JPH1176419A - Endoscope indwelling basket - Google Patents

Abstract

(57) [Summary] [Problem] To be able to release a stenosis state by placing it in a stenosis part endoscopically, and to be able to easily remove it from the stenosis part endoscopically as needed. To provide an indwelling basket for an endoscope. At least three elastic wires are bound at a leading end and a trailing end, and are formed so as to expand in a cage shape by their own elasticity and to be narrowed by an external force in a natural state, and to be rearward from a rear end binding portion. The tail-shaped members 14, 30, and 40 are extended and arranged, and the collection tool engaging portions 16, 31, and 41 for inserting and removing the collection tool used by being inserted into and removed from the treatment tool insertion channel of the endoscope are described above. It was formed on the extension end side of the tail members 14, 30, 40.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an indwelling basket for an endoscope which is indwelled in a stenosis through a treatment tool insertion channel of an endoscope in order to release stenosis of a tubular organ in a body cavity.

[0002]

2. Description of the Related Art When stenosis occurs in the biliary tract due to biliary tract cancer or the like, it becomes difficult to cause bile fluid to flow from the liver to the duodenum, causing jaundice and the like. Need to be detained.

Therefore, conventionally, for example, Japanese Utility Model Publication No.
No. 6, a tube having a protruding spine for retaining, or a metal thin wire described in Japanese Patent Publication No. 5-54344 is formed in a cage-shaped bulging shape. A basket, a net-like tubular stent formed by knitting a thin metal wire into a tubular shape, or the like has been placed in the stenosis.

[0004]

[Problems to be solved by the invention]
In the tube shown in No. 5346, the projection formed by spinning out is caught on the mucous membrane, and the tube is disclosed in Japanese Patent Publication No. 5-54344.
In the baskets and reticulated tubular stents shown in the above item, the thin lines protruding from the ends are caught on the mucous membrane, so any of them can easily be used from the stenosis part if you want to use it temporarily before surgery or if clogging occurs. There was an inconvenience that cannot be removed.

[0005] Therefore, the present invention provides a method in which a stenotic state can be released by being endoscopically placed in a stenotic portion and easily removed from the stenotic portion by endoscopically as needed. An object of the present invention is to provide an indwelling basket for an endoscope.

[0006]

In order to achieve the above object, an indwelling basket for an endoscope according to the present invention binds at least three elastic wires at a front end and a rear end thereof, and in a natural state, the self-retaining basket has a self-contained shape. A collection tool that is formed so as to expand in a cage shape by elasticity and contracted by an external force, extends and arranges a tail-shaped member rearward from a rear end binding portion, and is used by being inserted into and removed from a treatment tool insertion channel of an endoscope. And a collecting tool engaging portion for engaging with the tail-shaped member is formed on the extended end side of the tail-shaped member.

[0007] Each of the elastic wires may be formed to be bent in a smooth curve, or each of the elastic wires may be formed in a spirally twisted curve. May be bent at an obtuse angle on the way.

[0008] The tips of the plurality of elastic wires may be fixed and bound to a hollow cylindrical member, or the tips of the plurality of elastic wires may be directly fixed to each other. Further, the tail-shaped member may be a tubular body, and in that case, the collection tool engaging portion may be a hole formed in the tail-shaped member.

Then, flexible pushing means is inserted into the tail-shaped member from the rear, and the distal ends of the flexible pushing means are pushed forward by the distal ends thereof, whereby the plurality of elastic wires are pushed forward. May be made to be in a constricted state.

[0010] Further, by accommodating the plurality of elastic wires and the tail-shaped member in an outer tube inserted into and removed from the treatment instrument insertion channel of the endoscope, the plurality of elastic wires are constricted. You may make it become. In this case, it is preferable that an extruding means for extruding the indwelling basket for the endoscope from the inside of the mantle tube is detachable into the mantle tube.

The tail-like member may be a cord-like body. In this case, the collecting tool engaging portion may be a knob-like part formed at the extending end of the string-like tail-like member. You may.

[0012]

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 shows an indwelling basket 10 for an endoscope according to a first embodiment of the present invention, which is for endoscopically indwelling a narrowed portion of a biliary tract.

