JPH02246986A - In-vivo guiding tool - Google Patents

Abstract

PURPOSE:To allow the free insertion and removal of an inserting material into and from a living body by providing a tubular body which is introduced into the desired section in a living body and has the flexibility to allow the insertion of the inserting material therein in the lower part of a communicating hole ad providing an elastic plug which can be repeatedly pierced by the inserting material in the front end part thereof. CONSTITUTION:A grape sugar sensor 14 is projected from the front end of a sensor probe 18 and the front end thereof is immersed through the elastic plug 11 provided at the front end of a guide tube 10 into blood 24 running in a blood vessel 13. The sensor 14 is pulled from the plug 11 by pulling the operating part of the probe 18 and is retreated into the probe 18 so as not to come into contact with the blood 24 in the case of stopping the measurement of the blood sugar value. Since the plug 11 consists of the elastic material, such as silicone rubber, which can be repeatedly pierced, the plug is tightly and hermetically closed after the sensor 14 is pulled. The back flow of the blood 24 through the plug 11 into the tube 10 is thus obviated. The infiltration of foreign matter into the living body is prevented if a cap body 12 is previously screwed into the communicating hole 6.

Description

Detailed Description of the Invention "Industrial Application Fields" The present invention is an in-vivo guide used for percutaneously extracting biological information, supplying energy to artificial organs, administering medicinal solutions to affected areas, etc. Regarding ingredients.

[Conventional technology] Conventionally, a device was partially implanted under the skin of a living body to measure blood pressure, blood flow rate, temperature,
Electrical terminals for extracting various biological information such as electrocardiographic signals, electrical terminals for supplying energy to artificial organs such as artificial hearts and pacemakers implanted in living bodies, and electrical stimulation of living organisms, or infusions, BACKGROUND OF THE INVENTION In-vivo guide devices are known that are used as an inlet for blood flow extraction, injection, etc. for injection of various drug solutions, 2 artificial kidney dialysis, and the like.

As this type of in-vivo guide device, Japanese Patent Application Laid-Open No. 60-9276
As shown in Japanese Patent No. 8 and Japanese Patent Application Laid-Open No. 189164/1989, conductive members such as gold wire, silver wire, platinum wire 2 alloy wire, carbon fiber, etc. for electrical communication between inside and outside of a living body are used as guide tools. The conductive member is fixed within a communication hole provided in the main body, and is guided to the target site in the living body or its vicinity.

Problem to be solved by the invention C WJ] However, the conventional in-vivo guide device described above does not include a conductive member for electrical communication between the inside and outside of the living body, and a sensor for collecting various biological information. The vessel was left in the living body while being fixed to a communication hole provided in the guide body. The main body of the guide device is sometimes made of biocompatible materials, but the conductive members and sensors cannot be made of biocompatible materials, and if various biological information is extracted, the energy input to the implantable artificial organ cannot be made. When using an in-vivo guide device for a long period of time, such as when supplying a Ta. If deterioration occurs in the living body or damage occurs at the fixing part of the communication hole, it is necessary to undergo surgical treatment to replace the conductive member or sensor. When replacing a sensor to change an item or a sensing site, a similar surgical procedure is required, which is extremely invasive to the patient.

The present invention has been made in view of the above-mentioned circumstances, and allows inserts such as conductive members and sensors to be guided into the living body to be freely inserted into and removed from the living body. It is an object of the present invention to provide an in-vivo guide device that does not require frequent attachment and detachment.

[Means and effects for solving the problem] In order to achieve the above object, the in-vivo guide device of the present invention has a conductive device at the bottom of the communication hole that is guided to the in-vivo ostium or its vicinity. By providing a flexible tubular body through which an insert such as a sexual member or a sensor passes, and providing an elastic stopper at the tip of this tubular body that can be repeatedly punctured by the insert, the 1- 2. Inserts such as conductive members and sensors can be freely inserted and removed from the living body.

