BALLOON UNIT FOR UTERINE HEMOSTASIS
20210186561 · 2021-06-24
Inventors
- Eiji KONDOH (Kyoto-shi, Kyoto, JP)
- Keisuke WAKABAYASHI (Saitama City, Saitama, JP)
- Ryoko KAKINUMA (Saitama City, Saitama, JP)
- Shinichi KOBAYASHI (Saitama City, Saitama, JP)
- Tatsuhiko Seki (Saitama City, Saitama, JP)
- Ichiro Matsubara (Tokyo, JP)
Cpc classification
A61B2017/12004
HUMAN NECESSITIES
A61B17/12099
HUMAN NECESSITIES
A61B17/42
HUMAN NECESSITIES
International classification
A61B17/42
HUMAN NECESSITIES
A61B17/12
HUMAN NECESSITIES
Abstract
Provided is a balloon unit for uterine hemostasis capable of reliably suppressing or stopping uterine bleeding. The balloon unit includes a flexible tube and a balloon provided in a distal end portion of the tube. The balloon has a lower uterine lumen compression portion that compresses an inner surface of a lower uterine lumen and an upper uterine lumen compression portion that compresses an inner surface of an upper uterine lumen. As the balloon, two balloons including a first balloon functioning as the lower uterine lumen compression portion and a second balloon functioning as the upper uterine lumen compression portion are provided.
Claims
1. A balloon unit for uterine hemostasis comprising: a flexible tube; and a balloon provided in a distal end portion of the tube, wherein the balloon has a lower uterine lumen compression portion that compresses an inner surface of a lower uterine lumen and an upper uterine lumen compression portion that compresses an inner surface of an upper uterine lumen.
2. The balloon unit for uterine hemostasis according to claim 1, wherein as the balloon, two balloons including a first balloon forming the lower uterine lumen compression portion and a second balloon forming the upper uterine lumen compression portion are provided.
3. The balloon unit for uterine hemostasis according to claim 2, wherein maximum capacity of the first balloon is larger than maximum capacity of the second balloon.
4. The balloon unit for uterine hemostasis according to claim 3, wherein the maximum capacity of the first balloon is 450 ml to 880 ml, the maximum capacity of the second balloon is 250 ml to 400 ml, and a ratio between the maximum capacity of the first balloon and the maximum capacity of the second balloon is 1.8 to 2.2:1.
5. The balloon unit for uterine hemostasis according to claim 2, wherein the second balloon in an inflated state is disposed on a distal end side from the first balloon.
6. The balloon unit for uterine hemostasis according to claim 2, wherein the tube has a first tube in which the first balloon is disposed, and a second tube in which the second balloon is disposed and which is inserted into the first tube.
7. The balloon unit for uterine hemostasis according to claim 6, wherein the second balloon in a deflated state is accommodated inside the first tube.
Description
BRIEF DESCRIPTION OF DRAWINGS
[0041]
[0042]
[0043]
[0044]
[0045]
[0046]
[0047]
[0048]
[0049]
[0050]
DESCRIPTION OF EMBODIMENTS
[0051] Hereinafter, an embodiment of a balloon unit for uterine hemostasis according to the present invention will be described with reference to the drawings.
[Schematic Configuration of Balloon Unit for Uterine Hemostasis]
[0052] As illustrated in
[0053] In the balloon unit 1, a side on which the balloon 3 is provided will be referred to as a distal end side, and a side opposite thereto will be referred to as a proximal end side.
[Configuration of Tube]
[0054] The tube 2 has a first tube 2A and a second tube 2B. For example, each of the tubes 2A and 2B is formed of a synthetic resin such as polyvinyl chloride, silicone rubber, and a thermoplastic elastomer, and is flexible. A line (not illustrated) is formed in each of the tubes 2A and 2B along an extending direction of each of the tubes 2A and 2B. The line is formed in such a way that a material which can be detected by an X-ray is applied to or mixed with each of the tubes 2A and 2B. Out of these, the second tube 2B is formed to have a length approximately twice (1.8 to 2.2 times) that of the first tube 2A. Specifically, a length L3 of the first tube 2A is set to 360 mm to 400 mm, a length L1 of the second tube 2B is set to 660 mm to 880 mm, and a ratio between L3 and L1 is L3:L1=1:1.8 to 2.2. In addition, a diameter of the second tube 2B is formed to be smaller than a diameter of the first tube 2A. Each of the first tube 2A and the second tube 2B will be described in detail below.
