JP2004033261A - Medical instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To apply to a fine diameter site and perform the expansion treatment or the like of a constricted site in a short time by a simple structure. <P>SOLUTION: A medical instrument 1 comprises an insertion treatment tool 4 made up of a capillary such as a catheter inserted into the pancreatic duct 3, and a magnetic field generator 5 arranged outside an organism 2 and generating a rotating magnetic field. The insertion treatment tool 4 is made up of a slender insertion portion 6 having flexibility and a rotating treatment member 8 rotatably arranged in the insertion portion 6. The magnetic field generator 5 comprises electromagnets 9 attached to a plurality of peripheral positions of the organism 2, a drive device 10 supplying drive current of pulse form to the electromagnets 9 and an operating section 11 instructing the turning on and off of the drive current of the drive device 10 and the period or the like of the rotating magnetic field. <P>COPYRIGHT: (C)2004,JPO

Description

【０００１】
【発明の属する技術分野】
本発明は体腔内における狭窄部位等を治療処置する医療装置に関する。
【０００２】
【従来の技術】
近年、医療分野においては細長の挿入部を有する内視鏡が広く採用されるようになった。
【０００３】
また、内視鏡の挿入部での挿入が困難になるような細い管腔内に狭窄部ができた場合には、例えば特開平４−１０５６６０号に開示されているようにカテーテルを挿入し、その先端部にバルーン及び狭窄部に留置するためのステントを設けて、先端部を狭窄部に配置してカテーテルの中空部を介してバルーンに流体を供給してバルーンを膨張させることによりその外側に配置したステントを拡張させて狭窄部に留置させるようにしている。
【０００４】
【発明が解決しようとする課題】
この従来例はカテーテルの先端外周にバルーン及びステントを設けるため、狭窄部がカテーテルの外径程度となるような血管内の狭窄部のように細い管腔内部に対しては適用することが困難になる。
【０００５】
また、挿入した場合に、拡張する前の先端部のステントの外径よりも狭い狭窄部であった場合には、狭窄部に配置することが困難になる。
【０００６】
また、狭窄部を短時間に治療することができないし、複数箇所に狭窄部が存在する場合には適用しにくい。
【０００７】
本発明は、上記事情に鑑みてなされたものであり、細径な部位に対しても適用できると共に、簡単な構成で狭窄部の拡張処置等が短時間に行うことのできる医療装置を提供することを目的としている。
【０００８】
【課題を解決するための手段】
本発明の医療装置は、体内に挿入されるカテーテルと、前記カテーテルの先端より離脱可能な回転部材と、前記カテーテルが挿入される前記生体内の周囲で回転磁界を発生する磁界発生部とを有する医療装置において、前記回転部材が、少なくとも一部に、前記磁界発生部が発生した磁界を受け、回転する永久磁石と、少なくとも外周部に形成された螺旋状部とを有し、前記磁界発生部が発生した磁界を受け、前記カテーテル先端部から離脱可能に構成した。
【０００９】
【発明の実施の形態】
以下、図面を参照しながら本発明の実施の形態について述べる。
【００１０】
第１の実施の形態：
図１ないし図１４は本発明の第１の実施の形態に係わり、図１は医療装置の構成を示す構成図、図２は図１の回転処置部材の断面を示す断面図、図３は図１の医療装置の作用を説明する第１の図、図４は図１の医療装置の作用を説明する第２の図、図５は図１の医療装置の作用を説明する第３の図、図６は図１の医療装置の作用を説明する第４の図、図７は図１の医療装置の第１の変形例を説明する第１の図、図８は図１の医療装置の第１の変形例を説明する第２の図、図９は図１の医療装置の第２の変形例を説明する第１の図、図１０は図１の医療装置の第２の変形例を説明する第２の図、図１１は図１の医療装置の第３の変形例を説明する第１の図、図１２は図１の医療装置の第３の変形例を説明する第２の図、図１３は図１の医療装置の第３の変形例を説明する第３の図、図１４は図１の医療装置の第４の変形例を説明する図である。
【００１１】
図１に示すように、本実施の形態の医療装置１は、生体２内の細管例えば膵管３内に挿入されるカテーテル等の細管よりなる挿入処置具４と、生体２の外部に配置され、回転磁界を発生する磁界発生装置５とから構成される。
【００１２】
