manufacturing costs.

[0007] SUMMARY OF THE INVENTION It is therefore an object of the present invention to provide an insertion device for medical treatment tools that can introduce a plurality of treatment tools of a wide range of sizes without requiring a complex mechanism. [Means for solving the problem]

[0008] The insertion device for a medical treatment tool of the present invention is attached to the body surface side of a retraction means attached to an opening in the human body and is capable of setting a port through which a medical treatment tool is inserted, and the insertion device comprises a dome body made of an elastic material, an attachment portion to the retraction means, and a port setting portion defined as an area where the port can be set by puncturing and penetrating the body cavity without providing a through-hole or slit in advance, and a plurality of the port setting portions are provided on the dome body. Note that the dome body of the present invention is defined to include, in addition to a dome shape, a truncated cone, a spindle, a drop shape, or a three-dimensional shape with an open bottom facing the body surface side of the retraction means, such as a cylinder with a closed top.

[0009] The following parts are preferably formed as follows: At least one of the port setting portions is provided on the top side of the dome body. Furthermore, it is preferable that a plurality of the port setting portions are provided on the peripheral surface of the bottom side of the dome body. The port setting portion provided on the top side is formed to have a larger area than the port setting portions provided at other positions. The port setting portion has a rib that stands upright and surrounds the entire setting range. The dome body is preferably made of a light-transmitting surface, and further, surfaces with different tackiness are preferably arranged alternately. The dome body has a plurality of cell regions formed continuously and partitioned by mesh-like protrusions. The dome body and the port setting portion are integrally formed from the same material. The port setting portion is formed to be thicker than the dome body. The port setting portion may be formed to be detachable from the dome body. The boundary between the port setting section and the dome main body may have a constricted section that widens toward the port setting section.

[0010] (action) According to this means, a plurality of port setting sections are provided on the dome body, each section defining an area where a port can be set by puncturing and penetrating without the need for a through-hole or slit in advance in the body cavity. By puncturing a port according to the size of the treatment tool into the port setting section, no gap is created between the treatment tool and the port, and the airtight state inside the body cavity can be maintained. In addition, by selecting any puncture position from the plurality of port setting sections, the treatment tools can be optimally positioned according to the surgical content.

[0011] Furthermore, since the dome body and the port setting portion are integrally formed from the same material, there is no need to assemble the dome body and the port setting portion, making manufacturing easy, and there are no joints between the parts, making them less likely to break. Furthermore, by forming the port setting portion thicker than the dome body, even if it is integrally formed from the same material, it is possible to prevent tearing or leakage from the port setting portion while maintaining the flexibility of the dome body.

[0012] Furthermore, the port setting section provided on the apex side is formed with a larger area than the port setting sections provided in other positions, so that a large-diameter treatment tool (robot arm entry guide) used in single-port robotic surgery can be inserted into the port setting section on the apex side, and a small-diameter treatment tool used for auxiliary operations can be inserted into the port setting section at other positions.

[0013] Furthermore, the port setting section has a rib that extends around the entire periphery of the setting area, allowing the surgeon to grasp the rib for a stable grip when puncturing the port. Furthermore, if the dome body and the port setting section are formed from a single piece of material, even if the port puncture site is torn due to excessive force being applied during operation, the rib can prevent damage to the dome body from spreading.

[0014] The dome body has a translucent surface, allowing the surgeon to view the inside of the body cavity. Furthermore, the dome body has alternating surfaces with different tackiness, making it less likely to stick to the surgeon's fingers when gripped. Furthermore, during manufacturing, stickiness is reduced when the dome body is removed from the molding die.

[0015] Furthermore, the dome body is formed by a continuous series of multiple cell regions separated by mesh-like protrusions, which allows the overall flexibility to be maintained, and even if a wound occurs within a cell region due to contact with a treatment tool or the like, the thickly formed protrusions can prevent the spread of the tear.

[0016] Furthermore, since the port setting section is formed detachably on the dome main body, a trocar can be inserted into the port setting section in a state where it is separated from the dome main body.

