JP4355689B2 - Endoscopic syringe - Google Patents

Description

  The present invention relates to an endoscope injection tool for injecting a drug solution or the like into a body cavity via an endoscope.

  Conventionally, as a method for treating varicose veins, a sclerosing agent having a blood coagulation property is injected into the affected varicose vein or outside the varicose vein so as to stagnate in the affected portion, and the blood circulation is blocked by forming a thrombus. There are endoscopic varicose sclerotherapy (EIS) or endoscopic varicose sclerotherapy and simultaneous ligation therapy (EISL) to destroy and treat the aneurysm. As an endoscopic drug solution injection needle used in such a treatment method, those shown in FIGS. 6A and 6B are known (for example, see Patent Document 1). This is a double tube structure consisting of an inner tube tube 102 having a needle 101 attached to the tip in the axial direction and an outer tube tube 103 outside the needle tube 101. By moving the inner tube tube 102 axially forward and backward, the needle 101 protrudes / immerses from the axial tip of the outer tube 103. An operation unit 104 having a connector for operating the inner tube 102 in the axial direction and injecting a chemical into the inner tube is attached to the axial tail end of the double tube.

  In the above-described treatment, after inserting the outer tube 103 into the forceps hole of the endoscope while the needle 101 is immersed, the needle 101 is protruded from the distal end of the outer tube 103 to enter the inside of the affected blood vessel or its A puncture is made around the periphery, and a curing agent is injected into the blood vessel from the operation unit 104 with a syringe.

By the way, the varicose that is an affected part has high mobility in the submucosal layer of the varicose vein, and there is a large movement due to expansion and contraction of the internal organs. Here, there is no problem if the punctured needle 101 moves flexibly following the movement of the affected submucosa, but the needle 101 is made of metal and has high rigidity, and follows the movement of the affected submucosa. Can't move. Accordingly, when the punctured needle 101 is advanced to the deep part of the affected part, the needle 101 may be damaged by the movement of the submucosal layer of the affected part or the like to damage the part other than the affected part. For this reason, the needle 101 cannot be punctured so deeply that it can easily fall off from the affected area, and it may be difficult to inject the medicinal solution into the blood supply part that is the root of the varicose vein. Further, the needle 101 cannot be punctured for a very long time in order to avoid damaging a part other than the affected part, and in the case of injecting a drug solution necessary for treatment at a certain time interval, It is necessary to repeatedly remove the needle 101 from the affected area and puncture again.
JP 2000-271217 A

  In view of the above points, an object of the present invention is to provide an endoscope injection tool that can stably inject a drug solution into a deep part of an affected area.

In order to solve the above-described problems, an endoscope injection tool according to the present invention includes an outer cylinder, an inner cylinder that is inserted into the outer cylinder so as to freely advance and retract in the axial direction, and an axial advance and retreat in the inner cylinder. A medical tube inserted freely and a hollow puncture needle provided at the axial end of the chemical tube, and the inner cylinder is pierced into the affected area as a unit with the puncture needle, and then the inner cylinder alone The distal end of the tube is made of a soft and flexible tube so as to advance to the deep part of the affected area .

According to the endoscope injection tool of the present invention, the inner cylinder and the puncture needle are respectively connected to the outer cylinder and the inner cylinder by advancing and retracting the inner cylinder and the drug solution tube in the axial direction with respect to the outer cylinder and the inner cylinder, respectively. Can be projected / immersed. When puncturing the affected area, the inner cylinder is protruded from the distal end of the outer cylinder, and the puncture needle is protruded from the distal end of the inner cylinder to puncture the inner cylinder and the puncture needle integrally with the affected area. After puncturing, the puncture needle is inserted into the inner cylinder and the amount of protrusion of the inner cylinder from the outer cylinder is increased, and the tip of the inner cylinder is advanced to the deep part of the affected area. At this time, the root of the inner cylinder that has been punctured can be fixed by pressing the tip of the large-diameter outer cylinder against the affected part. Therefore, it is possible to prevent the punctured inner cylinder from dropping from the affected area before or during the injection of the drug solution. In addition, since the inner cylinder is composed of a flexible and flexible tube, even when the inner cylinder is advanced to the deep part of the affected area, the inner cylinder is flexible following the movement of the submucosal layer of the affected area. There is no risk of moving or injuring other parts than the affected part. Therefore, the distal end portion of the inner cylinder can be safely advanced to the root of the varicose vein, and the drug solution can be injected into the blood supply portion that is the root of the varicose vein. In addition, the inner cylinder can be punctured for a long time because there is no risk of damaging the part other than the affected part, and the medical solution necessary for treatment can be injected at regular time intervals according to the state of the affected part. Yes, there is no need to puncture again.

