JP2021151378A

JP2021151378A - Medical device

Info

Publication number: JP2021151378A
Application number: JP2020052931A
Authority: JP
Inventors: 太輝人犬飼; Takito Inukai
Original assignee: Terumo Corp
Current assignee: Terumo Corp
Priority date: 2020-03-24
Filing date: 2020-03-24
Publication date: 2021-09-30

Abstract

To provide a medical device which improves operability when a medical worker uses treatment devices such as a guiding catheter and a stent in combination.SOLUTION: A medical device 100 is used when a long catheter device 200 insertable into an organism lumen and a guiding catheter 300 into which the catheter device is insertable are used in combination. The medical device comprises: a first holding part 10 for holding the proximal end of the catheter device; a second holding part 30 for holding the proximal end of the guiding catheter, at the distal end side of the first holding part; and a moving part 20 which has the first holding part or the second holding part fixed thereto and has the other one connected thereto movably in a longitudinal direction X.SELECTED DRAWING: Figure 1

Description

本発明は、医療装置に関する。 The present invention relates to a medical device.

患者を外科的に治療する方法としてＰＣＩ（ＰｅｒｃｕｔａｎｅｏｕｓＣｏｒｏｎａｒｙＩｎｔｅｒｖｅｎｔｉｏｎ：経皮的冠動脈形成術）が知られている。ＰＣＩによる従来の手技では一例としてシースイントロデューサからガイディングカテーテルを進入させ、ガイディングカテーテルを冠動脈等にエンゲージさせ、治療デバイスを用いてステント等を留置することが行われる（特許文献１参照）。 PCI (Percutaneous Coronary Intervention) is known as a method for surgically treating a patient. In the conventional procedure using PCI, as an example, a guiding catheter is inserted from a sheath introducer, the guiding catheter is engaged in a coronary artery or the like, and a stent or the like is placed using a therapeutic device (see Patent Document 1).

特開２０１０−１６６９３６号公報JP-A-2010-166936

ＰＣＩ手技においてステントやバルーンカテーテル等の治療デバイスを使用する際には、一般的に左手にガイディングカテーテル後端を、右手に治療デバイスのシャフト部を把持する。そして、治療部位に治療デバイスを送達するためにガイディングカテーテル内の先端側に向けて挿入する動作を行う。この際、ガイディングカテーテルが治療デバイスとの摩擦により先端側に従動するのを防止するため、左手は治療デバイスの摩擦力と同等の反力をガイディングカテーテルに付与している。しかしながら、治療デバイスの挿入は例えば数ｃｍ刻みで複数回にわたって行われ、左手はガイディングカテーテルに都度反力を付与する必要があり、意図せず反力が不足することがある。また、過度な反力を付与することによりガイディングカテーテルは先端方向もしくは後端方向に移動することがある。これにより、ガイディングカテーテルの生体に対する位置が変わってしまうおそれがある。さらに、生体内において治療デバイスの設置位置を調整する際に、前記のように反力を調整できないことにより、例えば１ｍｍ単位等のような精密な前後移動を行うことが困難となり得る。 When using a therapeutic device such as a stent or balloon catheter in a PCI procedure, the rear end of the guiding catheter is generally held in the left hand and the shaft portion of the therapeutic device is held in the right hand. Then, the operation of inserting the therapeutic device toward the distal end side in the guiding catheter is performed in order to deliver the therapeutic device to the therapeutic site. At this time, in order to prevent the guiding catheter from moving to the distal end side due to friction with the treatment device, the left hand applies a reaction force equivalent to the frictional force of the treatment device to the guiding catheter. However, the insertion of the therapeutic device is performed multiple times, for example, in increments of several centimeters, and the left hand needs to apply a reaction force to the guiding catheter each time, which may unintentionally lack the reaction force. In addition, the guiding catheter may move in the distal end direction or the posterior end direction by applying an excessive reaction force. As a result, the position of the guiding catheter with respect to the living body may change. Further, when adjusting the installation position of the treatment device in the living body, the reaction force cannot be adjusted as described above, so that it may be difficult to perform precise back-and-forth movement such as in units of 1 mm.

本発明は、医療従事者がガイディングカテーテルと治療デバイスのような医療器具を併用する際の操作性を向上させることを目的とする。 An object of the present invention is to improve operability when a medical worker uses a guiding catheter and a medical device such as a therapeutic device in combination.

本発明の一態様は、生体管腔に挿入可能な長尺の第１管状部材と、第１管状部材を挿入可能な第２管状部材を併用する際の医療装置である。医療装置は、第１管状部材の基端部を保持する第１保持部と、第１保持部の先端側に、第２管状部材の基端部を保持する第２保持部と、第１保持部と第２保持部のいずれかが固定され、一方が長手方向に移動可能に接続された移動部と、を備える。 One aspect of the present invention is a medical device for using a long first tubular member that can be inserted into a living lumen and a second tubular member into which the first tubular member can be inserted. The medical device includes a first holding portion that holds the base end portion of the first tubular member, a second holding portion that holds the base end portion of the second tubular member, and a first holding portion on the tip end side of the first holding portion. A moving portion in which either the portion or the second holding portion is fixed and one of the portions is movably connected in the longitudinal direction is provided.

上記医療装置によれば、医療従事者がガイディングカテーテルと治療デバイスのような医療器具を併用する際の操作性を向上できる。 According to the medical device, it is possible to improve the operability when a medical worker uses a medical device such as a guiding catheter and a therapeutic device in combination.

本発明の一実施形態に係る医療装置を示す概略斜視図である。It is a schematic perspective view which shows the medical apparatus which concerns on one Embodiment of this invention. 医療装置を図１と異なる方向から見た概略斜視図である。It is a schematic perspective view which looked at the medical device from the direction different from FIG. 医療装置を示す正面図である。It is a front view which shows the medical apparatus. 図３の４部分を示す拡大図である。It is an enlarged view which shows 4 parts of FIG. 第１保持部を構成する第１挟持部材と第２挟持部材の係合について示す拡大断面図である。It is an enlarged cross-sectional view which shows the engagement of the 1st holding member and the 2nd holding member which make up a 1st holding part. 第１変形例に係る医療装置について示す概略正面図である。It is a schematic front view which shows the medical apparatus which concerns on 1st modification. 図６の７部分を示す拡大図である。It is an enlarged view which shows 7 parts of FIG. 第２変形例に係る医療装置を示す概略斜視図である。It is a schematic perspective view which shows the medical apparatus which concerns on the 2nd modification. 図８の正面図である。It is a front view of FIG. 図９の１０−１０線に沿う断面図である。It is sectional drawing which follows the line 10-10 of FIG.

