WO1992019159A1

WO1992019159A1 - Device for sampling tissue cells and method of guiding said device

Info

Publication number: WO1992019159A1
Application number: PCT/JP1992/000575
Authority: WO
Inventors: Tomoyasu Tokuyama
Original assignee: Tomoyasu Tokuyama
Priority date: 1991-05-07
Filing date: 1992-05-01
Publication date: 1992-11-12

Abstract

A device for enabling sampling of the least necessary quantity of tissue cells without injuring tissue cells. The device is provided with: a slender flexible sampling unit proper (1) capable of minute reciprocatory movement with respect to a fixed part (6); a hollow sampling tube (2) slidably supported by said unit proper (1), flexible to follow said unit proper, and having a sampling hole (3) at the periphery near the tip thereof; a suction device (9) connected to the base part of said sampling tube (2); and a cutting mechanism for cutting part of tissue sucked through said sampling hole (3) by air suction into said sampling tube (2) so that cut tissue as specimen may be taken into the sampling tube. Ultrasonic wave transmitter/receivers (10, 11) are fixed to the tip of the sampling unit proper (1) and connected to an ultrasonic range finder (12). By observing waveforms representing the intensity of received signals indicated on said range finder (12), the sampling device can be guided to a tissue to be sampled.

Description

Ming Tissue cell collection device and its guiding method

TECHNICAL FIELD The present invention relates to a tissue cell collecting apparatus used for collecting a part of tissue cells of an animal, mainly a human body.

Background technology

Recently, the number of births due to chromosomal abnormalities, for example, Down syndrome, etc., has been increasing due to the increase in elderly births. Such a disease can be detected by amniotic fluid examination after passing 10 weeks after pregnancy, but if the time is lost, births of children with down syndrome etc. You will see

As a means to detect such an event early, some of the tissue cells of the fetus, such as the villi, that surround the fetus in the uterus during the first few weeks of gestation By detecting tissues and examining chromosomal abnormalities, a prognostic tool has been found, which allows early application of gene therapy.

Conventionally, the villous tissue of the fetal sac was collected using a syringe-shaped aspirator, which was inserted into the uterus to aspirate the villous tissue on the surface of the fetal sac and aspirated the tissue There is a method that is used to extract and cut into pieces.

However, in the above-mentioned conventional collection method, when an aspirator is inserted through the os of the uterus to aspirate villous tissue, an appropriate amount of aspiration is obtained. Therefore, it is extremely difficult to collect the minimum necessary tissue. Also, when the aspirator is inserted into the uterus, it can be inadvertently mistakenly sighted and punctured the fetal sac, damaging it, or reaching the uterus accurately. It can be difficult. In addition, since the aspirated tissue is torn apart, there is an inevitable danger of damaging the embryo and causing exfoliation of the embryo. Thus, although villus sampling has a remarkable effect on early detection of abnormalities, it does not work well, and if it is not sufficiently practiced, early detection of It has missed opportunities and has hampered medical progress.

Disclosure of the invention

In view of the above, the present invention provides a tissue cell collection device capable of reliably collecting a necessary minimum amount of tissue cells without damaging biological functions and tissue cells. O '

Further, another object of the present invention is to provide a tissue cell sampling device that can accurately and easily reach a target tissue in a living body.

In order to solve the above-mentioned problems of the conventional technology, the present invention is directed to a flexible and slender sampler main body, and a supporter near the tip supported by the sampler main body. A collection tube having a tissue collection hole formed in the peripheral surface of the collection tube, a suction device connected to the base of the collection tube, and suction into the collection hole by sucking the inside of the collection tube. Cutting means for cutting a part of the tissue Provided is a tissue / cell collection device which is configured to take a cut collection tissue into a collection tube. In addition, this device is equipped with an ultrasonic transmitter / receiver at the tip of the main body of the sampler, which can be connected to an ultrasonic distance measuring device to measure the distance between the tip of the main body of the sampler and the target tissue In this way, the guidance to the target tissue can be made easier and more accurate.

In the case of collecting fetal tissue in the uterus, for example, the collector is inserted into the uterus from the cervix of the uterus, and ultrasonic waves are transmitted from the tip of the collector to measure the distance. While checking the distance to the womb, which is the target object, using the device, approach the womb, and when it reaches the optimal position, aspirate the inside of the collection tube with the suction device. As a result, a part of the carpet tissue on the surface of the embryo is sucked into the sampling hole. At this time, the tissue cut into the collection hole by the cutting means is cut and taken into the collection tube. In this way, the main body of the collection device is removed from the uterus, and the collected tissue in the collection tube is taken out for inspection. In this case, the tissue that enters the collection hole by suction is quantified, and this is cut by a cutting means, so that when the sample is collected, the embryo is pierced or the tissue is shredded. There is no such thing, and it is possible to safely and surely collect the minimum amount of tissue.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a perspective view showing one embodiment of the present invention.

