JPH0441847Y2 - - Google Patents

Description

[Detailed Description of the Invention] A. Field of Industrial Application The present invention relates to a medical tube body whose tip portion is connected to a blood flow path.

B. Prior Art In recent years, progress has been made in the development of artificial hearts for auxiliary and temporary replacement of the functions of the heart outside the body during open-heart surgery and other surgeries. For example, as shown in FIG. 7, a sac type blood pump device 11 is connected between the right atrium and the pulmonary artery of the living body's heart 10, and between the left atrium and the aorta 50, respectively.
Such blood pump devices are being researched in Japan ahead of the rest of the world, and have already been put into clinical use as auxiliary hearts.

As clearly shown in FIG. 8, this blood pump device 11 mainly includes a pressure-resistant (for example, made of polycarbonate or polyurethane) hanging outer case 1 and a flat bag-shaped bag that is airtightly housed within the housing outer case. It consists of type 2 blood chambers. At the top of this blood chamber 2, there is a blood introduction tube 3 that communicates with the blood chamber.
and a blood discharge pipe 4 are formed upward and substantially parallel to each other. A flange portion 5 forming a part of the housing is provided around the upper part of the blood chamber.
The blood chamber is hermetically housed within the housing outer case 1 by this flange. Furthermore, inside each of the blood introduction pipe 3 and the blood discharge pipe 4, an artificial check valve 6 for preventing backflow of the blood 17,
7 is attached, so that the blood 17 introduced into the blood chamber 2 from the blood introduction tube 3 is
The blood is discharged from a blood discharge tube 4.
To pump blood, fluid is pumped through a port 8 provided at the bottom of the housing outer case 1.
For example, by alternately introducing and discharging compressed air and decompressed air, the blood chamber is repeatedly expanded and contracted as the external pressure of the blood chamber changes. Each cannula 12 connected to the heart of the living body by anastomosis, and the blood inlet tube 3 and blood outlet tube 4 on the blood chamber 2 side are connected to each connector 13.
The ring-shaped flange 14 is fitted from both ends thereof to the ring-shaped flange 14 provided at the center thereof.
As shown in an enlarged view in FIG. 9, the tip of the cannula 12 is provided with a ring-shaped collar 15 that has a retaining effect when connected to the heart.
Side hole 16 to prevent the inner wall of the atrium etc. from being sucked into the cannula tip port and reducing the flow rate during blood removal.
A hole 16A at the tip opening to the tip 18 having a shape as if cut diagonally is formed.

However, it has been found that the cannula 12 shown in FIG. 9 has the following defects.

For example, the connection of the cannula to the aorta will be explained with reference to FIG. That is, first, the tip of the cannula 12 is inserted through the cut 53 previously made in the aorta 50 using, for example, a scalpel until the collar 15 is located inside the aorta 50, and then a purse string is tied around the cut 53 in advance. The cannula 12 is quickly tightened by tightening the thread 54 that has been sewn using a suturing technique.
Ligate.

In this case, the hole 16A at the tip of the cannula 12
is opened obliquely in the direction of the flow path so as not to limit the flow rate of the blood 17 flowing in the direction of the arrow in the aorta 50. However, if the peripheral wall of the aorta 50 digs into or comes into contact with the tip 18 of the cannula 12, as shown by the phantom line in FIG. Therefore, the rate-determining effect described above is inhibited, and the blood flow becomes insufficient. Moreover, as a result, it is not only difficult to control the amount of blood supplementation, but also a thrombus or a pannus is easily formed, which is disadvantageous.
Furthermore, the thrombus and pannus block the tip hole 16A and/or the side hole 16B, further promoting the insufficient blood flow and the formation of the thrombus and pannus, which is extremely inconvenient.

In addition, the cannula 12 shown in FIG. 9 is not only unsuitable for use in blood vessels as described above, but also has the hole 16A at the tip clogged depending on the orientation when used in connection with a biological wall such as an atrium. Easy to worship.

C. Purpose of the invention The present invention has been made in view of the above circumstances, and has a low rate-limiting flow rate of blood in the blood flow path.
The purpose of the present invention is to provide a medical tube body that does not cause changes in the flow rate of blood, has no risk of undesirable solid matter being formed, and can be manufactured into a shape that is easy to attach and difficult to remove. There is.

