JPH0382459A - Device for dissolving calculus in living body - Google Patents
Device for dissolving calculus in living bodyInfo
- Publication number
- JPH0382459A JPH0382459A JP21883189A JP21883189A JPH0382459A JP H0382459 A JPH0382459 A JP H0382459A JP 21883189 A JP21883189 A JP 21883189A JP 21883189 A JP21883189 A JP 21883189A JP H0382459 A JPH0382459 A JP H0382459A
- Authority
- JP
- Japan
- Prior art keywords
- dissolving agent
- stone
- gallbladder
- sensor
- dissolving
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
- 239000003795 chemical substances by application Substances 0.000 claims abstract description 46
- 239000004575 stone Substances 0.000 claims description 28
- 238000001727 in vivo Methods 0.000 claims description 7
- 238000004090 dissolution Methods 0.000 claims 2
- 210000000232 gallbladder Anatomy 0.000 abstract description 28
- HVYWMOMLDIMFJA-DPAQBDIFSA-N cholesterol Chemical compound C1C=C2C[C@@H](O)CC[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@H]([C@H](C)CCCC(C)C)[C@@]1(C)CC2 HVYWMOMLDIMFJA-DPAQBDIFSA-N 0.000 abstract description 14
- 210000001198 duodenum Anatomy 0.000 abstract description 11
- 235000012000 cholesterol Nutrition 0.000 abstract description 7
- 239000000945 filler Substances 0.000 abstract description 5
- 210000001124 body fluid Anatomy 0.000 abstract description 4
- 239000010839 body fluid Substances 0.000 abstract description 4
- 230000010355 oscillation Effects 0.000 abstract description 3
- 238000000034 method Methods 0.000 description 10
- 201000001883 cholelithiasis Diseases 0.000 description 9
- 208000001130 gallstones Diseases 0.000 description 8
- 230000010412 perfusion Effects 0.000 description 8
- 210000001096 cystic duct Anatomy 0.000 description 6
- 239000002904 solvent Substances 0.000 description 6
- 210000001953 common bile duct Anatomy 0.000 description 5
- 238000003780 insertion Methods 0.000 description 5
- 230000037431 insertion Effects 0.000 description 5
- 239000000463 material Substances 0.000 description 5
- BZLVMXJERCGZMT-UHFFFAOYSA-N Methyl tert-butyl ether Chemical compound COC(C)(C)C BZLVMXJERCGZMT-UHFFFAOYSA-N 0.000 description 4
- 239000004809 Teflon Substances 0.000 description 4
- 229920006362 Teflon® Polymers 0.000 description 4
- 230000002183 duodenal effect Effects 0.000 description 4
- 238000003756 stirring Methods 0.000 description 4
- 230000008961 swelling Effects 0.000 description 4
- 238000002604 ultrasonography Methods 0.000 description 4
- 230000000694 effects Effects 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- XMGQYMWWDOXHJM-JTQLQIEISA-N (+)-α-limonene Chemical compound CC(=C)[C@@H]1CCC(C)=CC1 XMGQYMWWDOXHJM-JTQLQIEISA-N 0.000 description 2
- IAZDPXIOMUYVGZ-UHFFFAOYSA-N Dimethylsulphoxide Chemical compound CS(C)=O IAZDPXIOMUYVGZ-UHFFFAOYSA-N 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- XMGQYMWWDOXHJM-UHFFFAOYSA-N limonene Chemical compound CC(=C)C1CCC(C)=CC1 XMGQYMWWDOXHJM-UHFFFAOYSA-N 0.000 description 2
- 210000002438 upper gastrointestinal tract Anatomy 0.000 description 2
- 101000998140 Homo sapiens Interleukin-36 alpha Proteins 0.000 description 1
- 101000998126 Homo sapiens Interleukin-36 beta Proteins 0.000 description 1
- 101001040964 Homo sapiens Interleukin-36 receptor antagonist protein Proteins 0.000 description 1
- 101000998122 Homo sapiens Interleukin-37 Proteins 0.000 description 1
- 102100021150 Interleukin-36 receptor antagonist protein Human genes 0.000 description 1
- 210000001015 abdomen Anatomy 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- 239000003463 adsorbent Substances 0.000 description 1
- 238000011978 dissolution method Methods 0.000 description 1
- RTZKZFJDLAIYFH-UHFFFAOYSA-N ether Substances CCOCC RTZKZFJDLAIYFH-UHFFFAOYSA-N 0.000 description 1
- 238000001704 evaporation Methods 0.000 description 1
