JP4650020B2 - Medical instruments - Google Patents

Description

  The present invention relates to a medical instrument.

  In order to inject a drug solution or the like into an affected part in a body cavity, it is known to insert an injection needle through a forceps port of an endoscope, puncture the affected part, and inject a drug (for example, Patent Document 1). The configuration of such an injection needle is as follows. (A) An inner tube catheter with a puncture needle attached to the tip, the inner tube catheter has a lumen through which a drug solution flows, an inner grip is attached to the rear end, and (b) the outer tube catheter is It is provided at the distal end of the outer tube catheter for determining the position of the external grip that houses the inner tube catheter in the lumen, the inner tube grip that projects the lumen catheter from the distal end of the outer tube catheter, and the front and rear needles. And abutting surface.

  In order to make the puncture needle tip protrude from the outer tube catheter tip, the inner grip is pushed along the slide groove provided in the outer grip by pushing the inner grip accommodated in the outer grip toward the tip side. Protrudes from the distal end of the outer tube catheter. At this time, a stop tip is provided at the distal end of the outer cylinder, and the protruding length of the puncture needle protruding from the tip of the stop tip is determined by the base portion of the puncture needle hitting the stop tip.

  However, since these types of medical devices have a fixed length of puncture needle that can be protruded, if you want to change the part to be used or change the protrusion length of the puncture needle immediately depending on the patient's condition, There is a problem in that it is necessary to prepare a medical device having a protruding length. In addition, there is a problem in that the number of stocks increases because it is necessary to prepare many different types of medical devices with different protruding lengths based on the site to be used and the patient's condition.

  As another type of grip structure, there is an internal grip that moves back and forth inside the lumen of the external grip, a tapered surface is provided on the distal lumen of the outer tube catheter, and a tapered surface is also provided on the outer periphery of the internal grip. When protruding the inner grip, the inner grip is pushed into the outer grip side, and is projected at the portion where both tapered surfaces meet (for example, Patent Document 2).

  As another type, there is a medical device of a type in which a mechanism for adjusting the protruding length of the puncture needle is provided with a handle located at the end of the catheter, and a fixed protruding length is set, and then the puncture needle is protruded. (For example, patent document 3). In this type, the protrusion length of the puncture needle is adjusted by setting with the handle.

  A common problem with these medical devices is that it is difficult to determine at a glance whether the puncture needle is housed in the lumen of the outer tube catheter or is in a protruding state, and the internal grip and the external grip are of the same color. In some cases, there was a problem that it was more difficult to understand. If the catheter is pulled out or inserted from the forceps opening of the endoscope with the puncture needle protruding from the outer tube catheter by mistake, there is a possibility that the forceps opening lumen of the endoscope may be damaged. Further, when the puncture needle is pulled out and pulled out from the forceps opening, there is a possibility that the drug solution may scatter from the tip of the puncture needle.

  Further, in the type in which the protrusion length is adjusted, the outer tube of the inner tube catheter is formed by the gap between the outer tube catheter and the inner tube catheter because the catheter has a double structure depending on the degree of bending of the catheter and the number of bent portions. The protruding length of the puncture needle confirmed before insertion of the endoscope due to the accumulation of minute meanders in the catheter and the frictional resistance with the inner tube catheter in the outer tube catheter differs from the protrusion length at the time of actual puncture It is empirically known that this phenomenon is unavoidable due to the structure, especially when the endoscope tip is greatly bent, the friction resistance with the inner tube catheter in the outer tube catheter is extremely high. There is a possibility that a problem arises that the puncture needle does not protrude due to an increase in size.

Japanese Utility Model Publication No. 1-68052 Japanese Utility Model Publication No. 2-139649 Japanese Utility Model Publication No. 63-26351

  The present invention has been made in view of the above circumstances, and an object of the present invention is to variably maintain a constant protrusion amount. Further, even in a curved catheter, the puncture needle is reliably protruded from the distal end. To provide a medical device that can be used.

According to the present invention, an inner tube catheter having a puncture needle attached to the tip,
An outer tube catheter that accommodates at least a part of the inner tube catheter so as to be able to advance and retreat; and
A tubular body fixed to the rear end of the inner tube catheter;
A housing for accommodating the tubular body so as to be capable of advancing and retreating;
An adjustment mechanism for variably adjusting the stroke length of the cylindrical body;
With
A slider is provided on one of the cylindrical body and the casing, and a guide groove is provided on the other side for guiding the slider to advance and retract the cylindrical body relative to the casing.
The puncture needle is accommodated in the outer tube catheter when the tubular body is retracted, and the puncture needle protrudes from the outer tube catheter when the tubular body is advanced,
The adjustment mechanism has an inclined surface that is inclined along a circumferential direction around the axis with respect to a surface perpendicular to the longitudinal axis of the cylindrical body, and the slider abuts the inclined surface. Limiting the sliding range of the slider in the guide groove, and
The inclined surface includes a first inclined surface that is inclined in a smooth curved shape at a first angle, and a notch portion that is provided continuously with the first inclined surface or a second angle that is larger than the first angle. An inclined second inclined surface, and the stroke length is variably adjusted by rotating about the axis with respect to the slider and changing a contact position with the slider in a forward and backward direction,
Of the adjustment mechanism, the portion having the first inclined surface constitutes a first adjustment unit that continuously fine-tunes the stroke length within a predetermined range,
Of the adjustment mechanism, the notched portion or the portion having the second inclined surface includes a second adjustment portion that coarsely adjusts the stroke length larger than a maximum stroke length that can be adjusted by the first adjustment portion. Configured
A first state in which the sliding range of the slider is limited when the slider abuts on the first inclined surface, and the slider abuts on the notch or the second inclined surface. The second state in which the sliding range is limited is configured to be switched by rotating the inclined surface around the axis, to provide a medical instrument.