以下、各図面を参照して、本発明の実施形態を説明する。なお、図面の寸法比率は、説明の都合上誇張されており、実際の比率とは異なる場合がある。本実施形態に係る医療装置１００は、上述したＰＣＩ等において生体管腔に挿入可能な長尺の第１管状部材と、第１管状部材を挿入可能な第２管状部材を併用する際に利用される。 Hereinafter, embodiments of the present invention will be described with reference to the drawings. The dimensional ratios in the drawings are exaggerated for convenience of explanation and may differ from the actual ratios. The medical device 100 according to the present embodiment is used when a long first tubular member that can be inserted into a living lumen and a second tubular member into which a first tubular member can be inserted are used in combination in the above-mentioned PCI or the like. NS.

なお、以下では説明にあたり図面に直交座標を図示する。直交座標のＸは医療装置１００において後述する移動部２０を構成するベース２３の長手方向に相当し、長手方向Ｘと称する。直交座標のＹはベース２３の幅方向に相当し、幅方向Ｙと称する。直交座標のＺは医療装置１００の高さ方向に相当し、高さ方向Ｚと称する。 In the following description, Cartesian coordinates are shown in the drawings. The X of the orthogonal coordinates corresponds to the longitudinal direction of the base 23 constituting the moving portion 20 described later in the medical device 100, and is referred to as the longitudinal direction X. The Y in Cartesian coordinates corresponds to the width direction of the base 23, and is referred to as the width direction Y. The Z in Cartesian coordinates corresponds to the height direction of the medical device 100, and is referred to as the height direction Z.

図１、図２に示すように、医療装置１００は、第１保持部１０と、移動部２０と、第２保持部３０と、を有する。以下、詳述する。 As shown in FIGS. 1 and 2, the medical device 100 has a first holding unit 10, a moving unit 20, and a second holding unit 30. The details will be described below.

（第１保持部）
第１保持部１０は生体管腔に挿入可能な長尺の第１管状部材の基端部を保持するように構成している。第１保持部１０は、図２、図４等に示すように第１挟持部材１１と、第２挟持部材１２と、ヒンジ部１３（回転部に相当）と、目盛り部１４と、を備える。 (1st holding part)
The first holding portion 10 is configured to hold the proximal end portion of a long first tubular member that can be inserted into the living lumen. As shown in FIGS. 2, 4 and the like, the first holding portion 10 includes a first holding member 11, a second holding member 12, a hinge portion 13 (corresponding to a rotating portion), and a scale portion 14.

なお、ここでいう第１管状部材としては、患者に対して何等かの処置を行う長尺状の医療器具であれば特に限定されないが、一例としてバルーンカテーテル、アテレクトミーデバイス、ステントデリバリーカテーテル等の治療デバイスを挙げることができる。 The first tubular member referred to here is not particularly limited as long as it is a long medical device that performs some kind of treatment on a patient, but as an example, treatment of a balloon catheter, an atherectomy device, a stent delivery catheter, or the like. Devices can be mentioned.

第１挟持部材１１は、第２挟持部材１２とともに組をなし、ステント等を送達するカテーテルデバイス２００（第１管状部材に相当）を挟持するように構成している。第１挟持部材１１と第２挟持部材１２は、先端側から基端側にかけてカテーテルデバイス２００と接触する部分（接触面）を比較的多く確保するように構成している。第１挟持部材１１と第２挟持部材１２は、エラストマー等の比較的摩擦抵抗の高い材料を含むように構成することができる。これにより、第１保持部１０によって保持した際のカテーテルデバイス２００の長手方向Ｘへの移動を防止できる。 The first sandwiching member 11 is assembled together with the second sandwiching member 12 so as to sandwich the catheter device 200 (corresponding to the first tubular member) for delivering a stent or the like. The first sandwiching member 11 and the second sandwiching member 12 are configured to secure a relatively large number of portions (contact surfaces) that come into contact with the catheter device 200 from the distal end side to the proximal end side. The first holding member 11 and the second holding member 12 can be configured to include a material having a relatively high frictional resistance such as an elastomer. This makes it possible to prevent the catheter device 200 from moving in the longitudinal direction X when it is held by the first holding portion 10.

第１挟持部材１１には図５等に示すツメ形状１１ａを設け、第２挟持部材１２には第１挟持部材１１のツメ形状１１ａと係合可能な嵌め込み部１２ａを設けることによって第１挟持部材１１と第２挟持部材１２とが接近した状態を維持できる。これにより、第１保持部１０がカテーテルデバイス２００を挟持した状態を維持することができる。 The first holding member 11 is provided with the claw shape 11a shown in FIG. 5 and the like, and the second holding member 12 is provided with the fitting portion 12a capable of engaging with the claw shape 11a of the first holding member 11. The state in which the 11 and the second holding member 12 are close to each other can be maintained. As a result, the first holding portion 10 can maintain the state in which the catheter device 200 is sandwiched.

第２挟持部材１２は、ヒンジ部１３によって第１挟持部材１１と接近離間可能に連結している。第２挟持部材１２は、カテーテルデバイス２００を挟持する際に高さ方向Ｚにおいて第１挟持部材１１と隣接するように構成している。 The second sandwiching member 12 is connected to the first sandwiching member 11 by a hinge portion 13 so as to be close to and separated from each other. The second sandwiching member 12 is configured to be adjacent to the first sandwiching member 11 in the height direction Z when sandwiching the catheter device 200.

第２挟持部材１２は移動部２０の構成部品を収容可能な空間を備える。第２挟持部材１２は、本実施形態において直方体を中空にした箱型形状に構成し、これにより移動部２０を構成するピニオン２２を収容可能に構成している。ただし、ピニオン２２を収容して移動部２０を構成するベース２３に対して第１保持部１０を相対的に移動できれば、具体的な形状は上記に限定されない。 The second holding member 12 has a space capable of accommodating the components of the moving portion 20. In the present embodiment, the second sandwiching member 12 is formed in a box shape in which a rectangular parallelepiped is hollow, whereby the pinion 22 constituting the moving portion 20 can be accommodated. However, the specific shape is not limited to the above as long as the first holding portion 10 can be moved relative to the base 23 that accommodates the pinion 22 and constitutes the moving portion 20.

