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WO2022054950A1 - Gaine médicale et cathéter - Google Patents

Gaine médicale et cathéter Download PDF

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Publication number
WO2022054950A1
WO2022054950A1 PCT/JP2021/033584 JP2021033584W WO2022054950A1 WO 2022054950 A1 WO2022054950 A1 WO 2022054950A1 JP 2021033584 W JP2021033584 W JP 2021033584W WO 2022054950 A1 WO2022054950 A1 WO 2022054950A1
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WO
WIPO (PCT)
Prior art keywords
joint
rotation
circumferential position
medical sheath
members
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/JP2021/033584
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English (en)
Japanese (ja)
Inventor
辰也 嶋
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.)
Zeon Corp
Original Assignee
Zeon 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 Zeon Corp filed Critical Zeon Corp
Priority to JP2022548378A priority Critical patent/JP7563464B2/ja
Publication of WO2022054950A1 publication Critical patent/WO2022054950A1/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
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices

Definitions

  • the present invention relates to a medical sheath and a catheter, and more particularly to a medical sheath in which a plurality of tubes are connected by a joint and a catheter provided therein.
  • the medical sheath used for the catheter is required to have sufficient mechanical properties that can correspond to various curved shapes and bifurcated shapes of the lumen in the patient's body.
  • it is required to deflect the distal end (tip) at the branch of the lumen of the body in a specific branch direction. In many cases.
  • two operating wires passing through the catheter are provided radially apart from the distal end to the proximal end side, and a tensile load is applied to one of the wires.
  • the distal end portion can be deflected in response to an operation input from the proximal end side by a deflection operation in which the above is applied (see, for example, Patent Document 1).
  • a tip rotating portion having a contrasting lumen capable of discharging a contrast medium is attached to the distal end of the catheter body so as to be rotatable around the axis, and the tip rotating portion is provided in the distal end of the catheter body.
  • a tip rotation catheter that is rotationally driven around the axis by a motor is also known (see, for example, Patent Document 2).
  • the annular connecting member attached to the distal end of the catheter body supports the tip portion that can be deflected by the torsional contraction of the internal wire, and the internal wire of the tip portion passes through the catheter body and the connecting member. It is also known that the twisting rotation operation is performed via forceps (see, for example, Patent Document 3).
  • the present invention has been made to solve the above-mentioned conventional unsolved problems, and it is easy to mount a plurality of functional parts including an axial rotation function on a distal end portion, and moreover, a plurality of functional parts are provided. It is an object of the present invention to provide a compact medical sheath and a catheter having excellent operability in which the wires necessary for the operation of the functional part of the above can be easily arranged inside.
  • the medical sheath according to the present invention has a first tube and a second tube adjacent to each other in the direction of the axis, and a hollow joint connecting the first tube and the second tube.
  • first and second joint members While fixed and held in the first circumferential position with respect to one of the members, it is movably engaged with the other joint member of the first and second joint members in the second circumferential position. Then, the first and second joint members can be relatively rotated so that the first circumferential position and the second circumferential position are relatively displaced toward one side in the increasing / decreasing direction of the relative helix angle.
  • a second rotation that is interposed between the rotation operating member and the first and second joint members and can relatively displace the first and second joint members to the other side in the increasing / decreasing direction of the relative helix angle.
  • the operating member is attached to it.
  • the first rotation operating member that is fixedly held in the first circumferential position of one joint member of the joint and movably engages with the second circumferential position of the other joint member.
  • Both joint members can be relatively rotated so as to relatively displace the first and second circumferential positions to one side in the increasing / decreasing direction of the relative helix angle, and are interposed between the first and second joint members.
  • the second rotation operation member both joint members can be relatively rotated so as to be relatively displaced toward the other side in the increasing / decreasing direction of the relative helix angle. Therefore, depending on the operation of the first and second rotation operation members, the first and second joint members can be rotated by a required rotation angle in an arbitrary relative rotation direction.
  • first rotation operation member and the second rotation operation member can be arranged in the substantially tubular space surrounding the hollow inner cylinder portion of the hollow joint, the wires necessary for the operation of the other functional portions can be arranged. It can be easily placed at the axial center of the medical sheath. Therefore, the sheath is compact and has excellent operability.
  • At least one of the first rotation operating member and the second rotation operating member is fixedly held at the first circumferential position with respect to the one joint member.
  • the other joint member is movably engaged with the second circumferential position in the direction of the axis, and the first circumferential position and the second circumferential position are twisted relative to each other.
  • It can be configured to be composed of a flexible wire rod that can be pulled and operated in the axial direction so as to be angularly displaced in the increasing / decreasing direction of the angle. In this case, it becomes a more compact medical sheath.
  • the first rotation operation member and the second rotation operation member are each composed of the flexible wire rod, and the first rotation operation member is formed. Any one of the operating member and the second rotation operating member is pulled in the axial direction, and the first and second joint members are placed in the first circumferential position and the second circumferential position.
  • the relative rotation is performed so as to angularly displace the relative twist angle in the increasing / decreasing direction
  • the other one of the first rotation operating member and the second rotation operating member is with respect to the first and second joint members. It can also be configured to be wound in a spiral shape. In this case, the medical sheath is lighter, more compact, and has excellent operability.
  • the first rotation operating member and the second rotation operating member are fixedly held at different positions in the circumferential direction with respect to the one joint member at predetermined angular intervals. It may be configured as such. In this case, mutual interference during the operation of the first rotation operation member and the second rotation operation member can be effectively suppressed.
  • first rotation operating member and the second rotation operating member are fixedly held at the same position in the circumferential direction with respect to the one joint member, and the other.
  • the joint member may be engaged with the joint member at different positions in the circumferential direction so as to be movable in the axial direction at a predetermined angular interval. Even in this way, mutual interference during the operation of the first rotation operation member and the second rotation operation member can be effectively suppressed.
  • the first rotation operating member is made of the flexible wire rod, and the first rotation operating member is pulled in the axial direction to obtain the above.
  • the first and second joint members rotate relative to each other so that the first circumferential position and the second circumferential position are angularly displaced to one side in the increasing / decreasing direction of the relative twist angle, the second rotation operation is performed.
  • the member is elastically deformed and the second rotation operation member is elastically recovered, the relative twist angles of the first and second joint members in the first circumferential position and the second circumferential position are increased or decreased.
  • the first rotation operating member can be configured to be spirally wound around the first and second joint members while rotating relative to the other side in the direction.
  • the first circumferential position of the one joint member and the second circumferential position of the other joint member sandwich the substantially tubular space. It is preferable that they are separated in the direction of the axis. By doing so, the first and second joint members can be accurately and relatively rotated via the first and second rotation operation members in the substantially cylindrical space according to the operation input.
  • the hollow joint further includes a cylindrical guide member that guides the first and second joint members coaxially and relatively axially rotatable. It may be the one that exists.
  • the hollow joint is interposed between the first and second joint members in the direction of the axis, and the axial direction of the first and second joint members. It may further have a tubular abutting member that limits the relative position.
