JP2003038497A - Shunt inserting tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make smoothly and surely performable the work of inserting a shunt to a body tubular tissue without directly nipping the shunt with forceps. SOLUTION: Shunt inserting tools A-C are tools for inserting the shunt 1 for ensuring the passing of a liquid (blood) by being inserted to the body tubular tissue (blood vessel) to the blood vessel. Each tool is constituted by having an introduction part 2 to be introduced to the dissected of the blood vessel; a holding part 3 formed continuously to the introduction part 2 to movably hold the shunt in the inner part; and a pushing member 4 for moving the shunt 1 held by the holding part 3 to the introduction part 2 side and pushing it into the blood vessel. The introduction part 2 and the holding part 3 are formed on the tip side of a pipe member 10, and the pipe member 10 is connected to a body 12 through a connecting member 11. An operation member 13 is mounted on the rear end side of the pushing member 4, and when the operation member 13 is pushed, the pushing member 4 moves the shunt 1 to insert it into the blood vessel through the introduction part 2.

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a shunt capable of easily and surely inserting a shunt into a target tubular tissue when performing a surgical operation on a tubular tissue of a living body. It relates to an insertion tool. 2. Description of the Related Art For example, when performing a coronary artery bypass operation, when a site to be anastomosed on a side wall of a coronary artery is incised, blood infiltrates from the incision and obstructs the field of view. A problem arises that the anastomosis operation cannot be performed. The shunt is an instrument for solving such a problem. The shunt is inserted into the incision to secure blood flow in the coronary artery, prevent blood from leaching, and realize a smooth anastomosis. [0003] As described above, the shunt is inserted into a tubular tissue of a living body to perform a surgical operation (typically, an anastomosis operation on a blood vessel) to secure the flow of the bodily fluid and to perform the bodily fluid to the operation site. In order to exhibit this function, a flexible tube is provided, and at both outer end portions of the tube, a closing portion is provided which abuts against the inner wall of the tubular tissue to close the tube. It is configured. The operation of inserting a shunt into an incision in a coronary artery will be described with reference to FIG. First, after incising a required portion (for example, a site where a thrombus occurs) in the coronary artery, the shunt 51 is sandwiched between tweezers 52 as shown in FIG. Then, as shown in FIG. 3B, the remaining portion that has not yet been inserted is bent into a C-shape, and then inserted upstream in the blood flow direction. In this case, the shunt 51 is made of a soft material equivalent to the blood vessel, has high elasticity, easily returns to the original shape when the holding by the tweezers 52 is loosened, and is very difficult to handle. Insertion work is a great stress. When the shunt 51 is indwelled at the predetermined position, blood does not leak out from the incision due to the closing portion that abuts on the inner wall of the blood vessel, and a smooth anastomosis can be realized. Further, the shunt 51 is pulled out just before the end of the target operation, for example, the anastomosis operation, to be detached from the insertion site, and then the last suture is performed. As described above, the operation of inserting the shunt into the incised coronary artery proceeds with the shunt sandwiched between tweezers. However, the shunt is soft, has high elasticity, and its shape is easy to return to its original shape. Holding with tweezers puts great stress on the surgeon. Furthermore,
Around the incision, there are a hemostatic clip, a device for blowing blood by blowing carbon dioxide gas to secure a visual field, and a stabilizer. This stabilizer is an instrument for keeping only the anastomotic site in a substantially stationary state because the moving coronary artery on the surface of the heart cannot be anastomosed. Due to the presence of these multiple instruments, space is limited and it is difficult to freely move the tweezers. This also causes a great stress on the operator. [0006] In the case of cardiac surgery, it is common to use a heart-lung machine while the heart is stopped.
