WO2003092782A1

WO2003092782A1 - Indwelling tube guide device

Info

Publication number: WO2003092782A1
Application number: PCT/JP2003/005509
Authority: WO
Inventors: Hiroaki Goto; Takaaki Komiya; Yoshimitsu Inoue
Original assignee: Olympus Corporation
Priority date: 2002-04-30
Filing date: 2003-04-30
Publication date: 2003-11-13
Also published as: DE10392571T5; JPWO2003092782A1

Abstract

An indwelling tube guide device having a indwelling tube (14) and a pusher tube (15). The proximal portion of a linear member (20) is positioned closer to the proximal side than the indwelling tube (14) is. The distal portion of this linear member (20) is provided with an engaging member (21). By axially moving the guide member (11), the engaging member (21) is capable of moving from a first state in which it is engaged with the indwelling tube (14) to a second state in which it is disengaged from the indwelling tube (14).

Description

Specification

Indwelling tube guide device

Technical field

The present invention relates to an indwelling tube guide device used for inserting and placing an indwelling tube in a body cavity of a patient using an endoscope.

Background art

For example, the following treatment is performed as a treatment for draining bile and the like accumulated in the bile duct. First, the insertion section of the endoscope is inserted into a body cavity or the like in advance. The stent as an indwelling tube is guided to the stenotic part of the bile duct through the channel provided in the insertion part. The stent is then placed in the stenosis. The bile collected in the bile duct is drained through the lumen of this stent.

As shown in, for example, Japanese Utility Model Application Laid-Open No. 63-200854, the state is relatively flexible using a polymer compound such as polyethylene or silicone rubber as a material. It is a hollow pipe. Flaps facing each other are provided on the outer peripheral portion near both ends of this stent to prevent removal.

The procedure for guiding the stent configured as described above into the body cavity endoscopically and placing the stent in the constriction of the bile duct is performed in the following procedure.

As shown in FIG. 1 OA, a long guide wire 3 made of a flexible wire is inserted into a forceps channel 2 provided in an insertion portion 4 of the endoscope 1, and the guide wire is inserted. The guide 3 is guided to the bile duct 5 together with the insertion section 4 of the endoscope 1. Next, the guide wire 3 is operated by hand. Through the stenosis 6. Then, as shown by the arrow in FIG. 1 OA, from the proximal end of the guide wire 3, the stent 7 is inserted, and then the pusher tube 8 is inserted.

Next, as shown in FIG. 10B, the guide wire 3 having passed through the stenosis 6 is used as a guide, and the state 7 is pushed in by the pusher tube 8 so that the step is performed. Insert the implant 7 into the stenosis 6 and place it there.

The stenosis 6 cannot be observed with the endoscope 1 because it is located deep within the body cavity. Therefore, the procedure is generally performed under radiography. Here, when the stent 7 is pushed into the stenosis 6 by the pusher tube 8, it may be pushed too far. The force 7 and the pusher tube 8 are not connected to the stem 7. For this reason, as shown by the arrow in FIG. 10B, even if the pusher tube 8 is pulled back, the state 7 cannot be pulled back. For this reason, it is inconvenient that the stent 7 cannot be accurately positioned.

U.S. Pat. No. 5,921,952 discloses a drainage force delivery system in which a pusher tube and a stent are connected by a thread. As will be described in detail below, in a drainage catheter delivery system, if the pusher tube is pulled too far when the pusher tube is pulled too far, the stent will be pulled through the thread. You can pull it back.

In this drainage catheter delivery system, an insertion hole through which a thread passes is provided at the distal end of the pusher tube. Also, by forming a flap on the stent, There is an opening in the center. Then, tie a thread to the guide wire. This yarn is derived from the opening force of the stent. In addition, tie this thread through the insertion hole of the pusher tube. Thus, the stent and the pusher tube are connected.

Therefore, if the pusher tube is pulled back when the state is pushed too much, the state can be pulled back through the thread. When the stent is placed in the stenosis, the guidewire is pulled back after the stent is placed in the stenosis. When the distal end of the guide wire comes off the entangled portion with the thread, the thread comes off the stint. In this way, the stent and the pusher tube are separated.

In this drainage catheter system, when the stent is placed, the guide is pulled back after the stent is placed in the stenosis. At this time, if the distal end of the guide wire does not come off from the portion entangled with the thread, the stent and the pusher tube cannot be separated.

