JP5450359B2 - Biopsy equipment - Google Patents

Description

  The present invention relates to a biopsy device used for collecting a part of a living tissue such as a liver and a kidney.

  Conventionally, this type of biopsy device includes an inner needle having a notch on the outer peripheral surface on the distal end side, a hollow outer needle in which the inner needle is coaxially inserted, and an outer needle biased in the distal direction. There is known a device including a coiled spring (see, for example, Patent Document 1).

  In this biopsy device, the inner needle is arranged to pass through the device main body in the front-rear direction, and the inner needle moves in the front-rear direction with respect to the device main body by operating a plunger attached to the rear end of the inner needle. It is supposed to be. In addition, an outer needle holder for holding the rear end of the outer needle is provided in the apparatus main body so as to be movable in the front-rear direction. When the plunger is pulled rearward, the outer needle holder is locked to the plunger and is moved backward in the apparatus main body. The spring is compressed by the outer needle holder that moves and moves backward, and when the outer needle holder moves to a predetermined position, the outer needle holder is locked. In this case, the inner needle and the outer needle are disposed inside the spring so as to be coaxial with the central axis of the spring.

  When a living tissue is collected using the biopsy device, first, the inner needle and the outer needle are punctured to a target position in the living body, and then the inner needle is protruded from the tip of the outer needle by a plunger to Insert into. Next, when the plunger is further moved forward, the lock of the outer needle holder is released, and the outer needle holder is vigorously moved to the distal end side of the inner needle by the restoring force of the spring. Thereby, a part of the tissue is taken into the cutout portion of the inner needle while the tissue is torn with the needle tip of the outer needle. Thereafter, the inner needle and the outer needle are pulled out from the living body, the plunger is pulled backward again to lock the outer needle holder, and then the inner needle is moved forward, whereby the tissue in the notch is collected.

JP 2002-360694 A

  By the way, in the said biopsy apparatus, since the outer needle is arrange | positioned coaxially with the center axis | shaft of a spring, the space which accommodates a spring is restrict | limited only to the back of an outer needle holder. For this reason, since the length of the spring is shortened and the amount of compression is insufficient, it is necessary to use a spring having a strong elastic force in order to obtain a sufficient restoring force of the spring.

  However, if a spring having a strong elastic force is used, the spring is easily deformed in the lateral direction when the spring is compressed, and when the outer needle holder is unlocked if the spring is compressed in the laterally deformed state. In this case, the spring cannot be restored smoothly, and the speed of the outer needle is lowered, so that it is not possible to sufficiently obtain the needle input of the outer needle by the spring. As a result, there is a problem that the tissue cannot be reliably cut with the outer needle, and the tissue is not taken into the notch portion of the inner needle.

  The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide a biopsy device capable of reliably obtaining a needle input of an outer needle by ensuring a sufficient amount of compression of a spring. It is to provide.

  In order to achieve the above object, the present invention provides an inner needle having a notch on the outer peripheral surface on the distal end side, a hollow outer needle in which the inner needle is movably inserted coaxially, and an outer needle in the distal direction. A coiled spring that urges the inner needle to protrude from the tip of the outer needle and insert it into the tissue of the living body, and then the outer needle is moved toward the tip of the inner needle by the restoring force of the spring. In a biopsy device for moving and collecting a part of tissue in a cutout portion of an inner needle, the biopsy device includes a slider that holds the proximal end side of the outer needle and is movable in the front-rear direction on the main body base The slider is provided with a spring accommodating portion that accommodates the spring at a position where the center axis of the spring is deviated in a direction perpendicular to the axis of the outer needle. It is formed to be longer than the distance to the base end.

  Thereby, since the spring is accommodated in a position where the center axis of the spring is displaced in the direction perpendicular to the axis of the outer needle, the spring accommodating space is not limited to the rear of the outer needle, It becomes possible to use a long spring with a large amount of compression. That is, since the spring accommodating portion is formed so that the total length of the spring is longer than the distance from one end of the spring to the proximal end of the outer needle, a sufficient amount of compression of the spring is ensured, and the spring having strong elastic force Even without using, the needle input of the outer needle can be reliably obtained.

  According to the present invention, since the amount of compression of the spring can be sufficiently ensured, it is possible to reliably obtain the puncture input of the outer needle without using a spring having a strong elastic force. Therefore, since the spring does not deform laterally during compression as in the case of using a spring having a strong elastic force, the spring can always be restored smoothly and tissue can be collected reliably.

