JP4827818B2 - Fluid supply body - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide the fluid supplying body of a balloon catheter excellent in maneuverability in which an operator can perform extension operation for the desired balloon diameter without knowing the relation between the amount of fluid injection and a balloon dilation diameter and can also perform the delicate establishment of the amount of an injection fluid. <P>SOLUTION: Three fitting recesses 42a, 42b, and 42c are juxtaposed along the direction of the axis of a piston 24 in the inside surface of the cylindrical member 23 of the fluid supplying body 22, at least one projection portion 41 is projected onto the circumference face of the piston 24, a concavo-convex fitting unit is prepared, which carries out concavo-convex fitting between any one of the three fitting recesses 42a, 42b, and 42c of the cylindrical member 23 and the projection portion 41 of the piston 24, to position the piston 24 within the cylindrical member 23, so that the amount of a fluid poured into a balloon 3 can be controlled. <P>COPYRIGHT: (C)2008,JPO&amp;INPIT

Description

  The present invention relates to a fluid supply body for a balloon catheter that is used, for example, in the medical field and is inserted into a body cavity via an endoscope.

  In general, in the medical field, a medical urinary catheter with a balloon such as a catheter for indwelling urine, a medical device with a balloon having a balloon near the distal end of a catheter such as an endotracheal tube, a digestive catheter, or a heart pumping balloon catheter. Many catheters are used.

  As such a balloon catheter, in Patent Document 1, as shown in FIG. 14, a tubular balloon b is put on the outer periphery of a flexible tube a forming the catheter, and both ends thereof are covered with a linear member such as a thread, for example. The structure which provided the fixing | fixed part c fixed by winding and binding to the outer periphery of this to the circumference direction is shown. Furthermore, a balloon lumen d and a guide wire lumen e are formed inside the flexible tube a. Further, a side hole f, which is an opening for supplying a fluid such as air, a contrast medium, or physiological saline, from the balloon lumen d into the balloon b is formed in the tube wall of the flexible tube a.

In addition, when inflating the balloon of the medical catheter with a balloon as described above, a fluid supply body (for example, a medical syringe) is attached to the hand-side base fluidly connected to the balloon portion, and a necessary amount of fluid In general, the balloon is inflated.
Japanese Patent Publication No.62-19871

  When performing various treatments using a balloon catheter as in Patent Document 1, it is clear that it is a very important issue for the effect of the treatment that the operator knows the size of the balloon inflated during the treatment. is there. During the treatment, the balloon portion is placed in the body cavity of the patient, so that the balloon inflation diameter cannot be visually confirmed. On the other hand, this type of treatment is often performed, for example, under X-ray fluoroscopy, but since the balloon material is generally a material that does not transmit X-rays, it is difficult to confirm the expansion diameter of the balloon even under X-ray fluoroscopy. It becomes. Therefore, a desired balloon diameter is obtained by injecting a predetermined amount of fluid using the scale of the fluid supply body used for fluid injection. Therefore, when using a fluid supply body as described above, the operator needs to know the relationship between the balloon diameter and the fluid volume before treatment, and the fluid injection volume must be set according to the size of the balloon diameter to be expanded. I must. This is a very complicated and stressful action for the surgeon. Further, when setting the fluid injection amount with the conventional fluid supply body, it is necessary for the operator to adjust the piston to a fixed position by using a scale provided on the cylinder. This adjustment work needs to be performed carefully, and it was a very complicated and stressful action for the operator, especially when setting slightly different balloon inflation diameters.

  In view of the above background, the present invention allows an operator to perform an expansion operation to a desired balloon diameter without knowing the relationship between the fluid injection amount and the balloon inflation diameter, and can also perform a fine setting of the injection fluid amount. An object of the present invention is to provide a fluid supply body for a balloon catheter that is excellent in operability.

The invention of claim 1 is used in combination with a balloon catheter, and has a cylindrical member having a distal end and a proximal end opening, a piston slidable with respect to the lumen of the cylindrical member, In a fluid supply body comprising an elastic member that is in close contact with and slidable with a tubular member, at least one uneven fitting portion in which a protrusion and a fitting recess are fitted between the tubular member and the piston. The fitting portion enables the piston to be fixed at a position corresponding to the expansion diameter of the balloon, the protrusion and the fitting recess are separated from each other, and the operation during movement in a state where the concave-convex fitting is released Due to the difference between the amount of force and the amount of operation force when the protrusion and the fitting recess are fitted, the concavo-convex fitting part between the cylindrical member and the piston has a feeling during operation of fitting the concave and convex. Make it possible to recognize that the piston has reached the fitting position. A fluid supply member, wherein.

In the invention according to claim 2, the fitting state of the cylindrical member and the piston by the concave and convex fitting portion is such that either one of the concave and convex fitting portions is elastically deformed by a pressing force for operating the piston. 2. The fluid supply body according to claim 1, wherein the fluid supply body is set to be releasable, and a click feeling is generated by elastic deformation of the fitting portion when the fitting state and the non-fitting state are switched. It is.

The invention according to claim 3 is characterized in that at least one index for recognizing the expansion diameter of the balloon at the position of the piston in the cylindrical member is added to the cylindrical member. 1. The fluid supply body according to 1.

The invention according to claim 4 is provided with a cylindrical member attachment fixed to the cylindrical member, and at least one or more fitting portions between the cylindrical member attachment and the piston are fitted with a protrusion and a fitting recess . An uneven fitting portion is provided, and the fitting portion can fix the piston at a position corresponding to the expansion diameter of the balloon, and the protrusion and the fitting recess are separated and the uneven fitting is released. Movement of the concave and convex portions between the cylindrical member and the piston due to the difference between the amount of operational force during movement and the amount of operational force when the protrusion and the fitting recess fit together 2. The fluid supply body according to claim 1, wherein it is possible to recognize that the piston has reached the fitting position with a feeling of time.

According to a fifth aspect of the present invention, a cylindrical member attachment fixed to the cylindrical member and a piston attachment fixed to the piston are provided, and a protrusion and a fitting recess are provided between the cylindrical member attachment and the piston attachment. Is provided with at least one concave-convex fitting portion to be fitted, and the protruding portion and the fitting concave portion are separated from each other, and the amount of operating force during movement in a state where the concave-convex fitting is released, and the protruding portion, Due to the difference in the amount of operation force when the fitting recess is fitted, the fitting portion is moved by a hand feeling during the operation in which the uneven fitting portion between the tubular member attachment and the piston attachment is unevenly fitted. 2. The fluid supply body according to claim 1, wherein a state in which the piston is fixed at a position corresponding to an expansion diameter of the balloon can be recognized.

The invention according to claim 6 is characterized in that at least one index for recognizing the expansion diameter of the balloon at the position of the piston in the cylindrical member is added to the piston attachment. It is a fluid supply body as described in above.
According to the seventh aspect of the present invention, at least one rod-shaped member is attached to either the cylindrical member or the piston, and a recess is provided in either the rod-shaped member and the cylindrical member or the piston. And providing at least one concave-convex fitting portion in which the protrusion and the fitting concave portion are fitted between the rod-shaped members, and the fitting portion can fix the piston at a position corresponding to the expansion diameter of the balloon, Due to the difference between the amount of operating force during movement in a state where the protrusion and the fitting recess are separated and the uneven fitting is released, and the amount of operating force when the protrusion and the fitting recess are engaged 2. It is possible to recognize that the piston has reached the fitting position by a hand feeling during an operation in which the concave and convex fitting portion between the concave portion and the rod-like member is fitted into a concave and convex shape. It is a fluid supply body of description.

  According to the balloon inflation fluid supply body according to the present invention, by having the concave-convex fitting portion linked to the balloon inflation diameter, the surgeon can expand to the desired balloon inflation diameter without knowing the relationship between the fluid injection amount and the balloon inflation diameter. The operation can be performed. Furthermore, the operator can easily adjust the piston position, and the effect is particularly remarkable when the delicate balloon inflation diameter setting is repeated. As described above, it is possible to provide a balloon catheter fluid supply body excellent in operability.

  The first embodiment of the present invention will be described below with reference to FIGS. FIG. 1 shows the overall configuration of a balloon catheter 1 of the present embodiment. The balloon catheter 1 is provided with a flexible elongated sheath 2 to be inserted into a body cavity. The sheath 2 is formed of a resin material such as Teflon (registered trademark), polyethylene, or polyamide-based elastomer.

