JP4728047B2

JP4728047B2 - Endoscope catheter with balloon

Info

Publication number: JP4728047B2
Application number: JP2005162695A
Authority: JP
Inventors: 勝湯淺; 耕木村
Original assignee: Olympus Medical Systems Corp
Current assignee: Olympus Medical Systems Corp
Priority date: 2005-06-02
Filing date: 2005-06-02
Publication date: 2011-07-20
Anticipated expiration: 2025-06-02
Also published as: JP2006334149A

Description

本発明は、医療分野において、特に内視鏡と組み合わせて使用され、生体内の液体成分を回収するための内視鏡用バルーンカテーテルに関する。 The present invention relates to an endoscopic balloon catheter used in the medical field, particularly in combination with an endoscope, for collecting a liquid component in a living body.

従来、気管支肺胞内の液体成分を回収して診断する方法に気管支肺胞洗滌診断（Bronchoalveolar Lavage:BAL）がある。これは、気管支鏡自体の先端を目的部位にウェッジし、気管支肺胞に生理食塩水を注入した後、気管支肺胞内の液体を吸引して回収し、この回収した洗浄液に含まれる細胞成分などを分析し、病理診断や病因論的解析するものである。 Conventionally, bronchoalveolar lavage (BAL) is a method for recovering and diagnosing liquid components in bronchoalveoli. This is because the tip of the bronchoscope itself is wedged to the target site, saline is injected into the bronchoalveoli, the liquid in the bronchoalveoli is aspirated and collected, and the cellular components contained in the collected lavage fluid, etc. Analysis, pathological diagnosis and etiological analysis.

この場合、注入する生理食塩水は、気管支鏡のチャンネルから注入され、気管支肺胞内の液体は、気管支鏡に接続された外部の吸引装置により気管支鏡のチャンネルに陰圧を加えることにより気管支鏡のチャンネルを介して吸引回収するようにしていた。 In this case, the physiological saline to be injected is injected from the bronchoscope channel, and the liquid in the bronchoalveoli is applied to the bronchoscope channel by applying negative pressure to the bronchoscope channel by an external suction device connected to the bronchoscope. It was made to collect by suction through the channel.

従来の診断手法では、内視鏡が挿入できる気管支が比較的太い部分、即ち中枢気道領域からの生理食塩水の注入および回収が可能な領域にのみ適用できる。また、気管支鏡を用いた従来のＢＡＬでは、内視鏡先端より先の気管支は無数に分岐し、検査目的とする気管支以外の場所にも生理食塩水が注入され、その結果、ある程度広範囲な領域の細胞成分を回収してしまうため、病巣がどの気管支に存在するかは明確に解らなかった。
特表平９−５００３１２ The conventional diagnostic method can be applied only to a portion where the bronchus into which the endoscope can be inserted is relatively thick, that is, a region where physiological saline can be injected and recovered from the central airway region. In addition, in the conventional BAL using a bronchoscope, the bronchus ahead of the endoscope tip branches innumerably, and physiological saline is injected into places other than the bronchus to be examined. It was not clear which bronchus the lesions existed in because it collects the cellular components.
Special table hei 9-500312

そこで、特定の気管支を狙って、気管支鏡の先端より先の気管支に病巣が存在するか否かを確認したり、病態変化を観察したりする意味での限局性のＢＡＬ手技を提案する。これは、バルーン付きのカテーテルを用い、そのバルーンの拡張にて気管支腔にカテーテルをウェッジさせようとするものである。 Therefore, we propose a localized BAL technique in the sense of aiming at a specific bronchi and confirming whether a lesion exists in the bronchus beyond the tip of the bronchoscope or observing pathological changes. In this method, a catheter with a balloon is used, and the catheter is wedged into the bronchial cavity by expanding the balloon.

バルーン付カテーテルの形態としては、使用目的が異なるものの、特許文献１（特表平９−５００３１２）において提案される薬剤配分ＰＴＣ血管内カテーテルがある。 As a form of the balloon catheter, there is a drug distribution PTC intravascular catheter proposed in Patent Document 1 (Japanese Translation of PCT International Publication No. 9-500312), although the purpose of use is different.

しかしながら、この特許文献１によって提案されるダブルバルーンカテーテルは、送水ルーメン・吸引ルーメン・バルーン拡張用ルーメンを備え、それぞれのルーメンに接続される多数のポートがあるように、複雑で太径化し易い構造のものであるとともに、仮に、これをＢＡＬの手技に適用する場合、その取扱いが非常に煩雑になり、素早い処置が困難になってしまう。 However, the double balloon catheter proposed by Patent Document 1 includes a water supply lumen, a suction lumen, and a balloon expansion lumen, and has a complicated and easily increased diameter structure such that there are a large number of ports connected to each lumen. In addition, if this is applied to a BAL procedure, the handling becomes very complicated and a quick treatment becomes difficult.

ＢＡＬでは局部的ではあるが、気管支内を液体で満たしてしまうため、患者への負担が大きい。そのため、送液した生理食塩水を早急に吸引する必要がある。特許文献１のダブルバルーンカテーテルのように複数のルーメンを設けたものであると、一つ一つのルーメン径が小径になってしまい、流体を送り出したり吸引したりする際に管路抵抗が大きくなって、吸引時間が長くなってしまうという問題がある。 Although it is localized in BAL, it fills the bronchi with fluid, which places a heavy burden on the patient. Therefore, it is necessary to aspirate the supplied physiological saline immediately. When a plurality of lumens are provided as in the double balloon catheter of Patent Document 1, each lumen diameter becomes small, and the pipe resistance increases when fluid is sent out or sucked. Therefore, there is a problem that the suction time becomes long.

