JP2016087151A - Basket-shaped medical instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a basket-shaped medical instrument that easily accommodates a foreign object in a basket-shaped body and prevents the foreign object from falling out when the accommodated foreign object is picked up.SOLUTION: In the basket-shaped medical instrument, a basket part 22 entirely extends from a distal opening 3 of a catheter tube 4, and each of wires 22a to 22d has, in a state where the basket part is opened, a plurality of outwardly bent parts ro2 and ro3 having corner parts facing outside, between a connection part 28 of the basket part and a front chip 26. An outwardly bent part where the outer diameter of the basket part is the largest is a largest-diameter outwardly bent part rk. An outwardly bent part located on the distal end side of the basket part is a distal end side outwardly bent part rd. When W1 denotes the distance between the largest-diameter outwardly bent part and a central axis C, W2 denotes the distance between the distal end side outwardly bent part and the central axis C, and L1 denotes the length along the central axis C of the basket part 22 from the largest-diameter outwardly bent part and the distal end side outwardly bent part, W1>W2>W1/2 and L1>W1 are satisfied.SELECTED DRAWING: Figure 3A

Description

  The present invention relates to a medical basket type treatment instrument.

  2. Description of the Related Art A medical basket type treatment instrument is known as a technique that is used together with an endoscope and removes foreign substances in the body such as gallstones in a bile duct. The medical basket-type treatment instrument is configured so that a foreign object can be grasped by a basket portion made up of a plurality of basket wires that is fed out from the distal end opening of the catheter tube.

  When the operator operates the basket portion that has grasped the foreign matter so as to draw it into the catheter tube, a force is applied to the foreign matter, and the foreign matter can be crushed or removed. In the medical basket type treatment instrument, various studies have been made on the shape of the basket portion in order to improve the durability of the wire and the capturing of foreign matter. For example, the basket wire has a plurality of bent portions. Thus, studies have been made to improve the durability of the wire and the trapping property of foreign matters (see Patent Document 1 and Patent Document 2).

  By the way, when gripping a foreign object using a conventional medical basket type treatment instrument, the basket portion is normally expanded at a position ahead of the position of the foreign object to be gripped (inside of the body), It is common to perform an operation for accommodating foreign matter in the basket portion through the gap between the basket wires by pulling back the opened basket portion to the position of the foreign matter. However, when a body lumen such as a bile duct is wide or a foreign body such as a gallstone is large, it may be difficult to accommodate the foreign body. Further, in the conventional medical basket type treatment instrument, when the foreign matter is accommodated in the basket portion and then the basket portion is operated to be pulled into the catheter tube to try to grasp the foreign matter, the basket portion is deformed and the basket portion is deformed. In some cases, foreign matter may fall off the part. That is, the conventional medical basket-type treatment instrument has a problem that it is difficult to efficiently store foreign matter in the basket portion when the body lumen is wide or the foreign matter is large, and the foreign matter stored in the basket portion is in the basket. There is a problem that foreign matter tends to fall off when trying to grip the part.

No. 6-91 JP 2013-22386 A

  The present invention has been made in view of such a situation, the purpose of which can be easily accommodated in the basket portion even when the body lumen is wide or when the foreign matter is large, It is an object of the present invention to provide a medical basket type treatment instrument in which foreign matter is not easily dropped when grasping the contained foreign matter.

  As a result of intensive studies to achieve the above-mentioned object, the present inventors have contracted the wire constituting the basket portion of the medical basket type treatment instrument when the wire has a plurality of bent portions satisfying specific conditions. If the basket part is placed at the position of the foreign object to be gripped and the basket part is expanded at that position, the foreign object can be easily collected even if the body lumen is wide or the foreign object is large. We found that it was accommodated in the department. It has also been found that the basket portion formed of a wire having a plurality of bent portions satisfying a specific condition makes it difficult for the foreign matter to fall off when gripping the contained foreign matter. The present invention has been completed based on these findings.

