JP2012179087A - Puncture needle - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a puncture needle capable of easily adjusting the puncture angle.SOLUTION: The puncture needle includes a leading end part 114 equipped with a needle tip 112, a hollow needle part 110 having the needle part lumen 118 communicating with the needle tip 112 and the stylet 120 freely sliding to be inserted in the needle part lumen 118. The needle part 110 is arranged at a position separated from the needle tip 112 and has a flexible part 113 elastically deformed by the puncture load of the needle tip 112. The stylet 120 has reinforcing parts 124A and 124B for obstructing the elastic deformation of the flexible part 113. The reinforcing parts 124A and 124B slide through the needle part lumen 118 to freely support the inner periphery of the flexible part 113.

Description

  The present invention relates to a puncture needle.

  For example, when it is necessary to puncture the abdominal wall or vaginal wall, a Veress needle in which the needle tip is guarded is applied to avoid damage to an organ located inside the puncture site (for example, Patent Document 1 and Patents). Reference 2).

Japanese Patent Laid-Open No. 5-130999 Japanese Patent Laid-Open No. 9-135841

  However, because the tip of the Beres needle is thin, even if the needle tip is guarded, there is a risk of organ damage when contacting the organ, and it is preferable to puncture avoiding the organ by changing the puncture angle, For example, in the case of puncture from the vagina wall, it is difficult to change the puncture angle because the inside of the vagina is narrow, and thus there is a problem that puncture cannot be performed in a desired direction.

  The present invention has been made to solve the problems associated with the above-described prior art, and an object thereof is to provide a puncture needle that can easily adjust the puncture angle.

To achieve the above object, the present invention provides:
A hollow needle portion having a tip portion provided with a needle tip and a needle portion lumen communicating with the needle tip;
And a stylet that is slidably inserted into the needle lumen. In addition, the needle portion is disposed at a position separated from the needle tip, and has a flexible portion that is elastically deformed by a puncture load by the needle tip, and the stylet prevents elastic deformation of the flexible portion. The reinforcing portion is configured to freely support the inner periphery of the flexible portion by sliding in the needle portion lumen.

  According to the present invention, before puncturing, the reinforcing portion of the stylet is positioned on the flexible portion at the distal end portion of the needle portion, and is supported by the outer periphery of the reinforcing portion of the stylet. It is possible to secure rigidity and suppress inadvertent deformation of the tip of the needle portion. On the other hand, at the time of puncturing, the support of the flexible portion at the distal end portion of the needle portion can be released by sliding (moving) the reinforcing portion of the stylet and separating it from the flexible portion at the distal end portion of the needle portion. Is possible. Accordingly, when a puncture load (resistance) is applied to the needle tip, the flexible portion is bent due to elastic deformation and the direction of the needle tip changes, so that the puncture angle is adjusted. Therefore, it is possible to provide a puncture needle that can easily adjust the puncture angle.

  Further, the stylet is provided with a bendable bending portion, and the reinforcing portion has a first reinforcing portion located on the needle tip side of the needle portion and a second reinforcing portion located on the proximal end side of the needle portion. The bending portion is positioned between the first reinforcement portion and the second reinforcement portion, and the flexible portion can be configured to be elastically deformable by overlapping at least partly with the bending portion. preferable. In this case, it is possible to adjust the bending position and the bending direction of the flexible portion at the distal end portion of the needle portion by changing the configuration of the bent portion of the stylet. That is, the degree of freedom regarding the setting of the bending position and the bending direction of the flexible portion can be improved.

  Regarding the axial direction of the needle part, the length of the bent part is preferably shorter than the length of the flexible part. In this case, it is possible to adjust the bending position in the flexible portion by changing the region where the bent portion in the stylet overlaps in the region occupied by the flexible portion in the distal end portion of the needle portion. That is, the length from the bent portion of the needle portion to the needle tip can be changed by moving the bent portion within the region occupied by the flexible portion.

  Regarding the axial direction of the needle part, the length of the first reinforcing part is preferably longer than the length of the flexible part. In this case, it is possible to support the entire area occupied by the flexible part at the tip of the needle part by the first reinforcing part in the stylet, and reliably prevent the elastic deformation of the flexible part (maintain a straight line). can do.

