JPH11216187A - Magnetically guided cannulation device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make a canula easily and speedily reachable to an affected part at the deep inside a tract without high technique for insertion by making the top end of the cannula bendable in a desired direction by use of interaction between a strong magnet and conducting part that moves in correspond to the magnetic power. SOLUTION: An operator inserts a cannula 1 toward an affected part through a patient tract by hand as observing the fluoroscoped image of the client projected on the TV monitor. For example, when operator confirms that the top end of the cannula 1 reaches the divergence of a vein, the operator operates the lever of a controller so as to weld electrically welding coil 8 to the top end of the cannula 1. When the cannula 1 is to be inserted into the vein at the right side, the welding coil 8 is welded electrically as the top end cannula 1 around which the welding coil 8 is wound can be bent to the right by the interaction between the direction of the coil 8's magnetization and a pair of magnets.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cannulation device for diagnosing and treating blood vessels such as arteries, veins, lymph vessels, biliary tracts, pancreatic ducts, ureters, renal pelvis, renal pelvis and other deep parts of a human body. About.

[0002]

2. Description of the Related Art Conventionally, when a cannula is inserted into a deep part of a lumen of a living body, a surgeon manually inserts the cannula into a target site while observing an X-ray fluoroscopic image or an ultrasonic tomographic image or observing with an endoscope. I was trying to reach the guidance. If it is necessary to guide the cannula to any branch that does not reach the bifurcation deep in the lumen, use a cannula with various bends in the tip in advance according to the purpose, and use the cannula whose tip has reached the bifurcation. Is rotated by hand to insert a cannula into a predetermined branch.

[0003]

However, the above-mentioned method of inserting a cannula requires a high level of skill and time, and it is difficult to insert a deep part into a target branch depending on the shape of the branch at the branch. In some cases, it was impossible at all. Especially for patients with myocardial infarction, a contrast agent is injected into the thrombus site through a cannula to diagnose the lesion,
In addition, treatment is often performed to inject a thrombolytic agent through a cannula to dissolve and remove the thrombus and return to a normal blood flow state. Is a serious problem affecting the life of the patient. The use of a cannula for the diagnosis and treatment of cancer lesions also requires considerable urgency and advanced technology.

Accordingly, the present invention does not require the use of various shapes of cannulas for the vasculature, exocrine lumen, etc. of all organs other than the gastrointestinal tract. It is an object of the present invention to provide a device that can insert a cannula having a distal end portion thereof and can easily and quickly reach a target lesion affected part in a deep lumen without requiring an advanced insertion technique. Things.

[0005]

According to the present invention, in order to achieve the above object, a pair of strong magnets arranged opposite to each other with a human body therebetween, and the pair of strong magnets centered on a living body axis of the human body. Means for relatively rotatably supporting the magnetic field, a controller for controlling the generation and strength of the magnetic field of the pair of strong magnets, and a magnetically responsive energization attached to the outer periphery of the distal end of a cannula inserted into a human body lumen And a magnetic field induction cannulation device characterized in that an end portion of the cannula is bent in a desired direction by an interaction between the strong magnet and the magnetically responsive current-carrying portion.

[0006] The magnetic field induction cannulation device of the present invention further includes a drive energizing section attached to the outer periphery of the cannula over a predetermined axial length behind the magnetically responsive energizing section at the tip of the cannula. The drive energizing section moves the cannula forward and backward by interaction with a magnetic field generated by the pair of strong magnets.

[0007]

According to the present invention, when the tip of the cannula reaches the bifurcation, the magnetic field generated by the pair of strong magnets interacting with the magnetically responsive energizing section is controlled by the controller, and the tip of the cannula is moved to a desired position by the electromagnetic force. It can be bent in the direction of the branch and the cannula can be easily inserted into the branch.

In the case where a driving energizing portion is attached to the outer periphery of the cannula over a predetermined axial length behind the magnetically responsive energizing portion and a second pair of strong magnets is provided, the second pair of strong magnets is generated. By controlling the magnetic field generated by the controller and interacting with the drive energizing section, the forward and backward movement of the cannula can be automatically operated without manual operation according to the framing left hand rule.

