DE10104106A1 - Protective sheath for endoscopes comprises thin film sleeves enclosing guide channel plus end sleeve with ring seals fitted or sheath-replacing cannula permitting sharp-edged instruments. - Google Patents

Protective sheath for endoscopes comprises thin film sleeves enclosing guide channel plus end sleeve with ring seals fitted or sheath-replacing cannula permitting sharp-edged instruments.

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Publication number
DE10104106A1
DE10104106A1 DE2001104106 DE10104106A DE10104106A1 DE 10104106 A1 DE10104106 A1 DE 10104106A1 DE 2001104106 DE2001104106 DE 2001104106 DE 10104106 A DE10104106 A DE 10104106A DE 10104106 A1 DE10104106 A1 DE 10104106A1
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DE
Germany
Prior art keywords
sheath
guide channel
protective cover
thin film
sleeve
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
DE2001104106
Other languages
German (de)
Inventor
Johannes Woitzik
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to DE2001104106 priority Critical patent/DE10104106A1/en
Publication of DE10104106A1 publication Critical patent/DE10104106A1/en
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00142—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with means for preventing contamination, e.g. by using a sanitary sheath
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B17/3431—Cannulas being collapsible, e.g. made of thin flexible material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3435—Cannulas using everted sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/40—Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment

Abstract

The endoscope sheath consists of a thin film tube (3,4) housing a removable guide channel (5), all without cell entrainment. The sheath has a sleeve at each distal end for easier handling. The inner sheath can be replaced by a cannula tube joined to the outer film to permit the use of sharp-edged endoscope instruments without damaging the inner sleeve. Each distal end has its own seal fitted (9) to guard against fluid build-up between sleeve and channel and the sheath is also to be used to prevent material flowing along the channel.

Description

Die beschriebene Erfindung gehört in das Gebiet von Endoskopiegeräten.The described invention belongs to the field of endoscopy devices.

Es ist bekannt, daß beim Operieren von malignen Tumoren in endoskopischer Technik Zellen entlang des Arbeitskanals in gesundes Gewebe verschleppt werden können und dadurch möglicherweise Impfmetastasen entstehen1-3. Um dieses Risiko zu verringern, wurde versucht, mittels eines Plastik-bags4 die Aussaat zu verringern. Hierbei wird der Tumor vor Entfernung von einer Plastikfolie umhüllt. Von einigen Autoren wurde dem Gas, welches zum Erzeugen eines Pneumoperitoneums verwandt wird, ein gewisser Einfluß zugeschrieben5. Zytostatika und immunmodulierende Faktoren zeigten in experimentellen Arbeiten einen Nutzen6,7.It is known that when malignant tumors are operated on using endoscopic technology, cells can be carried along the working channel into healthy tissue and this may result in vaccine metastases 1-3 . In order to reduce this risk, attempts were made to reduce the sowing using a plastic bag 4 . The tumor is wrapped in a plastic sheet before removal. Some authors have attributed some influence to the gas used to create a pneumoperitoneum 5 . Cytostatics and immunomodulating factors showed a benefit in experimental work 6.7 .

Der im Patentanspruch angegebenen Erfindung liegt das Problem zugrunde, eine Verschleppung von Zellmaterial entlang des Arbeitskanals der endoskopischen Instrumente und damit eine potentielle Implantation von Impfmetastasen zu verhindern.The problem specified in the invention is based on a problem Carrying of cell material along the working channel of the endoscopic instruments and thus prevent a potential implantation of vaccine metastases.

Dieses Problem wird durch den im Patentanspruch aufgeführten Folienschlauch gelöst, welcher als Schutzhülle die Innen- und Außenseite eines Führungskanals auskleidet und welcher nach Durchführung des endoskopischen Eingriffs zur Entfernung des Führungskanals dient. Dabei wird durch vorsichtigen Zug am inneren Folienschlauch der Führungskanal aus dem Stichkanal entfernt. Der äußere Folienschlauch schlägt dabei am distalen Ende des Kanals nach innen um. Potentiell maligne Zellen gelangen so in das innere Lumen der Kanüle und können den Stichkanal wie beim herkömmlichen Zurückziehen nicht mehr kontaminieren.This problem is solved by the film tube listed in the claim, which lines the inside and outside of a guide channel as a protective cover and which after performing the endoscopic procedure to remove the guide channel serves. The guide channel is opened by carefully pulling on the inner film tube the branch channel removed. The outer film tube hits the distal end of the Channel inside around. Potentially malignant cells get into the inner lumen of the cannula and can no longer use the stitch channel as with conventional retraction contaminate.

