Gastrostomy catheter kit

Abstract

To provide an insertion jig and a gastrostomy catheter kit that enable more stable placement of the gastrostomy catheter on the body surface. [Solution] The insertion jig 100 for a gastrostomy catheter is an insertion jig used to insert and leave in place the bumper 250 and shaft 210 of a gastrostomy catheter 200, which has a shaft 210 having a lumen 211, a bumper 250 provided at the lower end of the shaft 210, and a body surface contact portion 220 provided at the upper end of the shaft 210, through a fistula 430. The jig comprises a tubular body 10 extending vertically and a connecting portion 40 provided on the tubular body 10 and detachably hooked onto a connecting portion 230 formed at the upper end of the body surface contact portion 220.

Description

Technical Field

[0001] The present invention relates to an insertion jig for a gastrostomy catheter and a gastrostomy catheter kit.

Background Art

[0002] As an insertion jig for a gastrostomy catheter used for indwelling a gastrostomy catheter, for example, there is one described in Patent Document 1. The insertion jig for a gastrostomy catheter in Patent Document 1 (described as a gastrostomy catheter insertion assisting kit in the same document) has a holding part (described as a locking member in the same document) capable of holding the body surface contact part of the gastrostomy catheter (described as an external fixing part in the same document), and in a state where the holding part holds the body surface contact part, a part of the holding part is disposed below the lower surface of the body surface contact part.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] According to the study by the inventor of the present application, there is still room for improvement in the insertion jig for a gastrostomy catheter in Cited Document 1 with respect to the stability of the gastrostomy catheter against the body surface.

[0005] The present invention has been made in view of the above problems, and provides an insertion jig for a gastrostomy catheter and a gastrostomy catheter kit having a structure capable of indwelling the gastrostomy catheter more stably against the body surface.

Means for Solving the Problems

[0006] According to the present invention, an insertion jig is used for inserting and placing the bumper and shaft of a gastrostomy catheter, which has a shaft having a lumen, a bumper provided at the lower end of the shaft, and a body surface contact portion provided at the upper end of the shaft, through a fistula. A tubular body extending vertically, A connecting portion is provided on the tubular body and is detachably hooked onto a connecting portion formed at the upper end of the body surface contact portion, An insertion device for a gastrostomy catheter is provided, which includes the following features.

[0007] Furthermore, the present invention provides a gastrostomy catheter kit comprising the insertion jig for a gastrostomy catheter of the present invention and the gastrostomy catheter. [Effects of the Invention]

[0008] According to the present invention, it becomes possible to more stably place a gastrostomy catheter on the body surface. [Brief explanation of the drawing]

[0009] [Figure 1] This is a perspective view of a gastrostomy catheter kit according to the first embodiment. [Figure 2] Figures 2(a) and 2(b) are longitudinal cross-sectional views of a gastrostomy catheter kit according to the first embodiment. [Figure 3] This is a front view of an insertion jig for a gastrostomy catheter according to the first embodiment. [Figure 4] Figures 4(a) and 4(b) show the connecting portion and surrounding structure of the insertion jig in the first embodiment, with Figure 4(a) being a perspective view and Figure 4(b) being a bottom view. [Figure 5] Figure 5(a) is a perspective view showing the connected portion and surrounding structure of the gastrostomy catheter in the first embodiment, and Figure 5(b) is a cross-sectional view along the BB line shown in Figure 2(a). [Figure 6]Figures 6(a), 6(b), 6(c), and 6(d) show the locking member in the first embodiment, where Figure 6(a) is a plan view, Figure 6(b) is a side view, Figure 6(c) shows the locking member inserted into the tubular body, and Figure 6(d) shows the locking member removed from the tubular body. [Figure 7] Figures 7(a) and 7(b) are side views showing the connecting portion of the insertion jig and the connected portion of the gastrostomy catheter and their surrounding structures in the first embodiment. Figure 7(a) shows the state where the claw portion is located at the other end of the recess, and Figure 7(b) shows the state where the connecting portion is rotated relative to the connected portion from the state shown in Figure 7(a). [Figure 8] Figures 8(a) and 8(b) are diagrams illustrating the operation of the gastrostomy catheter kit according to the first embodiment. Figure 8(a) shows the gastrostomy catheter kit inserted into the fistula, and Figure 8(b) shows the guidewire removed from the gastrostomy catheter kit. [Figure 9] Figures 9(a) and 9(b) are diagrams illustrating the operation of the gastrostomy catheter kit according to the first embodiment. Figure 9(a) shows the inner tube being pushed downward relative to the outer tube, and Figure 9(b) shows the insertion jig for the gastrostomy catheter being removed from the gastrostomy catheter. [Figure 10] Figures 10(a), 10(b), and 10(c) are longitudinal cross-sectional views showing the connecting portion of the insertion jig and the connected portion of the gastrostomy catheter and their surrounding structures in Modified Example 1. Figure 10(a) shows the state before the connecting portion is hooked onto the connected portion, Figure 10(b) shows the state after the connecting portion is hooked onto the connected portion, and Figure 10(c) shows the state after the connecting portion is separated from the connected portion. [Figure 11] Figures 11(a) and 11(b) are longitudinal cross-sectional views showing the connecting portion, the connected portion and its surrounding structure in modified example 2. Figure 11(a) shows the state before the connecting portion is engaged with the connected portion, and Figure 11(b) shows the state after the connecting portion is engaged with the connected portion. [Figure 12] This is a longitudinal cross-sectional view of a gastrostomy catheter kit according to the second embodiment. [Figure 13] Fig. 13(a) is a perspective view showing the connected portion of the gastrostomy catheter and its peripheral structure in the second embodiment, and Fig. 13(b) is a plan view. [Figure 14] Figs. 14(a), 14(b) and 14(c) are views showing the connection connector in the second embodiment. Among them, Fig. 14(a) is a perspective view, Fig. 14(b) is a bottom view, and Fig. 14(c) is a side view. [Figure 15] Figs. 15(a) and 15(b) are side views showing the connecting portion of the insertion jig, the connected portion of the gastrostomy catheter, and its peripheral structure in the second embodiment. Among them, Fig. 15(a) shows a state where the second claw portion is located at the other end of the concave portion, and Fig. 15(b) shows a state where the connecting portion is rotated with respect to the connected portion from the state shown in Fig. 15(a).

Mode for Carrying Out the Invention

[0010] Hereinafter, each embodiment of the present invention will be described with reference to the drawings. In all the drawings, the same reference numerals are given to the same components, and the description thereof will be omitted as appropriate.

[0011] 〔First Embodiment〕 First, the first embodiment will be described with reference to Figs. 1 to 11(b). Note that Fig. 2(a) is a cross-sectional view taken along the line B-B shown in Fig. 3, and Fig. 2(b) is a cross-sectional view taken along the line A-A shown in Fig. 2(a). Also, Figs. 8(a) to 9(b) are cross-sectional views at positions corresponding to the line B-B shown in Fig. 3. In addition, the various components of the gastrostomy catheter kit 300 of the present invention do not necessarily exist independently. It is acceptable that a plurality of components are formed as one member, one component is formed of a plurality of members, a certain component is a part of another component, a part of a certain component and a part of another component overlap, and the like. In the following description, it is assumed that the downward direction in FIGS. 2(a) and 2(b) is downward and the upward direction is upward. Also, the axial direction of the tubular body 10 may be simply referred to as the axial direction, and the radial direction of the tubular body 10 may be simply referred to as the radial direction. Further, the circumferential direction of the tubular body 10 may be simply referred to as the circumferential direction.

[0012] As shown in FIGS. 1, 2(a), and 2(b), an insertion jig (hereinafter, insertion jig 100) for a gastrostomy catheter according to the present embodiment is used to insert and留置 the bumper 250 and the shaft 210 of the gastrostomy catheter 200 having a lumen 211, a bumper 250 provided at the lower end of the shaft 210, and a body surface contact portion 220 provided at the upper end of the shaft 210 through a fistula hole 430 (see FIGS. 8(a) and 8(b), etc.). The insertion jig 100 includes a tubular body 10 extending vertically and a connecting portion 40 provided on the tubular body 10 and detachably hooked to a connecting portion 230 formed at the upper end of the body surface contact portion 220.

[0013] According to the present embodiment, the insertion jig 100 includes a connecting portion 40 that is detachably hooked to a connecting portion 230 formed at the upper end of the body surface contact portion 220. Thereby, since the insertion jig 100 is connected to the connecting portion 230 disposed at the upper end of the body surface contact portion 220, the insertion jig 100 can be prevented from潜入 the lower surface side of the body surface contact portion 220. For this reason, the gastrostomy catheter 200 can be disposed such that the lower surface of the body surface contact portion 220 follows the body surface, so that the gastrostomy catheter 200 can be more stably留置 on the body surface. Furthermore, according to the present embodiment, by hooking the connecting portion 40 to the connecting portion 230, the insertion jig 100 can be attached to the gastrostomy catheter 200. Also, by releasing the hook of the connecting portion 40 with respect to the connecting portion 230, the insertion jig 100 can be removed from the gastrostomy catheter 200. That is, the attachment and detachment of the insertion jig 100 to and from the gastrostomy catheter 200 become easier.

