JP6829351B1 - Medical device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To easily deliver a contrast medium or a drug to a target site or its surroundings while being inserted into a body, and to insert a biopsy forceps or the like without damaging the target site and its surroundings. Provide a device. SOLUTION: A medical device 1 combines a guide wire 10, a dilator 20, and a sheath 30 and sends the guide wire 10 to a target site in the body and its surroundings by guiding the guide wire 10, indwells the sheath 30, and places the sheath 30 in the indwelled sheath 30. It is used to insert biopsy forceps and remove gallstones and tissues multiple times. A contact portion S in which the outer surface of the dilator 20 and the inner surface of the sheath 30 are close to each other or in contact with each other, and a separation portion T in which the outer surface of the dilator 20 and the inner surface of the sheath 30 are separated from each other are provided. The sheath 30 is provided with a hole 32 penetrating the outer surface and the inner surface of the sheath 30 at the separation portion T, and in a state where the dilator 20 and the sheath 30 are combined, a contrast medium or a drug is injected into the body through the hole 32. it can. [Selection diagram] Fig. 2

Description

The present invention relates to a medical device capable of injecting a contrast medium, a drug, or the like into an affected area while being inserted into a body.

Various medical devices equipped with a dilator and a sheath have been conventionally proposed.

For example, Patent Document 1 includes a dilator in which at least one lumen is provided and the outer diameter of the distal end decreases toward the distal side, and an outer sheath having a lumen into which the dilator can be inserted. A positioning portion movably arranged axially between the dilator, the dilator and the outer sheath, or projectable distal to the dilator, and a length that can be inserted into the lumen of the dilator. It is disclosed that it is a medical device having a long-sized puncture device, the puncture position can be easily grasped, erroneous puncture can be suppressed, and safety can be enhanced.

On the other hand, when performing a transendoscopic (papillary) bile duct biopsy, multiple or multiple biopsies are required. Therefore, conventionally, it has been necessary to remove the biopsy forceps from the endoscope after collecting the sample, reinsert the biopsy forceps, and then perform the biopsy at the second and subsequent locations. As a result, it was necessary to repeat this series of operations according to the number of biopsies.

JP-A-2018-50734

In Patent Document 1, a puncture device (guide wire), a dilator, and an outer sheath (sheath) are combined and inserted into a living lumen to puncture a living tissue and widen a hole formed by the puncturing. A medical device held in a state is disclosed, and a contrast agent, a drug, or the like is injected into the sheath from a port portion of the medical device.

However, this medical device has a problem that the outer surface of the dilator and the inner surface of the sheath are in close contact with each other, and a contrast medium, a drug, or the like cannot be injected unless the dilator is removed.

On the other hand, as described above, in transendoscopic (papillary) bile duct biopsy, it is necessary to insert biopsy forceps into the papilla multiple times. At that time, there is a problem that the biopsy forceps may injure the papilla and its peripheral part.

In view of the above circumstances, the present invention can easily deliver a contrast medium or a drug to or around the target site while being inserted into the body, and can use biopsy forceps or the like without damaging the target site or its surroundings. The purpose is to provide a medical device into which the forceps can be inserted.

As a result of diligent research and development on the above-mentioned problems, the inventor of the present invention has found the following epoch-making medical devices.

The first aspect of the present invention for solving the above problems is a medical device in which a guide wire, a dilator, and a sheath are combined and inserted into the body to indwell the sheath in the body, and the dilator is a guide wire. Has an opening through which the guide wire can be moved and a tapered portion whose outer diameter decreases toward the tip so as to approach the pipe diameter of the opening, and the sheath covers the dilator and faces the tip. It has a tapered portion whose outer diameter is narrowed, and at least one or more holes penetrating the outer surface and the inner surface of the sheath are formed in the sheath from the tapered portion of the sheath toward the rear end of the sheath. It is in the medical device.

Here, the shape of the "tapered portion" is not particularly limited as long as the outer diameter becomes smaller toward the tip so as to approach the pipe diameter of the opening. For example, it may have a shape in which the outer diameter is smoothly reduced, or a shape in which the outer diameter is reduced in a stepped manner.

