JP3647025B2 - Gastrointestinal anastomosis balloon catheter - Google Patents
Gastrointestinal anastomosis balloon catheter Download PDFInfo
- Publication number
- JP3647025B2 JP3647025B2 JP2000269367A JP2000269367A JP3647025B2 JP 3647025 B2 JP3647025 B2 JP 3647025B2 JP 2000269367 A JP2000269367 A JP 2000269367A JP 2000269367 A JP2000269367 A JP 2000269367A JP 3647025 B2 JP3647025 B2 JP 3647025B2
- Authority
- JP
- Japan
- Prior art keywords
- balloon
- anastomosis
- catheter tube
- tube
- catheter
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
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- Surgical Instruments (AREA)
Description
【０００１】
【発明の属する技術分野】
本発明は、人体の消化管を簡易な手技により吻合するに用いるバルーンカテーテルに関するものである。
【０００２】
【従来の技術】
従来の消化管吻合は、吻合部における消化管壁と消化管壁とを接着させ、吻合部組織の止血のため縫合針及び縫合糸を用いて組織を縫い合わせる手技が基本であり、最近では自動縫合器や自動吻合器も実用化されているが、該手技における施術者の巧拙により、その成否の個人差は避けることができず、より簡易で、従って施術者の巧拙に左右されることの少ない、安全で良い成績をあげることができる手技が切望されている。また、衰弱した患者の全身状態や吻合部組織の血行不良のもとでは、縫合が組織を障害する一因となり、接合部の血行障害を招き、かえって創の治癒を阻害し、縫合不全をきたす結果となることも少なくない。更に、従来の消化管吻合では、吻合部の腸管内圧減圧のために経鼻胃管などのドレナージチューブが必要である。のみならず、万一生ずる可能性のある縫合不全に対処する目的で腹腔ドレーンが留置される。一旦、縫合不全が生ずると再度縫合せず、経鼻胃管などを用い、吻合部のドレナージによる創の自然治癒を待つ外はない。この間、長期に輸液を行ったり、経管栄養供与が必要となる。
【０００３】
【発明が解決しようとする課題】
従来の無縫合による消化管吻合には、自動吻合器や自動吻合器が広く使われているが、吻合部の狭窄、縫合不全、出血などの合併症が生ずる危険性があるので、器械の使用法などについての熟練した技術が必要となってくる。全身状態が不良な患者では、低侵襲で迅速かつ簡易であり、吻合部組織の血行、吻合部における消化管壁相互の接着、吻合部組織の止血、吻合部消化管の内圧上昇を確実にコントロールできる手段が求められている。そこで、消化管吻合や腸管吸引・減圧を安全、かつ的確に施行し、吻合が確実に成立するまで、例えば腸瘻用カテーテルとして使用でき、その後は吻合口の大きさの調節を可能とするスリーバルーンカテーテルを提案し、患者への侵襲を最小限に止め、かつ施術者の手技を容易にすることにより、医療上顕著な効果をあげ得ることを目的とする。
【０００４】
【課題を解決するための技術手段】
上記課題を解決するため鋭意研究した結果、次の構成が最も適切であることが明らかとなった。まず、消化管瘻を形成するため、腹壁、消化管壁を穿通することができるように、カテーテルチューブのメインルーメンを経由してカテーテルチューブの先端まで穿刺用の内套針を挿着し、腹壁、消化管壁を切開せずに前記内套針によりカテーテルチューブを穿刺貫通する。カテーテルチューブ先端が消化管腔内に到達した際、カテーテルチューブが消化管壁より脱落しないように、カテーテルチューブの先端部近傍管壁に３か所設けてあるバルーン部のうち最先端に設けたバルーン部を膨張させ、内套針を抜去する。次に、吻合する他方の消化管腔内で、カテーテルチューブの最も基端部寄りに設けたバルーン部を膨張させ、吻合対象である双方の消化管壁を接着させる。更に、吻合部消化管の治療目的に応じて、前記膨張させた２個所のバルーン部の中間に設けたバルーン部を徐々に膨張させ、吻合口の大きさを拡大する手段に用いる。
【０００５】
【発明の実施の形態】
本発明に係る消化管吻合用バルーンカテーテルの実施例を図面を用いて説明する。図１は発明の概要を示す側面図、図２は図１のＡ−Ａ線における端面図、図３は内套針の一例を示す側面図、図４はバルーン部を膨張させた状態を示す説明図である。ゴム又は合成樹脂を用いて形成したカテーテルチューブ（１）に、内套針（１２）を挿通するための単数のメインルーメン（２）と、カテーテルチューブ（１）の先端部近傍管壁に流体を送入し、及び排出して膨張又は収縮させるための３個所のバルーン部（３）、（４）及び（５）と、該バルーン部（３）、（４）及び（５）にそれぞれ連通するサブルーメン（６）、（７）及び（８）と、カテーテルチューブ（１）の基端部に前記サブルーメン（６）、（７）及び（８）に連通し、端部にバルブ（図示しない。）を備えた分岐管（９）、（１０）及び（１１）とを設けてある。
【０００６】
【発明の効果】
本発明によれば、腹壁、消化管壁を切開せずに、カテーテルチューブ（１）のメインルーメン（２）を経由して内套針（１２）を挿着して腹壁、消化管腔内に穿通し、前記バルーン部（３）を膨張させ、カテーテルチューブ（１）が脱落しないようにし、次いで内套針（１２）を抜去する。その上で吻合対象である消化管と消化管を接着させるため、バルーン部（５）を膨張させる。また、バルーン部（４）を膨張させ、吻合口を拡大する手段に用いることができる。このようにすれば、患者に対する侵襲を最小限に抑制し、また、術者の熟練度に依存する従来の施術に比し、簡易かつ安全に施術できる。
【図面の簡単な説明】
【図１】 実施例の概要を示す側面図
【図２】 図１のＡ−Ａ線における断面図
【図３】 内套針の一例を示す側面図
【図４】 バルーン部を膨張させた状態を示す説明図
【符号の説明】
１・・カテーテルチューブ
２・・メインルーメン
３・・バルーン部
４・・バルーン部
５・・バルーン部
６・・サブルーメン
７・・サブルーメン
８・・サブルーメン
９・・分岐管
