JPH0417160Y2 - - Google Patents

Description

[Detailed description of the invention] [Industrial application field] This invention allows medical personnel to perform retrograde transhepatic biliary tract surgery during surgery by using a preoperative percutaneous transhepatic external fistula route and a guide wire. The present invention relates to disposable, inexpensive tools used to create drainage routes.

[Conventional technology]

A catheter or tube is placed in the bile duct for the purpose of injecting drugs or contrast media into internal organs, especially the bile duct, or draining bile (drainage). There are two methods: one method involves puncturing the bile duct and placing a drainage tube into the bile duct through the outer skin, and the other method involves placing a drainage tube under surgery.

In the case of the latter method, a T-tube is generally used, and the drainage tube is guided directly outside the body from the common bile duct without going through the liver, but the T-tube has the disadvantage that bile tends to leak into the body cavity. Furthermore, in operations such as bile duct duodenostomy in which the common bile duct is completely removed, it is difficult to use a T tube, and it is more advantageous to place a straight tube transhepatically during the operation than in the biliary tract.

As a tool suitable for this kind of use, it was developed in 1983.
No. 121838 discloses a medical drainage tube indwelling device in which a puncture needle with a conical tip and a drainage tube are connected, and the puncture needle includes a metal pipe that can be easily deformed; It consists of a thermoplastic plastic molded body that is installed through the metal type and integrally molded with the tip of the puncture needle at one end and the rear end connector at the other end, and the rear connector has the same outer diameter as the puncture needle. Drainage tubes are connected without any steps. However, when using this drainage tube indwelling device, it is necessary to newly puncture the bile duct and liver parenchyma during the operation, resulting in blind puncture, and the artery or portal vein that runs parallel to the intrahepatic bile duct or is distributed in the liver parenchyma. There was a problem with the risk of puncture and bleeding.

[The problem that the idea aims to solve]

In view of the above-mentioned shortcomings of the device and the current situation in clinical practice, the present invention was developed by expanding the percutaneous transhepatic external fistula route along the guide wire without damaging the living tissue when leading it out of the body. The object of the present invention is to provide a biliary drainage device that can be easily punctured and installed by a person, and is inexpensive and disposable.

[Means to solve the problem]

The present invention is a medical drainage tube indwelling device in which an advanced part with a conical tip and a hollow inner cavity is connected to a drainage tube, in which the advanced part is made of semi-hard plastic and the drainage tube is made of soft plastic. Molded from plastic, a drainage tube with the same outer diameter as the advanced section is connected to the rear end of the advanced section without a step, and its inner cavity is undercut at the transition part from the advanced section side to the drainage tube side. This is a retrograde transhepatic biliary drainage device characterized by having no surface.

An embodiment of the drainage device according to the present invention will be described with reference to the drawings.As shown in FIG.
A drainage tube 4 is fitted and connected to a connector 3 inserted into the rear end of the advanced section 2. The advanced portion 2 has a conical tip 1 and an open hole at its tip, and a side hole 5 and a distal hole 6 are provided at the distal end of the drainage tube 4.

In cases of biliary tract disease as mentioned above, the method of percutaneously puncturing the intrahepatic bile duct and placing a drainage tube through the outer skin into the bile duct without surgery allows the external fistula route to be performed percutaneously and transhepatically. is often added before surgery. Therefore, when actually using the drainage device of the present invention, during the surgery, the surgeon inserts the end of the guide wire inside the body remaining in the percutaneous transhepatic external fistula route into the tip 1 of the advanced section, and then 2
is grasped and pushed along the guide wire toward the outside of the body through the bile duct while expanding the external fistula route, and the advanced portion 2 is percutaneously pushed out of the body. Subsequently, the drainage tube 4 is led out of the body. After that, when the distal end of the drainage tube 4 is installed at the target part of the biliary tract, the distal end of the drainage tube 4 is cut to separate the advanced part 2, and the drainage tube 4 is inserted percutaneously and transhepatically. Placed outside the body.

The tip 1 of the advanced part has a tip angle A of 5° to 5° as shown in FIG. 2 to facilitate puncturing and penetrating living tissue.
It is machined to an angle of 65°, preferably between 10° and 30°, the conical tip is open, and the corners are rounded by chamfering. The inner diameter of the opening is preferably 0.3 to 1.5 mm, and the gap with the guide wire used is preferably about 0.2 mm. The chamfering of the corners is approximately R0.3 to 1 mm to minimize excessive damage to the living tissue to be punctured/pierced and damage to the blood vessel wall. In addition, if the tip angle A is less than 5°, it will be difficult to process, and if it is more than 65°, it will be difficult to puncture living tissue.
Penetration becomes extremely difficult or impossible.

