Abstract:
The present invention relates to a surgical tool guide, which is easily installed and separated to reduce operating time, and furthermore surgical instruments are not separated from the abdominal walls or gas does not leak to stably perform the surgical operation. In addition, the present invention relates to a protection cap for a surgical instrument guide, which is interlocked together with surgical instruments to maintain a seal even though the surgical instruments for the operation are variously moved, thereby efficiently preventing the leakage of gas. Therefore, since it is unnecessary to inject gas again during the operation, the surgical operation can be smoothly performed.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS AND CLAIM OF PRIORITY 
       [0001]    This patent application claims benefit under 35 U.S.C. 119(e), 120, 121, or 365(c), and is a National Stage entry from International Application No. PCT/KR2010/009399, filed on Dec. 28, 2010, which claims priority to Korean Patent Application numbers 10-2010-0046840 filed on May 19, 2010, 10-2010-0046842 filed on May 19, 2010, and 10-2010-0076338 filed on Aug. 9, 2010, entire contents of which are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    1. Technical Field 
         [0003]    The present invention relates to a surgical tool guide, and to a protection cap for a surgical tool guide. 
         [0004]    2. Background Art 
         [0005]    In general, laparoscopic endoscopic operations, during which skin of a patient is minimally cut unlike an existing laparotomy operation to allow the patient to promptly recover, have been performed. 
         [0006]    The endoscopic operation corresponds to a method of punching a small hole in the belly of a patient by using an intubation surgical device called a trocar, in which at least one trocar is inserted into the belly and various surgical devices such as a forceps, a cutting device, an internal organ extraction device, and an endoscopic camera are introduced to an operated portion in the belly through the trocar to perform various operations such as a gall bladder removal surgery, a gall bladder calculus removal surgery, an appendectomy, and a general surgery. 
         [0007]    In recent years, endoscopic operations in which a scar is rarely left are being performed through a portion of a navel without trying a plurality of trocars and cuttings as described above to reduce the scar left in the belly of the patient and recover the patient promptly. 
         [0008]    In general, if a hole for an operation is perforated in the naval of a human body, since the wound is not easily exposed to the outside even after the wound is healed up and is not visually recognized as a wound, an endoscopic operation through a navel is currently preferred. 
         [0009]    In order to perform such a surgical operation, an operation hole of 10 mm to 12 mm is perforated in the navel according to the type of the surgery, and a surgical tool guide for introducing various surgical tools into the belly is installed in the operation hole to be used. 
         [0010]    However, the surgical tool guide according to the related art delays an operation as it is easily separated from its installation position such as a belly or nitrogen gas is often leaked during the operation. Thus, the problems were recognized, and a surgical tool guide for preventing separation of a guide to ensure a smooth operation was developed the inventor of the present invention (Korean Patent No. 10-915882). 
         [0011]    The patented surgical tool guide of Korean Patent NO. 10-915882 is shown in  FIG. 1 . In the surgical tool guide  1 , a tool entrance  3  for entry of various surgical tools is provided at an upper portion of a body  2 , an attaching ring  4  having a resiliency to be attached to and supported by an upper portion of an operation hole is installed at an end of an opened bottom surface of the body  2 , and a support ring  5  located in an interior overlapped by surrounding an exterior of the attaching ring  4  and configured to support the body  2  with the attaching ring when the surgical tool guide is introduced into an abdominal cavity through an operation hole is installed at an outer lengthwise side of the body  2 . 
         [0012]    The surgical tool guide  1  is installed by locating the attaching ring  4  located at an upper side of the operation hole with the support ring  5  being stopped by the belly at an upper side of the belly according to a thickness of the belly while overturning the attaching ring  4  to an outer side as shown in  FIGS. 2 and 3 , and then tightly tensioning the body  2 . Thus, the surgical tool guide  1  is not easily separated from the operation hole and minimizes interference of a surgical tool by tightly maintaining the body  2  between the support ring  5  and the attaching ring  4 . 
         [0013]    However, the inventor of the present invention realized that the surgical tool guide  1  has an installation problem in that a process of continuously overturning the attaching ring  4  until the attaching ring  4  is attached to an upper side of the belly is troublesome, and also has an separation problem in that a process of overturning the attaching ring  4  in an opposite direction while the body  2  is tensioned tightly during an separation thereof after an operation is not easy. 
         [0014]    Further, the inventor of the present invention also realized that a distance from the tool entrance  3  into which the surgical tool is introduced to the belly is so long as to cause many problems in the operation, and it is not easy to adjust the distance short. 
