JP5047297B2 - Mucosal dissection aid - Google Patents

Description

  The present invention relates to a mucosal dissection exfoliation assisting tool that lifts the mucous membrane and assists the mucosal dissection exfoliation when the mucous membrane is incised and separated.

  2. Description of the Related Art Conventionally, in the mucosal incision and exfoliation method for incising and exfoliating the mucous membrane, an endoscopic auxiliary tool for lifting the mucosa to be incised and exfoliated (counter traction) includes one that penetrates and holds and pulls the mucous membrane (for example, non Patent Document 1).

Gastrointestinal Endoscopy, 59 (2), 284, 2004, H. et al. Kondo, T .; Gotoda, H .; Ono, I .; Oda, T .; Kozu, M .; Fujishiro, D .; Saito, S .; Yoshida

  The above-mentioned endoscope auxiliary tool is for directly grasping and pulling the mucous membrane through the skin and the like from outside the body. Therefore, it is necessary to provide a perforation for inserting the endoscope auxiliary tool from outside the body, and it takes time to introduce the auxiliary tool. In addition, the skin surface can be perforated.

  Therefore, in view of the above circumstances, the present invention is introduced together with an endoscope so as not to make a perforation or a puncture wound on the skin surface, and it is possible to apply counter traction by pulling so that the end of the incised mucosa is folded back. An object of the present invention is to provide an auxiliary tool for mucosal dissection.

  The mucosal dissection exfoliation assisting tool of the present invention is a mucosal dissection exfoliation assisting tool that pulls the mucosa when incising and exfoliating the mucous membrane, and has a plurality of elastic members and a connecting member that connects the elastic members. The ends of the elastic members are connected by the connecting members such that the plurality of elastic members and the plurality of connecting members are in a ring shape.

  The mucosal dissection exfoliation assisting tool of the present invention is provided with a plurality of connecting members at a plurality of locations at the end of the mucosa to be incised and exfoliated. As a result, the restoring force generated by pulling the elastic member can pull the end of the mucosa back to the inside of the mucosa to be incised and peeled through the connecting member, and counter traction can be applied.

  Therefore, it is not necessary to continue to apply force from outside the body in order to apply counter traction, and it is not necessary to provide perforations to perform operations from outside the body. That is, the burden on the patient can be reduced.

It is a figure which shows the structure of the mucosal dissection exfoliation auxiliary tool of this invention demonstrated in Embodiment 1. FIG. It is a figure which shows the structure of the forceps hole which introduces the mucosal dissection exfoliation assisting tool of this invention demonstrated in Embodiment 1 into a body. It is a figure which shows the state with which the mucous membrane to cut and peel was equipped with the mucosal dissection exfoliation auxiliary tool of this invention demonstrated in Embodiment 1. FIG. It is a figure which shows the state which has pulled the edge part of the mucous membrane to cut | disconnect by the mucosal dissection exfoliation auxiliary tool of this invention demonstrated in Embodiment 1. FIG. It is a figure which shows the structure of the mucosal dissection exfoliation auxiliary tool of this invention demonstrated in Embodiment 2. FIG. It is a figure which shows the state with which the mucous membrane which incises and peels the mucosal dissection exfoliation auxiliary tool of this invention demonstrated in Embodiment 2 was equipped. It is a figure which shows the state which has pulled the edge part of the mucous membrane to cut | disconnect by the mucosal dissection exfoliation auxiliary tool of this invention demonstrated in Embodiment 2. FIG. It is a figure which shows the structure of the mucosal dissection exfoliation auxiliary tool of this invention demonstrated in Embodiment 3. FIG. It is a figure which shows the structure of the forceps hole which introduces the mucosal dissection exfoliation auxiliary tool of the present invention explained in Embodiment 3 into the forceps hole introduced into the body.

[Embodiment 1]
Hereinafter, the mucosal dissection exfoliation aid of the present invention forms a ring shape by alternately arranging two elastic members 1 and two connecting members 2 as shown in FIG.

