JPH0382462A - Device for dissolving calculus - Google Patents

Abstract

PURPOSE:To rapidly and surely remove a calculus by selecting a discharging passage by a selector means upon discharge next to such a mode that the selector means selects a filling passage upon suction by a fluid pump. CONSTITUTION:A control section 14 instructs starting the suction of a pump 4 without a selector valve 6 being change over. Dissolving agent which has been used and which contains therein calculus pieces and human body liquid is extracted into a cylinder 21 of a pump 4 by way of a catheter 10. Then, the control section 14 delivers a selector change-over control signal so that the selector valve 6 is changed over in order to connect a pump side passage 9 with a discharge container 8 side passage 12. Further, the pump starts its discharge operation so as to discharge the used dissolving agent into the discharge container 8. With this arrangement, the filling and discharging of the dissolving agent can be made by the suction and discharge operation of a single pump 4, and further, an agent filling contained 7 for the dissolving agent and the discharge container 8 are independently from each other, and the connection thereto is changed over by means of the selector valve 6, thereby it is possible to fill and discharge unused and used dissolving agent.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to a stone dissolving device, and more particularly to a stone dissolving device for dissolving and removing stones in a living body using a dissolving agent.

[Conventional technology]

As a known technique related to the above-mentioned stone dissolving device,
No. 2-117545 (USP No.

4,655,744), as shown in FIG.
4, an injection/exhaust channel system consisting of a channel 62 and a catheter 63, and a single trap 6 inserted in series in the channel.
It consists of 1.

The pump 64 repeatedly injects and discharges the solubilizing agent into the living body 65. The dissolving agent, body fluid discharged from the living body, and stone fragments after being repeatedly injected into and discharged from the living body 65 are stored together in a single trap 61. In this case, the above body fluid is not dissolved in the dissolving agent, and the specific gravity of the body fluid and stone fragments is generally greater than the specific gravity of the dissolving agent. Therefore, a mixed dissolving agent of unused and used dissolving agents is released in the upper layer of the trap 61, and this is reinjected into the living body to dissolve the stone.

[Problems to be Solved by the Invention] However, in the stone dissolving device described above, since the injection/discharge channel is closed, the same dissolving agent stored in the trap 61 is repeatedly injected/discharged into the living body. It happens. Therefore, as we continue the above injection/draining operation,
The concentration of calculus components eluted into the dissolving agent increases, thus
There was a problem in that the stone dissolving ability of the dissolving agent deteriorated and treatment required a very long time.

Furthermore, in the above-mentioned device, the trap 61 is inserted in series in the flow path system, and the total amount of dissolving agent that can be used for treatment at one time is limited to the internal volume of the trap 61, making it impossible to dissolve all stones. There was a risk. Furthermore, the fluid in the trap 61 is agitated by the suction and discharge operations of the pump 64, and there is a risk that stone fragments in the trap 61 may fly into the catheter 63 and flow back into the living body, reducing the therapeutic effect. .

Further, if the body fluid at the treatment site is not dissolved in the lytic agent and its specific gravity is not greater than the lytic agent, the body fluid will be trapped in the trap 61.
They become inseparable inside. Therefore, it could not be applied to treatment areas containing such body fluids.

An object of the present invention is to solve the above-mentioned problems and provide a stone dissolving device that can remove stones more simply, quickly, and reliably.

[Means and effects for solving the problem] The stone dissolving device of the present invention is a stone dissolving treatment device that percutaneously injects a stone dissolving agent into a stone in a body cavity to dissolve and remove the stone. The stone dissolving agent is injected percutaneously or orally into the stone site, and has an injection/drainage channel and an injection channel for injecting and discharging the used dissolving agent containing the stone dissolving component. an injection container containing an unused stone dissolving agent; a discharge container having a discharge channel and storing the used stone dissolving agent;
A fluid pump that alternately suctions and discharges fluid; one end is connected to this fluid pump, and the other end is selectively connected to either the injection/discharge channel, the injection channel, or the discharge channel; A switching means for communicating the pump with one of the three flow paths, and when the switching means selects the injection/discharge flow path when the fluid pump is suctioning, the switching means connects the fluid to the injection/drainage path during the subsequent discharge. controlling the switching means such that when the switching means selects the injection flow path when the fluid pump is suctioning, the switching means selects the injection/discharge flow path during subsequent discharge; The present invention is characterized by comprising a control means for controlling.

