JP3233953B2 - Catheter device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for inserting a contrast medium, collecting foreign substances, collecting cells,
The present invention relates to a catheter device for performing a procedure such as excision of a lesion.

[0002]

2. Description of the Related Art For example, a medical catheter device is inserted into a narrow portion such as a biological duct, and performs procedures such as injection of a contrast agent, collection of foreign matter, collection of cells, and excision of a lesion. . Medical procedures using this type of catheter device have the advantage of being less invasive than surgical procedures involving skin incisions.

[0003] However, although the catheter device is generally very flexible and long, the portion to be treated is often deep in the human body, so that the catheter device is inserted into a target site in the human body. To do so requires special methods and skills. In addition, there are many cases in which insertion is difficult such that insertion is not possible even if the surgeon has considerable skill.

Conventionally, a method of inserting a catheter into a body cavity includes a method of inserting a catheter through a channel of an endoscope, a method of inserting a guide wire into a body cavity in advance, and inserting the guide wire under guidance of the guide wire. There is.

[0005] In the former case, the endoscope itself can be inserted by utilizing the angle function of the endoscope while monitoring the image of the endoscope. Therefore, it is possible to reliably reach the target portion. In addition, when the distal end of the insertion portion of the endoscope is inserted to the target site, it is easy to insert the catheter through the channel of the endoscope, so that the catheter can be securely inserted into the target site. There is.

However, of course, this method can only be used for a large lumen into which the insertion portion of the endoscope can be inserted. Therefore, there is a problem that it can be used only in a very limited part of the lumen of the human body.

In the latter case, since the catheter is inserted under the guidance of a guide wire, there is an advantage that the catheter can be applied to a narrow lumen into which an endoscope cannot be inserted, such as a coronary artery. However, unlike the case of using an endoscope, the angle function cannot be utilized, and the endoscope image cannot be monitored. Therefore, this method requires a very high level of skill and has a problem that the success rate of insertion into a target site is extremely low.

[0008]

As described above, the conventional catheter device is extremely flexible and long, so that it requires extremely high skill for insertion, and the part to be treated is located in the deep part of the human body. In such a case, it is extremely difficult to insert, and there is a problem that an insertable portion is limited.

The present invention has been made in view of the above-mentioned circumstances, and the purpose thereof is that skill is required even if a part to be treated is a deep part of a human body or a narrow lumen. It is an object of the present invention to provide a catheter device which can be reliably inserted into a target site by a simple operation without any operation.

[0010]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention provides a flexible sheath ,
A first lumen provided along the long axis direction,
It extends along the lumen and has an opening at the tip of the sheath.
Formed and the insertion of a treatment tool or injection of fluid
2 and the outer side of the sheath on the first lumen side
The long axis so as to reach at least the first lumen from a circumference;
A plurality of notches cut in a direction orthogonal to each other and arranged at predetermined intervals along a longitudinal direction of the sheath ;
The sheath is provided so as to be inserted through the first lumen, and the longitudinal axis of the sheath is provided.
The sheath is bayed by being pulled or relaxed in the
And a wire to be bent.
In the device.

[0011]

By pulling or relaxing the wire at hand, the portion of the sheath where the notch is provided can be bent at an arbitrary bending angle, and the sheath can be inserted into a target portion.

[0012]

Embodiments of the present invention will be described below with reference to the drawings.

1 to 3 show a first embodiment. Reference numeral 1 denotes a flexible sheath formed of a synthetic resin material forming a catheter. This sheath 1 is an elongated flexible cylindrical rod-shaped body, and its eccentric portion extends in the longitudinal direction.
The through-hole 4 as a first lumen and the second lumen
It is provided lumen 2 of the. Then, a fluid such as a contrast agent can be injected through the lumen 2.

A plurality of notches 3 are provided at the distal end of the sheath 1 in a direction perpendicular to the long axis direction of the sheath 1 and at predetermined intervals in the long axis direction. These notches 3 are formed at positions away from the axis of the sheath 1 so as not to communicate with the lumen 2.

Further, the distal end of the sheath 1 is bent in an arc so that the side of the notch 3...
(A)) and the notch 3
Are formed to penetrate through the through-hole 4.
Is bored over the entire length of the sheath 1.

A single wire 5 is inserted through the through hole 4, and the distal end of the wire 5 is fixed to the distal end of the sheath 1 by a knot 6, and the proximal end of the wire 5 is connected to the sheath 1. It extends to the hand operation unit 7. Hand operation unit 7
Is composed of a shaft 8 provided integrally with the sheath 1 and a knob 9 slidably fitted in the shaft 8 in the axial direction. The base of the wire 5 is knotted on the knob 9. It is fixed by 10.