The medical basket type treatment instrument according to the present invention thus completed is
An operation wire disposed inside the catheter tube;
Expanding and contracting by being connected to the distal end portion of the manipulation wire, moving the manipulation wire along the longitudinal direction inside the catheter tube, and entering and exiting from the distal end opening of the catheter tube A basket part that is possible,
A tip bundling portion provided at a distal end portion of the basket portion, in which the distal end portions of a plurality of basket wires constituting the basket portion are bundled;
A basket-type treatment instrument for medical use, comprising: a proximal end portion of the basket portion; and a rear end binding portion in which the proximal ends of a plurality of basket wires constituting the basket portion are bundled. ,
With the basket portion protruding from the distal end opening of the catheter tube and the basket portion being expanded, each basket wire is connected between the rear end binding portion and the tip binding portion of the basket portion. Having at least a plurality of outward bent portions with the corners facing outwards,
Each of the basket wires has, as one of the plurality of outward bent portions, a maximum diameter outward bent portion at a position where the outer diameter of the basket portion is the largest, and further, the plurality of outer bent portions. As another one of the direction bent portions, it has a distal end side outward bent portion on the distal end side with respect to the maximum diameter outward bent portion,
The distal end side outward bent portion has a distance W1 from the central axis of the basket portion of the maximum diameter outward bent portion, and the center of the basket portion of the distal end side outward bent portion. When the distance from the axis is W2, and the length along the central axis of the basket portion from the maximum diameter outward bent portion to the distal end side outward bent portion is L1, W1> W2 It is a position satisfying> W1 / 2 and L1> W1.

  In the medical basket type treatment instrument of the present invention, W1> W2> W1 / 2 and L1> W1. For this reason, when the basket portion is gradually fed out from the distal end opening of the catheter tube in the axial direction toward the distal end, the maximum diameter of the basket portion is immediately after being fed out from the distal end opening. The basket wire located between the outward bent portion and the distal-end-side outward bent portion has a deformed recess recessed inward. Therefore, when the basket portion is expanded at a position where there is a foreign object, the foreign object is caught in the deformed recess, and the foreign object cannot escape to the proximal end side or the distal end side of the basket portion.

  Thereafter, when the basket portion is further fed out from the distal end opening in the axial direction toward the distal end, the basket wire positioned between the maximum-diameter outward bent portion and the distal end-side outward bent portion is formed. Deformation parallel portions that are substantially parallel to the central axis are generated. In that state, the foreign matter is sandwiched between the basket wires corresponding to the deformed parallel portions.

  Thereafter, when the basket portion is further fed out from the distal end opening in the axial direction toward the distal end, the basket wire positioned between the maximum-diameter outward bent portion and the distal end-side outward bent portion A mutual space | interval spreads further and a foreign material enters the inside of a basket part and is accommodated.

  Next, when the basket portion is pulled inside the distal end opening in the axial proximal end direction, the basket wire between the maximum diameter outward bending portion and the distal end side outward bending portion is The foreign matter is sandwiched and the foreign matter is gripped by the basket portion. In the medical basket type treatment instrument of the present invention, since W1> W2> W1 / 2 and L1> W1, the degree of deformation of the basket portion at the location where the foreign object is sandwiched in the process of pulling the basket portion into the distal end opening. Is smaller than a conventional medical basket-type treatment instrument, so that the foreign matter stored in the basket portion is difficult to fall off.

  Furthermore, when the basket portion is pulled into the distal end opening toward the proximal end in the axial direction, the foreign matter is sandwiched between the basket wires inside the basket portion, and a force is applied to enable the crushing process. Become. In addition, it is also possible to take out the foreign matter by pulling out the medical basket type treatment instrument itself outside the body while holding the foreign matter inside the basket portion without performing the crushing process.

  Preferably, the length along the central axis of the basket portion from the distal end of the rear end binding portion of the basket portion to the maximum-diameter outward bending portion is L2, and the distal end-side outward bending is performed. L3 / L2 is 1/3 to 1, where L3 is the length along the central axis of the basket portion from the portion to the proximal end of the tip binding portion of the basket portion. With this configuration, when gripping foreign matter with the basket portion, the basket wires that come into contact with the foreign matter are likely to be in a substantially parallel state, so that the gripping force is easily applied to the foreign matter and accommodated in the basket portion. The foreign matter is more difficult to drop off.

