Stent delivery system and endoscope system

Abstract

The support delivery system includes: a first outer cylinder component; a second outer cylinder component located at a position closer to the base end of the first outer cylinder component; an inner cylinder component extending through the inner side of the first outer cylinder component; a traction component extending through the inner side of the second outer cylinder component; and a support received between the inner cylinder component and the first outer cylinder component, wherein the base end of the first outer cylinder component is connected to the front end of the traction component, and the base end of the inner cylinder component is connected to the front end of the second outer cylinder component, and the support is held in place by pulling the first outer cylinder component relative to the inner cylinder component towards the base end.

Description

Technical Field

[0001] This invention relates to a stent delivery system, an endoscope system, and a stent placement method. Background Technology

[0002] A surgical procedure is known to place and dilate stents in stenosis or occlusion (hereinafter referred to as "stenosis, etc.") in the digestive tract, etc. A stent delivery system is used to place the stent in the stenosis, etc. The stent delivery system passes through the instrument channel of the endoscope to deliver the stent to the stenosis, etc.

[0003] For example, in the conventional stent delivery system described in Patent Document 1, the guide tube penetrating the interior of the sheath is arranged in a manner that allows it to slide relative to the sheath. The stent is accommodated in the gap between the guide tube and the sheath at the front end of the delivery system. By pulling the sheath relative to the guide tube toward the hand side, the stent accommodated at the front end is placed in narrow or other confined spaces.

[0004] An assistant, tasked with assisting the endoscopist operating the endoscope, pulls the sheath relative to the guide tube toward the operator's hand. The assistant positions the stent by pulling the sheath relative to the guide tube toward the operator's hand while keeping the guide tube in place to prevent movement.

[0005] Existing technical documents

[0006] Patent documents

[0007] Patent Document 1: Japanese Patent Publication No. 2007-526096 Summary of the Invention

[0008] The problem the invention aims to solve

[0009] However, in conventional stent delivery systems, when the sheath is retracted towards the hand, the reaction force generated by the bent sheath contacting the endoscope's instrument channel can sometimes cause the guide tube to move towards the tip. In this case, the stent is left in a position deviated from its target location. To prevent this from happening, the endoscopist coordinates the adjustment of the stent delivery system's position in conjunction with the assistant's pulling action on the sheath.

[0010] Based on the above, the object of the present invention is to provide a stent delivery system, an endoscope system, and a stent placement method that can easily place a stent in a target location.

[0011] Solution for solving the problem

[0012] To address the above problems, the present invention proposes the following solution.

[0013] The first technical solution of the present invention provides a support conveying system comprising: a first outer cylinder component; a second outer cylinder component located at a position closer to the base end of the first outer cylinder component; an inner cylinder component extending through the inner side of the first outer cylinder component; a traction component extending through the inner side of the second outer cylinder component; and a support received between the inner cylinder component and the first outer cylinder component, wherein the base end of the first outer cylinder component is connected to the front end of the traction component, and the base end of the inner cylinder component is connected to the front end of the second outer cylinder component, and the support is held in place by pulling the first outer cylinder component relative to the inner cylinder component towards the base end.

[0014] The second technical solution of the present invention includes an endoscope and the stent delivery system described above.

[0015] The third technical solution of the present invention provides a stent placement method using an endoscope system, which includes: an endoscope; and a stent delivery system having a first outer cylinder member capable of penetrating the endoscope, a second outer cylinder member capable of penetrating the channel, an inner cylinder member capable of penetrating the channel and penetrating the inner side of the first outer cylinder member, a traction member capable of penetrating the channel and penetrating the inner side of the second outer cylinder member, and a stent. The base end of the first outer cylinder member is connected to the front end of the traction member, and the base end of the inner cylinder member is connected to the front end of the second outer cylinder member. The stent placement method includes: an insertion step in which the stent delivery system is inserted into the channel and inserted to a target position; a fixing step in which the second outer cylinder member and the endoscope are fixed to each other; and a traction step in which the traction member is pulled towards the base end.

[0016] The effects of the invention

[0017] The stent delivery system, endoscope system, and stent placement method of the present invention can easily place the stent in the target position. Attached Figure Description

[0018] Figure 1 This is a diagram showing the overall structure of the endoscope system according to the first embodiment of the present invention.

[0019] Figure 2 This is a diagram showing the stent delivery system of the endoscope system according to the first embodiment.

[0020] Figure 3 This is a diagram showing the support conveying system of the first embodiment, represented by local fractures and cross-sections.

[0021] Figure 4 This is a diagram showing the overall structure of the inner cylinder component, the second outer cylinder component, and the head of the support conveying system according to the first embodiment.

[0022] Figure 5 This is a diagram showing the support transport system for the endoscope handling instrument channel that runs through the endoscope system of the first embodiment.

[0023] Figure 6 This diagram illustrates the actions of an endoscopist when placing a stent in the target position.