この挿入処置具４は、可撓性を有する細長の挿入部６と、この挿入部６内に回転自在に配置された回転処置部材８とから構成される。
【００１３】
また、磁界発生装置５は、生体２の周囲に例えばリング状に配置されるリング状部材における周方向の複数箇所（例えば６０°　の角度間隔でそれぞれが対向するように配置された６箇所）に取り付けられた電磁石９と、電磁石９にパルス状の駆動電流を供給する駆動装置１０と、この駆動装置１０による駆動電流のＯＮ／ＯＦＦ等や、回転磁界の周期等の指示操作を行う操作部１１とからなる。
【００１４】
回転処置部材８は、本体部２０はカプセル形状をなし、その外周面には螺旋状の螺旋突起部２１が設けられている。この螺旋突起部２１は、例えば左ネジ状で、かつ接触する組織等を損傷しないよう丸みを付けた形状をなしている。
【００１５】
図２に示すように、回転処置部材８の本体部２０の内部は長手軸を含む中心面２２を境にＮ極及びＳ極に着磁された永久磁石で形成されており、磁界発生装置５が発生する回転磁界により本体部２０が回転し、螺旋突起部２１がその外周壁と接触することで回転処置部材８が長手軸方向に進退可能になっている。
【００１６】
このような構成による本実施の形態の作用を、生体２内の細管例えば膵管３の狭窄部３１ができている場合の処置例で説明する。
【００１７】
まず、図示しないＸ線透視装置や体外式超音波診断装置等により、膵管３の狭窄部３１の位置を描出できる状態にする。
【００１８】
そして、図３に示すように、内視鏡４１の図示しない処置具チャンネルを介して処置しようとする狭窄部３１ができている膵管３内に挿入処置具４を先端側から挿入し、挿入処置具４の後端側を押す等して、挿入処置具４を先端を狭窄部３１に近づけていく。
【００１９】
そして、挿入処置具４を先端が狭窄部３１にある程度近接した位置にきたら、図１に示すようにその外側に配置した磁界発生装置５により、操作部１１の電源スイッチをＯＮし、時計回り方向の回転磁界を印加する指示操作を行う。
【００２０】
すると、図４に示すように回転処置部材８を形成する永久磁石が回転磁界と共に回転し、その回転により、螺旋突起部２１が挿入処置具４内面に接触して回転することにより回転処置部材８が挿入処置具４の先端より飛び出し、さらに図５に示すように螺旋突起部２１が膵管３の内壁に接触して回転することにより膵管３を推進移動し、螺旋突起部２１が狭窄部３１に到達すると、図６に示すように狭窄部３１の内面に接触して回転することにより、狭窄部３１を押し広げながら推進移動する。
【００２１】
このようにして回転処置部材８が狭窄部３１を通過して拡張処置が終了した場合には、回転磁界の向きを反対にして回転処置部材８を後退移動させる。
【００２２】
また、１回の拡張処置では拡張が十分でない場合には、狭窄部３１に対して回転処置部材８を複数回、往復移動することによって十分に拡張する処置ができる。
【００２３】
また、複数箇所に狭窄部３１が存在する場合には、１つの狭窄部３１に対して上述したようにして回転処置部材８を通過させることにより拡張処置を行い、さらに回転処置部材８を回転することにより深部側に移動してより深部側に存在する次の狭窄部３１に対して同様の拡張処置を行えば良い。
【００２４】
このように本実施の形態によれば、簡単な構成でしかも膵管３等の細管内でも使用できるような小型にでき、拡張処置も簡単な操作で行うことができる効果がある。
【００２５】
なお、回転処置部材８を挿入処置具４内に予め配置するとしたが、これに限らず、例えば挿入処置具４を内視鏡４１の図示しない処置具チャンネルを介して膵管３等の細管に挿入させ、挿入処置具４を先端が狭窄部３１にある程度近接した位置に配置した後、生体外にある挿入処置具４の基端より回転処置部材８を挿入処置具４に押し込み、ワイヤ等を用いて挿入処置具４内の回転処置部材８を押し込んで、回転処置部材８を挿入処置具４を先端近傍に位置させてから回転磁界により回転処置部材８を回転させるようにしてもよい。
【００２６】
また、図７に示すように、挿入処置具４の先端内壁に回転処置部材８の螺旋突起部２１が螺合するネジ部５１を設け、回転処置部材８の螺旋突起部２１をネジ部５１に螺合した状態で挿入処置具４を膵管３等の細管に挿入してよく、螺旋突起部２１をネジ部５１に螺合させることで、回転処置部材８を脱落させることなく挿入処置具４の先端に配置させ、図８に示すように、回転磁界により回転処置部材８をネジ部５１より離脱させることができ、より速く回転処置部材８により挿入処置具４の先端に近接している狭窄部３１を処置することができる。
【００２７】
さらにまた、図９に示すように、回転処置部材８の先端に糸部材６１により細径化したステント６２を配置し、回転処置部材８の螺旋突起部２１をネジ部５１に螺合した状態で挿入処置具４を膵管３等の細管に挿入し、狭窄部３１にステント６２を位置させた後に、回転磁界により回転処置部材８をネジ部５１より突出させ、挿入処置具４の先端に一端が固定されたステント６２の糸部材６１を切ることで、図１０に示すようにステント６２を拡張させ、狭窄部３１を処置するような構成としてもよい。
【００２８】
また、図１１に示すように、回転処置部材８を中空のカプセル形状の本体部２０ａより構成し、図１２に示すように、中空の本体部２０ａを長手軸を含む中心面２２を境にＮ極及びＳ極に着磁された永久磁石で構成してもよい。この場合、図１３に示すように、回転磁界により回転処置部材８を狭窄部３１に進退移動させることで拡張処置を行うことも可能であると共に、狭窄部３１に回転処置部材８を配置することで中空の本体部２０ａがステント６２の役割を果たすことが可能となる。
【００２９】
