JP2012040293A - Insertion aid - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an insertion aid with which a receiving portion of a catheter which receives the insertion aid, securely and safely receives the insertion aid, the receiving portion has a simple and strong structure, and the process and cost for manufacturing the catheter are reduced.SOLUTION: The insertion aid 1 includes a grip head 10 and an inserted portion 11 extending from the grip head 10, so that the insertion aid is inserted into an introducing tube 21 of the catheter 2 which is mounted with an expandable bumper 40 at the distal end of the introducing tube 21 to insert the catheter 2 into a desired position along a guide wire W. the inserted portion 11 has an inserted rod 111 extending into a rod shape to be inserted into the introducing tube 21, and a hollow guide pipe 112 extending in the same direction as the inserted rod 111 and inserting the guide wire W therethrough. The inserted rod 111 has a distal end inserted into the receiving portion provided in the bumper 40, and the guide pipe 112 has a distal end positioned near the grip head 10 relative to the distal end of the inserted rod 111.

Description

  The present invention is an insertion for inserting a catheter into a desired position along a guide wire by inserting the catheter into the introduction tube of a catheter equipped with an expandable / shrinkable bumper for preventing removal at the distal end portion of the introduction tube. It relates to assistive devices.

Conventionally, there is a gastrostomy catheter, for example, as a catheter placed in an organ. In recent years, the distal end side of the guide wire is previously stopped at a desired position in the stomach so as not to place the gastrostomy catheter in a wrong position, and the gastrostomy catheter is placed in the stomach along the guide wire. It is possible to easily and surely guide to a desired position. For example, it is as shown to patent document 1 which the applicant of this application has proposed.
In other words, a balloon for preventing a dropout that protrudes before the distal end of the catheter body when it is expanded is attached as a bumper to the distal end portion of the introduction tube that is the catheter body, and an insertion auxiliary rod inserted into the introduction tube is attached to the outer peripheral portion of the balloon. A receiving part that can receive and hold the tip part is provided inside, and the receiving part can be inserted into the insertion auxiliary rod and passed through the guide wire extending from the tip of the insertion auxiliary bar to the outside of the receiving part. A guide wire passage is formed.

JP 2009-125251 A

  However, in the technique of Patent Document 1, since the guide wire passage penetrates the receiving portion, the strength of the receiving portion is weakened accordingly, and there is no possibility that the tip of the insertion assisting rod penetrates the receiving portion. . In order to solve this, in the technique of Patent Document 1, a reinforcing portion is provided in the receiving portion. For this reason, there is a problem that the number of parts increases and the number of manufacturing steps increases, leading to an increase in manufacturing cost.

  In addition, since the guide wire passage is formed in the receiving portion of the bumper, the structure becomes complicated accordingly. This also increases the manufacturing process, leading to an increase in manufacturing cost.

  The present invention has been made paying attention to such problems of the prior art, and the receiving part on the catheter side that receives the insertion assisting tool can receive the insertion assisting tool reliably and safely. It is an object of the present invention to provide an insertion assisting tool that can have a simple structure and high strength, and can reduce the manufacturing process and manufacturing cost of the catheter.

The gist of the present invention for achieving the object lies in the inventions of the following items. [1] The catheter (2) is inserted into the introducer tube (21) of the catheter (2) equipped with an expandable / shrinkable bumper (40) for preventing it from coming off at the distal end of the introducer tube (21). In the insertion aid (1) for inserting the desired position along the guide wire (W),
A gripping head (10), and an insertion portion (11) extending from the gripping head (10),
The insertion portion (11) includes a rod-shaped insertion rod (111) that is inserted into the introduction tube (21), and the guide wire (W) that extends in the same direction as the insertion rod (111) extends. A hollow guide pipe (112) for passing through,
The insertion rod (111) is received by a receiving portion (400) provided at the tip of the bumper (40),
The insertion aid (1), wherein the guide pipe (112) has a tip (112a) closer to the gripping head (10) than a tip (111a) of the insertion rod (111).

