JP6713907B2

JP6713907B2 - Catheter, guide wire for catheter, and treatment tool for endoscope

Info

Publication number: JP6713907B2
Application number: JP2016210351A
Authority: JP
Inventors: 山田　佳男; 佳男山田; 重樹石川; 一夫岩田; 秀雅伊藤; 孝之千田
Original assignee: NHK Spring Co Ltd
Current assignee: NHK Spring Co Ltd
Priority date: 2016-10-27
Filing date: 2016-10-27
Publication date: 2020-06-24
Anticipated expiration: 2036-10-27
Also published as: JP2018068550A

Description

本開示の実施形態は、医療用処置具に関する。特に医療用のカテーテル、カテーテル用ガイドワイヤ、および内視鏡用処置具に関する。 Embodiments of the present disclosure relate to a medical treatment tool. In particular, it relates to a medical catheter, a guide wire for a catheter, and a treatment tool for an endoscope.

カテーテルおよび内視鏡用処置具は、検査や治療の際に用いられる医療用器具であって、細長いチューブ状の形状をとり、胸腔や腹腔などの体腔、消化管や尿管などの管腔部または血管を介して、体内の目的部位まで挿入することができる。これらを用いた検査においては、様々な情報を体内の目的部位から直接取得することができ、その後の治療に有用であることから積極的に導入されている。さらには、何れの場合も治療に必要とされる様々な機能を有する機器が搭載可能であり、カテーテル治療および内視鏡手術は、従来のような開腹手術と比べて患者の体への負担が少なく、早期の社会復帰を可能とする治療方法として特に注目されている。 BACKGROUND ART Catheter and endoscopic treatment tools are medical instruments used for examinations and treatments, and have an elongated tubular shape, and have a body cavity such as a chest cavity or abdominal cavity, or a lumen part such as a digestive tract or ureter. Alternatively, it can be inserted into a target site in the body via a blood vessel. In the examination using these, various kinds of information can be directly obtained from the target site in the body and are useful for the subsequent treatment, and thus are actively introduced. Furthermore, in any case, devices having various functions required for treatment can be mounted, and catheter treatment and endoscopic surgery impose a burden on the patient's body as compared with conventional open surgery. It is a particularly rare and therapeutic method that enables early social rehabilitation.

カテーテルおよび内視鏡用処置具は、その挿入部位や用途によって、形状も機能も大きく異なる。特に血管のような微細で複雑な形状に沿うようにカテーテルまたは内視鏡用処置具を挿入する場合、カテーテルを引導するガイドワイヤまたは内視鏡用処置具の先端部の形状、特に湾曲角度および方向が重要になってくる。しかしながら従来のガイドワイヤおよび内視鏡用処置具は、一定の角度および方向に湾曲した先端部を有し、医師は先端部とは反対側の遠位の一端を、長軸方向または回転方向に操作することで先端部の動作を制御することしかできなかった。しかしながら患者によっては解剖学的形状が異なる、または変化しており、選択された先端形状のカテーテルまたは内視鏡用処置具では、目的部位に到達することが困難となる場合もある。このとき、ガイドワイヤまたは内視鏡用処置具の先端部の形状を変えるためには、一旦、体内から抜去して、先端部を調整または交換する必要があり、患者および医師ともに負担が大きくなる。 The shape and function of the catheter and the treatment instrument for an endoscope greatly differ depending on the insertion site and the application. In particular, when inserting a catheter or a treatment tool for an endoscope along a minute and complicated shape such as a blood vessel, the shape of the guide wire for guiding the catheter or the shape of the distal end portion of the treatment tool for an endoscope, especially the bending angle and Direction becomes important. However, the conventional guide wire and the treatment tool for an endoscope have a tip portion curved at a constant angle and direction, and a doctor has a distal end opposite to the tip portion in a longitudinal direction or a rotation direction. Only the operation of the tip could be controlled by the operation. However, the anatomical shape is different or changed depending on the patient, and it may be difficult to reach the target site with the catheter or the endoscopic treatment tool having the selected tip shape. At this time, in order to change the shape of the distal end portion of the guide wire or the treatment tool for an endoscope, it is necessary to once remove it from the body and adjust or replace the distal end portion, which increases the burden on both the patient and the doctor. ..

引用文献１には、高度の伸直性および回転追従性を有する中空撚線コイル体を、カテーテル、カテーテル用ガイドワイヤ、または内視鏡用処置具の先端部として応用することが開示されている。引用文献２には、収縮状態では可撓性が低くなり、延伸状態では可撓性が高くなる弾性部材を先端部に有するガイドワイヤが開示されている。引用文献３には、互いに先端部の形状が異なる２重のカテーテルを組み合わせて用いることにより、先端形状を２種類の形状に変えることができるカテーテル組立体が開示されている。しかしながら、上記引用文献１から３に記載の発明においても、カテーテルまたは内視鏡用処置具の先端部を任意の角度および方向に制御できるものではない。 Reference 1 discloses that a hollow stranded wire coil body having a high degree of straightness and rotation followability is applied as a distal end portion of a catheter, a guide wire for a catheter, or a treatment tool for an endoscope. .. Citation 2 discloses a guide wire having an elastic member at its distal end that has low flexibility in a contracted state and high flexibility in a stretched state. Citation 3 discloses a catheter assembly in which the tip shape can be changed to two kinds of shapes by combining and using double catheters having different tip shapes. However, even in the inventions described in the above cited documents 1 to 3, it is not possible to control the distal end portion of the catheter or the treatment tool for an endoscope to an arbitrary angle and direction.

特開２００４−１９０１６７号公報JP 2004-190167 A 特開２０１０−２０７２５１号公報JP, 2010-207251, A 特開２００４−３５７８０５号公報JP, 2004-357805, A

本開示の実施形態は、上述の問題を解決するもので、体内の挿入部位に合わせて迅速かつ安全に目的部位まで挿入することができる先端部を有する医療用処置具を提供することを目的とする。 An embodiment of the present disclosure is to solve the above-mentioned problems, and an object thereof is to provide a medical treatment tool having a tip portion that can be quickly and safely inserted to a target site in accordance with an insertion site in a body. To do.

本開示の一実施形態によると、先端部、屈曲部、屈曲部を介して先端部とは反対側に配置された連結部、及び連結部側の巻き解け部を有する屈曲コイルと、連結部に接続して屈曲コイルを回転可能に支持する支持部と、巻き解け部と接する回転抑制部と、前記支持部とは反対側の基端と、を有するチューブと、を含み、屈曲コイルの巻き解け部側の一端を、回転抑制部を介して、チューブの基端側に移動させて、屈曲コイルを回転させることを特徴とする医療用処置具が提供される。 According to one embodiment of the present disclosure, a bending coil having a tip portion, a bent portion, a connecting portion disposed on the opposite side of the tip portion via the bent portion, and a winding portion on the connecting portion side, and a connecting portion An unwinding of the bending coil, which includes a tube having a supporting portion that rotatably supports the bending coil by connecting it, a rotation suppressing portion that is in contact with the unwinding portion, and a base end opposite to the supporting portion. There is provided a medical treatment tool characterized in that one end of a section side is moved to a base end side of a tube via a rotation suppressing section to rotate a bending coil.

また、別の態様において、屈曲コイルは少なくとも２つの部分を有し、巻き解け部側の第１のコイルの部分は先端部側の第２のコイルの部分よりもばね定数が小さくてもよい。 Further, in another aspect, the bending coil may have at least two portions, and the first coil portion on the unwinding portion side may have a smaller spring constant than the second coil portion on the tip end side.

連結部は少なくとも、第１のコイルの部分を含んでもよい。 The connecting portion may include at least a portion of the first coil.

また、別の態様において、屈曲コイルの先端部は、屈曲コイルの回転方向とは反対方向に湾曲していてもよい。 In another aspect, the tip of the bending coil may be curved in a direction opposite to the rotating direction of the bending coil.

本開示の一実施形態によると、先端部、屈曲部、屈曲部を介して先端部とは反対側に配置された連結部、連結部側の巻き解け部、及び巻き解け部から離隔して、連結部に位置する固定部を有する屈曲コイルと、可撓性を有し、連結部に接続して屈曲コイルを回転可能に支持する支持部と、巻き解け部と接する回転抑制部と、固定部と接続し、固定部から巻き解け部までの屈曲コイルの長さを保持する固定端部と、支持部とは反対側の基端と、を有するチューブと、を含み、連結部は少なくとも２つの部分を有し、巻き解け部側の第１のコイルの部分と固定部側の第２のコイルの部分は逆巻きに接続し、屈曲コイルの巻き解け部側の一端を、回転抑制部を介して、チューブの基端側に移動させて、屈曲コイルを回転させることを特徴とする医療用処置具が提供される。 According to one embodiment of the present disclosure, the tip portion, the bent portion, the connecting portion arranged on the opposite side to the tip portion via the bent portion, the unwinding portion on the connecting portion side, and the unwinding portion, A bending coil having a fixing portion located at the connecting portion, a supporting portion that is flexible and that rotatably supports the bending coil by connecting to the connecting portion, a rotation suppressing portion that contacts the unwinding portion, and a fixing portion. And a tube having a fixed end portion for holding the length of the bending coil from the fixed portion to the unwinding portion, and a base end opposite to the support portion, and the connecting portion includes at least two. The first coil portion on the unwinding portion side and the second coil portion on the fixed portion side are connected in reverse winding, and one end of the bending coil on the unwinding portion side is connected via the rotation suppressing portion. There is provided a medical treatment tool characterized in that the bending coil is rotated by moving the tube to the proximal end side of the tube.

また、別の態様において、第２のコイルの部分は第１のコイルの部分よりもばね定数が大きくてもよい。 In another aspect, the second coil portion may have a larger spring constant than the first coil portion.

また、別の態様において、固定部は連結部の屈曲部側に位置してもよい。 In another aspect, the fixing portion may be located on the bent portion side of the connecting portion.

また、別の態様において、回転抑制部は屈曲コイルの巻き解け部が位置する支持部の側壁部に設けられた開口部であってもよい。 Further, in another aspect, the rotation suppressing portion may be an opening provided in a side wall portion of the support portion where the unwinding portion of the bending coil is located.

また、別の態様において、一端が先端部に接続し、屈曲コイルおよびチューブの内部空間を介して、他端がチューブの基端側に引き出されるワイヤ、をさらに含んでもよい。 In another aspect, one end may be further connected to the distal end portion, and the other end may be further pulled out through the bending coil and the internal space of the tube, and the other end may be pulled out to the proximal end side of the tube.

また、別の態様において、少なくとも連結部の屈曲コイルは、金属の素線を密着巻きして形成された一次コイルの中心軸をらせん状に巻いた二重コイルであってもよい。 Further, in another aspect, at least the bending coil of the connecting portion may be a double coil in which a central axis of a primary coil formed by closely winding a metal element wire is spirally wound.

また、別の態様において、素線は、線径が１４μｍ以上２００μｍ以下の白金、金、パラジウム、タングステン、タンタル、コバルト、ロジウム、チタン、それらの合金、ステンレス、ニッケル合金またはモリブデン合金から選択されてもよい。 In another embodiment, the wire is selected from platinum, gold, palladium, tungsten, tantalum, cobalt, rhodium, titanium, alloys thereof, stainless steel, nickel alloys or molybdenum alloys having a wire diameter of 14 μm or more and 200 μm or less. Good.

また、別の態様において、少なくとも連結部の屈曲コイルは、超弾性を有する金属の素線をらせん状に巻いて形成されたコイルであってもよい。 Further, in another aspect, the bending coil at least in the connecting portion may be a coil formed by spirally winding a metal wire having superelasticity.

また、別の態様において、素線は、線径が５０μｍ以上３００μｍ以下のニッケル―チタン合金であってもよい。 In another aspect, the strand may be a nickel-titanium alloy having a wire diameter of 50 μm or more and 300 μm or less.

また、別の態様において、ワイヤの一端が、屈曲コイルの伸張側に位置する先端部に接続されてもよい。 Further, in another aspect, one end of the wire may be connected to a tip portion located on the extension side of the bending coil.

また、別の態様において、連結部の屈曲コイルの少なくとも一部は、隣接して配置されたコイルを構成する線が無荷重時において離隔していてもよい。 Further, in another aspect, at least a part of the bending coil of the connecting portion may be separated from each other by a line forming a coil disposed adjacent to each other when there is no load.

また、別の態様において、屈曲コイルの屈曲側に隣接して配置されたコイルを構成する線が無荷重時に接していてもよい。 Moreover, in another aspect, the wire which comprises the coil arrange|positioned adjacent to the bending side of a bending coil may contact|connect when there is no load.

また、別の態様において、屈曲コイルは、先端部に向かってコイルの径が縮小した形状を備えていてもよい。 In another aspect, the bending coil may have a shape in which the diameter of the coil is reduced toward the tip.

また、別の態様において、屈曲コイルは、先端部にキャップを備えていてもよい。 Moreover, in another aspect, the bending coil may include a cap at the tip.

本開示の実施形態によると、体内の挿入部位に合わせて迅速かつ安全に目的部位まで挿入することができる先端部を有する医療用処置具を提供することができる。 According to the embodiment of the present disclosure, it is possible to provide a medical treatment tool having a distal end portion that can be quickly and safely inserted to a target site in accordance with an insertion site in the body.

本開示の一実施形態に係る医療用処置具の（Ａ）全体図、（Ｂ）上面図、および（Ｃ）分解図である。It is (A) whole view, the (B) top view, and the (C) exploded view of the medical treatment tool concerning one embodiment of this indication. 本開示の一実施形態に係る医療用処置具の断面図である。1 is a cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. 本開示の一実施形態に係る屈曲コイルの拡大断面図である。It is an expanded sectional view of the bending coil concerning one embodiment of this indication. 本開示の一実施形態に係る医療用処置具の動作を示す断面図である。FIG. 6 is a cross-sectional view showing an operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す上面図である。FIG. 7 is a top view showing the operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の（Ａ）全体図、（Ｂ）上面図、および（Ｃ）分解図である。It is (A) whole view, the (B) top view, and the (C) exploded view of the medical treatment tool concerning one embodiment of this indication. 本開示の一実施形態に係る医療用処置具の断面図である。1 is a cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す断面図である。FIG. 6 is a cross-sectional view showing an operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す断面図である。FIG. 6 is a cross-sectional view showing an operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す上面図である。FIG. 7 is a top view showing the operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の（Ａ）全体図、（Ｂ）上面図、および（Ｃ）分解図である。It is (A) whole view, the (B) top view, and the (C) exploded view of the medical treatment tool concerning one embodiment of this indication. 本開示の一実施形態に係る医療用処置具の断面図である。1 is a cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す断面図である。FIG. 6 is a cross-sectional view showing an operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す上面図である。FIG. 7 is a top view showing the operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の（Ａ）全体図、（Ｂ）上面図、および（Ｃ）分解図である。It is (A) whole view, the (B) top view, and the (C) exploded view of the medical treatment tool concerning one embodiment of this indication. 本開示の一実施形態に係る医療用処置具の断面図である。1 is a cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す断面図である。FIG. 6 is a cross-sectional view showing an operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す断面図である。FIG. 6 is a cross-sectional view showing an operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の一実施形態に係る医療用処置具の動作を示す上面図である。FIG. 7 is a top view showing the operation of the medical treatment tool according to the embodiment of the present disclosure. 本開示の変形例に係る医療用処置具の回転抑制部と支持部の形状を示す図である。It is a figure which shows the shape of the rotation suppression part and support part of the medical treatment tool which concerns on the modification of this indication. 本開示の変形例に係る医療用処置具の形態を示す図である。It is a figure which shows the form of the medical treatment tool which concerns on the modification of this indication. 本開示の変形例に係る医療用処置具の形態を示す図である。It is a figure which shows the form of the medical treatment tool which concerns on the modification of this indication. 本開示の変形例に係る医療用処置具の先端部の形状を示す断面図である。It is sectional drawing which shows the shape of the front-end|tip part of the medical treatment tool which concerns on the modification of this indication.

以下、図面を参照して、本開示の一実施形態に係る医療用処置具について説明する。但し、本開示の一実施形態に係る医療用処置具は多くの異なる態様で実施することが可能であり、以下に示す実施の形態の記載内容に限定して解釈されるものではない。また、図面は説明をより明確にするため、実際の態様に比べ、各部の幅、厚さ、形状等について模式的に表される場合があるが、あくまで一例であって、本発明の解釈を限定するものではない。なお、本実施の形態で参照する図面において、同一部分または同様な機能を有する部分には同一の符号を付し、その繰り返しの説明は省略する。 Hereinafter, a medical treatment tool according to an embodiment of the present disclosure will be described with reference to the drawings. However, the medical treatment tool according to an embodiment of the present disclosure can be implemented in many different modes, and is not construed as being limited to the description of the embodiment below. Further, in order to make the description clearer, the drawings may schematically show the width, thickness, shape, etc. of each part as compared with the actual mode, but this is merely an example, and the interpretation of the present invention is not limited to this. It is not limited. Note that in the drawings referred to in this embodiment, the same portions or portions having similar functions are denoted by the same reference numerals, and repeated description thereof is omitted.

〈実施形態１〉
［医療用処置具の概要］
図１から図３を用いて、本開示の一実施形態に係る医療用処置具の構成及び構造を説明する。図１は、本開示の一実施形態に係る医療用処置具の（Ａ）全体図、（Ｂ）上面図、および（Ｃ）分解図である。図２は、本開示の一実施形態に係る医療用処置具の断面図である。図３は、本開示の一実施形態に係る医療用処置具の拡大断面図である。本実施形態に係る医療用処置具とは、例えば、カテーテル、ガイドワイヤ、または内視鏡用処置具などを示す。 <Embodiment 1>
[Outline of medical treatment tools]
A configuration and structure of a medical treatment tool according to an embodiment of the present disclosure will be described with reference to FIGS. 1 to 3. FIG. 1 is an (A) overall view, a (B) top view, and a (C) exploded view of a medical treatment tool according to an embodiment of the present disclosure. FIG. 2 is a cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. FIG. 3 is an enlarged cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. The medical treatment tool according to the present embodiment indicates, for example, a catheter, a guide wire, a treatment tool for an endoscope, or the like.

図１および図２に示すように、医療用処置具１００は、屈曲コイル１２０と、チューブ１６０と、を備える。屈曲コイル１２０は、先端部１２２、無荷重時において中心軸１３６が屈曲している屈曲部１２４、屈曲部１２４を介して先端部１２２とは反対側に配置された連結部１２６、及び連結部１２６側の巻き解け部１２８を有する。チューブ１６０は、屈曲コイル１２０を回転可能に支持する支持部１６２と、巻き解け部１２８と接する回転抑制部１４４と、支持部１６２とは反対側の基端１６４とを有する。屈曲コイル１２０の連結部１２６は、チューブ１６０の支持部１６２に接続される。ここで本実施形態にかかる医療用処置具１００をチューブ１６０の軸方向において屈曲コイル１２０側（図１（Ａ）のＢ方向）から見た図を上面図（図１（Ｂ）、図５）とする。また、全体図（図１（Ａ））、分解図（図１（Ｃ））、及び断面図（図２、図４）は、チューブ１６０の軸と垂直方向（図１（Ｂ）のＡ方向）から見た図である。 As shown in FIGS. 1 and 2, the medical treatment tool 100 includes a bending coil 120 and a tube 160. The bending coil 120 includes a tip portion 122, a bending portion 124 in which the central axis 136 is bent when no load is applied, a connecting portion 126 disposed on the opposite side of the tip portion 122 via the bending portion 124, and a connecting portion 126. It has a side unwinding portion 128. The tube 160 has a support portion 162 that rotatably supports the bending coil 120, a rotation suppressing portion 144 that is in contact with the unwinding portion 128, and a base end 164 opposite to the support portion 162. The connecting portion 126 of the bending coil 120 is connected to the supporting portion 162 of the tube 160. Here, a view of the medical treatment instrument 100 according to the present embodiment as seen from the bending coil 120 side (B direction in FIG. 1A) in the axial direction of the tube 160 is a top view (FIG. 1B and FIG. 5). And In addition, an overall view (FIG. 1A), an exploded view (FIG. 1C), and a cross-sectional view (FIGS. 2 and 4) are shown in a direction perpendicular to the axis of the tube 160 (direction A in FIG. 1B). ) It is the figure seen from.

本実施形態において、円筒型のチューブ１６０は円筒軸方向の一端である支持部１６２において、屈曲コイル１２０の連結部１２６を屈曲コイル１２０の内側から回転可能に支持する。チューブ１６０の一端である支持部１６２は、屈曲コイル１２０の内側に差し込まれるように配置される。すなわち、チューブ１６０の円筒外側は、屈曲コイル１２０の内側と接している。しかしながら支持部１６２の屈曲コイル１２０を支持する形態及び形状はこれに限定されず、屈曲コイル１２０を回転可能に支持できればよい。例えば、円筒型のチューブ１６０は円筒軸方向の一端である支持部１６２において、屈曲コイル１２０の連結部１２６を屈曲コイル１２０の外側から支持してもよい。この場合、屈曲コイル１２０の連結部１２６は、チューブ１６０の一端である支持部１６２の内側に差し込まれるように配置される。さらに、支持部１６２は屈曲コイル１２０が接する円周方向に凸部を有してもよく、凸部において、屈曲コイル１２０の連結部１２６を先端部１２２とは反対側から支持してもよい。また、チューブ１６０の支持部１６２は、円筒型でなくてもよく、２本以上の支柱で屈曲コイル１２０を支持するような形状であってもよい。支持部１６２は、チューブ１６０と一体でなくてもよく、チューブ１６０に屈曲コイル１２０を連結する連結部材を取り付けてもよい。 In the present embodiment, the cylindrical tube 160 rotatably supports the connecting portion 126 of the bending coil 120 from the inside of the bending coil 120 at the support portion 162 that is one end in the cylindrical axis direction. The support portion 162, which is one end of the tube 160, is arranged so as to be inserted inside the bending coil 120. That is, the outside of the cylinder of the tube 160 is in contact with the inside of the bending coil 120. However, the shape and shape of the supporting portion 162 that supports the bending coil 120 are not limited to this, and it is sufficient that the bending coil 120 can be rotatably supported. For example, the cylindrical tube 160 may support the connecting portion 126 of the bending coil 120 from the outside of the bending coil 120 at the support portion 162 that is one end in the cylindrical axis direction. In this case, the connecting portion 126 of the bending coil 120 is arranged so as to be inserted inside the support portion 162 which is one end of the tube 160. Further, the supporting portion 162 may have a convex portion in the circumferential direction with which the bending coil 120 contacts, and the convex portion may support the connecting portion 126 of the bending coil 120 from the side opposite to the tip portion 122. Further, the support portion 162 of the tube 160 may not have a cylindrical shape, and may have a shape in which the bending coil 120 is supported by two or more columns. The support 162 does not have to be integrated with the tube 160, and a connecting member that connects the bending coil 120 to the tube 160 may be attached.