- 230000008020 evaporation Effects 0.000 description 1
- 230000001678 irradiating effect Effects 0.000 description 1
- 229940087305 limonene Drugs 0.000 description 1
- 235000001510 limonene Nutrition 0.000 description 1
- 230000000387 litholytic effect Effects 0.000 description 1
- 210000004185 liver Anatomy 0.000 description 1
- 229910052751 metal Inorganic materials 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 125000002496 methyl group Chemical group [H]C([H])([H])* 0.000 description 1
- LCGLNKUTAGEVQW-UHFFFAOYSA-N methyl monoether Natural products COC LCGLNKUTAGEVQW-UHFFFAOYSA-N 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- GCLGEJMYGQKIIW-UHFFFAOYSA-H sodium hexametaphosphate Chemical compound [Na]OP1(=O)OP(=O)(O[Na])OP(=O)(O[Na])OP(=O)(O[Na])OP(=O)(O[Na])OP(=O)(O[Na])O1 GCLGEJMYGQKIIW-UHFFFAOYSA-H 0.000 description 1
- 235000019982 sodium hexametaphosphate Nutrition 0.000 description 1
- 238000001179 sorption measurement Methods 0.000 description 1
- 239000001577 tetrasodium phosphonato phosphate Substances 0.000 description 1
Landscapes
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
【発明の詳細な説明】
［産業上の利用分野］
本発明は生体内の結石を溶解剤を用いて除去する生体内
結石の溶解装置に関する。DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to an in-vivo stone dissolving device that removes in-vivo stones using a dissolving agent.
［従来の技術］
近年、生体内に生じる胆石等の結石を除去する方法が種
々考えられている。一般的な方法として外科的に除去す
るもの、経内視鏡的にバスケット鉗子を体腔内に導入し
、結石を把持して取り出すものなどがある゛。[Prior Art] In recent years, various methods have been considered for removing stones such as gallstones that occur in living bodies. Common methods include surgical removal and endoscopically introducing basket forceps into the body cavity to grasp and remove the stone.
しかし、外科的に除去する方法は患者の負担が大きい。However, surgical removal methods place a heavy burden on the patient.
また、経内視鏡的にバスケット鉗子を使用する方法はバ
スケット鉗子を導入できる部位の結石に限られるととも
に、その結石の大きさ等の条件によって取り出すことが
できない場合が多い。Furthermore, the endoscopic method of using basket forceps is limited to stones in areas where the basket forceps can be introduced, and it is often impossible to remove the stone depending on conditions such as the size of the stone.
一方、超音波等の衝撃波を生体外から体内の結石部位に
向けて集中的に照射することにより結石を破砕する方式
も知られている（特開昭６２−１２０８４６号公報）。On the other hand, there is also known a method of crushing a stone by intensively irradiating shock waves such as ultrasonic waves from outside the body toward the stone site within the body (Japanese Patent Application Laid-open No. 120846/1984).
この方式は装置が大掛かりになるとともに、結石それ自
体を除去することにはならない。This method requires a large-scale device and does not remove the stone itself.
［発明が解決しようとする課題］
ところが、最近、生体内の結石を（直接）溶解剤を用い
て除去する結石溶解方法が提案されている（特開昭６３
−４０５４１号公報）。これは胆石のある胆嚢内に結石
溶解剤を入れ、胆石を化学的に溶解しようとする優れた
方法である。[Problems to be Solved by the Invention] However, recently, a stone dissolution method has been proposed in which stones in the living body are (directly) removed using a dissolving agent (Japanese Patent Application Laid-Open No. 1983-1999).
-40541 publication). This is an excellent method of placing a stone-dissolving agent into the gallbladder where the gallstones are located and attempting to chemically dissolve the gallstones.
この方法においての溶解剤は、例えばコレステロール胆
石には、メチルを一エーテル（ＭＴＢＥ）が使用される
。The dissolving agent in this method is, for example, methyl monoether (MTBE) for cholesterol gallstones.
しかしながら、この結石溶解剤は胆嚢内では生体に適合
してコレステロール胆石を溶解させる作用を行うが、こ
の結石溶解剤が胆嚢から漏れ出し、胆嚢管から総胆管を
通じて例えば十二指腸に至ると、患者に激痛を起させる
。However, this stone-dissolving agent is biocompatible in the gallbladder and has the effect of dissolving cholesterol gallstones, but if this stone-dissolving agent leaks from the gallbladder and reaches the duodenum via the cystic duct and the common bile duct, it can cause severe pain to the patient. cause to happen.
また、他の結石溶解剤のときにも同じであるが、漏れ出
してそこで吸収されることは一般に有害である。Also, as with other litholytic agents, leakage and absorption is generally harmful.
