JP2017080316A5

JP2017080316A5 -

Info

Publication number: JP2017080316A5
Application number: JP2015214928A
Authority: JP
Filing date: 2015-10-30
Publication date: 2018-06-07
Anticipated expiration: 2035-10-30

Description

前述した目的を達成するための本発明の要旨とするところは、以下の各項の発明に存する。
［１］体壁に穿刺孔を開けると共に、該穿刺孔から別の医療用器具を体腔まで挿入するために穿刺孔を拡張する医療用拡張器具（１０Ａ）において、
ガイドワイヤーを軸方向に挿通可能な中空の穿刺針（２０）と、該穿刺針（２０）と同軸上に延びて該穿刺針（２０）を内側に挿通可能な円筒状のダイレーター（４０）と、前記穿刺針（２０）および前記ダイレーター（４０）をそれぞれ支持するケース体（１１）とを備え、
前記ダイレーター（４０）は、基端部が前記ケース体（１１）の前側にて該ケース体（１１）の内腔と連通する状態に固定され、先端部は先に向かって漸次縮径する先細りのテーパー状に形成され、
前記穿刺針（２０）は、前記ダイレーター（４０）の内側に挿通された状態で、基端部が前記ダイレーター（４０）の基端部より前記ケース体（１１）の内腔まで延出して、該ケース体（１１）の内腔にて穿刺針（２０）の軸方向に移動可能に配されたスライダー（１７）にある取付孔（１７ａ）に嵌入されて固定され、先端部は前記スライダー（１７）の移動に伴い前記ダイレーター（４０）の先端部より出没し、
前記ケース体（１１）に、その内腔に配された前記スライダー（１７）を前記穿刺針（２０）の先端部が突出する方向へ動かすための操作部（５０）と、前記スライダー（１７）を前記穿刺針（２０）の先端部が突出した位置に保持するロック部（７０）と、該ロック部（７０）による保持を解除して前記スライダー（１７）を前記穿刺針（２０）の先端部が没入する位置まで戻すロック解除部（７５）とを設け、
前記操作部（５０）は、前記スライダー（１７）に連結されて、前記ケース体（１１）の後側より突出して押込み操作が可能なノックロッド（５１）を有し、
前記ノックロッド（５１）には、その内部に延びる挿入孔（５２）が穿設され、該挿入孔（５２）は、前記取付孔（１７ａ）に嵌入された前記穿刺針（２０）の内側と連通していることを特徴とする医療用拡張器具（１０Ａ）。 The gist of the present invention for achieving the object described above resides in the inventions of the following items.
[1] In the medical expansion device (10A) for opening a puncture hole in a body wall and expanding the puncture hole in order to insert another medical device from the puncture hole into a body cavity,
A hollow puncture needle (20) through which the guide wire can be inserted in the axial direction, and a cylindrical dilator (40) extending coaxially with the puncture needle (20) and through which the puncture needle (20) can be inserted. And a case body (11) for supporting the puncture needle (20) and the dilator (40),
The dilator (40) is fixed in a state where the base end portion communicates with the inner cavity of the case body (11) on the front side of the case body (11), and the distal end portion gradually decreases in diameter toward the front. It is formed in a tapered shape,
The puncture needle (20) is inserted into the inside of the dilator (40), and the base end portion extends from the base end portion of the dilator (40) to the lumen of the case body (11). Then, in the lumen of the case body (11), it is fitted and fixed in the mounting hole (17a) in the slider (17) arranged to be movable in the axial direction of the puncture needle (20), and the tip part is As the slider (17) moves, it appears and disappears from the tip of the dilator (40),
An operation unit (50) for moving the slider (17) disposed in the inner cavity of the case body (11) in a direction in which the tip of the puncture needle (20) protrudes, and the slider (17) Is held at the position where the tip of the puncture needle (20) protrudes, and the holding by the lock (70) is released, and the slider (17) is moved to the tip of the puncture needle (20). An unlocking part (75) for returning to a position where the part is immersed ,
The operation part (50) is connected to the slider (17) and has a knock rod (51) that protrudes from the rear side of the case body (11) and can be pushed.
The knock rod (51) has an insertion hole (52) extending therein, and the insertion hole (52) is formed on the inside of the puncture needle (20) fitted in the attachment hole (17a). A medical expansion device (10A) characterized by being in communication.