Fig. 2 is an essential diagram showing the tissue sampling process according to the embodiment of Fig. 1. Sectional drawing of a part.

FIG. 3 is a sectional view of a main part showing another example of the tissue cutting means in the present invention.

FIG. 4 is a sectional view showing still another example of the tissue cutting means according to the present invention.

FIG. 5 is a sectional view showing still another embodiment of the present invention.

Fig. 6 is an explanatory diagram showing the state of collecting the surface tissue of the fetus in the uterus.

FIG. 7 is a side view showing still another embodiment of the present invention.

FIG. 8 is a sectional view showing a main part of the embodiment of FIG.

FIG. 9 is a cross-sectional view of a main part showing a tissue sampling state according to the embodiment of FIG.

FIG. 10 is an explanatory diagram showing the state of arrival of the sampling device in the uterus in the uterus. -FIG. 11 is a sectional view of a main part showing still another embodiment of the present invention.

FIG. 12 is a cross-sectional view of a main part showing a tissue sampling state according to the embodiment of FIG.

FIG. 13 is a side view showing still another embodiment of the present invention.

FIG. 14 is a side view showing still another embodiment of the present invention.

FIG. 15 is an explanatory diagram showing a state when the sampling device has reached the vicinity of the uterus in the uterus and a reception state of the ultrasonic waves at that time.

FIG. 16 is an explanatory diagram showing a state when the sampling device arrives like a womb in a uterus and a reception state of an ultrasonic wave at that time. FIG. 17 is a side view showing several different embodiments of the conduit and the ultrasonic transceiver.

FIG. 18 is a cross-sectional view showing several different embodiments of the collection tube.

FIG. 19 is a cross-sectional view showing another embodiment of the sampling tube. FIG. 20 is a front view showing the shape of the tip end surface of the component used in the embodiment of FIG.

Figure 21 is a side view showing several different embodiments of how to attach the collection tube to the conduit.

FIG. 22 is a partial cross-sectional view showing another embodiment of a method of attaching a sampling pipe to a conduit.

FIG. 23 is a side view showing yet another embodiment of a method of attaching a sampling pipe to a conduit.

FIG. 24 is a cross-sectional view showing several different embodiments of suction and drive of the collection tube.

FIG. 25 is a side view showing an embodiment of the present invention in which guidance by visual observation can be used together.

FIG. 26 is a perspective view showing still another embodiment of the present invention.

Figure 27 shows yet another embodiment of the sampling tube.

BEST MODE FOR CARRYING OUT THE INVENTION

Hereinafter, the present invention will be described with reference to embodiments shown in the drawings. FIG. 1 shows an embodiment of the present invention, in which a structure suitable for collecting the surface tissue (villus tissue) of the fetal sac surrounding the fetus in the uterus is shown. Shear tissue as a means It is intended to be collected by the Japanese government.

It has a rod-shaped sampler body 1 formed of a flexible material having a thickness suitable for insertion into the uterus and having a hollow shape in the axial direction of the sampler body 1. Sampling pipe 2 is slidably inserted. The collection tube 2 is made of a material having the same flexibility as that of the main body 1 of the collection device, and is smooth so that the tip 2a is not obstructed and the target tissue is not damaged at the time of collection. A sampling hole 3 having a diameter of 0.5 ram or less is formed on the peripheral surface of the hemispherical shape at a required distance from the tip 2a. The sampling pipe (opening of the through hole 4) of the sampling body 1 from which the tip 2 a of the sampling pipe 2 protrudes is an edge portion 5 that is as close as possible to the peripheral surface of the sampling pipe 2. It is said that

The base of the sampler main body 1 is supported so that it can be slightly moved forward and backward with respect to a fixing part 6 which can be fixed closely to the entrance of the vagina or uterus. ing. The fixing portion 6 has, for example, a bearing portion 8 which is stably fixed to the human body side by forceps 7 or the like.The base portion of the sampler main body 1 can be moved forward and backward by this bearing portion 8. It is communicated.

A suction device 9 is connected to the base end of the collection tube 2. The suction device 9 can use a suction device structure such as a syringe, a suction pump, or the like.

An ultrasonic transmitting unit 10 and a receiving unit 11 are provided on the distal end surface of the sampler body 1, and these units have an ultrasonic oscillator. The receiver 11 is connected to the ultrasonic ranging device 12 and measures the distance by receiving the surface wave transmitted from the transmitter 10 and reflected by the object to be collected by the receiver 11. The display is made to be displayed on the display unit 13 of the acoustic distance measuring device 12. It is also possible to adopt a display method based on visualization for this display.

In FIGS. 2 to 6, 14 denotes the fetal sac, 15 denotes the villous tissue of the collected fetal sac, and 16 denotes the uterus.

