JPH0736664Y2 - Tube for retrograde transhepatic biliary tract treatment - Google Patents

Description

[Detailed Description of the Invention] [Industrial field of application] The present invention is placed in the common bile duct and the intrahepatic bile duct for postoperative bile drainage, observation by cholangioscopy, and stone mounting, and The present invention relates to a retrograde transhepatic biliary tract treatment tube having a mechanism capable of bending a puncture needle intraoperatively to puncture the distal end of the intrahepatic bile duct and pulling the tube end out of the body.

[Conventional technology]

As a means for injecting a drug or contrast agent into the internal organs of the body, especially for injecting a contrast agent or draining bile (drainage), a catheter or tube is placed in the bile duct. There are a method of indwelling the drainage tube that has been punctured in the bile duct and a method of indwelling the drainage tube in the bile duct by surgery.

Of these, when the latter method is adopted, a T tube is generally used, and the drainage tube is guided outside the body directly from the common bile duct without passing through the liver. However, the T-tube has a defect that bile easily leaks into the body cavity, and also has a problem that a stone reoccurs with the T-tube fixing suture as a nucleus.

Further, since it is difficult to use the T tube in an operation such as a bile duct-duodenal anastomosis for completely removing the common bile duct, it is advantageous to place the straight tube transhepaticly from the biliary tract.

From this viewpoint, the present applicant has already proposed a retrograde transhepatic biliary drainage device having a structure in which a puncture needle and a drainage tube are connected (Shokai Sho 60-182061). According to this tool, the puncture needle can be retrogradely inserted during operation by deforming the puncture needle by hand force according to the curvature of the intrahepatic bile duct, and the distal end of the bile duct can be punctured to guide the drainage tube out of the liver surface to the outside of the body. Because it is possible, it is useful for medical staff.

[Problems to be solved by the device]

However, the retrograde transhepatic biliary drainage device according to the above-mentioned prior art secures a bile drainage route, inserts a cholangioscope, and mounts a stone because the drainage tube is composed of a straight tube having the same diameter as the puncture needle. In order to form a wax hole, the catheter has to be successively exchanged for a larger diameter to form a desired wax hole diameter, which is complicated in the procedure.

The purpose of the present invention is to solve the problems of the prior art, to secure a bile drainage route with a single procedure, to insert a cholangioscope,
It is an object of the present invention to provide a retrograde transhepatic biliary tract treatment tube having a structure excellent in operability and capable of forming a wax hole for mounting a stone.

[Means for Solving the Problems]

A retrograde transhepatic biliary tract treatment tube according to the present invention for achieving the above-mentioned purpose is a puncture in which a rear end connector portion is integrated with a sharp cone-shaped needle head having an angle of 5 to 40 ° through an intermediate pipe. A tube structure in which a needle and a drainage tube are connected to each other, wherein the needle head portion and the rear end connector portion are made of a highly rigid material, and the intermediate pipe is an easily plastically deformable metal rod or a metal pipe. The drainage tube is made of a rod filled with a low-rigidity material, and the diameter of the drainage tube is gradually tapered from the connecting portion having the same diameter as the puncture needle, and the proximal end portion has an inverse tapered taper shape. This is a structural feature.

[Action]

According to the retrograde transhepatic biliary tract treatment tube of the present invention,
Since the puncture needle is composed of the tip angle suitable for puncturing biological tissue and the needle head made of a highly rigid material and the intermediate pipe of the metal rod that can be easily plastically deformed, it can be used for the intrahepatic bile duct that bends during the surgical process. It can be easily transformed into a conforming form by the force of the fingertip. Moreover, since the diameter of the puncture needle is designed to be smaller than the diameter of the treatment tube, not only the puncture and penetration proceed smoothly, but also the surrounding internal tissue is not damaged and it is safe.

Further, the shape of the drainage tube has the same diameter at the connection portion with the puncture needle, but then exhibits a gradual taper shape from that to the proximal end to increase the diameter and finally taper in an inverted taper shape at the proximal end. Since it is configured as described above, it can be easily introduced retrogradely into the body through the hepatobiliary duct while being guided by the puncture needle. Therefore, it becomes possible to indwell a large-diameter tube without exchanging the tube, and it is possible to form a brazing hole of an appropriate size early after removing the tube.

Through such a mechanism, the intraoperative procedure can be safely performed with good operability, and postoperative bile drainage, choledoscopic insertion, stone mounting, etc. can be performed smoothly and quickly.

〔Example〕

Hereinafter, the present invention will be described in detail with reference to an embodiment shown in the drawings.

FIG. 1 is a longitudinal sectional view showing a puncture needle portion of a retrograde transhepatic biliary tract treatment tube according to the present invention, in which 1 is a needle head, 2 is an intermediate pipe, and 3 is a rear end connector portion. FIG. 3 is a partially cutaway vertical sectional view showing the overall structure of the present invention. The tip of the drainage tube 5 is connected to the rear end connector portion 3 of the puncture needle 4, and the end has side holes and end holes. It has a basic structure that constitutes the base end portion 6 provided.

During actual use, the puncture needle 4 is guided out of the body through the intrahepatic bile duct through the liver during operation, and the drainage tube 5 is inserted.
Is led by the puncture needle 4 and pulled out of the body. Puncture needle 4
When the proximal end 6 of the drainage tube 5 is placed at the target site of the biliary tract after the needle is pulled out, the distal end is cut off and the puncture needle 4 is cut off to drain the drainage tube 5 intrahepatically. Detain.

