JP2018186900A - Fallopian tube narrowed part improvement tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a fallopian tube narrowed part improvement tool which can easily reach the ostium of the fallopian tube, and in which an insertion operation is easy, capable of excellently improving the fallopian tube having a narrowed part.SOLUTION: A fallopian tube narrowed part improvement tool 1 includes a flexible outer tube 2 and an internal insertion body 3. The flexible outer tube 2 includes a hollow tube body 20 provided with a small diameter part 22 for insertion into the fallopian tube, and an outer tube hub 40. The internal insertion body 3 includes a tubular body 31, a coil-like tubular member 34 whose tip side protrudes from the tip part of the tubular body 31, a tip swollen part 38 in contact with the tip of the coil-like tubular member, and a linear member 35 including a linear part 37 inserted into the coil-like tubular member from the tip swollen part, whose base end part is fixed to the tubular body. The internal insertion body 3 is slidable from a state in which the coil-like tubular member protrudes from the tip of the flexible outer tube 2 to a state in which the entire coil-like tubular member 34 of the internal insertion body 3 is stored in the flexible outer tube 2.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an oviductal stenosis-improving device for improving occlusions and stenosis occurring in a body cavity of an oviduct.

Conventionally, in order to treat occlusions and stenosis in an oviduct, an outer tube, an inner tube movable in the outer tube in the axial direction, one end attached to the distal end of the outer tube, and the other end A balloon catheter is used that includes a balloon attached to the distal end of the tube.
This balloon catheter is used as follows.
First, an endoscope is inserted into the lumen of the inner tube, and the distal end of the endoscope reaches the distal end of the outer tube. Then, with the balloon completely housed in the lumen of the outer tube, the balloon catheter is inserted into the uterus from the uterine jaw. Then, after confirming the fallopian tube opening with an endoscope, the inner tube is pushed into the distal end side, the balloon is protruded from the distal end of the outer tube, and the balloon is inserted into the fallopian tube. Then, the lesioned part is expanded (treated) with a balloon while observing a lesioned part such as an obstructed part or a stenotic part with an endoscope.
In order to perform these operations safely, it is necessary to always know the position of the distal end portion of the endoscope relative to the distal end portion of the balloon. That is, it is necessary to prevent damage to organs in the living body such as the uterus and fallopian tube due to the projection of the endoscope from the end of the balloon on the tip side.
In order to satisfy such requirements, Japanese Patent No. 2813463 (Patent Document 1) has marks provided at equal intervals on the inner tube of the balloon catheter and the proximal side of the endoscope. A catheter device is disclosed that counts to determine the longitudinal position of the endoscope relative to the distal end of the balloon.

Japanese Patent No. 2813463

In the thing of the said patent document 1, it is necessary to insert the balloon part of a balloon catheter in an oviduct, and insertion operation to the oviduct mouth of the balloon part of a balloon catheter is not easy. Further, in the fallopian tube where the stenosis has progressed, it may be difficult to advance the balloon portion of the balloon catheter that has reached the mouth of the fallopian tube into the fallopian tube.
Therefore, the present invention provides an oviductal stenosis part improving tool that is easy to reach and reach the fallopian tube opening and that can satisfactorily improve an oviduct having a stenosis part.

What achieves the above object is the following tubal stenosis improvement tool.
(1) An oviductal stenosis-improving tool comprising a flexible outer tube and an internal insertion body that passes through the flexible outer tube, and the flexible outer tube is inserted into the oviduct at the distal end. A hollow tube body having a small-diameter portion and an outer tube hub fixed to a proximal end portion of the tube body, the inner insertion body is a tubular body, and a proximal end side enters the distal end portion of the tubular body. A coiled tubular member that is fixed and has a distal end projecting a predetermined length from the distal end of the tubular body, a distal bulging portion that is in contact with the distal end of the coiled tubular member, and the coiled tubular from the distal bulging portion. A linear member having a linear portion inserted through the member and having a proximal end portion fixed internally to the tubular body or the coiled tubular member; The distal end portion of the coiled tubular member of the insertion body protrudes from the distal end of the flexible outer tube. An oviductal stricture improvement tool that is slidable from a state where the coiled tubular member is at least entirely accommodated in the flexible outer tube.

