JP5401364B2 - Guide needle for tube - Google Patents

Guide needle for tube Download PDF

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JP5401364B2
JP5401364B2 JP2010049979A JP2010049979A JP5401364B2 JP 5401364 B2 JP5401364 B2 JP 5401364B2 JP 2010049979 A JP2010049979 A JP 2010049979A JP 2010049979 A JP2010049979 A JP 2010049979A JP 5401364 B2 JP5401364 B2 JP 5401364B2
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needle
main body
guide
tube
bevel surface
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JP2011182898A (en
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浩 石坂
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本発明は、管体用ガイド針に関し、殊に、体内目的箇所までのルートを確保して穿刺針やカテーテル等の管体を体外から目的箇所まで誘導するのに用いる管体用ガイド針に関する。   The present invention relates to a guide needle for a tubular body, and more particularly to a guide needle for a tubular body that is used for securing a route to a target location in the body and guiding a tubular body such as a puncture needle and a catheter from the outside of the body to the target location.

近年、超音波やX線等によるリアルタイムの画像ガイド下にて、所定の機能を有する穿刺針を体内の目的箇所まで刺入して所定の処置を行う治療法が普及しており、このように穿刺針を介して経皮的に処置を行うことで通常の手術療法よりも患者への侵襲や負担を小さく抑えることができる。   In recent years, under the real-time image guide using ultrasonic waves, X-rays, and the like, a treatment method for performing a predetermined treatment by inserting a puncture needle having a predetermined function to a target location in the body has become widespread. By performing the treatment percutaneously through the puncture needle, it is possible to reduce the invasion and burden on the patient to a smaller extent than in normal surgical therapy.

例えば、注入針を介して腫瘍組織にエタノールを注入してこれを変性・壊死させる経皮的エタノール注入療法や、腫瘍組織に電極針を刺入して高周波による熱でこれを壊死させる高周波温熱療法、或いは注入針を介して神経節にピンポイントで薬剤を注入して痛みの伝達経路を遮断する神経ブロックなどの治療法が知られている。   For example, percutaneous ethanol injection therapy in which ethanol is injected into a tumor tissue through an injection needle and this is denatured or necrotized, or high-frequency thermotherapy in which an electrode needle is inserted into the tumor tissue and necrotized with heat by high frequency Alternatively, a therapeutic method such as a nerve block that blocks a pain transmission path by injecting a drug into a ganglion pinpoint via an injection needle is known.

斯かる治療法では、穿刺針の先端側を目的箇所に正確に置くことが重要になるが、目的箇所が体深部などの到達が難しい場所にあるケースでは、穿刺針が目的箇所に到達するまでに何度も針の抜き刺し動作を行ってしまうことがある。殊に、呼吸運動により目的臓器が動いてしまう場合や、目的箇所の近くや刺入ルートの途中に太い動脈や他の臓器がある場合には、手技において困難やリスクを伴いやすい。   In such a treatment method, it is important to accurately place the distal end side of the puncture needle at the target location, but in cases where the target location is difficult to reach such as the deep part of the body, until the puncture needle reaches the target location. In some cases, the needle may be repeatedly inserted and removed. In particular, when the target organ moves due to respiratory motion, or when there is a thick artery or other organ near the target location or in the middle of the insertion route, the procedure is likely to be difficult or risky.

これに対し、例えば特開平8−238248号公報には、位置決め用の投光器及び支持器を備えて、体表側でガイド筒を目的箇所の方向に支持することにより穿刺針の刺入点及び刺入角を決定する器具が提案されており、CTガイド下でこれを用いることにより、目的箇所が体深部にあっても穿刺針の刺入点と刺入方向を正確に決定して穿刺できるようにしている。   On the other hand, for example, in Japanese Patent Laid-Open No. 8-238248, there is provided a projector and a support for positioning, and the puncture needle is inserted and inserted by supporting the guide tube in the direction of the target location on the body surface side. An instrument for determining the angle has been proposed. By using this device under the CT guide, the insertion point and insertion direction of the puncture needle can be accurately determined and punctured even if the target location is deep in the body. ing.

しかし、このようにして最初の刺入位置・角度が正確に決まっても、上腹部や胸部の病変では、息止めが可能な患者でも、息止めのタイミングのわずかな差で目的箇所は移動し、また穿刺針は体内組織の抵抗により比較的容易に曲がって最初の刺入方向からずれることが多々あり、特に、カット面が傾斜しているベベルタイプのものはベベル面の向きの逆側に針が曲がりやすいため、体深部にある目的箇所に真っ直ぐ到達させるのが困難である。また、目的箇所への刺入ルートの途中に他の臓器や血管などの危険部位がある場合には、目的箇所に安全に到達できないのは従来と同様である。   However, even if the first insertion position and angle are determined accurately in this way, the target site moves with a slight difference in the timing of breath-holding even if the patient can hold his / her breath due to lesions in the upper abdomen or chest. In addition, the puncture needle often bends relatively easily due to the resistance of the body tissue and deviates from the initial insertion direction. Especially, the bevel type with the inclined cut surface is on the opposite side of the direction of the bevel surface. Since the needle is easy to bend, it is difficult to reach the target location in the deep part of the body. Further, when there is a dangerous part such as another organ or blood vessel in the middle of the insertion route to the target place, it is the same as in the past that the target place cannot be safely reached.

このように穿刺針の刺入に際し困難やリスクを伴うケースでは、細い穿刺針の方が複数回抜き差し動作を行っても患者への侵襲が小さく、また他の臓器等に誤って刺入した場合でも危険性が小さい点で有利とも言える。ところが、細い針では体内でさらに曲がりやすくなるため、針先の正確なコントロールが一層困難になってしまう。従って、比較的細い針を用いて体内で刺入方向を自在にコントロールすることができれば、先に体内目的箇所まで刺入して挿入ルートを確保しておくことにより、所定の機能を発揮する穿刺針を正確且つ安全に目標箇所まで到達させることが可能になるため、極めて有用なものとなる。   In cases where there is difficulty or risk when inserting a puncture needle in this way, when the thin puncture needle is inserted and removed multiple times, the patient is less invasive and accidentally inserted into other organs, etc. However, it can be said that it is advantageous in terms of low risk. However, since a thin needle is more easily bent in the body, accurate control of the needle tip becomes more difficult. Therefore, if the insertion direction can be freely controlled in the body using a relatively thin needle, a puncture that performs a predetermined function can be performed by first inserting the body into a target location and securing an insertion route. Since the needle can reach the target position accurately and safely, it is extremely useful.

一方、上述した治療法の他に、体内の病変に対し体外から生検針をガイド筒とともに刺入して経皮的に組織を採取する処置や、先に穿刺針で挿入ルートを確保してから体内目的箇所までカテーテルを挿入してドレナージや薬剤の連続注入を行う処置も普及しており、このような場合もこれらの管体を体内目的箇所に刺入または挿入して配置する際には、上述した問題が同様に生じることになる。   On the other hand, in addition to the above-described treatment methods, a treatment for collecting tissue percutaneously by inserting a biopsy needle with a guide tube from outside the body to a lesion in the body, or first securing an insertion route with a puncture needle Procedures for inserting a catheter to a target site in the body and continuously injecting drainage and drugs are also popular, and even in such cases, when these tubes are inserted or inserted into the target site in the body, The problem described above will occur as well.

