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WO2021065848A1 - Dispositif médical allongé - Google Patents

Dispositif médical allongé Download PDF

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Publication number
WO2021065848A1
WO2021065848A1 PCT/JP2020/036765 JP2020036765W WO2021065848A1 WO 2021065848 A1 WO2021065848 A1 WO 2021065848A1 JP 2020036765 W JP2020036765 W JP 2020036765W WO 2021065848 A1 WO2021065848 A1 WO 2021065848A1
Authority
WO
WIPO (PCT)
Prior art keywords
gear
shaft
rotation
planetary gear
sun gear
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2020/036765
Other languages
English (en)
Japanese (ja)
Inventor
小澤佳
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Terumo Corp
Original Assignee
Terumo Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Terumo Corp filed Critical Terumo Corp
Priority to JP2021551278A priority Critical patent/JPWO2021065848A1/ja
Publication of WO2021065848A1 publication Critical patent/WO2021065848A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0041—Catheters; Hollow probes characterised by the form of the tubing pre-formed, e.g. specially adapted to fit with the anatomy of body channels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0097—Catheters; Hollow probes characterised by the hub
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0113—Mechanical advancing means, e.g. catheter dispensers

Definitions

  • the present invention relates to a medical long body having a long shaft that is inserted into a living body.
  • a catheter device such as a support catheter provided with a shaft on which a guide wire lumen is formed, a balloon catheter, and the like are known.
  • the operation is performed at the hand portion on the base end side of the shaft. Examples of such a long medical body include those listed in Patent Document 1.
  • the present invention has been made to solve the above-mentioned problems, and an object of the present invention is to provide a medical long body capable of reducing the difference between the rotation angle at the hand portion and the rotation angle at the tip portion of the shaft. And.
  • the medical long body according to the present invention that achieves the above object has a long shaft that is inserted into a living body and a rotary transmission unit that transmits rotation from the hand side to the shaft.
  • the unit has a grip portion that is held so as not to rotate, and an operation portion that is rotated with respect to the grip portion, and the rotation of the operation portion is speed-shifted and transmitted to the shaft.
  • the difference between the rotation angle due to the rotation operation of the operation unit and the rotation angle at the tip of the shaft can be reduced by shifting the rotation of the shaft.
  • the rotary transmission has a sun gear at the center of rotation, an internal gear around the rotation, and a planetary gear arranged between the sun gear and the internal gear, and the center position of the sun gear is the shaft. If it is placed on the rotation axis of, the rotation input from the operation unit can be changed and output to the shaft with a simple structure.
  • the operating portion rotationally drives the planetary gear
  • the sun gear rotationally driven by the planetary gear rotates the shaft, a set of planets
  • the gear mechanism allows the shaft to rotate at an accelerated speed in the forward direction with the rotation operation direction.
  • the planetary gear mechanism can be housed in the casing member to compactly configure the rotary transmission portion. it can.
  • the internal gear is provided on the inner peripheral portion of the casing member, it is not necessary to provide a component for the internal gear, so that the number of parts can be reduced.
  • the planetary gear is rotationally supported and has a support plate that rotates with respect to the internal gear, and the support plate is provided with a handle portion as the operation portion, the handle portion is moved in the circumferential direction of the casing member. By operating in this way, the rotation operation can be easily performed.
  • the grip portion has a lock portion that prevents the handle portion from rotating with respect to the grip portion, it is possible to prevent the shaft from being unexpectedly accelerated and rotated when the rotation operation is not performed.
  • the rotary transmission includes a first rotary transmission having a first solar gear, a first internal gear, and a first planetary gear, and a second solar gear provided at different positions in the axial direction from the first rotary transmission. It has a second rotary transmission unit having a second internal gear and a second planetary gear, and the first sun gear is connected so as to rotationally drive the second internal gear, and is connected to the first planetary gear and a second.
  • the first sun gear is supported by the grip portion, the operating portion rotationally drives the first internal gear, and is rotationally driven by the first internal gear via the first planetary gear. If the second sun gear is rotationally driven via the second internal gear and the second planetary gear and the second sun gear rotationally drives the shaft, the first rotary transmission unit rotates the operation unit. Is reversed while accelerating, and the rotation of the first rotation transmission unit is reversed while accelerating at the second rotation transmission unit. Therefore, the shaft can be rotated in the forward direction while accelerating the rotation operation of the operation unit. ..
  • FIG. 5 is an enlarged cross-sectional view of the vicinity of the first rotary transmission section and the second rotary transmission section cut along a plane including the central axis of the shaft in the second embodiment.
  • the catheter 1 will be described as a medical long body.
  • the catheter 1 has a shaft 2 which is a long tubular body, a hub 3 provided at a base end portion of the shaft 2, and a rotary transmission unit 4 attached to the hub 3. .
  • the shaft 2 is made of a flexible material. Therefore, the shaft 2 can be inserted along the shape of the blood vessel.
  • the material of the shaft 2 is, for example, a thermoplastic elastomer such as styrene-based, polyolefin-based, polyurethane-based, polyester-based, polyamide-based, polybutadiene-based, transpolyisoprene-based, fluororubber-based, chlorinated polyethylene-based, or among these.
  • a thermoplastic elastomer such as styrene-based, polyolefin-based, polyurethane-based, polyester-based, polyamide-based, polybutadiene-based, transpolyisoprene-based, fluororubber-based, chlorinated polyethylene-based, or among these.
  • a combination of two or more of the above can be used.
  • a metal blade or a metal coil wire embedded as a reinforcing material may be used.
  • the rotary transmission unit 4 is held by hand to perform a rotation operation, thereby accelerating the rotation due to the rotation operation and rotating the shaft 2. Since the speed increase ratio is set to 1: 3 in the present embodiment, when the rotary transmission unit 4 is rotated once, the shaft 2 is rotated three times.
  • the rotary transmission unit 4 will be described in detail.
  • the rotary transmission unit 4 of the present embodiment is a casing member 10 having a grip portion 20 that is held by hand so as not to rotate, and a handle that is an operation unit that protrudes from the base end portion of the casing member 10 and is manually rotated. It has a part 37.
  • a planetary gear mechanism is housed inside the casing member 10.
  • the casing member 10 has a hollow inside, and an internal gear 22 is formed on the inner peripheral surface thereof.
  • a sun gear 30 is provided via three planetary gears 33 in the circumferential direction.
  • the sun gear 30 has a hole portion 31 in the central portion for inserting and fixing the central shaft member 40 communicating with the shaft 2.
  • the planetary gear 33 is rotatably supported by a ring-shaped support plate 35.
  • the support plate 35 is formed with handle fixing portions 36 at three locations in the circumferential direction, and the handle portions 37 are fixed to these handle fixing portions 36, respectively. Therefore, three handle portions 37 are provided in the circumferential direction, and by moving these in the circumferential direction with respect to the casing member 10, the planetary gear 33 can be rotationally driven via the support plate 35.
  • the ratio of the inner diameter of the internal gear 22 to the outer diameter of the sun gear 30 is 1: 3, and the ratio of the number of teeth of the internal gear 22 to the sun gear 30 is 1: 3. Therefore, while the planetary gear 33 makes one revolution in the circumferential direction of the internal gear 22, the sun gear 30 makes three rotations.
  • the gear ratio is a multiple of the number of teeth of the internal gear 22 with respect to the sun gear 30. In this embodiment, the gear ratio is 3.
  • an internal gear 22 is formed on the tip end side, and a support plate holding portion 24 for rotatably holding the support plate 35 is formed on the base end side.
  • the base end surface of the casing member 10 has a large opening, and the handle portion 37 fixed to the support plate 35 projects from the casing member 10 toward the base end side.
  • a central shaft member 40 having a lumen 42 is inserted through the central portion of the casing member 10.
  • the central axis of the central shaft member 40 is on the rotation axis of the shaft 2.
  • the central shaft member 40 has a tip insertion portion 41 that is inserted from the base end side of the hub 3.
  • the base end portion of the hub 3 has a tapered inclined surface 3a on the inner surface, and the tapered tip insertion portion 41 is inserted so as to abut the inclined surface 3a.
  • the central shaft member 40 has a base end opening 43, and a guide wire can be inserted through the shaft 2 via a lumen 42.
  • the center of the sun gear 30 is on the central axis of the central shaft member 40 communicating with the shaft 2, and the central shaft member 40 is fixed to the hole 31 of the sun gear 30. Therefore, the shaft 2 can rotate together with the sun gear 30 via the central shaft member 40.
  • the central shaft member 40 is rotatable with respect to the casing member 10 and the support plate 35.
  • the outer peripheral surface of the casing member 10 is a grip portion 20 held by the operator by hand.
  • the operator holds the grip portion 20 by hand and moves the handle portion 37 in the circumferential direction of the casing member 10, so that the planetary gear 33 is rotationally driven by the handle portion 37 while the internal gear 22 is fixed in the circumferential direction.
  • the sun gear 30 connected to the central shaft member 40 by the planetary gear 33 is rotationally driven.
  • the sun gear 30 also rotates in the forward direction.
  • the shaft 2 connected to the central shaft member 40 has an angle three times the angle at which the operator rotates the handle portion 37 with respect to the grip portion 20. Rotates in the forward direction with.
  • the shaft 2 is flexible, and in a curved state, the rotation angle at the tip portion is smaller than that at the base end portion.
