JP2020185033A - Drain catheter - Google Patents

Abstract

To provide a drain catheter which seldom causes closure when it is bent at an acute angle near a body surface and is capable of suppressing a decrease in a discharge flow rate of exudates and infectious diseases.SOLUTION: A drain catheter 100A includes: a liquid collection part 101 provided for an end part; a transition part 102 provided for a base end side of the liquid collection part 101; and a hand part 103 provided for the base end side of the transition part 102. The liquid collection part 101 has: a plurality of liquid collecting ports collecting exudates; and a plurality of liquid collecting passages 111 guiding the exudates collected by the liquid collecting ports to the transition part. The transition part 102 has a plurality of transition part lumens 121 corresponding to the liquid collecting passages 111 respectively, and the hand part 103 has one hand part lumen 131. The plurality of transition part lumens 121 have circular diagonal direction cross-sectional shapes respectively.SELECTED DRAWING: Figure 1

Description

The present disclosure relates to a drain catheter.

A tube called a drain catheter is used to drain the exudate generated in the wound or the like in the body after the operation. A general drain catheter has a liquid collecting part that is embedded in the body and collects exudate, and an extension part that connects the liquid collecting part and a storage bag or the like.

The exudate generated at the wound contains various components and easily coagulates. In addition, solid or semi-solid substances such as blood clots and body tissue fragments are often contained. For this reason, the drain catheter that collects exudate and guides it to the outside of the body is prone to stenosis and closure. In order to make it difficult to close the liquid collecting part, it is considered to suppress the occurrence of clogging by dividing the liquid collecting part into a plurality of parts extending in the longitudinal direction and providing slits extending in the longitudinal direction in each part. (See, for example, Patent Document 1).

The extension, on the other hand, is connected to a storage bag and is optionally decompressed for suction. For this reason, a single lumen tube is used for the extension. When the liquid collecting part is divided into a plurality of parts, the liquid collecting part having a different shape and the extension part are connected, but the leachate may stay or the contained components may be deposited in such a connecting part. easy. In order to avoid the retention of exudate in the connecting portion, it has been studied to connect from the collecting portion to the extending portion while smoothly shifting the lumen (see, for example, Patent Document 2).

Japanese Unexamined Patent Publication No. 8-206219 JP-A-2002-224222

Conventionally, a method of forming a subcutaneous tunnel for implanting a drain catheter has been common. However, with the development of endoscopic surgery, in order to suppress the invasion as much as possible, a drain catheter is implanted using the channel hole of the endoscope without providing a new subcutaneous tunnel. When implanting a drain catheter using the channel hole of an endoscope, the drain catheter having a circular outer circumference of the catheter is inserted substantially perpendicular to the body surface according to the shape of the channel hole and the guide sheath. On the other hand, considering the burden on the patient, it is preferable that the extracorporeal part of the drain catheter is aligned with the body surface as much as possible. In addition, rubbing the drain catheter around the channel hole can cause ulcers, so it is necessary to pull out the drain catheter to a position slightly away from the body surface and then bend it at a steep angle to fix it to the body surface side. Will be.
However, if the conventional drain catheter is bent at a steep angle, the tube may be broken (kink) and the catheter may be closed. In addition, with the conventional drain catheter, there is a risk of infection due to a decrease in the flow rate of the exudate discharged to the outside of the body and the retention of the exudate inside the lumen.

An object of the present disclosure is to realize a drain catheter that is unlikely to be closed even when bent at a steep angle near the body surface. In addition, it is to realize a drain catheter that can suppress a decrease in the discharge flow rate of exudate and the occurrence of an infectious disease.

One aspect of the drain catheter of the present disclosure is to have a liquid collecting portion provided at the tip portion, a transition portion provided on the proximal end side of the liquid collecting portion, and a hand portion provided on the proximal end side of the transition portion. The liquid collection unit has a plurality of liquid collection ports for collecting exudate and a plurality of liquid collection passages for guiding the exudate collected by the liquid collection port to the transition part, and each of the transition parts is provided. Has a plurality of transitional lumens corresponding to the liquid collection passage, the hand portion has one handy portion lumen, and each of the plurality of transitional portion lumens has a circular cross-sectional shape in the radial direction.

