WO2018174242A1 - ダイレータ - Google Patents
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- Publication number
- WO2018174242A1 WO2018174242A1 PCT/JP2018/011673 JP2018011673W WO2018174242A1 WO 2018174242 A1 WO2018174242 A1 WO 2018174242A1 JP 2018011673 W JP2018011673 W JP 2018011673W WO 2018174242 A1 WO2018174242 A1 WO 2018174242A1
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- WO
- WIPO (PCT)
- Prior art keywords
- shaft
- pitch
- dilator
- spiral convex
- convex portion
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
-
- 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
- A61B90/02—Devices for expanding tissue, e.g. skin tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
- A61M25/0052—Localized reinforcement, e.g. where only a specific part of the catheter is reinforced, for rapid exchange guidewire port
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
- A61M25/0053—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids having a variable stiffness along the longitudinal axis, e.g. by varying the pitch of the coil or braid
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/008—Strength or flexibility characteristics of the catheter tip
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00902—Material properties transparent or translucent
- A61B2017/00915—Material properties transparent or translucent for radioactive radiation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3454—Details of tips
- A61B2017/3456—Details of tips blunt
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3454—Details of tips
- A61B2017/3458—Details of tips threaded
-
- 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
- A61B2090/3966—Radiopaque markers visible in an X-ray image
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M2025/006—Catheters; Hollow probes characterised by structural features having a special surface topography or special surface properties, e.g. roughened or knurled surface
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
- A61M2025/0687—Guide tubes having means for atraumatic insertion in the body or protection of the tip of the sheath during insertion, e.g. special designs of dilators, needles or sheaths
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
Definitions
- the present invention relates to a dilator.
- a dilator that expands a hole formed in a wall of a patient's digestive tract or the like for acupuncture.
- the hole is expanded by inserting the tip of the dilator into the hole formed in the wall and pushing the tapered portion into the hole.
- Such a dilator is disclosed in Patent Document 1, for example.
- An object of the present invention is to provide a dilator capable of easily expanding the diameter of a hole formed in a wall of a digestive tract or the like.
- a dilator in order to achieve this object, includes a hollow shaft and a grip portion provided at a base end of the shaft.
- the shaft includes a tapered portion having a distal end outer diameter smaller than a proximal end outer diameter, a distal end portion provided on a distal end side of the tapered portion and extending toward a distal end side, and a proximal end side provided on a proximal end side of the tapered portion.
- a proximal end portion that is provided on the proximal end side of the tapered portion and extends toward the proximal end side without having the distal end portion.
- a spiral convex portion is provided on the outer peripheral surface of the shaft, and the spiral convex portion has a gap in an adjacent portion along the axis of the shaft.
- the pitch of the adjacent portions along the axis of the spiral convex portion provided in the tapered portion is the spiral convex portion provided in the base end portion. It is smaller than the pitch of the part adjacent along the said axis
- the pitch of the adjacent portions along the axis of the spiral convex portion provided in the tapered portion is the spiral provided in the tip portion or the base end portion. Smaller than the pitch of the adjacent portions along the axis of the convex portion.
- the pitch of the adjacent portions along the axial direction of the spiral convex portion provided in the tapered portion is the spiral shape provided in the tip portion. It is smaller than the pitch of the part adjacent along the axial direction of the convex part, and smaller than the pitch of the part adjacent along the axial direction of the spiral convex part provided at the base end part. Also good.
- the shaft may be composed of a first coil in which a wire is wound into a hollow shape.
- the spiral convex portion may be composed of a second coil obtained by winding an element wire around the outer peripheral surface of the shaft.
- the shaft is composed of a first coil in which a strand is wound in a hollow shape
- the spiral protrusion is composed of a second coil in which the strand is wound around an outer peripheral surface of the shaft.
- the strands of the coil and the second coil may be wound in opposite directions.
- the dilator includes a hollow shaft and a grip portion provided at the base end of the shaft.
- the shaft includes a tapered portion having a distal end outer diameter smaller than a proximal end outer diameter, a distal end portion provided on a distal end side of the tapered portion and extending toward a distal end side, and a proximal end side provided on a proximal end side of the tapered portion.
- a proximal end portion that is provided on the proximal end side of the tapered portion and extends toward the proximal end side without having the distal end portion.
- a spiral convex portion is provided on the outer peripheral surface of the shaft, and the spiral convex portion has a gap in an adjacent portion along the axis of the shaft.
- the pitch of the adjacent portions along the axis of the spiral convex portion provided in the tapered portion is the spiral convex portion provided in the base end portion. It is larger than the pitch of the part which adjoins along the said axis
- the pitch of the adjacent portions along the axis of the spiral convex portion provided in the tapered portion is the spiral provided in the tip portion or the base end portion. It is larger than the pitch of the part adjacent along the said axis
- a dilator capable of easily expanding the diameter of a hole formed in a wall of a digestive tract or the like.
