WO2022014159A1

WO2022014159A1 - Medical applicator

Info

Publication number: WO2022014159A1
Application number: PCT/JP2021/019498
Authority: WO
Inventors: 早川浩一
Original assignee: テルモ株式会社
Priority date: 2020-07-16
Filing date: 2021-05-24
Publication date: 2022-01-20

Abstract

A medical applicator (10) is equipped with a nozzle (16). The tip end part of the nozzle (16) is provided with a plurality of discharge ports (84) for spraying a mixed solution (G) together with a gas. The plurality of discharge ports (84) are formed such that an interval (d) between center lines (CL) of adjacent discharge ports (84) widens in the direction in which the tip end of the nozzle (16) is oriented.

Description

Medical application tool

The present invention relates to a medical application tool.

For example, Japanese Patent Application Laid-Open No. 2009-131590 discloses a medical application tool provided with a nozzle for spraying a mixed solution of a first solution and a second solution onto a target site in a living body. At the tip of this nozzle, one discharge port for spraying the mixed liquid together with the gas is formed.

In the above-mentioned conventional technique, there is only one discharge port. Therefore, when the discharge port is located relatively close to the target portion, the mixed liquid sprayed from the discharge port is concentrated, and the mixed liquid is likely to drip at the target portion (liquid dripping is likely to occur). .. In order to suppress such liquid dripping, it is necessary to reduce the pore diameter of the discharge port and widen the diffusion diameter (spray region) of the mixed liquid sprayed from the discharge port. However, when the hole diameter of the discharge port is reduced, there is a problem that the discharge resistance of the mixed liquid increases. It is not desirable to widen the spray area by increasing the gas flow rate of the nozzle because the amount of gas supplied into the living body increases.

The present invention has been made in consideration of such a problem, and it is possible to widen the spray region while reducing the discharge resistance of the mixed liquid, thereby suppressing the liquid dripping at the target site. It is an object of the present invention to provide an application tool.

One aspect of the present invention is a medical coating tool provided with a nozzle for spraying a mixed solution of a first solution and a second solution into a living body, and the mixed solution is placed at the tip of the nozzle. A plurality of discharge ports for spraying together with the gas are provided, and the plurality of discharge ports are formed so that the distance between the center lines of the discharge ports adjacent to each other is widened in the direction in which the tip of the nozzle is directed. , A medical application tool.

According to the present invention, since a plurality of discharge ports are provided at the tip of the nozzle, the discharge resistance of the mixed liquid is increased as compared with the case where only one discharge port having a relatively small hole diameter is provided at the tip of the nozzle. It can be reduced. Further, the plurality of discharge ports are formed so that the distance between the center lines of the discharge ports adjacent to each other is widened in the direction in which the tip of the nozzle is directed. As a result, the spray area of the mixed liquid sprayed from the plurality of discharge ports can be effectively expanded. Therefore, it is possible to suppress liquid dripping at the target site.

It is a schematic block diagram of the medical application tool which concerns on one Embodiment of this invention. It is a vertical sectional view of the nozzle of FIG. It is an enlarged cross-sectional view of the tip side of the nozzle of FIG. FIG. 3 is a cross-sectional view taken along the line IV-IV of FIG. It is a front view of the nozzle of FIG. It is explanatory drawing explaining the spread of a mixture. It is explanatory drawing of the use method of the medical coating tool of FIG.

Hereinafter, a suitable embodiment of the medical application tool according to the present invention will be described with reference to the attached drawings.

As shown in FIG. 7, in the medical application tool 10 according to the embodiment of the present invention, for example, an adhesion preventing material (mixed solution G) for preventing postoperative adhesion is applied to a target site 208 (damaged site) in the living body. ) Is a spray-type applicator that sprays (sprays). Specifically, the medical application tool 10 is used in laparoscopic surgery. In this case, the medical application tool 10 is inserted into the abdominal cavity 206 via the trocar 204. However, the medical application tool 10 is not limited to the example used for laparoscopic surgery, and can also be used in open surgery. Further, the medical application tool 10 may be an application tool that sprays a biological tissue adhesive (mixed liquid G) for adhering a biological tissue onto a target site in the living body.

As shown in FIGS. 1 and 7, the medical coating tool 10 sprays a mixed liquid G in which the first liquid M1 and the second liquid M2 are mixed with a gas. The first liquid M1 is an acidic liquid. The second liquid M2 is an alkaline liquid (curing material). The viscosity of the first liquid M1 is higher than the viscosity of the second liquid M2. The volume ratio of the first liquid M1 and the second liquid M2 in the mixed liquid G is 4: 1 (first liquid M1: second liquid M2 = 4: 1). However, the volume ratio of the first liquid M1 and the second liquid M2 in the mixed liquid G can be appropriately set. Further, the first liquid M1 may be an alkaline or neutral liquid, and the second liquid M2 may be an acidic or neutral liquid.

