WO2016027523A1 - 医療用処置具 - Google Patents
医療用処置具 Download PDFInfo
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- WO2016027523A1 WO2016027523A1 PCT/JP2015/063098 JP2015063098W WO2016027523A1 WO 2016027523 A1 WO2016027523 A1 WO 2016027523A1 JP 2015063098 W JP2015063098 W JP 2015063098W WO 2016027523 A1 WO2016027523 A1 WO 2016027523A1
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- Prior art keywords
- needle
- diameter
- medical treatment
- diameter portion
- small
- Prior art date
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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
- A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
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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
- A61B10/04—Endoscopic instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
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- 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
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- 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
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
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- 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
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
- A61B2017/2937—Transmission of forces to jaw members camming or guiding means with flexible part
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320064—Surgical cutting instruments with tissue or sample retaining means
Definitions
- the present invention relates to a medical treatment instrument. More specifically, the present invention relates to a medical treatment instrument that is inserted into a body from a treatment instrument channel of an endoscope and collects tissues and cells at a predetermined site in the body.
- This application claims priority based on Japanese Patent Application No. 2014-166318 for which it applied to Japan on August 19, 2014, and uses the content here.
- Patent Document 1 a treatment tool described in Patent Document 1 is known as a treatment tool for treating a tissue or cell at a predetermined site in the body.
- Patent Document 2 discloses a treatment tool for treating a submucosal tumor.
- the treatment instrument described in Patent Document 2 includes a sheath, an operation motion transmission member that is disposed so as to be able to advance and retreat in the axial direction along the sheath, and that advances and retreats by an operation from the hand side, and can be opened and closed like a hook.
- a pair of distal treatment members that are disposed at the distal end and are driven to open and close by the forward and backward movement of the operation motion transmitting member.
- the distal end portions of the pair of distal treatment members are formed in a sharply sharp shape toward the front.
- aspiration biopsy performed by FNA (Fine-Needle Aspiration) is known.
- FNA Frine-Needle Aspiration
- the tissue is punctured with a biopsy needle, and the tissue is aspirated with a negative pressure inside the biopsy needle with a syringe or the like.
- the outer diameter of the needle is generally set to about 1 mm at the maximum.
- the link mechanism used to open and close the pair of distal treatment members is also configured in a small size due to the above limitation.
- the link mechanism is small as described above, so that sufficient force to split the tissue cannot be produced, and a pair of tip treatments against the tissue hardness
- the member may not be fully closed. In this case, a sufficient amount of tissue for tissue diagnosis may not be collected.
- the outer diameter of the biopsy needle is thin, and the tissue can be aspirated only in the region defined by the inner diameter of the biopsy needle. Furthermore, since the biopsy needle does not have a structure for actively taking the tissue into its own internal space, even if the tissue of the submucosal tumor, which is a hard tissue, is sucked, no tissue is collected inside the biopsy needle or Only a very small amount of tissue may be collected. For this reason, it may be difficult for aspiration biopsy to collect a sufficient amount of tissue for tissue diagnosis.
- An object of the present invention is to provide a medical treatment instrument that can be punctured suitably in a tissue and can collect a sufficient amount of the tissue in the tissue.
- a medical treatment instrument includes a sheath, a needle that is inserted into the sheath so as to be able to advance and retreat, a tubular needle, and a needle that is inserted into the needle so as to be able to advance and retract.
- a stylet having a diameter.
- the tip of the needle is elastically deformable.
- the distal end portion of the needle includes a housing portion in which a space is formed, a small diameter portion provided at a proximal end of the housing portion and having an inner diameter smaller than the inner diameter of the housing portion, and at least the distal end of the housing portion To a base end of the small-diameter portion, and a slit communicating with the space.
- the tip of the stylet has a large diameter portion having a second outer diameter that is larger than the first outer diameter.
- the first outer diameter may be smaller than the inner diameter of the small diameter portion.
- the second outer diameter may be larger than the inner diameter of the small diameter portion and smaller than the inner diameter of the housing portion.
- a plurality of the slits may be formed.
- the large diameter portion is positioned more distal than the small diameter portion in an initial state, and the stylet The large-diameter portion may expand the small-diameter portion by pulling the proximal end with respect to the needle.