Next, the operation of the above embodiment will be described.

In the case of collecting the surface tissue of the uterus 14 in the uterus 16, as shown in Fig. 6, the collector 1 is inserted into the uterus 16 from the ostium of the uterus and fixed. After fixing the part 6 on the human body side, transmit ultrasonic waves from the transmitting part 10 on the distal end face of the sampler body 1 and check the distance from the surface of the fetus 14 to the surface. When approaching the womb 14 and reaching the optimum distance, the hair tissue 15 is aligned with the sampling hole 3 of the sampling tube 2. When the suction device 9 is operated to make the inside of the collection tube 2 a negative pressure, the villous tissue 15 is sucked into the collection hole 3 (FIG. 2A).

Then, when the collection tube 2 is retracted at a very low speed, the base of the villous tissue 15 sucked into the collection hole 3 is located at the tip of the collection tube 4 of the collection device body 1. The villous tissue 15 is completely sheared by the edge portion 5 due to the shearing action of the edge portion 5 of FIG. 2 (FIG. 2B), and by further retracting the collection tube 2. Be cut (Fig. 2C) 0

The cut villous tissue 15 is taken into the collection tube 2. ― S one

If multiple samples need to be collected, the above operation can be repeated to collect the samples.

After the collection is completed, the fixing part 6 is removed, the sampler body 1 is pulled out from the uterus 16, the sampling tube 2 is pulled out from the sampler body 1, a sample is taken out, and the sample is provided for inspection. In this collection, the tissue to be collected is sucked into the minute sampling hole 3 on the peripheral surface of the sampling pipe 2 by suction, and the tissue that has entered is cut and separated. Since it is necessary to obtain the minimum amount of tissue safely and securely, there is no need to intervene in any action that pierces the womb 14 or shred the tissue. Collection is performed.

FIG. 3 is a cross-sectional view showing only a main part of another embodiment of the cutting means, in which the inhalation tissue is sheared by rotating the collection tube 2 with respect to the collection device body 1. This is the case. In this embodiment, the sampling tube 2 is rotatably inserted into the sampling device body 1 without moving in the axial direction, and the tip of the sampling tube through hole 4 of the sampling device body 1 is closed. . In addition, a suction port 17 that can be aligned with the sampling hole 3 of the sampling pipe 2 is opened in the peripheral surface of the sampler main body 1, and the inner periphery of the suction port 17 is formed in the edge portion 5. It is said that. In addition, as a means for confirming the match between the suction port 17 and the sampling hole 3, an index is appropriately set on the base of the sampler body 1 and the sampling pipe 2, and this should be used as a guide. And be able to do it.

Therefore, at the time of sampling, the suction port 17 of the sampler body 1 and the sampling hole 3 of the sampling tube 2 must be aligned, and When the inside of the sampling tube 2 is further sucked, a part of the tissue enters the sampling hole 3 from the suction port 17 and the sampling tube 2 is rotated, whereby the edge portion is removed. In 5, the inhaled tissue is cut, and the cut tissue is taken into the collection tube 2.

In addition, as another example of the cutting means, as shown in FIG. 4, a laser conducting wire 18 is arranged in the sampling tube 2 and the tissue sucked into the sampling hole 3 is subjected to a laser cutting. It is also possible to make it cut by a user.

In each of the above-described embodiments, the case where the present invention is used for the collection of tissue cells from the uterus of the uterus has been described. This is obviously the case. It is also possible to dispose of a part of the device and use it as a type, and of course, disinfect the entire sampler body and use it repeatedly.

Fig. 5 shows an example in which a part is discarded to be a type. The sampler main body 1 is formed thin, and has an ultrasonic transmitting unit 10 and a receiving unit 11 The ultrasonic device 18 is a separate unit and is detached from the sampler body 1.The tissue device is inserted into the sampler body 1 during tissue sampling, and the ultrasonic device 18 is used. It was taken out and the discarder body 1 and the sampling pipe 2 were discarded. According to this, it is possible to ensure the safety by discarding only the sampling device body 1 and the sampling tube 2 which can be obtained relatively inexpensively.

FIG. 7 shows the overall configuration of another embodiment of the sampling apparatus of the present invention. You. This example also applies to the collection of fetal villous tissue in the uterus.

The collection device has a thickness suitable for insertion into the uterus (eg, 4-5 mm in diameter) and flexibility and rigidity, such as a conduit such as a vinyl tube. Has zero. An extremely thin (for example, a diameter of 1 to 2 ιπιπ) sampling pipe 22 is attached to the outer surface of the conduit 20 by a fixed band 23. An ultrasonic transceiver 21 is fixed to the end of the conduit 20. The direction of the ultrasonic waves 25 emitted from the ultrasonic transceiver 21 is directed along the axis of the conduit 20 or as shown in the drawing with respect to the axis. It is adjusted so that it leans slightly to the side.