When the mixed liquid G is an adhesion preventive material, for example, a liquid obtained by mixing NHS-modified CM dextrin and trehalose hydrate is used as the first liquid M1, and for example, sodium carbonate is used as the second liquid M2. A liquid in which sodium hydrogen carbonate is mixed is used. Such first liquid M1 and second liquid M2 are gelled by being mixed with gas (compressed air). The gelled mixed solution G contains a microvalve and looks white. Therefore, the mixed liquid G surely stays at the target site 208 in the living body and can be easily visually recognized.

In FIG. 1, the medical application tool 10 includes a liquid supply unit 12, a gas supply device 14, and a nozzle 16.

The liquid supply unit 12 is for supplying the first liquid M1 and the second liquid M2 to the nozzle 16. The liquid supply unit 12 has a syringe unit 18 and a pusher 20. The syringe portion 18 is integrally molded with a resin material. The syringe unit 18 includes a first syringe outer cylinder 22 (first liquid supply unit), a second syringe outer cylinder 24 (second liquid supply unit), a connecting portion 26, and a flange portion 28.

The first syringe outer cylinder 22 and the second syringe outer cylinder 24 are arranged side by side so that the axis of the first syringe outer cylinder 22 and the axis of the second syringe outer cylinder 24 are parallel to each other. The first liquid M1 is housed in the first syringe outer cylinder 22. The second liquid M2 is housed in the second syringe outer cylinder 24. The volume of the first syringe outer cylinder 22 is larger than the volume of the second syringe outer cylinder 24. Specifically, the volume of the first syringe outer cylinder 22 is four times the volume of the second syringe outer cylinder 24. However, the volumes of the first syringe outer cylinder 22 and the second syringe outer cylinder 24 can be appropriately set. The total length of the first syringe outer cylinder 22 is the same as the total length of the second syringe outer cylinder 24.

The connecting portion 26 connects the tip end side of the first syringe outer cylinder 22 and the tip end side of the second syringe outer cylinder 24 to each other. The flange portion 28 is connected to the base end of the first syringe outer cylinder 22 and the base end of the second syringe outer cylinder 24. The flange portion 28 extends in the alignment direction of the first syringe outer cylinder 22 and the second syringe outer cylinder 24. The flange portion 28 is formed in a size that allows the user's fingers to be hung on the flange portion 28.

The pusher 20 has a first gasket 30, a second gasket 32, a first pusher main body 34, a second pusher main body 36, a pusher connecting portion 38, and a pressing portion 40. The first gasket 30 is arranged in the lumen of the first syringe outer cylinder 22 so as to be slidable in the axial direction of the first syringe outer cylinder 22. The first gasket 30 is in liquid-tight contact with the inner peripheral surface of the first syringe outer cylinder 22. The second gasket 32 is arranged in the lumen of the second syringe outer cylinder 24 so as to be slidable in the axial direction of the second syringe outer cylinder 24. The second gasket 32 is in liquid-tight contact with the inner peripheral surface of the second syringe outer cylinder 24. Each of the first gasket 30 and the second gasket 32 is made of an elastic material such as rubber.

The first pusher main body 34, the second pusher main body 36, the pusher connecting portion 38, and the pressing portion 40 are integrally molded with a resin material. The first pusher main body 34 presses the first gasket 30 toward the tip of the first syringe outer cylinder 22. The first pusher main body 34 extends along the axial direction of the first syringe outer cylinder 22. One end of the first pusher body 34 is connected to the first gasket 30. The second pusher main body 36 presses the second gasket 32 toward the tip of the second syringe outer cylinder 24. The second pusher main body 36 extends along the axial direction of the second syringe outer cylinder 24. One end of the second pusher body 36 is connected to the second gasket 32.

The pusher connecting portion 38 connects the other end of the first pusher body 34 and the other end of the second pusher body 36 to each other. The pressing portion 40 is provided at the other end of the first pusher main body 34. The pressing portion 40 is located on the axis of the first pusher main body 34. The pressing portion 40 is formed in a plate shape.

The gas supply device 14 is connected to the nozzle 16 via the air supply tube 42. The gas supply device 14 supplies gas (compressed air). The gas pressure of the gas supply device 14 is set to, for example, 0.1 MPa. However, the gas pressure of the gas supply device 14 can be appropriately set, and is preferably set to 0.01 MPa or more and 0.2 MPa or less.

