JP2005230132A - Medical treatment tool - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical treatment tool to be inserted into a body cavity to highly efficiently perform foreign matter removal treatment in the body cavity by capturing and recovering foreign matters within the body cavity through an endoscope and thrombus removal treatment with high quality. <P>SOLUTION: The medical treatment tool is characterized by such a structure that, in a flexible linear wire for which an operational core material 4 is freely slidably inserted into a main linear wire portion 2 of a hollow wire-stranded coil body 6 having a coating outer layer 8, both ends of the operational core material 4 are connected to a front end of the main linear wire portion 2 and a hand operation portion 5 at a rear end of the main linear wire portion 2. A diametrically expandable portion 3 composed of the hollow wire-stranded coil body in an exposed straight form is provided near the distal end of the main linear wire portion 2, and at least the diametrically expandable portion 3 is composed of the diametrically reduced hollow wire-stranded coil body 6. By the relative sliding of the operational core material 4 and the main linear wire portion 2 by the hand operation part 5, the diametrically expandable portion 3 freely forms a basket-like expanded configuration and a diametrically shrunken configuration from the basket-like expanded configuration. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a medical treatment instrument that is inserted into a body cavity and used for “intrabody foreign body removal treatment for capturing and collecting foreign bodies in the body cavity via an endoscope”, “thrombus removal treatment”, and the like.

  A medical treatment instrument used for capturing and collecting foreign matter in a body cavity has a background art disclosed in Patent Documents 1 and 2, which is a long flexible resin tube (see FIG. 8A). In addition to the provision of an “advanceable core wire operation wire 31” in the sheath 30, the tip of the sheath 30 can be deformed by advancing and retracting the operation wire 31. A structure having a molded basket portion 33 "is shown. By changing the basket portion 33 enormously or reducing its diameter, foreign matter in the body cavity is captured and collected in the basket portion 33 and taken out of the body. ing.

  In Patent Document 2 (see FIG. 8B), the tip of the operation wire 31 is inserted into the sheath 30 by the basket portion 33 composed of the basket wire 32 that has been formed into a predetermined curved shape in advance by mold forming and heat treatment. 1 has a structure in which the basket portion 33 is enlarged and reduced in diameter by pulling or pushing the latter half portion of the basket portion 33 into the sheath 30 by the advancement / retraction operation of the operation wire 31. It is used in such a way that foreign matter in the body cavity is captured and collected in a huge basket 33 and taken out of the body.

Japanese Patent Laid-Open No. 9-19439 JP 2002-253558 A

  In Patent Document 1 of the background art described above, when the pulling operation of the operation wire 31 is released, the basket portion 33 is reduced in diameter to the initial set shape, but since the trapped foreign substance in the body cavity cannot be tightened and held, the holding force is low. weak. Since the basket 33 is fixed to the resin sheath 30, the basket 33 is detached from the sheath 30, or the fixing portion becomes thick, so that it is difficult to reduce the diameter of the endoscope and the burden on the patient is increased. .

  In Patent Document 2, the operation wire 31 is pulled and the basket portion 33 is forcibly pulled into the resin sheath 30, so that the end portion of the sheath 30 is easily expanded by the reduced diameter resistance of the basket portion 33. Since the diameter of the basket portion 33 is reduced by reducing the diameter of the basket portion 33, the holding force of the captured and recovered body cavity foreign body is not stable.

  Further, since the basket portion 33 of Patent Documents 1 and 2 is formed of a collection of “simple, generally arcuate” basket wires 32 having the operation wire 31 as a string, the adjacent gap between the basket wires 32 is a resistance to collision in the body cavity. In addition, it is unavoidable that the external shape of the trapped foreign matter easily oversizes and collapses. In the above background art, it is difficult to capture and store foreign substances in the body cavity, and in addition, the captured foreign substances may fall into the body cavity, and there is a difficulty in hindering the therapeutic properties. Processed into a predetermined shape by mold processing and heat treatment, and then assembled into a basket portion 32 by applying a fixing means to the sheath 30 to make the basket portion 32 complicated and time-consuming, and forming into a beautiful shape There are difficulties in molding.

  The present invention provides a therapeutic treatment tool that solves the above-mentioned problems of the background art.

