JP2019146706A - Medical device and medical system - Google Patents

Abstract

To provide a medical device and a medical system which, even when an elongated flexible medical member is replaced during a procedure, can restrain the procedure from becoming complicated.SOLUTION: A medical device 200 comprises: an elongated flexible main body 211; a medical member 210 insertable into a blood vessel; and a housing 220 for holding the medical member 210. The housing is attachable to and detachable from a drive device which drives a first operation for sending out the medical member from the housing and a second operation for moving the medical member to the housing.SELECTED DRAWING: Figure 4

Description

  The present invention relates to a medical instrument and a medical system.

  When performing treatment on a treatment target site (for example, a stenosis formed in a blood vessel) formed in a patient's living body lumen, a medical device used for the treatment or a medical device for acquiring a diagnostic image is provided. Insert into the body lumen. In addition, an operator such as a doctor (hereinafter referred to as an operator) uses a medical instrument such as a guide wire or a sheath (a support catheter, a microcatheter, etc.) to insert a medical device into a living body lumen. Deliver the device.

  In a procedure using an imaging diagnostic catheter as described in Patent Document 1 below, the operator inserts a long drive shaft (medical member) into a living body lumen, and then progresses the procedure, treatment Considering the state of the target site, the state of the patient's biological lumen, etc., selecting the optimal medical member suitable for the procedure, and performing the work of replacing the medical member with another medical member during the procedure is there. For example, the surgeon selects and replaces a medical member that is more suitable for the procedure in consideration of the specifications (such as the ultrasonic frequency) of the imaging unit provided on the drive shaft.

International Publication No. 2008/086356

  However, in the diagnostic imaging catheter described in Patent Document 1, a medical member and a sheath (long member) for introducing the medical member into a living body lumen are integrated. Therefore, when replacing the medical member, the surgeon must also remove the sheath together with the medical member. Therefore, when replacing the medical member during the procedure, the surgeon must remove the sheath together with the medical member from the living body, and then insert the sheath and another replaced medical member again. Thereby, the procedure becomes complicated.

  The present invention has been made in order to solve the above-described problems, and even when a long and flexible medical member is exchanged during the procedure, the medical procedure that can prevent the procedure from becoming complicated. An object is to provide an instrument and a medical system.

  A medical device according to the present invention includes a long and flexible main body, a medical member that can be inserted into a living body lumen, and a housing that holds the medical member. The first operation of feeding the medical member from the housing and the second operation of moving the medical member to the housing can be attached to and detached from a drive device that can be driven.

  The medical system according to the present invention controls a medical instrument, a long member that can be inserted into a living body lumen and into which a medical member can be inserted, a drive device, and an operation control of the drive device. And a control unit for performing.

  According to the medical instrument or the medical system configured as described above, when the operator replaces the medical member during the procedure, the operator removes the housing holding the medical member to be replaced from the drive device, and performs another medical treatment. An operation of attaching the housing holding the member to the driving device is performed. This eliminates the need for the operator to remove the elongated member from the body lumen together with the medical member when replacing the medical member. Therefore, according to the medical instrument or the medical system described above, even when the medical member is replaced during the procedure, it is possible to prevent the procedure from becoming complicated.

1 is a diagram schematically illustrating an overall configuration of a medical system according to an embodiment. 2A to 2C are cross-sectional views for explaining the configuration of the distal end portion of the long member. 3A and 3B are cross-sectional views schematically showing a state before and after connecting the long member to the driving device. 4A and 4B are diagrams for explaining the configuration of the medical instrument. FIG. 5A and FIG. 5B are diagrams schematically illustrating a state before and after the medical instrument is attached to the driving device. 6A to 6C are cross-sectional views for explaining the configuration of the distal end portion of the long member according to the first modification.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In addition, the following description does not limit the meaning of the technical scope and terms described in the claims. In addition, the dimensional ratios in the drawings are exaggerated for convenience of explanation, and may differ from actual ratios.