In this case, instruments and shunts typified by stabilizers were unnecessary. However, with the development of the technique, it becomes possible to perform an operation without placing a burden on the patient and without stopping the heart, and the above-described devices are required. [0007] The technique disclosed in Japanese Patent Application Laid-Open No. 11-335 relates to a blood vessel anastomosis assisting device, in which a flexible rod is inserted into a lumen of a shunt to serve as a guide, and the shunt is inserted into a blood vessel. When doing, first insert the guide,
Thereafter, the shunt is sandwiched between tweezers, inserted by the above-described method, and then moved along the guide so that the shunt can be smoothly inserted. [0008] However, even the above technique is not perfect, and has several problems to be solved. That is, since the rod serving as a guide penetrates the lumen of the shunt, in order to insert the shunt into the blood vessel, it is necessary to move the shunt directly by sandwiching it with tweezers, and Since a plurality of instruments are mixed near the formed incision and the surrounding space is limited, there remains a problem that the tweezers cannot be freely moved by hand. In this operation, since the shunt is soft and the waist is weak, it is not possible to smoothly push the shunt into the blood vessel with tweezers over the entire length, and therefore, the shunt must be bent and inserted in a V shape. In addition, there is a problem that even if the shunt is bent, the shunt easily returns to its original state, and maintaining the bent state gives a great stress to the operator. An object of the present invention is to insert a shunt into a tubular tissue of a living body without directly pinching it with tweezers.
Another object of the present invention is to provide a shunt insert that can be smoothly and reliably operated without bending. [0010] In order to solve the above-mentioned problems, a shunt insertion device according to the present invention inserts a shunt inserted into a tubular tissue of a living body to ensure the flow of bodily fluids into the tubular tissue. A shunt insertion tool for the introduction portion to be introduced into the tubular tissue of a living body, and a holding portion formed continuously with the introduction portion and movably holding the shunt inside,
An extruding member configured to move the shunt held by the holding section toward the introduction section and extrude the shunt into the tubular tissue. [0011] In the shunt insertion device, the shunt is held inside the holding portion, and the introduction portion formed continuously with the holding portion is introduced into the tubular tissue of the living body to operate the pushing member. The shunt can be moved from the retainer to the introducer and extruded into the tubular tissue. Therefore, the shunt held by the holding portion can be inserted into the incision in the tubular tissue without using tweezers and without bending. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a preferred embodiment of a shunt insertion tool according to the present invention will be described with reference to the drawings. FIG. 1 is a cross-sectional view illustrating the configuration of the shunt insert according to the first embodiment. FIG. 2 is a diagram illustrating a configuration of a member including a shunt introduction portion and a holding portion. FIG. 3 is a diagram illustrating the configuration of the pushing member and the main body. FIG. 4 is a diagram illustrating an example of a shunt. FIG. 5 is a diagram illustrating a configuration of a shunt insert according to the second embodiment. FIG. 6 is a diagram illustrating the configuration of a shunt insert according to the third embodiment. FIG. 7 is a diagram illustrating a procedure for inserting a shunt. [0013] The shunt insertion device according to the present invention is a tubular tissue of a living body such as a blood vessel or a lymph vessel (hereinafter simply referred to as "blood vessel").
When performing a bypass operation for incising the side wall of the incision and connecting another blood vessel to the incision, the shunt can be easily and reliably inserted into the incision. Prior to description of the shunt insert according to the present embodiment, an example of a shunt will be described with reference to FIG.
The shunt 1 shown in FIG. 1 is temporarily inserted into an inside of a blood vessel from an incision formed in a side wall of the blood vessel to secure blood flow and prevent blood from leaking from the incision. The shunt 1 has a tube portion 1a which is thinner and more flexible than the inner diameter of the blood vessel to be inserted, and an outer diameter formed on the outer periphery of both ends of the tube portion 1a and substantially equal to the inner diameter of the blood vessel to be inserted. , A take-out thread 1c bound to the tube 1a between the close-up sections 1b, and a handle 1d attached to an end of the take-out thread 1c. In the shunt 1 configured as described above, when inserted into a blood vessel, the closed part 1b comes into contact with the inner wall surface of the blood vessel and closes on both sides of the incision formed in the blood vessel, and the tube part 1a is closed. It is possible to secure blood flow by conducting on both sides of the closing portion 1b. When shunt 1 is inserted into a blood vessel,
The removal thread 1c and the handle 1d are put out of the blood vessel, and the shunt 1 can be pulled out of the blood vessel by the operator grasping and pulling the handle 1d just before the anastomosis is completed. At this time, the tube portion 1a is bent in a “<” shape. Next, the configuration of the shunt insert A according to the first embodiment will be described with reference to FIGS. In the figure, a shunt insert A according to the present invention comprises an introduction part 2 to be introduced into a blood vessel, a holding part 3 formed continuously with the introduction part 2 and holding the shunt 1 movably. And an extruding member 4 for moving the shunt 1 held by the holding section 3 toward the introduction section 2 and pushing the shunt 1 into the blood vessel in accordance with the operation of the operator. The introduction portion 2 and the holding portion 3 are formed in a pipe shape having an inner diameter substantially equal to or slightly larger than the outer diameter of the closing portion 1b of the shunt 1 to accommodate the shunt 1 therein. The pushing member 4 is formed in an elongated rod or wire shape so as to push the shunt 1 held by the holding portion 3 from the insertion portion into the blood vessel. For this reason, the shunt inserter A has a pipe member 10 having an inner diameter substantially equal to or slightly larger than the outer diameter of the shunt, and a distal end portion of the pipe member 10 (the left side in FIG.
