JP2016059716A - Basket catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a basket catheter capable of surely collecting a foreign substance in a living body.SOLUTION: A basket catheter 1 includes: a shaft body part 2; and two or more wires 3 that are at least partially stored in the shaft body part 2, and of which a portion exposed from the shaft body part 2 forms a basket 4 capable of shifting to a first expansion form and a second expansion form shrinking more than the first expansion form. At least one of the wires 3 includes a loop 5 that is wound near a tip of the basket, and the loop 5 includes one or more transforming parts that transform more preferentially than other portions in the loop 5 in association with shifting of the basket 4 from the first expanded form to the second expanded form.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a basket catheter.

  Foreign substances such as calculi generated in the living body such as ureters, renal pelvis, and renal cup may be collected by a basket catheter having a basket. As a basket catheter that collects foreign matter, for example, as disclosed in Patent Document 1, a medical instrument that collects foreign matter with a basket exposed from the tip of an elongated member is known. The medical instrument is inserted into a living body by an operator, grasps the foreign matter with a basket, and collects the foreign matter.

  The basket of the medical device includes at least one wire loop, at least one wire leg, and a movement limiting means for limiting relative movement between the at least one wire loop and the at least one wire leg. The movement limiting means is formed continuously and without kinking in at least one of the wire loop and the wire leg, and preferably both.

Special table 2001-512355 gazette

  The medical device as described above has a problem in that foreign matter is frequently dropped from the basket because the basket cannot be quickly contracted.

  As a result of intensive studies, the present inventors have found that by providing a deformed portion in the wire loop constituting the basket, the basket can be quickly contracted and foreign matter in the living body can be reliably recovered. The invention has been completed.

That is, the present invention relates to the following.
[1] Shaft body,
A basket in which at least a part is accommodated in the shaft main body portion and a portion exposed from the shaft main body portion can be transferred to a first expanded configuration and a second expanded configuration contracted more than the first expanded configuration. Two or more wires to be formed,
At least one of the two or more wires has a loop that circulates near the tip of the basket;
The basket has one or more deformable portions that deform preferentially over other portions in the loop as the basket moves from the first expanded configuration to the second expanded configuration.
[2] The basket catheter according to [1], wherein the loop has one deformed portion at a position facing an intersection of the loops.
[3] The basket catheter according to [2], wherein at least one wire other than the wire having the loop passes through the loop.
[4] The [1] to [3], in which the loop includes the two deformable portions, and the two deformable portions are arranged to face each other across the shaft of the shaft main body portion. The basket catheter according to any one of the above.
[5] The basket catheter according to any one of [1] to [4], wherein the deformable portion is a portion having lower rigidity than other portions of the loop.

[6] The basket catheter according to any one of [1] to [5], wherein the loop circulates toward the shaft main body.
[7] A first wire set composed of two or more wires and a second wire set composed of two or more wires,
As the basket shifts from the first expanded configuration to the second expanded configuration, the second wire set rotates relative to the first wire set around the axis of the shaft main body. The basket catheter according to any one of [1] to [6].
[8] At least a part of the shaft is housed in the shaft main body, and a portion exposed from the shaft main body can be shifted to a first expanded form and a second expanded form contracted more than the first expanded form. Two or more wires forming a basket, and at least one of the two or more wires has a loop that circulates near the tip of the basket, and the loop A basket catheter having one or more deformable portions that deform preferentially over other portions in the loop as the basket moves from the first expanded configuration to the second expanded configuration. Delivering the basket to a location where foreign matter in the living body is present; and
Transitioning the basket to the first expanded configuration and capturing the foreign matter inside the basket;
Shrinking the basket through the second expanded configuration to grip the foreign matter;
A method for collecting foreign matter in a living body.

  ADVANTAGE OF THE INVENTION According to this invention, the basket catheter which can grasp | ascertain the foreign material in a biological body reliably can be provided.

It is a side view showing roughly the 1st expansion form of the basket catheter concerning the 1st embodiment of the present invention. FIG. 2A is a side view schematically showing a first expanded form of the basket of FIG. 1. FIG. 2B is a side view schematically showing a second expanded configuration of the basket of FIG. 1. FIG. 3A is a side view schematically showing the loop of FIG. 2A. FIG. 3B is a side view schematically showing the loop of FIG. 2B. FIG. 4A is a side view schematically showing a basket in a conventional basket catheter. 4B is a side view schematically illustrating the basket of FIG. 2B. FIG. 5A is a side view schematically showing a first expanded form of a basket 4A according to a second embodiment of the present invention. FIG. 5B is a side view schematically showing a second expanded configuration of the basket 4A according to the second embodiment of the present invention. FIG. 6A is a side view schematically showing a first expanded form of a basket 4B according to a third embodiment of the present invention. FIG. 6B is a side view of the basket 4B according to the third embodiment of the present invention, which has shifted from the first expanded configuration to a state in which the expansion is maintained but the expansion is maintained (second expanded configuration). FIG. 7A is a side view schematically showing the loop of FIG. 6A. FIG. 7B is a side view schematically showing the loop of FIG. 6B. FIG. 8A is a side view schematically showing a first expanded form of a basket catheter according to a fourth embodiment of the present invention. FIG. 8B is a side view schematically showing a first expanded configuration of the basket catheter according to the fourth embodiment of the present invention. It is a perspective view which shows 2C of shaft main-body parts of FIG. 10A is a cross-sectional view taken along line VA-VA in FIG. 10B is a cross-sectional view taken along line VB-VB in FIG. FIG. 11 is a side view schematically showing the basket 4C of FIG. 8A. 12A to 12C are explanatory diagrams for explaining the foreign matter recovery method of the present invention.

