JP5886454B1 - Biopsy needle - Google Patents

Biopsy needle Download PDF

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JP5886454B1
JP5886454B1 JP2015032602A JP2015032602A JP5886454B1 JP 5886454 B1 JP5886454 B1 JP 5886454B1 JP 2015032602 A JP2015032602 A JP 2015032602A JP 2015032602 A JP2015032602 A JP 2015032602A JP 5886454 B1 JP5886454 B1 JP 5886454B1
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needle
tip
inner needle
groove
cell tissue
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JP2016154583A (en
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今井 孝典
孝典 今井
廣田 淳
淳 廣田
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OUYOUDENSHI IND. CO., LTD.
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Abstract

【課題】被検者の細胞組織を採取するための生検針を、確実に細胞組織の切断ができるようにするとともに、該切断された細胞組織を生検針内部に保持して採取する。【解決手段】、生検針を、中実状の内針2と内針2が移動自在に内嵌する中空状の外針3とを備えたものとし、内針2の先端部2hが外針3の先端3qから突出する突出姿勢と、内針2の先端部2hが外針3の先端より没入する収納姿勢とに相対移動し、内針2の先端部2hには、被検者の細胞組織を切断する切断部2kと、切断された細胞組織を保持する保持部2mとが形成された貫通孔2iが形成され、貫通孔2iは、内針先端部2hが突出姿勢のときには被検者の体温を受けて径方向外側に拡開変形し、収納姿勢のときには切断された細胞組織を内包できる空隙を有する状態で外針3に押圧されて径方向内側に収縮変形するよう形状記憶合金で形成されている。【選択図】図3A biopsy needle for collecting a cell tissue of a subject is surely capable of cutting the cell tissue, and the cut cell tissue is held and collected inside the biopsy needle. A biopsy needle is provided with a solid inner needle 2 and a hollow outer needle 3 into which the inner needle 2 is movably fitted, and a distal end portion 2h of the inner needle 2 is an outer needle 3. The tip 2q of the inner needle 2 is moved relative to the protruding posture of the inner needle 2 and the retracted posture of the inner needle 2 being retracted from the tip of the outer needle 3. The tip 2h of the inner needle 2 has a cell tissue of the subject. A through hole 2i is formed in which a cutting portion 2k for cutting the cut tissue and a holding portion 2m for holding the cut cell tissue are formed. The through hole 2i is formed when the inner needle tip 2h is in a protruding posture. Formed with a shape memory alloy that expands and deforms outward in the radial direction in response to body temperature, and is compressed by the outer needle 3 in a retracted position while being pressed by the outer needle 3 in a state of containing a cut cell tissue. Has been. [Selection] Figure 3

Description

本発明は、主に医療分野において、生体内の細胞組織を検体として採取するための生検針の技術分野に関するものである。   The present invention relates to a technical field of a biopsy needle for collecting a cellular tissue in a living body as a specimen mainly in the medical field.

一般に、医療分野において、被検者の体内から採取した細胞組織を検体として検査するにあたって、医療器具である生検針を被検者の体内に穿刺して細胞組織を採取する手法が知られている。このような生検針にあっては、生検針の先端部を採取対象域まで穿刺させた後、先端部に設けた切断部材によって細胞組織の一部を切断し、該切断された細胞組織を採取するようにしている。   In general, in the medical field, a method of collecting a cellular tissue by puncturing a biopsy needle, which is a medical instrument, into the body of a subject when a cellular tissue collected from the body of the subject is examined as a specimen is known. . In such a biopsy needle, after the tip of the biopsy needle is punctured to the collection target area, a part of the cell tissue is cut by a cutting member provided at the tip, and the cut cell tissue is collected. Like to do.

このような生検針として、例えば以下のようなものが知られている。
生検針を、中実状の内針と、該内針が軸心方向に移動自在に内嵌する中空状の外針とを備えたものとし、内針の先端部近傍には細胞組織が入り込む凹溝が形成されたものとする一方、外針の先端は傾斜状にカットされたものとし、凹溝が外針先端部から突出しない状態で生検針を穿刺していき、生検針の先端部が採取対象域近傍に到達したら、凹溝が外針の先端部から突出するよう内針を移動させ、該突出した凹溝内に採取対象の細胞組織を入り込ませ、その後外針を勢いよく突出させることによって前記凹溝に入り込んだ細胞組織を切断するとともに、外針先端部で凹溝を覆蓋することで、前記切断された細胞組織を凹溝内に封じ込め、その後生検針を体内から抜き取ることで細胞組織の採取を行うようにしたものがある(例えば特許文献1参照)。
As such biopsy needles, for example, the following are known.
The biopsy needle is provided with a solid inner needle and a hollow outer needle in which the inner needle is fitted so as to be movable in the axial direction, and a concave portion into which cellular tissue enters near the tip of the inner needle. It is assumed that a groove is formed while the tip of the outer needle is cut in an inclined shape, and the biopsy needle is punctured with the concave groove not protruding from the tip of the outer needle, and the tip of the biopsy needle is When the vicinity of the collection target area is reached, the inner needle is moved so that the concave groove protrudes from the tip of the outer needle, the cellular tissue to be collected enters the protruding concave groove, and then the outer needle is protruded vigorously. By cutting the cellular tissue that has entered the concave groove by covering the concave groove with the outer needle tip, the cut cellular tissue is sealed in the concave groove, and then the biopsy needle is removed from the body Some cell tissues are collected (for example, patent documents) Reference).

また、以下のようなものが知られている。
生検針を中実の棒状体とし、該棒状体の側面には径方向に出没する刃体が設けられるとともに、該刃体の後方には刃体によって切断された細胞組織を収納するための収納袋を設けて、棒状体を、刃体が棒状体の側面に没入した状態の棒状体を被検者の体内に穿刺していって、棒状体先端部が採取対象域に達したら刃体を棒状体側面から突出させて、棒状体を軸回り方向に回動することで細胞組織を刃体で切断するとともに、さらに回動することで切断された細胞組織を収納袋に収納していき、その後刃体を棒状体側面に再び没入させた状態にして生検針を体内から抜き取ることで細胞組織を採取するようにしたものがある(特許文献2参照)。
Further, the following are known.
The biopsy needle is a solid rod-shaped body, and a blade body protruding and projecting in the radial direction is provided on the side surface of the rod-shaped body, and a storage for storing the cell tissue cut by the blade body behind the blade body Provide a bag, puncture the rod-shaped body into the subject's body with the rod-shaped body immersed in the side surface of the rod-shaped body, and when the tip of the rod-shaped body reaches the collection target area, Projecting from the side of the rod-shaped body, cutting the cell tissue with the blade body by rotating the rod-shaped body in the direction around the axis, and storing the cell tissue cut by further rotating in the storage bag, In some cases, the tissue is collected by removing the biopsy needle from the body with the blade body again immersed in the side surface of the rod-like body (see Patent Document 2).

