JP2000084065A - Drainage tube detention tool for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To properly detain a drainage tube for discharging outside secretion liquid in a living body or the like in a transendoscope manner, regardless of the constrictive region. SOLUTION: This detention tool has overall length larger than the length of the treatment implement insertion channel 101 of an endoscope 100. In addition, the treatment implement insertion channel 101 is provided with a drainage tube 1 made of a freely insertable and electrically insulating flexible tube, a guide wire 2 having overall length larger than the length of the drainage tube 1, and freely insertable in the drainage tube 1 for protrusion from the forward end thereof, wire guide 2, a high-frequency power source connection means 11 for supplying power to the guide wire 2, and a tube wire fixing means 20 for freely fixing and releasing the drainage tube 1 and the guide wire 2 to and from the base end of the drainage tube 1.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a drainage tube for an endoscope for placing a drainage tube for draining a body secretion or the like accumulated in a stenosis part in the body out of the body using an endoscope. About the tool.

[0002]

2. Description of the Related Art When a bile duct is constricted or obstructed, bile secreted from the inside thereof cannot be discharged, causing jaundice. In such cases, the distal end of the long drainage tube is inserted endoscopically into Mr. Vater's papilla, which is the exit of the bile duct into the duodenum, and is placed there.The proximal end of the drainage tube is passed out of the patient's nose and out of the body. An action to be taken is performed.

[0003]

However, in cases such as when the Vater's nipple is affected by cancer, the tissue cannot be passed through the drainage tube due to deformation and hardening of the tissue. Endoscopic treatment did not reduce jaundice.

[0004] Therefore, the present invention provides an endoscope in which a drainage tube for discharging body secretions and the like out of the body can be securely placed endoscopically regardless of the state of the stenosis site. It is an object to provide a drainage tube indwelling device for use.

[0005]

In order to achieve the above object, a drainage tube indwelling device for an endoscope according to the present invention has a total length longer than a treatment instrument insertion channel of an endoscope, and the treatment instrument insertion channel is provided. A drainage tube made of an electrically insulating flexible tube that can be inserted into and removed from the drainage tube; and a conductive material that has an overall length longer than the drainage tube and can be inserted into and removed from the drainage tube and protrude from the tip of the drainage tube. And a high-frequency power supply connecting means for supplying a high-frequency current to the guide wire, and the drainage tube and the guide wire can be fixed / released at the base end side of the drainage tube. A tube-wire fixing means is provided.

[0006] The high-frequency power supply connecting means and the tube-wire fixing means may be integrally provided on a base end portion of the drainage tube. Further, a flexible electrically insulating tube for not directly exposing the guide wire extending from the base end side of the drainage tube to the outer surface is coated from the base end portion of the drainage tube to the base end portion of the guide wire. It may be.

[0007] The tube-wire fixing means may be arranged so that the drainage tube, the guide wire, and the electrical insulating tube can be fixed / released freely, and the tube-wire fixing means is provided with the drainage tube and the electric wire. Only the guide wire may be fixed / released.

[0008] An operating portion for operating the tube-wire fixing means in the axial direction of the drainage tube is detachably provided at the entrance of the treatment instrument insertion channel of the endoscope. Is also good.

[0009]

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 shows a drainage tube indwelling device for an endoscope according to a first embodiment of the present invention.

Reference numeral 1 denotes a drainage tube which is inserted into and removed from a treatment instrument insertion channel of an endoscope and is left in the body in order to discharge internal secretion fluid and the like accumulated in a stenosis in the body.

The drainage tube 1 is formed of an electrically insulating flexible tube, and has a length longer than a treatment instrument insertion channel of an endoscope used for indwelling. For example, the length of the drainage tube 1 is 2 with respect to the length of the treatment instrument insertion channel of the endoscope of 1 m.
m or more.

As shown in FIG. 2, the drainage tube 1 has a tapered end portion which is gradually narrowed and has several holes 1a formed in a side wall in the vicinity thereof. It is formed so that.

Returning to FIG. 1, a guide wire 2 made of a conductive flexible wire is removably inserted into the drainage tube 1. The guide wire 2 has a longer overall length than the drainage tube 1, and projects the distal end of the guide wire 2 from the distal end of the drainage tube 1 with the proximal end of the guide wire 2 protruding from the proximal end side of the drainage tube 1. Can be done.

Connected to the base end of the drainage tube 1 is a connection portion 10 having a connection terminal 11 for connecting the base end of the guide wire 2 to a power cord of a high-frequency power supply (not shown). .

In the connection portion 10, the root of the connection terminal 11 is screwed into the conductive block 12 built in the electrically insulating housing 13, and the base end of the guide wire 2 is pressed and fixed to the conductive block 12. I have. Therefore, by connecting the high-frequency power cord to the connection terminal 11,
A high-frequency current can be supplied to the guide wire 2.