  The medical treatment tool of the present invention that solves the above technical problems is a flexible linear body in which an operation core material is slidably inserted into a main linear portion of a hollow stranded wire coil body having a coating outer layer, Both ends of the operation core are connected to the front end of the main wire portion and the hand operation portion at the rear end of the main wire portion, and the hollow stranded coil body in the form of an exposed straight near the front end of the main wire portion Comprising a hollow twisted wire coil body in which at least the expansion / contraction diameter portion is reduced in diameter, and by the relative sliding of the core material for operation by the hand operation portion and the main wire portion, The medical treatment instrument of the first invention of “a structure in which a basket-like expanded diameter deformed portion of the expanded and contracted diameter portion and a reduced diameter deformed shape from the basket-shaped expanded diameter are made freely”;

  “A flexible wire body in which an operation core material is slidably inserted in a main wire portion of a hollow stranded wire coil body, and both ends of the operation core material are connected to a front end of the main wire portion and the main wire wire. And an expansion / contraction diameter portion made of the hollow stranded wire coil body in a basket-like expansion shape in a free state in the vicinity of the distal end of the main wire portion. The medical treatment tool according to the second aspect of the present invention is characterized in that the structure allows the expansion / contraction diameter variation of the expansion / contraction diameter part by operation of the part.

  That is, the medical treatment instrument of the first invention having the above-described configuration is disclosed in Japanese Patent Application Laid-Open No. 2002-275774, etc. “A hollow twist of a flexible linear body in which a large number of coil wires are twisted on the same circumference. The main part is constituted by the operation core material inserted in the wire coil body and the flexible linear body, and the operation core material is “pulled” after being inserted into the body cavity. A feature of the present invention is that a part of the twisted coil body “the above-mentioned inflated / contracted diameter portion subjected to forced diameter reduction by swaging or the like” is expanded and elastically deformed to function as a therapeutic basket portion.

  In the medical treatment instrument of the second invention, the "basket-like expansion and contraction diameter part formed by the hollow stranded coil body in a free state" provided at the tip of the main part similar to the first invention is operated as described above. The core material can be forced to shrink in a straight shape by pushing the core material (moving forward relative to the hollow stranded wire coil body), inserted into the body cavity in the reduced diameter state, and restored and expanded in the body cavity. It is characterized by the idea of making it into a diameter state and functioning as a therapeutic basket portion.

  In the medical treatment instrument of the first and second inventions described above, from the technical intent to further improve the specific action and effect described later, the hand operating part is referred to as “screwing mechanism of female screw body and male screw body” or “ The operation core is composed of a “sliding mechanism for approaching / separating the operation piece”, the operation core is “single wire or a form in which a thin wire is twisted on the outer periphery of the thick wire”, and the twisted wire of the hollow stranded coil body is “of rigid wire and flexible wire “Combination form” is adopted.

  In addition, the expansion / contraction diameter portion is “a mode in which a coil wire missing zone is provided and a spoon shape is exhibited in the expansion diameter state and functions as a scooping portion for scavenging foreign matter in the body cavity”. “Attachment of set lock means in reduced diameter state” “Attachment of fixing means of hollow stranded wire coil bodies at both ends of expansion / contraction diameter portion” “Length of coil wire group of expansion / contraction diameter portion is set to 360 of the coil wire. ° Form that is set to be almost the same as the twist span ”“ The operation piece is a combination of a relatively slidable female operation piece and a male operation piece, and the hand operation part that connects the rear end of the main wire to the female operation piece Aspects such as “form” are adopted as necessary.

  The medical treatment instrument of the first invention has the following specific effects. That is, the expansion / contraction diameter portion that functions as a capturing / recovery portion of the foreign substance in the body cavity is constituted by the “exposed hollow stranded coil body without the outer coating layer” and other than the expansion / contraction diameter portion, Since it has a continuous integrated structure with the hollow stranded wire coil body, the straight coil element wire of the expansion / contraction diameter part reacts straightly by the pull external force applied to the core material for operation in the hollow part of the main wire part. Then, it is elastically displaced to “change in diameter to an intermediate enormous / both-end throttle rib assembly basket shape”. When the pull external force is absent, the coil element wire restores itself to the original straight shape by the restoring reaction force of each coil wire and acts to reduce the diameter. When the pull external force is applied, the hollow stranded coil body of the main wire portion other than the expansion / contraction diameter portion has a coating outer layer, so that there is no risk of the expansion diameter change and a normal straight shape is maintained.

  And the coil strand of the hollow stranded coil body in the expanded diameter deformed state is based on the twisting angle (lead angle) by the coil winding, with respect to the operation core material of the center line of the deformed basket shape. It has a `` spiral shape '' and is elastically deformed with the processing stress due to coil winding remaining, so that there is very little geometric distortion due to external force, and the basket part that the spiral coil element group outlines is a gap between the element wires. The basket has a very good basket shape with little collapse, and there is no risk of deformation due to contact resistance or "viscosity" in the body cavity. Have

  Furthermore, the basket portion is composed of a set of “symbols of a spiral coil wire” whose operation core is a string, and the length of the string can be adjusted by the relative sliding degree. By adjusting the chord length, the "flat shape basket part with a large enormous diameter and small enormous span", "spindle form basket part with a small enormous diameter and large enormous span", and an "intermediate form of both" set In addition, since the expansion / contraction diameter portion of the base of the basket portion can be set at an arbitrary position of the main striate portion, it is possible to set various shape patterns of the basket portion that match the circumstances of the body cavity treatment site. Be free. The above shape characteristics and shape changeability make it easy to capture foreign matter in the body cavity and prevent troubles of falling of the captured foreign matter.