         [0015]    Meanwhile,  FIG. 4  shows an example of the tool entrance  3  of the surgical tool guide, and valve units  6  and  7  for introducing the surgical tool while preventing leakage of gas is provided at an upper portion of the tool entrance  3 . Here, only any one  6  or  7  of the valve units  6  and  7  may be provided, and reference numeral “ 8 ” denotes a tool entry hole. 
         [0016]    However, when the tool entrance  3  is used, since the gas in the belly injected for expansion of the belly of a patient is gradually leaked when the operation is performed while a location of the surgical tool is changed after the entry of the surgical tool, there occurs a troublesome problem of performing a process of frequently re-injecting gas into the belly during an operation. 
         [0017]    That is, as shown in  FIG. 5 , as an excessive aperture is generated in the valve units  6  and  7  and the tool entry hole  8  by the surgical tool T variously moved as the surgical tool T is used, a large amount of injected gas is leaked through the aperture, and accordingly, there occurs a problem of having to inject gas into the belly again during the operation. 
       SUMMARY 
       [0018]    One or more embodiments of the present invention has been made in an effort to solve the above-described problems, and an aspect of the present invention is to provide a surgical tool guide which can be installed and separated very conveniently to shorten an operation time, and can always maintain a distance between an entry end of a surgical tool and a belly at the shortest distance. 
         [0019]    An aspect of the present invention also provides a surgical tool guide which can be stably installed in an operation hole for an endoscopic operation to shorten an operation time, and can allow an endoscopic operation to be stably performed. 
         [0020]    An aspect of the present invention also provides a protection cap for a surgical tool guide which can is moved in conjunction with a surgical tool even when the surgical tool is moved variously, still maintaining a sealed state and efficiently preventing leakage of gas. 
         [0021]    In order to solve at least one of the above problems, according to an aspect of the present invention, there is provided a surgical tool guide including: a body a lower end of which is opened and having an upper portion with which at least one surgical tool entrance is communicated; a support ring located at a lower side of the body to be freely deformed and restored; a protection tube one end of which is fixed to the body to extend downward and an opposite end of which extends upward toward an upper side of the body while accommodating the body therein via the support ring; and a pressing ring fitted around the protection tube that extends upward, configured to press the body downward to lower the body relative to the protection tube, and selectively fastened to the body when the body is pressed. 
         [0022]    Here, a ring periphery portion supporting the pressing ring may protrude from the opened lower end of the body. 
         [0023]    A stopping boss may protrude from an outer surface of the body and a boss holder into which the stopping boss is inserted may be formed on an inner surface of the pressing ring, so that the pressing ring is selectively fastened to the body as the stopping boss is inserted into or separated from the boss holder according to horizontal rotation of the pressing ring while the pressing ring presses the body. 
         [0024]    A passage opening through which the stopping boss passes may be formed on a lower surface of the pressing ring. 
         [0025]    According to another aspect of the present invention, there is provided a surgical tool guide including: a body a lower end of which is opened and having an upper portion with which at least one surgical tool entrance is communicated; a support ring located at a lower side of the body to be freely deformed and restored; a protection tube including an inner tube fixed to an inner surface of the body to extend downward, and an outer tube connected to the inner tube, extending upward via the support ring, and fixed to an outer surface of the body; and a gas inlet formed in the inner tube and configured to introduce gas into a sealed space between the inner tube and the outer tube to expand the protection tube. 
         [0026]    The surgical tool guide may further include: a gas outlet formed in the outer tube and provided with a discharge valve to discharge the gas filled in the sealed space. 
         [0027]    The surgical tool guide may further include: a support ring pulling string connected to the support ring and extending outward via the sealed space and the body. 
         [0028]    A folding portion having a small thickness to be easily folded may be formed in the support ring in a predetermined section. 
         [0029]    According to yet another aspect of the present invention, there is provided a surgical tool guide installed in an operation hole of a patient perforated during an endoscopic operation to safely guide various surgical tools introduced through an upper tool entrance into an abdominal cavity, wherein the surgical tool guide is fixedly installed in the tool entrance while sealing and surrounding an upper end of the tool entrance and formed at a center of an upper surface thereof with a tool entry hole for entry of the surgical tools, and the surgical tool guide is formed of a flexible resilient material which is freely deformed and restored so that the tool entry hole is engaged with the surgical tools while adhering to the surgical tools even when the introduced surgical tools are moved. 
         [0030]    Here, an inner surface of the protection cap may be spaced apart from the tool entrance to surround the tool entrance while forming a predetermined marginal gap therein. 
