Surgical nosepieces and outpatient nosepieces

Abstract

To provide a nosepiece for surgery and a nosepiece for outpatient care mounted in the nasal cavity of a patient to suppress emission of aerosol and droplets in surgery or outpatient care in nasal care which guide medical equipment to an affected part.SOLUTION: A nosepiece for surgery and a nosepiece for outpatient care include: a large diameter part having flexibility with roughly a cylindrical outer shape, which is inserted from the nostril and detained in the nasal cavity, is positioned in the vicinity of the entrance of the nostril, and regulates advance to the nasal cavity by the diameter of the entrance expanding larger than the diameter of the nostril; and a roughly cylindrical small diameter part whose diameter is smaller than the diameter of the large diameter part, which is continuously connected to the large diameter part, and detained from the nostril to the nasal cavity. An inlet valve member and / or an outlet valve member are provided inside the large diameter part and the small diameter part, which, when medical equipment is inserted into the large diameter part and the small diameter part respectively, open while coming in contact with the medical equipment around its axis by the advance, and cause the distal side of the medical equipment to protrude.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to a surgical nosepiece and an outpatient nosepiece that are attached to the patient's nasal cavity during surgery or outpatient care in rhinology to suppress the release of aerosols and droplets, guide medical instruments to the affected area, and protect the nasal vestibule. [Background technology]

[0002] Awareness and social demand for antibacterial and antiviral properties have increased dramatically due to the spread of infectious diseases, and masks are now worn on a daily basis, but in medical settings in particular, it is preferable for medical workers to wear N95 medical masks, which have a higher bacterial and viral capture rate than regular sanitary masks. However, since there is a limit to the continuous wearing time of N95 medical masks, it has become common for medical workers to wear regular medical masks and / or medical face shields during outpatient consultations and surgery to prevent droplets from patients, and in addition, to wear personal protective equipment (PPE) during surgery (see Patent Documents 1 and 2).

[0003] On the other hand, especially in rhinology (outpatient examinations, treatments, and surgery), there is a very high risk of infection from aerosols and droplets originating from the nasal cavity, so there is a problem that wearing medical masks and / or medical face shields and PPE is difficult to adequately protect medical workers from infection. For example, during surgery, where rigid endoscopes and forceps are inserted and suctioned through the nostrils, and power instruments are used, the medical masks, face shields, and PPE used up to now have not been sufficient to prevent aerosols and droplets. In addition, even in outpatient examinations, nasopharyngeal fiberscopes and the like are often inserted into the nostrils, and wearing PPE like during surgery is not sufficient, so it is difficult to say that relying on medical masks and / or medical face shields is sufficient infection prevention.

[0004] Furthermore, for example, Patent Document 3 provides a nosepiece that can easily deal with the occurrence of nasal discharge, nasal mucus, and other liquids, as well as nosebleeds, etc.; however, this nosepiece is capable of dealing with the occurrence of nasal discharge, nasal mucus, and other liquids, as well as nosebleeds, etc., by using a moisture-absorbing member when a nasal endoscope is inserted into the nasal cavity, and is not intended to prevent aerosols and droplets from being generated in the nasal cavity in the first place.

[0005] Furthermore, in actual clinical settings, ease of use is required when inserting and removing medical instruments such as endoscopes and forceps into the nasal cavity, and at the same time, it is desirable to minimize damage to the nasal vestibule caused by the medical instruments, and there was a potential need for a nosepiece that could satisfy these requirements. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] Utility Model Registration No. 3227608 [Patent Document 2] Utility Model Registration No. 3227608 [Patent Document 3] JP 2011-142949 A Summary of the Invention [Problem to be solved by the invention]

[0007] The present invention was created in consideration of the above circumstances, and its object is to provide a surgical nosepiece and a nosepiece for outpatient treatment that can be easily positioned in the patient's nasal cavity during surgery or outpatient treatment in rhinology, maintains operability even when medical instruments are inserted, ensures airtightness to prevent aerosols and droplets from leaking to the outside, and at the same time protects the nasal vestibule from medical instruments. [Means for solving the problem]

[0008] The first aspect of the present invention, which was created to solve the above problems, is: A surgical nosepiece having a flexible, generally cylindrical outer shape that is inserted through the anterior nostril and placed in the nasal cavity, a large diameter portion positioned near the entrance of the anterior nostril and having a diameter larger than the diameter of the anterior nostril to restrict progression into the nasal cavity; a substantially cylindrical small diameter portion having a diameter smaller than a diameter of an inlet of the large diameter portion and connected to the large diameter portion, the small diameter portion being placed from the anterior nostril to the inside of the nasal cavity; The interior of the large diameter portion and the small diameter portion are provided with an inlet valve member and an outlet valve member that, when a medical instrument is inserted into the large diameter portion side and the small diameter portion side, respectively, open while coming into contact around the axis of the medical instrument as the medical instrument progresses, thereby allowing the distal side of the medical instrument to protrude.

