JP2020011058A - Communication member - Google Patents

Abstract

An object of the present invention is to more easily communicate communication between two hollow organs. A communication member 100 that communicates two luminal organs (for example, a lymphatic vessel L1 and a vein L2), which connects each tube wall of the two luminal organs arranged so that their sides face each other. It is indwelled so as to penetrate through the tube, has a cylindrical main body part 1, and is inserted into each of the through holes L1a and L2a by bringing the outer surface of the main body part 1 into contact with the inner surface of each of the through holes L1a and L2a of the tube wall. In the inserted state, the main body part 1 is positioned in the axial direction of the main body part 1 and in the radial direction crossing the axial direction, and is configured to be indwellable. [Selection diagram] Figure 3

Description

  The present invention relates to a communication member.

2. Description of the Related Art Conventionally, there has been known a technique of anastomosis between luminal organs such as blood vessels and lymph vessels so as to communicate with each other (for example, lymphatic vein anastomosis).
Anastomosis between luminal organs, particularly anastomosis between the end of the first luminal organ and the side of the second luminal organ, requires abundant experience and high skill from the practitioner. A vascular joint for anastomosis between the end of a first blood vessel and the side of a second blood vessel without using a suture has been proposed (for example, see Patent Document 1).

JP-T-2002-534208

  However, in the case of the vascular joint described in Patent Literature 1, it is necessary to properly insert each part of the vascular joint into each corresponding blood vessel, but if the structure is complicated like the vascular joint, the operation is difficult. difficult. That is, as long as the technique of anastomosis between the end of the first lumen organ and the side of the second lumen organ is employed, a high skill is still required. There is a need for a method of easily communicating.

  An object of the present invention is to provide a communication member that can easily communicate two luminal organs.

The communication member according to the present invention,
A communication member for communicating the two luminal organs,
Indwelled to penetrate each tube wall of the two luminal organs arranged so that the sides face each other,
It has a cylindrical main body,
In a state where the outer surface of the main body is inserted into each of the through holes such that the outer surface of the main body is brought into contact with the inner surface of each of the through holes of the tube wall, the main body is axially and the direction intersecting with the axial direction. The present invention is characterized in that the main body is positioned so as to be placed therein.

  According to the present invention, communication between two luminal organs can be performed more easily.

FIG. 1 is a perspective view schematically showing a use state of a communication member according to an embodiment of the present invention. FIGS. 2A and 2B are views showing the communication member of FIG. FIG. 3 is an enlarged front view showing a use state of the communication member of FIG. 1. FIG. 4 is an enlarged front view showing a use state of a modified example of the communication member according to the present invention.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
FIG. 1 is a perspective view schematically showing a use state of a communication member 100 according to an embodiment of the present invention. FIGS. 2A and 2B are enlarged views of the communication member 100. FIG. 2A is a perspective view of the communication member 100, and FIG. () Is an AA cross-sectional view of the communication member 100. FIG. 3 is an enlarged front view showing a use state of the communication member 100.

As shown in FIG. 1, for example, the communication member 100 of the present embodiment is used for treatment of lymphedema, and a lymph vessel (first luminal organ) L1 in which the flow of lymph is stagnant due to obstruction or the like, The vein (second luminal organ) L2 near the tube L1 is communicated with the vein L2.
Specifically, as shown in FIG. 1 and the like, the communication member 100 has the lymph vessel L1 and the vein L2 facing each other at their side portions (outer peripheral surfaces), and the wall surfaces of the lymphatic vessel L1 and the vein L2. Is placed so as to penetrate. Then, the lymph vessel L1 and the vein L2 are communicated by the communication member 100, and the lymph fluid flowing through the lymph vessel L1 flows into the vein L2 and returns with the blood.
In FIGS. 1 and 3, the flow of lymph is schematically represented by a dashed line, and the flow of blood is schematically represented by a solid line.

  As shown in FIGS. 2A and 2B, the communication member 100 is provided at both ends of the cylindrical main body 1 in the axial direction of the main body 1, and the communication member 100 is connected to the lymphatic vessel L1 and the vein L2. First and second engaging portions 21 and 22 that can be engaged with the inner surface of the tube wall are provided.

