JP2013220297A - Lacrimal passage-expandable bougie - Google Patents

Lacrimal passage-expandable bougie Download PDF

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JP2013220297A
JP2013220297A JP2012095412A JP2012095412A JP2013220297A JP 2013220297 A JP2013220297 A JP 2013220297A JP 2012095412 A JP2012095412 A JP 2012095412A JP 2012095412 A JP2012095412 A JP 2012095412A JP 2013220297 A JP2013220297 A JP 2013220297A
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slider
tube body
lacrimal
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diameter
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JP5615317B2 (en
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Yasuo Tanaka
保夫 田中
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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

本発明は、涙器疾患のうち、涙小管から鼻涙管に至る涙道閉塞の治療、すなわち、これに挿入して涙道を形成するために用いる涙道拡張型ブジーに関するものである。   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.

涙道閉塞は、涙道内に老廃物が徐々に蓄積して次第に該涙道が閉塞するに至るというようなことで発症する場合が多いとのことであるが、この治療は、以上のように、涙道拡張型ブジーを涙道に挿入し、その先端で突くことによって行われている。   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.

特許文献1は、涙道治療用ブジーに関するもので、これは、中央のつかみ部分と該つかみ部分の両側から各々両側に延長した、涙道に挿入するためのワイヤー部とからなり、そのうち該ワイヤー部を超弾性合金ワイヤーにより構成したところに特徴を有するものである。   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.

従ってこの特許文献1の涙道治療用ブジーによれば、これを涙道に挿入した場合に、該超弾性合金の超弾性効果により、涙道の曲がりに沿って比較的容易に曲がり変形することが可能であり、これによって作業性良好にその治療行為を行うことができるとされる。また涙道に沿って良好に曲がり変形するため、その先端で涙道に傷つけてしまう可能性を低減することもできるとされる。   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.

もっとも涙道には、その内径を越える外径のワイヤー部を挿入することは通常困難であり、他方、その内径を下回る外径のワイヤー部では涙道を拡張することは困難であるが、この特許文献1の涙道治療用ブジーでは、そのような問題に応えるものではない。   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.

特許文献2は、涙道ブジーに関するもので、円筒状をなす挟持部と,この挟持部の両端からそれぞれ同軸をなすように突出する該挟持部より小径の細棒を備えたものであり、該細棒の先端を先細り状に構成したものである。   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.

従ってこの特許文献2の涙道ブジーによれば、細棒を涙道に挿入した場合に、その先端が先細り状に構成されているので、比較的容易に挿入可能となり、かつ挟持部の両側の細棒の径を一定寸法だけ変え、かつ大径側細棒の先細り状の先端部の径を小径側の細棒の径と一致させておけば、小径側の細棒を挿入して治療した後、大径側の細棒を挿入して治療をする際に、比較的スムーズな挿入を行うことができる利点があるとされる。同様の関係で、最小径の細棒を備えた涙道ブジーから最大径の細棒を備えた涙道ブジーまでを用意しておき、最小径の細棒を備えた涙道ブジーから治療行為を開始し、順次径の大きなそれと交換して最大径の細棒を備えた涙道ブジーによる治療行為までを行えば、適切な治療が完了できるされる。   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.

この特許文献2の涙道ブジーによれば、細棒の先細りの先端を利用することにより、その内径を越える細棒でも挿入が可能になると思われるが、挿入しながら拡張するので、挿入時にある程度の大きな力が必要となり、挿入前と挿入後の径差をある程度以上に大きくすることはできないと思われる。要するに、径差の少ない細棒からなる非常に多くの涙道ブジーを用意し、それを順次交換して挿入する多数回の治療行為を繰り返す必要があると思われる。   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.

特開平10−225477号公報Japanese Patent Laid-Open No. 10-225477 特開平11−128263号公報JP-A-11-128263

本発明は、涙道にスムーズに無理なく挿入し得るとともに、その涙道を更に無理なく能率的に拡径可能な挿入手段を備えた涙道拡張型ブジーを提供することを解決の課題とする。   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. .

本発明の1は、グリップ部と、
前記グリップ部内のスライド空間に前後方向スライド自在に配置したスライダと、
前記グリップ部から前方に延長した弾力性を有するチューブ体と、
前記スライダに後部を固定しかつ該チューブ体に進退自在に挿入したワイヤ部材と、
前記チューブ体の先端直前に位置させるべく前記ワイヤ部材の先端に固設した頭部体であって、先端に向かって細くなる先細り部及びその後部から後方に向かって細くなる後細り部からなる頭部体と、
前記スライダに結合した該スライダ部を前後方向にスライド移動させ、前記ワイヤ部材の先端の頭部体の後細り部をチューブ体内に引き込むべく操作するための操作棒であって、前記グリップ部の一側又は両側に突出する操作棒と、
で構成した涙道拡張型ブジーである。
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

本発明の2は、本発明の1の涙道拡張型ブジーにおいて、
前記スライダに、これを前記グリップ部のスライド空間の前方側に移動させるべく付勢するバネ材を配したものである。
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.