  As shown in FIG. 1, a medical system 100 according to this embodiment includes a medical member 210 and a medical instrument 200 including a housing 220 that holds the medical member 210, and a medical member 210 that can be inserted into a living body lumen. Includes a sheath (corresponding to an elongate member) 300 having a lumen 315 into which can be inserted, a drive device 500, a control unit 600 that controls the operation of the drive device 500, and a monitor 700.

  The medical system 100 according to the present embodiment is a system that acquires an image by an intravascular ultrasonic diagnostic method (IVUS: Intra Vascular Ultra Sound). As will be described later, the medical member 210 acquires an ultrasonic image by an imaging unit 213 (see FIG. 2C) provided at the distal end portion of the medical member 210.

  The operation of the medical system 100 is controlled by the control unit 600. Control unit 600 includes a CPU (Central Processing Unit) and a memory as main components. The control unit 600 is electrically connected to the driving device 500 and the monitor 700. The control unit 600 can cause the monitor 700 to display an ultrasonic image (a tomographic image of a living body lumen) acquired by the imaging unit 213 of the medical member 210. Note that “electrically connected” in this specification means that target devices and members are connected in a communicable state. The electrical connection may be wired via an electrical signal line, or may be wireless without an electrical signal line.

  In this specification, the side of the sheath 300 that is inserted into the living body lumen is referred to as the distal end side (the left side in FIGS. 2A to 2C), and the hub portion 320 side provided in the sheath 300 (see FIG. A) and the right side of FIG. 3B are referred to as the proximal end side, and the extending direction of the sheath 300 is referred to as the axial direction.

  The medical device 200 will be described.

  As shown in FIGS. 4 (A) and 4 (B), a medical device 200 includes a long, solid, flexible main body 211 and a medical member 210 that can be inserted into a living body lumen. And a housing 220 that holds the medical member 210.

  As shown in FIG. 2C, the medical member 210 includes a tube that forms the main body 211 of the medical member 210 and an imaging unit that is provided at the distal end of the main body 211 and acquires image information of a biological lumen. 213, and a drive shaft provided with 213.

  A signal line 212 electrically connected to the imaging unit 213 is inserted into the main body (tubular body) 211 of the medical member 210.

  The term “solid” in the present specification means that there is no lumen (space) into which another device or member can be inserted inside a tubular or cylindrical member. In addition, the “solid” includes, for example, a device in which another device or member cannot be inserted separately because another device or member is inserted (filled) into the lumen. For example, a signal wire 212 is inserted in the body portion 211 of the medical member 210 that is not configured to insert another member inside, such as a guide wire that is a medical instrument. Those that are not configured to allow other members to pass through are included in the “solid”.

  The main body 211 of the medical member 210 can be constituted by, for example, multilayer coils having different winding directions around the axis. Examples of the constituent material of the coil include stainless steel and Ni—Ti (nickel / titanium) alloy. The signal line 212 can be constituted by, for example, a twisted pair cable or a coaxial cable.

  The imaging unit 213 included in the medical member 210 includes a signal transmission / reception unit 213a that transmits / receives ultrasonic waves, and a housing (housing) 213b in which the signal transmission / reception unit 213a is accommodated. The signal transmitting / receiving unit 213a generates a piezoelectric effect by applying a voltage to generate ultrasonic waves.

  As shown in FIGS. 4A and 4B, the housing 220 included in the medical device 200 has a winding part 221 that holds the main body part 211 of the medical member 210 in a wound state. The winding part 221 is rotatable in the direction indicated by arrows r1-r2 in the drawing.

  The winding part 221 is provided with a plurality of electrical connection parts 225a, 225b, 225c. The signal line 212 that passes through the main body 211 of the medical member 210 is electrically connected to each of the electrical connection portions 225a, 225b, and 225c in a state where the main body 211 is wound around the winding portion 221. The electrical connection portions 225a and 225b can be used to electrically connect the signal line 212 (twisted pair cable or coaxial cable), for example, and the electrical connection portion 225c can shield the signal line 212, for example. Can be used to

  The winding unit 221 is provided with a communication unit 226. For example, as described later, the communication unit 226 enables predetermined information to be communicated with the control unit 600 in a state where the housing 220 is mounted on the driving device 500 (see FIG. 5B). The communication unit 226 can be configured by, for example, a non-contact type reading barcode, RFID (Radio Frequency Identifier), or the like. The data communicated by the communication unit 226 includes, for example, the type of the medical member 210, the total length of the medical member 210, the product specifications of the imaging unit 213 included in the medical member 210 (for example, the ultrasonic frequency), and the serial number of the medical member 210. Etc. Note that the other device with which the communication unit 226 communicates is not limited to the control unit 600, and may be a predetermined communication device other than the control unit 600, for example.