  • the catheter according to the present invention is a catheter provided with a medical sheath having any of the above configurations, and has the first tube, the second tube, and the hollow joint in the main lumen.
  • a main operating member that extends from the proximal end side to the distal end side and deflects the tube on the distal end side is provided. Therefore, the main operating member or the like that deflects the tube member on the distal end side can be easily arranged at the axial center of the medical sheath, and the medical sheath is compact and has excellent operability.
  • the catheter according to the present invention is, or a catheter provided with a medical sheath having any of the above configurations, in which the first tube, the second tube, and the hollow are hollow in the main lumen. It penetrates the joint and extends from the proximal end side to the distal end side, and is provided with a main wire that allows fluid, electricity, or signals to pass through. Therefore, the fluid, electrical or signal main wire required for the operation of other functional parts on the distal end side can be easily placed at the axial center of the medical sheath, and the medical sheath is compact and has excellent operability. Will be.
  • the present invention it is easy to mount a plurality of functional parts including an axial rotation function on the distal end portion, and moreover, it is a compact operation that can easily arrange wires necessary for the operation of the plurality of functional parts. It is possible to provide a medical sheath and a catheter having excellent properties.
  • FIG. 1A It is a schematic front view of the medical sheath which concerns on 1st Embodiment of this invention. It is a schematic front sectional view of the medical sheath shown in FIG. 1A. It is a schematic front sectional view of the main part on the distal end side of the catheter provided with the medical sheath which concerns on 1st Embodiment of this invention. It is a partially enlarged front sectional view of the main part of the catheter provided with the medical sheath which concerns on 1st Embodiment of this invention. It is a partially enlarged front sectional view which shows the operation state which rotates the tip rotation part of the distal end side of the catheter provided with the medical sheath which concerns on 1st Embodiment of this invention in one side in the rotation direction.
  • FIG. 4 is a partially enlarged front sectional view showing an operating state in which the tip rotating portion of the catheter shown in FIG. 4A is rotated to the other side in the rotation direction.
  • FIG. 4 is a partially enlarged front sectional view showing a state in which the tip rotating portion of the catheter shown in FIG. 4A is in the intermediate position in the rotation direction during operation. It is a schematic explanatory drawing of the main part of the tip rotation mechanism in the catheter provided with the medical sheath which concerns on 2nd Embodiment of this invention, and the pair of linear rotation operation members has a predetermined angle with respect to a hollow joint.
  • FIG. 5A is a schematic explanatory view showing a second operation state of a plurality of rotation operation members in the tip rotation mechanism of the catheter shown in FIG. 5A, in which a pair of linear second rotation operation members are the first and second joint members. It shows a state in which a pair of linear first rotation operating members are spirally wound in a left-handed screw direction at a predetermined angular interval with respect to a hollow joint having the above, and each of them is pulled in a straight state.
  • FIG. 6A shows the neutral state of a plurality of rotation operation members in the tip rotation mechanism of the catheter provided with the medical sheath which concerns on 3rd Embodiment of this invention, with respect to the hollow joint which has the 1st and 2nd joint members.
  • a linear first and second rotation operating members spirally wound in opposite directions and a linear third rotation operating member linearly arranged in the middle thereof are shown.
  • FIG. 6A It is a schematic perspective view of the medical sheath which concerns on 3rd Embodiment of this invention. It is a schematic perspective sectional view of the medical sheath shown in FIG. 7A. It is a partially enlarged front sectional view of the medical sheath which concerns on 4th Embodiment of this invention.
  • FIG. 8 is a partially enlarged front sectional view of a main part of the medical sheath shown in FIG. 8A. It is a partially enlarged front sectional view of the medical sheath which concerns on 5th Embodiment of this invention.
  • FIG. 9 is a partially enlarged perspective sectional view of a main part of the medical sheath shown in FIG. 9A. It is a partially enlarged perspective sectional view of the medical sheath which concerns on 6th Embodiment of this invention. It is a partially enlarged front sectional view which shows the 1st operation state of the tip rotation mechanism in the medical sheath which concerns on 7th Embodiment of this invention. It is a partially enlarged front sectional view which shows the 2nd operation state of the tip rotation mechanism in the medical sheath which concerns on 7th Embodiment of this invention. It is a partially enlarged perspective sectional view which shows the return state of the tip rotation mechanism in the medical sheath which concerns on 8th Embodiment of this invention.
  • (First Embodiment) 1A, 1B to 4 show a medical sheath and catheter according to the first embodiment of the present invention. First, the configuration will be described.
  • the medical sheath 10 of the present embodiment is used for the catheter 1, and has a tubular catheter body 11 (first tube) and a catheter body. It has a tubular tip rotating portion 12 (second tube) attached to the distal end 11a of 11 and a hollow rotating joint 13 interposed between the catheter body 11 and the tip rotating portion 12. ing.
  • the medical sheath 10 has at least one lumen, eg, a shaft, rotatably connected to the catheter body 11 and the tip rotating portion 12 via a hollow rotary joint 13.
  • a plurality of lumens are formed, including a main lumen 14 near the heart and other lumens parallel to it (not shown).
  • the hollow rotary joint 13 rotates the tip rotation portion 12 on the distal end side with respect to the catheter body 11 on the proximal end side of the catheter 1 by relatively rotating the first and second joint members 31 and 32. It constitutes a part of the tip rotation mechanism 40 that can be made to rotate.
  • the tip rotation mechanism 40 has a first rotation structure, for example, each of which is composed of a flexible wire rod (including a string-shaped or ply-shaped operating wire) as a plurality of rotation operating members. It has an operation member 41 and a second rotation operation member 42.
  • the first and second rotation operating members 41 and 42 may be slidably housed in a narrow operation line lumen parallel to the main lumen 14 of the catheter body 11.
  • flexible wire rods 15a and 15b (main operating members) for driving the deflection operating mechanism 15 (tip movable mechanism) mounted on the tip rotating portion 12, for example, are inserted into the main cavity 14.
  • the deflection operation mechanism 15 rotates the tip via the pull ring 15c (which may be a contrast ring) embedded in the tip rotation portion 12.
  • the portion 12 is deflected to any one side in the separation direction of the flexible wire rods 15a and 15b.
  • a tip tip 16 having a fluid hole or a tip tip of another method is attached to the tip of the tip rotating portion 12.
  • a fluid tube or the like may be inserted into the main lumen 14.
  • the catheter body 11, the tip rotating portion 12, and the hollow rotating joint 13 penetrate and extend from the proximal end side to the distal end side of the medical sheath 10, and fluid is inside.
  • a main wire that passes electricity or a signal may be provided.
  • any of the plurality of lumens may be a fluid lumen capable of discharging a contrast medium or other fluid from a plurality of openings on the distal end portion 11a side of the catheter body 11.
