JP5198987B2 - Indwelling catheter removal aid - Google Patents

Description

  The present invention relates to an auxiliary tool used when removing an indwelling catheter placed in a body cavity such as a stomach or a bladder.

  As this type of indwelling catheter removal aid, for example, one disclosed in Patent Document 1 below is known. Patent Document 1 discloses an auxiliary tool for removing a fistula catheter provided with a bumper formed at a distal end portion of a tube having a diameter larger than the outer diameter of the tube. The auxiliary tool includes a cylindrical member having an inner diameter that is substantially the same as the outer diameter of the tube. The tube is inserted into the cylindrical member from the rear end, and the cylindrical member is inserted into the fistula in this state. Insert the tip into the body cavity. By pulling the tube backward from this state, the bumper can be deformed and pulled into the cylindrical member, and the bumper can be pulled out from the cylindrical member.

  However, it is actually not easy to draw a bumper having a diameter larger than the outer diameter of the tube into a cylindrical member having an inner diameter substantially the same as the outer diameter of the tube. If the surgeon tries to pull the bumper into the cylindrical member and pulls the tube strongly against the cylindrical member, the bumper may come off from the tip of the tube. In addition, when the tube is pulled strongly, the cylindrical member must be pressed with a strong force. However, when a strong force is applied to the cylindrical member, the cylindrical member moves in the axial or radial direction of the fistula, causing pain to the patient. There is also a risk of giving.

  Therefore, it has an outer cylinder to be inserted into the fistula and an inner cylinder that is inserted into the outer cylinder and through which the tube can be inserted, and provided with a notch at the tip of the outer cylinder and the inner cylinder, An auxiliary tool is conceivable in which either or both of the outer cylinder and the inner cylinder are rotated about an axis so that the bumper is sandwiched between the notch portion of the outer cylinder and the notch portion of the inner cylinder.

  According to the auxiliary tool, by rotating either one or both of the outer cylinder or the inner cylinder around the axis, the bumper is sandwiched between the notch portion of the outer cylinder and the notch portion of the inner cylinder, Since the bumper is housed inside the outer cylinder, a strong force is not required to pull the bumper into the outer cylinder, and therefore it is not necessary to hold the outer cylinder with a strong force.

However, in the auxiliary tool, the bumper may not be completely accommodated inside the outer cylinder. In this case, the removal of the indwelling catheter is hindered, and further improvement is desired.
JP 2005-168980 A, paragraphs 0018, 0019, FIG.

  An object of the present invention is to improve an auxiliary tool used when removing an indwelling catheter placed in a body cavity. More specifically, in view of the above circumstances, the body cavity fixing portion is securely accommodated inside the outer cylinder with a light force. An object of the present invention is to provide an indwelling catheter removal aid that can be pulled out of the fistula without any problem.

  In order to achieve the above object, an indwelling catheter removal assisting device according to the present invention includes a flexible tube main body whose distal end is inserted into a body cavity through a fistula, and a body cavity provided at the distal end of the tube main body. An extraction assisting tool for extracting an indwelling catheter from the body cavity with a flexible bowl-shaped body cavity fixing part that regulates the extraction of the tube body from the outer cylinder, An outer cylinder inserted into the outer cylinder and into which the tube main body can be inserted, and the outer cylinder is cut at a distal end portion inserted into the body cavity so as to face the body cavity fixing section. A cutout portion of the outer cylinder and a cam portion formed in a spiral shape at the rear end portion are provided, and the inner cylinder for removal faces the body cavity fixing portion at a distal end portion inserted into the body cavity. The inner cylinder cutout portion that is cut out like this and the rear end portion An engagement portion that engages with the insertion portion, and is inserted so that the rear end side of the tube body is inserted from the distal end side of the inner tube for removal and the distal end portion reaches the body cavity through the fistula. The inner cylinder for removal is inserted into the outer cylinder and the tube body is pulled rearward so that the body cavity fixing portion faces the inner cylinder notch, and the outer cylinder or the inner cylinder Either or both of them are rotated around the axis, and the engaging portion of the inner tube for removal is slid along the cam portion of the outer tube, so that the inner tube for removal is moved with respect to the outer tube. The body cavity fixing part is retracted and accommodated in the outer cylinder, and at least the extraction inner cylinder and the indwelling catheter are formed so as to be removable from the body cavity via a fistula.