[0024] Figure 7 This is a diagram showing an indwelling stent.

[0025] Figure 8 This is a diagram showing the stent delivery system of the endoscope system according to the second embodiment of the present invention, represented by partial fractures and cross-sections.

[0026] Figure 9 This diagram illustrates the actions of an endoscopist when placing a stent in the target position.

[0027] Figure 10 This is a diagram showing the stent delivery system of the endoscope system according to the third embodiment of the present invention, represented by partial fractures and cross-sections.

[0028] Figure 11 This is a diagram showing the stent delivery system of the endoscope system according to the fourth embodiment of the present invention, represented by partial fractures and cross-sections.

[0029] Figure 12 This is a diagram of a support conveying system according to a fourth embodiment, where bending is represented by localized fractures and cross-sections.

[0030] Figure 13 This is a diagram showing the stent delivery system of the fourth embodiment when the stent is in place.

[0031] Figure 14 This is a diagram showing the stent delivery system of the fourth embodiment when the stent is in place.

[0032] Figure 15 This is a cross-sectional view of a support conveying system according to a fourth embodiment, in which the support is fixed in place using a lifting platform.

[0033] Figure 16 This is a diagram showing a modified example of the endoscope according to the above embodiment.

[0034] Figure 17 This is a diagram showing a modified example of the endoscope according to the above embodiment.

[0035] Figure 18 This is a diagram showing a modified example of the second outer cylinder component of the above embodiment. Detailed Implementation

[0036] (First Implementation)

[0037] Reference Figures 1 to 7 The first embodiment of the present invention will be described.

[0038] [Endoscopic System 300]

[0039] Figure 1 This is a diagram showing the overall structure of the endoscope system 300 according to the first embodiment.

[0040] The endoscope system 300 includes an endoscope 200 and a stent delivery system 100 that passes through a channel in the endoscope 200.

[0041] [Endoscope 200]

[0042] Endoscope 200 is a known side-viewing flexible endoscope, including an elongated insertion portion 210 and an operating portion 220 provided at the base of the insertion portion 210. Alternatively, endoscope 200 may also be a direct-viewing flexible endoscope.

[0043] The insertion portion 210 has a front rigid portion 211 provided at the front end, a bendable portion 212 mounted on the base end side of the front rigid portion 211, and a flexible tube portion 213 mounted on the base end side of the bend portion 212. A light guide 215 and a camera unit 216 with a CCD are provided on the side of the front rigid portion 211 in an exposed state.

[0044] An instrument channel 230 is formed in the insertion portion 210 for endoscopic instruments such as the stent delivery system 100 to pass through. The front end portion 230a of the instrument channel 230 opens on the side of the front rigid portion 211. The base end portion of the instrument channel 230 extends to the operation portion 220.

[0045] A lifting platform 214 is provided at the front rigid portion 211 of the treatment instrument channel 230. The base end of the lifting platform 214 is rotatably supported on the front rigid portion 211. A lifting platform operation line (not shown) fixed at the front end of the lifting platform 214 extends through the insertion portion 210 to the base end side.

[0046] The bending portion 212 is configured to be flexible in both vertical and horizontal directions. The front end of the operating line is fixed to the front end of the bending portion 212. The operating line extends through the insertion portion 210 to the operating portion 220.

[0047] The base of the operating section 220 is provided with a knob 223 for operating the operating cable and a switch 224 for operating the camera unit 216, etc. The user can bend the bending section 212 in the desired direction by operating the knob 223.

[0048] A forceps jaw 222 communicating with the instrument passage 230 is provided at the front end of the operating section 220. The user can insert endoscopic instruments such as the stent delivery system 100 through the forceps jaw 222. A forceps latch 225 is installed in the forceps jaw 222 to prevent leakage of bodily fluids.

[0049] [Support Conveying System 100]

[0050] Figure 2 This is a diagram showing the support conveying system 100. Figure 3 This is a diagram showing the support conveying system 100 with partial fracture and cross-section. The support conveying system 100 is generally elongated and includes a first outer cylinder component 1, an inner cylinder component 2, a traction component 3, a second outer cylinder component 4, a head 5, and a support 6.

[0051] The first outer cylindrical member 1 is a long, cylindrical member capable of penetrating the instrument channel 230 of the endoscope 200. The first outer cylindrical member 1 is formed of resin or the like and is flexible. The first outer cylindrical member 1 has a first opening 11 at its front end 1a and a second opening 12 at its base end 1b. The first opening 11 and the second opening 12 communicate with the internal space (lumen) 13 of the first outer cylindrical member 1. The first opening 11 and the second opening 12 are generally circular openings through which the inner cylindrical member 2 can pass.

[0052] The traction member 3 is a long strip that can pass through the instrument channel 230 of the endoscope 200. The traction member 3 is made of resin or the like and is flexible. The front end 31 of the traction member 3 is connected to the base end 14 of the first outer cylinder member. By pulling the traction member 3, the surgeon can pull the first outer cylinder member 1 towards the base end.