  The medical instrument according to the present invention inserts an inner tube catheter with a puncture needle attached to the tip from the forceps port of an endoscope to puncture the affected part in order to inject a drug solution or the like into the affected part in the body cavity, It is an instrument used to inject chemicals and the like. Since the adjustment mechanism for adjusting the protrusion length of the puncture needle is provided, the puncture needle is protruded after setting the fixed protrusion length, so that the arbitrary protrusion length can be fixed.

In the medical instrument of the present invention, the adjustment mechanism includes a first adjustment unit that finely adjusts the stroke length within a predetermined range;
It is good also as a medical instrument containing the 2nd adjustment part coarsely adjusted to the stroke length larger than the maximum value of the stroke length which can be adjusted by the 1st adjustment part.

In the medical instrument of the present invention, a slider is provided on one of the cylindrical body and the casing, and a guide groove for guiding the slider is provided on the other. The sliding of the slider causes the cylindrical body to advance and retreat. And is configured to
The adjustment mechanism may be a medical instrument configured to variably limit sliding of the slider toward the puncture needle.

Further, in the medical instrument of the present invention, the adjustment mechanism has a contact surface that contacts the slider when the slider slides toward the puncture needle and limits the sliding range of the slider,
The position of the contact surface in the sliding direction of the slider may be adjusted.

Furthermore, in the medical instrument of the present invention, the adjustment mechanism is a cylindrical member that has the same central axis as the casing and is disposed on the rear end side of the casing, and the cylindrical member is An inclined surface inclined along a circumferential direction around the central axis with respect to a plane perpendicular to the central axis;
The sliding range of the slider is limited when the slider abuts on the inclined surface, and the abutting position is adjusted by rotating the cylindrical member around the central axis. It is good also as an instrument. By rotating the cylindrical member around the central axis, the protruding amount of the puncture needle can be variably adjusted.

  By carrying out like this, it can be set as the arbitrary protrusion length according to the case.

In the medical instrument of the present invention, the inclined surface includes a first inclined surface that is inclined at a first angle, and a second angle that is provided continuously with the first inclined surface and is greater than the first angle. A portion having the first inclined surface of the cylindrical member constitutes a first adjustment unit that finely adjusts the stroke length within a predetermined range,
The portion having the second inclined surface constitutes a second adjustment unit for coarse adjustment to a stroke length larger than the maximum stroke length adjustable by the first adjustment unit,
The sliding state of the slider is limited by the first state in which the sliding range of the slider is limited by the slider contacting the first inclined surface, and the sliding range of the slider is limited by the slider contacting the second inclined surface. The second state may be a medical device that is switched by rotating the cylindrical member around the central axis.

  Furthermore, in the medical instrument of the present invention, the inclined surface includes a first inclined surface inclined at a first angle and a notch, and the portion having the first inclined surface has the stroke length within a predetermined range. A first adjustment unit that finely adjusts, and a second adjustment unit that coarsely adjusts the portion having the notch portion to a stroke length larger than the maximum stroke length that can be adjusted by the first adjustment unit. And a first state in which the sliding range of the slider is limited by contact of the slider with the first inclined surface, and the sliding of the slider by contact of the slider with an end portion of the notch. The second state in which the range is limited may be a medical instrument that is switched by rotating the cylindrical member around the central axis. In this way, since the projection length can be finely adjusted and the projection length is roughly adjusted, when the endoscope distal end is operated with a large curvature, the inner catheter is connected to the inner catheter within the outer catheter. Even when the puncture needle does not protrude from the first adjustment portion due to friction, the puncture needle can be protruded by using the coarse adjustment portion.

  In the medical instrument of the present invention, when the cylindrical member in the first state is rotated around the central axis in a state where the slider is located on the proximal end side, the first state is changed to the second state. When the cylindrical member in the first state is rotated around the central axis with the slider positioned on the puncture needle side, the first state is changed to the second state. It is good also as a medical instrument made to permit switching. By restricting switching from the first state to the second state, it is possible to prevent the puncture needle from suddenly moving from the fine adjustment region to the large stroke region.

  In the medical device of the present invention, the cylindrical member has an abutment surface provided corresponding to the position of the second adjustment portion, and the cylindrical member in the first state is moved to the central axis. The medical device may be configured such that, when rotated around, the slider abuts against the abutting surface and switching to the second state is restricted.

  Further, in the medical instrument of the present invention, the cylindrical member has a guide surface that is inclined along the central axis with respect to a plane including the central axis, and when the cylindrical body is retracted, A medical instrument in which the slider is switched from the second state to the first state along the guide surface may be used. Accordingly, the operator can change to the first adjustment unit only by the operation of storing the puncture needle without being particularly conscious, and it can be prevented that the projection length is erroneously used with the maximum length.

  Moreover, the medical instrument of this invention is good also as a medical instrument which has the protrusion length display part which displays the protrusion length of the said puncture needle.