  The basket wire located on the distal end side of the distal end side outward bent portion is located on the most distal end side among the plurality of outward bent portions, and the distal end side You may form the most distal end outward bending part different from an outward bending part. By comprising in this way, the above-mentioned deformation | transformation recessed part becomes easy to produce and the catching of the foreign material by a basket part becomes easier.

  Further, at least one outward bent portion may be formed on the basket wire positioned between the rear end binding portion and the maximum diameter outward bent portion. By forming the outward bent portion, it becomes easy to make the above-described deformed recess or deformed parallel portion.

  Furthermore, at least one inward bent portion may be formed on the basket wire positioned between the rear end binding portion and the maximum diameter outward bent portion. The inward bent portion formed between the rear end bundling portion and the maximum diameter outward bent portion facilitates drawing of the basket portion into the distal end opening of the catheter tube, and the distal end of the catheter tube. A function that makes it easier to pull out the basket part from the opening, and when holding a foreign object in the basket part, each basket wire that comes into contact with the foreign object is likely to be in a substantially parallel state, so that the foreign substance contained in the basket part is more dropped. It fulfills functions that make it difficult.

FIG. 1 is a cross-sectional view showing the overall configuration of a medical basket type treatment instrument according to an embodiment of the present invention. FIG. 2 is a perspective view showing the basket portion and the distal end portion of the catheter tube shown in FIG. 3A is a side view of the basket portion shown in FIG. FIG. 3B is a side view of a basket portion in a medical basket type treatment instrument according to another embodiment of the present invention. FIG. 4A is a side view showing a process in which the basket portion shown in FIG. 3A grips foreign substances such as gallstones. FIG. 4B is a side view showing a step subsequent to FIG. 4A. FIG. 4C is a side view showing a step subsequent to FIG. 4B. FIG. 4D is a side view showing a step continued from FIG. 4C. FIG. 4E is a side view showing a step subsequent to FIG. 4D.

  Hereinafter, the present invention will be described based on embodiments shown in the drawings.

  The medical basket type treatment instrument 2 shown in FIGS. 1 and 2 is inserted into a channel of an endoscope (not shown) so as to be axially movable, and is inserted into a bile duct from a duodenal papilla of a duodenum (not shown), for example. Used.

  First, the overall configuration of the medical basket type treatment instrument 2 will be described. As shown in FIG. 1, the medical basket type treatment instrument 2 of this embodiment includes a catheter tube 4 having a lumen 5 continuous from a distal end 4 a to a proximal end 4 b, and a proximal end 4 b of the tube 4. It has a connector hub 7 connected through a connector tube 6 and a wire member 20 with a basket that penetrates the lumen 5 of the catheter tube 4 in the axial direction.

  In the present embodiment, the connector hub 7 is formed with two connection ports 8 and 10, but the specific shape of the connector hub 7 is not particularly limited, and a connector having only a single connection port, three or more A connector having a connection port may be used. In general, the rigidity (hardness) of the connector hub 7 is higher than the rigidity (hardness) of the catheter tube 4, and the connector hub 7 is made of, for example, polycarbonate, polyamide, polysulfone, polyacrylate, methacrylate-butylene-styrene copolymer, or the like. It is made of a thermoplastic resin or a metal such as stainless steel. The connector hub 7 is located outside the patient's body and is shaped and shaped to be easily grasped by an operator with one hand.

  The inner diameter of the catheter tube 4 is preferably 1.0 mm to 5.0 mm, and the wall thickness of the catheter tube 4 is preferably 0.1 mm to 1.0 mm. A tubular distal end member 4 c is connected to the distal end 4 a of the catheter tube 4. The distal end member 4c is preferably made of a metal such as stainless steel, for example, from the viewpoint of securing strength for pulling the basket portion 22 into the catheter tube 4 and crushing foreign matter, but is necessarily a metal. It is not necessary and may be made of other materials, and the distal end member 4c may not be provided. The axial length of the catheter tube 4 is not particularly limited, but is generally 1000 to 3000 mm.

