JP6199473B1 - Stent kit - Google Patents

Abstract

To provide a stent kit capable of collecting fluid and the like from an organ when placing a stent for placement, and capable of collecting fluid and the like after placement. A stent kit (10) includes an indwelling stent (20) and an outer catheter (30), and an inner catheter (40) through which the inside is inserted and a through hole (46) is provided in a projecting portion (43). Since the first and second connecting members 32 and 42 are detachable at the base end of 40, if the first and second connecting members 32 and 42 are removed, only the endoscope 12 can be pulled out of the body. Therefore, fluid or the like can be collected while leaving the indwelling stent 20, the outer catheter 30, and the inner catheter 40 in the body. [Selection] Figure 1

Description

  The present invention relates to a stent (hereinafter simply referred to as “in-dwelling stent”) that is inserted into a human body (hereinafter simply referred to as “body”) through an endoscope and placed in a tubular organ such as a bile duct. The present invention relates to a stent kit including an outer catheter that engages with an indwelling stent, and an inner catheter that passes through the inside of the indwelling stent and the outer catheter.

  An indwelling stent is placed in a tubular organ such as a bile duct or a ureter through an endoscope to ensure fluid communication in the tubular organ, or to prevent rupture of an aneurysm formed in the tubular organ, etc. Used for purposes. On the other hand, in addition to indwelling the indwelling stent in the tubular organ, for example, fluid such as bile may be aspirated from an organ near the indwelling position of the indwelling stent. Here, examples of the suction catheter include the following.

JP-A-10-151195 JP 2009-72294 A

  Patent Document 1 discloses an intestinal residue discharge tube in which a balloon that can be inflated and deflated is attached to a tube, and a side hole is provided in a tube on the tip side of the balloon.

  Patent Document 2 discloses a suction catheter including an outer tube having a suction lumen, and a plurality of through holes in a side wall, and an inner tube provided in the outer tube.

  When using a suction catheter as disclosed in Patent Documents 1 and 2 and sucking fluid or the like from an organ in the body, the suction catheter is inserted into the body through an endoscope to perform a suction operation. Next, when the indwelling stent is placed in the body, after the suction operation is completed, the suction catheter is pulled out from the endoscope, and is composed of an inner catheter, an indwelling stent, and an outer catheter separate from the suction catheter. It is necessary to insert a stent kit into the body through an endoscope and place an indwelling stent. As described above, since it is necessary to insert and remove the catheter and the stent kit into and from the endoscope twice at the time of suction and indwelling, it takes time and effort during the operation.

  In addition, as described above, in the technique of indwelling the indwelling stent after suction of the fluid or the like, it is not planned to collect the fluid or the like after the indwelling stent is indwelled. If the fluid or the like is collected after the placement of the catheter, it is inconvenient because the endoscope must be inserted into the body again and the suction catheter must be inserted, and the burden on the patient is great.

  Therefore, in view of the above-described problems, an object of the present invention is to provide a stent kit that can collect a fluid or the like from an organ when an indwelling stent is indwelled and can collect a fluid or the like after the indwelling.

The present invention is a stent kit having a tubular inner catheter inserted through an endoscope, an indwelling stent through which the inner catheter is inserted, and an outer catheter,
The indwelling stent is located on the distal end side of the inner catheter from the proximal end of the outer catheter,
The inner catheter is provided at a distal end side opening and a projecting portion that projects further to the distal end side than the indwelling stent, a through hole communicating with the inside of the inner catheter, and a first connecting member that can be attached to and detached from the proximal end With
The outer catheter includes a second connecting member that is proximal to the indwelling stent and removable from the distal end side of the first connecting member ,
By removing the first connecting member and the second connecting member, the endoscope through which the inner catheter, the indwelling stent, and the outer catheter are inserted can be pulled out by the stent kit, Solved the problem.

  According to the present invention, the inner catheter inserted through the indwelling stent has a through hole in the protruding portion that protrudes more distally than the indwelling stent, and each of the inner catheter and the outer catheter is at the proximal end. Since the detachable first connecting member and the second connecting member are provided, when the indwelling stent is indwelled, the organ in the vicinity of the indwelling stent indwelling position through the opening or through hole on the distal end side of the inner catheter. Fluids can be collected from In addition, if the first connecting member and the second connecting member are removed after the indwelling stent is in place, there is no member interfering with the catheter insertion port of the endoscope, so that at least the inner catheter and the stent are inserted into the body The endoscope can be removed. In this state, fluid or the like can be collected from an organ in the vicinity of the indwelling position of the indwelling stent through the opening or the through hole on the distal end side of the inner catheter. The present invention can be applied to a stent that cannot expand and contract and a stent that can expand and contract (mostly metallic stent).