  The sheath 300 will be described.

  As shown in FIGS. 1 and 2A, the sheath 300 is formed of a long member including a main body portion 310 in which a hollow lumen 315 is formed. As shown in FIGS. 1 and 3A, a hub portion 320 is provided in the vicinity of the base end portion 313 of the main body portion 310 of the sheath 300.

  As shown in FIG. 2A, a distal end opening 311 a communicating with the lumen 315 is formed near the distal end 311 of the main body 310 of the sheath 300.

  The main body 310 of the sheath 300 can be made of, for example, a resin material used for a catheter device known in the medical field. Further, the hub portion 320 of the sheath 300 can be made of, for example, a hard resin material. When the medical system 100 is configured as an ultrasonic diagnostic system, the vicinity of the distal end portion 311 of the main body 310 of the sheath 300 is preferably formed of a material that does not impede the transmission of ultrasonic waves.

  As shown in FIG. 3A, the main body portion 310 of the sheath 300 is fixed to the distal end side of the hub portion 320 provided in the sheath 300. The hub portion 320 is formed with a lumen 325 communicating with the lumen 315 of the main body portion 310. In the vicinity of the base end portion 323 of the hub portion 320, a connection portion 323b that can be connected to and disconnected from the drive device 500 is provided. In addition, a proximal end opening 323 a that communicates with the inner cavity 315 of the hub portion 320 and the outside of the hub portion 320 is formed at the proximal end of the hub portion 320.

  The sheath 300 is configured to be detachable from the drive device 500. FIG. 3B shows a state in which the sheath 300 and the driving device 500 are connected via the connecting portion 323 b of the hub portion 320 and the connecting portion 511 b of the driving device 500. The structure of each connection part 323b, 511b is not specifically limited, For example, fitting type connection structures, such as a luer taper, a screw-in type connection structure, etc. are employable.

  Next, the driving device 500 will be described.

  As illustrated in FIG. 5A, the driving device 500 includes an outer case 510 that accommodates each component of the driving device 500. The exterior case 510 is formed with an accommodation space 521 in which the medical instrument 200 can be accommodated, and an opening 522 that allows the accommodation space 521 to communicate with the outside of the exterior case 510.

  As shown in FIG. 5B, the medical instrument 200 can be accommodated in the accommodation space 521 of the exterior case 510 through the opening 522. The medical instrument 200 is mechanically and electrically connected to the driving device 500 by being accommodated in the accommodating space 521 of the exterior case 510. In this embodiment, the opening 522 is formed on the upper surface of the driving device 500, but the opening 522 may be formed on the side surface of the driving device 500, for example. Further, the outer case 510 of the driving device 500 may be provided with a lid member that covers the opening 522, for example.

  The driving device 500 includes a first driving unit 530 for driving a first operation for feeding the medical member 210 from the housing 220 and a second operation for moving the medical member 210 to the housing 220, and a third operation for rotating the medical member 210 in the circumferential direction. And a second drive unit 540 that drives the operation.

  The first operation is an operation for moving the medical member 210 forward along the axial direction of the sheath 300 (an operation for moving the medical member 210 toward the distal end side indicated by an arrow a1 in each drawing). Moreover, said 2nd operation | movement is operation | movement which retracts the medical member 210 along the axial direction of the sheath 300 (operation | movement which moves to the base end side shown by arrow a2 in each figure). The third operation is an operation of rotating the medical member 210 along the circumferential direction of the sheath 300 (an operation indicated by an arrow r3 'or an arrow r4' in each drawing).