ヒンジ部１３は、第２挟持部材１２に対して第１挟持部材１１を相対的に移動可能であるとともに着脱可能な部材の一例として構成している。ヒンジ部１３は、第２挟持部材１２に対して第１挟持部材１１を回転させるように第１挟持部材１１と第２挟持部材１２とを回転可能に連結している。これにより、ヒンジ部１３を回転軸として第１挟持部材１１と第２挟持部材１２とを回転方向に接近離間させることができる。第１保持部１０は、図５に示すようにツメ形状１１ａ、嵌め込み部１２ａとヒンジ部１３とによって第１挟持部材１１と第２挟持部材１２とを開閉可能にし、脱着を容易に構成している。 The hinge portion 13 is configured as an example of a member in which the first sandwiching member 11 is relatively movable and detachable with respect to the second sandwiching member 12. The hinge portion 13 rotatably connects the first sandwiching member 11 and the second sandwiching member 12 so as to rotate the first sandwiching member 11 with respect to the second sandwiching member 12. As a result, the first sandwiching member 11 and the second sandwiching member 12 can be brought close to each other in the rotational direction with the hinge portion 13 as the rotation axis. As shown in FIG. 5, the first holding portion 10 allows the first holding member 11 and the second holding member 12 to be opened and closed by the claw shape 11a, the fitting portion 12a, and the hinge portion 13, so that the first holding member 11 can be easily attached and detached. There is.

目盛り部１４は、移動部２０に対する第１保持部１０の相対的な移動距離（位置関係）の確認を容易にするために設けられる。目盛り部１４は、第１保持部１０を構成する第２挟持部材１２の側面に目盛りを設けることによって構成している。目盛りは本実施形態において１ｍｍ間隔で設けているが、移動部２０に対する第１保持部１０の移動距離の確認が容易にできれば、０．１ｍｍ等の他の間隔であってもよい。また、目盛りは１ｍｍ間隔に加えて例えば５ｍｍ間隔毎に目盛りの大きさを変えるように構成してもよい。 The scale portion 14 is provided to facilitate confirmation of the relative movement distance (positional relationship) of the first holding portion 10 with respect to the moving portion 20. The scale portion 14 is configured by providing a scale on the side surface of the second holding member 12 constituting the first holding portion 10. Although the scales are provided at 1 mm intervals in the present embodiment, other intervals such as 0.1 mm may be used as long as the moving distance of the first holding unit 10 with respect to the moving unit 20 can be easily confirmed. Further, the scale may be configured to change the size of the scale at intervals of, for example, 5 mm in addition to the interval of 1 mm.

（移動部）
移動部２０は、第１保持部１０及び第２保持部３０のいずれか一方を固定し、他方を長手方向Ｘに移動可能に接続するように構成している。移動部２０は、本実施形態において第１保持部１０と別に設けている。移動部２０は、第１保持部１０によってカテーテルデバイス２００を保持し、第２保持部３０によってガイディングカテーテル３００を保持した状態において第２保持部３０を固定し、第１保持部１０を長手方向Ｘに移動可能に構成している。移動部２０は、図３、図４に示すようにラック２１と、ピニオン２２と、ベース２３と、ダイヤル２４と、目盛り部２５と、を備える。 (Moving part)
The moving portion 20 is configured to fix one of the first holding portion 10 and the second holding portion 30 and connect the other so as to be movable in the longitudinal direction X. The moving unit 20 is provided separately from the first holding unit 10 in the present embodiment. The moving portion 20 holds the catheter device 200 by the first holding portion 10, fixes the second holding portion 30 in a state where the guiding catheter 300 is held by the second holding portion 30, and moves the first holding portion 10 in the longitudinal direction. It is configured to be movable to X. As shown in FIGS. 3 and 4, the moving portion 20 includes a rack 21, a pinion 22, a base 23, a dial 24, and a scale portion 25.

ラック２１は、第１保持部１０を移動させる部位としてベース２３に設けている。ラック２１は、本実施形態においてベース２３の上部に設けているが、第１保持部１０を移動可能にできればベース２３におけるラックの設置位置は上記に限定されない。 The rack 21 is provided on the base 23 as a portion for moving the first holding portion 10. Although the rack 21 is provided above the base 23 in the present embodiment, the rack installation position on the base 23 is not limited to the above as long as the first holding portion 10 can be moved.

ピニオン２２は、ラック２１と係合可能に構成している。ピニオン２２はラック２１と係合しつつ回転可能であることによって第１保持部１０をラック２１に対して長手方向Ｘに段階的に移動可能に構成している。また、ピニオン２２にはラッチ機構を設けてもよい。このように構成することによってクリック音により第１保持部１０の移動部２０に対する移動量を直感的に把握できる、又は把握しやすくできる。 The pinion 22 is configured to be engageable with the rack 21. Since the pinion 22 can rotate while engaging with the rack 21, the first holding portion 10 is configured to be movable in a stepwise manner in the longitudinal direction X with respect to the rack 21. Further, the pinion 22 may be provided with a latch mechanism. With this configuration, the amount of movement of the first holding unit 10 with respect to the moving unit 20 can be intuitively grasped or easily grasped by the click sound.

ベース２３はラック２１を設置する部位として構成している。ベース２３は、本実施形態において略直方体形状に構成しているが、第１保持部１０を移動可能に構成できればベース２３の具体的な形状は直方体に限定されない。ベース２３は手術室の手術台等に載置できれば大きさは特に限定されないが、例えば長手方向Ｘの長さを２０ｃｍ程度に構成できる。 The base 23 is configured as a part where the rack 21 is installed. Although the base 23 is configured to have a substantially rectangular parallelepiped shape in the present embodiment, the specific shape of the base 23 is not limited to the rectangular parallelepiped as long as the first holding portion 10 can be configured to be movable. The size of the base 23 is not particularly limited as long as it can be placed on an operating table or the like in an operating room, but for example, the length of the longitudinal direction X can be configured to be about 20 cm.

ダイヤル２４はピニオン２２を回転可能に構成している。ダイヤル２４は、ピニオン２２を回転させることによってラック２１に対するピニオン２２の位置を相対的に移動させるために設けている。ダイヤル２４は医療従事者等の使用者の手指によって把持可能に構成している。 The dial 24 is configured to rotate the pinion 22. The dial 24 is provided to move the position of the pinion 22 relative to the rack 21 by rotating the pinion 22. The dial 24 is configured to be grippable by the fingers of a user such as a medical worker.

ダイヤル２４は本実施形態において略円柱形状に構成している。ただし、使用者の手指によって把持しやすければ、ダイヤル２４の具体的な形状は円筒に限定されず、上記以外にも例えば円錐台形状等であってもよい。ダイヤル２４は、ピニオン２２に対して幅方向Ｙに離間して配置している。 The dial 24 has a substantially cylindrical shape in the present embodiment. However, the specific shape of the dial 24 is not limited to a cylinder as long as it can be easily gripped by the user's fingers, and may be, for example, a truncated cone shape or the like in addition to the above. The dial 24 is arranged so as to be separated from the pinion 22 in the width direction Y.

また、ダイヤル２４は、本実施形態においてピニオン２２と同軸に構成している。ただし、ダイヤル２４の操作によってピニオン２２を回転できればダイヤルはピニオンと同軸でなくてもよい。 Further, the dial 24 is configured coaxially with the pinion 22 in the present embodiment. However, the dial does not have to be coaxial with the pinion as long as the pinion 22 can be rotated by operating the dial 24.

