JP2005177237A - Hepatic tissue biopsy instrument - Google Patents

Hepatic tissue biopsy instrument Download PDF

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JP2005177237A
JP2005177237A JP2003424397A JP2003424397A JP2005177237A JP 2005177237 A JP2005177237 A JP 2005177237A JP 2003424397 A JP2003424397 A JP 2003424397A JP 2003424397 A JP2003424397 A JP 2003424397A JP 2005177237 A JP2005177237 A JP 2005177237A
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needle
outer
tube
inner
tip
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JP4462534B2 (en )
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Tatsu Ishikawa
Hidehiko Nishizawa
達 石川
英彦 西澤
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Hakko Co Ltd
株式会社八光
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<P>PROBLEM TO BE SOLVED: To provide an instrument optimal for conducting a biopsy of the hepatic tissue safely even in a case of severe hepatopathy by conducting the hepatic biopsy using the jugular vein approach but not by the conventional percutaneous approach. <P>SOLUTION: The instrument for conducting the hepatic biopsy is inserted into the internal jugular vein at the neck and reaches the liver via the right hepatic vein. The instrument comprises a longitudinal guide tube 1 having an elbowed front end and a rear end with a guide base having a reverse flow preventing means, a contrast agent infusion tube 2 branched out from the guide base and having the reverse flow preventing means on its rear end, and a suction biopsy needle 3 having an outer needle 31 inserted slidably into the inner cavity of the guide tube 1, an inner needle 34 inserted slidably into the outer needle, and a suction means installed on the base part of the outer and inner needles. The effective length of the guide tube is ≥400 mm and ≤700 mm, and the effective length of the suction biopsy needle is ≥500 mm and ≤800 mm . <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

本発明は、急性肝不全などの症例に対して、肝臓組織の一部を採取して検査を行うための肝臓組織生検器具に関する。 The present invention is, with respect to cases such as acute liver failure, relates liver tissue biopsy device for inspecting and collect a portion of the liver tissue.

肝臓の一部を採取して、その組織や細胞の様子を検査するための肝臓の生検(以下、肝生検)は、慢性肝炎や肝硬変の確定診断の目的で広く行われる検査手技であるが、より重症で、肝炎ウイルスあるいは薬剤等による劇症肝炎に由来するものが多い、急性肝不全などにおいても、その肝臓組織の状態を把握して、治療などへの判断とするためこの肝生検が必要となっている。 A portion of the liver was collected and biopsies of the liver for inspecting the state of the tissue or cell (hereinafter, liver biopsy) is a test procedure carried out widely for the purpose of definitive diagnosis of chronic hepatitis and liver cirrhosis but more severe, those derived from fulminant hepatitis by hepatitis virus or drug or the like is large, even in such as acute liver failure, to grasp the status of the liver tissue, the liver production to the judgment of the treating the like biopsy has become necessary.

従来の肝生検は、局所麻酔下に超音波画像などを指標とし、経皮的に170mm程度の生検針を穿刺し、胸郭または腹壁を貫通させて肝臓内部まで針先を到達させ、該生検針により所望部位の検査用の標本を採取するもので、その生検針の代表的な形態として一つには、例えば、先端部に組織採取のための切断刃が形成された外針と、該外針に摺動自在に挿入され、内部に組織を収納採取するための切り欠け部(スペースメンノッチ)を有した内針、及び前記外針及び内針に各々接続されたハブにより構成し、ハブの相互の往復動作により、内針は外針の先端開口部から進出後退する構造となっており、内針を外針に収納した状態で、経皮的に所望臓器直前まで穿刺したのち、内針を突出させると切り欠け部に組織が収納され、この状態で外 Conventional liver biopsy, an index such as an ultrasound image under local anesthesia, percutaneously punctures the biopsy needle of about 170 mm, the thorax or abdominal wall by penetrating the needle tip to reach the inside liver, organism meter reading by those collecting specimens for examination of the desired site, in part as a representative form of the biopsy needle, for example, an outer needle cutting blades for tissue collection was formed at the end portion, the slidably inserted into the outer needle, constituted by each connected hub inner needle having a cutout for accommodating collected tissue therein (Spacemen notch), and the outer needle and the inner needle, the mutual reciprocating movement of the hub, the inner needle has a structure to advance backward from the distal end opening portion of the outer needle, in a state of accommodating the inner needle to the outer needle, after puncture until percutaneously desired organ immediately before, protruding the inner needle and cutout in the tissue are housed outside in this state を押し出すことにより該外針の切断刃により組織を押し切り採取するようなカットタイプの生検針がある。 There are biopsy needle cut type as collecting press cutting the tissue by the cutting edge of the outer needle by extruding. (特許文献1参照) (See Patent Document 1)
また、もう一つの代表的な生検針として、例えば、シリンダーの先端に固定された外径を先端側より段階的に太くした管状の外針と、プランジャーの先端に固定されて該プランジャーの前記シリンダー内の移動に基づいて前記外針の中を移動する内針とを備え、前記外針と前記内針の相対的位置関係によって前記シリンダー内に形成される吸引空間に密封状態(内針が外針の細径部に位置し、外針の内腔に内針が密着している吸引初期段階の状態)と非密封状態(内針が外針の太径部に位置し、外針の内腔に内針が密着していない吸引後期段階の状態)を提供する生検針で、経皮的に所望組織直前まで針管を挿入し、プランジャーを引き、シリンダー内の陰圧を針先に生じさせた状態で、針を前後させて吸引圧により組織を採取するような吸 Further, as another typical biopsy needle, for example, tubular and the outer needle which is stepwise thicker than the distal end side outer diameter which is fixed to the distal end of the cylinder, it is fixed to the tip of the plunger of the plunger and a inner needle that moves within the outer needle on the basis of the movement in said cylinder, sealed (the inner needle aspiration space formed in the cylinder by the relative positional relationship between the inner needle and the outer needle There located in the small-diameter portion of the outer needle, aspiration initial stage when the inner needle into the lumen of the outer needle is in close contact state) and unsealed (inner needle is positioned in the large diameter portion of the outer needle, an outer needle the inner needle is a state of the suction late stage it is not attached firmly) in biopsy needle to provide a lumen, percutaneously inserting the needle tube to the desired tissue just before, pull the plunger, a negative pressure in the cylinder tip of the absorption, such as by resulting allowed state, to obtain a tissue by suction pressure needle by back and forth 生検針がある。 There is a biopsy needle. (特許文献2参照) (See Patent Document 2)
特公昭47−8913号公報 JP-B-47-8913 JP 特公平1−54058号公報 Kokoku 1-54058 Patent Publication No.