  The catheter tube 4 is formed of a coil tube in which a metal coil is covered with a fluororesin, for example. When the catheter tube 4 is composed of a coil tube, the catheter tube 4 has a certain degree of flexibility that can be inserted along a torsional body cavity and is intended to crush foreign substances such as gallstones. Is pulled into the catheter tube 4 and has such an axial strength that foreign matter can be crushed. In order to improve the insertion characteristics of the catheter tube 4, only a predetermined length range of the distal end portion of the catheter tube 4 may be configured to be particularly flexible. The means for flexibly configuring only the predetermined length range of the distal end portion of the catheter tube 4 is not particularly limited. For example, the coil winding pitch in the coil tube may be sparse on the distal end side. .

  A wire member 20 with a basket is inserted into the lumen 5 of the catheter tube 4 so as to be movable along the axial direction thereof. The wire member 20 with a basket includes an operation wire 24 and a basket portion 22 connected to a distal end portion thereof via a joint portion 28.

  As shown in FIG. 2, the basket portion 22 is composed of a plurality (four in this embodiment) of basket wires 22 a to 22 d, and the tip ends of the basket wires 22 a to 22 d are tip tips (an example of a tip bundling portion) 26. Are joined together. The plurality of basket wires 22a to 22d may be formed of separate wires, or two basket wires may be formed by bending one wire within the tip tip 26. In the embodiment, four basket wires 22a to 22d are formed by bending each of the two wires within the tip 26. Further, the rear end portions of the basket wires 22 a to 22 d are bound by a welding method such as silver brazing welding at a joining portion (an example of the rear end binding portion) 28 and joined to the operation wire 24.

  Each basket wire 22a to 22d shown in FIG. 2 protrudes from the distal end opening 3 (see FIG. 2) of the distal end member 4c attached to the distal end 4a of the catheter tube 4 in the radially outward direction. It is brazed so that it swells by elasticity. The inner diameter of the distal end opening 3 is approximately the same as the inner diameter of the catheter tube 4, but may be increased to about 1.0 to 10 mm.

  In the present embodiment, as shown in FIG. 1, a foreign object 30 such as a gallstone can be held in the gap between the basket wires 22 a to 22 d. When the basket portion 22 is pulled into the catheter tube 4, the basket portion 22 is folded and elastically deformable so that the outer diameter thereof is reduced.

  The operation wire 24 shown in FIG. 2 may be formed by extending the four basket wires 22a to 22d constituting the basket portion 22 in the longitudinal direction, but is completely different from these basket wires 22a to 22d. You may comprise with a wire. The operation wire 24 transmits an operation force acting on the proximal end side thereof to the basket portion 22, and the basket portion 22 folded inside the catheter tube 4 is passed through the opening 3 at the distal end 4 a of the catheter tube 4. Rigidity that can be sent to the outside. Further, the operation wire 24 has a tensile strength that can transmit a force for crushing the foreign matter 30 such as gallstones by using a force by which the outer diameter of the basket portion 22 contracts.

  The basket wires 22a to 22d constituting the basket portion 22 are made of metal wires having a wire diameter of about 0.2 mm to 1.0 mm, for example. Examples of the material of the wire include stainless steel, nickel titanium alloy, gold, silver, platinum, nickel, iron, titanium, aluminum, tin, zinc, tungsten and the like, but stainless steel or nickel titanium alloy is preferable. . The operation wire 24 may be made of the same material and wire diameter as the basket wires 22a to 22d, or may be made of a different material and wire diameter.

  As shown in FIG. 1, in a state where the basket portion 22 protrudes from the distal end opening 3 of the catheter tube 4 (the same applies to the description of the shape of the basket portion 22), the wires 22 a to 22 d are shown in FIG. 3A. As shown, the proximal end ep of the basket portion 22 (that is, the distal end of the rear end binding portion 28) is sequentially directed toward the distal end ed of the basket portion 22 (that is, the proximal end of the front end binding portion 26). , First inward bent portion ri1, second inward bent portion ri2, first to fourth outward bent portions ro1 to ro4, and third inward bent portion ri3. The outward bent portion is a wire bent portion that is convex outward in the radial direction with respect to the central axis C of the basket portion 22, and in contrast to the inward bent portion, the basket This is a bent portion of the wire that is convex inward in the radial direction with respect to the central axis C of the portion 22. Further, the central axis of the basket portion 22 is on the extension line in the longitudinal direction of the operation wire 24, and the central axis where the wires 22 a to 22 d are bundled when the basket portion 22 is contracted to the minimum in the radial direction. It is.