[0014] The gastrostomy catheter kit 300 according to this embodiment comprises an insertion jig 100 for a gastrostomy catheter and a gastrostomy catheter 200.

[0015] As shown in Figures 1 and 3, the tubular body 10 comprises, for example, an outer tube portion 20 having a connecting portion 40 that is detachably connected to the upper end of the shaft 210, and an inner tube portion 30 through which a guide wire 500 (Figure 8(a)) can be inserted and which is inserted into the outer tube portion 20 so as to be vertically slidable. In Figure 8(a), the guide wire 500 is shown by a dashed line.

[0016] The outer tube portion 20 is formed in a cylindrical shape with the vertical direction as its axial direction. A finger rest portion 25 is formed at the upper end of the outer tube portion 20, where the user's fingers can be placed. The finger rest portion 25 is formed as a flat plate that protrudes radially outward from the outer circumferential surface of the upper end of the outer tube portion 20, and its surface is perpendicular to the axial direction. The planar shape of the finger rest portion 25 is, for example, approximately circular.

[0017] In this embodiment, as shown in Figures 4(a) and 4(b), the connecting portion 40 includes, for example, a pair of protruding portions 42 extending laterally from the tubular body 10, a pair of downwardly protruding portions 44 each projecting downward from the tips of the pair of protruding portions 42, and a pair of claw portions 46 each projecting radially inward from the lower ends of the pair of downwardly protruding portions 44. More specifically, in this embodiment, the connecting portion 40 is formed at the lower end of the outer tube portion 20, and the pair of protruding portions 42 protrude laterally from the lower end of the outer tube portion 20. Here, "later" refers to the direction perpendicular to the axial direction, i.e., the radial direction. In this embodiment, the pair of protruding portions 42 are positioned at different locations relative to each other, for example, around the axis of the outer tube portion 20. More specifically, for example, they are positioned 180 degrees rotationally symmetrical with respect to the axis of the outer tube portion 20. Similarly, the pair of downward projections 44 are positioned 180 degrees rotationally symmetrical with respect to the axis of the outer tube portion 20, and the pair of claw portions 46 are also positioned 180 degrees rotationally symmetrical with respect to the axis of the outer tube portion 20. As shown in Figures 2(a) and 3, each of the pair of protruding portions 42 is formed in a flat plate shape perpendicular to the axial direction. Furthermore, each of the pair of protruding portions 42 is wider toward the outer tube portion 20. This ensures sufficient bending rigidity of the pair of protruding portions 42. In this embodiment, one downward projection 44 protrudes downward from each of the two protruding portions 42 (the tip in the protruding direction). The upper part of the downward projection 44 gradually widens towards the protruding portion 42. The lower part of the downward projection 44 remains substantially constant regardless of its position in the vertical direction. This suppresses stress concentration at the boundary between the protruding portion 42 and the downward projection 44. Furthermore, as shown in Figure 3, each claw portion 46 protrudes radially inward from the lower end of the downward projection 44. As shown in Figure 4(b), the tip surface 46a (the tip in the projection direction) of each claw portion 46 is, for example, a flat surface perpendicular to the radial direction. Similarly, the upper end surface of each claw portion 46 is a flat surface perpendicular to the axial direction. In addition, a portion of both ends of each claw portion 46 in the circumferential direction is a chamfered shape portion 46b. Furthermore, the connecting portion 40 has a cylindrical portion 41 that protrudes downward from the lower end of the outer tube portion 20. The outer diameter of the cylindrical portion 41 is set to be approximately the same as the inner diameter of the outer tube portion 20.

[0018] As shown in Figures 2(a), 2(b), and 3, the inner tube portion 30 includes, for example, a first cylindrical portion 31 that is inserted into the outer tube portion 20 so as to be slidable vertically, and a second cylindrical portion 36 that protrudes downward from an opening at the lower end of the first cylindrical portion 31. Each of the first cylindrical portion 31 and the second cylindrical portion 36 is formed in a cylindrical shape with the vertical direction as its axial direction. The lumen of the first cylindrical portion 31 and the lumen of the second cylindrical portion 36 are in communication with each other and constitute the lumen of the inner tube portion 30. The inner diameter of the first cylindrical portion 31 is set to be approximately the same as the outer diameter of the second cylindrical portion 36. The outer diameter of the first cylindrical portion 31 is set to be slightly smaller than the inner diameter of the outer tube portion 20. The upper end of the second cylindrical portion 36 is fitted into the lumen of the lower end of the first cylindrical portion 31, and the first cylindrical portion 31 and the second cylindrical portion 36 are integrally inserted into the lumen of the outer tube portion 20 so as to be slidable.

[0019] Here, a pressing portion 38 is formed at the upper end of the first cylindrical portion 31, which is pressed downward by the user. When the pressing portion 38 is pressed downward, the inner tube portion 30 (the first cylindrical portion 31 and the second cylindrical portion 36) is pushed downward relative to the outer tube portion 20. The pressing portion 38 is formed as a flat plate that protrudes radially outward from the outer circumferential surface of the upper end of the first cylindrical portion 31, for example, and its plate surface is perpendicular to the axial direction. The planar shape of the pressing portion 38 is, for example, approximately circular. As shown in Figures 2(a) and 2(b), the outer diameter of the finger rest portion 25 of the outer tube portion 20 and the outer diameter of the pressing portion 38 are set to approximately the same dimensions. The lower surface of the pressing portion 38 and the upper surface of the finger rest portion 25 face each other. As shown in Figure 9(a), during the pushing operation, the lower surface of the pressing portion 38 comes into contact with the upper surface of the finger rest portion 25, thereby restricting further downward movement of the inner tube portion 30 relative to the outer tube portion 20. Furthermore, the lumen of the inner tube section 30 (first cylindrical section 31) is open at the upper end surface of the pressing section 38 (hereinafter referred to as the opening 39), and one end of the guide wire 500, which is inserted into the lumen of the inner tube section 30, is led out to the outside through the opening 39.

[0020] Furthermore, in this embodiment, the vertical dimension of the inner tube portion 30 is greater than the vertical dimension of the outer tube portion 20, and the lower end of the inner tube portion 30 protrudes from the opening on the lower end side of the outer tube portion 20. More specifically, the vertical dimension of the first cylindrical portion 31 is set to be approximately the same as or slightly smaller than the vertical dimension of the outer tube portion 20. On the other hand, the vertical dimension of the second cylindrical portion 36 is greater than the vertical dimension of the first cylindrical portion 31 and also greater than the vertical dimension of the outer tube portion 20. Therefore, at least the lower end of the second cylindrical portion 36 protrudes from the opening on the lower end side of the outer tube portion 20. As the inner tube portion 30 is pushed downward relative to the outer tube portion 20, the amount of protrusion of the second cylindrical portion 36 from the opening on the lower end side of the outer tube portion 20 increases.

[0021] The outer tube portion 20 and the first cylindrical portion 31 are integrally formed from, for example, a rigid resin material. The rigid resin material is not particularly limited, but examples include polyethylene, polyolefins such as polypropylene, polyamide, polycarbonate, and polystyrene. The second cylindrical portion 36 is made of a metal material such as stainless steel (SUS). The inner tube section 30 may, for example, be integrally molded as a whole. The outer tube section 20 may, for example, be constructed by assembling a plurality of individually molded components.

[0022] Furthermore, in this embodiment, the insertion jig 100 includes a locking member 60 (see Figures 6(a) to 6(d), etc.) that is detachably attached to the outer tube portion 20 and the inner tube portion 30. When the locking member 60 is attached to the outer tube portion 20 and the inner tube portion 30, it maintains a state in which the vertical movement of the inner tube portion 30 relative to the outer tube portion 20 is restricted. More specifically, the locking member 60 has a base portion 62 and a bifurcated portion 64 that protrudes from the base portion 62 in a bifurcated manner. The base portion 62 is formed, for example, as a long, roughly rectangular flat plate. One surface of the base portion 62 faces the outer tube portion 20. As shown in Figure 3, the width dimension (lengthwise dimension) of the base portion 62 is set to be smaller than the outer diameter of the finger rest portion 25. This prevents the locking member 60 from interfering with the user's hand when the user grips the insertion jig 100. The bifurcated portion 64 is formed as a flat plate that protrudes from the surface of the base portion 62 on the outer tube portion 20 side in a direction perpendicular to the plate surface of the base portion 62. The plate surface of the bifurcated portion 64 is perpendicular to the longitudinal direction of the base portion 62 and also perpendicular to the axial direction. The bifurcated portion 64 has a notched portion 64a that penetrates the bifurcated portion 64 in the thickness direction. The notched portion 64a extends in a direction perpendicular to the plate surface of the base portion 62 and is open toward the outer tube portion 20 side. Because such a notched portion 64a is formed in the bifurcated portion 64, the bifurcated portion 64 is formed in a bifurcated shape that is open toward the outer tube portion 20 side.

