JP3526082B2 - Medical tubing - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical device used for a catheter or an endoscope having a bending mechanism for injecting a drug solution into a lumen of a living body or inserting an instrument for intraluminal observation and treatment. Regarding tubes.

[0002]

2. Description of the Related Art Conventionally, there is already known a mechanism for operating a distal end of a endoscope by bending the distal end of the endoscope for the purpose of observing and treating an arbitrary region in a lumen. Most of these are due to the wire and node ring structure, but it is unsuitable in terms of size to incorporate them into a small-diameter endoscope due to mechanical restrictions. In view of this situation, in some small-diameter endoscopes, bending is realized only by the wire mechanism. However, even in this mechanism, a lumen for passing the wire is required, and there is a limit in reducing the diameter in order to maintain the wire strength for bending. Further, generally, medical catheters having a diameter smaller than that of an endoscope have been reported to have a bending mechanism.
There is a wire like 105798 which tries to realize bending by a wire, but this also has a limit in reducing the diameter for the reason described above. Further, in Japanese Patent Application Laid-Open No. 6-54796, there is a method in which a film-shaped electrostatic actuator is energized to deform the actuator to thereby bend the tube. It is not practically preferable from the viewpoint of electrical safety such as generation of leakage current from the. Further, Japanese Patent Application Laid-Open No. 6-154157 proposes a reversibly heat-expandable and pressure-sensitive material which is heated and cooled to bend in an arbitrary direction. However, heating and cooling in a living body may damage living tissues. It is not preferable because there is. Further, as an example in which a photoresponsive polymer material is used as an actuator, Japanese Patent Application Laid-Open No. 6-142209
The photo-responsive polymer material in the tube tip or in the balloon provided at the tube tip is irradiated / quenched to contract / expand the photo-responsive polymer material to bend the tube tip. . Regarding the concavo-convex structure for the purpose of dispersing the bending stress of the catheter, JP-A-6-470 is known.
There is 94.

Regarding the photoresponsive polymer material, Irie et al. Introduced a polymethacrylic acid-chrysophenine G mixed system, a polymer containing azobenzene, a polymer containing a leuco body of triphenylmethane in a side chain, and the like. There is. (1
989 Published “Mechanochemistry” Maruzen Co., Ltd.
21-53)

[0004]

However, the conventional bending mechanism using the photoresponsive polymer material is generated because the photoresponsive polymer material is provided without changing the wall structure of the tube. The photoresponsive polymer material having a relatively small force has a problem that it is difficult to obtain sufficient curvature due to the rigidity of the tube body.

Further, in the conventional bending mechanism using the wire or the photoresponsive polymer material, only one bending portion can be obtained.

According to the present invention, by using a tube having a continuous ring composed of a photoresponsive substance and a groove, a medical tube having a sufficient bending function and a small diameter can be obtained, and further a plurality of bending sections are provided. The purpose is to obtain a medical tube.

[0007]

The object is to provide a medical tube having a curved portion, in which the tube main body wall in the curved portion has a concave groove portion, and the groove portion is loaded with a photoresponsive substance, This is achieved by providing the photoresponsive material with a bending control means for selectively irradiating drive light.

Further, it is preferable that the photoresponsive substance is made of a photoresponsive polymer gel, and a groove portion of the medical tube has a flexible outer casing having moisture permeability in order to prevent leakage of the polymer gel. It is preferably covered with a high molecular weight polymeric material.

Further, the bending control means is equipped with at least one optical fiber in the lumen of the tube, the core of the optical fiber is exposed in the groove portion, and the driving light is the optical fiber. It is preferable to irradiate the photoresponsive substance from the core.

Further, in the groove portion of the medical tube, a plurality of grooves circumferentially formed on the tube body wall form a continuous row along the axis of the tube, and the optical line is formed for each groove row. It is preferable that the core of the fiber is exposed.

Furthermore, the groove portion of the medical tube is formed in a continuous spiral shape on the tube body wall,
It is preferable that the core of the optical fiber is exposed for each circumference of the spiral groove.

Further, it is preferable that the bending control means has means for guiding light to the optical fiber and means for changing the light guiding amount for each optical fiber according to the bending direction and the bending amount.

Further, it is preferable that the bending portion comprises a plurality of joints.