  In the present embodiment, the basket portion 22 extends from the proximal end ep of the basket portion 22 (the distal end of the rear end binding portion 28) to the distal end portion ed of the basket portion 22 (the proximal end of the tip binding portion 26). The length along the central axis C is L0. In addition, the outwardly bent portion ro2 of the basket wire 22 at the position where the outer diameter of the basket portion 22 is the largest in a state where the basket portion 22 is opened to the maximum is set as the maximum diameter outwardly bent portion rk.

  In the present embodiment, the basket wires 22a to 22d located on the distal end side of the maximum diameter outward bent portion rk have an outward bent portion ro3 different from the maximum diameter outward bent portion rk. The bent portion ro3 is formed as a distal end side outward bent portion rd.

  The distal-end-side outward bent portion rd has a distance W1 from the central axis C of the basket portion 22 of the maximum-diameter outward-folded portion rk, and is from the central axis C of the distal-end-side outward bent portion rd. Is a distance W2 and the length along the central axis C of the basket portion 22 from the maximum-diameter outwardly bent portion rk to the distal end-side outwardly bent portion rd is L1, the following two formulas It is in a position that satisfies.

  One of the two formulas is W1> W2> W1 / 2. That is, the value of W2 / W1 is more than 1/2 and less than 1. The value of W2 / W1 is preferably more than 1/2 and less than 4/5, more preferably more than 1/2 and less than 7/10. The other of the two formulas is L1> W1. That is, the value of L1 / W1 exceeds 1. Moreover, the value of L1 / W1 is preferably 5/4 to 2, and more preferably 3/2 to 2.

  Preferably, L1 / L0 is 1/2 to 4/5, more preferably 1/2 to 2/3.

  Preferably, the length along the central axis C of the basket portion 22 from the proximal end ep of the basket portion 22 (distal end of the rear end binding portion 28) to the maximum-diameter outwardly bent portion rk is L2. When the length along the central axis C of the basket portion 22 from the outwardly bent portion rd of the basket portion 22 to the distal end ed of the basket portion 22 is L3, L3 / L2 is: 1/3 to 1, more preferably 1/2 to 5/6. Further, L2 / L0 is preferably 1/10 to 1/2, more preferably 1/4 to 1/2.

  In addition, the full length L0 of the basket part 22 is determined according to a patient, a use, etc., Although it does not specifically limit, Usually, it selects in the range of 20-100 mm. Further, the distance W1 from the central axis C of the maximum-diameter outwardly bent portion rk varies depending on the patient and the use and is not particularly limited, but is preferably 10 to 25 mm.

  An angle θ1 with respect to the central axis C of the wires 22a to 22d from the joint portion 28 to the first inward bent portion ri1 is preferably 5 to 50 degrees, and more preferably 10 to 40 degrees. Further, the bending angle θ2 of each outward bent portion ro1 to ro4 is preferably 120 to 175 degrees, and more preferably 130 to 170 degrees. The bending angle θ3 of each inwardly bent portion ri1 to ri3 is substantially the same as the inner angle θ2 of each of the outwardly bent portions ro1 to ro4, but is not necessarily the same.

  In order to mold the basket portion 22 of the present embodiment, first, the distal ends of the wires 22a to 22d are joined to the tip tip 26 by silver soldering or the like, and the proximal ends thereof are silver soldered or the like. Are joined together to form a joint 28. Thereafter, as shown in FIGS. 2 and 3A, the wires 22a to 22d may be bent to form the inward bent portions ri1 to ri3 and the outward bent portions ro1 to ro4. Bending is performed using a bending die or tweezers.

  In addition, the code | symbol 60 shown in FIG. The operating instrument 60 includes a connection tool 76 including a luer taper portion 78 and a luer lock portion 80 that is rotatably mounted on the outer periphery of the luer taper portion 78 in the circumferential direction. As shown in FIG. 1, the tip tapered portion of the luer tapered portion 78 is inserted into the connection port 8 of the connector hub 7, and the luer lock portion 80 is detachably attached to the outer peripheral portion of the connection port 8. The proximal end portion of the operation wire 24 extending through the inside of the catheter tube 4 and the inside of the connector hub 7 passes through the inside of the luer taper portion 78 via the connection port 8 and is connected to driving means (not shown). Yes, by operating the driving means, the operation wire 24 can move in the axial direction in the catheter tube 4.