- the needle accommodating portion can be expanded in the radial direction of the needle by elastic deformation, the outer diameter of the needle is thin enough to suitably puncture the tissue. Even so, a sufficient amount of tissue can be collected by expanding the accommodating portion.
- FIG. 1 is a view showing an endoscope 100 used together with the medical treatment tool 1 according to the present embodiment.
- the endoscope 100 includes an endoscope insertion unit 101 that is inserted into the body, and an operation unit 102 that operates the endoscope insertion unit 101.
- the operation unit 102 is provided at the proximal end of the endoscope insertion unit 101.
- the operation unit 102 bends the distal end portion of the endoscope insertion unit 101 via an angle wire (not shown).
- a known imaging means for observing the inside of the body is provided at the distal end of the endoscope insertion portion 101.
- a channel 103 is formed inside the endoscope insertion portion 101. The channel 103 extends from the distal end of the endoscope insertion unit 101 to the vicinity of the side of the operation unit 102.
- the distal end opening of the channel 103 is formed at the distal end of the endoscope insertion portion 101, and the proximal end opening of the channel 103 is formed near the side portion of the operation portion 102.
- the proximal end opening of the channel 103 is an insertion port for a treatment instrument to be inserted into the endoscope 100.
- the medical treatment tool 1 according to this embodiment is inserted into the channel 103 from this insertion port.
- FIG. 2 is a side view of the medical treatment tool 1 according to the present embodiment.
- FIG. 3 is a side sectional view of the medical treatment instrument 1.
- FIG. 4 is a view showing the medical treatment instrument 1 as seen from the arrow A in FIG.
- FIG. 5 is a side sectional view of the distal end portion of the medical treatment instrument 1.
- the medical treatment instrument 1 includes a needle 10, a stylet 30, and a sheath 40.
- the needle 10 is formed in a tubular shape and is inserted into the sheath 40 so as to be able to advance and retract.
- the stylet 30 has a predetermined outer diameter (first outer diameter), and is inserted into the needle 10 so as to be able to advance and retract.
- the needle 10 is made of a metal such as stainless steel or nickel / titanium alloy and can be elastically deformed.
- the needle 10 is formed in a tubular shape and has a lumen 11.
- the needle 10 can have a size of about 19 gauge (outer diameter 1.1 mm, inner diameter 0.78 mm), for example, like a general puncture needle. Further, a needle thinner than this size may be used for the needle 10.
- the tip of the needle 10 is formed in a curved surface so that the needle 10 can be easily punctured into the tissue.
- the tip of the needle 10 may be formed in a sharp shape.
- the tip 12 of the needle 10 can be elastically deformed.
- the distal end portion 12 of the needle 10 has a housing portion 14, a small diameter portion 16, and a slit 18.
- the accommodating portion 14 has a space 15 formed therein.
- the small diameter portion 16 is provided at the proximal end of the accommodating portion 14 and has an inner diameter smaller than the inner diameter of the accommodating portion 14.
- the slit 18 extends at least from the distal end of the accommodating portion 14 to the proximal end of the small-diameter portion 16 and communicates with the space 15.
- a space 15 capable of accommodating the tissue to be collected is formed.
- the inner diameter and the outer diameter of the accommodating portion 14 are substantially the same as the inner diameter and the outer diameter of the needle 10 on the proximal side from the distal end portion 12, respectively.
- the inner diameter and the outer diameter of the accommodating portion 14 may be set to dimensions different from the inner diameter and the outer diameter of the needle 10 on the proximal end side from the distal end portion 12, respectively.
- the length of the accommodating portion 14 in the axial direction of the needle 10 is appropriately set according to the amount of tissue to be collected.
- the size of the space 15 is defined by the inner diameter of the accommodating portion 14 and the length of the accommodating portion 14 in the axial direction of the needle 10.
- the small diameter portion 16 is provided at the proximal end of the accommodating portion 14.
- the small diameter portion 16 has an inner diameter smaller than the inner diameter of the other portion of the needle 10 including the accommodating portion 14.
- the small diameter portion 16 may be formed by denting a part of the proximal end side of the accommodating portion 14 in the needle 10 in the radial direction of the needle 10.