  Regarding the axial direction of the needle portion, the sum of the length of the first reinforcing portion and the length of the bent portion is preferably shorter than the length between the needle tip and the flexible portion. In this case, it is easy to suppress the first reinforcing portion in the stylet from protruding from the needle tip (needle lumen).

  The flexible portion is preferably formed by cutting the wall portion of the needle portion into a spiral shape. In this case, the flexible part can be easily formed.

  The bent portion is preferably configured to be elastically deformed by a puncture load by the needle tip. In this case, since the bent portion has elasticity, the stylet is prevented from being bent carelessly.

  The bent portion is preferably formed by cutting the wall portion of the stylet into a spiral shape. In this case, the bent portion can be easily formed.

  It is preferable to arrange a marker that generates a reflected echo with respect to the ultrasonic wave at the tip of the needle portion. In this case, it is easy to confirm (detect) the position of the tip of the needle part by receiving the reflected echo of the marker in ultrasonic echo diagnosis (examination).

  The stylet is hollow, provided with a stylet lumen that penetrates along the axial direction of the needle, and the puncture needle is slidably inserted into the stylet lumen, and the insertion member is urged It is also possible to further have a biasing means. In this case, before the puncture with the needle tip and after the puncture is completed, the distal end portion of the insertion member protrudes from the needle tip, and when the needle tip punctures, the distal end portion of the insertion member becomes a stylet lumen by a load due to the puncture By configuring the biasing means so as to move backward, the tip of the needle is guarded by the protruding tip of the insertion member (functions as a Veress needle) before puncture and after completion of puncture. Therefore, it is possible to avoid inadvertent damage to the organ located in the introduction path to the puncture site and the organ located inside the puncture site.

  The insertion member is hollow and may have an insertion member lumen penetrating along the axial direction of the needle portion. In this case, a therapeutic device such as a catheter, endoscope, forceps, or the like can be easily introduced into the puncture site via the insertion member lumen.

  The distal end portion of the insertion member preferably has flexibility. In this case, when the flexible portion is elastically deformed by a puncture load by the needle tip, it is possible to suppress interference due to the presence of the distal end portion of the insertion member.

  The stylet and the insertion member can be configured to be detachable from the needle portion. In this case, after the puncture is completed, the needle portion can be used as an indwelling needle by separating the stylet and the insertion member from the needle portion retained at the puncture site.

  It is preferable to provide a lever portion to which the base end portion of the stylet is connected, and an opening portion through which the lever portion is visible and allows the lever portion to move along the axial direction of the needle portion. In this case, it is possible to indirectly grasp the change in the position of the bent portion of the stylet by the change in the position of the lever portion.

  It is preferable to arrange a limiter that limits the amount of movement of the lever portion, and to set the amount of movement to a length that eliminates the overlap between the flexible portion of the needle portion and the bent portion of the stylet. In this case, the elimination of the overlap between the flexible portion of the needle portion and the bent portion of the stylet (restoration from the bent shape to the straight shape) can be detected by restricting the movement of the lever portion by the limiter, so that workability is improved. It is good.

  It is preferable to arrange a stopper that limits the amount of protrusion of the distal end portion of the insertion member from the needle portion at the hand operation portion where the urging means is disposed. In this case, it is possible to avoid that the distal end portion of the insertion member protrudes excessively due to the urging force of the urging means and carelessly damages an organ located inside the puncture site.