[0009] The surgical nosepiece 10, 10', which is the first invention, is inserted through the anterior nostril of the patient, positioned within the nasal cavity, and closed with an "airtight" seal to prevent aerosols and droplets from being released to the outside even when a medical instrument such as forceps or an endoscope is inserted into the nosepiece during surgery in order to prevent aerosols and droplets from being released to the outside. This surgical nosepiece can be easily inserted into the nasal cavity by inserting it into the nasal cavity from the small diameter portion, while the large diameter portion 12, 12' has a larger diameter at the entrance side than the anterior nostril, so it stops at the anterior nostril and is restricted from progressing further into the nasal cavity, allowing it to be positioned within the nasal cavity.

[0010] During surgery, the two valve members, the inlet valve member 16 and the outlet valve member 18, are closed, but the two valve members 16, 18 are flexible, and when a medical instrument is pushed in the axial direction, the valve members are opened while contacting the medical instrument due to the incisions 26 radially provided from the center when positioned in the nasal cavity. Therefore, with this surgical nosepiece 10, medical instruments can be easily inserted to the affected area while it is indwelled in the nasal cavity, and "operability" is ensured even when multiple medical instruments are inserted. In addition, since the two valve members 16, 18 are in contact with the periphery of the medical instrument even during insertion, "airtightness" is ensured, and aerosols and droplets can be prevented from being released to the outside. Furthermore, the diameter of the entrance of the large diameter parts 12, 12' of this surgical nosepiece 10, 10' is larger than the diameter of the anterior nostril, and the edge of the entrance side of this large diameter part 12 also plays a role in preventing the medical instrument from damaging the edge of the anterior nostril.

[0011] It is also preferable that the large diameter portion has a tapered portion that continuously reduces in diameter from at least the inlet side toward the small diameter portion, and that the nasal cavity side of the large diameter portion is connected to the small diameter portion that is smaller in diameter than the nasal cavity.

[0012] As a preferred example, large diameter section 12' of the surgical nosepiece has a tapered section 12b that continuously tapers from an entrance larger than anterior nostril 22 to a diameter smaller than nasal cavity 24, and has a shape such that the small diameter section 14 side of large diameter section 12' (the small diameter section 14 side of return section 12a, if there is a return section 12a described below) is connected to the entrance of small diameter section 14. With this shape, simply inserting the nosepiece through the patient's anterior nostril 22 causes the entrance of large diameter section 12 to act as a stopper at anterior nostril 22, restricting movement in the forward direction and preventing the nosepiece from entering the nasal cavity when inserting a medical instrument during surgery.

[0013] Alternatively, the large diameter section of the surgical nosepiece may have a generally cylindrical shape with a diameter larger than that of the nasal cavity on the small diameter section side, and the large diameter section may have a tapered section that tapers stepwise to a diameter smaller than that of the nasal cavity near the boundary with the small diameter section and connects to the small diameter section. As a particularly preferred example, the large diameter section has a generally cylindrical shape that is a generally elliptical shape that is long in the vertical direction.

[0014] That is, in one preferred example, large diameter section 12'' of this surgical nosepiece has a cross section on the small diameter side that is formed into a generally cylindrical shape with a diameter larger than the nasal cavity, and more preferably a generally elliptical shape that is long in the vertical direction (the major axis is in the vertical direction and the minor axis is in the horizontal direction), and the portion of large diameter section 12'' near the boundary on the connecting side with small diameter section 14 tapers in a stepped manner to the diameter of small diameter section 14, which is smaller than the nasal cavity. In other words, large diameter section 12'' has a cylindrical shape with a diameter larger than the diameter of the nasal cavity, and is formed in a so-called brim shape that suddenly tapers near the boundary with small diameter section 14 and connects to small diameter section 14. In this example of the surgical nosepiece, large diameter section 12" is not continuously tapered like a tapered or curved shape, but is formed into a roughly cylindrical shape with a diameter larger than the nasal cavity, and is stepped near the boundary with small diameter section 14. Therefore, large diameter section 12" is firmly positioned in anterior nostril 22, and can protect the nasal vestibule from medical instruments, such as endoscopes and various forceps, even when multiple medical instruments are inserted. Furthermore, even if the thickness of the surgical nosepiece is thin and soft to facilitate insertion into the nasal cavity and ensure an operating area for medical instruments, large diameter section 12" acts as a stopper to firmly protect the nasal vestibule and reliably prevent the surgical nosepiece from accidentally entering the nasal cavity.

[0015] Furthermore, as described above, for doctors who insert and operate multiple medical instruments, such as endoscopes and various forceps, into the nasal cavity, it is necessary to secure an area to operate the medical instruments, and considering that a typical anterior nostril 22 is longer in the up-down direction than in the left-right direction, if large diameter section 12" of surgical nosepiece 10" is also made to be a roughly elliptical shape that is longer in the up-down direction to match the shape of anterior nostril 22, the left-right length will be shorter even when surgical nosepiece 10" is inserted and left in both the left and right nostrils simultaneously, and left-right interference during surgery will be reduced.