[0009]

FIG. 1 shows an arterial stenosis (arteriosclerosis) part 4 of a coronary artery 3 of a heart of a patient having myocardial infarction as an example.
Shows a state in which the cannula 1 is inserted through the aorta 2. The hatched portion indicated by 5 in the figure indicates that a part of the left ventricle is in an ischemic state. In this state, cannula 1
After a contrast agent is injected into the stenosis 4 through the stenosis 4 and a radiographic x-ray is taken to diagnose the lesion site, a thrombolytic agent is injected through the cannula to dissolve and remove the thrombus in the stenosis 4, and a normal blood flow state The treatment to return to is performed.

Conventionally, cannula 1 is inserted into stenosis 4
The operator can manually advance the cannula 1 in the direction of the arrow in the figure while confirming the position of the tip of the cannula 1 with an X-ray fluoroscopic image or an ultrasonic tomographic image, and the cannula tip reaches the bifurcation of the left coronary artery 3. At this time, in order to send the cannula 1 to the branch where the stenosis 4 exists, the operation is performed by rotating the cannula 1 at hand of the surgeon so that the tip of the cannula faces the direction of the branch of the stenosis 4. This insertion operation requires a high degree of skill and time.

FIG. 2 is a schematic diagram showing a state in which a cannula 1 is inserted into a patient's heart 6 through a femoral artery by a magnetic field induced cannulation device of the present invention. One embodiment of the cannula used in the present invention, as shown in FIG. 3, is a current-carrying coil 8 having a cannula tip 7 made of a ferromagnetic ceramic and a wire around which the electric resistance is extremely small.
To form a magnetic field responsive energizing section. Further, a cooling water pipe 9 is wound in a coil shape adjacent to the energizing coil 8 for the purpose of reducing the electric resistance of the energizing coil 8 and preventing a rise in temperature. The lead wires 8 ', 8' of the energizing coil 8 and the inlet and outlet pipe portions 9 ', 9' of the coiled cooling pipe 9 are
As shown in FIG. 3A as an AA section in FIG. 3, the flexible plastic cannula 1 is embedded in the main body. In FIG. 2, reference numeral 10 denotes a cooling device for circulating cooling water.

FIG. 4 shows a state in which the cannula 1 shown in FIG. 3 is actually inserted into a patient lying on the bed 11 using the cannulation device of the present invention. Bed 11
Has a concave cross-section, can move vertically and horizontally as indicated by arrows, and can rotate to some extent, and adjusts the position and direction of the patient to the position where the affected part is irradiated by the X-ray irradiation device 12. 12 'is an X-ray imaging tube. A pair of strong positive and negative electromagnets 13 and 14 are arranged opposite to each other vertically below the X-ray irradiation device 12 with a patient therebetween. In the figure, reference numeral 15 denotes a controller with a television monitor 16, reference numeral 17 denotes a power supply for supplying a current to the current-carrying coil 8 through a lead wire 8 ', and reference numeral 18 denotes a drip bottle for a drug solution injected through the cannula 1. A pair of electromagnets 13, 1
Numeral 4 is attached to a support frame (not shown) rotatable about a living body axis of the patient, and the support frame has a structure in which the angle between the rotation surface and the living body axis can be changed.

The operator manually inserts the cannula 1 of FIG. 3 through the lumen of the patient toward the affected area while observing the fluoroscopic image of the patient displayed on the television monitor 16. For example, when the cannula is inserted through a blood vessel, when the operator confirms that the tip of the cannula 1 has reached the bifurcation of the blood vessel 19 as shown in FIG. Power is supplied to the power supply coil 8 at the distal end. When the cannula 1 is to be inserted into the blood vessel branch 19 'on the right side of FIG. 5, the direction of magnetization of the energized energizing coil 8 is wound around the energizing coil due to the interaction with the magnetic field formed by the pair of electromagnets 13 and 14. The current is supplied to the current supply coil 8 so that the current flows in a direction such that the tip of the cannula is bent rightward. The cannula with its tip directed towards the vessel branch 19 'is thus inserted into the branch 19' by the surgeon pushing the cannula further by hand. When the cannula is to be inserted into the branch 19 ", the surgeon operates the control lever so that current flows through the energizing coil 8 in the opposite direction.