Therefore, after placing the station, remove the guidewire and check. For this reason, even if the next treatment is performed using the guide wire as a guide, no treatment can be performed.

In addition, it is necessary to provide a through hole at the distal end of the pusher tube for inserting a thread. For this reason, there is an inconvenience that the liquid leaks from the through hole when the liquid is sent through the pusher tube.

Further, in this drainage catheter delivery system, a stent is inserted through a guidewire. And The proximal end of this stent is in abutment with the distal end of the pusher tube. For this reason, the bending strength of the connecting portion between the pusher tube and the stent is weak. Therefore, if the pusher tube is pushed forward to place the stent in the stenosis, the stent and the pusher tube may buckle at the joint. This makes it impossible to approach the stent to the target site.

Disclosure of the invention

The purpose of the present invention is that when the indwelling tube is indwelled, it can be pulled back even if the indwelling tube is pushed in too much, and the bending strength at the connecting portion between the pusher tube and the indwelling tube The present invention provides an indwelling tube guide device that can push an indwelling tube to a target portion even if the traveling path of the indwelling tube is large and curved.

The indwelling tube guide device of the present invention has an indwelling tube to be indwelled in a body cavity. This indwelling tube has a lumen. On the proximal side of the indwelling tube, a pusher tube for moving the indwelling tube is arranged. An elongated guide catheter is inserted into the indwelling tube and pusher tube so as to be able to advance and retreat. At least at the distal end of the guide catheter, a guidewire can be accommodated. Further, the indwelling tube guide device of the present invention has a linear member. The proximal portion of the linear member is located more proximally than the indwelling tube. An engagement member is provided at a distal portion of the linear member. The engagement member is moved from the first state in which the guide catheter is engaged with the indwelling tube by moving the guide catheter in the axial direction thereof, and thereby the indwelling tube is moved. It is possible to shift to the second state in which the engagement with Ube is released. In the present invention, when the indwelling tube is indwelled, the indwelling tube is inserted by the pusher tube in a state where the guide catheter is inserted into the connecting portion between the indwelling tube and the pusher tube. Push to the site. Further, when the indwelling tube is pushed too much, the engaging member engaged with the indwelling tube pulls the proximal portion of the linear member provided in the distal portion to the proximal side. Then pull back the indwelling tube. When the indwelling tube is indwelled, the guide member is moved in the axial direction so that the engaging member is moved from the first state in which the indwelling tube is engaged with the indwelling tube. Move to the second state in which the engagement with the tube is released. After placing the indwelling tube, the guided wire housed in the guided catheter is left as it is.

The indwelling tube of the present invention preferably has an engagement concave portion on the inner wall where the engagement member can be disengaged. Then, in the first state, the engagement member is locked by the peripheral wall of the guide catheter passed through the indwelling tube and the engagement recess.

In the present invention, preferably, the engaging member is locked by the engaging concave portion provided in the indwelling tube and the peripheral wall of the guide catheter inserted in the indwelling tube.

The proximal portion of the linear member of the present invention is preferably fixed to a pusher tube.

In the present invention, preferably, the proximal portion of the linear member is fixed to the pusher tube. Preferably, the engaging member of the present invention is locked by the distal end face of the indwelling tube and the peripheral wall of the guide catheter protruding from the distal portion of the indwelling tube in the first state. ing.

In the present invention, preferably, the engaging member is locked by the distal end face of the indwelling tube and the peripheral wall of the guide catheter protruding from the distal portion of the indwelling tube. .

Preferably, the peripheral wall of the guide catheter according to the present invention is provided with an opening through which the engaging member can drop. Then, the engaging member can be shifted to the second state by dropping into the opening.

In the present invention, the engaging member is preferably locked by the indwelling tube and the peripheral wall of the guide catheter. Then, by moving the guide catheter in the axial direction, the engaging member is dropped into an opening provided on the peripheral wall of the guide catheter. In this way, the engagement between the engaging member and the indwelling tube is released.

The indwelling tube of the present invention preferably has an engagement hole in which the engagement member is detachable. Then, in the first state, the engaging member is locked by the peripheral wall of the guide catheter inserted into the indwelling tube and the engaging hole.

In the present invention, preferably, the engagement member is locked by an engagement hole provided in the indwelling tube and a peripheral wall of the guide catheter inserted in the indwelling tube.

The guide catheter of the present invention is preferably located distal to the pusher tube. Then, near the guide catheter, The position part is connected to the distal part of the towing wire which is inserted into the pusher tube so as to be able to move forward and backward.

