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WO2003092783A1 - Dispositif guide a tube a demeure - Google Patents

Dispositif guide a tube a demeure Download PDF

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Publication number
WO2003092783A1
WO2003092783A1 PCT/JP2003/005581 JP0305581W WO03092783A1 WO 2003092783 A1 WO2003092783 A1 WO 2003092783A1 JP 0305581 W JP0305581 W JP 0305581W WO 03092783 A1 WO03092783 A1 WO 03092783A1
Authority
WO
WIPO (PCT)
Prior art keywords
tube
indwelling tube
indwelling
stent
guide
Prior art date
Application number
PCT/JP2003/005581
Other languages
English (en)
Japanese (ja)
Inventor
Hiroaki Goto
Takaaki Komiya
Yoshimitsu Inoue
Original Assignee
Olympus Corporation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Corporation filed Critical Olympus Corporation
Priority to JP2004500964A priority Critical patent/JPWO2003092783A1/ja
Priority to DE10392575T priority patent/DE10392575T5/de
Publication of WO2003092783A1 publication Critical patent/WO2003092783A1/fr
Priority to US10/977,650 priority patent/US20050085892A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/94—Stents retaining their form, i.e. not being deformable, after placement in the predetermined place
    • 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
    • A61M25/0017—Catheters; Hollow probes specially adapted for long-term hygiene care, e.g. urethral or indwelling catheters to prevent infections
    • 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
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2002/041—Bile ducts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0091—Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
    • 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
    • A61M2025/0681—Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube

Definitions

  • the present invention relates to an indwelling tube guide device used for performing an operation of inserting an indwelling tube into a body cavity of a patient and performing indwelling using an endoscope.
  • the following treatment is performed as a treatment for discharging bile and the like accumulated in the bile duct. That is, the stent serving as an indwelling tube is guided to the stenotic part of the bile duct through the channel of the endoscope, and the stent is indwelled in the stenotic part. In this state, the bile collected in the bile duct is drained through the lumen of the stent.
  • the stent is made of a polymer material such as polyethylene or silicone rubber. It is a flexible hollow pipe. Flaps facing each other are provided on the outer peripheral portions near both ends of the station to prevent removal.
  • the procedure for guiding the stent configured as described above into the body cavity endoscopically and placing it in the stenosis of the bile duct is performed in the following procedure. That is, as shown in FIG. 23A, a long guide wire 3 made of a flexible wire is previously inserted into the forceps channel 2 provided in the insertion section 4 of the endoscope 1. In this state, the guide wire 3 is guided to the bile duct 5 together with the insertion section 4 of the endoscope 1. Next, the guide wire 3 is advanced by the operation on the hand side to pass through the stenosis 6. Thereafter, as shown in FIG. 23B, the guide wire 3 that has passed through the stenosis portion 6 is used as a guide, and the stent 7 is pushed in by the pusher tube 8, enters the stenosis portion 6, and is left.
  • the stenosis 6 is located deep within the body cavity. Therefore, the stenosis 6 cannot be directly observed with the endoscope 1.
  • the stenosis 6 is treated under radiography. In this case, when the stent 7 is pushed into the stenosis 6 by the pusher tube 8, the stent 7 may be pushed too far. The state 7 and the pusher tube 8 are not connected. For this reason, if the pusher tube 8 is pulled back as shown by the arrow in FIG. 23B when the state 7 is pushed too much, the state 7 cannot be pulled back. There is inconvenience.
  • Patent Document 2 a train catheter delivery system disclosed in US Pat. No. 5,921,952 (Patent Document 2) was developed.
  • the pusher tube and the stent are connected by a thread. If the pusher tube is pulled back when the stent is pushed in too much, the stent can be pulled back through the thread.
  • a through hole for passing a thread is provided at a distal end of a pusher tube.
  • the stall has an opening that is opened by forming a flap. Then, a thread (soil) entangled with the guide wire is led out from the opening of the stent. Next, pass the thread through the through hole of the pusher tube. It is linked by tying.
  • the stent can be pulled back through the thread.
  • the guide wire is pulled back.
  • the distal end of the guide wire comes off the entangled portion with the yarn, the yarn is pulled out by the stent force.
  • the stent and the pusher tube are separated from each other.
  • the present invention has been made in view of the above circumstances, and the purpose thereof is to allow the indwelling tube to be pulled back even if it is excessively pushed in during the operation of indwelling the indwelling tube. Even if the bending strength of the indwelling tube is high and the bending angle of the bending portion of the endoscope is large, the indwelling tube can be pushed forward to the target site, and furthermore, when the liquid is sent, liquid leakage may occur.
  • An object of the present invention is to provide an indwelling tube guide device without fear.
  • the present invention relates to an indwelling tube guide device, an indwelling tube, a guide member having at least a distal portion insertable into the indwelling tube, and having a lumen, and a lumen of the indwelling tube.
  • a locking part inserted between the guide member and the guide member to lock the indwelling tube in a detachable manner, and at least a part of a lumen of the guide member.
  • a piercing portion that penetrates, a traction member that traction-operates the indwelling tube when the locking portion and the indwelling tube are engaged, and moves the traction member in an axial direction of the guide member.
  • the locking member connected to the distal portion of the traction member is positioned in an engaged state between the indwelling tube and the guide member. Therefore, by moving the guide member forward, the indwelling tube can be approached and indwelled at the target site. If the indwelling tube is pushed too far, the indwelling tube can be pulled back by retracting the traction member in the proximal direction.
  • the engaging state between the locking member and the indwelling tube is released by pulling the traction member in the proximal direction while holding the guide member, and placing the indwelling tube.
  • the tube can be placed at the target site. Further, since the distal portion of the guide member penetrates through the lumen of the indwelling tube, the indwelling tube can be pushed to the target site following the bending of the bending portion of the endoscope.
  • FIG. 1A is a side view showing the entire indwelling tube guide device according to the first embodiment of the present invention.
  • FIG. 1B is a longitudinal sectional view of a distal end portion of the indwelling tube guide device according to the first embodiment. ⁇ —
  • FIG. 2A is a side view in which a part of an indwelling tube guide device according to a second embodiment of the present invention is cut away.
