JPH03176074A - Fastener to be set in body cavity - Google Patents

Abstract

PURPOSE:To achieve a higher insertability with a higher fastening performance and with limited damage to living body by attaching a simple expansion control means to a fastener. CONSTITUTION:A tube body 3 shrinks in a dry condition and an expansion limiting tube 4 gets tight on an external surface of the tube body 3 being slackened in a bellows, while an ERBD tube 2 shrinks as a whole. Then, when the tube body 3 absorbs moisture, it expands diametrically and axially. The expansion limiting tube 4 gets tight on the outer cicumferential surface of the tube body 3 when being extended almost to the fullest and the ERBD tube 2 expands as a whole. On the other hands, as with axial expansion thereof, the expansion limiting tube 4 turns to a bellows in shape, it 4 becomes free from a resistance by a tensile force. In addition, the expansion limiting tube 4 extends together with the tube body 3, thereby allowing the tube body 3 to expand without being extruded from the expansion limiting tube 4.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an indwelling device in a body cavity, such as a drainage tube, a prosthesis, or a catheter, which is used by being indwelled in a body lumen.

[Prior art] For example, when a stricture occurs in the bile duct, ureter, or esophagus,
By inserting and indwelling an indwelling device into the narrowed area, a treatment to secure the duct is performed, and remarkable results have been achieved for, for example, malignant bile duct stricture (see Japanese Utility Model Application Publication No. 180442/1983). .

Our company has developed an indwelling device that is made of a mixture of super absorbent resin and rubber-like elastic resin and has a cylindrical bottom that absorbs moisture and expands (Utility Application No. 171512/1983). This is done by placing the indwelling device a in a dry state, that is, in a contracted state, in the narrowed part of the lumen, as shown in Fig. 32, and then allowing it to absorb the surrounding body vagina, etc., as shown in Fig. 33. The tube is inflated as shown, thereby dilating the stenosis.

[Problems to be Solved by the Invention] However, the above-mentioned indwelling device a only expands by absorbing moisture in the tit, and does not have a structure that regulates the amount of expansion when the stenosis is expanded. , there is a risk that the stenosis may be expanded more than necessary, causing damage to the living body such as laceration or perforation of the lumen C.

Further, in the above-mentioned indwelling device a, it is possible to regulate the amount of expansion to some extent by controlling the material of which the indwelling device a is made, such as the material and composition.

However, the amount of expansion of the indwelling device a varies depending on the concentration of ions, etc. in the body fluid to be absorbed. Since the concentration of ions and the like in body fluids varies depending on the individual, the rate of expansion of the indwelling device a changes depending on the individual use, resulting in variations in the amount of expansion. Therefore, it is difficult to reliably control the amount of dilatation of the stenotic part just by changing the material of the indwelling device a as described above.

On the other hand, with regard to intrabody cavity indwelling devices such as drainage tubes and vascular catheters, although they must be securely placed in the lumen where they are indwelled, the overall shape is thin so as not to impair insertability. It is usually composed of smooth and straight pieces.

However, with such a configuration, sufficient pipe lines cannot be secured. Furthermore, even if the patient is left in detention for a while, the patient may move or leave the detention position.

Furthermore, it is a burden to place the catheter in a conduit that curves or branches like a blood vessel.

The present invention was made with attention to the above 11 circumstances, and its purpose is to improve the indwelling performance by providing a simple fat expansion control means to the indwelling device, and further to prevent damage to the cow's body. It is an object of the present invention to provide an intrabody cavity indwelling device that can be reduced in size and have improved insertability.

[Means for Solving the Mixing Problem] In order to achieve the above-mentioned problems, the present invention provides a solution to the outer periphery, inner periphery, or inside of the indwelling device main body, which is formed into a cylindrical shape from a super absorbent resin that absorbs water and expands. The intracorporeal indwelling device is constructed by providing an expansion limiting member for regulating the amount of expansion of the indwelling device main body.

[Operation] In such a configuration, the indwelling device body absorbs body fluid and expands to form a sufficient conduit. Furthermore, since the seed hole can be made thinner, it is easy to insert the seed hole. Further, the amount of expansion is regulated to an optimal form by the expansion limiting member, ensuring safety and maintaining an optimal placement state.

[Embodiment] FIGS. 1 to 5 show a first embodiment of the present invention.