In the present invention, the guide catheter is preferably disposed on the distal side of the pusher tube. Then, the guide catheter is advanced and retracted by retracting and retracting the traction wire having the distal portion connected to the proximal portion of the guide catheter.

Further, the indwelling tube guide device of the present invention has an indwelling tube to be indwelled in a body cavity. This indwelling tube has a lumen. On the proximal side of the indwelling tube, a pusher tube for moving the indwelling tube is arranged. An elongated guide member is inserted into the indwelling tube and pusher tube so as to be able to advance and retreat. Further, the indwelling tube guide device of the present invention has a linear member. The proximal part of this linear member is located more proximally than the indwelling tube. An engagement member is provided at a distal portion of the linear member. The engagement member moves from the first state in which the guide member is engaged with the indwelling tube to the second state in which the engagement with the indwelling tube is released by moving the guide member in the axial direction. It can transition to the state.

In the present invention, when the indwelling tube is to be indwelled, the indwelling tube is inserted by the pusher tube in a state where the guide member is passed through the connecting portion between the indwelling tube and the pusher tube. Push to the site. Also, if the indwelling tube is pushed too far, the engaging member engaged with the indwelling tube may pull the proximal portion of the linear member provided at the distal portion to the proximal side. Then pull back the indwelling tube. And the indwelling tube When the guide member is placed in the indwelling tube, by moving the guide member in the axial direction, the engagement member is moved from the first state in which the guide member is engaged with the indwelling tube. Move to the released second state.

Preferably, in the first state, the engagement member of the present invention is locked by the peripheral wall of the guide member inserted into the indwelling tube and the inner surface of the indwelling tube. At this time, the distal portion of the engaging member holds the distal portion of the indwelling tube. Further, the proximal portion of the engagement member holds the proximal portion of the indwelling tube.

Then, in the present invention, preferably, in the first state, the distal portion of the indwelling tube is held by the distal portion of the engaging member. Also, the proximal part of the indwelling tube is held by the proximal part of the engaging member.

The indwelling tube guide device of the present invention has an indwelling tube to be indwelled in a body cavity. This indwelling tube has a lumen. On the proximal side of the indwelling tube, a pusher tube for moving the indwelling tube is arranged. The guide catheter is rotatably inserted in the indwelling tube and the pusher tube in the axial direction. At least at the distal portion of the guide catheter, a guidewire can be received. Further, the indwelling tube guide device of the present invention has a linear member. The proximal portion of this linear member is located more proximally than the indwelling tube. An engagement member is provided at a distal portion of the linear member. The engagement member is configured to rotate the guide catheter in the direction around the axis, thereby releasing the engagement with the indwelling tube from the first state in which the indwelling tube is engaged. It is possible to move to state 2 is there.

According to the present invention, when the indwelling tube is to be indwelled, the indwelling tube is inserted by the pusher tube in a state where the guide catheter is inserted into the connecting portion between the indwelling tube and the pusher tube. Push to the site. Also, if the indwelling tube is pushed too far, the engaging member engaged with the indwelling tube may pull the proximal portion of the linear member provided at the distal end thereof to the proximal side. Then, the indwelling tube is pulled back. When the indwelling tube is to be indwelled, the guide member is rotated in the direction around the axis, so that the engagement member is brought into the first state in which the indwelling tube is engaged with the indwelling tube. From the second state in which the engagement with the indwelling tube is released. After placing the indwelling tube, the guidewire housed in the guide catheter is left as it is.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1A is a vertical cross-sectional view of the indwelling tube guide device in a state where a stent is engaged, showing a first embodiment of the present invention. FIG. 1B is a side view of the distal end portion of the indwelling tube guide device of FIG. 1A.

FIG. 1C is a longitudinal sectional view of the indwelling tube guide device according to the first embodiment of the present invention, in which the stent is not engaged.

FIG. 1D is a longitudinal side view of the distal end portion of the indwelling tube guide device of FIG. 1C.

FIG. 2 shows an indwelling tube guide according to a second embodiment of the present invention. FIG. 3 is a vertical cross-sectional view of a tip portion of the storage device.

FIG. 3 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device according to a third embodiment of the present invention.

FIG. 4A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where a stent is engaged, showing a fourth embodiment of the present invention.

FIG. 4B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the stent is not engaged, showing the fourth embodiment of the present invention.

FIG. 5A is a longitudinal sectional view of an indwelling tube guide device according to a fifth embodiment of the present invention.

