JP2003514632A - Cleaning of hollow bodies - Google Patents

Abstract

(57) [Summary] The present invention relates to a catheter (1) for washing a hollow organ in a human body with a washing solution, and comprises a lumen (2) for introducing a washing solution, a washing solution and debris (4). A lumen (3) for draining from the organ.

Description

Detailed Description of the Invention

The present invention relates to irrigation of a human body, such as a wound / surgical irrigation or of a hollow organ of the human body, in particular of the bladder of a patient, including catheters, methods and systems for this irrigation,
The term is to be understood as flushing debris from the bladder to be washed.

Bladder irrigation and lavage are often used to remove debris from the bladder to prevent the effects of such debris formation, stone formation and skin formation that result in obstruction.

Catheterization is used in the management of urethral dysfunction in a large number of patients. Approximately 4% of the community nursing practices will be patients undergoing long-term catheterization (LTC), and approximately 10% of hospitalized patients will have urethral catheters inserted. The application of urethral catheterization changes due to the reasons of short-term catheterization (STC) including postoperative urination, monitoring of urination during sudden illness, and reduction of urinary stasis. LT
C is considered for the management of long-term urethral dysfunction, such as refractory urinary incontinence, neuropathy, bladder outlet obstruction.

[0004] Complications associated with LTC are common and include discomfort, infection, urine leakage, trauma, catheter occlusion, crusting, occlusion and calculus formation.

Pubic catheterization has been shown to ameliorate some of the complications associated with urethral catheterization, including infections. However, there remains the problem of debris formation, stone formation and crusting (via the catheter) leading to obstruction. The most common cause of catheter occlusion is the development of scab inside the lumen of the catheter. Crusts and calculi are composed of a range of substances, including fossil fossils, and the most dense main component of calculi is brushite (density 2500 kg / m ³ ).

Bladder irrigation and irrigation is performed especially via a urethral catheter. Bladder irrigation is usually through a catheter, by supplying a given amount of washout solution into the bladder by a bag or syringe connected to the catheter, then drawing this liquid into the bladder and expelling debris into the bag. . Bladder cleansing is performed by simultaneously supplying and draining the bladder. Within these two definitions (wash and wash) there is a wide range of flow rates. Rinsing is currently used, believed to clear blood and light debris from the bladder following surgical treatment.

In the current practice of crusting and occlusion management, diet, fluid uptake, etc. are also important, but to some extent they rely on bladder irrigation or catheter replacement. Despite the use of regular bladder lavage in 40% of patients with LTC, it was found that this lavage did not effectively remove debris from the bladder. High-flow surgical irrigation is also used to remove small stone-containing debris from the bladder, but these stones should grow to a size that requires removal by endoscopic or surgical procedures. There are many. A potential risk associated with performing bladder irrigation is trauma to the bladder mucosa.

Therefore, according to the first aspect of the present invention, in order to perform the cleaning of the hollow organ in the human body with the cleaning solution, the lumen for containing the cleaning solution and the cleaning solution and the debris are discharged from the hollow organ. A catheter having a lumen is provided.

According to the second aspect of the present invention, a catheter is inserted into the hollow organ, the distal end of the catheter is positioned at a desired distance from the inner boundary wall of the hollow organ, and the washing liquid is supplied from the washing liquid source to the catheter. A method of flushing a hollow body organ is provided which flushes along one lumen into a hollow organ and drains flushing liquid and debris from the bladder along the other lumen.

[0010]   The lavage fluid can pass under gravity through the hollow organ.

In another example, the cleaning liquid can be passed through the hollow organ by a suitable device such as a pump.

According to a third aspect of the present invention, there is provided a system for cleaning a hollow organ in a human body, the system including a catheter and a cleaning liquid source.

The lumen has an orifice at the tip of the catheter. This makes it easy to use and efficient.

The orifice consists of an open tip with one lumen at the tip of the catheter. This results in a relatively simple structure.

There is an orifice spaced apart from the tip and entering the other lumen, and the orifices of each lumen are adjacent and adjacent to each other. As a result, the cleaning liquid can be efficiently introduced and discharged.

One of the lumens is configured to introduce the cleaning liquid into the hollow organ or to discharge the cleaning liquid from the hollow organ.

Accordingly, it is possible to provide a relatively simple configuration while having the flexibility of performing desired introduction and discharge.

The other lumen is configured to drain or introduce cleaning fluid from the hollow organ. This also provides flexibility in use.

