CN1136965A - 穿刺方法和穿刺装置 - Google Patents

穿刺方法和穿刺装置 Download PDF

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CN1136965A
CN1136965A CN95121624A CN95121624A CN1136965A CN 1136965 A CN1136965 A CN 1136965A CN 95121624 A CN95121624 A CN 95121624A CN 95121624 A CN95121624 A CN 95121624A CN 1136965 A CN1136965 A CN 1136965A
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佐佐木宽
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/04Endoscopic instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/0045Devices for taking samples of body liquids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/0233Pointed or sharp biopsy instruments
    • A61B10/0283Pointed or sharp biopsy instruments with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00491Surgical glue applicators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02Instruments for taking cell samples or for biopsy
    • A61B10/04Endoscopic instruments
    • A61B2010/045Needles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00637Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for sealing trocar wounds through abdominal wall
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00646Type of implements
    • A61B2017/0065Type of implements the implement being an adhesive
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3419Sealing means between cannula and body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B2017/348Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/3484Anchoring means, e.g. spreading-out umbrella-like structure
    • A61B2017/3488Fixation to inner organ or inner body tissue

Abstract

本发明的目的在于实现从人体器官内或动物器官内抽取样品和对其内部检查,而不会有任何体液和类似物泄漏到器官内的穿刺方法和穿刺装置。其具有下列结构,即使安置在储存器上的伞形部分通过粘结剂粘到被穿刺部位上,把针体整个地通过储存器的密封部分插入被穿刺的部位,以抽出内部的体液,通过密封部分的相反操作可防止体液的泄漏。

