JP2011182898A - Guide needle for tube - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To make procedure practicable without making invasiveness to a patient excessive by precisely and safely inserting a tube even in any condition in the procedure done arranging the tube in a target site in a body. <P>SOLUTION: The guide needle 2 for percutaneously arranging the tube in the target site in the body includes the needle tip part 22 in which the bevel surface 22a is formed at the distal end side of the body 20 formed in a linear shape in a thickness so as to be able to insert it into the tube, the predetermined range of the distal end side of the body 20 is an easy-to-bent part 23 more easily bent to the opposite side of the direction of the bevel surface 22a than the other part, the guide needle has the direction indicating section 24 for making an operator recognize the direction of the bevel surface on the proximal end side of the body 20, a puncturing in direction is bent to the opposite side of the direction of the bevel surface 22a by bending mainly the easy-to-bent part by puncturing into the body, the operator advances the needle tip and make the same arrive in front of the target site while controlling the puncturing direction to a desired direction by turning the body 20 around an axis, thereafter inserts the tube into the body along the body 20, and thereby guides tube tip to the target site. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a guide needle for a tubular body, and more particularly to a guide needle for a tubular body that is used for securing a route to a target location in the body and guiding a tubular body such as a puncture needle and a catheter from the outside of the body to the target location.

  In recent years, under the real-time image guide using ultrasonic waves, X-rays, and the like, a treatment method for performing a predetermined treatment by inserting a puncture needle having a predetermined function to a target location in the body has become widespread. By performing the treatment percutaneously through the puncture needle, it is possible to reduce the invasion and burden on the patient to a smaller extent than in normal surgical therapy.

  For example, percutaneous ethanol injection therapy in which ethanol is injected into a tumor tissue through an injection needle and this is denatured or necrotized, or high-frequency thermotherapy in which an electrode needle is inserted into the tumor tissue and necrotized with heat by high frequency Alternatively, a therapeutic method such as a nerve block that blocks a pain transmission path by injecting a drug into a ganglion pinpoint via an injection needle is known.

  In such a treatment method, it is important to accurately place the distal end side of the puncture needle at the target location, but in cases where the target location is difficult to reach such as the deep part of the body, until the puncture needle reaches the target location. In some cases, the needle may be repeatedly inserted and removed. In particular, when the target organ moves due to respiratory motion, or when there is a thick artery or other organ near the target location or in the middle of the insertion route, the procedure is likely to be difficult or risky.

  On the other hand, for example, in Japanese Patent Laid-Open No. 8-238248, there is provided a projector and a support for positioning, and the puncture needle is inserted and inserted by supporting the guide tube in the direction of the target location on the body surface side. An instrument for determining the angle has been proposed. By using this device under the CT guide, the insertion point and insertion direction of the puncture needle can be accurately determined and punctured even if the target location is deep in the body. ing.

  However, even if the first insertion position and angle are determined accurately in this way, the target site moves with a slight difference in the timing of breath-holding even if the patient can hold his / her breath due to lesions in the upper abdomen or chest. In addition, the puncture needle often bends relatively easily due to the resistance of the body tissue and deviates from the initial insertion direction. Especially, the bevel type with the inclined cut surface is on the opposite side of the direction of the bevel surface. Since the needle is easy to bend, it is difficult to reach the target location in the deep part of the body. Further, when there is a dangerous part such as another organ or blood vessel in the middle of the insertion route to the target place, it is the same as in the past that the target place cannot be safely reached.

  In cases where there is difficulty or risk when inserting a puncture needle in this way, when the thin puncture needle is inserted and removed multiple times, the patient is less invasive and accidentally inserted into other organs, etc. However, it can be said that it is advantageous in that the risk is small. However, since a thin needle is more easily bent in the body, accurate control of the needle tip becomes more difficult. Therefore, if the insertion direction can be freely controlled in the body using a relatively thin needle, a puncture that performs a predetermined function can be performed by first inserting the body into a target location and securing an insertion route. Since the needle can reach the target position accurately and safely, it is extremely useful.

  On the other hand, in addition to the above-described treatment methods, a treatment for collecting tissue percutaneously by inserting a biopsy needle with a guide tube from outside the body to a lesion in the body, or first securing an insertion route with a puncture needle Procedures for inserting a catheter to a target site in the body and continuously injecting drainage and drugs are also popular, and even in such cases, when these tubes are inserted or inserted into the target site in the body, The problem described above will occur as well.