D. Structure of the invention In other words, the present invention provides a medical tube whose distal end is connected to a blood flow path, including a plurality of annular protrusions protruding outward on the side surface of the distal end of the main body; A through hole is provided in each of the annular protrusions and communicates with the main body, and the distal end portion of the main body including the plurality of annular protrusions has a tapered shape, and the most distal end thereof is closed. ,and,
The size of the through hole approximately corresponds to the inner diameter of the blood flow path, and the annular protrusion and the closed end portion are both configured to be in close contact with the inner wall of the blood flow path. The present invention relates to a medical tube body characterized by the following.

Example Examples of the present invention will be described below.

Example 1 FIGS. 1 to 4 show an example in which the present invention is applied to a cannula. Note that parts common to those in FIGS. 7 to 10 are designated by the same reference numerals.

Figure 1 is a perspective view of the cannula.
2 is used in the same manner as the cannula 12 described in FIG.

This cannula 22 includes a main body 22b and a distal end 22.
It is made of a flexible and substantially transparent material (polyvinyl chloride in this example). Tip part 22
As shown in Fig. 2 as a left side view and as shown in Fig. 3 as a sectional view taken along the - line in Fig. present,
The front shape is wedge-shaped, and the width becomes narrower toward the tip. Further, the most distal end side is closed by the most distal wall portion 28 . Adjacent to the wall portion 28, a pair of through holes are provided in the side wall of the distal end portion 22a at diametrically opposite positions in a direction substantially perpendicular to the main body 22b, and these through holes form a predetermined blood flow. ing. A blood conduction path 22c between the openings 26A and 26B serves as a blood conduction path 22c.
communicates with the blood conduction path 22d of the main body 22b.

The leading edge wall 28 is curved somewhat upward in the center. A pair of annular protrusions 27 having an oval shape and protruding somewhat outward are formed on the wall 29 in contact with the openings 26A and 26B.

Next, examples of connecting the distal end of the cannula 22 to the aorta, for example, are shown in FIGS. 4A, 4B, and 4.
This will be explained with reference to FIG. C and FIG. 4D (however, the longitudinal section of FIG. 4D is FIG. 4C).

First, as shown in FIG. 4A, a predetermined portion of the aorta 50 is partially clamped with the vascular forceps 51. In this state, an incision 53 is made with a scalpel 52, or a similar opening is made with scissors.

Next, as shown in FIG. 4B, while inserting the distal end 22a of the cannula 22 perpendicularly into the aorta 50 through the incision 53, the vascular forceps 51 shown in FIG. 4A is removed. Subsequently, as shown in FIG. 4C, the part of the peripheral wall of the aorta 50 that is in contact with the vicinity of the protrusion 27 is in close contact with the outer surface of the cannula tip 22a in the vicinity of the protrusion 27, and the part of the peripheral wall of the aorta 50 that is in contact with the vicinity of the protrusion 27 is The distal end of the cannula that contacts the wall 28 is in close contact with the outer surface of the wall 28 . When this condition occurs, immediately adjust the inner position of the protrusion 27 and the wall portion 2.
The peripheral wall of the aorta 50 is ligated with a thread 64 between the cannula 22 and the aorta 50, thereby completing the connection of the cannula 22 to the aorta 50. In this state, the wall portion 28 and the annular protrusion 2
7 is in close contact with the inner wall surface of the aorta 50, and the inner diameters of the openings 26A and 26B that are in contact with this in the protrusion 27 approximately correspond to the inner diameter of the aorta 50.

In FIG. 4C, the conduction path 22c of the cannula body 22b is used to introduce or remove blood from the aorta 50 to the blood chamber (2 in FIG. 8) (indicated by the actual arrow), or from the blood chamber to the aorta 50.
Blood is supplied to or sent to (indicated by a dashed-dotted arrow). At the same time, the blood 17 flows through the opening 26A, the distal conduction path 22c, and the opening 26B.
It flows through the aorta 50 as shown by the arrow.