特開平8−238248号公報JP-A-8-238248

本発明は、上記のような問題を解決しようとするものであり、管体を体内目的箇所に配置して実施する処置について、あらゆる状況においても管体を正確且つ安全に挿入可能とし、患者への侵襲を過大にすることなく処置を実施できるようにすることを課題とする。   The present invention is intended to solve the above-described problems, and it is possible to insert a tubular body accurately and safely in any situation for a treatment performed by placing the tubular body at a target position in the body, and to a patient. It is an object of the present invention to make it possible to carry out a treatment without excessively invading the body.

そこで、本発明は、所定の機能を有する管体を経皮的に体内の目的箇所に配置するためのガイド針であって、その管体に挿入可能な太さで大部分が直線状に形成された線状金属からなる本体の先端側に1つのベベル面を形成した針先部を備えているとともに、この針先部に近接した本体先端側の所定範囲が他の部分よりもベベル面の向きの逆側に湾曲しやすい易湾曲部とされ、且つ本体基端側にベベル面の向き又はその逆の向きを術者に認識させるための方向指示部を備えており、体内に刺入することでベベル面の延長方向に針先の進行が案内されながら主として易湾曲部を湾曲させてベベル面の向きの逆側に刺入方向を曲げるものとされ、所定の画像ガイド下で術者が本体を軸周りに回動させて刺入方向を所望の向きにコントロールしながら針先を進めて目的箇所又は目的箇所手前に到達させた後、本体を挿通した管体を本体に沿って体内に挿入することにより、管体先端を目的箇所までガイドすることを特徴とするものとした。   Accordingly, the present invention is a guide needle for transcutaneously placing a tube having a predetermined function at a target location in the body, and is formed in a straight line with a thickness that can be inserted into the tube. A needle tip portion having one bevel surface formed on the distal end side of the main body made of a linear metal, and a predetermined range on the distal end side of the main body in the vicinity of the needle tip portion is more on the bevel surface than the other portions. It is an easy-bending part that is easy to bend on the opposite side of the direction, and is provided with a direction indicating part on the base end side of the main body for recognizing the direction of the bevel surface or the opposite direction, and is inserted into the body. Thus, while the advance of the needle tip is guided in the extension direction of the bevel surface, the bendable direction is mainly bent so that the insertion direction is bent to the opposite side of the bevel surface direction. Rotate the body around the axis to control the insertion direction to the desired direction After the needle tip is advanced to reach the target location or near the target location, the tube body inserted through the main body is inserted into the body along the main body to guide the tip of the tube to the target location It was.

このように、所定の管体を体内の目的箇所までガイドするためのガイド針を、針先をベベル面にして針先に近接した所定範囲をベベル面の向きとは逆側に湾曲しやすい構造としながら、基端側にベベル面の向き又はその逆方向を認識させる構造を設けたことにより、術者が刺入方向の曲がる側を認識しつつ途中で抜き差し動作をしなくても刺入方向を変更できることに加え、危険な箇所を迂回して針先を進めることも可能になって、患者への侵襲とリスクを最小限にして体内目的箇所に正確に到達できるものとなる。   In this way, a guide needle for guiding a predetermined tube body to a target location in the body is easily bent to a side opposite to the direction of the bevel surface, with the needle tip being a bevel surface and a predetermined range close to the needle tip. However, by providing a structure for recognizing the direction of the bevel surface or the opposite direction on the proximal end side, the insertion direction can be realized even if the surgeon recognizes the bending side of the insertion direction and does not perform insertion / removal operation on the way In addition to being able to change, it is also possible to advance the needle tip by bypassing the dangerous place, and it is possible to reach the in-vivo target place accurately with minimal invasion and risk to the patient.

また、その易湾曲部は、ベベル面の向きに一致する方向の幅がベベル面の向きに対し直角方向の幅よりも短く形成されてなることを特徴としたものとすれば、ベベル面の向きに一致する方向の可撓性がベベル面の向きに対し直角方向の可撓性よりも大きなものとなり、その方向に曲がりやすいものとなる。   In addition, the easy-bending portion is formed so that the width in the direction corresponding to the direction of the bevel surface is shorter than the width in the direction perpendicular to the direction of the bevel surface. Is greater than the flexibility in the direction perpendicular to the direction of the bevel surface, and is likely to bend in that direction.

この場合、本体の中心軸線に対し直角な面による断面形状は易湾曲部及び針先部を除いて円形であり、易湾曲部の断面形状が円形からベベル面側の所定範囲を削ってなる略半円形であることを特徴としたものとすれば、湾曲により最も延伸されるベベル面側が削られていることにより、ベベル面の向きの逆側に一層湾曲しやすいものとなる。   In this case, the cross-sectional shape of the surface perpendicular to the central axis of the main body is circular except for the bendable portion and the needle tip portion, and the cross-sectional shape of the bendable portion is an approximate shape formed by cutting a predetermined range on the bevel surface side from the circle. If it is characterized by being semi-circular, the bevel surface side that is most extended by bending is cut away, so that it becomes easier to bend to the opposite side of the direction of the bevel surface.

さらに、上述した管体用ガイド針において、その方向指示部は、直線状の線状金属部材からなる本体の基端側所定範囲を、ベベル面の向きとは逆側又はベベル面の向き側に屈曲してなることを特徴としたものとすれば、その屈曲された端部側の向きによりベベル面の向き又は刺入方向の曲がる側を術者が認識しやすいものとなる。   Further, in the tube guide needle described above, the direction indicating portion has a predetermined range on the proximal end side of the main body made of a linear metal member on the opposite side of the bevel surface or the direction of the bevel surface. If it is characterized by being bent, the operator can easily recognize the direction of the beveled surface or the side of bending in the insertion direction depending on the direction of the bent end.

さらにまた、上述した管体用ガイド針において、その本体の基端側には、本体よりも大径で円柱状の部材からなるハブが、その中心軸線を通る挿通孔に本体を挿通した状態で、少なくとも軸周り方向回動不能に本体に固定されており、刺入操作時の把持部として用いられるとともに、本体を軸周り方向に回動させる際の摘みとして用いられることを特徴としたものとすれば、術者によるガイド針の操作が容易なものとなる。   Further, in the tube guide needle described above, on the proximal end side of the main body, a hub made of a cylindrical member having a diameter larger than that of the main body is inserted through the insertion hole passing through the central axis. And is fixed to the main body at least so as not to rotate around the axis, and is used as a gripping part at the time of insertion operation, and as a knob when rotating the main body in the direction around the axis. Then, the operator can easily operate the guide needle.

加えて、上述した管体用ガイド針において、その本体には、先端からの距離が挿通する管体の全長に一致する位置に、管体の挿入深さの基準として用いるための目印が表示されていることを特徴としたものとすれば、管体の先端を正確な位置に置きやすいものとなる。   In addition, in the guide needle for a tubular body described above, a mark for use as a reference for the insertion depth of the tubular body is displayed on the main body at a position where the distance from the tip coincides with the entire length of the tubular body to be inserted. If it is characterized by being, it will become easy to place the front-end | tip of a tubular body in an exact position.