[Example] The present invention will be explained below with reference to illustrated embodiments.

FIG. 1 is a schematic diagram of a stone dissolving device according to a first embodiment of the present invention. The configuration of this device is driven by a drive unit 5, and is configured to use a new, unused dissolving agent for calculus (hereinafter referred to as unused dissolving agent) or a used one of the above-mentioned dissolving agent (
A pump holder is a fluid pump that repeatedly sucks in and discharges the used lysing agent (hereinafter referred to as a used lysing agent), and a lysing agent sensor 14 detects the state of the lysing agent in the cylinder of the pump (unused or used); An injection container 7 for storing unused lysing agent and a discharge container 8 for storing used lysing agent, which are provided independently to avoid mixing, and a single entrance/exit boat connected to the pump. A switching valve 6, which is a switching means, has three branch boats that are connected to the container 7.8 and the catheter 1o and can communicate with the inlet/outlet port, and a A channel 9 that connects the inlet/outlet boat, a catheter 10 that is connected to one of the branch boats of the switching valve 6 and serves as an injection/discharge channel, and another branch boat of the switching valve 6 and the container 7.
or 8, respectively, and an injection channel 11 and a discharge channel 12, which independently connect each other, and a control section 13, which is a control means for controlling the drive section 5 of the pump 4, the solubilizing agent sensor 14, and the drive section of the switching valve 6. It is made up of. Further, a stone 3 existing in a treatment site 2 of a living body 1 in FIG. 1 is an object to be dissolved by the apparatus of this embodiment.

The pump 4 is of a reciprocating type as shown in FIG. 2, and has a cylinder 21 and a piston 22.
3 is provided with a rack portion, and a pinion gear 2 meshes with the rack portion.
4 causes the piston 22 to reciprocate, and its suction/discharge action causes the dissolving agent to be sucked/discharged through the suction/discharge port 21a.

Furthermore, as a modification of the above-mentioned pumps, a roller pump as shown in FIG. 3 can also be used. This roller pump 1 is composed of a casing 26, a flexible tube 29 having a suction/discharge port 29a, a roller 27 pivotally supported by the casing 26, and a channel 28 to which one end of the tube 29 is connected. And roller 27
The dissolving agent 25 is sucked in or discharged by rotating it clockwise or counterclockwise.

The catheter 10 is inserted percutaneously or orally into a treatment site (stone site) 2 of a living body 1, and injects a dissolving agent or extracts (discharges) a used solubilizing agent from the treatment site 2. Further, the catheter 10 may be replaced with a puncture needle. It is assumed that the puncture needle and the boat of the switching valve 6 are connected by a flexible tube.

The switching valve 6 is a rotary type switching valve as shown in FIGS. 4 and 5, and is surrounded by three branch boats 35.
It consists of a distribution cylinder 35 having a * 35 b r 35 c, and a rotor 36 driven by a drive section 37 and rotatably fitted into the distribution cylinder 35 . Note that one entrance/exit boat 36a is provided at the center of the rotor 36, and the boat 36a is provided at the outer periphery of the rotor 36.
A communication boat 36b leading to the port a is provided. Then, by rotating the rotor 36 and aligning the communication port 36b with one of the branch boats 35a, 35b, and 35c, the entrance/exit boat 36a and one of the branch boats are selected and brought into communication. A channel 9 is connected to the boat 36a, and a catheter 10 is connected to each of the boats 35a, 35b, and 35c.
．． Injection channel 11 and discharge channel 12 are connected.