  The first drive unit 530 rotates the housing 220 attached to the drive device 500 in the direction in which the medical member 210 is wound (the direction of arrows r1-r2 in FIGS. 4A and 5B). When the housing 220 rotates in the direction of the arrow r1, the main body portion 211 of the medical member 210 held in a state of being wound around the winding portion 221 is sent out from the housing 220 toward the sheath 300 (arrow a1 in FIG. 4A). See). Further, when the housing 220 rotates in the direction of the arrow r2, the main body portion 211 of the medical member 210 moves to the housing 220 side (see the arrow a2 in FIG. 4A). The main body portion 211 of the medical member 210 is wound around the winding portion 221 by continuing the rotation of the housing 220 in the direction of the arrow r2.

  The second drive unit 540 rotates the first drive unit 530 mechanically connected to the housing 220 in the circumferential direction of the medical member 210 (in the direction of arrows r3-r4 in FIG. 5B). When the housing 220 rotates in the direction of the arrow r3, the medical member 210 rotates along the same direction as the arrow r3 (the r3 ′ direction in FIG. 2C). Further, when the housing 220 rotates in the arrow r4 direction, the medical member 210 rotates along the same direction as the arrow r4 direction (r4 ′ direction in FIG. 2C).

  As shown in FIGS. 3A and 3B, the driving device 500 has a plurality of rotatable members 551, 552a, and 552b. The rotating members 551, 552 a, and 552 b are arranged in a passage portion 523 provided inside the driving device 500. As shown in FIGS. 5A and 5B, the passage portion 523 is connected to an accommodation space 521 of the drive device 500 in which the medical instrument 200 is accommodated. The passage portion 523 is connected to the hub portion 320 in the driving device 500, for example, in order to facilitate the feeding of the main body portion 211 of the medical member 210 from the accommodation space 521 to the passage portion 523 side (FIG. 5A). It can be formed in a shape narrowed toward the left side of

  As shown in FIG. 3B, the rotating members 552a and 552b are arranged so as to sandwich the main body 211 of the medical member 210. Further, the rotation member 551 is disposed so as to support the main body portion 211 of the medical member 210 on the proximal end side of the passage portion 523 with respect to the rotation members 552a and 552b.

  The main body 211 of the medical member 210 comes into contact with the rotating members 551, 552a, and 552b when the first drive unit 530 drives the movement of the sheath 300 toward the distal end side. Each rotating member 551, 552a, 552b rotates in the direction indicated by the arrow r5 in FIG. 3B when moving the main body 211 of the medical member 210 to the distal end side, and guides the movement of the medical member 210. Further, each of the rotating members 551, 552a, and 552b rotates in the direction indicated by the arrow r6 in FIG. 3B when moving the main body 211 of the medical member 210 to the proximal end side, and guides the movement of the medical member 210. To do. As described above, each of the rotating members 551, 552a, and 552b rotates while being in contact with the main body 211 of the medical member 210 when the medical member 210 moves forward and backward (moves in the direction of the arrow a1-a2 in the drawing). This functions as a guide for smoothly moving the medical member 210. Note that the rotation of each of the rotating members 551, 552a, and 552b and the stop of the rotation are controlled by the control unit 600.

  Each of the rotating members 551, 552a, and 552b can be configured by, for example, a roller or a sphere that is rotatably supported inside the driving device 500. The number, shape, arrangement, specific structure, etc. of the rotating member are not particularly limited, and can be changed as appropriate.

  As shown in FIGS. 5A and 5B, the driving device 500 has an electrical connection portion 560. When the housing 220 included in the medical device 200 is attached to the drive device 500, the housing 220 is mechanically attached to the first drive unit 530 included in the drive device 500. In addition, the signal line 212 (see FIG. 2C) of the medical member 210 is electrically connected to the electrical connection portion 560 of the driving device 500 via the electrical connection portions 225a, 225b, and 225c provided in the housing 220. Connected to.

  Next, a usage example of the medical system 100 according to the present embodiment will be described. In the present embodiment, a method for acquiring a tomographic image of a blood vessel performed using the medical member 210 will be described. Each procedure described below shows an example of a procedure for using the medical system 100, and the exact procedure is not limited to the contents described.

