JPH035812B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION TECHNICAL FIELD The present invention relates to a tube for insertion into the body suitable for use during laser surgery. Conventional technology Examples of lasers used in medical treatment include krypton laser, argon laser, and Nd-YAG.
There are many types of lasers, carbon dioxide lasers, etc., and they are used for diagnosis, treatment, surgery, etc. depending on their optical characteristics. These lasers, which can emit medium to high energy, are used for cauterizing affected areas, stopping bleeding, and for scalpel use. However, when using a high-energy laser, there is a risk that normal body tissue other than the affected area may be damaged due to mistaken firing. In particular, carbon dioxide lasers are suitable for use as laser scalpels because they are capable of high output, but because their wavelengths are in the infrared range, they cannot be seen, making it extremely difficult to prevent accidental firing. If the laser from a laser scalpel is mistakenly emitted into normal tissue in the human body, burns will occur in that area no matter how short the time. However, the most dangerous accidental firing occurs when a laser is accidentally fired into the endotracheal tube when performing surgery with a laser scalpel using an internally inserted tube such as an endotracheal tube. The endotracheal tube is made of flexible polyvinyl chloride resin or silicone rubber, but if an accidental shot is fired into the polyvinyl chloride resin endotracheal tube, the part immediately burns and decomposes, creating a hole and destroying normal tissue. and the decomposition of the resin not only produces combustion gases but also extremely toxic chlorine gas.
Furthermore, when general anesthesia is administered through an endotracheal tube, the oxygen flowing through the endotracheal tube may ignite, which is extremely dangerous. If the endotracheal tube is made of silicone rubber, there is no danger from the generation of chlorine gas, but the remaining dangers are the same as with vinyl chloride resin. The above is a description of the most dangerous troubles associated with endotracheal tubes, but when using an intratracheal tube other than an endotracheal tube, mistakenly firing a laser at the tube can also burn out the tube and cause damage to the tube. There is no difference from the endotracheal tube in that it damages the normal tissues of the human body. Previously, in order to prevent damage to the endotracheal tube due to erroneous firing of laser beams, it has been proposed to protect the tube surface by wrapping it with aluminum tape or the like. However, aluminum tape is easily twisted and has sharp edges, which may injure the tracheal mucosa. A further problem is that the endotracheal tube cuff cannot be wrapped with tape. In the case of a carbon dioxide laser, it is well absorbed by water, so applying wet gauze to the cuff can be a temporary solution, but the operation is complicated and extremely troublesome. Additionally, this technique is similar to other lasers currently used in surgical procedures.
Nd-YAG laser and argon laser are ineffective. Purpose The present invention has been made in order to eliminate the drawbacks of the above-mentioned prior art, and is resistant to laser light and has flexibility without loss.
It is an object of the present invention to provide a tube for insertion into the body suitable for use in laser surgery. Configuration As a result of intensive research in order to achieve the above object, the present inventor found that in a tube for insertion into the body, at least a portion of the tube that may be at risk due to erroneous laser emission is made of metal fine powder and/or The above object is achieved by providing a tube for insertion into the body for use in laser surgery, which is composed of an inner layer made of silicone rubber containing fine ceramic powder and an outer layer made of silicone rubber containing black pigment. I found out what I can do. Next, the present invention will be explained in detail with reference to the accompanying drawings. In FIG. 1, 1 is a tube for insertion into the body for laser surgery, and this tube 1 includes a silicone rubber layer 2 containing a fine metal powder and/or a fine ceramic powder, and a black pigment, as the cross section of the tube 1 is shown in FIG. It is obtained by co-extrusion molding the silicone rubber layer 3 in two layers. FIG. 3 is a perspective view showing a configuration example when the present invention is applied to an endotracheal tube. Reference numeral 17 indicates at least a part where there is a possibility of danger due to mistaken laser firing, but this part 17 is one example;
