JPH0445178B2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] During endoscopic surgery, irrigation fluid mixed with patient's body fluids and blood is discharged from the affected area as irrigation drainage. Splashing liquid may cause MRSA,
This causes environmental pollution due to the scattering and leakage of malignant pathogenic microorganisms such as hepatitis virus and AIDS virus, which in turn poses serious social problems.

The present invention aims to prevent the infection of the above-mentioned difficult-to-treat and potentially fatal diseases, and has a barrier function that blocks direct contact with pathogenic microorganisms. The present invention relates to a prevention method and a barrier covering for preventing infection.

[Prior Art] This type of known technology includes, for example, the one shown in FIG. As shown in the figure, a covering cloth 21 is attached with a liquid collection bag 5 that collects the perfusion drainage liquid.
is hung over the patient so that the affected area opening 22 provided in the covering cloth contacts the corresponding affected area, and the endoscope 10 is attached to the affected area exposed to the outside through the affected area opening 22. is the endoscope eyepiece 10a while pouring irrigation fluid for cleaning the affected area from the endoscope 10.
Since the endoscope is operated while looking directly at the patient, the perfusion fluid mixed with the patient's body fluids and blood that is drained from the affected area of the body is scattered around the operator, and the operator is constantly exposed to contamination. As a result, such medical work always involved the risk of contracting serious diseases.

[Problem to be solved by the invention] In the case of endoscopic surgery, for example, transurethral resection surgery,
Due to the nature of the surgery, a large amount of irrigation fluid (10 to 20 liters) is used for irrigation. As a result, it is necessary to process an equal or larger amount of perfusion fluid mixed with the patient's body fluids and blood. In the conventional method, as shown in FIG. 5, recovery of the perfusion liquid is far from perfect, and sometimes it overflows from the covering cloth 21 and flows out, and there is no means to prevent the perfusion liquid from scattering. The situation is that it has not been done.

Under these circumstances, the surgeon performs the resection while diagnosing the condition of the affected area through the eyepiece of the endoscope. The patient is in a defenseless state, and the nurse assisting the surgeon is also in a similar state.
Moreover, external contamination due to the scattering of the waste liquid is not a consideration.

The present invention provides a method for performing surgery (for example, transurethral resection surgery) or endoscopic diagnosis using the above-mentioned endoscope.
In order to solve the problem of infection and external contamination caused by malignant pathogenic microorganisms that are difficult to treat and deadly, such as MRSA, hepatitis virus, AIDS virus, etc., and to carry out reliable medical work under safe conditions, we are equipped with an internal camera equipped with a video camera. An endoscope operation space that includes an endoscope and an affected area, and in which the perfusion drainage fluid flows out and scatters, is configured as a closed space that is completely shut off from the outside, and a video monitor is provided outside the closed space to prevent the perfusion and drainage. A method for preventing infection due to leakage and splashing of perfusion fluid, which allows the endoscope to be operated while diagnosing the patient's condition while avoiding direct contact with contamination by pathogenic microorganisms in the fluid. The purpose is to provide a protective barrier covering.

[Means for Solving the Problems] In order to achieve the above object, the method for preventing infection due to leakage and scattering of perfusion drainage fluid of the present invention is as follows:
This is an endoscope operation space that includes an endoscope with a video camera and the affected area to which it is attached, and a barrier member is used to make the operation space, where perfusion drainage fluid flows out and scatters, a closed space completely shielded from the outside. The contaminated operating space is isolated from the outside to prevent leakage and scattering of the perfusion liquid to the outside, and a space provided outside the closed space is provided to avoid direct contact with the contamination. The system was configured so that the image from the video camera could be viewed on a video monitor.

The infection prevention barrier covering of the present invention is water-impermeable and transparent, and has a connecting part on the side of the affected area that connects to the affected area at one end in a space that houses an endoscope with a video camera and the affected area. The flexible sheet and the surgical gown integrated with the other end of the sheet form the space into a closed space that can be watertight and sterilized to prevent leakage and scattering of perfusion fluid, and the upper sides of the closed space are It has a surgical opening for inserting the operator's upper limb, and a connecting opening for passing a set of connecting cords, which are accessories of the endoscope, at corresponding locations around the endoscope, and an irrigation and drainage hole at the bottom. A liquid collection bag is provided for the liquid.

The closed space of the above-mentioned infection prevention barrier covering has an affected area side connection part at one end that is adhesively connected to the surrounding area of the affected area to form an exposed area of the affected area, and has both sleeves of the surgical gown at the other end. By firmly connecting it to the chest sheet containing the surgical gown, the surgical gown is formed from a water-impermeable transparent flexible cylindrical sheet that has an integral structure, and contains the affected area, the endoscope, and both sleeves of the surgical gown, and the inside of the upper section. having the connection opening at a corresponding location around the endoscope;
A water-tight sterilizable closed space may be provided with a collection bag for perfusion drainage at the bottom to prevent leakage and scattering of perfusion drainage.