    Hereinafter, the present invention will be described in detail based on preferred embodiments with reference to the accompanying drawings.

[First Embodiment]
First, the basket catheter 1 according to the first embodiment of the present invention will be described. FIG. 1 is a side view schematically showing a first expanded form of a basket catheter according to a first embodiment of the present invention. FIG. 2A is a side view schematically showing a first expanded form of the basket of FIG. 1. FIG. 2B is a side view schematically showing a second expanded configuration of the basket of FIG. 1. FIG. 3A is a side view schematically showing the loop of FIG. 2A. FIG. 3B is a side view schematically showing the loop of FIG. 2B. FIG. 4A is a side view schematically showing a basket in a conventional basket catheter. 4B is a side view schematically illustrating the basket of FIG. 2B. In each drawing in the present application, for ease of explanation, the size of each member is emphasized as appropriate, and the illustrated members do not indicate actual sizes.

  As shown in FIG. 1, the basket catheter 1 according to the first embodiment of the present invention includes a shaft main body 2, a wire 31 and a wire 32 housed in the shaft main body 2, and the wire 31 and the wire 32. A basket 51, a loop 51 and a loop 52 provided on the wire 31 and the wire 32, and an operation unit 6 near the tip of the basket 4. The basket catheter 1 is used for collecting foreign substances in a living body.

  Examples of the living body to which the basket catheter 1 is applied include the inside of organs such as the urinary system, circulatory system, respiratory system, digestive system, genital system, endocrine system, nervous system, and sensory system. Examples of urinary organs include ureters, renal pelvis, renal cup, urethra, and bladder.

  Further, the foreign matter is not particularly limited, but refers to a solid matter that should be removed in vivo as necessary, and is a concept that includes a mixture of a solid such as a gel-like matter and a liquid and / or gas. Examples of foreign substances include thrombus, various stones such as gallstones, kidney stones, urinary tract stones, bladder stones, and urethral stones, and sputum. The basket catheter 1 is particularly suitable for removing stones generated inside the urinary organs such as the ureter, renal pelvis, and renal cup.

  The shaft main body 2 is configured as a long tube and has a space for storing the wire 31 and the wire 32. Although it will not specifically limit as long as the length of the shaft main-body part 2 is the length which can reach the foreign body in a biological body, For example, it is 300-2000 mm, Preferably, it can be 500-1500 mm. Moreover, it does not specifically limit as an outer diameter of the shaft main-body part 2, For example, it is 0.3-1.1 mm, Preferably, it can be 0.5-1.0 mm.

  Although it does not specifically limit as a material which comprises the shaft main-body part 2, The material which has moderate flexibility is preferable. In this case, examples of the material constituting the shaft main body 2 include metals and resins. Examples of the metal include pseudoelastic alloys (including superelastic alloys) such as Ni-Ti alloys, shape memory alloys, stainless steel (for example, SUS304, SUS303, SUS316, SUS316L, SUS316J1, SUS316J1L, SUS405, SUS430, SUS434, SUS444, SUS429, SUS430F, SUS302, etc.), cobalt-based alloys, noble metals such as gold and platinum, tungsten-based alloys, carbon-based materials (including Viano wires), and the like.

  Examples of the resin include polyolefin (for example, polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or a mixture of two or more thereof), polyvinyl chloride, polyamide, Polyamide elastomers, polyesters, polyester elastomers, polyurethanes, polyurethane elastomers, engineering plastics such as polyimide and polyetheretherketone, polymer materials such as fluororesin or mixtures thereof, or two or more of the above polymer materials It is done. The shaft main body 2 may be applied with a composite of these metals and resins (for example, a multilayer tube in which a metal and a resin are laminated). Furthermore, the shaft body 2 may be formed as a coil tube in which a wire is wound spirally. Further, it may be formed as a braided blade. Although the material of a wire is not specifically limited, The above metals and resin, or the composite of these metals and resin is mentioned.

  Both ends of the wire 31 and the wire 32 are accommodated in the shaft main body 2 so as to be able to advance and retreat, while being exposed from the tip of the shaft main body 2 to constitute the basket 4. Further, both ends of the wire 31 and the wire 32 pass through the shaft main body 2, are exposed from the base end of the shaft main body 2, and are connected and fixed to the hub 61 of the operation unit 6. Further, the base end of the shaft main body 2 is connected and fixed to the operation element 62 of the operation unit 6. The surgeon advances and retracts the wire 61 and the wire 32 relative to the shaft main body 2 by moving the hub 61 and the operator 62 relative to each other, thereby exposing the basket 4 from the shaft main body 2. be able to.