It is a side view for demonstrating the puncture needle which concerns on embodiment of this invention. It is a top view of the puncture needle shown by FIG. It is sectional drawing for demonstrating the front-end | tip part of the puncture needle shown by FIG. It is sectional drawing for demonstrating the hand operation part of the puncture needle shown by FIG. It is sectional drawing for demonstrating the usage method of the puncture needle which concerns on embodiment of this invention, and has shown the front-end | tip part at the time of the puncture start. It is sectional drawing for demonstrating the hand operation part at the time of a puncture start. It is sectional drawing for demonstrating receding of the bending part of a stylet in the middle of puncture. It is sectional drawing for demonstrating receding of the lever part of the hand operation part in the middle of puncture. It is sectional drawing for demonstrating the bending of a front-end | tip part. It is sectional drawing for demonstrating the front-end | tip part at the time of puncture completion. It is sectional drawing for demonstrating the hand operation part at the time of puncture completion. It is sectional drawing for demonstrating receding of the bending part of a stylet after puncture completion. It is sectional drawing for demonstrating retraction of the lever part of a hand operation part after puncture completion. It is sectional drawing for demonstrating the front-end | tip part at the time of isolation | separation of a needle part. It is sectional drawing for demonstrating the hand operation part at the time of isolation | separation of a needle part. It is sectional drawing for demonstrating indwelling of a needle part. It is a side view for demonstrating the modification 1 which concerns on embodiment of this invention. It is a side view for demonstrating the modification 2 which concerns on embodiment of this invention. It is sectional drawing for demonstrating the modification 3 which concerns on embodiment of this invention.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  1 is a side view for explaining a puncture needle according to an embodiment of the present invention, FIG. 2 is a plan view of the puncture needle shown in FIG. 1, and FIG. 3 is a tip of the puncture needle shown in FIG. FIG. 4 is a cross-sectional view for explaining the hand operating portion of the puncture needle shown in FIG. 1.

  A puncture needle 100 according to an embodiment of the present invention has a needle part 110, a stylet 120, an insertion member 130, and a hand operation part 140, and is used to puncture a wall part in a living body. The wall is the vaginal wall when applied to a transvaginal laparoscope (THL). The wall portion is not limited to the vagina wall and can be applied to the abdominal wall.

  The needle portion 110 is formed of a hollow tube, and includes a distal end portion 114 in which a sharp needle tip 112 is formed, a proximal end portion 116 to which the hand operating portion 140 is connected, and a needle portion lumen 118 that communicates with the needle tip 112. And having. The distal end portion 114 further includes a flexible portion 113 that is disposed at a position separated from the needle tip 112.

  The flexible portion 113 is configured to be elastically deformed by a puncture load (resistance) by the needle tip 112. The rigidity of the part sandwiching the flexible part 113 (the distal end part 114A located on the needle tip side of the needle part 110 from the flexible part 113 and the proximal end part 114B located on the proximal side of the needle part 110 from the flexible part 113) is It is larger than the flexible portion 113 and is set so as not to be elastically deformed by a puncture load by the needle tip 112.

  A convex limiter 116A and a concave stopper 116B are disposed on the base end portion 116 (FIG. 4). As will be described later, the limiter 116A controls the movement of the stylet 120, and the stopper 116B is used to control the movement of the insertion member 130.

  In addition, the base end portion 116 has an opening 119 that allows a later-described lever portion 126 to be seen and allows the lever portion 126 to move along the axial direction S of the needle portion 110.

  Next, the stylet 120 will be described.

  The stylet 120 is formed of a hollow tube, is slidably inserted into the needle lumen 118, and the stylet lumen 128 through which the insertion member 130 is inserted, and a bendable bending portion 123 (see FIG. 3). And a proximal end portion provided with a lever portion 126 disposed at the proximal end portion 116 of the needle portion 110.

  The bent portion 123 is located on the distal end side of the flexible portion 113 of the needle portion 110 in the initial state before puncturing with the needle tip 112.

  The rigidity of the part sandwiching the bent part 123 (the distal end part 124A located on the needle tip side of the needle part 110 from the bent part 123 and the proximal end part 124B located on the proximal side of the needle part 110 from the bent part 123) is It is set so as not to be elastically deformed by the puncture load by the needle tip 112. That is, the distal end portion 124A and the proximal end portion 124B are a first reinforcing portion and a second reinforcing portion having rigidity capable of preventing elastic deformation of the flexible portion 113, and are slid in the needle portion lumen 118. The inner periphery of the flexible portion 113 is configured to be freely supported.

Regarding the axial direction S of the needle portion 110, the length L ₁₀ of the bent portion 123 of the stylet 120 is preferably shorter than the length L ₂₀ of the flexible portion 113 of the needle portion 110. In this case, it is possible to adjust the bending position in the flexible portion 113 by changing the region where the bending portion 123 overlaps in the region occupied by the flexible portion 113 in the distal end portion 114 of the needle portion 110. That is, the length from the bent portion of the needle portion 110 to the needle tip 112 can be changed by moving the bent portion 123 within the region occupied by the flexible portion 113.