JP-A-8-238248

  The present invention is intended to solve the above-described problems, and it is possible to insert a tubular body accurately and safely in any situation for a treatment performed by placing the tubular body at a target position in the body, and to a patient. It is an object of the present invention to make it possible to carry out a treatment without excessively invading the body.

  Accordingly, the present invention is a guide needle for transcutaneously placing a tube having a predetermined function at a target location in the body, and is formed in a straight line with a thickness that can be inserted into the tube. A needle tip portion having one bevel surface formed on the distal end side of the main body made of a linear metal, and a predetermined range on the distal end side of the main body in the vicinity of the needle tip portion is more on the bevel surface than the other portions. It is an easy-bending part that is easy to bend on the opposite side of the direction, and is provided with a direction indicating part on the base end side of the main body for recognizing the direction of the bevel surface or the opposite direction, and is inserted into the body. Thus, while the advance of the needle tip is guided in the extension direction of the bevel surface, the bendable direction is mainly bent so that the insertion direction is bent to the opposite side of the bevel surface direction. Rotate the body around the axis to control the insertion direction to the desired direction After the needle tip is advanced to reach the target location or near the target location, the tube body inserted through the main body is inserted into the body along the main body to guide the tip of the tube to the target location It was.

  In this way, a guide needle for guiding a predetermined tube body to a target location in the body is easily bent to a side opposite to the direction of the bevel surface, with the needle tip being a bevel surface and a predetermined range close to the needle tip. However, by providing a structure for recognizing the direction of the bevel surface or the opposite direction on the proximal end side, the insertion direction can be realized even if the surgeon recognizes the bending side of the insertion direction and does not perform insertion / removal operation on the way In addition to being able to change, it is also possible to advance the needle tip by bypassing the dangerous place, and it is possible to reach the in-vivo target place accurately with minimal invasion and risk to the patient.

  In addition, the easy-bending portion is formed so that the width in the direction corresponding to the direction of the bevel surface is shorter than the width in the direction perpendicular to the direction of the bevel surface. Is greater than the flexibility in the direction perpendicular to the direction of the bevel surface, and is likely to bend in that direction.

  In this case, the cross-sectional shape of the surface perpendicular to the central axis of the main body is circular except for the bendable portion and the needle tip portion, and the cross-sectional shape of the bendable portion is an approximate shape formed by cutting a predetermined range on the bevel surface side from the circle. If it is characterized by being semi-circular, the bevel surface side that is most extended by bending is cut away, so that it becomes easier to bend to the opposite side of the direction of the bevel surface.

  Further, in the tube guide needle described above, the direction indicating portion has a predetermined range on the proximal end side of the main body made of a linear metal member on the opposite side of the bevel surface or the direction of the bevel surface. If it is characterized by being bent, the operator can easily recognize the direction of the beveled surface or the side of bending in the insertion direction depending on the direction of the bent end.

  Further, in the tube guide needle described above, on the proximal end side of the main body, a hub made of a cylindrical member having a diameter larger than that of the main body is inserted through the insertion hole passing through the central axis. And is fixed to the main body at least so as not to rotate around the axis, and is used as a gripping part at the time of insertion operation, and as a knob when rotating the main body in the direction around the axis. Then, the operator can easily operate the guide needle.

  In addition, in the guide needle for a tubular body described above, a mark for use as a reference for the insertion depth of the tubular body is displayed on the main body at a position where the distance from the tip coincides with the entire length of the tubular body to be inserted. If it is characterized by being, it will become easy to place the front-end | tip of a tubular body in an exact position.

  In addition, the tube guide needle described above is characterized in that the tube is an injection needle for injecting a predetermined liquid, a guide tube for a biopsy needle, or a guide tube for an electrode needle. As a result, it is extremely useful to ensure an accurate and safe insertion operation, or in the above-described guide needle for a tubular body, the tubular body is accumulated in an infusion catheter or body lumen for injecting a predetermined liquid. Even if it is a drain catheter for discharging liquid, it is extremely useful as well.

  According to the present invention, which has a bevel surface at the tip of the guide needle and is provided with a structure that easily bends in the opposite direction of the bevel surface and a structure that recognizes the bending direction, the operator can easily control the insertion direction. In any situation, the tube body can be inserted accurately and safely, and the treatment can be performed without excessively invading the patient.

