WO2018003934A1 - Instrument d'aide à l'introduction dans l'organisme, et procédé pour montage d'un instrument d'aide à l'introduction dans l'organisme sur un endoscope - Google Patents

Instrument d'aide à l'introduction dans l'organisme, et procédé pour montage d'un instrument d'aide à l'introduction dans l'organisme sur un endoscope Download PDF

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Publication number
WO2018003934A1
WO2018003934A1 PCT/JP2017/023997 JP2017023997W WO2018003934A1 WO 2018003934 A1 WO2018003934 A1 WO 2018003934A1 JP 2017023997 W JP2017023997 W JP 2017023997W WO 2018003934 A1 WO2018003934 A1 WO 2018003934A1
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WO
WIPO (PCT)
Prior art keywords
sheet
support piece
endoscope
adhesive sheet
introduction
Prior art date
Application number
PCT/JP2017/023997
Other languages
English (en)
Japanese (ja)
Inventor
栄彦 藤堂
弘 家城
彰洋 飴谷
佳那 矢野尾
Original Assignee
グンゼ株式会社
株式会社ハイレックスコーポレーション
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by グンゼ株式会社, 株式会社ハイレックスコーポレーション filed Critical グンゼ株式会社
Priority to JP2018525270A priority Critical patent/JPWO2018003934A1/ja
Publication of WO2018003934A1 publication Critical patent/WO2018003934A1/fr

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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