This first embodiment is applied to a drainage tube (hereinafter referred to as an ERBD tube) 2 that is inserted and left in a bile duct 1, and the ERBD tube 2 is biocompatible and absorbs water. superabsorbent resins that expand with water, such as starch-polyacronitrile hydrate, starch-polyacrylates, carboxymethyl cellulose and its derivatives, vinyl acetate-methyl acrylate copolymers, polysodium acrylate crosslinked products, etc. A resin film having biocompatibility, such as silicone rubber or polyethylene, is placed around the outer periphery of the tube body 3, which is formed into a cylindrical shape by mixing a rubber-like elastic resin that also has biocompatibility, such as silicone elastomer, urethane elastomer, etc. The tube body 3 is covered with an expansion limiting tube (member) 4 formed into a bellows shape from polyurethane, polytetrafluoroethylene, etc., and regulating the amount of expansion of the tube body 3.

In the dry state, the tube body 3 is in a contracted state as shown in FIG.
The BD tube 2 as a whole is in a contracted state. When the tube body 3 absorbs water, it expands in the radial and axial directions as shown in FIG.
The expansion limiting tube 4 is brought into close contact with the outer circumferential surface of the tube body 3 in an almost fully extended state, and the ERBD tube 2 as a whole is in an expanded state. In other words, the expansion of the tube body 3 in the radial direction h is suppressed by the tension of the expansion limiting tube 4, and is stopped at a certain predetermined diameter. On the other hand, the expansion in the axial direction is not resisted by the tension of the expansion restriction tube 4 because the expansion restriction tube 4 has a bellows shape, and because the expansion restriction tube 4 extends integrally with the tube body 3, the tube body 3 expands without protruding from the expansion restriction tube 4.

The ERBD tube 2 having such a configuration is used in the following manner. In other words, in Figure 3, 5 is the duodenum,
Reference numeral 6 indicates the duodenal papilla, 1 indicates the bile duct, 8 indicates the gallbladder, and 9 indicates the cancerous tissue area causing stricture. It is inserted retrogradely into the cancerous tissue area 9 and left in place.

Immediately after insertion, the ERBD tube 2 is in a contracted state as shown in FIG. 4, but after a certain amount of time, it absorbs surrounding body fluids and expands by a predetermined amount as shown in FIG. Expand section 9 to ensure sufficient conduit.

In this manner, when expanding the cancerous tissue portion 9, the amount of expansion of the tube body 3, particularly in the radial direction, is regulated by the expansion restriction tube 4, so that the amount of expansion of the cancerous tissue portion 9 can be reliably controlled. Therefore, there is no risk of damage to the living body such as laceration or perforation of the bile duct 1 due to excessive dilation, and it is highly safe.

6 to 10 show a second embodiment of the invention.

This second embodiment is applied to an esophageal prosthesis 12 that is inserted and left in the esophagus II, and the esophageal prosthesis 12 is similar to the tube body 3 of the first embodiment, as shown in FIG. Non-elastic edges 1ik14 having biocompatibility, such as Teflon, Dacron, etc., are distributed along the axial direction of the prosthesis body 13 within the prosthesis body 13, and non-elastic edges 1ik14 having biocompatibility are disposed on the outer periphery of the prosthesis body 13. Expansion-limiting mesh made of supine fibers 1
It is constructed by covering 5.

In the dry state, the prosthesis main body 13 is the seventh
As shown in the figure, the expansion restriction network 15 is in a contracted state, and is in close contact with the outer peripheral surface of the prosthesis body 13 in the contracted state.
The esophageal prosthesis 12 is in a contracted state as a body. When the prosthesis body 13 absorbs moisture, it tries to expand in the radial and axial directions, but the inelastic fibers 14 suppress the expansion in the axial direction, and the prosthesis body 13 only expands in the radial direction, as shown in FIG. inflates to
Further, expansion in the radial direction is restricted when the expansion control ocular meshwork 15 is almost fully extended.

The esophageal prosthesis 12 having such a configuration is used in the following manner. First, as shown in FIG. 9, a guide tube 17 with a balloon 16 attached to its tip is inserted into the esophagus 11 slightly deeper than the cancerous tissue part 18 with the balloon 16 contracted, and then the balloon 16 is inflated. The guide tube 17 is fixed.

Next, the esophageal prosthesis 12 is placed over the proximal portion of the guide tube 17, and the esophageal prosthesis 12 is inserted into the esophagus 11 via the guide tube 17 using the push tube 19. Once placed inside the cancerous tissue portion 18, saline is introduced into the esophagus 11 to inflate and fix the esophageal prosthesis 12. Thereafter, the push tube 19 and guide tube 17 are removed, and only the esophageal prosthesis 12 is removed from the cancerous tissue area 1, as shown in FIG.
Detained at 8.