         [0031]    An embossing portion having a plurality of bosses in a predetermined radial range from the tool entry hole may be formed on an upper surface of the protection cap. 
         [0032]    The thickened portion having a section having a large thickness in a predetermined radial range from the tool entry hole may be formed on an upper surface of the protection cap. 
         [0033]    A fixing member may be integrally formed at a lower end of the protection cap, and may be coupled and fixed by a coupling ring while being inserted into the tool entrance. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0034]      FIG. 1  is an exemplary view showing a surgical tool guide according to the related art; 
           [0035]      FIGS. 2 and 3  are exemplary views showing an installation and an operation of the surgical tool guide according to the related art; 
           [0036]      FIG. 4  is an exemplary view showing a tool entrance of the surgical tool guide according to the related art; 
           [0037]      FIG. 5  is an exemplary view showing a state of the tool entrance according to the related art as a surgical tool is moved; 
           [0038]      FIG. 6  is an exploded perspective view of a surgical tool guide according to the first embodiment of the present invention; 
           [0039]      FIG. 7  is a perspective view showing an assembled state of the surgical tool guide of  FIG. 6 ; 
           [0040]      FIG. 8  is a sectional view of  FIG. 7 ; 
           [0041]      FIG. 9  is a top sectional view showing an example of an attaching unit; 
           [0042]      FIGS. 10 and 11  are exemplary views showing an installation and an operation of the surgical tool guide according to the first embodiment of the present invention; 
           [0043]      FIG. 12  is a perspective view of a surgical tool guide according to the second embodiment of the present invention; 
           [0044]      FIG. 13  is a sectional view of the surgical tool guide of  FIG. 12 ; 
           [0045]      FIG. 14  is a perspective view showing a support ring and a support ring pulling string; 
           [0046]      FIG. 15  is a plan view showing a folding portion of the support ring; 
           [0047]      FIGS. 16 and 17  are exemplary views showing an installation and an operation of the surgical tool guide according to the second embodiment of the present invention; 
           [0048]      FIG. 18  is a perspective view of a protection cap for a surgical tool guide according to the embodiment of the present invention; 
           [0049]      FIG. 19  is a sectional view of the protection cap of  FIG. 18 ; 
           [0050]      FIG. 20  is an exemplary view showing a state in which the protection cap according to an embodiment of the present invention is installed in a tool entrance; 
           [0051]      FIG. 21  is an exemplary view showing a state in which a surgical tool is introduced into the tool entrance where the protection cap is installed according to an embodiment of the present invention; and 
           [0052]      FIGS. 22 and 23  are exemplary views showing an associated movement of the protection cap according to an embodiment of the present invention as the surgical tool is moved in various ways. 
       
    
    
     DETAILED DESCRIPTION 
       [0053]    Hereinafter, an exemplary embodiment of the present invention will be described in detail with reference to the accompanying drawings. 
         [0054]    The embodiment is provided to more fully describe the present invention to those skilled in the art to which the present invention pertains, and it is noted that the shapes and sizes of elements in the drawings may be exaggerated to emphasize a more clear description. 
         [0055]    Further, in the description of the embodiment, a detailed description of known functions and configurations which are apparent to those skilled in the art to which the present invention pertains will be omitted when they may make the technical feature of the present invention unnecessarily unclear. 
         [0056]      FIGS. 6 to 11  are views showing a surgical tool guide  100  according to the first embodiment of the present invention, and the surgical tool guide  100  according to the first embodiment of the present invention will be described with reference to  FIGS. 6 to 11 . 
         [0057]    Referring to the drawings, the surgical tool guide  100  according to the first embodiment may include a body  110 , a support ring  120 , a protection tube  130 , and a pressing ring  140 . 
         [0058]    First, the body  110  may have a substantially cylindrical shape a lower end of which is opened, and an annular ring periphery portion  111  may protrude from the opened lower end along a circumference thereof. The ring periphery portion  111  supports the pressing ring  140  so that the pressing ring  140  presses the body  110  when the pressing ring  140  to be described above is moved downward. 
         [0059]    At least one surgical tool entrance  112  is provided at an upper portion of the body  110  to be communicated with the body  110 . 
         [0060]    The surgical tool entrance  112  is adapted to introduce various surgical tools for an operation into the surgical tool guide  110 , and a valve unit  113  for easily introducing the surgical tools while maximally preventing leakage of gas may be provided at an upper end thereof. Various structures for the surgical tool entrance  112  are well known in the art to which the present invention pertains, and the surgical tool entrance  112  may have various known structures and may not be limited to those shown in the drawings. 
