CN101574306B - Catheter kit for burrow - Google Patents
Catheter kit for burrow Download PDFInfo
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- CN101574306B CN101574306B CN 200910141399 CN200910141399A CN101574306B CN 101574306 B CN101574306 B CN 101574306B CN 200910141399 CN200910141399 CN 200910141399 CN 200910141399 A CN200910141399 A CN 200910141399A CN 101574306 B CN101574306 B CN 101574306B
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- obturator
- burrow
- flexible pipe
- conduit
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- 235000016709 nutrition Nutrition 0.000 claims abstract description 30
- 230000035764 nutrition Effects 0.000 claims abstract description 19
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- 230000000694 effects Effects 0.000 claims description 38
- 206010016717 Fistula Diseases 0.000 claims description 28
- 230000003890 fistula Effects 0.000 claims description 28
- 239000000284 extract Substances 0.000 claims description 16
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- 210000002784 stomach Anatomy 0.000 abstract description 35
- 235000015097 nutrients Nutrition 0.000 abstract description 4
- 239000000126 substance Substances 0.000 abstract description 3
- 210000003811 finger Anatomy 0.000 description 16
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- 238000001727 in vivo Methods 0.000 description 5
- 206010065713 Gastric Fistula Diseases 0.000 description 4
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- Medical Preparation Storing Or Oral Administration Devices (AREA)
Abstract
A catheter kit for a burrow having a catheter and an obturator and excellent in operability. The catheter comprises a tube having, inside, a nutrient passage leading nutrition or chemicals from the outside of a body to the inside of a stomach and extending along the wall surface of the burrow and a non-balloon type endodwelling member fitted to the tip part of the tube, normally placed in an expanded state and reduced in diameter less than that in the expanded state when an external force acts thereon by the obturator, and indwelled in the stomach in a buried state in a living body. The obturator comprises a guide wire passage detachably engaged with the catheter and allowing a guide wire installed in the obturator ranging from the tip to the midway thereof to be inserted therein and an operation part for transmitting the external force to the endodwelling member fitted to the rear end thereof. The rear end part of the guide wire passage and the operation part are arranged in a separated state.
Description
The application is that international filing date is on April 26th, 2004; International application no is dividing an application of the international application of the PCT/JP2004/005976 application for a patent for invention that gets into the China national stage; The applying date of the application for a patent for invention in this entering China national stage is on April 26th, 2004; Application number is 200480011112.1, and denomination of invention is " catheter kit for burrow ".
Technical field
The present invention relates to the superior catheter kit for burrow of a kind of operability, being used for supply nutrient or medicament is the percutaneous endoscopic stomach fistulation that purpose is carried out.
Background technology
As medication to the patient that can not administered through oral absorbs nourishment, the general three kinds of medications that transvenous nutrition administration arranged, insert the nutrition flexible pipe stomach tube nutrition administration that stomach or intestinal carry out and get into through nose through the nutrition administration of intestinal from gastric fistula.In recent years, owing to, carry out more and more frequently through the enteral alimentation management of percutaneous endoscopic stomach fistulation (PEG:PercutaneousEndoscopic Gastrostomy) through the nutrient of intestinal and the prosperity of its medication.PEG compares with the abdomen stomach fistulation of opening of surgery, so because with minor operation make the wound of establishing due to the fistula hole little, can reduce medical expense significantly, so become the standard art formula of stomach fistulation the America and Europe.Catheter kit for burrow is the apparatus that is used for implementing this PEG, specifically, is to be used for from external apparatus to supply nutrition of gastric percutaneous or medicinal liquid.
The motion of various catheter kit for burrow is arranged all the time.General, catheter kit for burrow is made up of conduit and intracorporeal indwelling portion; This conduit has and is used for from external chamber to gastric supply nutrition or medicinal liquid; This intracorporeal indwelling portion at the state of burying underground of the leading section that is attached to this conduit, is positioned at body and prevents that conduit from extracting from gastric.In addition also as required, for its flexible pipe does not bury at gastric, has the external fixed part of flat in the rear end of this flexible pipe.
In the past, this intracorporeal indwelling portion, the sacculus by shell forms usually, with through supplying with to this sacculus, discharging fluid, selects the expansion of intracorporeal indwelling portion and the mode of contraction to constitute.,, can not keep the state of burying underground that conduit is inserted into gastric, extract probability and have from gastric if intracorporeal indwelling portion balloon type will cause predetermined outer distortion owing to its equivalent damage that breaks.
4,863, No. 438 communiques of United States Patent (USP) at patent documentation 1 disclose and have solved these inconvenient catheter kit for burrow.This catheter kit for burrow possesses the intracorporeal indwelling portion of non-balloon type; The intracorporeal indwelling portion of this non-balloon type; Because of external force generation strain, under free state, be from conduit to its outstanding state in radial direction outside, under the state of power effect outside; Make intracorporeal indwelling portion and the conduit projected area of projection gained coaxially, reduce than outstanding state.
According to this catheter kit for burrow, during from external insertion gastric, bar-shaped obturator in the inboard or the outside of this conduit, is inserted into the leading section of this conduit, pushes obturator again, stretches thereby intracorporeal indwelling portion is flexibly pushed away conduit.Insert gastric to conduit and obturator together at this state.After the insertion, only extract obturator from conduit, intracorporeal indwelling portion returns to outstanding state thus.Like this, because intracorporeal indwelling portion is non-balloon type, conduit is buried underground after the gastric, and is different with the situation of balloon type, the less likely of predetermined outer distortion, thus prevent that conduit from extracting from gastric.
, this catheter kit for burrow is located at the situation that gastric is inserted in patient fistula hole on one's body to conduit from external via making though disclose, and does not show the method that it is concrete.Make when establishing the fistula hole, on patient's stomach wall and coat of the stomach, make perforation, insert this perforation to conduit etc. with pin etc.When inserting like this,, so that coat of the stomach at will do not move relative to stomach wall, to be completely fixed in the reality and be difficult to, and can not suitably carry out making of gastric fistula and establish, also cause acute peritonitis easily though fix through stitching thread etc.
Specially permit communique No. 3347315 at the JP of patent documentation 2; Disclose and solved the gastric fistula of making the problem when establishing in this fistula hole with conduit apparatus 500: like Figure 21 and shown in Figure 22; Conduit 100 is extracted possibly with the intracorporeal indwelling portion 102 that is attached to the below of flexible pipe 101 and is cooperated; Transmit from external external force to intracorporeal indwelling portion 102 in this mated condition; And make by having inner hollow stick 200 of inserting the excellent inner gateway 202 that has led to seal wire 400, under mated condition, indwelling portion 102 has and makes excellent inner gateway 202 get in touch with the spatial contact path 105 of gastric in vivo.Hollow stick 200 has the function as obturator with slotting admittance silk 400.
Specifically, if because the central shaft of the perforation 303 of coat of the stomach 302, stomach wall 301 does not line up insertion conduit 100 that just can not be suitable; Institute is so that seal wire 400 is inserted logical perforation 303; Form a line the perforation 303 of stomach wall 301 and coat of the stomach 302 along seal wire 400, make the insertion route of conduit 100 more suitable thus, here; Seal wire 400 is passed in hollow stick 200 and is pushed away the excellent inner gateway 202 and contact path 105 in the assembly of the intracorporeal indwelling portion 102 of stretching, and inserts conduit 100 from external to gastric.
; Specially permit in the conduit apparatus of No. 3347315 communique record at JP; The intracorporeal indwelling portion 102 that makes conduit 100 is during from the free state strain to the external force active state, because seal wire path 202 passes in the operating portion 201 of hollow stick 200, during the operating portion 201 of the hollow stick that press...withes one's finger down 200; Seal wire 400 just becomes barrier, can make the operating personnel avoid seal wire 400 (Figure 22) consciously.In addition, become barrier, also considered to make the shape that expansion extends out outside the radial direction of hollow stick 200 to operating portion 201 in order not make seal wire 400., at this moment, because the direction of operating portion 201 of the hollow stick 200 that press...withes one's finger down, depart from the central shaft of hollow stick 200, have can not be efficiently from the problem of the intracorporeal indwelling portion 102 transmission power of hollow stick 200 conductive pipe 100.