  Further, in the medical instrument of the present invention, the protrusion length display portion has a scale portion on the side surface of the tubular member, the numerical value representing the protrusion length of the puncture needle is attached along the circumferential direction, It is good also as a medical instrument comprised so that the said numerical value may be displayed corresponding to the rotation position of a cylindrical member. Since the surgeon can confirm the protrusion length at hand, it is safe because puncture with an incorrect protrusion length can be prevented.

  ADVANTAGE OF THE INVENTION According to this invention, even if it is a curved catheter, the medical instrument which can make a puncture needle protrude reliably from a front-end | tip can be maintained variably and can maintain the protrusion amount.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. In all the drawings, common constituent elements are denoted by the same reference numerals, and detailed description will be appropriately omitted in the following description.

  As shown in FIG. 1, the medical instrument includes an inner tube catheter (11) having a puncture needle (1) attached to the tip, and an outer tube catheter that accommodates at least a part of the inner tube catheter (11) so as to be able to advance and retreat. (12), a cylindrical body (internal grip) (2) fixed to the rear end of the inner cylindrical catheter (11), and a housing (external grip) for accommodating the cylindrical body (2) so as to be able to advance and retract ( 5) and an adjusting mechanism (stroke adjusting mechanism) (9) for variably adjusting the stroke length of the cylindrical body (2), and the puncture needle (1) when the cylindrical body (2) is retracted Is accommodated in the outer tube catheter (12) and the puncture needle (1) protrudes from the outer tube catheter (12) when the tubular body (2) is advanced, and the puncture needle is adjusted by adjusting the stroke length by the adjustment mechanism (9). The protruding amount of the needle (1) is variably adjusted. Moreover, the protrusion state display part which displays the state of the protrusion length of the puncture needle (1) is provided in the outer peripheral front end side of the cylindrical body (2). Furthermore, the side surface of the adjustment mechanism (9) has a scale portion (8) in which a numerical value representing the protrusion length of the puncture needle is attached along the circumferential direction, and the numerical value corresponding to the rotational position of the adjustment mechanism (9). Is displayed.

  Hereinafter, the configuration of each unit will be described.

  The inner tube catheter (11) is used so as to move back and forth in the longitudinal direction of the lumen of the outer tube catheter (12), while the outer tube catheter (12) is inserted from the forceps port of the endoscope. As the material used for the inner tube catheter (11), for the reasons described above, it is preferable that the surface is slippery and it is preferable that the back flow of blood can be visually recognized at the base of the needle through the catheter after puncture. Things are desirable. In addition, since the catheter protruding from the endoscope tip is punctured into the affected area, the catheter does not bend during puncture, and when the lumen of the forceps opening of the curved endoscope is moved back and forth, it can be bent appropriately. And a synthetic resin such as polytetrafluoroethylene resin (PTFE), tetrafluoroethylene-hexafluoropropylene copolymer resin (FEP), and polyamide-based resin is preferably used.

  Since the outer tube catheter (12) is used so as to be inserted from the forceps opening of the endoscope, the surface of the outer tube catheter (12) has a good slidability like the inner tube catheter (11). Since it is preferable that the backflow of blood can be visually recognized in the portion, it is desirable to have transparency. Therefore, as the material, a synthetic resin such as a polytetrafluoroethylene resin (PTFE), a tetrafluoroethylene-hexafluoropropylene copolymer resin (FEP), or a polyamide resin is used as in the case of the inner tube catheter (11). It is preferable.

  As for the size of the catheter, the inner tube catheter (11) has a high liquid chemical flow, and if it is too thin, the chemical injection resistance becomes high. If it is too thick, the chemical injection resistance becomes too low and the operability is not good. Is preferably 0.4 mm or more and 1.2 mm or less. The outer diameter is not particularly defined as long as the outer diameter has a thickness capable of withstanding the pressure at the time of drug solution injection, but it is necessary to consider the dimensions of the outer tube catheter (12).

  When the gap between the inner diameter of the inner tube catheter (11) and the inner diameter of the outer tube catheter (12) is narrow, the inner tube catheter (12) has an increased frictional resistance when the puncture needle (1) is projected or stored. If it is too wide, the inner tube catheter (11) has an outer diameter portion that closely contacts the curved inner tube catheter (12) along the inner diameter of the curved outer tube catheter (12). Therefore, the inner diameter is preferably set to be 0.1 mm or more and 0.3 mm or less larger than the outer diameter of the inner tube catheter (11). The outer diameter is not specified unless it can be smoothly inserted into the forceps opening of the endoscope and does not hinder air supply or suction.

  Further, the length is preferably 1.5 to 2.5 m, although there are differences depending on the puncture site for both the inner tube catheter (11) and the outer tube catheter (12).

  In order to prevent the inner tube catheter (11) and the outer tube catheter (12) protruding from the housing (5) from bending, the kink prevention tube (13) is covered with the outer diameter portion of the outer tube catheter (12). You may attach to a body (5) by adhesion | attachment or crimping | compression-bonding. The kink preventing tube (13) is a tube that prevents the inner tube catheter (11) and the outer tube catheter (12) from bending, and is preferably made of an elastic material such as a polyamide-based resin or a soft polyvinyl chloride resin (PVC). A synthetic resin having moderate elasticity is preferred. The length from the housing (5) is preferably 30 to 60 mm. In addition, it is a preferable example that a heat-shrinkable tube is used if appropriate bending rigidity can be obtained and bending can be prevented.