また加えて、上述した管体用ガイド針において、その管体は所定の液体を注入するための注入針又は生検針用のガイド筒又は電極針用のガイド筒であることを特徴としたものとすれば、正確且つ安全な挿入操作の確保が極めて有用なものとなり、或いは、上述した管体用ガイド針において、その管体は所定の液体を注入するための注入用カテーテル又は体内腔に溜まった液体を排出するためのドレーン用カテーテルであることを特徴としたものとしても、同様に極めて有用なものとなる。   In addition, the tube guide needle described above is characterized in that the tube is an injection needle for injecting a predetermined liquid, a guide tube for a biopsy needle, or a guide tube for an electrode needle. As a result, it is extremely useful to ensure an accurate and safe insertion operation, or in the above-described guide needle for a tubular body, the tubular body is accumulated in an infusion catheter or body lumen for injecting a predetermined liquid. Even if it is a drain catheter for discharging liquid, it is extremely useful as well.

ガイド針先端にベベル面を有するとともにベベル面の向きの逆側に湾曲しやすい構造及び湾曲方向を認識させる構造を設けた本発明によると、術者が刺入方向を容易にコントロールできるようになり、あらゆる状況においても管体を正確且つ安全に挿入可能とし、患者への侵襲を過大にすることなく処置を実施できるものである。   According to the present invention, which has a bevel surface at the tip of the guide needle and is provided with a structure that easily bends in the opposite direction of the bevel surface and a structure that recognizes the bending direction, the operator can easily control the insertion direction. In any situation, the tube body can be inserted accurately and safely, and the treatment can be performed without excessively invading the patient.

本実施の形態の管体用ガイド針の正面図。The front view of the guide needle for pipes of this Embodiment. (A)は図1の管体用ガイド針の先端側部分を拡大した部分正面図、(B)は(A)のX−X線に沿う拡大した断面図。(A) is the fragmentary front view which expanded the front end side part of the guide needle for tubes of FIG. 1, (B) is expanded sectional drawing which follows the XX line of (A). (A)は図1の管体用ガイド針のハブの構造の詳細を示す部分正面図、(B)は図1の管体用ガイド針を穿刺針に挿通した状態を示す部分正面図。(A) is the partial front view which shows the detail of the structure of the hub of the guide needle for tubes of FIG. 1, (B) is the partial front view which shows the state which penetrated the guide needle for tubes of FIG. 1 to the puncture needle. (A),(B),(C)は、図1の管体用ガイド針の使用手順を説明するための部分正面図(身体部分は縦断面図)。(A), (B), (C) is a partial front view for demonstrating the use procedure of the guide needle for pipes of FIG. 1 (a body part is a longitudinal cross-sectional view). (A),(B),(C)は、図4に引き続いて図1の管体用ガイド針の使用手順を説明するための部分正面図(身体部分は縦断面図)。(A), (B), (C) is the partial front view for demonstrating the use procedure of the guide needle for pipes of FIG. 1 following FIG. 4 (a body part is a longitudinal cross-sectional view). (A),(B)は、図1の管体用ガイド針を用いて1の刺入点で複数の病変を処置する場合の使用手順を説明するための部分正面図(身体部分は縦断面図)。(A), (B) is the partial front view for demonstrating the use procedure in the case of treating several lesions at one penetration point using the guide needle for pipes of Drawing 1 (a body part is a longitudinal section) Figure). (A)は管体が生検針のガイド筒である場合の正面図(身体部分は縦断面図)、(B)は管体がカテーテルである場合の正面図(身体部分は縦断面図)、(C)は最初に挿入する管体が穿刺針でありガイドワイヤを介し最終的に挿入する管体がカテーテルである場合の正面図(身体部分は縦断面図)。(A) is a front view when the tube is a guide tube of a biopsy needle (a body part is a longitudinal sectional view), (B) is a front view when a tube is a catheter (a body part is a longitudinal sectional view), (C) is a front view when the tube body to be inserted first is a puncture needle and the tube body to be finally inserted through the guide wire is a catheter (the body part is a longitudinal sectional view).

以下に、図面を参照しながら本発明を実施するための形態を説明する。   Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings.

図1は、本実施の形態である管体用のガイド針2の構成を示すものであり、このガイド針2は、体内に存在する病変等の目的箇所に、穿刺針、ガイド筒、カテーテルなどの管体を経皮的に配置して処置を行う際のガイドとして用いられ、ステンレス鋼線等の硬質で所定レベル以上の弾性変形能を備えた線状金属からなり大部分が直線状に形成された本体20の基端側に、これよりも大径で円柱状の部材で術者が操作時に把持する部分となるハブ25が同軸的に固定されてなるものである。   FIG. 1 shows a structure of a guide needle 2 for a tubular body according to the present embodiment. This guide needle 2 is placed at a target location such as a lesion existing in the body, such as a puncture needle, a guide tube, a catheter, and the like. It is used as a guide when performing treatment by placing the tube body percutaneously, and is mostly made of a linear metal that is hard and has a predetermined level or more of elastic deformability, such as stainless steel wire. On the base end side of the main body 20, a hub 25 that is a part having a larger diameter and a columnar shape that is gripped by the operator during operation is coaxially fixed.

その本体20は、図面では視認性の都合により実際より太めに描いてあるが、その径が0.35mm〜0.55mmの太さ(さらに好ましくは0.45mm前後)であることが、刺入時の患者への侵襲の小ささと画像上の視認性とのバランス、及び使用する管体に挿通可能な太さの観点から好適であり、その長さは25cm〜35cmであることが、使用する管体の長さと操作性のバランスの観点から好適である。   The main body 20 is drawn thicker than the actual size for the sake of visibility in the drawing, but the diameter is 0.35 mm to 0.55 mm (more preferably around 0.45 mm). It is suitable from the viewpoint of the balance between the small invasion to the patient and the visibility on the image, and the thickness that can be inserted into the tube to be used, and the length is 25 cm to 35 cm. From the viewpoint of the balance between the length of the pipe body to be operated and the operability.

また、この本体20は、その中心軸線に対し直角方向の面による断面形状が基本的に円形とされて、その先端側に中心軸線に対し傾斜した1つのベベル面22aを形成してなる針先部22を備えているが、全体としてある程度の可撓性を有しているとともに先端側を固定した状態で基端側のハブ25を術者が指で摘んで軸周りに捩った場合に殆どトルク変形しないトルク強度を有していることが好ましい。   The main body 20 has a needle tip formed by forming a single bevel surface 22a inclined with respect to the central axis on the tip side thereof, with the cross-sectional shape of a surface perpendicular to the central axis being basically circular. When the operator grasps the hub 25 on the proximal end side with a finger and twists it around the axis with the distal end side fixed, with a portion 22 provided. It is preferable to have a torque strength that hardly deforms the torque.

そして、この本体20先端側の針先部22に近接した位置、好ましくは針先部22に隣接した位置から、基端方向に15mm〜30mmの範囲で、本体20の他の部分よりもベベル面22aの向きの逆側に湾曲しやすい構造による易湾曲部23が形成されており、この点が本発明における第1の特徴部分となっている。   Then, a position closer to the needle tip portion 22 on the distal end side of the main body 20, preferably a position adjacent to the needle tip portion 22, in a range of 15 mm to 30 mm in the proximal direction, is more beveled than other portions of the main body 20. An easily bendable portion 23 having a structure that is easily bent is formed on the opposite side of the direction of 22a, and this is the first characteristic portion in the present invention.

