JP2006218334A - Esophageal fistula button - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an esophageal fistula button which is a medical implement to safely and reliably secure a route for discharge of body fluid and infusion of drug solution, nutrients, etc., in particular which enables a fistula created in the esophagus to be safely formed and maintained and discomfort feeling of a patient to be reduced. <P>SOLUTION: The esophageal fistula button includes a flange part at the rear end of a leading edge-rounded shaft part, wherein a cover to cover the flange part is formed of one piece with the flange part and a cap part to block the inner cavity of the shaft part is provided on the cover. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a medical device for ensuring a safe and reliable route for discharging body fluids and injecting medicinal solutions / nutrients, and in particular, it is possible to form and maintain a fistula built in the esophagus. Concerning the esophageal heel button

  2. Description of the Related Art Conventionally, as a method for enteral nutrition administration, percutaneous endoscopic gastrostomy, which is one of endoscopic operations for forming a fistula in the stomach cavity and the skin surface of the abdominal wall using an endoscope. In 1979, pediatric surgeon Gaudert and endoscopic surgeon Ponsky developed (PEG 6-503243), and several techniques using this procedure were developed and are becoming widespread. . However, because it punctures the stomach wall / abdominal wall, it cannot be used in cases such as “cases with a large amount of ascites”, “cases where the liver and transverse colon are between the stomach and the abdominal wall”, and “patients with a history of gastric surgery”. It was difficult.

  In addition, there is a method of placing the tube nasally in the stomach, but in the long-term placement, pain in the nostril, nasal cavity, pharynx becomes strong, ulcers may be formed in the nostril, and continuous placement may be difficult, Furthermore, pneumonia may even occur due to difficulty in sputum discharge. These are not preferable from the viewpoint of QOL.

  On the other hand, the inventors of the present invention are able to ensure a safe and reliable route for fluid drainage and medicinal solution / nutrient injection etc. esophagus to overcome the above-mentioned problems of PEG and nasal tube. Japanese Patent Application No. 10-17994 has proposed an invention of a medical tube introduction tool and a method of using the same. However, in the above invention, there is no detailed description of the indwelling tube, and when a currently used tube is used, it is necessary to use a long tube, so that the portion protruding outside the body becomes long. However, it is troublesome for a patient who needs long-term indwelling, and in some cases, the tube may be intentionally pulled out by the patient himself.

  As a method for preventing such a problem caused by the length of the portion protruding outward from the body, a medical device composed of a mushroom-like or hemispherical member that reduces the protrusion and fixes it inside the body. It has been proposed (US Pat. Nos. 5,549,657, 4,863,438, etc.). However, when the proposed device is placed in the esophagus, there is a problem that the fixed part is bulky at the esophagus entrance and the oral intake becomes difficult.

On the other hand, when left in place for a long time, it is effective to use a soft material for the shaft part to avoid excessive load on the body tissue. It was also necessary at the same time. In addition, the formation angle of the neck structure and the fistula may be different for each patient, and if the angle formed by the shaft portion and the flange portion is fixed, a load may be applied to the body tissue. Furthermore, when connecting a catheter for infusion, etc., it is necessary to ensure the airtightness of the connection and reliable fixation. In addition, some patients repeatedly repeat vomiting after injecting a nutrient into the stomach. In such patients, it is necessary to insert the tip of the shaft portion up to the small intestine. The operation is not easy, and it takes time to place the tube, and there is a problem that it imposes a mental and physical burden on the operator and the patient.
Japanese National Patent Publication No. 6-503243 US Pat. No. 5,549,657 U.S. Pat. No. 4,863,438

  The present invention has been made in view of the above-mentioned circumstances, and the object of the present invention relates to a medical device for ensuring a safe and reliable route such as body fluid discharge and medicinal solution / nutrient injection. An object of the present invention is to provide an esophageal fistula button that can safely form and maintain a fistula built in the esophagus and reduce the discomfort of a patient.