The perspective view of the biopsy apparatus which shows one Embodiment of this invention An exploded perspective view showing a part of the biopsy device Exploded perspective view showing other parts of biopsy device Plan sectional view of the biopsy device showing the slider moving forward Plan sectional view of the biopsy device showing the slider moving backward Side sectional view showing the operation of the biopsy device Side sectional view showing the operation of the biopsy device Side sectional view showing the operation of the biopsy device Enlarged side sectional view showing the operation of the inner and outer needles

  1 to 9 show an embodiment of the present invention, which relates to a biopsy device used to collect a part of a living tissue such as a liver and a kidney.

  The biopsy device of this embodiment includes an inner needle 10 and an outer needle 20 that are inserted into a human body, a plunger 30 that holds the proximal end side of the inner needle 10, and a slider 40 that holds the proximal end side of the outer needle 20. A main body base 50 that supports the slider 40 movably in the front-rear direction, a main body case 60 that covers the slider 40 supported by the main body base 50, and a coiled spring 70 that biases the slider 40 forward. The main body base 50 and the main body case 60 constitute an apparatus main body.

  The inner needle 10 is a solid needle having a sharp tip, and a notch 10a is provided on the outer peripheral surface on the tip side. A hub 11 that is detachably fixed to the plunger 30 is provided on the proximal end side of the inner needle 10, and the hub 11 is formed on the proximal end side of the inner needle 10 by integral molding of synthetic resin. The hub 11 includes a cylindrical portion 11a formed coaxially with the inner needle 10 and a plate-like portion 11b extending to one side from the cylindrical portion 11a. A plurality of protrusions are formed on the outer peripheral surface of the cylindrical portion 11a. A pair of upper and lower portions 11c are provided at intervals in the front-rear direction. Further, the plate-like portion 11b is provided with a circular fixing hole 11d for fixing to the plunger 30, and the fixing hole 11d penetrates in the vertical direction.

  The outer needle 20 is a hollow needle having a sharp opening at the tip, and the inner needle 10 is inserted coaxially therein so as to be movable in the axial direction. A hub 21 that is detachably fixed to the slider 40 is provided on the proximal end side of the outer needle 20, and the hub 21 is formed on the proximal end side of the outer needle 20 by integral molding of synthetic resin. In this case, the proximal end of the outer needle 20 opens at the rear end of the hub 21. The hub 21 includes a columnar portion 21a formed coaxially with the outer needle 20 and a plate-shaped portion 21b extending from the columnar portion 21a to one side. A plurality of protrusions are formed on the outer peripheral surface of the columnar portion 21a. A pair of upper and lower portions 21c are provided at intervals in the front-rear direction. The plate-like portion 21b is provided with a circular fixing hole 21d for fixing to the slider 40, and the fixing hole 21d penetrates in the vertical direction.

  The plunger 30 includes a hub accommodating portion 31 that accommodates the hub 11 of the inner needle 10, a cover 32 that covers the upper surface side of the hub accommodating portion 31, an arm portion 33 that engages with the slider 40, and a grasping portion that can be grasped with fingers. 34. The hub accommodating portion 31 has an upper surface and one side surface opened, and a pin 31a that is press-fitted into the fixing hole 11d of the hub 11 protrudes upward. A U-shaped notch 31 b is provided on the front wall of the hub accommodating portion 31, and the notch 31 b is configured to receive the front end side of the cylindrical portion 11 a of the hub 11. In addition, square holes 31 c are respectively provided in lower portions on both side surfaces of the hub accommodating portion 31. The cover 32 is formed in a U-shaped cross section so as to cover the upper surface and both side surfaces of the fixing portion 31, and claws 32 a that are engaged with the holes 31 c of the hub accommodating portion 31 are provided on the lower ends of the both side walls. . The arm portion 33 extends forward from the lower portion of the front end of the hub accommodating portion 31, and an engaging portion 33 a that engages with the slider 40 is provided on the tip end side. The engaging portion 33a protrudes above the arm portion 33 and is formed to be bent in an L shape toward the rear. The grip portion 34 is provided on the rear end side of the hub accommodating portion 31 and is formed in a disk shape that spreads in a flange shape with respect to the inner needle 10.