Description

穿刺方法和穿刺装置
本发明涉及一种穿刺方法和一种穿刺装置,更具体地,本发明涉及一种穿刺方法和穿刺装置的新的改进,以便实现从器官中抽取样品和检查器官的内部情况而在人体或动物器官内无体液和类似物向外渗出。
传统地使用的穿刺方法一般包括把注射针刺入在器官内的穿刺部位并抽取其内的体液和类似物,用于对体液和类似物进行病理检查。
由于传统的穿刺方法含有上述过程,它有下列明显缺点。
当注射针插入欲穿刺的部位以抽吸和随后排出体液和类似物时,在用注射针穿刺的部位上保留一个开口,使得体液和类似物可能偶然渗到体内,如果体液是有害的,最终会使体液转移进入其它器官。
本发明已经实现了克服上述问题。本发明的目的在于提供一种穿刺方法和一种穿刺装置,以便实现从器官中抽取样品和检查器官的内部情况,而不会使人体或动物器官内的体液或类似物渗出。
用按照本发明的穿刺方法和穿刺装置,把穿刺装置通过在人体或动物体的壁体上形成的开口插入,以便只推入第一管状体,伞状部分和储液器从第二管状体中弹出,由此,伞状部分由压紧形状张开成原来的伞形。在该状态,通过由另一方向插入的干燥装置使穿刺部位的表面干燥,之后通过切开袋状部分,去掉塞子或其它粘结剂输送夹紧装置输送粘结剂到欲穿刺部位或伞状部分上,使最终的薄膜厚度约为0.1到0.2mm。
在上述的状态下,向内推动整个装置,使伞状部分与欲穿刺部位密切结合,由此,由于粘结剂的作用使两部分构成一体。
把注射针体插入第一管状体内,然后,注射针体刺穿密封部分,通过欲穿刺部位。在这种情况下,从管状的注射针部分中只抽出类似于杆的注射针部分,并把抽取器插入管状注射针部分的头部内,用于抽取,穿刺部位内的体液和类似物便可以被抽取和排出。在完成这样的抽取之后立即切断管状体,而把伞状部分和部分管状体保留在穿刺部位上,同时压实密封部分,以便恢复原来的形状,这样,由注射针体在穿刺时所造成的开口也因此而消失,且穿刺部位上所形成的开口也由密封部分完全阻塞,由此可防止内部的体液向外渗漏,进而可以防止通过这种渗漏使恶性肿瘤转移给其它器官。
通过插入照相机或样品收集器替代上述的抽取器,可以观察到穿刺部位的内部情况,或者可以采集生物学的样品。
图1是说明按照本发明的穿刺装置的主要部分的剖视图;
图2是说明图1的密封部分的放大剖面图;
图3是表示图2的另一个例子的剖面图;
图4是表示图2的再一个例子的剖面图;
图5是图1所示装置的结构分解图,用于安装第一管状体;
图6是表示第二管状体的结构图;
图7是表示注射针体的管状针部分的剖面图;
图8是表示杆状针部分的剖面图;
图9是针体的剖面图;
图10是表示穿刺方法的构成图;
图11是表示穿刺方法的构成图;
图12是表示穿刺方法的构成图;
图13是穿刺之前状态的纵向剖视图;
图14是图11的横向剖视图;
图15是穿刺之前状态的纵向剖视图;
图16是图13的横向剖视图;
图17是切开袋部分的纵向剖视图;
图18是图15的横向剖视图;
图19是表示伞状部分在粘结到欲穿刺部位时的状态的纵向剖视图;
图20是图17的横向剖视图;
图21是穿刺之前瞬刻状态的纵向剖视图;
图22是图19的横向剖视图;
图23是穿刺状态的纵向剖视图;
图24是图21的横向剖视图;
图25是抽取状态的纵向剖视图;
图26是图23的横向剖视图;
图27是抽取后当去掉注射针体时的状态的纵向剖视图;
图28是切去弹性支承前的剖面图;
图29是图26所示切割状态的横向剖面图;
图30是去掉穿刺装置后的纵向剖面图;
图31是图28的横向剖面图;
图32是使用照相机的实施例的横向剖视图;
图33是使用样品收集器的实施例的横向剖视图;
图34是表示另一个实施例的剖视图;
图35是表示又一个实施例的剖视图;
图36是表示再一个实施例的剖视图;
图37是表示再一个实施例的剖视图;
图38是表示外科手术状态的剖面图。
下面将参照附图详细说明本发明的穿刺方法和穿刺装置,首先说明第一个实施例。
图1表示穿刺装置的主要部分,″1″表示由尿烷橡胶制成的成伞形的伞形部分,含粘结剂储存器2的管状体3在伞形部分1的轴中心位置上一体地形成(也可以分开成形);并且储存器2包括挡块1A和以密封的方式装在管状体3内的密封部分3A。在此,管状体3,伞形部分1和密封部分3A可以一体地注塑成形,或者由分开的零件组成,然后把它们连接在一起。挡块1A由橡胶和类似的材料制成并以可移动的方式装在管状体3上。通过拉动与挡块1A连接的线1Aa,可以将挡块1A从管状体3中取出。如图2所示,密封部分3A包括沿轴向装在两端的第一和第三薄膜3Aa和3Ac及位于它们两者之间的第二薄膜3Ab,截面3B形成于第二薄膜3Ab上,由此,在下面将要说明的针和类似物可以容易地通过密封部分3A。另外,密封部分3A的结构不仅仅包括这样的三层也可以是单层或两层。此外,它们可以如图3和图4所示设置密封部分3A。
在管状体3上,可以装有抗腐蚀的铝和其它材料的管形螺纹体5。将粘结剂7(如外科用的Allon-alfa)和类似物(也可以使用其它粘结剂)用注射器6在使用之前立即注入储存器2内。粘结剂7也可以在去掉停止器1A之后不用注射器6就注入储存器2。顺便说一下,这种粘结剂优选的装入量为0.1cc到2.0cc。
第一管状体9具有近乎与螺纹体5的外径相同的外径,它由防腐蚀的铝和类似物制成并也具有第一支托器8,第一管状体9与螺纹体5以串联的方式成螺旋形连接。另外,第一管状体9可以直接的或间接的与管状体3以一体的或分离的方式连接。
