JP2013220297A - Lacrimal passage-expandable bougie - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a lacrimal passage-expandable bougie including an insertion means smoothly and naturally inserted into a lacrimal passage and capable of naturally and efficiently expanding a diameter.SOLUTION: A lacrimal passage-expandable bougie includes: a grip part 1 comprising a distal end part 1a and a grip body 1b; a slider 2 slidably disposed in a slide space 1b1 inside the grip body 1b; a tube body 3 extended forward from the grip part 1; a wire member 4 having a rear part fixed to the slider 2, and inserted in the tube body 3 movably forward and backward; a head body 5 fixed to the distal end thereof, and comprising a front convergent tapered part 5a and a rear convergent tapered part 5b; an operation rod 6 extended to both sides of the slider 4, and having both the ends projected from both side parts of the grip body 1b; and a coil spring 7 biasing the slider 4 to the front side of the slide space 1b1.

Description

  The present invention relates to treatment of lacrimal passage from lacrimal canal to nasolacrimal duct among lacrimal diseases, that is, to a lacrimal dilatation type bougie used for insertion to form lacrimal passage.

  It is said that lacrimal passage obstruction often develops due to the gradual accumulation of waste products in the lacrimal passage, which gradually obstructs the lacrimal passage. It is done by inserting a lacrimal tract dilatation bougie into the lacrimal passage and poking at its tip.

  Patent Document 1 relates to a bougie for treating lacrimal tract, which is composed of a central grip portion and a wire portion that extends from both sides of the grip portion to both sides, and is inserted into the lacrimal passage. It is characterized in that the part is made of a superelastic alloy wire.

  Therefore, according to the lacrimal tract treatment bougie disclosed in Patent Document 1, when it is inserted into the lacrimal passage, the superelastic effect of the superelastic alloy can bend and deform relatively easily along the bending of the lacrimal passage. Thus, it is said that the treatment can be performed with good workability. Moreover, since it bends and deforms well along the lacrimal passage, the possibility of damaging the lacrimal passage at its tip can also be reduced.

  However, it is usually difficult to insert an outer diameter wire portion exceeding the inner diameter of the lacrimal passage, while it is difficult to expand the lacrimal passage with an outer diameter wire portion lower than the inner diameter. The bougie for lacrimal tract treatment of Patent Document 1 does not meet such a problem.

  Patent Document 2 relates to a lacrimal bougie, comprising a cylindrical sandwiching portion, and a thin rod having a diameter smaller than that of the sandwiching portion protruding coaxially from both ends of the sandwiching portion, The tip of the thin rod is tapered.

  Therefore, according to the lacrimal bougie of this patent document 2, when the thin stick is inserted into the lacrimal passage, the tip thereof is configured to be tapered, so that it can be inserted relatively easily, and both sides of the sandwiching portion can be inserted. If the diameter of the thin rod is changed by a certain size and the diameter of the tapered tip of the large-diameter side thin rod is matched with the diameter of the small-diameter side thin rod, the small-diameter side thin rod is inserted for treatment. Later, when a treatment is performed by inserting a thin rod on the large diameter side, it is said that there is an advantage that a relatively smooth insertion can be performed. From the same relationship, prepare a lacrimal bougie with the smallest diameter rod to a lacrimal bougie with the largest diameter rod, and treat the lacrimal bougie with the smallest diameter rod. If the treatment is started with the lacrimal bougie, which is replaced with the one with the largest diameter and replaced with the one with the largest diameter, the appropriate treatment can be completed.

  According to the lacrimal bougie of this patent document 2, it seems that it is possible to insert even a thin rod exceeding the inner diameter by using the tapered tip of the thin rod. Therefore, it seems that the difference in diameter before and after insertion cannot be increased to a certain extent. In short, it seems necessary to prepare a large number of lacrimal bougies composed of thin rods with a small diameter difference, and to repeat a number of treatments that are sequentially replaced and inserted.

Japanese Patent Laid-Open No. 10-225477 JP-A-11-128263

  It is an object of the present invention to provide a lacrimal tract expansion type bougie that can be smoothly and easily inserted into the lacrimal passage and that has insertion means capable of expanding the lacrimal passage more efficiently and efficiently. .