目盛り部２５は、移動部２０に設けられ、移動部２０に対する第１保持部１０の移動距離（位置関係）の確認を容易にするために設けられる。目盛り部２５は、本実施形態において移動部２０を構成するベース２３の側面であって第１保持部１０を設置した際に目盛り部１４と同一の側に設けるように構成している。また、目盛り部２５は、目盛り部１４と同様に例えば１ｍｍ間隔で設定することができる。 The scale portion 25 is provided in the moving portion 20 and is provided in order to facilitate confirmation of the moving distance (positional relationship) of the first holding portion 10 with respect to the moving portion 20. The scale portion 25 is a side surface of the base 23 constituting the moving portion 20 in the present embodiment, and is configured to be provided on the same side as the scale portion 14 when the first holding portion 10 is installed. Further, the scale portion 25 can be set at intervals of, for example, 1 mm in the same manner as the scale portion 14.

このように移動部２０はいわゆる一軸タイプのステージとなるように構成している。このように構成することによって、目盛り部２５を用いて第１保持部１０の移動部２０に対する迅速かつ細かな位置調整を容易に行うことができる。 In this way, the moving unit 20 is configured to be a so-called uniaxial type stage. With this configuration, the scale portion 25 can be used to easily and finely adjust the position of the first holding portion 10 with respect to the moving portion 20.

（第２保持部）
第２保持部３０は、第１保持部１０の先端側に設けている。第２保持部３０は、カテーテルデバイス２００を挿通可能なガイディングカテーテル３００（第２管状部材に相当）の基端部を保持するように構成している。第２保持部３０は、図１、図２に示すように取り付け部３１と、設置部３２と、を備える。 (2nd holding part)
The second holding portion 30 is provided on the tip end side of the first holding portion 10. The second holding portion 30 is configured to hold the proximal end portion of the guiding catheter 300 (corresponding to the second tubular member) through which the catheter device 200 can be inserted. The second holding portion 30 includes a mounting portion 31 and an mounting portion 32 as shown in FIGS. 1 and 2.

取り付け部３１は、ガイディングカテーテル３００等を取り付け可能に構成している。取り付け部３１は、本実施形態において中空形状であって、中空形状の内側面がＩＳＯ等に規定するルアーテーパ等を設けるように構成している。取り付け部３１は、ガイディングカテーテル３００等のハブと接続可能に構成している。 The attachment portion 31 is configured so that the guiding catheter 300 and the like can be attached. The mounting portion 31 has a hollow shape in the present embodiment, and the inner side surface of the hollow shape is configured to provide a luer taper or the like specified in ISO or the like. The attachment portion 31 is configured to be connectable to a hub such as a guiding catheter 300.

設置部３２は、取り付け部３１をベース２３と連結するように構成している。設置部３２は、本実施形態において断面が矩形状の中実形状を取り付け部３１とベース２３との間に設けることによって構成している。ただし、ベース２３に取り付け部３１を設置できれば、設置部の具体的な形状は上記に限定されない。 The installation portion 32 is configured to connect the attachment portion 31 to the base 23. The installation portion 32 is configured by providing a solid shape having a rectangular cross section between the attachment portion 31 and the base 23 in the present embodiment. However, if the mounting portion 31 can be installed on the base 23, the specific shape of the mounting portion is not limited to the above.

（使用方法）
次に本実施形態に係る医療装置１００の使用方法について説明する。まず、医療従事者は生体に穿刺部位を形成し、穿刺部位にイントロデューサシースを配置する。 (how to use)
Next, a method of using the medical device 100 according to the present embodiment will be described. First, the medical worker forms a puncture site in the living body and places an introducer sheath at the puncture site.

そして、術者はイントロデューサシースからガイドワイヤを生体管腔に進入させて、造影画像等で確認しながら、目的部位まで進入させる。次に術者はガイドワイヤに沿わせてガイディングカテーテル３００を挿入し、冠動脈にエンゲージさせる。医療従事者はこの時点でガイディングカテーテル３００の基端部を医療装置１００の第２保持部３０に取り付ける。 Then, the surgeon inserts the guide wire from the introducer sheath into the living lumen and advances it to the target site while checking with a contrast image or the like. The surgeon then inserts the guiding catheter 300 along the guide wire to engage the coronary artery. At this point, the healthcare professional attaches the proximal end of the guiding catheter 300 to the second holding portion 30 of the medical device 100.

次に術者はガイディングカテーテル３００の内腔に一例としてステントを送達するカテーテルデバイス２００を挿入する。そして、カテーテルデバイス２００を医療従事者の手指を用いて目的部位近傍まで移動させる。カテーテルデバイス２００の先端が目的部位近傍まで移動できたら、医療従事者は、この状態でカテーテルデバイス２００の基端部を第１保持部１０の第１挟持部材１１と第２挟持部材１２とによって挟持した状態で保持させる。 The surgeon then inserts a catheter device 200 that delivers the stent, for example, into the lumen of the guiding catheter 300. Then, the catheter device 200 is moved to the vicinity of the target site using the fingers of a medical worker. When the tip of the catheter device 200 can be moved to the vicinity of the target site, the medical staff holds the proximal end portion of the catheter device 200 by the first holding member 11 and the second holding member 12 of the first holding portion 10. Hold it in the same state.

次に、医療従事者は移動部２０のダイヤル２４を回転させて第１保持部１０を移動させることによって、第１保持部１０が保持したカテーテルデバイス２００を進退移動させる。このとき、目盛り部１４、２５を確認しつつ移動させることによってカテーテルデバイス２００の細かな位置調整を行うことができる。カテーテルデバイス２００を目的部位に位置決めできたら、医療従事者はステントの拡張・留置等の処置を行う。 Next, the medical staff rotates the dial 24 of the moving unit 20 to move the first holding unit 10, thereby moving the catheter device 200 held by the first holding unit 10 forward and backward. At this time, the catheter device 200 can be finely adjusted in position by moving the scale portions 14 and 25 while checking the scale portions 14 and 25. After positioning the catheter device 200 at the target site, the medical staff performs treatments such as expansion and placement of the stent.

処置が終了したら、第１保持部１０による保持を解除し、カテーテルデバイス２００を生体管腔から抜去する。そして、第２保持部３０による保持を解除し、ガイディングカテーテル３００を生体管腔から抜去する。 When the procedure is completed, the holding by the first holding portion 10 is released, and the catheter device 200 is removed from the living lumen. Then, the holding by the second holding portion 30 is released, and the guiding catheter 300 is removed from the living lumen.