On the one hand, because the used conduit of existing catheter kit for burrow all made by elastomeric material, if the external force effect is arranged, not only intracorporeal indwelling portion there is no need to push away the flexible pipe of stretching and also can be stretched by insignificant pushing away in obturator or hollow stick.Promptly shown in figure 22, the length l of the free state of flexible pipe 101
1The state of power effect has outside become length l
2(＞l
1).At this moment,, but also have the operation that strengthens external force, then become difficult all the more to intravital insertion operation because external force does not concentrate on intracorporeal indwelling portion.In addition; Existing catheter kit for burrow has such problem: stretch if will intracorporeal indwelling portion pushed away through obturator or hollow stick; The front end that intracorporeal indwelling portion will destroyed and penetrate to obturator or hollow stick in its contact portion then can not insert intracorporeal indwelling portion in the body.And; Existing catheter kit for burrow has such problem: the pushing away of the intracorporeal indwelling portion 102 of conduit 100 stretched operation and must be carried out simultaneously to the operation that gastric inserts conduit 100; Compare with the method for carrying out individual operation in order, operational capacity and operating technology must be arranged.
Patent documentation 1: United States Patent (USP) 4,863, No. 438 communiques.
Patent documentation 2:JP speciallys permit No. 3347315 description (claim 1～3, Fig. 5～Fig. 7).
Thus, the purpose of this invention is to provide a kind of catheter kit for burrow, improve the operability when insert in the fistula hole of employed conduit apparatus in percutaneous endoscopic stomach fistulation.
Summary of the invention
That is, the present invention provides a kind of catheter kit for burrow, and it possesses the patient from external to the supply nutrition of gastric percutaneous or the conduit and the obturator of medicinal liquid; This conduit has flexible pipe, intracorporeal indwelling portion, external fixed part and contact hole; It extends this flexible pipe along having in inside from the external wall that imports the nutritional channel fistula hole of nutrition or medicinal liquid to gastric, this intracorporeal indwelling portion, and it is attached to the leading section of this flexible pipe; The standing shape that has been to the hole enlargement of the footpath of this flexible pipe direction outside; Be under the external force effect that causes by obturator in outstanding state undergauge, bury state underground at health, kept somewhere in the intracorporeal indwelling portion of the non-balloon type of gastric; This external fixed part, it is attached to this flexible pipe rear end, is being standing shape to the footpath of aforementioned flexible pipe direction; This gets in touch with the hole; Be used for getting in touch with from external the seal wire path of the aforementioned obturator of the leading section that is attached to aforementioned intracorporeal indwelling portion to gastric; This obturator is, till touching with aforementioned intracorporeal indwelling portion, extract the obturator that is engaged in aforementioned conduit possibly, it has; Seal wire path and operating portion, this seal wire path are used for inserting logical seal wire from setting up till its front end partways; This operating portion is used for transmitting external force to this intracorporeal indwelling portion that is attached to its rear end, and the rearward end and the operating portion of this seal wire path dispose with released state.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, and aforementioned obturator is an obturator of extracting the flexible pipe that is engaged in aforementioned conduit possibly, has the external diameter slightly littler than the internal diameter of aforementioned flexible pipe.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, from the seal wire path that the front end of aforementioned obturator partways and set up, is hollow bulb or slot part.
In addition; The present invention provides a kind of aforementioned catheter kit for burrow; Also possesses seal wire; This seal wire is when inserting logical the use from aforementioned contact hole and aforementioned seal wire path, and guiding is being inserted logical state the assembly of aforementioned intracorporeal indwelling portion, aforementioned flexible pipe and aforementioned obturator, via this fistula hole from external seal wire to the gastric insertion.
In addition; The present invention provides a kind of aforementioned catheter kit for burrow; Aforementioned intracorporeal indwelling portion constitutes basket with the arm more than 2, aforementioned intracorporeal indwelling portion's front and aforementioned intracorporeal indwelling portion rear end side, or the arm of a certain side between seam portion inboard, possess recess.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, hole enlargement length (diameter) flat pattern also longer than the axial length of aforementioned flexible pipe under the free state of aforementioned intracorporeal indwelling portion.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, also is provided with the overshooting shape thing at the front end of aforementioned intracorporeal indwelling portion.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, also possesses at the leading section of aforementioned flexible pipe to prevent from gastric via nutritional channel to the external check valve that backflows.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, and the part of the preceding end in contact of the aforementioned obturator of aforementioned intracorporeal indwelling portion is reinforced with strenthening member.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, and aforementioned strenthening member is metal net.
In addition; The present invention provides a kind of aforementioned catheter kit for burrow, also possesses the urceolus of extracting the flexible pipe that is engaged in aforementioned conduit possibly, and it has restrictions and obturator path; This restrictions, restriction has the distortion of the flexible pipe of the external diameter slightly littler than the internal diameter of aforementioned flexible pipe; This obturator path, sliding has cooperated obturator possibly.
In addition; The present invention provides a kind of aforementioned catheter kit for burrow; Also possess latch-up structure, it is made up of the jut that is located at aforementioned obturator and 2 lock holes being located at aforementioned urceolus, chimeric through this jut and this lock hole; For the front position of aforementioned urceolus, determine the front position of aforementioned obturator in any 2 positions.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, at the base end part of aforementioned urceolus, also possesses retainer, and it is when making aforementioned intracorporeal indwelling portion undergauge owing to the external force effect, and restriction is moved relative to the aforementioned conduit of aforementioned urceolus.
In addition, the present invention provides a kind of aforementioned catheter kit for burrow, and the base end part of the urceolus above aforementioned retainer also possesses the finger hook that is to the standing shape in the axial outside of this urceolus.
According to the present invention, the rearward end and the operating portion of the seal wire path in the obturator dispose with released state, and during the operating portion of the obturator that press...withes one's finger down, seal wire can not become barrier, so the operating personnel there is no need to take notice of seal wire.In addition, as long as the center of the operating portion of the obturator that press...withes one's finger down (axle center) will be delivered to power the intracorporeal indwelling portion of conduit efficiently.
In addition, according to the present invention, except that play with the same effect of aforementioned invention, can push away not meaninglessly and stretch flexible pipe, make the force localization that causes by obturator to intracorporeal indwelling portion.Therefore, the insertion operation to intravital conduit becomes easy.
In addition, according to the present invention, except that play with the same effect of aforementioned invention, can insert seal wire reliably and lead to obturator.When particularly the seal wire path is slot part, make obturator in the time of can being hollow bulb than seal wire path more at an easy rate.
In addition, according to the present invention, except that play with the same effect of aforementioned invention, through the guiding of seal wire, can be the assembly of conduit and obturator, via this fistula hole from the external gastric that inserts reliably.
In addition; According to the present invention, except that play with the same effect of aforementioned invention, conduit when gastric inserts; The in the past little power of the enough ratios of ability; Make the resulting projected area ratio of projection free state minimizing coaxially, can alleviate patient's burden, be expected to improve the operability of operator and shorten the activity duration with intracorporeal indwelling portion.
In addition, according to the present invention, except that play with the same effect of aforementioned invention, can make the fistula hole be stabilized in patient's abdominal part with conduit.
In addition, according to the present invention, except that play with the same effect of aforementioned invention, when inserting the fistula hole to conduit, be easy for the location in the fistula hole of intracorporeal indwelling portion, and can improve the operability of operator.
In addition, according to the present invention, except that play with the same effect of aforementioned invention, can to the patient from external in the supply nutrition or medicinal liquid of gastric percutaneous, do not have liquid substance to backflow to external from gastric.
In addition; According to the present invention, except that play with the same effect of aforementioned invention, even apply the external force effect to intracorporeal indwelling portion by obturator; Obturator yet can not destroy and penetrate the front end of intracorporeal indwelling portion, can insert intracorporeal indwelling portion in the body easily and reliably at the undergauge state.
In addition, according to the present invention, except that play with the same effect of aforementioned invention, intracorporeal indwelling portion that can locking catheters to push away the state of stretching constant, insert conduit to gastric, thereby operation becomes easy all the more.