[0016] The second nosepiece for outpatient care according to the present invention comprises: A flexible nosepiece for outpatient care that is inserted through the anterior nostril and left in the nasal cavity, a large diameter portion positioned near the entrance of the anterior nostril to restrict progression into the nasal cavity; a substantially cylindrical small diameter portion that is smaller in diameter than the large diameter portion and is connected to the large diameter portion and is placed from the anterior nostril to the inside of the nasal cavity; an inlet valve member provided inside the large diameter portion and the small diameter portion, the inlet valve member opening while contacting the medical instrument around its axis as the medical instrument advances when the medical instrument is inserted into the large diameter portion and the small diameter portion, and allowing the distal side of the medical instrument to protrude; The large diameter portion is continuously reduced in diameter at least from the inlet side toward the small diameter portion until it is connected to the small diameter portion.

[0017] The outpatient nosepiece 100, which is the second invention of the present invention, is similar to the surgical nosepiece 10 described above in that it is inserted through the patient's anterior nostril and positioned inside the nasal cavity to prevent aerosol and droplet exposure from the patient to medical staff, and diagnostic and treatment instruments are inserted into it, but the outpatient nosepiece 100 differs in that the valve member is a single piece consisting of only the inlet valve member 16 on the large diameter portion 12 side. This is because the nosepiece is worn by patients in a non-anesthetized state during outpatient treatment, and since it is unlikely that multiple medical instruments will be inserted at the same time, a single valve member is sufficient in terms of the balance between preventing the external release of droplets and aerosols and avoiding pain to the patient.

[0018] It is also preferable that the large diameter portion of the surgical nosepiece has an entrance diameter larger than the anterior nostril, and has a return portion that narrows toward the nasal cavity and then widens again near the boundary with the small diameter portion.

[0019] In the surgical nosepieces described above, the large diameter section tapers toward the small diameter section 14, specifically, examples have been shown in which the large diameter section 12' tapers until it reaches the small diameter section 14, but an example in which the large diameter section 12' is provided with a return section 12a that expands in diameter once near the boundary with the small diameter section 14 is also preferably used. In the examples described above, the entrance of the large diameter section 12 is larger than the diameter of the anterior nostril, and serves as a stopper to prevent instruments from falling into the nasal cavity and to protect the anterior nostril. However, in the case of a surgical nosepiece in which multiple medical instruments are inserted and removed, in particular, it is necessary to prevent instruments from slipping out to the outside. In the preferred example of the surgical nosepiece shown here (see reference numeral 10'), the large diameter section 12' is provided with a return section 12a that tapers toward the nasal cavity once by the reduction section 12b, but then expands again before connecting to the small diameter section 14, preventing instruments from falling out of the anterior nostril 24 when they are removed or replaced.

[0020] Furthermore, in the above-mentioned nosepiece for surgery or outpatient treatment, it is preferable that under normal circumstances the opening along the edge on the inlet side of the large diameter portion is closed horizontally in the radial direction by the inlet valve member having a plurality of notches extending radially from the center, and that when a medical instrument is inserted, the fan members separated by the notches elastically deform due to the pressing force caused by the progression of the medical instrument, curving or bending into the small diameter portion, thereby opening the opening while coming into contact with the medical instrument.

[0021] In either case of surgical or outpatient nosepieces 10, 10', 100, the inlet valve member provided on the inlet side of large diameter section 12, 12' is closed horizontally with radial cuts from the center like a so-called chrysanthemum-shaped rubber band, and when the medical instrument is pressed in the axial direction (direction of travel), the fan-shaped members separated by the cuts bend inward, and the fan-shaped members come into contact with the axial circumference of the medical instrument, suppressing the external release of aerosols and droplets.

[0022] Furthermore, in this surgical nosepiece, it is preferable that the outlet valve member normally has a generally conical shape in which a plurality of sectorial sections formed by a plurality of cuts extending radially from the center from the large diameter section to the outlet side of the small diameter section come together to form a side wall and close, tapering toward the outlet side with an internal space opening into the large diameter section, and that when a medical instrument is inserted, the sectorial section elastically deforms from the apex of the generally conical shape due to the pressing force of the medical instrument as it advances, and opens while coming into contact with the medical instrument.

[0023] As described above, the surgical nosepiece 10, 10' has a two-leaf valve member, and in addition to the inlet valve member 16, it has an internal outlet valve member 18 that tapers from the inlet to the outlet. In the case of the surgical nosepiece 10, it is particularly necessary to suppress the release of aerosols and droplets to the outside, and it is also essential to insert multiple medical instruments simultaneously for operation. Therefore, the additional outlet valve member 18 is a roughly cone-shaped valve member to gently guide the medical instruments toward the center while increasing the area that comes into contact with each of the various medical instruments during insertion. When viewed from the axial direction, the outlet valve member 18 has multiple fan members formed by cuts 28 that extend radially from the center, similar to the inlet valve member 16.

[0024] Furthermore, in the surgical nosepiece, the notches in the inlet valve member and the notches in the outlet valve member can be out of phase with each other.

[0025] In the surgical nosepiece 10, 10', the phase of the cuts in the inlet valve member 16 and the outlet valve member 18 is shifted when a medical instrument is inserted, and the formation of a linear gap from the inlet to the outlet is avoided even when both valve members 16, 18 are opened, thereby improving airtightness. .