[2] The guide pipe (112) has a proximal end (112b) fixed to the inside of the gripping head (10),
The gripping head (10) has a guide wire introduction path (13) for introducing the guide wire (W) into the guide pipe (112) with an outer side of the gripping head (10) and the guide pipe (112). The insertion assisting tool (1) according to [1], which is formed so as to communicate with the opening (112c) on the base end (112b) side.

[3] The insertion assist according to [1] or [2], wherein the insertion portion (11) is formed by integrally forming the insertion rod (111) and the guide pipe (112). Ingredient (1).

The present invention operates as follows.
When the catheter (2) is inserted into the organ, the distal end side of the guide wire (W) is previously inserted into a desired position in the organ from a fistula such as a gastrostoma or intestinal fistula. On the other hand, the catheter (2) contracts the bumper (40) provided at the distal end of the introduction tube (21).

  In this state, the inlet (28) on the inlet side of the introduction tube (21) passes through one end of the guide wire (W) from the outlet (28) side of the introduction tube (21) of the catheter body (20) into the introduction tube (21). One end is taken out from 35). Further, one end of the guide wire (W) is passed from the distal end (112a) side of the guide pipe (112) of the insertion assisting tool (1) and out from the other end (13a) side.

  Next, the insertion part (11) of the insertion assisting tool (1) is inserted into the introduction tube (21) of the catheter (2). At this time, it inserts until the front-end | tip (111a) of the insertion rod (111) of an insertion auxiliary tool (1) is settled in the receiving part (400) of a bumper (40). When the insertion assisting tool (1) is further pushed in with the distal end (111a) of the insertion rod (111) placed in the receiving part (400) of the bumper (40), the bumper (40) is moved from the distal end of the introduction tube (21). It is stretched first and becomes an elongated state.

  Even when the bumper (40) is elongated, the guide pipe (112) passing through the guide wire (W) has a tip (112a) gripping head more than the tip (111a) of the insertion rod (111). Since it is close to (10), the insertion assisting tool (1) can be smoothly inserted into the organ along the guide wire (W) without the guide wire (W) being obstructed by the bumper (40) or the like. Can do.

  Thus, the insertion assisting tool (1) does not pass the guide wire (W) through the insertion rod (111), but passes through the guide pipe (112) different from the insertion rod (111). It is not necessary to form a passage through which the guide wire (W) passes in the receiving part (400) provided on the bumper (40) side of 2). Thereby, the receiving part (400) can have a simple structure and a sufficiently high strength, and at the same time, the manufacturing process and manufacturing cost of the catheter (2) can be reduced.

  According to the insertion aid according to the present invention, the guide wire is passed through a guide pipe different from the insertion rod. Therefore, when the catheter is inserted into the organ along the guide wire with the insertion aid attached to the catheter. Can be inserted smoothly.

  In addition, since the catheter does not need to be provided with a passage for passing the guide wire in the receiving portion provided in the bumper, the structure of the receiving portion can be simply and sufficiently high in strength. It can be received reliably and safely, and since a reinforcing member is not required, the manufacturing process and manufacturing cost can be reduced.

It is a longitudinal cross-sectional view of the insertion auxiliary tool which concerns on one embodiment of this invention. It is an external view of the insertion auxiliary tool of FIG. It is a figure which shows the side surface and both end surfaces of the insertion part of the insertion auxiliary tool of FIG. It is a front view which shows the structure of the catheter in which the insertion assistance tool which concerns on one embodiment of this invention is used. FIG. 5 is an explanatory view showing a state where the insertion assisting tool of FIG. 1 is about to be inserted into the catheter of FIG. 4. It is explanatory drawing which shows the state which inserted the insertion rod in the receiving part provided in the bumper of the catheter of FIG. 4, and extended the bumper thinly.

Hereinafter, a preferred embodiment of the present invention will be described with reference to the drawings.
Each figure shows an embodiment of the present invention.
1-3 has shown the insertion assistance tool which concerns on one embodiment of this invention. FIG. 1 is a longitudinal sectional view of an insertion assisting tool, FIG. 2 is an external view of the insertion assisting tool, and FIG.