The distal end of the collecting tube 22 is opened so that the villous tissue of the embryo can be sucked into the collecting tube 22 from the distal end. The tip of the sampling tube 22 is fixed close to the tip of the ultrasonic transmitter / receiver 21 (the transmitting / receiving end of the ultrasonic wave). Thus, when the tip of the ultrasonic transceiver 21 comes into contact with the womb, the tip of the collection tube 22 also comes into contact with the womb.

The base of the collection tube 22 is connected to the suction device 26 via a connection tube 27 having flexibility, for example, like a vinyl tube. As the suction device 26, for example, a syringe is used. A syringe needle 26b having a sufficient length is attached to a tip of a cylinder 26a of the syringe 26. The injection needle 26 b is fixed to the conduit 20 along the conduit 20 by a fixed band 24. The distal end of the injection needle 26 b is connected to the proximal end of the collection tube 22 via the connection tube 27. By inserting the piston 26c of the syringe 26 into the bow I, the follicular villous tissue can be inhaled into the collection tube 22 from the opening of the distal end of the collection tube 22. ing .

The ultrasonic transmitter / receiver 21 is connected to an ultrasonic distance measuring device 29 via a signal line 28 passed through a conduit 20. The ultrasonic wave ranging device 29 drives the ultrasonic transceiver 21 to emit an ultrasonic wave 25. The emitted ultrasonic wave 25 is reflected by a living tissue existing in the direction of the ultrasonic wave and received by the ultrasonic transmitter / receiver 21. The received signal is sent to the ultrasonic ranging device 29. The ultrasonic ranging device 29 calculates the distance from the ultrasonic transceiver 21 to the living tissue based on the time difference between the emission and reception of the ultrasonic wave. Then, a graph in which the horizontal axis is distance and the vertical axis is received signal strength is displayed on the display screen 30. This graph is an indicator to determine whether the tip of the conduit 20 (ie, the tip of the collection tube 22) has reached the womb as accurately as the womb in the uterus. Used as

FIG. 8 is a cross-sectional view showing the detailed structure of the distal end portion of the conduit 20 and the sampling pipe 22.

An ultrasonic transmitter / receiver 21 is fixed to the end of the conduit 20 by a fixing / filling material 31 such as a resin, for example. Collection The pipe 22 is fixed to the outer peripheral surface of the pipe 20 by a fixed band 23.

The sampling tube 22 has a metal tube 22a having a closed end. An injection needle 22b is inserted into the metal tube 22a. The injection needle 22b is rotatable around a shaft in the metal tube 22a. The tip of the injection needle 22a is cut diagonally, like the tip of a normal injection needle. The proximal end of the injection needle 22 b is connected to the injection needle 26 b from the syringe 26 via a connecting tube 27. By rotating the cylinder 26a of the syringe 26, the injection needle 22b can be rotated in the metal tube 22a.

On the peripheral wall near the tip of the metal tube 22a, there is a minute (for example, a diameter of 0.5 mm or less) for introducing a fetal villous tissue into the metal tube 22a. The sampling hole 22c has been drilled. A sleeve 22 d with an open end is covered on the top part including the end of the metal tube 22 a to the sampling hole 22 c. The inner diameter of this sleeve 22 d is larger than the outer diameter of the metal tube 22 a, and the tip of the sleeve is opened from the sampling hole 22 c of the metal tube 22 a. And serves to facilitate the inhalation of villous tissue into the collection hole 22c.

FIG. 9 shows a state in which 14 pieces of villous tissue- 15 are collected by the sampling apparatus.

As shown in the figure, when the tip of the sampling device is brought into contact with the womb 14 and the bone 26 c of the syringe 26 is bowed, The villous tissue 15 of the uterus 14 is inhaled into the sleeve 22 d, and then taken into the metal tube 22 a through the sampling hole 22 c and injected with a needle. It is introduced in 22 b. When the cylinder 22a of the syringe 26 is rotated in this state, the injection needle 22b rotates within the metal tube 22a, and the edge and the sampling hole on the tip surface thereof are rotated. The villous tissue 15 is sheared by the peripheral edge of 22 c. In this way, an appropriate aliquot of villous tissue 15 can be obtained.

FIG. 10 shows a state in which this sampling device has been inserted into the uterus 16. If the fetus 14 is relatively large as shown in Fig. 10 (A), inserting the sampling device into the uterus 16 will naturally correct the tip surface of the sampling device. It comes into contact with the womb 14 and can be harvested as described above. However, when the embryo 14 is relatively small as shown in Fig. 1 ◦ (B) (for example, the diameter of the embryo is about 12 to 13 at 4 weeks of gestation) mm), the sampling device inserted into the uterus 16 passes by the side of the womb 14 and the tip of the collection device is well placed into the womb 14. No contact. In such a case, a sampling device with a structure as shown in Fig. 11 is suitable.

