JP6367632B2 - Insertion aid for gastrostomy tube - Google Patents

Description

  The present invention relates to a gastrostomy tube insertion aid for use in inserting a gastrostomy tube for feeding nutrients into the stomach.

  The gastrostomy tube includes a tube main body whose tip is inserted into the stomach via the gastrostoma and a saddle-like bumper portion that is placed in the stomach. When inserting such a gastrostomy tube into the stomach via the gastrostomy, generally an insertion assisting tool for gastrostomy tube is used.

  As this type of gastrostomy tube insertion aid, one having a stainless steel holding rod and a synthetic resin locking member attached to the tip of the rod is known (see Patent Document 1 below).

  When using this gastrostomy tube insertion assisting tool, first, the distal end of the holding rod is locked at one place in the circumferential direction of the bumper portion of the gastrostomy tube, and then the tube body is pulled toward the proximal end portion to thereby bump the bumper. The part is deformed into an elongated shape. Then, maintaining this state, the gastrostomy tube is inserted into the gastrostomy together with the holding rod. Then, the holding rod is pulled out when the bumper part enters the stomach. As a result, the bumper portion is restored to a saddle shape in the stomach, the withdrawal of the gastrostomy tube from the stomach is restricted, and the gastrostomy tube is left in place.

  By the way, the gastrostoma is formed so as to penetrate both the abdominal wall and the gastric wall, but when the gastrostomy tube is inserted into the gastrostomy, if the abdominal wall fistula and the gastric wall fistula are misaligned, In some cases, the bumper portion of the gastrostomy tube that has passed through abuts against a portion other than the fistula in the stomach wall, and the bumper portion cannot be smoothly inserted into the fistula in the gastric wall.

  Therefore, the gastrostomy tube is inserted into the gastrostoma using a linear guide member such as a guide wire. That is, in the gastrostomy tube insertion aid shown in Patent Document 1, a guide passage is formed which communicates from the handle portion gripped by the practitioner to the holding rod and the locking member. The guide member can be inserted. On the other hand, the guide member is placed in the gastric fistula in a state where it is inserted through the fistula of the abdominal wall and the fistula of the gastric wall in advance.

  When inserting the gastrostomy tube into the gastrostomy, the guide member is inserted into the holding rod from the distal end of the locking member with the bumper portion held by the holding rod. A through hole through which the tip of the locking member passes is formed in the bumper portion, and a guide passage is opened at the tip of the locking member that penetrates and is exposed through the bumper portion. A guide member is inserted into the guide passage from this opening, and the guide member is led out of the handle portion from the terminal opening of the guide passage provided in the handle portion. Next, the gastrostomy tube together with the holding rod is inserted into the gastrostomy until the bumper part reaches the stomach so as to be along the guide member. Thereafter, the guide member is removed from the gastrostomy and the guide member is removed from the gastrostomy.

  Thus, the fistula tube can be smoothly inserted into the gastrostoma while the positional deviation between the fistula of the abdominal wall and the fistula of the gastric wall is suppressed by the guide member previously placed in the gastrostoma.

JP 2009-254578 A

  However, in the thing of the said patent document 1, since the guide path of a guide member is formed in communication with a locking member, a holding rod, and a handle | pattern part, the insertion distance is very long, and the insertion operation of a guide member is quick. There is an inconvenience that cannot be done.

  Moreover, in the thing of the said patent document 1, since a gastrostomy tube is inserted in a gastrostoma in the state which the guide member penetrated the surrounding wall of the bumper part, there exist the following inconveniences. In other words, if the holding rod is accidentally removed from the bumper before the bumper has fully entered the stomach, it is necessary to remove the remaining bumper from the gastrostomy and insert it again. There is. At this time, the bumper portion is deformed so as to be folded inside the gastrostomy, and the guide member penetrating the bumper portion is tightened by the bumper portion. If the bumper part is removed from the gastrostoma in this state, the guide member is also removed from the stomach together with the bumper part, and the guide member cannot be used when the gastrostomy tube is reinserted into the gastrostomy. There is a risk that smooth insertion of the tube cannot be expected.