Description of drawings
Fig. 1 is conduit and the skeleton diagram of obturator that constitutes the catheter kit for burrow of this routine free state.
Fig. 2 is the axonometric chart of the conduit of Fig. 1.
Fig. 3 is the profilograph of the conduit of Fig. 1.
Fig. 4 (A) is the amplification end view drawing of seeing along the A-A line of Fig. 1, and Fig. 4 (B) is the amplification end view drawing of seeing along the B-B line of Fig. 1, and Fig. 4 (C) is the amplification end view drawing of seeing along the C-C line of Fig. 1.
Fig. 5 is the skeleton diagram at the catheter kit for burrow of this routine external force active state.
Fig. 6 is the enlarged drawing of fore-end of the conduit of Fig. 1.
Fig. 7 is the key diagram of an example of expression check valve.
Fig. 8 (A) is that Fig. 8 (B) is the right side view of Fig. 8 (A) at the front view of the obturator of the conduit apparatus use of second embodiment example.
Fig. 9 (A) is the figure that sees along the D-D line of Fig. 6, and Fig. 9 (B) is the figure that sees along the E-E line of Fig. 8.
Figure 10 (A) is that Figure 10 (B) is the right side view of Figure 10 (A) at the front view of the urceolus of this routine conduit apparatus use.
Figure 11 (A) is the figure that sees along the F-F line of Figure 10, and Figure 11 (B) is the figure that sees along the G-G line of Figure 10.
Figure 12 is the skeleton diagram at the assembly of the free state of this routine conduit apparatus.
Figure 13 is the profilograph of Figure 12.
Figure 14 is the skeleton diagram of the assembly under the external force active state of this routine conduit apparatus.
Figure 15 is that the flexible pipe of this routine conduit apparatus of explanation is out of shape inhibiting figure.
Figure 16 is the figure of the flexible pipe distortion of the existing conduit apparatus of explanation.
Figure 17 is the axonometric chart at the urceolus of the conduit apparatus use of the 3rd embodiment example.
Figure 18 (A) is the front view of the urceolus of Figure 17, and Figure 18 (B) is the left side view of Figure 18 (A).
Figure 19 is the profilograph of the assembly under the free state of this routine conduit apparatus.
Figure 20 is the profilograph of the assembly under the external force active state of this routine conduit apparatus.
Figure 21 is the skeleton diagram under the free state of existing conduit apparatus.
Figure 22 is the skeleton diagram of the assembly under the external force active state of existing conduit apparatus.
The specific embodiment
Below, with reference to Fig. 1～Fig. 7 the catheter kit for burrow in first embodiment of the present invention is described.Fig. 1 constitutes the conduit of the catheter kit for burrow under this routine free state and the skeleton diagram of obturator.Fig. 2 is the axonometric chart of the conduit of Fig. 1.Fig. 3 is the profilograph of the conduit of Fig. 1.Fig. 4 (A) is the amplification end view drawing of seeing along the A-A line of Fig. 1, and Fig. 4 (B) is the amplification end view drawing of seeing along the B-B line of Fig. 1, and Fig. 4 (C) is the amplification end view drawing of seeing along the C-C line of Fig. 1.Fig. 5 is the skeleton diagram of the catheter kit for burrow under this routine external force active state.Fig. 6 is the enlarged drawing of fore-end of the conduit of Fig. 1.Fig. 7 is the key diagram of an example of expression check valve.In addition, in this description, call " front end " to the body inboard, call " rear end " to external side.
Catheter kit for burrow 50 in first embodiment is made up of conduit 10 and obturator 20, is from external apparatus to gastric supply nutrition percutaneously or medicinal liquid to the patient.
Intracorporeal indwelling portion 12 is embedded in intravital state at conduit 10 and is located at the part that is positioned at patient's gastric, and conduit 10 is not pulled out from the patient on one's body.It is intracorporeal indwelling portion 12; Material by elastically deformable is made; Be standing shape in free state to the hole enlargement of the footpath of the flexible pipe 11 direction outside, under the external force effect that causes by obturator 20 in outstanding state undergauge, under health is buried state underground, be retained in gastric (Fig. 5).
Intracorporeal indwelling portion 12 under free state, is the shape that performance prevents to extract the function of conduit 10; Under the state of power effect outside, so long as it is just passable to insert the shape in fistula hole 33 easily, not special restriction; For example; As shown in Figure 6ly made basketly by the arm more than two 124, also the seam (thigh portion) between the arm of indwelling portion front end and intracorporeal indwelling portion rear end side part is inboard in vivo, possesses recess 121,122.In addition, recess 121,122 can only be located at any side.Owing to set up recess 121,122, the external force active state of indwelling portion 12 can dwindle the expansion of seam portion between the arm 124 in vivo, reduces to follow to the fistula hole and inserts, extracts the burden that the operation of conduit 10 brings to the patient, improves the operability of operator.
In addition; The creep R processing of the corners (rib) 127 in the outside of the arm 124 of intracorporeal indwelling portion 12; Such advantage is arranged: can make the shape of the intracorporeal indwelling portion 12 under the state of power effect outside and flexible pipe 11 become same shape, that is, and near the rectilinear form that does not have expansion.Because common R processing is partly to carry out R processing to whole corner angle with identical size; Make the thickness of arm all identical; Relative therewith; The R that creeps processing is only to get bigger R to the corners of the part 126 of the state of power effect outside expansion, thereby makes the thickness attenuation of this part, is the uneven thickness one that makes arm whole.
In addition, intracorporeal indwelling portion 12, preferably the diameter a to the outside hole enlargement of the footpath of flexible pipe 11 direction compares at the also big flat pattern of the axial length b of aforementioned flexible pipe.Thus, can reduce stimulation at the state of catheter retaining in patient's gastric portion to patient's stomach bottom.
The leading section of indwelling portion 12 in vivo also has the contact site 18 of external force effect.Contact site 18 is with when the front end 24 of obturator 20 contacts, and is pushed into the inboard part of body.In addition, at this contact site 18, set up the contact hole 15 of the contact function of and gastric external with the seal wire path 22 common performances of obturator 20.Thus,, just can pass through the guiding of seal wire 40 as long as the seal wire of stating after making 40 passes contact hole 15 and seal wire path 22, via the fistula hole from the external assembly that inserts flexible pipe 11 and obturator 20 to gastric reliably.
This contact site 18; Reinforce with strenthening member 19; Even make external force affact intracorporeal indwelling portion 12 by obturator 20, obturator 20 yet can not destroy and penetrate the front end of intracorporeal indwelling portion 12, has to insert intravital advantage to intracorporeal indwelling portion 12 easily and reliably at the undergauge state.Strenthening member 19; Though only otherwise the contact function by the seal wire path of contact hole 15 that is attached to intracorporeal indwelling portion 12 and the obturator 20 22 common external and gastric that produce is produced obstacle; Just do not limit its shape or material etc. especially; But preferably use the material of for example making, the net of special preferable alloy system by materials such as metal or thermosetting resins.Thus, contact site 18 is buried the state in the resin underground becoming strenthening member 19, and the net of enlarged metal system and elastic deformation material's contact area can improve intensity.
External fixed part 14 is to bury state underground at conduit, does not bury the part that is provided with in the external position of patient in the body for making conduit 10.The shape of external fixed part 14 is the standing shapes in the footpath direction of the flexible pipe 11 that is attached to flexible pipe 11 rear ends, for example is attached to the parameatal flat thing of the rear end of nutritional channel 13.External fixed part 14 is in conduit 10, and the unique visible part of patient is therefore if the flat thing has the advantage that volume expanded is few, life that can not give the patient brings obstacle.In addition, be entrenched in the bolt 17 of opening of the rear end of nutritional channel 13, be installed in the external fixed part 14 of this example through connecting elements 171.Bolt 17 is buried state underground at conduit, not from external during to supply nutrition of gastric percutaneous or medicinal liquid, is entrenched in the opening of nutritional channel 13, the sealing that can keep gastric through making bolt 17.