The two lumens are substantially parallel to each orifice formed in the open tip of the catheter. This is a relatively simple construction, especially if the two lumens are coaxial.

[0020]   The two lumens may be selectively longitudinally offset.

The orifices spaced from the tip include a plurality of orifices spaced in the longitudinal direction of the catheter, the orifices entering one or the other lumen.

[0022]   This provides a relatively unobstructed flow of cleaning fluid.

The orifice is substantially 90 degrees to the length of the catheter, or about 60 degrees to the length of the catheter.

When tilted, the orifice is guided into the catheter at an angle towards the tip of the catheter.

A spacer may be provided which, in use, separates the tip of the catheter from the wall of the hollow organ. This effectively removes the rinse and debris and prevents the mucosa of the bladder from being drawn into the drainage orifice.

The spacer may consist of an extension of the boundary wall of the catheter. As another example, the spacer may include a separate spacer element configured to attach to the tip of a catheter.

[0027]   The catheter may be made in one piece as a single piece.

In this method, the angle of introduction of the washing liquid to the debris in the hollow organ is in the range of 0 to 25 degrees with respect to the vertical axis.

The distance of the orifice of the other lumen is in the range of 0 to 20 mm from the debris. This enables efficient cleaning.

[0030]   The distance is about 8 mm.

The upper limit of the flow rate of the washing liquid introduced is about 650 ml / min, preferably about 150 ml / min. This provides an efficient method.

[0032]   In this system, a source of lavage fluid may be connected to the introduction lumen.

In the following, a catheter, a method and a system for cleaning a hollow body organ of a human body will be described by way of example with reference to the accompanying drawings.

Referring to the drawings, a hollow organ in the human body by the washing liquid, which comprises a lumen 2 for introducing the washing liquid and a lumen 3 for discharging the washing liquid and debris 4 (FIG. 14) from the organ. A catheter 1 for rinsing is shown. This illustrated catheter 1 is a dual type catheter, in other words it has only two lumens, one of which has an orifice 5 at the tip 6 of the catheter which constitutes the open end of one lumen. This is provided at the tip 6 of the catheter. The other lumen 3 has a similar orifice, and the orifices 5, 7 of each lumen 2, 3 are closely adjacent to each other.

In all embodiments, one lumen 2 can be used to introduce a flush into a hollow human organ, which in this embodiment is the bladder, or to drain flush and debris therefrom. Yes, the other lumen 3 can be used for the opposite role depending on the role of the one lumen.

Stated another way, one lumen can be used to introduce a wash solution or drain a wash solution and debris, and the other lumen can drain a wash solution and debris from the bladder or a wash solution. Can be used for introduction and cleaning. In the drawing, each stream is designated by I for inlet and R for drain and wash.

1, FIG. 1A and FIG. 2 are typical examples integrally formed of a polymer material or another suitable material such as stainless steel by a suitable forming process such as molding and / or extrusion. 2 illustrates various embodiments. This catheter 1 is a dual-type catheter having a dual type lumen 3 having a large diameter for discharging the cleaning liquid and debris and a small diameter 2 for introducing the cleaning liquid. The catheter 1 has a handle or finger grip 8 with an inlet port 9 and an outlet port 10 at a location remote from the tip for connection to a bladder management system. The exit from the lumen 2 is an open orifice at the cut or tip, similar to the inlet to the flushing liquid and debris discharge lumen 3, and the provision of a through hole or eyelet 11 facilitates its progress into the lumen. It In a preferred embodiment, the area of the lumen 2 is 2.85 mm ^2, the area of the lumen 3 is 8.05 (38.095) mm ^2.

Figures 3 (a) -6 (b) illustrate any of the dual type lumen catheters used in accordance with the present invention. In Figures 3 (a) and 3 (b), the two lumens 2 and 3 are arranged coaxially and their inlet and outlet are formed by the cut open end of the catheter.

In Figures 4 (a) and 4 (b), the lumen 2 is open at the tip to the bladder and provides an inlet (Figure 4 (a)) or outlet (Figure 4 (b)), On the other hand, introduction or discharge into the lumen is performed via spaced through orifices 41 having an axis substantially perpendicular to the long axis of the catheter.

