JP6864910B2 - Fallopian tube stenosis improving tool - Google Patents

Fallopian tube stenosis improving tool Download PDF

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JP6864910B2
JP6864910B2 JP2017089884A JP2017089884A JP6864910B2 JP 6864910 B2 JP6864910 B2 JP 6864910B2 JP 2017089884 A JP2017089884 A JP 2017089884A JP 2017089884 A JP2017089884 A JP 2017089884A JP 6864910 B2 JP6864910 B2 JP 6864910B2
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tip
tube
stenosis
tubular member
outer tube
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JP2018186900A (en
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井上　太
太 井上
千恵 稲葉
千恵 稲葉
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Kitazato Corp
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Description

本発明は、卵管の体腔内に生じた閉塞部、狭窄部を改善するための卵管狭窄部改善具に関するものである。 The present invention relates to a fallopian tube stenosis improving tool for improving an obstruction or stenosis generated in the body cavity of the fallopian tube.

従来、卵管に生じた閉塞部・狭窄部を治療するために、外管と、外管内を軸方向に移動可能な内管と、一端が外管の先端部に取り付けられ、他端が内管の先端部に取り付けられたバルーンとを備えたバルーンカテーテルが使用されている。
このバルーンカテーテルは、以下のような使い方をする。
まず、内管のルーメンに内視鏡を挿入して、内視鏡の先端を外管の先端に到達させる。そして、バルーンを外管のルーメン内に完全に収納した状態にして、バルーンカテーテルを子宮顎より子宮に挿入する。そして、内視鏡により卵管口を確認した後、内管を先端側に押し込んで、バルーンを外管の先端より突出させて、バルーンを卵管内に挿入する。そして、内視鏡で閉塞部・狭窄部等の病変部の観察を行いながら、バルーンによって病変部の拡張（治療）を行う。
これらの操作を安全に行うためには、バルーンの先端側端部に対する内視鏡の先端側端部の位置を常に知る必要がある。つまり、バルーンの先端側端部より内視鏡が突出することによる、子宮、卵管等の生体内の器官の損傷を防ぐ必要がある。
このような要求を満たすために、特許第２８１３４６３号公報（特許文献１）には、バルーンカテーテルの内管および内視鏡の手元側にそれぞれ等間隔にマークが設けられており、これらのマークを数えることによって、バルーンの先端側端部に対する内視鏡の長手方向の位置を判断するカテーテル装置が開示されている。 Conventionally, in order to treat an obstruction / stenosis that occurs in the fallopian tube, an outer tube, an inner tube that can move in the outer tube in the axial direction, one end is attached to the tip of the outer tube, and the other end is inside. A balloon catheter with a balloon attached to the tip of the tube is used.
This balloon catheter is used as follows.
First, the endoscope is inserted into the lumen of the inner tube so that the tip of the endoscope reaches the tip of the outer tube. Then, with the balloon completely housed in the lumen of the outer tube, the balloon catheter is inserted into the uterus from the uterine jaw. Then, after confirming the ostium of the fallopian tube with an endoscope, the inner tube is pushed toward the tip side, the balloon is projected from the tip of the outer tube, and the balloon is inserted into the oviduct. Then, while observing the lesions such as the obstruction and the stenosis with an endoscope, the lesions are expanded (treated) with a balloon.
In order to perform these operations safely, it is necessary to always know the position of the distal end of the endoscope with respect to the distal end of the balloon. That is, it is necessary to prevent damage to organs in the living body such as the uterus and fallopian tubes due to the protrusion of the endoscope from the distal end of the balloon.
In order to satisfy such a requirement, Japanese Patent No. 2813463 (Patent Document 1) provides marks on the inner tube of the balloon catheter and the hand side of the endoscope at equal intervals, respectively. A catheter device for determining the longitudinal position of an endoscope with respect to the distal end of the balloon by counting is disclosed.

特許第２８１３４６３号公報Japanese Patent No. 2813463

上記特許文献１のものでは、バルーンカテーテルのバルーン部を卵管内に挿入する必要があり、バルーンカテーテルのバルーン部の卵管口への挿入操作が容易でない。また、狭窄が進んだ卵管では、卵管口に到達したバルーンカテーテルのバルーン部を卵管内に進行させることが困難な場合があった。
そこで、本発明は、卵管口への到達および挿入操作が容易であり、かつ、狭窄部を有する卵管を良好に改善することができる卵管狭窄部改善具を提供するものである。 In the case of Patent Document 1, it is necessary to insert the balloon portion of the balloon catheter into the oviduct, and the operation of inserting the balloon portion of the balloon catheter into the oviduct opening is not easy. Further, in the oviduct with advanced stenosis, it may be difficult to advance the balloon portion of the balloon catheter that has reached the oviduct opening into the oviduct.
Therefore, the present invention provides a fallopian tube stenosis improving tool capable of easily reaching and inserting the fallopian tube mouth and satisfactorily improving the fallopian tube having a stenosis.

上記目的を達成するものは、以下の卵管狭窄部改善具である。
（１） 可撓性外管と、前記可撓性外管内を挿通する内部挿通体とからなる卵管狭窄部改善具であって、前記可撓性外管は、先端部に卵管内挿入用小径部を備える中空のチューブ本体と、前記チューブ本体の基端部に固定された外管ハブとを備え、前記内部挿通体は、管状体と、前記管状体の先端部内に基端側が進入しかつ固定され、先端側が前記管状体の先端部より所定長突出したコイル状管状部材と、前記コイル状管状部材の先端と当接した先端膨出部と、前記先端膨出部より前記コイル状管状部材内を挿通し、基端部が前記管状体もしくは前記コイル状管状部材に内部にて固定された線状部とを有する線状部材とを備え、前記卵管狭窄部改善具は、前記内部挿通体の前記コイル状管状部材の先端側部分が、前記可撓性外管の先端より突出する状態から、少なくとも前記コイル状管状部材の全体が前記可撓性外管内に収納された状態まで、摺動可能となっている卵管狭窄部改善具。 Those that achieve the above objectives are the following fallopian tube stenosis improving tools.
(1) A fallopian tube stenosis improving tool including a flexible outer tube and an internal insertion body that inserts the inside of the flexible outer tube, and the flexible outer tube is for insertion into the fallopian tube at the tip. A hollow tube body having a small diameter portion and an outer tube hub fixed to the base end portion of the tube body are provided. A coiled tubular member that is fixed and whose tip side protrudes from the tip of the tubular body for a predetermined length, a tip bulging portion that is in contact with the tip of the coiled tubular member, and the coiled tubular member from the tip bulging portion. The oviduct stenosis improving tool includes the tubular body or a linear member having a linear portion internally fixed to the coiled tubular member through the inside of the member. From a state in which the tip end side portion of the coiled tubular member of the insert body protrudes from the tip of the flexible outer tube to a state in which at least the entire coiled tubular member is housed in the flexible outer tube. A slidable fallopian tube stenosis improving tool.