特公平6−28663号公報Japanese Patent Publication No. 6-28663 特開2002−282254号公報JP 2002-282254 A

しかしながら、特許文献1のものにおいては、検査対象部位の細胞組織が凹溝に入り込んだことの確認ができず、また仮に凹溝内に細胞組織が入り込んだとしても、外針の先端縁で細胞組織を切断するときに細胞組織が凹溝から逃げ出してしまうこともあって採取の確実性に劣る。そして、採取出来なかった場合には再度生検針を穿刺して採取を試みることになるが、このような再度の試みは被検者にとって肉体的、精神的な苦痛が大きいばかりでなく、生検針を何度も穿刺することによる穿刺部位や細胞組織の損傷によって病原菌感染のリスクが高まることにもなり、被検者にとっては好ましいことではない。さらに、生検針の再使用は衛生上認められていないため、再度の採取を試みるにあたっては新しい生検針を用意しなければならならず、費用的にも問題となる。   However, in Patent Document 1, it is not possible to confirm that the cell tissue of the region to be inspected has entered the groove, and even if the cell tissue has entered the groove, the cell is detected at the tip edge of the outer needle. When cutting the tissue, the cell tissue may escape from the groove, resulting in poor collection reliability. If the biopsy needle cannot be collected, the biopsy needle is punctured again to attempt the collection. However, such a second attempt not only has great physical and mental pain for the subject, but also the biopsy needle. The risk of infection with pathogenic bacteria increases due to the puncture site and cell tissue damage caused by puncturing the needle many times, which is not preferable for the subject. Furthermore, since reuse of a biopsy needle is not permitted for hygiene purposes, a new biopsy needle must be prepared when attempting to collect again, which is also a problem in terms of cost.

また、特許文献2のものにおいては、刃体は穿刺時と抜き取り時には棒状体の内側に格納されるものの、細胞組織切断時には棒状体の側面から大きく突出するため、組織を圧迫してしまい、また組織を抉るようにして切断するため、組織が変形してしまうだけでなく外見上の形状も変わってしまうことがあって被検者にとって肉体的、精神的負担になるという問題がある。また、細胞組織が収納される収納袋は棒状体の側面から突出した状態で抜き取られることになるため、収納されている細胞組織は棒状体の取出時に体内組織から圧迫を受けることになって、圧迫による細胞組織の変形や変質の惧れがあるのみならず、押圧によって収納袋が破けて採取した細胞組織が被検者の健康な細胞組織内に漏れ出てしまう惧れもあり、採取した細胞組織が癌細胞のような転移性のある病変組織であった場合には転移を促進させてしまうという問題がある。さらにまた圧迫によって収納袋ごと生検針から外れて被検者の体内に袋に入った状態で取り残されてしまう可能性もあり、このような場合には直ぐに切開手術を施して収納袋ごと摘出しなければならないことになって、被検者の負担はさらに増大することになり、これらに本発明が解決せんとする課題がある。   Moreover, in the thing of the patent document 2, although a blade body is stored inside a rod-shaped body at the time of puncture and extraction, since it protrudes greatly from the side surface of a rod-shaped body at the time of cell tissue cutting | disconnection, it presses a structure | tissue, Since the tissue is cut as if it is wounded, not only the tissue is deformed but also the appearance is changed, which causes a physical and mental burden on the subject. In addition, since the storage bag in which the cell tissue is stored is to be extracted in a state of protruding from the side surface of the rod-shaped body, the stored cell tissue is subjected to pressure from the body tissue when the rod-shaped body is taken out, Not only is there any risk of deformation or alteration of the cellular tissue due to compression, but there is also a risk that the collected cell tissue will leak due to pressure and the collected tissue will leak into the healthy cellular tissue of the subject. If the cell tissue is a diseased tissue with metastasis such as cancer cells, there is a problem of promoting metastasis. In addition, there is a possibility that the entire storage bag will be removed from the biopsy needle and left in the patient's body due to compression. In such a case, an incision operation is performed immediately and the entire storage bag is removed. Therefore, the burden on the subject is further increased, and there is a problem that the present invention does not solve.

