JP4418203B2 - Drainage tube - Google Patents

Description

  The present invention relates to a drainage tube that is inserted into, for example, a pancreatic duct or a bile duct and used to drain a body fluid.

When the stenosis occurs in the pancreatic duct that drains pancreatic juice or the bile duct that drains bile, pain is caused by the delayed drainage of pancreatic juice or bile. In order to alleviate this pain, a drainage method is known in which a drainage tube is inserted into the pancreatic duct or bile duct to drain pancreatic juice or bile (see, for example, Patent Document 1). Further, as a treatment method in the case where stenosis occurs in the pancreatic duct due to the formation of a cyst, a drainage method is also known in which a body fluid inside the cyst is discharged by inserting a drainage tube into the cyst.
JP 2003-135590 A (FIG. 1)

  However, the following problems remain in the conventional drainage tube. That is, in the conventional drainage tube, the drainage method was judged by checking the moored drainage tube by observation by X-ray transmission or observation by reinserting the endoscope. There was a problem that it was complicated and burdened the patient.

  The present invention has been made in view of the above-described problems, and an object of the present invention is to provide a drainage tube that can easily determine the effect of the drainage method.

The present invention employs the following configuration in order to solve the above problems. That is, the drainage tube according to the present invention is an optical device that is anchored in a body cavity and observes an optical image around the distal end in a drainage tube that discharges bodily fluids or the like into the digestive tract from a through hole provided in an axial direction. An observation means is provided.

  According to the present invention, the effect of the drainage method can be easily determined by optically observing, for example, the internal wall of the cyst or the body fluid inside the cyst by an optical observation means provided near the distal end of the drainage tube. It can be done. In addition, the mooring point can be diagnosed and the follow-up can be observed at any position.

In the drainage tube according to the present invention, the optical observation means has a lens unit that forms an optical image of an object, and a solid-state imaging device that is disposed at an imaging position of the lens unit and converts the optical image into an electrical signal. It is preferable to provide an element.
According to the present invention, an optical image obtained through the lens unit can be converted into an electrical signal by the solid-state imaging device.

In the drainage tube according to the present invention, a side viewing window is preferably opened on a side surface near the distal end.
According to this invention, the side of the drainage tube can be observed from the side viewing window provided on the side surface.

In addition, the drainage tube according to the present invention preferably includes an insertion hole that allows the optical observation means to move forward and backward or rotate separately from the through hole.
According to the present invention, a wider range of diagnosis and follow-up can be performed by moving the optical observation means back and forth or rotating in the insertion hole. Also, by adjusting the amount of projection of the optical observation means protruding from the insertion hole, for example, the distance between the inner wall of the cyst and the tip opening of the through hole can be set, so the amount of fluid discharged from the through hole is adjusted You can also

In addition, the drainage tube according to the present invention preferably includes a positioning mechanism that determines a position of the optical observation means in the insertion hole.
According to the present invention, the state of the optical observation means can be reliably maintained by positioning the optical observation means in the insertion hole by the positioning mechanism.

Moreover, it is preferable that the drainage tube which concerns on this invention is comprised with the translucent material.
In addition, the drainage tube according to the present invention preferably includes transmission means for transmitting the optical image converted into an electrical signal.
In addition, the drainage tube according to the present invention preferably includes illumination means for irradiating illumination light to an observation range by the optical observation means, and the observation means and the illumination means are operated by electric power supplied from the outside. .
In any of the inventions, since the through hole can be observed from the optical observation means in the insertion hole, it is possible to observe the state of the clogging of the through hole, and it becomes easy to determine the replacement time of the drainage tube.

  According to the present invention, it is possible to optically observe the state of the inner wall of the cyst and the state of body fluid inside the cyst by the optical observation means. Therefore, it becomes easy to determine the effect of the drainage method, and the burden on the patient can be reduced.

  Hereinafter, a first embodiment of a drainage tube 1 according to the present invention will be described with reference to FIGS. 1 and 2. FIG. 1 is a schematic sectional view of a drainage tube in the present embodiment, and FIG. 2 is a schematic view showing a drainage method using the drainage tube in the present embodiment.