According to the first aspect, by providing the dilator and the sheath with a tapered portion, mobility and followability in the internal organ with respect to the dilator and the sheath inserted into the internal organ by the guidance of the guide wire are achieved, and the tip is narrow. Even in a state (a state in which the tip is narrowed), a contrast medium, a drug, or the like can be appropriately injected into the body through the hole. Further, even if the biological forceps are inserted into the sheath with the sheath indwelling, the contrast medium, the drug, or the like can be reliably injected into the body through the holes.

In the second aspect of the present invention, the dilator is composed of a first part, a second part and a third part from the front end portion to the rear end portion, and a tapered portion of the dilator is formed on the outer surface of the first part. The first aspect is formed, wherein the outer diameter of the second part is the largest, the outer diameter is close to the inner diameter of the sheath, and the outer diameter of the third part is smaller than the outer diameter of the second part. It is in the medical device described in.

According to the second aspect, the outer surface of the second part and the inner surface of the sheath are close to each other to improve the followability of the sheath to the dilator during internal movement, and the friction between the outer surface of the third part and the inner surface of the sheath is reduced. It can be made smaller to make it easier to pull the dilator out of the sheath.

Further, since a space is formed between the outer surface of the third part and the inner surface of the sheath, a contrast medium, a drug, or the like can be easily injected from the rear end of the dilator and the sheath.

A third aspect of the present invention is to provide a contact portion in which the outer surface of the second part and the inner surface of the sheath are close to each other or in contact with each other, and a separating portion in which the outer surface of the third part and the inner surface of the sheath are separated from each other. The medical device according to the first or second aspect.

According to the third aspect, the friction between the outer surface of the dilator and the inner surface of the sheath can be reduced by the separating portion, and the dilator can be easily pulled out from the sheath. Further, by providing the separating portion, the contrast medium or the drug can be easily injected into the sheath.

A fourth aspect of the present invention is in the medical device according to the third aspect, wherein the hole is formed in a separation portion.

According to the fourth aspect, by injecting the contrast medium or the drug into the separated portion, the contrast medium or the drug can be easily and surely supplied to the target site and its surroundings through the hole. ..

A fifth aspect of the present invention is that in a state where the dilator and the sheath are combined, the sheath has the same or most the outer diameter of the dilator and the inner diameter of the sheath between the portions where the holes are formed from the tip. The medical device according to the first aspect, wherein the medical device has a closest contact portion having a diameter close to that of the device.

In the fifth aspect, as in the second embodiment, the friction between the outer surface of the dilator and the inner surface of the sheath can be reduced to facilitate the dilator being pulled out from the sheath.

Further, since a space is formed between the outer surface of the dilator and the inner surface of the sheath on the rear end side of the closest contact portion of the sheath, a contrast medium, a drug or the like can be easily injected from the rear end of the dilator and the sheath. ..

A sixth aspect of the present invention is the medical device according to any one of the first to fifth aspects, which is inserted into the duodenal papilla in a state where a dilator and a sheath are combined, and is a contrast medium. It is in a medical device that can inject drugs and drugs into the body.

In the sixth aspect, a contrast medium or a drug can be easily delivered to the duodenal papilla while being inserted into the duodenal papilla, and biopsy forceps or the like can be applied to the duodenal papilla without damaging the papilla. Can be inserted.

It is a schematic side view which shows an example of the medical device which concerns on Embodiment 1. FIG. It is a schematic side view which enlarged the part A of FIG. It is the schematic sectional drawing which enlarged the part A of FIG. An example of the dilator according to the first embodiment is shown, (a) is a schematic front view, (b) is a schematic cross-sectional view taken along the line AA of (a), and (c) is a schematic cross-sectional view taken along the line BB of (a). .. It is a schematic side view which shows an example of the sheath which concerns on this embodiment. It is a schematic diagram of an example in a living body in which a medical device according to this embodiment is indwelled. It is a schematic side view which shows an example of the shape of the tip side of the medical device which concerns on this embodiment, (a) is Example 1 and (b) is Example 2. It is a schematic side view which shows the modification of the contact part of the medical device which concerns on this embodiment, (a) is modification 1 and (b) is modification 2.

