JPH0670984A - Living body spreading tool - Google Patents

Abstract

PURPOSE:To provide a living body spreading tool which can surely spread a living body without increasing the outside diameter and obviating the necessity of always applying a high pressure from this side after applying a high pressure to the initial state when a sqeezed part is to be spread. CONSTITUTION:A living body expanding tool 3 for spreading a living body tissue is constituted of a balloon 5, poured substance 15 which is poured into the balloon 5 and whose viscosity is varied by the external stimulus, device 13 for applying the external stimulus to the substance whose viscosity is varied, light source 16, etc., and the living body tissue can be spread without increasing the outside diameter of the balloon 5 and obviating the necessity of always applying a high pressure from this side after applying a high pressure to the initial state when the sqeezed part of the living body is spread.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a living body expander for expanding living tissue such as esophagus, bile duct, blood vessel, large intestine, urethra, fistula and the like.

[0002]

2. Description of the Related Art Conventionally, as a method for treating a stenosis occurring in such a living duct, for example, "Gastroenterolo
gical Endoscopy ”Vol. 29 (1), Jan. 84th of 1987
~ The procedure described on page 89 is known. For biliary stricture, an endoscope is inserted by a percutaneous transhepatic route or transpapillary route, a balloon catheter is inserted into the stricture site in the bile duct through the channel of the endoscope, and then the balloon is inserted. By expanding, the narrowed part of the biliary tract is expanded.

As disclosed in Japanese Patent Publication No. 4-674, a water-absorbing polymer gel is stored in a flexible container having elasticity and a liquid for swelling the water-absorbing polymer gel is used. Mechanochemical catheters that are injected from the outside and expand the stenosis are also known.

[0004]

However, in the conventional method for expanding a stenosis with a balloon catheter, in the case of a pneumatic method in which air is fed into the balloon, the pressurized state is expanded from the beginning with a high pressure. Since it must be maintained, a fairly high degree of countermeasures against air leakage is required, and the inconvenience of increasing the diameter of the balloon catheter itself or impairing its flexibility tends to occur. Further, in order to maintain the pressurized state for a long time, the risk of the patient to the high pressure leak must be taken into consideration. For this reason,
Although the gauge pressure can be applied only up to 5 atm, when the tissue of the stenosis is hard and the restraining pressure thereof is large, when the applied pressure gradually decreases, the balloon catheter 1 becomes a gourd-shaped shape as shown in FIG. On the other hand, it tends to unnecessarily compress and expand even a normal area in the vicinity, but the narrowing effect of the narrowed portion 2 itself is small, and a sufficient therapeutic effect cannot be expected.

Further, in the mechanochemical catheter disclosed in Japanese Patent Publication No. 4-674 in which a water-absorbent polymer gel is provided in a balloon and a solution is injected from outside the body,
Since the water-absorbent polymer gel is provided in the balloon,
Inevitably, the outer diameter becomes large, and it is extremely difficult to insert the balloon portion into the narrowed portion in the endoscope channel or living body duct.

The present invention has been made in view of the above-mentioned problems, and its purpose is to prevent the outer diameter from becoming thicker and to provide a high pressure to the initial state when the stenosis is expanded and then to the proximal side. It is an object of the present invention to provide a living body expander capable of surely expanding a living body without having to constantly apply high pressure.

[0007]

In order to solve the above-mentioned problems, the present invention provides a balloon and a means for selectively injecting into the balloon a substance whose viscosity is changed by an external stimulus in a living-body expander for expanding a living tissue. And a means for applying an external stimulus to the substance whose viscosity changes.

As described above, in the bioexpansion device for expanding the living tissue, the balloon, the means for selectively injecting the substance whose viscosity is changed by the external stimulus into the balloon, and the external stimulus is applied to the substance whose viscosity is changed. By configuring the living body expander from the means for doing so, the outer diameter of the balloon does not become thicker, and after applying high pressure to the initial state when expanding the narrowed part of the living body, always apply high pressure from the proximal side. The living tissue is surely expanded without the need for continuous application.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 3 show a first embodiment of the present invention. The living body dilator 3 in this embodiment has a catheter 4 made of a transparent multi-lumen tube having a light-transmitting property, and a balloon 5 is attached to the outer periphery of the distal end portion of the catheter 4. The catheter 4 has a first lumen 6 for introducing and discharging a liquid from the outside into the balloon 5, and a second lumen 7 having a closed end. A branch portion 8 is provided at a rear end portion of the catheter 4, and includes a first catheter 9 that communicates with the first lumen 6 and a second catheter 10 that communicates with a second lumen 7. Is provided in a state of branching and leading.

