WO2004041098A1 - 経内視鏡的医療具 - Google Patents
経内視鏡的医療具 Download PDFInfo
- Publication number
- WO2004041098A1 WO2004041098A1 PCT/JP2003/014222 JP0314222W WO2004041098A1 WO 2004041098 A1 WO2004041098 A1 WO 2004041098A1 JP 0314222 W JP0314222 W JP 0314222W WO 2004041098 A1 WO2004041098 A1 WO 2004041098A1
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- WIPO (PCT)
- Prior art keywords
- sheath
- distal end
- medical device
- locking
- penetrating
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00314—Separate linked members
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00318—Steering mechanisms
- A61B2017/00323—Cables or rods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00336—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means with a protective sleeve, e.g. retractable or slidable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
- A61B2017/22049—Means for locking the guide wire in the catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22072—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other
- A61B2017/22074—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320044—Blunt dissectors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
- A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3904—Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
- A61B2090/3908—Soft tissue, e.g. breast tissue
Definitions
- the present invention relates to a transendoscopic medical device used for diagnosis or treatment or the like endoscopically.
- a treatment tool such as a biopsy forceps must be introduced endoscopically into the peripheral bronchus.
- No. The approach to the peripheral bronchi has been performed repeatedly while repeatedly inserting a treatment tool such as forceps while confirming the current position of the insertion under fluoroscopy.
- tissue cells are collected from peripheral lesions.
- stereotactic radiotherapy has been increasingly used in recent years.
- a tracheal branch is selected, and Endoscopic medical devices that are suitable for guiding these items are needed.
- an X-ray opaque marker is used to identify the irradiated area in the peripheral bronchus near the lesion. It is inserted into the cavity. In other words, radiation is applied to the lesion while tracking the moving object with a radiopaque marker as the target.
- the device described in US Pat. No. 6,228,055 is a marking device in which a marker element is embedded in tissue, which is a device for inserting a marker into a catheter. Is a method in which a marker element is buried by puncturing the inside of a tissue.
- a specific bronchial segment may be required to allow a transendoscopic diagnostic item to approach the peripheral bronchial site, such as placing an X-ray opaque device in the peripheral bronchial site.
- a transendoscopic medical device was required to select the branch and reach the diagnostic item to the target lesion deep inside the tracheal branch.
- the tubing device of USP Nos. 5, 791, 338 has a bendable articulated distal end. For this reason, it becomes thick and complicated in itself, and has a certain rigidity. Therefore, it was extremely difficult to enter deep areas such as the peripheral bronchi. Also, multiple items for use in diagnosis and treatment must be inserted and removed from deep lesions, which is difficult.
- the marking device described in USP No. 6,228,055 punctures the tip of the insertion portion of the catheter into the tissue, and assembles the device.
- a marker element is embedded in the weave. The selective insertion into the peripheral bronchial branch cannot be performed, and the marker element cannot be placed deep in the desired body cavity.
- the present invention enables selective insertion into, for example, complicated tracheal branches and the like, and ensures that insertion into a target site such as the peripheral bronchus can be performed reliably and quickly. It is an object of the present invention to provide a transendoscopic medical device capable of realizing a diagnosis and a treatment performed in a reliable and prompt manner.
- the present invention provides a sheath that can pass through a channel of an endoscope, a plurality of kinds of penetrating tools that can be detached from the sheath, and at least any of the penetrating tools inserted into the sheath.
- a transendoscopic medical device comprising: locking the device to the sheath; and a locking portion provided on the sheath.
- the present invention provides a sheath penetrating a channel of an endoscope, a first penetrating tool detachable from the sheath, and a first penetrating member detachable from the sheath.
- a second penetrating tool different from the tool or either the first penetrating tool or the first penetrating tool is locked to the sheath, and a locking portion provided on the sheath is provided. It is a transendoscopic medical device provided.
- the present invention provides a sheath unit penetrating through a channel of an endoscope, and a guiding unit having a bending portion at a distal end, which can be inserted into and removed from the sheath and can be bent by a bending operation means. And an insertion tool that is detachable from the sheath and is separate from the guiding unit, and the guiding unit that has passed through the sheath is attached to the sheath. And a locking section provided on the sheath.
- the present invention is capable of being inserted into a channel of an endoscope, has a tip opening having at least a tapered inner diameter at the tip, and an X-ray opaque material inside the tip.