  According to the indwelling catheter removal assisting device of the present invention, the body cavity fixing portion is moved away from the inner tube notch by pulling the tube body backward while the outer tube and the removal inner tube are inserted into the body cavity. It becomes a shape facing the part. In order to achieve such a state, it is not necessary to forcefully deform the body cavity fixing portion, and therefore the tube body may be pulled with a force smaller than that of a conventional auxiliary tool.

  Then, when the outer cylinder or the extraction inner cylinder is rotated about the axis, the body cavity fixing portion is sandwiched between the outer cylinder notch portion and the inner cylinder notch portion. Further, by the rotation, the engagement portion provided at the rear end portion of the removal inner cylinder slides along the cam portion provided at the rear end portion of the outer cylinder, and the Thus, since the extraction inner cylinder is retracted, the body cavity fixing portion is drawn into the outer cylinder, and can be reliably accommodated in the outer cylinder. Therefore, when the outer cylinder, the extraction inner cylinder, and the indwelling catheter are removed from the fistula in this state, there is no obstacle and the pain given to the patient can be minimized.

  In the indwelling catheter removal assisting device of the present invention, only the removal inner tube and the indwelling catheter can be removed while the outer tube is inserted into the fistula. In this case, since the body cavity fixing portion is already accommodated in the outer cylinder, the inside of the outer cylinder can be easily passed. Further, in this case, the removal inner cylinder and the indwelling catheter do not come into contact with the fistula, so that no pain is given to the patient. Further, since the outer cylinder is left in the fistula, when exchanging the indwelling catheter, it becomes easy to insert a new indwelling catheter into the body cavity via the outer cylinder.

  In the indwelling catheter removal assisting device of the present invention, the outer tube notch portion and the inner tube notch portion may be inclined obliquely toward the distal ends of the outer tube and the removal inner tube portion. preferable. Thus, when the outer cylinder notch part and the inner cylinder notch part are inclined obliquely, the body cavity fixing part is the outer cylinder or the removal when the outer cylinder or the removal inner cylinder is rotated. It gradually deforms as the inner cylinder rotates. For this reason, the deformation | transformation part of the said body cavity fixed part is performed smoothly, and the accommodation to the inside of the said outer cylinder becomes easy.

  In the indwelling catheter removal assisting device of the present invention, it is preferable that a deforming protrusion for deforming the body cavity fixing portion is provided on the inner peripheral surface of the distal end portion of the removal inner cylinder. Since the deforming projection is provided on the inner peripheral surface of the distal end portion of the extraction inner cylinder, the body cavity is fixed when the tube body is pulled backward with respect to the outer cylinder and the extraction inner cylinder. The portion deforms with the deformation protrusion as a base point. As a result, the body cavity fixing part is smoothly deformed as compared with the case where there is no deformation protrusion, so that the body cavity fixing part can be quickly deformed, and the outer cylinder or the removal tube can be subsequently removed. The rotating operation of the inner cylinder is also facilitated.

  Moreover, it is preferable that the deformation protrusion is provided at a position slightly deviated from the center of the front view with respect to the inner tube notch portion in the rotational direction side. When the body cavity fixing part is deformed in the absence of the deformation projection, the deformation starts because the deformation often starts from a position slightly deviated to the rotational direction side from the center in front view of the inner tube notch. By providing the deformation protrusion at the position, the body cavity fixing portion is deformed more smoothly.

  When the indwelling catheter is not simply removed but is replaced and a new indwelling catheter is attached, it is necessary to insert the new indwelling catheter into the body cavity through the fistula. At that time, if a linear or rod-like temporary indwelling member such as a guide wire is placed in the fistula, it can be easily inserted when a new indwelling catheter is inserted.

  Therefore, in the indwelling catheter removal assisting device of the present invention, it is preferable that a guide passage for guiding the linear or rod-shaped temporary indwelling member is provided inside the outer peripheral surface of the outer cylinder. By providing the guide passage inside the outer peripheral surface of the outer cylinder, the temporary indwelling member does not come into contact with the fistula when the temporary indwelling member is inserted into the fistula, and the patient is painful. There is no.

  In the indwelling catheter removal assisting tool of the present invention, the wall surface of the removal inner cylinder is linearly deformed inward in the axial direction, and the deformation projection and the guide passage are integrally formed. It is preferable. In this way, by forming the deformation projection and the guide passage integrally, it becomes easy to process the inner cylinder for removal.