(2) The coil-shaped tubular member has a smaller diameter than the tubular body, and has substantially the same outer diameter as a whole. The outer diameter of the linear portion is smaller than the inner diameter of the coil-shaped tubular member, and the linear member Is the oviductal stricture improvement tool according to (1), which does not hinder the flexibility of the coiled tubular member.
(3) The linear portion of the linear member includes a proximal end protruding portion that protrudes rearward from a rear end of the coiled tubular member, and the tubular body and the coiled tubular are formed at the proximal end protruding portion. The oviductal stricture improvement tool according to (1) or (2), which is fixed to a member.
(4) The tubal stenosis-improving device according to any one of (1) to (3), wherein the outer tube hub includes a liquid injection port provided on a side portion.
(5) The said oviduct constriction part improvement tool is provided with the internal insertion body front-end | tip direction movement control part which controls so that the said tubular body of the said internal insertion body may not protrude from the front-end | tip of the said flexible outer tube | pipe. (1) thru | or the tubal stenosis part improvement tool in any one of (4).
(6) The said oviduct constriction part improvement tool is beyond the state which the front-end | tip part of the said tubular body of the said internal insertion body protrudes a little, and the said internal insertion body does not protrude from the front-end | tip of the said flexible outer tube | pipe. The oviductal stenosis-improving device according to any one of (1) to (4), further including an inner insertion body distal-end-direction movement restricting portion that restricts the inner insert.
(7) The tube main body includes an outer layer and an inner layer having a tip protruding from the tip of the outer layer, and the small-diameter portion for insertion into the fallopian tube is formed by the tip of the inner layer. (6) The fallopian tube stenosis part improvement tool in any one of.

  The oviductal stricture improvement tool of the present invention includes a flexible outer tube and an inner insertion body that is inserted through the flexible outer tube. The flexible outer tube includes a hollow tube main body having a small-diameter portion for insertion into the fallopian tube at the distal end portion, and an outer tube hub fixed to the proximal end portion of the tube main body. The internal insertion body includes a tubular body, a coiled tubular member whose proximal end enters and is fixed in the distal end portion of the tubular body, and whose distal end protrudes a predetermined length from the distal end portion of the tubular body, and the distal end of the coiled tubular member. A linear member having a contacted bulging portion, and a linear portion that is inserted through the coiled tubular member from the distal bulging portion and has a proximal end fixed internally to the tubular body or the coiled tubular member; Is provided. The oviductal stricture improvement tool is such that at least the entire coiled tubular member is housed in the flexible outer tube from the state in which the distal end portion of the coiled tubular member of the inner insertion body protrudes from the distal end of the flexible outer tube. It is possible to slide to the state where it is done.

  In this fallopian tube stenosis portion improving tool, the inner insertion body includes a coiled tubular member, and this coiled tubular member functions as a guide portion, and the coiled tubular member is inserted into the fallopian tube first, thereby being flexible. It is possible to easily guide the small diameter portion for insertion into the fallopian tube into the fallopian tube mouth. Then, the small-diameter portion for insertion into the fallopian tube of the flexible outer tube enters the fallopian tube mouth, and further, the inner insertion body is moved to the rear end side, and then the liquid is injected from the outer tube hub, whereby the egg The oviduct can be easily and reliably expanded without damaging the tube.