  A tubular balloon 3 is provided at the distal end of the sheath 2 so as to be placed on the outer surface of the sheath 2. The balloon 3 is made of a material such as natural rubber, synthetic rubber, polyurethane, polyamide elastomer, or silicon. Further, a proximal side operation unit 4 is provided on the proximal end side of the sheath 2. The balloon catheter 1 is operated by the operation unit 4.

  Further, as shown in FIG. 2B, a plurality of lumens 5, 6 and 7 are formed in the sheath 2 in the present embodiment. Here, a guide wire lumen for inserting the guide wire 8 shown in FIG. 5 used for guiding the balloon catheter 1 to the target site is formed by the lumen 5 having the largest cross-sectional area. Furthermore, a balloon lumen for supplying fluid, for example, air, contrast medium, or physiological saline, into the balloon 3 by the other lumen 6, and another lumen 7 from the vicinity of the tip of the balloon catheter 1 to the body cavity. A liquid supply lumen for supplying a fluid, for example, a contrast medium or physiological saline is formed.

  The outer diameter of the sheath 2 is changed in at least one step as it extends in the axial direction. In this case, the insertion portion 2a of the sheath 2 to be inserted into the body has a small diameter, and the proximal end portion 2b operated by the operator has a large diameter. This is a specification that is widely adopted not only for the balloon catheter 1 of the present embodiment but also for various catheters in order to achieve both minimally invasive and good operability for the living body.

  Further, as shown in FIG. 2A, a taper portion 9 that is tapered in the longitudinal direction (axial direction) is formed at the most distal portion of the sheath 2. As a result, when the insertion portion 2a of the sheath 2 is inserted into the body, the insertion into a narrow lumen is improved and the pressure on the living body is minimized.

  Furthermore, as for the specific dimensions of the sheath 2, the optimum numerical value varies depending on the endoscope 10 used in combination as shown in FIG. 5. For example, the overall length is about 500 to 4000 mm, and the outer diameter of the large diameter portion is It is preferable that the outer diameter of the narrow portion is set in the range of about 2 to 5 mm, the outer diameter of the small diameter portion is about 1 to 2 mm, and the outer diameter of the tip portion of the taper portion 9 is about 0.5 to 2 mm. Here, the length of the small diameter portion is preferably set within a range of about 50 to 300 mm depending on the length of the lumen into which the sheath 2 is inserted.

  Further, as shown in FIG. 2B, the shapes of the lumens 5, 6 and 7 inside the sheath 2 have the following characteristics. That is, the cross sections of the balloon lumen 6 and the liquid feeding lumen 7 are shown on the sheath 2 with reference to the guide wire lumen 5 that is restricted by the outer diameter of the guide wire 8 used in combination with the balloon catheter 1 of the present embodiment. In order to set the balloon lumen 6 and the liquid feeding lumen 7 as large as possible within the limits of the outer diameter, the balloon lumen 6 and the liquid feeding lumen 7 are formed in a substantially oval shape, and the guide wire lumen 5 is formed in a substantially fan shape. With this configuration, it is possible to minimize the fluid resistance in each of the lumens 5, 6, 7 and obtain the maximum liquid feeding capacity.

  Here, the balloon lumen 6 and the liquid feeding lumen 7 have, for example, a substantially elliptical cross-sectional shape having a minor axis of about 0.2 to 0.4 mm and a major axis of about 0.5 to 1 mm, and the guide wire lumen 5 has a radius of 0. It is desirable that it has a substantially fan-shaped cross-sectional shape of about 9 to 1.5 mm and a central angle of about 80 to 120 °. Note that the shapes and dimensions of the lumens 5, 6, and 7 are arbitrary as long as they do not deviate from the above conditions.

  The operation section 4 is provided with a branch section 11 made of a material such as Teflon, polyethylene, or polyamide elastomer. Like the sheath 2, the branch portion 11 has three guide sheaths 12, 13, and 14 made of a material having flexibility, such as Teflon, polyethylene, or polyamide-based elastomer, extending in three directions. . Here, the connecting portions between the branch portion 11 and the sheath 2 and the guide sheaths 12, 13, and 14 are fixed by insert molding or using an adhesive such as silicon, cyanoacrylate, or epoxy. Here, one guide sheath 12 communicates with the balloon lumen 6. The guide sheath 12 forms a balloon sheath. Further, the other one guide sheath 13 communicates with the guide wire lumen 5 to form a guide wire sheath. Further, the other one guide sheath 14 communicates with the liquid feeding lumen 7 to form a liquid feeding sheath.

  Furthermore, the balloon sheath 12, the guide wire sheath 13, and the liquid feeding sheath 14, which are the above three guide sheaths, are colored in different colors or have different lengths so that their purposes can be clearly recognized in appearance. Or by using means such as clarification using symbols or characters.

  Further, as shown in FIG. 3A, the balloon lumen 6 is closed at the distal end portion of the sheath 2. Further, a side hole 15 communicating with the balloon lumen 6 is opened at the distal end portion of the sheath 2. The side hole 15 is disposed in a region where the middle portion of the balloon 3 is located on the outer peripheral surface of the sheath 2. The balloon lumen 6 communicates with the balloon 3 through the side hole 15.

  The balloon 3 is a so-called rubber elastic body, and is fitted on the outer peripheral surface in the vicinity of the distal end of the sheath 2 so as to be inflated and contracted so as to cover the side hole 15 for balloon expansion / contraction of the sheath 2. For example, the balloon 3 may be of a specification that can expand to an extent of 0 to 40 mm in the radial direction and has sufficient strength to scrape out foreign substances in the body cavity. Furthermore, it is desirable that the thickness of the balloon 3 be as thin as possible within the range in which the above-mentioned purpose of use can be achieved.

  Further, on the outer peripheral surface of the sheath 2, a linear member, for example, a thread 16 is wound around the sheath 2 in the circumferential direction of the sheath 2 so that the both ends 3 a and 3 b of the balloon 3 are wrapped around the sheath 2. A balloon winding portion (first fixing means) 17 to be fixed is provided. Here, in order to bring the balloon 3 into close contact with the sheath 2, it is desirable to attach the balloon 3 to the sheath 2 in a state where the balloon 3 is previously extended in the longitudinal direction (axial direction) of the sheath 2.

  Further, a tubular member 18 is fitted on the outer peripheral surface of the sheath 2 before and after the balloon 3, and is welded to the sheath 2 by heat or bonded and fixed with, for example, a silicon-based or epoxy-based adhesive. The tubular member 18 is formed of, for example, a pipe made of plastic, stainless steel, or tungsten, tantalum, or platinum having excellent radiopacity. The inner diameter of these tubular members 18 is set smaller than the outer diameter of the sheath 2 and may be press-fitted and fixed to the sheath 2.

  Further, in the present embodiment, at least one of the balloon winding portions 17 of the both end portions 3a and 3b of the balloon 3, in this embodiment, the balloon winding portion 17 of the rear end portion 3b of the balloon 3 is, for example, a thread as shown in FIG. One or a plurality (two in FIG. 3A) of holding yarns (second fixing means) 19 configured in the above is passed in the axial direction of the sheath 2. As shown in FIG. 3A, the end portion of the holding yarn 19 extends in the longitudinal direction (axial direction) of the sheath 2 and is bonded and fixed to the tubular member 18 or the sheath 2.

  The holding thread 19, the balloon winding portion 17, the tubular member 18, and the sheath 2 are integrally fixed to restrict the balloon winding portion 17 from moving in the axial direction of the sheath 2.

  As shown in FIG. 1, a balloon base 20 having a luer-shaped opening is provided at the proximal end of the balloon sheath 12. The balloon base 20 is provided with a valve 21 that can control the outflow and sealing of the fluid. Here, the balloon sheath 12 and the balloon cap 20 are fixed by insert molding or using an adhesive such as silicon, cyanoacrylate, or epoxy.

  Further, a balloon fluid supply body 22 is detachably connected to the balloon base 20 via a valve 21. As shown in FIG. 4, the balloon fluid supply body 22 is provided with a cylindrical member 23 and a piston 24 to be inserted into the lumen of the cylindrical member 23. Here, a narrow-diameter portion 25 having an opening at the tip is projected from the tip of the cylindrical member 23. Further, an elastic member 26 that is in close contact with the inner cavity of the cylindrical member 23 and is slidable is attached to the tip of the piston 24.

