Conduit system
By introducing a protrusion into the catheter system and cooperating with the endoscope, the problem of narrow field of view in fallopian tube endoscopy was solved, enabling efficient insertion and accurate positioning of the balloon, thus improving the efficiency and safety of fallopian tube treatment.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- TERUMO KK
- Filing Date
- 2021-09-30
- Publication Date
- 2026-08-04
AI Technical Summary
In existing technologies, the narrow field of view and short focal distance of fallopian tube endoscopes make it difficult to efficiently insert the balloon into the fallopian tube opening, and the low quality of the captured images makes it difficult to accurately locate the balloon insertion position.
A catheter system was designed, comprising an outer tube, an inner tube, and a balloon. The outer tube has a protrusion at its tip. An endoscope is inserted into the balloon lumen, and the position of the protrusion is confirmed by taking images through the endoscope. The protrusion is used to locate the target site for balloon insertion, and the balloon tip is everted and inserted by pushing force.
This improved the efficiency of balloon insertion into the biological tube opening, ensured accurate positioning of the external tube's tip opening, and clearly displayed the protrusion on the endoscopic image, reducing damage to biological tissues and achieving highly efficient fallopian tube treatment.
Smart Images
Figure CN115025373B_ABST
Abstract
Description
Technical Field
[0001] This invention relates to catheter systems. Background Technology
[0002] For example, Patent Document 1 discloses a catheter system comprising a balloon catheter and a fallopian tube endoscope (endoscopy) for treating lesions (stenosis or blockage) of the fallopian tube. The balloon catheter comprises: a flexible outer tube; an inner tube disposed within the lumen of the outer tube in a manner that allows it to move relative to the outer tube in the axial direction of the outer tube; and a tubular balloon that connects the front end of the outer tube to the front end of the inner tube and expands radially inward toward the outer tube.
[0003] During salpingectomy under salpingoscopy, the balloon is supported by the linear insertion part of the fallopian tube. The balloon is in an inflated state and is pushed forward from the inner tube to the front end. As a result, the front end of the balloon is everted and protrudes from the front opening of the outer tube and is inserted into the fallopian tube opening.
[0004] Existing technical documents
[0005] Patent documents
[0006] Patent Document 1: Japanese Patent No. 3921108 Summary of the Invention
[0007] However, compared to hysteroscopy, which observes the inside of the uterus, the fallopian tube endoscope inserted into the balloon has a narrower field of view and a shorter focal distance. Furthermore, the images captured by the fallopian tube endoscope are darker and of lower quality than those captured by the hysteroscopy. Therefore, users may find it difficult to locate the fallopian tube opening based on the images captured by the fallopian tube endoscope, and may be unable to efficiently insert the balloon into the fallopian tube opening (the opening of the biological tube).
[0008] This invention was made in consideration of such a problem, and its purpose is to provide a catheter system that can efficiently insert a balloon into the orifice of a living organism.
[0009] One aspect of the present invention is a catheter system comprising: a balloon catheter having a flexible outer tube, an inner tube disposed in the lumen of the outer tube in a manner movable relative to the outer tube in the axial direction of the outer tube, and a tubular balloon that connects the front end of the outer tube to the front end of the inner tube and expands radially inward toward the outer tube; and an endoscope having a linear insertion portion inserted into the lumen of the balloon. In this catheter system, the front end of the balloon protrudes toward the front end from the front opening of the outer tube while being everted outward. The outer tube has a tubular outer tube body, an outer tube front end provided at the front end of the outer tube body and having the front opening, and a protrusion protruding from the outer tube front end in the front end, the protrusion being integrally formed on the outer tube front end.
[0010] Invention Effects
[0011] According to the present invention, by inserting the protrusion into the insertion site of the balloon and confirming the visibility of the protrusion using endoscopic images (endoscopic images), it is easy to distinguish whether the insertion site is a biological opening or simply a recess. Thus, the user can easily locate the biological opening (e.g., the fallopian tube opening) based on the endoscopic images. Furthermore, by inserting the protrusion into the biological opening, the tip opening of the outer tube can be positioned relative to the biological opening. Therefore, the balloon can be inserted into the biological opening efficiently. Attached Figure Description
[0012] Figure 1 This is a schematic structural diagram of a catheter system according to one embodiment of the present invention.
[0013] Figure 2 yes Figure 1 A longitudinal sectional view of an omitted portion of the conduit system.
[0014] Figure 3 yes Figure 2 An enlarged longitudinal section view of an omitted portion of the outer tube.
[0015] Figure 4 yes Figure 3 A diagram showing the outer tube as viewed from the front of the front opening.
[0016] Figure 5A yes Figure 2 A three-dimensional view of the tip side of the balloon catheter. Figure 5B yes Figure 5A A top view of the balloon catheter from the cap side, showing the tip of the catheter.
[0017] Figure 6 This is an explanatory diagram showing the angle formed by the front face of the endoscope and the protrusion.
[0018] Figure 7 Is using Figure 1 The first illustration shows the endoscopic tubal salpingography using a balloon catheter.
[0019] Figure 8 This is the second illustration of the aforementioned endoscopic fallopian tube reconstruction procedure.
[0020] Figure 9 This is the third illustration of the aforementioned tuboscopic tuboformation procedure.
[0021] Figure 10 This is the fourth illustration of the aforementioned tuboscopic tuboformation procedure.
[0022] Figure 11 This is the fifth illustration of the aforementioned endoscopic fallopian tube reconstruction procedure.
[0023] Figure 12 This is the sixth illustration of the aforementioned tuboscopic tuboformation procedure.
[0024] Figure 13 This is the 7th illustration of the aforementioned tuboscopic tuboformation procedure.
[0025] Figure 14A This is a perspective view of the tip side of the balloon catheter in the first modified example. Figure 14B yes Figure 14A A top view of the balloon catheter from the cap side, showing the tip of the catheter.
[0026] Figure 15A This is a three-dimensional view of the tip side of the balloon catheter in the second modification example. Figure 15B yes Figure 15A A top view of the balloon catheter from the cap side, showing the tip of the catheter.
[0027] Figure 16 This is a three-dimensional view of the front end of the balloon catheter in the third modification.
[0028] Figure 17A It means in Figure 16 A three-dimensional diagram illustrating the state in which the protruding end of the balloon catheter is inserted into the anterior opening. Figure 17B It is a cross-sectional diagram illustrating the action of exposing the protruding end of the protrusion from the front opening toward the front.
[0029] Figure 18A This is a three-dimensional view of the tip side of the balloon catheter in the fourth variation. Figure 18B It means in Figure 18A A diagram illustrating the angle between the tip of the endoscope and the protrusion in a balloon catheter.
[0030] Figure 19This is a three-dimensional view of the front end of the balloon catheter in the fifth variation.