  Further, when the outer catheter and the inner catheter are inserted through the body nasally, the outer diameter of the nasal cavity-corresponding portion of the outer catheter that is located in the nasal cavity is smaller than other portions of the outer catheter. When only the mirror is pulled out, discomfort and discomfort in the nasal cavity through which the outer catheter passes can be reduced.

1 is a partial front sectional view of a first embodiment of the present invention. Schematic of the use condition of 1st Embodiment of this invention. The front view of 2nd Embodiment of this invention. The front fragmentary sectional view of 3rd Embodiment of this invention.

  Hereinafter, embodiments of the present invention will be described with reference to FIGS. However, the present invention is not limited to this embodiment.

  A stent kit 10 shown in FIG. 1 includes an indwelling stent 20, an outer catheter 30, and an indwelling stent 20 and an inner catheter 40 that passes through the outer catheter 30. Since the indwelling stent 20, the outer catheter 30, and the inner catheter 40 are all tubular and separate from each other, they can move forward and backward.

  The indwelling stent 20 is made of polyethylene or plastic and cannot be expanded / contracted, and is positioned closer to the distal end side of the inner catheter 40 than the proximal end of the outer catheter 30. In addition, flaps 22 are provided on both sides in the axial direction to prevent dropping off from the indwelling position. In addition, as the indwelling stent, various types such as those having side holes, those having no side holes, those having no flaps, straight types, curved types, and pigtail types can be applied. In some cases, a valve body may be provided.

  The outer catheter 30 is located on the proximal end side of the inner catheter 40 with respect to the indwelling stent 20. Here, the diameters of the indwelling stent 20 and the outer catheter 30 are configured such that the proximal side surface of the indwelling stent 20 and the distal side surface of the outer catheter 30 are in contact with each other. The indwelling stent 20 is pushed in the same direction. As described above, in the case of the indwelling stent 20 that cannot be expanded and contracted, it is necessary that the indwelling stent 20 and the outer catheter 30 are partially in contact with each other in the axial direction so that the indwelling stent 20 can be pushed out. Although not shown in the drawings, a connecting means may be provided separately so that when the outer catheter 30 is pulled in the proximal direction of the inner catheter 40, the indwelling stent 20 is also pulled back.

  Since the inner catheter 40 is inserted through the inside of the indwelling stent 20 and the outer catheter 30, the inner catheter 40 has an outer diameter smaller than the inner diameter of the indwelling stent 20 and the outer catheter 30. It has an axial dimension that is longer than the total axial length. Moreover, since the inner catheter 40 is tubular, it includes a distal end side opening 44. Further, the protruding portion 43 includes a plurality of through holes 46 communicating with the inside of the inner catheter 40. The protruding portion 43 includes a portion protruding toward the distal end side relative to the indwelling stent 20. The shape of the protruding portion 43 of the inner catheter 40 can be a curved type or a pigtail type in addition to the straight type as shown in the figure.

  The inner catheter 40 includes a first connecting member 42 that can be attached to and detached from the proximal end. The first connecting member 42 is attached to the inner catheter 40 on the proximal end side of the proximal end side surface of the outer catheter 30 and prevents the inner catheter 40 from entering the outer catheter 30 completely. . The inside of the inner catheter 40 and the inside of the first connecting member 42 are in fluid communication, and the proximal end side opening 42a of the first connecting member 42 can be connected to a tube of the drainage bag or the like. It is also possible to inject a contrast medium or the like into the body from the proximal end side opening 42a. Moreover, the 1st connection member 42 may be a Y-shaped thing provided with two base end side opening parts. In this case, one opening can be used as a guide wire insertion opening, and the other opening can be used as an opening for liquid injection / suction.

  The outer catheter 30 includes a second connecting member 32 that is detachable on the proximal end side from the indwelling stent 20 and further on the distal end side than the first connecting member 42. The second connecting member 32 is for preventing the outer catheter 30 from completely entering the endoscope 12 described later. In addition, the 1st connection member 42 and the 2nd connection member 32 can also be comprised so that a mutual connection is possible.

  Next, a method for using the stent kit 10 will be described. The indwelling stent 20, the outer catheter 30, and the inner catheter 40 are passed through the endoscope 12 from the treatment instrument insertion port 14 of the endoscope 12 that has been previously inserted into the body, and through the inside of the endoscope 12. Inserted into. Specifically, for example, when placing the indwelling stent 20 in the bile duct, first, a guide wire (not shown) is inserted through the endoscope into the bile duct, and then the inner catheter 40 is inserted along the guide wire. The indwelling stent 20 is pushed by the outer catheter 30 along the inner catheter 40. Then, the indwelling stent 20 is pushed to the indwelling place.