[0023] The inner tube portion 30 has, for example, a constricted portion 33 (see Figures 6(c) and 6(d)) that engages with the bifurcated portion 64, and the engagement of the bifurcated portion 64 with the constricted portion 33 restricts the vertical movement of the inner tube portion 30 relative to the outer tube portion 20. More specifically, on the outer circumferential surface of the first cylindrical portion 31, a portion in the axial direction is locally narrower in diameter, and this narrowed portion constitutes a constricted portion 33. Furthermore, as shown in Figures 1 and 2(b), the outer tube portion 20 has a notch 22 into which, for example, the bifurcated portion 64 can be inserted from the side. In this embodiment, two notches 22 are formed in the outer tube portion 20. The two notches 22 are positioned 180 degrees rotationally symmetrical to each other with respect to the axis of the outer tube portion 20. Each notch 22 is a slit that penetrates the inside and outside of the outer tube portion 20 and extends horizontally. Also, in this embodiment, as shown in Figure 3, each notch 22 is formed at the upper end of the outer tube portion 20. Therefore, the locking member 60 is attached to the upper end of the outer tube portion 20.

[0024] In this embodiment, as shown in Figure 6(d), the notches 22 and the constricted portion 33 are formed at positions corresponding to each other in the axial direction (the constricted portion 33 can be seen through the notches 22 when viewed from one side in the radial direction). Therefore, as shown in Figures 6(a) and 6(c), when the bifurcated portion 64 is inserted into each of the notches 22, the bifurcated portion 64 engages with a portion of the constricted portion 33 in the circumferential direction. More specifically, as shown in Figure 6(c), the maximum opening width of the notched portion 64a is smaller than the outer diameter of the first cylindrical portion 31 and is approximately the same as the outer diameter of the constricted portion 33. Furthermore, the dimensions of the axial cut 22 and the constricted portion 33 are set to approximately the same dimensions as, for example, the thickness of the bifurcated portion 64. When the bifurcated portion 64 is inserted into each notch 22, the bifurcated portion 64 engages with each notch 22, thereby restricting the vertical movement of the outer tube portion 20 relative to the locking member 60. Furthermore, since the bifurcated portion 64 fits into the constricted portion 33, the vertical movement of the inner tube portion 30 relative to the locking member 60 is restricted. Thus, the vertical movement of the inner tube portion 30 relative to the outer tube portion 20 is restricted. In this way, the locking member 60 is attached to the outer tube portion 20 and the inner tube portion 30, and the vertical movement of the inner tube portion 30 relative to the outer tube portion 20 is maintained in a restricted state.

[0025] In this embodiment, as shown in Figures 8(a) and 8(b), the gastrostomy catheter 200 further includes, in addition to the shaft 210, lumen 211, body surface contact portion 220, connecting portion 230, and bumper 250 described above, a capsule cover 260 that maintains the bumper 250 in a contracted state. In this embodiment, with the connecting portion 40 connected to the connected portion 230, the portion of the second cylindrical portion 36 protruding from the opening at the lower end of the outer tube portion 20 is inserted into the lumen 211 and the interior of the capsule cover 260. The lower end of the second cylindrical portion 36 then presses the capsule cover 260 downward, causing the capsule cover 260 to detach from the bumper 250, thereby expanding the bumper 250. This locks the bumper 250 to the stomach wall 420 and places the gastrostomy catheter 200 in place. In this state, the gastrostomy catheter 200 connects the inside of the stomach with the outside of the body, and a liquid such as a nutritional supplement is injected into the stomach via the gastrostomy catheter 200. Note that the capsule cover 260 is not shown in Figures 1, 2(a), and 2(b). Also, in Figures 8(a) and 8(b), the retracted bumper 250 is shown by a dashed line.

[0026] In this embodiment, the lumen of the shaft 210 constitutes the lumen 211. As shown in Figures 2(a) and 2(b), the shaft 210 is formed in a cylindrical shape with its axial direction in the vertical direction. The outer diameter of the lower end of the shaft 210 is tapered in two stages, for example, downwards. The outer diameter of the upper end of the shaft 210 is relatively larger than that of the rest of the shaft 210. A connecting portion 230 is attached to the upper end of the shaft 210. The body surface contact portion 220 is the part exposed to the user's body surface when the gastrostomy catheter 200 is in place, and the lower surface of the body surface contact portion 220 faces the outer surface of the abdominal wall 410. The body surface contact portion 220 protrudes laterally from, for example, the outer peripheral surface of the upper end of the shaft 210. The lower surface of the body surface contact portion 220 is formed flat. In this embodiment, as described above, the insertion jig 100 is connected to the connecting portion 230 located at the upper end of the body surface contact portion 220, so the insertion jig 100 does not slip under the body surface contact portion 220. Therefore, the insertion jig 100 is not located below the lower surface of the body surface contact portion 220, and the lower surface of the body surface contact portion 220 is able to face the outer surface of the abdominal wall 410 directly. As a result, the lower surface of the body surface contact portion 220 can be positioned along the outer surface of the abdominal wall 410, so that the gastrostomy catheter 200 can be stably placed on the body surface. Furthermore, a plug member 82, as shown in Figure 1, is formed on the body surface contact portion 220. The plug member 82 can be inserted into the upper end of the check valve 240 to close the opening 231 on the upper end side of the connected portion 230.

[0027] The shaft 210 and the body surface contact portion 220 are integrally molded from, for example, a resin material. The resin material is not particularly limited, but examples include polyvinylidene fluoride resin, polytetrafluoroethylene resin, polyethylene resin, polypropylene resin, or silicone rubber or other rubber materials.

[0028] The capsule cover 260 is formed, for example, as a bottomed cylindrical shape with the vertical direction as its axial direction. As shown in Figure 8(a), the capsule cover 260 is attached to the lower end of the shaft 210, and the bumper 250 is housed in a contracted state inside the capsule cover 260 before the gastrostomy catheter 200 is placed. An insertion hole 261 is formed at the bottom of the capsule cover 260, through which a guide wire 500 can be inserted. The materials constituting the capsule cover 260 are not particularly limited, but examples include cellulose-based or gelatin-based edible materials, or biodegradable materials such as polylactic acid.

[0029] The bumper 250 is flexible and expandable in the radial direction. A portion of a wire (not shown) is arranged inside the bumper 250 in a coiled manner. One end of the wire is introduced into the bumper 250 through an inlet hole 212 formed in the shaft 210 (see Figure 8(a), etc.), and the other end is led to the outside of the bumper 250 through the inlet hole 212. As shown in Figure 9(a), when the capsule cover 260 is detached from the bumper 250, the bumper 250 expands radially due to the elastic restoring force of the wire and locks into the stomach wall 420. Then, from this state, when the wire inside the bumper 250 is removed from the bumper 250, the bumper 250 contracts radially and its locking into the stomach wall 420 is released. The gastrostomy catheter 200 may, for example, be equipped with a balloon (not shown) instead of a bumper 250. In this case, saline solution or distilled water is injected into the balloon, causing it to inflate and lock onto the stomach wall 420. Then, by draining the saline solution or distilled water from inside the balloon, the balloon deflates, and its lock onto the stomach wall 420 is released.

[0030] Furthermore, the connected portion 230 is equipped with, for example, a check valve 240 (see Figures 2(a) and 2(b)), which allows the nutritional supplement to pass from outside the body into the stomach, while restricting the reflux of stomach contents from the stomach to the outside of the body. In this embodiment, the check valve 240 is, for example, a duckbill valve. The check valve 240 is fitted, for example, into the lumen at the upper end of the lumen 211. Under normal conditions, the check valve 240 closes the opening at the upper end of the lumen 211, but when injecting nutritional supplements into the stomach via the gastrostomy catheter 200, it connects the lumen 211 with the outside of the body. Furthermore, when the connecting portion 40 is locked to the connected portion 230, as shown in Figure 2(b), the second cylindrical portion 36 is inserted through the check valve 240 from top to bottom and is slidable up and down within the lumen of the check valve 240.

[0031] As shown in Figures 2(b) and 5(a), the connected portion 230 is formed in a flattened cylindrical shape, for example, with an axial dimension smaller than the radial dimension. The connected portion 230 includes a cylindrical main body portion 230b and an inner flange portion 230a that protrudes radially inward from the upper end of the main body portion 230b. The inner periphery of the inner flange portion 230a defines the opening 231 on the upper end side of the connected portion 230. The outer diameter of the opening 231 is set to be larger than the cylindrical portion 41 of the outer tube portion 20. As shown in Figure 2(b), the outer diameter of the connected portion 230 is set to a dimension approximately equivalent to the distance (radial distance) between the inner surfaces (outer tube side surfaces) of the pair of downward protrusions 44. Therefore, when the connecting portion 40 is inserted into the connected portion 230 from above, the connected portion 230 is positioned between the pair of downward protrusions 44.

