WO2006030596A1 - 生体組織採取器具、内視鏡システムおよび生体組織採取方法 - Google Patents
生体組織採取器具、内視鏡システムおよび生体組織採取方法 Download PDFInfo
- Publication number
- WO2006030596A1 WO2006030596A1 PCT/JP2005/014928 JP2005014928W WO2006030596A1 WO 2006030596 A1 WO2006030596 A1 WO 2006030596A1 JP 2005014928 W JP2005014928 W JP 2005014928W WO 2006030596 A1 WO2006030596 A1 WO 2006030596A1
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- WIPO (PCT)
- Prior art keywords
- biological tissue
- collection
- conduit
- suction
- collected
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/04—Endoscopic instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B2010/0225—Instruments for taking cell samples or for biopsy for taking multiple samples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2939—Details of linkages or pivot points
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/71—Suction drainage systems
- A61M1/79—Filters for solid matter
Definitions
- the present invention relates to a biological tissue collection device, an endoscope system, and a biological tissue collection method for collecting a biological tissue percutaneously or transendoscopically.
- an aspiration conduit having a hollow puncture needle for an endoscope at the tip is inserted into a living body through a treatment instrument penetration channel of the endoscope.
- This puncture needle for an endoscope is collected by sucking the biological tissue while piercing the target biological tissue under observation by the endoscope.
- a living tissue collected using such an endoscopic puncture needle is transported to an examination site separate from the endoscopy laboratory, where pathological diagnosis and other tests such as biochemical analysis and genome analysis are performed. Done.
- Japanese Patent Publication No. 2000-516832 discloses a biopsy forceps device used with an endoscope.
- a forceps portion is disposed at the distal end portion of the suction conduit. For this reason, the biological tissue collected by the forceps protruding from the distal end of the treatment instrument passing channel of the endoscope can be sucked by directing the distal end force proximal end of the suction conduit.
- Japanese Patent Application Laid-Open No. 2001-124767 discloses a method of destroying a cell membrane of a living tissue by reciprocating a flow path of a syringe having a bent portion. In this way, cells can be destroyed and chromosomes can be easily removed.
- the instrument disclosed in Japanese Patent Application Laid-Open No. 2001-124767 has a bent portion in the syringe. For this reason, it is necessary that the diameter of the treatment instrument penetration channel is formed to be large in accordance with the bending length of the bent portion, particularly when the treatment instrument penetration channel is inserted through the endoscope. Therefore, depending on the diameter of the endoscope channel, it may be difficult to collect biological tissue endoscopically.
- the present invention has been made to solve such a problem, and the purpose thereof is to be able to easily and quickly crush the collected biological tissue, for example, pathological examination, biochemical analysis,
- An object of the present invention is to provide a biological tissue collection instrument, an endoscope system, and a biological tissue collection method that can shorten the preparation time for performing genome analysis and the like.
- a biological tissue collection device has a collection unit for collecting biological tissue at a distal end portion, and has a suction mechanism for sucking the tissue collected by the collection unit at a proximal end portion. It has a hollow pipe line. At least a part of the inner peripheral surface of the pipe line is provided with a convex portion projecting inward.
- the collected biological tissue can be easily and quickly crushed, and for example, preparation time for performing pathological examination, biochemical analysis, genome analysis, etc. can be shortened.
- a plurality of the convex portions are non-uniformly formed inside the conduit. Since the convex portion is formed on the inner peripheral surface of the duct with a random size, for example, at a random position, the living tissue is reliably crushed as the distal-end force of the duct also moves toward the proximal end.
- the inner diameter of the conduit is formed unevenly by the convex portion. Therefore, the inner diameter and the outer diameter of the conduit can be deformed and molded. Only the inner peripheral surface may be deformed.
- a plurality of the convex portions are formed independently.
- the convex portion is formed so that at least a part thereof is continuous.
- the convex portion is formed by applying pressure from the outside of the conduit.
- the suction mechanism includes a suction cavity part capable of storing the biological tissue collected from the collection part.
- the living tissue broken by suction can be stored without using another container.
- the suction cavity portion stores a solution mixed with the biological tissue collected from the collection portion.
- the crushed living tissue and the solution can be mixed to delay the deterioration of the living tissue.
- This solution can also be used as a reagent.
- the suction mechanism is detachably provided with a container capable of storing a biological tissue collected from the collection unit between a proximal end portion of the duct and the suction cavity. .
- a container capable of storing a biological tissue collected from the collection unit between a proximal end portion of the duct and the suction cavity.
- the biological tissue crushed by suction can be stored in the container.
- transport for performing pathological examination, biochemical analysis, genome analysis and the like is easy.
- the container stores a solution to be mixed with the biological tissue collected from the collection unit.
- the suction mechanism is in a communication state in which the collection unit and the suction cavity unit are communicated with each other and in a blocking state in which the collection unit and the suction cavity unit are blocked.
- a valve mechanism having a flow path that is switchable and communicated with the suction cavity portion in the shut-off state is provided between the proximal end portion of the conduit and the suction cavity portion.
- the living tissue can be discharged through the flow path by operating the valve mechanism.
- a container capable of storing biological tissue collected from the collection unit is disposed at the end of the flow path of the valve mechanism.
- the biological tissue discharged from a flow path can be received. Also, by removing the container from the flow path, for example, it can be easily transported for pathological examination, biochemical analysis, genome analysis, and the like.