- the small diameter portion 16 has an outer diameter smaller than the outer diameter of the other portion of the needle 10 including the accommodating portion 14.
- the proximal end of the small diameter portion 16 is continuous with the straight tube portion of the needle 10.
- the straight tube portion of the needle 10 is formed in a tubular shape having a constant inner diameter and outer diameter.
- the slit 18 is formed in the distal end portion 12 and extends from the distal end of the needle 10 (the distal end of the accommodating portion 14) toward the proximal end of the distal end portion 12.
- the slit 18 only needs to extend from at least the distal end of the needle 10 to the proximal end of the small diameter portion 16.
- an example in which three slits 18 are formed is shown.
- the number of slits is not limited, and one or more slits may be used.
- the slits 18 are formed at equal intervals in the circumferential direction of the needle 10 as in the present embodiment shown in FIG.
- the slit 18 communicates with the lumen 11 and the space 15. Further, the slits 18 intersect or merge with each other at the tip of the needle 10. For this reason, the front-end
- the width of the slit 18 in the circumferential direction of the needle 10 is not particularly limited as long as the distal end portion 12 is divided by the slit 18. From the viewpoint of preventing a foreign substance other than the target tissue from entering the space 15, the width of the slit 18 is preferably as narrow as possible.
- the slit 18 is formed linearly along the longitudinal axis of the needle 10, but the shape of the slit 18 is not limited to this.
- the slit 18 may be formed in a linear shape or a curved shape inclined with respect to the longitudinal axis of the needle 10.
- a needle operation unit 20 is provided at the proximal end of the needle 10.
- An insertion passage 21 communicating with the lumen 11 is formed inside the needle operation unit 20.
- the needle 10 can be advanced and retracted relative to the sheath 40 by advancing and retracting the needle operation unit 20.
- the stylet 30 has a predetermined outer diameter (first outer diameter), and is inserted into the needle 10 so as to advance and retract.
- the stylet 30 is made of a metal such as stainless steel and is formed in a round bar shape.
- the stylet 30 is inserted through the lumen 11 and the insertion passage 21 and can advance and retreat with respect to the needle 10.
- the outer diameter (first outer diameter) of the stylet 30 is smaller than the inner diameter of the small diameter portion 16.
- the tip portion 32 of the stylet 30 has a large diameter portion 34.
- the large diameter portion 34 is formed in a substantially cylindrical shape and has an outer diameter (second outer diameter) larger than the outer diameter (first outer diameter) of the other part of the stylet 30.
- the outer diameter (second outer diameter) of the large diameter portion 34 is larger than the inner diameter of the small diameter portion 16 and smaller than the inner diameter of the accommodating portion 14.
- a stylet operation unit 36 is provided at the base end of the stylet 30. By moving the stylet operation section 36 forward and backward, the stylet 30 can be advanced and retracted with respect to the needle 10.
- the sheath 40 is made of a resin material and is formed in a tubular shape.
- the sheath 40 may be formed of a coil sheath in which metal wires such as stainless steel are tightly wound so that no gap is formed between them.
- the needle 10 is inserted into the lumen of the sheath 40 so as to be able to advance and retract with respect to the sheath 40.
- the tip of the needle 10 is stored in the sheath 40. This prevents the needle 10 and the inner surface of the channel 103 from coming into direct contact and damages the needle 10 and the channel 103.
- a sheath operating portion 42 is provided at the proximal end of the sheath 40. By moving the sheath operating portion 42 back and forth, the sheath 40 can be moved back and forth with respect to the channel 103 of the endoscope 100.
- FIG. 6 is a side cross-sectional view of the distal end portion of the medical treatment instrument 1 when it is expanded.
- the large diameter portion 34 can be fitted to the small diameter portion 16.
- the inner diameter of the small diameter portion 16 is smaller than the outer diameter of the large diameter portion 34.
- the needle 10 can be elastically deformed, when the width of the slit 18 in the circumferential direction of the needle 10 is increased, the inner diameter of the small-diameter portion 16 is expanded to the same size as the outer diameter of the large-diameter portion 34. can do. For this reason, the large diameter portion 34 can be fitted to the small diameter portion 16.
