JP6504424B1 - Medical devices and systems - Google Patents

Abstract

In the medical device, a first sheath, a bendable bending portion, and a second sheath are connected from the distal end side, and the first sheath and the second sheath are long members having higher rigidity than the bending portion. A medical device which is used by being inserted into a longitudinally penetrating insertion hole of a sheath, wherein the treatment unit, the first transmission unit, the bendable treatment instrument bending unit, the second transmission unit, and the third transmission A transmission member, which is a long member connected to each other, and a stopper that prevents the third transmission portion from being inserted into the sheath when the treatment portion is inserted into the insertion hole at the beginning. The first transmission portion and the second transmission portion are higher in rigidity than the treatment instrument bending portion, and at least one of the two conditions of the first condition and the second condition is satisfied.

Description

  The present invention relates to a medical device and a medical system provided with the medical device. Priority is claimed on Japanese Patent Application No. 2017-252603, filed Dec. 27, 2017, the content of which is incorporated herein by reference.

  Conventionally, a medical treatment that includes a medical device such as an endoscope or treatment tool that performs observation and treatment in a body cavity or a lumen, for example, the deep region of the large intestine or small intestine, and a guide sheath that assists the insertion of the medical device into the body The system is known.

  For example, in a treatment tool, a transmission member such as an operation wire is attached to a treatment mechanism such as a gripping mechanism or a high frequency knife provided at the tip of the treatment tool, and the operator operates the transmission member from the proximal end Operate the treatment section of In order to insert the treatment tool according to the shape of the body cavity or lumen, the transmission member of the treatment tool needs to be bendable, but it is also necessary to be able to responsively transmit operations such as rotation and back and forth by the operator. . Therefore, as for the transmission member of a treatment tool, it is desirable to be constituted combining a bendable curved part and a rigid transmission part.

  In Patent Document 1, a treatment tool for an endoscope, in which the transmission member is configured by combining a three-layer coil sheath (curved portion) with good curvature and a nine-row coil sheath (transmission portion) with good movement response, Have been described. The endoscope treatment tool described in Patent Document 1 is capable of operating the treatment portion with good response while curving the transmission member in accordance with the shapes of the body cavity and the lumen.

Japan JP 2009-240761

  However, the endoscope treatment tool described in Patent Document 1 is not particularly defined regarding the dimensional relationship with the flexible channel (guide sheath) into which the endoscope treatment tool is inserted. Therefore, the endoscope treatment tool described in Patent Document 1 does not exhibit the above effects even when inserted into any guide sheath.

  For example, when the bending portion of the transmission member of the endoscopic treatment tool is disposed at a position not overlapping the bendable region of the guide sheath, the transmission member of the endoscopic treatment tool can not be curved in the first place.

  Based on the above circumstances, the present invention is a medical system that includes a medical device that can be curved according to the dimensions of the guide sheath to be inserted and can be operated with good response, and the same medical device and the guide sheath. And aims to provide.

In order to solve the above-mentioned subject, this invention proposes the following means.
In the medical device according to the first aspect of the present invention, the first sheath, the bendable bending portion, and the second sheath are sequentially connected in the longitudinal direction from the distal end side, and the first sheath and the second sheath A medical device which is inserted into a longitudinally penetrating insertion hole of a sheath which is a long member having a rigidity higher than that of the curved portion and which has a treatment portion and a distal end attached to the treatment portion A transmission member, which is an elongated member in which one transmission portion, a bendable treatment instrument bending portion, a second transmission portion, and a third transmission portion are sequentially connected in the longitudinal direction, and the treatment portion at the top And a stopper for preventing the third transmission portion from being inserted into the sheath when inserted into the insertion hole, wherein the first transmission portion and the second transmission portion are the treatment instrument bending portion. The rigidity is higher, and the length of the second transmission portion in the longitudinal direction is equal to that of the curved portion and the second portion. First condition shorter than the sum of the longitudinal lengths of the first transmission portion and the longitudinal length of the first transmission portion than the sum of the longitudinal lengths of the first sheath and the curved portion At least one of the two conditions of the short second condition is satisfied.

