JP2013169226A - Medical equipment - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide medical equipment for easily performing the traction operation of an operating line.SOLUTION: Medical equipment (for instance, a catheter 10) includes: a long and flexible body part (sheath 16); an operating line 40 which is embedded in the body part and whose distal end is fixed to the distal end of the body part; and a hand operation part 70 provided to the proximal end of the body part, for performing the operation of bending the body part by pulling the operating line 40. The hand operation part 70 includes: a body case 700; a wheel operation part 760 provided rotatably with respect to the body case 700 with a crossing direction to the longitudinal axis of the proximal end of the body part as a rotary axis; and a traction part (for instance, a take-up reel 740) for pulling the operating line 40 linked with the operation and rotation of the wheel operation part 760. Over the entire periphery of the rotary axis, at least a part of the wheel operation part 760 is arranged at a position at which it can be operated with a finger from the outside of the body case 700.

Description

  The present invention relates to a medical device.

  2. Description of the Related Art In recent years, various medical devices have been developed that are configured to change the direction of entry into a body cavity by performing an operation of bending a distal end portion (hereinafter referred to as a “distal end portion”). As a typical example, for example, a catheter is known.

In Patent Document 1, an operation line (a traction cable in the same document) is fixed to the distal end portion of the catheter, and an operation unit (handle / A technique for providing an actuator) and bending a distal end portion by a pulling operation is described.
The operation unit includes a housing and a disk-shaped wheel operation unit (wheel of the same document) that is rotatably supported in the housing. A part of the peripheral portion of the wheel operation portion is exposed in an arc shape from the housing, and the operation line can be pulled by rotating the wheel operation portion with a finger placed on the exposed portion.

In Patent Document 2, an operation line (the tension wire in the same document) is fixed to the distal end portion of the catheter, and an operation portion (control handle in the same document) for performing a pulling operation of the operation line on the proximal end portion of the catheter. ), And a technique for bending the distal end by pulling the operation line by a pulling operation is described.
The operation unit has a lever structure that is rotatably supported in the housing, and an operation line is coupled to the lever structure. The lever structure is connected to a deflection knob arranged outside the housing, and is rotatable around an axis in conjunction with the deflection knob. The operation line is pulled by operating the deflection knob to rotate the lever structure.
The deflection knob has a pair of cylindrical knobs, and these knobs are arranged at positions that are opposed to each other by 180 degrees across the axis. The towing operation is considered to be performed by operating the knob.

Japanese Patent Laid-Open No. 06-292728 JP 2006-000649 A

By the way, in order to direct the traveling direction of the catheter and the discharge direction of the drug solution from the catheter in a desired direction, there is a case where it is necessary to perform an operation of rotating the entire catheter including the operation portion around its longitudinal axis.
Here, as the entire catheter is rotated by torque, the rotation angle of the operating portion changes around the longitudinal axis of the catheter. For this reason, when attempting to pull the operation line while keeping the catheter in a desired direction, depending on the rotation phase of the operation unit, the wheel operation unit can be rotated by operating the wheel operation unit with a finger. Difficult to do. That is, a situation where it is difficult to pull the operation line can occur.

  The present invention has been made in view of the above-described problems, and provides a medical device in which an operation line can be easily pulled.

The present invention comprises a long and flexible main body,
An operation line embedded in the main body and having a tip fixed to the tip of the main body,
A proximal operation portion provided at a proximal end portion of the main body portion, connected to a proximal end portion of the operation line, and performing an operation of bending the main body portion by pulling the operation line;
Have
The hand operating unit is
A body case,
A wheel operation unit that is provided so as to be rotatable with respect to the main body case, with a direction intersecting the longitudinal axis of the base end of the main body as a rotation axis;
A towing unit that pulls the operation line in conjunction with the wheel operation unit being operated and rotating;
Have
Provided is a medical device characterized in that at least one part of the wheel operation unit is disposed at a position operable by a finger from the outside of the main body case over the entire circumference of the rotating shaft.

  According to this medical device, at least one part of the wheel operation unit is disposed at a position where it can be operated by a finger from the outside of the main body case over the entire circumference of the rotation axis of the wheel operation unit. Therefore, in any direction around the rotation axis of the wheel operation unit, the wheel operation unit can be rotated by accessing the wheel operation unit with a finger from the outside of the main body case. For this reason, the rotation operation of the wheel operation unit, that is, the operation of pulling the operation line becomes easier.

  According to the present invention, the operation line can be easily pulled.

It is a figure which shows the hand operation part of the catheter which concerns on 1st Embodiment, Among these, (a) is a perspective view of an upper surface side, (b) is a perspective view of a lower surface side. It is a figure which shows the hand operation part of the catheter which concerns on 1st Embodiment, Among these, (a) is a top view, (b) is a side view, (c) is a bottom view, (d) is a front view, (e ) Is a rear view. It is a sectional side view of the hand operation part of the catheter which concerns on 1st Embodiment. It is a schematic diagram which shows the catheter which concerns on 1st Embodiment, Among these, (a) is a natural state, (b) is the state which bent the front-end | tip part to one side, (c) is bent to the other end part. Each of these states is shown. It is a longitudinal cross-sectional view which shows an example of the catheter which concerns on 1st Embodiment, and has shown only the front-end | tip part of the catheter. It is II-II sectional drawing of FIG. It is a figure which shows the lower case of the hand operation part of the catheter which concerns on 1st Embodiment, (a) is a top view, (b) is a sectional side view, (c) is a bottom view, (d) is a front view FIG. 4E is a rear view. It is a figure which shows the upper case of the hand operation part of the catheter which concerns on 1st Embodiment, Among these, (a) is a top view, (b) is a sectional side view, (c) is a bottom view, (d) is a front view. FIG. 4E is a rear view. It is a figure which shows the state which removed the upper case and the wheel operation part from the hand operation part of the catheter which concerns on 1st Embodiment, Among these, (a) is a top view, (b) is a side view, (c) is a side. It is sectional drawing. It is a figure which shows the guide part of a hand operation part, among these, (a) is a top view, (b) is a front view, (c) is a bottom view, (d) is a sectional side view. It is a figure which shows the pulling part of a hand operation part, among these, (a) is a top view, (b) is a bottom view, (c) is a front view, (d) is a side view. It is a figure which shows the wheel operation part of the hand operation part of the catheter which concerns on 1st Embodiment, Among these, (a) is a top view, (b) is a side view, (c) is a bottom view. It is a figure which shows the limiter member of a hand operation part, (a) is a top view, (b) is a bottom view, (c) is a front view, (d) is a side view. It is a figure which shows the fixing pin of the hand operation part of the catheter which concerns on 1st Embodiment, Among these, (a) is a side view, (b) is a bottom view. It is a figure which shows the sagging amount adjustment operation part of a hand operation part, among these, (a) is a top view, (b) is a front view, (c) is a side view. It is a schematic diagram which shows the path | route of the operation line in a hand operation part, among these, (a) is a top view, (b) is a side view. It is sectional drawing which shows the branch part vicinity of the hollow tube from a sheath. It is a schematic diagram for demonstrating the adjustment operation of the amount of sag of the operation line using a sag amount adjustment operation part, (a) is a side view among these, (b) is a top view. It is a figure which shows the hand operation part of the catheter which concerns on 2nd Embodiment, Among these, (a) is a perspective view of an upper surface side, (b) is a perspective view of a lower surface side. It is a figure which shows the hand operation part of the catheter which concerns on 2nd Embodiment, Among these, (a) is a top view, (b) is a side view, (c) is a bottom view, (d) is a front view, (e ) Is a rear view. It is a sectional side view of the hand operation part of the catheter which concerns on 2nd Embodiment. It is a figure which shows the lower case of the hand operation part of the catheter which concerns on 2nd Embodiment, (a) is a top view, (b) is a sectional side view, (c) is a bottom view, (d) is a front view FIG. 4E is a rear view. It is a perspective view of the state which assembled | attached the hub and the sheath to the lower case of the hand operation part of the catheter which concerns on 2nd Embodiment. It is a figure which shows the 1st half part of the wheel operation part of the hand operation part of the catheter which concerns on 2nd Embodiment, Among these, (a) is a top view, (b) is a side view, (c) is a bottom view. is there. It is a figure which shows the 2nd half part of the wheel operation part of the hand operation part of the catheter which concerns on 2nd Embodiment, (a) is a top view, (b) is a side view, (c) is a bottom view. is there. It is a figure which shows the 1st fixing pin of the hand operation part of the catheter which concerns on 2nd Embodiment, among these, (a) is a side view, (b) is a bottom view. It is a figure which shows the 2nd fixing pin of the hand operation part of the catheter which concerns on 2nd Embodiment, among these, (a) is a side view, (b) is a bottom view. It is a figure which shows the hand operation part of the catheter which concerns on 3rd Embodiment, Among these, (a) is a perspective view of an upper surface side, (b) is a perspective view of a lower surface side. It is a figure which shows the hand operation part of the catheter which concerns on 3rd Embodiment, Among these, (a) is a top view, (b) is a side view, (c) is a bottom view, (d) is a front view, (e ) Is a rear view. It is a sectional side view of the hand operation part of the catheter which concerns on 3rd Embodiment. It is a figure which shows the lower case of the hand operation part of the catheter which concerns on 3rd Embodiment, Among these, (a) is a top view, (b) is a sectional side view, (c) is a bottom view, (d) is a front view. FIG. 4E is a rear view. It is a figure which shows the upper case of the hand operation part of the catheter which concerns on 3rd Embodiment, among these, (a) is a top view, (b) is a sectional side view, (c) is a bottom view, (d) is a front view. FIG. 4E is a rear view. It is a perspective view of the state which assembled | attached the hub and the sheath to the lower case of the hand operation part of the catheter which concerns on 3rd Embodiment. It is a side view which shows the 1st half part of the wheel operation part of the hand operation part of the catheter which concerns on 3rd Embodiment. It is a side view which shows the 2nd half part of the wheel operation part of the hand operation part of the catheter which concerns on 3rd Embodiment. It is a schematic diagram which shows the hand operation part of the catheter which concerns on 4th Embodiment, Among these, (a) is a side view, (b) is a top view. It is a typical side view which shows the hand operation part of the catheter which concerns on 5th Embodiment.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. In all the drawings, the same components are denoted by the same reference numerals, and description thereof will be omitted as appropriate.

[First Embodiment]
FIG. 1 to FIG. 3 are views showing the hand operation unit 70 of the catheter 10 according to the first embodiment. 1 (a) is a perspective view of the upper surface side, FIG. 1 (b) is a perspective view of the lower surface side, FIG. 2 (a) is a plan view, FIG. 2 (b) is a side view, and FIG. FIG. 2D is a front view, FIG. 2E is a rear view, and FIG. 3 is a side sectional view (II sectional view of FIG. 2A).
FIG. 4 is a schematic view showing the catheter 10 according to the first embodiment, in which (a) shows a natural state, (b) shows a state in which the tip is bent in one direction, and (c) shows a tip. A state in which is bent to the other is shown.
FIG. 5 is a longitudinal sectional view showing an example of the catheter 10, and shows only the distal end portion of the catheter 10. 6 is a cross-sectional view taken along the line II-II in FIG.
7A and 7B are views showing the lower case 710 of the hand operation unit 70, in which (a) is a plan view, (b) is a side sectional view, (c) is a bottom view, (d) is a front view, and (e) ) Is a rear view.
8A and 8B are views showing the upper case 720 of the hand operating unit 70, in which (a) is a plan view, (b) is a side sectional view, (c) is a bottom view, (d) is a front view, (e ) Is a rear view.
FIG. 9 is a view showing a state in which the upper case 720 and the wheel operation unit 760 are removed from the hand operation unit 70, in which (a) is a plan view, (b) is a side view, and (c) is a side sectional view. is there.
10A and 10B are views showing the guide portion 780 of the hand operation portion 70, in which FIG. 10A is a plan view, FIG. 10B is a front view, FIG. 10C is a bottom view, and FIG.
FIG. 11 is a view showing a take-up reel (traction unit) 740 of the hand operation unit 70, in which (a) is a plan view, (b) is a bottom view, (c) is a front view, and (d) is a side view. FIG.
FIG. 12 is a view showing the wheel operation unit 760 of the hand operation unit 70, in which (a) is a plan view, (b) is a side view, and (c) is a bottom view.
FIGS. 13A and 13B are views showing the limiter member 750 of the hand operation unit 70, in which (a) is a plan view, (b) is a bottom view, (c) is a front view, and (d) is a side view.
14A and 14B are diagrams showing the fixing pin 810 of the hand operation unit 70, in which (a) is a side view and (b) is a bottom view.
15A and 15B are diagrams showing a sag amount adjusting operation unit 770 of the hand operation unit 70, in which (a) is a plan view, (b) is a front view, and (c) is a side view.
FIG. 16 is a schematic diagram showing a route of the operation line 40 in the hand operation unit 70, in which (a) is a plan view and (b) is a side view.
FIG. 17 is a cross-sectional view showing the vicinity of the branch portion of the hollow tube 32 from the sheath 16.
18A and 18B are schematic diagrams for explaining the adjustment operation of the sag amount of the operation line 40 using the sag amount adjustment operation unit 770, in which (a) is a side view and (b) is a plan view.

