Method for producing graduated transparent guide tube for use in removal surgery for endoscopic hematoma

Abstract

To provide a method for manufacturing a transparent guide tube used when inserting a surgical instrument such as an endoscope and a suction tube into the vicinity of a lesion in a deep part of the brain through a punctured lumen in a removal surgery for endoscopic hematoma in a neurosurgery field.SOLUTION: A transparent guide tube constituted of a cylindrical outer tube 7 and a cylindrical inner tube used for a removal surgery for endoscopic hematoma is constituted of the outer tube 7 having a structure in which a position scale 8 and a numeral scale 9 are given to the inside of the outer tube along the longitudinal direction and the inner tube having a structure in which the position scale and the numeral scale are given to the outside of the inner tube along the longitudinal direction. In the transparent guide tube, a cylindrical outer cylinder 7 is structured so as to be cut by scissors or the like, and the cylindrical outer cylinder 7 is not crushed and has such hardness as to be deformed according to the deformation of the surgical instrument inserted into the outer cylinder 7. Further, core rods are installed at four positions in the circumferential direction in the cylindrical outer cylinder, the core rods are pushed out from the tip part of the outer cylinder to the outside, and the area of the outer cylinder in this region is enlarged.SELECTED DRAWING: Figure 3

Description

Technical Field

[0001] The present invention relates to the manufacture of a transparent guide tube used for inserting surgical instruments such as an endoscope and a suction tube through a drilled lumen to the vicinity of a deep brain lesion in endoscopic hematoma removal in the field of neurosurgery.

Background Art

[0002] When intracerebral hemorrhage occurs, endoscopic hematoma removal, which is a minimally invasive surgery, has been increasingly performed in recent years. In this surgical method, the scalp is incised about several centimeters, a small hole is made in the skull, and a transparent tube-shaped guide tube for inserting an endoscope and a suction tube for removing bleeding (hematoma) is inserted to the bleeding site. Then, the hematoma is removed, and the severed blood vessel that caused the bleeding is found and hemostasis is performed.

[0003] This surgery is often performed using a resin-made transparent guide tube called "Neuroport" sold by Olympus Corporation. This device is a guide tube composed of a cylindrical outer tube and an inner tube, and scales are provided on the inner tube at intervals of about 10 mm. Since it is molded using the same resin and only colored, when inserting through the hole made in the skull with the inner tube inserted and attached to the outer tube, the insertion position can be confirmed while the scale can be seen from the outside through the outer tube.

[0004] After the guide tube reaches the affected bleeding part, the inner tube is pulled out, and the endoscope and the suction tube are inserted. However, since there are no scales on the outer tube, the insertion positions of the endoscope and the suction tube are unknown, and the surgeon has to rely on memory.

[0005] To solve this problem, in Patent Document 1, scales are provided not only on the inner tube but also on the outer tube. However, since these scales have no X-ray contrast (are X-ray transmissive), even if an attempt is made to three-dimensionally grasp the inside of the brain including the guide tube by X-ray irradiation, it cannot be done because there are no scales, and it is only possible to confirm the insertion position visually.

[0006] In order to provide X-ray contrast graduations, Patent Document 2 attaches a metal ring with X-ray contrast (X-ray impermeability) to the outer cylinder. However, since it adopts a method of producing an annular groove for fixing the metal ring to the cylindrical thin tube by cutting, the processing is difficult, the processing accuracy is poor, mass production is impossible, and it has not yet been put into practical use.

[0007] As a method with good processing accuracy and mass production possibility due to improvement of the processing method, in Patent Document 3, in a transparent guide tube, the position graduations sandwiched between two layers of the outer cylinder are formed by bending a metal thin film into a ring shape and fixing it only by the adhesion of the two layers without forming a groove on the inner layer surface of the two layers, and the numerical graduations are corresponded by pasting a resin thin film with numbers printed on it to the inner layer surface of the two layers. Thereby, under X-ray irradiation, a three-dimensional grasp including the guide tube with graduations in the brain becomes possible, a minimally invasive operation can be performed without imposing a burden on the patient, it can be accurately inserted to the position where an appropriate endoscope and suction tube should be required, hematoma suction and hemostasis are possible, and the treatment of the patient is effectively carried out. However, the manufacturing cost is extremely high, and although the performance evaluation by trial production is perfect, it has not yet been put into practical use.

Prior Art Documents

Patent Documents

[0008]

Patent Document 1

Patent Document 2

Patent Document 3

[0009] However, with the recent advancements in endoscopic hematoma removal, in a guide tube with graduations, there is no longer a necessity to use a material with X-ray contrast for both position graduations and numerical graduations. As a result, in the method shown in Patent Document 3 with good processing accuracy and mass producibility, it has become possible to significantly reduce the manufacturing cost. That is, in endoscopic hematoma removal, in order to enable a three-dimensional understanding including a guide tube with graduations in the brain, a manufacturing method with good processing accuracy and mass producibility at a low cost is required. Furthermore, a guide tube with many functions has come to be demanded.