本発明の3は、本発明の1又は2の涙道拡張型ブジーにおいて、
前記チューブ体をポリテトラフルオロエチレン又はポリプロピレンで構成したものである。
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.

本発明の1の涙道拡張型ブジーによれば、これを涙道閉塞の治療に利用する場合は、そのチューブ体で外装されたワイヤ部材を該チューブ体と共にその先端の頭部体から涙道に挿入して、該涙道の拡径治療操作を容易に行うことができる。   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.

前記チューブ体の先端には頭部体が配置してあり、該頭部体の先端側には先端に向かって細くなる先細り部が形成してある。それ故、涙道の内径が、該頭部体の最大径部及びチューブ体の外径より小さい場合であっても該頭部体の前部側の先細り部がその中に進入しつつ該涙道に対して若干の拡径作用を果たし得る。従ってチューブ体を外装したワイヤ部材は涙道への容易な挿入が可能となる。   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.

また涙道に挿入した後は、前記操作棒を操作して、前記チューブ体の先端部に、その直前に位置させてある頭部体をその後細り部から進入させることにより、該チューブ体の先端部をその分だけ拡径させ、これによって該チューブ体の先端部が進入している涙道の該当部位を拡径させることができる。この拡径は、涙道の既に進入している部位の拡開であるので、外部から拡径させながら涙道に進入する場合より比較的容易に行われ、より確実に涙道を拡径することができる。   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.

この後は、また前記頭部体を、初期状態のチューブ体の直前に復帰させ、該チューブ体の先端部を拡径状態から当初の非拡径状態に戻した上で、涙道を、該チューブ体の先端の拡径可能な範囲程度の長さ分だけ更に奥に進ませ、その後、また前記操作棒を操作して頭部体を後退動作させ、該チューブ体の先端部を拡径する拡径操作を行う。このような頭部体及びワイヤ部材と該チューブ体との進出動作及びこれに引き続く該チューブ体の拡径動作を必要なだけ繰り返すことにより、涙道の全範囲に渡る拡径処置を完了させることができる。この後は、一般の技法によりN−Sチューブの挿入等を行うことができる。   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.

本発明の2の涙道拡張型ブジーによれば、前記チューブ体の先端の拡径後に、前記操作棒による前方への復操作を行わなくても、該操作棒に対する後方に向けた操作力を解除するのみで、前記頭部体が、前記バネ材の作用により、前方に自動的に復帰動作するので、操作が簡単になる。   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.

本発明の3の涙道拡張型ブジーによれば、前記チューブ体の拡径及び縮小が容易に行われうることになり、かつ安全にこれを涙道に用いることができる。   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)は実施例の涙道拡張型ブジーの一部切欠平面図、(b)は実施例の涙道拡張型ブジーの一部切欠断面図。(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)はワイヤ部材が初期状態にある涙道拡張型ブジーの横向きの一部切欠平面図、(b)はワイヤ部材が後退状態にある涙道拡張型ブジーの横向きの一部切欠平面図。(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)はワイヤ部材の一部切欠平面図、(b)はチューブ体に挿入した初期状態のワイヤ部材の一部切欠断面図、(c)はチューブ体に挿入した後退状態のワイヤ部材の一部切欠断面図。(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. ワイヤ部材をスライダに固定した状態を示すスライダ付近の縦断面図。The longitudinal cross-sectional view of the slider vicinity which shows the state which fixed the wire member to the slider.

発明を実施するための形態を、実施例に基づき図面を参照しながら説明する。   A mode for carrying out the invention will be described based on an embodiment with reference to the drawings.

この実施例の涙道拡張型ブジーは、図1(a)、(b)に示すように、基本的に、グリップ部1と、該グリップ部1内のスライド空間1b1にスライド自在に配置したスライダ2と、該グリップ部1から前方に延長したチューブ体3と、該スライダ2に後部を固定しかつ該チューブ体3に進退自在に挿入したワイヤ部材4と、該ワイヤ部材4の先端に固設した先細り部5aと後細り部5bとからなる頭部体5と、前記スライダ4の両側方に延びる操作棒6とで構成したものである。   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.