FIG. 1 is a partially omitted front view of an embodiment of the fallopian tube stenosis improving device of the present invention. FIG. 2 is a partially omitted front view of an example of a flexible outer tube used in the oviductal stenosis improving device of the present invention. FIG. 3 is a partially omitted front view of an example of an internal insertion member used in the oviductal stenosis improving device of the present invention. FIG. 4 is an enlarged front view of the distal end portion of the fallopian tube stenosis improvement tool shown in FIG. FIG. 5 is an enlarged cross-sectional view of the distal end portion of the fallopian tube stenosis improvement tool shown in FIG. 6 is an enlarged cross-sectional view of the distal end portion of the internal insertion member shown in FIG. FIG. 7 is an enlarged cross-sectional view of the vicinity of the outer tube hub of the oviductal stricture improvement tool shown in FIG. FIG. 8 is an enlarged cross-sectional view of the base end portion of the internal insertion member shown in FIG. 3. FIG. 9 is an explanatory diagram for explaining the operation of the oviductal stenosis improving device of the present invention. FIG. 10 is an enlarged cross-sectional view of the distal end portion of the fallopian tube stricture improvement tool of another embodiment of the present invention.

The oviductal stricture improvement tool of the present invention will be described with reference to the embodiments shown in the drawings.
The oviductal stricture improvement tool 1 of the present invention includes a flexible outer tube 2 and an inner insertion body 3 that is inserted through the flexible outer tube 2. The flexible outer tube 2 includes a hollow tube body 20 having a small-diameter portion 22 for insertion into an oviduct at a distal end portion, and an outer tube hub 40 fixed to a proximal end portion of the tube body 20. The internal insertion body 3 includes a tubular body 31, a coiled tubular member 34 whose proximal end enters and is fixed in the distal end of the tubular body 31, and whose distal end protrudes a predetermined length from the distal end of the tubular body 31, and a coiled tubular A distal end bulging portion 38 that is in contact with the distal end of the member 34, and the inside of the coiled tubular member 34 are inserted through the distal end bulging portion 38, and the proximal end portion is internally fixed to the tubular body 31 or the coiled tubular member 34. And a linear member 35 having a linear portion 37.
The oviductal stricture improvement tool 1 is configured such that at least the coiled tubular member of the inner insertion member 3 is in a state where the distal end portion of the coiled tubular member 34 of the inner insertion member 3 protrudes from the distal end 53 of the flexible outer tube 2. The whole 34 can be slid until it is accommodated in the flexible outer tube 2.

As shown in FIG. 1, the fallopian tube stenosis improvement tool 1 includes a flexible outer tube 2 and an inner insertion body 3 that passes through the flexible outer tube 2.
As shown in FIGS. 1, 3 to 6, the internal insertion body 3 includes a tubular body 31, a coiled tubular member 34 fixed to the distal end portion of the tubular body 31, and the distal end of the coiled tubular member 34. A linear member 35 having a tip bulging portion 38 and a linear portion 37 that are in contact with each other, and an insertion body hub 32 fixed to the proximal end portion of the tubular body 31 are provided.
As the tubular body 31, one extending from the tip to the base end with substantially the same outer diameter is used. As the tubular body 31, a tubular member made of metal or semi-rigid resin is used. The total length of the tubular body is preferably about 300 to 1000 mm, and particularly preferably 500 to 800 mm. The outer diameter of the tubular body 31 is preferably about 0.5 mm to 2.0 mm. The outer diameter of the tubular body 31 is preferably smaller by about 0.3 to 1.0 mm than the inner diameter of the tube body 20 of the flexible outer tube 2. The inner diameter of the tubular body 31 is preferably about 0.3 mm to 1.5 mm. As the tubular member made of metal or semi-rigid resin, a stainless steel pipe, a fluororesin tube (for example, PTFE tube, ETFE tube) or the like can be suitably used.

  As shown in FIG. 6, a coiled tubular member 34 is fixed to the distal end portion of the tubular body 31. Specifically, the coiled tubular member 34 has a smaller diameter than the tubular body 31, and the proximal end portion thereof enters the distal end portion of the tubular body 31, and the other portion (the distal end side portion) is the tubular body 31. It protrudes from the tip. As the coiled tubular member 34, a member that extends from the distal end to the proximal end with substantially the same outer diameter is used. The coiled tubular member 34 can be a metal coil, and is preferably a closely wound coil wound so that adjacent wires are in contact with each other.