Eine vorteilhafte Ausgestaltung der Erfindung ist im Patentanspruch 2 angegeben. Zur einfacheren Handhabung wird eine Hülse jeweils am distalen Ende des inneren und äußeren Folienschlauchs befestigt.An advantageous embodiment of the invention is specified in claim 2. to Ease of use is a sleeve at the distal end of the inner and outer Foil tube attached.

Zweckmäßigerweise wird beim Einsatz des Führungskanals das zu verwendende Enodskopieinstrument so bearbeitet, daß der innere Folienschlauch nicht verletzt werden kann. Um jedoch auch scharfkantige Endoskopieinstrumente einsetzten zu können, kann der innere Folienschlauch gemäß Patentanspruch 3 durch ein Kanülenrohr ersetzt werden, welches mit der äußeren Folie verklebt wird. Da eine Flüssigkeitsansammlung zwischen Folienschlauch und Führungskanal zur Adhäsion dieser beiden Komponenten führt, wird gemäß Patentanspruch 4 ein Dichtring am distalen Ende der inneren und äußeren Folie angebracht.The one to be used is expediently used when the guide channel is used Enodoscope instrument processed so that the inner film tube is not damaged can. However, in order to be able to use sharp-edged endoscopy instruments, the inner film tube according to claim 3 can be replaced by a cannula tube, which is glued to the outer film.  There is a build-up of liquid between the film tube and the guide channel for adhesion leads of these two components, according to claim 4 is a sealing ring on the distal End of the inner and outer film attached.

Gemäß Anspruch 5 ist der Schutzmechanismus universell einsetzbar, wann immer es um die Verhinderung von Verschleppung eines Materials entlang eines Arbeitskanals geht.According to claim 5, the protective mechanism can be used universally whenever it is about Prevention of carryover of material along a working channel.

Ein Ausführungsbeispiel der Erfindung ist in den Zeichnungen dargestellt und wird im folgenden näher beschrieben.An embodiment of the invention is shown in the drawings and is in following described in more detail.

Ein herkömmlicher Führungskanal (5) wird innen und außen mit einem dünnen Folienschlauch (z. B. 5 µm PE-Folie) so überzogen (3 und 4), daß er am distalen Ende des Führungskanals (5) nahtlos ineinander übergeht. Zur einfacheren Handhabung wird der äußere Folienschlauch (3) an seinem distalen Ende mit einer Hülse (2) verklebt. An der Hülse (1) für den inneren Folienschlauch (4) sind zusätzlich zwei kleine Griffe (kleine Kreise) angebracht, an welchen die Führungskanal nach Beendigung des Eingriffs durch leichten Zug entlang des geraden Pfeils entfernt wird. Dabei schlägt der äußere Folieschlauch (3) in das innere Lumen des Führungskanals um (gebogener Pfeil). Anhaftende Zellen (7) gelangen so in das Innere des Führungskanals und können nicht entlang des Stichkanals verschleppt werden. Zwei Dichtungsringe (9) verhindern das Eindringen von Flüssigkeit zwischen Folie und Kanüle und vermeiden damit eine Adhäsion dieser Komponenten.A conventional guide channel ( 5 ) is covered inside and outside with a thin film tube (e.g. 5 µm PE film) ( 3 and 4 ) so that it merges seamlessly into one another at the distal end of the guide channel ( 5 ). For easier handling, the outer film tube ( 3 ) is glued at its distal end to a sleeve ( 2 ). On the sleeve ( 1 ) for the inner film tube ( 4 ) there are also two small handles (small circles) on which the guide channel is removed by pulling lightly along the straight arrow after the end of the procedure. The outer film tube ( 3 ) folds into the inner lumen of the guide channel (curved arrow). Adherent cells ( 7 ) thus get inside the guide channel and cannot be carried along the branch channel. Two sealing rings ( 9 ) prevent liquid from penetrating between the film and the cannula and thus prevent these components from adhering.