4 is a front view showing the structure of a catheter in which the insertion assisting tool according to one embodiment of the present invention is used. FIG. 5 is a diagram illustrating the insertion assisting tool shown in FIG. FIG. 6 is an explanatory view showing a state in which the bumper is elongated by inserting an insertion rod into a receiving portion provided on the bumper of the catheter of FIG.
When inserting the catheter 2 shown in FIG. 4 into an organ, the insertion assisting tool 1 is inserted into the catheter 2 and inserted into a desired position using the guide wire W.

  As shown in FIG. 1, the insertion assisting tool 1 has an insertion portion 11 extending from a gripping head 10. The proximal end side of the insertion portion 11 is fitted and fixed inside the gripping head 10. The insertion portion 11 includes an insertion rod 111 extending in a rod shape to be inserted into the catheter body 20 of the catheter 2 described later, and a guide pipe 112 extending in the same direction as the direction in which the insertion rod 111 extends.

  The distal end portion 111a of the insertion rod 111 has a shape that fits into a receiving portion 400 formed on a bumper 40 provided at the distal end of the introduction tube 21 of the catheter 2 described later shown in FIG.

  The guide pipe 112 is a hollow pipe through which a guide wire introduction path 113 for passing the guide wire W passes. The guide pipe 112 is shorter than the insertion rod 111, and the tip 112 a is closer to the gripping head 10 than the tip 111 a of the insertion rod 111.

  The guide wire introduction path 113 of the guide pipe 112 is connected to the guide wire introduction path 13 formed in the holding head 10 at the opening 112c on the base end 112b side. The guide wire introduction path 13 penetrates the gripping head 10 and communicates with the guide wire introduction port 13a opened to the outside and the guide wire introduction port 112d opened at the tip 112a of the guide pipe 112.

Next, the catheter 2 for inserting the insertion assisting tool 1 will be described.
The illustrated catheter 2 is a catheter as a gastrostomy button. This catheter 2 is for introducing a liquid food or nutrient into the stomach. In the catheter 2, a catheter head 30 is attached to a catheter body 20 including an introduction tube 21 and a bumper 40.

  The distal end of the introduction tube 21 of the catheter 2 is equipped with an expandable / shrinkable bumper 40 to prevent the catheter 2 from coming off. The bumper 40 is made of a flexible and elastically deformable material, for example, made of silicone rubber. The illustrated bumper 40 is a balloon made of silicone rubber.

  In the catheter head 30, an inlet 35 having a funnel-like diameter is formed on the inlet side of the introduction tube 21. The catheter head 30 is attached to the catheter body 20 so that the lower end portion of the injection port 35 communicates with the inlet of the introduction tube 21. Liquid food or nutrients to be injected into the stomach are injected from the injection port 35 through the catheter body 20. Further, the catheter head 30 is provided with a fluid conducting plug portion 31 for mounting a syringe I, which will be described later, and a lid 33 that can block the injection port 35. The lid 33 is provided on a belt 34 extending from the catheter head 30.

  The introduction tube 21 of the catheter body 20 is provided with a main lumen 22 and a sub-lumen 25 that allows fluid to flow to the bumper 40. One end of the main lumen 22 is an inlet of the introduction tube 21, and the other end is an outlet of the distal end portion 27 of the introduction tube 21.

  In addition, the sub-lumen 25 is formed as a very thin conduit that allows fluid to pass through, and extends in parallel to the main lumen 22 from the inlet side to the outlet side of the introduction tube 21. The sub-lumen 25 communicates with a communication path 32 formed in the catheter head 30 on the inlet side of the introduction tube 21. The communication passage 32 communicates with the fluid conduction plug portion 31.

  The fluid conducting plug portion 31 is configured to conduct the sub-lumen 25 to the outside only when the syringe I is set. For example, the fluid conduction plug portion 31 has a check valve so that fluid can flow when the syringe I is inserted.

  The bumper 40 of the catheter body 20 has a rubber balloon shape, and is attached to the distal end portion 27 of the introduction tube 21 so as to extend from the distal end portion 27 first. That is, the elastic thin film of the bumper 40 is joined so as to sandwich the distal end portion 27 of the main lumen 22 from inside and outside, and when the fluid is removed, the donut surrounding the distal end portion 27 in a ring shape is crushed. The bumper 40 can be deformed so as to extend conically at the tip of the introduction tube 21.

