WO2014007380A1 - Aiguille pour biopsie et appareil endoscopique utilisant ladite aiguille pour biopsie - Google Patents

Aiguille pour biopsie et appareil endoscopique utilisant ladite aiguille pour biopsie Download PDF

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Publication number
WO2014007380A1
WO2014007380A1 PCT/JP2013/068544 JP2013068544W WO2014007380A1 WO 2014007380 A1 WO2014007380 A1 WO 2014007380A1 JP 2013068544 W JP2013068544 W JP 2013068544W WO 2014007380 A1 WO2014007380 A1 WO 2014007380A1
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WIPO (PCT)
Prior art keywords
needle
wire
biopsy
biopsy needle
hollow
Prior art date
Application number
PCT/JP2013/068544
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English (en)
Japanese (ja)
Inventor
賢 植木
松本　和也
Original Assignee
国立大学法人鳥取大学
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Application filed by 国立大学法人鳥取大学 filed Critical 国立大学法人鳥取大学
Priority to JP2014523809A priority Critical patent/JP6183858B2/ja
Publication of WO2014007380A1 publication Critical patent/WO2014007380A1/fr

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    • 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
    • A61B10/0233—Pointed or sharp biopsy 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
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A61B10/0266—Pointed or sharp biopsy instruments means for severing sample
    • A61B10/0275—Pointed or sharp biopsy instruments means for severing sample with sample notch, e.g. on the side of inner stylet
    • 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
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A61B10/0283—Pointed or sharp biopsy instruments with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving 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
    • A61B10/04—Endoscopic instruments
    • A61B2010/045—Needles

Definitions

  • the present invention relates to a biopsy needle used for collecting a part of a living tissue and an endoscope apparatus using the biopsy needle.
  • a biopsy in which a part of a tissue to be diagnosed is taken as a specimen and examined, is particularly important in the diagnosis of a malignant tumor.
  • Various methods of sampling can be considered even if it is called a biopsy, but sampling is performed using a hollow needle called a “biopsy needle” for screening or definitive diagnosis of visceral tissue lesions.
  • a “needle biopsy” is commonly performed.
  • needle biopsy is generally performed percutaneously, but recently, needle biopsy is performed under endoscopic observation (also called “endoscopic biopsy”). It is coming.
  • Biopsy needles used for needle biopsy are broadly classified into those for collecting a sample by suction and those having a mechanism for cutting and collecting a tissue, depending on the sample collection mechanism.
  • the former is called aspiration biopsy or fine-needle aspiration biopsy, and the latter is called a core needle biopsy.
  • FIG. 10A is a cross-sectional view of a biopsy needle described in Patent Document 1 below
  • FIG. 10B is a cross-sectional view taken along line XB-XB in FIG. 10A
  • FIG. 10C is a tissue view of the biopsy needle of FIG.
  • FIG. 10D is a diagram showing a state in which tissue is collected in a biopsy needle.
  • a vine-cut biopsy needle 50 described in Patent Document 1 below includes an inner needle 52 in which a notch 51 is formed at the tip, and the inner needle 52 is inserted. And a hollow outer needle 53.
  • the tip of the inner needle 52 is punctured into the tissue 54, and then the outer needle 53 is pushed forward to move the inner needle.
  • the specimen 55 is collected by cutting the tissue 54 and placing the tissue 54 in the notch 53 of the inner needle 52 by covering the specimen 52.
  • an automatic biopsy needle in which a small instrument with a built-in spring is combined with this vine-cut type biopsy needle has become widespread.
  • FIG. 11A is a cross-sectional view of a conventional Menghini-type biopsy needle
  • FIG. 11B is a view showing a state where the biopsy needle is punctured into a tissue
  • FIG. 11C is a view showing a state of a sample in the biopsy needle.
  • the Menghini-type biopsy needle 60 is punctured into the tissue 63 with the distal end of the inner needle 61 positioned on the distal end side of the hollow outer needle 62 as shown in FIG. 11A.
  • the inner needle 61 is moved backward relative to the outer needle 62 to create a space in the outer needle 62, and then the inside of the outer needle 62 is brought to a negative pressure by connecting the syringe to the proximal end and pulling the syringe.
  • the specimen 64 is taken into the outer needle 62 as shown in FIG. 11C by further moving the outer needle 62 forward.
  • TSURU-CUT type biopsy needle has a mechanism for cutting tissue as described above, and can reliably collect a sample.
  • the thickness of the tissue piece that can be collected with respect to the outer diameter of the needle is thinner than the tissue piece obtained by the Menghini biopsy needle, when trying to obtain a specimen of the same size as the Menghini biopsy needle Has to use a thicker needle compared to a Menghini-type biopsy needle, which is highly invasive and increases the risk of complications such as bleeding.
  • the Menghini type biopsy needle can reduce the patient's burden because the outer diameter can be made thinner than the vine cut type biopsy needle, and when using an invasive needle similar to the vine cut type, Thicker specimens can be collected.
  • the target tissue is relatively hard, it is difficult to cut the tissue only by the negative pressure by suction. Therefore, in an actual procedure, as shown in FIG. 11B, the specimen 64 is often collected by adding a twist 65 to the outer needle 62 and cutting a deep portion of the tissue 63.
  • a wire-like member provided to be tensionable in the radial direction of the outer needle on the distal end side of the outer needle is in a state in which the wire-like member is tensioned by pulling from the outside of the outer needle,
  • a biopsy needle is described in which a wire-like member can be rotated together with the outer needle by twisting the outer needle.
  • the Menghini-type biopsy needle does not have a function for reliably cutting the tissue as described above, so it is difficult to apply when the tissue is hard, and even if an attempt is made to sample by adding a twist. As long as it is a mechanism for suction by negative pressure, there is a problem that the tissue tends to be separated.