[0053] Figure 4 This is a diagram showing the overall structure of the inner cylinder component 2, the second outer cylinder component 4, and the head 5.

[0054] The inner tube component 2 is a long, cylindrical component that can pass through the treatment instrument channel 230 of the endoscope 200. The inner tube component 2 is made of resin or the like and is flexible. The inner tube component 2 has a front opening 21 at the front end 2a and a base opening 22 at the base end 2b. The front opening 21 and the base opening 22 communicate with the lumen (guide wire lumen) 23 of the inner tube component 2.

[0055] like Figure 2 As shown, the inner cylinder component 2 passes through the first opening 11 and the second opening 12 in a manner that allows relative movement within the cavity 13 of the first outer cylinder component 1. The outer diameter of the inner cylinder component 2 passing through the cavity 13 of the first outer cylinder component 1 is smaller than the inner diameter of the cavity 13 of the first outer cylinder component 1.

[0056] like Figure 2As shown, the second outer cylindrical member 4 is a long, cylindrical member capable of penetrating the treatment instrument channel 230 of the endoscope 200. The second outer cylindrical member 4 is formed of resin or the like and is flexible. The second outer cylindrical member 4 has a first opening 41 at its front end 4a and a second opening 42 at its base end 4b. The first opening 41 and the second opening 42 communicate with the internal space (lumen) 43 of the second outer cylindrical member 4. The first opening 41 and the second opening 42 are generally circular openings through which the traction member 3 can pass.

[0057] like Figure 4 As shown, the front end 44 of the second outer cylinder component 4 is connected to the base end 24 of the inner cylinder component 2. The internal space (cavity) 43 of the second outer cylinder component 4 is connected to the cavity (guide line cavity) 23 of the inner cylinder component 2. The guide line G, which passes through the cavity (guide line cavity) 23 of the inner cylinder component 2, extends through the internal space (cavity) 43 of the second outer cylinder component 4 to the base end side.

[0058] like Figure 2 As shown, the traction member 3 passes through the first opening 41 and the second opening 42 in a manner that allows relative movement within the internal space (cavity) 43 of the second outer cylinder member 4. The outer diameter of the traction member 3 passing through the internal space (cavity) 43 of the second outer cylinder member 4 is smaller than the inner diameter of the cavity 43 of the second outer cylinder member 4.

[0059] like Figure 4 As shown, the head 5 has a generally conical shape and a through hole 51 extending along the axial direction. The head 5 has a front end 52 with a smaller diameter and a base end 53 with a larger diameter, and the head 5 is connected to the inner cylinder member 2 on the base end 53 side. Since the diameter of the base end 53 is larger than the outer diameter of the inner cylinder member 2, a step 55 exists at the connection between the head 5 and the inner cylinder member 2. Since the through hole 51 communicates with the cavity 23 of the inner cylinder member 2 through the front opening 21, when a guide wire is inserted into the through hole 51 of the head 5, the guide wire can enter the guide wire cavity 23 of the inner cylinder member 2.

[0060] The support 6 is a cylindrical, self-expanding support formed by weaving in wire. The support 6 is housed in the gap between the inner cylinder member 2 and the first outer cylinder member 1, with the inner cylinder member 2 inserted inside and its diameter reduced. The support 6 is secured to a locking portion (not shown) formed on the outer circumferential surface of the inner cylinder member 2. Thus, the support 6 is positioned relative to the inner cylinder member 2 in its reduced-diameter state and does not move relative to it along the length of the inner cylinder member 2. Alternatively, the support 6 can also be a laser-cut type support formed by laser cutting a metal cylinder.

[0061] The following materials can be used as materials for the first outer cylinder member 1, the inner cylinder member 2, the traction member 3, and the second outer cylinder member 4. There are no particular restrictions on the materials as long as the desired mechanical properties are met in the first outer cylinder member 1 and the inner cylinder member 2.

[0062] • Olefin resins such as polypropylene and polyethylene and their copolymers, polyester resins such as polyethylene terephthalate (PET) and polybutylene terephthalate (PBT), and general-purpose resins such as polyvinyl alcohol (PVA).

[0063] • Engineering resins such as polyamide resins, fluorinated resins (e.g., polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF), PFA, FEP, ETFE, etc.), and polyether ether ketone (PEEK).

[0064] Furthermore, various elastic resins (polystyrene-based, polyolefin-based, polyurethane-based, polyester-based, polyamide-based, polyvinyl chloride-based, etc.), silicone-containing resins, and polyurethane-based resins can be used alone or in combination. Additionally, to suppress longitudinal bending, materials composited with meshes made of stainless steel or similar materials can be used.

[0065] Furthermore, in the case of stent delivery systems used under X-ray fluoroscopy, X-ray-nontransmissible metallic markers (medical X-ray-nontransmissible metals and alloys such as platinum, tungsten, and iridium) or mixed X-ray-nontransmissible materials (such as barium sulfate) can be added.