  The size of the puncture needle (1) attached to the distal end of the inner tube catheter (11) is preferably 20G to 25G, and may be selected depending on the site to be used and the chemical solution, and protrudes from the distal end of the outer tube catheter (12). The length of the puncture needle (1) to be used is preferably 2 to 8 mm, and in this case as well, it may be selected according to the site to be used.

  The cylindrical body (2) is provided on the rear end side of the inner cylindrical catheter (11), and the puncture needle (1) is moved in and out of the outer cylindrical catheter (12) by moving the cylindrical body (2) back and forth. be able to. A slider (3) is provided on either the cylindrical body (2) or the housing (5), and a guide groove for guiding the slider (3) is provided on the other side. By sliding the slider (3), The medical device is configured such that the cylindrical body (2) is advanced and retracted, and the adjustment mechanism (9) is configured to variably limit the sliding of the slider (3) toward the puncture needle. is there.

  As for the shape of the cylindrical body (2), since a syringe for injecting a chemical solution is connected to the end and a high-viscosity chemical solution is injected, it is necessary to have a shape that can connect a Luer taper-shaped syringe. is there. Further, since it is inserted into the lumen of the casing (5) and used integrally with the casing (5), the material is the same as that of the casing (5), but a material resistant to the chemical used. Is needed.

  A housing | casing (5) accommodates a cylindrical body (2) so that advancing and retreating is possible. As the shape of the housing (5), when the puncture needle (1) is protruded, the outer shape of the housing (5) is held by hand and the cylindrical body (2) is pushed in. However, there is no limitation as long as the shape is easy to grip. The material is preferably a plastic that is excellent in processability, inexpensive and lightweight, and more preferably an ABS resin, a polycarbonate resin, or a rigid polyvinyl chloride resin.

  The adjustment mechanism (9) includes a first adjustment unit that finely adjusts the stroke length within a predetermined range, and a second adjustment unit that roughly adjusts the stroke length to be larger than the maximum stroke length that can be adjusted by the first adjustment unit. , Is composed of. The adjustment mechanism (9) has a contact surface that contacts the slider (3) when the slider (3) slides toward the puncture needle (1) and limits the sliding range of the slider (3). The position of the contact surface in the sliding direction of the slider (3) can be adjusted.

The adjustment mechanism (9) has a central axis that is the same as that of the casing (5), and is a cylindrical member that is disposed on the rear end side of the casing (5). Having an inclined surface inclined along a circumferential direction around the central axis with respect to a perpendicular surface;
The sliding range of the slider (3) is limited by the slider (3) coming into contact with the inclined surface, and the contact position is adjusted by rotating the cylindrical member around the central axis. It is an instrument.

  The adjustment of the protrusion level is performed by an adjustment mechanism (9) that operates in conjunction with the protrusion length adjustment grip (7). That is, as shown in FIGS. 3A to 3G, the adjustment mechanism (9) adjusts the distance between the slider (3) and the slider abutting portion (10), which is the sliding distance of the reciprocating motion of the slider (3). Adjustment is performed by the upper slider abutting portion (10) to adjust the distance for pushing the cylindrical body (2) toward the housing (5), and the puncture needle (1) protrudes from the distal end of the outer cylindrical catheter (12). The length can be adjusted.

  The adjustment mechanism (9) rotates in conjunction with the operation of the protrusion length adjustment grip (7), and rotates with the cylindrical body (2) by a rotational movement about the same axis as the longitudinal axis of the cylindrical body (2). It is an important point that the positional relationship can be changed, and the linear distance between the slider (3) and the contact surface (10) varies depending on the rotational position with respect to the cylindrical body (2). The pushing distance is adjusted to adjust the protruding length of the puncture needle (1). Therefore, it is not always necessary to have a component structure as shown in the exploded view of FIG. 4. For example, a stroke adjusting mechanism (9) is integrally provided on the inner surface of the outer handle, and the slider (3) and the cylindrical body (2) project. The length adjustment grip (7) is fixed integrally or by adhesion or other methods, and the cylindrical body (2) is rotated about the longitudinal axis by the operation of the protrusion length adjustment grip (7). By changing the rotational position with respect to the adjustment mechanism (9), the same effect can be obtained even if the linear distance between the slider (3) and the contact surface (10) can be adjusted. And the assembly process and the like may be determined.

  As shown in FIG. 5A, the contact surface (10) includes a first inclined surface (23) and a second inclined surface (24), and the first inclined surface (23) has the slider (3) by the above structure. ) Is a part that selectively controls the stroke length, and is not limited to the smooth curved shape as shown in the figure, but may be a multi-step step shape, a more complicated curved shape, etc. Although it may be determined in consideration of the number of protrusion length levels in 1), it is more preferable that a continuous protrusion length can be adjusted due to the curved shape. The second inclined surface (24) is configured such that the stroke length of the slider (3) is longer than that of the first inclined surface (23), and the protruding length of the puncture needle (1) is always maximized.