１０・・分岐管
１１・・分岐管
１２・・内套針[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a balloon catheter used for anastomosing the digestive tract of a human body by a simple procedure.
[0002]
[Prior art]
The conventional gastrointestinal anastomosis is based on the technique of adhering the gastrointestinal tract wall and the gastrointestinal tract wall at the anastomotic site and stitching the tissue with a suture needle and suture for hemostasis of the anastomotic site tissue. An instrument and an automatic anastomosis device have also been put into practical use, but due to the skill of the practitioner in the procedure, individual differences in success or failure cannot be avoided, and it is simpler and therefore less influenced by the practitioner's skill Therefore, there is a strong demand for a procedure that can give a safe and good result. In addition, under the general condition of weak patients and poor circulation of the anastomotic tissue, suturing contributes to damage to the tissue, leading to impaired blood circulation at the junction, which in turn inhibits wound healing and causes failure of the suture. Often results. Furthermore, in the conventional gastrointestinal tract anastomosis, a drainage tube such as a nasogastric tube is necessary to reduce the intestinal pressure in the anastomotic region. In addition, an abdominal drain is placed for the purpose of dealing with suture failure that may occur. Once suture failure occurs, it is not possible to re-sutt, but use a nasogastric tube or the like to wait for the natural healing of the wound by drainage of the anastomosis. During this time, infusion is required over a long period of time, and tube feeding is required.
[0003]
[Problems to be solved by the invention]
Conventional gastrointestinal anastomoses without sutures are widely used with automatic anastomosis devices and automatic anastomosis devices, but there is a risk of complications such as narrowing of the anastomosis, suture failure, and bleeding. Skilled techniques about law are required. For patients with poor general condition, it is minimally invasive and quick and simple, and reliably controls blood circulation of the anastomotic tissue, adhesion between the gastrointestinal tract walls at the anastomosis, hemostasis of the anastomotic tissue, and increased internal pressure of the gastrointestinal tract There is a need for a means to do this. Therefore, it is possible to use gastrointestinal anastomosis, intestinal aspiration / decompression safely and accurately, and use it as a catheter for intestinal fistula, for example, until the anastomosis is established, and then adjust the size of the anastomosis. The purpose of the present invention is to propose a balloon catheter, to minimize the invasion to a patient, and to facilitate the procedure of a practitioner, thereby achieving a remarkable medical effect.