［２］前記ロック部（７０）は、前記スライダー（１７）に設けられて、前記ケース体（１１）の内壁に向かい弾発的に突出する係止爪（７１）と、前記ケース体（１１）に設けられて、前記ノックロッド（５１）の押込み操作により前記スライダー（１７）が前記穿刺針（２０）の先端部を突出させる位置まで移動すると、当該位置で前記係止爪（７１）がスナップフィット係合する被係止孔（７２）とを有し、
前記ロック解除部（７５）は、前記ケース体（１１）にて前記被係止孔（７２）を外側から臨む位置に設けられ、該被係止孔（７２）に嵌入して前記係止爪（７１）のスナップフィット係合を解除するように弾性変形が可能な押ボタン（７６）と、前記スライダー（１７）を前記穿刺針（２０）の先端部が没入する方向へ付勢する付勢手段（７７）とを有し、
前記ノックロッド（５１）を前記付勢手段（７７）の付勢力に抗して押込むことで、前記スライダー（１７）は前記穿刺針（２０）の先端部を突出させる位置まで移動し、当該位置で前記係止爪（７１）は前記被係止孔（７２）にスナップフィット係合して保持され、前記押ボタン（７６）を押すことで、前記スナップフィット係合は解除され、前記スライダー（１７）は前記付勢手段（７７）の付勢力で前記穿刺針（２０）の先端部が没入する位置まで引き戻されるように設定されたことを特徴とする前記［１］に記載の医療用拡張器具（１０Ａ）。 [2] the lock portion (70), said provided in the slider (17), and locking claws (71) for facing resiliently to protrude to the inner wall of the case body (11), said case body (11 When the slider (17) is moved to a position where the tip of the puncture needle (20) protrudes by pushing the knock rod (51), the locking claw (71) is moved to the position. A locked hole (72) for snap-fit engagement;
The unlocking portion (75) is provided at a position of the case body (11) facing the locked hole (72) from the outside, and is fitted into the locked hole (72) to form the locking claw. The push button (76) that can be elastically deformed so as to release the snap-fit engagement of (71), and the bias that biases the slider (17) in the direction in which the tip of the puncture needle (20) is retracted Means (77),
By pushing the knock rod (51) against the urging force of the urging means (77), the slider (17) moves to a position where the tip of the puncture needle (20) is projected, At this position, the locking claw (71) is snap-engaged and held in the locked hole (72), and when the push button (76) is pressed, the snap-fit engagement is released, and the slider (17) The medical device according to [1], wherein the urging force of the urging means (77) is set so that the tip of the puncture needle (20) is retracted to a position where the puncture needle (20) is retracted. Expansion device (10A).

前記ケース体（１１）に設けられた操作部（５０）は、前記スライダー（１７）に連結されて、前記ケース体（１１）の後側より突出して押込み操作が可能なノックロッド（５１）を有する。前記ノックロッド（５１）には、その内部に延びる挿入孔（５２）が穿設され、該挿入孔（５２）は、前記取付孔（１７ａ）に嵌入された前記穿刺針（２０）の内側と連通している。
また、ロック部（７０）、それにロック解除部（７５）は、具体的には例えば、前記［２］に記載したように比較的簡易な構成で実現することができる。かかる構成によれば、操作部（５０）のノックロッド（５１）を押込むだけで、スライダー（１７）は穿刺針（２０）の先端部を突出させる位置まで移動し、当該位置でロック部（７０）の係止爪（７１）が被係止孔（７２）にスナップフィット係合する。これにより、穿刺針（２０）はそのまま突出した状態に保持される。 The operation part (50) provided in the case body (11) is connected to the slider (17), and protrudes from the rear side of the case body (11) so that a knock rod (51) that can be pushed in is provided. Have. The knock rod (51) has an insertion hole (52) extending therein, and the insertion hole (52) is formed on the inside of the puncture needle (20) fitted in the attachment hole (17a). Communicate.
Further , specifically , the lock unit (70) and the lock release unit (75) can be realized with a relatively simple configuration as described in [2] above, for example. According to such a configuration, the slider (17) moves to a position where the tip of the puncture needle (20) protrudes only by pushing in the knock rod (51) of the operation section (50), and the lock section ( 70) the locking claw (71) is snap-fit engaged with the locked hole (72). Thereby, the puncture needle (20) is held in a protruding state as it is.