The entire tube body 11 may be made of the tube of the present invention. At least a portion of the tube body 11 may be reinforced with a coil or mesh-like reinforcing material. In this example, the region 17 where it is necessary to prevent erroneous laser firing is approximately 20 cm from the tip of the tube body 11 including the cuff 13, but it may be longer if necessary. In FIG. 4, 19 is an air introduction pipe, 21 is a pilot balloon, and 23 is an air introduction port. Metal powders used in the present invention to impart laser beam resistance, heat resistance, and durability to the silicone rubber body include silver, stainless steel, nickel, titanium, tungsten, tantalium, aluminum, etc. Examples of fine ceramic powder include zirconia, silicon nitride, silicon carbide, zircon, silicon dioxide,
Fine powders such as silicates and alumina may be mentioned, and these may be used alone or in combination. Further, it is appropriate to blend these fine powders in an amount of 0.1 to 80 parts by weight, preferably 5 to 50 parts by weight, per 100 parts by weight of silicone rubber. Examples of the black pigment used in the present invention to prevent reflection of laser light include carbon black and graphite fine powder. The black pigment is suitably blended in an amount of 0.1 to 80 parts by weight, preferably 5 to 50 parts by weight, per 100 parts by weight of silicone rubber. The tube may be made of silicone rubber, vinyl chloride, etc., with silicone rubber being particularly preferred. Furthermore, the resistance to laser light may vary by simply coating the surface of a silicone rubber tube with the metal fine powder, ceramic fine powder, and black pigment using an appropriate coating method such as dipping, but the object of the present invention is to is achieved. Effects Since the tube for insertion into the body of the present invention has the above-mentioned structure, it does not have any twisting like conventional aluminum tape wrapped tubes.
It does not damage the tracheal mucosa. Furthermore, the cuff portion can also be constructed in the same manner. In addition, even if the laser beam is accidentally emitted, the inner layer is resistant to the laser beam, so it will burn out and decompose, creating holes.
Conventional problems such as damage to normal tissues of the human body can be solved. Furthermore, since the erroneously emitted laser beam is absorbed by the outer layer without being reflected, there is no damage to other normal tissues due to direct reflection, which can occur when only the inner layer is used, and is extremely safe. Since both the inner layer and the outer layer are made of silicone rubber, it has excellent flexibility and is easy to use. Next, the present invention will be explained in more detail with reference to the following examples, using an endotracheal tube as an example. Example: Silicone rubber KE174− manufactured by Shin-Etsu Chemical Co., Ltd.
After adding 30 parts by weight of stainless steel SUS316-L fine powder to 100 parts by weight of U and thoroughly kneading, crosslinking agent C-
153A3 parts by weight, control agent X-93-072 0.3 parts by weight,
Add 0.03 parts by weight of platinum catalyst X-93-001 and thoroughly knead with a roll to prepare a compound for the first layer (inner layer) of the endotracheal tube body.
Next, 2.7 parts by weight of crosslinking agent X-65-065 and platinum catalyst X-
Add 0.1 part by weight of 93-001 and knead thoroughly with a roll in the same manner to prepare a compound for the second layer (outer layer) of the endotracheal tube body. These two types of compounds are co-extruded and the inner diameter is approximately 8.5.
The inner layer is made of silicone rubber containing stainless steel SUS316-L fine powder, and the outer layer is made of silicone rubber containing carbon black.
A two-layer tube was created. On the other hand, the cuff is Torre
100 parts by weight of silicone rubber SE1184 manufactured by Silicone Co., Ltd., 20 parts by weight of stainless steel SUS316-L fine powder and silicone oil KF-96H manufactured by Shin-Etsu Chemical Co., Ltd.
After adding 5 parts by weight of 12500cs and thoroughly kneading with a roll, 1.2 parts by weight of vulcanizing agent RC-2 was added and extrusion molded using a 50 mm extruder to form an inner diameter of about 11.2 mm and an outer diameter of about 11.6 mm.