チューブ１６０は、屈曲コイル１２０の巻き解け部１２８が位置する支持部１６２に、回転抑制部１４４を有する。後述する図２０（Ａ）に示すように、本実施形態において回転抑制部１４４は、支持部１６２の円筒側壁部に円形の開口部として配置される。しかしながらこれに限定されず、回転抑制部１４４の開口部は、円形状、多角形状、又はスリット状であってもよい。回転抑制部１４４の開口部は、屈曲コイル１２０の径より小さく、屈曲コイル１２０を形成する巻線の径よりも大きければどんな形状であってもよい。さらに回転抑制部１４４は、例えば、リング状、フック状、柱状であってもよい。回転抑制部１４４は、屈曲コイル１２０が支持部１６２に安定して支持され、巻き解け部１２８が掛かる形状であればよい。回転抑制部１４４の形状の詳細は、変形例１で後述する。 The tube 160 has a rotation suppressing portion 144 on the support portion 162 where the unwinding portion 128 of the bending coil 120 is located. As shown in FIG. 20(A) described later, in the present embodiment, the rotation suppressing portion 144 is arranged in the cylindrical side wall portion of the support portion 162 as a circular opening portion. However, the present invention is not limited to this, and the opening of the rotation suppressing portion 144 may have a circular shape, a polygonal shape, or a slit shape. The opening of the rotation suppressing portion 144 may have any shape as long as it is smaller than the diameter of the bending coil 120 and larger than the diameter of the winding wire forming the bending coil 120. Further, the rotation suppressing portion 144 may have, for example, a ring shape, a hook shape, or a column shape. The rotation suppressing portion 144 may have any shape as long as the bending coil 120 is stably supported by the supporting portion 162 and the unwinding portion 128 hangs. The details of the shape of the rotation suppressing portion 144 will be described later in Modification 1.

回転抑制部１４４には、屈曲コイル１２０の巻き解け部１２８が接している。本実施形態において屈曲コイル１２０の巻き解け部１２８側の端部１３０は、チューブ１６０の回転抑制部１４４を介して円筒内部空間に配置される。巻き解け部１２８が回転抑制部１４４と接触することにより、巻き解け部１２８より先の屈曲コイル１２０の部分は係止する。屈曲コイル１２０の端部１３０を、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の屈曲コイル１２０とは反対側の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４で解け、解けた分だけ屈曲コイル１２０は回転する。 The unwinding portion 128 of the bending coil 120 is in contact with the rotation suppressing portion 144. In the present embodiment, the end portion 130 of the bending coil 120 on the side of the unwinding portion 128 is arranged in the cylindrical inner space via the rotation suppressing portion 144 of the tube 160. By the unwinding portion 128 coming into contact with the rotation suppressing portion 144, the portion of the bending coil 120 ahead of the unwinding portion 128 is locked. The bending coil 120 is restrained from rotating by moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160 opposite to the bending coil 120 via the rotation suppressing portion 144 and the internal space of the tube 160. The bending coil 120 is unwound by the portion 144, and the bending coil 120 is rotated by the unwound amount.

本実施形態において、屈曲コイル１２０の端部１３０は、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の基端１６４側に移動させる。しかしながらこれに限定されず、屈曲コイル１２０の端部１３０は、例えば、支持部１６２の屈曲コイル１２０を支持する形態、形状、および回転抑制部１４４の形状などによって、回転抑制部１４４を介してチューブ１６０の外側に配置してもよい。屈曲コイル１２０の端部１３０を、チューブ１６０の回転抑制部１４４を介して円筒外側においてチューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４で解け、解けた分だけ屈曲コイル１２０は回転する。 In the present embodiment, the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160 via the rotation suppressing portion 144 and the internal space of the tube 160. However, the end portion 130 of the bending coil 120 is not limited to this, and the end portion 130 of the bending coil 120 may be connected to the tube via the rotation suppressing portion 144 depending on, for example, the shape and shape of the supporting portion 162 that supports the bending coil 120 and the shape of the rotation suppressing portion 144. It may be arranged outside 160. By moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160 on the outer side of the cylinder via the rotation suppressing portion 144 of the tube 160, the bending coil 120 is melted by the rotation suppressing portion 144, and only the unwound portion is melted. The bending coil 120 rotates.

屈曲コイル１２０は少なくとも２つの部分を有し、巻き解け部１２８側の第１のコイル１２０ａの部分と、先端部１２２側の第２のコイル１２０ｂの部分とを含む。第１のコイル１２０ａの部分と第２のコイル１２０ｂの部分を区別しない時には、屈曲コイル１２０という。本実施形態において、連結部１２６は第１のコイル１２０ａであり、第１のコイル１２０ａと隣接する先端部１２２側の屈曲コイル１２０は第２のコイル１２０ｂである。すなわち、屈曲コイル１２０は巻き解け部１２８と屈曲部１２４の間に少なくとも２つの部分を有し、巻き解け部１２８側の第１のコイル１２０ａの部分と、屈曲部１２４側の第２のコイル１２０ｂ’の部分とを有する。第１のコイル１２０ａの部分のばね定数は、第２のコイル１２０ｂの部分のばね定数よりも小さい。屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させるとき、第１のコイル１２０ａの部分はばね定数が小さいことから、回転抑制部１４４で解けやすく、屈曲コイル１２０は回転する。第２のコイル１２０ｂの部分はばね定数が大きいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させようとしても、回転抑制部１４４で解けず、屈曲コイル１２０は回転も止まる。 The bending coil 120 has at least two parts, and includes a part of the first coil 120a on the unwinding part 128 side and a part of the second coil 120b on the tip end part 122 side. When the portion of the first coil 120a and the portion of the second coil 120b are not distinguished, they are referred to as bending coils 120. In the present embodiment, the connecting portion 126 is the first coil 120a, and the bending coil 120 on the tip end 122 side adjacent to the first coil 120a is the second coil 120b. That is, the bending coil 120 has at least two parts between the unwinding part 128 and the bending part 124, and the part of the first coil 120a on the unwinding part 128 side and the second coil 120b on the bending part 124 side. 'With the part. The spring constant of the portion of the first coil 120a is smaller than the spring constant of the portion of the second coil 120b. When the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, the first coil 120a has a small spring constant, and therefore the rotation suppressing portion 144 can easily loosen the bending coil 120. Since the second coil 120b has a large spring constant, even if an attempt is made to move the end portion 130 of the bending coil 120 toward the base end 164 side of the tube 160, the rotation suppressing portion 144 does not solve it and the bending coil 120 rotates. Also stops.

第１のコイル１２０ａの部分のばね定数は小さいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動するとき、第１のコイル１２０ａを容易に解くことができ、屈曲コイル１２０の回転を容易に制御することができる。第２のコイル１２０ｂの部分のばね定数は大きいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動しようとしても回転抑制部１４４で解けにくく、さらに屈曲部１２４の屈曲角度を維持することができる。第１のコイル１２０ａの部分のばね定数と第２のコイル１２０ｂの部分のばね定数は、医療用処置具１００として使用時にかかる抵抗に対して、形状を維持するだけの剛性を有し、且つ適度な弾性を有する範囲内で選択することができる。 Since the spring constant of the portion of the first coil 120a is small, when the end portion 130 of the bending coil 120 is moved to the proximal end 164 side of the tube 160, the first coil 120a can be easily unraveled, and the bending coil The rotation of 120 can be easily controlled. Since the spring constant of the portion of the second coil 120b is large, even if the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, it is difficult for the rotation suppressing portion 144 to unravel, and the bending angle of the bending portion 124 is further increased. Can be maintained. The spring constant of the portion of the first coil 120a and the spring constant of the portion of the second coil 120b have rigidity enough to maintain the shape with respect to the resistance applied during use as the medical treatment instrument 100, and are appropriate. It can be selected within a range having various elasticity.

本実施形態において支持部１６２と、第１のコイル１２０ａの部分と、第２のコイル１２０ｂの部分のうち第１のコイル１２０ａとの隣接部から屈曲部１２４までとの３つの円筒軸方向の長さはほぼ同じである。すなわち、連結部１２６は第１のコイル１２０ａであり、連結部１２６と屈曲部１２４の間に、支持部１６２と円筒軸方向に同じ長さの第２のコイル１２０ｂ’を有する。しかしながらこれに限定されず、連結部１２６と屈曲部１２４の間の第２のコイル１２０ｂ’の部分が、支持部１６２より円筒軸方向に長くてもよい。屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させるとき、第１のコイル１２０ａの部分は解けやすいが、第２のコイル１２０ｂの部分で止まる。連結部１２６と屈曲部１２４の間の第２のコイル１２０ｂ’の部分が、支持部１６２と円筒軸方向に同じ長さを有することで、第１のコイル１２０ａの部分がすべて巻き解けても、支持部１６２が屈曲部１２４に接することを阻止することができる。これによって意図せず、屈曲コイル１２０の屈曲角度が変化することを抑制することができる。 In the present embodiment, three cylindrical axial lengths of the support portion 162, the portion of the first coil 120a, and the portion of the second coil 120b adjacent to the first coil 120a to the bent portion 124 are provided. Are about the same. That is, the connecting portion 126 is the first coil 120a, and has the second coil 120b' having the same length as the supporting portion 162 in the cylindrical axial direction between the connecting portion 126 and the bent portion 124. However, the present invention is not limited to this, and the portion of the second coil 120b' between the connecting portion 126 and the bent portion 124 may be longer than the supporting portion 162 in the cylindrical axis direction. When the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, the first coil 120a portion is easy to unwind, but the second coil 120b portion stops. Since the portion of the second coil 120b′ between the connecting portion 126 and the bent portion 124 has the same length as the supporting portion 162 in the cylindrical axial direction, even if the portion of the first coil 120a is completely unwound, It is possible to prevent the support portion 162 from coming into contact with the bent portion 124. This can prevent the bending angle of the bending coil 120 from changing unintentionally.

図３は、図２の屈曲コイル１２０の巻き解け部１２８周辺における拡大断面図である。図３に示すように、本実施形態において屈曲コイル１２０は、金属の素線１をらせん状に密着巻きして形成された一次コイル１０の中心軸をさらにらせん状に密着巻きした二重コイルである。屈曲コイル１２０は、先端部１２２、屈曲部１２４、及び連結部１２６において二重コイルを形成する。巻き解け部１２８から端部１３０までは一次コイル１０に解かれた形状で、チューブ１６０の内部空間に配置される。屈曲コイル１２０は、回転抑制部１４４において解ける。屈曲コイル１２０は、金属の素線１を密着巻きして形成された中空の一次コイル１０を密着巻きした二重コイルであるため、可撓性が高く、屈曲コイル１２０を容易に解くことができ、屈曲コイル１２０の回転を制御することができる。 FIG. 3 is an enlarged cross-sectional view around the unwinding portion 128 of the bending coil 120 of FIG. As shown in FIG. 3, in the present embodiment, the bending coil 120 is a double coil in which the central axis of the primary coil 10 formed by closely winding the metal element wire 1 in a spiral shape is further closely wound in a spiral shape. is there. The bending coil 120 forms a double coil in the tip portion 122, the bending portion 124, and the connecting portion 126. The unwound portion 128 to the end portion 130 have a shape unwound by the primary coil 10 and are arranged in the internal space of the tube 160. The bending coil 120 can be unwound at the rotation suppressing unit 144. Since the bending coil 120 is a double coil in which the hollow primary coil 10 formed by closely winding the metal wire 1 is closely wound, the bending coil 120 has high flexibility and the bending coil 120 can be easily unwound. The rotation of the bending coil 120 can be controlled.

隣接して配置された素線１は密着して一次コイル１０を形成する。このため一次コイル１０の表面は滑らかであり、回転抑制部１４４及びチューブ１６０の内部空間における移動時の摩擦を抑制することができる。隣接して配置された一次コイル１０は密着して二重コイルを形成する。このため二重コイルである屈曲コイル１２０の表面は滑らかであり、屈曲コイル１２０の回転時の摩擦を抑制することができる。しかしながらこれに限定されず、図１（Ｄ）に示すように、屈曲コイル１２０が二重コイルである場合、隣接して配置された一次コイル１０は無荷重時において離隔していてもよい。隣接して配置された一次コイル１０間のピッチが大きくなるほど、屈曲コイル１２０を解くのに必要な力は小さくなり、解けた一次コイル１０の長さ当たりの回転速度は抑制されることから、屈曲コイル１２０の回転をより精密に制御することができる。 The wires 1 arranged adjacent to each other are in close contact with each other to form the primary coil 10. Therefore, the surface of the primary coil 10 is smooth, and it is possible to suppress the friction during the movement of the rotation suppressing portion 144 and the tube 160 in the internal space. The primary coils 10 arranged adjacent to each other are in close contact with each other to form a double coil. Therefore, the surface of the bending coil 120, which is a double coil, is smooth, and friction during rotation of the bending coil 120 can be suppressed. However, the invention is not limited to this, and when the bending coil 120 is a double coil as shown in FIG. 1D, the adjacent primary coils 10 may be separated from each other when there is no load. As the pitch between the adjacent primary coils 10 increases, the force required to unwind the bending coil 120 decreases, and the rotational speed per length of the unraveled primary coil 10 is suppressed. The rotation of the coil 120 can be controlled more precisely.

本実施形態において屈曲コイル１２０は、金属の素線１を密着巻きして形成された一次コイル１０を密着巻きした二重コイルを用いたが、屈曲コイル１２０の少なくとも一部は中実または中空の素線をらせん状に巻いた通常のコイルであってもよく、その場合、隣接して配置された素線は密着していてもよいし、隣接して配置された素線は無荷重時において離隔していてもよい。中実または中空の素線で形成されるコイルであっても、本実施形態の医療用処置具１００と同様の動作をすることが可能である。さらに、屈曲コイル１２０の少なくとも連結部１２６に位置するコイルの部分が、金属の素線１を密着巻きして形成された一次コイル１０を巻いた二重コイルであることで、屈曲コイル１２０を容易に解くことができ、屈曲コイル１２０の回転を制御することができる。 In the present embodiment, the bending coil 120 is a double coil in which the primary coil 10 formed by closely winding the metal wire 1 is closely wound, but at least a part of the bending coil 120 is solid or hollow. It may be a normal coil in which the wires are wound spirally, in which case the wires arranged adjacent to each other may be in close contact with each other, and the wires arranged adjacent to each other may have no load. It may be separated. Even a coil formed of a solid or hollow element wire can perform the same operation as the medical treatment device 100 of the present embodiment. Further, the bending coil 120 can be easily formed by the double coil in which the primary coil 10 formed by closely winding the metal wire 1 is wound around at least the coil portion of the bending coil 120 that is located at the connecting portion 126. The rotation of the bending coil 120 can be controlled.

図１（Ａ）に示すように、屈曲コイル１２０は、屈曲部１２４において中心軸１３６が屈曲している。このため屈曲部１２４の屈曲側（図１（Ａ）のＣ側）は密着しているが、屈曲部１２４の伸張側（図１（Ａ）のＤ側）は隣接して配置された一次コイル１０が無荷重時において離隔している。屈曲部１２４における屈曲角度は、０°より大きく１８０°以下の範囲で適宜調整することができる。ここで屈曲角度とは、チューブ１６０の円筒軸方向に対する屈曲コイル１２０の屈曲部１２４のなす角度を示し、チューブ１６０の円筒軸方向に先端部１２２が位置する屈曲していない状態の角度を０°とする。 As shown in FIG. 1A, in the bending coil 120, the central axis 136 is bent at the bending portion 124. Therefore, the bent side of the bent portion 124 (the C side in FIG. 1A) is in close contact, but the extended side of the bent portion 124 (the D side in FIG. 1A) is adjacent to the primary coil. 10 are separated when there is no load. The bending angle in the bending portion 124 can be appropriately adjusted within the range of more than 0° and 180° or less. Here, the bending angle indicates an angle formed by the bending portion 124 of the bending coil 120 with respect to the cylindrical axis direction of the tube 160, and an angle of the tip portion 122 in the cylindrical axis direction of the tube 160 in an unbent state is 0°. And

本実施形態において屈曲コイル１２０は、先端部１２２から連結部１２６の方向に右巻きである。このため屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４を支点に解けた分だけ、チューブ１６０の円筒軸方向の屈曲コイル１２０側（図１（Ａ）Ｂ方向）から見て右回りに回転する（図１（Ｂ）のＥ方向）。屈曲コイル１２０が回転することで、屈曲部１２４の屈曲方向も回転する。すなわち屈曲コイル１２０が１周解けることで、屈曲方向はチューブ１６０の円筒軸方向の屈曲コイル１２０側（図１（Ａ）Ｂ方向）から見て右回りに３６０°回転する。しかしながらこれに限定されず、屈曲コイル１２０は、先端部１２２から連結部１２６の方向に左巻きであってもよい。この場合、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４を支点に解けた分だけ、チューブ１６０の円筒軸方向の屈曲コイル１２０側（図１（Ａ）Ｂ方向）から見て左回りに回転する。屈曲コイル１２０が回転することで、屈曲部１２４の屈曲方向も回転する。すなわち屈曲コイル１２０が１周解けることで、屈曲方向はチューブ１６０の円筒軸方向の屈曲コイル１２０側（図１（Ａ）Ｂ方向）から見て左回りに３６０°回転する。屈曲コイル１２０の端部１３０の位置を制御することで、屈曲コイル１２０の屈曲方向を制御することができる。ここで屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させるとき、屈曲コイル１２０が回転する方向を、屈曲コイルの回転方向とする。 In this embodiment, the bending coil 120 is right-handed in the direction from the tip portion 122 to the connecting portion 126. Therefore, by moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160, the bending coil 120 is unwound around the rotation suppressing portion 144 as a fulcrum, and thus the bending coil 120 side in the cylindrical axis direction of the tube 160. It rotates clockwise as viewed from (direction B in FIG. 1A) (direction E in FIG. 1B). As the bending coil 120 rotates, the bending direction of the bending portion 124 also rotates. That is, when the bending coil 120 is unwound one round, the bending direction rotates 360° clockwise when viewed from the bending coil 120 side (direction B in FIG. 1A) in the cylindrical axis direction of the tube 160. However, the invention is not limited to this, and the bending coil 120 may be left-handed in the direction from the tip portion 122 to the connecting portion 126. In this case, the bending coil 120 is moved toward the base end 164 side of the tube 160 by moving the end portion 130 of the bending coil 120, and the bending coil 120 in the cylindrical axial direction of the tube 160 corresponds to the amount by which the rotation suppressing portion 144 is released. Rotate counterclockwise as viewed from the side (direction B in FIG. 1A). As the bending coil 120 rotates, the bending direction of the bending portion 124 also rotates. That is, when the bending coil 120 is unwound one round, the bending direction rotates 360° counterclockwise when viewed from the bending coil 120 side in the cylindrical axis direction of the tube 160 (direction B in FIG. 1A). By controlling the position of the end portion 130 of the bending coil 120, the bending direction of the bending coil 120 can be controlled. Here, when the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, the direction in which the bending coil 120 rotates is referred to as the rotation direction of the bending coil.

図１（Ｂ）に示すように、チューブ１６０の円筒軸方向の屈曲コイル１２０側（図１（Ａ）のＢ方向）から見たときに、屈曲コイル１２０の先端部１２２は、屈曲コイルの回転方向（図１（Ｂ）のＥ方向）とは反対方向に湾曲していてもよい。本実施形態に係る屈曲コイル１２０は、先端部１２２から連結部１２６の方向に右巻きであり、チューブ１６０の円筒軸方向の屈曲コイル１２０側（図１（Ａ）のＢ方向）から見たときに右回りに回転し、先端部１２２の中心軸１３６は屈曲コイルの回転方向と反対方向に湾曲していてもよい。いいかえると、本実施形態において屈曲コイル１２０は、連結部１２６から先端部１２２の方向に左巻きであり、屈曲コイルの先端部１２２から屈曲コイル１２０の中心軸１３６方向に見たときに、屈曲コイル１２０の中心軸１３６は連結部１２６から先端部１２２の方向に右側に湾曲していてもよい。屈曲コイル１２０の先端部１２２が屈曲コイルの回転方向と逆方向に湾曲していることで、医療用処置具１００を体内の目的部位に挿入するとき、屈曲コイル１２０の先端部１２２に係る摩擦などの力の向きが屈曲コイル１２０を締める方向にかかる。これによって、屈曲コイル１２０の先端部１２２に係る摩擦などの力によって、屈曲コイル１２０が意図せず解けてしまうことを防止することができる。 As shown in FIG. 1(B), when viewed from the bending coil 120 side of the tube 160 in the cylindrical axis direction (direction B in FIG. 1(A)), the tip end portion 122 of the bending coil 120 rotates the bending coil. It may be curved in a direction opposite to the direction (direction E in FIG. 1B). The bending coil 120 according to the present embodiment is right-handed in the direction from the tip portion 122 to the connecting portion 126, and when viewed from the bending coil 120 side of the tube 160 in the cylindrical axis direction (direction B in FIG. 1A). It may rotate clockwise and the central axis 136 of the tip 122 may be curved in a direction opposite to the direction of rotation of the bending coil. In other words, in the present embodiment, the bending coil 120 is left-handed in the direction from the connecting portion 126 to the tip 122, and when viewed from the tip 122 of the bending coil in the direction of the central axis 136 of the bending coil 120, the bending coil 120. The central axis 136 may be curved rightward from the connecting portion 126 toward the tip portion 122. Since the tip end portion 122 of the bending coil 120 is curved in the direction opposite to the rotation direction of the bending coil 120, when the medical treatment instrument 100 is inserted into the target site in the body, friction related to the tip end portion 122 of the bending coil 120, etc. Is applied in the direction in which the bending coil 120 is tightened. As a result, it is possible to prevent the bending coil 120 from being unintentionally unraveled by a force such as friction on the tip portion 122 of the bending coil 120.

本実施形態において屈曲コイル１２０は円筒型であり、先端部１２２の形状は開口している。しかしながらこれに限定されず、屈曲コイル１２０の先端部１２２の形状は、先端部に向かってコイルの径が縮小したテーパー形状であってもよく、先端部にキャップを備えてもよい。先端部１２２がこのような形状をとることによって、医療用処置具１００を円滑に体内の目的部位に挿入することができ、また挿入部位を損傷させる可能性を低減することができる。 In this embodiment, the bending coil 120 has a cylindrical shape, and the tip 122 has an open shape. However, the shape of the tip portion 122 of the bending coil 120 is not limited to this, and may be a tapered shape in which the diameter of the coil is reduced toward the tip portion, or the tip portion may be provided with a cap. With the tip 122 having such a shape, the medical treatment device 100 can be smoothly inserted into a target site in the body, and the possibility of damaging the insertion site can be reduced.

屈曲コイル１２０を構成する素線１に用いる金属としては、医療用に認可された金属であれば特に限定されるものではなく、例えば、白金、金、パラジウム、タングステン、タンタル、コバルト、ロジウム、チタン、それらの合金、ステンレス、ニッケル合金またはモリブデン合金から選択される。屈曲コイル１２０は、金属の素線１を密着巻きして形成された一次コイル１０を密着巻きした二重コイルであるため、このように巻き付け可能な弾性係数や硬さを有する材料を用いる。 The metal used for the wire 1 that constitutes the bending coil 120 is not particularly limited as long as it is a metal approved for medical use, and examples thereof include platinum, gold, palladium, tungsten, tantalum, cobalt, rhodium, and titanium. , Their alloys, stainless steel, nickel alloys or molybdenum alloys. Since the bending coil 120 is a double coil in which the primary coil 10 formed by closely winding the metal element wire 1 is closely wound, a material having an elastic modulus and hardness that can be wound in this way is used.