[0031] Explanation of reference numerals in the attached figures
[0032] 10…Catheter system 12, 12A~12E…Balloon catheter
[0033] 14…Endoscope 18, 18a~18d…Sliding component
[0034] 22…balloon 24, 24a~24d…outer tube
[0035] 30…Outer tube body 34…First inner cavity
[0036] 36…front opening; 38, 38a…outer tube body
[0037] 40, 40a~40c…protrusions 52…region 1
[0038] 54…Region 2, 72, 72a…Slider body
[0039] 74, 74a~74c…cover section 78…inner tube
[0040] 100… Insertion section 102… Filming section
[0041] 104…front face L1…protruding length
[0042] Lc…tangent P1…base endpoint
[0043] θ1…first angle θ2…second angle. Detailed Implementation
[0044] Hereinafter, preferred embodiments of the catheter system of the present invention will be described, with reference to the accompanying drawings. Figure 1 The explanation will be provided later.
[0045] like Figure 1 As shown, a catheter system 10 according to one embodiment of the present invention includes a balloon catheter 12 and an endoscope 14 (fallopian tube endoscope) as a medical device. Figures 7-13 As shown, the catheter system 10 is used for, for example, endoscopic salpingography to treat lesions 204 (stenosis or blockage, etc.) in the fallopian tube 202. However, in addition to the fallopian tube 202, the catheter system 10 can also be used to treat lesions in other biological tubes such as blood vessels, bile ducts, trachea, esophagus, urethra, large intestine, and other organs.
[0046] In the following description of the catheter system 10, Figure 1 The left side (in the direction of arrow X1) is called the "front end". Figure 1 The right side (in the direction of arrow X2) is called the "base".
[0047] like Figure 1 and Figure 2 As shown, the balloon catheter 12 includes an outer catheter 16, a slider 18 disposed on the outer catheter 16, an inner catheter 20 inserted into the outer catheter 16, and a balloon 22.
[0048] The outer conduit 16 includes: a flexible, long outer tube 24, an outer tube seat 26 (outer tube operating part) provided at the base end of the outer tube 24, and a fixing screw 28 provided at the outer tube seat 26. The overall length of the outer tube 24 is preferably set to 100 mm or more and 1500 mm or less, and more preferably set to 200 mm or more and 1000 mm or less.
[0049] exist Figure 2 In this design, the outer tube 24 includes an outer tube body 30 and a front end component 32 (front end head) located at the front end of the outer tube body 30. Examples of materials used to construct the outer tube body 30 and the front end component 32 include polyolefins (e.g., polyethylene, polypropylene, polybutene, etc.), polyesters (e.g., polyethylene terephthalate, etc.), elastomer resins (e.g., polyolefin elastomers, polyester elastomers, polyamide elastomers, fluoropolymer elastomers, polyurethane elastomers, etc.), flexible polymer materials (polytetrafluoroethylene, polyimide, ethylene-vinyl acetate copolymer, silicone rubber, etc.), soft polyvinyl chloride, polyurethane, polyamide, etc. Furthermore, the outer tube body 30 and the front end component 32 can also be integrally formed.
[0050] A first inner cavity 34 is formed in the outer tube body 30, extending from the front end to the base end. The front end of the outer tube body 30 is shaped by bending into an arc in the axial direction. The outer tube body 30 has a substantially constant outer diameter along its entire length.
[0051] like Figures 2-4 As shown, the front end component 32 has: an outer tube front end portion 38 located at the front end of the outer tube body 30 and having a front end opening 36, and a protrusion 40 protruding from the outer tube front end portion 38 in the front end direction. The front end component 32 is a one-piece molded article. In other words, the protrusion 40 is integrally formed on the outer tube front end portion 38.
[0052] The outer peripheral surface of the front end 38 of the outer tube is bent to prevent damage to biological tissue. At the front end 38 of the outer tube, a balloon exit hole 42 is formed for the balloon 22 to be extended in the forward direction (arrow X1 direction) compared to the front end 38 of the outer tube.
[0053] The balloon exit port 42 includes: a first port 44 communicating with and extending linearly into the first inner cavity 34 (inner cavity 94 described later); and a second port 46 communicating with and extending linearly into the first port 44. Both the first port 44 and the second port 46 have a circular cross-section. The diameter of the first port 44 is the same as the diameter of the second port 46. The extension direction of the second port 46 is inclined relative to the extension direction of the first port 44. The second port 46 communicates with the front opening 36 of the outer tube 24. The wall portion located on the outer periphery of the front opening 36 has a semi-circular cross-section. That is, the front end face 48 of the front end portion 38 of the outer tube is curved into an arc-shaped cross-section. The front opening 36 faces a direction intersecting the first centerline La of the first port 44.
[0054] A circular opening connecting portion 50 is provided at the boundary between the front opening 36 and the second hole 46. For example... Figure 4 As shown, when viewed from the extension direction of the second centerline Lb of the front opening 36 (front opening 36 viewed from the front), the front end portion 38 of the outer tube includes a first region 52 located on the front end side compared to the tangent line Lc passing through the point (base endpoint P1) in the base end direction (arrow X2 direction) in the outer periphery of the opening connection portion 50, and a second region 54 located on the base end side compared to the tangent line Lc. The wall thickness of the first region 52 is thicker than the wall thickness of the second region 54 (see reference). Figure 2 and Figure 3 ).
[0055] exist Figures 2-4 In the middle, the protrusion 40 protrudes from the first region 52 of the front end 38 of the outer tube toward the front end. Specifically, the protrusion 40 is located on the opposite side of the base endpoint P1 relative to the second centerline Lb. Figure 3 In this design, the protruding length L1 of the protrusion 40 (the distance from the front end face 48 of the outer tube front end 38 to the protruding end of the protrusion 40) is set to be 1.5 mm or more and 60 mm or less. Preferably, the protruding length L1 of the protrusion 40 is set to be in the range of 2 mm or more and 7 mm or less. The protrusion 40 is flexible. That is, the protrusion 40 is formed to flex when in contact with the inner surface of the fallopian tube 202 or the uterus. Materials that are the same as those used for the outer tube body 30 can be used as the constituent material of the protrusion 40.
[0056] The protrusion 40 is formed to be narrow and thin in the direction of protrusion. The protrusion 40 includes a flat inner protrusion surface 56 on the side where the front opening 36 is located, and a curved outer protrusion surface 60 on the opposite side of the inner protrusion surface 56.
[0057] The base end of the inner surface 56 of the protrusion is connected to the front end face 48 of the front end portion 38 of the outer tube. The base end of the outer surface 60 of the protrusion is connected to the outer peripheral surface of the front end portion 38 of the outer tube. The base end of the outer surface 60 is located in the base end direction (arrow X2 direction) compared to the base end of the inner surface 56 of the protrusion. The width of the base end of the outer surface 60 (the widest part of the protrusion 40) is greater than the diameter of the front opening 36. The front end of the outer surface 60 is the protruding end of the protrusion 40 and is located in the front end direction compared to the front end of the inner surface 56 of the protrusion.