According to the esophageal prosthesis 12 having such a configuration, in addition to the effects listed in the first embodiment, in particular, the expansion restriction network 1
Since the expansion in the axial direction is suppressed by the inelastic fibers 14 of No. 5, the esophagus 11 is not occupied more than necessary, and therefore the tissues surrounding the cancerous tissue portion 18 are not adversely affected, resulting in higher safety. .

In addition, the unevenness of the expansion restriction net 15 that constitutes the outer surface of the esophageal prosthesis 12 engages with the outer surface of the cancerous tissue portion 18 and serves to prevent it from moving or falling off from the target site.

11 to 13 show a third embodiment of the present invention.

This third embodiment has an ERBD similar to the first embodiment.
Applied to tube 2, its ERBD tube 2
As shown in FIG. 11, the outer periphery of the tube body 3 similar to that of the first embodiment is formed into a bellows-like shape from a biocompatible rubber-like elastic material, and the wall thickness at the axial center and both ends is is covered with an expansion limiting tube 4 that is formed thicker than other parts.

The rest of Masumoto's configuration is the same as the first embodiment, but
Here, especially when the tube body 3 expands, the thickness of the expansion limiting tube 4 partially differs, so the tube body 3 expands.
The tension applied to the ERBD tube 2 as a whole is different depending on the part, and as shown in FIG. 12, the ERBD tube 2 as a whole swells into a gourd shape where the thicker axial center and both ends are thinner than the other parts.

According to the ERBD tube 21 with such a filtration,
In addition to the effects listed in the first embodiment above, in addition to regulating the amount of fat swelling, we also controlled the shape after expansion, so that the shape after expansion matched the shape of the target area as shown in Figure 13. By setting the shape in advance, you can securely and firmly fix it to the target area. Therefore, movement or falling off from the target area can be more reliably prevented.

14 and 15 show a fourth embodiment of the present invention. This is in contrast to the first embodiment above.
The outer periphery of the tube body 3 is covered with a fat expansion limiting net 21 made of a rubber-like elastic material. In this case, the first
As shown in Fig. 5, when the tube body 3 swells, the swell restriction net 21 regulates the radial expansion of the fat in the almost fully extended state, and the same effect as in the first embodiment can be obtained. .

16 to 19 show a fifth embodiment of the present invention. This is a prosthesis 12 similar to the second embodiment, in which a hard tube 22 is folded over the outer periphery of the prosthesis body 13 along the circumferential direction.

In this case, as shown in FIGS. 18 and 19, when the prosthesis main body 13 swells, the hard tube 22 is almost fully extended and restricts the radial expansion. A similar effect can be obtained.

In addition, in this configuration, as shown in FIGS. 18 and 19, a plurality of positioning protrusions 23 are provided at both axial ends of the rigid tube 22, and the esophageal prosthesis 12 when indwelled is
It may also be designed to prevent movement or falling off.

Figures 20 to 23 show a sixth embodiment of the present invention. This embodiment is an example of a catheter 25 for biliary drainage, and the catheter main body 26 thereof is formed into a straight cylindrical shape from a super absorbent resin as described above.

As shown in FIG. 21, there is a length g within the wall thickness at both ends of the catheter body 26. Thin stainless steel wire 27.28
is embedded along the axial direction of the catheter body 26. The stainless steel wire 27 on one end side is buried in the upper wall portion, and the stainless steel wire 1128 on the other end side is buried in the lower wall portion. In other words, each stainless steel wire 27, 28 is provided symmetrically on the opposite circumference.

In this embodiment, one piece is provided on each end side, but a plurality of pieces may be provided. And this stainless steel wire 27
．． Reference numeral 28 constitutes an expansion limiting member that limits and regulates the swelling at each end of the catheter body 26. Furthermore, a plurality of drainage holes 29 are provided at each end of the catheter body 26, respectively.

Then, as described above in the first embodiment, this is introduced, for example, through a mirror and placed in the biliary tract. This biliary drainage catheter 25 is used in the 21st
As shown in the figure, it is in a contracted state, but after a certain amount of time, it absorbs surrounding body fluids and swells. That is, in the initial cutting state shown in FIG. 21, the outer diameter is rounded. and the inner diameter is d. However, as shown in FIG. 22, when the fat is expanded, the outer diameter is rounded and the inner diameter becomes dl. Here, the outer diameter is Do<D,
, the inner diameter becomes df<dl, and the tube is expanded to secure the duct.

Further, as the catheter body 26 expands, it swells in the axial direction, but the portions at both ends where the stainless steel wires 27 and 28 as expansion limiting members are located cannot swell.

In other words, the length. It remains as it is. However, the opposite portion at the same end can be swollen and extend to the length of Dl. Due to this difference in length, both ends of the catheter body 26 are bent four times, forming a loop as shown in FIG.
A so-called big tail 31.32 is formed.