         [0061]    A gas adjusting valve  114  may be provided at an upper portion of the body  110  in addition to the surgical tool entrance  112 , and the gas adjusting valve  114  is adapted to control entry and exit of the gas for expanding a belly during an operation. 
         [0062]    Next, the support ring  120  is an annular ring located at a lower side of the body  110 , and is stopped by an abdominal wall in an abdominal cavity after passing through an operation hole of a patient. 
         [0063]    Thus, the support ring  120  is formed of a resilient material which can be freely deformed, that is, can be folded or shrunk to be easily stopped while and after passing through the operation hole, and can be directly restored into an original state if an external force is removed. 
         [0064]    Next, one end of the protection tube  130  is fixed to the body  110  to extend downward, and extends upward again via the support ring  120  located at a lower side of the body  110 . That is, the protection tube  130  extends upward while surrounding an outer side of the supporting ring  120  after passing through the supporting ring  120 , and the protection tube  130  is formed to be thick from the body  110  and the support ring  120 . 
         [0065]    An opposite end of the upwardly extending protection tube  130  extends to an upper side of the body  110  while accommodating the body  110  therein again. 
         [0066]    The protection tube  130  may be manufactured of a urethane sheet having an excellent resiliency. 
         [0067]    Next, the pressing ring  140  is fitted around the protection tube  130  extending upward as described above. 
         [0068]    The pressing ring  140  functions to press the body  110  downward while descending along the protection tube  130 , and if the pressing ring  140  fitted around the protection tube  130  is pressed while the upwardly extending protection tube  130  is gripped, the body  110  is pressed downward while the pressing ring  140  is supported by the ring periphery portion  111  of the body  110 , and accordingly, an interval between the body  110  and the lower support ring  120  becomes narrower while the body  110  is moved downward with respect to the protection tube  130 . 
         [0069]    The pressing ring  140  may be selectively fastened to the body  110  to maintain a pressed state while the body  110  is pressed. 
         [0070]    To this end, an attaching unit  150  for selectively fastening the pressing ring  140  and the body  110  may be provided between the pressing ring  140  and the body  110 . 
         [0071]    Various configurations may be considered for the attaching unit  150 , and  FIG. 9  shows an example of such an attaching unit  150 . 
         [0072]    As shown, a stopping boss  151  protrudes from an outer surface of the body  110 , and a boss holder  152  into which the stopping boss  151  may be inserted is formed on an inner surface of the pressing ring  140 . 
         [0073]    Through this, in the state in which the pressing ring  140  presses the body  110 , if the pressing ring  140  is horizontally rotated in one direction as shown in  FIG. 9 , the stopping boss  151  is inserted into the boss holder  152  so that the pressing ring  140  and the body  110  are fastened to each other to maintain a pressed state, and if the pressing ring  140  is horizontally rotated in an opposite direction, the stopping boss  151  is separated from the boss holder  152  to be released so as to release the pressed state. 
         [0074]    The number of the stopping bosses  151  and the boss holders  152  corresponding thereto may be variously selected. For example, two pairs of the stopping bosses and the boss holders  151  may be formed at an angle of  180  degrees, three pairs of the stopping bosses and the boss holders  151  may be formed at an angle of  120  degrees, and four pairs of the stopping bosses and the boss holders  151  may be formed at an angle of  90  degrees. The shapes of the stopping bosses  151  and the boss holders  152  also is not limited to those shown in the drawings, and may include various shapes which can be selectively stopped or released. 
         [0075]    A passage opening  141  through which the stopping boss  151  passes is cut on a lower surface of the pressing ring  140  so that the movement of the pressing ring  140  cannot be obstructed by the stopping boss  151  protruding from an outer surface of the body  110  when the pressing ring  140  descends and approaches the body  110 . Here, for example, the passage opening  141  is formed at an angle spaced apart from the boss holder  152  formed on an inner surface thereof so that the stopping boss  151  having passed through the passage opening  141  and having been introduced into the pressing ring  140  may be directly inserted into the boss holder  152  due to rotation of the pressing ring  140 . 
         [0076]    Meanwhile, the embodiment of forming the passage opening  141  in the pressing ring  140  corresponds to a case where the pressing ring  140  is completely separated from the body  110  to be elevated, and an embodiment of installing the pressing ring  140  in the state in which the pressing ring  140  is accommodated in the stopping boss  151  from the initial stage so that the pressing ring  140  is moved by a small distance while being restricted by the body  110  to perform a pressing/releasing operation is also possible, and the in the latter embodiment, it can be understood that the passage opening  141  may not be formed. 
