Fistulectomy method between first duct and second duct, ultrasonic endoscope, catheter with balloon, magnet retaining device, and magnet set

• US 20080051626A1
• Filed: 08/28/2006
• Published: 02/28/2008
• Est. Priority Date: 08/28/2006
• Status: Abandoned Application

• Current Assignee: Olympus Medical Systems Corporation (Olympus Corporation)
• Original Assignee: Olympus Medical Systems Corporation (Olympus Corporation)
• Inventors: Mizunuma, Akiko, Mikkaichi, Takayasu, Kaji, Kunihide, Sato, Masatoshi, Suzuki, Takayuki, Shiono, Junji
• Application Number:
  US11/511,197
• Publication Number:
  US 20080051626A1
• Time in Patent Office: Days
• US Class Current: 600/101
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00179 for off-axis viewing
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/1103 Approximator
• CPC Class Codes: A61B 2017/1117 adapted for discharge after necrotisation, e.g. by evacuation, expulsion or excretion
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4416 : related to combined acquisition of different diagnostic modalities, e.g. combination of ultrasound and X-ray acquisitions
• CPC Class Codes: A61B 8/445 : Details of catheter construction

Abstract

A fistulectomy method of forming a fistula between a first duct and a second duct includes sticking a puncture needle into the second duct from the inside of the first duct through a wall surface of the first duct and a wall surface of the second duct, arranging the puncture needle at a position of a central axis and sticking a coil needle around the puncture needle from the first duct toward the second duct to couple the first duct with the second duct, maintaining the coil needle in a state where the first duct communicates with the second duct, and forming the fistula on an inner side of the coil needle.

Claims

1. A fistulectomy method of forming a fistula between a first duct and a second duct, comprising:

sticking a puncture needle into the second duct from the inside of the first duct through a wall surface of the first duct and a wall surface of the second duct;

arranging the puncture needle at a position of a central axis and sticking a coil needle around the puncture needle from the first duct toward the second duct to couple the first duct with the second duct;

maintaining the coil needle in a state where the first duct communicates with the second duct; and

forming the fistula on an inner side of the coil needle.

2. The fistulectomy method according to claim 1, further comprising:

using an ultrasonic observing function of an endoscope to recognize a position of the second duct before sticking the puncture needle from the inside of the first duct toward the second duct.

3. The fistulectomy method according to claim 1, further comprising:

discharging an electroconductive evagination member having an electroconductive cord-like member fixed at a central part thereof from a distal end of the puncture needle to arrange the evagination member in the second duct when the puncture needle is stuck into the second duct; and

pulling the cord-like member toward the first duct side and pushing an inner wall of the second duct by the evagination member to allow the second duct to be appressed against the first duct.

4. The fistulectomy method according to claim 3, further comprising:

discharging the evagination member to the first duct from the second duct through the inside of the coil needle in a state where a current is flowed through the cord-like member and the evagination member.

5. The fistulectomy method according to claim 1, further comprising:

sticking the coil needle around the puncture needle to couple the first duct with the second duct in a state where a proximal end of the coil needle is engaged with a distal end of an over-tube; and

releasing engagement between the over-tube and the coil needle to maintain the coil needle in a state where the first duct communicates with the second duct.

6. An ultrasonic endoscope comprising:

an elongated insertion section having a distal end and a proximal end; and

an operation section provided at the proximal end of the insertion section,

wherein the insertion section includes on a distal end surface at the distal end a distal end hard portion having an ultrasonic transducer, a forceps channel opening portion and an object lens on a straight line.

7. A fistulectomy method of forming a fistula between a first duct and a second duct, comprising:

sticking a puncture needle toward the outside of the first duct from the inside of the first duct;

discharging an adhesive to a space between the first duct and the second duct from the puncture needle;

relatively moving the first duct and the second duct closer to each other and bonding outer wall surfaces of the first duct and the second duct to each other by using the adhesive; and

forming the fistula on an inner side of an edge of a part where the outer wall surfaces are bonded to each other.

8. The fistulectomy method according to claim 7, comprising:

using an endoscope to endoscopically lead the puncture needle to the first duct.