  A stainless steel wire is suitable as a material for forming the metal coil. The outer diameter of the coiled tubular member 34 is substantially the same as or slightly smaller than the inner diameter of the tubular body 31. The coiled tubular member 34 has a total length of 20 mm to 200 mm, preferably 30 mm to 150 mm. The outer diameter of the coiled tubular member 34 is 0.2 to 1.8 mm, preferably 0.3 mm. ~ 1.6 mm.

  Further, the internal insertion body 3 includes a linear member 35 that is inserted through the coiled tubular member 34. The linear member 35 includes a linear portion 37, a bulging portion 38 formed at the distal end of the linear portion 37, and a base end protruding portion 39 that protrudes rearward from the rear end of the coiled tubular member 34. .

  In the linear member 35, the base end protruding portion 39 is fixed to the inner surface of the tubular body 31 with an adhesive 55 in a state where the bulging portion 38 is in contact with the distal end of the coiled tubular member 34. . By providing the linear member 35, the axial expansion of the coiled tubular member 34 is suppressed. Further, the bulging portion 38 is formed in a substantially hemispherical shape, and is not easily damaged even if it comes into contact with a living body part (for example, the inner wall of the uterus or the inner surface of the fallopian tube). In this embodiment, the coiled tubular member 34 is fixed to the inner surface of the tubular body 31 with an adhesive 55 at the proximal end portion that has entered the tubular body 31. Further, the coiled tubular member 34 is not fixed at the distal end portion of the tubular body 31, and a cylindrical gap 57 is provided between the coiled tubular member 34 and the tubular body 31. By having such a gap, the proximal end portion of the coiled tubular member 34 can be slightly deformed in the distal end portion of the tubular body 31. For this reason, kinking at the tip of the tubular body 31 of the coiled tubular member 34 is suppressed.

  The outer diameter of the linear portion 37 is smaller than the inner diameter of the coiled tubular member 34, the linear portion 37 is flexible, and the linear member 35 does not hinder the flexibility of the coiled tubular member 34. It has become. As a material for forming the linear member 35, polyamide (for example, 6 nylon, 66 nylon), polyolefin (for example, polyethylene, polypropylene, ethylene-propylene copolymer), polyester (for example, polyethylene terephthalate), or the like is preferable.

And as shown in FIG. 8, the insertion body hub 32 is being fixed to the base end part of the tubular body 31. As shown in FIG. The insertion body hub 32 includes a main body portion 33 that forms a grip portion, and a small-diameter protruding portion 56 that protrudes from the main body portion 33 in the distal direction.
As shown in FIGS. 1 and 2, the flexible outer tube 2 includes a hollow tube body 20 having a small-diameter portion 22 for insertion into the fallopian tube at the distal end, and an outer tube fixed to the proximal end portion of the tube body 20. And a hub 40.

  As shown in FIGS. 1, 2, and 5, the tube main body 20 includes a main body portion 21 that extends a predetermined length with substantially the same outer diameter, and a small-diameter portion 22 for insertion into the fallopian tube that has a smaller diameter than the main body portion. The small-diameter portion 22 for insertion into the fallopian tube forms the distal end portion of the tube body 20. Further, in the flexible outer tube 2 of this embodiment, the tube body 20 is composed of a synthetic resin inner layer 24 and a synthetic resin outer layer 23 covering the outer surface of the synthetic resin inner layer 24. Is provided with a lumen 52. Further, in the flexible outer tube 2 of this embodiment, the distal end portion of the inner layer 24 projects from the distal end of the outer layer 23, and the projecting portion of the inner layer 24 forms a small diameter portion 22 for insertion into the fallopian tube.

  The total length of the tube body 20 is preferably about 300 to 1000 mm, and particularly preferably 500 to 800 mm. The outer diameter of the main body portion 21 of the tube main body 20 is preferably about 1.0 mm to 3.0 mm. The inner diameter of the tube body 20 is preferably about 0.5 mm to 2.0 mm. The outer diameter of the small-diameter portion 22 for insertion into the fallopian tube of the tube main body 20 is preferably about 0.5 mm to 2.5 mm, and 0.3 to 0.00 mm from the outer diameter of the main body portion 21 of the tube main body 20. It is preferably about 6 mm smaller.