Next, a modification of the switching valve 6 shown in FIG. 6 is a switching valve device in which a plurality of electromagnetic valves are combined. This switching valve device consists of three solenoid valves 40°, 41, 42, the flow path of the inlet/outlet port 43 connecting the flow path 9 is branched and connected to one boat of each of the three solenoid valves, and , catheters 10., 40a, 41a, 42a of each solenoid valve, respectively. Channels 11 and 12 are connected.

Each electromagnetic valve is turned on and off by a drive signal from the control unit 13, and the flow path is switched by selecting and opening one electromagnetic valve as necessary.

As shown in FIG. 7, the solubilizing agent sensor 14 is connected to a cylinder 21 filled with liquid (solubilizing agent, etc.) sucked into the pump 4.
A pair of transparent windows 4 provided opposite to the interior 21b of the
7, 48, a light source device 49 consisting of a light source, a lens, etc., which is provided on the outside of one window 47 so that the light beam enters the window 47 obliquely, and the other window. The photoelectric conversion element 50 is provided outside the portion 48. The output signal of the photoelectric conversion element 50 is then input to the control section 13.

The photoelectric conversion element 50 is arranged in the cylinder 21.
This is the position where the light beam of the light source device 49 is refracted according to the refractive index of the unused dissolving agent when the interior 21a is filled with an unused dissolving agent (luminous flux Bp in FIG. 7). When the inside 21a of the cylinder 21 is filled with the used dissolving agent, the refractive index changes as the density of the liquid increases due to calculus dissolution, so the above luminous flux is transmitted to the photoelectric conversion element 50. does not reach the light-receiving surface (see light flux C in FIG. 7). Further, even if air or the like gets mixed into the cylinder 21, the above-mentioned light flux will not reach the light receiving surface of the photoelectric conversion element 50 due to the refractive index. Therefore, the unused solubilizer is in the cylinder 21.
Only when the condition is satisfied, the output signal of the photoelectric conversion element 50 turns "on" and is input to the control section 13.

Although the dissolving agent sensor 1 utilizes changes in the refractive index, it detects changes in the transparency or electrical conductivity of the dissolving agent to determine whether the solution is unused or used. It is also possible to use the sensor 14 instead.

Another modification of the solubilizing agent sensor 14 shown in FIG. 8 is for determining the state of use of the solubilizing agent by measuring the weight of the inhaled solubilizing agent. In this modification, a load cell 51, which is a weight sensor, is mounted below the cylinder of the pump 4, and when the cylinder has sucked a predetermined amount of unused or used dissolving agent, the pump It is assumed that the weight including ± is measured in advance and the control unit 13 stores the boundary value of both weights.

Then, the output value of the load cell 51 when the pump 4 sucks the dissolving agent is compared with the weight value at the boundary to determine whether the liquid is unused or used. Although this modification uses a weight sensor, other sensors may be used to measure the specific gravity of the liquid, and a float-type specific gravity sensor or minute pressure sensor may be used to measure the state of the liquid. If it is determined, the accuracy of the determination can be further improved.

In addition, the control unit 13 includes a well-known sequencer or
A personal computer can also be used.

The sequence operation of the calculus dissolving device of the first embodiment configured as above will be explained with reference to FIGS. 1 and 9.

(I) Suction (injection) process First, a switching valve control signal is output from the control unit 13, and the flow path 9 on the pump side and the flow path 1 on the side of the injection container 7 for unused dissolving agent.
The branch state of the switching valve 6 is set so that the switching valve 6 is in the connected state. Then, the pump shaft starts the suction operation, and the unused dissolving agent is supplied into the cylinder 21 of the pump ± until it is full.

(n) Injection stroke Next, the control unit 13 applies a switching valve control signal to the switching intervention, and the switching valve is pneumatically switched (switched) so that the pump-side flow path 9 and the catheter 10 are in a connected state. The pump starts the evacuation operation and unused lysing agent is injected into the treatment site 2 via the catheter 10.