さらに、各ポートに接続したシリンジにより、バルーンの拡張・生理食塩水の注入を行い、吸引装置に接続された吸引チューブにより吸引ルーメンから回収液の吸引を行うため、従来の「鉗子口から生理食塩水を入れ、吸引装置により鉗子チャンネル内に陰圧をかけ、鉗子チャンネルを介して生理食塩水を回収する」という従来のＢＡＬの操作方法とは異なる煩雑な操作方法となってしまい、使用勝手が悪くなる。 In addition, the syringe connected to each port expands the balloon, injects physiological saline, and sucks the recovered liquid from the suction lumen using the suction tube connected to the suction device. This is a complicated operation method that is different from the conventional BAL operation method, in which water is put in, negative pressure is applied to the forceps channel by a suction device, and physiological saline is recovered through the forceps channel. Deteriorate.

本発明の目的は、上記課題を解決するために考えられたもので、内視鏡のチャンネルに挿入して生体内の成分を液体と共に回収することが簡便でかつ素早く行うことができるようになり、従来の回収方法と同様な操作で回収作業を可能とするバルーンカテーテルを提供することである。
The object of the present invention has been conceived to solve the above-mentioned problems, and it is possible to simply and quickly perform the recovery of the components in the living body together with the liquid by inserting into the channel of the endoscope. Another object of the present invention is to provide a balloon catheter that enables a recovery operation by the same operation as the conventional recovery method.