[0017] Furthermore, since the boundary between the port setting portion and the dome main body has a constricted portion, when tilting the treatment tool inserted into the port setting portion or pressing down the port setting portion, the constricted portion deforms preferentially over other parts of the dome main body, thereby preventing the dome main body from bending inward. [Effects of the Invention]

[0018] According to the present invention, it is possible to provide an insertion device for a medical treatment tool that can introduce a plurality of treatment tools of a wide range of sizes without requiring a complex mechanism. [Brief explanation of the drawings]

[0019] [Figure 1] FIG. 2 is a diagram showing a state in which the insertion device according to the first embodiment of the present invention is used. [Figure 2] FIG. [Figure 3] FIG. [Figure 4] FIG. [Figure 5] FIG. 10 is an external view of an insertion device according to a second embodiment of the present invention. [Figure 6] FIG. [Figure 7] FIG. [Figure 8] FIG. 10 is an external view of an insertion device according to a third embodiment of the present invention. [Figure 9] FIG. [Figure 10] FIG. DETAILED DESCRIPTION OF THE INVENTION

[0020] A first embodiment of the insertion device of the present invention will be described in detail below with reference to the drawings. Figure 1 shows the insertion device of this embodiment in use, with Figure 1A being a perspective view and Figure 1B being a cross-sectional view.

[0021] The insertion instrument 1 of the present invention is preferably used in single-port breast surgery, which is one type of endoscopic surgery, but the present invention does not specify the use of the insertion instrument. As shown in FIG. 1, the insertion device 1 covers the body surface side of a cylindrical retractor a attached to an incision, and is used to open an access route by inserting a trocar b together with a trocar needle into the port setting section 30, and to introduce a treatment tool c such as an endoscope or forceps from the trocar b into the body cavity.

[0022] 2A is a perspective view, FIG. 2B is a front view, FIG. 3A is a plan view, and FIG. 3B is a bottom view of the insertion device of this embodiment. Also, FIG. 4 is a cross-sectional view taken along line α-α shown in FIG. 2B.

[0023] The insertion device 1 is composed of a dome body 10, a port setting portion 30, and an attachment portion 40 that engages with a retractor, and is integrally formed from an elastic material such as silicone resin.

[0024] The dome body 10 has a hemispherical dome shape made of a thin film, and in this example, is formed to a thickness of 0.8 mm. Furthermore, by selecting a translucent elastic material, the entire dome body 10 is formed as a translucent surface. The dome body 10 alternates between high-translucency sections 21 and low-tackiness surfaces 22, which are less translucent than the high-translucency sections 21 but have reduced tackiness. Specifically, the high-translucency sections 21 are triangular areas adjacent to sub-port setting sections 32 (described below) and pentagonal areas located between the sub-port setting sections 32. The low-tackiness surfaces 22 are areas other than the high-translucency sections 21 on the inner and outer surfaces of the dome body 10. The low-tackiness surfaces 22 can be formed by embossing during molding or by coating with another resin.

[0025] The attachment part 40 is a part for connecting the retractor a to the lower edge of the dome body 10, and its inner surface has a groove shape that fits into a ring or the like on the body surface side of the retractor a. Also, on the outer surface of the attachment part 40, three handles 41 extending in the radial direction are provided evenly on the outer periphery.

[0026] The port setting section 30 is formed by partially thickening the dome body 10, and the outer surface is flat. A main port setting section 31 is provided at the top of the dome body 10, and multiple sub-port setting sections 32 are provided on the circumferential surface of the dome body 10. The sub-port setting sections 32 are arranged in two stages, at the bottom side and the middle part of the dome body 10, with three sub-port setting sections 32 each provided at equal intervals on the circumferential surface, and with their positions on the bottom side and the middle part shifted.

[0027] The port setting section 30 has a shape in which the puncture section 33 is surrounded by a rib 34. In this example, the main port setting section 31 is a regular hexagon capable of accommodating a circle with a diameter of 50 mm, and the sub-port setting section 32 is an equilateral triangle capable of accommodating a circle with a diameter of 10 mm, with each corner rounded. The thickness of the puncture section 33 is 2.5 mm, the height of the rib 34 from the puncture section 33 is 2.5 mm, and the width of the rib 34 is 2 mm. The material hardness and thickness of the puncture section 33 may be appropriately set so that it can be punctured with a trocar b, it adheres to the trocar b due to the restoring force of the elastic material, and the perforation closes when the trocar b is removed.