[0004]
[Technical means for solving the problems]
As a result of intensive studies to solve the above problems, it has become clear that the following configuration is most appropriate. First, in order to form a gastrointestinal fistula, an inner needle for puncture is inserted through the main lumen of the catheter tube to the tip of the catheter tube so that the abdominal wall can be penetrated. The catheter tube is punctured and penetrated by the inner needle without incising the digestive tract wall. A balloon provided at the forefront of the three balloon portions provided on the tube wall in the vicinity of the distal end of the catheter tube so that the catheter tube does not fall off from the digestive tract wall when the distal end of the catheter tube reaches the digestive tract cavity. The part is inflated and the trocar is removed. Next, in the other digestive tract cavity to be anastomosed, the balloon portion provided closest to the proximal end of the catheter tube is inflated, and both digestive tract walls to be anastomosed are bonded. Further, according to the treatment purpose of the digestive tract of the anastomosis part, the balloon part provided in the middle of the two inflated balloon parts is gradually inflated, and used as a means for expanding the size of the anastomosis opening.
[0005]
DETAILED DESCRIPTION OF THE INVENTION
An embodiment of a balloon catheter for gastrointestinal anastomosis according to the present invention will be described with reference to the drawings. 1 is a side view showing an outline of the invention, FIG. 2 is an end view taken along the line AA in FIG. 1, FIG. 3 is a side view showing an example of an inner needle, and FIG. 4 shows a state where a balloon portion is inflated. It is explanatory drawing. A single main lumen (2) for inserting the inner trocar (12) into the catheter tube (1) formed using rubber or synthetic resin, and fluid on the tube wall near the distal end of the catheter tube (1). Three balloon portions (3), (4) and (5) for inflow and discharge to be inflated or deflated communicate with the balloon portions (3), (4) and (5), respectively. Sublumen (6), (7) and (8), and the proximal end of the catheter tube (1) communicated with the sublumen (6), (7) and (8), and a valve (not shown) at the end Branch pipes (9), (10) and (11) provided with.
[0006]
【The invention's effect】
According to the present invention, the inner needle (12) is inserted through the main lumen (2) of the catheter tube (1) without incising the abdominal wall and digestive tract wall, and is inserted into the abdominal wall and digestive tract cavity. The balloon part (3) is inflated to prevent the catheter tube (1) from falling off, and then the inner needle (12) is removed. Then, the balloon part (5) is inflated in order to bond the digestive tract and the digestive tract as an anastomosis target. Moreover, it can be used as a means for expanding the anastomosis opening by inflating the balloon part (4). In this way, the invasion to the patient can be suppressed to the minimum, and the operation can be performed simply and safely as compared with the conventional operation depending on the skill level of the operator.
[Brief description of the drawings]
FIG. 1 is a side view showing an outline of the embodiment. FIG. 2 is a cross-sectional view taken along line AA in FIG. 1. FIG. 3 is a side view showing an example of an inner needle. Explanatory drawing showing [signs]
1. ・ Catheter tube 2 ・ Main lumen 3 ・ Balloon part 4 ・ Balloon part 5 ・ Balloon part 6 ・ Sub-brume 7 ・ Sub-brume 8 ・ Sub-brume 9 ・ ・ Branch tube 10 ・ ・ Branch tube 11. ・
Claims (1)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2000269367A JP3647025B2 (en) | 2000-08-02 | 2000-08-02 | Gastrointestinal anastomosis balloon catheter |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2000269367A JP3647025B2 (en) | 2000-08-02 | 2000-08-02 | Gastrointestinal anastomosis balloon catheter |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JP2002045427A JP2002045427A (en) | 2002-02-12 |
| JP3647025B2 true JP3647025B2 (en) | 2005-05-11 |
Family
ID=18755990
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2000269367A Expired - Fee Related JP3647025B2 (en) | 2000-08-02 | 2000-08-02 | Gastrointestinal anastomosis balloon catheter |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP3647025B2 (en) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20080051626A1 (en) * | 2006-08-28 | 2008-02-28 | Olympus Medical Systems Corp. | Fistulectomy method between first duct and second duct, ultrasonic endoscope, catheter with balloon, magnet retaining device, and magnet set |
| CN208927391U (en) * | 2017-11-07 | 2019-06-04 | 南京鼓楼医院 | Dual balloon catheter device for gastrointestinal anastomosis |
-
2000
- 2000-08-02 JP JP2000269367A patent/JP3647025B2/en not_active Expired - Fee Related
Also Published As
| Publication number | Publication date |
|---|---|
| JP2002045427A (en) | 2002-02-12 |
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