  Further, in the indwelling catheter removal aid according to the present invention, the removal inner cylinder includes a cylindrical outer cylinder main body and an inner cylinder flange portion protruding radially outward from a rear end portion of the outer cylinder main body. It is preferable that the inner cylinder flange portion is provided with a holding groove for holding the tube body so that the body cavity fixing portion can be held in a state of facing the inner cylinder notch portion. According to the said structure, since the said outer cylinder or the said extraction inner cylinder can be rotated around an axis | shaft in the state which clamped and fixed the said tube main body to the said clamping groove, operation becomes easy.

  The indwelling catheter removal assistance tool of the present invention is inserted into the body cavity by inserting the rear end side of the tube body from the distal end portion and guiding the tube body. At this time, the extraction inner cylinder may be inserted into the outer cylinder, but between the outer cylinder and the extraction inner cylinder, or between the extraction inner cylinder and the main tube body. If there is a gap, the fistula may be caught in the gap and damage the fistula.

  Therefore, the indwelling catheter removal assisting tool of the present invention is replaceable with the removal inner tube, and includes an insertion inner tube that is inserted into the outer tube and into which the tube body can be inserted. The inner cylinder is in close contact with the inner peripheral surface of the outer cylinder at the outer peripheral surface in a state of being inserted into the outer cylinder, and is in close contact with the outer peripheral surface of the tube main body inserted through the inner peripheral surface, It is preferable to be inserted into the body cavity through the fistula together with the outer cylinder by sliding along the tube body. According to the insertion inner cylinder, there is no gap between the inner cylinder for insertion and the outer cylinder or the tube body because the inner cylinder is in close contact with the inner circumferential surface of the outer cylinder and the outer circumferential surface of the tube body. Since the fistula is not involved, the fistula is not damaged and the patient is not painful.

  The insertion inner cylinder is inserted into the body cavity through the fistula together with the outer cylinder, and then removed while the outer cylinder is inserted into the fistula, and is replaced with the extraction inner cylinder. Since the inner cylinder for extraction is inserted into the outer cylinder that has already been inserted into the fistula, it does not come into contact with the fistula at the time of insertion and does not cause pain to the patient.

  Next, an example of an embodiment of the indwelling catheter removal aid of the present invention will be described with reference to FIGS. 1 to 5. FIG. 1 is an explanatory view showing a gastrostomy catheter removal aid (hereinafter simply referred to as “removal aid”) as an example of an embodiment of the present invention, FIG. 2 is an exploded view of the removal aid of FIG. 1, and FIG. FIG. 4 is an exploded view of the extraction assisting device of FIG. 3, and FIGS. 5 (a) to 5 (c) are extracted with the gastrostomy catheter inserted into the body cavity. FIGS. 6A to 6D are explanatory views showing a procedure for removing the body cavity fixing portion of the gastrostomy catheter from the fistula.

  As shown in FIG. 1, the removal assisting tool 1 of the present embodiment includes an outer tube 2 inserted into a gastrostoma (fistula) A, and an indwelling catheter (gastrostomy catheter) 4 inserted into the outer tube 2 and provided therein. And an extraction inner cylinder 3 into which the tube main body 41 can be inserted.

  As shown in FIGS. 1 and 2, the outer cylinder 2 includes an outer cylinder main body 21 and an outer cylinder flange portion 22. The outer cylinder main body 21 is a cylindrical member made of synthetic resin, and has an outer cylinder cutout portion 23 that is inclined toward the distal end side at the distal end portion. The outer cylinder flange 22 is provided on the base end side (the upper side in FIGS. 1 and 2) of the outer cylinder main body 21, and protrudes outward from the outer peripheral surface over the entire circumference of the outer cylinder main body 21. Yes. A cylindrical outer cylinder extending part 24 is provided on the opposite side of the outer cylinder flange 22 from the outer cylinder main body 21, and a part of the peripheral wall of the outer cylinder extending part 24 is cut out to form a spiral shape. The cam portion 25 is formed. The cam portion 25 is formed on the peripheral wall of the outer cylinder extending portion 24 in a range of about 225 °, and at both ends thereof, a locking portion 25a is provided to stabilize the position of the removal inner cylinder 3 with respect to the outer cylinder 2. , 25b are provided.

