JP6211234B2 - 内視鏡用アタッチメント及び内視鏡システム - Google Patents
内視鏡用アタッチメント及び内視鏡システム Download PDFInfo
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- JP6211234B2 JP6211234B2 JP2017520552A JP2017520552A JP6211234B2 JP 6211234 B2 JP6211234 B2 JP 6211234B2 JP 2017520552 A JP2017520552 A JP 2017520552A JP 2017520552 A JP2017520552 A JP 2017520552A JP 6211234 B2 JP6211234 B2 JP 6211234B2
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- 238000005192 partition Methods 0.000 claims description 77
- 238000003780 insertion Methods 0.000 claims description 27
- 230000037431 insertion Effects 0.000 claims description 27
- 238000004891 communication Methods 0.000 claims description 15
- 210000001519 tissue Anatomy 0.000 description 34
- 210000000056 organ Anatomy 0.000 description 19
- 210000000683 abdominal cavity Anatomy 0.000 description 18
- 238000000034 method Methods 0.000 description 17
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- 239000012530 fluid Substances 0.000 description 8
- 230000003902 lesion Effects 0.000 description 8
- 210000004400 mucous membrane Anatomy 0.000 description 8
- 238000011282 treatment Methods 0.000 description 8
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- 238000006073 displacement reaction Methods 0.000 description 4
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- 210000003815 abdominal wall Anatomy 0.000 description 3
- 238000005452 bending Methods 0.000 description 3
- 210000004876 tela submucosa Anatomy 0.000 description 3
- 238000012323 Endoscopic submucosal dissection Methods 0.000 description 2
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- 201000011510 cancer Diseases 0.000 description 2
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- 238000002357 laparoscopic surgery Methods 0.000 description 2
- 230000009401 metastasis Effects 0.000 description 2
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- 210000002784 stomach Anatomy 0.000 description 1
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- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
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- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
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- A61B1/00089—Hoods
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- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
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- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- Molecular Biology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Pathology (AREA)
- Biophysics (AREA)
- Radiology & Medical Imaging (AREA)
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Rheumatology (AREA)
- Endoscopes (AREA)
Description
そこで、内視鏡で管腔臓器内から病変位置を確認し、マージンを含む管腔臓器の一定領域を管腔臓器の内側から指示することにより、腹腔側すなわち管腔臓器の外側から必要最小限の範囲を切除する手技が試みられている。
しかし、このマーカー留置には指示する術者と留置する術者との協調動作が必要であるため、実際は容易ではない。
図4に示すように、本実施形態の内視鏡システム100は、アタッチメント1と、内視鏡101と、穿刺デバイス4とを備えている。内視鏡101は公知の内視鏡を用いる。図3に示すように、アタッチメント1が内視鏡101の挿入部102の先端部に装着されたときに、本体2は、中心軸Cが挿入部102の長手軸C1と同軸であり、挿入部102の先端部から突出して長手軸C1に沿って延設されるように構成されている。
挿入部102は、円柱状に形成されている。挿入部102内には、長手方向に延びるチャンネル104が複数形成されている。複数のチャンネル104には、観察ユニット105、流体流通路107及びライトガイド106がそれぞれ設けられる。
仕切り部3は、リング部3cと3本の線状部材3bとからなる例を挙げたが、仕切り部の構成はこれに限定されない。例えば、線状部材3bの数が2本あるいは4本以上であってもよい。ただし、吸引時に、吸引された管腔組織205に定位面を安定して形成させるためには、仕切り部3は、少なくとも3本以上の線状部材からなる構成が好ましい。また、仕切り部3は、線状部材3b及びリング部3cをワイヤで形成し、内壁2cに固定する構成であってもよい。仕切り部3は、本体2と一体成形されていている構成の他、線状部材3bが本体2の内壁2cに嵌合される構成や接合される構成であってもよい。
管腔組織に留置具を留置する方法であって、
筒状の本体及び前記本体の先端面よりも前記基端部側の前記本体内に設けられ、前記本体の基端側と先端側とを流体が移動可能に連通させる連通部を有する仕切り部を有する内視鏡用アタッチメントを挿入部の先端に取り付けられた内視鏡と、留置具が挿入された針管を備える穿刺デバイスと、前記内視鏡の挿入部に設けられた流体流通路に接続された吸引部と、を用い、
前記内視鏡の挿入部を体内に挿入し、