  • FIG. 2B is a cross-sectional view taken along the line IIB-IB of FIG. 2A.
  • Fig. 2C is a cross-sectional view taken along the line IIC-ICC in Fig. 2A.
  • FIG. 2D is a side view of the indwelling tube guide device according to the second embodiment.
  • FIG. 3A is a longitudinal sectional view showing a distal end portion of an indwelling tube guide device according to a third embodiment of the present invention.
  • Figure 3B shows the distal end of the indwelling tube guide device of Figure 3A. Side view.
  • FIG. 4A is a side view in which a part of an indwelling tube guide device according to a fourth embodiment of the present invention is cut away.
  • FIG. 4B is a cross-sectional view taken along the line IVB-IVB of FIG. 4A.
  • FIG. 4C is a cross-sectional view taken along the line IVC-IVC in FIG. 4A.
  • FIG. 4D is a side view of the indwelling tube guide device according to the fourth embodiment.
  • FIG. 5A is a side view showing a state where a part of the indwelling tube guide device according to the fourth embodiment is cut away to separate a flexible wire and a stent.
  • FIG. 5B is a side view showing a state in which the flexible wire and the stent of the indwelling tube guide device of the fourth embodiment are separated.
  • FIG. 6A is a longitudinal sectional view of a distal end showing a state in which a stent is indwelled in a stenosis by the indwelling tube guide device according to the fourth embodiment.
  • FIG. 6B is a longitudinal sectional view of a main part showing a modification of the indwelling tube guide device of the fourth embodiment.
  • FIG. 6C is a longitudinal sectional view showing a state where the flexible wire of the indwelling tube guide device of FIG. 6B is pushed.
  • FIG. 7 is a side view showing an indwelling tube guide device according to a fifth embodiment of the present invention.
  • FIG. 8A is a longitudinal sectional view showing a distal end portion of an indwelling tube guide device according to a sixth embodiment of the present invention.
  • FIG. 8B is a longitudinal sectional view of a main part showing a first modification of the indwelling tube guide device according to the sixth embodiment.
  • FIG. 8C is a longitudinal sectional view of a main part showing a second modification of the indwelling guide device according to the sixth embodiment.
  • FIG. 8D is a longitudinal cross-sectional view of a main part showing a third modification of the indwelling guide device according to the sixth embodiment.
  • FIG. 8E is a longitudinal sectional view of a main part showing a fourth modification of the indwelling tube guide device of the sixth embodiment.
  • FIG. 8F is a longitudinal sectional view of a main part showing a fifth modification of the indwelling guide device according to the sixth embodiment.
  • FIG. 8G is a longitudinal sectional view of a main part showing a sixth modification of the indwelling tube guide device of the sixth embodiment.
  • FIG. 8H is a longitudinal sectional view of a main part showing a seventh modification of the indwelling tube guide device of the sixth embodiment.
  • FIG. 8I is a longitudinal sectional view of an essential part showing an eighth modification of the indwelling tube guide device of the sixth embodiment.
  • FIG. 9 is a side view in which a part of an indwelling tube guide device according to a seventh embodiment of the present invention is cut away.
  • FIG. 10 is a plan view showing a state in which the stent and the locking member of the indwelling tube guide device according to the seventh embodiment are engaged.
  • FIG. 11A is a longitudinal sectional view showing a state where a locking member of the indwelling tube guide device according to the seventh embodiment is set at a position where the locking member is engaged with a stent.
  • FIG. 11B is a longitudinal sectional view showing a state in which the locking member of the indwelling tube guide device according to the seventh embodiment is pushed forward and disengaged from the state.
  • FIG. 11C shows an indwelling tube guide device according to the seventh embodiment.
  • FIG. 6 is a longitudinal sectional view showing a state where the locking member of FIG.
  • FIG. 12 is an explanatory diagram illustrating an operation state of a locking member of the indwelling tube guide device according to the seventh embodiment.
  • FIG. 13A is a perspective view showing a state where a stent and a pusher tube are connected in an indwelling tube guide device according to an eighth embodiment of the present invention.
  • FIG. 13B is a perspective view showing a state where a stent and a pusher tube are separated in the indwelling tube guide device according to the eighth embodiment.
  • FIG. 13C is a longitudinal sectional view of a portion A in FIG. 13A.
  • FIG. 14 is a longitudinal sectional view of a connection portion between a stent and a pusher tube according to a ninth embodiment of the present invention.
  • FIG. 15 is a longitudinal sectional view of a connection portion between a stent and a pusher tube according to a tenth embodiment of the present invention.
  • FIG. 16A is a perspective view showing a state where the stent and the pusher tube are connected in the indwelling tube guide device according to the first embodiment of the present invention.
  • FIG. 16B is a perspective view showing a state in which the stent and the pusher tube in the device according to the first embodiment are separated.
  • FIG. 16C is a longitudinal sectional view of a portion B in FIG. 16A.
  • FIG. 17A is a cross-sectional view showing a state where the cylindrical member in the device according to the 12th embodiment of the present invention is press-fitted into the lumen of the stent and the pusher tube.
  • FIG. 17B is a cross-sectional view showing a modification of the stent of the first and second embodiments.
  • 18 is a perspective view showing a state in which the stent and the pusher tube are connected in the device according to the thirteenth embodiment of the present invention.
  • FIG. 19 is a longitudinal sectional view of a portion B in FIG.
  • FIG. 20 is a perspective view showing a state in which the stent and the pusher tube in the device of the thirteenth embodiment are separated.
  • FIG. 21A is a longitudinal sectional view of a main part showing a state in which a state and a pusher tube in the device according to the fourteenth embodiment of the present invention are connected.
  • FIG. 21B is a longitudinal cross-sectional view of a main part of the device according to the fourteenth embodiment, showing a state where the stud and the pusher tube are separated.
  • FIG. 22A is a longitudinal sectional view of a main part showing a state in which a stent and a pusher chip are connected in a modified example of the device of the fourteenth embodiment.
  • Fig. 22B is a longitudinal sectional view of a main part showing a state in which the stent and the pusher tube in Fig. 22A are separated.
  • FIG. 23A is an explanatory view for explaining a procedure for guiding a stent into a body cavity transendoscopically.