[0066] The wire forming the support 6 is a superelastic alloy with NiTi as the main material. The superelastic alloy with NiTi as the main material does not undergo permanent deformation at the time of weaving, and the weaving shape is memorized by applying heat treatment in the weaving state.

[0067] Figure 5 This is a diagram showing the support conveying system 100 that runs through the treatment device channel 230. Figure 5 The front end of the stent delivery system 100 shown protrudes from the front end 230a of the treatment instrument channel 230 of the endoscope 200.

[0068] With the support 6 receiving portion of the support delivery system 100 protruding from the front end 230a of the endoscope 200's treatment instrument channel 230 and the support 6 positioned in the indwelling position, the second opening 12 of the first outer cylinder member 1 and the first opening 41 of the second outer cylinder member 4 are disposed inside the treatment instrument channel 230. The second opening 42 of the second outer cylinder member 4 is disposed outside the treatment instrument channel 230.

[0069] exist Figure 5In the middle section between the first outer cylinder member 1 and the second outer cylinder member 4, the inner cylinder member 2 runs parallel to the traction member 3. The length D3 of the middle section is longer than the length D1 of the support 6.

[0070] The procedure of placing a stent 6 in the bile duct is used as an example to illustrate the stent placement method using an endoscope system 300 that includes a stent delivery system 100 configured as described above.

[0071] The endoscopist inserts the insertion part 210 of the endoscope 200 into the patient's body cavity through a natural opening such as the mouth. At this time, the endoscopist operates the knob 223 or the like to bend the curved part 212 as needed.

[0072] The endoscopist inserts a guide liner G into the instrument channel 230 of the endoscope 200, and while observing with the endoscope 200, inserts the guide liner into the bile duct. Then, under X-ray fluoroscopy, the endoscopist manipulates the guide liner G to break through the narrowing in the bile duct, moving the tip of the guide liner G to a position closer to the liver than the narrowing (target position).

[0073] The endoscopist inserts the base of the guide wire G, which protrudes from the forceps 225 of the endoscope 200, into the through hole 51 of the head 5 of the stent delivery system 100. The guide wire G then enters the guide wire lumen 23 of the inner cylinder component 2 through the through hole 51.

[0074] The endoscopist advances the stent delivery system 100 along the guide line G while maintaining the guide line G (insertion procedure). The tip of the stent delivery system 100 protrudes from the tip of the instrument channel 230 of the endoscope 200. If the tip of the stent delivery system 100 breaks through a narrow section (target position), the endoscopist moves the stent delivery system 100 forward and backward to determine the placement position of the stent 6. Alternatively, the endoscopist may insert the stent delivery system 100 into the instrument channel 230 without using the guide line G.

[0075] like Figure 5 As shown, with the support 6 receiving portion of the support delivery system 100 protruding from the front end 230a of the endoscope 200's treatment instrument channel 230 and the support 6 positioned in the indwelling position, the first opening 41 of the second outer cylinder member 4 is disposed inside the treatment instrument channel 230. In this state, the second outer cylinder member 4 is discharged from the forceps bolt 225. The traction member 3 is discharged from the second outer cylinder member 4 outside the treatment instrument channel 230.

[0076] Figure 6 This diagram illustrates the actions of an endoscopist when placing the stent 6 in the target position. Figure 7 This is a diagram showing the indwelling stent 6.

[0077] Once the target location of stent 6 is determined, the endoscopist will proceed as follows: Figure 6 As shown, while holding the operating part 220 of the endoscope 200 with one hand L, the second outer cylinder member 4 is fixed near the clamp bolt 225 of the operating part 220 (fixing process), and while the other hand R is used to pull the traction member 3 towards the base end (traction process). As a result, the first outer cylinder member 1 retracts relative to the inner cylinder member 2. The result is as follows: Figure 7 As shown, stent 6 gradually expands and is exposed from the anterior end. The endoscopist can perform the stent placement procedure independently while operating the endoscope 200, without the assistance of a helper.

[0078] By fixing the second outer cylinder component 4 to the operating part 220, the traction component 3 is pulled towards the base end, thereby preventing the inner cylinder component 2 from moving forward or backward relative to the treatment instrument channel 230, and only the first outer cylinder component 1 moves backward towards the base end. Therefore, the position of the inner cylinder component 2 is maintained, and the position accommodating the support 6 is not easily displaced from the target position.

[0079] Alternatively, stent placement can be performed by an endoscopist and an assistant. The endoscopist uses their hand to hold the second outer cylinder member 4 in place near the forceps 225. In this position, the assistant, while gently holding the basal side of the second outer cylinder member 4 with one hand, uses the other hand to pull the traction member 3 towards the basal side. Thus, the assistant can easily place the stent in the target position without needing to coordinate with the endoscopist.

