JP2944900B2 - Endoscope puncture tool - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a puncture device used as a mucosal puncture device in colorectal mucosal incision, colonoscopic hemostasis, and an endoscopic polyp resection. .

[0002]

2. Description of the Related Art Conventionally, there is a colorectal fiber scopie mucosal inking method as shown in FIG. 12, which is used to determine a treatment range, track a site after treatment, etc., and to aseptically sterilize it directly under an endoscope. Ink is injected into the gastrointestinal tract wall to form a dot-like mark. In the figure, (20) indicates a scope, and (23)
Indicates a needle, and (25) indicates an affected part. Also, there is a colonoscopic hemostasis method as shown in FIG. 13, which is used when a blood vessel exposed by a gastrointestinal tract wall tumor or the like is torn and bleeding occurs. This is a method of injecting a drug solution to stop bleeding. In the figure, (20) indicates the scope, and (23)
Indicates a needle, and (26) indicates a blood vessel. Further, there is an endoscopic polyp resection method for a sessile, flat polyp as shown in FIG. For this purpose, endoscopic polypectomy (mucosal excision) for excision of polyps generated in the digestive organs such as the stomach, small intestine, and large intestine has been frequently performed. In the endoscopic polypectomy, an endoscope corresponding to a target site is inserted, a polyp is captured with a snare wire inserted from a forceps port, and a high-frequency current is applied to cut the polyp. The excised and recovered excision is then examined to determine whether it is benign or malignant and to help determine the course of subsequent treatment. Therefore, it is important to recover all excised polyps and to recover the polyp tissue with as little damage as possible. In the polyp resection method using a large intestine fiber, which is currently frequently performed, not only protruding polyps but also protruding ones that cannot be captured by a snare wire (stemless, flat polyp) are often used, and it often takes time to remove. In such a case, a saline solution or the like is injected into the ligature of the polyp to protrude and clarify the existing portion of the polyp, and the snare wire makes it easier to capture, so that the endoscope is safer and has no leftover. A mirror resection has been performed. This will be described later in detail with reference to the present invention shown in FIG. As a result, it has become possible to safely and easily perform difficult polypectomy procedures so far, and to diagnose and treat colorectal cancer and polyps. Mucosal resection (MR) procedure in the large intestine is 1973
It is said that this is the first time that a saline solution has been injected into the submucosal layer of a lesioned sessile polyp and then removed with a snare wire.

[0003]

As described above, mucosal puncture has been conventionally performed for treatment with an endoscope. In this case, however, there is no dirt in the endoscope inserted into the large intestine. However, the needle for injecting the infusate passes through the lumen and is very unsanitary. Further, there is a disadvantage that the inner wall of the lumen of the endoscope is damaged because the needle passes directly through the endoscope, and the digestive tract wall is inadvertently damaged by the needle coming out of the end of the endoscope. In conventional endoscopic treatments, various studies have been made to solve such problems. An object of the present invention is to provide a disposable endoscope puncture device that guides a puncture needle for injecting an infusate safely and hygienically to a target site without damaging the lumen inner wall of the endoscope.

[0004]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention provides the following disposable puncture tool for an endoscope. That is, it is a disposable tool for performing mucosal puncture by mucosal instillation, hemostasis, endoscopic polypectomy, etc., and a puncture needle for injecting black ink, a hemostatic solution, physiological saline, etc. into a target site. A puncture device for an endoscope, which is slidably provided in an outer tube that guides to a target site, and has a pierceable cap for protecting the tip of the needle at the tip of the outer tube. In the puncture device, the cap at the tip of the outer tube is colored with a fixed length, and the base tube of the puncture needle is fitted into the base tube of the outer tube, The stopper provided on the base tube slides along the guide groove that regulates the length of the needle provided on the base tube of the outer tube, and the needle of a certain length projects from the cap. is there.

[0005]

[Function] The tip of the puncture needle for injecting the infusate is protected by the cap at the tip of the outer tube, so that when the needle passes through the endoscope, it does not damage the inner wall of the lumen of the endoscope. The puncture needle is not contaminated with dirt in the endoscope.
Further, it is possible to prevent the infusion liquid from flowing out before performing puncture.
Also, by sliding the stopper provided on the base tube of the puncture needle along the guide groove that regulates the protrusion length of the needle provided on the base tube of the outer tube, the needle of a certain length protrudes from the cap. Liquid can be injected into the mucous membrane.