- a line marker member can be arranged, and when no load is applied, the X-ray force-locking member is locked at the opening at the tip, and when a predetermined pressing force is applied, the X-ray is moved from the opening at the tip.
- a sheath for discharging the X-ray marker member which is detachable with respect to the sheath, and is capable of pressing the X-ray marker member when inserted into the sheath, and a distal end opening of the sheath;
- a guiding unit having a distal end that can be protruded and retracted from the head, a bending portion that is operated by bending operating means and that can deflect the direction of the distal end, and locks the guiding unit to the sheath.
- a transendoscopic medical device comprising: a locking means;
- the present invention relates to a sheath which can be inserted into a channel of an endoscope, and into which a plurality of kinds of penetrating tools can be individually inserted and detached, and at least the penetrating tool inserted into the sheath.
- a transendoscopic medical device that can be locked to any one of the devices, and that includes: locking means for positioning the penetrating device with respect to the sheath.
- FIG. 1 is a perspective view of an entire endoscopic medical device according to a first embodiment of the present invention.
- FIG. 2 is a longitudinal sectional view of the vicinity of the distal end of the endoscopic medical device according to the first embodiment.
- FIG. 3 is a longitudinal sectional view of the vicinity of a hand of the endoscopic medical device according to the first embodiment.
- FIG. 4 is a longitudinal sectional view of another state near the base end of the endoscopic medical device according to the first embodiment.
- FIG. 5 is a longitudinal sectional view of another state of the vicinity of the front end of the endoscopic medical device according to the first embodiment.
- FIG. 6 is a longitudinal cross-sectional view of the vicinity of the distal end of the endoscopic medical device according to the first embodiment in yet another state.
- FIG. 7 is a longitudinal cross-sectional view of the vicinity of the distal end of the endoscopic medical device according to the first embodiment in yet another state.
- FIG. 8 is a side view of the operation unit in the guide unit of the endoscopic medical device according to the first embodiment.
- FIG. 9 is a perspective view of the distal end working unit of the guide unit of the endoscopic medical device according to the first embodiment.
- FIG. 10 is a side view of the distal end working part of the guide unit of the endoscopic medical device according to the first embodiment.
- FIG. 11 is a longitudinal sectional view of the vicinity of the distal end portion of the endoscopic medical device according to the first embodiment in which the marker member is loaded.
- FIG. 12 is a longitudinal sectional view of the vicinity of the distal end when the marker member of the endoscopic medical device according to the first embodiment is pushed out.
- FIG. 13 is a longitudinal sectional view of the vicinity of the distal end when the marker member of the endoscopic medical device according to the first embodiment is released.
- FIG. 14 is an explanatory diagram of a case where the endoscopic medical device according to the first embodiment is similarly guided to a lesion in the bronchus that cannot be reached by the endoscope or the vicinity thereof.
- FIG. 15 is an explanatory view of a case where the endoscopic medical device according to the first embodiment is similarly guided to an intrabronchial lesion that cannot be reached by the endoscope or the vicinity thereof.
- FIG. 16 is an explanatory view showing a case in which the endoscopic medical device according to the first embodiment is similarly guided to a bronchial lesion that cannot be reached by the endoscope or in the vicinity thereof to perform a biopsy.
- Fig. 17 is an enlarged view of section A in Fig. 16.
- FIG. 18 is an explanatory view showing a case where the transendoscopic medical device according to the first embodiment is similarly guided to a lesion in the bronchus that cannot be reached by the endoscope or in the vicinity thereof, and the marker is placed.
- FIG. 19 is a perspective view of a distal end working portion of the guide unit of the endoscopic medical device according to the second embodiment of the present invention.
- FIG. 20 is also a side view of the vicinity of the distal end working portion of the guide unit of the endoscopic medical device according to the second embodiment.
- FIG. 21 is a perspective view of a distal end working portion in a guide unit of a transendoscopic medical device according to a third embodiment of the present invention.
- FIG. 22 is a longitudinal sectional view of a distal end portion of the guide unit of the endoscopic medical device according to the third embodiment.
- FIG. 23 is a perspective view of a distal end working portion of a guide unit of a transendoscopic medical device according to a fourth embodiment of the present invention.