[0080] like Figure 5 As shown, the length D3 of the middle section is longer than the length D1 of the support 6. Therefore, even when the traction member 3 is pulled towards the base end until the support 6 is placed, the first outer cylinder member 1 and the second outer cylinder member 4 do not come into contact.

[0081] If the support 6 is fully exposed, it expands along its entire axial direction, and the inner diameter of the support 6 becomes larger than the outer diameter of the inner cylinder component 2. Consequently, the locking between the support 6 and the inner cylinder component 2 is released.

[0082] Before the support 6 fully expands, by advancing the first outer cylinder member 1 relative to the inner cylinder member 2, the support 6 can also be retracted (recaptured) between the first outer cylinder member 1 and the inner cylinder member 2. Recapture is useful in situations such as when resetting the position.

[0083] After the locking between the stent 6 and the inner cylinder component 2 is released, if the endoscopist moves the inner cylinder component 2 backward, the stent 6 will remain in the indwelling position, and the inner cylinder component 2 can be pulled out from the stent 6.

[0084] If the endoscopist pulls the portion of the stent delivery system 100, excluding stent 6, out of the body, the stent 6 placement procedure is complete. Afterwards, a contrast catheter can be inserted along the guide wire, and contrast agent can be used to confirm the opening status of the stenosis.

[0085] According to the stent placement method using the endoscope system 300 including the stent delivery system 100 of this embodiment, the endoscopist can easily place the stent 6 in a target location such as a narrow space without the assistance of an assistant. By fixing the second outer cylinder member 4 to the operating part 220, the endoscopist can retract only the traction member 3 and the first outer cylinder member 1 towards the base. Therefore, by maintaining the position of the inner cylinder member 2, the position containing the stent 6 is less likely to shift from the target position.

[0086] The first embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes are included without departing from the spirit of the present invention. Furthermore, the constituent elements shown in the above-described embodiment and the variations shown below can be appropriately combined to form a configuration.

[0087] (Second Implementation)

[0088] Reference Figure 8 The second embodiment of the present invention will now be described. In the following description, the same reference numerals will be used for structures that are common to those already described, and repeated descriptions will be omitted. The endoscope system 300B of the second embodiment differs from the endoscope system 300 of the first embodiment in that the inner cylinder member has an opening on the side.

[0089] The endoscope system 300B includes an endoscope 200 and a stent delivery system 100B that passes through a channel in the endoscope 200.

[0090] Figure 8 This is a diagram showing the support conveying system 100B using partial fracture and cross-section. The support conveying system 100B includes a first outer cylinder component 1, an inner cylinder component 2B, a traction component 3, a second outer cylinder component 4, a head 5, and a support 6.

[0091] The inner cylinder component 2B has the same structure as the inner cylinder component 2 in the first embodiment, and also includes an opening 25. The opening 25 is provided on the side of the inner cylinder component 2B and communicates with the lumen (guide wire lumen) 23 of the inner cylinder component 2. The opening 25 is an opening through which the guide wire can pass.

[0092] like Figure 8 As shown, the opening 25 is positioned in the middle between the first outer cylinder member 1 and the second outer cylinder member 4, with the support 6 being accommodated.

[0093] To prevent longitudinal bending of the opening 25, such as Figure 8 As shown, a reinforcing member 26 is installed around the periphery of the opening 25. The reinforcing member 26 is a member that is wound circumferentially around the periphery of the opening 25 along its outer peripheral surface. The material of the reinforcing member 26 is preferably a resin that is resistant to longitudinal bending or a material composited with a mesh made of stainless steel or the like, but it is not limited to these materials.

[0094] The guide wire G, inserted through the through hole 51 of the head 5, is pulled out through the opening 25 to the outside of the support transport system 100B. By pulling the guide wire G out from the middle of the support transport system 100B, the guide wire G can be shortened, making it easier to introduce the support transport system 100B into the treatment device channel 230.

[0095] Figure 9 This diagram illustrates the actions of an endoscopist when placing the stent 6 in the target position.

[0096] The guide wire G separates from the second outer tube component 4 and is discharged from the forceps bolt 225. Since the guide wire G does not pass through the second outer tube component 4, the endoscopist can easily manipulate the traction component 3 and the second outer tube component 4.

[0097] According to the stent placement method using the endoscope system 300B including the stent delivery system 100B of this embodiment, the endoscopist can easily place the stent 6 in a target location such as a stenosis without the assistance of an assistant. Furthermore, by maintaining the position of the inner cylinder member 2B, the position where the stent 6 is housed is less likely to shift from the target position.

[0098] The second embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes are included without departing from the spirit of the present invention. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0099] (Third Implementation)

[0100] Reference Figure 10 The third embodiment of the present invention will be described below. In the following description, the same reference numerals will be used for structures that are common to those already described, and repeated descriptions will be omitted. The endoscope system 300C of the second embodiment differs from the endoscope system 300 of the first embodiment in that the second outer cylinder member has an opening.