The front view of the guide needle for pipes of this Embodiment. (A) is the fragmentary front view which expanded the front end side part of the guide needle for tubes of FIG. 1, (B) is expanded sectional drawing which follows the XX line of (A). (A) is the partial front view which shows the detail of the structure of the hub of the guide needle for tubes of FIG. 1, (B) is the partial front view which shows the state which penetrated the guide needle for tubes of FIG. 1 to the puncture needle. (A), (B), (C) is a partial front view for demonstrating the use procedure of the guide needle for pipes of FIG. 1 (a body part is a longitudinal cross-sectional view). (A), (B), (C) is the partial front view for demonstrating the use procedure of the guide needle for pipes of FIG. 1 following FIG. 4 (a body part is a longitudinal cross-sectional view). (A), (B) is the partial front view for demonstrating the use procedure in the case of treating several lesions at one penetration point using the guide needle for pipes of Drawing 1 (a body part is a longitudinal section) Figure). (A) is a front view when the tube is a guide tube of a biopsy needle (a body part is a longitudinal sectional view), (B) is a front view when a tube is a catheter (a body part is a longitudinal sectional view), (C) is a front view when the tube body to be inserted first is a puncture needle and the tube body to be finally inserted through the guide wire is a catheter (the body part is a longitudinal sectional view).

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings.

  FIG. 1 shows a structure of a guide needle 2 for a tubular body according to the present embodiment. This guide needle 2 is placed at a target location such as a lesion existing in the body, such as a puncture needle, a guide tube, a catheter, and the like. It is used as a guide when performing treatment by placing the tube body percutaneously, and is mostly made of a linear metal that is hard and has a predetermined level or more of elastic deformability, such as stainless steel wire. On the base end side of the main body 20, a hub 25 that is a part having a larger diameter and a columnar shape that is gripped by the operator during operation is coaxially fixed.

  The main body 20 is drawn thicker than the actual size for the sake of visibility in the drawing, but the diameter is 0.35 mm to 0.55 mm (more preferably around 0.45 mm). It is suitable from the viewpoint of the balance between the small invasion to the patient and the visibility on the image, and the thickness that can be inserted into the tube to be used, and the length is 25 cm to 35 cm. From the viewpoint of the balance between the length of the pipe body to be operated and the operability.

  The main body 20 has a needle tip formed by forming a single bevel surface 22a inclined with respect to the central axis on the tip side thereof, with the cross-sectional shape of a surface perpendicular to the central axis being basically circular. When the operator grasps the hub 25 on the proximal end side with a finger and twists it around the axis with the distal end side fixed, with a portion 22 provided. It is preferable to have a torque strength that hardly deforms the torque.

  Then, a position closer to the needle tip portion 22 on the distal end side of the main body 20, preferably a position adjacent to the needle tip portion 22, in a range of 15 mm to 30 mm in the proximal direction, is more beveled than other portions of the main body 20. An easily bendable portion 23 having a structure that is easily bent is formed on the opposite side of the direction of 22a, and this is the first characteristic portion in the present invention.

  Further, the main body 20 is a straight portion 21 composed of a portion extending linearly in a uniform state with a circular cross section from the easily bendable portion 23 to the base end side. A predetermined range on the base end side of the main body 20 is bent to the opposite side of the direction of the bevel surface 22a, and a direction indicating portion 24 for allowing the operator to recognize the side where the insertion direction is bent by the bevel surface 22a is formed. This is the second feature of the present invention. In addition, it is preferable that the direction indicating unit 24 has a bending angle of about 90 ° and a length of 1.5 cm to 3 cm in that the direction can be easily recognized without interfering with the operation. The direction may be on the bevel surface 22a side.

  In addition, a cylindrical hub (needle base) 25, which is a separate member, is coaxially fixed to the base end side of the main body 20. The hub 25 is fixed so that it cannot rotate in the direction around the axis and cannot slide in the longitudinal direction in a state where the main body 20 is inserted through the insertion hole penetrating the central axis, and the operator inserts the guide needle 2 into the hub 25. In addition to being used as a grip portion when performing an insertion operation, it is also used as a knob portion when the operator rotates the main body 20 around an axis in order to change the insertion direction.