（２） 前記コイル状管状部材は、前記管状体より小径であり、全体がほぼ同一外径であり、前記線状部の外径は、前記コイル状管状部材の内径より小さく、前記線状部材は、前記コイル状管状部材の柔軟性を阻害しないものとなっている上記（１）に記載の卵管狭窄部改善具。
（３） 前記線状部材の前記線状部は、前記コイル状管状部材の後端より後方に突出する基端突出部を備え、前記基端突出部にて、前記管状体および前記コイル状管状部材に固定されている上記（１）または（２）に記載の卵管狭窄部改善具。
（４） 前記外管ハブは、側部に設けられた液体注入ポートを備えている上記（１）ないし（３）のいずれかに記載の卵管狭窄部改善具。
（５） 前記卵管狭窄部改善具は、前記内部挿通体の前記管状体が、前記可撓性外管の先端より突出しないように規制する内部挿通体先端方向移動規制部を備えている上記（１）ないし（４）のいずれかに記載の卵管狭窄部改善具。
（６） 前記卵管狭窄部改善具は、前記内部挿通体の前記管状体の先端部が若干突出する状態を越えて、前記内部挿通体が、前記可撓性外管の先端より突出しないように規制する内部挿通体先端方向移動規制部を備えている上記（１）ないし（４）のいずれかに記載の卵管狭窄部改善具。
（７） 前記チューブ本体は、外層と、前記外層の先端より先端部が突出した内層とからなり、前記卵管内挿入用小径部は、前記内層の先端部により形成されている上記（１）ないし（６）のいずれかに記載の卵管狭窄部改善具。 (2) The coiled tubular member has a smaller diameter than the tubular body and has substantially the same outer diameter as a whole, and the outer diameter of the linear portion is smaller than the inner diameter of the coiled tubular member. Is the tubal stenosis improving tool according to (1) above, which does not impair the flexibility of the coiled tubular member.
(3) The linear portion of the linear member includes a proximal end projecting portion that protrudes rearward from the rear end of the coiled tubular member, and the tubular body and the coiled tubular portion at the proximal end protruding portion. The fallopian tube stenosis improving tool according to (1) or (2) above, which is fixed to a member.
(4) The fallopian tube stenosis improving tool according to any one of (1) to (3) above, wherein the outer tube hub is provided with a liquid injection port provided on a side surface.
(5) The oviduct stenosis improving tool includes an internal inserter tip direction movement restricting portion that regulates the tubular body of the internal inserter so as not to protrude from the tip of the flexible outer tube. The fallopian tube stenosis improving tool according to any one of (1) to (4).
(6) The fallopian tube stenosis improving tool is provided so that the internal insert does not protrude from the tip of the flexible outer tube beyond the state in which the tip of the tubular body of the internal insert slightly protrudes. The fallopian tube stenosis improving tool according to any one of (1) to (4) above, which is provided with an internal insertion body tip direction movement restricting portion.
(7) The tube body is composed of an outer layer and an inner layer having a tip protruding from the tip of the outer layer, and the small diameter portion for insertion into the oviduct is formed by the tip of the inner layer (1) to the above. The fallopian tube stenosis improving tool according to any one of (6).

本発明の卵管狭窄部改善具は、可撓性外管と、可撓性外管内を挿通する内部挿通体とからなる。可撓性外管は、先端部に卵管内挿入用小径部を備える中空のチューブ本体と、チューブ本体の基端部に固定された外管ハブとを備える。内部挿通体は、管状体と、管状体の先端部内に基端側が進入しかつ固定され、先端側が管状体の先端部より所定長突出したコイル状管状部材と、コイル状管状部材の先端と当接した先端膨出部と、先端膨出部よりコイル状管状部材内を挿通し、基端部が管状体もしくはコイル状管状部材に内部にて固定された線状部とを有する線状部材とを備える。卵管狭窄部改善具は、内部挿通体のコイル状管状部材の先端側部分が、可撓性外管の先端より突出する状態から、少なくともコイル状管状部材の全体が可撓性外管内に収納された状態まで、摺動可能となっている。 The fallopian tube stenosis improving tool of the present invention comprises a flexible outer tube and an internal insertion body that inserts the inside of the flexible outer tube. The flexible outer tube includes a hollow tube body having a small diameter portion for insertion into the oviduct at the tip portion, and an outer tube hub fixed to the base end portion of the tube body. The internal insert is a tubular body, a coiled tubular member in which the proximal end side enters and is fixed in the distal end portion of the tubular body, and the distal end side projects a predetermined length from the distal end portion of the tubular body, and the tip of the coiled tubular member. A linear member having a contacting tip bulging portion and a linear portion having a coiled tubular member inserted through the tip bulging portion and the base end portion fixed internally to the tubular body or the coiled tubular member. To be equipped. In the oviduct stenosis improving tool, at least the entire coiled tubular member is housed in the flexible outer tube from the state where the tip end side portion of the coiled tubular member of the internal insert protrudes from the tip of the flexible outer tube. It is slidable until it is in a slidable state.

この卵管狭窄部改善具では、内部挿通体がコイル状管状部材を備え、このコイル状管状部材が誘導部として機能し、このコイル状管状部材を卵管内に先に挿入することにより、可撓性外管の卵管内挿入用小径部を卵管口に容易に誘導することができる。そして、可撓性外管の卵管内挿入用小径部を卵管口に進入させ、さらに、内部挿通体を後端側に移動させた後、外管ハブより、液体を注入することにより、卵管に損傷を与えることなく、卵管を容易かつ確実に拡張することができる。 In this fallopian tube stenosis improving tool, the internal insert is provided with a coiled tubular member, and this coiled tubular member functions as a guide portion, and the coiled tubular member is flexed by being inserted into the fallopian tube first. The small diameter portion of the external tube for insertion into the fallopian tube can be easily guided to the ostium of the fallopian tube. Then, the small diameter portion of the flexible outer tube for insertion into the fallopian tube is inserted into the fallopian tube opening, the internal insert is moved to the rear end side, and then the liquid is injected from the outer tube hub to make the egg. The fallopian tubes can be easily and reliably expanded without damaging the tubes.