An embodiment of the medical device according to the present invention will be described below with reference to the accompanying drawings. The present invention is not limited to the following embodiments.
(Embodiment 1)

FIG. 1 is a schematic side view showing an example of a medical device according to the present embodiment. FIG. 2 is an enlarged schematic side view of part A in FIG. FIG. 3 is an enlarged schematic cross-sectional view of part A in FIG. 4A and 4B show an example of a dilator according to the present embodiment, where FIG. 4A is a schematic front view, FIG. 4B is a schematic sectional view taken along line AA of FIG. 4A, and FIG. 4C is a schematic sectional view taken along line BB of FIG. It is a sectional view. FIG. 5 is a schematic side view showing an example of the sheath according to the present embodiment. The medical device of this embodiment will be described with reference to FIGS. 1 to 5.

The medical device 1 of the present embodiment is an instrument that penetrates the biological tissues of at least two biological organs. The two biological organs refer to, for example, the common bile duct and the duodenum, blood vessels and blood vessels, etc., and may be the same organ, and are not necessarily limited to different biological organs. In the present embodiment, an operation of penetrating the duodenum and the common bile duct using the medical device 1 to remove gallstones and tissues, for example, will be described as an example.

As shown in FIG. 1, the medical device 1 is configured by combining a guide wire 10, a dilator 20 in which the guide wire 10 is inserted inside, and a sheath 30 in which the dilator 20 is inserted inside.

Then, the medical device 1 configured in this way is sent to a target site (inside the common bile duct) in the body by the guidance of the guide wire 10, and when the tip portion reaches the target site, the sheath 30 is placed. Then, after the guide wire 10 and the dilator 20 are pulled out from the sheath 30, biopsy forceps or the like are inserted into the indwelling sheath 30 a plurality of times so that gallstones, tissues, and the like can be taken out.

The guide wire 10 is a line that guides the dilator 20 and the sheath 30 in the organ to a target site using an endoscope or the like. The guide wire 10 is generally spirally covered with an extra-fine, spring-loaded steel wire centered on the core of the steel wire, and a hemispherical steel wire with extremely high elasticity and flexibility is at the tip. It is welded and treated with Teflon® throughout. The material and shape of the guide wire 10 are not particularly limited as long as they have the above-mentioned functions. In the present embodiment, an operation unit 40 provided with a connector operated by a doctor or the like, an endoscope, or the like is provided on the rear end side of the guide wire 10.

As shown in FIG. 4, the dilator 20 has a cylindrical tube shape, and the guide wire 10 can be inserted into the dilator 20. Then, the dilator 20 is sent into the body together with the guide wire 10 by the guidance of the inserted guide wire 10.

A penetrating opening 21 through which the guide wire 10 can be inserted is provided at the central portion of the dilator 20 in the axial direction. As shown in FIG. 2, the diameter of the opening 21 is formed to be slightly larger than the outer diameter D1 of the guide wire 10. Therefore, the guide wire 10 can move freely within the opening 21 of the dilator 20.

In the present embodiment, as shown in FIG. 4, the dilator 20 is divided into three parts. The three parts are the first part 22, the second part 23, and the third part 24 from the tip side. In addition, these three parts may be composed of one part, and the composition is not particularly limited.

The first part 22 is formed with a tapered portion 22a whose outer diameter decreases toward the tip so as to approach the pipe diameter of the opening 21, and the outer diameter D2 of the tip is slightly larger than the outer diameter D1 of the guide wire 10. (D1≈D2, D1 <D2). With this configuration, the step between the guide wire 10 and the tip of the dilator 20 is eliminated. As a result, the dilator 20 and the guide wire 10 are smoothly moved in the body. Here, the tip of the dilator 20 is a portion guided by the guide wire 10 and first inserted into the body, and is a portion on the upper side of FIG.

The second part 23 is continuously formed from the first part 22, has a constant outer diameter D3, and has a tapered shape in which the diameter decreases toward the rear end side, as shown in FIG. Here, the outer diameter D3 is the same as or close to the inner diameter of the sheath 30 described later.

The third part 24 is continuously formed from the second part 23 and has a predetermined outer diameter D4 as shown in FIG. The outer diameter D3 of the second part 23 is the largest (D3> D1, D3> D4), and the outer diameter D4 of the third part 24 is close to or the same as the tip outer diameter D2 of the first part 22. There is.

Next, the sheath 30 will be described. As shown in FIGS. 2 and 3, the sheath 30 has a cylindrical tube shape, and a through hole 31 through which the dilator 20 penetrates is formed.

