WO2020202715A1 - Medical tubular body delivery device - Google Patents

Abstract

A medical tubular body delivery device (1) that has: an outside tube (3) that has a medical tubular body (20) arranged in the lumen thereof; a linear traction member (7) that is connected to a proximal end part of the outside tube (3); an inside tube (4) that is arranged in the lumen of the outside tube (3) and the lumen of the medical tubular body (20) and extends further to the proximal side than a proximal end (3P) of the outside tube (3); and a protection tube (5) that has the proximal end part of the outside tube (3), the portion of the inside tube (4) that extends further to the proximal side than the proximal end (3P) of the outside tube (3), and the linear traction member (7) arranged in the lumen thereof. A holding member (9) that restrains the linear traction member (7) and the inside tube (4) is provided in the lumen of the protection tube (5). The holding member (9) is formed so as to be capable of moving in the distal-proximal direction relative to the linear traction member (7).

Description

Medical tubular body transport device

The present invention relates to a medical tubular body transport device which is a device for transporting a medical tubular body such as a stent into the body.

A medical tubular body represented by a stent is a medical device for treating various diseases caused by stenosis or occlusion of a living lumen such as a gastrointestinal tract such as a bile duct or a pancreatic duct and a blood vessel such as an iliac artery. is there. The medical tubular body includes a lesion such as a stenosis or an obstruction that is expanded from the inside and placed in the lesion to maintain the inner diameter of the lumen, or a thrombus that has formed in or around the lesion. Some are entangled and removed to the outside of the body to restore the inner diameter of the lumen at the lesion.

As an example of treatment with a medical tubular body using an endoscope, in a biliary tract obstructed by bile duct cancer, a medical tubular body is placed in the biliary tract in order to drain bile from the bile duct to the duodenum side. The method of indwelling will be described below. First, an endoscope is inserted from the mouth to the entrance (papillary) of the bile duct of the duodenum. Next, the guide wire is conveyed to the lesion through the endoscope. In addition, the medical tubular body transport device is transported to the lesion along the guide wire. Then, the medical tubular body transport device is operated to place the medical tubular body in the lesion portion.

As a medical tubular body transport device, for example, Patent Document 1 describes a distal end tube having a guide wire lumen, a proximal end tube having a distal end fixed to the proximal end of the distal tube, and a distal end of the distal tube. A tubular member for storing a stent that covers the side and is slidable in the direction of the proximal end of the tube on the distal end side, a stent housed in the tubular member for storing the stent, and one end of the tubular member for storing the stent. Disclosed is a biological organ dilation device comprising a traction member that is fixed and extends within a proximal tube.

Japanese Unexamined Patent Publication No. 2006-271565

In the biological organ dilation device disclosed in Patent Document 1, a stent, which is a medical tubular body, is placed between the distal tube and the tubular member for storing the stent and transported to the lesion portion, and the stent is stored in the lesion portion. By pulling the traction member fixed to the proximal end side of the tubular member to the proximal side, the stent can be exposed from the stent storage tubular member, and the stent can be deployed and placed at the lesion. By the way, in the biological organ expansion device of Patent Document 1, the traction member is composed of a wire, and the biological organ expansion device provided with such a traction member moves through the body cavity when the medical tubular body is transported to the lesion portion. By advancing while bending, between the distal tube and the traction member when the wire-like traction member wraps around the distal tube or pulls the traction member proximally to deploy a medical tubular body. There is a risk that the traction member will come into strong contact with the tip side tube or the like due to a bending difference, and the traction resistance will increase. As a result, when the medical tubular body is placed in the body, the traction member may not be able to be towed suitably.

The present invention has been made in view of the above circumstances, and an object of the present invention is a medical tubular body transport device provided with a linear traction member, in which a medical tubular body is inserted into a body and transported to a lesion portion. It is an object of the present invention to provide a medical tubular body transport device in which the linear traction member is difficult to wrap inside and the linear traction member can be preferably pulled when the medical tubular body is placed in the body. ..

The medical tubular body transport device of the present invention that has been able to solve the above problems is a device that transports the medical tubular body into the body; and an outer tube in which the medical tubular body is arranged in the lumen; With a linear traction member connected to the proximal end of the outer tube and extending proximally from the proximal end of the outer tube; as well as being placed in the lumen of the outer tube and the lumen of the medical tubular body An inner tube that extends proximal to the proximal end of the outer tube; a proximal end of the outer tube, a portion of the inner tube that extends proximal to the proximal end of the outer tube, and linear traction. The member has a protective tube arranged in the lumen; the lumen of the protective tube is provided with a holding member that restrains the linear traction member and the inner tube, and the holding member is relative to the linear traction member. It is characterized in that it is formed so as to be movable in the perspective direction. In the medical tubular body transport device of the present invention, the holding member may be one whose length in the perspective direction can be reduced.

Since the medical tubular body transport device of the present invention is provided with a holding member that restrains the linear traction member and the inner tube, when the transport device is inserted into the body to transport the medical tubular body to the lesion portion. , It is possible to suppress the linear traction member from wrapping around the inner tube, and it is possible to improve the torque transmission from the hand side. When the linear traction member is pulled proximally to place the medical tubular body in the body, the holding member can prevent the linear traction member from widening the bending difference between the inner tube, so that the linear traction member is linear. The towing member can be preferably towed. The "bending difference" means that the bending diameters of two or more members are different.

It is preferable that a plurality of holding members are provided. By providing a plurality of holding members, the holding member and the linear traction member can be separated from each other while preventing the linear traction member from wrapping around the inner tube and suppressing the bending difference between the linear traction member and the inner tube from widening. It is possible to suppress an increase in contact resistance.

When a plurality of holding members are provided, the distance between the plurality of holding members in the perspective direction is preferably 10 mm or more and 50 mm or less. By setting the distance between the plurality of holding members in the perspective direction to 50 mm or less, it becomes easy to prevent the linear traction member from wrapping around the inner tube, and when the linear traction member is pulled to the proximal side, the linear traction member is linear. It becomes easy to suppress the widening of the bending difference between the traction member and the inner tube. On the other hand, by setting the distance between the plurality of holding members in the perspective direction to 10 mm or more, it is possible to suppress an increase in contact resistance between the holding member and the linear traction member when the linear traction member is pulled to the proximal side. it can.

The holding member is preferably formed in a monocyclic shape when viewed from the proximal side or the distal side. By forming the holding member in a single ring shape, the linear traction member and the inner tube can be compactly combined in a vertical cross section with respect to the perspective direction, and the outer diameter of the protective tube can be made small.

The inner diameter of the holding member formed in a single ring shape when no load is applied is preferably smaller than the sum of the outer diameter of the linear traction member and the outer diameter of the inner tube. When the holding member is formed in this way, it becomes easy to hold the holding member at a predetermined position of the linear traction member and the inner tube without pulling the linear traction member. Therefore, when the transport device is inserted into the body to transport the medical tubular body to the lesion portion, the holding member is easily maintained in the initial position with respect to the linear traction member and the inner tube, and the holding member is provided. The effect is more likely to be exhibited favorably.

It is preferable that the holding member is formed so as to be movable in the perspective direction with respect to the linear traction member and the inner tube. As a result, the linear traction member can be towed more smoothly toward the proximal side.

The length of the holding member in the perspective direction is preferably 1 mm or more and 10 mm or less. By forming the holding member in such a size, it becomes easy to secure the strength of the holding member, and when the linear traction member is pulled to the proximal side, the contact resistance between the holding member and the linear traction member is increased. It can be suppressed.

The cavity of the protective tube is provided with a traction member storage tube through which a linear traction member is inserted, and the holding member is proximal to the proximal end of the outer tube and distal to the traction member storage tube. It is preferably located distal to the end. By inserting the linear traction member into the cavity of the traction member storage tube, the linear traction member can get lost inside the protective tube at the part where the linear traction member is not restrained from the inner tube by the holding member, or the wire It is possible to prevent the linear traction member from wrapping around a member other than the traction member storage tube and to prevent the linear traction member from being extremely bent.

