JP2014117397A - Medical device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical device with a tube bending function capable of bending a tube body by a hand-side (extracorporeal) operation without using a sheath element of the tube body to be inserted in the body.SOLUTION: The medical device comprises: a multi-lumen tube 10 to be inserted into a body; and pressure control means 1 and 2 that are connected to a distal end of a lumen 12 that is at least one lumen of the multi-lumen tube and passes through a position radially separated from a central axis of the multi-lumen tube, and controls pressure of a fluid in the lumen. The medical device is constituted for endoscopes and catheters. The proximal end of the lumen 12 is encapsulated, so that internal pressure of the lumen 12 is increased by the pressure control means to expand the lumen 12, so that the multi-lumen tube 10 can be bent, with the lumen 12 side defined as an extension side. Especially, the multi-lumen tube can be significantly bent at an axial range A where a large-diameter part 12b is disposed.

Description

  The present invention relates to a medical device having a tube bending function capable of bending a tube body inserted into a body applicable to an endoscope, a catheter, and the like by a hand (external) operation.

As is well known, tube bodies such as endoscopes and catheters are used for medical treatment, and these tube bodies are inserted into body cavities, lumens, blood vessels, etc., and the tip portion is arranged at a desired site. Some have a function of bending by an operation at hand.
For example, in the invention described in Patent Document 1, in a medical catheter in which a balloon is attached to a distal end portion of a catheter body having a predetermined length, a thread, a belt, or the like extends between a front position and a rear position in the axial direction from the balloon of the catheter body. The distal end portion bend imparting body comprising the end portion of the catheter body is fixed with the bend end portions being bent in the direction in which the bend imparting body is provided by the bend imparting body when the balloon is inflated. It is characterized by.

JP 2000-102620 A

However, in the invention described in Patent Document 1, since the bending is realized by the action of the balloon, the thread, and the band sheathed on the catheter body, the following problems are raised.
First, since the inflating balloon presses against the tube wall in the small-diameter tube in the body to fix the catheter, it is difficult to move the catheter.
In addition, there is a problem in safety because threads and bands may involve tissues in the body.
The bending direction is only one direction, and it is necessary to rotate the catheter body around the axis when changing, but buckling may occur if the rigidity is weak.

  The present invention has been made in view of the above problems in the prior art, and the tube body can be bent by hand (external) operation without using an exterior element of the tube body inserted into the body. It is an object to provide a medical device having a tube bending function.

The invention according to claim 1 for solving the above-described problems is a multi-lumen tube that can be inserted into the body,
Pressure control means for controlling the pressure of the fluid in the lumen, connected to the base end of the lumen that is at least one lumen of the multi-lumen tube and that is located radially away from the central axis of the multi-lumen tube; With
The tip of the lumen is sealed,
The medical device is configured such that the multi-lumen tube can be bent with the lumen side as an expansion side when the internal pressure of the lumen is increased by the pressure control means and the lumen is expanded.

  According to a second aspect of the present invention, the lumen has a large-diameter portion that is partially formed with a large diameter, and the multi-lumen tube is provided by the pressure control means in an axial range where the large-diameter portion is disposed The medical device according to claim 1, wherein the medical device is configured to be greatly bent with respect to a range in the axial direction.

  According to a third aspect of the present invention, in the multi-lumen tube, the thickness of the outer peripheral side of the large diameter portion is formed thinner than the thickness of the inner peripheral side of the large diameter portion. Device.

In the invention according to claim 4, in the multi-lumen tube, the distal end portion including the distal end portion of the lumen is configured with relatively low hardness, and the proximal end side is configured with relatively high hardness from the distal end portion,
2. The medical device according to claim 1, wherein the multi-lumen tube is configured to be largely bent with respect to the proximal end side by the pressure control means in an axial range in which the lumen of the distal end portion is disposed.