According to the catheter device configured as described above, as shown in FIG. 2A, when the knob 9 of the hand operation unit 7 is slid forward, the wire 5 inserted through the through hole 4 is moved. Is relaxed. Therefore, since the distal end portion of the sheath 1 is not restrained, the sheath 1 is bent in advance, so that the sheath 1 bends in the direction of arrow A, that is, the direction in which the cutout portion 3 opens.

Next, as shown in FIG. 2B, when the knob 9 of the hand operation unit 7 is slid backward and moved to the middle,
The wire 5 inserted into the through hole 4 is pulled toward the hand operation unit 7. Therefore, since the distal end of the sheath 1 is pulled, the bending habit applied in advance is corrected and becomes straight.

Further, as shown in FIG. 3C, when the knob 9 of the hand operation unit 7 is further slid backward, the through-hole 4
Is pulled toward the operation section 7 at hand.
Therefore, since the tip of the sheath 1 is further pulled,
It is curved to the opposite side from FIG.

Therefore, the distal end of the sheath 1 can be bent in an arbitrary direction by operating the hand operation unit 7 and guided to a target site, and a fluid such as a contrast agent is injected through the lumen 2 provided in the sheath 1. can do. The site where the contrast agent is injected using this catheter may be, for example, the coronary artery of the heart. In this case, the notch 3 is not limited to the distal end of the sheath 1, and the notch 3 may be provided at an appropriate hand side of the sheath 1 so that insertion is most easily performed.

FIGS. 4 and 5 show a second embodiment.
The same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted. In this embodiment, the notch 11 provided at the distal end of the sheath 1 is notched deeply until it reaches the lumen 2. Therefore, the distal end of the sheath 1 is made more flexible by the deep cutout 11, and the distal end can be bent rapidly.

Therefore, the catheter of this embodiment is
As shown in FIG. 5, it is suitable for application to, for example, basket forceps 12. Generally, when trying to insert the basket forceps 12 into the common bile duct to remove stones in the biliary tract,
It is necessary that the basket forceps 12 bend sharply at Fata's nipple.

Conventionally, the forceps have been forcibly bent and inserted by a forceps raising device of a duodenal endoscope. However, since the shape near the papilla of Mr. Fata varies greatly between individuals, it may not be possible to insert the forceps in some cases. there were.

However, if a basket forceps is inserted using the angle function of the catheter device of this embodiment in combination with the forceps raising device of the endoscope for duodenum, the curved state can be finely adjusted. Can be inserted without failure in the case.

It is desirable to provide an operating means for opening and closing the basket portion of the basket forceps 12 in addition to the angle function. It is desirable that the length relationship between the tube sheath 13 and the coil sheath 14 of the basket forceps 12 can be adjusted.

That is, FIG. 6 shows an operation section of a sheath slide type crushed stone basket, and 15 is a slide section.
A slide groove 16 is provided in this axial direction. Tip of this slide groove 16 (projection side of tube sheath 13)
Are provided with one distal locking groove 17, and a plurality of proximal locking grooves 18 are provided at the proximal end (the side where the tube sheath 13 is drawn in).
Is provided.

The tube sheath 1 is provided in the slide groove 16.
An operation knob 19 is provided for connecting to the tube sheath 13 and the coil sheath 14 by selectively locking the operation knob 19 in the base locking groove 18. It is possible to match the tip surfaces of the fourteen, and the adjustment can be easily performed.

FIG. 7 shows a slide groove 16 provided with a plurality of base-end locking grooves 18 on both side edges on the base end side for the same purpose as in FIG. With this configuration, the length relationship between the tube sheath 13 and the coil sheath 14 can be adjusted more accurately and easily.

FIGS. 8 to 10 show a third embodiment in which the calculus collecting tool 20 is inserted into the lumen 2 of the sheath 1 in the first embodiment so as to be able to advance and retreat. The calculus collecting tool 20 includes a flexible tube 21 made of a synthetic resin material, an operation wire 22 inserted into the tube 21 so as to be able to advance and retreat, and a tip of the tube 21 connected to a tip of the operation wire 22. And the tip 23 fixed to the front end. Further, a plurality of cuts 24 extending in the long axis direction are provided on the outer periphery near the distal end of the tube 21.

