JP2006334149A - Catheter with balloon for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a balloon catheter the collecting work of which is achieved by operation equal to a conventional method simply and quickly in a localized BAL. <P>SOLUTION: In the catheter with a balloon for an endoscope, a suction hole 7a of a suction lumen 7 is on the distal end side compared with a distal end side balloon 4, and the proximal end side aperture part 7b of the suction lumen 7 is on a proximal end side compared with a proximal end side balloon 5. Thus, the catheter can be used so as to communicate with a channel 13 of the endoscope 12. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an endoscopic balloon catheter used in the medical field, particularly in combination with an endoscope, for collecting a liquid component in a living body.

  Conventionally, bronchoalveolar lavage (BAL) is a method for recovering and diagnosing liquid components in bronchoalveoli. This is because the tip of the bronchoscope itself is wedged to the target site, saline is injected into the bronchoalveoli, the liquid in the bronchoalveoli is aspirated and collected, and the cellular components contained in the collected lavage fluid, etc. Analysis, pathological diagnosis and etiological analysis.

  In this case, the physiological saline to be injected is injected from the bronchoscope channel, and the liquid in the bronchoalveoli is applied to the bronchoscope channel by applying negative pressure to the bronchoscope channel by an external suction device connected to the bronchoscope. It was made to collect by suction through the channel.

The conventional diagnostic method can be applied only to a portion where the bronchus into which the endoscope can be inserted is relatively thick, that is, a region where physiological saline can be injected and collected from the central airway region. In addition, in the conventional BAL using a bronchoscope, the bronchus ahead of the endoscope tip branches innumerably, and physiological saline is injected into places other than the bronchi to be examined. It was not clear which bronchus the lesions existed in because it collects the cellular components.
Special table hei 9-500312

  Therefore, we propose a localized BAL technique in the sense of aiming at a specific bronchi and confirming whether a lesion exists in the bronchus beyond the tip of the bronchoscope or observing pathological changes. In this method, a catheter with a balloon is used, and the catheter is wedged into the bronchial cavity by expanding the balloon.

  As a form of the balloon catheter, there is a drug distribution PTC intravascular catheter proposed in Patent Document 1 (Japanese Translation of PCT International Publication No. 9-500312), although the purpose of use is different.

  However, the double balloon catheter proposed by Patent Document 1 includes a water supply lumen, a suction lumen, and a balloon expansion lumen, and has a complicated and easily increased diameter structure such that there are a large number of ports connected to each lumen. In addition, if this is applied to a BAL procedure, the handling becomes very complicated and a quick treatment becomes difficult.

  Although it is localized in BAL, it fills the bronchi with fluid, which places a heavy burden on the patient. Therefore, it is necessary to aspirate the supplied physiological saline immediately. When a plurality of lumens are provided as in the double balloon catheter of Patent Document 1, each lumen diameter becomes small, and the pipe resistance increases when fluid is sent out or sucked. Therefore, there is a problem that the suction time becomes long.

  In addition, the syringe connected to each port expands the balloon, injects physiological saline, and sucks the recovered liquid from the suction lumen using the suction tube connected to the suction device. This is a complicated operation method that is different from the conventional BAL operation method, in which water is put in, negative pressure is applied to the forceps channel by a suction device, and physiological saline is recovered through the forceps channel. Deteriorate.

  An object of the present invention is to provide a balloon catheter that is conceived to solve the above-described problems, and that enables a collection operation in a localized BAL by the same operation as a conventional collection method in a simple and quick manner. .

