JP2000300570A - Puncture aid - Google Patents
Puncture aidInfo
- Publication number
- JP2000300570A JP2000300570A JP11117210A JP11721099A JP2000300570A JP 2000300570 A JP2000300570 A JP 2000300570A JP 11117210 A JP11117210 A JP 11117210A JP 11721099 A JP11721099 A JP 11721099A JP 2000300570 A JP2000300570 A JP 2000300570A
- Authority
- JP
- Japan
- Prior art keywords
- opening
- endoscope
- vein
- puncture
- hood
- Prior art date
- Legal status (The legal status 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 status listed.)
- Pending
Links
Abstract
Description
【０００１】[0001]
【発明の属する技術分野】本発明は、食道静脈瘤に対す
る内視鏡的硬化療法（以下、ＥＩＳと略す）で、穿刺針
を静脈内に刺すときの補助具に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an assisting device for inserting a puncture needle into a vein in endoscopic sclerotherapy (hereinafter abbreviated as EIS) for esophageal varices.
【０００２】[0002]
【従来の技術】肝硬変に伴う食道静脈瘤の治療法として
は、血液凝固性を持つ硬化剤を静脈瘤内あるいは静脈瘤
外に注入して局所に停滞させ、血栓の形成で血行を遮断
することにより静脈瘤を荒廃させ治療するＥＩＳと、内
視鏡下で静脈瘤をＯリングで結紮し、静脈瘤内の血流を
遮断する食道静脈瘤結紮術（以後ＥＶＬという）があ
る。 ＥＩＳは静脈瘤内に硬化剤を注入して静脈瘤内の
血液を凝固させることにより、ＥＶＬは内視鏡下で静脈
瘤をＯリングで結紮し、静脈瘤内の血流を遮断すること
により、静脈瘤を虚血状態にして荒廃させ、最終的に食
道壁から脱落させる手技であり、現在、広く適用されて
いる。2. Description of the Related Art As a method of treating esophageal varices associated with cirrhosis, a sclerosing agent having a blood coagulant is injected into or out of the varicose vein to cause local stagnation and block blood circulation by forming a thrombus. Esophageal varices ligation (hereinafter referred to as EVL), in which the varicose veins are devastated and treated by an esophagus, and the varicose veins are ligated with an O-ring under an endoscope to block blood flow in the varicose veins. EIS is by injecting a sclerosing agent into the varicose vein and coagulating the blood in the varicose vein, and EVL is ligating the varicose vein with an O-ring under an endoscope and blocking the blood flow in the varicose vein. This is a technique for making an varicose vein ischemic, devastating it, and finally dropping it off the esophagus wall, and is currently widely used.
【０００３】ＥＶＬは、その簡便性から緊急症例での使
用が広まり、定着したが、処置後の経過観察で静脈瘤が
再発することが多数報告されたため、現在では、ＥＩＳ
を組み合わせて治療する方法が主流となっている。先に
述べたように、ＥＩＳには、血液凝固性を持つ硬化剤を
静脈瘤内に注入する方法と、静脈瘤外に注入する方法の
２種類がある。前者の方法は、静脈瘤の供血路まで硬化
剤を注入して、静脈瘤を血栓で完全に閉塞するものであ
り、完全に供血路を閉塞できれば、その効果はきわめて
高い。ところが、内視鏡下で静脈を穿刺するのは容易で
はなく、特に細い血管ほど、穿刺できない場合が多い。
このため、静脈瘤の供血路を完全につぶすことができ
ず、この場合、再発する場合が少なくない。[0003] EVL has been widely used in emergency cases because of its simplicity, and has been established. However, it has been reported that varicose veins recur during follow-up after treatment.
The method of treating with a combination of these is the mainstream. As described above, there are two types of EIS, a method of injecting a sclerosing agent having a blood coagulation property into varicose veins and a method of injecting sclerosing agents outside of varicose veins. The former method involves injecting a sclerosing agent into the blood supply passage of the varicose vein and completely closing the varicose vein with a thrombus. If the blood supply passage can be completely closed, the effect is extremely high. However, it is not easy to puncture a vein under an endoscope, and in particular, thinner blood vessels often cannot be punctured.
For this reason, the blood supply path of the varicose vein cannot be completely crushed, and in this case, the recurrence often occurs.
【０００４】[0004]
【発明が解決しようとする課題】本発明の目的はＥＩＳ
を実施するために、内視鏡下で容易かつ確実に穿刺針を
静脈内に刺すことを可能にする補助具を提供することで
ある。SUMMARY OF THE INVENTION An object of the present invention is to provide an EIS.