[0101] The endoscope system 300C includes an endoscope 200 and a stent delivery system 100C that passes through a channel in the endoscope 200.

[0102] Figure 10This is a diagram showing the support conveying system 100C using partial fracture and cross-section. The support conveying system 100C includes a first outer cylinder component 1, an inner cylinder component 2, a traction component 3, a second outer cylinder component 4C, a head 5, and a support 6.

[0103] like Figure 10 As shown, the second outer cylindrical member 4C is a long, cylindrical member capable of penetrating the treatment instrument channel 230 of the endoscope 200. The second outer cylindrical member 4C is formed of resin or the like and is flexible. The second outer cylindrical member 4C has a first opening 41 at its front end 4a and a second opening 42 at its base end 4b. The first opening 41 and the second opening 42 communicate with the internal space (lumen) 43 of the second outer cylindrical member 4. The first opening 41 and the second opening 42 are generally circular openings through which the traction member 3 can pass.

[0104] The front end portion 44C of the second outer cylinder member 4C is formed into a flared shape with a larger outer diameter on the front end side. An opening 45 is provided on the side of the front end portion 44C of the second outer cylinder member 4C. The opening 45 communicates with the lumen (guide wire lumen) 23 through the base end opening 22 of the inner cylinder member 2. The opening 45 is an opening through which the guide wire can pass.

[0105] The front end 44C of the second outer cylinder component 4C is connected to the base end 24 of the inner cylinder component 2. The lumen (guide wire lumen) 23 of the inner cylinder component 2 passes through the first opening 41 and connects to the opening 45. The guide wire G, which passes through the lumen (guide wire lumen) 23 of the inner cylinder component 2, passes through the opening 45 and is pulled out to the outside of the support conveying system 100C. By pulling the guide wire G out from the middle part of the support conveying system 100C, the guide wire G can be shortened, making it easier to introduce the support conveying system 100C into the treatment device channel 230.

[0106] An opening 45 is formed on the side of the front end portion 44C, which is shaped like a horn. Therefore, when the guide wire is pulled out to the outside of the support conveying system 100C, the guide wire is less likely to come into contact with the second outer cylinder member 4C, and a reaction force due to contact is less likely to be generated.

[0107] According to the stent placement method using the endoscope system 300C including the stent delivery system 100C of this embodiment, the endoscopist can easily place the stent 6 in a target location such as a stenosis without the assistance of an assistant. Furthermore, by maintaining the position of the inner cylinder member 2, the position containing the stent 6 is less likely to shift from the target position.

[0108] The third embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes are included without departing from the spirit of the present invention. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0109] (Fourth Implementation)

[0110] Reference Figures 11-14 The fourth embodiment of the present invention will be described. In the following description, the same reference numerals will be used for structures that are common to those already described, and repeated descriptions will be omitted. The endoscope system of the fourth embodiment differs from the endoscope system 300 of the first embodiment in that it has a middle sheath 7.

[0111] The endoscope system includes an endoscope 200 and a stent delivery system 100D that passes through a channel of the endoscope 200.

[0112] Figure 11 This is a diagram showing the support conveying system 100D using partial fracture and cross-section. The support conveying system 100D includes a first outer cylinder component 1, an inner cylinder component 2, a traction component 3, a second outer cylinder component 4, a head 5, a support 6, and an intermediate sheath 7.

[0113] The intermediate sheath 7 is a long, cylindrical component that can pass through the instrument channel 230 of the endoscope 200. The intermediate sheath 7 is made of a flexible, slip-resistant material (such as fluoropolymer resin). The intermediate sheath 7 has a first opening 71 at its front end and a second opening 72 at its base end. The second opening 72 is fixed to the outer peripheral surface of the front end 4a of the second outer cylinder component 4. The inner cylinder component 2 and the traction component 3 pass through the internal space of the intermediate sheath 7.

[0114] The length of the intermediate sheath 7 in the longitudinal direction is longer than the length D3 of the intermediate portion in the longitudinal direction. Therefore, when the intermediate sheath 7 is not bent, the first opening 71 is positioned on the outer periphery of the base end 14 of the first outer cylinder member, closer to the base end side than the base end side of the support 6. The first opening 71 is not fixed to the base end 14 of the first outer cylinder member 1. Alternatively, the intermediate sheath 7 may have the first opening 71 fixed to the base end 14 of the first outer cylinder member, and the second opening 72 not fixed to the front end 4a of the second outer cylinder member 4.

[0115] Figure 12 This is a diagram showing a curved support conveying system 100D.

[0116] If the middle part bends when the traction member 3 is being pulled, the inner cylinder member 2 in the middle part may sometimes deflect in the bending direction P. The support conveying system 100D has a middle part sleeve 7 that covers the middle part, and the inner cylinder member 2 contacts the inner circumferential surface of the middle part sleeve 7, thereby suppressing the deflection of the inner cylinder member 2 in the bending direction P.