  Here, in the stent kit 10, fluid such as bile is collected from the distal end side opening 44 and the through hole 46 of the inner catheter 40 by sucking from the proximal end side opening 42 a of the first connecting member 42. Can do. Further, if the first connecting member 42 and the second connecting member 32 are removed, there is no member interfering with the treatment instrument insertion port 14 of the endoscope 12, so that the indwelling stent 20, the outer catheter 30, and the inner catheter 40 are removed. Only the endoscope 12 can be pulled out of the body while remaining in the body. FIG. 2 shows the state at this time. After that, if at least the first connecting member 42 is reattached to the proximal end side of the inner catheter 40 and sucked from the proximal end side opening portion 42a of the one connecting member 42, the distal end side opening portion 44 of the inner catheter 40 and the through hole are provided. From 46, fluid such as bile in the bile duct 52 can be collected. Further, after the fluid such as bile is collected, the outer catheter 30 and the inner catheter 40 can be removed while the indwelling stent 20 remains in the body by pulling out the outer catheter 30 and the inner catheter 40.

  As shown in FIG. 2, when the indwelling stent 20 of the stent kit 10 is placed in the bile duct 54 and the outer catheter 30 and the inner catheter 40 are left in the body, the outer catheter 30 and the inner catheter 40 are inserted nasally. The burden is less on the patient. Here, when the outer catheter 30 and the inner catheter 40 are inserted through the body nasally, like the stent kit 10a shown in FIG. 3, the outer catheter 30a located outside the nasal cavity corresponding portion 32a of the outer catheter 30 is located outside the nasal cavity 54. It is preferable to make the diameter smaller than the other part of the outer catheter 30 because the uncomfortable feeling and discomfort in the nasal cavity 54 can be reduced. When a stent kit other than for bile ducts is used, the outer diameter of the outer catheter at the part where the patient feels uncomfortable or uncomfortable may be reduced.

  As shown in FIG. 4, the present invention is also applicable to a stent kit 10b having an indwelling stent 20a that can be expanded and contracted. The indwelling stent 20a of the stent kit 10b is made of metal or resin and is configured to expand in a natural state. In this case, the outer catheter 30b is fitted so as to cover the outer diameter side of the indwelling stent 20a in a contracted state. When the outer catheter 30b is pulled at the indwelling position of the indwelling stent 20a in the body, the indwelling stent 20a is restricted from moving in the axial direction by the stopper 48 provided on the inner catheter 40a, and from the distal end side exposed from the outer catheter 30b. Expand gradually. Thus, the stent kit 10b is partially different in configuration from the stent kit 10, but includes the distal end side opening 44 and the through hole 46 of the inner catheter 40a, and the first connecting member 42 and the second connecting member 32. Since these are the same, the same effects as the stent kit 10 can be obtained. That is, when indwelling the indwelling stent 20a, fluid or the like can be collected from the organ in the vicinity of the indwelling position of the indwelling stent 20a through the distal end opening 44 or the through hole 46 of the inner catheter 40a, and With the indwelling stent 20a, the outer catheter 30b, and the inner catheter 40a left in the body, only the endoscope (not shown) is withdrawn from the body, and in this state, fluid flows from the organ in the vicinity of the indwelling position of the indwelling stent 20a. Etc. can be collected. In addition, it is also possible to reduce the outer diameter of the outer catheter 30b in a part where the patient feels uncomfortable and uncomfortable like the stent kit 10a.

  As described above, it is possible to provide a stent kit that can collect a fluid or the like from an organ when an indwelling stent is indwelled and can collect a fluid or the like after the indwelling.

10-10b Stent kit 20, 20a Indwelling stent 30-30b Outer catheter 32 Second connecting member 40, 40a Inner catheter 42 First connecting member 43 Protruding portion 46 Through hole 48 Stopper

Claims (4)

A stent kit having a tubular inner catheter inserted into an endoscope, an indwelling stent and an outer catheter through which the inner catheter is inserted,
The indwelling stent is located on the distal end side of the inner catheter from the proximal end of the outer catheter,
The inner catheter is provided at a distal end side opening and a projecting portion that projects further to the distal end side than the indwelling stent, a through hole communicating with the inside of the inner catheter, and a first connecting member that can be attached to and detached from the proximal end With
The outer catheter includes a second connecting member that is proximal to the indwelling stent and removable from the distal end side of the first connecting member ,
By removing the first connecting member and the second connecting member, the endoscope through which the inner catheter, the indwelling stent, and the outer catheter are inserted can be pulled out .
Stent kit.   The stent according to claim 1, wherein when the outer catheter and the inner catheter are inserted through the body nasally, the outer diameter of the nasal cavity-corresponding portion of the outer catheter is smaller than the other part of the outer catheter. kit. The indwelling stent cannot expand and contract;
The stent kit according to claim 1 or 2, wherein the indwelling stent and the outer catheter are configured to contact each other in the axial direction. The indwelling stent can expand and contract;
The inner catheter has a stopper for preventing axial movement of the indwelling stent on the proximal side of the indwelling stent;
The stent kit according to claim 1 or 2, wherein the outer catheter is fitted on an outer diameter side of the indwelling stent in a contracted state.

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