  FIG. 2 shows the details of the configuration of the front end side portion of the main body 20, and as shown in FIG. 2A, the needle tip portion 22 is formed by cutting on a surface inclined with respect to the central axis of the main body 20. And a bevel surface 22a. Further, the following easily curved portion 23 is a needle of the main body 20 made of a linear metal having a circular cross section, as shown in FIG. 2B, which is an enlarged cross sectional view taken along the line XX of FIG. A predetermined range close to the tip portion 22 is cut from the bevel surface 22a side by a predetermined range, thereby forming a flat cutting surface 23a and having a substantially semicircular cross section.

  That is, when the diameter of the main body 20 is 0.45 mm, for example, the easy-bending portion 23 has a width in a direction corresponding to the direction of the bevel surface 22a of about 0.25 mm and is perpendicular to the direction of the bevel surface 22a. The width is significantly shorter than the width (0.45 mm). As a result, the flexibility in the direction corresponding to the direction of the bevel surface 22a is greater than the flexibility in the direction perpendicular to the direction of the bevel surface 22a, so that the bevel surface 22a is easily bent. It remains difficult to bend. Further, since the most extended side is cut along with the bending, it is easier to bend to the opposite side of the direction of the bevel surface 22a.

  FIG. 3A shows the details of the structure of the hub 25. The hub 25 is composed of a cylindrical upper portion 251 made of a resin material and a cylindrical lower portion 252 made of a resin material having a larger diameter than this. A screw-like portion 251a protrudes from the lower end side of the upper portion 251. By screwing this screw-like portion 251a into a screw hole (not shown) opened at the upper end of the lower portion 252, the screw-like portion The front end side of the 251a that has been split into two is closed, and the main body 20 is sandwiched between the inner peripheral sides thereof. By completely screwing the screw-shaped portion 251a, the hub 25 rotates in the axial direction on the main body 20. It is firmly fixed in a state incapable of sliding in the longitudinal direction.

  On the other hand, FIG. 3 (B) shows a state in which the distal end side of the main body 20 is inserted from the open end of the connecting portion 41 on the proximal end side of the puncture needle 4 to be guided and protruded from the needle tip 41a at the distal end of the tubular needle portion 40. The state inserted through is shown. Thus, the main body 20 of the guide needle 2 can be inserted in a state in which the diameter thereof is slightly smaller than the inner diameter of the puncture needle 4 and fitted thereto, and the entire length thereof is longer than the entire length of the puncture needle 4. In the state shown in the figure, the puncture is performed from the outside of the body toward the target site in the body.

  Further, on the outer peripheral surface of the main body 20, a mark 21 a (a puncture needle 4 of the puncture needle 4) is used at a position where the distance from the distal end coincides with the entire length of the inserted tube as shown in FIG. By displaying a mark corresponding to the length (which is hidden in the lumen of the puncture needle 4), the tip of the tube body can be easily placed at an accurate position. A plurality of displays such as 15 cm, 18 cm, and 20 cm may be displayed step by step so as to match the length of a tube body such as a puncture needle that is frequently used.

  Next, the procedure for using the guide needle 2 of the present embodiment will be described in detail with reference to FIG. As shown in FIG. 4A, in this embodiment, the tubular body to be used is the puncture needle 4, and the guide needle 2 is inserted through the opening of the connecting portion 41 on the proximal end side of the puncture needle 4. Then, the puncture is started in a state where the distal end side of the main body 20 protrudes from the distal end of the puncture needle 4 with a predetermined length.

  This technique is usually performed by an operator under image guidance using ultrasound, X-rays, etc., but in this embodiment, puncture such as an artery, nerve, or organ is performed in the middle as shown in the figure. A case will be described in which the first insertion direction is intentionally shifted with respect to the lesion 100 when there is a dangerous portion 90 that is not desired to be circumvented. Note that the same procedure is performed even in the case where the puncture direction is corrected when the puncture direction is deviated with respect to the target lesion 100 even if the dangerous portion 90 does not exist.

  Since the needle having the beveled surface can be advanced linearly to some extent by being inserted while rotating around the axis, the needle is inserted almost straight while being rotated to the position of FIG. Then, as shown in FIG. 4 (B), the operator rotates the hub 25 on the proximal end side of the main body 20 around the axis with a finger so that the direction indicating section 24 faces the side where the insertion direction is desired to be bent. By the operation, the direction of the bevel surface 22a is directed to the opposite side to the lesion 100.