As shown in FIG. 1, the drainage tube 1 according to the present embodiment is a substantially cylindrical tube having flexibility and formed of a translucent material such as polyethylene, and is used to distribute body fluid in the longitudinal direction. A through hole 2 is provided. Further, the drainage tube 1 includes a locking flap 3 provided so as to protrude by two at both ends of the outer peripheral edge, an optical observation means 4 for observing the periphery on one end surface side, and a periphery of a lens portion described later. And a white LED (illumination means) 5 that irradiates the observation range by the optical observation means 4 and an observation image by the optical observation means 4 is transmitted to a receiver (not shown) provided outside the body cavity. And a transmission unit (transmission means) 6.

  The locking flap 3 of the present embodiment is formed by raising a tube piece obtained by cutting the outer peripheral edge of the drainage tube 1 in the circumferential direction and heat-treating it. In addition, the formation method of the latching flap 3 is not restricted to the method mentioned above. This locking flap 3 maintains the state where the drainage tube 1 is anchored in the body cavity when the drainage tube is anchored in the body cavity.

The optical observation means 4 includes a lens unit 11 that forms an optical image of an object within the illumination range illuminated by the white LED 5, and a CCD that converts the optical image formed at the imaging position into an electrical signal. (Solid-state imaging device) 12.
Here, the white LED 5 and the lens unit 11 are provided so as to protrude from the tip of the through hole 2, and an observation window 13 that is a transparent cover is provided at the tip.

The CCD 12 is electrically connected to a memory 14 that records optical image data converted into electrical signals by the CCD 12. The memory 14 is electrically connected to the transmission unit 6 that transmits optical image data outside the body cavity.
The optical observation means 4, the white LED 5, the transmission unit 6 and the memory 14 are connected to a battery 15 which is a power source for supplying power thereto.

The method of anchoring the drainage tube 1 having the above-described configuration in the body cavity varies depending on the treatment target site and the like. Here, a tube placement method for cyst drainage treatment will be described with reference to FIG.
First, an ultrasonic endoscope is inserted into a body cavity, and a puncture site where the stomach wall X and the cyst Y are in contact is observed by ultrasonic observation using an ultrasonic transducer. Subsequently, the stomach wall X and the cyst Y are punctured using a puncture needle, and the guide wire 20 is inserted through a through hole provided in the puncture needle.
Then, the proximal end side of the guide wire 20 is inserted into the through-hole 2 of the drainage tube 1, and the drainage tube 1 is pushed in using a pusher tube (not shown) so that the stomach wall X and the cyst Y are in communication with each other.
At this time, it arrange | positions so that the front-end | tip of the optical observation means 4 of the drainage tube 1 may contact | connect the cyst Y inner wall.
In this state, by pulling the guide wire 20 out of the body cavity, only the drainage tube 1 is anchored in the body cavity, and the body fluid inside the cyst is circulated through the through hole 2 to the stomach.

The moored drainage tube 1 irradiates the inner wall of the cyst Y from the white LED 5 provided at the tip, and the observation image of the inner wall of the cyst Y acquired by the optical observation means 4 through the observation window 13 is stored in the memory 14. To record.
The recorded observation image is transmitted by the transmission unit 6 to a reception unit provided outside the body cavity, and the received observation image is displayed on a display device such as a monitor to diagnose the inside of the cyst.

  Thus, according to the drainage tube 1 which concerns on this embodiment, since the optical observation means 4 is provided in the front end side, it becomes easy to judge the effect of the drainage method and reduces the burden on a patient. be able to. In addition, it is possible to make a diagnosis by directly observing the inside of the cyst and to observe the progress inside the cyst.

  Next, a second embodiment will be described with reference to FIG. FIG. 3 is a schematic sectional view of the drainage tube in the present embodiment. In addition, the basic configuration of the embodiment described here is the same as that of the first embodiment described above, and another element is added to the first embodiment described above. Therefore, in FIG. 3, the same components as those in FIG.

The difference between the second embodiment and the first embodiment is that, in the drainage tube 1 in the first embodiment, the optical observation means 4 is an optical system for observing the axial direction. As shown in FIG. 3, the drainage tube 30 according to the embodiment is a side-viewing optical observation means 32 for observing the outside from a side viewing window 31 provided on the side surface on the distal end side.
That is, the optical observation means 32 includes a prism 33, and the prism 33 transmits an observation image from the side viewing window 31 to the CCD 12 provided in the axial direction.