さらに、図１４に示すように、中空のカプセル形状の本体部２０ａを有する２つの回転処置部材８ａ，８ｂを用意し、一方の回転処置部材８ａの螺旋突起部２１を左ネジ状に、また他方の回転処置部材８ｂの螺旋突起部２１を右ネジ状に形成することで、同一の回転磁界により双方を互いに接近させて拡張処置を行うことが可能となる。この場合も拡張処置を行うことも可能であると共に、狭窄部３１に回転処置部材８ａ，８ｂを配置することで中空の本体部２０ａがステント６２の役割を果たすことが可能となる。
【００３０】
第２の実施の形態：
図１５ないし図１９は本発明の第２の実施の形態に係わり、図１５は医療装置の要部の構成を示す構成図、図１６は図１５の医療装置の作用を説明する図、図１７は図１５の回転処置部材の第１の変形例を説明する図、図１８は図１５の回転処置部材の第２の変形例を説明する第１の図、図１９は図１５の回転処置部材の第２の変形例を説明する第２の図である。
【００３１】
第２の実施の形態は、第１の実施の形態とほとんど同じであるので、異なる点のみ説明し、同一の構成には同じ符号をつけ説明は省略する。
【００３２】
ところで、従来より、体腔内の所定部位に直接、薬品等を供給するドラッグ・デリバリー・システム（以下、ＤＤＳ）においては、図２０に示すように、着磁された体液で溶融可能なカプセル１０１内に薬品を充填させ、細径で可撓性を有する挿入器具１０２の先端内に設けた電磁石１０３にカプセル１０１を磁気的に接続させて、体腔内の所望の位置にカプセル１０１を位置させた後に電磁石１０３をオフすることで、図２１に示すように、カプセル１０１を離脱し体腔内の所定部位に配置し、カプセル１０１を溶融させてカプセル１０１の薬品を所定部位に供給するものが提案されている。
【００３３】
なお、このＤＤＳにおいては、薬品だけでなく体腔内のｐＨ等を検知するための各種センサ等を搭載したカプセル形状の医療センサ器具を所定部位に配置させて、所定部位の各種データを取得するものがある。
【００３４】
しかし、このように挿入器具１０２の先端に電磁石等を配置する構成では、電磁石の配置だけではなく配線等を挿入器具１０２に行わなければならず、挿入器具１０２を細径化することがむずかしいという問題がある。
【００３５】
そこで、第２の実施の形態では、挿入器具の細径化を図ることのできる医療装置について説明する。
【００３６】
図１５に示すように、本実施の形態の医療装置１１０は、カプセル形状の本体部１２１の前後に雄ネジ部１２２ａ，１２２ｂを有するｐＨセンサ等の各種センサを内蔵した回転処置部材１２３と、回転処置部材１２３の雄ネジ部１２２ｂと螺合する雌ネジ部１２４を先端内壁部に有する生体２内に挿入されるカテーテル等の細管よりなる挿入処置具４とを有し、図示はしないが、第１の実施の形態と同様に、生体２の外部に配置され、回転磁界を発生する磁界発生装置５を備えて構成される。
【００３７】
なお、ここで、図示はしないが、例えば雄ネジ部１２２ａ，１２２ｂの少なくとも一方が、あるいは回転処置部材１２３の外壁部が、長手軸を含む中心面を境にＮ極及びＳ極に着磁された永久磁石で形成されている。
【００３８】
そして、図１６に示すように、挿入処置具４の先端を体腔内の所望の位置、例えば胃壁１３１に接近させて位置させる。この状態で、磁界発生装置５により、操作部１１の電源スイッチをＯＮし、時計回り方向の回転磁界を印加する指示操作を行う。
【００３９】
すると、回転処置部材１２３が有する永久磁石が回転磁界と共に回転し、その回転により、雄ネジ部１２２ｂが雌ネジ部１２４より離脱すると共に、雄ネジ部１２２ａが胃壁１３１にねじ込まれて固定され、挿入処置具４を体腔内より抜去することで、所望の部位に回転処置部材１２３を配置する。このように配置することで、本体部１２１内に設けられた各種センサにより体腔内データを取得することが可能となる。
【００４０】
なお、図１７に示すように、本体部１２１を電磁波を受け発熱するハイパーサーミア部材１４１より構成することで、所望の部位を加熱治療するハイパーサーミアを行う回転処置部材１２３ａとすることも可能である。
【００４１】
さらに、図１８に示すように、回転処置部材１２３ｂを薬品１５１を充填させたカプセル本体部１５２と雄ネジ部１２２ｂとから構成し、カプセル形状の本体部１５２の先端キャップ部１５３を体液で溶融可能な材質で形成することで、回転処置部材１２３ｂを所望の位置に配置させた後、図１９に示すように、先端キャップ部１５３が体液で溶融し、カプセル本体部１５２内の薬品１５１を所定部位に直接供給させることができる。
【００４２】
このように本実施の形態では、体腔内の所定部位に直接、薬品、センサ等を供給するＤＤＳにおいて、カプセル形状の本体部１２１に一体的に設けられた雄ネジ部１２２ｂを雌ネジ部１２４に螺合させ、所望位置に配置させた後に回転磁界により回転処置部材１２３を回転させて挿入処置具４より離脱させるので、挿入処置具４には先端内部に雌ネジ部１２４を形成するだけでよいので、構造が簡単で挿入処置具４の細径化を図る事が可能となる。
【００４３】
なお、本実施の形態では、挿入処置具４には先端内部に雌ネジ部１２４を形成し、本体部１２１の雄ネジ部１２２を螺合させるとしたが、これに限らず、図示はしないが、例えば挿入処置具４には先端外周面に先端雄ネジ部を形成し、本体部１２１の雄ネジ部１２２の代わりに、内面に該先端雄ネジ部と螺合する雌ネジ部を形成した円筒部材を設け、挿入処置具４と回転処置部材１２３とを接続するように構成してもよく、この場合も回転処置部材８が有する永久磁石が回転磁界と共に回転し、その回転により、先端雄ネジ部より雌ネジ部が離脱することで、本実施の形態と同様な作用・効果を得ることができる。
【００４４】
［付記］
（付記項１）　生体内に挿入されるカプセル本体の外面に螺旋状部を形成し、中央付近にカプセル本体の前後を連通する中空部を形成したカプセル状医療装置と、前記カプセル状医療装置が挿入される生体内の周囲で回転磁界を発生する磁界発生部とを有する医療装置において、
前記磁界発生部が発生した磁界を受け、前記カプセル状医療装置が回転するように、カプセル状医療装置の少なくとも一部に永久磁石を配置したこと