  The piston 24 of the balloon fluid supply body 22 is operated to supply the inflation fluid into the balloon 3 through the balloon sheath 12 and the balloon lumen 6 in this order.

  In addition, after supplying the fluid into the balloon 3 and inflating the balloon 3, the balloon 3 can be maintained in an inflated shape by closing the valve 21 to prevent the back flow of the fluid.

  Further, the cylindrical member 23 of the balloon fluid supply body 22 is provided with a fluid discharge side hole 27 at a predetermined position. Here, when the piston 24 is closer to the side than the position of the side hole 27, the fluid is discharged from the side hole 27, so that the fluid is not fed into the balloon lumen 6. Also, the fluid is fed into the balloon lumen 6 only after the piston 24 moves to the tip side from the position of the side hole 27. The side holes 27 prevent the balloon 3 from being inflated to a specified expansion diameter or more and rupturing the balloon 3.

  Further, by preparing in advance a plurality of the side holes 27 whose positions are arbitrarily changed in the longitudinal direction (axial direction) of the tubular member 23 of the balloon fluid supply body 22, it is possible to respond to the expansion diameter of the balloon 3. The balloon 3 can be inflated to a desired size by selecting each of the prescribed fluid supply bodies 22.

  Further, as shown in FIGS. 3A and 3B, an opening 5 a of the guide wire lumen 5 is formed at the most distal end of the sheath 2. A guide wire sheath 13 communicates with the proximal end side of the guide wire lumen 5. A guide wire base 28 having a luer-shaped opening is provided at the proximal end of the guide wire sheath 13. Furthermore, the guide wire sheath 13 and the guide wire base 28 are fixed by insert molding or using an adhesive such as silicon, cyanoacrylate, or epoxy.

  The guide wire 8 can be inserted through the guide wire sheath 13 and the guide wire lumen 5 sequentially through the opening of the guide wire base 28. Thereby, the balloon catheter 1 is guided to the target site through the guide wire 8.

  In addition, as shown in FIG. 3B, the liquid feeding lumen 7 is closed at the distal end portion of the sheath 2. Further, at least one liquid supply opening 29 communicating with the liquid supply lumen 7 is formed at the distal end portion of the sheath 2 on the distal end side of the balloon 3. Depending on the purpose, the liquid supply opening 29 may be provided only on the front end side of the balloon 3, or may be provided only on the rear end side, or may be provided on both sides.

  Further, the proximal end side of the liquid feeding lumen 7 is communicated with the liquid feeding sheath 14. A liquid feeding base 30 having a luer-shaped opening is provided at the proximal end of the liquid feeding sheath 14. The liquid feeding sheath 14 and the liquid feeding base 30 are fixed by insert molding or using an adhesive such as silicon, cyanoacrylate, or epoxy. A fluid supply body 22 can be detachably attached to the liquid feeding base 30, and fluid can be fed into the body cavity by the fluid supply body 22.

  The three balloon bases 20, the guide wire base 28, and the liquid supply base 30 are colored in different colors or clearly indicated by symbols or characters so that the purpose of each can be clearly recognized in appearance. It may be distinguished using means.

  Next, the operation of the above configuration will be described. One example of the procedure used by the balloon catheter 1 of the present embodiment will be described with reference to FIGS. Here, as an example of treatment performed using the balloon catheter 1, the balloon catheter 1 is inserted through a channel (not shown) of the endoscope 10 with the endoscope 10 inserted in advance into the duodenum 31 as shown in FIG. A method for discharging the calculus 33 generated in the bile duct 32 to the duodenum 31 side through the duodenal papilla 34 using this balloon catheter 1 will be described.

  First, the valve 21 is mounted on the balloon base 20 in a state where the balloon 3 of the balloon catheter 1 is deflated (see FIG. 3A). In this state, as shown in FIG. 5, the balloon catheter 1 is inserted into a channel (not shown) of the endoscope 10 previously inserted into the duodenum 31, and the distal end portion of the balloon catheter 1 is projected from the distal opening 10a of the channel.

  Further, the distal end portion of the balloon catheter 1 is guided to the duodenal papilla 34 and the balloon catheter 1 is inserted into the bile duct 32 from the duodenal papilla 34. At this time, before the balloon catheter 1 is inserted into the bile duct 32, there is a case in which the guide wire 8 leading to the outside of the body cavity is inserted into the bile duct 32 from the duodenal papilla 34 via a channel of the endoscope 10 (not shown) in advance. is there. In that case, the distal end (not shown) of the guide wire 8 outside the body cavity is inserted into the opening 5 a of the guide wire lumen 5 at the most distal position of the balloon catheter 1, and the balloon catheter 1 is pushed forward along the guide wire 8. Thus, it is inserted into the bile duct 32.

  Subsequently, a contrast agent is supplied from the liquid feeding cap 30 of the liquid feeding sheath 14. Thereby, as shown in FIG. 5, the bile duct 32 is filled with the contrast medium 35, and the position of the calculus 33 is confirmed using an X-ray apparatus.

  Thereafter, the sheath 2 is advanced, and the balloon catheter 1 is pushed out until the balloon 3 at the distal end of the balloon catheter 1 passes through the calculus 33 and reaches the upstream portion of the bile duct 32 as shown in FIG.

  Subsequently, a balloon fluid supply body 22 adapted to a desired balloon size is engaged with the valve 21 of the balloon sheath 12. Then, the balloon 3 is inflated to a predetermined size as shown in FIG. 6 by sending fluid from the balloon fluid supply body 22 through the balloon sheath 12 to the balloon lumen 6.

  When the balloon fluid supply body 22 is operated, the fluid is fed into the balloon lumen 6 only when the piston 24 of the balloon fluid supply body 22 moves to the tip side from the position of the side hole 27. Therefore, it is possible to prevent a fluid having a flow rate higher than necessary from being fed into the balloon 3.

  Further, in the state shown in FIG. 6, the balloon catheter 1 is pulled to the proximal side. Accordingly, the calculus 33 is scraped from the bile duct 32 to the duodenum 31 via the duodenal papilla 34 as shown in FIG. 7 by the inflated balloon 3 as the inflated balloon 3 moves backward. At this time, the calculus 33 scraped to the duodenum 31 is collected outside the body using a dedicated instrument or is naturally discharged through the digestive tract.

  Further, when the calculus 33 is larger than the size of the duodenal papilla 34 during the operation of scraping the calculus 33 in a state where the balloon 3 is inflated, the calculus 33 is hardly scraped to the duodenum 31. In this case, since a large amount of tensile force is applied to the balloon 3 in the longitudinal direction (axial direction), as a result, the amount of force is concentrated on the balloon wrapping portions 17 of the both end portions 3a and 3b of the balloon 3. At this time, in the present embodiment, the tubular member 18 is disposed on the outer peripheral surface of the sheath 2 before and after the balloon 3, and the holding yarn 19 is provided in the axial direction of the sheath 2, and the holding yarn 19, the tubular member 18, the balloon The balloon winding portion 17 is restricted from moving in the axial direction of the sheath 2 by integrally fixing the winding portion 17 and the sheath 2. Therefore, in this embodiment, since the fixing strength of the balloon winding part 17 at both end portions 3a and 3b of the balloon 3 is increased, the balloon winding part 17 is not detached from the sheath 2 even when the calculus 33 is large. 33 can be scraped into the duodenum 31.

  When a portion where the fixing strength is locally weakened is provided in a part of the balloon winding portion 17, the balloon winding is performed when a certain amount of tensile force in the longitudinal direction (axial direction) is applied. There is a problem that a part of the portion 17 (part where the fixing strength is weak) is detached and the balloon 3 is deflated, so that the work of scraping the calculus 33 cannot be performed and the original purpose cannot be achieved.

  In the present embodiment, the balloon winding portion 17, the holding yarn 19, the tubular member 18 and the sheath 2 are integrally fixed to increase the strength of the balloon winding portion 17, so that even when the calculus 33 is large, the balloon winding portion 17 does not come off, and the work of scraping the calculus 33 to the duodenum 31 can be performed reliably.

  In addition, when the calculus 33 is abnormally large, an excessive amount of force that is not originally expected may rarely act on the balloon 3. In this case, as in the prior art, in a catheter (see FIG. 14) in which the balloon 3 is fixed simply by winding a thread, when the balloon fixing portion c is peeled and moved to the front of the flexible tube a, the balloon b Wrinkles when squeezed. For this reason, when the balloon catheter is returned to the endoscope channel after a predetermined operation by the balloon catheter, the frictional resistance of the accommodating portion of the balloon b becomes high, which may make it difficult to perform the operation.

