JP3015077B2 - Endoscope extension - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope extension device that is inserted endoscopically into a tubular organ and expands the tubular organ.

[Prior art] Conventionally, as a means for expanding a stenotic part of a living body, Japanese Patent Publication No.
An extension device made of a shape memory alloy as disclosed in -6655 has been proposed. This dilator stores the shape of the expanded diameter, is deformed into a small diameter so that it can be inserted into the stenosis at the time of insertion into the body, and after being inserted into the stenosis, is expanded by heating. However, once the expander was expanded, it was difficult to retrieve.
Therefore, as disclosed in JP-A-63-238872,
A stent using a directional shape memory alloy,
As shown in 83251, an expansion device having a memory shape smaller than the inner diameter of a tubular organ has been proposed.

[Problem to be Solved by the Invention] When a conventional dilator is applied to, for example, a stenosis at the back of the biliary tract near the hepatic portal, a dilator that is very long, 12 to 18 cm, is inserted endoscopically. And insertion into the stenosis was very difficult. Similarly, it has been difficult to collect the extension inserted into the back.

The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide an endoscope extension tool that can be easily inserted into and recovered from a stenosis at the back.

[Means for Solving the Problems] An endoscope dilator according to the present invention is inserted endoscopically into a tubular organ, and the endoscope dilator for expanding the tubular organ is provided. An expansion portion that is formed of a memory member and expands in the tubular organ; and an extension that extends from the proximal end of the expansion portion toward the proximal side along the axial direction of the expansion portion and has a length that remains in the body. It is characterized by comprising a projecting portion and means provided on the hand side of the projecting portion and gripped and pulled when being recovered from the tubular organ.

[Operation] In the present invention, the extension device is inserted into the stenosis portion with the extension portion at the hand side. When collecting the extension, the extension is grasped and collected. Therefore, there is no need to unnecessarily lengthen the extension.

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

1 to 6 relate to a first embodiment of the present invention. FIG. 1 is a side view of an endoscope dilator, and FIG. 2 is an endoscopically inserted overtube in a stenosis. FIG. 3 is an explanatory view showing a state in which the endoscope dilator is inserted into the stenosis, FIG. 4 is an explanatory view showing a state in which the endoscope dilator is collected from the stenosis, FIG. 5 is a sectional view showing the overtube, the endoscope extension device and the pusher tube, and FIG. 6 is a sectional view showing the overtube, the endoscope extension device and the insertion device.

As shown in FIG. 1, an endoscope extension device (hereinafter, referred to as an extension device) 1 of this embodiment has a substantially rectangular cross-sectional shape and is restored to a memory shape at a temperature of 45 ° C. to 50 ° C. An expanded portion 2 formed by spirally winding a wire made of a shape memory alloy to be formed, and one end of the shape memory alloy wire constituting the expanded portion 2 is extended in the axial direction of the expanded portion 2. And the extended portion 3 formed. The total length of the extension 1 is, for example, 12 to 18 cm.

In addition, after the diameter of the extension portion 3 is once reduced,
A hand-side end 4 having a spherical warhead shape on the end side is provided. Further, the other end side of the expansion portion 2 is also slightly stretched in the axial direction of the expansion portion 2, and the end portion is formed in a warhead shape.

In the shape memory alloy, when the martensite phase (low-temperature phase) reversely transforms to the austenite phase (high-temperature phase), the shape-memory alloy deforms in the martensite phase and returns to the stored shape in the austenite phase. . In the present embodiment, the expansion portion 2 stores the shape of the outer diameter capable of expanding the stenosis portion. However, when the expansion portion 2 is inserted into the body, the expansion portion 2 is deformed into a shape having a small outer diameter so that the stenosis portion can be inserted. ing.

Next, a procedure of inserting and collecting the dilator 1 will be described with reference to FIGS. 2 to 6, taking as an example a case where the constriction of the biliary tract is dilated by the dilator 1.

First, when inserting the dilator 1 into the stenosis, the endoscope 6 (the insertion part) is orally inserted into the duodenum 5 as shown in FIG. The guide wire 9 is inserted endoscopically from the duodenal papilla 7 through the biliary tract 11
Through the stenosis 8 to the upstream 12 of the hepatic portal. Subsequently, the overtube 10 passing through the channel is inserted along the guide wire 9 until it passes through the stenosis 8.

Next, as shown in FIG. 5, the extension device 1 is placed in the overtube 10 with the extension portion 3 at the hand side, and the extension device 1 is expanded using the pusher tube 14 inserted into the overtube 10. By pushing the proximal side of the part 2, the dilator 1 is advanced to the tip of the overtube 10. When the extension device 1 reaches the tip of the overtube 10, the pusher tube 14 is pushed in by the same amount while pulling out the overtube 10, and the overtube is kept fixed while the position of the extension device 1 is fixed.
Remove 10 and guide wire 9. Next, warm physiological saline at 45 ° C. to 50 ° C. is injected through the pusher tube 14. Thereby, as shown in FIG. 3, the expansion part 2 of the dilator 1 is expanded, and the dilator 1 is placed in the stenosis part 8. At this time, the proximal end 4 of the extension 3 projects from the duodenal papilla 7 toward the duodenum 5.

Next, when pulling out the indwelling extension 1 outward, the fourth
As shown in the figure, for example, a biopsy forceps 13 is inserted endoscopically through the channel of the endoscope 6 to the duodenum 5,
The proximal end 4 of the dilator 1 protruding from the duodenal papilla 7 toward the duodenum 5 is grasped by the biopsy forceps 13 and the endoscope 6
At the same time, the extension tool 1 is pulled out and collected. In addition, biopsy forceps 13
Instead, a grasping forceps may be used.

