JPH0310731Y2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to a cutting scalpel for a curved tract, which is inserted into a curved ureter or the like to incise a stricture or the like.

[Prior art] In recent years, it has been possible to insert a hard insertion part through a narrow puncture hole or insert a soft insertion part through an insertion path in the oral cavity, etc., without making an incision through the body wall. Endoscopes have become widely used to diagnose the affected areas of patients, and to perform treatment using treatment instruments as necessary.

By the way, when a stricture is formed in the urethra, a conventional example of incising the stricture is shown in FIG. 9.

That is, a ureteral catheter (not shown) that can be inserted through the rigid pipe 2 is inserted through a rigid pipe 2 having an incision blade 1 at its tip, and the rigid pipe 2 is inserted using this catheter as a guide. This rigid pipe 2 is provided with a stabilizer pipe 3 through which an optical viewing tube can pass, and under observation of the optical viewing tube inserted through the stabilizer pipe 3, the blade 1 at the tip of the rigid pipe 2 causes the stenosis. It was as if the area was to be incised.

The above conventional example is effective for straight parts where the stricture does not reach the deep part of the urethra, but it is difficult to insert a rigid pipe into a stricture in the ureter that passes through the urethra and bladder. However, it also had the disadvantage of causing greater pain to the patient.

In addition, for this type of incision scalpel, a West German patent has been published.
As described in Japanese Patent No. 3,231,127, it is known that a shaft member into which a flexible guide catheter can be inserted has one incision blade provided in the axial direction on the outer circumference near the distal end of the shaft member.

[Problem to be solved by the invention] In the case where there is one blade as in the prior art example described above and the example shown in FIG. It is necessary to perform the incision operation while rotating the patient several times, which takes more time than necessary for the incision surgery. In addition, when there is only one incision blade as described above, it is necessary to deepen the incision depth at the stenosis site, and accordingly, it is necessary to be more careful not to cut outside the stenosis site. Furthermore, if there is only one blade, care must be taken to rotate the blade relative to its axis in order to align the position of the blade with the incision site.

On the other hand, in all of the above conventional examples, the female part is an integral type that cannot be separated from the shaft part, so it is necessary to prepare a shaft part including a female part of a size according to the area to be incised, and the female part It is not possible to replace only the shaft or the shaft.

The present invention was developed in consideration of these circumstances, and it can be inserted into the curved path of the urethral canal, and can incise multiple locations in a single operation to incise the stenotic area, making it possible to cut in a short period of time. Incision surgery is possible, and since multiple incisions are made, the depth of incision per case can be made shallower, which improves safety.Furthermore, the incision can be made in any direction without worrying about the direction of rotation of the blade relative to its axis. While it is possible to incise in a rotational position,
For curved passages, the female part can be attached to and removed from the shaft member, and as a result, the female part can be selectively replaced with a female part of a size appropriate for the stenosis site, and a shaft member with a softness according to the bend area. The purpose is to provide an incision scalpel.

[Means for Solving the Problems] The present invention includes a shaft member whose at least the distal end side is soft and which is provided with an insertion passage through which a guide member can be inserted, and an insertion passage that communicates with the insertion passage of the shaft member. On the other hand, it includes a female part having a plurality of blades arranged at equal intervals on the outer circumference, and the female part is detachably attached to the tip of the shaft member by an attachment means.

[Example] The present invention will be specifically described below with reference to the drawings.

1 to 5 relate to a first embodiment of the present invention, FIG. 1 shows a cutting knife for a curved path according to the first embodiment, and FIG. 2 shows an enlarged view from the front.
FIG. 3 shows the disassembled state, FIG. 4 shows the first usage example, and FIG. 5 shows the second usage example.

As shown in FIG. 1, the bending path incision knife 11 of the first embodiment has a blade attached to the distal end side of a shaft portion made of a flexible pipe 12 formed of a hollow and elongated flexible member.
A female part 14 having numbers 3, 13, 13, 13 formed thereon is detachably attached.

That is, the front end of the flexible pipe 12 has a female thread 12A.
On the other hand, the rear end of the female part 14 is provided with a male screw 14A that can be screwed into the female screw 12A.
It is designed so that it can be attached as shown in the figure and used as an incision scalpel 11.

The female part 14 has, for example, four blades 1 along the longitudinal direction from the front end on the outer surface of the hard pipe.
3, 13, 13, 13 are provided protrudingly. Each blade 1
3 is, for example, in the shape of a semicircular plate, and the peripheral edge of this semicircular plate is thin and has a sharp blade portion formed thereon. Therefore, by pressing the periphery of this semicircular disk against the stenosis, the incision can be easily made.

Since the scalpel section 14 is configured to be detachable from the flexible pipe 12, it is possible to replace it with a scalpel section of a size suitable for the incision site.