A catheter 10 as a medical device according to the present embodiment includes a long and flexible main body (sheath 16), an operation line 40 embedded in the main body and having a distal end fixed to the distal end of the main body. A hand operation unit 70 provided at a base end portion of the main body for pulling the operation line 40 to bend the main body. The hand operation unit 70 includes a main body case 700, a wheel operation unit 760 that is provided so as to be rotatable with respect to the main body case 700 about a direction intersecting the longitudinal axis of the base end portion of the main body portion, and a main body case 700. A pulling unit (for example, a take-up reel 740) that is connected to the operation line 40 and pulls the operation line 40 in conjunction with the operation and rotation of the wheel operation unit 760 is provided. At least one part of the wheel operation unit 760 is disposed at a position where it can be operated by a finger from the outside of the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760. The longitudinal axis of the main body (sheath 16) is the direction from the distal end to the proximal end (from the proximal end to the distal end).
Details will be described below.

  The catheter 10 is a suitable example that is an intravascular catheter used by being inserted into a blood vessel. More specifically, it is a preferred example that the catheter 10 is of a size that allows the sheath 16 to enter any of the eight sub-regions of the liver.

As shown in FIG. 4, the catheter 10 has a sheath 16 as a long main body.
In this specification, the predetermined length region including the distal end (tip) DE of the catheter 10 (and the sheath 16) is referred to as the distal end portion 15 of the catheter 10 (and the sheath 16). Similarly, the predetermined length region including the proximal end (proximal end) PE (FIG. 3) of the catheter 10 (and the sheath 16) is referred to as the proximal end portion (proximal end portion) of the catheter 10 (and the sheath 16). ) 17

  As shown in FIGS. 5 and 6, a main lumen 20 and a sub-lumen 30 are formed inside the sheath 16. The main lumen 20 and the sub-lumen 30 extend along the longitudinal direction (the left-right direction in FIG. 5) of the sheath 16 (the catheter 10). As shown in FIG. 6, the main lumen 20 is disposed, for example, in the center of the transverse section (cross section orthogonal to the longitudinal direction) of the sheath 16, and the sub-lumen 30 is disposed around the main lumen 20. More specifically, in the cross section, the sub-lumens 30 are arranged at rotationally symmetric positions with respect to the center of the main lumen 20.

  The catheter 10 has a plurality of sub-lumens 30, for example. Each sub-lumen 30 has a smaller diameter than the main lumen 20.

  The sub-lumens 30 and the main lumen 20 and the sub-lumen 30 are arranged separately from each other. For example, the plurality of sub-lumens 30 are distributed around the main lumen 20. 5 and 6, the number of sub-lumens 30 is two, and the sub-lumens 30 are arranged around the main lumen 20 at intervals of 180 degrees.

  The operation lines 40 are respectively inserted into the sub-lumens 30. That is, the catheter 10 has two operation lines 40a and 40b.

  The operation line 40 is movable relative to the sub-lumen 30 in the longitudinal direction of the sub-lumen 30 by sliding with respect to the peripheral wall of the sub-lumen 30. That is, the operation line 40 is slidable in the longitudinal direction of the sub-lumen 30.

The operation wire 40 may be formed of a single wire, but may be a stranded wire formed by twisting a plurality of thin wires.
The number of fine wires constituting one stranded wire is not particularly limited, but is preferably 3 or more. A suitable example of the number of thin wires is three or seven. When the number of fine lines is 3, the three fine lines are arranged point-symmetrically in the cross section. When the number of fine lines is seven, the seven fine lines are arranged point-symmetrically in a honeycomb shape in the cross section.

  In addition to flexible metal wires such as low carbon steel (piano wire), stainless steel (SUS), titanium or titanium alloy, the material of the wire constituting the operation wire 40 (or the fine wire constituting the stranded wire) Poly (paraphenylene benzobisoxazole) (PBO), polyether ether ketone (PEEK), polyphenylene sulfide (PPS), polybutylene terephthalate (PBT), polyimide (PI) or polytetrafluoroethylene (PTFE), boron fiber, etc. Polymer fibers can be used.

  Here, examples of the structure of the sublumen 30 include the following two structures.

  In the first structure, as shown in FIGS. 5 and 6, a hollow tube 32 formed in advance is embedded in the outer layer 60 (described later) along the longitudinal direction of the sheath 16, and The lumen is sublumen 30. That is, in these examples, the sub-lumen 30 is constituted by the lumen of the hollow tube 32 embedded in the sheath 16.

  The hollow tube 32 can be made of, for example, a thermoplastic resin. Examples of the thermoplastic resin include low friction resins such as polytetrafluoroethylene (PTFE) and polyetheretherketone (PEEK).

  In the second structure, the sub-lumen 30 is formed by forming a long hollow along the longitudinal direction of the sheath 16 in the outer layer 60 (described later).

  More specifically, the sheath 16 includes, for example, an inner layer 21, an outer layer 60 formed by laminating around the inner layer 21, and a coat layer 64 formed around the outer layer 60.

  The inner layer 21 is made of a tubular resin material. A main lumen 20 is formed at the center of the inner layer 21.

  The outer layer 60 is made of the same or different resin material as the inner layer 21. The sub-lumen 30 is formed inside the outer layer 60.

Examples of the material of the inner layer 21 include a fluorine-based thermoplastic polymer material. Specifically, the fluorine-based thermoplastic polymer material is, for example, polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF), or perfluoroalkoxy fluororesin (PFA).
By configuring the inner layer 21 with such a fluorine-based resin, the delivery property when supplying a contrast medium or a drug solution to the affected area through the main lumen 20 is improved.

  The material of the outer layer 60 is, for example, a thermoplastic polymer. As this thermoplastic polymer, polyimide (PI), polyamideimide (PAI), polyethylene terephthalate (PET), polyethylene (PE), polyamide (PA), nylon elastomer, polyurethane (PU), ethylene-vinyl acetate resin (EVA) And polyvinyl chloride (PVC) or polypropylene (PP).

  The sheath 16 is made of, for example, a resin material. That is, the sheath 16 includes the outer layer 60 and the inner layer 21 made of a resin material.

  The resin material constituting the sheath 16 may contain an inorganic filler. For example, as the resin material constituting the outer layer 60 that occupies most of the thickness of the sheath 16, a material containing an inorganic filler can be used.

  Examples of the inorganic filler include barium sulfate and bismuth subcarbonate. By mixing such an inorganic filler in the outer layer 60, the X-ray contrast property is improved.

The coat layer 64 constitutes the outermost layer of the catheter 10 and is made of a hydrophilic material. The coat layer 64 may be formed only in a region extending over a part of the distal end portion 15 of the sheath 16, or may be formed over the entire length of the sheath 16.
The coat layer 64 is made hydrophilic by molding it with a hydrophilic resin material such as polyvinyl alcohol (PVA) or polyvinyl pyrrolidone. The coat layer 64 may be formed by subjecting the outer surface of the outer layer 60 to lubrication so that at least the outer surface of the outer layer 60 is hydrophilic.

For example, the catheter 10 further includes a coil 50 wound around the inner layer 21. The coil 50 is configured by, for example, bending one or more wire rods 52 formed of an elastic body such as metal or resin in a spiral shape. The coil 50 is included in the outer layer 60, for example. Specifically, for example, stainless steel (SUS), nickel titanium alloy, steel, titanium, or copper alloy can be used as the metal material of the wire 52. Although the cross-sectional shape of the wire 52 is not particularly limited, for example, a rectangular shape or a circular shape is a preferable example.
The sublumen 30 is formed outside the coil 50 inside the outer layer 60.

  The catheter 10 may have a blade layer (not shown) instead of the coil 50. The blade layer is formed by knitting a wire in a mesh shape, and is disposed at the same position as the coil 50.

  The distal end portion 15 of the catheter 10 is provided with a ring-shaped marker 66 made of a material that does not transmit radiation such as X-rays. Specifically, the marker 66 is made of a metal material such as platinum. For example, the marker 66 is provided around the main lumen 20 and inside the outer layer 60.

Here, the typical dimension of each component of the catheter 10 of this embodiment is demonstrated.
The radius of the main lumen 20 is about 200 to 300 μm, the thickness of the inner layer 21 is about 10 to 30 μm, the thickness of the outer layer 60 is about 50 to 150 μm, the outer diameter of the coil 50 is 500 to 860 μm, and the inner diameter of the coil 50 is the diameter. It can be 420-660 micrometers.
The radius (distance) from the axial center of the catheter 10 to the center of the sublumen 30 is about 300 to 450 μm, and the inner diameter (diameter) of the sublumen 30 is 40 to 100 μm. And the thickness of the operation line 40 shall be about 30-60 micrometers.
The outermost diameter (radius) of the catheter 10 is about 350 to 490 μm, that is, the outer diameter is less than 1 mm in diameter. Thereby, the catheter 10 of the present embodiment can be inserted into a blood vessel such as a celiac artery.

  The distal end portion 41 of the operation line 40 is fixed to the distal end portion 15 of the sheath 16. A mode in which the tip 41 of the operation line 40 is fixed to the distal end 15 is not particularly limited. For example, the tip 41 of the operating line 40 may be welded or fastened to the marker 66, welded to the distal end 15 of the sheath 16, or the distal end of the marker 66 or the sheath 16 with an adhesive. 15 may be adhered and fixed.

  The sublumen 30 is open at least on the proximal end 17 side of the catheter 10. The base end portion of each operation line 40 protrudes from the opening of the sub-lumen 30 toward the proximal end PE. The proximal end portion of each operation line 40 is connected to a bending operation portion 730 (FIGS. 1 to 4) of a hand operation portion 70 provided at the proximal end portion 17 of the sheath 16 (details will be described later).

  The bending operation portion 730 is a mechanism that bends the distal end portion 15 of the catheter 10 by the operator pulling the two operation lines 40 individually.

  Next, the hand operation unit 70 will be described in detail.

  As shown in FIGS. 1 and 2, the hand operation unit 70 includes a main body case 700, a bending operation portion 730 provided in the main body case 700, and a hub 790 attached to the rear end portion of the main body case 700. ,have.

In the following description, the distal end side (the left side in FIGS. 1 and 2 (a) to (c) and FIGS. 3 and 4) of the catheter 10 (FIG. 4) is forward (front), and the proximal end side of the catheter 10 ( 1, 2 (a) to 2 (c), and the right side in FIGS. 3 and 4) are referred to as rear (rear).
2 (b), (d), (e) and the upper side of FIG. 3 are considered to be upper (upper) and the lower side is considered to be lower (lower). Further, the upper side of FIG. 1A is considered to be right (right), and the lower side is considered to be left (left).
However, the definition of these directions is only a specification for convenience of explanation, and does not specify the direction in the usage state of the hand operation unit 70.

  A passage hole 707 through which the base end portion of the sheath 16 passes from the outside to the inside of the body case 700 is formed at the front end portion of the main body case 700, and a part of the base end portion of the sheath 16 is formed through the passage hole 707. It is introduced into the main body case 700.

  The proximal end PE of the sheath 16 is introduced into the front end portion of the hub 790 and fixed to the front end portion (FIG. 2). The hub 790 is a cylindrical body in which a hollow 791 that penetrates the hub 790 forward and backward is formed. The inner diameter of the rear part of the hub 790 is larger than the inner diameter of the front part. The hollow 791 of the hub 790 communicates with the main lumen 20 of the sheath 16.

  An injector (syringe) (not shown) can be inserted into the hub 790 from behind. By injecting a liquid such as a chemical solution into the hub 790 with this injector, the liquid is supplied to the distal end of the sheath 16 via the main lumen 20, and the liquid is supplied from the distal end of the sheath 16 into the body cavity of the patient. can do.