屈曲コイル１２０は、金属の素線１で形成された一次コイル１０を密着巻きした二重コイルであるため、素線１の線径は１０μｍ以上２００μｍ以下であることが好ましい。線径が１０μｍよりも細くなると、強度が不足して、上述のような構造を形成することはできない。また、線径が２００μｍを超えると、二重コイルの径が大きくなり、血管などの挿入部位に挿入するのが困難となる。 Since the bending coil 120 is a double coil in which the primary coil 10 formed of the metal wire 1 is closely wound, the wire diameter of the wire 1 is preferably 10 μm or more and 200 μm or less. If the wire diameter is smaller than 10 μm, the strength is insufficient and the above structure cannot be formed. Further, if the wire diameter exceeds 200 μm, the diameter of the double coil becomes large and it becomes difficult to insert the wire into an insertion site such as a blood vessel.

本実施形態において屈曲コイル１２０は、金属の素線１を密着巻きして形成された一次コイル１０を密着巻きした二重コイルを用いたが、屈曲コイル１２０は素線を巻いたコイルであってもよく、その場合、超弾性を有する金属の素線を用いてもよい。ここで超弾性を有する金属とは、少なくとも室温〜体温の温度範囲で応力を加え変形させても、応力を除くと再び元の形に戻る性質を有する金属をいう。構成する素線に用いる金属としては、医療用に認可された金属であれば特に限定されるものではなく、例えば、ニッケル―チタン合金を用いてもよい。素線の線径は５０μｍ以上３００μｍ以下であることが好ましい。線径が５０μｍよりも細くなると、強度が不足して、上述のような構造を形成することはできない。また、線径が３００μｍを超えると、コイルの径が大きくなり、血管などの挿入部位に挿入するのが困難となる。超弾性を有する金属の素線を用いて屈曲コイル１２０を形成することで、本実施形態の医療用処置具１００と同様の動作をすることが可能となる。 In the present embodiment, the bending coil 120 is a double coil in which the primary coil 10 formed by closely winding the metal wire 1 is closely wound, but the bending coil 120 is a coil in which the wire is wound. In that case, a metal wire having superelasticity may be used. Here, the metal having superelasticity refers to a metal having a property of returning to its original shape when stress is removed even when stress is applied and deformed at least in a temperature range of room temperature to body temperature. The metal used for the constituent wires is not particularly limited as long as it is a metal approved for medical use, and for example, a nickel-titanium alloy may be used. The wire diameter of the strand is preferably 50 μm or more and 300 μm or less. If the wire diameter is smaller than 50 μm, the strength is insufficient and the above structure cannot be formed. Further, if the wire diameter exceeds 300 μm, the diameter of the coil becomes large and it becomes difficult to insert the coil into an insertion site such as a blood vessel. By forming the bending coil 120 using a metal wire having superelasticity, it is possible to perform an operation similar to that of the medical treatment tool 100 of the present embodiment.

医療用処置具１００は、その挿入部位や用途によって、適したサイズおよび機能を有するものを適宜選択することができる。このため屈曲コイル１２０と、チューブ１６０とは、外径０．３ｍｍ以上１０ｍｍ以下および内径０．１ｍｍ以上９．８ｍｍ以下の範囲で適宜選択することができる。屈曲コイル１２０と、チューブ１６０とは、中空である。後述する医療用処置具１００の動作に影響しないかぎり、屈曲コイル１２０およびチューブ１６０の内部空間には様々な機能を有する機器が搭載可能である。屈曲コイル１２０およびチューブ１６０の内部空間には、例えば、コアとなるワイヤ、内視鏡、鉗子、はさみ、高周波スネア、または薬剤カートリッジなどを搭載してもよく、これらの複数を組み合わせて搭載してもよい。このような機器を搭載することで、医療用処置具１００はカテーテル、ガイドワイヤ、薬剤等の注入機構、処置具として機能することができる。 As the medical treatment instrument 100, one having an appropriate size and function can be appropriately selected depending on the insertion site and application. Therefore, the bending coil 120 and the tube 160 can be appropriately selected within a range of an outer diameter of 0.3 mm or more and 10 mm or less and an inner diameter of 0.1 mm or more and 9.8 mm or less. The bending coil 120 and the tube 160 are hollow. Devices having various functions can be mounted in the internal space of the bending coil 120 and the tube 160 as long as they do not affect the operation of the medical treatment instrument 100 described later. In the inner space of the bending coil 120 and the tube 160, for example, a wire to be a core, an endoscope, forceps, scissors, a high-frequency snare, a drug cartridge, or the like may be mounted, and a plurality of these may be mounted in combination. Good. By mounting such a device, the medical treatment instrument 100 can function as a catheter, a guide wire, an injecting mechanism for a drug or the like, and a treatment instrument.

本実施形態においてチューブ１６０は、説明を分かりやすくするため、短く直線的に図示した。しかしながらこれに限定されず、チューブ１６０の長さは２００ｍｍ以上１８００ｍｍ以下の範囲で適宜選択することができる。またチューブ１６０は、医療用処置具１００として使用時にかかる抵抗に対して、十分な剛性を有し、且つ適度な弾性を有することができる。 In the present embodiment, the tube 160 is illustrated as a short linear shape for easy understanding of the description. However, the length of the tube 160 is not limited to this, and can be appropriately selected within the range of 200 mm or more and 1800 mm or less. In addition, the tube 160 can have sufficient rigidity and appropriate elasticity with respect to the resistance applied when the medical treatment tool 100 is used.

［医療用処置具の動作の概要］
次に図４および図５を用いて、本実施形態に係る医療用処置具１００の動作について詳細に説明する。図４は、本開示の一実施形態に係る医療用処置具１００の動作を示す断面図である。図５は、本開示の一実施形態に係る医療用処置具１００の動作を示す上面図である。 [Outline of operation of medical treatment instrument]
Next, the operation of the medical treatment device 100 according to the present embodiment will be described in detail with reference to FIGS. 4 and 5. FIG. 4 is a sectional view showing an operation of the medical treatment tool 100 according to an embodiment of the present disclosure. FIG. 5: is a top view which shows operation|movement of the medical treatment tool 100 which concerns on one Embodiment of this indication.

本実施形態に係る医療用処置具１００を例えば、血管内に挿入する場合、先端部１２２側から血管内に挿入し、血流に従って医療用処置具１００を軸方向に進行させる。このときチューブ１６０の基端１６４側は常に執刀医の手元で操作できる状態にある。医療用処置具１００は可撓性を有するため、挿入部位が単純な形状を有するのであれば、医療用処置具１００を進行方向に押し進めることで、挿入部位の形状に合わせて進行することができる。 For example, when inserting the medical treatment instrument 100 according to the present embodiment into a blood vessel, the medical treatment instrument 100 is inserted into the blood vessel from the distal end portion 122 side, and the medical treatment instrument 100 is advanced in the axial direction according to the blood flow. At this time, the proximal end 164 side of the tube 160 is always in a state where it can be operated by the surgeon. Since the medical treatment instrument 100 has flexibility, if the insertion portion has a simple shape, the medical treatment instrument 100 can be pushed in the traveling direction to proceed according to the shape of the insertion portion. ..

しかしながら、医療用処置具１００の先端が血管分岐などの複雑な構造に到達したとき、従来の医療用処置具では、執刀医の手元のチューブを回転することで先端を方向転換するしかなく、方向の制御が難しい。特に挿入経路が湾曲している場合、摩擦が大きくなることから、手元のチューブのトルクを先端に伝えることは容易ではない。 However, when the tip of the medical treatment instrument 100 reaches a complicated structure such as a blood vessel branch, in the conventional medical treatment instrument, the tip can only be turned by rotating the tube at the surgeon's hand. Is difficult to control. In particular, when the insertion path is curved, friction increases, so it is not easy to transmit the torque of the tube at hand to the tip.

本実施形態に係る医療用処置具１００は、屈曲コイル１２０の端部１３０を、チューブ１６０の基端１６４側に引っ張ることで、屈曲コイル１２０を回転させることができる。図４（Ｂ）に示すように、図４（Ａ）の状態から屈曲コイル１２０の端部１３０を基端１６４側に１／４周長引っ張り、屈曲コイル１２０を１／４回転解くことで、屈曲コイル１２０は図５（Ａ）から図５（Ｂ）に示すように、チューブ１６０の円筒軸方向の屈曲コイル１２０側から見たときに、右周りに９０°回転する。図４（Ｃ）および図５（Ｃ）に示すように、屈曲コイル１２０の端部１３０をさらに１／４周長引っ張り、屈曲コイル１２０をさらに１／４回転解くことで、屈曲コイル１２０は右周りに計１８０°回転する。図４（Ｄ）および図５（Ｄ）に示すように、屈曲コイル１２０の端部１３０をさらに１／４周長引っ張り、屈曲コイル１２０をさらに１／４回転解くことで、屈曲コイル１２０は右周りに計２７０°回転する。図４（Ａ）および図５（Ａ）に示すように、屈曲コイル１２０をさらに１／４回転解くことで、屈曲コイル１２０は右周りに計３６０°回転し、１周して元の位置に戻る。屈曲コイル１２０は屈曲していることから、屈曲コイル１２０が右周りに計３６０°回転することで、屈曲方向も右周りに計３６０°回転し、屈曲コイル１２０はコイル１周分短くなる。ここで周長とは、コイル円周ではなく、１周分の巻き線の長さをいう。 The medical treatment instrument 100 according to the present embodiment can rotate the bending coil 120 by pulling the end portion 130 of the bending coil 120 toward the proximal end 164 side of the tube 160. As shown in FIG. 4B, by pulling the end portion 130 of the bending coil 120 from the state of FIG. 4A toward the base end 164 by a quarter circumference, and unwinding the bending coil 120 by a quarter rotation, As shown in FIGS. 5A and 5B, the bending coil 120 rotates 90° clockwise when viewed from the bending coil 120 side in the cylindrical axis direction of the tube 160. As shown in FIGS. 4C and 5C, the bending coil 120 is pulled to the right by further pulling the end portion 130 of the bending coil 120 for a quarter circumference and unwinding the bending coil 120 by a further 1/4 rotation. Rotate a total of 180 degrees around. As shown in FIGS. 4(D) and 5(D), the bending coil 120 is pulled to the right by pulling the end portion 130 of the bending coil 120 for another ¼ circumference and unwinding the bending coil 120 for another ¼ rotation. Rotate a total of 270° around. As shown in FIGS. 4(A) and 5(A), by further unwinding the bending coil 120 by a quarter turn, the bending coil 120 rotates clockwise 360° in total, and makes one turn to return to the original position. Return. Since the bending coil 120 is bent, when the bending coil 120 rotates clockwise by 360° in total, the bending direction also rotates clockwise by 360° in total, and the bending coil 120 is shortened by one turn of the coil. Here, the circumference means not the circumference of the coil but the length of the winding for one round.

図４および図５において屈曲コイル１２０は１／４周長ずつ引っ張り、１／４回転ずつ解き、９０°ずつ回転する様態を示したが、これに限定されない。屈曲コイル１２０の端部１３０を引っ張る距離は適宜調整でき、屈曲コイル１２０の屈曲方向は任意の方向に制御することができる。 4 and 5, the bending coil 120 is pulled by 1/4 circumference, unwound by 1/4 rotation, and rotated by 90°, but is not limited thereto. The distance by which the end 130 of the bending coil 120 is pulled can be adjusted as appropriate, and the bending direction of the bending coil 120 can be controlled in any direction.

本実施形態に係る医療用処置具１００は、医療用処置具１００の先端が血管分岐などの複雑な構造に到達したときであっても、執刀医の手元の屈曲コイル１２０の端部１３０を引っ張ることで、屈曲コイル１２０を回転することができ、先端の屈曲方向を自由に制御することができる。したがって、迅速かつ安全に医療用処置具１００の先端を体内の目的部位まで挿入することができ、患者および医師ともに負担が軽減される。 The medical treatment instrument 100 according to the present embodiment pulls the end portion 130 of the bending coil 120 at the surgeon's hand even when the tip of the medical treatment instrument 100 reaches a complicated structure such as a blood vessel branch. As a result, the bending coil 120 can be rotated, and the bending direction of the tip can be freely controlled. Therefore, the tip of the medical treatment device 100 can be quickly and safely inserted into the target site in the body, and the burden on both the patient and the doctor is reduced.

〈実施形態２〉
［医療用処置具の概要］
図６および図７を用いて、本開示の一実施形態に係る医療用処置具の構成及び構造を説明する。なお本実施形態は、屈曲コイル１２０とワイヤ１３２の構成以外は、本開示の実施形態１と本質的に同じであり、その繰り返しの説明は省略する。図６は、本開示の一実施形態に係る医療用処置具の（Ａ）全体図、（Ｂ）上面図、および（Ｃ）分解図である。図７は、本開示の一実施形態に係る医療用処置具の断面図である。本実施形態に係る医療用処置具とは、例えば、カテーテル、ガイドワイヤ、または内視鏡用処置具などを示す。 <Embodiment 2>
[Outline of medical treatment tools]
The configuration and structure of the medical treatment tool according to an embodiment of the present disclosure will be described with reference to FIGS. 6 and 7. The present embodiment is essentially the same as the first embodiment of the present disclosure except for the configuration of the bending coil 120 and the wire 132, and the repeated description thereof will be omitted. FIG. 6 is (A) overall view, (B) top view, and (C) exploded view of a medical treatment tool according to an embodiment of the present disclosure. FIG. 7 is a cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. The medical treatment tool according to the present embodiment indicates, for example, a catheter, a guide wire, a treatment tool for an endoscope, or the like.

図６および図７に示すように、医療用処置具２００は、屈曲コイル１２０と、チューブ１６０と、を備える。屈曲コイル１２０は、先端部１２２、無荷重時において中心軸１３６が屈曲している屈曲部１２４、屈曲部１２４を介して先端部１２２とは反対側に配置された連結部１２６、及び連結部１２６側の巻き解け部１２８を有する。屈曲コイル１２０はさらに、先端部１２２に接続されたワイヤ１３２を有する。チューブ１６０は、屈曲コイル１２０を回転可能に支持する支持部１６２と、巻き解け部１２８と接する回転抑制部１４４と、支持部１６２とは反対側の基端１６４とを有する。屈曲コイル１２０の連結部１２６は、チューブ１６０の支持部１６２に接続される。ここで、本実施形態に係る医療用処置具２００をチューブ１６０の軸方向において屈曲コイル１２０側（図６（Ａ）のＢ方向）から見た図を上面図（図６（Ｂ）、図１０）とする。また、全体図（図６（Ａ））、分解図（図６（Ｃ））、及び断面図（図７、図８、図９）は、チューブ１６０の軸の垂直方向（図６（Ｂ）のＡ方向）から見た図である。 As shown in FIGS. 6 and 7, the medical treatment tool 200 includes a bending coil 120 and a tube 160. The bending coil 120 includes a tip portion 122, a bending portion 124 in which the central axis 136 is bent when no load is applied, a connecting portion 126 disposed on the opposite side of the tip portion 122 via the bending portion 124, and a connecting portion 126. It has a side unwinding portion 128. Bending coil 120 further includes wire 132 connected to tip 122. The tube 160 has a support portion 162 that rotatably supports the bending coil 120, a rotation suppressing portion 144 that is in contact with the unwinding portion 128, and a base end 164 opposite to the support portion 162. The connecting portion 126 of the bending coil 120 is connected to the supporting portion 162 of the tube 160. Here, a view of the medical treatment instrument 200 according to the present embodiment seen from the bending coil 120 side (B direction in FIG. 6A) in the axial direction of the tube 160 is a top view (FIG. 6B, FIG. 10). ). In addition, an overall view (FIG. 6A), an exploded view (FIG. 6C), and a cross-sectional view (FIGS. 7, 8, and 9) are shown in a direction perpendicular to the axis of the tube 160 (FIG. 6B). It is the figure seen from A direction.

チューブ１６０は、屈曲コイル１２０の巻き解け部１２８が位置する支持部１６２に回転抑制部１４４を有する。回転抑制部１４４には、屈曲コイル１２０の巻き解け部１２８が接している。本実施形態において屈曲コイル１２０の巻き解け部１２８側の端部１３０は、チューブ１６０の回転抑制部１４４を介して円筒内部空間に配置される。巻き解け部１２８が回転抑制部１４４と接触することにより、巻き解け部１２８より先の屈曲コイル１２０の部分は係止する。屈曲コイル１２０の端部１３０を、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の屈曲コイル１２０とは反対側の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４で解け、解けた分だけ屈曲コイル１２０は回転する。 The tube 160 has a rotation suppressing portion 144 on the support portion 162 where the unwinding portion 128 of the bending coil 120 is located. The unwinding portion 128 of the bending coil 120 is in contact with the rotation suppressing portion 144. In the present embodiment, the end portion 130 of the bending coil 120 on the side of the unwinding portion 128 is arranged in the cylindrical inner space via the rotation suppressing portion 144 of the tube 160. By the unwinding portion 128 coming into contact with the rotation suppressing portion 144, the portion of the bending coil 120 ahead of the unwinding portion 128 is locked. The bending coil 120 is restrained from rotating by moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160 opposite to the bending coil 120 via the rotation suppressing portion 144 and the internal space of the tube 160. The bending coil 120 is unwound by the portion 144, and the bending coil 120 is rotated by the unwound amount.

屈曲コイル１２０の伸張側に位置する先端部１２２には、ワイヤ１３２の一端が接続される。屈曲コイル１２０に接続されたワイヤ１３２は、屈曲コイル１２０およびチューブ１６０の内部空間に配置され、一端とは反対側の他端がチューブ１６０の基端１６４側に位置する。屈曲コイル１２０に接続されたワイヤ１３２を、屈曲コイル１２０およびチューブ１６０の内部空間を介して、チューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は屈曲部１２４の伸張側で収縮し、収縮した分だけ屈曲コイル１２０の屈曲角度が減少する。屈曲コイル１２０は弾性変形の範囲内で収縮することから、屈曲部１２４の伸張側では斥力が生じる。屈曲コイル１２０に接続されたワイヤ１３２を、屈曲コイル１２０およびチューブ１６０の内部空間を介して、屈曲コイル１２０側に移動させることで、屈曲コイル１２０の屈曲部１２４の伸張側は伸張し、伸張した分だけ屈曲コイル１２０の屈曲角度が増大する。 One end of a wire 132 is connected to the tip portion 122 located on the extension side of the bending coil 120. The wire 132 connected to the bending coil 120 is arranged in the internal space of the bending coil 120 and the tube 160, and the other end opposite to the one end is located on the proximal end 164 side of the tube 160. By moving the wire 132 connected to the bending coil 120 to the proximal end 164 side of the tube 160 through the internal space of the bending coil 120 and the tube 160, the bending coil 120 contracts on the extension side of the bending portion 124. The bending angle of the bending coil 120 is reduced by the amount of contraction. Since the bending coil 120 contracts within the range of elastic deformation, a repulsive force is generated on the extension side of the bending portion 124. By moving the wire 132 connected to the bending coil 120 to the bending coil 120 side through the internal space of the bending coil 120 and the tube 160, the extension side of the bending portion 124 of the bending coil 120 is extended and expanded. The bending angle of the bending coil 120 is increased by that amount.

本実施形態において、ワイヤ１３２の他端は、屈曲コイル１２０およびチューブ１６０の内部空間を介して、チューブ１６０の基端１６４側に移動させる。しかしながらこれに限定されず、ワイヤ１３２の他端は、例えばチューブ１６０の開口部を介してチューブ１６０の外側に配置してもよい。ワイヤ１３２の他端を、チューブ１６０の開口部を介してチューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は屈曲部１２４の伸張側で収縮し、収縮した分だけ屈曲コイル１２０の屈曲角度が減少する。屈曲コイル１２０は弾性変形の範囲内で収縮することから、屈曲部１２４の伸張側では斥力が生じる。屈曲コイル１２０に接続されたワイヤ１３２を、屈曲コイル１２０およびチューブ１６０の開口部を介して、屈曲コイル１２０側に移動させることで、屈曲コイル１２０の屈曲部１２４の伸張側は伸張し、伸張した分だけ屈曲コイル１２０の屈曲角度が増大する。 In the present embodiment, the other end of the wire 132 is moved to the proximal end 164 side of the tube 160 via the bending coil 120 and the internal space of the tube 160. However, the present invention is not limited to this, and the other end of the wire 132 may be arranged outside the tube 160, for example, via the opening of the tube 160. By moving the other end of the wire 132 to the proximal end 164 side of the tube 160 through the opening of the tube 160, the bending coil 120 contracts on the extension side of the bending portion 124, and the bending coil 120 is contracted by the contracted amount. The bending angle is reduced. Since the bending coil 120 contracts within the range of elastic deformation, a repulsive force is generated on the extension side of the bending portion 124. By moving the wire 132 connected to the bending coil 120 to the bending coil 120 side through the opening of the bending coil 120 and the tube 160, the extension side of the bending portion 124 of the bending coil 120 is expanded and extended. The bending angle of the bending coil 120 is increased by that amount.

本実施形態において、ワイヤ１３２の一端は、屈曲コイル１２０の伸張側に位置する先端部１２２に接続される。しかしながらこれに限定されず、ワイヤ１３２の一端は、例えば屈曲コイル１２０の屈曲側に位置する先端部１２２に接続されてもよい。またワイヤ１３２の一端は、屈曲コイル１２０の屈曲部１２４より先端部側に接続されれば、先端部１２２でなくてもよい。 In the present embodiment, one end of the wire 132 is connected to the tip portion 122 located on the extension side of the bending coil 120. However, the invention is not limited to this, and one end of the wire 132 may be connected to, for example, the distal end portion 122 located on the bending side of the bending coil 120. Further, one end of the wire 132 may not be the tip portion 122 as long as it is connected to the tip portion side of the bending portion 124 of the bending coil 120.

屈曲コイル１２０に接続されたワイヤ１３２をチューブ１６０の基端１６４側に移動させるとき、第２のコイル１２０ｂの部分は屈曲部１２４の伸張側で収縮し、収縮した分だけ屈曲コイル１２０の屈曲角度が減少する。第２のコイル１２０ｂは弾性変形の範囲内で収縮し、ばね定数が大きいことから、屈曲部１２４の伸張側では大きな斥力が生じる。第２のコイル１２０ｂの斥力を利用して、屈曲コイル１２０に接続されたワイヤ１３２を屈曲コイル１２０側に移動させることで、第２のコイル１２０ｂの部分の屈曲部１２４の伸張側は伸張し、伸張した分だけ屈曲コイル１２０の屈曲角度が増大する。 When the wire 132 connected to the bending coil 120 is moved to the proximal end 164 side of the tube 160, the portion of the second coil 120b contracts on the extension side of the bending portion 124, and the bending angle of the bending coil 120 corresponding to the contraction. Is reduced. The second coil 120b contracts within the range of elastic deformation and has a large spring constant, so that a large repulsive force is generated on the extension side of the bent portion 124. By using the repulsive force of the second coil 120b to move the wire 132 connected to the bending coil 120 to the bending coil 120 side, the extension side of the bending portion 124 of the portion of the second coil 120b extends. The bending angle of the bending coil 120 increases by the amount of extension.