  • the length of the shaft 2 is 180 to 250 cm.
  • the tip end portion of the shaft makes approximately one rotation when the base end portion makes three rotations. Therefore, the angle at which the operator rotates the handle portion 37 with respect to the grip portion 20 and the rotation angle of the tip portion of the shaft 2 are substantially the same, and the rotation operation of the shaft 2 can be performed with a small number of rotations.
  • the rotary transmission unit 7 of the second embodiment is provided with the first rotation transmission unit 8 and the second rotation transmission unit 9.
  • the first rotation speed change unit 8 and the second rotation speed change unit 9 are arranged at different positions in the axial direction of the shaft 2.
  • the first rotation transmission unit 8 has an inner first casing member 51
  • the second rotation transmission unit 9 has an inner second casing member 52.
  • the inner first casing member 51 and the inner second casing member 52 are housed in the outer casing member 50.
  • the inner first casing member 51 and the inner second casing member 52 each have a planetary gear mechanism inside.
  • the outer peripheral surface of the outer casing member 50 is the grip portion 60
  • the outer peripheral surface exposed from the outer casing member 50 of the inner first casing member 51 is the operation portion 55.
  • the inner first casing member 51 has a first internal gear 70, a first sun gear 72, and a first planetary gear 76 inside.
  • the first internal gear 70 is formed on the inner peripheral surface of the inner first casing member 51.
  • a first support plate 78 that rotatably supports the first planetary gear 76 is provided in the inner first casing member 51.
  • the central shaft member 90 is inserted into the hole 73 of the first sun gear 72, but the central shaft member 90 is not fixed to the first sun gear 72.
  • the first sun gear 72 has a connecting portion 74 whose tip portion projects toward the tip side, and the connecting portion 74 is fixed to the inner second casing member 52.
  • the fixing structure of the central shaft member 90 to the hub 3 is the same as in the case of FIG. 3, and the tip insertion portion 91 is inserted into the base end side of the hub 3. Further, the central shaft member 90 has a base end opening 93.
  • the inner second casing member 52 has a second internal gear 80, a second sun gear 82, and a second planetary gear 86 inside.
  • the second internal gear 80 is formed on the inner peripheral surface of the inner second casing member 52.
  • a second support plate 88 that rotatably supports the second planetary gear 86 is provided in the inner second casing member 52.
  • the second support plate 88 is rotatable with respect to the inner second casing member 52.
  • a central shaft member 90 is inserted and fixed in the hole 83 of the second sun gear 82, and the shaft 2 can be rotationally driven by the second sun gear 82 via the central shaft member 90.
  • the outer casing member 50 has a planetary gear support portion 61 that rotationally supports the first planetary gear 76 of the inner first casing member 51 and the second planetary gear 86 of the inner second casing member 52, respectively. Due to the planetary gear support portion 61, neither the first support plate 78 nor the second support plate 88 rotates with respect to the outer casing member 50.
  • the gear ratio between the first internal gear 70 and the first sun gear 72 is ⁇ 3, and the gear ratio between the second internal gear 80 and the second sun gear 82 is also ⁇ 3.
  • the first sun gear 72 rotates ⁇ 3 times the rotation of the operation unit 55
  • the second sun gear 82 rotates ⁇ 3 times the rotation of the first sun gear 72.
  • the speed of 82 is increased so as to rotate three times as much as the rotation of the operation unit 55.
  • the inner diameter of the first internal gear 70 is ⁇ 3 times the outer diameter of the first sun gear 72
  • the inner diameter of the second internal gear 80 is also ⁇ 3 times the outer diameter of the second sun gear 82.
  • the operator holds the grip portion 60 of the outer casing member 50 by hand, and rotates the operation portion 55, which is the outer peripheral surface of the inner first casing member 51, in the circumferential direction of the outer casing member 50, whereby the first internal gear 70 is generated. It rotates with respect to the outer casing member 50, and the first planetary gear 76 is rotationally driven in a state where the circumferential position with respect to the outer casing member 50 is fixed. The rotation of the first planetary gear 76 causes the first sun gear 72 to rotate, and the inner second casing member 52 connected by the connecting portion 74 is rotationally driven. When the operator rotates the operation unit 55 in the forward direction, the rotation direction of the first sun gear 72 is opposite, and the inner second casing member 52 also rotates in the opposite direction.
  • the second planetary gear 86 By rotating the inner second casing member 52, the second planetary gear 86 is rotated by the second internal gear 80. The second planetary gear 86 also rotates in a state where the circumferential position with respect to the outer casing member 50 is fixed by the planetary gear support portion 61. The rotation of the second planetary gear 86 drives the rotation of the second sun gear 82, and the shaft 2 rotates via the central shaft member 90. As described above, since the inner second casing member 52 rotates in the opposite direction, the rotation direction of the second sun gear 82 is in the forward direction, and the shaft 2 also rotates in the forward direction.