本発明は、上記の如き実情に鑑みこれらの課題を解決することを目的として創作されたものであって、請求項1の発明は、被検者の体内に穿刺して細胞組織を採取するための生検針であって、該生検針を、中実状の内針と、該内針が軸心方向に移動自在に内嵌する中空状の外針とを備え、内針と外針とを、内針の先端部が外針の先端から突出する突出姿勢と、外針の先端より没入する収納姿勢とに相対移動するよう構成するにあたり、内針は外針に対して軸周り方向に回動自在に構成されており、前記内針の先端部には、前記突出姿勢に位置する内針を外針に対して軸回り方向に回動させることで被検者の細胞組織を切断する切断部と、該切断された細胞組織を保持する保持部とが形成されており、該切断部と保持部とは、内針先端部が突出姿勢のときには被検者の体温を受けて径方向外側に拡開変形し、収納姿勢のときには切断された細胞組織を内包できる空隙を有する状態で外針に押圧されて径方向内側に収縮変形するよう形状記憶合金で形成されており、前記内針は、収納姿勢で外針の先端よりも突出した先端突出部を有し、該先端突出部は、先端ほど先鋭となるよう傾斜していて内針の針先を構成し、外針の先端部は、前記先端突出部と同じ斜度で傾斜状に形成されていて、内針が収納姿勢のとき内針の先端突出部と連続するよう傾斜していて生検針の針先を構成していると共に、内針には、外径方向に突出する係合突起が形成され、外針には、前記係合突起が係合する係合溝が側面を貫通するようにして切欠き形成されており、前記係合溝は、内針を収納姿勢と突出姿勢とのあいだに移動させる軸方向に長い第一、第二縦溝と、該第一、第二縦溝の先端部同士を連結する軸回り方向に長い横溝と、横溝から基端側に向けて形成されていて内針を突出姿勢に維持するよう係合突起が係合可能な仮止め溝とを備えて構成されていることを特徴とする生検針である。
請求項2の発明は、内針の先端部には、径方向に貫通する貫通孔が形成され、該貫通孔の孔端縁が切断部であり、貫通孔の互いに対向する内周面間が保持部であることを特徴とする請求項1記載の生検針である。
請求項の発明は、内針の先端部は、径方向の断面がC形状をしていて軸方向に長い長溝形成され、該長溝の溝端縁が切断部であり、溝跨部が保持部であることを特徴とする請求項1記載の生検針である。
The present invention has been created in order to solve these problems in view of the above circumstances, and the invention of claim 1 is for puncturing the body of a subject to collect cellular tissue. A biopsy needle comprising a solid inner needle and a hollow outer needle in which the inner needle is movably fitted in the axial direction, the inner needle and the outer needle, When the inner needle is configured to move relative to the protruding posture in which the distal end of the inner needle protrudes from the distal end of the outer needle and the retracted posture in which the inner needle is retracted from the distal end of the outer needle, the inner needle rotates about the axis with respect to the outer needle. A cutting section configured to freely cut and cut the cell tissue of the subject by rotating the inner needle located in the protruding posture in the direction around the axis with respect to the outer needle at the distal end of the inner needle And a holding portion for holding the cut cell tissue, and the cutting portion and the holding portion protrude from the inner needle tip portion. When energized, the body temperature of the subject expands and deforms outward in the radial direction, and when in the retracted position, the outer needle is pressed and contracted and deformed radially inward while having a gap that can contain the cut cell tissue. The inner needle has a tip protruding portion that protrudes from the tip of the outer needle in the storage position, and the tip protruding portion is inclined so that the tip is sharper toward the tip. Consists of the needle tip of the needle, and the tip of the outer needle is formed in an inclined shape with the same inclination as the tip protrusion, and is inclined so as to be continuous with the tip protrusion of the inner needle when the inner needle is in the retracted position. The inner needle is formed with an engaging protrusion protruding in the outer diameter direction, and the outer needle has an engaging groove with which the engaging protrusion is engaged. The engagement groove is formed with a notch so as to penetrate the side surface. The first and second longitudinal grooves that are long in the axial direction to be moved between, the transverse groove that is long in the direction around the axis connecting the distal ends of the first and second longitudinal grooves, and formed from the lateral groove toward the base end side The biopsy needle is provided with a temporary fixing groove that can be engaged with an engaging projection so as to maintain the inner needle in a protruding posture .
In the invention of claim 2, a through hole penetrating in the radial direction is formed at the distal end portion of the inner needle, a hole edge of the through hole is a cut portion, and a gap between mutually opposed inner peripheral surfaces of the through hole is formed. The biopsy needle according to claim 1, wherein the biopsy needle is a holding portion.
According to a third aspect of the present invention, a long groove is formed in the distal end portion of the inner needle having a C-shaped radial cross section and long in the axial direction, the groove edge of the long groove is a cut portion, and the groove straddling portion is The biopsy needle according to claim 1, wherein the biopsy needle is a holding portion.

請求項1の発明とすることにより、生検針は、内針先端部を、外針先端から突出する突出姿勢と、先端より没入する収納姿勢とに相対移動させることで被検者から細胞組織を採取することができるものであり、内針は、外針に対して軸心回りに回動させることで先端部に設けた切断部で細胞組織を切断し、そして保持部で保持して採取できるものでありながら、該切断部と保持部とは、突出姿勢のときには被検者の体温を受けて径方向に拡開変形し、収納姿勢のときには細胞組織を内包できる空隙を有する状態で径方向に収縮変形するよう形状記憶合金で形成されている結果、内針先端部が突出姿勢のときには、切断部および保持部が径方向に拡開変形することになって大きな断面積で切断をし、さらに切断された細胞組織を切断位置で保持するため、細胞組織は確実に切断されるとともに保持されるものであり、内針先端部が収納姿勢のときには、切断部および保持部が径方向に収縮変形するため内針先端部には切断した細胞組織を内包する空隙が形成される。このように、本発明では、切断部を生検針の径方向外側に拡開変形させて細胞組織を切断するとともに、切断後は切断部および細胞組織を保持する保持部を収縮変形させて外針の内側に収納するため、切断した細胞組織の採取を確実におこなうことができる。
また、請求項2の発明とすることにより、内針先端部に貫通孔を形成し、該貫通孔の拡開変形によって切断部が径方向に拡開して細胞組織の切断をおこなうため、細胞組織の切断を確実におこなうことができるとともに、内針先端部は切断された細胞組織を保持部に保持した状態で収縮変形して外針内部で収納姿勢となるため、細胞組織が確実に保持部に保持される。
また、請求項の発明とすることにより、内針の先端部には、径方向の断面がC形状の長溝形成されるため、切断部で切断された細胞組織が確実に保持部に入り込むとともに、一旦入り込んだ細胞組織が出て行ってしまうようなことがない。
According to the invention of claim 1, the biopsy needle moves the inner tissue tip from the subject by relatively moving the tip of the inner needle into a protruding posture protruding from the tip of the outer needle and a storage posture recessed from the tip. The inner needle can be collected by cutting the cell tissue with the cutting part provided at the tip by rotating it around the axis with respect to the outer needle and holding it with the holding part. However, the cutting part and the holding part are expanded in a radial direction in response to the body temperature of the subject when in a protruding posture, and in a radial direction with a gap that can contain cellular tissue when in a storing posture. As a result of being formed of a shape memory alloy so as to shrink and deform, when the inner needle tip portion is in a projecting posture, the cutting portion and the holding portion are expanded and deformed in the radial direction and cut with a large cross-sectional area, Hold the cut tissue at the cutting position Therefore, the cell tissue is surely cut and held, and when the inner needle tip portion is in the storage position, the cutting portion and the holding portion are contracted and deformed in the radial direction so that the inner needle tip portion is cut. A void that encloses cellular tissue is formed. Thus, in the present invention, the cutting part is expanded and deformed outward in the radial direction of the biopsy needle to cut the cell tissue, and after cutting, the cutting part and the holding part for holding the cell tissue are contracted and deformed. Therefore, the cut cell tissue can be reliably collected.
Further, according to the invention of claim 2, since a through hole is formed in the distal end portion of the inner needle, and the cutting portion expands in the radial direction due to the expansion deformation of the through hole, the cell tissue is cut. The tissue can be cut reliably, and the tip of the inner needle contracts and deforms with the cut cell tissue held in the holding part, and it is stored in the outer needle. Held in the department.
Further, with the invention of claim 3, the distal end portion of the inner needle, since the radial cross section is long groove C shape is formed, cleaved cellular tissue cutting portion enters the securely held unit At the same time, the cellular tissue once entered does not go out.

