JP4806940B2 - Gastrostomy catheter guide - Google Patents

Description

The present invention relates to a gastrostomy catheter guide device that is fitted into a gastric fistula catheter before the gastrostomy catheter that has already been inserted is extracted, and after the gastrostomy catheter is extracted, the gastrostomy catheter is inserted along the catheter.

Conventionally, when removing a gastric fistula catheter that has already been inserted when replacing the gastrostomy catheter, the gastric fistula catheter is directly removed without using a device that holds the gastric fistula hole, and the gastrostomy catheter is guided. Without using an instrument, a newly inserted gastric fistula catheter was inserted directly into the gastric lumen through the gastric fistula. Further, there is a prior art in which a gastrostomy catheter is newly inserted by extracting a catheter that has already been inserted using an instrument provided with a guide portion. (See Patent Document 1)
Published Patent Publication No. 2002-17866

However, in the case of using a device as shown in Patent Document 1, a shift of the gastric fistula caused by an impact when removing the already inserted gastric fistula catheter, which occurs when the device is not used, or respiratory movement of the stomach Although curving of the gastric fistula due to the amount of air in the stomach and the like can be prevented, there is a fear that the distal end of the guide portion hits the intragastric holder of the gastric fistula catheter and it is difficult to insert it deeply. In addition, once the gastrostomy catheter is inserted into the gastric lumen, the gastrostomy catheter and the tip of the guide section are used when the gastrostomy catheter that has already been inserted is pulled out, even if the gastrostomy catheter guide device is inserted into the gastric fistula. There is a risk that it will be difficult to pull out the gastric fistula catheter.

Therefore, the present invention overcomes the above-mentioned problems, and further, is the original purpose, that is, gastric fistula displacement caused by impact when removing a previously inserted gastrostomy catheter, gastric respiratory movement, and intragastric The present invention provides a gastrostomy catheter guide device that prevents curving of the gastric fistula due to the amount of air, etc., and allows the gastrostomy catheter that has already been inserted to be removed and a new gastrostomy catheter inserted smoothly.
(1) In a cylindrical hollow tube, provided with one or more cut in the tip, by providing the tip extension means to said hollow tube, Ri hollow tube tip Hiroga radially,
The tip extending means is to provide an inner cylinder inside the hollow tube, to provide one or more cuts at the tip of the inner cylinder, and to provide a connecting means between the hollow tube and the inner cylinder,
The connecting means is connected at a plurality of locations of the hollow tube tip and the inner tube tip, and when the inner tube is moved within the hollow tube, the hollow tube tip and the inner tube tip are It characterized that you have to prevent a predetermined distance or more, gastrostomy catheter guide instrument.
(2) The gastric fistula according to (1) , wherein in the connecting means, connection between the distal end portion of the hollow tube and a plurality of locations of the distal end portion of the inner cylinder is made by a string-like body. Catheter guide device.
(3) The gastrostomy catheter guide device according to any one of (1) to (2) , wherein the inner tube tip is radially expanded by pushing the inner tube toward the distal end of the hollow tube. .
(4) Any one of (1) to (3) , wherein one or more convex portions or concave portions are provided on the inner surface of the hollow tube, and one or more concave portions or convex portions are provided on the outer surface of the inner cylinder. A gastrostomy catheter guide device according to any one of the above.

In the present invention, as described in the above solution, the gastrostomy catheter guide device is installed by inserting the distal end of the gastrostomy catheter guide device into the gastric lumen until it comes into contact with the gastrostomy catheter internal holding portion. Is pushed in the same direction as the distal end of the hollow tube, and is completed when the distal end of the inner cylinder expands radially. Therefore, it is not necessary to insert the distal end of the gastrostomy catheter guide device deeper than the intragastric holder, and it can be easily installed. It has the effect.
Even when the gastric fistula catheter is removed, the gastric holder will come out while abutting inside the gastrostomy catheter guide device, so that the gastric holder does not directly contact the patient's stomach and gastric fistula, but the button The type of gastric fistula catheter also has an effect that it can be performed smoothly without suffering from the patient.
Furthermore, when a gastrostomy catheter is newly inserted, it is only necessary to insert it into the lumen of the gastrostomy catheter guiding instrument, and it takes time to insert it into a place other than the gastric lumen or to insert it into the gastric lumen. Such a problem does not occur.
Also, when removing the gastrostomy catheter guide device, simply pulling the inner tube in the direction opposite to the distal end of the hollow tube returns the radially expanded inner tube tip to its original state. It can be easily removed from the lumen.