  That is, for example, by capturing the foreign matter in the body cavity in the basket portion by the spindle-shaped basket portion / intermediate shape basket portion and then deforming it into the flat shape, the “inclination between the major axis direction of the operation core and the coil wire” By “increasing the angle”, the contact area with the foreign matter is increased, and the captured foreign matter in the basket portion can be pressed, caught, and removed accurately without being dropped.

  Further, at least the expansion / contraction diameter portion of the hollow stranded wire coil body of the first invention is subjected to forced diameter reduction processing by known swaging processing / dies processing, and the strands constituting the coil body are: The basket section formed by the strands has a greater holding power for captured foreign matter in the body cavity than that of the above-mentioned background art. It becomes particularly large. And since the rigidity of the strand is improved by the forced diameter reduction processing, it is possible to reduce the diameter of the strand, and the above-described foreign matter capturing action is particularly improved. The diameter can be reduced and the burden on the patient can be reduced.

  Furthermore, the therapeutic treatment device of the present invention can be configured with a main part by two elements of “a hollow stranded wire coil body with a coating outer layer and an operation core material inserted into the hollow stranded wire coil body”. The three elements “sheath 30, operation wire 31, basket wire 32” make the structure simpler than those constituting the main part, and the mechanical structure is stabilized.

  Specifically, in the background art, the basket wire 32 requires “bending” processing and heat treatment processing for holding the bending, and the processing basket wire 32 is bundled and arranged in a difficult manner. Is indispensable, and the moldability of the basket portion 33 is extremely inferior, and there is a high risk of causing an arrangement error and the shape stability is lacking. However, according to the present invention, it is possible to form an accurate expansion / contraction diameter portion by simply peeling the outer sheath layer of the hollow stranded wire coil body to the required length, and changing the peeling position, and the position of the basket portion can be changed. It can be set freely, can be molded very easily, and can be formed with an accurately shaped expansion / contraction diameter portion.

  On the other hand, the medical treatment instrument of the second invention has the following specific effects. That is, according to the second invention, the expansion / contraction diameter portion of the first invention is set in a free state, and the expansion / contraction diameter portion is forcibly reduced only when inserted into the body cavity, so that the expansion / contraction diameter in the body cavity is free. Since the only difference in form is that of the expanded state of state release, the expanded form of the expanded / contracted diameter part is “naturally more stable than the one that is forcedly expanded and deformed in the body cavity of the first invention. "Is improved, and the effects shown in the paragraphs 0015 to 0021 of the first invention can be" stably improved ".

  Further, the spoon-shaped one of the first and second aspects of the present invention has a spoon-shaped expansion / contraction diameter portion “for example, by rotating the hand operation portion to rotate the spoon to function as a spoon, A new and efficient way of “capturing ugly” becomes possible.

  Due to the above-mentioned specific action, the medical treatment instrument of the present invention has a high practicality that makes the treatment such as capture and collection of a foreign substance in a body cavity extremely accurate and quick, and particularly improves the therapeutic performance. There are the above main effects.

  The preferred embodiments of the first and second inventions will be described below.

  First, a medical treatment instrument 1A (hereinafter simply referred to as a treatment instrument 1A) according to the first embodiment of the first invention will be described with reference to FIGS. That is, an “inflated / reduced diameter portion 3 that allows the basket portion B for capturing and collecting foreign matter in the body cavity to freely expand and contract” is provided in the vicinity of the front end of the elongated flexible main linear portion 2, and the rear of the main linear portion 2. In the treatment tool for capturing and treating a foreign body in a body cavity, which is provided with a “hand operating section 5 for operating the expansion / contraction diameter section 3” at the end, the main line section 2 of this embodiment is “a number of wire rods”. A hollow twisted wire coil body 6 formed by twisting and extracting a central core material, or twisting a number of wires on the same circumference and forming a hollow portion 10 penetrating the central portion in the length direction " Further, the resinous outer coating layer 8 is integrally provided.

