JP2006246983A - Guide wire for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a safe guide wire for an endoscope in which only a catheter can be removed from a treating instrument insertion channel of the endoscope so that the distal end part of the guide wire does not come out from pancreaticobiliary ducts or the like even when the catheter in a general shape is used without the risk of damaging or closing the pancreaticobiliary ducts or being incapable of removal from the pancreaticobiliary ducts or the like. <P>SOLUTION: The guide wire for the endoscope comprises: a flexible shaft part 11 formed by surrounding the periphery of a flexible core wire 1 arranged so as to be freely moved forward and backward at an axial position by a plurality of elastic wires 2 bound in such a state that they are not to be separated from each other; an expansion/contraction part 12 where the plurality of elastic wires 2 surrounding the periphery of the core wire 1 are arranged in the state of being separated from each other at the distal end of the flexible shaft part 11 and the plurality of elastic wires 2 are expanded and contracted by pulling the core wire 1 from the hand side; and a distal end flexible shaft part 13 provided on the distal end of the expansion/contraction part 12 so that the core wire 1 and the plurality of elastic wires 2 are integrally bent by external force without being able to relatively move in an axial direction. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an endoscope guide wire.

  When a catheter is inserted into a thin lumen such as the pancreaticobiliary duct and the catheter is replaced with another catheter, the tip of the catheter through which the guide wire is inserted is first inserted. Insert into the pancreaticobiliary duct etc. via the treatment instrument insertion channel of the endoscope, then remove the catheter leaving only the distal end portion of the guidewire in the pancreaticobiliary duct, and insert another catheter using the guidewire as a guide The procedure is taken.

  However, if the tip of the guide wire is simply left in the pancreaticobiliary duct and only the catheter is to be removed, the guide wire will be removed when the catheter is pulled out from the long treatment instrument insertion channel provided in the endoscope. There are many cases in which the tip part falls out of the pancreaticobiliary duct and everything has to be redone from the beginning.

  To prevent this, the tip of the guide wire may be inflated in the pancreaticobiliary duct to obtain a retaining function. As a result, there is a risk that the guide wire cannot be removed.

Therefore, conventionally, the proximal side of the guide wire can be selectively fixed to the entrance portion of the treatment instrument insertion channel of the endoscope (for example, Patent Document 1).
Special table 2002-515305

  However, as described in Patent Document 1, in order to be able to remove only the catheter while the proximal side of the guide wire is fixed to the entrance portion of the treatment instrument insertion channel of the endoscope, the guide wire is attached to the catheter. Since it is necessary to extend along the outer surface, a specially shaped catheter such as a catheter having a U-shaped groove formed on the entire outer surface must be used, which is not common.

  Therefore, the present invention can remove only the catheter from the treatment instrument insertion channel of the endoscope so that the distal end portion of the guide wire does not come out of the pancreaticobiliary duct or the like even if a catheter having a general shape is used. It is an object of the present invention to provide a safe guide wire for an endoscope without risk of damage or obstruction of the pancreaticobiliary duct or inability to remove the pancreaticobiliary duct.

  In order to achieve the above object, an endoscope guide wire according to the present invention is an endoscope guide wire that can be inserted into and removed from a flexible catheter that is inserted into and removed from a treatment instrument insertion channel of an endoscope. A flexible shaft portion formed by surrounding a flexible core wire disposed in an axial position so as to be movable back and forth with a plurality of elastic wires bound in a state where they are not separated from each other; and a core wire When pulled from the proximal side, the plurality of elastic wires are elastically deformed so that the plurality of elastic wires swell to a size that cannot pass through the outlet side mouth portion of the endoscope treatment instrument insertion channel at the distal end of the flexible shaft portion. The expansion / contraction part arranged around the core wire in a state where they are separated from each other, and the core wire and the plurality of elastic wires cannot move relative to each other in the axial direction, and are provided at the tip of the expansion / contraction part so as to be bent integrally by an external force. Tip flexible shaft And it has a door.

  The core wire extends from the proximal end of the flexible shaft portion to the proximal side alone so that the proximal end extension portion of the core wire can be advanced and retracted with respect to the flexible shaft portion. Alternatively, the core wire may independently extend forward from the distal flexible shaft portion.

  According to the present invention, the expansion / contraction portion is inflated with the distal flexible shaft portion left in the pancreaticobiliary duct, so that the expansion / contraction portion is caught by the outlet side opening of the treatment instrument insertion channel of the endoscope. Since it is no longer drawn out, only the catheter can be removed from the treatment instrument insertion channel of the endoscope so that the distal end portion of the guide wire does not come out of the pancreaticobiliary duct etc. Since the blocking force for holding the distal end portion of the wire in the pancreaticobiliary duct is not applied to the pancreaticobiliary duct, there is no risk of damage to the pancreatobiliary duct, obstruction, or inability to remove the guide wire from the pancreaticobiliary duct.