  As shown in FIGS. 1 and 2, the extraction inner cylinder 3 includes an inner cylinder body 31 and an inner cylinder flange 32. The inner cylinder main body 31 is a cylindrical member made of synthetic resin, and has an inner cylinder cutout portion 33 that is inclined toward the distal end side at the distal end portion. Further, a deformation projection 33a that protrudes in a hemispherical shape radially inward is provided on the inner peripheral surface of the distal end portion of the extraction inner cylinder 3 provided with the notch 33. The deformation projection 33 a is provided at a position that is deviated from the center in the front view to the rotation direction side with respect to the inner tube notch 33. As shown in FIG. 2, an engagement pin 34 that protrudes from the peripheral wall in the notch direction of the inner cylinder notch 33 is attached to the proximal end side of the inner cylinder main body 31 a. The engaging pin 34 engages with the cam portion 25 provided in the outer cylinder extending portion 24 described above. The inner cylinder body 31 protrudes outward from the distal end of the outer cylinder 2 in a state where the engagement pin 34 is engaged with the engagement part 25 b on the lower end side of the cam part 25.

  The inner cylinder flange portion 32 is provided at the proximal end portion of the inner cylinder main body 31 and protrudes outward from the outer peripheral surface of the inner cylinder main body 31. The inner cylinder flange portion 32 is provided with flat portions 32a and 32b that are parallel to each other, and a holding groove 35 that can hold the tube body 41 of the gastrostomy catheter 4 is provided above the flat portion 32a. . In the present embodiment, the holding groove 35 is provided in the notch direction of the inner cylinder main body 31, and is a notch display in the inner cylinder flange portion 32.

  Further, the inner cylinder flange 32 is provided with a guide hole 36 penetrating toward the outer peripheral surface of the inner cylinder main body 31, and the outer peripheral surface of the inner cylinder main body 31 corresponding to the back side of the inner cylinder notch 33 has a shaft. A guide groove 37 extending along the direction is provided. In this embodiment, a guide passage 38 through which the guide wire 5 shown in FIG. 5 is inserted is formed by the guide hole 36, the guide groove 37, and the inner peripheral surface of the outer cylinder main body 21.

  As shown in FIG. 2, the outer cylinder 2 and the extraction inner cylinder 3 configured as described above are configured such that the distal end portion of the inner cylinder main body 31 is inserted from the proximal end side of the outer cylinder 2 and the engagement pin 34 is connected to the cam portion 25. Engage and engage with the locking portion 25 b on the lower end side of the cam portion 25. As a result, the extraction inner cylinder 3 does not come out of the outer cylinder 2. Further, the outer cylinder 2 and the removal inner cylinder 3 are relatively rotatable by about 225 ° as the engagement pin 34 slides along the cam portion 25. Further, when the engaging pin 34 is locked to the locking portion 25 a on the upper end side of the cam portion 25, the extraction inner tube 3 is in a state where the tip is accommodated in the outer tube 2.

  Further, as shown in FIGS. 3 and 4, the removal assisting tool 1 of the present embodiment is inserted into the outer cylinder 2 so that the tube body 41 of the indwelling catheter (gastrostomy catheter) 4 can be inserted therein. A tube 6 is provided. The insertion inner cylinder 6 can be replaced with the removal inner cylinder 3.

  As shown in FIGS. 3 and 4, the insertion inner cylinder 6 includes an inner cylinder body 61, an inner cylinder provided at the base end portion of the inner cylinder body 61 and protruding outward from the outer peripheral surface of the inner cylinder body 61. It consists of a cylindrical flange 62. The inner cylinder body 61 is a cylindrical member made of synthetic resin, and includes a tapered portion 63 that gradually decreases in diameter from the proximal end side toward the distal end side at the distal end portion, and an engagement projecting from the peripheral wall on the proximal end side. A pin 64 is attached. The engaging pin 64 is locked to the locking portion 25b of the cam portion 25 provided on the outer cylinder extending portion 24, so that the position of the insertion inner cylinder 6 with respect to the outer cylinder 2 is stabilized. It has become.

  The insertion inner cylinder 6 has a distal end provided with a taper part 63 protruding outward from the distal end of the outer cylinder 2 in a state where the engagement pin 64 is engaged with the engagement part 25 b on the lower end side of the cam part 25. Yes. Further, the insertion inner cylinder 6 is in close contact with the inner peripheral surface of the outer cylinder 2 at the outer peripheral surface, and is in close contact with the outer peripheral surface of the tube main body 41 inserted through the inner peripheral surface.

  Next, a procedure when the gastrostomy catheter 4 is extracted using the extraction assisting tool 1 having the above-described configuration will be described with reference to FIGS. 5 and 6. In the figure, symbol B is an abdominal wall and symbol C is a stomach wall. FIG. 5A shows a state where the gastrostomy catheter 4 is inserted into the body cavity (inside the stomach) via the gastrostomy A. The gastrostomy catheter 4 is a so-called bumper-type gastrostomy catheter having a tube body 41 and a bumper 42 as shown in FIG.