In addition, conduit 10 possesses the leading section that is attached to flexible pipe 11, i.e. the check valve 16 of the outlet of nutritional channel 13, have can to the patient from external in supply nutrition of gastric percutaneous or medicinal liquid, prevent liquid substance from gastric to external advantage of backflowing.Check valve 16; Can use known valve; The a pair of valve member 16a, the 16b that are for example extended out by the front end from flexible pipe as shown in Figure 7 11 constitute since in common body intrinsic pressure just like shown in the arrow, close a pair of valve member 16a, 16b and form sealing state; At the supply state of nutrition etc., open a pair of valve member 16a, 16b etc.
In addition, the outside wall surface of the front end of indwelling portion 12 has been set up overshooting shape thing 191 in vivo.This overshooting shape thing 191 is the semicircular section shape, and the diameter of its maximum gauge and flexible pipe 11 is roughly the same.Thus, when conduit 10 inserted to the fistula hole, the operability of operator can improve with respect to the position relation in fistula hole in easy visual intracorporeal indwelling portion 12.Also have, the not special restriction of the size of overshooting shape thing, its maximum gauge is little also more passable than the diameter of flexible pipe 11.
Form intracorporeal indwelling portion 12, flexible pipe 11, external fixed part 14, check valve 16 and the strenthening member 19 of conduit 10, make through compression forming usually, preferably make with monolithic molding.
Obturator 20; Be to extract the flexible pipe 11 that is engaged in conduit possibly; Obturator with external diameter slightly littler than the internal diameter of flexible pipe 11 makes flexible pipe not do insignificant pushing away and stretches, and having can be the advantage of the force localization that is produced by obturator to intracorporeal indwelling portion.In addition; Obturator 20 to till intracorporeal indwelling portion 12 contacts, is extracted and is engaged in conduit 10 possibly; Have seal wire path 22 and operating portion 21; Seal wire path 22 is used for inserting the seal wire of setting up till logical front end from bar-shaped 25 partways 40, and operating portion 21 is used for transmitting external force to the intracorporeal indwelling portion that is attached to bar-shaped 25 rear end 12, and the rearward end 23 of seal wire path 22 and operating portion 21 dispose with released state.Obturator 20 is made through injection molding forming usually.Because the rearward end of seal wire path 22 23 and operating portion 21 dispose with released state, during the operating portion 21 of the obturator 20 that press...withes one's finger down, seal wire 40 can not become obstacle.In addition, the center (axle center) of the operating portion 21 of the obturator 20 that can press...with one's finger down is delivered to power the intracorporeal indwelling portion 12 of conduit 10 efficiently.
As seal wire path 22, though not special restriction is the hollow bulb with circular section of the internal diameter bigger than the diameter of seal wire in this example.Seal wire path 22 forms part, that is, from the minimum length that bar-shaped 25 front end partways, though not special restriction, it is also bigger than the greatest length of the conduit of the state of power effect outside, and the advantages such as insertion of easy operation seal wire 40 are arranged.In addition, seal wire path 22, the end is connected to bar-shaped 25 openning 26 thereafter, with external communications.Thus; When seal wire 40 slotting contact hole 15, seal wire path 22 and the opennings 26 that lead at conduit 11 use; Can also guide at it and insert logical state the assembly of intracorporeal indwelling portion 12, flexible pipe 11 and obturator 20, via the operation of fistula hole 33 from external insertion gastric.
Then, the method for using to the routine catheter kit for burrow of first embodiment describes.The method for using of the catheter kit for burrow that this is routine is, the gastric of operation, conduit apparatus inserted to make and establishes operation before the gastric that carries out preceding disposal operation, the conduit apparatus of patient's side in order inserted.The preceding disposal operation of patient's side is to the coat of the stomach of accomplishing immobilized patients and the operation till the stomach wall.Promptly at first fully supply gas the insertion patient's of endoscope gastric, stomach wall 31 and coat of the stomach 32 are adjacent to.Next, by the position of coming from endoscope that light is confirmed stomach that sees through, carry out skin of abdomen sterilization, local anesthesia.Next, at this position, carry out the relative position skew that the coat of the stomach stomach wall fixedly prevents stomach wall 31 and coat of the stomach 32.Near this coat of the stomach stomach wall is fixed, implement small incision surgery with scalpel.This position becomes the insertion predetermined position of conduit 10.
Gastric at the conduit apparatus inserts in the operation, at first passes stomach wall 31, coat of the stomach 32 to hollow needle or band sheath pin in order at little cutting part, forms patchhole.At the inner chamber of patchhole, be inserted into gastric to seal wire 40 via hollow needle or sheath.After insertion finishes, stay the there to seal wire 40, extract hollow needle or band sheath pin on one's body from the patient.Before conduit 10 inserts gastric,, sufficiently long seal wire 40 is inserted gastric for seal wire 40 in the operation afterwards can not extracted without reason.
Below, expand the operation of the diameter of patchhole 33.For example, insert patchhole 33 to dilator along seal wire 40.After dilation procedure finishes, extract dilator seal wire 40 on one's body from the patient above staying.Next, obturator 20 is inserted from the open rearward end of flexible pipe 11.For being exposed to external seal wire 40 from patchhole 33, pass through in order according to the contact hole 15 of intracorporeal indwelling portion 12, the seal wire path 22 of obturator 20 and the order of openning 26, make conduit 10 insert logical respectively to the gastric direction.At this moment, the front end 24 of obturator 20 is in the free state that contacts with the contact site 18 of intracorporeal indwelling portion 12, and intracorporeal indwelling portion 12 is in the outstanding state to the outside hole enlargement of the footpath of flexible pipe 11 direction.
Next, through the operating portion 21 that further pushes obturator 20, intracorporeal indwelling portion 12 under the external force effect that causes by obturator 20 in outstanding state undergauge, be deformed to external force active state (Fig. 5).Under this state, the seal wire path 22 of inserting admittance silk 40 employed obturators 20 is to insert logical state with the contact hole 15 that is attached to contact site 18.Like this, the operation of the operating portion 21 of the obturator 20 that press...withes one's finger down is because the opening 26 of the rearward end of seal wire 40 is released states with operating portion 21, so can forget it seal wire 40 and the central part (axle center) of push operation portion 21.Also have,, be not limited to above-mentioned period, also can after being changed to the external force active state to intracorporeal indwelling portion 12, carry out as in the period of seal wire 40 to contact hole 15, seal wire path 22 and openning 26 insertions of intracorporeal indwelling portion 12.
Next, the gastric that carries out the conduit apparatus inserts to make establishes operation.Gastric inserts makes that to establish operation be containing from the conduit 10 of the intracorporeal indwelling portion 12 of outstanding state generation strain undergauge and the assembly of obturator 20, inserting the operation of gastric along seal wire 40.Insert gastric to intracorporeal indwelling portion 12 by the guiding of seal wire 40, when the external fixed part 14 in the rear end of flexible pipe 11 contacts with patient's stomach wall 31, stop insertion.In the gastric of conduit apparatus inserts, from obturator 20, take out the operation of seal wire 40, owing to separate, just can insert so not be used in the seal wire 40 of unexpected portion with operating portion 21.Next, weaken the operating physical force on the operating portion 21 that is added in obturator 20, make the intracorporeal indwelling portion 12 that is in the external force active state return to free state.Thus, also recovered the function that prevents that conduit 10 from extracting from the patient on one's body.
Insert to gastric with such method and to make the conduit of establishing 10, not to the patient from external during, owing to be entrenched in the opening of the rear end of flexible pipe 11, the sealing that can keep gastric to the bolt 17 that is attached to external fixed part 14 to supply nutrition of gastric percutaneous or medicinal liquid.In addition, in that the patient during to supply nutrition of gastric percutaneous or medicinal liquid, is opened the chimeric of bolt 17 and nutritional channel 13 from external, can carry out the disposal of nutrient.