さらに、この本体20は、易湾曲部23から続いて基端側まで断面円形の均一な状態で直線的に延びた部分からなる直線部21となっており、この直線部21の末端側、即ち本体20の基端側の所定範囲がベベル面22aの向きの逆側に屈曲されて、ベベル面22aにより刺入方向が曲がる側を術者に認識させるための方向指示部24が形成されており、この点が本発明における第2の特徴部分となっている。尚、この方向指示部24は、屈曲角度が90°前後で長さが1.5cm〜3cmであることが操作の邪魔にならずに方向を認識しやすい点で好適であり、また、その屈曲方向はベベル面22a側であっても良い。   Further, the main body 20 is a straight portion 21 composed of a portion extending linearly in a uniform state with a circular cross section from the easily bendable portion 23 to the base end side. A predetermined range on the base end side of the main body 20 is bent to the opposite side of the direction of the bevel surface 22a, and a direction indicating portion 24 for allowing the operator to recognize the side where the insertion direction is bent by the bevel surface 22a is formed. This is the second feature of the present invention. In addition, it is preferable that the direction indicating unit 24 has a bending angle of about 90 ° and a length of 1.5 cm to 3 cm in that the direction can be easily recognized without interfering with the operation. The direction may be on the bevel surface 22a side.

加えて、本体20の基端側には、これとは別部材の円柱状のハブ(針基)25が同軸的に固定されている。このハブ25は、その中心軸線を貫通した挿通孔を本体20が挿通した状態で、軸周り方向に回動不能且つ長手方向に摺動不能に固定されており、術者がガイド針2を刺入操作する際の把持部として用いられるとともに、術者が刺入方向を変えるために本体20を軸周りに回動させる際の摘み部としても用いられる。   In addition, a cylindrical hub (needle base) 25, which is a separate member, is coaxially fixed to the base end side of the main body 20. The hub 25 is fixed so that it cannot rotate in the direction around the axis and cannot slide in the longitudinal direction in a state where the main body 20 is inserted through the insertion hole penetrating the central axis, and the operator inserts the guide needle 2 into the hub 25. In addition to being used as a grip portion when performing an insertion operation, it is also used as a knob portion when the operator rotates the main body 20 around an axis in order to change the insertion direction.

図2は、本体20先端側部分の構成の詳細を示すものであり、図2(A)に示すように、針先部22は本体20の中心軸線に対し傾斜した面でカットして形成されたベベル面22aを有している。また、これに続く易湾曲部23は、図2(A)のX―X線に沿う断面図を拡大した図2(B)に示すように、断面円形の線状金属からなる本体20の針先部22に近接した所定範囲が、ベベル面22a側から所定範囲削られたことで平坦な切削面23aを形成して断面略半円形とされてなるものである。   FIG. 2 shows the details of the configuration of the front end side portion of the main body 20, and as shown in FIG. 2A, the needle tip portion 22 is formed by cutting on a surface inclined with respect to the central axis of the main body 20. And a bevel surface 22a. Further, the following easily curved portion 23 is a needle of the main body 20 made of a linear metal having a circular cross section, as shown in FIG. 2B, which is an enlarged cross sectional view taken along the line XX of FIG. A predetermined range close to the tip portion 22 is cut from the bevel surface 22a side by a predetermined range, thereby forming a flat cutting surface 23a and having a substantially semicircular cross section.

即ち、易湾曲部23は、例えば本体20の径が0.45mmの場合に、ベベル面22aの向きに一致する方向の幅を0.25mm程度にして、ベベル面22aの向きに対し直角方向の幅(0.45mm)よりも顕著に短くなるようにしたものである。これにより、ベベル面22aの向きに一致する方向の可撓性がベベル面22aの向きに対し直角方向の可撓性よりも大きくなって湾曲しやすくなるが、ベベル面22aの向きに対し直角方向には湾曲しにくいままとなる。また、湾曲に伴い最も延伸される側が削られたことにより、ベベル面22aの向きの逆側に一層湾曲しやすくなっている。   That is, when the diameter of the main body 20 is 0.45 mm, for example, the easy-bending portion 23 has a width in a direction corresponding to the direction of the bevel surface 22a of about 0.25 mm and is perpendicular to the direction of the bevel surface 22a. The width is significantly shorter than the width (0.45 mm). As a result, the flexibility in the direction corresponding to the direction of the bevel surface 22a is greater than the flexibility in the direction perpendicular to the direction of the bevel surface 22a, so that the bevel surface 22a is easily bent. It remains difficult to bend. Further, since the most extended side is cut along with the bending, it is easier to bend to the opposite side of the direction of the bevel surface 22a.

図3(A)は、ハブ25の構造の詳細を示すものであり、ハブ25は樹脂素材からなる円柱状の上部251と、これよりも大径の樹脂素材からなる円柱状の下部252の2つの部材で構成され、上部251の下端側にはネジ状部251aが突設されており、このネジ状部251aを下部252上端に開口した図示しないネジ孔に螺入することにより、ネジ状部251aの2つに割れた先端側が閉じてその内周側で本体20を挟み込むようになっており、ネジ状部251aを完全に螺入することで、ハブ25は本体20上で軸方向回動不能かつ長手方向摺動不能な状態でしっかりと固定される。   FIG. 3A shows the details of the structure of the hub 25. The hub 25 is composed of a cylindrical upper portion 251 made of a resin material and a cylindrical lower portion 252 made of a resin material having a larger diameter than this. A screw-like portion 251a protrudes from the lower end side of the upper portion 251. By screwing this screw-like portion 251a into a screw hole (not shown) opened at the upper end of the lower portion 252, the screw-like portion The front end side of the 251a that has been split into two is closed, and the main body 20 is sandwiched between the inner peripheral sides thereof. By completely screwing the screw-shaped portion 251a, the hub 25 rotates in the axial direction on the main body 20. It is firmly fixed in a state incapable of sliding in the longitudinal direction.

一方、図3(B)は、ガイド対象である穿刺針4基端側の連結部41開口端から本体20の先端側を挿入して管状の針部40先端の針先41aから突出させて完全に挿通した状態を示している。このように、ガイド針2の本体20は、その径が穿刺針4の内径よりも僅かに小さくこれにフィットした状態で挿入できるとともに、その全長が穿刺針4の全長よりも長くなっており、図のような状態で体外から体内目的箇所に向かって穿刺するようになっている。   On the other hand, FIG. 3 (B) shows a state in which the distal end side of the main body 20 is inserted from the open end of the connecting portion 41 on the proximal end side of the puncture needle 4 to be guided and protruded from the needle tip 41a at the distal end of the tubular needle portion 40. The state inserted through is shown. Thus, the main body 20 of the guide needle 2 can be inserted in a state in which the diameter thereof is slightly smaller than the inner diameter of the puncture needle 4 and fitted thereto, and the entire length thereof is longer than the entire length of the puncture needle 4. In the state shown in the figure, the puncture is performed from the outside of the body toward the target site in the body.