  First, as shown in FIG. 5A, the rear end of the tube main body 41 of the gastrostomy catheter 4 is removed so that the tube main body 41 passes through the inner cylinder 6 for insertion inserted into the outer cylinder 2. It inserts in the inner cylinder 6 for insertion of the auxiliary tool 1.

  Next, as shown in FIG. 5 (b), the distal end portion of the removal assisting tool 1 is inserted into the gastrostomy A. At this time, the removal assisting tool 1 includes an inner cylinder 6 for insertion, and the inner cylinder 6 for insertion is in close contact with the outer peripheral surface of the tube main body 41 and the inner peripheral surface of the outer cylinder 2 and there is no gap. Therefore, the removal assisting tool 1 can be smoothly inserted into the gastrostoma A without entrapping the gastrostoma A by sliding the insertion inner cylinder 6 along the tube body 41.

  Next, the operator presses the outer cylinder 2 of the removal assisting tool 1 by hand, and the outer cylinder 2 is removed from the insertion cylinder 6 while being inserted into the gastrostoma A, and replaced with the extraction inner cylinder 3. To do. The extraction inner tube 3 is inserted into the outer tube 2 by inserting the rear end of the tube body 41 of the gastrostomy catheter 4 into the tube body and sliding it along the tube body 41. The extraction inner cylinder 3 inserted into the outer cylinder 2 is positioned with respect to the outer cylinder 2 by engaging the engaging pin 34 with the engaging portion 25b on the lower end side of the cam portion 25. In the state, the distal end of the inner cylinder main body 31 protrudes outward from the distal end of the outer cylinder 2, that is, into the stomach which is a body cavity.

  Next, the operator presses the removal assisting tool 1 by hand, and pulls the tube body 41 backward. Then, as shown in FIG. 5C, the bumper 42 comes to face the notch surface of the inner cylinder notch 33, and the bumper 42 is deformed to shrink. At this time, the bumper 42 is folded from the portion in contact with the deformation protrusion 33a, and the deformation is smoothly performed. Next, the tube main body 41 is clamped in the clamping groove 35 of the inner cylinder flange portion 32 in this state. Thereby, even if the surgeon releases the hand from the tube main body 41, the bumper 42 is held in the state of FIG.

  Next, the surgeon holds the outer cylinder 2 by hand and rotates the inner cylinder flange 32 about the axis as shown in FIG. As described above, when the extraction inner cylinder 3 is rotated with respect to the outer cylinder 2, the engagement pin 34 slides along the cam portion 25, and the extraction inner cylinder 3 is gradually retracted with respect to the outer cylinder 2. At the same time, the bumper 42 facing the inner cylinder notch 33 is gradually sandwiched between the inner cylinder notch 33 and the outer cylinder notch 23 and deformed to a small extent. Then, as shown in FIG. 6B, when the extraction inner cylinder 3 is rotated to a position where the engaging pin 34 is locked to the locking portion 25a on the upper end side of the cam portion 25, the inner cylinder notch portion 33 is completely drawn into the outer cylinder main body 21, and the bumper 42 is completely accommodated in the outer cylinder main body 21 accordingly.

  Next, as shown in FIG. 6 (c), the guide wire 5 is inserted into the stomach via the removal assisting tool 1. This guide wire 5 is used not only to remove the gastrostomy catheter 4 but also to replace it with a new gastrostomy catheter 4. The guide wire 5 is a general one used in this type of gastrostomy procedure. The surgeon inserts the distal end portion of the guide wire 5 into the guide hole 36 of the inner cylinder flange portion 32 and inserts it into the stomach from the distal end portions of the inner cylinder body 31 and the outer cylinder body 21 through the guide passage 38.

  Next, as shown in FIG. 6 (d), the removal assisting tool 1 is removed from the gastrostomy A while the guide wire 5 is left in the gastrostomy A. By the above procedure, the gastrostomy catheter 4 that has been placed in the stomach via the gastrostoma A can be removed.

  In the above embodiment, the stomach is used as an example of the body cavity. However, the removal assisting device of the present invention can be used for other body cavities such as the bladder and trachea.

  Moreover, in the said embodiment, although the deformation | transformation protrusion 33a is made into the shape protruded in a hemispherical shape, it is not restricted to this.