         [0077]    Hereinafter, a surgical operation using the above-configured surgical tool guide  100  will be described with reference to  FIGS. 10 and 11 . 
         [0078]    First, after an operation hole for a laparoscopic operation is perforated at the navel of a patient, a portion of the surgical tool guide  100  according to an embodiment of the present invention is introduced through the operation hole to be installed. 
         [0079]    In more detail, the protection tube  130  extending downward from the body  110  extends upward while accommodating the body  110  therein via the support ring  120  located on the lower side, and the surgical tool guide  100  is prepared in the upwardly extending protection tube  130  while the pressing ring  140  is fitted around the protection tube  130 . Then, a vertical separation interval between the body  110  and the support ring  120  may be large. 
         [0080]    In the prepared state, after the support ring  120  located at a lower side of the body  110  is shrunk or folded to a narrow size, the support ring  120  is introduced into the abdominal cavity through the operation hole. 
         [0081]    Then, after completely passing through the operation hole, the introduced support ring  120  is restored to an original state (that is, an annular state) by a resiliency thereof, and accordingly, the support ring  120  is expanded in the belly by the resilient restoration thereof while remaining stopped by the abdominal wall naturally. 
         [0082]    If the support ring  120  is introduced and installed in this way, as shown in  FIG. 10 , one hand applies a force to the pressing ring  140  to push the pressing ring  140  downward while an opposite end of the upwardly extending protection tube  130  being gripped by the other hand. Then, the pressing ring  140  presses the body  110  while descending to be moved downward together with the body  110 , and accordingly, the interval between the support ring  120  stopped in the abdominal cavity and the body  110  becomes narrower and the protection tube  130  becomes relatively tight. 
         [0083]    The pressing ring  140  is moved downward until the ring periphery portion  111  of the body  110  is attached to an upper surface of the belly, and if the body  110  is completely attached to an upper surface of the belly, the pressing ring  140  is horizontally rotated slightly to maintain the pressed state so that the stopping boss  151  is inserted into the boss holder  152  to fasten the pressing ring  140  and the body  110 . 
         [0084]    If the installation is completed in this way, as shown in  FIG. 11 , the protection tube  130  is tensioned tightly, and the body  110  and the interior of the belly remains completely sealed. 
         [0085]    The surgical tool guide  100  installed in this way secures an operation space as gas is introduced through the gas adjusting valve  114  provided in the body  110 , and various surgical tools (not shown) are introduced through the surgical tool entrance  112  to perform an operation. 
         [0086]    Further, after the operation, the pressing ring  140  is rotated slightly in an opposite direction to release the fastening of the pressing ring  140  and the body  110 , and the pressing ring  140  is raised along the protection tube  130  to release the pressed state. Thus, the surgical tool guide  100  can be simply separated by performing a process reverse to the installation process. 
         [0087]    As described above, since the surgical tool guide  100  according to an embodiment of the present invention is installed by the pressing ring, it can be installed and separated very conveniently, can be easily installed in the abdominal wall having various thicknesses through adjustment of the pressing of the pressing ring. Further, since the sealed state may be stably maintained, a laparoscopic operation can be performed safely without leaking nitrogen gas. 
         [0088]      FIGS. 12 to 17  are views showing a surgical tool guide  200  according to the second embodiment of the present invention, and the surgical tool guide according to the second embodiment of the present invention will be described with reference to  FIGS. 12 to 17 . 
         [0089]    Referring to the drawings, the surgical tool guide  200  according to the second embodiment of the present invention includes a body  210 , a support ring  220 , and a protection tube  230 . 
         [0090]    First, the body  210  may have a substantially cylindrical shape, and a lower end thereof is opened. At least one surgical tool entrance  211  is formed at an upper portion of the body  210  to be communicated with the body  210 . 
         [0091]    The surgical tool entrance  211  is adapted to introduce various surgical tools for an operation into the surgical tool guide  200  according to an embodiment of the present invention, and a valve unit  212  for easily introducing the surgical tools while maximally preventing leakage of gas may be provided at an upper end thereof. Various structures for the surgical tool entrance  211  are well known in the art to which the present invention pertains, and the surgical tool entrance  211  may have various known structures and may not be limited to those shown in the drawings. 
         [0092]    A gas adjusting valve  213  may be provided at an upper portion of the body  210  in addition to the surgical tool entrance  211 , and the gas adjusting valve  213  is adapted to control entry and exit of the gas for expanding a belly during an operation. 