  • FIG. 23B is a view for explaining a state in which the stent is pushed in by the pusher tube, inserted into the stenosis, and left in place, and the best mode for carrying out the invention.
  • FIGS. 1A and 1B show an indwelling tube guide device according to a first embodiment.
  • the indwelling tube guide device of the present embodiment is provided with a long guide catheter 11 that can pass through a forceps channel of an endoscope (not shown).
  • the guide catheter 11 is formed of a flexible synthetic resin material, for example, a fluorine resin or a nylon resin.
  • the guide catheter 11 has a lumen 12 formed over the entire length.
  • a guide catheter cock 13 is provided at the proximal end of the guide catheter 11.
  • one small hole 14 is formed in the side wall near the distal end of the guide catheter 11.
  • a fixed ring 15 as an enlarged portion having a large outer diameter is fitted on the outer peripheral surface of the guide catheter 11 at a position corresponding to the small hole 14.
  • the fixing ring 15 is arranged so as to close a part of the small hole 14.
  • a hollow pipe-shaped stent 16 as an indwelling tube is provided on the outer peripheral surface of the guide catheter 11 on the distal side of the fixed ring 15. With the stent 16 fitted in the guide catheter 11, the small hole 14 of the guide catheter 11 is closed by the fixing ring 15 and the stent 16.
  • the stent 16 is made of a biocompatible resin such as, for example, polyethylene, fluorine resin, nylon resin, thermoplastic elastomer, silicon rubber and the like. It is desirable to coat a hydrophilic lubricant on the outer peripheral surface of the stent 16. The outer periphery near both ends of the stent 16 is attached to each other to prevent removal. Opposing flaps 17 are provided.
  • a guide wire 18 and a flexible wire 19 as a traction member are passed through the lumen 12 of the guide catheter 11.
  • the flexible wire 19 is made of a long metal wire. At least a part of the flexible wire 19 may be a linear body such as stainless steel, nickel, titanium alloy, nylon, liquid crystal polymer, or silk. Further, the flexible wire 19 may have a substantially rectangular cross section and a substantially circular diameter, and may have an enlarged portion at the distal end.
  • the guide wire 18 may be a long metal wire, a stranded wire, or a coil, particularly a metal having a superelastic property made of a nickel-titanium alloy. I like it.
  • the distal end of the guide 18 is tapered.
  • the proximal end of the guide wire 18 is led out of the guide catheter cock 13 to the outside.
  • the distal side of the flexible wire 19 is led out of the inner cavity of the guide catheter 11 to the outside of the guide catheter 11 through the small hole 14.
  • the distal end of the flexible wire 19 is press-fitted between the inner peripheral surface of the stent 16 and the outer peripheral surface of the guide catheter 11.
  • An operating ring 20 is provided at the proximal end of the flexible wire 19.
  • distal end of the flexible wire 19 is not necessarily
  • Pressure contact force that can be moved to the proximal side integrally with It only needs to be engaged to the extent that it is possible. For example, it is sufficient that about 5 mm or more in the axial direction of the flexible wire 19 is located in the stent 16.
  • the indwelling tube guide device of this embodiment is set as follows.
  • a flexible wire 19 is passed through the lumen 12 of the guide catheter 11 of the indwelling tube guide device, and the distal end thereof is led out from the small hole 14. Then, a stent 16 is fitted to the guide catheter 11 from its distal end. Further, the distal portion of the flexible wire 19 is press-fitted between the stent 16 and the guide catheter 11. As a result, as shown in FIG. 1B, the guide catheter 11, the stent 16 and the flexible wire 19 are set in a state where they are assembled.
  • the insertion portion of the endoscope is inserted into the body cavity in advance, and the distal end component disposed at the distal end of the insertion portion of the endoscope is guided to the vicinity of the bile duct.
  • the guide wire 18 is passed through the forceps channel of the endoscope inserted into the body. At this time, the guide wire 18 is advanced to guide the distal end of the guide wire 18 to the narrowed portion of the bile duct under observation using an endoscope and observation using X-rays.
  • the guide with stent 16 set The catheter 11 is passed through the guide wire 18, and the guide catheter 11 is passed through the forceps channel using the guide wire 18 as a guide.
  • the guide catheter 11 is advanced by a manual operation on the proximal end side of the guide catheter 11. Then, the guide catheter 11 is led out from the distal end component of the endoscope, and the guide catheter 11 and the stent 16 are passed through the stenosis.
  • the stent 16 is held in a state of being fitted to the guide catheter 11. Therefore, the bending strength of the stent 16 is high, and the stent 16 does not buckle even when the guide wire 18 is bent at a large bending angle. Then, the stent 16 can be advanced integrally with the guide catheter 11 and guided to the target site.
  • the stent 16 After the stent 16 is inserted into the stenosis by the guide catheter 11, observation by X-ray is performed. If it is confirmed by this X-ray observation that the stem 16 has been pushed too deeply, the work of pulling the stent 16 back to the proximal side is performed. During this operation, fingers should be placed on the operation ring 20 and pulled in the proximal direction. As a result, the stent 16 can be pulled back via the flexible wire 19, and the stent 16 can be reliably positioned and retained at a target portion.
  • the guide wire 18 is held in a state of being inserted into the guide catheter 11.
  • the distal end of this guidewire 18 remains at the stenosis. Therefore, it is possible to use the guide wire 18 as a guide to perform the following measures.
  • the guide catheter 11 has the lumen 12, it is also possible to feed or suck the liquid from the guide catheter cock 13.
  • the above configuration has the following effects. That is, in the indwelling tube guide device of the present embodiment, the stent 16 is fitted to the guide catheter 11, and furthermore, the flexible member is provided between the stent 16 and the guide catheter 11. The distal part of the sex wire 19 is press-fitted. As a result, as shown in FIG. 1B, the guide catheter 11, the stent 16 and the flexible wire 19 are set in a state where they are integrally assembled. ing. For this reason, when the stent 16 is placed in the constriction of the bile duct, even if the stent 16 is pushed too much, the stent 16 can be pulled back through the flexible wire 19 to the proximal side. And can be.
