JPH0737103U - Esophageal intubation tube - Google Patents

Abstract

(57) [Summary] [Construction] In the present invention, in a tube for esophageal intubation, which is composed of a cylinder which is gently curved as a whole and a flange member arranged at one end thereof, the flange member of the cylinder is arranged. The end opposite to the end of the tube is reduced like a nozzle, and that part is a tube consisting of at least two leaflets; and the collar member is the outer peripheral surface of the tube. A ring-like opening / closing member that is slidable in the axial direction of the tube and is provided near the end; and one end near the tip of the leaflet valve and the other end of the opening / closing member. And as many connecting members as there are valves; [Effects] According to the tube for esophageal intubation of the present invention, intubation of the esophagus can be smoothly performed without resistance, and the endoscope can be freely taken in and out in a tube intubated state. it can.

Description

[Detailed description of the device]

[0001]

[Industrial applications]

 The present invention relates to a tube for intubating an esophagus in a treatment using an endoscope, and particularly to an esophageal intubation tube used in a treatment for an esophageal varices.

[0002]

[Prior art]

 As shown in FIGS. 18 and 19, the tip of the tube (the end that exists in the back when the tube is inserted into the esophagus) has a diameter larger than the main body of the tube, that is, a diameter like a trumpet tube, or a conventional tube. The tube had only the same diameter throughout the tube.

[0003]

[Problems to be solved by the device]

 To intubate the tube into the esophagus (hereinafter referred to as esophageal intubation), first insert the endoscope passed through the tube into the esophagus and then push the tube into the esophagus.

In a conventional tube whose tip has a diameter similar to that of a trumpet tube, when the tube is pushed into the esophagus, the tip of the tube is recessed in the pharynx, which makes intubation itself difficult.

On the other hand, in the operation of esophageal varices, only the endoscope needs to be frequently taken in and out while the esophageal intubation tube is intubated during the operation, but the tip of the tube has the same diameter as the main part of the tube. In a conventional tube, when the endoscope is pulled out, the convex portion of the endoscope is easily caught on the distal end of the tube, which hinders the smooth progress of the operation, and in order to avoid this adverse effect, Increasing the overall diameter in turn makes intubation itself difficult.

The present invention has been made for the purpose of providing a tube for esophageal intubation which improves the above-mentioned drawbacks of the conventional tube for esophageal intubation, that is, enables smooth intubation and insertion / removal of an endoscope. Is.

[0007]

[Means for Solving the Problems]

 That is, the present invention relates to an esophageal intubation tube which is composed of a cylinder that is gently curved as a whole and a flange member that is arranged at one end of the cylinder, and the end of the cylinder that is opposite to the side where the flange member is arranged. The part is reduced in diameter like a nozzle, and that part is a pipe consisting of at least two leaflets; and the pipe attached to the outer peripheral surface of the pipe near the end where the collar member is arranged. A ring-like opening / closing member that is slidable in the axial direction of the tube; one end thereof near the tip of the leaflet, and the other end of the opening / closing member, the number of connecting members being the same number as the locked leaflets; It is characterized by including.

Hereinafter, the present invention will be described in detail with reference to the accompanying drawings.

In the drawings, reference numerals 1 and 2 are a cylindrical pipe and a flange member, which are basic components of the present invention.

The tube (1) has a gently curved shape as a whole in accordance with the anatomical shape of the human body from the oral cavity to the pharynx to the esophagus for smooth intubation. The reason for providing the collar member (2) is to prevent the intubated esophageal tube from falling out from the esophagus.

As the material of the tube (1), one having an appropriate flexibility (if it is too soft, the intubation is not smoothly performed in the pharynx, and in extreme cases, buckling or twisting occurs. However, if it is too hard, it will damage the mucous membranes and organs.) That is not toxic to the living body. Specific materials include polyvinyl chloride and silicone rubber.

The material of the collar member (2) does not have to be specifically limited from the purpose of using the member, unlike the pipe (1). It may be a metal material such as stainless steel, or a plastic material such as polycarbonate or ABS resin. Considering weight and price, plastic material is preferable.