Regarding the axial direction S, the length L ₁₁ of the tip portion (first reinforcing portion) 124 A of the stylet 120 is preferably longer than the length L ₂₀ of the flexible portion 113 of the needle portion 110. In this case, the entire region occupied by the flexible portion 113 in the distal end portion 114 of the needle portion 110 can be supported by the distal end portion 124A, and inadvertent elastic deformation of the flexible portion 113 can be reliably prevented (in a straight line). Maintenance).

Further, with respect to the axial direction S, the sum of the length L ₁₁ of the distal end portion 124 A of the stylet 120 and the length L ₁₀ of the bent portion 123 is based on the length L ₂₁ between the needle tip 112 and the flexible portion 113. Short is preferred. In this case, it is easy to suppress the distal end portion 124A from protruding from the needle tip 112 (needle portion lumen 118).

  The lever portion 126 is disposed at the proximal end portion 116 of the needle portion 110 and is slidable along the axial direction S of the insertion member 130. By moving the lever portion 126, the position of the bent portion 123 is changed. It is possible to change. Therefore, when the lever portion 126 is retracted so that the bent portion 123 and the flexible portion 113 of the needle portion 110 overlap at least partially, the distal end portion 124A or the proximal end portion (second reinforcing portion) with respect to the flexible portion 113 ) The support by 124B disappears and can be elastically deformed, so that it can be elastically deformed by the puncture load by the needle tip 112.

  The movement of the lever portion 126 is restricted by contacting the convex limiter 116 </ b> A disposed at the proximal end portion 116 of the needle portion 110. The position of the limiter 116 </ b> A is set so as to allow the bent portion 123 to move to the base end side from the flexible portion 113.

  That is, a limiter 116 </ b> A that restricts the amount of movement of the lever portion 126 is disposed in the hand operation unit 140, and the amount of movement of the lever portion 126 includes the flexible portion 113 of the needle portion 110 and the bent portion 123 of the stylet 120. It is set to a length that eliminates the overlap. Thereby, since the cancellation of the overlap can be sensed by the movement of the lever portion 126 being restricted by the limiter 116A, the workability is good.

  The lever portion 126 is exposed (protruded) from the opening 119 of the proximal end portion 116 of the needle portion 110 and is visible. Therefore, the change in the position of the bent portion 123 of the stylet 120 can be indirectly grasped by the change in the position of the lever portion 126.

  The stylet 120 is configured to be detachable from the needle portion 110 by pulling the lever portion 126 beyond the limiter 116 </ b> A and taking out (separating from) the needle portion lumen 118.

  Next, the insertion member 130 will be described.

  The insertion member 130 is slidably inserted into the stylet lumen 128 and has a distal end portion 134 that protrudes from the distal end portion 114 of the needle portion 110 and a proximal end portion 136 that extends the inside of the hand operating portion 140.

  The distal end portion 134 is configured to guard the needle tip 112 in order to avoid damage to an organ located inside the puncture site of the wall portion (see FIG. 3).

  The base end portion 136 has an extended portion 137 that protrudes in a direction that intersects the axial direction S of the insertion member 130. The extended portion 137 is integrated with the proximal end portion 136 and is positioned so as to contact the end surface of the proximal end portion 116 of the needle portion 110. The outer diameter (size) of the extended portion 137 is It is larger than the outer diameter (size) of the end face of the base end portion 116 (see FIG. 4).

  It is preferable that at least the distal end portion 134 of the insertion member 130 has flexibility. In this case, when the flexible portion 113 is elastically deformed by a puncture load by the needle tip 112, it is possible to suppress interference due to the presence of the distal end portion 134 of the insertion member 130.

  The insertion member 130 is configured to be detachable from the stylet 120 (and the needle portion 110) by pulling the extension portion 137 and removing (separating) it from the stylet lumen 128.

  Next, the hand operation unit 140 will be described.

  The hand operation part 140 has a cap part 146 in which the base end part 116 of the needle part 110 and the base end part 136 of the insertion member 130 are detachably connected, and the biasing means 150 is disposed (FIG. 4). .

  The urging unit 150 includes an elastic member (for example, a spring) that applies an urging force to the expansion portion 137 of the insertion member 130. The urging force of the urging means 150 is applied by the puncture when the distal end portion 134 of the insertion member 130 protrudes from the needle tip 112 before and after the puncture by the needle tip 112 and the needle tip 112 punctures. It is set so that the distal end portion 134 of the insertion member 130 is retracted to the needle portion lumen 118 by the load.