- the valve mechanism has a plurality of communication passages that are selectively communicated with the flow passage, and each of the flow passages allows a container that can store a biological tissue to be attached to and detached from the communication passage.
- a switching mechanism is provided.
- the biological tissue once accumulated in the suction cavity can be separated into a plurality of parts.
- biological tissues at different sites can be discharged into different containers.
- At least one of the conduit and the suction mechanism is provided with a filter for capturing a part of the biological tissue collected from the collection unit.
- the filter can be impregnated with an RNA stabilizer. For this reason, the intracellular nucleic acid captured by the filter is quickly stabilized at the time of capture.
- a biological tissue affinity compound is attached to the filter so as to face the collection part side.
- At least one of the conduit and the suction mechanism includes a magnetic bead having a biological tissue-affinity compound on an outer surface, and at least one of a magnet and an electromagnet that applies a magnetic force to the magnetic bead. Is arranged.
- the biological tissue affinity compound is a cancer cell recognizing antibody.
- cancer cells remain on the filter and the magnetic beads, and other cells are accumulated in, for example, the aspiration cavity.
- the suction mechanism is connected to a cooling mechanism for cooling the biological tissue collected from the collection unit.
- the collection unit includes a hollow puncture needle that is punctured into a living tissue.
- the living tissue is placed inside the puncture needle.
- the living tissue can be crushed through the inside of the duct.
- the outer peripheral surface of the pipe is formed to be hard.
- the conduit has flexibility.
- the collection unit includes an openable / closable forceps for gripping a living tissue.
- the biological tissue can be crushed by sucking the biological tissue collected by the forceps. Further, by combining the puncture needle and the forceps, a desired living tissue can be collected more reliably.
- An endoscope system includes an endoscope and a biological tissue collection device.
- the endoscope includes an elongated insertion portion having a treatment instrument penetration channel along the axial direction thereof, and an operation portion that is disposed at a proximal end portion of the insertion portion and operates the insertion portion.
- the biological tissue collection device has an outer diameter that can be inserted into and removed from the treatment instrument penetration channel, and has a convex portion that protrudes inward at least at a part of the inner peripheral surface thereof.
- a hollow conduit formed longer than the length of the passage channel, a collection portion provided at the distal end portion of the conduit so as to be detachable from the treatment instrument penetration channel, and collecting a biological tissue;
- a suction device that is provided at the proximal end of the duct and sucks the biological tissue collected by the collection unit Structure.
- the biological tissue can be crushed.
- the suction mechanism can store the biological tissue collected from the collection unit, and can be switched between a container for storing a solution and a state in which the solution is communicated with and a state in which the container is blocked. And a suction part.
- the crushed biological tissue sucked by the suction part can be stored in the container.
- the suction part can be switched between a state where it is communicated with the container and a state where it is blocked, the container can be attached and detached.
- the solution since the solution is stored in the container, the broken biological tissue and the solution are mixed and the deterioration of the biological tissue can be delayed.
- the solution can also be used as a reagent.
- the suction mechanism is disposed between a suction cavity part capable of storing a biological tissue collected from the collection part, and a proximal end part of the duct and the suction cavity part. And is switched between a communication state in which the collection portion and the suction cavity portion communicate with each other and a blocking state in which the space between the collection portion and the suction cavity portion is blocked. And a valve mechanism having a flow path communicating with the portion.
- the living tissue broken by suction can be stored without using another container.
- the living tissue can be discharged through the flow path by operating the valve mechanism.
- the collection unit includes a hollow puncture needle that is punctured into a living tissue.
- the biological tissue By aspirating with the hollow puncture needle punctured, the biological tissue can be crushed through the inside of the puncture needle and the inside of the duct. For this reason, it is easy to collect biological tissue endoscopically.
- the collection unit includes a tube that can be inserted into a conduit in a living body.
- a living body conduit for example, a knee tube, a bile duct, etc.
- the tissue or cells exfoliated from the secretion fluid can be separated for subsequent inspection.
- the collection unit includes an openable / closable forceps for gripping a living tissue.
- the conduit includes an opening / closing mechanism connected to the forceps to open / close the forceps at a base end portion.
- the biological tissue can be crushed by sucking the biological tissue collected by operating and grasping the forceps by operating the opening / closing mechanism. Further, by combining the puncture needle and the forceps, a desired living tissue can be collected more reliably.
- the biological tissue collection method uses a biological tissue collection device. Aspiration of the biological tissue collected by the collection part while colliding with the convex part of the duct is provided, and the suction mechanism includes storing the biological tissue crushed by colliding with the convex part.
- the biological tissue collected by the collection unit can be stored in the suction mechanism in a crushed state.
- a biological treatment is collected percutaneously.
- a biological tissue collection method uses a biological tissue collection device.
- the biological tissue collected by the sampling part is sucked while colliding with the convex part of the duct to crush the biological tissue, the crushed biological tissue is stored in the container, and the container is connected to the tube Removing from between the base end portion of the path and the suction mechanism. For this reason, the biological tissue collected by the collection unit can be stored in a container in a crushed state.
- analysis of the crushed biological tissue can be performed easily. The same applies to the case where a biological treatment is collected percutaneously.
- the biological tissue collection method includes crushing a biological tissue by sucking the biological tissue collected by the collection unit while colliding with the convex portion of the duct. Temporarily storing the crushed living tissue in the suction mechanism, switching the valve mechanism to a state in which the inside of the container and the suction mechanism are communicated, and the living tissue from the suction mechanism. Discharging to the container through the valve mechanism, and removing the container. For this reason, the biological tissue collected by the collection unit with the valve mechanism in communication can be stored in the suction mechanism in a crushed state. In this state, the valve mechanism is switched to the shut-off state, and the living tissue can be discharged to the container through the valve mechanism. The same applies to the case where a biological treatment is collected percutaneously.
