JP3737057B2 - Medical catheter - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a medical catheter, and more particularly to a catheter that can be used for diagnosis and treatment of intestinal obstruction and that can smoothly pass through even a bent portion of the digestive tract.
[0002]
[Prior art]
The applicant previously communicated a guide balloon for locally inflating one side region of the peripheral wall of the catheter body in the vicinity of the front portion of the catheter body, independently with a conduit provided in the body. A medical catheter that can be expanded and contracted has been proposed (Japanese Patent Laid-Open No. 10-85337). With this technique, for example, for diagnosis and treatment of intestinal obstruction, after inserting the catheter into the stomach, the guide balloon is inflated and the patient's body position is changed by bending along the gastrostomy, and assistance such as an endoscope. Even without this, it is possible to smoothly guide to the pylorus and reach the duodenum, shorten the time to reach the target site of the catheter, and shorten the time required to release the patient from pain Became possible.
[0003]
However, even with the technique described above, at the part where the bending of the small intestine is large, the inductor part at the tip cannot follow the bending and the collision may stop at the intestinal wall, but the peristaltic movement is nevertheless caused. As a result, the distal end side of the guide balloon is loosened so as to wrap around the stomach. At this time, even if the balloon for peristaltic motion is deflated and the balloon for guide is inflated, there are many cases in which the bending force is absorbed by the flexibility of the catheter body. Changing or returning the catheter a little, etc., this is uncomfortable and painful for the patient, and more time is lost in the small intestine than the shortening of the transit time in the stomach, increasing the burden on the patient. It was.
[0004]
[Problems to be solved by the invention]
Therefore, the present invention solves the above-mentioned conventional problems, and even when the advancing in the small intestine, even if the tip part collides with the intestinal wall or the like, the operation is resumed with an operation that places little burden on the patient. However, it aims at providing the medical catheter which can aim at shortening of the arrival time to the target site.
[0005]
[Means for Solving the Problems]
In order to achieve the above object, the invention according to claim 1 is a medical catheter in which an inductor portion is provided at a distal end portion of a catheter body, and a first balloon is provided in a catheter body behind the inductor portion. 2, the second balloon is divided into a plurality in the circumferential direction so as to cover substantially the half of the inductor part on the side of the catheter body, and provided independently so as to be inflatable, and divided in the circumferential direction of the second balloon. When the part of the balloons inflated, the latter half of the inductor part is bent so that the side of the balloon that is opposite to the balloon and that is not inflated faces inward, and the first half of the inductor part Is bent to an angle close to a substantially right angle with respect to the distal end portion of the catheter body.
[0006]
According to a second aspect of the present invention, in the first aspect, the first balloon is divided into a plurality of portions in the circumferential direction and provided independently so as to be inflatable. The invention of claim 3 is characterized in that, in claim 1 or 2, the second balloon and / or the first balloon has a non-slip projection on the outer surface. According to a fourth aspect of the present invention, in any one of the first to third aspects, the second balloon and / or the first balloon is made of a material that is opaque to X-rays.
[0007]
DETAILED DESCRIPTION OF THE INVENTION
A medical catheter showing an embodiment of the present invention will be described with reference to the accompanying drawings. 1 to 4 show a first embodiment. 1 is an overall front view showing a part of the length omitted, FIG. 2 is an enlarged front sectional view of a main part, and FIGS. 3A to 3E are cut along a line AA in FIG. It is a sectional side view. Reference numeral 1 denotes a medical catheter, which is made of a material that is flexible and suitable for living bodies, such as silicone rubber and soft polyvinyl chloride. For example, the outer diameter is 14 to 20 Fr (about 4.7 to 6.7 mm), and the total length is about 3000 mm. The tube-shaped catheter main body 2 is provided. An inductor 3 is connected to the distal end of the catheter body 2, and a balloon 5 for peristaltic motion is provided on the catheter body 2 behind the inductor 3. The inductor portion 3 includes a tube-shaped cover 6 made of silicone rubber or the like having both ends opened, and a plurality of ring-shaped weights 7 formed of metal, ceramics, resin, or the like that are positioned and arranged at almost equal intervals by the cover. It is made up of. The front end opening of the cover 6 is closed by the closing member 8, and the rear end opening communicates with the front end opening of the main lumen described later of the catheter body 2.
[0008]
A guide balloon 11 is provided so as to cover almost half of the inductor portion 3 on the catheter body 2 side. As shown in FIG. 3, the guide balloon 11 is divided into two in the circumferential direction, and the two divided balloons 11a and 11b can be inflated independently. In the figure, the chain line indicates the inflated state of the balloons 11a and 11b, and the solid line indicates the deflated state. Both the guide balloon 11 and the peristaltic movement balloon 5 are made of an X-ray opaque material. In this embodiment, both balloons 11 and 5 are made of a material that does not transmit X-rays, but only one of them may be used.