しかし、経皮的に肝生検を行う場合、超音波画像下に穿刺経路を定めているとはいえ、患者の呼吸などによる臓器の位置ずれや、不意の体動による穿刺経路のぶれなどにより発生する、生検針の刃先による肺など他の組織への接触や穿刺の可能性を完全に排除することはできず、また、穿刺による体内での内出血の確認も確実とはいえないことから、術後に、感染や腹腔内出血などの重篤な合併症をきたすことがある。 However, when performing percutaneous liver biopsy, said that defines a puncture route under ultrasound image, and displacement of the organs due to the patient's breathing, such as by shaking the puncture route by the body movement of the unexpected occurs, it is impossible to completely eliminate the possibility of contact and puncture by edge of the biopsy needle into other tissues such as the lungs, also, since it can not be said that reliably be confirmed internal bleeding in the body by puncture, postoperatively, which may lead to serious complications such as infection and hemoperitoneum.
また、本発明が好適となる急性肝不全などの重症例においては、腹水貯留や出血傾向を示す高度肝機能低下例も多く、これらの症例では始めから前記リスクのある経皮的肝生検の実施が困難である場合が多々あった。 Also, such as acute liver failure present invention is suitable in severe cases, advanced hepatic dysfunction examples showing ascites and bleeding tendency many, from in these cases the beginning of the percutaneous liver biopsy with the risk If the implementation is difficult there were many.

そこで、本発明は、前記したような重篤な合併症を来すことが少なく、高度肝障害例であっても安全な肝生検が可能な手段として、従来の経皮的ではなく経頸静脈的アプローチにより該肝生検を行うための最適な器具を提供することを課題とした。 Accordingly, the present invention, the serious complications less likely to lead to such as, as a severe liver disorder example an A that can also be secure liver biopsy means, rather than conventional percutaneous Kei頸to provide the best instrument for performing 該肝 biopsies by intravenous approach was a challenge.

本発明の肝臓組織生検器具は、頸部右内頸静脈より挿入して、右肝静脈を経由して肝臓に到達させ、肝生検を行うための器具であって、先端部位を湾曲形状に癖付けした長軸の管状体、及び、該管状体の基端部に設ける逆流防止手段を備えたガイド基よりなるガイドチューブと、前記ガイドチューブの内腔に摺動可能に挿入される、刃面を有する外針、該外針に摺動可能に挿入される鋭利な刃先を有する内針、及び外針及び内針の基端部に設ける吸引手段よりなる吸引生検針と、前記ガイド基より分岐して設けられ、端部に逆流防止手段を備えた造影剤注入用チューブより構成する。 Liver tissue biopsy instrument of the present invention is to insert from the neck right internal jugular vein, through the right hepatic vein to reach the liver, a device for performing the liver biopsy, curved tip portion the tubular body of the long axis put habit, and a guide tube made of a guide base having a backflow preventing means provided in the base end portion of the tubular body, slidably inserted into the lumen of the guide tube, outer needle having a cutting surface, an inner needle, and it consists of suction means provided in the proximal portion of the outer needle and the inner needle aspiration biopsy needle having a slidably inserted are sharp cutting edge to the external needle, the guide group provided more branches, constituting from contrast injection tube provided with a backflow prevention means to an end. また、好ましくは、前記ガイドチューブはX線不透過な素材か、X線不透過な造影剤を含む素材により形成する。 In a preferred embodiment, the guide tube or X-ray opaque material is formed of a material including an X-ray opaque contrast agent.

前記手段のより具体的な構成として、前記ガイドチューブは、基端部に外筒基を備えた可撓性樹脂よりなる外筒と、前記外筒の内腔に挿入され、基端部に前記吸引生検針の針管が挿通可能な逆流防止弁と造影剤注入チューブを接続する分岐部を備えた内筒基を有する金属あるいは硬性樹脂のパイプよりなる内筒より構成し、外筒内腔に内筒を挿着し、前記外筒基の後端と内筒の先端を接続して一体化したとき、内筒の先端と外筒の先端がほぼ同じ長さとなるように形成する。 As a more specific configuration of the unit, the guide tube includes an outer tube made of a flexible resin having a outer tube base to the base end portion is inserted into the lumen of the outer cylinder, wherein the proximal portion constitutes the inner cylinder of the needle tube of the suction biopsy needle is formed of a pipe of metal or hard resin having a cylinder groups among which includes a branching portion connecting the can be inserted and the backflow preventing valve contrast injection tube, the inner to the outer tube lumen and inserting the tube, when integrated by connecting the tip of the rear end and the inner tube of the outer cylinder group, the tip of the tip and the outer tube of the inner cylinder is formed to be substantially the same length.

一方、吸引生検針の具体的な構成として、先端に組織を採取するための刃面を備えたステンレスパイプよりなる外針と、該外針の内腔と隙間を有する外径であって、外針に摺動自在に挿入される先端部に刃先を備えたステンレス棒状体の内針と、吸引手段となる、前記外針の基端部に設けるシリンジ、及び、前記内針の基端部に設けるプランジャーより構成する。 On the other hand, as a specific configuration of the suction biopsy needle, an outer needle made of stainless steel pipe having a blade surface for collecting a tissue at the tip, a outer diameter having a lumen and a gap of the outer needle, an outer an inner needle stainless rod-like body having a cutting edge at the distal end which is slidably inserted into the needle, the suction means, the syringe is provided to the base end portion of the outer needle, and, the proximal end portion of the inner needle it is constituted by a plunger provided.

また、別の吸引生検針の具体的な構成として、先端に組織を採取するための切断刃を備え、先端側が所定の長さ減径されたステンレスパイプよりなる外針と、前記外針の減径部の内腔に密着される外径であって、該外針に摺動自在に挿入される先端部に刃先を備えたステンレス棒状体の内針と、該外針及び内針の基端部に設ける吸引手段として、外針の基端部にはシリンジを、内針の基端部にはプランジャーを備えて構成し、外針及びシリンジの内部に内針及びプランジャーを挿入して一体化したとき、プランジャーがシリンジの最先端に位置する状態では、内針の先端は外針の先端より突出した位置にあり、プランジャーをいっぱいに引いた状態では、内針の先端は外針の減径部より僅かに後退した非減径部に位置するように形成する。 As a specific configuration of another suction biopsy needle, comprising a cutting blade for collecting tissue at the tip, an outer needle tip side is formed of a predetermined stainless steel pipe which is long down diameter, reduction of the outer needle a outer diameter that is close contact with the inner lumen of the diameter, and the inner needle stainless rod-like body having a cutting edge at the distal end which is slidably inserted into the outer needle, the inner needle and the inner needle base end as a suction unit provided in the section, the syringe in the proximal portion of the outer needle, the proximal end portion of the inner needle and configured to include a plunger, insert the inner needle and a plunger inside the outer needle and syringe when integrated, in a state in which the plunger is at the forefront of the syringe, the tip of the inner needle is in the position protruding from the tip of the outer needle, when drawn to fill the plunger, the tip of the inner needle out It is on the non-reduced diameter portion which is slightly recessed from the reduced diameter portion of the needle.

更に本器具は、経頸静脈的な手技に適用して、人体頸部から肝臓までの解剖学的な長さに適合して、前記ガイドチューブの有効長は、400mm以上、700mm以下、吸引生検針の有効長は、500mm以上、800mm以下とする。 The present device is applied to transjugular maneuvers, and adapted to the anatomical length from the body and neck to the liver, the effective length of the guide tube, 400 mm or more, 700 mm or less, suction raw effective length of the needle is, 500 mm or more and 800mm or less. 尚、有効長とは、基部等を除く、チューブ及び針管のみの人体に挿入可能な長さのことを示す。 Here, the effective length, excluding base like, indicates that the insertable length of the human body only tube and needle tube.