  In view of the above points, an object of the present invention is to provide a gastrostomy tube insertion aid that can smoothly perform a gastrostomy tube insertion operation using a guide member.

  The present invention relates to a gastrostomy tube insertion aid that holds a gastrostomy tube and inserts it into the gastrostomy tube, and holds the flexible scissor-shaped bumper provided on the gastrostomy tube at the front end. And a retaining member provided at a front end portion of the retaining rod for retaining the bumper portion. The retaining member is provided on a part of the outer peripheral surface of the retaining rod. A protrusion that protrudes outward of the rod, and the protrusion includes a guide hole through which a linear guide member previously placed in the gastrostomy is inserted at an outer position of the holding rod. To do.

  According to the present invention, the protrusion is provided in the locking member, and the guide hole is provided in the protrusion, so that the guide member is inserted into the guide hole as compared with the case where the guide member is inserted into the guide passage in the holding rod. This guide member insertion operation can be performed very easily and quickly. In addition, by providing the guide hole in the protruding portion, a guide operation by the guide member can be performed without penetrating the bumper portion of the gastrostomy tube. As a result, even if the holding rod is removed from the bumper part and the bumper part remaining in the middle position of the gastrostoma is deformed to be folded inside the gastrostoma, the guide member penetrates the bumper part. Compared to the case, the guide member is hardly tightened by the bumper portion. Therefore, the state where the guide member is indwelled in the gastrostoma can be maintained, and only the bumper portion can be extracted from the gastrostomy, and the guide member can be used again when the gastrostomy tube is reinserted into the gastrostomy. Therefore, the gastrostomy tube can be smoothly reinserted.

  In the present invention, the protrusion includes a pair of side wall plates facing each other and extending in the front-rear direction, and a connection wall that is positioned between the side wall plates and connects the both side wall plates, A guide hole is formed.

  According to this, the connecting wall can be made relatively thin and the total length of the guide hole can be made extremely small. Therefore, the guide member can be quickly inserted into the guide hole without resistance. In addition, the bumper portion in a state of being locked to the locking member is prevented from being brought into contact with the guide member positioned between the side wall plates by the pair of side wall plates, so that the guide member in the guide hole can be smoothly inserted and moved. Therefore, the operation of inserting the gastrostomy tube into the gastrostomy by guiding the guide member can be performed smoothly.

  By the way, since the protruding portion protrudes from a part of the outer peripheral surface of the locking member, when the protruding portion passes through the gastrostoma, there is a possibility that the gastrostomy may be damaged. Therefore, in the present invention, an insertion guide inclined portion that is inclined in a direction gradually separating from the holding rod is formed on the front end side of the protruding portion, and the holding end is provided on the rear end side of the protruding portion. It is preferable to form an extraction guide inclined portion that is inclined in a direction gradually approaching the rod.

  According to this, when inserting the bumper portion of the gastrostoma tube into the gastrostoma, the projection guide portion is prevented from being caught by the gastrostoma by the insertion guide inclined portion, and the holding of the bumper portion stored in the stomach is released. When the holding rod is removed from the gastrostoma, the projection guide is prevented from being caught on the gastrostoma by the withdrawal guide inclined portion. Therefore, even if a protruding portion that protrudes from the locking member is provided, the gastrostomy tube can be inserted smoothly by preventing the gastrostomy from being caught or damaged.

The side view which shows the insertion assistance tool for gastrostomy tubes of embodiment of this invention. The side view which shows the insertion assistance tool for gastrostomy tubes of the state holding the gastrostomy tube. The explanatory perspective view of the principal part of a gastrostomy tube. Sectional drawing of the principal part of a gastrostomy tube. The side view of a locking member. The front view of a locking member. Explanatory sectional drawing which shows the front end part of a locking member and a holding rod.

  An embodiment of the present invention will be described with reference to the drawings. As shown in FIG. 1, a gastrostomy tube insertion aid 1 (hereinafter simply referred to as “insertion aid 1”) of this embodiment includes a metal holding rod 2 such as stainless steel and a rear end of the holding rod 2. And a handle portion 3 made of synthetic resin provided in the portion. The handle portion 3 is formed in an L shape with an angle in a side view, and is formed so that a practitioner can easily grasp it.

