The present invention generally relates to a catheter assembly.
In a patient suffering from urinary incontinence, particularly stress urinary incontinence, involuntary urination occurs due to an abdominal pressure exerted during a normal exercise or by laughing, coughing, sneezing or the like. This is attributable, for example, to loosening of the pelvic floor muscle, which is a muscle for supporting the urethra, caused by childbirth or the like.
For treatment of urinary incontinence, surgical therapy is effective. For instance, a tape-shaped implant called a “sling” is set indwelling in the body so as to support the urethra by the sling. An example is disclosed in Japanese Patent Application Publication No. 2010-99499. In order to put a sling indwelling in the body, an operator incises the vagina with a surgical knife, dissects a biological tissue between the urethra and the vagina, and provides communication between the dissected (excised) biological tissue and the exterior through an obturator foramen by using a puncture needle or the like. Then, in such a state, the sling is set indwelling in the dissected biological tissue in the body.
However, since the biological tissue between the urethra and the vagina is a very thin layer, an insufficient skill of the operator may lead to damage of the urethra during dissection of the biological tissue. In addition, where the dissected (excised) layer of the biological tissue is close to the vagina side, the sling set indwelling may be located excessively close to the vagina side. In such a case, with the lapse of time after the surgery, the sling may come to break through the vaginal wall, to be exposed to the inside of the vagina.
According to one aspect, a catheter assembly includes a catheter comprised of a catheter body possessing at least one lumen, and a stylet comprised of a linear body positionable in the lumen in the catheter body in an assembled state of the catheter assembly. The stylet includes a curved section that is curved, and the linear body of the stylet, inclusive of the curved section, possesses a rigidity greater than the rigidity of the catheter body. The catheter body includes a deformation section that is deformable so that when the stylet is positioned in the lumen with the curved section of the stylet located in the lumen in the assembled state of the catheter assembly the deformation section of the catheter body deforms to a curved shape caused by the curved section of the stylet, and when the stylet is removed from the lumen the deformation section of the catheter body changes to a shape different from the curved shape. When the catheter in the assembled state is positioned in one of two living-body lumens adjacent to each other with biological tissue between the two living-body lumens, the deformation section of the catheter body which possess the curved shape curves a portion of the one living-body lumen facing the deformation section.
The curved section of the stylet preferably includes a first curved portion curved in one direction, and two second curved portions each curved in an opposite direction compared with the first curved portion, with one of the second curved portions being located immediately on a distal side of the first curved portion and the other second curved portion and immediately on a proximal side of the first curved portion.
The stylet preferably includes another section different from the curved section, with the other section of the stylet possessing a rectilinear shape in a natural state when no force is applied to the stylet, and where the distance between a straight line and a central portion of the first curved portion in a longitudinal direction of the first curved portion is not more than 10 mm, wherein the straight line interconnects both end sides of the stylet, and the curved section possessing a length along the straight line that is not more than four times the distance.
The curved section is preferably provided at an intermediate portion of the stylet in a longitudinal direction of the stylet so that a portion of the stylet extends from a proximal end of the curved section to a proximal end of the stylet and so that a portion of the stylet extends from a distal end of the curved section to a distal end of the stylet. The stylet possesses an outer diametrical size throughout the curved section that is greater than the outer diametrical size throughout the portion of the stylet on the distal side of the curved section and throughout the portion of the stylet on the proximal side of the curved section.
The curved section can be provided at an intermediate portion in a longitudinal direction of the stylet, with a portion of the stylet that is on a distal side of the curved section possessing a tapered shape where the outside diameter of the stylet gradually decreases along a distal direction.
The stylet can include a marker identifying the range over which the deformation section extends.
The marker can be a luminous element that emits light.
Alternatively, the marker can include a projecting portion that projects from an outer circumferential portion of the stylet.
Alternatively, the marker is a portion having an imaging property.
The stylet can also include a portion that identifies the direction of curvature of the curved section.
Restriction means for restricting rotation of the stylet about an axis of the catheter body in the assembled state can be provided.
The outer surface of the stylet can be a reduced friction outer surface treated by to reduce friction between the outer surface of the stylet and the catheter at the time of obtaining the assembled state.
The catheter body can include a longitudinally extending reinforcement member that prevents extension and contraction of the catheter body in the longitudinal direction.
The catheter body can also include a longitudinally extending inner layer and a longitudinally extending outer layer, with the a longitudinally extending reinforcement member disposed between the a longitudinally extending inner layer and the a longitudinally extending outer layer. The reinforcement member can be in the form of a spirally wound coil.
The reinforcement member can be configured to exhibit a lower winding density on the distal side than on the proximal side.
The deformation section of the catheter body can be located at a portion of the catheter body at which the winding density is low.
The stylet can be inserted and pulled out, and the catheter assembly can further comprise a correcting pipe insertable into the lumen together with the stylet in the inserted state to forcibly deform the curved section into a rectilinear shape.
