JP2010136734A - Gastric outlet obstruction apparatus for endoscope and gastric outlet obstruction method performed by using the gastric outlet obstruction apparatus for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To solve the problem that an intestinal tract is expanded and a pain by an abdomen enlarged feeling is generated since compressed air sent into a stomach leaks out from the exit (gastric outlet) of the stomach to the intestinal tract side conventionally when sending the compressed air from an endoscope distal end part into the stomach and expanding the inside of the stomach. <P>SOLUTION: In the gastric outlet obstruction apparatus for an endoscope, a balloon 3 is disposed at the distal end part of the endoscope 1, the endoscope 1 is provided with a pusher 4 for pushing the balloon 3 to the front of the endoscope distal end, the distal end part of an air supply tube 5 is connected to the balloon 3, the compressed air is injected into the balloon 3 through the air supply tube 5 by an air supply pump 6 from the hand side of the endoscope 1, and also the distal end part of the air supply tube 5 is made disconnectable from the balloon 3. By using the gastric outlet obstruction apparatus for the endoscope, the balloon 3 is expanded at the gastric outlet part 81 and the gastric outlet part 81 is obstructed by the balloon 3. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an endoscopic gastric pyloric occlusion device for occluding a pyloric portion of a stomach using an endoscope in combination, and a gastropyloric occlusion method performed using the endoscopic gastric pyloric occlusion device. is there.

  In recent years, for example, in the treatment of gastric ulcer, stomach cancer, etc., it is often performed from the inside of the stomach using an endoscope, but the diseased part in the stomach is seen from the inside of the stomach using an endoscope. When treating, it is desirable that the stomach be expanded. In other words, in the natural state of the stomach, the stomach wall shrinks and the stomach volume tends to be reduced, and if the stomach volume is reduced, the field of view by the endoscope becomes narrower and treatment with the endoscope becomes difficult. When treatment is performed from the inside of the stomach with a mirror, it is desirable that the stomach be expanded.

  Incidentally, in order to increase (expand) the stomach volume during endoscopic treatment, conventionally, the endoscope 1 is generally inserted into the stomach 8 as shown in FIG. 9, and the distal end portion 1a of the endoscope 1 is inserted. The compressed air A is fed into the stomach 8 from the inside.

  However, the duodenum 84 and the small intestine are connected to the exit side of the stomach 8 through the gastropyloric part 81. When compressed air A is injected into the stomach 8, the air in the stomach 8 is naturally reduced by the stomach wall 8a. It moves from the gastric pyloric region 81 through the duodenum 84 into the small intestine as indicated by the arrow A ′ (sometimes reaching the large intestine). Therefore, in order to keep the inside of the stomach in an expanded state, it is necessary to inject air A into the stomach 8 at all times (or intermittently). However, the longer the treatment takes, the longer the intestine (small intestine and large intestine). The inflow of air A ′ to the side increases.

  Thus, when the amount of air inflow to the intestinal tract increases, there is a problem that the patient feels pain due to a feeling of fullness of the abdomen. In addition, when the intestinal tract (small intestine or large intestine) is expanded by the air from the stomach 8, the field of view is narrowed by the expanded intestinal tract when performing endoscopic surgery or laparoscopic surgery, and there is also a problem that it is difficult to perform the operation.

  However, conventionally, there is no means for preventing the air A sent into the stomach to expand the stomach 8 from moving into the intestinal tract via the stomach pyloric part 81 and the duodenum 84, and endoscopic treatment of the inside of the stomach. In the present situation, the above-mentioned problems (occurrence of patient pain caused by dilatation of the intestinal tract with air and a point of view narrowing at the time of treatment) remain.

  Therefore, the present invention is an endoscope for endoscopic treatment of the inside of the stomach so that the air fed into the stomach to expand the stomach does not move to the intestinal tract side. It is an object of the present invention to provide a gastric pyloric occlusion device and a gastric pyloric occlusion method performed using the endoscopic gastric pyloric occlusion device.

  The present invention has the following configuration as means for solving the above problems.

