KR102569595B1 - Endoscopic catheter - Google Patents

Abstract

The present invention is a guide catheter having a wire insertion portion provided on the outer surface, and a first guide wire channel is provided on the inside from the wire insertion portion to the proximal portion; and a cannula inserted into the proximal portion of the guide catheter and having a second guide wire channel communicating with the first guide wire channel therein.

Description

Endoscopic catheter {Endoscopic catheter}

The present invention relates to an endoscopic catheter applicable to ERCP.

In general, endoscopic surgery is performed as a relatively less invasive surgical method. In particular, endoscopic retrograde cholangio-pancreatography (hereinafter referred to as 'ERCP') can be performed to treat bile duct or pancreatic duct-related lesions, such as removing gallstones formed in the patient's bile duct. .

ERCP is, for example, for observing and operating the duodenum, the papillae (ampulla of Vater), the bile duct, the gallbladder (gallbladder), and the pancreas. During the examination, like a general endoscope, after inserting the endoscope into the duodenum, a cannula is inserted into the endoscope channel After insertion, the cannula is forcibly inserted up to the opening of the nipple where bile or pancreatic juice is discharged into the duodenum, and then endoscopic sphincterectomy (EST) incises the nipple sphincterectomy with the sphincterotome provided on the cannula. ) is implemented.

An endoscopic catheter applicable to such ERCP has a long guide wire method in which a guide wire passes through a cannula.

In the long guide wire method, when the operator inserts the cannula into the endoscope channel, the guide wire is also inserted and the assistant discharges the guide wire. A cooperative operation of inserting the guide wire is required.

Therefore, the long guide wire method requires breathing and skill of the operator and assistant, and there is a problem in that it is difficult for the operator to operate the cannula and the guide wire alone.

In addition, the long guide wire method has a problem in that the radiation exposure time increases as the treatment time increases.

Korean Registered Patent Publication No. 10-1396017 (2014.05.09)

The present invention has been made to solve the above-described problems, and an object of the present invention is to provide an endoscopic catheter for which an instrument can be easily replaced.

In addition, another object of the present invention is to provide an endoscopic catheter capable of preventing separation of a guide wire when an instrument is replaced.

In addition, another object of the present invention is to provide an endoscopic catheter capable of reducing medical personnel since the operator can operate the cannula and the guide wire alone during ERCP surgery.

In addition, another object of the present invention is to provide an endoscopic catheter capable of improving the success rate of cannulation in which an operator alone inserts a cannula into a target point inside a living body.

The problems to be solved by the present invention are not limited to the problems mentioned above, and other problems not mentioned will be clearly understood by those skilled in the art from the description below.

An endoscopic catheter according to an embodiment of the present invention includes a guide catheter having a wire insertion portion provided on an outer surface and a first guide wire channel provided therein from the wire insertion portion to a proximal portion; and a cannula connected to a proximal portion of the guide catheter and having a second guide wire channel therein communicating with the first guide wire channel.

In addition, guide wires sequentially inserted into the wire insertion unit, the first guide wire channel, and the second guide wire channel may be further included.

In addition, the wire insertion portion may be formed closer to the proximal portion of the guide catheter than the distal portion of the guide catheter.

In addition, the wire insertion part may be formed to be inclined with respect to the first guide wire channel.

In addition, when the guide wire is inserted into the wire insertion unit, it may further include a guide for guiding the guide wire to the first guide wire channel.

The guide part may include an inclined part provided on an inclined surface of the wire insertion part and guiding the guide wire into the first guide wire channel.

In addition, the guide portion may include a sealing portion connected to the inclined portion and sealing the inclined surface of the wire insertion portion.

In addition, the diameter of the first section from the proximal portion of the guide catheter to the wire insertion portion may be greater than the diameter of the second section from the distal portion of the guide catheter to the wire insertion portion.

In addition, a diameter from a proximal portion of the first guide wire channel to the wire insertion portion may be greater than a diameter from a distal portion of the first guide wire channel to the wire insertion portion.

In addition, a cutting wire passing through the guide catheter and the cannula may be further included.

In addition, the incision wire may incise the nipple sphincter adjacent to the opening of the nipple through which bile or pancreatic juice of the human body is discharged into the duodenum.

In addition, the cutting wire may include a Nitinol material.

In addition, the guide catheter and the cannula may include a flexible material.

In addition, the guide wire may include a rubber, silicone or urethane material.