  Although it does not specifically limit as a material which comprises the wire 31 and the wire 32, The material which has moderate elasticity is preferable. In this case, a metal is mentioned as a material which comprises the wire 31 and the wire 32. FIG. Examples of the metal include pseudoelastic alloys (including superelastic alloys) such as Ni-Ti alloys, shape memory alloys, stainless steel (for example, SUS304, SUS303, SUS316, SUS316L, SUS316J1, SUS316J1L, SUS405, SUS430, SUS434, SUS444, SUS429, SUS430F, SUS302, etc.), cobalt-based alloys, noble metals such as gold and platinum, tungsten-based alloys, carbon-based materials (including Viano wires), and the like.

  The basket 4 is formed by bending a wire 31 and a wire 32 exposed from the distal end portion of the shaft main body 2 to form a ring and intersecting the vicinity of the distal end of the basket 4. The wires 31 and 32 are radially arranged at 90 ° intervals in the circumferential direction of the shaft body 2 when the proximal direction is viewed from the distal end side of the basket catheter 1. The wire 31 and the wire 32 are respectively provided with a loop 51 and a loop 52 that circulate toward the shaft main body 2 near the tip of the basket 4. In addition, the basket 4 of FIG. 1 is the state (1st expansion form) most developed to the radial direction outer side.

  As shown in FIG. 2A, the basket 4 can be shifted from a first expanded form to a state where the first expanded form is slightly contracted but kept expanded (second expanded form) as shown in FIG. 2B. It is. The transition of the basket 4 to the first expanded form is performed by advancing the wire 31 and the wire 32 relative to the shaft main body 2 and lengthening the portion of the wire 31 and the wire 32 that constitutes the basket 4. be able to. In the 1st expansion form, since the volume inside basket 4 is the maximum and the distance between wire 31 and wire 32 is also the maximum, a foreign substance can be easily taken into the inside of a basket.

  The transition of the basket 4 to the second expanded form is performed by retracting the wire 31 and the wire 32 relative to the shaft body 2 and shortening the portion of the wire 31 and the wire 32 that constitutes the basket 4. be able to. Further, the basket 4 can be housed in the shaft body 2 by further retracting the wire 31 and the wire 32. With the transition of the basket 4 to the second expanded form, the volume of the internal space of the basket 4 shrinks and the distance between the wire 31 and the wire 32 also decreases, so that foreign matter taken inside the basket 4 is removed by the basket 4. I can grab it.

  The transition of the basket 4 from the first expanded configuration to the second expanded configuration, the transition from the first expanded configuration to the second expanded configuration, and the storage of the basket 4 in the shaft body 2 are performed by operating the operation unit 6. The wire 31 and the wire 32 constituting the basket 4 can be moved forward and backward relative to the shaft body 2.

  As shown in FIG. 2A, in the present embodiment, the wire 31 and the wire 32 that constitute the basket 4 include a loop 51 and a loop 52 that circulate toward the shaft body 2 near the tip of the basket 4, respectively. Have. The loop 51 and the loop 52 pass through each other and limit the relative movement in the radial direction of the shaft body 2 between the wire 31 and the wire 32.

  3A and 3B are side views schematically showing the loop of FIGS. 2A and 2B, respectively. In the following description, the wire 31 and the wire 32 are described as the wire 3 for simplification. The other parts will be described in the same manner.

  As shown in FIG. 3A, the loop 5 has one deformation portion 8. The deformation portion 8 is arranged at a position facing the intersection 7 of the loop 5. In the first expanded form of the basket 4, the loop 5 has a substantially circular shape. The deformation portion 8 is a portion that deforms preferentially in the loop 5 over other portions of the loop 5. In the present embodiment, the deformable portion 8 is a portion having lower rigidity than other portions of the loop 5. The deformed portion 8 is formed by performing kink processing at a position facing the intersection 7 of the loop 5. The kink processing can be performed by applying heat, pressure, mechanical force, or the like at a position facing the intersection 7 of the loop 5. By storing the shape by such processing, the deformable portion 8 can always maintain the same shape in a state where the external force is released (natural state).

  As shown in FIG. 2B and FIG. 3B, when the wire 3 is moved backward relative to the shaft main body 2, the basket 4 moves in the axial direction of the shaft main body 2 and the direction perpendicular to the axis of the shaft main body 2. Shrink. As the basket 4 contracts, the loop 5 provided on the wire 3 also contracts. At this time, the force acting on the loop 5 is transmitted to the deformed portion 8 of the loop 5, and the deformed portion 8 of the loop 5 is preferentially deformed and bent over other portions of the loop 5. When the basket 4 is further contracted than in the second expanded configuration, the deformed portion 8 of the loop 5 is further bent accordingly.