The first catheter 9 has a reservoir 1 for storing an injectate 15 into the balloon 5 which will be described later.
1 and a pump 12 for injecting the injectate 15 from the reservoir 11 into the balloon 5. Further, the reservoir 11 is provided with an ultraviolet light irradiation device 13 for the reason described later. Meanwhile, the second
An insertion mouthpiece 14 is provided at the rear end of the catheter 10.

The injection fluid material 15 will be described. The injectate 15 is housed inside the reservoir 11, which is a fluid substance whose viscoelasticity is reduced by an external stimulus such as irradiation of ultraviolet rays. As a material whose viscoelasticity is changed by irradiating this ultraviolet ray, for example, "intelligent material"
As described in “CMC Co., Ltd.” (P.156-158), azobenzene that causes a structural change from trans type to cis type by irradiation with ultraviolet rays (see the molecular structural formula in FIG. Polyamide, etc., containing the above) are used. For example, pyrrolidone containing LiCl (N-meth
When polyamide II dissolved in a yl-2-pyrrolidone solution is irradiated with ultraviolet light (410 nm>λ> 350 nm), the viscosity is reduced by 63%, and the original viscosity is restored by irradiation with light having λ = 470 nm or more or heating.

The magnitude of the change in viscosity depends on the rigidity and length of the polymer chain bonded to azobenzene. That is, if the structure of the molecules that are bound is rigid,
The structural change in azobenzene is rapidly transmitted to the entire polymer chain, and a large change in viscosity is induced, but if the molecular structure is flexible, the three-dimensional structure is absorbed by this morphological change of the molecular chain, and the entire polymer chain is absorbed. The morphology does not change, and the change in viscosity is small.

Next, the living body dilator 3 thus constructed
The usage of is described below. First, the injection material 15 inside the reservoir 11 provided outside the body is irradiated with ultraviolet rays by the ultraviolet light irradiation device 13 in advance to reduce the viscosity of the injection material 15. On the other hand, the air inside the balloon 5 is evacuated by the pump 12, and the balloon 5 is deflated and kept in a small diameter state. Then, the living body dilator 3 is inserted into the narrowed portion 2 (see FIG. 3) generated in the living body lumen such as the esophagus, the bile duct, the blood vessel, the large intestine, and the urethra through a channel of an endoscope (not shown), and the balloon 5 Is located at the site of the stenosis 2.

Then, the injectate 15 whose viscosity has been lowered in advance by the ultraviolet light irradiation by the ultraviolet light irradiation device 13 is fed into the balloon 5 by the pump 12 through the first catheter 9 of the catheter 4 to inflate the balloon 5.

Next, the optical fiber 1 connected to the light source 16
7 is inserted into the lumen of the second catheter 10 and brought to a position where the balloon 5 is located. Then, the light source 16 is operated to emit visible light, and the visible light is emitted from the tip of the optical fiber 17 toward the entire injectate 15. As described above, the viscosity of the injectate 15 is increased by the irradiation of visible light, so that the balloon 5 is cured. The pressure of the pump 12 is released when the entire balloon 5 is cured. Balloon 5
When the whole is cured, the narrowed portion 2 of the living body lumen is maintained in an expanded state by the balloon 5 of the expander 3 as shown in FIG.

When the constricted part 2 of the living body is sufficiently expanded in this way, the light source 16 is operated to emit ultraviolet light, and the second light is emitted.
Ultraviolet light is radiated from the optical fiber 17 inserted in the lumen 7 of FIG. By the irradiation of this ultraviolet light, the viscosity of the injectate 15 is reduced again and fluidized.
Then, the fluidized injectate 15 is discharged by the pump 12, and the living body dilator 3 is removed from the body while the balloon 5 is deflated.