[0026] In addition, it is preferable that the outer peripheral wall of the small diameter portion of this surgical or outpatient nosepiece has a plurality of protrusions that extend in the axial direction at a predetermined interval around the axis and have a height that is equal to or lower than that of the large diameter portion.

[0027] In the present nosepiece 10, 10', 100 for surgery or outpatient treatment, there are axially long protrusions 20 at a specified distance from the outer circumferential wall of the small diameter section 14, the protrusions 20 being equal to or shorter in height than the large diameter sections 12, 12'. These protrusions 20 come into contact with the inner wall of the nasal cavity 24, thereby positioning the nosepiece 10, 10', 100 in the insertion and withdrawal directions. Effect of the Invention

[0028] The surgical nosepiece and outpatient nosepiece of the present invention can be easily positioned in the patient's nasal cavity during surgery in rhinology or outpatient care, and provides an airtight nosepiece for surgery and outpatient care that maintains operability even when a medical instrument is inserted and does not release aerosols or droplets to the outside. [Brief description of the drawings]

[0029] [Figure 1] FIG. 1A is a perspective view of a first embodiment of a surgical nosepiece according to the first invention, and FIG. 1B is a cross-sectional perspective view cut in the axial direction along the radius of FIG. [Diagram 2] 2(a) shows a side view of the surgical nosepiece of FIG. 1, and (b) shows a side view thereof. [Diagram 3] FIG. 3(a) is a bottom view of the surgical nosepiece of FIG. 1 and FIG. 2, and FIG. [Figure 4] FIG. 4 is a photograph showing the surgical nosepiece of FIGS. 1 to 3 inserted and placed through the anterior nostril of a human model. [Diagram 5] FIG. 1A is a perspective view of a second embodiment of a surgical nosepiece according to the first aspect of the present invention, and FIG. 1B is a cross-sectional perspective view cut in the axial direction along the radius of FIG. [Figure 6] 6(a) shows a side view of the surgical nosepiece of FIG. 5, and (b) shows a cross-sectional side view thereof. [Figure 7] FIG. 7(a) shows a bottom view of the surgical nosepiece in FIGS. 5 and 6, and FIG. 7(b) shows a top view thereof. [Figure 8]FIG. 11A is a perspective view of a third embodiment of a surgical nosepiece according to the first aspect of the present invention, and FIG. 11B is a cross-sectional perspective view cut axially along the long axis of FIG. [Figure 9] 9(a) is a side view of the surgical nosepiece of FIG. 8, and FIG. 9(b) is a cross-sectional side view thereof. [Figure 10] 8 and 9. FIG. 8(a) shows a top view of the surgical nosepiece of FIG. 8 and FIG. 9, and FIG. [Figure 11] FIG. 1A is a perspective view of an embodiment of a nosepiece for outpatient treatment according to the second aspect of the present invention, and FIG. 1B is a cross-sectional perspective view cut in the axial direction along the radius of FIG. [Figure 12] 12(a) is a side view of the nosepiece for outpatient treatment in FIG. 11, and FIG. 12(b) is a cross-sectional side view thereof. [Figure 13] 13(a) is a bottom view of the nosepiece for outpatient treatment in FIG. 11 and FIG. 12, and FIG. 13(b) is a top view thereof. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0030] Hereinafter, an embodiment of the nosepiece of the present invention will be described by way of example. In this specification and drawings, the same reference number indicates the same member in the same embodiment, and the reference number having the same last two digits indicates the same member in different embodiments.

[0031] <<First embodiment of the surgical nosepiece>> First, a first embodiment of a surgical nosepiece 10 according to the first aspect of the present invention will be described with reference to Figs. 1 to 4. Fig. 1(a) is a perspective view of surgical nosepiece 10 as seen from the nasal cavity side, Fig. 1(b) is a perspective cross-sectional view cut in the axial direction along the radius in (a), Fig. 2(a) is a side view of surgical nosepiece 10, Fig. 2(b) is a side view of Fig. 1(b), Fig. 3(a) is a bottom view of surgical nosepiece 10, and Fig. 3(b) is a top view of surgical nosepiece 10. Fig. 4 is a photograph showing surgical nosepiece 10 inserted and placed through anterior nostril 22 of a human model.

[0032] As shown in Figs. 1 to 4, the surgical nosepiece 10 is made of silicone rubber as a flexible material, and is composed of a large diameter portion 12, a small diameter portion 14, an inlet valve member 16, an outlet valve member 18, and a protrusion 20. The surgical nosepiece 10 is inserted into the anterior nostril 22 from the small diameter portion 14 side and placed in the nasal cavity. The large diameter portion 12 has a hollow structure with a thin outer shell whose diameter on the inlet side (lower side of Fig. 1(a)) is larger than the inner diameter of the anterior nostril 22, and the diameter of the large diameter portion 12 gradually decreases toward the nasal cavity side (upper side of Fig. 1(a)) like the base of a so-called dome shape, with its edge continuously connected to the edge of the small diameter portion 14. Due to this shape, when the surgical nosepiece 10 is inserted into the anterior nostril 22, the inlet side of the large diameter portion 12 acts as a stopper to position the large diameter portion 12 in the insertion direction (advancement direction) in the anterior nostril 22.