In the figure, reference numeral 11 denotes a plurality of elastic wires made of, for example, a single wire or a stranded wire of a thin stainless steel wire, which swells in a cage shape in its natural state due to its own elasticity, and receives an external force (a radial crushing force or an axial It is bent in a smooth curved shape so as to be elastically deformed and narrowed by a stretching force in the direction. The elastic wire 11 returns to the original cage shape when the external force is removed after being constricted.

It is to be noted that at least three or more elastic wires 11 are required, and four to eight wires are appropriate. All of the plurality of elastic wires 11 are formed in the same shape and are equally spaced, for example, 90 ° intervals for four wires and 60 ° for six wires.
° arranged at intervals.

The distal ends of the plurality of elastic wires 11 are bundled by a distal end cap 12. The distal end cap 12 is fixed to an inner tube 12a that receives the inner surfaces of the distal ends of the plurality of elastic wires 11 and the outer peripheral surface of the inner tube 12a. The inside and outside of the plurality of elastic wires 11 communicate with each other by a hole 13 formed of an outer tube 12b to be pressed and fixed and formed in the inner tube 12a in the axial direction.

A flexible tube 14 (tail-shaped member) made of synthetic resin is connected to the rear ends of the plurality of elastic wires 11 in a tail shape, and the rear ends of the plurality of elastic wires 11 are bundled to be flexible. It is fixed to the outer peripheral surface of the distal end of the sex tube 14.

In order to fix the flexible tube, a flexible tube 1
A short fixing tube 15 made of the same material as 4 is coated on the boundary between the rear end portions of the plurality of elastic wires 11 and the flexible tube 14 and welded to the flexible tube 14.

The inner diameter D of the flexible tube 14 is
It is formed larger than the inner diameter d of the hole 13 of the inner tube 12a. The fixing tube 15 is a flexible tube 14
May be integrally formed.

In the vicinity of the rear end of the flexible tube 14, a traction hole 16 (collection device engaging portion) is formed in a direction perpendicular to the axial direction, and an endoscope treatment is performed there. By engaging a basket collection tool (for example, grasping forceps for an endoscope) used by being inserted into and removed from the tool insertion channel, the indwelling basket 10 in the indwelling state can be pulled and collected.

The indwelling basket 10 constructed as described above
As shown in FIG. 2, a push tube 20 made of, for example, a flexible synthetic resin tube is inserted into the flexible tube 14 from behind, and the tip of the push tube 20 is used. Is passed through the plurality of elastic wires 11 and is brought into contact with the tip base 12. Then, the push-in tube 20 is further pushed in, and the plurality of elastic wires 11 are stretched in the axial direction to be narrowed.

FIG. 3 shows a state in which the indwelling basket 10 of the above embodiment is inserted endoscopically from the duodenum 101 into the biliary tract 102, and is inserted into the treatment instrument insertion channel 2 of the endoscope 1. The indwelling basket 10 is pushed forward from the hand side by the pushing tube 20 and guided into the biliary tract 102.

As shown in FIG. 3, the plurality of elastic wires 11 may partially expand slightly in the radial direction during the operation, but if the pushing tube 20 is pushed in, the plurality of elastic wires 11 are thereby formed. It is stretched and reduced in diameter.

Then, when the intermediate portion of the plurality of elastic wires 11 reaches the narrowed portion 103 of the biliary tract 102, the pushing tube 20 is left together with the endoscope 1 with the indwelling basket 10 left there, as shown in FIG. Removed from the duodenum 101.

Then, the indwelling basket 10 is indwelled in the biliary tract 102 in a state where the stenotic portion 103 is expanded by the elasticity of the plurality of elastic wires 11, and the flexible tube 14 is
Only in the vicinity of the rear end of the flexible tube 14 (the length of the flexible tube 14 is set so as to be such that the length is, for example, about 20 cm to 80 cm).

As a result, bile fluid and the like in the biliary tract 102 pass between the hole 13 of the tip base 12 and the plurality of elastic wires 11, and from there through the flexible tube 14 to the duodenum 1.
01 is discharged.