(The same applies to the following.), The introduction part 2 is formed, and the holding part 3 is formed continuously to the introduction part 2. Further, the rear end side of the pipe member 10 (the right side in the figure, the same applies hereinafter) is detachably attached to the main body 12 via the connecting member 11, and penetrates through the pipe member 10, the connecting member 11, and the main body 12, and pushes out. 4 are arranged.
Further, an operation member 13 is attached to an end of the pushing member 4. The introduction portion 2 is formed at the distal end of the pipe member 10 and is inserted into the incision of the blood vessel when the shunt is inserted into the incision formed in the side wall of the blood vessel. It has a function of conducting the holding portion and the inside of the blood vessel. The introduction section 2 is inserted into an incision in a blood vessel. For this reason, the leading end of the pipe member 10 and the introduction portion 2
Is formed into a curved surface so as not to form a sharp edge. The holding part 3 is formed continuously with the introduction part 2,
It has a function of holding the shunt 1 inside. For this reason,
The inner diameter of the holding portion 3 is preferably substantially equal to or slightly larger than the outer diameter of the closing portion 1b of the shunt 1. Therefore,
A plurality of types of holding parts 3 are prepared according to the size of the shunt 1 to be used. Although the size of the shunt 1 is not particularly limited, for example, the length is 1.2 mm to 3.0 mm and the outer diameter is 1.
About 25 mm to 4.0 mm is desirable. By forming the holding portion 3 with such an inner diameter, when the shunt 1 is inserted, the shunt 1 can self-hold. While the shunt 1 is being held by the holding section 3,
The take-out thread 1c attached to the shunt 1 is drawn out of the holding unit 3. The form of pulling out the thread 1c from the holding section 3 is not particularly limited. When the shunt 1 is held by the holding section 3, the thread 1c may be pulled out from the introduction section 2. However, in the present embodiment, a groove 10a is formed in the side wall of the pipe member 10 from a tip portion corresponding to the introduction portion 2 to a portion corresponding to the holding portion 3, and the takeout thread 1c is introduced into the groove 10a. ing. It is sufficient that at least one groove 10a is provided in the pipe member 10. The pipe member 10 formed with the introduction part 2 and the holding part 3 has a rear end 10b inserted into a hole 11a formed in the connection member 11 and fixed by means such as bonding or screwing. The length of the pipe member 10 is not particularly limited, and does not adversely affect the incision in the blood vessel where a plurality of instruments intersect with each other. Preferably, the length is such that it can be operated. That is, if the pipe member 10 is too short, the workability may be deteriorated, and if the pipe member 10 is too long, it may be unstable when introduced. The pipe member 10 is made of a material capable of exerting an appropriate strength and having no adverse effect on the living body. Such materials include stainless steel pipes and tetrafluoroethylene resin (PTF).
E) pipes and the like. The connecting member 11 is for connecting the pipe member 10 to the main body 12, and has a hole 10a for fixing the pipe member 10 at one end and a main body at the other end.
A tapered hole 11b is formed to be fitted to and detached from the tapered projection 12a provided on the projection 12, and the pushing member 4 is provided at the center.
Is formed. It is necessary that the connecting member 11 and the main body 12 have a function to be surely integrated with each other and to be easily detachable. For this reason, in the present embodiment, the hole 11b and the projection 12a are formed in a tapered shape and mounted by fitting (press-fitting), and can be detached by pulling out one. In this case, it is preferable that at least one is made of a material that can exhibit appropriate elasticity. For example, by forming the connection member 11 from a synthetic resin and forming the main body 12 from a metal, the hole 11b can be fitted into the projection 12a to achieve a reliable integration. Similar effects can be expected even if both the connection member 11 and the main body 12 are formed of synthetic resin. As described above, the pipe member 10 and the connecting member 11 are integrated members, and are configured to be detachable from the main body 12 through the holes 11b and the projections 12a. As described above, by configuring the pipe member 10 to be detachable from the main body 12, it is possible to select and use an optimum pipe member 10 according to the size of the shunt 1 to be used.