Die obere Zeichnung zeigt den mit einem Folienschlauch (3 und 4) versehenen Führungskanal (5) nach Durchführung des endoskopischen Eingriffs. Der Führungskanal (5) ist noch unverändert im Gewebe plaziert. Die Spitze liegt dabei noch im malignen Gewebe (6). Die untere Zeichnung zeigt den Führungskanal (5) während er durch Zug an der Hülse (1) des inneren Folienschlauchs (4) entfernt wird. Anhaftende Zellen (7) werden dabei in das Lumen des Führungskanals gezogen.The upper drawing shows the guide channel ( 5 ) provided with a film tube ( 3 and 4 ) after the endoscopic intervention has been carried out. The guide channel ( 5 ) is still placed unchanged in the tissue. The tip is still in the malignant tissue ( 6 ). The lower drawing shows the guide channel ( 5 ) while it is removed by pulling on the sleeve ( 1 ) of the inner film tube ( 4 ). Adherent cells ( 7 ) are drawn into the lumen of the guide channel.

Um den inneren Folienschlauch (4) beim Verwenden von scharfkantigen Endoskopieinstrumenten nicht zu verletzten, kann dieser alternativ durch ein dünnwandiges Kanülenrohr ersetzt werden. In order not to injure the inner film tube ( 4 ) when using sharp-edged endoscopy instruments, this can alternatively be replaced by a thin-walled cannula tube.

Literaturliterature

1. Reddy YP, Sheridan WG. Port-site metastasis following laparoscopic cholecystectomy: a review of the literature and a case report. Eur J Surg Oncol 2000; 26: 95-98.
2. Winston CB, Chen JW, Fang Y, Schwartz LH, Panicek DM. Recurrent gallbladder carcinoma along laparoscopic cholecystectomy port fracks: CT demonstration. Radiology. 1999; 212: 439-444.
3. Sammak B, Yousef B, Abd EB et al. Needle track seeding following percutaneous ethanol injection for treatment of hepatocellular carcinoma. Hepatogastroenterology 1998; 45: 1097-1099.
4. Paolucci V, Schaeff B, Schneider M, Gutt C. Tumor seeding following laparoscopy: international survey. World J Surg 1999; 23: 989-995.
5. Ishida H, Murata N, Yamada H et al. Influence of trocar placemenmt and CO (2) pneumoperitoneum on port site metastasis following laparoscopic timor surgery. Surg Endosc 2000; 14: 193-197.
6. Neuhaus SJ, Watson DI, Ellis T, Dodd T, Rofe AM, Jamieson GG. Efficacy of cytotoxic agents for the prevention of laparoscopic portsite metastases. Arch Surg 1998; 133: 762-766.
7. Mathew G, Watson DI, Ellis TS, Jamieson GG, Rofe AM. The role off peritoneal immunity and the tumour-bearing state on the development of wound and peritoneal metastases after laparoscopy. Aust N Z J Surg 1999; 69: 14-181. Reddy YP, Sheridan WG. Port-site metastasis following laparoscopic cholecystectomy: a review of the literature and a case report. Eur J Surg Oncol 2000; 26: 95-98.
2. Winston CB, Chen JW, Fang Y, Schwartz LH, Panicek DM. Recurrent gallbladder carcinoma along laparoscopic cholecystectomy port fracks: CT demonstration. Radiology. 1999; 212: 439-444.
3. Sammak B, Yousef B, Abd EB et al. Needle track seeding following percutaneous ethanol injection for treatment of hepatocellular carcinoma. Hepatogastroenterology 1998; 45: 1097-1099.
4. Paolucci V, Schaeff B, Schneider M, Gutt C. Tumor seeding following laparoscopy: international survey. World J Surg 1999; 23: 989-995.
5. Ishida H, Murata N, Yamada H et al. Influence of trocar placemenmt and CO (2) pneumoperitoneum on port site metastasis following laparoscopic timor surgery. Surg Endosc 2000; 14: 193-197.
6. Neuhaus SJ, Watson DI, Ellis T, Dodd T, Rofe AM, Jamieson GG. Efficacy of cytotoxic agents for the prevention of laparoscopic portsite metastases. Arch Surg 1998; 133: 762-766.
7. Mathew G, Watson DI, Ellis TS, Jamieson GG, Rofe AM. The role off peritoneal immunity and the tumor-bearing state on the development of wound and peritoneal metastases after laparoscopy. Aust NZJ Surg 1999; 69: 14-18

Claims (5)