The catheter body has two lumens, and the stylet is insertable into one of the two lumens, whereas a high-rigidity stylet having higher rigidity than the stylet and forcibly deforming the curved section in the assembled state is insertable into the other lumen.
The high-rigidity stylet can also include a luminous element that emits light, at its portion corresponding to the curved section in the assembled state.
According to another aspect, a catheter assembly includes a catheter comprised of a catheter body that includes a lumen, a stylet including a curved section that is curved in a natural state in which no force is applied to the curved section, the curved section of the stylet possessing a rigidity, and at least a portion of the catheter possessing a rigidity that is less than the rigidity of the curved section of the stylet. The curved section of the stylet which is curved being positioned inside the lumen in the catheter body so that the portion of the catheter body which possesses a rigidity less than the rigidity of the curved section surrounds the curved section of the stylet and is curved in a manner matching the curvature of the curved section of the stylet so that the portion of the catheter body is a curved portion. The rigidity of the curved section of the stylet causes, when the catheter is positioned in one of two living-body lumens adjacent to each other with biological tissue between the two living-body lumens, the curved portion of the catheter body to spread a portion of the biological tissue between the two living-body lumens to space the two living-body lumens further away from each other as compared to before positioning the catheter in the one of two living-body lumens.
The stylet is preferably a rectilinear shape, and the curved section of the catheter is forcibly deformed into a rectilinear shape along the stylet in the assembled state.
The catheter can include a radiopaque section which is flexible and which is disposed on the catheter body along the longitudinal direction of the catheter body.
The stylet can have a radiopaque section which is flexible and which is disposed on the stylet along the longitudinal direction of the stylet.
In accordance with another aspect, a method includes inserting a catheter into one of two living-body lumens positioned adjacent to each other with biological tissue between the two living-body lumens, wherein the insertion of the catheter into the one living-body lumen is performed to position at least a part of the catheter in the one living-body lumen. The method also comprises changing a shape of a portion of the catheter that is positioned in the one living-body lumen by curving the portion of the catheter in a direction away from the other living-body lumen so that the curving portion of the catheter causes a portion of the biological tissue facing the curving portion to be pulled away from the other living-body lumen.
One of the two living-body lumens is a urethral lumen, and the other living-body lumen is a vaginal cavity, and the catheter assembly is for use in therapy of a disease in pelvic viscera.
The catheter assembly disclosed here is configured so that at the time of applying a surgical treatment to a biological tissue between two living-body lumens, the treatment can be carried out rather easily and assuredly.
For instance, where the catheter assembly is used for therapy of female urinary incontinence, the catheter assembly is inserted into a urethral lumen in an assembled state.
In the therapy or treatment of urinary incontinence, a part of the biological tissue located between the urethral lumen and the vaginal cavity is dissected, and the thus dissected or excised part and the exterior of the body are caused to communicate with each other, through a puncture hole formed by puncture or the like, for example. Then, an implant for supporting the urethra is set indwelling in the puncture hole in the biological tissue.
Since the catheter is formed with the deformation section, when the catheter assembly in the assembled state is inserted into the urethral lumen, a part of the biological tissue that faces the deformation section is spread by the deformation section in such direction as that the urethral lumen and the vaginal cavity are spaced away from each other. In addition, the thus spread portion is spread to an extent sufficient for execution of the dissection and the puncture. The catheter assembly disclosed here thus helps ensure that that when a surgical treatment such as dissection and puncture is applied to the spread portion, the treatment can be carried out relatively easily and assuredly.
a) and 2(b) are partial longitudinal cross-sectional views sequentially illustrating a method of using the catheter assembly shown in
a) and 3(b) are partial longitudinal cross-sectional views sequentially illustrating the method of using the catheter assembly shown in
a) and 4(b) are partial longitudinal cross-sectional views sequentially illustrating the method of using the catheter assembly shown in
a) and 14(b) illustrate a sixth embodiment of the catheter assembly disclosed here, where
a) and 20(b) are side views illustrating an eleventh embodiment of the catheter assembly disclosed here, where
a) and 21(b) are side views illustrating a twelfth embodiment of the catheter assembly disclosed here, where
a)-23(d) are side views as seen from the direction of the arrow 23 in
a) and 24(b) are partial longitudinal cross-sectional views illustrating a state in use of a catheter assembly according to an additional embodiment representing another example of the catheter assembly disclosed here.
a) and 30(b) are side views illustrating a further embodiment of the catheter assembly, where
a)-31(c) are side views illustrating a further embodiment of the catheter assembly disclosed here, where
Set forth below. With reference to the accompanying drawing figures, is a detailed description of embodiments of a catheter assembly representing examples of the inventive catheter assembly disclosed here
The catheter assembly 1 shown in
The urethral lumen 100 is adjacent to a vaginal cavity (another living-body lumen) 200, with a biological tissue 300 located between the urethral lumen 100 and the vaginal cavity (see
The implant is an instrument which, for treatment of female urinary incontinence, is buried in the biological tissue 300 to support the urethra in the manner of pulling the urethra away from the vaginal wall (see
Examples of the implant include a flexible long (elongated) body. In the present embodiment, the implant is composed of a belt 80. This belt 80 is called a “sling.”