図１は、本発明の卵管狭窄部改善具の一実施例の部分省略正面図である。FIG. 1 is a partially omitted front view of an embodiment of the fallopian tube stenosis improving tool of the present invention. 図２は、本発明の卵管狭窄部改善具に使用される可撓性外管の一例の部分省略正面図である。FIG. 2 is a partially omitted front view of an example of a flexible outer tube used in the fallopian tube stenosis improving tool of the present invention. 図３は、本発明の卵管狭窄部改善具に使用される内部挿通体の一例の部分省略正面図である。FIG. 3 is a partially omitted front view of an example of an internal insert used in the fallopian tube stenosis improving tool of the present invention. 図４は、図１に示した卵管狭窄部改善具の先端部の拡大正面図である。FIG. 4 is an enlarged front view of the tip of the fallopian tube stenosis improving tool shown in FIG. 図５は、図１に示した卵管狭窄部改善具の先端部の拡大断面図である。FIG. 5 is an enlarged cross-sectional view of the tip of the fallopian tube stenosis improving tool shown in FIG. 図６は、図３に示した内部挿通体の先端部の拡大断面図である。FIG. 6 is an enlarged cross-sectional view of the tip end portion of the internal insert shown in FIG. 図７は、図１に示した卵管狭窄部改善具の外管ハブ付近の拡大断面図である。FIG. 7 is an enlarged cross-sectional view of the vicinity of the outer tube hub of the fallopian tube stenosis improving tool shown in FIG. 図８は、図３に示した内部挿通体の基端部の拡大断面図である。FIG. 8 is an enlarged cross-sectional view of the base end portion of the internal insert shown in FIG. 図９は、本発明の卵管狭窄部改善具の作用を説明するための説明図である。FIG. 9 is an explanatory diagram for explaining the action of the fallopian tube stenosis improving tool of the present invention. 図１０は、本発明の他の実施例の卵管狭窄部改善具の先端部の拡大断面図である。FIG. 10 is an enlarged cross-sectional view of the tip of the fallopian tube stenosis improving tool according to another embodiment of the present invention.

本発明の卵管狭窄部改善具を図面に示した実施例を用いて説明する。
本発明の卵管狭窄部改善具１は、可撓性外管２と、可撓性外管２内を挿通する内部挿通体３とからなる。可撓性外管２は、先端部に卵管内挿入用小径部２２を備える中空のチューブ本体２０と、チューブ本体２０の基端部に固定された外管ハブ４０とを備える。内部挿通体３は、管状体３１と、管状体３１の先端部内に基端側が進入しかつ固定され、先端側が管状体３１の先端部より所定長突出したコイル状管状部材３４と、コイル状管状部材３４の先端と当接した先端膨出部３８と、先端膨出部３８よりコイル状管状部材３４内を挿通し、基端部が管状体３１もしくはコイル状管状部材３４に内部にて固定された線状部３７とを有する線状部材３５とを備える。
卵管狭窄部改善具１は、内部挿通体３のコイル状管状部材３４の先端側部分が、可撓性外管２の先端５３より突出する状態から、少なくとも内部挿通体３のコイル状管状部材３４の全体が可撓性外管２内に収納された状態まで、摺動可能となっている。 The fallopian tube stenosis improving tool of the present invention will be described with reference to the examples shown in the drawings.
The fallopian tube stenosis improving tool 1 of the present invention includes a flexible outer tube 2 and an internal insertion body 3 that inserts the inside of the flexible outer tube 2. The flexible outer tube 2 includes a hollow tube main body 20 having a small diameter portion 22 for inserting into an egg tube at the tip end portion, and an outer tube hub 40 fixed to the base end portion of the tube main body 20. The internal insertion body 3 includes a tubular body 31, a coiled tubular member 34 in which the proximal end side enters and is fixed in the distal end portion of the tubular body 31, and the distal end side projects a predetermined length from the distal end portion of the tubular body 31, and a coiled tubular body. The tip bulging portion 38 in contact with the tip of the member 34 and the inside of the coiled tubular member 34 are inserted through the tip bulging portion 38, and the base end portion is internally fixed to the tubular body 31 or the coiled tubular member 34. It is provided with a linear member 35 having a linear portion 37.
In the oviduct stenosis improving tool 1, at least the coiled tubular member of the internal insert 3 is provided from a state in which the tip end side portion of the coiled tubular member 34 of the internal insert 3 protrudes from the tip 53 of the flexible outer tube 2. The entire 34 can be slidable until it is housed in the flexible outer tube 2.

卵管狭窄部改善具１は、図１に示すように、可撓性外管２と、可撓性外管２内を挿通する内部挿通体３とからなる。
内部挿通体３は、図１、図３ないし図６に示すように、管状体３１と、管状体３１の先端部に固定されたコイル状管状部材３４と、コイル状管状部材３４の先端と当接した先端膨出部３８と線状部３７とを有する線状部材３５と、管状体３１の基端部に固定された挿通体ハブ３２とを備える。
管状体３１としては、先端から基端までほぼ同一外径にて延びるものが使用される。また、管状体３１としては、金属製もしくは半硬質樹脂製の管状部材が使用される。管状体の全長は、３００〜１０００ｍｍ程度が好適であり、特に、５００〜８００ｍｍが好適である。管状体３１の外径としては、０．５ｍｍ〜２．０ｍｍ程度であることが好ましい。また、管状体３１の外径は、可撓性外管２のチューブ本体２０の内径より、０．３〜１．０ｍｍ程度小さいことが好ましい。管状体３１の内径としては、０．３ｍｍ〜１．５ｍｍ程度であることが好ましい。金属製もしくは半硬質樹脂製の管状部材としては、ステンレス鋼パイプ、フッ素樹脂チューブ（例えば、ＰＴＦＥチューブ、ＥＴＦＥチューブ）などが好適に使用できる。 As shown in FIG. 1, the oviduct stenosis improving tool 1 includes a flexible outer tube 2 and an internal insertion body 3 that inserts the inside of the flexible outer tube 2.
As shown in FIGS. 1, 3 to 6, the internal insertion body 3 corresponds to the tubular body 31, the coiled tubular member 34 fixed to the tip of the tubular body 31, and the tip of the coiled tubular member 34. It includes a linear member 35 having a tip bulging portion 38 and a linear portion 37 in contact with each other, and an inserter hub 32 fixed to the base end portion of the tubular body 31.
As the tubular body 31, a tubular body 31 extending from the tip end to the base end with substantially the same outer diameter is used. Further, as the tubular body 31, a tubular member made of metal or semi-hard resin is used. The total length of the tubular body is preferably about 300 to 1000 mm, and particularly preferably 500 to 800 mm. The outer diameter of the tubular body 31 is preferably about 0.5 mm to 2.0 mm. Further, the outer diameter of the tubular body 31 is preferably smaller than the inner diameter of the tube body 20 of the flexible outer tube 2 by about 0.3 to 1.0 mm. The inner diameter of the tubular body 31 is preferably about 0.3 mm to 1.5 mm. As the tubular member made of metal or semi-hard resin, a stainless steel pipe, a fluororesin tube (for example, a PTFE tube, an ETFE tube) or the like can be preferably used.