如图6所示,与弹性支承5连接的第一管状体9具有一个第二支托架10,并沿同轴方向插入到由防腐蚀的铝和类似物做成的第二管状体11。因此,按照本发明的穿刺装置20在图6中示出了它的整个状态。在该状态,伞形部分1改进成比原来形状更紧凑的形状,并装在第二管状体11内。如图1所示,伞形部分1由尿烷橡胶和类似物制成,而管状体3由硅橡胶,树脂和类似物制成。
图7至图9示出了用于上述的  图6所示穿刺装置20中的针体30的结构;图7说明管状针部分31;图8说明要被插入管状针部分31的杆状针部分32。在管状针部分31的后端上形成锥形的插入件33,并通过穿过插入件33把杆状针部分32插入管状针部分31内来,使管状针部分31内的导孔30a被阻塞。在杆状针部分32的后部上形成的扩大部分32a的直径远大于插入件33的孔径,这样,插入件33可以通过扩大部分32a从结构上被堵住。此外,针体30整个地涂有硅氧烷涂层。
接下去说明用上述的结构实际穿刺人体组织或动物组织的情况。在本实施例中,将说明其中选择人体的卵巢癌作为穿刺位置。
如图10至图14所示,将腹腔镜41在充气膨胀的情况下插入壁体40,以便使管状的第一套针42直立。如图13和14所示,把本发明的穿刺装置20经第一套针42插入壁体40,以便只推入第一管状体9(如图15所示),伞形部分1从第二管状体11内推出。因此,伞形部分1从压缩形状张开成原来的伞形。
如图16所示,使用用于提供干燥空气或气体的干燥装置44,使之通过第二套针43从另一个方向插入壁体40,欲穿刺的卵巢癌变部位45的表面,例如,被干燥。之后,从第二套针43中取出干燥装置44,把替代的钩住装置46插入壁体40,用于如图17和18所示拉动线1Aa,取出挡块1A,以便向欲穿刺部位45上提供粘结剂7。此外,粘结剂7应该在手术进行之前直接注入储存器2内。
如图19和20所示,把穿刺装置20推入壁体40,使伞形部分1通过粘结剂7固定在欲穿刺部位45的表面45a上。如图21和22所示,在该状态,把针体30插入穿刺装置20。然后,如图23和24所示,使针体30穿过密封部分3A,由此,使针体30的针尖插入被穿刺部位45。
如图25和26所示,在该状态下,从管状针部分31中只抽出杆状部分32,把抽取器50插入管状针部分31的插入部分33内,以便实现抽取,在被穿刺部位45中的体液或类似物被抽入抽取器50,由此完成采样。
在完成抽取之后,如图27和29所示,取出管状针部分31,把装有剪子的切割装置46A插入壁体40,以便把处于固定到穿刺部位45上的状态的管状体3切出凹槽状的凹口3C,只有一部分管状体3和伞形部分保留处于固定到被穿刺部位45上的状态。在这种情况下,被穿刺部位45的形状与原来的形状相比处于压紧的形状。另外,因为在取出针体30后留在密封部分3A上的开口由于弹性体的收缩作用被堵住,所以,能够防止被穿刺部位45内的体液和类似物漏到外面(亦即,腹内区域)。
接着,应该确定被穿刺部位45中的体液和类似物是否是恶性的,和应采取什么样的手术。当诊断样品是良性的时,应该切除被穿刺的部位45。与切除部位45同时,应把留在体内的伞形部分1和类似物从体内取出,如图30和31所示的那样。当体液和类似物是恶性的,可以选择地,把被穿刺部位45在这种状态时切除,同时用一个袋(未示出)包起来,以防止体液和类似物扩散到腹内区域。由此,可以防止恶性肿瘤转移到(如果有的话)其它器官。另外,用硅氧烷涂层涂覆针体30的针尖,以便防止粘结剂粘结,针体30有利地穿过密封部分3A。
如图32所示,在另一个例子中,把替代抽取器50的照相机60插入被穿刺的部位45内,其内部的情况可以用监视器TV61来检查,以便确定诊断。
此外,如图33所示,把替代照相机60的众所周知的采样收集器70插入并通过摇控器71控制采样收集器70,生物试样可以从要被穿刺的部位45取出。
上面的例子描述了人体的外科手术。无需说明,上述例子也可以用于动物,且对人类也没有任何限制。上述例子说明用腹腔镜41的外科手术。不过,如果不使用这种腹腔镜41,所述装置就不需要第二管状体11,但需要管状体3和第一管状体9(如图5所示)。顺便说一下,本发明并不限于上述实施例,且也可以用于下列实施例。
这样,如说明第二个实施例的图34所示,为了替换上述第一个实施例中用塞子1A的储存器2,把一个装有粘结剂的粘结剂供给夹具插入腹腔,以便供给粘结剂7,而不使用储存器2和塞子1A。此外,在图35所示的第三实施例中,将一个用防腐蚀的铝或类似物制造的管状体4装在弹性支托体3的外缘上,由此,可以通过管状体4从它的外周边向弹性支托体3施加压力,从而压挤和收缩在用针体或类似物穿刺之后形成的孔3A,使它恢复到原来状态。一个由防腐蚀的铝或类似物制造的管状的螺纹体5装在弹性支托体的下端。附带地,把粘结剂(如外科用的Allon-alfa等)在使用前立即用注入装置6注入袋部分2内,该袋部分2替代在伞形部分1内配置的储存器2。因此,袋部分2具有图36和37所示的结构。对于实际外科手术而言,如图38所示,袋部分2在腹腔内用切割装置43,46剪破,以便供给粘结剂7,使伞形部分1粘到被穿刺的部位上,由此,可以达到类似于第一个实施例的方法。
由于按照本发明的穿刺方法和穿刺装置如上所述的构成,它可带来如下优点。
由于伞形部分通过粘结剂粘到欲被穿刺的部位上,然后使针体通过密封部分插入,所以可在取出针体后,使密封部分的开口收缩并堵住,以防止在穿刺部位中的体液或类似物向外泄漏。
照相机和采样收集器可以通过针体插入,因此,在医学领域可以实现更广泛的使用。