In addition, the dimensions of the belt 80 are not particularly limited but are set as required. Preferably, however, the width of the implant is about 3 to 15 mm, and the thickness of the implant is about 0.2 to 2 mm.
The material constituting the belt 80 is not specifically restricted. For instance, various biocompatible resin materials and the like can be used as the material for the belt 80.
The implant is composed of a single belt 80 in this embodiment, but this is not a limitation. For example, the implant may be composed of a plurality of belts 80.
In addition, the implant is not restricted to the belt 80. For example, other flexible long (elongated) bodies such as threads and strings can be used. In the case where a thread or string is used as the implant and the thread or string is circular in cross-sectional shape, the diameter is preferably about 0.2 to 5 mm.
As shown in
As shown in
The catheter body 21 is composed of a tube (tubular) body that is flexible and is substantially rectilinear in a natural state when no external force is exerted on catheter body 21. The tube body (catheter body 21) may be either monolayer or multilayer in form; in this embodiment, the tube body is in a monolayer form. In this case, the material constituting the tube body is not particularly limited. Examples of the material which can be used here include various thermoplastic and thermosetting resins, such as polyolefin resins, polyamide resins, polyurethane resins, and polyimide resins. Specific examples of the applicable material include polyolefins such as polyethylene, polypropylene, ethylene-propylene copolymers, ethylene-vinyl acetate copolymers (EVA), etc.; polyvinyl chloride; polyesters such as polyethylene terephthalate (PET), polybutylene terephthalate (PBT), etc.; polyurethane; polyamides; polyimides; polystyrene resins; fluoro-resins; and various thermoplastic elastomers based on styrene, polyolefin, polyvinyl chloride, polyurethane, polyester, polyamide, polybutadiene, fluoro-rubber or the like.
The catheter body 21 has lumens 211 and 212. The lumen 211 is greater than the lumen 212 in cross-sectional size.
The rectilinear stylet 3 or the curved stylet 4 is selectively inserted in the lumen 211. This lumen 211 opens at the distal portion of the catheter body 21, forming a side hole 218. That is, the lumen 211 opens to the outside of the catheter body 21 at the side hole 218. The number of side hole(s) 218 here is not particularly limited; for example, one side hole or a plurality of side holes may be formed.
The lumen 212 is disposed at a position different from the position of the lumen 211. That is, the two lumens 212, 211 are separate from one another. The lumen 212 constitutes a flow path through which a working fluid for inflation and deflation of the balloon 22 passes. In addition, the lumen 212 opens at a distal portion of the catheter body 21 in a position on the proximal side of the side hole 218, forming a side hole 219. That is, the lumen 212 opens to the outside of the catheter body 21 at the side hole 219. The working fluid can be fed into and out of the balloon 22 via the side hole 219, so that the balloon 22 is inflated and deflated.
In addition, the distal end 217 of the catheter body 21 is rounded. This helps ensure that when the catheter assembly 1 is inserted into the urethral lumen 100, the biological tissue 300 can be prevented from being damaged by the distal end 217. Consequently, insertion of the catheter assembly 1 into the urethral lumen 100 can be carried out safely.
The balloon 22 is composed of a membrane possessing a tubular shape, and is set in place by gas-tight attachment of a proximal portion and a distal portion of the balloon 22 onto an outer circumferential surface of the catheter body 21. The side hole 219 opens into the inside of the balloon 22. That is the side hole 219 is located in the balloon 22. When supplied with a working fluid, the balloon 22 is inflated into a spherical shape. Upon inflation of the balloon 22 in the condition where the catheter assembly 1 is inserted in the urethral lumen 100, the balloon 22 can rather easily engage with an inner wall of a bladder 400. This helps ensure that the catheter assembly 1 can be securely prevented from being pulled out of the urethral lumen 100 in an unintentional manner. The method for attaching the balloon 22 onto the catheter body 21 is not specifically restricted. For example, a method by fusion bonding (thermal fusion bonding, high-frequency fusion bonding, ultrasonic fusion bonding, etc.), a method by adhesion (adhesion by use of an adhesive or a solvent) or the like method can be used.
The material constituting the balloon 22 is not particularly limited. Examples of the material applicable here include: polyester resins such as polyethylene terephthalate, polyethylene naphthalate, polybutylene terephthalate, polybutylene naphthalate, etc. and polyester elastomer containing such a polyester resin; olefin resins such as polyethylene, polypropylene, etc. and cross-linked products of such olefin resins (especially, products cross-linked by irradiation with electron beams); polyamide resins such as nylon 11, nylon 12, nylon 610, etc. and polyamide elastomer containing such a polyamide resin; polyurethane resin; ethylene-vinyl acetate copolymers and cross-linked products thereof; and polymer blends, polymer alloys and the like containing at least one of these resin materials.
