JP2537579B2 - Medical catheter - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION The present invention is mainly applied to lumens in the body,
For example, the present invention relates to a medical catheter for injecting a drug solution into the common bile duct from the gallbladder duct.

[0002]

BACKGROUND OF THE INVENTION Intraoperative cholangiography in laparoscopic cholecystectomy has the same significance as conventional means for laparotomy, such as finding residual stones and confirming the movement of the gallbladder duct, and the main points of laparoscopic procedures. It has become a more indispensable intraoperative treatment for safe and reliable treatment of the gallbladder duct. Then, in general, the gallbladder duct is peeled off to a sufficient length, closed by a clip or a ligature near the neck of the gallbladder duct, and the gallbladder duct is incised or cut just proximal to that and a catheter is inserted. Performing intraoperative cholangiography.

In the procedure of laparotomy, a tip made of a soft metal tube or a tube made of a resin and having a metal stylet incorporated therein is devised so that the operator can easily insert it into the gallbladder tube while looking straight. A catheter that can be shaped into and has an appropriate rigidity has been used. However, in the laparoscopic procedure, the catheter is inserted into the gallbladder duct through the linear trocar or the lumen of the forceps, so even if it is shaped outside the body, it recovers in the abdominal cavity, and the procedure by laparotomy is performed. A catheter suitable for use in laparoscopic procedures loses its significance.

At present, catheters used in laparoscopic procedures are resin tubes generally used in the fields of surgery and internal medicine. The tip of the catheter is tapered to improve the insertability into the lumen, It is only devised so that the insertion depth can be read with a scale line. Therefore, in order to surely insert into the common bile duct through the flexing neck through the opening of the soft and thin gall bladder duct, a burden is not negligible to the operator, and in particular, the catheter is indirectly connected by the direction of the trocar or forceps. This technique of operation requires a high degree of skill. Also,
In an uncertain insertion state, tube deviation easily occurs due to movement of the affected part position, injection pressure of the drug solution, etc., and effective intraoperative cholangiography cannot be performed.

Generally, when it is difficult to insert a catheter into a lumen of the body for various reasons, a guide wire is preceded to guide the catheter to a predetermined site. This procedure can be applied to intraoperative cholangiography, but with the conventional catheter, it is impossible to inject a drug solution or the like without removing the guide wire after inserting the gallbladder duct, and the catheter also deviates at the same time when the guide wire is removed. there were. Further, in order to prevent the catheter inserted into the gallbladder duct from deviating, it is generally ligated or fixed with a medical clip, and a knotted catheter is devised to ensure the effect. However, in the laparoscopic procedure, since it is inserted into the abdominal cavity through a rigid forceps or a trocar lumen, it is unavoidable to select these insertion instruments having an inner diameter larger than the outer diameter of the node, and the laparoscopic view and operative field. For the purpose of ensuring the above, the carbon dioxide gas that is insufflated to inflate the abdominal cavity leaks out from the gap between the catheter and the insertion instrument, and there is a problem that the abdominal pressure cannot be achieved due to the decrease in the abdominal pressure.

[0006]

DISCLOSURE OF THE INVENTION The present invention has been made as a result of various studies in order to solve the above problems of the conventional catheter in the laparoscopic procedure. A medical device that has excellent operability so that it can be inserted to the desired position in the lumen, and that it is possible to inject a drug solution without departing from the inserted state and safely perform intraoperative cholangiography in laparoscopic cholecystectomy. To provide a catheter for use.

[0007]

A medical catheter according to the present invention for achieving the above object comprises a main pipe serving as a passage over the entire length and a flow of a drug solution or the like provided in a wall of the pipe forming the main pipe. A catheter composed of an auxiliary tube that serves as a passage, wherein the vicinity of the distal end has a smaller diameter than the main body portion, and the small diameter portion is provided with an annular knuckle protruding on the outer surface, A structural feature is that an opening hole for an auxiliary pipe is provided at a position, the auxiliary pipe is branched from the vicinity of the rear end of the main body, and a connector for connection is attached to the rear end. .

The present invention will be described in detail below with reference to the illustrated embodiments. FIG. 1 is a cutaway sectional view showing a medical catheter according to the present invention, and FIG. 2 is a detailed view near the tip.

The tube (1) is composed of a main pipe (2) serving as a passage over the entire length thereof and an auxiliary pipe (3) provided in a pipe wall forming the main pipe, and has a large diameter main body portion (4). ) Is connected to the small diameter portion (5). A connector (11) communicating with the main pipe (2) is attached to the rear end of the main body (4), and a branch communicating with the auxiliary pipe (3) from the vicinity of the rear end of the tube (1). The pipe tube (9) is branched, and the branch pipe connector (10) is connected to the rear end thereof.

The outer diameter of the tube (1) is usually about 2 to 10 mm in the main body part (4) and about 1 to 3 mm in the small diameter part (5). For example, soft vinyl chloride resin, polyurethane resin, silicone. It is extruded from a material having appropriate flexibility and rigidity such as rubber. Further, the main body portion (4) and the small diameter portion (5) are integrally molded, and the small diameter portion (5) can be formed by drawing or simultaneous molding, but separately molded tubes are bonded and connected. You may form it. It is important that the boundary part between the main body part (4) and the small diameter part (5) is processed smoothly with few steps, and the tube (1) is kneaded with barium sulfate or the like to give an X-ray contrast property. It is preferable to have.