  The elastic member 1 is an elastic member formed by an elongate spring formed by winding a metal wire in a spiral shape, and a restoring force for returning to the original shape is generated by extending in the longitudinal direction. The mucosal dissection exfoliation assisting tool of the present invention can be pulled using the restoring force so as to fold back the end of the mucous membrane to be incised and exfoliated.

  The length of the elastic member 1 in the longitudinal direction is not particularly limited, but may be appropriately changed according to the size of the mucosa to be incised and exfoliated provided with the mucosal incision / exfoliation auxiliary tool. For example, the elastic member 1 It is preferable that the length in the longitudinal direction during contraction is about 2/3 to 1/2 of the distance between the end portions of the mucous membrane provided in the auxiliary device for mucosal dissection.

  The elastic member 1 is preferably thick enough to pass through a forceps hole provided in an endoscope or a laparoscope as a mucosal dissection exfoliation assisting tool. More specifically, in the case of Embodiment 1, it is preferable to use a spring having a diameter smaller than about ½ of the inner diameter of the forceps hole of the endoscope or laparoscope.

  The connecting member 2 is an annular member having flexibility and connecting both ends of a linear member made of a material such as rubber or nylon. One of the connecting members 2 connects one end of one elastic member 1 and one end of another elastic member 1 of the two elastic members 1, and the other connecting member 2 is the elastic member 1. Is connected to the other end of another elastic member 1. Thereby, the mucosal dissection exfoliation auxiliary tool is in a state where the two elastic members 1 and the two connecting members are alternately arranged and connected in a ring shape.

  In the case of the first embodiment, the connecting member 2 is an annular member. The size of the ring is such that a clip as a holding member, which will be described later, provided at the end of the mucosa is hooked. If it has, it will not be limited.

  Since the mucosal dissection exfoliation assisting tool of the present invention having such a configuration is provided for a mucous membrane having a lesion to be excised having a stomach, esophagus, and large intestine, it is introduced into the body as follows.

  First, the mucosal incision assisting tool is provided in the forceps hole 3 provided in the endoscope or laparoscope as shown in FIG. The forceps hole 3 is provided with an introduction tube 4 having a hollow inside, and a spring 5 is provided therein. The mucosal dissection exfoliation assisting tool is provided in the introduction tube 4 so that the spring 5 is contracted.

  An endoscope or laparoscope provided with a mucosal dissection exfoliation auxiliary tool in the introduction tube 4 of the forceps hole 3 is introduced into the body. At this time, the mucosal dissection exfoliation assisting tool is provided by arranging the outer side surfaces of the elastic member 1 and deforming them in parallel so that the two connecting members 2 are end portions.

  When an endoscope or a laparoscope is introduced into the body and its tip reaches the vicinity of the mucosa to be incised and separated, the mucosal incision / exfoliation assisting tool is utilized by utilizing the repulsion of the spring 5 provided in the introduction tube 4. Extruded.

  As shown in FIG. 3, for example, as shown in FIG. 3, the periphery of the mucous membrane having the lesion 92 is incised by a needle scalpel or the like while confirming with an introduced endoscope or laparoscope. Then, the medical clip 91 is hooked on the connecting member 2 of the mucosal dissection exfoliation assisting tool pushed out into the body, and the end of the mucous membrane 90 that dissects and separates the medical clip 91 on which the connecting member 2 is hooked is provided. Thereby, the connecting member 2 can be provided at the end of the mucous membrane 90.

  Similarly, by attaching another connecting member 2 to another end portion of the mucous membrane 90, the mucosal 90 to be incised and peeled can be provided with a mucosal dissection exfoliation auxiliary tool. Here, the medical clip 91 is used as a member for attaching the connecting member 2 to the end of the mucous membrane 90, but the present invention is not limited to this.