Definitions

  • the present invention relates to an in-vivo introduction tool that introduces a patch sheet into the body and affixes it to an affected part in the body, and a method of mounting the in-body support tool on an endoscope.
  • a lesion such as a tumor
  • the mucosa such as the esophagus, stomach, or duodenum
  • treatment is performed to remove the lesion under the endoscope.
  • delayed bleeding or perforation may occur several days after resection of the lesion. For this reason, after excising a lesioned part, the treatment which covers an affected part with a sticky sheet is performed, and bleeding and perforation are prevented.
  • Patent Document 1 proposes an auxiliary tool for introducing a patch sheet into the body.
  • the auxiliary tool of Patent Document 1 is inserted into a forceps channel (forceps port) of an endoscope, an inner sheath is inserted into an outer sheath, and a protective sheet (affixing sheet) is attached to the distal end of the inner sheath.
  • a first linear member attached in a roll shape is provided.
  • the tip of the second linear member inserted into the inner sheath protrudes from the tip of the inner sheath, and one end of the protective sheet is fixed.
  • the interval between the first and second linear members is widened so that the protective sheet is Can be spread.
  • the second linear member is pulled with respect to the inner sheath to separate the protective sheet from the fixed portion of the second linear member, and the end of the protective sheet is aligned with the peripheral edge of the affected part and pasted. wear.
  • the first linear member is moved, the roll-shaped protective sheet is pulled out to the end of winding, the protective sheet is separated from the first linear member, and is attached to the affected part.
  • the present invention has been made in order to solve the above-described problems, and an object thereof is to provide an in-vivo introduction tool capable of easily pulling out a sticking sheet and a method of mounting the in-body introduction aid on an endoscope. To do.
  • An in-vivo introduction tool for an adhesive sheet is an in-vivo introduction tool for an adhesive sheet used to introduce an adhesive sheet into the body and apply it to an affected area, and is mounted with the adhesive sheet.
  • a sheet support piece for supporting the adhesive sheet the sheet support piece is configured to be capable of transitioning between an attachable state and an unfolded state, and the sheet support piece in the unfolded state is disposed inside the body in the affected area. In order to be able to secure a space between them, it is configured to have a sheet shape or a non-cylindrical shape.
  • the method for mounting the in-vivo support tool of the embodiment of the present invention on the endoscope is a method of mounting the above-described in-board support tool on the endoscope
  • the mounting portion of the in-vivo support tool Comprises a pocket housing part having an opening through which the seat support piece can be taken in and out
  • the method for attaching the in-vivo introduction aid to the endoscope is a first step of attaching a spacer to the distal end part of the endoscope.
  • a part of the sticking sheet protrudes from the opening, and the other part of the sticking sheet is housed in the pocket housing part, with the spacer interposed only at the tip side of the pocket housing part.
  • the body introduction aid is mounted so that the sticking sheet can be taken out from the pocket housing portion by the gripping means.
  • An in-situ introduction aid for an adhesive sheet is an in-body introduction aid for an adhesive sheet used to introduce an adhesive sheet into the body and apply it to an affected area.
  • the sheet support piece is configured to have a sheet shape or a non-cylindrical shape so that a space can be secured between the affected part and the body.
  • An in-situ introduction aid for an adhesive sheet is an in-body introduction aid for an adhesive sheet used for introducing an adhesive sheet into a body cavity and applying it to an affected area.
  • a mounting portion for mounting a sheet wherein the mounting portion includes a pocket housing portion having an opening through which the adhesive sheet can be taken in and out, and the pocket housing portion includes two overlapping film sheets, and the film sheet By sealing the outer peripheral edge of the film leaving the opening, the adhesive sheet can be accommodated between the film sheets, and the opening can be taken in and out of the pocket accommodating part. With a wide opening width.
  • the sticking sheet can be pulled out easily and can be stuck to the affected area with a simple operation.
  • “Pulling the sticking sheet” refers to moving the sticking sheet from a predetermined position in order to stick the sticking sheet, and the moving direction of the sticking sheet is not limited.
  • FIG. 2 is a perspective view of the in-body introduction aid of the embodiment shown in FIG. 1 with a sticking sheet being pulled out.
  • FIG. 2 is a perspective view of the in-body introduction auxiliary tool concerning a 2nd embodiment.
  • FIG. 7 is a perspective view of the in-body introduction aid of the embodiment shown in FIG.
  • FIG. 7 is explanatory drawing of the state which the sheet
  • (A) is a perspective view
  • (B) is a front view.
  • (A) is a perspective view
  • (B) is a front view.
  • FIG. 6 shows the state which the sheet
  • FIG. 1 It is a perspective view of the sheet
  • FIG. 2 It is a perspective view of the body introduction assistance tool which concerns on 7th Embodiment. It is a figure which shows the state in which the sticking sheet is engaging with the engaging part of the body introduction assistance tool of embodiment shown by FIG. It is a perspective view which shows the modification of the in-body introduction assistance tool of embodiment shown by FIG. It is the elements on larger scale which show the engaging part of the body introduction assistance tool of embodiment shown by FIG. It is a perspective view of the body introduction assistance tool which concerns on 8th Embodiment. It is a perspective view which shows the modification of the in-body introduction assistance tool of embodiment shown by FIG.
  • an in-vivo introduction aid and an in-vivo introduction aid according to an embodiment of the present invention on an endoscope.
  • the following embodiment is an example to the last, and the method of attaching the in-vivo introduction aid and the in-vivo introduction aid of the present invention to the endoscope is not limited to the following embodiment.
  • the features described in the following embodiments can be used in combination with different embodiments.
  • First Embodiment> 1 and 2 show an in-vivo aid 10 according to a first embodiment of the present invention.
  • the direction in which the endoscope E around which the body introduction assisting tool 10 is wound is introduced into the body is the front end side
  • the direction opposite to the front end side is the rear end side, along the front end side and the rear end side.
  • the direction is the front-rear direction.
  • the thickness direction of the sheet support piece 15 is the vertical direction.
  • the in-vivo introduction aid 10 is used to introduce the sticking sheet S into the body and stick it to the affected part.
  • the body introduction assisting tool 10 is attached to the distal end portion of a medical instrument introduced into the body, such as an endoscope or a laparoscope.
  • the body introduction aid 10 is introduced into a digestive tract such as the esophagus, stomach, and duodenum, and other internal organs through a medical instrument such as the endoscope E, for example.
  • the in-vivo introduction assisting tool 10 is used, for example, to affix a patch sheet S to an affected area in order to prevent accidental onset such as bleeding or perforation after excision of a lesion in the body. In the present embodiment, as shown in FIG.
  • the body introduction assisting tool 10 is mounted along the outer periphery of the distal end portion of the endoscope E, and moves with the endoscope E in the vicinity of the affected area. To reach.
  • the endoscope E is described as an example of the attachment target of the in-vivo support tool 10, but the attachment target of the in-vivo support tool 10 is not limited to the endoscope E.
  • the patch sheet S is a medical material in the form of a sheet that is introduced into the body by the body introduction aid 10 and is stuck to the affected area.
  • the patch sheet S is transported through the body in a state of being attached to the body introduction assisting tool 10, and after the body introduction assisting tool 10 reaches the vicinity of the affected area, one or a plurality of sheets are affixed to the affected area.
  • the material and structure of the patch sheet S are not particularly limited as long as it can be introduced into the body by the body introduction aid 10 and can be stuck to the affected area.
  • the patch sheet S can be, for example, a medical nonwoven fabric having a predetermined size.
  • an absorbent suture reinforcing material (Neoval (registered trademark) which is a nonwoven fabric made of polyglycolic acid manufactured by Gunze Co., Ltd. can be mentioned.
  • gauze or an adhesion prevention material may be used.
  • the body introduction aid 10 includes a mounting portion A for mounting the adhesive sheet S and a sheet support piece 15 for supporting the adhesive sheet S. Further, the body introduction assisting tool 10 may include a base B on which the mounting part A and the sheet support piece 15 are provided.
  • the base portion B can be provided with a mounting portion A, and the sheet support piece 15 is movable relative to the base portion B.
  • the base B serves as a base member when the mounting part A is inserted into the body, and may be ring-shaped or sheet-shaped.
  • the base B may be provided with a pocket accommodating portion 12 as the mounting portion A.
  • one of the two overlapping film sheets 11, 11 is configured to be the base B and is attached to the distal end of the endoscope E.
  • the structure of the base B is not particularly limited as long as it can be attached to an attachment target such as the endoscope E.
  • the base B is configured in a flexible sheet shape so that the base B can be wound around and attached to the outer periphery of the endoscope E.
  • the base B may have a width that covers the entire circumferential direction of the outer periphery of the endoscope E, or may have a width that covers a part of the circumferential direction.
  • the material of the base B is not particularly limited, and for example, a flexible synthetic resin such as polyethylene, polypropylene, polystyrene, polyvinyl chloride, or the like can be used.
  • the base B has a fixing portion 14 that can be attached to the endoscope E, and the in-vivo assisting tool 10 is attached to the endoscope E via the fixing portion 14.
  • the fixing portion 14 is shown as a portion on the rear end side of the base B, and the fixing tape 30 is wound around the outer periphery of the endoscope E as shown in FIG. It is fixed so as not to move in the axial direction with respect to the endoscope E by a fixing means such as.
  • the structure of the fixing portion 14 is not particularly limited as long as the in-vivo assisting tool 10 can be attached to an attachment target such as the endoscope E.
  • the fixing portion may be an annular rubber band integrally attached to the base B or a clip-like member that can be fitted to the outer periphery of the endoscope E.
  • the fixing portion may be an adhesive layer provided on a surface of the base B that faces the outer periphery of the endoscope E.
  • the fixing portion 14 is provided on the rear end side of the base B, but the position where the fixing portion is provided is not limited to the rear end side of the base B.
  • the mounting part A is a part where the patch sheet S is mounted in the in-vivo introduction aid 10.
  • the mounting part A can be transported in a state where the adhesive sheet S is mounted to the target site when the body introduction assisting tool 10 is introduced into the body.
  • the mounting portion A may be configured such that after the adhesive sheet S is transported to the target site, the adhesive sheet S is detached and installed at the target site. For example, when the distal end portion of the endoscope E moves to the vicinity of the affected area, the mounting portion A only needs to be able to be mounted in a state where the adhesive sheet S can be introduced into the body.
  • the mounting part A can mount at least a part of the patch sheet S, and can be provided at any location of the body introduction aid 10 as long as the patch sheet S can be mounted in a state where the patch sheet S can be introduced into the body.
  • the mounting portion A may be a part of the base B or a part of the sheet support piece 15.
  • the mounting portion A is composed of the pocket housing portion 12.
  • the pocket housing part 12 has an opening 13 on the tip side.
  • the adhesive sheet S can be accommodated in the pocket accommodating portion 12.
  • the shape of the adhesive sheet S is changed from the initial state before introduction into the body in the process of moving the adhesive sheet S to the vicinity of the affected part. Hard to collapse.
  • the adhesive sheet S has a property such that the adhesive force is activated by moisture, the adhesive sheet S is preferably attached to the affected part in a dry state.
  • the pocket accommodating portion 12 accommodates the adhesive sheet S and the sheet support piece 15.