In addition, as shown in FIG. 6, instead of the pusher tube 14, the expansion tool 1 may be pushed forward by using a solid insertion tool 15. In this case, when expanding the expansion section 2, a pusher tube 14 is used, except that a warmed saline solution of 45 ° C. to 50 ° C. is injected from the overtube 10 or a heating means using electromagnetic waves or high-frequency waves is used. Is the same as the case of using.

As described above, according to the present embodiment, the extension portion 3
When the dilator 1 is to be collected, the extension 3 located closer to the hand than the stenosis is grasped even when the dilator 1 is used for stenosis at the back of the biliary tract 11 near the hepatic portal. Since it can be collected, the extension part 2 does not need to be unnecessarily lengthened, and insertion becomes easy. When the extension 1 is collected, the extension 3
Extend to the proximal side, for example, since the proximal end 4 of the dilator 1 protrudes from the duodenal papilla 7 to the duodenum 5 side, the dilator 1 is easily grasped by the biopsy forceps 13 or the like, and goes out of the dilator 1. Recovery becomes easier.

7 and 8 relate to a second embodiment of the present invention.
7A is a side view of an endoscope extension device, FIGS. 7B and 7C are side views showing modifications of a proximal end, respectively, and FIG. 8 is an explanatory view showing a pull-out device. is there.

In the present embodiment, the proximal end portion 4 of the expansion tool 1 is formed in a shape that can be easily engaged with a member for pulling out at the time of pulling out.

In the example shown in FIG. 7 (a), a hole 16
A substantially disk-shaped engaging portion 16 having a is provided. In the example shown in FIG. 7 (b), as the proximal end 4, an engaging portion 17 having a step with a small diameter on the extended portion 2 side and an enlarged diameter on the end side is used.
Is provided. In the example shown in FIG. 7 (c), a hook-shaped engaging portion 18 is provided as the proximal end portion 4.

In any case, the extension device 1 is pulled out using a pulling-out device that engages with the engaging portions 16, 17, and 18. For example, with respect to the example shown in FIG. 7 (a), as shown in FIG. 8, a wire rod whose tip end can be inserted into the hole 16a of the engaging portion 16 and bent so as to be hooked in this hole 16a Extraction device consisting of 19
Is used.

Note that a string may be attached to the engaging portions 16, 17, and 18, and the string may be retained.

According to the present embodiment, the proximal end portion 4 of the expansion device 1 is formed so that the pulling-out device can easily engage with it, so that the expansion device 1 can be more easily collected outside the body.

Other configurations, operations and effects are the same as those of the first embodiment.

FIG. 9 is a side view of an endoscope extension device according to a third embodiment of the present invention.

In the expansion device 1 of this embodiment, the material of the expansion portion 2 is a shape memory alloy as in the first embodiment, and the material of the extension portion 3 is other than a shape memory alloy softer than the shape memory alloy. At the part 20, the extension part 2 and the extension part 3 are bonded.

According to the present embodiment, since the material of the extension portion 3 of the expansion device 1 is softer than the shape memory alloy, it is difficult to damage the lumen.

Other configurations, operations and effects are the same as those of the first embodiment.

It should be noted that the present invention is not limited to the above embodiments, and for example,
The expansion part is not limited to a spirally wound shape memory alloy wire, for example, a shape memory alloy plate material is wound to memorize a cylindrical shape having an outer diameter capable of expanding a stenosis part, and a small diameter when inserted. You may wind it up.

Further, a shape memory resin may be used instead of the shape memory alloy.

Further, the dilator of the present invention can be applied not only to dilation of a stenotic part but also to compression and hemostasis of a bleeding site in a body lumen.

[Effects of the Invention] As described above, according to the present invention, even when the endoscope dilator is inserted into the stenosis at the back of the body lumen, the extension extends to the proximal side. It is possible to easily insert the stenosis into the stenosis at the back without unnecessarily lengthening it, and to easily recover the stenosis.

[Brief description of the drawings]

FIGS. 1 to 6 relate to a first embodiment of the present invention.
FIG. 2 is a side view of the endoscope dilator, FIG. 2 is an explanatory view showing a state in which the overtube is inserted into the stenosis part endoscopically,
FIG. 3 is an explanatory view showing a state in which the endoscope dilator is inserted into the stenosis, FIG. 4 is an explanatory view showing a state in which the endoscope dilator is recovered from the stenosis, and FIG. 5 is an overtube. FIG. 6 is a cross-sectional view showing an endoscope extension device and a pusher tube, FIG. 6 is a cross-sectional view showing an overtube, an endoscope extension device and an insertion device, and FIGS. 7 and 8 are second embodiments of the present invention. 7 (a) is a side view of the endoscope extension tool, FIGS. 7 (b) and 7 (c) are side views each showing a modification of the proximal end, and FIG. FIG. 9 is a side view of an endoscope extension device according to a third embodiment of the present invention. DESCRIPTION OF SYMBOLS 1 ... Endoscope extension tool 2 ... Expansion part, 3 ... Extension part 4 ... Hand side end part

──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Shuichi Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside O-Limpus Optical Industry Co., Ltd. (72) Inventor Kazuhiro Inoue 2-34-2 Hatagaya, Shibuya-ku, Tokyo (56) References JP-A-2-289240 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61M 29/02

Claims (1)

(57) [Claims] An endoscopic dilator inserted endoscopically into a tubular organ for expanding said tubular organ, comprising: a shape memory member, and an expanding portion expanding in said tubular organ. An extension portion extending from the proximal end portion of the extension portion toward the proximal side along the axial direction of the extension portion and extending to a length remaining in the body, provided on the proximal side of the extension portion, Means for being gripped and towed when being recovered from the inside of the tubular organ.