また、本体20の外周面には、先端からの距離が挿入する管体の全長に一致する位置に、図のように管体の挿入深さの基準として用いるための目印21a(穿刺針4の長さに一致した目印は穿刺針4の中腔に隠れている)を表示しておくことにより、管体の先端を正確な位置に置くことが容易になり、その先端からの距離は、例えば使用頻度の高い穿刺針等の管体の長さに一致するように、例えば15cm、18cm、20cmのように段階的に複数表示しておけばよい。   Further, on the outer peripheral surface of the main body 20, a mark 21 a (a puncture needle 4 of the puncture needle 4) is used at a position where the distance from the distal end coincides with the entire length of the inserted tube as shown in FIG. By displaying a mark corresponding to the length (which is hidden in the lumen of the puncture needle 4), the tip of the tube body can be easily placed at an accurate position. A plurality of displays such as 15 cm, 18 cm, and 20 cm may be displayed step by step so as to match the length of a tube body such as a puncture needle that is frequently used.

次に、図4を参照しながら本実施の形態ガイド針2の使用手順を詳細に説明する。図4(A)に示すように、本実施の形態では使用する管体が穿刺針4の場合であり、ガイド針2を穿刺針4の基端側の連結部41の開口部から挿通して、穿刺針4先端から本体20先端側が所定の長さで突出した状態にして穿刺を開始する。   Next, the procedure for using the guide needle 2 of the present embodiment will be described in detail with reference to FIG. As shown in FIG. 4A, in this embodiment, the tubular body to be used is the puncture needle 4, and the guide needle 2 is inserted through the opening of the connecting portion 41 on the proximal end side of the puncture needle 4. Then, the puncture is started in a state where the distal end side of the main body 20 protrudes from the distal end of the puncture needle 4 with a predetermined length.

この手技は、術者が超音波やX線等よる画像ガイド下にて操作を行うのが通常であるが、本実施の形態では、図のように途中に動脈、神経、臓器のような穿刺したくない危険部位90があるときに、これを迂回するため意図的に病変100に対し最初の刺入方向をずらして行う場合を説明する。尚、危険部位90が存在しなくても目的箇所である病変100に対して穿刺方向がずれてしまった場合に刺入方向を修正するケースでも同様の手順になる。   This technique is usually performed by an operator under image guidance using ultrasound, X-rays, etc., but in this embodiment, puncture such as an artery, nerve, or organ is performed in the middle as shown in the figure. A case will be described in which the first insertion direction is intentionally shifted with respect to the lesion 100 when there is a dangerous portion 90 that is not desired to be circumvented. Note that the same procedure is performed even in the case where the puncture direction is corrected when the puncture direction is deviated with respect to the target lesion 100 even if the dangerous portion 90 does not exist.

ベベル面が形成された針は軸回りに回転させながら刺入することである程度直線的に進めることが可能であるため、図4(A)の位置まで回動させながらほぼ真っ直ぐに刺入する。そして、図4(B)に示すように、術者が指で本体20の基端側のハブ25を軸周りに回動させて方向指示部24が刺入方向を曲げたい側に向くように操作することにより、ベベル面22aの向きは病変100とは逆側に向く。   Since the needle having the beveled surface can be advanced linearly to some extent by being inserted while rotating around the axis, the needle is inserted almost straight while being rotated to the position of FIG. Then, as shown in FIG. 4 (B), the operator rotates the hub 25 on the proximal end side of the main body 20 around the axis with a finger so that the direction indicating section 24 faces the side where the insertion direction is desired to be bent. By the operation, the direction of the bevel surface 22a is directed to the opposite side to the lesion 100.

この状態でガイド針2を押し進めると、図4(C)に示すように傾斜したベベル面22aが体内組織に当接しながら傾斜面の延長線に追従するように針先部22が曲がって進み、主に易湾曲部23を湾曲させながら刺入方向が病変100に向かって危険部位90を迂回しながら針先部22aを進めることができ、易湾曲部23が湾曲した状態で体内組織を通過することで曲がって形成された刺入ルートにより、易湾曲部23から続く直線部21も湾曲させられる。   When the guide needle 2 is pushed forward in this state, as shown in FIG. 4C, the needle tip portion 22 bends and advances so that the inclined bevel surface 22a follows the extension line of the inclined surface while contacting the body tissue, While the bendable portion 23 is mainly bent, the insertion direction can be advanced toward the lesion 100 and the needle tip portion 22a can be advanced while bypassing the dangerous portion 90, and passes through the body tissue with the bendable portion 23 being curved. The straight portion 21 that continues from the easily bendable portion 23 is also bent by the insertion route formed by bending.

図5(A)を参照して、ガイド針2の針先が病変100の手前に到達したら、図5(B)に示すように穿刺針4をガイド針2に沿って進めて先端を病変100に到達させる。この場合、穿刺針4の針部40が18〜20Gの比較的太いものであっても、目標箇所の直前で方向転換する場合を除き、ガイド針2の本体20に沿ってスムースに湾曲した状態で進ませることができる。   Referring to FIG. 5A, when the needle tip of guide needle 2 reaches the front of lesion 100, puncture needle 4 is advanced along guide needle 2 as shown in FIG. To reach. In this case, even if the needle portion 40 of the puncture needle 4 is a comparatively thick one of 18 to 20G, it is smoothly curved along the main body 20 of the guide needle 2 except when the direction is changed immediately before the target location. You can go on.

このようにしてガイド針2の穿刺ルート途中に危険な部位がある場合でも、術者は所定の画像によるガイド下にて途中で何回も抜き差し動作を行うことなく刺入方向を途中で適宜変更しながら、安全且つ確実に体内の目的箇所に到達させることができる。そして、例えばエタノール等の液体を病変に注入する処置では、図5(C)に示すように穿刺針4を留置してガイド針2を抜去し、液体を充填したシリンジ50を穿刺針4の連結部41に連結することにより、病変100に対し液体を注入することができる。   In this way, even if there is a dangerous part in the puncture route of the guide needle 2, the operator appropriately changes the puncture direction in the middle without performing the insertion / removal operation several times under the guide by the predetermined image. However, it is possible to reach the target location in the body safely and reliably. For example, in the treatment of injecting a liquid such as ethanol into the lesion, the puncture needle 4 is placed and the guide needle 2 is removed as shown in FIG. 5C, and the syringe 50 filled with the liquid is connected to the puncture needle 4. By connecting to the part 41, the liquid can be injected into the lesion 100.

図6は、図1のガイド針2を用いて複数の病変に対し1の刺入点で各々処置を行う場合を示しており、図6(A)に示すように、体内で比較的近接した位置に複数の病変101,102があるとき、所定の画像ガイド下にてガイド針2をその中間点に向かう位置・方向にて穿刺し、穿刺針4の先端を病変101,102の深さの中間位置あたりで止め、方向指示部24を最初の病変101に向けた状態にして針先部22が病変101の手前に達するまで進める。   FIG. 6 shows a case where a plurality of lesions are each treated at one insertion point using the guide needle 2 of FIG. 1, and relatively close to each other in the body as shown in FIG. 6 (A). When there are a plurality of lesions 101 and 102 at a position, the guide needle 2 is punctured at a position and direction toward the intermediate point under a predetermined image guide, and the tip of the puncture needle 4 is set to the depth of the lesions 101 and 102. Stopping at an intermediate position, the direction indicating unit 24 is directed toward the first lesion 101, and the needle tip unit 22 is advanced until reaching the front of the lesion 101.