According to the catheter kit for burrow in the first embodiment example; Because the rearward end and the operating portion of the seal wire path in obturator dispose with released state; During the operating portion of obturator, seal wire can not become barrier, so the operating personnel there is no need to take notice of seal wire so press...with one's finger.In addition, as long as the center of the operating portion of the obturator that press...withes one's finger will be delivered to power the intracorporeal indwelling portion of conduit efficiently.In addition, because the guiding of seal wire, can be via the fistula hole from the external assembly that inserts conduit and obturator to gastric reliably.
Below, the catheter kit for burrow of second embodiment is described with reference to Fig. 8～Figure 15.Fig. 8 (A) is that Fig. 8 (B) is the right side view of Fig. 8 (A) at the front view of the obturator of this routine conduit apparatus use.Fig. 9 (A) is the figure that sees along the D-D line of Fig. 8, and Fig. 9 (B) is the figure that sees along the E-E line of Fig. 8.Figure 10 (A) is that Figure 10 (B) is the right side view of Figure 10 (A) at the front view of the urceolus of this routine conduit apparatus use.Figure 11 (A) is the figure that sees along the F-F line of Figure 10, and Figure 11 (B) is the figure that sees along the G-G line of Figure 10.Figure 12 is the skeleton diagram of the assembly under the free state of this routine conduit apparatus.Figure 13 is the amplification profilograph of Figure 12.Figure 14 is the enlarged outline map of the assembly under the external force active state of this routine conduit apparatus.Figure 15 is the figure of the flexible pipe limit deformation effect of this routine conduit apparatus of explanation.Figure 16 is the figure of the flexible pipe distortion of the existing conduit apparatus of explanation.
Like the catheter kit for burrow in second embodiment of Fig. 8～shown in Figure 15, omit the explanation that is attached to the prosign on the same element with Fig. 1～Fig. 7, mainly describe with regard to difference.Promptly; In the conduit apparatus in second embodiment, with the difference of the conduit apparatus of first embodiment example be: make the seal wire path of obturator slot part, as new member of formation the urceolus of obturator be set, set up locking mechanism at obturator and urceolus.
The seal wire path of the obturator 20a that uses at this routine conduit apparatus is slot part 22a.This obturator 20a, in the time of on being engaged in conduit, because the urceolus of stating after using 60, and between the inwall of slot part 22a and urceolus 60, form hollow bulb.Therefore, can not hinder the logical or guiding of inserting of seal wire 40.In addition, possess the obturator 20a of slot part 22a, compare, can lower the manufacturing cost of injection molding forming with the obturator 20 that possesses hollow bulb at circular cross section.
In addition, obturator 20a has above slot part 22a the jut 29 that constitutes locking mechanism from operating portion 21 downwards.Jut 29, relative to seal wire path 22a to the position that circumferencial direction moves 90 degree, be formed on from the front end of the thin plate 28 of locking main body 25 bifurcateds, apply elasticity laterally and suppress.Jut 29, be attached to after 2 lock hole 62a, 62b of the urceolus 60 stated match, the front position of urceolus is confirmed the front position of obturator in any 2 positions relatively.In addition, the position of jut 29 is not limited to relative to seal wire path 22a and moves on the position of 90 degree to circumferencial direction, can be the optional position.
That is, restrictions 64 is the outer peripheral face shape of the front of urceolus 60, is when making external force affact intracorporeal indwelling portion 12, is used to limit the deformable members to the longitudinal direction of flexible pipe 11.In existing conduit apparatus shown in Figure 16, between flexible pipe 11 and obturator 20a, there is gap 112.Therefore if push away the contact site 18 of stretching intracorporeal indwelling portion 12 with obturator 20a, will as Figure 16 with that kind shown in the double dot dash line, intracorporeal indwelling portion 12 not only, flexible pipe 11 also is elongated at undergauge simultaneously, all extended length of its result are l
3+ l
4+ l
5To this, the conduit apparatus 50a that this is routine is owing to urceolus 60 cylindraceous almost seamlessly is entrenched on the flexible pipe 11, so even receive the external force effect, urceolus also can limit the undergauge of flexible pipe 11.Therefore, active force is almost inoperative to flexible pipe 11, and only concentrates on intracorporeal indwelling portion 12, thereby restriction is to the distortion of the longitudinal direction of flexible pipe 11.Ensemble length is l in Figure 15
3+ l
5Like this; The shape of restrictions 64 is not limited to seamlessly to act on the shape of whole inner peripheral surfaces of flexible pipe 11; One of which is partly contacted, for example roughly be I word section, roughly be T word section, roughly be anti-T word section, roughly be cruciform cross-section, rectangular section etc. roughly.
Under 2 lock hole 62a, 62b and the situation that the jut 29 of obturator 20a cooperates, the front position 111 of urceolus 60 is confirmed the front position of obturator 20a in any 2 positions relatively.That is,, the jut 29 of obturator 20a is cooperated with the lock hole 62a of urceolus 60 tops in free state shown in Figure 13.Thus, relatively in the front position 111 of the urceolus 60 of the link position of flexible pipe 11 and intracorporeal indwelling portion 12, the front position of obturator 20a is in the contact site 18 of the intracorporeal indwelling portion 12 under the free state.On the other hand, at external force active state shown in Figure 14, the jut 29 of obturator 20a is combined together with the lock hole 62b of the below of urceolus 60.Thus, the front position of obturator 20a is separated with the front position 111 of urceolus 60, pushes away the contact site 18 of stretching intracorporeal indwelling portion 12.This lock function is because conduit 10 is to be made by material that can strain, so can be easy to switch latched position through the counteracting force of intracorporeal indwelling portion 12.According to above-mentioned lock function; Can maintain free state and external force active state to intracorporeal indwelling portion 12 respectively; Therefore also can carry out obturator 20a simultaneously and push away the operation of stretching intracorporeal indwelling portion 12 and insert intravital operation to conduit 10 and just can accomplish, thus the raising working performance.In addition, lock function is the jut 29 of the flat spring of the obturator 20a as Figure 12～Figure 14 not also, but makes with the jut of spring and spring tabling.Also have, lock function because jut 29 is along the circumferential direction mobile between 2 lock hole 62a, 62b, and is reached the effect of only sliding at longitudinal direction, so can not have influence on the guidance system of cross-drilled hole 63 or seal wire 40.
The method for using of the catheter kit for burrow of second embodiment example; Be to make the method for establishing to the gastric fistula that aforementioned catheter kit for burrow is used for health; Carry out following operation in order: the seal wire of inserting the logical fistula hole that forms for the stomach wall that runs through health and coat of the stomach; Under the state that is locked as free state or external force active state by lock function, insert the operation of communications and liaison network hole, slot part and cross-drilled hole; Make the assembly of seal wire guide catheter, obturator and urceolus under the state of power effect outside, insert this assembly to gastric from external via this fistula hole simultaneously, be embedded in intracorporeal indwelling portion the operation of gastric; Unlock, from this conduit, extract this obturator and urceolus, when making this intracorporeal indwelling portion flexibly return to free state, extract external operation to this seal wire.About the method for using of the routine catheter kit for burrow of this second embodiment, mainly just describe with the routine difference of first embodiment.Promptly in the second embodiment example, the difference routine with first embodiment is operation before the gastric of conduit apparatus 50a inserts.That is, before the gastric of conduit apparatus 50a inserts, in the operation, urceolus 60 and obturator 20a are cooperated be assembled in conduit 10 (Figure 12 and Figure 13).That is, imbed the flexible pipe 11 of conduit 10 to urceolus 60, imbed obturator 20a in the obturator path 61 of urceolus 60.At this moment, the operating portion 21 that pushes obturator 20a a little makes the front end 24 of obturator 20a contact with the contact site 18 of intracorporeal indwelling portion 12.At this moment, intracorporeal indwelling portion 12 is outstanding free state to the outside hole enlargement of the footpath of flexible pipe 11 direction.Next for being exposed to external seal wire 40, pass the contact hole 15 of intracorporeal indwelling portion 12, the slot part 22a of obturator 20a and the cross-drilled hole 63 of urceolus 60 in order, make the conduit assembly insert logical respectively to the gastric direction from patchhole 33.
