JPS6219157A - Stone crushing apparatus - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a stone crushing device for crushing stones formed within a body cavity.

[Conventional technology]

Stones that occur in organs such as the biliary tract or bladder have a negative impact on patients. In particular, enlarged stones cause extremely great pain to patients.

Therefore, as a treatment for this, a stone crushing device or the like is used endoscopically to crush the stone that has generated pressure inside the body cavity and discharge or remove it from the body.

This type of stone crushing device has a basket made of a plurality of elastic wires at the tip of the operating wire, and the basket is inserted together with the operating wire into a flexible sheath with a hard part at the tip. There is one that is made to advance and retreat from the rear end of the operating wire. Once the stone is grasped by the basket protruding from the tip of the flexible sheath by operating the operating wire, the basket is pulled into the flexible sheath and reduced in size, thereby crushing the stone into fine pieces. I have to. (Jitsukai 55-3481
No. 0) [Problems to be Solved by the Invention] However, in such a stone crushing device, the operating wire that advances and retreats within the flexible sheath is composed of a plurality of wires of the same length.

Therefore, when the stone is grasped with the basket and the operating wire is pulled to pull the basket into the flexible sheath for lithotripsy, if the stone is hard, the operating wire will break. This cutting of the operating wire occurs in all the wires because the wires have the same length, and the basket and the operating wire on the distal side of the cut portion fall into the body cavity.

This invention prevents one or more of the wires constituting the operating wire from breaking even when the stone is hard and a large tensile force is applied to the operating wire during stone crushing, thereby preventing the basket from falling off. It is an object of the present invention to provide a lithotripter that prevents the occurrence of calculus.

[Means for solving problems]

As shown in FIG. 1, the present invention includes a flexible sheath 1 with a proximal sliding operation section 2, an internal pressure operating wire 3 inserted through the flexible sheath 1, and a proximal end of the operating wire 30 that is slidable. It is connected to the dynamic operation section 2, and a basket 6 is provided at the tip.

This operating wire 3 includes a tension wire 4 that transmits the tensile force of the sliding operating section 2 and a connecting wire that loosely connects the basket 6 and the sliding operating section 2 without transmitting the tensile force of the sliding operating section 2. Become.

[Effect]

This invention opens and closes the basket 6 via the operation wire 3 by advancing and retracting the sliding operation part 2, and after the stone is grasped in the basket 6, the stone is crushed and the ear 5 remains to prevent the basket 6 from falling off. .

〔Example〕

FIGS. 2 to 5 are diagrams for explaining a first embodiment of the present invention. The stone crushing device shown in FIG. 2 is equipped with a flexible sheath 1 made of a tightly wound coil or the like. A cylindrical hard part 12 is attached to the tip of the flexible sheath 1, and a base 13 is attached to the base. As shown in FIG. 3, this cap 13 includes a first member 15 having a busy liquid feeding spout 14;
A second part l1lf16 screwed onto this first member 15
These members 15 and 16 are coaxially formed with a through hole 17 passing through them in the axial direction. Said first member 1
A liquid-tight tube 18 , which is inserted into the flexible sheath 1 and made of a material such as fluororesin, is connected to the through hole 17 to communicate with the tube 5 . Therefore, a button is provided so that a syringe (not shown) can be connected to the liquid feeding port body 14 and a liquid such as a contrast medium can be flowed into the liquid-tight tube 18.

An operating wire 3 is inserted through the flexible sheath 1. A basket 6 is provided at the tip of the operating wire 3. This basket 6 has the rear ends of a plurality of elastic wires 210 connected to each other by tips 22, and has a bent part 23 formed in the middle, so that it can be expanded and contracted in the axial direction of the operating wire 3, that is, it has a basket shape that can be opened and closed. It has become.

The operating wire 3 is made up of a plurality of elastic wires, including a tension wire 4 and a connecting wire 5 that is longer than the tension wire 4. The tip of a straight rod-shaped coupling member 24 is fixed to the base end of the operating wire 30. This connecting member 2
4 is slidably inserted into the through hole 17 of the base 13, and its base end protrudes from the second member 16.