針先が病変100に向いてからは本体20を軸周りに回動させることでその先の部分を真っ直ぐに進めることができる。そして、図示は省略するが、ガイド針2の本体20に沿って穿刺針4を進めて病変101まで到達させ、上述と同様にガイド針2を抜去して液体注入等の所定の処置を行う。   After the needle tip is directed toward the lesion 100, the tip of the needle 20 can be moved straight by rotating the main body 20 around the axis. And although illustration is abbreviate | omitted, the puncture needle 4 is advanced along the main body 20 of the guide needle 2 to reach the lesion 101, and the guide needle 2 is removed in the same manner as described above to perform a predetermined treatment such as liquid injection.

次に、穿刺針4の先端を病変101,102の深さの中間位置あたり(分岐点の手前)の位置になるまで引き戻し、図6(B)に示すようにガイド針2を穿刺針4の基端側から再度挿入して針先部22が穿刺針4の先端から突出したら、方向指示部24を次の病変102に向けた状態にして進めることで刺入ルートを分岐させ、針先が病変102手前に達するまで進めてから前述と同様の操作を行う。このようにすることで、1の刺入点にて比較的近接した複数箇所の病変に対し各々処置を行えることから、患者への侵襲は最小限に抑えられる。   Next, the tip of the puncture needle 4 is pulled back to a position around the intermediate position of the depth of the lesions 101 and 102 (before the branch point), and the guide needle 2 is moved to the puncture needle 4 as shown in FIG. When the needle tip portion 22 protrudes from the distal end of the puncture needle 4 by re-inserting from the proximal end side, the direction indication portion 24 is advanced toward the next lesion 102 to branch the insertion route, and the needle tip is After proceeding until the lesion reaches 102, the same operation as described above is performed. By doing so, since it is possible to treat each of a plurality of lesions relatively close to each other at one insertion point, the invasion to the patient can be minimized.

図7(A)は、ガイド筒5を前述の穿刺針4と同様にガイド針2を用いて病変103までガイドし、このガイド筒5を介して生検針51を病変103に挿入して組織を採取する場合を示しており、図7(B)はガイド針2で短尺のカテーテル52を体内の膿瘍腔104までガイドして配置し、連結部52aに連結した他の管体55を介して膿瘍のドレーンを行う場合を示している。また、図7(C)はガイド針2を用いて配置した穿刺針4に、先にガイドワイヤ54を挿通して先端を膿瘍腔104に置き、次に穿刺針4を抜去しガイドワイヤ54に沿ってカテーテル53を挿入して膿瘍のドレーンを行う場合を示している。   In FIG. 7A, the guide tube 5 is guided to the lesion 103 using the guide needle 2 in the same manner as the puncture needle 4 described above, and the biopsy needle 51 is inserted into the lesion 103 via the guide tube 5 so as to remove the tissue. FIG. 7B shows a case where a short catheter 52 is guided to the abscess cavity 104 in the body with the guide needle 2 and is disposed through another tube 55 connected to the connecting portion 52a. This shows the case of performing draining. 7C, the guide wire 54 is first inserted into the puncture needle 4 arranged using the guide needle 2 and the tip is placed in the abscess cavity 104. Next, the puncture needle 4 is removed and the guide wire 54 is removed. A case where the catheter 53 is inserted along the drainage of the abscess is shown.

このように、本実施の形態のガイド針2は、様々な処置において使用される管体を正確且つ安全に体内目的箇所までガイドして経皮的に配置させ、患者への侵襲を最小限に抑えながら処置を実施することを可能にする。また、目的箇所が体内の近接位置に複数ある場合には、前述と同様に1の刺入点で総ての目的箇所に対し処置を行うことができる。   As described above, the guide needle 2 according to the present embodiment guides a tube used in various treatments to a target position in the body accurately and safely and arranges it percutaneously to minimize the invasion to the patient. It is possible to carry out treatment while suppressing. In addition, when there are a plurality of target locations at close positions in the body, it is possible to treat all target locations at one insertion point as described above.

以下に、図1に示した管体用のガイド針を実際に作成して、超音波ガイド下にて穿刺針を目的箇所までガイドした実施例1、及び実際の経皮的エタノール注入療法に使用した実施例2について説明する。   In the following, the guide needle for the tubular body shown in FIG. 1 was actually created, and the puncture needle was guided to the target location under the ultrasound guide, and used for actual percutaneous ethanol injection therapy. Example 2 will be described.

(実施条件)
ガイド針:先端ベベル状のステンレス製ガイド針で長さ30cm、径0.45mmとし、易湾曲部を針先部に隣接した20mmの範囲(ベベル面方向から切削して0.25mmの断面略半円状に形成)とし、方向指示部をベベル面とは逆側に3cmの長さで直角に屈曲させて形成したものとした(ハブは樹脂成型品)。
穿刺針:上記ガイド針を挿通可能な内径を有したステンレス製の22ゲージで長さが20cmの市販品を用いた。
実施対象:生食に浸した新鮮な牛の肝臓の下に直径5mmの粘土ボールを2cm間隔で4個配置した(超音波イメージ面に平行、肝臓の表面から2〜8cm)。
(Implementation conditions)
Guide needle: A tip bevel-shaped stainless steel guide needle having a length of 30 cm and a diameter of 0.45 mm, and an easily curved portion in the range of 20 mm adjacent to the needle tip (cut from the bevel surface direction, approximately 0.25 mm in cross section) The direction indicating portion was formed by bending the direction indicating portion at a right angle with a length of 3 cm on the side opposite to the bevel surface (the hub is a resin molded product).
Puncture needle: A commercially available 22 gauge stainless steel gauge having an inner diameter through which the guide needle can be inserted was used.
Implementation target: Four clay balls having a diameter of 5 mm were arranged at intervals of 2 cm under the liver of a fresh cow soaked in raw food (parallel to the ultrasonic image plane, 2 to 8 cm from the surface of the liver).

(実施方法)
最初に超音波ガイド下でガイド針を回転させずに牛の肝臓に対し3cm又は8cm進めて湾曲させながら穿刺を行い、湾曲したガイド針に沿って穿刺針を進めることができるか否かを試した。次に、3人の異なる術者が1の刺入点にてボールを1,2,3,4の順に穿刺を行った(3人ともエタノール注入療法に精通しているが管体用のガイド針を使うトレーニングは行っていない)。この試験は、各術者が互いに肝臓の異なる場所で実施した。
(Implementation method)
At first, puncture is performed while advancing and curving the liver of the cow 3 cm or 8 cm without rotating the guide needle under an ultrasonic guide, and test whether the puncture needle can be advanced along the curved guide needle It was. Next, three different surgeons punctured the balls in the order of 1, 2, 3 and 4 at one insertion point (all three are familiar with ethanol injection therapy but are guides for the tube) I don't do training with a needle). This test was performed by each operator at a different location in the liver.