The connecting portion 10 of this embodiment is provided with a tube-wire fixing portion 20 capable of fixing / releasing the drainage tube 1 and the guide wire 2 at the base end portion of the drainage tube 1.

FIG. 3 is a sectional view taken along the line III-III of FIG. 3, showing a slit 22 for dividing the passage hole 21 of the drainage tube 1 into which the guide wire 2 is inserted. A manual screw 23 for tightening the housing 22 is screwed to the housing 13.

Therefore, by tightly tightening the manual screw 23, the drainage tube 1 is pressed from both sides and pressed against the guide wire 2 as shown in FIG. 3, and the drainage tube 1 and the guide wire 2 are joined together. The state is fixed to the housing 13.

When the manual screw 23 is loosened, the fixed state is released, and the drainage tube 1 can be removed from the housing 13. To remove the guide wire 2 from the housing 13, the connection terminal 11
Can be loosened manually.

FIGS. 4 to 6 show a procedure for using the drainage tube indwelling device of the first embodiment described above. First, a state is shown in which the distal end of the guide wire 2 slightly protrudes from the distal end of the drainage tube 1. The tube-wire fixing part 20 is fixed.

When the drainage tube 1 is pushed from the hand side and the tip of the guide wire 2 is pressed against an external fixed object,
Although the distal end of the guide wire 2 is pushed into the drainage tube 1 to some extent, the tube-wire fixing portion 20 may be fixed so that the distal end of the guide wire 2 still projects from the distal end of the drainage tube 1 by about 5 mm.

The connection terminal 11 has a high-frequency power cord 200
And the drainage tube indwelling device is connected to the treatment instrument insertion channel 1 of the endoscope 100 as shown in FIG.
01, the distal end portion is made to protrude from the distal end 102 of the insertion section of the endoscope 100. Then, the distal end of the guide wire 2 is pressed against the stomach wall or the duodenal wall or the like from the inside of the stomach or the duodenum to the bile duct or the pancreatic duct, and the high-frequency current is applied.

When the stomach wall or the duodenal wall or the like is cauterized to form a hole up to the bile duct or pancreatic duct, the manual screw 23 of the tube-wire fixing portion 20 is loosened, and the guide wire 2 is used as a guide for the drainage tube 1. Push the tip into the bile duct or pancreatic duct.

In this state, the connection terminal 11
The connection part 10 is also loosened and removed from the proximal ends of the drainage tube 1 and the guide wire 2, and as shown in FIG. 5, only the endoscope 100 is removed with the drainage tube 1 and the guide wire 2 kept as they are.

Finally, the guide wire 2 is pulled out from the drainage tube 1, and the drainage tube 1 pulled out of the patient's mouth is pulled out of the patient's nose as shown in FIG. Move. As a result, bile, pancreatic juice, and the like secreted from the body are discharged out of the body via the drainage tube 1.

FIG. 7 shows a drainage tube retainer for an endoscope according to a second embodiment of the present invention.
0 and the tube-wire fixing part 20 are provided separately,
In the meantime, a flexible electrically insulating tube 3 for preventing the guide wire 2 extending from the base end side of the drainage tube 1 from being directly exposed to the outer surface is provided from the base end portion of the drainage tube 1 to the base end portion of the guide wire 2. It is coated.

With this configuration, it is possible to ensure a sufficiently long advance / retreat stroke of the guide wire 2 with respect to the drainage tube 1. The tube-wire fixing part 20 is composed of the drainage tube 1 and the guide wire 2.
And the electrically insulating tube 3 may be collectively arranged at a position where they can be fixed / released, or only the drainage tube 1 and the guide wire 2 may be arranged at a position where they can be fixed / released.

FIG. 8 shows a drainage tube indwelling device for an endoscope according to a third embodiment of the present invention, and an operation unit capable of integrally operating the drainage tube 1 and the guide wire 2 in the axial direction. 40 is provided detachably at the entrance of the treatment instrument insertion channel 101 of the endoscope 100.

Further, an electric insulating tube 3 similar to that of the second embodiment covers the base end portion of the guide wire 2, and the connection terminal 11 is directed rearward to the rear end of the connection portion 10. The high-frequency power cord 200 is placed
To be connected straight to. Further, a manual screw 14 for fixing / releasing the drainage tube 1 to / from the connection portion 10 is provided separately from the connection terminal 11.

The operation unit 40 has a first finger hook 42 for engaging the operator's thumb at one end, and a treatment instrument insertion channel 101 at the other end of an elongated operation unit main body 41.
A detachable screw-type (luer-lock type) connection nut 43 is attached to the mouth of the device.

A second finger hook for engaging the index finger and the middle finger of the operator is formed on the slider 44 which engages with the operation section main body 41 so as to be able to advance and retreat in the axial direction. And the guide wire 2 can be fixed / released with respect to the slider 44.