Explanatory drawing which shows the gastrostomy catheter removal assistance tool which is an example of embodiment of this invention. The exploded view of the extraction assistance tool of FIG. Explanatory drawing which shows the other structure of the extraction assistance tool of FIG. The exploded view of the extraction assistance tool of FIG. (A) thru | or (c) is explanatory drawing which shows the procedure which inserts a removal assistance tool in a fistula in the state which inserted the gastrostomy catheter inside the body cavity. (A) thru | or (d) is explanatory drawing which shows the procedure which extracts the body cavity fixing | fixed part of a gastrostomy catheter from a fistula.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Extraction assistance tool, 2 ... Outer cylinder, 3 ... Inner cylinder for extraction, 4 ... Gastrostomy catheter (indwelling catheter), 6 ... Inner cylinder for insertion, 21 ... Outer cylinder main body, 25 ... Cam part, 31 ... Inner cylinder A main body, 35 ... clamping groove, 41 ... tube main body, 42 ... bumper (fixing part in body cavity), A ... gastric fistula (fistula).

Claims (7)

A flexible tube main body whose distal end is inserted into a body cavity through a fistula, and a flexible bowl-shaped body cavity that is provided at the distal end of the tube main body and regulates the extraction of the tube main body from the body cavity An extraction assisting tool for extracting an indwelling catheter having a fixing part from the body cavity,
An outer cylinder that is inserted into the fistula, and an extraction inner cylinder that is inserted into the outer cylinder and into which the tube main body can be inserted.
The outer cylinder is provided with an outer cylinder notch portion that is notched so as to face the body cavity fixing portion at a distal end portion that is inserted into the body cavity, and a cam portion that is spirally formed at the rear end portion. ,
The inner cylinder for removal includes an inner cylinder notch portion that is notched so as to face the body cavity fixing portion at a distal end portion that is inserted into the body cavity, and an engagement portion that engages the cam portion at a rear end portion. And
The rear end side of the tube main body is inserted from the front end side of the extraction inner cylinder, and the extraction inner cylinder is inserted into the outer cylinder inserted so that the front end portion reaches the body cavity through the fistula. Insert,
Pulling the tube body rearward causes the body cavity fixing portion to face the inner tube notch portion, and either one or both of the outer tube and the inner tube for removal is rotated about the axis, and for the removal The engaging portion of the inner cylinder is slid along the cam portion of the outer cylinder, the extraction inner cylinder is moved backward with respect to the outer cylinder, and the body cavity fixing portion is accommodated inside the outer cylinder. An indwelling catheter removal assisting device, wherein at least the removal inner cylinder and the indwelling catheter are formed so as to be removable from the body cavity through a fistula.   2. The indwelling catheter removal assistance according to claim 1, wherein the outer tube notch portion and the inner tube notch portion are inclined obliquely toward the distal ends of the outer tube and the removal inner tube. Ingredients.   The indwelling catheter removal assisting device according to claim 1 or 2, wherein the removal inner cylinder is provided with a deformation protrusion for deforming the body cavity fixing portion on an inner peripheral surface of a distal end portion.   The indwelling catheter extraction according to any one of claims 1 to 3, wherein a guide passage for guiding a linear or rod-like temporary indwelling member is provided inside the outer peripheral surface of the outer cylinder. Auxiliary tool.   5. The indwelling catheter according to claim 4, wherein a wall surface of the extraction inner cylinder is linearly deformed inward in the axial direction, and the deformation protrusion and the guide passage are integrally formed. Extraction aid.   The extraction inner cylinder includes a cylindrical outer cylinder main body and an inner cylinder flange portion that protrudes radially outward from a rear end portion of the outer cylinder main body, and the body cylinder cavity is fixed to the inner cylinder flange portion. The indwelling device according to any one of claims 1 to 5, wherein a holding groove for holding the tube main body is provided so that the portion can be held in a state of facing the inner cylinder notch portion. A catheter removal aid. It is replaceable with the extraction inner cylinder, and includes an insertion inner cylinder that is inserted into the outer cylinder and can be inserted through the tube main body.
The insertion inner cylinder is in close contact with the inner peripheral surface of the outer cylinder at the outer peripheral surface in a state of being inserted into the outer cylinder, and is in close contact with the outer peripheral surface of the tube main body inserted through the inner peripheral surface. The indwelling catheter removal assisting device according to any one of claims 1 to 6, wherein the indwelling catheter removal aid is inserted into a body cavity through a fistula together with the outer cylinder by sliding along the tube body. .

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