JP3617019B2 - An anastomotic stenosis treatment instrument - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to medicine, and more particularly to a treatment instrument for anastomotic stenosis, which is a complication of rectal instrument anastomosis in low anterior resection for rectal diseases.
[0002]
[Prior art]
Treatment of anastomotic stenosis, which is a complication of a conventional rectal instrument anastomosis, uses a dilator, which is represented by diversion of an esophageal dilator. When the anastomosis is treated using a dilator, the symptoms of stenosis temporarily improve, but the frequency of restenosis is extremely high. The reason is considered to be caused by irreversible deformation and shrinkage of the staple as will be described later.
[0003]
[Problems to be solved by the invention]
Stenosis of the rectal instrument anastomosis in low anterior resection is the most common complication and has been an unbearable pain for many postoperative patients. Accordingly, there has been a long-awaited appearance of a means for effectively removing this stenosis symptom early .
[0004]
[Means for Solving the Problems]
The present invention has been made to solve the above-described conventional problems , and is a treatment instrument for cutting staples of a stenosis in an instrumental anastomosis of a rectum so that it can be inserted into the rectum from the outside. Two shafts that are integrally provided long in one direction, and projecting and fixed in an L-shaped right angle from the upper surface of the shaft main body at the front end portions of the shafts, are in close contact with each other, and move relatively linearly 2 It comprises a therapeutic device for anastomotic stenosis characterized by comprising a head (1) composed of a single blade and a handle (2) for operating it. In general, the cause of anastomotic stenosis is not yet clear, but unlike an anastomotic stenosis in instrument anastomosis, there is a high possibility that staples used for instrument anastomosis are involved. That is, it is presumed that the irreversible deformation contraction of the staple caused by the scar contraction of the living body as a healing mechanism of the anastomosis forms a pathological condition that is difficult to treat. Therefore, a cutter that cuts the staple causing the deformation and contraction was created and actually used clinically.
[0005]
DETAILED DESCRIPTION OF THE INVENTION
It was actually used in 9 cases of anastomotic stenosis after rectal instrument anastomosis, and the effect was examined. Further, as shown in FIG. 4, the method of use is to perform stapling and manual expansion of two narrowed portions under the assistance of a normal anoscope. The use of the treatment device according to the present invention is safe and simple because it is performed under direct vision, and the X-ray device that is essential when using a conventional dilator is not required, so that all cases can be treated at the bedside. . Staple cutting can be easily manually expanded for stenosis. In all cases, an extension of 20 mm or more in diameter was obtained. The first pain of stenosis is frequent defecation, but as shown in FIG. 5, a dramatic decrease in the number of defecations was observed in 8 of 9 cases after treatment. In addition, restenosis frequently observed with dilator use was observed in only 2 cases, and these 2 cases were relieved by retreatment (FIG. 6).
[0006]
【The invention's effect】
According to the treatment instrument of the present invention, the staple at the stenosis in the instrumental anastomosis part of the rectum can be easily cut under direct vision using an anoscope. In addition, the number of defecations after treatment can be dramatically reduced, and restenosis can be eliminated and the patient's pain can be removed. Furthermore, the use of the treatment device according to the present invention is safe and simple because it is performed under direct vision, and the X-ray device required when using a conventional dilator is not necessary, so that all cases are treated at the bedside. Can do.
[Brief description of the drawings]
FIG. 1 is a side view of an anastomotic stenosis treatment apparatus according to the present invention.
FIG. 2 is a partially enlarged plan view of a head portion (cutter) when an instrument for treating an anastomosis stenosis is performed, and shows A: when opened, and B: when cut.
FIG. 3 is an enlarged perspective view of a main part of a head part (cutter) when the treatment instrument of the present invention is implemented.
FIG. 4 is an embodiment of the present invention, and shows a state in which the staple (6) of the anastomotic stenosis (5) is cut by the instrument (3) of the present invention with the assistance of the anoscope (4).
FIG. 5 is a diagram showing the effect before and after treatment in terms of symptoms, and it can be seen that dramatic improvement in symptoms was observed in 8 cases out of 9 cases having stenosis symptoms.
It is a principal part expansion perspective view of the head part (cutter) at the time of implementation of the treatment instrument of this invention.
FIG. 6 is a graph showing the remote results of treatment. Restenosis was observed in only 2 cases, and these 2 cases were relieved by retreatment.
[Explanation of symbols]
1 Head (cutter)
2 Handle 3 Anastomotic stenosis treatment device (Invention)
4 Normal anoscope 5 Rectal anastomotic stenosis 6 Stapling of the anastomosis

Claims (1)

A treatment instrument for cutting the stenosis staple in the rectal instrument anastomosis ,
Two shafts integrally provided long in one direction so as to be inserted into the rectum from the outside,
A head (1) comprising two blades projecting and fixed in an L-shaped right angle from the upper surface of the shaft body at the tip of the shafts, and in close contact with each other to move linearly ;
A treatment instrument for anastomotic stenosis, characterized in that it comprises a handle (2) for actuating it.

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