- the step of crushing the biological tissue by sucking the biological tissue collected by the collection unit while colliding with the convex portion of the duct is the tip of the treatment instrument perforation channel of the endoscope.
- the step of projecting the sampling portion is included in advance.
- FIG. 1 is a schematic perspective view showing an endoscope system according to a first embodiment.
- FIG. 2 is a schematic perspective view showing a biological tissue collection device used in the endoscope system according to the first embodiment.
- FIG. 3 is a schematic perspective view showing a needle-like collecting portion for collecting a biological tissue and a distal end portion of a duct in the biological tissue collecting device according to the first embodiment.
- FIG. 4 is a schematic longitudinal sectional view of a conduit of the biological tissue collection device according to the first embodiment.
- FIG. 5A is a schematic cross-sectional view showing a forceps-like collection unit that collects biological tissue in the biological tissue collection device according to the first embodiment.
- FIG. 5B is a schematic cross-sectional view showing a forceps-like collection unit that collects a biological tissue in the biological tissue collection device according to the first embodiment.
- FIG. 6 is a schematic view showing a biological tissue collection device according to a second embodiment.
- FIG. 7 is a schematic view showing a proximal end portion of a duct and a suction mechanism in a biological tissue collection device according to a third embodiment.
- FIG. 8 is a schematic view showing a proximal end portion of a duct and a suction mechanism in a biological tissue collection device according to a fourth embodiment.
- FIG. 9A is a schematic diagram showing a proximal end portion of a conduit and a suction mechanism in a biological tissue collection device according to a fifth embodiment.
- FIG. 9B is a schematic view showing a valve mechanism disposed at the proximal end portion of the conduit in the biological tissue collection device according to the fifth embodiment.
- FIG. 10 is a schematic view showing a proximal end portion of a duct and a suction mechanism in a biological tissue collection device according to a sixth embodiment.
- FIG. 11 is a schematic view showing a proximal end portion of a conduit and a suction mechanism in a biological tissue collection device according to a seventh embodiment.
- FIG. 12 is a schematic view showing a proximal end portion of a conduit and a suction mechanism in a biological tissue collection device according to the eighth embodiment.
- FIG. 13 is a schematic view showing a proximal end portion of a conduit and a suction mechanism in a biological tissue collection device according to a ninth embodiment.
- FIG. 14 is a schematic view showing a proximal end portion of a conduit and a suction mechanism in a biological tissue collection device according to the tenth embodiment.
- FIG. 15A is a schematic longitudinal cross-sectional view showing convex portions with continuous conduits in the biological tissue collection device according to the eleventh embodiment.
- FIG. 15B is a schematic longitudinal sectional view showing that the conduits in the biological tissue collection device according to the eleventh embodiment are squeezed to form convex portions and concave portions.
- an endoscope system 10 includes an endoscope 12 and a biological tissue collection device 14 used in combination with the endoscope 12.
- the biological tissue in this embodiment includes, in addition to the normal tissue part, tumors, cysts, and exfoliated tissues and cells in body cavity fluid (for example, peritoneal fluid, thoracic fluid, spleen fluid, bile fluid, etc.). It is a waste.
- the endoscope 12 includes an elongated insertion portion 22 that can be inserted into a body cavity, and an operation portion 24 that is provided at a proximal end portion of the insertion portion 22 and is operated by being held by an operator.
- the insertion portion 22 includes a flexible flexible tube portion 26, a bendable bending portion 28, and a hard tip. And an end rigid portion 30.
- a proximal end portion of the flexible tube portion 26 is connected to the operation portion 24.
- the bending portion 28 is provided at the distal end portion of the flexible tube portion 26.
- the distal end rigid portion 30 is disposed at the distal end portion of the bending portion 28.
- the distal end rigid portion 30 is provided with an illumination optical system and an objective optical system in parallel.
- the illumination optical system emits illumination light that is also guided by the light source built in the controller 42 described later, toward the observation target.
- the objective optical system captures an optical image of the observation object illuminated by the emitted illumination light and transmits the optical image to the controller 42.
- the illumination optical system emits illumination light in different directions with respect to the longitudinal axis of the insertion portion 22.
- the object optical system has an optical axis in the same direction as the illumination light so as to capture an image of the part illuminated by the illumination light. That is, the illumination optical system and the objective optical system are formed so as to observe different directions with respect to the longitudinal axis of the insertion portion 22. Therefore, the endoscope 12 according to this embodiment is a so-called perspective type side view type.
- the endoscope 12 will be described using a side view type, but there is no problem even if a so-called perspective type or direct view type is used.
- the insertion portion 22 includes a treatment instrument penetration channel (not shown) along its axial direction.
- the treatment instrument communication channel is provided in parallel with the illumination optical system and the objective optical system.
- a forceps raising base (not shown) is provided at the distal end of the treatment instrument piercing channel for locking the elongated heel treatment tool that penetrates the treatment instrument piercing channel. For this reason, it is possible to lock and fix a later-described conduit 52 of the biological tissue collection device 14 at a desired position.
- a forceps plug 32 is disposed at the proximal end portion of the treatment instrument insertion channel.
- the forceps plug 32 is disposed at the proximal end portion of the insertion portion 22.