  • the adhesive sheet S is used. You may accommodate only the sheet
  • the pocket accommodating part 12 is comprised by the two overlapping film sheets 11 and 11, and one film sheet serves as the base B as mentioned above.
  • the outer peripheral edges of the two film sheets 11, 11 are sealed by heat welding, adhesion or the like so that the end on the distal end side when the distal end of the endoscope E is wound becomes the opening 13. It is stopped, and the pocket accommodating part 12 is comprised.
  • the opening 13 is provided at the end of the film sheets 11, 11 on the front end side, and has an opening width that allows the adhesive sheet S to be taken in and out of the pocket housing part 12.
  • the pocket housing part 12 is not limited to the structure described above.
  • the pocket accommodating part 12 may be configured such that the base part B is constituted by a single sheet, and a separate pocket accommodating part 12 having an opening 13 is attached to the base part B.
  • the pocket accommodating portion 12 is folded back by one film material, and the end portion on the distal end side when wound around the distal end portion of the endoscope E and each side other than the folded back side are sealed by heat welding, adhesion or the like. It may be configured.
  • the pocket accommodating part 12 may be comprised by using tube-shaped film material and sealing one side by heat welding, adhesion
  • the pocket accommodating part 12 may be comprised with the material same as the base B, and may be comprised with the material different from the base B. Good.
  • the opening 13 of the pocket accommodating portion 12 is provided only at the end on the front end side of the pocket accommodating portion 12, but all the sides other than the side on the rear end side of the pocket accommodating portion 12 may be the opening 13, and at least the inside view
  • the shape of the opening 13 can be changed to various shapes as long as the adhesive sheet S can be taken in and out from the end on the front end side when wound around the front end side of the mirror E.
  • the shape of the pocket accommodating portion 12 and the shape of the adhesive sheet S accommodated in the pocket accommodating portion 12 are not limited to a rectangular shape, and any shape can be used as long as the adhesive sheet S having a desired shape can be accommodated in the pocket accommodating portion 12.
  • the shape may be an ellipse, a circle, or a polygon.
  • the shape in which the pocket accommodating part 12 and the sticking sheet S differ may be sufficient.
  • the sheet support piece 15 is configured to be able to support the adhesive sheet S, and can support the adhesive sheet S so as to be able to be applied to the target site in the unfolded state.
  • the sheet support piece 15 has flexibility that can be wound around the distal end portion of the endoscope E, and supports the adhesive sheet S in a state of being wound around the distal end portion of the endoscope E. May have such a rigidity.
  • the material of the sheet support piece 15 is not particularly limited as long as the material can transition while supporting the patch sheet S.
  • the sheet support piece 15 can use the same material as the material of the base B described above.
  • the sheet support piece 15 may use a material different from the material of the base B.
  • the sheet support piece 15 is configured to be able to transition between a mountable state and a deployed state.
  • the body introduction assisting tool 10 including the sheet support piece 15 can be attached to a medical instrument such as the endoscope E introduced into the body, such as wrapping around the distal end portion of the endoscope E.
  • This is a state in which the sheet support piece 15 is retracted from the affected part with respect to the deployed state.
  • the “deployed state” is a state in which the sheet support piece 15 is moved or deformed from the mountable state and is displaced so that the patch sheet S mounted on the in-vivo assist device 10 approaches the affected part.
  • the sheet support piece 15 in the mountable state, the sheet support piece 15 is retracted in the front-rear direction, and the tip of the sheet support piece 15 protrudes from the opening 13 of the pocket housing portion 12. It is the state accommodated in the state.
  • the unfolded state is a state in which the sheet support piece 15 has advanced from the two-dot chain line in FIG.
  • the mountable state and the deployed state are not limited to the states shown in the present embodiment.
  • the mountable state is a state in which the sheet support piece 15 is contracted
  • the unfolded state is a state in which the sheet support piece 15 is expanded.
  • the displacement to the deployed state may be a state in which the medical device such as the endoscope E is mounted so as to be able to be introduced into the body and separated from the medical device and deployed. May be in a state where the length in the width direction, which is a direction perpendicular to the insertion direction, is increased.
  • the transition from the mountable state of the seat support piece 15 to the unfolded state is performed by an operation member that causes the seat support piece 15 to transition in a predetermined direction.
  • the operation member is a grasping means (not shown) such as a forceps inserted into the forceps port of the endoscope E and coming out from the distal end side of the forceps port.
  • the sheet support piece 15 and the leading end side of the adhesive sheet S are held by gripping means such as forceps, and the sheet support piece 15 is moved to the deployed state by moving the sheet support piece 15.
  • the operation member that causes the sheet support piece 15 to transition is not limited to gripping means such as forceps.
  • the operation member may be a connection member 16 (see FIG.
  • the operation member includes a fluid supply unit (for example, a syringe) that supplies a fluid for expanding and contracting the sheet support piece 15 and a tubular member 16 that serves as a fluid flow path. (See FIG. 6).
  • a fluid supply unit for example, a syringe
  • the outer periphery of the endoscope E and the in-vivo introduction tool wound around the outer periphery of the endoscope E. 10 is preferably configured so as to have a gap in the radial direction of the endoscope E. Due to this gap, the resistance when the sheet support piece 15 and the adhesive sheet S transition to the unfolded state is reduced, and the transition of the sheet support piece 15 and the adhesive sheet S is facilitated.
  • the surface facing the outer periphery of the endoscope E of the body introduction assisting tool 10 and the outer periphery of the endoscope E A spacer interposed between the surfaces can be used.
  • the distal end side of the body introduction assisting tool 10 is configured in an annular shape so that a gap is formed in advance between the distal end portion of the endoscope E and the sheet supporting piece 15 and the sticking piece 15. The transition to the developed state of the sheet S may be facilitated.
  • the sheet support piece 15 is at least one of the adhesive sheets S so that the adhesive sheet S supported by the sheet support pieces 15 does not hang down in the direction of gravity during the transition process from the mountable state to the deployed state. It is preferable that it is comprised so that a part may be supported.
  • the sheet support piece 15 may be configured to continuously support the adhesive sheet S from the mountable state to the expanded state, or from the middle of the transition process from the mountable state to the expanded state, You may comprise so that the sticking sheet S may be supported.
  • the sheet support piece 15 is accommodated in the pocket accommodating portion 12 and the upper surface of the pocket accommodating portion 12 or the like other than the pocket accommodating portion 12 in the mountable state.
  • the sticking sheet S is attached to the part.
  • the sheet support piece 15 and the adhesive sheet S are moved to the distal end side by gripping means such as forceps and the adhesive sheet S is supported by the sheet support piece 15 after being detached from the upper surface of the pocket housing portion 12.
  • the area of the adhesive sheet S supported by the sheet support piece 15 may increase as the state transitions from the mountable state to the deployed state.
  • the sticking sheet S is attached to the outside of the pocket housing portion 12, it is preferable that the sticking sheet S is in a wet state impregnated with physiological saline or the like because the shape at the time of attachment is easily maintained.
  • the sheet support piece 15 that supports the sticking sheet S is provided, and the sheet support piece 15 is configured to be able to transition between the mountable state and the unfolded state. Therefore, the adhesive sheet S can be easily pulled out from the in-vivo introduction aid 10 via the sheet support piece 15, and the adhesive sheet S can be attached to the affected area with a simple operation.
  • seat support piece 15 changes to a mounting
  • the sheet support piece 15 is configured in a sheet shape as shown in FIG. 1 and has a support surface 15a for supporting the adhesive sheet S.
  • the shape and structure of the sheet support piece 15 are not limited to those shown in the drawings as long as the sticking sheet S can be supported.
  • the support surface 15a of the sheet support piece 15 is configured to support the entire patch sheet S, but the support surface 15a does not need to support the entire patch sheet S.
  • the support surface 15a of the sheet support piece 15 may be configured to support at least a part of the peripheral edge of the adhesive sheet S.
  • the support surface 15a of the sheet support piece 15 is configured to support at least the rear end side of the adhesive sheet S in the peripheral portion of the adhesive sheet S, the rear end of the adhesive sheet S hangs down due to gravity. This can be suppressed. Further, when the support surface 15a of the sheet support piece 15 is configured to support at least the distal end side of the adhesive sheet S along the distal end side of the adhesive sheet S in the peripheral portion of the adhesive sheet S, the adhesive sheet It is easy to maintain the shape of the tip side of S.
  • the support surface 15a of the sheet support piece 15 is configured to support at least both side edges connecting the front end and the rear end of the adhesive sheet S among the peripheral edges of the adhesive sheet S, the adhesive sheet S The shape of the side edge portion is maintained, and the sheet support piece 15 is suppressed from hanging down. Further, when the support surface 15a of the sheet support piece 15 is configured to support the corners of the adhesive sheet S, or when the periphery of the adhesive sheet S is supported in a frame shape, the shape of the adhesive sheet S is also the same. The sheet support piece 15 is suppressed from hanging down.
  • seat support piece 15 is comprised larger than the area of the sticking sheet S, if the whole shape of the sticking sheet S does not collapse, the area of the sticking sheet S Alternatively, the support surface 15a of the sheet support piece 15 may be smaller, or the support surface 15a may have a notch or a hole.
  • the sheet support piece 15 in the deployed state is configured to have a sheet shape so that a space can be secured between the affected part and the body. Since the sheet support piece 15 is in the form of a sheet, when the sheet support piece 15 is in a deployed state, a space is secured between the sheet support piece 15 and the inner wall of an organ in the affected area. In this case, the gastrointestinal tract and trachea are not blocked. For this reason, for example, it is possible to eliminate the adverse effects caused by the airway being closed or the duct being blocked. In addition, since the space is secured between the sheet support piece 15 and the body, the field of view of the objective lens Ec of the endoscope E is not blocked by the sheet support piece 15 even during the application work of the adhesive sheet S. The sticking operation of the sticking sheet S can be performed while ensuring the front view.
  • the sheet support piece 15 has a sheet shape, but when the sheet support piece 15 can be expanded and contracted as in the embodiment described later, the sheet support piece 15 has a non-cylindrical shape other than the sheet shape. May be. In this case as well, the gastrointestinal tract and trachea are not blocked. In addition, since the space is secured between the sheet support piece 15 and the body, the field of view of the objective lens Ec of the endoscope E is not blocked by the sheet support piece 15 even during the application work of the adhesive sheet S. The sticking operation of the sticking sheet S can be performed while ensuring the front view.
  • the sheet support piece 15 when the sheet support piece 15 is in a non-cylindrical shape when expanded, the distal end portion of the endoscope E to which the in-vivo assist device 10 is attached is prevented from pressing the inner wall of the digestive tract due to the expansion of the sheet support piece 15. be able to.
  • the sheet support piece 15 may have a shape having a plurality of curved surfaces having different curvatures in a cross section perpendicular to the insertion direction.
  • this in-vivo aid 10 includes a sheet support piece 15 that can be inserted into and removed from the opening 13 with respect to the pocket housing 12.