[0058] like Figure 1 and Figure 2 As shown, the outer tube seat 26 is made of rigid resin or metal (stainless steel, titanium, titanium alloy, etc.). Examples of rigid resins include polycarbonate, acrylic resin, polyester, polyolefin, styrene resin, polyamide, polysulfone, acrylate polymer, polyetherimide, etc.
[0059] exist Figure 2 In this design, the outer tube seat 26 is hollow, sized for easy manual operation. The outer tube seat 26 includes a first space 64 communicating with the first inner cavity 34 of the outer tube 24, a first insertion hole 66 located at the base of the first space 64 for the inner catheter 20 to pass through, and a first inlet port 68 for introducing balloon dilation fluid into the first space 64. The balloon dilation fluid is used to... Figure 2 The balloon 22 shown expands radially inward toward the outer tube 24. The balloon dilation fluid is, for example, physiological saline. A first sealing member 70 is provided at the outer tube seat 26 to prevent the balloon dilation fluid in the first space 64 from leaking to the outside through the first insertion hole 66.
[0060] The fixing screw 28 is used to secure the inner conduit 20 relative to the outer tube seat 26. The fixing screw 28 may be made of the same material as the outer tube seat 26.
[0061] like Figure 1 and Figure 2 As shown, the slider 18 is arranged in a state where it can move (slide) relative to the outer peripheral surface of the outer tube body 30 in the axial direction of the outer tube 24. The total length of the slider 18 is shorter than the total length of the outer tube 24. The slider 18 has a long tubular slider body 72, a cover 74 protruding from the front end of the slider body 72 toward the front end, and a slider seat 76 (slider operation part) provided at the base end of the slider body 72. The materials used to construct the slider body 72, the cover 74, and the slider seat 76 are the same as those used to construct the outer tube seat 26.
[0062] like Figure 1 , Figure 2 , Figure 5A and Figure 5BAs shown, in the state where the slider 18 is moved to the foremost side (arrow X1 direction) relative to the outer tube body 30 (the initial state of the slider 18), the foremost side of the outer tube body 30 extends in a straight line along the shape of the slider body 72. Figure 6 and Figure 8 As shown, when the slider 18 is moved to the base side relative to the outer tube body 30 (in the direction of arrow X2) (so that the base of the slider 18 is located at the front end of the outer tube seat 26), the front end side of the outer tube body 30 is exposed to the front end side and bent into an arc shape compared to the slider body 72.
[0063] exist Figure 1 , Figure 2 , Figure 5A and Figure 5B In the initial state of the slider 18, the cover 74 covers the protrusion 40. In other words, in the initial state of the slider 18, the inner surface of the cover 74 is opposite to the inner protruding surface 56 of the protrusion 40. The cover 74 covers the front end 38 (front opening 36) of the outer tube in the initial state of the slider 18. In the initial state of the slider 18, the protruding end of the cover 74 is located at the same position as the protruding end of the protrusion 40 in the axial direction of the slider body 72 (see reference). Figure 5B However, the protruding end of the cover 74 may also be located on the front end side compared to the protruding end of the protrusion 40 in the initial state of the slider 18.
[0064] The longitudinal and cross sections of the cover 74 are both formed into arc shapes. Figure 5B In the cover portion 74, the central portion in the protruding direction of the cover portion 74 has the largest width. In other words, the width of the central portion in the protruding direction of the cover portion 74 is greater than the width of both ends of the cover portion 74. The width of the cover portion 74 gradually increases from the slider body 72 toward the central portion in the protruding direction of the cover portion 74, and gradually narrows from the central portion toward the protruding ends of the cover portion 74. The width of the central portion in the protruding direction of the cover portion 74 is larger than the outer diameter of the slider body 72. The size of the cover portion 74 can be appropriately set.
[0065] exist Figure 1 and Figure 2 In this design, the sliding seat 76 is formed in a ring shape to facilitate manual operation. The inner guide tube 20 includes an inner tube 78 of a long length and an inner tube seat 80 (inner tube operating part) provided at the base end of the inner tube 78. The total length of the inner tube 78 is preferably set to 100 mm or more and 1500 mm or less, and more preferably to 200 mm or more and 1000 mm or less.
[0066] exist Figure 2In the inner tube 78, relatively rigid resins (e.g., fluororesin, polycarbonate, polyimide, PEEK resin, etc.) or metals (e.g., stainless steel, titanium, titanium alloy, etc.) can be used as constituent materials. A second inner cavity 82 is formed in the inner tube 78, extending from the front end to the base end.
[0067] The inner tube 78 passes through the outer tube seat 26 and is disposed in the first inner cavity 34 of the outer tube body 30. The front end of the inner tube 78 is located in the base direction (arrow X2 direction) compared with the front end of the outer tube body 30. Between the outer peripheral surface of the inner tube 78 and the inner peripheral surface of the outer tube body 30, there is an outer lumen Sa (expansion lumen) for the flow of balloon dilation fluid.
[0068] An elongated insertion portion 100, which also functions as a balloon support device, is inserted into the second inner cavity 82 of the inner tube 78. With the insertion portion 100 inserted into the second inner cavity 82 of the inner tube 78, an inner lumen Sb (irrigation lumen) for the flow of irrigation fluid is formed between the inner tube 78 and the insertion portion 100. The irrigation fluid is, for example, physiological saline.
[0069] The inner tube seat 80 is made of the same material as the outer tube seat 26. The inner tube seat 80 is hollow. The inner tube seat 80 has a second space 84 communicating with the second inner cavity 82 of the inner tube 78, a second insertion hole 86 located on the base end side of the second space 84 for the insertion part 100 to pass through, and a second inlet port 88 for introducing irrigation fluid into the second space 84. The inner tube seat 80 has a second sealing member 90 for preventing the irrigation fluid in the second space 84 from leaking to the outside through the second insertion hole 86.
[0070] The balloon 22 is a tubular component that connects the front end of the outer tube 24 to the front end of the inner tube 78. The balloon 22 expands radially inward through the balloon expansion fluid. In other words, the balloon 22 is configured to elastically deform in the radial direction.
[0071] The constituent material of the balloon 22 is preferably composed of polyolefins (e.g., polyethylene, polypropylene, polybutene, etc.), polyesters (polyethylene terephthalate, etc.), elastomer resins (polyolefin elastomers, polyester elastomers, polyamide elastomers, fluoropolymer elastomers, polyurethane elastomers, etc.), flexible polymer materials (natural rubber, ethylene propylene copolymer, polytetrafluoroethylene, polyimide, ethylene-vinyl acetate copolymer, silicone rubber, etc.), soft polyvinyl chloride, polyurethane, polyamide, polyisoprene, polyester, etc.