  • the operation unit 17 is connected to the proximal end side of the catheter body 11. Although the details are not shown, the operation unit 17 increases the pulling force of some of the flexible wires 15a and 15b for the deflection operation by the deflection operation mechanism 15, for example. Occasionally, a first operation lever 15d (see, for example, Japanese Patent Application Laid-Open No. 2015-173822) that is rotationally operated so as to reduce the tensile force of the remaining wire rod 15b or 15a, and a plurality of linear rotation operation members 41, 42.
  • a second operation lever (not shown) that is rotated so as to decrease the tensile force of the remaining rotation operation member 42 or 41 when the tensile force of some of the rotation operation members 41 or 42 is increased, and a first operation.
  • a motion conversion mechanism is provided that converts the input of the rotation operation to each of the lever and the second operation lever into the operation force in the pulling direction of the rotation operation members for a plurality of operations.
  • the operation unit 17 may be provided with a switch for starting / stopping the device, a valve for controlling the supply or discharge of fluid, a branch tube for injecting fluid, and the like.
  • a reinforcing material layer such as a metal braided tube (not shown) having an elliptical cross-sectional shape is embedded in the flexible tube material constituting the tip rotating portion 12, and the tip rotating portion is formed.
  • the catheter body 11 and the tip rotating portion 12 of the medical sheath 10 are mainly composed of, for example, a flexible tube, for example, a fluororesin tube or the like.
  • the outer diameter of these tubes of the medical sheath 10 is, for example, 0.5 to 5 mm, and the total length is, for example, 1 to 6 m.
  • the material and structure of the catheter body 11 are not limited to the above example, and the tube is made of a polymer material such as fluororesin (PTFE, PFA, FEP, etc.), polyamide, polyamide-based elastomer, polyurethane, polyurethane-based elastomer, and the like.
  • a coil tube formed by spirally winding a metal wire such as a stainless wire, a hollow stranded wire formed by twisting a plurality of metal wires, or the like.
  • an X-ray contrast material may be mixed with the polymer material constituting the tube.
  • the catheter 1 includes a medical sheath 10 having a catheter body 11 and a tip rotating portion 12 (first tube and second tube) adjacent to each other in the axial direction, and a hollow rotating joint 13 connecting them.
  • the main lumen 14 and the like extending in the axial direction of the medical sheath 10 are formed over substantially the entire length.
  • the hollow rotary joint 13 is configured to include a first joint member 31 and a second joint member 32 that engage with each other unevenly in the axial direction, and the first joint member 31 and the second joint member 32 are configured.
  • the joint members 32 are connected to each other so as to be rotatable around an axis.
  • the first joint member 31 is provided at one end side of a large-diameter cylindrical portion 31a fitted into the distal end portion 11a of the catheter main body 11 and the large-diameter cylindrical portion 31a.
  • a connecting portion that integrally connects the outer flange 31b abutted against the distal end portion 11a of 11 and the small-diameter cylindrical portion 31c that has entered the second joint member 32 and the small-diameter cylindrical portion 31c to the large-diameter cylindrical portion 31a. It has 31d.
  • each axial through hole 31e is shown to have a cylindrical inner peripheral surface shape, but it goes without saying that the axial central portion may be constricted so as to have a small diameter. ..
  • the second joint member 32 has a large-diameter cylindrical portion 32a formed to have substantially the same diameter as the large-diameter cylindrical portion 31a of the first joint member 31 and fitted into the proximal end portion 12a of the tip rotating portion 12.
  • the small-diameter cylindrical portion 32c concentrically facing the small-diameter cylindrical portion 31c of the first joint member 31 inside the large-diameter cylindrical portion 32a and the small-diameter cylindrical portion 31c are integrally connected to the large-diameter cylindrical portion 31a. It has a connecting portion 32d.
  • the hollow rotary joint 13 of the present embodiment further has a cylindrical shape that surrounds the small-diameter cylindrical portions 31c and 32c between the connecting portions 31d and 32d of the first joint member 31 and the second joint member 32.
  • a sleeve 33 (cylindrical guide member) is provided.
  • the sleeve 33 has a thrust bearing and a coaxial guide and radial bearing function during mutual rotation with respect to the first joint member 31 and the second joint member 32. That is, the sleeve 33 has the function of a cylindrical guide member that guides the first and second joint members 31 and 32 coaxially and relatively so as to be rotatable around the axis, and the sleeve 33 is the first in the direction of the axis of the hollow rotary joint 13. It is interposed between the first and second joint members 31 and 32, and also has the function of a tubular abutting member that limits the axial relative positions of both joint members 31 and 32.
  • the small-diameter cylindrical portions 31c and 32c of the first joint member 31 and the second joint member 32 constitute the hollow inner cylinder portion 13c of the hollow rotary joint 13, so as to surround the hollow inner cylinder portion 13c.
  • a substantially tubular space 34 whose both ends are defined by the connecting portions 31d and 32d is formed.
  • first joint member 31 and the second joint member 32 form a hollow inner cylinder portion 13c by the small-diameter cylindrical portions 31c and 32c that face each other while being rotatably connected around the axis, and the hollow inner cylinder portion 13c is formed.
  • a substantially tubular space 34 surrounding the inner cylinder portion 13c is formed.
  • the first rotary operation member 41 and the second rotary operation member 42 passing through the substantially tubular space 34 are provided with respect to the second joint member 32 which is one of the joint members. It is fixedly held and mounted so as to be movably engaged with the first joint member 31, which is the other joint member, in the axial through hole 31e.
  • the distal end of the first rotation operating member 41 corresponds to any one of the plurality of operating member mounting holes 32e of the second joint member 32, which is any one joint member. It is fixedly held at a position, for example, a first circumferential position P1 on a specific cross section shown in FIG. 4C. Further, the first rotation operation member 41 is located at a position corresponding to any one of the plurality of axial through holes 31e with respect to the first joint member 31 which is the other joint member, for example, each of FIGS. 4A to 4C. It is movably engaged (movable state with limitation of circumferential movement) in the axial through hole 31e at the second circumferential position P2 on the specific cross section shown in the figure.
  • the operation member mounting hole 32e corresponding to the first circumferential position P1 and the axial through hole 31e corresponding to the second circumferential position P2 are the axes of the hollow rotary joint 13 with the substantially tubular space 34 interposed therebetween. Separated in the direction.
  • the first rotation operating member 41 moves the first circumferential position P1 and the second circumferential position P2 to one side in the increasing / decreasing direction of the relative helix angle, for example, from the state of FIG. 4C to the state of FIG. 4B.
  • the first joint member 31 and the second joint member 32 can be relatively rotated so as to be relatively displaced toward the reduction side of the separation angle of the positions P1 and P2 in both circumferential directions on one side in the rotation direction of the joint member 32 of 2. It has become like.
  • the distal end portion of the second rotation operating member 42 is 180 degrees from the first circumferential position P1 on the specific cross section shown in FIG. 4C among the plurality of operating member mounting holes 32e of the second joint member 32. It is fixedly held in the operating member mounting hole 32e located at the third circumferential position P3 away. Further, the second rotation operation member 42 is located in the fourth circumferential position P4 180 degrees away from the second circumferential position P2 with respect to the first joint member 31 which is the other joint member. It is movably engaged in the through hole 31e.