[0009]
2 and 3, 13 is a main lumen communicating with the inside of the cover 6 through the opening of the tip, 14 is a suction lumen, 15 a and 15 b are lumens for inflating a guide balloon, 16 is a lumen for peristaltic balloons, and 17 and 18 are sides. Each hole is formed in the catheter body 2. The lumens 13 to 16 are connected to and communicated with the connector 21 of the funnel portion 20 provided at the rear end portion of the catheter body 2 and the branched branches 22 to 25, respectively, as shown in FIG. That is, the connector 21 communicates with the main lumen 13, the branched branch pipe 22 communicates with the suction lumen 14, the connector 26 is provided at the end thereof, and the branch pipe 23 communicates with the lumen 15a for inflating the guide balloon 11a. The one-way valve 27 is provided at its end, the branch pipe 24 communicates with the inflation lumen 15b of the guide balloon 11b, the one-valve 28 is provided at its end, and the branch pipe 25 is used for peristaltic motion. The balloon 5 communicates with the lumen 16 for inflation, and a one-way valve 29 is provided at the end thereof. In FIG. 1, reference numeral 30 denotes a bonding margin portion formed when the circumferential edges of the balloons 11 a and 11 b are bonded to the catheter body 2.
[0010]
When diagnosing or treating intestinal obstruction, a drainage bag or a low-pressure continuous suction device (not shown) is connected to the connector 26 of the branch pipe 22 communicated with the suction lumen 14, and then the medical catheter 1 is placed in the nasal cavity or, in some cases, the oral cavity. After sufficiently applying the lubricant and the local anesthetic, the catheter 1 is advanced to the stomach of the patient, and the stomach contents are sucked from the side holes 17 and 18 through the suction lumen 14 as necessary. After suction, a syringe (not shown) is connected to the guide balloon inflating one-way valve 27, and sterilized purified water or physiological saline is injected to inflate the guide balloon 11a. Bend (Figure 4). Alternatively, depending on the direction of the distal end of the catheter body 2, an operation such as injecting sterilized purified water or physiological saline from the one-way valve 28 for inflating the guide balloon to inflate the guide balloon 11b and bend it to the opposite side is performed. Then, the direction of the distal end portion of the catheter body 2 is changed, and the catheter 1 is guided to the pylorus and duodenum while confirming under X-rays.
[0011]
When the catheter 1 advances into the duodenum, the guide balloon 11a (11b) is contracted and the peristaltic motion balloon 5 is inflated to advance in the small intestine by the force of peristaltic motion. In the small intestine, it moves about 3 to 5 cm per hour by peristaltic movement, so the progress is confirmed visually or by X-ray fluoroscopy with a progress scale (not shown) applied to the catheter body 2 every few hours. In this case, when the catheter 1 advances in the small intestine, the small intestine bends greatly, and the inductor portion 3 at the distal end does not follow the bend and hits the intestinal wall and does not advance as shown in FIG. Under X-ray fluoroscopy, the guide balloon 11a (11b) is appropriately selected and inflated while confirming its direction, and the inductor 3 is bent to change the patient's body position or to slightly return the catheter 1. The tip of the catheter 1 can be separated from the intestinal wall without increasing the burden on the patient.
[0012]
When it is expected that the region where the intestinal bending is large continues for a while, the peristaltic motion balloon 5 is deflated, both of the guide balloons 11a and 11b are expanded to receive the force of the peristaltic motion, and after passing through the large bending region. It is also possible to adopt a technique of inflating the peristaltic balloon 5 again. In this case, it is possible to reduce the time loss that the distal end of the catheter body does not collide with the intestinal wall, and to shorten the time to reach the target site. When arriving at a target site in the intestine, an X-ray contrast medium or a drug solution is injected from the connector 21 leading to the main lumen 13 to diagnose or treat intestinal obstruction.
[0013]
5 and 6 show a second embodiment. FIG. 5 is an overall front view showing a part of the length direction omitted. In this embodiment, the balloon for peristaltic movement is divided into two in the circumferential direction like the guide balloon, and these two divided balloons 5a and 5b can be inflated independently. Therefore, the branch pipe 32 having the one-way valve 33 is further increased by one and provided in the funnel portion 20. Thereby, the balloon for peristaltic movement also functions as a guide balloon. Since the configuration other than this is the same as that of the above-described embodiment, the same parts are denoted by the same reference numerals and the description will be simplified.
[0014]
In this embodiment, since the peristaltic balloon is divided into two as described above, when the peristaltic balloon 5a in the same direction as the guide balloon 11a is inflated simultaneously as shown in FIG. 6, the catheter body 2 can be bent greatly. FIG. 7 is a reference diagram that shows how the distal end portion of the catheter body 2 bends when the guide balloon and the peristaltic balloon are inflated in various combinations, with the balloon omitted. When the guide balloon opposite to the peristaltic balloon is inflated, the distal end portion of the catheter body 2 is bent in an S shape as shown in the figure, and a complicated movement can be performed.