  On the other hand, in the balloon catheter 1 of the present embodiment, the balloon wrapping portion 17, the holding thread 19, the tubular member 18, and the sheath 2 are integrally fixed to increase the strength of the balloon wrapping portion 17, whereby the sheath 2 of the balloon 3. The fixing strength of the balloon 3 is increased to be larger than the fixing strength of the general balloon 3. Therefore, under the situation where the calculus 33 is abnormally large, the balloon 3 itself is cut as shown in FIG. 8 before the balloon winding portion 17 moves. In this case, the fluid filled in the balloon 3 flows out of the balloon 3, so that the balloon 3 contracts as shown in FIG. 9 and wrinkles are eliminated, and the balloon catheter 1 can be easily connected to the endoscope channel. Can be pulled out from. From the above, in the present embodiment, it is possible to provide the balloon catheter 1 that is excellent in operability even under a situation where the calculus 33 is abnormally large.

  Therefore, the above configuration has the following effects. That is, in the balloon catheter 1 of the present embodiment, the tubular member 18 is disposed on the outer peripheral surface of the sheath 2 before and after the balloon 3, and the holding yarn 19 is provided in the axial direction of the sheath 2, and the balloon winding portion 17 and the holding yarn are provided. 19, the tubular member 18 and the sheath 2 are integrally fixed, and the movement of the balloon winding portion 17 in the axial direction of the sheath 2 is restricted. Therefore, even when the amount of fixing force of the balloon 3 in the axial direction of the catheter 1 is increased and an excessive load is applied to the balloon 3 in the axial direction of the catheter 1, the balloon wrapping portions 17 on both sides of the balloon 3 may be detached. Absent. Therefore, the balloon 3 can be accurately inflated into a preset balloon shape, and when the balloon 3 is deflated, it does not wrinkle but becomes resistance when returning to the channel of the endoscope 10 after a predetermined operation. It is possible to provide a balloon catheter 1 that is easy to operate without fear.

  Further, in the balloon fluid supply body 22 of the present embodiment, a side hole 27 for fluid discharge is formed in a predetermined position in the cylindrical member 23, and when the piston 24 is closer to the hand side than the position of the side hole 27, the cylinder The fluid in the member 23 is discharged from the side hole 27. For this reason, the side holes 27 can prevent the balloon 3 from being inflated to a specified expansion diameter or more and rupturing the balloon 3. As a result, by using the balloon fluid supply body 22 according to the present embodiment, the balloon 3 can be reliably brought to the desired inflation diameter of the balloon 3 without the operator knowing the relationship between the fluid injection amount and the inflation diameter of the balloon 3. You can perform expansion operations.

  Further, in the balloon fluid supply body 22 according to the present embodiment, a fluid having a flow rate higher than necessary is not injected into the balloon 3, so that excessive inflation of the balloon 3 unintended by the operator, and further excessive fluid is generated. Rupture of the balloon 3 due to injection into the balloon 3 can be prevented in advance. Therefore, in the present embodiment, it is possible to provide the fluid supply body 22 of the balloon catheter 1 that is excellent in operability.

  FIGS. 10A and 10B show a second embodiment of the present invention. In the present embodiment, the configuration of the balloon fluid supply body 22 in the balloon catheter 1 of the first embodiment (see FIGS. 1 to 9) is changed as follows.

  That is, the configuration of the main part of the balloon fluid supply body 22 of the present embodiment is the same as that of the balloon fluid supply body 22 of the first embodiment, and the balloon fluid of the first embodiment. The same parts as those of the supply body 22 are denoted by the same reference numerals, and the description thereof is omitted here.

  In the balloon fluid supply body 22 of the present embodiment, at least one protrusion 41 protrudes outwardly from the outer peripheral surface of the piston 24 as shown in FIG. Further, a plurality of fitting recesses 42 having a shape corresponding to the protrusion 41 of the piston 24 are formed on the inner peripheral surface of the cylindrical member 23 along the axial direction of the piston 24, and in this embodiment, three fitting recesses 42a. , 42b, 42c are arranged in order from the right side in FIG. During the operation of moving the piston 24 in the axial direction along the inner peripheral surface of the cylindrical member 23, the protrusion 41 of the piston 24 is sequentially fitted into the fitting recesses 42a, 42b, and 42c. It is locked (stopped) so that it can be engaged and disengaged at the mating position. That is, by arranging a plurality of fitting recesses 42a, 42b, and 42c that are unevenly fitted to the protrusions 41 of the piston 24 in the moving direction of the piston 24, the number of the fitting recesses 42a, 42b, and 42c is the same. Only the locking position (stop position) of the piston 24 can be set.

  In this embodiment, as shown in FIG. 10A, a substantially transparent tubular member 23 is provided, and a scale 43 is provided on the surface of the tubular member 23. The scale 43 shows, for example, the diameter of expansion of the balloon 3 at each locking position of the piston 24 (an uneven fitting position with each fitting recess 42). Further, as the position index of the piston 24, either the elastic member 26 or the protrusion 41 may be used, and other indices may be used. As a result, the position of the elastic member 26, which is the position index of the piston 24 in the cylindrical member 23, is transmitted through the substantially transparent wall surface of the cylindrical member 23 and aligned with the scale 43 of the cylindrical member 23, thereby visually. Is configured to recognize the expansion diameter of the balloon 3.

  In addition, you may make it the structure which displays the expansion diameter of the balloon 3 in each position also between each latching position of the piston 24. FIG.

  Next, the operation of the above configuration will be described. In the balloon fluid supply body 22 of the present embodiment, the position where the protrusion 41 of the piston 24 is engaged with the engagement recess 42a at the right end position in FIG. 10B is the initial engagement position of the piston 24. Set as When the balloon fluid supply body 22 is used, the piston 24 is pushed to the position of the scale 43 corresponding to the expansion diameter of the balloon 3 desired by the operator.

  At this time, the projection 41 of the piston 24 leaves the fitting recess 42a at the initial fitting position by the pressing force for pushing the piston 24 from the initial fitting position (the concave and convex fitting position with the fitting concave portion 42a). The match is released. Then, the piston 24 moves from the initial fitting position (the concave / convex fitting position with the fitting concave portion 42a) toward the next (central position) fitting concave portion 42b, and the concave / convex with the next fitting concave portion 42b. When the fitting position is reached, the fitting recess 42b is again concavo-convexly fitted.

  At this time, the operator recognizes that the piston 24 has reached the fitting position with the fitting recess 42b with a hand feeling (click feeling) by the operation of the protrusion 41 of the piston 24 engaging with the fitting recess 42b. it can.

  Further, by visually observing the expansion diameter of the balloon 3 shown on the scale 43 of the cylindrical member 23 by the position index of the piston 24 at the concave / convex fitting position with the fitting concave portion 42b, the concave / convex fitting with the fitting concave portion 42b is performed. The expansion diameter of the balloon 3 at the joint position can be understood without checking the actual expansion diameter of the balloon 3.

  Further, when the piston 24 is pushed further from the concave / convex fitting position with the fitting concave portion 42b, the scale 43 provided between the fitting concave portions 42b and 42c is used to set the stop position of the piston 24. By determining, further fine adjustment of the expansion diameter of the balloon 3 can be performed within the range of the expansion diameter of the balloon 3 set between the fitting recesses 42b and 42c.

  Therefore, the above configuration has the following effects. That is, in the balloon fluid supply body 22 of the present embodiment, the position of the piston 24 in the cylindrical member 23, for example, the position of the elastic member 26 is transmitted through the substantially transparent wall surface of the cylindrical member 23, and the cylindrical member By aligning with the scale 43 of 23, the expansion diameter of the balloon 3 is visually recognized. Therefore, by using the balloon fluid supply body 22 of the present embodiment, the operator can perform an expansion operation to a desired inflation diameter of the balloon 3 without knowing the relationship between the fluid injection amount and the inflation diameter of the balloon 3. .

  Further, in the present embodiment, the surgeon has a hand feeling (click feeling) by the operation in which the protrusion 41 of the piston 24 is engaged with the recesses 42a, 42b, 42c at any position of the cylindrical member 23. The fitting position of the piston 24 can be recognized. Therefore, since the operator can recognize the position of the piston 24 by hand and can recognize the expansion diameter of the balloon 3 by the position of the piston 24, the operator can surely inflate to the desired balloon diameter and Position adjustment operation becomes easy. In particular, the effect becomes remarkable when the delicate setting of the balloon expansion diameter is repeated.