  As shown in FIG. 3B, the loop 5 contracts in a direction perpendicular to the axis of the shaft body 2 with the intersection 7 and the bent deformed portion 8 as a base point in accordance with the transition of the basket 4 to the second expanded form. Can do. When the loop 5 contracts in the direction perpendicular to the axis of the shaft body 2, the drag in the direction perpendicular to the axis of the shaft body 2 of the loop 5 decreases. Along with this, the basket 4 formed by the wires 3 easily contracts in a direction perpendicular to the axis of the shaft body 2. Thereby, the basket 4 can be contracted quickly and foreign substances in the living body can be reliably grasped.

  Also, as shown in FIG. 3B, the loop 51 and the loop 52 are contracted and fixed so as to sandwich each other. Therefore, the positional relationship of the wire 31 and the wire 32 in the circumferential direction of the shaft body 2 is as described above. The shaft body 2 is fixed radially at 90 ° intervals in the circumferential direction. Thereby, the careless rotation to the circumferential direction of the shaft main-body part 2 of the wire 31 and the wire 32 is suppressed, and the basket 4 can maintain the state which hold | gripped the foreign material in a biological body.

  Returning to FIG. 1, the operation portion 6 of the basket catheter 1 includes the hub 61 to which both ends of the wire 3 are connected and fixed as described above, and the operation element 62 to which the base end of the shaft main body portion 2 is connected and fixed. The surgeon advances and retracts the operation element 62 relative to the hub 61 to advance and retract the wire 3 relative to the shaft body 2 to expose and store the basket 4. The transition to the first extended form and the second extended form can be performed.

  Hereinafter, the basket of the conventional basket catheter and the basket 4 of the basket catheter 1 in this embodiment will be described in comparison. As shown in FIGS. 4A and 4B, the conventional basket T and the basket 4 of the present invention are in the most expanded state radially outward as indicated by the dotted line L in the first expanded configuration. As shown by a solid line in FIG. 4A, the loop P in the conventional basket T contracts while maintaining a substantially circular shape as the basket T contracts. On the other hand, as indicated by a solid line in FIG. 4B, the loop 5 in the basket 4 of the present invention contracts in a direction perpendicular to the axis of the shaft body 2 as the basket 4 contracts. And the basket 4 becomes easy to shrink | contract in the direction perpendicular | vertical to the axis | shaft of the shaft main-body part 2. As shown in FIG.

  As described above, the basket catheter 1 according to the present embodiment has one deformable portion 8 in the loop 5 of the wire 3, so that the basket 4 constituted by the wire 3 can rapidly contract. Further, inadvertent rotation of the wire 3 in the circumferential direction of the shaft main body 2 is suppressed, and the basket 4 can continue to hold a foreign substance in the living body. Therefore, the basket catheter 1 can reliably grasp foreign substances in the living body.

[Second Embodiment]
Next, a basket catheter 1A according to a second embodiment of the present invention will be described. FIG. 5A is a side view schematically showing a first expanded form of a basket 4A according to a second embodiment of the present invention. FIG. 5B is a side view schematically showing a second expanded configuration of the basket 4A according to the second embodiment of the present invention. In addition, in the following description, the same code | symbol is attached | subjected about the same part as the structure of the basket catheter 1 which concerns on a 1st embodiment, and those description is abbreviate | omitted.

  The basket catheter 1A according to the second embodiment differs from the basket catheter 1 according to the first embodiment in that the loop 5 has a substantially elliptical shape in the first expanded form of the basket 4. As shown in FIG. 5A, the loop 5A according to the second embodiment has a substantially elliptical shape having a major axis in the axial direction of the shaft body 2 in the first expanded form of the basket 4A. The elliptical shape can be formed by applying heat, pressure, mechanical force or the like to the loop 5A.

  As shown in FIG. 5A, a portion (that is, the deformed portion 8A) facing the intersection 7 of the loop 5A having a substantially elliptic shape is bent more than the other portions in the loop 5A. Therefore, the force acting on the loop 5A is more likely to act on the deformed portion 8A than other parts. As illustrated in FIG. 5B, the basket 4 </ b> A contracts in the axial direction of the shaft main body 2 and the direction perpendicular to the axis of the shaft main body 2 with the transition to the second expanded configuration. As the basket 4A contracts, the loop 5A of the wire 3A contracts similarly. At this time, the force acting on the loop 5A is more likely to act on the deformed portion 8A than the other portions of the loop 5A. Therefore, the deformed portion 8A of the loop 5A deforms preferentially over the other portions of the loop 5A. Then bend.

  As shown in FIG. 5B, the loop 5A contracts in a direction perpendicular to the axis of the shaft main body 2 with the intersection 7 and the bent deformed portion 8A as a base point in accordance with the transition of the basket 4A to the second expanded form. Can do. When the loop 5A contracts in the direction perpendicular to the axis of the shaft body 2, the drag in the direction perpendicular to the axis of the shaft body 2 of the loop 5A decreases. Accordingly, the basket 4 </ b> A formed by the wire 3 </ b> A is easily contracted in a direction perpendicular to the axis of the shaft body 2. As a result, the basket 4A can be quickly contracted, and foreign substances in the living body can be reliably grasped.