  According to a second aspect of the present invention, in the medical device according to the first aspect, both the first condition and the second condition may be satisfied.

  According to a third aspect of the present invention, in the medical device according to the first aspect, the sum of the longitudinal lengths of the curved portion and the second transmission portion is greater than the longitudinal length of the sheath. It may be short.

  According to a fourth aspect of the present invention, in the medical device according to the first aspect, the sum of the longitudinal lengths of the first transmission portion and the second transmission portion is greater than the longitudinal length of the sheath. It may also be short.

  According to a fifth aspect of the present invention, in the medical device according to the first aspect, the first transmission portion and the second transmission portion are formed of a metal rod having no flexibility. Good.

  In the medical system according to the sixth aspect of the present invention, the first sheath, the bendable bending portion, and the second sheath are sequentially connected in the longitudinal direction from the distal end side, and the first sheath and the second sheath Is a long member having higher rigidity than the curved portion, and is a medical system including a sheath having an insertion hole penetrating in the longitudinal direction, and a medical device inserted and used in the insertion hole of the sheath, The medical device includes a treatment unit, a first transmission unit having a tip attached to the treatment unit, a bendable treatment instrument bending unit, a second transmission unit, and a third transmission unit in a longitudinal direction. A transmission member, which is an elongated member connected in order, and a stopper for preventing the third transmission portion from being inserted into the sheath when the medical device is inserted into the insertion hole with the treatment portion at the top And the first transmission unit and the second transmission unit A first condition having a rigidity higher than that of the treatment instrument curved portion, and a length in a longitudinal direction of the second transmission portion being shorter than a sum of lengths in a longitudinal direction of the curved portion and the second sheath; The longitudinal length of one transmission portion satisfies at least one of the two conditions of the second condition, which is shorter than the sum of the longitudinal lengths of the first sheath and the curved portion.

  According to a seventh aspect of the present invention, in the medical device according to the sixth aspect, both of the first condition and the second condition may be satisfied.

  According to an eighth aspect of the present invention, in the medical device according to the sixth aspect, the sum of the longitudinal lengths of the curved portion and the second transmission portion is greater than the longitudinal length of the sheath. It may be short.

  According to a ninth aspect of the present invention, in the medical device according to the sixth aspect, the sum of the longitudinal lengths of the first transmission portion and the second transmission portion is greater than the longitudinal length of the sheath. It may also be short.

  According to a tenth aspect of the present invention, in the medical device according to the sixth aspect, the first transmission portion and the second transmission portion are formed of a metal rod having no flexibility. Good.

  According to the present invention, a medical device which can be curved according to the dimensions of the guide sheath to be inserted and which can be operated with good response, and a medical system provided with the medical device and the guide sheath Can be provided.

BRIEF DESCRIPTION OF THE DRAWINGS It is a figure which shows the whole structure of the medical treatment system which concerns on 1st embodiment. It is sectional drawing of the treatment tool arrange | positioned in the largest protrusion position in the medical system. It is sectional drawing of the treatment tool arrange | positioned in the minimum protrusion position in the medical system. It is sectional drawing of the treatment tool which is curving at the bending point in the medical system. It is sectional drawing of the modification of the treatment tool of the medical system. It is sectional drawing of the treatment tool arrange | positioned in the largest protrusion position in the medical system which concerns on 2nd embodiment. It is sectional drawing of the treatment tool of the medical system which concerns on 3rd embodiment.

First Embodiment
A first embodiment of the present invention will be described with reference to FIGS. 1 and 5.
FIG. 1 is a diagram showing an entire configuration of a medical system 100 according to the present embodiment.
The medical system 100 is provided with the guide sheath 1 and the treatment tool 2 as shown in FIG.