  • the stent 16 is held in a state of being fitted to the guide catheter 11. Therefore, even when the bending strength of the stent 16 is high and the bending angle of the bending portion of the endoscope is large, the stent 16 can be pushed forward to a target portion.
  • small holes 14 of guide catheter 11 are fixed rings 1 Since it is closed by 5 and the stent 16, there is no danger of the liquid leaking from the small holes 14 when feeding the liquid.
  • FIGS. 2A to 2D show a second embodiment of the present invention.
  • the same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • a stent 16 is externally fitted to the distal end of the guide catheter 11.
  • a pusher tube 21 is fitted to the outer peripheral surface of the guide catheter 11 on the proximal side of the stent 16 so as to be able to advance and retreat in the axial direction.
  • the pusher tube 21 is made of a synthetic resin material having flexibility.
  • a pusher tube cock 22 is provided at the proximal end of the pusher tube 21, .
  • a flexible wire 19 as a pulling member is passed between the outer peripheral surface of the guide catheter 11 and the inner peripheral surface of the pusher tube 21 so as to be able to advance and retreat in the axial direction.
  • the distal end of the flexible wire 19 is pressed and engaged between the inner peripheral surface of the stent 16 and the outer peripheral surface of the guide catheter 11.
  • the proximal end of the flexible wire 19 is led out of the pusher tube cock 22.
  • An operating ring 20 is provided at the proximal end of the flexible wire 19. '
  • the indwelling tube guide device is set as follows.
  • a flexible wire 19 is passed between the guide catheter 11 and the pusher tube 21 of the indwelling tube guide device.
  • the distal end of the flexible wire 19 is press-fitted between the stent 16 and the guide catheter 11.
  • the guide catheter 11, the stent 16, the flexible wire 19, and the pusher tube 21 are set in a state where they are assembled. Is done.
  • the guide wire 18 is passed through the forceps channel of the endoscope, and then the stent 16 is guided to the stenotic part of the bile duct via the guide catheter 11. It is. This method is the same as in the first embodiment. Then, in the present embodiment, the pusher tube 21 is advanced to pass the stent 16 to the stenosis.
  • X-ray observation is performed. If it is confirmed by this X-ray observation that the state 16 has been pushed too deeply, the work of returning the state 16 to the proximal side is performed. During this operation, fingers should be placed on the operation ring 20 and pulled in the proximal direction. As a result, the stent 16 can be pulled back via the flexible wire 19, and the stent 16 can be reliably positioned and retained at the target portion.
  • the guide catheter 11 has the lumen 12, it is possible to feed or suck the liquid from the guide catheter cock 13.
  • the stent 16 can be inserted through the flexible wire 19. 6 can be pulled back.
  • the stent 16 is held in a state of being fitted to the guide catheter 11. Further, since the distal portion of the flexible wire 19 is penetrated through the lumen of the stem 16, the bending strength of the stent 16 is high. Therefore, even when the bending angle of the bending portion of the endoscope is large, the stent 16 can be pushed to the target site by following the bending of the bending portion of the endoscope.
  • the flexible wire 19 is pulled in the proximal direction while the guide force table 11 is held. Disengage the distal end of the tube from the stent 16. This allows the stent 16 to be placed at the target site.
  • 3A and 3B show a third embodiment of the present invention.
  • the same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • a small-diameter portion 23a is formed at the tip.
  • a large-diameter portion 23 b is formed at the base end of the state 23.
  • the large diameter portion 23b is set to the same diameter as the pusher tube 21.
  • the distal end of the flexible wire 19 is pressed into and engaged between the inner peripheral surface of the large-diameter portion 23 b of the stem 23 and the outer peripheral surface of the guide catheter 11. Have been.
  • the small-diameter portion 2 is the small-diameter portion 2
  • FIGS. 4A to 6A show a fourth embodiment of the present invention.
  • a pusher tube 24 having a configuration different from that of the pusher tube 21 of the second embodiment (see FIGS. 2A to 2D) is provided.
  • the other portions have the same configuration as the second embodiment. Note that the same components as those of the second embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • a small diameter portion 24 a is provided at the distal end of the pusher tube 24. This small diameter part 2
  • the pusher tube 24 is provided with a step 24c between the small-diameter portion 24a and the large-diameter portion 24b on the proximal end side of the small-diameter portion 24a.
  • This step portion 24c is provided with a through hole 25. I have.
  • the distal end of the flexible wire 19 passed through the lumen of the pusher tube 24 is guided to the outside of the small diameter portion 24 a through the through hole 25.
  • the distal end of the flexible wire 19 is press-fitted and engaged between the inner peripheral surface of the stent 16 and the outer peripheral surface of the small diameter portion 24a.
  • a side hole 26 is provided on a side wall of the pusher tube 24.
  • the proximal end of the flexible wire 19 is led out from a side hole 26 of the pusher tube 24.
  • the indwelling tube guide device of this embodiment is set as follows.
  • a flexible wire 19 is passed through the lumen of the pusher tube 24, and its distal end is led out of the small diameter portion 24 a through the through hole 25. Subsequently, the state 16-is fitted to the small diameter portion 24 a at the distal end of the pusher tube 24. Then, as shown in FIG. 4B, the distal end of the flexible wire 19 is pressed into and engaged between the inner peripheral surface of the stent 16 and the outer peripheral surface of the small diameter portion 24a. I do. As a result, as shown in FIG. 4A, the pusher 24, the stent 16 and the flexible wire 19 are set in a state where they are assembled.
  • Step 24 c abuts the proximal end of stent 16.
  • the stent 16 passes through the stenosis.
  • the stent 16 is inserted into the stenosis by the pusher tube 24, observation by X-ray is performed. At this time, if it is confirmed by X-ray observation that the stage 16 has been pushed too deeply, the position of the stage 16 is pulled back to the proximal side. During this operation, fingers should be placed on the operation ring 20 and pulled in the proximal direction. Thus, the stent 16 can be pulled back via the flexible wire 19, and the stent 16 can be reliably positioned at the target portion.
  • the guide wire 18 is held in a state of being passed through the pusher tube 24.
  • the distal end of this guidewire 18 remains at the stenosis. Therefore, it is possible to use the guide wire 18 as a guide to perform the following measures.