本構成の肝臓組織生検器具によれば、頸部右内頸静脈より経頸静脈的にガイドチューブを刺入し、肝臓内の右肝静脈までガイドチューブを誘導挿管し、造影剤注入チューブより造影剤を注入し肝静脈内での該ガイドチューブの正確な位置を確認しながら所望組織に近づけ、該ガイドチューブのガイド基後端部の逆流防止手段から吸引生検針をガイドチューブ内腔に沿って挿入して、肝臓の所望組織の部位で針先端を突出させて穿刺、吸引手段により吸引して目的組織を採取するといった手技により肝生検が達成できる。 According to liver tissue biopsy instrument of the present configuration, puncture the transjugular the guide tube from the neck right internal jugular vein, the guide tube to induce intubation to the right hepatic vein in the liver, from contrast injection tube close to the desired tissue while checking the exact position of the guide tube in the hepatic vein to inject contrast, along the guide tube lumen aspiration biopsy needle from the backflow preventing means of the guide base rear end portion of the guide tube insert Te, the needle tip is protruded puncture, liver biopsy can be achieved by procedures such as by suction by the suction means to recover the target tissue at the site of the liver of a desired tissue.
これにより経皮的な生検で問題となった他臓器への針先の接触や穿刺といった問題を回避することができ、また、出血に関しても、穿刺が頸静脈を通しての肝臓内部だけに限定されるため、頸部頸静脈の穿刺部の止血処理のみを注意すれば体腔内部での内出血を心配する必要がない。 This makes it possible to avoid the needle tip problems such contact and puncture the percutaneous other organs in question biopsy, also with respect to bleeding, puncture is limited to the liver inside through jugular vein because, there is no need to worry about internal bleeding in the body cavity inside if attention only hemostasis processing of puncture of the neck jugular vein.
この作用により、生検による感染症や内出血といった合併症の発生を少なくすることができ、また、高度肝障害例であっても適用可能とすることができる、安全で禁忌の少ない経頸静脈的肝生検の手技に最適な生検器具を提供することができる。 This action can reduce the occurrence of complications such as infection and hemorrhage by biopsy, also, severe liver even failure examples may be applicable, contraindications less transjugular safe it is possible to provide an optimal biopsy instrument procedure of liver biopsy.
また、ガイドチューブにX線不透過な材質を用いると、体内での該ガイドチューブの位置確認を容易にすることができる。 Moreover, the use of X-ray opaque material in the guide tube, it is possible to facilitate the localization of the guide tube in the body.

また、前記手段の具体的な構成のガイドチューブによれば、該ガイドチューブの先端部位が湾曲していることにより、大静脈から肝静脈への分岐部で、該ガイドチューブの右肝静脈側への誘導を容易にすることができ、管状体を可撓性樹脂とステンレスパイプの2重管としたことにより、血管に接触する外筒は柔軟な樹脂のため血管壁を傷つけることがなくスムーズな挿入が可能で、吸引生検針の通路となる内筒は硬質な金属パイプのため針管の挿入時に針先による引っかかりや外筒の突き破りを防止することができると共に、適度なコシがあるため、血管内への挿入がしやすいといった作用を両立することができる。 Further, according to the guide tube of a specific configuration of the unit, by the distal end portion of said guide tube is curved, with the branch portion from the vena cava into the hepatic vein, the right hepatic vein side of the guide tube induce can facilitate the, by the tubular body and a double tube of flexible resin and stainless steel pipe, the outer tube in contact with the blood vessel smooth without damaging the vessel wall for flexible resin insertion is possible, since with the inner tube serving as a passage for suction biopsy needle can be prevented breaks through the catch and the outer cylinder by the needle point during insertion of the needle tube for hard metal pipe, there is a moderate stiffness, vascular it is possible to achieve both the effect such insertion into the inner is likely.
更には、ガイド基に吸引生検針の針管が挿通可能な逆流防止弁を設けたことにより、ガイドチューブの血管挿入時には血液の逆流を防止し、吸引生検針挿入時にはそのままは針管を挿入することを可能にしている。 Furthermore, by the needle tube of the suction biopsy needle to guide group provided can be inserted check valve, at the time of blood vessel insertion of the guide tube to prevent backflow of blood, that is when the suction biopsy needle inserted directly inserting a needle tube It is possible.

一方、前記具体的な構成の吸引生検針によれば、あらかじめ外針及び内針に吸引手段を設けていることからワンタッチで吸引生検操作を行うことが可能で、外針の内腔と内針とを密着せずに隙間を設けていることにより、プランジャーを引くことで生じる陰圧が隙間を通して針先に伝わり組織を吸引することができる。 On the other hand, the according to the aspiration biopsy needle of a specific configuration, advance is possible to perform aspiration biopsy operation by one touch since it is provided with a suction means to the outer needle and inner needle, the inner and the inner lumen of the outer needle by providing the gap without contact with the needle, it can be negative pressure generated by subtracting the plunger to aspirate tissue transmitted to the needle tip through the gap. 尚、経皮的な穿刺においては、この内外針に隙間があることは、穿刺性の悪化を招き、組織への悪影響につながる問題となるが、本手技においては、生検針は穿刺部直前まで前記ガイドチューブ内に挿入されているため大きな問題とはならない。 In the percutaneous puncture, that there is a gap in this inner and outer needles, leading to deterioration of the puncture resistance, it becomes a problem which leads to adverse effects on tissues, in this procedure, the biopsy needle until immediately before puncture not a serious problem because it is inserted into the guide tube.
更に、外針に減径パイプを用い、かつ、内外針の先端位置の関係を前記した、プランジャーがシリンジの最先端にあるときは、内針の先端は外針の先端より突出した位置にあり、プランジャーをいっぱいに引いた状態では、内針の先端は外針の減径部より僅かに後退した非減径部に位置するようにした吸引生検針を用いると、前記作用に加え、プランジャーの引き始めの吸引初期では針先に吸引力が伝わらず組織は採取されず、いっぱいに引いた段階において外針の内面と内針との間に隙間が生じ、始めてシリンジ内の陰圧が針先に伝わり、強い吸引力が一気に発生する構成となっているため、吸引初期の吸引力が弱い段階で組織が針先に詰まり目詰まりを生じるなどの不都合が生じることなく、一層安定した確実な組織採取を期待すること Further, using a reduced diameter pipe outer needle, and were the relationships of the tip position of the inner and outer needles, when the plunger is in the most advanced syringe tip of the needle is in a position protruding from the tip of the outer needle There, in the state drawn fill the plunger, the tip of the inner needle is the use of suction biopsy needle that is to be located in the non-necked down portion which is slightly recessed from the reduced diameter portion of the outer needle, in addition to the action, plunger pull tissue not transmitted suction force to the needle tip at the beginning of the suction early will not be collected, filled a gap between the inner surface and the inner needle of the outer needle at the stage drawn, the first time a negative pressure in the syringe transmitted to the needle tip, since the strong suction force has a structure in which stretch occurs, tissue aspiration initial stage suction force is weak without it to occur a disadvantage such as clogging occurred clogging in the needle tip, it was more stable to expect a reliable tissue sampling できる。 It can be.
また、生検針を吸引生検針としたことで、カットタイプの生検針に比較し肝臓組織や採取組織に与えるダメージを少なく抑えるこが可能となり、更に、生検針を湾曲させて使用することを考慮すると、カットタイプでは内外針の摺動性が悪くなることで生検しづらいことが予想されることから、吸引生検針を選択したことにより一層安全で安定した生検器具とすることができる。 In addition, it has a suction biopsy needle biopsy needle enables this to suppress less damage compared to the biopsy needle of cut type liver tissue or tissue taken further, consider using by bending the biopsy needle then, since it is expected that hard to biopsy by sliding of the inner and outer needles is poor in cut type, it can be a more secure and stable biopsy instrument by selecting the aspiration biopsy needle.