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a cross-sectional view of the gastrostomy catheter guide device 1 in a state where the inner tube tip 111 is closed. From this state, the hollow tube 12 is held with one hand, and the inner tube 11 is pushed down by a certain distance with the other hand, so that the thread 13 connecting the hollow tube tip and the inner tube tip 111 becomes the inner tube. When the tip 111 is pulled, the inner cylinder 11 is bent from the crease 112, and the inner cylinder tip 111 is radially expanded as shown in FIG. Next, a method of using the gastrostomy catheter guide device 1 during surgery will be described.
FIG. 3 is a view in which the gastric fistula catheter 2 is inserted into the gastric fistula hole 6. First, in this state, the gastrostomy catheter guide is inserted into the gastric fistula hole 6 while the gastrostomy catheter is inserted into the lumen of the gastrostomy catheter guide. At this time, it becomes easier to insert by applying a lubricant such as silicon or petrolatum to the inner surface of the gastrostomy catheter guide device 1.
FIG. 4 shows the gastrostomy catheter guide device 1 inserted into the gastric fistula hole 6. When the gastrostomy catheter guide device 1 is inserted into the stomach and the distal end of the gastrostomy catheter guide device abuts against the internal holder of the gastric fistula catheter already inserted, the gastrostomy catheter guide device 1 is hollow. The tube 12 is held with one hand, and only the inner tube 11 of the gastrostomy catheter guide device 1 is further inserted into the stomach with the other hand. Here, the distal end of the inner tube of the gastrostomy catheter guide device and the distal end of the hollow tube are connected by an adhesive with a thread 13, and there are a plurality of cuts at the inner tube tip 111 and a plurality of folds 112 near the tip of the inner tube. Since only the inner cylinder 11 is inserted into the stomach, the thread 13 pulls the inner cylinder tip 111, and the inner cylinder 11 is bent from the fold 112, so that the inner cylinder tip 111 is radially expanded. .
FIG. 5 is a view in which only the gastrostomy catheter guide device inner tube 11 is inserted into the stomach. From this state, by inserting the inner cylinder 11 further into the stomach, the distal end of the hollow tube and the inner cylinder 11 are connected by the thread 13, so that the force that minimizes the distance between the connecting portions works. The tip 111 extends perpendicular to the length direction.
FIG. 6 is a view in which the gastrostomy catheter guide device inner tube 11 is further inserted into the stomach as described above. In this state, the installation of the gastrostomy catheter guide device 1 is completed. At this time, as shown in FIG. 13, there are a convex portion 14 on the outer periphery of the inner cylinder and a concave portion 15 on the inner periphery of the hollow tube.
Thus, the distal end of the gastrostomy catheter guide device is inserted into the gastric lumen 5 until it comes into contact with the internal holder of the gastrostomy catheter 2 that has already been inserted. Since this is completed when the Naito tip 111 is pushed in and radially expands, it is not necessary to insert the tip of the gastrostomy catheter guide device into the back of the gastric holder, and it has the effect that it can be easily installed. Thereafter, the already-inserted gastric fistula catheter 2 is removed from the gastric lumen 5.
FIG. 7 is a view in which the inserted gastric fistula catheter 2 is extracted. By pulling up the gastric fistula catheter 2 upward, the gastric fistula catheter internal holding portion is deformed so as to enter the inner cylinder inner surface of the gastric fistula catheter guide device, and is taken out from the gastric lumen 5. At this time, if a lubricant such as silicon or petrolatum is applied to the inner surface of the gastrostomy catheter guide device, it is easier to take out.
FIG. 8 is a view in which the gastric fistula catheter 2 is completely extracted.
In this way, since the intragastric retainer comes out while abutting inside the gastrostomy catheter guide device, the intragastric retainer does not directly abut the patient's stomach and gastric fistula, so that the intragastric retainer is a button type gastrostomy catheter. Also, it has the effect that it can be performed smoothly without suffering from the patient.
After completely removing the gastric fistula catheter, the gastric fistula catheter 7 is newly inserted through the lumen of the gastric fistula catheter guide device.
FIG. 9 is a view in which a gastric fistula catheter 7 is newly inserted. The gastric fistula catheter 7 is pushed into the stomach through the lumen of the gastrostomy catheter guide device, and is installed in the gastric lumen 5. At this time, there is a recess in the gastrostomy catheter internal holding portion, and if the rod-shaped body is inserted into the recess, the gastrostomy catheter can be easily inserted if the internal holding portion is elongated. Further, if a lubricant such as silicon or petrolatum is applied to the inner surface of the gastrostomy catheter guide device, the insertion becomes easier.
FIG. 10 is a view in which the gastric fistula catheter 7 is installed in the gastric lumen 5.
In this way, the gastrostomy catheter 7 can be installed only by inserting it into the lumen of the gastrostomy catheter guiding instrument, and it takes time to insert it into a place other than the gastric lumen 5 or to insert it into the gastric lumen 5. Such a problem does not occur.
After the gastrostomy catheter 7 is installed in the gastric lumen 5, the hollow tube 12 is held with one hand, and the gastrostomy catheter guide instrument inner tube 11 is pulled upward with the other hand, whereby the inner tube 11 is folded. 112 is in contact with the tip of the hollow tube, and the radially inner end 111 is closed.
FIG. 11 is a view of the gastrostomy catheter guide device inner tube 11 being pulled upward. After returning the gastrostomy catheter guide device inner tube 11 to its original state, the gastrostomy catheter guide device 1 is extracted from the body. At this time, since the distal end of the gastrostomy catheter guide device does not spread radially, it can be easily removed from the body. Moreover, it becomes easier to insert by applying a lubricant such as silicon or petrolatum to the surface of the gastrostomy catheter guide device 1.
FIG. 12 is a view in which the gastrostomy catheter guide device 1 has been completely extracted.
In this way, by simply pulling the inner cylinder 11 upward, the distal end of the innermost hollow tube that has expanded radially returns to its original state, and the gastric fistula catheter guide device 1 can be easily removed from the gastric lumen 5. is there.
In this state, the replacement of the gastric fistula catheter is completed.