  The bending operation unit 730 is formed in a disk shape, for example.

  The bending operation unit 730 includes a disk-shaped wheel operation unit 760 that is operated by an operator.

  In the main body case 700, a portion where the bending operation unit 730 is disposed is formed in a disc shape in accordance with the outer shape of the bending operation unit 730 and the wheel operation unit 760, for example. A central portion of the main body case 700 in the front-rear direction is referred to as a disk-shaped portion 701.

  The disk-shaped part 701 and the bending operation part 730 are disposed, for example, in the central part in the front-rear direction of the main body case 700. The disk-shaped part 701 projects in an arc shape in the left-right direction as compared with the front part 702 and the rear part 703 of the main body case 700.

The bending operation unit 730 is provided so as to be rotatable with respect to the main body case 700, with a crossing direction (for example, an orthogonal direction) with respect to the longitudinal axis of the proximal end portion of the sheath 16 as a rotation axis.
Therefore, it can be said that the wheel operation unit 760 is also provided so as to be rotatable with respect to the main body case 700 with the direction intersecting the longitudinal axis of the base end portion of the sheath 16 (for example, the orthogonal direction) as the rotation axis.

  More specifically, the bending operation unit 730 including the wheel operation unit 760 is rotatable with respect to the main body case 700 by being pivotally supported by the shaft portion 713 of the main body case 700 and the fixing pin 810, for example. It has become. The rotation axis of the bending operation unit 730 and the wheel operation unit 760 extends in the vertical direction.

  The distal end portion of the catheter 10 (the distal end portion of the sheath 16) can be bent by an operation of rotating the wheel operation portion 760 around the rotation axis (details will be described later).

  In the case of this embodiment, one surface of the wheel operation unit 760 in the axial direction of the rotation axis is exposed to the outside of the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760. Specifically, for example, the upper surface 767 of the wheel operation unit 760 is exposed to the outside of the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760.

  Accordingly, the operator can perform an operation of rotating the wheel operation unit 760 around the rotation axis by placing a finger on the upper surface 767 of the wheel operation unit 760 from the upper surface side of the hand operation unit 70, for example.

  Here, the upper surface 767 is exposed to the outside of the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760. Therefore, the wheel operation unit 760 can be rotated by easily accessing the upper surface 767 of the wheel operation unit 760 from any direction around the rotation axis of the wheel operation unit 760.

  For example, the wheel operation unit 760 can be rotated by rotating the finger around the rotation axis while keeping the top of the finger ung on the upper surface 767.

  Further, in the case of the present embodiment, the side peripheral surface 768 of the wheel operation unit 760 is partially covered by an upper case 720 (described later) of the main body case 700, but the side peripheral surface thereof A region exceeding half of 768 is exposed to the outside of the main body case 700. Specifically, the side peripheral surface 768 is exposed to the outside of the main body case 700 at, for example, the left part and the right part of the wheel operation unit 760.

  Thus, the operator can perform an operation of rotating the wheel operation unit 760 around the rotation axis by placing a finger on the side peripheral surface 768 of the wheel operation unit 760 from the side of the hand operation unit 70.

Here, the rotation angle of the wheel operation unit 760 necessary to bend the sheath 16 by 90 ° is assumed to be X °. The side peripheral surface 768 of the wheel operation unit 760 is continuously disposed at a position where it can be operated by a finger from the outside of the main body case 700 over an angle range of X ° or more around the rotation axis. That is, as an example, if X ° is 120 °, the angle α shown in FIG. 2A is 120 ° or more.
As a result, the sheath 16 can be bent 90 degrees by rotating the wheel operation unit 760 by one-touching the side peripheral surface 768 without releasing the finger from the side peripheral surface 768. Therefore, the operability of the catheter 10 is improved.
In the case of this embodiment, the side peripheral surface 768 is continuously outside the main body case 700 over an angle range of X ° or more around the rotation axis in each of the left and right portions of the wheel operation unit 760. It is arranged at a position where it can be operated with more fingers.
X ° and the angle α are, for example, 120 ° or more.

  In the present embodiment, the lower surface of the wheel operation unit 760 is covered with the main body case 700 and cannot be operated with a finger.

  For example, the upper surface 767 and the side peripheral surface 768 of the wheel operation unit 760 are each formed smoothly. However, the wheel operation unit 760 may be formed of a soft resin or the like so that a sufficient frictional resistance between the outer surface of the wheel operation unit 760 and the finger can be obtained. Further, it may be attached to the side peripheral surface 768.

  The main body case 700 includes, for example, a lower case 710 that constitutes a lower portion of the main body case 700 and an upper case 720 that constitutes an upper portion of the main body case 700.

  As shown in FIG. 7, the lower case 710 is integrally formed as a whole. The lower case 710 is formed in a flat semi-housing shape that opens upward.

  On the other hand, as shown in FIG. 8, the upper case 720 has a divided structure divided into a front part 720a and a rear part 720b. The front part 720a and the rear part 720b are each formed in a semi-casing shape that opens downward.

The front portion 720a is assembled to the front portion of the lower case 710 so that the opening at the lower end of the front portion 720a and the opening at the upper end of the front portion of the lower case 710 are combined, and a fastening member 705 such as a screw ( 2), it is fixed to the front part of the lower case 710.
Similarly, the rear portion 720b is assembled to the rear portion of the lower case 710 so that the opening at the lower end of the rear portion 720b and the opening at the upper end of the rear portion of the lower case 710 are combined, and a fastening member 705 such as a screw (FIG. It is fixed to the rear part of the lower case 710 by 2).

  As shown in FIG. 7, for example, a sheath disposition groove 715 for positioning the sheath 16 is formed at the bottom of the inner surface of the lower case 710. The sheath disposition groove 715 is formed in the central portion of the lower case 710 so as to extend linearly in the front-rear direction. A sheath 16 is arranged in the sheath arrangement groove 715.

For example, a support base 716 that supports a limiter member 750 described later is formed on the inner bottom surface of the center portion of the lower case 710.
A passage groove 716 b that allows the sheath 16 to pass from the front to the rear (from the distal end side to the proximal end side) is formed in the support base 716. The passage groove 716 b is located above the sheath provision groove 715.
The upper surface of the support base 716 is positioned above the upper end of the sheath 16 provided in the sheath installation groove 715 and the passage groove 716b. Therefore, the sheath 16 and the limiter member 750 do not interfere with each other.

  For example, the lower case 710 has a shaft portion 713 that supports the bending operation portion 730.

  The shaft portion 713 is formed on the support base 716, for example. Note that the support base 716 also extends around the shaft portion 713 in plan view.

  The shaft portion 713 includes, for example, a pair of left and right divided shaft portions 713a that are spaced apart from each other. In a plan view, the sheath disposition groove 715 passes between the pair of split shaft portions 713a.

  Each divided shaft portion 713a is a columnar body having a semi-cylindrical cross section, and stands upward from the inner bottom surface of the lower case 710. The shaft portion 713 including the pair of split shaft portions 713a is formed in a cylindrical shape as a whole.

The opposing surfaces of the pair of split shaft portions 713a are each a semi-cylindrical concave curved surface, and these opposing surfaces define a cylindrical insertion hole 713b as a whole. A fixing pin 810 is press-fitted and fixed in the insertion hole 713b (FIG. 3).
Note that the lower end of the fixing pin 810 is not in contact with the sheath 16 disposed in the sheath installation groove 715 in a state where the fixing pin 810 is fixed to the insertion hole 713b.

  A shaft portion 713 is provided on the support base 716, and the sheath 16 passes from the front to the rear via a passage groove 716 b formed in the support base 716. For this reason, the sheath 16 is a linear path passing through the back side of the shaft support portion (shaft portion 713) when viewed from one side (in this case, the upper side) of the wheel operation portion 760 in the axial direction. The operation unit 70 is guided from the distal end side to the proximal end side.

As shown in FIG. 8, a sheath pressing portion 721 that protrudes toward the lower case 710 is formed at the front end portion of the front portion 720 a of the upper case 720. On the other hand, as shown in FIG. 7, a notch-shaped portion 711 facing the sheath pressing portion 721 is formed at the front end portion of the lower case 710.
The sheath pressing portion 721 is inserted into the notch-shaped portion 711, and the sheath pressing portion 721 partially presses and fixes the sheath 16 against the bottom of the notch-shaped portion 711 (FIG. 3).
The passage hole 707 is configured by combining a notch-shaped portion 711 and a sheath pressing portion 721.
The bottom of the notch-shaped portion 711 is formed to the same depth as the sheath disposition groove 715 (FIG. 3).

As shown in FIG. 7, a hub holding recess 712 is formed at the rear end of the lower case 710. The hub holding recess 712 is disposed adjacent to the rear of the sheath placement groove 715.
On the other hand, a hub holding recess 722 is formed at the rear end portion of the rear portion 720b of the upper case 720 (FIG. 8).
The hub 790 is fixed to the main body case 700 by sandwiching and holding the front portion 792 of the hub 790 by the hub holding recess 712 and the hub holding recess 722 (FIG. 3).

  Similarly to the main body case 700, the lower case 710 has a circular central portion in the front-rear direction. Note that the upper case 720 does not exist on the central portion of the lower case 710. A wheel operation unit 760 is disposed on the central portion of the lower case 710 (FIGS. 1 and 2).

Further, the front part 720 a of the upper case 720 is located in front of the wheel operation part 760, and the rear part 720 b of the upper case 720 is located behind the wheel operation part 760.
As described above, the upper case 720 is divided into the front and rear parts, and the front part 720a is arranged in front of the wheel operation part 760 and the rear part 720b is arranged behind the wheel operation part 760, respectively. A configuration in which at least the upper surface 767 is exposed to the outside of the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760 is realized.

More specifically, for example, the front part 720a is adjacent to the front of the wheel operation part 760, and the rear part 720b is adjacent to the rear of the wheel operation part 760.
Here, as shown in FIG. 8, the rear end surface 726 of the front portion 720a of the upper case 720 is an arc-shaped concave curved surface that is recessed forward. On the other hand, the front end surface 727 of the rear portion 720b of the upper case 720 is an arc-shaped concave curved surface that is recessed rearward. The rear end surface 726 and the front end surface 727 are located on the same circumference in plan view.
As shown in FIG. 2A, the rear end surface 726 is disposed along the front portion of the side peripheral surface 768 of the wheel operation unit 760. The rear end surface 726 and the front portion of the side peripheral surface 768 of the wheel operation unit 760 are opposed to each other with a slight clearance.
Similarly, the front end surface 727 is disposed along the rear portion of the side peripheral surface 768 of the wheel operation unit 760. The front end surface 727 and the rear portion of the side peripheral surface 768 of the wheel operation portion 760 are opposed to each other with a slight clearance.
With these features, it is possible to realize a structure that enhances the sense of unity between the wheel operation unit 760 and the main body case 700 (particularly the upper case 720), and it is possible to suitably protect the sheath 16 in the main body case 700 from the outside.

  As shown in FIG. 3, the hand operation unit 70 further includes a guide unit 780 disposed in front of the bending operation unit 730 in the main body case 700.

  As shown in FIG. 10, the guide portion 780 includes a pair of left and right legs 781 fixed to the lower case 710, a beam-like portion 782 laid between the upper portions of the pair of legs 781, and each leg portion. And a pair of left and right columnar portions 783 standing above each of 781.

  A region surrounded by the pair of leg portions 781 and the beam-like portion 782 constitutes a passage gate 784 that allows the sheath 16 to pass through the inside (see FIG. 3).

Each of the pair of legs 781 is formed with an insertion hole 788 that opens downward (FIG. 10C).
On the other hand, a pair of left and right fixing pins 714 for fixing the guide portion 780 are formed on the bottom surface of the lower case 710 so as to stand upward (FIG. 7).
The corresponding fixing pins 714 are inserted into the respective insertion holes 788, and the upper end surfaces of the respective columnar portions 783 are in contact with the ceiling surface of the front portion 720a of the upper case 720 (FIG. 3). Thereby, the guide part 780 is fixed inside the front part of the main body case 700.

  The upper case 720 has a support portion 724 formed so as to hang downward from the interior ceiling surface, and the back surface of the guide portion 780 is supported by the support portion 724 (FIG. 3). ).