In FIGS. 5 (a), 5 (b), 6 (a), and 6 (b), the introduction or discharge passage to the lumen 3 has a penetrating that is inclined at a predetermined angle with respect to the major axis of the catheter 50. Orifice 51
, 61. The tilt angle is about 60 degrees with respect to the long axis of the catheter. The distance between the centers of the orifices in FIGS. 4 (a) and 4 (b) is 10 mm. In this embodiment, the length X (FIG. 1) is 130 mm.

Referring to FIGS. 7, 7 (a), 7 (b), these figures show an experimental apparatus 70 that mimics a bladder flushing / washing system embodying the present invention. The spherical transparent flask 71 represents the bladder, and the movement of the fragment 4 shown in FIG. 14 can be seen. Although only one device is shown, two sizes of flask 71 were used in this experiment, one of model A has a diameter of 80 mm (volume of about 270 ml) and model B has
Was a 60 mm diameter flask. Model A (Fig. 7, 7 (a))
And 7 (b)), the flask 71 has one central port 72 and two angled ports 73, 74, which mimics a catheter with two lumens. Yes, one tilt port 74 is closed, Model B
In (not shown) the flask had only one tilted port in addition to the central port.

For both models, a tilted port 73 was used to house a calibrated pressure transducer 76 (gauge from 0 to 0.35 bar) to monitor intravesical pressure during the experiment. Such a schematic structure is shown in FIG. For both flasks 71 tap water was used as the fluid medium or cleaning liquid. Because its density (37
This is because 993 kg / m ^{3 at} ℃ is not significantly different from the density of urine (1016 to 1022 kg / m ³ ). The flow rate introduced into the flask or bladder model 71 through the flush tube 75 was controlled by a pressure head and choke (adjustable throttle) and monitored by a suitable flow meter. A standard cleaning bag was used as the tank for the cleaning liquid. A water column head pressure of about 1.6 m was used to obtain the desired volumetric flow rate, so the change in the pressure head during the test (about 60 mm water column) is small in proportion, which means that for each test Guaranteed that the flow rate remained virtually constant within 3%.

The wash liquid and all suspended particles on the outlet side of the wash tube were directed onto the filter paper in one of three vacuum assisted filter funnels 77 (FIG. 7). All tests were performed at room temperature (between 18 and 24 ° C). In some tests, the flask was submerged in a rectangular perspex tank of water to eliminate the light twist.

The embodiment of the cleaning tube of FIGS. 3 (a) -6 (b) was tested. It consists entirely of an outer tube of stainless steel with an inner diameter (id) of 5.84 mm and an inner tube of coaxial stainless steel with an inner diameter of 3.2 mm, both tubes having a wall thickness of 0.5 mm. It was These inner and outer tubes were brazed at the T-shaped ends. For each embodiment, inner tubes were used for (a) inlet stream I and (b) outlet stream R. As a control, a PVC three-way continuous cleaning 20Ch catheter (Rusc
h Simplastic-trade name). Diameter 0.212 ~ 0.300 mm, density 250
0 kg / m ³ glass beads were used to mimic the hard compact debris inside the bladder. The collection system consisted of three vacuum-assisted filter funnels (one of which is shown in Figure 7), used sequentially with Whatman grade 1 filter paper (nature-medium speed).
.

In each test, the bladder model 71 was filled with water and 5 g of dried glass beads were added to it. The flush / flush tube and bladder model were then positioned and oriented as desired. The wash started to flow under gravity by opening a valve (not shown) and lasted up to 12 minutes. The effluent stream R from the bladder model 71 was directed to another filter funnel at 4 minute intervals and all three vessels were used during the 12 minute (maximum) experiment.

After each test, the bladder model 71 was emptied and washed thoroughly to remove all glass beads. The three filter papers were removed from the funnel, dried in a dryer at 150 ° C. for 30 minutes, and the weight of the subsequently washed and dried glass beads was determined. (Preliminary tests showed that a constant drying weight was obtained with a drying time of 30 minutes.) The following experiment was performed.

(I) A 12 minute test was performed to determine which tube configurations were effective in removing debris from bladder models A and B. Five irrigation / irrigation tubes or catheters were each held vertically with their tips located 5 mm from the floor of the bladder model.

[0048]   Subsequently, tests were conducted and the following effects were examined.

(Ii) When the distance of the tube tip to the floor of the bladder is changed. Distances in the range of 5-10 mm were considered. (iii) When the working angle (φ), which is the orientation of the tube with respect to the fragments, is changed (Fig. 9)
.

