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US-12616357-B2 - Surgical system and expansion device

US12616357B2US 12616357 B2US12616357 B2US 12616357B2US-12616357-B2

Abstract

A surgical system includes: an overtube including a channel into which an endoscope is inserted; and an expansion device configured to ensure a surgical space by expanding an interior of a body at a distal side relative to a tip of the overtube. The expansion device includes a sheath and a wire configured to be protrudable from the sheath. The wire is configured to be switchable between a first configuration in which the wire protrudes from the sheath and a second configuration in which the wire protrudes from the sheath in a state where the wire is tilted, around a longitudinal axis, at an angle different from the first configuration.

Inventors

  • Jun Wakasone
  • Hiroyoshi Kobayashi
  • Takeshi Murata
  • Shotaro Takemoto

Assignees

  • OLYMPUS CORPORATION

Dates

Publication Date
20260505
Application Date
20240716

Claims (20)

  1. 1 . A method of securing a surgical space in a lumen, the method comprising: inserting one or more expansion devices into one or more respective first channels in an overtube; inserting a distal side of the one or more expansion devices into the lumen; causing a wire to protrude radially outward from each of the one or more expansion devices, the wire being provided at the distal side of each of the one or more expansion devices; and rotating the one or more expansion devices around a longitudinal axis of the one or more respective first channels to change a protruding angle of the wire and increase a visual field of an affected site in the lumen.
  2. 2 . The method according to claim 1 , further comprising adjusting a length by which the wire protrudes radially outward from each of the one or more expansion devices.
  3. 3 . The method according to claim 1 , further comprising: inserting an endoscope into the lumen via a second channel in the overtube.
  4. 4 . The method according to claim 3 , further comprising: checking a position of an affected site in the lumen using the endoscope; and adjusting the protruding direction of the wire for each of the one or more expansion devices based on a result of the checked position.
  5. 5 . The method according to claim 1 , wherein the wire is configured to protrude from the one or more expansion devices using a ratchet mechanism provided on the expansion device and connected to an end of the wire.
  6. 6 . The method according to claim 1 , further comprising locking the wire of each of the one or more expansion devices in a protruding state.
  7. 7 . The method according to claim 6 , further comprising unlocking the protruding state of the wire of each of the one or more expansion devices.
  8. 8 . The method according to claim 7 , further comprising pulling the one or more expansion devices out of the lumen with the wire unlocked.
  9. 9 . The method according to claim 1 , wherein the causing of the wire to protrude radially outward from each of the one or more expansion devices comprises moving a proximal end of the wire distally relative to a distal end of the wire.
  10. 10 . The method according to claim 1 , wherein the causing of the wire to protrude radially outward from each of the one or more expansion devices comprises moving the wire from an internal lumen of each of the one or more expansion devices through a longitudinal slot at the distal side of each of the one or more expansion devices.
  11. 11 . The method according to claim 1 , further comprising limiting an angle of rotation of the one or more expansion devices using a stop arranged on the overtube.
  12. 12 . The method according to claim 1 , further comprising inserting an endoscope into the lumen via a second channel in the overtube.
  13. 13 . The method according to claim 12 , further comprising: checking a position of an affected site in the lumen using the endoscope; and adjusting the protruding direction of the wire for each of the two expansion devices based on a result of the checked position.
  14. 14 . A method of securing a surgical space in a lumen, the method comprising: inserting two expansion devices into two respective first channels in an overtube; inserting a distal side of the two expansion devices into the lumen; causing a wire to protrude radially outward from each of the two expansion devices, the wire being provided at the distal side of each of the two expansion devices; and rotating the two expansion devices around a longitudinal axis of the two respective first channels independently of each other to change a protruding angle of the wire and increase a visual field of an affected site in the lumen.
  15. 15 . The method according to claim 14 , wherein the rotating comprises rotating a first of the two expansion devices in a first direction and rotating a second of the two expansion devices in a second direction opposite to the first direction.
  16. 16 . The method according to claim 15 , wherein a rotation amount in the first direction is equal to a rotation amount in the second direction.
  17. 17 . The method according to claim 14 , wherein the causing of the wire to protrude radially outward from each of the two expansion devices comprises moving a proximal end of the wire distally relative to a distal end of the wire.