  That is, the hollow stranded wire coil body 6 (see FIG. 2) is obtained by twisting 10 coil strands 7 (diameter = 0.3 粍) obtained by twisting seven thin wire materials (0.1 粍 diameter). (Diameter D5 = 1.3 mm), and then the hollow coil body is subjected to forced reduction (diameter D6 = 1.1 mm) by a known “swaging process / dies drawing process” to obtain a coil. Each of the strands 7 is formed in a shape in which the cross section is substantially fan-shaped and the adjacent substantially fan-shaped side surfaces are in close pressure contact with each other. Further, a coating outer layer 8 is provided on the outer periphery thereof to form a “flexible coil body having a diameter D1 = 1.5 mm and an inner diameter D2 = 0.7 mm”.

  In addition, the resinous material of the coating outer layer 8 may be any of thermoplastic resins (polyamide, fluorine resin, etc.) and thermosetting resins (phenol resin, epoxy resin, etc.). 8 may be provided. A thermoplastic resin having a relatively high hardness of Rockwell hardness 80 (R scale) or higher is preferable.

  Then, in the hollow portion 10 of the main line portion 2, the operation core material 4 having the front end connected to the front end of the main line portion 2 and the rear end connected to the male screw body 12 of the hand operation portion 5 slides. Further, the expansion / contraction diameter portion 3 is made into “a structure in which only the outer sheath layer 8 of the main wire portion 2 is peeled and the straight outer periphery of the hollow stranded coil body 6 is exposed as it is”. The length L is formed and set near the tip of the strip 2. In the figure, reference numeral 15 denotes a leading plug in which the tip of the hollow portion 10 of the main wire portion 2 is closed and the front end of the operating core material 4 is connected, and 16 is a loose insertion hole of the operating core material 4.

  The hand operating section 5 (see FIG. 1 (D)) “cylindrical female screw body 11 having a female screw hole 17 fixed to the rear end of the main wire strip 2 and a male screw screwed into the female screw body 11. The screw 18 has a screwing mechanism comprising a combination of male screw bodies 12 projecting in front of a rod-shaped gripping portion 13, and a handle fin 14 projecting from the outer periphery of the female screw body 11 is held by a fingertip. When the other fingertip is operated to rotate, a pull operation force is generated in the operation core material 4, and the operation core material 4 slides in the hollow portion 10 of the hollow stranded wire coil body 6 of the main wire portion 2, Relative sliding operation of the main line part 2 and the operation core material 4 can be performed.

  The operation core material 4 of this embodiment (see FIG. 2 (C)) is a set of seven strands having a diameter of 0.16 mm, one of which is a core wire and the other six are core wires. It is a known “1 × 7” stranded wire twisted and has a diameter D4 = about 0.5 mm. The hollow stranded wire coil body 6 is formed by twisting a rope shape using the coil wire 7 and the central core material, and then extracting the central core material and molding it, or without using the central core material. A twisted strand is formed by twisting on the same circumference.

  The hand operating portion 5 of this embodiment uses a screwing mechanism for the female screw body 11 and the male screw body 12 to rotate the male screw body 12 (left rotation for a right screw or right rotation for a left screw) and retreat. Since the operation core material 4 is pulled and operated, the twist direction of the operation core material 4 hollow stranded wire coil body 6 is set as follows. That is, the stranded wire of the operation core material 4 is set in the twist direction (S twist / Z twist) according to the rotation direction of the pull operation, and the coil of the hollow stranded coil body 6 is twisted. The direction is set to a twisted form that is the same as the twisting direction of the twisted wire of the operation core material 4.

  The treatment instrument 1A of FIG. 1 embodiment (see FIG. 3) is inserted into the body cavity from the front plug 15 to capture and treat the foreign body in the body cavity. When pulling the material 4 toward the hand side to move backward within the main striated portion 2 ”, the sliding movement creates an external force that draws the head plug 15 toward the hand side and expands and contracts as an absorption cushion for the external force. The diameter part 3 functions.

  Thus (see the solid line arrow in FIG. 3 (A)), an expansion force balanced with the attracting external force is generated in the expansion / contraction diameter portion 3, and each of the coil wires 7 is elastically strained outwardly in the shape of a medium-high mountain, and “coil Each of the strands 7 is deformed enormously into a “basket portion B1 having an enormous diameter D1 and an enormous span S1” which becomes an outline rib line with an appropriate amount of interval.

  Then, when the hand operating part 5 is operated in this state and the pulling force due to the pulling operation is eliminated, the basket part B1 moves back and forth with the restoring contraction force of the coil wire 7 itself and the forward operating force or the main filament of the operating core material 4. With the assistance of the retreating force of the part 2, each of the coil wires 7 in the enormous deformation state can be deformed to be reduced in diameter to the original position by returning to the original position or the original position approximation.