[Invention of Claim 1 of the Present Application]
The invention of claim 1 of the present application is directed to an endoscopic gastric pyloric occlusion device for occluding the pyloric portion of the stomach using an endoscope in combination. And the gastro-pyloric occlusive device for endoscope of Claim 1 of this application is equipped with each following structure.

  First, at the distal end portion of the endoscope, a balloon that can be expanded and contracted by air and extends in the expanded state across the front and back of the gastric pyloric ring is closed in a contracted state.

  The pyloric portion at the exit of the stomach has an annular pyloric ring (pyloric sphincter) that protrudes to the inner surface side, and the duodenal bulb portion that is radially expanded is present on the duodenum side of the pyloric ring. The balloon used in the endoscopic gastric pyloric occlusion device according to claim 1 includes a back-side bag body that is expanded in the duodenal bulb and a near-side bag body that is expanded on the stomach side of the pyloric ring. What was formed continuously is preferable. In that case, a constricted portion having a small diameter when the balloon is expanded is formed between the back side bag body and the near side bag body of the balloon. The balloon is provided with an air inlet with a check valve.

  This balloon may be disposed at the distal end of a forceps insertion hole provided in the outer tube of the endoscope, or may be disposed at the distal end of a thin tube externally attached along the outer surface of the outer tube of the endoscope. May be.

  The endoscope is provided with a pusher for pushing the balloon disposed at the endoscope distal end portion forward of the endoscope distal end. This pusher can be pushed and pulled from the proximal side of the endoscope.

  The balloon is connected to the distal end portion of an air supply tube extending from the proximal side of the endoscope toward the distal end side of the endoscope. Then, compressed air can be injected into the balloon through the air supply tube by the air supply pump from the proximal side of the endoscope.

  Moreover, the front-end | tip part of an air supply tube is separable with respect to a balloon. For example, the tip of the air supply tube and the air inlet of the balloon are connected with a pressure that does not inadvertently come off when air is supplied, and the air supply tube is pulled strongly after the balloon is expanded. It is preferable that the tube tip can be removed from the air inlet. In another example, the distal end portion of the air supply tube is fixedly continuous with the air inlet of the balloon, and another cutting means (through the forceps insertion hole of the endoscope after expansion of the balloon bag body) It is also possible to cut the position near the tip of the air supply tube with scissors or the like.

  The gastric pyloric occlusive device for endoscope according to claim 1 is capable of occluding the pyloric part of the stomach as described in the next item (claim 2).

[Invention of claim 2 of the present application]
The invention of claim 2 of the present application is directed to a gastric wall incision suture method performed using the gastropyloric occlusive device for endoscope of claim 1 described above. The gastric pylorus occlusion method according to the second aspect of the invention is characterized in that the following first to fifth steps are sequentially performed.

  In the first step, the endoscope tip is inserted from the oral cavity to a position near the pylorus in the stomach with the balloon disposed in a reduced state at the tip of the endoscope. At this time, while observing with the CCD camera of the endoscope, the tip of the endoscope is positioned in the vicinity immediately before the pyloric portion (hole of the pylorus ring) serving as the stomach exit.

  In the second step, the pusher pushes the balloon from the distal end of the endoscope to a position straddling the pyloric ring of the gastric pyloric part back and forth. At this time, the pusher is operated from the proximal side of the endoscope while observing with the CCD camera of the endoscope, and the balloon is positioned so as to straddle the pyloric ring.

  In the third step, compressed air is fed into the balloon through the air feeding tube from the proximal side of the endoscope through the air feeding tube, and is expanded until the outer peripheral surface of the balloon is in pressure contact with the inner peripheral surface of the gastric pylorus. At this time, the outer peripheral surface of the balloon is pressed against the inner peripheral surface of the gastric pyloric part and the balloon is expanded before and after the pyloric ring, so that the balloon is held in a stable state in the gastric pyloric part.