  18. 18 . The method according to claim 14 , wherein the causing of the wire to protrude radially outward from each of the two expansion devices comprises moving the wire from an internal lumen of each of the two expansion devices through a longitudinal slot at the distal side of each of the two expansion devices.
  19. 19 . The method according to claim 14 , further comprising limiting an angle of rotation of the two expansion devices using a stop arranged on the overtube.
  20. 20 . The method according to claim 14 , further comprising adjusting a length by which the wire protrudes radially outward from each of the two expansion devices.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This is a divisional application of U.S. patent application Ser. No. 17/069,470, filed Oct. 13, 2020, now issued as U.S. Pat. No. 12,070,186, which is a continuation of International Application PCT/JP2018/016972, with an international filing date of Apr. 26, 2018, each of which is hereby incorporated herein by reference in their entirety. TECHNICAL FIELD The present invention relates to surgical systems and expansion devices. BACKGROUND ART A known system is provided with a retractor that ensures a visual field and a surgical field by spreading tissue disposed around an endoscope and a surgical tool guided by a flexible outer tube. This is achieved by causing a wire similarly guided by a flexible outer tube to protrude in a bent state at the distal ends of the endoscope and the surgical tool (e.g., see Patent Literature 1). CITATION LIST Patent Literature (PTL 1)Japanese Translation of PCT International Application, Publication No. 2016-526397 SUMMARY OF THE INVENTION An aspect of the present invention is directed to a surgical system comprising: an overtube comprising a channel into which an endoscope is inserted; and an expansion device configured to ensure a surgical space by expanding an interior of a body at a distal side relative to a tip of the overtube, wherein the expansion device comprises: a sheath; and a wire configured to be protrudable from the sheath, wherein the wire is configured to be switchable between a first configuration in which the wire protrudes from the sheath and a second configuration in which the wire protrudes from the sheath in a state where the wire is tilted, around a longitudinal axis, at an angle different from the first configuration. Another aspect of the present invention is directed to an expansion device configured to ensure a surgical space by expanding an interior of a body, the expansion device comprising: a sheath; and a wire configured to be protrudable from the sheath, wherein the wire is configured to be switchable between a first configuration in which the wire protrudes from the sheath and a second configuration in which the wire protrudes from the sheath in a state where the wire is tilted, around a longitudinal axis, at an angle different from the first configuration. Another aspect of the present invention is directed to a lumen expanding method comprising: inserting an endoscope, an overtube, and an expansion device into a lumen, the expansion device being configured to ensure a surgical space by expanding an interior of a body; causing a wire to protrude radially outward from the expansion device at a distal side relative to a tip of the overtube; and rotating the wire around a longitudinal axis of the expansion device to change a protruding direction of the wire. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view illustrating a surgical system according to an embodiment of the present invention. FIG. 2 is a partial perspective view illustrating the distal end of the surgical system in FIG. 1. FIG. 3 is a perspective view illustrating one of expansion devices provided in the surgical system in FIG. 1. FIG. 4 is a perspective view illustrating a state where a wire of the expansion device in FIG. 3 protrudes from a slit. FIG. 5 is a cross-sectional view illustrating a state where tissue is expanded by reducing the angle between wires by using two expansion devices of the surgical system in FIG. 1. FIG. 6 is a cross-sectional view illustrating a state where tissue is expanded by increasing the angle between the wires by using the two expansion devices of the surgical system in FIG. 1. FIG. 7 is a partial vertical-sectional view illustrating a retraction prevention stopper provided in a modification of the surgical system in FIG. 1. FIG. 8 is a partial vertical-sectional view illustrating a state where an engagement by the retraction prevention stopper in FIG. 7 has been canceled. FIG. 9 is a partial perspective view illustrating a modification of each expansion device provided in the surgical system in FIG. 1. FIG. 10 is a cross-sectional view of a slit in the expansion device in FIG. 9. FIG. 11 is a cross-sectional view of the slit, illustrating a state where the wire of the expansion device in FIG. 9 is rotated. FIG. 12 is a partial perspective view illustrating the proximal end of the expansion device in FIG. 9. FIG. 13 is a perspective view of a modification of the expansion device in FIG. 9, illustrating a state where a plurality of components constituting the distal end of a sheath are moved away from each other. FIG. 14 is a perspective view illustrating a state where the components in FIG. 13 are moved into contact with each other. DESCRIPTION OF EMBODIMENTS A surgical system 1 and an expansion device 4 according to an embodiment of the present invention will be described below with reference to the drawings. As shown in FIGS. 1 and 2, the surgical system 1 according to this embodiment includes a