Summary of the Invention

Problems to be Solved by the Invention

[0010] In endoscopic hematoma removal, in order to enable a three-dimensional understanding including a guide tube with graduations in the brain, there is a problem of inexpensively providing graduations to the guide tube by a method with good processing accuracy and mass producibility. Also, as graduations, in addition to equally spaced strip-shaped graduations indicating position, there is also a problem of providing numerical graduations indicating specific positions along the length direction of the position graduations. Although it is no longer necessary to use a material with X-ray contrast as graduations, a guide tube with many functions has come to be demanded. Many functions mean that the diameter of the guide tube can be variously changed, and in addition to hematoma removal, it can also handle biological tissue sampling and brain tumors, and there is also a demand for a function to change the length of the guide tube during the operation and a function to expand the area of the guide tube in the brain.

Means for Solving the Problems

[0011] In order to solve the above-mentioned problems, the present invention is characterized in that in a transparent guide tube composed of a cylindrical outer tube and a cylindrical inner tube used in endoscopic hematoma removal, the outer tube has a structure in which position graduations and numerical graduations are provided along the length direction inside the outer tube, and the inner tube has a structure in which position graduations and numerical graduations are provided along the length direction on the outside of the inner tube that can be smoothly inserted, attached, and withdrawn from the outer tube.

[0012] Moreover, the present invention is characterized in that in the transparent guide tube, the cylindrical outer tube has a structure that can be cut with scissors or the like as needed.

[0013] Furthermore, the present invention is characterized in that in the transparent guide tube, the cylindrical outer tube is not crushed and has a hardness such that it deforms according to the deformation of the surgical instrument inserted into the outer tube.

[0014] Still further, the present invention is characterized in that in the transparent guide tube, mandrels wrapped with soft transparent sheets are installed at four circumferential positions on the cylindrical outer tube, and the mandrels are pushed out to the outside from the tip of the outer tube as needed to expand the area of the outer tube in this region.

Advantages of the Invention

[0015] By using the transparent guide tube of the present invention, in endoscopic hematoma removal surgery, a three-dimensional understanding including the guide tube in the brain becomes possible, minimally invasive surgery can be performed without imposing a burden on the patient, the endoscope and the suction tube can be accurately inserted to the required positions, hematoma suction and hemostasis can be performed, and the treatment of the patient can be effectively carried out. Also, the treatment cost can be reduced. Also, in terms of clarity, since the cylindrical outer tube can be cut with scissors or the like as needed during the operation, there is no need to replace the guide tube with a new one, the endoscope and the suction tube can be accurately inserted to the required positions, leading to a shortening of the operation time. Furthermore, in the present invention, since a transparent guide tube (outer tube) with appropriate hardness can be used, the surgical instrument inserted into the outer tube can be operated in a form that fully satisfies its function, which is extremely effective for the operator. Still further, in the present invention, after inserting the outer tube to the lesion position (bleeding part), the area of the outer tube can be expanded, so that hematoma removal and hemostasis can be effectively performed.

Brief Description of the Drawings

[0016]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Mode for Carrying Out the Invention

[0017] Hereinafter, the manufacturing method of the present invention will be specifically described with reference to the drawings.

[0018] Figure 3 is a diagram showing graduations and numerical graduations applied inside the cylindrical outer cylinder. The inner diameter is basically 10 mm, but those with inner diameters of 6, 8, 12, and 15 mm are added according to the requirements of the operator. The thickness is basically 1.0 mm and the length is basically 120 mm. The interval between the position graduations is basically 10 mm.

[0019] The material is a fluorine-based or Teflon-based resin tube so that no harmful components elute even when inserted into the brain, and a commercially available resin tube can be used as it is. The hardness of the cylindrical outer cylinder needs to be such that it is not crushed and deforms according to the deformation of the surgical instrument inserted into the outer cylinder, and it is necessary to select the material and thickness.

[0020] The position graduations and numerical graduations applied inside the cylindrical outer cylinder can be made by laser marking, and the thickness dissolved by the laser is set to about 0.025 to 0.05 mm (10 in Figure 4). As a result, the graduations do not disappear and no unevenness occurs in the inner diameter. Note that when applying the numerical graduations inside the cylindrical outer cylinder so that they can be normally seen when viewed from the endoscope inserted into the outer cylinder, the front and back are reversed.

[0021] Figure 1 is a diagram with scale marks and numerical scales provided on the outside of a cylindrical inner tube. The outer diameter is set to have a gap of about 0.05 - 0.1 mm so that it can be smoothly inserted, attached, and removed from the cylindrical outer tube. Also, in order to avoid the possibility of negative pressure being applied and bleeding when removing the cylindrical inner tube, grooves can be provided on the side surface of the cylindrical inner tube. The thickness is based on 2.0 mm.