Note that the member 15 of Wc1 of the base 13 and the second member 1
An O-ring 25 is provided at the joining portion with 6, and the connecting member 24 is passed through this O-ring 25 so that the through hole 17 is maintained liquid-tight. Operation 9 The ear 3 and basket 6 can be pulled out from the flexible sheath 1 as shown in FIG.

First, the base 13 is removably connected to the operating section 26. This operating section 26 is connected to the main body 2 as shown in FIG.
7, and a grip portion 28 for the operator to grasp is integrally formed at the tip of the main body 27. An insertion hole 29 is formed coaxially through the main body 27 and the grip part 28 , and the end of the @2 member 16 of the base 13 is inserted into the ring body 30 at the tip of the grip part 28 . into the groove 1f formed on the outer peripheral surface of the second member 16.
ia, the cap 13 can be connected to the operating section 26.

A rank body 32 having a circular cross section is slidably inserted into the insertion hole 29 of the operating portion 26, and a rank 33 is formed on the outer surface of one radial end thereof over almost the entire length in the power direction. Further, a guide groove 34 that is open to the other end in the radial direction is formed at a location other than both ends in the axial direction, and a through hole 35 that communicates with the guide groove 34 is formed in both ends in the axial direction.

The proximal end portion of the coupling member 240 protruding from the second member 16 of the base 13 connected to the operating portion 26 is inserted into the through hole 35 and the guide groove 34, and the distal end extends from the proximal end of the rank body 32. It stands out. Note that the rank body 32 is
The operating section 260 main body 27iC is screwed into the guide groove 34K.

Rotation is prevented by the engaged guide screw 361C.

A gripping portion 37 is connected to the base end of the rack body 320. A mounting hole 38 is formed in this grip portion 37 coaxially with the coupling member 24 inserted into the operating portion 26 . The end of the coupling member 24, on which the flat portion 24a is formed, is inserted into the attachment hole 38. In addition, the grip part 37 has a mounting hole 3.
A storage hole 39 is formed in the radial direction to intersect with the housing hole 8 . This storage hole 39Vc has a retaining hole 41 penetrating in the radial direction in the middle of the axial direction, and a fixing rod 43 having a button 42 attached to the upper end is biased in the projecting direction by a spring 44. . Therefore, the fixing rod 43 is pushed against the spring 44, and with its retaining hole 41 facing the mounting hole 38, the end of the coupling member 24 is inserted into the mounting hole 38, and the flat part 24a is engaged. When the fixing rod 43 is positioned in the hole 41 and then the fixing rod 43 is released, the flat portion 24a and the fixing rod 43 are engaged, so that the connecting member 24 is fixed to the gripping portion 37.

Therefore, the operating wire 3 can be moved forward and backward by the gripping portion 37 via the coupling member 24.

The main body 27IC of the operating section 26 is rotatably supported by a first support shaft 45 having a handle in a direction perpendicular to the rack body 32. Further, the main body 27 rotatably supports a second support shaft 46 whose axis is parallel to the first support shaft 35 . One end of the second support shaft 46 is provided with a gear that meshes with the gear provided on the first support shaft and has more teeth than that gear. A portion of the main body 27 corresponding to the middle part of the second support shaft 49 is a housing portion 47 that is open to the guide groove 34.
is formed. A second support shaft 46 is provided in this housing portion 47.
A gear 48 is provided which is fitted into the rack 33 and meshes with the rack 33. Therefore, when the handle is rotated, this rotation is decelerated and transmitted to the gear 48, so that the rack body 32 can be moved forward and backward by the gear 48, and the operation wire 19 can be interlocked with this through the coupling member 24. It is now possible to do so.

The proximal end of the flexible sheath 1 is protected by a cover 49 attached to the base 13 as shown in FIG. 2.

Next, how to use the device having the above structure will be explained. First, with the operating portion 26 removed from the base 13, the flexible sheath l is endoscopically introduced into the body cavity, protruded from the distal end of the endoscope, and inserted into the bile duct, for example, from the duodenal papilla. Then, the operating section 16 is connected and fixed to the base 13.