[Effect] When performing endoscopic surgery (for example, transurethral resection surgery) or endoscopic diagnosis, the operating space of the endoscope, which includes the endoscope with a video camera and the affected area, is where perfusion fluid flows out. However, the operation space is a closed space that is completely blocked off from the outside by the infection prevention barrier covering, which is a barrier member, and prevents the leakage and scattering of the affected area and irrigation fluid. The source of contamination caused by this is blocked from the outside, forming a barrier that cuts off direct contact with pathogenic microorganisms.

Under such conditions, safe medical work is performed outside the closed space while viewing images projected on a monitor installed outside the space.

Therefore, even if the perfusion liquid is scattered within the closed space, direct contact of the operator and the assisting nurse, etc. with pathogenic microorganisms in the perfusion liquid can be completely avoided. Moreover, the used covering cloth can be disposed of without causing environmental pollution.

[Example] A method for preventing infection due to leakage and scattering of perfusion drainage fluid and a barrier covering for preventing infection according to the present invention will be described based on an example with reference to the drawings.

FIG. 1 schematically shows an embodiment of the method for preventing infection due to leakage and scattering of perfusion drainage fluid according to the present invention.

In the figure, 1 is an affected area, 4 is a closed space, 10 is an endoscope, 12 is a video camera, and 13 is a video monitor.

The closed space 4 is an operation space for the endoscope 10 that includes the affected area 1 and the endoscope 10, and is a space where the operator operates the handle of the endoscope 10.

In the operating space, as mentioned above, the perfusion drainage mixed with the patient's body fluids and blood flows out and scatters from the affected area 1, so the perfusion drainage may be contaminated with pathogenic microorganisms contained in the perfusion drainage. ing. This contaminated operation space is constituted by a closed space 4 which is isolated from the outside by a suitably constructed barrier member to prevent the perfusion liquid from leaking out and scattering to the outside.

The endoscope 10 has a video camera 12 at its eyepiece.
is provided, and the image is projected onto a video monitor 13 provided at an appropriate location outside the closed space 4.

In this case, the operator does not need to look directly into the eyepiece of the endoscope 10, that is, the operator is not exposed to the scattering of perfusion drainage fluid, and can see the affected area and the image projected on the monitor 13. While diagnosing the disease, it is possible to provide the necessary medical care while avoiding direct contact with pathogenic microorganisms.

The perfusion drainage liquid is also collected in the lower part of the closed space 4 without leaking outside, and the splashing of the perfusion drainage liquid is also blocked by the closed space 4 and does not scatter outside, becoming droplets and collecting in the lower part as above. liquid. Therefore, it is possible to avoid indoor contamination due to external leakage of perfusion liquid and its scattering.

FIG. 2 is a schematic diagram showing an embodiment of the barrier covering for preventing infection of the present invention.

In the figure, 1 is the affected area, 2 is the area around the affected area, and 3 is the affected area.
are both sleeves of surgical gown 9, 4 is a closed space, 5 is a liquid collection bag, 5
a is a filter sheet, 6a is a connection opening for passing through a set of connection cords that are accessories of the endoscope, 6b, 6c
1 is a surgical opening for inserting the upper limb of the operator, 7 is a water-impermeable transparent flexible sheet, 9 is a surgical gown, and 10 is an endoscope.

An affected part side connection part is formed at one end of the flexible sheet 7 and adhesively connected to the affected part periphery 2, and the other end is fixedly connected to the chest sheet of the surgical gown 9 to form an integral structure with the surgical gown 9. , a closed space 4 that can be watertightly sterilized is formed. The inside of the closed space 4 contains an affected area 1 and an endoscope 10 that is attached to the affected area and has a video camera 12 in its eyepiece, and has surgical openings on both upper sides for insertion of the upper limbs of the surgeon. Part 6b,
6c, and a connection opening 6a for passing a set of connection cords, which are accessories of the endoscope 10, is provided at corresponding locations around the eyepiece of the endoscope 10. Further, a liquid collection bag 5 for perfusion and drainage having a filter sheet 5a is provided at the lower part. In addition, the sizes of the surgical opening and the connection opening are set appropriately depending on the thickness of the upper limb and connection cord to be penetrated and the required functions thereof, and the former is set to be slightly loose and the latter is set to be firmer to prevent leakage of perfusion drainage fluid. It is designed to hold down.

FIG. 3 is a schematic view showing another embodiment of the barrier covering for preventing infection of the present invention. In this case, instead of providing the surgical opening, both sleeves of the surgical gown are built into the closed space in advance.