When the sheath 30 is combined with the dilator 20, at least a part of the first part 22 of the dilator 20 projects from the tip of the sheath 30. That is, in the state of being combined with the dilator 20, at least a part of the first part 22 is not covered by the sheath 30, but the second part 23 and the third part 24 are covered by the sheath 30.

Further, as shown in FIG. 5, the sheath 30 has a tapered portion 30a whose outer diameter becomes smaller toward the tip, and the tip in contact with the dilator 20 is substantially the same as the outer diameter of the dilator 20. The step between the 20 and the sheath 30 is almost eliminated. As a result, the movement in the body is smoothly performed together with the dilator 20.

Further, the inner diameter (tube diameter of the through hole 31) d of the sheath 30 is substantially the same as the outer diameter D3 of the second part 23 of the dilator 20, as shown in FIG. 3 when the sheath 30 is combined with the dilator 20. Is provided with a contact portion S in which the inner surface of the sheath 30 and the outer surface of the dilator 20 are in contact with or close to each other.

After the sheath 30 is placed at the target site, it is necessary to pull out the dilator 20 from the sheath 30. At that time, since the outer diameter D4 of the third part of the dilator 20 is smaller than the inner diameter d of the sheath 30 (D4 <d), the sheath 30 and the dilator 20 are almost in contact with each other (including proximity). Only the contact portion S is provided. As a result, the resistance when the dilator 20 is pulled out from the sheath 30 can be reduced as compared with the conventional medical device, so that the dilator 20 can be easily pulled out from the sheath 30.

The sheath 30 is formed with a plurality of holes 32 penetrating the outer surface and the inner surface from the rear end of the sheath 30 rather than the contact portion S. As shown in FIG. 3, the portion where the hole 32 is formed is a separation portion T in which the inner surface of the sheath 30 formed from the tapered portion of the second part 23 and the outer surface of the dilator 20 are separated from each other. That is, the hole 32 communicates with the separating portion T. Therefore, when the sheath 30 is combined with the dilator 20 and the contrast medium or the drug is injected from the rear end of the sheath 30 and the dilator 20, the contrast medium or the drug can be easily sent into the body through the hole 32. In the present embodiment, a plurality of holes 32 are formed, but the number thereof is not limited, and one or more holes may be formed.

The dilator 20 and the sheath 30 are preferably molded from a flexible material, for example, polyolefins such as polyethylene and polypropylene, polyamides, polyesters such as polyethylene terephthalate, fluoropolymers such as ETFE and PTFE, and polyethers. Etherketone, polyimide and the like can be preferably used.

FIG. 6 is an example in a living body in which the medical device 1 according to the present embodiment is indwelled, and is a schematic view showing a state in which the sheath 30 is indwelled. An example of using the medical device 1 will be described below with reference to FIG.

The medical device 1 is invaded through the mouth into the duodenum 100, which is a biological organ composed of living tissue. Specifically, as shown in this figure, the medical device 1 is placed on the duodenal papilla at the boundary between the duodenum 100 and the common bile duct 101 in a state where the sheath 30 and the dilator 20 are combined by guidance with the guide wire 10. It is arranged in the vicinity of 102 (target site). Then, as described above, a contrast medium, a drug, or the like is injected into the target site and its periphery through the hole 32 in which the sheath 30 is formed. Then, the dilator 20 and the guide wire 10 are pulled out from the sheath 30. Then, biopsy forceps are inserted into the sheath a plurality of times to remove, for example, biological tissue or gallstones from the duodenal papilla 102 (target site) or its peripheral portion.

The dilator 20 and the sheath 30 are guided by the guide wire 10 and travel in the internal organs. In the medical device 1, since the shapes of the tips of the dilator 20 and the sheath 30 are tapered portions 22a and 30a that taper toward the tips, resistance during progress can be suppressed as much as possible.

Here, two forms are possible with respect to the tapered portion 22a of the dilator 20. Specifically, as shown in FIG. 7A, there are cases where the tip is close to no thickness, and there are cases where the tip of the dilator 20 is slightly thick as shown in FIG. 7B. Both can be selected depending on the situation.