[0072] One end of the balloon 22 is bonded or fused to the front end of the outer tube 24 (the base end of the front end 38 of the outer tube). In other words, one end of the balloon 22 is bonded or fused to the vicinity of the base end of the balloon outlet 42 in the outer tube 24. Specifically, one end of the balloon 22 is clamped between the front end of the outer tube body 30 and the front end member 32. The other end of the balloon 22 is fixed to the outer peripheral surface of the front end of the inner tube 78 by the balloon fixing member 92. Alternatively, the other end of the balloon 22 may also be bonded or fused to the front end of the inner peripheral surface of the inner tube 78. The balloon 22 has an inner cavity 94 into which the insertion part 100 of the endoscope 14 can be inserted. Between the outer peripheral surface of the balloon 22 and the inner peripheral surface of the outer tube body 30, a pouch-shaped outer space Sc with the front end closed is formed.
[0073] like Figure 11 As shown, in balloon 22, by transmitting a thrust (thrust in the front direction) from the inner tube 78 to balloon 22, the front end 22a of balloon 22 folds outward and protrudes in the front direction from the front opening 36 of the outer tube 24. At this time, in the protruding portion 22b of balloon 22 that protrudes in the direction of arrow X1 compared to the front opening 36 of the outer tube 24, two layers are formed that overlap radially.
[0074] like Figure 2 and Figure 6 As shown, endoscope 14 is used to observe fallopian tube 202 (see reference). Figure 8 The fallopian tube endoscope 14 has a flexible insertion portion 100 that is inserted into the second lumen 82 of the inner tube 78 of the balloon catheter 12 and the lumen 94 of the balloon 22. Figure 6 In the insertion part 100, a shooting part 102 is provided on the flat front end surface 104 for taking pictures of the front end of the insertion part 100.
[0075] With the endoscope 14's front end face 104 positioned at or near the front end opening 36, the angle (hereinafter referred to as "first angle θ1") between the protrusion 40 (protrusion inner surface 56) and the front end face 104 is set to 40° or more and 150° or less. When the first angle θ1 is less than 40°, the protrusion 40 obstructs the movement of the balloon 22 when it protrudes from the front end opening 36 towards the front end, posing a risk of damage to the balloon 22 due to the protrusion 40. When the first angle θ1 is greater than 150°, the protrusion 40 is difficult to visually identify in the image captured by the endoscope 14 (endoscope image), and the protrusion 40 is prone to contacting the inner surface of the fallopian tube 202 (potentially damaging the inner surface of the fallopian tube 202 due to the protrusion 40). The first angle θ1 is more preferably 55° or more and 105° or less. In this case, the mobility of the balloon 22 and the visual recognizability of the protrusion 40 displayed on the endoscopic image are further improved.
[0076] Next, the endoscopic tubal salpingectomy using the catheter system 10 constructed in this manner will be described.
[0077] In the fallopian tube reconstruction under endoscopic tubal ossification, the aforementioned catheter system 10 is prepared during the preparation process. Then, the user secures the inner tube 78 by using the fixing screw 28 while it is fully pulled to the base side (arrow X2 direction). Furthermore, the sliding member 18 is set to its initial state. As a result, the front end of the outer tube body 30 extends straight due to the sliding member body 72, and the protrusion 40 is covered by the cover portion 74.
[0078] Next, during the insertion procedure, the user inserts the balloon catheter 12 through the cervical canal to the fundus 200 of the uterus. At this time, because the cover 74 covers the protrusion 40, the protruding end of the protrusion 40 is prevented from touching the inner wall of the uterus (because the protrusion 40 would damage the inner surface of the uterus).
[0079] Then, during the sliding process, the slider 18 is pulled back relative to the outer tube 24 towards the base end of the outer tube 24. As a result, the front end of the outer tube body 30 protrudes from the slider 18 and becomes curved. Furthermore, the protruding end of the cover 74 is located on the base end side compared to the front end portion 38 of the outer tube. In other words, the protrusion 40 is fully exposed. At this time, the user positions the front end face 104 of the insertion portion 100 of the endoscope 14 near or at the front opening 36 of the front end portion 38 of the outer tube. As a result, the endoscope 14 takes an image of the balloon catheter 12 from the front opening 36 of the outer tube 24 towards the front end. The endoscopic image taken by the endoscope 14 is displayed on a display unit (monitor) (not shown). Furthermore, the protrusion 40 is displayed on the endoscopic image.
[0080] Then, in the determination process, the user determines the predetermined insertion site 203 of the inserted balloon 22 based on the endoscopic image. Next, in the confirmation process, the user manipulates the balloon catheter 12 to insert the protrusion 40 into the insertion site 203 (see reference). Figure 8 The user then uses an endoscopic image to confirm the appearance of the protrusion 40. If, for example, the user confirms with the endoscopic image that the protrusion 40 is inserted into the insertion target 203, the user determines that the insertion target 203 is the fallopian tube opening 202a.
[0081] On the other hand, if the user confirms, for example, through an endoscopic image that the protrusion 40 is not inserted into the insertion target site 203, they determine that the insertion target site 203 is not the fallopian tube opening 202a (for example, it is just a recess). If the user determines that the insertion target site 203 is not the fallopian tube opening 202a, they repeat the above-described determination and confirmation steps until the fallopian tube opening 202a is found.
[0082] If the fallopian tube opening 202a is identified during the confirmation process, the user, after retracting the insertion part 100 of the endoscope 14 a predetermined distance relative to the outer tube 24 (becoming...), Figure 9 After the state shown, the balloon extraction procedure is performed. Specifically, in the balloon extraction procedure, as... Figure 10 As shown, balloon dilation fluid is supplied to the first inlet port 68 (pressurization process). The balloon dilation fluid is then supplied from the first inlet port 68 through the outer lumen Sa to the outer space Sc of the balloon 22. Consequently, the balloon 22 is elastically deformed radially inward by the balloon dilation fluid supplied to the outer space Sc. That is, the portion of the balloon 22 located on the outer periphery of the insertion portion 100 is in close contact with the outer peripheral surface of the insertion portion 100. The inner surfaces of the portion of the balloon 22 located on the front end side of the insertion portion 100 are in contact with each other.
[0083] Then, with the fixing screw 28 loosened, the user operates the inner tube seat 80, causing the inner tube 78 to advance relative to the outer tube 24 (advancing process). Thus, as... Figure 11 As shown, the balloon 22, which is pushed forward by the inner tube 78, moves forward together with the insertion part 100 relative to the outer tube 24. That is, by transmitting the pushing force from the inner tube 7 to the balloon 22, the balloon 22 and the insertion part 100 protrude together from the front opening 36 of the outer tube 24 in the front direction (arrow X1 direction).
[0084] During the forward movement, since one end of the balloon 22 is fixed to the front end of the outer tube 24, the balloon 22 advances while its front end 22a (protruding end) is everted. That is, the balloon 22 is everted with its inner surface of the front end 22a (protruding end) facing outward. Therefore, the balloon 22 advances a distance equivalent to half the forward distance of the insertion part 100.