According to the living body dilator 3 thus constructed, high pressure is required only in the initial state when the balloon 5 is inflated, and thereafter it is not necessary to maintain the high pressure from the hand side. After the balloon 5 is cured, the stenosis 2 can be surely expanded without losing the pressure of the stenosis 2 as shown in FIG.

Next, a second embodiment of the present invention will be described with reference to FIGS. The basic structure of the biological expander 18 of this embodiment is the same as that of the first embodiment described above, but the following points are different. That is, the nichrome wire 19 is spirally wound around the outer periphery of the catheter 4 where the balloon 5 is provided, and the Joule heat of the nichrome wire 19 can heat the injectate 15 injected into the balloon 5. I did it. The lead wire 20 led out from the nichrome wire 19 is led out of the body via the branch portion 8,
This is connected to a power supply 21 and a switch 22 provided outside the body.

The living body expander 18 having the above-described structure is, like the first embodiment, first the reservoir 1 provided outside the body.
The ultraviolet light irradiating device 13 irradiates the injection material 15 whose viscosity is reduced by the irradiation of ultraviolet rays inside the injection material 1 with ultraviolet light in advance, and
To reduce the viscosity of. Then, the air inside the balloon 5 is evacuated and contracted by the pump 12, and the dilator 18 is inserted into the narrowed portion 2 of the biological duct via the channel of the endoscope or the like, and the balloon 5 is placed at the narrowed portion 2. Position it. Then, the injectate 15 with reduced viscosity is fed into the balloon 5 by the pump 12 via the first catheter 9,
The balloon 5 is inflated.

Next, the switch 22 is operated to apply the voltage of the power source 21 to the nichrome wire 19 to uniformly heat the injectate 15 inside the balloon 5. As described above, the viscosity of the injectate 15 is increased by heating, so that the balloon 5 is hardened. The pressure of the pump 12 is released when the entire balloon 5 is cured. When the entire balloon 5 is cured, the stenosis 2 is expanded by the balloon 5 of the expander 18 as shown in FIG. 3 as in the first embodiment. When the stenosis 2 is sufficiently expanded, the optical fiber 17 is inserted into the second catheter 10 via the base 14, and the balloon 5 in the second lumen 7 is inserted.
Bring to the position. Then, the light source 16 is operated to irradiate the entire injected material 15 with ultraviolet light from the optical fiber 17. Upon irradiation with ultraviolet light, the viscosity of the injectate 15 is reduced again and fluidized. Therefore, the fluidized injectate 15 is discharged by the pump 12, the balloon 5 is deflated, and the dilator 3 is removed from the body.

Even with the living body expander 18 constructed in this way, high pressure is required only in the initial state when the balloon 5 is expanded, and thereafter it is not necessary to maintain high pressure from the hand side. After the balloon 5 is cured, the stenosis 2 can be surely expanded without losing the pressure of the stenosis 2.

FIG. 5 shows a living body extender 23 according to a third embodiment of the present invention. The living body expander 23 is configured to include a catheter 24 and a balloon 25 provided at the tip of the catheter 24. The catheter 24 has a lumen 26 for introducing and discharging a fluid from the outside into the balloon 25. Then, the lumen 26 communicates with a catheter 28 that is led out through the branch portion 8. Further, the catheter 28 is connected to a reservoir 29 that stores an injectate 33 to be injected into the balloon 25, which will be described later, and a pump 12 that introduces / extracts the injectate 33 into the balloon 25.

On the other hand, on the inner circumference of the balloon 25, an electrode 27 is provided for applying an electric field after injecting the injectate 33 into the balloon 25, which is connected to the lead wire 30 led out through the branch portion 8. It is connected. The lead wire 30 is connected to the switch 31 and the power supply 32, and is configured to be able to apply a voltage to the electrode 27.

Next, inside the reservoir 29, an injectate 33 made of an electrorheological fluid is stored, which has high fluidity when no voltage is applied, but whose viscosity rapidly increases only when an electric field is applied. ing. As the electrorheological fluid, for example, an electrically insulating liquid such as mineral oil, silicone, a fluorine compound, or synthetic hydrocarbon, in which ceramic particles such as zeolite, silica gel, potassium titanate whiskers as a dispersoid are dispersed is used. .