In the invention according to claim 5, the multi-lumen tube has a metal coil sheathed on the proximal end side from the distal end portion including the distal end portion of the lumen.
2. The medical device according to claim 1, wherein the multi-lumen tube is configured to be largely bent with respect to the proximal end side by the pressure control means in an axial range in which the lumen of the distal end portion is disposed.

  The invention according to claim 6 is the medical device according to any one of claims 1 to 5, wherein the fluid is a liquid in which a gas or a micro solid having different sound transmission characteristics from the liquid is mixed. It is.

  A seventh aspect of the present invention is the medical device according to any one of the first to fifth aspects, wherein a metal or resin wire is inserted into the lumen.

In the invention described in claim 8, an objective lens and an image fiber for observing an image of an object in the distal direction are configured in one lumen that opens at the distal end surface of the multi-lumen tube.
The medical optical fiber according to any one of claims 1 to 7, wherein an illumination optical fiber that guides light for illuminating the object is formed in another lumen that opens at a distal end surface of the multi-lumen tube. Device.

The invention according to claim 9 includes a small-diameter tube that can be inserted into one lumen that opens at a distal end surface of the multi-lumen tube,
The objective lens for observing the image of the object in the distal direction and the image fiber, and the illumination optical fiber for guiding the light for illuminating the object are configured on the small-diameter tube. It is a medical device as described in above.

Invention of Claim 10 is comprised so that the said small diameter tube can be extended from opening of the front end surface of the said multi-lumen tube,
Another objective lens and other image for observing an image of an object in the distal direction with a wider viewing angle than the objective lens of the small-diameter tube in another lumen that opens at the distal end surface of the multi-lumen tube The medical device according to claim 9, wherein the fiber is configured.

According to the present invention, the multi-lumen tube can be bent by the expansion of the lumen (diameter) in the multi-lumen tube without using the exterior element of the multi-lumen tube, and the multi-lumen tube is inserted into the body from the distal end. Pressure control means for controlling the pressure of the fluid in the lumen can be held outside the body on the proximal end side of the multi-lumen tube.
Using the multi-lumen tube as a catheter for injecting liquid, discharging body fluid, etc. through other lumens that open to the distal end surface of the multi-lumen tube, making or inserting an endoscope into the other lumen, Various medical devices can be configured as a tube body for inserting the multi-lumen tube into the body by inserting a surgical tool such as forceps.
Therefore, according to the present invention, tube bending that allows the multi-lumen tube to be bent by hand (external) operation by the pressure control means without using an exterior element of the multi-lumen tube that is a tube body inserted into the body. A medical device having a function can be configured.

Further, since it is not necessary to add an element for realizing the function to the outer peripheral surface of the multi-lumen tube in order to provide the tube bending function, the possibility of damaging the tissue in the body is low and the safety is excellent.
In addition, since it is not necessary to add an element for realizing the tube bending function to the multi-lumen tube, the multi-lumen tube can be manufactured at low cost, and the multi-lumen tube can be removed from the pressure control means and used for replacement. It is easy to use the lumen tube in a disposable (disposable) manner. Disposable can avoid the risk of infection.
Since the multi-lumen tube can be bent by the expansion of the lumen (diameter) in the multi-lumen tube, the multi-lumen tube can be bent while maintaining a relatively small diameter. Therefore, it can be bent in a relatively small diameter tube.

Fig. (A) is a sectional view of the distal end portion of the multi-lumen tube according to the first embodiment of the present invention. is there. It is a tube body tip section sectional view of a medical device concerning a 2nd embodiment of the present invention. It is a tube body front-end | tip part sectional drawing of the medical device which concerns on 3rd Embodiment of this invention. It is a tube body front-end | tip part sectional drawing of the medical device which concerns on 4th Embodiment of this invention. It is a tube body front-end | tip part sectional drawing of the medical device which concerns on 5th Embodiment of this invention.

  An embodiment of the present invention will be described below with reference to the drawings. The following is one embodiment of the present invention and does not limit the present invention.