It is preferable that the holding member is arranged within 20 mm from the midpoint between the proximal end of the outer tube and the distal end of the traction member storage tube with the outer tube on the most distal side. By arranging the holding member in this way, it becomes easier to prevent the linear traction member from wrapping around the inner tube, and torque transmission from the hand side can be further enhanced.

It is also preferable that the holding member is arranged within 20 mm from the distal end of the traction member storage tube to the distal side with the outer tube on the most distal side. By arranging the holding member in this way, it is possible to suppress an increase in resistance when the linear traction member is pulled to the proximal side, and the linear traction member can be easily stably stored in the traction member storage tube. Become.

It is also preferable that the holding member is arranged within 20 mm from the proximal end of the outer tube to the proximal side with the outer tube on the most distal side. By arranging the holding member in this way, it is possible to suppress an increase in resistance when the linear traction member is pulled to the proximal side, and the linear traction member is positioned at a predetermined position at the proximal end of the outer tube. It becomes easy to connect stably to.

Since the medical tubular body transport device of the present invention is provided with a holding member that restrains the linear traction member and the inner tube, when the transport device is inserted into the body to transport the medical tubular body to the lesion portion. , It is possible to prevent the linear traction member from wrapping around the inner tube. When the linear traction member is pulled proximally to place the medical tubular body in the body, the holding member can prevent the linear traction member from widening the bending difference between the inner tube, so that the linear traction member is linear. The towing member can be preferably towed.

The whole view of the medical tubular body transporting apparatus which concerns on embodiment of this invention is shown. A plan view of a portion of the medical tubular body transport device shown in FIG. 1 including an outer tube, an inner tube, and a protective tube, in which the medical tubular body is housed in the lumen of the outer tube. Top view of the medical tubular body transport device shown in FIG. 2 in a state where the medical tubular body is expanded in the radial direction by moving the outer tube to the proximal side in the portion including the outer tube, the inner tube and the protective tube. Represents. An example of a partial cross-sectional view of the proximal end of the outer tube of the medical tubular body transport device and its vicinity along the perspective direction is shown, and FIG. 4A shows a state in which the outer tube is located on the most distal side. Is shown, and FIG. 4B shows a state in which the linear traction member is towed to the proximal side and the outer tube is moved to the proximal side. Another example of a partial cross-sectional view of the proximal end of the outer tube of a medical tubular body carrier and its vicinity along the perspective direction is shown in FIG. 5 (a), where the outer tube is located most distally. FIG. 5 (b) shows a state in which the linear traction member is towed to the proximal side and the outer tube is moved to the proximal side. An example of a radial cross-sectional view of a portion including an inner tube, a protective tube, and a linear traction member of a medical tubular body transport device is shown.

Hereinafter, the present invention will be specifically described based on the following embodiments, but the present invention is not limited by the following embodiments as well as the present invention, and appropriate modifications are made to the extent that it can be adapted to the purpose of the above and the following. Of course, it is also possible to carry out the above, and all of them are included in the technical scope of the present invention. In each drawing, hatching, member reference numerals, and the like may be omitted for convenience, but in such cases, the specification and other drawings shall be referred to. In addition, the dimensions of various members in the drawings may differ from the actual dimensions because priority is given to contributing to the understanding of the features of the present invention.

The basic configuration of the medical tubular body transport device will be described with reference to FIGS. 1 to 3. FIG. 1 is an overall plan view of the medical tubular body transport device, and FIG. 2 is a partial plan view of the medical tubular body transport device shown in FIG. 1, in which the medical tubular body is housed in the transport device. In the medical tubular body transport device shown in FIG. 2, the outer tube is moved to the proximal side, and the medical tubular body is exposed from the transport device in the radial direction. Represents a plan view in an expanded state.

The medical tubular body transport device 1 is a medical device that transports a medical tubular body 20 such as a stent into the body. The medical tubular body transport device 1 is a long device including an outer tube 3, an inner tube 4, and a protective tube 5, and the extending direction of these tubes is referred to as a perspective direction. The proximal side of the medical tubular body transport device 1 refers to the user's hand side with respect to the perspective direction of the medical tubular body transport device 1, and the direction opposite to the distal side, that is, the treatment target side. Point in the direction. In FIGS. 1 to 3, the right side of the drawing corresponds to the proximal side, and the left side of the drawing corresponds to the distal side. Further, the direction perpendicular to the perspective direction is referred to as a radial direction. Hereinafter, the "medical tubular body transport device" may be simply referred to as a "transport device".

The transport device 1 has an outer tube 3, an inner tube 4, and a protective tube 5. Hereinafter, the outer tube, the inner tube, and the protective tube may be collectively referred to as a "shaft portion". The transport device 1 is used for treatment of blood vessels and gastrointestinal tract. For example, in the case of treatment using an endoscope, the shaft portion 2 is inserted into the forceps channel from the forceps opening of the endoscope and transported to the lesion portion. .. The transport device 1 can move the outer tube 3 in the perspective direction with respect to the inner tube 4 and the protective tube 5 by operating the controller 12 provided on the proximal side of the shaft portion 2.

The outer tube 3 is located at the distal portion of the shaft portion 2, and the medical tubular body 20 is arranged in the lumen of the outer tube 3. The outer tube 3 is formed so as to be movable in the perspective direction with respect to the inner tube 4 and the protective tube 5, FIG. 2 shows a state in which the outer tube 3 is located on the most distal side, and FIG. 3 shows a state in which the outer tube 3 is located on the most distal side. It shows the state where the tube 3 is located on the most proximal side. The outer tube 3 protects the medical tubular body 20 from being exposed to the outside of the shaft portion 2 as shown in FIG. 2 when the medical tubular body 20 is transported to the lesion portion. The outer tube 3 also functions to hold the medical tubular body 20 in a reduced diameter state during transport of the medical tubular body 20, thereby facilitating transport of the medical tubular body 20 to the lesion. .. The perspective length of the outer tube 3 can be appropriately set according to the perspective length of the medical tubular body 20 arranged in the lumen, and can be, for example, about 50 mm to 800 mm. The range in which the outer tube 3 can move in the perspective direction can be appropriately set according to the length in the perspective direction of the medical tubular body 20 arranged in the lumen of the outer tube 3, and the medical tubular body 20 can be moved. It is preferably longer than the perspective length. The outer diameter of the outer tube 3 may be, for example, about 0.5 mm to 3.5 mm.

A typical example of the medical tubular body 20 is a stent. By using a stent, it is possible to treat various diseases caused by stenosis or occlusion of a digestive tract such as a bile duct or an in vivo lumen such as a blood vessel. The medical tubular body 20 includes a coiled medical tubular body formed of a single linear metal or polymer material, or a medical tubular body obtained by cutting out a metal tube or a tube made of a polymer material with a laser or the like. There are a body, a medical tubular body assembled by welding linear members, a medical tubular body made by weaving a plurality of linear metals, and the like. As the medical tubular body, in addition to the stent, a stent graft, an occlusion tool, an injection catheter, a prosthesis valve and the like can also be used.

From the viewpoint of the expansion mechanism, the medical tubular body 20 is (i) a balloon in which the medical tubular body is mounted (mounted) on the surface of the balloon and transported to the lesion portion, and the medical tubular body is expanded by the balloon at the lesion portion. It can be classified into an expansion type and a self-expansion type in which the medical tubular body is transported to the lesion portion in a state where the expansion is suppressed and the member that suppresses the expansion is removed at the lesion portion to expand by itself. The transport device 1 is suitably used for transporting a self-expandable medical tubular body, and the outer tube 3 functions as a member that suppresses the expansion of the medical tubular body 20. Therefore, when the medical tubular body 20 is installed in the lumen of the outer tube 3, the medical tubular body 20 contracts in the radial direction and extends in the longitudinal axis direction, so that the diameter of the medical tubular body 20 is a cylindrical form elongated from the expanded state. It becomes a state. Since the self-expandable medical tubular body does not need to be provided with a balloon inside, the diameter of the reduced diameter state can be made smaller than that of the balloon-expandable medical tubular body.