In one aspect of the drain catheter, the lumen of the transition part is difficult to kink even if the transition part is greatly bent, and the exudate is smoothly discharged even when the exudate is placed in the wound using a channel hole or the like formed in endoscopic surgery. It can be excreted from the body. In addition, since dead volume is less likely to occur in the transitional lumen, duct resistance can be reduced and liquid pooling can be less likely to occur, it is possible to avoid a decrease in the discharge flow rate of exudate and suppress the occurrence of infectious diseases.
In one aspect of the drain catheter, the liquid collecting portion is composed of a sheet-like member in which a plurality of liquid collecting passages are arranged, and the liquid collecting port can be an opening at the tip of the liquid collecting passage. With such a configuration, liquid can be collected from a wide range.

In this case, the transition portion may be a wound sheet-like member. With such a configuration, the transition portion can be easily formed. Further, the outer peripheral shape of the transition portion can be easily made into a circular shape.

In one aspect of the drain catheter, the plurality of liquid collection passages are tubes independent of each other, and the liquid collection port can be an opening at the tip of the liquid collection passage. With such a configuration, a plurality of liquid collecting ports can be directed in a plurality of directions, and a liquid collecting portion capable of collecting liquid from a wide range can be easily formed.

In one aspect of the drain catheter, each of the plurality of liquid collection passages has a slit extending in the longitudinal direction on the side surface, and the liquid collection port can be a slit of the liquid collection passage. With such a configuration, it is possible to prevent the liquid collection port from being blocked.

According to the drain catheter of the present disclosure, it is possible to prevent closure even when the drain catheter is bent at a steep angle in the vicinity of the body surface. In addition, it is possible to suppress a decrease in the discharge flow rate of exudate and the occurrence of infectious diseases.

It is a perspective view which shows the drain catheter which concerns on one Embodiment. It is sectional drawing in line II-II of FIG. FIG. 3 is a cross-sectional view taken along the line III-III of FIG. It is a perspective view which shows the drain catheter which concerns on the modification. It is a perspective view which shows the sheet-shaped member in an enlarged manner. It is sectional drawing in the VV line of FIG. It is the schematic which shows the measurement system which evaluates the difficulty of occurrence of a kink.

As shown in FIG. 1, the drain catheter 100A of the present embodiment has a liquid collecting portion 101 provided on the distal end side, a transition portion 102 provided on the proximal end side of the liquid collecting portion 101, and a base of the transition portion 102. It has a hand portion 103 provided on the end side.

In the present embodiment, the liquid collecting portion 101 is three independent tubes 115, and the tip opening of each tube 115 functions as a liquid collecting port for collecting the exudate of the wound portion, and the cavity of each tube 115 is formed. It functions as a liquid collection passage that guides the exudate collected by the liquid collection port to the transition portion 102.

As shown in FIG. 2, in the transition portion 102, three tubes 115 are bundled and housed in the sheath 122, and the lumen of each tube 115 functions as the transition portion lumen 121.

As shown in FIG. 3, the hand portion 103 is composed of a single lumen tube having one hand portion cavity 131 extending in the longitudinal direction. All transitional cavities 121 are connected to the hand cavities 131.

The drain catheter 100A of the present embodiment is inserted into the body through, for example, a channel hole when endoscopic surgery is performed, the liquid collecting part 101 is located near the wound part, and the transition part 102 is inside and outside the body. It is arranged so as to be located across. The exudate collected in the liquid collecting section 101 passes through the transition section 102 and the hand section 103, and is stored in a drainage bag or the like connected to the base end of the hand section 103. If necessary, the pressure can be reduced and suction can be performed.

In the general usage of the drain catheter, the portion of the transition portion 102 drawn out of the body is bent toward the body surface at a position protruding from the channel hole by about 5 mm to 15 mm, and is about 10 mm to 20 mm from the channel hole. It is fixed so that it touches the body surface at a distant position.

