JP2509918B2 - Removal tool for foreign bodies in body cavity - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to a tool for removing foreign matter in a body cavity, which is used when removing foreign matter such as stones generated in the body cavity.

[Prior Art] Large calculi that do not spontaneously discharge may occur in the body cavity. As a removing tool used for removing such a stone in the body cavity, there is one disclosed in Japanese Utility Model Publication No. 56-109705. In this, a basket made of a plurality of wires is provided on the distal end side of the sheath, the basket is opened to take in the calculus, and the basket is closed to capture the calculus.

Further, as disclosed in US Pat. No. 3,119,392, it is known that the distal end portion of a tube is configured to be bendable with a wire, and the distal end portion overcomes the calculus and then is curved to remove the calculus.

[Problems to be Solved by the Invention] By the way, since the one disclosed in Japanese Utility Model Laid-Open No. 56-109705 forms a basket with a plurality of wires and a tip end is attached to the tip of the basket, For example, in the case of a calculus in a small-diameter lumen, especially when most of the calculus is in close contact with the lumen wall, the basket is difficult to pass through, and the basket wire is difficult to open. Therefore, it may happen that the calculi cannot be captured.

Also, under similar circumstances, U.S. Pat.
In what was known as No. 392, the tip of the tube was sometimes unable to overcome the stone.

The present invention has been made in view of the above-mentioned problems, and its object is to make it possible to easily remove foreign matter existing in a lumen having a small diameter and to reliably remove the foreign matter. It is to provide a tool for removing foreign matter.

[Means and Actions for Solving Problems] In order to solve the above-mentioned problems, the present invention provides a foreign matter capturing portion including a tip loop portion formed by folding a wire made of a shape memory alloy in a loop shape and a straight portion following the tip loop portion. And having both ends of the wire provided in a flexible sheath,
An object of the present invention is to provide a removal tool for foreign matter in a body cavity, wherein the straight portion of the foreign matter capturing portion is curved and deformed in a direction orthogonal to a surface formed by the tip loop portion at a transformation temperature or higher.

[Embodiment] An embodiment of the present invention will be described below with reference to the drawings.

This stone removing tool 1 is constructed as shown in FIG. That is, this is provided with a calculus complementing portion 3 protruding from the distal end portion of a sheath 2 which is inserted into a channel of a biliary tract endoscope 10 to be described later. The wire 5 is attached and fixed to the distal end of the sheath 2. Also, this wire 5 is a shape memory alloy,
For example, it is formed of a Ni-Ti alloy. Further, the tip of the wire 5 is heat-treated so as to be bent into an L-shape as shown in FIGS. 1 and 3, and this shape is stored. In this state, the Ni-Ni alloy is in the R phase (intermediate phase) at room temperature.
Is formed. Further, the end temperature Af point at which the austenite phase is transformed is set in the range of 40 ° to 42 ° C. Then, the tip portion of the wire 5 is deformed into a straight shape as shown in FIG. 2 by applying an external force at room temperature, for example, 25 ° C. At this time, the deformed portion of the Ni-Ti alloy forms a deformed martensite phase (low temperature phase). An operation knob 6 is attached to the proximal end portion of the sheath 2 as shown in FIG.

On the other hand, this stone removing tool 1 is inserted into the body cavity by passing through the channel 11 of the biliary endoscope 10. This endoscope 10 is provided with an operation portion 13 at the proximal end of a flexible insertion portion 12, and the operation portion 13 has an operation knob connected to a wangle wire.
14, a light guide cable with a built-in light guide fiber and an eyepiece 15 connected to the image guide fiber
16 are linked. A connector 17 is provided at the extension end of the light guide cable 16, and the connector 17
The light source 17 is detachably connected to the light source device 18 for illumination. Further, the operation section 13 has a forceps insertion port 19 and an injection port 20 which are inserted into the same channel 11, respectively.
Are provided. Filling tube 21 in filling port 20
A syringe 22 for injecting a physiological saline solution is detachably connected to the injection tube 21. The channel 11 is provided with an objective lens 23 connected to the image guide fiber and an illumination window 24 connected to the light guide fiber on the front end surface 22 of the insertion portion 12.