Claims

In a medical expansion device that opens a puncture hole in a body wall and expands the puncture hole in order to insert another medical device from the puncture hole into a body cavity,
A hollow puncture needle through which a guide wire can be inserted in the axial direction, a cylindrical dilator that extends coaxially with the puncture needle and through which the puncture needle can be inserted, and supports the puncture needle and the dilator And a case body
The dilator is fixed in a state where the base end portion communicates with the inner cavity of the case body on the front side of the case body, and the distal end portion is formed in a tapered shape that gradually decreases in diameter toward the tip,
In the state where the puncture needle is inserted inside the dilator, the base end portion extends from the base end portion of the dilator to the lumen of the case body, and the puncture needle is inserted in the lumen of the case body It is fixed by being fitted into a mounting hole in a slider arranged so as to be movable in the axial direction of the slider, and the tip part appears and disappears from the tip part of the dilator as the slider moves,
An operation unit for moving the slider disposed in the inner cavity of the case body in a direction in which the tip of the puncture needle protrudes, and a lock for holding the slider at a position where the tip of the puncture needle protrudes And a lock release unit that releases the holding by the lock unit and returns the slider to a position where the tip of the puncture needle is retracted ,
The operation portion is connected to the slider and has a knock rod that protrudes from the rear side of the case body and can be pushed in,
An insertion hole extending in the knock rod is formed in the knock rod, and the insertion hole communicates with the inside of the puncture needle fitted in the attachment hole .

The locking portion is provided on the slider, and a locking claw that protrudes elastically toward the inner wall of the case body, and is provided on the case body, and the slider is punctured by a pushing operation of the knock rod. When it moves to a position where the tip of the needle protrudes, it has a locked hole in which the locking claw snap-engages at that position,
The unlocking portion is provided at a position of the case body facing the locked hole from the outside, and is elastically deformed so as to be fitted into the locked hole and release the snap fit engagement of the locking claw. And a push button capable of supporting, and a biasing means for biasing the slider in a direction in which the tip of the puncture needle is immersed,
By pushing the knock rod against the urging force of the urging means, the slider moves to a position where the tip of the puncture needle protrudes, where the locking claw is the locked hole. When the push button is pressed, the snap fit engagement is released, and the slider is pulled back to the position where the tip of the puncture needle is retracted by the biasing force of the biasing means. The medical expansion device according to claim 1, wherein the medical expansion device is set so as to be configured.