[Configuration of Second Tube]
[0055] As illustrated in
[0056] In addition, as illustrated in
[0057] Here, the second tube 2B is provided with the line formed in such a way that the material which can be detected by the X-ray is applied thereto or mixed therewith as described above. Accordingly, although the position of the second tube 2B can be detected by the X-ray, when there is no X-ray inspection device, the position cannot be detected even when the second tube 2B of the balloon unit 1 is inserted into the uterus. In order to cope with this situation, in the present embodiment, as illustrated in
[0058] The detection member 23 (detection member 23B and detection member 23A (to be described later)) is formed of the metal which can be detected by the ultrasonic echo. However, preferably, the detection member 23 is formed of a non-ferrous metal or stainless steel which is resistant to rust in the metal. More preferably, the detection member 23 is formed of aluminum which less affects a living body. In this case, the detection member 23 may be formed of pure aluminum having the same composition as that of a stylet 5 (to be described later).
[Configuration of First Tube]
[0059] As illustrated in
[0060] As illustrated in
[0061] In the present embodiment, the first drain flow path 21A has the shape extending straight. However, the configuration is not limited thereto. For example, the diameter of the portion serving as the accommodation portion Ar1 may be set to be larger than the inner diameter L5 of the portion other than the accommodation portion Ar1.
[0062] In addition, the detection member 23A similar to the above-described detection member 23B is sealed on the distal end side of the first supply-discharge flow path 22A. Therefore, even when there is no X-ray inspection device, the position of the first balloon 3A can be easily detected by the ultrasonic echo.
[Configuration of Balloon]
[0063] For example, the balloon 3 is formed of silicone rubber or the like. The balloon 3 has a first balloon 3A communicating with the first supply-discharge flow path 22A and a second balloon 3B communicating with the second supply-discharge flow path 22B, and is inflated by the liquid such as water injected via each of the supply-discharge flow paths 22A and 22B. As illustrated in
[0064] Out of these, the first balloon 3A is configured so that the liquid having a volume approximately twice (1.8 to 2.2 times) that of the second balloon 3B can be injected. For example, the liquid of maximum 450 ml to 880 ml can be injected. On the other hand, the second balloon 3B is configured so that the liquid of maximum 250 ml to 400 ml can be injected. A ratio between maximum capacity of the first balloon 3A and maximum capacity of the second balloon 3B is the maximum capacity of the first balloon 3A: the maximum capacity of the second balloon 3B=1.8 to 2.2:1. The maximum capacity of the liquid can be injected into each of the balloons 3A and 3B. However, when the balloon is inserted into the uterus, a proper amount according to a uterine shape is injected. More specifically, a proper amount according to a shape of a lower uterine lumen M1 is injected into the first balloon 3A, and a proper amount according to a shape of an upper uterine lumen M2 is injected into the second balloon 3B.
[0065] In addition, a length L6 of the first balloon 3A in a state where the liquid is not injected is set to 75 mm to 95 mm, and a diameter L7 is set to 35 mm to 45 mm. In contrast, the length L6 of the first balloon 3A when the liquid of 500 ml is injected is set to 90 mm to 110 mm, and the diameter L7 is set to 95 mm to 105 mm. When the liquid is injected into the first balloon 3A in this way, the first balloon 3A has a substantially spherical shape as illustrated in
[0066] On the other hand, the second balloon 3B is configured so that the liquid having approximately half the volume of the first balloon 3A can be injected. As described above, the liquid of maximum 250 ml to 400 ml can be injected. Specifically, a length L8 of the second balloon 3B is 80 mm to 110 mm, and the diameter L9 is 19 mm to 29 mm in a state where the liquid is not injected. In contrast, the length L8 of the second balloon 3B is 100 mm to 130 mm, and the diameter L9 is 65 mm to 75 mm when the liquid of 300 ml is injected. When the liquid is injected into the second balloon 3B in this way, the second balloon 3B has a substantially columnar shape as illustrated in
[0067] When the liquid is injected into each of the first balloon 3A and the second balloon 3B, a gap is not formed between the first balloon 3A and the second balloon 3B as illustrated in
[Configuration of Connector]
[0068] The connector 4 includes the drain terminal 41 communicating with the second drain flow path 21B and provided in the proximal end portion of the second tube 2B, the flexible second supply-discharge tube 42B communicating with the second supply-discharge flow path 22B on the distal end side from the drain terminal 41 and extending by branching outward of the second tube 2B, the second supply-discharge terminal 43B provided in the proximal end of the second supply-discharge tube 42B and communicating with the second supply-discharge tube 42B, the flexible first supply-discharge tube 42A communicating with the first supply-discharge flow path 22A and extending by branching outward of the first tube 2A, and the first supply-discharge terminal 43A provided in the proximal end of the first supply-discharge tube 42A and communicating with the first supply-discharge tube 42A.