請求項１の発明は、内視鏡のチャンネルに挿通して生体内の成分を液体と共に回収するために使用する内視鏡用バルーン付カテーテルにおいて、可撓性を有する管状部材と、上記管状部材に沿って形成された、膨張流体提供手段に接続される第１内空と、液体提供手段に接続される第２内空と、第３内空と、上記管状部材の先端部に配置され、上記第１内空を通じて膨張流体提供手段から膨張流体の供給を受けて膨張し、上記生体内を封止する状態で該生体に保持される先端側膨張部材と、上記先端側膨張部材よりも基端側に位置して上記管状部材上に配置され、上記第１内空を通じて膨張流体提供手段から膨張流体の供給を受けて膨張し、内視鏡のチャンネルを封止する状態で該チャンネルの内壁に保持される基端側膨張部材と、上記先端側膨張部材よりも先端側に位置した上記管状部材の部分における外面に設けられ、上記第２内空を生体内に連通する開孔と、上記先端側膨張部材よりも先端側に位置した上記管状部材の部分における外面に設けられ、上記第３内空を生体内に連通する先端開孔部と、上記基端側膨張部材よりも基端側に位置した上記管状部材の部分における外面に設けられ、上記第３内空を上記内視鏡のチャンネルに連通する基端開孔部と、を備えたことを特徴とする。
請求項２の発明は、内視鏡のチャンネルに挿通して生体内の成分を液体と共に回収するために使用する内視鏡用バルーン付カテーテルにおいて、可撓性を有する第１管状部材と、上記第１管状部材を進退移動可能に挿通する可撓性を有する第２管状部材と、上記第１管状部材に沿って形成された、第１膨張流体提供手段に接続される第１内空と、液体提供手段に接続される第２内空と、第３内空と、上記第２管状部材に沿って形成された、第２膨張流体提供手段に接続される第４内空と、上記第１管状部材の先端部に配置され、上記第１内空を通じて上記第１膨張流体提供手段から膨張流体の供給を受けて膨張し、上記生体内を封止する状態で該生体に保持される先端側膨張部材と、上記第２管状部材の先端部に配置され、上記第４内空を通じて上記第２膨張流体提供手段から膨張流体の供給を受けて膨張し、内視鏡のチャンネルを封止する状態で該チャンネルの内壁に保持される基端側膨張部材と、上記先端側膨張部材よりも先端側に位置した上記第１管状部材の部分における外面に設けられ、上記第２内空を生体内に連通する開孔と、上記先端側膨張部材よりも先端側に位置した上記第１管状部材の部分における外面に設けられ、上記第３内空を生体内に連通する先端開孔部と、上記基端側膨張部材よりも基端側に位置した上記第１管状部材の部分における側面に設けられ、上記第３内空に連通する基端開孔部と、上記第２管状部材上に設けられ、上記基端側膨張部材よりも基端側に位置して開孔し、上記基端開孔部に連通する切欠き部と、を備えたことを特徴とする。
請求項３の発明は、内視鏡のチャンネルに挿通して生体内の成分を液体と共に回収するために使用する内視鏡用バルーン付カテーテルにおいて、可撓性を有する管状部材と、上記管状部材に沿って形成された第１内空、第２内空および第３内空と、上記管状部材の先端部に配置され、上記第１内空を通じて膨張流体の供給を受けて膨張し、上記生体内を封止する状態で該生体に保持される先端側膨張部材と、上記先端側膨張部材よりも基端側に位置して上記管状部材上に配置され、上記第１内空を通じて膨張流体の供給を受けて膨張し、内視鏡のチャンネルを封止する状態で該チャンネルの内壁に保持される基端側膨張部材と、上記第１内空に接続され、該第１内空に膨張流体を提供する膨張流体提供手段と、上記先端側膨張部材よりも先端側に位置した上記管状部材の部分における外面に設けられ、上記第２内空を生体内に連通する開孔と、上記第２内空に接続され、該第２内空に液体を提供する液体提供手段と、上記先端側膨張部材よりも先端側に位置した上記管状部材の部分における外面に設けられ、上記第３内空を生体内に連通する先端開孔部と、上記基端側膨張部材よりも基端側に位置した上記管状部材の部分における側面に設けられ、上記第３内空を上記内視鏡のチャンネルに連通する基端開孔部と、を備えたことを特徴とする。
請求項４の発明は、内視鏡のチャンネルに挿通して生体内の成分を液体と共に回収するために使用する内視鏡用バルーン付カテーテルにおいて、可撓性を有する第１管状部材と、上記第１管状部材を進退移動可能に挿通する可撓性を有する第２管状部材と、上記第１管状部材に沿って形成された第１内空、第２内空および第３内空と、上記第２管状部材に沿って形成された第４内空と、上記第１管状部材の先端部に配置され、上記第１内空を通じて膨張流体の供給を受けて膨張し、上記生体内を封止する状態で該生体に保持される先端側膨張部材と、上記第１内空に接続され、該第１内空に膨張流体を提供する第１膨張流体提供手段と、上記第２管状部材の先端部に配置され、上記第４内空を通じて膨張流体の供給を受けて膨張し、内視鏡のチャンネルを封止する状態で該チャンネルの内壁に保持される基端側膨張部材と、上記第４内空に接続され、該第４内空に膨張流体を提供する第２膨張流体提供手段と、上記先端側膨張部材よりも先端側に位置した上記第１管状部材の部分における外面に設けられ、上記第２内空を生体内に連通する開孔と、上記先端側膨張部材よりも先端側に位置した上記第１管状部材の部分における外面に設けられ、上記第３内空を生体内に連通する先端開孔部と、上記基端側膨張部材よりも基端側に位置した上記第１管状部材の部分における側面に設けられ、上記第３内空に連通する基端開孔部と、上記第２管状部材上に設けられ、上記基端側膨張部材よりも基端側に位置して開孔し、上記基端開孔部に連通する切欠き部と、を備えたことを特徴とする。
The invention according to claim 1 is a catheter having a balloon for an endoscope, which is used for recovering a component in a living body together with a liquid by being inserted into a channel of an endoscope, and a tubular member having flexibility, and the tubular member A first inner space connected to the inflation fluid providing means, a second inner space connected to the liquid providing means, a third inner space, and a distal end portion of the tubular member, A distal-side expansion member that is inflated by receiving an expansion fluid supplied from the expansion fluid providing means through the first inner space and that is sealed in the living body, and more The inner wall of the channel is disposed on the tubular member at the end side, expands upon receiving the supply of the inflation fluid from the inflation fluid providing means through the first inner space, and seals the channel of the endoscope. a base end side inflation member being held in, the tip An opening provided on the outer surface of the tubular member portion located on the distal end side with respect to the inflating member, and communicating with the second inner space into the living body, and the tubular member located on the distal end side with respect to the distal end side inflating member Provided on the outer surface of the portion, provided on the outer surface of the portion of the tubular member located on the proximal side relative to the proximal side expansion member, and the distal end opening portion communicating the third inner space with the living body, A proximal end opening that communicates the third inner space with a channel of the endoscope .
According to a second aspect of the present invention, there is provided a catheter having a balloon for an endoscope, which is used for recovering a component in a living body together with a liquid by being inserted into a channel of an endoscope. A flexible second tubular member that is inserted through the first tubular member so as to be capable of moving forward and backward, and a first inner space formed along the first tubular member and connected to the first inflation fluid providing means; A second inner space connected to the liquid providing means ; a third inner space; a fourth inner space formed along the second tubular member and connected to the second inflation fluid providing means; and the first A distal end side that is disposed at the distal end of the tubular member, expands upon supply of the inflation fluid from the first inflation fluid providing means through the first inner space , and is held by the living body in a state of sealing the living body passing the expandable member is disposed at the distal end of the second tubular member, the fourth in the sky And the second expansion from the fluid providing means supplied with inflation fluid expands, the proximal expandable member in a state of sealing the channels of the endoscope is held on an inner wall of the channel Te, the leading end side inflation member The first tubular member is provided on the outer surface of the first tubular member located closer to the distal end than the distal end expansion member and the opening that communicates the second inner space with the living body. A distal end opening provided on the outer surface of the tubular member portion and communicating the third inner space with the living body, and a side surface of the first tubular member portion located on the proximal side of the proximal end expansion member provided, the a proximal opening communicating with the third inner air, provided on the second tubular member, and opening located on the base end side than the base end side inflation member, the group And a notch communicating with the end opening.
According to a third aspect of the present invention, there is provided a catheter having a balloon for an endoscope, which is used for collecting a component in a living body together with a liquid by being inserted into a channel of the endoscope, and a tubular member having flexibility, and the tubular member The first inner space, the second inner space, and the third inner space formed along the inner space, and the distal end portion of the tubular member are expanded by receiving the supply of the expansion fluid through the first inner space. A distal-side expansion member held by the living body in a state of sealing the inside of the body, and disposed on the tubular member at a proximal end side with respect to the distal-end-side expansion member; The base end side expansion member held on the inner wall of the channel in a state where the supply expands and seals the channel of the endoscope, and is connected to the first internal space, and the expansion fluid is connected to the first internal space An expansion fluid providing means for providing a distal end than the distal end side expansion member Provided on the outer surface of the portion of the tubular member located at the position, and an opening that communicates the second inner space with the living body, and a liquid that is connected to the second inner space and provides the liquid to the second inner space Means, a distal opening portion provided on an outer surface of the tubular member located on the distal side of the distal-side expansion member, and communicating the third inner space with the living body; and a proximal-side expansion member And a proximal end opening portion provided on a side surface in the portion of the tubular member positioned on the proximal end side and communicating the third inner space with the channel of the endoscope.
According to a fourth aspect of the present invention, there is provided a catheter having a balloon for an endoscope, which is used for collecting a component in a living body together with a liquid by being inserted into a channel of an endoscope, the first tubular member having flexibility, and the above-mentioned A flexible second tubular member that is inserted through the first tubular member so as to be movable forward and backward, a first inner space, a second inner space, and a third inner space formed along the first tubular member; A fourth inner space formed along the second tubular member and a distal end portion of the first tubular member are arranged to expand by receiving an inflation fluid supplied through the first inner space, thereby sealing the inside of the living body. A distal-side inflating member held by the living body in a state of being connected, a first inflating fluid providing means connected to the first inner space and providing an inflating fluid to the first inner space, and a distal end of the second tubular member Placed in the section, receives the supply of the expansion fluid through the fourth inner space, and expands, A proximal-side expansion member that is held on the inner wall of the channel in a state of sealing the channel, and a second expansion fluid providing means that is connected to the fourth inner space and provides the expansion fluid to the fourth inner space; An opening provided on the outer surface of the portion of the first tubular member located on the distal end side with respect to the distal end side expansion member, and communicating with the second interior space into the living body, and on the distal end side with respect to the distal end side expansion member A distal end opening provided on the outer surface of the portion of the first tubular member that is positioned and communicating the third inner space with the living body, and the first tubular positioned closer to the proximal side than the proximal end expansion member A base end opening provided on a side surface of the member and communicating with the third inner space; and a base end opening provided on the second tubular member and positioned closer to the base end than the base end expansion member. And a notch portion that communicates with the base end opening portion.