Hereinafter, the living body dilator 2 thus constructed will be described.
The usage of 3 will be described. First, the balloon 25 is deflated, and the living body expander 23 is inserted into a narrowed portion such as an esophagus, a bile duct, a blood vessel, a large intestine, and a urethra through an endoscope channel or the like, and the balloon 25 is positioned at the narrowed portion. And
The injectate 33, which is contained in the reservoir 29 and is composed of an electrorheological fluid having high fluidity in the absence of voltage applied,
Through the catheter 28 into the balloon 25 to inflate the balloon 25.

Next, the switch 31 provided outside the body is operated to apply the voltage of the power source 32 to the electrode 27 in the balloon 25. When a voltage is applied to the electrode 27, it is injected into the balloon 25 and a voltage is applied to the injectate 33 made of an electrorheological fluid, and the viscosity of the injectate 33 increases as described above. Then, the balloon 25 is cured. The pressure of the pump 12 is released when the entire balloon 25 is cured. When the entire balloon 25 is hardened in this manner, the narrowed portion 2 is expanded by the balloon 25 of the expander 23, as shown in FIG. 3 described above. When the stenosis 2 is sufficiently expanded, the switch 31 is operated to turn off the voltage of the power supply 32, and the balloon 25
The injectable substance 33 composed of the electrorheological fluid in the inside is brought into a state in which the voltage is not applied again. As described above, the injectate 33 made of the electrorheological fluid has low viscosity and exhibits fluidity when no voltage is applied. Therefore, the fluidized infusate 33 is discharged by the pump 12, the balloon 25 is deflated, and the dilator 23 is removed from the body. This biological extender 23
Also has the same effect as the above-mentioned one.

Next, the fourth embodiment of the present invention shown in FIGS.
The applicator according to the embodiment will be described. This is an applicator 34 for a hyperthermia used for the treatment of benign prostatic hyperplasia. The applicator 34 includes a sheath 35 made of a transparent member, a positioning first balloon 36 provided near the distal end of the sheath 35, and a second expansion balloon provided in the center of the sheath 35. It consists of a balloon 37. Then, a first catheter 38 and a second catheter 39 for injecting a fluid from outside the body in order to expand the first balloon 36 and the second balloon 37, respectively, are connected to the balloons 36, 37. Each of the catheters 38 and 39 passes through the inner cavity of the sheath 35 and is led out to the outside through a branch portion 40.

A base 41 is connected to the end of the first catheter 38, and a syringe or the like is connected to the base 41 to expand the first balloon 36. Further, the reservoir 11 and the pump 12 are connected to the second catheter 39 as in the first embodiment. Further, the reservoir 11 is provided with an ultraviolet light irradiation device 13.

Further, inside the reservoir 11,
As in the case of the first embodiment described above, an injectate 42 which is injected into the balloon 37 and whose viscosity is reduced by irradiation with ultraviolet light is stored. A second member made of a transparent member is provided in the lumen of the sheath 35.
The sheath 43 is inserted. Then, both the third catheter 44 and the fourth catheter 45 are connected to the second sheath 43 via the branch portion 40. A base 46 is connected to the end of the third catheter 44, and an insert can be inserted into the second sheath 43 via the base 46.

On the other hand, a reflux device 47 is connected to the fourth catheter 45, whereby the sheath 35 is connected.
The cooling liquid can flow back into the inner cavity of the first sheath 43 and the inner cavity of the second sheath 43. Further, the outer surface of the sheath 35 and the outer surface of the second balloon 37 are respectively provided with the first and second thermocouples 5.
1, 52 are provided, which are connected to a measuring unit 53 provided outside the body so that the heating temperature can be monitored.

An example of using the living body extender 23 configured as described above will be described below. First, the first balloon 36 and the second balloon 37 in a deflated state are inserted into the urethra 48 as shown in FIG. 7, and the portion of the first balloon 36 provided at the distal end of the sheath 35 beyond the sphincter muscle 50. Is located at the end of the bladder 49. In this state, air or physiological saline is sent from the mouthpiece 41 with a syringe or the like, and the balloon 36
Are inflated to lock the balloon 36 to the end of the bladder 49 (see FIG. 7).