  • the stent 16 can be kept at hand via the flexible wire 19. Pull back to the side I can do it.
  • the guide catheter 11 can be omitted, the cost can be reduced.
  • FIGS. 6B and 6C show modified examples of the indwelling tube guide device according to the fourth embodiment.
  • the guide wire 18 is inserted into the inside of the pusher tube 24 through the side hole 26 of the pusher tube 24.
  • FIG. 7 shows a fifth embodiment of the present invention.
  • the indwelling tube guide device of the fourth embodiment (see FIGS. 48 to 6) is modified as follows. Note that the same parts as those in the fourth embodiment are denoted by the same reference numerals, and description thereof is omitted.
  • the operation ring 20a is fitted to the proximal portion of the guide catheter 11 so as to be able to advance and retreat in the axial direction.
  • the proximal end of the flexible wire 19 passed through the pusher tube 24 is connected to the operation ring 20.
  • FIG. 8A shows a sixth embodiment of the present invention.
  • the same parts as those of the second embodiment are denoted by the same reference numerals, and description thereof will be omitted.
  • a bent portion 19c that is bent upward is provided at the distal end of the flexible wire 19. This bent part 19 c is pressed against the wall of stent 16 It was done.
  • FIG. 8B shows a first modification of the indwelling tube guide device according to the sixth embodiment.
  • a wavy bent portion 27 is provided at the distal end of the flexible wire 19. The wavy bent portion 27 is pressed against the inner wall of the stent 16.
  • FIG. 8C shows a second modification of the indwelling tube guide device according to the sixth embodiment.
  • an S-shaped bent portion 28 is provided at the distal end of the flexible wire 19.
  • the S-shaped bent portion 28 is pressed against the inner wall of the stent 16.
  • FIG. 8D shows a third modification of the indwelling tube guide device according to the sixth embodiment.
  • a widened portion 29 is provided by expanding the distal end of the flexible wire 19 in the width direction.
  • the widened portion 29 is pressed against the inner wall of the stage 16.
  • FIG. 8E shows a fourth modification of the indwelling tube guide device according to the sixth embodiment.
  • one flexible wire 19 is bent inside the stent 1 & to provide a folded portion 30-and the folded portion 30 is pressed against the inner wall of the stent 16. Things.
  • FIG. 8F shows a fifth modification of the indwelling tube guide device according to the sixth embodiment.
  • a meandering portion 31 is provided at the distal end of the flexible wire 19. This meandering part 31 is pressed against the inner wall of the state 16.
  • FIG. 8G shows a sixth modification of the indwelling tube guide device of the sixth embodiment.
  • a wavy bent portion 32 that bends in the width direction in a wavy manner is provided at the distal end of the flexible wire 19. The wavy bent portion 32 is pressed against the inner wall of the stent 16.
  • FIG. 8H shows a seventh modification of the indwelling tube guide device according to the sixth embodiment. In this modification, a spiral portion 33 is provided at the distal end of the flexible wire 19. The spiral portion 33 is pressed against the inner wall of the stent 16.
  • FIG. 8I shows a first modification of the indwelling tube guide device of the sixth embodiment.
  • two flexible wires 19a and 19b are provided in parallel. The distal ends of the two flexible wires 19a and 19b are pressed against the inner wall of the stem 16.
  • FIGS. 9 to 12 show a seventh embodiment of the present invention.
  • This embodiment is a modification of the indwelling tube guide device of the second embodiment (see FIGS. 2A to 2D) as follows. Note that, in the indwelling tube guide device of the present embodiment, the same portions as those of the second embodiment are denoted by the same reference numerals, and description thereof will be omitted.
  • the stent 16 of the indwelling tube guide device of the present embodiment has an opening 17a formed by a flap 17 on the front end side as shown in FIG.
  • a locking member 42 is provided at the tip of the flexible wire 19 as a pulling member.
  • the locking member 42 is provided with a plate spring-shaped locking plate 43.
  • the locking plate 43 has a spring characteristic, and for example, a substantially plate-shaped member made of stainless steel spring material is used.
  • the front end of the locking plate 43 is fixed to the front end of the flexible wire 19 by means such as a lip. Then, as shown in FIG. 9 and FIG. 10, the rear end of the lock ⁇ 43 It is detachably engaged while being inserted into the side hole 17 a formed by the tap 17.
  • the rear end of the locking plate 43 is inserted into the side hole 17 a of the stent 16 as shown in FIGS. 11A and 12. And set to the locked state.
  • the guide wire 18 is passed through the forceps channel of the endoscope similarly to the first embodiment, and then the stent 16 is stenotically constricted through the guide catheter 11. An operation leading to the department is performed. This method is the same as in the first embodiment.
  • the stent 16 passes through the stenosis by moving the pusher tube 21 forward.
  • X-ray observation is performed. If it is confirmed by this X-ray observation that the state 16 has been pushed too deeply, the work of returning the state of the state 16 to the proximal side is performed. — During this operation, put your finger on the operation ring 20 and pull it proximally. As a result, the stent 16 can be pulled back via the flexible wire 19, and the stent 16 can be reliably positioned and retained at the target portion.
  • the operating ring 20 is pushed in once. Thereby, the flexible wire 19 is pushed forward and operated. At this time, the locking plate 43 is detached from the side hole 41 of the state 16 due to the elastic deformation of the locking member 42. Then, as shown in FIG. 11B, the rear end of the locking plate 43 is pulled out from the side hole 41 of the stent 16. This and At this time, the locking plate 4 3 returns to its original shape that was immediately extended. Therefore, in this state, by pulling the flexible wire 19 backward, the locking plate 43 is moved to the side hole of the stent 16 as shown in FIG. 11C. It is pulled back over 4 1. As a result, the flexible wire 19 and the stent 16 are separated, and the stent 16 is placed in the stenosis.
  • the above configuration has the following effects. That is, in the present embodiment, the rear end of the locking plate 43 of the locking member 42 is inserted into the side hole 17a of the state 16 and is set to be locked. Is done. Therefore, when the stent 16 is indwelled in the constriction of the bile duct, even if the stent 16 is pushed too far, the stent 16 is pulled back through the flexible wire 19 to the hand side. it can.