1. Schutzhülle für ein Endoskop, wobei die Schutzhülle aus einem dünnen Folienschlauch besteht, welcher einen Führungskanal innen und außen überzieht und das Entfernen des Führungskanals ermöglicht, ohne daß dabei Zellen im Gewebe verschleppt werden.1. Protective cover for an endoscope, the protective cover made of a thin film tube exists, which covers a guide channel inside and outside and the removal of the Guiding channel allows cells in the tissue are not carried over. 2. Schutzhülle nach Anspruch 1, bei welcher die distalen Enden jeweils mit einer Hülse versehen sind, um eine einfache Handhabung zu ermöglichen.2. Protective sheath according to claim 1, wherein the distal ends each with a sleeve are provided to enable easy handling. 3. Schutzhülle nach Anspruch 1, wobei die innere Schutzhülle durch ein Kanülenrohr ersetzt wird, welches mit der äußeren Schutzfolie verbunden wird und die Verwendung von scharfkantigen Endoskopiegeräten ermöglicht, ohne daß dabei die innere Schutzhülle verletzt wird.3. Protective cover according to claim 1, wherein the inner protective cover is replaced by a cannula tube which is connected to the outer protective film and the use of Sharp-edged endoscopic devices allows without sacrificing the inner protective cover get hurt. 4. Schutzhülle nach Anspruch 1, wobei am distalen Ende jeweils eine Dichtung eingesetzt ist, um eine Ansammlung von Flüssigkeit zwischen der Schutzhülle und dem Führungskanal zu verhindern.4. Protective sleeve according to claim 1, wherein a seal is used at the distal end is to prevent an accumulation of liquid between the protective cover and the To prevent the guide channel. 5. Schutzhülle nach Anspruch 1, wobei diese bei anderen Anwendungen, bei welchen es um die Verhinderung von Materialien entlang eines Arbeitskanals geht, zum Einsatz kommt.5. Protective cover according to claim 1, wherein this in other applications in which it is the prevention of materials along a working channel is used.
DE2001104106 2001-01-31 2001-01-31 Protective sheath for endoscopes comprises thin film sleeves enclosing guide channel plus end sleeve with ring seals fitted or sheath-replacing cannula permitting sharp-edged instruments. Withdrawn DE10104106A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
DE2001104106 DE10104106A1 (en) 2001-01-31 2001-01-31 Protective sheath for endoscopes comprises thin film sleeves enclosing guide channel plus end sleeve with ring seals fitted or sheath-replacing cannula permitting sharp-edged instruments.

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE2001104106 DE10104106A1 (en) 2001-01-31 2001-01-31 Protective sheath for endoscopes comprises thin film sleeves enclosing guide channel plus end sleeve with ring seals fitted or sheath-replacing cannula permitting sharp-edged instruments.

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DE10104106A1 true DE10104106A1 (en) 2002-08-01

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DE2001104106 Withdrawn DE10104106A1 (en) 2001-01-31 2001-01-31 Protective sheath for endoscopes comprises thin film sleeves enclosing guide channel plus end sleeve with ring seals fitted or sheath-replacing cannula permitting sharp-edged instruments.

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1593337A1 (en) * 2003-02-11 2005-11-09 Olympus Corporation Overtube, producing method and placing method of the same, and method of treating intra-abdominal cavity
DE102009022306A1 (en) * 2009-05-22 2010-11-25 Karl Storz Gmbh & Co. Kg Medical instrument for use in endoscopic surgery, has suction or flushing canal and single piece sleeve shaped coating fixed in suction or flushing canal, where coating is formed as hose which is made of elastically deformed material

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1593337A1 (en) * 2003-02-11 2005-11-09 Olympus Corporation Overtube, producing method and placing method of the same, and method of treating intra-abdominal cavity
EP1593337A4 (en) * 2003-02-11 2006-03-01 Olympus Corp Overtube, producing method and placing method of the same, and method of treating intra-abdominal cavity
US7645230B2 (en) 2003-02-11 2010-01-12 Olympus Corporation Over-tube, method of manufacturing over-tube, method of disposing over-tube, and method of treatment in abdominal cavity
US8784304B2 (en) 2003-02-11 2014-07-22 Olympus Corporation Over-tube, method of manufacturing over-tube, method of disposing over-tube, and method of treatment in abdominal cavity
DE102009022306A1 (en) * 2009-05-22 2010-11-25 Karl Storz Gmbh & Co. Kg Medical instrument for use in endoscopic surgery, has suction or flushing canal and single piece sleeve shaped coating fixed in suction or flushing canal, where coating is formed as hose which is made of elastically deformed material

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