  In the basket catheter 1A as described above, the basket 4A formed by the wire 3A can rapidly contract by forming the loop 5A so as to have a substantially elliptical shape. Therefore, the basket catheter 1 </ b> A can reliably grasp foreign substances in the living body.

[Third embodiment]
Next, a basket catheter 1B according to a third embodiment of the present invention will be described. FIG. 6A is a side view schematically showing a first expanded form of a basket 4B according to a third embodiment of the present invention. FIG. 6B is a side view of the basket 4 according to the third embodiment of the present invention, which has shifted from the first expanded configuration to a state (second expanded configuration) that is slightly contracted but maintained expanded. FIG. 7A is a side view schematically showing the loop of FIG. 6A. FIG. 7B is a side view schematically showing the loop of FIG. 6B. In addition, in the following description, the same code | symbol is attached | subjected about the same part as the structure of the basket catheter 1 which concerns on a 1st embodiment, and those description is abbreviate | omitted.

  The basket catheter 1B according to the third embodiment differs from the basket catheter 1 according to the first embodiment in terms of the position and number of the deformable portions 8 arranged in the loop 5.

  As shown to FIG. 6A, the basket 4B can transfer to a 1st expansion form and a 2nd expansion form as shown to FIG. 6B. In this embodiment, the wire 31B and the wire 32B that constitute the basket 4B have a loop 51B and a loop 52B that circulate toward the shaft main body 2 near the tip of the basket 4B. The loop 51B and the loop 52B pass through each other, and limit the relative movement in the radial direction of the shaft body 2 between the wire 31B and the wire 32B.

  7A and 7B are side views schematically showing the loop 5B of FIGS. 6A and 6B, respectively. In the following description, the wire 31B and the wire 32B will be described as the wire 3B for simplification. The other parts will be described in the same manner.

  As shown in FIG. 7A, the loop 5B has two deformation portions 8B, and the two deformation portions 8B are arranged in the loop 5B so as to face each other across the axis of the shaft main body portion. Yes. In the first expanded form of the basket 4B, the loop 5B has a substantially circular shape. The two deformable portions 8B are portions that preferentially deform in the loop 5B over other portions of the loop 5B. In the present embodiment, the two deformable portions 8B are portions having lower rigidity than other portions of the loop 5B.

  As shown in FIGS. 6B and 7B, when the wire 3B is moved backward relative to the shaft main body 2, the basket 4B moves in the axial direction of the shaft main body 2 and the direction perpendicular to the axis of the shaft main body 2. Shrink. As the basket 4B contracts, the loop 5B of the wire 3B contracts similarly. At this time, the force acting on the loop 5B is transmitted to the two deformed portions 8B of the loop 5B, and the two deformed portions 8B of the loop 5B are deformed and bent preferentially over other portions of the loop 5B.

  As shown in FIG. 7B, the loop 5B can be contracted in the axial direction of the shaft body 2 with the two deformed portions 8B bent as a base point in accordance with the transition of the basket 4B to the second expanded configuration. When the loop 5B contracts in the axial direction of the shaft main body 2, the axial drag of the shaft main body 2 of the loop 5B decreases. Accordingly, the basket 4 </ b> B formed by the wire 3 </ b> B is easily contracted in the axial direction of the shaft body 2. Thereby, the basket 4B can be quickly contracted, and foreign substances in the living body can be reliably grasped.

  Further, since the loop 5B can be contracted in the axial direction of the shaft body 2, the foreign matter taken inside the basket 4B is not inadvertently pressed. Therefore, the basket 4B can maintain the state where the foreign substance in the living body is gripped.

  The basket catheter 1B as described above has two deformation portions 8B in the loop 5B, so that the basket 4B formed by the wire 3B rapidly contracts. Therefore, the basket catheter 1B can reliably hold foreign substances in the living body.

[Fourth Embodiment]
Next, a basket catheter 1C according to a fourth embodiment of the present invention will be described. FIG. 8A is a side view schematically showing a first expanded form of a basket catheter according to a fourth embodiment of the present invention. FIG. 8B is a side view schematically showing a first expanded configuration of the basket catheter according to the fourth embodiment of the present invention. FIG. 9 is a perspective view showing the shaft body 2C of FIG. 10A is a cross-sectional view taken along line VA-VA in FIG. 10B is a cross-sectional view taken along line VB-VB in FIG. FIG. 11 is a side view schematically showing the basket 4C of FIG. 8A. In addition, in the following description, the same code | symbol is attached | subjected about the same part as the structure of the basket catheter 1 which concerns on a 1st embodiment, and those description is abbreviate | omitted.

The basket catheter 1C according to the fourth embodiment includes a first wire set 311 composed of two wires, and a second wire set 321 composed of two wires, and the second wire set 321 is a first wire set. The basket catheter 1 according to the first embodiment is different from the basket catheter 1 according to the first embodiment in that it can be rotated around the axis of the shaft main body 2 </ b> C relative to the set 311.
As shown in FIGS. 8A and 8B, a basket catheter 1C according to the fourth embodiment includes a shaft body 2C, a first wire set 311 composed of two wires, and a second wire set 321 composed of two wires, A basket 4C and a loop 5 are provided.