[First Embodiment]
First, a basic embodiment of the present invention will be described as a first embodiment with reference to FIG.
As the medical device of this embodiment, the multi-lumen tube 10 shown in FIG. 1 is applied as a tube body to be inserted into the body. The multi-lumen tube 10 is made of resin. The axis AX is the central axis of the multi-lumen tube 10.
The multi-lumen tube 10 has a first lumen 11 and a second lumen 12.
The first lumen 11 is used as an injection path into the body, as a discharge path from the body, or as a path through which a medical instrument such as an endoscope or a medical instrument such as forceps is inserted. .
On the other hand, the second lumen 12 is a structure for bending the multi-lumen tube 10. The second lumen 12 passes through the meat portion around the first lumen 11 and passes through a position away from the central axis AX in the radial direction. In order to make the multi-lumen tube 10 easy to bend, the second lumen 12 is formed as close to the outer peripheral surface of the multi-lumen tube 10 as possible.

The first lumen 11 opens at the distal end surface of the multi-lumen tube 10. The tip of the second lumen 12 is sealed. Although the illustration of the base end side of the multi-lumen tube 10 is omitted, the base end sides of the first lumen 11 and the second lumen 12 are open to the end face on the base end side of the multi-lumen tube 10.
Two syringes 1 and 2 as pressure control means shown in FIG. 1B are connected to the proximal end side opening of the second lumen 12. A gas 1 a such as air is pressed into the second lumen 12 from the syringe 1. A liquid 2 a such as physiological saline is pressed into the second lumen 12 from the syringe 2.

As shown in FIG. 1 (a), the second lumen 12 has a small diameter portion 12a and a large diameter portion 12b. A large-diameter portion 12 b is provided in the axial range A so as to be bent greatly in the axial range A. Although the large diameter part 12b may be comprised by one and may be comprised by multiple. Concentrate on the area where you want to bend a large amount. Further, the multi-lumen tube 10 is formed so that the outer wall thickness t1 of the large diameter portion 12b is thinner than the inner wall thickness t2 of the large diameter portion 12b so as to be more easily bent. Thereby, it becomes easy to extend to the outer periphery, and the multi-lumen tube 10 is easily bent.
When the syringes 1 and 2 are operated in the direction in which the fluids 1a and 2a are delivered, the internal pressure of the second lumen 12 increases according to the operation amount, and the second lumen 12 expands. Since the second lumen 12 expands in the radial direction but also expands in the axis AX direction, the multi-lumen tube 10 is bent as shown in FIG. In particular, the outer peripheral side thin portion of the large-diameter portion 12b (the portion having the thickness t1 in FIG. 1A) expands significantly, and the second lumen 12 on the tip side from the axial range A does not pass through the axial direction. It can be largely bent in the axial range A in which the large-diameter portion 12b is disposed with respect to the range in which only the small-diameter portion 12a on the proximal end side from the range A passes. Even if the bending angle of one large-diameter portion 12b is small, the total bending angle increases in proportion to the number of large-diameter portions 12b.
When changing the direction to be bent, the multi-lumen tube 10 is rotated around the axis AX.

  A structure in which a plurality of second lumens 12 are arranged at different positions in the circumferential direction may be implemented. In this case, the multi-lumen tube 10 can be bent in different directions without rotating around the axis AX. However, when a plurality of second lumens 12 are arranged, the degree of freedom in the bending direction increases, but the operation of injecting the inflation fluid becomes complicated, and the unit price of the multi-lumen tube also increases. It is desirable to change the bending direction by rotating the multi-lumen tube 10 about the axis AX with one second lumen 12.