  The structure of the present invention made for the purpose of solving the above-mentioned problem is that the cover for covering the flange portion is provided in the esophageal trowel button in which the flange portion is provided at the rear end of the shaft portion whose tip is rounded. And a cap portion for closing the inner cavity of the shaft portion is attached to the cover.

  Another configuration of the present invention, which has been made for the purpose of solving the above-mentioned problems, is an esophageal trowel button in which a flange portion is provided at the rear end of the shaft portion whose tip is rounded. The insertion portion of the connector inserted into the rear end is clamped by a split-type fixing flange and fixed to the rear end of the shaft portion.

  According to the esophageal fistula button of the present invention, the cover that covers the flange portion is integrally formed with the flange portion, and the cap portion that closes the lumen of the shaft portion is attached to the cover, whereby the airtightness of the lumen is increased. The effect that it can raise and maintain it is acquired. Further, even when the flange portion is retrofitted to the shaft portion, the insertion portion of the connector inserted into the rear end of the shaft portion is sandwiched by the split-type fixing flange and fixed to the rear end of the shaft portion. Therefore, the shaft portion is not pulled into the body due to the contraction movement of the esophagus or stomach (or intestine), and the effect of high safety is obtained.

  Hereinafter, the present invention will be specifically described with reference to the drawings. 1 is a perspective view of a first reference example of an esophageal heel button, FIG. 2 is a perspective view of a second reference example of the esophageal heel button, and FIG. 3 is a flange portion of the first example of the esophageal heel button of the present invention. FIG. 4 is a perspective view schematically showing the structure of the flange portion in the second example of the esophageal heel button of the present invention, and FIG. 5 is in the second reference example of the esophageal heel button. FIG. 6 is a cross-sectional view of the esophageal trowel button of FIG. 5, FIG. 7 is a perspective view of another example of the check valve, and FIG. 8 is the esophageal trowel button of the first reference example and its FIG. 9 is a schematic diagram showing an indwelling state, FIG. 9 is a schematic diagram showing an esophageal fistula button of the second reference example and its indwelling state, FIG. 10 is a schematic diagram showing an example of inserting the esophageal fistula button of the present invention, and FIG. Fig. 12 is a schematic view showing another example of inserting the esophageal erosion button of the present invention, and Fig. 12 shows an example of the detention state of the esophageal erosion button of the present invention. FIG. 13 is a schematic view, FIG. 13 is a sectional view showing an example of a detachable stylet applied to an example of an esophageal heel button to which the present invention is applied, and an insertion state thereof, and FIG. It is a figure which shows an example, (a) is the perspective view, (b) is the fragmentary longitudinal cross-sectional view of FIG. 14 (a), FIG. 15 shows the flange part of the three examples of the esophageal fistula button which applied this invention. 15A is a perspective view thereof, FIG. 15B is a partial longitudinal sectional view of FIG. 15A, FIG. 15C is a front view showing a state in which the cap is closed, and FIG. FIG. 16 is a front view showing an example of a connection tube connector applied to the flange part of a), FIG. 16 is a schematic side view showing a tip part of a shaft part in an esophageal fistula button to which the present invention is applied, and FIG. Schematic diagram showing a first example of a weight attached to the tip of the shaft, (b) is attached to the tip of the shaft. FIG. 17C is a cross-sectional view of FIG. 16B, and FIG. 17 is a schematic side view showing another example of the tip of the shaft portion of the esophageal fistula button to which the present invention is applied. FIG. 18 is a schematic side view of an esophageal sputum button to which the present invention is applied.

  As shown in FIG. 1, the first reference example of the esophageal heel button includes a shaft portion (1) and a substantially disc-shaped flange portion (2) provided at the rear end (upper portion in the drawing). . The shaft portion (1) is cylindrical in appearance, and the tip (lower portion in the figure) is rounded to prevent damage to the esophageal mucosa. The shaft portion (1) is formed with a length suitable for the patient's physique to ensure that the tip is positioned within the esophagus, and the thickness of the shaft portion (1) facilitates the maintenance of the fistula and the insertion and removal of buttons and catheters. Therefore, it is desirable to be equivalent to a catheter for injecting nutrients or chemicals. Furthermore, it has moderate flexibility and elasticity at normal room temperature and body temperature, and as a material for forming it, synthetic resins such as soft vinyl chloride resins, polyurethane resins, polyamide resins or their elastomers, silicone rubber, etc. are usually used. Although used suitably, it is not limited to these. Moreover, you may provide contrast property for the position confirmation in a body.