  An endoscope guide wire that can be inserted into and removed from a flexible catheter that is inserted into and removed from a treatment instrument insertion channel of an endoscope, and has a flexible core wire that is disposed so as to be movable forward and backward at an axial position. When the core wire is pulled from the proximal side, the plurality of elastic wires are internally viewed at the distal end of the flexible shaft when the core wire is pulled from the proximal side. An expansion / contraction portion arranged around the core wire in a state where a plurality of elastic wires are separated from each other so as to be elastically deformed so as to swell so as not to pass through the exit side mouth portion of the treatment instrument insertion channel of the mirror, and the core wire The wire and the plurality of elastic wires have a distal end flexible shaft portion provided at the distal end of the expansion / contraction portion so that the wire and the plurality of elastic wires cannot move relative to each other in the axial direction and bend integrally by an external force.

Embodiments of the present invention will be described with reference to the drawings.
FIG. 3 shows a state in which the guide wire 10 is passed through a catheter 20 that is inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown), and the catheter 20 alone is as shown in FIG. A bifurcated shape is formed at the proximal end (hand side end portion) of a flexible catheter tube 21 made of a tetrafluoroethylene resin tube having a general circular cross-sectional shape with a diameter of about 2 mm and a length of about 2 m. The base 22 is attached.

  The guide wire 10 that can be inserted into and removed from the catheter 20 has a length that is at least twice that of the catheter 20, and as shown in FIG. An expansion / contraction portion 12 having a length of about 1 to 4 cm is provided at the tip, and a distal end flexible shaft portion 13 having a length of about 3 to 10 cm is provided at the tip of the expansion / contraction portion 12. .

  Further, core wires extend from the proximal end portion of the flexible shaft portion 11 and the distal end of the distal flexible shaft portion 13 (hand side extending portion 1a, distal end side extending portion 1b). However, the distal end side extending portion 1b may be omitted.

  Such a guide wire 10 has a plurality of (for example, six wires) around a core wire 1 made of a material such as a superelastic metal or a flexible synthetic resin as shown in FIG. ) It is formed by processing one wire row surrounded by parallel elastic wires 2. However, a stranded wire as shown in FIG. 7 may be used, and the number of elastic wires 2 may be other than six.

  1 and 2 show an enlarged configuration of each part of the guide wire 10. In the flexible shaft 11, a plurality of elastic wires 2 arranged around the core wire 1 are not separated from each other. The core wire 1 is independently arranged at the axial position so as to be movable back and forth in the axial direction.

  Therefore, the core wire 1 is advanced and retracted inside the elastic wire 2 in the flexible shaft portion 11 by operating the proximal side extending portion 1 a of the core wire 1 in the axial direction with respect to the elastic wire 2. The plurality of elastic wires 2 can be bonded to each other by various means such as coating of a heat-shrinkable tube or coating with a synthetic resin.

  In the expansion / contraction part 12, a plurality of elastic wires 2 are arranged in a state of being separated from each other, and the core wire 1 and all the elastic wires 2 are connected to the boundary with the distal end flexible shaft part 13 which is the most advanced part. For example, it is fixed by bonding or brazing.

  Therefore, when the core wire 1 is pulled from the hand side, as shown in FIG. 1, the plurality of elastic wires 2 swell outward in the expansion / contraction part 12, and the size of the bulge is determined by the endoscope treatment. The length of the expansion / contraction part 12 is set so that it cannot pass through the outlet side mouth part of the instrument insertion channel. Note that a slight bulge may be formed on the elastic wire 2 in advance. And if the core wire 1 is pushed in from the hand side, as shown in FIG. 2, the expansion / contraction part 12 will return to a straight state.

  The distal end flexible shaft portion 13 is formed in a simple flexible shaft shape in which the core wire 1 and the elastic wire 2 cannot move relative to each other in the axial direction and bend integrally by an external force. In order to do so, the distal flexible shaft portion 13 may be covered with a heat-shrinkable tube or coated with a synthetic resin, and the core wire 1 and the elastic wire 2 are attached at the most distal end portion of the distal flexible shaft portion 13. It may be fixed integrally. Then, only the core wire 1 extends further forward from the distal end of the distal end flexible shaft portion 13 to form the distal end side extending portion 1b.