  In the fourth step, the tip of the air supply tube is separated from the expanded balloon. At this time, in the case where the tip of the air supply tube is detachably connected to the air inlet of the balloon, the tip of the air supply tube is attached to the balloon by strongly pulling the air supply tube from the proximal side of the endoscope. Can be removed from the air inlet. On the other hand, when the tip of the air supply tube is fixedly connected to the balloon, the position near the tip of the air supply tube is cut by another cutting means (such as scissors) through the forceps insertion hole of the endoscope. be able to.

  In the fifth step, the air supply tube (separated) and the pusher are pulled out of the body with the expanded balloon left in the stomach pylorus. In this case, the air supply tube and the pusher may be pulled out of the body together with the endoscope.

  In the gastric pyloric occlusion method according to claim 2, the first step to the fifth step are performed by using the endoscopic gastric pyloric occlusion device according to claim 1, whereby the balloon is expanded into the gastric pylorus portion. Can leave (gastric pylorus can be occluded with a balloon). When the gastric pyloric region is occluded with a balloon in this way, even if compressed air is sent into the stomach through the endoscope for gastric dilation, the air is blocked by the balloon in the gastric pyloric region and the intestinal tract (small intestine) side There is no leakage.

  The endoscopic gastric pyloric occlusion device of claim 1 and the gastropyloric occlusion method of claim 2 have the following effects.

  First, since the gastric pyloric part that is the exit of the stomach can be closed with a balloon as described above, even if compressed air is sent into the stomach while the gastric pyloric part is closed, the supplied air remains in the stomach pyloric part. No leakage to the intestinal tract (duodenum, small intestine) side. As a result, there is no pain to the patient due to abdominal bloating as before, and the intestinal tract (small intestine or large intestine) is dilated with air from the stomach. Therefore, there is an effect that the field of view is not narrowed during endoscopic surgery or laparoscopic surgery (the procedure is easier to perform).

  In the present invention, in order to close the gastric pylorus, the balloon is pushed forward from the tip of the endoscope with a pusher together with an endoscope, and compressed air is blown into the balloon bag through an air supply tube by an air supply pump. After the delivery, the gastric pyloric part can be blocked by the balloon by separating the air feeding tube from the balloon, so that the gastric pyloric part can be easily and reliably blocked.

  Hereinafter, with reference to FIGS. 1-8, the gastropyloric obstruction | occlusion method performed using the gastric pyloric obstruction | occlusion apparatus for endoscopes of this Example and this gastropyloric occlusive apparatus for endoscopes is demonstrated.

  As shown in FIGS. 3 to 6, the pylorus 81 serving as the exit of the stomach 8 has an annular pyloric ring (pyloric sphincter) 82 projecting to the inner surface side, and the pyloric ring 82 has a diameter on the duodenum 84 side. There is a duodenal bulb 83 that is expanded in the direction. Note that an intestinal tract (small intestine to large intestine) (not shown) continues to the distal end side of the duodenum 84.

  First, the configuration of the endoscopic gastric pyloric occlusion device shown in FIGS. 1 to 2 will be described. The endoscopic gastropyloric occlusion device of this embodiment is an ordinary endoscope 1 called a gastric camera. A gastric pyloric occlusion device 2 for occluding the pyloric part serving as the exit of the stomach is provided.

  The endoscope 1 is provided with an imaging device (CCD camera) 12 and an illumination lamp (not shown) at the tip of a flexible outer tube 11 having a predetermined length as shown in FIG. The distal end portion of the outer tube 11 of the endoscope 1 can change the directing direction by the hand controller 10. The outer tube 11 of the endoscope 1 is often about 10 to 15 mm in thickness.

  An air supply passage 15 is provided in the outer tube 11 of the endoscope 1. The air supply passage 15 has a length that reaches the distal end surface 1a of the endoscope from the hand controller 10.

  A forceps insertion port 14 is provided on the proximal side of the outer tube 11 of the endoscope 1. An insertion hole 14a is provided from the forceps insertion opening 14 to the distal end surface 1a of the endoscope 1, and forceps and other instruments (a pusher 4 and an air supply tube of the gastropyloric obturator 2 described later) are provided from the forceps insertion opening 14. 5 etc.), various operations can be performed in front of the distal end of the endoscope 1.