以上説明したように本実施形態に係る医療装置１００は生体管腔に挿入可能なカテーテルデバイス２００と、カテーテルデバイス２００を挿入可能なガイディングカテーテル３００を併用する際に用いられる。医療装置１００は第１保持部１０と移動部２０と第２保持部３０とを有する。第１保持部１０は生体管腔に挿入可能な長尺のカテーテルデバイス２００の基端部を保持する。第２保持部３０は第１保持部１０の先端側においてガイディングカテーテル３００の基端部を保持する。移動部２０は、第１保持部１０と第２保持部３０のいずれか一方を固定し、他方を長手方向Ｘに移動可能に接続している。 As described above, the medical device 100 according to the present embodiment is used when the catheter device 200 that can be inserted into the living lumen and the guiding catheter 300 that can insert the catheter device 200 are used in combination. The medical device 100 has a first holding unit 10, a moving unit 20, and a second holding unit 30. The first holding portion 10 holds the proximal end portion of a long catheter device 200 that can be inserted into the living lumen. The second holding portion 30 holds the proximal end portion of the guiding catheter 300 on the distal end side of the first holding portion 10. The moving portion 20 fixes either one of the first holding portion 10 and the second holding portion 30 and connects the other so as to be movable in the longitudinal direction X.

カテーテルデバイス２００を生体管腔に対して位置決めする際に医療従事者等の使用者は一方の手でガイディングカテーテル３００を持ち、もう一方の手でカテーテルデバイス２００をもってカテーテルデバイス２００等を進退移動させる場合がある。医療従事者はカテーテルデバイス２００を移動させる際に無意識のうちにガイディングカテーテル３００を手元側に引き抜いてしまう場合があり、そのような場合ガイディングカテーテル３００の生体管腔に対するエンゲージの位置がずれてしまう虞がある。また、目的部位である病変部にカテーテルデバイス２００が差し掛かった際にはカテーテルデバイス２００の先端にかかる抵抗が大きくなり、押し込む力に対して作用・反作用によりガイディングカテーテル３００が移動してしまう場合がある。 When positioning the catheter device 200 with respect to the living lumen, a user such as a medical worker holds the guiding catheter 300 with one hand and moves the catheter device 200 or the like forward and backward with the catheter device 200 with the other hand. In some cases. The healthcare professional may unknowingly pull out the guiding catheter 300 toward the hand when moving the catheter device 200, in which case the engaging catheter 300 is misaligned with respect to the biological lumen. There is a risk that it will end up. Further, when the catheter device 200 approaches the lesion portion which is the target site, the resistance applied to the tip of the catheter device 200 increases, and the guiding catheter 300 may move due to the action / reaction against the pushing force. be.

これに対して上記のように医療装置１００に第１保持部１０と第２保持部３０を設けることによって、手術中にガイディングカテーテル３００等の医療器具の位置がずれてしまうことを防止できる。そのため、医療従事者がガイディングカテーテル３００およびカテーテルデバイス２００のような医療器具を併用する際の操作性を向上させることができる。 On the other hand, by providing the first holding portion 10 and the second holding portion 30 in the medical device 100 as described above, it is possible to prevent the position of the medical device such as the guiding catheter 300 from being displaced during the operation. Therefore, it is possible to improve the operability when a medical worker uses a medical device such as a guiding catheter 300 and a catheter device 200 in combination.

また、移動部２０は第１保持部１０を段階的に移動可能に構成している。これにより、第１保持部１０によって保持されるカテーテルデバイス２００を生体管腔に対して位置決めし易くすることができる。 Further, the moving unit 20 is configured so that the first holding unit 10 can be moved stepwise. As a result, the catheter device 200 held by the first holding portion 10 can be easily positioned with respect to the living lumen.

また、移動部２０は、ラック２１と、ラック２１と係合するピニオン２２とを備えるように構成している。これにより、第１保持部１０によってカテーテルデバイス２００を保持させた状態であれば、医療従事者が手指によりカテーテルデバイス２００を保持しなくても第１保持部１０によってカテーテルデバイス２００を進退移動させることができる。 Further, the moving portion 20 is configured to include a rack 21 and a pinion 22 that engages with the rack 21. As a result, if the catheter device 200 is held by the first holding portion 10, the medical worker can move the catheter device 200 forward and backward by the first holding portion 10 without holding the catheter device 200 by fingers. Can be done.

また、移動部２０は、ピニオン２２を回転可能であって、使用者の手指によってラック２１に対するピニオン２２の位置を相対的に移動可能なダイヤル２４を備えるように構成している。これにより、第１保持部１０によってカテーテルデバイス２００を保持させた状態であれば、医療従事者等の使用者が手指によってカテーテルデバイス２００を保持しなくても、カテーテルデバイス２００の生体管腔に対する位置を調整することができる。 Further, the moving unit 20 is configured to include a dial 24 capable of rotating the pinion 22 and relatively moving the position of the pinion 22 with respect to the rack 21 by the finger of the user. As a result, if the catheter device 200 is held by the first holding portion 10, the position of the catheter device 200 with respect to the living lumen is obtained even if the user such as a medical worker does not hold the catheter device 200 by fingers. Can be adjusted.

また、第１保持部１０および移動部２０には移動部２０に対する第１保持部１０の位置関係を示す目盛り部１４、２５を設けるように構成している。このように構成することによって、医療従事者等の使用者が第１保持部１０に保持させたカテーテルデバイス２００を進退移動させる際の移動量を把握しやすくすることができる。 Further, the first holding portion 10 and the moving portion 20 are configured to be provided with scale portions 14 and 25 indicating the positional relationship of the first holding portion 10 with respect to the moving portion 20. With such a configuration, it is possible for a user such as a medical worker to easily grasp the amount of movement when the catheter device 200 held by the first holding portion 10 is moved back and forth.

また、第１保持部１０によってカテーテルデバイス２００を保持すると共に、第２保持部３０によってガイディングカテーテル３００を保持した状態において移動部２０は第２保持部３０を固定し、第１保持部１０を長手方向Ｘに移動可能に接続している。このように構成することによって、手術中にガイディングカテーテル３００等の医療器具の位置がずれてしまうことを防止できる。そのため、医療従事者がガイディングカテーテル３００およびカテーテルデバイス２００のような医療器具を併用する際の操作性を向上させることができる。 Further, in a state where the catheter device 200 is held by the first holding portion 10 and the guiding catheter 300 is held by the second holding portion 30, the moving portion 20 fixes the second holding portion 30 and holds the first holding portion 10. It is movably connected in the longitudinal direction X. With such a configuration, it is possible to prevent the position of the medical device such as the guiding catheter 300 from being displaced during the operation. Therefore, it is possible to improve the operability when a medical worker uses a medical device such as a guiding catheter 300 and a catheter device 200 in combination.