[0014]

According to the present invention, an endoscopic image or an X-ray projection image is displayed when a medical tube is inserted into a body cavity and the tube is advanced in an arbitrary direction in, for example, bronchioles or bifurcations of blood vessels. While observing, the bending operation of the bending section is performed in the hand operation section in the direction of advancing the tube. When this operation is performed, light in the vicinity of the maximum wavelength of the absorption spectrum of the photoresponsive substance embedded in the tube groove is generated from the light generation device in the control device and embedded in the tube lumen through the condensing optical system. Guided optical fiber. The light guided by the optical fiber bends in the groove of the tube body by controlling the irradiation of the photoresponsive substance embedded in the groove from the exposed portion of the core of the optical fiber. As a site, the photoresponsive substance is reversibly expanded and contracted to control the tube curvature. Therefore, since the bending stress is dispersed by the groove structure, a stable tube bending with a constant bending point can be obtained by a microscopic force by the photoresponsive polymer material, and thereby a medical tube in a branched lumen organ. The bending operation can be performed safely, reliably and easily.

Further, by providing a plurality of bending portions to form a multi-joint tube, each bending portion is independently bent in accordance with the bending inside the body cavity having a complicated shape, so that the body cavity can be inserted when the medical tube is inserted. It is possible to prevent the risk of damaging the insertion lumen in the tube with the tube and to reduce the compression by the tube.

[0016]

【Example】

(Embodiment 1) FIG. 1 is an explanatory view showing the constitution of a medical tube showing Embodiment 1 of the present invention, and FIG. 2 is a sectional view showing the constitution of the distal end portion of the medical tube according to Embodiment 1.

The medical tube shown in FIG. 1 generates a light for bending the bending portion 14 by detecting signals from the operating portion 3 for bending the tube body 1 and the bending portion 14 thereof and the operating portion. It is composed of a control unit 2.

The tube body 1 is made of a highly flexible polymer material such as polyurethane, polyolefin, polyester, polycarbonate, polysulfone or silicone, and has a lumen 4 and a light for inserting a medicinal solution and an observation / treatment instrument. Having the lumens 8a and 8b for inserting the fibers 7a and 7b, the bending portion 14
In, the five grooves 6 formed on the wall surface of the tube body 1 are formed. An optical fiber 7 having a core portion exposed at the curved portion 14 is inserted into the lumens 8a and 8b, and the groove portion 6 is irradiated with light from this portion. In the groove portion 6,
Photoresponsive polymer substance 5 which is a photo-mechanical energy conversion substance
Are filled in, and a plurality of these are arranged in the curved portion 14. The outer portion of the tube main body 1 at the curved portion is covered with a sleeve 13 made of a flexible polymer material that is permeable to water, and prevents the photoresponsive polymer substance 5 from leaking out.

As the photoresponsive polymer substance 5, a leuco form of triphenylmethane, polystyrene in which leuco hydroxide is partially introduced into the side chain, poly (N, N-dimethylacrylamide), polyacrylamide or the like is used. The tube body 1 is fixed by filling the groove portion 5. A polymeric substance containing a leuco form of triphenylmethane in its side chain has no electric charge and is neutral in the non-irradiated state, but the leuco form of triphenylmethane undergoes ionic dissociation upon light irradiation and changes into an ionic gel. . The ionic gel having a fixed charge contains many mobile ions in the gel as compared with the external liquid (body fluid), and as a result, the osmotic pressure of the gel becomes high. This osmotic pressure causes the gel to swell until the osmotic pressure and gel elasticity are balanced. When the irradiation of the driving light is stopped, the ions are neutralized and the osmotic pressure is reduced, so that the original contraction state is restored by the elastic force of the gel.

As the moisture permeable sleeve 13 for the exterior of the curved portion, in addition to a porous polymer material such as GORE-TEX,
A film made of a flexible polymer material having fine holes formed by laser processing, ion beam processing, or the like may be used. By using a moisture permeable material for the sleeve 13, it is possible to obtain necessary moisture from the outside when the photoresponsive polymer substance 5 expands.

The light guided to the optical fibers 7a and 7b receives the control signal from the operation section 3, is generated by the arithmetic circuit 12, and is obtained by the light sources 10a and 10b controlled by the light source driver 11. Light sources 10a, 10b
The generated light is guided to the optical fibers 7a and 7b by meeting the respective optical fiber coupling optical systems 9a and 9b.

The light emitted from the light sources 10a and 10b preferably emits a wavelength in the vicinity of the maximum of the absorption spectrum of the photoresponsive polymer substance 5 described above. For example, a leuco body of triphenylmethane is used as a side chain. When the polymer containing is used as the photoresponsive polymer substance 5, the wavelength is 270 to 700.
It is preferable to generate nm. This light source 10a, 10
b may be a xenon lamp, a metal halide lamp, a halogen lamp, a mercury lamp, or a lamp having a wide emission spectrum and an optical filter for obtaining an appropriate wavelength, or a semiconductor laser or a wavelength tunable laser. It may be a laser light source such as.