  • the upper surface of the sheet support piece 15 is a support surface 15a for supporting the adhesive sheet S.
  • the sheet support piece 15 is accommodated in the pocket accommodating portion 12 in a state where the adhesive sheet S is supported at least on the upper surface.
  • the planar shape of the sheet support piece 15 is formed in a convex shape in which the width on the rear end side is larger than the width on the front end side, and a notch surface 15f is provided on the front end side on both sides of the rear end portion.
  • the pocket accommodating portion 12 is formed such that the width of the opening 13 is smaller than the width inside the pocket accommodating portion 12, and a terminal surface 12 b is provided on the rear end side of the sealing portion on the front end side. For this reason, when the sheet support piece 15 is pulled out from the opening 13 of the pocket accommodating portion 12, the notch surface 15 f of the sheet support piece 15 comes into contact with the end surface 12 b of the pocket accommodating portion 12.
  • the length of the seat support piece 15 in the front-rear direction is set to be longer than the length of the pocket accommodating portion 12 in the depth direction (front-rear direction). That is, in the state where the sheet support piece 15 is accommodated in the pocket accommodating portion 12, the end portion 15b on the rear end side of the sheet support piece 15 abuts on the end portion 12a on the opposite side of the opening portion 13 of the pocket accommodating portion 12, An end 15c on the front end side of the sheet support piece 15 protrudes from the opening 13 and is substantially aligned with the front end of the adhesive sheet S.
  • the length of the sheet support piece 15 in the front-rear direction is not limited thereto, and when the sheet support piece 15 and the adhesive sheet S are accommodated in the pocket accommodating part 12 with their respective leading ends aligned, the adhesive sheet It is only necessary that the rear end side Sa of S be accommodated so that it is closer to the front (front end side) than the notch surface 15f of the sheet support piece 15.
  • the length (width) on the front end side of the sheet support piece 15 may be smaller than the adhesive sheet S as long as it can be taken in and out from the opening 13.
  • the material of the sheet support piece 15 is formed of a synthetic resin of the same material as the film sheets 11 and 11, but is not particularly limited as long as it can be taken in and out of the pocket housing portion 12. Alternatively, other materials may be used. It is preferable that the sheet support piece 15 is made of a transparent material so that the adhesive sheet S superimposed on the upper surface can be confirmed with the endoscope E when the sheet support piece 15 is viewed from below.
  • a grasping means such as forceps is inserted from the distal end surface Ea of the endoscope E. It advances and grasps both the sticking sheet S and the sheet
  • the grasping means is advanced and the adhesive sheet S and the sheet support piece 15 are pulled out as shown in FIG.
  • the patch sheet S is pulled out while being supported by the support surface 15a of the sheet support piece 15.
  • the rear end portion of the sheet support piece 15 is the pocket housing portion. Since it is not pulled out from the inside, it does not hang down in the direction of gravity, and the support surface 15a of the sheet support piece 15 maintains the state of supporting the adhesive sheet S. In this state, the sticking sheet S is spread using the gripping means and the distal end portion of the endoscope E and attached to the affected part.
  • the support surface 15a of the sheet support piece 15 maintains the state in which the patch sheet S is supported, so that the patch sheet S does not hang down in the direction of gravity. It becomes easy to perform the pasting operation.
  • the notch surface 15f of the sheet support piece 15 comes into contact with the end surface 12b of the pocket housing portion 12 and resistance when pulled out increases. It is possible to prevent all the sheet support pieces 15 from being pulled out. It is also possible to prevent the sheet support piece 15 from dropping and being left in the body when the endoscope E is pulled out of the body after the patch sheet S is pasted to the affected area.
  • the adhesive sheet S is smaller than the sheet support piece 15 and is accommodated on the support surface 15a of the sheet support piece 15, but the size of the adhesive sheet S is not limited to this, You may accommodate in the pocket accommodating part 12 in the state folded and pinched
  • FIG. 3 shows a body introduction aid 10 according to the second embodiment of the present invention. Note that the features described in the first embodiment may be applied to the in-vivo introduction aid of the second embodiment, and the features described in the second embodiment may be applied in other embodiments. The description of the points common to the in-vivo introduction aid of the first embodiment will be omitted, and the second embodiment will be described focusing on the differences from the first embodiment.
  • the in-vivo assisting device 10 includes a long connecting member 16 that is connected to the sheet support piece 15 at one end and can operate the sheet support piece 15. Moreover, in this embodiment, the connection member 16 can be inserted, and the hollow outer cylinder 17 with which the opening of one end side is connected to the inside of the pocket accommodating part 12 is provided.
  • the sheet support piece 15 is connected to a connecting member 16 having a tip inserted into the pocket accommodating portion 12 from the end opposite to the opening 13 of the pocket accommodating portion 12.
  • the front end portion of the outer cylinder 17 is between the two film sheets 11, 11 at the connection portion 14 a, and the end portion 12 a on the rear end side of the pocket storage portion 12. Further, it is inserted into the pocket accommodating portion 12 and fixed by welding, adhesion or the like.
  • the connecting member 16 is slidably inserted into the outer cylinder 17, and the front end portion is connected to the central portion of the end portion 15 b on the rear end side of the sheet support piece 15.
  • connection member 16 is not limited, it should just have flexibility, for example, from the wire which consists of metal wires, such as stainless steel, or a twisted wire, and synthetic resins, such as polyethylene, polypropylene, polystyrene, and polyvinyl chloride Made up of yarn or braid.
  • the material of the connection member 16 is a synthetic resin of the same material as the sheet support piece 15, the sheet support piece 15 and the connection member 16 can be connected by heat welding.
  • the material of the outer cylinder 17 is not limited, but is composed of a flexible tube made of a synthetic resin such as polyethylene, polypropylene, polystyrene, polyvinyl chloride or the like.
  • a synthetic resin such as polyethylene, polypropylene, polystyrene, polyvinyl chloride or the like.
  • the planar shape of the sheet support piece 15 and the pocket accommodating portion 12 may be a simple rectangular shape as shown in FIG.
  • the connection member 16 is pulled to the rear end side, so that the sheet support piece 15 is accommodated in the pocket again. It can be stored in the part 12.
  • the observation visual field of the endoscope E can be ensured after sticking the sticking sheet S to an affected part, and the sticking state to the affected part of the sticking sheet S is immediately carried out. Can be confirmed.
  • connection member 16 is slidably inserted into the outer cylinder 17, but the outer cylinder 17 may not be used.
  • a through-hole that does not weld the two film sheets 11, 11 may be provided in the connection portion 14 a of the fixing portion 14, and the connection member 16 may be slidably inserted therein.
  • the connecting member 16 since the connecting member 16 may not slide when it is fixed to the outer periphery of the endoscope E with the fixing tape 30, it is better to dispose a cylindrical hollow member in the connecting portion 14a.
  • the connecting member 16 moves outside the endoscope E, the connecting member 16 cannot be fixed to the endoscope E and is difficult to handle when the endoscope E is inserted into the body or pulled out of the body. .
  • the movement of the connecting member 16 is directly transmitted to the patient, giving discomfort.
  • the outer cylinder 17 through which the connecting member 16 is inserted the outer tube 17 can be fixed to the endoscope E, and the movement of the connecting member 16 can be prevented from being transmitted to the patient.
  • FIG. 4 shows a body introduction aid 10 according to the third embodiment of the present invention. Note that the features described in the first and second embodiments may be applied to the in-vivo introduction tool of the third embodiment, and the features described in the third embodiment are applied in other embodiments. Also good. Description of points common to the in-vivo introduction aids of the first and second embodiments will be omitted, and the third embodiment will be described focusing on differences from the first and second embodiments.
  • the sheet support piece 15 is continuous in a part of the pocket housing portion 12 and the opening portion 13, and can be pulled out from the opening portion 13 by being folded and folded back into the pocket housing portion 12. Yes.
  • the sheet support piece 15 is accommodated in the pocket accommodating portion 12 in a state where the adhesive sheet S is supported on at least the upper surface.
  • the patch sheet S is accommodated between the folded upper surface of the sheet support piece 15 and the inner surface of the pocket accommodating portion 12 (upper film sheet 11 in FIG. 4).
  • description of the sticking sheet S is abbreviate
  • the sheet support piece 15 When the sheet support piece 15 is pulled out and deployed, the length from the distal end 15c to the opening 13 is longer than the length in the front-rear direction of the adhesive sheet S, and the entire adhesive sheet S is the pocket accommodating part.
  • the sheet support piece 15 pulled out together with the adhesive sheet S can support the end Sa (see FIG. 3) on the rear end side of the adhesive sheet S.
  • FIG. 5 shows an in-vivo aid 10 according to a fourth embodiment of the present invention.
  • the features described in the first to third embodiments may be applied to the in-vivo introduction aid of the fourth embodiment, and the features described in the fourth embodiment are applied to other embodiments. Also good. Description of points common to the in-vivo introduction aids of the first to third embodiments will be omitted, and the fourth embodiment will be described focusing on differences from the first to third embodiments.
  • FIG. 5 is a modification of the embodiment of FIG. 4.
  • the tip of the connection member 16 is connected to the center of the folded portion 15b of the sheet support piece 15 of FIG.
  • the sheet support piece 15 is pulled out together with the adhesive sheet S and the adhesive sheet S is attached to the affected area, when the connecting member 16 is pulled to the rear end side, the sheet support piece 15 is folded back. It is stored again in the pocket storage unit 12.
  • the in-vivo assisting tool 10 of the fourth embodiment after affixing the adhesive sheet S to the affected area, by storing the sheet support piece 15 again, The observation visual field of the endoscope E can be ensured, and the state of application of the adhesive sheet S to the affected area can be confirmed immediately.
  • ⁇ Fifth Embodiment> 6 to 11 show the body introduction aid 10 of the fifth embodiment. Note that the features described in the first to fourth embodiments may be applied to the in-vivo introduction aid of the fifth embodiment, and the features described in the fifth embodiment are applied to other embodiments. Also good. Description of points common to the in-vivo introduction aids of the first to fourth embodiments will be omitted, and the fifth embodiment will be described focusing on differences from the first to fourth embodiments.
  • the sheet support piece 15 is configured to be able to transition between a mountable state and a deployed state that is deployed by introduction of a fluid.
  • the sheet support piece 15 is configured to expand and contract as a fluid is introduced and discharged.
  • the seat support piece 15 can be attached to the distal end portion of the endoscope E, the fluid is not introduced, or the discharged state is contracted (attachable state), and the fluid is introduced in an expanded state. Transition to (expanded state) is possible.
  • the patch sheet S supported by the sheet support surface 15 can move toward the affected area. Therefore, when the sticking sheet S is stuck, the sticking sheet S can be easily moved toward the affected part via the sheet support piece 15, and the sticking sheet S can be stuck to the affected part by a simple operation. .
  • the seat support piece 15 is mounted in the retracted state in the pocket housing portion 12 (base B), and is advanced forward in the contracted state with respect to the mountable state. It is comprised so that it may change between a state (refer FIG. 9) and the expansion
  • the sheet support piece 15 is at least one of the adhesive sheets S so that the adhesive sheet S supported by the sheet support pieces 15 does not hang down in the direction of gravity in the transition process from the mountable state to the advanced state. It is preferable that it is comprised so that a part may be supported.