第１のコイル１２０ａの部分のばね定数は小さいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動するとき、第１のコイル１２０ａを容易に解くことができ、屈曲コイル１２０の回転を容易に制御することができる。第２のコイル１２０ｂの部分のばね定数は大きいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動しようとしても回転抑制部１４４で解けにくく、さらに屈曲部１２４の屈曲角度を維持することができる。第２のコイル１２０ｂの部分のばね定数は大きいことから、ワイヤ１３２をチューブ１６０の基端１６４側に移動させることで、屈曲部１２４の伸張側では大きな斥力が生じ、屈曲コイル１２０の屈曲角度を容易に制御することができる。第１のコイル１２０ａの部分のばね定数と第２のコイル１２０ｂの部分のばね定数は、医療用処置具１００として使用時にかかる抵抗に対して、形状を維持するだけの剛性を有し、且つ適度な弾性を有する範囲内で選択することができる。 Since the spring constant of the portion of the first coil 120a is small, when the end portion 130 of the bending coil 120 is moved to the proximal end 164 side of the tube 160, the first coil 120a can be easily unraveled, and the bending coil The rotation of 120 can be easily controlled. Since the spring constant of the portion of the second coil 120b is large, even if the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, it is difficult for the rotation suppressing portion 144 to unravel, and the bending angle of the bending portion 124 is further increased. Can be maintained. Since the spring constant of the portion of the second coil 120b is large, moving the wire 132 to the proximal end 164 side of the tube 160 causes a large repulsive force on the extension side of the bending portion 124 to change the bending angle of the bending coil 120. It can be controlled easily. The spring constant of the portion of the first coil 120a and the spring constant of the portion of the second coil 120b have rigidity enough to maintain the shape with respect to the resistance applied during use as the medical treatment instrument 100, and are appropriate. It can be selected within a range having various elasticity.

本実施形態において屈曲コイル１２０は、金属の素線１をらせん状に密着巻きして形成された一次コイル１０の中心軸をさらにらせん状に巻いた二重コイルである。屈曲コイル１２０は先端部１２２および屈曲部１２４において、一次コイル１０を密着巻きした二重コイルを形成する。屈曲コイル１２０は連結部１２６において、隣接して配置された一次コイル１０が無荷重時において離隔しているピッチ巻きした二重コイルを形成する。巻き解け部１２８から端部１３０までは一次コイル１０に解かれた形状で、チューブ１６０の内部空間に配置される。屈曲コイル１２０は、回転抑制部１４４において解ける。屈曲コイル１２０は、金属の素線１を密着巻きして形成された中空の一次コイル１０を巻いた二重コイルであるため、可撓性が高く、屈曲コイル１２０を容易に解くことができ、屈曲コイル１２０の回転を制御することができる。 In the present embodiment, the bending coil 120 is a double coil in which the central axis of the primary coil 10 formed by closely winding the metal element wire 1 in a spiral shape is further spirally wound. The bending coil 120 forms a double coil in which the primary coil 10 is closely wound at the tip 122 and the bending portion 124. The bending coil 120 forms, at the connecting portion 126, a pitch-wound double coil in which the adjacent primary coils 10 are separated from each other when there is no load. The unwound portion 128 to the end portion 130 have a shape unwound by the primary coil 10 and are arranged in the internal space of the tube 160. The bending coil 120 can be unwound at the rotation suppressing unit 144. Since the bending coil 120 is a double coil in which the hollow primary coil 10 formed by closely winding the metal wire 1 is wound, the bending coil 120 has high flexibility, and the bending coil 120 can be easily unraveled. The rotation of the bending coil 120 can be controlled.

隣接して配置された素線１は密着して一次コイル１０を形成する。このため一次コイル１０の表面は滑らかであり、回転抑制部１４４及びチューブ１６０の内部空間における移動時の摩擦を抑制することができる。屈曲コイル１２０は連結部１２６において、隣接して配置された一次コイル１０が無荷重時において離隔した二重コイルを形成する。隣接して配置された一次コイル１０間のピッチが大きくなるほど、屈曲コイル１２０を解くのに必要な力は小さくなり、解けた一次コイル１０の長さ当たりの回転速度は抑制されることから、屈曲コイル１２０の回転をより精密に制御することができる。さらにワイヤ１３２の他端をチューブ１６０の基端１６４側に移動させるとき、屈曲コイル１２０の屈曲部１２４での収縮が連結部１２６にも分散されることから、屈曲コイル１２０の屈曲角度をより精密に制御することができる。しかしながらこれに限定されず、屈曲コイル１２０が二重コイルである場合、連結部１２６における隣接して配置された一次コイル１０は密着していてもよい。隣接して配置された一次コイル１０が密着して二重コイルを形成することで、屈曲コイル１２０の表面は滑らかであり、屈曲コイル１２０の回転時の摩擦を抑制することができる。 The wires 1 arranged adjacent to each other are in close contact with each other to form the primary coil 10. Therefore, the surface of the primary coil 10 is smooth, and it is possible to suppress the friction during the movement of the rotation suppressing portion 144 and the tube 160 in the internal space. The bending coil 120 forms a double coil in the connecting portion 126 in which the adjacent primary coils 10 are separated from each other when there is no load. As the pitch between the adjacent primary coils 10 increases, the force required to unwind the bending coil 120 decreases, and the rotational speed per length of the unraveled primary coil 10 is suppressed. The rotation of the coil 120 can be controlled more precisely. Further, when the other end of the wire 132 is moved to the proximal end 164 side of the tube 160, the contraction of the bending coil 120 at the bending portion 124 is also dispersed to the connecting portion 126, so that the bending angle of the bending coil 120 is more precise. Can be controlled. However, the present invention is not limited to this, and when the bending coil 120 is a double coil, the adjacent primary coils 10 in the connecting portion 126 may be in close contact with each other. Since the primary coils 10 arranged adjacent to each other are in close contact with each other to form a double coil, the surface of the bending coil 120 is smooth and friction during rotation of the bending coil 120 can be suppressed.

本実施形態において屈曲コイル１２０は、金属の素線１を密着巻きして形成された一次コイル１０を巻いた二重コイルを用いたが、屈曲コイル１２０の少なくとも一部は中実または中空の素線をらせん状に巻いた通常のコイルであってもよく、その場合、隣接して配置された素線は密着していてもよいし、隣接して配置された素線は無荷重時において離隔していてもよい。中実または中空の素線で形成されるコイルであっても、本実施形態の医療用処置具２００と同様の動作をすることが可能である。さらに、屈曲コイル１２０の少なくとも連結部１２６側に位置するコイルの部分が、金属の素線１を密着巻きして形成された一次コイル１０を巻いた二重コイルであることで、屈曲コイル１２０を容易に解くことができ、屈曲コイル１２０の回転を制御することができる。 In the present embodiment, the bending coil 120 is a double coil in which the primary coil 10 formed by closely winding the metal wire 1 is wound, but at least a part of the bending coil 120 is a solid or hollow element. It may be an ordinary coil in which the wire is wound in a spiral shape, in which case the adjacent wires may be in close contact, and the adjacent wires may be separated when no load is applied. You may have. Even a coil formed of a solid or hollow element wire can perform the same operation as the medical treatment device 200 of the present embodiment. Further, since the coil portion located at least on the connecting portion 126 side of the bending coil 120 is a double coil in which the primary coil 10 formed by closely winding the metal wire 1 is wound, the bending coil 120 is It can be easily solved and the rotation of the bending coil 120 can be controlled.

図６（Ａ）に示すように、屈曲コイル１２０は、屈曲部１２４において中心軸１３６が屈曲している。このため屈曲部１２４の屈曲側（図６（Ａ）のＣ側）は密着しているが、屈曲部１２４の伸張側（図６（Ａ）のＤ側）は隣接して配置された一次コイル１０が無荷重時において離隔している。屈曲部１２４における屈曲角度は、０°より大きく１８０°以下の範囲で適宜調整することができる。 As shown in FIG. 6A, in the bending coil 120, the central axis 136 is bent at the bending portion 124. Therefore, the bent side of the bent portion 124 (the C side of FIG. 6A) is in close contact, but the extended side of the bent portion 124 (the D side of FIG. 6A) is adjacent to the primary coil. 10 are separated when there is no load. The bending angle in the bending portion 124 can be appropriately adjusted within the range of more than 0° and 180° or less.

本実施形態においてチューブ１６０は、説明を分かりやすくするため、短く直線的に図示した。しかしながらこれに限定されず、チューブ１６０の長さは２００ｍｍ以上１８００ｍｍ以下の範囲で適宜選択することができる。またチューブ１６０は、医療用処置具２００として使用時にかかる抵抗に対して、十分な剛性を有し、且つ適度な弾性を有することができる。 In the present embodiment, the tube 160 is illustrated as a short linear shape for easy understanding of the description. However, the length of the tube 160 is not limited to this, and can be appropriately selected within the range of 200 mm or more and 1800 mm or less. Moreover, the tube 160 can have sufficient rigidity and appropriate elasticity with respect to the resistance applied when the medical treatment tool 200 is used.

［医療用処置具の動作の概要］
次に図８、図９、及び図１０を用いて、本実施形態に係る医療用処置具２００の動作について詳細に説明する。図８及び図９は、本開示の一実施形態に係る医療用処置具２００の動作を示す断面図である。図１０は、本開示の一実施形態に係る医療用処置具２００の動作を示す上面図である。 [Outline of operation of medical treatment instrument]
Next, the operation of the medical treatment tool 200 according to the present embodiment will be described in detail with reference to FIGS. 8, 9, and 10. 8 and 9 are cross-sectional views showing the operation of the medical treatment tool 200 according to an embodiment of the present disclosure. FIG. 10 is a top view showing the operation of the medical treatment tool 200 according to an embodiment of the present disclosure.

本実施形態に係る医療用処置具２００は、ワイヤ１３２の他端をチューブ１６０の基端１６４側に引っ張ることで、屈曲コイル１２０の屈曲角度を制御することができる。図８（Ｂ）に示すように、図８（Ａ）の状態からワイヤ１３２の他端を基端１６４側に引っ張ることで、屈曲コイル１２０は屈曲部１２４の伸張側および連結部１２６で収縮し、屈曲部１２４で収縮した分だけ屈曲コイル１２０の屈曲角度が減少する。屈曲コイル１２０は弾性変形の範囲内で収縮することから、屈曲部１２４の伸張側では斥力が生じる。図８（Ｃ）に示すように、ワイヤ１３２の他端をさらに基端１６４側に引っ張ることで、屈曲コイル１２０は屈曲部１２４の伸張側および連結部１２６で収縮し、屈曲部１２４で収縮した分だけ屈曲コイル１２０の屈曲角度がさらに減少する。屈曲コイル１２０は弾性変形の範囲内で収縮することから、屈曲部１２４の伸張側ではさらに斥力が生じる。 The medical treatment tool 200 according to the present embodiment can control the bending angle of the bending coil 120 by pulling the other end of the wire 132 toward the proximal end 164 side of the tube 160. As shown in FIG. 8B, by pulling the other end of the wire 132 toward the base end 164 from the state of FIG. 8A, the bending coil 120 contracts at the extension side of the bending portion 124 and the connecting portion 126. The bending angle of the bending coil 120 is reduced by the amount of contraction at the bending portion 124. Since the bending coil 120 contracts within the range of elastic deformation, a repulsive force is generated on the extension side of the bending portion 124. As shown in FIG. 8C, by pulling the other end of the wire 132 toward the proximal end 164 side, the bending coil 120 contracts at the extension side of the bending portion 124 and the connecting portion 126, and contracts at the bending portion 124. The bending angle of the bending coil 120 is further reduced accordingly. Since the bending coil 120 contracts within the elastic deformation range, repulsive force is further generated on the extension side of the bending portion 124.

図８（Ｄ）に示すように、ワイヤ１３２を引っ張る力を緩めることで、屈曲コイル１２０は屈曲部１２４の伸張側および連結部１２６で伸張し、屈曲部１２４で伸張した分だけ屈曲コイル１２０の屈曲角度が増大する。屈曲部１２４の伸張側の斥力は、屈曲コイル１２０が伸張した分だけ緩和される。このとき、ワイヤ１３２の他端の位置も屈曲コイル１２０が伸張する分、屈曲コイル１２０側に移動する。図８（Ｅ）に示すように、ワイヤ１３２を引っ張る力をさらに緩めることで、屈曲コイル１２０は屈曲部１２４の伸張側および連結部１２６で伸張し、屈曲部１２４で伸張した分だけ屈曲コイル１２０の屈曲角度がさらに増大して元の屈曲角度に戻る。屈曲部１２４の伸張側の斥力は、解消される。このときワイヤ１３２の他端の位置は、屈曲コイル１２０が伸張する分、屈曲コイル１２０側に移動して元の位置に戻る。 As shown in FIG. 8D, the bending coil 120 is extended by the extension side of the bending portion 124 and the connecting portion 126 by loosening the pulling force of the wire 132, and the bending coil 120 is extended by the extension amount of the bending portion 124. The bending angle increases. The repulsive force on the extension side of the bending portion 124 is alleviated by the amount of extension of the bending coil 120. At this time, the position of the other end of the wire 132 also moves to the side of the bending coil 120 as the bending coil 120 extends. As shown in FIG. 8E, the bending coil 120 is further extended by the extension side of the bending portion 124 and the connecting portion 126 by further loosening the pulling force of the wire 132, and the bending coil 120 is extended by the amount extended by the bending portion 124. The bending angle of is further increased and returns to the original bending angle. The repulsive force on the extension side of the bent portion 124 is eliminated. At this time, the position of the other end of the wire 132 moves to the side of the bending coil 120 and returns to the original position as the bending coil 120 extends.

ワイヤ１３２による屈曲コイル１２０の屈曲角度の増減は、屈曲コイル１２０の弾性変形の範囲内で行われることから、繰り返すことができる。図８において屈曲コイル１２０のワイヤ１３２は２段階に引っ張り、２段階に緩めたが、これに限定されない。屈曲コイル１２０のワイヤ１３２を引っ張る距離は適宜調整でき、屈曲コイル１２０の屈曲角度は任意の角度に制御することができる。 The increase and decrease of the bending angle of the bending coil 120 by the wire 132 can be repeated because it is performed within the elastic deformation range of the bending coil 120. Although the wire 132 of the bending coil 120 is pulled in two steps and loosened in two steps in FIG. 8, the present invention is not limited to this. The distance for pulling the wire 132 of the bending coil 120 can be adjusted as appropriate, and the bending angle of the bending coil 120 can be controlled to any angle.

本実施形態に係る医療用処置具２００は、屈曲コイル１２０の端部１３０を、チューブ１６０の基端１６４側に引っ張ることで、屈曲コイル１２０を回転させることができる。図９（Ｂ）に示すように、図９（Ａ）の状態から屈曲コイル１２０の端部１３０を基端１６４側に１／４周長引っ張り、屈曲コイル１２０を１／４回転解くことで、屈曲コイル１２０は図１０（Ａ）から図１０（Ｂ）に示すように、チューブ１６０の円筒軸方向の屈曲コイル１２０側から見たときに、右周りに９０°回転する。図９（Ｃ）および図１０（Ｃ）に示すように、屈曲コイル１２０の端部１３０をさらに１／４周長引っ張り、屈曲コイル１２０をさらに１／４回転解くことで、屈曲コイル１２０は右周りに計１８０°回転する。図９（Ｄ）および図１０（Ｄ）に示すように、屈曲コイル１２０の端部１３０をさらに１／４周長引っ張り、屈曲コイル１２０をさらに１／４回転解くことで、屈曲コイル１２０は右周りに計２７０°回転する。図９（Ａ）および図１０（Ａ）に示すように、屈曲コイル１２０をさらに１／４回転解くことで、屈曲コイル１２０は右周りに計３６０°回転し、１周して元の位置に戻る。屈曲コイル１２０は屈曲していることから、屈曲コイル１２０が右周りに計３６０°回転することで、屈曲方向も右周りに計３６０°回転し、屈曲コイル１２０はコイル１周分短くなる。ここで周長とは、コイル円周ではなく、１周分の巻き線の長さをいう。 The medical treatment instrument 200 according to the present embodiment can rotate the bending coil 120 by pulling the end portion 130 of the bending coil 120 toward the base end 164 side of the tube 160. As shown in FIG. 9(B), by pulling the end portion 130 of the bending coil 120 toward the base end 164 for a quarter circumference from the state of FIG. 9(A), and unwinding the bending coil 120 by ¼ rotation, As shown in FIGS. 10A and 10B, the bending coil 120 rotates 90° clockwise when viewed from the bending coil 120 side in the cylindrical axis direction of the tube 160. As shown in FIG. 9(C) and FIG. 10(C), the bending coil 120 is pulled to the right by pulling the end portion 130 of the bending coil 120 for another ¼ circumference and unwinding the bending coil 120 for another ¼ rotation. Rotate a total of 180 degrees around. As shown in FIGS. 9(D) and 10(D), the bending coil 120 is pulled to the right by pulling the end portion 130 of the bending coil 120 for a further 1/4 turn and unwinding the bending coil 120 for a further 1/4 rotation. Rotate a total of 270°. As shown in FIGS. 9(A) and 10(A), by further unwinding the bending coil 120 by a quarter turn, the bending coil 120 rotates clockwise by a total of 360°, and makes one turn to return to the original position. Return. Since the bending coil 120 is bent, when the bending coil 120 rotates clockwise by 360° in total, the bending direction also rotates clockwise by 360° in total, and the bending coil 120 is shortened by one turn of the coil. Here, the circumference means not the circumference of the coil but the length of the winding for one round.

図９および図１０において屈曲コイル１２０は１／４周長ずつ引っ張り、１／４回転ずつ解き、９０°ずつ回転する様態を示したが、これに限定されない。屈曲コイル１２０の端部１３０を引っ張る距離は適宜調整でき、屈曲コイル１２０の屈曲方向は任意の方向に制御することができる。 In FIG. 9 and FIG. 10, the bending coil 120 is pulled by 1/4 circumference, unwound by 1/4 rotation, and rotated by 90°, but the invention is not limited to this. The distance by which the end 130 of the bending coil 120 is pulled can be adjusted as appropriate, and the bending direction of the bending coil 120 can be controlled in any direction.

本実施形態に係る医療用処置具２００は、医療用処置具２００の先端が血管分岐などの複雑な構造に到達したときであっても、執刀医の手元の屈曲コイル１２０のワイヤ１３２を引っ張ることで、屈曲コイル１２０の屈曲角度を自由に制御することができる。屈曲コイル１２０の端部１３０を引っ張ることで、屈曲コイル１２０を回転することができ、先端の屈曲方向を自由に制御することができる。したがって、迅速かつ安全に医療用処置具２００の先端を体内の目的部位まで挿入することができ、患者および医師ともに負担が軽減される。 The medical treatment instrument 200 according to the present embodiment pulls the wire 132 of the bending coil 120 at the surgeon's hand even when the tip of the medical treatment instrument 200 reaches a complicated structure such as a blood vessel branch. Thus, the bending angle of the bending coil 120 can be freely controlled. By pulling the end 130 of the bending coil 120, the bending coil 120 can be rotated, and the bending direction of the tip can be freely controlled. Therefore, the tip of the medical treatment device 200 can be quickly and safely inserted to the target site in the body, and the burden on both the patient and the doctor is reduced.

〈実施形態３〉
［医療用処置具の概要］
図１１および図１２を用いて、本開示の一実施形態に係る医療用処置具の構成及び構造を説明する。なお、本実施形態において、本開示の実施形態１と同じである部分は、その繰り返しの説明は省略する。図１１は、本開示の一実施形態に係る医療用処置具の（Ａ）全体図、（Ｂ）上面図、および（Ｃ）分解図である。図１２は、本開示の一実施形態に係る医療用処置具の断面図である。本実施形態に係る医療用処置具とは、例えば、カテーテル、ガイドワイヤ、または内視鏡用処置具などを示す。 <Third Embodiment>
[Outline of medical treatment tools]
The configuration and structure of the medical treatment tool according to an embodiment of the present disclosure will be described with reference to FIGS. 11 and 12. In addition, in the present embodiment, the repeated description of the same parts as those of the first embodiment of the present disclosure will be omitted. FIG. 11 is an (A) overall view, a (B) top view, and a (C) exploded view of a medical treatment tool according to an embodiment of the present disclosure. FIG. 12 is a cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. The medical treatment tool according to the present embodiment indicates, for example, a catheter, a guide wire, a treatment tool for an endoscope, or the like.

図１１および図１２に示すように、医療用処置具５００は、屈曲コイル１２０と、チューブ１６０と、を備える。屈曲コイル１２０は、先端部１２２、無荷重時において中心軸１３６が屈曲している屈曲部１２４、屈曲部１２４を介して先端部１２２とは反対側に配置された連結部１２６、及び連結部１２６側の巻き解け部１２８を有する。屈曲コイル１２０はさらに、巻き解け部１２８から離隔して、連結部１２６に位置する固定部１３８を有する。チューブ１６０は、可撓性を有し、屈曲コイル１２０を回転可能に支持する支持部１６２と、巻き解け部１２８と接する回転抑制部１４４と、支持部１６２とは反対側の基端１６４とを有する。チューブ１６０はさらに、固定部１３８と接続し、固定部１３８から巻き解け部１２８までの屈曲コイル１２０の長さを保持する固定端部１４８を有する。屈曲コイル１２０の連結部１２６は、チューブ１６０の支持部１６２に接続される。ここで、本実施形態に係る医療用処置具５００をチューブ１６０の軸方向において屈曲コイル１２０側（図１１（Ａ）のＢ方向）から見た図を上面図（図１１（Ｂ）、図１４）とする。また、全体図（図１１（Ａ））、分解図（図１１（Ｃ））、及び断面図（図１２、図１３）は、チューブ１６０の軸の垂直方向（図１１（Ｂ）のＡ方向）から見た図である。 As shown in FIGS. 11 and 12, the medical treatment tool 500 includes a bending coil 120 and a tube 160. The bending coil 120 includes a tip portion 122, a bending portion 124 in which the central axis 136 is bent when no load is applied, a connecting portion 126 disposed on the opposite side of the tip portion 122 via the bending portion 124, and a connecting portion 126. It has a side unwinding portion 128. The bending coil 120 further includes a fixing portion 138 that is located at the connection portion 126 and is separated from the unwinding portion 128. The tube 160 is flexible and includes a support portion 162 that rotatably supports the bending coil 120, a rotation suppressing portion 144 that contacts the unwinding portion 128, and a base end 164 that is opposite to the support portion 162. Have. The tube 160 further has a fixed end portion 148 which is connected to the fixed portion 138 and holds the length of the bending coil 120 from the fixed portion 138 to the unwinding portion 128. The connecting portion 126 of the bending coil 120 is connected to the supporting portion 162 of the tube 160. Here, a view of the medical treatment instrument 500 according to the present embodiment as seen from the bending coil 120 side (B direction in FIG. 11A) in the axial direction of the tube 160 is a top view (FIG. 11B, FIG. 14). ). In addition, an overall view (FIG. 11A), an exploded view (FIG. 11C), and a cross-sectional view (FIGS. 12 and 13) show a direction perpendicular to the axis of the tube 160 (direction A in FIG. 11B). It is the figure seen from.