As described above, the expansion fluid filled in the second lumen 12 for bending the multi-lumen tube 10 is assumed to be a mixture of the liquid 2a with a gas 1a or a micro solid having different sound transmission characteristics from the liquid 2a. . The sound wave transmission characteristics are sound wave transmission speed (sound speed) and attenuation characteristics. The reason why the liquid is used is that the operability is improved because the volume change due to the pressure is smaller than that of the gas, and that the material having high hardness can be expanded, and the multi-lumen tube 10 is made of the material having high hardness. This is because the followability of the distal end portion with respect to the rotation operation of the proximal end portion is improved.
In addition, detection by the ultrasonic diagnostic device is facilitated by mixing the liquid 2a and the gas 1a or the micro solid having different sound transmission characteristics, and the position of the multi-lumen tube 10 is confirmed from the outside by detecting the multi-lumen tube 10 by the ultrasonic diagnostic device. It can be safely and reliably guided to a desired position in the body. Since the position can be confirmed from the outside without using radiation such as X-rays, there is no risk of exposure and medical costs can be reduced because a large device is not used.
Similarly, it is effective to insert a metal or resin wire into the second lumen 12 in order to facilitate detection by the ultrasonic diagnostic machine. The wire may be rod-shaped or coil-shaped.
As the gas 1a, carbon dioxide can be applied in addition to air. A metal powder or the like can be applied as the fine solid, and a liquid such as physiological saline mixed with a solid such as a fine metal powder can be used as the expansion fluid.

  When filling the second lumen 12 with the inflation fluid, the air in the second lumen 12 must be removed. For this purpose, it is effective to configure the outer peripheral thin-walled portion 12c at the distal end portion with a waterproof and moisture-permeable material that allows gas to be used recently but does not allow liquid to pass.

It is preferable to use the multi-lumen tube 10 in a disposable (disposable) manner. This is because the risk of infection can be avoided if it is made disposable.
When making it disposable, it is preferable to rupture the outer surrounding portion of the second lumen 12 of the multi-lumen tube 10 after use. This is because reuse can be prevented. According to the thickness t1 of the outer peripheral side thin portion of the large diameter portion 12b and the material design, the outer peripheral side thin portion can be ruptured at a predetermined bursting limit pressure in the second lumen 12. The pressure exceeding the bursting limit pressure is input by a syringe capable of outputting a pressure exceeding the bursting limit pressure. For example, when the syringe 2 can output a pressure exceeding the rupture limit pressure, a relief valve is provided for safety, and the pressure in the second lumen 12 is controlled within a safety range sufficiently lower than the limit pressure during use. It is preferable to configure so that. Moreover, you may connect to the syringe which can output the pressure exceeding a bursting limit pressure after use, and you may make it burst.

[Second Embodiment]
Next, a second embodiment of the present invention will be described with reference to FIG. The medical device of the present embodiment is a disposable endoscope having a resin multi-lumen tube 10A shown in FIG. 2 as a main body. The tube bending function is the same as that of the first embodiment, and portions common to the first embodiment are denoted by common reference numerals and description thereof is omitted.
The multi-lumen tube 10 </ b> A includes a third lumen 14 in addition to the first lumen 11 and the second lumen 12 similar to those in the first embodiment.
The third lumen 14 passes through the flesh around the first lumen 11, and passes through a position away from the central axis AX in the radial direction, and is open at both ends.
A metal or resin lens frame 22 containing the objective lens 21 is inserted in the distal end portion of the first lumen 11. Although the objective lens 21 is made of glass or resin, it is preferably an aspherical lens in order to form an image with a single lens, and is preferably made of resin because it is disposable.
An image fiber 24 is abutted through the objective lens 21 and the spacing tube 23 and is fixed to the lens frame 22 with an adhesive. If the objective lens 21, the lens frame 22, and the spacing tube 23 are replaced with resin molded parts in which these are integrated, the cost can be further reduced.

  An illumination optical fiber 25 is inserted in the third lumen 14. Light for illuminating the object in the distal direction is guided by the illumination optical fiber 25, and an optical system for observing the image of the object in the distal direction is configured by the objective lens 21 and the image fiber 24 to acquire the image. A plurality of the third lumens 14 may be arranged for improving the illumination performance.