本発明によれば、バルーンカテーテルを内視鏡のチャンネルに挿入して生体内の成分を液体と共に回収することが簡便でかつ素早く容易に行うことが可能となる。その操作方法は、通常のＢＡＬと同様の操作方法にて行うことが可能である。また、吸引ルーメンをカテーテル全長に渡り配置する必要がなく、その分、バルーン膨張用ルーメンや送液ルーメンを大きく取ることができ、管路抵抗を軽減することが可能となる。さらに、内視鏡の処置具チャンネルを吸引管路とすることで、一般的なカテーテル内のルーメンで吸引する場合と比較して吸引能力が向上し、しかも、吸引時間を短縮できる。
According to the present invention, it is simple, quick and easy to insert a balloon catheter into a channel of an endoscope and collect components in the living body together with the liquid . The operation method can be performed by the same operation method as normal BAL. Further, there is no need to arrange the suction lumen over the entire length of the catheter, and accordingly, a balloon inflation lumen and a liquid feeding lumen can be made larger, and the duct resistance can be reduced. Furthermore, by using the treatment instrument channel of the endoscope as a suction line, the suction ability is improved as compared with the case of suction with a lumen in a general catheter, and the suction time can be shortened.

（第１実施形態）
図１〜図５を参照して本発明の第１実施形態に係る内視鏡用バルーンカテーテルについて説明する。 (First embodiment)
An endoscope balloon catheter according to a first embodiment of the present invention will be described with reference to FIGS.

図１（ａ）に示すように、内視鏡用バルーンカテーテル１は、後述する内視鏡のチャンネルに挿通可能で可撓性を有する管状部材としてのカテーテルチューブ２を有しており、カテーテルチューブ２内には、後述するように複数の内空が形成されている。カテーテルチューブ２の先端部３には、先端側膨張部材としての先端側バルーン４と、この先端側バルーン４よりも基端側に位置して設けられる基端側膨張部材としての基端側（後端側）バルーン５とが設けられている。カテーテルチューブ２の基端部２１は２つの部分に分岐し、それぞれの分岐端には液体を提供する手段としての送水ポート９と、膨張流体を提供する手段としてのバルーン膨張用ポート１０が別々に取り付けられている。 As shown in FIG. 1 (a), an endoscope balloon catheter 1 has a catheter tube 2 as a flexible tubular member that can be inserted into an endoscope channel, which will be described later. A plurality of inner spaces are formed in 2 as will be described later. The distal end portion 3 of the catheter tube 2 includes a distal end side balloon 4 as a distal end side inflating member and a proximal end side (rear side) as a proximal end side inflating member provided at a proximal end side with respect to the distal end side balloon 4. End side) balloon 5 is provided. The proximal end portion 21 of the catheter tube 2 branches into two parts, and a water supply port 9 as a means for providing a liquid and a balloon inflation port 10 as a means for providing an inflation fluid are separately provided at each branch end. It is attached.

図２（ａ）に示すように、カテーテルチューブ２の先端部３には先端側バルーン４よりも先端側に位置して側周壁面に開孔した送水孔６ａが設けられ、この送水孔６ａはカテーテルチューブ２内の送水ルーメン（内空）６を介して上記送水ポート９へ連通している。カテーテルチューブ２の先端部３には先端側バルーン４よりも先端側に位置して吸引孔７ａが設けられており、本実施形態ではカテーテルチューブ２の先端に開口している。この吸引孔７ａはカテーテルチューブ２内の吸引ルーメン（内空）７を介して基端側バルーン５よりも基端側に位置して側周壁面に開孔した吸引ルーメン開孔部７ｂに連通している。吸引孔７ａと吸引ルーメン開孔部７ｂの間にはカテーテルチューブ２の先端部３の領域に設けた先端側バルーン４と基端側バルーン５の両方が位置する。 As shown in FIG. 2 (a), the distal end portion 3 of the catheter tube 2 is provided with a water supply hole 6a which is located on the distal end side with respect to the distal end side balloon 4 and is opened in the side peripheral wall surface. The water supply port 9 communicates with the water supply port 9 through a water supply lumen (inside air) 6 in the catheter tube 2. The distal end portion 3 of the catheter tube 2 is provided with a suction hole 7a located on the distal end side with respect to the distal end side balloon 4, and is opened at the distal end of the catheter tube 2 in this embodiment. The suction hole 7 a communicates with a suction lumen opening 7 b that is located on the base end side of the base end side balloon 5 through the suction lumen (inside air) 7 in the catheter tube 2 and is opened in the side wall surface. ing. Between the suction hole 7a and the suction lumen opening 7b, both the distal balloon 4 and the proximal balloon 5 provided in the region of the distal end 3 of the catheter tube 2 are located.