FIG. 5B is a side view of the indwelling tube guide device of FIG. 5A.

FIG. 6 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device, showing a sixth embodiment of the present invention.

FIG. 7 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device according to a seventh embodiment of the present invention.

FIG. 8A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where an indwelling tube is engaged, showing an eighth embodiment of the present invention.

FIG. 8B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the indwelling tube is not engaged, showing the eighth embodiment of the present invention.

FIG. 8C is a perspective view of the engaging member according to the eighth embodiment of the present invention. FIG. 9A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where a stent is engaged, showing a ninth embodiment of the present invention.

FIG. 9B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the stent is not engaged, showing the ninth embodiment of the present invention.

FIG. 10A is an explanatory diagram of a technique for guiding a stent into a body cavity endoscopically.

FIG. 10B is an explanatory view of a procedure for guiding a stent into a body cavity endoscopically and then placing the stent in a stenotic part of a bile duct.

BEST MODE FOR CARRYING OUT THE INVENTION

FIG. 1A is a longitudinal sectional view of the indwelling tube guide device in a state where a stent is engaged, showing a first embodiment of the present invention. FIG. 1B is a side view of the distal end portion of the indwelling tube guide device of FIG. 1A. FIG. 1C is a longitudinal sectional view of the indwelling tube guide device according to the first embodiment of the present invention in a state where the stent is not engaged. FIG. 1D is a side view of the distal end of the indwelling tube guide device of FIG. 1C.

The guide catheter 11 is a long guide member that can be inserted into the forceps channel of the endoscope. The guide catheter 11 is formed of a flexible synthetic resin material, for example, a fluorine-based resin or a nylon-based resin. Guide catheter 1 1 has a full length! : The lumen 1 2 is formed. At the proximal end of the guide catheter 11, a guide catheter cock 13 is provided. The distal end of the guide catheter 11 is provided with a stent 14 as an indwelling tube. This stent 14 has a lumen. Guide catheter 11 is passed through the lumen of stent 14. A pusher tube 15 is provided on the guide catheter 11 on the proximal side of the stent 14. The guide catheter 11 is inserted into the lumen of the pusher tube 15.

Stent 14 is a relatively flexible hollow pipe. The stent 14 is made of a biocompatible resin such as, for example, polyethylene, fluorine resin, nylon resin, thermoplastic elastomer, or silicone rubber. It is desirable that the stent 14 be coated with a hydrophilic lubricant on the outer peripheral surface. Flaps 16 facing each other are provided on the outer peripheral portions near both ends of the state 14 to prevent removal. Further, an engagement recess 17 is provided on a part of the inner peripheral surface of the stent 14.

The pusher tube 15 is formed by molding a flexible synthetic resin material, for example, a fluorine-based resin or a nylon-based resin. A pusher tube cock 18 is provided at the proximal end of the pusher tube 15.

In addition, a guide wire 19 is inserted through the lumen of the guide catheter 11 in the axial direction. A linear member 20 extends in the axial direction between the outer peripheral surface of the guide catheter 11 and the inner peripheral surface of the pusher tube 15.

The guide wire 19 is made of a long metal body, a stranded wire body, a coil body, or the like, and is preferably a nickel-titanium alloy. Made of a metal having superelastic properties. The distal end of this guidewire 19 is tapered. On the other hand, the proximal end of the guidewire 19 is derived from the guide catheter cock 13 force.

The linear member 20 is a linear body such as stainless steel, nickel, titanium alloy, nylon, liquid crystal polymer, and silk. At the distal end of the linear member 20, an engaging member 21 is provided. The engaging member 21 is engageable with and disengageable from the engaging recess 17 of the stent 14. The engagement member 21 is formed of a ball-shaped enlarged portion formed of metal, ceramic, thermoplastic resin, or the like. The proximal side of the linear member 20 is fixed to the pusher tube cock 18.

When the guide catheter 11 is inserted through the stent 14, the engagement member 21 is pressed against the engagement recess 17 on the outer peripheral surface of the guide catheter 11, and 17 is engaged. Therefore, when the linear member 20 is retracted to the proximal side, the stent 14 can be moved in the proximal direction. When the guide force catheter 11 is withdrawn from the state 14 force, the engagement member 21 comes out of the engagement recess 1 Ί, and the engagement of the engagement member 21 is released. You.