1 of the present invention includes a grip portion,
A slider disposed in a sliding space in the grip portion so as to be slidable in the front-rear direction;
A tube body having elasticity extending forward from the grip portion;
A wire member having a rear portion fixed to the slider and inserted into the tube body so as to freely advance and retract;
A head body fixed to the distal end of the wire member to be positioned immediately before the distal end of the tube body, and comprising a tapered portion that narrows toward the distal end and a rear tapered portion that narrows toward the rear from the rear portion. The body,
An operating rod for sliding the slider unit coupled to the slider in the front-rear direction and operating the rear narrow part of the head body at the tip of the wire member into the tube body. An operating rod protruding to the side or both sides,
It is a lacrimal tract expansion type bougie composed of

According to 2 of the present invention, in the lacrimal tract dilatation bougie of 1 of the present invention,
The slider is provided with a spring material that urges the slider to move to the front side of the slide space of the grip portion.

The present invention 3 is the lacrimal tract dilatation bougie 1 or 2 of the present invention,
The tube body is made of polytetrafluoroethylene or polypropylene.

  According to the lacrimal tract expandable bougie of the present invention, when this is used for the treatment of lacrimal passage occlusion, the wire member covered with the tube body and the tube body together with the tube body from the head body at the distal end are used. Can be easily inserted into the lacrimal passage.

  A head body is disposed at the distal end of the tube body, and a tapered portion that narrows toward the distal end is formed on the distal end side of the head body. Therefore, even when the inner diameter of the lacrimal passage is smaller than the maximum diameter portion of the head body and the outer diameter of the tube body, the tapered portion on the front side of the head body enters the tear body while entering the inside thereof. It can have some diameter expansion effect on the road. Therefore, the wire member that covers the tube body can be easily inserted into the lacrimal passage.

  In addition, after the insertion into the lacrimal passage, the distal end of the tube body is operated by operating the operation rod and then allowing the head body positioned immediately before it to enter the distal end portion of the tube body from the narrowed portion thereafter. The diameter of the portion can be increased by that amount, whereby the corresponding portion of the lacrimal passage into which the distal end of the tube body has entered can be expanded. Since this diameter expansion is the expansion of the part that has already entered the lacrimal passage, it is performed relatively easily compared with the case of entering the lacrimal passage while expanding the diameter from the outside, and the diameter of the lacrimal passage is expanded more reliably. be able to.

  Thereafter, the head body is returned immediately before the tube body in the initial state, the distal end portion of the tube body is returned from the expanded state to the initial non-expanded state, The tube body is further advanced to the extent that the diameter of the distal end of the tube body can be expanded, and then the head body is retracted again by operating the operation rod to expand the distal end portion of the tube body. Perform diameter expansion operation. By repeating the advancement operation of the head body and wire member and the tube body and the subsequent diameter expansion operation of the tube body as necessary, the diameter expansion treatment over the entire range of the lacrimal passage is completed. Can do. Thereafter, the NS tube can be inserted by a general technique.

  According to the lacrimal tract expansion type bougie 2 of the present invention, after the diameter of the distal end of the tube body is increased, the operation force directed toward the rear with respect to the operation rod can be obtained without performing the backward operation with the operation rod. Since the head body automatically returns to the front by the action of the spring material simply by releasing the operation, the operation is simplified.

  According to the lacrimal tract expansion type bougie 3 of the present invention, the tube body can be easily expanded and contracted, and can be used safely in the lacrimal passage.

(a) is a partially cutaway plan view of the lacrimal passage expandable bougie according to the embodiment, and (b) is a partially cutaway sectional view of the lacrimal passage expandable bougie according to the embodiment. (a) is a partially cutaway plan view of the lacrimal tract expandable bougie with the wire member in the initial state, and (b) is a partially cutaway plan view of the lacrimal tract expandable bougie with the wire member in the retracted state. (a) is a partially cutaway plan view of the wire member, (b) is a partially cutaway cross-sectional view of the wire member in the initial state inserted into the tube body, and (c) is one of the retracted wire members inserted into the tube body. FIG. The longitudinal cross-sectional view of the slider vicinity which shows the state which fixed the wire member to the slider.

  A mode for carrying out the invention will be described based on an embodiment with reference to the drawings.