  • the mechanism that rotates the sun gear in the direction opposite to the operation direction by rotating the internal gear by operation to drive the sun gear is provided in the axial direction of the shaft 2.
  • the speed of the shaft 2 connected to the second sun gear 82 can be accelerated in the forward direction.
  • the operator can roughly match the angle at which the operation portion 55 is rotated with respect to the grip portion 60 and the rotation angle of the tip portion of the shaft 2, and can perform the rotation operation of the shaft 2 with a small number of rotations. ..
  • the first rotation transmission unit 8 and the second rotation transmission unit 9 are required, but since the gear ratios of the respective gear ratios are smaller than those in the first embodiment, the overall diameter can be reduced.
  • the medical long body 1 has a long shaft 2 inserted into a living body and a rotary transmission unit 4 for transmitting rotation from the hand side to the shaft 2.
  • the rotary speed change unit 4 has a grip portion 20 that is held so as not to rotate, and an operation unit (handle portion 37) that is rotated with respect to the grip portion 20. Communicate to. As a result, the rotation of the shaft 2 is changed, so that the difference between the rotation angle due to the rotation operation of the operation portion and the rotation angle at the tip portion of the shaft 2 can be reduced.
  • the rotary transmission unit 4 has a sun gear 30 at the center of rotation, an internal gear 22 at a peripheral portion of rotation, and a planetary gear 33 arranged between the sun gear 30 and the internal gear 22. If the center position of is on the rotation axis of the shaft 2, the rotation input from the operation unit can be changed and output to the shaft 2 with a simple structure.
  • the operation portion rotationally drives the planetary gear 33
  • the sun gear 30 rotationally driven by the planetary gear 33 rotationally drives the shaft 2, one set
  • the planetary gear mechanism allows the shaft 2 to accelerate and rotate in the forward direction with the rotation operation direction.
  • the planetary gear mechanism is housed in the casing member 10 to accommodate the rotary transmission unit 4. It can be configured compactly.
  • the internal gear 22 is provided on the inner peripheral portion of the casing member 10, it is not necessary to provide the parts for the internal gear 22, so that the number of parts can be reduced.
  • the handle portion 37 can be attached to the casing member 10.
  • the rotation operation can be easily performed by operating the gear so as to move it in the circumferential direction.
  • the grip portion 20 has a lock portion that prevents the handle portion 37 from rotating with respect to the grip portion 20, it is possible to prevent the shaft 2 from being unexpectedly accelerated and rotated when the rotation operation is not performed. it can.
  • the rotary transmission unit is provided at a position different in the axial direction from the first rotation transmission unit 8 having the first sun gear 72, the first internal gear 70, and the first planetary gear 76, and the first rotation transmission unit 8. It has a second rotary transmission unit 9 having a second sun gear 82, a second internal gear 80, and a second planetary gear 86, and the first sun gear 72 is connected so as to rotationally drive the second internal gear 80.
  • the first planetary gear 76 and the second planetary gear 86 are supported by the grip portion 60, and the operating portion 55 rotationally drives the first internal gear 70 and is rotationally driven by the first internal gear 70 via the first planetary gear 76.
  • the first sun gear 72 is driven by rotating the second sun gear 82 via the second internal gear 80 and the second planetary gear 86, and the second sun gear 82 is driven to rotate the shaft 2.
  • the first rotary transmission 8 reverses the rotation operation of the operation unit 55 while accelerating it
  • the second rotary transmission 9 reverses the rotation of the first rotation gear 8 while accelerating the rotation of the operation unit 55.
  • the shaft 2 can be rotated in the forward direction while accelerating the operation.
  • the gear ratio is set to 3, but any other gear ratio can be used if necessary.
  • the gear ratio can be set to greater than 1 and less than 4, preferably 1.5 to 3. When the gear ratio is 1, there is no difference from manual rotation, and when it exceeds 4, the rotation speed of the tip is too fast and there is a possibility of blood vessel damage.
  • the rotation of the shaft 2 is accelerated by the rotary transmission units 4 and 7, but the shaft may be decelerated.
  • the shaft may be decelerated.
  • the shaft By holding the grip portion by hand and rotating the operation portion, the shaft decelerates and rotates in the forward direction according to the gear ratio.
  • the rotation angle By decelerating the shaft, the rotation angle can be made smaller than the rotation operation, so that it can be used when a precise rotation operation is required.
  • a lock mechanism may be provided to prevent the handle portion 37 from rotating with respect to the grip portion 20.
  • the handle portion of the handle portion 37 is allowed to move along the axial direction of the shaft 2, and the casing member 10 serving as the grip portion 20 is provided with a recess for accommodating the handle portion of the handle portion 37. ..
  • the recess becomes a lock portion that prevents the handle portion 37 from rotating.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Retarders (AREA)