(結果)
ガイド針の先端は超音波ガイド下で充分に確認することができ、エコーで針先が迷うこともなかった。22ゲージの穿刺針は湾曲したガイド針に沿って容易に追従し、3cm,8cmの深さでも追従した。また、術者がガイド針を進めると同時に軸周りに回動させることで直進させることもできた。さらに、ベベル面の向きを変えることにより刺入方向を容易に変えることができ、ベベル面の向きに沿った方向以外には有意に曲がることはなかった。尚、4つのボールはガイド針を3〜4cm引いて進めることにより、連続的に穿刺することができた。このとき、ガイド針を何度か引いたり進めたりする動作は必要であったが、引く距離は2cm程度で済んだ。
(result)
The tip of the guide needle could be fully confirmed under an ultrasonic guide, and the needle tip was not lost by echo. The 22 gauge puncture needle followed easily along the curved guide needle and followed even 3 and 8 cm deep. In addition, the surgeon can advance the guide needle and simultaneously move it straight by turning it around the axis. Further, the direction of insertion can be easily changed by changing the direction of the bevel surface, and there was no significant bending except in the direction along the direction of the bevel surface. The four balls could be punctured continuously by pulling the guide needle 3-4 cm and proceeding. At this time, it was necessary to pull or advance the guide needle several times, but the pulling distance was about 2 cm.

(実施条件)ガイド針及び穿刺針は実施例1と同様。実施対象は肝臓に複数の腫瘍のある4人の患者(うち3人は肝硬変)。
(実施方法)肝臓の複数の腫瘍に対し超音波ガイド下にて経皮的エタノール注入療法を実施し、可能な限り1つの刺入点で複数の腫瘍に連続的に注入した。
(Implementation conditions) The guide needle and the puncture needle are the same as in Example 1. The subjects were 4 patients with multiple tumors in the liver (3 of whom had cirrhosis).
(Execution method) A plurality of tumors in the liver were subjected to percutaneous ethanol injection therapy under an ultrasonic guide, and continuously injected into a plurality of tumors at one insertion point as much as possible.

(結果)
この4人の患者おいても、比較的容易に刺入方向を途中で調節することができ、1の刺入点で複数の腫瘍に処置を行うことができ、実施例1とほぼ同様の操作性が確認できた。
(result)
In these four patients, the direction of insertion can be adjusted relatively easily, and a plurality of tumors can be treated at one insertion point. The sex was confirmed.

経皮的エタノール注入療法は、3cm以下3個以内の肝腫瘍に対して有用であることが確立された治療法であるが、追加する部分にエタノールを注入する必要があり、またアクシデンタルに穿刺針の方向が変位して病変を穿刺できなくなることも多々あるため、通常は多数回の穿刺が必要になる。一方、細い穿刺針は肝臓のダメージやエタノールの逆流・漏れを最小限に抑えられる点で優れているが、細ければ細い程、体内で曲がりやすくなって正確な穿刺が困難になり、深い病変に到達しにくくなる点が問題である。   Percutaneous ethanol injection therapy is an established treatment that is useful for liver tumors of 3 cm or less and 3 or less, but it is necessary to inject ethanol into the additional part, and the needle is accidentally inserted. In many cases, it is impossible to puncture the lesion due to the displacement of the direction, and usually a large number of punctures are required. On the other hand, thin puncture needles are superior in that they can minimize liver damage and ethanol backflow / leakage, but the thinner the needle, the easier it is to bend in the body, making accurate puncture difficult, and deeper lesions. The problem is that it is difficult to reach the point.

これに対し、本発明による管体用のガイド針を用いたことにより、針先を肝臓内で簡単にコントロールできるようになり、多数の病変に対し正確な穿刺が可能であった。その結果、針先の場所を決める時間を短縮することができ、合併症や患者の苦痛を減らすこともできたと考えられる。また、本実施例の管体用ガイド針は、通常用いる穿刺針と比べて極めて細いことから、肝臓のダメージを最小限に抑えることができた。尚、易湾曲部がベベル面側を削って平坦面を形成したものであるため、ベベル面方向のみのしなやかさが出て傾斜面の延長方向のみに曲がりやすくなったと思われる。   On the other hand, by using the guide needle for a tubular body according to the present invention, the needle tip can be easily controlled in the liver, and accurate puncture can be performed for many lesions. As a result, the time for deciding the location of the needle tip could be shortened, and complications and patient pain could be reduced. In addition, since the guide needle for a tubular body of this example was extremely thin as compared with a normally used puncture needle, damage to the liver could be minimized. In addition, since the bendable part is formed by scraping the bevel surface side to form a flat surface, it seems that the flexibility of only the bevel surface direction comes out and it is easy to bend only in the extending direction of the inclined surface.

本発明の管体用ガイド針を用いたことによる上述した作用・効果は、上述の経皮的エタノール注入療法に限らず、体内の目的箇所に管体を配置して経皮的に処置を行う様々な場合において同様に発揮されるものである。例えば、体内目的箇所にエタノール以外の液体(薬剤、低温の液化ガス、酢酸、熱湯等)を注入して行う治療法の場合や、高周波温熱療法において電極針がある程度細く可撓性があるものでそのガイド筒を目的箇所までガイドする場合、或いは体内所定位置からドレナージを行ったり体内目的箇所に連続的に薬液を注入したりする際にカテーテルを配置する場合にも同様に使用することができ、同様に有用なものとなる。   The actions and effects described above by using the guide needle for a tubular body of the present invention are not limited to the above-described percutaneous ethanol injection therapy, and a treatment is performed percutaneously by placing a tubular body at a target location in the body. It is also demonstrated in various cases. For example, in the case of a treatment method in which a liquid other than ethanol (pharmaceutical, low-temperature liquefied gas, acetic acid, hot water, etc.) is injected into a target site in the body, or the electrode needle is somewhat thin and flexible in high-frequency thermotherapy. When guiding the guide tube to a target location, or when draining from a predetermined position in the body or injecting a medical solution continuously into the target location in the body, it can be used similarly, It will be useful as well.

殊に、病変への刺入ルート途中に他の臓器がある場合や呼吸により病変のある臓器が動きやすい場合、或いは病変の近くに危険な部位があるような場合に、困難なルートや危険なルートを回避しながら針を進めることにより、患者への侵襲とリスクを最小限に抑えながら、効果的に手技を行うことを可能にするものである。   In particular, when there are other organs along the route of insertion into the lesion, or when the organ with the lesion is easily moved by breathing, or when there is a dangerous part near the lesion, it is difficult or dangerous. By advancing the needle while avoiding the route, it is possible to perform the procedure effectively while minimizing patient invasion and risk.

尚、上述した本発明によるガイド針を用いた経皮的エタノール注入療法は、その後数十人の患者に実際に使用しており、いずれも前述と同様の効果を発揮している。また、体内組織の生検にも複数例使用してその有用性が確認されており、殊に、ガイド針の進行経路の途中に太い血管や胆管、胆嚢など、穿刺を避けたい箇所がある場合に、一旦その箇所を迂回しながら目的箇所に到達することを可能とし、また同軸法による生検を実施した場合には外筒による1箇所の穿刺にて、その外筒を通して複数の異なった箇所で採取することを可能としている。   The percutaneous ethanol injection therapy using the guide needle according to the present invention described above is actually used for several tens of patients thereafter, and all of them exhibit the same effects as described above. In addition, its usefulness has been confirmed by using multiple examples of biopsy of body tissues, especially when there are places such as thick blood vessels, bile ducts, gallbladders, etc. that you do not want to puncture in the course of the guide needle In addition, once it is possible to reach the target location while bypassing the location, and when a biopsy is performed by the coaxial method, a single puncture with the outer tube allows a plurality of different locations through the outer tube. It is possible to collect with.