- FIG. 1 is an overall view of a dilator according to a first embodiment of the present invention. It is a figure which shows the front end side part of the dilator which concerns on 2nd Embodiment. It is a general view of the dilator concerning a 3rd embodiment. It is a partial cross section figure of the front end side part of the dilator concerning a 4th embodiment. It is a partial cross section figure of the front end side part of the dilator concerning a 5th embodiment. It is a partial cross section figure of the front end side part of the dilator concerning a 6th embodiment. It is a figure which shows the modification of the dilator which concerns on 3rd Embodiment.
- FIG. 1 is an overall view of a dilator 1 according to a first embodiment of the present invention.
- the left side in the figure is the distal end side (distal side) to be inserted into the body
- the right side is the proximal end side (hand side, proximal side) operated by an operator such as a doctor.
- a dilator 1 includes a first coil 3 formed in a hollow shape by winding a plurality of metal strands, and a first coil 3 (left-handed toward the tip) on an outer peripheral surface 3A of the first coil 3.
- a multilayer body 7 composed of a second coil 5 made of one metal strand wound in the opposite direction (right-handed toward the tip) and a hollow connected to the base end of the multilayer body 7 And a connector 9 having a shape.
- the strands constituting the first coil 3 and the second coil 5 are, for example, metal strands such as stainless steel and a superelastic alloy such as nickel-titanium, or resin strands.
- the first coil 3 is formed by winding a metal wire made of, for example, 10 stainless steels.
- the first coil 3 has a hollow shape in which a lumen 3B penetrating from the proximal end to the distal end is formed.
- the first coil 3 has a proximal end portion 3C, a tapered portion 3D, and a distal end portion 3E.
- the first coil 3 corresponds to a shaft.
- the base end 3C is located on the base end side of the dilator 1, and the connector 9 is connected to the base end. Further, the base end portion 3C has a substantially constant outer diameter from the base end to the tip.
- the tapered portion 3D is located on the distal end side of the proximal end portion 3C, extends from the distal end of the proximal end portion 3C to the distal end side, and is configured such that the outer diameter decreases toward the distal end side.
- the distal end portion 3E is located on the distal end side of the tapered portion 3D and extends from the distal end of the tapered portion 3D to the distal end side.
- the distal end portion 3E has a substantially constant outer diameter from the proximal end to the distal end.
- the 1st coil 3 which is a shaft has comprised the hollow shape whose outer diameter of a front end is smaller than the outer diameter of a base end.
- one metal strand is wound around the outer peripheral surface 3 ⁇ / b> A of the first coil 3 in a direction opposite to the first coil 3 (left-handed toward the tip) (rightward toward the tip).
- the metal wire is wound in close contact on the proximal end side, and is wound away from the distal end side of the proximal end portion 3C, the tapered portion 3D, and the distal end portion 3E.
- a portion of the second coil 5 that is wound apart is provided on the outer peripheral surface 3 ⁇ / b> A of the first coil 3 with a spiral convex portion that protrudes to the outside (the outermost surface and the outermost surface of the dilator 1).
- the spiral convex portion has a gap in an adjacent portion (adjacent metal strand) along the axis A of the first coil 3.
- the dilator 1 can also be advanced by a rotating operation of the dilator 1 by the screw action of the spiral convex portion.
- the pitch of the part adjacent along the axis A of the 2nd coil 5 provided in the taper part 3D is adjacent along the axis A of the 2nd coil 5 provided in the base end part 3C and the front-end
- each pitch in the front end side of 3 C of base end parts may be equal, and may differ.
- Each pitch in taper part 3D may be equal, and may differ.
- the distance between adjacent metal wires gradually decreases toward the base end side at the base end portion 3C.
- the length of the dilator in this embodiment and other embodiments described hereinafter is, for example, 2000 mm, preferably 1600 mm to 2500 mm, and the length of the tip 3E is, for example, 10 mm, preferably 0 to 100 mm.
- the length of the tapered portion 3D is, for example, 30 mm, preferably 5 to 100 mm.
- the inner diameter at the distal end of the first coil 3 is, for example, 0.7 mm, preferably 0.4 to 1.0 mm, and the inner diameter at the proximal end of the first coil 3 is, for example, 1.5 mm, preferably 1.0 to 3 mm. 0.0 mm.
- the outer diameter at the distal end of the second coil 5 is, for example, 1.84 mm, preferably 0.8 to 3.0 mm, and the outer diameter at the proximal end of the second coil 5 is, for example, 2.64 mm, preferably 1.4 mm. -5.0 mm.
- the diameter of the metal wire of the first coil 3 is, for example, 0.21 mm, preferably 0.1 to 0.5 mm, and the diameter of the metal wire of the second coil 5 is, for example, 0.36 mm, preferably 0.1 to 0.5 mm.