[Embodiment] A first embodiment of the present invention will be described below with reference to FIGS. 1 to 4.

FIG. 1 shows an in-vivo guide device 1 of the present invention, and the guide device body 2 includes an upper flange 3 to be placed outside the living body, a lower flange 4 to be implanted in the living body, and these upper flanges 3.
A shaft portion 5 connecting the lower flange 4 and the lower flange 4 is integrally molded. A communication hole 6 is provided at approximately the center of the shaft portion 5 and is open to the upper flange 3 and the lower flange 4 and communicates between the inside and outside of the living body. The materials of the guide body 2 include hydroxyapatite, β-TCP, and alumina.

Non-toxic ceramic materials such as zirconia, polyether sulfone, and polyethylene.

Polymer materials such as polypropylene and fluororesin are used,
Or, a calcium phosphate compound, ceramic powder, etc. is exposed on the outer surface of the polymeric material mentioned above in contact with living tissue. Further, a plurality of suture holes 9 are bored in the outer circumferential portion of the lower flange 4, through which suture threads 8 used for temporarily fixing the guide main body 2 to the biological skin tissue 7 are passed.

The lower part of the communicating hole 6 is filled with silicone rubber.

One end of a guide tube 10 made of a flexible member such as polyurethane is adhesively fixed with a sealing agent or the like.

Further, inside the other end of the guide tube 10, there is an elastic plug 11 made of high water content rubber such as silicone rubber or PVA hydrogel, which can be repeatedly punctured by an insert inserted into the tube 10, and an adhesive or the like. It is airtightly glued and fixed.

Further, a lid 12 is removably screwed onto the upper part of the communication hole 6 to prevent foreign matter from entering the living body through the communication hole 6 and the guide tube 10.

Next, a case will be described below in which the in-vivo guide device 1 having such a configuration is used, for example, for monitoring the blood sugar level of a diabetic patient. First, as shown in FIG. 2, with the upper flange 3 of the guide body 2 placed outside the living skin tissue 7, the lower flange 4 is implanted subcutaneously, and the lower flange 4 is inserted from outside the living skin tissue ta7. The suture thread 8 is passed through the suture hole 9 and sewn up to fix the guide main body 2 to the living skin tissue 7.

Note that this suture thread 8 is removed approximately 10 times after the surgery. Then, the distal end of the guide tube 10 of the in-vivo guide device 1 is inserted and left in the patient's blood vessel 13 and fixed to this blood vessel 13 by suture. To measure the blood sugar level of a diabetic patient, a sensor probe 18 equipped with a microneedle glucose sensor 14 at its tip, and an operating section 15, a current-voltage conversion amplifier 16, and a monitor 17 is used outside the body. Here, as shown in FIG. 4, the microneedle type glucose sensor 14 has an anode 21 made of a platinum wire sealed in a glass tube 20 that is heat-fixed in a cathode 19 made of a silver-plated stainless steel tube. Furthermore, an immobilized glucose oxidase layer 22 and a polyurethane film 23 are formed at the tip of the cathode 19. and,
Insert the sensor probe 18 into the guide tube 10 through the communication hole 6 of the guide main body 2, and then insert the sensor probe 1
8, the glucose sensor 14 protrudes from the tip of the sensor probe 18, as shown in FIG.
, and its tip is immersed in the blood 24 flowing inside the blood vessel 13 . Glucose sensor 14 in contact with blood 24
The excitation power changes depending on the glucose concentration -1 in the blood 24, and the excitation power changes depending on the glucose concentration in the blood 24.
By reading this amount of change through 7, the patient's blood sugar level can be known at any time. To stop measuring the blood sugar level, the glucose sensor 1 immersed in the blood 24 can be stopped by pulling the operation part 15 of the sensor probe 18.
4 is pulled out from the elastic stopper 11 and retracted into the sensor probe 18 so that it does not come into contact with the blood 24. At this time, since the elastic stopper 11 is made of an elastic member such as silicone rubber or high water content rubber that can be punctured repeatedly, after the glucose sensor 14 is pulled out, the blood 24 is tightly sealed and the blood 24 passes through the elastic stopper 11 into the guide tube 10. There will be no backflow. After use, if the sensor probe 18 is removed from the guide tube 10 and the communication hole 6 and the lid body 12 is screwed into the communication hole 6 of the guide main body 2, foreign substances can pass through the communication hole 6 and the guide tube 10. It can prevent it from entering the body.