In the figure, 1 is the affected area, 2 is the area around the affected area, and 3 is the affected area.
1 is both sleeves, 4 is a closed space, 5 is a liquid collection bag, 6a is a connection opening, 8 is a water-impermeable transparent flexible cylindrical sheet, 9 is a surgical gown, 10 is an endoscope, and 12 is a video camera.

The closed space 4 is made of a water-impermeable transparent flexible cylindrical sheet 8
The affected area 1 is formed by forming an affected area side connection part at one end of the
The affected area 1 is exposed inside the closed space 4, and the other end of the sheet is firmly connected to the chest sheet including both sleeves 3 of the surgical gown 9 for watertight sterilization. forming a closed space 4 of possible
A video camera 12 attached to the affected area 1 of the affected area 1
It has a structure in which an endoscope 10 having an eyepiece and both sleeves 3 of a surgical gown 9 are built in.

At the upper and lower parts of the closed space 4, as shown in Fig. 2,
A connection opening 6a and a liquid collecting bag 5 for perfusion and drainage are provided respectively.

FIG. 4 shows a partial improvement of the embodiment shown in FIG. 2, in which surgical arm bags 11a and 11b made of water-impermeable stretchable flexible sheets are inserted into surgical openings 6b and 6c, and their bases are secured. FIG. 6 is a diagram showing a case in which they are connected to form a watertight movable surgical arm pouch.

With the above configuration, when using the system, the operator first attaches the endoscope 10 to the affected area and then attaches the water-impermeable transparent flexible sheet 7 or the water-impermeable transparent flexible cylindrical sheet 8 that forms the closed space 4. The patient wears the surgical gown 9, which has the joint on the affected side connected to the patient's affected area 2 with adhesive and is integrally constructed with the other ends of the sheets 7 and 8. In the case of FIG. 2, the upper limbs wrapped in arm bags are inserted into the surgical openings 6b and 6c of the surgical gown, and in the case of FIG. Wear it by inserting it into sleeve 3.

Thereafter, the patient begins medical treatment while viewing an image of the affected area projected on the video monitor 13 provided at an appropriate location outside the closed space 4. In this case, the operation of the endoscope is performed by opening the surgical opening 6 in the closed space 4.
The surgery was performed through the upper limbs wrapped in arm pouches inserted into the arms 3 and 6c, or the upper limbs wrapped in gloves inserted through both sleeves 3 of the surgical gown 9, completely blocking the surgeon from direct contact with pathogenic microorganisms. He is able to carry out medical work in this condition.

Incidentally, external leakage and external scattering of perfusion drainage fluid that occurs when the drainage fluid flows out of the patient's body can be prevented by the water-impermeable transparent flexible sheet 7 or the water-impermeable transparent flexible cylindrical sheet 8 constituting the closed space 4. The liquid is intercepted by the water, becomes droplets, and is collected together with the waste liquid at the lower part of the closed space 4, and is completely collected in the liquid collection bag 5 via the filter sheet 5a.

As described above, the direct contact of the surgeon and the caregiver with pathogenic microorganisms is completely blocked, and the scattering and leakage of pathogenic microorganisms to the outside, as well as indoor contamination, can be prevented. It is indispensable to the structure of

In the case of FIG. 3, the operator only has to insert his upper limbs through both sleeves of the surgical gown built into the closed space 4 in advance, so that the sealing performance and workability are further improved.
In addition, the ability to block direct contact of pathogenic microorganisms to the operator and the caregiver and prevent leakage, leakage, and scattering to the outside functions more reliably.

In the case of FIG. 4, the operator only has to insert the upper limb into the arm pouch that has been fixed in advance to the surgical openings 6b and 6c of the water-impermeable transparent flexible sheet 7, and the closed space 4 is airtight in the case of FIG. It becomes more expensive and easier to use.

The infection-preventing barrier covering of the present invention is gas sterilized and packed together with the surgical gown with which it is integrated, and then opened before use. After use, it is folded and disposed of.

[Effects] Since the present invention is configured as described above, it produces the effects described below.

Using an endoscope with a video camera, a video monitor, and a barrier covering for preventing infection,
A watertight closed space that is an endoscope operation space that contains the affected area and the endoscope, and in which the operation space where perfusion drainage fluid flows out and scatters is completely blocked off from the outside by the infection prevention barrier covering. As a result, it has become possible to perform medical work while avoiding direct contact with pathogenic microorganisms while viewing images of the affected area projected on the video monitor provided outside the closed space.

Claim 1 provides that the operator and his/her assistant perform diagnosis or treatment outside the endoscope operation space, which is completely isolated from the affected area contaminated by perfusion drainage fluid and its scattering, and from the endoscope operation space that contains the built-in endoscope with a video camera. It is possible to carry out necessary medical actions while diagnosing, and it is possible to prevent direct contact with pathogenic microorganisms and completely prevent pathogenic microorganisms from leaking, leaking, and scattering, and preventing infections caused by MRSA, hepatitis virus, AIDS virus, etc. It has a tremendous effect on prevention.