  • the second rotation operation member 41 moves the third circumferential position P3 and the fourth circumferential position P4 to the other side in the increasing / decreasing direction of the relative helix angle, for example, from the state of FIG. 4C to the state of FIG. 4A.
  • the first joint member 31 and the second joint member 32 can be relatively rotated so as to be relatively displaced toward the reduction side of the separation angle of the positions P3 and P4 in both circumferential directions on the other side of the rotation direction of the joint member 32 of 2. It has become.
  • the first joint member 31 and the second joint member 32 are moved by a pulling operation of either one.
  • the rotation operating members 41 or 42 is in a straight state due to relative rotation, the other rotation operating member 42 or 41 is spiral with respect to the hollow inner cylinder portion formed by the sleeve 33 and the small diameter cylindrical portions 31c and 32c. It is designed to be wound once.
  • the tip rotating portion 12 responds to the pulling operation of one of the rotation operating members 41 or 42 by the second rotation operating member 41. It rotates integrally with the joint member 32. Further, when the tip rotating portion 12 and the second joint member 32 are located between the rotation operation completion positions shown in FIGS. 4A and 4B, the deflection operation direction of the tip rotating portion 12 by the deflection operation mechanism 15 is the paper surface of FIG. 4C. In the vertical direction, as shown in FIG. 4C, the first rotation operation member 41 and the second rotation operation member 42 are in a state of intersecting each other in the substantially tubular space 34.
  • the first rotation operation member 41 and the second rotation operation member 42 have different winding directions with respect to the hollow rotation joint 13, and any one of them, for example, the first rotation operation
  • the first circumferential position P1 and the second circumferential position P2 are moved from the state of FIG. 4C to the state side of FIG. 4B in the rotation direction R1 of the second joint member 32.
  • the other second rotation operation member 42 is the first joint member 31 and the second joint member 32.
  • the second rotation operation member 42 is pulled to the unwinding side to move the first circumferential position P1 and the second circumferential position P2 from the state of FIG. 4C to the state side of FIG. 4A.
  • the joint member 32 is displaced relative to the reduction side of the separation angle of the circumferential positions P3 and P4 on the rotation direction R2 side, one of the first rotation operation members 41 is the first joint member 31 and the second joint.
  • any one of the first rotation operation member 41 and the second rotation operation member 42 is pulled in the axial direction, and the first joint member 31 and the second joint member 32 are in the first circumferential direction.
  • the position P1 and the second circumferential position P2 are rotated relative to each other so as to be angularly displaced in the increasing / decreasing direction of the relative twist angle, the other one of the first rotation operating member 41 and the second rotation operating member 42 is the second. It is adapted to be spirally wound around the joint member 31 of 1 and the joint member 32 of 2nd.
  • FIGS. 3 and 4A to 4C the number of turns of the other rotation operation member 42 or 41 wound around the hollow inner cylinder portion of the rotation joint 13 by the pulling operation of one rotation operation member 41 or 42 to the straight state is shown.
  • the number of turns or the winding angle is arbitrary, and for example, half-turn or two-turn winding may be performed.
  • At least one of the first rotation operating member 41 and the second rotation operating member 42 have different angular positions in the relative twisting direction as shown in FIG. 4C.
  • Flexible wire rods that can be pulled along their respective axes so that P1 and the second circumferential position P2 are closer to the reduced side of the relative twist angle in a particular tip rotation walk R1 or R2, such as polyamide, fluorine. It is composed of a resin, a resin such as polyethylene, and a twisted yarn of a metal such as stainless steel.
  • the first and second rotation operating members 41 and 42 have predetermined angles at different positions in the axial rotation direction with respect to one of the first and second joint members 31 and 32.
  • the first and second rotation operation members 41 and 42 are hollowly rotated. Since it takes the posture of the intermediate position twisted in opposite directions with respect to the joint 13, the deflection operation according to the operation amount of the first and second rotation operation members 41 and 42 from the rotation neutral position of the tip rotation portion 12. The amount and deflection operation direction can be set accurately.
  • the first rotation operation member 41 and the second rotation operation member 42 are fixedly held at the same position Pc in the axial rotation direction with respect to one joint member 32, and the axial rotation direction with respect to the other joint member 31. It may be configured to be engaged so as to be movable in the axial direction at different positions of the above with a predetermined angular interval. For example, as shown by a virtual line in FIG. 4C, the angular distance between the first rotation operating member 41 and the second rotation operating member 42 at the engaging position with the first joint member 31 is 180 °, and the engaging position thereof.
  • the first rotation operation member 41 and the second rotation operation member Reference numeral 42 is not a substantially X-shaped intersecting state as shown by a solid line in FIG. 4C in the substantially tubular space 34, but a substantially V-shaped shape that opens to the left by a virtual line in the same figure.
  • the twist angle to the position Pc that engages with the second joint member 32 is 270 ° in opposite directions, the inclination becomes steeper than the substantially X-shaped crossing state as shown by the solid line in FIG. 4C. ..
  • the first rotation operation member 41 is made of a flexible wire rod, and the first rotation operation member 41 is pulled in the axial direction to operate the first joint member 31 and the second joint member 31 and the second.
  • the second rotation operating member 42 is hollow. It is configured to spirally wind around the hollow inner cylinder portion 13c of the rotary joint 13 to enable a pulling operation in the opposite direction.
  • the second rotary operation member 42 is a member that can be elastically deformed. The second rotation operating member 42 may be configured to store elastic energy when the first rotation operating member 41 is pulled in the axial direction.
  • the first joint member 31 and the second joint member 32 rotate around the first circumferential position P1 and the second circumferential position P2 in the axial rotation direction.
  • the first rotation operating member 41 is spirally wound around the first joint member 31 and the second joint member 32 while rotating relative to each other so as to be separated from each other (relative twisting direction).
  • the second rotation operation member 42 is a band having a tension spring or rubber elasticity, and a first joint, which are stretched between the connecting portions 31d and 32d of the first joint member 31 and the second joint member 32. It can be composed of a torsion torque spring or the like interposed between the small diameter cylindrical portions 31c and 32c of the member 31 and the second joint member 32.
  • the other joint is fixedly held at the first circumferential position P1 of one joint member 32 of the hollow rotary joint 13.
  • the first rotation operation member 41 movably engaged with the second circumferential position P2 of the member 31 causes the first and second circumferential positions P1 and P2 to be relatively displaced to one side in the increasing / decreasing direction of the relative twist angle.
  • Both joint members 31 and 32 can be relatively rotated, and both joint members 31 and 32 are placed on the other side in the increasing / decreasing direction of the relative twist angle by the second rotation operating member 42 interposed between the both joint members 31 and 32.
  • Both joint members 31 and 32 can be relatively rotated so as to be relatively displaced.