The purpose of the present invention is to provide an assisting device that enables a puncture needle to be easily and reliably inserted into a vein under an endoscope.
【０００５】[0005]
【課題を解決するための手段】本発明は、内視鏡装着部
と先端開口部を有するフードであって、開口部は内視鏡
装着部から徐々に絞りこまれて、内視鏡の外径の１２〜
７０％となるとともに、開口部の中心が、内視鏡の鉗子
チャンネルの出口の中心と同軸上にあることを特徴とす
る穿刺補助具である。SUMMARY OF THE INVENTION The present invention is a hood having an endoscope mounting portion and a distal end opening, wherein the opening is gradually narrowed from the endoscope mounting portion so as to be outside the endoscope. 12 ~
70%, and the center of the opening is coaxial with the center of the exit of the forceps channel of the endoscope.
【０００６】[0006]
【発明の実施の形態】以下、図面により本発明を詳細に
説明する。図１は本発明の一実施例となる穿刺補助具を
内視鏡に装着した状態を示す図である。図２（ａ）から
（ｂ）は、本発明の補助具を用いて、食道表面の静脈を
穿刺する方法を示すための内視鏡画像の図である。本発
明の目的を達成する穿刺補助具は、図１に示すように内
視鏡の先端に装着されるフード（２）である。フード
（２）は装着部（３）と開口部（４）を有しており、装
着部（３）から開口部（４）に向かって、徐々に内外径
が小さくなる。開口部（４）の径ｄは使用する内視鏡の
外径の１２％から７０％が好ましく、１２％より小さい
と、穿刺時にフード内に穿刺すべき静脈を十分吸引する
ことができないので好ましくなく、７０％より大きい
と、逆に静脈の周囲の組織を広範囲に吸引してしまい、
確実に静脈を穿刺できなくなる可能性があるので好まし
くない。DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, the present invention will be described in detail with reference to the drawings. FIG. 1 is a view showing a state in which a puncture aid according to one embodiment of the present invention is mounted on an endoscope. FIGS. 2A and 2B are views of an endoscopic image for illustrating a method of puncturing a vein on the surface of the esophagus using the assisting device of the present invention. The puncture aid that achieves the object of the present invention is a hood (2) attached to the end of the endoscope as shown in FIG. The hood (2) has a mounting portion (3) and an opening (4), and the inner and outer diameters gradually decrease from the mounting portion (3) toward the opening (4). The diameter d of the opening (4) is preferably from 12% to 70% of the outer diameter of the endoscope to be used. If the diameter d is smaller than 12%, the vein to be punctured into the hood at the time of puncturing cannot be sufficiently sucked. If it is larger than 70%, on the contrary, the tissue around the vein will be widely sucked,
It is not preferable because the vein cannot be surely punctured.
【０００７】開口部（４）の径は細い静脈を穿刺する時
には、小さめにし、逆に、太い静脈を穿刺する時には、
大きめにして吸引できる範囲を制御するとよい。このよ
うに使い分けることにより、穿刺性はいっそう向上す
る。開口部（４）の中心は内視鏡（１）の鉗子チャンネ
ル（５）の出口の中心と同軸上にくるように配置され
る。開口部（４）の中心が内視鏡（１）の鉗子チャンネ
ル（５）の出口の中心と一致しない場合、鉗子チャンネ
ル（５）から突出させた穿刺針は、フード（２）に当た
ってしまい、穿刺すべき静脈を穿刺できなくなるので好
ましくない。[0007] The diameter of the opening (4) is made small when puncturing a thin vein, and conversely, when puncturing a thick vein.
It is better to control the range in which suction can be made larger. Puncturing properties are further improved by properly using them in this manner. The center of the opening (4) is arranged coaxially with the center of the exit of the forceps channel (5) of the endoscope (1). If the center of the opening (4) does not coincide with the center of the exit of the forceps channel (5) of the endoscope (1), the puncture needle protruding from the forceps channel (5) hits the hood (2) and punctures. This is not preferable because the vein to be punctured cannot be punctured.