As shown in FIG. 2, the nozzle 16 includes a shaft 44, a liquid feeding unit 46, a support member 48, a gas supply member 50, a nozzle tube 52, a tip tip 54 (tip member), and a sheath member 56. In the following description, in the nozzle 16, the side where the discharge port 84 on which the mixed liquid G is sprayed is located is referred to as a “tip”, and the opposite side thereof is referred to as a “base end”.

The shaft 44 is a tubular member extending in one direction. The shaft 44 has a constant inner diameter and a constant outer diameter over its entire length. The shaft 44 is preferably made of, for example, stainless steel. However, the constituent material of the shaft 44 can be appropriately set. That is, the shaft 44 may be made of a metal material such as titanium, a titanium alloy, aluminum, an aluminum alloy, an iron alloy (other than stainless steel), a hard resin material, or ceramics.

The total length of the shaft 44 is preferably set to 100 mm or more and 500 mm or less, more preferably 200 mm or more and 400 mm or less, and even more preferably 250 mm or more and 350 mm or less. However, the total length of the shaft 44 can be appropriately set.

In FIGS. 2 to 4, the liquid feeding unit 46 is inserted into the lumen of the shaft 44. The liquid feeding unit 46 has a first tube 58 through which the first liquid M1 flows and a second tube 60 through which the second liquid M2 flows. Each of the first tube 58 and the second tube 60 may have flexibility or may be made of a hard material. Each of the first tube 58 and the second tube 60 is preferably made of polyurethane, polyester elastomer or polyamide elastomer from the viewpoint of ease of processing and the like.

However, the constituent materials of the first tube 58 and the second tube 60 can be appropriately set. That is, each of the first tube 58 and the second tube 60 may be made of a resin material (for example, polyetheretherketone or the like) or a metal material other than the above. The inner diameter of the first tube 58 is larger than the inner diameter of the second tube 60.

The first tube 58 and the second tube 60 are juxtaposed with each other. A gas flow path 64 through which gas flows is formed in the space between the inside of the shaft 44 and the outside of the first tube 58 and the second tube 60.

In FIG. 3, the tip end portion of the first tube 58 is radially inwardly reduced in diameter and inserted into the base end portion of the gas supply member 50. The tip of the second tube 60 is radially inwardly reduced in diameter and is inserted into the base end of the gas supply member 50. The first tip opening 58a of the first tube 58 and the second tip opening 60a of the second tube 60 are located at the tip of the liquid feeding portion 46. However, the first tip opening 58a and the second tip opening 60a may be positioned so as to be offset from each other in the axial direction of the liquid feeding portion 46.

The first flow path cross-sectional area S1 on the proximal end side of the first tube 58 is larger than the second flow path cross-sectional area S2 on the proximal end side of the second tube 60 (see FIG. 4). The respective sizes of the first flow path cross-sectional area S1 and the second flow path cross-sectional area S2 are appropriately set according to the respective viscosities of the first liquid M1 and the second liquid M2.

As shown in FIG. 2, the support member 48 supports the base end portion of the first tube 58 and the base end portion of the second tube 60 in a state of being provided at the base end portion of the shaft 44. The support member 48 is integrally molded of a hard resin material.

The support member 48 has a support body 68, a first connection portion 70, and a second connection portion 72. The support body 68 is formed so as to cover the proximal end portion of the first tube 58 and the proximal end portion of the second tube 60. The support body 68 is formed wide from the tip end portion connected to the base end portion of the shaft 44 toward the base end portion. An air supply tube 42 is connected to the tip of the support body 68. The support member 48 has a gas introduction hole 74 into which the gas guided from the air supply tube 42 is introduced, a first arrangement hole 76 in which the base end portion of the first tube 58 is arranged, and a base of the second tube 60. A second arrangement hole 78 in which the end is arranged is formed.

The gas introduction hole 74 is open on the tip surface of the support body 68. The base end portion of the shaft 44 is inserted into the gas introduction hole 74. The outer peripheral surface of the base end portion of the shaft 44 is airtightly joined to the inner surface of the gas introduction hole 74. The gas introduction hole 74 communicates with the gas flow path 64.

The first arrangement hole 76 is provided on the proximal end side of the gas introduction hole 74. The inner surface of the first arrangement hole 76 is in contact with the outer peripheral surface of the base end portion of the first tube 58. The second arrangement hole 78 is provided on the proximal end side of the gas introduction hole 74. The outer peripheral surface of the second tube 60 is in contact with the inner surface of the second arrangement hole 78. The gas introduction hole 74 is provided with a seal member (not shown) that blocks the inflow of gas from the gas introduction hole 74 into the first arrangement hole 76 and the second arrangement hole 78.