- a distal end portion of a bending operation wire (not shown) is connected to the bending portion 28.
- the base end portion of the bending operation wire is connected to a bending operation knob 36 described later of the operation unit 24 through the flexible tube portion 26.
- the operation section 24 is a switch such as a bending operation knob 36 for bending the bending section 28 of the insertion section 22 or an air supply / water supply switch for supplying air or water from the distal end portion of the insertion section 22.
- Class 38 is provided.
- One end of a universal cable 40 is attached to the operation unit 24.
- This A controller 42 is disposed at the other end of the universal cable 40.
- the controller 42 has a built-in light source that supplies light toward the illumination optical system provided in the distal end rigid portion 30 of the insertion portion 22, and an objective disposed in the distal end rigid portion 30 of the insertion portion 22. An optical image captured by the optical system is acquired.
- the biological tissue collection device 14 includes a flexible hollow conduit 52 and a collection portion 54 that is formed at the distal end of the conduit 52 and collects biological tissue. And a suction mechanism (suction part) 56 disposed at the base end part of the pipe line 52.
- the suction mechanism 56 includes a barrel (suction cavity) 62 serving as an outer cylinder and a plunger 64 serving as an inner cylinder.
- the outer peripheral surface of the tip end portion of the plunger 64 is formed so as to be in close contact with the inner peripheral surface of the barrel 62.
- the distal end of the barrel 62 is connected to the proximal end portion of the pipe line 52.
- the inside of each of the conduit 52 and the barrel 62 is in communication. For this reason, the plunger 64 is pushed into the barrel 62. Force When the plunger 64 is pulled toward the barrel 62, the air in the pipe 52 is drawn into the barrel 62 (suction cavity). .
- the collection part 54 is formed as a hollow puncture needle.
- the tissue is collected, or the body cavity is punctured to remove exfoliated tissue in body cavity fluid (for example, peritoneal fluid, thoracic fluid, spleen fluid, bile fluid, etc.) It is preferably used when collecting cells.
- body cavity fluid for example, peritoneal fluid, thoracic fluid, spleen fluid, bile fluid, etc.
- the pipe 52 and the sampling part 54 are formed substantially integrally. That is, there is no clear boundary between the pipeline 52 and the sampling part 54. At this time, the combined length of the pipe 52 and the sampling part 54 is sufficiently longer than the length of the treatment instrument penetration channel.
- the outer diameter of the sampling part 54 is, for example, 0.7 mm (corresponding to the injection needle standard 22G).
- the maximum inner diameters of the sampling part 54 and the pipe 52 are both 0.3 mm.
- the material used for the sampling part 54 and the pipe line 52 but since it is inserted into the living body, it must be resistant to corrosion. For example, it is preferable to use a stainless steel material, a corrosion-resistant grease material, or the like. It is particularly preferable to use a stainless steel material.
- the pipe 52 only needs to have one or more on the inner wall portion thereof, but preferably has a large number of convex portions 70 at random positions.
- the length of the tubular body including the pipe line 52 and the sampling part 54 is, for example, 1550 mm. Forty-eight are formed.
- the number of such convex portions 70 changes as appropriate depending on the length of the conduit 52 and the shape of the convex portion 70 itself and the degree of protrusion.
- These convex portions 70 have, for example, a substantially hemispherical shape formed when a substantially spherical shape or a substantially saddle shape is cut along an appropriate plane.
- the height of the convex portion 70 is, for example, about 0.15 mm with respect to the inner wall surface, the major axis of the convex portion 70 is about 0.5 mm, and the minor axis is about 0.2 mm. preferable.
- the convex part 70 is provided at random and the shape of each convex part 70 is non-uniform
- the shape of the convex portion 70 is not limited to such a shape, and has a shape that does not block the conduit 52, and is formed so that the tissue can be crushed when passing through the living tissue. Good.
- the distal rigid portion 30 of the insertion portion 22 of the endoscope 12 is inserted to the vicinity of the site where the biological tissue in the body cavity is to be collected. At this time, the entire endoscope 12 is rotated about the axis of the insertion portion 22 to rotate the insertion portion 22 or the bending operation knob 36 of the operation portion 24 of the endoscope 12 is operated to operate the insertion portion 22. The bending portion 28 is bent. In this way, the optical image of the biological tissue to be collected is taken into the objective optical system of the distal end hard portion 30 of the insertion portion 22. Therefore, an optical image of a desired living tissue is observed by the operator through the controller 42.
- the biological tissue collection device 14 is introduced from the forceps plug 32 provided at the proximal end portion of the insertion portion 22 through the treatment instrument penetration channel.
- an appropriate portion of the conduit 52 of the biological tissue collection device 14 is locked at the distal end portion of the treatment instrument penetration channel using a forceps raising base.
- the insertion section 22 of the endoscope 12 is moved by force toward the living tissue, and the sampling section 54 is punctured into the living tissue.
- the collection portion 54 is moved forward and backward with respect to the treatment instrument penetration channel. Penetrated into living tissue You can sting. In this case, the locking by the forceps raising base is released.
- the plunger 64 of the suction mechanism 56 is pulled toward the proximal side with respect to the barrel 62 in a state where the collection unit 54 is punctured into the living tissue. Then, the living tissue is aspirated through the lumen of the puncture needle of the collection unit 54 and the lumen of the duct 52. The biological tissue collected at this time is crushed by colliding with the convex portion 70 provided on the inner wall surface of the conduit 52 many times when moving from the distal end of the conduit 52 toward the proximal end. . The biological tissue is decomposed to the cellular level by colliding with the convex part 70 many times. The decomposed biological tissue is held in the lumen of the conduit 52 and the lumen (suction cavity) of the barrel 62 of the suction mechanism 56.