As shown in FIG. 1, the guide sheath (sheath) 1 has a first sheath 11, a flexible bending portion 12 and a second sheath 13 sequentially connected in the longitudinal direction from the distal end side, It is a long member.
Here, as shown in FIG. 1, the lengths in the longitudinal direction of the first sheath 11, the bending portion 12 and the second sheath 13 are defined as “m”, “n” and “p”, respectively. Further, the length in the longitudinal direction of the entire guide sheath 1 including the first sheath 11, the bending portion 12 and the second sheath 13 is defined as “F”.

  As shown in FIG. 1, the guide sheath 1 includes a lumen (insertion hole) 1 a which penetrates the entire guide sheath 1 in the longitudinal direction. The lumen 1 a communicates with the external space from the distal end opening 11 a provided at the distal end of the first sheath 11 and the proximal end opening 13 a provided at the proximal end of the second sheath 13. The lumen 1a has an inner diameter dimension through which a part of the treatment instrument 2 can be inserted. The operator can insert the distal end of the treatment tool 2 from the proximal end opening 13a and project it from the distal end opening 11a.

  In addition, the guide sheath 1 is provided with an endoscope lumen (not shown) which penetrates the entire guide sheath 1 in the longitudinal direction. The endoscope lumen communicates with the external space at the distal end and the proximal end of the guide sheath 1 as with the lumen 1a. The endoscope lumen has an inside diameter that allows a part of the endoscope to pass through. The operator can insert the distal end of the endoscope from the proximal end side of the endoscope lumen and project it from the distal end of the guide sheath 1.

The curved portion 12 is a member having flexibility, and may be entirely or partially formed of a flexible material. In addition, the curved portion 12 may be formed in a tubular shape having a plurality of slits. The slits are formed in a radial direction perpendicular to the longitudinal direction of the curved portion 12 or in an oblique direction, and the curved portion 12 can be curved in the direction in which the slits are formed by changing the distance between the slits. By forming the plurality of slits, the bending angle of the bending portion 12 can be increased. Further, by forming the plurality of slits in different directions in the radial direction, it is possible to increase the direction in which the bending portion 12 can bend.
The bending portion 12 may be formed by combining bending pieces formed of a material having high rigidity, and may be formed by connecting adjacent bending pieces so as to be relatively movable. That is, the bending part 12 should just have flexibility as a whole.

The first sheath 11 and the second sheath 13 have higher rigidity than the bending portion 12, and are formed of, for example, a plastic material. Here, "the rigidity is higher than the bending portion 12" indicates that the rigidity of the first sheath 11 and the second sheath 13 is higher than the entire rigidity of the bending portion 12. For example, in the case where the bending portion 12 is formed by connecting bending pieces having high rigidity and the first sheath 11 and the second sheath 13 are formed of a plastic material, the bending portion 12 is more Although the rigidity is high, the rigidity of the first sheath 11 and the second sheath 13 is higher because the curved portion 12 can be curved as compared with the whole as a whole.
The first sheath 11 and the second sheath 13 may be made of a flexible material as long as the rigidity is higher than that of the bending portion 12.

  Since the entire guide sheath 1 is not composed only of the bending part 12 but is composed of the bending part 12, the first sheath 11 with high rigidity, and the second sheath 13 in combination, the operator can When the sheath 1 is inserted into the inside of a body cavity or a lumen, it is possible to perform an operation such as advancing and retreating with good response while curving the guide sheath 1.

When the endoscope inserted into the endoscope lumen has an active bending portion that actively bends, the bending portion 12 of the guide sheath 1 follows the bending operation of the active bending portion of the endoscope. To bend.
In addition, the guide sheath 1 may have a guide wire whose tip is attached to the first sheath 11 and which passes through the inside of the guide sheath 1. In this case, the operator can bend the bending portion 12 of the guide sheath 1 by operating the guide wire from the proximal side.

  The treatment tool (medical device) 2 is provided with the treatment part 3 which performs treatment, the transmission member 4, the stopper 5, the protection member 6, and the operation part 7 as shown in FIG.