If an abnormality is found in the blood glucose level measurement, a drug solution administration probe (not shown) is inserted into the guide tube 10 through the communication hole 6 of the guide main body 2 instead of the sensor probe 18, and the same procedure as above is performed. It is also possible to perform treatment by puncturing the elastic plug 11 with a needle and administering a medicinal solution such as insulin into the blood 24.

According to the in-vivo guide device 1 having such a configuration, the guide tube 10 through which the sensor probe 18 and drug solution administration probe are passed is provided at the lower part of the communication hole 6, and the sensor probe 18 is provided at the distal end of the guide tube 10. Since the elastic stopper 11 that can be repeatedly punctured by the glucose sensor 14 is provided, the sensor probe 18 can be freely inserted and removed into the living body via the in-vivo guide 1 only when, for example, the blood glucose level meter #1 is required. . Therefore, there is no need to fix a sensor or the like to an in-vivo guide device and leave it in the living body for a long period of time as in the past, and this eliminates the need for deterioration of the sensor probe 18 in the living body.
Damage to the guide body 2 and the communication hole 6 can be avoided. In addition, if an abnormality occurs in the sensor probe 18,
By removing it from the living body, it can be easily replaced without performing any surgical procedure.

5 and 6 show a second embodiment of the invention.

The in-vivo guide device 31 of this embodiment is used as an electrical terminal for supplying energy to an artificial organ 32 implanted in the living body. That is, the distal end of the guide tube 10 can be replaced with an elastic stopper 11 made of silicone rubber, high water content rubber, etc., as described in the first embodiment, and can be repeatedly punctured with a needle.
A conductive member 33 made of conductive rubber is airtightly fixed with an adhesive or the like. In addition, an insulating member 34 made of ceramics or the like that cannot be pierced is attached to the lower part of the conductive member 33 to maintain electrical insulation from the living body and to prevent the possibility of accidentally flowing electricity into the living body. A lead wire 35 is electrically connected to the conductive member 33 through an insulating member 34.

Note that the other basic configurations are the same as those of the first embodiment.

Using the in-vivo guide device 31 configured as described above, the artificial organ 3 is
When supplying energy to 2, as shown in Figure 6,
In the same manner as in the first embodiment, the guide main body 2 is partially implanted and fixed under the skin of a living body, and the lead wire 35 connected to the conductive member 33 is used as a base maker for the purpose of energy supply or for an artificial body such as an artificial heart. It is guided to the organ 32 and electrically connected thereto. Then, the sensor blow 11 described in the first embodiment
8, an energy supply probe 3 equipped with a conductive needle 36 at its tip, and equipped with an operating section 15 and a battery 37 electrically connected to the conductive needle 36 outside the living body.
8 into the guide tube 10 through the communication hole 6 of the guide main body 2 in the same manner as in the first embodiment, and further push the operating portion 15 of the energy supply probe 38 to release the tip of the energy supply probe 38. A conductive needle 36 is protruded from the conductive member 33, and the conductive member 33 is punctured with the conductive needle 36. Thereby, the battery 37 is electrically connected to the artificial organ 32 via the conductive needle 36, the conductive member 33, and the lead wire 35, and the electrical energy of the battery 37 is supplied to the artificial organ 32. When the supply of energy to the artificial organ 32 is to be stopped, the operation unit 15
By pulling , the conductive needle 36 is pulled out from the conductive member 33 and retracted into the energy supply probe 38, so that the conductive needle 36 does not come into contact with the conductive member 33. After use, the energy supply probe 38 is removed from the guide tube 10 and the communication hole 6 in the same manner as in the first embodiment, and the lid 12 is screwed into the communication hole 6 of the guide body 2. It can prevent foreign substances from entering the living body.