[0085] Next, the user determines whether the balloon 22 has reached the lesion 204 based on the endoscopic image. When the balloon 22 is located proximal to the lesion 204, the balloon dilation fluid is depressurized and perfusion fluid (perfusion fluid) is supplied to the second inlet port 88 (depressurization process). Thus, the perfusion fluid flows through the inner lumen Sb between the balloon 22 and the insertion portion 100 of the endoscope 14. Then, the user... Figure 12 As shown, the endoscope 14 is moved back a specified distance (retraction process). Then, the above-mentioned pressurization process and forward process are performed again.
[0086] Then, as Figure 13 As shown, if the balloon 22 passes completely through the lesion 204, the lesion 204 is dilated using the balloon 22. That is, the narrowing or blockage of the fallopian tube 202 is improved.
[0087] After dilating the lesion 204, the user removes the balloon catheter 12 and endoscope 14 after decompressing the balloon dilation fluid (removal procedure). Furthermore, before removing the balloon catheter 12, the balloon 22 is retracted by pulling the inner tube 78 while injecting irrigation fluid through the second inlet port 88, and the endoscope 14 is positioned at the anterior end 22a of the balloon 22. This allows for observation of the fallopian tube 202 during the removal procedure. Thus, the endoscopic fallopian tube reconstruction is completed.
[0088] This implementation method achieves the following effects.
[0089] According to this embodiment, by inserting the protrusion 40 into the insertion target portion 203 of the balloon 22 and confirming the visibility of the protrusion 40 using an endoscopic image, it is easy to distinguish whether the insertion target portion 203 is the fallopian tube opening 202a (biological opening) or simply a recess. Therefore, the user can easily locate the fallopian tube opening 202a based on the endoscopic image. Furthermore, by inserting the protrusion 40 into the fallopian tube opening 202a, the front opening 36 of the outer tube 24 can be positioned relative to the fallopian tube opening 202a. Therefore, the balloon 22 can be efficiently inserted into the fallopian tube opening 202a.
[0090] The front end face 48 of the insertion part 100 is provided with a shooting part 102 for taking pictures of the front end of the insertion part 100. When the insertion part 100 is located at or near the front end opening 36, the angle (first angle θ1) formed by the front end face 48 of the insertion part 100 and the protrusion 40 is 40° or more and 150° or less.
[0091] With this structure, the protrusion 40 can be suppressed from becoming an obstacle to the movement of the balloon 22 and the protrusion 40 can be displayed efficiently on the endoscopic image.
[0092] When viewed from the front, the front end portion 38 of the outer tube is divided into a first region 52 located in the front direction relative to the tangent Lc passing through the base endpoint P1 located in the base direction of the outer tube 24, and a second region 54 located in the base direction relative to the tangent Lc. The protrusion 40 is located in the first region 52. The first angle θ1 is 55° or more and 105° or less.
[0093] This structure improves the visual recognizability of the protrusion 40 displayed on the endoscopic image.
[0094] The wall thickness of region 52 is greater than that of region 54.
[0095] With this structure, the protrusion 40 can be supported by the first region 52, which has a relatively thick wall.
[0096] The protrusion length of the protrusion 40 is more than 1.5 mm and less than 60 mm.
[0097] Based on this structure, since the protrusion length of the protrusion 40 is 1.5 mm or more, by inserting the protrusion 40 into the insertion target site 203 of the balloon 22, it is easier to distinguish whether the insertion target site 203 is the fallopian tube opening 202a or simply a recess. Furthermore, since the protrusion length of the protrusion 40 is 60 mm or less, it is possible to prevent the protrusion 40 from becoming an obstruction when inserting the balloon catheter 12 into the uterine fundus 200.
[0098] The balloon catheter 12 has a slider 18 that is configured to move relative to the outer peripheral surface of the outer tube 24 along the axial direction of the outer tube 24 and is used to keep the outer tube 24 in a straight shape. The front end of the outer tube body 30 protrudes from the slider 18 when the slider 18 has been moved relative to the outer tube 24 toward the base end and is curved into an arc shape in the axial direction.
[0099] With this structure, since the outer tube 24 is kept in a straight shape by using the slider 18, it can be easily inserted into the fundus 200 of the uterus. In addition, by moving the slider 18 towards the base after the outer tube 24 is inserted into the fundus 200 of the uterus, the front end of the outer tube body 30 is bent into an arc shape in the axial direction, and the front opening 36 can be easily positioned near the fallopian tube opening 202a.
[0100] The slider 18 has a tubular slider body 72 and a cover 74 protruding from the front end of the slider body 72 toward the front end direction. In the initial state of the slider 18, which causes the slider 18 to move to the maximum extent relative to the outer tube 24 in the front end direction, the cover 74 is located in the front end direction compared to the front end of the front end 38 of the outer tube.
[0101] With this structure, when the outer tube 24 is inserted into the uterine fundus 200, the cover 74 can prevent the protruding end of the protrusion 40 from touching the inner surface of the uterus.
[0102] The cover 74 is opposite to the protrusion 40 in the initial state of the slider 18.
[0103] With this structure, the protruding end of the protrusion 40 can be effectively prevented from contacting the inner surface of the uterus by the cover 74.
[0104] (Example 1)
[0105] Next, while referring to Figure 14A and Figure 14BThe balloon catheter 12A of the first modified example will be described. In addition, in the balloon catheter 12A of this modified example, the same reference numerals are used for structures that are the same as those of the balloon catheter 12 described above, and their descriptions are omitted.
[0106] like Figure 14A and Figure 14B As shown, balloon catheter 12A includes an outer catheter 16a and a slider 18a. Furthermore, the structure of balloon catheter 12A other than the outer catheter 16a and the slider 18a is the same as that of balloon catheter 12 described above.
[0107] The outer tube 24a of the outer conduit 16a includes an outer tube body 30 and a front end component 32a. The front end component 32a has: an outer tube front end portion 38a located at the front end of the outer tube body 30 and having a front end opening 36; and a protrusion 40 protruding from the outer tube front end portion 38a in the frontal direction. The outer tube front end portion 38a has a shape in which a portion of the outer peripheral surface of the aforementioned outer tube front end portion 38 is cut off.
[0108] Specifically, the outer peripheral surface of the front end 38a of the outer tube includes a first curved surface 110 with a semi-circular cross-section, a pair of flat side surfaces 112 located on both sides of the first curved surface 110, and a second curved surface 114 for connecting to the base end of the protrusion 40 (see reference). Figure 14A The first curved surface 110 extends from the second region 54 of the outer tube front end 38a across the first region 52. In other words, the first curved surface 110 extends throughout the second region 54 and a portion of the first region 52. The first curved surface 110 is located radially inward compared to the outer circumferential surface of the outer tube body 30. Each side surface 112 extends along the axial direction (arrow X direction) of the outer tube 24a.