本発明の生検針の全体図であって、内針が外針に収納された収納姿勢を示す側面断面図である。It is a whole figure of the biopsy needle of this invention, Comprising: It is side surface sectional drawing which shows the accommodation attitude | position in which the inner needle was accommodated in the outer needle. 本発明の生検針の全体図であって、内針の先端部が外針の先端から突出した突出姿勢を示す側面断面図である。It is a whole view of the biopsy needle of this invention, Comprising: It is side surface sectional drawing which shows the protrusion attitude | position which the front-end | tip part of the inner needle protruded from the front-end | tip of an outer needle. (A)、(B)は、それぞれ内針と外針の収納姿勢、突出姿勢を示す部分側面断面図である。(A), (B) is a partial side sectional view showing a storage posture and a projection posture of an inner needle and an outer needle, respectively. は、外針の展開図である。These are the expanded views of an outer needle. (A)、(B)、(C)は、それぞれ、内針の先端部の収縮変形、拡開変形の様子を示す正面断面図、拡開変形の様子を示す部分断面斜視図である。(A), (B), (C) is a front sectional view showing the state of contraction deformation and expansion deformation of the tip of the inner needle, respectively, and a partial cross-sectional perspective view showing the state of expansion deformation. (A)は、第二の実施の形態における内針の先端部の収縮変形、(B)、(C)、(D)は、それぞれ拡開変形の様子を示す正面断面図である。(A) is contraction deformation of the front-end | tip part of the inner needle in 2nd embodiment, (B), (C), (D) is front sectional drawing which each shows the mode of expansion deformation. (A)、(B)は、それぞれ本発明の第三の実施の形態における内針の先端部の収縮変形および拡開変形を示す正面断面図である。(A), (B) is front sectional drawing which shows the contraction deformation | transformation and expansion deformation | transformation of the front-end | tip part of the inner needle in 3rd embodiment of this invention, respectively.

次に、本発明の実施の形態を図面に基づいて説明する。図面において、1は被検者の細胞組織を採取するための生検針であって、該生検針1は、中実状の内針2と、該内針2が軸心方向に移動自在に内嵌する中空状の外針3とを備えて構成されている。
内針2は、外側面の基端側(操作者の手元側)が大径部2a、先端側(針先側)が小径部2bとなっており、大径部2aと小径部2bとのあいだには段差状の内針段差部2cが形成される。また、外針3は、内側面の基端側が大径部3a、先端側が小径部3bとなっており、大径部3aと小径部3bとのあいだには段差状の外針段差部3cが形成される。そして、前記内針段差部2cと外針段差部3cとのあいだには、弾機(本実施の形態ではコイルばねを使用)4が、基端部および先端部をそれぞれ内針段差部2cおよび外針段差部3cに当接させた状態で伸縮自在に巻装されており、該弾機4の付勢力によって、内針2は常に外針3に対して基端側に付勢された状態となっている。
Next, embodiments of the present invention will be described with reference to the drawings. In the drawings, reference numeral 1 denotes a biopsy needle for collecting a subject's cellular tissue. The biopsy needle 1 includes a solid inner needle 2 and an inner fitting in which the inner needle 2 is movable in the axial direction. And a hollow outer needle 3 that is configured.
The inner needle 2 has a large-diameter portion 2a on the proximal end side (on the operator's hand side) of the outer surface and a small-diameter portion 2b on the distal end side (needle tip side), and has a large-diameter portion 2a and a small-diameter portion 2b. In the meantime, a step-shaped inner needle step 2c is formed. The outer needle 3 has a large-diameter portion 3a on the base end side of the inner side surface and a small-diameter portion 3b on the distal end side. A step-shaped outer needle step portion 3c is provided between the large-diameter portion 3a and the small-diameter portion 3b. It is formed. And, between the inner needle stepped portion 2c and the outer needle stepped portion 3c, an elastic machine (using a coil spring in the present embodiment) 4 has a proximal end portion and a distal end portion respectively connected to the inner needle stepped portion 2c and It is wound in a stretchable manner in contact with the outer needle stepped portion 3c, and the inner needle 2 is always urged toward the proximal end side with respect to the outer needle 3 by the urging force of the bullet mechanics 4 It has become.

内針2は、基端側端部が外径方向にフランジ状に延出する押出し支持部2dとなっており、該押出し支持部2dを先端方向に向けて押し込み操作することによって、内針2が弾機4の付勢力に抗して外針3に対して先端側に移動するようになっている。該押出し支持部2dの先端側には、内針2を外針3に対して軸回り方向に回動させるための回動操作部2eが径方向外方に向けて一対配設されている。そして、押出し支持部2dで内針2の押出し操作をした後に、該内針2が押出されている状態は保持したままで回動操作部2eを回動させることで、内針2を外針3に対して軸回り方向に相対回動させるようになっている。   The inner needle 2 is an extrusion support portion 2d whose proximal end is extended in a flange shape in the outer diameter direction, and the inner needle 2 is operated by pushing the extrusion support portion 2d toward the distal end. However, it moves to the tip side with respect to the outer needle 3 against the urging force of the bullet machine 4. At the distal end side of the push-out support portion 2d, a pair of turning operation portions 2e for turning the inner needle 2 with respect to the outer needle 3 in the direction around the axis is disposed radially outward. Then, after the pushing operation of the inner needle 2 is performed by the pushing support portion 2d, the inner needle 2 is turned to the outer needle by rotating the turning operation portion 2e while keeping the inner needle 2 being pushed. 3 is rotated relative to the axis.

内針2の大径部2aには、外径方向に突出する係合突起2fが形成されているが、該係合突起2fは、外針3の筒側面部を貫通して形成される係合溝3eに移動自在に係合するようになっており、前記押出し支持部2dによる押出し操作および回動操作部2eによる回動操作によって、係合突起2fが後述する係合溝3e内を軸心方向および軸回り方向に移動するようになっている。   The large-diameter portion 2a of the inner needle 2 is formed with an engaging protrusion 2f that protrudes in the outer diameter direction. The engaging protrusion 2f is formed through the cylindrical side surface portion of the outer needle 3. The engaging groove 2e is movably engaged, and the engaging protrusion 2f is pivoted in an engaging groove 3e described later by the pushing operation by the pushing support portion 2d and the turning operation by the turning operation portion 2e. It moves in the center direction and the direction around the axis.