The inner tube 4 is arranged in the lumen of the outer tube 3 and the lumen of the medical tubular body 20, and extends proximally from the proximal end 3P of the outer tube 3. When the medical tubular body 20 is transported into the body by the transport device 1, the medical tubular body 20 is arranged between the inner tube 4 and the outer tube 3 in the radial direction. A guide wire is inserted into the lumen of the inner tube 4. By inserting the guide wire into the lumen of the inner tube 4 and moving the shaft portion 2 along the guide wire, the tip of the shaft portion 2 can be delivered to the lesion portion. The length of the inner tube 4 in the perspective direction may be, for example, about 200 mm to 3000 mm. The outer diameter of the inner tube 4 may be, for example, about 0.3 mm to 3.0 mm.

On the proximal side of the outer tube 3, a protective tube 5 in which the proximal end of the outer tube 3 is arranged in the lumen is provided. A proximal end of the outer tube 3 and an inner tube 4 are arranged in the lumen of the protective tube 5, and the protective tube 5 extends proximal to the proximal end 3P of the outer tube 3. The proximal end of the outer tube 3 includes the proximal end 3P of the outer tube 3 and means a portion of a predetermined length distal to the proximal end. A controller 12 for the user to operate the transport device 1 is provided on the proximal side of the protective tube 5. The length of the protective tube 5 in the perspective direction may be, for example, about 150 mm to 2200 mm. The outer diameter of the protective tube 5 may be, for example, about 0.5 mm to 3.5 mm.

The proximal end of the outer tube 3 is placed in the lumen of the protective tube 5 with the outer tube 3 located most proximally and most distally. The perspective length of the proximal end of the outer tube 3 arranged in the lumen of the protective tube 5 may be, for example, 1 mm or more and 50 mm or less in a state where the outer tube 3 is located on the most distal side. The inner tube 4 has at least a part of the portion extending proximally from the proximal end 3P of the outer tube 3 arranged in the lumen of the protective tube 5, and the portion distal to it, specifically. The portion overlapping the proximal end of the outer tube 3 which is arranged in the lumen of the protective tube 5 is also arranged in the lumen of the protective tube 5.

It is preferable that the protective tube 5 is provided with a guide wire port 6 for passing the guide wire through the cavity of the inner tube 4. The guide wire port 6 serves as an inlet on the proximal side of the guide wire inserted into the lumen of the inner tube 4 in the transport device 1. The installation position of the guide wire port 6 in the perspective direction may be appropriately set according to the model of the transport device 1, that is, the rapid exchange type or the over-the-wire type. Although the drawing shows a configuration example of a rapid exchange type medical tubular body transport device in which a guide wire is inserted halfway from the distal end portion to the proximal end portion of the shaft portion, the present invention describes the shaft portion. It can also be applied to an over-the-wire type medical tubular body transport device in which a guide wire is inserted from the distal end to the proximal end of the portion. The guide wire port 6 is preferably located proximal to the proximal end 3P of the outer tube 3 with the outer tube 3 located most proximally.

A linear traction member 7 is connected to the proximal end of the outer tube 3. The linear traction member 7 extends proximally from the proximal end 3P of the outer tube 3 and is located in the lumen of the protective tube 5 and is connected to the controller 12 directly or via other members. By operating the controller 12, the linear traction member 7 and the outer tube 3 can be moved in the perspective direction. For example, as shown in FIG. 3, the linear traction member 7 is towed proximally from the state shown in FIG. 2, and the outer tube 3 is moved proximally to the inner tube 4 and the protective tube 5. The medical tubular body 20 can be exposed to the outside of the shaft portion 2 and placed in the body. Further, the linear traction member 7 is sent to the distal side while the medical tubular body 20 is exposed, and the outer tube 3 is moved to the distal side with respect to the inner tube 4 and the protective tube 5, so that the medical tubular body 20 is exposed. It is also possible to re-store the 20 in the lumen of the outer tube 3 and adjust the placement location of the medical tubular body 20. By forming the traction member 7 in a linear shape, the outer diameter of the protective tube 5 can be made small. The inner tube 4 and the protective tube 5 do not move to the proximal side due to the operation of pulling the linear traction member 7 to the proximal side.

The length of the linear traction member 7 in the perspective direction may be, for example, about 150 mm to 2300 mm. The outer diameter of the linear traction member 7 may be, for example, about 0.1 mm to 1.5 mm. As a result, the outer diameter of the linear traction member 7 can be reduced and the outer diameter of the protective tube 5 can be reduced while ensuring the strength of the linear traction member 7. The outer diameter of the inner tube 4 is preferably larger than the outer diameter of the linear traction member 7. The outer diameter of the inner tube 4 is, for example, preferably 1.5 times or more, more preferably 2 times or more, further preferably 2.5 times or more, and preferably 10 times or less the outer diameter of the linear traction member 7. 8 times or less is more preferable, and 7 times or less is further preferable.

Only one linear traction member 7 may be provided, or a plurality of linear traction members 7 may be provided. In the latter case, it is preferable that a plurality of outer tubes 3 are provided at different positions in the circumferential direction. From the viewpoint of forming the outer diameter of the protective tube 5 to be smaller, it is preferable that only one linear traction member 7 is provided.

At the proximal end of the outer tube 3, the linear traction member 7 may be connected to the inner surface of the outer tube 3, the outer surface of the outer tube 3, and the inner and outer surfaces of the outer tube 3. It may be connected to the peripheral wall portion between the sides. Further, the proximal end portion of the outer tube 3 may have a multilayer structure, the distal end portion of the linear traction member 7 may be arranged between the layers, and the linear traction member 7 may be connected to the outer tube 3. As the joining means of the linear traction member 7 to the outer tube 3, known joining means such as adhesion by an adhesive, welding, fitting, and interlayer pressure bonding of the outer tube 3 having a multi-layer structure can be adopted.

Each member constituting the shaft portion 2 can be made of resin, metal, or a composite material thereof. Moreover, it is preferable that each of these materials has biocompatibility. Examples of the resin material include polyolefin resins such as polyethylene and polypropylene, polyamide resins such as nylon, polyester resins such as polyethylene terephthalate, aromatic polyether ketone resins such as PEEK, polyether polyamide resins, and polyurethane resins. Examples thereof include resins, polyimide resins, fluororesins such as PTFE, PFA and ETFE, synthetic resins such as polyvinyl chloride resins and silicone resins. Examples of the metal material include stainless steel such as SUS304 and SUS316, carbon steel, platinum, nickel, cobalt, chromium, titanium, tungsten, gold, Ni—Ti alloy, Co—Cr alloy, and combinations thereof.

The outer tube 3, inner tube 4, and protective tube 5 constituting the shaft portion 2 may be composed of a single layer or may be composed of a plurality of layers as long as they are formed in a tubular shape. In each of these tubes, a part in the perspective direction and another part may be made of different materials, or a part in the perspective direction may be made of a single layer and the other part may be made of a plurality of layers. Good. It is preferable that each of these tubes has a substantially circular outer edge shape and inner edge shape in a vertical cross section in the perspective direction.

When the outer tube 3, the inner tube 4, and the protective tube 5 are composed of a resin and metal composite material, the composite material includes a structure in which a metal wire is arranged in the resin layer or between a plurality of resin layers. An example has a structure in which a metal wire is arranged. The metal wire may be, for example, arranged in a single or multiple spirals or form a braided layer. If each tube is configured in this way, the strength, slidability, and kink resistance of each tube can be improved.

The outer tube 3 preferably has a resin layer made of a fluorine-based resin, and PTFE is preferable as the fluorine-based resin. With the outer tube 3 configured in this way, slidability can be improved. In particular, it is preferable that the inner surface of the outer tube 3 is composed of a resin layer made of a fluororesin, whereby the slidability between the outer tube 3 and the medical tubular body 20 can be improved, or the outer tube 3 and the inner surface can be improved. The slidability with the tube 4 can be improved, and the medical tubular body 20 can be easily placed in the body.