The esophageal heel button illustrated in FIG. 2 as a second reference example includes a shaft portion (1), a flange portion (2), and a cap portion (3). In the example of FIG. 2, the shaft portion (1) is cylindrical, and a guide wire or a tube for infusion is inserted, so that a lumen (1a) penetrating from the rear end to the tip is formed in the shaft portion (1). Has been. As in the case of FIG. 1, it is desirable that the length suitable for the patient's physique and that the tube inserted into the esophageal fistula button be formed with a thickness that allows easy insertion and removal.
On the other hand, in the case of the second reference example in FIG. 2, it is possible to inject a nutrient or a chemical solution directly into the stomach (or intestine). In that case, as shown in FIG. 12, it is necessary to place the tip of the shaft portion (1) at an appropriate position with respect to the stomach (or intestine). For this purpose, the shaft portion (1) is previously removed from the fistula to the stomach. (Or intestine) is adjusted to the length or formed, or the shaft portion (1) is placed in a predetermined position, then cut to a desired length, and the flange portion (2) is placed behind the shaft portion (1). Fit to the end. This shaft portion (1) also has moderate flexibility and elasticity at normal room temperature and body temperature, and as its forming material, synthetic resins such as soft vinyl chloride resin, polyurethane resin, polyamide resin and their resins are usually used. Materials such as elastomer and silicone rubber are preferably used, but are not limited thereto. In addition, when inserting or removing an infusion tube or guide wire, in order to keep the resistance low, a forming material impregnated with a lubricant such as silicone oil is used, or the inner surface of the shaft (1). May be subjected to a hydrophilic treatment.

  The flange part (2) in the esophageal fistula button described above needs appropriate flexibility because it directly contacts the skin. On the other hand, moderate hardness is also required to prevent the shaft portion (1) from being drawn into the body due to contraction of the esophagus or stomach (or intestine). Therefore, the material for forming the flange portion (2) is preferably a soft vinyl chloride resin, a polyurethane resin, a polyamide resin, or an elastomer or silicone rubber thereof. Further, these materials are made to have an appropriate size and thickness. By setting, it becomes possible to obtain good flexibility and hardness.

  Regarding the above points, as in the examples shown in FIGS. 14B and 15B, the internal hard material (2h) is integrated with the soft material (2s) to form the flange portion (2). The same effect as described above can be obtained by covering the surface. In this case, since chemicals and nutrients come into contact with the hard material, a material exhibiting chemical resistance and nutrient resistance (for example, fat emulsion) is required. Polyvinyl chloride resin, polyurethane resin, polyamide resin, polyether sulfone resin, and the like are preferable. Moreover, as a soft material (2s), since moderate softness | flexibility is required as above-mentioned, a soft vinyl chloride resin, a polyurethane resin, a polyamide resin or those elastomers, silicone rubber, etc. are suitable.

  The esophageal fistula button having the lumen (1a) as shown in FIG. 2 has a cap portion (3) attached to the flange portion (2) in order to maintain airtightness. The cap part (3) is formed integrally with the flange part (2), or integrated with a cover (5) covering the flange part (2) as in the example of the esophageal heel button of the present invention shown in FIG. It may be molded. The shape of the cap portion (3) is not particularly limited, but in order to prevent the patient from opening unexpectedly, for example, a curved surface shape such as a substantially dome shape as shown in FIG. A structure in which a nail or the like is not easily caught is preferable. In addition, since the esophageal fistula button (9) of the present invention in the indwelling state as shown in FIG. 12 may be fixed to the patient by one-needle stitching, as shown in FIG. 2 and FIG. An appropriate number of small holes (10) may be provided in the vicinity of the outer peripheral portion of the cover (5). Further, a slit (20) as shown in FIGS. 14 (a) and 14 (b) and FIGS. 15 (a) and 15 (b), for example, is provided so that the band can be fixed by a wide band instead of the suture fixing. May be.