  The insertion assisting tool 1 of this embodiment holds a gastrostomy tube 4 as shown in FIG. First, the configuration of the gastrostomy tube 4 employed in the present embodiment will be described. The gastrostomy tube 4 is a well-known one, but as shown in FIGS. 3 and 4, a tube main body 5 for feeding nutrients and the like inside, and a bowl-shaped bumper portion 6 provided at the tip of the tube main body 5 And. The tube body 5 and the bumper part 6 are integrally formed of a flexible synthetic resin (silicone resin).

  As shown in FIGS. 3 and 4, a thick wall portion 7 that protrudes radially inward is formed on the inner surface of the circumferential wall portion of the bumper portion 6 on one side in the circumferential direction. A hole 8 that opens radially inward is formed. The outer diameter of the bumper part 6 is formed larger than the outer diameter of the tube body 5. A communication port 9 that communicates with the tube main body 5 is formed at the center of the bumper portion 6. A notch portion 10 is formed at a position facing the hole portion 8 in the peripheral wall portion of the bumper portion 6.

  As shown in FIG. 2, the insertion assisting tool 1 of the present embodiment that holds the gastrostomy tube 4 having the above-described configuration has a tube body 5 of the gastrostomy tube 4 on the rear end side (front end of the handle 3) of the holding rod 2. The tube latching | locking part 11 which latches is provided. Further, a synthetic resin locking member 12 for locking the bumper portion 6 of the gastrostomy tube 4 is attached to the tip (front end) of the holding rod 2.

  As shown in FIGS. 5 to 7, the locking member 12 includes a cylindrical main body 13 that is fitted and fixed to the holding rod 2, and a small-diameter portion 14 that extends forward from the front end (front end) of the main body 13. , And a projecting portion 15 projecting to one side of the main body portion 13.

  As shown in FIG. 6, the protrusion 15 includes a pair of side wall plates 16, 16 facing each other and a connecting wall 17 that is located between the side wall plates 16, 16 and connects the side wall plates 16, 16. It is configured. A guide hole 18 is formed in the connecting wall 17, and a linear guide member W such as a guide wire can be inserted into the guide hole 18 as shown in FIG. . Thereby, the guide member W inserted through the guide hole 18 is positioned outside the holding rod 2 without penetrating the bumper portion 6 as in the prior art. Further, since the connecting wall 17 is formed to be relatively thin, the total length of the guide hole 18 is extremely small.

  Further, on the front end side of each connecting wall 17 of the projecting portion 15, an insertion guide inclined portion 19 that is inclined while smoothly bending in a direction gradually separating from the holding rod 2 inserted into the main body portion 13 is formed. On the rear end side of each connecting wall 17 of the projecting portion 15, the extraction guide inclined portion 20 that inclines while smoothly curving in the direction of gradually approaching the holding rod 2 inserted into the main body portion 13. Is formed.

  When the gastrostomy tube 4 is held by the insertion aid 1 having the above-described configuration, referring to FIGS. 2 and 5, first, the insertion aid is inserted into the hole 8 formed in the thick portion 7 on the inner surface of the bumper portion 6. The small-diameter portion 14 of the locking member 12 attached to the front end of one holding rod 2 is inserted. Next, the tube body 5 is pulled rearward along the holding rod 2. Then, the tube body 5 is locked to the tube locking portion 11 of the insertion assisting tool 1.

  As a result, the bumper portion 6 is deformed into an elongated shape in a state where the bumper portion 6 is locked to the locking member 12, and the tube main body 5 is in a posture along the longitudinal direction of the holding rod 2. Held at 1.

