Ureteral stent removal tool and ureteral stent removal method

Abstract

To provide a ureteral stent removal tool and a ureteral stent removal method capable of easily and safely removing a placed ureteral stent.SOLUTION: Ureteral stent removal tools 1, 2 respectively comprise: hook-shaped hook parts 13, 23 which are formed of a rod-shaped member, and are formed on one end of the rod-shaped member, and to which a part of a stent placed in a body is hooked; grip parts 12, 22 which are formed on the other end of the rod-shaped member and are gripped by the fingers of an operator; and circular-column shaped or elliptic-column shaped body parts 11, 21 which connect the hook parts 13, 23 and the grip parts 12, 22. The hook parts 13, 23 are opened to the body parts 11, 21 side, and contours of the hook parts 13, 23 in view in an axial direction of the body parts 11, 21 are formed so as to be settled in contours of the body parts 11, 21.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to a ureteral stent removal instrument and a ureteral stent removal method. [Background technology]

[0002] Conventionally, in order to prevent the ureter from being compressed and blocked due to some cause such as ureteral stones or swelling, ureteral stent placement has been performed in which a stent (ureteral stent) is placed between the kidney and the bladder. Various ureteral stents for use in ureteral stent placement have been developed. Since the placed ureteral stent needs to be replaced or removed depending on the patient's condition, etc., ureteral stents that are easy to remove have also been developed (for example, Patent Document 1). [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2002-85573 A Summary of the Invention [Problem to be solved by the invention]

[0004] The ureteral stent in Patent Document 1 is a coil-shaped stent made of a shape-memory alloy, and cold water is injected to deform the coil, making it easy to remove from the urethra. However, ureteral stents made of a shape-memory alloy are not widely used because they are expensive due to the need for special materials and specific processing steps, and because cold water is injected when removing the stent, which places a physical burden on the patient.

[0005] Generally, a typical tubular stent member with a pigtail shape at the end inside the kidney and the end inside the bladder is used as a ureteral stent. When replacing or removing such an indwelling ureteral stent, a method of inserting a cystoscope into the bladder and grasping and removing the stent with forceps while observing, or a method of grasping and removing the stent with curved forceps inserted into the bladder under X-ray fluoroscopy, etc. are used.

[0006] However, when using a cystoscope, many medical instruments are used, and a lot of work is required for preparation and post-processing sterilization, etc. In addition, when curved forceps are used under X-ray fluoroscopy, there is a risk that the bladder mucosa will be damaged by the forceps when clamping the ureteral stent, which may result in infection or hematuria due to mucosal damage.

[0007] The present invention has been made in consideration of the above circumstances, and an object of the present invention is to provide a ureteral stent removal instrument and a ureteral stent removal method that can safely and easily remove an placed ureteral stent. [Means for solving the problem]

[0008] In order to achieve the above object, a ureteral stent removal device according to a first aspect of the present invention comprises: Formed from a rod-shaped member, a hook-shaped hook portion formed at one end of the rod-shaped member for hooking a part of a stent placed in the body; a grip portion formed at the other end of the rod-shaped member and held by an operator with his / her fingers; A cylindrical or elliptical cylindrical main body portion connecting the hook portion and the grip portion, The hook portion is open on the main body side, The outer shape of the hook portion when viewed in the axial direction of the main body portion is formed to fit within the outer shape of the main body portion.

[0009] A ureteral stent removal device according to a second aspect of the present invention comprises: Formed from a rod-shaped member, a hook-shaped hook portion formed at one end of the rod-shaped member for hooking a part of a stent placed in the body; a grip portion formed at the other end of the rod-shaped member and held by an operator with his / her fingers; A cylindrical or elliptical cylindrical main body portion connecting the hook portion and the grip portion, The hook portion is open on the main body side, The outer shape of the hook portion as viewed in the axial direction of the main body portion is formed to fit within the outer shape of the main body portion, The main body portion has a bent portion whose axial direction is bent at an angle of 5 degrees or more and 20 degrees or less.

[0010] In addition, the outer diameter of the main body is 5 mm or more and 8 mm or less. This may also be the case.

[0011] In addition, the length of the gap formed in the hook portion and into which the stent is introduced is 5 mm or more and 20 mm or less. This may also be the case.

[0012] In addition, the width of the opening of the gap formed in the hook portion and into which the stent is introduced is 2 mm or more and 10 mm or less. This may also be the case.

[0013] The width of the gap gradually decreases from the opening side to the end side. This may also be the case.

[0014] In addition, the width of the end of the gap is 1 mm or less. This may also be the case.