Then, the indwelling basket 10 is moved to the stenosis 10
When it is necessary to remove the indwelling basket 10 from the biliary tract 102 by inserting the endoscope into the duodenum 101 and engaging the basket collection tool with the towing hole 16 when it becomes necessary to remove the indwelling basket 10 from the biliary tract 102
It can be pulled out and collected.

At this time, when the flexible tube 14 is pulled from the drawing hole 16 side, the plurality of elastic wires 11 are stretched in the axial direction and reduced in diameter.
It will be in a state where it can be easily pulled out from inside.

When pushing the indwelling basket 10 into the biliary tract 102, the distal end portion of the endoscope 1 is guided into the duodenum 101 and then the indwelling basket 10 is passed through the treatment instrument insertion channel. However, as shown in FIG. 5, the indwelling basket 10 is set in advance at the distal end portion of the treatment instrument insertion channel of the endoscope 1 and only the pushing tube 20 needs to be pushed in from the hand side. You may leave.

As shown in FIG. 6, the indwelling basket 10 is accommodated in the distal end of an outer tube 21 made of a flexible tube that can be inserted into and removed from the treatment instrument insertion channel of the endoscope. The wire 11 may be narrowed.

In this case, the mantle tube 21 is passed through the treatment tool insertion channel of the endoscope, for example, to the flexible tube 14.
The hook 22 engaging with the towing hole 16 of FIG. 1 pushes out the indwelling basket 10 with the basket collection tool 23 formed at the tip, and then, as shown in FIG.
0 can be separated from the collection tool 23 and placed in the body cavity.

Then, when it becomes necessary to remove the indwelling basket 10 from the indwelling place, the basket collecting tool 23 is independently passed through the treatment tool insertion channel of the endoscope to remove the indwelling basket 10 in the body cavity. Towing hole 1
By engaging the hook 22 with 6, the indwelling basket 10 can be collected endoscopically.

The indwelling basket 10 for indwelling in the biliary tract
For example, as shown in FIG. 8, the tip shape of each of the plurality of elastic wires 11 is formed by bending each of the plurality of elastic wires 11 into a curved shape twisted helically, or each of the plurality of elastic wires 11 is bent at an obtuse angle at a plurality of locations. Various modes, such as a combination of bending and curved bending, can be adopted.

FIG. 9 shows an indwelling basket 10 for an endoscope according to a second embodiment of the present invention. A plurality of elastic wires 11 are provided with short rigid members instead of flexible tubes 14 at the rear ends. A discharge pipe 24 made of a pipe is connected, and a thread 30 is connected to a hole 26 formed near the rear end of the discharge pipe 24 to form a tail-like member. At the rear end of the thread 30 is formed a knot-shaped portion 31 formed of a knot for engaging the collection tool. The configuration of the plurality of elastic wires 11 and their distal end portions is the same as in the first embodiment.

The indwelling basket 10 of the second embodiment having the above-described configuration is also transendoscopically similar to the indwelling basket 10 of the first embodiment, as shown in FIG. It is placed in the biliary tract 102 so that the aneurysm 31 formed by the knot of the thread 30 remains in the duodenum 101.

Then, for example, the tip loop wire 52 of the endoscope snare 50 shown in FIG.
The indwelling basket 10 can be collected by hooking on the knob-like portion 31 and pulling it into the distal end of the mantle tube 51 as shown in FIG. 53 in FIG. 11 is a tip loop wire 52.
Is an operation unit for performing an operation of changing the loop diameter by inserting and removing the inside of the flexible tube 51.

FIG. 14 shows an indwelling basket 10 for an endoscope according to a third embodiment of the present invention. The distal end portions of a plurality of elastic wires 11 are inserted into a distal end base 12 and a silver solder is inserted there. The base end is also inserted into the front half of the metal connection pipe 32 and fixed and bound by silver brazing or the like.

As the tail-shaped member, a metal stranded wire 40 such as a stainless steel wire is used. The stranded wire is inserted into the rear half of the connection pipe 32 and fixed thereto by silver brazing or the like. I have.