  As for the shaft main-body part 2C, the trunk | drum which occupies most longitudinal directions is comprised by the double-pipe structure of the outer side shaft 21C and the inner side shaft 22C. In this embodiment, the outer shaft 21C and the inner shaft 22C are formed as a coil tube in which a wire is wound spirally, and the inner shaft 22C is accommodated in the outer shaft 21C so as to be able to advance and retract. The shaft body 2C includes a guide tube 21 connected and fixed to the tip of the outer shaft 21C, and a holding member 22 connected and fixed to the tip of the inner shaft 22C inside the guide tube 21. The axial length of the inner shaft 22C is formed slightly longer than the axial length of the outer shaft 21C. Thereby, the tip of the inner shaft 22C is also inserted into the guide tube 21, and the holding member 22 is fixedly supported therein.

  Both ends of the first wire set 311 and the second wire set 321 are accommodated in the shaft main body portion 2C so as to be able to advance and retreat, and are exposed from the tip side of the shaft main body portion 2C to constitute the basket 4C. The first wire set 311 and the second wire set 321 extend through the inner shaft 22C to the base end portion of the shaft main body portion 2C, and are connected and fixed to the hub of the operation portion. The base end portion of the outer shaft 21C is connected and fixed to the operation element of the operation unit. The proximal end portion of the inner shaft 22C is connected and fixed to the hub of the operation unit.

  As shown in FIG. 9A, a guide groove 211 is provided on the peripheral wall of the guide tube 21. The guide groove 211 is short on the distal end side of the guide tube 21 and extends in the distal direction. The guide groove 211 extends to the distal end groove portion 212 and extends obliquely through the guide tube 21. The guide groove 211 extends to the inclined groove portion 213 and extends in the proximal direction. And a proximal groove 214 that is sufficiently longer than the distal groove 212. The distal end groove portion 212 and the proximal end groove portion 214 are formed at positions shifted from each other by 45 ° in the circumferential direction of the guide tube 21.

  As shown in FIG. 9B, a protrusion 221 that has a cylindrical shape and protrudes radially outward is formed on the outer peripheral surface of the holding member 22. The holding member 22 is guided to the guide groove 211 via the protrusion 221. That is, the holding member 22 rotates around the circumference in the inclined groove portion when the protrusion moves from the distal end groove portion 212 to the proximal end groove portion 214 (or moves in reverse).

  The holding member 22 has a plurality of holes formed so as to penetrate along the axial direction of the holding member 22. Specifically, one wire fixing hole 222 formed in a circular cross section in the axial center portion, and four wires extending in the circumferential direction by drawing a slight arc at a radially outer position of the wire fixing hole 222 Arrangement hole 223. The wire arrangement holes 223 are formed at equal intervals (90 ° intervals) along the circumferential direction of the holding member 22. The second wire set 321 is bundled and stored in the wire fixing hole 222. Thereby, the holding member 22 contacts and holds the second wire set 321 with a strong compression force, and firmly fixes the second wire set 321. Conversely, both ends of the second wire set 321 are inserted into the four wire arrangement holes 223, respectively.

  The second wire set 321 is configured to rotate integrally with the holding member 22, and rotates with the holding member 22 when the holding member 22 rotates about the axis of the shaft main body 2 </ b> C. On the other hand, the first wire set 311 is inserted through the four wire arrangement holes 223 of the holding member 22. The first wire set 311 keeps the arrangement position without following the rotation even when the holding member 22 rotates. The first wire set 311 and the second wire set 321 are respectively provided with a loop 5C and a loop 5D that circulate toward the shaft main body 2C near the tip of the basket 4C.

  As shown in FIG. 8A, in a state where the holding member 22 is positioned on the distal end side of the guide tube 21, the first wire set 311 and the second wire set 321 exposed from the holding member 22 are each in the first expanded form. In this first expanded form, the holding member 22 has a protrusion 221 disposed in the distal end groove portion 212 so that the relative position with respect to the guide tube 21 is defined. As shown in FIG. 10A, the second wire set 321 is It arrange | positions in the proximity | contact position of the 1st wire set 311. FIG. That is, in the first expanded form, the distance in the circumferential direction of the shaft body 2C between the first wire set 311 and the second wire set 321 constituting the basket 4C is the largest, and foreign matter can be easily taken into the basket 4C. it can.

  On the contrary, as shown in FIG. 8B, at the stage where the guide tube 21 advances relative to the holding member 22 and the protrusion 221 enters the proximal groove 214, the second wire set 321 and the first wire set 311 are It becomes a 2nd expansion form. In this second expanded form, the holding member 22 rotates about the 45 ° axis with respect to the guide tube 21 by the projection 221 being guided by the proximal groove 214 through the inclined groove 213. Therefore, the second wire set 321 is also rotated by 45 ° with respect to the first wire set 311. As shown in FIG. 10B, the second wire set 321 is arranged at a substantially middle portion between the adjacent first wire sets 311. Is done. Therefore, the basket 4C can suppress the spillage of the calculus taken inside.