  According to the drainage tube 30 according to the present embodiment, since the side viewing window 31 and the side viewing type optical observation means 32 are provided, the side surface in the axial direction can be observed.

Next, a third embodiment will be described with reference to FIG.
The basic configuration of the embodiment described here is the same as that of the first embodiment described above, and another element is added to the first embodiment described above. Therefore, in FIG. 4, the same components as those in FIG.

  The difference between the third embodiment and the first embodiment is that the drainage tube 1 in the first embodiment is a short drainage tube anchored in a body cavity, whereas the third embodiment is different from the first embodiment. As shown in FIG. 4, the drainage tube 40 is a long drainage tube that protrudes from the body cavity to the outside of the body cavity through the nostril.

That is, the drainage tube 40 is a long tube having a cylindrical shape and having flexibility, and is provided with a locking flap 3 that protrudes in the circumferential direction only at the distal end side.
The CCD 12 is connected to an image guide cable 41 for transmitting optical image data converted into an electrical signal by the CCD 12 to the outside of the body cavity.
Further, the optical observation means 4 and the white LED 5 are connected to an electric cable 42 that supplies power for driving them from a power source (not shown) provided outside the body cavity.

  The drainage tube 40 transmits the optical image data obtained by the optical observation unit 4 to the image processing apparatus provided outside the body cavity via the image guide cable 41 in the same manner as described above.

  Although the drainage tube 40 according to the present embodiment has the same functions and effects as the drainage tube 1 according to the first embodiment described above, the body fluid inside the cyst can be collected, so that the body fluid can be diagnosed. Become. In addition, since power can be obtained from outside the body cavity via the electric cable 42, it is not necessary to worry about the battery life, and observation can be performed for a long time.

In the third embodiment, the optical system observes the axial direction. However, the present invention is not limited to this, and the side-view type optical observation means 32 may be used as in the second embodiment.
Although the through hole 2 extends outside the body cavity, the present invention is not limited to this, and the image guide cable 41 and the electric cable 42 may extend outside the body cavity, and the body fluid flowing through the through hole 2 may be discharged into the stomach. .

Next, a fourth embodiment will be described with reference to FIG.
The basic configuration of the embodiment described here is the same as that of the above-described third embodiment, and another element is added to the above-described third embodiment. Therefore, in FIG. 5, the same components as those in FIG. 4 are denoted by the same reference numerals, and the description thereof is omitted.

  The difference between the fourth embodiment and the third embodiment is that the optical observation means 4 is fixed to the distal end side in the drainage tube 40 in the third embodiment, whereas the fourth embodiment is different from the fourth embodiment. In the drainage tube 50, as shown in FIG. 5, the side-view type optical observation means 32 is capable of moving back and forth in the axial direction and rotating around the axis.

In other words, the drainage tube 50 is provided with an insertion hole 52 for allowing the box-like container 51 in which the optical observation means 32 and the white LED 5 are housed to move in the axial direction and rotate around the axis. The insertion hole 52 is provided in parallel with the through hole 2.
The container 51 is connected to a wire 53 that moves the container 51 forward and backward in the insertion hole 52 and rotates around the axis, and a positioning mechanism 54 that fixes the container 51 in the insertion hole 52.

The positioning mechanism 54 includes a balloon 55 and an air pressure control device 57 that controls the air pressure of the balloon 55 via an air supply tube 56. The balloon 55 is attached to a balloon attachment groove 51A provided on the proximal end side of the container 51. When the air pressure of the balloon 55 is increased, the balloon 55 is inflated to closely contact the inner wall of the insertion hole 52, and the insertion hole The container 51 is fixed by increasing the frictional force with the inner wall of 52.
The wire 53 and the air supply tube 56 are long so as to extend outside the body cavity in the same manner as the image guide cable 41 and the electric cable 42, and the air supply tube 56 is connected to a pneumatic control device 57 provided outside the body cavity. ing.