According to the in-vivo guide device 31 having such a configuration, the communication hole 6
A guide tube 10 through which the energy supply probe 38 passes is provided at the lower part of the guide tube 10, and a conductive member that can be repeatedly punctured by the conductive needle 36 of the energy supply probe 38 is provided at the tip of the guide tube 10. 3
In addition, an insulating member 34 that cannot be punctured and maintains electrical insulation from the living body, and a lead wire 35 that is electrically connected to the conductive member 33 are provided, so that energy can be supplied to the implantable artificial organ 32. The energy supply probe 38 can be inserted into and removed from the living body via the living body guide 31 only when necessary, and therefore the same effects as in the first embodiment are achieved.

7 and 8 show a third embodiment of the invention.

The in-vivo guide device 41 of this embodiment is used as a guide for an endoscope 42 when percutaneously observing and treating the inside of a living body using an endoscope m42. That is, guide tube 1
0, the elastic stopper 11 made of silicone rubber or high water content rubber described in the first embodiment, and the conductive member 33 made of conductive rubber described in the second embodiment are repeatedly inserted. A transparent elastic member 43 that can be punctured and is transparent is hermetically fixed with an adhesive or the like. The materials of the transparent elastic member 43 include collagen, polyhydroxymethyl methacrylate (PHHMA), high water content methyl methacrylate and vinyl pyrrolidone copolymer (MMA-VP),
A solution of A LX HPV A in a mixed solvent of water/organic solvent (dimethyl sulfoxide, etc.) and crystallized at a low temperature is used.

Note that the other basic configurations are the same as those of the first embodiment.

When observing and treating, for example, the liver 44 using the in-vivo guide device 41 having such a configuration, as shown in FIG.
In the same manner as in the first and second embodiments, the guide main body 2 is partially implanted and fixed under the skin of the living body, and the guide tube 10 is inserted into the abdominal cavity near the liver 44. Then, the sensor probe 18 described in the first embodiment and the energy supply probe 38 described in the second embodiment are replaced with an endoscope 42 similar to those in the first and second embodiments. is inserted into the guide tube 10 through the communication hole 6 of the guide body 2, and the liver 4 in the abdominal cavity is inserted through the transparent elastic member 43 using the endoscope 42.
Observe 4. At this time, since the guide tube 10 is flexible, by rotating the bending knob 45 of the endoscope 42 to curve the insertion portion 46, the guide tube 10 will also curve accordingly. , it is possible to observe all kinds of organs within the abdominal cavity.

In this way, it is possible to diagnose a patient's disease by observing the color of the liver 44 and the like. For example, if a patient has a disease such as fatty liver, the color of the liver 44 will change from the normal brownish-brown color to a yellowish color, which is the color of fat. You can discover it quickly.

If a disease is detected in this way, a treatment instrument or the like is inserted into the channel 47 of the endoscope 42, and a treatment such as injecting a drug solution into the target liver 44 via the transparent elastic member 43 is performed. When the treatment of the liver 44 is completed, the treatment instrument is pulled out from the transparent elastic member 43, and the transparent elastic member 43 is tightly sealed, and the interstitial fluid etc. will not flow back into the guide tube 10 through the transparent elastic member 43. After use, the endoscope 42 is removed from the guide tube 10 and the communication hole 6 in the same manner as in the first and second embodiments, and the lid body 12 is screwed into the communication hole 6 of the guide main body 2. For example, it is possible to prevent foreign substances from entering the living body.