Next, a push operation portion 21, intracorporeal indwelling portion 12 will be deformed to external force active state (Figure 14) simultaneously from by the outstanding state undergauge due to the external force effect of obturator 20a.Under this state, assembly is locked, and the slot part 22a that inserts the obturator 20a that has led to seal wire 40 is the logical state of inserting with the contact hole 15 that is attached to contact site 18.Also have,, be not limited to above-mentioned period, also can after being changed to the external force active state to intracorporeal indwelling portion 12, carry out as inserting logical period to seal wire 40 to contact hole 15, slot part 22a and the cross-drilled hole 63 of intracorporeal indwelling portion 12.
Insert to make at the gastric of conduit apparatus 50a and establish in the operation; Can use the assembly of conduit 10, obturator 20a and the urceolus 60 of the intracorporeal indwelling portion of having contained from the outstanding state undergauge of strain 12 with the same method of first embodiment example and insert gastric along seal wire 40.Assembly according to this routine conduit 10, obturator 20a and urceolus 60; Can be by lock function; Maintain the external force active state to intracorporeal indwelling portion 12; Therefore can carry out the pushing away of intracorporeal indwelling portion 12 of obturator 20a simultaneously and stretch operation and insert intravital operation to conduit 10 and complete operation, improve working performance.
By the assembly of conduit 10, obturator 20a and urceolus 60, after in the intracorporeal indwelling portion 12 insertion bodies, remove the locking mechanism of external force active state, make intracorporeal indwelling portion 12 return to free state.Thus, also recovered the function that prevents that conduit 10 from extracting from the patient on one's body.From patient on one's body extract seal wire 40, obturator 20a and urceolus 60 thereafter.Thus, bury the end of operation of conduit 10 underground to the patient.
Method for using according to the routine catheter kit for burrow of second embodiment; Except that play with the same effect of the method for using of first embodiment example; Conduit apparatus 50a is because urceolus 60 almost seamlessly is embedded into flexible pipe 11, even the external force effect; Active force is also almost inoperative to flexible pipe 11, and can only concentrate on intracorporeal indwelling portion 12 to active force.Therefore, compare when not using urceolus 60 and can use less action force, prolonged the service life of contact site 18.In addition, seal wire 40 is in obturator 20a, because it is inner to pass the path of being made by slot part 22a and urceolus 60, so this path performance is as the effect of hollow bulb.In addition; Because intracorporeal indwelling portion 12 maintains the external force active state by lock function; Therefore also can not carry out the operation that the intracorporeal indwelling portion 12 of conduit 10 is pushed away stretch and insert intravital operations to conduit 10 and complete operation, thereby raising working performance simultaneously by obturator 20a.
Below, the catheter kit for burrow of the 3rd embodiment is described with reference to Figure 17～Figure 20.Figure 17 is the axonometric chart of the urceolus that uses in this example.Figure 18 (A) is the front view of the urceolus of Figure 17, and Figure 18 (B) is the left side view of Figure 18 (A).Figure 19 is the profilograph at the assembly of the free state of this routine conduit apparatus.Figure 20 is the profilograph at the assembly of the external force active state of this routine conduit apparatus.
In the catheter kit for burrow of the 3rd embodiment of Figure 17～shown in Figure 20, omit the explanation that is attached to the prosign on the same element with Fig. 8～Figure 16, mainly describe with regard to difference.That is, in the conduit apparatus in the 3rd embodiment, be: on urceolus, be provided with when referring to hook and retainer and making obturator be entrenched in urceolus, between spring with the difference of the conduit apparatus of second embodiment example.Promptly; The urceolus 60a that this is routine; Also have first base end part 86 and on hook 70, the first base end parts 86 retainer 80 that is positioned at restrictions 64 tops has been installed, refer to that hook 70 is that vertical direction to the footpath of urceolus direction is second base end part 87 that being attached to of standing shape is positioned at first base end part, 86 tops with referring to.In addition, cross-drilled hole 63 forms probably to arrive the length that refers to hook 70 from first base end part 86 at direction of principal axis, and the cylinder element of lock hole 621 side above urceolus of top forms at direction of principal axis with the length of regulation.In addition, in the obturator path 61 of urceolus 60a, the section that forms an end of fixing spring differs from 623.
The finger hook 70 that is attached to second base end part 87 of urceolus 60a is, pushes the operating portion 21 of obturator 20a, becomes the member of the operation of the auxiliary intracorporeal indwelling portion 12 that is delivered to external force conduit 10, thereby makes the operation of the one hand of operator become easy.That is, when making obturator 20a,, can improve the operability that will be delivered to the intracorporeal indwelling portion 12 of conduit 10 extraordinarily by the external force that obturator 20a causes because the finger hook 70 of urceolus 60a becomes fulcrum as impetus.
Retainer 80 is; In aforementioned intracorporeal indwelling portion by the external force effect during undergauge; Restriction is to the member that moves relative to the preceding extreme direction of the conduit 10 of urceolus 60a, have the fitting portion that is formed at first base end part 86 65 slide possible wrist shape sliding part 83 and possess each other at a distance of with the external diameter of the flexible pipe 11 of an end that is attached to sliding part 83 much at one a pair of clamping part 851 of length fixed part 85, from an end of fixed part 85 to the direction of crooked 180 degree prolong the spring that flaky first push portion 81, be attached to sliding part 83 the other end second push portion 84.As the shape of the fitting portion that is formed on first base end part 86 65, not special the qualification for example, can be the hole shape of circular hole, square hole etc.; The groove shape of I word groove, T word groove, curved slot etc.At this moment, the shape of corresponding fitting portion 65 is come the section shape of suitable decision sliding part 83.Fitting portion 65 is groove shape, and the advantage that can be installed in sliding part 83 loading and unloading of retainer 80 possibly fitting portion 65 is arranged.In addition, be formed on the fitting portion 65 of first base end part 86, have relatively direction of principal axis set up a plurality of advantages with suitable spacing.Thus, be installed in the suitable position of the fitting portion 65 of urceolus 60a to retainer 80, through changing the position of clamping part 851, can the different various conduit 10 of corresponding flexible pipe 11 length.
For using retainer 80 conduit 10 and urceolus 60a are installed; Will be in advance after the location have cooperated conduit 10 and urceolus 60a (the solid line part of Figure 18 (A)); Push portion 81 to first and be pushed into urceolus 60a side, make clamping part 851 be positioned at external fixed part 14 under clamp conduit 10 (the double dot dash line part of Figure 18 (B)).Thus, follow the push operation of conduit 10, can in the variation in positional relation of eliminating conduit 10 and urceolus 60a, can only focus on intracorporeal indwelling portion 12 to active force, thereby make flexible pipe 11 not do insignificant pushing away to stretch.
About the method for using of the routine catheter kit for burrow of the 3rd embodiment, mainly just describe with the routine difference of second embodiment.That is, in the 3rd embodiment example, the gastric that is conduit apparatus 50b with the routine main difference of second embodiment inserts preceding operation.That is, before the gastric of conduit apparatus 50b inserts, in the operation, urceolus 60a and obturator 20a are cooperated be installed in conduit 10.Promptly; Be embedded in obturator 20a the urceolus 60a of obturator path 61 states; Embed the flexible pipe 11 of conduit 10, next, push portion 81 to first of retainer 80 and push urceolus 60a side; Clamp the flexible pipe 11 under the external fixed part 14 with the clamping part 851 of retainer 80, obtain the conduit assembly.At this moment, push the operating portion 21 of obturator 20a a little, the front end 24 of obturator 20a is contacted with the contact site 18 of intracorporeal indwelling portion 12.At this moment, intracorporeal indwelling portion 12 is to the hole enlargement of the footpath of the flexible pipe 11 direction outside, is the free state (Figure 19) of having given prominence to.Also have, when making obturator 20a embed into obturator path 61, in advance that spring 98 is mediate.Next for being exposed to external seal wire 40,, make the conduit assembly insert logical respectively to the gastric direction in order through contact hole 15, the slot part 22a of obturator 20a and the cross-drilled hole 63 of urceolus 60a of intracorporeal indwelling portion 12 from patchhole 33.