The first connection portion 70 and the second connection portion 72 project from the base end surface of the support main body 68. The first connection portion 70 is formed with a first connection hole 70a into which the tip end portion of the first syringe outer cylinder 22 is liquid-tightly fitted. The first connection hole 70a is tapered in diameter from the protruding end of the first connection portion 70 toward the support main body 68. The first connection hole 70a communicates with the first base end opening 58b of the first tube 58. The second connection portion 72 is formed with a second connection hole 72a into which the tip end portion of the second syringe outer cylinder 24 is liquidtightly fitted. The diameter of the second connection hole 72a is tapered from the protruding end of the second connection portion 72 toward the support main body 68. The second connection hole 72a communicates with the second base end opening 60b of the second tube 60.

As shown in FIG. 3, the gas supply member 50 is provided at the tip of the liquid feeding unit 46 and forms a gas permeation tube 51 for mixing the first liquid M1 and the second liquid M2 with gas. Is. A reduced diameter tip portion of the liquid feeding portion 46 is inserted into the base end portion of the gas supply member 50. The gas supply member 50 is liquid-tightly adhered to the outer peripheral surfaces of the liquid feeding unit 46 (first tube 58 and second tube 60).

The gas supply member 50 is made of a flexible material. The wall portion of the gas supply member 50 is formed so as not to allow the liquid to permeate. The wall portion of the gas supply member 50 allows the permeation of gas from the outside to the mixing chamber 51, while suppressing or blocking the permeation of the first liquid M1 and the second liquid M2 from the mixing chamber 51 to the outside. It is preferably formed in.

The gas supply member 50 is formed in a tubular shape by a hydrophobic filter. Specifically, the gas supply member 50 is preferably configured in a tubular shape with polytetrafluoroethylene (PTFE). However, the gas supply member 50 may be formed in a tubular shape by a hydrophilic filter. Further, the gas supply member 50 may be a tubular mesh member. In this case, the mesh size of the mesh is set to such a size that the first liquid M1 and the second liquid M2 do not permeate. Further, the gas supply member 50 may be formed by a tightly wound coil spring. In this case, the pitch of the coil allows gas to flow into the mixing chamber 51 from the outside of the gas supply member 50, while suppressing or blocking the outflow of gas from the mixing chamber 51 to the outside of the gas supply member 50. It is preferable to set the size as such.

The nozzle tube 52 is arranged on the outer peripheral side of the gas supply member 50. In other words, the gas supply member 50 is inserted into the nozzle tube 52. The tip of the gas supply member 50 projects toward the tip of the nozzle 16 from the tip opening 52a of the nozzle tube 52. The inner peripheral surface of the base end portion of the nozzle tube 52 is airtightly joined to the outer peripheral surface of the tip end portion of the shaft 44. The nozzle tube 52 is made of a flexible material. The wall portion of the nozzle tube 52 does not allow gas to pass through. The nozzle tube 52 is made of a soft resin material such as urethane. However, the constituent material of the nozzle tube 52 can be appropriately set.

The tip tip 54 is provided at the tip of the nozzle tube 52. The tip 54 can be made of, for example, the same material as the nozzle tube 52. However, the constituent material of the tip tip 54 can be appropriately set. The tip 54 is formed with a recess 80 into which the tip of the nozzle tube 52 is inserted. The bottom surface 80a of the recess 80 is separated from the gas supply member 50. The outer peripheral surface of the tip of the nozzle tube 52 is airtightly joined to the side surface 80b of the recess 80. The tip of the gas supply member 50 is liquidtightly and airtightly joined to the tip 54 by the joining portion 82. The joint 82 is made of, for example, an adhesive.

As shown in FIGS. 3 and 5, the tip portion (tip portion of the nozzle 16) of the tip tip 54 communicates with the tip opening 50a of the gas supply member 50 to spray the mixed liquid G (this implementation). In the form, three) discharge ports 84 are formed.

In FIG. 3, the tip portion of the tip tip 54 is formed in a dome shape (hemispherical shape). The inner surface (tip inner surface 86) of the tip portion of the tip tip 54 is formed in a hemispherical shape (longitudinal cross section is arcuate). The tip inner surface 86 forms the bottom surface 80a of the recess 80. The tip inner surface 86 forms a chamber 87 into which the mixed liquid G derived from the mixing chamber 51 is introduced. The outer surface (tip outer surface 88) of the tip portion of the tip tip 54 is formed in a hemispherical shape (longitudinal cross section is arcuate).

