JP2006087747A - Pressurizing and dwelling device and medical catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a pressurizing and dwelling device which supplies a fluid into a tube, retains a pressurized condition, does not leave a structure having a diameter larger than that of a tube applied during dwelling, and facilitates removal of the tube or an endoscope externally inserted. <P>SOLUTION: The pressurizing and dwelling device has a cylindrical body 5 having an outer diameter not larger than that of the tube 3 and a valve 6 stored in the cylindrical body 5 and having an outer periphery brought into hermetical contact with the inner peripheral face 5a of the cylindrical body 5. A slit 6c is formed at the end part on the tube 3 side of the valve 6. The valve 6 is made of an elastic material. A pressurized fluid supply hole 8a at the tip of a pressurized fluid supply member 7 is moved to the tube 3 side beyond the valve 6 to supply the pressurized fluid into the tube 3 for pressurization. After pressurization, the pressurizing fluid supply member 7 is positioned outward of the valve 6 and pressure is retained by hermetically sealing the slit 6c by the pressure of the fluid in the tube 3. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention provides a pressurizing / holding jig and a pressurizing / holding treatment capable of supplying a fluid to pressurize the inside of a medical tube such as a balloon catheter and holding the pressure after pressurizing. More particularly, the present invention relates to a pressurizing / holding jig and a medical catheter having a structure capable of preventing a member having a large diameter from being present during pressure holding.

  Conventionally, various tubes such as a urethral Foley catheter, an embolus removal catheter, a gastric catheter, an endotracheal tube, and a tracheostomy tube have been used in medical applications.

  In recent years, an expansion procedure using a balloon catheter has been performed while observing with an endoscope using an endoscope.

  The balloon catheter has a catheter that is mainly a tube and a balloon provided in the vicinity of one end of the catheter, and an end of the catheter opposite to the balloon has an open end so that fluid can be press-fitted. In use, this balloon catheter is inserted into a forceps channel of an elongated endoscope, for example. In this case, the balloon catheter is inserted into the forceps channel of the endoscope with the balloon catheter end on the side where the balloon is provided at the head. Through the forceps channel of the endoscope, the balloon is made to reach a stenosis part, an obstruction part or the like to be treated. Next, fluid is pressed into the balloon catheter from the open end of the balloon catheter, and the balloon is expanded by the pressure of the fluid. By expanding the balloon, the narrowed portion, the closed portion, etc. into which the balloon is inserted are expanded. In such a state, treatment for a stenosis part, a blockage part, etc. is performed. Therefore, the expanded state of the balloon needs to be maintained during the treatment.

  In order to maintain the expansion of the balloon, that is, for holding pressure, a method of sealing the open end of the balloon catheter with a rubber stopper has been proposed. Furthermore, various valve structures have been proposed that enable pressure retention by sealing the open end of a tube such as a balloon catheter.

For example, Patent Document 1 below discloses a medical one-way valve provided with an annular elastic portion that engages and locks with a valve body and a resilient portion that biases the valve body toward the annular elastic portion. ing. This medical one-way valve is configured such that the valve main body contact surface is in close contact with the contact surface of the annular elastic portion, and can hold pressure under a wide range of pressures.
JP 2002-113100 A

  However, depending on the treatment method, a tube or sheath may be provided on the outer periphery of the balloon catheter, and the outer tube or sheath may be removed while maintaining the expanded state of the balloon catheter. In addition, even when performing an expansion procedure using a balloon catheter using an endoscope, the balloon is expanded after reaching the treatment target site through the forceps channel of the endoscope inserted into the body, and then the balloon It is also possible to remove the outer endoscope while keeping the balloon catheter inserted into the body while maintaining the expanded state. As an endoscope, a forceps channel having a diameter of 2.8 mm is generally used although it depends on a use site.