In the drawings, reference numerals 10, 11 and 12 respectively denote a main body which is a constituent element of the pipe (1), an end on which a collar member is arranged and an end opposite to the main end. In principle, these are manufactured as one piece made of the same material.

A ring-like opening / closing member (13) slidable in the axial direction of the tube (1) is additionally provided on the outer peripheral surface near the end (11), and the other end (12). ) Has a shape reduced in diameter like a nozzle as a whole, and as a member, the part is manufactured so as to form at least two leaflets (12a, 12b) (two in the drawing).

The leaflets (12a, 12b) and the opening / closing member (13) are connected by the same number of connecting members (14a, 14b) as the leaflets. This connecting member opens the leaflets (12a, 12b) by moving the opening / closing member in the axial direction of the tube (1) -a state in which the diameter of the virtual circular surface formed by the tip of the leaflet is expanded (hereinafter , Called open). In the illustrated embodiment, the diameter of the virtual circular surface formed by the tip of the leaflet is the smallest when the leaflet is closed, that is, when the pulling force via the connecting member is not applied. State (hereinafter referred to as the closed state. In principle, the diameter is approximately the same as the maximum diameter of a commercially available endoscope) -Because it is a force transmitting member, it has the property of extending extremely at least when a tensile force is applied. Any material that is not present (specifically, a linear member such as a stainless steel twisted wire or a piano wire, a polycarbonate rod or the like and a belt-shaped member such as a woven fabric or a plastic film) may be used. The arrangement (the linear member may be inserted in the wall portion (10a) of the pipe so as to be slidable in the axial direction of the pipe (see FIGS. 3, 7, 8, 9 and 12)). It may be attached to the outer peripheral surface of (see FIGS. 2, 4, 5, 6 and 10). In this case, in order to guide this member (it also has the effect of softening the contact with the esophageal fabric during intubation), small diameter pipes (15a, 15b) -made of Teflon are preferable in terms of sliding- The pipe itself may be attached to the outer peripheral surface of the pipe, and this member may be passed through the hollow portion of the pipe), or a band-shaped member may be attached to the outer peripheral surface of the pipe) to exert a rib-like action on the pipe. A stainless stranded wire or a plastic film is preferable because it impairs the appropriate flexibility. As for the installation location, in the case of a strip-shaped member, it is attached to the outer peripheral surface of the pipe, and in the case of a linear member, it is inserted into the wall portion (10a) of the pipe. It is preferable in that it contributes to smooth intubation without forming parts. It should be noted that, as for the engagement of the connecting member, the end portion on the side of the leaflet may be adhered to the outer surface near the tip of the leaflet with an adhesive-particularly suitable for a band member. It is of course possible to separately prepare a plate-like small piece to be attached and to attach it together with the small piece-it may be embedded in the wall portion (10a) of the pipe in the vicinity of the tip thereof-especially in the case of a linear member (in this case). Is suitable for the case where it is preferable to process the end portion into a spherical shape). On the other hand, the end portion on the side of the opening / closing member may be directly attached to the outer surface of the opening / closing member with an adhesive, or a plate-like small piece to be separately attached may be prepared and attached together with the small piece. Good.

The material of the opening / closing member (13) is a member that the practitioner picks with his / her finger, so that it may have any appropriate rigidity. In principle, use the same material as the collar member (2).

The esophageal intubation tube of the present invention is operated according to the following procedure. First, pass an endoscope through the tube (at this time, the opening / closing member (13) is at the left end of its movable range-the position farthest from the collar member (2) -and the leaflets (12a, 12b)). 2 and 3. In order to determine the diameter of the virtual circular surface formed by the tips of the leaflets (12a, 12b) of the tube (1) in this state, the maximum diameter of the endoscope is used as a reference. , The endoscope is allowed to pass through the tip while abutting the inner peripheral surface of the tip), and then the tube is slid along the fiber away from the endoscope, and only the endoscope Insert in the esophagus. The tube is then slid along the fiber to approximate the endoscope inserted in the esophagus, pushing the tube into the esophagus. Observe and treat a prescribed part of the inner surface of the esophagus. The open / close member (13) is picked up with a finger, the member is moved so as to approach the collar member (2), the leaflets (12a, 12b) are opened, and the tube is inserted into the esophagus. Only pull out the body. The endoscope is inserted again into the esophagus via the tube to observe and treat the next predetermined site on the inner surface of the esophagus. The operation is repeated a predetermined number of times. When the observation / treatment is completed, the endoscope is pulled out of the body together with the tube or after the tube is pulled out.