  8 to 11 sequentially show the use state of the guide wire 10 configured as described above. First, as shown in FIGS. 8 and 9, the catheter tube 21 in a state where the guide wire 10 is inserted is shown. The distal end portion of the catheter tube 21 that is passed through the treatment instrument insertion channel 51 of the endoscope 50 and protrudes from the outlet side mouth portion 51 a of the treatment instrument insertion channel 51 toward the pancreaticobiliary duct 100 is inserted into the pancreaticobiliary duct 100. 52 is a treatment tool raising piece.

  Then, by performing an operation of pulling out only the catheter tube 21 while holding the flexible shaft portion 11 of the guide wire 1 so as not to move on the hand side, the distal flexible shaft portion of the guide wire 10 as shown in FIG. Since 13 remains in the pancreaticobiliary duct 100, only the catheter tube 21 is retracted into the treatment instrument insertion channel 51, and the inflated / deflated portion 12 is exposed from the distal end of the catheter tube 21, so that the inflating / deflating portion 12 is inflated. Do.

  Therefore, if the operation of removing the catheter tube 21 from the treatment instrument insertion channel 51 is continued, a pulling force may be applied to the guide wire 10 as well. However, as shown in FIG. The guide wire 10 is not pulled out to the proximal side by being caught by the outlet side mouth 51a of the instrument insertion channel 51.

  Therefore, the catheter tube 21 can be smoothly withdrawn from the treatment instrument insertion channel 51 with the distal flexible shaft portion 13 of the guide wire 10 left in the pancreaticobiliary duct 100 without taking much care in holding the guide wire 10. Can do.

  The blocking force for holding the distal flexible shaft portion 13 in the pancreaticobiliary duct 100 is applied to the outlet side mouth 51a of the treatment instrument insertion channel 51 and not to the pancreaticobiliary duct 100. Or there is no risk that the guide wire 10 cannot be removed from the pancreaticobiliary duct 100.

It is a perspective view of the state where the expansion / contraction part of the guide wire for endoscopes of the Example of this invention swelled. It is a perspective view in the state where the expansion-contraction part of the guide wire for endoscopes of the Example of this invention was narrowed. It is side surface sectional drawing of the state by which the guide wire for endoscopes of the Example of this invention was penetrated by the catheter. It is side surface sectional drawing of the catheter of the Example of this invention. It is a side view of the guide wire for endoscopes of the example of the present invention. It is a perspective view of the wire row | line | column used as the raw material of the guide wire for endoscopes of the Example of this invention. It is a perspective view of the other example of the wire row | line | column used as the raw material of the guide wire for endoscopes of the Example of this invention. It is a schematic diagram which illustrates the use condition of the guide wire for endoscopes of the example of the present invention. It is a schematic diagram which illustrates the use condition of the guide wire for endoscopes of the example of the present invention. It is a schematic diagram which illustrates the use condition of the guide wire for endoscopes of the example of the present invention. It is a schematic diagram which illustrates the use condition of the guide wire for endoscopes of the example of the present invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Core wire 1a Hand side extension part 1b Tip side extension part 2 Elastic wire 10 Guide wire 11 Flexible shaft part 12 Expansion / contraction part 13 Tip flexible shaft part 20 Catheter 21 Catheter tube 50 Endoscope 51 Treatment instrument insertion channel 51a Exit side mouth part 100 Pancreaticobiliary duct

Claims (3)

An endoscope guide wire that can be inserted into and removed from a flexible catheter that is inserted into and removed from a treatment instrument insertion channel of an endoscope,
A flexible shaft portion formed by surrounding a flexible core wire disposed in an axial position so as to be able to advance and retreat by being surrounded by a plurality of elastic wires that are not separated from each other;
When the core wire is pulled from the proximal side, the plurality of elastic wires are elastically deformed at the distal end of the flexible shaft portion so as to swell to a size that cannot pass through the outlet side mouth portion of the treatment instrument insertion channel of the endoscope. The expansion / contraction part disposed around the core wire in a state where the plurality of elastic wires are separated from each other,
The core wire and the plurality of elastic wires have a tip flexible shaft portion provided at a tip of the expansion / contraction portion so that the core wire and the plurality of elastic wires cannot be relatively moved in the axial direction and bend integrally by an external force. Endoscope guide wire.   The core wire extends from the proximal end of the flexible shaft portion to the proximal side alone, and the proximal end extension portion of the core wire can be moved forward and backward with respect to the flexible shaft portion. The guide wire for endoscope as described.   The guide wire for an endoscope according to claim 1 or 2, wherein the core wire extends independently forward from the distal flexible shaft portion.

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