  In the present invention, the shaft portion (1) and the flange portion (2) are joined by means of integral molding, adhesion, fitting, etc., but the esophageal trowel button (9) of the present invention adopting the use mode illustrated in FIG. ), When the flange portion (2) is retrofitted to the shaft portion (1), in order to prevent the shaft portion (1) from being pulled into the body due to contraction movement of the esophagus or stomach (or intestine), for example, As shown in FIG. 4 as two examples of the esophageal fistula button of the present invention, after inserting the connector (14) at the rear end of the shaft portion (1), the shaft portion (1) is separated by a split-type fixing flange (15). ) And the connector (14) must be securely fixed. In this case, the connector (14) and the fixing flange (15) are made of a hard material because the soft shaft portion (1) is sandwiched and fixed between the connector (14) and the fixing flange (15). For example, polyvinyl chloride resin, polysulfone resin, acrylic resin, ABS resin, polymethylpentene resin, polyamide resin, polyurethane resin, polyester resin, and polymer alloys thereof are preferable.

  Next, the backflow prevention valve (4) illustrated in FIG. 6 attached near the flange portion (2) will be described. This backflow prevention valve (4) is attached in order to prevent the contents in the body from leaking out. The shape, structure, and material are not particularly specified, but it is necessary to smoothly insert and remove the tube, ensure airtightness when the tube is not inserted, and eliminate the bulk as much as possible. is there. For this reason, in the present invention, as shown in FIGS. 5 and 6, a flat plate structure having elasticity with a cross cut (4a) or a duckbill type as shown in FIG. 7 is preferable. As the forming material, thermoplastic elastomer, silicone rubber and the like are suitable.

  The esophageal fistula button to which the present invention is applied is placed in accordance with the situation of the neck of any patient, so that the bulk outside the body is suppressed and the angle of the shaft portion (1) and the flange portion (2) is changed. A possible structure is also possible. As an example of this, as shown in FIG. 14B, a movable connector (18) having a convex spherical structure is provided at the rear end of the shaft portion (1), and a holder (19) having a concave spherical structure is provided at the flange portion. By providing in (2), it is possible to hold | maintain a shaft part (1) and a flange part (2) mutually at a predetermined angle in arbitrary directions. In this case, the holder (19) is preferably covered with a soft material in order to come into contact with the skin.

  When the tip of the shaft portion (1) is located in the stomach (or intestine) as in the indwelling example of FIG. 12, the flange portion (2) of the esophageal fistula button (9) when injecting a chemical solution or a nutrient. The infusion catheter is directly connected to the device, but means for securely fixing the flange portion (2) and the catheter is necessary to prevent accidental dropout. Although the structure is not specified, as an example, a tube connector (27) having a structure as shown in FIG. 15 (d) is used. In this connector (27), a locking hook (25) formed on the outer periphery of the main body is inserted into a notch (21) formed in the upper end of the shaft (1), and then this connector (27) is inserted into the groove (24). The connecting tube is fixed to the esophageal sputum button by turning along and turning the hook (25) over the small protrusion (22) and rotating the predetermined protrusion until the small protrusion (23) is prevented from rotating. Although this tube connector (27) applies a force in the rotational direction when the tube is connected, since no force is applied when the tube is connected in the direction of pressing the fistula portion, the QOL can be further improved. Moreover, if a seal ring (26) is attached to the lower connection part of this connector (27), airtightness can be maintained.