  • the flexible wire 19 is connected across the state 16 and the pusher tube 21. Therefore, at the connection between the stent 16 and the pusher tube 21 Since the bending strength of the endoscope is high, buckling at the connection between the stem 16 and the pusher tube 21 is reduced even if the bending angle of the bending portion of the endoscope is large.
  • FIGS. 13A to 13C show an indwelling chip guide device according to an eighth embodiment of the present invention.
  • the indwelling tube guide device of the present embodiment is provided with a long guide catheter 111 that can pass through a forceps channel of an endoscope (not shown).
  • the guide catheter 111 is formed of a flexible synthetic resin material, for example, a fluorine-based resin or a nylon-based resin.
  • the guide catheter 111 has a lumen 112 formed over the entire length.
  • a guide catheter cock 113 is provided at the proximal end of the guide catheter 111.
  • a stent 114 is provided as an indwelling tube while being fitted to the guide catheter 111.
  • a pusher tube 1 15 is provided on the outer peripheral surface of the guide catheter 1 1 1 on the proximal side of the stent 1 1 4. The pusher tube 115 is held in a state fitted to the guide catheter 111.
  • the stent 114 is a relatively flexible hollow pipe made of a biocompatible polymer compound such as, for example, polyethylene or silicone rubber. It is desirable that the outer surface of the stent 114 be coated with a hydrophilic lubricant. Flaps 116 facing each other are provided on the outer peripheral portion near both ends of the stent 114 to prevent removal.
  • the pusher tube 115 is formed of a flexible synthetic resin material, for example, a fluorine-based resin or a nylon-based resin.
  • a pusher tube cock 117 is provided at the proximal end of the pusher tube 115.
  • the guide catheter 111 is guided through the lumen of the guide catheter 111 in the S-axis direction.
  • Guide wires 1 18 are made of long metal strands.
  • the distal end of the guidewire 1 18 is tapered and shaped.
  • the proximal end of guidewire 118 is led out of guidewire 113.
  • a cylinder as a connection mechanism spans the lumen at the proximal portion of the stent 114 and the lumen at the distal portion of the pusher tube 115.
  • Member 1 19 is press-fitted.
  • the stem 114 and the pusher tube 115 are detachably connected by the cylindrical member 119.
  • This cylindrical member 119 is formed of a synthetic resin material or a metal material.
  • a guide catheter 111 is passed through the lumen of the cylindrical member 119.
  • One end of an operation wire 120 as a releasing means is connected to a proximal end of the cylindrical member 1 19.
  • the other end of the operation wire 120 extends through the lumen of the pusher tube 115 to the vicinity of the pusher tube cock 117.
  • the pusher tube 115 near the pusher tube cock 117 has a side hole 121.
  • the operation wire 120 is led out of the side hole 122 and is connected to the operation ring 122. Therefore, the above configuration has the following effects. That is, according to the indwelling tube guide device configured as described above, the stent 114 and the pusher tube 115 are connected by the cylindrical member 119.
  • the stem 114 can move physically in the axial direction by the reciprocation of the pusher tuple 115 in the axial direction.
  • the cylindrical member 1 19 is press-fitted into the lumen of the stem 114 and the pusher tube 115. Therefore, the bending strength at the connection between the stent 114 and the pusher tube 115 is high. Thereby, even if the bending angle of the bending portion of the endoscope is large, the stent 114 can be pushed to the target portion without buckling at the connection portion.
  • the distal portion of the cylindrical member 119 becomes a stent. It escapes from the lumen of 114 and is pulled into the lumen of pusher tube 115. Therefore, the stent 114- and the pusher tube 115 are separated from each other.
  • the indwelling tube guide device of this embodiment is used, the indwelling tube guide device is set as follows.
  • the operation wire 120 is passed through the pusher tube 1 15. Subsequently, the proximal portion of the cylindrical member 119 is pressed into the lumen at the distal portion of the pusher tube 115. The operation wire 12 0 is connected to the cylindrical member 1 19.
  • a stent 114 is passed through the distal portion of the guide catheter 111.
  • the distal end of the cylindrical member 1 19 is press-fitted into the lumen of the stent 1 14 to abut the proximal end of the stent 1 14 with the distal end of the pusher tube 1 15 .
  • the pusher tube 115, the state 114, and the cylindrical member 119 are set in a state where they are assembled.
  • the insertion portion of the endoscope is inserted into the body cavity in advance, and the distal end component disposed at the distal end of the insertion portion of the endoscope is guided to the vicinity of the bile duct.
  • the guide wire 118 is passed through the forceps channel of the endoscope inserted into the body. At this time, based on the observation by the endoscope and the observation by X-ray, the guide wire 118 is advanced to guide the distal end of the guide wire 118 to the stenosis of the bile duct.
  • the guide catheter 111 in which the stent 114 and the pusher tube 115 are set is connected to the guide wire 118.
  • Communicate the guide catheter 111 is passed through the guide wire 111 from the proximal end of the guide wire 111, and the guide catheter 111 is passed through the forceps channel using the guide wire 118 as a guide.
  • the guide catheter 1 11 and the pusher tube 1 15 are advanced by a manual operation on the proximal end side of the guide catheter 1 1 1, and are drawn out from the distal end component of the endoscope.
  • the guide catheter 111 and the stent 114 are passed through the stenosis.
  • the stent 114 is fitted to the guide catheter 111, and the stent 114 and the pusher tube 114 are also fitted.
  • the cylindrical member 1 19 is press-fitted into the bore 15. Therefore, even if the guide wire 118 is bent at a large bending angle, it does not buckle, and the stent 114 moves forward integrally with the guide catheter 111 and the pusher tube 115. It can lead to the target site.
  • the stent 114 After the stent 114 is inserted into the stenosis by the guide catheter 111, observation by X-ray is performed. If the X-ray observation confirms that the stent 114 has been pushed too deep, pull the pusher tube 115 back proximally. As a result, the stent 114 can be pulled back through the cylindrical member 119, and the stent 114 can be reliably positioned and retained at the target portion.