チューブ１６０は、屈曲コイル１２０の固定部１３８が位置する支持部１６２に固定端部１４８を有する。固定端部１４８は、固定部１３８と接続し、固定部１３８から巻き解け部１２８までの屈曲コイル１２０の長さを保持する。固定端部１４８に接続する屈曲コイル１２０の固定部１３８が回転すると、支持部１６２は可撓性を有することから、支持部１６２が捩じれて固定端部１４８は回転する。さらに、支持部１６２は弾性を有することから、後述する第２のコイル１２０ｂ’とともに、再び元の状態に戻る性質を有する。本実施形態において固定端部１４８は、チューブ１６０の基端１６４とは反対側の一端に位置する。すなわち支持部１６２は、屈曲コイル１２０の固定部１３８から巻き解け部１２８までと、円筒軸方向においてほぼ同じ長さを有する。しかしながらこれに限定されず、固定端部１４８は、屈曲コイル１２０が解けて回転したとき、固定部１３８から巻き解け部１２８までの屈曲コイル１２０の長さを保持でき、固定端部１４８が少なくとも３６０°回転可能な位置であればよい。 The tube 160 has a fixed end portion 148 on the support portion 162 where the fixed portion 138 of the bending coil 120 is located. The fixed end portion 148 is connected to the fixed portion 138 and holds the length of the bending coil 120 from the fixed portion 138 to the unwinding portion 128. When the fixed portion 138 of the bending coil 120 connected to the fixed end portion 148 rotates, the support portion 162 has flexibility, so that the support portion 162 is twisted and the fixed end portion 148 rotates. Further, since the support portion 162 has elasticity, it has a property of returning to the original state again together with the second coil 120b' described later. In the present embodiment, the fixed end portion 148 is located at one end of the tube 160 opposite to the base end 164. That is, the supporting portion 162 has substantially the same length in the cylindrical axis direction as the fixing portion 138 of the bending coil 120 to the unwinding portion 128. However, the invention is not limited to this, and the fixed end portion 148 can hold the length of the bending coil 120 from the fixing portion 138 to the unwinding portion 128 when the bending coil 120 is unwound and rotated, and the fixed end portion 148 has at least 360. ° Any position can be used.

チューブ１６０は、屈曲コイル１２０の巻き解け部１２８が位置する支持部１６２に、回転抑制部１４４を有する。回転抑制部１４４には、屈曲コイル１２０の巻き解け部１２８が接している。屈曲コイル１２０の巻き解け部１２８側の端部１３０は、チューブ１６０の回転抑制部１４４を介して円筒内部空間に配置される。巻き解け部１２８が回転抑制部１４４と接触することにより、巻き解け部１２８より先の屈曲コイル１２０の部分は係止する。さらに屈曲コイル１２０の固定部１３８は、支持部１６２の固定端部１４８に接続する。屈曲コイル１２０の端部１３０を、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の屈曲コイル１２０とは反対側の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４で解け、解けた分だけ屈曲コイル１２０は回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、屈曲コイル１２０の固定部１３８から巻き解け部１２８は屈曲コイル１２０が解けた分だけ伸張する。屈曲コイル１２０は弾性変形の範囲内で伸張することから、屈曲コイル１２０の固定部１３８から端部１３０の間で引力が生じる。屈曲コイル１２０の端部１３０を、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の屈曲コイル１２０側に移動させることで、屈曲コイル１２０は回転抑制部１４４で巻き戻り、巻き戻った分だけ屈曲コイル１２０は回転する。 The tube 160 has a rotation suppressing portion 144 on the support portion 162 where the unwinding portion 128 of the bending coil 120 is located. The unwinding portion 128 of the bending coil 120 is in contact with the rotation suppressing portion 144. The end portion 130 of the bending coil 120 on the side of the unwinding portion 128 is arranged in the cylindrical inner space via the rotation suppressing portion 144 of the tube 160. By the unwinding portion 128 coming into contact with the rotation suppressing portion 144, the portion of the bending coil 120 ahead of the unwinding portion 128 is locked. Further, the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162. The bending coil 120 is restrained from rotating by moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160 opposite to the bending coil 120 via the rotation suppressing portion 144 and the internal space of the tube 160. The bending coil 120 is unwound by the portion 144, and the bending coil 120 is rotated by the unwound amount. Since the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162, the unwinding portion 128 extends from the fixed portion 138 of the bending coil 120 by the amount that the bending coil 120 is unwound. Since the bending coil 120 expands within the range of elastic deformation, an attractive force is generated between the fixed portion 138 and the end portion 130 of the bending coil 120. By moving the end portion 130 of the bending coil 120 to the bending coil 120 side of the tube 160 via the rotation suppressing portion 144 and the internal space of the tube 160, the bending coil 120 is rewound and rewound by the rotation suppressing portion 144. The bending coil 120 is rotated by an amount.

本実施形態において、屈曲コイル１２０の端部１３０は、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の基端１６４側に移動させる。しかしながらこれに限定されず、屈曲コイル１２０の端部１３０は、例えば、支持部１６２の屈曲コイル１２０を支持する形態、形状、および回転抑制部１４４の形状などによって、回転抑制部１４４を介してチューブ１６０の外側に配置してもよい。屈曲コイル１２０の端部１３０を、チューブ１６０の回転抑制部１４４を介して円筒外側においてチューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４で解け、解けた分だけ屈曲コイル１２０は回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、屈曲コイル１２０の固定部１３８から巻き解け部１２８は屈曲コイル１２０が解けた分だけ伸張する。屈曲コイル１２０は弾性変形の範囲内で伸張することから、屈曲コイル１２０の固定部１３８から端部１３０の間で引力が生じる。屈曲コイル１２０の端部１３０を、回転抑制部１４４介して、円筒外側においてチューブ１６０の屈曲コイル１２０側に移動させることで、屈曲コイル１２０は回転抑制部１４４で巻き戻り、巻き戻った分だけ屈曲コイル１２０は回転する。 In the present embodiment, the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160 via the rotation suppressing portion 144 and the internal space of the tube 160. However, the end portion 130 of the bending coil 120 is not limited to this, and the end portion 130 of the bending coil 120 may be connected to the tube via the rotation suppressing portion 144 depending on, for example, the shape and shape of the supporting portion 162 that supports the bending coil 120 and the shape of the rotation suppressing portion 144. It may be arranged outside 160. By moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160 on the outer side of the cylinder via the rotation suppressing portion 144 of the tube 160, the bending coil 120 is melted by the rotation suppressing portion 144, and only the unwound portion is melted. The bending coil 120 rotates. Since the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162, the unwinding portion 128 extends from the fixed portion 138 of the bending coil 120 by the amount that the bending coil 120 is unwound. Since the bending coil 120 expands within the range of elastic deformation, an attractive force is generated between the fixed portion 138 and the end portion 130 of the bending coil 120. By moving the end portion 130 of the bending coil 120 to the bending coil 120 side of the tube 160 on the outer side of the cylinder via the rotation suppressing portion 144, the bending coil 120 is rewound by the rotation suppressing portion 144, and is bent by the unwound amount. The coil 120 rotates.

屈曲コイル１２０は、固定部１３８を有する。固定部１３８は、支持部１６２の固定端部１４８に接続する。固定部１３８は、巻き解け部１２８から離隔した連結部１２６に位置する。本実施形態において固定部１３８は、連結部１２６の巻き解け部とは反対側の屈曲部１２４側に位置する。しかしながらこれに限定されず、固定部１３８は、巻き解け部１２８で屈曲コイル１２０が解けて回転したとき、固定部１３８から巻き解け部１２８までの屈曲コイル１２０が弾性変形の範囲内で伸縮可能な位置であればよい。 The bending coil 120 has a fixing portion 138. The fixed portion 138 is connected to the fixed end portion 148 of the support portion 162. The fixing portion 138 is located at the connecting portion 126 separated from the unwinding portion 128. In the present embodiment, the fixing portion 138 is located on the side of the bent portion 124 opposite to the unwinding portion of the connecting portion 126. However, the present invention is not limited to this, and when the bending coil 120 is unwound and rotated by the unwinding portion 128, the fixed portion 138 can expand and contract within the range of elastic deformation of the bending coil 120 from the fixing portion 138 to the unwinding portion 128. Any position will do.

屈曲コイル１２０は少なくとも２つの部分を有し、巻き解け部１２８側の第１のコイル１２０ａの部分と、先端部１２２側の第２のコイル１２０ｂの部分とを含む。第１のコイル１２０ａの部分と第２のコイル１２０ｂの部分を区別しない時には、屈曲コイル１２０という。本実施形態において、連結部１２６は少なくとも２つの部分を有し、巻き解け部１２８側の第１のコイル１２０ａの部分と、第１のコイル１２０ａと隣接する屈曲部１２４側の第２のコイル１２０ｂ’の部分とを有する。すなわち、屈曲コイル１２０は巻き解け部１２８と固定部１３８の間に少なくとも２つの部分を有し、巻き解け部１２８側の第１のコイル１２０ａの部分と、屈曲部１２４側の第２のコイル１２０ｂ’の部分とを有する。第１のコイル１２０ａの部分と第２のコイル１２０ｂの部分は、接合部１４０において逆巻きに接続する。さらに本実施形態において、第１のコイル１２０ａの部分のばね定数は、第２のコイル１２０ｂの部分のばね定数よりも小さい。本実施形態において、第１のコイル１２０ａの部分は先端部１２２から連結部１２６の方向に左巻きであり、第２のコイル１２０ｂの部分は先端部１２２から連結部１２６の方向に右巻きである。接合部１４０は、固定部１３８から巻き解け部１２８の間に位置する。すなわち屈曲コイル１２０の固定部１３８から巻き解け部１２８の間には少なくとも２つの部分を有し、巻き解け部１２８側の第１のコイル１２０ａの部分と、固定部１３８側の第２のコイル１２０ｂ’の部分を有する。本実施形態において、第２のコイル１２０ｂは一体で示したがこれに限定されない。第２のコイル１２０ｂは固定部１３８の部分で別体に分かれていてもよい。 The bending coil 120 has at least two parts, and includes a part of the first coil 120a on the unwinding part 128 side and a part of the second coil 120b on the tip end part 122 side. When the portion of the first coil 120a and the portion of the second coil 120b are not distinguished, they are referred to as bending coils 120. In the present embodiment, the connecting portion 126 has at least two portions, and the portion of the first coil 120a on the unwinding portion 128 side and the second coil 120b on the bending portion 124 side adjacent to the first coil 120a. 'With the part. That is, the bending coil 120 has at least two parts between the unwinding part 128 and the fixing part 138, and the part of the first coil 120a on the unwinding part 128 side and the second coil 120b on the bending part 124 side. 'With the part. The portion of the first coil 120a and the portion of the second coil 120b are connected in reverse winding at the joint portion 140. Further, in the present embodiment, the spring constant of the portion of the first coil 120a is smaller than the spring constant of the portion of the second coil 120b. In the present embodiment, the portion of the first coil 120a is left-handed in the direction from the tip portion 122 to the connecting portion 126, and the portion of the second coil 120b is right-handed in the direction from the tip portion 122 to the connecting portion 126. The joining portion 140 is located between the fixing portion 138 and the unwinding portion 128. That is, at least two parts are provided between the fixing part 138 and the unwinding part 128 of the bending coil 120, and the part of the first coil 120a on the unwinding part 128 side and the second coil 120b on the fixing part 138 side. 'Has a part. In the present embodiment, the second coil 120b is shown integrally, but the present invention is not limited to this. The second coil 120b may be separately provided at the fixing portion 138.

屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させるとき、第１のコイル１２０ａの部分はばね定数が小さいことから、回転抑制部１４４で解けやすく、屈曲コイル１２０は回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、支持部１６２の固定端部１４８は屈曲コイル１２０とともに回転し、支持部１６２は捩じれる。屈曲コイル１２０の固定部１３８から巻き解け部１２８は屈曲コイル１２０が解けた分だけ弾性変形の範囲内で軸方向に伸張する。屈曲コイル１２０の固定部１３８から巻き解け部１２８が軸方向に伸張することで、第１のコイル１２０ａの部分には径の縮小方向に力がかかり、第２のコイル１２０ｂ’の部分には径の拡張方向に力がかかる。第１のコイル１２０ａの部分と第２のコイル１２０ｂ’の部分とが逆巻きに接続することから、屈曲コイル１２０の固定部１３８から巻き解け部１２８が軸方向に伸張しても、固定部１３８から巻き解け部１２８の径の大きさは変わらない。屈曲コイル１２０の固定部１３８から巻き解け部１２８が軸方向に伸張するとき、第２のコイル１２０ｂの部分はばね定数が大きいことから、第２のコイル１２０ｂ’の部分は軸方向に大きな引力を生じる。第２のコイル１２０ｂ’の部分はばね定数が大きいことから、屈曲コイル１２０の端部１３０をさらにチューブ１６０の基端１６４側に移動させようとしても、回転抑制部１４４で解けず、屈曲コイル１２０は回転も止まる。第２のコイル１２０ｂ’の引力を利用して、屈曲コイル１２０の端部１３０を屈曲コイル１２０側に移動させることで、第２のコイル１２０ｂ’の部分は軸方向に収縮し、第１のコイル１２０ａの部分は回転抑制部１４４で巻き戻り、巻き戻った分だけ屈曲コイル１２０は回転する。 When the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, the first coil 120a has a small spring constant, and therefore the rotation suppressing portion 144 can easily loosen the bending coil 120. Since the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162, the fixed end portion 148 of the support portion 162 rotates together with the bending coil 120, and the support portion 162 is twisted. The unwinding portion 128 from the fixing portion 138 of the bending coil 120 extends in the axial direction within the range of elastic deformation by the amount that the bending coil 120 is unwound. As the unwinding portion 128 extends axially from the fixed portion 138 of the bending coil 120, a force is applied to the portion of the first coil 120a in the direction of decreasing the diameter, and a portion of the second coil 120b′ is changed to the diameter. Force is applied in the direction of expansion. Since the first coil 120a part and the second coil 120b' part are connected in reverse winding, even if the unwinding part 128 extends axially from the fixing part 138 of the bending coil 120, The diameter of the unwinding portion 128 does not change. When the unwinding portion 128 extends axially from the fixed portion 138 of the bending coil 120, the second coil 120b portion has a large spring constant, so that the second coil 120b′ portion exerts a large attractive force in the axial direction. Occurs. Since the second coil 120b′ has a large spring constant, even if the end portion 130 of the bending coil 120 is further moved to the base end 164 side of the tube 160, the rotation suppressing portion 144 does not solve the bending coil 120. Also stops spinning. By using the attractive force of the second coil 120b' to move the end 130 of the bending coil 120 to the bending coil 120 side, the portion of the second coil 120b' contracts in the axial direction, and the first coil The portion 120a is rewound by the rotation suppressing portion 144, and the bending coil 120 is rotated by the unwound portion.

第１のコイル１２０ａの部分のばね定数は小さいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動するとき、第１のコイル１２０ａを容易に解くことができ、屈曲コイル１２０の回転を容易に制御することができる。さらに第２のコイル１２０ｂの部分のばね定数は大きいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させることで、固定部１３８から巻き解け部１２８のうちの第２のコイル１２０ｂ’の部分には大きな引力が生じ、屈曲コイル１２０の回転を容易に制御することができる。第１のコイル１２０ａの部分と第２のコイル１２０ｂの部分とが逆巻きに接続することから、屈曲コイル１２０の固定部１３８を支持部１６２の固定端部１４８に固定した状態で固定部１３８から巻き解け部１２８を伸張しても、屈曲コイル１２０の径が縮小することを抑制することができる。第２のコイル１２０ｂの部分のばね定数は大きいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側にさらに移動しようとしても回転抑制部１４４で解けにくく、さらに屈曲部１２４の屈曲角度を維持することができる。第１のコイル１２０ａの部分のばね定数と第２のコイル１２０ｂの部分のばね定数は、医療用処置具１００として使用時にかかる抵抗に対して、形状を維持するだけの剛性を有し、且つ適度な弾性を有する範囲内で選択することができる。 Since the spring constant of the portion of the first coil 120a is small, when the end portion 130 of the bending coil 120 is moved to the proximal end 164 side of the tube 160, the first coil 120a can be easily unraveled, and the bending coil The rotation of 120 can be easily controlled. Further, since the spring constant of the portion of the second coil 120b is large, by moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160, the second portion of the unwinding portion 128 from the fixing portion 138 is moved. A large attractive force is generated in the portion of the coil 120b', and the rotation of the bending coil 120 can be easily controlled. Since the portion of the first coil 120a and the portion of the second coil 120b are connected in reverse winding, the fixing portion 138 of the bending coil 120 is wound from the fixing portion 138 while being fixed to the fixed end portion 148 of the support portion 162. Even if the unraveling portion 128 is extended, it is possible to suppress the diameter of the bending coil 120 from being reduced. Since the spring constant of the portion of the second coil 120b is large, even if the end portion 130 of the bending coil 120 is further moved to the base end 164 side of the tube 160, it is difficult for the rotation suppressing portion 144 to unravel and the bending portion 124 is further bent. The angle can be maintained. The spring constant of the portion of the first coil 120a and the spring constant of the portion of the second coil 120b have rigidity enough to maintain the shape with respect to the resistance applied during use as the medical treatment instrument 100, and are appropriate. It can be selected within a range having various elasticity.

本実施形態において屈曲コイル１２０は、金属の素線１をらせん状に密着巻きして形成された一次コイル１０の中心軸をさらにらせん状に密着巻きした二重コイルである。屈曲コイル１２０は、先端部１２２、屈曲部１２４、及び連結部１２６において二重コイルを形成する。巻き解け部１２８から端部１３０までは一次コイル１０に解かれた形状で、チューブ１６０の内部空間に配置される。屈曲コイル１２０は、回転抑制部１４４において解ける。屈曲コイル１２０は、金属の素線１を密着巻きして形成された中空の一次コイル１０を密着巻きした二重コイルであるため、可撓性が高く、屈曲コイル１２０を容易に解くことができ、屈曲コイル１２０の回転を制御することができる。 In the present embodiment, the bending coil 120 is a double coil in which the central axis of the primary coil 10 formed by closely winding the metal element wire 1 in a spiral shape is further wound in a spiral shape. The bending coil 120 forms a double coil in the tip portion 122, the bending portion 124, and the connecting portion 126. The unwound portion 128 to the end portion 130 have a shape unwound by the primary coil 10 and are arranged in the internal space of the tube 160. The bending coil 120 can be unwound at the rotation suppressing unit 144. Since the bending coil 120 is a double coil in which the hollow primary coil 10 formed by closely winding the metal wire 1 is closely wound, the bending coil 120 has high flexibility and the bending coil 120 can be easily unwound. The rotation of the bending coil 120 can be controlled.

隣接して配置された素線１は密着して一次コイル１０を形成する。このため一次コイル１０の表面は滑らかであり、回転抑制部１４４及びチューブ１６０の内部空間における移動時の摩擦を抑制することができる。隣接して配置された一次コイル１０は密着して二重コイルを形成する。このため二重コイルである屈曲コイル１２０の表面は滑らかであり、屈曲コイル１２０の回転時の摩擦を抑制することができる。しかしながらこれに限定されず、屈曲コイル１２０が二重コイルである場合、隣接して配置された一次コイル１０は無荷重時において離隔していてもよい。隣接して配置された一次コイル１０間のピッチが大きくなるほど、屈曲コイル１２０を解くのに必要な力は小さくなり、解けた一次コイル１０の長さ当たりの回転速度は抑制されることから、屈曲コイル１２０の回転をより精密に制御することができる。 The wires 1 arranged adjacent to each other are in close contact with each other to form the primary coil 10. Therefore, the surface of the primary coil 10 is smooth, and it is possible to suppress the friction during the movement of the rotation suppressing portion 144 and the tube 160 in the internal space. The primary coils 10 arranged adjacent to each other are in close contact with each other to form a double coil. Therefore, the surface of the bending coil 120, which is a double coil, is smooth, and friction during rotation of the bending coil 120 can be suppressed. However, the invention is not limited to this, and when the bending coil 120 is a double coil, the adjacent primary coils 10 may be separated from each other when there is no load. As the pitch between the adjacent primary coils 10 increases, the force required to unwind the bending coil 120 decreases, and the rotational speed per length of the unraveled primary coil 10 is suppressed. The rotation of the coil 120 can be controlled more precisely.

本実施形態において屈曲コイル１２０は、金属の素線１を密着巻きして形成された一次コイル１０を密着巻きした二重コイルを用いたが、屈曲コイル１２０の少なくとも一部は中実または中空の素線をらせん状に巻いた通常のコイルであってもよく、その場合、隣接して配置された素線１は密着していてもよいし、隣接して配置された素線１は無荷重時において離隔していてもよい。中実または中空の素線で形成されるコイルであっても、本実施形態の医療用処置具５００と同様の動作をすることが可能である。さらに、屈曲コイル１２０の少なくとも連結部１２６に位置するコイルの部分が、金属の素線１を密着巻きして形成された一次コイル１０を巻いた二重コイルであることで、屈曲コイル１２０を容易に解くことができ、屈曲コイル１２０の回転を制御することができる。 In the present embodiment, the bending coil 120 is a double coil in which the primary coil 10 formed by closely winding the metal wire 1 is closely wound, but at least a part of the bending coil 120 is solid or hollow. It may be a normal coil in which the wires are wound in a spiral shape, in which case the adjacent wires 1 may be in close contact with each other, or the adjacent wires 1 may be unloaded. It may be separated at times. Even a coil formed of a solid or hollow element wire can perform the same operation as that of the medical treatment instrument 500 of the present embodiment. Further, the bending coil 120 can be easily formed by the double coil in which the primary coil 10 formed by closely winding the metal wire 1 is wound around at least the coil portion of the bending coil 120 that is located at the connecting portion 126. The rotation of the bending coil 120 can be controlled.

図１１（Ａ）に示すように、屈曲コイル１２０は、屈曲部１２４において中心軸１３６が屈曲している。このため屈曲部１２４の屈曲側（図１１（Ａ）のＣ側）は密着しているが、屈曲部１２４の伸張側（図１１（Ａ）のＤ側）は隣接して配置された一次コイル１０が無荷重時において離隔している。屈曲部１２４における屈曲角度は、０°より大きく１８０°以下の範囲で適宜調整することができる。 As shown in FIG. 11A, in the bending coil 120, the central axis 136 is bent at the bending portion 124. Therefore, the bent side of the bent portion 124 (the C side of FIG. 11A) is in close contact, but the extended side of the bent portion 124 (the D side of FIG. 11A) is adjacent to the primary coil. 10 are separated when there is no load. The bending angle in the bending portion 124 can be appropriately adjusted within the range of more than 0° and 180° or less.