内針2の先端部2hにあって先端2gよりも基端側部位には、軸心方向に長い貫通孔2iが径方向に貫通した状態で形成されているが、該貫通孔2iは、孔の端縁部に先鋭状の切断刃2kが形成されており、さらに貫通孔2iの互いに対向する内周面間は、切断刃2kによって切断された細胞組織を内包するための空隙であって、該空隙が保持部2mとして形成されている。
内針2はニッケル(Ni)とチタン(Ti)の合金からなる形状記憶合金で形成されており、貫通孔2iのある先端部2hは、常温においては、図3(A)に示すように、貫通孔2iが径方向に収縮変形する収納姿勢となって外針3の内側に没入可能となるが、被検者の体温を受けると、図3(B)に示すように、貫通孔2iが径方向に拡開変形するよう設定されている。
また図3(A)から明らかなように、内針2は、該内針2が収納姿勢の状態で外針3の先端3rよりも突出した先端突出部2nを有しており、該先端突出部2nは先端ほど先鋭となるよう傾斜して内針2の針先を構成している。
尚、本発明の実施の形態では、形状記憶合金をニッケルとチタンの合金としたが、人体に影響を与えないで形状記憶機能を有する素材であれば、他の素材を用いて形成しても良いことは勿論である。
A through hole 2i that is long in the axial direction is formed in the distal end portion 2h of the inner needle 2 at the proximal end side with respect to the distal end 2g, and the through hole 2i is formed as a hole. A sharp cutting blade 2k is formed at the end edge of the through hole 2i, and the space between the mutually facing inner peripheral surfaces of the through-hole 2i is a gap for enclosing the cell tissue cut by the cutting blade 2k, The gap is formed as a holding portion 2m.
The inner needle 2 is formed of a shape memory alloy made of an alloy of nickel (Ni) and titanium (Ti), and the tip portion 2h having the through hole 2i is as shown in FIG. The through-hole 2i is retracted in the radial direction and can be immersed inside the outer needle 3, but when the body temperature of the subject is received, as shown in FIG. It is set to expand and deform in the radial direction.
3A, the inner needle 2 has a tip protruding portion 2n that protrudes from the tip 3r of the outer needle 3 when the inner needle 2 is in the retracted position. The portion 2n is inclined so as to be sharper toward the tip, and constitutes the needle tip of the inner needle 2.
In the embodiment of the present invention, the shape memory alloy is an alloy of nickel and titanium. However, as long as the material has a shape memory function without affecting the human body, it may be formed using other materials. Of course it is good.

外針3の側面部からは、一対の把手3dが径方向外方に向けて突出形成されており、操作者が生検針1を被検者に穿刺する際には、該把手3dを両手で把持して先端2gを被検者の体内に穿刺するとともに、被検者の体内において細胞組織を外針内に収納した後は、再び把手3dを把持して生検針1を手前に引くことで生検針1を被検者から抜き取るようになっている。 A pair of grips 3d are formed to project radially outward from the side surface of the outer needle 3. When the operator punctures the subject with the biopsy needle 1, the grip 3d is held with both hands. After grasping and puncturing the tip 2g into the body of the subject, and storing the cellular tissue in the outer needle in the body of the subject, the biopsy needle 1 is pulled forward by grasping the handle 3d again. The biopsy needle 1 is extracted from the subject.

外針3の小径部3bには、筒側面を貫通するようにして前述の係合溝3eが切欠き形成されているが、該係合溝3eは、軸方向に略同じ長さの第一縦溝3fおよび第二縦溝3gが径方向の略対向位置に形成されるとともに、該第一縦溝3fの先端部3hと第二縦溝3gの先端部3iとが周回り方向に長い横溝3jの両端部に連結して形成されている。そして、係合突起2fを弾機4の付勢に抗して第一縦溝3fの基端部3kから先端部3hへと移動させることで、内針2の先端部2hは、外針3の内部に収納される収納姿勢から外針3の先端から突出する突出姿勢へと移動し、被検者の体温を受けて径方向に拡開変形する。そして係合突起2fを横溝3jの第一縦溝3fの先端部3hから第二縦溝3gの先端部3iへと移動させるべく回動操作部2eを回動することで、内針2の先端部2hは被検者の体内で内針2の略半周分を回動し、該回動によって貫通孔2iの孔端縁に形成される切断刃2kが回動して被検者の細胞組織を切断するようになっている。しかる後、係合突起2fが第二縦溝3gの先端部3iに到達した後で、操作者が押出し支持部2dおよび回動操作部2eから手を離すと、係合突起2fは弾機4の付勢によって第二縦溝3gの先端部3iから基端部3mへと移動し、先端部2hは切断された細胞組織を保持部2mに保持した状態で外針3の先端部3qに押圧されて径方向に収縮変形し突出姿勢から収納姿勢へと変化するようになっている。
尚、横溝3jの第一縦溝3f寄りの位置には、係合突起2fを仮止めするための仮止め溝3nが基端側に向けて切欠き形成されており、第一縦溝3fの先端部3hに到達した係合突起2fを該仮止め溝3nに一旦係合させて突出姿勢となった先端部2hを被検者の体内で静止状態にし、超音波画像等で内針先端部2hが拡開変形したことを確認できるようになっている。
In the small diameter portion 3b of the outer needle 3, the above-mentioned engagement groove 3e is cut out so as to penetrate the cylinder side surface, and the engagement groove 3e is a first having substantially the same length in the axial direction. The longitudinal groove 3f and the second longitudinal groove 3g are formed at substantially opposite positions in the radial direction, and the distal end portion 3h of the first longitudinal groove 3f and the distal end portion 3i of the second longitudinal groove 3g are long in the circumferential direction. It is connected to both ends of 3j. Then, the distal end portion 2h of the inner needle 2 is moved from the proximal end portion 3k to the distal end portion 3h of the first longitudinal groove 3f against the urging force of the bullet machine 4 so that the distal end portion 2h of the inner needle 2 is moved to the outer needle 3 It moves from the storage posture stored in the inside to a protruding posture protruding from the distal end of the outer needle 3, and expands and deforms in the radial direction in response to the body temperature of the subject. Then, the distal end of the inner needle 2 is rotated by rotating the rotation operation portion 2e so as to move the engagement protrusion 2f from the distal end portion 3h of the first vertical groove 3f to the distal end portion 3i of the second vertical groove 3g. The portion 2h rotates approximately half a circumference of the inner needle 2 in the body of the subject, and the cutting blade 2k formed at the hole edge of the through hole 2i is rotated by the rotation to rotate the cell tissue of the subject. Is supposed to cut off. Thereafter, after the engaging projection 2f reaches the tip 3i of the second vertical groove 3g, when the operator releases his / her hand from the push-out support portion 2d and the rotation operation portion 2e, the engaging projection 2f is moved to the bullet 4 Is moved from the distal end 3i of the second longitudinal groove 3g to the proximal end 3m, and the distal end 2h is pressed against the distal end 3q of the outer needle 3 in a state where the cut cell tissue is held by the holding 2m. Thus, it is contracted and deformed in the radial direction to change from the protruding posture to the stowed posture.
In addition, a temporary fixing groove 3n for temporarily fixing the engaging projection 2f is formed at a position near the first vertical groove 3f of the horizontal groove 3j, and is cut out toward the base end side. The engaging protrusion 2f that has reached the distal end portion 3h is temporarily engaged with the temporary fixing groove 3n, and the distal end portion 2h in a protruding posture is brought into a stationary state in the body of the subject. It can be confirmed that 2h has been expanded and deformed.