- the large-diameter portion 34 is located on the tip side of the small-diameter portion 16 in the initial state. From this state, the stylet operating portion 36 is retracted and the stylet 30 is pulled toward the proximal end side with respect to the needle 10, whereby the large diameter portion 34 moves toward the proximal end side as shown in FIG. It fits into the diameter portion 16 and the width of the slit 18 increases.
- the operator who operates the stylet operation portion 36 can obtain an operation feeling (click feeling).
- the width of the slit 18 increases, so that each portion of the distal end portion 12 is elastically deformed so as to move outward in the radial direction of the needle 10. To do. That is, the accommodating portion 14 and the small diameter portion 16 expand in the radial direction of the needle 10, and the space 15 opens to the outside of the needle 10.
- the fitting between the large-diameter portion 34 and the small-diameter portion 16 is released.
- the large diameter portion 34 moves to the proximal end side of the small diameter portion 16.
- each portion of the distal end portion 12 is moved inward in the radial direction of the needle 10 due to the elastic force to return to the original shape of the needle 10.
- the width of the slit 18 returns to the original size. That is, the accommodating portion 14 and the small diameter portion 16 are closed, and the space 15 is closed with respect to the outside of the needle 10.
- the operation of the distal end portion 12 when the large diameter portion 34 is moved from the distal end side to the proximal end side of the small diameter portion 16 has been described.
- the distal end portion 12 performs the same operation when moved from the proximal end side toward the distal end side.
- FIGS. 7 to 10 are diagrams illustrating an operation when the medical treatment tool 1 is used.
- a procedure for collecting tissue of a gastric submucosal tumor will be described as an example.
- the mucosa layer M, the mucosal muscle plate MM, the submucosa SM, the intrinsic muscle layer PM, and the serosa sublayer SS are arranged in this order. Is formed.
- the operator inserts the endoscope insertion portion 101 of the endoscope 100 into the body from the patient's mouth, and sends the tip of the endoscope insertion portion 101 to the vicinity of the target site T.
- the medical treatment instrument 1 is inserted into the channel 103, and the distal end of the medical treatment instrument 1 is sent to the distal end of the endoscope insertion portion 101.
- the tip of the needle 10 is stored in the sheath 40.
- the large diameter portion 34 of the stylet 30 is disposed on the distal end side of the small diameter portion 16 of the needle 10 in the initial state.
- the surgeon operates the sheath operation unit 42 to project the sheath 40 from the distal end of the endoscope insertion unit 101 while observing the target site T with the imaging means provided at the distal end of the endoscope insertion unit 101.
- the needle operation unit 20 is advanced to cause the needle 10 to protrude from the distal end of the sheath 40, and the needle 10 is punctured into the target site T.
- the operator When puncturing the target site T with the needle 10, first, as shown in FIG. 7, the operator inserts the tip of the needle 10 into the submucosa SM. Next, as shown in FIG. 8, the stylet operating portion 36 is retracted to pull the stylet 30 toward the proximal side with respect to the needle 10, and the large diameter portion 34 is moved to the proximal side. Thereby, the large diameter part 34 fits into the small diameter part 16, and the accommodating part 14 expands. At this time, since the accommodating portion 14 is inside the mucous membrane layer M, the operator cannot confirm that the accommodating portion 14 has been expanded by the imaging means of the endoscope insertion portion 101. However, the surgeon can determine that the accommodating portion 14 has expanded by perceiving a click feeling generated by fitting the large diameter portion 34 and the small diameter portion 16 together.
- the surgeon operates the needle operation unit 20 to insert the needle 10 into the submucosal tumor ST as shown in FIG.
- the stylet operating portion 36 is moved backward to further pull the stylet 30 toward the proximal end side with respect to the needle 10 and move the large diameter portion 34 further toward the proximal end side.
- the fitting of the large diameter portion 34 and the small diameter portion 16 is released, and the accommodating portion 14 is closed by the elastic force of the needle 10 as shown in FIG.
- the container 14 is closed, the tissue of the submucosal tumor ST can be collected in the space 15.
- the storage unit 14 may be slightly swollen from the original closed state.