  When the distal end of the shaft portion (1) of the esophageal fistula button of the present invention is placed in the stomach or small intestine, a weight (28) is attached to the distal end portion of the shaft as shown in FIGS. 16 (a) to (c). Thus, the insertability can be improved. Although there is no specification for the shape and material, for example, as shown in FIGS. 16A to 16C, a plurality of metal or ceramic products such as those used for general ileus tubes are used. Spherical or cylindrical weight (28), spherical or cylindrical weight (28) provided with a small hole penetrating in the central part, covered with a soft tube, or spherical part provided with a small hole penetrating in the central part Alternatively, a cylindrical weight (28) passed through a tube or a spring and covered with a soft tube is preferably attached to the tip of the shaft portion (1).

  In the esophageal fistula button according to the present invention, a highly flexible material is used as much as possible for the shaft portion (1) placed in the body, and a detachable wire or the like may be attached so as not to impair the insertion property. . Although there is no particular designation for its shape, structure, and material, for example, as shown in FIG. 13, a metal stylet (17) with a microsphere (17a) attached to the tip is fitted into the flange (2). What is provided with the fixing tool (16) for fixing is suitable.

  In the esophageal fistula button of the present invention, particularly when the tip of the shaft portion (1) is placed in the small intestine, as shown in FIG. 17, a balloon (29) is attached to the tip portion to further improve the insertability. Is possible. The balloon (29) is inserted into the body after being inflated and deflated for confirmation. However, when the balloon (29) is inserted through the sheath tube, if the balloon does not deflate reliably, such as wrinkles after deflation, Since the catheter cannot be inserted into the sheath, a material having good contractibility is preferable, and silicone rubber, natural rubber, isoprene rubber or the like is used.

  Further, when the shaft portion (1) of the esophageal fistula button according to the present invention is placed, when a fixing portion is required inside the body, a structure that is hooked to the gastric cardia portion is preferable, but the entire cardia portion is sealed like a balloon. Such a thing is not preferable because it causes obstruction of passage taken orally by saliva or swallowing training. Therefore, in the present invention, for example, as shown in FIG. 18, it is preferable that the tip of the shaft portion (1) has a malecot structure (30) so that the entire cardia portion is not blocked. The shape, structure, and material are not particularly specified, but in order to maintain the shape for a long time in the stomach, for example, a structure in which a shape memory alloy is embedded in the malecot portion is preferable.

  Next, a method for using the esophageal heel button of the present invention will be described with reference to the drawings. As an example, in the esophageal sputum button of the first example, first, as shown in FIG. 10, a route is secured from outside the body to the esophagus (6), and an indwelling tube (11) for discharging body fluid or injecting medicinal solution / nutrient is inserted. . After the fistula is completed, the esophageal fistula button (9) is inserted along the fistula so that the tip (tip of the shaft portion (1)) faces the anus, and the flange portion (12) is fixed with tape or the like. . By doing so, as shown in FIG. 8, the portion protruding from the body surface (flange portion (2)) is flat and extremely small, so that it is possible to greatly reduce the troublesomeness of the patient even if left for a long time. Therefore, the possibility of deliberate withdrawal by the patient himself can be greatly reduced. When draining body fluid or injecting medicinal solution / nutrient, remove the esophageal fistula button (9), insert the indwelling tube (11) through the fistula, place the tip in a desired position, I do. After the treatment is completed, the indwelling tube (11) is removed, and the esophageal fistula button (9) is again placed as described above.

  When the esophageal fistula button (9) having the lumen (1a) shown in FIG. 2 of the second reference example is used, a route from outside the body to the esophagus (6) is secured, and at the same time, the esophagus according to the present invention is provided in the fistula portion. Place the heel button (9) so that its tip faces the anal side. That is, for example, as shown in FIG. 11, a dilator (13) in which an esophageal heel button (9) is fitted in advance along a guide wire (12) placed in the route formed in the esophagus (6) from outside the body. After inserting the guide wire (12) and the dilator (13) and placing the esophageal heel button (9), or a sheath that can be divided in the length direction placed in the route formed in the esophagus from outside the body After inserting the esophageal fistula button (9) into the tube, remove the sheath tube while dividing it, and place it by the method of placing the esophageal fistula button (9) or a combination of them, medical tape, fixing It is fixed by a band for use or a single needle suture.