  • the sheet support piece 15 may be configured to continuously support the adhesive sheet S from the attachable state to the advanced state, or from the middle of the transition process from the attachable state to the advanced state, You may comprise so that the sticking sheet S may be supported.
  • the sheet support piece 15 is configured to expand while supporting the adhesive sheet S from the advanced state to the expanded state.
  • the sheet support piece 15 is configured in a sheet shape having a support surface 15a on the upper surface in the contracted state. Further, in the expanded state, the sheet support piece 15 has a direction in which the support surface 15a is substantially perpendicular to the direction in which the body introduction assisting tool 10 is introduced into the body (or to the support surface 15a in the contracted state). It is configured to extend to.
  • the patch sheet S can be moved toward the affected part while being supported by the support surface 15a of the sheet support piece 15, and can be moved to the affected part while maintaining the effective area of the patch sheet S. It becomes easy to apply.
  • the support surface 15a of the sheet support piece 15 expanded by the introduction of the fluid can be elastically deformed together with the adhesive sheet S according to the surface shape of the internal wall of the body where the affected part is located. is there. Therefore, the patch sheet S can be easily pasted even in an affected area having a complicated surface shape.
  • the structure of the sheet support piece 15 is not particularly limited as long as the sheet support piece 15 can be switched between the mountable state and the deployed state by introducing a fluid.
  • the sheet support piece 15 includes an airtight chamber 152 that is formed fluid-tight, and is configured to be in an expanded state by introduction of fluid into the airtight chamber 152.
  • the sheet support piece 15 is connected to a tubular member 16 having a lumen, the tip of which is inserted into the pocket accommodating portion 12 from the end opposite to the opening 13.
  • the lumen of the tubular member 16 communicates with the hermetic chamber 152 and is configured to introduce fluid into the hermetic chamber 152 through the lumen.
  • One opening of the tubular member 16 communicates with the airtight chamber 152, and the other opening is connected to a fluid supply unit (not shown) that supplies fluid such as air into the airtight chamber 152 such as a syringe.
  • a fluid supply unit (not shown) that supplies fluid such as air into the airtight chamber 152 such as a syringe.
  • the tubular member 16 is slidably inserted through the outer cylinder 17.
  • the sheet support piece 15 can be moved from the mountable state to the advanced state by moving the tubular member 16 to the front end side in the outer cylinder 17.
  • the sheet support piece 15 in the deployed state is configured to have a non-cylindrical shape so that a space SP can be secured between the affected part and the body. ing.
  • a space SP is secured between the sheet support piece 15 and the inner wall of the organ in the affected area. Therefore, the gastrointestinal tract and trachea are not blocked. Therefore, for example, conventionally, it has been necessary to perform a careful work so that the airway is not closed or the pipeline is not blocked. It can be done easily.
  • the shape of the sheet support piece 15 in the unfolded state is a non-cylindrical shape, and the cross-sectional shape in the width direction, which is a direction perpendicular to the direction of introduction into the body, is non-circular, and between the affected part and the body.
  • the length in the width direction may be configured to be longer than the length in the vertical direction, which is a direction perpendicular to the introduction direction and the width direction.
  • the cylindrical shape is a shape formed such that a circular cross section having a circular cross section in the width direction has a length, and includes shapes such as a cylindrical shape and a rugby ball shape.
  • a balloon made of a stretchable material is uniformly expanded in a direction perpendicular to the introduction direction, and thus has a cylindrical shape when inflated with a fluid.
  • the sheet support piece 15 in the deployed state preferably expands so as not to block the front of the objective lens Ec and / or the forceps port Eb of the endoscope E.
  • the field of view of the objective lens Ec of the endoscope E and the space SP in front of the forceps port Eb are not blocked by the expanded sheet support piece 15 at the time of applying the application sheet S.
  • the functions of instruments such as forceps protruding from the objective lens Ec of the endoscope E and the forceps port Eb toward the distal end are not easily restricted.
  • a flat shape expanded in a direction perpendicular to the introduction direction in the body can be used.
  • the sheet support piece 15 in the unfolded state is flat, a wide space SP is secured on the distal end side of the endoscope E.
  • the sheet support piece 15 in the unfolded state is configured to expand in the same manner on both the upper surface side and the lower surface side with respect to the sheet-like sheet support piece 15 before the unfolded state.
  • the sheet support piece 15 has an expansion amount on the upper surface side that is the affected area side larger than an expansion amount on the lower surface side, for example, by making the rigidity of the material on the lower surface side higher than the rigidity of the material on the upper surface side.
  • the lower surface side may be configured not to expand.
  • the number of the airtight chambers 152 provided in the sheet support piece 15 is not particularly limited, and the number of the airtight chambers 152 may be one or plural. In the present embodiment, as shown in FIGS. 7 and 10, the sheet support piece 15 is divided into two airtight chambers 152 a and 152 a communicating with each other, but the number of the airtight chambers 152 is not particularly limited. Further, when there are a plurality of the airtight chambers 152, the partitioning direction may be partitioned in the front-rear direction, or may be partitioned in the width direction in the direction orthogonal to the front-rear direction in the sheet support piece 15.
  • the sheet support piece 15 in this embodiment has a substantially rectangular planar shape, and the outer peripheral edges of the two overlapping support film sheets 151 and 151 are sealed by heat welding or the like.
  • An airtight chamber 152 is formed.
  • a sealing portion 15d is formed up to a middle position by thermal welding or the like from the end portion 15c on the front end side to the end portion 15b on the rear end side.
  • the chambers 152a and 152a are formed by being divided into two in the direction in which they are made.
  • tubular connection member (tubular member) 16 is connected to the sheet support piece 15 at an end portion 15 b on the rear end side of the sheet support piece 15 so that only the inner cavity communicates with the airtight chamber 152.
  • material of the tubular member 16 is not limited, it is comprised from the tube which has the softness
  • the tubular member 16 is fixed to the tubular member 16 by thermal welding at a time when sealing the periphery of the support film sheets 151 and 151. Can do.
  • the rear end portion (not shown) of the tubular member 16 is connected to a syringe via a luer lock-shaped connector part or the like.
  • the air in the syringe is introduced into the airtight chamber 152 of the sheet support piece 15 through the lumen of the tubular member 16, and the sheet support piece 15 expands.
  • the plunger of the syringe is pulled, the air in the airtight chamber 152 of the sheet support piece 15 is sucked into the syringe through the lumen of the sheet support piece 15, so that the sheet support piece 15 contracts.
  • a gripping portion 15 e for gripping the sheet support piece 15 by a gripping means such as forceps protrudes from the end portion 15 c on the front end side of the sheet support piece 15.
  • the gripping portion 15 e protrudes from the opening portion 13.
  • the grip portion 15e is formed at the center of the end portion 15c on the front end side of the sheet support piece 15, but may be formed over the entire end portion 15c on the front end side of the sheet support piece 15. Good.
  • the shape of the gripping part 15e may be a pocket shape (bag shape) or a hole as long as it can be gripped by the gripping means, or may be a ring member formed of a thread or the like. Moreover, you may comprise so that the sticking sheet S may be pulled out from the front-end
  • a method for attaching the in-vivo introduction aid 10 of this embodiment to the endoscope E and an in-body introduction method for the adhesive sheet S using the in-body introduction aid 10 will be described.
  • the spacer 20 is extracted.
  • the grip portion 15 e and the sealing portion 15 d located at the center of the sheet support piece 15 are closest to the forceps port Eb on the distal end surface Ea of the endoscope E. It is wound around the outer peripheral surface of the endoscope E so as to be located at a location.
  • a grasping means such as forceps is advanced from the forceps port Eb on the distal end surface Ea of the endoscope E, and the sticking sheet S protruding from the distal end surface Ea of the endoscope E toward the distal end side.
  • the grip part 15e of the sheet support piece 15 is gripped.
  • a holding means will be advanced and the whole sticking sheet S will be pulled out.
  • the pulled-out sticking sheet S and the sheet support piece 15 are pulled out while maintaining the shape wound around the endoscope E as shown in FIG.
  • the sheet support piece 15 expands as shown in FIGS. 10 (A) and 10 (B).
  • the distal end surface Ea of the endoscope E is flatter or slightly curved at the distal end side, and the adhesive sheet S supported by the support surface 15a of the sheet support piece 15 is pasted so as to be pressed against the affected area.
  • the airtight chamber 152 of the sheet support piece 15 is divided into chambers 152a and 152a by the sealing portion 15d, and the sealing portion 15d is positioned at a position closest to the forceps port Eb on the distal end surface Ea of the endoscope E.
  • the sheet support piece 15 since the body introduction assisting tool 10 is wound around the outer peripheral surface of the endoscope E, the sheet support piece 15 has a wing shape (flat shape) sandwiching the gripping means advanced from the forceps port Eb of the endoscope E. In one example) it expands on both sides.
  • the sealing portion 15d does not exist, the sheet support piece 15 expands in the vertical direction in the drawing of FIG.
  • the support surface 15 a that is the upper surface of the sheet support piece 15 is pressed against the affected area, while a large space is provided on the lower surface side of the sheet support piece 15. SP is secured. Therefore, in the present embodiment, unlike a balloon-like structure that swells into a cylindrical shape, the duct in the body is not blocked, and a space SP is secured in front of the objective lens Ec and the forceps port Eb of the endoscope E. .
  • the gripping means is released and the gripping means is retracted, and then the fluid of the sheet support piece 15 is extracted to contract the sheet support piece 15. And the sheet
  • seat support piece 15 is accommodated in the pocket accommodating part 12 again by pulling the tubular member 16 to the rear-end side.
  • ⁇ Sixth Embodiment> 12 and 13 show the body introduction aid 10 of the sixth embodiment. Note that the features described in the first to fifth embodiments may be applied to the in-vivo introduction aid of the sixth embodiment, and the features described in the sixth embodiment are applied in other embodiments. Also good. Description of points common to the in-vivo introduction aids of the first to fifth embodiments will be omitted, and the sixth embodiment will be described focusing on differences from the first to fifth embodiments.
  • the sheet support piece 15 in this modification differs from the sheet support piece 15 of the embodiment of FIG. 7 in that the grip portion 15e is not present, but a grip portion 15e may be provided.
  • the sheet support piece 15 is folded in half so that the adhesive sheet S is on the outside in a state where the adhesive sheet S is superimposed on the support surface 15 a.
  • the end portion 15c on the front end side that is folded back is located on the front end side with respect to the end portion 15b on the rear end side to which the tubular member 16 is connected. In this state, as shown in FIG.
  • the piece 15 is accommodated in the pocket accommodating portion 12 of the body introduction aid 10.
  • the in-vivo assisting tool 10 in this state is wrapped around the distal end portion of the endoscope E via a spacer 20 (see FIG. 23) or the like only, and the spacer 20 is pulled out to remove the outer peripheral surface of the endoscope E and the in-vivo introduction assisting tool.
  • the gap 40 (see FIG. 25) is formed between the distal end of the endoscope E and the affected part of the body, the distal end of the endoscope E is introduced to the affected part without grasping the adhesive sheet S and the sheet support piece 15 by the grasping means.
  • the tubular member 16 is pushed to the front end side to push out the folded sheet support piece 15 until the entire adhesive sheet S and the end portion 15c on the front end side of the sheet support piece 15 come out of the opening 13.