As shown in these figures, the tip of the sheath 30 covers the outer circumference of the dilator 20 and forms a contact portion S in which the outer surface of the dilator 20 and the inner surface of the sheath 30 are in contact with or close to each other. In the present embodiment, the contact portion S has a predetermined length. The contact portion S may be formed at a position other than the tip. For example, as shown in FIG. 8A, the outer diameter of the dilator 20 may be slightly larger, and as shown in FIG. 8B, the inner diameter of the sheath 30 may be slightly smaller. By forming the contact portion S, the ability of the sheath 30 to follow the movement of the dilator 20 is improved.

The sheath 30 needs to be placed at a target site in the body, and an operation of pulling out the dilator 20 from the sheath 30 that has reached the target site is required. Since the separating portion T having the outer diameter D4 of the dilator 20 smaller than the inner diameter d of the sheath 30 is formed on the rear end side of the A contact portion S, the dilator 20 can be easily pulled out from the sheath 30. In the present embodiment, as shown in FIG. 4, a tapered portion is provided from the rear end of the second part 23 of the dilator 20 toward the third part 24, and a separating portion T is formed between the dilator 20 and the sheath 30. .. Due to this separating portion T, the resistance of pulling out the dilator 20 at the separating portion T becomes small, and the dilator 20 can be smoothly pulled out from the sheath 30. In addition, the separation portion T facilitates the injection of a contrast medium, a drug, or the like.

Further, the tip portions of the dilator 20 and the sheath 30 become smaller as the outer diameter toward the tip end, improving the insertability of the medical device 1 into the body and the followability of the guide wire 10.

Here, in the medical device disclosed in Patent Document 1, since the surface of the dilator and the inner surface of the sheath are in close contact with each other, a contrast medium, a drug, or the like cannot be injected unless the dilator is removed from the sheath. On the other hand, in the present invention, since the hole 32 is formed in the sheath 30, even when the dilator 20 and the sheath 30 are inserted into the body, a contrast medium or a drug can be injected regardless of the shape of the tip. .. In addition, the separation portion T makes it easier to inject a contrast medium, a drug, or the like. Further, even when the tip side of the dilator 20 and the sheath 30 is narrowed (when narrowed) by an organ or the like with the sheath 30 indwelled, the contrast medium or the drug can be easily injected into the body. Can be done.

The medical device 1 of the present invention is a medical device 1 in which a guide wire 10, a dilator 20, and a sheath 30 are combined and inserted into the body, and the sheath 30 is placed in the body. The dilator 20 has an opening 21 through which the guide wire 10 penetrates and the guide wire 10 can move, and a tapered portion 22a whose outer diameter decreases toward the tip so as to approach the pipe diameter of the opening 21. doing. The sheath 30 has a tapered portion 30a that covers the dilator 20 and whose outer diameter decreases toward the tip, and penetrates the outer and inner surfaces of the sheath 30 from the tapered portion 30a of the sheath 30 to the rear end of the sheath 30. At least one or more holes 32 are formed in the sheath 30.

By configuring the medical device 1 in this way, since the dilator 20 and the sheath 30 are provided with the tapered portions 22a and 30a, the inside organ of the internal organ with respect to the dilator 20 and the sheath 30 inserted into the internal organ by the guidance of the guide wire 10. In addition to improving the mobility and followability of the wire, a contrast medium, a drug, or the like can be appropriately injected into the body through the hole 32.

As one aspect of the medical device 1 of the present invention, for example, the dilator 20 is composed of a plurality of parts, a tapered portion 22a of the dilator 20 is formed on the outer surface of the first part 22, and the outer diameter D3 of the second part 22 is formed. The outer diameter D3 is close to the inner diameter d of the sheath 30, and the outer diameter D4 of the third part 24 is small. By configuring the medical device 1 in this way, the outer surface of the second part 23 and the inner surface of the sheath 30 are close to each other to improve the followability of the sheath 30 to the dilator 20 when moving inside the body, and the outer surface of the third part 24. The dilator 20 can be easily pulled out from the sheath 30 by eliminating friction between the sheath 30 and the inner surface of the sheath 30.

As one aspect of the medical device 1 of the present invention, for example, a contact portion S in which the outer surface of the second part 23 and the inner surface of the sheath 30 are close to each other or in contact with each other, and the outer surface of the third part 24 and the inner surface of the sheath 30 are separated from each other. A part T is provided. With this configuration, the separation portion T eliminates friction between the outer surface of the dilator 20 and the inner surface of the sheath 30, making it easier to pull out the dilator 20 from the sheath 30. Further, by providing the separation portion T, the contrast medium or the drug can be easily injected into the sheath 30.