  According to the esophageal fistula button of the second reference example, as shown in FIG. 9, since the shaft portion (1) is cylindrical, a tube for discharging body fluid or injecting medicinal solution / nutrient before the fistula is completed. (8) can be arbitrarily inserted and removed. Therefore, when the treatment is unnecessary, the tube (8) can be removed. In this case, since the protruding portion to the outside of the body is flat and small, the patient can avoid the troublesomeness of the tube protruding from the beginning of the treatment. To be released. When treatment such as body fluid discharge or chemical / nutrient injection is not performed, the plug (3a) of the cap (3) attached to the flange (2) is opened to the lumen (1a) in the shaft (1). It is possible to prevent leakage of contents from the body by inserting into the part. Since the cap part (3) is connected to the flange part (2), there is no possibility of losing the cap part (3) when not needed. Furthermore, since the backflow prevention valve (4) is provided near the flange portion (2), it is possible to reliably prevent the contents from leaking out of the body. The inconvenience that the person suffers can be avoided.

  Furthermore, as shown in FIG. 12, the esophageal fistula button (9) of the present invention is also inserted by the above-mentioned method when the tip of the shaft portion (1) is placed in the stomach (or intestine), but in particular it is placed in the intestine. In this case, after inserting the shaft part (1) of the esophageal fistula button to the stomach, the guide wire is inserted to the end of the shaft part (1) in the esophageal fistula button (9), and the weight is changed while changing the position of the patient. After inserting (28) into the stomach pylorus, the shaft part is gradually pushed together with the guide wire to the anus side, or fluid is injected into the balloon (29) and inflated, and the shaft is moved to the anus side by peristaltic movement of the intestine. Proceed to In addition, when replacing the esophageal fistula button after completion of the fistula, if it is inserted into the stomach and the shaft (1) is soft, after inserting the stylet (17) and then only the stylet (17) By pulling out, the soft tube can be left in the body and can be removed from the living body. When injecting a nutrient or the like, a treatment can be reliably performed by connecting and fixing a tube for infusion to the flange portion (2). After the treatment is completed, the infusion tube portion is removed and the cap portion (3) is applied to prevent leakage, and the shape of the cap portion (3) is, for example, a curved shape with little catching. The cap will not come off unexpectedly. Therefore, when the tip of the shaft (1) is always located in the stomach (or intestine), it is not necessary to insert / remove a tube for draining body fluid or injecting a chemical / nutrient every time the treatment is required. Thus, it is possible to greatly save the trouble of the patient and the caregiver. Furthermore, if the patient repeats self-extraction, it can be avoided that the esophageal fistula button of the present invention is withdrawn if it is placed so that the malecott part (30) of the shaft is positioned at the cardia.

  As described above, according to the present invention, when a treatment such as body fluid discharge or a chemical / nutrient is performed via a route formed in the esophagus, the tube can be removed when the treatment is not performed. Or the removal of the tube is not necessary, and the portion protruding outside the body of the esophageal fistula button that is placed instead of the tube is extremely small. It can be mitigated, and therefore the possibility of deliberate withdrawal by the patient himself can be greatly reduced.