  Therefore, before puncturing and after completion of puncturing, the needle tip 112 is guarded by the protruding distal end portion 134 of the insertion member 130 (to function as a Veress needle), and therefore, the organ located in the introduction path to the puncture site and It is possible to avoid inadvertent damage to an organ located inside the puncture site.

  The cap portion 146 has a claw portion 147 that fits with a concave stopper 116B disposed at the proximal end portion 116 of the needle portion 110. The nail | claw part 147 fixes the base end part 116 of the needle part 110 by fitting with the stopper 116B. The end surface of the proximal end portion 116 of the needle portion 110 abuts on the expanded portion 137 of the insertion member 130, thereby stopping the advancement of the insertion member 130 (protrusion of the distal end portion 134). Therefore, the stopper 116 </ b> B has a function of limiting the protruding amount of the distal end portion 134 of the insertion member 130 from the needle portion 110, and the distal end portion 134 of the insertion member 130 protrudes excessively by the urging force of the urging means 150. Thus, it is possible to avoid inadvertently damaging an organ located inside the puncture site.

  As described above, the puncture needle 100 positions the reinforcing portions (the distal end portion 124A and the proximal end portion 124B) of the stylet 120 on the flexible portion 113 at the distal end portion 114 of the needle portion 110 before the puncture, By supporting the outer periphery of the reinforcing portion of the let 120, it is possible to ensure the rigidity of the tip portion 114 of the needle portion 110 and to prevent inadvertent deformation of the tip portion 114 of the needle portion 110. On the other hand, at the time of puncturing, the reinforcing portion of the stylet 120 is slid (moved) and separated from the flexible portion 113 at the distal end portion 114 of the needle portion 110, whereby the flexible portion 113 at the distal end portion 114 of the needle portion 110. It is possible to release the support. Thereby, when a puncture load is applied to the needle tip 112, the flexible portion 113 is bent by elastic deformation and the direction of the needle tip 112 changes, so that the puncture angle is adjusted.

  Further, a bendable bending portion 123 is provided between the reinforcing portions of the stylet 120 (the distal end portion 124A and the proximal end portion 124B), and the flexible portion 113 overlaps with the bending portion 123 at least partially, It is configured to be elastically deformable. Therefore, the bending position and the bending direction of the flexible portion 113 can be adjusted by changing the configuration of the bending portion 123. That is, the degree of freedom regarding the setting of the bending position and the bending direction of the flexible portion 113 can be improved.

  The flexible portion 113 is preferably formed by cutting the wall portion of the needle portion 110 into a spiral shape. In this case, the flexible part 113 can be easily formed. The flexible portion 113 is not limited to a form integrated with the needle portion 110 as long as it can be elastically deformed by a puncture load by the needle tip 112. For example, the flexible portion 113 is not limited to a coil made of a spring material or a flexible plastic. It is also possible to separately form the flexible portion 113 configured by the above and arrange (join) between the distal end portion 114A and the proximal end portion 114B of the needle portion 110.

  The bent portion 123 of the stylet 120 is preferably configured to be elastically deformed by a puncture load by the needle tip 112. In this case, since the bending part 123 has elasticity, it is suppressed that the stylet 120 bends carelessly.

  Moreover, it is preferable to form the bending part 123 by cutting the wall part of the stylet 120 helically. In this case, the bent portion 123 can be easily formed. The bent portion 123 is not limited to the form integrated with the stylet 120 as long as it can be bent. For example, the bent portion 123 is separately formed by a coil made of a spring material or a flexible plastic, It is also possible to arrange (join) between the part 124A and the base end part 124B.

  The stylet 120, the insertion member 130, and the hand operation unit 140 are configured to be detachable from the needle unit 110. Therefore, after the puncture is completed, the needle unit 110 can be used as an indwelling needle by separating the stylet 120, the insertion member 130, and the hand operation unit 140 from the needle unit 110 placed at the puncture site. .

  Examples of the constituent material of the needle part 110, the stylet 120, and the insertion member 130 include a flexible metal, a relatively high-rigidity polymer material, or a combination of these appropriately. For example, the metal is stainless steel, Ni—Ti alloy, Cu—Zn alloy, cobalt alloy, tantalum, and the polymer material is polyamide, polyimide, ultrahigh molecular weight polyethylene, polypropylene, aromatic polyether ketone (eg, PEEK). ), A fluororesin.