When a tube with only one normal lumen is bent at a steep angle, it is almost completely occluded when a kink occurs and the lumen is crushed. In the case of a tube provided with a plurality of cavities, there is a possibility that distribution can be maintained as a whole even if some cavities are occluded when bent at a steep angle. However, when the lumen is partitioned by a straight partition wall, the radial cross-sectional shape of each lumen is substantially fan-shaped, so that the repulsive force against external pressure is small and the tube becomes thin. Therefore, extreme deformation of the shape is likely to occur in each lumen, and the tube is likely to be kinked, resulting in narrowing or obstruction of the flow path. Further, since the actual flow path is the central portion of the fan shape, the peripheral portion of the cavity wall forming the corner portion becomes the conduit resistance, which tends to cause a decrease in the flow rate. Furthermore, if there is a corner in the cavity, the corner becomes a dead volume, and the exudate stays and the components contained in the exudate accumulate or stick to cause an infectious disease.

In the drain catheter 100A of the present embodiment, the transition portion 102 has a plurality of transition portion lumens 121, and the transition portion lumen 121 has a circular radial cross-sectional shape. As a result, a thin portion is unlikely to be formed on the tube wall surrounding the transition portion lumen 121, and a repulsive force against external pressure can be obtained. Therefore, when the transition portion 102 is bent at a steep angle, a kink of the tube is generated. Hateful. The lumen can be kept flowable and the discharge flow rate can be secured. The circular shape referred to here is not limited to a perfect circle, but includes an ellipse, an oval, an oval, and other similar circles. Further, it is preferable that the shape connecting the center points of the radial cross-sectional shape of the transition portion lumen 121 is arranged so as to have a substantially regular n-square shape (n is the number of transition portion lumens). With such an arrangement, each transition portion lumen 121 can be balanced, and blockage when bent can be made less likely to occur. Therefore, by arranging the transition portion 102 at the drawer portion so that the transition portion 102 can be bent, it is possible to prevent blockage at the drawer portion.

Further, by making the radial cross-sectional shape of the transition portion lumen 121 circular, the dead volume is eliminated and the liquid flows through the entire lumen, so that accumulation and sticking in the lumen are less likely to occur. It also has the advantage of suppressing the outbreak of infectious diseases.

The transition portion 102 may be formed only at a portion that can be bent near the body surface, but the length is preferably 20 mm or more, and more preferably 30 mm or more from the viewpoint of facilitating alignment. Further, from the viewpoint of increasing the manufacturing cost and the cross-sectional area of the flow path of the catheter as a whole, it is preferably 200 mm or less, and more preferably 150 mm or less. The length of the liquid collecting portion 101 may be appropriately selected according to the usage situation, but can be about 10 mm to 100 mm. The length of the liquid collecting portion 101 can also be adjusted at the time of use according to the position of the wound portion in the body. The length of the hand portion 103 may be appropriately selected according to the usage situation, but can be about 20 cm to 150 cm.

The outer diameters of the liquid collecting portion 101, the transition portion 102, and the hand portion 103 may be appropriately selected depending on the usage conditions, but are generally about 2 mm to 10 mm. It is preferable that the outer diameters of the liquid collecting portion 101, the transition portion 102, and the hand portion 103 are the same because they can be less likely to be caught during insertion and removal, but the outer diameter is about 0.5 mm to 2 mm. There may be a difference.

The inner diameter of the hand portion 103 depends on the outer diameter, but is preferably about 1 mm to 8 mm. The inner diameter of the transition portion cavity 121 depends on the outer diameter of the transition portion 102 and the number of the transition portion cavities 121, but is preferably 35% or less of the outer diameter. When the inner diameters of the transition portion cavities 121 are the same, it is possible to prevent obstruction when bent.

The drain catheter 100A of the present embodiment can be manufactured, for example, by bundling three tubes 115 with a sheath 122 excluding the tip portion and connecting a tube serving as a hand portion 103 to the proximal end side thereof. The hand portion 103 can be connected to the transition portion 102, for example, by fitting a tube having an outer diameter substantially equal to the inner diameter of the sheath 122 into the sheath 122. However, the connection method between the transition unit 102 and the hand unit 103 is not limited to such a method.

In this case, the filler 123 can be filled in the sheath 122. As a result, kink can be made less likely to occur when the transition portion 102 is bent. The filler 123 has flexibility such as a synthetic resin such as polyurethane, soft polyvinyl chloride resin, silicone resin, styrene elastomer, vinyl chloride elastomer, olefin elastomer, polyester elastomer, polyamide elastomer, or natural rubber. It can be a resin. However, depending on the materials of the tube 115 and the sheath 122, the filler 123 may not be filled.