In this case, when a valve structure as described in Patent Document 1 is attached to the open end of the balloon catheter and an endoscope having a diameter of the outer tube, sheath, or forceps channel of φ2.8 mm is used, There is a problem that the outer diameter of the valve structure becomes larger than the diameter, and the tube, sheath, or endoscope that has been extrapolated while the balloon catheter remains in the body cannot be removed.

  In the above case, if the outer tube or sheath and the forceps channel of the endoscope have a diameter that allows the valve structure to pass through, the tube or sheath that has been extrapolated while leaving the balloon catheter inside the body. Or, the endoscope can be removed, but since the outer diameter of the extrapolation tube or sheath, or the endoscope becomes large, there is a problem that the patient is suffered or the treatment itself becomes difficult. there were.

  On the other hand, a method of pressing the fluid into the balloon catheter by sealing the opening end of the balloon catheter in advance using a rubber stopper and inserting the syringe needle into the rubber stopper is also conceivable. There was a problem that workability and safety were lowered.

  An object of the present invention is to allow a fluid to be supplied and pressurized in a tube, in particular, a medical tube such as a catheter in a balloon catheter in view of the above-described state of the prior art, and the pressurized state can be maintained. In addition, a member having a large diameter can be prevented from being present at the time of holding pressure, and therefore, a pressurizing / holding jig having a structure that makes it possible to easily remove an extrapolated endoscope or the like, and a pressurizing jig. An object of the present invention is to provide a medical catheter to which a pressure / holding jig is attached.

  The pressurizing / holding jig according to the present invention supplies a pressurizing fluid into the tube to pressurize the inside of the tube and maintain the pressure in the tube after pressurizing. A tubular body that is airtightly attached to one end of a tube to be applied, and an outer peripheral surface that is made of an elastic material and is hermetically pressed against the inner peripheral surface of the tubular body, A valve body that is closed at a side end, that is open at an end opposite to the tube side, and that has a slit formed at the tube side end, and the tube side end of the tubular body And a pressurizing fluid supply hole at the tip, and a hollow flow passage connected to the pressurization fluid supply hole, and the flow passage is formed outside the cylindrical body. The pressurizing fluid is supplied outside the cylindrical body. A pressurizing fluid supply member configured to obtain, and a pressurization operation state in which the pressurization fluid supply hole of the pressurization fluid supply member is positioned on the tube side beyond the slit of the valve body; The pressurizing fluid supply member is disposed in the lengthwise direction of the tubular body in the tubular body between the pressure retaining fluid supply hole positioned on the opposite side of the tube from the slit of the valve body. It is comprised so that it can be moved to.

  In a specific aspect of the pressurizing / holding jig according to the present invention, the pressurizing fluid supply member is fixed to a valve opening / closing member provided at a tip, and an end of the valve opening / closing member opposite to the tube. And an airtight sealing member having an outer peripheral surface portion that is airtightly adhered to the inner peripheral surface of the cylindrical body, the hollow flow path reaching the airtight sealing member, and A hermetic sealing member is extended to the outside of the cylindrical body.

  In still another specific aspect of the pressurizing / holding jig according to the present invention, the tube is a catheter of a medical balloon catheter, and the pressurizing / holding jig for the balloon catheter.

  The medical catheter according to the present invention is characterized in that a pressurizing / holding jig configured according to the present invention is attached to an end of a medical catheter as a tube.

Examples of the medical catheter according to the present invention can include various catheters,
An example is a balloon catheter.