The branch tube (9) is formed by extruding a tube made of a flexible material such as a soft vinyl chloride resin, a polyurethane resin or a silicone rubber.
The material may be the same as or different from the tube (1) body. Branch pipe connector (1
0) and the connector (11) are metal processed products or plastic molded products, and are adhesively connected to the tube (1). Further, the terminal structure of these tubes (1) may be an integrally molded product by insert molding.

The main pipe (2) extends from the connector (11) at the rear end of the main body (4) to the main pipe opening hole (7) at the tip of the small-diameter portion (5), and is usually 0.018. ~ 0.052
It has an inner diameter that allows an inch (0.46-1.32 mm) guide wire to pass smoothly. The auxiliary pipe (3) allows gas-liquid flow from the branch pipe connector (10) to the auxiliary pipe opening hole (8) located near the tip of the small diameter portion (5), and the auxiliary pipe opening hole is the opening portion. As shown in FIG. 2, one or more openings (8) are formed in the side surface of the small diameter portion (8) or the tip surface of the small diameter portion (8).

It is important that the corners of the tip surface of the small-diameter portion (8) are chamfered and smooth to reduce damage to the inner wall of the lumen, and it is more preferable that the tip is tapered. . In addition, as shown in FIG. 2, the outer surface of the small-diameter portion (8) is provided with one or more annularly projecting node portions (6), and the height of the protrusion is about 0.5 to 2 mm.
The width is about 0.5 to 3 mm. Moreover, it is important that the shape is a smooth, rounded shape shown in FIG. 1, and it is processed by thermal processing integrally with the tube of the small diameter portion (5), but it is processed separately. Alternatively, metal or plastic parts may be adhesively fixed.

In use, a guide wire is inserted from the rear end of the main tube (2), and its distal end is inserted to the position of the incision of the gallbladder duct, and under the guidance thereof, the node portion (5) of the small diameter portion (5). Place up to 6) in the lumen. If necessary, it is ligated or clipped and fixed together with the lumen wall on the rear side of the node, and a drug solution such as a contrast agent is injected from the branch tube connector (10).

[0015]

According to the medical catheter of the present invention, the tube main body forming the main pipe and the auxiliary pipe has a large diameter and rigidity, and the operability of the distal end portion from the outside of the body is excellent, and the auxiliary pipe is a flow passage for a drug solution or the like. Because the inner diameter of can be secured, the flow resistance can be reduced,
It is possible to quickly inject and discharge chemicals and the like. In addition, since the vicinity of the tip has a small diameter, it has moderate flexibility that is easily guided by the guide wire that leads the catheter insertion from the gallbladder duct to the common bile duct, and can reduce the resistance with the inner wall of the gallbladder duct. The catheter can be safely and reliably inserted into the common bile duct without damaging the inner wall tissue of the gallbladder duct.

Furthermore, since the main pipe that serves as the passage for the guide wire and the auxiliary pipe that serves as the flow passage for the chemical liquid are independent of each other,
When the opening reaches the target site in the lumen,
It becomes possible to immediately inject and discharge the drug solution and the like, and it is possible to omit a complicated procedure for the operator who removes the guide wire and injects and discharges, and it is possible to prevent the catheter from departing.

Further, by matching the inner diameter of a trocar or forceps, which is a catheter introducing device in the abdominal cavity, with the outer diameter of the tube (1) main body (4), the abdominal wall is inflated and the field of view of the endoscope is secured. In addition, since positive pressure and leakage of carbon dioxide gas to be sent can be prevented, the safety of the procedure can be improved.

By combining these functions, excellent safety and operability are realized, and intraoperative cholangiography in laparoscopic cholecystectomy can be performed.

[0019]

As described above, when the medical catheter of the present invention is used, it can be safely and surely inserted into the gallbladder duct to a desired position, and the medicinal solution can be injected without departing, and
It is also suitable as a catheter introduction device and can prevent the leakage of carbon dioxide gas that has been sent into the abdominal wall, and is therefore useful as a medical catheter for intraoperative cholangiography in laparoscopic cholecystectomy.

[Brief description of drawings]

FIG. 1 is a cutaway sectional view showing a structure of a medical catheter according to an embodiment of the present invention.

FIG. 2 is a schematic view showing the shape of the vicinity of the tip of the medical catheter of the present invention.

[Explanation of symbols]

 2 Main pipe 3 Auxiliary pipe 4 Body part 5 Small diameter part 6 Node part 7 Main pipe opening hole 8 Auxiliary pipe opening hole 9 Branch pipe tube 10 Branch pipe connector

Claims (1)

(57) [Claims] 1. A catheter comprising a main pipe serving as a passage over the entire length thereof and an auxiliary pipe provided in a pipe wall forming the main pipe and serving as a passage for a drug solution or the like. The diameter of the auxiliary tube is reduced to a small diameter, and the small diameter portion is provided with an annular knuckle protruding on the outer surface and an opening hole of an auxiliary pipe is provided at a position on the tip side of the knuckle. A medical catheter characterized in that it is branched from the vicinity and a connecting connector is attached to the rear end thereof.