  As shown in FIG. 10, the pair of columnar portions 783 are each formed in a cylindrical shape. The beam-like portion 782 is formed in a shape in which at least its upper surface protrudes upward in an arc shape. Further, a boundary portion 785 between the side peripheral surface of the columnar portion 783 and the upper surface of the beam-shaped portion 782 is chamfered into an arcuate concave curved surface shape when viewed from the front.

Here, the hollow tube 32 is branched from the sheath 16 at the front end portion of the hand operation portion 70, and is routed from the front to the rear of the guide portion 780 through a pair of columnar portions 783 (FIG. 16 ( a)). The hollow tube 32 is engaged with the upper surface of the beam-shaped portion 782, the boundary portion 785, and the side peripheral surface of each columnar portion 783 facing the other columnar portion 783.
As described above, since the columnar portion 783 has a columnar shape, the upper surface of the beam-shaped portion 782 has an arc shape, and the boundary portion 785 has a concave curved surface shape, the hollow tube 32 is damaged by contact with the guide portion 780. Is suppressed.

  Next, the bending operation unit 730 will be described in detail.

  As shown in FIG. 3, the bending operation unit 730 includes a take-up reel 740 that winds up the operation line 40, a wheel operation unit 760 that allows the operator to rotate the take-up reel 740, a limiter member 750, have.

As shown in FIG. 11, the take-up reel 740 has a disk-shaped main body 741.
A shaft support hole 743 that passes through the front and back of the main body 741 is formed at the center of the main body 741 in plan view. The shaft support hole 743 is circular in plan view.

  On the upper surface of the main body 741, an accommodation recess 744 that accommodates a part of the limiter member 750 (a pair of spring-like bodies 752 (described later)) is formed on the peripheral edge of the shaft support hole 743. The shape of the outer peripheral wall surface of the housing recess 744 has a corrugated shape including a plurality of corrugated recesses 745 arranged repeatedly along the circumference.

  A slit-like groove 741 a that circulates around the main body portion 741 is formed on the side surface of the main body portion 741, so that the intermediate portion in the vertical direction of the main body portion 741 is partially reduced in diameter. As a result, a winding body portion 742 that winds up the operation line 40 is formed in the main body portion 741. The winding body 742 has a cylindrical shape that is coaxial with the outer peripheral surface of the main body 741.

For example, a plurality of concave portions 741b having a circular arc shape in plan view are formed on the upper surface side of the main body portion 741. These concave portions 741b are arranged on the same diameter and coaxial circumference as the winding body portion 742. The weight of the main body 741 is reduced by the recesses 741b.
Instead of the recess 741b, openings arranged at the same position as the recess 741b in a plan view may be formed, and these openings may be communicated with at least the innermost part of the groove 741a in the main body 741. In this case, the winding state of the operation line 40 around the winding body 742 can be visually recognized from above the winding reel 740 through the opening.

  On the back surface of the main body 741, an annular locking recess 749 is formed at the peripheral edge of the shaft support hole 743 (FIG. 11B). A locking claw 756 (described later) of the limiter member 750 is locked to the locking recess 749.

A pair of left and right accommodating recesses 746 for accommodating a sag amount adjusting operation portion 770 (described later) are formed on the upper surface side of the peripheral edge portion of the main body portion 741. These housing recesses 746 are arranged around the housing recess 744 at intervals of 180 degrees.
The lowermost portion of the housing recess 746 communicates with the groove 741a except for a portion corresponding to a support base 747 described later.
Each accommodation recess 746 has a rectangular shape in plan view (FIG. 11A) and a rectangular shape in side view (FIG. 11D).

Each housing recess 746 is formed deeper than the groove 741a in the radial direction of the main body portion 741 (up to a position near the radial center of the main body portion 741).
As a result, the bottom surface of the housing recess 746, in other words, the portion facing the housing recess 746 on the top surface of the winding body 742 is the same as the top surface of the groove 741a (the upper surface in FIGS. 11C and 11D). A support base 747 located at a height is formed.
By supporting the sagging amount adjusting operation unit 770 with the support base 747, the lower surface of the sagging amount adjusting operation unit 770 is the same height as the top surface of the groove 741a, that is, the same height as the upper end of the winding body 742. Retained.

  On the inner surface of the housing recess 746, a pair of protrusions 748 extending vertically are formed on the portion located at the end in the radial direction of the main body 741 so as to face each other. These protrusions 748 suppress the dropout of the sag amount adjusting operation portion 770 from the housing recess 746 (see FIG. 9A).

  By operating the wheel operation unit 760 and rotating the take-up reel 740 around the axis, the amount of winding of the operation line 40 by the take-up body 742 is increased, and the operation line 40 is pulled. be able to. In addition, the tension | tensile_strength of the operation line 40 increases with traction operation.

As illustrated in FIG. 12, the wheel operation unit 760 includes a disc-shaped main body 761. An upper surface 767 (of the main body 761) of the wheel operation unit 760 is, for example, flat. However, the upper surface 767 may be formed in a convex curved surface shape (a bowl shape) protruding upward.
A side peripheral surface 768 (of the main body portion 761) of the wheel operation portion 760 has an annular shape (cylindrical shape).
Note that a boundary portion between the upper surface 767 and the side peripheral surface 768 is preferably chamfered.

  The outer diameter of the main body 761 is larger than the outer diameter of the main body 741 of the take-up reel 740 (FIG. 3). The wheel operation unit 760 and the take-up reel 740 are arranged coaxially with each other, but the side peripheral surface 768 of the wheel operation unit 760 is more outward in plan view than the main body 741 of the take-up reel 740. Located in.

A shaft support hole 763 penetrating the front and back of the main body 761 is formed at the center of the main body 761.
The shaft support hole 763 has, in order from the top, a pin head accommodating portion 763a, a bearing hole portion 763b, and a fitting portion 763c.
The pin head accommodating portion 763a, the bearing hole portion 763b, and the fitting portion 763c are located coaxially with each other and communicate with each other.
The diameter of the bearing hole portion 763b is smaller than the diameters of the pin head accommodating portion 763a and the fitting portion 763c.

The wheel operation portion 760 is pivotally supported by the fixed pin 810 by inserting a shaft portion 812 (described later) of the fixed pin 810 into the bearing hole portion 763b.
Further, the head portion 813 of the fixing pin 810 is accommodated in the pin head accommodating portion 763a. Note that the diameter of the head portion 813 is larger than the diameter of the bearing hole portion 763 b, and the wheel operation portion 760 is prevented from coming off by a fixing pin 810.

  A plurality of locking recesses 764 for locking locking protrusions 755 (described later) of the limiter member 750 are formed on the inner peripheral surface of the fitting portion 763c. Each locking recess 764 has a linear groove shape extending from the upper end to the lower end of the fitting portion 763c. A plurality of locking recesses 764 are intermittently formed in the circumferential direction of the insertion portion 763c, and a planar shape (a shape of the wheel operation portion 760 viewed from the back side) is a combination of the insertion portions 763c and the plurality of locking recesses 764. ) Has a gear shape (FIG. 12C).

  An accommodation recess 765 is formed on the back surface of the main body 761 so as to be located around the shaft support hole 763. The housing recess 765 includes a first recess 765a positioned on the inner peripheral side and a second recess 765b positioned on the outer peripheral side. The first recess 765a is formed shallower than the second recess 765b.

The first recess 765a houses a pair of spring-like bodies 752 of the limiter member 750 (see FIG. 3).
The second recess 765b accommodates the upper portion of the peripheral edge 741c (FIG. 11A) of the take-up reel 740 (see FIG. 3). The peripheral edge 741 c is a portion around the accommodation recess 744 in the take-up reel 740.

  Next, the limiter member 750 will be described.

  The limiter member 750 rotates integrally with the wheel operation unit 760 around the rotation axis, and transmits a rotational driving force from the wheel operation unit 760 to the take-up reel 740. However, the limiter member 750 transmits the rotational driving force from the wheel operation unit 760 to the take-up reel 740 only when the tension of the operation line 40 is within a predetermined range.

  As shown in FIG. 13, the limiter member 750 has a cylindrical main body 751 and a spring-like body 752.

  A shaft support hole 754 that passes through the front and back of the main body 751 is formed in the center of the main body 751. The shaft support hole 754 is circular in plan view.

  The limiter member 750 is rotatably supported with respect to the main body case 700 by inserting the shaft portion 713 of the main body case 700 into the shaft support hole 754 (FIG. 3).

  The spring-like body 752 is provided, for example, at the center of the main body 751 in the vertical direction, and projects outward from the main body 751 in the horizontal direction. The limiter member 750 has, for example, a pair of spring-like bodies 752.

  The spring-like body 752 is formed in a C shape in plan view, and both ends thereof are connected to the outer peripheral surface of the main body 751. An opening 757 having a C shape in plan view is formed between the spring-like body 752 and the main body 751.

  An engagement protrusion 753 is formed at the center of the arc-shaped (arched) portion of the spring-like body 752. The engaging protrusion 753 is a corrugated protrusion that protrudes outward in the horizontal direction. Each engagement protrusion 753 is engaged with any one of the plurality of corrugated recesses 745 of the take-up reel 740 (see FIG. 9A).

  The spring-like body 752 can be elastically deformed in the direction in which the engagement protrusion 753 approaches the main body 751 (the direction in which the opening 757 narrows).

As shown in FIGS. 13C and 13D, the main body 751 includes an upper projecting portion 751a projecting upward from the spring-like body 752 and a lower projecting portion projecting downward from the spring-like body 752. 751b.
For example, the upper protrusion 751a is formed to have a smaller diameter than the lower protrusion 751b.

  A plurality of locking projections 755 extending in the vertical direction are intermittently formed on the side peripheral surface of the upper protrusion 751a in the circumferential direction of the side peripheral surface. The plurality of locking projections 755 and the locking recesses 764 of the wheel operation unit 760 correspond one-to-one.

The upper projecting portion 751a is fitted in the fitting portion 763c of the wheel operating portion 760, and each of the locking projections 755 is locked with the corresponding locking recess 764.
As a result, the limiter member 750 cannot rotate around the axis with respect to the wheel operation unit 760, and the limiter member 750 rotates integrally with the wheel operation unit 760.
It can be said that the wheel operation portion 760 is pivotally supported by the shaft portion 713 via the limiter member 750.

  The lower end surface of the downward projecting portion 751 b is in contact with the upper surface of the support base 716. Further, the upper end surface of the upper projecting portion 751a is in contact with the step surface between the fitting portion 763c of the wheel operation portion 760 and the bearing hole portion 763b. Thereby, the drop-off of the limiter member 750 from the shaft portion 713 is suppressed.

  The downward projecting portion 751 b is fitted in the shaft support hole 743 of the take-up reel 740.

  A locking claw 756 is formed at the lower end of the downward projecting portion 751b. The limiter member 750 has, for example, a pair of locking claws 756 disposed around the shaft support hole 754 at intervals of 180 degrees.

Each locking claw 756 projects outward from the cylindrical outer peripheral surface of the downward projecting portion 751b. Each locking claw 756 is locked to the locking recess 749 of the take-up reel 740.
Thereby, the limiter member 750 and the take-up reel 740 are integrated with each other.

In the downward projecting portion 751b, slits 751c extending in the vertical direction are formed in portions adjacent to both sides of the locking claw 756 in the circumferential direction. Thereby, the latching claw 756 can be elastically deformed in the radial direction of the downward projecting portion 751b.
When the downward projecting portion 751b is inserted into the shaft support hole 743 of the take-up reel 740, the locking claw 756 is elastically deformed toward the center in the radial direction of the downward projecting portion 751b, thereby enabling smooth insertion. ing. When the downward projecting portion 751b is fitted into the shaft support hole 743, the locking claw 756 is elastically returned outward in the radial direction of the downward protruding portion 751b, and the locking claw 756 is in contact with the locking recess 749. And locked.

  The limiter member 750 and the take-up reel 740 are mutually rotatable around the axis in an integrated state.

  Since the locking recess 749 of the take-up reel 740 is formed in an annular shape as described above, when the limiter member 750 rotates relative to the take-up reel 740, the locking claw 756 It moves in an arc along 749.

  Further, the spring-like body 752 is housed in the housing recess 744 of the take-up reel 740 (see FIGS. 9A and 9C).

  The limiter member 750 transmits the rotational driving force from the wheel operation unit 760 to the take-up reel 740 only when the tension of the operation line 40 during the pulling operation is within a predetermined range. When the tension of the operation line 40 during the pulling operation exceeds a predetermined range, the limiter member 750 rotates idly with respect to the take-up reel 740.