In other words, the proximal end of the coupling member 240 is fixed to the gripping part 37 by the hard outer rod 43, and the second
Insert the member 16 into the ring body 301C and tighten the set screw 311C.
Therefore, fix it.

Next, if you observe the inside of the bile duct with the endoscope and find a stone, push in the grip part 37 and advance the operating wire 3 together with the rack body 32.The basket 6 will then protrude from the tip of the flexible sheath. Let me open it. Once the basket 6 is opened in this way, the elastic wire 21
The stone is taken into the interior through the gap between the
to the rear end to retract the basket 6.

If the stone held in the basket 6 in this way is too large to be removed from the bile duct, rotating the handle of the operation unit 26 in the direction in which the rack body 32 moves backward will cause the stone to be manipulated by the movement of the rack body 32. The pull wire 4 in the wire 3 works together to pull the basket 6 into the flexible sheath 1 and contract it, so that the calculus is squeezed by the elastic wire 21 of the basket 6 and crushed.

At this time, if the stone is hard and a large tensile force is applied to the tension ear 4 during stone crushing, the tension ear 4 will be damaged as shown in FIG.
may be disconnected. In this case, the connecting wire 5
Since it is formed longer than the tension wire 4, no tension is applied to it, and even if the tension wire 4 is cut, it will not be cut. Therefore, one basket 6 is connected by the connecting wire 5, and an accident of dropping into the body cavity can be prevented.

In the above embodiment, one connecting wire 5 is used, but two or more connecting wires may be used.

Next, based on FIGS. 6 and 7, the present invention will be explained.
1 A second embodiment will be explained. In this second embodiment, only the operating wire is different, so only the operating wire 50 will be explained. The operation wire 50 is connected to a tension wire 51 and connected to the ear 5.
The connecting wire 52 is partially formed as a spring-like part 53 wound around the tension wire 51.

In the second embodiment, the stone is handled in the same manner as the first embodiment, and the stone is gripped by the passer 6 and the tension wire 51 is operated by the operating section 26 to crush the stone. If the calculus is hard (or when a large tensile force is applied to the tension ear 511C and the tension wire 51 breaks, the connecting wire 52 will be absorbed by the spring-like portion 53 and will not be cut, and will remain in the body cavity of the basket 6. It is possible to prevent it from falling off.

〔Effect of the invention〕

According to this invention, since the operation wire of the stone crushing device is composed of a tension ear that applies a tension force to the basket portion and a connecting wire that does not apply tension force during the tension operation, a large tension force is applied during stone crushing. Even if the tension wire is cut, the connecting wire is not cut, so the basket does not fall into the body cavity and is safe.

[Brief explanation of the drawing]

Figure A1 is a diagram explaining this invention, Figures 2 to 5 are diagrams showing a first embodiment of this invention, Figure 2 is an overall view of the stone crushing device, and Figure 3 is a flexible FIG. 4 is a cross-sectional view of the operating wire, FIG. 5 is a diagram showing the operating wire in a cut state, and FIGS. 6 and 7 are diagrams showing a second embodiment of the present invention. FIG. 6 is a sectional view of the operating wire, and FIG. 7 is a diagram showing the operating wire in a cut state. DESCRIPTION OF SYMBOLS 1...Flexible sheath, 3...Manipulation wire 4--Tension wire 5...Connection wire 6...Basket

Claims (3)

[Claims] (1) a flexible sheath, an operating wire slidably inserted through the flexible sheath, a basket comprising a plurality of elastic wires connected to the distal end of the operating wire, and a proximal end of the operating wire; In the stone crushing device, the operating wire is connected to the basket without transmitting the tensile force of the sliding operating section to the pulling wire that transmits the tensile force of the sliding operating section. A stone crushing device comprising: and a connecting wire that loosely connects the sliding operation part. (2) The stone crushing device according to claim 1, wherein the connecting wire is configured to be longer than the pulling wire. (3) The stone crushing device according to claim 1, wherein a portion of the connecting wire is formed into a spring-like portion.