前記グリップ部1は、図1(a)、(b)に示すように、先端側が先細りとなった尖端部1aとこれを先端に備えた角筒状のグリップ本体1bとからなる部材であり、前記スライド空間1b1は該グリップ本体1bの前部側に形成したものである。図中では明瞭ではないが、該グリップ本体1bは径方向に二分割状態となっている一対の支分部材を接合して構成したものである。なお、このグリップ部1はその全構成要素をそれぞれプラスチック材により成形したものである。   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.

前記したように、前記スライド空間1b1には、特に図1(b)に示すように、前記スライダ2が前後方向スライド自在な状態に配置してある。該スライダ2の後部中央には,同図に示すように、前記操作棒6と結合するための結合用突起2aが突出させてあり、更に該結合用突起2aの後面中央にはバネ座を構成する小突起7aが突出させてある。なお、該小突起7aは、該スライダ2を前記スライド空間1b1の前部側に押し付け状態(図1(b)の状態)に保持するためのコイルバネ(バネ材)7の前端を係止するバネ座を構成するものである。また、同図に示すように、該スライド空間1b1の後部中央には、該コイルバネ7の後端を配置するためのバネ座を構成する凹部7bが構成してある。   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.

図1(a)、(b)に示すように、前記小突起7aと凹部7bとの間には前記コイルバネ7が配置してある。これは、圧縮コイルバネであり、前記したように、前記スライダ2を前方に押すべく作用し、外力が加わらない限り、該スライダ2を前記スライド空間1b1の前部側に押し付け状態に保持する。前記操作棒6の操作が行われ、該スライダ2が後方に移動させられた場合も、該操作棒6に対して加えられている操作力が解除されると、言うまでも無く、すぐに該スライダ2を前方に押し戻すように作用する。   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.

前記チューブ体3は、図1(a)、(b),図2(a)、(b)及び図3(b)、(c)に示すように、弾力性を有する管状部材であり、この実施例ではポリプロピレンで作成した部材である。該チューブ体3は、図1(b)に示すように、その後部を、前記グリップ部1の尖端部1aの中央孔1a1及びグリップ本体1bの前端中央孔1b2に貫通させ、かつこれらの中央孔1a1及び前端中央孔1b2に固定してあり、更にその後端を前記スライド空間1b1側に開口させてある。   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.

このチューブ体3の径は、0.8mmから1.0mm程度の範囲が適当であり、涙道拡張型ブジーは、その範囲の径の、例えば、0.8mm、0.9mm及び1.0mmのチューブ体3の径を有する三種のそれを作成し、順次小径のそれから大径のそれを使用して涙道の拡径治療に用いるのが適当である。なお、該チューブ体3の肉厚は0.2mm程度であり、それ故、チューブ体3の内径は、0.8mm径のそれは0.4mm、0.9mm径のそれは0.5mm、1.0mmのそれは0.6mm程度であることになる。   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.

前記ワイヤ部材4は、特に図3(a)〜(c)に示すように、その先端に頭部体5を備えた針金状の部材である。その径は、前記チューブ体3の径(外径)が0.8mmのとき0.4mm、0.9mmのとき0.5mm、1.0mmのとき0.6mmをそれぞれ僅かに下回る程度とする。材質は、この実施例では、若干の弾力性を備えたステンレススチールを採用した。   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.

先端の頭部体5は、先に述べ、図3(a)〜(c)に示すように、先細り部5aと後細り部5bとからなるものであり、先細り部5aは、より詳細には先に向かって細くなる円錐状の構成であり、この実施例では、縦断面した場合の先細り部5aの後方に向かって開く角度αが60度になるように構成したものである。この角度αは60度に限定されないが、この程度の角度が適当である。後細り部5bの角度βもこの実施例では同様に60度に構成したものである。この角度βも60度に限定されないがこの程度の角度が適当である。なお、この頭部体5もワイヤ部材4と同様にステンレススチールで構成し、この実施例では、ワイヤ部材4と一体に構成した。   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.