According to a first aspect of the present invention, a flexible tubular member, a first inner space, a second inner space and a third inner space formed along the tubular member, and a distal end portion of the tubular member are arranged. A distal-side expansion member that is connected to the first inner space and expands upon receiving supply of an expansion fluid, and is disposed closer to the proximal end side than the distal-end expansion member, and is connected to the first inner space and expanded A proximal end expansion member that expands upon supply of fluid, and the first inner space communicates with the distal end expansion member and the proximal end expansion member and provides the expansion fluid. The second inner space is located on a distal end side of the distal-side expansion member and is opened to the outside of the tubular member, and is connectable to a means for providing a liquid. 3 The inner space has a front end opening and a base end opening, and the front end opening is expanded on the front end side. The proximal end opening portion is located on the proximal end side of the proximal end side expansion member and is opened on the exterior side of the tubular member. A catheter with a balloon for an endoscope.
According to a second aspect of the present invention, there is provided a flexible first tubular member, a flexible second tubular member that is inserted through the first tubular member so as to be capable of moving forward and backward, and the first tubular member. A first inner space formed along the second inner space, a second inner space, and a third inner space; a fourth inner space formed along the second tubular member; and a distal end of the first tubular member, and inflated. A distal end side expansion member that expands upon receiving a supply of fluid; and a proximal end side expansion member that is disposed at a distal end of the second tubular member and expands upon receiving a supply of expansion fluid. The second inner space is located on the front end side of the front end side expansion member and communicates with the front end side expansion member, and is connected to a means for providing an expansion fluid. And the third inner space is connected to the tip opening and the base. An opening portion, the distal end opening portion is located on the distal end side of the distal end side expansion member and is opened to the outside of the first tubular member, and the proximal end opening portion is expanded on the distal end side expansion. It is located on the base end side of the member and is opened to the outside of the first tubular member, and the fourth inner space communicates with the base end side expansion member and is connected to a means for providing an expansion fluid A notch portion is formed on the second tubular member and is located closer to the base end side than the base end side expansion member and communicates with the base end opening portion of the third inner space. This is a catheter with a balloon for an endoscope.

  According to the present invention, localized BAL can be easily performed using a balloon catheter. The operation method can be performed by the same operation method as normal BAL. Further, there is no need to arrange the suction lumen over the entire length of the catheter, and accordingly, a balloon inflation lumen and a liquid feeding lumen can be made larger, and the duct resistance can be reduced. Furthermore, by using the treatment instrument channel of the endoscope as a suction line, the suction ability is improved as compared with the case of suction with a lumen in a general catheter, and the suction time can be shortened.

(First embodiment)
An endoscope balloon catheter according to a first embodiment of the present invention will be described with reference to FIGS.

  As shown in FIG. 1 (a), an endoscope balloon catheter 1 has a catheter tube 2 as a flexible tubular member that can be inserted into an endoscope channel, which will be described later. A plurality of inner spaces are formed in 2 as will be described later. The distal end portion 3 of the catheter tube 2 includes a distal end side balloon 4 as a distal end side inflating member and a proximal end side (rear side) as a proximal end side inflating member provided at a proximal end side with respect to the distal end side balloon 4. End side) balloon 5 is provided. The proximal end portion 21 of the catheter tube 2 branches into two parts, and a water supply port 9 as a means for providing a liquid and a balloon inflation port 10 as a means for providing an inflation fluid are separately provided at each branch end. It is attached.

  As shown in FIG. 2 (a), the distal end portion 3 of the catheter tube 2 is provided with a water supply hole 6a which is located on the distal end side with respect to the distal end side balloon 4 and is opened in the side peripheral wall surface. The water supply port 9 communicates with the water supply port 9 through a water supply lumen (inside air) 6 in the catheter tube 2. The distal end portion 3 of the catheter tube 2 is provided with a suction hole 7a located on the distal end side with respect to the distal end side balloon 4, and is opened at the distal end of the catheter tube 2 in this embodiment. The suction hole 7 a communicates with a suction lumen opening 7 b that is located on the base end side of the base end side balloon 5 through the suction lumen (inside air) 7 in the catheter tube 2 and is opened in the side wall surface. ing. Between the suction hole 7a and the suction lumen opening 7b, both the distal balloon 4 and the proximal balloon 5 provided in the region of the distal end 3 of the catheter tube 2 are located.

  As shown in FIG. 2 (a), the distal end portion 3 of the catheter tube 2 has a distal end side balloon opening 8 a located in the distal end side balloon 4 and a proximal end side located in the proximal end side balloon 5. A balloon opening 8b is provided. The distal balloon inner opening 8a and the proximal balloon opening 8b are both connected to and communicate with a balloon inflation lumen (inner space) 8 formed in the catheter tube 2. The proximal end of the balloon inflation lumen 8 communicates with the balloon inflation port 10.

  Next, with reference to FIGS. 3-6, the effect | action of the balloon catheter 1 for endoscopes which concerns on this embodiment is demonstrated.

  First, as shown in FIG. 3, the catheter tube 2 is inserted into the target bronchus 11 through the treatment instrument channel 13 of the endoscope 12 inserted up to the bronchus. The distal balloon 4 is positioned in the target bronchus 11 and the proximal balloon 5 is positioned in the treatment instrument channel 13 of the endoscope 12.