The blood 17 flowing through the aorta 50 is connected to the opening 26
Since the inner diameters of A and 26B approximately correspond to the inner diameter of the aorta 50 and both openings are located along the flow of blood, the flow path is not bent or narrowed, and the flow is not disturbed. There is nothing to do and it flows smoothly. In addition, the canyule body 22
The conduction path 22d of b is the conduction path 22 of the tip portion 22a.
Since the aorta 50 is widely connected to the blood chamber 50, blood flows smoothly between the blood chamber and the aorta 50. In this way, the blood 17 flows through the pair of openings 2.
There are no elements disturbed by 6A and 26B, and the desired smooth blood flow can be ensured. Therefore, there is no change in blood flow rate, and there is no risk of thrombus or pernus occurring. Moreover, since the leading edge of the cannula 22 is closed by the wall 28, the 4th C
As shown in the figure, even when it comes into close contact with the blood vessel wall, the tip does not become blocked or clogged, unlike conventional methods.

In this example, the distal end portion 22a has a shape that tapers toward the distal end as explained in FIGS. 2 and 3, so in the step of FIG. 4B, the distal end 22a is distal end 22 into the aorta 50 of
Since the insertion of a can be performed naturally while pushing and expanding the incision 53, it can be performed extremely easily and quickly. Further, the tip portion 22a has a protrusion 27, and the center of the wall portion 28 of the tip portion is curved upward.
In the process shown in Figure C, near the protrusion 27 and the most extreme wall 2
8, the cannula tip 22a can be reliably ligated to the aorta 50 with a simple operation, and the cannula can be tied to the aorta without the need for troublesome operations like conventional purse string sutures. Although the joining can be carried out quickly and satisfactorily, in addition, the aorta 5
The peripheral wall of 0 is formed by the projection 27 of the tip 22a.
The distal end 22a is effectively prevented from coming out of the aorta 50. Furthermore, the cannula can be easily removed from the aorta in the later stages of the surgery. That is, the thread 64 is cut and the cannula is pulled out from the aorta;
Suture the incision.

Note that the shapes of the openings 26A and 26B shown in FIG. 2 are important for ensuring blood flow and preventing thrombus formation, and facilitate insertion of the tip into the aorta via the above-mentioned incision. Considering that,
It is best to have an oval shape as described above. Further, the length l in the vertical direction of the openings 26A and 26B is 12
The optimum value is ~15mm. Furthermore, the distance d between the two concave portions on the inside of each protrusion 27 shown in FIG. 3 should not be made too narrow from the viewpoint of strength of the cannula, prevention of the cannula from slipping out, and ease of ligation with the thread described above. is not preferable, and it is better to have a certain interval.

As described above, in this example, the cannula can be quickly and reliably connected to the aorta with a simple operation, which must be done skillfully and quickly, and a cannula structure suitable for use in blood vessels can be provided.

Embodiment 2 FIG. 5 is a sectional view showing an example in which the present invention is applied to a blood bypass tube.

The arteries 60A and 60B each conduct blood 17 in the direction of the arrow and are connected at locations not shown. If a disorder such as an aneurysm occurs at or near this connection and blood flow between the arteries 60A and 60B is obstructed, the blood bypass tube 32 artificially connects the arteries 60A and 60B. In addition,
In FIG. 5, arteries 60A and 60B are each shown in cross section through their center lines.

The blood bypass tube 32 is made of flexible and transparent polyvinyl chloride, similar to the cannula of the first embodiment. The blood bypass tube 32 is constructed by disposing distal ends 32a and 32b at both ends of the blood bypass tube body 32c, and the distal ends 32a and 32b both have the same structure as the distal end of the cannula in Example 1. .

Blood bypass tube 32 is coupled to arteries 60A and 60B in the following manner. The blood bypass tube 32 is filled with physiological saline in advance, and the vicinity of both ends of the main body 32 are sealed with forceps.
The tip 32a is removed in the same manner as explained in the figure.
is connected to artery 60A.

Other details are shown in FIG. 4A and FIG. 4 in Example 1 above.
There is no difference from the procedure described with reference to FIGS. B and 4C.