図２（ａ）に示すように、カテーテルチューブ２の先端部３には、先端側バルーン４内に位置した先端側バルーン内開孔部８ａと、基端側バルーン５内に位置した基端側バルーン内開孔部８ｂとが設けられている。そして、先端側バルーン内開孔部８ａと基端側バルーン内開孔部８ｂはいずれもカテーテルチューブ２内に形成したバルーン膨張用ルーメン（内空）８に接続され、互いに連通している。また、バルーン膨張用ルーメン８の基端は上記バルーン膨張用ポート１０へ連通している。 As shown in FIG. 2 (a), the distal end portion 3 of the catheter tube 2 has a distal end side balloon opening 8 a located in the distal end side balloon 4 and a proximal end side located in the proximal end side balloon 5. A balloon opening 8b is provided. The distal balloon inner opening 8a and the proximal balloon opening 8b are both connected to and communicate with a balloon inflation lumen (inner space) 8 formed in the catheter tube 2. The proximal end of the balloon inflation lumen 8 communicates with the balloon inflation port 10.

次に、図３〜図６を参照して、本実施形態に係る内視鏡用バルーンカテーテル１の作用を説明する。 Next, with reference to FIGS. 3-6, the effect | action of the balloon catheter 1 for endoscopes which concerns on this embodiment is demonstrated.

まず、図３に示すように、気管支まで挿入した内視鏡１２の処置具チャンネル１３を介してカテーテルチューブ２を目的気管支１１へ挿入する。そして、先端側バルーン４が目的気管支１１内に位置し、基端側バルーン５は内視鏡１２の処置具チャンネル１３内に位置するようにする。 First, as shown in FIG. 3, the catheter tube 2 is inserted into the target bronchus 11 through the treatment instrument channel 13 of the endoscope 12 inserted up to the bronchus. The distal balloon 4 is positioned in the target bronchus 11 and the proximal balloon 5 is positioned in the treatment instrument channel 13 of the endoscope 12.

次に、バルーン膨張用ポート１０へ流体を注入し、これにより、バルーン膨張用ルーメン８を介して、先端側バルーン４に流体を注入し、先端側バルーン４を膨張させることにより、目的気管支１１内にウェッジさせる。このとき、基端側バルーン５は、同じバルーン膨張用ルーメン８に連通しているため、同時に内視鏡１２の処置具チャンネル１３内で膨張し、チャンネル内を封止する。 Next, a fluid is injected into the balloon inflating port 10, thereby injecting the fluid into the distal balloon 4 via the balloon inflation lumen 8 and inflating the distal balloon 4, so To wedge. At this time, since the proximal balloon 5 communicates with the same balloon inflation lumen 8, it is simultaneously inflated in the treatment instrument channel 13 of the endoscope 12 and seals the inside of the channel.

その後、送水ポート９から送水ルーメン６に生理食塩水１４を注入する。送水ルーメン６に注入された生理食塩水１４は、先端側バルーン４より先に位置する送水孔６ａよりカテーテルチューブ２の外へ送液され、目的気管支１１内に注入される。 Thereafter, physiological saline 14 is injected from the water supply port 9 into the water supply lumen 6. The physiological saline 14 injected into the water supply lumen 6 is supplied to the outside of the catheter tube 2 through the water supply hole 6 a located before the distal end side balloon 4 and injected into the target bronchus 11.

この生理食塩水１４の注入後、内視鏡１２に設けられた吸引装置２３（図６参照）により、内視鏡１２の処置具チャンネル１３内に陰圧をかける。 After the injection of the physiological saline 14, negative pressure is applied in the treatment instrument channel 13 of the endoscope 12 by a suction device 23 (see FIG. 6) provided in the endoscope 12.

このとき、内視鏡１２の処置具チャンネル１３の先端側部分では、図４に示すように、基端側バルーン５が封止する。また、処置具チャンネル１３の基端側部分では、図５に示すように、鉗子栓１６により封止されている。したがって、吸引装置２３による陰圧は、吸引ルーメン開孔部７ｂを介して、吸引ルーメン７にかかるので、先端側バルーン４より先に位置する吸引孔７ａからカテーテルチューブ２外の液体を吸引する。 At this time, at the distal end portion of the treatment instrument channel 13 of the endoscope 12, the proximal balloon 5 is sealed as shown in FIG. Further, the proximal end portion of the treatment instrument channel 13 is sealed with a forceps plug 16 as shown in FIG. Therefore, since the negative pressure by the suction device 23 is applied to the suction lumen 7 via the suction lumen opening 7b, the liquid outside the catheter tube 2 is sucked from the suction hole 7a located before the distal end side balloon 4.