It is also preferable that the outer tube 3 has a resin layer made of a polyimide-based resin, whereby both rigidity and flexibility can be imparted to the outer tube 3. From the viewpoint of increasing the strength of the outer tube 3, it is preferable that the metal wire is arranged on the outer tube 3, and it is particularly preferable that the outer tube 3 has a braided layer made of the metal wire. For example, the portion of the outer tube 3 arranged in the lumen of the protective tube 5 is the protective tube 5 and the inner tube 4 when the outer tube 3 is moved proximal to the inner tube 4 and the protective tube 5. It is desirable that the outer tube 3 is inserted straight into the space between the spaces along the extending direction of the space without being deformed. That is, it is preferable that the outer tube 3 is inserted into the space between the protective tube 5 and the inner tube 4 without bending the outer tube 3, changing the shape of the lumen, or expanding or contracting in the perspective direction. From such a viewpoint, it is preferable that at least the portion of the outer tube 3 arranged in the inner cavity of the protective tube 5 has a resin layer made of a polyimide resin, and further preferably has a braided layer made of a metal wire rod. .. The portion of the outer tube 3 arranged in the inner cavity of the protective tube 5 has a resin layer made of a fluororesin as an inner layer and a resin layer made of a polyimide resin as an outer layer, and a metal wire rod between the inner layer and the outer layer. It is preferable that a braided layer made of (particularly stainless wire) is provided.

The inner tube 4 preferably has a resin layer made of a polyimide resin. As a result, the guide wire is inserted into the inner cavity of the inner tube 4, and the shaft portion 2 can be easily sent into the body along the guide wire. Further, since the inner tube 4 has a resin layer made of a polyimide resin, the improvement of the tensile strength of the inner tube 4 in the perspective direction is improved, the inner tube 4 is less likely to break, and the medical tubular body 20 is developed. The axial compression resistance required for the medical tubular body 20 is improved, and the medical tubular body 20 can be easily deployed stably.

The inner tube 4 may further have a braided layer made of a metal wire (particularly a stainless wire). By configuring the inner tube 4 in this way, the strength, slidability, and kink resistance of the inner tube 4 can be improved. The braided layer made of the metal wire may be provided only on the distal side portion of the inner tube 4, whereby the pushability when the shaft portion 2 is sent into the body along the guide wire can be enhanced. Further, since the inner tube 4 has a braided layer made of a metal wire, the tensile strength and the axial compression resistance of the inner tube 4 in the perspective direction are improved, and the deployment operation of the medical tubular body 20 is stabilized, which makes it safer. The medical tubular body 20 can be deployed.

The protective tube 5 preferably has a resin layer made of a fluorine-based resin, and PTFE is preferable as the fluorine-based resin. As a result, the slidability of the protective tube 5 can be improved. In particular, in the portion where the outer tube 3 is arranged in the inner cavity of the protective tube 5, it is preferable that at least the inner surface of the protective tube 5 is composed of a resin layer made of a fluororesin, whereby the protective tube 5 and the outer tube are formed. The slidability with 3 is improved, and the medical tubular body 20 can be easily placed in the body.

The protective tube 5 may have a resin layer made of a polyimide resin, a polyamide resin, or the like, thereby increasing the rigidity of the protective tube 5 and imparting both rigidity and flexibility to the protective tube 5. Can be done. As a result, the protective tube 5 can have both the flexibility of bending along the shape in the body cavity and the rigidity of surely reaching the lesion portion in a well-balanced manner. Therefore, when the shaft portion 2 is inserted into the body through the forceps channel of the endoscope, the shaft portion 2 can be easily pushed into the forceps channel along the shape of the body cavity.

The protective tube 5 may have a braided layer made of a metal wire (particularly a stainless steel wire), whereby the strength, slidability, and kink resistance of the protective tube 5 can be enhanced. For example, when the protective tube 5 has a braided layer made of a resin layer and a metal wire, the inner tube arranged in the inner cavity of the protective tube 5 can easily maintain the shape of the inner cavity of the protective tube 5 even when bent. Kink of 4 or the like can be prevented, and the shaft portion 2 can be easily moved in the perspective direction along the guide wire. Further, since the protective tube 5 has a braided layer made of a metal wire, the cavity shape of the protective tube 5 can be easily maintained, and the resistance when the outer tube 3 is moved in the protective tube 5 in the perspective direction is reduced. Can be done.

As the linear traction member 7, a thread formed of a metal wire or a synthetic resin can be used. The linear traction member 7 may be a composite made of a plurality of materials, for example, a composite of a metal and a synthetic resin. The linear traction member 7 is preferably made of a metal wire, more preferably made of a stainless steel wire. By forming the linear traction member 7 in this way, the strength of the linear traction member 7 is increased, and even if the linear traction member 7 is repeatedly moved in the perspective direction, the linear traction member 7 is less likely to be damaged. The linear traction member 7 may also have a structure in which a metal wire is coated with a resin. In particular, the linear traction member 7 is preferably configured by coating the surface of a metal wire with a fluororesin, particularly PTFE, which can improve the slidability of the linear traction member 7 for medical use. The operation of deploying the tubular body 20 becomes easy. The linear traction member 7 preferably has a substantially circular vertical cross-sectional shape with respect to the perspective direction.

When the shaft portion 2 is configured as described above, the transport device 1 pulls the linear traction member 7 to move the outer tube 3 to the proximal side, and the medical tubular body 20 is desired in the body cavity. It becomes easy to place it in the position of. Specifically, when the outer tube 3 is moved proximal to the inner tube 4 and the protective tube 5, the outer tube 3 can be housed in the lumen of the protective tube 5, so that the outer tube 3 can be stored. It is possible to reduce the generation of frictional resistance due to the outer tube 3 coming into contact with the forceps channel or the forceps opening of the endoscope when the outer tube 3 is moved in the perspective direction. Therefore, the operating load when moving the outer tube 3 in the perspective direction is reduced, and the medical tubular body 20 can be stably deployed. Further, when the medical tubular body 20 is deployed, the protective tube 5 is fixed and only the outer tube 3 is pulled to the proximal side via the linear traction member 7, so that the entire shaft portion 2 is proximal. The movement to the side can be suppressed, and the medical tubular body 20 can be accurately placed at a desired position.

By the way, in the transport device 1 configured as described above, when the shaft portion 2 is inserted into the forceps channel of the endoscope and the medical tubular body 20 is transported to the lesion portion, the shaft portion 2 bends in the body cavity. There is a possibility that the linear traction member 7 may be wound around the inner tube 4 by proceeding while proceeding. When the linear traction member 7 is wrapped around the inner tube 4, after delivering the tip of the shaft portion 2 to the lesion portion, pull the linear traction member 7 to the proximal side to deploy the medical tubular body 20. Then, the linear traction member 7 cannot be smoothly pulled toward the proximal side. Further, even when the linear traction member 7 is not wound around the inner tube 4, when the linear traction member 7 is pulled to the proximal side at the portion where the shaft portion 2 is bent, the linear traction member 7 is pulled at the bent portion. Since it extends more linearly, a bending difference occurs between the inner tube 4 and the linear traction member 7 and between the protective tube 5 and the linear traction member 7, and the linear traction member 7 becomes the protective tube 5 and the inner side. It becomes easy to make strong contact with the tube 4. Therefore, as the linear traction member 7 is pulled to the proximal side, the frictional resistance of the linear traction member 7 tends to increase. Further, although the linear traction member 7 has an advantage that the outer diameter of the shaft portion 2 can be reduced by being formed linearly, the linear traction member 7 is simply placed in the inner cavity of the protective tube 5 by the inner tube 4 There is also a problem that the torque transmission property to the operation from the hand side is inferior just by arranging them side by side.

Therefore, in the transport device 1, a holding member 9 for restraining the linear traction member 7 and the inner tube 4 is provided in the cavity of the protective tube 5. The holding member 9 is formed so as to be movable in the perspective direction with respect to the linear traction member 7 as shown in FIG. 4, or the length of the holding member 9 in the perspective direction can be reduced as shown in FIG. Is formed to be. 4 and 5 show a partial cross-sectional view of the proximal end of the outer tube 3 and its vicinity along the perspective direction, and the holding member 9 shows a state seen from the side surface. 4 (a) and 5 (a) show a state in which the outer tube 3 is located on the most distal side, and FIGS. 4 (b) and 5 (b) show the linear traction member 7. A state in which the outer tube 3 is moved to the proximal side by being pulled to the proximal side is shown.