An observation method using the drainage tube 50 having the above configuration will be described.
First, the optical observation means 32 is moved to a desired observation site by operating the wire 53. Next, the optical observation means 32 is positioned in the insertion hole 52 by sending air from the air pressure control device 57 to the balloon 55.
Here, the observation image acquired by the optical observation means 32 is transmitted to the image processing apparatus via the image guide cable 41 as in the third embodiment.
Moreover, the observation image of the through-hole 2 can be obtained by operating the wire 53 and rotating the optical observation means 32 about the axis so that the optical observation means 32 faces the through-hole 2 side.

  As described above, according to the drainage tube 50 according to the present embodiment, the insertion hole 52 is provided, and the optical observation means 32 can be advanced and retracted in the insertion hole 52 by the wire 53. Can be done. Further, since the optical observation means 32 is rotatable in the insertion hole 52, the clogging of the through hole 2 can be observed from the insertion hole 52. Therefore, it is possible to easily determine the replacement time of the drainage tube.

In the fourth embodiment, the optical observation means 32 has a structure for observing the side surface of the drainage tube. However, as in the first embodiment, the optical observation means 4 observes the axial direction. There may be.
Similarly to the third embodiment, the image guide cable 41, the electric cable 42, the wire 53, and the air supply tube 56 extend out of the body cavity, and the body fluid that has circulated through the through hole 2 can be discharged into the stomach. Good.

In addition, this invention is not limited to the said embodiment, A various change can be added in the range which does not deviate from the meaning of this invention.
For example, in each of the above embodiments, the drainage tube is a straight tube, but may be a pigtail drainage tube, for example.
In the first and second embodiments, the power source is a battery. However, the present invention is not limited to this, and a drainage tube is provided with a conversion unit that converts electromagnetic waves received by irradiating electromagnetic waves from the outside into electrical energy. It may be a power source. By doing in this way, it is not necessary to worry about the life of the battery, and long-time observation can be performed.

  Moreover, in 3rd and 4th embodiment, although illumination light was irradiated using white LED5 to the observation range by an optical observation means, it is not restricted to white LED5, For example, the halogen used as the light source of illumination light outside a body cavity A lamp or the like may be provided, and the illumination light may be irradiated to the observation range by guiding the illumination light to the tip of the drainage tube using a light guide made of, for example, an optical fiber.

It is a schematic sectional drawing which shows the drainage tube which concerns on the 1st Embodiment of this invention. It is the schematic which shows the drainage method using the drainage tube which concerns on the 1st Embodiment of this invention. It is a schematic sectional drawing which shows the drainage tube which concerns on the 2nd Embodiment of this invention. It is a schematic sectional drawing which shows the drainage tube which concerns on the 3rd Embodiment of this invention. It is a schematic sectional drawing which shows the drainage tube which concerns on the 4th Embodiment of this invention.

Explanation of symbols

1, 30, 40, 50 Drainage tube
2 Through hole
4, 32 Observation means (optical observation means)
5 White LED (lighting means)
6 Transmitter (Transmission means)
11 Lens part
13 CCD (solid-state image sensor)
31 Side view window
52 Insertion hole
54 Positioning mechanism

Claims (8)

In a drainage tube that is anchored in the body cavity and discharges body fluid etc. into the digestive tract from a through hole provided in the axial direction,
A drainage tube characterized in that an optical observation means for observing a surrounding optical image is provided near the distal end.   The optical observation means includes a lens unit that forms an optical image of an object, and a solid-state imaging device that is disposed at an imaging position of the lens unit and converts the optical image into an electrical signal. The drainage tube according to claim 1.   The drainage tube according to claim 1 or 2, wherein a side viewing window is opened on a side surface near the distal end.   The drainage tube according to any one of claims 1 to 3, wherein the optical observation means includes an insertion hole capable of at least one of advancing and retreating and rotation separately from the through hole.   The drainage tube according to claim 4, further comprising a positioning mechanism that determines a position of the optical observation means in the insertion hole.   The drainage tube according to any one of claims 1 to 5, wherein the drainage tube is made of a translucent material. The drainage tube according to any one of claims 2 to 6, further comprising transmission means for transmitting the optical image converted into an electric signal. Illuminating means for irradiating illumination light to the observation range by the optical observation means,
  The drainage tube according to any one of claims 1 to 7, wherein the observation unit and the illumination unit are operated by electric power supplied from the outside.

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