In the above operation, it is of course possible to continue to pinch the opening / closing member (13) operated by the practitioner with a finger while pulling out the endoscope, but it is necessary to pull out the endoscope with certainty. In order to reduce the burden on the practitioner, it is preferable to further provide a mechanism for holding the opening / closing member in the open state.

In one of the above-mentioned mechanisms, the opening / closing member (13) is in the open position-the position where the opening / closing member exists when the leaflets (12a, 12b) are fully opened, that is, the opening / closing member is the collar member ( When the pipe (1) is provided with a member that temporarily locks the left edge portion of the opening-closing member-the edge portion on the side away from the collar member-when it is in the position closest to 2). (Hereinafter referred to as type-B1). Specifically, at least one convex portion (13a) may be formed on the outer peripheral surface near the end of the tube on the side where the collar member is arranged (see FIGS. 4, 7 and 11). The height of the convex portion is such that the opening / closing member sliding on the outer peripheral surface of the pipe can be overcome, and the left edge of the opening / closing member is caught against the force of closing the leaflet. It may be set arbitrarily to the extent that it can be used. The shape of the convex portion is not particularly limited as long as the purpose of locking is achieved.

Another is that when the opening / closing member (13) is in the open position, the concave portion (13b) is formed on the outer peripheral surface of the pipe (1) facing the appropriate position in the width direction of the opening / closing member-for convenience, the reference position. On the other hand, at least one convex portion (13c) that can be loosely fitted in the concave portion of the pipe is provided at the reference position on the inner peripheral surface of the opening / closing member, and the same number as the concave portion formed in the pipe (hereinafter, Type-B2, see FIGS. 5, 8, 13 and 15). The height of the convex portion is such that the opening / closing member can slide smoothly on the outer peripheral surface of the pipe and the opening / closing member is held against the force of closing the leaflet valve. It can be set arbitrarily. However, it goes without saying that the depth of the concave portion is somewhat larger than the height of the convex portion. The shapes of the convex portion and the concave portion are not particularly limited, except that the cross-sections are similar to each other and the convex portion can be loosely fitted in the concave portion.

In the above operation, the practitioner may of course grasp the operation of moving the opening / closing member (13) to the open position with his / her finger, but this means to reduce the burden on the practitioner for the operation. Then, a mechanism other than the mechanism described so far may be provided. That is, at least one groove (13d) is formed in the outer peripheral surface near the end of the pipe (1) on the side where the flange member is arranged, and the groove (13) is further formed on the flange member (2). The outer peripheral surface of the body is formed with a body portion (2a) which can be fitted onto the outer peripheral surface of the body, and at least two spiral grooves (13e, 13f) are formed on the inner peripheral surface of the body portion (both grooves do not intersect with each other. And a convex portion (13g) that can be loosely fitted to the groove on the inner peripheral surface of the opening / closing member (13) and a convex portion (13h, 13i that can be loosely fitted to the spiral groove on the outer peripheral surface thereof. ) Are formed in the same number as the grooves and the spiral grooves, respectively (hereinafter, referred to as type-B3. See FIGS. 6, 9, 14 and 16). With such a work, by rotating the collar member (2) in the direction of the arrow in FIG. 6 or 9, the opening / closing member moves smoothly so as to approach the collar member. Here, the groove (13d) and the convex portion (13g) loosely fitted thereto prevent rotation of the opening / closing member, that is, restrict the opening / closing member so as to move only in the axial direction of the pipe. It is a thing. Further, a convex portion (13g) or a convex portion (13h, 13i) is formed at the end of the groove (13d) closer to the flange member or at the end of the spiral groove (13e, 13f) closer to the flange member. It is preferable to provide recesses (13j) or (13k, 13l) that can be loosely fitted. This is for holding the opening / closing member (13) in the open position, as in the above-described aspect. The length of the body portion (2a) of the collar member is the length of the spiral groove (13e, 13f) to be set-the longer the rotation operation of the opening / closing member (13), the smaller the force required. Depending on the force that the leaflets (12a, 12b) try to close-depending on the material of the pipe used and the depth of the incision for forming the leaflet on the pipe, it is set appropriately. do it.