  • the length from the operation unit to the distal end is long and may be as long as 1 m or longer, so the length of the biopsy needle is also increased in proportion to the length. Become. When such a long biopsy needle is twisted on the operation unit side, the twisting force is hardly transmitted to the tip.
  • An object of the present invention is to provide a biopsy needle capable of reliably collecting tissue without being divided and an endoscope apparatus using the biopsy needle.
  • the biopsy needle of the present invention comprises: A biopsy needle that includes a hollow needle portion having an injection needle-shaped opening at the tip, punctures into a living tissue, takes a part of the tissue into the hollow needle portion, and collects the tissue.
  • Cutting means for cutting the tissue located in the opening portion of the injection needle shape is provided on the distal end side of the hollow needle portion, The cutting means is characterized in that a cutting operation can be performed from the rear end side of the hollow needle portion by pulling a wire passed through the inside or outside of the hollow needle portion.
  • the cutting means is operated by pulling the wire to thereby open the injection needle-shaped opening portion.
  • the deep part of the tissue located in can be cut. Therefore, according to the biopsy needle of the present invention, the sample collected in the hollow needle portion is less likely to be divided, and the sample can be reliably collected in the hollow needle portion with a large size. .
  • the sample collected in the hollow needle part is in an undivided state, it is easier not only to determine whether there are cancer cells but also to determine more precisely how much cancer has infiltrated. In addition, it becomes easy to accurately determine the nature of the cancer.
  • the cutting means can be easily and reliably operated by operating the wire.
  • the deep part of the tissue located in the part can be easily cut.
  • an ultra-fine nylon thread having a thickness of about 0.1 mm, Teggs, stainless steel, titanium or carbon fiber, etc.can be appropriately selected and used.
  • At least one through-hole penetrating the hollow needle wall is provided on the rear end side of the injection needle-shaped opening, and the wire has an end on one side.
  • the through-hole and the injection needle-shaped opening are passed through and fixed to the hollow needle portion, and a portion extending from the one end portion extends along the injection needle-shaped opening wall. It is fixed on the opening wall in a loop shape by an easily peelable adhesive, and the other end passes through the hollow needle part so as to extend beyond the rear end of the hollow needle part.
  • the wire can also serve as the cutting means.
  • the wire when the other end of the wire is pulled after the biopsy needle is punctured into the target tissue and the tissue is introduced into the hollow needle, the wire extends from one end of the wire.
  • the portions are sequentially peeled from the injection needle-shaped opening wall and pulled into the hollow needle portion along the injection needle-shaped opening wall. During this time, since the deep part of the tissue located in the injection needle-shaped opening is cut by the wire itself, the deep part of the tissue located in the injection needle-shaped opening can be cut.
  • the easily peelable adhesive in the present invention means that the wire is not peeled off due to resistance during puncture of the biopsy needle of the present invention into the tissue, and the wire is injected when the wire is pulled from the other end.
  • an adhesive or pressure-sensitive adhesive having an adhesive strength enough to be peeled off from the needle-shaped opening wall and has a good biocompatibility, such as water glue, polyvinyl alcohol, polyvinyl pyrrolidone, etc. Good.
  • first and second through holes penetrating the hollow needle wall are provided on the rear end side of the injection needle-shaped opening, The end portion on the side is fixed to the hollow needle portion through the first and second through holes, and the portion extending from the one end portion is formed on the injection needle-shaped opening wall Along the opening wall and fixed in a loop shape by an easily peelable adhesive, and the other end extends beyond the rear end of the hollow needle through the inside of the hollow needle. It is good also as what is penetrated so that the said wire may serve as the above-mentioned cutting means.
  • the wire has one end bonded and fixed to the hollow needle, and a portion extending from the one end has the shape of the injection needle. Is fixed in a loop shape on the opening wall along the opening wall by an easily peelable adhesive, and the other end portion passes through the inside of the hollow needle portion from the rear end of the hollow needle portion. It is good also as what is penetrated so that it may extend, and the said wire may serve as the above-mentioned cutting means. With such a configuration, a biopsy needle that exhibits the above effects can be easily produced.
  • the wall of the injection needle-shaped opening is formed with a hook-like portion made of a groove formed in a substantially J shape in an arc shape along the wall, and the wire
  • the one end portion is bonded and fixed to the hollow needle portion, the portion extending from the one end portion extends along the injection needle-shaped opening wall, and the hook-shaped portion is It is fixed in a loop on the opening wall, and the other end is inserted so as to extend beyond the rear end of the hollow needle through the hollow needle.
  • the wire may also serve as the cutting means.
  • the hook-shaped portion is formed of a synthetic resin.
  • the substantially J-shaped angle may be changed depending on the presence or absence of the inner needle inserted into the injection needle-shaped opening.
  • the synthetic resin, silicon resin, etc. which are used for the normal medical device can be selected suitably, and can be used.
  • a pair of openings are formed in the walls on both side ends of the injection needle-shaped opening, and the cutting means is made of a wire processed into a C-shape,
  • the C-shaped end portions are rotatably fitted in the pair of openings, and at least one through hole is provided on the distal end side of the injection needle-shaped opening.
  • One end is pivotally attached to the C-shaped wire rod through the at least one through hole, and the other end is outside the hollow needle. It may be arranged so as to extend from the rear end of the hollow needle portion along the.
  • the biopsy needle having such a configuration is aimed in a state in which the wire is pulled from the other end so that the C-shaped wire constituting the cutting means is not located on the opening side of the injection needle shape.
  • the tissue is punctured.
  • the wire processed into a C shape rotates toward the distal end side of the biopsy needle, so that the opening portion of the injection needle shape Since the deep part of the tissue located at the position is cut by the wire processed into a C-shape, the deep part of the tissue located at the opening part of the injection needle shape can be cut.
  • a micrometer-sized pulley may be formed in the through hole through which the wire passes so that the wire can be operated smoothly.
  • the two through holes are provided, and the wire is passed through the pair of through holes in a state in which one end portion is divided into two and separated from each other, And even if it rotates, it is good also as what is attached to the support part of the said wire processed into the said C shape in the position which does not hang on the said needle-shaped opening.
  • two through-holes are provided, and the wire is composed of two wires, and is passed through the pair of through-holes in a state of being separated from each other. It does not matter even if it is attached to the support portion of the wire processed into the C-shape at a position not overhanging.
  • the wire processed in the C shape can be rotated without adversely affecting the tissue located on the injection needle-like opening, The cutting ability of the deep part of the tissue is improved.
  • the other end of the biopsy needle is attached to the C-shaped wire, and the other end of the biopsy needle follows the outside of the hollow needle part. You may further provide the wire extended rather than an end.
  • the wire processed into a C-shape can be reciprocated, so that the deep part of the tissue can be cut at multiple locations, respectively. It becomes possible to collect tissue specimens from a plurality of locations sequentially.
  • the cross-sectional shape of the distal end side of the hollow needle portion and the opening of the injection needle shape are rectangular, and the walls on both side ends of the injection needle shape opening are respectively Grooves are formed on the opening side so as to face each other, and between the grooves, a tip end side of a foil-like plastic sheet longer than the length of the groove is slidably attached, and the injection needle At least one through-hole is provided at the front end side of the shape-shaped opening, and the wire has one end fixed to the front end side of the foil piece-shaped plastic sheet, and the other end is at least the above-mentioned It is good also as what is arrange
  • a biopsy needle having such a configuration, puncture the target tissue with the wire loosened so that the foil piece of plastic sheet constituting the cutting means is not located on the opening side of the injection needle shape. Is done.
  • the plastic sheet in the form of a foil piece slides toward the distal end side of the biopsy needle so that it is positioned at the opening portion of the injection needle shape. Since the deep part of the tissue is cut by the foil piece-shaped plastic sheet, the deep part of the tissue located in the injection needle-shaped opening can be cut.
  • the cross-sectional shape of the front end side of a hollow needle part if the front end side is made into square shape, the other part may be made circular.
  • a micrometer-sized pulley may be formed in the through hole through which the wire passes so that the wire can be operated smoothly.
  • a biopsy needle provided with such a foil piece-shaped plastic sheet
  • one end is fixed to the rear end side of the foil piece-shaped plastic sheet, and the other end is the hollow needle portion.
  • the biopsy needle of the present invention preferably includes an inner needle inserted into the hollow needle portion.
  • the biopsy needle of the present invention when a specimen of a deep tissue is collected, the inner needle is pulled out after being inserted to a predetermined depth or the hollow needle portion is pushed out from the inner needle. Only a sample of deep tissue can be collected.
  • the wire can be a thread.
  • the wire is made of a thread, it is flexible so that a portion extending from one end of the wire can be easily arranged along the injection needle-shaped opening wall, or a wire rod processed into a C-shape It can be pulled and fixed on a foil-like plastic sheet.
  • the yarn used here may be monofilament or multifilament.
  • the endoscope apparatus of the present invention is characterized by including any of the biopsy needles described above.
  • the biopsy needle of the present invention can easily cut the tissue located in the opening portion of the injection needle shape even if the length is long, the tissue at a desired position and depth can be obtained by combining with the endoscope apparatus. It becomes possible to collect the sample easily and in good condition.
  • an ultrasonic endoscope apparatus as an endoscope apparatus used in the present invention, a tissue positioned deep from the surface can be collected while confirming with an image, and therefore the biopsy needle of the present invention The said effect comes to be show
  • FIG. 1A is a plan view of the biopsy needle of Embodiment 1
  • FIG. 1B is a partial cross-sectional view of FIG. 1A
  • 2A is a partial cross-sectional view showing a state in which the biopsy needle and the inner needle of Embodiment 1 are combined
  • FIG. 2B is a partial cross-sectional view showing a state where the biopsy needle and the inner needle shown in FIG. 2C is a view showing a state in which the thread is partially pulled from the state of FIG. 2B
  • FIG. 2D is a plan view of the vicinity of the injection needle-shaped opening in the biopsy needle of FIG. 2C
  • FIG. It is a figure which shows a collection state.
  • FIG. 3A is a plan view of the biopsy needle of Embodiment 2
  • FIG. 3A is a plan view of the biopsy needle of Embodiment 2
  • FIG. 3A is a plan view of the biopsy needle of Embodiment 2
  • FIG. 3A is a plan view of the biopsy needle of
  • FIG. 3B is a partial cross-sectional view of FIG. 3A.
  • 4A is a plan view of the vicinity of the injection needle-shaped opening in the biopsy needle of the third embodiment
  • FIG. 4B is a plan view of the vicinity of the injection needle-shaped opening of the biopsy needle of the fourth embodiment.
  • 5A is a plan view of the biopsy needle of Embodiment 5
  • FIG. 5B is a side view of FIG. 5A.
  • 6A is a plan view of a biopsy needle of Embodiment 6
  • FIG. 6B is a side view
  • FIG. 6C is a side view when the cutting means is operated.
  • FIG. 7A is a plan view of the biopsy needle of Embodiment 7
  • FIG. 7C is a side view when the cutting means is operated.
  • FIG. 8A is a plan view of the biopsy needle of Embodiment 8
  • FIG. 8B is a side view when the cutting means is operated.