In order to bend the tip of the cannula in various other directions, the direction of the magnetic field formed by the pair of electromagnets 13 and 14 must also be changed. Therefore, the pair of electromagnets 13 and 14 not only can change the direction of the magnetic field in a plane perpendicular to the living body axis, but also can tilt the direction in which the magnetic field is formed from the direction perpendicular to the living body axis. A support frame for the electromagnets 13 and 14 is configured. FIG. 6 shows an example in which a soft string-shaped cannula 1 inserted into a blood vessel 19 is bent into a branch 20 at an acute angle. Insertion of a cannula into such a sharp branch has not been possible with conventional manual operations. According to the present invention, assuming that the direction of the magnetic field of the electromagnets 13 and 14 is in the horizontal direction of the drawing, the tip of the cannula can be bent in a direction perpendicular to the main blood vessel 19 by energizing the energizing coil 8. Furthermore, the tip of the cannula can be bent in the direction of the branch 20 by inclining the support frame so that the direction of the magnetic field of the electromagnets 13 and 14 is in the direction of the branch 20. Thus, it is possible to insert the cannula into the lumen in the direction opposite to the initial traveling direction.

FIG. 7 is a perspective view showing another embodiment of the cannula of the present invention used for automatic cannulation.
Unlike the cannula of FIG. 3, the magnetic field responsive energizing part of the cannula tip 7 divides the tip outer peripheral surface into four sections by 90 degrees,
A vertical parallel circuit 21 is attached to each area. Each of the vertical parallel circuits 21 extends in the circumferential direction connecting two ends thereof, each of which is composed of several (five in the figure) wires 22 having very low electric resistance and extending in parallel to the axial direction of the cannula. Connection 2
3 and 23 ', and the connection 23 has an input lead 2
4. The output side lead wire 24 'is connected to the connection 23'. The input lead 24 extends along the surface of the cannula 1 to the rear end, and the output lead 24 'extends through the inside of the tube wall of the cannula 1 to the rear end, and each is connected to a power source via a controller described later. In the figure, reference numeral 25 denotes a cooling water passage which penetrates through the inside of the tube wall of the cannula in the axial direction, and absorbs Joule heat generated during the operation of the magnetic field responsive current applying section.

Further, the cannula is provided with two drive energizing sections 2 at a slight distance in the axial direction behind a magnetic field responsive energizing section composed of four longitudinal parallel circuits 21 attached to the tip.
6 and 26 are provided. Usually, it is sufficient to provide two drive energizing sections, but if necessary, three or more drive energizing sections may be provided. Each drive energizing section 26 is constituted by a circumferential parallel circuit 27 in which the outer peripheral surface of the cannula is provided in each of four sections divided by 90 degrees so as to match the four vertical parallel circuits of the magnetic field responsive energizing section. Is done. Each circumferential parallel circuit 27 includes an input lead 28 and an output lead 29 which extend in the axial direction along both edges of each section, and lead wires 28 arranged at both ends in parallel along the surface of each section. , 2
9 (six in the figure) and an arc-shaped conducting wire 30 made of a wire having extremely low electric resistance.

FIG. 8 shows the operation of the cannulation device according to the invention using the cannula shown in FIG. The cannulation device of FIG. 8 is similar to the case of FIG.
2 ', a pair of positive and negative strong electromagnets 13 and 14 are opposed to each other to be supported rotatably about a living body axis,
And a controller 15 provided with a television monitor 16. Although not shown, another pair of strong positive and negative electromagnets may be provided behind the electromagnets 13 and 14 in the bioaxial direction with a vertical interval between the patients on the bed 11.

The cannulation device shown in FIG. 4 is for manually inserting the cannula. The cannulation device shown in FIG.
The operation of inserting the cannula can be performed by the external drive device 33 operated in step 5. FIG. 9 is a sectional view showing the internal structure of the external drive device 33. A pair of pulley-shaped drive rollers 35, 35 for sandwiching the cannula 1 from above and below are provided in a housing 34 through which the cannula passes through the center. The drive roller 35 is driven by a motor 36. A pair of drive rollers 3
Numerals 5 and 35 hold and rotate a portion of the cannula that has come out of the body from a cannula insertion port (for example, a femoral aorta) to move the cannula tip forward or backward with respect to the target site.