  As shown in FIGS. 1 (a) and 1 (b), the lacrimal tract expandable bougie of this embodiment is basically a slider that is slidably disposed in a grip portion 1 and a slide space 1b1 in the grip portion 1. 2, a tube body 3 that extends forward from the grip portion 1, a wire member 4 that has a rear portion fixed to the slider 2 and that is inserted into the tube body 3 so as to be able to advance and retreat, and a wire member 4 that is fixed to the tip of the wire member 4. The head body 5 composed of the tapered portion 5 a and the rear tapered portion 5 b and the operation rod 6 extending on both sides of the slider 4 are configured.

  As shown in FIGS. 1 (a) and 1 (b), the grip portion 1 is a member composed of a pointed end portion 1a having a tapered tip end side and a rectangular tube-shaped grip body 1b provided with the tip end portion 1a. The slide space 1b1 is formed on the front side of the grip body 1b. Although not clearly shown in the figure, the grip body 1b is formed by joining a pair of branching members that are divided into two in the radial direction. In addition, this grip part 1 shape | molds all the components by a plastic material, respectively.

  As described above, the slider 2 is arranged in the slide space 1b1 so as to be slidable in the front-rear direction as shown in FIG. As shown in the figure, a coupling projection 2a for coupling with the operation rod 6 is projected at the center of the rear portion of the slider 2, and a spring seat is formed at the center of the rear surface of the coupling projection 2a. A small projection 7a is projected. The small protrusion 7a is a spring that holds the front end of a coil spring (spring material) 7 for holding the slider 2 in a pressed state (the state shown in FIG. 1B) against the front side of the slide space 1b1. It constitutes the seat. As shown in the figure, a concave portion 7b constituting a spring seat for arranging the rear end of the coil spring 7 is formed in the center of the rear portion of the slide space 1b1.

  As shown in FIGS. 1A and 1B, the coil spring 7 is disposed between the small projection 7a and the recess 7b. This is a compression coil spring and, as described above, acts to push the slider 2 forward, and holds the slider 2 pressed against the front side of the slide space 1b1 unless an external force is applied. Needless to say, even when the operation bar 6 is operated and the slider 2 is moved backward, the operation force applied to the operation bar 6 is released. It acts to push the slider 2 back.

  The tube body 3 is a tubular member having elasticity, as shown in FIGS. 1 (a), 1 (b), 2 (a), 2 (b) and 3 (b), 3 (c). In the embodiment, it is a member made of polypropylene. As shown in FIG. 1 (b), the tube body 3 has its rear portion penetrated through the central hole 1a1 of the pointed end portion 1a of the grip portion 1 and the front end central hole 1b2 of the grip body 1b, and these central holes. 1a1 and the front end central hole 1b2, and the rear end is opened to the slide space 1b1 side.

  The diameter of the tube body 3 is suitably in the range of about 0.8 mm to 1.0 mm, and the lacrimal tract bougie has diameters in the range, for example, 0.8 mm, 0.9 mm, and 1.0 mm. It is appropriate to prepare three kinds of tubes having the diameter of the tube body 3 and use them in order of diameter expansion treatment of the lacrimal tract using the ones having a smaller diameter and then the larger diameter. The wall thickness of the tube body 3 is about 0.2 mm. Therefore, the inner diameter of the tube body 3 is 0.4 mm for the 0.8 mm diameter, and 0.5 mm and 1.0 mm for the 0.9 mm diameter. That is about 0.6 mm.

  The wire member 4 is a wire-like member having a head body 5 at its tip as shown in FIGS. 3 (a) to 3 (c). The diameter of the tube body 3 is slightly less than 0.4 mm when the diameter (outer diameter) is 0.8 mm, 0.5 mm when 0.9 mm, and 0.6 mm when 1.0 mm. In this embodiment, the material used was stainless steel with some elasticity.

  The head body 5 at the tip is composed of a tapered portion 5a and a rear tapered portion 5b as described above and shown in FIGS. 3 (a) to 3 (c). The tapered portion 5a is more specifically described. In this embodiment, the angle α that opens toward the rear of the tapered portion 5a in a longitudinal section is 60 degrees. The angle α is not limited to 60 degrees, but such an angle is appropriate. In this embodiment, the angle β of the rear narrow portion 5b is also set to 60 degrees. This angle β is not limited to 60 degrees, but an angle of this level is appropriate. The head body 5 is also made of stainless steel in the same manner as the wire member 4, and in this embodiment, the head body 5 is integrally formed with the wire member 4.