ことを特徴とする医療装置。
【００４５】
（付記項２）　前記カプセル状医療装置を少なくとも２個体内に挿入し、２個の螺旋部の螺旋方向を逆にすることで、２個の螺腹部が近づいたり離れたりして、狭窄部や縮小部の拡張治療などの医療行為を行えるようにした
ことを特徴とする付記項１に記載の医療装置。
【００４６】
（付記項３）　体内に挿入されるカテーテルと、前記カテーテル先端部に設けられた支持部材に支持された医療行為を行うための回転部材と、カテーテルが挿入される生体内の周囲で回転磁界を発生する磁界発生部とを有する医療装置において、
前記磁界発生部が発生した磁界を受け、前記回転部材が前記支持部材から離脱可能に構成した
ことを特徴とする医療装置。
【００４７】
本発明は、上述した実施の形態に限定されるものではなく、本発明の要旨を変えない範囲において、種々の変更、改変等が可能である。
【００４８】
【発明の効果】
以上説明したように本発明によれば、細径な部位に対しても適用できると共に、簡単な構成で狭窄部の拡張処置等が短時間に行うことができるという効果がある。
【図面の簡単な説明】
【図１】本発明の第１の実施の形態に係る医療装置の構成を示す構成図
【図２】図１の回転処置部材の断面を示す断面図
【図３】図１の医療装置の作用を説明する第１の図
【図４】図１の医療装置の作用を説明する第２の図
【図５】図１の医療装置の作用を説明する第３の図
【図６】図１の医療装置の作用を説明する第４の図
【図７】図１の医療装置の第１の変形例を説明する第１の図
【図８】図１の医療装置の第１の変形例を説明する第２の図
【図９】図１の医療装置の第２の変形例を説明する第１の図
【図１０】図１の医療装置の第２の変形例を説明する第２の図
【図１１】図１の医療装置の第３の変形例を説明する第１の図
【図１２】図１の医療装置の第３の変形例を説明する第２の図
【図１３】図１の医療装置の第３の変形例を説明する第３の図
【図１４】図１の医療装置の第４の変形例を説明する図
【図１５】本発明の第２の実施の形態に係る医療装置の要部の構成を示す構成図
【図１６】図１５の医療装置の作用を説明する図
【図１７】図１５の回転処置部材の第１の変形例を説明する図
【図１８】図１５の回転処置部材の第２の変形例を説明する第１の図
【図１９】図１５の回転処置部材の第２の変形例を説明する第２の図
【図２０】従来のＤＤＳを実現する医療装置の要部の構成を示す構成図
【図２１】図２０の医療装置の作用を説明する図
【符号の説明】
１…医療装置
２…生体
３…膵管
４…挿入処置具
５…磁界発生装置
６…挿入部
８…回転処置部材
９…電磁石
１０…駆動装置
１１…操作部
２０…本体部
２１…螺旋突起部
３１…狭窄部
４１…内視鏡[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a medical device for treating a stenosis site or the like in a body cavity.
[0002]
[Prior art]
In recent years, endoscopes having an elongated insertion portion have been widely used in the medical field.
[0003]
Further, when a stenosis is formed in a thin lumen that makes it difficult to insert the endoscope at the insertion portion, a catheter is inserted as disclosed in, for example, JP-A-4-105660, The distal end is provided with a balloon and a stent for indwelling in the stenosis, and the distal end is disposed in the stenosis, and the fluid is supplied to the balloon through the hollow portion of the catheter to inflate the balloon, thereby expanding the balloon. The deployed stent is expanded and left in the stenosis.
[0004]
[Problems to be solved by the invention]
In this conventional example, since a balloon and a stent are provided on the outer periphery of the distal end of the catheter, it is difficult to apply the method to a narrow lumen such as a stenotic part in a blood vessel in which the stenotic part is about the outer diameter of the catheter. Become.
[0005]
In addition, if the stenosis is smaller than the outer diameter of the stent at the distal end before the insertion, it becomes difficult to arrange the stenosis in the stenosis.