In the embodiment of FIG. 11, an ultrasonic transmitter / receiver 21 is attached to the end of the conduit 20, and the direction of the ultrasonic wave 25 is perpendicular to the axis of the conduit 20. ing . In the collection tube 220, the collection hole 22c for taking in the villous tissue is located in the scope of the ultrasonic wave 25 and is directed in the same direction as the ultrasonic wave 2. Thus, it is attached to the outer wall of conduit 20. This collection tube 220 does not have a sleeve 22d like the collection tube 22 of the previous embodiment. The configuration of the other parts is the same as in the previous embodiment.

By using this collection device, as shown in FIG. 12, the villous tissue 15 of the fetus 14 can be inhaled and collected from the side of the collection device.

FIG. 13 shows a modification of the embodiment of FIG.

In this sampling device, a flexible tube having a built-in known swinging mechanism used for a scope in a digestive organ or the like is used as a conduit 20. An operation unit 32 having a knob 32a for adjusting the direction and amount of the swing is connected to the proximal end of the conduit 20. . As shown by the dashed line, the direction of the tip of the conduit 20 and the tip of the collection tube 22 can be changed, which is convenient for finding the uterus in the womb.

In the embodiment shown in FIG. 11, the same flexible tube can be used as the conduit 20.

FIG. 14 shows another modification of the embodiment of FIG.

In this sampling device, the rotation of the syringe cylinder 26a for shearing the inhaled villous tissue is automatically performed by the driving device 33 attached to the cylinder 26a. It was designed to be able to be performed in a targeted manner. This driving device 33 has a built-in motor 33a, and the rotational motion of the motor 33 is combined with a rubber roller or the like. The transmission is made to the cylinder 26a through the transmission mechanism 33b which is more likely to be transmitted.

Next, a description will be given of a method applied to some of the above-described embodiments for accurately guiding the sampling device to the position of a womb. In this example, the sampling device shown in Fig. 7 will be described as an example, but it can be easily understood by those skilled in the art that a similar method can be applied to other sampling devices. Should be.

Fig. 15 (A) shows the condition when the sampling device arrived in the uterus near the womb 14 and Fig. 15 (B) shows the distance measurement at this time. 9 shows a graph representing the relationship between the received ultrasonic wave intensity and the distance displayed on the device 29. At this time, since there is uterine tissue between the tip of the sampling device and the womb 14, a relatively strong reflected wave from the uterine tissue appears on the graph ( Area A). Also, since the inside of the womb 14 is liquid, the reflected wave from this is relatively weak (region B). Since there is uterine tissue at the end of the womb, the reflected waves are relatively strong (region C). Therefore, in this case, the graph in the area B corresponding to the embryo 14 has a reception intensity boket, that is, the reception intensity has a step-like shape. The waveform has a reduced part. As the sampling device approaches the womb 14, the area A becomes narrower and the pockets in the area B approach the vertical axis (distance zero).

Fig. 16 (A) shows the condition when the sampling device has completely reached the womb 14 and Fig. 15 (B) shows the measuring device at this time. Shows the graph displayed in position 19. The area A is almost eliminated, and the waveform of the pocket in the area B indicating the womb 14 is almost in contact with the ordinate axis (zero distance).

Therefore, while inserting the sampling device into the uterus, observe the graph displayed on the measuring device 19 and adjust the insertion position so that the pocket of the reception intensity approaches the ordinate axis. If adjustment is made and the position adjustment stops when this pocket touches the ordinate axis, the sampling device has reached the womb 14 correctly at this stop position. become. In this way, the collection device can be easily and accurately guided to the womb.

The representative embodiments of the present invention have been described above. However, the present invention is not limited to these embodiments. Those skilled in the art can implement the present invention in various other modifications. Further, the present invention is suitable for collecting villous tissue from a fetus, but can also be applied to collecting other living tissues. The above-mentioned method of approaching the target tissue by referring to the graph of the ultrasonic reception intensity is applicable not only to the womb but also to access to other tissues whose contents are mainly liquid. it can. .

Hereinafter, a variation of an embodiment included in the scope of the present invention will be described.

FIG. 7 shows several embodiments of a conduit 20 and an ultrasonic transceiver 21 at the tip thereof, which can be used in the sampling apparatus of the present invention.

Figure 17 (A) shows the ultrasonic wave direction of the ultrasonic transceiver 21. -1 1-Shows the most basic mode in which the direction coincides with the axis of conduit 20. In the embodiment of FIG. 7 already described, it is possible to adopt the mode of FIG. 17 (A).