The main body 1 is, for example, formed in a cylindrical shape having an elliptical cross section in the axial direction and a predetermined length in the axial direction. The outer diameter, particularly the short diameter, of the main body 1 is larger than the outer diameters of the through holes L1a, L2a in the wall of the lymphatic vessel L1 and the vein L2, and the main body 1 is pressed into the through holes L1a, L2a. It has become so. That is, in a state where the communication member 100 is inserted into each of the through holes L1a and L2a, the outer surface of the main body 1 is brought into contact with the inner surface of each of the through holes L1a and L2a over the entire circumference in the circumferential direction. .
The main body 1 is preferably placed so that the major axis of the ellipse is substantially parallel to the axial directions of the lymphatic vessels L1 and veins L2.
The cross-sectional shape in the axial direction of the main body 1 is an example, and is not limited to an elliptical shape, and can be arbitrarily changed to, for example, a circular shape, a square shape, or the like.

Further, the main body 1 is formed, for example, with a skeleton part covered with a coating part, although not shown.
Specifically, for example, the skeleton portion is formed by winding a thin metal wire having a circular or elliptical cross section in a spiral shape in the axial direction while bending so that peaks and valleys are alternately formed. Have been. Note that the skeleton portion may be formed by arranging a plurality of skeletons formed in an annular shape while bending a metal wire rod so that peak portions and valley portions are formed alternately at predetermined intervals in the axial direction. Good.
The skeletal portion is configured to be self-expandable in a radial direction substantially perpendicular to the axial direction, from a contracted state in which it contracts inward to an expanded state in which it expands outward to define a cylindrical flow path.

Examples of the material of the metal wire forming the skeleton include known metals or metal alloys such as stainless steel, Ni-Ti alloy (Nitinol), and titanium alloy. Further, an alloy material having X-ray contrast may be used. Note that the skeleton may be formed of a material other than the metal material (for example, ceramic or resin).
The skeleton may be formed by, for example, laser processing (laser cutting) a single metal pipe (for example, a pipe made of a Ni—Ti alloy).

  The membrane is a membrane that forms a lymph fluid flow path. The coating portion may be disposed on the outer peripheral surface and the inner peripheral surface of the skeleton portion so as to sandwich the skeleton portion, or may be disposed on only one of the outer peripheral surface and the inner peripheral surface of the skeleton portion.

  Examples of a material for forming the film portion include a silicone resin, a fluorine resin such as PTFE (polytetrafluoroethylene), and a polyester resin such as polyethylene terephthalate.

The first and second engaging portions 21 and 22 have an elliptical cross section in the axial direction, and are expanded in an “eight” shape such that a radial cross section orthogonal to the axial direction intersects the main body 1. (See FIG. 2A and FIG. 2B).
The first and second engaging portions 21 and 22 are expanded in the radial direction substantially perpendicular to the axial direction from the contracted state contracted inward to the outside in the same manner as the skeletal portion of the main body 1. It is configured to be self-expandable to an expanded state defining a flow path.

Further, the first and second engaging portions 21 and 22 are formed by, for example, omitting the illustration, a thin metal wire having a circular or elliptical cross-section woven in a mesh shape.
The material of the metal wire forming the first and second engaging portions 21 and 22 is represented by, for example, stainless steel, a Ni—Ti alloy (Nitinol), a titanium alloy, and the like, like the skeleton of the main body 1. Known metal or metal alloy. Further, an alloy material having X-ray contrast may be used. Note that the skeleton may be formed of a material other than the metal material (for example, ceramic or resin).
The first and second engagement portions 21 and 22 may be formed by, for example, laser processing (laser cutting) a single metal pipe (for example, a pipe made of a Ni—Ti alloy).

Further, the first and second engagement portions 21 and 22 pass through the inner surface of the tube wall in a state where the communication member 100 is inserted into the through holes L1a and L2a of the tube walls of the lymphatic vessel L1 and the vein L2. It engages with the periphery of the holes L1a, L2a.
That is, the outer diameters, particularly the short diameters, of the proximal ends of the first and second engaging portions 21 and 22 are larger than the outer diameters of the through holes L1a and L2a in the wall of the lymphatic vessel L1 and the vein L2. I have. Then, the base ends of the first and second engagement portions 21 and 22 are press-fitted into the through holes L1a and L2a, and the outer surfaces of the base ends of the first and second engagement portions 21 and 22 are inserted into the through holes L1a and L2a. Are brought into contact with the inner surfaces of both ends in the axial direction over the entire circumference in the circumferential direction. The outer diameters of the distal ends of the first and second engaging portions 21 and 22 are larger than the outer diameters of the through holes L1a and L2a in the wall of the lymphatic vessel L1 and the vein L2. The communication member 100 is retained in a state where the communication member 100 is prevented from falling off by the second engagement portions 21 and 22.