[0033] As described above, the edge of the small diameter section 14 on the inlet side is continuously connected to the edge of the large diameter section 12 on the outlet side, which has a reduced diameter, and forms a thin, generally tubular mantle that tapers in the axial direction and extends for a predetermined length. The diameter of the small diameter section 14 is smaller than the inner diameter of the nasal cavity 24, so that it can be smoothly inserted into the nasal cavity 24. The outer peripheral wall of the small diameter section 14 has protrusions 20 that are long in the axial direction and have a height equal to or lower than that of the large diameter section 12, at predetermined intervals around the axis, for example, at 90° intervals in the example of Figs. 1 to 3. The protrusions 20 come into contact with the inner wall of the nasal cavity 24 to position the surgical nosepiece 10 in the insertion and withdrawal directions. In particular, even if the surgical nosepiece 10 is easily displaced when a medical instrument is inserted and operation is performed, the positioning force is actually increased because the longitudinal directions of the protrusions 20 are oriented in different directions when the small diameter section 14 is twisted by the medical instrument.

[0034] Inside the large diameter portion 12 and the small diameter portion 14, an inlet valve member 16 is provided at the inlet edge of the large diameter portion 12, and an outlet valve member 18 is provided from the large diameter portion 12 to the vicinity of the outlet of the small diameter portion 14. The inlet valve member 16 is a disk-shaped thin plate member that closes the opening surface along the edge of the inlet side of the large diameter portion 12, and has six notches 26 that spread radially from the center along the radius like a so-called chrysanthemum-shaped rubber. That is, the inlet valve member 16 is formed by combining fan members separated by the notches 26 at 60° intervals. Then, when a medical instrument is pushed into the inlet valve member 16 during surgery, each fan member separated by the six notches 26 is also pushed in due to its elastic deformation, opening the inlet valve member 16, and the medical instrument advances inside the small diameter portion 14 positioned in the nasal cavity 24. At this time, each fan member of the inlet valve member 16 comes into contact with most of the outer periphery of the medical instrument, ensuring airtightness.

[0035] The surgical nosepiece 10 is provided with an outlet valve member 18 in addition to the inlet valve member 16. The outlet valve member 18 is formed in a generally conical shape that tapers from the narrowing diameter of the inner wall of the large diameter portion 12 to the outlet of the small diameter portion 14, and the internal space opens into and is connected to the inside of the large diameter portion 12. The outlet valve member 18 has multiple notches that extend radially from the apex of the cone shape on the outlet side to the vicinity of the boundary with the large diameter portion 12, and as shown in Figure 4(b) when viewed from above, it has four notches 28 that extend radially from the center along the radius like a so-called chrysanthemum-shaped rubber, similar to the inlet valve member 16. In other words, the outlet valve member 18 is formed by joining together fan members separated by notches 28 at 90° intervals. When a medical instrument passing through inlet valve member 16 during surgery pushes into outlet valve member 18, each of the fan members separated by four notches 26 is also pushed in due to its elastic deformation and released from near the apex on the outlet side, causing the distal tip of the medical instrument to protrude outside the outlet side of surgical nosepiece 10 and proceed through nasal cavity 24 to be guided to the target affected area. At this time, each fan member of outlet valve member 18 contacts most of the outer periphery of the medical instrument while guiding the distal tip of the medical instrument toward the apex, so that in combination with inlet valve member 16, sufficient airtightness is ensured.

[0036] Furthermore, the notches 26 of the inlet valve member 16 are spaced at 60° intervals, while the notches 28 of the outlet valve member 18 are spaced at 90° intervals. Therefore, the phases of the notches 26 and 28 are the same every 180°, and are out of phase at other times. As a result, even when a medical instrument is inserted and both the inlet valve member 16 and the outlet valve member 18 are open, there are few situations in which a gap is formed in a straight line in the axial direction, which also improves the "airtightness" of the surgical nosepiece 10.

[0037] <<Second embodiment of the surgical nosepiece>> Next, surgical nosepiece 10' as a second embodiment, which is a variation of surgical nosepiece 10 according to the first aspect of the present invention, will be described with reference to Figures 5 to 7. Figure 5(a) is a perspective view of surgical nosepiece 10' as seen from the nasal cavity side, Figure 5(b) is a perspective cross-sectional view cut in the axial direction along the radius of Figure 5(a), Figure 6(a) is a side view of surgical nosepiece 10', Figure 6(b) is a side view of Figure 5(b), Figure 7(a) is a bottom view of surgical nosepiece 10', and Figure 7(a) is a top view of surgical nosepiece 10'.

[0038] As shown in Figures 5 to 7, surgical nosepiece 10' uses silicone rubber as a flexible material and is generally similar to surgical nosepiece 10 in Figures 1 to 3, consisting of large diameter section 12', small diameter section 14, inlet valve member 16, outlet valve member 18, and protrusion 20, and is inserted into anterior nostril 22 from small diameter section 14 and left in the nasal cavity. Therefore, here we will explain the parts of surgical nosepiece 10' that are different from surgical nosepiece 10, specifically large diameter section 12'. Note that parts in surgical nosepiece 10' in Figures 5 to 7 that have the same reference numbers as surgical nosepiece 10 in Figures 1 to 3 have the same configuration.