- the accommodating part 14 can extract
- the surgeon retracts the needle operation portion 20 and retracts the needle 10 until the tip of the needle 10 is stored in the sheath 40. Then, the medical treatment instrument 1 is pulled out from the channel 103.
- the large diameter portion 34 is disposed on the distal end side of the small diameter portion 16 in the initial state, but the large diameter portion 34 is disposed on the proximal end side of the small diameter portion 16 in the initial state. It may be. In this case, the operation of moving the large diameter portion 34 to the proximal end side in the above description is replaced with the operation of moving the large diameter portion 34 to the distal end side.
- a slit 18 is provided at the distal end portion 12 of the needle 10, and the distal end portion 12 (the accommodating portion 14 and the small diameter portion 16) is elastic so as to expand radially outward. It is possible to deform. For this reason, even if the outer diameter of the needle 10 is thin, a sufficient amount of tissue can be collected. Moreover, in the medical treatment tool 1 which concerns on this embodiment, it returns from the state which the front-end
- a blade may be formed at a portion where the slit 18 of the distal end portion 12 of the needle 10 is formed.
- the operator can recognize that the large-diameter portion 34 is fitted to the small-diameter portion 16 with a click feeling. Further, by providing a known stopper mechanism in the stylet operating portion 36 that stops the stylet 30 when the stylet 30 is operated by a predetermined amount, the surgeon confirms that the large-diameter portion 34 is fitted to the small-diameter portion 16.
- the medical treatment tool 1 may be configured so that the above can be confirmed.
- the sheath 40 is not an essential configuration.
- the medical treatment instrument 1 may not include the sheath 40.
- a known sheath and the medical treatment instrument 1 may be used in combination.
- the medical treatment tool 201 according to the present embodiment is different from the medical treatment tool 1 according to the first embodiment in that the stylet 30 is not provided. Moreover, the medical treatment tool 201 according to the present embodiment is different from the medical treatment tool 1 according to the first embodiment in the configuration of the distal end portion of the needle 10 and the distal end portion of the sheath 40. In addition, the detailed description is abbreviate
- FIG. 11 is a side sectional view of the distal end portion of the medical treatment tool 201 according to the present embodiment.
- FIG. 12 is a diagram showing a state where the distal end portion 212 of the needle 210 of the medical treatment instrument 201 is closed.
- FIG. 13 is a view showing a state in which the distal end portion 212 is opened with respect to the distal end portion 212 of the needle 210 of the medical treatment instrument 201.
- FIG. 14 is a diagram showing the needle 210 viewed from the arrow B in FIG.
- the medical treatment instrument 201 includes a needle 210 and a sheath 240, but does not include a stylet.
- the distal end portion 212 of the needle 210 is provided at the housing portion 214, the straight tube portion 222 provided at the proximal end of the housing portion 214, and the proximal end of the straight tube portion 222. And a stepped portion 224.
- the accommodating portion 214 is formed with a space 215 that can accommodate the tissue to be collected.
- the accommodating portion 214 is formed with a slit 218 extending from the distal end to the proximal end of the accommodating portion 214. In the present embodiment, an example in which three slits 218 are formed is shown, but the number of slits is not limited to this and may be one or more.
- the accommodating part 214 is divided
- FIG. 13 the accommodating portion 214 is formed in a shape in which each portion is expanded radially outward of the needle 210 by plastic deformation. Since the needle 210 can be elastically deformed in the same manner as the needle 10 of the first embodiment, as shown in FIG.
- the accommodating portion 214 is elastically deformed in a closed state by a sheath tip member 242 described later. Can do.
- the tip of the accommodating part 214 is formed in a curved surface shape. For this reason, in this state, the needle 210 can be easily punctured into the tissue.
- the outer diameter of the accommodating portion 214 in a state where the accommodating portion 214 is closed is appropriately set in consideration of puncture performance.
- the straight pipe portion 222 is disposed between the accommodating portion 214 and the step portion 224.
- the straight pipe portion 222 has an inner diameter and an outer diameter that are substantially the same as the inner diameter and the outer diameter of the housing portion 214 in a state where the housing portion 214 is closed.
- the outer diameter of the straight pipe portion 222 is smaller than the outer diameter of the other portion of the needle 210 excluding the accommodating portion 214.