  First, the surgeon does not connect the sheath 300 to the driving device 500 (the state shown in FIG. 3A), and the main body of the sheath 300 up to a blood vessel observation site (for example, a lesion such as a stenosis). Deliver part 310. At this time, as shown in FIG. 2B, the operator inserts the long member 400 inserted into the blood vessel prior to delivery of the sheath 300 into the lumen 315 of the main body portion 310 of the sheath 300. The surgeon can smoothly deliver the sheath 300 by moving the sheath 300 along the elongated member 400.

  As long as the elongated member 400 used for delivery of the sheath 300 can be inserted into the lumen 315 of the sheath 300, the specific structure is not limited. Therefore, for example, a long metal member (mandrel or the like) or a guide wire having desired physical properties (rigidity or the like) can be used as the long member 400. The surgeon selects the elongated member 400 having desired physical properties, thereby comparing with the case of delivering an IVUS catheter in which a drive shaft including a tube composed of a flexible coil and a sheath are integrated. Thus, the sheath 300 can be easily delivered to a desired position in the blood vessel.

  Prior to inserting the sheath 300 into the blood vessel, the surgeon supplies a priming solution (not shown) to the lumen 315 of the sheath 300. The surgeon supplies the priming solution to the lumen 315 of the sheath 300 by discharging the gas such as air accumulated in the lumen 315 from the distal end opening 311a of the sheath 300 by supplying the priming solution to the lumen 315 of the sheath 300. Let The priming liquid filled in the lumen 315 of the sheath 300 prevents the ultrasonic waves from being attenuated by the air staying in the lumen 315 of the sheath 300, and enables the ultrasonic waves to be transmitted and received efficiently. When the surgeon supplies priming liquid to the sheath 300, a surgeon uses a predetermined connector or the like having a fluid supply port for supplying the priming liquid to the hub portion 320 (see FIG. 3) of the sheath 300. Can be connected.

  The surgeon delivers the sheath 300 to the observation target site of the blood vessel, and then connects the sheath 300 to the driving device 500 (see FIG. 3B). The operator removes the long member 400 from the lumen 315 of the sheath 300 before connecting the sheath 300 to the driving device 500. The operator holds the distal end portion 311 of the sheath 300 in a predetermined position (near the observation target site in the blood vessel) with the elongated member 400 removed from the lumen 315 of the sheath 300, and the hub portion of the sheath 300. 320 is connected to the driving device 500 in close proximity.

  Next, the surgeon attaches the medical instrument 200 to the drive device 500 (see FIG. 5B). The wound body 221 of the housing 220 provided in the medical device 200 is prepared in a state where the main body 211 of the medical member 210 is wound. Note that the operation of attaching the medical instrument 200 to the drive device 500 may be performed, for example, in a preparation stage before performing a procedure using the medical system 100.

  Next, the operator inserts the medical member 210 into the lumen 315 of the sheath 300. At this time, the surgeon can operate the drive device 500 through control by the control unit 600 provided in the medical system 100.

  Specifically, the control unit 600 operates the first driving unit 530 (see FIG. 5B) to indicate the housing 220 of the medical device 200 by a predetermined direction (arrow r1 in FIG. 5B). Direction). The medical member 210 wound around the housing 220 is sent out to the passage portion 523 of the driving device 500 as the housing 220 rotates (arrow a1 in FIGS. 2C, 3B, and 4A). See). In addition, the control unit 600 rotates the rotating members 551, 552 a, and 552 b arranged in the passage unit 523, thereby causing the main body part 211 of the medical member 210 sent to the passage unit 523 to move to the hub part 320 of the sheath 300. Feed into lumen 325. The control unit 600 operates the first driving unit 530 and the rotating members 551, 552a, and 552b as described above to move the imaging unit 213 disposed at the distal end portion of the medical member 210 to the observation target site in the blood vessel. Move.