As shown in FIGS. 3 and 5, the plurality of discharge ports 84 face different directions from each other. Specifically, the plurality of discharge ports 84 are formed so that the distance d between the center lines CL of the discharge ports 84 adjacent to each other spreads in the direction in which the tip of the nozzle 16 points. The angle θ formed by the center line CL of each discharge port 84 and the axis line Ax of the tip tip 54 is the same as each other.

In FIG. 5, the center points P of the plurality of discharge ports 84 are located equidistant from the axis Ax of the tip tip 54. In other words, in front view of the tip tip 54, the plurality of discharge ports 84 are provided so that the center point P of the plurality of discharge ports 84 is located at the apex of the equilateral triangle T.

The shape of each discharge port 84 (the shape seen from the extending direction of the center line CL) is formed into a perfect circular shape. However, the shape of each discharge port 84 (shape seen from the extending direction of the center line CL) is not particularly limited, and may be a polygonal shape (triangular shape, quadrangular shape, etc.), an elliptical shape, or the like. As shown in FIG. 3, each discharge port 84 has a tapered diameter increasing from the tip inner surface 86 toward the tip outer surface 88. The outer diameter of each discharge port 84 (opening diameter on the inner surface 86 side of the tip) is smaller than the inner diameter of the tip opening 50a of the gas supply member 50.

The plurality of discharge ports 84 are formed to have the same size and shape as each other. However, the sizes and shapes of the plurality of discharge ports 84 may be different from each other. The opening diameter on the tip inner surface 86 side of each discharge port 84 is set so that the total opening area obtained by adding the opening areas on the tip inner surface 86 side of each discharge port 84 is 0.2 mm ² or more and 0.6 mm ^{2 or less.} Is preferable. Specifically, in the present embodiment, the opening diameter of each discharge port 84 on the inner surface 86 side of the tip is preferably 0.3 mm or more and 0.5 mm or less. In this case, the mixed liquid G can be effectively sprayed while suppressing an increase in the discharge resistance of the mixed liquid G at each discharge port 84. However, the opening diameter on the inner surface 86 side of the tip of the discharge port 84 can be appropriately set. Each discharge port 84 may extend from the tip inner surface 86 to the tip outer surface 88 with a constant outer diameter.

In the following description, as shown in FIG. 5, the three discharge ports 84 may be distinguished from the "first discharge port 84a", the "second discharge port 84b", and the "third discharge port 84c". Further, as shown in FIG. 6, the mixed liquid G sprayed from the first discharge port 84a is the “first mixed liquid G1”, and the mixed liquid G sprayed from the second discharge port 84b is the “second mixed liquid G2”. , The mixed liquid G sprayed from the third discharge port 84c may be referred to as "third mixed liquid G3".

FIG. 6 shows the spread state of the first mixed liquid G1, the second mixed liquid G2, and the third mixed liquid G3 at a position separated from the tip end of the tip 54 by a predetermined distance (for example, 2 cm). In FIG. 6, each of the first mixed liquid G1, the second mixed liquid G2, and the third mixed liquid G3 spreads out in a circular shape. The first mixed liquid G1, the second mixed liquid G2, and the third mixed liquid G3 are located so as to overlap each other. That is, the mixed liquid G contains the first to seventh regions R1 to R7.

The first region R1 is a region composed of only the first mixed liquid G1. The second region R2 is a region composed of only the second mixed liquid G2. The third region R3 is a region composed of only the third mixed liquid G3. The fourth region R4 is a region where only the first mixed liquid G1 and the second mixed liquid G2 overlap. The fifth region R5 is a region where only two of the first mixed liquid G1 and the third mixed liquid G3 overlap. The sixth region R6 is a region where only two of the second mixed liquid G2 and the third mixed liquid G3 overlap. The seventh region R7 is a region in which the first mixed liquid G1, the second mixed liquid G2, and the third mixed liquid G3 overlap each other. The seventh region R7 is located in the central portion of the mixed liquid G (on the axis Ax of the tip 54).

In such a tip tip 54, at a position separated by a predetermined distance (for example, 2 cm) from the tip end of the tip tip 54, a gap in which the first to third mixed liquids G1 to G3 do not overlap each other in the central portion of the mixed liquid G. The area does not exist. Therefore, it is possible to reliably apply the mixed solution G to the target site 208 in the living body.

In the tip 54, the number and position of the discharge ports 84 can be appropriately set. The discharge port 84 may be two or four or more, and the discharge port 84 may be located on the axis Ax of the tip 54.