  As can be seen from FIG. 4, when the bumper 40 is expanded, the bumper 40 has a donut shape positioned ahead of the outlet 28 at the tip of the introduction tube 21, and a lead-out conduit 51 through which the lead-out 28 communicates is formed at the center. It is like that.

  As shown in FIGS. 4 and 5, the receiving portion 400 is provided so as to face the outside of the bumper 40 when expanded. The receiving portion 400 receives the insertion rod 111 of the insertion assisting tool 1 inserted from the main lumen 22 of the introduction tube 21. The distal end portion 111a of the insertion rod 111 can be inserted into the receiving portion 400 with the bumper 40 contracted.

  As shown in FIGS. 4 and 5, the receiving portion 400 is provided at a position that does not interfere with the outlet conduit 51 when the bumper 40 is inflated. Since the receiving portion 400 is formed integrally with the bumper 40, the material is the same as that of the bumper 40, has flexibility, and can be elastically deformed. The receiving portion 400 is formed with a fitting portion 410 (inside) into which the distal end portion 111a of the insertion rod 111 of the insertion assisting tool 1 is fitted.

  The fitting portion 410 has a cross-sectional shape similar to that of the distal end portion 111 a of the insertion rod 111. For example, if the cross section of the distal end portion 111 a of the insertion rod 111 is circular, the insertion portion 410 has a circular shape whose inner diameter is slightly larger than the outer diameter of the distal end portion 111 a of the insertion rod 111. However, since the material of the receiving portion 400 is flexible and can be elastically deformed, the inner diameter may be smaller than the outer diameter of the distal end portion 111a of the insertion rod 111. In addition, the shape of the cross section of the insertion part 410 may not be similar to the shape of the cross section of the front end part 111a of the insertion rod 111, and may be a polygon into which the front end part 111a can be inserted, for example.

  FIG. 6 shows a state in which the grasping head 10 of the insertion assisting tool 1 is pushed so that the distal end portion 111a of the insertion rod 111 protrudes. In this state, the terminal end of the receiving part 400 is pulled to have a pointed shape. Further, the bumper 40 in FIG. 5 is also pulled up on the opposite side, so that the bumper 40 has a pointed cone shape as a whole.

The insertion assisting tool 1 according to the present embodiment operates as follows.
In the catheter 2, the introduction tube 21 and the bumper 40 below the catheter head 30 are inserted into the organ. Prior to inserting the catheter 2 into the organ, a guide wire W is inserted into the gastrostomy where the catheter 2 is to be inserted. The tip of the guide wire W is inserted at a desired position.

  On the other hand, the catheter 2 contracts the bumper 40 provided at the distal end of the introduction tube 21. Further, the guide wire W is taken out from the inlet 35 through the outlet 28 from the distal end side of the catheter 2. One end of the guide wire W is further passed from the distal end 112 a side of the guide pipe 112 of the insertion assisting tool 1 and is taken out from the guide wire introduction port 13 a of the gripping head 10.

  Next, the insertion portion 11 of the insertion assisting tool 1 is inserted into the introduction tube 21 of the catheter 2, and the distal end 111 a of the insertion rod 111 is stored in the receiving portion 400 of the bumper 40. With the distal end 111a of the insertion rod 111 fitted in the receiving part 400 of the bumper 40, the insertion assisting tool 1 is further pushed in so that the bumper 40 is extended before the distal end 27 of the introduction tube 21 so that it is in an elongated state. .

  In order to make the bumper 40 into an elongated state, as shown in FIG. Drain the fluid completely. As a result, the bumper 40 is contracted to be in a state like a rubber balloon from which fluid is removed, so that it can be elongated as described above.

  After this state, the distal end portion 27 of the catheter 2 is inserted into the stomach through the fistula. After the insertion, the bumper 40 is greatly expanded to prevent the introduction tube 21 from coming off. When expanding the bumper 40, the syringe I may be set in the fluid conduction plug portion 31 and the fluid may be injected into the bumper 40 through the sub-lumen 25.

