JP5499927B2 - Overtube - Google Patents

Description

  The present invention relates to an overtube that supports insertion of an intracorporeal treatment instrument such as a catheter or an endoscope while maintaining an opening of a human body in an expanded state.

  Medical treatments such as endoscopy and catheterization may be performed by inserting an intracorporeal treatment tool such as an endoscope or a catheter from an opening hole such as the anus or oral cavity into the body. In such a case, in order to facilitate medical practice, an overtube, also called a mantle tube, is inserted from the oral cavity or anus into the body, and an intracorporeal treatment tool is inserted into the overtube.

  There is also a proposal of an overtube that is inserted into an opening hole penetrating from the body surface to the abdominal cavity. The overtube includes a conduit having a plurality of lumens, a valve member built-in portion connected to the conduit, a pneumoperitone gas inlet attached to the valve member built-in portion, and a contractible and circumferential direction attached to the conduit A plurality of balloons, and a converter capable of airtightly connecting a thin body treatment tool.

  This overtube can be safely and easily inserted into the abdominal wall without using a needle, an obturator, or the like, and a plurality of intracorporeal treatment tools can be operated simultaneously under the pneumoperitone (Patent Document 1).

JP 2002-282268 A

  However, in the conventional overtube, it is difficult to maintain the opening hole of the human body in an expanded state with the tube body. Furthermore, since it is not possible to hold an intracorporeal treatment instrument inserted into the body from the tube body, it may be difficult to perform medical treatment using the intracorporeal treatment instrument.

  The present invention has been made in view of the above-described problems, and holds an intracorporeal treatment tool inserted into a body from the tube body while the opening hole of the human body is maintained in an expanded state in the tube body. An overtube that can be provided is provided.

  The overtube of the present invention is an overtube that maintains an opening hole of a human body in an expanded state and assists insertion of an intracorporeal treatment instrument such as a catheter or an endoscope, and is inserted into the human body from the opening hole. A tube body, a body balloon that expands outside the tube body inside the human body inserted through the opening hole, and a device holding mechanism that holds the body treatment device inserted in the tube body in a freely detachable manner.

  Therefore, in the overtube of the present invention, the tube body is inserted into the human body through the opening hole. The internal balloon expands outside the tube body inside the human body inserted from the opening hole. The in-vivo treatment tool inserted into the tube body is detachably held by the tool holding mechanism. Therefore, the treatment tool inserted into the body from the tube body can be held in the tube body while the opening hole of the human body is maintained in the expanded state by the tube body.

  In the overtube as described above, the tool holding mechanism may be a balloon member disposed on the inner surface of the tube body.

  Further, in the overtube as described above, the tool holding mechanism may be composed of a balloon member arranged outside at the position of at least one through hole formed in the tube body.

  In the overtube as described above, the balloon member of the device holding mechanism may also be used as the internal balloon.

  Further, the overtube as described above may further include an extracorporeal holding member positioned outside the human body facing the opening hole outside the tube main body.

  Further, in the overtube as described above, the extracorporeal holding member may be a balloon member disposed on the outer surface of the tube main body.

  In the overtube as described above, the balloon member of the tool holding mechanism and the extracorporeal holding member may be combined.

  In the overtube as described above, the extracorporeal holding member may be made of an elastic body that is not a balloon member.

  In the overtube as described above, the extracorporeal holding member may be formed in a shape corresponding to the outer shape of the human body around the opening hole.

  In the overtube as described above, the opening hole of the human body may be an anus, and the external holding member may have an elliptical cross-sectional shape orthogonal to the longitudinal direction of the overtube.

  In the overtube as described above, the extracorporeal holding member may be mounted on the outer surface of the tube main body so as to be slidable in the axial direction.

  Further, in the overtube as described above, the device holding mechanism may include a binding band that binds the body treatment device together with the tube body from the outside.

  In the overtube as described above, the device holding mechanism may be a clamp member that presses the tube body against the body treatment device from the outside.

  The various components of the present invention do not necessarily have to be independent of each other. A plurality of components are formed as a single member, and a single component is formed of a plurality of members. It may be that a certain component is a part of another component, a part of a certain component overlaps with a part of another component, or the like.