Here, as described above, the engaging protrusion 753 of the spring-like body 752 is engaged with any one of the corrugated recesses 745 of the take-up reel 740. When the limiter member 750 rotates relative to the take-up reel 740, the spring-like body 752 performs an elastic return operation after the engaging protrusion 753 is elastically deformed in a direction approaching the main body 751. By this elastic return, the engaging protrusion 753 newly engages with the corrugated recess 745 adjacent to the corrugated recess 745 that has been engaged so far.
That is, when the tension of the operation line 40 during the pulling operation exceeds a predetermined range, the spring-like body 752 is elastically deformed in this way, and the limiter member 750 is idled with respect to the take-up reel 740. Even if the 760 is rotated, the rotational driving force is not transmitted to the take-up reel 740 and the take-up reel 740 does not rotate.
As a result, the tension of the operation line 40 is maintained within a predetermined range.

As shown in FIG. 14, the fixing pin 810 includes, for example, a cylindrical body portion 811, a shaft portion 812 adjacent to the upper side of the body portion 811, and a head portion 813 adjacent to the upper side of the shaft portion 812. doing. The body portion 811, the shaft portion 812, and the head portion 813 are located coaxially with each other. The shaft portion 812 is formed in a cylindrical shape (also referred to as a disc shape). The head 813 has, for example, a disk shape, but may have other shapes.
The diameter of the shaft portion 812 is larger than the diameter of the body portion 811, and is slightly smaller than the inner diameter of the bearing hole portion 763b of the wheel operation portion 760.
The diameter of the head portion 813 is larger than the diameter of the shaft portion 812. However, the diameter of the head portion 813 is smaller than the inner diameter of the pin head accommodating portion 763a of the wheel operation portion 760.

  The fixing pin 810 is fixed to the main body case 700 by press-fitting and fixing the body portion 811 to the insertion hole 713 b of the shaft portion 713. By fixing the fixing pin 810 to the main body case 700, the bending operation unit 730 (the limiter member 750, the take-up reel 740, and the wheel operation unit 760) is rotatably attached to the main body case 700.

  As shown in FIG. 9A, the hand operation unit 70 further includes a sag adjustment operation unit 770. The sagging amount adjustment operation unit 770 corresponds to the operation line 40 on a one-to-one basis. That is, in the case of this embodiment, the hand operation unit 70 includes two sag amount adjusting operation units 770 (sag amount adjusting operation units 770a and 770b). The base end of the operation line 40 is fixed to each sag amount adjusting operation portion 770.

  Each slack amount adjusting operation portion 770 is accommodated in the corresponding accommodating recess 746 of the take-up reel 740 and is held by the take-up reel 740. That is, the sag amount adjusting operation unit 770 is provided in the bending operation unit 730.

  As illustrated in FIG. 15, the sag amount adjusting operation unit 770 includes a rounded polygonal columnar main body 771. That is, each of the ridge lines 775 (FIG. 15C) of the main body 771 is chamfered. For this reason, as shown in FIG. 15C, the outer shape of the side surface and the side section of the main body 771 is a rounded polygon (however, formation of a winding groove 772 and an operation portion 774 described later). Excluding points).

  Specifically, the main body 771 has, for example, a rounded octagonal prism shape. That is, the side surface shape and the side cross-sectional shape of the main body 771 are rounded octagonal shapes.

The main body portion 771 is formed with a winding groove (groove) 772 that circulates around the main body portion 771 around its body. The operation wire 40 is wound around the winding groove 772.
As shown in FIG. 15C, the winding path of the winding groove 772 passes on the circumference centering on the central axis of the main body 771. The central axis of the main body 771 is a straight line passing through the center of one end surface 776 of the main body 771 and the center of the other end surface 777.

  As shown in FIGS. 15A and 15B, the cross-sectional shape of the winding groove 772 is formed in an arc shape. Thus, the operation line 40 is prevented from being damaged due to the contact between the winding groove 772 and the operation line 40.

Further, a fixing hole 773 for fixing the base end of the operation line 40 to the main body 771 is formed in the main body 771.
The fixing hole 773 extends, for example, in the diameter direction of a circle corresponding to the winding path of the winding groove 772. For example, the fixing hole 773 passes through the main body 771, and both ends of the fixing hole 773 communicate with the winding groove 772.

On one end surface 776 of the main body portion 771, an operation portion 774 for performing an operation of rotating the main body portion 771 around its central axis is formed. In the case of this embodiment, the operation part 774 is a linear groove | channel extended in the direction orthogonal to the central axis of the main-body part 771, for example. For example, the main body 771 can be rotated by inserting the tip of a tool such as a flat-blade screwdriver into the operation unit 774 and rotating the tool.
However, the operation portion 774 may be a cross-shaped groove for enabling the main body portion 771 to be rotated using a Phillips screwdriver or the like. Further, the operation portion 774 may be a linear or other shape protrusion.

  The other end surface 777 of the main body 771 is formed flat, for example.

  The slack amount adjusting operation portion 770 configured as described above is housed in the housing recess 746 of the take-up reel 740 in a state where the end portion on the end surface 777 side is supported on the support base 747.

Here, in the housing recess 746, the inner wall surface 746a (FIGS. 11A and 11D) on the center side in the radial direction of the take-up reel 740 is formed flat. The end surface 777 of the main body 771 is in contact with or close to the inner wall surface 746a (see FIG. 9A).
When rotating the sag adjusting operation portion 770 around the central axis of the main body portion 771, the end surface 777 slides relative to the inner wall surface 746a or is guided by the inner wall surface 746a with a very small clearance. The

  In the housing recess 746, the distance between the pair of inner side surfaces 746 b (FIGS. 11A and 11D) facing each other in the circumferential direction of the take-up reel 740 is the same as the distance between the pair of facing surfaces of the main body 771. The distance E is set substantially equal to the distance E (FIG. 15C).

As a result, in the normal state of the sag amount adjusting operation unit 770, any one set of opposing surfaces of the main body 771 is parallel to the inner side surface 746b, and the sag amount adjusting operation unit 770 is stabilized in posture. That is, except for the state in the middle of rotating the sag amount adjusting operation portion 770, any one set of opposing surfaces of the main body portion 771 is always parallel to the inner side surface 746b (FIGS. 9B and 18A). )reference).
That is, at least a part of the main body 771 in the axial direction has a rounded polygonal cross-sectional shape orthogonal to the axial direction. The take-up reel 740 of the bending operation unit 730 sandwiches two opposing surfaces in the part (a part of the main body 771 whose cross-sectional shape orthogonal to the axial direction is a rounded polygon). The part is held rotatably about the axis.
For this reason, the rotation operation of the sag amount adjusting operation unit 770 is an operation accompanied by a click feeling.

  It should be noted that the magnitude of the force required to rotate the sag amount adjusting operation portion 770 is greater than the force required to idle the limiter member 750 with respect to the take-up reel 740. Therefore, the sag amount adjusting operation unit 770 does not rotate with the tension of the operation line 40.

  Next, a route such as the operation line 40 in the hand operation unit 70 will be described.

For example, the operation line 40 and the hollow tube 32 are branched from the sheath 16 (a portion of the sheath 16 excluding the hollow tube 32) at the front end portion of the main body case 700 (for example, the front end portion of the passage hole 707 described above) ( FIG. 16 (a)).
As shown in FIG. 17, the hollow tube 32 is branched from the portion excluding the hollow tube 32 in the sheath 16 so as to tear the outer peripheral portion of the sheath 16 from the hollow tube 32.

The sheath pressing portion 721 of the upper case 720 holds and fixes the sheath 16 against the lower case 710 at the front end portion of the main body case 700, and the hollow tube 32 branched from the sheath 16 also has a lower case. It is pressed against 710 and fixed.
However, the hollow tube 32 is sandwiched with such a force that the hollow tube 32 is not deformed (cannot be crushed) so that the operation line 40 can easily slide with respect to the hollow tube 32. In addition, the sheath 16 is sandwiched by a force that does not cause the main lumen 20 to be deformed (cannot be crushed) so that liquid can be supplied from the hub 790 via the main lumen 20.

  Here, the corner 725 of the rear end portion of the sheath pressing portion 721 is chamfered. As a result, the hollow tube 32 branched from the sheath 16 can be prevented from being damaged, and the sheath 16 can be prevented from being damaged.

The hollow tube 32 engages with the guide portion 780 behind the sheath pressing portion 721, and further extends rearward of the guide portion 780 (rightward in FIG. 16A).
Here, since the operation line 40 does not directly contact the guide part 780 but the hollow tube 32 surrounding the operation line 40 contacts the guide part 780, stress applied to the operation line 40 is reduced. be able to.

  The operation line 40 is exposed from the hollow tube 32 between the guide portion 780 and the take-up reel 740. That is, the base end 32 a of the hollow tube 32 is located between the guide portion 780 and the take-up reel 740.

  The operation line 40 exposed from the hollow tube 32 is wound (engaged) on the winding body portion 742 of the winding reel 740 and wound on the winding groove 772 of the sag amount adjusting operation portion 770. Yes.

Here, the operation line 40 is wound around the take-up reel 740 by a route that circulates around 270 degrees around the take-up reel 740.
That is, one operation line 40a is engaged with the upper left portion in FIG. 16A with respect to the take-up reel 740, and the upper end portion and the right end portion in FIG. It is wound around a sag amount adjusting operation unit 770 (sag amount adjusting operation unit 770a) arranged at the lower end in (a).
The other operation line 40b is engaged with the lower left portion in FIG. 16A with respect to the take-up reel 740, and passes through the lower end portion and the right end portion in FIG. It is wound around a sag amount adjusting operation unit 770 (sag amount adjusting operation unit 770b) arranged at the upper end in (a).

  The base ends of the operation lines 40a and 40b are inserted into the fixing holes 773 of the sag amount adjusting operation portions 770a and 770b, and the sag is formed in the fixing holes 773 by, for example, an adhesive 779 (FIG. 16B). It is fixed to the amount adjustment operation unit 770. That is, in the case of this embodiment, the sag amount adjusting operation unit 770 is provided in the bending operation unit 730, and the base end of the operation line 40 is connected to the sag amount adjusting operation unit 770.

By performing an operation of rotating the sag amount adjusting operation portion 770 around the central axis of the main body portion 771 in one direction, and increasing the winding amount of the operation line 40 to the winding groove 772, the operation amount from the hand operating portion 70 is increased. The amount by which the operation line 40 can be extended can be reduced, and the amount of sag of the operation line 40 can be reduced. With this operation, the tension of the operation line 40 increases.
Further, by operating the sag amount adjusting operation portion 770 to rotate in the opposite direction around the central axis of the main body portion 771, the amount of winding of the operation line 40 to the winding groove 772 is reduced, whereby the hand operating portion 70. The amount by which the operation line 40 can be extended can be increased, and the amount of sag of the operation line 40 can be increased. With this operation, the tension of the operation line 40 decreases.

The operation line 40a will be described in detail with reference to FIGS. 18 (a) and 18 (b).
When the main body portion 771 of the sag adjusting operation portion 770 is rotated in the direction of arrow A, the amount of operation wire 40 wound around the winding groove 772 increases, so that the operation wire 40a is located around the take-up reel 740. Move in the direction of arrow C. As a result, the operable amount of the operation line 40a from the hand operation unit 70 decreases, the amount of sag of the operation line 40 decreases, and the tension of the operation line 40 increases.
On the other hand, when the main body portion 771 of the sag amount adjusting operation portion 770 is rotated in the direction of arrow B, the amount of operation wire 40 wound around the winding groove 772 decreases, so that the operation wire 40a is provided around the take-up reel 740. , Move in the direction of arrow D. As a result, the amount by which the operation line 40a can be extended from the hand operation unit 70 increases, the amount of sag of the operation line 40 increases, and the tension of the operation line 40a decreases.

  In this way, by rotating the sag adjustment operation unit 770 while maintaining the rotation phase of the take-up reel 740 of the bending operation unit 730 at a desired phase, the operation line 40 can be drawn out from the hand operation unit 70. The amount can be adjusted. That is, the sag amount adjusting operation unit 770 is for performing an operation for adjusting the amount by which the operation line 40 can be drawn from the hand operation unit 70 without changing the pulling amount of the operation line 40 by the bending operation unit 730. is there.