  When the guide needle 2 is pushed forward in this state, as shown in FIG. 4C, the needle tip portion 22 bends and advances so that the inclined bevel surface 22a follows the extension line of the inclined surface while contacting the body tissue, While the bendable portion 23 is mainly bent, the insertion direction can be advanced toward the lesion 100 and the needle tip portion 22a can be advanced while bypassing the dangerous portion 90, and passes through the body tissue with the bendable portion 23 being curved. The straight portion 21 that continues from the easily bendable portion 23 is also bent by the insertion route formed by bending.

  Referring to FIG. 5A, when the needle tip of guide needle 2 reaches the front of lesion 100, puncture needle 4 is advanced along guide needle 2 as shown in FIG. To reach. In this case, even if the needle portion 40 of the puncture needle 4 is a comparatively thick one of 18 to 20G, it is smoothly curved along the main body 20 of the guide needle 2 except when the direction is changed immediately before the target location. You can go on.

  In this way, even if there is a dangerous part in the puncture route of the guide needle 2, the operator appropriately changes the puncture direction in the middle without performing the insertion / removal operation several times under the guide by the predetermined image. However, it is possible to reach the target location in the body safely and reliably. For example, in the treatment of injecting a liquid such as ethanol into the lesion, the puncture needle 4 is placed and the guide needle 2 is removed as shown in FIG. 5C, and the syringe 50 filled with the liquid is connected to the puncture needle 4. By connecting to the part 41, the liquid can be injected into the lesion 100.

  FIG. 6 shows a case where a plurality of lesions are each treated at one insertion point using the guide needle 2 of FIG. 1, and relatively close to each other in the body as shown in FIG. 6 (A). When there are a plurality of lesions 101 and 102 at a position, the guide needle 2 is punctured at a position and direction toward the intermediate point under a predetermined image guide, and the tip of the puncture needle 4 is set to the depth of the lesions 101 and 102. Stopping at an intermediate position, the direction indicating unit 24 is directed toward the first lesion 101, and the needle tip unit 22 is advanced until reaching the front of the lesion 101.

  After the needle tip is directed toward the lesion 100, the tip of the needle 20 can be moved straight by rotating the main body 20 around the axis. And although illustration is abbreviate | omitted, the puncture needle 4 is advanced along the main body 20 of the guide needle 2 to reach the lesion 101, and the guide needle 2 is removed in the same manner as described above to perform a predetermined treatment such as liquid injection.

  Next, the tip of the puncture needle 4 is pulled back to a position around the intermediate position of the depth of the lesions 101 and 102 (before the branch point), and the guide needle 2 is moved to the puncture needle 4 as shown in FIG. When the needle tip portion 22 protrudes from the distal end of the puncture needle 4 by re-inserting from the proximal end side, the direction indication portion 24 is advanced toward the next lesion 102 to branch the insertion route, and the needle tip is After proceeding until the lesion reaches 102, the same operation as described above is performed. By doing so, since it is possible to treat each of a plurality of lesions relatively close to each other at one insertion point, the invasion to the patient can be minimized.

  In FIG. 7A, the guide tube 5 is guided to the lesion 103 using the guide needle 2 in the same manner as the puncture needle 4 described above, and the biopsy needle 51 is inserted into the lesion 103 via the guide tube 5 so as to remove the tissue. FIG. 7B shows a case where a short catheter 52 is guided to the abscess cavity 104 in the body with the guide needle 2 and is disposed through another tube 55 connected to the connecting portion 52a. This shows the case of performing draining. 7C, the guide wire 54 is first inserted into the puncture needle 4 arranged using the guide needle 2 and the tip is placed in the abscess cavity 104. Next, the puncture needle 4 is removed and the guide wire 54 is removed. A case where the catheter 53 is inserted along the drainage of the abscess is shown.

  As described above, the guide needle 2 according to the present embodiment guides a tube used in various treatments to a target position in the body accurately and safely and arranges it percutaneously to minimize the invasion to the patient. It is possible to carry out treatment while suppressing. In addition, when there are a plurality of target locations at close positions in the body, it is possible to treat all target locations at one insertion point as described above.