  In the overtube of the present invention, the body treatment tool inserted into the body from the tube body can be held in the tube body while the opening hole of the human body is maintained in the expanded state by the tube body. Therefore, the inside of the human body inside the opening hole maintained in the expanded state by the tube body can be easily treated with the body treatment tool held by the tube body.

It is a typical perspective view which shows the external appearance of the overtube of embodiment of this invention. It is a typical vertical front view which shows the state just before inserting an overtube in the opening hole of a human body. It is a typical vertical front view which shows the state which inserted the overtube in the opening hole of the human body. It is a typical longitudinal section front view showing the state where the extracorporeal holding member which consists of the balloon inside and the balloon member of an overtube was expanded. It is a typical longitudinal section front view showing the state just before inserting a treatment instrument in the body into an overtube. It is a typical vertical front view which shows the state which inserted the treatment tool in the body into the overtube. It is a typical vertical front view which shows the state which extended the tool holding mechanism which consists of a balloon member of an overtube. It is a typical cross-sectional bottom view which shows the shape of the internal balloon of an overtube, an external holding member, and a tool holding mechanism. It is a typical front view which shows the shape of the external holding mechanism of the one modification. It is a typical front view which shows the shape of the external holding mechanism of another modification. It is a typical front view which shows the shape of the external holding mechanism of another modification. It is a typical perspective view which shows the assembly structure of the tool holding mechanism of another modification. It is a typical cross-sectional bottom view which shows the shape of the extended tool holding mechanism. It is a typical front view which shows the structure of the tool holding mechanism of another modification. It is a typical front view which shows the structure of the tool holding mechanism of another modification. It is a typical perspective view which shows the structure of the airtight opening / closing mechanism of another modification.

  An embodiment of the present invention will be described below with reference to FIGS. As shown in FIGS. 2 to 7, the overtube 100 according to the present embodiment maintains the opening hole OH of the human body HB in an expanded state to assist the insertion of the intracorporeal treatment instrument 10 such as a catheter or an endoscope. .

  For this reason, as shown in FIG. 1, the overtube 100 according to the present embodiment includes a tube main body 110 inserted into the human body HB through the opening hole OH and a tube inside the human body HB inserted through the opening hole OH. An intracorporeal balloon 120 that expands outside the main body 110, an extracorporeal holding member 130 that is positioned outside the human body HB facing the opening hole OH outside the tube main body 110, and the intracorporeal treatment instrument 10 inserted into the tube main body 110. And a tool holding mechanism 140 that holds the tool in a detachable manner.

  Furthermore, in the overtube 100 of the present embodiment, the tool holding mechanism 140 is made of a balloon member disposed on a part of the inner surface of the tube main body 110 as shown in FIG. The extracorporeal holding member 130 is also a balloon member disposed on the outer surface of the tube main body 110.

  The overtube 100 of the present embodiment is formed so as to be inserted from the anus to the rectum as the opening hole OH of the human body HB, and the extracorporeal holding member 130 includes the opening hole OH as shown in FIG. It is formed to expand into an ellipse that is a shape corresponding to the outer shape of the opposing human body HB.

  More specifically, the tube body 110 is formed in a cylindrical shape having an outer shape and a full length inserted from the anus to the rectum as described above. An air pump 122 is connected to the internal balloon 120 by a flexible tube 121.

  The flexible tube 121 and the air pump 122 are pulled out from the end portion 112 of the tube main body 110. The internal balloon 120 is expanded by manual operation of the air pump 122 and is deflated by manual operation of the check valve 123 of the air pump 122.

  Instead of the air pump 122 as described above, a one-way valve and a syringe may be connected to the flexible tube 121 (not shown), and air may be press-fitted into the intracorporeal balloon 120 by manual operation of the syringe.

  Furthermore, air may be press-fitted into the internal balloon 120 not by manual operation of the air pump 122 (not shown) by stepping on the foot pump (not shown), or air may be press-fitted into the internal balloon 120 by an electric pump ( Not shown).

  Similarly, an air pump 132 is connected to the extracorporeal holding member 130 made of a balloon member by a flexible tube 131, and an air pump 142 is connected to the tool holding mechanism 140 by a flexible tube 141, respectively. It is expanded by manual operation of 142 and contracted by manual operation of check valves 133 and 143.