  When the control unit 600 sends out the medical member 210 toward the distal end side of the sheath 300, for example, the second drive unit 540 (see FIG. 5B) is moved in a predetermined direction (an arrow r3 in FIG. 5B) It can be rotated in the direction indicated by arrow r4. The housing 220 of the medical device 200 rotates with the second drive unit 540 as the second drive unit 540 rotates. The medical member 210 held by the housing 220 rotates the main body portion 211 of the medical member 210 along the circumferential direction of the sheath 300 as the housing 220 rotates (arrow r3 ′ and arrow r4 in FIG. 2C). '). When the surgeon delivers the medical member 210 to the site to be observed in the blood vessel, the medical member 210 is appropriately rotated in the circumferential direction of the sheath 300 as described above, thereby performing medical treatment on the curved or bent portion of the blood vessel. The member 210 can be smoothly inserted.

  The control unit 600 operates the second driving unit 540 of the driving device 500 after the imaging unit 213 arranged at the distal end portion of the main body 211 of the medical member 210 has moved to the observation target site in the blood vessel to operate the medical member 210. Is rotated in a predetermined direction (a direction indicated by an arrow r3 or an arrow r4 in FIG. 5B. For example, a direction opposite to the direction rotated when the medical member 210 is delivered). In this way, the control unit 600 rotates the medical member 210 in the circumferential direction.

  Further, the control unit 600 operates the first drive unit 530 (see FIG. 5B) to move the housing 220 of the medical device 200 in a predetermined direction (the direction indicated by the arrow r2 in FIG. 5B). The rotating members 551, 552a, and 552b disposed in the passage portion 523 are rotated while being rotated. The controller 600 moves the main body 211 of the medical member 210 toward the housing 220 attached to the driving device 500 by performing the above-described operation control. The medical member 210 is wound around the winding portion 221 of the housing 220 while moving toward the housing 220 side.

  The control unit 600 transmits and receives ultrasonic waves by the signal transmission / reception unit 213a while moving the medical member 210 to the proximal end side of the sheath 300 while rotating the medical member 210 in the circumferential direction. Specifically, the signal transmission / reception unit 213a transmits an ultrasonic wave based on a signal transmitted from the control unit 600. A signal corresponding to the reflected wave received by the signal transmission / reception unit 213 a is sent to the control unit 600 via the signal line 212 of the medical member 210 and the driving device 500. The control unit 600 generates a tomographic image of the blood vessel based on the signal transmitted from the signal transmission / reception unit 213a and displays the generated image on the monitor 700.

  The medical device 200 according to the present embodiment has the following advantages.

  For example, a plurality of medical members 210 (members described as drive shafts in the embodiment) provided in the medical device 200 having different product types can be prepared prior to the procedure. As an example, the surgeon prepares one having specifications with different frequencies of ultrasonic waves transmitted from the signal transmission / reception unit 213a (for example, those having frequencies of 40 MHz and 60 MHz). When the operator wants to use the medical member 210 having a different specification during the procedure, the operator removes the medical instrument 200 in use from the driving device 500. Further, the surgeon selects the housing 220 holding the desired medical member 210 from the plurality of housings 220 and attaches it to the driving device 500. Therefore, the operator does not need to remove the sheath 300 from the living body when replacing the medical member 210 during the procedure. Therefore, the surgeon can easily and smoothly perform the operation of replacing the medical member 210.

  In addition, in the procedure using the IVUS catheter in which the sheath and the drive shaft are integrally connected, when the drive shaft is replaced during the procedure, after the drive shaft is pulled out from the sheath, another drive shaft is removed. Must be reinserted into the sheath. In a general IVUS catheter, a sealing member is provided so that the priming solution does not leak into the connector (connector for electrical connection with the driving device) disposed on the proximal end side of the hub portion of the sheath. Has been placed. Therefore, when performing an operation of exchanging the drive shaft, the operator may not be able to smoothly proceed with the operation of inserting the drive shaft into the sheath because the drive shaft may be caught by the seal member.

  Moreover, the medical member 210 can adjust the length at the time of using it for a procedure by controlling the length sent out from the housing 220. That is, the medical member 210 has high versatility with respect to a plurality of types of sheaths 300 (for example, a support catheter and a microcatheter) having different lengths. Thus, since the medical member 210 can respond to a plurality of types of sheaths 300 having different lengths, it is possible to improve medical economy.

  Moreover, since the housing 220 with which the medical device 200 is provided holds the medical member 210 in a wound state, the medical member 210 can be stored in a compact manner.