- the length of the straight tube portion 222 in the axial direction of the needle 210 is appropriately set according to the length of puncturing the target tissue with the needle 210.
- the stepped part 224 has a shape that is larger in diameter than the straight pipe part 222.
- the step portion 224 comes into contact with a protrusion 244 of a sheath tip member 242 described later.
- the stepped portion 224 comes into contact with the protruding portion 244 to prevent the needle 210 from moving further toward the distal end side with respect to the sheath 240.
- a sheath tip member 242 is attached to the tip of the sheath 240.
- the sheath tip member 242 is formed in a tubular shape having an inner diameter and an outer diameter that are substantially the same as the inner diameter and the outer diameter of the sheath 240.
- the lumen of the sheath tip member 242 communicates with the lumen of the sheath 240, and the needle 210 is inserted into the lumen of the sheath tip member 242.
- the needle 210 can move forward and backward with respect to the sheath 240 and the sheath tip member 242.
- a protrusion 244 that protrudes radially inward of the sheath tip member 242 is provided at the tip of the sheath tip member 242.
- An opening 246 that communicates with the lumen of the sheath tip member 242 is formed on the radially inner side of the protrusion 244 at the tip of the sheath tip member 242.
- the diameter of the opening 246 is slightly larger than the outer diameter of the straight pipe portion 222 and smaller than the outer diameter of the step portion 224. For this reason, the straight pipe portion 222 can be inserted into the opening 246, but the stepped portion 224 comes into contact with the protrusion 244 and cannot be inserted into the opening 246.
- the accommodating portion 214 can be inserted into the opening 246 by being elastically deformed in a closed state. That is, by inserting the accommodating portion 214 into the opening 246, the outer surface of the accommodating portion 214 is pressed by the protrusion 244, and the accommodating portion 214 is elastically deformed to a closed state.
- FIGS. 15 to 17 are diagrams for explaining the operation when the medical treatment tool 201 is used.
- a procedure for collecting a tissue of a gastric submucosal tumor will be described as an example.
- the operator uses the endoscope 100 to send the distal end of the medical treatment tool 201 to the vicinity of the target site T.
- the needle operation unit 20 is advanced to project the needle 210 from the distal end of the sheath distal end member 242.
- a part of the accommodating portion 214 is disposed in the opening 246, and the accommodating portion 214 is closed by the protrusion 244. In this state, the surgeon punctures the target site T with the needle 210.
- the operator advances the needle 210 relative to the sheath tip member 242.
- the accommodating portion 214 moves to the tip side beyond the projection 244
- the accommodating portion 214 pushes away the surrounding tissue by the elastic force to return to the original shape of the accommodating portion 214 as shown in FIG. Return to the original expanded state.
- the operator further advances the needle 210 relative to the sheath distal end member 242 until the stepped portion 224 comes into contact with the protruding portion 244.
- the tissue of the submucosal tumor ST is accommodated in the space 215 of the accommodating portion 214.
- the outer surface of the housing portion 214 is pressed by the protrusion 244, and the housing portion 214 is closed by elastic deformation. Thereby, the tissue accommodated in the space 215 can be collected. Thereafter, the needle 210 is pulled out from the target site T, and the medical treatment tool 201 is pulled out of the body.
- a slit 218 is provided in the accommodation portion 214 of the needle 210, and the accommodation portion 214 is formed by plastic deformation into a shape expanded radially outward, and the accommodation portion 214. Can be closed by elastic deformation. For this reason, after the needle 210 is punctured into the tissue in a state where the storage portion 214 is closed, the storage portion 214 is expanded, so that a sufficient amount of tissue can be collected even if the outer diameter of the needle 210 is small. Further, in the medical treatment instrument 1 according to the present embodiment, the protrusion 214 244 of the sheath distal end member 242 presses the outer surface of the storage part 214, thereby closing the storage part 214. For this reason, even when a tissue of a submucosal tumor, which is a hard tissue, is collected, the accommodating portion 214 can be closed against the tissue hardness, and the tissue can be reliably collected.