  As shown in FIG. 5, the outer layer 23 covers the inner layer 24 and forms the outer surface of the fallopian tube stricture improving tool 1. As a material for forming the outer layer 23, a material having adhesiveness with the inner layer forming material is preferable, and a material having the same quality as or similar to the resin used for forming the inner layer is preferable. For example, polyolefins using polyethylene, polypropylene, ethylene-propylene copolymer, etc., polyvinyl chloride, ethylene-vinyl acetate copolymers, polyamide elastomers, thermoplastic resins such as polyurethane, silicone rubber, latex rubber and the like can be used.

  As the material for forming the inner layer 24, a material having a certain degree of flexibility is preferable. For example, a polyolefin elastomer, polyvinyl chloride, ethylene-vinyl acetate copolymer using polyethylene, polypropylene, ethylene-propylene copolymer, Thermoplastic resins such as polyamide elastomer and polyurethane, silicone rubber, latex rubber and the like can be used. The inner layer forming material may be harder than the outer layer forming material. The tube body 20 may be a single layer.

  Further, as shown in FIGS. 1, 2, and 7, an outer tube hub 40 is fixed to the proximal end portion of the tube body 20. As shown in FIG. 7, the outer tube hub 40 includes an outer tube hub main body 41 and a seal member 46 that is accommodated in the outer tube hub main body 41 and that is capable of sliding and holding the inner insertion member 3 in a liquid-tight manner. ing. The outer tube hub 40 includes a side port 42 that branches obliquely rearward from the vicinity of the center of the outer tube hub body 41. The outer tube hub 40 includes a communication passage 44 communicating with the lumen 52 in the tube main body 20 inside.

  Further, the outer tube hub 40 is provided with an inner tube locking mechanism that restricts the movement of the inner insert 3. In this embodiment, the lock mechanism includes a seal member 46 that clamps the base end portion of the inner insertion member 3 in a liquid-tight state by compression, an operation member 43 that compresses the seal member 46, and an outer tube hub body 41. . By providing this locking mechanism, the inner insertion body 3 can be fixed at an arbitrary position with respect to the flexible outer tube 2.

  The seal member 46 is installed in a storage portion provided at the proximal end portion of the outer tube hub main body 41, and an insertion passage communicating with the lumen 52 is formed inside the seal member 46. The internal shape of the seal member 46 is such that the central portion in the axial direction swells in an annular shape, and when the seal member 46 is compressed by the operation member 43, the central bulge portion is reduced in diameter, and the internal insertion member 3 (specifically, the tubular body 31) is in liquid-tight contact with the outer surface.

  Specifically, the operation member 43 is formed in a central portion so as to enclose the cylindrical pressing portion 47 projecting toward the front end side, and the outer surface of the rear end of the outer tube hub main body 41. The outer cylinder part 43a provided with the screwing part 48 and the screwing part 48 which can be screwed together is provided. The proximal end portion of the operation portion 43 is a diameter-expanded portion 43b, which can be easily grasped when the operation member 43 is rotated.

  In addition, an internal passage communicating with the lumen 52 is provided inside the pressing portion 47. Further, as shown in FIG. 7, the front end side portion of the pressing portion 47 has entered the storage portion, and the seal member 46 can be compressed by moving the operating body toward the front end.

  In the lock mechanism of this embodiment, when the operation member 43 is rotated and the screwing is advanced so as to move to the front end side of the outer tube hub 40, the front end of the pressing portion 47 comes into contact with the rear end of the seal member 46. Further, when the operation member 43 is rotated to advance the screwing, the seal member 46 is compressed in the axial direction. As the compression of the seal member 46 progresses, the inner diameter of the internal passage becomes smaller, and the inner insert 3 is finally held and fixed by the seal member 46. Note that the lock mechanism is released by a rotation operation reverse to the above.