Here, for example, as shown in FIG. 2 (b), most of the operation part 774 of the sag amount adjusting operation part 770 is not operated in the state in which the main body case 700 is assembled. The wheel operation unit 760 is covered by the peripheral edge.
For example, as shown in FIG. 9, the sag amount adjusting operation unit 770 is operated from the side with the upper case 720 removed from the lower case 710 and the wheel operation unit 760 removed from the limiter member 750.

  The lower case 710 is formed with an operation cutout shape portion 717 for avoiding interference between a tool such as a flat-blade screwdriver and the lower case 710 when the sag amount adjusting operation portion 770 is rotated (FIG. 9 (a)). Thereby, the rotation operation of the sag amount adjusting operation unit 770 can be easily performed using a tool such as a flat-blade screwdriver.

Next, the operation will be described.
As shown in FIG. 4B, when the wheel operation unit 760 is rotated in one direction around the rotation axis, the take-up reel 740 is also rotated in the same direction in conjunction with the rotation. As a result, the winding amount of the operation line 40a by the take-up reel 740 increases, the amount of protrusion of the operation line 40a from the proximal end 32a of the hollow tube 32 increases, and the operation line 40a is pulled toward the proximal end side. The Then, the distal end portion 15 of the sheath 16 bends toward the sub-lumen 30 through which the operation line 40a is inserted, with the axis of the sheath 16 as a reference. That is, the distal end portion 15 of the sheath 16 bends in one direction.

  Further, as shown in FIG. 4C, when the wheel operation unit 760 is rotated in the other direction around the rotation axis, the take-up reel 740 is also rotated in the same direction. As a result, the amount of operation wire 40b taken up by the take-up reel 740 increases, the amount of protrusion of the operation wire 40b from the proximal end 32a of the hollow tube 32 increases, and the operation wire 40b is pulled to the proximal end side. The Then, the distal end 15 of the sheath 16 bends toward the sub-lumen 30 through which the operation line 40b is inserted, with the axis of the sheath 16 as a reference. That is, the distal end portion 15 of the sheath 16 bends in the other direction.

  Here, the bending of the sheath 16 includes a mode in which the sheath 16 bends in a “shape” and a mode in which the sheath 16 is bent like a bow.

  In this way, by selectively pulling the two operation lines 40 by the operation on the wheel operation unit 760, the distal end 15 of the catheter 10 is moved in the first direction and the second direction which is the opposite direction. Can be bent in any direction. The first direction and the second direction are included in the same plane.

It is possible to freely control the direction of the distal end DE of the catheter 10 by performing a combination of a torque operation for rotating the entire catheter 10 and a pulling operation.
Furthermore, the amount of bending of the distal end DE of the catheter 10 can be adjusted by adjusting the pulling amount of the operation line 40.
For this reason, the catheter 10 of this embodiment can be made to approach in a desired direction, for example with respect to body cavities, such as a branching blood vessel.

  When the tension of the operation line 40 becomes too strong due to the pulling operation, the limiter member 750 rotates idly with respect to the take-up reel 740, so that the tension of the operation line 40 is maintained within a predetermined range.

When assembling the hand operation unit 70, each sag amount adjusting operation unit 770 is individually operated to individually adjust the sag amount and tension of the operation lines 40a and 40b.
Specifically, for example, as shown in FIG. 9A, the operation lines 40a and 40b are wound around the take-up reel 740 by an equal amount, that is, the sag adjusting operation portion 770a is taken up by the take-up reel. With the sag amount adjusting operation portion 770b located at the left end of the take-up reel 740, the sag amount and tension of the operation lines 40a and 40b are individually adjusted. For example, the operation lines 40a and 40b may be adjusted so that there is no slack in the operation lines 40a and 40b in the sheath 16 on the distal end side of the hand operation unit 70, and the tensions of the operation lines 40a and 40b are substantially zero. Is possible.

According to the first embodiment as described above, at least one part of the wheel operation unit 760 can be operated by a finger from the outside of the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760. Placed in position.
Therefore, in any direction around the rotation axis of the wheel operation unit 760, the wheel operation unit 760 can be rotated by accessing the wheel operation unit 760 with a finger from the outside of the main body case 700. For this reason, the rotation operation of the wheel operation unit 760, that is, the pulling operation of the operation line 40 can be performed more easily.

  The wheel operation unit 760 rotates around the shaft portion 713 and the fixing pin 810 of the main body case 700. That is, the rotation axis of the wheel operation unit 760 is the shaft unit 713 and the fixed pin 810.

More specifically, at least one portion of the wheel operation unit 760 is an upper surface 767 as at least one surface of the wheel operation unit 760 in the axial direction of the rotation axis of the wheel operation unit 760. Then, at least one region in the radial direction of the upper surface 767 of the wheel operation unit 760 is arranged at a position that can be operated by a finger from the outside of the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760. Yes.
Therefore, in any direction around the rotation axis of the wheel operation unit 760, the wheel operation unit 760 can be rotated by accessing the upper surface 767 with a finger from the outside of the main body case 700.

  More specifically, the upper surface 767 of the wheel operation unit 760 is exposed to the outside of the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760. Accordingly, the wheel operation unit 760 can be rotated by accessing the upper surface 767 with a finger from the outside of the main body case 700 more easily.

  More specifically, on the upper surface 767 of the wheel operation unit 760, a portion around the rotation axis of the wheel operation unit 760 is exposed to the outside of the main body case 700 over the entire surface. That is, on the upper surface 767 of the wheel operation unit 760, any part in the radial direction around the rotation axis of the wheel operation unit 760 is exposed to the outside of the main body case 700. Accordingly, the wheel operation unit 760 can be rotated by accessing the upper surface 767 with a finger from the outside of the main body case 700 more easily.

  Further, if the rotation angle of the wheel operation unit 760 necessary to bend the sheath 16 by 90 ° is X °, the side peripheral surface 768 of the wheel operation unit 760 has an angle range of X ° or more around the rotation axis. It is continuously arranged at a position where it can be operated with a finger from the outside of the main body case 700. Therefore, the sheath 16 can be bent by 90 ° by rotating the wheel operation unit 760 by one-touch operation of the side peripheral surface 768 without releasing the finger from the side peripheral surface 768.

Further, as described above, the main body case 700 has the shaft portion 713 as a shaft support portion that rotatably supports the wheel operation portion 760.
The sheath 16 is a linear path that passes through the back side (lower side) of the shaft portion 713 when viewed from one side in the axial direction of the rotation axis of the wheel operation unit 760 (from the upper side in the case of this embodiment). The proximal operation side 70 is guided from the distal end side to the proximal end side.
Therefore, the sheath 16 and the shaft portion 713 can be prevented from interfering with each other, and since it is not necessary to bend the sheath 16 in the hand operating portion 70, the liquid can be smoothly supplied through the main lumen 20. Can do.

  The operation line 40 branches off from the sheath 16 (a portion of the sheath 16 excluding the hollow tube 32 and the operation line 40 in the sheath 16) on the distal end side relative to the shaft portion 713. It is connected to a take-up reel 740. Therefore, what passes through the back side (lower side) of the shaft portion 713 is a portion of the sheath 16 excluding the hollow tube 32 and the operation line 40 inside thereof.

[Second Embodiment]
FIGS. 19 to 21 are views showing the hand operating portion 70 of the catheter 10 according to the second embodiment, in which FIG. 19 (a) is a top perspective view, and FIG. 19 (b) is a bottom perspective view. 20 (a) is a plan view, FIG. 20 (b) is a side view, FIG. 20 (c) is a bottom view, FIG. 20 (d) is a front view, FIG. 20 (e) is a rear view, and FIG. It is a sectional side view (II sectional drawing of Fig.20 (a)).
22A and 22B are views showing the lower case 710 of the hand operation unit 70, in which (a) is a plan view, (b) is a side sectional view, (c) is a bottom view, (d) is a front view, and (e) ) Is a rear view.
FIG. 23 is a perspective view of the lower case 710 with the hub 790 and the sheath 16 assembled. In FIG. 23, illustration of the hollow tube 32 and the operation line 40 branched from the sheath 16 is omitted.
FIG. 24 is a view showing the first half 830 of the wheel operation unit 760 of the hand operation unit 70, in which (a) is a plan view, (b) is a side view, and (c) is a bottom view.
FIG. 25 is a view showing the second half 840 of the wheel operation unit 760 of the hand operation unit 70, in which (a) is a plan view, (b) is a side view, and (c) is a bottom view.
FIG. 26 is a view showing the first fixing pin 850 of the hand operation unit 70, in which (a) is a side view and (b) is a bottom view.
27A and 27B are views showing the second fixing pin 860 of the hand operation unit 70, in which (a) is a side view and (b) is a bottom view.

  The catheter 10 according to the second embodiment differs from the catheter 10 according to the first embodiment in the points described below, and is otherwise the same as the catheter 10 according to the first embodiment. It is configured.

In 1st Embodiment, the wheel operation part 760 was comprised by the single member.
On the other hand, in the catheter 10 according to the second embodiment, as shown in FIGS. 19 and 20, the wheel operation unit 760 includes a first half 830 (FIG. 19) that constitutes the upper half of the wheel operation unit 760. 24) and a second half 840 (FIG. 25) constituting the lower half of the wheel operation unit 760.

  As shown in FIG. 21, the first half 830 and the second half 840 rotate around the same rotation axis. That is, the first half 830 and the second half 840 rotate around the shaft 713.

As shown in FIG. 22, the shaft portion 713 of the lower case 710 is formed in a cylindrical shape. As in the first embodiment, the shaft portion 713 pivotally supports the limiter member 750 and thus the entire bending operation portion 730 so as to be rotatable.
A shaft support hole 713c is formed in the center of the shaft portion 713 so as to penetrate the lower case 710 vertically.

  As shown in FIG. 22A, in the case of this embodiment, the sheath disposition groove 715 is a curved path that bypasses the shaft portion 713 in plan view, from the distal end side to the proximal end side of the lower case 710. And extended.

  As shown in FIG. 23, the sheath 16 is guided from the distal end side to the proximal end side of the lower case 710 through a curved path that bypasses the shaft portion 713.

  As shown in FIGS. 22B and 22C, a recess 718 is formed on the lower surface of the lower case 710. The front and rear ends of the recess 718 are defined by arcuate walls 719a and 719b, respectively.

  As shown in FIG. 21, the second half 840 is disposed in the recess 718, and the arcuate walls 719a, 719b and the side peripheral surface 768b of the second half 840 face each other with a slight clearance.

As shown in FIGS. 19 to 21, the upper case 720 is configured similarly to the first embodiment.
And as shown to Fig.19 (a), the 1st half part 830 is provided with respect to the main body case 700 by the arrangement | positioning similar to the wheel operation part 760 (FIG.1 (a)) in 1st Embodiment. ing.

As shown in FIG. 24, the 1st half part 830 has the disk-shaped main-body part 831, for example. The upper surface of the main body portion 831 of the first half 830, that is, the upper surface 767 of the wheel operation unit 760 is, for example, flat. A side peripheral surface 768a (of the main body portion 831) of the first half 830 has an annular shape (cylindrical shape).
Note that the boundary between the upper surface 767 and the side peripheral surface 768a is preferably chamfered.
The outer diameter of the main body portion 831 is larger than the outer diameter of the main body portion 741 of the take-up reel 740.

A shaft support hole 833 that passes through the front and back of the main body 831 is formed at the center of the main body 831.
The shaft support hole 833 has, in order from the top, a pin head housing portion 833a, a small diameter hole portion 833b, and a fitting portion 833c. The pin head accommodating portion 833a, the small diameter hole portion 833b, and the fitting portion 833c are located coaxially with each other and communicate with each other.
The dimension of the small diameter hole part 833b is smaller than the dimension of the pin head accommodating part 833a and the fitting part 833c.

  The planar shape of the pin head accommodating portion 833a is, for example, a polygonal shape such as a hexagon.

The fitting portion 833c is formed in the same manner as the fitting portion 763c in the first embodiment. A plurality of locking recesses 764 for locking locking protrusions 755 (described later) of the limiter member 750 are formed on the inner peripheral surface of the fitting portion 833c.
A housing recess 765 similar to that of the first embodiment is formed on the back surface of the main body portion 831.