  The gastric pyloric occlusion device 2 includes a balloon 3 disposed at the distal end portion of the outer tube 11, a pusher 4 that pushes the balloon 3 forward from the distal end surface 1 a of the endoscope, and an air supply connected to a bag body 31 of the balloon 3. A tube 5 and an air supply pump 6 for supplying compressed air to the air supply tube 5 are provided.

  As the balloon 3, a bag body 31 provided with an air inlet 33 with a check valve 32 is employed. The check valve 32 has a function of preventing air from leaking to the outside while allowing air supply into the bag body 31. In a state where the balloon bag body 31 is contracted to the minimum, the bag body 31 can be accommodated in the forceps insertion hole 14a as shown in FIGS.

  The bag 31 of the balloon 3 can be expanded and contracted by compressed air, and for example, a rubber balloon can be adopted. The bag body 31 includes a back side bag body 31a and a front side bag body 31b. In the bag body 31, a constricted portion 31c having a small diameter in the radial direction is formed between the back side bag body 31a and the front side bag body 31b in the bag body expanded state (FIGS. 5 and 6). It has become. In the expanded state of the bag body 31, as will be described later (FIGS. 5 and 6), the back side bag body 31a and the front side bag body 31b sandwich the pyloric ring 82 of the gastric pylorus 81 from the front and back. The side bag body 31a comes into pressure contact with the inner surface of the duodenal bulb 83, while the front side bag body 31b comes into pressure contact with the front surface (gastric side portion) of the pyloric ring 82.

  And this balloon 3 is arrange | positioned in the position near the front-end | tip part in the forceps penetration hole 14a in the state which shrunk the bag 31 as shown in FIG.1 and FIG.2.

  In this embodiment, the pusher 4 is in the form of a flexible tube as shown in FIGS. 1 and 2, and in the following description, the pusher 4 may be referred to as a pusher tube. As the pusher tube 4, a tube having a predetermined length longer than the entire length of the forceps insertion hole 14a of the endoscope 1 is used. The pusher tube 4 is removably inserted into the forceps insertion hole 14a of the endoscope 1. Note that the thickness (outer diameter) of the pusher tube 4 is substantially the same as the outer diameter of the casing of the check valve 32 of the balloon 3, and when the pusher 4 is advanced with respect to the balloon 3 as will be described later. In addition, the check valve 32 of the balloon 3 can be pressed by the distal end portion 4 a of the pusher tube 4.

  As the air supply tube 5, a flexible tube having a slightly smaller diameter (for example, about 2 mm) than the inner diameter of the pusher 4 is employed. The air supply tube 5 is longer than the entire length of the pusher tube 4 by a predetermined length. In this embodiment, the front end 5a of the air supply tube 5 can be connected to and separated from the air inlet 33 of the balloon 3. The air supply tube tip 5a and the air inlet 33 are connected with a pressure contact force that does not inadvertently come off when air is supplied, and the air supply tube 5 is pulled strongly after the balloon bag 31 is expanded. Thus, the air supply tube tip 5a can be removed from the air inlet 33.

  The air supply tube 5 and the pusher tube 4 are mounted by inserting the pusher tube 4 into the forceps insertion hole 14 a of the endoscope 1 in a state where the air supply tube 5 is inserted into the pusher tube 4. The At this time, the proximal end 4b of the pusher tube 4 is exposed from the forceps insertion opening 14 by a predetermined length, while the proximal end 5b of the air supply tube 5 is exposed from the proximal end 4b of the pusher tube 4 by a predetermined length. Just expose.