- the pitches L1 and L3 of the second coil 5 at the base end portion 3C and the tip end portion 3E are, for example, 2 mm, and the pitch L2 of the second coil 5 at the taper portion 3D is, for example, 1.5 mm, and the ratio of both. (L2 / L1 or L3) is 0.75.
- the pitches L1 and L3 of the second coil 5 at the base end portion 3C and the tip end portion 3E are preferably 0.25 to 5 mm, and the pitch L2 of the second coil 5 at the taper portion 3D is preferably 0.2.
- the range of the ratio of both is 0.04 to 1.
- the connector 9 which is a heel gripping part is a part where the technician pushes the dilator into the body or performs a rotation operation.
- the distal end of the connector 9 is connected to the proximal end of the first coil 3 and the proximal end of the second coil 5.
- the connector 9 is made of resin and has a hollow shape having a lumen communicating with the lumen 3 ⁇ / b> B of the first coil 3.
- a spiral convex portion (second coil 5) that protrudes to the outside is provided on the outer peripheral surface 3A of the first coil 3 that is a shaft, and the spiral convex portion is the first coil. 3 has a gap in an adjacent portion along the axial direction.
- the pitch of the part adjacent along the axis A of the 2nd coil 5 provided in the taper part 3D is adjacent along the axis A of the 2nd coil 5 provided in the base end part 3C and the front-end
- the shaft is composed of the first coil 3 in which a plurality of metal strands are wound in a hollow shape
- the flexibility of the shaft and the torque transmission by the first coil 3 can be improved.
- the spiral convex portion is composed of the second coil 5 in which one metal strand is wound around the outer peripheral surface 3A of the first coil 3, the spiral convex portion can be easily formed. Due to the elasticity of the second coil 5, the flexibility of the tip of the dilator 1 can be secured, and the torque transmission can be improved. Further, since the strands of the first coil 3 and the second coil 5 are wound in opposite directions, even when the dilator 1 is rotated in the opening direction, the second coil 5 is closed. Since the force is applied in the direction, the opening of the first coil 3 can be suppressed, and the force applied to the connector 9 of the dilator 1 can be transmitted to the tip side.
- a hole is made by puncturing an object using an introduction needle.
- the introduction needle is withdrawn.
- the proximal end of the guide wire is inserted into the lumen of the dilator, and the dilator is inserted.
- the dilator is pushed forward while rotating the shaft, and the hole of the puncture portion is expanded.
- the taper portion advances due to the screw action of the spiral convex portion by the rotation operation of the shaft, the hole can be smoothly expanded by the taper portion.
- FIG. 2 is a diagram illustrating a tip side portion of the dilator 10 according to the second embodiment. Further, in FIG. 2, the left side in the figure is the distal end side (distal side) inserted into the body, and the right side is the proximal end side (hand side, proximal side) operated by an operator such as a doctor.
- the dilator 10 of this embodiment is fundamentally the same structure as the dilator 1 of 1st Embodiment, the same number is attached
- the dilator 10 includes a first coil 3 formed in a hollow shape by winding a plurality of metal strands, and a first coil 3 (left-handed toward the tip) on an outer peripheral surface 3 ⁇ / b> A of the first coil 3. ) And a multi-layer body 17 composed of a second coil 5 made of a single metal wire wound in the opposite direction (right-handed toward the tip) and connected to the base end of the multi-layer body 17. And a hollow connector 9.
- the dilator 10 is different from the dilator 1 in that it has a most advanced portion 6 instead of the tip 3E of the first coil 3 of the dilator 1.
- the first coil 3 having the tip 6 provided at the tip corresponds to the shaft.
- the most advanced portion 6 is formed by pouring a brazing material (silver tin brazing material, gold tin brazing material, etc.) into the tip of the first coil 3, and the shape thereof is a substantially cylindrical hollow shape.
- a brazing material silver tin brazing material, gold tin brazing material, etc.
- the surface of the most advanced portion 6 is not an uneven shape like the tip of the multilayer body 7 but is flat.
- the pitch of the adjacent portions along the axis A of the second coil 5 provided in the tapered portion 3D is adjacent along the axis A of the second coil 5 provided in the proximal end portion 3C. It is configured smaller than the pitch of the part. That is, the portions adjacent to each other along the axis A of the second coil 5 are configured such that L11> L12 when the pitch at the distal end side of the base end portion 3C is L11 and the pitch at the tapered portion 3D is L12. ing.
- the same effects as the dilator 1 of the first embodiment can be obtained. That is, when the dilator 10 is rotated, in the tapered portion 3D of the first coil 3, the frictional resistance with the object (eg, digestive tract such as stomach, liver) becomes larger than that of the proximal end portion 3C. Therefore, the propulsive force in the tapered portion 3D can be made larger than the propulsive force in the proximal end portion 3C of the dilator 10, and the hole can be easily expanded.