Therefore, it is sufficient that the engaging member 21 can be disengaged from the engaging concave portion 17 of the state 14. That is, the shape is not limited to the ball-shaped enlarged portion, and may be a cylindrical shape, a rectangular block shape, or a hook shape.

Next, the operation of the first embodiment will be described.

The operation of guiding the indwelling tube guide device configured as described above into a body cavity endoscopically and indwelling the stent 14 in the stenosis of the bile duct will be described. As shown in Figures 1A and 1B, The pusher tube 15 is fitted to the guiding catheter 11 from its distal end. Further, from the distal end of the guide catheter 11, a stent 14 is fitted. At this time, the engaging member 21 at the distal portion of the linear member 20 led out from the inner cavity of the pusher tube 15 is engaged with the engaging recess 17.

On the other hand, the insertion portion of the endoscope is inserted into the body cavity, and the distal end component is guided to the vicinity of the bile duct. Next, the guider 19 is inserted into the forceps channel of the endoscope. The guider 19 is advanced under the endoscope and X-ray observation. Then, the distal end of the guidewire 19 is guided to the bile duct stenosis.

Next, the guide catheter 11 is inserted through the guide wire 19 from the proximal end of the guide wire 19. A guide 14 and a pusher tube 15 are set in the guide catheter 11. Using the guide wire 19 as a guide, insert the guide force table 11 through the forceps channel.

The guide catheter 11 is advanced by the proximal operation at the proximal end. Then, the distal portion of the guide catheter 11 is led out from the distal end component of the endoscope. Further, the distal portion is inserted through the stenosis. Then, by pushing the pusher tube 15, the stent 14 is inserted through the stenosis along the guide catheter 11. At this time, the distal end of the stent 14 is located more proximally than the distal end of the guide catheter 11. Here, when it is confirmed by X-ray observation or the like that the stent 14 has been pushed too deeply, the pusher tube 15 is pulled back to the proximal side. Then, the state 1 is connected via the linear member 20. 4 is pulled back.

Then, while leaving guidewire 19 in place, guide catheter 11 is retracted proximally relative to stent 14. Then, the distal portion of the guide catheter 11 comes out of the lumen of the stent 14. As a result, as shown in FIGS. 1C and 1D, the engaging member 21 comes out of the engaging concave portion 17 of the state 14. Therefore, the linear member 20 and the stem 14 are separated. In this way, the statement 14 is placed in the stenosis.

At this time, the distal end of the guide wire 19 is located at the stenosis. For this reason, this guidewire 19 remains inserted through the stenosis.

Therefore, the following effects are obtained with the above configuration. That is, in the present embodiment, in order to hold the stent 14, the stent 14 is pushed forward by the pusher tube 15. At this time, the guide catheter 11 is inserted through the connection between the stem 14 and the pusher tube 15. Therefore, the bending strength at the connection between the stent 14 and the pusher tube 15 is high. Therefore, even when the traveling path of the stent 14 is largely curved, the stent 14 and the pusher tube 15 do not buckle. Therefore, it is possible to push the stent 14 smoothly.

When the stent 14 is placed, the engaging member 21 is engaged with the stem 14. The engaging member 21 is connected to a distal portion of the linear member 20. The proximal part of the linear member 20 is fixed to the pusher tube 15. Because of this, stainless steel If the pusher 14 is pushed too far, the pusher tube 15 is moved to the proximal side. State 14 can be pulled back.

Then, when the stent 14 is to be placed, the guide catheter 11 is retracted proximally with respect to the stent 14. At this time, the guide wire 19 inserted through the guide catheter 11 is kept as it is. For this reason, after the stent 14 is indwelled, the distal portion of the guide wire 19 is left inserted through the stenosis. Therefore, after the stent 14 is placed, the following treatment can be performed using the guide wire 19 as a guide.

FIG. 2 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device, showing a second embodiment of the present invention. Hereinafter, the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

In the present embodiment, the proximal end of the linear member 20 is connected to the inner surface of the distal portion of the pusher tube 15. The operation of the present embodiment is the same as the operation of the first embodiment. In the present embodiment, the length of the linear member 20 can be reduced. For this reason, the cost can be reduced by simplifying the configuration.

FIG. 3 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device according to a third embodiment of the present invention. Hereinafter, the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

In the present embodiment, the engaging member 21 provided at the distal end of the linear member 20 is engaged with the distal end of the stent 14. The operation of the present embodiment is the same as the operation of the first embodiment. In this embodiment, it is not necessary to provide the engaging recess 17 in the stem 14. For this reason, the conventional stent 14 can be used as it is. As a result, costs can be reduced.