また、外針3の先端3qは、前述の内針2の先端突出部2nと同じ斜度で傾斜状に形成されており、内針2の収納姿勢においては、生検針1の先端が内針の先端突出部2nと外針の先端3qとによって連続した傾斜で生検針1の針先を形成するようになっており、収納姿勢で被検者に穿刺しやすいようになっている。 In addition, the distal end portion 3q of the outer needle 3 is formed in an inclined shape with the same inclination as the distal end protruding portion 2n of the inner needle 2, and the distal end portion of the biopsy needle 1 is in the retracted position of the inner needle 2. The tip of the biopsy needle 1 is formed with a continuous inclination by the distal end protruding portion 2n of the inner needle and the distal end portion 3q of the outer needle, so that the subject can be easily punctured in the retracted position. .

叙述の如く構成された本発明の実施の形態において、生検針1を被検者の体内に穿刺するにあたっては、生検針1を、内針2の先端2hが外針3の先端3qに没入する収納姿勢の状態にして生検針1の把手3dを両手で把持し、生検針1の先端2gが採取領域に到達するように生検針1を穿刺していくが、このような穿刺は、一般的に、超音波画像等によって被検者の体内における生検針1の位置を確認しながらおこなわれる。
先端2gが採取領域に到達したことが超音波画像等で確認されたら、穿刺のための押し込み操作を停止し、把手3dは保持したままの状態にして外針3の姿勢を保ちながら外針3に対して押出し支持部2dを押し込み操作し、被検者の体内で内針2の先端部2hが外針3の先端3から突出する突出姿勢に変姿させる。このとき係合突起2fは、押出し支持部2dの押出しによって、第一縦溝3fの基端部3kから先端部3hへと移動するが、該係合突起2fが先端部3hに当接したら押出し支持部2dの押し出し状態は保ったまま、回動操作部2eを把持して軸心回りに(本実施の形態では反時計回り)少しだけ回動させて係合突起2fを仮止め溝3nに係合させる。
In the embodiment of the present invention constructed as narrative, the biopsy needle 1 when piercing the body of the subject, the biopsy needle 1, the tip portion 2h of the inner needle 2 in the distal end portion 3q of the outer needle 3 While holding the handle 3d of the biopsy needle 1 with both hands in the retracted storage posture state, the biopsy needle 1 is punctured so that the distal end 2g of the biopsy needle 1 reaches the sampling region. Generally, it is performed while confirming the position of the biopsy needle 1 in the body of the subject by an ultrasonic image or the like.
When it is confirmed by ultrasonic images or the like that the distal end 2g has reached the collection region, the pushing operation for puncturing is stopped, and the outer needle 3 is maintained while maintaining the posture of the outer needle 3 while holding the handle 3d. extruding the support portion 2d is pushed in and is Hensugata the projecting posture tip 2h of the inner needle 2 in the body of the subject is projected from the tip 3 r of the outer needle 3 against. At this time, the engaging protrusion 2f moves from the base end 3k of the first longitudinal groove 3f to the tip 3h by the pushing of the push-out support part 2d. However, when the engaging protrusion 2f contacts the tip 3h, the push-out is pushed out. While maintaining the pushing-out state of the support portion 2d, the rotation operation portion 2e is grasped and rotated slightly around the axis (counterclockwise in the present embodiment), and the engagement protrusion 2f is inserted into the temporary fixing groove 3n. Engage.