[0022] As the material, a commercially available transparent acrylic tube is used. For bonding the handle and the lens, an "ultraviolet curable resin" that cures when exposed to ultraviolet light can be used.

[0023] When cutting the cylindrical outer tube shorter with scissors or the like, insert the scissors between the appropriate scale marks at the upper part of Figure 3. In order to align the tip parts of the cylindrical inner tube and the cylindrical outer tube, it is necessary to insert a stopper at the upper part of the cylindrical inner tube.

[0024] Figure 5 is a diagram showing the structure of a device for expanding the area of the tip of the outer tube after inserting the outer tube to the lesion position (bleeding part). (a) is a diagram showing the state before expansion as seen from the lower part of the outer tube. In order to install a mandrel wrapped with a soft transparent sheet in the outer tube, the outer tube needs to be a double tube, and a soft transparent sheet with a length sufficient to ensure expansion together with the mandrel is stored therein.

[0025] (b) is a diagram showing the state after expansion as seen from the lower part of the outer tube. By a driving device that expands the mandrel towards the outside of the outer tube, a region with a square area having the length of the transparent sheet sufficient to ensure expansion as one side and the mandrel as the apex is formed. (c) is a diagram of this state as seen from the side.

[0026] How much area is to be ensured beyond the lower end part of the cylindrical outer tube is determined by the length of the mandrel that expands towards the outside and the length of the soft transparent sheet, etc. Furthermore, it is necessary to carefully design the structure for preventing the backflow of blood from the intracerebral lesion part.

Industrial Applicability

[0027] Hereinafter, the industrial applicability of the present invention will be described.

[0028] If a guide tube of the present invention, which is provided with position graduations and numerical graduations along the longitudinal direction of the guide tube, has good machining accuracy and can be mass-produced, and is provided at low cost, a three-dimensional grasp including a guide tube with graduations in the brain can be achieved, and a minimally invasive surgery that does not impose a burden on the patient can be performed, enabling accurate hematoma aspiration and hemostasis, realizing an innovative and effective treatment for the patient, and reducing the treatment cost. In addition, if a function of changing the length of the guide tube during the operation is provided, there is no need to replace the guide tube with a new one, and it can be accurately inserted to the required position of the endoscope and the suction tube, leading to a reduction in the operation time. If a transparent guide tube (outer cylinder) with appropriate hardness is provided, the surgical instruments inserted into the outer cylinder can be operated in a form that fully satisfies their functions, which is extremely effective for the operator. Furthermore, if guide tubes with various diameters are provided, in addition to hematoma removal, it is possible to handle biopsy and brain tumors. Moreover, if the area of the outer cylinder can be expanded after inserting the outer cylinder to the lesion position (bleeding part), hematoma removal and hemostasis can be effectively performed.

Explanation of Reference Numerals

[0029] 1: Cylindrical inner cylinder provided with graduations 2: Handle of the cylindrical inner cylinder 3: Lens of the cylindrical inner cylinder 4: Position graduation of the cylindrical inner cylinder 5: Numerical graduation of the cylindrical inner cylinder 6: Graduation provided on the outside of the cylindrical inner cylinder 7: Cylindrical outer cylinder provided with graduations 8: Position graduation of the cylindrical outer cylinder 9: Numerical graduation of the cylindrical outer cylinder 10: Graduation provided on the inside of the cylindrical outer cylinder 11: Cylindrical outer cylinder 12: Mandrel 13: Soft transparent sheet

Claims

1. In a transparent guide tube composed of a cylindrical outer tube and a cylindrical inner tube used for endoscopic hematoma removal, the outer tube has a structure with position graduations and numerical graduations provided along the length direction on the inner side, and the inner tube has a structure with position graduations and numerical graduations provided along the length direction on the outer side of the inner tube that can be smoothly inserted into, attached to, and withdrawn from the outer tube. A method for manufacturing a transparent guide tube, characterized by being composed of the outer tube and the inner tube

2. In the transparent guide tube according to Claim 1, the cylindrical outer tube has a structure that can be cut with scissors or the like as needed. A method for manufacturing a transparent guide tube, characterized by this

3. In the transparent guide tube according to Claim 1, the cylindrical outer tube is not crushed and has a hardness such that it deforms according to the deformation of the surgical instrument inserted into the outer tube. A method for manufacturing a transparent guide tube, characterized by this

4. In the transparent guide tube according to Claim 1, mandrels with soft transparent sheets wound around the cylindrical outer tube are installed at four locations in the circumferential direction, and the mandrels are pushed out externally from the tip of the outer tube as needed to expand the area of the outer tube in this region. A method for manufacturing a transparent guide tube, characterized by this

Images