[0015]
FIG. 8 shows a third embodiment. FIG. 8 is an overall front view showing a part of the length direction omitted. In this embodiment, anti-slip projections 35a, 35b and 36a, 36b are provided in a lattice pattern on the entire outer surfaces of the guide balloons 11a, 11b and the peristaltic balloons 5a, 5b. Since the configuration other than this is the same as that of the first and second embodiments, the same parts are denoted by the same reference numerals and the description will be simplified. If projections are provided on the entire outer surfaces of the guide balloons 11a and 11b and the peristaltic movement balloons 5a and 5b as described above, the gap between the grids acts like a sucker and the balloon can be prevented from slipping. The force of peristaltic movement of the intestine can be reliably transmitted to the catheter 1 and the time to reach the target site can be shortened. In this embodiment, both the balloons are provided with protrusions, but this may be provided only on one of them, or not necessarily on the entire outer surface. Further, the shape of the protrusion is not necessarily a lattice shape, and may be a dot shape or a line shape.
[0016]
Each of the embodiments described above is merely a preferable example. For example, the guide balloon and the peristaltic balloon may be divided into three or more instead of two, and in the case of three divisions, a three-dimensional vector synthesis is performed. Therefore, the movement of the distal end portion of the catheter body 2 becomes more complicated. Various modifications can be made during implementation, such as separately providing a balloon for closing the stomach, or providing a side hole for suctioning the stomach. Further, when it is desired to make the bending of the guide balloon stronger, it is possible to make the catheter body 2 at that portion more flexible.
[0017]
【The invention's effect】
The inventions of claims 1 to 4 are configured as described above, and when a part of the balloon divided in the circumferential direction of the second balloon is inflated, the balloon on the opposite side of the balloon is not inflated . The latter half of the inductor part is bent so that one side faces inward, and the front half of the inductor part can be bent to an angle close to a right angle with respect to the distal end of the catheter body. Even when the tip does not collide with the part where the bending is large, the second balloon can be advanced again by the operation of only the expansion of the second balloon with little burden on the patient. In addition, it is possible to expect an excellent effect that it is possible to shorten the arrival time to the target site.
[0018]
In addition, when the first balloon in the same direction as the second balloon is inflated at the same time, the tip of the invention can be bent greatly. According to the third aspect of the present invention, since the balloon can be less slid by the projection, the force of the peristaltic movement of the intestine can be reliably transmitted to the catheter, and the time to reach the target site can be further shortened. The invention of claim 4 can surely perform catheter guidance while confirming under X-rays.
[Brief description of the drawings]
FIG. 1 is an overall front view showing a first embodiment of the present invention, omitting a part of the length of a medical catheter in the length direction.
FIG. 2 is a front sectional view showing an enlarged main part of a distal end portion of the catheter main body.
3A is a side cross-sectional view taken along line AA in FIG. 2, FIG. 3B is a side cross-sectional view taken along line BB in FIG. 2, and FIG. FIG. 3D is a side sectional view taken along line C in FIG. 2; FIG. 4E is a side sectional view taken along line EE in FIG.
4 is a drawing corresponding to FIG. 1 for explaining the operation. FIG.
FIG. 5 is an overall front view showing a second embodiment, omitting a part in the length direction of a medical catheter.
6 is a drawing corresponding to FIG. 1 for explaining the operation. FIG.
FIG. 7 is a reference view in which a balloon showing how the distal end portion of the catheter body bends when the guide balloon and the peristaltic balloon are inflated is omitted.
FIG. 8 is an overall front view showing a third embodiment with a part of the medical catheter in the length direction omitted.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Medical catheter 2 Catheter main body 3 Inductor part 5 (5a, 5b) Balloon for peristaltic movement (1st balloon)
6 Cover 7 Weight 8 Closure member 11 (11a, 11b) Guide balloon (second balloon)
13 main lumen 14 suction lumen 15 guide balloon inflation lumen 16 peristaltic balloon lumen 17, 18 side hole 20 funnel part 21 connectors 22 to 25 branch pipe

Claims (4)

In the medical catheter in which the inductor portion is provided at the distal end portion of the catheter body, and the first balloon is provided in the catheter body behind the inductor portion,
The second balloon is divided into a plurality of circumferential directions so as to cover almost half of the inductor portion on the catheter body side, and independently provided so as to be inflatable. The second balloon is divided in the circumferential direction of the second balloon. When some balloons are inflated, the latter half of the inductor part is bent so that the side of the balloon that is opposite to the balloon and not inflated faces inward, and the first half of the inductor part is catheterized. A medical catheter characterized in that it can be bent to an angle close to a substantially right angle with respect to the tip of the main body. The medical catheter according to claim 1, wherein the first balloon is divided into a plurality of portions in the circumferential direction and provided independently so as to be inflatable. The medical catheter according to claim 1 or 2, wherein the second balloon and / or the first balloon has a non-slip protrusion on an outer surface. The medical catheter according to any one of claims 1 to 3, wherein the second balloon and / or the first balloon is made of a radiopaque material.

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