The advanced part 2 is hollow, and its inner diameter is thicker than the tip 1 of the advanced part.As shown in FIG. mated with a built-in structure,
It also has flexibility that does not impair the guidance of the inserted guide wire when puncturing or penetrating living tissue, and the tip of the advanced section 2 is flexible enough to prevent the surgeon from grasping the rear part of the advanced section 2 and puncturing or penetrating the living tissue. 1 generates sufficient propulsive force while expanding the percutaneous transhepatic external fistula route,
It is necessary to have rigidity that can be transmitted from the rear to the tip. As such a material, thermoplastic semi-hard plastics such as polyvinyl chloride resin, ABS resin, polyethylene, polyester, and polypropylene can be used, but are not limited to these. In polyvinyl chloride resin,
The number of plasticizer parts is preferably 15 to 35 parts by weight, and the length is preferably 50 to 250 mm from the viewpoint of flexibility and rigidity in consideration of operator operability.

The drainage tube 4 needs to be flexible and strong enough to be guided by the distal end 2 and penetrate the living tissue, not to be deteriorated by bile, and to be transparent so that the bile inside the tube can be visually observed. At times, X-rays may be used to confirm the location of detention.
Needless to say, it is desirable to have a line for contrast imaging. Materials for drainage tubes include thermoplastics such as soft polyvinyl chloride resin, polyurethane, and polyethylene.
Rubbers such as silicone rubber and various thermoplastic elastomers can be used, but are not limited to these. In polyvinyl chloride resin, the plasticizer part number is preferably 40 to 60 parts by weight. Furthermore, barium sulfate, bismuth subcarbonate, and the like are used as materials for the X-ray contrast line, but the material is not limited to these. Side holes and a terminal hole are provided at the end of the drainage tube, and the diameter is generally 0.5 to 2.0 m/m, with 2 to 3 side holes and one terminal hole. However, there are no particular limitations as long as the shape and number are such that drainage is easy.

The connector 3 is connected to the advanced part 2 as shown in FIG.
When the guide wire is inserted from the advanced section 2 side, it is required to be inserted smoothly into the drainage tube 4 side without being caught. Therefore, it is necessary to have an inner diameter sufficient for the guide wire to pass through smoothly, and to have no undercut surface at the transition part from the advanced section 2 side to the drainage tube 4 side. The entrance has an internal chamfer with an opening angle B of 5° to 90°. Hard plastic or metal is used as the material for the connector 3, but metal, such as stainless steel, is preferable in order to achieve thin and strong connectivity. Further, since the guide wire penetrates the living tissue while being guided by the guide wire, it is desirable that the rigid portion be as short as possible.

Further, the means for connecting the advanced part 2 and the drainage tube 4 is not limited to the connector 3, but for example, the connecting means for connecting the advanced part 2 and the drainage tube 4 is not limited to the connector 3. It is also possible to insert the drain tube 4 with a part of the end left open, stretch the distal end side to form the conical tip 1 of the advanced part, and connect the drainage tube 4 to the thin-walled pipe exposed on the rear end side. be. This method is preferable because it does not create an undercut surface where the guide wire inserted from the advanced section 2 side might get caught.

[Effect of idea]

As mentioned above, the drainage device according to the present invention is
The tip has a conical shape that does not damage living tissues, especially blood vessels, and has an appropriate rigidity when the operator punctures the needle while being guided by a guide wire along the percutaneous transhepatic external fistula route. It has an advanced part made of flexible semi-rigid plastic, which provides safety and reliable operability for the procedure, and allows for smooth drainage of the guide wire inserted during puncture without getting caught in the middle. Penetrated to the tube,
Provides reliability and simplicity of procedure.

In addition, the drainage tube, which is guided by the advanced part and placed inside the body, is made of flexible soft plastic and has a side hole at the rear end. Allows bile drainage. Furthermore, since it can be produced at a very low cost, it is easy to use and disposable, making it extremely useful as a tool for retrograde percutaneous transhepatic installation of drainage tubes in the body.

[Brief explanation of the drawing]

Figures 1 to 3 are views showing a drainage device that is an embodiment of the present invention, with Figure 1 being an overall view and Figure 2 being an overall view.
The figure is an enlarged view of the tip of the advanced part, and FIG. 3 is a sectional view of the connection part between the advanced part and the drainage tube.

Claims (1)

[Scope of utility model registration request] A medical drainage tube indwelling device in which an advanced part with a conical tip and a hollow inner cavity is connected to a drainage tube, in which the advanced part is made of semi-hard plastic and the drainage tube is made of soft plastic. A drainage tube having the same outer diameter as the advanced part is connected to the rear end of the advanced part without a step, and the inner cavity has an undercut surface at the transition part from the advanced part side to the drainage tube side. A retrograde transhepatic biliary drainage device characterized by: