JPH0928665A - Catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make the diameter smaller by minimizing the number of lumina required in an expander-installed catheter tube main body with its end bendable by operating a wire. SOLUTION: A catheter of this design comprises a tube main body 2, a tight-wrapped coil installed immovable along the axis of a lumen 24 to occupy the lumen 24 but not a bendable section 25 in the tube main body 2, a traction wire 4 with an end fixed immovable to the end of the tube main body 2, and an expander capable of expansion and contraction installed on the outer circumference of the tube main body 2. The lumen 24 accommodating the tight wrapped coil and the traction wire 4 does not open to the end of the tube main body 2 but to the inside of the expander.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a catheter, particularly a flexible endoscope, which is used by inserting it into a body cavity such as heart, blood vessel, digestive tract, urethra, abdominal cavity, etc. for observing the insertion site and performing medical treatment. Constituting catheter.

[0002]

2. Description of the Related Art In a catheter used by being inserted into a body cavity, in order to orient the tip of the catheter in the direction of the target site or to position it at the target site,
A catheter having a bending mechanism (pivoting mechanism) for bending the distal end portion by remote control has been developed. Especially,
In the catheter that constitutes the endoscope, the bending mechanism of the distal end portion is one of the important mechanisms for selecting the field of view of the observation site.

Conventionally, such an endoscope is provided with a four-wire structure in which a bent portion in which a plurality of node rings are rotatably connected in sequence is provided at the tip portion, and the tip is fixed to each of the bent portions. Among them, a wire having a structure in which the bending portion is bent in four directions of up, down, left, and right by pulling a desired wire from the operation portion on the proximal end side has been used. Along with the advance in diameter, a tip bending mechanism that does not use node rings has been developed.

As one example thereof, a plurality of lumens are formed along the longitudinal direction of a tube body composed of a non-bent portion provided with a certain degree of rigidity (or anti-shrinkage) and a bent portion located on the tip side thereof. There is a catheter having a structure in which a pulling wire is installed in the lumen of the prepared multi-lumen catheter. Due to the relationship between the diameter of the catheter and the arrangement of lumens, the tube body of such a multi-lumen catheter is a 4-lumen tube, one is a lumen for housing a fiberscope, and one is a fluid injection into a body cavity or the like. A lumen for a working channel used for suctioning fluid from the body cavity and inserting various medical treatment instruments,
The other two are bending operation lumens with traction wires installed, and by arranging these bending operation lumens at symmetrical positions via the central axis of the tube body, it is possible to develop a symmetrical bidirectional bending mechanism. Target.

In a catheter having such a tip bending mechanism, it may be necessary to install an expander near the tip of the catheter for the purpose of blocking the flow of blood flow or bile. In this case, a lumen for injecting and discharging the fluid into and from the expandable body is required. A method for adding a lumen for expanding the expandable body to the above-mentioned 4 lumen tube to form 5 lumens and a bending operation lumen are provided. One method is to use a 4-lumen tube.

[0006]

However, if a lumen for expanding the expandable body is added to make 5 lumens, the outer diameter of the catheter becomes large, and the bending operation lumen cannot be installed at symmetrical positions. There is a problem that it is impossible to bend in two symmetrical directions. Further, if there is one bending operation lumen as the four lumens, the bending direction of the distal end portion of the catheter is limited to one direction. In either case, it is necessary to rotate the catheter excessively so that the bent distal end portion faces the desired direction, and there is a problem that the operability of the catheter deteriorates.

The present invention has been made in view of the above problems, and provides a small-diameter catheter having a distal end bending mechanism, in which an expandable body can be installed without increasing the outer diameter of the catheter. The purpose is to

[0008]

Such an object is achieved by the present invention described in (1) to (9) below.