  In the pressurizing / holding jig according to the present invention, a cylindrical body is hermetically attached to one end of a tube to be applied, and the cylindrical body has an outer diameter according to a desired diameter at the time of holding pressure. Can be adjusted as appropriate, and the outer diameter of the applied tube can be made equal to or smaller than the outer diameter. For example, when applied to a medical catheter, the outer diameter of the cylindrical body is less than the inner diameter of the tube or sheath provided on the outer periphery, or less than the inner diameter of the forceps channel of the endoscope. The tubular body has an outer peripheral surface pressed against the inner peripheral surface of the cylindrical body and contains a valve body made of an elastic material, and a slit is formed at the tube side end of the valve body. Has been. Therefore, when the pressurizing fluid supply member is inserted into the cylindrical body and the tip of the pressurization fluid supply member is moved so as to be positioned on the tube side beyond the slit of the valve body, the pressurization fluid supply member The fluid supply hole is located in the tube inside the valve body. Therefore, if the pressurizing fluid is supplied from the pressurizing fluid supply member in this state, the inside of the tube is pressurized.

  After that, after the inside of the tube is pressurized to a predetermined pressure, the pressurizing fluid supply member is pulled back, and the pressurization fluid supply hole at the tip of the pressurization fluid supply member is placed outside the slit of the valve body. Move. In this state, since the inside of the tube is pressurized, the slit of the valve body is hermetically sealed by the pressure. Therefore, the inside of the tube is maintained at a predetermined pressure.

  In the pressurizing / holding jig according to the present invention, the inside of the tube can be held by the valve body which is a very small member, so the diameter of the cylindrical body containing the valve body is reduced. In other words, the diameter of the cylindrical body can be designed according to the desired diameter during holding.

  Therefore, when the tube is inserted into an extracorporeal tube such as a long endoscope and inserted into the body, the diameter of the cylindrical body should be less than the inner diameter of the extrapolated tube such as an endoscope. Thus, it is possible to easily remove the extrapolation tube such as an endoscope from the end of the tube while the pressure-holding tube remains.

  The pressurizing fluid supply member is fixed to a valve opening / closing member provided at the tip of the pressurizing fluid supply member, and an end of the valve opening / closing member opposite to the tube, and the inside of the cylindrical body A hermetic sealing member having an outer peripheral surface portion hermetically adhered to the peripheral surface, the hollow flow path reaching the hermetic sealing member, and the hermetic sealing member extending to the outside of the cylindrical body In this case, the pressurizing fluid can be reliably supplied into the tube from the hollow flow path of the pressurizing fluid supply member. Further, when pressurizing the inside of the tube by the pressurizing fluid supply member, the pressurizing fluid hardly leaks from the cylindrical body to the outside. Moreover, the portion of the pressurizing fluid supply member that extends outside the cylindrical body is connected to a tube or the like connected to a syringe or pump so that the pressurization fluid can be easily transferred into the pressurization fluid supply member. Can lead to.

  When the tube is a medical balloon catheter, according to the present invention, the balloon of the balloon catheter can be expanded by pressurization to ensure the expanded state. In addition, even when performing an expansion procedure using a balloon catheter using an endoscope, it is possible to hold the balloon expansion at a stenosis portion, an occlusion portion, etc., and to remove the endoscope while the balloon catheter is inserted. .

Further, in the medical catheter in which the pressurizing / holding jig according to the present invention is attached to the end, the medical catheter is inserted into an extrapolation tube such as a long endoscope as described above. Thus, when inserted into the body or the like, an extrapolation tube such as an endoscope can be easily removed while the medical catheter remains. In particular, when the medical catheter is a balloon catheter, the balloon is reliably inflated using the pressurizing / holding jig,
The expanded state can be reliably held.

  Hereinafter, the present invention will be clarified by describing specific embodiments of the present invention with reference to the drawings.

  FIGS. 1A and 1B are a front view showing a balloon catheter to which a pressurizing / holding jig 2 according to an embodiment of the present invention is attached, and a partially cutaway front sectional view showing an essential part thereof. .

  As shown in FIG. 1 (a), a pressurizing / holding jig 2 according to this embodiment is attached to a balloon catheter 1. The balloon catheter 1 has a catheter 3 and a balloon 4 attached in the vicinity of the inner end 3 a of the catheter 3.