[0006]
In addition, it is difficult to treat a stenosis in a short time, and it is difficult to apply the method when a stenosis exists at a plurality of locations.
[0007]
The present invention has been made in view of the above circumstances, and provides a medical device that can be applied to a small-diameter portion and that can perform a dilation procedure or the like of a stenosis portion with a simple configuration in a short time. It is aimed at.
[0008]
[Means for Solving the Problems]
The medical device of the present invention includes a catheter inserted into a body, a rotating member detachable from a distal end of the catheter, and a magnetic field generating unit that generates a rotating magnetic field around the inside of the living body into which the catheter is inserted. In the medical device, the rotating member has, at least in part, a permanent magnet that rotates by receiving a magnetic field generated by the magnetic field generating unit, and a helical portion formed at least on an outer peripheral portion, and the magnetic field generating unit It is configured to be able to be separated from the catheter distal end portion upon receiving the generated magnetic field.
[0009]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
[0010]
First embodiment:
1 to 14 relate to a first embodiment of the present invention, FIG. 1 is a configuration diagram showing a configuration of a medical device, FIG. 2 is a cross-sectional view showing a cross section of a rotation treatment member of FIG. 1, and FIG. 1 is a first diagram illustrating the operation of the medical device of FIG. 1, FIG. 4 is a second diagram illustrating the operation of the medical device of FIG. 1, FIG. 5 is a third diagram illustrating the operation of the medical device of FIG. 6 is a fourth diagram illustrating the operation of the medical device of FIG. 1, FIG. 7 is a first diagram illustrating a first modification of the medical device of FIG. 1, and FIG. 8 is a fourth diagram of the medical device of FIG. FIG. 9 is a first diagram illustrating a second modification of the medical device of FIG. 1, and FIG. 10 is a second diagram illustrating a second modification of the medical device of FIG. FIG. 11 is a first diagram illustrating a third modification of the medical device of FIG. 1, FIG. 12 is a second diagram illustrating a third modification of the medical device of FIG. 1, FIG. 13 shows the medical device of FIG. Third diagram for explaining a third modification, FIG. 14 is a diagram for explaining a fourth modification of the medical device of FIG.
[0011]
As shown in FIG. 1, a medical device 1 of the present embodiment is arranged outside a living body 2 with an insertion treatment tool 4 formed of a thin tube such as a catheter inserted into a thin tube such as a pancreatic duct 3 in a living body 2. And a magnetic field generator 5 for generating a rotating magnetic field.
[0012]
The insertion treatment tool 4 includes an elongated insertion portion 6 having flexibility, and a rotation treatment member 8 rotatably disposed in the insertion portion 6.
[0013]
In addition, the magnetic field generator 5 is provided at a plurality of circumferential locations (for example, six locations which are arranged so as to face each other at an angular interval of 60 °) in a ring-shaped member arranged around the living body 2 in, for example, a ring shape. An attached electromagnet 9, a driving device 10 for supplying a pulsed driving current to the electromagnet 9, and an operation unit 11 for instructing ON / OFF of the driving current by the driving device 10, a cycle of the rotating magnetic field, and the like. Consists of
[0014]
The main body 20 of the rotation treatment member 8 has a capsule shape, and a spiral projection 21 having a spiral shape is provided on the outer peripheral surface thereof. The helical projection 21 has, for example, a left-handed screw shape and a rounded shape so as not to damage a contacting tissue or the like.
[0015]
As shown in FIG. 2, the inside of the main body 20 of the rotation treatment member 8 is formed of permanent magnets that are magnetized to N poles and S poles with a center plane 22 including a longitudinal axis as a boundary. The main body 20 is rotated by the rotating magnetic field generated by the rotation, and the helical projection 21 comes into contact with the outer peripheral wall of the main body 20 so that the rotation treatment member 8 can advance and retreat in the longitudinal axis direction.
[0016]
The operation of the present embodiment having such a configuration will be described with reference to a treatment example in the case where a stenosis portion 31 of a thin tube, for example, the pancreatic duct 3 in the living body 2 is formed.
[0017]
First, the position of the stenotic part 31 of the pancreatic duct 3 is set in a state where it can be visualized by an X-ray fluoroscope, an extracorporeal ultrasonic diagnostic apparatus, or the like (not shown).
[0018]
Then, as shown in FIG. 3, the insertion treatment tool 4 is inserted from the distal end side into the pancreatic duct 3 in which the stenosis part 31 to be treated is formed via a treatment tool channel (not shown) of the endoscope 41, and the insertion treatment is performed. The distal end of the insertion treatment tool 4 is brought closer to the stenosis 31 by pressing the rear end side of the tool 4 or the like.
[0019]
Then, when the distal end of the insertion treatment tool 4 comes to a position close to the stenosis part 31 to some extent, the power switch of the operation part 11 is turned on by the magnetic field generator 5 arranged outside as shown in FIG. An instruction operation for applying the rotating magnetic field is performed.