  In the treatment, foreign bodies in the body cavity are captured and collected in the basket portion B1 in the bulging deformation state. After that, in order to prevent the stored foreign matter from falling, the hand operating portion 5 is operated to adjust the pull amount of the operation core material 4 so that the basket portion B1 having the enormous span S1 and the enormous diameter D1 is expanded to the enormous span S2. -A treatment method for deforming into a basket portion B2 having an enormous diameter D2 flat shape and pinching and holding the foreign substance by the coil wire 7 and accurately collecting it outside the body is executed as necessary. In addition, the said forced diameter reduction process of the hollow stranded wire coil body 6 is not necessarily the full length of the hollow stranded wire coil body 6, and it is sufficient to apply only to the site | part of the expansion / contraction diameter part 3 at least.

  The treatment instrument 1A of the above embodiment has the following main functions and effects and the following functions and effects. That is, since the constituent wire of the inflated / reduced diameter portion 3 has a substantially fan-shaped irregular cross section, there is a function of crushing the collected body-incorporated foreign body by the corners of the coil wire 7, and the progress of the expansion degree shown in FIG. (See FIG. 3 (C)), “the spiral coil wire 7 is perpendicular to the center line formed by the operation core 4”, and the twisting and reversing action of the illustrated arrow occurs. As a result, there is a characteristic action that the collected foreign matter in the basket portion B is firmly held and is not dropped.

  And since the core material 4 for operation and the hollow strand wire coil body 6 consist of the said twisted structure, while there is no relaxation of the strand wire of the core material 4 for operation by pull operation, and the transmission property of pull operation force becomes favorable ( The hollow stranded wire coil body 6 affected by the pull operation rotation in the T1 direction of the operation core material 4 receives an acting force for returning the coil twist in the T2 direction, and has an expansion / contraction diameter existing in the vicinity. Since there is an action that supports the diameter-changing action of the portion 3 and the coil strand 7 of the hollow stranded wire coil body 6 constituting the basket portion B is spirally twisted and is a stranded wire, Since the coil wire 7 that outlines the part B is more flexible than the “same straight form of straight wire” and the surface area of contact with the foreign material is increased, it is possible to capture blood clots and other blood clots in blood vessels. The recovery becomes easier and damages the blood vessel wall etc. That there is no. From the above-described actions, the treatment instrument 1A of this embodiment can particularly improve the therapeutic property by making the capture and recovery treatment of foreign matter in the body cavity extremely simple and accurate.

  Next, a medical treatment instrument 1B (hereinafter simply referred to as a treatment instrument 1B) according to the first embodiment of the second invention will be described with reference to FIGS. That is, it consists of “a hollow stranded wire coil body 6 provided with an expansion / contraction diameter portion 3 at the tip portion, a main wire portion 2 through which an operation core material 4 is inserted, and a hand operation portion 5”, similar to the treatment instrument 1A. In the basic form, the expansion / contraction diameter portion 3 of this embodiment is a basket expansion body (about B1 in FIG. 3) in which the coil wire 7 of the hollow stranded coil body 6 exhibits a necessary expansion in a free state. It is set by plastic deformation.

  In addition, the expansion-contraction diameter part 3 of this free state expansion diameter is shape | molded, for example with the following construction method. That is, after peeling off the outer covering layer 8 of the main wire portion 2, the coil wire 7 of the hollow stranded coil body 6 is fitted into “the groove portion of the bulging shaped cored bar provided with the spiral groove portion” The metal core is molded in large quantities by the upper and lower molds that hold the core metal for molding from above and below, and is then heat treated to be removed from the metal core and molded into a shape that maintains the required expanded shape in a free state.

  Then, by pushing the operation core material 4 by the operation of the hand operation section 5, the operation core material 4 is pushed forward, thereby forcibly reducing the expansion-contraction diameter-reduced diameter portion 3 to "straight form". Alternatively, it can be freely set to “a finely expanded form capable of being inserted into a body cavity”, and a further change in the expanded diameter of the expanded / contracted diameter part 3 by pulling the operation core 4 (about B2 in FIG. 3). Can do.

  Specifically, the hand operating part 5 of this embodiment (see FIG. 4 (D)) is a male operating piece having a fingertip locking hole 23 at the rear end in a tubular body connected and fixed to the rear end of the main line 2. 22 and a slit 25 cut through the body wall of the male operating piece 22 and cut through the peripheral wall of the male operating piece 22 so as to be slidable in the longitudinal direction of the male operating piece 22 and fingertips on both sides. The female operation piece 21 provided with the locking hole 23 constitutes the approaching / separating slide mechanism, and the rear end of the operation core member 4 is connected to the female operation piece 21.