  As shown in FIGS. 1 (a), (b), 2 (a), (b) and FIGS. 3 (b), (c), the wire member 4 is the same as the above, except for its rear part. It arranges in the tube body 3. The distal end of the wire member 4 is in a positional relationship that substantially coincides with the distal end of the tube body 3 in the initial state, and the head body 5 formed at the distal end of the wire member 4 is in the initial state immediately before the front end of the tube body 3. Place it so that it is located in As shown in FIG. 1B, the rear portion of the wire member 4 is protruded from the rear end of the tube body 3, and is further inserted into a through hole 2b that is opened in a state of penetrating back and forth in the center of the slider 2. It is what is. The vicinity of the rear center of the wire member 4 inserted into the through hole 2b of the slider 2, as shown in FIG. 1 (b) and FIG. 4, from the outside of the grip body 1b of the grip portion 1 through the screw notch 1c. 2 is fixed by a fixing screw 8 screwed into the female screw portion 2c formed on the head 2. The female screw portion 2c is a screw hole that is opened from above the slider 2 in an inverted T shape with respect to the through hole 1c until it reaches the through hole 1c, and the fixing screw 8 is connected to the female screw portion 2c. By screwing into the through hole 1c, the vicinity of the rear center of the wire member 4 inserted into the through hole 1c is pressed against the peripheral side of the through hole 2c and fixed.

  As shown in FIGS. 1B and 4, the screw cutout 1c is formed by cutting out an upper peripheral wall defining the slide space 1b1 of the grip body 1b. As shown in FIGS. 1 (a), 1 (b), 2 (a), 2 (b) and 4, the dimensions of the threaded cutout 1c in the width direction (direction perpendicular to the sliding direction of the slider 2) are The diameter of the later-described screw portion 8b of the fixing screw 8 is slightly exceeded, and the dimension in the length direction (the direction along the sliding direction of the slider 2) is slightly larger than the sliding stroke of the slider 2.

  As shown in FIGS. 1 (a), 1 (b), 2 (a), 2 (b), and FIG. 4, the fixing screw 8 comprises a disk-shaped knob portion 8a and a screw portion 8b below it. The threaded portion 8b is screwed into the female threaded portion 2c of the slider 2 through the threaded notch 1c, and further, as shown in FIG. This is a length dimension that can be pressed and fixed to the inner peripheral surface of 2b.

  As shown in FIGS. 1 (a) and 1 (b) and FIGS. 2 (a) and 2 (b), the operating rod 6 is fixed to the coupling protrusion 2a of the slider 2 at the center in the longitudinal direction. It is a rod-shaped member arranged in a direction perpendicular to the sliding direction of the slider 2, and its both end portions project from both sides of the grip body 1b.

  As shown in FIG. 1 (b), the slider 2 is coupled to the coupling protrusion 2a by externally fixing a fitting hole 6a formed in the central portion of the operation rod 6 to the coupling protrusion 2a. To do. In this embodiment, the fitting state between the coupling protrusion 2a and the fitting hole 6a is fixed by an adhesive.

  As shown in FIGS. 1 (a), 2 (a), and 2 (b), both ends of the operating rod 6 are horizontally long on the peripheral side portion of the grip body 1b (the side wall portions on both sides defining the slide space 1b1). The operation holes 1d and 1d are opened and protruded on both sides through these holes. The operation holes 1d and 1d are configured to be long in the sliding direction of the slider 2, and the dimension in the length direction is slightly larger than the sliding stroke of the slider 2.

  The lacrimal tract expandable bougie of this embodiment is configured as described above. According to this, when this is used for treatment of lacrimal tract obstruction, the wire member 4 covered with the tube body 3 is used. Can be inserted into the lacrimal passage from the head body 5 at the tip thereof together with the tube body 3, and the diameter expansion treatment operation of the lacrimal passage can be easily performed.

  This lacrimal passage type bougie includes, for example, the grip body 1b of the grip 1 gripped with the thumb, the little finger and the ring finger, the index finger is hung from one side of the operation rod 6 located on the thumb side, and the middle finger is placed on the ring finger The wire member 4 sheathed with the tube body 3 is inserted into the lacrimal passage from the distal end of the head body 5 in a state where it is hung from the front side on the other side of the operation rod 6 positioned at the position.