[0020]
Then, as shown in FIG. 4, the permanent magnet forming the rotation treatment member 8 rotates together with the rotating magnetic field, and the rotation causes the helical projection 21 to contact the inner surface of the insertion treatment tool 4 and rotate. Protrudes from the distal end of the insertion treatment tool 4, and further, as shown in FIG. 5, the helical projection 21 rotates in contact with the inner wall of the pancreatic duct 3, thereby propelling and moving the pancreatic duct 3, and the helical projection 21 moves to the stenosis part 31. Upon reaching, as shown in FIG. 6, the stenotic portion 31 rotates while being in contact with the inner surface thereof.
[0021]
When the rotational treatment member 8 has passed through the stenosis 31 and the dilation treatment has been completed, the rotational treatment member 8 is moved backward by reversing the direction of the rotating magnetic field.
[0022]
If the dilation is not enough in one dilation procedure, a sufficient dilation procedure can be performed by reciprocating the rotary treatment member 8 with respect to the stenosis 31 a plurality of times.
[0023]
When the stenosis portion 31 exists at a plurality of locations, the dilation treatment is performed by passing the rotation treatment member 8 through one stenosis portion 31 as described above, and the rotation treatment member 8 is further rotated. As a result, it is only necessary to move to the deeper side and perform the same dilation procedure for the next stenotic part 31 existing on the deeper side.
[0024]
As described above, according to the present embodiment, there is an effect that the device can be made compact with a simple configuration and can be used even in a thin tube such as the pancreatic duct 3, and the dilation procedure can be performed by a simple operation.
[0025]
Although the rotation treatment member 8 is arranged in advance in the insertion treatment tool 4, the present invention is not limited to this. For example, the insertion treatment tool 4 is inserted into a thin tube such as the pancreatic duct 3 via a treatment tool channel (not shown) of the endoscope 41. After the insertion treatment tool 4 is disposed at a position where the distal end is somewhat close to the stenosis 31, the rotation treatment member 8 is pushed into the insertion treatment tool 4 from the base end of the insertion treatment tool 4 outside the living body, and a wire or the like is used. Alternatively, the rotation treatment member 8 in the insertion treatment tool 4 may be pushed in, and the rotation treatment member 8 may be positioned near the distal end of the insertion treatment tool 4, and then the rotation treatment member 8 may be rotated by the rotating magnetic field.
[0026]
As shown in FIG. 7, a screw portion 51 with which the spiral projection 21 of the rotation treatment member 8 is screwed is provided on the inner wall of the distal end of the insertion treatment tool 4, and the spiral projection 21 of the rotation treatment member 8 is attached to the screw portion 51. The insertion treatment tool 4 may be inserted into a thin tube such as the pancreatic duct 3 in a screwed state. By screwing the helical projection 21 into the screw portion 51, the insertion treatment tool 4 can be inserted without dropping the rotation treatment member 8. 8, the rotating treatment member 8 can be separated from the screw portion 51 by the rotating magnetic field, as shown in FIG. 31 can be treated.
[0027]
Further, as shown in FIG. 9, a stent 62 reduced in diameter by a thread member 61 is arranged at the tip of the rotation treatment member 8, and the spiral projection 21 of the rotation treatment member 8 is screwed into the screw portion 51. After inserting the insertion treatment tool 4 into a tubule such as the pancreatic duct 3 and positioning the stent 62 in the stenosis 31, the rotating treatment member 8 is projected from the screw portion 51 by a rotating magnetic field, and one end is attached to the distal end of the insertion treatment tool 4. By cutting the thread member 61 of the fixed stent 62, the stent 62 may be expanded as shown in FIG. 10 to treat the stenosis 31.
[0028]
In addition, as shown in FIG. 11, the rotation treatment member 8 is constituted by a hollow capsule-shaped main body portion 20a, and as shown in FIG. 12, the hollow main body portion 20a is separated by a center plane 22 including a longitudinal axis. It may be constituted by a permanent magnet magnetized on the pole and the S pole. In this case, as shown in FIG. 13, it is possible to perform the dilation treatment by moving the rotation treatment member 8 toward and away from the stenosis part 31 by the rotating magnetic field, and to arrange the rotation treatment member 8 in the stenosis part 31. Thus, the hollow main body 20a can play the role of the stent 62.
[0029]
Further, as shown in FIG. 14, two rotation treatment members 8a and 8b having a hollow capsule-shaped main body portion 20a are prepared, and the spiral projection 21 of one rotation treatment member 8a is formed into a left-handed screw shape, and the other is rotated. By forming the spiral projection 21 of the rotation treatment member 8b in a right-handed screw shape, it is possible to perform an extension treatment by bringing both members close to each other by the same rotating magnetic field. In this case, the dilation treatment can be performed, and the hollow main body 20a can play the role of the stent 62 by disposing the rotation treatment members 8a and 8b in the stenosis portion 31.
[0030]
Second embodiment:
15 to 19 relate to the second embodiment of the present invention, FIG. 15 is a configuration diagram showing a configuration of a main part of the medical device, FIG. 16 is a diagram for explaining the operation of the medical device of FIG. FIG. 18 is a view for explaining a first modification of the rotation treatment member of FIG. 15, FIG. 18 is a first view for explaining a second modification of the rotation treatment member of FIG. 15, and FIG. 19 is a rotation treatment member of FIG. It is the 2nd figure explaining the 2nd modification of.