  The distance that the medical member 210 can move in the axial direction in the lumen 315 of the sheath 300 corresponds to the length of the medical member 210 (the total length wound around the winding portion 221). For example, in a medical system provided with a drive device that drives the axial movement of the drive shaft by a ball screw, the movement amount of the drive shaft in the axial direction is limited by the total length of the ball screw. In the medical instrument 200 according to the present embodiment, the movement of the medical member 210 in the axial direction relative to the sheath 300 can be adjusted by feeding or winding the wound medical member 210. Therefore, in the procedure using the medical instrument 200, there is no problem that the movement amount of the medical member 210 due to the entire length of the ball screw is limited. Therefore, the surgeon can acquire a tomographic image of the blood vessel with an arbitrary pullback length (amount of movement toward the base end side). The surgeon can also set the position at which pullback is started (diagnosis image capturing start position) to an arbitrary position by adjusting the length at which the medical member 210 is delivered to the lumen 315 of the sheath 300.

  Further, when the body portion 211 of the medical member 210 is pulled back while being inserted into the blood vessel, the body portion 211 is wound around the winding portion 221 of the housing 220. Therefore, even when the pullback length of the medical member 210 is increased, an assistant who assists the procedure using the medical system 100 moves the driving device 500 away from the sheath 300 in accordance with the pullback operation of the medical member 210. There is no need to perform the work to move to. Therefore, the surgeon can reduce the labor and work load required for the procedure by using the medical instrument 200.

  Further, the hub portion 320 included in the sheath 300 is detachable from the drive device 500. Therefore, the surgeon separates the sheath 300 from the drive device 500 when delivering the sheath 300 into the living body lumen, thereby providing a desired member other than the drive shaft as the elongated member 400 for assisting the delivery of the sheath 300. A medical device or the like having physical properties can be used. Therefore, the operator can improve the delivery of the sheath 300 in the blood vessel.

<Modification>
Next, a sheath 300A according to a modification will be described. The same components as those in the above-described embodiment are denoted by the same reference numerals, and description thereof is omitted.

  As shown in FIGS. 6A to 6C, for example, the sheath 300A may have a structure in which the distal end portion 311 is closed. By having such a structure, the sheath 300A can prevent the medical member 210 from coming into contact with body fluid or the like when the main body portion 211 of the medical member 210 is inserted into the lumen 315 of the sheath 300A. Therefore, even when the medical member 210 is used to acquire a tomographic image in a blood vessel, it can be prevented from being contaminated by contact with a body fluid. Therefore, the surgeon can prevent the reuse of the medical member 210 from being restricted due to contamination due to contact with body fluid.

  As a structure for closing the distal end portion 311 of the sheath 300A, for example, a valve body 318 that prevents inflow of body fluid into the lumen 315 of the sheath 300A can be used. As shown in FIG. 6B, the valve body 318 is formed with an insertion portion 318a through which a long member 400 such as a guide wire can be inserted. The insertion part 318a can be expanded so that the long member 400 is inserted when the long member 400 is pushed. The valve body 318 is in close contact with the outer peripheral surface of the long member 400 in a state where the long member 400 is inserted through the insertion portion 318a, and maintains liquid tightness. Therefore, when the sheath 300A is delivered to a desired position in the blood vessel, the sheath 300A can be smoothly moved along the elongated member 400.

  In addition, you may obstruct | occlude the front-end | tip part of sheath 300A with the tube wall (tubular meat) of sheath 300A, for example. When the sheath 300A is configured in this manner, for example, a tubular member for inserting a long member 400 such as a guide wire can be disposed on the outer periphery of the distal end portion of the sheath 300A. When delivering the sheath 300A, the sheath 300A can be moved to a desired position in the blood vessel by inserting a long member 400 such as a guide wire through the tubular member. Instead of providing the tubular member as described above, for example, a long member such as a guide wire may be inserted into the lumen 315 of the sheath 300A to deliver the sheath 300A into the living body lumen. . In this case, the surgeon delivers the sheath 300A together with a long member such as a guide wire to a desired position in the living body lumen through a guiding catheter or the like inserted into the living body lumen prior to insertion of the sheath 300A. can do.

