JP6525668B2 - 医療器具 - Google Patents
医療器具 Download PDFInfo
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- JP6525668B2 JP6525668B2 JP2015067178A JP2015067178A JP6525668B2 JP 6525668 B2 JP6525668 B2 JP 6525668B2 JP 2015067178 A JP2015067178 A JP 2015067178A JP 2015067178 A JP2015067178 A JP 2015067178A JP 6525668 B2 JP6525668 B2 JP 6525668B2
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- tubular member
- lymphatic vessel
- vein
- lumen
- puncture
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00561—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated creating a vacuum
- A61B2017/00566—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated creating a vacuum fixation of form upon application of vacuum
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00898—Material properties expandable upon contact with fluid
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1132—End-to-end connections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1135—End-to-side connections, e.g. T- or Y-connections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections
Description
次に、図11〜図13を参照して、筒状部材(リンパ管側筒状部材および静脈側筒状部材)を使用した手技の変形例を説明する。なお、各変形例の説明において特に説明のない処置手順や医療器具10の構成等については、前述した実施形態と同様のものとすることができ、その説明は省略する。また、変形例ごとの説明においても、同様の手順や同様の構成等については、その説明を適宜省略する。
図11には、リンパ管側筒状部材330と静脈側筒状部材340を使用して、リンパ管Lの開口端L31と静脈Pの管壁P12とを接合する端側吻合術を示している。
図12には、リンパ管側筒状部材130と静脈側筒状部材340を使用して、リンパ管Lの管壁L12と静脈Pの管壁P12を接合する側側吻合術を示している。
図13には、リンパ管側筒状部材330と静脈側筒状部材340を使用して、リンパ管Lの開口端L31と静脈Pの開口端P31を接合する端端吻合術を示している。
次に、筒状部材の改変例を説明する。各改変例の説明において特に説明のない処置手順や医療器具10の構成等については、前述した実施形態と同様のものとすることができ、その説明は省略する。また、改変例ごとの説明においても、同様の手順や同様の構成等については、その説明を適宜省略する。
図14(A)、(B)には、改変例1に係るリンパ管側筒状部材130aと、当該リンパ管側筒状部材130aをリンパ管Lに固定する前後の様子を示している。
図15(A)には、改変例2に係るリンパ管側筒状部材130aと、当該リンパ管側筒状部材130aをリンパ管Lに固定した際の様子を示している。
図15(B)には、改変例3に係るリンパ管側筒状部材130aと、当該リンパ管側筒状部材130aをリンパ管Lに固定した際の様子を示している。
図16(A)、(B)には、改変例4に係るリンパ管側筒状部材130aと、当該リンパ管側筒状部材130aをリンパ管Lに固定する前後の様子を示している。
図17(A)、(B)には、改変例5に係るリンパ管側筒状部材130aと、当該リンパ管側筒状部材130aをリンパ管Lに固定する前後の様子を示している。
図18(A)、(B)には、改変例6に係るリンパ管側筒状部材130aと、当該リンパ管側筒状部材130aをリンパ管Lに固定する前後の様子を示している。
次に、他の実施形態に係る筒状部材を説明する。本実施形態の説明において特に説明のない処置手順や医療器具10の構成等については、前述した第1実施形態および各改変例と同様のものとすることができ、その説明は省略する。
100 穿刺部材、
101 内腔、
103 先端開口部、
105 基端開口部、
107 針先、
130、130a、330 リンパ管側筒状部材(筒状部材)、
137、417、427a、427b、437、447、457、467 抜け防止部、
138 側壁、
140、340 静脈側筒状部材(連結用筒状部材)、
148 側壁、
150 押し子、
153 押し込み部、
170 外筒、
173 先端開口部、
175a 基端壁、
180 負圧発生部、
183 弁部材、
468 溝部、
530 筒状部材、
b 刺入目標位置、
d 切開部、
g 空間部、
L リンパ管、
La リンパ管の上流側、
Lb リンパ管の下流側、
L11 リンパ管の管腔、
L12 リンパ管の管壁、
L12a 管壁の外面、
L12b 管壁の内面、
L12c 管壁の底面、
L13 膨出部、
L31 リンパ管の開口端、
P 静脈、
P11 静脈の管腔、
P12 静脈の管壁、
P31 静脈の開口端、
S 皮膚、
t 穿刺部位。
Claims (8)
- 生体管腔としてのリンパ管および静脈を接合するために使用される医療器具であって、
内腔および前記内腔の先端側に連なる先端開口部が形成され、前記生体管腔の管壁を穿刺して穿刺部位を形成する針先を先端に備える穿刺部材と、
前記穿刺部材の内腔に収容され、径方向外方へ拡張変形および収縮変形可能に構成された筒状部材と、
前記穿刺部材の内腔に移動可能に挿入され、前記穿刺部材に対する相対的な移動に伴って前記筒状部材を前記穿刺部材の先端開口部から放出させる押し子と、を有し、
前記針先は、前記穿刺部材の最先端に位置する前記先端開口部の開口端により構成されており、
前記筒状部材は、前記穿刺部材の内腔に収縮した状態で収容されており、前記穿刺部材の先端開口部からの放出に伴って拡張変形することにより前記穿刺部位に対して固定される、医療器具。 - 前記穿刺部材の外周面を覆うように配置され、前記針先を前記生体管腔の管壁に穿刺する際に前記穿刺部材および前記生体管腔の管壁との間に空間部を区画する外筒と、
前記空間部に負圧を発生させることにより、前記穿刺部材の針先側へ前記生体管腔の管壁を変位させる負圧発生部と、をさらに有する請求項1に記載の医療器具。 - 前記負圧発生部は、前記穿刺部材の内腔に摺動可能に挿入され前記穿刺部材の基端側へ摺動することによって前記穿刺部材の先端開口部を介して前記空間部に吸引圧を作用させる弁体を有する、請求項2に記載の医療器具。
- 前記筒状部材は、当該筒状部材が前記穿刺部位から抜け出るのを防止する係止力を前記生体管腔の管壁に作用させる抜け防止部を有する、請求項1〜3のいずれか1項に記載の医療器具。
- 前記抜け防止部は、前記穿刺部材の先端開口部からの突出に伴い突出方向と交差する方向へ拡張変形可能に構成されている、請求項4に記載の医療器具。
- 前記筒状部材は、当該筒状部材の延在方向の異なる位置にそれぞれ配置され、前記生体管腔の管壁の内面および前記生体管腔の管壁の外面に対してそれぞれ係止される複数の前記抜け防止部を有する、請求項5に記載の医療器具。
- 前記穿刺部材の内腔において前記筒状部材が収容された位置よりも基端側に収容され、径方向外方へ拡張変形および収縮変形可能に構成されるとともに前記筒状部材と連結可能に構成された連結用筒状部材をさらに有する請求項1〜6のいずれか1項に記載の医療器具。
- 拡張変形後における前記連結用筒状部材の内腔の径が、拡張変形後における前記筒状部材の外径よりも大きくなるように形成されている、請求項7に記載の医療器具。
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