  • the first and second joint members 31 and 32 can be rotated by the required rotation angle in any relative rotation direction. Moreover, since the deflection operation direction of the tip rotation portion 12 by the deflection operation mechanism 15 is set to the vicinity of the intermediate rotation position, the tip rotation portion 12 can be repeatedly rotated around the axis within a predetermined angle range on both sides of the rotation direction. For example, it is possible to sufficiently improve the insertability even in a high-level intubation operation such as selective bile duct insertion.
  • first rotation operation member 41 and the second rotation operation member 42 can be arranged in the substantially tubular space 34 surrounding the hollow inner cylinder portion 13c of the hollow rotation joint 13, the deflection operation mechanism 15 and the like can be used. Wires necessary for the operation of other functional parts can be easily arranged at the axial center of the medical sheath 10. Therefore, it is possible to embody a catheter 1 in which a tip movable mechanism such as a deflection operation mechanism 15 and a tip rotation mechanism that relatively rotates the first and second joint members 31 and 32 are compactly combined. Therefore, the catheter 1 is provided with the medical sheath 10 which is compact and has excellent operability.
  • the medical sheath 10 is more compact.
  • the first rotation operation member 41 and the second rotation operation member 42 are each composed of a flexible wire rod, and the first rotation operation member 41 and the second rotation operation are performed. Any one of the members 42 is pulled in the axial direction, and the first and second joint members 31 and 32 reduce the relative twist angles of the first circumferential position P1 and the second circumferential position P2.
  • the other one of the first rotation operation member 41 and the second rotation operation member 42 is spirally wound around the hollow inner cylinder portion 13c of the rotation joint 13. Therefore, it is possible to realize a medical sheath having excellent operability, which can switch the rotation operation direction alternately, in a lighter weight and more compactly.
  • first rotation operation member 41 and the second rotation operation member 42 are located at different positions in the axial rotation direction with respect to the second joint member 32 on the distal end side of the distal end. It is fixedly held at a predetermined angular interval (for example, 180 °). Therefore, mutual interference during the operation of the first rotation operation member 41 and the second rotation operation member 42 can be effectively suppressed.
  • the fixed holding positions on the distal end sides of the first rotation operating member 41 and the second rotation operating member 42 are set to predetermined angular intervals, but they do not necessarily have to be different fixed holding positions.
  • the first rotation operation member 41 and the second rotation operation member 42 are located at the same position in the axial rotation direction with respect to the second joint member 32 on the distal end side, for example, the first circumferential position P1 and the second. Is fixedly held at the intermediate position of the circumferential position P2, and is engaged with the first joint member 31 on the near end side so as to be movable in the axial direction at different positions in the axial rotation direction at predetermined angular intervals. It may be configured. Even in this way, mutual interference during the operation of the first rotation operation member 41 and the second rotation operation member 42 can be effectively suppressed.
  • the second rotation operation member 42 when the first rotation operation member 41 made of the flexible wire is pulled in the axial direction, the second rotation operation member 42 is attached to the hollow inner cylinder portion 13c of the rotation joint 13. On the other hand, by winding it in a spiral shape, the tip can be rotated in the opposite direction.
  • the first rotation operation member 41 made of the flexible wire is pulled in the axial direction, and the first and second joint members 31, 32 are placed in the first circumferential positions P1 and the second circumference.
  • the first and second joint members 31, 32 rotates relative to each other so as to increase the relative twist angle of the first circumferential position P1 and the second circumferential position P2, and the first rotation operating member 41 is the first and second joint members 31, 32, etc.
  • the rotary joint 13 may be spirally wound around the hollow inner cylinder portion 13c.
  • first circumferential position P1 on the distal end side and the second circumferential position P2 on the proximal end side are separated in the axial direction of the rotary joint 13 with the substantially tubular space 34 interposed therebetween. good.
  • both rotation operation members 41 and 42 in the substantially tubular space 34 can be reliably changed in shape in response to the pull operation input to the first rotation operation member 41 and the second rotation operation member 42.
  • the first and second joint members 31, 32 can be accurately rotated relative to each other.
  • the medical sheath 10 constituting the main part of the catheter 1 penetrates the main lumen 14 and extends from the proximal end side to the distal end side, and the tube member on the distal end side. Since the main operating members 15a and 15b for deflecting the tip rotating portion 12 are provided, the main operating members 15a and 15b for deflecting the tip rotating portion 12 can be easily attached to the axial center portion of the medical sheath 10. It can be arranged, is compact and has excellent operability.
  • the medical sheath 10 constituting the main part of the catheter 1 penetrates the main lumen 14 and extends from the proximal end side to the distal end side, and is fluid or electric or electric or electric inside.
  • a main wire for passing signals may be provided, and in that case, a fluid or electric or main wire for signals necessary for the operation of other functional parts on the distal end side can be easily provided in the axial center.
  • the medical sheath 10 is compact and has excellent operability.
  • FIGS. 5A and 5B are schematic explanatory views of a main part of the tip rotation mechanism in the catheter provided with the medical sheath according to the second embodiment of the present invention.
  • the configuration and operation of the present embodiment and the following third embodiment other than the main parts of the tip rotation mechanism are the same as those of the above-mentioned first embodiment, they are referred to as the first embodiment in the following description.
  • the differences from the first embodiment will be mainly described while using the reference numerals of the corresponding components in FIGS. 1 to 4. However, as shown by virtual lines in FIGS.
  • the hollow rotary joint 13 in the present embodiment has a small diameter as a relative rotatable coupling structure of the first joint member 31 and the second joint member 32.
  • the small diameter cylindrical portions 31c and 32c are provided with annular inner protrusions 31p and 32p that are axially separated from each other on the inner peripheral surface side and have a small diameter.
  • the first and second inner sleeves 37 (cylindrical guide member, tubular abutting member) slidably fitted to the cylindrical portions 31c and 32c are abutted and engaged with both annular inner protrusions 31p and 32p.
  • the joint members 31 and 32 of the above are provided with a thrust bearing and a coaxial guide and a radial bearing function at the time of mutual rotation.
  • the hollow inner cylinder portion of the rotary joint 13 in which the pair of linear second rotation operation members 52a and 52b are hollow is spirally wound around the 13c in the right-handed screw direction at a predetermined angular interval (for example, 90 °), and is mounted on the hollow rotary joint 13 in the opposite phase to the second rotary operation members 52a and 52b, respectively. It is possible to take the first operation state in which the pair of linear first rotation operation members 51a and 51b are pulled and operated in a straight state, respectively.
  • a pair of linear first rotation operating members 51a, 51b is spirally wound in the left-handed screw direction around a hollow rotary joint 13 having first and second joint members 31, 32 at a predetermined angular interval, and is a pair of linear second rotary operation members.
  • 52a and 52b can be pulled and operated in a straight state, respectively.
  • the first rotation operating members 51a and 51b that are movably engaged with the directional positions P2 and P2'to the straight state shown in FIG. 5A the first circumferential position as shown in FIG. 5B.