Other specific details of the invention are included in the detailed description and drawings.

In the endoscopic catheter according to an embodiment of the present invention, it is possible to easily replace the instrument.

In addition, the endoscopic catheter according to an embodiment of the present invention can prevent the guide wire from being separated when the instrument is replaced.

In addition, since the endoscopic catheter according to an embodiment of the present invention allows the operator to operate the cannula and the guide wire alone during ERCP, it is possible to reduce the number of medical personnel.

In addition, the endoscopic catheter according to an embodiment of the present invention can improve the success rate of cannulation in which the operator alone inserts the cannula into a target point inside the living body.

Through this, the endoscopic catheter according to an embodiment of the present invention can shorten the ERCP procedure time and the operator's radiation exposure time.

The effects of the present invention are not limited to the effects mentioned above, and other effects not mentioned will be clearly understood by those skilled in the art from the description below.

1 is a perspective view showing an endoscopic catheter according to an embodiment of the present invention.
2 is an enlarged view showing a wire insertion portion of an endoscopic catheter according to an embodiment of the present invention.
3 is a cross-sectional view showing an endoscopic catheter according to an embodiment of the present invention.
4 to 8 are schematic views showing an operation example of an incision wire of an endoscopic catheter according to an embodiment of the present invention.

Advantages and features of the present invention, and methods of achieving them, will become clear with reference to the detailed description of the following embodiments taken in conjunction with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below, but may be implemented in various different forms, only these embodiments are intended to complete the disclosure of the present invention, and are common in the art to which the present invention belongs. It is provided to fully inform the person skilled in the art of the scope of the invention, and the invention is only defined by the scope of the claims.

Terminology used herein is for describing the embodiments and is not intended to limit the present invention. In this specification, singular forms also include plural forms unless specifically stated otherwise in a phrase. As used herein, "comprises" and/or "comprising" does not exclude the presence or addition of one or more other elements other than the recited elements. Like reference numerals throughout the specification refer to like elements, and “and/or” includes each and every combination of one or more of the recited elements. Although "first", "second", etc. are used to describe various components, these components are not limited by these terms, of course. These terms are only used to distinguish one component from another. Accordingly, it goes without saying that the first element mentioned below may also be the second element within the technical spirit of the present invention.

Unless otherwise defined, all terms (including technical and scientific terms) used in this specification may be used with meanings commonly understood by those skilled in the art to which the present invention belongs. In addition, terms defined in commonly used dictionaries are not interpreted ideally or excessively unless explicitly specifically defined.

The endoscopic catheter according to an embodiment of the present invention may be applied to endoscopic retrograde cholangio pancreatography (ERCP). For reference, the endoscopic catheter according to an embodiment of the present invention can be applied to other procedure methods in addition to the ERCP procedure method mentioned below, and the present invention is not particularly limited thereto.

Endoscopy and radiation are used to observe the patient's lesion using ERCP. In other words, after inserting the endoscope up to the duodenum, inserting a thin tube into the small hole (nipple opening (1)) through which bile or pancreatic juice is discharged into the duodenum, inserting medicine that can be X-rayed, and taking a picture do.

Endoscopy and a sphincterotome are used to operate a patient's lesion using ERCP. That is, after inserting the cannula into the endoscope channel, forcibly inserting the cannula to the opening of the nipple through which bile or pancreatic juice is discharged into the duodenum, endoscopic sphincterectomy (EST) incising the incision site of the nipple sphincter with the sphincter dissection provided on the cannula. Papillary sphincterotomy) was performed. Here, the sphincter insulator may be an incision wire to be described later.

There is a risk of inflammation and secondary complications in the incised papillae. To prevent secondary complications, plastic stent insertion (ERBD: Endoscopic retrograde Biliary drain) is performed.

There are various types of plastic stents, such as a form in which both ends are rolled in the same direction or in opposite directions, a form in which barbs are formed at both ends, etc., depending on the purpose or place of operation, and may be formed in a cylindrical shape as a whole.

Such a plastic stent may be inserted into an endoscope channel inserted into a living body in a state where the plastic stent is inserted into a guide catheter or cannula, and may be operated at a desired location.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.

1 is a perspective view showing an endoscopic catheter according to an embodiment of the present invention, FIG. 2 is an enlarged view showing a wire insertion portion of the endoscopic catheter according to an embodiment of the present invention, and FIG. This is a cross-sectional view showing the endoscopic catheter.