In this way, both end portions of the catheter body 26 are connected to the picktail 31. 32 prevents the indwelling tube from moving within the biliary tract and from falling out.

In addition, since this biliary drainage catheter 25 has a small diameter and a straight shape until it is placed in the biliary tract, t,
It requires only 11 people to work on the device, and it does not put a burden on the patient. In particular, the patient's pain can be significantly reduced because a narrow-diameter endoscope can be used.

After the indwelling, it expands on its own to secure a sufficient duct. Furthermore, the period of use during which the inside of the catheter 25 becomes clogged can be extended.

24 to 27 show a seventh embodiment of the present invention. This embodiment is also an example of a catheter 35 for biliary drainage.

This catheter main body 36 is formed into a straight cylindrical shape from a sieve water-absorbing resin in the same manner as described above. A plurality of flaps 38, 39 are formed in the wall at both ends of the catheter body 36 by making cuts 37 therein. The notch 37 is formed at an angle so that each flap 38, 39 can be deflected to the outside of the catheter body 36.

Further, a linear expansion limiting member 40 made of stainless steel wire, polymer wire such as Kevlar, etc. is fixed to the outer side portion of each flap 38, 39.

Therefore, in this embodiment as well, the tube is introduced via an endoscope and placed in the biliary tract as described above.

The catheter 35 remains in a contracted state immediately after being indwelled, but after a certain period of time, it absorbs surrounding body fluids and swells, expanding its inner and outer diameters to ensure a sufficient duct.

Furthermore, as each part of the catheter body 36 swells, the flaps 38 and 39 at both ends also swell. but,
The expansion of the outer portions of the flaps 38 and 39 is limited by a linear expansion eye-limiting member 40. For this reason,
Each flap 38,39 is curved outwardly as shown in FIG.

And the flap 38 that curved and stood up like this
．． 39 acts as a support force against the wall of 1lQ3jA, which prevents movement of the catheter body 36 within the biliary tract, ensures that it remains in place, and prevents it from falling off.

Moreover, since this biliary drainage catheter 35 has a small diameter and a straight shape until it is placed in the biliary tract, the insertion and placement work is easy and does not place a burden on the patient. In particular, since a small-diameter endoscope can be used, patient pain can be significantly reduced.

Moreover, after being indwelled, it expands on its own to secure a sufficient duct. Furthermore, the period of use during which the inside of the catheter 35 becomes clogged can be extended.

28 to 31 show an eighth embodiment of the present invention. This embodiment uses an intravascular indwelling catheter 45.
This is an example. This catheter body 46 is made of super absorbent resin and is formed into a straight cylindrical shape, similar to that of the sixth embodiment described above.

A linear expansion limiting member 47 made of stainless steel wire or a polymer wire tube such as Kevlar is embedded along the axial direction of the catheter body 46 in the side wall thereof. Fixed. The indwelling position and length of the expansion limiting member 47 are set so as to curve along the Mff1J geometrical shape of the blood vessel 48 to be indwelled, as will be described later.

Therefore, this catheter 45 can be used, for example, for transendoscopic,
It is introduced into the blood W48 by various methods, such as introduction by X-ray transmission. Immediately after placement, it is in a contracted and thin state as shown in Figure 28, but after a certain amount of time, it absorbs surrounding moisture and swells as shown in Figure 30. That is, in the initial state shown in Fig. 28, the outer diameter is Do and the inner diameter is d.However, when the fat is expanded as shown in Fig. 30, the outer diameter becomes Dl and the inner diameter becomes dl. The length of the pipe is d.<d, and the pipe is expanded to ensure a sufficient duct.This allows for smooth injection of medicinal fluids and the like.

Further, as the catheter main body 46 expands, it swells in the direction of the axis h°, but the portion where the expansion restricting member 47 is located is prevented from expanding, so that it curves in that direction. In other words,
The length of the portion where the expansion limiting member 47 is located is 1. remain, but the opposite sidewall part at the same site can swell,
Extends to a length of gl. This difference in length causes the catheter body 46 to curve. Then, as shown in FIG. 31, it is curved along the cut-out shape of the blood vessel 48 to be placed.

In this way, since it is curved and placed in accordance with the anatomical shape of the blood vessel 48, there is less burden on the blood vessel 48, and the j of the blood vessel 48 is
M1 can be prevented.

Further, since the catheter 45 has a small diameter until it is placed in the blood vessel 48, it is easy to insert the catheter 45 into the blood vessel 48, and it does not put a burden on the patient.