The working fluid for inflation and deflation of the balloon 22 is not specifically restricted. Examples of the working fluid applicable here include liquids such as physiological saline solution, etc. and gases such as air, carbon dioxide gas, etc.
The hub 23 includes a tubular main body section 231, and a tubular branch port 232 branching from an intermediate portion in the longitudinal direction of the main body section 231.
The main body section 231 communicates with the lumen 211 in the catheter body 21. The rectilinear stylet 3 and the curved stylet 4 can be inserted into the lumen 211 via the main body section 231.
The branch port 232 communicates with the lumen 212 in the catheter body 21. A syringe, for example, can be connected to the branch port 232. By operating the syringe, the working fluid can flow distally and proximally within the lumen 212.
The material constituting the hub 23 is not particularly limited. Examples of the applicable material include resin materials such as polyvinyl chloride, polyethylene, polypropylene, polycarbonate, polymethyl methacrylate, acrylonitrile-styrene-butadiene copolymer, etc. and various metallic materials.
The catheter 2 in this embodiment is a balloon catheter having the balloon 22, but the catheter is not limited in this regard. A catheter in which such balloon 22 is omitted may also be used. In the case where the catheter 2 is a catheter in which the balloon 22 is omitted, the catheter body 21 can be a catheter body having only one lumen 211.
As shown in
The distal end 31 of the rectilinear stylet 3 is rounded. This helps ensure that when the rectilinear stylet 3 is inserted into the lumen 211 of the catheter body 21 to obtain the first assembled state, the distal end 31 is prevented from being caught on an inner circumferential portion of the catheter body 21. Therefore, the inserting operation can be carried out rather easily.
In addition, the rigidity of the rectilinear stylet 3 is greater than the rigidity of the catheter body 21. This helps ensure that when the catheter assembly 1 in the first assembled state is inserted into the urethral lumen 100 (see
The material or materials constituting the rectilinear stylet 3 and the curved stylet 4 are not particularly limited. For example, the material(s) may be stainless steel.
As shown in
The distal end 41 of the curved stylet 4 is rounded. This helps ensure that, when the curved stylet 4 is inserted into the lumen 211 in the catheter body 21 to obtain the second assembled state, the distal end 41 is prevented from being caught on an inner circumferential portion of the catheter body 21. Therefore, the inserting operation can be conducted rather easily.
The curved stylet 4 has a curved section 42 which is curved in a natural state, at an intermediate portion in the longitudinal direction thereof, specifically, at its portion on the distal side. The natural state refers to the state in which no force (external or internal) is applied to the curved section of the curved stylet. The curved shape of the curved section 42 is substantially maintained even in the second assembled state (see
As shown in
As shown in
In the catheter assembly 1 (catheter 2) in the second assembled state in which the catheter assembly is inserted in the urethral lumen 100, the deformation section 24 can curve a portion of the urethral lumen 100 that faces the deformation section 24, whereby a portion of the biological tissue 300 that faces the deformation section 24 can be pulled toward the deformation section 24 side (the upper side in
The biological tissue 300 is spread by the deformation section 24, normally by about one-and-a-half to three times the size of the biological tissue 300 before being spread.
In addition, assume a straight line O (shown in
When the portion of the biological tissue 300 that faces the deformation section 24 is pulled by the deformation section 24 toward the deformation section 24 side, as illustrated in the part indicated by two-dot chain line in
In addition, the curved stylet 4 is configured so that sections other than the curved section 42, namely the distal-side section and the proximal-side section interconnected through the curved section 42, are rectilinear sections 43 and 44 which are rectilinear in shape in a natural state. The natural state refers to the state in which no force (external or internal) is applied to the distal-side section and the proximal-side section of the curved stylet. The rectilinear section 44 includes a bent section 441, a part (proximal portion) of which is bent, as in the configuration shown in
Now, an example of the method of using the catheter assembly 1, or a procedure for burying the belt 80 into a living body in order to treat female urinary incontinence, will be described below referring to
[1] First, the rectilinear stylet 3 is inserted, starting from its distal end, into the lumen 211, through a main body section 231 of the hub 23 of the catheter 2, to put the catheter assembly 1 into the first assembled state. The catheter 2 thus exhibits a rectilinear shape. In this instance, the balloon 22 of the catheter 2 is not yet inflated but is in a deflated state. In addition, a syringe prefilled with physiological saline solution is prepared. The physiological saline solution is for use as a working fluid for actuating the balloon 22 of the catheter 2.
Then, as shown in
[2] Next, as shown in
[3] Subsequently, as shown in
Consequently, as shown in
[4] Next, as shown in
[5] Subsequently, as shown in
[6] Next, as shown in
Then, both end portions of the belt 80 which have protruded to the exterior of the living body are each pulled with a predetermined force. This results in that the urethral wall is pulled in such a direction as to be spaced away from the vaginal wall, by the tension of the belt 80, and the urethra is supported by the belt 80.