FIG. 4A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where a stent is engaged, showing a fourth embodiment of the present invention. FIG. 4B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the stent is not engaged, showing the fourth embodiment of the present invention.

In the present embodiment, an opening 22 is provided in the vicinity of the distal portion of the guide catheter 11 and in the peripheral wall inserted into the lumen of the stent 14. The opening 22 can face the engagement recess 17 of the state 14. In addition, the engagement member 21 can fall into the opening 22.

In the present embodiment, the state 14 is inserted into the stenosis by the pusher tube 15. When confirming that the stent 14 has been pushed too deep under X-ray observation, pull the pusher tube 15 back to the proximal side. Then, as shown in FIG. 4A, the stent 14 can be pulled back via the linear member 20. As a result, the stent 14 can be reliably positioned and retained at the target portion.

Next, the guide catheter 11 is retracted proximally while keeping the guide wire 19 and the pusher tube 15 unchanged. Then, the opening 22 of the guide catheter 11 faces the engaging recess 17. As a result, the engaging member 21 falls into the opening 22. Accordingly, as shown in FIG. 4B, the engagement member 21 escapes from the engagement recess 17 of the state 14. In this way, the linear member 20 and the Tents 14 and are separated. As a result, the stent 14 is placed in the stenosis.

According to the present embodiment, the guide catheter 11 is slightly retracted to the proximal side, and the opening 22 faces the engaging member 21. Then, the engaging member 21 is dropped into the opening 22. As a result, the linear member 20 and the stent 14 can be separated. Thus, the operability has been improved.

FIG. 5A is a longitudinal sectional view of an indwelling tube guide device according to a fifth embodiment of the present invention. FIG. 5B is a side view of the indwelling tube guide device of FIG. 5A. Hereinafter, the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof will be omitted.

An engagement hole 23 is formed in a part of the peripheral wall of the state 14. An engagement member 21 provided at the distal end of the linear member 20 is engaged with the engagement hole 23. The proximal end of the linear member 20 is connected to the pusher tube cock 18.

A short guide catheter 24 is inserted through the distal end of the stent 14 and the pusher tube 15 so as to be able to advance and retreat. The proximal portion of the guide catheter 24 is connected to the distal portion of the traction wire 25. The traction wire 25 extends to the proximal end of the pusher tube 15. The proximal end of the towing wire 25 is connected to the operating ring 26. Further, a side hole 27 is provided near the proximal portion of the pusher tube 15. The guide wire 19 is led out of the side hole 27.

In this embodiment, the guide catheter 24 is used to Insert 14 into the stenosis. When confirming that the stent 14 has been pushed too deep under X-ray observation, pull the pusher tube 15 back to the proximal side. Then, the stent 14 can be pulled back via the linear member 20. In this way, it is possible to reliably position and retain the state 14 at the target portion.

Next, the fingers are put on the operation ring 26 while leaving the guide wire 19 and the pusher tube 15 as they are. Then, when the tow guide 25 is retracted to the proximal side, the guide catheter 24 retreats. Then, the distal end of the guide catheter 24 is moved to the proximal end through the engagement hole 23. As a result, the engaging member 21 engaged with the engaging hole 23 escapes from the engaging hole 23. In this way, the linear member 20 and the stent 14 are separated. As a result, the stent 14 is placed in the stenosis.

According to the present embodiment, there is no need to prepare a long guide catheter 11. Therefore, the cost can be reduced by simplifying the configuration.

FIG. 6 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device, showing a sixth embodiment of the present invention. Hereinafter, the same components as those of the fifth embodiment are denoted by the same reference numerals, and description thereof is omitted.

In the present embodiment, the linear member 20 is provided outside the pusher tube 15 along the axial direction of the pusher tube 15. Then, the distal portion of the linear member 20 is introduced into the lumen of the stent 14 from the distal end of the pusher tube 15. Further, the engaging member 21 is engaged with the engaging hole 23. The operation of the present embodiment is the same as the operation of the fifth embodiment. In the present embodiment, the linear portion Routing of timber 20 is easy. For this reason, assembly workability can be improved.

FIG. 7 is a longitudinal sectional view of a distal end portion of an indwelling tube guide device according to a seventh embodiment of the present invention. Hereinafter, the same components as those of the fifth embodiment are denoted by the same reference numerals, and description thereof is omitted.