  As described above, in a state where the communication member 100 is inserted into each of the through-holes L1a and L2a in the wall of the lymphatic vessel L1 and the vein L2, in the axial direction of the main body 1 and in the direction (radial direction) intersecting with the axial direction. The main body 1 is positioned so that it can be placed.

Next, a method of placing the communication member 100 will be described.
First, through holes L1a and L2a are formed in opposing portions of the side of the lymphatic vessel L1 and the vein L2. The through holes L1a and L2a are formed by, for example, incising the wall of the lymphatic vessel L1 and vein L2.
Then, the first engaging portion 21 of the communication member 100 held by a holder (not shown) and reduced in diameter in the radial direction is inserted into the through hole L1a of the lymphatic vessel L1, and the second engaging portion is inserted. 22 is inserted into the through hole L2a of the vein L2. In this state, the communication member 100 self-expands in the radial direction, whereby the main body 1 is retained so as to push and expand the through holes L1a, L2a, and the first and second engagements are formed on the peripheral edges of the through holes L1a, L2a. The parts 21, 22 are engaged.
As a result, the communication member 100 is indwelled, and the communication member 100 communicates the lymphatic vessel L1 and the vein L2.

  The method of placing the communication member 100 described above is an example and is not limited to this, and can be arbitrarily changed as appropriate.

As described above, the communication member 100 according to the present embodiment is the communication member 100 that allows two luminal organs (for example, the lymphatic vessel L1 and the vein L2) to communicate with each other, and is arranged so that the sides are opposed to each other. It has a tubular main body 1 that is indwelled so as to penetrate each of the tube walls of the two luminal organs, and the outer surface of the main body 1 is brought into contact with the inner surfaces of the through holes L1a and L2a of the tube wall. The main body 1 is positioned in the axial direction of the main body 1 and in a radial direction intersecting with the axial direction in a state where the main body 1 is inserted into each of the through holes L1a and L2a.
Therefore, two luminal organs (for example, the lymphatic vessel L1 and the vein L2) can be formed simply by placing the communicating member 100 such that the outer surface of the main body 1 is in contact with the inner surfaces of the through holes L1a and L2a of the vessel wall. Can communicate. In particular, the communication member 100 can be placed while the main body 1 is positioned in the axial direction and the radial direction. Specifically, the first and second engagements are formed on the inner peripheral surfaces of the through holes L1a and L2a on the inner surface of the tube wall while being inserted through the through holes L1a and L2a of the tube walls of the lymphatic vessel L1 and the vein L2. The main body 1 can be positioned in the axial direction and the radial direction by engaging the parts 21 and 22.
Thus, compared to the case where the end of the first luminal organ (for example, lymphatic vessel L1) and the side of the second luminal organ (for example, vein L2) are anastomosed, these two lumens are compared. The communication of organs can be performed more easily.

  As described above, the invention made by the inventor has been specifically described based on the embodiment. However, the present invention is not limited to the above embodiment, and can be changed without departing from the gist of the invention.

  Hereinafter, a modified example of the communication member 100 according to the present invention will be described with reference to FIG. The modification of the communication member 100 is substantially the same as the above embodiment except for the points described below, and a detailed description thereof will be omitted.

FIG. 4 is an enlarged front view showing a use state of the communication member 200 of the present modified example.
As shown in FIG. 4, similarly to the communication member 100 of the above-described embodiment, the communication member 200 includes a cylindrical main body 201 and first and second main bodies 201 provided at both ends in the axial direction of the main body 201. There are provided engaging portions 221 and 222.