  The treatment unit 3 is a grasping mechanism, and is used for treatment of an affected area of a living body to be treated inside a body cavity or a lumen. The treatment unit 3 may be a high frequency knife or the like.

  As shown in FIG. 1, the transmission member 4 is an elongated member having a distal end attached to the treatment unit 3 and a proximal end attached to the operation unit 7, and the operator operates the operation unit 7 by the treatment unit 3. To communicate. The operator operates the operation unit 7 to move the transmission member 4 so that the treatment unit 3 can be rotated or advanced and retracted.

As shown in FIG. 1, the transmission member 4 has a first transmission portion 41 having a distal end attached to the treatment portion 3, a bendable bending portion 42, a second transmission portion 43, and a third transmission portion 44. Are sequentially connected in the longitudinal direction.
Here, as shown in FIG. 1, the lengths in the longitudinal direction of the first transmission portion 41, the bending portion 42 and the second transmission portion 43 are defined as "b", "c" and "d", respectively. .

  The bending portion (treatment tool bending portion) 42 is a bendable member, desirably as rigid as possible, and is made of, for example, a metal wire.

The first transmission portion 41, the second transmission portion 43, and the third transmission portion 44 are members having a rigidity higher than that of the bending portion 42. For example, flexibility that can not be easily bent can be obtained. It is an elongated metal rod not having.
The first transmission portion 41, the second transmission portion 43, and the third transmission portion 44 may be made of a flexible material as long as the rigidity is higher than that of the curved portion 42.

  The whole of the transmission member 4 is not constituted only by the bending portion 42, but is constituted by combining the bending portion 42, the first transmission portion 41 with high rigidity, the second transmission portion 43 and the third transmission portion 44. Therefore, when the operator inserts the transmission member 4 into the lumen 1a, the operator can perform an operation such as advancing and retreating with good response while curving the transmission member 4.

  When the treatment instrument 2 is inserted into the lumen 1a from the proximal end opening 13a with the treatment section 3 at the top, the stopper 5 treats the treatment section 3, the first transmission portion 41, the bending portion 42, and the second transmission portion 43. Is inserted into the lumen 1a, but the third transmission part 44 is a member that restricts insertion into the lumen 1a. That is, the stopper 5 is a member which limits the length which can be inserted into the guide sheath 1 of the treatment tool 2. In the present embodiment, the stopper 5 is a convex member provided on the proximal end side of the treatment tool 2, and the third transmission portion 44 has the lumen 1 a when the stopper 5 engages with the proximal end opening 13 a. Restrict being inserted into

  In addition, although the 2nd transmission part 43 and the 3rd transmission part 44 are described as another member for convenience depending on whether insertion to the inside of lumen 1a is restricted by stopper 5, the 2nd transmission part 43 The third transmission unit 44 may be configured by a single member.

  The protective member 6 is a flexible member covering the entire periphery of the transmission member 4 and is made of, for example, a rubber-based material. Covering the transmission member 4 with the protection member 6 can prevent the wear caused by the transmission member 4 advancing and retracting the inside of the lumen 1 a.

The operation unit 7 is a member for operating the treatment unit 3. The operation unit 7 has a handle, and the operator moves the transmission member 4 by moving the handle relative to the other portion of the operation unit 7 to operate the treatment unit 3 (for example, open / close operation). Can.
The operator can advance and retract the transmission member 4 and the treatment portion 3 along the longitudinal direction of the transmission member 4 by advancing and retracting the entire operation unit 7. Further, the operator rotates the entire operation unit 7 around the longitudinal axis of the transmission member 4 to rotate the transmission member 4 and the treatment unit 3 around the longitudinal axis of the transmission member 4. be able to. The operator can rotate the operation unit 7 so that the treatment unit 3 is oriented in an appropriate direction for treatment.