When the pipe member 10 is selectively attached to the main body 12, the connecting member 11 and the main body 12 do not necessarily need to be configured to be detachable, and the pipe member 10 and the connecting member 11 may be configured to be detachable. Further, the connecting member 11 and the main body 12 and the pipe member 10 and the connecting member 11 may be configured to be detachable. However, in the shunt insertion device, the pipe member and the main body do not necessarily need to be separable. Even if both are integrated, the shunt can be held and can be smoothly introduced into a blood vessel. Any function that satisfies the function of moving the held shunt and inserting it into the blood vessel may be used. In this case, when changing the size of the shunt, it is necessary to change the shunt insert.
In other words, the shunt and the shunt insert are used as a pair. That is, the simplest shunt insertion tool has a configuration in which the pushing member 4 is inserted through the pipe member 10 provided with the introduction portion 2 and the holding portion 3. Even a shunt insertion tool having such a shape can be used effectively. The main body 12 is used by an operator to hold the shunt insertion tool A when inserting the shunt 1 into an incision in a blood vessel.
A sliding portion 12b is formed therein for accommodating the operation member 13 so as to be slidable along the axial direction. In particular, the external shape of the main body 12 is set in consideration of the easiness of the operator's holding and / or the operability of the operating member 13, and as shown in each embodiment described later, It is not set uniquely, but some shapes are set. In the present embodiment, a ring member 14 for inserting a finger is provided on the outer peripheral rear end side of the main body 12, and the shunt insertion tool A is securely inserted by the surgeon inserting the finger into the ring member 14. It is configured to be able to be held.
That is, when inserting the shunt 1 into a blood vessel, the surgeon inserts the index finger and the middle finger into the ring member 14 of the main body 12 and hangs the operation unit 13 with the thumb to perform a push operation. The pushing member 4 includes a pipe member 10, a connecting member 11,
The shunt 1, which is slidably housed through the main body 12 and is held by the holding portion 3 in accordance with the pushing operation of the operating portion 13, is moved toward the insertion portion 2, and the blood vessel is moved from the insertion portion 2. It has the function of being inserted into the incision. For this reason, the pushing member 4 is configured by a wire in which a thin wire is twisted. As such a material, there is stainless steel.
-A rod made of Ti alloy is subjected to linear shape memory processing and used in the superelastic range. An abutting member 4a is attached to the end of the pushing member 4 which abuts on the shunt 1 so as to be able to securely contact the end face of the tube portion 1a of the shunt 1, and an operating member 13 is provided on the rear end. Is attached. The contact member 4a is formed in a cup shape having an outer diameter larger than the outer diameter of the intermediate portion 1a of the shunt 1 and smaller than the outer diameter of the closing portion 1b, and having an inner diameter substantially equal to the outer diameter of the pushing member 4. ing. Then, by being fitted to the tip of the pushing member 4, it is possible to come into contact with the end face of the space 1 a between the shunts 1 regardless of the thickness of the pushing member 4. An operating member 13 is attached to the rear end side of the pushing member 4. The method of attaching the operating member 13 to the pushing member 4 is not particularly limited, and the operating member 13 can be attached by inserting the rear end of the pushing member 4 into a hole 13a formed in the operating member 13 and screwing or bonding. It is. That is, the pushing member 4 is inserted from the front end side of the main body 12,
When the end is exposed to the rear end of the main body 12, the end is fitted into the hole 13a of the operation member 13 and fixed, so that the pushing member 4
And the operating member 13 are integrated. The operating member 13 is used to push the shunt 1 held by the holder 3 when inserting the shunt 1 into a blood vessel. For this reason, the operating member 13 is formed assuming a shape that is most easily operated by an operator. In this embodiment, the operating member 13 has a flange-shaped operating portion 13b at the rear end so that the operator can easily operate the operating member.