  Furthermore, there is an effect that it is not necessary to replace the fluid supply body 22 for each balloon expansion diameter. Therefore, in the present embodiment, it is possible to provide the fluid supply body 22 of the balloon catheter 1 that is extremely excellent in operability.

  In the present embodiment, as shown in FIG. 10B, the tubular member 23 is provided with a plurality of fitting recesses 42a, 42b, 42c, and the piston 24 is provided with a protrusion 41. The fitting relationship may be reversed, and the tubular member 23 may be provided with the protrusion 41 and the piston 24 with a plurality of fitting recesses 42a, 42b, and 42c.

  Further, the concave / convex fitting portion between each fitting recess 42 a, 42 b, 42 c of the tubular member 23 of the present embodiment and the protrusion 41 of the piston 24 is 1 in the circumferential direction of the tubular member 23 and the piston 24. It is desirable that the protrusion 41 and / or each of the fitting recesses 42a, 42b, and 42c be formed over the entire circumference in the circumferential direction.

  FIG. 11 shows a third embodiment of the present invention. In this embodiment, the configuration of the balloon fluid supply body 22 in the second embodiment (see FIGS. 11A and 11B) is changed as follows.

  That is, an attachment 51 is attached to the rear end portion of the tubular member 23 in the balloon fluid supply body 22 of the present embodiment. The attachment 51 is provided with a claw portion 52 projecting inwardly.

  Furthermore, a plurality of engaging recesses 53 are formed on the outer peripheral surface of the piston 24 along the axial direction. Each engaging recess 53 is engaged with a claw 52 of the attachment 51 so as to be detachable. Then, when the piston 24 is pushed, the claw portions 52 of the attachment 51 are sequentially engaged with the respective engagement recesses 53 so that the pistons 24 can be stopped and disengaged. It has become. That is, by arranging a plurality of engaging recesses 53 in the longitudinal direction (axial direction) of the piston 24, the stop position of the piston 24 is set by the set number of engaging recesses 53.

  Further, in the present embodiment, as the position index of the piston 24, either the elastic member 26 or the engagement recess 53 may be used, and other indices may be used. As in the second embodiment, the position of the piston 24 in the cylindrical member 23, for example, the position of the elastic member 26 is transmitted through the wall surface of the substantially transparent cylindrical member 23, and the scale of the cylindrical member 23 is measured. By adjusting to 43, the expansion diameter of the balloon 3 is visually recognized.

  When the balloon fluid supply body 22 of the present embodiment is used, an operation of pushing the piston 24 is performed, so that the claw portions 52 of the attachment 51 are engaged with the respective engagement recesses 53 so as to be sequentially disengageable. At this time, the engagement concave portion 53 of the piston 24 causes the claw portion 52 of the attachment 51 to be pushed by the pressing force that pushes the piston 24 from the initial state where the claw portion 52 of the attachment 51 is engaged with the engagement concave portion 53 of the initial position. The concavo-convex engagement is released. Then, the piston 24 moves from the initial engagement position (the uneven engagement position between the claw portion 52 of the attachment 51 and the engagement recess 53) in the pushing direction, and the next engagement recess 53 and the claw portion of the attachment 51 are moved. When the concave / convex engagement position with 52 is reached, the concave engagement portion 53 and the claw portion 52 of the attachment 51 again engage with the concave / convex engagement.

  At this time, the operation of engaging and disengaging the engaging recess 53 of the piston 24 with the claw 52 of the attachment 51 causes the operator to feel the click (click feeling) so that the piston 24 moves to the next engaging recess 53 and the claw of the attachment 51. It can be recognized that the fitting position with 52 has been reached.

  Therefore, the above configuration has the following effects. That is, in the balloon fluid supply body 22 of the present embodiment, the position of the piston 24 in the cylindrical member 23, for example, the position of the elastic member 26 is transmitted through the substantially transparent wall surface of the cylindrical member 23, and the cylindrical member By aligning with the scale 43 of 23, the expansion diameter of the balloon 3 is visually recognized. Therefore, by using the balloon fluid supply body 22 of the present embodiment, the operator can perform an expansion operation to a desired inflation diameter of the balloon 3 without knowing the relationship between the fluid injection amount and the inflation diameter of the balloon 3. .

  Further, in the present embodiment, the operator engages the engagement position of the piston 24 with a hand feeling (click feeling) by the operation in which the claw portion 52 of the attachment 51 engages with the engagement recess 53 at any position of the piston 24. Can be recognized. Therefore, since the operator can recognize the position of the piston 24 by hand and can recognize the expansion diameter of the balloon 3 by the position of the piston 24, the operator can surely inflate to the desired balloon diameter and Position adjustment operation becomes easy. In particular, the effect becomes remarkable when the delicate setting of the balloon expansion diameter is repeated.

  Furthermore, there is an effect that it is not necessary to replace the fluid supply body 22 for each balloon expansion diameter. Therefore, also in this embodiment, it is possible to provide the fluid supply body 22 of the balloon catheter 1 that has excellent operability as in the second embodiment.

  In the present embodiment, as shown in FIG. 11, a configuration in which a plurality of engaging recesses 53 are provided in the piston 24 and a claw portion 52 is provided in the attachment 51 is shown. Absent.

  Further, at least one concavo-convex engagement portion between the claw portion 52 of the attachment 51 and the plurality of engagement concave portions 53 of the piston 24 is formed in the circumferential direction of the attachment 51 and the piston 24, and the claw portion 52 and the engagement concave portion are formed. It is desirable that both or one of 53 is formed over the entire circumference.

  FIG. 12 shows a fourth embodiment of the present invention. This embodiment is still another modification of the balloon fluid supply body 22 of the second embodiment (FIGS. 11A and 11B).

  That is, in the balloon fluid supply body 22 of the present embodiment, at least one pin 61 protrudes in the circumferential direction from the rear end portion of the cylindrical member 23 in the inward direction. The pin 61 and the cylindrical member 23 are bonded and fixed with an adhesive such as silicon, cyanoacrylate, or epoxy. The tubular member 23 may be provided with a hole 62 having an inner diameter smaller than the outer diameter of the pin 61 and press-fitted into the hole 62 or may be welded by heat. The pin 61 is preferably made of a metal such as stainless steel, a material such as plastic, rubber, or silicon.

  The piston 24 is formed with at least one engaging recess 63 that engages with the pin 61 in the longitudinal direction (axial direction). And the stop position of the piston 24 in the cylindrical member 23 is determined by each engagement position of the pin 61 and the engagement recessed part 63 of any one of the piston 24. That is, by arranging a plurality of engaging recesses 63 in the longitudinal direction (axial direction) of the piston 24, the stop position of the piston 24 is set by the set number of engaging recesses 63.

  Further, in the present embodiment, an elastic member 26 is used as a position index of the piston 24. As in the second embodiment, the position of the piston 24 in the cylindrical member 23, for example, the position of the elastic member 26 is transmitted through the wall surface of the substantially transparent cylindrical member 23, and the scale of the cylindrical member 23 is measured. By adjusting to 43, the expansion diameter of the balloon 3 is visually recognized.

  Then, when the balloon fluid supply body 22 of the present embodiment is used, an operation of pushing the piston 24 is performed, so that the pins 61 of the tubular member 23 are engaged with the respective engagement recesses 63 so as to be sequentially disengageable. At this time, the engaging recess 63 of the piston 24 causes the pin 61 of the tubular member 23 to be pushed by the pressing force that pushes the piston 24 from the initial state where the pin 61 of the tubular member 23 is engaged with the engaging recess 63 of the initial position. The concavo-convex engagement is released and released. Then, the piston 24 moves from the initial engagement position (the concave / convex engagement position between the pin 61 of the tubular member 23 and the engagement concave portion 63) toward the pushing direction, and the next engagement concave portion 63 and the pin of the tubular member 23 are moved. When the concave / convex engagement position with 61 is reached, the concave engagement portion 63 and the pin 61 of the tubular member 23 again engage with the concave / convex engagement.

  At this time, by the operation in which the engaging recess 63 of the piston 24 engages with the pin 61 of the tubular member 23, the operator feels (clicks) the piston 24 with the next engaging recess 63 and the pin of the tubular member 23. It can be recognized that the engagement position with 61 has been reached.