  The slider 40 is formed in a block shape that is long in the front-rear direction, and a hub accommodating portion 41 that accommodates the hub 21 of the outer needle 20 is provided on the center side in the front-rear direction. The hub accommodating portion 41 has an upper surface and one side surface opened, and a pin 41a that is press-fitted into the fixing hole 21d of the hub 21 protrudes upward in the inside thereof. Grooves 42 and 43 extending in the front-rear direction from the hub accommodating portion 41 are provided on the upper surface of the slider 40, the outer needle 20 is received in the front groove 42, and the inner needle 10 is received in the rear groove 43. It has become so. On the lower surface of the slider 40, a first locking portion 44 that locks to the main body base 50 at a first position in the front-rear direction, and a second position behind the main body base 50 by a predetermined distance from the first position. The second locking portions 45 that are locked in the above are protruded downward, and the locking portions 44, 45 are formed to be displaceable in the vertical direction by elastic deformation. In this case, each of the locking portions 44 and 45 is formed such that the front end is formed vertically and the rear end is inclined upward toward the rear. Furthermore, an engaging portion 46 that engages with the engaging portion 33a of the plunger 30 is projected on the lower surface of the slider 40, and the engaging portion 46 is formed to be bent in an L shape toward the front. . The slider 40 is provided with a spring accommodating portion 47 that accommodates the spring 70. The spring accommodating portion 47 is formed in a cylindrical shape extending in the front-rear direction, and the rear end thereof is opened so that the spring 70 can be inserted, and the inner diameter thereof is slightly larger than the outer diameter of the spring 70. In this case, the spring accommodating portion 47 is provided at a position displaced to one side (the other side surface) in the width direction of the slider 40 with respect to the outer needle 20, whereby the central axis of the spring 70 is aligned with the axis of the outer needle 20. On the other hand, it is shifted in the vertical direction (width direction of the slider 40). Further, the spring accommodating portion 47 is provided such that the front end thereof is positioned in front of the proximal end of the outer needle 20 (the rear end of the hub 21 accommodated in the hub accommodating portion 41). Thus, the spring accommodating portion 47 is formed such that the total length L1 of the spring 70 is longer than the distance L2 from one end of the spring 70 to the proximal end of the outer needle 20.

  The main body base 50 is formed in a flat plate shape, and grips 51 are provided on both sides in the width direction. Each grip 51 extends outward in the width direction of the main body base 50 and is formed in an annular shape into which a finger can be inserted. A front wall portion 52 that extends upward is provided at the front end of the main body base portion 50, and an extension portion 52 a that extends forward is provided on the front wall portion 52. The extending portion 52a is provided with a groove 52b extending in the front-rear direction, and the outer needle 20 is received in the groove 52b. The main body base portion 50 is provided with a locking portion 53 to which one of the first locking portion 44 and the second locking portion 45 of the slider 40 is locked. In this case, each locking portion 53 is formed such that the front end is inclined downward toward the front, and the rear end is formed vertically. A pair of width direction guide rails 54 extending in the front-rear direction is provided on the upper surface of the main body base 50, and movement in the width direction of the slider 40 sliding in the front-rear direction on the main body base 50 is restricted by each guide rail 54. It is like that. The main body base 50 is provided with a long hole 55 extending from the center in the front-rear direction to the rear end, and the arm part 33 of the plunger 30 is engaged with the long hole 55 so as to be movable in the front-rear direction. ing. Furthermore, a pair of front and rear mounting holes 56 for fixing the main body case 60 is provided on both sides of the main body base 50 in the width direction.