In this way, the arteries 60A, 60B are quickly and securely connected by the blood bypass tube 32, and as shown in FIG.
It flows smoothly within 0A and 60B as shown by the arrows, and flows smoothly from artery 60A to artery 60B via the conduction path 32e of main body 32c of blood bypass tube 32.

Blood bypass tube 32 is connected to arteries 60A, 60
To prevent air from entering when connecting to B,
Either cut the main body 32c and connect it in physiological saline using the connector 13 shown in FIG.
Air is discharged from 2g into a syringe (not shown) through a syringe needle (not shown).

Although this example is an example in which arteries are connected using a blood bypass tube, it goes without saying that veins can be similarly connected using the blood bypass tube described above.

Both Embodiments 1 and 2 are examples in which the present invention is applied to a cannula or blood bypass tube that conducts blood, but the medical tube body based on the present invention can be used not only for the above-mentioned organs but also for other organs and blood flow channels. It is also applicable to other surgeries.

In addition, the number, shape, opening angle (for example, shown in Fig. 6), dimensions, etc. of the through holes (openings) in the side wall of the tip of the tube body may be determined as appropriate depending on the type of blood flow path to be connected, the connection location, etc. You can change it. Furthermore, the area and shape of the wall that closes off the tip of the tube body may also be changed.

F. Effects of the Invention As explained above, the medical tube body based on the present invention has a plurality of annular protrusions on the side surface of the distal end of the main body, an opening in these annular protrusions, and an inner diameter approximately corresponding to the inner diameter of the blood flow path. A through hole is provided, and the most distal end of the distal end of the main body is closed, so that the through hole is located along the blood flow direction. As a result, this method is significantly different from regulating the flow rate of blood using an opening at the cutting edge, and the blood can flow reliably along the flow, and there are no problems such as the opening being blocked. As a result, blood flows smoothly in the living body, and there is no possibility that undesirable solids will be generated from the liquid. In addition, by making the tip tapered toward the most distal end and having an annular protrusion on the side wall that contacts the through hole, it is easy to insert into the blood flow path, and it is difficult to escape from the blood flow path. It is possible to have a structure.

[Brief explanation of the drawing]

Figures 1 to 6 show an embodiment of the present invention, in which Figure 1 is a perspective view of the cannula, Figure 2 is an enlarged side view of the tip of the cannula, and Figure 3 is the same as in Figure 2. 4A, 4B, 4C, and 4D are schematic diagrams sequentially showing the cannula coupling operation; FIG. 5 is a schematic sectional diagram showing how the blood bypass tube is used; and FIG. The figure is an enlarged partial sectional view of another cannula. 7 to 10 show conventional examples, in which FIG. 7 is a schematic diagram showing the state of use of the blood pump device, FIG. 8 is a schematic perspective view of the blood pump device, and FIG. 9 is a diagram of the cannula. FIG. 10 is a partial perspective view and a cross-sectional view showing a state in which the cannula is connected to a blood vessel of a living body. In addition, in the symbols shown in the drawings, 2... blood chamber, 11... blood pump device, 12,
22...Canyule, 17...Blood, 22a...
Cannula tip, 22b... cannula body,
22c, 22d...Blood conduction path, 26A, 26B
...Through hole (opening), 27... Protrusion, 28... Cutting edge wall, 32... Blood bypass tube, 3
2a, 32b...Blood bypass tube tip end, 32c...Blood bypass tube body, 5
0,60A,60B...Artery, 53...Artery incision, 54,64...Thread.

Claims (1)

[Scope of utility model registration request] In a medical tube body whose distal end of the main body is connected to a blood flow path, the distal end of the main body has a plurality of annular protrusions projecting outward on a side surface thereof, and a plurality of annular protrusions each opening into each of the annular protrusions. A through hole communicating with the inside of the main body is provided, the distal end portion of the main body including the plurality of annular protrusions has a tapered shape, the tip end thereof is closed, and the size of the through hole is the same as the size of the through hole. Medical use, characterized in that the annular protrusion and the obstructed leading end are both in close contact with the inner wall of the blood flow path, the diameter approximately corresponding to the inner diameter of the blood flow path. Tube type.