本発明は上記課題に着目してなされたもので、その目的
とするところは、必要部位以外に結石溶解剤が漏れたこ
とを検知して安全に処置できるようにした生体内結石の
溶解装置を提供することにある。The present invention has been made in view of the above-mentioned problems, and its purpose is to provide an in-vivo stone dissolving device that can detect and safely treat the leakage of a stone dissolving agent to areas other than the required areas. It is about providing.
［課題を解決する手段および作用］
上記課題を解決するために本発明は、結石の存在する体
腔内に結石溶解剤を入れ、その結石を溶解して除去する
生体内結石の溶解装置において、結石のある体腔外に漏
れ出す結石溶解剤を検出するセンサ手段を設けたもので
ある。[Means and effects for solving the problems] In order to solve the above problems, the present invention provides an in-vivo stone dissolving device that dissolves and removes stones by introducing a stone dissolving agent into a body cavity where a stone exists. A sensor means is provided for detecting a stone-dissolving agent leaking out of a certain body cavity.
これによれば、結石溶解剤の漏れの存在を検出すること
ができるから、その漏れを検知して安全に処置できる。According to this, the presence of leakage of the calculus dissolving agent can be detected, so that the leakage can be detected and safely treated.
［実施例］
第１図ないし第３図は本発明の第１の実施例を示すもの
である。第１図は生体内結石の溶解装置の構成を概略的
に示しており、同図中１は患者（生体）で、ベット２の
上に載せられている。患者１の上部消化器管には経口的
に内視鏡３の挿入部３ａが十二指腸４の十二指腸乳頭部
５の付近まで導入されている。また、内視鏡３の挿通用
チャンネル（図示しない。）を通じて潅流用カテーテル
６と後述するセンサ７が挿入されるようになっている。[Embodiment] FIGS. 1 to 3 show a first embodiment of the present invention. FIG. 1 schematically shows the structure of an apparatus for dissolving stones in a living body. In the figure, 1 is a patient (living body) placed on a bed 2. As shown in FIG. The insertion portion 3a of the endoscope 3 is orally introduced into the upper gastrointestinal tract of the patient 1 to the vicinity of the duodenal papilla 5 of the duodenum 4. Further, a perfusion catheter 6 and a sensor 7 to be described later are inserted through an insertion channel (not shown) of the endoscope 3.
潅流用カテーテル６はその内視鏡３または図示しないガ
イドワイヤなどを利用して総胆管８から胆嚢管９または
胆嚢１０まで導入される。The perfusion catheter 6 is introduced from the common bile duct 8 to the cystic duct 9 or the gallbladder 10 using the endoscope 3 or a guide wire (not shown).
そして、このカテーテル６を通じて胆嚢１０内に結石溶
解剤を導入したり、結石溶解剤を潅流したりする。セン
サ７は十二指腸４の十二指腸乳頭部５の付近、または総
胆管８から胆嚢管９の範囲内に位置させられる。Then, a stone-dissolving agent is introduced into the gallbladder 10 through this catheter 6, or the stone-dissolving agent is perfused. The sensor 7 is located near the duodenal papilla 5 of the duodenum 4 or within the range from the common bile duct 8 to the cystic duct 9.
胆嚢１０に対応した患者１の腹部外面には超音波照射装
ｇ１１１が設置されている。超音波照射装置１１は観察
用超音波振動子１２と攪拌照射用超音波振動子１３とを
有し、観察用超音波振動子１２は超音波観察装置１４に
接続されている。攪拌照射用超音波振動子１３は増幅器
１４を介して発振＄１５に接続されている。そして、こ
の超音波観察装置１１４と発振器１５は制御装ＦＩＬ１
６に接続されている。An ultrasound irradiation device g111 is installed on the outer surface of the abdomen of the patient 1 corresponding to the gallbladder 10. The ultrasonic irradiation device 11 has an ultrasonic vibrator 12 for observation and an ultrasonic vibrator 13 for stirring irradiation, and the ultrasonic vibrator 12 for observation is connected to the ultrasonic observation device 14 . The stirring irradiation ultrasonic vibrator 13 is connected to an oscillation signal 15 via an amplifier 14. The ultrasonic observation device 114 and the oscillator 15 are controlled by the control device FIL1.
6.
また、上述した潅流用カテーテル６を接続する潅流駆動
装ｆ！１７と、センサ７を接続したセンサ装置本体１８
も、制御装置１６に接続されている。Also, a perfusion drive device f! to which the above-mentioned perfusion catheter 6 is connected! 17 and a sensor device main body 18 to which the sensor 7 is connected.
is also connected to the control device 16.
なお、制御装置１６には、外部制御指令部１つとモニタ
２０が接続されている。Note that one external control command section and a monitor 20 are connected to the control device 16.