  Then, by inserting the fingertip into the fingertip locking hole 23 and pushing the female operation piece 21 forward, the main wire portion 2 and the operation core material 4 are moved relative to each other, as shown in FIG. As shown by the dotted arrow, the inflated / reduced diameter portion 3 of B1 shown in the figure, which has been previously inflated, is deformed and set into a “straight-shaped inflated / reduced diameter portion 3” and inserted into and removed from the body cavity, and the treatment site in the body cavity is set. The set “straight-shaped expansion / contraction diameter portion 3” is set to an arbitrary expansion degree as shown in B1 and B2 in the drawing, and is set to a structure for performing an intracorporeal treatment in the same manner as in the embodiment of FIG.

  In addition, since the compressive force is applied to the treatment tool 1B of this embodiment in the longitudinal direction of the operation core member 4 during the push operation (see FIG. 4C), the thin wire WB is formed with the thick wire WA or the thick wire WA as the core wire. While using the twisted twisted wire core 4 for high buckling resistance, the female operation piece 21 is provided with a buckling prevention pipe P1 for the core 4. A “set lock screw 27” that sets and locks an arbitrary degree of expansion / contraction diameter of the expansion / contraction diameter portion 3 is provided on the body portion of the male operation piece 22. The treatment instrument 1B of the above embodiment has the above main effects.

  Next, another embodiment of the first and second inventions will be described with reference to FIGS. That is, FIG. 5A shows another embodiment of the second invention. Similar to the one shown in FIG. , The rear end of the hollow stranded coil body 6 is connected to the female operation piece 21, and the rear end of the operation core material 4 is connected to the male operation piece 22. Then, by inserting the fingertip into the fingertip locking hole 23 and pulling the female operation piece 21 toward the male operation piece 22 (push operation), the hollow stranded coil body 6 is moved backward (relative to the operation core material 4). A retraction force) is applied, and the expansion / contraction diameter process is performed by changing the diameter of the expansion / contraction diameter portion 3 to an arbitrary diameter reduction degree by the retraction force.

  Also in this embodiment, the protective pipe P2 for preventing the operation core material 4 in the vicinity of the male operation piece 22 from being bent when the female operation piece 21 is pulled toward the male operation piece 22 is provided with a male locking piece. 22 is set. This expansion / contraction diameter process is an operation process similar to that of the background art, so that there is an advantage that a conventional technique familiar to the surgeon can be applied.

  On the other hand, FIG. 5 (B) shows an embodiment of the treatment instrument 1B comprising the hand operating portion 5 of the screwing mechanism shown in FIG. 1 (D), and the rear end of the main line portion 2 is connected to the front end of the female screw body 11. Connected, the rear end of the operating core 4 is connected to the rear end of the male screw body 12. By rotating the male screw body 12, the operating core 4 is pushed and slid to move the expansion / contraction diameter portion 3. Reduce diameter. Then, if necessary, the pulling operation is reversed to perform the expansion operation.

  And the "protection pipe P3 which protects the main filament 2 from the stress which arises by the said push operation" is protrudingly provided in the front end of the internal thread body 11 of the thing of this Example.

  Next, FIG. 6 shows an embodiment of “spoon-shaped expansion / contraction diameter part 3” shown in paragraph 0014, and among the coil strands 7 of the hollow stranded wire coil body 6 constituting the expansion / contraction diameter part 3, Several coil strands 7 are missing (the one in this embodiment is missing 3 out of 10 which should originally exist), and a strand missing zone 28 is provided. “Spoon-shaped expansion / contraction diameter part 3 which becomes a spoon-like basket part in the expanded diameter state” is formed.

  In the embodiment of FIG. 6, the expansion / contraction diameter portion 3 of the spoon shape is made into an arbitrary spoon shape with a deep bottom and a shallow bottom, and is rotated in the body cavity to function as a spoon body so as to function in the body cavity. The scavenging and catching of foreign substances becomes possible, and the quality and performance of a medical treatment instrument that is easy to pass through a branch part of a body cavity such as a digestive tract or a blood vessel (passed using the strand missing zone 28) is further improved. . In addition, since the thing of this spoon form adds a big external force to the coil strand 7 which functions as a spoon, the rigid-form coil strand 7 illustrated in FIG.4 (C) is preferable.

  Next, FIG. 7 shows another embodiment of the coil strand 7 of the hollow stranded coil body 6 constituting the expansion / contraction diameter portion 3, and a single coil strand 7 B and a “1 × 7 stranded coil” are shown. 7A ”is set to a combination of a rigid wire (7B) and a flexible wire (7A). FIG. 7 (A) is an arrangement form of 6A continuous 7A and 4B continuous 7B, and FIG. 7A and 7B are arranged alternately. The thing of this FIG. 7 embodiment has the following specific effect | action.