以上、前記した作用、効果、及びガイドチューブ及び吸引生検針を人体頸部から肝臓までの解剖学的な長さに適合した前記寸法に形成することにより、経頸静脈的肝臓生検に最適な肝臓組織生検器具を提供することができる。 Above, wherein the operation and effect, and the guide tube and suction biopsy needle from the body and neck by forming the size adapted to the anatomical length of up to liver, ideal for transjugular liver biopsy it is possible to provide a liver tissue biopsy instrument.

以下、本発明の実施の形態の一例につき図面を参考にしながら詳細に説明する。 It will be described in detail with the accompanying drawings with reference per an embodiment of the present invention. 図1は、本発明の実施の形態を示す経頸静脈的肝臓組織生検器具の全体の構成図を示し、Aがガイドチューブ及び造影剤注入用チューブ、Bが吸引生検針を示している。 Figure 1 is a block diagram of a whole transjugular liver tissue biopsy instrument showing an embodiment of the present invention, A guide tube and a contrast injection tube, is B indicates a suction biopsy needle.
ガイドチューブ1は、経頸静脈的に肝臓まで組織採取のための生検針を挿入するのに先立ち、該生検針を血管内へ安全、確実に目的部位まで誘導するために、その通路にガイドとして挿入される誘導管で、外筒チューブ111と該外筒チューブ111の基端部に接続される内筒基112よりなる内筒11(図2参照)、及び前記外筒チューブ111の内腔に挿着される内筒管121と内筒管の基端部に接続される内筒基122よりなる内筒12(図2参照)より基本構成され、前記内筒基122の後端部には、吸引生検針3の挿入部であり、かつ、人体挿入時に血液の逆流を防止するための逆止弁13を内部に保持している逆止弁キャップ124と、該内筒基122の内腔を分岐させた、後記する造影剤注入用チューブ2の端部23を接続す The guide tube 1, prior to inserting the biopsy needle for tissue extraction to transjugular liver, said biological needle to induce safety into the vessel, reliably to a target site, as a guide to its passage induction tube is inserted, the inner cylinder 11 formed of an outer sleeve member 111 and the inner cylinder group 112 connected to the proximal end of the outer cylinder tube 111 (see FIG. 2), and into the lumen of the outer cylinder tube 111 the inner cylinder 12 made of a cylinder group 122 connected to the proximal end of the inner tube and the inner tube 121 to be inserted from (see FIG. 2) is the basic structure, the rear end portion of the inner cylinder group 122 a insertion portion of the suction biopsy needle 3, and a check valve cap 124 holds the check valve 13 for preventing the backflow of blood upon the human body inserted into the lumen of the inner cylinder group 122 It was allowed to branch, connecting the end 23 of the contrast injection tube 2 to be described later チューブ取り付け部125(図2参照)を備えている。 Tube mounting portion 125 and a (see FIG. 2). また、外筒の内腔に内筒を挿着して一体化すると、外筒チューブ111の先端と内筒管121の先端は一致するか、わずかに内筒管121の先端が突出する長さとし、先端部は血管内に挿入していくさいに大静脈から肝静脈への分岐部で容易に右肝静脈が選択できるように、先端部の適当な長さを湾曲形状に癖付けした湾曲部115を設けて構成している。 Furthermore, when integrated by inserting the inner tube into the lumen of the outer tube, or the tip of the tip and the inner tube 121 of the outer cylinder tube 111 is consistent, Satoshi Cho a slightly projecting tip of the inner tube 121 , the tip so easily right hepatic vein bifurcation from vena cava again going inserted into a blood vessel to the hepatic vein can be selected, the bending portion 115 with habit appropriate length of the tip portion in a curved shape It constitutes a provided.
造影剤注入用チューブ2は、前記ガイドチューブ1が肝静脈内に到達した後、該ガイドチューブ1の正確な位置を把握するため、X線により血管の状況を映し出すための造影剤を血管内に注入するチューブで、前記ガイドチューブ1に設けたチューブ取り付け部125に一方端部23を接続したチューブ21と、該チューブ21の他端部に設けるチューブ基22及び該チューブ基22に接続される逆流防止手段とした。 Contrast injection tube 2, after the guide tube 1 has reached in the hepatic vein, in order to grasp the accurate position of the guide tube 1, a contrast agent for imaging the situation of the blood vessel by X-ray in a blood vessel in the injection tubes, the tube 21 which is connected on the other hand the end 23 to the tube attachment section 125 provided in the guide tube 1, is connected to a tube base 22 and the tube base 22 is provided at the other end of the tube 21 back flow It was preventing means. 尚、本例においては、逆流防止手段として、汎用の二方(あるいは三方)活栓24を用い、ロックリング25で前記チューブ基22と接続して構成した。 In the present embodiment, as the backflow preventing means, using a general-purpose two-way (or three-way) stopcocks 24, constituted by connecting with the tube base 22 with locking ring 25.
吸引生検針3は、前記ガイドチューブ1の内腔をガイドとして、先端部を肝静脈まで挿入して、肝臓の目的部位の組織を穿刺、吸引して組織採取するための生検針で、先端に刃面311を備えた外針31と、先端に刃先341を備え、前記外針31の内腔と隙間37を有して摺動自在に挿入される内針34、及び吸引手段となる、前記外針31と外針基32を介して接続されるシリンジ33と、該シリンジ33内部に挿着され前記内針34と接続されるプランジャー35より基本構成され、加えて、前記外針基32とシリンジ33の接続を確実にするためシリンジ33先端にはロックリング331を設け、また、プランジャー35にはシリンジ33の内面と確実に密着させるためのゴム弾性を有するガスケット36が設けられる。 Aspiration biopsy needle 3, as a guide lumen of the guide tube 1, the distal end portion is inserted to the hepatic vein, the tissue site of interest the liver puncture in biopsy needle for sucking to tissue collection, the tip an outer needle 31 having a blade surface 311, the tip includes a cutting edge 341, the inner needle 34, and a suction means which is slidably inserted into a lumen and a gap 37 of the outer needle 31, the a syringe 33 which is connected through the outer needle 31 and the outer needle hub 32, is the basic structure from the plunger 35 which is inserted inside the syringe 33 is connected to the inner needle 34, in addition, the outer hub 32 and the lock ring 331 to the syringe 33 tip to ensure the connection of the syringe 33 is provided, also a gasket 36 having a rubber elasticity to be reliably brought into close contact with the inner surface of the syringe 33 is provided on the plunger 35.