一方、上記センサ７は第１図で、示すように可撓性のチ
ューブ２１の先端にテフロン製の先端チップ２２を取着
してなり、先端チップ２２の先端部には凹部２３を形成
しである。この凹部２３内には、一対の電極２４ａ、２
４ｂの先端を対向して設け、さらに、この凹部２３内に
はコレステロールからなる充填物２５を充填しである。On the other hand, as shown in FIG. 1, the sensor 7 has a tip 22 made of Teflon attached to the tip of a flexible tube 21, and a recess 23 is formed at the tip of the tip 22. be. Inside this recess 23, a pair of electrodes 24a, 2
The tips of the recesses 4b are provided facing each other, and the recess 23 is further filled with a filler 25 made of cholesterol.
そして、この充填物２５を充填するとき、一対の電極２
４ａ、２４ｂの先端は互いに離れるようにする。また、
充填物２５がないとき、一対の電極２４ａ、２４ｂの先
端はそれ自身の弾性力で接触するようになっている。な
お、充填物２５がないときにも、一対の電極２４ａ、２
４ｂの先端が離れていても、この間に介在する体液が一
般に導電性を有するので、必ずしも、電極２４ａ、２４
ｂの先端同志が接触しなくてもよい。When filling this filling material 25, a pair of electrodes 2
The tips of 4a and 24b are separated from each other. Also,
When there is no filler 25, the tips of the pair of electrodes 24a, 24b are brought into contact by their own elastic force. Note that even when there is no filling material 25, the pair of electrodes 24a, 2
Even if the tips of the electrodes 24a and 24b are separated, the body fluid interposed between them is generally conductive, so the electrodes 24a and 24 are not necessarily separated.
The tips of b do not need to contact each other.
また、一対の電極２４ ａ、２４ｂにそれぞれ通じる導
電ワイヤ２６ａ、２６ｂはチューブ２１内を通じて上記
センサ装置本体１８に接続されている。Further, conductive wires 26a and 26b respectively connected to the pair of electrodes 24a and 24b are connected to the sensor device main body 18 through the tube 21.
次に、この生体内結石の溶解装置の作用を説明する。Next, the operation of this in-vivo stone dissolving device will be explained.
まず、第２図で示すように、患者１の上部消化器管に、
内視鏡３の挿入部３ａを経口的に挿入し、十二指腸４の
十二指腸乳頭部５の付近まで導入する。そして、この内
視鏡３の挿通用チャンネルを通じ、さらに必要ならば、
ガイドワイヤなどを利用して潅流用カテーテル６を総胆
管８から胆嚢管９を通り胆嚢１０まで導入する。これら
の状況は超音波照射装置１１および超音波観察装置１４
によりモニタ２０で観察できる。First, as shown in Figure 2, in the upper gastrointestinal tract of patient 1,
The insertion section 3a of the endoscope 3 is orally inserted and introduced to the vicinity of the duodenal papilla 5 of the duodenum 4. Then, if necessary, through the insertion channel of the endoscope 3,
A perfusion catheter 6 is introduced from the common bile duct 8 through the cystic duct 9 to the gallbladder 10 using a guide wire or the like. In these situations, the ultrasound irradiation device 11 and the ultrasound observation device 14
It can be observed on the monitor 20.
一方、センサ７は内視鏡３の挿通用チャンネルを通じて
十二指腸４の千二指腸乳頭部５の付近、または総胆管８
から胆嚢管９の範囲内にその先端チップ２２の部分を位
置させる。On the other hand, the sensor 7 is inserted into the vicinity of the duodenal papilla 5 of the duodenum 4 or the common bile duct 8 through the insertion channel of the endoscope 3.
The distal tip 22 is positioned within the cystic duct 9 from the cystic duct 9.
そして、潅流駆動装ｆｌ！１７を作動し、そのカテーテ
ル６を通じて胆嚢１０内に結石溶解剤を導入するととも
に、必要に応じてその結石溶解剤を潅流する。このよう
にして胆嚢１０内にある胆石２７はその溶解剤によって
溶解する。一般に胆石２７はコレステロール系のもので
あり、このため、溶解剤もそれを溶解できるもの、例え
ばメチルｔ−エーテル（ＭＴＢＥ）を使用する。And perfusion drive system fl! 17 to introduce the stone-dissolving agent into the gallbladder 10 through the catheter 6, and perfuse the stone-dissolving agent as necessary. In this way, the gallstones 27 in the gallbladder 10 are dissolved by the dissolving agent. Generally, gallstones 27 are cholesterol-based, and therefore, a dissolving agent capable of dissolving them, such as methyl t-ether (MTBE), is used.