In FIG. 2, the sheath member 56 has a sheath tube 90 extending in one direction and a sheath hub 92 provided at a base end portion of the sheath tube 90. The sheath tube 90 is located on the outer peripheral side of the nozzle tube 52 and the outer peripheral side of the shaft 44. In other words, the shaft 44 is inserted into the sheath tube 90. The sheath tube 90 is movable (sliding) along the axial direction of the shaft 44.

The sheath tube 90 is preferably made of a resin material such as high-density polyethylene, polypropylene, or polycarbonate. The sheath hub 92 is formed in an annular shape in a size that is easy to operate manually.

As shown in FIG. 3, a gap 94 for discharging air from the tip end to the base end of the sheath tube 90 is formed inside the sheath tube 90. This prevents the abdominal pressure from becoming excessively high when the nozzle 16 is inserted into the abdominal cavity 206 (see FIG. 7) in laparoscopic surgery. Further, a side hole (not shown) penetrating in the thickness direction of the sheath tube 90 may be provided on the tip end side of the sheath tube 90. By doing so, the sheath tube 90 is moved to the tip side of the nozzle 16, and even if the sheath tube 90 is sprayed in a state where the sheath tube 90 is in close contact with the step between the nozzle tube 52 and the tip tip 54, the air exhaust function in the abdominal cavity 206 is performed. Never lose.

With the sheath member 56 most moved to the base end side of the nozzle 16 with respect to the nozzle tube 52, the nozzle tube 52 and the gas supply member 50 are exposed to the tip end side of the nozzle 16 with respect to the sheath tube 90 and have an arc shape. Curves to. The nozzle tube 52 and the gas supply member 50 extend linearly along the shape of the sheath tube 90 in a state where the sheath member 56 is most moved toward the tip end side of the nozzle 16 with respect to the nozzle tube 52.

Next, a method of using the medical application tool 10 configured in this way will be described. First, as shown in FIG. 1, the user fills the first syringe outer cylinder 22 with the first liquid M1 and fills the second syringe outer cylinder 24 with the second liquid M2. After that, the gas supply device 14 is operated to supply gas to the nozzle 16. Then, the gas introduced from the gas supply device 14 into the gas introduction hole 74 via the air supply tube 42 is guided into the nozzle tube 52 via the gas flow path 64 between the shaft 44 and the liquid supply unit 46. .. The gas guided into the nozzle tube 52 passes through the wall portion of the gas supply member 50, flows into the mixing chamber 51, and flows out from the plurality of discharge ports 84.

Further, the user connects the tip of the first syringe outer cylinder 22 to the first connection hole 70a and the tip of the second syringe outer cylinder 24 to the second connection hole 72a. Then, as shown in FIG. 7, in the case of laparoscopic surgery, the sheath member 56 was moved to the tip side of the nozzle 16 and provided on the skin 202 of the patient 200 with the tip of the nozzle 16 straightened. It is inserted into the abdominal cavity 206 (in vivo) via the trocar 204.

Subsequently, the user moves the sheath member 56 toward the base end side of the nozzle 16 to bend the tip portion of the nozzle 16 in an arc shape, and directs the discharge port 84 toward the target portion 208 (damaged portion) in the abdominal cavity 206. At this time, the spraying distance is set to 2 cm or more and 5 cm or less from the discharge port 84. Next, the user presses the pressing unit 40 of the liquid supply unit 12. Then, the first gasket 30 moves toward the tip of the first syringe outer cylinder 22, and the second gasket 32 moves toward the tip of the second syringe outer cylinder 24. The first liquid M1 pushed by the first gasket 30 is guided into the mixing chamber 51 through the lumen of the first tube 58. The second liquid M2 pushed by the second gasket 32 is guided into the mixing chamber 51 through the lumen of the second tube 60.

In the mixing chamber 51, the first liquid M1 and the second liquid M2 are mixed by gas. At this time, a micro valve is generated in the mixed liquid G. Then, the mixed liquid G containing the microvalve is sprayed (injected) from the plurality of discharge ports 84 toward the target portion 208. The mixed liquid G sprayed from the discharge port 84 gels and is applied to the target portion 208 to become a physical partition wall. This prevents adhesions at the injured site. The air in the abdominal cavity 206 is exhausted through the gap 94 inside the sheath tube 90.

After the application of the mixed liquid G is completed, the user moves the sheath member 56 toward the tip end side of the nozzle 16 and removes the nozzle 16 from the trocar 204 with the tip end portion of the nozzle 16 straightened.