As one aspect of the medical device 1 of the present invention, for example, the hole 32 is formed in the separation portion T. As a result, by injecting the contrast medium or the drug into the separation portion T, the contrast medium or the drug is reliably supplied to the target site and its surroundings through the hole 32.

As one aspect of the medical device 1 of the present invention, for example, since the dilator 20 and the sheath 30 are inserted into the duodenal papilla 102 in a combined state, a contrast medium, a drug, or the like is injected into the duodenal papilla 102 or its vicinity. it can.
(Embodiment 2)

In the first embodiment, the outer diameter of a part (second part) of the tip portion of the dilator is the same as or close to the inner diameter of the sheath 30. That is, the second part is the closest contact portion where the outer diameter of the dilator and the inner diameter of the sheath are the same or the closest diameter, but the present invention is not limited to this.

For example, unlike the dilator of the first embodiment, a dilator having a constant diameter from the front end to the rear end may be used. However, in that case, in the state where the dilator and the sheath are combined, the inner diameter of the sheath portion (closest contact portion) corresponding to the second part of the dilator of the first embodiment is the same as or the outer diameter of the dilator. The diameter needs to be close. Needless to say, the hole formed in the sheath in this case is formed from the rear end of the sheath rather than the closest portion. Even if the medical device is configured in this way, the same effect as that of the first embodiment can be obtained.
(Embodiment 3)

In the first embodiment, the second part constituting the dilator has a tapered shape whose diameter decreases toward the rear end side, but the present invention is not limited to this. For example, the second part is not tapered, but is composed of a predetermined length portion having an outer diameter of D3 in the axial direction and a portion having an outer diameter of D4 on the rear end side, so that there is a step. It may be configured, or it may be configured so that the diameter decreases toward the rear end side in a stepped manner. Even if the medical device is configured in this way, the same effect as that of the first embodiment can be obtained.

The present invention is not limited to the above-described embodiment, and can be appropriately modified, improved, and the like. In addition, the material, shape, size, numerical value, form, number, arrangement location, etc. of each component in the above-described embodiment are arbitrary and are not limited as long as the present invention can be achieved.

The medical device of the present invention is most suitable for a field in which a contrast medium or a drug is desired to be injected in a state in which a dilator and a sheath are combined or in an indwelling state.

1 Medical device 10 Guide wire 20 Dilator 21 Opening 22 First part 22a Dilator taper part 23 Second part 24 Third part 30 Sheath 30a Sheath taper part 31 Through hole 32 hole 40 Operation part 100 Duodenum 101 Common bile duct 102 Duodenum Papillary

Claims (4)

It is a medical device used for surgery using a flexible endoscope in the digestive organ area, and is a medical device in which a guide wire, a dilator, and a sheath are combined and inserted into the body to indwell the sheath.
The dilator has an opening through which the guide wire penetrates and the guide wire can move, and is composed of a first part, a second part, and a third part from a front end portion to a rear end portion.
On the outer surface of the first part, a tapered portion whose outer diameter decreases toward the tip is formed so as to approach the pipe diameter of the opening.
The outer diameter of the second part is the largest, and the outer diameter is close to the inner diameter of the sheath.
The outer diameter of the third part is smaller than the outer diameter of the second part.
The sheath covers the dilator and has a tapered portion whose outer diameter decreases toward the tip.
A separating portion is provided so that the outer surface of the third part and the inner surface of the sheath are separated from each other.
A contrast medium or a drug that penetrates the outer surface and the inner surface of the sheath and flows through the separated portion is applied to the portion of the sheath where the outer surface of the second part and the inner surface of the sheath are separated from each other or in the vicinity of the third part side thereof. It is characterized in that at least one or more holes that can be released are formed.
Medical device. The rear end portion of the second part forming the separation portion is provided with a tapered portion whose outer diameter becomes smaller toward the third part.
The medical device according to claim 1. The medical device according to claim 1 or 2, wherein the biopsy forceps are inserted into the sheath after the guide wire and the dilator are pulled out. The medical device according to any one of claims 1 to 3 .
A medical device in which the dilator and the sheath are combined and inserted into the duodenal papilla to inject a contrast medium or a drug into the body.