[0022]

【Example】

 Example 1 Length of pipe (1) (from tip of leaflets (12a, 12b) to collar member (2)): 300 mm, inner diameter of main body (10) of pipe (1): 20 mm, closed state The diameter (inner diameter) of the virtual circular surface formed by the tip of the leaflet: 11 mmφ (the diameter of the currently used endoscope is 9 mmφ and 11 mmφ, which are two types, which are large). Depth of cut for making: 50 mm esophageal intubation tube (see Figures 2 and 4). Here, the material of each member is as follows. Pipe: Vinyl chloride flange member: Polycarbonate Opening / closing member: Polycarbonate Connecting member: Stranded wire of stainless steel The connecting members (14a, 14b) are arranged in such a manner that the outer peripheral surface of the pipe (1) has a small diameter (inner diameter: 1.0 mmφ). The Teflon tube (15a, 15b) of (1) was attached and disposed in the hollow portion of the Teflon tube (hereinafter referred to as type-A1). The locking mechanism of the opening / closing member (13) in the open position is of type-B1.

Example 2 The same material as in Example 1 except that the arrangement of the connecting members (14a, 14b) was inserted into the wall portion (10a) of the pipe (1) (hereinafter referred to as type-A2).・ Specification of esophagus Intubation tube (see Figures 3 and 7) was manufactured.

Example 3 A tube for esophageal intubation having the same material and specifications as in Example 1 except that a type-B2 was adopted as a locking mechanism of the opening / closing member (13) to the open position (see FIGS. 2 and 5). Made.

Example 4 An esophageal intubation tube (see FIGS. 3 and 8) having the same material and specifications as in Example 3 except that the arrangement of the connecting members (14a, 14b) was changed to Type-A2. did.

Example 5 A tube for esophageal intubation (see FIGS. 2 and 6) having the same material and specifications as in Example 1 except that Type-B3 was adopted as a mechanism for moving the opening / closing member (13) to the open position. Made.

Example 6 An esophageal intubation tube (see FIGS. 3 and 9) having the same material and specifications as in Example 5 except that the arrangement of the connecting members (14a, 14b) was changed to Type-A2. did.

[0028]

[Effect of device]

 As a result of applying the tube for esophageal intubation described in each of the above-mentioned examples to patients with esophageal varices (30 cases each), intubation into the esophagus was performed smoothly without resistance, and the tube was left in the intubated state. It was confirmed that the endoscope can be freely taken in and out any number of times. It should be noted that a belt-shaped member (a synthetic fiber woven fabric) was used as the connecting member, and the tube was attached to the outer peripheral surface of the tube, which was also applied to patients with esophageal varices (30 cases each). The effect was confirmed.

[Brief description of drawings]

FIG. 1 is a perspective view showing an entire esophageal intubation tube of the present invention (partially omitted)

FIG. 2 is an enlarged side view of a portion A of FIG. 1 showing one disposition aspect of a connecting member.

FIG. 3 is an enlarged side view of a portion A in FIG. 1 showing another arrangement mode of a connecting member.

FIG. 4 is an enlarged side view of part B of FIG. 1 showing one locking mechanism of the opening / closing member.

5 is an enlarged side view of a portion B of FIG. 1 showing another locking mechanism of the opening / closing member.

FIG. 6 is an enlarged side view of a B part in FIG. 1 illustrating a moving mechanism of an opening / closing member.