As shown in FIGS. 1 to 3 , an endoscopic catheter according to an embodiment of the present invention includes a guide catheter 10 , a cannula 20 and a guide wire 30 . Prior to the description of the present invention, one end of the guide catheter 10, the cannula 20, and the guide wire 30 inserted into the living body is defined as a proximal end, and the guide catheter 10, the cannula 20, and the guide wire ( 30) is defined as the distal part.

Overall, the guide catheter 10 is provided with a wire insertion portion 12 on the outer surface, and a first guide wire channel 11 is provided inside from the wire insertion portion 12 to the proximal portion. The cannula 20 is inserted into the proximal portion of the guide catheter 10, and a second guide wire channel 21 communicating with the first guide wire channel 11 is provided therein. The guide wire 30 is sequentially inserted into the wire insertion unit 12 , the first guide wire channel 11 and the second guide wire channel 21 .

Here, the guide wire 30 is pre-inserted into the endoscope channel 61, and the guide catheter 10 and the cannula 20 are passed through the endoscope channel 61 along the guide wire 30 pre-inserted into the endoscope channel 61. can be inserted. At this time, when the proximal part of the guide wire 30 is inserted into a specific part of the living body, the guide catheter 10 and the cannula 20 inserted along the guide wire 30 pre-injected into the endoscope channel 61 are also inserted into the living body. It can be inserted into a specific site of At this time, the specific part of the living body may be the nipple opening 1 through which bile or pancreatic juice is discharged into the duodenum.

After the cannula 20 is connected to the proximal part of the guide catheter 10, the guide catheter 10 and the cannula 20 follow the guide wire 30 pre-inserted into the endoscope channel 61 via the endoscope channel 61. It can be inserted into a specific site in the living body.

Hereinafter, describing the structure of the guide catheter 10, the wire insertion portion 12 is provided on the outer surface of the guide catheter 10. The guide wire 30 may be inserted into the first guide wire channel 11 through the wire insertion part 12 .

The guide catheter 10 and the cannula 20 may be made of a flexible material. Thus, bending of the guide catheter 10 and the cannula 20 can be facilitated.

Inside the guide catheter 10, first guide wire channels 11 each formed in a hollow are provided. The first guide wire channel 11 may be formed along the length direction of the guide catheter 10 . In addition, a guide wire 30 is inserted into the first guide wire channel 11 .

The wire insertion portion 12 may be formed closer to the proximal portion of the guide catheter 10 than the distal portion of the guide catheter 10 . Since the guide wire 30 is inserted in the guide catheter 10 from the wire insertion portion 12 to the proximal portion of the guide catheter 10, the wire insertion portion 12 is closer to the guide catheter than the distal portion of the guide catheter 10. When formed close to the proximal portion of (10), the length of the guide wire (30) inserted into the guide catheter (10) is shortened. As a result, when the guide catheter 10 moves along the guide wire 30 pre-inserted into the endoscope channel 61, the contact area between the guide catheter 10 and the guide wire 30 becomes small, so the guide catheter 10 ) can be easily inserted along the guide wire 30.

The wire insertion part 12 may have a shape cut obliquely with respect to the first guide wire channel 11 . Therefore, the guide wire 30 can be easily inserted along the inclined surface of the wire insertion part 12 .

The cannula 20 is inserted into the proximal portion of the guide catheter 10, and a hollow second guide wire channel 21 may be formed inside the cannula 20. A guide wire 30 may be inserted into the second guide wire channel 21 .

The cannula 20 may be provided with an incision wire 50 for incision of the papillary sphincter through which bile or pancreatic juice is discharged into the duodenum. This cutting wire 50 will be described later.

Additionally, the cannula 20 may be provided with a plastic stent (not shown) for ERBD.

The guide wire 30 is pre-injected into the endoscope channel 61 to guide the insertion path of the catheter and the cannula 20 . The proximal part of the guide wire 30 can be forcibly inserted into a specific part of the internal organs of the living body, and at this time, the guide catheter 10 and the cannula 20 inserted along the guide wire 30 are guided to the specific part of the internal organs of the living body. It can be. In addition, the guide wire 30 is directional along with the role of support when exchanging instruments necessary for intubation of the bile duct or pancreatic duct, reaching the bile duct in the liver for a specific target, or passing through the stenosis site, and performing targeted diagnostic and treatment procedures thereafter. It can also serve as a suggestion. Here, the instrument may be a plastic stent, a biopsy, a cutter, a protrusion, forceps, and the like. This instrument may be provided proximal to the guide catheter 10 or proximal to the cannula 20 .