In this case, the medical application tool 10 according to the present embodiment has the following effects.

A plurality of discharge ports 84 for spraying the mixed liquid G together with the gas are provided at the tip of the nozzle 16, and the plurality of discharge ports 84 have a nozzle 16 at intervals d of the center lines CL of the discharge ports 84 adjacent to each other. It is formed so that the tip of the tip spreads in the direction in which it points.

According to such a configuration, since a plurality of discharge ports 84 are provided at the tip of the nozzle 16, mixing is performed as compared with the case where only one discharge port having a relatively small hole diameter is provided at the tip of the nozzle 16. The discharge resistance of the liquid G can be reduced. Further, the plurality of discharge ports 84 are formed so that the distance d between the center lines CL of the discharge ports 84 adjacent to each other is widened in the direction in which the tip of the nozzle 16 is directed. As a result, the spray area of the mixed liquid G sprayed from the plurality of discharge ports 84 can be effectively expanded. Therefore, it is possible to suppress the liquid dripping at the target portion 208.

The tip of the nozzle 16 is provided with a tip outer surface 88 having an arcuate vertical cross section, and a plurality of discharge ports 84 are open to the tip outer surface 88.

According to such a configuration, it is possible to make the distance between the discharge ports 84 adjacent to each other relatively wide on the tip outer surface 88 as compared with the case where the tip outer surface 88 is formed flat. As a result, it is possible to effectively prevent the mixed liquid G adhering to the opening edge portion of the tip outer surface 88 side of the discharge port 84 from blocking the discharge port 84 adjacent to the discharge port 84.

Each of the plurality of discharge ports 84 has a tapered diameter increasing from the inner surface (tip inner surface 86) of the tip portion of the nozzle 16 to the outer surface (tip outer surface 88).

According to such a configuration, the spray area of the mixed liquid G sprayed from each discharge port 84 can be effectively expanded.

The nozzle 16 includes a gas supply member 50 that forms one mixing chamber 51 that mixes the first liquid M1 and the second liquid M2 and supplies gas to the mixing chamber 51. Each of the plurality of discharge ports 84 communicates with the mixing chamber 51.

According to such a configuration, the mixed liquid G in the mixing chamber 51 can be smoothly guided to each discharge port 84.

The gas supply member 50 is formed of a hydrophobic filter.

According to such a configuration, it is possible to prevent the first liquid M1 and the second liquid M2 from leaking from the mixing chamber 51 to the outside of the gas supply member 50.

The nozzle 16 has a liquid feeding unit 46 which is connected to the gas supply member 50 and guides the first liquid M1 and the second liquid M2 to the mixing chamber 51.

According to such a configuration, the first liquid M1 and the second liquid M2 can be introduced into the mixing chamber 51 by the liquid feeding unit 46.

The liquid feeding unit 46 has a first tube 58 that guides the first liquid M1 to the mixing chamber 51, and a second tube 60 that guides the second liquid M2 to the mixing chamber 51.

According to such a configuration, the first liquid M1 derived from the first tube 58 and the second liquid M2 derived from the second tube 60 can be mixed in the mixing chamber 51.

The nozzle 16 has a tubular shaft 44 for guiding the gas to the gas supply member 50.

According to such a configuration, the first liquid M1 and the second liquid M2 can be efficiently mixed by gas in the mixing chamber 51.

A support member 48 for supporting the base end portion of the first tube 58 and the base end portion of the second tube 60 is provided at the base end portion of the shaft 44. The support member 48 includes a first connection portion 70 to which a first syringe outer cylinder 22 (first liquid supply portion) for introducing the first liquid M1 into the first base end opening 58b of the first tube 58 can be attached and detached. It has a second connecting portion 72 to which a second syringe outer cylinder 24 (second liquid supply portion) for introducing the second liquid M2 into the second base end opening 60b of the second tube 60 can be attached and detached.

According to such a configuration, the first liquid M1 can be introduced into the first tube 58 and the second liquid M2 can be introduced into the second tube 60 by a simple configuration.

The center points P of the plurality of discharge ports 84 are located equidistant from the axis Ax of the tip portion of the nozzle 16 (tip portion of the tip tip 54).

According to such a configuration, the region where the mixed liquid G sprayed from each discharge port 84 overlaps (7th region R7) can be positioned on the axis Ax at the tip of the nozzle 16.

The present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the gist of the present invention.

The shape of the tip outer surface 88 of the tip tip 54 can be appropriately set. The shape of the tip outer surface 88 of the tip tip 54 may be a truncated cone shape, a conical shape, a cylindrical shape, or the like. The number, position, size, and shape of the discharge ports 84 can be appropriately set according to the shape of the tip outer surface 88 of the tip tip 54.