[0039] Large diameter section 12' of surgical nosepiece 10' is formed by reduced diameter section 12b on the entrance side (lower side in FIG. 5(a)) and turned section 12a on the exit side (nasal cavity side (upper side in FIG. 5(a))). Like large diameter section 12 in FIGS. 1 to 3, reduced diameter section 12b has a maximum diameter on the entrance side and continuously reduces in diameter to near the middle in the axial direction, and is connected to the edge of turned section 12a. When surgical nosepiece 10' is inserted into anterior nostril 22, reduced diameter section 12b is positioned by the expanded diameter part on the entrance side and serves to protect the opening edge of anterior nostril 22 from medical instruments while restricting further progression.

[0040] Furthermore, the diameter of return portion 12a, which is once reduced at reduced diameter portion 12b, expands again toward the nasal cavity (upper side in FIG. 5(a)), expands to a predetermined diameter, and then contracts to the diameter of small diameter portion 14, where it is connected. Return portion 12a serves to restrict the movement of the entrance side to prevent surgical nosepiece 10' inserted into nasal cavity 24 from slipping out. This is particularly useful in the case of surgical nosepiece 10' which performs an advancement or retreat operation while a medical instrument is inserted, because surgical nosepiece 10' easily slips out of nasal cavity 24 in response to the removal of the medical instrument. The diameter of return portion 12a is smaller than the entrance diameter of reduced diameter portion 12b, and the slope of the expansion of return portion 12a is steeper than the slope of the reduction in diameter of reduced diameter portion 12b. However, the inner wall of the large diameter portion 12' is connected to the inner wall of the outlet valve member 18 in a manner similar to that of the surgical nosepiece 10, and forms a generally conical shape.

[0041] <<Regarding the Third Embodiment of the Surgical Nosepiece>> Next, surgical nosepiece 10" as a third embodiment, which is a variation of surgical nosepieces 10, 10' of the first present invention, will be described with reference to Figs. 8 to 10. Fig. 8(a) is a perspective view of surgical nosepiece 10" as seen from the nasal cavity side. Fig. 8(b) is a perspective cross-sectional view cut axially along the major axis of Fig. 8(a). Fig. 9(a) is a side view of surgical nosepiece 10" as seen from the minor axis side. Fig. 9(b) is a side view of Fig. 8(b) as seen from the minor axis side. Fig. 10(a) is a top view of surgical nosepiece 10", and Fig. 10(b) is a top view of surgical nosepiece 10'.

[0042] 7 and 8. As shown in FIGS. 8-10, surgical nosepiece 10" uses silicone rubber as a flexible material and is generally similar to surgical nosepiece 10 in FIGS. 1-3 and surgical nosepiece 10' in FIGS. 5-7. It is composed of large diameter section 12", small diameter section 14, inlet valve member 16, outlet valve member 18, and protrusion 20, and is inserted into anterior nostril 22 from small diameter section 14 and left in the nasal cavity. Therefore, like surgical nosepiece 10', we will explain the parts of surgical nosepiece 10" that differ from surgical nosepieces 10, 10", specifically, large diameter section 12", outlet valve member 18', and wall thicknesses t1 and t2 of surgical nosepiece 10". Note that in surgical nosepiece 10" in FIGS. 8-10, parts that have the same reference numbers as surgical nosepiece 10 in FIGS. 1-3 and surgical nosepiece 10' in FIGS. 5-7 have the same configuration.

[0043] Large diameter section 12" of surgical nosepiece 10" is formed by reduced diameter section 12c on the outlet side (nasal cavity side (upper side in FIG. 8(a))), same diameter section 12d, and lower edge section 12e on the entrance side (lower side in FIG. 8(b)). Lower edge section 12e differs from large diameter section 12 in FIGS. 1 to 3 and large diameter section 12' in FIGS. 5 to 8 in that it forms a substantially elliptical cross section (cross section taken along a plane perpendicular to the axis) with a major axis of length a and a minor axis of length b. Also, same diameter section 12 is formed in a cylindrical shape of substantially the same diameter as lower edge section 12e on the entrance side, and the diameter is stepped down at reduced diameter section 12c on the outlet side to connect to the edge of small diameter section 14. When the surgical nosepiece 10" is inserted into the anterior nostril 22, the large diameter portion 12" is positioned in a phase such that the long diameter of length a is in the up-down direction and the short diameter of length b is in the left-right direction, and has the role of protecting the opening edge of the anterior nostril 22 from medical instruments while restricting further progression into the nasal cavity. This large diameter portion 12" generally fits the anterior nostril 22 in the up-down direction rather than the left-right direction, ensuring an operating area for medical instruments in the up-down direction during surgery and reducing left-right interference when used in both the left and right nasal cavities.

[0044] Large diameter section 12" has constant diameter section 12d extending upward from lower edge 12e, and has reduced diameter section 12c that tapers radially inward in a stepped manner from the upper edge of same diameter section 12d to connect to small diameter section 14, forming a so-called brim shape. As a result, large diameter section 12" acts as a stopper at anterior nostril 22, preventing surgical nosepiece 10" from entering the nasal cavity even if it is slightly deformed. As a result, as shown in FIG. 9(b), thicknesses t1, t2 of surgical nosepiece 10" can be made thinner than the thicknesses of surgical nosepiece 10 in FIGS. 1 to 3 and surgical nosepiece 10' in FIGS. 5 to 8, which makes it softer (improved flexibility) and greatly reduces limitations on the manipulation range of medical instruments during surgery.

[0045] In addition, since the surgical nosepiece 10" in FIGS. 8 to 10 has a thin wall thickness and is easily deformed, in this example, in order to prevent a decrease in the ability to leak aerosols and droplets and to ensure its function as a valve, the outlet valve member 18' is made into an approximation of a dome shape that is curved downward from a generally conical shape.

[0046] <<About the embodiment of the nosepiece for outpatient treatment>> Next, a first embodiment of the nosepiece 100 for outpatient treatment, which is the second invention of the present invention, will be described with reference to Fig. 11 to Fig. 13. Fig. 11(a) is a perspective view of the nosepiece 100 for outpatient treatment, seen from the nasal cavity side, Fig. 11(b) is a perspective view of a cross section cut in the axial direction along the radius in (a), Fig. 12(a) is a side view of the nosepiece 100 for outpatient treatment, Fig. 12(b) is a side view of Fig. 1(b), Fig. 13(a) is a bottom view of the nosepiece 100 for outpatient treatment, and Fig. 13(b) is a top view of the nosepiece 100 for outpatient treatment.

[0047] 11 to 13, outpatient nosepiece 100 uses silicone rubber as a flexible material, and has, similarly to surgical nosepieces 10 and 10' in Figs. 1 to 7, a large diameter portion 12, a small diameter portion 14, an inlet valve member 16, and a protrusion 20 as its components. It is inserted into an anterior nostril 22 from the small diameter portion 14 side and left in the nasal cavity, with large diameter portion 12 positioned at anterior nostril 22. However, unlike surgical nosepieces 10 and 10', it does not have an outlet valve member 18. This is because, although it is unlikely that multiple medical instruments are inserted simultaneously into outpatient nosepiece 100 during outpatient treatment and less droplets and aerosols are released to the outside than during surgery, the patient is not anesthetized when nosepiece 100 is used, so consideration must be given to avoiding pain, and it must be inexpensive and easy to manufacture because it is used frequently and by a large number of patients, and a single valve member is appropriate.

[0048] Therefore, outpatient nosepiece 100 has the same components as surgical nosepiece 10, except that it does not have outlet valve member 18. The same reference numbers are used in FIGS. 11-13 as in FIGS. 1-3, and because the same components (same reference numbers) are used here, a description of each will be omitted and reference will be made to surgical nosepiece 10 described above.

[0049] Specifically, the outpatient nosepiece 100 uses silicone rubber as a flexible material, similar to the surgical nosepiece 10, and is composed of a large diameter portion 12, a small diameter portion 14, an inlet valve member 16, and a protrusion 20. It is inserted into the anterior nostril 22 from the small diameter portion 14 side and left in the nasal cavity. The large diameter portion 12 has a hollow structure of a thin outer shell that tapers from the inlet side, which is larger than the inner diameter of the anterior nostril 22, toward the nasal cavity side, which is smaller than the inner diameter of the anterior nostril 22. Similar to the surgical nosepiece 10, the large diameter portion 12 is connected to the small diameter portion 14 at the base of a so-called dome shape, and when inserted into the anterior nostril 22, the inlet side of the large diameter portion 12 serves as a stopper and is left in the anterior nostril 22. In the examples of Figs. 8 to 13, the small diameter portion 14 forms an approximately cylindrical shape that extends a predetermined length with approximately the same diameter in the axial direction, and similar to the surgical nosepiece 10, a plurality of protrusions 20 are provided around the axis on the outer circumferential wall. Although small diameter section 14 may have a tapered shape as in surgical nosepiece 10 in FIGS. 1-7, in the case of outpatient nosepiece 100, which does not have an outlet valve member, a tapered shape would be prone to twisting deformation when the medical instrument is inserted. Additionally, to increase the prevalence of this product in outpatient care, it is necessary to mass-produce it at low cost. For this reason, it is envisioned that small diameter section 14 will have approximately the same diameter in the axial direction.

[0050] Additionally, the inlet valve member 16 is similar to the surgical treatment nosepiece 10 in that it has notches 26 that radiate out from the center along the radius, like a so-called chrysanthemum-shaped rubber band. However, because it is used during outpatient treatment, emphasis is placed on ensuring the operability of medical instruments and ensuring widespread use rather than on ensuring airtightness for the surgical treatment nosepiece 10, and modifications such as enlarging the notch width or increasing or decreasing the number of notches may be adopted.