  In addition, the tube body 110 may be formed with a tapered shape or a hemispherical shape in order to facilitate insertion of the human body HB into the opening hole OH. In order to do so, the end 112 may be expanded.

  In addition, an airtight valve 150 for sealing the inserted intracorporeal treatment instrument 10 is attached to the end portion 112 of the tube main body 110. This airtight valve 150 is made of an elastic film body, and has a through-hole 151 having a diameter slightly smaller than that of the body treatment tool 10. This airtight valve 150 may be formed detachably.

  In the configuration as described above, when the body treatment tool 10 such as a catheter or an endoscope is inserted into the body using the overtube 100 of the present embodiment, it is inserted through the opening hole OH as shown in FIG. As shown in FIG. 3, the overtube 100 in which the internal balloon 120 that expands outside the tube main body 110 inside the human body HB, the external holding member 130, and the tool holding mechanism 140 is deflated is formed as an opening hole OH of the human body HB. Insert into.

  In such a state, the internal balloon 120 and the external holding member 130 are expanded by manually operating the air pumps 122 and 133. Thus, the internal balloon 120 is in close contact with the inside of the opening hole OH, and the extracorporeal holding member 130 is in close contact with the surface of the human body HB opposite to the opening hole OH, so that the tube body 110 is fixed to the opening hole OH. .

  In this state, as shown in FIGS. 5 and 6, the intracorporeal treatment instrument 10 is inserted from the distal end portion 112 to the distal end portion 111 of the tube main body 110. At this time, the airtight state is maintained by the airtight valve 150 at the end 112 of the tube body 110.

  When the distal end portion of the body treatment tool 10 reaches a desired position on the human body HB, the tool holding mechanism 140 is expanded by manually operating the air pump 143. Thus, the body treatment tool 10 is pressed against and held by the tube main body 110 by the tool holding mechanism 140. Therefore, medical actions such as endoscopy and catheter surgery are performed by the held in-vivo treatment tool 10.

  In addition, the position of the front-end | tip of the body treatment tool 10 can also be moved if desired by operating the check valve 143 of the air pump 143 manually and contracting the tool holding mechanism 140 if necessary.

  Further, when a meat piece (not shown) is advanced as a catheter operation by the intracorporeal treatment instrument 10, the internal balloon 120 and the external holding member 130 are contracted by manual operation of the air pumps 122 and 134 as necessary, so that the internal body Pulling the overtube 100 together with the treatment tool 10 from the opening hole OH of the human body HB is also executed.

  In the overtube 100 according to the present embodiment, the body treatment tool 10 inserted into the body from the tube body 110 is maintained while the opening OH of the human body HB is maintained in the expanded state by the tube body 110 as described above. 110 can be held.

  Therefore, the inside of the human body HB inside the opening hole OH maintained in the expanded state by the tube main body 110 can be easily treated with the internal treatment tool 10 held by the tube main body 110.

  In addition, the tool holding mechanism 140 includes a balloon member disposed on the inner surface of the tube main body 110. Therefore, the intracorporeal treatment instrument 10 can be reliably held in the tube main body 110 with a simple structure.

  Further, the extracorporeal holding member 130 is made of a balloon member disposed on the outer surface of the tube main body 110. For this reason, the tube main body 110 can be reliably held at a position facing the opening hole OH of the human body HB with a simple structure.

  In particular, as shown in FIG. 8, since the extracorporeal holding member 130 expands into an elliptical shape, the tube body 110 can be appropriately disposed outside the anus, which is the opening hole OH of the human body HB.

  The present invention is not limited to the present embodiment, and various modifications are allowed without departing from the scope of the present invention. For example, in the above embodiment, the extracorporeal holding member 130 is exemplified by a balloon member attached to the tube main body 110.

  However, as shown in FIG. 9, the extracorporeal holding member 250 is made of an elastic body such as a foam that is not a balloon member having a predetermined shape, and is mounted on the outer surface of the tube body 110 so as to be slidable in the axial direction. Good. Also in this case, the tube body 110 can be reliably held at a position facing the opening hole OH of the human body HB with a simple structure.

  In addition, as shown in FIG. 10, you may form the above-mentioned external body holding member 260 in the shape of a truncated cone. However, the frustoconical extracorporeal holding member 260 also preferably has an elliptical rear surface shape.