(Iv) A case in which the bladder model and the tube are tilted at different angles (Θ) from the vertical, and the working angle and the offset angle are combined (FIG. 7B).

[0051]    (v) When the flow rate is changed.

[Unless otherwise noted, the tube of FIG. 3 (a) was held vertically and directed at the debris at a distance of 5 mm from the flow of bladder model A and used at a flow rate of 150 ml / min for 4 minutes. ] The internal pressure of the bladder model is (150 ml / m 2) in the tube of FIGS.
During initial testing (done in flow rate), it was found to be within 0.01 bar (1 kPa) of atmospheric pressure. This pressure was small enough that the recordings in subsequent tests were correct. It was found during initial testing that the flow rate did not change more than 3%. The change was determined to be an acceptably low value.

In test (i), different tube configurations were compared (FIGS. 8, 9, 10, 11).
). Two experiments were performed for each tube for Model A. Tube 3 (a)
[87%, 91%], 3 (b) [45%, 59%], 4 (b) [13%, 12%
], Significant debris removal was achieved. In all cases, the main removal of debris was done in the first 4 minutes. Other tubes are 5% over the 12 minute test time
The following was the removal of debris (Figure 8). Comparison of the removal rates of Models A and B showed that bladder size had a minor effect within the tested range.

The removal rates obtained with the tube of FIG. 3 (a) were much higher and more reproducible than those obtained with the other configurations. Therefore, in subsequent tests, the tube of Figure 3 (a) was used exclusively.

The results of test (ii) showed a high removal rate (about 80% after 4 minutes) if the tube was within 8 mm from the floor of the bladder model (FIG. 8). When the distance is longer than 8 mm, the efficiency drops sharply, and when the distance is 10 mm, the removal rate becomes lower than 20%. According to visual observations and photographs, the dependence of debris removal on distance is shown by the interaction of the internal jet flow, the walls of the bladder model and the glass beads with a region of locally high debris particle velocity within 8 mm above (“fluidization”). It was strongly suggested that this occurs due to the presence of the region (Fig. 14). This fluidized particle region is shown in FIGS. 3 (a), 4 (a), 5 (
It was observed in tubes a), 6 (a) and tubes 3 (b) and 4 (b), but not in the other tubes. The fact that tubes 1 and 2 gave higher removal rates and that tube 4 (b) performed better than tube 4 (a) was due to the presence of the effluent flow tube in the fluidization zone being an important factor for effective debris removal. It is a proof of that. It has also been found that the debris removal rates are relatively insensitive to values up to 25 and 20 degrees for angle [φ in test (iii)] and combined angle / mismatch [Θ in test (iv)], respectively. It was The 20 degree angle Θ corresponds to a 14 mm misalignment and an additional vertical distance of 2 mm from the debris, and therefore the debris removal efficiency reduction for Θ> 20 degrees is partially due to tilt and debris misalignment. It should be noted that it is due to changes in distance and not simply to tilt.

Finally, the results of test (v) show that debris removal increased sharply until the flow reached 150 ml / min, after which it reached 650 ml / min (maximum flow used, FIG. 13). , Showed that the removal was basically not affected by the flow rate.

The flow rate used in the experiment (typically 150 ml / min) is relatively large compared to the flow rate used in recent washing, but preliminary studies have shown that a urine flow meter for 8 subjects. It was shown to be much lower than the typical maximum and average flow rates during bladder washes (1180 ± 250 ml / min and 540 ± 200 ml / min, mean ± SD), measured and recorded in. It should also be noted that for the flush tube configurations studied (Tubes 1-4), a water flow of 150 ml / min was delivered without a significant increase in hydrostatic pressure in the bladder model. Furthermore, for the tube 1 (a), an upper limit can be set for the normal stress (σ) that occurs in the floor of the bladder model due to the internal jet flow of the washing liquid, and when the flow rate is 150 ml / min. , Inequality σ <0.5 ρ ²
(Where ρ is the density of water and v is the average velocity of the flow inside the tube) gives σ of 50 Pa or less.

The experiment showed that there was a region of fluidized debris near the position where the jet of inflowing flushing liquid hits the floor of the bladder model, and the drainage flow region of the flushing tube was within this fluidizing region. It shows that debris is removed at a high rate (Fig. 14). Conversely, debris removal was not successful if the outlet flow tube was not present in this fluidization zone. Therefore, in the case of a debris cleaning catheter with constant flow, the outlet of the inlet lumen and the inlet of the outlet lumen into the catheter should be located close to each other. Furthermore, if the jet of inflow cleaning liquid is directed towards the deposited debris, an angle of up to 25 degrees from the vertical axis gives a high removal rate.