  The endoscope injection tool of the present invention is connected to the operation portion provided at the axial tail end portion of the outer tube and the inner tube, and is provided in the operation portion so as to freely advance and retract in the axial direction. It is desirable to include an inner tube terminal and a puncture terminal that is connected to the drug solution tube and is provided in the operation portion so as to be movable forward and backward in the axial direction. According to this, since the inner cylinder is connected to the inner cylinder terminal, the inner cylinder can be protruded / immersed from the tip of the outer cylinder by moving the inner cylinder terminal back and forth in the axial direction by the operation portion. Further, the puncture needle can be protruded / immersed from the distal end of the inner cylinder by moving the puncture terminal in the axial direction with the operation portion. Therefore, the surgeon can cause the inner tube and the puncture needle to protrude and immerse each other by advancing and retracting the inner tube terminal and the puncture terminal in the axial direction using the operation unit.

  Furthermore, in the endoscope injection tool of the present invention, it is desirable that the operation section includes an interlocking mechanism that pushes the inner tube terminal axially forward in conjunction with the movement of the puncture terminal axially forward. According to this, when the inner tube and the puncture needle are punctured into the affected part, the puncture needle moves in the direction protruding from the tip of the inner tube by moving the puncture terminal axially forward. Further, in conjunction with the movement of the puncture terminal, the inner cylinder terminal is pushed forward in the axial direction, and the inner cylinder moves in a direction protruding from the tip of the outer cylinder. Therefore, the inner cylinder and the puncture needle can be punctured into the affected area only by moving the puncture terminal in the axial direction.

  Still further, in the endoscope injection tool according to the present invention, the operation section has a stopper for restricting movement of the puncture needle in the axial direction forward at a predetermined position, and the stopper is arranged in the axial direction of the puncture terminal. It is movable to a first position that restricts the forward movement at the predetermined position and a second position that is a predetermined distance away from the first position in the axial direction, and can be locked to the second position. It is desirable that the puncture terminal is moved from the predetermined position in the axial direction in conjunction with the movement of the stopper from the first position to the second position. According to this, when the inner tube and the puncture needle are punctured into the affected area, the movement of the puncture terminal in the axial direction is restricted at a predetermined position by the stopper existing in the first position. The axial movement of the inner tube terminal that is pushed and moved in conjunction is also restricted. Therefore, it is possible to prevent the inner cylinder and the puncture needle from protruding excessively from the tip of the outer cylinder. In addition, after the inner tube and puncture needle are punctured into the affected area, the puncture terminal is moved in the axial direction in conjunction with the stopper by moving the stopper from the first position to the second position that is a predetermined distance away in the axial direction. Is done. Then, by locking the stopper at the second position, it is possible to prevent an accident in which the puncture needle protrudes from the inner cylinder accidentally and damages the affected part and the part other than the affected part before or during the injection of the drug solution. .

  As shown in FIG. 1, the endoscope injection tool 1 of this embodiment includes an outer cylinder 2, an inner cylinder 3, and a chemical liquid tube 4 (see FIG. 2). The outer cylinder 2 is made of a flexible synthetic resin tube. An operation unit 5 is provided at the axial tail end of the outer cylinder 2. The inner cylinder 3 is made of a synthetic resin tube having flexibility and flexibility, and is inserted into the outer cylinder 2 so as to freely advance and retract in the axial direction. Moreover, the axial direction front-end | tip part of the inner cylinder 3 is formed in the taper shape. The chemical liquid tube 4 is made of a flexible tube, and is inserted into the inner cylinder 3 so as to be movable forward and backward in the axial direction. A hollow puncture needle 10 is fitted to the distal end portion of the drug solution tube 4.