As shown in FIG. 1, the puncture needle 4 has the protrusion of the needle head portion 1 and the protrusion of the rear end connector portion 3 fitted into both ends of the intermediate pipe 2 and fixed by means such as caulking or bonding. The other end of the rear end connector portion 3 is a scaly projection, and has a shape that allows the drainage tube to be connected without a step.

The needle head 1 facilitates puncture and penetration of living tissue,
The tip angle α shown in FIG. 2 (enlarged view of the tip of the needle head) is 5 to
It is processed to have a sharp cone shape in the range of 40 °, preferably 20 to 30 °. If this angle is less than 5 °, the internal tissues, especially blood vessels, will be easily damaged, and if it exceeds 40 °, puncturing and penetration of living tissues will be extremely difficult or impossible.

The needle head portion 1 and the rear end connector portion 3 of the puncture needle need to be made of a highly rigid material capable of withstanding the force of puncturing and penetrating a biological tissue and the force of securely fixing and leading the drainage tube. Examples of such materials include metals such as steel, stainless steel, and brass, or phenol resin,
Examples thereof include thermosetting resins such as epoxy resins and silicone resins, polycarbonate, acetal resins, engineering plastics such as polysulfones, but are not limited thereto.

The intermediate pipe 2 of the puncture needle is a part that provides a mechanism that can be freely deformed into a desired shape by the force of a fingertip, and is made of a metal material that is easily plastically deformed. For example, the rod may be made of a thin tube such as aluminum, copper or an alloy thereof, but when the pipe is bent, a resin may be formed inside the metal pipe to prevent the pipe section from being unrecoverably deformed or broken. It is desirable to use a rod filled with a low-rigidity material such as rubber. As the low-rigidity material to be filled, thermoplastic resin such as ABS, polyvinyl chloride, polyurethane, polyethylene, ethylene-vinyl acetate copolymer, or rubber such as natural rubber, chloroprene rubber, butyl rubber, silicone rubber, various thermoplastic elastomers, etc. The kind can be illustrated.

As shown in FIG. 3, the drainage tube 5 has the same diameter as the puncture needle 4 and is connected without a step at the connecting portion 7 with the rear end connector portion 3. From this position as a starting point, the drainage tube 5 is gradually tapered and thick. The diameter is increased, and finally the base end portion 6 is tapered in an inverse taper shape. The most desirable shape is to show a gradual taper to increase the diameter, then once provide a straight portion, and then design the shape to reach the base end portion. In this case, the preferred drainage tube 5 has a diameter of the connecting portion of 2 to 3 mm, a length of the tapered portion of 300 to 600 mm, preferably about 400 mm, and a diameter of the thickened straight portion of 3 to 15 mm, preferably The length is 6 to 8 mm and the length of the straight portion is 50 to 300 mm.

In addition, the side hole and the end hole installed in the base end portion 6 are usually
Two to three side holes and one end hole are provided with a diameter of 0.5 to 2.0 mm, but the shape and number are not particularly limited as long as the shape and number facilitate drainage.

The property of the drainage tube 5 is that it has the flexibility and strength necessary for smoothly penetrating a living tissue by being guided by a puncture needle, that it does not deteriorate due to contact with bile, and that the bile in the tube is visible and transparent. Something is necessary. As materials that meet these material requirements, thermoplastic resins such as soft polyvinyl chloride, polyurethane, and polyethylene,
Although rubbers such as silicone rubber and various thermoplastic elastomers can be mentioned, it is preferable to use a soft polyvinyl chloride resin from the viewpoint of wax hole formation and moldability.

In addition, X that allows you to check the placement position with X-rays when placing
A line for line contrast is required to be inserted, and as this material, barium sulfate, bismuth subcarbonate, etc. are generally used.

[Effect of device]

The retrograde transhepatic / biliary tract treatment tube according to the present invention has a specified constituent material and a unique tapered drainage tube structure, which facilitates puncture and penetration of biological tissue during the operation stage, and bile after surgery. Drainage, cholangioscopic observation, and treatments such as mounting stones are greatly facilitated.

Therefore, it is guaranteed that a medical procedure with excellent operability and safety is always performed.

[Brief description of drawings]

FIG. 1 shows an embodiment of the present invention. FIG. 1 is a longitudinal sectional view of a puncture needle portion, FIG. 2 is an enlarged view of a tip portion of a needle head, and FIG.
The figure is a partially cutaway longitudinal sectional view showing the overall structure of a tube for treating retrograde transhepatic biliary tract. 1 ... Needle head, 2 ... Intermediate pipe 3 ... Rear end connector part, 4 ... Puncture needle 5 ... Drainage tube, 6 ... Base end part 7 ... Connection part

 ─────────────────────────────────────────────────── ─── Continuation of the front page (56) References JP-A-60-160970 (JP, A) Actual development S60-182061 (JP, U)

Claims (1)

[Scope of utility model registration request] 1. A tube structure in which a draining tube and a puncture needle in which a rear end connector portion is integrated via an intermediate pipe are connected to a sharp cone-shaped needle head portion whose tip is an angle of 5 to 40 °, The needle head portion and the rear end connector portion are made of a highly rigid material, and the intermediate pipe is made of a metal rod that can be easily plastically deformed or a rod in which the metal pipe is filled with a low-rigidity material. A retrograde transhepatic biliary tract treatment tube, characterized in that a diameter gradually increases from a connecting portion having the same diameter as that of a puncture needle to a gradually tapering shape, and a proximal end portion is tapered in an inversely tapering shape.