[0069] The drain terminal 41 is a flexible tubular member formed of silicone rubber. The diameter of the drain terminal 41 is gradually enlarged toward the proximal end side. The drain terminal 41 communicates with the second drain flow path 21B. Accordingly, the blood inside the uterus which flows from the opening 211B is discharged from an opening 411 (refer to
[0070] For example, the respective supply-discharge tubes 42A and 42B are formed of silicone rubber or the like, and are flexible. The distal ends of the respective supply-discharge tubes 42A and 42B communicate with the supply-discharge flow paths 22A and 22B inside the respective tubes 2A and 2B, and extend outward from the vicinity of the proximal end portions of the respective tubes 2A and 2B. The respective supply-discharge terminals 43A and 43B are provided in the proximal ends of the respective supply-discharge tubes 42A and 42B. For example, the respective supply-discharge terminals 43A and 43B are formed of hard polyvinyl chloride (PVC) or the like. A two-way cock (not illustrated) is connected to each of the supply-discharge terminals 43A and 43B.
[0071] A liquid dispenser such as a syringe (not illustrated) is connected to the above-described two-way cock. When the liquid is injected from the liquid dispenser via the two-way cock, the liquid is supplied into the respective balloons 3A and 3B via the respective supply-discharge terminals 43A and 43B, the respective supply-discharge tubes 42A and 42B, and the respective supply-discharge flow paths 22A and 22B. On the other hand, when the two-way cock is unlocked in a state where the liquid is supplied into the respective balloons 3A and 3B, the liquid inside the respective balloons 3A and 3B flows back to deflate the respective balloons 3A and 3B.
[Configuration of Stylet and Cap]
[0072] The stylet 5 is disposed inside the second drain flow path 21B as illustrated in
[0073] Here, when the distal end of the stylet 5 exceeds the distal end of the second balloon 3B, there is a possibility that the stylet 5 may protrude from the distal end of the second drain flow path 21B. On the other hand, when the distal end of the stylet 5 does not extend to the proximal end portion of the second balloon 3B, the second balloon 3B cannot be supported by the stylet 5. Accordingly, the second balloon 3B is less likely to be inserted into the upper uterine lumen M2.
[0074] In the present embodiment, the length of the stylet 5 is set to the length in which the stylet 5 is located from a position where the distal end of the stylet 5 does not exceed the distal end of the second balloon 3B to the proximal end portion of the second balloon 3B, when the cap 6 is mounted on the opening 411 of the drain terminal 41. In this manner, the balloon unit 1 can be properly inserted into a mother's body while undesirable protruding of the stylet 5 is suppressed.
[0075] It is desirable that the length of the stylet 5 is set to such a dimension that the distal end of the stylet 5 is disposed at an intermediate position of the length of the second balloon 3B, in a state where the cap 6 is mounted on the opening 411 of the drain terminal 41 (refer to
[0076] The stylet 5 is formed to have the outer diameter so that a slight gap is formed between the stylet 5 and the second tube 2B in a state of being inserted into the second drain flow path 21B.
