WO2020179045A1 - Dispositif médical - Google Patents

Dispositif médical Download PDF

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Publication number
WO2020179045A1
WO2020179045A1 PCT/JP2019/009003 JP2019009003W WO2020179045A1 WO 2020179045 A1 WO2020179045 A1 WO 2020179045A1 JP 2019009003 W JP2019009003 W JP 2019009003W WO 2020179045 A1 WO2020179045 A1 WO 2020179045A1
Authority
WO
WIPO (PCT)
Prior art keywords
balloon
medical device
balloons
pair
sheath body
Prior art date
Application number
PCT/JP2019/009003
Other languages
English (en)
Japanese (ja)
Inventor
俊二 武井
善朗 岡崎
和敏 熊谷
Original Assignee
オリンパス株式会社
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 オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2019/009003 priority Critical patent/WO2020179045A1/fr
Publication of WO2020179045A1 publication Critical patent/WO2020179045A1/fr

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Classifications

    • 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
    • A61B1/313—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 for introducing through surgical openings, e.g. laparoscopes
    • 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
    • A61B1/32—Devices for opening or enlarging the visual field, e.g. of a tube of the body
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters

Definitions

  • the present invention relates to a medical device.
  • An object of the present invention is to provide a medical device that can more securely secure the field of view of an endoscope inserted into a narrow body and facilitate observation and/or treatment of a target site.
  • One aspect of the present invention is to provide an elongated tubular sheath main body having a channel through which an endoscope can be inserted, and to separate from the distal end surface of the sheath main body in a first direction along the longitudinal direction of the sheath main body, A pair of first balloons that are mainly inflatable in a third direction that intersects the first direction and the second direction, and a pair of first balloons that are mainly inflatable in the second direction at positions apart from each other in the second direction that intersects the one direction. And a second balloon connecting a pair of the first balloons at a position spaced from one end side in the third direction.
  • FIG. 7 is a cross-sectional view of the balloon of the medical device of FIG. 6.
  • FIG. 5 is a perspective view showing a state in which a balloon is contracting, which is a tip portion of a modified example of the medical device of FIG. It is a perspective view which shows the state which expanded the balloon of the medical device of FIG. It is a perspective view which shows the modification of the medical device of FIG.
  • FIG. 5 is a perspective view showing a state in which a balloon is contracting, which is a tip portion of a modified example of the medical device of FIG. It is a perspective view which shows the state which expanded the balloon of the medical device of FIG.
  • the medical device 1 extends in the longitudinal direction from the distal end surface 2a of the sheath main body 2 to the front, and a long flexible tubular sheath main body 2. It includes a cantilever-shaped protrusion 3 and a balloon 4 arranged at the tip of the protrusion 3.
  • the sheath body 2 is provided with a channel 5 that penetrates along the longitudinal direction and allows the endoscope 100 to be inserted.
  • the endoscope 100 is a flexible endoscope having a curved portion 110 at its distal end, penetrates the inside of the channel 5 from the proximal end side of the sheath body 2, and is projected forward of the distal end surface 2a. By bending the bending portion 110, the treatment target portion arranged radially outside the sheath body 2 can be arranged within the visual field.
  • a channel (medium channel) for supplying fluid (medium) to the balloon 4 provided at the tip of the protrusion 3 and discharging fluid from the balloon 4 in the protrusion 3 along the longitudinal direction. 6 is provided.
  • the balloon 4 is fixed to the side surface of the protruding portion 3 on the channel 5 side.
  • the flow path 6 opens into the balloon 4.
  • the balloon 4 is separated from the distal end surface 2a of the sheath body 2 in the first direction along the longitudinal direction by the supply of the fluid via the flow path 6, and the first A pair of first balloons 7 that are mainly inflatable in a first direction and a third direction that is orthogonal to the second direction, and a pair of first balloons that are mainly inflatable in the second direction.
  • a second balloon 8 that connects a pair of first balloons 7 to each other is provided at an end portion on the side of the protruding portion 3 in the three directions.
  • the second balloons 8 are connected to the respective first balloons 7 at positions where a predetermined distance is provided from the tip end side of the pair of inflated first balloons 7 to the protruding portion 3 side.
  • each of the balloons 7 and 8 are in communication with the internal space, and can be simultaneously expanded by the supply of the fluid via the single flow path 6.
  • each of the balloons 7 and 8 has a shape of an elongated cylinder or an elliptic sphere, and is made of a polymer resin material such as polyamide, polyester or polyurethane.
  • the first balloon 7 may be made of a material having greater elasticity in the longitudinal direction than the second balloon 8.
  • the balloon 4 expands when a fluid is supplied, and at the tip of the protruding portion 3, a pair of rod-shaped first balloons 7 that are spaced apart in the second direction and extend in the third direction, and these first balloons 7.
  • the one balloon 7 is connected to one end by a rod-shaped second balloon 8 extending in the second direction to form a portal shape.
  • the medical device 1 in order to observe and treat a lesion part of the heart X using the medical device 1 according to the present embodiment, the medical device 1 is inserted into the patient's body from the lower part of the xiphoid process and brought close to the heart X. Next, the tip of the medical device 1 penetrating the pericardium Z is placed between the pericardium Z and the heart X, as shown in FIG.
  • the protruding portion 3 of the medical device 1 is arranged so as to face the pericardium Z side with respect to the channel 5.