また、第１保持部１０はカテーテルデバイス２００を保持する一組の第１挟持部材１１と第２挟持部材１２を備えるように構成している。そのため、医療従事者等の使用者が手技の最中にカテーテルデバイス２００を少なくとも一時的に保持せずにすみ、操作性を向上させることができる。 Further, the first holding portion 10 is configured to include a set of the first holding member 11 and the second holding member 12 for holding the catheter device 200. Therefore, the user such as a medical worker does not have to hold the catheter device 200 at least temporarily during the procedure, and the operability can be improved.

また、第１保持部１０は第２挟持部材１２に対して第１挟持部材１１を相対的に移動可能であるとともに着脱可能な部材を備える。当該部材は第２挟持部材１２に対して第１挟持部材１１を回転可能なヒンジ部１３を備えるように構成している。これにより、医療従事者等の使用者が手指によってカテーテルデバイス２００を保持しなくてもカテーテルデバイス２００を保持した状態にすることができる。 Further, the first holding portion 10 includes a member that allows the first holding member 11 to move relative to the second holding member 12 and is removable. The member is configured to include a hinge portion 13 capable of rotating the first holding member 11 with respect to the second holding member 12. As a result, the catheter device 200 can be held by a user such as a medical professional without holding the catheter device 200 by his / her fingers.

また、第２保持部３０の取り付け部３１には、ルアーテーパを設けるように構成している。これにより、専用のアダプタ等を用いなくてもガイディングカテーテル３００のような第２管状部材に一般の医療器具を使用することができる。 Further, the attachment portion 31 of the second holding portion 30 is configured to be provided with a luer taper. As a result, a general medical device can be used for the second tubular member such as the guiding catheter 300 without using a dedicated adapter or the like.

なお、本発明は上述した実施形態にのみ限定されず、特許請求の範囲において種々の変更が可能である。 The present invention is not limited to the above-described embodiment, and various modifications can be made within the scope of the claims.

図６は本発明の第１変形例に係る医療装置１００Ａを示す側面図である。図７は図６の７部分を示す拡大図である。 FIG. 6 is a side view showing the medical device 100A according to the first modification of the present invention. FIG. 7 is an enlarged view showing seven parts of FIG.

上記ではカテーテルデバイス２００を挟持する第１保持部１０の第２挟持部材１２にダイヤル２４を設け、第２挟持部材１２の内部にダイヤル２４によって回転可能なピニオン２２を収容し、ベース２３にはピニオン２２と係合可能なラック２１を設けると説明した。 In the above, the dial 24 is provided in the second holding member 12 of the first holding portion 10 that holds the catheter device 200, the pinion 22 rotatable by the dial 24 is housed inside the second holding member 12, and the pinion 22 is housed in the base 23. It has been described that a rack 21 that can be engaged with 22 is provided.

しかし、第１保持部１０を移動部２０に対して移動できれば、具体的な構成は上記に限定されない。上記以外にも図６、図７の医療装置１００Ａに示すように移動部２０Ａを構成するラック２１Ａを第２挟持部材１２Ａに設ける。移動部２０Ａを構成するベース２３Ａは上記と同様に高さ方向Ｚにおいて第１保持部１０Ａを構成する第２挟持部材１２Ａと隣接して配置する。 However, the specific configuration is not limited to the above as long as the first holding portion 10 can be moved with respect to the moving portion 20. In addition to the above, as shown in the medical devices 100A of FIGS. 6 and 7, a rack 21A constituting the moving portion 20A is provided on the second holding member 12A. The base 23A constituting the moving portion 20A is arranged adjacent to the second holding member 12A constituting the first holding portion 10A in the height direction Z in the same manner as described above.

移動部２０Ａを構成するピニオン２２Ａは、ベース２３Ａに回転可能に収容する。移動部２０Ａを構成するダイヤル２４Ａは、ベース２３Ａの外側面に回転可能に設ける。第１保持部１０Ａを構成する第１挟持部材１１および第２保持部３０等の構成は上記と同様であるため、説明を省略する。 The pinion 22A constituting the moving portion 20A is rotatably housed in the base 23A. The dial 24A constituting the moving portion 20A is rotatably provided on the outer surface of the base 23A. Since the configurations of the first holding member 11 and the second holding portion 30 and the like constituting the first holding portion 10A are the same as described above, the description thereof will be omitted.

このように構成することによって、ダイヤル２４Ａを回転させればピニオン２２Ａが回転し、ピニオン２２Ａと係合するラック２１Ａを設けた第１保持部１０Ａを移動させることができる。これにより、医療従事者等の使用者がカテーテルデバイス２００とガイディングカテーテル３００のような医療器具を併用する際の操作性を向上させることができる。 With this configuration, if the dial 24A is rotated, the pinion 22A is rotated, and the first holding portion 10A provided with the rack 21A that engages with the pinion 22A can be moved. This makes it possible to improve the operability when a user such as a medical worker uses the catheter device 200 and a medical device such as the guiding catheter 300 in combination.

図８、図９、図１０は本発明の第２変形例に係る医療装置１００Ｂを示す図である。上記ではツメ形状１１ａが嵌め込み部１２ａに嵌め込まれることによって第１挟持部材１１と第２挟持部材１２とが接近した状態を維持すると説明した。ただし、第１挟持部材と第２挟持部材とが接近した状態を維持できれば、具体的な形状は図５に限定されない。 8, 9, and 10 are views showing the medical device 100B according to the second modification of the present invention. In the above, it has been described that the first sandwiching member 11 and the second sandwiching member 12 are maintained in close contact with each other by fitting the claw shape 11a into the fitting portion 12a. However, the specific shape is not limited to FIG. 5 as long as the first holding member and the second holding member can be maintained in close proximity to each other.

上記以外にも図１０に示すように医療装置１００Ｂのツメ形状に相当する係合部１１ｂと被係合部１２ｂのように構成することによって第１挟持部材１１Ｂと第２挟持部材１２Ｂとを接近した状態に維持してもよい。ツメ形状１１ａがヒンジ部１３の回転軸に対して径方向の比較的内側を向くように構成していたのに対し、係合部１１ｂはヒンジ部１３Ｂに対して径方向の比較的外側を向くように構成している。 In addition to the above, as shown in FIG. 10, the first sandwiching member 11B and the second sandwiching member 12B are brought closer to each other by configuring the engaging portion 11b and the engaged portion 12b corresponding to the claw shape of the medical device 100B. You may keep it in the same state. The claw shape 11a is configured to face relatively inward in the radial direction with respect to the rotation axis of the hinge portion 13, whereas the engaging portion 11b faces relatively outward in the radial direction with respect to the hinge portion 13B. It is configured as follows.