When the distal end of the endoscope is extremely bent, a puncture needle (in a stroke adjustment region in which a normal protrusion length is adjusted by an increase in play and frictional resistance between the outer tube catheter (12) and the inner tube catheter (11) ( 1) may not protrude, as described above, in order to solve this problem, the first inclined surface (23) is formed on the contact surface (10) of the stroke adjusting mechanism (9) as shown in FIG. ) And a second inclined surface (24). Since the second inclined surface (24) has a longer stroke length than the first inclined surface (23), the puncture needle (1) is caused by frictional resistance between the outer tube catheter (12) and the inner tube catheter (11). When the protrusion is insufficient or defective, the piercing needle (1) is protruded by switching to the second inclined surface (24), and the puncture needle (1) can be reliably protruded. The second inclined surface (24) is intended puncture needle (1) is completely protrudes from the outer tube catheter (12), the projection length is always maximized.

  In the second inclined surface (24), as shown in FIG. 6A, it is assumed that not only the puncture needle (1) but also the inner tube catheter (11) protrudes from the distal end of the outer tube catheter (12). The protruding length of the puncture needle (1) is the length of the puncture needle (1) from the tip of the puncture needle (1) to the tip of the inner tube catheter (11). When it is feared that not only the puncture needle (1) but also the inner tube catheter (11) may be pierced into the living tissue depending on the target site of puncture, as shown in FIG. 6 (b), the outer tube catheter (12) The diameter of the opening (19) at the distal end is reduced so that only the puncture needle (1) can be inserted and the inner tube catheter (11) cannot be inserted, thereby increasing the surface in contact with the living tissue at the time of puncture. This is a desirable example because the catheter can be prevented from being pierced into the living tissue and the risk of perforation can be eliminated.

  Since the protruding length of the puncture needle (1) is always the maximum length on the second inclined surface (24), it is not preferable from the viewpoint of safety to always be the second inclined surface (24). This problem is solved by providing a guide surface (14) shown in FIG. The storing operation of the puncture needle (1) slides the cylindrical body (2), and the slider (3) hits the guide surface (14). Since the guide surface (14) is an inclined surface, when the slider (3) hits, the stroke adjusting mechanism (9) is rotated about the axis and can be changed to the first inclined surface (23). Thus, the operator can change to the first inclined surface (23) only by the operation of storing the puncture needle (1) without being particularly conscious, and the projection length is erroneously used with the maximum length. Can be prevented.

  The inclined surface includes a first inclined surface (23) inclined at a first angle and a second inclined surface provided continuously with the first inclined surface (23) and inclined at a second angle larger than the first angle. (24). The part which has a 1st inclined surface (23) among cylindrical members comprises the 1st adjustment part which finely adjusts the said stroke length within the predetermined range. The portion having the second inclined surface (24) constitutes a second adjustment unit that roughly adjusts the stroke length to be larger than the maximum stroke length that can be adjusted by the first adjustment unit. The first state where the sliding range of the slider (3) is limited by the slider (3) coming into contact with the first inclined surface (23), and the slider (3) coming into contact with the second inclined surface (24) Thus, the second state in which the sliding range of the slider (3) is limited is switched by rotating the cylindrical member around the central axis.

  The inclined surface may have a structure shown in FIG. The inclined surface of FIG. 5B includes a first inclined surface (23) inclined at a first angle and a notch (25). The portion having the first inclined surface (23) constitutes a first adjustment portion that finely adjusts the stroke length within a predetermined range, and the portion having the notch portion (25) can be adjusted by the first adjustment portion. A second adjustment unit that roughly adjusts the stroke length to be larger than the maximum stroke length is configured. When the slider (3) contacts the first inclined surface (23), the sliding range of the slider (3) is limited, and when the slider (3) contacts the end of the notch. The second state where the sliding range of the slider (3) is limited is configured to be switched by rotating the cylindrical member around the central axis.

  When the cylindrical member in the first state is rotated around the central axis with the slider (3) positioned on the proximal end side, switching from the first state to the second state is restricted, and the slider (3) When the cylindrical member in the first state is rotated around the central axis in a state where the is located on the puncture needle (1) side, switching from the first state to the second state is permitted, When the cylindrical member in the first state is rotated around the central axis, the slider (3) is brought into contact with the abutting surface. It is configured to abut and to limit the switching to the second state.

  This is because, when the protrusion length adjustment operation is performed with the puncture needle (1) stored, it may be unintentionally shifted to the second inclined surface (24). Puncture is expected, but this can be solved by providing an abutment surface (15) as shown in FIG. That is, the slider (3) hits the abutting surface (15) and restricts the operation of the stroke adjusting mechanism (9), thereby preventing the slider (3) from moving to the second inclined surface (24) by unconscious operation. There is a preferable embodiment in which the guide surface (14) and the continuous surface described above can be smoothly operated in protrusion and storage.

  The cylindrical member has a guide surface that is inclined along the central axis with respect to a plane including the central axis. When the cylindrical member is rotated around the central axis, the slider (3) guides along the guide surface. Thus, the first state and the second state are switched.

  The puncture needle (1) has a scale portion (8) for displaying the projection length of the puncture needle (1). The scale portion (8) has a numerical value representing the projection length of the puncture needle (1) along the circumferential direction on the side surface of the cylindrical member. The numerical value is displayed corresponding to the rotational position of the cylindrical member.

  The window (6) indicating the protruding length level and the protruding state is provided on a part of the outer periphery of the casing (5), but the position is not easily hidden when the casing (5) is gripped. If there is no special provision. In this embodiment, it is also used as the track of the slider (3), but it is not always necessary to aggregate the functions, and there is no problem even if the functions are separated. However, the movement and position of the slider (3) can also be effectively used to show the protruding state of the puncture needle (1), and the form as in this embodiment is more preferable.