  As the constituent material of the outer tube hub body 41 and the operation member 43, a hard or semi-hard material is used. Examples of the hard or semi-rigid material include polycarbonate, polyolefin (for example, polyethylene, polypropylene, ethylene-propylene copolymer), styrene resin [for example, polystyrene, MS resin (methacrylate-styrene copolymer), MBS resin (methacrylate-butylene- Styrene copolymer)], synthetic resins such as polyester, metals such as stainless steel, aluminum or aluminum alloys can be used.

  An elastic material is used as a constituent material of the seal member 46. Examples of elastic materials include synthetic rubbers such as urethane rubber, silicone rubber, and butadiene rubber, rubbers such as natural rubber such as latex rubber, olefin elastomers (eg, polyethylene elastomer, polypropylene elastomer), polyamide elastomers, and styrene elastomers (eg, , Styrene-butadiene-styrene copolymer, styrene-isoprene-styrene copolymer, styrene-ethylenebutylene-styrene copolymer), synthetic resin elastomers such as polyurethane, urethane elastomer, and fluororesin elastomer.

  The oviductal constriction part improving tool 1 of the present invention has at least the coil of the inner insertion body 3 from the state in which the distal end portion of the coiled tubular member 34 of the inner insertion body 3 protrudes from the distal end 53 of the flexible outer tube 2. The entire tubular member 34 is slidable until it is accommodated in the flexible outer tube 2. For this reason, since the internal insertion body 3 does not become an obstacle at the time of liquid injection into the fallopian tube, the fallopian tube can be expanded well by liquid injection.

  In the fallopian tube stricture improvement tool 1 of this embodiment, the inner insertion body 3 can be removed from the flexible outer tube 2. Furthermore, in the fallopian tube constriction part improving tool 1 of this embodiment, the tubular body 31 of the inner insertion body 3 is the tip 53 of the flexible outer tube 2 (specifically, the tip of the small-diameter portion 22 for insertion into the fallopian tube). An internal insertion body tip direction movement restricting portion for restricting so as not to protrude further is provided.

  Specifically, as shown in FIG. 9, the small-diameter protruding portion 56 provided on the insertion body hub 32 can enter the rear end portion of the outer tube hub 40. Further, the insertion body hub 32 can be brought into contact with the outer tube hub 40. In the case shown in FIG. 9, the front end surface of the main body portion 33 of the insertion body hub 32 can come into contact with the rear end surface of the outer tube hub 40 (specifically, the rear end surface of the pressing portion 47). .

  In the state where the inserter hub 32 and the outer tube hub 40 are in contact with each other, the distal end of the tubular body 31 of the inner inserter 3 is slightly more proximal than the distal end 53 of the flexible outer tube 2 as shown in FIG. It is located on the end side. For this reason, only the coiled tubular member of the inner insertion member 3 protrudes from the distal end 53 of the flexible outer tube 2 (specifically, the distal end of the small diameter portion 22 for insertion into the fallopian tube).

In addition, the fallopian tube constriction part improvement tool of this invention is not limited to said thing.
As the fallopian tube stenosis portion improving tool, the distal end portion of the tubular body 31 of the inner insertion body 3 is more than the distal end 53 of the flexible outer tube 2 as in the fallopian tube stricture portion improving tool 1a of the embodiment shown in FIG. You may provide the internal insertion body front-end | tip direction movement control part which controls not to protrude from the front-end | tip of the flexible outer tube | pipe 2 beyond the state which protrudes a little.

  In this embodiment, in the state where the insertion body hub 32 and the outer tube hub 40 are in contact with each other, the distal end of the tubular body 31 of the inner insertion body 3 is the distal end of the flexible outer tube 2 as shown in FIG. It is more prominent. In this way, by slightly projecting the tip of the tubular body 31 of the inner insertion body 3, the distal end of the tubular body 31 of the inner insertion body 3 is moved to the egg of the small diameter portion 22 for insertion into the fallopian tube of the flexible outer tube 2. It becomes possible to function as a guiding portion into the tube opening.