In a medical expansion device that opens a puncture hole in a body wall and expands the puncture hole in order to insert another medical device from the puncture hole into a body cavity,
A hollow puncture needle that can be inserted through the guide wire in the axial direction, a cylindrical first dilator that extends coaxially with the puncture needle and that can be inserted into the puncture needle, and coaxial with the first dilator A cylindrical second dilator that extends through the first dilator and can be inserted through the first dilator, and a case body that supports the puncture needle and the dilator, respectively.
The second dilator is fixed in a state where the base end portion communicates with the inner cavity of the case body on the front side of the case body, and the distal end portion is formed in a tapered shape that gradually decreases in diameter toward the front. ,
The first dilator is inserted into the second dilator and the base end portion extends from the base end portion of the second dilator to the inner cavity of the case body. It is fixed to the first slider arranged to be movable in the axial direction of the first dilator in the lumen, and the tip part protrudes and appears from the tip part of the second dilator with the movement of the first slider,
In the state where the puncture needle is inserted inside the first dilator, the base end portion extends from the base end portion of the first dilator to the lumen of the case body, and the lumen of the case body Is fixed to a second slider which is arranged so as to be movable in the axial direction of the puncture needle, and the tip part protrudes and appears from the tip part of the first dilator as the second slider moves,
An operation unit for moving the sliders arranged in the inner cavity of the case body in a direction in which the tip of the puncture needle and the first dilator protrudes by a series of operations, and the first slider. A first lock portion that holds the tip portion of the first dilator in a protruding position; a second lock portion that holds the second slider in a position where the tip portion of the puncture needle protrudes; and the second lock portion. A second unlocking portion for releasing the holding by the second position and returning the second slider to a position where the tip of the puncture needle is retracted, and the holding by the second locking portion is released by the second unlocking portion As a premise, there is provided a medical extension characterized in that a first unlocking part is provided that releases the holding by the first locking part and returns the first slider to a position where the tip of the first dilator is retracted. Instrument

Each of the sliders is arranged in the lumen of the case body such that the first slider is disposed on the front side and the second slider is disposed on the rear side, and each slider is movable in the axial direction of the puncture needle
The first slider is provided with a through hole through which the puncture needle fixed to the second slider is inserted and guided to the inside of the first dilator fixed to the first slider.
The operation part is connected to the second slider, and has a knock rod that protrudes from the rear side of the case body and allows a series of pushing operations.
The first lock portion is provided on the first slider, and is provided with a first locking claw that elastically protrudes toward the inner wall of the case body, and is provided on the case body to push the knock rod. When the first slider moves to a position where the tip end portion of the first dilator protrudes through the second slider, the first locked hole in which the first locking claw is snap-fit engaged at the position. And
The second lock portion is provided on the second slider, and is provided with a second locking claw that protrudes elastically toward the inner wall of the case body. The second lock portion is provided on the case body and is operated to push the knock rod. When the second slider moves to a position where the tip of the puncture needle protrudes, the second locking claw has a second locked hole in which the second locking claw is snap-fit engaged at the position.
The first unlocking portion is provided at a position of the case body so as to face the first locked hole from the outside, and is fitted into the first locked hole to engage the snap fitting of the first locking claw. A first push button that can be elastically deformed so as to release the engagement, and a first urging means that urges the first slider in a direction in which a tip portion of the first dilator is immersed,
The second unlocking portion is provided at a position of the case body so as to face the second locked hole from the outside, and is fitted into the second locked hole to engage the snap fitting of the second locking claw. A second push button that can be elastically deformed so as to release the engagement, and a second urging means that urges the second slider in a direction in which the tip of the puncture needle is retracted,
By pushing the knock rod against the urging force of the second urging means, the second slider moves to a position where the tip of the puncture needle protrudes, and at the position, the second locking claw is moved. Is held in a snap-fit engagement with the second locked hole, and the first slider is pushed by the second slider and moves to a position where the tip of the first dilator protrudes. The first locking claw is snap-engaged and held in the first locked hole,
By pressing the second push button, the snap fit engagement between the second locking claw and the second locked hole is released, and the second slider is moved by the biasing force of the second biasing means. The tip of the puncture needle is pulled back to the position where it is retracted, and then the first push button is pressed to release the snap fit engagement between the first locking claw and the first locked hole, The medical expansion instrument according to claim 3, wherein the first slider is set so as to be pulled back to a position where the tip of the first dilator is retracted by the biasing force of the first biasing means.

5. The medical expansion instrument according to claim 3, wherein a distal end portion of the first dilator is also formed in a tapered shape that gradually decreases in diameter toward the tip.