  • the distal ends of the guide catheter 111 and the guide wire 118 are in a state of being inserted into the stenosis, so that the guide catheter 111 is used as a guide to send a contrast medium or the like. And use the guidewire 1 18 as a guide to perform the following steps: This is also possible.
  • FIG. 14 shows a ninth embodiment.
  • a part of the indwelling tube guide device of the eighth embodiment is modified as follows. Note that the same parts as those in the eighth embodiment are denoted by the same reference numerals, and description thereof will be omitted.
  • This embodiment is an embodiment that does not use the guide catheter 111 of the eighth embodiment. Therefore, in the present embodiment, the cost can be reduced by simplifying the configuration. Furthermore, the stent 114 and the pusher tube 115 can be made thinner, so that the stent 114 can be easily inserted when the stenosis is narrow. It is.
  • FIG. 15 shows a tenth embodiment of the present invention.
  • This embodiment is an embodiment in which the guide catheter 111 is not used.
  • a substantially cylindrical member as a connecting member is formed by the spiral body 123.
  • the distal part of the spiral body 123 is press-fitted into the lumen of the stent 114, and the proximal part is press-fitted into the lumen of the pusher tube 115.
  • the restoring force of the elastic deformation at the connection portion is excellent, and the buckling resistance of the connection portion can be further improved.
  • FIGS. 16A to 16C show a eleventh embodiment of the present invention.
  • the present embodiment is an embodiment in which the guide catheter 111 is not used.
  • the cylindrical member 124 is tightly fitted to the outer peripheral surface of the stent 114 and pusher tube 115, and is laid.
  • a side hole 125 is provided on the side wall of the distal portion of the pusher tube 115.
  • the operation wire 120 connected to the cylindrical member 124 is introduced into the lumen of the pusher tube 115 through the side hole 125.
  • the stent 114 is inserted into the stenosis, observation using X-rays is performed. If it is confirmed by this X-ray observation that the stage 114 has been pushed too deeply, the pusher tube 115 is pulled back to the proximal side. Thus, the stent 114 can be pulled back through the cylindrical member 124, and the stent 114 can be reliably positioned and retained at the target portion.
  • the cylindrical member 122 is moved through the operation wire 120. 4 is drawn into the outer peripheral surface of the pusher tube 1 15. Therefore, as shown in FIG. 16B, the distal portion of the cylindrical member 124 comes off the outer peripheral surface of the stent 114, and the stent 114 and the pusher tube 115 are separated. The stent 114 is left in the stenosis.
  • the inner diameter of the stent 114 and the pusher tube 115 has no built-in material, so that the diameter can be further reduced.
  • FIG. 17A shows a twelfth embodiment of the present invention.
  • the cylindrical member 1 19 as a connection mechanism of the indwelling tube guide device of the eighth embodiment is modified as follows.
  • the cylindrical member 1 2 6 of the present embodiment has a plurality of Uneven portions 127 are provided. Each concavo-convex portion 127 extends in the axial direction of the cylindrical member 126. Then, the cylindrical member 126 of the present embodiment is press-fitted into the lumen of the stent 114 and the pusher tube 115. In this case, the cylindrical member 1 26 and the pusher tube 1 15 are firmly pressed into the lumens of the S-state S 114 and the pusher tube 115 to be fixed.
  • FIG. 17B shows a modification of the cylindrical member 126 of the first embodiment.
  • a convex ridge portion 1229 is provided on a part of the outer peripheral surface of the cylindrical member 128 along the axial direction thereof.
  • the cylindrical member 128 of the present embodiment is press-fitted into the lumen of the stent 114 and the pusher tube 115.
  • the cylindrical member 128 is firmly pressed into the lumen of the stem 114 and the pusher tube 115.
  • FIGS. 18 to 20 show a thirteenth embodiment of the present invention.
  • the cylindrical member 124 of the first embodiment (see FIGS. 16A to 16C) is formed by a heat-shrinkable tube.
  • a recess 131 is provided on the outer peripheral surface of the stent 114 at a part of the covering portion of the cylindrical member 124.
  • a ball chip 13 2 is buried in the recess 13 1.
  • the pole tip 132 is connected to the tip of the operation wire 120.
  • the heat shrink tube of the cylindrical member 124 is covered with the pole tip 132 attached to the concave portion 131 of the stent 114, and the cylindrical member 124 and the stent 134 are covered.
  • the pole tip 13 2 is to be buried between the recess 14 and the recess 14 You.
  • the stent 114 and the pusher tube 115 are connected by the cylindrical member 124. Therefore, the state of the pusher tube 114 can be moved in the axial direction by moving the pusher tube 115 in the axial direction. Moreover, the cylindrical member 1 19 is covered so as to straddle the outer peripheral surfaces of the stent 114 and the pusher tube 1 15. Therefore, the bending strength at the connection between the stem 114 and the pusher tube 115 is high. Thus, even when the bending angle of the bending portion of the endoscope is large, the stent 114 can be pushed to the target portion without buckling at the connection portion.
  • the pole tip 13 2 becomes the cylindrical member 1 2 4 and the stain 1. It is pulled out from between the recessed portion 1 3 and the recessed portion 1 3.
  • the pusher tube 1 15 is pulled out of the bore of the cylindrical member 124 by pulling out the port 13 2 and the state 1 14 and the pusher tube are removed.
  • the stent 114 is left in the stenosis.
  • the same effects as in the eleventh embodiment can be obtained. Furthermore, in the present embodiment, in particular, when the stent 114 and the pusher tube 115 are separated, the separation is performed in a state where the cylindrical member 124 is connected to the stem 114. Is done. Therefore, when replacing the stem 114, the cylindrical part of the stem 114 is replaced. The part of the material 124 can be grasped, and the work of removing the stent 114 can be facilitated.
  • FIGS. 21A and 21B show a fifteenth embodiment of the present invention.
  • the cylindrical member 119 of the eighth embodiment (see FIGS. 13A to 13C) is formed by a shape memory alloy pipe.
  • the shape memory alloy pipe of this cylindrical member 119 expands to an outer diameter larger than that of the stent 114 as shown in Fig. 21A. Have been. At this time, the stent 114 and the pusher tube 115 are detachably connected by the cylindrical member 119.