In FIG. 2, the treatment instrument 2 is inserted into the lumen 1 a to a position where the insertion is blocked by the stopper 5, that is, to a position where the treatment portion 3 protrudes most from the lumen 1 a (hereinafter referred to as “maximum projection position”). It is sectional drawing of the treatment tool 2 in case.
As shown in FIG. 2, the length d in the longitudinal direction of the second transmission portion 43 is shorter than the sum (n + p) of the lengths in the longitudinal direction of the curved portion 12 of the guide sheath 1 and the second sheath 13 1). This condition is hereinafter referred to as the "first condition".

  When the treatment tool 2 satisfies the first condition, as shown in FIG. 2, when the treatment tool 2 is disposed at the maximum projecting position, at least a part of the curved portion 42 of the transmission member 4 is the guide sheath 1 It is disposed at a position where it overlaps with the curved portion 12 in the longitudinal direction. Here, a place where the curved portion 12 of the guide sheath 1 and the curved portion 42 of the transmission member 4 overlap is defined as a “bending point B”.

FIG. 3 is a cross-sectional view of the treatment tool 2 disposed at a position where the projection length from the lumen 1 a of the treatment section 3 is the shortest (hereinafter referred to as “minimum projection position”).
As shown in FIG. 3, the length b in the longitudinal direction of the first transmission portion 41 is shorter than the sum (m + n) of the lengths in the longitudinal direction of the first sheath 11 and the curved portion 12 of the guide sheath 1 2). This condition is hereinafter referred to as the "second condition".

  When the treatment tool 2 satisfies the second condition, as shown in FIG. 3, when the treatment tool 2 is disposed at the minimum projecting position, at least a part of the curved portion 42 of the transmission member 4 is the guide sheath 1 There is a bending point B that overlaps the bending portion 12 in the longitudinal direction.

FIG. 4 is a cross-sectional view of the treatment tool 2 curved at a bending point B.
When the treatment tool 2 satisfies the first condition and the second condition simultaneously, the range from the minimum protrusion position to the maximum protrusion position of the treatment tool 2, that is, the movable range in the case of performing the treatment (hereinafter referred to as "effective movable range" In the case where the treatment tool 2 is moved to any position, the bending point B is always present. Therefore, when the treatment tool 2 is in the effective movable range, the medical system 100 can always be curved. If the first condition and the second condition are not satisfied, a state in which there is no bending point B occurs, and in that state, it is difficult to bend the treatment instrument 2 and the guide sheath 1 together.

  According to the treatment tool 2 and the medical system 100 according to the present embodiment, it can be curved according to the bendable region (curved portion 12) of the guide sheath 1 to be inserted, and can be operated with good response.

The first embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like within the scope of the present invention are also included. . In addition, the components shown in the above-described first embodiment and the modifications described below can be combined appropriately.
(Modification 1)
For example, in the above embodiment, the treatment device 2 satisfies the first condition and the second condition, but the aspect of the treatment device is not limited thereto. The treatment tool may be configured to satisfy at least one of the two conditions of the first condition and the second condition. The more conditions that are satisfied, the more easily the treatment tool is bent and responsive to the dimensions of the guide sheath to be inserted.

(Modification 2)
For example, although the stopper 5 is a convex member provided on the proximal end side of the treatment tool 2 in the above embodiment, the aspect of the stopper is not limited to this. The stopper may be any one as long as it prevents the third transmission part 44 from being inserted into the lumen 1 a when the treatment tool 2 is inserted into the lumen 1 a with the treatment part 3 at the top. The stopper may be, for example, a convex member provided on the distal end side of the treatment tool 2 and engaged with the distal end opening 11 a.

(Modification 3)
For example, in the above-mentioned embodiment, although the 3rd transmission part 44 of treatment implement 2 was restricted so that it might not be inserted in lumen 1a by stopper 5, the mode of treatment implement 2 is not limited to this. FIG. 5 is a cross-sectional view of a treatment tool 2A which is a modification of the treatment tool 2. The treatment tool 2A is provided with the treatment part 3, the transmission member 4A, the protection member 6, and the operation part 7A, as shown in FIG. The transmission member 4A is configured of a first transmission portion 41, a bendable bending portion 42, and a second transmission member 43. The operation unit 7A may play the role of the third transmission member and the stopper. Specifically, the operation unit 7A has a diameter such that the tip end to which the second transmission member 43 is attached is not inserted into the lumen 1a. Therefore, the operation unit 7A exhibits the same function as the stopper 5 of the above embodiment.