The effect | action of the fallopian tube stenosis part improvement tool of this invention is demonstrated using drawing.
As shown in FIG. 5 or FIG. 10, the coiled tubular member 34 of the inner insertion body 3 protrudes from the distal end of the flexible outer tube 2, and if necessary, the elastic member 46 is pressed and the state is reached. To fix. Then, the oviductal stenosis improving device 1 from which the coiled tubular member 34 protrudes is inserted into the uterus transvaginally or percutaneously, and further advanced, so that the coiled tubular member 34 is removed from the oviduct opening. Enter into the tube. Then, after the small-diameter portion for insertion into the fallopian tube of the flexible outer tube reaches the fallopian tube mouth, the small-diameter portion for insertion into the fallopian tube is caused to enter the fallopian tube mouth by further pushing. And after moving an internal penetration body to the rear-end side, a fallopian tube is expanded with a liquid by inject | pouring a liquid (for example, physiological saline) from an outer tube | pipe hub. Thereby, the stenosis part in an oviduct is pushed open and a stenosis part improves.

DESCRIPTION OF SYMBOLS 1, 1a Oviduct constriction part improvement tool 2 Flexible outer tube 3 Internal insertion body 20 Tube main body 31 Tubular body 34 Coiled tubular member 35 Linear member 22 Small diameter part 40 for insertion in an oviduct Outer tube hub

Claims (7)

An oviductal stenosis-improving device comprising a flexible outer tube and an inner insertion body that is inserted through the flexible outer tube,
The flexible outer tube includes a hollow tube body having a small-diameter portion for insertion into an oviduct at a distal end portion, and an outer tube hub fixed to a proximal end portion of the tube body,
The internal insertion body includes a tubular body, a coiled tubular member whose proximal end enters and is fixed in the distal end of the tubular body, and the distal end protrudes a predetermined length from the distal end of the tubular body, and the coiled tubular member A bulging portion that is in contact with the distal end of the wire, and a linear shape that is inserted through the coiled tubular member from the bulging portion of the distal end and has a proximal end fixed internally to the tubular body or the coiled tubular member A linear member having a portion,
The oviductal stricture improvement tool is configured so that at least the entire coiled tubular member is at least the entirety of the coiled tubular member from the state in which the distal end portion of the coiled tubular member of the inner insertion body protrudes from the distal end of the flexible outer tube. An oviductal stricture improvement tool characterized by being slidable to a state of being accommodated in a flexible outer tube.   The coiled tubular member has a smaller diameter than the tubular body, and the entire outer diameter is substantially the same, the outer diameter of the linear portion is smaller than the inner diameter of the coiled tubular member, and the linear member is The oviductal stricture improvement tool according to claim 1, which does not impair the flexibility of the coiled tubular member.   The linear portion of the linear member includes a base end protruding portion that protrudes rearward from a rear end of the coiled tubular member, and is fixed to the tubular body and the coiled tubular member at the base end protruding portion. The oviductal stricture improvement tool according to claim 1 or 2.   The tubal stricture improvement tool according to any one of claims 1 to 3, wherein the outer tube hub includes a liquid injection port provided on a side portion.   The said oviduct constriction part improvement tool is provided with the internal insertion body front-end | tip direction movement control part which controls so that the said tubular body of the said internal insertion body may not protrude from the front-end | tip of the said flexible outer tube | pipe. 4. The oviductal stricture improvement tool according to any one of 4 above.   The oviductal stricture improvement tool regulates the internal insertion member so that it does not protrude beyond the distal end of the flexible outer tube beyond the state where the distal end portion of the tubular body of the internal insertion member protrudes slightly. The oviductal stricture improvement tool according to any one of claims 1 to 4, further comprising an inner insertion body distal direction movement restricting portion.   The tube main body includes an outer layer and an inner layer having a tip protruding from the tip of the outer layer, and the small-diameter portion for insertion into the fallopian tube is formed by the tip of the inner layer. The tubal stenosis improvement tool as described in any one of Claims 1-3.

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