【０００８】本発明によれば、開口部（４）を構成する
面は内視鏡（１）の端面に対して、一定の角度θを持た
せてもよい。角度をつけることにより、開口部（４）全
体を患部にあてがうことが可能になり、穿刺がより安定
的、かつ確実に行えるようになる。θの角度は術者の好
みにより適宜決定してよいが、特に２０〜５０°が好ま
しい。θが２０°より小さいと開口部（４）を患部にあ
てがうには、狭い食道内で内視鏡（１）に相当なアング
ルをかけなければならず、穿刺操作を悪化させる原因と
なるので好ましくなく、θが５０°より大きいと、フー
ド（２）の先端が鋭利となり、内視鏡（１）を食道内に
挿入した時に、装着した穿刺補助具により静脈瘤を傷つ
け、大出血を引き起こす原因となるので好ましくない。According to the present invention, the surface constituting the opening (4) may have a constant angle θ with respect to the end surface of the endoscope (1). By setting the angle, the entire opening (4) can be applied to the affected part, and puncturing can be performed more stably and reliably. The angle θ may be appropriately determined according to the operator's preference, but is preferably 20 to 50 °. If θ is smaller than 20 °, the endoscope (1) must be set at a considerable angle in the narrow esophagus in order to apply the opening (4) to the affected part, which may deteriorate the puncture operation. When θ is greater than 50 °, the tip of the hood (2) becomes sharp, and when the endoscope (1) is inserted into the esophagus, the puncture aid attached may damage the varicose vein and cause major bleeding. Is not preferred.
【０００９】本発明によれば、フード（２）は透明性に
優れる樹脂から形成されるのが好ましい。不透明な樹脂
を使用すると開口部（４）以外の視野が得られいず、患
部を十分観察できないので好ましくない。透明な樹脂で
あれば特に、使用に制限はなく、たとえば、ポリ塩化ビ
ニル、ポリメチルペンテン、ポリスチレン、ポリメチル
メタクリレート、ポリヒドロキシメチルメタクリレー
ト、透明ナイロン、ポリカーボネート等が好適である。
また、フードの表面にはポリエチレングリコール、ヒア
ルロン酸、ポリビニルピロリドンのような親水性樹脂を
コーティングしたり、プラズマ処理により親水性処理を
してもよい。このような親水性処理はフード表面の水の
接触角を小さくして、消化管の水滴がフード（２）に付
着して視野を悪化させるのを防止するのに有効である。According to the present invention, the hood (2) is preferably formed of a resin having excellent transparency. Use of an opaque resin is not preferable because a visual field other than the opening (4) cannot be obtained, and the affected part cannot be sufficiently observed. The use of a transparent resin is not particularly limited, and examples thereof include polyvinyl chloride, polymethylpentene, polystyrene, polymethyl methacrylate, polyhydroxymethyl methacrylate, transparent nylon, and polycarbonate.
The surface of the hood may be coated with a hydrophilic resin such as polyethylene glycol, hyaluronic acid, or polyvinylpyrrolidone, or may be subjected to a hydrophilic treatment by a plasma treatment. Such a hydrophilic treatment is effective for reducing the contact angle of water on the surface of the hood and for preventing water droplets in the digestive tract from adhering to the hood (2) and deteriorating the visual field.
【００１０】次に、本発明の穿刺補助具の使用方法を述
べることにより、本発明の効果を明確にする。図２
（ａ）は、本発明の穿刺補助具を装着して、食道の静脈
を穿刺しようとしている時の内視鏡画像を示す。開口部
（４）を画像のほぼ中央に確認することができる。この
図より明らかなように、患部の観察はフード（２）をと
おして行うことになる。観察が完了し、穿刺しようとす
る静脈を確認して、穿刺部位が決定したら、開口部
（４）を穿刺しようとする静脈にあてがい、その部分を
固定する。次いで、図２（ｂ）に示したように、内視鏡
（１）の吸引を働かせて、固定した静脈をフード（２）
の内部に吸引する。開口部（４）による固定と、引き続
き実施される吸引操作により、穿刺しようとする静脈を
完全に固定することが可能となる。この状態で、穿刺針
（６）を吸引された静脈（１０）に刺せば、静脈（１
０）内への穿刺が完了する。静脈（１０）に針が入った
ことは穿刺針（６）内に血液が逆流することで確認がで
きる。この後に硬化剤を注入すればＥＩＳは完了する。Next, the effect of the present invention will be clarified by describing a method of using the puncture aid of the present invention. FIG.
(A) shows an endoscopic image when the puncture assisting device of the present invention is worn and a vein of the esophagus is about to be punctured. The opening (4) can be confirmed almost at the center of the image. As is clear from this figure, observation of the affected part is performed through the hood (2). After the observation is completed and the vein to be punctured is confirmed and the puncture site is determined, the opening (4) is applied to the vein to be punctured, and the portion is fixed. Then, as shown in FIG. 2 (b), the fixed vein is removed from the hood (2) by the suction of the endoscope (1).