この場合、発振器１５を動作させて、超音波照射装置１
１の攪拌照射用超音波振動子１３から上記胆１１１０に
向けて超音波を・照射する。これにより溶解剤が攪拌さ
れ、胆石２７に対する溶解作用が促進される。In this case, the oscillator 15 is operated and the ultrasonic irradiation device 1
Ultrasonic waves are irradiated from the stirring irradiation ultrasonic vibrator 13 of No. 1 toward the gallbladder 1110. This stirs the dissolving agent and promotes the dissolving action on the gallstones 27.
また、この溶解作用を受けている状況を超音波観察装置
１４によりモニタ２０で観察できる。Furthermore, the state of the dissolving action can be observed on the monitor 20 using the ultrasonic observation device 14.
ところで、この処置中に、胆嚢１０から溶解剤が十二指
腸４側に漏れ出すと、あらかじめ設置しておいたセンサ
７の先端チップ２２における凹部２３に充填しておいた
コレステロールからなる充填物２５が溶解する。したが
って、この凹部２３内の一対の電極２４ａ、２４ｂが露
出し、それ自身の弾性力で接触し、あるいはその体液等
を介して導通する。この導通信号はセンサ装置本体１８
において処理される。そして、この溶解剤の洩れ信号を
制御装置１６が判断して、システムの動作を制御する。By the way, during this procedure, if the dissolving agent leaks from the gallbladder 10 to the duodenum 4 side, the filling 25 made of cholesterol that has been filled in the recess 23 of the distal tip 22 of the sensor 7 installed in advance will dissolve. do. Therefore, the pair of electrodes 24a and 24b in the recess 23 are exposed and come into contact with each other by their own elastic force or are electrically connected via their body fluids or the like. This conductive signal is transmitted to the sensor device main body 18.
Processed in Then, the control device 16 determines the leakage signal of the solvent and controls the operation of the system.
例えば溶解剤の潅流動作を停止させる。発振器１５の発
振動作を停止させる。さらに、図示しない警告用ブザー
やランプを動作させて術者に知らせる。また、カテーテ
ル６を通じて胆嚢１０内に結石溶解剤を吸引除去する。For example, the perfusion operation of the dissolving agent is stopped. The oscillation operation of the oscillator 15 is stopped. Further, a warning buzzer and lamp (not shown) are activated to notify the operator. Further, the stone dissolving agent is removed by suction into the gallbladder 10 through the catheter 6.
゛さらには十二指腸４側に漏れ出した溶解剤をカテーテ
ル等により吸引除去する処置を行う。このようにして胆
嚢１０から溶解剤が十二指腸４側に漏れ出したときの安
全を確保する。``Furthermore, a procedure is performed to remove the dissolving agent that has leaked into the duodenum 4 by suction using a catheter or the like. In this way, safety is ensured when the dissolving agent leaks from the gallbladder 10 to the duodenum 4 side.
第４図は本発明の第２の実施例を示すものである。これ
は別のセンサ３０の例である。このセンサ３０はテフロ
ン製の先端チップ２２にその側面側に開口する凹部３１
を形成し、この凹部３１内に、対向する一対の電極２４
ａ、２４ｂを設置し、さらに、これを覆うコレステロー
ルからなる充填物２５を充填したものである。その他の
構成は上記第１の実施例のものと同じである。このセン
サ３０は上記実施例の場合と略同様に使用することがで
きる。ただ、先端チップ２２の側面からの溶解液の検出
を効率的に行うことができる。FIG. 4 shows a second embodiment of the invention. This is an example of another sensor 30. This sensor 30 has a recess 31 opened on the side surface of the tip 22 made of Teflon.
A pair of opposing electrodes 24 are formed in the recess 31.
a and 24b are installed, and a filling material 25 made of cholesterol is further filled therein. The other configurations are the same as those of the first embodiment. This sensor 30 can be used in substantially the same manner as in the above embodiment. However, it is possible to efficiently detect the solution from the side surface of the distal tip 22.
第５図ないし第７図は本発明の第３の実施例を示すもの
である。この実施例は胆嚢１０の胆嚢顎１０ａの部分を
栓４０で塞ぐようにした。そして、この栓４０に後述す
るようにセンサを組み込むものである。5 to 7 show a third embodiment of the present invention. In this embodiment, the gallbladder jaw 10a of the gallbladder 10 is plugged with a plug 40. A sensor is incorporated into this stopper 40 as described later.
栓４０は芯部材４１の外周に、使用する溶解剤を吸収し
て膨脹する部材４２を被嵌してなり、膨脹用部材４２は
その材料として溶解剤がＭＴＢＥのときには例えばシリ
コンを使用し、これをいわゆるスポンジ状に形成する。The plug 40 is formed by fitting a member 42 that absorbs and expands the dissolving agent used on the outer periphery of a core member 41, and the expanding member 42 is made of, for example, silicone when the dissolving agent is MTBE. is formed into a so-called sponge shape.
