JP2004248790A - Insertion tool for tracheal/bronchial stent - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an insertion tool for a bronchial stent which requires no skill for insertion thereof into the trachea or bronchia and moreover, is inexpensive. <P>SOLUTION: The insertion tool 1 has three tubes each with a different diameter made of a resin or a rubber which are soft and formed slightly curved as a whole. The insertion tool includes a first tube 2, a second tube 3 which is inserted into the first tube and houses the stent for the trachea or the bronchia on the tip side thereof and a third tube 4 which is inserted into the second tube and pushes out the stent for the trachea or the bronchia housed in the second tube. Moreover, a connector 8 is provided on the rear end side of the first tube, a stopper 13 which abuts on the connector of the first tube by the insertion thereof is provided on the rear end side of the second tube and a connector 17 which abuts on the stopper of the second tube by the insertion thereof is provided on the rear end side of the third tube. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a device for facilitating insertion of a trachea or a bronchial stent.
[0002]
[Prior art]
The tracheal or bronchial stent, as previously proposed by the applicant as Japanese Utility Model Publication No. 7-56005, prevents obstruction of the lumen from the stenosis when the lumen of the trachea or bronchus is narrowed due to, for example, cancer. It is used to secure the lumen.
[0003]
Heretofore, there has been no dedicated insertion tool for inserting the stent as described above, and it has been only provided as an optional component of the rigid bronchoscope.
[0004]
However, since the rigid bronchoscope is expensive, it cannot be provided in all medical facilities, and this has contributed to a decline in the penetration rate of stents. In addition, since the rigid bronchoscope has a large diameter and is linear, intubation requires skill, and even a skilled physician may suffer from complications such as tracheal damage due to the end of the bronchoscope during intubation. Many had occurred.
[0005]
[Problems to be solved by the invention]
Accordingly, an object of the present invention is to solve the above-mentioned conventional problems and to provide an inexpensive bronchial stent insertion tool that does not require skill in intubating the trachea or bronchi.
[0006]
[Means for Solving the Problems]
In order to achieve the above object, the invention according to claim 1 is for a trachea or a bronchus having three tubes each having a slightly curved shape and made of flexible resin or rubber and having different diameters. A stent insertion tool, comprising: a first tube; a second tube inserted into the first tube, which stores a trachea or a bronchial stent at the distal end; and a second tube inserted into the second tube. A third tube for pushing out a trachea or a bronchial stent housed in the second tube, a connector is provided on a rear end side of the first tube, and a third tube is inserted into a rear end side of the second tube by insertion. A stopper for contacting the connector of the first tube is provided, and a connector for contacting the stopper of the second tube by insertion is provided on the rear end side of the third tube.
[0007]
According to a second aspect of the present invention, when the first tube, the second tube, and the third tube are inserted until the respective rear-end connectors and stoppers come into contact with each other, the first tube, the second tube, and the third tube of the first embodiment, Are set to have substantially the same position in the length direction. According to a third aspect of the present invention, in the first aspect, when the first tube, the second tube, and the third tube are inserted until the respective rear end side connectors and stoppers come into contact with each other, the second tube, The distal ends of the tubes and the third tube are located forward of the distal ends of the first tube, and the distal ends of the second tube and the third tube are located at substantially the same position in the longitudinal direction. Is set.
[0008]
According to a fourth aspect of the present invention, in any one of the first to third aspects, the first tube, the second tube, and the third tube are inserted until the rear end connector and the stopper come into contact with each other. Sometimes, each tube is provided with a side hole that opens at the same site.
[0009]
BEST MODE FOR CARRYING OUT THE INVENTION
Embodiments of the present invention will be described with reference to the accompanying drawings.
[0010]
[Embodiment 1]
FIG. 1 shows three tubes constituting a stent insertion tool, (A) is a first tube, (B) is a second tube, (C) is a front view of a third tube, and FIG. FIG. 3 is a cross-sectional plan view showing a state in which three tubes are inserted, and FIG. 3 is an enlarged cross-sectional plan view of a front end side and a rear end side in FIG.
[0011]
Reference numeral 1 denotes an insertion tool which is formed in a slightly curved shape as a whole and is made of three tubes made of flexible resin or rubber having different diameters. That is, the first tube 2, the second tube 3, and the third tube 4 are used as an outer tube. The first tube 2 includes a PTFE tube body 6 having an outer diameter of about 13 mm and an inner diameter of about 12.5 mm, both ends of which are open, and a total length L1 of about 370 mm on the outside of the curve, and the tube body has a substantially circular cross section. . A plurality of side holes 7 are formed on the distal end side of the tube body 6. To the rear end of the tube body 6, a connector 8 branched into two branches in a substantially Y-shape is connected.
[0012]
The connector 8 is made of resin and has a short tubular base portion 8a, a short tubular mounting portion 8b rotatably fitted and connected to the base portion, and having an inclined short tubular branch portion 8c. And a distal end 8d rotatably fitted to and connected to the branching portion, and a rubber cap 9 that opens and closes a rear end opening is attached to the attaching portion 8b. The cap 9 comprises a ball 9a capable of closing the rear end opening of the mounting portion 8b and a flexible sheet 9b supporting the ball 9a.