It is formed in the shape of a piston provided with. Next, the procedure for inserting the shunt 1 into the incision using the shunt insert A configured as described above will be described with reference to FIG. Prior to anastomosis of a blood vessel, an optimal shunt 1 and a pipe member 10 corresponding to the shunt 1
Is selected, the shunt 1 is held in the holding portion 3 of the selected pipe member 10, and the take-out thread 1c is pulled out from the groove 10a. The operator operates with the finger inserted into the ring member 14 of the main body 12, and as shown in FIG.
Is introduced into the blood vessel through an incision in the blood vessel. When the operating portion 13b of the operating member 13 is pushed in this state, the pushing member 4 moves with this operation, and the shunt 1 held by the holding portion 3 is inserted from the introduction portion 2 into the blood vessel. At this time, the shunt 1 is inserted into the peripheral side of the blood vessel over substantially the entire length, and in this state, the function of closing the incision is not exhibited. After inserting the shunt 1 on the distal side of the blood vessel,
Pull out the shunt insert A, and as shown in FIG.
The shunt 1 is left inside the blood vessel. Then, handle 1d
Is gripped and pulled to the center side, and as a result, FIG.
As shown in (1), the shunt 1 is moved to the central side, and a pair of closing portions 1b are arranged on both sides of the incision. As a result, it is possible to secure the blood flow at the incision, and the central and peripheral sides of the incision are closed by the closing portion 1b of the shunt 1, so that blood seeps from the incision. Can be prevented. Immediately before the desired anastomosis is completed, the shunt 1 inserted into the blood vessel is taken out by pulling the take-out thread 1c. As described above, when the shunt 1 is inserted into a blood vessel, the shunt 1 is not directly sandwiched between tweezers and operated, and instruments are not mixed around the incision in the blood vessel. In addition, it becomes possible to introduce the introduction portion 2 into the incision portion and use it as a guide, and it is possible to insert the shunt reliably with a simple operation. Next, the configuration of the shunt insert B according to the second embodiment will be described with reference to FIG. In the drawing, the same portions and portions having the same functions as those in the above-described first embodiment are denoted by the same reference numerals, and description thereof is omitted. The basic configuration of the shunt insert B according to the present embodiment is the same as that of the shunt insert A described above. As shown in the figure, a spring 15 is inserted into the sliding portion 12b of the main body 12 constituting the shunt insertion tool B. The spring 15 has a function of urging the pushing member 4 toward the rear end.
When the operator pushes the operation member 13 when inserting the shunt 1 into a blood vessel, the operator comes into contact with the distal end surface of the operation member 13 to apply a reaction force in the operation direction. Therefore, when the shunt 1 is inserted into a blood vessel, a delicate reaction force can be applied to the surgeon along with the movement of the pushing member 4, and the movement amount of the shunt 1 can be delicately adjusted. It can be adjusted to achieve smooth and secure insertion. Next, the configuration of the shunt insert C according to the third embodiment will be described with reference to FIG. In the drawings, the same portions and portions having the same functions as those in the above-described embodiments are denoted by the same reference numerals, and description thereof will be omitted. In the figure, a bending portion bent at a predetermined angle is provided at the tip end of a pipe member 10 constituting a shunt insertion tool C.
10c is formed. The bending portion 10c is formed on the rear end side of the introduction portion 2 and the holding portion 3, and is configured to be able to hold the shunt 1 in a straight state without being bent. The bending section 10c is intended to make the introduction section 2 and the holding section 3 easily visible to an operator by bending the pipe member 10, and the bending section 10c is configured to bend the pipe member 10. The angle may be any angle that can achieve the above object,
There is no particular limitation. For this reason, in this embodiment, the refraction angle of the refraction portion 10c is set to about 45 degrees. The pipe member 10 forming the bending portion 10c is made of a relatively rigid material such as a stainless steel pipe. The pipe member 10 is formed by using a flexible synthetic resin pipe. When configured, it may be linear. The bending portion 10c formed on the pipe member 10 is 1
It is not limited to a single location, and may be formed at multiple locations in order to achieve the purpose of improving the visibility of the operator. The connecting member 11 and the main body 12 are screwed together. That is, a female screw portion 11d is formed on the rear end side of the connection member 11, and a male screw portion 12c is formed on the front end side of the main body 12, and the two are screwed together to be integrated, and the screwed state is established. It is configured so that it can be separated by releasing. On the rear end side of the main body 12, a stopper 12d is formed in place of the ring member, on which the operator's finger is hung. The operator holds the outer periphery of the main body 12 with his / her finger and holds the stopper.