(m) Extraction (discharge) stroke Next, the pump 4 starts a suction operation according to an instruction from the control section 13 without switching the switching intervention. Then, the used dissolving agent mixed with dissolved calculus pieces and body fluids is extracted into the cylinder 21 of the pump 4 via the catheter 10.

(IV) Discharge Stroke Next, the control section 13 outputs a switching valve control signal, and the switching mechanism is switched so that one channel on the pump side and the channel 12 on the side of the discharge container 8 are connected. Then, the pump 4 starts a discharge operation and discharges the used dissolving agent in the cylinder 21 into the discharge container 8.

A used dissolving agent mixed with stone fragments 181 and body fluid 17 is stored in the discharge container 8 .

The above steps complete one cycle of stone dissolution treatment. If necessary, several cycles of dissolution treatment are performed.
The stone 3 within the treatment area 2 is dissolved and expelled from the body.

In addition, before the injection process in (n) above or restarting operation, the suction in the cylinder 21 of the pump 4 or the remaining dissolving agent is dissolved whether it is unused or used. It is detected by the agent sensor 14.

Then, if the dissolving agent is unused, the injection process is directly started.

However, if the dissolving agent is a used one or a foreign substance other than an unused one, such as air, the next processing is the injection step (n) in the sequence, but the processing (I)
V), and the switching valve 6 is switched to be connected to the drain container 8 side. Therefore, the unused solution is discharged into the discharge container 8 and is not injected into the treatment area 2.

As described above, in this embodiment, the dissolving agent is injected and discharged by the suction and discharge operation of a single pump 4, and furthermore, the dissolving agent injection container 7 and the discharging container 8 are made independent.
These flow paths are switched by a switching valve to inject and discharge unused and used liquid. Therefore, both hot and cold mills do not mix and new, unused solubilizer is always injected without the need for separation and reuse as in conventional equipment. In addition, since it is not necessary to separate the solubilizing agent from body fluids, it can be used without problems even in treatment areas that have body fluids that are difficult to separate from the solubilizing agent. In addition, the container 7 of this device,
8 is not inserted in series in the flow path as in conventional devices (the first
(see Figure 1), and are connected to the open ends of each of the flow channels 11 and 12, making it easy to replace, and the containers can be replaced even during treatment.

Furthermore, in the apparatus of this embodiment, during treatment, for example, (
When the operation is temporarily interrupted with the spent dissolving agent mixed with stone fragments etc. mixed in the cylinder 21 during the extraction process of (III), and then the operation is restarted, or
) When foreign matter such as air is sucked into the cylinder 21 of the pump 4 during the supply process, the above-mentioned solubilizing agent sensor 14 determines that a liquid other than the unused dissolving agent is present in the cylinder 21 and performs a discharge process. Therefore, there is no possibility that these liquids, air, etc. are injected into the treatment area 2.

As a modification of the first embodiment of the present invention described above, a stone dissolving device will be described in which, by selecting and specifying another control sequence of the control unit 13 by operating a switch, it is also possible to discharge body fluid from the treatment site 2. When the body fluid discharge operation is selected by the switch, prior to the stone dissolution operation, (m), (I
V) Extraction.

Only the ejection stroke is repeated. That is, in the extraction process, body fluid is extracted into the cylinder 21 through the catheter 10, and then in the discharge process, the body fluid is discharged into the discharge container 8. By repeating this operation, all the body fluid in the treatment area 2 is drained out of the body, leaving only the stone 3 in the body and completely exposed from the body fluid.

After that, if the above-mentioned normal stone dissolution operation sequence is selected and the dissolving agent is perfused, all surfaces of the stone 3 will come into contact with the dissolving agent, increasing the speed of dissolution, making it quick and A reliable treatment effect can be obtained. Such an effect is achieved only in the apparatus using this embodiment and the above-mentioned modification, and is an operation that is impossible with conventional apparatuses.