  Further, in a sheath having a structure in which the distal end portion is closed like the sheath 300A, the priming to the lumen 315 of the sheath 300A is performed by, for example, a method of filling the sheath 300A in advance with a priming liquid, It can be performed by a method of filling the priming liquid in a negative pressure state.

  As mentioned above, although the medical instrument and medical system which concern on this invention were demonstrated through embodiment, this invention is not limited only to each structure demonstrated, It can change suitably based on description of a claim. It is.

  For example, the IVUS system has been described as an example of the medical system. However, the medical system includes, for example, an optical coherence tomography diagnosis system, an intravascular ultrasonic diagnosis system, and an optical coherence tomography diagnosis system. It is also possible to apply to a dual type diagnostic imaging system that can be used by switching or simultaneously using each function, an diagnostic imaging system that uses an optical frequency domain imaging method, and the like. . When the configuration of the medical system is changed as described above, the specifications of each part of the medical member (for example, the specification of the imaging unit, etc.) can be changed to a configuration suitable for the system.

  In addition, the medical member is not limited to, for example, for the purpose of image diagnosis, and may be, for example, a long member such as a guide wire, or a hollow long member having a lumen formed therein. A main body part may be provided.

  Further, the drive device may be configured so that, for example, a plurality of different types of medical instruments (medical members and housings) can be simultaneously mounted. When the drive device is configured in this way, the medical instrument can be arranged side by side in parallel inside the drive device, for example. Further, for example, the control unit may perform operation control of the medical system so as to select and use an arbitrary medical member from medical devices arranged in parallel during the procedure.

  In addition, a specific configuration of the housing included in the medical device is not limited as long as the medical member can be held. For example, the housing may be configured to hold the medical member in a form other than the wound state.

  In the embodiment, since the IVUS medical system has been described, the supply of the priming liquid has also been described. For example, the medical system uses another medical system (an optical coherence tomography diagnosis system or an optical frequency domain imaging method). In the case of an image diagnosis system or the like, the priming can be omitted. Further, in the IVUS medical system, when the imaging unit is configured in a phased array system, the third operation (circumferential rotation operation) can be omitted as appropriate.

100 medical system,
200 medical devices,
210 medical member (drive shaft),
211 Main body (tube) of medical member,
212 signal lines,
213 imaging unit,
220 housing,
221 winding part,
225a, 225b, 225c electrical connections,
226 communication unit,
300, 300A sheath (long member),
310 the body of the sheath,
315 the lumen of the sheath,
318 disc,
318a Valve body insertion part,
320 hub part,
323b connection,
325 lumen of the hub,
400 long member,
500 drive,
510 exterior case,
511b connection,
521 containment space,
522 opening,
523 passage section,
530 first drive unit,
540 second drive unit,
551, 552a, 552b rotating member,
560 electrical connections,
600 control unit,
700 monitor.

Claims (6)

A medical member having a long and flexible main body, and insertable into a living body lumen;
A housing for holding the medical member,
The said housing is a medical instrument which can be attached or detached to the drive device which can drive the 1st operation | movement which sends out the said medical member from the said housing, and the 2nd operation | movement which moves the said medical member to the said housing. The medical member is a drive shaft including a tube constituting the main body and an imaging unit that is provided at a distal end of the tube and acquires image information of the biological lumen,
In addition to the first operation and the second operation, the drive device can freely drive a third operation that rotates the drive shaft in the circumferential direction.
The medical device according to claim 1, wherein the housing is capable of electrically connecting the driving device and the imaging unit by attaching the housing to the driving device.   The medical device according to claim 1, wherein the housing has a winding portion that holds the main body portion of the medical device in a wound state.   The said housing has a communication part which enables communication of predetermined information between other apparatuses in the state attached to the said drive device. Medical instruments. The medical device according to any one of claims 1 to 4,
An elongate member that is insertable into the living body lumen and includes a lumen into which the medical member can be inserted;
The drive device;
And a control unit that controls the operation of the driving device.   The medical system according to claim 5, wherein the elongate member has a hub portion that is detachable from the drive device.