Thereafter, an unnecessary portion of the belt 80 is cut away, followed by predetermined suture and the like, to complete the procedure.
In this embodiment, the catheter assembly 1 has been described referring to the case where an implant capable of being buried is buried (positioned) in a living body for treatment of female urinary incontinence, but this is not restrictive. The catheter assembly 1 can be applied to other uses as well.
This embodiment is the same as the first embodiment, except for a difference in part of the procedure for treatment of female urinary incontinence.
As shown in
The syringe 20 includes: a syringe outer tube 202; an injection needle 203 mounted to a mouth portion of the syringe outer tube 202; a gasket 204 slidably disposed within the syringe outer tube 202; and a plunger 205 operated to move the gasket 204. A space surrounded by the syringe outer tube 202 and the gasket 204 is filled with the liquid 201. The liquid 201 is not limited to a specific liquid. For example, a mixture of an anesthetic liquid and physiological saline solution can be used as the liquid 201. Furthermore, a medicine for enhancing a hemostatic effect may be mixed in the liquid 201.
Meanwhile, when a portion of the biological tissue 300 that faces the deformation section 24 is pulled by the deformation section 24 toward the deformation section 24 side, as shown in the part indicated by two-dot chain line in
This embodiment is the same as the first embodiment above, except for a difference in part of the procedure for treatment of female urinary incontinence.
As shown in
The vaginal insertion instrument 30 is composed of a hard bar-like body of which the outside diameter is constant along the longitudinal direction or extent. The outside diameter of the vaginal insertion instrument 30 is preferably approximately equal to the inside diameter of the vaginal cavity 200, in order that formation of a gap between the vaginal insertion instrument 30 and a vaginal wall is prevented as securely as possible.
As shown in
The material constituting the vaginal insertion instrument 30 is not particularly limited. Examples of materials include the same materials as those for the hub 23.
When a portion of the biological tissue 300 that faces a deformation section 24 is pulled by the deformation section 24 toward the deformation section 24 side, as shown in the part indicated by the two-dot chain line in
This embodiment is the same as the first embodiment above, except for a difference in part of the procedure for treatment of female urinary incontinence.
As shown in
The colposcope 40 has a pair of tongue pieces 401 configured to approach each other and move away from each other. The tongue pieces 401 are so configured that the spacing between the tongue pieces can be maintained.
Meanwhile, when a portion of a biological tissue 300 that faces a deformation section 24 is pulled by the deformation section 24 toward the deformation section 24 side, as shown in the part indicated by two-dot chain line in
This embodiment is the same as the first embodiment above, except for a difference in the configuration of the catheter.
As shown in
A long (elongated) tubular or hollow needle 50 having a sharp needle tip 501 is positioned in and passes through the lumen 213. When the tubular needle 50 is inserted and passed in the lumen 313, the needle tip 501 protrudes distally from the side hole 216. This helps ensure that a portion of a biological tissue 300 which will be an expanded portion 301 is punctured by the needle tip 501. Then, in the punctured state, a liquid 502 can be inserted into the portion under consideration, through the tubular needle 50. The liquid 502 is not restricted to a specific liquid. For example, a mixture of an anesthetic liquid and physiological saline solution can be used as the liquid 502. Furthermore, a medicine for enhancing a hemostatic effect may be mixed in the liquid 502.
Meanwhile, when a portion of the biological tissue 300 that faces the deformation section 24 is pulled by the deformation section 24 toward the deformation section 24 side, as shown in the part indicated by two-dot chain line in
This sixth embodiment is the same as the first embodiment above, except for differences in the configurations of a catheter and a curved stylet.
As shown in
The material constituting the inner layer 25 is not specifically restricted. It is preferable, however, that a portion of the inner layer 25 that makes contact with a rectilinear stylet 3 or a curved stylet 4A at the time of inserting such a stylet into a lumen 211 is formed of a low-friction material. This helps ensure that each stylet can be moved longitudinally relative to the catheter body 21 under a comparatively small sliding resistance, thereby contributing to enhancement of operability. Examples of the low-friction material include various resin materials such as polyamides, polyether-polyamides, polyester-polyamides, polyesters (e.g., polyethylene terephthalate, polybutylene terephthalate, polyethylene naphthalate, etc.), polyurethane, flexible polyvinyl chloride, ABS resin, AS resin, and fluoro-resins such as polytetrafluoroethylene.
The material constituting the outer layer 26 is not particularly limited. Examples of the material applicable here for the outer layer 26 include various thermoplastic elastomers based on styrene, polyolefin, polyurethane, polyester, polyamide, polybutadiene, trans-polyisoprene, fluoro-rubber, chlorinated polyethylene or the like, and, further, combinations (polymer alloys, polymer blends, laminates and the like) of two or more of these thermoplastic elastomers.