このようにして、吸引孔７ａから吸引された回収液１５は、吸引ルーメン７を介して、吸引ルーメン開孔部７ｂよりカテーテルチューブ２外へ排出され、内視鏡１２の処置具チャンネル１３に入り込む。その後、回収液１５は、図５および図６に示すように、内視鏡１２の処置具チャンネル１３と、外部の吸引チューブ２４を介して、回収容器２２内に回収される。 In this way, the collected liquid 15 sucked from the suction hole 7a is discharged from the catheter lumen 2 through the suction lumen 7 through the suction lumen 7, and enters the treatment instrument channel 13 of the endoscope 12. . Thereafter, the recovery liquid 15 is recovered in the recovery container 22 via the treatment instrument channel 13 of the endoscope 12 and the external suction tube 24 as shown in FIGS. 5 and 6.

以上の如く、本実施形態によれば、先端側バルーン４を設けたことにより、送水孔６ａから送出された液体が先端側バルーン４よりも基端側に漏出することを防ぐ。このため、特定の気管支における限局的なＢＡＬを実施できる。 As described above, according to the present embodiment, the provision of the distal end side balloon 4 prevents the liquid delivered from the water supply hole 6 a from leaking to the proximal end side from the distal end side balloon 4. For this reason, localized BAL in a specific bronchus can be performed.

また、基端側バルーン５と鉗子栓１６により、処置具チャンネル１３内の気密を保つことができるので、通常の内視鏡検査に用いられる吸引装置で回収液を回収することが可能である。
さらに、本実施形態によれば、通常のＢＡＬと同じ操作方法で限局的ＢＡＬを実施することができる。 Further, the proximal balloon 5 and the forceps plug 16 can keep the inside of the treatment instrument channel 13 airtight, so that the collected liquid can be collected by a suction device used for normal endoscopy.
Furthermore, according to the present embodiment, the localized BAL can be performed by the same operation method as a normal BAL.

（第２実施形態）
図７を参照して、本発明の第２実施形態に係る内視鏡用バルーンカテーテルについて説明する。本実施形態に係る内視鏡用バルーンカテーテル１は、摺動し合って互いに軸方向への進退が可能なインナーカテーテル１７とアウターカテーテル１８により構成されている。 (Second Embodiment)
With reference to FIG. 7, a balloon catheter for an endoscope according to a second embodiment of the present invention will be described. The endoscope balloon catheter 1 according to the present embodiment is constituted by an inner catheter 17 and an outer catheter 18 that can slide and move forward and backward in the axial direction.

図７（ａ）に示すように、インナーカテーテル１７は、内部に複数の内空を有した可撓性を有する長尺なカテーテル１９の部分と、このカテーテル１９の先端部に位置して設けられた先端側バルーン１０４とからなる。カテーテル１９には、送水ルーメン１０６と、吸引ルーメン１０７と、バルーン拡張用ルーメン１１０が形成されている。 As shown in FIG. 7 (a), the inner catheter 17 is provided at a position of the flexible long catheter 19 having a plurality of inner spaces and a distal end portion of the catheter 19. And a distal end side balloon 104. In the catheter 19, a water supply lumen 106, a suction lumen 107, and a balloon expansion lumen 110 are formed.

送水ルーメン１０６は、先端側バルーン１０４よりも先端側に位置して外部に開孔する送水孔１０６ａを有しており、カテーテル１９の基端側に設置された送水ポートに連通している。吸引ルーメン１０７は、カテーテル１９の最先端に開孔した先端吸引孔１７ａと、インナーカテーテル１７の側外周壁に先端側バルーン１０４よりも基端側に位置して開孔した吸引ルーメン孔１０７ｂとを連通させる。インナーカテーテル１７内に形成されたバルーン拡張用ルーメン１１０は先端側バルーン内開孔部１１０ａに接続されている。 The water supply lumen 106 has a water supply hole 106 a that is located on the distal end side than the distal end side balloon 104 and opens to the outside, and communicates with a water supply port installed on the proximal end side of the catheter 19. The suction lumen 107 includes a distal suction hole 17a opened at the foremost end of the catheter 19 and a suction lumen hole 107b opened at a proximal end side of the distal side balloon 104 on the side outer peripheral wall of the inner catheter 17. Communicate. The balloon expansion lumen 110 formed in the inner catheter 17 is connected to the distal-end balloon opening 110a.

上記アウターカテーテル１８は、複数の内空を備えた可撓性を有する長尺な筒状のチューブ２０と、このチューブ２０の先端部に取り付けられた基端側バルーン１０５とからなり、さらに、上記チューブ２０には、上記基端側バルーン１０５に連通したバルーン膨張用ルーメン１０８と、インナーカテーテル１７のカテーテル１９の部分を摺動自在に挿通するためのインナーカテーテル挿通ルーメン１０９と、図７（ｂ）に示すように、カテーテル１９の長軸方向に延びて長い切欠き部２６とを有する。バルーン膨張用ルーメン１０８は基端側バルーン内開孔部１０８ａを介して基端側バルーン１０５に連通している。バルーン膨張用ルーメン１０８は、上述したインナーカテーテル１７の基端側バルーン１０５に連通している。 The outer catheter 18 includes a flexible long cylindrical tube 20 having a plurality of inner spaces, and a proximal balloon 105 attached to the distal end portion of the tube 20. The tube 20 has a balloon inflation lumen 108 communicating with the proximal balloon 105, an inner catheter insertion lumen 109 for slidably inserting the catheter 19 portion of the inner catheter 17, and FIG. As shown in FIG. 3, the catheter 19 has a long notch 26 extending in the long axis direction. The balloon inflation lumen 108 communicates with the proximal balloon 105 via the proximal balloon opening 108a. The balloon inflation lumen 108 communicates with the proximal balloon 105 of the inner catheter 17 described above.