  As shown in FIG. 11, the first wire set 311 and the second wire set 321 constituting the basket 4C are respectively looped around the tip of the basket 4C toward the shaft main body 2C side, and the loop 5C and the loop 5D. Is provided. One deforming portion 8C is disposed at a position facing the intersection 7 of the loop 5C and the loop 5D. Further, the loop 5C and the loop 5D are connected by the annular ring 9, and the second wire set 321 can be smoothly rotated with respect to the first wire set 311. Thereby, the first wire set 311 and the second wire set 321 can be expanded and contracted more integrally.

  The loop 5C and the loop 5D can be contracted in a direction perpendicular to the axis of the shaft main body 2C with the intersection 7 and the deformed portion 8C as a base point in accordance with the transition of the basket 4C to the second expanded form. Along with this, the basket 4C formed by the first wire set 311 and the second wire set 321 easily contracts in a direction perpendicular to the axis of the shaft body 2C. Thereby, the basket 4C can be quickly contracted, and the foreign matter taken inside the basket 4C can be reliably grasped. In addition, the second wire set 321 is disposed at a substantially intermediate portion between the adjacent first wire sets 311. Therefore, the basket 4C can suppress the spillage of the calculus taken inside.

  In the basket catheter 1C as described above, the basket 4C rapidly contracts. In addition, the second wire set 321 is disposed at a substantially intermediate portion between the adjacent first wire sets 311. Therefore, the basket catheter 1 </ b> C can reliably grasp foreign matter in the living body.

The basket catheter according to Embodiments 1 to 4 of the present invention has been described above, but the present invention is not limited to this.
In the present invention, each component can be replaced with any component that can exhibit the same function, or any component can be added.

  The number of wires constituting the basket is 2 or 4 in the above-described embodiments 1 to 3, but may be, for example, 2 to 12, preferably 4 to 8, and may be an odd number. Also good. The number of loops provided in the wire is 1 or 2 in the above-described embodiments 1 to 3, but may be 1 to 6, preferably 2 to 4, for example.

Further, the loop of the wire may be provided other than near the tip of the basket.
The loop may be formed on at least one of the wires.
Further, the wire may not pass through the loop.
A plurality of deformation portions may be provided at any position of the loop. Although the number of deformation | transformation parts is 1 or 2 in Embodiment 1-3 mentioned above, it can be 1-12, for example, Preferably, it is 1-8.
In addition, the deforming portion may be arranged on the wire 3 by appropriately combining the deforming portion 8, the deforming portion 8A, the deforming portion 8B, and the deforming portion 8C. For example, the basket 4 may be configured by arranging the deformable portion 8 on the wire 31 and the deformable portion 8B on the wire 31.

  In the above-described fourth embodiment, the distal end groove portion 212 and the proximal end groove portion 214 are formed at positions that are deviated from each other by 45 ° in the circumferential direction of the guide tube 21. For example, the shape of the guide groove 211 of the guide tube 21 is particularly limited. However, the amount of shift (angle) in the circumferential direction between the distal end groove 212 and the proximal end groove 214 may be freely designed. That is, the rotation angle of the second wire set 321 can be freely set.

  The first wire set 311 and the second wire set 321 may be formed in different shapes (for example, a wire diameter, a wire length, etc.) when viewed from the side. The second wire set 321 may be disposed on either the outside or the inside of the first wire set 311. The wire 3 may have a cross-sectional shape formed in a D shape (or semicircular shape) or a crescent shape (or C shape). In this case, it is preferable that the wire 3 is arranged with the portion cut out from the circular cross section facing inward. Moreover, you may comprise the basket 4 combining the wire 3 from which cross-sectional shape differs. Further, the annular ring 9 may be omitted.

Next, the foreign material recovery method of the present invention will be described based on a preferred embodiment.
The foreign matter recovery method of the present invention includes:
A basket in which at least a part is accommodated in the shaft main body portion and a portion exposed from the shaft main body portion can be transferred to a first expanded configuration and a second expanded configuration contracted more than the first expanded configuration. Two or more wires to be formed, and at least one of the two or more wires has a loop that circulates in the vicinity of the tip of the basket, A basket catheter having one or more deformable portions that deform preferentially over other portions in the loop as the basket moves from the first expanded configuration to the second expanded configuration is inserted into the living body. Delivering the basket to a place where a foreign substance exists in the living body (delivery step);
Transitioning the basket to the first expanded form and taking in the foreign matter inside the basket (expanding step);
Shrinking the basket through the second expanded configuration to grip the foreign object (shrinking step);
Have

The foreign substance recovery method of the present invention can be applied to any part in any living body, but in this embodiment, the part is a ureter and the foreign substance is a calculus.
Further, the basket catheter is not particularly limited as long as it is within the scope of the present invention, but in the present embodiment, the basket catheter 1 described above is described as being used.

  Stones that form in the ureter can damage the ureter and block the ureter. At this time, using a soft pelvic ureteroscope (f-URS), observe the calculus in the ureter, crush the calculus with a laser, etc., and extract the calculus that has been crushed with a basket forceps, etc. There is a technique to do. In the procedure, for example, the operator draws a calculus by the following procedure.