[0032] Here, for example, as shown in Figures 5(a) and 5(b), a pair of recesses 232 are formed on the outer circumferential surface of the main body portion 230b of the connected portion 230, and the connecting portion 40 is hooked onto the connected portion 230 by engaging the corresponding claw portion 46 with each recess 232. Each of the pair of recesses 232 is recessed radially inward and extends circumferentially. The pair of recesses 232 are positioned 180 degrees rotationally symmetric to each other with respect to the axis of the connected portion 230, for example, and are also rotationally symmetric to each other. The depth of each recess 232 (radial dimension) is set to approximately the same dimension as, for example, the protruding length of a pair of claw portions 46. In the radial direction, the distance between the outer surfaces 232d of each recess 232 is set to approximately the same dimension as the distance between the tip surfaces 46a of each claw portion 46. The width dimension (axial dimension) of each recess 232 is set to approximately the same dimension as, for example, the thickness dimension (axial dimension) of a pair of claw portions 46.

[0033] As shown in Figures 5(a) and 5(b), each recess 232 is, for example, a groove extending in the circumferential direction. The other end 232c of each recess 232 in the circumferential direction reaches the upper end of the main body 230b and opens upward. That is, an opening 232a is formed at the upper end of each recess 232. Furthermore, at the upper end of the connected portion 230, each recess 232 is defined, and the areas where the opening 232a is not formed become detachment restricting portions 234 that the corresponding claw portions 46 abut against. The lower surface of the detachment restricting portion 234 is the top surface of the recess 232. Furthermore, a locking projection 233 is formed at one end 232b of the recess 232, for example, extending radially outward from the outer surface 232d of the recess 232. The protruding length (radial dimension) of the locking projection 233 is set to a dimension smaller than the formation depth, for example.

[0034] As shown in Figures 7(a) and 7(b), for example, by inserting a pair of claws 46 into the connected portion 230 from above and rotating the tubular body 10 and the connecting portion 40 in one direction around the axis, the connecting portion 40 is hooked onto the connected portion 230 while the pair of claws 46 are prevented from falling out upward from the connected portion 230.

[0035] More specifically, in order to engage the connecting portion 40 with the connected portion 230, first, a pair of claw portions 46 are inserted into the connected portion 230 from above, and the cylindrical portion 41 of the connecting portion 40 is inserted into the lumen of the check valve 240 through the opening 231 of the connected portion 230. At this time, each claw portion 46 is inserted into the interior of the corresponding recess 232 through the opening 232a of the recess 232 and positioned at the other end 232c of the recess 232. In this state, the tip surface 46a of each claw portion 46 is in contact with the outer surface 232d of the corresponding recess 232. Next, the connecting portion 40 and the connected portion 230 are rotated relative to each other around their axis. For example, when the connecting portion 40 is rotated in the direction of the arrow shown in Figure 7(b) (clockwise as an example), each claw portion 46 is guided by the outer surface 232d and moves from the other end 232c side to the one end 232b side of the recess 232. This rotation operation is continued until each claw portion 46 has overcome the corresponding locking projection 233 (see Figure 7(b)). In this state, the upper end surface of each claw portion is in contact with the lower surface of the corresponding detachment restricting portion 234. As a result, with the pair of claw portions 46 prevented from detaching upward from the connected portion 230, the connecting portion 40 is hooked onto the connected portion 230, and the insertion jig 100 is attached to the gastrostomy catheter 200. In this embodiment, the dimension of the recess 232 on the side of one end 232b relative to the locking projection 233 in the circumferential direction is set to be approximately equal to the width dimension of the claw portion 46. Therefore, when rotation is performed, after each claw portion 46 overcomes each locking projection 233, each claw portion 46 engages with the gap between the end face on the side of one end 232b of the recess 232 and the locking projection 233. This restricts the relative displacement of the connecting portion 40 with respect to the connected portion 230 in the rotational direction. As a result, rattling of the connecting portion 40 in the rotational direction is reduced, and the state in which the connecting portion 40 is hooked onto the connected portion 230 can be stably maintained. Furthermore, as described above, a chamfered shape portion 46b is formed on a part of both ends of each claw portion 46 in the circumferential direction. Therefore, when rotation is performed, each claw portion 46 can smoothly overcome the corresponding locking projection 233. Furthermore, as each claw portion 46 moves from one end 232b to the other end 232c, a clicking sensation is generated as each claw portion 46 overcomes each locking projection 233. This clicking sensation allows the user to easily recognize that the connection of the connecting portion 40 to the connected portion 230 has been completed.

[0036] Furthermore, for example, from a state in which the connecting portion 40 is hooked onto the connected portion 230, the tubular body 10 and the connecting portion 40 are rotated around the axis in opposite directions to one direction, and the pair of claw portions 46 are pulled upward from the connected portion 230, thereby separating the connecting portion 40 from the connected portion 230.

[0037] More specifically, from a state in which the pair of claw portions 46 are restricted from falling upward relative to the connected portion 230 (as shown in Figure 7(b)), by rotating the connecting portion 40 in the opposite direction of the arrow shown in Figure 7(b) (for example, counterclockwise), each claw portion 46 is guided by the outer surface 232d and moves from one end 232b side to the other end 232c side of the recess 232. This rotation operation is continued until each claw portion 46 moves to a position corresponding to the opening 232a. In this state, by pulling the pair of claw portions 46 upward from the connected portion 230, the connecting portion 40 is separated from the connected portion 230, and the insertion jig 100 can be removed from the gastrostomy catheter 200. In this embodiment, the chamfered shape 46b of each claw portion 46 allows each claw portion 46 to smoothly overcome each locking projection 233 even when the connecting portion 40 is rotated counterclockwise. However, for example, the chamfered shape 46b of the claw portion 46 may be formed on the other end 232c side in the circumferential direction, but not on the one end 232b side. By doing so, each claw portion 46 becomes less likely to move from the one end 232b side to the other end 232c side (it becomes less likely to overcome the locking projection 233), so the state in which the connecting portion 40 is hooked to the connected portion 230 can be maintained well. Furthermore, when each claw portion 46 moves from one end 232b to the other end 232c, a clicking sensation is generated as each claw portion 46 overcomes the locking projection 233. This clicking sensation allows the user to easily recognize that the separation of the connecting portion 40 from the connected portion 230 has begun.

[0038] The following describes an example of how to use the gastrostomy catheter kit 300, which includes the gastrostomy catheter 200 and the insertion jig 100 for the gastrostomy catheter, using Figures 8(a) to 9(b). The description begins with the assumption that the fistula 430 into which the guidewire 500 is inserted is formed by penetrating the abdominal wall 410 and the stomach wall 420, and that the guidewire 500 is inserted into the fistula 430. First, the insertion jig 100 is attached to the gastrostomy catheter 200 by connecting the connecting part 40 to the connected part 230. Next, as shown in Figure 8(a), the outer end of the guidewire 500 is inserted into the lumen of the inner tube 30 through the insertion hole 261 of the capsule cover 260. One end of the guidewire 500 inserted into the lumen of the inner tube 30 is led out through the opening 39 on the upper end side of the first cylindrical part 31. Then, along the guidewire 500, the shaft 210 and the lower end of the second cylindrical part 36 are inserted into the lumen of the fistula 430, and the bumper 250 is positioned inside the stomach. In this state, the body surface contact portion 220 and the portion above the body surface contact portion 220 of the gastrostomy catheter kit 300 are positioned along the body surface. Next, the guidewire 500 is withdrawn from the body via the gastrostomy catheter 200. Next, as shown in Figures 8(b) and 9(a), the locking member 60 is removed from the outer tube portion 20 and the inner tube portion 30. Then, the inner tube portion 30 is pushed downward relative to the outer tube portion 20. As a result, the lower end of the second cylindrical portion 36 presses downward against the capsule cover 260, causing the capsule cover 260 to detach from the bumper 250 and the bumper 250 to expand. This locks the bumper 250 against the stomach wall 420, and the gastrostomy catheter 200 is placed in position. Furthermore, the capsule cover 260, detached from the bumper 250, is made of edible material or a material that is biodegradable in the body, as described above, and is therefore excreted with the stomach contents or dissolved in the stomach. Once the gastrostomy catheter 200 is in place, the connection of the connecting part 40 to the connected part 230 is released, as shown in Figure 9(b), and the insertion jig 100 is removed from the gastrostomy catheter 200. Then, the plug member 82 is inserted into the upper end of the check valve 240 to close the opening 231 on the upper end side of the connected portion 230.

[0039] <Example 1> Next, Modification 1 will be described using Figures 10(a), 10(b), and 10(c). The insertion jig 100 for a gastrostomy catheter according to this modification differs from the insertion jig 100 for a gastrostomy catheter according to the above embodiment in the points described below, and is otherwise configured in the same way as the insertion jig 100 for a gastrostomy catheter according to the above embodiment. Note that Figures 10(a), 10(b), and 10(c) are cross-sectional views along the line corresponding to line AA shown in Figure 2(a).

[0040] As shown in Figures 10(a), 10(b), and 10(c), in this modified example, the connecting portion 40 has a pair of extending portions 71 that extend vertically, a pair of extending portion connecting portions 73 that connect the pair of extending portions 71 to the tubular body 10, and a pair of claw portions 46 that protrude inward from the lower ends of the pair of extending portions 71. By pushing the connecting portion 40 onto the connected portion 230 from above, the connected portion 230 is pushed between the pair of claw portions 46, causing the pair of claw portions 46 to elastically engage with the connected portion 230, and the connecting portion 40 is locked onto the connected portion 230. With this modified example, the insertion jig 100 can be easily attached to the gastrostomy catheter 200 by hooking the connecting portion 40 onto the connected portion 230.