  Next, a method for using the medical basket type treatment instrument 2 according to the present embodiment will be described. The medical basket type treatment instrument 2 according to the present embodiment is used together with an endoscope not shown. When the distal end of the endoscope is guided to the vicinity of the duodenal papilla inside the duodenum (not shown) according to a conventional method, the medical basket type treatment instrument 2 is endoscopeed from the proximal end of the endoscope. Insert into the channel of the tube body. The distal end portion of the medical basket type treatment instrument 2 is protruded laterally from the distal end opening of the endoscope tube body, and is inserted into the bile duct through the nipple.

  Since the metal distal end member 4c (see FIG. 1) is attached to the distal end of the medical basket type treatment instrument 2, the insertion position of the distal end of the medical basket type treatment instrument 2 is inserted. Can be observed by X-rays.

  Thereafter, if necessary, the contrast medium is flowed into the bile duct from the connection port 10 shown in FIG. 1 through the catheter tube 4, and the inside of the bile duct is observed with X-rays. Next, the basket portion 22 of the wire member 20 with a basket is popped out from the distal end opening 3 of the catheter tube 4, the basket portion 22 is expanded, and a foreign object 30 such as a gallstone is grasped by the basket portion 22. Thereafter, the manipulation wire 24 is moved in the catheter tube 4 from the distal end portion toward the proximal end portion using the wire driving device 60 or the like, and the basket portion 22 is opened to the distal end of the catheter tube 4. 3, the outer diameter of the basket portion 22 is narrowed and the foreign material 30 is crushed.

  In the medical basket type treatment instrument 2 according to the present embodiment, W1> W2> W1 / 2 and L1> W1 are satisfied. For this reason, as shown in FIG. 4A, when the basket portion 22 is gradually fed out from the distal end opening 3 of the catheter tube 4 in the distal end direction A of the central axis C, the maximum diameter outward bent portion ro2 is far away. The basket wires 22a to 22d between the maximum-diameter outwardly bent portion rk and the distal-end-side outwardly bent portion rd at a timing immediately after jumping out from the distal end opening 3 are arranged in the radial direction with respect to the central axis C. A deformed recess 22α that is recessed inward is generated. Therefore, a foreign substance 30 such as gallstones is caught in the body cavity in the deformed recess 22α formed on the side of the basket part 22, and the foreign substance 30 cannot escape to the proximal end side or the distal end side of the basket part 22.

  Thereafter, as shown in FIGS. 4B and 4C, when the basket portion 22 is further fed out from the distal end opening 3 in the distal end direction A of the central axis C, the outer diameter of the maximum-diameter outward bent portion rk is increased. The deformed concave portion 22α in the basket portion 22 gradually decreases, and the portion changes into a deformed parallel portion 22β that is substantially parallel to the central axis C. In this state, it is considered that the first outward bent portion ro <b> 1 in the basket portion 22 also protrudes from the distal end opening 3. The foreign object 30 is sandwiched between basket wires (for example, 22b and 22c) adjacent in the circumferential direction corresponding to the deformed parallel portion 22β. Absent.

  Thereafter, as shown in FIG. 4D, when the basket portion 22 is further fed out from the distal end opening 3 in the distal end direction A of the central axis C, the outer diameter of the maximum diameter outward bent portion rk further increases, At the same time, the mutual spacing between the basket wires (for example, 22b and 22c) that are located between the maximum-diameter outwardly bent portion rk and the distal-end-side outwardly bent portion rd and that are adjacent to each other in the circumferential direction further increases. 30 enters the inside (center axis C side) from the side (side) of the basket portion 22. In this state, it is considered that the second inwardly bent portion ri2 protrudes from the distal end opening 3.

  In addition, when the foreign material 30 is larger, even the first inwardly bent portion ri1 shown in FIG. 3A may protrude from the distal end opening 3 shown in FIG. 4D. In that case, even if the foreign matter 30 is larger, the interval between the basket wires (for example, 22b and 22c) adjacent in the circumferential direction further increases, and the foreign matter 30 is located inside the basket portion 22 (on the central axis C side). Get in. Alternatively, if the foreign matter 30 is small, the foreign matter 30 can be moved into the interior of the basket portion 22 by popping the basket portion 22 in the direction of arrow A from the distal end opening 3 until the state shown in FIG. 4D or 4C. Get in.