Next; For example be hooked in forefinger and middle finger on the finger hook 70; Being hooked in thumb on the operating portion 21 of obturator 20a, is fulcrum with the finger hook 70 of urceolus 60a, pushes the operating portion 21 of obturator 20a; Intracorporeal indwelling portion 12 will through under the external force effect of obturator 20a from outstanding state undergauge, be deformed to external force active state (Figure 20) simultaneously.Be locked at this state downcomer assembly, the slot part 22a that inserts the obturator 20a of admittance silk 40 is the logical state of inserting with the contact hole 15 that is attached to contact site 18.
Assembly by conduit 10, obturator 20a and urceolus 60a; In body, insert after the intracorporeal indwelling portion 12; Push jut 29, remove the locking mechanism of external force active state, and then push portion 84 to second of retainer 80 and push urceolus 60a side; Remove the clamping of flexible pipe 11, make intracorporeal indwelling portion 12 return to free state.Thus, also recovered the function that prevents that conduit 10 from extracting from the patient on one's body.From patient on one's body extract seal wire 40, obturator 20a and urceolus 60a thereafter.Thus, bury the end of operation of conduit 10 underground to the patient.
In addition, the releasing of the latch-release of the assembly of conduit 10, obturator 20a and urceolus 60a and the clamping action that produced by retainer 80 is not limited to said sequence, carries out earlier that whichever will do.
According to the method for using of the catheter kit for burrow of the 3rd embodiment example, remove play with the same effect of the routine method for using of second embodiment, conduit apparatus 50b; Because urceolus 60 almost seamlessly is embedded into flexible pipe 11; Even external force effect, active force are also almost inoperative to flexible pipe 11, and; Because the effect of retainer 80; Be accompanied by pushing away of flexible pipe 11 and stretch operation, eliminated the variation in positional relation of flexible pipe 11 and urceolus 60a, can make active force only concentrate on intracorporeal indwelling portion 12 all the more.
In addition, catheter kit for burrow of the present invention is being located at patient's conduit (conduit in the use) on one's body and can using when being replaced with new conduit making.The example of representing a this replacing operation below.At first, make obturator 20 or obturator 20a and urceolus 60 (60a), from the open rearward end of flexible pipe 11, insertion has been made and has been located at patient's conduit 10 on one's body.Next; Seal wire 40 is passed according to the order in the contact hole 15 of openning 26, seal wire path 22 and the intracorporeal indwelling portion 12 of obturator 20; Perhaps pass, make seal wire 40 lead to gastric from external inserting according to the order in the contact hole 15 of the slot part 22a of the cross-drilled hole 63 of urceolus 60 (60a), obturator 20a and intracorporeal indwelling portion 12.Next, push the operating portion 21 of obturator 20 or obturator 20a, make intracorporeal indwelling portion 12 be deformed to the external force active state.And, keep this state constant, extract conduit 10 on one's body from the patient.At this moment, only extract conduit 10 and obturator 20 or obturator 20a and urceolus 60 (60a) on one's body from the patient, 40 of seal wires keep inserting logical patient's stomach wall 31 and the state of coat of the stomach 32 is retained in the there.Conduit 10 in using to this extract end of operation.Next, use new conduit 10, the gastric of operation, conduit apparatus inserts to make and establishes operation before inserting through the gastric that carries out the routine conduit apparatus of aforesaid first～the 3rd embodiment in order, accomplishes the replacing operation of conduit.
Industrial applicibility
According to the present invention, because seal wire path and operating portion in the obturator dispose with released state, as long as the center of the operating portion of the obturator that press...withes one's finger down will be delivered to power the intracorporeal indwelling portion of conduit efficiently.In addition, through the guiding of seal wire, can be the assembly of the assembly of conduit and obturator or conduit, obturator and urceolus, via the fistula hole from the external gastric that inserts reliably.In addition according to the present invention, in percutaneous endoscopic stomach fistulation, can only push away the intracorporeal indwelling portion of stretching, when improving operability, be expected to the seal wire of forgetting it, alleviate the pressure of operator, and shorten operating time.
Claims (22)
1. catheter kit for burrow, possess obturator, urceolus and to the patient from external conduit to supply nutrition of gastric percutaneous or medicinal liquid, it is characterized in that,
This conduit has:
Flexible pipe, portion has from external and imports the nutritional channel of nutrition or medicinal liquid to gastric within it, and said flexible pipe extends along the wall in fistula hole,
The intracorporeal indwelling portion of non-balloon type; The leading section that it is attached to this flexible pipe, the standing shape that has been to the radial outside hole enlargement of this flexible pipe, under the external force effect that causes by obturator from outstanding state undergauge; And kept somewhere in gastric being embedded under the intravital state of body
External fixed part, it is attached to this flexible pipe rear end, upwards is standing shape in the footpath of aforementioned flexible pipe,
The contact hole, it is used for getting in touch with from external the seal wire path of the aforementioned obturator of the leading section that is attached to aforementioned intracorporeal indwelling portion to gastric;
This obturator is engaged in the aforementioned conduit till touching with aforementioned intracorporeal indwelling portion, and can in aforementioned conduit, extract, and this obturator has:
The seal wire path, it is arranged on the part that partways from the front end of this obturator, is used for inserting the admittance silk,
Operating portion, the rear end that it is attached to this obturator is used for transmitting external force to this intracorporeal indwelling portion;
The rearward end of this seal wire path disposes with released state with this operating portion,
This urceolus is engaged in the flexible pipe of this conduit and can in the flexible pipe of this conduit, extracts, and this urceolus has: the outer peripheral face shape that possesses the front that limits than the slightly little external diameter of the internal diameter of this flexible pipe and to the extensional of flexible pipe; Match with obturator and to merge the obturator path that this obturator can be slided.
2. catheter kit for burrow as claimed in claim 1 is characterized in that, aforementioned obturator is engaged in the flexible pipe of aforementioned conduit and can in the flexible pipe of aforementioned conduit, extracts, and aforementioned obturator has the external diameter slightly littler than the internal diameter of aforementioned flexible pipe.
3. catheter kit for burrow as claimed in claim 1 is characterized in that, from the seal wire path that the front end of aforementioned obturator partways and sets up, is hollow bulb or slot part.
4. catheter kit for burrow as claimed in claim 2 is characterized in that, from the seal wire path that the front end of aforementioned obturator partways and sets up, is hollow bulb or slot part.
5. catheter kit for burrow as claimed in claim 1; It is characterized in that; Also possesses seal wire; This seal wire is from aforementioned contact hole and aforementioned seal wire path is inserted logical the use, and inserts to gastric from external via this fistula hole at the assembly of inserting the aforementioned intracorporeal indwelling of guiding portion, aforementioned flexible pipe and aforementioned obturator under the logical state.
6. catheter kit for burrow as claimed in claim 2; It is characterized in that; Also possesses seal wire; This seal wire is from aforementioned contact hole and aforementioned seal wire path is inserted logical the use, and inserts to gastric from external via this fistula hole at the assembly of inserting the aforementioned intracorporeal indwelling of guiding portion, aforementioned flexible pipe and aforementioned obturator under the logical state.
7. catheter kit for burrow as claimed in claim 3; It is characterized in that; Also possesses seal wire; This seal wire is from aforementioned contact hole and aforementioned seal wire path is inserted logical the use, and inserts to gastric from external via this fistula hole at the assembly of inserting the aforementioned intracorporeal indwelling of guiding portion, aforementioned flexible pipe and aforementioned obturator under the logical state.
8. catheter kit for burrow as claimed in claim 4; It is characterized in that; Also possesses seal wire; This seal wire is from aforementioned contact hole and aforementioned seal wire path is inserted logical the use, and inserts to gastric from external via this fistula hole at the assembly of inserting the aforementioned intracorporeal indwelling of guiding portion, aforementioned flexible pipe and aforementioned obturator under the logical state.
9. like any described catheter kit for burrow of claim 1～8; It is characterized in that; Aforementioned intracorporeal indwelling portion forms basket with the arm more than 2, the seam portion between the arm of aforementioned intracorporeal indwelling portion front inboard and/or seam portion inboard between the arm of aforementioned intracorporeal indwelling portion rear end side possess recess.