  • Both joint members so as to reduce the relative helix angle between P1, P1'and the second circumferential positions P2, P2'to the state of the helix angle 0 ° shown in FIG. 5A (relatively displaced to one side in the increasing / decreasing direction). 31 and 32 can be rotated relative to each other.
  • the first and second joint members are operated according to the operations of the first rotation operating members 51a and 51b and the second rotation operating members 52a and 52b.
  • 31 and 32 can be rotated by a required rotation angle in any relative rotation direction.
  • the tip rotating portion 12 can be repeatedly rotated around the axis by a required angle within a predetermined angle range on both sides of the rotation direction with the deflection operating direction of the tip rotating portion 12 by the deflection operating mechanism 15 as the vicinity of the intermediate rotation position. Therefore, it is possible to sufficiently improve the insertability even in a high-level infusion operation such as selective bile duct insertion.
  • first rotation operation members 51a and 51b and the second rotation operation members 52a and 52b can be arranged in the substantially tubular space 34 surrounding the hollow inner cylinder portion 13c of the hollow rotation joint 13, the deflection operation can be performed. Wires necessary for the operation of other functional parts such as the mechanism 15 can be easily arranged at the axial center portion of the medical sheath 10. Therefore, it is possible to embody a catheter 1 in which a tip movable mechanism such as a deflection operation mechanism 15 and a tip rotation mechanism 50 that relatively rotates the first and second joint members 31 and 32 are compactly combined. Therefore, the catheter 1 is provided with the medical sheath 10 which is compact and has excellent operability.
  • FIGS. 6A to 6C are schematic explanatory views of a main part of the tip rotation mechanism in the catheter provided with the medical sheath according to the third embodiment of the present invention.
  • the tip rotation mechanism 60 for relatively rotating the first and second joint members 31 and 32 is in a neutral state as shown in FIG. 6A, and FIGS. 6B and 6C. It is possible to take the rotation operation state in the clockwise direction and the counterclockwise direction as shown in.
  • the tip rotation portion 12 takes an initial rotation position with respect to the catheter body 11, and generally takes a posture corresponding only to the deflection operation by the deflection operation mechanism 15.
  • the linear first rotation operation member 61 and the second rotation operation member 62 form the first and second joint members 31, 32.
  • the hollow inner cylinder portion 13c of the hollow rotary joint 13 is spirally wound in opposite directions to each other, and the linear third rotation operation member 63 linearly arranged in the middle thereof is substantially linear. It is extending.
  • the second rotation operation member 61 is pulled.
  • the rotation operation member 63 and the third rotation operation member 63 are in a spiral winding state in the right-handed screw direction in which the number of turns (winding angle) with respect to the hollow rotary joint 13 is different from each other.
  • the number of turns of the second rotation operation member 62 is about 2 (winding angle of about 720 degrees)
  • the number of turns of the third rotation operation member 63 is about 1 (winding angle of about 360 degrees).
  • the second rotation operation member 62 of the other one of the first rotation operation member 61 and the second rotation operation member 62 is pulled until it becomes linear, the first rotation operation member 61 and the second rotation operation member 62 are pulled.
  • the rotation operation member 61 of 1 and the third rotation operation member 63 are in a spiral winding state in the left-handed screw direction in which the number of turns (winding angle) with respect to the hollow rotation joint 13 is different from each other.
  • the number of turns of the first rotation operation member 61 is about 2 (winding angle of about 720 degrees)
  • the number of turns of the third rotation operation member 63 is about 1 (winding angle of about 360 degrees).
  • the first rotation operation member 61, the second rotation operation member 62, and the third rotation operation member 63 can be operated according to the operation of the first rotation operation member 61.
  • the first and second joint members 31, 32 can be rotated by a required rotation angle in any relative rotation direction.
  • the tip rotating portion 12 can be repeatedly rotated around the axis by a required angle within a predetermined angle range on both sides of the rotation direction with the deflection operating direction of the tip rotating portion 12 by the deflection operating mechanism 15 as the vicinity of the intermediate rotation position. Therefore, it is possible to sufficiently improve the insertability of the catheter 1.
  • first rotation operation member 61, the second rotation operation member 62, and the third rotation operation member 63 can be arranged in the substantially tubular space 34 surrounding the hollow inner cylinder portion 13c of the hollow rotation joint 13. Therefore, the wires necessary for the operation of other functional parts such as the deflection operation mechanism 15 can be easily arranged at the axial center portion of the medical sheath 10. Therefore, it is possible to embody a catheter 1 in which a tip movable mechanism such as a deflection operation mechanism 15 and a tip rotation mechanism 60 that relatively rotates the first and second joint members 31 and 32 are compactly combined. Therefore, the catheter 1 is provided with the medical sheath 10 which is compact and has excellent operability.
  • the first and second joint members 31 and 32 of the hollow rotary joint 13 interposed between the catheter body 11 and the tip rotating portion 12 are relatively rotated.
  • a tip rotation mechanism 70 is provided.
  • first and second joint members 31 and 32 of the hollow rotary joint 13 in the present embodiment are from the first outer flanges 31f and 32f having small diameters on the end face side facing each other and the first outer flanges 31f and 32f. It has second outer flanges 31g and 32g that are axially separated and abutted and engaged with the distal end 11a of the catheter body 11 and the proximal end 12a of the tip rotating portion 12. Further, the outer diameters of the second outer flanges 31g and 32g substantially match the outer diameters of the catheter main body 11 and the tip rotating portion 12, and are larger than the first outer flanges 31f and 32f.
  • first and second joint members 31 and 32 have an inner protrusion ring 35 located between the second outer flanges 31g and 32g so as to surround the first outer flanges 31f and 32f, and an inner protrusion ring 35. Is assembled with an elastic band 36 that tightens in the radial direction.
  • the inner protrusion ring 35 is made of a synthetic resin component having elasticity or partial elasticity sufficient for assembly, and is fitted between the first outer flange 31f and the second outer flange 31g of the first joint member 31. Elasticity by having an annular inner convex portion 35a on one end side and an annular inner convex portion 35b on the other end side fitted between the first outer flange 32f and the second outer flange 32g of the second joint member 32.
  • the first joint member 31 and the second joint member 32 are configured to exert a function of coupling and guiding the first joint member 31 and the second joint member 32 coaxially and mutually rotatably with respect to a pulling operation force or an external force. .. That is, the inner collision ring 35 and the elastic band 36 have the functions of the above-mentioned tubular guide member and the tubular abutting member.
  • the first joint member 31 has a long small-diameter cylindrical portion 31c extending to the distal end of the second joint member 32, while the second one.
  • the joint member 32 of 2 is not provided with a small diameter cylinder portion.
  • the sleeve 33 surrounding the hollow inner cylinder portion 13c of the rotary joint 13 is provided.
  • the first and second joint members 31 and 32 can be fixed to the catheter body 11 and the tip rotating portion 12 by suppressing slippage or by adhesion or welding.