- the object eg, digestive tract such as stomach, liver
- the dilator is first pressed against the puncture portion, and then pushed while rotating, thereby improving the insertion property into the puncture portion. Further improvement can be achieved.
- FIG. 3 is an overall view of the dilator 20 according to the third embodiment.
- the left side in the figure is the distal end side (distal side) to be inserted into the body
- the right side is the proximal end side (hand side, proximal side) operated by an operator such as a doctor.
- the dilator 20 includes a shaft 21, a spiral convex portion 22, and a connector 9 connected to the proximal end of the shaft 21.
- the shaft 21 has a hollow shape in which a lumen 21A penetrating from the proximal end to the distal end is formed.
- the shaft 21 has a proximal end portion 23, a tapered portion 24, and a distal end portion 25.
- the material which comprises the shaft 21 and the helical convex part 22 is not specifically limited as long as the taper part 24 and the front-end
- stainless steel, nickel -It is made of a super elastic alloy material such as a titanium alloy or a synthetic resin such as a polyvinyl chloride resin, a urethane resin, a polyolefin resin, a polyamide resin, and a fluorine resin.
- the proximal end portion 23 is located on the proximal end side of the dilator 20, and the connector 9 is connected to the proximal end.
- the proximal end portion 23 is provided on the proximal end side of the tapered portion 24 and extends to the proximal end side.
- the proximal end portion 23 has a substantially constant outer diameter from the proximal end to the distal end.
- the taper portion 24 is connected to the distal end of the base end portion 23, extends from the distal end to the distal end side, and has a shape that tapers toward the distal end side.
- the distal end portion 25 is connected to the distal end of the tapered portion 24 and extends from the distal end to the distal end side.
- the distal end portion 25 has a substantially constant outer diameter from the proximal end to the distal end.
- the shaft 21 has a hollow shape in which the outer diameter at the distal end is smaller than the outer diameter at the proximal end.
- the spiral convex portion 22 is provided on the outer peripheral surface 21B of the shaft 21 so as to protrude to the outside (the outermost surface and the outermost surface of the dilator 20).
- the spiral convex portion 22 is provided at the distal end side portion of the base end portion 23, the tapered portion 24, and the distal end portion 25, and has a gap in a portion adjacent along the axial direction of the shaft 21. That is, the adjacent portions of the spiral convex portion 22 are separated from each other.
- the spiral convex portion 22 is integrally formed with the shaft 21 by casting or the like.
- the pitch of adjacent portions along the axis A of the spiral convex portion 22 provided in the tapered portion 24 is along the axis A of the spiral convex portion 22 provided in the base end portion 23 and the distal end portion 25.
- the pitch is smaller than the pitch of adjacent portions. That is, regarding the portions adjacent along the axis A of the spiral convex portion 22, when the pitch at the base end portion 23 is L21, the pitch at the tapered portion 24 is L22, and the pitch at the distal end portion 25 is L23, L21, L23> L22.
- tip part 25 may be equal, and may differ.
- Each pitch in the taper part 24 may be equal or different.
- a spiral convex portion 22 that protrudes to the outside is provided on the outer peripheral surface 21 ⁇ / b> B of the shaft 21, and the spiral convex portion 22 is adjacent to the portion along the axis A of the shaft 21. Has a gap.
- the dilator can be advanced not only by a pushing operation as in the prior art but also by a rotating operation by the spiral convex portion 22.
- the pitch of the adjacent portions along the axis A of the spiral convex portion 22 provided in the tapered portion 24 is set to the axis A of the spiral convex portion 22 provided in the base end portion 23 and the distal end portion 25. It is comprised smaller than the pitch of the part adjacent along.
- the frictional resistance with the object eg, digestive tract such as stomach, liver
- the propulsive force in the taper portion 24 can be made larger than the propulsive force in the base end portion 24 and the distal end portion 25 of the dilator 20, and the hole can be easily expanded.
- FIG. 4 is a partial cross-sectional view of the tip side portion of the dilator 30 according to the fourth embodiment of the present invention.
- the left side in the figure is the distal end side (distal side) to be inserted into the body
- the right side is the proximal end side (hand side, proximal side) operated by an operator such as a doctor.
- the dilator 30 includes a shaft 31, a spiral convex portion 32, and a connector 9 (see FIG. 3) connected to the base end of the shaft 31.
- the material which comprises the shaft 31 and the helical convex part 32 is the same as the material which comprises the shaft 21 and the helical convex part 22 of the dilator 20 of 3rd Embodiment.
- the shaft 31 has a hollow shape in which a lumen 31A penetrating from the proximal end to the distal end is formed.
- the shaft 31 has a base end portion 33 and a taper portion 34.