このワイヤ部材4は、前記し、図1(a)、(b)、図2(a)、(b)及び図3(b)、(c)に示すように、その後部を除いて、前記チューブ体3中に配置する。該ワイヤ部材4の先端は、初期状態で該チューブ体3の先端とほぼ一致する位置関係とし、該ワイヤ部材4の先端に構成した頭部体5を初期状態で該チューブ体3の前端の直前に位置するように配置する。該ワイヤ部材4の後部は、図1(b)に示すように、該チューブ体3の後端から突出させ、更に前記スライダ2の中央に前後貫通する状態に開口してある貫通孔2bに挿入してあるものである。また該スライダ2の貫通孔2bに挿入したワイヤ部材4の後部中央付近は、図1(b)及び図4に示すように、グリップ部1のグリップ本体1b外からそのねじ用切欠1cを通じて該スライダ2に形成してある雌ねじ部2cに螺合した固定ねじ8で固定してある。該雌ねじ部2cは、該スライダ2の上方から該貫通孔1cに対して逆T字状となる向きで該貫通孔1cに届くまで開口したねじ穴であり、前記固定ねじ8をこの雌ねじ部2cにねじ込むことで、その先端で該貫通孔1cに挿入したワイヤ部材4の後部中央付近を該貫通孔2cの周側に押し付けて固定するものである。   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.

前記ねじ用切欠1cは、図1(b)及び図4に示すように、グリップ本体1bのスライド空間1b1を区画する上部側周壁を切り欠いて構成したものである。図1(a)、(b)、図2(a)、(b)及び図4に示すように、該ねじ用切欠1cの幅方向(スライダ2のスライド方向に直交する方向)の寸法は該固定ねじ8の後記ねじ部8bの直径を僅かに越える程度にし、長さ方向(スライダ2のスライド方向に沿った方向)の寸法はスライダ2のスライドストロークを僅かに越える程度とする。   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.

前記固定ねじ8は、図1(a)、(b)、図2(a)、(b)及び図4に示すように、円板状のつまみ部8aとその下方のねじ部8bとからなり、該ねじ部8bを前記ねじ用切欠1cを通じて前記スライダ2の雌ねじ部2cに螺合し、更に、前記し、図4に示すように、その下端で前記ワイヤ部材4の後部中央を前記貫通孔2bの周側内面に押し付けて固定できる長さ寸法としたものである。   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.

前記操作棒6は、図1(a)、(b)及び図2(a)、(b)に示すように、その長さ方向中央部で前記スライダ2の前記結合用突起2aに固定し、該スライダ2のスライド方向に直交する向きに配した棒状部材であり、その両端部をグリップ本体1bの両側に突出状態にしてあるものである。   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.

前記スライダ2の結合用突起2aとの結合は、特に図1(b)に示すように、該結合用突起2aに、前記操作棒6の中央部に構成した嵌合穴6aを外装固定することにより行う。結合用突起2aと嵌合穴6aとの嵌合状態は、この実施例では、接着剤により固定した。   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.

前記操作棒6の両端は、図1(a)及び図2(a)、(b)に示すように、前記グリップ本体1bの周側部(スライド空間1b1を区画する両側部側周壁)に横長の操作穴1d、1dを開口し、これらを通じて両側に突出させたものである。なお、この操作穴1d、1dは、スライダ2のスライド方向に長く構成したものであり、その長さ方向の寸法は、該スライダ2のスライドストロークを僅かに越えるそれとする。   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.

この実施例の涙道拡張型ブジーは、以上のように構成したものであり、これによれば、これを涙道閉塞の治療に利用する場合は、そのチューブ体3で外装されたワイヤ部材4を該チューブ体3と共にその先端の頭部体5から涙道に挿入して、該涙道の拡径治療操作を容易に行うことができる。   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.

この涙道拡張型ブジーは、例えば、グリップ1のグリップ本体1bを親指と、小指及び薬指とで掴み、人差し指を、親指側に位置する操作棒6の一方側に前側から掛け、中指を薬指側に位置する操作棒6の他方側に前側から掛けた状態で、チューブ体3で外装されたワイヤ部材4をその先端の頭部体5側から涙道に挿入する。   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.

涙道拡張型ブジーは、以上において、操作棒6を後方に引いてはいないので、図1(a)及び図2(a)に示すように、前記スライダ2は、前記コイルバネ7の作用で、前記スライド空間1b1の前部側に位置し、それ故、前記頭部体5はチューブ体3の中には入らず、その直前に位置した状態となっている。従って涙道に該頭部体5側から挿入すると、その先端側には先端に向かって細くなる先細り部5aが形成してあるので、該涙道の内径が、該頭部体5の最大径部及びチューブ体3の外径より小さい場合であっても該頭部体5の先細り部5aが該涙道に対して若干の拡径作用を果たしながら無理なく進入することが可能となるものである。   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.

また涙道にそのように挿入した後は、人差し指及び中指で前記操作棒6を後方に移動させるべく操作して、該操作棒6を、図2(b)に示すように、距離Lだけ後方に移動させると、当然、これに伴って前記スライダ2も距離Lだけ後方に移動し、更にこれに伴って前記ワイヤ部材4も、その先端の頭部体5も距離Lだけ後退することになり、図2(b)及び図3(c)に示すように、該頭部体5が前記チューブ体3の先端部に後退進入することになる。   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.