The cannula 1 of FIG. 7 inserted into the lumen can be advanced by an external drive 33 or by energizing the drive energizing section 26. When the current supply section 26 is energized, currents in the same direction flow through the conductors 30 of all the circumferential parallel circuits 27, and these currents interact with the magnetic field created by a pair of external strong electromagnets to cause the left hand of framing. According to the law, a force is generated in a direction for moving the cannula 1 forward. When a current in the opposite direction is applied to all the conductors 30, a force is generated in a direction to retract the cannula. Thus, the forward / backward insertion operation of the cannula 1 can be performed by the energization control by the controller 15. In addition, even if the conducting direction of the conducting wire 30 is fixed, the driving direction of the cannula can be reversed by reversing the direction of the magnetic field of the strong electromagnet. FIG. 10 is a cross-sectional view of the drive energizing unit 26, and shows a contrast agent 3 that blocks a magnetic field such as heavy metal through the cannula 1.
7 is filled and flows, the magnetic field is cut off by the contrast agent 37 even when the upper and lower circuits A and C among the four circumferential parallel circuits A, B, C and D are energized, and the framing is performed. Since the forward or backward driving force based on the left hand rule does not work effectively, only the circuits B and D on both sides are energized.

FIG. 11 uses the cannula of FIG.
3 shows a pattern in which the distal end portion 7 is inserted into a branch pipe 20 having a sharp bend as shown in FIG. The cannula must be carefully inserted because the base of the branch tube 20 that branches to the main lumen 19 at an acute angle is easily damaged. First, while observing on the television monitor 16, manual operation, the external driving device 32,
Alternatively, the cannula 1 is moved into the
When it is confirmed that the tip 7 has reached the inlet of the branch pipe 20, the conductors 22 of the four longitudinal parallel circuits 21 of the magnetic field responsive current supply unit are energized in one direction at a time. FIG.
2 is a cross-sectional view of the cannula tip 7, and all the conductors 22 are directed in the direction indicated by F in the figure according to the framing left-hand rule when current flows in the same direction at right angles to the magnetic field generated by the pair of strong electromagnets 13 and 14. Receive strength. Thus, the cannula tip 7 is inclined toward the inlet of the branch pipe 20. The direction of this inclination can be changed by rotating the pair of strong electromagnets 13 and 14 to change the direction with respect to the cannula. When the direction of the current flowing in the opposing circuits 21A, 21C among the four circuits 21A, 21B, 21C, 21D is reversed, a force in the opposite direction acts on these circuits, and the cannula tip 7 is moved clockwise or counterclockwise. Can be rotated in any direction. By controlling the energizing directions of the four circuits 21 of the magnetic field responsive energizing section while controlling the directions of the magnetic fields generated by the strong electromagnets 13 and 14 by the controller 15, the tip of the cannula as shown in FIG. The part 7 can be smoothly guided to the branch pipe 20.

Next, when it is confirmed that the distal end portion 7 of the cannula has been completely inserted into the branch pipe 20, as shown in FIG. 11B, the energization to all the circuits 21 of the magnetic field responsive energizing section is stopped. When the branch tube 20 is narrow, it is often difficult to apply an external force to the rear portion of the cannula to feed the cannula tip 7 deep into the branch tube. , D to give forward driving force. In particular, when the branch pipe 20 is narrow and the cannula has to move forward by pushing the contact resistance of the branch pipe 20, the number of the drive energizing sections 26 is increased, for example, three as shown in the figure, and all the drive energizing sections 26 are energized. And FIG.
As shown in FIG. 1 (c), the cannula is separated from the branch tube 20 by a strong forward driving force acting on the drive energizing portion 26, rather than a pushing force due to an external force acting on the rear portion of the cannula.
Drag inside. It will be readily understood that the drive energizing section can be attached to the cannula shown in FIG. 3 so as to electrically apply the forward and backward driving force.