以上、述べたように、管体を体内目的箇所に配置して実施する処置について、本発明により、あらゆる状況においても管体を正確且つ安全に挿入可能とし、患者への侵襲を過大にすることなく処置を実施できるようになった。   As described above, with respect to the treatment to be performed by arranging the tube body at a target position in the body, the present invention makes it possible to insert the tube body accurately and safely in any situation, and excessively invades the patient. It became possible to carry out treatment without any problems.

2 管体用ガイド針、4 穿刺針、5 ガイド筒、20 本体、21 直線部、21a 目印、22 針先部、22a ベベル面、23 易湾曲部、23a 切削面、24 方向指示部、25 ハブ、40 針部、41,52a 連結部、41a 針先、50 シリンジ、51 生検針、52,53 カテーテル、54 ガイドワイヤ、55 管体、90 危険部位、100,101,102,103 病変、104 膿瘍腔、251 上部、251a ネジ状部、252 下部   2 Tube guide needle, 4 Puncture needle, 5 Guide tube, 20 Main body, 21 Straight part, 21a Mark, 22 Needle tip part, 22a Bevel surface, 23 Easy curve part, 23a Cutting surface, 24 Direction indicator, 25 Hub , 40 Needle part, 41, 52a Connection part, 41a Needle tip, 50 Syringe, 51 Biopsy needle, 52, 53 Catheter, 54 Guide wire, 55 Tubular body, 90 Hazardous area, 100, 101, 102, 103 Lesions, 104 Abscess Cavity, 251 upper part, 251a screw-like part, 252 lower part

Claims (8)

所定の機能を有する管体を経皮的に体内の目的箇所に配置するためのガイド針であって、前記管体に挿入可能な太さで大部分が直線状に形成された線状金属からなる本体の先端側に1つのベベル面を形成した針先部を備えているとともに、該針先部に近接した前記本体先端側の所定範囲が他の部分よりも前記ベベル面の向きの逆側に湾曲しやすい易湾曲部とされ、且つ前記本体基端側に前記ベベル面の向き又はその逆の向きを術者に認識させるための方向指示部を備えており、体内に刺入することで前記ベベル面の延長方向に針先の進行が案内されながら主として前記易湾曲部を湾曲させて前記ベベル面の向きの逆側に刺入方向を曲げるものとされ、所定の画像ガイド下で術者が前記本体を軸周りに回動させて刺入方向を所望の向きにコントロールしながら前記針先を進めて前記目的箇所又は前記目的箇所手前に到達させた後、前記本体を挿通した前記管体を前記本体に沿って体内に挿入することにより、前記管体先端を前記目的箇所までガイドする、ことを特徴とした管体用ガイド針。   A guide needle for transcutaneously placing a tube body having a predetermined function at a target location in the body, from a linear metal that has a thickness that can be inserted into the tube body and is mostly linear. A needle tip portion having one bevel surface formed on the distal end side of the main body, and a predetermined range on the distal end side of the main body adjacent to the needle tip portion is opposite to the direction of the bevel surface relative to other portions. And a direction indicating unit for allowing the operator to recognize the direction of the bevel surface or the opposite direction on the base end side of the main body. While the advance of the needle tip is guided in the extension direction of the bevel surface, the easy-bending portion is mainly bent so that the insertion direction is bent to the opposite side of the direction of the bevel surface, and the operator is operated under a predetermined image guide. Rotate the body around the axis to control the insertion direction to the desired direction. The tip of the tube is inserted into the body along the main body after the needle tip is advanced while the needle is advanced to reach the target location or the target location. A guide needle for a tubular body, characterized in that the guide needle is guided to the target location. 前記易湾曲部は、前記ベベル面の向きに一致する方向の幅が前記ベベル面の向きに対し直角方向の幅よりも短く形成されてなる、ことを特徴とする請求項1に記載した管体用ガイド針。   2. The tubular body according to claim 1, wherein the easily curved portion is formed so that a width in a direction corresponding to the direction of the bevel surface is shorter than a width in a direction perpendicular to the direction of the bevel surface. Guide needle. 前記本体の中心軸線に対し直角な面による断面形状は前記易湾曲部及び前記針先部を除いて円形であり、前記易湾曲部の前記断面形状が、前記円形から前記ベベル面側の所定範囲を削ってなる略半円形である、ことを特徴とする請求項2に記載した管体用ガイド針。   The cross-sectional shape of the surface perpendicular to the central axis of the main body is circular except for the bendable portion and the needle tip portion, and the cross-sectional shape of the bendable portion is a predetermined range from the circle to the bevel surface side. The guide needle for a tubular body according to claim 2, wherein the guide needle is a substantially semi-circular shape formed by cutting the surface. 前記方向指示部は、前記本体の基端側所定範囲を前記ベベル面の向きの逆側又は前記ベベル面の向き側に屈曲してなる、ことを特徴とする請求項1,2または3に記載した管体用ガイド針。   The said direction instruction | indication part bends the base end side predetermined range of the said main body to the reverse side of the direction of the said bevel surface, or the direction side of the said bevel surface, The Claim 1, 2, or 3 characterized by the above-mentioned. Guide needle for tubular body. 前記本体の基端側には、該本体よりも大径で円柱状の部材からなるハブがその中心軸線を通る挿通孔に前記本体を挿通した状態で、少なくとも軸周り方向回動不能に前記本体に固定されており、刺入操作時の把持部として用いられるとともに、前記本体を軸周り方向に回動させる際の摘みとして用いられる、ことを特徴とする請求項1,2,3または4に記載した管体用ガイド針。   At the base end side of the main body, a hub made of a cylindrical member having a diameter larger than that of the main body is inserted into the insertion hole passing through the central axis of the main body so that the main body cannot rotate at least around the axis. The first, second, third, or fourth aspect of the present invention is characterized in that it is used as a gripping part at the time of insertion operation and as a knob for rotating the main body in the direction around the axis. The guide needle for tubular bodies described. 前記本体には、先端からの距離が挿通する前記管体の全長に一致する位置に、前記管体の挿入深さの基準として用いるための目印が表示されている、ことを特徴とする請求項1,2,3,4または5に記載した管体用ガイド針。   The mark for use as a reference of the insertion depth of the tubular body is displayed on the main body at a position corresponding to the entire length of the tubular body through which the distance from the tip is inserted. The guide needle for tubular bodies described in 1, 2, 3, 4 or 5. 前記管体は、所定の液体を注入するための注入針又は生検針用のガイド筒又は電極針用のガイド筒である、ことを特徴とする請求項1,2,3,4,5または6に記載した管体用ガイド針。   7. The tube body is an injection needle for injecting a predetermined liquid, a guide tube for a biopsy needle, or a guide tube for an electrode needle. The guide needle for tubular bodies described in 1. 前記管体は、所定の液体を注入するための注入用カテーテル又は体内腔に溜まった液体を排出するためのドレーン用カテーテルである、ことを特徴とする請求項1,2,3,4,5または6に記載した管体用ガイド針。   6. The tube according to claim 1, 2, 3, 4, 5, wherein the tube is an injection catheter for injecting a predetermined liquid or a drain catheter for discharging a liquid accumulated in a body cavity. Or the guide needle for tubular bodies described in 6.
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CN114366996A (en) * 2021-12-21 2022-04-19 深圳市业聚实业有限公司 Guide wire needle and microcatheter system

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