The transport device 1 is provided with a holding member 9 that restrains the linear traction member 7 and the inner tube 4 as described above, so that the shaft portion 2 is inserted into the forceps channel of the endoscope and the medical tubular body 20 is provided. The linear traction member 7 can be prevented from wrapping around the inner tube 4 when the linear traction member 7 is transported to the lesion portion, and the linear traction member 7 is less likely to wrap around the inner tube 4, so that torque transmission from the hand side can be improved. Can be enhanced. When the linear traction member 7 is pulled to the proximal side in order to deploy the medical tubular body 20, it is possible to prevent the holding member 9 from widening the bending difference between the linear traction member 7 and the inner tube 4. Therefore, the linear traction member 7 can be preferably towed to the proximal side. Further, since the holding member 9 is formed so as to be movable in the perspective direction or contractible in the perspective direction with respect to the linear traction member 7, the linear traction member 7 is located proximal to the inner tube 4. When the linear traction member 7 is towed to move the outer tube 3 to the proximal side, the holding member 9 is moved to the space proximal to the proximal end 3P of the outer tube 3. Can be stored compactly.

The holding member 9 restrains the linear traction member 7 and the inner tube 4 so as to limit the range in which the linear traction member 7 and the inner tube 4 can move with each other in the radial direction. The holding member 9 is formed so as to have an opening through which both the linear traction member 7 and the inner tube 4 pass, or the opening and the inner side through which the linear traction member 7 passes, when viewed from the proximal side or the distal side, for example. It may be formed so as to have an opening through which the tube 4 passes. As long as the movable range of the linear traction member 7 and the inner tube 4 is limited in the radial direction, a part of the edge of the opening may be interrupted. In FIGS. 4 and 5, the holding member 9 is formed in a monocyclic shape when viewed from the proximal side or the distal side, and the linear traction member 7 and the inner tube 4 are inserted through the opening portion of the monocyclic ring. There is.

The holding member 9 restrains the linear traction member 7 and the inner tube 4 so that the linear traction member 7 can move in the perspective direction with respect to the inner tube 4. In FIG. 4, the holding member 9 is formed in an annular shape, and the holding member 9 is not fixed to both the linear traction member 7 and the inner tube 4. As a result, the holding member 9 can move in the perspective direction with respect to both the linear traction member 7 and the inner tube 4. The holding member 9 may be at least non-fixed to the linear traction member 7, which enables the linear traction member 7 to be towed proximally and the linear traction member 7. 7 can move in the perspective direction with respect to the inner tube 4.

In FIG. 5, the holding member 9 can be reduced in the perspective direction. In this case, the holding member 9 may be fixed to the linear traction member 7 and the inner tube 4, and the linear traction member 7 may be fixed. It may be fixed to the inner tube 4 and not fixed to the inner tube 4, or it may be fixed to the inner tube 4 and not fixed to the linear traction member 7, and the linear traction member 7 and the inner tube 4 may be fixed. It may be non-fixed to both of. When the holding member 9 is fixed to the linear traction member 7, it is preferable that the distal end portion of the holding member 9 is fixed to the linear traction member 7. When the holding member 9 is fixed to the inner tube 4, it is preferable that the proximal end of the holding member 9 is fixed to the inner tube 4.

In FIG. 5, the holding member 9 is formed in a coil shape, and when the linear traction member 7 is pulled to the proximal side, a force that contracts in the perspective direction is applied to the holding member 9, so that the holding member 9 moves in the perspective direction. On the other hand, it can be reduced. The holding member 9 can be contracted in the perspective direction by a combination of any of the following actions: (i) The holding member 9 is in contact with the proximal end 3P of the outer tube 3 and is pushed to the proximal side by the outer tube 3. (Ii) The holding member 9 is in contact with the distal end 8D of the traction member storage tube 8 described later, and the position of the proximal end of the holding member 9 is fixed by the traction member storage tube 8; (iii) the holding member 9 The distal end of is fixed to the linear traction member 7 and pulled proximally by the linear traction member 7; (iv) the proximal end of the holding member 9 is fixed to the inner tube 4 and the inner tube The position of the proximal end of the holding member 9 is fixed by 4. In any of these cases, the linear traction member 7 can move in the perspective direction with respect to the inner tube 4. The holding member 9 that can be reduced in the perspective direction is not limited to the one formed in a coil shape, and may be formed in a braided shape, a bellows shape, or the like, for example.

The holding member 9 can be made of resin, metal or a composite material thereof. For specific examples of each of these materials, the above description of the constituent materials of the shaft portion 2 is referred to.

The holding member 9 preferably has a resin layer made of, for example, an elastomer resin. Examples of the elastomer resin include polyurethane-based resins, polyester-based resins, and polyamide-based resins, and polyamide-based resins are particularly preferable. As a result, the holding member 9 can be elastically deformed, and it is easy to hold the holding member 9 at a predetermined position of the linear traction member 7 and the inner tube 4 without pulling the linear traction member 7. Become. Therefore, when the shaft portion 2 is inserted into the forceps channel of the endoscope and the medical tubular body 20 is conveyed to the lesion portion, the holding member 9 is maintained at the initial position with respect to the linear traction member 7 and the inner tube 4. The effect of providing the holding member 9 is likely to be suitably exhibited.

The holding member 9 also preferably has a highly slidable resin layer, and examples of such a resin are preferably polyolefin-based resins and fluorine-based resins, with polyolefin-based resins being more preferred. If the holding member 9 has such a resin layer, when the linear traction member 7 is pulled proximal to the inner tube 4, the linear traction member 7 or the inner tube 4 and the holding member 9 are held together. The frictional resistance between them is reduced, and the traction operation of the linear traction member 7 becomes easy.

The holding member 9 preferably has an elastomer resin layer and a highly slidable resin layer, and more preferably has a multi-layer structure in which the elastomer resin layer is sandwiched between the highly slidable resin layers. The holding member 9 preferably has, for example, a multi-layer structure in which a resin layer made of a polyamide resin is sandwiched between resin layers made of a polyolefin resin.

It is preferable that the holding member 9 is provided on the proximal side of the proximal end 3P of the outer tube 3 so as to be in direct contact with the inner tube 4 and the linear traction member 7. The holding member 9 is also preferably provided on the distal side of the distal end 8D of the traction member storage tube 8, which will be described later.

Only one holding member 9 may be provided, or a plurality of holding members 9 may be provided. From the viewpoint of preventing the linear traction member 7 from wrapping around the inner tube 4 and suppressing a widening difference in bending between the linear traction member 7 and the inner tube 4 when the linear traction member 7 is pulled to the proximal side. Therefore, it is preferable that the holding member 9 is provided in a wide range in the perspective direction of the linear traction member 7, but in this case, the resistance when the linear traction member 7 is pulled to the proximal side may increase. .. Therefore, from such a viewpoint, it is preferable to provide a plurality of holding members 9. Specifically, it is preferable that a plurality of holding members 9 are provided apart from each other in the perspective direction. By providing the holding member 9 in this way, the holding member 9 can prevent the linear traction member 7 from being wound around the inner tube 4, and the bending difference between the linear traction member 7 and the inner tube 4 can be widened. While suppressing it, it is possible to suppress an increase in contact resistance between the holding member 9 and the linear traction member 7. In particular, as shown in FIG. 4, when the holding member 9 does not shrink in the perspective direction, it is preferable to provide a plurality of holding members 9 in this way.

When a plurality of holding members 9 are provided, the distance between the holding members 9 in the perspective direction is preferably 10 mm or more and 50 mm or less. Specifically, it is preferable that the plurality of holding members 9 are arranged at such intervals before the transfer device 1 is used or before the shaft portion 2 is inserted into the forceps channel of the endoscope. By setting the distance between the plurality of holding members 9 in the perspective direction to 50 mm or less, the linear traction member 7 is wound around the inner tube 4 when the shaft portion 2 is inserted into the forceps channel of the endoscope and advanced. In addition, when the linear traction member 7 is pulled to the proximal side, it becomes easy to suppress a widening of the bending difference between the linear traction member 7 and the inner tube 4. On the other hand, by setting the distance between the plurality of holding members 9 in the perspective direction to 10 mm or more, the contact resistance between the holding member 9 and the linear traction member 7 is increased when the linear traction member 7 is pulled to the proximal side. Can be suppressed. The distance between the plurality of holding members 9 in the perspective direction is more preferably 15 mm or more, further preferably 20 mm or more, further preferably 45 mm or less, still more preferably 40 mm or less.