  The main body case 60 is formed in a hollow shape having an open front and lower surface, and a pair of front and rear mounting pieces 61 provided on both sides in the width direction are inserted into the mounting holes 56 of the main body base 50, respectively. It is attached. In this case, the claw 61 a provided at the tip of each mounting piece 61 is locked to the edge of the mounting hole 56, so that the main body case 60 is fixed to the main body base 50. In the main body case 60, a columnar spring support portion 62 inserted inside the spring 70 is provided, and the spring support portion 62 extends forward from the rear end surface in the main body case 60. In this case, the spring support 62 is formed so that its outer diameter is slightly smaller than the inner diameter of the spring 70 and its central axis is coaxial with the central axis of the spring accommodating portion 47 of the slider 40. 60 is provided at a position deviated to one side in the width direction. Further, a window portion 63 extending in the front-rear direction is provided on the upper surface of the main body case 60 so that the slider 40 in the main body case 60 can be seen from the outside through the window portion 63. In this case, a display part 63a indicating the position of the three stages in the front-rear direction is provided on the side of the window part 63, and “0”, “10”, “20” indicating the protruding amount (mm) of the outer needle 20 is displayed on the display part 63a. "Is displayed. An insertion hole 64 for inserting the inner needle 10 is provided on the back surface of the main body case 60. That is, the inner needle 10 held by the plunger 30 is inserted through the insertion hole 64 of the main body case 60 and is inserted into the proximal end side of the outer needle 20 held by the slider 40 in the main body case 60. Accordingly, when the plunger 30 is moved in the front-rear direction, the inner needle 10 is moved in the front-rear direction within the outer needle 20.

  One end of the spring 70 is locked to the rear end surface of the main body case 60 and the other end is locked to the front end of the spring accommodating portion 47, and is compressed when the slider 40 moves rearward. . In this case, the spring support portion 62 is inserted inside the spring 70, and the spring 70 is disposed between the outer peripheral surface of the spring support portion 62 and the inner peripheral surface of the spring accommodating portion 47.

  In the biopsy device configured as described above, when the plunger 30 is pulled backward as shown in FIG. 6, the engaging portion 33 a of the plunger 30 engages with the engaging portion 46 of the slider 40, and together with the plunger 30. The slider 40 moves backward. At that time, the spring 70 in the spring accommodating portion 47 is compressed. When the slider 40 moves backward, first, as shown in FIG. 6, the first locking portion 44 of the slider 40 is locked to the locking portion 53 of the main body base 50, and the slider 40 is locked at the first position. The When the plunger 30 is further pulled rearward, the second locking portion 45 of the slider 40 is locked to the locking portion 53 of the main body base 50 as shown in FIG. 7, and the slider 40 is locked at the second position. Is done. In this case, the slider 40 is locked at the first or second position according to the amount that the outer needle 20 is desired to protrude. At this time, the position where the slider 40 is locked can be confirmed by viewing the position of the slider 40 in the main body case 60 from the window 63. For example, when the slider 40 is locked at the first position, the upper surface predetermined position P (the rear end position of the hub accommodating portion 41) of the slider 40 stops at the display position “10” of the display portion 63a. Is locked at the second position, the position P of the slider 40 stops at the display position “20” of the display unit 63a.

  Next, when a tissue is collected from a living body, the outer needle 20 is punctured into the living body, and then the plunger 30 is pushed forward so that the inner needle 10 is moved from the distal end of the outer needle 20 as shown in FIG. Make it protrude. At that time, the engaging portion 33a of the plunger 30 is disengaged from the engaging portion 46 of the slider 40, and only the plunger 30 and the inner needle 10 advance. Here, when the plunger 30 is further pushed forward, the distal end of the arm portion 33 of the plunger 30 sequentially comes into contact with the first locking portion 44 and the second locking portion 45 of the slider 40, and these locking portions 44. 45 are displaced upward. As a result, the first locking portion 44 or the second locking portion 45 locked to the locking portion 53 of the main body base 50 is released from the locking portion 53 and unlocked, as shown in FIG. In addition, the outer needle 20 moves forward vigorously by the restoring force of the spring 70. As a result, the outer needle 20 covers the inner needle 10 while tearing the tissue around the inner needle 10 as shown in FIG. 9B, and a part of the tissue is taken into the notch 10 a of the inner needle 10.

  Thereafter, the specimen is collected in the biopsy needle 1 by withdrawing the biopsy device from the living body. After pulling out from the living body, the plunger 30 is pulled back again, the slider 40 is retracted and locked, the plunger 30 is advanced to a position where the lock is not released, and the inner needle 10 is exposed from the outer needle 20, The specimen can be taken out from the notch 10a of the inner needle 10.

