JPH044755Y2 - - Google Patents

Description

[Detailed Description of the Invention] (Industrial Application Field) The present invention relates to a knotted bypass shunt, which is a medical device for bypassing blood flow within a blood vessel during surgery.

(Prior Art) A bypass shunt, which is generally used during surgery, refers to a method devised to bypass blood flow by connecting arbitrary different blood vessel locations with an artificial tube, and refers to the medical equipment used therefor.

Bypass shunts include the so-called "external shunt" that bypasses blood flow with a tube that passes outside the blood vessel.
There is also an ``internal shunt,'' in which a tube is implanted inside the blood vessel and its ends are defined by ligatures to bypass blood flow.

Among these, internal shunts are typically seen during endarterectomy, which is used for small blood vessels such as the carotid artery, and even if the blood vessel is removed or damaged by surgery, bleeding may occur from there. However, as in the case shown in Fig. 3, side holes 2a and 2b are provided in the tube 1 for blood flow to pass through, and a part of the tube is placed outside the blood vessel. There is also a way to get it out. This method is
The bypass shunt tube has the advantage of being easy to insert into the blood vessel and easy to remove by pulling out after surgery.

Recently, shunt methods similar to conventional internal shunts have been used for partial resection of relatively large blood vessels such as the inferior vena cava, and bypass shunts have become increasingly important. ing.

(Problem that the invention aims to solve) However, when using a conventional bypass shunt, simply inserting it into the inferior vena cava and ligating it with a thread from the outside of the blood vessel does not allow the bypass shunt to Inadvertently dislodging from the inferior vena cava during surgery,
There were times when it would shift. In this way, if the bypass shunt is not securely fixed and comes out of the inferior vena cava, a large amount of bleeding may occur, and if the side hole is displaced from its original position, it may cause damage to the blood vessel. There was a risk that the blood would not flow through the bypass shunt tube because it was stuck tightly against the wall and blocked.

(Means for solving the problems) In view of the above-mentioned conventional problems, the present invention
The objective is to provide a bypass shunt that is easy to fix and highly safe, obtained through intensive research and development.

That is, in the present invention, in an internal shunt that is placed in a blood vessel and bypasses blood flow, a side hole 2b is bored at a predetermined position of the flexible tube 1, and holes for fixing the shunt position are provided on both sides of the side hole 2b. This invention relates to a knotted bypass shunt characterized by providing knots 3a and 3b.

The bypass shunt according to the present invention is made of a tube made of flexible synthetic resin such as polyvinyl chloride or polyurethane. The knotted bypass shunt according to the present invention has a side hole for blood flow passage at a predetermined position of the tube like a normal bypass shunt, but unlike the conventional one, the bypass shunt has a side hole on one or both sides of the tube. It has a knot for fixing the bolt, making it highly practical and safe. Note that it is essential to provide side holes 2b at predetermined positions, and in consideration of safety so that the entrance and exit of the bypass shunt will not be blocked, usually two side holes 2b are provided.
a, 2b.

Further, the shape of the fixing node is not particularly limited, but it is preferably ring-shaped so as not to damage blood vessels.

Hereinafter, the knotted shunt according to the present invention will be explained according to the embodiment shown in the drawings.

FIG. 1 shows a side view of one embodiment of the present invention.

In FIG. 1, reference numeral 1 denotes a flexible synthetic resin tube constituting the main body of the bypass shunt according to the present invention, which is similar to that used in ordinary bypass shunts.

The tube 1 is provided with side holes 2a and 2b near its tip and at a predetermined distance therefrom, and ring-shaped nodes 3a and 3b are provided on both sides of the side hole 2b.
is provided. The side hole 2b is arranged as a blood inlet for blood to pass through the tube. Further, the side hole 2b is located at the center of the blood vessel by the nodes 3a and 3b, ensuring inflow of blood flow. The side hole 2a is installed to increase blood flow.
That is, blood flows into the tube through the side hole 2b and flows out through the end opening in the inflow direction and the side hole 2a. Thickness of tube 1, side holes 2a, 2
There are no particular restrictions on the size and position of b and the ring-shaped nodes 3a and 3b, and they can be changed depending on the purpose.

The ring-shaped node 3a has a biconvex cross section, so that the bypass shunt can be inserted relatively smoothly, and if it is ligated with a thread 4a as shown in FIG. It is designed so that it does not get too deep. The ring-shaped node 3b has a plano-convex cross section and is not perpendicular to the length direction of the tube 1, but at an appropriate angle, so that it does not easily escape from the blood vessel 5.

However, whether the joints 3a and 3b are biconvex or plano-convex, or their angle with respect to the tube 1 varies depending on the location and purpose of the bypass shunt, and other types may be prepared in advance. I can do it. Furthermore, these ring-shaped nodes can be provided not only in the embodiment shown in FIG. 1 but also on one side or both sides near one or both of the two side holes, if necessary.