- the biological tissue collecting instrument 14 is pulled out together with the insertion portion 22 of the endoscope 12, and the biological tissue force is also extracted. For this reason, the state where the collection part 54 of the biological tissue collection device 14 is punctured into the biological tissue is released.
- the insertion portion 22 of the endoscope 12 is held so as not to move, the state in which the conduit 52 of the biological tissue collection device 14 is released by the forceps raising base is released, and the treatment instrument penetration channel is released.
- the biological tissue collection device 14 may be advanced or retracted. Then, the state where the collection part 54 of the biological tissue collection device 14 is punctured into the biological tissue is released.
- the biological tissue collection device 14 is pulled out from the treatment instrument through channel catheter. .
- the dissected biological tissue is taken out from the biological tissue collecting device 14 and transported, and pathological diagnosis and other tests such as biochemical analysis and genome analysis are performed.
- the sampling part 54 is provided with forceps 54a. Is suitable.
- the forceps 54 a includes a fixed jaw 74 and a movable jaw 76 that are integrally formed at the distal end of the duct 52.
- the movable jaw 76 is pivotally supported by a pivot pin 78 with respect to the fixed jaw 74 so as to be opened and closed.
- the movable jaw 76 is provided with a support portion 82 to which the tip end portion of the jaw opening / closing wire 80 is fixed.
- the open / close wire 80 is inserted in a cylindrical body 52 a formed outside the pipe 52 along the axial direction of the pipe 52.
- the base end portion of the open / close wire 80 is disposed in a wire advance / retreat mechanism (open / close mechanism) (not shown).
- This wire advance / retreat mechanism is provided in parallel with the suction mechanism 56. For this reason, when the open / close wire 80 moves to the distal end side of the pipe line 52 by the wire advance / retreat mechanism, the movable jaw 76 opens with respect to the fixed jaw 74. On the contrary, when it moves to the base end side of the conduit 52, the movable jaw 76 is closed with respect to the fixed jaw 74.
- the forceps 54a of the collection unit 54 of the biological tissue collection device 14 is disposed in the vicinity of the desired biological tissue 84 through the treatment instrument penetration channel of the endoscope 12.
- the movable jaw 76 is opened with respect to the fixed jaw 74 of the forceps 54a by operating the wire advance / retreat mechanism. In this state, the tip of the forceps 54a is pressed against the living tissue.
- the movable jaw 76 is closed with respect to the fixed jaw 74 of the forceps 54a by operating the wire advance / retreat mechanism. Then, the living tissue 84 sandwiched between the edge 76a of the movable jaw 76 and the edge of the fixed jaw 74 is cut. The cut biological tissue 84a is taken into the forceps 54a.
- the suction mechanism 56 is operated to suck the living tissue. Then, the sucked biological tissue collides with the convex portion 70 inside the pipe line 52 many times and is crushed, and finally is broken down to the cell level.
- the force-open type described for the single-opening type forceps 54a in which the movable jaw 76 can be opened and closed with respect to the fixed jaw 74 may be used.
- the blade portion 76a is allowed to have various shapes such as a jagged shape.
- the collection unit 54 is a forceps with a needle having a shape in which a forceps and a puncture needle are combined. In this case, a desired biological tissue is collected by forceps while the puncture needle is punctured into the biological tissue.
- FIG. 6 shows a biological tissue collection device 14 for collecting a biological tissue percutaneously without using the endoscope 12 shown in FIG.
- the biological tissue collection device 14 includes a hard conduit 52, a collection portion 54 provided at the distal end of the conduit 52, and a suction mechanism 56 provided at the proximal end of the conduit 52. .
- the collection part 54 is formed as a hollow puncture needle.
- the pipe 52 and the sampling part 54 are formed integrally.
- the outer diameter of the sampling part 54 is, for example, 0.7 mm (corresponding to the injection needle standard 22G).
- the maximum inner diameters of the sampling part 54 and the pipe line 52 are both 0.3 mm.
- the material used for the sampling section 54 and the pipe line 52 but for example, it is preferable to use a stainless steel material, a corrosion-resistant grease material, or the like. It is particularly preferable to use a stainless steel material.
- the length of the hollow tubular body in which the sampling section 54 is formed at the distal end of the conduit 52 is, for example, 80 mm. That is, the combined length of the tubular body 52 and the sampling portion 54 of this embodiment is sufficiently shorter than the length of the tubular body described in the first embodiment.
- convex portions 70 are formed unevenly.
- the shape of the convex portion 70 is the same as that described in the first embodiment, for example.
- the collection part 54 of the biological tissue collection device 14 is punctured percutaneously into the living body.
- the plunger 64 is pulled toward the hand side with respect to the barrel 62 of the suction mechanism 56.
- the living tissue is aspirated through the lumen of the puncture needle of the collection unit 54 and the lumen of the duct 52.
- the tissue collected at this time collides with the convex portion 70 provided on the inner wall surface of the duct 52 many times and is crushed. By colliding multiple times, biological tissue is degraded to the cellular level.
- the decomposed biological tissue is held in the lumen of the conduit 52 and the lumen of the barrel 62 of the suction mechanism 56.
- the biological tissue force is also extracted from the collection part 54 of the biological tissue collection device 14.