  As the protruding state display part (4) on the outer periphery of the cylindrical body (2), it is preferable to make the color contrast between when it is in the protruding state and when it is in the retracted state so that it can be determined at a glance. In a present Example, since the protrusion state and the accommodation state can be displayed clearly by making it the color of a cylindrical body (2) and a contrast color, it is preferable. Moreover, since the protrusion state display part (4) in the window (6) must be clearly visible, the contrast is clear and visible by using a contrast color with the color on the outer periphery of the housing (5). Is preferable. The color of the projecting state display section (4), the casing (5) and the cylindrical body (2) may be determined by silk screen printing, hot stamp printing, sticking such as a seal, coloring of the component itself, etc. Is not limited.

Hereinafter, the effect of the medical instrument according to the present embodiment will be described.
The medical instrument according to the present embodiment includes an inner tube catheter (11) having a puncture needle (1) attached to the tip, and an outer tube catheter (12) that accommodates at least a part of the inner tube catheter (11) so as to be able to advance and retreat. ), A cylindrical body (2) fixed to the rear end of the inner cylindrical catheter (11), a housing (5) for accommodating the cylindrical body (2) so as to advance and retract, and a cylindrical body (2) And an adjustment mechanism (9) that variably adjusts the stroke length of the tube. When the cylindrical body (2) is retracted, the puncture needle (1) is accommodated in the outer cylindrical catheter (12), and the cylindrical body (2 ) Is advanced, the puncture needle (1) protrudes from the outer tube catheter (12), and the protrusion amount of the puncture needle (1) is variably adjusted by adjusting the stroke length by the adjustment mechanism (9). By configuring, an adjustment mechanism (9) for adjusting the protruding length of the puncture needle (1) is provided. Runode, set the constant projecting length, so to protrude the puncture needle (1) can be protrude constant arbitrary projection length.

  The adjustment mechanism (9) has a first adjustment unit (23) for finely adjusting the stroke length within a predetermined range, and a stroke length larger than the maximum stroke length that can be adjusted by the first adjustment unit (23). By comprising the 2nd adjustment part (24) to perform rough adjustment, it can be set as the arbitrary protrusion length according to a case.

  The inclined surface includes a first inclined surface (23) inclined at a first angle and a notch (25), and the portion having the first inclined surface (23) finely adjusts the stroke length within a predetermined range. A first adjusting unit that has a notch (25) and a second adjusting unit that roughly adjusts the stroke length to be larger than the maximum stroke length that can be adjusted by the first adjusting unit. The first state in which the slider (3) comes into contact with the first inclined surface (23) to limit the sliding range of the slider (3), and the slider (3) at the end of the notch (25). A region in which the protrusion length can be finely adjusted by switching the second state in which the sliding range of the slider is restricted by contact with each other by switching the cylindrical member around the central axis, and the protrusion length Endoscope tip to have a rough adjustment area If the puncture needle (1) does not protrude from the first adjustment portion (23) due to friction with the inner tube catheter (11) within the outer tube catheter (12), By using the adjustment unit, the puncture needle (1) can be protruded.

  Further, when the cylindrical member in the first state is rotated around the central axis while the slider (3) is positioned on the proximal end side, switching from the first state to the second state is restricted, and the slider is When the tubular member in the first state is rotated around the central axis while being located on the puncture needle side, the first state is allowed to be switched from the first state to the second state. By restricting switching from the second state to the second state, it is possible to prevent the puncture needle (1) from suddenly moving from the fine adjustment region to the large stroke region.

  The cylindrical member has a guide surface that is inclined along the central axis with respect to the plane including the central axis. When the cylindrical body is retracted, the slider moves from the second state to the first state along the guide surface. By switching to the state, the operator can change to the first adjustment part (23) only by the operation of storing the puncture needle (1) without any particular attention, and the projection length is erroneously maximized. It can be prevented from being used as it is.

The protruding state display portion (4) has a scale portion (8) on the side surface of the cylindrical member, the scale portion (8) having a numerical value indicating the protruding length of the puncture needle (1) along the circumferential direction, and rotation of the cylindrical member. It is good also as a medical instrument comprised so that a numerical value may be displayed corresponding to a position. Since the surgeon can confirm the protrusion length at hand, it is safe because puncture with an incorrect protrusion length can be prevented.

  Hereinafter, the present invention will be described in accordance with usage examples.

  The puncture needle (1) of the medical device of the present invention is held in the lumen of the distal end of the outer tube catheter (12) before use for safety and protection of the puncture performance. ), The position is fixed by the slider (3) and the window (6) so that the puncture needle (1) does not protrude accidentally. While the puncture needle (1) is held in the lumen of the outer tube catheter (12), the tip of the outer tube catheter (12) is passed through the forceps opening of the endoscope, and the tip of the outer tube catheter (12) is passed through the affected part. Guide to. Here, as a projection preparation for the puncture needle (1), the projection length adjusting grip (7) is rotated to operate the stroke adjusting mechanism (9) and the display of the projection level display section (8) displayed in the window (6). Set to the desired protrusion length level.