The perspective view of the 1st reference example of an esophageal gourd button. The perspective view of the 2nd reference example of an esophageal gourd button. The perspective view which shows typically the structure of the flange part in the 1st example of this invention esophageal salmon button. The perspective view which shows typically the structure of the flange part in the 2nd example of this invention esophageal salmon button. The top view of the flange part in the 2nd reference example of an esophageal gourd button. FIG. 6 is a cross-sectional view of the esophageal gourd button of FIG. 5. The perspective view of the other example of a backflow prevention valve. The schematic diagram which shows the esophageal salmon button of the 1st reference example, and its indwelling state. The schematic diagram which shows the esophageal salmon button of the 2nd reference example, and its indwelling state. The schematic diagram which shows an example which inserts this invention esophageal salmon button. The schematic diagram which shows the other example which inserts this invention esophageal salmon button. The schematic diagram which shows an example of the indwelling state of this invention esophageal salmon button. Sectional drawing which shows an example of the detachable stylet applied to an example of the esophageal fistula button which applied this invention, and its insertion state. It is a figure which shows two examples of the esophageal fistula button to which this invention is applied, Comprising: (a) is the perspective view, (b) is the fragmentary longitudinal cross-section of Fig.14 (a). It is a figure which shows the flange part of three examples of the esophageal erosion button which applied this invention, Comprising: (a) is the perspective view, (b) is the fragmentary longitudinal cross-section of FIG. 15 (a), (c) is a cap. The front view which shows the closed state, (d) is a front view which shows an example of the connection tube connector applied to the flange part of Fig.15 (a). BRIEF DESCRIPTION OF THE DRAWINGS It is a typical side view which shows the front-end | tip part of the shaft part in the esophageal fistula button which applied this invention, (a) is a schematic diagram which shows the 1st example of the weight attached to the front-end | tip of a shaft, (b) is a shaft. The schematic diagram which shows the 2nd example of the weight attached to the front-end | tip of (c), (c) is sectional drawing of FIG.16 (b). The typical side view which shows another example of the front-end | tip part of the shaft part in the esophageal fistula button to which this invention is applied. The typical side view of the esophageal salmon button which applied this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Shaft part 2 Flange part 3 Cap part 4 Backflow prevention valve 5 Cover 6 Esophagus 7 Body surface 8 Tube 9 Esophageal heel button 10 Small hole 11 Indwelling tube 12 Guide wire 13 Dilator 14 Connector 15 Fixing flange 16 Fixing tool 17 Stylet 18 Movable connector 19 Holder 20 Slit 21 Notch 22 Small protrusion 23 Stopper 24 Groove 25 Hook 26 Seal ring 27 Connection tube connector 28 Weight 29 Balloon 30 Malecot

Claims (10)

  In an esophageal erosion button having a flange portion at the rear end of a shaft portion whose tip is rounded, a cover that covers the flange portion is formed integrally with the flange portion, and the lumen of the shaft portion is blocked by the cover. An esophageal gourd button with a cap attached.   In the esophageal trowel button having a flange portion at the rear end of the shaft portion having a rounded tip, the fixing portion of the type in which the insertion portion of the connector having the flange portion inserted into the rear end of the shaft portion is divided into two. An esophageal gourd button characterized by being pinched by and fixed to the rear end of the shaft portion.   The esophageal heel button according to claim 1 or 2, wherein the cover or the fixing flange is formed in a substantially dome-shaped curved surface.   A cross-sectional shape communicating from the shaft portion to the flange portion has a substantially circular lumen, and a means for fixing the infusion catheter to the flat and substantially circular flange portion is provided, and the opening of the flange portion is hermetically sealed The esophageal fistula button in any one of Claims 1-3 which has a means.   5. The esophageal fistula button according to claim 1, wherein a backflow prevention valve is provided in the vicinity of the opening of the flange portion.   6. The esophageal trowel button according to claim 1, further comprising a detachable metal wire provided between the opening of the flange portion and the vicinity of the tip of the shaft portion.   The esophageal fistula button in any one of Claims 1-6 which can set arbitrarily the angle which the plane which contact | connects the skin of a flange part, and the length direction of a shaft part.   The esophagus according to any one of claims 3 to 7, wherein a plurality of metal or ceramic spherical weights, or a spherical or columnar weight provided with a small hole penetrating the center part, are attached to the tip of the shaft part.瘻 button.   A balloon that can be expanded and contracted is attached to the outside of the shaft portion, a lumen that communicates with the balloon is provided on the shaft portion, and the same fluid is injected into the flange portion that communicates with the lumen and seals the fluid injected into the balloon. The esophageal erosion button according to claim 3, further comprising means for detachably connecting the instrument. The esophageal fistula button according to claim 3, further comprising a malecot-type fixing means at the tip of the shaft portion.

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