そこで、インナーカテーテル１７が、アウターカテーテル１８のインナーカテーテル挿通ルーメン１０９に挿入されているとき、インナーカテーテル吸引ルーメン孔１０７ｂは、図７（ｂ）に示すように、アウターカテーテル１８に形成した切欠き部２６に重複一致するように配置される。 Therefore, when the inner catheter 17 is inserted into the inner catheter insertion lumen 109 of the outer catheter 18, the inner catheter suction lumen hole 107b has a notch formed in the outer catheter 18, as shown in FIG. 26 are arranged so as to overlap with each other.

したがって、インナーカテーテル１７とアウターカテーテル１８が摺動可能に組み合わせられた状態で、インナーカテーテル１７の吸引ルーメン１０７はアウターカテーテル１８の切欠き部２６まで連通する。このため、先端吸引口１０７ａから吸引した回収液は、吸引ルーメン１０７を通り、インナーカテーテル吸引ルーメン孔１０７ｂを経由して切欠き部２６からアウターカテーテル１８の外へ送出し、最終的に内視鏡のチャンネルを通じて回収できる。この他の作用は第１実施形態の場合と同様である。 Accordingly, the suction lumen 107 of the inner catheter 17 communicates with the cutout portion 26 of the outer catheter 18 in a state where the inner catheter 17 and the outer catheter 18 are slidably combined. For this reason, the collected liquid sucked from the tip suction port 107a passes through the suction lumen 107, and is sent out of the outer catheter 18 from the notch portion 26 via the inner catheter suction lumen hole 107b, and finally the endoscope. Can be collected through other channels. Other operations are the same as those in the first embodiment.

本実施形態によれば、使用状況に応じて先端側バルーン１０４と基端側バルーン１０５の前後方向の相対位置を最適な状態に調整できる。また、インナーカテーテル吸引ルーメン孔１０７ｂはアウターカテーテル１８の切欠き部２６の開孔部分が一致するように配置されているので、インナーカテーテル１７が軸方向に相対的に移動した際にも吸引可能である。この他の効果は上述した第１実施形態と同様である。 According to the present embodiment, the relative position in the front-rear direction of the distal balloon 104 and the proximal balloon 105 can be adjusted to an optimum state in accordance with the usage situation. Further, since the inner catheter suction lumen hole 107b is arranged so that the opening portion of the cutout portion 26 of the outer catheter 18 coincides, it can be sucked even when the inner catheter 17 moves relatively in the axial direction. is there. Other effects are the same as those of the first embodiment.

なお、本発明は前述した実施形態に限定されるものではなく、他の形態にも適用可能である。 In addition, this invention is not limited to embodiment mentioned above, It can apply also to another form.

本発明の第１実施形態に係る内視鏡用バルーンカテーテル全体の外観図。1 is an external view of an entire endoscope balloon catheter according to a first embodiment of the present invention. FIG. （ａ）は同じく第１実施形態に係る内視鏡用バルーンカテーテルの先端部付近の縦断面図、（ｂ）は同じく第１実施形態に係る内視鏡用バルーンカテーテルの基端部付近の縦断面図。(A) is a longitudinal sectional view of the vicinity of the distal end portion of the endoscope balloon catheter according to the first embodiment, and (b) is a longitudinal section of the vicinity of the proximal end portion of the endoscope balloon catheter according to the first embodiment. Plan view. 同じく第１実施形態に係る内視鏡用カテーテルの使用状態の説明図。Explanatory drawing of the use condition of the catheter for endoscopes similarly concerning 1st Embodiment. 同じく第１実施形態に係る内視鏡用カテーテルの先端部付近の使用状態での断面図。Sectional drawing in the use condition of the front-end | tip part vicinity of the endoscope catheter which concerns on 1st Embodiment similarly. 同じく第１実施形態に係る内視鏡用カテーテルの基端部付近の使用状態での断面図。Sectional drawing in the use condition of the proximal end part of the endoscope catheter which concerns on 1st Embodiment similarly. 同じく第１実施形態に係る内視鏡用カテーテルを使用する場合の外部装置の説明図。Explanatory drawing of the external device in the case of using the endoscope catheter which concerns on 1st Embodiment similarly. （ａ）は本発明の第２実施形態に係る内視鏡用バルーンカテーテルの先端部付近の縦断面図、（ｂ）は同じく第２実施形態に係る内視鏡用バルーンカテーテルの基端部付近の平面図、（ｃ）は（ａ）中のＣ−Ｃ線に沿う断面図。(A) is a longitudinal sectional view of the vicinity of the distal end portion of the balloon catheter for an endoscope according to the second embodiment of the present invention, and (b) is the vicinity of the proximal end portion of the balloon catheter for an endoscope according to the second embodiment. (C) is sectional drawing which follows the CC line in (a).