  • 9A is a plan view of the biopsy needle of Embodiment 9
  • FIG. 9B is a side view
  • FIG. 9C is a side view when the cutting means is operated.
  • 10A is a cross-sectional view of a conventional biopsy needle
  • FIG. 10B is a cross-sectional view taken along line XB-XB in FIG. 10A
  • FIG. 10C is a diagram showing a state in which the biopsy needle of FIG.
  • FIG. 10D is a diagram showing a state in which the tissue is collected in the biopsy needle.
  • FIG. 10A is a plan view of the biopsy needle of Embodiment 8
  • FIG. 8B is a side view when the cutting means is operated.
  • 9A is a plan view of the biopsy needle of Embodiment 9
  • FIG. 9B is a side view
  • FIG. 9C is
  • FIG. 11A is a cross-sectional view of a conventional Menghini-type biopsy needle
  • FIG. 11B is a view showing a state where the biopsy needle is punctured into a tissue
  • FIG. 11C is a view showing a state of a sample in the biopsy needle.
  • the biopsy needle of the present invention will be described in detail with reference to embodiments.
  • the following embodiment shows an example of a biopsy needle for embodying the technical idea of the present invention, and is not intended to limit the present invention to this embodiment.
  • the present invention can be equally applied to various modifications without departing from the technical idea shown in the claims.
  • FIG. 1A is a plan view of the biopsy needle of Embodiment 1
  • FIG. 1B is a partial cross-sectional view of FIG. 1A.
  • the biopsy needle 10 of Embodiment 1 is formed with an injection needle-shaped opening 12 whose end is cut obliquely at one end of a hollow cylindrical needle 11.
  • a pair of through holes 13 and 14 penetrating the peripheral wall of the hollow cylindrical needle portion 11 are formed on the rear end side of the injection needle-shaped opening 12. Then, one end portion of the thread 15 is passed through the pair of through holes 13 and 14, and the one end portion of the thread 15 is fixed.
  • Reference numeral 16 indicates a knot of the thread 15.
  • flexibility such as a nylon thread
  • the portion extending from the knot 16 of the thread 15 is fixed in a loop shape on the wall 12a along the wall 12a of the needle-shaped opening 12 by an easily peelable adhesive (not shown). Further, the other end passes through one of the pair of through-holes 13 and 14 (here, the through-hole 14 is selected) and passes through the inside of the hollow cylindrical needle portion 11 to form a hollow cylindrical shape.
  • the needle portion 11 is inserted so as to extend from the rear end of the needle portion 11 to the outside.
  • the thread 15 is led to the outside from the through hole 18 provided in front of the needle base 17 provided at the other end of the hollow cylindrical needle part 11. However, it may be led out from the needle base 17 side.
  • This thread 15 corresponds to the cutting means of the present invention.
  • any thread may be used as long as it has adhesiveness enough to peel the thread 15 from the wall 12a of the needle-shaped opening 12 and has good biocompatibility.
  • Examples thereof include water glue, polyvinyl alcohol, and polyvinylpyrrolidone. It is done.
  • FIG. 2A is a partial cross-sectional view showing a state where the biopsy needle and the inner needle of Embodiment 1 are combined
  • FIG. 2B is a partial cross-sectional view showing a state where the biopsy needle and the inner needle shown in FIG. 2A are punctured into the tissue
  • 2C is a diagram showing a state in which the thread is partially pulled from the state of FIG. 2B
  • FIG. 2D is a plan view of the vicinity of the injection needle-shaped opening in the biopsy needle of FIG. 2C
  • FIG. It is a figure which shows the collection state of a sample.
  • the inner needle 20 having no opening is inserted into the hollow cylindrical needle portion 11 of the biopsy needle 10, and the tissue is inserted into the injection needle-shaped opening 12 of the biopsy needle 10. It is assumed that it does not enter.
  • the biopsy needle 10 and the inner needle 20 are simultaneously punctured into the tissue 21 so as to be positioned in the vicinity of the target site.
  • the biopsy needle 10 is further inserted to the target site.
  • the biopsy needle 10 is further inserted to the target site.
  • the tissue 21a enters the hollow cylindrical needle portion 11 of the biopsy needle 10.
  • the side surface that is in contact with the wall of the hollow cylindrical needle part 11 of the biopsy needle 10 is cut.
  • the deep portion 21b of the tissue 21 located on the needle-shaped opening 12 side is not cut. Therefore, when the biopsy needle 10 is pulled out together with the inner needle 20 in this state, the deep portion 21b of the tissue 21 is cut due to the negative pressure inside the hollow cylindrical needle portion 11, and the hollow cylindrical needle is cut. Although it may remain in the portion 11, many of them will come out of the hollow cylindrical needle portion 11, so that the specimen recovery rate becomes low.
  • the biopsy needle 10 of the first embodiment when the state shown in FIG. 2B is reached, an operation of pulling the thread 15 to the other end side is performed. Then, as shown in FIG. 2D, the thread 15 is gradually peeled off from the wall 12a of the needle-shaped opening 12 as it is pulled toward the other end, and the diameter of the loop is reduced. The deep portion 21 b of the tissue 21 is cut along the wall 12 a of the opening 12. A plan view of the vicinity of the injection needle-shaped opening 12 portion of the biopsy needle 10 in this state is shown in FIG. 2D. When the loop is closed, the deep portion 21b of the tissue 21 located in the injection needle-shaped opening 12 is substantially completely cut.
  • the biopsy needle 10 When the biopsy needle 10 is pulled out together with the inner needle 20 in this state, since the deep portion 21b of the tissue 21 is cut, the collected specimen 22 is contained in the hollow cylindrical needle portion 11 as shown in FIG. 2D. Therefore, the collection rate of the sample 22 is increased.