  • the shape memory alloy pipe of the cylindrical member 1 19 is heated to a temperature higher than the reference temperature or cooled to a temperature lower than the reference temperature, for example, as shown in FIG. 21B.
  • the outer diameter is set so as to be deformed into a smaller diameter than the stent 1 14.
  • the stent 114 and the busher tube 115 can be separated by deforming the shape memory alloy pipe of the cylindrical member 119 into a reduced shape. You.
  • the shape memory alloy pipe of the cylindrical member 1 19 may be heated by electric heating.
  • FIGS. 22A and 22B show a modification of the fourteenth embodiment.
  • a coil-shaped locking member 141 is provided in place of the shape memory alloy pipe of the cylindrical member 119 of the fourteenth embodiment (see FIGS. 21A and 21B). Have been.
  • the material 14 1 is formed by a spiral body of a shape memory alloy.
  • the shape memory alloy of the locking member 141 is expanded, for example, at room temperature (reference temperature) into a shape having an outer diameter larger than that of the stent 114 as shown in FIG. 22A. I have.
  • the stage 114 and the pusher tube 115 are separably connected by the locking member 141.
  • the shape memory alloy of the locking member 141 is heated to a temperature higher than the reference temperature or cooled to a temperature lower than the reference temperature, for example, as shown in FIG. 22B.
  • the outer diameter is set so that it can be deformed into a shape smaller than the diameter of the stains. Therefore, in the present embodiment, the stent 114 and the pusher tube 115 can be separated by deforming the shape memory alloy of the locking member 141 into a reduced shape. .
  • the present invention relates to the field of an indwelling tube guide device used for performing an operation of inserting an indwelling tube into a body cavity of a patient and performing indwelling using an endoscope. It is effective in the technical field of manufacturing and using this indwelling tube guide device.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Pulmonology (AREA)
  • Biophysics (AREA)
  • Epidemiology (AREA)
  • Urology & Nephrology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention concerne un dispositif qui comprend un tube à demeure (16, 114), un guide (11), un enclencheur (18, 119) introduit dans un espace entre le trou du tube à demeure (16, 114) et le guide (11) pour l'enclenchement libérable du tube à demeure (16, 114), et un pénétreur qui pénètre dans le trou du guide (11). Par ailleurs, un élément de traction (19, 120) tire le tube à demeure (16, 114) au moment de l'enclenchement entre l'enclencheur (19, 119) et le tube à demeure (16, 114), et un désenclencheur (20, 122) désenclenche l'enclencheur (19, 119) et le tube à demeure (16, 114).
PCT/JP2003/005581 2002-05-01 2003-05-01 Dispositif guide a tube a demeure WO2003092783A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
JP2004500964A JPWO2003092783A1 (ja) 2002-05-01 2003-05-01 留置チューブガイド装置
DE10392575T DE10392575T5 (de) 2002-05-01 2003-05-01 Stentabgabevorrichtung
US10/977,650 US20050085892A1 (en) 2002-05-01 2004-10-29 Stent delivery device

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
JP2002-129961 2002-05-01
JP2002129961 2002-05-01
JP2002-133127 2002-05-08
JP2002133127 2002-05-08

Related Child Applications (1)

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WO2003092783A1 true WO2003092783A1 (fr) 2003-11-13

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JP (1) JPWO2003092783A1 (fr)
DE (1) DE10392575T5 (fr)
WO (1) WO2003092783A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2010178869A (ja) * 2009-02-05 2010-08-19 Fujifilm Corp ドレナージチューブ
JPWO2015146321A1 (ja) * 2014-03-26 2017-04-13 オリンパス株式会社 ステントデリバリーシステム及び内視鏡システム
JP2021037080A (ja) * 2019-09-03 2021-03-11 シルックス株式会社 チューブステントデリバリーシステム

Citations (7)

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Publication number Priority date Publication date Assignee Title
JPH05220227A (ja) * 1991-04-03 1993-08-31 Olympus Optical Co Ltd 留置チューブ
JPH0737200U (ja) * 1993-12-21 1995-07-11 加藤発条株式会社 管状器官の治療具
JPH0838617A (ja) * 1994-07-29 1996-02-13 Honda Seiki Kk 排尿改善用体内留置器具の挿入器具及び挿入方法
JPH1176419A (ja) * 1997-09-03 1999-03-23 Asahi Optical Co Ltd 内視鏡用留置バスケット
US5895391A (en) * 1996-09-27 1999-04-20 Target Therapeutics, Inc. Ball lock joint and introducer for vaso-occlusive member
US5921952A (en) * 1997-08-14 1999-07-13 Boston Scientific Corporation Drainage catheter delivery system
JP2000152985A (ja) * 1998-11-20 2000-06-06 Olympus Optical Co Ltd 内視鏡用処置具

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH05220227A (ja) * 1991-04-03 1993-08-31 Olympus Optical Co Ltd 留置チューブ
JPH0737200U (ja) * 1993-12-21 1995-07-11 加藤発条株式会社 管状器官の治療具
JPH0838617A (ja) * 1994-07-29 1996-02-13 Honda Seiki Kk 排尿改善用体内留置器具の挿入器具及び挿入方法
US5895391A (en) * 1996-09-27 1999-04-20 Target Therapeutics, Inc. Ball lock joint and introducer for vaso-occlusive member
US5921952A (en) * 1997-08-14 1999-07-13 Boston Scientific Corporation Drainage catheter delivery system
JPH1176419A (ja) * 1997-09-03 1999-03-23 Asahi Optical Co Ltd 内視鏡用留置バスケット
JP2000152985A (ja) * 1998-11-20 2000-06-06 Olympus Optical Co Ltd 内視鏡用処置具

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2010178869A (ja) * 2009-02-05 2010-08-19 Fujifilm Corp ドレナージチューブ
JPWO2015146321A1 (ja) * 2014-03-26 2017-04-13 オリンパス株式会社 ステントデリバリーシステム及び内視鏡システム
JP2021037080A (ja) * 2019-09-03 2021-03-11 シルックス株式会社 チューブステントデリバリーシステム

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JPWO2003092783A1 (ja) 2005-09-08

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