[0109] Slider 18a has a slider body 72a, a cover 74a and a slider seat 76 (see reference). Figure 1 and Figure 2 The front end of the slider body 72a is cut off at an angle relative to its axial direction. As a result, the front end of the slider body 72a is formed into an arc shape (an arc less than 180°). The cover portion 74a protrudes from the front end of the slider body 72a in the forward direction.
[0110] The cover portion 74a is wide in the direction of its protrusion. The front end of the cover portion 74a has an arcuate shape that protrudes towards the front end. In the initial state of the slider 18a, the cover portion 74a covers the protrusion 40. In other words, in the initial state of the slider 18a, the inner surface of the cover portion 74a faces the inner protruding surface 56 of the protrusion 40. In the initial state of the slider 18a, the protruding end of the cover portion 74a is located at the same position as the protruding end of the protrusion 40 in the axial direction of the slider body 72a. However, in the initial state of the slider 18a, the protruding end of the cover portion 74a may also be located on the front end side compared to the protruding end of the protrusion 40.
[0111] In such a balloon catheter 12A, the same effect is achieved for the same structure as the balloon catheter 12 described above.
[0112] (Second variation)
[0113] Next, while referring to Figure 15A and Figure 15B The balloon catheter 12B of the second modification will be described. In addition, in the balloon catheter 12B of this modification, the same reference numerals are used for structures that are the same as those of the balloon catheters 12 and 12A described above, and their descriptions are omitted.
[0114] like Figure 15A and Figure 15B As shown, the balloon catheter 12B includes a slider 18b. Furthermore, the structure of the balloon catheter 12B other than the slider 18b is the same as that of the balloon catheter 12A in the first modified example.
[0115] Slider 18b has a slider body 72, a cover 74b and a slider seat 76 (see reference). Figure 1 and Figure 2 The cover portion 74b protrudes from the front end of the slider body 72 in the forward direction. The cover portion 74b is integrally formed with respect to the slider body 72. The cover portion 74b has a shape in which a portion of the cylindrical portion is obliquely cut off relative to its axis. As a result, the front end of the cover portion 74b is formed into an arc shape (an arc less than 180°). The cover portion 74b is narrow in the direction of its protrusion.
[0116] The cover portion 74b covers the protrusion 40 in the initial state of the slider 18b. In other words, the inner surface of the cover portion 74b faces the inner protruding surface 56 of the protrusion 40 in the initial state of the slider 18b. The protruding end of the cover portion 74b is located at the same position as the protruding end of the protrusion 40 in the axial direction of the slider body 72 in the initial state of the slider 18b. However, the protruding end of the cover portion 74b may also be located on the front end side compared to the protruding end of the protrusion 40 in the initial state of the slider 18b.
[0117] In such a balloon catheter 12B, the same structure as the balloon catheters 12 and 12A described above achieves the same effect.
[0118] (3rd variation)
[0119] Next, while referring to Figures 16-17B The balloon catheter 12C of the third modification will be described. In addition, in the balloon catheter 12C of this modification, the same reference numerals are used for structures that are the same as those of the balloon catheter 12 described above, and their descriptions are omitted.
[0120] like Figure 16 As shown, balloon catheter 12C includes an outer catheter 16b and a slider 18c. Furthermore, the structure of balloon catheter 12C, except for the outer catheter 16b and the slider 18c, is the same as that of balloon catheter 12 described above.
[0121] The outer tube 24b of the outer conduit 16b includes an outer tube body 30 and a front end component 32b. The front end component 32b has: an outer tube front end portion 38 located at the front end of the outer tube body 30 and having a front end opening 36; and a protrusion 40a protruding from the outer tube front end portion 38 in the front-end direction. The protrusion 40a protrudes from a first region 52 of the outer tube front end portion 38 in the front-end direction. The protrusion 40a is located at a position 180° circumferentially offset from the base endpoint P1 to the front end opening 36 in the front end face 48 of the outer tube front end portion 38.
[0122] The protruding length of the protrusion 40a is set to be the same as the protruding length L1 of the protrusion 40a described above. The protrusion 40a is flexible. In other words, the protrusion 40a is formed to be elastically deformable. The material of the protrusion 40a can be the same as the material of the outer tube body 30 described above. The protrusion 40a is formed in a cylindrical shape. The protruding end face of the protrusion 40a has an arc-shaped cross-section. When the front end face 48 of the endoscope 14 is located at or near the front end opening 36, the angle between the protrusion 40a and the front end face 48 is set to be the same as the first angle θ1 described above.
[0123] Slider 18c has a slider body 72 and a slider seat 76 (see reference) Figure 1 and Figure 2 That is, the slider 18c does not have the cover 74 described above.
[0124] like Figure 17A and Figure 17BAs shown, in the initial state of the conduit system 10, the protrusion 40a is elastically deformed, with its protruding end inserted into the front opening 36, and is locked to the inner surface of the front end portion 38 of the outer tube. That is, in this state, the protruding end of the protrusion 40a is pressed against the wall surface forming the second hole 46 by the restoring force of the protrusion 40a. Therefore, the protrusion 40a maintains its curved shape with its protruding end inserted into the front opening 36.
[0125] In this catheter system 10, during the insertion process, the balloon catheter 12C can be inserted to the fundus 200 of the uterus with the protruding end of the protrusion 40a inserted into the anterior opening 36. Therefore, it is possible to prevent the protruding end of the protrusion 40a from contacting the inner surface of the uterus (damage to the inner surface of the uterus due to the protrusion 40a). Furthermore, after the insertion process, by advancing the insertion portion 100 of the endoscope 14 relative to the outer tube 24b, the insertion portion 100 presses the protrusion 40a towards the anterior end. As a result, the locking of the protrusion 40a relative to the inner surface of the anterior end portion 38a of the outer tube is released, and the protrusion 40a becomes a straight shape along its entire length (see reference). Figure 17B Therefore, it is possible to reliably perform the defined and confirmed processes.
[0126] In such a balloon catheter 12C, the same effect is achieved for the same structure as the balloon catheter 12 described above.
[0127] The protrusion 40a can be inserted into the front opening 36 in an elastically deformed state and locked with the inner surface of the front end 38a of the outer tube. The locking of the protrusion 40a relative to the inner surface of the front end 38a of the outer tube is released by the insertion part 100 pressing the protrusion 40a in the front direction.
[0128] With this structure, since the outer tube 24b can be inserted into the fundus 200 of the uterus with the protrusion 40a inserted into the anterior opening 36, the protruding end of the protrusion 40a can be prevented from contacting the inner surface of the uterus. Furthermore, after the outer tube 24b is inserted into the fundus 200 of the uterus, by pressing the protrusion 40a towards the anterior end using the insertion part 100 of the endoscope 14, the protruding end of the protrusion 40a can be exposed towards the anterior end compared to the anterior end 38a of the outer tube. Thus, the protrusion 40a can be inserted into the fallopian tube opening 202a.