  • a fluid such as air is introduced into the hermetic chamber 152 of the sheet support piece 15 through the tubular member 16
  • the sheet support piece 15 expands, the half-folded state is released, extends to the front end side, and is flat or slightly curved
  • the patch sheet S supported by the support surface 15a of the sheet support piece 15 is pasted so as to be pressed against the affected area.
  • the fluid of the sheet support piece 15 is extracted and contracted, and the tubular member 16 is pulled to the rear end side, whereby the sheet support piece 15 is stored again in the pocket storage part 12.
  • FIG. 14 shows the body introduction aid 10 of the seventh embodiment. Note that the features described in the first to sixth embodiments may be applied to the in-vivo introduction aid of the seventh embodiment, and the features described in the seventh embodiment are applied to other embodiments. Also good. Description of points common to the in-vivo introduction aids of the first to sixth embodiments will be omitted, and the seventh embodiment will be described focusing on differences from the first to sixth embodiments.
  • the mounting portion A has an engaging portion 18 that can engage at least both ends in the width direction of the adhesive sheet S.
  • the mounting portion A having the engaging portion 18 is the pocket accommodating portion 12.
  • the patch sheet S is attached to the distal end side of the pocket accommodating portion 12 or the upper surface of the pocket accommodating portion 12 by engaging with the engaging portion 18 and is provided outside the in vivo introduction assisting tool 10 when introduced into the body. .
  • the engaging portion 18 is configured such that both end portions in the width direction of the adhesive sheet S are engaged at least.
  • the width direction of the adhesive sheet S is a direction orthogonal to the front-rear direction in a state where the adhesive sheet S is flat. Both end portions in the width direction of the adhesive sheet S need only be predetermined regions on both end sides in the width direction, and need not be edges in the width direction of the adhesive sheet S.
  • the engaging portion 18 is formed over the entire width direction, as shown in FIGS. 14 and 15. In this case, the range of engagement with the adhesive sheet S is increased, and the adhesive sheet S can be more reliably engaged.
  • the engagement portion 18 can be introduced into the body in a state where the flat region of the patch sheet S corresponding to the affected part is maintained in a state where the sheet support piece is attached to the medical instrument such as the endoscope E. Further, it may be provided so as to engage with the sticking sheet S. Moreover, the engaging part 18 may be comprised so that the sticking sheet S may be engaged with the sticking sheet S so that the flat part of a predetermined area may be formed in the unfolded state.
  • the mounting portion A has the engaging portions 18 at which both end portions in the width direction of the adhesive sheet S can be engaged at least.
  • both end portions of the patch sheet S may be turned up because both end portions of the patch sheet S are engaged with the engaging portions 18. It is suppressed.
  • the adhesive sheet S exposed and attached outside the in-vivo assist device 10 comes into contact with the inner wall of the organ in the body and is turned up with both ends turned up. It can suppress that the effective area at the time of sticking becomes smaller than the time of introduction. Therefore, in addition to the effects described in the first embodiment, when the adhesive sheet S is applied, the adhesive sheet S can be attached to the affected area in the original state or in a state close to the original state. The area can be utilized.
  • the engaging portion 18 allows movement in the introduction direction in which the adhesive sheet S is introduced into the body with respect to the engaging portion 18 so that the adhesive sheet S does not detach from the engaging portion 18, and is opposite to the introduction direction. It is preferable to restrict movement in the direction. In this case, when affixing the affixing sheet S to the affected area, for example, when the affixing sheet S and the sheet support piece 15 are advanced with respect to the pocket housing part 12 (base B) by forceps or the like, The engaging portion 18 does not become an obstacle, and the sticking sheet S can be smoothly moved to the front end side.
  • the sticking sheet S is restricted from moving with respect to the mounting portion A on the side opposite to the introduction direction into the body. Therefore, even if the end of the adhesive sheet S that is not grasped by the grasping means such as forceps is to be turned when introduced into the body, the engaging portion 18 is caught and the end of the adhesive sheet S is prevented from being turned. Therefore, the entire adhesive sheet S is conveyed in a state close to the original state without the end of the adhesive sheet S being turned up. Moreover, in this embodiment, since the mounting part A has the engaging part 18, the engaging sheet 18 can be simply engaged with the engaging part 18 from the outside of the body introduction assisting tool 10. Installation is complete.
  • the engaging part 18 may be engaged with the adhesive sheet S in the introduction direction, and the adhesive sheet S can be detached by moving the engaging part 18 in either direction.
  • the shape of the engaging portion 18 is not particularly limited as long as it can be engaged with both end portions of the adhesive sheet S to suppress turning up of both end portions of the adhesive sheet S.
  • the engaging portion 18 may be provided with a plurality of protruding engaging portions protruding toward the distal end side at the end edge of the pocket accommodating portion 12.
  • the engaging part 18 may be provided in the upper surface of the pocket accommodating part 12, as FIG. 16 shows.
  • the engaging portion 18 is configured as a spine-like engaging portion that protrudes from the upper surface of the pocket housing portion 12 and extends toward the distal end side.
  • the engaging portion 18 may be formed integrally with the pocket housing portion 12, or the engaging portion 18 of another member may be attached to the pocket housing portion 12 by adhesion or the like.
  • the position where the engaging portion 18 is provided is not particularly limited as long as it can be engaged with both end portions of the adhesive sheet S attached to the outside of the body introduction assisting tool 10.
  • the engaging portion 18 may be provided at any position from the front end side to the rear end side of the top surface of the pocket housing portion 12 or the top surface of the pocket housing portion 12 as the mounting portion A.
  • An engagement portion may be provided on the front end side and the rear end side of the sheet so as to suppress twisting in the width direction of the adhesive sheet S.
  • the engaging part 18 since the engaging part 18 is provided in the front end side of the pocket accommodating part 12, turning up of the front end side of the sticking sheet S is suppressed. In this case, the turning of the whole patch sheet S is suppressed, and the retainability of the shape of the patch sheet S can be improved.
  • the engaging part 18 is provided along the width direction of the mounting part A, for example, it is provided along the front-back direction so that the both sides edge of the sticking sheet S to be mounted may be followed. It may be done.
  • ⁇ Eighth Embodiment> 18 and 19 show the body introduction aid 10 of the eighth embodiment.
  • the features described in the first to seventh embodiments may be applied to the in-vivo introduction aid of the eighth embodiment, and the features described in the eighth embodiment are applied to other embodiments. Also good.
  • the description of the points common to the in-vivo introduction aids of the first to seventh embodiments is omitted, and the eighth embodiment will be described focusing on the differences from the first to seventh embodiments.
  • the in-body introduction aid of the present embodiment has the sheet support piece 15 having an engagement portion 18 that can engage at least both ends in the width direction of the adhesive sheet S. Yes.
  • the adhesive sheet S may be mounted inside the pocket housing part 12 or may be mounted on the upper surface of the pocket housing part 12.
  • the engaging portion 18 is configured such that at least both end portions in the width direction of the adhesive sheet S are engaged, as in the seventh embodiment.
  • the engaging portion 18 is formed over the entire width direction. In this case, the range of engagement with the adhesive sheet S is increased, and the adhesive sheet S can be more reliably engaged.
  • the sheet support piece 15 has the engaging portions 18 with which both end portions in the width direction of the adhesive sheet S can be engaged.
  • the both ends of the adhesive sheet S are engaged with the engaging portion 18, thereby preventing the both ends of the adhesive sheet S from turning up.
  • the patch sheet S is accommodated in the pocket accommodating part 12, during the movement to the vicinity of the affected part in the body, the turning of the adhesive sheet S is suppressed in the pocket accommodating part 12, and it moved to the vicinity of the affected part. Later, when the sticking sheet S moves forward together with the sheet support piece 15, it is possible to prevent the end portions of the sticking sheet S from being turned up by the engaging portion 18. Therefore, in addition to the effects described in the first embodiment, when the adhesive sheet S is applied, the adhesive sheet S can be attached to the affected part in the original state or in a state close to the original state. The area can be utilized.
  • the shape of the engaging portion 18 is not particularly limited as long as it can be engaged with both end portions of the adhesive sheet S to suppress turning up of both end portions of the adhesive sheet S.
  • the engaging portion 18 can be provided on the front end side of the sheet support piece 15.
  • a plurality of projecting engaging portions 18 projecting toward the front end side are provided on the end edge on the front end side of the sheet support piece 15.
  • the engaging portion 18 may be provided on the upper surface of the sheet support piece 15 as shown in FIG.
  • the engaging portion 18 is shown as a spine-like engaging portion that protrudes from the upper surface of the sheet support piece 15 and extends toward the distal end side.
  • the engaging portion 18 may be formed integrally with the sheet support piece 15, or the engaging portion 18, which is a separate member, may be attached to the sheet support piece 15 by adhesion or the like.
  • the position where the engaging portion 18 is provided is not particularly limited as long as it can engage with both end portions of the sticking sheet S.
  • the engaging portion 18 is provided on the front end side of the sheet support piece 15, and curling of the front end side of the adhesive sheet S is suppressed, so that the entire adhesive sheet S can be prevented from being turned up. Therefore, the retainability of the shape of the sticking sheet S can be improved.
  • the engaging portion 18 is provided so as to be exposed to the distal end side from the opening portion 13 of the pocket housing portion 12, and is exposed to the outside of the body introduction assisting tool 10 so that the adhesive sheet S can be attached. It has become.
  • the engagement portion 18 is provided on the front end side of the sheet support piece 15, and the sheet S is engaged with the engagement portion 18 by moving the sheet support piece 15 to the front end side. It is comprised so that it may move to a front end side with the support piece 15. FIG. Therefore, in this embodiment, when moving the sticking sheet S to the distal end side, it is not necessary to hold the sticking sheet S by gripping means such as forceps, and other instruments can be inserted into the forceps port Eb. In addition, when using the in-vivo introduction aid 10 of this embodiment, you may hold
  • FIG. 20 shows the body introduction aid 10 of the ninth embodiment.
  • the features described in the first to eighth embodiments may be applied to the in-vivo introduction aid of the ninth embodiment, and the features described in the ninth embodiment are applied to other embodiments. Also good. Description of points common to the in-vivo introduction aids of the first to eighth embodiments will be omitted, and the ninth embodiment will be described focusing on differences from the first to eighth embodiments.
  • FIG. 20 shows the body introduction aid 10 of the ninth embodiment.
  • the body introduction assisting tool 10 includes a mounting portion A on which the adhesive sheet S is mounted.
  • the mounting part A is constituted by a pocket housing part 12 having an opening 13 through which the adhesive sheet S can be taken in and out.
  • the in-vivo introduction aid 10 is configured by two overlapping film sheets 11 and 11 having a rectangular planar shape
  • the pocket accommodating portion 12 is configured by two overlapping film sheets 11 and 11. .
  • the film sheets 11 and 11 are made of a flexible synthetic resin such as polyethylene, polypropylene, polystyrene, or polyvinyl chloride, but may be made of other synthetic resins.