また、芯部材４１は同じく使用する溶解剤によって溶解
しない、例えばテフロンによって形成する。Further, the core member 41 is made of, for example, Teflon, which is not dissolved by the dissolving agent that is also used.
また、芯部材４１の一端には鍔４３が形成され、芯部材
４１の他端には球状部４４が形成されている。この球状
部４４には凹部４５を形成する。この凹部４５内には、
センサの一対の電極２４ａ。Further, a collar 43 is formed at one end of the core member 41, and a spherical portion 44 is formed at the other end of the core member 41. A recess 45 is formed in this spherical portion 44 . Inside this recess 45,
A pair of electrodes 24a of the sensor.
２４ｂがその先端を対向して設けられている。さらに、
この凹部４５内にはコレステロールからなる充填物４６
を充填しである。そして、この充填物４６を充填すると
き、一対の電極２４ａ。24b are provided with their tips facing each other. moreover,
This recess 45 is filled with a filling 46 made of cholesterol.
It is filled with. Then, when filling this filling material 46, a pair of electrodes 24a.
２４ｂの先端が離れるようにする。また、充填物２５が
ないとき、一対の電極２４ａ、２４ｂの先端はそれ自身
の弾性力で接触するようになっている。なお、充填物２
５がないときにも、一対の電極２４ａ、・２４ｂの先端
が離れていても、この間に介在する体液が一般に導電性
を有するので、必ずしも、電極２４ａ、２４ｂの先端同
志が接触しないようにしてもよい。Make sure that the tip of 24b is separated. Furthermore, when there is no filler 25, the tips of the pair of electrodes 24a, 24b are brought into contact by their own elastic force. In addition, filling 2
5, even if the tips of the pair of electrodes 24a, 24b are separated, the body fluid interposed between them is generally conductive, so the tips of the electrodes 24a, 24b do not necessarily come into contact with each other. Good too.
また、この一対の電極２４ａ、２４ｂには、それぞれ電
極コード２６ａ、 ２５ｂが接続されている。この電
極コード２６ａ、２６ｂは芯部材４１を通じて鍔４３側
に導かれ、コード４８にまとめられて導出するようにな
っている。なお、このコード４８は第１の実施例に場合
と同様にセンサ装置本体１８に接続されるようになって
いる。Furthermore, electrode cords 26a and 25b are connected to the pair of electrodes 24a and 24b, respectively. The electrode cords 26a, 26b are led to the collar 43 side through the core member 41, and are collected into a cord 48 and led out. Note that this cord 48 is connected to the sensor device main body 18 as in the first embodiment.
この実施例の場合は経皮的に処置される。すなわち、栓
４０は第７図で示すように外科手術により経皮的に胆嚢
１０に導入され、胆嚢顎１０ａの部分に設置される。そ
して、同じく胆嚢１ｏ内に経皮的に導入したカテーテル
４つを通じてその胆嚢１０内に溶解剤５０としてのＭＴ
ＢＥを導入する。栓４０の膨脂用部材４２はその溶解剤
５ｏによって第５図の状態から第６図の状態に膨脹し、
第７図で示すように胆嚢１ｏの胆嚢顎１０ａを完全に閉
止する。In this example, the treatment is percutaneous. That is, as shown in FIG. 7, the plug 40 is percutaneously introduced into the gallbladder 10 by a surgical procedure and placed in the gallbladder jaw 10a. Then, MT as a solubilizer 50 is introduced into the gallbladder 10 through four catheters percutaneously introduced into the gallbladder 1o.
Introduce BE. The fat swelling member 42 of the stopper 40 is expanded from the state shown in FIG. 5 to the state shown in FIG. 6 by the dissolving agent 5o,
As shown in FIG. 7, the gallbladder jaw 10a of the gallbladder 1o is completely closed.
カテーテル４つの先端孔４９ｍから溶解剤５゜を注入し
、そのカテーテル４９の側孔４９ｂから溶解剤を吸引し
て溶解剤５０を潅流させる。このようにして胆嚢１０内
の胆石２７を溶解して除去する。A solubilizing agent 5° is injected through the tip holes 49m of the four catheters, and the solubilizing agent is suctioned through the side hole 49b of the catheter 49 to perfuse the solubilizing agent 50. In this way, the gallstones 27 in the gallbladder 10 are dissolved and removed.