The reinforcement member 27 has an extension/contraction-preventive function for preventing the catheter body 21 from extending or contracting in the longitudinal direction. This makes it possible to securely prevent an increase in frictional resistance between the catheter body 21 and each stylet which might arise from a decrease in diameter of the catheter body 21 according to a longitudinal extension of the catheter body 21.
The reinforcement member 27 is composed of a coil obtained by flattening a stainless steel wire rod and spirally winding the flattened product. This enables an extension/contraction-preventive function to be displayed rather assuredly.
As shown in
The winding density of the reinforcement member 27 may vary stepwise or continuously (gradually).
In addition, while the reinforcement member 27 is a spiral-shaped reinforcement member in the configuration shown in
As shown in
On the other hand, the curved stylet 4A is provided with an engaging portion 45 which extends proximally further from a rectilinear section 44 and which engages the deficit portion 233 in the second assembled state. The engaging portion 45 is obtained by a method in which a linear body constituting the curved stylet 4A is wound into a ring-like shape. Of the curved stylet 4A, the engaging portion 45 engages the deficit portion 233 in the second assembled state, whereby rotation of the catheter 2A about its axis is restricted (see
Thus, in the catheter assembly 1 in this embodiment, the deficit portion 233 of the catheter 2A and the engaging portion 45 of the curved stylet 4A function as restriction means for restricting the curved stylet 4A from rotating about the axis of the catheter 2A in the second assembled state.
In addition, the outer surface of the curved stylet 4A has undergone a friction-reducing treatment for reducing the friction between the outer surface and the catheter 2A at the time of obtaining the second assembled state. This helps ensure that insertion of the curved stylet 4A into the catheter 2A can be carried out rather smoothly.
In the configuration shown in
This embodiment is the same as the second embodiment above, except for a difference in the configuration of the stylet.
As shown in
The rectilinear section 43 possesses a tapered shape wherein the outside diameter φd2 of the rectilinear section 43 gradually decreases along the distal direction. This enables the curved stylet 4B to move in the longitudinal direction relative to a catheter body 21 under a comparatively small sliding resistance between the curved stylet 4B and the catheter body 21, which contributes to enhancement of operability. The operability is enhanced especially for a patient having a urethral lumen 100 that is originally tortuous.
This embodiment is the same as the first embodiment, except for a difference in the configuration of the curved stylet.
As shown in
Upon visual inspection of a biological tissue 300 from the side of a vaginal cavity 200, the light emitted from the luminous element 471a and transmitted through a distal portion 303 of the expanded portion 301 is visually confirmed. Also, the light emitted from the luminous element 471b and transmitted through a proximal portion 304 of the expanded portion 301 is visually confirmed. This makes it possible to rather easily grasp the portion of the biological tissue 300 at which is located the expanded portion 301. Consequently, a surgical treatment of the expanded portion 301 can be carried out in an assured manner.
This embodiment is the same as the eighth embodiment described above, except for a difference in the configuration of marker.
As shown in
Upon insertion of a finger 500 into a vaginal cavity 200, the feeling of the projecting portion 472a is transmitted through a distal portion 303 of the expanded portion 301. That is, an individual can feel the projecting portion 472a. Similarly, the feeling of the projecting portion 472b is transmitted through a proximal portion 304 of the expanded portion 301 and so an individual can feel the projecting portion 472b. This makes it possible to rather easily grasp the portion of the biological tissue 300 at which the expanded portion 301 is formed or located. Consequently, surgical treatment of the expanded portion 301 can be performed in a reliable manner.
This embodiment is the same as the eighth embodiment above, except for a difference in the configuration of the marker.
The marker 47 of a curved stylet 4E in the
The ultrasonic probe 60, in the configuration shown in
In the ultrasonic transducer 601 of the ultrasonic probe 60, an ultrasonic wave is emitted and a reflected ultrasonic wave is received. Thus, emission and reception of ultrasonic waves are conducted. By the emission and reception of ultrasonic waves, an image of a part to be observed can be picked up. Specifically, in the ultrasonic transducer 601, the reflected ultrasonic wave received is converted into a signal, which is transmitted to a controller. The controller receives the signal, performs processing such as coordinate transformation, and generates an image signal representing the part to be observed. The image signal is sent from the controller to a display, on which the image of the part to be observed (namely, an ultrasonic image) is displayed. Generally speaking, the ultrasonic image is formed as follows. Based on the time from transmission of the ultrasonic wave from the ultrasonic transducer until the return of the reflected wave to the ultrasonic transducer, the distance to an object and the like are determined, and the object is visualized on the basis of determination results.
When the ultrasonic probe 60 is actuated in the state of the catheter 1 being inserted in the urethral lumen 100, an ultrasonic image of the imaging portion 473 is obtained. This makes it possible to rather easily grasp the part of the biological tissue 300 at which the expanded portion 301 is located. Consequently, a surgical treatment of the expanded portion 301 can be carried out in an assured manner.