  • the first and second joint members 31, 32 depending on the operation of the first rotation operation member 41 and the second rotation operation member 42. Can be rotated by the required rotation angle in any relative rotation direction.
  • the tip rotating portion 12 can be repeatedly rotated around the axis by a required angle within a predetermined angle range on both sides of the rotation direction with the deflection operating direction of the tip rotating portion 12 by the deflection operating mechanism 15 as the vicinity of the intermediate rotation position. Therefore, it is possible to sufficiently improve the insertability of the catheter 1.
  • first rotation operation member 41 and the second rotation operation member 42 can be arranged in the substantially tubular space 34 surrounding the hollow inner cylinder portion 13c of the hollow rotation joint 13, the deflection operation mechanism 15 and the like can be arranged. Wires necessary for the operation of other functional parts can be easily arranged at the axial center portion of the medical sheath 10. Therefore, it is possible to embody a catheter 1 in which a tip movable mechanism such as a deflection operation mechanism 15 and a tip rotation mechanism 70 that relatively rotates the first and second joint members 31 and 32 are compactly combined. Therefore, the catheter 1 is provided with the medical sheath 10 which is compact and has excellent operability.
  • (Fifth Embodiment) 9A and 9B show key parts of the distal end rotation mechanism in a catheter with a medical sheath according to a fifth embodiment of the present invention.
  • the first and second joint members 31 and 32 of the hollow rotary joint 13 interposed between the catheter body 11 and the tip rotating portion 12 are relatively rotated.
  • the tip rotation mechanism 80 is provided.
  • the internal collision ring 35 pulls the first joint member 31 and the second joint member 32 and rotates coaxially and mutually with respect to the operating force and the external force. It can exert the function of binding and guiding as much as possible.
  • the tip rotation mechanism 80 has a configuration in which the sleeve 33 is removed from the tip rotation mechanism 70 of the fourth embodiment, but the small-diameter cylindrical portion 31c of the first joint member 31 is integrated with the large-diameter cylindrical portion 31a.
  • a plurality of axial through holes 31e penetrating in the axial direction are formed at equal angular intervals in the connecting portion 31d to be connected.
  • an annular connecting portion 32d rotatably fitted to the outer peripheral portion of the tip of the long small-diameter cylindrical portion 31c of the first joint member 31 is provided. It is provided integrally.
  • FIG. 10 shows the main part of the tip rotation mechanism on the distal end side in the catheter provided with the medical sheath according to the sixth embodiment of the present invention.
  • the first and second joint members 31 and 32 of the hollow rotary joint 13 interposed between the catheter body 11 and the tip rotating portion 12 are relatively rotated.
  • a tip rotation mechanism 90 is provided.
  • the first outer flanges 31f and 32f of the first joint member 31 and the second joint member 32 face each other in the axial direction with a predetermined area, and the first rotation operation member 41 and It is possible to slide and contact in the relative rotation direction with respect to the tensile operation force and the external force applied to the second rotation operation member 42. Also.
  • the internal protrusion ring 35 can exert a function of coupling and guiding the first joint member 31 and the second joint member 32 coaxially and mutually rotatable with respect to the operating force and the external force in the pulling direction thereof. be.
  • the tip rotation mechanism 90 has a configuration in which the second outer flanges 31 g and 32 g of the first joint member 31 and the second joint member 32 are removed from the tip rotation mechanism 80 of the fifth embodiment.
  • another functional portion 18 (not shown in detail) having a main wire rod 18a extending through the main lumen portion 14 from the proximal end side to the distal end side of the catheter 1 is provided.
  • a fluid, electricity, or signal is passed through the inside of the main wire 18a.
  • Other configurations are the same as those in the fifth embodiment.
  • the tip rotating mechanism 90 and the other functional portion 18 are mounted on the tip rotating portion 12, the main wire 18a for fluid, electricity, or signal necessary for the operation of the other functional portion 18 is provided.
  • the medical sheath 10 that can be easily arranged at the axial center of the medical sheath 10 and is compact and has excellent operability can be embodied, and the same effects as those of the above-described embodiments can be obtained.
  • (7th Embodiment) 11A and 11B show key parts of the distal end rotation mechanism in a catheter with a medical sheath according to a seventh embodiment of the present invention.
  • the hollow rotary joint 13 of the medical sheath 10 in the present embodiment is distal to the catheter body 11 on the proximal end side of the catheter 1 by relatively rotating the first and second joint members 31 and 32. It is similar to the first embodiment in that it constitutes a tip rotation mechanism 40 capable of rotating the tip rotation portion 12 on the end side.
  • the distal end portion of the first rotation operating member 41 is located at a position corresponding to any one of the plurality of operating member mounting holes 32e of the second joint member 32, which is an arbitrary one joint member, for example. It is fixedly held at a fixed position P11 on a plane orthogonal to the specific cross section shown in FIG. 11A. Further, the first rotation operation member 41 is located at a position corresponding to any one of the plurality of axial through holes 31e with respect to the first joint member 31 which is the other joint member, for example, each of FIGS. 4A to 4C. It is movably engaged (movable state with limitation of circumferential movement) in the axial through hole 31e at the second circumferential position P2 on the specific cross section shown in the figure.
  • the angle distance between the first rotation operating member 41 and the second rotation operating member 42 at the engagement positions P2 and P4 with the first joint member 31 is 180 °.
  • the relative twist angle spacing of the fixed positions P11 and P13 on the tip side engaged with the second joint member 32 is 270 °.
  • the first rotation operating member 41 is shown in FIG. 11B so as to reduce the helix angle (twist angle interval between the engagement position P2 and the fixed position P11 on the distal end side) from the twisted state shown in FIG. 11A.
  • the second joint member 32 is relative to the first joint member 31 in the direction of the arrow R1 in the figure up to 270 °. Can be rotated.
  • the second rotation operation member 42 is shown in FIG. 11A so as to reduce the helix angle (twist angle interval between the engagement position P4 and the fixed position P13 on the tip side) from the twisted state shown in FIG. 11B.
  • the second joint member 32 is oriented with respect to the first joint member 31 in the arrow R2 direction (arrow R1 direction) in the figure. Can be rotated 270 ° relative to the opposite direction of rotation).
  • the first joint member 31 and the second joint member 32 are relatively rotated by a pulling operation of either one of the first rotation operation member 41 and the second rotation operation member 42, and one rotation operation member 41 is used.
  • the point that the other rotation operation member 42 or 41 is spirally wound around the hollow inner cylinder portion 13c of the hollow rotation joint 13 when the 42 is in the straight state, and other configurations are the first embodiments. Is similar to.
  • the rotation operation angle of the second joint member 32 with respect to the first joint member 31 is set to a set angle of 270 °, which is smaller than the 360 ° of the first embodiment.
  • the second joint member 32 can be alternately inverted (reverse rotation operation) with respect to the first joint member 31, but the set angle is within a range of a predetermined spiral inclination angle or more. It goes without saying that it can be set to an arbitrary angle within, and it becomes possible to accurately correspond to various devices mounted on the medical sheath 10.