In all embodiments, the tip of the catheter 1 is flushed and flushed from the wall of the bladder so that the drainage lumen is located in the area of the “fluidized” debris 4 created by the impingement of a jet of inflowing flushing fluid. A spacer device or means may be provided at the tip of the catheter to ensure that it is separated by an optimum distance for This means may be an extension of the catheter itself, for example by a bend in the end formed by a semi-circular cut, or it may be removably attached to the tip before the cleaning and washing operation begins. It may be a separate spacer.

In all embodiments, the tasks described are performed by the action of gravity. However, an appropriate device such as a pump may be used instead of relying only on gravity.
Existing cleaning / flushing systems may be used in conjunction with the catheters and / or systems described herein.

It will be appreciated that, in all embodiments, the ratio of lumen diameters allows for optimal removal of debris from the bladder.

The invention described with reference to the drawings can also be applied to other applications such as storage tanks, swimming pools, bats, cleaning of containers that contain liquid and are relatively inaccessible for cleaning. It will be understood that

[Brief description of drawings]

1 is a perspective view of a catheter according to the present invention. FIG. (A) is an enlarged view of the catheter tip of FIG. 1.

[Fig. 2]   FIG. 2 is a further enlarged plan view of the tip of the catheter of FIGS. 1 and 1 (A).

3 (a) and 3 (b) are schematic representations of a catheter embodiment of the present invention, respectively, at a reduced magnification, where the illustration in (a) shows an example of the flow through a particular embodiment. FIG. 3 (b) shows a second system of flow through a particular embodiment.

4 (a) and (b) are schematic representations of another embodiment of the catheter of the present invention, respectively, at a small magnification, wherein the illustration in (a) passes through a particular embodiment. One system of flow is shown, the diagram in (b) shows a second system of flow through a particular embodiment.

5 (a) and 5 (b) are schematic representations of another embodiment of the catheter of the present invention, respectively, at a small magnification, and the drawing in (a) passes through a specific embodiment. One system of flow is shown, the diagram in (b) shows a second system of flow through a particular embodiment.

6 (a) and (b) are schematic representations of another embodiment of the catheter of the present invention, respectively, at a small magnification, wherein the illustration in (a) passes through a particular embodiment. One system of flow is shown, the diagram in (b) shows a second system of flow through a particular embodiment.

FIG. 7 shows a model of a bladder cleaning system according to the present invention. (A) and (b) show variants of this system.

FIG. 8: Wash tube 3 (a) held 5 mm vertically from the floor of bladder system A
The percentage of debris removed (y) (average of 2 tests) as a function of time (t) for ~ 6 (b) is shown. The flow rate was 150 ml / min.

9: Tubes 3 (a) -6 held vertically 5 mm from the floor of bladder system B
The percentage of debris (y) as a function of time (t) relative to (b) is shown. Flow rate is 15
It was 0 ml / min.

FIG. 10 is the time (t) versus the distance from the floor of the bladder system X to the tip of the tube 1 (a).
) Shows the percentage of debris removed from Model A after 4 minutes as a function of ().
The flow rate was 150 ml / min.

FIG. 11 shows the percentage (y) of debris removed from Model A after 4 minutes as a function of working angle (φ). The flow rate was 150 ml / min.

FIG. 12 (y) of debris removed from model A after 4 minutes as a function of angle / mismatch θ
Shows the ratio of. The flow rate was 150 ml / min.

FIG. 13 shows the percentage of debris removed from Model A by tube 1 (a) at 4 minutes as a function of flow rate (x).

FIG. 14 is a photograph of an ongoing wash / wash operation showing the area of fluidized particles near the tip of the catheter.