9. The fistulectomy method according to claim 8, further comprising:

bending a bending portion of the insertion section of the endoscope and moving the first duct toward the second duct side to bond the first duct to the second duct.

10. A fistulectomy method of forming a fistula between a first duct and a second duct, comprising:

pushing an inner wall of the first duct toward the second duct;

giving an energy to the inner wall of the first duct to connect the first duct with the second duct in a state where the first duct is in contact with the second duct; and

forming the fistula on an inner side of an edge of a part where the first duct is connected with the second duct.

11. A fistulectomy method of forming a fistula between a first duct and a second duct, comprising:

sticking a puncture needle into the second duct from the first duct;

arranging in the second duct a first balloon provided at a distal end of an outer peripheral surface of a cylindrical member through a punctured part into which the puncture needle is stuck;

inflating the first balloon;

pushing an inner wall of the second duct toward the first duct side to move the second duct toward the first duct in a state where the first balloon is inflated, and arranging in the first duct a second balloon provided on a proximal end side of the first balloon on the outer peripheral surface of the cylindrical member;

inflating the second balloon to hold the wall surfaces of the first and second ducts;

holding the wall surfaces of the first and second ducts between the first and second balloons to allow the first and second ducts to adhere to each other in a state where the punctured part is maintained on the outer peripheral surface of the cylindrical member; and

deflating the first and second balloons and pulling out the cylindrical member from the punctured part to form the fistula.

12. The fistulectomy method according to claim 11, further comprising:

moving the second balloon to the first balloon to reduce a distance between the first balloon and the second balloon when the second balloon is inflated to hold the first and second ducts.

13. The fistulectomy method according to claim 11, further comprising:

inflating a third balloon which is provided between the first and second balloons and has an inflation amount smaller than those of the first and second balloons to increase a diameter of the fistula.

14. A catheter with balloons which is arranged in a fistula, comprising:

a cylindrical member having a distal end and a proximal end;

a first balloon provided on an outer peripheral surface at the distal end of the cylindrical member;

a second balloon which is provided on the outer peripheral surface of the cylindrical member on a proximal end side of the first balloon;

a first fluid duct which is coupled with the first balloon and through which fluid flows into/from the first balloon; and

a second fluid duct which is coupled with the second balloon and through which fluid flows into/from the second balloon.

15. A fistulectomy method of forming a fistula between a first duct and a second duct, comprising:

arranging a first magnet in the second duct from the first duct;

arranging a second magnet larger than the first magnet in the first duct and holding wall surfaces of the first and second ducts between the first and second magnets to exert attraction forces;

necrotizing the first and second ducts by holding based on the attraction forces of the first and second magnets to form the fistula; and

discharging the first magnet into the first duct through the fistula and dropping the first and second magnets in the first duct.

16. A magnet retaining device which retains a magnet which is magnetically attached to the other magnet through a wall surface of a biomedical tissue, comprising:

a puncture needle having a needle tube at a distal end;

a side hole provided in the needle tube;

a magnet provided to allow access from the side hole; and

a stylet which is detachable at a proximal end of the needle tube and discharges the magnet from the side hole by insertion.

17. A magnet assembly which is magnetically attached to the other magnet through a wall surface of a biomedical tissue, comprising:

a linear cord-like member;

a plurality of magnets into which the cord-like member is inserted and which are aligned; and

a stopper which is provided to the cord-like member and prevents the magnet from falling from the cord-like member.

18. The magnet assembly according to claim 17,

wherein the plurality of magnets have a substantially-arc-like shape as a whole when the magnets adjacent to each other are magnetically attached to each other.

19. A magnet assembly which is magnetically attached to the other magnet through a wall surface of a biomedical tissue, comprising:

an annular cord-like member;

a plurality of magnets into which the cord-like member is inserted and which are aligned; and

a stopper which slides in a state where the cord-like member is superimposed thereon and is configured to increase/reduce a loop shape of the cord-like member on a side where the magnets are arranged.

20. The magnet assembly according to claim 19,

wherein the plurality of magnets have a substantially-arc-like shape as a whole when the magnets adjacent to each other are magnetically attached to each other.