  When the gastrostomy tube 4 is held by the insertion aid 1, the elongated and deformed bumper portion 6 is deformed so as to wrap around the locking member 12 at the tip of the holding rod 2. At this time, the side wall plates 16 and 16 of the protruding portion 15 of the locking member 12 restrict the bumper portion 6 so that the guide hole 18 of the connecting wall 17 is not covered. Even when the protruding portion 15 of the locking member 12 protrudes from the bumper portion 6, the locking member 12 is inserted into the gastrostomy by the insertion guide inclined portion 19 and the extraction guide inclined portion 20 formed in the protruding portion 15. The resistance can be reduced when removing from the stomach and stomach.

  When inserting the gastrostomy tube 4 into the gastrostomy, although not shown, first, the guide member W such as a guide wire drawn out from the stomach via the gastrostomy is inserted into the protruding portion of the locking member 12. 15 guide holes 18 are inserted. At this time, as shown in FIG. 7, the side wall plates 16 and 16 regulate the bumper portion 6 so that the guide hole 18 is visible. Moreover, the thickness of the connecting wall 17 is relatively thin, and the total length of the guide hole 18 is extremely small. Therefore, the insertion resistance resistance of the guide member W into the guide hole 18 is small, and the insertion work of the guide member W into the guide hole 18 can be performed quickly.

  Next, the bumper portion 6 of the gastrostomy tube 4 together with the holding rod 2 is inserted into the gastrostomy along the guide member W. In addition, although not shown in the figure, when the operation failure or the like occurs and the bumper part 6 is detached from the holding rod 2 in the middle position of the gastrostoma, the bumper part 6 and the holding rod 2 are once removed from the gastrostoma and inserted again. Perform the operation. At this time, unlike the conventional case where the guide member W penetrates the bumper portion 6, the guide member W is held without penetrating the bumper portion 6 by the guide hole 18 of the protruding portion 15 of the locking member 12. The rod 2 is guided. Therefore, even if the remaining bumper portion 6 is deformed so as to be folded inside the gastrostomy, there is almost no tightening of the guide member W by the deformed bumper portion 6, and an operation failure or the like occurs, and the bumper portion 6 and the holding rod once. When the 2 is extracted from the gastrostomy, the guide member W can be prevented from being accidentally pulled out.

  When the bumper portion 6 of the gastrostomy tube 4 enters the stomach, the tube body 5 is removed from the tube locking portion 11 and the guide member W is removed from the gastrostomy, and then the holding rod 2 of the insertion aid 1 is removed. Remove from stomach fistula. By the above procedure, the gastrostomy tube 4 can be reliably inserted into the gastrostomy using the guide member W and the insertion assisting tool 1.

DESCRIPTION OF SYMBOLS 1 ... Gastrostomy tube insertion aid, 2 ... Holding rod, 4 ... Gastrostomy tube, 6 ... Bumper part, 12 ... Locking member, 15 ... Projection part, 16 ... Side wall plate, 17 ... Connecting wall, 18 ... Guide Hole: 19 ... Insertion guide inclined part, 20 ... Extraction guide inclined part, W ... Guide member.

Claims (2)

A gastrostomy tube insertion aid for holding a gastrostomy tube and inserting the gastrostomy tube,
A rod-shaped holding rod that holds the flexible rod-shaped bumper portion provided on the gastrostomy tube at the front end portion, and a latch that is provided at the front end portion of the holding rod and locks the bumper portion. In what comprises a member,
The locking member includes a protruding portion protruding toward the outside of the holding rod on a part of the outer peripheral surface thereof,
The projecting portion includes a guide hole through which a linear guide member previously placed in the gastrostomy is inserted at an outer position of the holding rod ,
The projecting portions are a pair of side wall plates facing each other and extending in the front-rear direction, and a connecting wall that connects the side wall plates by spanning from the front-rear direction intermediate portion of the one side wall plate to the front-rear direction intermediate portion of the other side wall plate. And
A gastrostomy tube insertion aid, wherein the guide hole is formed in the connecting wall. In claim 1 Symbol placement of the gastrostomy tube for insertion aid, to the front end side of the projecting portion is inserted guide inclined portion inclined in a direction away gradually is formed from the holding rod,
A gastrostomy tube insertion assisting device, wherein an extraction guide inclined portion that is inclined in a direction of gradually approaching the holding rod is formed on the rear end portion side of the protruding portion.

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