  As shown in FIG. 2, the operation unit 5 includes a main body 6, an inner tube terminal 7, a puncture terminal 11, and a stopper 12. The main body 6 has a hollow, generally cylindrical shape, as shown in a sectional view above the center line in FIG. 2, and the axial tail end of the outer cylinder 2 is fitted to the axial front end of the main body 6. Further, axially long grooves 13 for engaging the stopper 12 are formed on both sides of the outer periphery of the axial tail end of the main body 6, and further, an axially long slit 14 is formed in the center of the main body 6. Has been.

  The inner cylinder terminal 7 includes a slide cylinder 15 provided in the main body 6 and a knob 16 integral with the slide cylinder 15 that protrudes outside the main body 6 through the slit 14. The axial tail end of the inner cylinder 3 is fitted to the axially distal end portion of the slide cylinder 15. A large-diameter guide portion 17 that is in contact with the inner wall of the main body 6 is provided at the tail end portion in the axial direction of the slide cylinder 15.

  The puncture terminal 11 includes a cylindrical terminal body 18 to which a syringe, a syringe, and the like are connected, and a pipe member 20 that is inserted into the slide cylinder 15 so as to be movable forward and backward in the axial direction. The pipe member 20 is made of a pipe that is hard and difficult to deform, and has an axial tail end fitted to the terminal body 18 and an axial tail end of the chemical liquid tube 4 fitted to the axial tip. Further, on the outer periphery of the pipe member 20, a flange 21 having a diameter larger than the inner diameter of the slide cylinder 15 is provided so as to be positioned axially in the tail of the slide cylinder 15.

  The stopper 12 includes a cup-shaped receiving portion 22 that is externally inserted into the pipe member 20 so as to advance and retreat in the axial direction, and lever portions 24 that are provided in a pair on both sides around the receiving portion 22 via connecting portions 23. . A convex portion 25 is formed at the tip end portion in the axial direction of the lever portion 24 to engage with the groove portion 13 provided in the main body 6 so as to be pressed. The stopper 12 is normally locked by a frictional force acting between the convex portion 25 and the groove portion 13 at a first position where the receiving portion 22 contacts the axial tail end surface of the main body 6 of the operation portion 5. In addition, the lever portion 24 is formed with a grip portion 26 extending in the axial direction more than the connecting portion 23. And it is comprised so that the convex part 25 may open to radial direction by pinching the holding | grip part 26 by using the connection part 23 as a fulcrum. Therefore, it is possible to move the stopper 12 in the axial direction from the first position in a state where the grip portion 26 is gripped. Then, when the stopper 12 is moved to the second position where the convex portion 25 is disengaged from the groove 13 of the main body 6 in the axial direction, the movement of the stopper 12 in the axial direction forward thereafter moves to the axial tail end surface of the main body 6. The stopper 12 is stopped at the second position by being blocked by the contact of the convex portion 25.

  Next, operation | movement of the injection tool 1 for endoscopes formed in this way is demonstrated. In the initial state of the endoscope injection tool 1, as shown in FIG. 3, the puncture terminal 11 is in a position retracted from the main body 6 in the axial direction, and the inner tube terminal 7 is retracted to the puncture terminal 11 side. Exist. In this state, as shown in FIG. 4A, the puncture needle 10 protrudes from the tip of the inner cylinder 3, and the inner cylinder 3 and the puncture needle 10 are immersed in the outer cylinder 2. In this state, the surgeon inserts the endoscope injection tool 1 into the insertion channel (not shown) of the endoscope 27 from the distal end of the outer tube 2, and the distal end of the endoscope 27 and the distal end of the outer tube 2. Is placed so as to reach the varicose vein that is the affected area.