  Next, as shown in FIG. 4E, when the basket portion 22 is pulled into the distal end opening 3 in the proximal end direction B of the central axis C, the maximum-diameter outwardly bent portion rk and the distal end side outer side are located. The foreign matter 30 is sandwiched from the outer periphery inside the basket portion 22 by the basket wires 22 a to 22 d between the facing bent portions rd. In the medical basket type treatment instrument 2 according to the present embodiment, in order to satisfy W1> W2> W1 / 2 and L1> W1, in the process of pulling the basket portion 22 into the distal end opening 3 in this way, a foreign object is sandwiched. Since the degree of deformation of the basket portion 22 is smaller than that of the conventional medical basket type treatment instrument, the foreign matter stored in the basket portion 22 is difficult to drop off.

  Furthermore, when the basket portion 22 is pulled into the distal end opening 3 in the proximal end direction B of the central axis C, the foreign matter 30 is sandwiched between the basket wires 22 a to 22 d inside the basket portion 22. Force is applied and crushing is possible. In addition, it is also possible to take out the foreign substance 30 by pulling out the medical basket type treatment instrument 2 itself outside the body while holding the foreign substance inside the basket portion 22 without performing the crushing process.

  In the present embodiment, as shown in FIG. 3A, the basket wires 22a to 22d located on the distal end side of the distal end side outward bent portion rd are arranged on the most distal end side as the outward bent portions. The outward bent portion ro4 closest to the tip tip (tip bundling portion) 26 is formed as the distalmost end outward bent portion rm. By forming the distal-end-end outward bent portion rm separately from the distal-end-side outward bent portion rd, the deformed recess 22α (see FIG. 4A) is more likely to occur, and the foreign matter caused by the basket portion 22 Is easier to capture.

  In the present embodiment, as shown in FIG. 3A, at least one outward bent portion ro1 is formed in the basket wires 22a to 22d located between the maximum diameter outward bent portion rk and the joint portion 28. It is. By forming the outward bent portion ro1, it becomes easy to make the deformed recess 22α or the deformed parallel portion 22β described above.

  Furthermore, in this embodiment, two inwardly bent portions ri1 and ri2 are formed in the basket wires 22a to 22d located between the joint portion 28 and the maximum diameter outwardly bent portion rk. The inwardly bent portion ri1 is formed in the vicinity of the joint portion (rear end binding portion) 28, and this inwardly bent portion ri1 makes it easy to pull the basket portion 22 into the distal end opening 3 of the catheter tube 4. At the same time, the basket portion 22 is easily drawn out from the distal end opening 3 of the catheter tube 4. Further, the inward bent portion ri2 is formed by the basket wires 22a to 22d extending from the maximum diameter outward bent portion rk to the distal end side in the process of drawing the basket portion 22 into the distal end opening 3 of the catheter tube 4. When it is substantially parallel (in the state shown in FIG. 4E), the inward bent portion ri2 is formed so as to be positioned at the distal end opening 3, and when the foreign matter is gripped by the basket portion 22, The basket wires 22a to 22d in contact with each other are likely to be substantially parallel to each other, so that the foreign matter stored in the basket portion is more difficult to drop off. The number of inwardly bent portions formed in the basket wires 22a to 22d located between the joint portion 28 and the maximum diameter outwardly bent portion rk is preferably at least one, and at least two. It is more preferable.

  The present invention is not limited to the above-described embodiment, and can be variously modified within the scope of the present invention. For example, in the medical basket type treatment instrument of the present invention, the basket wires 22a to 22d include a plurality of at least a maximum diameter outwardly bent part rk and a distal end side outwardly bent part rd satisfying the above-described formula. If there is at least one distal end outward bent portion rd satisfying the above-mentioned formula per basket wire 22a to 22d, the distal end side outer portion may be provided. There may be a plurality of facing bent portions rd, or other outward bent portions or inward bent portions may be formed. More specifically, for example, as shown in FIG. 3B, the basket wires 22a to 22d located between the distal end side outward bent portion rd and the maximum diameter outward bent portion rk have a distal end. An outward bent portion ro5 or an inward bent portion (not shown) different from the end-side outward bent portion rd may be formed. Other configurations of the present embodiment are the same as those of the above-described embodiment, and have the same effects.