Next, a method of using the stone removing tool 1 will be described. First, the common bile duct is exposed percutaneously to make an incision, and the insertion portion 12 of the biliary endoscope 10 is inserted from this incision portion. And
A stone 31 in the bile duct 30 is found with the endoscope 10. Therefore, the tip surface 22 is brought close to the calculus 31, and then the calculus removing tool 1 is inserted from the forceps opening portion 19 as shown in FIG. At this time, the tip of the wire 5 is deformed in a straight shape by applying an external force at room temperature. Then, the wire 5 of the stone removing tool 1 guided through the channel 11 is inserted into the gap between the stone 31 and the bile duct 30. At this time, since the wire 5 is extremely thin and straight, it can be easily inserted into the gap. Then, this time, the syringe 22 is connected to the injection tube 21, and the wire 5 made of the shape memory alloy is connected.
Af transformation point is 40 ° C to 42 ° C, physiological saline is injected 2 to 3 ° C higher, and the bile duct is passed through the gap with the sheath 2 in the channel 11.
Inject into 30. The tip of the wire 5 is heated by this physiological saline solution, and when it reaches the transformation temperature Af point or higher, it bends into the memorized L shape as shown in FIG.

Therefore, the calculus removing tool 1 having the operation knob 6 is pulled toward the operator's side, and the L-shaped calculus capturing portion 3 is applied to the calculus 31 and the calculus removing tool 1 is integrated with the endoscope 10 together with the calculus 31. Move to the side. Then, after moving to the incised part of the common bile duct, it is taken out from the incised part with tweezers.
In the above example, the application to stones in the bile duct was extended, but the stone removing tool of the present invention can be used not only for bile ducts but also for stones that occur in luminal organs in the body, such as ureteral stones and blood clots in blood vessels. .

Further, the heating method for the tip portion of the wire of the calculus capturing portion is not limited to that in the above embodiment. For example, you may heat with high frequency from outside the body. Alternatively, the wires may be energized from both ends and the resistance heat may be used to heat the wires.
It is also possible to heat the wire by the body temperature after insertion.

Furthermore, the material of the wire of the stone removing tool is Ni-Ti described above.
It is not limited to alloys only. For example, a Cu-Zn-Al-based alloy or the like that exhibits a shape memory effect may be used. Further, the shape memory alloy is not limited to a unidirectional alloy and may be a bidirectional (bidirectional) alloy. In this case, the shape memory alloy should be L-shaped on the high temperature side and straight on the low temperature side. Remember. Then, before inserting it into the bile duct, make it straight by putting it in cold water.

[Effects of the Invention] As described above, the foreign matter removing device of the present application has a simple structure in which a wire is looped, and has sufficient strength to hold a foreign matter. Further, it is possible to reduce the diameter, and it is possible to easily insert even a narrow gap. After the insertion, the tip can be restored to the memorized shape only by heating the tip, so that the tip operates reliably regardless of the size of the gap between the inner surface of the organ lumen and the foreign substance. Further, by looping the tip of the wire, it can be used safely without damaging the inside of the organ lumen. Further, since the memory shape has a shape for catching a foreign matter, the foreign matter can be easily caught.

[Brief description of drawings]

FIG. 1 is a perspective view showing an embodiment of the present invention, FIGS. 2 and 3 are perspective views of the same operation and use state, and FIG. 4 is a perspective view of the same inserted into an endoscope. Is. 1 ... stone removing tool, 2 ... wire, 3 ... stone capturing part,
10 …… Endoscope.

Claims (1)

(57) [Claims] 1. A foreign matter catching portion including a tip loop portion obtained by folding a wire made of a shape memory alloy into a loop shape and a straight portion continuing from the tip loop portion, and both ends of the wire are provided in a flexible sheath. The removal tool for foreign matter in a body cavity, wherein the straight portion of the foreign matter capturing portion is curved and deformed in a direction orthogonal to a surface formed by the tip loop portion at a transformation temperature or higher.