The method for forming the drain catheter 100A of the present embodiment is not limited to such a method. For example, a tube to be a transition portion 102 having three lumens is separately molded, and the drain collecting portion 101 is formed in this tube. It can also be formed by connecting the tube and the tube serving as the hand portion 103.

In the present embodiment, the tube 115 serving as the liquid collecting portion 101 and the transition portion 102 and the tube serving as the hand portion 103 can be formed of a flexible resin material. Among them, polyamide, polyamide-based elastomer, vinyl chloride, polyurethane, polyimide, polyethylene, polyester elastomer, polypropylene, polytetrafluoroethylene, polyether ether ketone, polyvinylidene fluoride, etc., silicone resin, styrene-based elastomer, vinyl chloride-based elastomer, olefin A heat-bondable material such as a synthetic resin such as a based elastomer, a polyester-based elastomer, or a polyamide-based elastomer, or a natural rubber is preferable. In addition, each part may be formed by the same material or may be formed by a different material.

The tube 115, which serves as the liquid collecting portion 101, can be preliminarily habituated so as to spread outward. In this way, the tubes 115 can be bundled, housed in an outer tube (not shown), inserted to the vicinity of the wound, and then pulled out so that the tubes 115 expand in different directions. it can. In this way, the exudate can be sucked from a wide area near the wound.

Further, a slit extending in the longitudinal direction can be provided on the side surface of the tube 115 forming the liquid collecting passage. Since the slit functions as a liquid collecting port, liquid can be collected from the side surface of the tube 115, and the liquid collecting range can be further widened. The structure of the liquid collecting port on the side surface is not limited to the slit, but may be a side hole or the like.

In the present embodiment, an example in which the number of tubes 115 constituting the liquid collecting passage 111 and the transition portion cavity 121 is three is shown, but the number may be two or four or more.

Like the drain catheter 100B of the modified example shown in FIG. 4, the liquid collecting portion 101 can be formed by a sheet-like member 116 in which a plurality of liquid collecting passages 111 are arranged in the radial direction. As shown in FIG. 5, the sheet-shaped member 116 is a sheet having a plurality of cavities extending in parallel in the longitudinal direction, and each cavities are independent liquid collecting passages 111. The tip opening of each liquid collecting passage 111 functions as a liquid collecting port. For example, the tip of the sheet-shaped member 116, which is the liquid collecting portion 101, is housed in the outer cylinder tube (not shown) in a wound state, and the liquid collecting portion 101 is arranged in the vicinity of the wound portion. The drain catheter 100B can be indwelled in a state where the tip end portion of the sheet-shaped member 116 is expanded. This makes it possible to collect liquid from a wide range.

It should be noted that each cavity provided in the sheet-shaped member 116 may be provided with a slit extending in the longitudinal direction so that liquid can be collected from the side surface of the sheet-shaped member 116 as well. However, the structure of the liquid collecting port on the side surface is not limited to the slit, and may be a plurality of side holes or the like.

Further, in the present modification, the sheet-like member 116 in which the lumen serving as the liquid collecting passage 111 is arranged in one step is shown, but the lumen may be arranged in two or more steps. Further, a plurality of sheet-shaped members can be stacked one on top of the other. Further, it is also possible to provide a notch or the like at the tip portion of the sheet-shaped member 116 so that the tip portion expands.

In the drain catheter 100B of the second modification, as shown in FIG. 6, the base end portion of the sheet-shaped member 116 is spirally wound, and this portion is accommodated in the sheath 122 to be fixed so as not to expand. Can be the transition unit 102. By winding the sheet-shaped member 116, it is possible to prevent kink from occurring when the sheet-shaped member 116 is bent. The filler 123 can be filled in the sheath 122. However, the filler 123 may be filled as needed and may not be filled.

Further, if the wound sheet-like member 116 can be prevented from expanding, it does not have to be housed in the sheath 122. For example, it can be wound and fixed with an adhesive or the like.