7 is an enlarged side view of a portion B of FIG. 1 showing an esophageal intubation tube according to the present invention having the connecting member arrangement shown in FIG. 3 and the opening / closing member locking mechanism shown in FIG.

8 is an enlarged side view of a portion B of FIG. 1 showing an esophageal intubation tube according to the present invention having the connecting member arrangement shown in FIG. 3 and the opening / closing member locking mechanism shown in FIG.

9 is an enlarged side view of a portion B of FIG. 1 showing an esophageal intubation tube according to the present invention having the connecting member arrangement shown in FIG. 3 and the opening / closing member moving mechanism shown in FIG. 6;

FIG. 10 is a sectional view taken along line I-I of FIGS. 4, 5 and 6;

FIG. 11 is a sectional view taken along line II-II of FIGS. 4 and 7.

FIG. 12 is a sectional view taken along line III-III of FIGS. 7, 8 and 9.

13 is a cross-sectional view taken along the line IV-IV of FIGS. 5 and 8.

14 is a sectional view taken along line VV of FIGS. 6 and 9. FIG.

FIG. 15 is an enlarged view of part C of FIG.

16 is an enlarged view of part D in FIG.

FIG. 17 is an enlarged view of part E in FIG.

FIG. 18 is a side view showing the distal end of one conventional esophageal intubation tube.

FIG. 19 is a side view showing the tip of another conventional esophageal intubation tube.

[Explanation of symbols]

 1 ... Pipe 2 ... Tsuba member 2a ... ·· Body 12a, 12b ··· Leaflet 13 ······ Opening / closing member 13a ···· Convex portion 13b ···・ ・ ・ ・ ・ ・ ・ ・ Concave part 13c ・ ・ ・ ・ ・ ・ ・ ・ ・ ・ ・ Convex part 13d ・ ・ ・ ・ ・ ・ ・ ・ ・ ・ ・ Grooves 13e, 13f ・ ・ ・ ・ Spiral groove 13g ·········································

Claims (5)

[Scope of utility model registration request] 1. An esophageal intubation tube comprising a cylinder that is gently curved as a whole and a collar member arranged at one end of the cylinder, the end of the cylinder being opposite to the side where the collar member is arranged. A tube having a diameter reduced like a nozzle, and that part is composed of at least two leaflets; and the tube provided on the outer peripheral surface of the tube near the end where the collar member is arranged. A ring-like opening / closing member that is slidable in the axial direction; and one end near the tip of the leaflet, and the other end of the opening / closing member in the same number as the locked leaflets. A tube for intubation of the esophagus, which comprises: 2. A linear member or a belt-shaped member in which the connecting member is inserted in a wall portion of the pipe so as to be slidable in the axial direction of the pipe or attached to an outer peripheral surface of the pipe. The tube for esophageal intubation according to claim 1, which is a strip-shaped member attached to the outer peripheral surface of the tube. 3. The tube for esophageal intubation according to claim 2, wherein the tube has at least one convex portion formed on an outer peripheral surface near an end of the tube on the side where the collar member is arranged. . 4. The pipe has at least one concave portion formed on an outer peripheral surface near an end portion where the flange member of the pipe is arranged, and the opening / closing member has an inner peripheral surface. The esophageal intubation tube according to claim 2, wherein the number of projections that can be loosely fitted in the recesses of the tube is the same as that of the recesses of the tube. 5. The flange member is formed by forming at least one groove in an axial direction of the tube on an outer peripheral surface near an end portion of the tube on the side where the flange member is arranged. Is a pipe having a body portion fitted on the outer peripheral surface of the tube and at least two spiral grooves are formed on the inner peripheral surface of the body portion, and the opening / closing member is the inner peripheral surface thereof. A convex portion that can be loosely fitted in a groove formed in the pipe, and a convex portion that can be loosely fitted in a spiral groove formed in the body portion on the outer peripheral surface of the convex groove, the groove and the spiral groove, respectively. The esophageal intubation tube according to claim 2, which is formed in the same number as