This embodiment is the same as the first embodiment above, except that the catheter assembly includes the correcting pipe.
As shown in
In addition, the curved stylet 4 can be inserted into and pulled out of the correcting pipe 5. In an insertion state in which the curved stylet 4 is located in the correcting pipe 5, a curved section 42 is forcibly deformed into a rectilinear shape (see
When a structure wherein the curved stylet 4 is inserted in the correcting pipe 5 is inserted into a lumen 211 of the catheter 2, as shown in
When the correcting pipe 5 is pulled out from the state shown in
This embodiment is the same as the first embodiment above, except for a difference in the configuration of the catheter.
As shown in
In this embodiment, the curved stylet 4 is formed from a superelastic alloy. The rectilinear stylet 3 is greater in diametrical size (thicker or greater outer diameter) than the curved stylet 4, and is formed from a high-rigidity material, for example, stainless steel.
When the rectilinear stylet 3 is further inserted into the catheter 2B in an assembled state in which the curved stylet 4 is located in the catheter 2B, as shown in
When the rectilinear stylet 3 is pulled out from the state shown in
This embodiment is the same as the twelfth embodiment above, except for a difference in the configuration of the high-rigidity stylet.
As shown in
When the state shown in
In the state shown in
In this way, it is possible to grasp in what state the biological tissue 300 is when observed.
a) and 24(b) illustrate a catheter assembly according to a fourteenth embodiment while the catheter assembly is in use. The following description focuses primarily on differences between this embodiment and the embodiments described above. Features in this fourteenth embodiment that are similar to features in the embodiments described above are identified by common reference numerals and a detailed description of such features is not repeated.
This embodiment is the same as the first embodiment above, except for a difference in the configuration of the catheter.
As shown in
A catheter body 21 of the catheter 2C is provided, at its intermediate portion in the longitudinal direction, specifically, at its portion on the distal side, with a curved section 28 that is curved in a natural state, namely, in a state where the rectilinear stylet 3 is not inserted therein and when no force (external or internal) is applied to the catheter body. The curved shape of the curved section 28 is the same as that of the curved section 42 of the curved stylet 4. The curved section 28 is higher in rigidity than the rectilinear stylet 3. In order that the curved section 28 has such a rigidity, it suffices, for example, to provide a structure wherein a reinforcement member composed of stainless steel is disposed.
As shown in
As shown in
This embodiment is the same as the first embodiment above, except that the catheter assembly includes a hard pipe.
As shown in
In addition, the hard pipe 6 has a curved section 61 at its intermediate portion in the longitudinal direction, specifically at its portion on the distal side. The curved shape of the curved section 61 is the same as that of a curved section 42 of a curved stylet 4. In an assembled state attained by inserting the catheter body 21 into the hard pipe 6, a portion of the catheter body 21 that is located in the curved section 61 is shaped (deformed) to match the shape of the curved section 61.
When the hard pipe 6 in the assembled state is inserted in a urethral lumen 100, the curved section 61 pulls a portion of a biological tissue 300 that faces the curved section 61 toward the curved section 61 side (the upper side in
As shown in
This embodiment is the same as the first embodiment above, except for a difference in the configuration of the catheter.
As shown in
The radiopaque section 9 includes: a linear portion 91 which is linear in shape and is flexible, and a first fixing portion 92 and a second fixing portion 93 by which both end parts of the linear portion 91 are supported on and fixed to the catheter body 21.
As shown in
The circular ring bodies 911 preferably have the same diameter.
In addition, while the linear section 91 has the structure in which the circular ring bodies 911 are mutually linked in the aforementioned case, this configuration is not restrictive. For instance, the linear section 91 may have a structure in which polygonal ring bodies are mutually linked, or a structure in which spherical bodies are mutually linked.
The first fixing portion 92 is a band supporting a distal part of the linear portion 91, and the second fixing portion 93 is a band supporting a proximal part of the linear portion 91. The spacing between the first fixing portion 92 and the second fixing portion 93 can be changed. This makes it possible to regulate the degree of flexure of the linear portion 91.
When the catheter assembly 1 is disposed in a urethral lumen 100, as shown in
In this embodiment, the curved stylet 4 shown in
a) and 30(b) illustrate a catheter assembly according to a seventeenth embodiment while the catheter assembly is in use. The following description focuses primarily on differences between this embodiment and the embodiments described above. Features in this seventeenth embodiment that are similar to features in the embodiments described above are identified by common reference numerals and a detailed description of such features is not repeated.
This embodiment is the same as the eleventh embodiment above, except for a difference in the configuration of the stylet.