  Next, a fluid is injected into the balloon inflating port 10, thereby injecting the fluid into the distal balloon 4 via the balloon inflation lumen 8 and inflating the distal balloon 4, so To wedge. At this time, since the proximal balloon 5 communicates with the same balloon inflation lumen 8, it is simultaneously inflated in the treatment instrument channel 13 of the endoscope 12 and seals the inside of the channel.

  Thereafter, physiological saline 14 is injected from the water supply port 9 into the water supply lumen 6. The physiological saline 14 injected into the water supply lumen 6 is supplied to the outside of the catheter tube 2 through the water supply hole 6 a located before the distal end side balloon 4 and injected into the target bronchus 11.

  After the injection of the physiological saline 14, negative pressure is applied in the treatment instrument channel 13 of the endoscope 12 by a suction device 23 (see FIG. 6) provided in the endoscope 12.

  At this time, at the distal end portion of the treatment instrument channel 13 of the endoscope 12, the proximal balloon 5 is sealed as shown in FIG. Further, the proximal end portion of the treatment instrument channel 13 is sealed with a forceps plug 16 as shown in FIG. Therefore, since the negative pressure by the suction device 23 is applied to the suction lumen 7 via the suction lumen opening 7b, the liquid outside the catheter tube 2 is sucked from the suction hole 7a located before the distal end side balloon 4.

  In this way, the collected liquid 15 sucked from the suction hole 7a is discharged from the catheter lumen 2 through the suction lumen 7 through the suction lumen 7, and enters the treatment instrument channel 13 of the endoscope 12. . Thereafter, the recovery liquid 15 is recovered in the recovery container 22 via the treatment instrument channel 13 of the endoscope 12 and the external suction tube 24 as shown in FIGS. 5 and 6.

  As described above, according to the present embodiment, the provision of the distal end side balloon 4 prevents the liquid delivered from the water supply hole 6 a from leaking to the proximal end side from the distal end side balloon 4. For this reason, localized BAL in a specific bronchus can be performed.

Further, the proximal balloon 5 and the forceps plug 16 can keep the treatment instrument channel 13 airtight, so that the collected liquid can be collected by a suction device used for normal endoscopy.
Furthermore, according to the present embodiment, the localized BAL can be performed by the same operation method as a normal BAL.

(Second Embodiment)
With reference to FIG. 7, a balloon catheter for an endoscope according to a second embodiment of the present invention will be described. The endoscope balloon catheter 1 according to the present embodiment is constituted by an inner catheter 17 and an outer catheter 18 that can slide and move forward and backward in the axial direction.

  As shown in FIG. 7 (a), the inner catheter 17 is provided at a position of the flexible long catheter 19 having a plurality of inner spaces and a distal end portion of the catheter 19. And a distal end side balloon 104. In the catheter 19, a water supply lumen 106, a suction lumen 107, and a balloon expansion lumen 110 are formed.

  The water supply lumen 106 has a water supply hole 106 a that is located on the distal end side than the distal end side balloon 104 and opens to the outside, and communicates with a water supply port installed on the proximal end side of the catheter 19. The suction lumen 107 includes a distal suction hole 17a opened at the foremost end of the catheter 19 and a suction lumen hole 107b opened at a proximal end side of the distal side balloon 104 on the side outer peripheral wall of the inner catheter 17. Communicate. The balloon expansion lumen 110 formed in the inner catheter 17 is connected to the distal-end balloon opening 110a.

  The outer catheter 18 includes a flexible long cylindrical tube 20 having a plurality of inner spaces, and a proximal balloon 105 attached to the distal end portion of the tube 20. The tube 20 has a balloon inflation lumen 108 communicating with the proximal balloon 105, an inner catheter insertion lumen 109 for slidably inserting the catheter 19 portion of the inner catheter 17, and FIG. As shown in FIG. 3, the catheter 19 has a long notch 26 extending in the long axis direction. The balloon inflation lumen 108 communicates with the proximal balloon 105 via the proximal balloon opening 108a. The balloon inflation lumen 108 communicates with the proximal balloon 105 of the inner catheter 17 described above.

  Therefore, when the inner catheter 17 is inserted into the inner catheter insertion lumen 109 of the outer catheter 18, the inner catheter suction lumen hole 107b has a notch formed in the outer catheter 18, as shown in FIG. 26 are arranged so as to overlap with each other.