         [0093]    Next,  FIGS. 14 and 15  are views showing the support ring  220 , in which the support ring  220  is an annular ring located at a lower side of the body  210 , and is stopped by an abdominal wall in an abdominal cavity after passing through an operation hole of a patient. Thus, the support ring  220  is formed of a resilient material which can be freely deformed, that is, can be folded or shrunk to be easily stopped while and after passing through the operation hole, and can be directly restored into an original state if an external force is removed. 
         [0094]    A folding portion  221  may be formed in a predetermined section of the support ring  220 , and as shown in  FIG. 15 , the thickness t 2  of the folding portion  221  is made small as compared with the thickness t 1  of the other portions so that the support ring  220  can be folded more narrowly. 
         [0095]    Accordingly, since when the support ring  220  is introduced into an operation hole, it may be folded more narrowly by the folding portion  221 , the support ring  220  may be easily introduced in to the operation hole. Further, since the thickness of only a predetermined section of the support ring  220  is reduced, the same support force can be maintained. 
         [0096]    Next, the protection tube  230  may be formed of a urethane sheet having an excellent resiliency, and includes an inner tube  231  and an outer tube  232 . 
         [0097]    The inner tube  231  is fixed to an inner surface of the body  210  to extend downward, and the outer tube  232  is connected to the inner tube  231  to extend upward via the support ring  220  and fixed to an outer surface of the body  210 . 
         [0098]    That is, the protection tube  230  has a dual structure such that one end of the protection tube  230  extends downward while being fixed to an inner surface of the body  210  and extends upward again while surrounding an outer side of the supporting ring  220  after passing through the interior of the support ring  220  such that an opposite end thereof is fixed to an outer surface of the body  210 , and the inner portion of the protrusion tube  230  is referred to as the inner tube  231  and the outer portion thereof is referred to as the outer tube  232 . 
         [0099]    In this way, since opposite ends of the protection tube  230  are fixed to the inner and outer surfaces of the body  210  while the protrusion tube  230  passes through the lower support ring  220 , a sealed space  233  is formed between the inner tube  231  and the outer tube  232 . 
         [0100]    A gas inlet  234  is formed in the inner tube  231 . 
         [0101]    The gas inlet  234  communicates an interior space of the inner tube  231  and the sealed space  233  to introduce the gas flowed into the interior space of the inner tube  231  into the sealed space  233 . 
         [0102]    A plurality of gas inlets  234  may be formed along a circumference of the inner tube  231 . 
         [0103]    The surgical tool guide  200  according to an embodiment of the present embodiment may further include a gas outlet  240 , and the gas outlet  240  is provided with a discharge valve formed in the outer tube  232  to be opened and closed to discharge the gas filled in the sealed space  233  and interrupt the discharge of the gas. 
         [0104]    The surgical tool guide  200  according to an embodiment of the present embodiment may further include a support ring pulling string  250 . 
         [0105]    The support ring pulling ring  250  is adapted to pull the support ring  220  hanging on an inner side of the abdominal wall and easily extract the support ring  220  from the operation hole after the operation, and may be installed to be connected to the support ring  220  to extend to the outside via the sealed space  233  and the body  210 . 
         [0106]    A knob  251  which a user can chuck with his or her hand may be provided at an end of the support ring pulling string  250 . 
         [0107]    Hereinafter, a surgical operation using the above-configured surgical tool guide  200  will be described with reference to  FIGS. 16 and 17 . 
         [0108]    First, after an operation hole for a laparoscopic operation is perforated at the navel of a patient, a portion of the surgical tool guide  200  according to an embodiment of the present invention is introduced through the operation hole to be installed. 
         [0109]    In more detail, after being shrunk or folded to a narrow size, the support ring  220  located at a lower side of the body  210  is introduced into the abdominal cavity through the operation hole. Then, as described above, if the folding portion  221  of the support ring  220  is folded, the support ring  220  can be introduced into the operation hole more easily. 
         [0110]    Then, as shown in  FIG. 16 , after completely passing through the operation hole, the introduced support ring  220  is restored to the original state (that is, the annular state) by the resilient force thereof, and accordingly, the support ring  220  is expanded in the belly with the restoring force thereof to maintain the stopped state of the abdominal wall naturally. 
         [0111]    If the support ring  220  is introduced and stopped by the abdominal wall in this way, the gas G for expanding the belly is introduced through the gas adjusting valve  213  provided in the body  210 . 
         [0112]    Then, the introduced gas G is filled in the belly along an interior space of the inner tube  231  to expand the belly, and is introduced into the sealed space  233  of the protection tube  230  through the gas inlet  234  formed in the inner tube  231  together at the same time. 