  That is, due to the highly secreted endocrine product, the diameter may not be increased due to adhesion between wires, but when a rigid wire is used as an adjacent line, for example, the diameter can be increased against the mutual adhesion force between wires. Although it may be difficult to increase the diameter evenly with only the flexible wire due to the uneven inner wall state of the organ or the like, the diameter can be increased evenly due to the presence of the rigid wire. And it becomes easy for a foreign material to enter into the inside of the expansion-contraction diameter part 3 from the bending deformation part of a flexible wire, and it becomes easy to catch. By providing a zone (FIG. 7 (A)) with different zones of rigidity in the direction perpendicular to the cylindrical axis of the expansion / contraction diameter portion, it is possible to easily bend one direction of the flexible wire 7A at a branching position of an organ / blood vessel, etc. It becomes easy to introduce the treatment instrument at the position.

  Next, another embodiment group of the first and second inventions described above will be described. That is, although not shown, as another embodiment of the present invention, the length L of the expansion / contraction diameter portion 3 may be set to be approximately the same as the 360 ° twisted one pitch of the coil wire 7. In this configuration, when the expansion / contraction diameter portion 3 is deformed, the coil wire 7 constituting the basket portion B has a spiral configuration in which the center line of the expansion / contraction diameter portion 3 is twisted by 360 °. In particular, the foreign matter catching force can be increased in the basket portion B2 having a large diameter D2 flat shape, and further, when the operation core material 4 is pulled, the spiral-shaped coil strands 7 are brought into contact with each other, The unique action of the is more stable and improved.

  Further, the treatment instruments 1A and 1B (see FIG. 7C) are provided with “binding fixing means by a binding ring body S that binds and fixes the coil strands 7 in a coiled state” to both ends of the expansion / contraction diameter portion 3 or “coil”. If necessary, a bundling and fixing means for the bundling group 7 of coil elements is provided as needed. In the case where the binding fixing means is provided, the binding fixing means carries the “stress based on the expanded diameter variation” generated in the coil wire 7 at both ends of the basket portion B when the expanded diameter variation of the expanded / contracted diameter portion 3 is performed. Since the coil wire 7 is prevented from lifting and loosening, the shape of the expansion / contraction diameter portion 3 and the basket portion B can be stably changed repeatedly. Is more stable and better.

  The treatment tools 1A and 1B of the present invention are not limited to the above-described embodiments. For example, the hand operation unit 5 of the above-described embodiment of the treatment tool 1B is set on the treatment tool 1A, or the treatment tool 1A is set on the treatment tool 1B. There is a change in setting the hand operating unit 5 of the embodiment. And since the coating outer layer 8 shown in the said Example is a protective coating for preventing that the expansion stress of the expansion / contraction diameter part 3 reaches hollow hollow wire coil bodies 6 other than the expansion / contraction diameter part 3. It is not always necessary for the treatment instrument 1B that is set in an expanded state in a free state.

  Then, the hollow stranded coil body 6 is disclosed in Japanese Patent Application No. 2002-358851 of the prior literature in the relevant field “It is twisted on the basis of a twisting resistance load and subjected to heat treatment for removing residual stress by processing. "Hollow stranded coiled body formed with high rotational followability / straightness imparting form" "Hollow stranded coiled body in which coil wire 7 is made of austenitic stainless steel wire" "Shape memory characteristics and superelastic characteristics" A range in which the coating outer layer 8 other than the hollow stranded wire coil body using the Ni—Ti alloy wire material as a part of the coil wire or the entire coil wire does not hinder the specific action of the present invention. The main wire section and hollow stranded coil body in all forms, including "Partly omitted form" and "Coating outer layer form of metal pipes such as stainless steel pipes and copper pipes instead of resin coating" It becomes.

  In the above-described embodiment, only the “expanded diameter portion 3 in an exposed form from which the outer covering layer 8 has been peeled” has been described, but the following form may be adopted. In other words, the “expanded / contracted diameter part structure with coating” is formed by forming a flexible coating such as rubber (natural rubber, urethane rubber, etc.) on the expansion / contraction diameter part 3 after peeling the outer coating layer 8. For example, by using a catheter or the like in combination, a treatment method for recovering foreign matter in the body cavity into the catheter tube while allowing the “inflated / reduced diameter portion with the covering” to be deformed enormously and brought into sliding contact with the blood vessel wall There is.

  The medical treatment tool of the present invention can be widely applied not only for the above-described capture and recovery treatment of foreign matter in a body cavity but also as a “vascular foreign matter removal treatment tool” and the like.