Although the knob-like portion 41 is formed by a knot, as shown in FIG. 15, a metal pipe may be fixed to the extending end of the stranded wire 40 by silver brazing or the like. What is necessary is just to make a part partly thick like a knob.

FIG. 16 shows an indwelling basket 10 for an endoscope according to a fourth embodiment of the present invention, in which the distal end portion and the proximal end portion of four elastic wires 11 show a II section. As shown in FIG. 17, they are fixed and bound directly by silver brazing or laser welding without using other binding members.

As the tail member, a plurality of elastic wires 11 are used.
One of the stranded wires 40 is used as it is extending backward, and a short wire piece is provided at the end of the stranded wire 40, as shown in FIG. 17 showing a II-II cross section. The knob-shaped part 41 is formed by being fixed by silver brazing. The collection from the indwelling unit can be performed by a snare-type collection tool shown in FIG.

In the case where six or more elastic wires 11 are used, the elastic wire 44 serving as a core is arranged at the center of the fixing and bundling portions as shown in FIG. What is necessary is just to fix and bind by such as.

FIG. 18 shows a case where the stenosis 103 of the biliary tract 102 is expanded by the indwelling basket 10 according to the third embodiment to drain bile fluid (drainage), and FIG.
It shows a case in which it is extended over a long range to a position reaching the duodenum 101. In such use,
The length of the elastic wire 11 may be appropriately set within a range of about 30 mm to 180 mm.

Even in the case where the tail-like member is formed of a string-like body such as the yarn 30 or the stranded wire 40, the elastic wires 11 are slightly warped as shown in FIG. A variety of shapes can be adopted, in addition to a cage formed by bending at a plurality of locations, a cage formed by bending a shape close to a triangle.

The indwelling basket for an endoscope of the present invention may have a configuration in which the tail member is omitted, as shown in FIG. 21, for example.

Further, the indwelling basket for an endoscope of the present invention can be used not only for dilating a stenotic part of a biliary tract, but also for dilating a stenotic part of a bronchus and a blood vessel and for various other purposes.

[0046]

According to the present invention, at least three elastic wires are bound at the leading end and the trailing end, and in a natural state, are formed so as to expand in a cage shape by their own elasticity and to be narrowed by an external force. It can be easily inserted into the target site through the treatment instrument insertion channel of the endoscope, and when the external force is removed, the elastic wire returns to its original cage shape by its own elasticity. Can be canceled.

Since the tail-shaped member extends rearward from the rear end of the elastic wire, when it is necessary to remove the indwelling basket, the tail-shaped member is pulled through the endoscope through the endoscope. Can be easily extracted and collected.

[Brief description of the drawings]

FIG. 1 is a side sectional view of an indwelling basket for an endoscope according to a first embodiment of the present invention.

FIG. 2 is a side sectional view showing a state in which a pushing tube is set in an indwelling basket for an endoscope according to the first embodiment of the present invention.

FIG. 3 is a schematic sectional view showing a state in which the indwelling basket for an endoscope according to the first embodiment of the present invention is inserted into a stenosis.

FIG. 4 is a schematic sectional view showing a state in which the indwelling basket for an endoscope according to the first embodiment of the present invention is indwelled in a stenosis.

FIG. 5 is a side view of the endoscope in a preparation state for inserting the indwelling basket for the endoscope according to the first embodiment of the present invention into a stenosis.

FIG. 6 is a side sectional view showing a state where the indwelling basket for an endoscope according to the first embodiment of the present invention is set in an outer tube.

FIG. 7 is a side sectional view showing a state where the indwelling basket for an endoscope according to the first embodiment of the present invention is pushed out of an outer tube.

FIG. 8 is a side view showing another example of the elastic wire shape of the indwelling basket for an endoscope according to the first embodiment of the present invention.

FIG. 9 is a side sectional view of an indwelling basket for an endoscope according to a second embodiment of the present invention.

FIG. 10 is a schematic cross-sectional view showing a state in which an indwelling basket for an endoscope according to a second embodiment of the present invention is indwelled in a stenosis.

FIG. 11 is an external view of a collection tool for collecting an indwelling basket for an endoscope according to a second embodiment of the present invention.