そして、図６に示すように、管状体３１の先端部に、コイル状管状部材３４が固定されている。具体的には、コイル状管状部材３４は、管状体３１より小径であり、その基端部が、管状体３１の先端部内に進入し、その他の部分（先端側部分）が、管状体３１の先端より突出した状態となっている。コイル状管状部材３４は、先端から基端までほぼ同一外径にて延びるものが使用される。また、コイル状管状部材３４は、金属製コイルが使用でき、特に、隣り合う線材が接触するように巻かれた密巻きコイルが好適である。 Then, as shown in FIG. 6, the coil-shaped tubular member 34 is fixed to the tip end portion of the tubular body 31. Specifically, the coiled tubular member 34 has a smaller diameter than the tubular body 31, its base end portion enters the tip portion of the tubular body 31, and the other portion (tip side portion) is the tubular body 31. It is in a state of protruding from the tip. As the coiled tubular member 34, a member extending from the tip end to the base end with substantially the same outer diameter is used. Further, as the coil-shaped tubular member 34, a metal coil can be used, and in particular, a tightly wound coil wound so that adjacent wires come into contact with each other is preferable.

金属製コイルの形成材料としては、ステンレス鋼線が好適である。コイル状管状部材３４の外径は、管状体３１の内径とほぼ同じもしくは若干小さいものとなっている。また、コイル状管状部材３４としては、全長が２０ｍｍ〜２００ｍｍ、好ましくは３０ｍｍ〜１５０ｍｍであり、コイル状管状部材３４の外径としては、直径０．２〜１．８ｍｍ、好ましくは、０．３〜１．６ｍｍである。 As a material for forming the metal coil, stainless steel wire is suitable. The outer diameter of the coiled tubular member 34 is substantially the same as or slightly smaller than the inner diameter of the tubular body 31. The total length of the coiled tubular member 34 is 20 mm to 200 mm, preferably 30 mm to 150 mm, and the outer diameter of the coiled tubular member 34 is 0.2 to 1.8 mm, preferably 0.3. It is ~ 1.6 mm.

さらに、内部挿通体３は、コイル状管状部材３４内を挿通する線状部材３５を備えている。線状部材３５は、線状部３７と、線状部３７の先端に形成された膨出部３８と、コイル状管状部材３４の後端より後方に突出する基端突出部３９を備えている。 Further, the internal insertion body 3 includes a linear member 35 that inserts the inside of the coiled tubular member 34. The linear member 35 includes a linear portion 37, a bulging portion 38 formed at the tip of the linear portion 37, and a proximal end protruding portion 39 projecting rearward from the rear end of the coiled tubular member 34. ..

そして、線状部材３５は、膨出部３８が、コイル状管状部材３４の先端に当接した状態にて、基端突出部３９が、管状体３１の内面に接着材５５により固着されている。この線状部材３５を設けることにより、コイル状管状部材３４の軸方向の伸張が抑制される。また、膨出部３８は、略半球状に形成されており、生体部位（例えば、子宮内壁、卵管内面）に当接しても損傷を与えにくいものとなっている。なお、この実施例では、コイル状管状部材３４は、管状体３１内に進入した基端部において、接着材５５により、管状体３１の内面に固定されている。また、管状体３１の先端部では、コイル状管状部材３４は固定されておらず、コイル状管状部材３４と管状体３１間には、円筒状の空隙５７を有するものとなっている。このような空隙を有することにより、コイル状管状部材３４の基端部は、管状体３１の先端部内にて若干変形可能である。このため、コイル状管状部材３４の管状体３１の先端でのキンクが抑制される。 Then, in the linear member 35, the proximal end protruding portion 39 is fixed to the inner surface of the tubular body 31 by the adhesive 55 in a state where the bulging portion 38 is in contact with the tip of the coiled tubular member 34. .. By providing the linear member 35, the axial extension of the coiled tubular member 34 is suppressed. Further, the bulging portion 38 is formed in a substantially hemispherical shape, and is less likely to be damaged even if it comes into contact with a biological part (for example, the inner wall of the uterus or the inner surface of the egg tube). In this embodiment, the coiled tubular member 34 is fixed to the inner surface of the tubular body 31 by the adhesive 55 at the base end portion that has entered the tubular body 31. Further, the coiled tubular member 34 is not fixed at the tip of the tubular body 31, and a cylindrical gap 57 is provided between the coiled tubular member 34 and the tubular body 31. By having such a gap, the base end portion of the coiled tubular member 34 can be slightly deformed in the tip end portion of the tubular body 31. Therefore, the kink at the tip of the tubular body 31 of the coiled tubular member 34 is suppressed.

線状部３７の外径は、コイル状管状部材３４の内径より小さく、また、線状部３７は、柔軟であり、線状部材３５は、コイル状管状部材３４の柔軟性を阻害しないものとなっている。線状部材３５の形成材料としては、ポリアミド（例えば、６ナイロン、６６ナイロン）、ポリオレフィン（例えば、ポリエチレン、ポリプロピレン、エチレン−プロピレンコポリマー）、ポリエステル（例えば、ポリエチレンテレフタレート）などが好適である。 The outer diameter of the linear portion 37 is smaller than the inner diameter of the coiled tubular member 34, the linear portion 37 is flexible, and the linear member 35 does not hinder the flexibility of the coiled tubular member 34. It has become. As the material for forming the linear member 35, polyamide (for example, 6 nylon, 66 nylon), polyolefin (for example, polyethylene, polypropylene, ethylene-propylene copolymer), polyester (for example, polyethylene terephthalate) and the like are suitable.