According to the in-vivo guide device 41 having such a configuration, the communication hole 6
A guide tube 10 for passing the endoscope m42 is provided at the lower part of the guide tube 10, and the endoscope 4 is attached to the distal end of the guide tube 10.
Since the transparent elastic member 43 that can be repeatedly punctured with the treatment instrument 2 is provided, the endoscope 42 can be inserted into the living body through the in-vivo guide tool 41 only when observation or treatment inside the living body is necessary. It can be inserted and removed freely, and therefore the same effects as in the first and second embodiments can be achieved.

9 to 11 show a fourth embodiment of the present invention.

The in-vivo guide device 51 of this embodiment is used as an injection port for percutaneously injecting various medicinal solutions into the living body. That is, the tip of the guide tube 10 is provided with the elastic plug 11 described in the first embodiment, the conductive member 33 described in the second embodiment, and the transparent elastic member 43 described in the third embodiment.
Instead, a mechanochemical polymer IMII 52 that can be repeatedly punctured and contracts by externally applied voltage is airtightly fixed with an adhesive or the like. The mechanochemical polymer membrane 52 is made of cross-linked polymer acrylamide-2-methylpropanesulfonic acid (PAMP).
Polyvinyl alcohol (PVA) impregnated with S)
A sheet or the like is used. In addition, an insulating member 34 made of ceramic or the like that cannot be punctured is attached to the lower part of the mechanochemical polymer membrane 52 while maintaining electrical insulation with the living body to prevent the possibility of accidentally flowing electricity into the living body. The insulating member 34 is adhesively fixed with a chemical or the like, and an opening 53 through which a chemical solution or the like passes is formed in the center of the insulating member 34 . Note that the other basic configurations are the same as those of the first embodiment.

When injecting a medicinal solution into the blood vessel 13 using the in-vivo guide device 51 having such a configuration, for example, the guide device main body 2 is placed under the skin of the living body in the same manner as in the first, second, and third embodiments. The distal end of the guide tube 10 is inserted and left in the blood vessel 13 in the same manner as in the first embodiment. The sensor probe 18 described in the first embodiment above,
A platinum electrode needle 5 for applying voltage to the mechanochemical polymer membrane 52 replaces the energy supply probe 38 described in the second embodiment and the endoscope 42 described in the third embodiment.
4 and a drug solution injection probe 55 having a drug solution inlet (not shown) are inserted into the guide tube 10 through the communication hole 6 of the guide main body 2 in the same manner as in the first, second, and third embodiments, and further A platinum electrode needle 54 is made to protrude from the tip of the chemical liquid injection probe 55 and punctured into the mechanochemical polymer membrane 52 . Thereafter, a voltage is applied to the mechanochemical polymer membrane 52 via the platinum electrode needle 54.

Then, since the outer periphery of the mechanochemical polymer membrane 52 is adhesively fixed to the inner periphery of the guide tube 10, the membrane 52
Its own size is fixed, and before voltage application, as shown in FIG. 10, the diameter of the membrane pores 56 was so small that the chemical solution could not pass through, but after voltage application, as shown in FIG. 11,
Isometric contraction occurs, and the diameter of the membrane pores 56 changes to a size large enough to allow the drug solution to pass through. After that, the chemical liquid injection probe 55
When the chemical solution is released from the tip of the mechanochemical polymer membrane 52 and the insulating member 34
is injected into the blood vessel 13 through the opening 53 of the tube. When the injection of the medicinal solution into the blood vessel 13 is to be stopped, the mechanochemical No voltage is applied to the polymer membrane 52, and the membrane pores 56 elastically return to their original diameters so small that the chemical solution cannot pass therethrough. After use, the chemical liquid injection probe 55 is removed from the guide tube 10 and the communication hole 6 in the same manner as in the first, second, and third embodiments, and the lid body 12 is removed from the communication hole 6 of the guide body 2. By screwing it into the body, foreign substances can be prevented from entering the body.