(Procedure 1) A guide wire is inserted into the ureter, and a rigid nephroscope is inserted along the guide wire into the ureter.
(Procedure 2) Observe the calculus in the ureter with a rigid pyeloscope, crush the calculus with a laser or the like, and extract the calculus with a basket forceps or the like.
(Procedure 3) The rigid pelvic ureteroscope is removed, a ureteral access sheath (UAS) is inserted into the ureter, and a flexible ureteroscope is inserted into the ureter along the ureteral access sheath.
(Procedure 4) Observe the calculus in the ureter with a soft ureteroscope, crush the calculus with a laser or the like, and extract the calculus with a basket forceps or the like.
(Procedure 5) The flexible ureteroscope is removed, and a ureteral stent is inserted into the ureter.
The foreign material recovery method of the present invention can be employed in calculus extraction in the above-described procedure 2 and procedure 4.

The foreign material recovery method of this embodiment will be described with reference to FIGS. 12A to 12C. In the following description, for the sake of simplification, the rigid pelvic ureteroscope and the flexible ureteroscope will be described simply as a ureteroscope.
As shown in FIG. 12A, the operator inserts the basket catheter 1 through the inside of the ureteroscope Y and into the ureter. At this time, the basket 4 is housed in the shaft body 2. The surgeon delivers the tip of the shaft main body 2 to the place where the calculus X exists (delivery step).
Next, the operator operates the operation unit 6 to expose the basket 4 from the tip end of the shaft main body 2 as shown in FIG. 12B, shift to the first expanded form, and from the outside of the basket 4. Take stone X inside (expansion step).
Next, the surgeon operates the operation unit 6 to shift the basket 4 from the first expanded form to the second expanded form as shown in FIG. 12C, and grasps the calculus X with the basket 4 (contraction step). . In this step, the basket 4 is quickly contracted, and the calculus X can be reliably grasped.
Next, the surgeon removes the basket catheter 1 from the ureter and extracts the calculus X.
As described above, by repeating the foreign substance collecting method described above, the calculus in the ureter can be reliably grasped by the basket catheter 1 and the calculus X can be collected.
As described above, the foreign matter recovery method of the present invention has been described based on a preferred embodiment, but the present invention is not limited to this.

1, 1A, 1B, 1C Basket catheter 2, 2C Shaft body portion 21C Outer shaft 21 Guide tube 211 Guide groove 212 Leading groove portion 213 Inclined groove portion 214 Base end groove portion 22C Inner shaft 22 Holding member 221 Protrusion 222 Wire fixing hole 223 Wire arrangement hole 3, 31, 32, 31A, 31B, 3A, 3B, 311, 321 Wire 4, 4A, 4B, 4C Basket 5, 51, 52, 5A, 5B, 51B, 52B, 5C, 5D Loop 6 Operation section 61 Hub 62 Operator 7 Intersection point 8, 8A, 8B, 8C Deformation part 9 Annular ring

Claims (8)

A shaft body,
A basket in which at least a part is accommodated in the shaft main body portion and a portion exposed from the shaft main body portion can be transferred to a first expanded configuration and a second expanded configuration contracted more than the first expanded configuration. Two or more wires to be formed,
At least one of the two or more wires has a loop that circulates near the tip of the basket;
The basket has one or more deformable portions that deform preferentially over other portions in the loop as the basket moves from the first expanded configuration to the second expanded configuration.   The basket catheter according to claim 1, wherein the loop has one deformed portion at a position facing an intersection of the loops.   The basket catheter according to claim 2, wherein at least one wire other than the wire having the loop passes through the loop.   The said loop has the said 2 deformation | transformation part, The said 2 deformation | transformation part is arrange | positioned so that it may mutually oppose on both sides of the axis | shaft of the said shaft main-body part. The basket catheter as described.   The basket catheter according to any one of claims 1 to 4, wherein the deformable portion is a portion having lower rigidity than other portions of the loop.   The basket catheter according to any one of claims 1 to 5, wherein the loop circulates toward the shaft main body. A first wire set composed of two or more wires and a second wire set composed of two or more wires;
As the basket shifts from the first expanded configuration to the second expanded configuration, the second wire set rotates relative to the first wire set around the axis of the shaft main body. The basket catheter according to any one of claims 1 to 6. A basket in which at least a part is accommodated in the shaft main body portion and a portion exposed from the shaft main body portion can be transferred to a first expanded configuration and a second expanded configuration contracted more than the first expanded configuration. Two or more wires to be formed, and at least one of the two or more wires has a loop that circulates in the vicinity of the tip of the basket, A basket catheter having one or more deformable portions that deform preferentially over other portions in the loop as the basket moves from the first expanded configuration to the second expanded configuration is inserted into the living body. Delivering the basket to a place where foreign matter exists in the living body;
Transitioning the basket to the first expanded configuration and capturing the foreign matter inside the basket;
Shrinking the basket through the second expanded configuration to grip the foreign matter;
A method for collecting foreign matter in a living body.