- the dilator 30 of the present embodiment is different in configuration from the dilator 20 of the third embodiment in that it does not have a tip portion.
- the configurations of the base end portion 33 and the taper portion 34 are the same as the base end portion 23 and the taper portion 24 of the second embodiment.
- the spiral convex portion 32 is provided on the outer peripheral surface 31 ⁇ / b> B of the shaft 31 so as to protrude to the outside (the outermost surface and the outermost surface of the dilator 30).
- the spiral convex portion 32 is provided in the distal end side portion of the base end portion 33 and the tapered portion 34, and has a gap in a portion adjacent along the axial direction of the shaft 31. That is, the adjacent portions of the spiral convex portion 32 are separated from each other.
- the spiral convex portion 32 is integrally formed with the shaft 31 by casting or the like.
- the pitch of the adjacent portions along the axis A of the spiral convex portion 32 provided on the tapered portion 34 is the pitch of the adjacent portion along the axis A of the spiral convex portion 32 provided on the base end portion 33. It is configured smaller than the pitch. That is, the portions adjacent to each other along the axis A of the spiral convex portion 32 are configured such that L31> L32 when the pitch at the base end portion 33 is L31 and the pitch at the tapered portion 34 is L32. Yes.
- each pitch in the base end part 33 may be equal, and may differ.
- Each pitch in the taper part 34 may be equal, and may differ.
- a spiral convex portion 32 that protrudes to the outside is provided on the outer peripheral surface 31 ⁇ / b> B of the shaft 31, and the spiral convex portion 32 is adjacent to the portion along the axis A of the shaft 31. Has a gap.
- the dilator can be advanced not only by a pushing operation as in the prior art but also by a rotating operation by the spiral convex portion 32.
- the pitch of the adjacent portions along the axis A of the spiral convex portion 32 provided on the tapered portion 34 is adjacent along the axis A of the spiral convex portion 32 provided on the base end portion 33. It is configured smaller than the pitch of the part.
- FIG. 5 is a partial cross-sectional view of a tip side portion of a dilator 40 according to a fifth embodiment of the present invention.
- the left side in the figure is the distal end side (distal side) to be inserted into the body
- the right side is the proximal end side (hand side, proximal side) operated by an operator such as a doctor.
- the same reference number is attached
- the dilator 40 includes a shaft 21, a spiral convex portion 42, and a connector 9 (see FIG. 3) connected to the base end of the shaft 41.
- the spiral convex portion 42 is provided on the outer peripheral surface 21B of the shaft 21 so as to protrude to the outside (the outermost surface and the outermost surface of the dilator 40).
- the spiral convex portion 42 is provided at the distal end side portion of the base end portion 23, the tapered portion 24, and the distal end portion 25, and has a gap in a portion adjacent along the axial direction of the shaft 21. That is, the adjacent portions of the spiral convex portion 42 are separated from each other.
- the spiral convex portion 42 is integrally formed with the shaft 21 by casting or the like.
- the pitch of adjacent portions along the axis A of the spiral convex portion 42 provided on the tapered portion 24 is along the axis A of the spiral convex portion 42 provided on the base end portion 23 and the distal end portion 25. It is comprised larger than the pitch of an adjacent part. That is, when the pitch of the proximal end portion 23 is L41, the pitch of the taper portion 24 is L42, and the pitch of the distal end portion 25 is L43 for portions adjacent along the axis A of the spiral convex portion 42, L41, It is comprised so that it may become L43 ⁇ L42.
- tip part 25 may be equal, and may differ.
- Each pitch in the taper part 24 may be equal or different.
- the dilator 40 of the present embodiment can be advanced not only by a pushing operation as in the prior art but also by a rotating operation by the spiral convex portion 42.
- the pitch of the adjacent portions along the axis A of the spiral convex portion 42 provided in the tapered portion 24 is set to the axis A of the spiral convex portion 42 provided in the base end portion 23 and the distal end portion 25. It is comprised larger than the pitch of the part adjacent along.
- the taper portion 24 of the shaft 21 is more resistant to friction with the object (eg, gastrointestinal tract such as the stomach, liver) than the proximal end portion 23 and the distal end portion 25. Get smaller. As a result, it is possible to suppress damage to the object due to biting into the object when the hole is expanded.
- FIG. 6 is a partial cross-sectional view of a tip side portion of a dilator 50 according to a sixth embodiment of the present invention.
- the left side in the figure is the distal end side (distal side) to be inserted into the body
- the right side is the base end side (hand side, proximal side) operated by an operator such as a doctor.
- the same reference number is attached
- the dilator 50 includes a shaft 31, a spiral convex portion 52, and a connector 9 (see FIG. 3) connected to the base end of the shaft 31.
- the spiral convex portion 52 is provided on the outer peripheral surface 31B of the shaft 31 so as to protrude outward (outermost surface, outermost surface of the dilator 50).