[0028] Furthermore, markers 35 are provided on the outer surface of the puncturing portion 33 to serve as a guide for the puncturing position. By aiming for the marker 35 in the center of the puncturing portion 33, the risk of damaging the surrounding ribs 34 is reduced. Furthermore, for the main port setting portion 31, by using six markers 35 arranged at equal intervals on a circle with a diameter of 30 mm centered on the central marker 35 as an index, it is possible to ensure an appropriate distance between the trocars when puncturing multiple trocars. The markers 35 can be formed by forming an uneven surface on the port setting portion 30 or by marking with ink, etc.

[0029] According to the insertion device 1 of this embodiment, the port setting section 30, which is formed from an elastic member and does not have a pre-formed through-hole, is provided on the dome body 10. This allows a trocar of any size to be inserted into the port setting section 30 to form an access route suitable for the size of the treatment tool, so that no gap is created between the treatment tool and the port, and the airtight state inside the body cavity can be maintained. Furthermore, by providing a main port setting section 31 on the top side of the dome body 10 and multiple sub-port setting sections 32 on the circumferential surface of the dome body 10, it is possible to optimally position multiple treatment tools according to the surgical content by selecting the puncture position from multiple port setting sections, and it is possible to suppress interference between the treatment tools and perform the surgery smoothly.

[0030] Furthermore, because the dome body 10 is formed into a thin film from an elastic material, the dome body 10 flexibly follows the movement of the treatment tool inserted into the port setting section 30, so that the tip of the treatment tool can be moved to the desired position in the surgical field without inserting or removing the treatment tool, further reducing interference between treatment tools.

[0031] Furthermore, by integrally forming the dome body 10 and the port setting portion 30 from the same material, there is no need to assemble the dome body 10 and the port setting portion 30, making manufacturing easier, and the absence of joints between the parts makes them less susceptible to breakage, reducing the risk of pneumoperitoneum gas leakage. Furthermore, by forming the port setting portion 30 thicker than the dome body 10, even though they are integrally formed from the same material, it is possible to prevent tearing or leakage from the port setting portion 30 while ensuring the flexibility of the dome body 10.

[0032] Furthermore, as described above, the main port setting portion 31 is formed as a surface with a diameter of more than 50 mm, which allows dedicated treatment instruments with a diameter of about 25 mm for single-port robotic surgery to be inserted into the main port setting portion 31, and further allows thin-diameter treatment instruments used for manual auxiliary operations to be inserted through the sub-port setting portion 32, which is smaller than the main port setting portion 31, making the insertion device 1 suitable for use in single-port robotic surgery. Furthermore, even in endoscopic surgical procedures other than single-port robotic surgery, the large size of the main port setting portion 31 allows for a high degree of freedom in port placement, and ensuring a sufficient distance between the main port and sub-port makes it possible to suppress interference between treatment instruments.

[0033] Furthermore, the port setting section 30 has a shape in which the puncture section 33 is surrounded by the ribs 34, which allows the surgeon to grasp the ribs 34 when puncturing the port, providing a stable grip and enabling reliable port puncture. Furthermore, although the dome body 10 and the port setting section 30 are formed from a single material, even if the puncture section 33 is torn due to excessive force being applied during operation, the ribs 34, which are formed thicker than the puncture section 33, can prevent damage to the dome body 10 from spreading.

[0034] Furthermore, by providing a handle 41 extending radially on the outer peripheral surface of the attachment portion 40, the surgeon can grasp the handle 41 to easily perform operations for attaching and detaching the insertion instrument 1 to the retractor and rotation operations for sliding the insertion instrument 1 in the circumferential direction. In particular, this rotation operation makes it possible to change the camera angle of the endoscope and the approach angle of the treatment tool relative to the surgical site, allowing for smoother surgery.

[0035] Furthermore, by alternately arranging the highly translucent portions 21 and the low-tack surfaces 22 on the inner and outer surfaces of the dome body 10, the inside of the body cavity can be visualized, and the dome body 10 does not stick to the surgeon's fingers when grasped, preventing interference with operations such as port puncture. Furthermore, during manufacturing, adhesion is reduced when the dome body is removed from the molding die, preventing scratches from occurring during the molding process.

[0036] Furthermore, the insertion device 1 of this embodiment can secure a working space for treatment tools using the hemispherical dome body 10, and furthermore, because an access route can be selected from any port setting section, it can be suitably used in single-port breast surgery, which performs treatment on a narrow surgical field adjacent to the inside of the retractor. In addition, in narrow-cavity surgeries such as this surgery, when the opening is sealed and the surgical field is expanded with gas, the pressure in the surgical field must be kept constant by repeatedly injecting and stopping gas using an air supply device. However, stabilizing the pressure is difficult because the total amount of gas is small. Even in such cases, gas can be stored within the dome body 10, thereby reducing pressure changes in the surgical field.