The embodiment of FIG. 17 (B) is adopted in the embodiment of FIG. 7, and the direction of the ultrasonic wave is oblique to the axis of the conduit 20. In this case, as shown in the embodiment of FIG. 7, disposing a sampling tube (not shown) on the inclined side of the ultrasonic wave directing direction makes the sampling tube accurately contact the target tissue. Desired for purpose.

The embodiment shown in FIG. 17 (C) is employed in the embodiment shown in FIG. 11, and the direction of the ultrasonic wave is substantially perpendicular to the axis of the conduit 20. In this case, as in the embodiment shown in FIG. 11, disposing a collection tube (not shown) on the side in the ultrasonic wave direction is a method for accurately bringing the collection tube into contact with the target tissue. Desired for the target.

In any of these modes, if the conduit 20 has a swing function as shown in Fig. 17 (D), the exploration and reach of the target tissue can be achieved. The ability is further improved.

FIG. 18 shows some embodiments for the collection tube 22. The embodiment of FIG. 18 (A) is adopted in the embodiment of FIG. 11, and the inner cylinder 2 2 a with the tip cut obliquely is inserted into the outer cylinder 22 a with the tip closed. 2b is connected to the rotating unit. By setting the inside of the inner cylinder 22b to a negative pressure, the target tissue that comes into contact with the side wall of the outer cylinder 22a is moved to the outer cylinder 22b as shown by the broken line. -IS-Inhaled into inner cylinder 22b through sampling hole 22c formed in the side wall of a. By rotating the inner cylinder 22b, the sampling hole 22c acts as an outer blade, and the tip of the inner cylinder 22b acts as an inner cutter, and Shear the tissue.

The embodiment of FIG. 18 (B) is adopted in the embodiment of FIG. 7, and the leading end of the outer cylinder 22a is covered with a slip 22d having an open end. . This makes it possible to inhale the target tissue from the distal end of the collection tube 22 as shown by the broken line.

In the embodiment of FIG. 18 (C), an inner rod 22f cut at an oblique end is inserted into the outer cylinder 22e having an open end at the rotation itself. The side wall of the outer cylinder 22 e is forcibly pierced with a suction hole 22 h, and an external suction pipe 22 i is connected to the suction hole 22 h. A wire 22g such as a Piano wire having sufficient flexibility and rigidity is connected to the base end of the inner rod 22f, and the wire 22g is connected to the wire 22g. Allows the inner rod 22 f to be rotated. By creating a negative pressure in the suction tube 22 i, the target tissue passes through the suction hole 22 j from the sampling hole 22 j at the tip of the outer cylinder 22 e as shown by the broken line. Then, it is sucked into the suction pipe 22i. By rotating the inner rod 22 f, the suction hole 22 h acts as an outer blade, and the tip of the inner rod 22 f acts as an inner blade. Shear the tissue. In the embodiment shown in Fig. 18 (D), the distal end is obliquely cut into the outer tube 22k with the distal end closed and the technical tube 22 1 on the proximal side wall. 22 m of the inner pipe is connected to the rotating body. A wire 22n such as a Piano wire is attached to the proximal end of the inner tube 22. This wire 22n is connected to the proximal end of the outer tube 22k. It goes out through the center hole of the packing 22 o fitted in the box. The inner pipe 22 m can be rotated by the wire 22 η. By applying a negative pressure through the branch pipe 221, the target tissue is sucked into the inner pipe 22m as shown by the broken line, and the inner pipe 22m is removed. The target tissue is sheared by the rotation.

FIG. 19 shows yet another embodiment of the collection tube 22. In the embodiment shown in Fig. 19 (A), an outer tube 22p having a half-moon-shaped sampling hole 22t at the distal end surface as shown in Fig. 20 (A) is provided. Within 2 p, a wire 22 V with a semi-lunar plate 22 Q attached to the tip as shown in Fig. 20 (B) is passed through the rotating body . The proximal end of the outer tube 22p is connected to a suction device (not shown) via a connecting tube 22r. By setting the inside of the outer tube 22 p to a negative pressure, the target tissue is sucked into the outer tube 22 p through the sampling hole 22 t at the end surface of the outer tube 22 p. . The flat plate 2 2 q is rotated by the wire 22 v so that the sampling hole 22 t serves as an outer blade and the flat plate 22 q serves as an inner blade. To shear the target tissue.

In the embodiment of FIG. 19 (B), a semi-lunar-shaped sampling hole 22 u as shown in FIG. 20 (C) is inserted into the outer tube 22 p similar to the embodiment of FIG. 19 (A). The inner tube 22 s on the surface rotates It is communicated. By making the inside of the inner tube 22 s a negative pressure, the target tissue is sucked into the inner tube 22 s through the sampling holes 22 t and 22 u, and then the inner tube 22 The target tissue is sheared by rotating s.

FIG. 22 shows several embodiments of how to attach the collection tube 22 to the conduit 20.