FIG. 12 is a partial side sectional view showing an engagement operation between an indwelling basket for an endoscope and a collecting tool according to a second embodiment of the present invention.

FIG. 13 is a partial side sectional view showing an engagement operation between an indwelling basket for an endoscope and a collecting tool according to a second embodiment of the present invention.

FIG. 14 is a side sectional view of an indwelling basket for an endoscope according to a third embodiment of the present invention.

FIG. 15 is a partial side sectional view showing another example of the knob-like portion of the indwelling basket for an endoscope according to the third embodiment of the present invention.

FIG. 16 is a side view of an indwelling basket for an endoscope according to a fourth embodiment of the present invention.

FIG. 17 is a front sectional view of a fixed portion and a binding portion of an elastic wire of an indwelling basket for an endoscope according to a fourth embodiment of the present invention.

FIG. 18 is a schematic sectional view showing a state where the indwelling basket for an endoscope of the present invention is used for biliary drainage.

FIG. 19 is a schematic cross-sectional view showing a state where the indwelling basket for an endoscope of the present invention is used for biliary drainage.

FIG. 20 is a side view showing another example of the shape of the elastic wire of the indwelling basket for an endoscope of the present invention.

FIG. 21 is a side view showing an example in which the tail basket is omitted from the indwelling basket for an endoscope of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Endoscope 2 Treatment tool insertion channel 10 Endoscope indwelling basket 11 Elastic wire 12 Tip mouthpiece 14 Flexible tube (tail-shaped member) 16 Retraction hole (recovery tool engagement part) 20 Push-in tube 21 Outer tube 23, 50 Collection tool 30 Thread (tail-shaped member) 31 Nodule part (collection tool engagement part) 40 Stranded wire (tail-shaped member) 41 Nodule part (collection tool engagement part)

Claims (13)

[Claims] At least three elastic wires are bound at a leading end and a trailing end, and are formed so as to swell in a cage shape by their own elasticity and to be narrowed by an external force in a natural state, and to extend rearward from a rear end binding portion. The tail-shaped member is extended and arranged, and a collection tool engaging portion for engaging a collection tool used by being inserted into and removed from the treatment tool insertion channel of the endoscope is provided on the extension end side of the tail-shaped member. An indwelling basket for an endoscope, wherein the basket is formed. 2. The indwelling basket for an endoscope according to claim 1, wherein each of said elastic wires is formed by bending into a smooth curve. 3. The indwelling basket for an endoscope according to claim 1, wherein each of said elastic wires is formed in a spirally twisted curved shape. 4. The indwelling basket for an endoscope according to claim 1, wherein each of said elastic wires is formed by being bent at an obtuse angle on the way. 5. The indwelling basket for an endoscope according to claim 1, wherein tips of the plurality of elastic wires are fixed and bound to a hollow cylindrical member. 6. The indwelling basket for an endoscope according to claim 1, wherein tips of the plurality of elastic wires are directly fixed to each other. 7. The indwelling basket for an endoscope according to claim 1, wherein the tail-like member is a tubular body. 8. The indwelling basket for an endoscope according to claim 7, wherein the collecting tool engaging portion is a hole formed in the tail-like member. 9. A plurality of elastic wires are inserted by inserting flexible push-in means from the back into the tail-shaped member and pushing forwardly the distal binding portions of the plurality of elastic wires at the tips thereof. 8. The squeezed state can be reduced.
Or the indwelling basket for endoscope according to 8. 10. The plurality of elastic wires and the tail-like member are housed in an outer tube inserted into and removed from a treatment tool insertion channel of an endoscope, so that the plurality of elastic wires are reduced. An indwelling basket for an endoscope according to any one of claims 1 to 8. 11. The indwelling basket for an endoscope according to claim 10, wherein the pushing means for pushing out the indwelling basket for the endoscope from the inside of the mantle tube is removably insertable into the mantle tube. 12. The indwelling basket for an endoscope according to claim 1, wherein the tail-like member is a string-like body. 13. The indwelling basket for an endoscope according to claim 12, wherein the collecting tool engaging portion is a knob-shaped portion formed at an extended end of the string-shaped tail member.