  • the biopsy needle 10 is pulled out together with the inner needle 20, if the inner needle 20 is first pulled out and then a syringe is attached and suction is applied, the lumen of the needle portion 11 becomes negative pressure, so that the specimen 22 is hollow. It comes to be located in the back
  • the deep portion 21b of the tissue 21 is cut in the biopsy needle 10 of the first embodiment, the tissue is collected with a weak negative pressure compared to the conventional method. It becomes possible to do. Therefore, the probability that the tissue is divided apart is also reduced.
  • the biopsy needle 10 of Embodiment 1 may be used as it is by being connected to a known syringe as it is, or may be used in combination with an endoscope apparatus.
  • the biopsy needle 10 of Embodiment 1 is used in combination with an endoscope apparatus, the length from the operation section of the endoscope apparatus to the injection needle-shaped opening 12 portion of the biopsy needle 10 is very long. Even in such a state, when the biopsy needle 10 is punctured to a target site of the tissue and then the thread 15 is pulled from the operation portion side, the deep portion of the tissue 21 located in the injection needle-shaped opening 12 portion. 21b can be easily cut.
  • the biopsy needle 10 and the inner needle 20 are used in combination.
  • Tissue specimens can be easily collected.
  • information in the depth direction of the tissue 21 can be visualized. It becomes possible to take a sample of depth.
  • the biopsy needle 10 may be used alone without using the inner needle 20 when collecting a sample of the surface of the tissue, but in this case as well, the same effect as the suction biopsy can be obtained by using the inner needle. Therefore, the sample collection efficiency is improved.
  • FIG. 3A is a plan view of the biopsy needle of Embodiment 2
  • FIG. 3B is a partial cross-sectional view of FIG. 3A.
  • the same components as those of the biopsy needle 10 of the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
  • the biopsy needle 10A of the second embodiment is formed with an injection needle-shaped opening 12 having an end cut obliquely at one end of a hollow cylindrical needle portion 11A.
  • a through hole 13a penetrating the wall of the hollow cylindrical needle portion 11A is formed.
  • one end portion of the thread 15 is passed through the through-hole 13a and the injection needle-shaped opening 12 and tied, and the one end portion of the thread 15 is fixed.
  • Reference numeral 16 indicates a knot of the thread 15.
  • the thread 15 can be made of the same material as that of the biopsy needle 10 of the first embodiment. However, since the thread 15 crosses the sharp needle-shaped opening 12, this injection is performed.
  • the biopsy needle 10A of the second embodiment is used by puncturing the tissue to be collected without using the inner needle or using the inner needle in the same manner as the biopsy needle 10 of the first embodiment. The same effect as the biopsy needle 10 of Embodiment 1 can be obtained.
  • FIG. 4A is a plan view of the vicinity of the injection needle-shaped opening in the biopsy needle 10B of the third embodiment
  • FIG. 4B is a plan view of the vicinity of the injection needle-shaped opening of the biopsy needle 10C of the fourth embodiment.
  • the same reference numerals are given to the same components as those of the biopsy needle 10A of the second embodiment, and detailed description thereof is omitted.
  • the hollow cylindrical needle portion 11A of the biopsy needle 10B of Embodiment 3 has the same configuration as the hollow cylindrical needle portion 11A of the biopsy needle 10A of Embodiment 2. That is, an injection needle-shaped opening 12 whose end is obliquely cut is formed at one end of the biopsy needle 10B of Embodiment 3, and the rear end side of the injection needle-shaped opening 12 is formed. A through-hole 13a is formed through the wall of the hollow cylindrical needle portion 11A. The one end portion of the thread 15 is firmly fixed by an adhesive (not shown) at the bonding portion 16a on the surface of the hollow cylindrical needle portion 11A.
  • the portion of the thread 15 extending from the adhesive portion 16a is fixed in a loop on the wall 12a along the wall 12a of the needle-shaped opening 12 by an easily peelable adhesive (not shown). Furthermore, the other end passes through the pair of through holes 13a, passes through the inside of the hollow cylindrical needle portion 11A, and extends from the rear end of the hollow cylindrical needle portion 11A to the outside.
  • the thread 15 can be made of the same material as that of the biopsy needle 10 of the first embodiment.
  • the tissue to be collected is punctured without using the inner needle or the inner needle, and a predetermined amount is obtained. It can be used to collect a sample, and the same effect as the biopsy needle 10 of the first embodiment can be obtained.
  • the biopsy needle 10C of the fourth embodiment has the same configuration as that of the biopsy needle 10B of the third embodiment except that a plurality of threads, here two threads 15a and 15b are independently arranged in parallel. Yes.
  • the biopsy needle 10C according to the fourth embodiment the biopsy needle according to the first embodiment is punctured into the tissue to be collected using the inner needle or without using the inner needle, and a single thread, for example, the thread 15a is used first.
  • a predetermined sample is collected. In this state, another yarn 15b remains in the initial state.
  • the biopsy needle 10C is punctured again into the tissue to be collected at another position using the inner needle or without using the inner needle, and the next thread 15b is obtained in the same manner as in the case of the biopsy needle 10 of the first embodiment.
  • a predetermined sample is collected using.
  • the biopsy needle 10C of the fourth embodiment the deep part of the tissue can be cut at a plurality of locations, so that the tissue specimens at the plurality of locations can be sequentially collected.
  • the yarn not only two yarns but also more yarns can be used. However, since the diameter of the hollow cylindrical needle portion 11A needs to be increased, it is limited to about two to three. It is preferable.
  • Embodiments 3 and 4 an example in which the hollow cylindrical needle portion 11A is provided with the through-hole 13 is shown, but the through-hole 13a is not necessarily required.