- the spiral convex portion 52 is provided in the distal end side portion of the base end portion 33 and the tapered portion 34, and has a gap in a portion adjacent along the axial direction of the shaft 31. That is, the adjacent portions of the spiral convex portion 52 are separated from each other.
- the spiral convex portion 52 is integrally formed with the shaft 31 by casting or the like.
- the pitch of the adjacent portions along the axis A of the spiral convex portion 52 provided in the tapered portion 34 is the pitch of the adjacent portion along the axis A of the spiral convex portion 52 provided in the base end portion 33. It is configured to be larger than the pitch. That is, the portions adjacent to each other along the axis A of the spiral convex portion 52 are configured such that L51 ⁇ L52 when the pitch at the base end portion 33 is L51 and the pitch at the tapered portion 34 is L52. Yes.
- each pitch in the base end part 33 may be equal, and may differ.
- Each pitch in the taper part 34 may be equal, and may differ.
- the dilator 50 of the present embodiment can be advanced not only by a pushing operation as in the prior art but also by a rotating operation by the spiral convex portion 52.
- the pitch of the adjacent portions along the axis A of the spiral convex portion 52 provided in the tapered portion 34 is adjacent along the axis A of the spiral convex portion 52 provided in the base end portion 33. It is comprised larger than the pitch of a part.
- the frictional resistance with the object eg, gastrointestinal tract such as stomach, liver
- the frictional resistance with the object becomes smaller in the tapered portion 34 of the shaft 31 than in the proximal end portion 33.
- the first coil 3 has been described as a hollow coil body composed of 10 strands.
- the number of strands is not limited to 10, but 1 or a plurality of strands. It may be.
- the second coil 5 has been described as a hollow coil body composed of one strand.
- the number of strands is not limited to one, but one or a plurality of strands. It may be.
- the foremost portion 6 of the second embodiment is formed by pouring a brazing material into the tip of the multilayer body 17, but the second coil 5 and / or the first coil near the tip of the multilayer body 17. 3 may be polished to form the most advanced portion 6 having a flat surface.
- a most advanced part 6 of 2nd Embodiment shall adhere to the front-end
- a most advanced part is the front-end
- the outer circumferences of the multilayer bodies 7 and 17 of the first and second embodiments and the shafts 21 and 31 and the spiral convex portions 22, 32, 42, and 52 of the third to sixth embodiments may be coated with resin.
- resin Good.
- the outer periphery of the shaft 21 and the spiral convex portion 22 of the dilator 20 of the third embodiment may be coated with a resin 26.
- the resin 26 can improve slipperiness and suppress biting of living tissue.
- the outer periphery of the shaft 21 is coated with the resin 26, the base end portion 23, the taper portion 24, and the tip portion 25 are coated with the resin 26.
- the protruding portion corresponds to the spiral convex portion 22.
- the resin 26 examples include biocompatible resin materials such as polyamide resin and fluororesin, and hydrophilic coating materials, and the thickness is, for example, 0.1 to 300 ⁇ m.
- biocompatible resin materials such as polyamide resin and fluororesin, and hydrophilic coating materials
- the thickness is, for example, 0.1 to 300 ⁇ m.
- the shafts 21 and 31 and the spiral convex portions 22, 32, 42, and 52 are integrally configured, they may be configured separately.
- the pitch of the adjacent portions along the axis A of the spiral convex portion 22 provided in the tapered portion 24 is: The pitch is configured to be smaller than the pitch of adjacent portions along the axis A of the spiral convex portion 22 provided at the base end portion 23 and the tip end portion 25.
- the pitch (L21, L22) of adjacent portions along the axis A of the spiral convex portion 22 provided at the taper portion 24 and the base end portion 23 is provided at the distal end portion 25. You may comprise smaller than the pitch (L23) of the part which adjoins along the axis
- L23> L21, L22 may be configured.
- tip part 25 may be equal, and may differ.
- Each pitch in the taper part 24 and the base end part 23 may be equal, and may differ.
- pitches (L22, L23) of adjacent portions along the axis A of the spiral convex portion 22 provided at the tapered portion 24 and the distal end portion 25 are provided at the proximal end portion 23.
- You may comprise smaller than the pitch (L21) of the part which adjoins along the axis
- each pitch in the base end part 23 may be equal, and may differ.
- tip part 25 may be equal, and may differ.
- the pitch of the adjacent portions along the axis A of the spiral convex portion 42 provided in the tapered portion 24 is The pitch is larger than the pitch of adjacent portions along the axis A of the spiral convex portion 42 provided at the base end portion 23 and the tip end portion 25.
- the pitch (L42, L43) of the adjacent portions along the axis A of the spiral convex portion 22 provided at the tapered portion 24 and the distal end portion 25 is provided at the proximal end portion 23.