The guide wire 30 may be a soft material such as rubber, silicone, or urethane so as not to damage the inner wall of the bile-pancreatic duct, but the present invention is not particularly limited thereto.

The guide wire 30 is sequentially inserted into the wire insertion unit 12 , the first guide wire channel 11 and the second guide wire channel 21 . In other words, the guide wire 30 is inserted into a portion of the guide catheter 10 and penetrated through the cannula 20 . That is, the guide wire 30 is inserted into a part of the guide catheter 10 and the cannula 20 in a very short length.

As the existing guide wire penetrates the entire guide catheter and the entire cannula, when the cannula is inserted into the endoscope channel, the guide wire is inserted along with it, so the assistant discharges the guide wire, or when the operator discharges the cannula from the endoscope channel. As the guide wire was also discharged, it was necessary to cooperate with the assistant to insert the guide wire.

Accordingly, as the guide wire 30 according to an embodiment of the present invention is inserted into a part of the guide catheter 10 and penetrates the entire cannula 20, the guide wire 30 introduced into the endoscope channel 61 When inserting or ejecting the cannula 20 along the way, the guide wire 30 is not inserted or ejected along with it.

That is, as the conventional guide wire 30 passes through the entire guide catheter 10 and the entire cannula 20, when the cannula 20 is inserted into the endoscope channel 61, the guide wire 30 is also inserted along with it. Cooperation in which the assistant inserts the guide wire 30 as the assistant discharges the guide wire 30 or the guide wire 30 is also discharged when the operator discharges the cannula 20 from the endoscope channel 61 Although the operation was necessary, the present invention allows the operator to operate the cannula 20 and the guide catheter 10 alone.

In addition, as the guide wire 30 according to an embodiment of the present invention penetrates the entire cannula 20, when the cannula 20 is inserted into or discharged from the endoscope channel 61, the guide wire in the cannula 20 (30) can be prevented from falling out.

The guide wire 30 according to an embodiment of the present invention is a guide unit for guiding the guide wire 30 to the first guide wire channel 11 when the guide wire 30 is inserted into the wire insertion unit 12. (40) may be further included.

The guide part 40 may include an inclined part 41 and a sealing part 42 .

The inclined portion 41 is provided on the inclined surface of the wire insertion portion 12 and serves to guide the guide wire 30 to the first guide wire channel 11 . Specifically, the inclined part 41 has an inclined surface corresponding to the inclined surface of the wire insertion part 12, and the guide wire 30 is guided to the first guide wire channel 11 along the inclined surface of the inclined part 41. It can be.

The sealing portion 42 is connected to the inclined portion 41 and seals the inclined surface of the wire insertion portion 12 . The sealing part 42 is press-fitted to the inclined surface of the wire insertion part 12, thereby sealing the inclined surface of the wire insertion part 12.

On the other hand, the diameter of the first section 13 from the proximal part of the guide catheter 10 to the wire insertion part 12 is the diameter of the second section 14 from the distal part of the guide catheter 10 to the wire insertion part 12. diameter can be greater than Therefore, the operator can easily insert the guide wire 30 along the first section 13 having a relatively large diameter of the guide catheter 10 . In addition, the diameter of the second section 14 from the distal part of the guide catheter 10 to the wire insertion part 12 is the diameter of the first section 13 from the proximal part of the guide catheter 10 to the wire insertion part 12. Since it is smaller than the diameter, the weight of the guide catheter 10 can be reduced. On the other hand, the diameter of the first section 13 preferably has a diameter corresponding to the diameter of the guide wire 30, but the present invention is not particularly limited. In addition, by forming an incision 10a cut in a region adjacent to the wire insertion portion 12 in the second section 14 from the distal portion of the guide catheter 10 to the wire insertion portion 12, the guide portion 40 may be inserted through the cutout 10a and placed opposite the wire insert 12 .

4 to 8 are schematic views showing an operation example of an incision wire of an endoscopic catheter according to an embodiment of the present invention.

As shown in FIGS. 4 to 8 , the incision wire 50 may pass through the catheter to be drawn in or out along the longitudinal direction of the catheter. The introduction or withdrawal of the incision wire 50 may be performed by an adjusting member (not shown). For example, the adjusting member may be an actuator that draws in or withdraws the distal portion of the incision wire 50 or a control knob that rotates a screw around which the distal portion of the incision wire 50 is wound.