After it is placed in place, it inflates by itself to secure a sufficient duct. Furthermore, the period of use during which the inside of the catheter 45 becomes clogged can be extended.

Note that the present invention is not limited to application to the above-mentioned ERBD tubes, esophageal prostheses, catheters for indwelling blood vessels, etc., but can be used for indwelling in various living body hollow organs. Moreover, various embodiments are conceivable, such as providing the expansion limiting member not only at the inner circumferential portion or outer circumferential portion of the tube body, but also within its wall thickness.

[Effects of the Invention] As explained above, according to the present invention, the device can be thin and easily inserted until it is indwelled in the body. After being indwelled in the body, the main body of the indwelling device absorbs body fluids and expands, forming a sufficient duct. Furthermore, the amount of expansion is regulated by an expansion limiting member to maintain optimal placement and ensure safety.

Furthermore, since an expansion limiting member is provided on the outer periphery, inner periphery, or inside of the indwelling device body, which expands by absorbing moisture, to regulate the amount of expansion of the indwelling device body, the configuration can be simplified for indwelling the indwelling device in the west of the body cavity. .

4. Explanation of Drawing No. 1: Figure 1 is a cross-sectional view of the ERBD tube before expansion showing the first embodiment of the present invention, Figure 2 is a cross-sectional view of the expansion amount, and Figures 3 to 5 are the same. Sectional view showing the state of use, No. 6
The figure is a side view of the prosthesis body of an esophageal prosthesis showing a second embodiment of the present invention, FIG. 7 is a side view of the esophageal prosthesis before expansion, partially cut away, and FIG. FIGS. 9 and 10 are sectional views similarly showing the state of use; FIG. 11 is a sectional view of the ERBD tube before expansion showing the third embodiment of the present invention; FIG. 12 is a sectional view of the expansion amount, FIG. 13 is a sectional view of the state of use, and FIG. 14 is a side view of the ERBD tube before expansion, showing the fourth embodiment of the present invention.
FIG. 15 is a side view showing the amount of expansion of the ERBD tube, FIG. 16 is a partially sectional side view of the esophageal prosthesis according to the fifth embodiment of the present invention, and FIG.
Figure 18 is a front view of the same, Figure 18 is a side view of the expansion amount showing the esophageal prosthesis partially in section,
The figure is also a self-view of the esophageal prosthesis, and Figures 20 to 23 show the sixth embodiment of the present invention.
21 is a side sectional view of a portion of the catheter; FIG. 22 is a sectional side view of a portion of the expanded catheter;
FIG. 23 is a side view of the modified catheter; FIGS. 24-f; FIG. 27 shows a seventh embodiment of the present invention;
4 is a side view of the ERBD tube, FIG. 25 is a side sectional view of a portion thereof, FIG. 26 is a side sectional view of a portion of the expanded ERBD tube, and FIG. 27 is a side view of the deformed ERBD tube. 28 to 31 show an eighth embodiment of the present invention, in which FIG. 28 is a side sectional view of the vascular catheter, FIG. 29 is a front sectional view of the vascular catheter, and FIG.
0 is a side cross-sectional view of the expanded vascular catheter, FIG. 31 is a sectional view of the vascular catheter in use, FIG. 32 is an oblique block diagram of a conventional indwelling device before expansion in use, and FIG.
Figure 3 is a diagonal diagram of the amount of expansion.

1... In front of the station, 2... ERBD tube, 3... Tube body, 4... Fat expansion restriction tube, 9, 18...
・Cancer tissue, 11... Esophagus, 12... Esophageal prosthesis, 13... Prosthesis body, 15.21...
- Swelling restriction net, 22... Hard tube, 25... Catheter, 26... Catheter body, 27.28... Stainless steel wire, 35... Catheter, 36... Catheter body, 40... ... Expansion limiting member, 45... Catheter, 46... Catheter body, 47... Expansion limiting member.

Outsourcing Agent Patent Attorney Atsushi Tsuboi No. 4 figure No. figure 4 No. figure 1st No. figure No. 9 figure No. 0 figure No. 1 figure No. 2 figure No. 4 figure No. 3 figure centre No. 5 figure No. 6 figure No. 8 figure hardship 7 figure No. 9 figure No. 27 figure No. 0 figure No. 1 figure

Claims (1)

[Claims] In an intrabody cavity indwelling device that is used while being indwelled in a body cavity, the indwelling device body is formed into a cylindrical shape from a super absorbent resin that absorbs water and expands, and the outer periphery, inner periphery, or thick inside of this indwelling device body is used. 1. An intrabody cavity indwelling device characterized by comprising an expansion limiting member provided in the indwelling device to regulate the amount of expansion of the indwelling device main body.