According to the in-vivo guide device 1 having such a configuration, the guide tube 10 allows the drug solution injection probe 55 to pass through the lower part of the communication hole 6.
At the same time, the distal end of the guide tube 10 can be repeatedly punctured by the platinum electrode needle 54 of the upper two drug solution injection probes 55, and the diameter of the membrane hole 56 changes by application of an external voltage, thereby increasing the permeation of the injected drug solution. 1 II is provided, and an insulating member 34 that cannot be punctured and maintains electrical insulation from the living body is provided, so that the blood vessel 1
The drug solution injection probe 55 can be inserted into and removed from the living body via the in-vivo guide device 51 only when it is necessary to inject a drug solution into the body. The injection of drug into the blood vessel 13 can be easily controlled.

Note that the present invention is not limited to the first to fourth embodiments described above. For example, in the second embodiment, a case where electrical energy is supplied to an artificial device implanted in a living body is shown, but this is not limited to this, but it is applicable to patients whose motor functions are paralyzed due to stroke, cerebral palsy, neurological disorder, etc. nerve gland (muscle) T to
It may also be used for 4 Qi stimulation. Further, in the third embodiment, the transparent elastic stopper 42 is provided at the tip of the guide tube 1o, but it may be provided at the side of the guide tube 10 if necessary, such as when using a side scope. Furthermore, in the fourth embodiment, a mechanochemical gel may be used instead of the mechanochemical polymer 1i51, which is impregnated with a chemical solution and contracts when an external voltage is applied to release the internal drug solution. In addition, in the first to fourth embodiments, one communication hole 6 and one guide tube 10 were provided in the guide main body 2, but the guide tube 10 is not limited to this, and if necessary, a plurality of guide tubes 10 are provided. You may also provide one.

[Effects of the Invention] As explained above, according to the in-vivo guide device of the present invention,
A flexible tubular body is provided at the bottom of the communication hole, which is guided to the vicinity of the target site in the living body, and has a flexible tubular body through which the insert into the living body is passed. Since an elastic stopper that can be repeatedly punctured is provided, the insert can be inserted and removed into the living body as needed, and therefore the insert does not need to be fixed to an in-vivo guide and left in the living body for a long period of time. Therefore, it is possible to avoid deterioration of the insert in the living body and damage between the insert and the communication hole of the in-vivo guide device. Additionally, if an abnormality occurs with the insert, it can be removed from the body, and multiple inserts can be used as needed, making it easy to replace or replace the insert without surgical intervention. It is something that can be used.

[Brief explanation of drawings]

1 to 4 show a first embodiment of the present invention, in which FIG. 1 is a side sectional view of the in-vivo guide device, FIG. 2 is a view showing its usage state, and FIG. 3 is a view of the guide tube. Diagram showing the tip part,
FIG. 4 is a side sectional view of a microneedle type glucose sensor, FIGS. 5 and 6 show the second and second embodiments of the present invention, FIG. 5 is a side sectional view of an in-vivo guide device, and FIG. 7 and 8 show a third embodiment of the present invention, FIG. 7 is a side sectional view of the in-vivo guide device, and FIG. 8 is a diagram showing its use state. , FIGS. 9 to 11 show a fourth embodiment of the present invention, FIG. 9 is a view showing the tip of the guide tube, and FIG. 10 is a side sectional view of the mechanochemical polymer membrane before voltage application. , FIG. 11 is a side sectional view of the mechanochemical polymer membrane after voltage application. 6... Communication hole, 7... Biological skin tissue, 1o... Guide tube, 11... Elastic stopper, 18... Sensor probe, 33... Conductive member, 38... For energy supply Probe, 42... Endoscope, 43... Transparent elastic member, 52... Mechanochemical polymer membrane, 55... Probe for drug injection.

Claims (1)

[Claims] In an in-vivo guide device that is fixed via the skin tissue of the living body and has a communication hole through which an insert is inserted into the living body and communicates between the inside and outside of the living body, there is a hole in the lower part of the communication hole that is guided to the target site in the living body or its vicinity. An in-vivo guide device characterized in that a flexible tubular body through which the insert passes through is provided, and an elastic stopper that can be repeatedly punctured by the insert is provided at the distal end of the tubular body.