Suction inside. The fixation by the opening (4) and the subsequent suction operation make it possible to completely fix the vein to be punctured. In this state, when the puncture needle (6) is pierced into the sucked vein (10), the vein (1) is pierced.
Puncture into 0) is completed. The fact that the needle has entered the vein (10) can be confirmed by the backflow of blood into the puncture needle (6). Thereafter, if a curing agent is injected, the EIS is completed.
【００１１】[0011]
【発明の効果】以上述べたごとく、本発明の穿刺補助具
は、穿刺しようとする静脈を完全に固定することが可能
であり、また、穿刺しようとする静脈を鉗子チャンネル
の同軸上に配置することか可能なため、単に刺すという
行為のみで静脈穿刺を完了できるので、容易、安全、確
実にＥＩＳを実施するための補助具として、きわめて有
用である。また、本発明によれば、開口部の径を小さく
して吸引できる範囲を制御することで、細い静脈も容易
に穿刺することが可能であり、食道静脈瘤の供血路を完
全に遮断するための手段としても、きわめて有用であ
る。As described above, the puncture aid of the present invention can completely fix the vein to be punctured, and arranges the vein to be punctured coaxially with the forceps channel. Since it is possible to complete the venipuncture only by the action of piercing, it is extremely useful as an auxiliary tool for easily, safely and securely performing the EIS. Further, according to the present invention, it is possible to easily puncture a thin vein by controlling the range in which suction can be performed by reducing the diameter of the opening, and to completely cut off the blood supply passage of the esophageal varices. It is also very useful as a means.
【図１】本発明の一実施例となる穿刺補助具を内視鏡に
装着した状態を示す図である。FIG. 1 is a view showing a state in which a puncture aid according to one embodiment of the present invention is mounted on an endoscope.
【図２】本発明の穿刺補助具を用いて、食道表面の静脈
を穿刺する方法を示すための内視鏡画像の図である。FIG. 2 is an endoscope image showing a method of puncturing a vein on the surface of the esophagus using the puncture aid of the present invention.
１ 内視鏡 ２ フード ３ 装着部 ４ 開口部 ５ 鉗子チャンネル ６ 穿刺針 １０ 静脈 DESCRIPTION OF SYMBOLS 1 Endoscope 2 Hood 3 Mounting part 4 Opening 5 Forceps channel 6 Puncture needle 10 Vein
───────────────────────────────────────────────────── フロントページの続き Ｆターム(参考） 4C060 FF26 FF29 MM24 4C061 AA02 BB00 CC00 DD00 FF37 4C066 AA07 BB01 CC10 FF03 KK02 ──────────────────────────────────────────────────続 き Continued on the front page F term (reference) 4C060 FF26 FF29 MM24 4C061 AA02 BB00 CC00 DD00 FF37 4C066 AA07 BB01 CC10 FF03 KK02
Claims (1)
ドであって、開口部は内視鏡装着部から徐々に絞りこま
れて、内視鏡の外径の１２〜７０％となるとともに、開
口部の中心が、内視鏡の鉗子チャンネルの出口の中心と
同軸上にあることを特徴とする穿刺補助具。1. A hood having an endoscope mounting portion and a distal end opening, wherein the opening is gradually narrowed from the endoscope mounting portion to become 12 to 70% of the outer diameter of the endoscope. And a center of the opening is coaxial with the center of the exit of the forceps channel of the endoscope.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP11117210A JP2000300570A (en) | 1999-04-23 | 1999-04-23 | Puncture aid |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP11117210A JP2000300570A (en) | 1999-04-23 | 1999-04-23 | Puncture aid |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| JP2000300570A true JP2000300570A (en) | 2000-10-31 |
Family
ID=14706125
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP11117210A Pending JP2000300570A (en) | 1999-04-23 | 1999-04-23 | Puncture aid |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP2000300570A (en) |
Cited By (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2002330918A (en) * | 2001-05-08 | 2002-11-19 | Hironori Yamamoto | Hood for endoscope |
| JP2006325867A (en) * | 2005-05-25 | 2006-12-07 | Fujinon Corp | Hood for endoscope |
| WO2007063658A1 (en) * | 2005-12-01 | 2007-06-07 | Olympus Medical Systems Corp. | Endoscope and hydrophilic cap |