そして、図８に示すように、管状体３１の基端部には、挿通体ハブ３２が固定されている。挿通体ハブ３２は、把持部を形成する本体部３３と、本体部３３より先端方向に突出する小径突出部５６を備えている。
可撓性外管２は、図１および図２に示すように、先端部に卵管内挿入用小径部２２を備える中空のチューブ本体２０と、チューブ本体２０の基端部に固定された外管ハブ４０とを備える。 Then, as shown in FIG. 8, the insertion body hub 32 is fixed to the base end portion of the tubular body 31. The insertion body hub 32 includes a main body portion 33 forming a grip portion and a small-diameter protruding portion 56 projecting from the main body portion 33 in the tip direction direction.
As shown in FIGS. 1 and 2, the flexible outer tube 2 includes a hollow tube body 20 having a small diameter portion 22 for inserting into an egg tube at the tip portion and an outer tube fixed to the base end portion of the tube body 20. A hub 40 is provided.

チューブ本体２０は、図１、図２および図５に示すように、ほぼ同一外径にて所定長延びる本体部２１と、この本体部より小径である卵管内挿入用小径部２２を備える。卵管内挿入用小径部２２が、チューブ本体２０の先端部を形成している。また、この実施例の可撓性外管２では、チューブ本体２０は、合成樹脂製内層２４と、この合成樹脂製内層２４の外面を被覆する合成樹脂製外層２３とにより構成されており、内部にルーメン５２を備える。また、この実施例の可撓性外管２では、内層２４の先端部が外層２３の先端より突出しており、内層２４のこの突出部により、卵管内挿入用小径部２２が形成されている。 As shown in FIGS. 1, 2 and 5, the tube main body 20 includes a main body portion 21 extending by a predetermined length with substantially the same outer diameter, and a small diameter portion 22 for insertion into the oviduct, which is smaller in diameter than the main body portion. The small diameter portion 22 for insertion into the oviduct forms the tip portion of the tube body 20. Further, in the flexible outer tube 2 of this embodiment, the tube body 20 is composed of a synthetic resin inner layer 24 and a synthetic resin outer layer 23 that covers the outer surface of the synthetic resin inner layer 24. Is equipped with a lumen 52. Further, in the flexible outer tube 2 of this embodiment, the tip portion of the inner layer 24 protrudes from the tip of the outer layer 23, and the protruding portion of the inner layer 24 forms a small diameter portion 22 for insertion into the oviduct.

チューブ本体２０の全長は、３００〜１０００ｍｍ程度が好適であり、特に、５００〜８００ｍｍが好適である。チューブ本体２０の本体部２１の外径としては、１．０ｍｍ〜３．０ｍｍ程度であることが好ましい。また、チューブ本体２０の内径としては、０．５ｍｍ〜２．０ｍｍ程度であることが好ましい。チューブ本体２０の卵管内挿入用小径部２２の外径は、０．５ｍｍ〜２．５ｍｍ程度であることが好ましく、また、チューブ本体２０の本体部２１の外径より、０．３〜０．６ｍｍ程度小さいことが好ましい。 The total length of the tube body 20 is preferably about 300 to 1000 mm, and particularly preferably 500 to 800 mm. The outer diameter of the main body 21 of the tube main body 20 is preferably about 1.0 mm to 3.0 mm. The inner diameter of the tube body 20 is preferably about 0.5 mm to 2.0 mm. The outer diameter of the small diameter portion 22 for inserting into the oviduct of the tube body 20 is preferably about 0.5 mm to 2.5 mm, and 0.3 to 0. It is preferably as small as about 6 mm.

外層２３は、図５に示すように、内層２４を被覆し、卵管狭窄部改善具１の外表面を形成する。外層２３の形成材料としては、内層形成材料と接着性を有するものが好ましく、内層の形成に用いた樹脂と同質または近似したものが好ましい。例えば、ポリエチレン、ポリプロピレン、エチレンープロピレン共重合体などを用いたポリオレフィン、ポリ塩化ビニル、エチレン−酢酸ビニル共重合体、ポリアミドエラストマー、ポリウレタン等の熱可塑性樹脂、シリコーンゴム、ラテックスゴム等が使用できる。 As shown in FIG. 5, the outer layer 23 covers the inner layer 24 and forms the outer surface of the fallopian tube stenosis improving tool 1. As the material for forming the outer layer 23, a material having adhesiveness with the material for forming the inner layer is preferable, and a material having the same quality as or similar to the resin used for forming the inner layer is preferable. For example, polyolefins using polyethylene, polypropylene, ethylene-propylene copolymers and the like, polyvinyl chloride, ethylene-vinyl acetate copolymers, polyamide elastomers, thermoplastic resins such as polyurethane, silicone rubbers, latex rubbers and the like can be used.

内層２４の形成材料としては、ある程度の可撓性を有するものが好ましく、例えば、ポリエチレン、ポリプロピレン、エチレンープロピレン共重合体などを用いたポリオレフィンエラストマー、ポリ塩化ビニル、エチレン−酢酸ビニル共重合体、ポリアミドエラストマー、ポリウレタン等の熱可塑性樹脂、シリコーンゴム、ラテックスゴム等が使用できる。また、内層形成材料は、外層形成材料より硬質なものを用いてもよい。なお、チューブ本体２０は、単層であってもよい。 The material for forming the inner layer 24 is preferably a material having a certain degree of flexibility. For example, a polyolefin elastomer using polyethylene, polypropylene, an ethylene-propylene copolymer, or the like, a polyvinyl chloride, an ethylene-vinyl acetate copolymer, etc. Polyolefin elastomer, thermoplastic resin such as polyurethane, silicone rubber, latex rubber and the like can be used. Further, as the inner layer forming material, a material harder than the outer layer forming material may be used. The tube body 20 may be a single layer.

また、チューブ本体２０の基端部には、図１、図２及び図７に示すように、外管ハブ４０が固定されている。外管ハブ４０は、図７に示すように、外管ハブ本体４１と、外管ハブ本体４１内に収納され、内部挿通体３を摺動可能、かつ液密に保持するシール部材４６を備えている。また、外管ハブ４０は、外管ハブ本体４１の中央付近より斜め後方に分岐するサイドポート４２を備えている。また、外管ハブ４０は、内部に、チューブ本体２０内のルーメン５２と連通する連通路４４を備えている。 Further, as shown in FIGS. 1, 2 and 7, an outer tube hub 40 is fixed to the base end portion of the tube body 20. As shown in FIG. 7, the outer tube hub 40 includes an outer tube hub main body 41 and a seal member 46 that is housed in the outer tube hub main body 41 and holds the internal insertion body 3 in a slidable and liquid-tight manner. ing. Further, the outer tube hub 40 includes a side port 42 that branches obliquely rearward from the vicinity of the center of the outer tube hub main body 41. Further, the outer pipe hub 40 is internally provided with a communication passage 44 that communicates with the lumen 52 in the tube main body 20.