被係合部１２ｂは、係合部１１ｂがヒンジ部１３Ｂを軸として回転する際の軌跡上に位置し、係合部１１ｂと当接可能に構成している。被係合部１２ｂは、第２挟持部材１２Ｂの内壁面から突出するように構成している。被係合部１２ｂは、ヒンジ部１３Ｂの回転軸に対して径方向の比較的内側を向くように突出している。 The engaged portion 12b is located on a locus when the engaging portion 11b rotates about the hinge portion 13B as an axis, and is configured to be in contact with the engaging portion 11b. The engaged portion 12b is configured to protrude from the inner wall surface of the second holding member 12B. The engaged portion 12b projects so as to face relatively inward in the radial direction with respect to the rotation axis of the hinge portion 13B.

また、移動部２０Ｂは図１０に示すようにレール２６を備え、第１保持部１０Ｂはレール２６に沿うスライダ１５を備える。 Further, the moving portion 20B includes a rail 26 as shown in FIG. 10, and the first holding portion 10B includes a slider 15 along the rail 26.

レール２６は、ベース２３Ｂに長手方向Ｘに沿う溝のような形状を設けることによって構成している。レール２６は、図１０に示すように長手方向Ｘ及び高さ方向Ｚによって形成される面を幅方向Ｙに凹ませた凹形状を対になるように設けて構成している。また、レール２６を設けたベース２３Ｂには使用者の手指によってレール２６に対するスライダ１５の位置を相対的に移動可能なダイヤル２４Ｂを回転可能に設けている。 The rail 26 is configured by providing the base 23B with a groove-like shape along the longitudinal direction X. As shown in FIG. 10, the rail 26 is configured by providing a pair of concave shapes in which the surfaces formed by the longitudinal direction X and the height direction Z are recessed in the width direction Y. Further, the base 23B provided with the rail 26 is provided with a dial 24B rotatably capable of relatively moving the position of the slider 15 with respect to the rail 26 by the finger of the user.

移動部２０Ｂを構成するベース２３Ｂに設置される第１保持部１０Ｂは上述した実施形態と同様に長手方向Ｘに移動する。ベース２３Ｂは、本変形例において医療従事者等の使用者によって持ち運びしやすいようにポータブルに構成している。具体的に言えば、移動部２０は、重量が１ｋｇ以下、長手方向Ｘの長さが３０ｃｍ以下および幅方向Ｙの寸法が３０ｃｍ以下程度に構成できる。 The first holding portion 10B installed on the base 23B constituting the moving portion 20B moves in the longitudinal direction X in the same manner as in the above-described embodiment. The base 23B is configured to be portable so that it can be easily carried by a user such as a medical worker in this modified example. Specifically, the moving portion 20 can be configured such that the weight is 1 kg or less, the length in the longitudinal direction X is 30 cm or less, and the dimension in the width direction Y is about 30 cm or less.

スライダ１５は、長手方向Ｘに延在し、レール２６において対となる凹形状と係合する凸形状を対にして設けるように構成している。スライダ１５は、図１０に示すように第２挟持部材１２Ｂにおいて幅方向Ｙの両側に向かって突出するように構成している。 The slider 15 extends in the longitudinal direction X and is configured to have a pair of convex shapes that engage with a pair of concave shapes on the rail 26. As shown in FIG. 10, the slider 15 is configured to project toward both sides in the width direction Y in the second holding member 12B.

なお、第１保持部１０Ｂのその他の構成は、詳細な形状は異なるが、各構成の機能は上述と同様である。すなわち、第１保持部１０Ｂは、カテーテルデバイス２００を保持する一組の第１挟持部材１１Ｂと第２挟持部材１２Ｂを備える。そのため、詳細な説明を省略する。 The other configurations of the first holding portion 10B differ in detailed shape, but the functions of each configuration are the same as described above. That is, the first holding portion 10B includes a set of the first holding member 11B and the second holding member 12B for holding the catheter device 200. Therefore, detailed description will be omitted.

また、移動部２０Ｂのその他の構成であるラック２１Ｂ、ピニオン２２Ｂ、ベース２３Ｂ、ダイヤル２４Ｂ、目盛り部２５Ｂについても詳細な形状は異なるが、各構成の機能は上述したものと同様である。さらに、保持部３０Ｂを構成する取り付け部３１Ｂおよび設置部３２Ｂについても詳細な形状等は異なるが、各構成の機能は上述したものと同様である。そのため、詳細な説明を省略する。 Further, the rack 21B, the pinion 22B, the base 23B, the dial 24B, and the scale portion 25B, which are other configurations of the moving portion 20B, have different detailed shapes, but the functions of the respective configurations are the same as those described above. Further, although the detailed shapes and the like of the mounting portion 31B and the mounting portion 32B constituting the holding portion 30B are different, the functions of the respective configurations are the same as those described above. Therefore, detailed description will be omitted.

以上のように本変形例では第１保持部１０Ｂがカテーテルデバイス２００を挟持する一組の第１挟持部材１１Ｂと第２挟持部材１２Ｂとを備える。そのため、医療従事者等の使用者が手技の最中にカテーテルデバイス２００を少なくとも一時的に保持せずにすみ、操作性を向上させることができる。 As described above, in the present modification, the first holding portion 10B includes a set of the first holding member 11B and the second holding member 12B for holding the catheter device 200. Therefore, the user such as a medical worker does not have to hold the catheter device 200 at least temporarily during the procedure, and the operability can be improved.

また、移動部２０Ｂはレール２６を備え、第１保持部１０Ｂはレール２６に沿うスライダ１５を備えるように構成している。このように構成することによって第１保持部１０Ｂを安定して移動させることができる。なお、本変形例では第１保持部１０Ｂを移動可能に構成したが、第２保持部を移動させる場合、第２移動部にスライダを設けてもよい。 Further, the moving portion 20B is provided with a rail 26, and the first holding portion 10B is configured to include a slider 15 along the rail 26. With this configuration, the first holding portion 10B can be moved stably. In this modification, the first holding portion 10B is configured to be movable, but when the second holding portion is moved, a slider may be provided in the second moving portion.

また、レール２６を設けたベース２３Ｂには使用者の手指によってレール２６に対するスライダ１５の位置を相対的に移動可能なダイヤル２４Ｂを設けるように構成している。このように構成することによって、第１保持部１０Ｂの位置を使用者の手指によって移動させることができる。 Further, the base 23B provided with the rail 26 is configured to be provided with a dial 24B capable of relatively moving the position of the slider 15 with respect to the rail 26 by the finger of the user. With this configuration, the position of the first holding portion 10B can be moved by the finger of the user.

また、ベース２３Ｂを含む移動部２０Ｂはポータブルであるように構成している。そのため、医療装置１００の持ち運びを容易にすることができる。 Further, the moving portion 20B including the base 23B is configured to be portable. Therefore, the medical device 100 can be easily carried.