  Thus, according to the biopsy device of the present embodiment, the central axis of the spring 70 is displaced in the direction perpendicular to the axis of the outer needle 20 on the slider 40 that holds the proximal end side of the outer needle 20. Since the spring accommodating portion 47 that accommodates the spring 70 is provided at the position, the accommodation space of the spring 70 is not limited only to the rear of the outer needle 20, and a long spring 70 with a large compression amount can be used. That is, by forming the spring accommodating portion 47 so that the total length L1 of the spring 70 is longer than the distance L2 from one end of the spring 70 to the proximal end of the outer needle 20, a sufficient amount of compression of the spring 70 is ensured. Therefore, it is possible to reliably obtain the stab input of the outer needle 20 without using a spring having a strong elastic force. Accordingly, since the spring does not deform laterally during compression as in the case of using a spring having a strong elastic force, the spring 70 can always be restored smoothly and tissue can be collected reliably. .

  In this case, since the main body case 60 is provided with the spring support portion 62 to be inserted inside the spring 70, the spring 70 is substantially spaced between the inner peripheral surface of the spring accommodating portion 47 and the outer peripheral surface of the spring support portion 62. Therefore, the spring 70 can be more reliably prevented from being deformed in the lateral direction.

  In addition, since the inner needle hub 11 provided on the proximal end side of the inner needle 10 is accommodated in the hub accommodating portion 31 of the plunger 30 so that the inner needle 10 is attached to the plunger 30, the inner needle 10 is previously attached to the inner needle 10. By providing the hub 11, the inner needle 10 can be easily attached as compared with the case where the inner needle 10 is directly attached to the plunger 30, and the assembly work can be performed efficiently.

  Furthermore, since the outer needle 20 provided on the proximal end side of the outer needle 20 is accommodated in the hub accommodating portion 41 of the slider 40 so that the outer needle 20 is attached to the slider 40, the same as in the case of the inner needle 10. By providing the outer needle 20 in advance on the outer needle 20, the outer needle 20 can be easily attached as compared with the case where the outer needle 20 is directly attached to the slider 40, and the assembly work can be performed efficiently. .

  Further, when the plunger 30 is moved backward, the slider 40 moves backward while being locked to the plunger 40 and is locked at a predetermined position, and when the plunger 30 is moved forward, the slider 40 is unlocked. Therefore, the compression of the spring 70 and the unlocking of the slider 40 can be performed only by operating the plunger 40, and the procedure at the time of tissue sampling can be easily performed.

  In this case, since the slider 40 is configured to be lockable at two different positions in the front-rear direction, the protruding amount of the outer needle 20 can be switched in two stages, and an arbitrary sampling amount can be obtained according to the purpose of inspection, etc. be able to. Note that the lock position of the slider 40 is not limited to two, and can be three or more.

  DESCRIPTION OF SYMBOLS 10 ... Inner needle, 10a ... Notch part, 11 ... Inner needle hub, 20 ... Outer needle, 21 ... Outer needle hub, 40 ... Slider, 47 ... Spring accommodating part, 50 ... Main body base, 60 ... Main body case, 62 ... Spring support, 70 ... spring.

Claims (6)

An inner needle having a notch on the outer peripheral surface on the distal end side, a hollow outer needle in which the inner needle is inserted so as to be movable coaxially, and a coiled spring that biases the outer needle in the distal direction After the tip of the inner needle protrudes from the tip of the outer needle and is inserted into the living tissue, the outer needle is moved to the tip of the inner needle by the restoring force of the spring, and the tissue is inserted into the notch of the inner needle. In a biopsy device that takes in and collects a part of
Holding the base end side of the outer needle, provided with a slider provided movably in the front-rear direction on the main body base,
The slider is provided with a spring accommodating portion that accommodates the spring at a position where the center axis of the spring is displaced in the direction perpendicular to the axis of the outer needle,
The biopsy device characterized in that the spring accommodating portion is formed such that the total length of the spring is longer than the distance from one end of the spring to the proximal end of the outer needle. The biopsy device according to claim 1, wherein a spring support portion to be inserted inside a spring is provided on the device main body side. The biopsy device according to claim 1 or 2, wherein the outer needle is attached to a slider via an outer needle hub provided on a proximal end side of the outer needle. A plunger for holding the proximal end side of the inner needle;
The biopsy device according to claim 1, 2, or 3, wherein the inner needle is attached to the plunger via an inner needle hub provided on the proximal end side of the inner needle. When the plunger is moved backward, the slider is moved backward while being locked to the plunger and locked at a predetermined position, and when the plunger is moved forward, the slider is unlocked. The biopsy device according to claim 4. The biopsy device according to claim 5, wherein the slider is configured to be lockable at a plurality of positions having different positions in the front-rear direction.

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