Claims (16)

1.一种穿刺方法,包括如下步骤:
把一个安置在腹腔内并由柔性材料构成的伞形部分置于被穿刺的部位上;
把粘结剂供给到被穿刺的部位内部或伞形部分上,以便把伞形部分粘结到被穿刺部位上;和
通过与伞形部分连接的管状体的密封部分把针体插入被穿刺的部位,以便把被穿刺部位中的体液抽出。
2.按照权利要求1所述的穿刺方法,包括把第二管状体通过定位在被穿刺部位前面的壁体插入,而将伞状部分通过第二管状体由原来的形状保持在改进的收缩形状。
3.按照权利要求1或2所述的穿刺方法,包括通过针体抽取在被穿刺部位内的体液。
4.按照权利要求1或2所述的穿刺方法,包括通过针体插入一个照相机,用于观察被穿刺部位内的情况。
5.按照权利要求1或2所述的方法,包括:通过针体插入一个采样收集器,以便由采样收集器收集一部分穿刺部位内的组织。
6.按照权利要求1至5的任一个所述的方法,其特征在于,管状体在切割后应留在被穿刺部位上。
7.按照权利要求1至6的任一个所述的方法,其特征在于,粘结剂装在设于伞形部分内的袋部分内,使得粘结剂可以通过剪开袋部分而供给。
8.按照权利要求1至6的任一个所述的方法,其特征在于,粘结剂是由装有粘结剂的粘结剂输送夹具输送的,且与伞形部分分开配置。
9.按照权利要求1至6的任一个所述的方法,其特征在于,粘结剂装在管状体(3)内,使得粘结剂可通过去掉管状体(3)上的塞子而输送。
10.一种穿刺装置,包括一个装在由柔性材料构成的伞形部分的轴中心上的管状体;一个装在该管状体内的密封部分;和一个按串联方式与管状体连接的第一管状体。
11.按照权利要求10所述的穿刺装置,其特征在于,伞形部分设有一个其中装有粘结剂的袋部分。
12.按照权利要求10或11所述的穿刺装置,其特征在于,管状体配有一个带塞子的储存器,且粘结剂装在该储存器内。
13.按照权利要求10至12中任一个所述的穿刺装置,其特征在于,管状体从结构上可以易于切去。
14.按照权利要求10至13中任一个所述的穿刺装置,其特征在于,密封部分包括一对密封板,其间装有乙醇。
15.按照权利要求10至14的任一个所述的穿刺装置,包括一个将插入弹性支承的针体,该针体由硅氧烷涂层涂覆,还包括一个管状针部分和一个沿着同轴方向插入管状针部分的杆状针部分。
16.按照权利要求12所述的穿刺装置,其特征在于,挡块有一根线。
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TW355676B (en) 1999-04-11
US5882331A (en) 1999-03-16
KR0172643B1 (ko) 1999-03-20
CN1112164C (zh) 2003-06-25
EP0745350A1 (en) 1996-12-04
US5853399A (en) 1998-12-29
JPH08317927A (ja) 1996-12-03
JP3633032B2 (ja) 2005-03-30
KR960040384A (ko) 1996-12-17

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