  The pressurizing / holding jig 2 has a cylindrical tubular body 5. The outer diameter of the cylindrical body 5 is made equal to the outer diameter of the catheter 3. In addition, the outer side of the cylindrical body 5 may be smaller than the outer diameter of the catheter 3, and may be larger than the outer diameter of the catheter 3 as long as the effect of the present invention is not impaired. In the present embodiment, the vicinity of the end 3b opposite to the side on which the balloon 4 of the catheter 3 is provided is the thin portion 3c. That is, the outer diameter of the thin-walled portion 3c is made smaller than the remaining portion of the catheter 3 so as to be thin. And the cylindrical body 5 is extrapolated and airtightly joined to this thin part 3b. Therefore, a step due to the end portion 3a is formed on the inner peripheral surface of the cylindrical body 5 due to the presence of the thin portion 3b.

  The cylindrical body 5 can be made of an appropriate material such as synthetic resin or metal. However, it is desirable that the cylindrical body 5 is made of a material having shape retention. When having shape retention, the movement of the valve body 6 and the pressurizing fluid supply member 7 described later can be performed stably.

  A valve body 6 is accommodated in the cylindrical body 5. The valve body 6 is made of an elastic material such as rubber or elastomer. The valve body 6 has a substantially cylindrical tubular portion 6a. The cylindrical part 6a is closed at the end on the tube 3 side, and the closed part has a substantially hemispherical shape. In this embodiment, as shown in FIG. 2, a cross-shaped slit is formed in the hemispherical tip 6b when viewed from the tip. The slit 6 c penetrates the valve body 6.

  On the other hand, the outer peripheral surface of the cylindrical part 6 a is in airtight pressure contact with the inner peripheral surface of the cylindrical body 5. On the other hand, when the inside of the tube 3 is pressurized as will be described later, the slit 6c is closed by the applied pressure and is configured to hermetically separate both sides of the valve body 6.

  The slit 6c is configured to be expanded by the tip of a pressurizing fluid supply member 7 described later. The pressurizing fluid supply member 7 has a valve opening / closing member 8 having a relatively small diameter. A pressurizing fluid supply hole 8 a is provided at the tip of the valve opening / closing member 8. Further, the end 8 b side opposite to the pressurizing fluid supply hole 8 a is press-fitted into the hollow flow path 9 a of the hermetic sealing member 9 having a diameter larger than that of the valve opening / closing member 8 and is hermetically fixed. The pressurizing fluid supply hole 8 a is connected to the hollow flow path 9 a through a flow path 8 c in the valve opening / closing member 8.

  The pressurizing fluid supply member 7 is movable in the length direction of the cylindrical body 5 in the cylindrical body 5. More specifically, a pressurizing operation state in which the pressurizing fluid supply hole 8a of the pressurizing fluid supply member 7 is positioned on the tube 3 side beyond the slit 6c of the valve body 6, and the slit 6c of the valve body 6 Also, the pressurizing fluid supply member can be moved between the pressure holding state in which the pressurizing fluid supply hole 8a is positioned on the opposite side to the tube 3.

As shown in FIG. 1A, the outer end of the hermetic sealing member 9 is connected to a connector 10 having a relatively large diameter. The connector 10 is configured such that a tip of a syringe (not shown) is press-fitted. That is, it is possible to press-fit a pressurizing gas or liquid from the syringe through the connector 10 into the pressurizing fluid supply member 7. The valve opening / closing member 8 and the hermetic sealing member 9 can be made of an appropriate material such as synthetic resin or metal.

  Next, an operation method using the balloon catheter 10 provided with the pressurizing / holding jig 1 of the present embodiment will be described. In the initial state, as shown in FIGS. 1A and 1B, the pressurization fluid supply hole 8 a of the pressurization fluid supply member 7 at the tip of the pressurization fluid supply member is positioned outside the valve body 6. Yes.