In the present invention, the cannula can be inserted into the target site using an endoscope. FIG. 13 shows an example thereof, in which the cannula 1 of FIG. 3 is inserted into a forceps passage of a fiberscope (endoscope) 37 and inserted into the duodenum 39 from the stomach 38 together with the fiberscope 37. In this case, a cannulation device having a pair of electromagnets 13 and 14 interacting with the energizing coil 8 as shown in FIG. 4 is used. Television monitor 16 may or may not be present. When the forceps port 40 on the side of the head of the fiberscope 37 reaches the bile duct entrance 41, the cannula tip 7 protrudes from the forceps port 40 and is inserted into the bile duct entrance 41, and then at the bifurcation of the common bile duct 42 and the main pancreatic duct 43. The interaction between the energizing coil 8 of the cannula tip 7 and the electromagnets 13 and 14 causes the cannula tip 7 to be bent toward the common bile duct 42 and inserted into the common bile duct 42.

FIG. 14 shows that the cannula of the present invention is advanced while observing and diagnosing relatively thick blood vessels and relatively thick lumens such as the common bile duct and the main pancreatic duct, and at the same time, the cells lost from the lesion are collected and Suction biops
This is an improvement so that y (aspiration biopsy) can be performed. In FIG. 14, the energizing coil 8 and the cooling water pipe 9 at the distal end 7 are arranged in exactly the same manner as the cannula of FIGS. 3 and 7, but a fiber scope 44 is further attached to the inner wall of the cannula 1, and Attach the observation fiberscope lens 45 to the tip. More cannula 1
A lens cleaner water supply pipe 47 is attached along the fiber scope 44, and a lens cleaner injection port 47 opening toward the fiber scope lens 45 is provided at the end of the water supply pipe 47. The cannula 1 configured as described above is inserted into the lumen as shown in FIG. 15, and is closely approached to a lesion (for example, cancer cell) 48 while observing the inside of the lumen with the fiberscope lens 45 at the distal end, and is slightly moved away. The suction bin (not shown) sucks the air in the collection bin 49 into which the rear end of the cannula 1 is inserted in the direction indicated by the arrow A, and the collection bin 4
In 9, it is possible to collect fluid near the lesion and to collect shed cells. In addition, as shown in FIG. 16, the cannula 1 is guided into the branch tube by the above-described method, and a tissue piece is collected in the collection bin 49 by applying a strong negative pressure to the collection bin 49 while being brought into close contact with the lesion 48 to thereby remove the cell tissue. The condition can be checked.

[0024]

According to the present invention, since the distal end of the cannula can be bent by electromagnetic action, the branch portion of the lumen having a sharp bend, which has conventionally required a high degree of skill and made it difficult to insert the cannula. The insertion operation can be easily performed, and there is an effect that the level of diagnosis and treatment using the cannula can be improved.

[Brief description of the drawings]

FIG. 1 is an external view of a heart showing a pattern in which diagnosis and treatment of myocardial infarction are performed by a cannula.

FIG. 2 is a schematic diagram showing a state in which a cannula according to the present invention is inserted into a heart from a thigh.

3A is a perspective view showing an embodiment of a cannula used in the present invention, and FIG. 3B is a cross-sectional view taken along a line BB.

FIG. 4 is a perspective view showing a pattern of performing cannulation using one embodiment of the cannulation device of the present invention.

5 is a schematic diagram showing a pattern in which a cannula is inserted into one branch at a blood vessel bifurcation using the cannula of FIG. 3;

FIG. 6 is a schematic view showing a state where the cannula is inserted into a blood vessel branch having a sharp bend using the cannula of FIG. 3;

FIG. 7 is a perspective view showing another embodiment of a cannula used in the present invention.

FIG. 8 is a perspective view showing a pattern of performing cannulation using another embodiment of the cannulation device of the present invention.

FIG. 9 is a cross-sectional view of the external cannula driving device shown in FIG. 8;

FIG. 10 is a cross-sectional view of a drive energizing section of the cannula shown in FIG. 7;

11A and 11B are schematic views showing a pattern in which the cannula shown in FIG. 7 is inserted into a branch pipe, wherein FIG. 11A shows a state where the tip of the cannula has begun to be inserted into the branch pipe, and FIG. (C) shows a state in which the drive energizing section is inserted, and (c) shows a state in which the drive energizing section is completely inserted into the narrow branch pipe and the entire cannula is drawn into the branch pipe.