  • the projecting portion 3 is arranged in a cantilever manner in front of the medical device 1, and thus in front of the channel 5.
  • the pericardium Z is prevented from hanging down, and the field of view in front of the endoscope 100 is secured.
  • the distal end portion of the endoscope 100 is projected from the distal end surface 2a of the sheath body 2 as shown in FIG. Is curved so that the visual field is directed toward the surface of the heart X.
  • the entire medical device 1 is moved back and forth in the longitudinal direction of the sheath body 2.
  • the advance/retreat of the entire medical device 1 is stopped. Then, in this state, the fluid is supplied into the balloon 4 via the flow path 6, and the balloon 4 is inflated as shown in FIG. Press the surface.
  • the protruding portion 3 is supported by the tip surface 2a of the sheath body 2 and the balloon 4 in the shape of a double-sided beam. Therefore, even if the protruding portion 3 receives a large pressing force from the pericardium Z, the protruding portion 3 is prevented from bending and the field of view of the endoscope 100 is secured.
  • the first balloon 7 has greater elasticity in the longitudinal direction than the second balloon 8
  • the pressing force from the pericardium Z differs depending on the size and shape of the heart X
  • the stress on the pericardium Z is adjusted so as not to become excessive.
  • the second balloon 8 is inflated at the same time to maintain the state in which the distance between the pair of first balloons 7 in the second direction is widened.
  • the second balloon 8 connects the first balloons 7 at the end opposite to the tip of the first balloon 7 in contact with the surface of the heart X, so that the surface of the heart X is connected by the second balloon 8.
  • the field of view of the endoscope 100 is arranged in a region passing through the gap between the pair of first balloons 7, and the surface of the heart X near the observation target site can be easily overlooked. There is an advantage that.
  • the second balloons 8 are mainly inflated in the direction of increasing the distance between the pair of first balloons 7, even if the pair of first balloons 7 receive a force in a direction in which they approach each other from the pericardium Z, It is possible to maintain the space between the first balloons 7 against each other.
  • the field of view of the endoscope 100 that is inserted into a narrow body can be more reliably ensured to facilitate observation and/or treatment of an observation target site.
  • the fluid is supplied into the balloon 4 via the single flow path 6 formed in the protrusion 3, but instead of this, as shown in FIG.
  • the second balloon 8 is divided into two at the center by the partition wall 9, and the halves of the first balloon 7 and the second balloon 8 are independently separated by the fluids supplied via the separate flow paths 10. It may be inflated.
  • the amount of fluid supplied to the first balloon 7 on the side receiving a larger external force is increased, or conversely, on the side receiving a smaller external force.
  • a uniform space is always formed when the pair of first balloons 7 is inflated.
  • the second balloon 8 is provided at the tip of one protruding portion 3, but as shown in FIG. 8, the balloons 4 are arranged in parallel by being deflated during insertion into the body.
  • a pair of flexible projecting portions 11 that can be branched so that the distal end portion expands in the second direction by the expansion of the second balloon 8 is adopted.
  • each of the protrusions 11 may be further provided with a separate flow path 10, and the first balloon 7 and the second balloon 8 may be inflated by the fluid supplied via the flow path 10.
  • the distal end side of the projecting member 11 expands in the direction intersecting the longitudinal axis of the projecting member 11, so that the pericardium Z can be widely supported, and a wider space can be secured in front of the endoscope 100. it can.
  • the case where the inner space of the second balloon 8 communicates with the inner space of the pair of first balloons 7 is illustrated, but instead of this, as shown in FIG.
  • the second balloon 8 may be disposed at a position which is disposed between the portions 11 and is inflated by the fluid supplied via the flow path different from the flow path 10 connected to the first balloon 7.
  • the second balloon 8 indirectly connects the pair of the first balloons 7 to each other with the protrusion 11 interposed therebetween.
  • a balloon 4 that is inflated in a portal shape between the tip of the protrusion 3 and the heart X is illustrated.
  • a pair of first balloons 12 extending forward from the distal end of the protruding portion 3 in the longitudinal direction of the sheath body 2 and curving downward obliquely to the left and right front.
  • the balloon 4 including the second balloons 13 which are connected to each other at an intermediate position in the longitudinal direction of the first balloons 12, for example, at a position half the length in the third direction.
  • the 2nd balloon 13 can be arranged in the position which does not obstruct the field of view of endoscope 100, and a pair of 1st balloon 12 can be maintained in the state where it was estranged by the 2nd balloon 13.
  • the present invention is not limited to this, and the respective directions are arranged to intersect with each other. Just do it.
  • the second balloon 8 exemplifies the case where the first balloons 7 are connected to each other at the ends of the pair of first balloons 7, but the present invention is not limited to this. It may be connected at an arbitrary position separated from the end portion in contact with the target portion in the third direction.
  • the medical device 1 it can be applied to the endoscope 100 for the cardiac sac, which is inserted into the cardiac sac and prevents the pericardium Z from hanging down into the field of view of the endoscope 100.
  • the medical device 1 is illustrated.
  • the present invention is not limited to this, and may be applied to the medical device 1 used for any procedure for securing a space for being inserted into a narrow body and preventing the visual field from being blocked by adjacent tissues.
  • the present invention may be applied to the medical device 1 including the endoscope 100.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Child & Adolescent Psychology (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Endoscopes (AREA)