[0041] Each of the pair of extending portion connecting portions 73 elastically swings the pair of extending portions 71 relative to the tubular body 10 at an intermediate position in the vertical direction of each of the pair of extending portions 71. From a state in which the connecting portion 40 is connected to the connected portion 230 (see Figure 10(b)), the engagement of the pair of claw portions 46 with the connected portion 230 is released by reducing the distance between the portions of the pair of extending portions 71 above the intermediate position, against the elastic force (elastic restoring force) of the extending portion connecting portion 73 (see Figure 10(c)).

[0042] More specifically, in this modified example, each of the pair of extension connecting portions 73 protrudes laterally from the outer circumferential surface of the outer tube portion 20. Each of the pair of extension connecting portions 73 is positioned 180 degrees rotationally symmetric with respect to the axis of the outer tube portion 20, and is also rotationally symmetric with respect to each other. Each extension portion 71 is connected to the tip (the tip in the protruding direction) of each extension portion connecting portion 73 at its intermediate point in the vertical direction. In the natural state of the connecting portion 40, the extension direction of the pair of extension portions 71 is perpendicular to the protruding direction of the pair of extension portion connecting portions 73. Therefore, in the protruding direction of the pair of extension portion connecting portions 73, the distance between the portions above the intermediate position of the pair of extension portions 71 and the distance between the portions below the intermediate position are approximately equal. In this modified example, the pair of extension portions 71 can swing against an elastic restoring force in the direction in which the distance between the portions above the intermediate position of the pair of extension portions 71 decreases, i.e., the distance between the portions below the intermediate position decreases, with respect to the boundary between the tip of the extension portion connecting portion 73 connected to each extension portion 71 as the axis, in the direction in which the extension portion connecting portion 73 protrudes.

[0043] In this modified example, the recesses 232 are grooves that extend in the circumferential direction. However, in this modified example, each recess 232 does not have an opening 232a, and the entire portion defining each recess 232 at the upper end of the main body 230b forms the detachment restricting portion 234.

[0044] Furthermore, the distance between the inner surface of one of the pair of extended portions 71 (the surface facing the outer tube portion 20) and the inner surface of the other extended portion 71 (the distance in the radial direction) is set to a dimension smaller than the outer diameter of the connected portion 230. Each claw portion 46 protrudes radially inward from the lower end of the extended portion 71. The lower surface of each tip of the pair of claw portions 46 is chamfered, and the lower surface of the tip is sloped upward radially inward. Therefore, when the connecting portion 40 is pushed onto the connected portion 230 from above, each claw portion 46 engages smoothly with the recess 232. Furthermore, the upper end surfaces of each of the pair of claw portions 46 are flat surfaces perpendicular to the axial direction. In this modified example, the connecting portion 40, which includes a pair of extended portions 71, a pair of connecting portions 73 for the extended portions, and a pair of claw portions 46, is integrally molded with the outer tube portion 20.

[0045] As shown in Figure 10(a), when the connecting portion 40 is pushed onto the connected portion 230 from above, the distance between the portions of the pair of extended portions 71 above the intermediate position is brought closer together against the elastic force of the extending portion connecting portion 73, thereby increasing the distance between the portions below the intermediate position. Next, as shown in Figure 10(b), the pair of claws 46 push the outer tube 20 downward until it overcomes the detachment restricting portion 234. This engages the claws 46 with the corresponding recesses 232 of the connected portion 230. As a result, the connecting portion 40 is connected to the connected portion 230. In this state, the upper end surfaces of the pair of claws 46 are in contact with, for example, the lower surface of the detachment restricting portion 234. Also, in the example shown in Figure 10(b), compared to the natural state, the distance between the portions of the pair of extending portions 71 below the intermediate position is slightly separated, and the portion above the claws 46 is elastically pressed against the detachment restricting portion 234, or the tip of the claws 46 is elastically pressed against the outer surface 232d. However, when the connecting portion 40 is connected to the connected portion 230, the pair of extending portions 71 may remain extended vertically. To release the connection of the connecting portion 40 to the connected portion 230, as shown in Figure 10(c), for example, by pinching the portion of the pair of extending portions 71 above the intermediate position with one's fingers, the distance between these upper portions is brought closer together against the elastic force of the extending portion connecting portion 73. This increases the distance between the portions below the intermediate position, releasing the engagement of the pair of claw portions 46 with the recess 232. While maintaining this state, the connecting portion 40 can be removed from the connected portion 230 by lifting it upward relative to the connected portion 230.

[0046] <Modification 2> Next, a modified example 2 will be explained using Figures 11(a) and 11(b). The modified insertion jig 100 for a gastrostomy catheter differs from the insertion jig 100 for a gastrostomy catheter according to the above embodiment in the respects described below, and is otherwise configured in the same way as the insertion jig 100 for a gastrostomy catheter according to the above embodiment. Figures 11(a) and 11(b) are cross-sectional views along the line corresponding to line AA shown in Figure 2(a).

[0047] As shown in Figures 11(a) and 11(b), in this modified example, the connecting portion 40 is pressed into the connected portion 230 by pushing it from above, thereby locking it into place. This configuration also makes it easier to attach and detach the insertion jig 100 to the gastrostomy catheter 200.

[0048] More specifically, the connecting portion 40 is, for example, secured to the connected portion 230 by press-fitting, and has a main body portion (in this modified example, a cylindrical portion 41) and a protruding portion 47 that protrudes laterally from the outer circumferential surface of the main body portion. The connecting portion 40 is secured to the connecting portion 230 by the fitting of the protruding portion 47 into the recess 241 formed in the connected portion 230. The protruding portion 47 is, for example, a circumferential rib formed at the lower end of the cylindrical portion 41. Furthermore, in this modified example, as in the embodiment, the connected portion 230 is equipped with a check valve 240. The recess 241 of the connected portion 230 is formed, for example, in the check valve 240. The recess 241 is, for example, a circumferential groove formed on the inner circumferential surface of the upper end of the check valve 240. As shown in Figures 11(a) and 11(b), by pushing the connecting portion 40 onto the connected portion 230 from above, the main body (cylindrical portion 41) of the connecting portion 40 is fitted into the lumen of the check valve 240, and the protruding portion 47 is fitted into the recess 241. As a result, the connecting portion 40 is connected to the connected portion 230. The recess 241 may be formed, for example, on the inner circumferential surface of the shaft 210 (the inner circumferential surface of the lumen 211). Alternatively, for example, the recess 241 may be formed on the main body of the connecting portion 40, and the protrusion 47 may be formed on the inner circumferential surface of the check valve 240 or the inner circumferential surface of the shaft 210.

[0049] [Second Embodiment] Next, a second embodiment will be described using Figures 12 to 15(b). The gastrostomy catheter kit 300 according to this embodiment differs from the gastrostomy catheter kit 300 according to the first embodiment and modified versions 1 and 2 described below in the respects described below, and is otherwise configured the same as the gastrostomy catheter kit 300 according to the first embodiment, modified version 1, or modified version 2 described above. In the following description, unless otherwise specified, the positional relationship between each part of the connection connector 610 and the body surface contact portion 220 refers to the positional relationship when the connection connector 610 is connected to the body surface contact portion 220.

[0050] In this embodiment, as shown in Figure 12, the gastrostomy catheter kit 300 further comprises a connection connector 610 that is detachably connected to the body surface contact portion 220 of the gastrostomy catheter 200, and a connection tube 660 provided on the connection connector 610, which communicates with the lumen 211 of the gastrostomy catheter 200 when the connection connector 610 is connected to the body surface contact portion 220. When injecting a nutritional supplement or other liquid into the stomach via the gastrostomy catheter 200, the stopper member 82 is removed from the opening 231 and the connection connector 610 is connected to the body surface contact portion 220. Here, as shown in Figure 12, the connection connector 610 includes a second connecting portion 630 that is detachably hooked onto the connected portion 230 of the body surface contact portion 220. The second connecting portion 630 is hooked onto the connected portion 230 by an operation in which the second connecting portion 630 is inserted onto the connected portion 230 from above, and an operation in which the second connecting portion 630 is rotated relative to the connected portion 230 around a second axis (AX2 shown in Figure 12) with respect to the direction of insertion as the axis. With this configuration, the connection connector 610 can be attached to the gastrostomy catheter 200 by hooking the second connecting portion 630 onto the connected portion 230. Furthermore, the connection connector 610 can be removed from the gastrostomy catheter 200 by releasing the hooking of the second connecting portion 630 onto the connected portion 230. In other words, attaching and detaching the connection connector 610 to the gastrostomy catheter 200 becomes easier.