The proximal extending end of the sheath 1 is connected and fixed to the first operating section main body 25, and the proximal extending end of the wire 5 inserted through the through hole 4 of the sheath 1 is connected to the first operating section main body. 25
Is fixedly connected to the first knob 27 through the inside of the side branch portion 26.

The tube 21 of the calculus collecting tool 20
The hand-side extending end portion is connected and fixed to the second operation portion main body 28 through the inside of the first operation portion main body 25. Also,
The proximal extension end of the operation wire 22 passes through the inside of the second operation portion main body 28 and is connected and fixed to a second knob 29. Further, the second operation portion main body 28 is provided with a luer base 30 that can be connected to a syringe (not shown), and is connected to a pipe inside the tube 21 in a watertight manner.

Next, the operation will be described with reference to FIG. 10. First, the sheath 1 forming the catheter device is introduced through the channel of the endoscope 31 inserted into the body cavity.
Then, the first knob 27 is operated to pull the wire 5 to bend the distal end of the sheath 1, and the distal end of the sheath 1 is directed to the papilla 34 of the duodenum.

The calculus collecting tool 20 inserted through the lumen 2 of the sheath 1 is advanced, and is introduced into the bile duct 32 through the nipple 34. Thereafter, when the second knob 29 is pulled and the operation wire 22 is pulled, the tip 23 is pulled, and the tube 21 is broken by the cut 24 to form an opening 22a.

In this state, when a contrast medium is injected from a syringe connected to the luer base 30 of the second operating section main body 28, the contrast medium is injected into the bile duct 32 through the opening 22a, and the bile duct 32 is injected.
The inside is filled with a contrast agent. Next, when suction pressure is applied from the syringe, the calculus 33 is taken into the opening 22a together with the contrast agent.

Then, by operating the first knob 29 and pushing the operation wire 22 toward the distal end side, the opening 22a is closed, and the collected calculus 33 is captured. And endoscope 3
Take the stone out of the body with 1.

According to this embodiment, the bending function can be provided with a simple structure, and the treatment instrument can be easily introduced into the duodenal papilla, which required a high degree of skill. Further, since the opening of the calculus collecting tool is opened by the force of the operation wire, the opening can be reliably opened in the bile duct as compared with the basket forceps as shown in FIGS. 6 and 7. In addition, by injecting and collecting the contrast agent and performing reflux of the contrast agent, even a small calculus floating in the bile duct, which was difficult to collect with a conventional basket forceps, can be easily collected.

[0037]

As described above, according to the present invention, the catheter device having the angle function requires skill even if the part to be treated is a deep part of a human body or a narrow lumen. This has the effect that it can be reliably inserted into the target site by a simple operation without any operation.

[Brief description of the drawings]

FIG. 1 is a longitudinal sectional side view of a first embodiment of the present invention, in which a part of a sheath is omitted.

FIGS. 2A to 2C are side views of a catheter device for explaining the operation of the embodiment.

FIGS. 3A and 3B are a side view and a cross-sectional view of a distal end portion of the sheath of the embodiment.

FIG. 4 is a side view and a sectional view of a distal end portion of a sheath showing a second embodiment of the present invention.

FIG. 5 is an operation explanatory view of the embodiment.

FIG. 6 is a side view of an operation unit of the sheath slide crushed stone basket of the embodiment.

FIG. 7 is a side view showing a modified example of the operation unit of the sheath slide crushed stone basket.

FIG. 8 is a side view of a sheath according to a third embodiment of the present invention, in which a distal end portion of the sheath is partially cut away.

FIG. 9 is a side view of the hand operation unit of the embodiment.

FIG. 10 is an operation explanatory view of the embodiment.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... sheath, 3 ... cutout part, 4 ... through-hole, 5 ... wire.

Continuation of front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 17/00-18/28 A61B 1/00 A61M 25/00-29/04

Claims (1)

(57) [Claims] 1. A sheath having flexibility, a first lumen provided along a longitudinal direction of the sheath, and an opening at a distal end of the sheath extending along the first lumen. A second lumen to be formed and through which a treatment tool is inserted or a fluid is injected, and which is orthogonal to the long axis so as to reach only the first lumen from the outer periphery of the sheath on the first lumen side. A plurality of notches having a flat bottom, which are arranged at predetermined intervals along the longitudinal direction of the sheath, and are provided so as to pass through the first lumen, A wire that bends the sheath by being pulled or relaxed in the longitudinal direction of the sheath.