FIG. 12 is a cross-sectional view of the distal end of the cannula shown in FIG.

FIG. 13 is a schematic diagram showing a pattern of performing cannulation using the cannula of FIG. 3 together with an endoscope.

FIG. 14 is a perspective view showing a distal end portion of an embodiment in which a fiberscope for intraluminal observation is mounted in a cannula.

FIG. 15 is a schematic diagram showing a state in which the tip of a cannula is brought close to a lesion, and liquid sampling near the lesion and collection of shed cells are performed.

FIG. 16 is a schematic view showing a state in which a tip of a cannula is brought into close contact with a lesion and a lesion cell tissue piece is collected.

[Description of Signs] 1 cannula 7 cannula tip 8 energizing coil 9 cooling water pipe 13 strong magnet 14 strong magnet 15 controller 16 TV monitor 21 vertical parallel circuit 26 drive energizing section 27 circumferential parallel circuit 32 strong magnet support frame 33 external drive unit for cannula 35 drive roller 45 fiberscope 48 lesion 49 collection bin

Claims (10)

[Claims] 1. A pair of strong magnets opposed to each other with a human body therebetween, means for supporting the pair of strong magnets so as to be relatively rotatable about a biological axis of the human body, and A controller for controlling the generation and strength of the magnetic field,
A magnetically responsive current-carrying part attached to the outer periphery of the distal end of the cannula inserted into the lumen of the human body, wherein the interaction between the strong magnet and the magnetically responsive current-carrying part causes the distal end of the cannula to bend in a desired direction. A magnetic field induction cannulation device characterized in that: 2. The magnetically responsive current-carrying portion includes a plurality of conducting wires extending in the axial direction of the cannula at the outer periphery of the distal end portion of the cannula and arranged in parallel at intervals over the entire circumference. The cannulation device according to claim 1, comprising a circuit. 3. The method according to claim 1, wherein the plurality of electric wires are divided into four groups at 90 degrees to form four vertical parallel circuits, and each of the vertical parallel circuits is separately energized and controlled through the controller. The cannulation device according to claim 2, characterized in that: 4. The cannulation device according to claim 1, wherein the magnetically responsive energizing section comprises an energizing coil wound in a coil shape around the tip of the cannula. 5. The cannulation device according to claim 1, wherein the means for rotatably supporting the pair of strong magnets is configured to change an angle of a rotation surface with respect to a living body axis. 6. A driving energizing part attached to the outer periphery of the cannula over a predetermined axial length behind the magnetically responsive energizing part at the tip of the cannula, wherein the driving energizing part is provided with the pair of strong magnets. The cannulation device according to claim 1, wherein the cannula is moved forward and backward by interaction with a magnetic field generated by the cannula. 7. A second drive energizing section attached to the outer periphery of the cannula over a predetermined axial length behind the drive energizing section and for moving the cannula forward and backward by interaction with a magnetic field generated by the pair of strong magnets. 7. The cannulation device according to claim 6, further comprising: 8. The drive energizing section includes an input side lead wire and an output side lead wire extending along the cannula and opposed in the axial direction, and an upper half portion and a lower portion thereof spaced apart in the axial direction on the outer peripheral surface of the cannula. 8. The semiconductor device according to claim 6, comprising a plurality of semicircular conductors having both ends extending along a half portion connected in parallel to the input-side lead wire and the output-side lead wire, respectively. Cannulation device. 9. Each of the drive energizing sections comprises a circuit formed by dividing a cannula into four sections each of which is divided at 90 degrees in a circumferential direction, and each of the circuits extends in an axial direction along an edge of each section. Extended input and output leads, and a plurality of arcs extending at intervals in the axial direction along the outer periphery of each area and having both ends connected in parallel to the input and output leads, respectively. The cannulation device according to claim 6, wherein the cannulation device is constituted by a shaped conductor. 10. The cannulation device according to claim 1, wherein a fiberscope having an observation lens attached to a tip thereof is disposed in the cannulation.