─────────────────────────────────────────────────── ─── Continued front page    (81) Designated countries EP (AT, BE, CH, CY, DE, DK, ES, FI, FR, GB, GR, IE, I T, LU, MC, NL, PT, SE, TR), OA (BF , BJ, CF, CG, CI, CM, GA, GN, GW, ML, MR, NE, SN, TD, TG), AP (GH, G M, KE, LS, MW, MZ, SD, SL, SZ, TZ , UG, ZW), EA (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), AE, AG, AL, AM, AT, AU, AZ, BA, BB, BG, BR, BY, B Z, CA, CH, CN, CR, CU, CZ, DE, DK , DM, DZ, EE, ES, FI, GB, GD, GE, GH, GM, HR, HU, ID, IL, IN, IS, J P, KE, KG, KP, KR, KZ, LC, LK, LR , LS, LT, LU, LV, MA, MD, MG, MK, MN, MW, MX, MZ, NO, NZ, PL, PT, R O, RU, SD, SE, SG, SI, SK, SL, TJ , TM, TR, TT, TZ, UA, UG, US, UZ, VN, YU, ZA, ZW (72) Inventor Ackermann             United Kingdom, Bristol BS 16 1             Kwai, Cold Harbor Lane,             University of the West             England (72) Inventor Covenay, Vince             United Kingdom, Bristol BS 16 1             Kwai, Cold Harbor Lane,             University of the West             England F term (reference) 4C167 AA02 AA04 AA38 BB02 BB08                       BB09 BB26 BB31 BB39 BB40                       CC04 CC26 GG16

Claims (26)

[Claims] 1. A catheter for cleaning a hollow organ in a human body with a cleaning liquid, comprising a lumen for introducing the cleaning liquid, and an lumen for discharging the cleaning liquid and debris from the hollow organ. catheter. 2. The catheter of claim 1, wherein one of the lumens has an orifice at the tip of the catheter. 3. The catheter of claim 2, wherein the orifice constitutes the open end of the one lumen at the tip of the catheter. 4. The catheter according to claim 2, further comprising an orifice spaced apart from the distal end and entering the other lumen, and the orifices of the respective lumens are adjacent to and close to each other. 5. The catheter according to claim 4, wherein the one lumen is configured to introduce a cleaning liquid into the hollow organ or to discharge the cleaning fluid from the hollow organ. 6. The catheter of claim 4, wherein the other lumen is configured to drain or introduce flushing fluid into or out of the hollow organ. 7. The catheter of claims 5 and 6 wherein the two lumens are substantially parallel to each orifice formed in one open tip of the catheter. 8. The catheter of claim 7, wherein the two lumens are coaxial. 9. The catheter of claim 7, wherein the two lumens are longitudinally offset. 10. The catheter of claim 8 or 9, wherein the orifices spaced from the tip include a plurality of orifices spaced longitudinally of the catheter, the orifices entering one or the other lumen. 11. The orifice is substantially 90 with respect to the length of the catheter.
The catheter of claim 10, wherein the catheter is angled in degrees. 12. The catheter of claim 10, wherein the orifice makes an angle of about 60 degrees with the length of the catheter. 13. The catheter according to claim 12, wherein the orifice is guided into the catheter at an angle toward the tip of the catheter. 14. A catheter according to any one of claims 1 to 13 including a spacer which, in use, separates the tip of the catheter from the wall of the hollow organ. 15. The catheter of claim 14, wherein the spacer comprises an extension of the boundary wall of the catheter. 16. The catheter of claim 14, wherein the spacer is a separate spacer element configured to attach to the tip of the catheter. 17. One of claims 1 to 16 which is made in one piece as one piece.
The catheter according to paragraph. 18. A method for cleaning a hollow organ in a human body, comprising inserting the catheter according to any one of claims 1 to 17 into the hollow organ, the tip of the catheter being an internal boundary of the hollow organ. Positioned at the desired distance from the wall, introducing a flush from a flush source into the hollow organ along one lumen of the catheter and expelling flush and debris from the bladder along the other lumen. A method consisting of steps. 19. The cleaning solution passes under gravity through the hollow organ.
The method described in. 20. The method according to claim 19, wherein the angle of introduction of the washing liquid with respect to the debris in the hollow organ is in the range of 0 to 25 degrees with respect to the vertical axis. 21. The distance of the orifice of the other lumen is 0 to 20 mm from the debris.
21. The method according to claim 20, wherein 22. The method of claim 21, wherein the distance is less than or equal to about 10 mm. 23. The method according to claim 18, wherein the upper limit of the introduction flow rate of the cleaning liquid is about 650 ml / min. 24. The method of claim 23, wherein the flow rate is about 150 ml / min. 25. A system for irrigating a hollow organ in a human body, which system comprises the catheter according to any one of claims 1 to 17 and a rinsing liquid source. 26. The cleaning fluid source is connected to the introduction lumen.
The system described in.