さらに、外管ハブ４０は、内部挿通体３の移動を規制する内管ロック機構を備えている。この実施例では、ロック機構は、圧縮により内部挿通体３の基端部を液密状態に挟持するシール部材４６とシール部材４６を圧縮する操作部材４３および外管ハブ本体４１により構成されている。このロック機構を備えることにより、内部挿通体３は可撓性外管２に対して任意の位置で固定可能である。 Further, the outer tube hub 40 is provided with an inner tube locking mechanism that regulates the movement of the internal insertion body 3. In this embodiment, the lock mechanism is composed of a seal member 46 that holds the base end portion of the internal insertion body 3 in a liquidtight state by compression, an operation member 43 that compresses the seal member 46, and an outer tube hub main body 41. .. By providing this locking mechanism, the internal insertion body 3 can be fixed to the flexible outer tube 2 at an arbitrary position.

シール部材４６は、外管ハブ本体４１の基端部に設けられた収納部内に設置されており、シール部材４６の内部には、ルーメン５２と連通する挿通路が形成されている。シール部材４６の内部形状は、軸方向中央部が、環状に膨らんだ状態となっており、シール部材４６が、操作部材４３により、圧縮された際、中央膨出部が小径化し、内部挿通体３（具体的には、管状体３１）の外面と液密に接触するものとなっている。 The seal member 46 is installed in a storage portion provided at the base end portion of the outer pipe hub main body 41, and an insertion passage communicating with the lumen 52 is formed inside the seal member 46. The internal shape of the seal member 46 is such that the central portion in the axial direction is bulged in an annular shape, and when the seal member 46 is compressed by the operating member 43, the diameter of the central bulging portion is reduced and the internal insertion body is inserted. 3 (specifically, the tubular body 31) is in liquid-tight contact with the outer surface.

具体的には、操作部材４３は、中央部に先端側に突出した筒状の押圧部４７と、この押圧部４７を被包するように形成され、かつ、外管ハブ本体４１の後端外面に形成された螺合部４８と螺合可能な螺合部を備える外筒部４３ａを備えている。操作部４３の基端部は、拡径部４３ｂとなっており、操作部材４３を回転させる際に把持することが容易なものとなっている。 Specifically, the operating member 43 is formed so as to enclose a tubular pressing portion 47 projecting toward the tip end side in the central portion and the pressing portion 47, and the rear end outer surface of the outer tube hub main body 41. It is provided with an outer cylinder portion 43a having a screwed portion 48 formed in the above and a screwed portion that can be screwed. The base end portion of the operating portion 43 is a diameter-expanded portion 43b, which makes it easy to grip the operating member 43 when rotating it.

また、押圧部４７の内部には、ルーメン５２と連通する内部通路を備えている。また、押圧部４７の先端側部分は、図７に示すように、収納部内に侵入しており、操作体の先端への移動によりシール部材４６を圧縮可能となっている。 Further, the inside of the pressing portion 47 is provided with an internal passage communicating with the lumen 52. Further, as shown in FIG. 7, the tip end side portion of the pressing portion 47 has penetrated into the storage portion, and the seal member 46 can be compressed by moving to the tip end of the operating body.

この実施例のロック機構では、操作部材４３を回転させて、外管ハブ４０の先端側に移動するように螺合を進行させると、押圧部４７の先端はシール部材４６の後端に接触して、さらに、操作部材４３を回転させて螺合を進行させるとシール部材４６は軸方向に圧縮される。そして、シール部材４６は圧縮が進行するに従い内部通路の内径は小さくなり最終的にシール部材４６により内部挿通体３が把持され固定される。なお、ロック機構の解除は、上記と逆の回転操作により行われる。 In the lock mechanism of this embodiment, when the operating member 43 is rotated and the screwing is advanced so as to move to the tip side of the outer tube hub 40, the tip of the pressing portion 47 comes into contact with the rear end of the seal member 46. Further, when the operating member 43 is rotated to advance the screwing, the seal member 46 is compressed in the axial direction. Then, as the compression of the seal member 46 progresses, the inner diameter of the internal passage becomes smaller, and finally the internal insert 3 is gripped and fixed by the seal member 46. The lock mechanism is released by the reverse rotation operation as described above.

外管ハブ本体４１および操作部材４３の構成材料としては、硬質もしくは半硬質材料が使用される。硬質もしくは半硬質材料としては、ポリカーボネート、ポリオレフィン（例えば、ポリエチレン、ポリプロピレン、エチレン−プロピレンコポリマー）、スチレン系樹脂［例えば、ポリスチレン、ＭＳ樹脂（メタクリレート−スチレン共重合体）、ＭＢＳ樹脂（メタクリレート−ブチレン−スチレン共重合体）］、ポリエステルなどの合成樹脂、ステンレス鋼、アルミもしくはアルミ合金などの金属が使用できる。 A hard or semi-hard material is used as a constituent material of the outer tube hub main body 41 and the operating member 43. Examples of the hard or semi-hard material include polycarbonate, polyolefin (for example, polyethylene, polypropylene, ethylene-propylene copolymer), styrene resin [for example, polystyrene, MS resin (methacrylate-styrene copolymer), MBS resin (methacrylate-butylene-). Styrene copolymer)], synthetic resins such as polyester, stainless steel, and metals such as aluminum or aluminum alloys can be used.

また、シール部材４６の構成材料としては、弾性材料が使用される。弾性材料としては、ウレタンゴム、シリコーンゴム、ブタジエンゴムなどの合成ゴム、ラテックスゴムなどの天然ゴムなどのゴム類、オレフィン系エラストマー（例えば、ポリエチレンエラストマー、ポリプロピレンエラストマー）、ポリアミドエラストマー、スチレン系エラストマー（例えば、スチレン−ブタジエン−スチレンコポリマー、スチレン−イソプレン−スチレンコポリマー、スチレン−エチレンブチレン−スチレンコポリマー）、ポリウレタン、ウレタン系エラストマー、フッ素樹脂系エラストマーなどの合成樹脂エラストマー等が使用される。 An elastic material is used as a constituent material of the seal member 46. Examples of the elastic material include synthetic rubbers such as urethane rubber, silicone rubber and butadiene rubber, rubbers such as natural rubbers such as latex rubber, olefin elastomers (for example, polyethylene elastomers and polypropylene elastomers), polyamide elastomers and styrene elastomers (for example). , Styrene-butadiene-styrene copolymer, styrene-isoprene-styrene copolymer, styrene-ethylenebutylene-styrene copolymer), synthetic resin elastomers such as polyurethane, urethane-based elastomers, and fluororesin-based elastomers are used.