In the present embodiment, a through hole 28 is provided in a side wall at the distal portion of the pusher tube 15 and the pusher tube 15 is laid. Then, the linear member 20 is passed through the through hole 28, and the linear member 20 is connected to the distal portion of the pusher tube 15. The operation of the present embodiment is the same as the operation of the fifth embodiment. In the present embodiment, the length of the linear member 20 is reduced. For this reason, cost can be reduced by simplifying the configuration.

FIG. 8A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where an indwelling tube is engaged, showing an eighth embodiment of the present invention. FIG. 8B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the indwelling tube is not engaged, according to the eighth embodiment of the present invention. FIG. 8C is a perspective view of the engaging member according to the eighth embodiment of the present invention. Hereinafter, the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

In the present embodiment, the engagement member 21 formed of the ball-shaped enlarged portion of the first embodiment is replaced with an elongated engagement member 29 shown in FIGS. 8A, 8B and 8C. is there. Although the rod member 34 is used as the guide member, a guide catheter 11 may be used.

As shown in FIG. 8C, the engaging member 29 of the present embodiment is It has a recess 30. The recess 30 is formed by cutting out a part of the outer peripheral surface of the main body 29 a of the engaging member 29. The recess 30 fits with the inner surface of the stent 14 along the axial direction. The proximal portion 33 of the engagement member 29 is connected to the distal portion of the linear member 20.

As shown in FIG. 8A, when the rod-shaped member 34 is inserted through the stent 14, the engaging member 29 is attached to the stem 1 by the peripheral wall of the rod-shaped member 34. 4 is fitted and locked. The distal portion 31 of the recess 30 holds the distal end of the state 14. The proximal portion 32 of the recess 30 holds the proximal end of the stent 14. In addition, the proximal portion 32 of the engagement member 29 is pulled proximally by the linear member 20 so that the pusher tube

It is in contact with the distal part of 15.

In the present embodiment, the pusher tube 15 is used to

Insert 14 into the stenosis. When it is confirmed that the stent 14 has been pushed too deep under X-ray observation, the linear member 20 is pulled back to the proximal side. In this way, state 14 is pulled back. At this time, the distal portion 31 of the engagement member 29 pushes the distal end of the stent 14 back to the proximal side.

Then, after positioning the stent 14 at the target portion, the bar-shaped member 34 is moved proximally with respect to the stent 14. Further, the rod-shaped member 34 is pulled out from the stairs by 14 cm. Then, the engagement member 29 is disengaged from the state 14. As a result, the engagement member 29 and the state 14 are separated. In this way, stent 14 is detained. After this, the engaging member 29 is housed in the pusher tube 15 by pulling the linear member 20 to the proximal side.

According to the present embodiment, the engaging member 29 is engaged by fitting the stem 14 into the recess 30. At this time, the engagement member 29 holds the distal end and the proximal end of the stent 14. As described above, since the engaging member 29 holds the both ends of the stent 14, it is possible to push the stent 14 forward or to pull it in. 4 can be moved accurately and reliably.

In addition, there is no need to perform additional work on Station 14. For this reason, conventional stains can be used. Therefore, cost down can be achieved.

FIG. 9A is a longitudinal sectional view of a distal end portion of an indwelling tube guide device in a state where a stent is engaged, showing a ninth embodiment of the present invention. FIG. 9B is a longitudinal sectional view of the distal end portion of the indwelling tube guide device in a state where the stent is not engaged, showing the ninth embodiment of the present invention. Hereinafter, the same components as those of the fourth embodiment are denoted by the same reference numerals, and description thereof is omitted.

In the present embodiment, the guide catheter 11 is inserted into the stent 14 and the pusher tube 15. The guide catheter 11 is rotatable around the shaft with respect to the stent 14 and the pusher tube 15. Further, near the distal portion of the guide catheter 11, an opening 22 is provided in a peripheral wall inserted into the lumen of the stent 14, and is provided. The engaging member 21 can fall into the opening 22. The opening 22 is substantially perpendicular to the central axis of the stem 14 and is in a plane crossing the engagement recess 17. Are located in

In the present embodiment, the guide catheter 11 is rotated in the direction around the axis while the guide wire 19 and the pusher tube 15 are left as they are. Then, the opening 22 of the guide catheter 11 faces the engaging recess 17. The engaging member 21 falls into the opening 22. As shown in FIG. 9B, the engaging member 21 escapes from the engaging recess 17 of the state 14. As a result, the linear member 20 and the stent 14 are separated. In this way, the stent 14 is placed in the stenosis.