  The balloon 3, the air supply tube 5, and the pusher tube 4 can be set in the forceps insertion hole 14a of the endoscope 1 as follows, for example. First, the distal end 4a side of the pusher tube 4 is inserted from the forceps insertion port 14, and the air supply tube 5 is inserted into the forceps insertion hole 14a. Next, the air supply tube 5 is inserted alone (before the balloon 3 is connected) with its tip 5 a inserted from the proximal end 4 b of the pusher tube 4, and the air supply tube tip 5 a is inserted into the pusher tube 4. The front end 4a and the front end 1a of the endoscope 1 are exposed forward. Subsequently, the air inlet 33 of the balloon 3 is fitted into the exposed air supply tube tip 5a, and the balloon 3 is connected to the air supply tube tip 5a. Thereafter, the proximal end 5b of the air supply tube 5 is pulled up (the proximal end 4b of the pusher tube 4 is also lifted as necessary), and the forceps is inserted in the contracted state of the balloon 3 as shown in FIGS. It is housed inside the hole 14a. As another set example, the following may be performed. First, the balloon 3 is connected in advance to the distal end portion 5a of the air supply tube 5 outside the endoscope 1 and the pusher tube 4, the pusher tube 4 is inserted into the forceps insertion hole 14a, and the distal end portion 4a is inserted into the forceps insertion hole. The proximal end 5b of the air supply tube 5 is inserted from the distal end 4a of the pusher tube 4 so as to be exposed from the distal end of the pusher tube 4, and the proximal end 5b of the air supply tube 5 is inserted into the proximal end of the pusher tube 4 4b, and finally, the proximal end portions 4b and 5b of the pusher tube 4 and the air supply tube 5 are pulled up, and the balloon 3 is housed inside the forceps insertion hole 14a.

  The discharge port 6a of the air supply pump 6 can be detachably connected to the proximal end 5b of the air supply tube 5. In this embodiment, a syringe is used as the air supply pump 6, but an appropriate structure can be used for the air supply pump 6 as long as it can supply air into the air supply tube 5.

  Next, a gastric pyloric occlusion method performed using the above-described endoscopic gastric pyloric occlusion device will be described with reference to FIGS. 3 to 8. The fifth step is performed sequentially to finally close the pyloric part 81 that is the exit of the stomach 8 with the expanded balloon 3 as shown in FIG.

  First, in the first step, the distal end portion 1a side of the endoscope 1 is inserted into the stomach 8 from the oral cavity with the gastric pyloric occlusion device 2 set on the endoscope 1 as shown in FIGS. As shown in FIG. 3, the endoscope distal end portion 1 a is positioned in the vicinity of the front side of the gastric pyloric portion 81. At this time, the air supply pump 6 is connected to the proximal end 5b of the air supply tube 5. Further, in the first step, the direction and position of the endoscope distal end portion 1a are adjusted with the hand controller 10 while observing with the CCD camera 12 of the endoscope 1.

  In the second step, as shown by a chain line in FIG. 3, the proximal end 4b of the pusher tube 4 is pushed toward the distal end side with respect to the endoscope 1, and the balloon 3 is indicated by reference numeral 3 'in FIG. Push forward from the endoscope tip 1a. At this time, while observing with the CCD camera 12 of the endoscope 1, the back side bag body 31 a and the front side bag body 31 b of the balloon bag body 31 are positioned so as to straddle the pyloric ring 82 of the gastric pyloric part 81 (back and forth). (A solid line is shown in FIG. 4).

  In the third step, as shown in FIG. 4, compressed air is injected into the balloon bag body 31 through the air supply tube 5 from the proximal side of the endoscope 1 by the air supply pump 6, The balloon bag body 31 is expanded until the outer circumferential surfaces of the bag body 31a and the front side bag body 31b are in pressure contact with the inner circumferential surface of the gastric pyloric portion 81 as shown by chain lines (reference numerals 31a 'and 31b') in FIG. (The state shown in FIG. 5 is obtained). At this time, as shown in FIG. 5, the outer peripheral surface of the balloon bag body 31 is in pressure contact with the inner peripheral surface of the gastric pyloric part 81, and the pylorus is formed between the back side bag body 31 a and the front side bag body 31 b of the bag body 31. Since the ring 82 is sandwiched from the front and rear (the constricted part 31c of the bag 31 corresponds to the pyloric ring 82), the balloon 3 is held in a stable state by the gastric pyloric part 81. The compressed air sent into the balloon bag body 31 remains sealed in the bag body 31 by the check valve 32.