  • the pocket accommodating part 12 can accommodate the adhesive sheet S between the film sheets 11 and 11 by sealing the outer peripheral edges of the film sheets 11 and 11 leaving the opening 13.
  • the outer peripheral edges of the film sheets 11 and 11 are sealed by heat welding, adhesion, or the like so that the end portion on the distal end side when being wound around the distal end portion of the endoscope E becomes the opening portion 13.
  • the sticking sheet S can be accommodated inside.
  • the opening 13 is provided at the end on the leading end side of the film sheets 11, and has an opening width that allows the adhesive sheet S to be taken in and out of the pocket housing portion 12.
  • the fixing portion 14 is a sealing portion located at the end portion on the rear end side of the film sheets 11, 11, and the fixing portion 14 is fixed to the outer peripheral surface of the endoscope E with tape as will be described later.
  • the pocket accommodating portion 12 is configured by folding back one film material and sealing each end other than the end portion on the distal end side when wrapped around the distal end portion of the endoscope E and each side other than the return side by heat welding, adhesion, or the like. It may be formed. Moreover, you may form the fixing
  • the opening portion 13 is provided only at the end portion on the distal end side of the pocket housing portion 12, but all the sides other than the side of the fixing portion 14 may be the opening portion 13, and at least at the distal end portion of the endoscope E.
  • the shape of the opening 13 can be changed to various shapes as long as the adhesive sheet S can be taken in and out from the end on the leading end side when wound.
  • the patch sheet S examples include an absorbent suture reinforcing material (Neoval (registered trademark)) that is a nonwoven fabric made of polyglycolic acid manufactured by Gunze Co., Ltd., but the patch sheet S is not limited to this. Gauze or anti-adhesion material may be used.
  • Neoval registered trademark
  • Gauze or anti-adhesion material may be used.
  • the shape of the pocket accommodating portion 12 and the shape of the adhesive sheet S accommodated in the pocket accommodating portion 12 are not limited to a rectangular shape, and any shape can be used as long as the adhesive sheet S having a desired shape can be accommodated in the pocket accommodating portion 12. Such a shape may be sufficient, and elliptical shape, circular shape, and polygonal shape may be sufficient. Moreover, the shape in which the pocket accommodating part 12 and the sticking sheet S differ may be sufficient.
  • the adhesive sheet S of the in-vivo assist device 10 is only sandwiched between two overlapping film sheets 11, 11, the adhesive sheet S can be easily taken out and applied to the affected area. Can do. Further, since the adhesive sheet S sandwiched between the film sheets 11 and 11 is wound around the endoscope E with a gap 40 formed between the film 20 and the endoscope E by the thickness of the spacer 20, the adhesive sheet S is attached. The sheet S can be reliably taken out between the film sheets 11 and 11. Since the gap 40 between the endoscope 20 provided by the spacer 20 differs depending on the thickness of the film sheets 11 and 11 and the adhesive sheet S and the length wound around the endoscope E, the necessary gap 40 can be obtained. What is necessary is just to set the thickness of the spacer 20 suitably.
  • FIG. 21 shows a spacer 20 that is used when the in-vivo assisting tool 10 containing the patch sheet S is wound around the distal end portion of the endoscope E.
  • the spacer 20 described below can also be used when the in-vivo aid 10 described in the first to eighth embodiments is wound around the distal end portion of the endoscope E.
  • the spacer 20 has a cylindrical portion having one end side as a knob portion 21 and the other end side as a main body portion 22.
  • the knob portion 21 is formed by cutting out the lower portion of the cylindrical body along the axial direction, and has an arc shape in a cross-sectional view.
  • the main body portion 22 is a portion attached to the distal end portion of the endoscope E, and the distal end side end portion 22 b is formed by forming the knob portion 21.
  • a diameter adjusting portion 22a is formed in the main body portion 22 by cutting an angular position opposite to the knob portion 21 with respect to the center of the cylindrical body over the entire axial direction.
  • the inner diameter of the cylindrical body of the spacer 20 is slightly smaller than the outer diameter of the distal end portion of the endoscope E to which the spacer 20 is attached, and is provided in the main body portion 22 when being attached to the distal end portion of the endoscope E.
  • a difference in diameter from the endoscope E can be absorbed, and the spacer 20 can be mounted along the outer periphery of the endoscope E.
  • the spacer 20 is made of a pipe made of metal such as stainless steel or a pipe made of synthetic resin such as polyethylene, polypropylene, polystyrene, polyvinyl chloride or the like, but a synthetic resin pipe having flexibility is preferable.
  • the spacer 20 may be made of other materials or shapes, but is preferably a cylindrical body because the state after attachment is stable.
  • the end portion 22 b on the distal end side of the main body portion 22 of the spacer 20 and the distal end surface Ea of the distal end portion of the endoscope E are aligned, and the spacer 20 is placed at the distal end portion of the endoscope E.
  • the knob portion 21 protrudes toward the distal end side of the endoscope E.
  • the other part of the adhesive sheet S is accommodated in the pocket accommodating part 12 of the body introduction aid 10 such that a part of the adhesive sheet S protrudes from the opening 13 of the pocket accommodating part 12.
  • the opening 13 is aligned with the distal end surface Ea of the distal end portion of the endoscope E, and the spacer 20 is interposed only on the distal end side of the body introduction assisting device 10 (pocket accommodating portion 12). Wrap it around the tip of the endoscope E in a state.
  • a forceps port Eb through which a gripping means (not shown) such as forceps can be inserted is provided so as to be able to advance and retreat.
  • a gripping means not shown
  • FIG. 10 is wound so that the central portion of the end portion on the front end side of the adhesive sheet S is positioned in the vicinity of the forceps port Eb.
  • the end portion on the front end side of the adhesive sheet S is disposed at a position where it can be gripped by forceps, the end portion of the end portion on the front end side of the adhesive sheet S is positioned in the vicinity of the forceps port Eb.
  • the part may be located.
  • the protruding portion of the sticking sheet S protruding from the film sheets 11 and 11 is in an exposed state and faces the forceps port Eb side. Therefore, the part in which the adhesive sheet S is accommodated from the pocket accommodating part 12 is pulled out by forceps so that the adhesive sheet S can be easily separated from the endoscope E.
  • the fixing portion 14 of the in-vivo assist device 10 is fixed to the outer peripheral surface of the endoscope E by the fixing tape 30 (second step).
  • the fixing tape 30 it is preferable to increase the width of the fixing portion 14 of the in-vivo introduction aid 10 so that the fixing tape 30 does not cover the pocket housing portion 12.
  • the tip tape 31 is wound around the position corresponding to the main body 22 of the spacer 20 from the outside of the body introduction assisting tool 10.
  • the length of the main body portion 22 of the spacer 20 in the axial direction is slightly longer than the width of the tip tape 31.
  • the width of the fixing tape 30 and the distal end tape 31 is such that the distal end portion of the endoscope is easily bent. It is preferable to make the body introduction assisting tool 10 as small as possible within a range where it can be firmly fixed to the endoscope E.
  • the fixed tape 30 and the tip tape 31 may be composed of a stretchable tape. Further, the fixing tape 30 and the leading end tape 31 may be made of the same material tape, or may be made of different materials.
  • the outer peripheral surface of the endoscope E and the body introduction assisting tool 10 (pocket housing portion). 12) is formed (third step).
  • the width of the body assisting device 10 in the direction of winding around the endoscope E (the opening 13 in FIG. 20).
  • the opening width + the width of the surrounding sealing portion is preferably longer than the outer peripheral length of the distal end portion of the endoscope E.
  • the endoscope is arranged so that the gripping means (not shown) is advanced from the forceps port Eb on the distal end surface Ea of the endoscope E so that the adhesive sheet S can be taken out from the pocket housing portion 12 by the gripping means.
  • the sticking sheet S protruding from the front end surface Ea of the mirror E to the front end side is gripped.
  • An objective lens (observation imaging member) Ec is attached to the distal end surface Ea of the endoscope E, and the portion of the endoscope E is projected from the distal end surface Ea of the endoscope E of the adhesive sheet S to the distal end side.
  • the endoscope E is inserted into the body in a state in which the gripping means is slightly retracted and the protruding portion of the adhesive sheet S is pulled back to secure the observation visual field of the endoscope E. Insert into.
  • the gripping means is advanced to bring the majority of the adhesive sheet S into a state of being pulled out as shown in FIG.
  • the adhesive sheet S is spread and applied while being pressed against the affected area, and then the remaining adhesive sheet S is attached while being pulled out while the endoscope E is retracted.
  • the endoscope E may be retracted while being pressed by the distal end portion of the endoscope E from the beginning of the sticking sheet S being pulled out.
  • the width in the winding direction of the adhesive sheet S to be wound around the distal end portion of the endoscope E can be pulled out even if it is longer than the outer peripheral length of the distal end portion of the endoscope E. It is preferable to be shorter than the outer peripheral length of the tip of the mirror E.
  • the adhesive sheet S of the in-vivo assist device 10 is only sandwiched between two overlapping film sheets 11, 11, the adhesive sheet S can be easily taken out and applied to the affected area. Can do. Further, since the adhesive sheet S sandwiched between the film sheets 11 and 11 is wound around the endoscope E with a gap 40 formed between the film 20 and the endoscope E by the thickness of the spacer 20, the adhesive sheet S is attached. The sheet S can be reliably taken out between the film sheets 11 and 11. Since the gap 40 between the endoscope 20 provided by the spacer 20 differs depending on the thickness of the film sheets 11 and 11 and the adhesive sheet S and the length wound around the endoscope E, the necessary gap 40 can be obtained. What is necessary is just to set the thickness of the spacer 20 suitably.
  • the adhesive sheet S may be wound around the distal end portion of the endoscope E without using the spacer 20.
  • the body introduction assisting tool 10 is wound around the distal end portion of the endoscope E, and is fixed with an appropriate strength when the distal end tape 31 is wound from above the body introduction assisting tool 10 to the distal end side.
  • tip part of the endoscope E is introduce
  • the sticking sheet S is taken out from between the film sheets 11 and 11 of the in-vivo auxiliary
  • the body introduction aid 10 is configured in an annular shape so that a gap is formed between at least the distal end side of the mounting portion A and the outer periphery of the distal end portion of the endoscope E without using the spacer 20. May be.
  • the tip end side of the mounting portion A is annular so that a gap is formed between the outer periphery of the tip end portion of the endoscope E, it is not necessary to fix the tip end side with the tip tape 31 or the like.
  • the attachment of the in-vivo aid 10 to the endoscope E is completed simply by stopping the rear end side with a tape or a rubber band.
  • the body introduction aid 10 in which the distal end side of the mounting portion A is configured in an annular shape may be configured such that, for example, the pocket accommodating portion 12 is cylindrical in the front-rear direction, or the distal end of the pocket accommodating portion 12 You may be comprised so that only the side may become a cylinder shape.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un instrument 10 d'aide à l'introduction d'une feuille de fixation S dans l'organisme, qui est pourvu d'une partie de montage A pour monter la feuille de fixation S, et d'une pièce de support de feuille 15 qui supporte la feuille de fixation S. La pièce de support de feuille 15 est conçue de manière à pouvoir passer d'un état de montage à un état déployé. La pièce de support de feuille 15 à l'état déployé est conçue pour prendre la forme d'une feuille ou une forme non tubulaire pour permettre le maintien d'un espace entre la pièce de support de feuille 15 et l'intérieur de l'organisme dans la zone affectée.
PCT/JP2017/023997 2016-07-01 2017-06-29 Instrument d'aide à l'introduction dans l'organisme, et procédé pour montage d'un instrument d'aide à l'introduction dans l'organisme sur un endoscope WO2018003934A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2018525270A JPWO2018003934A1 (ja) 2016-07-01 2017-06-29 体内導入補助具及び体内導入補助具を内視鏡に装着する方法