  Accordingly, the suction lumen 107 of the inner catheter 17 communicates with the cutout portion 26 of the outer catheter 18 in a state where the inner catheter 17 and the outer catheter 18 are slidably combined. For this reason, the collected liquid sucked from the tip suction port 107a passes through the suction lumen 107, and is sent out of the outer catheter 18 from the notch portion 26 via the inner catheter suction lumen hole 107b, and finally the endoscope. Can be collected through other channels. Other operations are the same as those in the first embodiment.

  According to the present embodiment, the relative position in the front-rear direction of the distal balloon 104 and the proximal balloon 105 can be adjusted to an optimum state in accordance with the usage situation. Further, since the inner catheter suction lumen hole 107b is arranged so that the opening portion of the cutout portion 26 of the outer catheter 18 coincides, it can be sucked even when the inner catheter 17 moves relatively in the axial direction. is there. Other effects are the same as those of the first embodiment.

  In addition, this invention is not limited to embodiment mentioned above, It can apply also to another form.

1 is an external view of an entire endoscope balloon catheter according to a first embodiment of the present invention. FIG. (A) is a longitudinal sectional view of the vicinity of the distal end of the endoscope balloon catheter according to the first embodiment, and (b) is a longitudinal section of the vicinity of the proximal end of the endoscope balloon catheter according to the first embodiment. Plan view. Explanatory drawing of the use condition of the catheter for endoscopes similarly concerning 1st Embodiment. Sectional drawing in the use condition of the front-end | tip part vicinity of the endoscope catheter which concerns on 1st Embodiment similarly. Sectional drawing in the use condition of the proximal end part of the endoscope catheter which concerns on 1st Embodiment similarly. Explanatory drawing of the external device in the case of using the endoscope catheter which concerns on 1st Embodiment similarly. (A) is a longitudinal sectional view of the vicinity of the distal end portion of the balloon catheter for an endoscope according to the second embodiment of the present invention, and (b) is the vicinity of the proximal end portion of the balloon catheter for an endoscope according to the second embodiment. (C) is sectional drawing which follows the CC line in (a).

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscope balloon catheter 2 ... Catheter 3 ... Tip part 4 ... Tip side balloon 5 ... Base end side balloon 6 ... Water supply lumen 7 ... Suction lumen 8 ... Balloon inflation lumen 13 ... Treatment instrument channel 14 ... Saline

Claims (2)

A flexible tubular member;
A first inner space, a second inner space and a third inner space formed along the tubular member;
A distal-side expansion member that is disposed at a distal end portion of the tubular member, is connected to the first inner space, and expands by receiving supply of an expansion fluid;
A proximal-side expansion member disposed on the proximal side of the distal-side expansion member, connected to the first inner space, and expanded by receiving supply of an expansion fluid; and
The first inner space communicates with the distal end side expansion member and the proximal end side expansion member, and is connectable to a means for providing the expansion fluid,
The second inner space is located on the tip side of the tip side expansion member and is opened to the outside of the tubular member, and is connectable to a means for providing a liquid,
The third inner space has a distal end opening portion and a proximal end opening portion, and the distal end opening portion is positioned on the distal end side with respect to the distal end side expansion member and opens to the outside of the tubular member, The catheter with a balloon for an endoscope, wherein the proximal end opening portion is located closer to the proximal end side than the proximal end side expansion member and is opened to the outside of the tubular member. A flexible first tubular member;
A second tubular member having flexibility for inserting the first tubular member so as to be capable of moving forward and backward;
A first inner space, a second inner space and a third inner space formed along the first tubular member;
A fourth inner space formed along the second tubular member;
A distal-side expansion member that is disposed at the distal end of the first tubular member and expands upon receiving supply of an expansion fluid;
A proximal-side expansion member that is disposed at the distal end of the second tubular member and expands upon supply of an expansion fluid;
With
The first inner space communicates with the distal end side expansion member and can be connected to a means for providing an expansion fluid;
The second inner space is located on the tip side of the tip-side expansion member and is opened to the outside of the first tubular member, and is connectable to a means for providing a liquid,
The third inner space has a distal end opening portion and a proximal end opening portion, and the distal end opening portion is located on the distal end side with respect to the distal end side expansion member and opens to the outside of the first tubular member. The proximal end opening portion is located on the proximal end side with respect to the distal end side expansion member and is opened to the outside of the first tubular member;
The fourth inner space communicates with the proximal-side expansion member and can be connected to a means for providing an expansion fluid;
On the second tubular member, a notch portion is formed which is located on the base end side with respect to the base end side expansion member and communicates with the base end opening portion in the third inner space. An endoscopic balloon catheter.

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