  Examples of the flexible plastic applied to the flexible portion 113 and the bent portion 123 formed separately are synthetic resin elastomers such as olefin elastomers, polyamide elastomers, styrene elastomers, polyurethanes, urethane elastomers, and fluororesin elastomers. , Synthetic rubber such as urethane rubber, silicone rubber and butadiene rubber, and natural rubber such as latex rubber.

  Examples of the constituent material of the hand operation unit 140 include thermoplastic resins such as polycarbonate, polyamide, polysulfone, polyarylate, and methacrylate-butylene-styrene copolymer.

  Next, a method for using the puncture needle according to the embodiment of the present invention will be described.

  FIGS. 5 and 6 are cross-sectional views for explaining the distal end portion and the hand operation portion at the start of puncturing, and FIGS. 7 and 8 illustrate the retraction of the bent portion of the stylet during the puncture and the lever portion of the hand operation portion. FIG. 9 is a cross-sectional view for explaining the retraction, FIG. 9 is a cross-sectional view for explaining the bending of the distal end portion, and FIGS. 10 and 11 are cross-sectional views for explaining the distal end portion and the hand operating portion when puncturing is completed 12 and 13 are cross-sectional views for explaining the retraction of the bent portion of the stylet and the retraction of the lever portion of the hand operation portion after completion of the puncture, and FIGS. 14 and 15 are the distal end portion when the needle portion is separated. FIG. 16 is a cross-sectional view for explaining the placement of the needle part.

  When applied to a laparoscope by a transvaginal approach, first, as a preparation, disinfection of the vulva and vagina, insertion of an ultrasonic probe, expansion of the vaginal vault by Cusco, etc. are performed.

  Thereafter, the tip of the puncture needle 100 is inserted into the vagina. At this time, the distal end portion 134 of the insertion member 130 protrudes from the distal end portion 114 of the needle portion 110 based on the biasing force of the biasing means 150, guards the needle tip 112 (see FIG. 3), and the puncture site It is possible to avoid inadvertent damage to the organ located in the introduction route and the organ located inside the puncture site. Moreover, since the protrusion amount of the front-end | tip part 134 of the insertion member 130 is restrict | limited by the stopper 116B of the hand operation part 140, it can avoid protruding too much.

  On the other hand, the flexible portion 113 at the distal end portion 114 of the needle portion 110 does not overlap the bent portion 123 of the stylet 120 located inside the needle portion 110, and the proximal end portion (second reinforcing portion) of the stylet 120. 124B. Therefore, the tip end portion 114 of the needle portion 110 is maintained in a straight line shape.

  When the distal end portion 134 of the insertion member 130 comes into contact with the wall portion 190, the distal end portion 134 moves backward to the needle portion lumen 118 against the urging force of the urging means 150 based on the load caused by the contact. Thereby, the front-end | tip part 114 of the needle part 110 is exposed, and the wall part 190 is punctured by the needle point 112 (FIG. 5). On the other hand, the expanded portion 137 of the base end portion 136 of the insertion member 130 compresses the biasing means 150 against the biasing force of the biasing means 150 (FIG. 6).

  At this time, since the organ 192 exists in front of the needle tip 112 (FIG. 7), the lever portion 126 of the stylet 120 is moved toward the cap portion 146 of the hand operation unit 140 (FIG. 8). As a result, the bent portion 123 of the stylet 120 moves backward (changes position), overlaps with the flexible portion 113 at the distal end portion 114 of the needle portion 110, and the support for the flexible portion 113 disappears.

  In this state, when the puncture with the needle tip 112 is advanced, the flexible portion 113 is elastically deformed and bent by the puncture load (FIG. 9). As a result, the direction of the needle tip 112 changes and the puncture angle is adjusted, so that the organ 192 does not exist in front of the needle tip 112. Thereby, the possibility that the needle tip 112 abuts on the organ 192 is eliminated.