本実施形態において屈曲コイル１２０は、第１のコイル１２０ａの部分が先端部１２２から連結部１２６の方向に左巻きであり、第２のコイル１２０ｂの部分が先端部１２２から連結部１２６の方向に右巻きである。このため屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４を支点に解けた分だけ、チューブ１６０の円筒軸方向の屈曲コイル１２０側（図１１（Ａ）のＢ方向）から見て左回りに回転する（図１１（Ｂ）のＥ方向）。屈曲コイル１２０が回転することで、屈曲部１２４の屈曲方向も回転する。すなわち屈曲コイル１２０が半周解けることで、屈曲方向はチューブ１６０の円筒軸方向の屈曲コイル１２０側（図１１（Ａ）のＢ方向）から見て左回りに１８０°回転する。しかしながらこれに限定されず、屈曲コイル１２０は、第１のコイル１２０ａの部分が先端部１２２から連結部１２６の方向に右巻きであり、第２のコイル１２０ｂの部分が先端部１２２から連結部１２６の方向に左巻きであってもよい。この場合、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４を支点に解けた分だけ、チューブ１６０の円筒軸方向の屈曲コイル１２０側（図１１（Ａ）のＢ方向）から見て右回りに回転する。屈曲コイル１２０が回転することで、屈曲部１２４の屈曲方向も回転する。すなわち屈曲コイル１２０が半周解けることで、屈曲方向はチューブ１６０の円筒軸方向の屈曲コイル１２０側（図１１（Ａ）のＢ方向）から見て右回りに１８０°回転する。屈曲コイル１２０の端部１３０の位置を制御することで、屈曲コイル１２０の屈曲方向を制御することができる。また、固定端部１４８の形状と、屈曲コイル１２０の弾性変形の範囲内で屈曲方向は１８０°以上回転してもよい。ここで屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させるとき、屈曲コイル１２０が回転する方向を、屈曲コイルの回転方向とする。 In the bending coil 120 in the present embodiment, the first coil 120a is left-handed in the direction from the tip 122 to the connecting portion 126, and the second coil 120b is right-hand in the direction from the tip 122 to the connecting portion 126. It is a roll. Therefore, by moving the end portion 130 of the bending coil 120 toward the base end 164 side of the tube 160, the bending coil 120 is unwound around the rotation suppressing portion 144 as a fulcrum, and thus the bending coil 120 side in the cylindrical axis direction of the tube 160. It rotates counterclockwise when viewed from (direction B in FIG. 11A) (direction E in FIG. 11B). As the bending coil 120 rotates, the bending direction of the bending portion 124 also rotates. That is, when the bending coil 120 is unwound halfway, the bending direction rotates 180° counterclockwise when viewed from the bending coil 120 side (direction B in FIG. 11A) in the cylindrical axis direction of the tube 160. However, the present invention is not limited to this, and in the bending coil 120, the portion of the first coil 120a is right-handed in the direction from the tip portion 122 to the connecting portion 126, and the portion of the second coil 120b is from the tip portion 122 to the connecting portion 126. It may be left-handed in the direction of. In this case, the bending coil 120 is moved toward the base end 164 side of the tube 160 by moving the end portion 130 of the bending coil 120, and the bending coil 120 in the cylindrical axis direction of the tube 160 corresponds to the amount by which the rotation suppressing portion 144 is released. It rotates clockwise when viewed from the side (direction B in FIG. 11A). As the bending coil 120 rotates, the bending direction of the bending portion 124 also rotates. That is, when the bending coil 120 is unwound halfway, the bending direction rotates clockwise by 180° when viewed from the bending coil 120 side in the cylindrical axis direction of the tube 160 (direction B in FIG. 11A). By controlling the position of the end portion 130 of the bending coil 120, the bending direction of the bending coil 120 can be controlled. Further, the bending direction may rotate by 180° or more within the shape of the fixed end portion 148 and the range of elastic deformation of the bending coil 120. Here, when the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, the direction in which the bending coil 120 rotates is referred to as the rotation direction of the bending coil.

図１１（Ｂ）に示すように、チューブ１６０の円筒軸方向の屈曲コイル１２０側（図１１（Ａ）のＢ方向）から見たときに、屈曲コイル１２０の先端部１２２は、屈曲コイルの回転方向（図１１（Ｂ）のＥ方向）と同じ方向に湾曲していてもよい。本実施形態に係る屈曲コイル１２０は、第１のコイル１２０ａの部分が先端部１２２から連結部１２６の方向に左巻きであり、第２のコイル１２０ｂの部分が先端部１２２から連結部１２６の方向に右巻きである。屈曲コイル１２０は、チューブ１６０の円筒軸方向の屈曲コイル１２０側（図１１（Ａ）のＢ方向）から見たときに左回りに回転し、先端部１２２の中心軸１３６は屈曲コイルの回転方向と同じ方向に湾曲していてもよい。いいかえると、本実施形態において第２のコイル１２０ｂの部分は、連結部１２６から先端部１２２の方向に左巻きであり、屈曲コイルの先端部１２２の方向から見たときに、屈曲コイル１２０の中心軸１３６は連結部１２６から先端部１２２の方向に右側に湾曲していてもよい。屈曲コイル１２０の先端部１２２が屈曲コイルの回転方向と同じ方向に湾曲していることで、医療用処置具５００を体内の目的部位に挿入するとき、屈曲コイル１２０の先端部１２２に係る摩擦などの力の向きが第２のコイル１２０ｂの部分を締める方向にかかる。これによって、屈曲コイル１２０の先端部１２２に係る摩擦などの力によって、第２のコイル１２０ｂの部分が意図せず解けてしまうことを防止することができる。 As shown in FIG. 11(B), when viewed from the bending coil 120 side of the tube 160 in the cylindrical axis direction (direction B in FIG. 11(A)), the tip end portion 122 of the bending coil 120 is rotated by the bending coil. It may be curved in the same direction (direction E in FIG. 11B). In the bending coil 120 according to the present embodiment, the portion of the first coil 120a is left-handed in the direction from the tip portion 122 to the connecting portion 126, and the portion of the second coil 120b is in the direction from the tip portion 122 to the connecting portion 126. Right-handed. The bending coil 120 rotates counterclockwise when viewed from the bending coil 120 side (direction B in FIG. 11A) in the cylindrical axis direction of the tube 160, and the central axis 136 of the tip 122 is the rotational direction of the bending coil. It may be curved in the same direction as. In other words, in the present embodiment, the portion of the second coil 120b is left-handed in the direction from the connecting portion 126 to the tip 122, and when viewed from the direction of the tip 122 of the bending coil, the central axis of the bending coil 120 is 136 may be curved to the right in the direction from the connecting portion 126 to the tip portion 122. Since the distal end portion 122 of the bending coil 120 is curved in the same direction as the rotating direction of the bending coil 120, when the medical treatment instrument 500 is inserted into a target site in the body, friction related to the distal end portion 122 of the bending coil 120, etc. Is applied in the direction of tightening the portion of the second coil 120b. As a result, it is possible to prevent the portion of the second coil 120b from being unintentionally unraveled by a force such as friction related to the tip end portion 122 of the bending coil 120.

本実施形態においてチューブ１６０は、説明を分かりやすくするため、短く直線的に図示した。しかしながらこれに限定されず、チューブ１６０の長さは２００ｍｍ以上１８００ｍｍ以下の範囲で適宜選択することができる。またチューブ１６０は、医療用処置具５００として使用時にかかる抵抗に対して、十分な剛性を有し、且つ適度な弾性を有することができる。特に支持部１６２は、固定端部１４８から回転抑制部１４４までの軸方向における長さを保持するのに十分な剛性を有し、且つ固定端部１４８の回転を許容するため適度な弾性を有することができる。 In the present embodiment, the tube 160 is illustrated as a short linear shape for easy understanding of the description. However, the length of the tube 160 is not limited to this, and can be appropriately selected within the range of 200 mm or more and 1800 mm or less. Further, the tube 160 can have sufficient rigidity and appropriate elasticity with respect to the resistance applied when the medical treatment tool 500 is used. In particular, the support portion 162 has sufficient rigidity to hold the length in the axial direction from the fixed end portion 148 to the rotation suppressing portion 144, and has appropriate elasticity to allow the fixed end portion 148 to rotate. be able to.

［医療用処置具の動作の概要］
次に図１３および図１４を用いて、本実施形態に係る医療用処置具５００の動作について詳細に説明する。図１３は、本開示の一実施形態に係る医療用処置具５００の動作を示す断面図である。図１４は、本開示の一実施形態に係る医療用処置具５００の動作を示す上面図である。 [Outline of operation of medical treatment instrument]
Next, the operation of the medical treatment instrument 500 according to the present embodiment will be described in detail with reference to FIGS. 13 and 14. FIG. 13 is a cross-sectional view showing the operation of the medical treatment tool 500 according to an embodiment of the present disclosure. FIG. 14: is a top view which shows operation|movement of the medical treatment tool 500 which concerns on one Embodiment of this indication.

本実施形態に係る医療用処置具５００は、屈曲コイル１２０の端部１３０を、チューブ１６０の基端１６４側に引っ張ることで、屈曲コイル１２０を回転させることができる。図１３（Ｂ）に示すように、図１３（Ａ）の状態から屈曲コイル１２０の端部１３０を基端１６４側に１／４周長引っ張り、屈曲コイル１２０を１／４回転解くことで、屈曲コイル１２０は図１４（Ａ）から図１４（Ｂ）に示すように、チューブ１６０の円筒軸方向の屈曲コイル１２０側から見たときに、左周りに９０°回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が解けた分だけ伸張する。屈曲コイル１２０は弾性変形の範囲内で伸張することから、屈曲コイル１２０の固定部１３８から端部１３０の間で引力が生じる。図１３（Ｃ）および図１４（Ｃ）に示すように、屈曲コイル１２０の端部１３０をさらに１／４周長引っ張り、屈曲コイル１２０をさらに１／４回転解くことで、屈曲コイル１２０は左周りに計１８０°回転する。屈曲コイル１２０の固定部１３８が支持部１６２固定端部１４８に接続していることから、屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が解けた分だけさらに伸張する。屈曲コイル１２０は弾性変形の範囲内で伸張することから、屈曲コイル１２０の固定部１３８から端部１３０の間でさらに引力が生じる。 The medical treatment instrument 500 according to the present embodiment can rotate the bending coil 120 by pulling the end portion 130 of the bending coil 120 toward the base end 164 side of the tube 160. As shown in FIG. 13B, by pulling the end portion 130 of the bending coil 120 from the state of FIG. 13A toward the base end 164 by a quarter circumference, and unwinding the bending coil 120 by a quarter rotation, As shown in FIGS. 14(A) to 14(B), the bending coil 120 rotates 90° counterclockwise when viewed from the bending coil 120 side in the cylindrical axis direction of the tube 160. Since the fixing portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the supporting portion 162, the unwinding portion 128 extends from the fixing portion 138 of the bending coil 120 by the amount that the bending coil 120 is unwound. Since the bending coil 120 expands within the range of elastic deformation, an attractive force is generated between the fixed portion 138 and the end portion 130 of the bending coil 120. As shown in FIG. 13(C) and FIG. 14(C), the end portion 130 of the bending coil 120 is further pulled by 1/4 circumference, and the bending coil 120 is further unwound by 1/4 rotation, whereby the bending coil 120 is left. Rotate a total of 180 degrees around. Since the fixing portion 138 of the bending coil 120 is connected to the supporting portion 162 fixing end portion 148, the unwinding portion 128 extends further from the fixing portion 138 of the bending coil 120 by the amount of the bending coil 120 unwinding. Since the bending coil 120 expands within the range of elastic deformation, further attractive force is generated between the fixed portion 138 and the end portion 130 of the bending coil 120.

図１３（Ｄ）および図１４（Ｄ）に示すように、屈曲コイル１２０の端部１３０を引っ張る力を緩めることで、屈曲コイル１２０は１／４回転巻き戻り、屈曲コイル１２０は、チューブ１６０の円筒軸方向の屈曲コイル１２０側から見たときに、右周りに９０°回転する。屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が巻き戻った分だけ収縮する。屈曲コイル１２０の固定部１３８から端部１３０の間の引力は、屈曲コイル１２０が巻き戻った分だけ緩和される。図１３（Ｅ）および図１４（Ｅ）に示すように、屈曲コイル１２０を引っ張る力をさらに緩めることで、屈曲コイル１２０は１／４回転巻き戻り、屈曲コイル１２０は右周りに計１８０°回転してもとの位置に戻る。屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が巻き戻った分だけ収縮してもとの位置に戻る。屈曲コイル１２０の固定部１３８から端部１３０の間の引力は解消される。ここで周長とは、コイル円周ではなく、１周分の巻き線の長さをいう。 As shown in FIG. 13(D) and FIG. 14(D), the bending coil 120 is rewound by a quarter turn by loosening the force of pulling the end portion 130 of the bending coil 120, and the bending coil 120 moves to the tube 160. When viewed from the bending coil 120 side in the cylindrical axis direction, it rotates 90° clockwise. The unwinding portion 128 from the fixing portion 138 of the bending coil 120 contracts by the amount of rewinding of the bending coil 120. The attractive force between the fixed portion 138 and the end portion 130 of the bending coil 120 is alleviated by the amount of rewinding of the bending coil 120. As shown in FIG. 13(E) and FIG. 14(E), by further loosening the force pulling the bending coil 120, the bending coil 120 is rewound by a quarter turn, and the bending coil 120 rotates clockwise by a total of 180°. Then return to the original position. The unwinding portion 128 from the fixing portion 138 of the bending coil 120 returns to the original position even when the bending coil 120 contracts by the amount of rewinding. The attractive force between the fixed portion 138 and the end portion 130 of the bending coil 120 is released. Here, the circumference means not the circumference of the coil but the length of the winding for one round.

図１３および図１４において屈曲コイル１２０は１／４周長ずつ引っ張り、１／４回転ずつ解き、９０°ずつ回転する様態、および１／４周長ずつ緩め、１／４回転ずつ巻き戻し、９０°ずつ回転する様態を示したが、これに限定されない。屈曲コイル１２０の端部１３０を引っ張る距離は適宜調整でき、屈曲コイル１２０の屈曲方向は任意の方向に制御することができる。また本実施形態において屈曲コイル１２０の固定部１３８は、支持部１６２の固定端部１４８に接続する。支持部１６２の固定端部１４８は３６０°回転可能であり、このため屈曲コイル１２０の屈曲方向は３６０°任意の方向に制御することができる。 In FIG. 13 and FIG. 14, the bending coil 120 is pulled by 1/4 circumference, unwound by 1/4 rotation, rotated by 90°, loosened by 1/4 circumference, and rewound by 1/4 rotation. Although it has been shown to rotate by °, it is not limited to this. The distance by which the end 130 of the bending coil 120 is pulled can be adjusted as appropriate, and the bending direction of the bending coil 120 can be controlled in any direction. Further, in the present embodiment, the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162. The fixed end portion 148 of the support portion 162 can rotate 360°, so that the bending direction of the bending coil 120 can be controlled in any direction of 360°.

本実施形態に係る医療用処置具５００は、医療用処置具５００の先端が血管分岐などの複雑な構造に到達したときであっても、執刀医の手元の屈曲コイル１２０の端部１３０を引っ張ることで、屈曲コイル１２０を回転することができ、先端の屈曲方向を自由に制御することができる。したがって、迅速かつ安全に医療用処置具５００の先端を体内の目的部位まで挿入することができ、患者および医師ともに負担が軽減される。 The medical treatment instrument 500 according to the present embodiment pulls the end portion 130 of the bending coil 120 at the surgeon's hand even when the tip of the medical treatment instrument 500 reaches a complicated structure such as a blood vessel branch. As a result, the bending coil 120 can be rotated, and the bending direction of the tip can be freely controlled. Therefore, the tip of the medical treatment instrument 500 can be quickly and safely inserted to the target site in the body, and the burden on both the patient and the doctor is reduced.

〈実施形態４〉
［医療用処置具の概要］
図１５および図１６を用いて、本開示の一実施形態に係る医療用処置具の構成及び構造を説明する。なお本実施形態は、屈曲コイル１２０とワイヤ１３２の構成以外は、本開示の実施形態３と本質的に同じであり、その繰り返しの説明は省略する。また本実施形態において、本開示の実施形態１と同じである部分は、その繰り返しの説明は省略する。図１５は、本開示の一実施形態に係る医療用処置具の（Ａ）全体図、（Ｂ）上面図、および（Ｃ）分解図である。図１６は、本開示の一実施形態に係る医療用処置具の断面図である。本実施形態に係る医療用処置具とは、例えば、カテーテル、ガイドワイヤ、または内視鏡用処置具などを示す。 <Embodiment 4>
[Outline of medical treatment tools]
The configuration and structure of the medical treatment tool according to an embodiment of the present disclosure will be described with reference to FIGS. 15 and 16. Note that this embodiment is essentially the same as the third embodiment of the present disclosure except for the configuration of the bending coil 120 and the wire 132, and repeated description thereof will be omitted. Further, in the present embodiment, the same description as that of the first embodiment of the present disclosure will not be repeated. FIG. 15 is an (A) overall view, a (B) top view, and a (C) exploded view of a medical treatment tool according to an embodiment of the present disclosure. FIG. 16 is a cross-sectional view of a medical treatment tool according to an embodiment of the present disclosure. The medical treatment tool according to the present embodiment indicates, for example, a catheter, a guide wire, a treatment tool for an endoscope, or the like.

図１５および図１６に示すように、医療用処置具６００は、屈曲コイル１２０と、チューブ１６０と、を備える。屈曲コイル１２０は、先端部１２２、無荷重時において中心軸１３６が屈曲している屈曲部１２４、屈曲部１２４を介して先端部１２２とは反対側に配置された連結部１２６、連結部１２６側の巻き解け部１２８、及び巻き解け部１２８から離隔して、連結部１２６に位置する固定部１３８を有する。屈曲コイル１２０はさらに、先端部１２２に接続されたワイヤ１３２を有する。チューブ１６０は、可撓性を有し、屈曲コイル１２０を回転可能に支持する支持部１６２、巻き解け部１２８と接する回転抑制部１４４、支持部１６２とは反対側の基端１６４、及び固定部１３８と接続し、固定部１３８から巻き解け部１２８までの屈曲コイル１２０の長さを保持する固定端部１４８を有する。屈曲コイル１２０の連結部１２６は、チューブ１６０の支持部１６２に接続される。ここで、本実施形態に係る医療用処置具６００をチューブ１６０の軸方向において屈曲コイル１２０側（図１５（Ａ）のＢ方向）から見た図を上面図（図１５（Ｂ）、図１９）とする。また、全体図（図１５（Ａ））、分解図（図１５（Ｃ））、及び断面図（図１６、図１７、図１８）は、チューブ１６０の軸の垂直方向（図１５（Ｂ）のＡ方向）から見た図である。 As shown in FIGS. 15 and 16, the medical treatment tool 600 includes a bending coil 120 and a tube 160. The bending coil 120 includes a tip portion 122, a bending portion 124 in which the central shaft 136 is bent when no load is applied, a connecting portion 126 disposed on the side opposite to the tip portion 122 via the bending portion 124, and a connecting portion 126 side. The unwinding part 128 and the fixing part 138 located at the connecting part 126 apart from the unwinding part 128. Bending coil 120 further includes wire 132 connected to tip 122. The tube 160 is flexible and has a supporting portion 162 that rotatably supports the bending coil 120, a rotation suppressing portion 144 that contacts the unwinding portion 128, a base end 164 opposite to the supporting portion 162, and a fixing portion. It has a fixed end portion 148 that is connected to the 138 and holds the length of the bending coil 120 from the fixed portion 138 to the unwinding portion 128. The connecting portion 126 of the bending coil 120 is connected to the supporting portion 162 of the tube 160. Here, a view of the medical treatment instrument 600 according to the present embodiment seen from the bending coil 120 side (B direction in FIG. 15A) in the axial direction of the tube 160 is a top view (FIG. 15B, FIG. 19). ). In addition, an overall view (FIG. 15A), an exploded view (FIG. 15C), and a cross-sectional view (FIGS. 16, 17, and 18) show a direction perpendicular to an axis of the tube 160 (FIG. 15B). It is the figure seen from A direction.

チューブ１６０は、屈曲コイル１２０の巻き解け部１２８が位置する支持部１６２に回転抑制部１４４を有する。回転抑制部１４４には、屈曲コイル１２０の巻き解け部１２８が接している。本実施形態において屈曲コイル１２０の巻き解け部１２８側の端部１３０は、チューブ１６０の回転抑制部１４４を介して円筒内部空間に配置される。巻き解け部１２８が回転抑制部１４４と接触することにより、巻き解け部１２８より先の屈曲コイル１２０の部分は係止する。さらに屈曲コイル１２０の固定部１３８は、支持部１６２の固定端部１４８に接続する。屈曲コイル１２０の端部１３０を、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の屈曲コイル１２０とは反対側の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４で解け、解けた分だけ屈曲コイル１２０は回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、屈曲コイル１２０の固定部１３８から巻き解け部１２８は屈曲コイル１２０が解けた分だけ伸張する。屈曲コイル１２０は弾性変形の範囲内で伸張することから、屈曲コイル１２０の固定部１３８から端部１３０の間で引力が生じる。屈曲コイル１２０の端部１３０を、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の屈曲コイル１２０側に移動させることで、屈曲コイル１２０は回転抑制部１４４で巻き戻り、巻き戻った分だけ屈曲コイル１２０は回転する。 The tube 160 has a rotation suppressing portion 144 on the support portion 162 where the unwinding portion 128 of the bending coil 120 is located. The unwinding portion 128 of the bending coil 120 is in contact with the rotation suppressing portion 144. In the present embodiment, the end portion 130 of the bending coil 120 on the side of the unwinding portion 128 is arranged in the cylindrical inner space via the rotation suppressing portion 144 of the tube 160. By the unwinding portion 128 coming into contact with the rotation suppressing portion 144, the portion of the bending coil 120 ahead of the unwinding portion 128 is locked. Further, the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162. The bending coil 120 is restrained from rotating by moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160 opposite to the bending coil 120 via the rotation suppressing portion 144 and the internal space of the tube 160. The bending coil 120 is unwound by the portion 144, and the bending coil 120 is rotated by the unwound amount. Since the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162, the unwinding portion 128 extends from the fixed portion 138 of the bending coil 120 by the amount that the bending coil 120 is unwound. Since the bending coil 120 expands within the range of elastic deformation, an attractive force is generated between the fixed portion 138 and the end portion 130 of the bending coil 120. By moving the end portion 130 of the bending coil 120 to the bending coil 120 side of the tube 160 via the rotation suppressing portion 144 and the internal space of the tube 160, the bending coil 120 is rewound and rewound by the rotation suppressing portion 144. The bending coil 120 is rotated by an amount.

本実施形態において、屈曲コイル１２０の端部１３０は、回転抑制部１４４とチューブ１６０の内部空間を介して、チューブ１６０の基端１６４側に移動させる。しかしながらこれに限定されず、屈曲コイル１２０の端部１３０は、例えば、支持部１６２の屈曲コイル１２０を支持する形態、形状、および回転抑制部１４４の形状などによって、回転抑制部１４４を介してチューブ１６０の外側に配置してもよい。屈曲コイル１２０の端部１３０を、チューブ１６０の回転抑制部１４４を介して円筒外側においてチューブ１６０の基端１６４側に移動させることで、屈曲コイル１２０は回転抑制部１４４で解け、解けた分だけ屈曲コイル１２０は回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、屈曲コイル１２０の固定部１３８から巻き解け部１２８は屈曲コイル１２０が解けた分だけ伸張する。屈曲コイル１２０は弾性変形の範囲内で伸張することから、屈曲コイル１２０の固定部１３８から端部１３０の間で引力が生じる。屈曲コイル１２０の端部１３０を、チューブ１６０の回転抑制部１４４を介して、円筒外側においてチューブ１６０の屈曲コイル１２０側に移動させることで、屈曲コイル１２０は回転抑制部１４４で巻き戻り、巻き戻った分だけ屈曲コイル１２０は回転する。 In the present embodiment, the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160 via the rotation suppressing portion 144 and the internal space of the tube 160. However, the end portion 130 of the bending coil 120 is not limited to this, and the end portion 130 of the bending coil 120 may be connected to the tube via the rotation suppressing portion 144 depending on, for example, the shape and shape of the supporting portion 162 that supports the bending coil 120 and the shape of the rotation suppressing portion 144. It may be arranged outside 160. By moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160 on the outer side of the cylinder via the rotation suppressing portion 144 of the tube 160, the bending coil 120 is melted by the rotation suppressing portion 144, and only the unwound portion is melted. The bending coil 120 rotates. Since the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162, the unwinding portion 128 extends from the fixed portion 138 of the bending coil 120 by the amount that the bending coil 120 is unwound. Since the bending coil 120 expands within the range of elastic deformation, an attractive force is generated between the fixed portion 138 and the end portion 130 of the bending coil 120. By moving the end portion 130 of the bending coil 120 to the bending coil 120 side of the tube 160 on the outer side of the cylinder via the rotation suppressing portion 144 of the tube 160, the bending coil 120 is rewound and rewound by the rotation suppressing portion 144. The bending coil 120 is rotated by an amount.

屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させるとき、第１のコイル１２０ａの部分はばね定数が小さいことから、回転抑制部１４４で解けやすく、屈曲コイル１２０は回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、支持部１６２の固定端部１４８は屈曲コイル１２０とともに回転し、支持部１６２は捩じれる。屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が解けた分だけ弾性変形の範囲内で軸方向に伸張する。屈曲コイル１２０の固定部１３８から巻き解け部１２８が軸方向に伸張することで、第１のコイル１２０ａの部分には径の縮小方向に力がかかり、第２のコイル１２０ｂ’の部分には径の拡張方向に力がかかる。第１のコイル１２０ａの部分と第２のコイル１２０ｂ’の部分とが逆巻きに接続することから、屈曲コイル１２０の固定部１３８から巻き解け部１２８が軸方向に伸張しても、固定部１３８から巻き解け部１２８の径の大きさは変わらない。屈曲コイル１２０の固定部１３８から巻き解け部１２８が軸方向に伸張するとき、第２のコイル１２０ｂの部分はばね定数が大きいことから、第２のコイル１２０ｂ’の部分は軸方向に大きな引力を生じる。第２のコイル１２０ｂ’の部分はばね定数が大きいことから、屈曲コイル１２０の端部１３０をさらにチューブ１６０の基端１６４側に移動させようとしても、回転抑制部１４４で解けず、屈曲コイル１２０は回転も止まる。第２のコイル１２０ｂ’の引力を利用して、屈曲コイル１２０の端部１３０を屈曲コイル１２０側に移動させることで、第２のコイル１２０ｂ’の部分は収縮し、第１のコイル１２０ａの部分は回転抑制部１４４で巻き戻り、巻き戻った分だけ屈曲コイル１２０は回転する。 When the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, the first coil 120a has a small spring constant, and therefore the rotation suppressing portion 144 can easily loosen the bending coil 120. Since the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162, the fixed end portion 148 of the support portion 162 rotates together with the bending coil 120, and the support portion 162 is twisted. The unwinding portion 128 from the fixing portion 138 of the bending coil 120 extends in the axial direction within the range of elastic deformation by the amount that the bending coil 120 is unwound. As the unwinding portion 128 extends axially from the fixed portion 138 of the bending coil 120, a force is applied to the portion of the first coil 120a in the direction of decreasing the diameter, and a portion of the second coil 120b′ is changed to the diameter. Force is applied in the direction of expansion. Since the first coil 120a part and the second coil 120b' part are connected in reverse winding, even if the unwinding part 128 extends axially from the fixing part 138 of the bending coil 120, The diameter of the unwinding portion 128 does not change. When the unwinding portion 128 extends axially from the fixed portion 138 of the bending coil 120, the second coil 120b portion has a large spring constant, so that the second coil 120b′ portion exerts a large attractive force in the axial direction. Occurs. Since the second coil 120b′ has a large spring constant, even if the end portion 130 of the bending coil 120 is further moved to the base end 164 side of the tube 160, the rotation suppressing portion 144 does not solve the bending coil 120. Also stops spinning. By using the attractive force of the second coil 120b' to move the end 130 of the bending coil 120 to the bending coil 120 side, the portion of the second coil 120b' contracts and the portion of the first coil 120a. Is rewound by the rotation suppressing unit 144, and the bending coil 120 is rotated by the unwound amount.

第１のコイル１２０ａの部分のばね定数は小さいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動するとき、第１のコイル１２０ａを容易に解くことができ、屈曲コイル１２０の回転を容易に制御することができる。さらに第２のコイル１２０ｂの部分のばね定数は大きいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動させることで、固定部１３８から巻き解け部１２８のうちの第２のコイル１２０ｂ’の部分は大きな引力が生じ、屈曲コイル１２０の回転を容易に制御することができる。第１のコイル１２０ａの部分と第２のコイル１２０ｂの部分とが逆巻きに接続することから、屈曲コイル１２０の固定部１３８を支持部１６２の固定端部１４８に固定した状態で固定部１３８から巻き解け部１２８を伸張しても、屈曲コイル１２０の径が縮小することを抑制することができる。第２のコイル１２０ｂの部分のばね定数は大きいことから、屈曲コイル１２０の端部１３０をチューブ１６０の基端１６４側に移動しようとしても回転抑制部１４４で解けにくく、さらに屈曲部１２４の屈曲角度を維持することができる。第２のコイル１２０ｂの部分のばね定数は大きいことから、ワイヤ１３２をチューブ１６０の基端１６４側に移動させることで、屈曲部１２４の伸張側では大きな斥力が生じ、屈曲コイル１２０の屈曲角度を容易に制御することができる。第１のコイル１２０ａの部分のばね定数と第２のコイル１２０ｂの部分のばね定数は、医療用処置具１００として使用時にかかる抵抗に対して、形状を維持するだけの剛性を有し、且つ適度な弾性を有する範囲内で選択することができる。 Since the spring constant of the portion of the first coil 120a is small, when the end portion 130 of the bending coil 120 is moved to the proximal end 164 side of the tube 160, the first coil 120a can be easily unraveled, and the bending coil The rotation of 120 can be easily controlled. Further, since the spring constant of the portion of the second coil 120b is large, by moving the end portion 130 of the bending coil 120 to the base end 164 side of the tube 160, the second portion of the unwinding portion 128 from the fixing portion 138 is moved. A large attractive force is generated in the portion of the coil 120b', and the rotation of the bending coil 120 can be easily controlled. Since the portion of the first coil 120a and the portion of the second coil 120b are connected in reverse winding, the fixing portion 138 of the bending coil 120 is wound from the fixing portion 138 while being fixed to the fixed end portion 148 of the support portion 162. Even if the unraveling portion 128 is extended, it is possible to suppress the diameter of the bending coil 120 from being reduced. Since the spring constant of the portion of the second coil 120b is large, even if the end portion 130 of the bending coil 120 is moved to the base end 164 side of the tube 160, it is difficult for the rotation suppressing portion 144 to unravel, and the bending angle of the bending portion 124 is further increased. Can be maintained. Since the spring constant of the portion of the second coil 120b is large, moving the wire 132 to the proximal end 164 side of the tube 160 causes a large repulsive force on the extension side of the bending portion 124 to change the bending angle of the bending coil 120. It can be controlled easily. The spring constant of the portion of the first coil 120a and the spring constant of the portion of the second coil 120b have rigidity enough to maintain the shape with respect to the resistance applied during use as the medical treatment instrument 100, and are appropriate. It can be selected within a range having various elasticity.

隣接して配置された素線１は密着して一次コイル１０を形成する。このため一次コイル１０の表面は滑らかであり、回転抑制部１４４及びチューブ１６０の内部空間における移動時の摩擦を抑制することができる。屈曲コイル１２０は連結部１２６において、隣接して配置された一次コイル１０が無荷重時において離隔した二重コイルを形成する。隣接して配置された一次コイル１０間のピッチが大きくなるほど、屈曲コイル１２０を解くのに必要な力は小さくなり、解けた一次コイル１０の長さ当たりの回転速度は抑制されることから、屈曲コイル１２０の回転をより精密に制御することができる。しかしながらこれに限定されず、屈曲コイル１２０が二重コイルである場合、連結部１２６における隣接して配置された一次コイル１０は密着していてもよい。隣接して配置された一次コイル１０が密着して二重コイルを形成することで、屈曲コイル１２０の表面は滑らかであり、屈曲コイル１２０の回転時の摩擦を抑制することができる。 The wires 1 arranged adjacent to each other are in close contact with each other to form the primary coil 10. Therefore, the surface of the primary coil 10 is smooth, and it is possible to suppress the friction during the movement of the rotation suppressing portion 144 and the tube 160 in the internal space. The bending coil 120 forms a double coil in the connecting portion 126 in which the adjacent primary coils 10 are separated from each other when there is no load. As the pitch between the adjacent primary coils 10 increases, the force required to unwind the bending coil 120 decreases, and the rotational speed per length of the unraveled primary coil 10 is suppressed. The rotation of the coil 120 can be controlled more precisely. However, the present invention is not limited to this, and when the bending coil 120 is a double coil, the adjacent primary coils 10 in the connecting portion 126 may be in close contact with each other. Since the primary coils 10 arranged adjacent to each other are in close contact with each other to form a double coil, the surface of the bending coil 120 is smooth and friction during rotation of the bending coil 120 can be suppressed.

本実施形態において屈曲コイル１２０は、金属の素線１を密着巻きして形成された一次コイル１０を巻いた二重コイルを用いたが、屈曲コイル１２０の少なくとも一部は中実または中空の素線をらせん状に巻いた通常のコイルであってもよく、その場合、隣接して配置された素線は密着していてもよいし、隣接して配置された素線は無荷重時において離隔していてもよい。中実または中空の素線で形成されるコイルであっても、本実施形態の医療用処置具６００と同様の動作をすることが可能である。さらに、屈曲コイル１２０の少なくとも連結部１２６側に位置するコイルの部分が、金属の素線１を密着巻きして形成された一次コイル１０を巻いた二重コイルであることで、屈曲コイル１２０を容易に解くことができ、屈曲コイル１２０の回転を制御することができる。 In the present embodiment, the bending coil 120 is a double coil in which the primary coil 10 formed by closely winding the metal wire 1 is wound, but at least a part of the bending coil 120 is a solid or hollow element. It may be an ordinary coil in which the wire is wound in a spiral shape, in which case the adjacent wires may be in close contact, and the adjacent wires may be separated when no load is applied. You may have. Even a coil formed of a solid or hollow element wire can perform the same operation as the medical treatment tool 600 of the present embodiment. Further, since the coil portion located at least on the connecting portion 126 side of the bending coil 120 is a double coil in which the primary coil 10 formed by closely winding the metal wire 1 is wound, the bending coil 120 is It can be easily solved and the rotation of the bending coil 120 can be controlled.

図１５（Ａ）に示すように、屈曲コイル１２０は、屈曲部１２４において中心軸１３６が屈曲している。このため屈曲部１２４の屈曲側（図１５（Ａ）のＣ側）は密着しているが、屈曲部１２４の伸張側（図１５（Ａ）のＤ側）は隣接して配置された一次コイル１０が無荷重時において離隔している。屈曲部１２４における屈曲角度は、０°より大きく１８０°以下の範囲で適宜調整することができる。 As shown in FIG. 15A, in the bending coil 120, the central axis 136 is bent at the bending portion 124. Therefore, the bent side of the bent portion 124 (the C side in FIG. 15A) is in close contact, but the extended side of the bent portion 124 (the D side in FIG. 15A) is adjacent to the primary coil. 10 are separated when there is no load. The bending angle in the bending portion 124 can be appropriately adjusted within the range of more than 0° and 180° or less.

本実施形態においてチューブ１６０は、説明を分かりやすくするため、短く直線的に図示した。しかしながらこれに限定されず、チューブ１６０の長さは２００ｍｍ以上１８００ｍｍ以下の範囲で適宜選択することができる。またチューブ１６０は、医療用処置具６００として使用時にかかる抵抗に対して、十分な剛性を有し、且つ適度な弾性を有することができる。特に支持部１６２は、固定端部１４８から回転抑制部１４４までの軸方向における長さを保持するのに十分な剛性を有し、且つ固定端部１４８の回転を許容するため適度な弾性を有することができる。 In the present embodiment, the tube 160 is illustrated as a short linear shape for easy understanding of the description. However, the length of the tube 160 is not limited to this, and can be appropriately selected within the range of 200 mm or more and 1800 mm or less. Further, the tube 160 can have sufficient rigidity and appropriate elasticity with respect to the resistance applied when the medical treatment tool 600 is used. In particular, the support portion 162 has sufficient rigidity to hold the length in the axial direction from the fixed end portion 148 to the rotation suppressing portion 144, and has appropriate elasticity to allow the fixed end portion 148 to rotate. be able to.

［医療用処置具の動作の概要］
次に図１７、図１８及び図１９を用いて、本実施形態に係る医療用処置具６００の動作について詳細に説明する。図１７及び図１８は、本開示の一実施形態に係る医療用処置具６００の動作を示す断面図である。図１９は、本開示の一実施形態に係る医療用処置具６００の動作を示す上面図である。 [Outline of operation of medical treatment instrument]
Next, the operation of the medical treatment tool 600 according to the present embodiment will be described in detail with reference to FIGS. 17, 18, and 19. 17 and 18 are cross-sectional views showing the operation of the medical treatment tool 600 according to an embodiment of the present disclosure. FIG. 19 is a top view showing the operation of the medical treatment tool 600 according to an embodiment of the present disclosure.

本実施形態に係る医療用処置具６００は、ワイヤ１３２の他端をチューブ１６０の基端１６４側に引っ張ることで、屈曲コイル１２０の屈曲角度を制御することができる。図１７（Ｂ）に示すように、図１７（Ａ）の状態からワイヤ１３２の他端を基端１６４側に引っ張ることで、屈曲コイル１２０は屈曲部１２４の伸張側および連結部１２６で収縮し、屈曲部１２４で収縮した分だけ屈曲コイル１２０の屈曲角度が減少する。屈曲コイル１２０は弾性変形の範囲内で収縮することから、屈曲部１２４の伸張側では斥力が生じる。図１７（Ｃ）に示すように、ワイヤ１３２の他端をさらに基端１６４側に引っ張ることで、屈曲コイル１２０は屈曲部１２４の伸張側および連結部１２６で収縮し、屈曲部１２４で収縮した分だけ屈曲コイル１２０の屈曲角度がさらに減少する。屈曲コイル１２０は弾性変形の範囲内で収縮することから、屈曲部１２４の伸張側ではさらに斥力が生じる。 The medical treatment instrument 600 according to the present embodiment can control the bending angle of the bending coil 120 by pulling the other end of the wire 132 toward the proximal end 164 side of the tube 160. As shown in FIG. 17(B), by pulling the other end of the wire 132 from the state of FIG. 17(A) to the proximal end 164 side, the bending coil 120 contracts at the extension side of the bending portion 124 and the connecting portion 126. The bending angle of the bending coil 120 is reduced by the amount of contraction at the bending portion 124. Since the bending coil 120 contracts within the range of elastic deformation, a repulsive force is generated on the extension side of the bending portion 124. As shown in FIG. 17C, by pulling the other end of the wire 132 toward the proximal end 164 side, the bending coil 120 contracts at the extension side of the bending portion 124 and the connecting portion 126, and contracts at the bending portion 124. The bending angle of the bending coil 120 is further reduced accordingly. Since the bending coil 120 contracts within the elastic deformation range, repulsive force is further generated on the extension side of the bending portion 124.

図１７（Ｄ）に示すように、ワイヤ１３２を引っ張る力を緩めることで、屈曲コイル１２０は屈曲部１２４の伸張側および連結部１２６で伸張し、屈曲部１２４で伸張した分だけ屈曲コイル１２０の屈曲角度が増大する。屈曲部１２４の伸張側の斥力は、屈曲コイル１２０が伸張した分だけ緩和される。このとき、ワイヤ１３２の他端の位置も屈曲コイル１２０が伸張する分、屈曲コイル１２０側に移動する。図１７（Ｅ）に示すように、ワイヤ１３２を引っ張る力をさらに緩めることで、屈曲コイル１２０は屈曲部１２４の伸張側および連結部１２６で伸張し、屈曲部１２４で伸張した分だけ屈曲コイル１２０の屈曲角度がさらに増大して元の屈曲角度に戻る。屈曲部１２４の伸張側の斥力は、解消される。このときワイヤ１３２の他端の位置は、屈曲コイル１２０が伸張する分、屈曲コイル１２０側に移動して元の位置に戻る。 As shown in FIG. 17(D), the bending coil 120 is extended by the extension side of the bending portion 124 and the connecting portion 126 by loosening the pulling force of the wire 132, and the bending coil 120 is extended by the extension amount of the bending portion 124. The bending angle increases. The repulsive force on the extension side of the bending portion 124 is alleviated by the amount of extension of the bending coil 120. At this time, the position of the other end of the wire 132 also moves to the side of the bending coil 120 as the bending coil 120 extends. As shown in FIG. 17E, the bending coil 120 is further extended by the extension side of the bending portion 124 and the connecting portion 126 by further loosening the pulling force of the wire 132, and the bending coil 120 is extended by the extension amount at the bending portion 124. The bending angle of is further increased and returns to the original bending angle. The repulsive force on the extension side of the bent portion 124 is eliminated. At this time, the position of the other end of the wire 132 moves to the side of the bending coil 120 and returns to the original position as the bending coil 120 extends.

ワイヤ１３２による屈曲コイル１２０の屈曲角度の増減は、屈曲コイル１２０の弾性変形の範囲内で行われることから、繰り返すことができる。図１７において屈曲コイル１２０のワイヤ１３２は２段階に引っ張り、２段階に緩めたが、これに限定されない。屈曲コイル１２０のワイヤ１３２を引っ張る距離は適宜調整でき、屈曲コイル１２０の屈曲角度は任意の角度に制御することができる。 The increase and decrease of the bending angle of the bending coil 120 by the wire 132 can be repeated because it is performed within the elastic deformation range of the bending coil 120. Although the wire 132 of the bending coil 120 is pulled in two steps and loosened in two steps in FIG. 17, the present invention is not limited to this. The distance for pulling the wire 132 of the bending coil 120 can be adjusted as appropriate, and the bending angle of the bending coil 120 can be controlled to any angle.

本実施形態に係る医療用処置具６００は、屈曲コイル１２０の端部１３０を、チューブ１６０の基端１６４側に引っ張ることで、屈曲コイル１２０を回転させることができる。図１８（Ｂ）に示すように、図１８（Ａ）の状態から屈曲コイル１２０の端部１３０を基端１６４側に１／４周長引っ張り、屈曲コイル１２０を１／４回転解くことで、屈曲コイル１２０は図１９（Ａ）から図１９（Ｂ）に示すように、チューブ１６０の円筒軸方向の屈曲コイル１２０側から見たときに、左周りに９０°回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が解けた分だけ伸張する。屈曲コイル１２０は弾性変形の範囲内で伸張することから、屈曲コイル１２０の固定部１３８から端部１３０の間で引力が生じる。図１８（Ｃ）および図１９（Ｃ）に示すように、屈曲コイル１２０の端部１３０をさらに１／４周長引っ張り、屈曲コイル１２０をさらに１／４回転解くことで、屈曲コイル１２０は左周りに計１８０°回転する。屈曲コイル１２０の固定部１３８が支持部１６２の固定端部１４８に接続していることから、屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が解けた分だけさらに伸張する。屈曲コイル１２０は弾性変形の範囲内で伸張することから、屈曲コイル１２０の固定部１３８から端部１３０の間でさらに引力が生じる。ここで周長とは、コイル円周ではなく、１周分の巻き線の長さをいう。 The medical treatment instrument 600 according to the present embodiment can rotate the bending coil 120 by pulling the end portion 130 of the bending coil 120 toward the base end 164 side of the tube 160. As shown in FIG. 18B, by pulling the end portion 130 of the bending coil 120 from the state of FIG. 18A toward the base end 164 by a quarter circumference, and unwinding the bending coil 120 by a quarter rotation, As shown in FIGS. 19(A) to 19(B), the bending coil 120 rotates 90° counterclockwise when viewed from the bending coil 120 side in the cylindrical axis direction of the tube 160. Since the fixing portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the supporting portion 162, the unwinding portion 128 extends from the fixing portion 138 of the bending coil 120 by the amount that the bending coil 120 is unwound. Since the bending coil 120 expands within the range of elastic deformation, an attractive force is generated between the fixed portion 138 and the end portion 130 of the bending coil 120. As shown in FIG. 18(C) and FIG. 19(C), the bending coil 120 is pulled to the left by pulling the end portion 130 of the bending coil 120 for another ¼ circumference and unwinding the bending coil 120 for another ¼ rotation. Rotate a total of 180 degrees around. Since the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162, the unwinding portion 128 extends further from the fixed portion 138 of the bending coil 120 by the amount that the bending coil 120 is unwound. Since the bending coil 120 expands within the range of elastic deformation, further attractive force is generated between the fixed portion 138 and the end portion 130 of the bending coil 120. Here, the circumference means not the circumference of the coil but the length of the winding for one round.

図１８（Ｄ）および図１９（Ｄ）に示すように、屈曲コイル１２０の端部１３０を引っ張る力を緩めることで、屈曲コイル１２０は１／４回転巻き戻り、屈曲コイル１２０は、チューブ１６０の円筒軸方向の屈曲コイル１２０側から見たときに、右周りに９０°回転する。屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が巻き戻った分だけ収縮する。屈曲コイル１２０の固定部１３８から端部１３０の間の引力は、屈曲コイル１２０が巻き戻った分だけ緩和される。図１８（Ｅ）および図１９（Ｅ）に示すように、屈曲コイル１２０を引っ張る力をさらに緩めることで、屈曲コイル１２０は１／４回転巻き戻り、屈曲コイル１２０は右周りに計１８０°回転してもとの位置に戻る。屈曲コイル１２０の固定部１３８から巻き解け部１２８は、屈曲コイル１２０が巻き戻った分だけ収縮してもとの位置に戻る。屈曲コイル１２０の固定部１３８から端部１３０の間の引力は解消される。 As shown in FIGS. 18D and 19D, the bending coil 120 is rewound by a quarter turn by loosening the force of pulling the end portion 130 of the bending coil 120, and the bending coil 120 moves to the tube 160. When viewed from the bending coil 120 side in the cylindrical axis direction, it rotates 90° clockwise. The unwinding portion 128 from the fixing portion 138 of the bending coil 120 contracts by the amount of rewinding of the bending coil 120. The attractive force between the fixed portion 138 and the end portion 130 of the bending coil 120 is alleviated by the amount of rewinding of the bending coil 120. As shown in FIGS. 18(E) and 19(E), the bending coil 120 is rewound by ¼ turn by further loosening the force pulling the bending coil 120, and the bending coil 120 rotates clockwise by a total of 180°. Then return to the original position. The unwinding portion 128 from the fixing portion 138 of the bending coil 120 returns to the original position even when the bending coil 120 contracts by the amount of rewinding. The attractive force between the fixed portion 138 and the end portion 130 of the bending coil 120 is released.

