Medical procedure carried out via a natural opening

Abstract

A medical procedure carried out via a natural opening, comprising: fastening the distal end of thread members to a tissue in a body cavity in proximity to a targeted incision site via a first introduction member that is inserted into a body cavity through a natural opening of an examination subject; inserting a second introduction member having a cutting instrument attached to the distal end thereof into a body cavity through a natural opening of an examination subject and disposing the cutting instrument in proximity to the targeted incision site; and cutting the tissue by pressing the cutting instrument against the tissue while pulling the proximal end sides of the thread members.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic drawing showing the overall overtube that is used in a medical procedure according to a first embodiment.

FIG. 2 is a drawing showing the essential components of the overtube that is used in a medical procedure according to a first embodiment.

FIG. 3 is a perspective view showing the distal end portion of the overtube that is used in a medical procedure according to a first embodiment.

FIG. 4A is a cross-sectional view along III-III in FIG. 3.

FIG. 4B is a cross-sectional view along IV-IV in FIG. 4.

FIG. 5 is a partial enlarged cross-sectional view showing the electrode control portion of the overtube that is used in a medical procedure according to a first embodiment.

FIG. 6 is a cross-sectional view showing the state in which the anchors are installed in the puncture needles of the overtube that is used in a medical procedure according to a first embodiment.

FIG. 7 is a partial cross-sectional view showing the needle control portion of the overtube that is used in a medical procedure according to a first embodiment.

FIG. 8 is a cross-sectional view in proximity to the endoscope lock button of the overtube that is used in a medical procedure according to a first embodiment.

FIG. 9 is a schematic drawing of the overall endoscope showing an example of the device that is passed through the overtube that is used in a medical procedure according to a first embodiment.

FIG. 10 is a flowchart of a medical procedure according to a first embodiment.

FIG. 11 is a drawing for explaining the state in which the endoscope has been inserted in the overtube in a medical procedure according to a first embodiment.

FIG. 12 is a drawing for explaining the state in which the overtube has been introduced to a targeted incision site in a medical procedure according to a first embodiment.

FIG. 13 is a drawing for explaining the state in which a portion of the stomach wall is sucked into the overtube in a medical procedure according to a first embodiment.

FIG. 14 is a drawing for explaining the state in which the stomach wall that has suction applied has been punctured by an injection needle in a medical procedure according to a first embodiment.

FIG. 15 is a drawing for explaining the state in which the stomach wall that has suction applied has been punctured by the puncture needles of the overtube while the abdomen is insufflated with air that has been delivered from the injection needle in a medical procedure according to a first embodiment.

FIG. 16 is a drawing for explaining the state in which the anchors have been released from the puncture needles in a medical procedure according to a first embodiment.

FIG. 17 is a drawing for explaining the state in which the stomach wall has been cut by the cutting electrode of the overtube while pulling the proximal end sides of the thread members in a medical procedure according to a first embodiment.

FIG. 18 is a drawing showing FIG. 17 after being rotated 90 degrees.

FIG. 19 is a drawing for explaining the state in which the endoscope has been inserted into the abdominal cavity in a medical procedure according to a first embodiment.

FIG. 20A is a drawing for explaining a procedure for suturing the opening portion that has been cut by using two retained anchors and the thread members extending therefrom in a medical procedure according to a first embodiment.

FIG. 20B is a drawing for explaining a procedure for suturing the opening portion that has been cut by using two retained anchors and the thread members extending therefrom in a medical procedure according to a first embodiment.

FIG. 21 is a cross-sectional view showing a modified example of the distal end portion of an overtube that is used in a medical procedure according to a first embodiment.

FIG. 22 is a drawing for explaining the state before the stomach wall has been cut by the cutting instrument while pulling the proximal end sides of the thread members in a medical procedure according to a second embodiment.

FIG. 23 is a drawing for explaining the state after the stomach wall has been cut by the cutting instrument while pulling the proximal end sides of the thread members in a medical procedure according to a second embodiment.