[0037] While the present example illustrates a configuration in which the outer edge of the port setting portion is provided with a rib, for example, another means having a higher rigidity than the inner region of the port setting portion may be provided on the outer edge instead of or in combination with the rib. Specifically, a reinforcing ring may be fitted or embedded on the outer edge of the port setting portion, and the reinforcing ring may be made of a material having a higher rigidity than the material forming the inner portion of the port setting portion, such as a hard resin such as polycarbonate or a metal. Alternatively, the outer edge of the port setting portion may be made of a material having a higher hardness than the inner portion of the port setting portion, and these materials may be molded by two-color molding. By forming the outer edge of the port setting portion to be more rigid than the inner region of the port setting portion, deformation of the port setting portion due to pressure when the surgeon grasps the outer edge of the port setting portion to puncture the port is suppressed, making it easier to puncture the trocar.

[0038] 5 to 7 show a second embodiment of the present invention. Since the components and shapes of the following embodiments are basically the same as those of the first embodiment, a description of the similarities will be omitted and differences will be mainly described.

[0039] Figures 5 and 6 are external views of an insertion device according to a second embodiment of the present invention, with Figure 5A being a perspective view, Figure 5B being a front view, Figure 5C being an enlarged view of the β portion shown in Figure 5B, Figure 6A being a plan view, and Figure 6B being a bottom view. Also, Figure 7A is an α-α cross-sectional view shown in Figure 5B, and Figure 7B being an enlarged view of the γ portion shown in Figure 7A.

[0040] In this example, the dome body 10 has a truncated spindle shape and is functionally divided into an upper dome body 11, an intermediate dome body 12, and a lower dome body 13. The upper dome body 11 has the same configuration as the first embodiment, and is provided with a port setting section 30, a high light-transmitting section 21, and a low-tack surface 22. The intermediate dome body 12 is formed as the high light-transmitting section 21 with a flat peripheral surface, and the lower dome body 13 has a base section 51 divided by mesh-like protrusions 52, with multiple cell regions 50 formed continuously around the entire periphery.

[0041] Furthermore, the mounting portion 40 of this example does not have a groove for fitting into a ring or the like on the body surface side of the retractor a, but is formed as an opening with the same thickness as the dome main body 10, and the inner diameter of the opening is set smaller than the fitting portion of the retractor a. Furthermore, four handles 41 are provided evenly on the outer periphery of the mounting portion 40. When the surgeon grasps the handles 41 and stretches the mounting portion 40 to fit over the retractor a, the mounting portion 40 contracts, allowing for stable fixation.

[0042] As with the previous embodiment, the insertion device 1 is made of a translucent elastic material, but the upper dome body portion 11 including the port setting portion 30 is made of a material with higher hardness than the middle dome body portion 12 and the lower dome body portion 13. The Shore A hardness (JIS K6253) of the upper dome body portion 11 is preferably 40 to 70, and the Shore A hardness of the other portions is preferably 30 or less. In this example, all materials are silicone resin, with the upper dome body portion 11 having a hardness of 50 and the other portions having a hardness of 20. The middle portion 12 and the lower portion 13 are integrally molded, and the middle portion 12 and the upper portion 11 are joined by insert molding, two-color molding, adhesive, or other methods.

[0043] In this example, the dome body 10 has a maximum outer diameter of 100 mm, a height from the bottom of the mounting portion 40 to the top of the rib 34 of the main port setting portion 31 of 110 mm, and an inner diameter of the mounting portion 40 of 50 mm. The thickness of the dome body upper portion 11 and the dome body middle portion 12 is 0.8 mm. Furthermore, the cell region 50 in the lower part of the dome body 13 is a regular hexagon with rounded corners, and the diameter of the circle inscribed in the cell is 3.5 mm. The thickness of the base 51 is 0.4 mm, the height of the protrusion 52 from the base 51 is 0.4 mm, and the width of the protrusion 52 is 1 mm.

[0044] The middle and lower dome body sections 12 and 13 are formed from a material with lower hardness than the upper dome body section 11, and as a result, the trocar fixing function is maintained by the port setting section 30 which is integrally molded with the high hardness upper dome body section 11, while the flexibility is increased by the low hardness of the middle and lower dome body sections 12 and 13, improving the ability of the insertion device 1 to follow the movement of the treatment tool inserted through the port setting section 30, and the high elasticity allows it to be adapted to a wide range of sizes of retractors.