- You may comprise larger than the pitch (L41) of the part which adjoins along the axis
- each pitch in the base end part 23 may be equal, and may differ.
- tip part 25 may be equal, and may differ.
- pitches (L41, L42) of adjacent portions along the axis A of the spiral convex portion 22 provided at the taper portion 24 and the base end portion 23 are provided at the distal end portion 25. It may be smaller than the pitch (L43) of the adjacent portions along the axis A of the spiral convex portion 22 formed. That is, it may be configured such that L41, L42> L43.
- tip part 25 may be equal, and may differ.
- Each pitch in the taper part 24 and the base end part 23 may be equal, and may differ.
- the frictional resistance with the object eg, digestive tract such as stomach, liver
- the object eg, digestive tract such as stomach, liver
- the shaft may have various coatings on the side of its surface (including a portion between the shaft and the spiral convex portion).
- the coating include a protective film (representative example, plating film) on the surface of the shaft, and a base film for improving the adhesion between the shaft and the spiral convex portion.
- the spiral convex portion does not constitute a blade.
- the dilator of this embodiment expands a hole formed in advance in an object (eg, a digestive tract wall such as a stomach of a patient). Therefore, if the spiral convex portion constitutes the blade, the living tissue on the inner surface of the hole is damaged.
- the spiral convex portion has an acute corner at the end portion on the radially outer side of the shaft of the cross-sectional shape (for example, the cross-sectional shape orthogonal to the spiral direction of the spiral convex portion shown in FIG. 3). It is preferable not to have. That is, it is preferable that the said edge part has the site
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Abstract
Description
<第1実施形態>
本発明の第1実施形態について、図面を参照しつつ説明する。
図1は、本発明の第1実施形態に係るダイレータ1の全体図である。
また、図1において、図示左側が体内に挿入される先端側(遠位側)、右側が医師等の手技者によって操作される基端側(手元側、近位側)である。
図2は、第2実施形態に係るダイレータ10の先端側部分を示す図である。
また、図2において、図示左側が体内に挿入される先端側(遠位側)、右側が医師等の手技者によって操作される基端側(手元側、近位側)である。
図3は、第3実施形態に係るダイレータ20の全体図である。
また、図3において、図示左側が体内に挿入される先端側(遠位側)、右側が医師等の手技者によって操作される基端側(手元側、近位側)である。
図4は、本発明の第4実施形態に係るダイレータ30の先端側部分の一部断面図である。
また、図4において、図示左側が体内に挿入される先端側(遠位側)、右側が医師等の手技者によって操作される基端側(手元側、近位側)である。
図5は、本発明の第5実施形態に係るダイレータ40の先端側部分の一部断面図である。
また、図5において、図示左側が体内に挿入される先端側(遠位側)、右側が医師等の手技者によって操作される基端側(手元側、近位側)である。なお、第3実施形態と同一の部材については同一の参照番号を付して説明を省略する。
図6は、本発明の第6実施形態に係るダイレータ50の先端側部分の一部断面図である。
また、図6において、図示左側が体内に挿入される先端側(遠位側)、右側が医師等の手技者によって操作される基端側(手元側、近位側)である。なお、第4実施形態と同一の部材については同一の参照番号を付して説明を省略する。
3 第1コイル
3A、21B、31B 外周面
5 第2コイル
9 コネクタ
21、31 シャフト
22、32、42、52 螺旋状の凸部
3D、24、34 テーパ部
3C、23、33 基端部
L1、L2、L3、L11、L12、L13、L21、L22、L23、L31、L32、L33、L41、L42、L43 ピッチ
Claims (6)
- 中空状のシャフトと、
前記シャフトの基端に設けられた把持部と、を備えるダイレータであって、
前記シャフトは、
先端の外径が基端の外径よりも小さいテーパ部と、
前記テーパ部の先端側に設けられ先端側へ延びる先端部および前記テーパ部の基端側に設けられ基端側へ延びる基端部と、または、前記先端部を有さずに、前記テーパ部の基端側に設けられ基端側へ延びる基端部と、を有し、