FIG. 24 is a perspective view of the cutting instrument that is used in a medical procedure according to a second embodiment.

FIG. 25 is a perspective view of another cutting instrument that is used in a medical procedure according to a second embodiment.

FIG. 26 is a perspective view of the tip of the cutting instrument that is used in a medical procedure according to a second embodiment.

FIG. 27A is a side view of the cutting instrument shown in FIG. 26.

FIG. 27B is a frontal view of the cutting instrument shown in FIG. 26.

FIG. 28A is a side view of another tip of a cutting instrument that is used in a medical procedure according to a second embodiment.

FIG. 28B is a frontal view of the tip of a cutting instrument that is shown in FIG. 28A.

FIG. 29 is a perspective view of a cutting instrument that is used in a medical procedure according to a third embodiment.

FIG. 30A is a drawing for explaining the state before the stomach wall is cut by the cutting instrument while pulling the proximal end sides of the thread members in a medical procedure according to a third embodiment.

FIG. 30B is a drawing for explaining the state after the stomach wall has been cut by the cutting instrument while pulling the proximal end sides of the thread members in a medical procedure according to a third embodiment.

FIG. 31 is a perspective view of another cutting instrument that is used in a medical procedure according to a third embodiment. FIG. 32A is a drawing for explaining the state before the stomach wall is cut by another cutting instrument while pulling the proximal end sides of the thread members in a medical procedure according to a third embodiment.

FIG. 32B is a drawing for explaining the state after the stomach wall has been cut by another cutting instrument while pulling the proximal end sides of the thread members in a medical procedure according to a third embodiment.

FIG. 33 is a perspective view of an endoscope that is used in a medical procedure according to a fourth embodiment.

FIG. 34 is a drawing for explaining the state before the stomach wall is cut by a cutting instrument while pulling the proximal end sides of the thread members in a medical procedure according to a fourth embodiment.

FIG. 35 is a drawing for explaining the state after the stomach wall has been cut by another cutting instrument while pulling the proximal end sides of the thread members in a medical procedure according to a fourth embodiment.

Claims

1. A medical procedure carried out via a natural opening, comprising: fastening the distal end of thread members to a tissue in a body cavity in proximity to a targeted incision site via a first introduction member that is inserted into a body cavity through a natural opening of an examination subject;inserting a second introduction member having a cutting instrument attached to the distal end thereof into a body cavity through a natural opening of an examination subject and disposing the cutting instrument in proximity to the targeted incision site; andcutting the tissue by pressing the cutting instrument against the same while pulling the proximal end sides of the thread members.

2. A medical procedure carried out via a natural opening according to claim 1, further comprising: fastening the distal ends of the thread members to the tissue in proximity to the targeted incision site by retaining the anchors attached to the distal ends of the thread members on the posterior side of the tissue in proximity to the targeted incision site.

3. A medical procedure carried out via a natural opening according to claim 2, further comprising: retaining the anchors on the posterior side of the tissue in proximity to the targeted incision site by hollow puncture needles that have been passed through a lumen provided on the first introduction member entering so as to reach from the anterior side to the posterior side of the tissue and the anchors being retained after passing through the hollow portion of the puncture needles on the posterior side of the tissue.

4. A medical procedure carried out via a natural opening according to claim 3, further comprising: providing two sets of a thread member and an anchor attached to the distal end sides thereof, and retaining each of the two anchors on both sides of the targeted incision cite so as to situate the targeted incision cite therebetween.

5. A medical procedure carried out via a natural opening according to claim 4, further comprising: using the anchors and the thread members to suture the opening portion that has been cut.

6. A medical procedure carried out via a natural opening according to claim 5, wherein the cutting instrument uses a high frequency.

7. A medical procedure carried out via a natural opening according to claim 5, wherein the cutting instrument is one in which the radius of curvature of the tip is set within a range of 0.05 mm to 0.5 mm.