  Since the elastic member 1 is shorter than the distance between the end portions of the mucous membrane provided by the mucosal dissection / exfoliation assisting tool, the elastic member 1 is stretched and the restoring force is generated by providing the connecting member 2 on the mucous membrane 90. ing. Then, the submucosal layer in the vicinity of the end of the mucous membrane 90 having the lesion 92 provided with the connecting member 2 is incised with a needle scalpel or the like while being confirmed with the introduced endoscope or laparoscope.

  When the incision is advanced, the end of the mucous membrane 90 is turned up by the elastic member 1, and the mucous membrane 90 is peeled off. By performing this at the end of the mucous membrane 90 provided with the connecting member 2, the end of the mucous membrane 90 is folded back inside the mucous membrane 90 to be incised and peeled off as shown in FIG. Can do.

  Thus, since the mucosal dissection exfoliation assisting tool of the present invention can be introduced into the body together with the endoscope and laparoscope, it is not necessary to provide a perforation for applying counter traction from outside the body. Then, by the restoring force generated by pulling the elastic member 1, the end of the mucous membrane can be pulled back inside the mucosa to be incised and peeled through the connecting member, and counter traction can be applied. At this time, since the end of the mucous membrane 90 is always pulled by the elastic member 1, the visual field of the submucosal layer is widened, and it becomes easy to observe the travel of the blood vessels of the submucosal layer.

  Therefore, it is possible to reduce the possibility of incising an unnecessary portion, and it is also possible to stop bleeding in advance when bleeding is confirmed or when bleeding is likely. That is, the mucosal dissection can be easily performed, and the burden on the patient can be reduced. Moreover, since it is such a simple structure, it can be manufactured at low cost and can be disposable.

[Embodiment 2]
The mucosal dissection exfoliation assisting tool of the present invention is not limited to the first embodiment. In the second embodiment, another form of mucosal dissection assisting tool will be described. As shown in FIG. 5, the mucosal dissection exfoliation assisting tool described in the second embodiment is composed of four elastic members 1 and four connecting members 2. The elastic member 1, the connecting member 2, and the like. Are formed in a ring shape alternately one by one. The elastic member 1 and the connecting member 2 are substantially the same as those in the first embodiment. In this case, the elastic member 1 is preferably shorter in length in the longitudinal direction than in the first embodiment.

  Such a mucosal dissection exfoliation aid is introduced in the same manner as in the first embodiment. As shown in FIG. 6, the introduced mucosal dissection exfoliation assisting tool has four connecting members 2 attached to the four end portions of the mucous membrane 90 that is incised and exfoliated as in the first embodiment. Similarly, each is provided. That is, it is possible to pull the end of the mucous membrane 90 to be incised and peeled from four places.

  Since the elastic member 1 is shorter than the distance between the end portions of the mucous membrane provided in the mucosal dissection exfoliation assisting tool, the elastic member 1 is provided with the connecting member 2 on the mucosa 90 as in the first embodiment. Is growing and restoring force is generated. Then, the submucosal layer in the vicinity of the end of the mucous membrane 90 provided with the connecting member 2 is incised with a needle scalpel or the like while confirming with the introduced endoscope or laparoscope.

  When the incision is advanced, the end of the mucous membrane 90 is turned up by the elastic member 1, and the mucous membrane 90 is peeled off. By performing this operation on the end of the mucous membrane 90 provided with the connecting member 2, the end of the mucous membrane 90 has a lesion 92 and is folded inside the mucosa 90 to be incised and peeled as shown in FIG. You can wrap up the center and apply counter traction.

  Even with such a mucosal dissection assisting device, the same effect as in the first embodiment can be obtained. And since the restoring force of the elastic member 1 is transmitted to more locations, more ends can be folded back, and the visual field of the submucosa can be broadened.