As shown in FIG. 25, the second half 840 has a disc-shaped main body 831, for example. The lower surface of the main body portion 841 of the second half 840, that is, the lower surface 769 of the wheel operation unit 760 is, for example, flat. The side peripheral surface 768b (of the main body portion 841) of the second half 840 has an annular shape (cylindrical shape).
Note that a boundary portion between the lower surface 769 and the side peripheral surface 768b is preferably chamfered.
The outer diameter of the main body portion 841 is larger than the outer diameter of the main body portion 741 of the take-up reel 740.

A shaft support hole 843 penetrating the front and back of the main body portion 841 is formed in the central portion of the main body portion 841.
The shaft support hole 843 has an insertion hole portion 843a and a pin head accommodating portion 843b in order from the top. The pin head accommodating portion 843b and the insertion hole portion 843a are located coaxially with each other and communicate with each other.
The dimension of the insertion hole part 843a is smaller than the dimension of the pin head accommodating part 843b. The inner diameter of the insertion hole portion 843a is equal to the inner diameter of the shaft support hole 713c.

  The planar shape of the pin head accommodating portion 843b is, for example, a polygonal shape such as a hexagon.

  In the present embodiment, the catheter 10 includes a first fixing pin 850 and a second fixing pin 860 that pivotally support the first half 830 and the second half 840 with respect to the shaft 713.

  As shown in FIG. 26, the first fixing pin 850 includes, for example, a cylindrical body portion 851, a disk-shaped portion 852 adjacent to the upper side of the body portion 851, and a head adjacent to the upper side of the disk-shaped portion 852. Part 853. The trunk portion 851, the disk-shaped portion 852, and the head portion 853 are located coaxially with each other. The head 853 has, for example, a polygonal shape such as a hexagonal shape.

The outer diameter of the body portion 851 is slightly smaller than the inner diameter of the shaft support hole 713c. The outer diameter of the disc-shaped portion 852 is larger than the outer diameter of the body portion 851 and slightly smaller than the inner diameter of the small-diameter hole portion 833b of the first half 830.
The planar dimension of the head 853 is larger than the planar dimension of the disk-shaped part 852. The planar shape of the head 853 is a polygonal shape similar to the planar shape of the pin head accommodating portion 833a. However, the planar dimension of the head 853 is slightly smaller than the planar dimension of the pin head accommodating portion 833a.
A press-fit hole 854 that opens downward is formed in the body portion 851. The inner diameter shape of the press-fitting hole 854 is a polygonal shape such as a hexagon.

As illustrated in FIG. 27, the second fixing pin 860 includes, for example, a body portion 861 and a head portion 862 adjacent to the lower side of the body portion 861. The body portion 861 and the head portion 862 are located coaxially with each other.
The body portion 861 is formed in a shape and size that can be press-fitted into the press-fitting hole 854. For example, the planar shape of the body portion 861 is a polygonal shape such as a hexagon.
The head 853 is formed in a shape and size that can be fitted into the pin head housing portion 843 b of the second half 840. For example, the planar shape of the head 853 is a polygonal shape such as a hexagon.

  As shown in FIG. 21, the first half 830 is disposed on the take-up reel 740. Here, the upper projecting portion 751a of the limiter member 750 is fitted into the fitting portion 833c of the first half 830, and each of the locking projections 755 of the limiter member 750 is in contact with the corresponding locking recess 764, respectively. It is locked. Therefore, the limiter member 750 rotates integrally with the wheel operation unit 760.

The body of the first fixing pin 850 from above the shaft support hole 833 with the first half 830 disposed on the take-up reel 740 and the second half 840 disposed in the recess 718 on the lower surface side of the lower case 710. The portion 851 is inserted into the shaft support hole 713c and the insertion hole portion 843a. Here, the head portion 853 is fitted into the pin head accommodating portion 833a, and the disc-like portion 852 is inserted into the small diameter hole portion 833b.
Further, the body portion 861 of the second fixing pin 860 is press-fitted and fixed into the press-fitting hole 854 of the body portion 851 of the first fixing pin 850 from the lower side of the shaft support hole 843. The head 862 is fitted in the pin head accommodating portion 843b.
As a result, the first fixing pin 850 and the second fixing pin 860 are fixed to each other.

  Here, the dimension of the head 853 of the first fixing pin 850 is larger than the inner diameter of the small-diameter hole 833b of the first half 830. The dimension of the head 862 of the second fixing pin 860 is larger than the inner diameter of the insertion hole 843a of the second half 840. Therefore, the first half 830 and the second half 840 are connected to each other by the first fixing pin 850 and the second fixing pin 860, and the first half 830 and the second half 840 are vertically moved. Separation is regulated.

Further, the polygonal head portion 853 in plan view is fitted into the pin head accommodating portion 833a having a polygonal shape in plan view, and the head portion 862 having a polygonal shape in plan view is fitted into the pin head accommodating portion 843b having a polygonal shape in plan view. A polygonal body portion 861 is press-fitted and fixed in a press-fitting hole 854 having a polygonal shape in plan view. Therefore, the first half 830, the first fixing pin 850, the second fixing pin 860, and the second half 840 rotate integrally around the axis of the shaft portion 713.
The planar shape of the head 853, the pin head accommodating portion 833a, the head 862, the pin head accommodating portion 843b, the body portion 861, and the press-fitting hole 854 is not limited to a polygonal shape, and is a non-circular shape such as a D-cut shape. May be.

  According to the second embodiment, the same effects as those of the first embodiment can be obtained, and the following effects can be obtained.

In the case of the present embodiment, both surfaces, that is, the upper surface 767 and the lower surface 769 of the wheel operation unit 760 in the axial direction of the rotation axis of the wheel operation unit 760 extend outside the main body case 700 over the entire circumference of the rotation axis of the wheel operation unit 760. Is exposed.
Therefore, in any direction around the rotation axis of the wheel operation unit 760, the wheel operation unit 760 can be rotated by accessing the upper surface 767 and the lower surface 769 of the wheel operation unit 760 with a finger from the outside of the main body case 700. it can. For this reason, the rotation operation of the wheel operation unit 760, that is, the pulling operation of the operation line 40 can be performed more easily.

  The wheel operation unit 760 rotates around the shaft portion 713, the first fixing pin 850, and the second fixing pin 860 of the main body case 700. That is, the rotation axes of the wheel operation unit 760 are the shaft unit 713, the first fixing pin 850, and the second fixing pin 860.

  More specifically, in each of the upper surface 767 and the lower surface 769 of the wheel operation unit 760, the portion around the rotation axis of the wheel operation unit 760 is exposed to the outside of the main body case 700 over the entire surface. That is, on the upper surface 767 of the wheel operation unit 760, any part in the radial direction around the rotation axis of the wheel operation unit 760 is exposed to the outside of the main body case 700. Further, on the lower surface 769 of the wheel operation unit 760, any part in the radial direction around the rotation axis of the wheel operation unit 760 is exposed to the outside of the main body case 700. Therefore, the wheel operation unit 760 can be rotated by accessing the upper surface 767 and the lower surface 769 with a finger from the outside of the main body case 700 more easily.

Further, as described above, the main body case 700 has the shaft portion 713 as a shaft support portion that rotatably supports the wheel operation portion 760.
The sheath 16 is a curved path that bypasses the shaft portion 713 when viewed from one side in the axial direction of the rotation axis of the wheel operation portion 760 (in the case of the present embodiment, from above or below). 70 is guided from the distal end side to the proximal end side.
Therefore, the sheath 16 and the shaft portion 713 can be prevented from interfering with each other.
In particular, as in this embodiment, in the configuration in which the first half 830 and the second half 840 of the wheel operation unit 760 are pivotally supported using the first fixing pin 850 and the second fixing pin 860, the sheath 16 and the first fixing pin 850 and the second fixing pin 860 can be prevented from interfering with each other.

[Third Embodiment]
FIGS. 28 to 30 are views showing the hand operating portion 70 of the catheter 10 according to the third embodiment, in which FIG. 28 (a) is a top perspective view and FIG. 28 (b) is a bottom perspective view. 29 (a) is a plan view, FIG. 29 (b) is a side view, FIG. 29 (c) is a bottom view, FIG. 29 (d) is a front view, FIG. 29 (e) is a rear view, and FIG. Side sectional view (II sectional view of FIG. 29A)
FIGS. 31A and 31B are views showing the lower case 710 of the hand operation unit 70, in which (a) is a plan view, (b) is a side sectional view, (c) is a bottom view, (d) is a front view, and (e) ) Is a rear view.
32A and 32B are views showing the upper case 720 of the hand operation unit 70, in which (a) is a plan view, (b) is a side sectional view, (c) is a bottom view, (d) is a front view, and (e) ) Is a rear view.
FIG. 33 is a perspective view of the lower case 710 with the hub 790 and the sheath 16 assembled. In FIG. 33, illustration of the hollow tube 32 branched from the sheath 16 and the operation line 40 is omitted.
FIG. 34 is a side view showing the first half 830 of the wheel operation unit 760 of the hand operation unit 70.
FIG. 35 is a side view showing the second half 840 of the wheel operation unit 760 of the hand operation unit 70.

  The catheter 10 according to the third embodiment is different from the catheter 10 according to the second embodiment in the points described below, and is otherwise the same as the catheter 10 according to the second embodiment. It is configured.

  As shown in FIG. 31A, in the case of this embodiment, the sheath disposition groove 715 extends from the distal end side to the proximal end side of the lower case 710 through a linear path.

  As shown in FIGS. 30 and 33, the sheath 16 is guided from the distal end side to the proximal end side of the lower case 710 through a linear path.

  However, in the case of this embodiment, the shaft portion 713 is disposed at a position offset from the path of the sheath 16 when viewed from one side (upper or lower) in the axial direction of the rotation axis of the wheel operation unit 760.

More specifically, for example, when viewed from one side in the axial direction of the rotation axis of the wheel operation unit 760, the path of the sheath 16 coincides with the central axis of the main body case 700, and the shaft portion 713 is the main body case 700. Is offset from the central axis.
That is, when viewed from one side (upper or lower) in the axial direction of the rotation axis of the wheel operation unit 760, the wheel operation unit 760 is arranged eccentrically with respect to the main body case 700. In addition, as shown in FIGS. 28, 29, and 31, the portion of the main body case 700 where the wheel operation unit 760 is disposed is also eccentric from the central axis of the main body case 700.
Furthermore, as shown in FIG. 32, the shape of the upper case 720 is also left-right asymmetric. That is, the rear end surface 726 of the front portion 720a of the upper case 720 and the front end surface 727 of the rear portion 720b are shaped along the side peripheral surface 768a (of the main body portion 831) of the first half portion 830 of the eccentric wheel operation portion 760. It has become.

  As in the first embodiment, the hub 790 is arranged so as to coincide with the central axis of the main body case 700.

  In the second embodiment, the example in which the upper surface 767 and the lower surface 769 of the wheel operation unit 760 are flat has been described. However, in the case of this embodiment, FIGS. 34, 35, 29, and 30 are used. As shown, the upper surface 767 and the lower surface 769 are formed in a convex curved surface shape.

  According to the third embodiment as described above, the following effects can be obtained in addition to the same effects as those of the second embodiment.

Also in this embodiment, the main body case 700 has a shaft portion 713 as a shaft support portion that rotatably supports the wheel operation portion 760. However, the sheath 16 is guided from the distal end side to the proximal end side of the hand operation unit 70 through a linear path. Further, the shaft portion 713 is disposed at a position offset from the path of the sheath 16 when viewed from one side in the axial direction of the rotation axis of the wheel operation portion 760.
For this reason, it is possible to prevent the sheath 16 and the shaft portion 713 from interfering with each other, and it is not necessary to bend the sheath 16 in the hand operating portion 70, so that the liquid is smoothly supplied through the main lumen 20. be able to.

Further, when viewed from one side in the axial direction of the rotation axis of the wheel operation unit 760, the path of the sheath 16 coincides with the central axis of the main body case 700 from the distal end side toward the proximal end side.
For this reason, it is possible to easily perform an operation of rotating the hand operating unit 70 around the sheath 16 (without moving the axis of the sheath 16).
In addition, when viewed from one side in the axial direction of the rotation axis of the wheel operation portion 760, the shaft portion 713 is offset from the central axis of the main body case 700 from the distal end side toward the proximal end side.

  In the present embodiment, the side peripheral surfaces 768a and 768b are arranged on the left and right sides of the wheel operation unit 760, although the wheel operation unit 760 is arranged offset from the central axis of the main body case 700. And exposed to the outside of the main body case 700, respectively. For this reason, also about the operativity of the wheel operation part 760, it becomes the equivalent thing equivalent to 2nd Embodiment.