  In this state, the balloon catheter 10 is inserted into a catheter insertion channel of an endoscope, for example, and positioned at a predetermined position in the balloon 4. Then, the pressurizing fluid supply member 7 is moved to the tube 3 side as indicated by the arrow in FIG. Then, as shown in FIG. 3, the pressurizing fluid supply member 7 is moved so as to be positioned on the tube 3 side beyond the slit 6c. The slit 6 c is expanded by the valve opening / closing member 8, and the pressurizing fluid supply hole 8 a at the tip of the valve opening / closing member 8 is positioned closer to the tube 3 than the valve body 6. This state is a pressurizing operation state. In the pressurizing operation state, the inside of the tube 3 is connected to the flow paths 8 c and 9 a of the pressurizing fluid supply member 7. In this state, since the valve body 6 is made of an elastic material, the outer peripheral surface of the valve opening / closing member 8 moved by expanding the slit 6c and the valve body 6 are in airtight contact. Therefore, a state where the one side and the other side of the valve body 6 are hermetically separated is ensured.

  The tip of the syringe is inserted into the connector 10 described above, and a pressurizing gas or fluid is press-fitted. The pressurizing fluid is supplied into the tube 3 from the pressurizing fluid supply hole 8a. Then, the inside of the tube 3 is pressurized with a pressurizing fluid, and the balloon 4 at the tip of the balloon catheter 10 is inflated. After the balloon 4 is inflated to a sufficient size and is in close contact with the inner peripheral surface of the body cavity, the pressurizing fluid supply member 7 is moved outside the valve body 6. That is, the slit 6c of the valve body 6 is hermetically closed by returning the pressurizing fluid supply hole 8a to the outside of the valve body 6, that is, returning to the initial state shown in FIG. This state is a pressure holding state. In the pressure-holding state, pressure is applied to the hemispherical portion 6b of the valve body 6 by the pressure in the tube 3, and the cross-shaped slit 6c is reliably hermetically sealed, so that the pressurized state is maintained.

  Next, the pressurizing fluid supply member 7 may be pulled out from the cylindrical body 5 as necessary. As shown in FIG. 4, in this pressure holding state, there is no member having a larger diameter than the cylindrical body 5 at the end of the tube 3. Therefore, by making the outer diameter of the cylindrical body 5 smaller than the inner diameter of the extrapolation tube 11, the extrapolation tube 11 that is extrapolated such as an endoscope can be easily removed while maintaining the pressure-holding state. be able to.

  In the pressure-holding state, the pressurizing fluid supply member 7 does not necessarily have to be pulled out from the cylindrical body 5, but it is easy to remove other extraneous members such as an endoscope. For this purpose, it is desirable to remove the pressurizing fluid supply member 7.

  Further, when pulling out the balloon catheter from the body cavity, the balloon 4 needs to be reduced. In this case, the pressurizing fluid supply hole 8a of the pressurizing fluid supply member 7 is moved again to the tube 3 side beyond the slit 6c of the valve body 6, and in this state, the connector 10 may be released to the atmosphere. . As a result, the internal pressurizing fluid flows backward to the pressurizing fluid supply member 7 side, and the pressure in the tube 3 is lowered. Accordingly, the balloon 4 is deflated. Therefore, the balloon catheter can be easily pulled out from the body cavity.

In the present embodiment, the valve body 6 is provided with a cross-shaped slit 6c as viewed from the front end. However, the valve body 6 is not limited to the cross shape, and an appropriate slit such as an I-shape can be formed. .

  Moreover, in the said embodiment, the level | step difference was provided inside the cylindrical body 5 by presence of the edge part 3a. Therefore, the valve body 6 is not easily moved to the tube 3 side by the step. But when the valve body 6 and the outer peripheral surface are being fixed to the cylindrical body 5, the said level | step difference does not necessarily need to be provided. Therefore, the outer peripheral surface of the cylindrical portion 6a of the valve body 6 may be fixed to the inner peripheral surface of the cylindrical body 5 by adhesion or welding. Further, the hermetic sealing portion 9 is not necessarily provided, and the valve opening / closing member 8 may be further extended to the outside of the cylindrical body 5. The connector 10 may be connected to the outer end of the valve opening / closing member 8.