An example of use will be described with reference to FIGS. 1 and 2. When inserting the tube main body 1 into the body cavity and advancing the tube in an arbitrary direction in branching of bronchioles or blood vessels, for example, the tube main body in the hand operation unit 3 while observing an endoscopic image or an X-ray projection image. The bending operation of the tube body 1 is performed in the direction of advancing 1. When this operation is performed, light near the maximum wavelength of the absorption spectrum of the photoresponsive polymer substance 5 embedded in the groove 6 is generated from the light sources 10a and 10b in the control device 2, and the optical fiber coupling optical system 9
It is guided to the optical fibers 7a and 7b embedded in the tube body 1 through a and 9b. At this time, the optical fibers 7a, 7
The light quantity guided to b is controlled by controlling the light quantity of the light sources 10a and 10b by the light source driver 11, and the bending direction and the bending angle of the bending portion 14 are controlled by the light quantity. The light guided to the optical fibers 7a and 7b is irradiated to the photoresponsive polymer substance 5 from the portion where the cores of the optical fibers 7a and 7b are exposed in the groove portion 6 of the tube body 1, and the groove portion 6 is bent to the curved portion 14 As a result, the photoresponsive polymer substance 5 is expanded.
The tube body 1 is contracted and the tube body 1 is curved. When the photoresponsive polymer substance 5 is polyacrylamide containing a leuco body of triphenylmethane in the side chain, this substance expands by absorbing light, so that the light in the desired bending direction is dimmed or extinguished, and the light on the opposite side is diminished. The bending portion 14 can be bent by irradiating with. At this time, the water necessary for the expansion of the photoresponsive polymer material 5 is obtained from the body fluid through the water permeable sleeve 13 which is the exterior of the bending portion 14 of the catheter 1. Since there are a plurality of groove portions 6, the bending stress is dispersed, and even if a minute force by the photoresponsive polymer substance 5, a stable tube bending at the bending portion 14 can be obtained. Optical fibers 7a, 7
As b, a quartz fiber, a multi-component glass fiber, a plastic optical fiber, or the like is used. Since the optical fibers 7a and 7b can freely slide in the optical fiber lumens 8a and 8b at the bending portion 14, it is possible to prevent an increase in bending stress due to the integration of the optical fiber and the tube, and thus, it does not hinder the bending. .

[0024] Thus, the catheter operation in the branched luminal organ can be performed safely and reliably.

(Embodiment 2) FIG. 3 is an explanatory view showing the structure of the distal end portion of a medical tube according to Embodiment 2 of the present invention.
It shows a tube that can be bent in three directions. The five groove portions 21 have three portions (21a, 21b, 21
The optical fiber is provided for irradiating light to each of the three parts. With such a configuration, the photoresponsive polymer materials 22a, 22b, 22c that function during bending are clearly separated, and more accurate bending is possible.

(Embodiment 3) FIG. 4 is an explanatory view showing the structure of the distal end portion of a medical tube according to Embodiment 3 of the present invention.
The groove portion 31 is continuously processed into a spiral shape in the curved portion 14 of the tube body 1, the portion of the groove is filled with the photoresponsive polymer substance 32, and the optical fiber is arranged at the bottom portion of the groove (FIG. (Not shown). A water-permeable polymer sleeve 13 is installed around the curved portion 14 so as to cover the outer circumference. Further, as in the second embodiment, the groove portions may be separated as shown in FIG. The spiral processing of the groove in this manner has an advantage that, in addition to the ease of bending, the torque transmissibility and the tensile strength are increased as compared with the ring-shaped processing as in the first and second embodiments. .

(Embodiment 4) FIG. 5 is an explanatory view showing the constitution of the distal end portion of a medical tube having a plurality of curved portions according to Embodiment 4 of the present invention, and FIG. 6 is a medical tube of this Embodiment 4. FIG. 7 is a use state explanatory view showing a state in which is inserted into a body cavity, and shows a state of a medical tube having five curved portions in a curved body cavity. In FIG. 5, since many components are common to those of the first embodiment shown in FIG. 1, the same parts are designated by the same reference numerals, and the description thereof will be omitted. Only different parts will be described.