In addition, in this first embodiment, since the insertion shaft portion is formed of the flexible pipe 12, it can be inserted not only into a straight insertion path but also into a curved path such as the ureter to prevent strictures. It is designed so that incisions can be made in the area. Further, by preparing flexible pipes with different degrees of flexibility as the shaft portion, it is possible to use one suitable for the bending part. Incidentally, a hollow insertion passage 15 through which a guiding guide wire can be inserted is formed so that the first embodiment can be easily guided into a stenotic region.

An example of the use of the first embodiment configured in this way will be described below with reference to FIG. 4.

A case will be described in which a stenosis site 22 occurs in the middle of the ureter 21 and the stenosis site 22 is incised.

In this case, a puncture hole for insertion is formed with a trocar (not shown), and the percutaneous pyeloscope 23 is inserted into this puncture hole.
is inserted, and its tip is guided into the renal pelvis 25 within the kidney 24, so that the ureter 21 can be observed.

Then, the incision scalpel 11 of the first embodiment is inserted into the channel of the pyeloscope 23, and the guide wire 26 is passed through the hollow insertion passage 15 of the incision knife 11, and the guide wire 26 is used as a guide. The cutting scalpel 11 can be guided to the stenosis site 22. In this case, since the shaft portion of the cutting scalpel 11 is a flexible pipe 12, it can be inserted along a curved path. However, incision scalpel 11
The blades 13, 13, 13, 13 at the tip of the stenosis site 2
2, the stenosis site 22 can be incised.

In the above usage example, a percutaneous pyeloscope 23 was used,
As shown in FIG. 5, the incision can also be performed using, for example, a cystourethroscope 31.

That is, the cystourethroscope 31 is inserted through the urethra, and its tip is guided to the vicinity of the bladder 32. Then, the incision knife 11 of the first embodiment is passed through the channel of the cystourethroscope 31, and the guide wire 26 is further passed through the insertion passage 15 of the incision knife 11.
Using this guide wire 26 as a guide, the incision scalpel 1
1 to the ureter 21 side, it is possible to perform incision treatment on the stricture site.

FIG. 6 shows a second embodiment of the invention.

In the incision knife 41 of this second embodiment, the knife part 4
2 has three blades 43, 43, 43 as shown in FIG.
It is formed of. Further, a soft shaft portion is formed of a spiral tube 44.

FIG. 8 shows a third embodiment of the present invention.

In this third embodiment, for example, in the second embodiment, the soft shaft portion is made of, for example, two wires 45,
45. Incidentally, at the tips of the wires 45, 45, there is a connecting part 4 to which the female part 42 can be attached and detached.
6 is provided so that female parts with different blade shapes and sizes can be exchanged and used. In this case, a guide wire can be inserted between both wires 45, 45. Alternatively, the soft shaft portion may be formed of three or more wires so that the guide wire can be inserted between them. Furthermore, one or two of these wires may be used interchangeably, so that the degree of flexibility of the shaft portion can be selected depending on the area of use.

In addition, each blade in the female part provided on the distal end side of the soft shaft part can be rotated, so that the insertion operation can be performed without protruding too much from the shaft part, and the blade can be made to protrude at the incision site. In this way, there is no risk of damaging the inner wall of the insertion path in areas other than the target area.

Note that the number of blades provided on the tip side of the shaft portion may be single or plural, or may have other shapes.

[Effects of the invention] As described above, according to the invention, it is possible to insert the urethral tube into a curved passage, and it is also possible to incise multiple places in a single operation to incise the stenotic part in a short time. Incision surgery is possible, and since incisions are made in multiple locations, the depth of incision per case can be made shallower, making it safer.Furthermore, it is possible to perform incisions at any time without worrying about the direction of rotation of the blade relative to its axis. While the incision can be made at the rotational position of It has the effect of allowing selective exchange.

[Brief explanation of the drawing]

Figures 1 to 5 relate to the first embodiment of the present invention, where Figure 1 is a side view showing the first embodiment, Figure 2 is an enlarged front view of Figure 1, and Figure 3 is the female part side. FIG. 4 is an explanatory diagram showing an example of the use of the first embodiment, FIG. 5 is an explanatory diagram showing another usage example of the first embodiment, and FIG. 7 is an enlarged front view of the second embodiment, FIG. 8 is a side view of the third embodiment of the present invention, and FIG. 9 is a side view showing the second embodiment.
The figure is a side view showing a conventional example. 11... Cutting knife for curved path, 12... Soft pipe, 13... Blade, 14... Female part.

Claims (1)

[Scope of utility model registration request] The shaft member has an insertion passage on the inside that allows the guide member to be inserted therein, and has a soft shaft member at least on the distal end side, and an insertion passage that communicates with the insertion passage of the shaft member. 1. An incision scalpel for a curved path, comprising: a scalpel section having a blade disposed thereon; and the scalpel section is detachably attached to the tip of the shaft member by means of attachment means.