Second Embodiment
A second embodiment of the present invention will be described with reference to FIG. In the following description, the same reference numerals are assigned to components common to those described above, and redundant description will be omitted.
A medical system 100B according to the present embodiment includes a guide sheath 1 and a treatment tool 2B.

FIG. 6 is a cross-sectional view of the treatment tool 2B disposed at the maximum projecting position.
The treatment tool (medical device) 2B, as shown in FIG. 6, includes a treatment unit 3 for performing treatment, a transmission member 4B, a stopper 5, a protection member 6, and an operation unit 7.
The transmission member 4B has the same configuration as the transmission member 4 of the treatment tool 2 according to the first embodiment, and satisfies the first condition and the second condition. The transmission member 4B differs from the transmission member 4 of the first embodiment only in that the bending portion 42 and the second transmission portion 43 satisfy the condition (third condition) described later.

Here, as shown in FIG. 6, the projection length (maximum projection length) from the lumen 1a of the transmission member 4B when the treatment tool 2B is disposed at the maximum projection position is defined as "K".
As shown in FIG. 6, the length b of the first transmission portion 41 is longer than the maximum projection length K (Equation 3). Therefore, even when the treatment tool 2B is disposed at the maximum projecting position, at least a portion of the first transmission portion 41 is located inside the lumen 1a. As a result, the curved portion 42 does not protrude from the lumen 1a.

そのため、式３は式４を用いて、以下のように書き換えることができる（式５）。

Here, the maximum protrusion length K is obtained by subtracting the length F in the longitudinal direction of the entire guide sheath 1 from the sum of the lengths of the first transmission portion 41, the bending portion 42, and the second transmission portion 43 (equation 4).

Therefore, Equation 3 can be rewritten as follows using Equation 4 (Equation 5).

That is, if the sum (c + d) of the lengths in the longitudinal direction of the bending portion 42 and the second transmission portion 43 is shorter than the length F in the longitudinal direction of the guide sheath 1, the bending portion 42 does not protrude from the lumen 1a . This condition is hereinafter referred to as the "third condition".
When the treatment tool 2B satisfies the third condition, the first transmission portion 41 and the treatment portion 3 are at positions unintended by the operator by bending a part of the bending portion 42 protruding from the distal end opening 11a of the lumen 1a. It can prevent moving.

  According to the treatment tool 2B and the medical system 100B of the present embodiment, the transmission member 4B combines the bending portion 42, the first transmission portion 41 with high rigidity, the second transmission portion 43, and the third transmission portion 44. Since the operator is configured, when inserting the transmission member 4B into the lumen 1a, the operator can perform operations such as advancing and retreating with good response while curving the transmission member 4B. In addition, even when the treatment tool 2B is disposed at the maximum projecting position, the bending portion 42 does not protrude from the lumen 1a, and the treatment portion 3 can be easily disposed at the position intended by the operator. is there.

  The second embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like within the scope of the present invention are also included. . Moreover, it is possible to combine and comprise the component shown in the above-mentioned 2nd embodiment and modification suitably.

(Modification 4)
For example, in the above embodiment, the transmission member 4B includes the first transmission portion 41, the bending portion 42, the second transmission portion 43, and the third transmission portion 44, but the configuration of the transmission member is not limited to this. The transmission member may be configured by the first transmission portion 41 and the bending portion 42. In this case, since “d” in the third condition “c + d <F” is zero, the third condition is “c <F”. If this condition is satisfied, the bending portion 42 does not protrude from the lumen 1a, and the treatment portion 3 can be easily disposed at the position intended by the operator.