[Using Method of Balloon Unit for Uterine Hemostasis]
[0077]
[0078] For example, the balloon unit 1 as described above is inserted into a mother's body M as illustrated in
[0079] Then, the liquid flows only into the first balloon 3A from the first opening 222A via the first supply-discharge tube 42A and the first supply-discharge flow path 22A. In this manner, the inner surface of the lower uterine lumen M1 is in a state of being compressed by the first balloon 3A. Specifically, as various dimensions when the liquid is injected into the first balloon 3A inside the lower uterine lumen M1, a vertical dimension L11 (refer to
[0080] The inner surface of the lower uterine lumen M1 is compressed by the first balloon 3A. Thereafter, the cap 6 connected to the stylet 5 is gripped, and is pushed inward. In this manner, the second tube 2B and the second balloon 3B slide inside the first drain flow path 21A of the first tube 2A, and the second balloon 3B protrudes to the inner side (distal end side) from the first balloon 3A. Then, the second balloon 3B reaches the upper uterine lumen M2. Thereafter, the liquid flows into the second balloon 3B from the second opening 222B via the second supply-discharge tube 42B and the second supply-discharge flow path 22B. In this manner, the inner surface of the upper uterine lumen M2 is in a state of being compressed by the second balloon 3B (state illustrated in
[0081] Specifically, when the liquid is injected into the second balloon 3B, as illustrated in
[0082] In this way, the inner surfaces of the lower uterine lumen M1 and the upper uterine lumen M2 are respectively compressed by the first balloon 3A and the second balloon 3B. Accordingly, even when there is bleeding at any position on the inner surfaces in the lower uterine lumen M1 and the upper uterine lumen M2, the bleeding can be reliably suppressed or stopped. In addition, the body fluid such as the blood can be discharged from each of the lower uterine lumen M1 and the upper uterine lumen M2 via the opening 211A, the opening 211B, and the respective drain flow paths 21A and 21B.
[0083] In this case, even when the second tube 2B is disposed in an inserted state, the first drain flow path 21A has a sufficient gap. Accordingly, the body fluid is discharged through the gap. In the second drain flow path 21B, the second balloon 3B is guided to the upper uterine lumen M2. Thereafter, the body fluid can be discharged from the second drain flow path 21B by pulling out the stylet 5 from the second drain flow path 21B.
[0084] In the present embodiment, the stylet 5 is formed of the pure aluminum. Accordingly, the stylet 5 can maintain a shape thereof at a bent angle, and deforms when a strong force is applied thereto. Therefore, operability of the balloon unit 1 can be improved. Therefore, an angle at which the respective balloons 3A and 3B can be easily inserted into the lower uterine lumen M1 and the upper uterine lumen M2 (angle α of the first tube 2A illustrated in
[Other Using Method]
[0085] In the above-described using method, an example has been described in which the balloon unit 1 is used in a state illustrated in
[0086] In addition, in the above-described embodiment, a method of inserting the balloon unit 1 into the uterus of the mother's body M by a normal method (method of inserting the balloon unit 1 from the vagina) has been described. However, the present invention is also properly applicable to a method of inserting the balloon unit 1 through an incised portion after a Caesarean section is performed.
[0087] In the present embodiment, the inner surface of the lower uterine lumen M1 can be compressed by the first balloon 3A that functions as the lower uterine lumen compression portion of the balloon 3, and the inner surface of the upper uterine lumen M2 can be compressed by the second balloon 3B that functions as the upper uterine lumen compression portion. Accordingly, the bleeding inside the uterus can be reliably suppressed or stopped. In addition, the first balloon 3A and the second balloon 3B are configured to be separate from each other, and the supply-discharge flow paths 22A and 22B are distributed in each of the first balloon 3A and the second balloon 3B. Accordingly, after the first balloon 3A is inflated to compress the inner surface of the lower uterine lumen M1, even when the second balloon 3B is not held by a doctor before the second balloon 3B is inflated, the second balloon 3B can be held by the first balloon 3A in an inflated state. Therefore, labor and time for the doctor to hold the second balloon 3B can be saved, and the second balloon 3B can be reliably inflated inside the upper uterine lumen M2. Furthermore, the maximum capacity of the first balloon 3A (for example, 450 ml to 880 ml) is larger than the maximum capacity of the second balloon 3B (for example, 250 ml to 400 ml), and a ratio between the maximum capacity of the first balloon 3A and the maximum capacity of the second balloon 3B is 1.8 to 2.2:1. Accordingly, the inner surface of the lower uterine lumen M1 can be reliably compressed by the first balloon 3A. When the second balloon 3B is inflated, the second balloon 3B can be supported by the first balloon 3A in an inflated state. Therefore, the inner surface of the upper uterine lumen M2 can be reliably compressed by the second balloon 3B.