[0031]
Since the second embodiment is almost the same as the first embodiment, only different points will be described, and the same components will be denoted by the same reference numerals and description thereof will be omitted.
[0032]
By the way, conventionally, in a drug delivery system (hereinafter, DDS) for directly supplying a drug or the like to a predetermined site in a body cavity, as shown in FIG. 20, a capsule 101 that can be melted with a magnetized body fluid is used. After the capsule 101 is magnetically connected to the electromagnet 103 provided in the distal end of the insertion tool 102 having a small diameter and flexibility, the capsule 101 is positioned at a desired position in the body cavity. By turning off the electromagnet 103, as shown in FIG. 21, the capsule 101 is detached and arranged at a predetermined site in the body cavity, and the capsule 101 is melted to supply the medicine of the capsule 101 to the predetermined site. I have.
[0033]
In this DDS, a capsule-shaped medical sensor device equipped with various sensors for detecting not only drugs but also pH and the like in a body cavity is arranged at a predetermined site, and various data of the predetermined site are acquired. There is.
[0034]
However, in such a configuration in which an electromagnet or the like is arranged at the tip of the insertion tool 102, not only the placement of the electromagnet but also wiring or the like must be performed on the insertion tool 102, and it is difficult to reduce the diameter of the insertion tool 102. There's a problem.
[0035]
Thus, in a second embodiment, a medical device capable of reducing the diameter of an insertion instrument will be described.
[0036]
As shown in FIG. 15, a medical device 110 according to the present embodiment includes a rotation treatment member 123 including various sensors such as pH sensors having male screw portions 122a and 122b before and after a capsule-shaped main body portion 121, and a rotation treatment member 123. An insertion treatment tool 4 made of a thin tube such as a catheter to be inserted into the living body 2 having a female screw portion 124 screwed to the male screw portion 122b of the treatment member 123 on the inner wall portion at the distal end; As in the first embodiment, a magnetic field generator 5 is provided outside the living body 2 and generates a rotating magnetic field.
[0037]
Here, although not shown, for example, at least one of the male screw portions 122a and 122b or the outer wall portion of the rotation treatment member 123 is magnetized to the N pole and the S pole with a center plane including the longitudinal axis as a boundary. Formed of permanent magnets.
[0038]
Then, as shown in FIG. 16, the distal end of the insertion treatment tool 4 is positioned close to a desired position in the body cavity, for example, the stomach wall 131. In this state, the magnetic field generator 5 turns on the power switch of the operation unit 11 and performs an instruction operation for applying a clockwise rotating magnetic field.
[0039]
Then, the permanent magnet of the rotation treatment member 123 rotates together with the rotating magnetic field, and the rotation causes the male screw part 122b to be detached from the female screw part 124, and the male screw part 122a to be screwed and fixed to the stomach wall 131 and inserted. By removing the treatment tool 4 from the body cavity, the rotation treatment member 123 is arranged at a desired site. By arranging in this way, it becomes possible to acquire data in the body cavity by various sensors provided in the main body 121.
[0040]
As shown in FIG. 17, by forming the main body 121 from a hyperthermia member 141 that receives electromagnetic waves and generates heat, it is possible to use the hyperthermia member 123a that performs hyperthermia for heating and treating a desired site.
[0041]
Further, as shown in FIG. 18, the rotation treatment member 123b is composed of a capsule body 152 filled with a medicine 151 and a male screw part 122b, and the tip cap 153 of the capsule-shaped body 152 can be melted with body fluid. After disposing the rotation treatment member 123b at a desired position, the tip cap portion 153 is melted with a bodily fluid, and the medicine 151 in the capsule body 152 is moved to a predetermined position, as shown in FIG. Can be supplied directly.
[0042]
As described above, in the present embodiment, in the DDS that supplies a drug, a sensor, and the like directly to a predetermined portion in a body cavity, the male screw portion 122b provided integrally with the capsule-shaped main body portion 121 is used as the female screw portion 124. After being screwed and arranged at a desired position, the rotating treatment member 123 is rotated by the rotating magnetic field to be separated from the insertion treatment tool 4, so that the insertion treatment tool 4 only needs to form the female screw portion 124 inside the distal end. Therefore, the structure is simple and the diameter of the insertion treatment tool 4 can be reduced.
[0043]
In the present embodiment, a female screw portion 124 is formed inside the distal end of the insertion treatment tool 4 and the male screw portion 122 of the main body portion 121 is screwed. However, the present invention is not limited to this, but is not shown. For example, the insertion treatment tool 4 has a distal-end male screw portion formed on the outer peripheral surface of the distal end, and has a female screw portion formed on the inner surface thereof instead of the male screw portion 122 of the main body portion 121 to be screwed with the male screw portion. A member may be provided to connect the insertion treatment tool 4 and the rotation treatment member 123. In this case as well, the permanent magnet of the rotation treatment member 8 rotates together with the rotating magnetic field. By detaching the female screw portion from the portion, the same operation and effect as in the present embodiment can be obtained.
[0044]
[Appendix]
(Additional Item 1) A capsule-shaped medical device in which a helical portion is formed on the outer surface of a capsule body inserted into a living body, and a hollow portion that connects the front and rear of the capsule body near the center is formed. In a medical device having a magnetic field generating unit that generates a rotating magnetic field around a living body to be inserted,
A medical device, wherein a permanent magnet is arranged on at least a part of the capsule medical device so that the capsule medical device rotates when receiving the magnetic field generated by the magnetic field generating unit.