(Modification 5)
For example, in the above embodiment, the third condition is applied to the treatment device 2B, but the application of the third condition is not limited to the treatment device 2B. The third condition can also be applied to other medical devices having a curved portion inserted into the guide sheath 1, and can also be applied to, for example, an endoscope.

(Modification 6)
For example, in the above embodiment, the treatment tool 2B satisfies all of the first condition, the second condition, and the third condition, but the aspect of the treatment device is not limited thereto. The treatment tool may be configured to satisfy the condition of any combination selected from the first condition, the second condition and the third condition. The more conditions that are satisfied, the more easily the treatment tool is bent and responsive to the dimensions of the guide sheath to be inserted.

Third Embodiment
A third embodiment of the present invention will be described with reference to FIG. The medical system of the third embodiment is different from the other embodiments in that two treatment tools are inserted into the guide sheath. In the following description, the same reference numerals are assigned to components common to those described above, and redundant description will be omitted.

FIG. 7 is a cross-sectional view of a medical system 100C according to the present embodiment.
The medical system 100C, as shown in FIG. 7, includes a guide sheath 1C and two treatment instruments 2C.

  As shown in FIG. 7, the guide sheath 1C includes two lumens 1a as compared with the guide sheath 1 of the first embodiment, and is different in that two treatment instruments 2C can be inserted. The two lumens 1a are arranged in parallel relationship.

  As shown in FIG. 7, the treatment tool (medical device) 2C includes a treatment unit 3 that performs treatment, a transmission member 4C, a stopper 5, a protection member 6, and an operation unit 7.

The transmission member 4C has the same configuration as the transmission member 4B of the treatment tool 2B according to the second embodiment, and satisfies the first condition, the second condition, and the third condition. The transmission member 4C is different from the transmission member 4B of the second embodiment only in that the first transmission portion 41 and the second transmission portion 43 satisfy the following conditions.
As shown in FIG. 7, the sum (b + d) of the lengths in the longitudinal direction of the first transmission portion 41 and the second transmission portion 43 is shorter than the length F in the longitudinal direction of the guide sheath 1C (equation 6). This condition is hereinafter referred to as the "fourth condition".

In FIG. 7, the treatment tool 2C located at the top is disposed at the minimum projection position, and the treatment instrument 2C located at the bottom is disposed at the maximum projection position.
Since the treatment tool 2C satisfies the first condition and the second condition, the bending point B always exists when the treatment tool 2C is in the effective movable range, as in the treatment tool 2B of the second embodiment.

Further, as shown in FIG. 7, since the treatment instrument 2C disposed at the minimum projecting position and the treatment instrument 2C disposed at the maximum projecting position satisfy the fourth condition, at least each of the curved portions 42 Some overlap in the longitudinal direction.
That is, when the treatment tool 2C satisfies the fourth condition in addition to the first condition and the second condition, the two treatment tools 2C may be moved to any position in the effective movable range. There is always a position where the bending point B of the treatment instrument 2C overlaps in the longitudinal direction. Therefore, when the two treatment tools 2C are in the effective movable range, the medical system 100C can always be curved.

  According to the treatment tool 2C and the medical system 100C according to the present embodiment, even in the case where two treatment tools 2C are inserted into the guide sheath 1C, in the bendable region (curved portion 12) of the guide sheath 1C to be inserted In addition, it can be curved and can be operated with good response.

  The third embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like within the scope of the present invention are also included. . Moreover, it is possible to combine and comprise the component shown in the above-mentioned 3rd embodiment and the modification suitably.

(Modification 7)
For example, although two treatment tools 2C can be inserted into the guide sheath 1C in the above embodiment, the aspect of the guide sheath is not limited to this. The guide sheath may be one into which three or more treatment instruments can be inserted. When the treatment instrument satisfies the fourth condition in addition to the first condition and the second condition, even when the three or more treatment instruments are inserted into the guide sheath 1, when the treatment instrument is in the effective movable range, The medical system 100C can always be curved.