The material of the cutting wire 50 may be nitinol. Nitinol is formed from Nitinol when nickel and titanium combine in the correct ratio. Nitinol is a unique shape memory alloy that has the ability to remember a specified shape after being deformed when exposed to a prespecified temperature and then return to its previous shape.

This control member may be electrically connected to an electric cauterizer (not shown). The electric cauterizer may supply electrical energy to the cutting wire 50 through the adjusting member. At this time, the incision wire 50 may incise the incision site of the living body by using the electrical energy supplied from the electric cauterizer. On the other hand, the electric cautery machine uses the principle of generating short sparks or heat without electric shock or stimulation to muscles when high-frequency current passes through the human body, and the waveform of 300kHz to 3MHz, 1 to 10kV is cut into the cutting wire 50. It may be a medical device used to incise a part of human tissue during a surgical operation and to prevent or reduce bleeding occurring during a surgical operation.

The proximal portion of the cutting wire 50 passes through the inner surface of the cannula 20 and is coupled to the outer surface of the cannula 20 while being exposed to the outside of the cannula 20 .

Therefore, when the adjusting member pulls the distal portion of the cutting wire 50, as a tensile force is applied to the proximal portion of the cutting wire 50, the proximal portion of the cutting wire 50 tensions and bends the cannula 20. As the proximal portion of the cutting wire 50 moves in a direction away from the outer circumferential surface of the cannula 20 and maintains tension, it is possible to cut a wide area through the proximal portion of the cutting wire 50.

Hereinafter, an operation example of the incision wire 50 of the endoscopic catheter according to an embodiment of the present invention will be described.

First, as shown in FIG. 4 , the endoscope 60 is inserted to a position close to a specific part of the internal organs of the living body. At this time, the specific part of the living body may be the nipple opening 1 through which bile or pancreatic juice is discharged into the duodenum.

Next, before inserting the guide catheter 10 and the cannula 20 into the endoscope channel 61, the guide wire 30 is inserted into the wire insertion portion 12 of the guide catheter 10 and the first guide wire channel 11 ) And sequentially inserted into the second guide wire channel 21 of the cannula 20.

Next, while the guide catheter 10 and the cannula 20 are connected, the guide wire 30 is passed through the guide catheter 10 and the cannula 20 and inserted along the endoscope channel 61 .

Subsequently, the guide catheter 10 and the cannula 20 are inserted along the guide wire 30 inserted into the endoscope channel 61 . At this time, the guide wire 30 is inserted into a part of the guide catheter 10 (the wire insertion part 12 and the first guide wire channel 11) and the cannula 20 (the second guide wire channel 21) As it penetrates, when the cannula 20 is inserted or discharged along the guide wire 30 inserted into the endoscope channel 61, the guide wire 30 is not inserted or discharged along with it. Therefore, the operator can operate the cannula 20 and the guide catheter 10 alone.

And, as shown in Figure 5, the adjusting member pulls the distal part of the cutting wire 50, through which the proximal part of the cutting wire 50 tensions the cannula 20 and bends the cannula 20, thereby reducing the cannula The proximal portion of (20) is directed to a specific site in the living organism.

Next, in a state where the guide catheter 10 and the cannula 10 are stopped, the guide wire 30 is additionally inserted and the proximal portion of the guide wire 30 is inserted into a specific part of the internal organs of the living body.

And, as shown in FIG. 6, while the guide wire 30 is stopped, the guide catheter 10 and the cannula 20 are additionally inserted along the guide wire 30 introduced into the endoscope channel 61 to , The proximal portion of the cannula 20 is inserted into a specific part of the living body.

Next, as shown in FIG. 7, when the control member additionally pulls the distal portion of the cutting wire 50, the proximal portion of the cutting wire 50 moves in a direction away from the outer circumferential surface of the cannula 20 and is built into the living body. incision in a specific part of

In this case, the incision wire 50 may electrically cut the incision site of the living body by applying the current supplied from the electric cauterizer. In this case, the incision site of the internal organs of the living body may be an incision site of the papillary sphincter muscle through which bile or pancreatic juice is discharged into the duodenum.

Next, as shown in FIG. 8 , while the guide wire 30 is stopped, the guide catheter 10 and the cannula 20 are discharged along the guide wire 30 introduced into the endoscope channel 61 .