[0117] Figure 13 and Figure 14This diagram illustrates the support conveying system 100D when the support 6 is in place. When the traction member 3 is pulled to place the support 6, regardless of the curvature of the intermediate sheath 7, the first opening 71 of the intermediate sheath 7 is positioned on the outer periphery of the base end portion 14 of the first outer cylinder member 1, closer to the base end portion of the support 6. Therefore, the support conveying system 100D can place the support 6 without it getting caught in the intermediate sheath 7.

[0118] Figure 15 This is a cross-sectional view of the stent delivery system 100D, which uses the lifting platform 214 to fix the receiving position of the stent 6. The endoscopist can also rotate the lifting platform 214 while placing the stent 6, using the lifting platform 214 and the instrument channel 230 to clamp the intermediate sheath 7. While using one hand L to fix the second outer cylinder member 4 near the forceps bolt 225 of the operating section 220, the endoscopist uses the other hand R to pull the traction member 3 towards the base, thus placing the stent 6. Because the intermediate sheath 7 is clamped by the lifting platform 214, the front end position of the first outer cylinder member 1 and the receiving position of the stent 6 are less likely to shift. As a result, the placement position is less likely to shift during stent placement.

[0119] According to the stent placement method using an endoscope system including the stent delivery system 100D of this embodiment, the endoscopist can easily place the stent 6 in a target location such as a stenosis without the assistance of an assistant. Furthermore, the inner cylinder member 2 is less likely to bend in the bending direction P, and the position where the stent 6 is housed is less likely to shift from the target position. Additionally, by fixing the intermediate sheath 7 using the lifting platform 214, the position where the stent 6 is housed is less likely to shift from the target position.

[0120] (Variation Example 1)

[0121] For example, in the above embodiment, the endoscopist uses one hand L holding the operating part 220 of the endoscope 200 to fix the second outer cylinder member 4 near the forceps latch 225 of the operating part 220; however, the fixing method of the inner cylinder member 2 is not limited to this. It can also be as follows: Figure 16 As shown, the endoscope 200 also has a fixing member 240. The fixing member 240 is installed near the operating part 220 and can fix the second outer tube member 4 in a manner that does not change the relative position of the inner tube member 2 and the operating part 220. If the fixing member 240 is used, the endoscopist does not need to use one hand L to fix the second outer tube member 4, 4C, and can concentrate on operating the traction member 3.

[0122] (Variation Example 2)

[0123] It can also be like Figure 17As shown, the endoscope 200 also includes an insertion member 250. The insertion member (fixation member) 250 can also be clamped between the second outer cylinder member 4 and the forceps bolt 225 to fix the second outer cylinder member 4 to the endoscope 200. The insertion member 250 is, for example, formed as a cylindrical shape with a slit in the length direction. The insertion member 250 is flexible and is clamped between the second outer cylinder member 4 and the forceps bolt 225. The insertion member 250 is formed of a resin with high frictional resistance to fix the relative position of the second outer cylinder member 4 and the forceps bolt 225. Furthermore, the insertion member 250 is not limited to a cylindrical shape; it can be any member clamped between the forceps bolt 225 and the second outer cylinder member 4.

[0124] (Variation Example 3)

[0125] The second outer cylinder member 4 can also be fixed to the endoscope 200 by increasing the reaction force exerted by the second outer cylinder member 4 on the clamp bolt 225. To increase the reaction force, the outer peripheral surface 4S of the second outer cylinder member 4 can, for example, be modified as follows: Figure 18 The surface shown is characterized by a relatively large surface roughness, such as an uneven shape. The surface roughness of the outer peripheral surface 4S of the second outer cylinder member 4 is higher than that of the outer peripheral surface of the first outer cylinder member 1. The surface roughness can also be imparted by machining or chemical processing of the second outer cylinder member 4. Alternatively, the surface roughness can be imparted by winding a component with surface roughness around the second outer cylinder member.

[0126] (Variation 4)

[0127] For example, in the above embodiment, stent 6 is a self-expanding stent, but the stent is not limited to a self-expanding stent. The stent may also be a non-self-expanding stent, and examples include stents made of CoCr alloys, biodegradable stents made of polylactic acid, polyglycolic acid and their copolymers. In addition, the stent may also be a fluid-expanding stent, and examples include non-self-expanding stents that expand using other treatment devices such as balloons.

[0128] Industrial availability

[0129] This invention can be applied to medical devices that deliver stents via an endoscope channel.

[0130] Explanation of reference numerals in the attached figures

[0131] 300, 300B, 300C, Endoscopic system; 200, Endoscope; 222, Forceps jaw; 225, Forceps bolt; 230, Handling instrument channel; 230a, Front end; 100, 100B, 100C, Support delivery system; 1, First outer cylinder component; 11, First opening; 12, Second opening; 13, Internal space (lumen); 14, Base end; 2, 2B, Inner cylinder component; 21, Front opening; 22, Base end opening; 23, Lumen (guide wire lumen); 24, Base end; 25, Opening; 3, Traction component; 31, Front end; 4, 4C, Second outer cylinder component; 41, First opening; 42, Second opening; 43, Internal space (lumen); 44, 44C, Front end; 45, Opening; 5, Head; 6, Support; 7, Intermediate sheath.