[0015] In addition, in a ureteral stent removal method according to a third aspect of the present invention, inserting the ureteral stent removal instrument according to the first aspect into the urethra from the hook portion; The ureteral stent is removed by hooking the hook portion onto the pigtail portion of the ureteral stent placed in the bladder and removing the ureteral stent removal instrument.

[0016] In addition, in a ureteral stent removal method according to a fourth aspect of the present invention, a ureteral stent removal device according to a second aspect of the present invention is inserted into a stretchable outer cylinder and inserted into the urethra through the hook portion; When the hook portion reaches the inside of the bladder, the hook portion is exposed from the outer tube. The ureteral stent is removed by hooking the hook portion onto the pigtail portion of the ureteral stent placed in the bladder and removing the ureteral stent removal instrument.

[0017] and after the hooking portion is hooked onto the ureteral stent, the outer cylinder is slid relative to the ureteral stent removal instrument, and the ureteral stent removal instrument is removed in a state in which the outer cylinder encloses the hooking portion. This may also be the case. Effect of the Invention

[0018] The ureteral stent removal device of the present invention has a simple structure comprising a hook-shaped hook portion formed on the end of a rod-shaped member and a cylindrical or elliptical cylindrical main body portion, and the outer shape of the hook portion when viewed in the axial direction of the main body portion is formed to fit within the outer shape of the main body portion, thereby reducing the risk of the urethra being damaged by the hook portion and allowing the ureteral stent to be removed safely and easily. Furthermore, the ureteral stent removal method of the present invention using the above-mentioned ureteral stent removal device allows the ureteral stent to be removed safely and easily. [Brief description of the drawings]

[0019] [Figure 1] 1A and 1B are diagrams of a ureteral stent removal instrument according to an embodiment of the present invention, in which (A) is a front view of a female ureteral stent removal instrument, and (B) is a front view of a male ureteral stent removal instrument. [Diagram 2] FIG. 4 is an enlarged view of a hook portion of the ureteral stent removal device according to the embodiment. [Diagram 3]FIG. 2 is a diagram showing a side view of the ureteral stent removal instrument in FIG. 1(A) and a partial projection view of the ureteral stent removal instrument in FIG. 1(B) in the direction of the arrow. [Figure 4] FIG. 13 is a side view of a ureteral stent removal instrument having a main body portion in the shape of an elliptical cylinder. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0020] The ureteral stent removal instrument according to the present invention will be described below with reference to the drawings. As shown in the front view of Fig. 1, in this embodiment, a female ureteral stent removal instrument 1 (Fig. 1(A)) and a male ureteral stent removal instrument 2 (Fig. 1(B)) will be described. The female ureteral stent removal instrument 1 and the male ureteral stent removal instrument 2 are configured to fit the shape of the respective urethras and have different shapes.

[0021] 1(A) and 1(B), the ureteral stent removal instruments 1 and 2 are rod-shaped members made of resin. The resin from which the ureteral stent removal instruments 1 and 2 are made is, for example, polypropylene, polyethylene, polyolefin, silicone rubber, latex, etc., which are widely used in medical instruments. The ureteral stent removal instruments 1 and 2 each include a cylindrical or elliptical cylindrical main body 11 and 21, a gripping portion 12 and 22 that is gripped by an operator, and a hooking portion 13 and 23 for hooking a ureteral stent.

[0022] The main body 11, 21 is a cylindrical or elliptical cylindrical part connecting the gripping part 12, 22 and the hooking part 13, 23. The size of the outer diameter of the main body 11, 21 is determined taking into consideration the thickness of the urethra, and is, for example, in the range of 5 mm to 8 mm. This allows the ureteral stent to be removed while maintaining strength and without placing an excessive physical burden on the patient. The axial length of the main body 11, 21 is set taking into consideration the length of the urethra. Specifically, it is preferable that the main body 11 of the ureteral stent removal instrument 1 for women is about 3 cm to 5 cm, and the main body 21 of the ureteral stent removal instrument 2 for men is about 20 cm to 25 cm. This allows the hooking parts 13, 23 to be operated in the bladder to hook and remove the ureteral stent.

[0023] The gripping portions 12, 22 are integrally formed at one end of the main body portions 11, 21, and are portions that are gripped by an operator such as a doctor. The gripping portions 12, 22 may be formed with projections and recesses by embossing, groove processing, or the like, so that they are less likely to slip when gripped by an operator. The gripping portions 12, 22 may also be formed continuously from the main body portions 11, 21, and may not have projections and recesses. This allows the operator to freely select a gripping position without feeling uncomfortable while operating the ureteral stent removal instruments 1, 2.