In the embodiment of FIG. 21 (A), a sampling tube 22 as shown in FIG. 18 (A) is attached to a conduit 20 to which ultrasonic waves are directed in the axial direction. In order to facilitate inhalation of the target tissue into the collection tube 22, the collection tube 22 protrudes from the end of the conduit 20, and the collection hole is directed to the axial side of the conduit 20. . In this case, as shown in Fig. 22, the sleeve 40 (shown in cross section) is put on the outside of the conduit 20 and the sampling tube 22 to obtain An effect can be expected that the target tissue can be more easily inhaled. In addition, at the time of insertion into the uterus, the collection tube 22 does not protrude from the distal end of the conduit 20 as shown in FIG. 23 (A), and only when the target tissue is collected, as shown in FIG. If the collection tube 22 slides out and protrudes as shown in (B), it is preferable because the safety at the time of introduction into the uterus increases.o

In the embodiment shown in FIG. 21 (B), a sampling tube 22 shown in FIG. 18 (B) is attached to a conduit 20 to which ultrasonic waves are directed in the axial direction. At this stage, the collection tube 22 can be inhaled from the distal end of the collection tube 22. It is not necessary to protrude from the end of tube 20.

The embodiments of FIGS. 21 (C) and (D) are adopted in the embodiment of FIG. The sampling tube 22 is arranged such that the sampling hole is located outside the ultrasonic scope but in the vicinity thereof as shown in (C), or (D) The sampling hole is positioned so as to be located in the ultrasonic scope as in (2).

FIG. 24 shows several embodiments for driving the suction of the collection tube 22.

The embodiment of FIG. 24 (A) is adopted in the embodiment of FIG. 14, and the sampling tube 22 shown in FIG. 18 (A), (B) and FIG. 19 (B) is used. Applies to A suction device (for example, a syringe) 26 is coupled to the motor 33a via an appropriate power transmission and speed control mechanism 33b and is rotated automatically, thereby collecting the sample. Rotate the inner blade in tube 22. '

The embodiment of FIG. 24 (B) is applied to the collection tube 22 shown in FIGS. 18 (C) and (D). As a separate system from the suction device 26, a mechanism for rotating the inner blade in the sampling pipe 22 is provided. That is, a wire 22 g (22 η) for rotating the inner blade is supplied to the motor 33 a via an appropriate power transmission and speed control mechanism 33 c. They are combined and rotated automatically.

FIG. 25 shows an embodiment in which, in addition to the guidance to the target tissue by the ultrasound, the guidance by the naked eye can be used together.

The conduit 20 has not only the sampling tube 22 but also a fiberscope 42 attached thereto. Fiber Scope Through the optical system 44 at the base end of 42, the sight seen from the tip of the fiber scope 42 can be observed with the naked eye. The fiber scope 42 is inserted into the conduit 20 so that the tip of the fiber scope 42 is connected to the conduit 20 together with the ultrasonic transceiver 21. It is also possible to expose the tip from the front end of the

FIG. 26 shows yet another embodiment of the present invention. A donut-shaped ultrasonic transceiver 48 is attached to the end of the conduit 20, and the sampling tube 22 is passed through the conduit 20, and the tip of the sampling tube 22 is ultrasonically connected. It is exposed to the outside through the center hole of the transceiver 48. In this case, it is desirable that the direction of the ultrasonic wave coincides with the axial direction of the conduit. Also, if a sampling pipe 22 is used as shown in Fig. 18 (A) or (D), it is shown to expose the sampling hole to the outside. It is necessary to protrude the tip of the sampling tube 22 from the ultrasonic transmitter / receiver 48 as shown in FIG. On the other hand, when the sampling tube 22 shown in FIGS. 18 (B), (C) or FIG. 19 is used as the sampling tube 22, the sampling tube 22 is transmitted / received by ultrasonic waves. vessel

There is no need to protrude from the uterus, so safety at the time of uterine introduction is high.

Fig. 27 shows a modification of the sampling tube. Figure 27 (A) is Figure 18 (A), Figure 27 (B) is Figure 18 (D), Figure 27 (C) is Figure 19 (A), Figure 27 (D) is Figure 19 (B), each of which has a pointed outer tube. ing . This pointed tip, when it reaches the fetal sac, breaks through the decidua enveloping the outer part of the follicular villus tissue and facilitates the collection tube to reach the villous tissue. In the embodiment described above, which serves to cause the ultrasonic waves to be directed, the direction of the ultrasonic wave is fixed with respect to the conduit, but the direction of the ultrasonic wave may be variable. For example, an intravascular or intracavitary imaging catheter manufactured by CVIS in the United States, which is involved in the import and sale of Goodman Co., Ltd. in Japan, is placed in a conduit. Due to the combination of the ultrasonic transmitter / receiver and the rotating mirror, the direction of the ultrasonic wave is 360 degrees around the conduit axis and in a plane perpendicular to this axis. It is rotated. It is advantageous to employ this mechanism in the sampling apparatus of the present invention, particularly in the portion of the ultrasonic transceiver 21 in the embodiment of FIG. In this case, it is desirable that the sampling hole 22c be located in the above plane. In this case, as the ultrasonic ranging device 29, the above-mentioned reception intensity display device called a so-called A-scope may be used. If an ultrasonic diagnostic imaging device called a so-called B scope is used instead, a tissue cross-sectional image in the above plane is displayed, so that more layer guidance is possible. Becomes easier. It is also possible to use such a rotating ultrasonic transmitting and receiving mechanism in combination with the fixed ultrasonic transmitting and receiving apparatus described above.