FIG. 9 is a sectional view taken along the line IX-IX showing the structure of this part. The fixing block 45, which is fixed to the slider 44 through the drainage tube 1 in which the guide wire 2 is inserted, is fixed to the operating section main body. 41 is loosely sandwiched in a slit formed in the central portion of the shaft 41 and elongated in the axial direction.

As shown in FIG. 10, the fixed block 4
5 has a through hole 451 through which the drainage tube 1 is passed.
A first slot 452 that divides the fixed block 45 through the center of the slot, and a second slot 453 that is parallel to the first slot 452 are formed.
4 are formed.

A manual screw 46 is screwed into the screw hole 454 as shown in FIG.
Is tightened, the fixed block 45 is deformed, and the drainage tube 1 and the guide wire 2 are fixed to the fixed block 45, and become integrated with the slider 44. Then, when the manual screw 46 is loosened, the drainage tube 1 and the guide wire 2 can freely advance and retreat.

FIG. 11 shows a state of use of the third embodiment described above.
Is attached to the entrance of the treatment instrument insertion channel 101 of the endoscope 100, and the slider 44 is advanced and retracted while the manual screw 46 is tightened, so that the drainage tube 1 and the guide from the distal end 102 of the insertion section of the endoscope 100 are The projecting state of the wire 2 can be easily adjusted. The procedure for placing the drainage tube 1 is the same as in the first embodiment.

[0036]

According to the present invention, a guide wire protruding from the distal end of a drainage tube having a longer overall length than the treatment instrument insertion channel of an endoscope is transendoscopically punctured into the inner wall of a patient's body cavity through high-frequency current. The drainage tube can be easily placed in a state where the tip reaches the deep part of the hole formed by puncturing, so that the body secretion fluid is discharged outside the body regardless of the state of the stenosis site. It has a very good therapeutic effect.

[Brief description of the drawings]

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

FIG. 2 is a side view showing the drainage tube according to the first embodiment of the present invention in a partial cross section.

FIG. 3 is a sectional view of the drainage tube indwelling device for an endoscope according to the first embodiment of the present invention, taken along the line III-III in FIG. 1;

FIG. 4 is a schematic view showing a use state of the first embodiment of the present invention.

FIG. 5 is a schematic diagram showing a use state of the first embodiment of the present invention.

FIG. 6 is a schematic view showing a use state of the first embodiment of the present invention.

FIG. 7 is a side sectional view of a drainage tube indwelling device for an endoscope according to a second embodiment of the present invention.

FIG. 8 is a side sectional view of a drainage tube indwelling device for an endoscope according to a third embodiment of the present invention.

FIG. 9 is a sectional view of the drainage tube indwelling device for an endoscope according to the third embodiment of the present invention, taken along the line IX-IX in FIG. 8;

FIG. 10 is a perspective view of a fixing block according to a third embodiment of the present invention.

FIG. 11 is a schematic view showing a use state of an endoscope drainage tube indwelling device according to a third embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Drainage tube 2 Guide wire 10 Connection part 11 Connection terminal 20 Tube-wire fixing part 23 Manual screw 40 Operation part 43 Connection nut 100 Endoscope 101 Treatment tool insertion channel 102 Insertion part tip 200 High frequency power cord

Claims (6)

[Claims] 1. A drainage tube having an overall length longer than a treatment instrument insertion channel of an endoscope and made of an electrically insulating flexible tube detachable from the treatment instrument insertion channel, and an overall length longer than the drainage tube. A guide wire made of a conductive flexible wire that can be inserted into and removed from the drainage tube and protrudes from the tip of the drainage tube; and a high-frequency power supply connection for applying a high-frequency current to the guide wire. Means, and a tube-wire fixing means for freely fixing / releasing the drainage tube and the guide wire at a base end side of the drainage tube. 2. The high-frequency power supply connecting means and the tube.
2. The endoscope drainage tube retainer according to claim 1, wherein a wire fixing means is integrally provided at a base end portion of the drainage tube. 3. A flexible electrical insulating tube for preventing the guide wire extending from the proximal end of the drainage tube from being directly exposed to the outer surface, the flexible electrical insulating tube being connected to the proximal end of the guide wire from the proximal end of the drainage tube. 2. The endoscope drainage tube indwelling device according to claim 1, wherein the device is covered over a portion. 4. An endoscope drainage tube retaining device according to claim 3, wherein said tube-wire fixing means is arranged so as to be capable of fixing / releasing the drainage tube, the guide wire and the electric insulating tube. 5. An endoscope drainage tube retaining device according to claim 3, wherein said tube-wire fixing means is arranged so as to be capable of fixing / releasing only said drainage tube and said guide wire. 6. An operation section for operating the tube-wire fixing means in the axial direction of the drainage tube so as to be removably provided at an entrance portion of a treatment instrument insertion channel of the endoscope. An endoscope drainage tube indwelling device according to claim 1.