  Since the lacrimal tract bougie does not pull the operating rod 6 backward in the above, as shown in FIGS. 1 (a) and 2 (a), the slider 2 is operated by the coil spring 7. It is located on the front side of the slide space 1b1, and therefore the head body 5 does not enter the tube body 3 but is located immediately before. Accordingly, when the lacrimal passage is inserted from the head body 5 side, a tapered portion 5a that narrows toward the distal end is formed on the distal end side. Therefore, the inner diameter of the lacrimal passage is the maximum diameter of the head body 5. Even if it is smaller than the outer diameter of the head part and the tube body 3, the tapered part 5a of the head body 5 can enter the lacrimal passage without difficulty while performing a slight diameter expanding action. is there.

  After the insertion into the lacrimal passage, the index bar and the middle finger are operated to move the operating bar 6 backward, and the operating bar 6 is moved backward by a distance L as shown in FIG. As a matter of course, the slider 2 also moves rearward by the distance L along with this, and further, the wire member 4 and the head body 5 at the tip thereof also move backward by the distance L accordingly. 2 (b) and 3 (c), the head body 5 moves backward into the distal end portion of the tube body 3.

  As shown in the figure, when the head body 5 is retracted, the head body 5 enters the distal end portion of the tube body 3 from the rear narrowed portion 5b on the rear side. The diameter of the tip of the body 3 can be increased. When the distal end portion of the tube body 3 is expanded in this way, naturally, the corresponding portion of the lacrimal passage into which the tube body 3 has entered is expanded. And this lacrimal tract diameter expansion operation is the diameter expansion of the part of the lacrimal passage that has already entered, so it is relatively easy to perform while expanding the diameter from the outside, more reliably of the lacrimal tract The diameter can be increased.

  Thereafter, when the force of the index finger and middle finger applied to the operation rod 6 is loosened, the action of the coil spring 7 causes the slider 2 to return to the front side of the slide space 1b1, and accordingly the wire member 4 In addition, the head body 5 at the tip thereof similarly returns to the initial position. The return movement distance is equal to the distance L, the initial position is as shown in FIGS. 1 (a) and 1 (b), and only the positional relationship among the wire member 4, the tube body 3 and the head body 5 is concerned. FIG. 2 (a) and FIG. 3 (b) are the positional relationships.

  After returning to the initial state as described above, the head body 5, the wire member 4 and the tube body 3 are again moved further into the lacrimal passage in that state, and the operating rod 6 is retracted, The diameter expansion operation of the distal end portion of the tube body 3 is performed. This cycle is repeated as necessary to complete the diameter expansion over the entire area of the lacrimal passage. Thereafter, the NS tube can be inserted by a general technique.

  The lacrimal duct expandable bougie of the present invention can be used in the field of manufacturing medical devices.

DESCRIPTION OF SYMBOLS 1 Grip part 1a Pointed part 1a1 Center hole 1b Grip main body 1b1 Slide space 1b2 Front end center hole 1c Screw cutout 1d Operation hole 2 Slider 2a Coupling protrusion 2b Through hole 2c Female thread part 3 Tube body 4 Wire member 5 Head body 5a Tapering Part 5b Rear narrowing part 6 Operation rod 6a Fitting hole 7 Coil spring 7a Small protrusion 7b Recessed part 8 Fixing screw 8a Knob part 8b Screw part L Distance α Angle β Angle

Claims (3)

A grip part;
A slider disposed in a sliding space in the grip portion so as to be slidable in the front-rear direction;
A tube body having elasticity extending forward from the grip portion;
A wire member having a rear portion fixed to the slider and inserted into the tube body so as to freely advance and retract;
A head body fixed to the distal end of the wire member to be positioned immediately before the distal end of the tube body, and comprising a tapered portion that narrows toward the distal end and a rear tapered portion that narrows toward the rear from the rear portion. The body,
An operating rod for sliding the slider unit coupled to the slider in the front-rear direction and operating the rear narrow part of the head body at the tip of the wire member into the tube body. An operating rod protruding to the side or both sides,
Lacrimal tract expansion type bougie composed of   The lacrimal tract expansion type bougie according to claim 1, wherein a spring material for urging the slider to move to the front side of the slide space of the grip portion is disposed on the slider.   The lacrimal tract expansion type bougie according to claim 1 or 2, wherein the tube body is made of polytetrafluoroethylene or polypropylene.

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