[0024] The axial length of the gripping parts 12, 22 is not particularly limited, but is preferably about 10 cm so that the operator can easily grip and operate it. The gripping parts 12, 22 may also be in the shape of an elliptical cylinder or a rectangular cylinder such as a hexagonal cylinder. This reduces the risk of the ureteral stent removal instruments 1, 2 rotating unintentionally, such as when the ureteral stent removal instruments 1, 2 slip in the operator's hand, and allows for safer and more reliable removal of the ureteral stent.

[0025] The hooks 13, 23 are formed continuously at the ends of the main bodies 11, 21 on the opposite side to the grips 12, 22. As shown in Fig. 1, the angles of the hooks 13, 23 relative to the main bodies 11, 21 differ between the female ureteral stent removal instrument 1 and the male ureteral stent removal instrument 2.

[0026] Since the female urethra is shorter and straighter than the male urethra, the hooking portion 13 of the female ureteral stent removal instrument 1 is formed linearly from the main body 11 as shown in FIG. 1(A). Since the male urethra is longer and has a more complicated shape than the female urethra, the hooking portion 23 is formed to be bent with respect to the main body 21 and the gripping portion 22 so as to enable smoother insertion and removal. More specifically, as shown in FIG. 1(B), the main body 21 of the male ureteral stent removal instrument 2 has a bent portion 21a whose axial direction is bent at an angle θ of 5 degrees or more and 20 degrees or less. The bent portion 21a is formed at a position relatively close to the hooking portion 23. The tip portion including the hooking portion 23 is bent at 5 to 20 degrees with respect to the axial direction of the main body 21 on the gripping portion 22 side. This allows the ureteral stent removal instrument 2 to be smoothly inserted into the male ureter, reducing the physical burden on the patient.

[0027] As shown in FIG. 2, the hooks 13, 23 are formed in a hook shape that opens toward the main body 11, 21 so that a part of a ureteral stent placed in the body can be hooked. The outer shape of the hooks 13, 23 as viewed in the axial direction of the main body 11, 21 is formed to fit within the outer shape of the main body 11, 21. More specifically, as shown in FIG. 3, which is a combination of the side view of FIG. 1(A) and a partial projection in the direction of the white arrow in FIG. 1(B), the outer shape of the hook-shaped hooks 13, 23 fits within the outer shape of the main body 11, 21. Although the main body 11, 21 according to this embodiment is cylindrical and has a circular cross section, even if the main body 11, 21 is an elliptical cylindrical shape and has an elliptical cross section, the outer shape of the hook-shaped hooks 13, 23 is formed to fit within the outer shape of the cross section of the main body 11, 21 (FIG. 4). This makes it possible to smoothly insert and remove the ureteral stent removal instruments 1 and 2 from the ureter, thereby reducing the physical burden on the patient.

[0028] The length of the gap 13a, 23a formed in the hooking portion 13, 23 according to this embodiment, through which the ureteral stent is hooked and introduced, is 5 mm or more and 20 mm or less. This allows efficient operation without excessively large movements when hooking the ureteral stent on the hooking portion 13, 23. In addition, the width of the opening 13b, 23b of the gap 13a, 23a is formed to be 2 mm or more and 10 mm or less. This allows a general ureteral stent with an outer diameter of about 1.6 to 2.7 mm to be smoothly introduced into the groove.

[0029] Furthermore, guide portions 13c, 23c are formed on the main body portion 11, 21 side of the openings 13b, 23b so as to form an angle of 30 to 45 degrees with respect to the axial direction of the main body portion 11, 21. This allows the ureteral stent to be smoothly introduced into the gaps 13a, 23a.

[0030] The width of the gaps 13a, 23a may be constant, but in this embodiment, it is gradually decreased from the openings 13b, 23b toward the terminal ends 13d, 23d (FIG. 2). As a result, when the ureteral stent removal devices 1, 2 are removed, the ureteral stent is guided to the terminal ends 13d, 23d of the gaps 13a, 23a and is held by the gaps 13a, 23a, so that the ureteral stent can be removed more reliably. The width L of the innermost terminal ends 13d, 23d of the gaps 13a, 23a is formed to be 1 mm or less. As a result, a general ureteral stent with an outer diameter of about 1.6 to 2.7 mm can be held more reliably.