Claims

1. A support conveying system, wherein, The support delivery system includes: first outer cylinder member; The second outer cylinder component is positioned closer to the base end than the first outer cylinder component. An inner cylinder component is connected to the front end of the second outer cylinder component and is configured to penetrate the interior of the first outer cylinder component; A traction member, which is connected to the base end of the first outer cylinder member and configured to penetrate the interior of the second outer cylinder member; and A support structure is accommodated between the inner cylinder component and the first outer cylinder component. The surface roughness of the outer peripheral surface of the second outer cylinder component is higher than that of the outer peripheral surface of the first outer cylinder component.

2. The support conveying system according to claim 1, wherein, In the middle section between the first outer cylinder component and the second outer cylinder component, the inner cylinder component runs parallel to the traction component.

3. The support conveying system according to claim 2, wherein, The length of the middle section is longer than the length of the bracket.

4. The support conveying system according to any one of claims 1 to 3, wherein, The inner cylinder component has a guide wire cavity through which the guide wire can pass. An opening communicating with the guide wire lumen is formed in the inner cylinder component.

5. The support conveying system according to any one of claims 2 to 3, wherein, The inner cylinder component has a guide wire cavity through which the guide wire can pass. An opening communicating with the guide tube cavity is formed in the middle portion of the inner cylinder component.

6. The support conveying system according to any one of claims 1 to 3, wherein, The inner cylinder component has a guide wire cavity through which the guide wire can pass. The second outer cylinder component has an opening that communicates with the guide wire cavity.

7. The support conveying system according to claim 6, wherein, The front end of the second outer cylinder component is formed in a trumpet shape, and the opening is formed on the side of the front end.

8. The support conveying system according to claim 1, wherein, The first outer cylinder member is pulled towards the base end relative to the inner cylinder member by fixing the second outer cylinder member and the endoscope having a channel through which the stent delivery system can pass, thereby retaining the stent.

9. The support conveying system according to claim 2, wherein, The support conveying system also includes an intermediate sheath, through which the inner cylinder component and the traction component pass. The length of the middle sheath is longer than the length of the middle portion. The opening at the front end of the intermediate sheath is fixed to the base end of the first outer cylinder component, and the opening at the base end of the intermediate sheath is not fixed to the front end of the second outer cylinder component; or, the opening at the front end of the intermediate sheath is not fixed to the base end of the first outer cylinder component, and the opening at the base end of the intermediate sheath is fixed to the front end of the second outer cylinder component.

10. An endoscope system, wherein, The endoscopic system includes a stent delivery system and an endoscope having a channel through which the stent delivery system passes. The support delivery system includes: first outer cylinder member; The second outer cylinder component is positioned closer to the base end than the first outer cylinder component. An inner cylinder component is connected to the front end of the second outer cylinder component and is configured to penetrate the interior of the first outer cylinder component; A traction member, which is connected to the base end of the first outer cylinder member and configured to penetrate the interior of the second outer cylinder member; and A support structure is accommodated between the inner cylinder component and the first outer cylinder component. The surface roughness of the outer peripheral surface of the second outer cylinder component is higher than that of the outer peripheral surface of the first outer cylinder component.

11. The endoscopic system according to claim 10, wherein, The endoscope has a fixing member for fixing the second outer cylinder component.

12. The endoscopic system according to claim 11, wherein, The fixing member is an insertion member that is clamped by the forceps bolt of the endoscope and the second outer cylinder member.

13. The endoscopic system according to claim 10, wherein, The inner cylinder component has a guide wire cavity through which the guide wire can pass. The second outer cylinder component has an opening that communicates with the guide wire cavity.

14. The endoscopic system according to claim 13, wherein, The front end of the second outer cylinder component is formed in a trumpet shape, and the opening is formed on the side of the front end.

15. The endoscopic system according to claim 10, wherein, By fixing the second outer cylinder component and the endoscope to each other, the first outer cylinder component is pulled towards the base end relative to the inner cylinder component, thereby retaining the support.

16. The endoscopic system according to claim 10, wherein, The support conveying system also includes an intermediate sheath, through which the inner cylinder component and the traction component pass. The length of the intermediate sheath is longer than the length of the intermediate portion between the first outer cylinder component and the second outer cylinder component. The opening at the front end of the intermediate sheath is fixed to the base end of the first outer cylinder component, and the opening at the base end of the intermediate sheath is not fixed to the front end of the second outer cylinder component; or, the opening at the front end of the intermediate sheath is not fixed to the base end of the first outer cylinder component, and the opening at the base end of the intermediate sheath is fixed to the front end of the second outer cylinder component.

Images