[0129] The balloon catheter 12C can also replace the slider 18c and have the aforementioned sliders 18, 18a, and 18b. In this case, since the cover portions 74, 74a, and 74b of the sliders 18, 18a, and 18b cover the protrusion 40a, the outer tube 24b can be inserted into the fundus 200 of the uterus with the protruding end of the protrusion 40a exposed from the front opening 36 in the frontal direction.
[0130] (4th variation)
[0131] Next, while referring to Figure 18A and Figure 18B The balloon catheter 12D of the fourth modification will be described. In addition, in the balloon catheter 12D of this modification, the same reference numerals are used for structures that are the same as those of the balloon catheter 12 described above, and their descriptions are omitted.
[0132] like Figure 18A and Figure 18B As shown, the balloon catheter 12D includes an outer catheter 16c and a slider 18d. Furthermore, the structure of the balloon catheter 12D, except for the outer catheter 16c and the slider 18d, is the same as that of the balloon catheter 12 described above.
[0133] The outer tube 24c of the outer conduit 16c includes an outer tube body 30 and a front end component 32c. The front end component 32c has: an outer tube front end portion 38 located at the front end of the outer tube body 30 and having a front end opening 36; and a protrusion 40b protruding from the outer tube front end portion 38 in the front-end direction. The protrusion 40b protrudes from a second region 54 of the outer tube front end portion 38 in the front-end direction. The protrusion 40b is located on the front end face 48 of the outer tube front end portion 38.
[0134] The protruding length of the protrusion 40b is set to be the same as the protruding length L1 of the protrusion 40 described above. The protrusion 40b is flexible. The material of the protrusion 40b can be the same as the material of the outer tube body 30 described above. The protrusion 40b extends circumferentially along the front opening 36. The protrusion 40b is narrow in its protruding direction. The inner protruding surface 120 of the protrusion 40b (the surface on the side where the front opening 36 is located) is curved into an arc shape along the circumference of the front opening 36 and also curved into an arc shape in the protruding direction of the protrusion 40b.
[0135] like Figure 18B As shown, with the front end face 48 of the endoscope 14 positioned near or at the front end opening 36, the angle (hereinafter referred to as "second angle θ2") between the front end face 48 of the insertion portion 100 and the protrusion 40b (the front end of the protruding inner surface 120 of the protrusion 40b) is set to 40° or more and 150° or less. The second angle θ2 is more preferably 100° or more and 130° or less. In this case, the mobility of the balloon 22 and the visual recognizability of the protrusion 40b displayed in the endoscopic image are further improved.
[0136] exist Figure 18A and Figure 18B In the middle, the slider 18d has a slider body 72, a cover 74c, and a slider seat 76 (see reference). Figure 1 and Figure 2The cover 74c has a shape that allows the cover 74 of the balloon catheter 12 to rotate 180° in the circumferential direction of the sliding body 72.
[0137] The cover 74c covers the protrusion 40b in the initial state of the slider 18d. In other words, the inner surface of the cover 74c faces the inner protruding surface 120 of the protrusion 40b in the initial state of the slider 18d. The protruding end of the cover 74c is located at the same position as the protruding end of the protrusion 40b in the axial direction of the slider body 72 in the initial state of the slider 18d. However, the protruding end of the cover 74c may also be located on the front end side compared to the protruding end of the protrusion 40b in the initial state of the slider 18d.
[0138] In such a balloon catheter 12D, the same structure as the balloon catheter 12 described above achieves the same effect.
[0139] The protrusion 40b is located in the second region 54, and the second angle θ2 is between 40° and 150°.
[0140] This structure improves the visual recognizability of the protrusion 40b displayed in the endoscopic image.
[0141] (5th variation)
[0142] Next, while referring to Figure 19 The balloon catheter 12E of the fifth modification will be described. In addition, in the balloon catheter 12E of this modification, the same reference numerals are used for structures that are the same as those of the balloon catheter 12 described above, and their descriptions are omitted.
[0143] like Figure 19 As shown, balloon catheter 12E includes an outer catheter 16d and a slider 18c. Furthermore, the structure of balloon catheter 12E, other than the outer catheter 16d and the slider 18c, is the same as that of balloon catheter 12 described above.
[0144] The outer tube 24d of the outer conduit 16d includes an outer tube body 30 and a front end component 32d. The front end component 32d has: an outer tube front end portion 38 located at the front end of the outer tube body 30 and having a front end opening 36; and a plurality of protrusions 40c protruding from the outer tube front end portion 38 in the frontal direction. The protrusions 40c may be made of the same material as the outer tube body 30 described above.
[0145] Multiple protrusions 40c are formed with the same shape. The protrusions 40c extend circumferentially along the front opening 36. The protrusions 40c are thin in the direction of protrusion. The protruding length of the protrusions 40c is set to be the same as the protruding length L1 of the protrusions 40 described above. The inner protruding surface 122 of the protrusion 40c (the surface on the side where the front opening 36 is located) is curved into an arc shape along the circumference of the front opening 36, and is also curved into an arc shape in the protruding direction of the protrusion 40c.
[0146] In this embodiment, the front end component 32d comprises a plurality of protrusions 40c, including three protrusions 40c1, 40c2, and 40c3. The three protrusions 40c1, 40c2, and 40c3 are located on the front end face 48 of the front end portion 38 of the outer tube. The three protrusions 40c1, 40c2, and 40c3 are equally spaced around the circumference of the front end opening 36. Two protrusions 40c1 and 40c2 protrude from the first region 52 of the front end portion 38 of the outer tube toward the front end. One protrusion 40c3 protrudes from the second region 54 of the front end portion 38 of the outer tube toward the front end.
[0147] With the front end face 48 of the endoscope 14 positioned near or at the front end opening 36, the angle between the protrusions 40c1 and 40c2 (the front ends of the inner surfaces 122 of the protrusions 40c1 and 40c2) protruding from the first region 52 of the outer tube and the front end face 48 of the endoscope 14 is set to be the same as the first angle θ1 described above. With the front end face 48 of the endoscope 14 positioned near or at the front end opening 36, the angle between the protrusion 40c3 (the front end of the inner surface 122 of the protrusions 40c3) protruding from the second region 54 of the outer tube and the front end face 48 of the endoscope 14 is set to be the same as the second angle θ2 described above.
[0148] In such a balloon catheter 12E, the same effect is achieved for the same structure as the balloon catheter 12 described above.
[0149] The protrusion 40c has multiple parts.
[0150] This structure improves the visual recognizability of the protrusions 40c displayed in the endoscopic image. Furthermore, it prevents only one protruding end of the protrusion 40c from contacting the inner surface of the uterus. In other words, even if the protrusion 40c contacts the inner surface of the uterus, multiple protrusions 40c can be used to reduce the force exerted on the inner surface of the uterus from the protrusions 40c.
[0151] The protrusions 40c are evenly spaced around the front end 38 of the outer tube.
[0152] This structure can further improve the visual recognizability of the protrusion 40c displayed in the endoscopic image.