[0031] As described above, the ureteral stent removal instruments 1, 2 according to the present embodiment have a simple structure and can be manufactured at low cost. In addition, since the ureteral stent removal instruments 1, 2 can be manufactured as resin members, they can be manufactured at low cost and can be made disposable (throw-away). This eliminates the need to sterilize and clean the instruments used to remove the ureteral stent, making it possible to reduce the risk of infection. In addition, the ureteral stent can be replaced and removed safely and at low cost. In addition, since the ureteral stent removal instruments 1, 2 are integrally formed from resin, variations in the length and thickness of the main body 11, 21 and the shape of the hook 13, 23 can be easily prepared at low cost, so that the ureteral stent removal instruments 1, 2 can be selected according to the patient's body type, etc., and the physical burden on the patient can be reduced.

[0032] A ureteral stent removal method using the ureteral stent removal instruments 1 and 2 of the present embodiment will be described below.

[0033] First, a method for removing a ureteral stent using a female ureteral stent removal instrument 1 will be described. In this embodiment, the ureteral stent in the bladder is hooked with the ureteral stent removal instrument 1 under X-ray fluoroscopy and removed. To prepare for this, an operator such as a doctor irradiates the vicinity of the bladder of a female patient on an operating table with X-rays. The operator holds the main body 11 or the gripping portion 12 of the ureteral stent removal instrument 1 with his or her fingers, and inserts the ureteral stent removal instrument 1 from the hooking portion 13 side into the urethra of the patient.

[0034] While checking the X-ray fluoroscopic image, the operator stops the insertion when the hook part 13 reaches inside the bladder. Then, the operator operates the hook part 13 so that a part of the pigtail part of the ureteral stent in the bladder is hooked on the opening 13b of the hook part 13.

[0035] After a part of the ureteral stent is caught in the opening 13b, the operator gently pulls the ureteral stent removal instrument 1 out of the urethra. When removal of the ureteral stent removal instrument 1 is started, the ureteral stent introduced from the opening 13b along the guide portion 13c into the gap 13a moves toward the terminal end 13d of the gap 13a due to the frictional resistance of the ureteral stent placed in the body. As it moves, the ureteral stent is clamped in the gradually narrowing gap 13a and is held more securely.

[0036] As the ureteral stent removal instrument 1 is removed, the placed ureteral stent is pulled by the portion clamped in the gap 13a of the hook-shaped catch 13 and removed to the outside of the body.

[0037] Next, a method for removing a ureteral stent using the male ureteral stent removal instrument 2 will be described. In order to accommodate the long and complex shape of the male urethra, the main body 21 of the male ureteral stent removal instrument 2 is bent near the hook 23. When inserting and removing the bent hook 23, the male ureteral stent removal instrument 2 is inserted with the ureteral stent removal instrument 2 covered with the outer tube 30 so as not to damage the urethra.

[0038] The outer cylinder 30 is a tubular member, and is, for example, a member made of metal, resin, or the like, formed to match the outer shape of the ureteral stent removal instrument 2. The material of the outer cylinder 30 is preferably a stretchable resin such as polypropylene, polyethylene, polyolefin, silicone rubber, latex, or the like. The outer cylinder 30 according to this embodiment is a stretchable silicone rubber member formed so that the inner diameter is smaller than the outer diameter of the main body 21 of the ureteral stent removal instrument 2. As a result, the outer cylinder 30 contracts to enclose the hook portion 23 of the ureteral stent removal instrument 2, and the ureteral stent removal instrument 2 can be safely and smoothly inserted into the urethra.

[0039] In preparation, the operator covers the ureteral stent removal instrument 2 with the outer tube 30. At this time, the operator inserts the ureteral stent removal instrument 2 into the outer tube 30 so that the outer tube 30 covers at least the opening 23b of the hook 23. Next, while irradiating the vicinity of the bladder of a male patient on the operating table with X-rays, the operator grasps the main body 21 or the gripping portion 22 of the ureteral stent removal instrument 2 with his fingers and inserts the ureteral stent removal instrument 2 from the hook 23 side into the urethra of the patient.

[0040] While checking the X-ray fluoroscopic image, the operator stops the insertion when the hooking portion 23 reaches the bladder. The operator slides the outer tube 30 relative to the ureteral stent removal instrument 2 to expose the hooking portion 23. Then, the operator operates the outer tube 30 so that a part of the pigtail portion of the ureteral stent in the bladder is hooked on the opening 23b of the hooking portion 23.

[0041] After a portion of the ureteral stent is caught in the opening 23b, the operator gently pulls the ureteral stent removal device 2 out of the urethra. When removal of the ureteral stent removal device 2 is started, the ureteral stent introduced from the opening 23b along the guide portion 23c into the gap 23a moves toward the terminal end 23d of the gap 23a due to the frictional resistance of the ureteral stent placed in the body. As it moves, the ureteral stent is clamped in the gradually narrowing gap 23a and is held more securely.