このように係合突起2fを仮止め溝3nに係合させた状態では、内針2の先端部2hは、被検者の体内で突出した状態で静止しており、被検者の体温を受けて径方向に拡開変形することになる。内針先端部2hが拡開変形する様子を画像等で確認した後は、押出し支持部2dを再び押出し操作して係合突起2fを仮止め溝3nから外し、その後回動操作部2eを再び把持して内針2の軸回り方向(本実施の形態では反時計回り)に回動させることで、係合突起2fを横溝3nの仮止め溝3nの形成位置から第二縦溝3gの先端部3iまで移動させ、この回動によって拡開変形した貫通孔2iに形成される切断刃2kが被検者の体内で細胞組織を切断するとともに、該切断された細胞組織を保持部2mに保持させる。そして、係合突起2fが第二縦溝先端部3iに到達した後は、把持していた押出し支持部2dおよび回動操作部2eから手をゆっくり離すことによって係合突起2fが弾機4の付勢力を受けて第二縦溝3gを先端部3iから基端部3mへと移動し、これによって内針2の先端部2hが収縮変形しながら外針3の内側に没入していって収納姿勢となる。このように内針先端部2hが突出姿勢から収納姿勢へと変姿する過程において、切断刃2kによって切断され、保持部2mに保持されていた細胞組織は、保持部2mに保持された状態のままで貫通孔2iとともに外針3に収納されることになるため、切断された細胞組織は貫通孔2iの内部から外れることなく、外針3の内側に収納される。   In this state where the engagement protrusion 2f is engaged with the temporary fixing groove 3n, the distal end portion 2h of the inner needle 2 is stationary in a state of protruding in the body of the subject, and the body temperature of the subject is increased. In response, it expands and deforms in the radial direction. After confirming the state in which the inner needle tip portion 2h is expanded and deformed by an image or the like, the push-out support portion 2d is pushed again to remove the engaging protrusion 2f from the temporary fixing groove 3n, and then the rotation operation portion 2e is again pushed. By gripping and rotating the inner needle 2 in the direction around the axis (counterclockwise in the present embodiment), the engagement protrusion 2f is moved from the position where the temporary fixing groove 3n of the lateral groove 3n is formed to the tip of the second vertical groove 3g. The cutting blade 2k formed in the through hole 2i expanded and deformed by this rotation is moved to the portion 3i and cuts the cell tissue in the body of the subject, and the cut cell tissue is held in the holding portion 2m. Let Then, after the engaging protrusion 2f reaches the second longitudinal groove tip 3i, the engaging protrusion 2f of the elastic machine 4 is released by slowly releasing the hand from the pushing support part 2d and the rotating operation part 2e. In response to the urging force, the second longitudinal groove 3g moves from the distal end portion 3i to the proximal end portion 3m, whereby the distal end portion 2h of the inner needle 2 is retracted and retracted into the inner side of the outer needle 3 for storage. Become posture. Thus, in the process in which the inner needle distal end portion 2h is transformed from the protruding posture to the retracted posture, the cell tissue cut by the cutting blade 2k and held by the holding portion 2m is in a state of being held by the holding portion 2m. Since it is housed in the outer needle 3 together with the through hole 2i, the cut cell tissue is housed inside the outer needle 3 without detaching from the inside of the through hole 2i.

このように内針2が形状記憶合金を用いて形成されていて、貫通孔2iが、被検者の体温を受けて径方向に拡開変形するため、被検者の細胞組織が貫通孔2iに入りやすく、そして該入った細胞組織を、内針2を回転させることで切断することになるため、細胞組織の採取が確実となり、そして採取された細胞組織は、内針先端部2hを外針3に没入させると、貫通孔2iは細胞組織を内包できる空隙を存した状態で径方向に収縮変形することになって細胞組織の取出ができることになる。   Thus, since the inner needle 2 is formed using a shape memory alloy, and the through hole 2i receives the body temperature of the subject and expands and deforms in the radial direction, the cellular tissue of the subject becomes the through hole 2i. Since it is easy to enter and the cell tissue that has entered is cut by rotating the inner needle 2, the cell tissue is reliably collected, and the collected cell tissue is removed from the tip 2h of the inner needle. When the needle 3 is immersed, the through-hole 2i is contracted and deformed in the radial direction in a state where there is a space that can contain the cell tissue, and the cell tissue can be taken out.

尚、本発明の実施の形態では、貫通孔の形状を楕円形状に拡開する長孔状に構成したが、これに限定される必要はなく、収納姿勢における貫通孔5を、図6(A)に示す第二の実施の形態のように、径方向の断面がC形状をしたものが互いに対向する円弧状態となるように形成してもよい。このように形成することによって、収納姿勢における保持部5aは孔端縁に形成される切断刃5b同士が近接位置で対向することになるため、切断された細胞組織は内針2だけで貫通孔5iの内側に内包されるようにして保持部5aに保持されるため、一層確実に保持される。また、このように形成される貫通孔5iの拡開姿勢を、図6(B)に示すように、孔端縁に形成される切断刃5bが全て径方向外方に拡開変形するように構成しても良いし、また、図6(C)に示すように、切断刃5bが一つだけ径方向外方に拡開変形するように構成しても良く、さらには、図6(D)に示すように、切断刃5bのうち、内針の径方向対角線上で対向する切断刃だけが拡開変形するように構成しても良い。このように、切断刃5bの拡開変形時における切断刃の形状を種々異なるものに変えて実施することができるため、適宜最適な形状を選択して形成することができる。   In the embodiment of the present invention, the shape of the through-hole is configured as a long hole that expands into an elliptical shape. However, the present invention is not limited to this, and the through-hole 5 in the storage posture is shown in FIG. As in the second embodiment shown in FIG. 2), those having a C-shaped radial cross section may be formed in an arcuate state facing each other. By forming in this way, the holding portion 5a in the storage posture is such that the cutting blades 5b formed on the hole edge face each other at close positions. Since it is held by the holding portion 5a so as to be contained inside 5i, it is held more securely. Moreover, as shown in FIG. 6 (B), the widening posture of the through-hole 5i formed in this way is such that all the cutting blades 5b formed at the hole edge are expanded and deformed outward in the radial direction. Further, as shown in FIG. 6 (C), only one cutting blade 5b may be configured to expand and deform outward in the radial direction. As shown in FIG. 5B, only the cutting blades facing each other on the radial diagonal line of the inner needle among the cutting blades 5b may be configured to expand and deform. As described above, the cutting blade can be formed by changing the shape of the cutting blade at the time of the expanding deformation of the cutting blade 5b to a different one, so that an optimum shape can be selected and formed as appropriate.

さらには、図7に示す第三の実施の形態のように、内針先端部に形成される貫通孔に代えて、径方向の断面がC形状であって内針の軸心方向に長く延びる長溝6としても良く、該長溝6は、収納姿勢においては、図7(A)に示すように端縁部同士が近接もしくは当接した状態となった保持部6aが形成され、突出姿勢においては、図7(B)に示すように端縁部である切断刃6b同士が拡開して該切断刃6bが外径方向に突出するように形成して構成しても良い。内針先端部2hをこのように構成した場合、切断部6bで切断された細胞組織は、長溝6に形成された保持部6aに確実に入り込むことになるとともに、一旦保持部6aに入り込んだ細胞組織が出て行ってしまうようなことがなく、細胞組織の保持を確実に行うことができる。   Further, as in the third embodiment shown in FIG. 7, instead of the through hole formed in the inner needle tip, the radial cross section is C-shaped and extends long in the axial direction of the inner needle. The long groove 6 may be a long groove 6, and in the retracted position, as shown in FIG. 7A, the long groove 6 is formed with a holding portion 6 a in which the edge portions are close to or in contact with each other. As shown in FIG. 7B, the cutting blades 6b, which are the edge portions, may be expanded so that the cutting blades 6b protrude in the outer diameter direction. When the inner needle tip 2h is configured in this way, the cell tissue cut by the cutting part 6b surely enters the holding part 6a formed in the long groove 6 and the cells once entered the holding part 6a. It is possible to reliably hold the cell tissue without causing the tissue to go out.