The length of the holding member 9 in the perspective direction is preferably 1 mm or more and 10 mm or less. In particular, as shown in FIG. 4, when the holding member 9 does not shrink in the perspective direction, it is preferable to form the holding member 9 in such a size. By setting the size of the holding member 9 in the perspective direction to 1 mm or more, it becomes easy to secure the strength of the holding member 9, and by setting the size of the holding member 9 in the perspective direction to 10 mm or less, the linear traction member 7 The resistance when pulling to the proximal side can be suppressed. The length of the holding member 9 in the perspective direction is more preferably 2 mm or more, further preferably 3 mm or more, further preferably 8 mm or less, still more preferably 7 mm or less.

When a plurality of holding members 9 are provided, it is also preferable that the pitch at which the plurality of holding members 9 are arranged in the perspective direction is 5 times or more and 100 times or less the outer diameter of the inner tube 4. Specifically, it is preferable that the plurality of holding members 9 are arranged at such a pitch before the transfer device 1 is used or before the shaft portion 2 is inserted into the forceps channel of the endoscope. As a result, when the shaft portion 2 is inserted into the forceps channel of the endoscope and advanced, it becomes easy to prevent the linear traction member 7 from wrapping around the inner tube 4, and the torque transmission from the hand side is enhanced. Can be done. The arrangement pitch of the plurality of holding members 9 in the perspective direction is more preferably 10 times or more, further preferably 20 times or more, still more preferably 85 times or less, and further preferably 50 times or less the outer diameter of the inner tube 4. preferable.

As shown in FIG. 5, in the case of the holding member 9 that can be reduced in the perspective direction, only one holding member 9 may be provided, or a plurality of holding members 9 may be provided. When a plurality of holding members 9 are provided, as described above, the distance between the plurality of holding members 9 in the perspective direction is preferably 10 mm or more and 50 mm or less, but the distance between the holding members 9 may be less than 10 mm. .. The length of the holding member 9 that can be reduced in the perspective direction may be 1 mm or more and 10 mm or less as described above, but the length in the perspective direction may exceed 10 mm.

As shown in FIG. 4, the holding member 9 is preferably movable in the perspective direction with respect to the linear traction member 7 because the linear traction member 7 can be towed proximally with a smaller force. It is more preferable that the linear traction member 7 does not shrink in the perspective direction when it is towed to the proximal side. Further, the holding member 9 can move in the perspective direction with respect to both the linear towing member 7 and the inner tube 4 from the viewpoint that the linear towing member 7 can be towed to the proximal side more smoothly. Is more preferable. That is, it is more preferable that the holding member 9 is not fixed to both the linear traction member 7 and the inner tube 4.

As shown in FIG. 6, the holding member 9 is preferably formed in a monocyclic shape when viewed from the proximal side or the distal side. By restraining the linear traction member 7 and the inner tube 4 together by the monocyclic holding member 9, the linear traction member 7 and the inner tube 4 can be compactly put together in a vertical cross section with respect to the perspective direction, and the protective tube. The outer diameter of 5 can be made small. Further, since the contact area between the holding member 9 and the linear traction member 7 can be reduced, an increase in contact resistance when the linear traction member 7 is pulled to the proximal side can be suppressed. Further, by forming the holding member 9 in the same shape in the circumferential direction, the selectivity of the orientation of the holding member 9 can be eliminated, so that the assembling work of the transport device 1 can be facilitated and the production efficiency can be improved.

It is preferable that the holding member 9 formed in a single ring shape is elastically deformable. This makes it easier for the holding member 9 to preferably hold the linear traction member 7 and the inner tube 4 while allowing the linear traction member 7 to move in the perspective direction.

The inner diameter of the holding member 9 formed in a single ring shape when no load is applied is preferably a value close to the sum of the outer diameter of the linear traction member 7 and the outer diameter of the inner tube 4. For example, the inner diameter of the single annular holding member 9 when no load is applied is preferably 0.85 times or more, more preferably 0.90 times or more, the sum of the outer diameter of the linear traction member 7 and the outer diameter of the inner tube 4. , 0.95 times or more, more preferably 1.30 times or less, more preferably 1.20 times or less, still more preferably 1.10 times or less. This makes it easier for the holding member 9 to preferably hold the linear traction member 7 and the inner tube 4 while allowing the linear traction member 7 to move in the perspective direction. The shape of the holding member 9 when there is no load means the shape when only the holding member 9 is taken out from the transport device 1 and placed without applying a load, and is usually preferably formed in a substantially circular shape.

The inner diameter of the holding member 9 formed in a single ring shape when no load is applied is preferably smaller than the sum of the outer diameter of the linear traction member 7 and the outer diameter of the inner tube 4. For example, the monocyclic holding member 9 is formed in a substantially circular shape when no load is applied when viewed from the proximal side or the distal side, and is not formed when the linear traction member 7 and the inner tube 4 are inserted and held. It is preferably circular (for example, oval). Then, when the circular inner diameter of the single annular holding member 9 when no load is applied is D ₁ , the outer diameter of the linear traction member 7 is D _2, and the outer diameter of the inner tube 4 is D ₃ , then D ₁ < It is preferable to have a relationship of D ₂ + D ₃ . When the holding member 9 is formed in this way, the holding member 9 is held at a predetermined position of the linear traction member 7 and the inner tube 4 without performing the operation of moving the linear traction member 7 in the perspective direction. It will be easier to do. Therefore, when the shaft portion 2 is inserted into the forceps channel of the endoscope and the medical tubular body 20 is conveyed to the lesion portion, the holding member 9 is maintained at the initial position with respect to the linear traction member 7 and the inner tube 4. The effect of providing the holding member 9 is likely to be suitably exhibited.

It is also preferable that the holding member 9 is temporarily fastened to the linear traction member 7 and / or the inner tube 4 until the operation of moving the linear traction member 7 in the perspective direction with respect to the inner tube 4 is performed. Also in this case, when the shaft portion 2 is inserted into the forceps channel of the endoscope and the medical tubular body 20 is conveyed to the lesion portion, the holding member 9 is in the initial position with respect to the linear traction member 7 and the inner tube 4. The effect of providing the holding member 9 is likely to be suitably exhibited. Temporary fastening of the holding member 9 to the linear traction member 7 and / or the inner tube 4 is performed, for example, by adhering the holding member 9 to the linear traction member 7 and / or the inner tube 4 with an adhesive having a weak adhesive force. It can be carried out.

It is preferable that the cavity of the protective tube 5 is provided with a traction member storage tube 8 through which the linear traction member 7 is inserted into the cavity. In this case, the distal end of the linear traction member 7 is joined to the outer tube 3, and at least a part of the portion proximal to the proximal end 3P of the outer tube 3 is inside the traction member storage tube 8. It will be inserted into the cavity. By inserting the linear traction member 7 into the cavity of the traction member storage tube 8, the linear traction member 7 is not restrained from the inner tube 4 by the holding member 9, and the linear traction member 7 is inside the protective tube 5. It is possible to prevent the linear traction member 7 from wrapping around a member other than the traction member storage tube 8 and to prevent the linear traction member 7 from being extremely bent.

The distal end 8D of the traction member storage tube 8 is preferably located proximal to the proximal end 3P of the outer tube 3 with the outer tube 3 located most proximally. On the other hand, regarding the portion on the proximal side of the traction member storage tube 8, the traction member storage tube 8 preferably extends to the proximal end 5P of the protective tube 5, and is proximal to the proximal end 5P of the protective tube 5. It may extend to the side and extend to the controller 12.