| US20070260273A1 (en) * | 2006-05-08 | 2007-11-08 | Ethicon Endo-Surgery, Inc. | Endoscopic Translumenal Surgical Systems |
| US7931584B2 (en) | 2004-01-07 | 2011-04-26 | Olympus Corporation | Medical capsule housing formed by thermal welding |
| JP2011517577A (en) * | 2007-12-05 | 2011-06-16 | インディアナ・ユニバーシティ・リサーチ・アンド・テクノロジー・コーポレーション | Device for delivering an anchor device into the wall of a body passage |
| JP2012125350A (en) * | 2010-12-14 | 2012-07-05 | Jichi Medical Univ | Hood for endoscope |
| JP2014510577A (en) * | 2011-02-16 | 2014-05-01 | ザ ジェネラル ホスピタル コーポレイション | Endoscope optical coupler |
| JP2014087489A (en) * | 2012-10-30 | 2014-05-15 | Olympus Medical Systems Corp | Endoscope adapter |
| JP2016002298A (en) * | 2014-06-17 | 2016-01-12 | オリンパス株式会社 | Connector and insertion apparatus |
| US10548467B2 (en) | 2015-06-02 | 2020-02-04 | GI Scientific, LLC | Conductive optical element |
| US10642020B2 (en) | 2014-09-23 | 2020-05-05 | Scott Miller | Optical coupler for optical imaging visualization device |
| US10856724B2 (en) | 2015-07-21 | 2020-12-08 | GI Scientific, LLC | Endoscope accessory with angularly adjustable exit portal |
-
1999
- 1999-04-23 JP JP11117210A patent/JP2000300570A/en active Pending
Cited By (29)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2002330918A (en) * | 2001-05-08 | 2002-11-19 | Hironori Yamamoto | Hood for endoscope |
| US7931584B2 (en) | 2004-01-07 | 2011-04-26 | Olympus Corporation | Medical capsule housing formed by thermal welding |
| US8709329B2 (en) | 2004-01-07 | 2014-04-29 | Olympus Corporation | Medical capsule housing formed by thermal welding |
| JP2006325867A (en) * | 2005-05-25 | 2006-12-07 | Fujinon Corp | Hood for endoscope |
| WO2007063658A1 (en) * | 2005-12-01 | 2007-06-07 | Olympus Medical Systems Corp. | Endoscope and hydrophilic cap |
| US8029438B2 (en) | 2005-12-01 | 2011-10-04 | Olympus Medical Systems Corp. | Endoscope and hydrophilic cap |
| US20070260273A1 (en) * | 2006-05-08 | 2007-11-08 | Ethicon Endo-Surgery, Inc. | Endoscopic Translumenal Surgical Systems |
| US8551058B2 (en) | 2006-05-08 | 2013-10-08 | Ethicon Endo-Surgery, Inc. | Endoscopic translumenal surgical systems |
| US9526487B2 (en) | 2007-12-05 | 2016-12-27 | Indiana University Research & Technology Corporation | Methods and apparatuses for delivering anchoring devices into body passage walls |
| JP2011517577A (en) * | 2007-12-05 | 2011-06-16 | インディアナ・ユニバーシティ・リサーチ・アンド・テクノロジー・コーポレーション | Device for delivering an anchor device into the wall of a body passage |
| JP2012125350A (en) * | 2010-12-14 | 2012-07-05 | Jichi Medical Univ | Hood for endoscope |
| US20150065795A1 (en) | 2011-02-16 | 2015-03-05 | The General Hospital Corporation | Optical Coupler for an Endoscope |
| JP2014510577A (en) * | 2011-02-16 | 2014-05-01 | ザ ジェネラル ホスピタル コーポレイション | Endoscope optical coupler |
| JP2017006732A (en) * | 2011-02-16 | 2017-01-12 | ザ ジェネラル ホスピタル コーポレイション | Optical coupler for an endoscope |
| JP2018079370A (en) * | 2011-02-16 | 2018-05-24 | ザ ジェネラル ホスピタル コーポレイション | Optical coupler for endoscope |
| US10506918B2 (en) | 2011-02-16 | 2019-12-17 | The General Hospital Corporation | Optical coupler for an endoscope |
| JP2014087489A (en) * | 2012-10-30 | 2014-05-15 | Olympus Medical Systems Corp | Endoscope adapter |
| JP2016002298A (en) * | 2014-06-17 | 2016-01-12 | オリンパス株式会社 | Connector and insertion apparatus |
| US10642020B2 (en) | 2014-09-23 | 2020-05-05 | Scott Miller | Optical coupler for optical imaging visualization device |
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