  In the fourth step, the tip 5a of the air supply tube 5 is separated from the air inlet 33 of the balloon 3 in the expanded state from the state of FIG. 5, but at this time, the proximal end 4b of the pusher tube 4 is pushed in (see FIG. 5) With the tip 4a of the pusher tube 4 pressed against the check valve (casing) 32 of the balloon 3, the hand-side end 5b of the air supply tube 5 is pulled strongly to obtain FIG. As shown, the tip 5 a of the air supply tube 5 can be removed from the air inlet 33 of the balloon 3. Even if the air supply tube tip 5a is removed from the air inlet 33, the check valve 32 is closed, so that air does not leak into the bag 31 from the air inlet 33, and the balloon bag 31 is expanded. The state (blocked state) is maintained.

  In the fifth step, the air supply tube 5 and the pusher tube 4 that have been separated in a state where the balloon 3 in the expanded state remains in the gastric pylorus 81 are extracted from the body. In this case, the air supply tube 5 and the pusher tube 4 may be extracted from the endoscope 1 while leaving the endoscope 1 as it is, or the air supply tube 5 and the pusher tube 4 may be extracted together with the endoscope 1 from the body. Also good. When the fifth step is completed, the operation for closing the gastric pylorus 81 by the balloon 3 is completed.

  During the operations from the first step to the fifth step, the stomach wall 8a may contract and the internal volume of the stomach 8 may be reduced. There is no particular hindrance.

  In the gastric pyloric occlusion method of this embodiment, the gastric pyloric portion 81 can be occluded with the balloon 3 by sequentially performing the first to fifth steps. The gastropyloric occlusive device for a mirror has a relatively simple and inexpensive construction, and each of these work steps can be performed relatively easily.

  FIG. 7 shows a state in which compressed air A is fed into the stomach from the endoscope distal end portion 1a through the air feeding passage 15 of the endoscope 1 with the gastric pyloric portion 81 blocked with the balloon 3. However, when the compressed air A is fed into the stomach, the inside of the stomach 8 becomes high pressure, and the inside of the stomach is expanded against the contraction action of the stomach wall 8a. At this time, since the gastric pyloric part 81 is blocked by the balloon 3, air in the stomach does not leak to the duodenum 84 side through the gastric pyloric part 81 even if the pressure in the stomach 8 becomes high. Therefore, as in the prior art (FIG. 9), various problems caused by leakage of air in the stomach 8 to the intestinal tract (duodenum 84, small intestine) side (pain due to abdominal bloating and reduced visual field due to swelling of the intestinal tract). Etc.) can be solved beforehand.

  Then, as shown in FIG. 7, in the state where the inside of the stomach 8 is expanded by air supply from the endoscope distal end portion 1a, a predetermined treatment is performed on the affected part in the stomach with the endoscope 1. Even if time is required, since there is no feeling of fullness of the abdomen, the pain to the patient can be alleviated accordingly.

  When the treatment of the affected part of the stomach by the endoscope 1 is completed, the balloon 3 needs to be discharged out of the body, but the operation is performed as shown in FIG. That is, a bag breaking device (having a bag breaking needle 16 at the distal end) is inserted from the forceps insertion opening 14 of the endoscope 1, and a hand operating device 20 of the bag breaking device is operated to expand the bag breaking needle 16. Break through the balloon bag 31. Then, the air in the balloon bag body 31 is released and the balloon bag body is shrunk so as to show a chain line (reference numeral 31 '). Subsequently, the forceps device is replaced with the forceps insertion opening 14, the balloon bag body 31 ′ contracted with the forceps 17 at the tip thereof is picked, and the balloon bag body 31 ′ is extracted together with the forceps 17 to the outside of the body. The work is complete. In this case, the endoscope 1 may be pulled out of the body with the forceps 17 gripped by the balloon bag 31 ′.