         [0113]    Further, as the gas G is continuously introduced into the sealed space  233 , the volume of the sealed space  233  is increased by the gas pressure to expand the protection tube  230 , and accordingly, the protection tube  230  is stably installed in the operation hole while being tightly tensioned. That is, as shown in  FIG. 17 , as the protection tube  230  maintains the expanded tension state while the support ring  220  is stopped by the interior of the abdominal wall, it can be firmly fixed without causing a problem of deviating from the operation hole. 
         [0114]    If the operation space is secured while the belly is expanded through introduction of gas and the surgical tool guide  200  is completely installed as the protection tube  230  is expanded at the same time, various surgical tools (not shown) is introduced into the belly through the surgical tool entrance  211  to perform an endoscopic operation after the gas adjusting valve  213  is closed. 
         [0115]    Meanwhile, after the operation, the surgical tool guide  200  can be separated from the operation hole by using the support ring pulling string  250 . That is, if the support ring pulling string  250  is pulled while the knob  251  is gripped, a pulling force is applied to one side of the support ring  220  so that the support ring  220  is easily deformed by the force, and accordingly, the support ring  220  can be extracted from the operation hole more easily. 
         [0116]    Further, for example, a tension state of the protection tube  230  is released by opening the discharge valve of the gas outlet  240  first and discharging the gas filled in the sealed space  233  to easily separate the surgical tool guide  200  before the support ring  220  is extracted through the support ring pulling string  250 . 
         [0117]    As described above, since the surgical tool guide  200  is automatically installed while the protection tube is expanded by the gas introduced for expansion of the belly if only the support ring is introduced into the operation hole, the surgical tool guide  200  can be installed very conveniently, and can be separated more easily through the support ring pulling string even after the operation. 
         [0118]      FIGS. 18 to 23  are views showing the protection cap  300  for a surgical tool guide according to an embodiment of the present invention, and the protection cap  300  will be described below with reference to  FIGS. 18 to 23 . 
         [0119]    As illustrated in the drawings, the protection cap  300  according to the embodiment of the present invention is fixedly installed in the tool entrance  400  provided at an upper end of the surgical tool guide (not shown). Here, it should be noted that the configuration of the surgical tool guide is not limited to a specific configuration and surgical tool guides having various configurations are possible. 
         [0120]    The protection cap  300  according to the embodiment of the present invention may have a circular shape as a whole when viewed from the top, and may be formed of a flexible resilient material, for example, a material such silicon and urethane to be moved in conjunction with the surgical tool while being freely deformed or to be restored to an original state according to the movement of the surgical tool. 
         [0121]    A tool entry hole  310  for entry and exit of various surgical tools is formed at a center of the upper surface of the protection cap  300 , and a fixing member  320  extending downward by a predetermined distance is integrally formed with a lower end thereof. 
         [0122]    As an embodiment, an embossing portion  330  having a plurality of bosses in a predetermined radial range from the tool entry hole  310  is formed on an upper surface of the protection cap  300 . The embossing portion  330  has a plurality of bosses to function to reduce friction while forming a point contact with the surgical tool instead of a surface contact when the surgical tool is introduced through the tool entry hole  310 . 
         [0123]    As an embodiment, a thickened portion  340  having a section having a large thickness in a predetermined radial range from the tool entry hole  310  is formed on an upper surface of the protection cap  300 . 
         [0124]    The thickened portion  340  has a thickness larger than those of the remaining portions, and thus has a strength higher than those of the remaining portions (that is, the outskirt portions  340 ′ of the protection cap  300 ), and accordingly, when the surgical tool introduced into the tool entry hole  310  is moved, the thickened portion  340  having the tool entry hole  310  may be more easily moved by the free deformation of the soft outskirt portion  340 ′ as if it is integrally formed with the surgical tool. 
         [0125]    As an embodiment, a support reinforcing portion  341  having an increased thickness as compared with other portions of the thickened portion  340  may be further formed in the thickened portion  340  to increase a support force of the surgical tool within a close radial range. 
         [0126]    The protection cap  300  is fixedly installed in the tool entrance  400  as shown in  FIG. 20 , and as a coupling ring  350  is coupled to an outer side of a fixing member while the fixing member  320  at a lower end of the protection cap  300  is inserted from the top of the tool entrance  400 , the protection cap  300  may be fixedly installed in the tool entrance  400 . 