In the multi-lumen tube 10 </ b> A, a metal coil 26 is sheathed on the proximal end side from the distal end portion including the distal end portion of the second lumen 12. The coil 26 is a flat coil, and has a structure in which the outer peripheral portion of the multi-lumen tube 10 </ b> A is fixed to the inner peripheral portion of the coil 26. The material of the coil 26 may be stainless steel or tungsten steel, but stainless steel such as SUS304 is realistic from the viewpoint of cost. The multi-lumen tube 10A can be made of a Teflon (registered trademark) material such as PTFE or PFA or a thermoplastic material such as nylon, but PTFE having excellent heat resistance is desirable.
The fixing method of the coil 26 and the multi-lumen tube 10A is that the multi-lumen tube 10A having an outer diameter larger than the inner diameter of the coil 26 is stretched in the longitudinal direction, plastically deformed until it becomes smaller than the inner diameter of the coil 26, and heated after being inserted into the coil 26. However, it is desirable to use a method in which the multi-lumen tube 10A is in close contact with the coil 26 by expanding.

The distal end portion of the multi-lumen tube 10A protrudes from the coil 26, and this protruding portion becomes an endoscope flexible portion. Therefore, the same axial range A as in the first embodiment is arranged in a range protruding from the coil 26. In the axial range A in which the second lumen 12 at the distal end portion is disposed, the multi-lumen tube 10A can be largely bent with respect to the proximal end side where the coil 26 is sheathed by the pressure control means (syringe 1, 2).
As described above, when the multi-lumen tube 10 is rotated around the axis AX to change the bending direction, the multi-lumen tube 10A is stiffened by the coil 26 even if the rigidity of the multi-lumen tube 10A alone is insufficient. The followability of the distal end portion with respect to the rotation operation of the proximal end portion is improved.

[Third Embodiment]
Next, a third embodiment of the present invention will be described with reference to FIG. The medical device of the present embodiment is a disposable endoscope having a resin multi-lumen tube 10B shown in FIG. 3 as a main body, and the basic configuration is the same as that of the second embodiment. Common portions are denoted by common reference numerals and description thereof is omitted. In the present embodiment, instead of eliminating the coil 26 of the second embodiment, the portion on the base end side C with respect to the tip end portion B is configured to have a relatively high hardness.
In the multi-lumen tube 10B, the distal end portion B including the axial range A of the distal end portion of the second lumen 12 is configured to have a relatively low hardness, and the proximal end side C portion from the distal end portion B has a relatively high hardness. It is configured. The distal end portion B including the axial range A is configured with a low hardness to ensure easy bending, and the proximal end C portion is configured with a high hardness so that the distal end with respect to the rotation operation of the proximal end portion Good trackability of the part is ensured. The control of the hardness by the axial range of the multi-lumen tube 10B can be executed by changing the drawing speed at the time of manufacturing (pulling forming). In the axial range A in which the second lumen 12 of the distal end portion B is disposed, the multi-lumen tube 10B can be largely bent with respect to the proximal end side C by the pressure control means (syringe 1, 2).

[Fourth Embodiment]
Next, a fourth embodiment of the present invention will be described with reference to FIG. The medical device of the present embodiment is a disposable endoscope having a resin multi-lumen tube 10C shown in FIG. 4 as a main body, and the basic configuration is the same as that of the second embodiment. Common portions are denoted by common reference numerals and description thereof is omitted. In the present embodiment, unlike the second embodiment, the thin endoscope 30 is inserted into the first lumen 11, and the third lumen 14 and the illumination optical fiber 25 of the second embodiment are used. Instead of being removed, the optical fiber 27 for illumination is configured in the small diameter endoscope 30.
The small-diameter endoscope 30 includes a thin tube 28 that can be inserted into the first lumen 11 as an exterior body, and an objective lens 21, a lens frame 22, a spacing tube 23, and an illumination optical fiber 27 are inserted into the thin tube 28. Has been configured.

