Method for accessing abdominal cavity and medical procedure via natural orifice

Abstract

The method for accessing the abdominal cavity according to the present invention, includes: introducing a first flow path into the abdominal cavity; introducing a second flow path into the hollow organ from the natural orifice of the living body, and performing a pressure control, using the first flow path and the second flow path, so that the pressure within the hollow organ is lower than the pressure of the abdominal cavity, and forming an opening in the wall of the hollow organ from the inside of the hollow organ when the pressure within the abdominal cavity, as accomplished by pressure control, is equal to or lower than the pressure of the abdominal cavity, and inserting a device for performing a medical procedure through the opening.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a diagram showing the entire structure of a medical system which includes an example of a device for accomplishing a medical procedure.

FIG. 1B is a partially enlarged diagram of FIG. 1A.

FIG. 2 is a diagram showing the structure of an air supply device.

FIG. 3 is a flow chart of the pressure regulation.

FIG. 4 is a diagram illustrating a medical procedure, and a diagram which forms an opening in the stomach.

FIG. 5 is a diagram which shows one mode of performing a medical procedure in which an endoscope is introduced to the abdominal cavity through an opening in the stomach.

FIG. 6A is a diagram illustrating the air supply route according to another embodiment.

FIG. 6B is an enlarged diagram of the stopper shown in FIG. 6A.

FIG. 6C is an enlarged diagram of the distal end of the endoscope shown in FIG. 6A.

FIG. 6D is an enlarged diagram of a local injection needle.

FIG. 7 is a diagram in which the local injection needle through the endoscope is inserted to the stomach wall, insufflation of the abdominal cavity.

FIG. 8 is a diagram showing the structure of an air supply device.

FIG. 9A and is a diagram illustrating the air supply route according to another embodiment.

FIG. 9B is an enlarged diagram of the overtube shown in FIG. 9A.

FIG. 10 is a flowchart of the pressure regulation.

FIG. 11 is a diagram showing the structure an air supply device.

FIG. 12 is a diagram in which the local injection needle through the endoscope is inserted to the stomach wall, insufflation of the abdominal cavity.

FIG. 13 is a diagram showing the overtube pressing into the stomach.

FIG. 14 is a flowchart of the pressure regulation.

FIG. 15 is a diagram in which the stomach wall is aspirated into the overtube.

FIG. 16 is a diagram showing the formation of an opening using a high frequency knife on the aspirated stomach wall.

FIG. 17 is a diagram illustrating the air supply route according to another embodiment.

FIG. 18 is a cross-sectional diagram showing the structure of an end cover.

FIG. 19 is a diagram of the stomach wall being aspirated into the overtube.

FIG. 20 is a diagram showing the formation of an opening of the aspirated stomach wall by means of a high frequency knife.

FIG. 21 is a diagram showing an embodiment in which a tube used for air expulsion is separately inserted into the endoscope.

FIG. 22 is a diagram showing an embodiment in which there is an attached tube used for air exhaust delivery on the external side of the endoscope.

FIG. 23 is a diagram showing an embodiment in which there is an attached tube used for air exhaust on the outer side of the overtube.

FIG. 25 is a cross-sectional diagram along the line XXV-XXV of FIG. 24.

Claims

1. A method for accessing an abdominal cavity, comprising: introducing a first flow path into the abdominal cavity;introducing a second flow path into a hollow organ from a natural orifice of the living body;performing a pressure control so that a pressure within the hollow organ is lower than a pressure of the abdominal cavity by using of the first flow path and the second flow path;forming an opening in a wall of the hollow organ from the inside of the hollow organ when the pressure within the hollow organ is equal to or less than the pressure within the abdominal cavity, in the step of performing a pressure control; andinserting a device for performing a medical procedure through the opening.

2. The method for accessing an abdominal cavity according to claim 1, wherein the first flow path is percutaneously introduced into the abdominal cavity.

3. The method for accessing an abdominal cavity according to claim 1, wherein the performing the pressure control comprises: performing insufflation within the abdominal cavity by using the first flow path; andreleasing gas within the hollow organ by using the second flow path until the pressure within the hollow organ is equal to or less than the pressure within the abdominal cavity.

4. The method for accessing an abdominal cavity according to claim 3, wherein the gas is supplied to the hollow organ prior to the gas within the hollow organ is released.