図2は、本発明の実施の形態のガイドチューブの構成図で、Aが外筒、Bが内筒を示している。 Figure 2 is a constitutional view of an embodiment of a guide tube of the present invention, A is the outer tube, B indicates the inner cylinder.
外筒11は前記したとおり外筒チューブ111と外筒基112より構成されており、外筒チューブ111は、血管内に挿入することを考慮して血液との滑りがよく安全な可撓性樹脂から選択されるが、本例においては、挿入時のX線に対する視認性も考慮し、造影剤(硫酸バリウム、酸化ビスマス、タングステン、酸化タングステンのような金属または金属酸化物等)を含有したフッ素系樹脂により形成した。 The outer cylinder 11 is composed of an outer sleeve member 111 and the outer cylinder group 112 as described above, the outer cylinder tube 111, slip may secure flexible resin with blood in view of the inserting into a blood vessel fluorine is selected, in this example, even considering visibility of the X-ray at the time of insertion and contained contrast medium (barium sulfate, bismuth oxide, tungsten, metal or metal oxide such as tungsten oxide or the like) from It was formed by a system resin. また、長さは、人体頸部より肝臓までの解剖学的な距離を考慮して400mm以上、700mm以下に設定されるが、本例においては一般的な大人の体型を考慮して550mmとした。 The length is, 400 mm or more in consideration of the anatomical distance to the liver from the body and neck, but is set below 700 mm, it was 550mm in view of the general adult type in this example . また、先端部114は血管内に挿入し易いようにテーパー状に形成し、前記したとおり先端部位の適当位置を湾曲形状に癖付けした湾曲部115を設けて形成した。 The tip portion 114 is tapered so as to be easily inserted into a blood vessel, and formed by providing a curved portion 115 with habit proper position of the distal end portion as described above the curved shape.
内筒12は、内筒管121と内筒管基122、及び内部に逆止弁13を保持する逆止弁キャップ124より構成しており、内筒管121は、ステンレスパイプよりなり、長さは前記外筒11に挿着されたさい先端部126が同じか、あるいは僅かに突出する長さに形成し、先端部は挿入血管内壁を傷つけないように面取りして、前記したとおり先端部位の適当位置を湾曲形状に癖付けした湾曲部127を設けて形成している。 The inner cylinder 12, inner tube 121 and inner tube group 122, and constitutes from check valve cap 124 to hold the check valve 13 therein, inner tube 121 is made of a stainless steel pipe, the length whether the outer tube 11 in inserted has been again tip 126 is the same, or is formed to a length that protrudes slightly, the distal end portion chamfered so as not to damage the insert interior vessel wall, the distal end portion as described above It is formed by providing a curved portion 127 with habit proper position in a curved shape. また、内筒基122は後端部近傍で分岐して側方側を前記造影剤注入チューブ2のチューブ取り付け部125とし、後端部は逆止弁キャップ124の接続部としている。 Further, the inner cylinder group 122 the lateral side and the tube mounting portion 125 of the contrast injection tube 2 branched at near the rear end, the rear end portion has a connecting portion of the check valve cap 124. 逆止弁キャップ124は内部に配置する逆止弁13を保持するキャップで、該逆止弁13を装着して前記内筒基122の後端部とネジ留めにより接続され、端部は吸引生検針3の挿入部として逆止弁13の中心部を露出させるように開口している。 The check valve cap 124 in the cap to retain the check valve 13 disposed therein, is connected by a rear end and screwed in the inner cylinder group 122 by mounting the check valve 13, the end suction raw It is opened to expose the central portion of the check valve 13 as the insertion portion of the needle 3.
逆止弁13は前記内筒基122の後端部と逆止弁キャップ124に挟持されてなる、円形の弾性ゴム(本例においてはシリコンゴム)により形成され、中心部に、血管内に挿入したさいに血液の逆流の心配のない程度の、吸引生検針3挿入のための小さな切れ込みを備えて構成される。 The check valve 13 is held between the rear end and the check valve cap 124 of the inner cylinder group 122, (in this example silicone rubber) circular elastic rubber is formed by, in the center, inserted into a blood vessel configured the Sai degree without fear of backflow of blood, and includes a small slit for suction biopsy needle 3 inserted.
以上の、外筒11及び内筒12を、外筒11内腔に内筒12を挿入し、外筒基112の後端部113のメステーパー部と内筒基122の先端部123のオステーパーで嵌合すると共にロックし一体化させガイドチューブ1として構成している。 Above, the outer cylinder 11 and inner cylinder 12, and insert the inner cylinder 12 into the outer cylinder 11 cavity, the male taper of the distal end portion 123 of the female taper portion and the inner cylinder group 122 of the rear end portion 113 of the outer cylinder group 112 It constitutes a guide tube 1 is locked integrally together in mating.

図3は本発明の吸引生検針の針管先端部分の拡大図を示している。 Figure 3 is an enlarged view of the needle tube tip portion of the suction biopsy needle of the present invention. 吸引生検針3の外針31の先端は組織採取に好適となるように斜め切断した後切断面を面取りして形成された刃面311とし、内針34の先端は穿刺性を考慮して鋭利な円錐状の刃先341として、内針34の刃先341に外針の先端がかからないように内針34を突出して形成される。 The tip of the outer needle 31 of the suction biopsy needle 3 is an edge surface 311 which is formed by chamfering the cut surface was obliquely cut so as to be suitable for tissue sampling, the tip of the inner needle 34 is sharpened considering the puncture resistance such as conical edge 341 is formed to protrude the inner needle 34 so as not the tip of the outer needle cutting edge 341 of the inner needle 34. また、内針34は、外針31の内面と隙間37を有して挿着されており、該隙間が、吸引生検のさいにシリンジ33内の陰圧を針先に伝えるための通路となっている。 The inner needle 34 is inserted has an inner surface with a gap 37 of the outer needle 31, is the gap, a passage for transmitting the Sai aspiration biopsy negative pressure in the syringe 33 to the needle tip going on. 尚、本例においては、外針31の内径0.9mmに対し、内針の外径を0.7mmに設定した。 In the present embodiment, with respect to the inner diameter 0.9mm of the outer needle 31, and set the outer diameter of the inner needle to 0.7 mm.