[0045]
(Additional Item 2) By inserting the capsule medical device into at least two individuals and reversing the helical directions of the two helical parts, the two helical parts approach or separate, and the stenosis part and 2. The medical device according to claim 1, wherein a medical action such as a dilation treatment of the reduction unit can be performed.
[0046]
(Additional Item 3) A catheter inserted into a body, a rotating member supported by a support member provided at the distal end of the catheter for performing a medical action, and a rotating magnetic field around a living body into which the catheter is inserted. Medical device having a magnetic field generating section,
The medical device, wherein the rotating member is configured to be detachable from the support member upon receiving a magnetic field generated by the magnetic field generating unit.
[0047]
The present invention is not limited to the above-described embodiment, and various changes and modifications can be made without departing from the spirit of the present invention.
[0048]
【The invention's effect】
As described above, according to the present invention, the present invention can be applied to a small-diameter portion, and has an effect that dilation of a stenosis can be performed in a short time with a simple configuration.
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing a configuration of a medical device according to a first embodiment of the present invention. FIG. 2 is a cross-sectional view showing a cross section of a rotation treatment member in FIG. 1. FIG. FIG. 4 is a second diagram illustrating the operation of the medical device of FIG. 1. FIG. 5 is a third diagram illustrating the operation of the medical device of FIG. 1. FIG. FIG. 7 is a fourth diagram illustrating the operation of the medical device. FIG. 7 is a first diagram illustrating a first modification of the medical device in FIG. 1. FIG. 8 is a diagram illustrating a first modification of the medical device in FIG. FIG. 9 is a first diagram illustrating a second modification of the medical device of FIG. 1. FIG. 10 is a second diagram illustrating a second modification of the medical device of FIG. 11 is a first diagram illustrating a third modification of the medical device of FIG. 1. FIG. 12 is a second diagram illustrating a third modification of the medical device of FIG. 1. FIG. Explain a third modification of the medical device FIG. 14 is a diagram illustrating a fourth modification of the medical device of FIG. 1. FIG. 15 is a configuration diagram illustrating a configuration of a main part of the medical device according to the second embodiment of the present invention. 16 is a diagram illustrating the operation of the medical device in FIG. 15; FIG. 17 is a diagram illustrating a first modification of the rotation treatment member in FIG. 15; FIG. 18 is a second modification of the rotation treatment member in FIG. FIG. 19 is a first diagram illustrating an example. FIG. 19 is a second diagram illustrating a second modification of the rotation treatment member in FIG. 15. FIG. 20 shows a configuration of a main part of a medical device for realizing a conventional DDS. FIG. 21 is a diagram for explaining the operation of the medical apparatus in FIG. 20.
DESCRIPTION OF SYMBOLS 1 ... Medical device 2 ... Living body 3 ... Pancreatic duct 4 ... Insertion treatment tool 5 ... Magnetic field generation device 6 ... Insertion part 8 ... Rotation treatment member 9 ... Electromagnet 10 ... Drive unit 11 ... Operation part 20 ... Body part 21 ... Spiral projection part 31 ... Stenosis part 41 ... Endoscope

Claims (3)

体内に挿入されるカテーテルと、前記カテーテルの先端より離脱可能な回転部材と、前記カテーテルが挿入される前記生体内の周囲で回転磁界を発生する磁界発生部とを有する医療装置において、
前記回転部材は、少なくとも一部に、前記磁界発生部が発生した磁界を受け、回転する永久磁石と、少なくとも外周部に形成された螺旋状部とを有し、
前記磁界発生部が発生した磁界を受け、前記カテーテル先端部から離脱可能に構成した
ことを特徴とする医療装置。In a medical device having a catheter to be inserted into the body, a rotating member detachable from the distal end of the catheter, and a magnetic field generating unit that generates a rotating magnetic field around the inside of the living body in which the catheter is inserted,
The rotating member, at least in part, receives a magnetic field generated by the magnetic field generating unit, has a rotating permanent magnet, and at least a spiral portion formed on the outer peripheral portion,
The medical device according to claim 1, wherein the medical device is configured to receive the magnetic field generated by the magnetic field generating unit and to be detachable from the distal end portion of the catheter. 生体内の周囲の回転磁界を受け回転する永久磁石と、
少なくとも外周部に形成された螺旋状部とを備え、
前記回転磁界を受け、前記螺旋状部と前記生体組織との摩擦より進退移動することを特徴とする自走式の医療装置。A permanent magnet that rotates by receiving a rotating magnetic field around the body;
A spiral part formed at least on the outer peripheral part,
The self-propelled medical device receives the rotating magnetic field and moves forward and backward by friction between the spiral portion and the living tissue. 体内に挿入されるカテーテル内を挿通し先端より離脱可能に構成された
ことを特徴とする請求項２に記載の自走式の医療装置。The self-propelled medical device according to claim 2, wherein the self-propelled medical device is configured to be inserted through a catheter inserted into a body and detachable from a distal end.

Images