5. The method for accessing an abdominal cavity according to claim 1, wherein, after being inserted into the hollow organ from the natural orifice of the living body, the first flow path is made penetrate the hollow organ and is introduced into the abdominal cavity.

6. The method for accessing an abdominal cavity according to claim 5, wherein the performing the pressure control comprises: performing insufflation within the abdominal cavity by using the first flow path; andreleasing gas within the hollow organ by using the second flow path until the pressure within the hollow organ is equal to or less than the pressure within the abdominal cavity.

7. The method for accessing an abdominal cavity according to claim 6, wherein the gas is supplied to the hollow organ prior to the gas within the hollow organ is released

8. The method for accessing an abdominal cavity according to claim 1, wherein the introducing the second flow path comprising inserting an overtube which functions as a device which has an insertion portion inserted into the living body such that a distal end of the second flow path is retained within the hollow organ.

9. The method for accessing an abdominal cavity according to claim 8, wherein the performing the pressure control comprises: performing insufflation within the abdominal cavity by using the first flow path; andreleasing gas within the hollow organ by using the second flow path until the pressure within the hollow organ is equal to or less than the pressure within the abdominal cavity.

10. The method for accessing an abdominal cavity according to claim 9, wherein the gas is supplied to the hollow organ prior to the gas within the hollow organ is released

11. The method for accessing an abdominal cavity according to claim 1, wherein the introducing the second flow path comprises pressing a cylindrical body communicating with the device against the wall of the hollow organ, and the performing the pressure control comprises aspirating a fluid in the space formed between the cylindrical body and the inner wall of the hollow organ.

12. A accomplished through a natural orifice, comprising: introducing a first flow path into an abdominal cavity;introducing the second flow path into the hollow organ from the natural orifice of the living body;performing a pressure control using the first flow path and the second flow path so that a pressure within the hollow organ is equal to or less than a pressure of the abdominal cavity; andin a state in which, by performing a pressure control, the pressure within the hollow organ is made equal to or less than the pressure within the abdominal cavity, withdrawing the device which is inserted from the natural orifice of the living body and is introduced into the abdominal cavity through an opening formed in the hollow organ, from the abdominal cavity.

13. The accomplished through a natural orifice according to claim 12, wherein the introducing the first flow path into the abdominal cavity comprises introducing into the abdominal cavity a device having the first flow path, through the opening of the hollow organ.

14. The accomplished through a natural orifice according to claim 12, wherein the introducing the first flow path into the abdominal cavity comprises percutaneously introducing the first flow path into the abdominal cavity.

15. The accomplished through a natural orifice according to claim 12, wherein the introducing the first flow path into the abdominal cavity comprises inserting the first flow path into the hollow organ from the natural orifice of the living body and making penetrate the hollow organ in a position different from the position of the opening.

16. The accomplished through a natural orifice according to claim 12, wherein the introducing the first flow path into the abdominal cavity comprises introducing an overtube which functions as an insertion guide of the device, and the performing the pressure control comprises performing a pressure adjustment in a space between the overtube and the device.

17. The accomplished through a natural orifice according to claim 12, wherein the performing the pressure control comprises: performing insufflation within the abdominal cavity by using the first flow path; andreleasing gas within the hollow organ by using the second flow path until the pressure within the hollow organ is equal to or less than the pressure within the abdominal cavity.

18. The accomplished through a natural orifice according to claim 12, wherein the gas is supplied to the hollow organ prior to the gas within the hollow organ is released.

19. The accomplished through a natural orifice according to claim 12, wherein, after being inserted into the hollow organ from the natural orifice of the living body, the first flow path is made penetrate the hollow organ and is introduced into the abdominal cavity.

20. The accomplished through a natural orifice according to claim 19, the performing the pressure control comprises: performing insufflation within the abdominal cavity by using the first flow path; andreleasing gas within the hollow organ by using the second flow path until the pressure within the hollow organ is equal to or less than the pressure within the abdominal cavity.

21. The accomplished through a natural orifice according to claim 12, wherein the introducing the second flow path comprises pressing a cylindrical body communicating with the device against the wall of the hollow organ, and the performing the pressure control comprises aspirating a fluid in the space formed between the cylindrical body and the inner wall of the hollow organ.