[0006]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. FIG. 1 shows a disposable endoscope puncture device according to the present invention.
As shown in FIG. 5, the puncture needle comprises a puncture needle (1) and an outer tube (2) for guiding the puncture needle to a target site, and a cap (3) for protecting the tip of the needle is provided at the tip of the outer tube. . At the base end (2a) of the outer tube (2), FIG.
There is a base cylinder (6) having a small cylinder (5) having a hole (4) into which the tube (2) shown in FIG. 7 is inserted. The base cylinder (6) has guide grooves (7) (7) in the axial direction symmetrically left and right. The guide groove (7) has a U-shape as shown in FIG. 8, and the vertical groove (8) at the beginning has a stopper stop (8a) and the end has a stopper stop (7a). As shown in FIG. 10, a base tube (9) inserted into the base tube (6) is provided at a base end (1a) of the puncture needle (1), and a base of the puncture needle (1) is inserted at a distal end. There is an insertion hole (10). Stoppers (11) and (11) are provided symmetrically on the base cylinder (9), and slide in guide grooves (7) and (7) of the base cylinder (6). Pick it at hand of the base cylinder (9) (12) (1
2) is provided symmetrically up and down and left and right, and a cyridine mounting cylinder (13) is provided. (14) is a pyridine attachment projection.

The puncture needle is made of stainless steel SUS304, and its base tube (9) is made of polypropylene (PP) or acrylic butadiene styrene (ABS), and its outer tube (2) is made of a slippery tube such as fluororesin. . Vinyl chloride is used for the cap (3). The cap (3) is colored in a certain length. The syringe used was a lock type of 20 ml. 15 and 16 show an endoscope (19), FIG. 16 is a cross-sectional view of a forceps outlet portion, (15) is a forceps outlet, (16) is a light guide, and (17) is a light guide. , (18) indicate objective lenses, respectively.

As shown in FIG. 4, the puncture needle (1) is used in a state of being inserted into an outer tube (2). The puncture needle (1) is inserted into a lumen through a forceps port (15) of an endoscope (19). Insert up to the site. At this time, the cap (3) at the tip of the outer tube (2) prevents dirt and blood from entering the tube (2) and the puncture needle (1). Further, there is no fear of damaging the inner wall of the lumen of the endoscope (19), and the mucous membrane is not inadvertently damaged by the tip of the needle (1) protruding from the tip of the endoscope (19). Since the cap (3) at the tip of the outer tube (2) is colored in a predetermined length in advance, the size of the lesion can be determined by comparing with the size of the cap (3), and the position of the tube can be determined. Can also be easily confirmed. The material of the cap (3) is more easily pierced than high-stretch materials such as latex and urethane.
The above-mentioned vinyl chloride which is easy to process and easy to color is desirable.

[0009] In order to perform mucosal instillation, hemostasis, and polypectomy using the puncture tool for an endoscope as described above, it is necessary to accurately inject it into a target site. Directly look at the target with the endoscope, insert the tool of the present invention from the forceps hole of the endoscope, and put out the tip of the tool about 1 cm from the tip of the endoscope. The cap is confirmed on the screen.) In the colorectal fiber scopie mucosal instillation method, sterile black ink is put into a puncture needle and injected into the mucous membrane at the target site. Next, in colonic endoscopic hemostasis, bleeding that is exposed and damaged by a tumor on the wall of the digestive tract is infused, and a drug solution (eg, anhydrous ethanol, ethoxysclerol, etc.) is injected directly under the endoscope and around the bleeding blood vessel. Further, endoscopic polypectomy (mucosal excision) for sessile and flat polyps is performed as follows. That is, in order to perform a polypectomy using the puncture device for an endoscope, the puncture device of the present invention is inserted from the forceps hole of the scope as shown in FIG.
For 4), position the tip of the scope at about 1 cm. Next, the inner cylinder (9) of the base cylinder (6) at hand is slid, the tip cap (3) is broken, and the puncture needle (1) is pierced as shown in FIG. Fig. 14
The lesion (24) is inflated as shown in (c). After injecting the liquid (21), the lesion (24) is captured by the snare wire (22) inserted from the forceps hole (15) as shown in (d) and (e) of FIG. Part (2
4) Excision. The excised lesion (24) is taken out from the forceps hole (15) with a newly injected trapping net (27).
The excised and recovered resections are then examined to determine whether they are benign or malignant, and to help determine subsequent treatment and other strategies. In the procedure as described above, in order to pierce the target site with the puncture needle (1), as shown in FIG. 5, the tip of the puncture needle (1) breaks through the cap (3), protrudes the needle, and punctures the target site. Inject liquid. When injecting a staining solution as an infusion solution, the effect of the present invention is reduced if the staining solution flows out of the tip of the needle before performing puncture. That is, the staining solution flowing out from the tip stains portions other than the originally required stained portion, and clear contrast cannot be obtained. In this sense, the tip cap of the device of the present invention has an effect of preventing the stain solution from flowing out before performing the puncture. At this time, the stopper of the base tube (9) of the puncture needle (1) is moved along the guide groove (7) of the base tube (6) of the outer tube (2) such that the needle of a predetermined length protrudes from the tip. Slide (11) from the stop position (8a) and pick (1) to the stop position (7a).
2) to move. As a result, the needle can pierce the cap (3) at the tip of the outer tube (2) and project from the tip of the outer tube (2) by a certain length, for example, 5 mm to puncture the lesion (24).