  • the hollow cylindrical needle portion 11A having no through-hole 13a is used, the other end of the thread passes through the inside of the hollow cylindrical needle portion 11A from the injection needle-shaped opening 12.
  • the hollow cylindrical needle portion 11A may be inserted so as to extend from the rear end.
  • FIG. 5A is a plan view of the biopsy needle 10D of the fifth embodiment
  • FIG. 5B is a side view of FIG. 5A.
  • the height of the hook-like portion 12b and the arrangement state of the thread 15 are exaggerated for easy understanding of the configuration.
  • the same reference numerals are assigned to the same components as those of the biopsy needle 10 ⁇ / b> B of the third embodiment, and detailed description thereof is omitted.
  • the biopsy needle 10D of the fifth embodiment has an injection needle shape in which the end is obliquely cut at one end of the hollow cylindrical needle portion 11A.
  • An opening 12 is formed, and a through-hole 13a penetrating the wall of the hollow cylindrical needle portion 11A is formed on the rear end side of the injection needle-shaped opening 12.
  • the wall 12a of the injection needle-shaped opening 12 is formed with a hook-shaped portion 12b made of a groove formed in an arc shape along the wall 12a.
  • the hook-shaped portion 12b is formed in a substantially J-shaped groove shape so that the distal end side of the wall 12a of the injection needle-shaped opening 12 is deepest.
  • the one end of the thread 15 is firmly fixed by an adhesive (not shown) at the adhesive portion 16a on the surface of the hollow cylindrical needle portion 11A.
  • the portion of the thread 15 extending from the adhesive portion 16a is arranged in a loop along the surface of the wall 12a of the injection needle-shaped opening 12 so as to pass through the hook-shaped portion 12b.
  • the other end passes through the through hole 13a, passes through the inside of the hollow cylindrical needle portion 11A, and is inserted so as to extend from the rear end of the hollow cylindrical needle portion 11A.
  • the angle ⁇ formed between the top of the hook-shaped portion 12b and the wall 12a of the injection needle-shaped opening 12 allows the biopsy needle 10D to be sampled when the thread 15 is fixed with an appropriate tension.
  • the thread 15 is not detached from the hook-shaped portion 12b when puncturing the tissue, and the obtuse angle is such that the thread 15 is detached from the hook-shaped portion 12b when the thread 15 is pulled strongly.
  • the thread 15 may be fixed with an easily peelable adhesive as in the biopsy needle 10B of the third embodiment, and a plurality of threads 15 are arranged in parallel as in the biopsy needle 10C of the fourth embodiment. You can also also in this case, the thread 15 can be made of the same material as the biopsy needle 10B of the third embodiment and the biopsy needle 10C of the fourth embodiment.
  • the biopsy needle 10B of the third embodiment and the biopsy needle 10C of the fourth embodiment should be collected using the inner needle or without using the inner needle.
  • the tissue can be punctured and used to collect a predetermined specimen, and the same effects as the biopsy needle 10B of the third embodiment and the biopsy needle 10C of the fourth embodiment can be obtained.
  • the biopsy needle 10D of the fifth embodiment after a predetermined specimen is once collected, the biopsy needle 10D is taken out and the specimen is collected, and then the thread 15 is fixed again at a predetermined position and reused. You can also do that.
  • the hook-shaped portion 12b is made of plastic (or silicon), adhered so as to slightly exceed the inner edge of 12a, and when the inner needle is inserted, a J-shape is formed. It can also be made deeper (inverted C shape). According to this configuration, when the needle is inserted into the tissue with the inner needle attached, the thread 15 is difficult to come off, and the inner needle is always pulled out when the tissue is collected. Since the character becomes shallower and closer to the I-character, the thread becomes slippery, so that the deep part of the tissue can be easily cut and the tissue can be reliably collected.
  • FIG. 6A is a plan view of the biopsy needle of Embodiment 6
  • FIG. 6B is a side view
  • FIG. 6C is a side view when the cutting means is operated.
  • the same referential mark is provided to the same component as the biopsy needle 10 of Embodiment 1, and the detailed description is abbreviate
  • the biopsy needle 10E of Embodiment 6 has an injection needle-shaped opening 12 formed at one end of a hollow cylindrical needle portion 11B, and walls on both side ends of the injection needle-shaped opening 12 are provided.
  • a pair of apertures 11a and 11b is formed in the, and a through-hole 13a is formed at the distal end side of the needle-shaped opening 12.
  • both ends of the wire rod 15c formed in a C shape are fitted to the pair of apertures 11a and 11b so as to be freely rotatable.
  • the wire 15c formed in a C-shape is made of a metal such as stainless steel or titanium having rigidity.
  • an end portion on one side of the wire 15d is rotatably attached to the intermediate support portion 16b of the wire 15c formed in the C shape, and an end portion on the other side of the wire 15d is It arrange
  • this wire 15d nylon thread, Tegs, stainless steel, titanium or carbon fiber, etc. are used.
  • the biopsy needle 10E is moved to the inner needle in a state in which the intermediate support portion 16b of the wire 15c formed in the C shape first rotates to the surface side of the hollow cylindrical needle portion 11B.
  • a part of the tissue is a hollow cylindrical needle. It enters the part 11B.
  • the C-shaped wire rod 15c has an opening in which the through hole 13a is formed. 12 is pulled to the distal end side and is turned around a pair of openings 11a and 11b formed in the hollow cylindrical needle portion 11B.
  • an intermediate support portion 16b of the wire 15c formed in a C shape is positioned on the distal end side of the injection needle-shaped opening 12.