- the biological tissue decomposed by suction is taken out from the biological tissue collection device 14 and subjected to examination such as pathological diagnosis, biochemical analysis, genome analysis, and the like.
- the convex portion 70 collides with the convex portions 70 many times during the suction of the biological tissue, and is finally broken down to the cellular level. The For this reason, it is possible to save time and labor for crushing the biological tissue before the nuclear acid extraction process when performing examinations such as pathological diagnosis, biochemical analysis, and genomic analysis. As described above, even when the living tissue is collected percutaneously without using the endoscope 12 (see FIG. 1), the same effect as that of the first embodiment can be obtained.
- a hollow collection tube in place of the hollow puncture needle in the collection unit 54.
- the shape of this collection tube is the same as that of the collection unit 54 shown in FIGS. 3 and 6, for example.
- the outer diameter of the sampling tube is not particularly limited, but usually the outer diameter is about 1 mm to 10 mm and the inner diameter is about 0.5 mm to 8 mm.
- the material of the sampling tube is preferably soft plastics or rubbers. When such a collection tube is used, it is used by inserting it into a conduit (for example, knee tube, bile duct, etc.) in a living body.
- the secretory fluid is collected from the in vivo conduit, and the secretory fluid peeled tissue and cells are separated by a filter (not shown), and the subsequent examination can be performed.
- the biological tissue collection device 14 having the collection tube 54 in the collection portion 54 described in the example in which the endoscope 12 is not used is inserted through the treatment instrument insertion channel of the endoscope 12. It is also suitable to use by inserting into a conduit in a living body.
- This embodiment is a modification of the biological tissue collection device 14 according to the first and second embodiments, and is the same as the members described in the first and second embodiments.
- a reference numeral is attached and a detailed description is omitted.
- the conduit 52 has flexibility that is longer than the length of the insertion portion 22 of the endoscope 12, it can be used as the endoscope system 10 together with the endoscope 12. If 52 is formed to be rigid, the biological tissue collection device 14 can be used percutaneously alone. The same applies to the fourth to eleventh embodiments below.
- a stable drug (preservation solution) 88 that prevents, for example, RNA degradation is provided in the barrel 62 of the suction mechanism 56 of the biological tissue collection device 14 according to this embodiment. It is accumulated. The biological tissue sucked and decomposed by the biological tissue collection device 14 is mixed with the stabilizing agent 88 inside the barrel 62. For this reason, the decomposed biological tissue is kept stable.
- the collected biological tissue can be crushed on site to be broken down to the cell level, and the cells can be stabilized with the Stabilizer 88. Can be omitted.
- This embodiment is a modification of the biological tissue collection device 14 according to the first to third embodiments.
- a container 90 is disposed between the proximal end portion of the conduit 52 and the barrel 62 of the suction mechanism 56.
- the container 90 includes connector portions 92a and 92b connected to the proximal end portion of the conduit 52 and the barrel 62 of the suction mechanism 56.
- the container 90 may contain only air, or may contain, for example, a stable drug (preservation solution) 88 that prevents RNA degradation.
- the biological tissue sucked and decomposed by the suction mechanism 56 is stored in the container 90. After completion of the suction, the connection state between the pipe 52 and the suction mechanism 56 and the connector portions 92a and 92b of the container 90 is released, and the connector portions 92a and 92b of the container 90 are plugged and transported.
- the container 90 can be easily transported. That is, the decomposed biological tissue can be easily transported. Further, since the container 90 is separable, the decomposed biological tissue can be easily taken out from the container 90.
- FIG. 9A a valve mechanism (flow channel switching) is provided at the proximal end portion of the conduit 52.
- Valve) 102 is provided.
- This valve mechanism 102 communicates the conduit 52 and the barrel 62 to block the communication state capable of sucking the biological tissue and the communication state between the conduit 52 and the barrel 62, thereby blocking the suction of the biological tissue.
- An open / close knob 104 that can be switched to a shut-off state is provided.
- the valve mechanism 102 includes a housing 108 having a flow path 106 that communicates with the barrel 62 when the valve mechanism 102 is in a shut-off state.
- a container 110 is detachably attached to the housing 108.
- the housing 108 is formed with a pressure release port 112 communicating with the inner cavity of the container 110 in a state where the container 110 is mounted.
- the open / close knob 104 of the valve mechanism 102 is operated to bring it into communication. In this state, the living tissue is sucked. At this time, the sucked living tissue is stored in the lumen of the barrel 62.
- the open / close knob 104 of the valve mechanism 102 is operated to switch to the shut-off state.
- the plunger 64 is pushed into the barrel 62. Therefore, the living tissue stored in the lumen of the barrel 62 is discharged from the barrel 62.
- the living tissue is discharged into the container 110 through the flow path 106 of the valve mechanism 102 communicating with the barrel 62 and is stored in the container 110. Therefore, the biological tissue decomposed to the cellular level is stored in the lumen of the container 110.
- the pressure in the container 110 is prevented from being increased by the pressure release port 112 to the outside.
- the container 110 is removed from the housing 108 of the valve mechanism 102.
- the container 110 is covered with a lid (not shown) and transported for examination such as pathological diagnosis, biochemical analysis, and genomic analysis.
- the decomposed biological tissue can be easily taken out into the container 110.
- the container 110 can be easily transported.
- This embodiment is a modification of the biological tissue collection device 14 according to the fifth embodiment.
- the valve mechanism 102 includes a first slide housing 114a.