- the needle accommodating portion can be expanded in the radial direction of the needle by elastic deformation, and thus the outer diameter of the needle is thin enough to suitably puncture the tissue. Even in such a case, a sufficient amount of tissue can be collected by expanding the accommodating portion.
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Abstract
Description
本願は、2014年8月19日に日本国に出願された特願2014-166318号に基づき優先権を主張し、その内容をここに援用する。
以下、本発明の第1実施形態について、図1から図10を参照して説明する。図1は、本実施形態に係る医療用処置具1と共に使用される内視鏡100を示す図である。
次に、本発明の第2実施形態について、図11から図17を参照して説明する。本実施形態に係る医療用処置具201は、スタイレット30を備えていない点で第1実施形態に係る医療用処置具1と異なる。また、本実施形態に係る医療用処置具201は、針10の先端部及びシース40の先端部の構成が第1実施形態に係る医療用処置具1とは異なる。なお、第1実施形態に係る医療用処置具1と同様の構成を有する部分については、その詳細な説明を省略する。
10、210 針
12、212 先端部
14、214 収容部
16 細径部
18、218 スリット
30 スタイレット
34 大径部
40、240 シース
Claims (4)
- シースと、
前記シースに進退可能に挿通され、管状に形成された針と、
前記針に進退可能に挿通され、第1の外径を有するスタイレットと、
を備え、
前記針の先端部は弾性変形可能であり、
前記針の前記先端部は、
内部に空間が形成された収容部と、
前記収容部の基端に設けられ、前記収容部の内径より小さい内径を有する細径部と、
少なくとも前記収容部の先端から前記細径部の基端まで延び、前記空間と連通するスリットと、
を有し、
前記スタイレットの先端部は、前記第1の外径より大きい第2の外径を有する大径部を有し、
前記大径部が前記細径部に嵌合することにより、前記スリットの幅が拡大するとともに前記細径部及び前記収容部が前記針の径方向に拡張するように弾性変形する
医療用処置具。 - 請求項1に記載の医療用処置具であって、
前記第1の外径は、前記細径部の前記内径より小さく、
前記第2の外径は、前記細径部の前記内径より大きく、かつ前記収容部の前記内径より小さい
医療用処置具。 - 請求項1に記載の医療用処置具であって、
前記スリットは複数形成されている
医療用処置具。 - 請求項1に記載の医療用処置具であって、
前記大径部は、初期状態において前記細径部よりも先端側に位置しており、前記スタイレットを前記針に対して基端側に引くことで、前記大径部が前記細径部を拡張する
医療用処置具。
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2016501907A JP5927365B1 (ja) | 2014-08-19 | 2015-05-01 | 医療用処置具 |
CN201580005661.6A CN105979881B (zh) | 2014-08-19 | 2015-05-01 | 医疗用处理器具 |
EP15833353.4A EP3184055A4 (en) | 2014-08-19 | 2015-05-01 | Medical treatment instrument |
US15/215,035 US20160324536A1 (en) | 2014-08-19 | 2016-07-20 | Medical treatment instrument |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2014-166318 | 2014-08-19 | ||
JP2014166318 | 2014-08-19 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/215,035 Continuation US20160324536A1 (en) | 2014-08-19 | 2016-07-20 | Medical treatment instrument |
Publications (1)
Publication Number | Publication Date |
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WO2016027523A1 true WO2016027523A1 (ja) | 2016-02-25 |
Family
ID=55350477
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Application Number | Title | Priority Date | Filing Date |
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PCT/JP2015/063098 WO2016027523A1 (ja) | 2014-08-19 | 2015-05-01 | 医療用処置具 |
Country Status (5)
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---|---|
US (1) | US20160324536A1 (ja) |
EP (1) | EP3184055A4 (ja) |
JP (1) | JP5927365B1 (ja) |
CN (1) | CN105979881B (ja) |
WO (1) | WO2016027523A1 (ja) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2017177098A1 (en) * | 2016-04-07 | 2017-10-12 | GYRUS ACMI, INC. (d/b/a OLYMPUS SURGICAL TECHNOLOGIES AMERICA) | Laparoscopic surgical device with flared tube |
WO2022244711A1 (ja) * | 2021-05-18 | 2022-11-24 | オリンパス株式会社 | 生検デバイスおよび検体採取方法 |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2006068242A1 (ja) * | 2004-12-24 | 2006-06-29 | Olympus Corporation | 結紮装置 |