The medical treatment tool of 1st invention 1 Example is shown, (A) is the whole front view, (B) (C) (D) is the principal part enlarged view. 1 shows the structure of the main part of the embodiment, (A) is a cross-sectional view of a hollow stranded wire coil body, (B) is a front view of an expanded and contracted diameter part, (C) is a cross-sectional view of an operating core material The action state of the medical treatment tool of the present invention is shown, and (A), (B), and (C) are also action explanatory diagrams The medical treatment tool of 2nd invention 1 Example is shown, (A) is the whole front view, (B) (D) is the principal part enlarged view, (C) is sectional drawing of the operation core material The front view which shows the other Example of the medical treatment tool of 2nd invention, and shows the structure and effect | action both (A) and (B) The expansion / contraction diameter part of the other Example of the medical treatment tool of 1st, 2nd invention is shown, (A) is the front view, (B) is the sectional drawing. The other Example of the medical treatment tool of 1st, 2nd invention is shown, (A) (B) is sectional drawing of a hollow stranded wire coil body, (C) is a front view of an expansion-contraction diameter part. The medical treatment tool of background art is shown (A) (B) and the principal part front view

Explanation of symbols

DESCRIPTION OF SYMBOLS 1A The medical treatment tool 1B of 1st invention The medical treatment tool 2 of 2nd invention 2 Main wire strip part 3 Expansion / contraction diameter part 4 Core material for operation 5 Hand operation part 6 Hollow stranded wire coil body 7 Coil strand 8 Coating outer layer 10 Hollow part 11 of the hollow stranded coil body Female thread body 12 Male thread body 13 Grasp part 17 Female thread hole 18 Male thread part 21 Female operation piece 22 Male operation piece 23 Fingertip locking hole 28 Coil wire missing zone B Basket part D Enormous diameter S Enormous span

Claims (11)

  A flexible wire body in which an operation core material is slidably inserted into a main wire portion of a hollow stranded wire coil body having a coating outer layer, and both ends of the operation core material are connected to a front end of the main wire portion and the main wire portion. It is connected to a hand operation part at the rear end of the main filament part, and has an expansion / contraction diameter part made of the hollow stranded coil body in the form of an exposed straight near the tip of the main filament part, and at least the expansion / contraction diameter part Is formed of a hollow stranded wire coil body whose diameter has been reduced, and a basket-like expansion diameter of the expansion-contraction diameter portion and the basket-like expansion diameter by relative sliding of the core material for operation and the main wire portion by the hand operation portion. A medical treatment instrument characterized by a structure in which a diameter-reduction deformed body is freely made.   A flexible filament body in which an operation core material is slidably inserted in a main filament portion of a hollow stranded wire coil body, and both ends of the manipulation core material are connected to a front end of the main filament portion and the main filament portion. A hand-operated portion connected to the hand-operated portion at the rear end of the main wire portion, and provided with an expansion / contraction diameter portion made of the hollow stranded coil body in a basket-like inflated shape in a free state near the front end of the main wire portion, A medical treatment characterized by a structure that enables the expansion / contraction diameter variation of the expansion / contraction diameter portion by the operation of   The medical treatment instrument according to claim 2, wherein the inflated / reduced diameter portion is formed of a hollow stranded coil body having a reduced diameter.   The medical treatment instrument according to any one of claims 2 and 3, wherein the core material for operation is formed by twisting a thin wire around a single wire or a thick wire outer periphery.   The hand operating section comprises a screwing mechanism of a female threaded body and a male threaded body on the main wire section side and the operating core material side, or a proximity / separation sliding mechanism of an operating piece on the main wire section side and the operating core material side. The medical treatment tool in any one of Claims 1-4.   The medical treatment tool according to any one of claims 1 to 5, wherein the expansion / contraction diameter portion includes a missing zone of the strand group of the hollow stranded wire coil body and exhibits a spoon shape in the expanded diameter state.   The medical treatment tool according to any one of claims 1 to 6, wherein the coil strand of the hollow stranded coil body constituting the expansion / contraction diameter portion is formed of a combination of a rigid wire and a flexible wire.   The medical treatment tool according to any one of claims 1 to 7, wherein a bundle fixing means for the coil strand group is provided in the hollow stranded coil body at both side portions of the expansion / contraction diameter portion.   The medical treatment instrument according to any one of claims 1 to 8, further comprising set lock means in an expanded or contracted state of the expanded / contracted diameter portion.   The medical treatment tool according to any one of claims 1 to 9, wherein a length of the coil wire group of the expanded / contracted diameter portion is set to be substantially the same as a 360 ° twist span of the coil wire group. The hand operating part is a proximity / separation sliding mechanism for the operating piece according to claim 5, wherein the operating piece is a combination of a female operating piece on the slide operation side and a male operating piece on the fixed side, and The medical treatment instrument according to claim 2, wherein a rear end is connected to the female operation piece, and a rear end of the operation core is connected to the male operation piece.

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