  When the needle tip 112 penetrates the wall portion 190, the load due to contact with the wall portion 190 disappears, so that the force of the urging means 150 that has been shrunk to the base end side is released and the stopper 116B acts. The extended portion 137 of the proximal end portion 136 of the insertion member 130 moves forward (FIGS. 10 and 11). Thereby, the front-end | tip part 134 of the penetration member 130 protrudes from the front-end | tip part 114 of the needle part 110, and guards the needle point 112 (FIG. 10). Therefore, inadvertent damage to the organ 192 located inside the puncture site of the wall 190 can be avoided.

  Thereafter, the lever portion 126 of the stylet 120 is retracted toward the cap portion 146 of the hand operation portion 140 until it contacts the limiter 116A (FIG. 13). Thereby, the overlap between the flexible portion 113 of the needle portion 110 and the bent portion 123 of the stylet 120 is eliminated, and the linear shape before elastic deformation is restored (FIG. 12).

  Then, the lever part 126 of the stylet 120 is moved over the limiter 116A until it abuts against the cap part 146 of the hand operation part 140 (FIGS. 14 and 15).

  Next, the fitting of the claw portion 147 of the cap portion 146 in the hand operation portion 140 and the stopper 116B in the proximal end portion 116 of the needle portion 110 is released, and the hand operation portion 140 is pulled to pull the hand operation portion 140. Separate from the needle portion 110. Then, the insertion member 130 and the stylet 120 are separated from the needle portion 110 by sequentially pulling and pulling out.

  Thereby, the needle part 110 is detained at the puncture site (FIG. 16), and constitutes an indwelling needle.

  Needle unit 110 placed at the puncture site (functioning as an indwelling needle) is used for injection of physiological saline, insertion of an endoscope, treatment, and the like.

  Saline is injected between the uterus and the rectum via a cannula inserted into the needle lumen 118, for example, to float the fallopian tube or ovary. The endoscope is inserted to inspect (observe) the surface of the oviduct or ovary in a floating state after removing the cannula after completion of the injection of physiological saline, for example. Test items include passage through the fallopian tube, adhesion around the fallopian tube, and presence or absence of endometriosis.

  The treatment target is, for example, external endometriosis (ectopic endometriosis), and is applied to puncture suction of a chocolate cyst.

  After use, as a post-treatment, bleeding from the puncture site is stopped.

  Next, Modifications 1 to 3 according to the embodiment of the present invention will be described sequentially.

  FIG. 17 is a side view for explaining the first modification according to the embodiment of the present invention.

  It is preferable to arrange a marker 160 that generates a reflected echo with respect to the ultrasonic wave at the distal end portion 114 of the needle portion 110. In this case, in the ultrasonic echo diagnosis (examination), by receiving the reflected echo of the marker 160, the confirmation (detection) of the position of the distal end portion 114 of the needle portion 110 is facilitated. The marker 160 can be configured by, for example, a scratch (unevenness) formed on the outer periphery of the distal end portion 114.

  FIG. 18 is a side view for explaining the second modification according to the embodiment of the present invention.

  The flexible part 113 of the needle part 110 is not limited to a single form, and a plurality of flexible parts 113 can be arranged.

  FIG. 19 is a cross-sectional view for explaining a third modification according to the embodiment of the present invention.

  The insertion member 130 is not limited to a solid form, and may be hollow and provided with an insertion member lumen 138 that penetrates along the axial direction S of the needle portion 110. In this case, a treatment device such as a catheter, endoscope, forceps, or the like can be easily introduced into the puncture site via the insertion member lumen 138.

  As described above, in the present embodiment, it is possible to provide a puncture needle that can easily adjust the puncture angle.

  The present invention is not limited to the above-described embodiments, and various modifications can be made within the scope of the claims. For example, it can be applied as a pneumoperitoneum that introduces carbon dioxide into the abdominal cavity. The treatment instrument inserted into the needle lumen is not limited to a cannula, an endoscope, and a puncture suction needle, and a catheter or an endoscope can be configured to be freely inserted.

  Further, in the initial state before puncturing with the needle tip, the bent portion of the stylet is not limited to the form positioned on the distal end side with respect to the flexible portion of the needle portion, and can be positioned on the proximal end side with respect to the flexible portion. is there. In this case, the flexible portion can be elastically deformed by moving (advancing) the stylet to the tip side. Furthermore, for example, by making the elasticity (strength) of the flexible part or the bent part nonuniform in the circumferential direction, it is possible to give directionality to the elastic deformation of the flexible part.