[0153] This invention is not limited to the above-described embodiments, and various changes can be made without departing from the spirit of this invention.
[0154] The above implementation methods can be summarized as follows.
[0155] The above embodiment discloses a catheter system comprising: a balloon catheter (12, 12A~12E) having a flexible outer tube (24, 24a~24d), an inner tube (78) disposed in the lumen (34) of the outer tube so as to be movable relative to the outer tube in the axial direction of the outer tube, and a tubular balloon (22) connecting the front end of the outer tube to the front end of the inner tube and expanding radially inward toward the outer tube; and an endoscope (14) having a linear insertion portion (100) inserted into the lumen (94) of the balloon. In the catheter system (10), the balloon is pushed toward the front end by transmitting an insertion force from the inner tube to the balloon. The front end of the balloon is turned outward and protrudes toward the front end from the front opening (36) of the outer tube. The outer tube has: a tubular outer tube body (30); an outer tube front end (38, 38a) provided at the front end of the outer tube body and having the front opening; and a protrusion (40, 40a~40c) protruding from the outer tube front end toward the front end, the protrusion being integrally formed on the outer tube front end.
[0156] In the above-described catheter system, a camera (102) for taking pictures of the front end of the insertion part is provided on the front end face (104) of the insertion part. When the insertion part is located at or near the front end opening, the angle (θ1, θ2) between the front end face of the insertion part and the protrusion is 40° or more and 150° or less.
[0157] In the aforementioned catheter system, when the front opening is viewed from the front, if the front end portion of the outer tube is divided into a first region (52) located in the front direction compared to the tangent (Lc) passing through the point (P1) in the outer periphery of the front opening that is most located in the base direction of the outer tube, and a second region (54) located in the base direction compared to the tangent, the protrusion is located in the first region, and the angle (θ1) formed therebetween is 55° or more and 105° or less.
[0158] In the aforementioned catheter system, when the front opening is viewed from the front, if the front end portion of the outer tube is divided into a first region located in the front direction compared to the tangent line passing through the point on the outer periphery of the front opening that is most located in the base direction of the outer tube, and a second region located in the base direction compared to the tangent line, the protrusion is located in the second region, and the angle (θ2) formed therebetween is 100° or more and 130° or less.
[0159] In the aforementioned catheter system, the wall thickness of the first region may be greater than that of the second region.
[0160] In the aforementioned catheter system, the protrusion length (L1) of the protrusion may be 1.5 mm or more and 60 mm or less.
[0161] In the aforementioned catheter system, the balloon catheter may have a slider (18, 18a~18d) that is configured to move relative to the outer peripheral surface of the outer tube along the axial direction of the outer tube and is used to keep the outer tube in a straight shape. The front end of the outer tube body protrudes from the slider when the slider is moved relative to the outer tube towards the base end, and is bent into an arc shape in the axial direction.
[0162] In the aforementioned conduit system, the slider may have a tubular slider body (72) and a cover (74, 74a~74c) protruding from the front end of the slider body toward the front end direction. In the initial state of the slider, in which the slider moves to the maximum extent relative to the outer tube toward the front end direction, the cover is located in the front end direction compared to the front end of the front end of the outer tube.
[0163] In the aforementioned conduit system, the cover portion may be opposite the protrusion portion in the aforementioned initial state of the sliding member.
[0164] In the aforementioned catheter system, there may also be multiple protrusions.
[0165] In the aforementioned conduit system, the protrusions may also be arranged at equal intervals in the circumferential direction at the front end of the outer tube.
[0166] In the aforementioned catheter system, the protrusion can be elastically deformed and inserted into the front opening, and then locked against the inner surface of the front end of the outer tube. The locking of the protrusion relative to the inner surface of the front end of the outer tube can be released by pressing the protrusion toward the front end using the insertion part.
Claims
1. A catheter system comprising: a balloon catheter having a flexible outer tube, an inner tube disposed within the lumen of the outer tube such that it is movable relative to the outer tube in the axial direction of the outer tube, and a tubular balloon connecting the proximal end of the outer tube to the proximal end of the inner tube and expanding radially inward toward the outer tube; and an endoscope having a linear insertion portion inserted into the lumen of the balloon. The catheter system is characterized in that... Within the balloon, a pushing force directed towards the front end is transmitted from the inner tube to the balloon, causing the front end of the balloon to flare outwards while protruding from the front opening of the outer tube towards the front end. The outer tube has: The outer tube body is tubular; The outer tube front end, which is located at the front end of the outer tube body and has the front end opening, and A protrusion extending from the front end of the outer tube toward the front end. The protrusion is integrally formed at the front end of the outer tube. The conduit system includes a slider that is movable relative to the outer peripheral surface of the outer tube along the axial direction of the outer tube and is used to maintain the outer tube in a straight shape. The front end of the outer tube body protrudes from the sliding member when the sliding member has moved relative to the outer tube towards the base end, and is bent into an arc shape in the axial direction. The slider has: Tubular sliding body; and A cover portion protruding from the front end of the slider body toward the front end. In the initial state of the slider, which moves the slider to its maximum extent relative to the outer tube in the direction of the front end, the cover is located on the side opposite to the protrusion relative to the front opening and is opposite to the protrusion.
2. The catheter system according to claim 1, characterized in that, The front end face of the insertion part is provided with a camera for taking pictures of the insertion part in the direction of the front end. When the insertion part is located at or near the front opening, the angle between the front end face of the insertion part and the protrusion is 40° or more and 150° or less.
3. The catheter system according to claim 2, characterized in that, When the front opening is viewed from the front, if the front end portion of the outer tube is divided into a first region located in the front-end direction compared to the tangent line passing through the point on the outer periphery of the front opening that is most located in the base-end direction of the outer tube, and a second region located in the base-end direction compared to the tangent line, then... The protrusion is located in the first region. The angle formed is between 55° and 105°.
4. The catheter system according to claim 2, characterized in that, When the front opening is viewed from the front, if the front end portion of the outer tube is divided into a first region located in the front-end direction compared to the tangent line passing through the point on the outer periphery of the front opening that is most located in the base-end direction of the outer tube, and a second region located in the base-end direction compared to the tangent line, then... The protrusion is located in the second region. The angle formed is between 100° and 130°.
5. The catheter system according to claim 3 or 4, characterized in that, The wall thickness of the first region is greater than that of the second region.
6. The catheter system according to any one of claims 1 to 4, characterized in that, The protrusion length of the protrusion is more than 1.5 mm and less than 60 mm.
7. The catheter system according to any one of claims 1 to 4, characterized in that, In the initial state of the slider, the cover is located in the front end direction compared to the front end of the outer tube.
8. The catheter system according to any one of claims 1 to 4, characterized in that, The protrusion can be elastically deformed and inserted into the front opening, and then locked onto the inner surface of the front end of the outer tube. The protrusion is released from its locking relative to the inner surface of the front end of the outer tube by pressing it toward the front end using the insertion part.