In any case, according to the puncture device of the present invention, since the stopper is provided so that the needle of a predetermined length protrudes from the tip of the outer tube (2), it is possible to puncture deeper than necessary. Nor.

[0011]

According to the present invention, a puncture needle, which was conventionally dangerous and unsanitary at the time of mucosal injection in a mucosal inking method, a hemostatic method, and an endoscopic polypectomy method, is covered with a cap at the tip of the outer tube. As it is protected, it can be inserted into the endoscope without damaging the inner wall of the lumen of the endoscope, and sterile and sanitary puncture is performed without contaminant blood entering the outer tube or puncture needle. In addition, since the puncture needle is protected by the cap until the lesion is punctured with the puncture needle, the wall of the digestive tract is not inadvertently damaged. Further, outflow of the infusate before performing the puncture can be prevented. Also, by comparing the size of the lesion of a polyp or the like with the size of the cap, the feeding of the outer tube can be clearly identified, so that the puncture can be performed safely and hygienically while checking the size of the lesion, which is disposable. It is suitable as a puncture tool for an endoscope.
The tool of the present invention can be easily distinguished from a used tool due to the breakage of the tip cap by a single use, thereby preventing a needle accident (infection) due to misuse of the same needle.

[Brief description of the drawings]

FIG. 1 is an external view of a puncture needle.

FIG. 2 is an external view of an outer tube.

FIG. 3 is an external view of a tip cap of the outer tube in FIG. 2;

4 is an explanatory view showing a state where the puncture needle of FIG. 1 is inserted into the outer tube of FIG. 2;

FIG. 5 is an explanatory view of a use state of the puncture device of the present invention.

FIG. 6 is an assembled sectional view of a puncture needle base and an outer tube base;

FIG. 7 is a sectional view of an outer tube base cylinder.

FIG. 8 is a partial plan view of the same.

FIG. 9 is a left side view of the same.

FIG. 10 is a sectional view of a puncture needle base.

FIG. 11 is a left side view of the same.

FIG. 12 is an explanatory diagram of a conventional mucosal ink method.

FIG. 13 is an explanatory view of a conventional endoscopic hemostasis method.

FIG. 14 is an explanatory view of use of the puncture device of the present invention.

FIG. 15 is an external view of an endoscope.

FIG. 16 is a cross-sectional view of a forceps outlet portion of the above forceps.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Puncture needle 2 Outer tube 3 Cap 6 Base tube 7 Guide groove 9 Base of puncture needle 11 Stopper 12 Knob 13 Syringe mounting tube 14 Projection for mounting siridine 15 Forceps outlet 16 Light guide 17 Light guide 18 Objective lens 19 Endoscope 20 Scope 21 Liquid (saline) 22 Snare wire 23 Needle 24 Lesion

──────────────────────────────────────────────────続 き Continued on the front page (58) Fields surveyed (Int. Cl. ⁶ , DB name) A61M 5/14 A61B 1/00 300 A61M 39/00

Claims (3)

(57) [Claims] Claims: 1. A colorectal fiber scopie mucosal ink method,
Disposable tools used for colonic endoscopic hemostasis, endoscopic polypectomy, etc.,
A puncture needle for injecting physiological saline or the like is slidably provided in an outer tube for guiding it to a target site, and a piercable cap for protecting the tip of the needle is provided at the end of the outer tube. A puncture tool for endoscopes. 2. The puncture device for an endoscope according to claim 1, wherein the cap at the tip of the outer tube is colored to a predetermined length. 3. A guide for fitting a base needle of a puncture needle into a base tube of an outer tube, and a stopper provided on the base tube of the puncture needle for controlling a protrusion length of the needle provided on the base tube of the outer tube. 3. The puncture device for an endoscope according to claim 1, wherein a needle having a predetermined length slides along the groove and protrudes from the cap.