[0051] The second connecting portion 630 of the connecting connector 610 includes, for example, a main body portion 620 to which the connecting tube 660 is connected, and a second cylindrical portion 640 that is inserted into the lumen of the check valve 240 of the connected portion 230. The main body 620 is formed, for example, in a roughly rectangular parallelepiped shape that is elongated in the radial direction. However, the main body 620 has a shape that gradually tapers from the center in the longitudinal direction toward one side (one side in the longitudinal direction). More specifically, in a plan view (see Figures 13(a) and 14(b)), the width dimension of the main body 620 gradually narrows from the center in the longitudinal direction toward one side. Also, in a side view (see Figures 12 and 14(c)), the upper surface of the main body 620 slopes downward in an arc from the center in the longitudinal direction toward one side. The second cylindrical portion 640 is formed in a cylindrical shape, for example, projecting downward from the lower surface of the main body portion 620. The second cylindrical portion 640 is located, for example, in the central part of the main body portion 620 in the longitudinal direction. In other words, both ends of the main body portion 620 in the longitudinal direction protrude radially outward from the second cylindrical portion 640. The inner and outer diameters of the second cylindrical portion 640 (excluding the lower end) are, for example, substantially constant regardless of their position in the axial direction. However, the outer diameter of the lower end of the second cylindrical portion 640 is, for example, tapered downwards. The outer diameter of the second cylindrical portion 640 is set to be approximately the same as the inner diameter of the check valve 240 of the connected portion 230, so that when inserted into the lumen of the check valve 240 of the connected portion 230, the outer surface of the second cylindrical portion 640 makes surface contact with the inner surface of the check valve 240. Therefore, the second cylindrical portion 640 can be easily engaged with the check valve 240. When the second cylindrical portion 640 is inserted into the lumen of the check valve 240 of the connected portion 230, the second cylindrical portion 640 is arranged coaxially with the connected portion 230 and, consequently, with the shaft 210.

[0052] As shown in Figure 12, the main body portion 620 has a communication hole 621 that communicates with the lumen of the second cylindrical portion 640. The shaft 210 of the gastrostomy catheter 200 communicates with the lumen of the connecting tube 660 via the communication hole 621. The communication hole 621 is formed, for example, in a side view, in a shape that is roughly L-shaped lying on its side, and includes a first portion that extends vertically and a second portion that extends radially from the upper end of the first portion toward the other side. The lower end of the lumen of the first portion of the communication hole 621 is continuous with the upper side of the lumen of the second cylindrical portion 640. Furthermore, the outer diameter of the first portion of the communication hole 621 is set to a dimension equivalent to, for example, the outer diameter of the second cylindrical portion 640. Furthermore, the outer diameter of the end of the second portion of the communication hole 621 opposite to the side connected to the first portion is formed to be relatively larger than the other portions, for example, and this end becomes the engaged portion 623 into which the connecting tube 660 engages.

[0053] In this embodiment, the main body portion 620 is collectively referred to as a pair of second protruding portions 631, which are the portion that protrudes to one side in the radial direction and the portion that protrudes to the other side in the radial direction, with respect to the axis of the second cylindrical portion 640. Furthermore, the tips of the pair of second protruding portions 631 are each formed with a pair of second downward protruding portions 634 that project downward, and a pair of second claw portions 636 that project radially inward from the lower ends of the pair of second downward protruding portions 634. In this embodiment, the pair of second protrusions 631 are positioned at different locations relative to each other, for example, around the axis of the second cylindrical portion 640. More specifically, for example, they are positioned 180 degrees rotationally symmetric with respect to the axis of the second cylindrical portion 640. Similarly, the pair of second downward projections 634 are positioned 180 degrees rotationally symmetric with respect to the axis of the second cylindrical portion 640, and the pair of second claws 636 are also positioned 180 degrees rotationally symmetric with respect to the axis of the second cylindrical portion 640. As shown in Figures 12 and 14(c), the lower surface of each of the pair of second protrusions 631 is flat, except for the area where the corresponding second downward projection 634 is formed. Also, the lower surface of each of the pair of second protrusions 631 is perpendicular to the axial direction. In this embodiment, one second downward projection 634 protrudes downward from each of the two second protruding portions 631 (the tip in the protruding direction). The upper part of the second downward projection 634 gradually widens toward the second protruding portion 631. The lower part of the second downward projection 634 remains substantially constant regardless of its position in the vertical direction. This suppresses stress concentration at the boundary between the second protruding portion 631 and the second downward projection 634. Furthermore, as shown in Figures 14(a) to 14(c), each second claw portion 636 protrudes radially inward from the lower end of the second downward projection 634. As shown in Figure 14(c), the tip surface 636a (the tip in the projection direction) of each second claw portion 636 is, for example, a flat surface perpendicular to the radial direction. Similarly, the upper end surface of each second claw portion 636 is a flat surface perpendicular to the axial direction.

[0054] As shown in Figures 12 and 13(b), the pair of second claw portions 636 are inserted into and locked into, for example, a pair of recesses 232 of the body surface contact portion 220. More specifically, in this embodiment, each of the pair of recesses 232 includes, in addition to the opening 232a similar to that in the first embodiment described above, an arc-shaped extension 236 that communicates with the area below the opening 232a and extends in an arc shape along the trajectory of movement of the second claw portion 636 as the second connecting portion 630 rotates around the second axis AX2. Furthermore, the arc-shaped extension portion 236 is formed with a locking projection 233 similar to that of the first embodiment, and the locking projection 233 locks the second claw portion 636 after it has moved arc-shaped within the arc-shaped extension portion 236. As shown in Figure 13(b), the pair of arc-shaped extensions 236 are positioned 180 degrees rotationally symmetrical to each other with respect to the axis of the connected portion 230, and are also rotationally symmetrical to each other. The depth of each recess 232 (radial dimension) is set to approximately the same dimension as, for example, the protruding length of a pair of second claw portions 636. In the radial direction, the distance between the outer surfaces 232d of each recess 232 is set to approximately the same dimension as the distance between the tip surfaces 636a of each second claw portion 636. The width dimension (axial dimension) of each recess 232 is set to approximately the same dimension as, for example, the thickness dimension (axial dimension) of a pair of second claw portions 636. Furthermore, each of the pair of arc-shaped extensions 236 is formed in an arc shape, for example, centered on the axis of the connected portion 230. Each of the pair of arc-shaped extensions 236 extends in the circumferential direction. One end of the arc-shaped extension 236 in the circumferential direction constitutes one end 232b of the recess 232. The other end of the arc-shaped extension 236 in the circumferential direction constitutes the other end 232c of the recess 232 and is continuous with the lower side of the opening 232a. The central angle of each of the pair of arc-shaped extensions 236 is not particularly limited, but is preferably 90 degrees or more and 180 degrees or less, and more preferably 120 degrees or more and 180 degrees or less.

[0055] The connecting tube 660 connects the lumen of the gastrostomy catheter 200 to the outside of the body, and through the connecting tube 660, liquids such as nutritional supplements are injected into the lumen and then into the stomach. The connecting tube 660 is formed, for example, as a long tubular shape in one direction. As shown in Figure 12, the outer diameter of one end 661 of the connecting tube 660 in the longitudinal direction is set to be approximately equal to the outer diameter of the engaged portion 623 of the connecting connector 610. The connecting tube 660 is connected to the connecting connector 610 by engaging one end 661 with the engaged portion 623. In this embodiment, the inner and outer diameters of the connecting tube 660 are, for example, substantially constant regardless of their position in the axial direction. Furthermore, when the connecting tube 660 is connected to the connecting connector 610, the lumen of the connecting tube 660 communicates with the communication hole 621 of the connecting connector 610. When the connecting connector 610 is connected to the body surface contact portion 220, the lumen of the connecting tube 660 communicates with the lumen 211 of the gastrostomy catheter 200 via the communication hole 621. The connecting tube 660 connected to the connecting connector 610 will be drawn out in a direction perpendicular to the shaft 210. However, the present invention is not limited to this example, and for example, the connecting tube 660 connected to the connecting connector 610 may be configured to be drawn out along the extension of the shaft 210.

[0056] Each of the connecting connector 610 and the connecting tube 660 is integrally molded from, for example, a resin material. The resin material is not particularly limited, but examples include polyvinylidene fluoride resin, polytetrafluoroethylene resin, polyethylene resin, polypropylene resin, or silicone rubber or other rubber materials.

[0057] As shown in Figures 15(a) and 15(b), for example, by inserting a pair of second claws 636 into the connected portion 230 from above and rotating the second connecting portion 630 in one direction around the second axis, the pair of second claws 636 are prevented from falling out upward from the connected portion 230, and the second connecting portion 630 is then hooked onto the connected portion 230.

[0058] More specifically, in order to engage the second connecting portion 630 with the connected portion 230, first, a pair of second claw portions 636 are inserted into the connected portion 230 from above, and the cylindrical portion 41 of the second connecting portion 630 is inserted into the lumen of the check valve 240 through the opening 231 of the connected portion 230. At this time, each second claw portion 636 is inserted into the interior of the corresponding recess 232 through the opening 232a of the recess 232 and positioned at the other end 232c of the recess 232. In this state, the tip surface 636a of each second claw portion 636 is in contact with the outer surface 232d of the corresponding recess 232. Next, the second connecting portion 630 and the connected portion 230 are rotated relative to each other around their axis. For example, when the second connecting portion 630 is rotated in the direction of the arrow shown in Figure 15(b) (clockwise as an example), each second claw portion 636 is guided by its outer surface 232d and moves in an arc from the other end 232c side to the one end 232b side of the recess 232 (arc-shaped extension portion 236). This rotation operation is continued until each second claw portion 636 has overcome the corresponding locking projection 233 (see Figure 15(b)). In this state, the upper end surface of each second claw portion 636 is in contact with the lower surface of the corresponding detachment restricting portion 234. As a result, with the pair of second claw portions 636 restricted from detaching upward from the connected portion 230, the second connecting portion 630 is hooked onto the connected portion 230, and the connecting connector is connected to the gastrostomy catheter 200. Furthermore, in this embodiment, when each second claw portion 636 moves from one end 232b to the other end 232c, a clicking sensation is generated as each second claw portion 636 overcomes each locking projection 233. This clicking sensation allows the user to easily recognize that the connection of the second connecting portion 630 to the connected portion 230 has been completed.

[0059] Thus, the second connecting portion 630 includes, for example, a pair of second protruding portions 631 that extend laterally, a pair of second downward protruding portions 634 that protrude downward from the tips of the pair of second protruding portions 631, and a pair of second claw portions 636 that protrude radially inward from the lower ends of the pair of second downward protruding portions 634. By inserting the pair of second claw portions 636 into the connected portion 230 from above and rotating the second connecting portion 630 in one direction around the second axis, the second connecting portion 630 is hooked onto the connected portion 230 while the pair of second claw portions 636 are prevented from falling out upward from the connected portion 230. In this context, "lateral" refers to the direction perpendicular to the axial direction, i.e., the radial direction. With this configuration, the second connecting portion 630 is hooked onto the connected portion 230 at two points in the circumferential direction, which reduces rattling of the connecting connector 610 against the body surface contact portion 220 and allows the second connecting portion 630 to be stably hooked onto the connected portion 230. More specifically, as shown in Figure 12, in this embodiment, the upper surface of the body surface contact portion 220 and the lower surface of the connection connector 610 (the lower surface of the main body portion 620) are arranged, for example, parallel and facing each other.

[0060] In this embodiment, the rotation angle of the second connecting portion 630 from the time the second claw portion 636 is inserted into the arc-shaped extension portion 236 until it is locked by the locking projection 233 is less than 45 degrees. This allows the rotational operation of the second connecting portion 630 to quickly prevent the pair of second claw portions 636 from detaching from the connected portion 230. More specifically, in the arc-shaped extension 236, the central angle of the portion from the other end of the arc-shaped extension 236 in the circumferential direction (the end on the other end side 232c) to the end on the one end side 232b of the locking projection 233 is set to, for example, less than 45 degrees. As a result, the rotation angle of the second connecting portion 630 from the time the second claw portion 636 is inserted into the arc-shaped extension 236 until it overcomes the second claw portion 636 (i.e., the rotation angle of the second connecting portion 630 until it is locked by the locking projection 233) is less than 45 degrees. In this embodiment, as an example, the rotation angle of the second connecting portion 630 from the time the second claw portion 636 is inserted into the arc-shaped extension portion 236 until it is locked by the locking projection 233 is approximately 35 degrees. Furthermore, in this embodiment, the rotation angle of the second connecting portion 630 from the time the second claw portion 636 is locked by the locking projection 233 until it reaches one end of the arc-shaped extension portion 236 (the end on the side of the one end portion 232b) is 90 degrees or more. More specifically, in the arc-shaped extension portion 236, the central angle of the portion from the end of the locking projection 233 on the end side 232b to the end of the arc-shaped extension portion 236 in the circumferential direction (the end on the end side 232b) is set, for example, to 90 degrees or more and 180 degrees or less. This allows the second connecting portion 630, and consequently the connecting connector 610, to be rotated relative to the connected portion 230 around its axis within an angular range of 90 degrees or more and 180 degrees or less, while maintaining the connection of the connecting connector 610 to the gastrostomy catheter 200. In other words, by adjusting the rotational phase of the connecting connector 610 around its axis, the radial extension direction of the connecting tube 660 can be appropriately adjusted. In this embodiment, for example, the rotational phase of the connection connector 610 around the axis can be adjusted within an angular range of approximately 120 degrees.

[0061] Furthermore, for example, from a state in which the second connecting portion 630 is hooked onto the connected portion 230, the tubular body 10 and the second connecting portion 630 are rotated around the axis in opposite directions to one direction, and the pair of second claw portions 636 are pulled upward from the connected portion 230, thereby separating the second connecting portion 630 from the connected portion 230.

[0062] More specifically, from a state in which the pair of second claw portions 636 are prevented from falling upward from the connected portion 230 (as shown in Figure 15(b)), by rotating the second connecting portion 630 in the opposite direction of the arrow shown in Figure 15(b) (for example, counterclockwise), each second claw portion 636 is guided by the outer surface 232d and moves in an arc from one end 232b to the other end 232c of the recess 232 (arc-shaped extension portion 236). This rotation operation is continued until each second claw portion 636 moves to a position corresponding to the opening 232a. In this state, by pulling the pair of second claw portions 636 upward from the connected portion 230, the second connecting portion 630 is separated from the connected portion 230, and the insertion jig 100 can be removed from the gastrostomy catheter 200. Furthermore, when each second claw portion 636 moves from one end 232b to the other end 232c, a clicking sensation is generated as each second claw portion 636 overcomes the locking projection 233. This clicking sensation allows the user to easily recognize that the separation of the second connecting portion 630 from the connected portion 230 has begun.

[0063] The present invention is not limited to the embodiments described above, and includes various modifications, improvements, and other forms as long as the objectives of the present invention are achieved.

[0064] This embodiment encompasses the following technical concepts. <1> An insertion jig used for inserting and placing the bumper and shaft of a gastrostomy catheter, which has a shaft with a lumen, a bumper provided at the lower end of the shaft, and a body surface contact portion provided at the upper end of the shaft, through a fistula. A tubular body extending vertically, A connecting portion is provided on the tubular body and is detachably hooked onto a connecting portion formed at the upper end of the body surface contact portion, An insertion device for a gastrostomy catheter, equipped with [a specific feature / feature]. <2> (1) The connecting portion is hooked onto the connected portion by inserting the connecting portion into the connected portion from above and rotating the connecting portion relative to the connected portion around an axis with respect to the direction of insertion, Or, (2) The connecting portion is hooked onto the connected portion by pushing the connecting portion onto the connected portion from above. <1> An insertion device for a gastrostomy catheter as described above. <3> The aforementioned connecting portion is A pair of protruding portions extending laterally from the tubular body, A pair of downward protrusions extending downward from the tips of the pair of overhangs, A pair of claw portions projecting radially inward from the lower ends of the pair of downward protrusions, It has, By inserting the pair of claws into the connected portion from above and rotating the tubular body and the connecting portion in one direction around the axis, the connecting portion is hooked onto the connected portion while the pair of claws are prevented from falling out upward from the connected portion. <2> An insertion device for a gastrostomy catheter as described above. <4> From the state in which the connecting portion is hooked onto the connected portion, the tubular body and the connecting portion are rotated around the axis in the opposite direction to the one direction, and the pair of claws are pulled upward from the connected portion, thereby separating the connecting portion from the connected portion. <3> An insertion device for a gastrostomy catheter as described above. <5> The aforementioned connecting portion is Each has a pair of extending parts that extend vertically, A pair of extension connecting parts connect the pair of extension parts to the tubular body, A pair of claw portions protruding inward from the lower ends of the pair of extended portions, It has, By pushing the connecting portion against the connected portion from above, the connected portion is pushed between the pair of claws, causing the pair of claws to elastically engage with the connected portion, and the connecting portion is locked against the connected portion. <2> An insertion device for a gastrostomy catheter as described above. <6> Each of the pair of extending portion connecting portions is elastically pivotable with respect to the tubular body at an intermediate position in the vertical direction of each of the pair of extending portions. From the state in which the connecting portion is connected to the connected portion, the engagement of the pair of claw portions with the connected portion is released by reducing the distance between the portions of the pair of extending portions above the intermediate position against the elastic force of the connecting portion of the extending portion. <5> An insertion device for a gastrostomy catheter as described above. <7> By pushing the connecting portion against the connected portion from above, the connecting portion is press-fitted into the connected portion and locked in place. <2> An insertion device for a gastrostomy catheter as described above. <8> The aforementioned connecting portion is It is secured to the aforementioned connected portion by press-fitting. The main body and A protruding portion that extends laterally from the outer circumferential surface of the main body, It has, The connecting portion is locked to the connected portion by fitting the protruding portion into the recess formed in the connected portion. <7> An insertion device for a gastrostomy catheter as described above. <9> <1> from <8> An insertion device for a gastrostomy catheter as described in any one of the items, The aforementioned gastrostomy catheter, A gastrostomy catheter kit equipped with [features / equipment]. <10> A connecting connector that is detachably connected to the body surface contact portion of the gastrostomy catheter, A connecting tube is provided on the aforementioned connecting connector, and when the connecting connector is connected to the body surface contact portion, it communicates with the shaft of the gastrostomy catheter, Furthermore, The aforementioned connection connector includes a second connecting portion which is detachably hooked onto the connected portion of the body surface contact portion, The second connecting portion is hooked onto the connected portion by an operation to insert the second connecting portion into the connected portion from above, and an operation to rotate the second connecting portion relative to the connected portion around a second axis with the direction of insertion as the axis. <9> The gastrostomy catheter kit described in [the document]. <11> The aforementioned second connecting portion is, A pair of second protrusions extending to the sides, A pair of second downward projections that protrude downward from the tips of the pair of second protruding portions, A pair of second claw portions project radially inward from the lower ends of the pair of second downward protrusions, It has, By inserting the pair of second claws into the connected portion from above and rotating the second connecting portion in one direction around the second axis, the pair of second claws are prevented from falling out upward from the connected portion, and the second connecting portion is then hooked onto the connected portion. <10> The gastrostomy catheter kit described in [the document]. <12> From the state in which the second connecting portion is hooked onto the connected portion, the second connecting portion is rotated around the second axis in the opposite direction to the one direction, and the pair of second claws are pulled upward from the connected portion, thereby separating the second connecting portion from the connected portion. <11> The gastrostomy catheter kit described in [the document]. <13> The body surface contact portion has a pair of recesses into which the pair of second claw portions are inserted and locked, Each of the pair of recesses is An opening into which the second claw portion is inserted into the recess from above, An arc-shaped extending portion that communicates with the lower part of the opening and extends in an arc shape along the movement trajectory of the second claw portion when the second connecting portion rotates around the second axis, Includes, The arc-shaped extension is provided with a locking projection that engages the second claw after it has moved arc-shaped within the arc-shaped extension. <11> or <12> The gastrostomy catheter kit described in [the document]. <14>The gastric fistula catheter kit according to <13>, wherein the rotation angle of the second connecting portion from when the second claw portion is inserted into the arcuate extending portion until it is locked by the locking protrusion is less than 45 degrees.<13>