Claims

The scope of the claims

1. A flexible and slender sampler body, a sampling tube supported by the sampler body and having a tissue sampling hole formed on the peripheral surface near the distal end, and a base portion of the sampling tube. A suction device connected thereto; and a cutting means for cutting a part of the tissue sucked into the sampling hole by sucking the inside of the sampling tube, and collecting the cut tissue to be cut. A tissue cell sampling device characterized in that it is taken into a tube.

2. An ultrasonic transmission / reception unit is provided at the tip of the sampler main body, and this is connected to an ultrasonic distance measuring device so that the distance between the sampler main body tip and the object to be sampled can be measured. The tissue cell sampling device according to claim 1, characterized in that:

3. The tissue cell collection device according to claim 2, wherein the direction of the ultrasonic wave from the ultrasonic transmission / reception unit is along the axial direction of the main body of the sampler.

4. The tissue cell according to claim 2, wherein the direction of the ultrasonic wave from the ultrasonic transmission / reception unit is inclined toward the collection tube with respect to the axial direction of the collection device main body. Sampling equipment mi o

5. The direction of the ultrasonic wave from the ultrasonic transmission / reception unit is perpendicular to the axial direction of the sampler main body, and the sample hole of the sample tube directs the direction of the ultrasonic wave. The said collection pipe | tube is arrange | positioned like this, The claim 2 characterized by the above-mentioned. The tissue cell collection device according to claim 1.

6. The collection tube is slidably inserted into the collection tube through hole of the collection device main body, and the cutting means is provided with an edge of a tip end of the collection tube through hole of the collection device main body. Claim 1 or Claim 1 which comprised the edge part, The tissue sucked in the said collection hole was made to shear by the said edge part by retracting the collection pipe. 3. The tissue cell sampling device according to 2.

7. The collection tube is slidably inserted into the collection tube through hole of the collection device main body, and the cutting means is provided in the collection tube main body of the collection device body. It is composed of the edge of the inner periphery of the suction port formed so as to be able to face directly, and it is sucked into the sampling hole of the sampling tube by the relative rotation of the sampling tube and the sampler body. 3. The tissue cell collecting apparatus according to claim 1, wherein the tissue is sheared at the edge portion.

8. The collecting tube has a closed main tube having the collecting hole near the distal end, a rotatable insertion of the main tube into the main tube, a distal end cut obliquely, and a proximal end having the suction. An injection needle coupled to a device, wherein the cutting means is constituted by an edge on an inner peripheral surface of the sampling hole and an edge on a distal end surface of the injection needle. 3. The tissue cell collection device according to claim 1, wherein the tissue sucked into the collection hole by rotating a needle is cut by the edge.

9. The collection tube is a negative tube generated by the suction, which is covered from a tip of the main tube to a head portion including the collection hole. The tissue cell collection device according to claim 8, further comprising a sleeve for guiding pressure from the collection hole to the tip of the collection tube.

10. The tissue cell collection device according to claim 1, wherein the cutting means is a laser.

11. An ultrasonic device having an ultrasonic transmitting unit and a receiving unit is formed so as to be freely detachable from the sampler body, and the sampler body and the sampling tube are discarded after use. The tissue cell collection device according to the above.

12. The body of the sampling device according to claim 1, wherein the body of the sampling device has a swing mechanism for changing a direction of a head portion including a tip and a portion supporting the sampling tube. Is the tissue cell collection device described in 2.

1 3. In the method of inserting a tissue cell sampling device having an ultrasonic transmitting / receiving section at the tip into a living body and guiding it to a target tissue, an ultrasonic ranging connected to the ultrasonic transmitting / receiving section A step of displaying, by the device, a graph indicating the reception intensity of the ultrasonic wave according to the distance from the tip of the sampling device, and the displayed graph corresponds to the target tissue. Adjusting the insertion position of the sampling device so that the pocket approaches the coordinate axis of the distance zero, and when the pocket substantially touches the coordinate axis of the distance zero. And a step of stopping the adjustment of the insertion position.