[0045] Here, we will explain the damage expansion suppression function of the cell region 50 of the dome body 10. The insertion device 1 attached to the body surface side of the retractor a attached to the patient's incision applies tension to the entire dome body 10 by pressurizing the body cavity with carbon dioxide. If a sharp tip of a treatment tool or the like comes into contact with the base portion 51 of the cell region 50 under such conditions and causes damage, the tension may cause the damage to tear and spread. However, the protrusions 52, which are formed thicker than the base portion 51, stop the tearing and suppress the damage from expanding. Furthermore, even if a crack occurs in the protrusions 52, the adjacent cell region 50 can stop the damage from expanding. These actions are expected to be effective in preventing the dome body 10 from detaching due to the expanding damage and causing pieces to fall into the body.

[0046] In particular, in a configuration in which the inner diameter narrows from the middle part 12 of the dome body to the mounting part 40, as in this example, the risk of damage can be reduced by locating the cell area only in the lower part 13 of the dome body, where contact with treatment tools is likely to occur, while the middle part 12 of the dome body is made into a flat, highly translucent part 21 without a cell area, thereby improving visibility.

[0047] Furthermore, the flexibility of the dome body lower portion 13 is further improved by forming the base portion 51 of the cell region 50 thinner than the protrusion portion 52. This further improves the ability of the insertion device 1 to follow the movement of the treatment tool described above, and the flexibility of the attachment portion 40 for fitting to the retractor.

[0048] In this example, the dome body middle part 12 and the dome body lower part 13 have different peripheral surfaces, but these peripheral surfaces may also have a single configuration that includes only either the highly translucent part 21 or multiple cell regions 50.

[0049] Figures 8 to 10 show a third embodiment of the present invention. In this example, the main port setting section at the top of the dome body is formed as a removable cap. Figure 8 is an external view of the insertion device with the cap removed, with Figure 8A being a perspective view and Figure 8B being a front view. Figure 9 is an explanatory view of the insertion device with the cap attached, with Figure 9A being a perspective view and Figure 9B being a front view. Figure 10 is a cross-sectional view taken along the line α-α shown in Figure 9B.

[0050] The insertion device 1 of this embodiment has a circular opening 60 formed on the top side of the dome body 10, and an annular elastic ring 61 is provided around the periphery of the opening 60. The material of the elastic ring 61 may be any material that has the desired elasticity and can be bonded to the dome body 10, such as elastic resin or elastic alloy, and the bonding is performed by a known method such as adhesive bonding or insert molding. The elastic ring 61 of this example has a core material made of Ni-Ti metal covered with a cover tube made of silicone resin, and is bonded to the opening 60 with a silicone adhesive.

[0051] Furthermore, a constricted portion 62 that widens toward the cap 70 is formed on the outer periphery of the opening 60. In this example, the opening of the dome body 10 before the elastic ring 61 is joined is cylindrical and extends toward the top, and the inner diameter of the cylindrical portion is set smaller than the outer diameter of the elastic ring 61. The inner diameter of the cylindrical portion is expanded to fit the outer periphery of the elastic ring 61 and then joined, thereby forming the constricted portion 62.

[0052] The cap 70 fitted onto the elastic ring 61 of the opening 60 is made of an elastic material such as silicone resin and is formed into a flat plate with a circular upper surface, and the central space on the surface of the plate, excluding the circular peripheral edge, becomes the main port setting section 31. A fitting groove 71 is provided on the inner periphery of the rear side of the circular peripheral edge, into which the elastic ring 61 is fitted and accommodated for an airtight connection, and furthermore, parts of the circular peripheral edge protrude outward to provide gripping sections 72 at three equally spaced locations around the circumference for use in attachment and detachment operations, and these are integrally formed.

[0053] According to the insertion device of this embodiment, the main port setting section 31 at the top of the dome body 10 is formed as a detachable cap 70, and therefore a trocar can be inserted into the main port setting section 31 with the cap 70 separated from the dome body 10, eliminating the risk of the trocar coming into contact with the dome body 10 and preventing damage to the dome body 10 due to accidental puncture. Furthermore, when retrieving a resected organ or the like outside the body during endoscopic surgery using this insertion device, the retrieved material can be easily taken out through the opening 60 by removing the cap 70.