Next, a calculus dissolving device showing the second embodiment of the present invention was installed in the 10th embodiment.
This will be explained using figures. This device is the stone dissolving device of the first embodiment with an ultrasonic treatment device added. and a water bag 58. It is assumed that the control section 55 has an ultrasonic drive control circuit added to the control section 13 of the first embodiment.

In the operation of this embodiment, the ultrasonic generator is operated in a state where the dissolving agent is injected into the treatment area 2 to form a sound field at the treatment area. Ultrasonic waves are applied to the stone while it is in contact with the dissolving agent, which significantly accelerates the dissolving action and allows for faster and more reliable treatment.

[Effects of the Invention] As explained above, the stone dissolving device of the present invention has independent containers for unused dissolving agent and used dissolving agent, and uses a switching valve to control the supply of dissolving agent. , the flow path is switched according to the injection, extraction, and discharge strokes, and each of the above strokes is performed by the suction/discharge operation of a single pump. Therefore, according to the device of the present invention: (i) new, unused dissolving agent is always injected, and the effectiveness and rate of stone dissolution can be maintained at the highest level;

(n) The container for the dissolving agent can be easily replaced even during the treatment, and the amount of dissolving agent used for treatment is not limited.
Sufficient amounts can be used.

(in) Since the containers for unused and used dissolving agents are separated, it is possible to avoid a situation in which stone fragments once extracted are returned to the body.

(iv) Since there is no need to reuse the used solubilizing agent extracted from the living body, it can be applied even to treatment areas where the body fluids of the affected area are mixed with the solubilizing agent and cannot be separated. .

It is possible to provide a stone dissolving device that has remarkable effects such as the following.

[Brief explanation of the drawing]

FIG. 1 is a schematic configuration diagram of a calculus dissolving device according to a first embodiment of the present invention, FIG. 2 is a vertical cross-sectional view of a main part of a pump used in the calculus dissolving device of FIG. 1, and FIG. FIG. 4 is a vertical cross-sectional view of a main part of a modification of the pump shown in FIG. 2 above; FIG. 4 is a longitudinal cross-sectional view of a main part of a switching valve used in the calculus dissolving device shown in FIG. 6 is a schematic configuration diagram of a switching valve device that is a modification of the switching valve shown in FIG. 4 above, and FIG. 7 is a dissolving agent sensor used in the stone dissolving device shown in FIG. 1 above. FIG. 8 is a vertical cross-sectional view of a main part of a modified example of the dissolving agent sensor shown in FIG. FIG. 10 is a schematic diagram of a stone dissolving device showing a second embodiment of the present invention, and FIG. 11 is a schematic diagram of a conventional stone dissolving device. 3・・・・・・・・・・・・Calculation 4.30...
... Pump (fluid pump) 6.45 ... Switching valve (switching means) 7 ...... Injection container 8 ... ......Discharge container 1
0... Catheter (injection/drainage channel) 11... Injection channel 12...
......Discharge flow path 13.55...Control section (
control means)

Claims (1)

[Claims] (1) A litholysis treatment device that percutaneously injects a stone-dissolving agent into a stone in a body cavity to dissolve and remove the stone, the stone-dissolving agent percutaneously or orally injecting into the stone site. inject and
It also has an injection/discharge channel for sucking in and discharging used dissolving agent containing calculus dissolving components, an injection container containing an unused calculus dissolving agent that has an injection channel, and a discharging channel. and a discharge container for storing the used dissolving agent, etc., and a fluid pump for alternately sucking in and discharging the fluid, one end of which is connected to the fluid pump, and the other end for the above-mentioned injection/discharge container.
a switching means for selectively connecting one of the discharge flow path, the injection flow path, and the discharge flow path to communicate the fluid pump with one of the three flow paths; When the injection/discharge channel is selected, the switching means is used to select the discharge channel during subsequent discharge, and when the switching means selects the injection channel when the fluid pump is suctioning, A calculus dissolving device comprising: control means for controlling the switching means so as to cause the switching means to select an injection/discharge channel during subsequent discharge.