[0013]
The second tube 3 includes a PTFE tube body 11 having an outer diameter of about 12 mm and an inner diameter of about 11 mm, both ends of which are open, and a total length L2 of about 420 mm on the outside of the curve, and the tube body has a substantially circular cross section. A plurality of side holes 12 are formed on the distal end side of the tube main body 11. A large diameter ring-shaped stopper 13 is connected to the rear end of the tube body 11. The stopper 13 is formed to have the same outer diameter as the mounting portion 8b of the connector 8, and a funnel-shaped chamfer 14 is provided on the outward end surface so that the third tube 4 can be easily inserted. As shown in FIG. 3, when the stopper 13 comes into contact with the mounting portion 8b of the connector 8, the side hole 12 overlaps and opens at the same portion as the side hole 7 of the first tube 2.
[0014]
The third tube 4 includes a PTFE tube main body 15 having an outer diameter of about 10 mm, an inner diameter of about 8 mm, and a curved outer length L3 of about 440 mm, both ends of which are open. The tube main body has a substantially circular cross section. A plurality of side holes 16 are formed on the distal end side of the tube main body 15. A connector 17 having substantially the same configuration as the connector 8 of the first tube 2 is connected to the rear end of the tube main body 15. Therefore, the same components are denoted by the same reference numerals with 9 added, and description thereof is omitted. The connector 17 differs from the connector 8 only in that a spacer 18 is provided as is clear from FIG. The spacer 18 is not always essential. If the thickness of the spacer is integrally formed on the inner surface of the connector 17, the spacer can be omitted. As shown in the figure, when the connector 17 comes into contact with the stopper 13, the side hole 16 is opened at the same position as the side hole 7 of the first tube 2 and the side hole 12 of the second tube 3.
[0015]
The operation of inserting the stent into the trachea and placing the stent therein will be described with reference to FIG. At the time of use, the specifications of the stent to be used are determined based on the results obtained by image diagnosis such as radiography before the operation and various examinations, and the stent is stored in the distal end of the second tube 3. FIG. 5 shows this stored state, and as is apparent from the figure, the stent is stored in a state of being folded in two in a direction intersecting the length direction.
[0016]
First, before the operation, the patient is observed under a general anesthesia with a bronchial fiber (not shown), and depending on the degree of stenosis, the stenosis site is widened by surgical resection. Next, as shown in FIG. 4 (A), the first tube 2 is intubated to such an extent that the distal end is slightly before the affected part in the trachea. At this time, the bronchial fiber is inserted into the first tube 2 at a position where the distal end opening of the first tube 2 and the trachea and the bronchial wall can be simultaneously observed, and the first tube 2 and the bronchial fiber are simultaneously inserted into the trachea and the bronchial fiber. Advancement into the bronchi facilitates intubation depth determination. A respiratory circuit (not shown) is connected to the branched distal end portion 8d of the connector 8 to prevent the patient from becoming anoxic, and the ball 9a of the cap 9 is mounted so as to close the rear end opening of the mounting portion 8b. To prevent breathing air from leaking. Also, upon insertion, the degree of curvature of the first tube 2 is close to the curve of the endotracheal tube specified by JIS, so that it is possible to intubate into the trachea without much skill. It is. The depth of the intubation is appropriately changed depending on the stenosis of the trachea.
[0017]
After the first tube 2 is placed at the target site, the ball 9a of the cap 9 is pulled out from the rear end opening of the mounting portion 8b and opened, and a bronchial fiber (not shown) is inserted through the opening to cut a stenosis site. Perform necessary procedures for stent placement. After the end, the bronchial fiber is pulled out, and the pulled out bronchial fiber is inserted from the opening of the mounting portion 8b of the connector 17 of the third tube 4 until its tip reaches almost near the tip of the tube.
[0018]
Next, after inserting the second tube 3 containing the stent until the stopper 13 hits the connector 8 of the first tube 2, the third tube 4 is inserted into the stopper 13 with the bronchial fiber inserted. Insert the stent through the opening until the stent can be identified by bronchial fiber. When the stopper 13 hits the connector 8, the stent accommodated at the distal end of the second tube 3 is at the position shown in FIG. 4B. Next, while confirming the degree of opening of the stent and the position of the stenosis site with the bronchial fiber, the stent is pushed out little by little from the second tube 3 housed in the third tube 4 as shown in FIG. 4C. At this time, since the stent is stored in the second tube 3 in a folded state, it is pushed out and expanded, and is placed in the affected part of the trachea as shown in FIG. 4D. If necessary, the placement position is adjusted using forceps attached to the bronchial fiber.
[0019]
[Embodiment 2]
6A and 6B show three tubes constituting a stent insertion tool, wherein FIG. 6A is a front view of a first tube, FIG. 6B is a front view of a second tube, and FIG. 6C is a front view of a third tube. It is a front view showing the state where three tubes were inserted.