  • the tissue located at the injection needle-shaped opening 12 portion is cut while the C-shaped wire rod 15c rotates. That is, in the biopsy needle 10E of the sixth embodiment, the wire 15c formed in a C shape corresponds to the cutting means of the present invention.
  • the wire 15d slides with respect to the through-hole 13a while bending so that the through-hole 13a serves as a fulcrum, so that the force for pulling the wire 15d is formed in a C shape.
  • the wire 15d needs to have a sufficient tensile strength and a certain degree of flexibility because the wire 15d needs to reach the wire 15c reliably.
  • a pulley or the like may be further provided in the through hole 13a so that the wire 15d can slide smoothly.
  • the wire 15c formed in a C-shape needs to be rotated with the pair of apertures 11a and 11b as fulcrums and to cut the tissue, so it is difficult to be deformed when pulled by the wire 15d.
  • the rigidity needs to be larger than that of the wire 15d. Therefore, when the wire 15c and the wire 15d formed in the C-shape are formed of the same material, it is desirable to use a wire 15c thicker than the wire 15d as the C-shaped wire 15c.
  • the wire 15c formed in a C shape only needs to be able to rotate around the pair of apertures 11a and 11b as a fulcrum and cut the tissue so as to fit into the hollow cylindrical needle portion 11B.
  • it is not always necessary to have a strict C shape, and it may be a horizontally elongated C shape, an elliptical shape, or a polygonal shape.
  • FIG. 7A is a plan view of the biopsy needle of Embodiment 7, and FIG. 7B is a side view when the cutting means is operated.
  • 7A and 7B the same components as those of the biopsy needle 10E of Embodiment 6 shown in FIG. 6 are given the same reference numerals, and detailed descriptions thereof are omitted.
  • the biopsy needle 10F of the seventh embodiment is devised in the shape of the wire 15d for driving the wire 15c formed in a C shape in the biopsy needle 10E of the sixth embodiment, and the wire 15d is pulled when pulling the wire 15d.
  • the needle-shaped opening 12 is not crossed, and the wire 15c formed in a C-shape is rotated so that the deep part of the tissue can be reliably cut. That is, the biopsy needle 10F according to the seventh embodiment is the same as the biopsy needle 10E according to the sixth embodiment, in which the wire 15c side of the wire 15d is bifurcated to form a pair of branch wire portions 15e and 15f, and the needle-like opening 12 is formed.
  • a pair of through holes 13b and 13c are provided as through holes provided on the distal end side of the wire, and the pair of branch wire portions 15e and 15f are respectively passed through the through holes 13b and 13c, and then formed into a C-shape. It is rotatably attached to two support portions 16c and 16d in the middle of 15c. And these two support parts 16c and 16d are made into the shape where each is not located in the injection needle-shaped opening 12, when the wire 15c formed in C shape rotates.
  • a pulley or the like is further provided in the through holes 13b and 13c so that the branch wire portions 15e and 15f of the wire 15d can slide smoothly. It may be provided.
  • FIG. 8A is a plan view of the biopsy needle of Embodiment 8
  • FIG. 8B is a side view when the cutting means is operated.
  • the same reference numerals are given to the same components as those of the biopsy needle 10F of the seventh embodiment shown in FIG. 7A, and the detailed description thereof is omitted.
  • the biopsy needle 10G of the eighth embodiment is the same as the biopsy needle 10F of the seventh embodiment except that a separate wire 15i having a pair of branch wire portions 15g and 15h branched into two is provided, and this wire 15i is provided with an empty cylindrical needle portion 11B. It arrange
  • the biopsy needle 10G of the eighth embodiment when the wire 15d is first loosened and the wire 15i is pulled, the initial state shown in FIG. 8A is restored. When the tissue to be collected is punctured in this state and the wire 15i is loosened and the wire 15d is pulled, the wire 15c formed in a C shape crosses the injection needle-shaped opening 12 as shown in FIG. 8B. So that the deep part of the tissue can be cut reliably.
  • the C-shaped wire 15c rotates in the reverse direction and returns to the initial state shown in FIG. 8A.
  • the branch wire portions 15e and 15f of the wire 15d and the branch wire portions 15g and 15h of the wire 15i can be prevented from crossing the injection needle-shaped opening 12, so that the pulling operation of these wires 15d and 15i
  • the wire 15c formed in a C-shape can be efficiently rotated a plurality of times, so that the deep part of the tissue can be cut more reliably.
  • the branch wire portions 15e and 15f and the branch wire portions 15g and 15h are formed by bifurcating the wire 15c side of the wire 15d and the wire 15i formed in the C shape.
  • two independent wires are rotatably attached to the two support portions 16c and 16d in the middle of the C-shaped wire rod 15c, and one of the two wires is attached to the through hole 13b. , 13c, the other two may be arranged so as to extend further than the rear end of the hollow cylindrical needle portion 11B.
  • FIG. 9A is a plan view of the biopsy needle of Embodiment 9
  • FIG. 9B is a side view
  • FIG. 9C is a side view when the cutting means is operated.
  • the same components as those of the biopsy needle 10 of the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
  • the needle portion 11C of the biopsy needle 10H in the ninth embodiment has a hollow rectangular tube shape.
  • An injection needle-shaped opening 12 having an end cut obliquely is formed at one end of the hollow square tubular needle portion 11C, and both end portions of the injection needle-shaped opening 12 are formed.
  • Grooves 11c are formed in the side walls so as to face each other. In these grooves 11c, both side ends of one end of the foil piece-shaped plastic sheet 15j are fitted, so that the foil piece-shaped plastic sheet 15j can slide in the groove 11c. Is attached.
  • a pair of through holes 13d and 13e are formed at both ends on the distal end side of the opening 12, and one end of the wire 15d is bifurcated to form a pair of branch wire portions 15e and 15f. ing.