ところで、この実施例では胆嚢１０の胆嚢顎１０ａの部
分を栓４０で閉塞するので、溶解剤５０が十二指腸４側
へ洩れ出すことを防止できる。Incidentally, in this embodiment, since the gallbladder jaw 10a portion of the gallbladder 10 is occluded with the stopper 40, it is possible to prevent the dissolving agent 50 from leaking to the duodenum 4 side.
しかし、これによっても、何等かの理由によって溶解剤
５０が十二指腸側４へ洩れ出すことがあると、その洩れ
出した溶解剤が、球状部４４の凹部４５に充填したコレ
ステロールからなる充填物４６を溶解し、その凹部４５
内の一対の電極２４ａ、２４ｂを露出させる。このため
、その−対の電極２４ａ、２４ｂが接触して導通し、溶
解剤５０が洩れたことを検出する。However, even with this, if the dissolving agent 50 leaks into the duodenum side 4 for some reason, the leaked dissolving agent will damage the filling 46 made of cholesterol filled in the recess 45 of the spherical portion 44. Dissolved and its recess 45
A pair of electrodes 24a and 24b inside are exposed. Therefore, the pair of electrodes 24a and 24b are brought into contact and conductive, and leakage of the dissolving agent 50 is detected.
そして、上記第１の実施例の場合と同様に溶解液５０の
潅流を停止したり、溶解液５０を回収したりして、安全
を確保する処置を行う。Then, as in the case of the first embodiment, measures are taken to ensure safety by stopping the perfusion of the solution 50 and collecting the solution 50.
なお、この実施例においても、上記第１の実施例の場合
と同様に超音波照射装置１１を設けて処置部位の観察、
および溶解剤５０の攪拌を行うようにしてもよい。In this embodiment, as in the case of the first embodiment, an ultrasound irradiation device 11 is provided to observe the treated area,
The dissolving agent 50 may also be stirred.
第８図は本発明の第４の実施例を示すものである。この
実施例は上記第３の実施例における栓４０の芯部材４１
に鍔４３側に開口する導入孔５１を形成し、さらに膨脂
用部材４２の内面に対応する周面にはその導入孔５１に
連通する多数の孔５２を形成する。FIG. 8 shows a fourth embodiment of the present invention. This embodiment is based on the core member 41 of the plug 40 in the third embodiment.
An introduction hole 51 opening toward the flange 43 is formed at the flange 43, and a large number of holes 52 communicating with the introduction hole 51 are formed on the circumferential surface corresponding to the inner surface of the fat-swelling member 42.
この実施例では膨脂用部材４２の一端面側部分を胆嚢１
０内の溶解剤に直接に接触させるだけでなく、上記導入
孔５１および導入孔５１を通じて膨脂用部材４２の内面
側からも溶解剤に接触させるようにした。したがって、
膨脂用部材４２を容易かつ迅速に膨脹させることができ
る。In this embodiment, one end surface side portion of the fat swelling member 42 is connected to the gallbladder 1.
The fat swelling member 42 is brought into contact with the dissolving agent not only directly but also from the inner surface of the fat swelling member 42 through the introduction hole 51 and the introduction hole 51. therefore,
The fat expansion member 42 can be expanded easily and quickly.
その他については上記第３の実施例のものと同様である
。Other aspects are the same as those of the third embodiment.
第９図ないし第１０図は上記第３の実施例におけるカテ
ーテル４９を改良したものである。すなわち、カテーテ
ル４９の外周に溶解剤が蒸発して生じたガスを吸着する
吸着材５５を被着したものである。ＭＴＢＥは特に揮発
性が高いので、このようにすれば、第１０図で示すよう
に胆嚢１ｏ内で気化したＭＴＢＨのガス６０を吸着除去
できる。9 and 10 show an improved version of the catheter 49 in the third embodiment. That is, an adsorbent 55 is attached to the outer periphery of the catheter 49 to adsorb gas generated by evaporation of the dissolving agent. Since MTBE is particularly volatile, in this way, the MTBH gas 60 vaporized within the gallbladder 1o can be removed by adsorption, as shown in FIG.
なお、本発明は上記各実施例のものに限定されるもので
はない。例えば上記先端チップの部材、栓の部材として
はテフロンに限らず、溶解剤ニとけない物であれば、金
属など他のものであってもよい。また、溶解剤の種類も
、天然リモネン酸剤リフコール（ｄ−リモネン）など、
種々なものを選択できる。また、他の体腔内結石、例え
ば膀胱内結石にも適用でき、その場合にはへキサメタリ
ン酸ナトリウム溶液やジメチルスルホキシドＣＤＭＳＯ
）などを使用できる。Note that the present invention is not limited to the above embodiments. For example, the member of the distal tip and the member of the stopper are not limited to Teflon, but may be made of other materials such as metal as long as they are not soluble in the dissolving agent. In addition, the types of solubilizers include natural limonene acid agent Lifcol (d-limonene), etc.