The main body 201 has a shorter axial length than the main body 1 of the communication member 100 of the above embodiment. Specifically, the length of the main body 201 in the axial direction is slightly longer than the length obtained by adding the walls of the lymphatic vessel L1 and the vein L2. Thereby, it is possible to hold the lymph vessel L1 and the vein L2 in a state where the sides of the vein L2 are almost in contact with each other.
Further, the main body 201 is press-fitted into the through holes L1a and L2a, and the main body 201 is positioned and retained in the axial direction of the main body 201 and in the radial direction intersecting with the axial direction by the expansion force of the main body 201. .
The first and second engaging portions 221 and 222 protrude so as to be substantially orthogonal to the axial direction in a state of being expanded in the radial direction. This makes it possible to more reliably prevent the communication member 200 from coming off in the axial direction.

As described above, the main body 201 of the communication member 200 is configured such that the two lumen organs (for example, the lymphatic vessel L1 and the vein L2) are brought into contact with each other, and the through-holes L1a and L2a of the vessel wall are formed. Is inserted through each of the.
Therefore, the two luminal organs can be held in close contact with each other by the communication member 200, and the lymph fluid flowing through the lymphatic vessel L1 and the blood flowing through the vein L2 can be hardly leaked.
At this time, the main body 201, which is configured to be freely expandable and contractible in the radial direction, is press-fitted into each of the through-holes L1a and L2a in the wall of the lymphatic vessel L1 and the vein L2, so that the main body 201 is moved in the axial and radial directions. And the communication member 200 can be detained.

Note that the shapes and configurations of the communication members 100 and 200 exemplified in the above embodiment are merely examples, and the present invention is not limited to these, and those communicating two luminal organs (for example, a lymphatic vessel L1 and a vein L2). If so, it can be changed arbitrarily as appropriate. The two luminal organs are not limited to the lymphatic vessel L1 and the vein L2, but may be, for example, blood vessels.
Also, for example, in the above-described embodiment, the communication member 100 (200) is provided with the first and second engagement portions 21 and 22 (221 and 222). However, this is merely an example and is not limited thereto. However, the first and second engaging portions 21 and 22 do not necessarily need to be provided as long as the main body portion 201 can be positioned in the axial direction and the radial direction by the expansion force of the main body portion 201 or the like.

  Further, in the above embodiment, the main body 1 is configured to be able to expand and contract in the radial direction, and the main body 1 is positioned in the axial direction and the radial direction by the expansion force. However, this is only an example and the present invention is limited to this. Instead, the positioning may be performed by the expansion force of the first and second engagement portions 21 and 22. At this time, the outer surfaces of the first and second engaging portions 21 and 22 may be brought into contact with the inner surfaces of both axial ends of the through holes L1a and L2a over the entire circumference in the circumferential direction. .

  The embodiments disclosed this time are to be considered in all respects as illustrative and not restrictive. The scope of the present invention is defined by the terms of the claims, rather than the description above, and is intended to include any modifications within the scope and meaning equivalent to the terms of the claims.

100, 200 Communication member 1, 201 Main body 21, 221 First engaging part 22, 222 Second engaging part L1 Lymph vessel (first luminal organ)
L2 vein (second luminal organ)
L1a, L2a Through-hole

Claims (4)

A communication member for communicating the two luminal organs,
Indwelled to penetrate each tube wall of the two luminal organs arranged so that the sides face each other,
It has a cylindrical main body,
In a state where the outer surface of the main body portion is inserted into each of the through holes so as to abut against the inner surface of each of the through holes of the tube wall, the main body portion extends in an axial direction and a direction intersecting with the axial direction. A communication member whose main body is positioned and configured to be able to be placed. It further has an engaging portion provided at both ends in the axial direction of the main body portion and capable of engaging with the inner surface of the tube wall,
In a state inserted into each of the through holes, the engaging portion is engaged with a peripheral portion of the through hole on the inner surface of the tube wall, and the main body portion is disposed in the axial direction and a direction intersecting with the axial direction. The communication member according to claim 1, which is positioned.   2. The communication according to claim 1, wherein the main body is configured to be expandable and contractible in a direction orthogonal to the axial direction, is press-fitted into each of the through holes, and is positioned in the axial direction and a direction intersecting with the axial direction. Element.   The said main-body part is inserted in each of the through-hole of the said tube wall in the state which mutually contacted the side part of the said two hollow organs, The Claims any one of Claims 1-3. Communication member.