  In this state, the puncture needle (1) is not protruded, but the protrusion state display part (4) colored in a color different from the color of the cylindrical body (2) is visible in the window (6). Is displayed in a state in which it can protrude. In this embodiment, as shown in FIG. 3, the protrusion length level is 3 to 5 in the first inclined surface (23), and is adjusted within this range. In a state where the puncture needle (1) is not protruded on the base side of the slider (3), the slider (3) hits the abutting surface (15), and the second adjusting portion (9) is controlled to suppress the operation of the stroke adjusting mechanism (9). 24, 25). This is a safety device that avoids misuse of the second adjusting portion (24, 25) in which the protruding length of the puncture needle (1) is always the maximum.

  When the adjustment of the projection length is completed, the cylindrical body (2) is pushed into the housing (5), and the slider (3) is abutted against the slider abutting portion (10) visible in the window (6) and fixed. The inner tube catheter (11) is pushed in as long as the tubular body (2) is pushed in, the puncture needle (1) advances forward in the lumen of the outer tube catheter (12), and the distal end of the outer tube catheter (12) The puncture needle (1) protrudes by the set protrusion length level. Here, the protruding state display part (4) of the window (6) becomes invisible, the color of the cylindrical body (2) becomes visible, and displays that the puncture needle (1) is in the protruding state.

  The protruding state of the puncture needle (1) is confirmed with an endoscope monitor, and the actual protruding length of the puncture needle (1) is confirmed. If it is determined that the set protrusion length has not been reached or has not been extended and the protrusion length is the maximum, the protrusion length adjusting grip (7) can be used with the puncture needle (1) protruding. Further operation is performed to shift to the second adjustment unit (24, 25). Here, by operating the cylindrical body (2), the puncture needle (1) is further pushed out in the projecting direction, and the puncture needle (1) can be reliably projected.

Then, the protruding puncture needle (1) is punctured into the affected area, and a medicine or the like is injected into the affected area by a syringe (not shown) attached to the end of the cylindrical body (2). When the injection of the drug solution is completed, the tubular body (2) is operated in the direction of pulling out from the housing (5), and the puncture needle (1) is housed in the lumen of the outer tubular catheter (12). At this time, even if the puncture needle (1) is protruded by the second adjusting portion (24, 25), the slider (3) presses the guide surface (14) by this storing operation to operate the stroke adjusting mechanism (9). In order to shift to the first inclined surface (23), even when the puncture operation is performed by continuously projecting the puncture needle (1), it is avoided that the second adjustment portion (24, 25) is accidentally projected. It can be done.
When all the punctures and liquid injections are completed, the product of the present invention is withdrawn from the endoscope, and the procedure ends.
As mentioned above, although embodiment of this invention was described with reference to drawings, these are the illustrations of this invention, Various structures other than the above are also employable. For example, the present invention includes the following aspects.
(1) An inner tubular catheter having a puncture needle attached to the distal end and an inner grip attached to a syringe at the distal end, an outer tubular catheter having a lumen capable of moving back and forth in the longitudinal direction of the inner tubular catheter, and the An endoscope injection needle that is attached to the distal end of an outer tube catheter, and the inner grip is composed of an outer grip having a lumen that can move back and forth in the longitudinal direction,
The inner grip and the outer grip are arranged on the same axis as the central axis, and the protrusion length adjusting grip that can rotate on the axis and the stroke of the inner grip that operates in conjunction with the protrusion length adjusting grip can be adjusted. It has a stroke adjustment mechanism, and the stroke adjustment mechanism has a first adjustment unit that can selectively control the stroke length, and a second adjustment unit that controls non-selectively. Needle.
(2) The stroke adjusting mechanism has a substantially cylindrical shape, has a notched slider abutting portion on the cylindrical surface, and has a protruding slider on a part of the outer periphery of the internal grip. Endoscopic injection needle.
(3) The slope has a slope with which the protruding slider of the internal grip can contact at a portion straddling the boundary between the first adjustment portion and the second adjustment portion on the base end side of the stroke adjustment mechanism, and the first adjustment portion of the slope The endoscope injection needle according to (1) or (2), wherein the slider has a stopper on the side, and has a stopper that suppresses the operation from the first adjustment unit to the second adjustment unit of the stroke adjustment mechanism.
(4) The endoscope injection needle according to any one of (1) to (3), further including a protrusion length level display portion that is disposed inside the external grip and operates in conjunction with the protrusion length adjustment grip.
(5) A display portion indicating the protruding state of the puncture needle from the distal end of the outer tube catheter is provided on a part of the outer periphery of the inner grip, and a window is provided on a part of the outer periphery of the outer grip. The endoscope needle for any one of the above.

  The medical instrument of the present invention has means for easily adjusting the protruding length of the puncture needle by operating the protruding length adjustment grip, and for reliably protruding the puncture needle even when the catheter is bent. The adjustment result can be easily confirmed by the display in the window on the housing, and the protruding state of the puncture needle can also be easily confirmed, so that it is possible to improve operability and prevent problems due to operational mistakes. It can be widely applied in drug solution injection in endoscopic treatment.