図4は、本発明の吸引生検針の構成図で、Aが外針及びシリンジ、Bが内針及びプランジャーを示している。 Figure 4 is a constitutional view of a suction biopsy needle of the invention, A is the outer needle and syringe and B show the inner needle and a plunger.
外針31は、前記したように先端に刃面311を形成したステンレスパイプよりなり、長さは、人体頸部より肝臓までの解剖学的な距離を考慮して500mm以上、800mm以下となるが、前記ガイドチューブ1に挿着したさい、該ガイドチューブ先端より50mmから100mm程度突出する長さに設定され、本例においては、一般的な大人の体型を考慮して650mmとし、前記ガイドチューブ1の先端より最大100mm突出可能に形成した。 Outer needle 31 is made of a stainless steel pipe forming the blade surface 311 to the distal end as described above, the length is 500 mm or more in consideration of the anatomical distance to the liver from the body and neck, becomes a 800mm or less the guide again inserted and attached to the tube 1, is set to a length that protrudes approximately 100mm from 50mm from the guide tube tip, in this example, a 650mm by considering the general adult type, the guide tube 1 up to 100mm can project formed from the tip. また、外針31の基端部にはメステーパーが形成された内針基32が設けられ、シリンジ33の先端部となるオステーパーが形成される筒先(図面では見えない)と接続すると共にロックリング331により固定され分離自在に接続される。 The lock with the proximal end portion of the outer needle 31 Uchiharimoto 32 female taper is formed is provided, connected to the cylindrical tip that male taper the tip of the syringe 33 is formed (not visible in the drawings) which is fixed detachably connected by the ring 331. また、本例のシリンジ33は、前記したように先端部には筒先を囲繞してロックリング331を、後端部には、吸引操作のさいに第一指を掛けシリンジ33を押えるためのシリンジキャップ333を設け、更に、該シリンジ33の中途部より後半部の軸対称の位置に、後記するプランジャー35の把持部351の軸352を突出、摺動させるための切り欠け部334(図面では側面に表れる)を、また該切り欠け部334の最後部にはプランジャー35の後退を抑止すると共に一時固定可能な嵌合部332(図面では側面に表れる)を設けて構成している。 Furthermore, syringe 33 of the present embodiment, the lock ring 331 surrounds the cylindrical tip is to the tip as described above, the rear end, a syringe for holding the multiplied syringe 33 a first finger again suction operation the cap 333 is provided, further, the position of the axis of symmetry of the latter half portion from the intermediate portion of the syringe 33, projecting shaft 352 of the grip portion 351 of the plunger 35 to be described later, the notched portion 334 (figures for sliding the appearing side), also the end portion of the 該切 Ri chipping unit 334 in the temporary fixable engagement portion 332 (figures to deter retraction of plunger 35 are configured by providing the appearing side).
内針34は、前記したように先端に刃先341を形成したステンレス棒状体よりなり、前記外針31内腔に挿着されたさいに、外針31より刃先341部が突出する長さに形成され、基端部でガスケット36を取り付けたプランジャー35に接続されている。 The inner needle 34, the tip made of stainless steel rod-shaped body forming the cutting edge 341 to as to please the outer needle 31 lumen is inserted into, formed to a length edge 341 parts from the outer needle 31 protrudes It is, and is connected to the plunger 35 fitted with a gasket 36 at the proximal end. また、本例のプランジャー35は、前記したとおり先端部にシリンジ33の内面に密着して摺動するガスケット36を被覆して設け、後端部には前記シリンジ33に挿着したさい、該シリンジ33の切り欠け部334より突出して、吸引操作のさいに第二指及び第三指を掛けて吸引操作する部位となる把持部351及び両翼となる該把持部351を繋ぐ軸352を設けて構成している。 Further, the plunger 35 of the present embodiment is provided to cover the gasket 36 that slides in close contact with the inner surface of the syringe 33 as the tip portion described above, again in the rear end portion that is inserted into the syringe 33, the protrudes from the cutout 334 of the syringe 33, the second finger and the shaft 352 that connects the gripping portion 351 serving as a grip portion 351 and wings to be sites of sucking operation by multiplying the third finger provided Sai suction operation It is configured.
以上の、外針31及びシリンジ33内に、内針34及びプランジャー35を装着し一体化させ吸引生検針として構成した。 Above, into the outer needle 31 and syringe 33, constructed as a suction biopsy needle is integrated wearing the inner needle 34 and the plunger 35.

ここで、本例の吸引生検針の吸引操作に付き、前記内容をまとめて簡単に説明すると、プランジャー35のガスケット36がシリンジ33の最先端部にある状態から、第二指及び第三指をプランジャーの把持部351に掛け、第一指でシリンジのシリンジキャップ333を押さえ、把持部の軸352をシリンジの切り欠け部334に沿って、該切り欠け部334の嵌合部332まで一気にプランジャー35を後退させ、前記把持部の軸352を前記嵌合部332に嵌合して固定すると、シリンジ33内が吸引真空状態となる。 Here, per suction operation of the suction biopsy needle of this embodiment, when briefly described together the contents, from the state in which the cutting edge portion of the gasket 36 the syringe 33 of the plunger 35, the second finger and third finger the hanging the grasping portion 351 of the plunger, holding the syringe cap 333 of the syringe at the first finger, the shaft 352 of the grip portion along the notch portion 334 of the syringe, once until the fitting portion 332 of 該切 Ri chipping unit 334 the plunger 35 is retracted, the fitted securing the shaft 352 of the grip portion to the fitting portion 332, the syringe 33 is aspirated vacuum. 尚、シリンジ内の陰圧を解除するには、シリンジ33の先端に設けたロックリング331を緩め、外針基32とシリンジ33の筒先とに隙間を設け空気の流通を許容すればよい。 Incidentally, in releasing the negative pressure in the syringe, loosen the locking ring 331 provided at the tip of the syringe 33, it may be allowed to air flow a gap is provided and snout of the outer needle base 32 and the syringe 33.

図5は、吸引生検針の別の形態の外針及び内針の先端部分の吸引操作前後の位置関係を示し、Aが吸引前、Bが吸引後の状態を示している。 Figure 5 shows the suction operation before and after the positional relationship between the outer needle and the tip portion of the inner needle of another form of suction biopsy needle, A is pre-sucking, B indicates a state after the suction.
本例の吸引生検針の内外針は、外針31は絞り部312で先端側が減径されており、内針34の外径は、外針31の減径部314の内腔に摺動可能に密着される径とし、非減径部315においては、該外針31の内面と内針34は隙間を有して挿着され構成されている。 Out needle aspiration biopsy needle of this embodiment, the outer needle 31 are reduced diameter tip side narrowed portion 312, the outer diameter of the inner needle 34 is slidable in the lumen of the reduced diameter portion 314 of the outer needle 31 and diameter into close contact, in the non-necked down portion 315, the inner surface and the inner needle 34 of the outer needle 31 is configured is inserted with a gap.
吸引前(プランジャー35のガスケット36がシリンジ33の最先端部にあるとき)は、前記したとおり、内針34の先端部341は外針31の先端部311より突出した状態となっており、吸引後(プランジャー35を一杯に後退しシリンジ33の嵌合部332に固定されたとき)は、内針34の先端部341は、絞り部312より僅かに後退した位置、即ち、外針31の減径部314を離れ、外針31の内面との間に隙間のある非減径部315に入った部位に位置している。 Before suction (when the gasket 36 of the plunger 35 is in the forefront of the syringe 33), as described above, the distal end portion 341 of the inner needle 34 has become a state of protruding from the distal end 311 of the outer needle 31, after suction (when secured to the fitting portion 332 of the plunger 35 retreats filled syringe 33), the tip portion 341 of the inner needle 34, a position slightly retracted from the aperture 312, i.e., the outer needle 31 leaving the decreased diameter 314 of, and located at a site that has entered the non-necked down portion 315 with a gap between the inner surface of the outer needle 31. よって、外針31の減径部314の長さはプランジャー35の摺動距離よりも5mm程度短く設定される。 Therefore, the length of the reduced diameter portion 314 of the outer needle 31 is about 5mm shorter set than sliding distance of the plunger 35.
これにより、前述されたように吸引前半の陰圧の弱い段階での組織の入り込みによる目詰まりを防止し、吸引後期に一気にシリンジ内の高い陰圧が針先に伝わる構成となっている。 This prevents clogging by entry of tissue at low stages of negative pressure in the first half aspirated as described above, a once high negative pressure within the syringe is transferred to the needle point configuration aspiration late.