  Further, as shown in FIG. 8, in the above embodiment, the tool holding mechanism 140 is exemplified by a balloon member arranged on a part of the inner surface of the tube main body 110. However, as shown in FIG. 11, the tool holding mechanism 210 may be formed of a balloon member that is disposed on the entire inner surface of the tube main body 110.

  In addition, the tool holding mechanism 220 may include a balloon member 222 disposed outside at the position of at least one through hole 221 formed in the tube main body 110. More specifically, as shown in FIG. 12 (a), a plurality of through holes 221 are formed at predetermined positions of the tube body 110, and as shown in FIG. 12 (b), they are sealed. A balloon member 222 is disposed outside the tube body 110.

  Furthermore, as shown in FIG. 12 (c), by attaching a cylindrical cover 223 that does not contract outside the balloon member 222, the balloon body 222 can be seen from a plurality of directions inside the tube body 110 as shown in FIG. The member 222 will expand. Therefore, the intracorporeal treatment instrument 10 can be held at the center of the tube main body 110 by the balloon member 222 that expands in this way.

  In addition, by forming the through hole 221 as described above in the vicinity of the distal end portion 111 of the tube main body 110 and not attaching the cover 223, the balloon member 222 of the tool holding mechanism 140 can also be used as an internal balloon (see FIG. Not shown).

  Similarly, the extracorporeal holding member 130 may be a balloon member disposed on the outer surface of the tube main body 110, and the balloon member of the tool holding mechanism 140 and the extracorporeal holding member 130 may be combined (not shown).

  Furthermore, as shown in FIG. 14, the tool holding mechanism 230 may include a binding band that binds the body treatment tool 10 together with the tube main body 110 from the outside. In this case, it is preferable that the portion bound by the tool holding mechanism 230 of the tube main body 110 is flexible.

  As shown in FIG. 15, the device holding mechanism may include a clamp member 240 that presses the tube main body 110 against the body treatment device 10 from the outside. Also in this case, it is preferable that a portion of the tube main body 110 that is pressed by the clamp member 240 is flexible.

  Further, in the above embodiment, the end portion 112 of the tube main body 110 into which the intracorporeal treatment instrument 10 is inserted is exemplified as being maintained in an airtight state by the airtight valve 150 made of an elastic film body. However, as shown in FIG. 16, it may be airtight by an airtight opening / closing mechanism 270 similar to the diaphragm mechanism of the camera. Such an airtight opening / closing mechanism 270 can also be used as a tool holding mechanism for holding the treatment instrument 10 in the body.

  Moreover, in the said form, it illustrated that the opening hole OH of the human body HB consists of an anus. However, the overtube 100 of the present embodiment can also be used for the oral cavity or the like as an opening hole of the human body HB (not shown).

Needless to say, the above-described embodiment and a plurality of modifications can be combined within a range in which the contents do not conflict with each other. Further, in the above-described embodiments and modifications, the structure of each part has been specifically described, but the structure and the like can be changed in various ways within a range that satisfies the present invention.
Hereinafter, examples of the reference form will be added.
1.
An overtube for maintaining the opening hole of the human body in an expanded state and assisting insertion of an intracorporeal treatment tool such as a catheter or an endoscope,
A tube body inserted into the human body from the opening hole;
An internal balloon that expands outside the tube body inside the human body inserted from the opening hole;
A tool holding mechanism for holding the in-vivo treatment tool inserted in the tube body in a freely detachable manner;
With overtube.
2.
The tool holding mechanism is composed of a balloon member disposed on the inner surface of the tube body. Overtube as described in.
3.
The tool holding mechanism is composed of a balloon member arranged on the outside at the position of at least one through hole formed in the tube body. Overtube as described in.
4).
2. The balloon member of the device holding mechanism is also used as the internal balloon. Overtube as described in.
5).
1. an extracorporeal holding member located on the outer side of the human body facing the opening hole on the outer side of the tube body; Or 4. The overtube according to any one of the above.
6).
4. The extracorporeal holding member is a balloon member disposed on the outer surface of the tube body. Overtube as described in.
7).
5. The balloon member of the tool holding mechanism and the extracorporeal holding member is also used. Overtube as described in.
8).
4. The extracorporeal holding member is made of an elastic body that is not a balloon member. Overtube as described in.
9.
The extracorporeal holding member is formed in a shape corresponding to the outer shape of the human body around the opening hole. Or 8. The overtube according to any one of the above.
10.
The opening hole of the human body consists of an anus,
4. The extracorporeal holding member has an elliptical cross-sectional shape orthogonal to the longitudinal direction of the overtube. Or 9. The overtube according to any one of the above.
11.
4. The extracorporeal holding member is slidably mounted on the outer surface of the tube body in the axial direction. Or 10. The overtube according to any one of the above.
12
The device holding mechanism includes a binding band that binds the body treatment device together with the tube body from the outside. Overtube as described in.
13.
The device holding mechanism includes a clamp member that presses the tube body against the body treatment device from the outside. Overtube as described in.