  As a modification of the third embodiment, when viewed from one side in the axial direction of the rotation axis of the wheel operation unit 760, the shaft unit 713 and the central axis of the main body case 700 from the distal end side toward the proximal end side, And the path of the sheath 16 is offset from the central axis of the main body case 700. In this case, since the wheel operation unit 760 is not eccentric with respect to the main body case 700, the operability of the wheel operation unit 760 is improved as compared with the third embodiment.

[Fourth Embodiment]
FIGS. 36A and 36B are schematic views showing the hand operation unit 70 of the catheter 10 according to the fourth embodiment, in which (a) is a side view and (b) is a plan view.

  In the first embodiment described above, a configuration in which a part of the side peripheral surface 768 of the wheel operation unit 760 is covered with the main body case 700 and cannot be operated with a finger is shown.

On the other hand, in the fourth embodiment, as shown in FIG. 36, the side peripheral surface 768 of the wheel operation unit 760 is arranged at a position that can be operated by a finger from the outside of the main body case 700 over the entire circumference. ing.
More specifically, the side peripheral surface 768 is exposed to the outside of the main body case 700 over the entire periphery.

  In order to realize such a configuration, for example, the entire wheel operation unit 760 is disposed outside the main body case 700. The wheel operation unit 760 and the take-up reel 740 inside the main body case 700 are connected via a connecting shaft 731. The rotation of the wheel operation unit 760 may be directly transmitted to the take-up reel 740 or may be transmitted via the limiter member 750 as described above.

  The configuration of the catheter 10 according to the fourth embodiment is the same as that of the first embodiment except for the configuration described above.

  According to the fourth embodiment as described above, the side peripheral surface 768 of the wheel operation unit 760 is disposed at a position that can be operated by a finger from the outside of the main body case 700 over the entire periphery. Therefore, in any direction around the rotation axis of the wheel operation unit 760, the wheel operation unit 760 can be rotated by accessing the side peripheral surface 768 with a finger from the outside of the main body case 700. For this reason, the rotation operation of the wheel operation unit 760, that is, the pulling operation of the operation line 40 can be performed more easily.

[Fifth Embodiment]
FIG. 37 is a schematic side view showing the hand operation unit 70 of the catheter 10 according to the fifth embodiment.

  In the second and third embodiments described above, a part of the side peripheral surface 768a of the first half 830 and the side peripheral surface 768b of the second half 840 of the wheel operation unit 760 is covered by the body case 700, and the finger I showed the configuration that can not be operated in

On the other hand, in the fifth embodiment, as shown in FIG. 37, each of the side peripheral surface 768a of the first half 830 and the side peripheral surface 768b of the second half 840 of the wheel operation unit 760 is formed as a whole. It is arranged at a position that can be operated by a finger from the outside of the main body case 700 over the circumference.
More specifically, each of the side peripheral surfaces 768a and 768b is exposed to the outside of the main body case 700 over the entire periphery.

  In order to realize such a configuration, for example, the entire first half 830 is disposed outside (upward) of the main body case 700, and the entire second half 840 is disposed outside (lower) of the main body case 700. ). The first half 830, the second half 840, and the take-up reel 740 are connected via a connecting shaft 731. The rotation of the wheel operation unit 760 may be directly transmitted to the take-up reel 740 or may be transmitted via the limiter member 750 as described above.

  The catheter 10 according to the fifth embodiment is the same as the second embodiment or the third embodiment except for the configuration described above.

  According to the fifth embodiment as described above, each of the side peripheral surface 768a of the first half 830 and the side peripheral surface 768b of the second half 840 of the wheel operation unit 760 extends over the entire circumference of the main body. It is arranged at a position where it can be operated with a finger from the outside of the case 700. Therefore, in any direction around the rotation axis of the wheel operation unit 760, the wheel operation unit 760 can be rotated by accessing the side peripheral surfaces 768a and 768b with a finger from the outside of the main body case 700. For this reason, the rotation operation of the wheel operation unit 760, that is, the pulling operation of the operation line 40 can be performed more easily.

  In the above description, the state of being exposed to the outside of the main body case 700 means that the target surface (the upper surface 767, the lower surface 769, the side peripheral surfaces 768, 768a, 768a, etc.) is not covered by the main body case 700, for example. Means state. In addition, in the above, in a state where the finger can be operated from the outside of the main body case 700, for example, the target surface is covered with the main body case 700 and the target surface is not only exposed And a state in which the target surface can be operated with a finger through a clearance between the main body case 700 and the main body case 700.

  In each of the above embodiments, the wheel operation unit 760 and the take-up reel 740 as the traction unit are configured as separate members. However, the wheel operation unit 760 and the traction unit are part of one member. It may be. For example, the operation line 40 is connected to the wheel operation unit 760 described above, and by rotating the wheel operation unit 760, the operation line 40 is wound around the wheel operation unit 760, and the operation line 40 is pulled. To be done.

  In each of the above embodiments, the example has been described in which the upper surface 767 of the wheel operation unit 760 or the upper surface 767 and the lower surface 769 can be operated over the entire circumference of the rotation axis, but the present invention is not limited to this example. For example, one of the top surface 767 and the bottom surface 769 can be operated 180 degrees around the rotation axis and the other surface can be the remaining 180 degrees. Various aspects may be used.

  In each of the above-described embodiments, the example in which the base end portion of the operation line 40 is connected to the bending operation unit 730 has been described. However, the operation line 40 is pulled so that the operation line 40 is pulled by an operation on the bending operation unit 730. The proximal end portion of the operation line 40 may be engaged with the bending operation unit 730 and connected to a portion other than the bending operation unit 730 in the hand operation unit 70.

  In the first to third embodiments, the example in which the rotation of the wheel operation unit 760 is transmitted to the take-up reel 740 via the limiter member 750 has been described. It may be transmitted directly to the take-up reel 740.

  Moreover, in the above, although the catheter was illustrated as a medical device, this invention is not restricted to this example. That is, the present invention can also be applied to other medical devices (for example, endoscopes) that bend the main body using an operation line.

DESCRIPTION OF SYMBOLS 10 Catheter 15 Distal end part 16 Sheath 17 Proximal end part 20 Main lumen 21 Inner layer 30 Sublumen 32 Hollow tube 32a Base end 40, 40a, 40b Operation line 41 Tip part 50 Coil 52 Wire 60 Outer layer 64 Coat layer 66 Marker 70 Hand operating part 700 Main body case 701 Disc-like part 702 Front part 703 Rear part 705 Fastening member 707 Passing hole 710 Lower case 711 Notch-shaped part 712 Hub holding recessed part 713 Shaft part 713a Split shaft part 713b Insertion hole 713c Shaft support hole 714 Fixing pin 715 Sheath disposition groove 716 Support base 716b Passing groove 717 Operation cutout shape portion 718 Recess 719a, 719b Arc-shaped wall 720 Upper case 720a Front portion 720b Rear portion 721 Sheath pressing portion 722 Hub holding recess 724 Support portion 725 Angle 726 Rear End face 727 Front end face 730 Operation part 731 Connecting shaft 740 Take-up reel 741 Main body part 741a Groove 741b Recess 741c Peripheral part 742 Take-up body part 743 Shaft support hole 744 Corrugation recess 745 Corrugation recess 746 Accommodation recess 746a Inner wall surface 746b Inner side 747 Support stand 748 Projection 749 Locking recess 750 Limiter member 751 Main body 751a Upper protrusion 751b Lower protrusion 751c Slit 752 Spring-like body 753 Engaging protrusion 754 Shaft support hole 755 Locking protrusion 756 Locking claw 757 Opening 760 Wheel operation part 761 Main body part 763 Axis Support hole 763a Pin head accommodating portion 763b Bearing hole portion 763c Insertion portion 764 Locking recess 765 Housing recess 765a First recess 765b Second recess 767 Upper surface 768 Side peripheral surface 768a Side peripheral surface 768b Side peripheral surface 769 Lower surfaces 770, 770a, 770b Slack adjustment operation part 7 DESCRIPTION OF SYMBOLS 1 Main-body part 772 Winding groove 773 Fixing hole 774 Operation part 775 Edge line 776 End surface 777 End surface 779 Adhesive material 780 Guide part 781 Leg part 782 Beam-like part 783 Column-like part 784 Passing gate 785 Boundary part 788 Insertion hole 790 Hub 791 Hollow 792 Front part 810 Fixing pin 811 Body part 812 Shaft part 813 Head part 830 First half part 831 Main part 833 Shaft support hole 833a Pin head accommodating part 833b Small diameter hole part 833c Insertion part 840 Second half part 841 Main part 843 Shaft support hole 843a Insertion hole portion 843b Pin head accommodating portion 850 First fixing pin 851 Body portion 852 Disc-shaped portion 853 Head portion 854 Press-fitting hole 860 Second fixing pin 861 Body portion 862 Head DE Distal end PE Proximal end

Claims (14)

A long and flexible body,
An operation line embedded in the main body and having a tip fixed to the tip of the main body,
A proximal operation portion provided at a proximal end portion of the main body portion, connected to a proximal end portion of the operation line, and performing an operation of bending the main body portion by pulling the operation line;
Have
The hand operating unit is
A body case,
A wheel operation unit that is provided so as to be rotatable with respect to the main body case, with a direction intersecting the longitudinal axis of the base end of the main body as a rotation axis;
A towing unit that pulls the operation line in conjunction with the wheel operation unit being operated and rotating;
Have
A medical device, wherein at least one portion of the wheel operation unit is disposed at a position operable by a finger from the outside of the main body case over the entire circumference of the rotation shaft. At least one portion of the wheel operation unit is at least one surface of the wheel operation unit in the axial direction of the rotation shaft,
The at least one region in the radial direction of the at least one surface is disposed at a position that can be operated by a finger from the outside of the main body case over the entire circumference of the rotating shaft. The medical device according to 1.   The medical device according to claim 2, wherein the at least one surface is exposed to the outside of the main body case over the entire circumference of the rotating shaft.   4. The medical device according to claim 3, wherein a portion around the rotation shaft on the at least one surface is exposed to the outside of the main body case over the entire surface thereof.   The medical device according to claim 3 or 4, wherein both surfaces of the wheel operation unit in the axial direction of the rotation shaft are exposed to the outside of the main body case over the entire circumference of the rotation shaft. . When the rotation angle of the wheel operation part necessary for bending the main body part by 90 ° is X °,
A side peripheral surface of the wheel operation unit is continuously disposed over a range of an angle of X ° or more around the rotation axis at a position that can be operated by a finger from the outside of the main body case. The medical device according to any one of claims 1 to 5.   The medical device according to claim 6, wherein a side peripheral surface of the wheel operation unit is disposed at a position that can be operated by a finger from the outside of the main body case over the entire periphery. The main body case has a shaft support portion that rotatably supports the wheel operation portion,
The main body is a linear path that passes through the back side of the shaft support when viewed from one side in the axial direction of the rotating shaft, and is guided from the distal end side to the proximal end side of the hand operating portion. The medical device according to any one of claims 1 to 4, characterized in that: The main body case has a shaft support portion that rotatably supports the wheel operation portion,
The main body is a curved path that bypasses the shaft support when viewed from one side in the axial direction of the rotating shaft, and is guided from the distal end side to the proximal end side of the hand operating portion. The medical device according to any one of claims 1 to 7. The main body case has a shaft support portion that rotatably supports the wheel operation portion,
The main body portion is a straight path, and is guided from the distal end side to the proximal end side of the hand operation portion,
The said shaft support part is arrange | positioned in the position offset from the path | route of the said main-body part, when it sees from one in the axial direction of the said rotating shaft. Medical equipment. When viewed from one side in the axial direction of the rotating shaft,
The path of the main body portion and the central axis of the main body case heading from the distal end side to the proximal end side coincide with each other,
The medical device according to claim 10, wherein the shaft support is offset from the central axis. When viewed from one side in the axial direction of the rotating shaft,
The shaft support and the central axis of the main body case from the distal end side toward the proximal end side coincide with each other,
The medical device according to claim 10, wherein the path of the main body is offset from the central axis. The operation line branches from the main body portion on the tip side of the shaft support portion,
The medical device according to any one of claims 8 to 12, wherein a base end side portion of the operation line is connected to the pulling portion.   The medical device according to any one of claims 1 to 13, wherein the medical device is a catheter.

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