[0054] Furthermore, the main port setting section 31 is formed as a flat cap onto which the elastic ring 61 can be fitted, which makes it easy to attach and detach the main port setting section 31. Furthermore, the flat cap 70 is easy for the surgeon to hold, and when inserting the trocar, deformation of the cap 70 can be suppressed by placing a finger on the backside of the insertion part, making insertion easier.

[0055] Furthermore, the boundary between the main port setting section 31 and the dome body 10 has a constricted section 62 that widens toward the main port setting section. This means that when tilting the treatment tool inserted into the main port setting section 31 or pressing down the main port setting section 31, the constricted section 62 deforms preferentially over other parts of the dome body 10, preventing the dome body 10 from bending inward and preventing the inner surface of the dome body 10 from coming into contact with the treatment tool, which would hinder the workability of the treatment.

[0056] Although the embodiments of the present invention have been described above, the present invention is not limited to the above-described embodiments and various modifications and implementations are possible. For example, the shape of the dome body may be a three-dimensional shape with the body surface side of the retractor at the bottom, a shape that allows the port setting unit to be placed, and a shape that ensures a working space for the treatment tool within the dome, such as a truncated cone, a spindle, or a cylinder with a closed top. Furthermore, while the shape of the port setting unit is a regular hexagon, an equilateral triangle, or a circle in the above-described embodiments, it is not limited to these and may be an ellipse or other polygonal shape. Furthermore, the detachable main port setting unit configuration shown in the third embodiment may also be applied to a sub-port setting unit. Furthermore, the detachable mechanism for the port setting unit may be configured to airtightly connect the cap and the dome body. For example, the opening of the dome body may be formed to cover the circular peripheral edge of the cap. [Explanation of symbols]

[0057] 1. Insertion device 10.Dome body 11. Top of the dome body 12. Middle part of the dome body 13. Bottom of the dome body 21.Highly transparent part 22. Low tack surface 30. Port settings section 31. Main port setting section 32. Sub-port setting section 33. Puncture site 34. Ribs 35. Marker 40. Mounting part 41. Handle 50. Cell Area 51. Base 52. Protrusion 60. Opening 61. Elastic ring 62. Waist 70. Cap 71.Mating groove 72.Gripping part a. Retractor b. Trocar c. Treatment tools

Claims

1. An insertion device for a medical treatment tool that is attached to a body surface side of a retraction means that is attached to an opening in a human body and that can set a port through which a medical treatment tool is inserted, The insertion device includes a dome body made of an elastic member; an attachment portion to the retraction means; a port setting section defined as a range in which the port can be set by puncturing and penetrating without providing a through-hole or slit in advance into the body cavity; The medical treatment tool insertion instrument is characterized in that a plurality of the port setting portions are provided on the dome body.

2. The medical treatment tool insertion instrument according to claim 1, wherein at least one of the port setting portions is provided on the top side of the dome body.

3. 3. The medical treatment tool insertion instrument according to claim 2, wherein a plurality of the port setting portions are provided on the peripheral surface of the bottom side of the dome body.

4. 3. The medical treatment tool insertion instrument according to claim 2, wherein the port setting portion provided on the top side is formed to have a larger area than the port setting portions provided at other positions.

5. 2. The medical treatment tool insertion instrument according to claim 1, wherein the port setting portion has a rib erected thereon surrounding the entire periphery of the setting range.

6. 2. The medical treatment tool insertion device according to claim 1, wherein the dome body has a light-transmitting surface.

7. The medical treatment tool insertion instrument according to claim 6, wherein the dome body has surfaces with different tackiness arranged alternately.

8. 2. The medical treatment tool insertion instrument according to claim 1, wherein the dome body has a plurality of cell regions formed continuously and partitioned by mesh-like protrusions.

9. The medical treatment tool insertion instrument according to claim 1 , wherein the dome body and the port setting portion are integrally formed from the same material.

10. The medical treatment tool insertion instrument according to claim 9, wherein the port setting portion is formed to be thicker than the dome body.

11. The medical treatment tool insertion instrument according to claim 1 , wherein at least one of the port setting portions is formed detachably on the dome body.

12. The medical treatment tool insertion instrument according to claim 1 , wherein a boundary between at least one of the port setting portions and the dome body has a constricted portion that widens toward the port setting portion.

Images