- the first slide housing 114a is provided with a cartridge mechanism (flow path switching mechanism) 116.
- the cartridge mechanism 116 has a first to third communication passages 118a, 118b, and 118c that can selectively communicate with the flow path 106 by sliding with respect to the first slide housing 114a.
- the slide housing 114b is provided. That is, the second slide housing 114b is slidable with respect to the first slide housing 114a. Noh.
- the containers 110a, 110b, and 110c can be attached to and detached from the communication passages 118a, 118b, and 118c, respectively.
- the second slide housing 114b of the cartridge mechanism 116 is slidably attached to the first slide housing 114a of the valve mechanism 102.
- the first slide and third communication passages 118a, 118b, 118c of the second slide knowing 114b are mounted with the containers 110a, 110b, 110c, respectively.
- the open / close knob 104 of the valve mechanism 102 is operated to bring it into a communicating state.
- the collection part 54 is punctured into the living tissue, and the living tissue is sucked into the lumen of the barrel 62 using the suction mechanism 56.
- the second slide housing 114b of the cartridge mechanism 116 is slid with respect to the first slide housing 114a of the valve mechanism 102 so that the flow path 106 and the first communication path 118a are in communication with each other. Keep it.
- the open / close knob 104 of the valve mechanism 102 is operated to switch to the shut-off state.
- the biological tissue stored in the lumen of the barrel 62 is discharged by the plunger 64.
- the biological tissue is discharged to the container 110a by the barrel 62 force through the flow path 106 of the valve mechanism 102 and the first communication path 118a of the cartridge mechanism 116, and is stored in the container 110a.
- all of the biological tissue stored in the barrel 62 is preferably stored in the container 110a through the first communication path 118a.
- the collection section 54 is punctured again with respect to the living tissue.
- the open / close knob 104 of the valve mechanism 102 is operated to switch to the communication state.
- the living tissue is sucked up to the barrel 62 using the suction mechanism 56. Remove the sampling part 54 from the living tissue.
- the second slide know 114b of the cartridge mechanism 116 is slid with respect to the first slide housing 114a of the valve mechanism 102, so that the flow path 106 and the second communication path 118b communicate with each other. Operate the open / close knob 104 to switch to the shut-off state. In this state, the plunger 64 is pressed against the barrel 62. The biological tissue is discharged from the barrel 62 to the container 110b through the flow path 106 of the valve mechanism 102 and the second communication path 118b of the cartridge mechanism 116, and is stored in the container 110b. At this time, a part of the living tissue is left in the barrel 62.
- the second slide know 114b of the cartridge mechanism 116 is slid with respect to the first slide housing 114a of the valve mechanism 102, and the flow path 106 and the third communication path 118c are brought into communication with each other.
- the plunger 64 is further pressed against the barrel 62.
- the biological tissue is discharged from the barrel 62 to the container 110c through the flow path 106 of the valve mechanism 102 and the third communication path 118c of the cartridge mechanism 116, and the biological tissue is stored in the container 110c.
- the containers 110a, 110b, and 110c are transported with lids (not shown).
- the biological tissue stored in the containers 110b and 110c is obtained by collecting the same site force.
- the biological tissue once stored in the barrel 62 of the suction mechanism 56 can be dispensed into a plurality of containers 110b and 110c. Therefore, contamination during dispensing can be prevented, and more accurate analysis can be performed.
- the biological tissue can be continuously stored in different containers 110a, 110b, 110c for every collection of biological tissue from different locations.
- the biological tissue once stored in the suction mechanism 56 can be dispensed into the plurality of containers 110a, 110b, 110c. For this reason, contamination when dispensing from inside the containers 110a, 110b, 110c can be prevented. Therefore, more accurate analysis can be performed when analyzing living tissue.
- the second slide housing 114b of the cartridge mechanism 116 is slid with respect to the first slide know 114a of the valve mechanism 102. There may be. Also formed on the second slide housing 114b The number of communication paths is not limited to three, but can be changed appropriately depending on the type of biological tissue analysis.
- This embodiment is a modification of the biological tissue collection device 14 according to the first embodiment.
- a filter 122 that captures a part of the living tissue is disposed in the lumen of the barrel 62 of the suction mechanism 56 when the living tissue is sucked.
- This filter 122 is provided with a biological tissue affinity compound on the surface of the conduit 52 side.
- a biological tissue affinity compound here, for example, a cancer cell capture antibody that is an antibody specific to cancer cells is used. In other words, the cancer cell capture antibody is immobilized on the filter 122.
- the filter 122 is removed from the lumen of the barrel 62. At this time, since only the cancer cells are captured by the filter 122, only the cancer cells can be easily taken out.
- the filter 122 is provided in the barrel 62 of the suction mechanism 56, but the filter 122 may be provided in the conduit 52.
- This embodiment is a modification of the biological tissue collection device 14 according to the fifth to seventh embodiments.
- a filter 122 that captures a part of the biological tissue when the biological tissue is aspirated is disposed so as to block the flow path 106. Yes.
- the open / close knob 104 of the valve mechanism 102 is switched to the shut-off state, and the container 11 The living tissue is discharged to 0. At that time, only the cancer cells are captured by the filter 122, and other biological tissues are stored in the container 110.
- the housing of the valve mechanism 102 Remove filter 122 from group 108. At this time, since only the cancer cells are captured by the filter 122, only the cancer cells can be taken out.
- This embodiment is a modification of the biological tissue collection device 14 according to the seventh and eighth embodiments.