In the endoscopic catheter according to an embodiment of the present invention, the guide wire 30 passes through the cannula 20 and is inserted into a portion of the guide catheter 10 . Therefore, since the length of the guide wire 30 inserted into the guide catheter 10 and the cannula 20 is very short, the guide catheter 10 and the cannula 20 can be quickly moved along the guide wire 30. there is. Therefore, when replacing an instrument provided at the proximal part of the guide catheter 10 or the proximal part of the cannula 20 inserted into the living body, the guide catheter 10 and the cannula 20 can be quickly discharged to the outside of the living body.

As a result, the endoscopic catheter according to an embodiment of the present invention can be easily replaced.

In addition, the endoscopic catheter according to an embodiment of the present invention can prevent the guide wire from being separated when the instrument is replaced.

In addition, since the endoscopic catheter according to an embodiment of the present invention allows the operator to operate the cannula and the guide wire alone during ERCP, it is possible to reduce the number of medical personnel.

In addition, the endoscopic catheter according to an embodiment of the present invention can improve the success rate of cannulation in which the operator alone inserts the cannula into a target point inside the living body.

Through this, the endoscopic catheter according to an embodiment of the present invention can shorten the ERCP procedure time and the operator's radiation exposure time.

Although the embodiments of the present invention have been described with reference to the accompanying drawings, those skilled in the art to which the present invention pertains can be implemented in other specific forms without changing the technical spirit or essential features of the present invention. you will be able to understand Therefore, it should be understood that the embodiments described above are illustrative in all respects and not restrictive.

1: Papillary opening through which bile or pancreatic juice drains into the duodenum
10: guide catheter
10a: incision
11: first guide wire channel
12: wire insertion part
13: Section 1
14: 2nd section
20: cannula
21: second guide wire channel
30: guide wire
40: guide
41: slope
42: seal
50: cutting wire
60: Endoscope
61 Endoscopic channel

Claims (14)

A guide catheter having a wire insertion part provided on an outer surface and a first guide wire channel provided therein from the wire insertion part to a proximal portion;
a cannula connected to a proximal portion of the guide catheter and having a second guide wire channel therein communicating with the first guide wire channel; and
When the guide wire is inserted into the wire insertion portion, a guide portion for supporting the guide wire and guiding the guide wire to the first guide wire channel,
An incision is formed in a region adjacent to the wire insertion portion in a second section from the distal portion of the guide catheter to the wire insertion portion,
Endoscopic catheter, characterized in that the guide portion is inserted through the incision and disposed opposite to the wire insertion portion.
According to claim 1,
The endoscopic catheter comprising a guide wire sequentially inserted into the wire insertion unit, the first guide wire channel, and the second guide wire channel.
According to claim 1,
The wire insertion part,
Endoscopic catheter, characterized in that formed closer to the proximal portion of the guide catheter than the distal portion of the guide catheter.
According to claim 1,
The wire insertion part,
Endoscopic catheter, characterized in that formed inclined with respect to the first guide wire channel.
delete According to claim 4,
The guide,
An endoscope catheter comprising an inclined portion provided on an inclined surface of the wire insertion portion and guiding the guide wire into the first guide wire channel.
According to claim 6,
The guide,
Endoscopic catheter comprising a sealing portion connected to the inclined portion and sealing the inclined surface of the wire insertion portion.
According to claim 1,
Endoscopic catheter, characterized in that the diameter of the first section from the proximal portion of the guide catheter to the wire insertion portion is larger than the diameter of the second section from the distal portion of the guide catheter to the wire insertion portion.
According to claim 1,
Endoscopic catheter, characterized in that the diameter from the proximal portion of the first guide wire channel to the wire insertion portion is greater than the diameter from the distal portion of the first guide wire channel to the wire insertion portion.
According to claim 1,
Endoscopic catheter further comprising a cutting wire penetrating the guide catheter and the cannula.
According to claim 10,
The cutting wire is
An endoscopic catheter that incises the nipple sphincter adjacent to the opening of the nipple through which bile or pancreatic juice of the human body is discharged into the duodenum.
According to claim 11,
The cutting wire,
An endoscopic catheter comprising a Nitinol material.
According to claim 2,
The guide catheter and the cannula,
Endoscopic catheter comprising a flexible material.
According to claim 2,
The guide wire,
Endoscopic catheter comprising a rubber, silicone or urethane material.

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