When the traction member storage tube 8 is provided, it is preferable that the holding member 9 is arranged on the proximal side of the proximal end 3P of the outer tube 3 and on the distal side of the distal end 8D of the traction member storage tube 8. As a result, the holding member 9 prevents the linear traction member 7 from being wound around the inner tube 4 at the portion where the linear traction member 7 is not housed in the cavity of the traction member storage tube 8, and the linear traction member 7 is prevented from being wound around the inner tube 4. It is possible to suppress the widening of the bending difference between the linear traction member 7 and the inner tube 4 when pulling the tube to the proximal side. The holding member 9 is provided on the proximal side of the proximal end 3P of the outer tube 3 and on the distal side of the distal end 8D of the traction member storage tube 8 in a state where the outer tube 3 is located on the most distal side. The holding member 9 is proximal to the proximal end 3P of the outer tube 3 even when the linear traction member 7 is pulled proximally and the outer tube 3 is located most proximally. It is preferably located distal to the distal end 8D of the traction member storage tube 8.

With the outer tube 3 located most distally, the perspective length from the proximal end 3P of the outer tube 3 to the distal end 8D of the traction member storage tube 8 and the perspective length of the holding member 9. The difference is preferably longer than the perspective length of the medical tubular body 20 located in the lumen of the outer tube 3. As a result, when the linear traction member 7 is towed to the proximal side, the medical tubular body 20 can be reliably exposed to the outside of the shaft portion 2. The perspective length of the holding member 9 described here means the total length of the holding member 9 when there are a plurality of holding members 9, and when the holding member 9 can be reduced in the perspective direction, the holding member 9 is reduced in the perspective direction. It means the length in the perspective direction in the state of being.

When the traction member storage tube 8 is provided, the holding member 9 is placed between the proximal end 3P of the outer tube 3 and the distal end 8D of the traction member storage tube 8 with the outer tube 3 on the most distal side. It is preferably arranged within 20 mm from the midpoint, more preferably within 10 mm, even more preferably within 5 mm. As a result, when the shaft portion 2 is inserted into the forceps channel of the endoscope and advanced, it becomes easier to prevent the linear traction member 7 from wrapping around the inner tube 4, and the torque transmission from the hand side is further improved. Can be enhanced.

It is also preferable that the holding member 9 is arranged in the vicinity of the proximal end 3P of the outer tube 3 with the outer tube 3 on the most distal side. For example, the holding member 9 is preferably arranged within 20 mm proximal to the proximal end 3P of the outer tube 3, more preferably within 10 mm, and even more preferably within 5 mm. When the linear traction member 7 winds around the inner tube 4 in the vicinity of the proximal end 3P of the outer tube 3, the resistance when pulling the linear traction member 7 to the proximal side greatly increases. In this way, the holding member By arranging the 9, it is possible to suppress an increase in resistance when the linear traction member 7 is pulled to the proximal side. Further, by arranging the holding member 9 in this way, the linear traction member 7 can be easily stably connected to a predetermined position at the proximal end of the outer tube 3.

It is also preferable that the holding member 9 is arranged in the vicinity of the distal end 8D of the traction member storage tube 8 with the outer tube 3 on the most distal side. For example, the holding member 9 is preferably arranged within 20 mm distal to the distal end 8D of the tow member storage tube 8, more preferably within 10 mm, even more preferably within 5 mm. When the linear traction member 7 is wound around the inner tube 4 in the vicinity of the distal end 8D of the traction member storage tube 8, the resistance when the linear traction member 7 is pulled to the proximal side is greatly increased. By arranging the holding member 9, it is possible to suppress an increase in resistance when the linear traction member 7 is pulled to the proximal side. Further, by arranging the holding member 9 in this way, the linear traction member 7 can be easily stably stored in the traction member storage tube 8.

The inner diameter of the tow member storage tube 8 is preferably 1.1 times or more, more preferably 1.2 times or more, still more preferably 1.3 times or more the outer diameter of the linear tow member 7. As a result, when the linear traction member 7 is moved in the perspective direction, the frictional resistance between the linear traction member 7 and the traction member storage tube 8 is less likely to increase excessively. On the other hand, the inner diameter of the tow member storage tube 8 is preferably 3.0 times or less, more preferably 2.5 times or less, still more preferably 2.0 times or less the outer diameter of the linear tow member 7. As a result, the bending of the linear towing member 7 in the towing member storage tube 8 can be suppressed, and the linear towing member 7 can be efficiently towed.

The traction member storage tube 8 can be made of resin, metal or a composite material thereof. For specific examples of each of these materials, the above description of the constituent materials of the shaft portion 2 is referred to. Among them, the traction member storage tube 8 is preferably made of metal, and more preferably made of stainless steel. By configuring the traction member storage tube 8 in this way, the durability of the traction member storage tube 8 can be enhanced, and the linear traction member 7 is inserted into the cavity of the traction member storage tube 8 in the perspective direction. The traction member storage tube 8 is less likely to be damaged even if it is repeatedly moved to. Further, even if the outer diameter of the tow member storage tube 8 is made small, it becomes easy to secure high rigidity, so that the entire diameter of the shaft portion 2 can be reduced.

It is preferable that the tow member storage tube 8 has a fixed position in the perspective direction with respect to the inner tube 4. For example, it is preferable that at least a part of the traction member storage tube 8 is joined to the inner tube 4. By fixing the position of the traction member storage tube 8 in the perspective direction with respect to the inner tube 4, the pushability of the shaft portion 2 can be enhanced, and the deliverability of the medical tubular body 20 to the lesion portion can be improved. .. Further, since the linear traction member 7 can be stably towed to the proximal side, the medical tubular body 20 can be easily deployed. As a method of fixing the position of the traction member storage tube 8 with respect to the inner tube 4 in the perspective direction, a method of adhering, welding, fitting or screwing the traction member storage tube 8 and the inner tube 4, and heat shrinkage are used. Examples include a method of inserting the traction member storage tube 8 and the inner tube 4 into the resin tube to be provided to heat-shrink the resin tube, a method of inserting the traction member storage tube 8 and the inner tube 4 into the metal tube, and crimping the metal tube. Be done.

It is preferable that the tow member storage tube 8 has a fixed position in the perspective direction with respect to the protective tube 5. For example, it is preferable that at least a part of the tow member storage tube 8 is joined to the protective tube 5, and more preferably to the proximal end of the protective tube 5. The traction member storage tube 8 may be directly joined to the protective tube 5, or may be indirectly joined via another member such as the controller 12. By fixing the position of the traction member storage tube 8 in the perspective direction with respect to the protective tube 5, the pushability of the shaft portion 2 can be enhanced, and the deliverability of the medical tubular body 20 to the lesion portion can be improved. .. Further, since the linear traction member 7 can be stably towed to the proximal side, the medical tubular body 20 can be easily deployed. Further, by suppressing the movement of the traction member storage tube 8 in the perspective direction when the medical tubular body 20 is deployed, the stability of the position accuracy when the medical tubular body 20 is placed in the body is improved.

As a method of fixing the position of the traction member storage tube 8 with respect to the protective tube 5 in the perspective direction, a method of adhering, welding, fitting or screwing the traction member storage tube 8 and the protective tube 5, and heat shrinkage are used. Examples include a method of inserting the traction member storage tube 8 and the protective tube 5 into the resin tube to be provided to heat-shrink the resin tube, a method of inserting the traction member storage tube 8 and the protective tube 5 into the metal tube, and crimping the metal tube. Be done. As a method of fitting the traction member storage tube 8 and the protective tube 5, for example, protrusions are provided on the outer surface of the traction member storage tube 8 and the inner surface of the protection tube 5, and the protrusions abut each other. As a result, the position of the tow member storage tube 8 in the perspective direction with respect to the protective tube 5 may be fixed. Alternatively, the protective tube 5 may be fitted to the controller 12 and the tow member storage tube 8 may be joined to the controller 12 to fix the position of the tow member storage tube 8 in the perspective direction with respect to the protective tube 5.