- FIG. 24 is a perspective view of another form of the distal end working portion in the guide unit of the endoscopic medical device according to the fourth embodiment of the present invention.
- FIG. 25 is a longitudinal sectional view of a distal end portion of a transendoscopic medical device according to a fifth embodiment of the present invention.
- FIG. 26 shows the endoscopic medical device according to the fifth embodiment.
- FIG. 27 is a longitudinal cross-sectional view of a proximal portion of a transendoscopic medical device according to a fifth embodiment of the present invention.
- a guide catheter for an endoscope as a transendoscopic medical device will be described with reference to FIG. 1 to FIG.
- the guiding catheter 100 of this embodiment includes a mantle tube 101 and a guiding unit 102. As shown in FIG. 1, the inlet of the guide unit 102 is inserted into the mantle unit 101, and the two units can be moved forward and backward and detachably. Combine. In such a combined state, the guiding catheter 100 is inserted endoscopically into the body cavity.
- a mantle tube 101 is a long and flexible tube (sheet) 1 that can pass through a channel of an endoscope, and a tube 1 of the tube 1. It has a connector 2 connected to the base end. As shown in FIG. 3, the two are connected by fitting the distal end portion of the connector 2 to the base end portion of the tube 1 and mechanically fixing the fitted portion.
- the inner space (hole) of tube 1 and the inner space (hole) of connector 2 communicate with each other.
- the distal end portion of the tube 1 in the mantle unit 101 is formed as a tapered portion 3 having a tapered inner and outer diameter.
- the tapered portion 3 can be elastically expanded when a predetermined pressing force is applied thereto.
- Tube 1 is thin Therefore, the tube 1 has a flexible configuration as a whole.
- the outer surface of the tapered portion 3 does not have to have a tapered shape, and it is sufficient if at least the inner surface has a tapered shape.
- the guide unit 102 is connected to the distal end working unit 11 and the operating unit 12 for operating the leading end working unit 11 via a metal sheath 13 made of a long coil or the like.
- 2 and 3 which are configurations that are mechanically connected to each other, show the relationship when the mantle unit 101 and the induction unit 102 are combined.
- the operation unit 12 of the guiding unit 102 and the sheath 13 are connected to the distal end of the slider rod 15 extending forward from the operation unit 12 by a sheath. They are connected by connecting the base ends of 13.
- a plurality of engagement grooves (recesses) 15a, 15b, 15c are formed on the outer peripheral surface of the slider rod 15 at predetermined intervals.
- a convex member 16 is provided inside the connector 2 of the mantle tube unit 101 so as to protrude inward.
- One of the engagement grooves 15a, 15b, and 15c of the slider rod 15 is selectively engaged with the convex member 16. This constitutes a means for locking and fixing the mantle unit 101 to the guiding force table 100 at a predetermined position.
- the convex member 16 is formed in a ring shape from an elastic material or the like. Therefore, the convex member 16 slides on the slider rod 15 and engages with the engagement grooves 15a and 15a, Removable engagement with 15b and 15c is possible.
- the convex member 16 provided inside the outer tube unit 101 engages with any of the engagement grooves 15 a to 15 c.
- Engagement groove 15a to l5c Defines a first position, a second position, and a third position as different stopping positions of the guiding unit 102 with respect to the mantle unit 101, respectively. With such a configuration, a so-called three-stage click mechanism in which three stop positions of the guidance unit 102 can be selected is configured.
- Each locking portion serves as a plurality of locking portions for holding the penetrating device with respect to the sheath.
- the convex member 16 is engaged with the first engagement groove 15a, and at this time, the tip action at the tip of the guiding unit 102 is performed.
- the part 11 is retracted into the tube 1 at the distal end of the tube 1 of the mantle tube 101 and is housed. In this retracted storage state, the distal end working portion 11 of the guide unit 102 is constrained by the inner wall of the tube 1, so that it has a straight shape along the tube 1.
- the number of the engaging grooves 15a to 15c and their installation positions are three, and they are provided at equal intervals.
- the number and installation positions are the allowable length of the slider rod 15 May be changed within the range.
- a slider 17 and a finger ring 18 are provided on the operation unit 12 of the guide unit 102.
- the base end of an operation wire 19 described later is connected to the slider 17.
- the operation wire 19 is guided to the distal end through the inside of the sheath 13 and a part of the slider rod 15.