  Subsequently, the surgeon pushes the terminal body 18 of the puncture terminal 11 forward in the axial direction. According to this, the collar portion 21 of the pipe member 20 of the puncture terminal 11 abuts on the axial tail end of the slide cylinder 15, and the inner cylinder terminal 7 moves in the axial direction in conjunction with the axial movement of the puncture terminal 11. As shown in FIG. 4B, the puncture needle 10 and the inner cylinder 3 protrude from the outer cylinder 2, and the puncture needle 10 and the inner cylinder 3 are punctured in the affected area. Then, when the puncture terminal 11 has moved a distance α in the axial direction, the terminal body 18 comes into contact with the receiving portion 22 of the stopper 12 existing in the first position, and the puncture terminal 11 is moved further in the axial direction. Be blocked.

  Next, the operator holds the grip portion 26 of the stopper 12 and lifts the convex portion 25 of the stopper 12 from the groove portion 13 of the main body 6. Thereby, the frictional force which acts between the convex part 25 and the groove part 13 is reduced, and the stopper 12 can move from the first position in the axial direction. From this state, the surgeon moves the stopper 12 in the axial direction by a distance β. At this time, since the terminal body 18 of the puncture terminal 11 is in contact with the receiving portion 22 of the stopper 12, the puncture terminal 11 is moved in the axial direction by a distance β in conjunction with the stopper 12. As a result, as shown in FIG. 4 (c), only the puncture needle 10 is immersed in the axial direction tail of the inner cylinder 3 by a distance β. Then, when the stopper 12 moves in the axial direction tail by the distance β and reaches the second position, the convex portion 25 of the stopper 12 is detached from the groove portion 13 of the main body 6 and falls on the tail end surface of the main body 6. Accordingly, the stopper 12 is prevented from moving in the axial direction from the second position, and the puncture body 18 that is in contact with the stopper 12 is also prevented from moving in the axial direction from this position. For this reason, it can prevent reliably that the puncture needle 10 protrudes from the inner cylinder 3 again. When the stopper 12 moves to the second axial position by the distance β in the axial direction, the collar 21 provided on the pipe member 20 of the puncture terminal 7 contacts the tail end of the main body 6 from the axial direction. Therefore, the stopper 12 and the puncture body 12 are prevented from moving in the axial direction beyond the second position.

  Subsequently, the surgeon pushes and moves the knob 16 of the inner tube terminal 7 axially forward by a distance γ. Thereby, as shown in FIG.4 (c), only the inner cylinder 3 can move further ahead in an axial direction, and the front-end | tip of the inner cylinder 3 can be advanced to the root of an affected part. In addition, since the front-end | tip part of the inner cylinder 3 is formed in the taper shape, the resistance at the time of pushing the inner cylinder 3 to the root of an affected part can be made small. Thereafter, the surgeon connects a syringe, a syringe, and the like to the terminal main body 18 of the puncture terminal 11 from the axial direction, and sends the drug solution to the terminal main body 18. The drug solution is conveyed from the terminal body 18 to the distal end of the inner cylinder 3 through the pipe member 20, the drug solution tube 4 and the puncture needle 10 and injected into the affected part. At this time, as shown in FIG. 5, the root of the inner cylinder 3 is fixed because the tip of the large-diameter outer cylinder 2 presses the affected part. Therefore, it is possible to prevent the punctured inner cylinder 3 from dropping from the affected area before or during the injection of the chemical solution. Further, the inner cylinder 3 moves flexibly following the movement of the submucosal layer of the affected part, and does not injure any part other than the affected part due to the movement of the submucosal layer of the affected part. Therefore, the distal end portion of the inner cylinder 3 can be advanced to the root of the varicose vein without worrying about damaging a part other than the affected part, and the medicinal solution can be injected into the blood supply part that is the root of the varicose vein. In addition, the inner cylinder 3 can be punctured for a long time because there is no risk of damaging a part other than the affected part, and a medical solution necessary for treatment is injected at regular intervals according to the state of the affected part. And there is no need to puncture again.