(Modification 8)
For example, in the above embodiment, the treatment instrument 2C satisfies all of the first condition, the second condition, the third condition, and the fourth condition, but the aspect of the treatment instrument is not limited thereto. The treatment tool may be configured to meet the conditions of any combination selected from the first condition, the second condition, the third condition and the fourth condition. The more conditions that are satisfied, the more easily the treatment tool is bent and responsive to the dimensions of the guide sheath to be inserted.

  The present invention can be applied to a medical treatment tool, an endoscope, and a medical system provided with them.

100, 100 B, 100 C Medical system 1, 1 C Guide sheath (sheath)
1a lumen (insertion hole)
11 first sheath 11a distal end opening 12 curved portion 13 second sheath 13a proximal end opening 2, 2B, 2C treatment tool (medical device)
3 treatment part 4, 4B, 4C transmission member 41 first transmission part 42 curved part (treatment tool curved part)
43 second transmission unit 44 third transmission unit 5 stopper 6 protection member 7 operation unit

Claims (10)

The first sheath, the bendable bending portion, and the second sheath are sequentially connected in the longitudinal direction from the distal end side, and the first sheath and the second sheath are long members having higher rigidity than the bending portion. A medical device which is used by being inserted into a longitudinally penetrating insertion hole of a certain sheath,
Treatment department,
It is an elongated member in which a first transmission unit whose tip is attached to the treatment unit, a bendable treatment instrument bending unit, a second transmission unit, and a third transmission unit are sequentially connected in the longitudinal direction. A transmission member,
And a stopper that prevents the third transmission portion from being inserted into the sheath when the treatment portion is inserted into the insertion hole at the beginning.
The first transmission portion and the second transmission portion are higher in rigidity than the treatment instrument curved portion,
A first condition under which the longitudinal length of the second transmission portion is shorter than the sum of the longitudinal lengths of the curved portion and the second sheath;
The longitudinal length of the first transmission portion satisfies at least one of two conditions of a second condition, which is shorter than the sum of the longitudinal lengths of the first sheath and the curved portion.
Medical equipment. Satisfying both the first condition and the second condition,
The medical device according to claim 1. The sum of the longitudinal lengths of the curved portion and the second transmission portion is shorter than the longitudinal length of the sheath,
The medical device according to claim 1. The sum of the longitudinal lengths of the first transmission portion and the second transmission portion is shorter than the longitudinal length of the sheath,
The medical device according to claim 1. The first transmission portion and the second transmission portion are formed of a non-flexible metal rod,
The medical device according to claim 1. The first sheath, the bendable bending portion, and the second sheath are sequentially connected in the longitudinal direction from the distal end side, and the first sheath and the second sheath are long members having higher rigidity than the bending portion. A sheath having a through hole extending in the longitudinal direction;
And a medical device inserted and used in the insertion hole of the sheath.
The medical device is
Treatment department,
It is an elongated member in which a first transmission unit whose tip is attached to the treatment unit, a bendable treatment instrument bending unit, a second transmission unit, and a third transmission unit are sequentially connected in the longitudinal direction. A transmission member,
And a stopper that prevents the third transmission portion from being inserted into the sheath when the medical device is inserted into the insertion hole with the treatment portion at the top.
The first transmission portion and the second transmission portion are higher in rigidity than the treatment instrument curved portion,
A first condition under which the longitudinal length of the second transmission portion is shorter than the sum of the longitudinal lengths of the curved portion and the second sheath;
The longitudinal length of the first transmission portion satisfies at least one of two conditions of a second condition, which is shorter than the sum of the longitudinal lengths of the first sheath and the curved portion.
Medical system. Satisfying both the first condition and the second condition,
The medical system according to claim 6. The sum of the longitudinal lengths of the curved portion and the second transmission portion is shorter than the longitudinal length of the sheath,
The medical system according to claim 6. The sum of the longitudinal lengths of the first transmission portion and the second transmission portion is shorter than the longitudinal length of the sheath,
The medical system according to claim 6. The first transmission portion and the second transmission portion are formed of a non-flexible metal rod,
The medical system according to claim 6.

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