このように本変形例においても上記のように構成することによって、ガイディングカテーテルとカテーテルデバイスを併用して医療器具を操作する際の操作性を向上させることができる。 As described above, in this modified example as well, by configuring as described above, it is possible to improve the operability when operating the medical device by using the guiding catheter and the catheter device in combination.

また、上記実施形態では第２保持部３０の取り付け部３１にはガイディングカテーテル３００のハブ等を接続すると説明したが、これに限定されない。上記以外にもガイディングカテーテル３００はＹコネクタ等の医療器具を介して取り付け部３１に取り付ける場合も本発明の一実施形態に含まれる。 Further, in the above embodiment, it has been described that the hub or the like of the guiding catheter 300 is connected to the attachment portion 31 of the second holding portion 30, but the present invention is not limited to this. In addition to the above, the guiding catheter 300 is also included in one embodiment of the present invention when it is attached to the attachment portion 31 via a medical device such as a Y connector.

また、第１保持部１０は上記においてダイヤル２４を用いてピニオン２２を医療従事者の手指によって回転させて移動させると説明したが、これに限定されない。上記以外にも移動部のダイヤルの代わりに例えば移動部２０のベース２３にモータを搭載してピニオンを回転させ、前進、後進、電源オフ等の状態をボタン等で切り替えることによって第１保持部１０の移動を制御するように構成してもよい。 Further, although it has been described above that the first holding unit 10 uses the dial 24 to rotate and move the pinion 22 by the fingers of a medical worker, the present invention is not limited to this. In addition to the above, instead of the dial of the moving part, for example, a motor is mounted on the base 23 of the moving part 20, the pinion is rotated, and the states such as forward, reverse, and power off are switched by a button or the like, so that the first holding part 10 It may be configured to control the movement of.

また、上記では移動部２０が第１保持部１０を段階的に移動可能にすると説明したが、手術中にガイディングカテーテル３００等の医療器具の位置がずれることを防止できれば、これに限定されない。上記以外にも医療装置において第１保持部を固定し、第２保持部を移動部によって段階的に移動可能とする場合も本発明の一実施形態に含まれる。 Further, although it has been described above that the moving portion 20 makes the first holding portion 10 movable in stages, the present invention is not limited to this as long as it is possible to prevent the position of the medical device such as the guiding catheter 300 from being displaced during the operation. In addition to the above, a case where the first holding portion is fixed in the medical device and the second holding portion is made movable stepwise by the moving portion is also included in one embodiment of the present invention.

また、上記では第１保持部の構成として第２挟持部材１２に対して第１挟持部材を相対的に移動可能であって着脱可能な部材がヒンジ部１３であると説明したが、これに限定されない。上記以外にも直進運動する弾性部材によって第１挟持部材と第２挟持部材を着脱可能に接続することによって、第１挟持部材と第２挟持部材とで第１管状部材を保持するように構成してもよい。より具体的に言えば上記弾性部材はバネなどを含み、第１挟持部材と第２挟持部材は各々弾性部材を取り付ける第１係合部と第２係合部を備える。弾性部材に係るバネ等は収縮時に第１係合部と第２係合部とが係合することによって第１保持部が第１管状部材の基端部を保持する場合も本発明の一実施形態に含まれる。 Further, in the above description, as the configuration of the first holding portion, the hinge portion 13 is described as a member in which the first holding member can be moved relative to the second holding member 12 and is detachable, but the present invention is limited to this. Not done. In addition to the above, by detachably connecting the first holding member and the second holding member with an elastic member that moves linearly, the first holding member and the second holding member are configured to hold the first tubular member. You may. More specifically, the elastic member includes a spring or the like, and the first sandwiching member and the second sandwiching member include a first engaging portion and a second engaging portion for attaching the elastic member, respectively. One embodiment of the present invention is also when the first holding portion holds the base end portion of the first tubular member by engaging the first engaging portion and the second engaging portion when the spring or the like related to the elastic member is contracted. Included in the form.

１００、１００Ａ医療装置、
１０、１０Ａ第１保持部、
１１第１挟持部材、
１２、１２Ａ第２挟持部材、
１３ヒンジ部（回転部）、
１４目盛り部、
２０、２０Ａ移動部、
２１ラック、
２２ピニオン、
２３ベース、
２４ダイヤル、
２５目盛り部、
３０第２保持部、
３１取り付け部、
２００カテーテルデバイス（第１管状部材）、
３００ガイディングカテーテル（第２管状部材）、
Ｘ長手方向。
100, 100A medical device,
10, 10A 1st holding part,
11 First holding member,
12, 12A 2nd holding member,
13 Hinge part (rotating part),
14 scales,
20, 20A moving part,
21 racks,
22 pinion,
23 base,
24 dials,
25 scales,
30 Second holding part,
31 Mounting part,
200 Catheter device (first tubular member),
300 Guiding Catheter (2nd Tubular Member),
X Longitudinal direction.

Claims

A medical device for using a long first tubular member that can be inserted into a living lumen and a second tubular member into which the first tubular member can be inserted.
A first holding portion that holds the base end portion of the first tubular member,
On the tip end side of the first holding portion, a second holding portion that holds the base end portion of the second tubular member, and
A medical device including a moving portion in which either the first holding portion or the second holding portion is fixed and one is movably connected in the longitudinal direction.

The medical device according to claim 1, wherein the moving portion can move either the first holding portion or the second holding portion in a stepwise manner.

The medical device according to claim 2, wherein the moving portion includes a rack and a pinion that engages with the rack.

The medical device according to claim 3, wherein the moving unit further includes a dial capable of rotating the pinion and relatively moving the position of the pinion with respect to the rack by a user's finger.

The medical device according to any one of claims 1 to 4, wherein the first holding portion and the moving portion are provided with a scale portion indicating the positional relationship of the first holding portion with respect to the moving portion.

In a state where the first tubular member is held by the first holding portion and the second tubular member is held by the second holding portion, the moving portion is fixed to the second holding portion, and the second holding portion is fixed. 1 The medical device according to claim 1, wherein the holding unit is movably connected.

The medical device according to claim 1, wherein the first holding portion includes a set of a first holding member and a second holding member for holding the first tubular member.

The medical device according to claim 7, wherein the first holding portion further includes a member in which the first holding member is relatively movable and detachable with respect to the second holding member.

The medical device according to claim 8, wherein the member includes a rotating portion capable of rotating the first holding member with respect to the second holding member.

The moving part is provided with rails.
The medical device according to claim 1, wherein the first holding portion or the second holding portion includes a slider along the rail.

The medical device according to claim 10, further comprising a dial provided on the rail or the slider and capable of relatively moving the position with respect to the rail or the slider by a user's finger.

The medical device according to any one of claims 1 to 11, wherein the moving unit is portable.