  In this state, if the distal end portion 27 of the introduction tube 21 is inserted into the organ through the fistula of the gastrostomy or intestinal fistula along the guide wire W that has been inserted into the organ in advance, it can be inserted smoothly and gently, and easy to wear. Therefore, the patient is not burdened and there is no worry about the occurrence of a medical accident. The guide wire W enters the main lumen 22 from the outlet 28 on the distal end side of the catheter 2, passes through the guide wire introduction path 113 from the distal end 112 a of the guide pipe 112 of the insertion assisting tool 1 inserted into the main lumen 22. Therefore, there is no obstacle in particular, and the catheter 2 can be smoothly moved along the guide wire W.

  When the introduction tube 21 of the catheter 2 is inserted into the stomach, the insertion assisting tool 1 and the guide wire W are extracted, and the syringe I is set in the fluid conduction plug portion 31 as shown in FIG. The fluid is injected from 25 and the bumper 40 is inflated. The bumper 40 swelled in this way has a donut shape with a lead-out conduit 51 formed in the center as shown in FIG. A nutrient tube or the like can be connected to the injection port 35 of the catheter head 30 to administer a nutrient or the like.

  As described above, the insertion assisting tool 1 does not pass the guide wire through the insertion rod 111 but passes through the guide pipe 112 different from the insertion rod 111, so that the receiving portion 400 provided on the bumper 40 side of the catheter. It is not necessary to form a passage for passing the guide wire W. Thereby, the receiving part 400 can have a simple structure and a sufficiently high strength, and at the same time, the catheter manufacturing process and manufacturing cost can be reduced.

  Note that the insertion portion 11 may be formed by integrally molding the insertion rod 111 and the guide pipe 112, or may be formed by bonding separately manufactured members.

  Further, in FIG. 3, the outer diameters of the insertion rod 111 and the guide pipe 112 are shown to be the same, but the outer diameters may be different. Moreover, although the insertion rod 111 and the guide pipe 112 are illustrated as having a circular cross-sectional outline, they may have different shapes.

  The insertion aid according to the present invention is not limited to the use of a gastrostomy catheter, but can be widely used and applied to those having a function similar to that of an insertion aid.

DESCRIPTION OF SYMBOLS I ... Syringe W ... Guide wire 1 ... Insertion aid 2 ... Catheter 10 ... Grasp head 11 ... Insertion part 13 ... Guide wire introduction path 13a ... Guide wire introduction port 20 ... Main body 21 ... Introduction tube 22 ... Main lumen 25 ... Sublumen 27 ... tip 28 ... outlet 30 ... catheter head 31 ... fluid conducting plug 32 ... communication path 33 ... lid 34 ... belt 35 ... inlet 40 ... bumper 51 ... outlet pipe 111 ... insertion rod 111a ... tip 112 ... guide pipe 112a ... distal end 112b ... base end 112c ... opening 112d ... guide wire introduction port 113 ... guide wire introduction path 400 ... receiving part 410 ... fitting part

Claims (3)

In an insertion aid for inserting the catheter into a desired position along a guide wire by inserting the catheter into the introduction tube of a catheter equipped with an expandable / shrinkable bumper for preventing removal at the distal end of the introduction tube ,
A gripping head and an insertion portion extending from the gripping head;
The insertion portion has a rod-shaped insertion rod that is inserted into the introduction tube, and a hollow guide pipe that extends in the same direction as the direction of the insertion rod and passes the guide wire.
The insertion rod is to be received by a receiving portion provided at the tip of the bumper,
The guide pipe has a tip that is closer to the gripping head than a tip of the insertion rod. The guide pipe has a proximal end fixed to the inside of the gripping head,
The gripping head is formed such that a guide wire introduction path for introducing the guide wire into the guide pipe is communicated with an outside of the gripping head and an opening on the proximal end side of the guide pipe. The insertion assisting tool according to claim 1, wherein   The insertion support tool according to claim 1 or 2, wherein the insertion portion is formed by integrally forming the insertion rod and a guide pipe.

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