[0051] Although the embodiments of the surgical nosepiece and outpatient nosepiece of the present invention have been described above by way of example, the present invention is not limited thereto, and it will be understood by those skilled in the art that other modifications and improvements can be made without departing from the spirit and teachings of the claims and the description, etc. For example, various modifications are conceivable, such as making the large diameter portion 12 substantially cylindrical, making the vicinity of the inlet into a brim-like shape to expand the diameter, and if a return portion 12a exists, making the vicinity of the connection with the small diameter portion 14 also brim-like to form the return portion 12a, or making the outlet valve member 18 into a disk shape that closes the edge on the outlet side of the small diameter portion 14, similar to the inlet valve member 16. [Explanation of symbols]

[0052] 10,10' Surgical Nosepiece 100 Surgical nosepiece 12,12' large diameter section 12a, 112a Return part 12b, 112b Reduced diameter part 14 Small diameter section 16 Inlet valve member 18 Outlet valve member 20 protrusions 22 Anterior nostril 24 Nasal cavity 26, 28 Cutting

Claims

1. A surgical nosepiece having a flexible, generally cylindrical outer shape that is inserted through the anterior nostril and placed in the nasal cavity, Positioned near the entrance of the anterior nostril, the diameter of the entrance is a large diameter portion that expands larger than the diameter of the hole and restricts the passage of the needle into the nasal cavity; a substantially cylindrical small diameter portion having a diameter smaller than a diameter of an inlet of the large diameter portion and connected to the large diameter portion, the small diameter portion being placed from the anterior nostril to the inside of the nasal cavity; The surgical nosepiece includes an inlet valve member and an outlet valve member inside the large diameter portion and the small diameter portion, respectively, which open and come into contact around the axis of a medical instrument as the medical instrument progresses when the medical instrument is inserted into the large diameter portion and the small diameter portion, respectively, thereby allowing the distal side of the medical instrument to protrude.

2. 2. The surgical nosepiece of claim 1, wherein the large diameter portion has a tapered portion that continuously reduces in diameter from at least an inlet side toward the small diameter portion, and a nasal cavity side of the large diameter portion is connected to the small diameter portion that has a diameter smaller than the nasal cavity.

3. 2. The surgical nosepiece of claim 1, wherein the large diameter portion has a generally cylindrical outer shape with a diameter larger than the diameter of the nasal cavity at least on the small diameter portion side, and the large diameter portion has a tapered portion that tapers stepwise to a diameter smaller than the diameter of the nasal cavity near a boundary with the small diameter portion and is connected to the small diameter portion.

4. 4. The surgical nosepiece according to claim 3, wherein the large diameter portion has a generally cylindrical outer shape that is generally elliptical and vertically long and larger than a diameter of a nasal cavity.

5. A flexible nosepiece for outpatient care that is inserted through the anterior nostril and left in the nasal cavity, a large diameter portion positioned near the entrance of the anterior nostril to restrict progression into the nasal cavity; a substantially cylindrical small diameter portion that is smaller in diameter than the large diameter portion and is connected to the large diameter portion and is placed from the anterior nostril to the inside of the nasal cavity; an inlet valve member provided inside the large diameter portion and the small diameter portion, the inlet valve member opening while contacting the medical instrument around its axis as the medical instrument advances when the medical instrument is inserted into the large diameter portion and the small diameter portion, and allowing the distal side of the medical instrument to protrude; The large diameter portion is continuously reduced in diameter at least from the inlet side toward the small diameter portion until it is connected to the small diameter portion.

6. 5. The surgical nosepiece according to claim 1, wherein the large diameter portion has an entrance diameter larger than the anterior nostril, and the large diameter portion has a return portion that reduces in diameter toward the nasal cavity and then expands in diameter again near the boundary with the small diameter portion.

7. 7. The nosepiece for surgery or outpatient treatment according to claim 1, wherein under normal circumstances, an opening along the edge on the inlet side of the large diameter portion is horizontally closed in the radial direction by the inlet valve member having a plurality of notches extending radially from a center, and when a medical instrument is inserted, the fan members separated by the notches elastically deform due to the pressing force caused by the progression of the medical instrument, curving or bending into the small diameter portion, thereby opening the opening while contacting the medical instrument.

8. 8. The surgical nosepiece of claim 1, wherein the outlet valve member is normally closed by a side wall formed by a plurality of sectorial sections formed by a plurality of cuts extending radially from a center from the large diameter section side to the outlet side of the small diameter section, and has a generally conical shape tapering toward the outlet side with an internal space opening into the large diameter section, and wherein, when a medical instrument is inserted, the sectorial section elastically deforms from the apex of the generally conical shape due to a pressing force caused by the progression of the medical instrument, and opens while coming into contact with the medical instrument.

9. 9. The surgical nosepiece of claim 1, wherein the inlet valve member and the outlet valve member have notches that are out of phase with each other.

10. 10. The nosepiece for surgery or outpatient care according to claim 1, wherein the outer peripheral wall of the small diameter portion has a plurality of protrusions extending in the axial direction at predetermined intervals around the axis and having a height equal to or lower than that of the large diameter portion.

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