In the endoscopes of the second and third embodiments, the optical system of the endoscope is fixed in the multi-lumen tubes 10A and 10B. However, in the present embodiment, the endoscope with a small diameter is used. The mirror 30 can be moved with respect to the multi-lumen tube 10 </ b> C and extended from the distal end surface 13. Therefore, this embodiment is suitable for observing small-bodies in the body, such as the fallopian tube, bile duct, and pancreatic duct.
For that purpose, while confirming the position of the multi-lumen tube 10C in the body using an ultrasonic diagnostic machine or the like, the multi-lumen tube 10C is appropriately bent or rotated, and the acquired image of the small-diameter endoscope 30 is appropriately acquired. However, it is confirmed that the distal end surface 13 is guided near the entrance of the target in-vivo small-diameter tube portion, and the small-diameter endoscope 30 is extended from the distal end surface 13 and inserted into the in-body small-diameter tube portion. The inside image is acquired.

[Fifth Embodiment]
Next, a fifth embodiment of the present invention will be described with reference to FIG. The medical device of the present embodiment is a disposable endoscope having a resin multi-lumen tube 10D shown in FIG. 5 as a main body, and the basic configuration is the same as that of the fourth embodiment. Common portions are denoted by common reference numerals and description thereof is omitted.
In the present embodiment, a wide-angle endoscope 40 is further configured in the third lumen 15 of the multi-lumen tube 10D with respect to the configuration in which the small-diameter endoscope 30 of the fourth embodiment is inserted.
As shown in FIG. 5, the small-diameter endoscope 30 is inserted through the first lumen 11 and can extend from the opening of the distal end surface 13 in the distal end direction.

  The third lumen 15 is open at both ends, and the wide-angle endoscope 40 is configured by inserting the objective lens 41, the spacing tube 42, and the image fiber 43 from the tip into the third lumen 15. The objective lens 41 and the image fiber 43 are abutted with each other through a spacing tube 42. The objective lens 41 has a lower magnification and a wider viewing angle than the objective lens 21.

Even in the present embodiment, the small-diameter endoscope 30 can be moved with respect to the multi-lumen tube 10 </ b> D and extended from the distal end surface 13. Therefore, this embodiment is suitable for observing small-bodies in the body, such as the fallopian tube, bile duct, and pancreatic duct.
For this purpose, while confirming the position of the multi-lumen tube 10D in the body using an ultrasonic diagnostic machine or the like, the multi-lumen tube 10D is appropriately bent or rotated to perform this in the vicinity of the entrance of the small-diameter tube portion. The front end surface 13 is guided so as to face the surface.
At this time, when searching for the entrance of the small-diameter tube part by relying only on the acquired image of the small-diameter endoscope 30, the field of view is relatively narrow because of the high magnification, so that the multi-lumen tube 10D is bent or rotated. Must be executed frequently until the entrance of the target small-diameter tube portion enters the acquired image of the small-diameter endoscope 30, which takes time and labor, and increases the burden on the patient. It is not preferable.
However, according to the present embodiment, when the distal end of the multi-lumen tube 10D enters the body cavity or lumen where the small-diameter tube portion opens, the target small-bore tube portion is displayed on the acquired image of the wide-angle endoscope 40. There is a high possibility that there is an entrance. Even if it is not, it can be put in the acquired image of the wide-angle endoscope 40 with a small search operation.
After confirming the position of the entrance of the target in-vivo small-diameter tube portion from the acquired image of the wide-angle endoscope 40, the multi-lumen tube 10D is appropriately bent and rotated to execute the target in-vivo small-diameter tube portion. The distal end surface 13 is guided so as to oppose it in the vicinity of the entrance, and the small-diameter endoscope 30 is extended from the distal end surface 13 and inserted into the in-vivo small-diameter tube portion, so that an internal image can be acquired quickly. A high-definition image in the small-diameter endoscope 30 can be acquired by the small-diameter endoscope 30 having a higher magnification than that of the wide-angle endoscope 40.
According to the present embodiment, the function of searching for the tube opening when the diameter is reduced, such as the pancreas and bile ducts from the intestine and the fallopian tube, and the function of observing the inside of the tube and the organ ahead By having two devices in one device, the treatment time can be shortened and the burden on the patient can be reduced.