本発明の卵管狭窄部改善具１は、内部挿通体３のコイル状管状部材３４の先端側部分が、可撓性外管２の先端５３より突出する状態から、少なくとも内部挿通体３のコイル状管状部材３４の全体が可撓性外管２内に収納された状態まで、摺動可能となっている。このため、卵管内への液体注入時に内部挿通体３が障害とならないため、良好に液体注入により、卵管を拡張することができる。 In the fallopian tube stenosis improving tool 1 of the present invention, at least the coil of the internal insertion body 3 is provided from a state in which the tip end side portion of the coiled tubular member 34 of the internal insertion body 3 protrudes from the tip end 53 of the flexible outer tube 2. The entire tubular member 34 is slidable until it is housed in the flexible outer tube 2. Therefore, since the internal insert 3 does not interfere with the injection of the liquid into the oviduct, the oviduct can be satisfactorily expanded by injecting the liquid.

この実施例の卵管狭窄部改善具１では、内部挿通体３は、可撓性外管２より抜去可能なものとなっている。さらに、この実施例の卵管狭窄部改善具１では、内部挿通体３の管状体３１が、可撓性外管２の先端５３（具体的には、卵管内挿入用小径部２２の先端）より突出しないように規制する内部挿通体先端方向移動規制部を備えている。 In the fallopian tube stenosis improving tool 1 of this embodiment, the internal insert 3 can be removed from the flexible outer tube 2. Further, in the fallopian tube stenosis improving tool 1 of this embodiment, the tubular body 31 of the internal insertion body 3 is the tip 53 of the flexible outer tube 2 (specifically, the tip of the small diameter portion 22 for insertion into the fallopian tube). It is equipped with an internal inserter tip-direction movement restrictor that regulates the protrusion so that it does not protrude more.

具体的には、図９に示すように、挿通体ハブ３２に設けられた小径突出部５６は、外管ハブ４０の後端部内に進入可能となっている。また、挿通体ハブ３２は、外管ハブ４０に当接可能なものとなっている。図９に示すものでは、挿通体ハブ３２の本体部３３の先端面は、外管ハブ４０の後端面（具体的には、押圧部４７の後端面）に当接可能なものとなっている。 Specifically, as shown in FIG. 9, the small-diameter protruding portion 56 provided on the insert hub 32 can enter the rear end portion of the outer tube hub 40. Further, the insertion body hub 32 is capable of contacting the outer tube hub 40. In the one shown in FIG. 9, the front end surface of the main body 33 of the insert hub 32 can be brought into contact with the rear end surface of the outer tube hub 40 (specifically, the rear end surface of the pressing portion 47). ..

そして、挿通体ハブ３２と外管ハブ４０が当接した状態において、図５に示すように、内部挿通体３の管状体３１の先端は、可撓性外管２の先端５３より、若干基端側に位置するものとなっている。このため、可撓性外管２の先端５３（具体的には、卵管内挿入用小径部２２の先端）より突出するのは、内部挿通体３のコイル状管状部材のみとなっている。 Then, in a state where the insertion body hub 32 and the outer tube hub 40 are in contact with each other, as shown in FIG. 5, the tip of the tubular body 31 of the inner insertion body 3 is slightly more base than the tip 53 of the flexible outer tube 2. It is located on the edge side. Therefore, only the coiled tubular member of the internal insertion body 3 protrudes from the tip 53 of the flexible outer tube 2 (specifically, the tip of the small diameter portion 22 for insertion into the oviduct).

なお、本発明の卵管狭窄部改善具は、上記のものに限定されるものではない。
卵管狭窄部改善具としては、図１０に示す実施例の卵管狭窄部改善具１ａのように、内部挿通体３の管状体３１の先端部が、可撓性外管２の先端５３より若干突出する状態を越えて、可撓性外管２の先端より突出しないように規制する内部挿通体先端方向移動規制部を備えるものであってもよい。 The fallopian tube stenosis improving tool of the present invention is not limited to the above.
As the fallopian tube stenosis improving tool, the tip of the tubular body 31 of the internal insertion body 3 is more than the tip 53 of the flexible outer tube 2 as in the fallopian tube stenosis improving tool 1a of the embodiment shown in FIG. It may be provided with an internal insertion body tip-direction movement restricting portion that regulates the flexible outer tube 2 so as not to protrude from the tip of the flexible outer tube 2 beyond a slightly protruding state.

この実施例のものでは、挿通体ハブ３２と外管ハブ４０が当接した状態において、図１０に示すように、内部挿通体３の管状体３１の先端は、可撓性外管２の先端より、若干突出するものとなっている。このように、内部挿通体３の管状体３１の先端を若干突出させることにより、内部挿通体３の管状体３１の先端部を、可撓性外管２の卵管内挿入用小径部２２の卵管口内への誘導部として機能させることが可能となる。 In this embodiment, when the insert hub 32 and the outer tube hub 40 are in contact with each other, as shown in FIG. 10, the tip of the tubular body 31 of the inner insert 3 is the tip of the flexible outer tube 2. It is slightly more prominent. In this way, by slightly projecting the tip of the tubular body 31 of the internal insertion body 3, the tip of the tubular body 31 of the internal insertion body 3 is inserted into the egg of the small diameter portion 22 for inserting into the oviduct of the flexible outer tube 2. It becomes possible to function as a guide part into the pipe mouth.