以下、本発明の肝臓組織生検器具を用いての経頸静脈的肝生検の方法を説明する。 Hereinafter, a method of transjugular liver biopsy be described with reference to liver tissue biopsy instrument of the present invention. 尚、図6、図7は本説明の中での、図6は、肝静脈へのガイドチューブ挿入段階、図7は、吸引生検針挿着後の目的物穿刺段階を示している。 Incidentally, FIG. 6, 7 of in the present description, FIG. 6, the guide tube insertion step into the hepatic vein, FIG. 7 shows the desired product puncture stage after aspiration biopsy needle insertion.
1. 1. 公知の穿刺針で右内頸静脈4を穿刺し、穿刺針の内腔に公知のガイドワイヤーを挿入し大静脈5内を進め、穿刺針を抜去する。 Puncture the right internal jugular vein 4 in a known puncture needle advances the vena cava 5 to insert the known guide wire lumen of the puncture needle is withdrawn the puncture needle.
2. 2. ガイドワイヤーに公知の先端を湾曲させたカテーテルを被せ挿入していき、肝静脈の分岐部で右肝静脈6を選択し、更に該右肝静脈内に進めておき、該カテーテルをガイドとしガイドワイヤーを右肝静脈6内に挿入し、挿入後カテーテルは抜去する。 Guide wire will insert covered with a catheter is curved known tip, select the right hepatic vein 6 bifurcation of the hepatic vein, and further advance advanced into said right hepatic vein, the catheter guides the guide wire It was inserted into the right hepatic vein 6, after insertion catheter is removed.
3. 3. ガイドワイヤーにガイドチューブ1を被せて右内頸静脈4の刺入部9(穿刺針の穿刺部)から右肝静脈6まで挿入し、挿入後にガイドワイヤーを抜去する。 Guide wire is covered with a guide tube 1 is inserted from the insertion site 9 in the right internal jugular vein 4 (puncture of the puncture needle) to the right hepatic vein 6, is pulled out of the guide wire after insertion. (図6参照) (See Fig. 6)
4. 4. 造影剤注入チューブ2より造影剤を注入して、ガイドチューブ1の右肝静脈6内での正確な位置を把握して肝臓7の目的部8に先端部を近づける。 By injecting a contrast medium from a contrast medium injection tube 2, close the distal end to grasp the exact location of within the right hepatic vein 6 of the guide tube 1 to the object portion 8 of the liver 7.
5. 5. 吸引生検針3をガイドチューブ1の逆止弁13から挿入し、該ガイドチューブ1内腔に沿って先端部まで進める。 Aspiration biopsy needle 3 is inserted from the check valve 13 of the guide tube 1, and advances to the tip along the guide tube 1 lumen.
6. 6. 吸引生検針3を更に進め、ガイドチューブ1の先端より突出させ肝臓7の目的部8に穿刺する。 Further advances aspiration biopsy needle 3 punctures the purpose part 8 of the liver 7 is projected from the distal end of the guide tube 1. (図7参照) (See Figure 7)
7. 7. 前記吸引生検針3の操作で説明したとおり、プランジャーを一気に引き吸引操作を行うと同時に、吸引生検針3を数回前後に往復運動させ組織を採取する。 The As described in the operation of the suction biopsy needle 3, and at the same time performs once pulling the suction operation of the plunger, is reciprocated to obtain a tissue aspiration biopsy needle 3 back and forth several times.
8. 8. 組織採取後、前記したように吸引生検針3のロックリングを緩めて陰圧を解除した後、吸引生検針3及びガイドチューブ1を抜去し、穿刺部の止血を行い、手技を終了する。 After tissue collection, after releasing the negative pressure by loosening the lock ring of the suction biopsy needle 3 as described above, and removing the suction biopsy needle 3 and the guide tube 1, perform hemostasis of puncture, and ends the procedure.

本発明の実施の形態を示す全体構成図 Overall configuration diagram showing an embodiment of the present invention 本発明の実施の形態のガイドチューブ(A外筒、B内筒)を示す構成図 Configuration diagram showing a guide tube of the embodiment of the present invention (A barrel, B inner tube) 本発明の実施の形態の吸引生検針の先端部分を示す拡大図 Enlarged view of the distal portion of the aspiration biopsy needle according to the embodiment of the present invention 本発明の実施の形態の吸引生検針(A外針、B内針)を示す構成図 Diagram illustrating an aspiration biopsy needle embodiment of the present invention (A outer needle, B in needle) 本発明の別の実施の形態の吸引生検針の外針及び内針の位置関係を示す説明図 Explanatory view showing a positional relationship between the outer needle and the inner needle of another embodiment of the aspiration biopsy needle of the invention 本発明の使用方法を説明する模式図(ガイドチューブ挿入段階) Schematic diagram illustrating the use of the present invention (the guide tube insertion step) 本発明の使用方法を説明する模式図(吸引生検針挿着段階) Schematic diagram illustrating the use of the present invention (suction biopsy needle inserted step)

符号の説明 DESCRIPTION OF SYMBOLS

1. 1. ガイドチューブ 11. The guide tube 11. 外筒 111. The outer cylinder 111. 外筒チューブ 112. The outer cylinder tube 112. 外筒基 115. Outer cylinder group 115. 外筒湾曲部 12. Outer tube bending portion 12. 内筒 121. The inner cylinder 121. 内筒管 122. Inner tube 122. 内筒基 124. Inner cylinder group 124. 逆止弁キャップ 125. Check valve cap 125. チューブ取り付け部 127. Tube mounting portion 127. 内筒湾曲部 13. Inner cylinder curved part 13. 逆止弁2. Check valve 2. 造影剤注入チューブ 21. Contrast agent injection tube 21. チューブ 22. Tube 22. チューブ基 24. Tube base 24. 活栓 25. Stopcock 25. ロックリング 3. The lock ring 3. 吸引生検針 31. Aspiration biopsy needle 31. 外針 311. The outer needle 311. 刃面 312. Blade surface 312. 絞り部 Throttle portion
314. 314. 減径部 315. Reduced diameter portion 315. 非減径部 32. Non-reduced diameter portion 32. 外針基 33. The outer needle based on 33. シリンジ 331. Syringe 331. ロックリング 34. The lock ring 34. 内針 341. The inner needle 341. 刃先 35. The cutting edge 35. プランジャー 36. The plunger 36. ガスケット 37. Gasket 37. 隙間 4. Gap 4. 右内頸静脈 5. Right internal jugular vein 5. 大静脈 6. Vena cava 6. 右肝静脈 7. Right hepatic vein 7. 肝臓 8. Liver 8. 目的部 9. The purpose section 9. 刺入部 Penetration