  Therefore, in the balloon fluid supply body 22 of the present embodiment configured as described above, the position of the elastic member 26, which is the position index of the piston 24 in the cylindrical member 23, is transmitted through the wall surface of the substantially transparent cylindrical member 23 to form a cylinder. The expansion diameter of the balloon 3 is visually recognized by matching with the scale 43 of the shaped member 23. Therefore, by using the balloon fluid supply body 22 of the present embodiment, the operator can perform an expansion operation to a desired inflation diameter of the balloon 3 without knowing the relationship between the fluid injection amount and the inflation diameter of the balloon 3. .

  Further, in the present embodiment, the operator engages the piston 24 with the hand feeling (click feeling) by the operation in which the pin 61 of the tubular member 23 engages with the engaging recess 63 at any position of the piston 24. Can be recognized. Therefore, since the operator can recognize the position of the piston 24 by hand and can recognize the expansion diameter of the balloon 3 by the position of the piston 24, the operator can surely inflate to the desired balloon diameter and Position adjustment operation becomes easy. In particular, the effect becomes remarkable when the delicate setting of the balloon expansion diameter is repeated.

  Furthermore, there is an effect that it is not necessary to replace the fluid supply body 22 for each balloon expansion diameter. Therefore, also in this embodiment, it is possible to provide the fluid supply body 22 of the balloon catheter 1 that has excellent operability as in the second embodiment.

  In this embodiment, as shown in FIG. 12, the pin 61 is provided on the cylindrical member 23. Instead, the pin 61 is provided on the piston 24, and the engaging recess 63 is provided on the cylindrical member 23. It may be provided.

  FIG. 13 shows a fifth embodiment of the present invention. This embodiment is still another modification of the balloon fluid supply body 22 of the second embodiment (FIGS. 11A and 11B).

  That is, the balloon fluid supply body 22 of the present embodiment is provided with the first attachment 71 at the rear end of the cylindrical member 23 and the second attachment 72 at the rear end of the piston 24.

  The first attachment 71 is provided with an extending portion 73 that extends in a direction orthogonal to the axial direction of the tubular member 23. A hole 74 is formed in the extending portion 73 in the axial direction of the tubular member 23. The hole 74 is formed with an engaging protrusion 75 protruding inward.

  The second attachment 72 is provided with an L-shaped member 76 bent in a substantially L shape. The L-shaped member 76 is provided with an insertion portion 77 that is inserted into the hole 74 of the first attachment 71. The insertion portion 77 is formed with a plurality of engagement concave portions 78 that are detachably engaged with the engagement convex portions 75 of the holes 74. And the engagement convex part 75 in the hole 74 of the 1st attachment 71 and the engagement recessed part 78 of either of the 2nd attachment 72 are engaged so that engagement / disengagement is possible, and the piston in the cylindrical member 23 is carried out. 24 stop positions are determined at each engagement position. That is, by arranging a plurality of engaging recesses 78 in the longitudinal direction (axial direction) of the piston 24, the stop position of the piston 24 is set by the set number of engaging recesses 78.

  Further, in the present embodiment, a scale 79 is provided on the second attachment 72 in order to visually recognize the position of the piston 24 in the cylindrical member 23. The scale 79 shows the inflated diameter of the balloon 3 at each position of the piston 24. Then, by aligning the end edge portion (position index) of the hole 74 of the first attachment 71 with the scale 79 of the second attachment 72, the expansion diameter of the balloon 3 is visually recognized. Further, the scale 79 may indicate the inflated diameter of the balloon 3 at a position between the plurality of engaging recesses 78.

  In addition, as a position index of the piston 24 in the cylindrical member 23, an index other than the edge portion of the hole 74 of the first attachment 71 may be used.

  When the balloon fluid supply body 22 of the present embodiment is used, an operation of pushing the piston 24 is performed, so that either of the engagement protrusion 75 in the hole 74 of the first attachment 71 and the second attachment 72 is selected. These engaging recesses 78 are engaged with each other in a releasable manner. At this time, the engagement concave portion 78 of the second attachment 72 is pressed by the pressing force that pushes the piston 24 from the initial state in which the engagement convex portion 75 of the first attachment 71 is engaged with the engagement concave portion 78 of the initial position. Leaves the engaging projection 75, and the concave-convex engagement is released. Then, the piston 24 moves from the initial engagement position (the concave / convex engagement position between the engagement convex portion 75 and the engagement concave portion 78) in the pushing direction, and the next engagement concave portion 78 and the engagement convex portion 75 When the concave / convex engaging position is reached, the next engaging concave portion 78 and the engaging convex portion 75 are engaged with the concave / convex portion again.

  At this time, the operation of engaging and disengaging the engagement concave portion 78 of the second attachment 72 of the piston 24 with the engagement convex portion 75 of the first attachment 71 causes the surgeon to move the piston 24 next with a hand feeling (click feeling). It can be recognized that the engagement position between the engagement recess 78 and the engagement protrusion 75 has been reached.

  Therefore, the above configuration has the following effects. That is, in the balloon fluid supply body 22 according to the present embodiment, the second attachment 72 is provided with a scale 79, and the end edge portion (position index) of the hole 74 of the first attachment 71 is defined as the scale 79 of the second attachment 72. Thus, the expanded diameter of the balloon 3 is visually recognized. Therefore, by using the balloon fluid supply body 22 of the present embodiment, the operator can perform an expansion operation to a desired inflation diameter of the balloon 3 without knowing the relationship between the fluid injection amount and the inflation diameter of the balloon 3. .

  In the present embodiment, the operator has a hand feeling (click feeling) by the operation in which the engaging convex portion 75 of the first attachment 71 engages with the engaging concave portion 78 at any position of the second attachment 72. Thus, the engagement position of the piston 24 can be recognized. Therefore, since the operator can recognize the position of the piston 24 by hand and can recognize the expansion diameter of the balloon 3 by the position of the piston 24, the operator can surely inflate to the desired balloon diameter and Position adjustment operation becomes easy. In particular, the effect becomes remarkable when the delicate setting of the balloon expansion diameter is repeated.

  Furthermore, there is an effect that it is not necessary to replace the fluid supply body 22 for each balloon expansion diameter. Therefore, also in this embodiment, it is possible to provide the fluid supply body 22 of the balloon catheter 1 that has excellent operability as in the second embodiment.

Furthermore, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention.
Next, other characteristic technical matters of the present application are appended as follows.
Record
(Additional Item 1) In the balloon catheter in which the balloon is fixed to the outer surface near the tip of the flexible tube by a fixing means, the strength in the longitudinal direction of the fixing portion is made larger than the strength specific to the balloon. catheter.

  (Additional Item 2) The balloon catheter according to Additional Item 1, further comprising means for preventing movement of the balloon in the longitudinal direction.

  (Additional Item 3) A balloon fixing linear member provided on the outer surface of the balloon and wound in the circumferential direction of the catheter, and means for preventing movement of the linear member in the longitudinal direction. Item 4. The balloon catheter according to Item 1.

  (Additional Item 4) A balloon-fixing linear member provided on the outer surface of the balloon and wound in the circumferential direction of the catheter, and a movement preventing means in the longitudinal direction of the linear member, the movement preventing means The balloon according to claim 1, wherein at least one or more movement preventing linear members are wound and fixed around the balloon fixing linear member in a direction substantially orthogonal to the balloon fixing linear member. catheter.

  (Additional Item 5) A flexible tube having at least one internal lumen and a balloon fixed to an outer surface in the vicinity of the distal end of the flexible tube, provided on the proximal side of the balloon and the flexible tube In the balloon catheter capable of inflating the balloon by injecting the fluid from the base into the balloon by fluid connection through the inner lumen of the flexible tube, the base is connected to the base and according to the expansion diameter of the balloon A balloon catheter comprising a fluid supply body in which at least one fluid amount is set in advance.

  (Additional Item 6) A cylindrical member that is used in combination with the balloon catheter according to Additional Item 1 or Additional Item 5, and that has a distal end and a proximal end opening, and a lumen of the cylindrical member In a fluid supply body comprising a slidable piston and an elastic member that is in close contact with and slidable with the cylindrical member, an expansion diameter of the balloon other than the distal end and proximal end openings of the cylindrical member A fluid supply body, wherein a fluid release side hole is provided at a position corresponding to the above.