- the distal end of the operation wire 19 is connected to the movable member of the distal end working portion 11 of the guide unit 102, as shown in FIGS. 9 and 10.
- the distal end working portion 11 of the guide unit 102 has three pieces, a tip 21a having a spherical tip, a joint 21b, and a base 21c. It is constructed by connecting members in series.
- the distal end 21 a and the joint 21 b are connected via a pivot pin 22, and the joint 21 b and the base 21 c are connected via a connecting pin 23.
- the position of the pivot pin 22 that pivots the tip 2 la and the joint 2 lb, and the position of the joint pin 23 that pivots the joint 2 lb and the base 21 c are It is arranged on the same side as the center of the action portion 11 1.
- the distal end 21a, the joint 21b, and the base 21c of the distal end working portion 11 constitute a deflectable bending portion that curves to the opposite side.
- the facing edges of the distal end 21a, the joint 21b, and the base 21c are notched diagonally.
- the cutout base ends are joined to each other.
- the tip surface of the tip 2 la is formed in a substantially spherical shape in order to make the contact with the tissue as soft as possible.
- the operation wire 19 passes through the sheath 21, passes through the internal force plate base 21 c, passes through the joint 21 b, reaches the distal end 21 a of the distal end working portion 11, and has a member at the distal end 2 la.
- the wire tip is connected.
- a connection pin 24 is provided across the tip 21a. The distal end of the operation wire 19 is rotatably wound around the connection pin 24 so that the distal end of the operation wire 19 is connected to the connection pin. 2 Connect to 4.
- the tip end operation unit 11 When the operation wire 19 is advanced and retracted by pushing and pulling the slider 17 of the operation unit 12 back and forth, the tip end operation unit 11 is bent. It constitutes a bending operation means.
- the tip of the joint 2 lb when the slider 17 is pulled toward the user and the tip 21a of the tip working portion 11 is pulled by the operation wire 19, the tip of the joint 2 lb is pulled. 2 la rotates around the support pin 22, the joint 21 b rotates around the connection pin 23 with respect to the base 21 c, and the distal end working portion 11 bends. Normally, the user starts moving from the tip 21 a to the joint 21 b in accordance with the pulling of the operation wire 19. Eventually, as shown in FIG.
- the distal end working portion 11 bends in a state where the whole is in a bent state.
- the level of this bending (bending) can be arbitrarily changed according to the moving distance of the slider 17.
- a spherical marker member 130 for indwelling the body made of a radiopaque material is inserted into the tube 1 and the marker member 1 is inserted.
- the guiding unit 106 is inserted and arranged at the rear side of the tube 30.
- the spherical marker member 130 is easily inserted from the end of the tube 1 at the tapered portion 3 at the end of the tube 1. It is locked so that it does not jump out.
- an X-ray marker is placed at or near a bronchial lesion that cannot be reached by the endoscope, or a tissue or cell at a site in a body cavity is used. Can be collected.
- the guide unit When placing an X-ray marker at or near an endobronchial lesion that is not reachable by the endoscope, the guide unit must first be placed under the X-ray fluoroscope through the endoscope channel. Then, only the guiding unit 102 is guided to the relevant site. At this time, as shown in FIG. 4, the operation unit 12 of the guide unit 102 is pushed into the mantle tube unit 101, and as shown in FIG. The tip action section 11 of 02 is completely protruded from the tip of the tube 1.
- the guiding catheter 100 is inserted into the body cavity through the treatment instrument channel of the endoscope. Only the guiding catheter 100 protrudes from the insertion end of the endoscope 200, and pushes the guiding catheter 100 into the body cavity under X-ray fluoroscopy.
- the operation unit 1 of the guidance unit 102 In step 2, the tip action section 11 of the guiding unit 102 is bent (curved) as needed while pushing and pulling the slider 17, and the tracheal branch 201 to be guided is selected.
- the distal end working portion 11 is pushed into the tracheal branch 201.
- the bending portion 200a at the insertion portion of the endoscope 200 is operated to bend and the distal end portion of the insertion portion is moved forward. The position and the direction may be selected together.
- the distal end working portion 11 of the guiding unit 102 is moved to the vicinity of the lesion 202.