Cross section of gastrostomy catheter guide (a) Cross-sectional view when the gastrostomy catheter guide device is opened radially (b) Cross-sectional view when FIG. 2 (a) is viewed from the direction of the arrow Sectional view of the gastrostomy catheter inserted in the gastric fistula Sectional view of the gastrostomy catheter guide device inserted into the gastric fistula Cross section of gastrostomy catheter guide device hollow tube pulled upward Cross section of gastrostomy catheter guide device hollow tube pulled upward Sectional view extracting the inserted gastric fistula catheter Cross section of gastrostomy catheter completely extracted Sectional view of newly inserting a gastric fistula catheter Cross section with the gastrostomy catheter fully inserted Sectional view pulling up the inner tube of the gastrostomy catheter guide device Cross-sectional view of the gastrostomy catheter guide Enlarged sectional view of gastrostomy catheter guide

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Gastric fistula catheter guide device 11 Inner cylinder 111 Inner cylinder front end 112 Fold 12 Hollow tube 13 Thread 14 Convex part 15 Concave part 2 Gastric fistula catheter 3 already inserted Body surface 4 Gastric wall 5 Gastric lumen 6 Gastric fistula hole

Claims (4)

In a cylindrical hollow tube, by providing one or more cuts at the tip, by providing a tip expansion means on the hollow tube, in the gastrostomy catheter guide device in which the tip of the hollow tube expands radially ,
The tip extending means is to provide an inner cylinder inside the hollow tube, to provide one or more cuts at the tip of the inner cylinder, and to provide a connecting means between the hollow tube and the inner cylinder,
The connecting means is connected at a plurality of locations of the hollow tube tip and the inner tube tip, and when the inner tube is moved within the hollow tube, the hollow tube tip and the inner tube tip are A gastric fistula catheter guide device characterized in that it is kept away from a certain distance . The gastric fistula catheter guide device according to claim 1 , wherein in the connecting means, a connection between the distal end portion of the hollow tube and a plurality of locations of the distal end portion of the inner cylinder is made by a string-like body. The gastrostomy catheter guide device according to any one of claims 1 to 2 , wherein the inner tube tip is radially expanded by pushing the inner tube toward the distal end of the hollow tube. The gastric fistula according to any one of claims 1 to 3 , wherein one or more convex portions or concave portions are provided on the inner surface of the hollow tube, and one or more concave portions or convex portions are provided on the outer surface of the inner cylinder. Catheter guide device.

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