  (Additional Item 7) A cylindrical member that is used in combination with the balloon catheter according to Additional Item 1 or Additional Item 5, and has a distal end and a proximal end opening, and a lumen of the cylindrical member In a fluid supply body composed of a slidable piston and an elastic member that is in close contact with the cylindrical member and is slidable, at least one uneven fitting portion is provided between the cylindrical member and the piston, The fluid supply body according to claim 1, wherein the fitting portion is configured to fix the piston at a position corresponding to an expansion diameter of the balloon.

  (Additional Item 8) The fluid supply body according to Additional Item 7, wherein at least one index capable of recognizing a balloon expansion diameter at the position of the piston in the cylindrical member is added to the cylindrical member. .

  (Additional Item 9) In the fluid supply body provided with the tubular member attachment fixed to the tubular member, at least one uneven fitting portion is provided between the tubular member attachment and the piston, and the fitting portion Item 8. The fluid supply body according to Item 7, wherein the piston can be fixed at a position corresponding to an expansion diameter of the balloon.

  (Additional Item 10) In the fluid supply body provided with the cylindrical member attachment fixed to the cylindrical member and the piston attachment fixed to the piston, at least one or more between the cylindrical member attachment and the piston attachment. 8. The fluid supply body according to appendix 7, wherein an uneven fitting portion is provided, and the fitting portion can fix the piston at a position corresponding to an expansion diameter of the balloon.

  (Additional Item 11) The fluid supply body according to Additional Item 10, wherein at least one index capable of recognizing a balloon expansion diameter at the position of the piston in the cylindrical member is added to the piston attachment.

  (Additional Item 12) At least one rod-shaped member is attached to either the cylindrical member or the piston, and a concave portion is provided in either the cylindrical member or the cylindrical member or the piston, and at least between the concave portion and the rod-shaped member. 8. The fluid supply body according to appendix 7, wherein one or more uneven fitting portions are formed, and the fitting portion can fix the piston at a position corresponding to an inflated diameter of the balloon.

  (Additional Item 13) A flexible catheter, a balloon fixed to the outer surface of the catheter, first fixing means for pressing and fixing the balloon in the circumferential direction of the catheter, and the first fixing means A balloon catheter, comprising: a second fixing means that fixes the catheter and restricts movement of the first fixing means in the longitudinal direction of the catheter.

  (Additional Item 14) The balloon catheter according to Additional Item 13, wherein the movement restricting force of the first fixing means by the second fixing means is stronger than the breaking strength of the balloon.

  (Prior Art of Additional Items 1-5) In the medical field, catheter tips such as medical urinary catheters with balloons such as catheters for indwelling urine, endotracheal tubes, digestive catheters, heart pumping balloon catheters, etc. A medical catheter with a balloon having a balloon in the vicinity is often used.

  In such a balloon catheter, as shown in Japanese Examined Patent Publication No. 62-19871, a tubular balloon is covered on the outer periphery of a flexible tube forming the catheter, and both ends of the balloon catheter are linear members, for example, threads. It was fixed by wrapping the outer periphery in the circumferential direction and binding it.

  However, the circumferential wrapping by this linear member is only the circumferential member pressing the balloon against the flexible tube in the circumferential direction, so the forceps desk placed at the distal end of the endoscope when inserted into the endoscope When a foreign object such as a calculus is scraped from the bile duct or pancreatic duct through the duodenal papilla into the duodenum, a force in the longitudinal direction is applied to the balloon, and the fastening and fixing part peels off and moves on the catheter. Sometimes.

  In order to solve such a problem, as in JP-A-1-254172 and JP-A-6-210001, a convex portion is provided in the vicinity of the balloon fixing portion so that the balloon fixing portion does not move in the longitudinal direction. There is what I did. In addition, it has been proposed to use the same material for the catheter and the balloon to melt and fix the fixing portion to obtain a strong fixing strength.

  (Problems to be solved by Supplementary Items 1 to 5) As described above, in the balloon fixing method in which the linear member is wound and tied, the linear member only presses the balloon against the flexible tube in the circumferential direction. The fixing strength of the balloon is advantageous in the circumferential direction but weak in the longitudinal direction. In addition, a method of increasing the strength in the longitudinal direction by increasing the winding tension of the linear member to the balloon is also conceivable, but if the winding tension is increased, the flexible tube loses its tension and is crushed. Therefore, the winding tension is limited. In such a case, if a force in the longitudinal direction is applied to the balloon, and the fastening and fixing portion may peel off and move on the catheter, the side hole for inflation provided in the catheter is exposed and the balloon is exposed. It will not work. To solve these problems, as disclosed in Japanese Patent Application Laid-Open No. 8-24348 or Japanese Patent Application Laid-Open No. 2002-143111, a means for avoiding this phenomenon is proposed by partially reducing the fixing strength of the balloon and the catheter. Has been. On the other hand, when the balloon is made thin, for example, to deteriorate the strength of the balloon itself and a load in the longitudinal direction is applied, a means for the balloon to break before the fixing portion is displaced can be easily considered. However, all of these are intended to provide a weak portion in a part of the structure of the balloon catheter, which impairs the quality of the balloon catheter. Due to the above background, it has been necessary to provide a structure with increased strength for fixing the balloon to the catheter.

  Further, in the case of preventing the balloon from dropping by providing a convex portion on the catheter as in JP-A-1-254172 and JP-A-6-210001, in order to form such a convex portion, the catheter is melted. When a convex shape is molded, or a very troublesome manufacturing process such as injection molding of a catheter having a convex portion in advance is required, and when the melting temperature of the resin using the catheter is high and the fluidity is poor, The molding of the catheter is difficult, and the resin used for the catheter has been specified as a resin having a relatively low melting temperature and a relatively high fluidity, that is, a moldable resin. As a means for providing the convex portion, a means for inserting a tubular member such as a stainless steel pipe on the outer surface of the catheter and disposing it at both ends of the balloon can be considered. However, in this case, the balloon catheter is extremely expensive. End up.

  (Object of Supplementary Items 1 to 5) The present invention has been made in view of these circumstances, and regardless of the material of the balloon or catheter, the amount of fixing force in the longitudinal direction of the balloon is increased by an inexpensive means, and the longitudinal direction of the balloon is increased. It is an object of the present invention to provide a high-quality balloon catheter in which the balloon is first broken as a breaking form without detaching the fixing portion even when an excessive load is applied in the direction.

  (Means for Solving the Problems of Additional Items 1 to 5) The balloon catheter of the present invention is the balloon catheter in which both ends of the balloon are fixed to the outer surface in the vicinity of the distal end of the flexible tube by fixing means. An inexpensive means for preventing movement in the direction is provided, and the strength of the fixed portion in the longitudinal direction is made larger than the strength specific to the balloon.

  (Operation of Supplementary Items 1 to 5) When an excessive force is applied to the balloon in the longitudinal direction by providing means for preventing movement of the balloon fixing portion in the longitudinal direction and making its strength greater than that inherent to the balloon. In addition, it is possible to avoid a phenomenon in which wrinkles are generated when the fixing portion is displaced and the balloon is deflated, making it difficult to pull out the balloon catheter from the endoscope channel. That is, it is possible to provide an inexpensive balloon catheter without degrading quality from the current situation.

  (Effects of Supplementary Items 1 to 5) As described above, according to the present invention, the strength in the longitudinal direction of the balloon fixing portion is improved by an inexpensive means, and further, it is made larger than the strength inherent to the balloon. Thus, it is possible to provide a very inexpensive and high-quality balloon catheter.

  (Prior Art of Additional Items 6 to 12) In addition, when the balloon of the medical catheter with a balloon as described above is inflated, a fluid supply body (for example, medical use) is connected to a hand-side base fluidly connected to the balloon portion. It is common to install a syringe barrel and inject a required amount of fluid to inflate the balloon.

  (Problems to be solved by additional items 6 to 12) When various treatments are performed using a balloon catheter, it is very important for the effect of the treatment that the operator knows the size of the balloon inflated during the treatment. Clearly it is a challenge. During the treatment, the balloon portion is placed in the body cavity of the patient, so that the balloon inflation diameter cannot be visually confirmed. On the other hand, this type of treatment is often performed, for example, under X-ray fluoroscopy, but since the balloon material is generally a material that does not transmit X-rays, it is difficult to confirm the expansion diameter of the balloon even under X-ray fluoroscopy. It becomes. Therefore, a desired balloon diameter is obtained by injecting a predetermined amount of fluid using the scale of the fluid supply body used for fluid injection. Therefore, when using a fluid supply body as described above, the operator needs to know the relationship between the balloon diameter and the fluid volume before treatment, and the fluid injection volume must be set according to the size of the balloon diameter to be expanded. I must. This is a very complicated and stressful action for the surgeon. Further, when setting the fluid injection amount with the conventional fluid supply body, it is necessary for the operator to adjust the piston to a fixed position by using a scale provided on the cylinder. This adjustment work needs to be performed carefully, and it was a very complicated and stressful action for the operator, especially when setting slightly different balloon inflation diameters.