  In addition, in the said Example, what adopted so that the front-end | tip part 5a of the air supply tube 5 could be connected with the air inlet 33 of the balloon 3 so that contact / separation was possible was employ | adopted, but in another Example, This can be done with the tip 5a of the air supply tube 5 fixedly connected to the air inlet 33 of the balloon 3. In this case, as shown in FIG. 5, after the balloon bag body 31 is expanded at the gastric pyloric region 81, the endoscope 1 is moved together with the pusher tube 4 outside the body leaving the expanded balloon 3 and the air supply tube 5. Pull out. At this time, the proximal end portion 5b of the air supply tube 5 is exposed outside the body from the oral cavity. Then, the distal end portion of the endoscope 1 is inserted into the stomach, another cutting means (with scissors at the distal end) is inserted into the forceps insertion hole 14a, and the distal end portion of the air supply tube 5 is inserted by the cutting means (scissors). If the close position is cut and the cut air supply tube 5 is extracted, only the balloon 3 in an expanded state can be left in the gastric pylorus 81.

It is a front view of the gastro-pyloric occlusive device for endoscopes of an example of this application. It is the elements on larger scale of the gastric pyloric obstruction | occlusion apparatus for endoscopes of FIG. It is explanatory drawing of the 1st and 2nd process of the gastric pylorus obstruction | occlusion method of an Example of this application. It is explanatory drawing of the 3rd process of the same stomach pylorus obstruction | occlusion method. It is explanatory drawing of the 3rd process completion state of the same stomach pylorus obstruction | occlusion method. It is explanatory drawing of the 4th process of the same stomach pylorus closure method. It is function explanatory drawing in a gastric pylorus obstruction | occlusion state. It is explanatory drawing of the discharge method of the balloon left in the stomach pylorus part. It is explanatory drawing of the gastric dilation method performed conventionally.

Explanation of symbols

  1 is an endoscope, 2 is a gastric pyloric occlusion device, 3 is a balloon, 4 is a pusher (pusher tube), 5 is an air supply tube, 6 is an air supply pump, 8 is a stomach, 11 is an exterior tube, and 12 is a CCD camera , 14 is a forceps insertion opening, 14a is a forceps insertion hole, 15 is an air supply passage, 31 is a balloon bag, 31a is a back bag, 31b is a front bag, 31c is a constricted portion, 32 is a check valve, 33 is an air inlet, 81 is a gastric pyloric part, 82 is a pyloric ring, and 83 is a duodenal bulb part.

Claims (2)

An endoscopic gastric pyloric occlusion device for occluding the pyloric portion of the stomach in combination with an endoscope,
At the distal end of the endoscope, a balloon that can be expanded and contracted by air and in the expanded state spans the front and back of the gastric pyloric ring and can close the gastric pyloric part in a reduced state,
The endoscope is provided with a pusher for pushing the balloon disposed at the endoscope distal end forward of the endoscope distal end,
Connect the tip of the air supply tube that extends from the proximal side of the endoscope toward the distal end of the endoscope to the balloon so that compressed air can be injected into the balloon through the air supply tube by the air supply pump. And
The tip of the air supply tube can be separated from the balloon.
A gastric pyloric occlusion device for an endoscope. A gastric pyloric occlusion method performed using the endoscopic gastric pyloric occlusion device according to claim 1,
Inserting the endoscope tip from the oral cavity to the position near the pyloric part in the stomach with the balloon placed at the endoscope tip in a contracted state; and
Pushing the balloon from the tip of the endoscope to the position straddling the pyloric ring of the gastric pyloric part back and forth with a pusher;
Injecting compressed air into the balloon through an air supply tube by an air supply pump and expanding the outer peripheral surface of the balloon until it comes into pressure contact with the inner peripheral surface of the gastric pylorus,
Separating the tip of the air supply tube from the expanded balloon;
Extracting the air supply tube and pusher out of the body with the expanded balloon left in the stomach pylorus,
And a gastric pyloric occlusion method performed using an endoscopic gastric pyloric occlusion device.

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