Then, the injectate 42, whose viscosity has been lowered by the ultraviolet light irradiation of the ultraviolet light irradiation device 13 housed in the reservoir 11 and provided outside the body, is pumped by the pump 12 through the second catheter 39 to the second balloon. Pour inside 37. Then, the microwave irradiation probe 54 is inserted into the second sheath 43 through the base 46, and the microwave is irradiated. At this time, the reflux device 47 is operated to operate the sheath 3
5 and the cooling water is circulated into the second sheath 43 at the same time,
The first and second thermocouples 51 and 52 measure the temperature of the heated region of the living body, and the measurement unit 53 outside the body monitors the temperature.

Further, by irradiation with microwaves, the prostate 5
The second balloon 3 is heated at the same time as the heating of the enlarged portion 5 is performed.
The injection material 42 injected inside 7 is also heated. Then, as described above, the viscosity of the injectate 42 increases due to its heating, so that the second balloon 37 becomes hard as a whole and the enlarged part of the prostate 55 is expanded as shown in FIG. 7. When the second balloon 37 becomes sufficiently hard, the pressure of the pump 12 can be released.

After the heating treatment by the microwave irradiation probe 54 and the dilatation treatment by the second balloon 37 are completed, this time, the second sheath 4 is inserted through the base 46.
The optical probe 56 is inserted into 3 and brought to the position of the second balloon 37. Then, ultraviolet light is emitted toward the injectate 42 from a light source (not shown) (see FIG. 6C).

The irradiation of the ultraviolet light causes the injectate 42 to be reduced in viscosity and fluidized. Therefore, the pump 12 discharges the second balloon 37 out of the body and contracts the second balloon 37. Also, similarly connect a syringe or the like to the base 41,
The physiological saline or air infused into the first balloon 36 is evacuated, and the first balloon 36 is also deflated. And
The applicator 34 is removed from the urethra 48.

According to the applicator 34 thus constructed, the thermotherapy with microwaves and the material whose viscosity changes can be provided in the balloon 37 and the dilatation therapy with the balloon 37 can be used together. 55 hypertrophy can be treated.

In the above-mentioned biological expander, the expansion of the narrowed portion of the biological duct has been described, but the present invention is not limited to this, and for example, percutaneous endoscopy or percutaneous It can also be applied to fistuloplasty for drainage.

[0038]

As described above, the biological expander of the present invention has a balloon, means for selectively injecting into the balloon a substance whose viscosity changes by external stimulus, and external stimulus to the substance whose viscosity changes. Since the means for providing
The outer diameter of the balloon does not become thicker, and it is not necessary to constantly apply high pressure from the proximal side when expanding the stenosis, and the living tissue can be expanded reliably.

[Brief description of drawings]

FIG. 1 is an explanatory diagram of a schematic configuration of a living body extender according to a first embodiment of the present invention.

FIG. 2 is an explanatory view of a transcis structure change of azobenzene.

FIG. 3 is an explanatory view of a usage state of the living body expander of the first embodiment.

FIG. 4 is an explanatory diagram of a schematic configuration of a living body extender according to a second embodiment of the present invention.

FIG. 5 is an explanatory diagram of a schematic configuration of a living body extender according to a third embodiment of the present invention.

FIG. 6 is an explanatory diagram of a schematic configuration of a living body extender according to a fourth embodiment of the present invention.

FIG. 7 is an explanatory view of a usage state of the living body expander of the fourth embodiment.

FIG. 8 is an explanatory diagram of a conventional usage state of the living body expander.

[Explanation of symbols]

3 ... Biological dilator, 4 ... Catheter, 5 ... Balloon, 12
... Pump, 13 ... Ultraviolet light irradiation device, 15 ... Injectate, 16
… Light source, 17… Optical fiber, 19… Nichrome wire, 23
... Biological expander, 24 ... Catheter, 34 ... Applicator, 35 ... Sheath, 42 ... Injectate.

Claims (1)

[Claims] 1. A living body expander for expanding living tissue, comprising:
A bio-expansion device comprising a balloon, means for selectively injecting a substance whose viscosity is changed by an external stimulus into the balloon, and means for applying an external stimulus to the substance whose viscosity is changed. .