The above embodiments can be summarized as follows.

In the above embodiment, a medical coating tool (10) provided with a nozzle (16) for spraying a mixed liquid (G), which is a mixture of a first liquid (M1) and a second liquid (M2), into a living body (206). The tip of the nozzle is provided with a plurality of discharge ports (84) for spraying the mixed liquid together with the gas, and the plurality of discharge ports are center lines (CL) of the discharge ports adjacent to each other. ) Discloses a medical application tool in which the interval (d) is formed so as to widen in the direction in which the tip of the nozzle is directed.

In the medical application tool, the tip portion of the nozzle is provided with a tip outer surface (88) having an arcuate vertical cross section, and the plurality of discharge ports may be opened to the tip outer surface.

In the medical application tool, each of the plurality of discharge ports may be tapered in diameter from the inner surface to the outer surface of the tip portion of the nozzle.

In the medical coating tool, the nozzle forms one mixing chamber (51) that mixes the first liquid and the second liquid, and the gas supply member (50) that supplies the gas to the mixing chamber. ), And each of the plurality of discharge ports may communicate with the mixing chamber.

In the above medical coating tool, the gas supply member may be formed by a hydrophobic filter.

In the medical coating tool, the nozzle may have a liquid feeding unit (46) connected to the gas supply member to guide the first liquid and the second liquid to the mixing chamber.

In the above medical application tool, the liquid feeding unit includes a first tube (58) that guides the first liquid to the mixing chamber, and a second tube (60) that guides the second liquid to the mixing chamber. May have.

In the medical application, the nozzle may have a tubular shaft (44) for guiding the gas to the gas supply member.

In the medical coating tool, a support member (48) for supporting the base end portion of the first tube and the base end portion of the second tube is provided at the base end portion of the shaft. The support member includes a first connection portion (70) to which a first liquid supply portion (22) for introducing the first liquid into the first base end opening (58b) of the first tube can be attached and detached, and the first. The second liquid supply part (24) for introducing the second liquid into the second base end opening (60b) of the second tube may have a detachable second connection part (72).

In the medical application tool, the center points (P) of the plurality of ejection ports may be located equidistant from the axis (Ax) of the tip of the nozzle.

Claims

A medical application tool equipped with a nozzle for spraying a mixed solution of a first solution and a second solution into a living body.
A plurality of discharge ports for spraying the mixed liquid together with the gas are provided at the tip of the nozzle.
The plurality of discharge ports are medical coating tools in which the distance between the center lines of the discharge ports adjacent to each other is widened in the direction in which the tip of the nozzle is directed.
The medical application according to claim 1.
The tip portion of the nozzle is provided with a tip outer surface having an arcuate vertical cross section.
The plurality of discharge ports are medical application tools having an opening on the outer surface of the tip.
The medical application according to claim 1 or 2.
Each of the plurality of discharge ports is a medical application tool whose diameter is tapered from the inner surface to the outer surface of the tip portion of the nozzle.
The medical application according to any one of claims 1 to 3.
The nozzle comprises a gas supply member that forms one mixing chamber for mixing the first liquid and the second liquid and supplies the gas to the mixing chamber.
Each of the plurality of discharge ports is a medical application tool communicating with the mixing chamber.
The medical application according to claim 4, wherein the medical coating tool is used.
The gas supply member is a medical application tool formed of a hydrophobic filter.
The medical application according to claim 4 or 5.
The nozzle is a medical application tool having a liquid feeding unit connected to the gas supply member and guiding the first liquid and the second liquid to the mixing chamber.
The medical application according to claim 6.
The liquid feeding part is
A first tube that guides the first liquid to the mixing chamber,
A medical application tool comprising a second tube for guiding the second liquid to the mixing chamber.
The medical application according to claim 7.
The nozzle is a medical application tool having a tubular shaft for guiding the gas to the gas supply member.
The medical application according to claim 8.
A support member for supporting the base end portion of the first tube and the base end portion of the second tube is provided at the base end portion of the shaft.
The support member is
A first connection portion to which a first liquid supply portion for introducing the first liquid into the first base end opening of the first tube can be attached and detached, and a first connection portion.
A medical application tool comprising a second connection portion to which a second liquid supply portion for introducing the second liquid into the second base end opening of the second tube can be attached and detached.
The medical application according to any one of claims 1 to 9.
A medical application tool in which the center points of the plurality of discharge ports are located equidistant from the axis of the tip of the nozzle.