本発明の卵管狭窄部改善具の作用を図面を用いて説明する。
図５もしくは図１０に示すように、可撓性外管２の先端より、内部挿通体３のコイル状管状部材３４が突出する状態とし、必要であれば、弾性部材４６を押圧し、その状態を固定する。そして、コイル状管状部材３４が突出した卵管狭窄部改善具１を経膣的もしくは経皮的にて、子宮内に挿入し、さらに進行させて、コイル状管状部材３４を卵管口より卵管内に進入させる。そして、可撓性外管の卵管内挿入用小径部を卵管口に到達させた後、さらに、押し込むことにより、卵管内挿入用小径部を卵管口内に進入させる。そして、内部挿通体を後端側に移動させた後、外管ハブより、液体（例えば、生理食塩水）を注入することにより、卵管を液体にて拡張する。これにより、卵管内の狭窄部が押し広げられ、狭窄部が改善する。 The operation of the fallopian tube stenosis improving tool of the present invention will be described with reference to the drawings.
As shown in FIG. 5 or 10, the coil-shaped tubular member 34 of the internal insertion body 3 is in a state of protruding from the tip of the flexible outer tube 2, and if necessary, the elastic member 46 is pressed in that state. To fix. Then, the oviduct stenosis improving tool 1 in which the coiled tubular member 34 protrudes is inserted into the uterus transvaginally or percutaneously and further advanced, so that the coiled tubular member 34 is inserted into the egg from the oviduct opening. Let it enter the pipe. Then, after the small diameter portion for insertion into the fallopian tube of the flexible outer tube reaches the ostium of the oviduct, the small diameter portion for insertion into the oviduct is further pushed into the ostium of the oviduct. Then, after moving the internal insert to the rear end side, the oviduct is expanded with the liquid by injecting a liquid (for example, physiological saline) from the outer tube hub. As a result, the stenosis in the oviduct is expanded and the stenosis is improved.

１、１ａ 卵管狭窄部改善具
２ 可撓性外管
３ 内部挿通体
２０ チューブ本体
３１ 管状体
３４ コイル状管状部材
３５ 線状部材
２２ 卵管内挿入用小径部
４０ 外管ハブ 1, 1a Oviduct stenosis improving tool 2 Flexible outer tube 3 Internal insertion body 20 Tube body 31 Tubular body 34 Coiled tubular member 35 Linear member 22 Small diameter part for insertion into the oviduct 40 Outer tube hub

Claims (7)

可撓性外管と、前記可撓性外管内を挿通する内部挿通体とからなる卵管狭窄部改善具であって、
前記可撓性外管は、先端部に卵管内挿入用小径部を備える中空のチューブ本体と、前記チューブ本体の基端部に固定された外管ハブとを備え、
前記内部挿通体は、管状体と、前記管状体の先端部内に基端側が進入しかつ固定され、先端側が前記管状体の先端部より所定長突出したコイル状管状部材と、前記コイル状管状部材の先端と当接した先端膨出部と、前記先端膨出部より前記コイル状管状部材内を挿通し、基端部が前記管状体もしくは前記コイル状管状部材に内部にて固定された線状部とを有する線状部材とを備え、
前記卵管狭窄部改善具は、前記内部挿通体の前記コイル状管状部材の先端側部分が、前記可撓性外管の先端より突出する状態から、少なくとも前記コイル状管状部材の全体が前記可撓性外管内に収納された状態まで、摺動可能となっていることを特徴とする卵管狭窄部改善具。 An oviduct stenosis improving tool including a flexible outer tube and an internal insert that inserts the inside of the flexible outer tube.
The flexible outer tube includes a hollow tube body having a small diameter portion for insertion into an egg tube at the tip portion, and an outer tube hub fixed to the base end portion of the tube body.
The internal insertion body includes a tubular body, a coiled tubular member in which the proximal end side enters and is fixed in the distal end portion of the tubular body, and the distal end side projects a predetermined length from the distal end portion of the tubular body, and the coiled tubular member. A linear shape in which the tip bulging portion in contact with the tip of the tip and the inside of the coiled tubular member are inserted through the tip bulging portion, and the base end portion is internally fixed to the tubular body or the coiled tubular member. With a linear member having a portion
In the fallopian tube stenosis improving tool, at least the entire coiled tubular member can be described from a state in which the tip end side portion of the coiled tubular member of the internal insert protrudes from the tip of the flexible outer tube. A fallopian tube stenosis improving tool characterized in that it can slide until it is stored in a flexible outer tube. 前記コイル状管状部材は、前記管状体より小径であり、全体がほぼ同一外径であり、前記線状部の外径は、前記コイル状管状部材の内径より小さく、前記線状部材は、前記コイル状管状部材の柔軟性を阻害しないものとなっている請求項１に記載の卵管狭窄部改善具。 The coiled tubular member has a smaller diameter than the tubular body and has substantially the same outer diameter as a whole, the outer diameter of the linear portion is smaller than the inner diameter of the coiled tubular member, and the linear member is said to have the same outer diameter. The fallopian tube stenosis improving tool according to claim 1, which does not impair the flexibility of the coiled tubular member. 前記線状部材の前記線状部は、前記コイル状管状部材の後端より後方に突出する基端突出部を備え、前記基端突出部にて、前記管状体および前記コイル状管状部材に固定されている請求項１または２に記載の卵管狭窄部改善具。 The linear portion of the linear member includes a proximal protrusion projecting rearward from the rear end of the coiled tubular member, and is fixed to the tubular body and the coiled tubular member at the proximal protruding portion. The fallopian tube stenosis improving tool according to claim 1 or 2. 前記外管ハブは、側部に設けられた液体注入ポートを備えている請求項１ないし３のいずれかに記載の卵管狭窄部改善具。 The fallopian tube stenosis improving tool according to any one of claims 1 to 3, wherein the outer tube hub is provided with a liquid injection port provided on a side surface. 前記卵管狭窄部改善具は、前記内部挿通体の前記管状体が、前記可撓性外管の先端より突出しないように規制する内部挿通体先端方向移動規制部を備えている請求項１ないし４のいずれかに記載の卵管狭窄部改善具。 The fallopian tube stenosis improving tool includes the internal inserter tip direction movement restricting portion that regulates the tubular body of the internal inserter so as not to protrude from the tip of the flexible outer tube. The fallopian tube stenosis improving tool according to any one of 4. 前記卵管狭窄部改善具は、前記内部挿通体の前記管状体の先端部が若干突出する状態を越えて、前記内部挿通体が、前記可撓性外管の先端より突出しないように規制する内部挿通体先端方向移動規制部を備えている請求項１ないし４のいずれかに記載の卵管狭窄部改善具。 The fallopian tube stenosis improving tool regulates the internal insert so as not to protrude from the tip of the flexible outer tube beyond the state in which the tip of the tubular body of the internal insert slightly protrudes. The fallopian tube stenosis improving tool according to any one of claims 1 to 4, further comprising an internal insert tip direction movement restricting portion. 前記チューブ本体は、外層と、前記外層の先端より先端部が突出した内層とからなり、前記卵管内挿入用小径部は、前記内層の先端部により形成されている請求項１ないし６のいずれかに記載の卵管狭窄部改善具。 The tube body is composed of an outer layer and an inner layer having a tip protruding from the tip of the outer layer, and the small diameter portion for insertion into the oviduct is formed by the tip of the inner layer. The fallopian tube stenosis improving tool described in.
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