Create a φ cuff tube, cut it to a length of approximately 3.8 cm, and attach the cuff using RTV silicone rubber SH781 manufactured by Toray Silicone Co., Ltd. at a position approximately 1.5 cm from the tip of the tube body of the endotracheal tube. I attached it by gluing it. Then, insert the air introduction tube with the pilot balloon about 20 cm from the tip of the tube body.
An endotracheal tube with a two-layer tube body was created by gluing the tube in the same manner. Liquid silicone rubber KE1941 manufactured by Shin-Etsu Chemical Co., Ltd. containing carbon black to inflate the cuff of the intratracheal tube.
A cuffed endotracheal tube was created by taping in a coating solution diluted by adding 750 ml of toluene to 140 g and curing with heat. The endotracheal tube of the present invention obtained as described above, as a comparative example, a silicone rubber endotracheal tube containing no fillers such as metal powder, ceramic powder, and black pigment, manufactured by Dover (Comparative Example 1), and a soft Vinyl chloride endotracheal tubes manufactured by Portex (Comparative Example 2) were prepared, and portions of the tube body and cuff were cut out to prepare test pieces. These test pieces were irradiated with laser pulses to the same point under the following irradiation conditions, and the number of irradiations until the perforation was completed was compared. Laser: Carbon dioxide laser, Model manufactured by Japan Infrared Industry Co., Ltd.
60Z Irradiation angle: 90 degrees Beam diameter: 1mm Laser output: Tube body; 50W 0.1 seconds Cuff; 5W 0.05
The results obtained are shown in the table below. 【table】

[Brief explanation of the drawing]

Fig. 1 is a perspective view of a tube for insertion into the body for laser surgery according to the present invention, and Fig. 2 shows a silicone rubber layer containing a fine metal powder and/or a fine ceramic powder and a silicone rubber layer containing a black pigment at the same time in two layers. A sectional view of a tube for insertion into the body for laser surgery obtained by extrusion molding, and FIG. 3 is a perspective view showing an embodiment in which the present invention is applied to an endotracheal tube. 1...Tube for insertion into the body for laser surgery, 2
... silicone rubber layer containing fine metal powder and/or fine ceramic powder, 3 ... silicone rubber layer containing black pigment, 11 ... tube body, 13 ... cuff, 19 ... air introduction tube, 21 ... pilot balloon, 23...Air inlet.

Claims (1)

[Scope of Claims] 1. In a tube for insertion into the body, at least a portion of the tube that may be at risk due to erroneous laser firing has an inner layer made of silicone rubber containing fine metal powder and/or fine ceramic powder, and a black color. 1. A tube for insertion into the body for use in laser surgery, characterized by comprising an outer layer made of pigment-containing silicone rubber. 2 the tube for insertion into the body is an endotracheal tube;
The tube for insertion into the body according to claim 1, which is any one of an intrarectal insertion tube, an intrathoracic insertion tube, an intraperitoneal insertion tube, a gastrointestinal tube, an intraoral tube, and an intracranial tube. 3. The tube for insertion into the body according to claim 1, wherein the tube for insertion into the body is a tubular object inserted into the vagina or the uterus. 4. The tube for insertion into the body according to claim 1, wherein the tube for insertion into the body is a catheter. 5. The tube for insertion into the body according to claim 1, wherein the metal fine powder is selected from silver, titanium, tungsten, tantalum, aluminum, stainless steel, and nickel fine powder. 6 The ceramic fine powder is zirconia, silicon nitride, silicon carbide, zircon, silicon dioxide,
The tube for insertion into the body according to claim 1, which is selected from fine powders of silicates and alumina. 7. The tube for insertion into the body according to claim 1, wherein the black pigment is selected from carbon black and graphite fine powder. 8. The tube according to claim 1, wherein the tube is obtained by co-extruding a silicone rubber for an inner layer containing fine metal powder and/or a fine ceramic powder and a silicone rubber for an outer layer containing a black pigment. Tube for insertion into the body.