DESCRIPTION OF SYMBOLS 10 Intracorporeal treatment tool 100 Overtube 110 Tube main body 111 Tip part 112 End part 120 Internal balloon 121 Flexible tube 122 Air pump 123 Check valve 130 External holding member 131 Flexible tube 132 Air pump 133 Check valve 140 Tool holding mechanism 141 Flexible tube 142 Air pump 143 Check valve 150 Airtight valve 151 Through hole 210 Tool holding mechanism 220 Tool holding mechanism 221 Through hole 222 Balloon member 223 Cover 230 Tool holding mechanism 240 Clamp member 250 Outside body holding member 260 Outside body holding member 270 Airtight opening / closing mechanism HB Human body OH opening hole

Claims (10)

An overtube for maintaining the opening hole of the human body in an expanded state and assisting insertion of an intracorporeal treatment tool such as a catheter or an endoscope,
A tube body inserted into the human body from the opening hole;
An internal balloon that expands outside the tube body inside the human body inserted from the opening hole;
A tool holding mechanism for holding the in-vivo treatment tool inserted in the tube body in a freely detachable manner;
I have a,
An overtube comprising a balloon member in which the tool holding mechanism is arranged outside at the position of at least one through hole formed in the tube body . The overtube according to claim 1 , wherein the balloon member of the device holding mechanism is also used as the internal balloon.   An overtube for maintaining the opening hole of the human body in an expanded state and assisting insertion of an intracorporeal treatment tool such as a catheter or an endoscope,
  A tube body inserted into the human body from the opening hole;
  An internal balloon that expands outside the tube body inside the human body inserted from the opening hole;
  A device holding mechanism for indirectly holding the treatment instrument inserted in the tube body via the tube body;
Have
  An overtube comprising a bundling band in which the device holding mechanism is attached to the outer peripheral surface of the tube main body and binds the intracorporeal treatment device together with the tube main body from the outside of the tube main body.   An overtube for maintaining the opening hole of the human body in an expanded state and assisting insertion of an intracorporeal treatment tool such as a catheter or an endoscope,
  A tube body inserted into the human body from the opening hole;
  An internal balloon that expands outside the tube body inside the human body inserted from the opening hole;
  A device holding mechanism for indirectly holding the treatment instrument inserted in the tube body via the tube body;
Have
  An overtube comprising a clamp member in which the device holding mechanism is attached to the outer peripheral surface of the tube main body and presses the tube main body against the internal treatment device from the outside of the tube main body.   The overtube according to any one of claims 1 to 4, further comprising an extracorporeal holding member located outside the human body and facing the opening hole outside the tube main body.   The overtube according to claim 5, wherein the extracorporeal holding member is a balloon member disposed on an outer surface of the tube main body.   The overtube according to claim 5, wherein the extracorporeal holding member is made of an elastic body that is not a balloon member. The overtube according to claim 7 , wherein the extracorporeal holding member is slidably mounted in an axial direction on an outer surface of the tube main body. The overtube according to any one of claims 5 to 7 , wherein the extracorporeal holding member is formed in a shape corresponding to an outer shape of the human body around the opening hole. The opening hole of the human body consists of an anus,
The overtube according to any one of claims 5, 6, 7 and 9 , wherein the extracorporeal holding member has an elliptical cross-sectional shape perpendicular to the longitudinal direction of the overtube.

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