- the guide unit is guided to the lesion in the bronchial cavity, particularly the peripheral bronchial cavity, by the bending function of the bendable distal end working portion 11. 2 is guided, and the tube 1 of the catheter 100 is guided to a lesion or the like through the guiding unit 102.
- the first operation is performed from the mantle tube 101 to the first part.
- the guide unit 102 as a transendoscopic penetrating instrument is completely removed, and a second transendoscopic penetrating instrument, such as a biopsy forceps, is used instead of an endoscope.
- a second transendoscopic penetrating instrument such as a biopsy forceps
- the endoscope treatment tool 203 has been described as a biopsy forceps, but the second transendoscopic treatment tool has been described.
- the outer tube unit 101 as a transendoscopic sheath, such as a cytodiagnosis item such as a cytology brush pellet or an aspiration biopsy needle, a high-frequency treatment device, etc.
- a transendoscopic sheath such as a cytodiagnosis item such as a cytology brush pellet or an aspiration biopsy needle, a high-frequency treatment device, etc.
- the type of transendoscopic item may be within the enclosure, and is not limited.
- the spherical marker member 130 is loaded into the tube 1 of the mantle tube unit 101 as shown in FIG. After guiding the tube 1 of the tube unit 101 to the desired tracheal branch 201, the guiding unit 102 is gradually pushed forward as shown in FIG. The spherical marker member 130 is pushed out and released into the tracheal branch 201 (see Fig. 18).
- the tube 1 is made thin, the spherical marker member 130 is detached from the mantle unit 101 while expanding and deforming the tapered portion 3 formed at the front end. As shown in Fig. 18, it can be released into the body cavity.
- the guide kit functions as a slidable and removable pusher element for pushing the marking member out of the mantle tube unit.
- the engagement groove 15b of the slider rod 15 is stopped at a position where it engages with the convex member 16 of the mantle unit 101.
- the spherical marker member 130 is completely disengaged from the mantle unit 101, as shown in FIG. 13, and is inserted into the body cavity, as shown in FIG.
- the spherical marker member 130 can be fitted and placed in the peripheral bronchial space.
- the bendable distal end portion 11 of the guiding unit 102 can reliably guide the catheter to a lesion in a bronchial cavity, particularly a complicated peripheral bronchial cavity.
- the guiding unit as the first endoscope penetration tool
- a diagnosis treatment of a lesion can be surely performed.
- the marker member 130 can be securely placed at the target site.
- This embodiment is different from the first embodiment in the configuration of the distal end working portion 11 in the guide unit 102. That is, as shown in FIGS. 19 and 20, the distal end working portion 11 was composed of two parts, the distal end 21a and the base 21c. Other configurations are not different from the first embodiment described above.
- the shape of the tip 21a constituting a part of the tip operating portion 11 of the guide unit 102 is configured as shown in FIGS. 21 and 22. That is, the tip 21 a is formed of a substantially columnar member, and a deep pot-shaped recess 40 is provided at the tip surface toward the center, and the peripheral edge 41 of the recess 40 is rounded. It is formed in a shape.
- the mortar-shaped recess 40 is configured so as to stably support the spherical marker member 130.
- Other configurations are the same as those in the above-described first and second embodiments.
- the spherical marker member 130 when placing the marker in the body cavity, as shown in FIG. 22, the spherical marker member 130 has a concave portion 40 at the tip 21 a as shown in FIG. It is held in a state where it falls inside. Therefore, when the power member 130 is placed in the body cavity at the target site, the power member 130 can be reliably pushed out of the tube 1 in a more stable state.
- Other functions and effects are the same as those of the above-described first and second embodiments.
- the shape of the distal end 21 a which is a constituent of the distal end working portion 11 of the induction unit 102, is a substantially cylindrical shape having a spherical distal end, as shown in FIG. A flat part 45 was formed in a part of the longitudinal direction. As shown in FIG. 24, the plane portion 45 may be formed like a wavy surface 46.
- the distal end working portion 11 is easily hooked on the tracheal cavity of the bifurcation. This also shortens the time required for the catheter to reach the target site.
- the mantle tube unit 101 has a length including the tapered portion 3 in the tapered portion 3 provided at the distal end of the tube 1 and at least one or more.
- the slit 50 is provided continuously from the open end 51 of the tube 1.
- Other configurations are the same as those of the above-described first to fourth embodiments.