100 puncture needle,
110 needle part,
112 needle points,
113 Flexible part,
114 tip,
114A tip region,
114B proximal end site,
116 proximal end,
116A limiter,
116B stopper,
118 Needle lumen,
119 opening,
120 stylet,
123 bent part,
124 tip,
124A tip portion (first reinforcing portion),
124B proximal end portion (second reinforcing portion),
126 lever part,
128 stylet lumens,
130 insertion member,
134 tip,
136 proximal end,
137 extension,
138 Insert member lumen,
140 Hand control unit,
146 cap part,
147 claw section,
150 biasing means,
160 markers,
190 wall,
192 organs,
L ₁₀ length of the bent part,
The length of the tip portion (first reinforcing portion) of the L ₁₁ stylet,
L ₂₀ flexible part of the length,
L ₂₁ Length between needle tip and flexible part,
S Axial direction.

Claims (16)

A hollow needle portion having a tip portion provided with a needle tip and a needle portion lumen communicating with the needle tip;
A stylet that is slidably inserted into the needle lumen;
The needle portion is disposed at a position separated from the needle tip, and has a flexible portion that is elastically deformed by a puncture load by the needle tip,
The stylet has a reinforcing portion for preventing elastic deformation of the flexible portion,
The puncture needle, wherein the reinforcing portion is configured to freely support the inner periphery of the flexible portion by sliding in the needle portion lumen. The stylet has a bendable portion,
The reinforcing portion has a first reinforcing portion located on the needle tip side of the needle portion and a second reinforcing portion located on the proximal end side of the needle portion,
The bent portion is located between the first reinforcing portion and the second reinforcing portion,
The puncture needle according to claim 1, wherein the flexible portion can be elastically deformed by overlapping at least a part of the bent portion.   The puncture needle according to claim 2, wherein a length of the bent portion is shorter than a length of the flexible portion with respect to an axial direction of the needle portion.   The puncture needle according to claim 2 or 3, wherein a length of the first reinforcing portion is longer than a length of the flexible portion with respect to an axial direction of the needle portion.   The sum of the length of the first reinforcing portion and the length of the bent portion in the axial direction of the needle portion is shorter than the length between the needle tip and the flexible portion. The puncture needle according to any one of 4 to 4.   The Veres needle according to any one of claims 2 to 5, wherein the flexible part is formed by spirally cutting a wall part of the needle part.   The puncture needle according to any one of claims 2 to 6, wherein the bent portion is configured to be elastically deformed by a puncture load applied by the needle tip.   The puncture needle according to claim 7, wherein the bent portion is formed by cutting a wall portion of the stylet in a spiral shape. It has a marker that generates a reflected echo for ultrasound,
The puncture needle according to any one of claims 2 to 8, wherein the marker is disposed at the distal end portion of the needle portion. The stylet is hollow and has a stylet lumen penetrating along the axial direction of the needle part,
The puncture needle is
An insertion member slidably inserted into the stylet lumen;
Before and after completion of puncturing with the needle tip, the distal end portion of the insertion member protrudes from the needle tip, and when the needle tip punctures, the distal end portion of the insertion member is An urging means for urging the insertion member so as to retreat to the stylet lumen;
The puncture needle according to any one of claims 2 to 9, further comprising:   The puncture needle according to claim 10, wherein the insertion member is hollow and has an insertion member lumen penetrating along the axial direction of the needle portion.   The puncture needle according to claim 10, wherein a distal end portion of the insertion member has flexibility.   The puncture needle according to any one of claims 10 to 12, wherein the stylet and the insertion member are configured to be detachable from the needle portion. A lever portion to which the base end portion of the stylet is coupled;
An opening that allows the lever portion to be visually observed and allows movement of the lever portion along the axial direction of the needle portion;
The puncture needle according to any one of claims 10 to 13, characterized by comprising: A limiter for limiting the amount of movement of the lever portion;
The puncture needle according to claim 14, wherein the movement amount is set to a length that eliminates an overlap between the flexible portion of the needle portion and the bent portion of the stylet. Having a hand operating part on which the urging means is disposed;
The puncture needle according to any one of claims 10 to 15, wherein the hand operation unit includes a stopper that limits a protruding amount of a distal end portion of the insertion member from the needle unit.

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