Explanation of symbols

１…内視鏡用バルーンカテーテル
２…カテーテル
３…先端部
４…先端側バルーン
５…基端側バルーン
６…送水ルーメン
７…吸引ルーメン
８…バルーン膨張用ルーメン
１３…処置具チャンネル
１４…生理食塩水 DESCRIPTION OF SYMBOLS 1 ... Endoscope balloon catheter 2 ... Catheter 3 ... Tip part 4 ... Tip side balloon 5 ... Base end side balloon 6 ... Water supply lumen 7 ... Suction lumen 8 ... Balloon inflation lumen 13 ... Treatment instrument channel 14 ... Saline

Claims

In a catheter with a balloon for an endoscope that is used to collect a component in a living body together with a liquid by being inserted into a channel of an endoscope.
A flexible tubular member;
A first inner space formed along the tubular member and connected to the inflation fluid providing means; a second inner space connected to the liquid providing means; and a third inner space;
A distal-side expansion member that is disposed at the distal end portion of the tubular member, expands upon supply of an expansion fluid from the expansion fluid supply means through the first inner space , and is held by the living body in a state of sealing the living body When,
It is located on the tubular member and is located on the proximal side relative to the distal-side expansion member, expands upon receiving supply of the expansion fluid from the expansion fluid supply means through the first inner space, and seals the channel of the endoscope. A proximal expansion member held on the inner wall of the channel in a stopped state ;
An opening provided on the outer surface of the portion of the tubular member located on the distal end side relative to the distal end-side expansion member, and communicating the second inner space with the living body;
A tip opening portion provided on the outer surface of the tubular member located on the tip side of the tip side expansion member, and communicating the third inner space with the living body;
A proximal end opening provided on the outer surface of the tubular member located on the proximal side relative to the proximal side expansion member, and communicating the third interior with the channel of the endoscope;
A catheter with a balloon for an endoscope, comprising:

In a catheter with a balloon for an endoscope that is used to collect a component in a living body together with a liquid by being inserted into a channel of an endoscope.
A flexible first tubular member;
A second tubular member having flexibility for inserting the first tubular member so as to be capable of moving forward and backward;
A first inner space formed along the first tubular member and connected to the first inflation fluid providing means; a second inner space connected to the liquid providing means; and a third inner space;
A fourth inner space formed along the second tubular member and connected to the second inflation fluid providing means ;
It is arrange | positioned at the front-end | tip part of the said 1st tubular member, receives supply of an expansion | swelling fluid from the said 1st expansion | swelling fluid provision means through the said 1st internal space, expand | swells, and is hold | maintained at this biological body in the state which seals the said biological body. A distal-side expansion member,
The second tubular member is disposed at the distal end of the second tubular member, expands upon receiving the supply of the inflation fluid from the second inflation fluid providing means through the fourth inner space, and seals the channel of the endoscope. A proximal expansion member held by the inner wall ;
An opening provided on the outer surface of the portion of the first tubular member located on the distal end side relative to the distal-end-side expansion member, and communicating the second inner space with the living body;
A tip opening provided on the outer surface of the portion of the first tubular member located on the tip side of the tip side expansion member, and communicating the third inner space with the living body;
A base end opening portion provided on a side surface of the first tubular member located on the base end side relative to the base end side expansion member, and communicating with the third inner space;
A notch portion provided on the second tubular member, located at a base end side with respect to the base end side expansion member, and opened to communicate with the base end opening portion;
A catheter with a balloon for an endoscope, comprising:

In a catheter with a balloon for an endoscope that is used to collect a component in a living body together with a liquid by being inserted into a channel of an endoscope.
A flexible tubular member;
A first inner space, a second inner space and a third inner space formed along the tubular member;
A distal-side expansion member that is disposed at the distal end of the tubular member, is connected to the first interior space, expands upon supply of an expansion fluid, and is held by the living body in a state of sealing the living body;
It is disposed on the tubular member and located on the proximal end side with respect to the distal-side expansion member, expands upon supply of an expansion fluid through the first inner space, and seals the channel of the endoscope. A proximal expansion member held on the inner wall of the channel;
An expansion fluid providing means connected to the first internal space and providing an expansion fluid to the first internal space;
An opening provided on the outer surface of the portion of the tubular member located on the distal end side relative to the distal end-side expansion member, and communicating the second inner space with the living body;
A liquid providing means connected to the second inner space for providing a liquid to the second inner space;
A tip opening portion provided on the outer surface of the tubular member located on the tip side of the tip side expansion member, and communicating the third inner space with the living body;
A proximal opening provided on a side surface of the tubular member located on the proximal side relative to the proximal expansion member, and communicating the third interior to the channel of the endoscope;
A catheter with a balloon for an endoscope, comprising:

In a catheter with a balloon for an endoscope that is used to collect a component in a living body together with a liquid by being inserted into a channel of an endoscope.
A flexible first tubular member;
A second tubular member having flexibility for inserting the first tubular member so as to be capable of moving forward and backward;
A first inner space, a second inner space and a third inner space formed along the first tubular member;
A fourth inner space formed along the second tubular member;
A distal-side expansion member that is disposed at the distal end of the first tubular member, is expanded by receiving supply of an inflation fluid through the first inner space, and is held by the living body in a state of sealing the living body;
A first inflation fluid providing means connected to the first interior and providing inflation fluid to the first interior;
A proximal end side that is disposed at the distal end portion of the second tubular member, expands upon supply of an inflation fluid through the fourth inner space, and is held on the inner wall of the channel in a state of sealing the channel of the endoscope An expansion member;
A second inflation fluid providing means connected to the fourth interior space for providing an inflation fluid to the fourth interior space;
An opening provided on the outer surface of the portion of the first tubular member located on the distal end side relative to the distal-end-side expansion member, and communicating the second inner space with the living body;
A tip opening provided on the outer surface of the portion of the first tubular member located on the tip side of the tip side expansion member, and communicating the third inner space with the living body;
A base end opening portion provided on a side surface of the first tubular member located on the base end side relative to the base end side expansion member, and communicating with the third inner space;
A notch portion provided on the second tubular member, located at a base end side with respect to the base end side expansion member, and opened to communicate with the base end opening portion;
A catheter with a balloon for an endoscope, comprising: