Endoscopic Device Insertion via Guide Wire Tug
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Solution Overview
Problem
Insertion of endoscopic devices into bile ducts or pancreatic ducts is challenging when obstructions or anatomical misalignment occurs, making it difficult to insert guide wires and subsequently the devices through the duodenal papilla.
Innovation Solution
A method involving the insertion of a guide wire into a first hollow organ, projecting it into a second hollow organ, and using a flexible endoscope to push an endoscopic device onto the guide wire, allowing for tugging the guide wire outside the body to guide the endoscopic device into the first hollow organ, facilitating insertion even when the papilla is closed or misaligned.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If the endoscopic device is pushed into the papilla via manual operation, then the device can be inserted into the hollow organ, but the device may bend in the space between the tip of the endoscope and the papilla, causing loss of force and making insertion difficult
Solution Approach 1:
Instead of pushing the endoscopic device forward into the papilla, the invention pulls the guide wire backward from the body exterior. This reverse action (pulling instead of pushing) transmits force directly to the device-papilla interface, overcoming the bending loss that occurs during forward pushing.
Solution Approach 2:
The guide wire serves as an intermediary element that transmits pulling force from the exterior to the endoscopic device. By engaging the device with the guide wire and pulling the wire from outside the body, the force is transmitted through the wire rather than being lost through bending of the device in the space between the endoscope tip and papilla.
2Ease of operation
If the papilla is tightly closed or not visible from the front, then standard endoscopic insertion becomes difficult, but the rendezvous method requires puncturing the bile duct from the gastrointestinal tract
Solution Approach 1:
The guide wire is inserted into the hollow organ (bile duct or pancreatic duct) through the closed or difficult-to-visualize papilla before the endoscopic device is introduced. This preliminary placement of the guide wire establishes a pathway that simplifies subsequent device insertion, as the device can be engaged with and pulled along the pre-positioned wire.
Solution Approach 2:
The guide wire acts as an intermediary that bridges the gap between the difficult-to-access papilla and the endoscopic device. By first establishing the wire's presence through the papilla and then using it to pull the device, the complexity of directly visualizing and accessing the closed papilla is overcome.
3Ease of operation
If the orientation of the opening significantly differs from the advancing direction of the therapeutic device, then guide wire insertion becomes difficult, but the invention requires projecting the guide wire into the lumen of the second hollow organ
Solution Approach 1:
The flexible endoscope is used to dynamically adjust its position and orientation to access the papilla from different angles. This dynamic positioning allows the guide wire to be projected into the lumen of the second hollow organ (duodenum) even when the opening orientation differs significantly from the initial advancing direction of the therapeutic device.
Solution Approach 2:
The procedure utilizes a second hollow organ (duodenum) as an alternative pathway. By projecting the guide wire into the lumen of this second organ and accessing the papilla from this different spatial dimension, the orientation mismatch between the original advancing direction and the opening is overcome.
Data Source
AI summary
In a method for inserting an endoscopic device, a guide wire is punctured into a subject from outside the body. A tip portion of the wire is inserted into a first hollow organ. A tip-side portion of the inserted wire is projected into a lumen of a second hollow organ that communicates with the first via an opening, from the opening. An endoscopic device is inserted through a flexible endoscope and pushed into the second hollow organ. A tip portion of the device is locked onto the tip-side portion of the wire projecting into the second hollow organ. A portion of the wire outside the body of the subject is held and is tugged outside of the body. The tip portion of the device is thus pulled into the first hollow organ from the second, via the opening. Therefore, the endoscopic device can be led to the first hollow organ.