         [0127]    However, the fixing of the protection cap  300  by the coupling ring  350  may be modified in different methods within a range of design modifications as an example, and the configuration of the tool entrance  400  shown in  FIG. 20  is illustrated as an example for convenience&#39; sake. Thus, it is noted that the configuration of the tool entrance  400  in which the protection cap  400  is installed is not limited thereto. 
         [0128]    If the protection cap  300  is fixed to the tool entrance  400 , the protection cap  300  surrounds and seals an upper end of the tool entrance  400 , and then an inner surface of the protection cap  300  is spaced apart from the tool entrance  400  by a predetermined interval to form a predetermined marginal space S in the protection cap  300 . The marginal space S may be understood as a space for free deformation of the protection cap  300 . 
         [0129]      FIGS. 21 to 23  are exemplary views showing an operation state of the protection cap according to an embodiment of the present invention, and an operation of the protection cap  300  according to an embodiment of the present invention installed in the tool entrance  400  will be described below. 
         [0130]    First, if the surgical tool guide (not shown) is completely installed in the operation hole of the patient, various surgical tools T are introduced through the tool entrance  400 . The surgical tool T is introduced after passing through the tool entry hole  310  on an upper surface of the protection cap  300  first. 
         [0131]    Here, the surgical tool T and an upper surface of the protection cap  300  contact each other when the surgical tool T is introduced, and since the introduced surgical tool T point-contacts an upper surface of the protection cap  300  by the embossing portions  330  formed at an periphery of the tool entry hole  310 , friction is reduced and the surgical tool T can be introduced more easily. 
         [0132]      FIG. 21  exemplifies a state in which the surgical tool T is completely introduced. 
         [0133]    Further,  FIGS. 22 and 23  exemplify state in which the introduced surgical tool T is variously moved according to the operation progress, and the introduced surgical tool T as shown is moved in various directions while during the operation. 
         [0134]    Then, as the surgical tool T is moved, as shown in  FIGS. 22 and 23 , since the protection cap  300  is also moved while being deformed by a force generated when the surgical tool T is moved, the tool entry hole  310  does not generate an aperture even when the surgical tool T is moved while still being attached to the surgical tool T, and accordingly, gas in the belly is prevented from being leaked. 
         [0135]    That is, if the surgical tool T is moved, the same force is transferred to the thickened portion  340  including the tool entry hole  310  surrounding the surgical tool T, and the outskirt portion  340 ′ of the protection cap  300  having a smaller thickness is easily deformed by the applied force so that the thickened portion  340  including the tool entry hole  310  is moved as if it is integrally formed with the surgical tool T. Thus, even when the surgical tool T is freely and variously moved for an operation, the surgical tool T and the tool entry hole  310  surrounding the surgical tool T continuously remains attached to each other, while preventing leakage of gas. 
         [0136]    In this way, since the protection cap  300  according to an embodiment of the present invention can efficiently prevent leakage of gas in the belly, an inconvenience of directly supplementing and injecting gas while an operation is performed can be solved, ensuring a smoother operation. 
         [0137]    The surgical tool guide according to one or more embodiments of the present invention can be installed and separated very conveniently and easily through a pressing/releasing operation of the pressing ring, thereby shortening an operation time. Further, the body is attached to the belly, thereby maintaining the distance between the entry end of the surgical tool and the belly at the shortest distance. In addition, as the interior of the surgical tool guide is completely sealed by a pressing operation of the pressing ring, an operation can be smoothly performed. 
         [0138]    Further, since the surgical tool guide according to one or more embodiments of the present invention does not need a separate installation process as the protection tube is automatically expanded by gas and installed in the operation hole, it can be installed in the operation hole very conveniently and stably. Further, the surgical tool guide can be more easily separated from the operation hole by pulling the support ring through the support ring pulling string after the completion of the operation. 
         [0139]    In addition, since the protection cap for a surgical tool guide according to the present invention can be moved in conjunction with the surgical tool even when the surgical tool is variously moved for an operation, leakage of gas can be efficiently interrupted. Thus, an operation can be smoothly performed without an inconvenience of injecting gas again during an operation and the surgical tool can be easily introduced and exited by reducing friction with the surgical tool through embossing. 
         [0140]    Furthermore, the unique effects which can be easily induced and expected from the feature configurations of the present invention correspond to the effects of the present invention in addition to the effects described in detail. 
         [0141]    Although exemplary embodiments of the present invention have been described until now, the scope of the present invention is not limited to the embodiments and the contents of the drawings, but the equivalent configurations corrected or modified by those skilled in the art to which the present invention pertains fall within the scope of the present invention.