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2016-131559 2016-07-01
JP2016131559 2016-07-01

Publications (1)

Publication Number Publication Date
WO2018003934A1 true WO2018003934A1 (fr) 2018-01-04

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PCT/JP2017/023997 WO2018003934A1 (fr) 2016-07-01 2017-06-29 Instrument d'aide à l'introduction dans l'organisme, et procédé pour montage d'un instrument d'aide à l'introduction dans l'organisme sur un endoscope

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020105577A1 (fr) * 2018-11-19 2020-05-28 持田製薬株式会社 Dispositif de fixation de feuille dans une cavité corporelle et procédé de fixation de feuille

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120209401A1 (en) * 2011-02-15 2012-08-16 Euteneuer Charles L Methods and apparatus for delivering and positioning sheet-like materials
WO2015172052A1 (fr) * 2014-05-09 2015-11-12 Rotation Medical, Inc. Système de pose d'implant médical pour un implant de type feuille

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20160091913A (ko) * 2013-11-29 2016-08-03 잇빤 자이단호진 가가쿠오요비겟세이료호겐쿠쇼 흡수성 조직 보강재의 딜리버리 장치

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120209401A1 (en) * 2011-02-15 2012-08-16 Euteneuer Charles L Methods and apparatus for delivering and positioning sheet-like materials
WO2015172052A1 (fr) * 2014-05-09 2015-11-12 Rotation Medical, Inc. Système de pose d'implant médical pour un implant de type feuille

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020105577A1 (fr) * 2018-11-19 2020-05-28 持田製薬株式会社 Dispositif de fixation de feuille dans une cavité corporelle et procédé de fixation de feuille
JPWO2020105577A1 (fr) * 2018-11-19 2020-05-28

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