前記内視鏡用アタッチメントの先端面を前記管腔組織の内側の所定の位置に当接させた状態で、前記吸引部により前記内視鏡用アタッチメントの内部を減圧させて、前記管腔組織を前記本体内に吸引して前記管腔組織を前記仕切り部に密着させ、
管腔の外側において、前記管腔組織が前記仕切り部に密着することにより形成された凹部に前記穿刺デバイスの前記針管が挿入されたシースを挿入してシースの先端を前記凹部の底面に当接させ、
前記針管が前記シースの先端から突出されて前記管腔組織に前記管腔の外側から穿刺され、
前記針管内に挿入された前記留置具を前記管腔組織に貫通させて留置する
留置具の留置方法。
2 本体
2a 基端部
2b 先端面
3 仕切り部
3a 貫通孔(連通部)
3b 線状部材(線状部)
3c リング部
4 穿刺デバイス
18 吸引部
34a 開口部
100 内視鏡システム
101 内視鏡
Claims (8)
- 内視鏡の挿入部に取付け可能な基端部を有する筒状の本体と、
前記本体の内部に設けられた仕切り部であって、前記本体の先端側から進入したデバイスの先端部が前記挿入部の先端面に接触することを防止するように、前記本体の中心軸が延びる方向において、前記仕切り部と接触した前記デバイスの前記先端部の前記本体の基端側への突出長さよりも前記基端部から前記仕切り部までの距離が長くなる位置に設けられた前記仕切り部と、
前記仕切り部に設けられ、生体組織を吸引して前記仕切り部に密着させた状態において、前記仕切り部から前記本体の先端までの前記本体の内壁とともに前記本体内において前記仕切り部の基端側と先端側とを連通する連通路を形成する連通部と、
を備える内視鏡用アタッチメント。 - 前記仕切り部は、前記本体の前記内壁に連続して接続され、且つ、前記本体の前記中心軸に対して直交する方向に延びている
請求項1に記載の内視鏡用アタッチメント。 - 前記連通部は、前記中心軸上に位置する貫通孔である
請求項1に記載の内視鏡用アタッチメント。 - 前記仕切り部は、前記本体の前記内壁と接続された複数の線状部材からなる
請求項1に記載の内視鏡用アタッチメント。 - 前記仕切り部は、前記貫通孔の周りに複数の孔が形成される
請求項3に記載の内視鏡用アタッチメント。 - 前記仕切り部は、前記基端部から前記仕切り部までの距離よりも前記本体の先端面から前記仕切り部までの距離が短い位置に設けられている
請求項1に記載の内視鏡用アタッチメント。 - 前記仕切り部は、前記本体の中空部の開口径よりも小さい直径のリング部と、前記リング部と前記内壁とを接続する複数の線状部材とを有し、
前記リング部は、前記本体の基端から前記本体の前記先端に向かって延びる前記中心軸上に開口部が位置し、先端面が前記中心軸と直交するように配置されて、前記複数の線状部材に支持されている
請求項1に記載の内視鏡用アタッチメント。 - 請求項1から請求項7のいずれか一項に記載の内視鏡用アタッチメントと、
前記挿入部の先端部に吸入口が設けられる吸引部を有する前記内視鏡と、
生体組織を穿刺する穿刺部を有する穿刺デバイスと、を備え、
前記挿入部の前記先端部に前記内視鏡用アタッチメントが取付けられる
内視鏡システム。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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PCT/JP2015/071210 WO2017017752A1 (ja) | 2015-07-27 | 2015-07-27 | 内視鏡用アタッチメント及び内視鏡システム |
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JPWO2017017752A1 JPWO2017017752A1 (ja) | 2017-08-17 |
JP6211234B2 true JP6211234B2 (ja) | 2017-10-11 |
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JP2017520552A Active JP6211234B2 (ja) | 2015-07-27 | 2015-07-27 | 内視鏡用アタッチメント及び内視鏡システム |
Country Status (3)
Country | Link |
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US (1) | US20180140169A1 (ja) |
JP (1) | JP6211234B2 (ja) |
WO (1) | WO2017017752A1 (ja) |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
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JP6656470B2 (ja) * | 2017-04-19 | 2020-03-04 | Hoya株式会社 | 内視鏡頂部の取り付け装置 |
US11039850B2 (en) * | 2018-02-28 | 2021-06-22 | Gi Supply | Endoscopic tool with suction for facilitating injection of a fluid into a submucosal layer of tissue |
Family Cites Families (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005065554A1 (ja) * | 2004-01-08 | 2005-07-21 | Olympus Corporation | 吻合器および生体内管腔器官壁部の切除方法 |
US8048062B2 (en) * | 2005-12-30 | 2011-11-01 | Boston Scientific Scimed, Inc. | Catheter assembly and method for internally anchoring a catheter in a patient |
JP5097558B2 (ja) * | 2006-01-13 | 2012-12-12 | オリンパスメディカルシステムズ株式会社 | 医療システム |
US8715281B2 (en) * | 2006-03-09 | 2014-05-06 | Olympus Medical Systems Corp. | Treatment device for endoscope |
EP2091442B1 (en) * | 2006-10-26 | 2011-05-18 | Wilson-Cook Medical Inc. | Biopsy collection device |
WO2015021133A2 (en) * | 2013-08-06 | 2015-02-12 | Cook Medical Technologies Llc | System and method for external percutaneous connections |
-
2015
- 2015-07-27 JP JP2017520552A patent/JP6211234B2/ja active Active
- 2015-07-27 WO PCT/JP2015/071210 patent/WO2017017752A1/ja active Application Filing
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2018
- 2018-01-18 US US15/874,620 patent/US20180140169A1/en not_active Abandoned
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Publication number | Publication date |
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WO2017017752A1 (ja) | 2017-02-02 |
JPWO2017017752A1 (ja) | 2017-08-17 |
US20180140169A1 (en) | 2018-05-24 |
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