You can choose from a variety of options. It can also be applied to other intravesical stones, such as intravesical stones, in which case sodium hexametaphosphate solution or dimethyl sulfoxide CDMSO
) etc. can be used.
［発明の効果］
以上説明したように１本発明によれば、必要部位以外に
結石溶解剤が漏れたことを検知して安全に処置できる。[Effects of the Invention] As explained above, according to the present invention, it is possible to detect leakage of a calculus dissolving agent to a site other than the required site and safely treat the leakage.
第１図ないし第３図は本発明の第１の実施例を示し、Ｍ
１図はセンサの先端付近の側断面図、第２図は肝臓周辺
の生体構造の解剖図、第３図は溶解装置の概略的な構成
説明図である。第４図は本発明の第２の実施例における
センサの先端付近の側断面図である。第５図ないし第７
図は本発明の第３の実施例を示し、第５図および第６図
は栓の断面図、第７図は使用状態の説明図である。第８
図は本発明の第４の実施例における栓体の側断面図であ
る。第９図はカテーテルの側断面図、第１０図はそのカ
テーテルの使用状態図である。
ｂ・・・カテーテル、７・・・センサ、１０・・・胆嚢
、１６・・・制御装置、１８・・・センサ装置本体、２
４ａ。
２４ｂ・・・電極、２５・・・充填物、２７・・・胆石
、５０・・・溶解剤。1 to 3 show a first embodiment of the present invention,
FIG. 1 is a side cross-sectional view of the vicinity of the tip of the sensor, FIG. 2 is an anatomical view of the biological structure around the liver, and FIG. 3 is a schematic explanatory diagram of the configuration of the dissolving device. FIG. 4 is a side sectional view of the vicinity of the tip of the sensor in the second embodiment of the present invention. Figures 5 to 7
The figures show a third embodiment of the present invention, with FIGS. 5 and 6 being sectional views of the stopper, and FIG. 7 being an explanatory view of the state of use. 8th
The figure is a side sectional view of a stopper in a fourth embodiment of the present invention. FIG. 9 is a side sectional view of the catheter, and FIG. 10 is a diagram showing the catheter in use. b...catheter, 7...sensor, 10...gallbladder, 16...control device, 18...sensor device main body, 2
4a. 24b... Electrode, 25... Filler, 27... Gallstone, 50... Dissolving agent.
Claims (1)
を溶解して除去する生体内結石の溶解装置において、結
石のある体腔外に漏れ出す結石溶解剤を検出するセンサ
手段を設けたことを特徴とする生体内結石の溶解装置。In an in-vivo stone dissolution device that dissolves and removes a stone by introducing a stone-dissolving agent into a body cavity in which a stone exists, a sensor means is provided to detect the stone-dissolving agent leaking out of the body cavity in which the stone is located. Characteristic in-vivo stone dissolution device.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP21883189A JPH0382459A (en) | 1989-08-25 | 1989-08-25 | Device for dissolving calculus in living body |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP21883189A JPH0382459A (en) | 1989-08-25 | 1989-08-25 | Device for dissolving calculus in living body |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| JPH0382459A true JPH0382459A (en) | 1991-04-08 |
Family
ID=16726028
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP21883189A Pending JPH0382459A (en) | 1989-08-25 | 1989-08-25 | Device for dissolving calculus in living body |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JPH0382459A (en) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006507033A (en) * | 2002-07-24 | 2006-03-02 | ティミ ３ システムズ， インコーポレイテッド | System and method for enabling monitoring and use of medical devices |
| US9196770B2 (en) | 2007-03-27 | 2015-11-24 | Newdoll Enterprises Llc | Pole-mounted power generation systems, structures and processes |
| US9200818B2 (en) | 2009-08-14 | 2015-12-01 | Newdoll Enterprises Llc | Enhanced solar panels, liquid delivery systems and associated processes for solar energy systems |
-
1989
- 1989-08-25 JP JP21883189A patent/JPH0382459A/en active Pending
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006507033A (en) * | 2002-07-24 | 2006-03-02 | ティミ ３ システムズ， インコーポレイテッド | System and method for enabling monitoring and use of medical devices |
| US9196770B2 (en) | 2007-03-27 | 2015-11-24 | Newdoll Enterprises Llc | Pole-mounted power generation systems, structures and processes |
| US9200818B2 (en) | 2009-08-14 | 2015-12-01 | Newdoll Enterprises Llc | Enhanced solar panels, liquid delivery systems and associated processes for solar energy systems |
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