Explanation of Reference Numerals

[0065] 10 Tubular main body 20 Outer tube portion 22 Notch 25 Finger hook portion 30 Inner tube portion 31 First cylindrical portion 33 Constricted portion 36 Second cylindrical portion 38 Pressing portion 39 Opening 40 Connecting portion 41 Cylindrical portion (main body portion) 42 Pair of protruding portions 44 Lower protruding portion 46 Pair of claw portions 46a Tip surface 46b Chamfered portion 47 Protruding portion 60 Locking member 62 Base portion 64 Forked portion 64a Notch-shaped portion 71 Pair of extending portions 73 Pair of extending portion connecting portions 82 Plug member 100 Insertion jig for gastric fistula catheter 200 Gastric fistula catheter 210 Shaft 211 Lumen 212 Introduction hole 220 Body surface contact portion 230 Connected portion 230a Inner flange portion 230b Main body portion 231 Opening 232 Recessed portion 232a Opening portion 232b One end portion 232c Other end portion 232d Outer surface 233 Locking protrusion 234 Dropping Control Section 236 Arcuate extension 240 Check valve 241 recess 250 Bumper 260 Capsule Covers 261 Insertion hole 300 Gastrostomy Catheter Kit 410 Abdominal wall 420 Stomach wall 430 Fistula 500 guide wires 610 Connection Connector 620 Main Unit 621 Communication hole 623 Engagement hole 630 2nd connection part 631 2nd overhang 634 Second downward protrusion 636 2nd claw part 640 Second cylindrical section 660 connecting tubes

Claims

1. An insertion jig used for inserting and placing the bumper and shaft of a gastrostomy catheter, which has a shaft with a lumen, a bumper provided at the lower end of the shaft, and a body surface contact portion provided at the upper end of the shaft, through a fistula. A tubular body extending vertically, A connecting portion is provided on the tubular body and is detachably hooked onto a connecting portion formed at the upper end of the body surface contact portion, An insertion device for a gastrostomy catheter, equipped with [a specific feature / feature].

2. (1) The connecting portion is hooked onto the connected portion by inserting the connecting portion into the connected portion from above and rotating the connecting portion relative to the connected portion around an axis with respect to the direction of insertion, Or, (2) The insertion jig for a gastrostomy catheter according to claim 1, wherein the connecting portion is locked to the connected portion by an operation of pushing the connecting portion to the connected portion from above.

3. The aforementioned connecting portion is A pair of protruding portions extending laterally from the tubular body, A pair of downward protrusions extending downward from the tips of the pair of overhangs, A pair of claw portions projecting radially inward from the lower ends of the pair of downward protrusions, It has, The insertion jig for a gastrostomy catheter according to claim 2, wherein the pair of claws are inserted into the connected portion from above, and the tubular body and the connecting portion are rotated in one direction around the axis, thereby preventing the pair of claws from falling out upward from the connected portion, and the connecting portion is locked onto the connected portion.

4. The insertion jig for a gastrostomy catheter according to claim 3, wherein, from a state in which the connecting portion is hooked to the connected portion, the tubular body and the connecting portion are rotated around the axis in the opposite direction to the one direction, and the pair of claw portions are pulled upward from the connected portion, thereby separating the connecting portion from the connected portion.

5. The aforementioned connecting portion is Each has a pair of extending parts that extend vertically, A pair of extension connecting parts connect the pair of extension parts to the tubular body, A pair of claw portions protruding inward from the lower ends of the pair of extended portions, It has, The insertion jig for a gastrostomy catheter according to claim 2, wherein by pushing the connecting portion against the connected portion from above, the connected portion is pushed between the pair of claw portions, the pair of claw portions elastically engage with the connected portion, and the connecting portion is locked against the connected portion.

6. Each of the pair of extending portion connecting portions is elastically pivotable with respect to the tubular body at an intermediate position in the vertical direction of each of the pair of extending portions. The insertion jig for a gastrostomy catheter according to claim 5, wherein, from a state in which the connecting portion is connected to the connected portion, the engagement of the pair of claw portions with the connected portion is released by bringing the distance between the portions of the pair of extending portions above the intermediate position closer together against the elastic force of the connecting portion of the extending portion.

7. The insertion jig for a gastrostomy catheter according to claim 2, wherein the connecting portion is pressed into the connected portion from above by an operation to push the connecting portion into the connected portion, thereby causing the connecting portion to be press-fitted and locked in place.

8. The aforementioned connecting portion is It is secured to the aforementioned connected portion by press-fitting. The main body and A protruding portion that extends laterally from the outer circumferential surface of the main body, It has, The insertion jig for a gastrostomy catheter according to claim 7, wherein the connecting portion is hooked onto the connected portion by the protruding portion fitting into a recess formed in the connected portion.

9. An insertion device for a gastrostomy catheter according to any one of claims 1 to 8, The aforementioned gastrostomy catheter, A gastrostomy catheter kit equipped with [features / equipment].

10. A connecting connector that is detachably connected to the body surface contact portion of the gastrostomy catheter, A connecting tube is provided on the aforementioned connecting connector, and when the connecting connector is connected to the body surface contact portion, it communicates with the shaft of the gastrostomy catheter, Furthermore, The aforementioned connection connector includes a second connecting portion which is detachably hooked onto the connected portion of the body surface contact portion, The gastrostomy catheter kit according to claim 9, wherein the second connecting portion is hooked onto the connected portion by an operation of inserting the second connecting portion onto the connected portion from above, and an operation of rotating the second connecting portion relative to the connected portion around a second axis with respect to the direction of insertion as the axis.

11. The second connecting portion is, A pair of second protrusions extending to the sides, A pair of second downward projections that protrude downward from the tips of the pair of second protruding portions, A pair of second claw portions project radially inward from the lower ends of the pair of second downward protrusions, It has, The gastrostomy catheter kit according to claim 10, wherein the pair of second claws are inserted into the connected portion from above, and the second connecting portion is rotated in one direction around the second axis, thereby the second connecting portion is hooked onto the connected portion while preventing the pair of second claws from falling out upward from the connected portion.

12. The gastrostomy catheter kit according to claim 11, wherein the second connecting portion is separated from the connected portion by rotating the second connecting portion around the second axis in the opposite direction to the one direction, from a state in which the second connecting portion is hooked to the connected portion, and pulling the pair of second claw portions upward from the connected portion.

13. The body surface contact portion has a pair of recesses into which the pair of second claw portions are inserted and locked, Each of the pair of recesses is An opening into which the second claw portion is inserted into the recess from above, An arc-shaped extending portion that communicates with the lower part of the opening and extends in an arc shape along the movement trajectory of the second claw portion when the second connecting portion rotates around the second axis, Includes, The gastrostomy catheter kit according to claim 11 or 12, wherein the arc-shaped extension portion is formed with a locking projection that locks the second claw portion at the end of the arc-shaped extension portion after it has moved in an arc shape within the arc-shaped extension portion.

14. The gastrostomy catheter kit according to claim 13, wherein the rotation angle of the second connecting portion from the time the second claw portion is inserted into the arc-shaped extension portion until it is locked by the locking projection is less than 45 degrees.

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