In FIG. 5, reference numerals 14, 15, 16 are all curved portions, and the optical fiber 7 and the lumen 8 are two for the curved portion 14 located at the most distal end, and the curved portions 15, 1, 1.
One for each of the six. Two or more optical fibers 7 may be provided in each of the curved portions 14, 15, and 16, but in the present embodiment, only the minimum necessary number is provided in order to reduce the diameter of the tube. Further, the optical fibers for the curved portions 15 and 16 do not need to extend from the curved portions to the tip, that is, the optical fibers for each joint are present at the proximal portion, but as the tip is reached, The number of optical fibers is reduced. The number of optical fiber coupling optical systems 9 and the number of light sources 10 in the control unit 2 are the same as the number of optical fibers 7.

Each curved portion is composed of five groove portions 6, and each is filled with the photoresponsive substance 5. Further, each curved portion is covered with a sleeve 13 made of a water-permeable polymer.

In order to safely advance the medical tubing according to the present invention in the body cavity, it is important to make the distal end flexible, but in this embodiment, each curved portion (joint) is moved to the distal end. The number of optical fibers decreases as it goes, and the tip can be softened. Further, the torque transmissibility of the tube is an important parameter for inserting the medical tube into the body cavity by remote control from the proximal part, but in the medical tube of the present invention, the optical fiber is attached to the tube wall due to its mechanism. Since it is embedded, it has better torque transmission than a tube made of a polymer material alone.

[0031]

As described above, according to the present invention, there is an effect that a catheter can be safely and reliably and easily inserted into an arbitrary tube in a lumen by remote control and advanced. In addition, by providing a plurality of bending portions, it is possible to realize bending that matches the shape of the body cavity, and it is possible to reduce damage to the body cavity and irritation to the body cavity.

[Brief description of drawings]

FIG. 1 is a configuration diagram of a medical tube showing Example 1 of the present invention.

FIG. 2 is a cross-sectional view showing the configuration of the distal end portion of the medical tube according to the first embodiment.

FIG. 3 is an explanatory diagram showing a configuration of a distal end portion of a medical tube according to a second embodiment.

FIG. 4 is an explanatory diagram showing a configuration of a distal end portion of a medical tube according to a third embodiment.

FIG. 5 is a configuration diagram of a medical tube according to a fourth embodiment.

FIG. 6 is an explanatory view of a usage state of the medical tube according to the fourth embodiment.

[Explanation of symbols]

1: Catheter body 14, 15, 1
6: curved part 2: control part 21a, 21b,
21c: Groove part 3: Operation part 22a, 22b,
22c: Photoresponsive substance 4: Lumen 41: Body cavity 5: Photoresponsive substance 6: Groove portions 7a, 7b: Optical fibers 8a, 8b: Lumens 9a, 9b for optical fiber: Optical fiber coupling optical system 10a, 10b: Light source 11: Light source driver 12: Arithmetic circuit 13: Sleeve

Continuation of front page (56) Reference JP-A-60-200782 (JP, A) JP-A-61-10972 (JP, A) JP-A-1-320068 (JP, A) JP-A-5-76599 (JP , A) JP-A-6-70940 (JP, A) JP-A-6-108963 (JP, A) JP-A-6-133922 (JP, A) JP-A-6-133924 (JP, A) JP-A-6-133924 (JP, A) 6-142209 (JP, A) (58) Fields investigated (Int.Cl. ⁷ , DB name) A61B 1/00

Claims (6)

(57) [Claims] 1. A medical tube having a curved portion, wherein a continuous spiral shape is formed on the wall of the tube main body in the curved portion.
And has a made a groove, medical tubing loaded photoresponsive material the groove portion, characterized by comprising a bending control means for selectively irradiating the drive light on the light-responsive material. 2. The light-responsive substance is made of a light-responsive polymer gel, and at least the groove exterior of the medical tube is covered with a water-permeable flexible polymer material. The medical tube according to claim 1. 3. The bending control means has at least one optical fiber provided inside the lumen of the tube, and the core of the optical fiber is exposed in the groove. 1. The medical tube according to 1. 4. The groove portion in the medical tube has a plurality of grooves formed circumferentially on the tube body wall and continuously forms a row along the axis of the tube, and the optical line is provided for each groove row. The medical tube according to claim 3, wherein the core portion of the fiber is exposed. 5. The bending control means includes means for guiding light to an optical fiber and means for changing the amount of light guiding for each optical fiber according to the bending direction and the bending amount. The medical tube according to item 3. 6. The medical tube according to claim 1, wherein there are a plurality of curved portions.