JP2006334242A (ja) * | 2005-06-03 | 2006-12-14 | Olympus Medical Systems Corp | 医療処置装置 |
JP2011024789A (ja) * | 2009-07-27 | 2011-02-10 | Hoya Corp | 内視鏡用生検鉗子 |
Family Cites Families (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US765879A (en) * | 1904-05-13 | 1904-07-26 | Wilber A K Campbell | Dilator. |
US6508825B1 (en) * | 1997-02-28 | 2003-01-21 | Lumend, Inc. | Apparatus for treating vascular occlusions |
US6217549B1 (en) * | 1997-02-28 | 2001-04-17 | Lumend, Inc. | Methods and apparatus for treating vascular occlusions |
WO1998040015A2 (en) * | 1997-03-13 | 1998-09-17 | Biomax Technologies, Inc. | Catheters and endoscopes comprising optical probes and bioptomes and methods of using the same |
NL1011063C2 (nl) * | 1999-01-19 | 2000-07-24 | Robertus Johannes Theodorus Jo | Inrichting voor het strippen van venen. |
US7850608B2 (en) * | 2002-10-25 | 2010-12-14 | K2M, Inc. | Minimal incision maximal access MIS spine instrumentation and method |
CN101087564B (zh) * | 2004-12-24 | 2010-06-02 | 奥林巴斯株式会社 | 结扎装置 |
JP4777012B2 (ja) * | 2005-08-11 | 2011-09-21 | オリンパスメディカルシステムズ株式会社 | 医療用処置具 |
EP2265184A1 (en) * | 2008-03-06 | 2010-12-29 | Trustees of Boston University | Low cost disposable medical forceps to enable a hollow central channel for various functionalities |
JP5625122B2 (ja) * | 2012-07-18 | 2014-11-12 | テルモ株式会社 | 医療用処置具 |
-
2015
- 2015-05-01 JP JP2016501907A patent/JP5927365B1/ja active Active
- 2015-05-01 EP EP15833353.4A patent/EP3184055A4/en not_active Withdrawn
- 2015-05-01 WO PCT/JP2015/063098 patent/WO2016027523A1/ja active Application Filing
- 2015-05-01 CN CN201580005661.6A patent/CN105979881B/zh active Active
-
2016
- 2016-07-20 US US15/215,035 patent/US20160324536A1/en not_active Abandoned
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2006068242A1 (ja) * | 2004-12-24 | 2006-06-29 | Olympus Corporation | 結紮装置 |
JP2006334242A (ja) * | 2005-06-03 | 2006-12-14 | Olympus Medical Systems Corp | 医療処置装置 |
JP2011024789A (ja) * | 2009-07-27 | 2011-02-10 | Hoya Corp | 内視鏡用生検鉗子 |
Non-Patent Citations (1)
Title |
---|
See also references of EP3184055A4 * |
Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2017177098A1 (en) * | 2016-04-07 | 2017-10-12 | GYRUS ACMI, INC. (d/b/a OLYMPUS SURGICAL TECHNOLOGIES AMERICA) | Laparoscopic surgical device with flared tube |
US10631836B2 (en) | 2016-04-07 | 2020-04-28 | Gyrus Acmi, Inc. | Laparoscopic surgical device with flared tube |
US11642110B2 (en) | 2016-04-07 | 2023-05-09 | Gyrus Acmi, Inc. | Laparoscopic surgical device with flared tube |
WO2022244711A1 (ja) * | 2021-05-18 | 2022-11-24 | オリンパス株式会社 | 生検デバイスおよび検体採取方法 |
Also Published As
Publication number | Publication date |
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EP3184055A1 (en) | 2017-06-28 |
JPWO2016027523A1 (ja) | 2017-04-27 |
EP3184055A4 (en) | 2018-04-04 |
CN105979881A (zh) | 2016-09-28 |
US20160324536A1 (en) | 2016-11-10 |
CN105979881B (zh) | 2019-08-23 |
JP5927365B1 (ja) | 2016-06-01 |
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