  • the pair of branch wire portions 15e and 15f are connected to coupling portions 16e and 16f provided at both ends of one end portion of the foil-like plastic sheet 15j through the through holes 13d and 13e, respectively.
  • the other end portion of the wire 15d is arranged so as to extend from the rear end of the hollow square tubular needle portion 11C along the outer periphery of the hollow square tubular needle portion 11C.
  • the end of one side of the foil-like plastic sheet 15j is in a state where the injection needle-shaped opening 12 is maximally opened (see FIGS. 8A and 8B), using the inner needle or using the inner needle. Without puncturing the tissue to be collected, a part of the tissue enters the hollow cylindrical needle portion 11C, for example, as in the case of the biopsy needle 10 of the first embodiment shown in FIG.
  • the wire 15d when the wire 15d is pulled, the wire 15d moves in the direction of the arrow shown in FIGS. 8B and 8C, and the foil-like plastic sheet 15j moves along the surface of the injection needle-shaped opening 12.
  • the foil piece-shaped plastic sheet 15j closes the distal end side of the injection needle-shaped opening 12.
  • the tissue located in the injection needle-shaped opening 12 is cut. That is, in the biopsy needle 10H of the ninth embodiment, the foil piece-shaped plastic sheet 15j corresponds to the cutting means of the present invention.
  • the biopsy needle 10H is pulled out together with the foil piece-shaped plastic sheet 15j and the wire 15d, the deep part of the tissue is cut, and thus, as in the case of the biopsy needle 10 of Embodiment 1 shown in FIG.
  • the sample is collected while remaining in the hollow cylindrical needle portion 11C.
  • a pulley or the like is further provided in the through holes 13d and 13e so that the branch wire portions 15e and 15f of the wire 15d can slide smoothly similarly to the through hole 13a in the sixth embodiment. It may be provided. Further, the foil piece-like plastic sheet 15j is difficult to deform when pulled by the wire 15d and can slide in the groove 11c, and it is necessary to cut the tissue. It is preferable to use a material having flexibility and a certain degree of rigidity.
  • a separate wire having a pair of branch wire portions branched into two is further provided, and this wire is used as an empty cylindrical needle. You may arrange

Abstract

Dans l'aiguille pour biopsie selon un mode de réalisation de la présente invention, des premier et second orifices de passage (13, 14) qui pénètrent la paroi de la section creuse (11) de l'aiguille sont fournis sur le côté du dos de l'ouverture en forme d'aiguille (12). Une extrémité d'un fil (15) est passée à travers les premier et second orifices de passage (13, 14) et est fixée à la section creuse (11) de l'aiguille. La portion s'étendant d'une extrémité du fil (15) est fixée en une forme de boucle sur la paroi d'ouverture le long de la paroi (12a) de l'ouverture en forme d'aiguille (12) avec un adhésif facilement pelable, et l'autre extrémité est insérée de manière à passer à travers l'intérieur de la section creuse (11) de l'aiguille et s'étend au-delà du dos de la section creuse (11) de l'aiguille. Étant donné que le tissu (21) à l'ouverture en forme d'aiguille (12) est coupé quand le fil (15) est tiré après insertion de l'aiguille pour biopsie, un échantillon (22) est récolté efficacement dans la section creuse (11) de l'aiguille.
PCT/JP2013/068544 2012-07-06 2013-07-05 Aiguille pour biopsie et appareil endoscopique utilisant ladite aiguille pour biopsie WO2014007380A1 (fr)

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EP3009075A1 (fr) 2014-10-13 2016-04-20 NeoDynamics AB Dispositif d'échantillonnage de tissu avec pointe distale
EP3009076A1 (fr) 2014-10-13 2016-04-20 NeoDynamics AB Agencement de trocart pour dispositif d'échantillonnage de tissu
JP2019176993A (ja) * 2018-03-30 2019-10-17 国立大学法人鳥取大学 生検針
EP3616625A1 (fr) 2018-09-03 2020-03-04 NeoDynamics AB Agencement de biopsie
EP3791794A1 (fr) 2019-09-12 2021-03-17 NeoDynamics AB (publ) Agencement de biopsie

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Publication number Priority date Publication date Assignee Title
EP3009075A1 (fr) 2014-10-13 2016-04-20 NeoDynamics AB Dispositif d'échantillonnage de tissu avec pointe distale
EP3009076A1 (fr) 2014-10-13 2016-04-20 NeoDynamics AB Agencement de trocart pour dispositif d'échantillonnage de tissu
WO2016058844A1 (fr) 2014-10-13 2016-04-21 Neodynamics Ab Dispositif d'échantillonnage de tissu à pointe distale
US10342519B2 (en) 2014-10-13 2019-07-09 Neodynamics Ab Trocar arrangement for tissue sampling device
US11083441B2 (en) 2014-10-13 2021-08-10 Neodynamics Ab Distal tip tissue sampling arrangement
JP2019176993A (ja) * 2018-03-30 2019-10-17 国立大学法人鳥取大学 生検針
JP7161740B2 (ja) 2018-03-30 2022-10-27 国立大学法人鳥取大学 生検針
EP3616625A1 (fr) 2018-09-03 2020-03-04 NeoDynamics AB Agencement de biopsie
WO2020048888A1 (fr) 2018-09-03 2020-03-12 Neodynamics Ab (Publ) Agencement d'aiguille de biopsie
EP3791794A1 (fr) 2019-09-12 2021-03-17 NeoDynamics AB (publ) Agencement de biopsie
WO2021047984A1 (fr) 2019-09-12 2021-03-18 Neodynamics Ab (Publ) Agencement de biopsie

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