In addition, there is no need for complicated cleaning work for indoor contamination that is associated with external contamination due to the scattering of perfusion fluid, which has been seen in the past, and waste can be disposed of easily and safely.

Claim 2 provides a barrier covering for infection prevention, which is a barrier member required when carrying out the method for preventing infection due to leakage and scattering of perfusion drainage fluid of the present invention, which covers the affected area and an interior with a video camera. In order to create a closed space where the endoscope operation space containing the endoscope is isolated from the outside, a water-impermeable transparent flexible sheet is used that is integrated with the surgical gown. Therefore, watertightness is maintained sufficiently, and there is no external outflow or leakage of perfusion drainage fluid, and it is possible to completely prevent the drainage fluid from scattering outside, eliminating indoor contamination, and completely disposing of it after use. You can.

Moreover, since it is integrated with the surgical gown, handling by the surgeon is extremely easy, and it goes without saying that direct contact between the surgeon and his assistants with the pathogenic microorganisms can be completely avoided.

Claim 3 is an endoscope operation space that incorporates an endoscope with a video camera and an affected area, and instead of providing a surgical opening for inserting the operator's upper limb in the closed space, both sleeves of a surgical gown are provided. Since it is directly built in, the degree of sealing of the closed space is improved, and the ability to block direct contact of pathogenic microorganisms to the operator and caregivers, and to prevent leakage, scattering, and the like, functions more reliably. . Furthermore, when the operator passes his upper limbs through the sleeves of the surgical gown, the upper limbs are located within a closed space, further improving work efficiency.

[Brief explanation of the drawing]

FIG. 1 is a schematic diagram showing an embodiment of the method for preventing infection due to leakage and scattering of perfusion drainage fluid according to the present invention, and FIG. 2 is a schematic diagram showing an embodiment of the barrier covering for preventing infection according to the present invention. FIG. 3 is a schematic diagram showing another embodiment of the infection prevention barrier covering shown in FIG. 2, and FIG. 4 is a schematic diagram showing another embodiment of the embodiment shown in FIG. It is a figure which shows an example. FIG. 5 is a diagram showing a case where endoscopic medical treatment is performed using a conventional covering. In the figure, 1 is the affected area, 2 is the area around the affected area, and 3 is the affected area.
are both sleeves, 4 is a closed space, 5 is a liquid collection bag, 6a is a connection opening, 6b, 6c are surgical openings, 7 is a water-impermeable transparent flexible sheet, 8 is a water-impermeable transparent flexible cylindrical sheet, 9 10 is a surgical gown, 10 is an endoscope, 11a and 11b are arm bags, 12 is a video camera, and 13 is a video monitor.

Claims (1)

[Scope of Claims] 1. An endoscope operation space that includes an endoscope with a video camera and an affected area to which it is attached, and the operation space where perfusion drainage fluid flows out and scatters is completely closed off from the outside. A barrier member is used as a space to block the contaminated operating space from the outside to prevent leakage and scattering of the perfusion liquid to the outside, and to avoid direct contact with the contaminated water. A method for preventing infection due to leakage and scattering of perfusion fluid, characterized in that an image from the video camera projected on a video monitor provided outside the closed space can be viewed. 2. In a space that houses an endoscope with a video camera and an affected area, an impermeable transparent flexible sheet having an affected area side connection part connected to the affected area surrounding the affected area at one end and integrated with the other end of the sheet. The space is configured as a watertight sterilizable closed space that prevents leakage and scattering of perfusion fluid by using structured surgical gowns, and surgical openings are provided on both sides of the upper side of the closed space for insertion of the surgeon's upper limbs. In addition, a connection opening for passing a set of connection cords, which are accessories of the endoscope, is provided at corresponding locations around the endoscope, and a liquid collection bag for perfusion and drainage is provided at the bottom. A barrier covering for preventing infection characterized by: 3. Hold the affected area side connecting part, which is adhesively connected to the area around the affected area to form the affected area exposed surface, at one end, and firmly connect the other end to the chest sheet area including both sleeves of the surgical gown, and attach it to the surgical gown. An integrated, water-impermeable, transparent, flexible cylindrical sheet allows perfusion and drainage to watertightly sterilize the space containing the exposed affected area, the endoscope with a video camera attached to the affected area, and both sleeves of the surgical gown. A closed space is constructed to prevent leakage and scattering of the air, and a connection opening for passing a set of connection cords, which are accessory parts of the endoscope, is provided at corresponding locations around the upper endoscope in the closed space. is a barrier covering for preventing infection, which is characterized by having a collection bag for perfusion drainage.