10. like any described catheter kit for burrow of claim 1～8; It is characterized in that; The hole enlargement length of aforementioned intracorporeal indwelling portion under free state, be diameter, than this intracorporeal indwelling portion aforementioned flexible pipe axially on length long, thereby this intracorporeal indwelling portion is flat pattern.
11. catheter kit for burrow as claimed in claim 9; It is characterized in that; The hole enlargement length of aforementioned intracorporeal indwelling portion under free state, be diameter, than this intracorporeal indwelling portion aforementioned flexible pipe axially on length long, thereby this intracorporeal indwelling portion is flat pattern.
12. any described catheter kit for burrow like claim 1～8 is characterized in that, has also set up the overshooting shape thing at the front end of aforementioned intracorporeal indwelling portion.
13. catheter kit for burrow as claimed in claim 9 is characterized in that, has also set up the overshooting shape thing at the front end of aforementioned intracorporeal indwelling portion.
14. any described catheter kit for burrow like claim 1～8 is characterized in that, also possesses at the leading section of aforementioned flexible pipe to prevent from gastric via nutritional channel to the external check valve that backflows.
15. catheter kit for burrow as claimed in claim 9 is characterized in that, also possesses at the leading section of aforementioned flexible pipe to prevent from gastric via nutritional channel to the external check valve that backflows.
16. any described catheter kit for burrow like claim 1～8 is characterized in that the aforementioned intracorporeal indwelling part with preceding end in contact aforementioned obturator portion is reinforced with strenthening member.
17. catheter kit for burrow as claimed in claim 9 is characterized in that, the aforementioned intracorporeal indwelling part with preceding end in contact aforementioned obturator portion is reinforced with strenthening member.
18. catheter kit for burrow as claimed in claim 16 is characterized in that, aforementioned strenthening member is metal net.
19. catheter kit for burrow as claimed in claim 17 is characterized in that, aforementioned strenthening member is metal net.
20. catheter kit for burrow as claimed in claim 1 is characterized in that, also possesses locking mechanism, this locking mechanism is made up of the jut that is located at aforementioned obturator and 2 lock holes being located at aforementioned urceolus.
21. catheter kit for burrow as claimed in claim 1 is characterized in that, also possesses retainer at the base end part of aforementioned urceolus, this retainer is owing to when external force effect and aforementioned intracorporeal indwelling portion undergauge, limit aforementioned conduit and move with respect to aforementioned urceolus.
22. catheter kit for burrow as claimed in claim 21 is characterized in that, the base end part of the urceolus above aforementioned retainer also possesses the finger hook that is standing shape towards the axial outside of this urceolus.
Applications Claiming Priority (6)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2003-123599 | 2003-04-28 | ||
| JP2003123599 | 2003-04-28 | ||
| JP2003123599 | 2003-04-28 | ||
| JP2003305683 | 2003-08-29 | ||
| JP2003-305683 | 2003-08-29 | ||
| JP2003305683 | 2003-08-29 |
Related Parent Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200480011112 Division CN1780599A (en) | 2003-04-28 | 2004-04-26 | Catheter kit for burrow |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101574306A CN101574306A (en) | 2009-11-11 |
| CN101574306B true CN101574306B (en) | 2012-12-26 |
Family
ID=36770595
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200910141399 Expired - Fee Related CN101574306B (en) | 2003-04-28 | 2004-04-26 | Catheter kit for burrow |
| CN 200480011112 Pending CN1780599A (en) | 2003-04-28 | 2004-04-26 | Catheter kit for burrow |
Family Applications After (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 200480011112 Pending CN1780599A (en) | 2003-04-28 | 2004-04-26 | Catheter kit for burrow |
Country Status (1)
| Country | Link |
|---|---|
| CN (2) | CN101574306B (en) |
Families Citing this family (14)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP5377944B2 (en) * | 2007-11-30 | 2013-12-25 | 住友ベークライト株式会社 | Gastrostomy sheath, sheathed dilator, gastrostomy sheath with insertion aid, gastrostomy catheter kit |
| JP5726029B2 (en) * | 2011-09-14 | 2015-05-27 | 日本コヴィディエン株式会社 | Fistula catheter |
| CN103041494B (en) * | 2011-10-17 | 2017-03-01 | 库利艾特梅迪克株式会社 | Conduit |
| JP6101206B2 (en) * | 2011-10-31 | 2017-03-22 | 鈴木 裕 | Medical dilator and medical dilator set |
| WO2014203259A1 (en) | 2013-06-20 | 2014-12-24 | Hadasit Medical Research Services And Development Ltd. | Devices and methods for percutaneous endoscopic gastrostomy and other ostomy procedures |
| US10702304B2 (en) | 2014-12-23 | 2020-07-07 | Fidmi Medical Ltd. | Devices and methods for ports to living tissue and/or lumens and related procedures |
| WO2016103268A1 (en) | 2014-12-23 | 2016-06-30 | Fidmi Medical Ltd. | Devices and methods for percutaneous endoscopic gastronomy and other ostomy procedures |
| WO2017109788A1 (en) | 2015-12-23 | 2017-06-29 | Fidmi Medical Ltd. | Devices and methods for ports to living tissue and/or lumens and related procedures |
| CN107551380B (en) * | 2016-06-30 | 2020-06-09 | 上海交通大学医学院附属第九人民医院 | Tube drawing device and tube drawing method for disc-shaped gastrostomy tube |
| CN106691397A (en) * | 2017-03-09 | 2017-05-24 | 四川大学华西第二医院 | Cerebrospinal fluid detection apparatus for intraspinal anesthesia |
| CN106861019A (en) * | 2017-03-31 | 2017-06-20 | 卞晓明 | Skin fixator |
| CN108261600B (en) * | 2018-02-02 | 2020-07-28 | 杭州富善医疗器械有限公司 | Mini stomach fistulization tube |
| CN109876275A (en) * | 2019-04-18 | 2019-06-14 | 宜兴市人民医院 | A kind of kidney stoma for the drainage of kidney hematocele hydrops |
| CN111067667B (en) * | 2019-12-27 | 2022-04-22 | 先健科技(深圳)有限公司 | Force measuring device and pushing assembly thereof |
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| CN2054700U (en) * | 1989-09-23 | 1990-03-21 | 山东省肿瘤防治研究院 | Spring type inside cavity tube and placing /getting device |
| US5112308A (en) * | 1990-10-03 | 1992-05-12 | Cook Incorporated | Medical device for and a method of endoscopic surgery |
| US5290249A (en) * | 1990-10-09 | 1994-03-01 | Vance Products Incorporated | Surgical access sheath |
| US5336203A (en) * | 1993-05-28 | 1994-08-09 | Abbott Laboratories | Low profile gastrostomy device with dome |
| WO2000054727A1 (en) * | 1999-03-15 | 2000-09-21 | Thierry Scheye | Device for providing fluid communication with a hollow viscus at the skin surface |
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- 2004-04-26 CN CN 200910141399 patent/CN101574306B/en not_active Expired - Fee Related
- 2004-04-26 CN CN 200480011112 patent/CN1780599A/en active Pending
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2054700U (en) * | 1989-09-23 | 1990-03-21 | 山东省肿瘤防治研究院 | Spring type inside cavity tube and placing /getting device |
| US5112308A (en) * | 1990-10-03 | 1992-05-12 | Cook Incorporated | Medical device for and a method of endoscopic surgery |
| US5290249A (en) * | 1990-10-09 | 1994-03-01 | Vance Products Incorporated | Surgical access sheath |
| US5336203A (en) * | 1993-05-28 | 1994-08-09 | Abbott Laboratories | Low profile gastrostomy device with dome |
| WO2000054727A1 (en) * | 1999-03-15 | 2000-09-21 | Thierry Scheye | Device for providing fluid communication with a hollow viscus at the skin surface |
| JP3347315B1 (en) * | 2001-12-13 | 2002-11-20 | 治郎 蟹江 | Gastrostomy catheter kit |
Also Published As
| Publication number | Publication date |
|---|---|
| CN1780599A (en) | 2006-05-31 |
| CN101574306A (en) | 2009-11-11 |
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