  • (8th Embodiment) 12A and 12B show key parts of the distal end rotation mechanism in a catheter with a medical sheath according to an eighth embodiment of the invention.
  • the hollow rotary joint 13 of the medical sheath 10 in the present embodiment is distal to the catheter body 11 on the proximal end side of the catheter 1 by relatively rotating the first and second joint members 31 and 32. It is similar to the sixth embodiment in that it constitutes a tip rotation mechanism 90 capable of rotating the tip rotation portion 12 on the end side.
  • the second rotation operation member 42 is composed of a string-shaped or rod-shaped elastic member, and the first rotation operation member 41 is pulled in the axial direction as shown by a left-pointing arrow in FIG. 12B.
  • the second rotary operation member 42 elastically deforms while being spirally stretched as shown in FIG. 12B and accumulates elastic energy. ing.
  • the second rotation operation member 42 may be housed in a tension spring (may be housed in a flexible tube) spanned between the connecting portions 31d and 32d of the first joint member 31 and the second joint member 32. ), A band having rubber elasticity, a torsion torque spring interposed between the small-diameter cylindrical portions 31c and 32c of the first joint member 31 and the second joint member 32, and the like.
  • the pulling operation force on the first rotation operation member 41 is released, and the second rotation operation member 42 elastically recovers from the elastic deformation state shown in FIG. 12B to the straight state shown in FIG. 12A (only the return to the free state).
  • the elastic energy stored in the second rotation operation member 42 causes the first joint member 31 and the second joint member. 32 rotates relative to each other so as to separate the first circumferential position P1 and the second circumferential position P2 in the axial rotation direction (relative twisting direction), and the first rotation operation member 41 is separated from the first joint member.
  • the winding operation is performed spirally around the 31 and the second joint member 32.
  • FIG. 13 shows the configuration of the main part on the distal end side in the catheter provided with the medical sheath according to the ninth embodiment of the present invention.
  • the hollow rotary joint 13 of the medical sheath 10 in the present embodiment is distal to the catheter body 11 on the proximal end side of the catheter 1 by relatively rotating the first and second joint members 31 and 32. It is similar to the first embodiment in that it constitutes a tip rotation mechanism 40 capable of rotating the tip rotation portion 12 on the end side.
  • the tip rotating portion is inserted in the main lumen 14 of the catheter main body 11 instead of the flexible wires 15a and 15b for the deflection operation as in the first embodiment.
  • a main wire 15j such as a power line, a signal line, a fluid tube, etc. for a medical device 56 (for example, a camera, a sensor, a surgical energy device, etc.) mounted on the 12 is housed and inserted into a hollow rotary joint 13. There is.
  • the main wire 15j penetrates the catheter body 11, the tip rotating portion 12, and the hollow rotating joint 13 in the main lumen 14, and extends from the proximal end side to the distal end side of the medical sheath 10. It is configured to pass fluid or electricity or a signal (electrical or optical signal) inside it.
  • any one of the plurality of lumens in the catheter body 11 may be a fluid lumen capable of discharging a contrast medium or other fluid from a plurality of openings on the distal end portion 11a side of the catheter body 11.
  • Other configurations are substantially the same as those of the first embodiment.
  • the fluid, electric or signal main wire 15j or the like necessary for the operation of the medical device 56 which is another functional part on the distal end side, is easily arranged at the axial center of the medical sheath. It is possible to obtain a medical sheath 10 that is compact and has excellent operability. Moreover, since the hollow rotary joint 13 can be easily arranged at an axial position suitable for the medical device 56 mounted on the tip rotating portion 12 and the luminal environment in use, movement during a deflection operation according to the arrangement can be performed. Distance setting and stable support are possible.
  • the tip-rotating catheter 1 is exemplified as applicable to a bile duct cannula or the like, but of course, other uses such as a guiding catheter, a penetrating catheter, a stirring catheter, etc. It can also be applied to a catheter for thrombus suction. Further, the medical rotation mechanism such as the tip rotation mechanism 40 can be applied not only to the medical sheath used for the catheter but also to the medical sheath for other purposes.
  • the present invention makes it easy to mount a plurality of functional parts including an axial rotation function on the distal end side (tip side), and is necessary for the operation of the plurality of functional parts. It is possible to provide a compact medical sheath and catheter having excellent operability in which wires can be easily arranged, and the present invention relates to a medical sheath formed by connecting a plurality of tubes with a joint and the same. It is useful for all catheters provided.

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Abstract

Gaine médicale comprenant des premier et second tubes (11, 12) reliés par une articulation (13) creuse, l'articulation (13) comprenant : une paire d'éléments d'articulation (31, 32) qui forme un cylindre creux interne (13c) et un espace généralement cylindrique (34) ; un premier élément de commande de rotation (41) qui est fixé et maintenu dans une première position circonférentielle (P1) du premier élément d'articulation (32) tout en étant en prise de façon mobile dans une seconde position circonférentielle (P2) du second élément d'articulation (31) et qui est apte à faire tourner les deux éléments d'articulation (31, 32) dans l'une des directions d'augmentation/diminution d'un angle de torsion relatif entre les positions circonférentielles (P1, P2) ; et un second élément de commande de rotation (42) qui est apte à faire tourner les deux éléments d'articulation (31, 32) dans l'autre des directions d'augmentation/diminution de l'angle de torsion relatif.
PCT/JP2021/033584 2020-09-11 2021-09-13 Gaine médicale et cathéter Ceased WO2022054950A1 (fr)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007098120A (ja) * 2005-09-06 2007-04-19 Fmd:Kk 医療用処置具及びその回転操作装置並びに医療用処置装置
US20120197239A1 (en) * 2011-01-31 2012-08-02 Paul Smith Endoscopic medical device with articulating joints
JP2013252338A (ja) * 2012-06-08 2013-12-19 Terumo Corp 医療用処置部材
JP2019509135A (ja) * 2016-03-21 2019-04-04 エドワーズ ライフサイエンシーズ コーポレイションＥｄｗａｒｄｓ Ｌｉｆｅｓｃｉｅｎｃｅｓ Ｃｏｒｐｏｒａｔｉｏｎ カム制御式多方向操向可能ハンドル

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007098120A (ja) * 2005-09-06 2007-04-19 Fmd:Kk 医療用処置具及びその回転操作装置並びに医療用処置装置
US20120197239A1 (en) * 2011-01-31 2012-08-02 Paul Smith Endoscopic medical device with articulating joints
JP2013252338A (ja) * 2012-06-08 2013-12-19 Terumo Corp 医療用処置部材
JP2019509135A (ja) * 2016-03-21 2019-04-04 エドワーズ ライフサイエンシーズ コーポレイションＥｄｗａｒｄｓ Ｌｉｆｅｓｃｉｅｎｃｅｓ Ｃｏｒｐｏｒａｔｉｏｎ カム制御式多方向操向可能ハンドル

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