As shown in
The radiopaque section 9 includes a linear portion 91 which is linear and flexible, and a first fixing portion 92 and a second fixing portion 93 by which both end parts of the linear portion 91 are supported and fixed. The respective configurations of the linear portion 91, the first fixing portion 92 and the second fixing portion 93 are the same as the respective configurations of the linear portion 91, the first fixing portion 92 and the second fixing portion 93 of the radiopaque section 9 described in the sixteenth embodiment above and shown in
The radiopaque section 9 with such a configuration is disposed in the same position as a curved section 42 of the curved stylet 4F, in the longitudinal direction of the curved stylet 4F.
At the time of insertion into a urethral lumen 100 of the catheter assembly 1 in an insertion state in which the curved stylet 4F is inserted into a correcting pipe 5 up to the curved section 42 (the radiopaque section 9), as shown in
Like in the sixteenth embodiment above, when the catheter assembly 1 is disposed in the urethral lumen 100, depending on the patient (the case) there may be cases where, even though a portion of a biological tissue 300 that faces a deformation section 24 is pulled by the deformation section 24, the urethral lumen 100 is expanded to cause a space 101 to be further formed within the urethral lumen 100, resulting in that an expanded portion 301 of the biological tissue 300 would not be formed (see
a)-(c) illustrate a catheter assembly according to an eighteenth embodiment while the catheter assembly is in use. The following description focuses primarily on differences between this embodiment and the embodiments described above. Features in this eighteenth embodiment that are similar to features in the embodiments described above are identified by common reference numerals and a detailed description of such features is not repeated.
This embodiment is the same as the twelfth embodiment above, except for a difference in the configuration of the catheter.
As shown in
The radiopaque section 9 includes a linear portion 91 which is linear in shape and is flexible, and a first fixing portion 92 and a second fixing portion 93 by which both end parts of the linear portion 91 are supported and fixed. The respective configurations of the linear portion 91, the first fixing portion 92 and the second fixing portion 93 are the same as the respective configurations of the linear portion 91, the first fixing portion 92 and the second fixing portion 93 of the radiopaque section 9 described in the sixteenth embodiment above and shown in
The radiopaque section 9 with such a configuration is disposed in the same position as a curved section 42 of a curved stylet 4 in an assembled state, in the longitudinal direction of the catheter 2E.
In this embodiment, the catheter body 21 is composed of a transparent tube body, the material of which is not specifically restricted. An example of the material includes polyethylene. In addition, the catheter body 21 may not necessarily be entirely formed of a transparent material. Thus, only a part of the catheter body 21, with a deformation section 24 as a center of the part, may be composed of a transparent member.
The degree of flexure of the linear portion 9 of the radiopaque section 9 in a state shown in
In addition, as shown in
Meanwhile, like in the sixteenth embodiment above, when the catheter assembly 1 is disposed in a urethral lumen 100, depending on the patient (the case) there may be cases where, even though a portion of a biological tissue 300 that faces the deformation section 24 is pulled by the deformation section 24, the urethral lumen 100 is expanded to cause a space 101 to be further formed within the urethral lumen 100, resulting in that an expanded portion 301 of the biological tissue 300 would not be formed (see
While the catheter assembly disclosed here has been described above with reference to the embodiments shown in the drawings, the invention is not restricted to the illustrated and described embodiments. The sections or portions constituting the catheter assembly can be replaced by sections or portions of other configurations which can exhibit equivalent or similar functions. Features and structures may also be added.
In addition, the catheter assembly may be configured to include a combination of the configurations (features) of two or more of the above embodiments.
The catheter assembly disclosed here generally includes: a catheter provided with a catheter body having at least one lumen; and a stylet that includes a linear body of higher rigidity than the catheter body and positioned in the lumen, with the catheter assembly being configured to assume an assembled state when assembled by inserting the stylet into the lumen. The catheter assembly is configured so that: the stylet has a curved section, a part of which is curved; the catheter body is formed with a deformation section that has been deformed in a curved manner along the curved shape of the curved section, at a portion where the curved section is located in the assembled state; and the catheter is so configured that, when the catheter is inserted into one of two living-body lumens adjacent to each other with biological tissue therebetween in the assembled state, the deformation section curves a portion of the one living-body lumen that faces the deformation section. Therefore, when a surgical treatment is applied to the biological tissue between the two living-body lumens, the treatment can be carried out relatively easily and assuredly.
The detailed description above describes features and aspects of embodiments of a catheter assembly. The invention is not limited, however, to the precise embodiments and variations described. Various changes, modifications and equivalents could be effected by one skilled in the art without departing from the spirit and scope of the invention as defined in the appended claims. It is expressly intended that all such changes, modifications and equivalents which fall within the scope of the claims are embraced by the claims.
Number | Date | Country | Kind |
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2011-253123 | Nov 2011 | JP | national |
This application is a continuation of International Application No. PCT/JP2012/079775 filed on Nov. 16, 2012, and claims priority to Japanese Application No. 2011-253123 filed on Nov. 18, 2011, the entire content of both of which is incorporated herein by reference.
Number | Date | Country | |
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Parent | PCT/JP2012/079775 | Nov 2012 | US |
Child | 14279973 | US |