  In the embodiment described above, the pressure control means is a syringe, but the pressure control means is not limited to this, and may be replaced with a pump and a control device that controls the pump.

1 Syringe (pressure control means)
1a Gas 2 Syringe (pressure control means)
2a Liquid 10 Multi-lumen tube 11 First lumen 12 Second lumen 12a Small diameter portion 12b Large diameter portion 13 Tip surface 14 Third lumen 15 Third lumen 21 Objective lens 22 Lens frame 23 Spacing tube 24 Image fiber 25 Illumination optical fiber 26 Coil 27 Optical fiber for illumination 28 Thin tube 30 Thin endoscope 40 Wide angle endoscope 41 Objective lens 42 Space tube 43 Image fiber AX Central axis

Claims (10)

A multi-lumen tube that can be inserted into the body,
Pressure control means for controlling the pressure of the fluid in the lumen, connected to the base end of the lumen that is at least one lumen of the multi-lumen tube and that is located radially away from the central axis of the multi-lumen tube; With
The tip of the lumen is sealed,
A medical device configured such that the multi-lumen tube can be bent with the lumen side as an expansion side when the internal pressure of the lumen is increased by the pressure control means and the lumen is expanded. The lumen has a large-diameter portion partially formed with a large diameter, and the multi-lumen tube is made larger than other axial ranges by the pressure control means in the axial range where the large-diameter portion is disposed. The medical device according to claim 1 configured to be bendable. The medical device according to claim 2, wherein the multi-lumen tube is formed such that a thickness on an outer peripheral side of the large diameter portion is thinner than a thickness on an inner peripheral side of the large diameter portion. In the multi-lumen tube, the distal end portion including the distal end portion of the lumen is configured with relatively low hardness, and the proximal end side is configured with relatively high hardness from the distal end portion,
The medical device according to claim 1, wherein the multi-lumen tube is configured to be largely bent with respect to the proximal end side by the pressure control means in an axial range in which the lumen of the distal end portion is disposed. In the multi-lumen tube, a metal coil is sheathed on the proximal end side from the distal end portion including the distal end portion of the lumen,
The medical device according to claim 1, wherein the multi-lumen tube is configured to be largely bent with respect to the proximal end side by the pressure control means in an axial range in which the lumen of the distal end portion is disposed. The medical device according to any one of claims 1 to 5, wherein the fluid is obtained by mixing a gas or a micro solid having a different sound wave transmission characteristic from the liquid. The medical device according to any one of claims 1 to 5, wherein a metal or resin wire is inserted into the lumen. An objective lens and an image fiber for observing an image of an object in the distal direction are configured in one lumen that opens at the distal end surface of the multi-lumen tube.
The medical optical fiber according to any one of claims 1 to 7, wherein an illumination optical fiber that guides light for illuminating the object is formed in another lumen that opens at a distal end surface of the multi-lumen tube. apparatus. A small-diameter tube that can be inserted into one lumen that opens at the distal end surface of the multi-lumen tube;
The objective lens for observing the image of the object in the distal direction and the image fiber, and the illumination optical fiber for guiding the light for illuminating the object are configured on the small-diameter tube. The medical device according to 1. The small-diameter tube is configured to be able to extend from the opening of the tip surface of the multi-lumen tube,
Another objective lens and other image for observing an image of an object in the distal direction with a wider viewing angle than the objective lens of the small-diameter tube in another lumen that opens at the distal end surface of the multi-lumen tube The medical device according to claim 9, wherein the fiber is configured.

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