Abstract

La présente invention concerne un dispositif médical allongé permettant de réduire la différence entre l'angle de rotation à une partie côté main et l'angle de rotation à l'extrémité de pointe d'une tige.　L'invention concerne un dispositif médical allongé (1) comportant : une tige allongée (2) qui est insérée dans un organisme vivant ; et une partie de changement de vitesse de rotation (4) qui transmet la rotation du côté main de la tige (2), la partie de changement de vitesse de rotation (4) comportant une partie de préhension (20) maintenue de manière à ne pas être entraînée en rotation et une partie d'actionnement (37) actionnée en rotation par rapport à la partie de préhension (20), et modifiant la vitesse de la rotation depuis la partie d'actionnement (37) et transmettant la rotation à la tige (2).
PCT/JP2020/036765 2019-09-30 2020-09-29 Dispositif médical allongé Ceased WO2021065848A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2021551278A JPWO2021065848A1 (fr) 2019-09-30 2020-09-29

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2019179473 2019-09-30
JP2019-179473 2019-09-30

Publications (1)

Publication Number Publication Date
WO2021065848A1 true WO2021065848A1 (fr) 2021-04-08

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PCT/JP2020/036765 Ceased WO2021065848A1 (fr) 2019-09-30 2020-09-29 Dispositif médical allongé

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113769236A (zh) * 2021-07-30 2021-12-10 青岛大学附属医院 一种用于急诊护理的介入导管辅助装置

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH06511180A (ja) * 1992-03-18 1994-12-15 ザ・スペクトラネティックス・コーポレーション 可撓先端付きカテーテル用回転制限器
JP2002523174A (ja) * 1998-09-01 2002-07-30 オルムコ コーポレイション 変速伝動装置を有する回転式医用および／または歯科用器械
JP2002355261A (ja) * 2001-05-31 2002-12-10 Morita Mfg Co Ltd 医療用アーム支持装置
US20160279423A1 (en) * 2015-03-27 2016-09-29 Medtronic, Inc. Medical device delivery system

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH06511180A (ja) * 1992-03-18 1994-12-15 ザ・スペクトラネティックス・コーポレーション 可撓先端付きカテーテル用回転制限器
JP2002523174A (ja) * 1998-09-01 2002-07-30 オルムコ コーポレイション 変速伝動装置を有する回転式医用および／または歯科用器械
JP2002355261A (ja) * 2001-05-31 2002-12-10 Morita Mfg Co Ltd 医療用アーム支持装置
US20160279423A1 (en) * 2015-03-27 2016-09-29 Medtronic, Inc. Medical device delivery system

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113769236A (zh) * 2021-07-30 2021-12-10 青岛大学附属医院 一种用于急诊护理的介入导管辅助装置

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