図１８および図１９において屈曲コイル１２０は１／４周長ずつ引っ張り、１／４回転ずつ解き、９０°ずつ回転する様態、および１／４周長ずつ緩め、１／４回転ずつ巻き戻し、９０°ずつ回転する様態を示したが、これに限定されない。屈曲コイル１２０の端部１３０を引っ張る距離は適宜調整でき、屈曲コイル１２０の屈曲方向は任意の方向に制御することができる。また本実施形態において屈曲コイル１２０の固定部１３８は、支持部１６２の固定端部１４８に接続する。支持部１６２の固定端部１４８は３６０°回転可能であり、このため屈曲コイル１２０の屈曲方向は３６０°任意の方向に制御することができる。 In FIG. 18 and FIG. 19, the bending coil 120 is pulled by 1/4 circumference, unwound by 1/4 rotation, rotated by 90°, loosened by 1/4 circumference, and rewound by 1/4 rotation by 90°. Although it has been shown to rotate by °, it is not limited to this. The distance by which the end 130 of the bending coil 120 is pulled can be adjusted as appropriate, and the bending direction of the bending coil 120 can be controlled in any direction. Further, in the present embodiment, the fixed portion 138 of the bending coil 120 is connected to the fixed end portion 148 of the support portion 162. The fixed end portion 148 of the support portion 162 can rotate 360°, so that the bending direction of the bending coil 120 can be controlled in any direction of 360°.

本実施形態に係る医療用処置具６００は、医療用処置具６００の先端が血管分岐などの複雑な構造に到達したときであっても、執刀医の手元の屈曲コイル１２０のワイヤ１３２を引っ張ることで、屈曲コイル１２０の屈曲角度を自由に制御することができる。屈曲コイル１２０の端部１３０を引っ張ることで、屈曲コイル１２０を回転することができ、先端の屈曲方向を自由に制御することができる。したがって、迅速かつ安全に医療用処置具６００の先端を体内の目的部位まで挿入することができ、患者および医師ともに負担が軽減される。 The medical treatment instrument 600 according to the present embodiment is capable of pulling the wire 132 of the bending coil 120 at the surgeon's hand even when the tip of the medical treatment instrument 600 reaches a complicated structure such as a blood vessel branch. Thus, the bending angle of the bending coil 120 can be freely controlled. By pulling the end 130 of the bending coil 120, the bending coil 120 can be rotated, and the bending direction of the tip can be freely controlled. Therefore, the distal end of the medical treatment instrument 600 can be quickly and safely inserted into the target site in the body, and the burden on both the patient and the doctor is reduced.

〈変形例１〉
図２０を用いて、本開示の変形例に係る医療用処置具の回転抑制部と支持部の形状を説明する。図２１を用いて、本開示の変形例に係る医療用処置具の形態を説明する。 <Modification 1>
The shapes of the rotation suppressing portion and the support portion of the medical treatment tool according to the modified example of the present disclosure will be described with reference to FIG. The form of the medical treatment tool according to the modification of the present disclosure will be described with reference to FIG.

図２０は、実施形態１〜実施形態４の変形例に係る医療用処置具の回転抑制部および支持部の形状の一例を示す図である。なお回転抑制部および支持部の形状以外は、本開示の実施形態１〜実施形態４と同じであり、その繰り返しの説明は省略する。またそれぞれの構成は組み合わせが可能であり、本開示の実施形態および変形例に限られたものではない。 20: is a figure which shows an example of the shape of the rotation suppression part and the support part of the medical treatment tool which concerns on the modification of Embodiment 1-4. It should be noted that, except for the shapes of the rotation suppressing portion and the supporting portion, they are the same as those of the first to fourth embodiments of the present disclosure, and repeated description thereof will be omitted. In addition, the respective configurations can be combined, and are not limited to the embodiments and modified examples of the present disclosure.

図２０に示すように、本開示の変形例に係る医療用処置具の回転抑制部１４４は様々な形状をとることができる。図２０（Ａ）に示す、円筒型の支持部１６２の円筒側壁部に円孔が配置された回転抑制部１４４と比較して、例えば、図２０（Ｂ）〜（Ｄ）の回転抑制部１４４は支持部１６２の円筒側壁部に長孔が配置される。円筒側壁部に配置される長孔の方向はとくに限定されず、（Ｂ）横長でも、（Ｃ）縦長でも、（Ｄ）斜めに長くてもよい。また回転抑制部１４４の開口部は、円形状、多角形状、又はスリット状であってもよい。回転抑制部１４４の開口部は、屈曲コイル１２０の径より小さく、屈曲コイル１２０を形成する巻線の径よりも大きければどんな形状であってもよい。このような形状の回転抑制部１４４を有することで、支持部１６２は屈曲コイル１２０の連結部１２６を内側から支持し、且つ屈曲コイル１２０の端部１３０は、回転抑制部１４４を介してチューブ１６０の内部空間側に配置することができる（実施形態１〜実施形態４参照）。 As shown in FIG. 20, the rotation suppressing portion 144 of the medical treatment tool according to the modified example of the present disclosure can have various shapes. 20A to 20D, for example, as compared with the rotation suppressing portion 144 in which circular holes are arranged in the cylindrical side wall portion of the cylindrical supporting portion 162 shown in FIG. 20A, the rotation suppressing portion 144 in FIGS. The elongated hole is arranged in the cylindrical side wall portion of the support portion 162. The direction of the long hole arranged in the side wall of the cylinder is not particularly limited, and may be (B) horizontally long, (C) vertically long, or (D) diagonally long. Further, the opening of the rotation suppressing portion 144 may have a circular shape, a polygonal shape, or a slit shape. The opening of the rotation suppressing portion 144 may have any shape as long as it is smaller than the diameter of the bending coil 120 and larger than the diameter of the winding wire forming the bending coil 120. By having the rotation suppressing portion 144 having such a shape, the supporting portion 162 supports the connecting portion 126 of the bending coil 120 from the inside, and the end portion 130 of the bending coil 120 has the tube 160 via the rotation suppressing portion 144. Can be disposed on the inner space side (see Embodiments 1 to 4).

さらに図２１（Ａ）に示すように、このような形状の回転抑制部１４４を有することで、支持部１６２は屈曲コイル１２０の連結部１２６を外側から支持し、且つ屈曲コイル１２０の端部１３０は、回転抑制部１４４を介してチューブ１６０の外側に配置することもできる。また、チューブ１６０の開口部は、ワイヤ１３２をチューブ１６０の外側に配置することもできる。 Further, as shown in FIG. 21(A), by having the rotation suppressing portion 144 having such a shape, the support portion 162 supports the connecting portion 126 of the bending coil 120 from the outside, and the end portion 130 of the bending coil 120. Can also be arranged outside the tube 160 via the rotation suppressing portion 144. The opening of the tube 160 may also allow the wire 132 to be located outside the tube 160.

図２０（Ｅ）〜（Ｈ）の回転抑制部１４４は、支持部１６２に、２つの開口部（Ｅ）、開口管（Ｆ）、リング（Ｇ）、フック（Ｈ）が配置される。図２０（Ｅ）では２つの開口部である回転抑制部１４４が、円筒型の支持部１６２の円筒側壁部に配置される。図２０（Ｆ）では、回転抑制部１４４として開口管が、円筒型の支持部１６２の円筒側壁部外側に配置される。図２０（Ｇ）ではリング状の回転抑制部１４４が、２本の支柱状の支持部１６２の外側に配置される。図２０（Ｈ）ではフック状の回転抑制部１４４が、２本の支柱状の支持部１６２の外側に配置される。図２１（Ｂ）および（Ｃ）に示すように、このような形状の回転抑制部１４４を有することで、支持部１６２は屈曲コイル１２０の連結部１２６を内側から支持し、且つ屈曲コイル１２０の端部１３０は、回転抑制部１４４を介してチューブ１６０の外側に配置することができる。 20E to 20H, the rotation suppressing portion 144 has two openings (E), an opening tube (F), a ring (G), and a hook (H) arranged on the supporting portion 162. In FIG. 20(E), the rotation suppressing portion 144, which is two openings, is arranged on the cylindrical side wall portion of the cylindrical supporting portion 162. In FIG. 20F, an opening tube is arranged as the rotation suppressing portion 144 on the outside of the cylindrical side wall portion of the cylindrical supporting portion 162. In FIG. 20G, the ring-shaped rotation suppressing portion 144 is arranged outside the two pillar-shaped supporting portions 162. In FIG. 20H, the hook-shaped rotation suppressing portion 144 is arranged outside the two pillar-shaped supporting portions 162. As shown in FIGS. 21B and 21C, by having the rotation suppressing portion 144 having such a shape, the supporting portion 162 supports the connecting portion 126 of the bending coil 120 from the inside, and also the bending coil 120. The end portion 130 can be arranged outside the tube 160 via the rotation suppressing portion 144.

しかしながらこれに限定されず、図２０（Ｆ）〜（Ｈ）の回転抑制部１４４は、支持部１６２の内側（チューブの中心軸１３６側）に配置してもよい。すなわち、図２０（Ｆ）〜（Ｈ）の回転抑制部１４４である開口管（Ｆ）、リング（Ｇ）、フック（Ｈ）は、円筒内部空間側に配置してもよい。図２１に示すように、回転抑制部１４４である開口管は、円筒型の支持部１６２の円筒側壁部内側に配置してもよい。このような形状の回転抑制部１４４を有することで、支持部１６２は屈曲コイル１２０の連結部１２６を外側から支持し、且つ屈曲コイル１２０の端部１３０は、回転抑制部１４４を介してチューブ１６０の内側に配置することができる。 However, the invention is not limited to this, and the rotation suppressing portion 144 of FIGS. 20F to 20H may be arranged inside the support portion 162 (on the side of the central axis 136 of the tube). That is, the opening tube (F), the ring (G), and the hook (H), which are the rotation suppressing portions 144 of FIGS. As shown in FIG. 21, the opening tube serving as the rotation suppressing portion 144 may be arranged inside the cylindrical side wall portion of the cylindrical supporting portion 162. By having the rotation suppressing portion 144 having such a shape, the supporting portion 162 supports the connecting portion 126 of the bending coil 120 from the outside, and the end portion 130 of the bending coil 120 has the tube 160 via the rotation suppressing portion 144. Can be placed inside.

〈変形例２〉
図２２を用いて、本開示の変形例に係る医療用処置具の形態を説明する。 <Modification 2>
The form of the medical treatment tool according to the modification of the present disclosure will be described with reference to FIG.

図２２（Ａ）および（Ｃ）は、実施形態１〜実施形態４の変形例に係る医療用処置具の連結部材の一例を示す図である。図２２（Ｂ）および（Ｄ）は、実施形態１〜実施形態４の変形例に係る連結部材を用いた医療用処置具の一例を示す図である。なお本変形例においては、連結部材を有すること以外は、本開示の実施形態１〜実施形態４と同じであり、その繰り返しの説明は省略する。またそれぞれの構成は組み合わせが可能であり、本開示の実施形態および変形例に限られたものではない。 22A and 22C are diagrams showing an example of a connecting member of the medical treatment tool according to the modified examples of the first to fourth embodiments. 22B and 22D are diagrams showing an example of a medical treatment tool using the connecting member according to the modified examples of the first to fourth embodiments. Note that this modified example is the same as Embodiments 1 to 4 of the present disclosure except that it has a connecting member, and repeated description thereof will be omitted. In addition, the respective configurations can be combined, and are not limited to the embodiments and modified examples of the present disclosure.

図２２に示すように、本開示の変形例に係る医療用処置具の連結部材１８０は様々な形状をとることができる。連結部材１８０は、前述した実施形態１〜実施形態４におけるチューブ１６０の支持部１６２と、回転抑制部１４４と、を有する。連結部材１８０は、チューブ１６０に屈曲コイル１２０を連結する As shown in FIG. 22, the connecting member 180 of the medical treatment tool according to the modified example of the present disclosure can have various shapes. The connecting member 180 includes the support portion 162 of the tube 160 according to the first to fourth embodiments described above and the rotation suppressing portion 144. The connecting member 180 connects the bending coil 120 to the tube 160.

図２２（Ａ）の連結部材１８０は円筒型であり、屈曲コイル１２０の連結部１２６を回転可能に支持する支持部１６２と、巻き解け部１２８と接する回転抑制部１４４と、屈曲コイル１２０の連結部１２６を先端部１２２とは反対側から支える凸部１８６と、を有する。図２２（Ｂ）に示すように、連結部材１８０は、円筒軸方向の両端に屈曲コイル１２０とチューブ１６０とを接続する。連結部材１８０の両端は、屈曲コイル１２０の内側とチューブ１６０の内側とに差し込まれるように配置される。すなわち、連結部材１８０の円筒外側は、屈曲コイル１２０の内側およびチューブ１６０の内側それぞれと接している。しかしながら連結部材１８０の支持部１６２の形状はこれに限定されず、屈曲コイル１２０を回転可能に支持できればよい。例えば、連結部材１８０の支持部１４２は、２本以上の支柱を屈曲コイル１２０に差し込むような形状であってもよい。屈曲コイル１２０の端部１３０は、回転抑制部１４４を介してチューブ１６０の円筒内部空間に配置される。しかしながらこれに限定されず、屈曲コイル１２０の端部１３０は、例えば、支持部１６２の屈曲コイル１２０を支持する形態、形状、および回転抑制部１４４の形状などによって、回転抑制部１４４を介してチューブ１６０の外側に配置してもよい。 The connecting member 180 of FIG. 22(A) is of a cylindrical type, and connects the bending coil 120 with the support portion 162 that rotatably supports the connecting portion 126 of the bending coil 120, the rotation suppressing portion 144 that contacts the unwinding portion 128. It has a convex portion 186 that supports the portion 126 from the side opposite to the tip portion 122. As shown in FIG. 22B, the connecting member 180 connects the bending coil 120 and the tube 160 at both ends in the cylinder axis direction. Both ends of the connecting member 180 are arranged so as to be inserted into the inside of the bending coil 120 and the inside of the tube 160. That is, the outside of the cylinder of the connecting member 180 is in contact with the inside of the bending coil 120 and the inside of the tube 160, respectively. However, the shape of the supporting portion 162 of the connecting member 180 is not limited to this, and it is sufficient that the bending coil 120 can be rotatably supported. For example, the support portion 142 of the connecting member 180 may have a shape in which two or more columns are inserted into the bending coil 120. The end portion 130 of the bending coil 120 is arranged in the cylindrical inner space of the tube 160 via the rotation suppressing portion 144. However, the end portion 130 of the bending coil 120 is not limited to this, and the end portion 130 of the bending coil 120 may be connected to the tube via the rotation suppressing portion 144 depending on, for example, the shape and shape of the supporting portion 162 that supports the bending coil 120 and the shape of the rotation suppressing portion 144. It may be arranged outside 160.

図２２（Ｃ）の連結部材１８０は、図２２（Ａ）の連結部材１８０の凸部を円筒内部空間側に有し、屈曲コイル１２０の連結部１２６を先端部１２２とは反対側から支える。図２２（Ｄ）に示すように、この場合、屈曲コイル１２０とチューブ１６０とは連結部材１８０の両端内側に差し込まれるように配置される。すなわち、連結部材１８０の円筒内側は、屈曲コイル１２０の外側およびチューブ１６０の外側それぞれと接している。しかしながら連結部材１８０の支持部１６２の形状はこれに限定されず、屈曲コイル１２０を回転可能に支持できればよい。例えば、連結部材１８０の支持部１４２は、２本以上の支柱を屈曲コイル１２０に差し込むような形状であってもよい。屈曲コイル１２０の端部１３０は、回転抑制部１４４を介してチューブ１６０の円筒外側に配置される。しかしながらこれに限定されず、屈曲コイル１２０の端部１３０は、例えば、支持部１６２の屈曲コイル１２０を支持する形態、形状、および回転抑制部１４４の形状などによって、回転抑制部１４４を介してチューブ１６０の外側に配置してもよい。 The connecting member 180 of FIG. 22C has the convex portion of the connecting member 180 of FIG. 22A on the cylindrical inner space side, and supports the connecting portion 126 of the bending coil 120 from the side opposite to the tip portion 122. In this case, as shown in FIG. 22D, the bending coil 120 and the tube 160 are arranged so as to be inserted inside both ends of the connecting member 180. That is, the inside of the cylinder of the connecting member 180 is in contact with the outside of the bending coil 120 and the outside of the tube 160, respectively. However, the shape of the supporting portion 162 of the connecting member 180 is not limited to this, and it is sufficient that the bending coil 120 can be rotatably supported. For example, the support portion 142 of the connecting member 180 may have a shape in which two or more columns are inserted into the bending coil 120. The end portion 130 of the bending coil 120 is arranged outside the cylinder of the tube 160 via the rotation suppressing portion 144. However, the end portion 130 of the bending coil 120 is not limited to this, and the end portion 130 of the bending coil 120 may be connected to the tube via the rotation suppressing portion 144 depending on, for example, the shape and shape of the supporting portion 162 that supports the bending coil 120 and the shape of the rotation suppressing portion 144. It may be arranged outside 160.

〈変形例３〉
図２３を用いて、本開示の変形例に係る医療用処置具の先端部の形状を説明する。 <Modification 3>
The shape of the distal end portion of the medical treatment tool according to the modified example of the present disclosure will be described with reference to FIG. 23.

図２３は、実施形態１〜実施形態４の変形例に係る医療用処置具の先端部の形状の一例を示す断面図である。なお先端部の形状以外は、本開示の実施形態１〜実施形態４と同じであり、その繰り返しの説明は省略する。 FIG. 23 is a cross-sectional view showing an example of the shape of the distal end portion of the medical treatment tool according to the modified examples of the first to fourth embodiments. Note that, except for the shape of the tip portion, it is the same as Embodiments 1 to 4 of the present disclosure, and repeated description thereof is omitted.

図２３に示すように、本開示の変形例に係る医療用処置具の先端部１２２は様々な形状をとることができる。図２３（Ａ）の、円筒型の屈曲コイル１２０の開口した先端部１２２と比較して、例えば、図２３（Ｂ）の屈曲コイル１２０は、先端部１２２にキャップを備える。図２３（Ｃ）の屈曲コイル１２０は、先端部に向かってコイルの径が縮小したテーパー形状である。先端部１２２がこのような形状をとることによって、医療用処置具を円滑に体内の目的部位に挿入することができ、また挿入部位を傷つけることを防止することができる。 As shown in FIG. 23, the distal end portion 122 of the medical treatment tool according to the modified example of the present disclosure can have various shapes. Compared to the open tip 122 of the cylindrical bending coil 120 of FIG. 23A, for example, the bending coil 120 of FIG. 23B has a cap at the tip 122. The bending coil 120 of FIG. 23C has a tapered shape in which the diameter of the coil is reduced toward the tip. With the tip 122 having such a shape, the medical treatment tool can be smoothly inserted into the target site in the body, and the insertion site can be prevented from being damaged.

なお本発明は上記の実施形態に限られたものではなく、趣旨を逸脱しない範囲で適宜変更することが可能である。 The present invention is not limited to the above embodiment, and can be modified as appropriate without departing from the spirit of the present invention.

１：素線、１０：一次コイル、１００、２００、３００、４００、５００、６００：医療用処置具、１２０：屈曲コイル、１２２：先端部、１２４：屈曲部、１２６：連結部、１２８：巻き解け部、１３０：端部、１３２：ワイヤ、１３６：中心軸、１３８：固定部、１４０：接合部、１４４：回転抑制部、１４８：固定端部、１６０：チューブ、１６２：支持部、１６４：基端、１８０：連結部材 1: strand, 10: primary coil, 100, 200, 300, 400, 500, 600: medical treatment tool, 120: bending coil, 122: tip portion, 124: bending portion, 126: connecting portion, 128: winding Unraveling part, 130: end part, 132: wire, 136: central axis, 138: fixed part, 140: joining part, 144: rotation suppressing part, 148: fixed end part, 160: tube, 162: support part, 164: Proximal end, 180: Connection member

Claims

A tip portion, a bent portion, a connecting portion arranged on the side opposite to the tip portion via the bent portion, and a bending coil having a unwinding portion on the connecting portion side,
A tube having a support part connected to the connection part to rotatably support the bending coil, a rotation suppressing part in contact with the unwinding part, and a base end opposite to the support part. ,
A medical treatment tool characterized in that one end of the bending coil on the side of the unwinding portion is moved to the proximal end side of the tube via the rotation suppressing portion to rotate the bending coil.

2. The bending coil has at least two parts, and the first coil part on the unwinding part side has a smaller spring constant than the second coil part on the tip end part side. The medical treatment tool described in.

The medical treatment instrument according to claim 2, wherein the connecting portion includes at least a portion of the first coil.

The medical treatment instrument according to any one of claims 1 to 3, wherein the distal end portion of the bending coil is curved in a direction opposite to the rotation direction of the bending coil.

A tip portion, a bent portion, a connecting portion arranged on the opposite side of the tip portion through the bent portion, a unwinding portion on the connecting portion side, and a position apart from the unwinding portion and located at the connecting portion A bending coil having a fixing portion for
A support portion that has flexibility and that rotatably supports the bending coil by connecting to the connecting portion, a rotation suppressing portion that contacts the unwinding portion, and a fixing portion, and connects the fixing portion to the A tube having a fixed end portion for holding the length of the bending coil up to the unwinding portion, and a base end opposite to the support portion,
The connecting part has at least two parts, and the first coil part on the unwinding part side and the second coil part on the fixed part side are connected in reverse winding,
A medical treatment tool characterized in that one end of the bending coil on the side of the unwinding portion is moved to the proximal end side of the tube via the rotation suppressing portion to rotate the bending coil.

The medical treatment tool according to claim 5, wherein the second coil portion has a spring constant larger than that of the first coil portion.

The medical treatment tool according to claim 6, wherein the fixing portion is located on the bent portion side of the connecting portion.

The medical device according to any one of claims 1 to 7, wherein the rotation suppressing portion is an opening portion provided in a side wall portion of the support portion where the unwinding portion of the bending coil is located. Treatment tool.

9. A wire further comprising: a wire, one end of which is connected to the distal end portion, and the other end of which is drawn out to the proximal end side of the tube through the bending coil and the internal space of the tube. The medical treatment tool according to any one of claims.

At least the bending coil of the connecting portion is a double coil in which a central axis of a primary coil formed by closely winding a metal element wire is spirally wound. The medical treatment tool according to 1 above.

The wire is selected from platinum, gold, palladium, tungsten, tantalum, cobalt, rhodium, titanium, alloys thereof, stainless steel, nickel alloys, or molybdenum alloys having a wire diameter of 14 μm or more and 200 μm or less. Item 10. The medical treatment tool according to item 10.

10. The medical device according to claim 1, wherein at least the bending coil of the connecting portion is a coil formed by spirally winding a metal wire having superelasticity. Treatment tool.

The medical treatment tool according to claim 12, wherein the element wire is a nickel-titanium alloy having a wire diameter of 50 μm or more and 300 μm or less.

The medical treatment tool according to claim 9, wherein one end of the wire is connected to the distal end portion located on the extension side of the bending coil.

15. At least a part of the bending coil of the connecting portion is configured such that lines constituting adjacent coils are separated from each other when no load is applied thereto. Medical treatment tool.

The medical treatment tool according to any one of claims 1 to 15, wherein a line that constitutes a coil disposed adjacent to the bending side of the bending coil is in contact with the bending coil when there is no load.

The medical treatment tool according to any one of claims 1 to 16, wherein the bending coil has a shape in which a diameter of the coil is reduced toward the distal end portion.

The medical treatment tool according to any one of claims 1 to 17, wherein the bending coil includes a cap at the tip portion.