- a magnetic bead 126 having, for example, an antibody specific to a cancer cell is disposed on the inner wall portion of the barrel 62 of the suction mechanism 56.
- a permanent magnet 128 is disposed outside the barrel 62 and outside the magnetic beads 126.
- the cancer cells specifically bind to the magnetic beads 126.
- the magnetic beads 126 to which the cancer cells are bound are collected at a certain place by the magnet 128. For this reason, only cancer cells can be taken out.
- a force electromagnet described using the permanent magnet 128 may be used.
- a magnetic field can be generated by energization, it is easier to use.
- the magnetic beads 126 and the magnet 128 are provided in the flow path 106 of the valve mechanism 102 described in the fourth to sixth and eighth embodiments, the container 110, and the like. It is preferable that they are arranged.
- This embodiment is a modification of the biological tissue collection device 14 according to the first embodiment.
- a cooling mechanism 130 is attached to the outside of the barrel 62 of the suction mechanism 56.
- a controller 134 is connected to the cooling mechanism 130 via a cable 132.
- the cooling method of the cooling mechanism 130 is not limited, for example, a cooling method using an electronic device such as a Peltier element is preferable because it is small.
- the biological tissue collected in the lumen of the barrel 62 at the time of suction by the suction mechanism 56 is frozen, for example, by the cooling mechanism 130 whose temperature is controlled by the controller 134.
- the ability to collect biological tissue can be disrupted to the cell level on the spot and stabilized as it is by freezing, etc., thereby preventing cell degradation and further eliminating the need for tissue disruption before nucleic acid extraction treatment.
- the force described for mounting the cooling mechanism 130 on the outside of the barrel 62 of the suction mechanism 56 for example, the fourth, sixth, and eighth embodiments.
- FIGS. 15A and 15B This embodiment is a modification of the first embodiment.
- the convex portion 71 of the conduit 52 is formed continuously. For this reason, the convex portion 71 is formed so as to produce, for example, a female screw.
- the conduit 52 includes a squeezed convex portion 72a and a concave portion 72b that has not been squeezed against the convex portion 72a. For this reason, the inner diameter of the pipe 52 is continuously changed. Note that the height of the convex portion 72a can be made uniform or non-uniform by changing the compressed state. For this reason, it is easy to mold the convex portion 72a into a random size at a random position.
- the collected biological tissue can be easily and quickly crushed, and the preparation time for performing a pathological examination, biochemical analysis, genomic analysis, etc., for example, can be shortened.
- An endoscope system and a biological tissue collection method can be provided.
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Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP05780232A EP1792574A1 (en) | 2004-09-14 | 2005-08-15 | Instrument for collecting vital tissue, endoscope system and method of collecting vital tissue |
JP2006535088A JPWO2006030596A1 (ja) | 2004-09-14 | 2005-08-15 | 生体組織採取器具、内視鏡システムおよび生体組織採取方法 |
US11/717,528 US20070213631A1 (en) | 2004-09-14 | 2007-03-13 | Living-tissue sampling instrument, endoscope system and method of sampling living tissues |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2004-267073 | 2004-09-14 | ||
JP2004267073 | 2004-09-14 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/717,528 Continuation US20070213631A1 (en) | 2004-09-14 | 2007-03-13 | Living-tissue sampling instrument, endoscope system and method of sampling living tissues |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2006030596A1 true WO2006030596A1 (ja) | 2006-03-23 |
Family
ID=36059854
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2005/014928 WO2006030596A1 (ja) | 2004-09-14 | 2005-08-15 | 生体組織採取器具、内視鏡システムおよび生体組織採取方法 |
Country Status (6)
Country | Link |
---|---|
US (1) | US20070213631A1 (ja) |
EP (1) | EP1792574A1 (ja) |
JP (1) | JPWO2006030596A1 (ja) |
KR (1) | KR100852841B1 (ja) |
CN (1) | CN101018507A (ja) |
WO (1) | WO2006030596A1 (ja) |
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JP2009011419A (ja) * | 2007-07-02 | 2009-01-22 | Hoya Corp | 内視鏡用体液採取カテーテル及び体液採取内視鏡システム |
JPWO2007020680A1 (ja) * | 2005-08-12 | 2009-02-19 | オリンパス株式会社 | 内視鏡用処置具と生体組織解析処理システムと組織解析処理用のサンプル採取方法 |
JP5836541B2 (ja) * | 2013-11-18 | 2015-12-24 | オリンパス株式会社 | 体液採取用デバイスおよび内視鏡システム |
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CN105615928B (zh) * | 2014-10-27 | 2019-01-15 | 中国人民解放军第二军医大学 | 一种针头 |
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CN113545832A (zh) * | 2021-09-18 | 2021-10-26 | 中山市瑞隆医疗科技有限公司 | 一种穿刺器 |
CN116898496B (zh) * | 2023-09-13 | 2023-11-17 | 湖南省华芯医疗器械有限公司 | 一种收样器和内窥镜 |
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- 2005-08-15 WO PCT/JP2005/014928 patent/WO2006030596A1/ja active Application Filing
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Also Published As
Publication number | Publication date |
---|---|
CN101018507A (zh) | 2007-08-15 |
KR100852841B1 (ko) | 2008-08-18 |
EP1792574A1 (en) | 2007-06-06 |
JPWO2006030596A1 (ja) | 2008-05-08 |
KR20070041784A (ko) | 2007-04-19 |
US20070213631A1 (en) | 2007-09-13 |
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