In the present embodiment, the guide catheter 11 is rotatable around the axis in the stent 14 and the pusher tube 15. Further, an opening 22 is provided on the peripheral wall of the guide catheter 11. The engaging member 21 can be dropped into the opening 22. The opening 22 is arranged in a plane substantially perpendicular to the central axis of the stent and crossing the engagement recess 17. For this reason, the engagement member 21 falls into the opening 22 simply by slightly rotating the guide catheter 11. In this way, the engagement between the stent 14 and the engagement member 21 can be released. Therefore, the operability has been improved.

Industrial applicability

According to the present invention, an indwelling tube guide device which is used in combination with an endoscope and can accurately position and indwell an indwelling tube in a body cavity or the like is obtained.

Claims

The scope of the claims

1. an indwelling tube having a lumen, which is to be indwelled in a body cavity; a pusher tube, which is disposed on the proximal side of the indwelling tube and moves the indwelling tube,

At least a guide wire that can be accommodated at a distal portion, and an elongated guide catheter that is inserted into the indwelling tube and the pusher tube so as to be able to advance and retreat, and

A linear member having a proximal portion located more proximally than the indwelling tube;

The guide catheter is provided at a distal portion of the linear member, and is engaged with the indwelling tube from the first state in which the guide catheter is engaged with the indwelling tube by moving the guide catheter in the axial direction. And an engagement member that can be shifted to the second state in which is released.

An indwelling tube guide device provided.

2. The indwelling tube has an engaging recess on the inner wall where the engaging member can be disengaged, and in the first state, the engaging member is the guide inserted through the indwelling tube. The indwelling tube guide device according to claim 1, wherein the indwelling tube guide device is locked by a peripheral wall of the catheter and the engaging recess.

3. The indwelling tube guide device according to claim 1, wherein a proximal portion of the linear member is fixed to the pusher tube.

4. In the first state, the engagement member is locked by a distal end surface of the indwelling tube and a peripheral wall of the guide catheter protruding from a distal portion of the indwelling tube. The indwelling tube guide device according to claim 1 which has been filed.

5. The peripheral wall of the guide catheter is provided with an opening through which the engaging member can be dropped, and the engaging member falls into the opening so as to form the second opening. The indwelling tube guide device according to claim 1, wherein the device can be shifted to a state.

6. The indwelling tube has an engaging hole through which the engaging member can be disengaged, and in the first state, the engaging member is inserted into the indwelling tube by the guide. The indwelling tube guide device according to claim 1, wherein the indwelling tube guide device is locked by the peripheral wall of the catheter and the engagement hole.

7. The guide catheter is disposed on the distal side of the pusher tube, and a proximal portion of the guide catheter is a distal portion of a traction wire inserted into the pusher tube so as to advance and retreat. The indwelling tube guide device according to claim 1, wherein the device is connected to a tube.

8. An indwelling tube having a lumen and indwelled in a body cavity; a pusher tube disposed on the proximal side of the indwelling tube for moving the indwelling tube;

An elongated guide member which is inserted into the indwelling tube and the pusher tube so as to be able to advance and retreat,

The guide member is provided at a distal portion of the linear member, and moves in the axial direction of the guide member so that the guide member moves from the first state in which the guide member is engaged with the indwelling tube. An engagement member capable of shifting to the second state in which the engagement is released, and

An indwelling tube guide device provided.

9. In the first state, the engagement member is locked by the peripheral wall of the guide member inserted into the indwelling tube and the inner surface of the indwelling tube, and is distant therefrom. The indwelling tube guide device according to claim 8, wherein a distal portion of the indwelling tube is held at a position, and a proximal portion of the indwelling tube is held at the proximal portion. .

10. An indwelling tube having a lumen and indwelled in a body cavity, a pusher tube arranged on the proximal side of the indwelling tube for moving the indwelling tube,

At least a guide wire that can be accommodated at the distal portion, and a guide catheter that is inserted into the indwelling tube and the pusher tube so as to rotate in the direction around the axis, and

The guide member is provided at a distal portion of the linear member, and rotates the guide member in a direction around an axis, whereby the guide member is engaged with the indwelling tube from a first state in which the indwelling tube is engaged. And an engagement member capable of transitioning to the second state in which the engagement has been released.

An indwelling tube guide device provided.