  In the above-described embodiment, the outwardly bent portions ro1 to ro5 and the inwardly bent portions ri1 to ri3 are formed at substantially the same position along the central axis C in the four basket wires 22a to 22d. However, as long as the effects of the present invention are exhibited, they may be slightly misaligned along the central axis C direction.

  Furthermore, in the said embodiment, although the thing which has the basket part 22 comprised by four basket wires 22a-22d was used as a wire member with a basket which should be inserted in the inside of the medical basket type treatment instrument 2, Other than that Moreover, you may use the wire member with a basket which has a basket part comprised by the 3 or more multiple basket wire.

  Furthermore, in the embodiment shown in the above-described drawings, the outward bent portions ro1 to ro5 and the inward bent portions ri1 to ri3 are bent in a square shape, but are not necessarily bent in a square shape, Corners may be rounded.

2 ... Medical basket type treatment instrument 3 ... Distal end opening 4 ... Catheter tube 4a ... Distal end 4b ... Proximal end 4c ... Distal end member 22 ... Basket portions 22a-22d ... Basket wire 26 ... Tip (tip) Unity)
28 ... Joint part (rear end bundling part)
ri1 to ri3 ... inward bent portions ro1 to ro5 ... outward bent portion rk ... maximum diameter outward bent portion rd ... distal end side outward bent portion rm ... most distal end outward bent portion

Claims (5)

An operation wire disposed inside the catheter tube;
Expanding and contracting by being connected to the distal end portion of the manipulation wire, moving the manipulation wire along the longitudinal direction inside the catheter tube, and entering and exiting from the distal end opening of the catheter tube A basket part that is possible,
A tip bundling portion provided at a distal end portion of the basket portion, in which the distal end portions of a plurality of basket wires constituting the basket portion are bundled;
A basket-type treatment instrument for medical use, comprising: a proximal end portion of the basket portion; and a rear end binding portion in which the proximal ends of a plurality of basket wires constituting the basket portion are bundled. ,
With the basket portion protruding from the distal end opening of the catheter tube and the basket portion being expanded, each basket wire is connected between the rear end binding portion and the tip binding portion of the basket portion. Having at least a plurality of outward bent portions with the corners facing outwards,
Each of the basket wires has, as one of the plurality of outward bent portions, a maximum diameter outward bent portion at a position where the outer diameter of the basket portion is the largest, and further, the plurality of outer bent portions. As another one of the direction bent portions, it has a distal end side outward bent portion on the distal end side with respect to the maximum diameter outward bent portion,
The distal end side outward bent portion has a distance W1 from the central axis of the basket portion of the maximum diameter outward bent portion, and the center of the basket portion of the distal end side outward bent portion. When the distance from the axis is W2, and the length along the central axis of the basket portion from the maximum diameter outward bent portion to the distal end side outward bent portion is L1, W1> W2 A medical basket type treatment instrument characterized by being in a position satisfying> W1 / 2 and L1> W1.   The length along the central axis of the basket portion from the distal end of the rear end binding portion of the basket portion to the maximum diameter outward bent portion is L2, and the length from the distal end side outward bent portion to the The medical use according to claim 1, wherein L3 / L2 is 1/3 to 1 where L3 is a length along the central axis of the basket portion to the proximal end of the tip binding portion of the basket portion. Basket-type treatment instrument.   The basket wire located on the distal end side of the distal end side outward bent portion is located on the most distal end side among the plurality of outward bent portions, and the distal end side The medical basket type treatment instrument according to claim 1 or 2, wherein a distal-end outward bending portion different from the outward bending portion is formed.   The at least 1 outward bending part is formed in the said basket wire located between the said rear end binding part and the said largest diameter outward bending part, The Claim 1 in any one of Claims 1-3 Medical basket type treatment instrument.   The basket wire located between the rear end binding portion and the maximum diameter outward bent portion has at least one inward bent portion formed therein. Medical basket type treatment instrument.

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