- the two slits 50 are formed symmetrically on one plane.
- FIG. 26 when the spherical marker member 130 is separated from the mantle tube unit 101, the slit 50 is broken and the spherical marker member 130 projects. become. Therefore, the spherical marker member 130 can easily protrude from the open end 51 of the tube 1 and can be discharged.
- Other operations are the same as those in the first to fourth embodiments.
- the marker member 130 when pushing out the marker member 130 from the catheter, the marker member 130 can be protruded with a lighter force. Further, even when the endoscope insertion tool is replaced with the mantle tube unit 101, the insertion tool can be easily protruded.
- the object on which the convex member 16 in the configuration of the above-described first embodiment is arranged is changed from the connector 2 to the slider rod 15 and the connector is changed.
- the inner wall 2 e that forms the inner space 2 d of 2 has three engagement grooves 12 a, 12 b, and 12 c at which the convex member 16 is locked at predetermined intervals. is there.
- the convex member 16 is provided on a slider rod 15 formed in front of the operation unit 104 of the guide unit 102.
- the convex member 16 is made of an elastic material or the like, and is detachably and closely fitted to a concave portion 15 d provided in the slider rod 15.
- An inner taper 2 g for facilitating insertion of the convex member 16 is formed in the open end 2 f of the connector 2.
- Other Is the same as the configuration of the first embodiment described above.
- the convex member 16 is engaged with the engagement groove 12c, and at this time, the outer cut 1001 and the guide cut 102 on the distal end side are connected.
- the relative positional relationship is as shown in Fig. 2.
- the state is as shown in FIG. 7, and when the convex member 16 and the engaging groove 12a are engaged, FIG. In the state shown in FIG.
- the number of the engagement grooves 12 a, 12 b, and 12 c is not limited to three. You may.
- the long inductor whose distal end exhibits a bending operation is constructed by slidably and detachably combining inside the long outer tube, it can selectively push a complicated tracheal branch. It can be advanced and insertion of the peripheral bronchus into the target site can be realized.
- a site such as a complicated tracheal branch, etc.
- Measures can be taken reliably and quickly.
- Deposition of the X-ray marker member at a predetermined position can be easily performed. Since a long inductor with a bend at its tip is constructed by combining a long outer tube with a slidable and detachable tube, it can selectively push forward a complicated tracheal branch. Thus, it is possible to achieve penetration of a peripheral bronchus into a target site.
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Ophthalmology & Optometry (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Endoscopes (AREA)
- Surgical Instruments (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP03810669.6A EP1588670B1 (en) | 2002-11-08 | 2003-11-07 | Transendoscopic medical instrument |
US11/119,472 US8496630B2 (en) | 2002-11-08 | 2005-04-29 | Transendoscopic medical instrument |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2002-325492 | 2002-11-08 | ||
JP2002325492A JP3960904B2 (ja) | 2002-11-08 | 2002-11-08 | 経内視鏡的医療具 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/119,472 Continuation US8496630B2 (en) | 2002-11-08 | 2005-04-29 | Transendoscopic medical instrument |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2004041098A1 true WO2004041098A1 (ja) | 2004-05-21 |
Family
ID=32310475
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2003/014222 WO2004041098A1 (ja) | 2002-11-08 | 2003-11-07 | 経内視鏡的医療具 |
Country Status (4)
Country | Link |
---|---|
US (1) | US8496630B2 (ja) |
EP (1) | EP1588670B1 (ja) |
JP (1) | JP3960904B2 (ja) |
WO (1) | WO2004041098A1 (ja) |
Cited By (1)
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CN110996756A (zh) * | 2017-08-16 | 2020-04-10 | 柯惠Lp公司 | 内窥镜*** |
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EP3668367A4 (en) * | 2017-08-16 | 2021-08-04 | Covidien LP | ENDOSCOPIC SYSTEM |
Also Published As
Publication number | Publication date |
---|---|
EP1588670B1 (en) | 2019-01-09 |
US8496630B2 (en) | 2013-07-30 |
US20050251111A1 (en) | 2005-11-10 |
JP3960904B2 (ja) | 2007-08-15 |
EP1588670A4 (en) | 2010-06-16 |
EP1588670A1 (en) | 2005-10-26 |
JP2004154485A (ja) | 2004-06-03 |
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