  However, the use of the hermetic sealing member 9 makes it difficult for the pressurizing fluid to leak outside during the pressurizing operation.

  Further, the connector 10 is not limited to one having a structure in which the tip of the syringe is press-fitted, and may be a structure to which a pressurizing tube connected to a pump is connected.

  Furthermore, although the example applied to the balloon catheter was shown in the above embodiment, the pressurizing / holding jig according to the present invention may be used for a medical catheter other than the balloon catheter, and a tube other than the medical catheter may be used. The pressurizing / holding jig according to the present invention may be used.

(A) is a front view showing a balloon catheter to which a pressurizing / holding jig according to an embodiment of the present invention is attached, and (b) is a pressurizing / holding jig attached to the balloon catheter. FIG. The figure which shows the valve body used for the pressurization and pressure holding jig of one Embodiment of this invention. The partial notch front sectional drawing which expands and shows the principal part of the pressurization and pressure holding jig which concerns on one Embodiment of this invention. The partial notch front sectional drawing for demonstrating the process of extracting the member currently inserted in the state which pressure-holds the inside of a catheter with the pressurization and pressure holding jig of one Embodiment of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Balloon catheter 2 ... Pressurization and pressure holding jig 3 ... Catheter 3a ... End part 3b ... Thin part 4 ... Balloon 5 ... Cylindrical body 5a ... Inner peripheral surface 6 ... Valve body 6a ... Cylindrical part 6b ... Hemispherical part 6c ... Slit 7 ... Pressure fluid supply member 8 ... Valve opening / closing member 8a ... Pressure fluid supply hole 8b ... End 8c ... Channel 9 ... Airtight sealing member 9a ... Channel 10 ... Connector 11 ... Extra tube

Claims (5)

A pressurizing / holding jig that supplies a pressurizing fluid into the tube to pressurize the tube and maintain the pressure in the tube after pressurization,
A cylindrical body that is airtightly attached to one end of the applied tube;
It is made of an elastic material, has an outer peripheral surface that is airtightly pressed against the inner peripheral surface of the cylindrical body, is closed at the tube side end, and an end opposite to the tube side is opened. A valve body in which a slit is formed at the tube side end,
The cylindrical body is inserted from the end opposite to the tube-side end, has a pressurizing fluid supply hole at the tip, and has a hollow flow channel connected to the pressurization fluid supply hole. A pressurizing fluid supply member configured so that a path reaches the outside of the cylindrical body, and a pressurizing fluid can be supplied outside the cylindrical body,
The pressurization fluid supply hole of the pressurization fluid supply member is positioned on the tube side beyond the slit of the valve body, and the pressurization operation state is on the opposite side of the tube from the slit of the valve body. The pressurizing fluid supply member is configured to be movable in the lengthwise direction of the tubular body in the tubular body between the pressure holding state where the pressure fluid supply hole is located, Pressurizing / holding jig.   The pressurizing fluid supply member is fixed to the valve opening / closing member provided at the tip, and the end of the valve opening / closing member opposite to the tube, and tightly adhered to the inner peripheral surface of the cylindrical body A hermetic sealing member having an outer peripheral surface portion, wherein the hollow flow path extends into the hermetic sealing member, and the hermetic sealing member is extended to the outside of the cylindrical body. Item 2. The pressurizing / holding jig according to Item 1.   The pressurizing / holding jig according to claim 1 or 2, wherein the tube is a catheter of a medical balloon catheter, and is a pressurizing / holding jig for the balloon catheter.   A medical catheter, wherein the pressurizing / holding jig according to any one of claims 1 to 3 is attached to an end of a medical catheter as a tube. The medical catheter according to claim 4, wherein the medical catheter is a balloon catheter.

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