[0042] In this embodiment, after a part of the ureteral stent is caught in the opening 23b, the operator gently pulls out the ureteral stent removal instrument 2 from the urethra, but this is not limited to the above. For example, after a part of the ureteral stent is caught in the opening 23b, the operator may slide the outer tube 30 relative to the ureteral stent removal instrument 2, and remove the ureteral stent removal instrument 2 in a state where the outer tube 30 encloses the hook portion 23. This allows the ureteral stent to be removed more safely.

[0043] As the ureteral stent removal instrument 2 is removed, the placed ureteral stent is pulled by the portion clamped in the gap 23a of the hook-shaped catch 23 and removed to the outside of the body.

[0044] As described above, the ureteral stent removal devices 1, 2 according to the present embodiment have a simple structure including a hook-shaped hook portion 13, 23 formed on the end of a rod-shaped member and a cylindrical or elliptical cylindrical main body portion 11, 21. Furthermore, the outer shape of the hook portion 13, 23 as viewed in the axial direction of the main body portion 11, 21 is formed to fit within the outer shape of the main body portion 11, 21. This reduces the risk of damaging the patient's urethra and allows the placed ureteral stent to be removed safely and easily. [Industrial Applicability]

[0045] The present invention is suitable for removing ureteral stents. [Explanation of symbols]

[0046] 1, 2 ureteral stent removal instrument, 11, 21 main body, 21a bending portion, 12, 22 gripping portion, 13, 23 hook portion, 13a, 23a gap portion, 13b, 23b opening portion, 13c, 23c guide portion, 13d, 23d terminal portion, 30 outer tube

Claims

1. Formed from a rod-shaped member, a hook-shaped hook portion formed at one end of the rod-shaped member for hooking a part of a stent placed in the body; a grip portion formed at the other end of the rod-shaped member and held by an operator with his / her fingers; A cylindrical or elliptical cylindrical main body portion connecting the hook portion and the grip portion, The hook portion is open on the main body side, The outer shape of the hook portion as viewed in the axial direction of the main body portion is formed to fit within the outer shape of the main body portion. A ureteral stent removal instrument comprising:

2. Formed from a rod-shaped member, a hook-shaped hook portion formed at one end of the rod-shaped member for hooking a part of a stent placed in the body; a grip portion formed at the other end of the rod-shaped member and held by an operator with his / her fingers; A cylindrical or elliptical cylindrical main body portion connecting the hook portion and the grip portion, The hook portion is open on the main body side, The outer shape of the hook portion as viewed in the axial direction of the main body portion is formed to fit within the outer shape of the main body portion, The main body portion has a bent portion in which the axial direction is bent at an angle of 5 degrees or more and 20 degrees or less. A ureteral stent removal instrument comprising:

3. The outer diameter of the main body is 5 mm or more and 8 mm or less.

3. The ureteral stent removal instrument according to claim 1 or 2.

4. The length of the gap formed in the hook portion and into which the stent is introduced is 5 mm or more and 20 mm or less.

3. The ureteral stent removal instrument according to claim 1 or 2.

5. The width of the opening of the gap formed in the hook portion and into which the stent is introduced is 2 mm or more and 10 mm or less.

3. The ureteral stent removal instrument according to claim 1 or 2.

6. The width of the gap gradually decreases from the opening side to the end side.

6. A ureteral stent removal instrument according to claim 5.

7. The width of the end of the gap is 1 mm or less.

7. The ureteral stent removal instrument according to claim 6.

8. 2. The ureteral stent removal device according to claim 1 is inserted into the urethra from the hook portion, the hooking portion is hooked onto a pigtail portion of the ureteral stent placed in the bladder, and the ureteral stent removal instrument is removed to remove the ureteral stent. A method for removing a ureteral stent comprising the steps of:

9. 3. The ureteral stent removal device according to claim 2 is inserted into an elastic outer cylinder and then inserted into the urethra from the hook portion, When the hook portion reaches the inside of the bladder, the hook portion is exposed from the outer tube. the hooking portion is hooked onto a pigtail portion of the ureteral stent placed in the bladder, and the ureteral stent removal instrument is removed to remove the ureteral stent. A method for removing a ureteral stent comprising the steps of:

10. After the hooking portion is hooked onto the ureteral stent, the outer cylinder is slid relative to the ureteral stent removal instrument, and the ureteral stent removal instrument is removed in a state in which the outer cylinder encloses the hooking portion. The method for removing a ureteral stent according to claim 9 .

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