  In the following, the guide needle for the tubular body shown in FIG. 1 was actually created, and the puncture needle was guided to the target location under the ultrasound guide, and used for actual percutaneous ethanol injection therapy. Example 2 will be described.

(Implementation conditions)
Guide needle: A tip bevel-shaped stainless steel guide needle with a length of 30 cm and a diameter of 0.45 mm. The direction indicating portion was formed by bending the direction indicating portion at a right angle with a length of 3 cm on the side opposite to the bevel surface (the hub is a resin molded product).
Puncture needle: A commercially available 22 gauge stainless steel gauge having an inner diameter through which the guide needle can be inserted was used.
Implementation target: Four clay balls having a diameter of 5 mm were arranged at intervals of 2 cm under the liver of a fresh cow soaked in raw food (parallel to the ultrasonic image plane, 2 to 8 cm from the surface of the liver).

(Implementation method)
At first, puncture is performed while advancing and curving the liver of the cow 3 cm or 8 cm without rotating the guide needle under an ultrasonic guide, and test whether the puncture needle can be advanced along the curved guide needle It was. Next, three different surgeons punctured the balls in the order of 1, 2, 3 and 4 at one insertion point (all three are familiar with ethanol injection therapy but are guides for the tube) I don't do training with a needle). This test was performed by each operator at a different location in the liver.

(result)
The tip of the guide needle could be fully confirmed under an ultrasonic guide, and the needle tip was not lost by echo. The 22 gauge puncture needle followed easily along the curved guide needle and followed even 3 and 8 cm deep. In addition, the surgeon can advance the guide needle and simultaneously move it straight by turning it around the axis. Further, the direction of insertion can be easily changed by changing the direction of the bevel surface, and there was no significant bending except in the direction along the direction of the bevel surface. The four balls could be punctured continuously by pulling the guide needle 3-4 cm and proceeding. At this time, it was necessary to pull or advance the guide needle several times, but the pulling distance was about 2 cm.

(Implementation conditions) The guide needle and the puncture needle are the same as in Example 1. The subjects were 4 patients with multiple tumors in the liver (3 of whom had cirrhosis).
(Execution method) A plurality of tumors in the liver were subjected to percutaneous ethanol injection therapy under an ultrasonic guide, and continuously injected into a plurality of tumors at one insertion point as much as possible.

(result)
In these four patients, the direction of insertion can be adjusted relatively easily, and a plurality of tumors can be treated at one insertion point. The sex was confirmed.

  Percutaneous ethanol injection therapy is an established treatment that is useful for liver tumors of 3 cm or less and 3 or less, but it is necessary to inject ethanol into the additional part, and the needle is accidentally inserted. In many cases, it is impossible to puncture the lesion due to the displacement of the direction, and usually a large number of punctures are required. On the other hand, thin puncture needles are superior in that they can minimize liver damage and ethanol backflow / leakage, but the thinner the needle, the easier it is to bend in the body, making accurate puncture difficult, and deeper lesions. The problem is that it is difficult to reach the point.

  On the other hand, by using the guide needle for a tubular body according to the present invention, the needle tip can be easily controlled in the liver, and accurate puncture can be performed for many lesions. As a result, the time for deciding the location of the needle tip could be shortened, and complications and patient pain could be reduced. In addition, since the guide needle for a tubular body of this example was extremely thin as compared with a normally used puncture needle, damage to the liver could be minimized. In addition, since the bendable part is formed by scraping the bevel surface side to form a flat surface, it seems that the flexibility of only the bevel surface direction comes out and it is easy to bend only in the extending direction of the inclined surface.

  The actions and effects described above by using the guide needle for a tubular body of the present invention are not limited to the above-described percutaneous ethanol injection therapy, and a treatment is performed percutaneously by placing a tubular body at a target location in the body. It is also demonstrated in various cases. For example, in the case of a treatment method in which a liquid other than ethanol (pharmaceutical, low-temperature liquefied gas, acetic acid, hot water, etc.) is injected into a target site in the body, or the electrode needle is somewhat thin and flexible in high-frequency thermotherapy. When guiding the guide tube to a target location, or when draining from a predetermined position in the body or injecting a medical solution continuously into the target location in the body, it can be used similarly, It will be useful as well.

  In particular, when there are other organs along the route of insertion into the lesion, or when the organ with the lesion is easily moved by breathing, or when there is a dangerous part near the lesion, it is difficult or dangerous. By advancing the needle while avoiding the route, it is possible to perform the procedure effectively while minimizing patient invasion and risk.