[0088] In the present embodiment, the second balloon 3B in a deflated state and the second tube 2B can be accommodated inside the first drain flow path 21A. Accordingly, compared to a case where the first tube 2A and the second tube 2B are respectively inserted into the uterus in an independent state, insertion resistance into the uterus can be reduced. In addition, in a state where the first balloon 3A is inflated in the lower uterine lumen M1 to compress the inner surface of the lower uterine lumen M1, the second balloon 3B can be slid to and inflated at the protruding position. Accordingly, the inner surface of the upper uterine lumen M2 can be reliably compressed by the second balloon 3B to stop the bleeding.
[0089] The present invention is not limited to the above-described embodiment, and various modifications can be added within the scope not departing from the concept of the present invention. For example, in the above-described embodiment, the balloon 3 has each of the first balloon 3A and the second balloon 3B. However, the configuration is not limited thereto. That is, the first balloon 3A and the second balloon 3B may be integrated with each other. In other words, the balloon 3 may have the lower uterine lumen compression portion and the upper uterine lumen compression portion which compress each of the inner surfaces of the lower uterine lumen M1 and the upper uterine lumen M2. In this case, the drain flow path 21 and the supply-discharge flow path 22 may be provided one by one. Accordingly, the outer diameter of the tube 2 can be reduced, and the insertion resistance into the uterus can be reduced. In addition, the balloon 3 may be configured to include three or more balloons.
[0090] In the above-described embodiment, the stylet 5 is formed of stainless steel, polypropylene or the like, in addition to pure aluminum or an aluminum alloy. However, the configuration is not limited thereto. That is, any composition of the stylet 5 may be adopted as long as the shape of the tube 2 (second tube 2B) can be maintained and the stylet 5 deforms when a strong force is applied thereto.
[0091] In the above-described embodiment, the stylet 5 is accommodated in the drain terminal 41, but the present invention is not limited to this. For example, a hole into which the stylet 5 can be inserted and removed may be formed in the second tube 2B so that the stylet 5 can be accommodated in the hole. Furthermore, if the first tube 2A and the second tube 2B have a certain degree of rigidity, the stylet 5 may not be provided.
[0092] In the above-described embodiment, the supply-discharge terminals 43A and 43B are connected to the two-way cock. However, the configuration is not limited thereto. For example, a one-way valve or a high-speed injection valve may be connected to the supply-discharge terminals 43A and 43B. Out of these, the one-way valve does not need to turn off a cock when a syringe is replaced during liquid supply. When the syringe is detached, the valve is opened to prevent a backflow from the respective balloons 3A and 3B sides. The high-speed injection valve is a valve in which two one-way valves are combined with each other. An infusion solution bag of distilled water or physiological saline solution is connected to an upper connection port, and the respective supply-discharge terminals 43A and 43B and the syringe are connected to each other. When the syringe is pulled, the valve on the infusion solution bag side is opened. The respective supply-discharge terminals 43A and 43B sides are closed, and the liquid flows into the syringe. On the other hand, when the syringe is pushed, the valve on the infusion solution bag side is closed. The valves on the respective supply-discharge terminals 43A and 43B sides are opened, and the liquid flows into the respective balloons 3A and 3B. Therefore, the liquid can be repeatedly injected into the respective balloons 3A and 3B without detaching the valve or the syringe.
INDUSTRIAL APPLICABILITY
[0093] The balloon unit for uterine hemostasis is used after delivery, and can reliably suppress or stop the uterine bleeding.
REFERENCE SIGNS LIST
[0094] 1 balloon unit for uterine hemostasis [0095] 2 tube [0096] 2A first tube [0097] 2B second tube [0098] 3 balloon [0099] 3A first balloon (lower uterine lumen compression portion) [0100] 3B second balloon (upper uterine lumen compression portion) [0101] 4 connector [0102] 5 stylet [0103] 6 cap [0104] 21 drain flow path [0105] 21A first drain flow path [0106] 21B second drain flow path [0107] 22 supply-discharge flow path [0108] 22A first supply-discharge flow path [0109] 22B second supply-discharge flow path [0110] 23 detection member [0111] 23A first detection member [0112] 23B second detection member [0113] 41 drain terminal [0114] 42A first supply-discharge tube [0115] 42B second supply-discharge tube [0116] 43 supply-discharge terminal [0117] 43A first supply-discharge terminal [0118] 43B second supply-discharge terminal [0119] 211A, 211B opening [0120] 222A, 222B opening [0121] 411 opening [0122] Ar1 accommodation portion [0123] M mother's body [0124] M1 lower uterine lumen [0125] M2 upper uterine lumen