A hand portion 103, which is a single lumen tube, can be connected to the base end of the transition portion 102. When the transition portion 102 is housed in the sheath 122, it can be connected to the transition portion 102 by, for example, fitting the hand portion 103 into the sheath 122 as a tube whose outer diameter is substantially equal to the inner diameter of the sheath 122. .. However, the connection method between the transition unit 102 and the hand unit 103 is not limited to such a method.

The size and the like of the sheet-shaped member 116 may be appropriately selected depending on the usage situation, but for example, the width is preferably about 20 mm to 40 mm and the thickness is preferably about 0.5 mm to 2 mm. The inner diameter of the cavity provided in the sheet-shaped member 116 is preferably about 0.2 mm to 1.5 mm.

The drain catheter of the present embodiment and each of the modified examples can be placed in the wound using the channel hole formed in the endoscopic surgery, but can also be placed in the wound by the subcutaneous tunnel method or the like.

For the drain catheter having the liquid collecting part, the transition part and the hand part, the difficulty of kinking was evaluated by the test system as shown in FIG. The transition portion is pulled out from the channel hole provided in the pseudo skin so that the pull-out height A from the surface of the pseudo skin is about 30 mm, and the transition portion is at a position where the distance B from the channel hole is 20 mm or 10 mm. The flow rate in the bent state was compared with the flow rate in the unbent state by pressing lightly until it came into contact with. Physiological saline was used as the test solution, and the flow rate in the unbent state was set to 190 mL / min. Moreover, the measurement was repeated three times, and the average value was taken.

For the measurement, the outer diameter of the transition part is 4.9 mm, the catheter 1 having three transition lumens having an inner diameter of 3.9 mm and the cross section is circular, and the outer diameter of the transition part is 5.5 mm, and the outer wall The procedure was performed on a catheter 2 having four fan-shaped transition lumens partitioned by a cross-shaped partition wall having a thickness of 1 mm and a thickness of 0.6 mm. Both the catheter 1 and the catheter 2 have a structure in which the liquid collecting portion has the same number of liquid collecting passages as the transitional lumen, and the hand portion is a single lumen tube.

In the case of catheter 1, the flow rate when the 20 mm position is pressed is 76.8% when the position is not bent, and the flow rate when the 10 mm position is pressed is 45.0% when the position is not bent. It was. In the case of the catheter 2, the flow rate when the 20 mm position is pressed is 70.9% when the position is not bent, and the flow rate when the 10 mm position is pressed is 29.4% when the position is not bent. It was. The measurement results are summarized in Table 1.

The drain catheter of the present disclosure is less likely to close even when bent at a steep angle in the vicinity of the body surface, and is useful as a drain catheter or the like to be placed in the body using the channel hole of an endoscope.

100A Drain catheter 100B Drain catheter 101 Liquid collection part 102 Transition part 103 Hand part 111 Liquid collection passage 112 Partition 113 Outer wall 113a Slit 115 Tube 116 Sheet-like member 121 Transition part lumen 122 Sheath 123 Filler 131 Hand lumen

Claims (5)

The liquid collecting part provided at the tip and
A transition portion provided on the base end side of the liquid collecting portion and
It is provided with a hand portion provided on the base end side of the transition portion.
The liquid collecting portion has a plurality of liquid collecting ports for collecting exudate, and a plurality of liquid collecting passages for guiding the exudate collected by the liquid collecting port to the transition portion.
Each of the transitions has a plurality of transition lumens corresponding to the collection passage.
The hand portion has one hand portion lumen, and has one hand portion.
A drain catheter in which each of the plurality of transition lumens has a circular cross-sectional shape in the radial direction. The liquid collecting portion is composed of a sheet-like member in which a plurality of the liquid collecting passages are arranged.
The drain catheter according to claim 1, wherein the liquid collection port is an opening at the tip of the liquid collection passage. The drain catheter according to claim 2, wherein the transition portion is composed of the wound sheet-like member. The plurality of liquid collection passages are tubes that are independent of each other.
The drain catheter according to claim 1, wherein the liquid collection port is an opening at the tip of the liquid collection passage. Each of the plurality of liquid collection passages has a slit extending in the longitudinal direction on the side surface.
The drain catheter according to claim 1, wherein the liquid collection port is a slit of the liquid collection passage.

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