[Embodiment 3]
The mucosal dissection exfoliation assisting tool of the present invention is not limited to the first and second embodiments. In the third embodiment, another form of mucosal dissection assistance tool will be described. The mucosal dissection exfoliation assisting tool described in Embodiment 3 is composed of two elastic members 6 and two connecting members 7 as shown in FIG.

  The elastic member 6 is substantially the same member as the elastic member described in the first embodiment. The elastic member 6 may be thicker than the elastic member of the first embodiment. For example, it is preferable to use a spring having a diameter smaller than the inner diameter of the forceps hole of an endoscope or laparoscope.

  The connecting member 7 is flexible and is a linear member made of a material such as rubber or nylon, and is longer than the length of the elastic member 6 in the longitudinal direction. One end of the connecting member 7 is connected to one end of one elastic member 6 of the two elastic members 6, and the other end opposite to the one end of the connecting member 7 is another elastic member. 6 is connected to one end. One end of another connecting member 7 is connected to the other end of the elastic member 6, and the other end of the other connecting member 7 is connected to the other end of the other elastic member 1. Thereby, the mucosal dissection exfoliation auxiliary tool is in a state where the two elastic members 1 and the two connecting members are alternately arranged and connected in a ring shape.

  Such a mucosal dissection exfoliation aid described in the third embodiment has an end portion of the elastic member 6 and another elastic member 6 as shown in FIG. It can be deformed in series so that the ends of the two face each other. In the same manner as in the first embodiment, the mucosal dissection exfoliation assisting tool is used in this state so that the spring 5 is contracted by the introduction tube 4 having the spring 5 therein. Prepared for.

  When an endoscope or a laparoscope is introduced into the body and its tip reaches the vicinity of the mucosa to be incised and separated, the mucosal incision / exfoliation assisting tool is utilized by utilizing the repulsion of the spring 5 provided in the introduction tube 4. Extruded. The extruded mucosal dissection exfoliation assisting tool can be provided at the end of the mucosa in the same manner as in the first embodiment, and counter traction can be applied to the mucosa.

  Even with such a mucosal dissection assisting device, the same effect as in the first embodiment can be obtained. Further, in the mucosal incision / peeling aid of the third embodiment, the elastic member 6 is thicker than the elastic member of the first or second embodiment. By providing, it becomes possible to provide in the forceps hole 3. And since the thicker elastic member 6 can be used compared with Embodiment 1 or 2, the elastic member which has a stronger restoring force can also be used, and a mucous membrane can be pulled more strongly.

Claims (4)

A mucosal dissection exfoliation auxiliary tool that pulls the mucous membrane when incising and exfoliating the mucosa,
A plurality of elastic members;
Having at least two annular connecting members having flexibility for connecting the elastic members;
The ends of the elastic members are connected by the connecting members so that the plurality of elastic members and the plurality of connecting members are in a ring shape ,
When introduced into the body, the elastic member is contracted, and the outer side surfaces of the elastic member are aligned and deformed in parallel so that the two connecting members are end portions. Auxiliary tool.   2. The mucosa according to claim 1, wherein the connecting member is provided in a plurality of holding members provided at an end of the mucosa to be incised and peeled, and pulls the mucosa by a restoring force of the elastic member. Incision stripping aid. A mucosal dissection exfoliation auxiliary tool that pulls the mucous membrane when incising and exfoliating the mucosa,
A plurality of elastic members;
Having at least two linear connecting members having flexibility to connect the elastic members;
The ends of the elastic members are connected by the connecting members so that the plurality of elastic members and the plurality of connecting members are in a ring shape,
When introduced into the body, the connecting member longer than the length of the elastic member in the longitudinal direction is deformed in series so that the end of the one elastic member and the end of the other elastic member face each other. thing
A mucosal dissection exfoliation assisting device. The mucosa according to claim 3, wherein the connecting member is provided in a plurality of holding members provided at an end of the mucosa to be incised and peeled, and pulls the mucosa by a restoring force of the elastic member. Incision stripping aid.

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