1 shows an example of a state in which a puncture needle protrudes from a distal end of an outer tube catheter in a medical instrument according to an embodiment of the present invention. In the middle portion of the outer tube catheter, a broken display is shown for omitting the entire length, and in the broken display portion, the inner tube catheter is broken and displayed for omitting the full length. The medical instrument used as the Example of this invention shows the state by which the puncture needle was accommodated in the lumen | bore of an outer tube | pipe catheter. In the middle portion of the outer tube catheter, a broken display is shown for omitting the entire length, and in the broken display portion, the inner tube catheter is broken and displayed for omitting the full length. It is the medical instrument used as the Example of this invention, and is the figure which showed the example of the protrusion state display part in a window which displays the operation result of a protrusion level adjustment grip and a cylindrical body, and a protrusion level display part. It is the exploded view of the grip part of the medical instrument used as the Example of this invention, and is the figure which showed the adjustment mechanism which is a component which is accommodated in the internal cavity of a housing | casing and cannot be seen. It is the figure which showed the detailed example of the stroke adjustment mechanism of the medical instrument used as the Example of this invention. It is the figure which showed the protrusion state of the puncture needle of the medical instrument used as the Example of this invention, and shows the example of the opening part of an outer cylinder catheter.

Explanation of symbols

1 Puncture needle 2 Tubular body (internal grip)
3 Slider 4 Projection state display section 5 Housing (external grip)
6 Guide groove (projection length display (window))
7 Protrusion length adjustment grip 8 Scale (protrusion length level display)
9 Adjustment mechanism (Stroke adjustment mechanism)
10 Contact surface (slider butting part)
11 Inner tube catheter 12 Outer tube catheter 13 Kink prevention tube 14 Guide surface (slope)
15 Abutting surface (stopper)
18 opening part 19 opening part 23 1st inclined surface (1st adjustment part)
24 2nd inclined surface (2nd adjustment part)
25 Notch (second adjustment part)

Claims (10)

An inner tube catheter with a puncture needle attached to the tip;
An outer tube catheter that accommodates at least a part of the inner tube catheter so as to be able to advance and retreat; and
A tubular body fixed to the rear end of the inner tube catheter;
A housing for accommodating the tubular body so as to be capable of advancing and retreating;
An adjustment mechanism for variably adjusting the stroke length of the cylindrical body;
With
A slider is provided on one of the cylindrical body and the casing, and a guide groove is provided on the other side for guiding the slider to advance and retract the cylindrical body relative to the casing.
The puncture needle is accommodated in the outer tube catheter when the tubular body is retracted, and the puncture needle protrudes from the outer tube catheter when the tubular body is advanced,
The adjustment mechanism has an inclined surface that is inclined along a circumferential direction around the axis with respect to a surface perpendicular to the longitudinal axis of the cylindrical body, and the slider abuts the inclined surface. Limiting the sliding range of the slider in the guide groove, and
The inclined surface includes a first inclined surface that is inclined in a smooth curved shape at a first angle, and a notch portion that is provided continuously with the first inclined surface or a second angle that is larger than the first angle. An inclined second inclined surface, and the stroke length is variably adjusted by rotating about the axis with respect to the slider and changing a contact position with the slider in a forward and backward direction,
Of the adjustment mechanism, the portion having the first inclined surface constitutes a first adjustment unit that continuously fine-tunes the stroke length within a predetermined range,
Of the adjustment mechanism, the notched portion or the portion having the second inclined surface includes a second adjustment portion that coarsely adjusts the stroke length larger than a maximum stroke length that can be adjusted by the first adjustment portion. Configured
A first state in which the sliding range of the slider is limited when the slider abuts on the first inclined surface, and the slider abuts on the notch or the second inclined surface. A medical instrument configured to switch between the second state in which the sliding range is limited by rotating the inclined surface around the axis. The medical instrument according to claim 1, wherein
The adjustment mechanism is a medical instrument configured to variably limit sliding of the slider toward the puncture needle. The medical instrument according to claim 2 ,
The adjustment mechanism has a contact surface that contacts the slider when the slider slides toward the puncture needle and limits the sliding range of the slider;
A medical instrument capable of adjusting the position of the contact surface in the sliding direction of the slider. The medical instrument according to claim 2 ,
The adjustment mechanism is a cylindrical member that has the same central axis as the casing and is disposed on the rear end side of the casing,
It said tubular member includes the inclined surface that is inclined along the circumferential direction around the central axis relative to a plane normal to said central axis,
A medical instrument in which the contact position between the inclined surface and the slider is adjusted by rotating the cylindrical member around the central axis. The medical instrument according to claim 4 ,
A medical instrument in which the first state and the second state are switched by rotating the cylindrical member around the central axis. The medical instrument according to claim 5 , wherein
When the cylindrical member in the first state is rotated around the central axis with the slider positioned on the proximal side, switching from the first state to the second state is limited,
When the cylindrical member in the first state is rotated around the central axis while the slider is positioned on the puncture needle side, switching from the first state to the second state is allowed. Medical equipment. The medical instrument according to claim 6 ,
The tubular member has an abutment surface provided corresponding to the position of the second adjustment portion,
A medical instrument in which when the cylindrical member in the first state is rotated around the central axis, the slider abuts against the abutting surface and switching to the second state is restricted. The medical instrument according to claim 6 or 7 ,
The cylindrical member has a guide surface inclined along the central axis with respect to a plane including the central axis,
A medical instrument in which the slider is switched from the second state to the first state along the guide surface when the cylindrical body is retracted. The medical instrument according to claim 4 ,
A medical instrument having a protrusion length display portion for displaying a protrusion length of the puncture needle. The medical instrument according to claim 9 ,
The protrusion length display part has a scale part with a numerical value indicating the protrusion length of the puncture needle along the circumferential direction on the side surface of the cylindrical member, and corresponds to the rotational position of the cylindrical member. A medical instrument configured to display the numerical value.

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