The transport device 1 is preferably provided with a tip 10 at the distal end of the inner tube 4 (see FIGS. 1 to 3). It is preferable that the tip 10 has a lumen, which communicates with the lumen of the inner tube 4. The tip tip 10 constitutes the distal end of the shaft portion 2 with the outer tube 3 located most distally, thereby inserting the shaft portion 2 into the forceps channel of the endoscope for medical use. When the tubular body 20 is transported to the lesion portion, it is possible to prevent the tip of the shaft portion 2 from damaging the lumen in the living body. Further, the followability of the shaft portion 2 to the preceding guide wire and the forceps channel and the deliverability of the tip of the shaft portion 2 to the lesion portion can be improved, and the operability of the transport device 1 is improved.

The proximal end of the tip tip 10 is preferably located proximal to the distal end of the outer tube 3 with the outer tube 3 located most distally. That is, the proximal end of the tip 10 is preferably in the lumen of the distal end of the outer tube 3. As a result, when the shaft portion 2 is inserted into the forceps channel of the endoscope and the medical tubular body 20 is conveyed to the lesion portion, the outer tube 3 can easily follow the bending movement of the tip tip 10. The operability of the shaft portion 2 when transporting the medical tubular body 20 to the lesion portion can be improved.

The tip 10 can be made of resin, metal or a composite material thereof. For specific examples of each of these materials, the above description of the constituent materials of the shaft portion 2 is referred to. Above all, the tip 10 is preferably made of an elastomer resin. Examples of the elastomer resin include polyurethane-based resins, polyester-based resins, and polyamide-based resins, and it is particularly preferable that the elastomer resin is composed of a polyamide-based resin. By configuring the tip tip 10 in this way, it is possible to improve the followability of the tip tip 10 to the guide wire and the safety of the tip of the shaft portion 2.

The transport device 1 is for allowing the medical tubular body 20 to be deployed to the outside of the transport device 1 together with the outer tube 3 without moving to the proximal side when the outer tube 3 is moved to the proximal side. It is preferable that the stopper 11 is provided on the proximal side of the medical tubular body 20. The stopper 11 is preferably provided on the outer surface of the inner tube 4, preferably proximal to the proximal end of the medical tubular body 20 and distal to the distal end of the protective tube 5. It is more preferable that the stopper 11 is arranged so as to be in contact with the proximal end of the medical tubular body 20. By providing the stopper 11 in this way, when the outer tube 3 is pulled to the proximal side, the medical tubular body 20 can be reliably exposed to the outside of the shaft portion 2. Although not shown in the drawings, the stopper 11 is provided between the inner surface of the medical tubular body 20 and the outer surface of the inner tube 4, and on the inner surface of the medical tubular body 20 and the outer surface of the inner tube 4. It can also be placed in contact.

The shape of the stopper 11 can be, for example, a ring shape. The outer diameter of the stopper 11 is preferably the same as or smaller than the outer diameter of the medical tubular body 20 housed in the lumen of the outer tube 3. By forming the stopper 11 in this way, when the medical tubular body 20 moves to the proximal side, the stopper 11 comes into contact with the proximal end face and the inner surface of the medical tubular body 20 to contact the medical tubular body 20. It is possible to prevent the 20 from moving further to the proximal side.

The stopper 11 can be made of resin, metal or a composite material thereof. For specific examples of each of these materials, the above description of the constituent materials of the shaft portion 2 is referred to. Among them, the stopper 11 is preferably made of an elastomer resin, which can prevent the medical tubular body 20 from being deformed or damaged when the stopper 11 and the medical tubular body 20 come into contact with each other. As the elastomer resin, it is preferable to use a polyamide resin, whereby the rigidity of the stopper 11 is increased, the proximal end of the medical tubular body 20 is supported by the stopper 11, and the medical tubular body 20 is effectively developed. be able to. In addition, the effect of facilitating the molding process of the stopper 11 can be obtained.

The shaft portion 2 may be provided with an X-ray opaque marker (not shown). By providing the X-ray opaque marker on the shaft portion 2, the position of the shaft portion 2 in the body can be confirmed by using the X-ray opaque marker as a mark under fluoroscopy. The X-ray opaque marker is preferably provided near the portion where the medical tubular body 20 of the shaft portion 2 is arranged, and is preferably provided on the tip tip 10 or the stopper 11. By providing the tip 10 with an X-ray opaque marker, the distal end portion of the shaft portion 2 can be confirmed under fluoroscopy. Further, by providing the X-ray opaque marker on the stopper 11, the position and the extruded state of the medical tubular body 20 can be confirmed under fluoroscopy. The number of X-ray opaque markers installed may be one or may be plural.

This application claims the benefit of priority based on Japanese Patent Application No. 2019-066429 filed on March 29, 2019. The entire contents of the specification of Japanese Patent Application No. 2019-068424 filed on March 29, 2019 are incorporated herein by reference.

1: Medical tubular body transfer device 2: Shaft part 3: Outer tube 4: Inner tube 5: Protective tube 6: Guide wire port 7: Linear traction member 8: Tow member storage tube 9: Holding member 10: Tip tip 11 : Stopper 12: Controller 20: Medical tubular body

Claims (12)

A device that transports a medical tubular body into the body;
With the outer tube where the medical tubular body is placed in the lumen;
With a linear traction member connected to the proximal end of the outer tube and extending proximally from the proximal end of the outer tube;
With an inner tube that is located in the lumen of the outer tube and the lumen of the medical tubular body and extends proximally to the proximal end of the outer tube;
It has a proximal end of the outer tube, a portion of the inner tube extending proximal to the proximal end of the outer tube, and a protective tube in which the linear traction member is disposed in the lumen. ；
A holding member for restraining the linear traction member and the inner tube is provided in the cavity of the protective tube, and the holding member is formed so as to be movable in the perspective direction with respect to the linear traction member. A medical tubular body transport device characterized by this. A device that transports a medical tubular body into the body;
With the outer tube where the medical tubular body is placed in the lumen;
With a linear traction member connected to the proximal end of the outer tube and extending proximally from the proximal end of the outer tube;
With an inner tube that is located in the lumen of the outer tube and the lumen of the medical tubular body and extends proximally to the proximal end of the outer tube;
It has a proximal end of the outer tube, a portion of the inner tube extending proximal to the proximal end of the outer tube, and a protective tube in which the linear traction member is disposed in the lumen. ；
A medical tubular characterized in that a holding member for restraining the linear traction member and the inner tube is provided in the cavity of the protective tube, and the length of the holding member in the perspective direction can be reduced. Body transport device. The medical tubular body transport device according to claim 1 or 2, wherein a plurality of the holding members are provided. The medical tubular body transport device according to claim 3, wherein the distance between the plurality of holding members in the perspective direction is 10 mm or more and 50 mm or less. The medical tubular body transport device according to any one of claims 1 to 4, wherein the holding member is formed in a monocyclic shape when viewed from the proximal side or the distal side. The medical tubular body transport device according to claim 5, wherein the inner diameter of the holding member formed in a single ring shape when no load is smaller than the sum of the outer diameter of the linear traction member and the outer diameter of the inner tube. The medical tubular body transport device according to any one of claims 1 to 6, wherein the holding member is formed so as to be movable in a perspective direction with respect to the linear traction member and the inner tube. The medical tubular body transport device according to any one of claims 1 to 7, wherein the length of the holding member in the perspective direction is 1 mm or more and 10 mm or less. A traction member storage tube through which the linear traction member is inserted is provided in the lumen of the protection tube.
The medical use according to any one of claims 1 to 8, wherein the holding member is arranged proximal to the proximal end of the outer tube and distal to the distal end of the traction member storage tube. Tubular body transport device. 9. The holding member is arranged within 20 mm from the midpoint between the proximal end of the outer tube and the distal end of the traction member storage tube with the outer tube on the most distal side. The medical tubular body transport device according to. The medical tubular according to claim 9 or 10, wherein the holding member is arranged within 20 mm distal to the distal end of the traction member storage tube with the outer tube on the most distal side. Body transport device. The holding member according to any one of claims 1 to 11, wherein the holding member is arranged within 20 mm from the proximal end to the proximal side of the outer tube with the outer tube on the most distal side. Medical tubular body transport device.

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