Claims (6)

  1. 頸部頸静脈より挿入し、肝静脈を経由して先端を肝臓に到達させ、肝臓組織を採取するための生検器具であって、 Insert from cervical jugular vein, the distal end through the hepatic veins to reach the liver, a biopsy instrument for collecting liver tissue,
    先端部位を湾曲形状に癖付けし、基端部に逆流防止手段を設けたガイド基を備えた長軸のガイドチューブと、 Attach habit tip portion in a curved shape, and the guide tube the long axis of which includes a guide base having a backflow preventing means to the base end portion,
    前記ガイドチューブのガイド基より分岐して設けられ、端部に逆流防止手段を備えた造影剤注入用チューブと、 Provided branched from the guide base of the guide tube, and contrast medium injection tube provided with a backflow prevention means to an end,
    前記ガイドチューブの内腔に摺動可能かつ先端部より突出可能に挿入される、切断刃を有する外針、該外針に摺動可能に挿入される鋭利な刃先を有する内針、及び外針並びに内針の基端部に設ける吸引手段からなる吸引生検針により構成することを特徴とする肝臓組織生検器具。 The inner needle, and an outer needle having a guide tube can project are inserted from slidably and tip in the lumen of the outer needle having a cutting blade, slidably inserted is sharp cutting edge to said outer needle and liver tissue biopsy instrument, characterized by configuring a suction biopsy needle comprising a suction unit provided in the base end portion of the inner needle.
  2. 前記ガイドチューブはX線不透過な材料または、X線不透過な造影剤を含有する材料より形成される請求項1の肝臓組織生検器具。 The guide tube is X-ray opaque materials or, X-rays opaque liver tissue biopsy instrument of claim 1 formed of a material containing a contrast agent.
  3. 前記ガイドチューブは、可撓性樹脂チューブよりなる外筒、該外筒内腔に挿入される金属管よりなる内筒、及び該外筒及び内筒の基端部に設ける、前記吸引生検針の針管を挿通可能な逆流防止弁及び前記造影剤注入用チューブとの分岐部を備えるガイド基より構成し、前記先端部位を湾曲形状に癖付けすると共に、外筒内腔に内筒を挿着したさい、内筒の先端と外筒の先端がほぼ同じ長さとなるように形成した請求項1乃至2の肝臓組織生検器具。 Wherein the guide tube has an outer tube made of a flexible resin tube, the inner cylinder made of a metal tube that is inserted into the outer cylinder bore, and provided to the proximal end of the outer cylinder and the inner cylinder, the suction biopsy needle the needle tube is composed of the guide group having a branch portion of the insertion can check valve and the contrast injection tube, as well as with habit said distal end portion in a curved shape, and inserting the inner tube into the outer tube lumen Sai, the inner cylinder of the tip and distal end of the outer tube is approximately the same length as the so as to form claims 1 to 2 in liver tissue biopsy instrument.
  4. 前記吸引生検針は、先端に組織を採取するための刃面を備えたステンレスパイプよりなる外針と、該外針の内腔と隙間を有する外径であって、外針に摺動自在に挿入される先端部に刃先を備えたステンレス棒状体の内針と、吸引手段となる、前記外針の基端部に設けるシリンジ、及び、前記内針の基端部に設けるプランジャーより構成した請求項1乃至3の肝臓組織生検器具。 The suction biopsy needle includes an outer needle made of stainless steel pipe having a blade surface for collecting a tissue at the tip, a outer diameter having a lumen and a gap of the outer needle, slidably in the outer needle an inner needle stainless rod-like body having a cutting edge at the distal end to be inserted, the suction means, the syringe is provided to the base end portion of the outer needle, and was composed of a plunger provided on the base end portion of the inner needle liver tissue biopsy instrument of claims 1 to 3.
  5. 前記吸引生検針は、先端に組織を採取するための刃面を備え、先端側が所定の長さ減径されたステンレスパイプよりなる外針と、該外針の減径部の内腔に密着する外径であって、外針に摺動自在に挿入される先端部に刃先を備えたステンレス棒状体の内針と、吸引手段となる、前記外針の基端部に設けるシリンジ、及び、前記内針の基端部に設けるプランジャーより構成し、外針内腔に内針を挿着したさい、プランジャーがシリンジの最先端に位置するときは、内針の先端は外針の先端より突出した位置にあり、プランジャーをいっぱいに引いた状態では、内針の先端は外針の減径部より僅かに後退した非減径部に位置するように形成した請求項1乃至3の肝臓組織生検器具。 The suction biopsy needle is provided with a blade surface for collecting a tissue at the tip, an outer needle tip side is formed of a predetermined stainless steel pipe which is the diameter down the length, in close contact with the lumen of the reduced diameter portion of the outer needle a outer diameter, an inner needle stainless rod-like body having a cutting edge at the distal end which is slidably inserted in the outer needle, and suction means, provided at the proximal end of the outer needle syringe, and the constitute from plunger provided on the base end portion of the inner needle, again inserted and attached to the inner needle to the outer needle lumen, when the plunger is at the forefront of the syringe, the tip of the needle from the tip of the outer needle located projecting position, in a state drawn fill the plunger, the inner needle tip liver of claims 1 to 3 was formed so as to be located in a non-reduced diameter portion which is slightly recessed from the reduced diameter portion of the outer needle tissue biopsy instrument.
  6. 人体頸部より肝臓までの解剖学的な長さに適合して、前記ガイドチューブの有効長は、400mm以上、700mm以下、前記吸引生検針の有効長は、500mm以上、800mm以下である請求項1乃至5の肝臓組織生検器具。 Conform to the anatomical length of from human cervix to the liver, the effective length of the guide tube, 400 mm or more, 700 mm or less, the effective length of the suction biopsy needle is claim 500mm or more and 800mm or less 1 to 5 of the liver tissue biopsy instrument.
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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011096515A1 (en) * 2010-02-05 2011-08-11 オリンパス株式会社 Test device
KR101481732B1 (en) * 2013-04-17 2015-01-12 전북대학교산학협력단 needle for inspecting the tissue of body
EP2994177A4 (en) * 2013-05-10 2017-01-11 Kahn, Sidney Lowell Transjugular intrahepatic portosystemic shunt device
US9907571B2 (en) 2007-09-28 2018-03-06 Vitrolife Sweden Ab Sampling needle

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9907571B2 (en) 2007-09-28 2018-03-06 Vitrolife Sweden Ab Sampling needle
WO2011096515A1 (en) * 2010-02-05 2011-08-11 オリンパス株式会社 Test device
JP5851247B2 (en) * 2010-02-05 2016-02-03 オリンパス株式会社 Inspection tool
KR101481732B1 (en) * 2013-04-17 2015-01-12 전북대학교산학협력단 needle for inspecting the tissue of body
EP2994177A4 (en) * 2013-05-10 2017-01-11 Kahn, Sidney Lowell Transjugular intrahepatic portosystemic shunt device

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