  The percutaneous ethanol injection therapy using the guide needle according to the present invention described above is actually used for several tens of patients thereafter, and all of them exhibit the same effects as described above. In addition, its usefulness has been confirmed by using multiple examples of biopsy of body tissues, especially when there are places such as thick blood vessels, bile ducts, gallbladders, etc. that you do not want to puncture in the course of the guide needle In addition, once it is possible to reach the target location while bypassing the location, and when a biopsy is performed by the coaxial method, a single puncture with the outer tube allows a plurality of different locations through the outer tube. It is possible to collect with.

  As described above, with respect to the treatment to be performed by arranging the tube body at a target position in the body, the present invention makes it possible to insert the tube body accurately and safely in any situation, and excessively invades the patient. It became possible to carry out treatment without any problems.

  2 Tube guide needle, 4 Puncture needle, 5 Guide tube, 20 Main body, 21 Straight part, 21a Mark, 22 Needle tip part, 22a Bevel surface, 23 Easy curve part, 23a Cutting surface, 24 Direction indicator, 25 Hub , 40 Needle part, 41, 52a Connection part, 41a Needle tip, 50 Syringe, 51 Biopsy needle, 52, 53 Catheter, 54 Guide wire, 55 Tubular body, 90 Hazardous area, 100, 101, 102, 103 Lesions, 104 Abscess Cavity, 251 upper part, 251a screw-like part, 252 lower part

Claims (8)

  A guide needle for transcutaneously placing a tube body having a predetermined function at a target location in the body, from a linear metal that has a thickness that can be inserted into the tube body and is mostly linear. A needle tip portion having one bevel surface formed on the distal end side of the main body, and a predetermined range on the distal end side of the main body adjacent to the needle tip portion is opposite to the direction of the bevel surface relative to other portions. And a direction indicating unit for allowing the operator to recognize the direction of the bevel surface or the opposite direction on the base end side of the main body. While the advance of the needle tip is guided in the extension direction of the bevel surface, the easy-bending portion is mainly bent so that the insertion direction is bent to the opposite side of the direction of the bevel surface, and the operator is operated under a predetermined image guide. Rotate the body around the axis to control the insertion direction to the desired direction. The tip of the tube is inserted into the body along the main body after the needle tip is advanced while the needle is advanced to reach the target location or the target location. A guide needle for a tubular body, characterized in that the guide needle is guided to the target location.   2. The tubular body according to claim 1, wherein the easily curved portion is formed so that a width in a direction corresponding to the direction of the bevel surface is shorter than a width in a direction perpendicular to the direction of the bevel surface. Guide needle.   The cross-sectional shape of the surface perpendicular to the central axis of the main body is circular except for the bendable portion and the needle tip portion, and the cross-sectional shape of the bendable portion is a predetermined range from the circle to the bevel surface side. The guide needle for a tubular body according to claim 2, wherein the guide needle is a substantially semi-circular shape formed by cutting the surface.   The said direction instruction | indication part bends the base end side predetermined range of the said main body to the reverse side of the direction of the said bevel surface, or the direction side of the said bevel surface, The Claim 1, 2, or 3 characterized by the above-mentioned. Guide needle for tubular body.   At the base end side of the main body, a hub made of a cylindrical member having a diameter larger than that of the main body is inserted into the insertion hole passing through the central axis of the main body so that the main body cannot rotate at least around the axis. The first, second, third, or fourth aspect of the present invention is characterized in that it is used as a gripping part at the time of insertion operation and as a knob for rotating the main body in the direction around the axis. The guide needle for tubular bodies described.   The mark for use as a reference of the insertion depth of the tubular body is displayed on the main body at a position corresponding to the entire length of the tubular body through which the distance from the tip is inserted. The guide needle for tubular bodies described in 1, 2, 3, 4 or 5.   7. The tube body is an injection needle for injecting a predetermined liquid, a guide tube for a biopsy needle, or a guide tube for an electrode needle. The guide needle for tubular bodies described in 1.   6. The tube according to claim 1, 2, 3, 4, 5, wherein the tube is an injection catheter for injecting a predetermined liquid or a drain catheter for discharging a liquid accumulated in a body cavity. Or the guide needle for tubular bodies described in 6.

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