In addition, it is preferable that the tube 1 is coated with a heparinized hydrophilic material on the inner and outer surfaces in order to impart antithrombotic properties. FIG. 3 is a perspective view showing an example of use of the knotted bypass shunt according to the present invention. A tobacco suture is applied to the blood vessel where the bypass shunt tube is to be inserted as shown in Figure 1.
Add an incision. A shunt tube whose inner and outer surfaces are coated with a heparinized hydrophilic material is inserted through the incision until the node 3b enters the blood vessel, and the tobacco suture is tightened. Next, palpate node 3a from above the blood vessel,
The downstream side of the blood flow (the side of the side hole 2a) of the node 3a is ligated.
At this point, the shunt tube is fixed and no longer enters the blood vessel. Section 3a,
3b, the side hole 2b is positioned approximately at the center of the blood vessel. Further, by ligating the upstream side of the blood flow (node 3a side) of the side hole 2a with the thread 4b, the blood flow flows into the shunt tube through the side hole 2b and flows out through the tip opening and the side hole 2a. Blood flow is cut off between the blood vessels ligated with the threads 4a and 4b, allowing surgery to be performed without fear of bleeding.

(Operation) The knotted shunt according to the present invention can be used in a method similar to the above-mentioned inner shunt.

When fixing the bypass shunt according to the present invention, by ligating the outside of the node, it can be fixed much more reliably and safely than conventional bypass shunts. In addition, since the side hole is located approximately in the center of the two nodes, the location of the side hole can be easily estimated by palpating the node from above the blood vessel after inserting the bypass shunt, and the position of the bypass shunt can be determined easily. can be done reliably.

(Example) Example 1 As shown in Figure 1, a bypass shunt tube 1 with a length of 25 cm is made from a polyvinyl chloride tube with an outer diameter of 8 mm and an inner diameter of 6 mm, and the tube is bent at an angle of approximately 30 degrees at a point 15 cm from the tip. bent at an angle. The tip of tube 1 will be the outlet for blood flow after insertion into the blood vessel, but it is cut diagonally to make it easier to insert it into the blood vessel.
Oval holes measuring 7 to 8 mm in the major axis direction and 5 to 6 mm in the minor axis direction were bored at positions of cm and 15 cm to form side holes 2a and 2b, respectively.

The ring-shaped nodes 3a and 3b were also made of polyvinyl chloride, and were provided at positions 1 cm on both sides from the center of the side hole 2b. In addition, ring-shaped node 3
The cross-sectional shapes of a and 3b were biconvex and plano-convex, respectively, and both had an outer diameter of 10 mm and a thickness of 1 mm.

A knotted bypass shunt with the above specifications,
For the purpose of treating cases of liver cancer in which invasion of the inferior vena cava was observed, the tube was inserted into the inferior vena cava and the inferior vena cava was ligated and blocked with threads 4a and 4b. As a result, as shown by arrows A, B, and C in Fig. 3, blood flow flows from the side hole 2b located approximately in the center of the bypass shunt, through the tube 1, and flows out from the tip and side hole 2a. The system was confirmed to work safely, and the cancer-infiltrated area was successfully removed.

Example 2 In addition to the structure of Example 1, a ring-shaped node 3c with an outer diameter of 10 mm and a thickness of 1 mm and a biconvex cross section was provided at a location 5 cm from the tip (FIG. 2). When the knotted bypass shunt according to the above specifications was used in a case of liver cancer infiltrating the inferior vena cava in the same manner as in Example 1,
It was confirmed that the bypass shunt can be more securely fixed within the blood vessel, and that even if the inferior vena cava is ligated and blocked, blood flows through the bypass shunt and functions safely.

(Effect of the invention) Since the knotted bypass shunt according to the present invention has a knot on one or both sides of the side hole, when it is placed in a blood vessel in a manner similar to an internal shunt,
It can be fixed reliably and safely.

Therefore, the bypass shunt does not escape from the blood vessel or go deeper than its optimal position, and the problem of blood stagnation due to the entrance and exit of the bypass shunt coming into close contact with the inner wall of the blood vessel does not occur.
Blood flow can be safely bypassed, allowing safe surgery.

[Brief explanation of the drawing]

FIG. 1 is a perspective view showing one embodiment of the knotted bypass shunt according to the present invention, FIG. 2 is a perspective view showing another embodiment, and FIG. 3 is a perspective view showing an example of use of the knotted bypass shunt according to the present invention. 1...Tube, 2a, 2b...Side hole, 3a,
3b, 3c... nodes, 4a, 4b... threads, 5... blood vessels.

Claims (1)

[Scope of utility model registration request] In an internal shunt that is placed in a blood vessel and bypasses blood flow, a side hole 2b is bored at a predetermined position of the flexible tube 1, and nodes 3a and 3b for fixing the shunt position are provided on both sides of the side hole 2b. Knotted bypass shunt.