It is configured so that a push operation can be performed by putting a finger on 12d. In the present embodiment, the ring member is removed from the main body 12, a ring member 16 is formed on the rear end side of the operation member 13, and the operator's thumb is put on the ring member 16. In the shunt insert C configured as described above, the surgeon operates the stopper 12d and the ring member 16 with his or her fingers while holding the shunt 1 in the holding section 3 to move the introduction section 2 into the blood vessel. Introduce into the incision. At this time, the pipe member
Since the portion 10 is bent, the introduction portion 2 and the holding portion 3 are easily visually recognized, and the operability when inserting the shunt 1 into a blood vessel is improved. Also, by connecting the connecting member 11 and the main body 12 by screws, the pipe member 10 can be surely integrated with the main body 12 even if the material forming these members is metal or synthetic resin. It is. The shunt inserts A to A configured as described above
In C, when the shunt 1 held by the holding portion 3 is inserted into a blood vessel, the operating member 13 is pushed to operate the pushing member 4.
Is moved to move the shunt 1, the operation itself is simple, and it is possible to easily insert the shunt 1 into the blood vessel without giving the surgeon an uncomfortable feeling. When the shunt 1 is held in the holding portion 3 by forming the groove 10a on the distal end side of the pipe member 10, the take-out thread 1c attached to the shunt 1 is inserted into the groove 10a.
Can be pulled out to the outside along with the shunt 1
Can be easily carried out when inserting from the introduction part 2 into the holding part 3. Further, by forming the pipe member 10 and the main body 12 so as to be detachable via the connecting member 11, the pipe member 10 selected according to the size of the shunt 1 can be connected to the common main body 12.
And the pushing member 4 can be attached to the main body 12.
It is possible to improve the degree of freedom when using. Further, by forming the bending portion 10c on the pipe member 10, it becomes possible to improve the visibility of the introduction portion 2 and the holding portion 3 by the operator, and the operation when inserting the shunt 1 into the blood vessel can be further improved. It can be performed smoothly and reliably. As described in detail above, in the shunt insertion device according to the present invention, the shunt is held in the holding portion continuous with the introduction portion, and the incision portion formed in the side wall of the blood vessel is provided. The shunt held by the holding section can be moved to the introduction section and inserted into the blood vessel by operating the pushing member by introducing the shunt into the blood vessel. At this time, since there is no need to perform an operation of bending the shunt into a shape of a pinched shape with tweezers, even if a plurality of instruments intersect in the incision and the space is limited, the shunt can be inserted smoothly and securely. I can do it. For this reason, stress of the operator can be eliminated,
Fatigue can be reduced.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a sectional view illustrating a configuration of a shunt insert according to a first embodiment. FIG. 2 is a diagram illustrating a configuration of a member including a shunt introduction portion and a holding portion. FIG. 3 is a diagram illustrating a configuration of a pushing member and a main body. FIG. 4 is a diagram illustrating an example of a shunt. FIG. 5 is a diagram illustrating a configuration of a shunt insertion tool according to a second embodiment. FIG. 6 is a diagram illustrating a configuration of a shunt insert according to a third embodiment. FIG. 7 is a diagram illustrating a procedure for inserting a shunt. FIG. 8 is a diagram illustrating a procedure for inserting a conventional shunt. [Description of Signs] A to C Shunt insert 1 Shunt 1a Pipe 1b Closure 1c Take-out thread 1d Handle 2 Introducing section 3 Retaining section 4 Pushing member 10 Pipe member 10a Groove 10b Rear end 10c Refraction section 11 Connecting member 11a to 11c Hole 11d Female screw part 12 Body 12a Projection 12b Sliding part 12c Male screw part 12d Stopper 13 Operating member 13a Hole 13b Operating part 14 Ring member 15 Spring 16 Ring member

Claims (1)

Claims 1. A shunt insertion tool for inserting a shunt inserted in a tubular tissue of a living body to secure the flow of body fluid into the tubular tissue, wherein the shunt is inserted into the tubular tissue of the living body. An introduction part, a holding part formed continuously with the introduction part and holding the shunt movably therein, and an extruding member for moving the shunt held by the holding part toward the introduction part and extruding it into the tubular tissue And a shunt insert.