  In the present embodiment, when the stopper 12 is in the second position, the convex portion 25 is in contact with the tail end surface of the main body 6, but the convex portion is in the second position on the outer peripheral surface of the main body 6. It is also possible to form a recess that is deeper than the groove 13 with which 25 engages, and to lock the stopper 12 in the second position.

  Further, in this embodiment, an interlocking mechanism that pushes the inner tube terminal 7 in the axial direction in conjunction with the movement of the puncture terminal 11 in the axial direction forward is provided on the pipe member 20 of the puncture terminal 11. Although it is configured with the collar portion 21 provided so as to contact the tail end of the slide cylinder 15, it is not limited thereto. For example, the slide cylinder 15 may be provided with an abutting portion where the tip of the pipe member abuts from the axial tail, and the aforesaid interlocking mechanism may be configured by the abutting portion.

  In the present embodiment, the chemical solution is injected into the affected part from the opening at the tip of the inner cylinder 3, but a side hole may be formed in the peripheral wall near the tip of the inner cylinder 3. According to this, a chemical | medical solution can be inject | poured into a more extensive site | part.

  Further, depending on the position of the affected part, it may be necessary to push the inner cylinder 3 to the affected part along a curved path. In this case, it is possible to push the inner cylinder 3 to the affected part by forming the inner cylinder 3 so as to have a curved shape in a free state. When puncturing, the inner cylinder 3 is kept in a straight shape by the puncture needle 10, so that no problem occurs.

The schematic diagram which shows the injection tool for endoscopes of this embodiment. Explanatory drawing which shows the operation part of this embodiment. The schematic diagram which shows the positional relationship of the inner cylinder terminal in this embodiment, a puncture terminal, and a stopper. The schematic diagram which shows the positional relationship of the outer cylinder in FIG. 3, an inner cylinder, and a puncture needle. Explanatory drawing which shows the mode of the chemical | medical solution injection | pouring in this embodiment. The schematic diagram which shows the conventional injection tool for endoscopes.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Endoscopic injection tool, 2 ... Outer cylinder, 3 ... Inner cylinder, 4 ... Chemical solution tube, 5 ... Operation part, 7 ... Inner cylinder terminal, 10 ... Puncture needle, 11 ... Puncture terminal, 12 ... Stopper.

Claims (4)

An outer cylinder,
An inner cylinder that is inserted into the outer cylinder so as to be movable back and forth in the axial direction;
A chemical solution tube inserted in the inner cylinder so as to be movable back and forth in the axial direction;
A hollow puncture needle provided at the axial tip of the drug solution tube;
The inner cylinder is formed with a flexible and flexible tube so that the distal end of the inner cylinder is tapered so that the inner cylinder is punctured into the affected area integrally with the puncture needle and then proceeds to the deep part of the affected area with the inner cylinder alone. An endoscope injection tool characterized by comprising: An operation unit provided at an axial tail end of the outer cylinder;
An inner cylinder terminal connected to the inner cylinder and provided in the operation portion so as to be movable back and forth in the axial direction;
The endoscope injection tool according to claim 1, further comprising a puncture terminal connected to the drug solution tube and provided in the operation portion so as to be movable forward and backward in an axial direction.   The endoscope operation tool according to claim 2, wherein the operation unit includes an interlocking mechanism that pushes the inner tube terminal axially forward in conjunction with movement of the puncture terminal axially forward. The operation unit has a stopper for restricting movement of the puncture needle in the axial direction ahead at a predetermined position,
The stopper is movable to a first position that restricts the movement of the puncture terminal in the axial direction ahead at the predetermined position and a second position that is a predetermined distance away from the first position in the axial direction, and 3. The puncture terminal can be locked at the second position, and the puncture terminal is moved in the axial direction from the predetermined position in conjunction with the movement of the stopper from the first position to the second position. Or the endoscope injection tool of 3 description.

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