  (Object of Supplementary Items 6 to 12) In view of the above background, the present invention allows an operator to perform an expansion operation to a desired balloon diameter without knowing the relationship between the fluid injection amount and the balloon inflation diameter, and a delicate injection fluid amount. An object of the present invention is to provide a balloon catheter fluid supply body excellent in operability that can be set.

  (Means for Solving the Problems in Additional Items 6-12) In addition, the balloon inflation fluid supply body according to the present invention is provided with a side hole in the tubular member of the fluid supply body, or an uneven fitting between the tubular member and the piston. A joint portion is provided to position the piston within the tubular member and to control the amount of fluid injected into the balloon.

  (Operation of Additional Items 6 to 12) Further, when the balloon fluid supply body according to the present invention is used, the fluid amount corresponding to the expansion diameter of the balloon is set in the fluid supply body in advance. An expansion operation can be performed to a desired balloon inflation diameter without knowing the relationship between the amount and the balloon inflation diameter. Further, by having a piston and cylinder concave / convex fitting portion linked to the balloon inflation diameter, the operator can easily adjust the piston position, and the effect is particularly remarkable when repeatedly setting the delicate balloon inflation diameter. It becomes. As described above, according to the present invention, it is possible to provide a balloon catheter fluid supply body having excellent operability.

  (Effects of Supplementary Items 6 to 12) According to the balloon inflation fluid supply body according to the present invention, the surgeon has a fluid infusion amount and a balloon inflation diameter by having an uneven fitting portion linked to the balloon inflation diameter. An expansion operation can be performed to a desired balloon inflation diameter without knowing the relationship. Furthermore, the operator can easily adjust the piston position, and the effect is particularly remarkable when the delicate balloon inflation diameter setting is repeated. As described above, it is possible to provide a balloon catheter fluid supply body excellent in operability.

The side view which shows the whole structure of the balloon catheter of the 1st Embodiment of this invention. (A) is a side view which shows the balloon mounting part of the front-end | tip part of the balloon catheter of 1st Embodiment, (B) is the IIB-IIB sectional view taken on the line of FIG. (A) is the IIIA-IIIA sectional view taken on the line of FIG. 2 (B), (B) is the IIIB-IIIB sectional view taken on the line of FIG. 2 (B). The perspective view which shows the whole structure of the balloon fluid supply body in the balloon catheter of 1st Embodiment. Explanatory drawing for demonstrating the operation | movement which inserts the balloon catheter of 1st Embodiment in a bile duct. Explanatory drawing for demonstrating the operation | movement which advances the front-end | tip part of a balloon catheter to the upstream part of the bile duct in which the balloon of the balloon catheter of 1st Embodiment exceeded the calculus. Explanatory drawing for demonstrating the operation | movement from which the calculus is scraped out to the duodenum via the duodenal papilla from the bile duct by the inflated balloon of the balloon catheter of 1st Embodiment. Explanatory drawing for demonstrating the operation | movement which balloon itself cuts before the balloon fixing | fixed part of the balloon catheter of 1st Embodiment moves. Explanatory drawing for demonstrating the operation | movement which pulls out a balloon catheter outside the body in the state which the balloon of the balloon catheter of 1st Embodiment contracted. The 2nd Embodiment of the fluid supply body for balloons in the balloon catheter of this invention is shown, (A) is a side view of the fluid supply body for balloons, (B) is a longitudinal cross-sectional view of the fluid supply body for balloons. The longitudinal cross-sectional view which shows 3rd Embodiment of the fluid supply body for balloons in the balloon catheter of this invention. The longitudinal cross-sectional view which shows 4th Embodiment of the fluid supply body for balloons in the balloon catheter of this invention. The side view which shows 5th Embodiment of the fluid supply body for balloons in the balloon catheter of this invention in part in cross section. The longitudinal cross-sectional view of the principal part which shows the state which the balloon fixing | fixed part of the front-end | tip part of the conventional balloon catheter peeled and the side hole for expansion | swelling of a balloon was exposed outside.

Explanation of symbols

    DESCRIPTION OF SYMBOLS 1 ... Balloon catheter, 3 ... Balloon, 22 ... Fluid supply body, 23 ... Cylindrical member, 24 ... Piston, 42a, 42b, 42c ... Fitting recessed part, 41 ... Projection part.

Claims (7)

A cylindrical member used in combination with a balloon catheter, having a distal end and a proximal end opening; a piston slidable with respect to the lumen of the cylindrical member; In a fluid supply body comprising a slidable elastic member,
Provided between the tubular member and the piston is at least one concave-convex fitting portion in which a protrusion and a fitting concave portion are fitted, and the fitting portion fixes the piston at a position corresponding to the expansion diameter of the balloon. Enable
Due to the difference between the amount of operating force during movement in a state where the protrusion and the fitting recess are separated and the uneven fitting is released, and the amount of operating force when the protrusion and the fitting recess are engaged ,
A fluid supply body characterized in that it is possible to recognize that the piston has reached the fitting position by a hand feeling when the concave-convex fitting portion between the cylindrical member and the piston is concave-convex fitted. The fitting state of the cylindrical member and the piston by the concave / convex fitting portion is set to be releasable by elastically deforming one of the concave / convex fitting portions by a pressing force for operating the piston. ,
2. The fluid supply body according to claim 1, wherein when the fitting state and the non-fitting state are switched, the fitting portion is elastically deformed to generate a click feeling.   2. The fluid supply body according to claim 1, wherein at least one index capable of recognizing an expansion diameter of the balloon at the position of the piston in the cylindrical member is added to the cylindrical member. . A cylindrical member attachment fixed to the cylindrical member is provided, and at least one uneven fitting portion is provided between the cylindrical member attachment and the piston, and a protrusion and a fitting concave portion are fitted , The fitting portion enables the piston to be fixed at a position corresponding to the expansion diameter of the balloon,
Due to the difference between the amount of operating force during movement in a state where the protrusion and the fitting recess are separated and the uneven fitting is released, and the amount of operating force when the protrusion and the fitting recess are engaged ,
2. It is possible to recognize that the piston has reached the fitting position by a hand feeling during an operation in which the concave and convex fitting portion between the cylindrical member and the piston is concave and convex. The fluid supply body described. A cylindrical member attachment fixed to the cylindrical member and a piston attachment fixed to the piston are provided, and at least one of a protrusion and a fitting recess is fitted between the cylindrical member attachment and the piston attachment. Provide two or more uneven fitting parts,
Due to the difference between the amount of operating force during movement in a state where the protrusion and the fitting recess are separated and the uneven fitting is released, and the amount of operating force when the protrusion and the fitting recess are engaged ,
Recognize the state where the piston is fixed at a position corresponding to the expansion diameter of the balloon with a hand feeling when the concave and convex fitting portion between the cylindrical member attachment and the piston attachment is concave and convex. The fluid supply body according to claim 1, wherein the fluid supply body is formed.   6. The fluid supply body according to claim 5, wherein at least one index capable of recognizing an expansion diameter of the balloon at the position of the piston in the cylindrical member is added to the piston attachment. At least one rod-shaped member is attached to either the cylindrical member or the piston, and a recess is provided in either the rod-shaped member and the cylindrical member or the piston, and a protrusion is formed between the concave portion and the rod-shaped member. Providing at least one concave-convex fitting portion in which the portion and the fitting concave portion are fitted, and the fitting portion is capable of fixing the piston at a position corresponding to the expansion diameter of the balloon;
Due to the difference between the amount of operating force during movement in a state where the protrusion and the fitting recess are separated and the uneven fitting is released, and the amount of operating force when the protrusion and the fitting recess are engaged ,
2. It is possible to recognize that the piston has reached the fitting position by a hand feeling when the concave and convex fitting portion between the concave portion and the rod-shaped member is fitted into the concave and convex portions. Fluid supply body.

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