同図に示すように、該頭部体5が後退すると、該頭部体5は、その後部側の後細り部5bから該チューブ体3の先端部に進入するので、スムーズかつ容易に該チューブ体3の先端部を拡径することができる。こうして該チューブ体3の先端部が拡径されると、当然、これが進入している涙道の該当部位を拡径させることになる。そしてこの涙道の拡径動作は、涙道の、既に進入している部位の拡径であるので、外部から拡径させながら進入する場合より比較的容易に行われ、より確実に涙道の拡径を行うことができるものである。   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.

この後は、前記操作棒6に加えていた人差し指及び中指の力を緩めると、前記コイルバネ7の作用で、スライダ2がスライド空間1b1の前部側に復帰移動し、これに伴ってワイヤ部材4及びその先端の頭部体5も同様に初期位置まで復帰移動する。復帰移動距離は前記距離Lと等距離であり、初期位置は、図1(a)、(b)に示すとおりであり、ワイヤ部材4、チューブ体3及び頭部体5の位置関係のみに関しては、図2(a)及び図3(b)に示すとおりの位置関係である。   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.

このように初期状態に戻した上で、再度、頭部体5、ワイヤ部材4及びチューブ体3をその状態で,更に涙道の奥に進入させ、また前記操作棒6を後退操作し、該チューブ体3の先端部の拡径操作を行う。このサイクルを必要なだけ繰り返して、涙道の全範囲に渡って拡径を完了させる。この後は、一般の技法によりN−Sチューブの挿入等を行うことができる。   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.

本発明の涙道拡張型ブジーは医療機器の製造の分野で利用できる。   The lacrimal duct expandable bougie of the present invention can be used in the field of manufacturing medical devices.

1 グリップ部
1a 尖端部
1a1 中央孔
1b グリップ本体
1b1 スライド空間
1b2 前端中央孔
1c ねじ用切欠
1d 操作穴
2 スライダ
2a 結合用突起
2b 貫通孔
2c 雌ねじ部
3 チューブ体
4 ワイヤ部材
5 頭部体
5a 先細り部
5b 後細り部
6 操作棒
6a 嵌合穴
7 コイルバネ
7a 小突起
7b 凹部
8 固定ねじ
8a つまみ部
8b ねじ部
L 距離
α 角度
β 角度
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)

グリップ部と、
前記グリップ部内のスライド空間に前後方向スライド自在に配置したスライダと、
前記グリップ部から前方に延長した弾力性を有するチューブ体と、
前記スライダに後部を固定しかつ該チューブ体に進退自在に挿入したワイヤ部材と、
前記チューブ体の先端直前に位置させるべく前記ワイヤ部材の先端に固設した頭部体であって、先端に向かって細くなる先細り部及びその後部から後方に向かって細くなる後細り部からなる頭部体と、
前記スライダに結合した該スライダ部を前後方向にスライド移動させ、前記ワイヤ部材の先端の頭部体の後細り部をチューブ体内に引き込むべく操作するための操作棒であって、前記グリップ部の一側又は両側に突出する操作棒と、
で構成した涙道拡張型ブジー。
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
前記スライダに、これを前記グリップ部のスライド空間の前方側に移動させるべく付勢するバネ材を配したも請求項1の涙道拡張型ブジー。   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. 前記チューブ体をポリテトラフルオロエチレン又はポリプロピレンで構成した請求項1又は2の涙道拡張型ブジー。   The lacrimal tract expansion type bougie according to claim 1 or 2, wherein the tube body is made of polytetrafluoroethylene or polypropylene.
JP2012095412A 2012-04-19 2012-04-19 Lacrimal tract expansion type bougie Expired - Fee Related JP5615317B2 (en)

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CN104665985A (en) * 2013-12-02 2015-06-03 李进凯 Puncta expanding hook

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JPH09225035A (en) * 1996-02-21 1997-09-02 Nippon Zeon Co Ltd Medical insertion aid
JPH10225477A (en) * 1997-02-13 1998-08-25 Furukawa Electric Co Ltd:The Lachrymal duct treating bougie and lachrymal duct treating probe
JPH11128263A (en) * 1997-10-27 1999-05-18 Masao Miyake Lacriminal passage bougie
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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107468417A (en) * 2017-09-08 2017-12-15 中国医科大学附属第医院 A kind of novel lacrimal dilatation probe
CN107468417B (en) * 2017-09-08 2023-07-18 中国医科大学附属第一医院 Lacrimal passage dilating probe

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