前記シャフトの外周面に、螺旋状の凸部が設けられ、
前記螺旋状の凸部は、前記シャフトの軸に沿って隣り合う部分に隙間を有し、
前記シャフトが前記先端部を有しない場合、前記テーパ部に設けられた前記螺旋状の凸部の前記軸に沿って隣り合う部分のピッチは、前記基端部に設けられた前記螺旋状の凸部の前記軸に沿って隣り合う部分のピッチよりも小さく、
前記シャフトが前記先端部を有する場合、前記テーパ部に設けられた前記螺旋状の凸部の前記軸に沿って隣り合う部分のピッチは、前記先端部または前記基端部に設けられた前記螺旋状の凸部の前記軸に沿って隣り合う部分のピッチよりも小さいダイレータ。 - 前記シャフトが前記先端部を有する場合、
前記テーパ部に設けられた前記螺旋状の凸部の前記軸方向に沿って隣り合う部分のピッチは、前記先端部に設けられた前記螺旋状の凸部の前記軸方向に沿って隣り合う部分のピッチよりも小さく、かつ、前記基端部に設けられた前記螺旋状の凸部の前記軸方向に沿って隣り合う部分のピッチよりも小さい請求項1に記載のダイレータ。 - 前記シャフトが、素線を中空形状に巻き回した第1コイルから構成される請求項1または請求項2に記載のダイレータ。
- 前記螺旋状の凸部が、素線を前記シャフトの外周面に巻き回した第2コイルから構成される請求項1から請求項3のいずれか一項に記載のダイレータ。
- 前記シャフトが、素線を中空形状に巻き回した第1コイルからなり、前記螺旋状の突部が、素線を前記シャフトの外周面に巻き回した第2コイルからなり、
前記第1コイル及び前記第2コイルの各素線が互いに反対向きに巻き回されている請求項1または請求項2に記載のダイレータ。 - 中空状のシャフトと、
前記シャフトの基端に設けられた把持部と、を備えるダイレータであって、
前記シャフトは、
先端の外径が基端の外径よりも小さいテーパ部と、
前記テーパ部の先端側に設けられ先端側へ延びる先端部および前記テーパ部の基端側に設けられ基端側へ延びる基端部と、または、前記先端部を有さずに、前記テーパ部の基端側に設けられ基端側へ延びる基端部と、を有し、
前記シャフトの外周面に、螺旋状の凸部が設けられ、
前記螺旋状の凸部は、前記シャフトの軸に沿って隣り合う部分に隙間を有し、
前記シャフトが前記先端部を有しない場合、前記テーパ部に設けられた前記螺旋状の凸部の前記軸に沿って隣り合う部分のピッチは、前記基端部に設けられた前記螺旋状の凸部の前記軸に沿って隣り合う部分のピッチよりも大きく、
前記シャフトが前記先端部を有する場合、前記テーパ部に設けられた前記螺旋状の凸部の前記軸に沿って隣り合う部分のピッチは、前記先端部または前記基端部に設けられた前記螺旋状の凸部の前記軸に沿って隣り合う部分のピッチよりも大きいダイレータ。
Priority Applications (11)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP18771309.4A EP3603548B1 (en) | 2017-03-24 | 2018-03-23 | Dilator |
KR1020197030762A KR102305196B1 (ko) | 2017-03-24 | 2018-03-23 | 다일레이터 |
CN201880010385.6A CN110290755B (zh) | 2017-03-24 | 2018-03-23 | 扩张器 |
JP2019507021A JP6588678B2 (ja) | 2017-03-24 | 2018-03-23 | ダイレータ |
EP18910592.7A EP3769702B1 (en) | 2017-03-24 | 2018-09-21 | Dilator |
JP2019508990A JP6588679B1 (ja) | 2018-03-23 | 2018-09-21 | ダイレータ |
CN201880091517.2A CN111970982B (zh) | 2017-03-24 | 2018-09-21 | 扩张器 |
PCT/JP2018/035089 WO2019181012A1 (ja) | 2017-03-24 | 2018-09-21 | ダイレータ |
JP2019166194A JP7344059B2 (ja) | 2017-03-24 | 2019-09-12 | ダイレータ |
US16/580,301 US11331459B2 (en) | 2017-03-24 | 2019-09-24 | Dilator |
US17/029,562 US20210001097A1 (en) | 2017-03-24 | 2020-09-23 | Dilator |
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JP2017012024 | 2017-03-24 |
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US16/580,301 Continuation US11331459B2 (en) | 2017-03-24 | 2019-09-24 | Dilator |
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PCT/JP2018/011672 WO2018174241A1 (ja) | 2017-03-24 | 2018-03-23 | ダイレータ |
PCT/JP2018/011671 WO2018174240A1 (ja) | 2017-03-24 | 2018-03-23 | ダイレータ |
PCT/JP2018/011674 WO2018174243A1 (ja) | 2017-03-24 | 2018-03-23 | ダイレータ |
PCT/JP2018/035088 WO2019181011A1 (ja) | 2017-03-24 | 2018-09-21 | ダイレータ |
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PCT/JP2018/011674 WO2018174243A1 (ja) | 2017-03-24 | 2018-03-23 | ダイレータ |
PCT/JP2018/035088 WO2019181011A1 (ja) | 2017-03-24 | 2018-09-21 | ダイレータ |
PCT/JP2018/035089 WO2019181012A1 (ja) | 2017-03-24 | 2018-09-21 | ダイレータ |
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EP (6) | EP3603551A4 (ja) |
JP (10) | JP6588676B2 (ja) |
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