Abstract

L'invention concerne un dispositif médical (1) qui comprend : un long corps de gaine tubulaire (2) qui a un canal (5) à travers lequel un endoscope (100) peut être inséré ; une paire de premiers ballonnets (7) qui, dans des positions espacées d'une face d'extrémité distale (2a) du corps de gaine (2) dans une première direction le long de la direction longitudinale du corps de gaine (2) et espacées dans une deuxième direction croisant la première direction, sont capables de s'étendre principalement dans une troisième direction croisant la première direction et la deuxième direction ; et un second ballonnet (8) qui est capable de s'étendre principalement dans la deuxième direction et relie la paire de premiers ballonnets (7) à une position espacée d'un côté d'extrémité dans la troisième direction.
PCT/JP2019/009003 2019-03-07 2019-03-07 Dispositif médical WO2020179045A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2019/009003 WO2020179045A1 (fr) 2019-03-07 2019-03-07 Dispositif médical

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2019/009003 WO2020179045A1 (fr) 2019-03-07 2019-03-07 Dispositif médical

Publications (1)

Publication Number Publication Date
WO2020179045A1 true WO2020179045A1 (fr) 2020-09-10

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ID=72337736

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2019/009003 WO2020179045A1 (fr) 2019-03-07 2019-03-07 Dispositif médical

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WO (1) WO2020179045A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5400773A (en) * 1993-01-19 1995-03-28 Loma Linda University Medical Center Inflatable endoscopic retractor
JPH10511589A (ja) * 1995-01-06 1998-11-10 ユーン，インバエ 内視鏡下で閉塞部位に空間を作るための拡張可能な多機能器具およびその方法
JP2004520090A (ja) * 2000-08-29 2004-07-08 アーロン ヴィー カプラン 心臓周囲の左心耳を閉鎖するための方法及び装置
JP2010508959A (ja) * 2006-11-09 2010-03-25 エヌコンタクト サージカル， インコーポレイテッド 後部外科アクセスのための横隔膜進入
US20150057501A1 (en) * 2012-03-29 2015-02-26 Lapspace Medical Ltd. Tissue retractor

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5400773A (en) * 1993-01-19 1995-03-28 Loma Linda University Medical Center Inflatable endoscopic retractor
JPH10511589A (ja) * 1995-01-06 1998-11-10 ユーン，インバエ 内視鏡下で閉塞部位に空間を作るための拡張可能な多機能器具およびその方法
JP2004520090A (ja) * 2000-08-29 2004-07-08 アーロン ヴィー カプラン 心臓周囲の左心耳を閉鎖するための方法及び装置
JP2010508959A (ja) * 2006-11-09 2010-03-25 エヌコンタクト サージカル， インコーポレイテッド 後部外科アクセスのための横隔膜進入
US20150057501A1 (en) * 2012-03-29 2015-02-26 Lapspace Medical Ltd. Tissue retractor

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