本発明は、主に医療分野において生体内の細胞組織を検体として採取するために用いられる生検針の技術分野に利用可能である。   INDUSTRIAL APPLICABILITY The present invention can be used in the technical field of biopsy needles that are mainly used in the medical field for collecting cellular tissue in a living body as a specimen.

1 生検針
2 内針
2h 先端部
3 外針
2k 切断刃
2m 保持部
1 Biopsy Needle 2 Inner Needle 2h Tip 3 Outer Needle 2k Cutting Blade 2m Holding Part

Claims (3)

被検者の体内に穿刺して細胞組織を採取するための生検針であって、該生検針を、中実状の内針と、該内針が軸心方向に移動自在に内嵌する中空状の外針とを備え、内針と外針とを、内針の先端部が外針の先端から突出する突出姿勢と、外針の先端より没入する収納姿勢とに相対移動するよう構成するにあたり、内針は外針に対して軸周り方向に回動自在に構成されており、前記内針の先端部には、前記突出姿勢に位置する内針を外針に対して軸回り方向に回動させることで被検者の細胞組織を切断する切断部と、該切断された細胞組織を保持する保持部とが形成されており、該切断部と保持部とは、内針先端部が突出姿勢のときには被検者の体温を受けて径方向外側に拡開変形し、収納姿勢のときには切断された細胞組織を内包できる空隙を有する状態で外針に押圧されて径方向内側に収縮変形するよう形状記憶合金で形成されており、前記内針は、収納姿勢で外針の先端よりも突出した先端突出部を有し、該先端突出部は、先端ほど先鋭となるよう傾斜していて内針の針先を構成し、外針の先端部は、前記先端突出部と同じ斜度で傾斜状に形成されていて、内針が収納姿勢のとき内針の先端突出部と連続するよう傾斜していて生検針の針先を構成していると共に、内針には、外径方向に突出する係合突起が形成され、外針には、前記係合突起が係合する係合溝が側面を貫通するようにして切欠き形成されており、前記係合溝は、内針を収納姿勢と突出姿勢とのあいだに移動させる軸方向に長い第一、第二縦溝と、該第一、第二縦溝の先端部同士を連結する軸回り方向に長い横溝と、横溝から基端側に向けて形成されていて内針を突出姿勢に維持するよう係合突起が係合可能な仮止め溝とを備えて構成されていることを特徴とする生検針。 A biopsy needle for puncturing into a body of a subject to collect a cellular tissue, the biopsy needle having a solid inner needle and a hollow shape in which the inner needle is movably fitted in the axial direction The inner needle and the outer needle are configured to move relative to each other between a protruding posture in which the tip of the inner needle protrudes from the tip of the outer needle and a retracted posture in which the tip of the outer needle is retracted. The inner needle is configured to be rotatable about the axis relative to the outer needle, and the inner needle positioned in the protruding posture is rotated about the axis relative to the outer needle at the distal end portion of the inner needle. A cutting part that cuts the cell tissue of the subject by being moved and a holding part that holds the cut cell tissue are formed, and the tip part of the inner needle protrudes from the cutting part and the holding part When in the posture, it receives the body temperature of the subject and expands and deforms outward in the radial direction. When in the stowed posture, it can contain the cut cell tissue Is formed of a shape memory alloy so as to pressed contracted radially inward deformation to the outer needle in a state having said inner needle has a distal protrusion protruding from the tip of the outer needle in the retracted position, the The tip protrusion is inclined so as to be sharper toward the tip and constitutes the needle tip of the inner needle, and the tip of the outer needle is formed in an inclined shape with the same inclination as the tip protrusion, and the inner needle When the needle is in the stowed position, it is inclined so as to be continuous with the tip protruding portion of the inner needle to constitute the needle tip of the biopsy needle, and the inner needle is formed with an engaging projection that protrudes in the outer diameter direction. The needle is formed with a notch so that the engaging groove with which the engaging protrusion engages penetrates the side surface, and the engaging groove moves the inner needle between the retracted position and the protruding position. First and second longitudinal grooves that are long in the axial direction, and lateral grooves that are long in the direction around the axis connecting the tips of the first and second longitudinal grooves. Biopsy needle, wherein the engagement projection is configured with a temporary fixing groove engageable to maintain the inner needle is formed toward the base end side from the transverse groove in the projecting position. 内針の先端部には、径方向に貫通する貫通孔が形成され、該貫通孔の孔端縁が切断部であり、貫通孔の互いに対向する内周面間が保持部であることを特徴とする請求項1記載の生検針。   A through-hole penetrating in the radial direction is formed at the distal end portion of the inner needle, a hole edge of the through-hole is a cutting portion, and a space between inner peripheral surfaces of the through-holes facing each other is a holding portion. The biopsy needle according to claim 1. 内針の先端部は、径方向の断面がC形状をしていて軸方向に長い長溝形成され、該長溝の溝端縁が切断部であり、溝跨部が保持部であることを特徴とする請求項1記載の生検針。 A long groove in the axial direction is formed at the distal end portion of the inner needle with a C-shaped radial cross section, the groove edge of the long groove is a cut portion, and the groove straddling portion is a holding portion. The biopsy needle according to claim 1.
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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030055373A1 (en) * 2001-08-03 2003-03-20 Stemsource Llc Devices and methods for extraction of bone marrow
JP2005503227A (en) * 2001-09-27 2005-02-03 ガリル メディカル リミテッド Apparatus and method for cryosurgical treatment of breast tumors
JP2005073798A (en) * 2003-08-28 2005-03-24 Olympus Corp Puncture needle device for endoscope
JP2005103107A (en) * 2003-09-30 2005-04-21 Shinshu Tlo:Kk Medical holder, and method for mounting the same in body

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030055373A1 (en) * 2001-08-03 2003-03-20 Stemsource Llc Devices and methods for extraction of bone marrow
JP2005503227A (en) * 2001-09-27 2005-02-03 ガリル メディカル リミテッド Apparatus and method for cryosurgical treatment of breast tumors
JP2005073798A (en) * 2003-08-28 2005-03-24 Olympus Corp Puncture needle device for endoscope
JP2005103107A (en) * 2003-09-30 2005-04-21 Shinshu Tlo:Kk Medical holder, and method for mounting the same in body

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