[0020]
The second embodiment is basically different from the first embodiment in that the lengths of the second tube 33 and the third tube 34 are longer than the first tube 32 of the insertion tool 31. That is. Other configurations are almost the same as those of the insertion tool 1 of the first embodiment, and therefore, the same configurations are denoted by the same reference numerals with the addition of 30, and the description thereof is omitted.
[0021]
More specifically, the overall lengths L6 and L7 of the second tube 33 and the third tube 34 outside the curve are longer than the total length L5 of the first tube 32 by about 30 mm, respectively. When the respective tubes are inserted so that the connectors 38 and 47 and the stopper 43 are in contact with each other as shown in FIG. 7, the distal ends of the second and third tubes 33 and 34 project from the distal end of the first tube 32 by 30 mm. Has become. At this time, the distal ends of the second tube 33 and the third tube 34 are located at substantially the same position in the length direction. Accordingly, if it is necessary to correct the indwelling position after a series of stent indwelling operations as described above, if the tubes 33 and 34 are removed, a gap is formed between the distal end of the tube 31 and the stent. Therefore, the stent can be moved to the near side while the tube 31 is inserted.
[0022]
The above embodiments are merely preferred examples. For example, the material of each tube 2, 3, 4, 32, 33, 34 is not limited to PTFE, but may be polyvinyl chloride, polyethylene, polyurethane, polycarbonate, or the like. It can be made by selecting from materials suitable for medical use, such as flexible resin and silicone rubber, and can also be stiffened inside the wall of the tube or used to prevent bending during use. Use a tube with a spiral or mesh embedded in the endotracheal tube for each tube of the insertion tool, or apply various coatings etc. on the tube surface for the purpose of improving the slipperiness when inserting these tubes. Can be used.
[0023]
Also, considering the invasion to the patient to be used, it is advantageous that the insertion tool used is as thin as possible, but since the size of the stent to be used naturally changes from the patient's body shape and the size of the stenosis site, Needless to say, the size of the insertion tool is changed accordingly. Further, the distal end portion of the insertion tool can be cut obliquely so that it can be easily intubated as seen in a normal endotracheal tube, and a scale for indicating the depth of intubation can be provided. Furthermore, in the embodiments, the stent is inserted into the trachea for convenience of explanation, but it goes without saying that the stent may be inserted into the bronchus.
[0024]
【The invention's effect】
Since the present invention has the above-described configuration, it has an excellent effect that, when inserting a trachea or a bronchial stent, the operation does not require skill, and an inexpensive insertion tool can be provided.
[Brief description of the drawings]
FIG. 1 shows three tubes constituting a stent insertion device according to a first embodiment of the present invention, wherein (A) is a first tube, (B) is a second tube, and (C) is a second tube. It is a front view of 3 tubes.
FIG. 2 is a front view showing a state where the three tubes are fitted in the same.
FIG. 3 is a partially enlarged cross-sectional plan view in the length direction showing a front end side and a rear end side of FIG.
FIGS. 4A to 4D are explanatory diagrams of the operation.
FIG. 5 is a view showing a stored state of a stent.
FIGS. 6A and 6B show three tubes constituting a stent insertion device according to the second embodiment, wherein FIG. 6A is a first tube, FIG. 6B is a second tube, and FIG. 6C is a third tube. FIG.
FIG. 7 is a front view showing a state where the three tubes are fitted in the same.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Insertion tool 2 1st tube 3 2nd tube 4 3rd tube 6,11,15 Tube main body 6
7, 12, 16 Side holes 8, 17 Connector 9 Cap 13 Stopper 18 Spacer 31 Inserter 32 First tube 33 Second tube 34 Third tube

Claims (4)

A trachea or bronchial stent insertion tool formed of three tubes each having a slightly curved shape and made of flexible resin or rubber and having different diameters. A second tube that is inserted into the tube and accommodates the trachea or bronchial stent on the distal end side, and a third tube that is inserted into the second tube and pushes out the trachea or bronchial stent accommodated in the second tube. A connector provided on the rear end side of the first tube, a stopper provided on the rear end side of the second tube for contacting the connector of the first tube by insertion, and a third tube A trachea or bronchial stent insertion tool, wherein a connector is provided at a rear end side thereof, the connector abutting on a stopper of the second tube by insertion. The first tube, the second tube, and the third tube are so long that their respective distal ends are located at substantially the same position in the longitudinal direction when inserted until the respective rear-end connectors and stoppers abut. The trachea or bronchial stent insertion tool according to claim 1, wherein When the first tube, the second tube, and the third tube are inserted until the respective connectors and stoppers at the rear ends thereof come into contact, the distal ends of the second tube and the third tube become the first tube. 2. The tracheal or bronchial stent according to claim 1, wherein the stent is located forward of the distal end, and has a length such that the distal ends of the second tube and the third tube are located at substantially the same position in the longitudinal direction. Inserts. When the first tube, the second tube, and the third tube are inserted until the respective rear-end connectors and stoppers come into contact with each other, a side hole that opens at the same site is provided in each tube. Item 4. An insertion tool for a trachea or a bronchial stent according to any one of Items 1 to 3.

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