(1) A flexible tube body having a distal end portion that is bent by a wire operation and an intermediate portion that is formed on the proximal end side of the distal end portion and that is not substantially curved by a wire operation, and the tube. A lumen for storing at least one tow wire formed over substantially the entire length of the main body,
At least one pulling wire housed in the lumen and having its tip fixed in an eccentric position near the tip of the tube body, and an expandable / contractible expander installed on the outer peripheral surface of the tube body on the tip side. A catheter provided on the proximal end side of the tube main body, the operating tool for pulling and operating the pulling wire, wherein the operating tool is attached to the proximal end side of the tube main body, and the lumen An operating tool main body having an internal space that fluid-tightly communicates, an opening provided in the operating tool main body, which communicates the outside of the operating tool main body with the internal space, and an operating tool body fluid-tightly connected to the operating tool main body. , A pulling tool for pulling the pulling wire in the proximal direction of the tube main body, the lumen is opened into the expansion body, and the fluid for expanding / contracting the expansion body is Catheter, characterized in that the wire is injected and discharged through the lumen housed.

(2) The catheter according to the above (1), characterized in that an anti-shrink member having a longitudinal anti-shrink property is fixed in the lumen at the intermediate portion of the tube body.

(3) The anti-shrink member has an inner cavity penetrating from the base end to the tip thereof, and the traction wire is housed in the inner cavity, and between the anti-shrink member and the traction wire. The catheter according to (2) above, wherein the fluid is configured to pass therethrough.

(4) The catheter according to (2) or (3), wherein the anti-shrink member is a tightly wound coil.

(5) The expansion body is provided on a boundary portion between the tip portion and the intermediate portion of the tube body, and the tube body is provided on the tip side of the tip of the anti-shrink member. The catheter according to any one of (2) to (4) above, which has at least one side port that allows a lumen to communicate with the expandable body.

(6) The expansion body is provided in the intermediate portion of the tube body, and at least a part of the anti-shrink member allows the fluid to be injected into and discharged from the expansion body. One side port is provided, and at least one side port for communicating the lumen and the expandable body is provided in the intermediate portion of the tube main body (2). The catheter according to any one of (4) to (4).

(7) The tube body has a second lumen which is open to the outside of the tube body,
The operation tool is disposed in the internal space of the operation tool body, and has one end formed in the operation tool body with a connection pipe that fluid-tightly connects to the second lumen. And a second opening communicating with the internal space, and the other end of the connecting pipe is fluid-tightly connected to the second opening, whereby the second lumen is inside the internal space. The catheter according to any one of (1) to (6) above, which communicates with the outside of the operation tool body through the connection pipe without communicating with a space.

(8) A flexible tube body having a distal end portion that is bent by a wire operation and an intermediate portion that is formed on the base end side of the distal end portion and that is not substantially curved by a wire operation, and the tube. A pair of lumens for storing the pulling wires, which are formed over substantially the entire length of the main body and are formed so as to be separated from each other in the opposite directions from the central axis of the tube main body,
A pair of pulling wires that are respectively housed in the lumens and whose ends are fixed to an eccentric position near the tip of the tube body, and an expandable / contractible expander installed on the outer peripheral surface of the tube body on the tip side. A catheter having an operating tool for pulling the pair of pulling wires, the operating tool being provided on the proximal side of the tube body, wherein the operating tool is mounted on the proximal side of the tube body, An operation tool body having an internal space that fluid-tightly communicates with at least one of the pair of lumens, an opening provided in the operation tool body, for communicating the outside of the operation tool body with the internal space, and the operation tool. A fluid-tightly connected to the main body, and has a pulling tool for pulling the pulling wire housed in the lumen communicating with the internal space in the tube body proximal direction.
At least one of the pair of lumens communicating with the internal space of the operation tool is open to the expansion body, and a fluid for expanding / contracting the expansion body is injected / discharged via the lumen. A catheter characterized by:

(9) The internal space of the operating tool is fluid-tightly communicated with both of the pair of lumens for accommodating wires, and the pair of pulling wires are independent by the pulling tool in the tube body proximal direction. The catheter according to (8) above, wherein the catheter is pulled.

[0018]

BEST MODE FOR CARRYING OUT THE INVENTION The catheter of the present invention will be described below in detail with reference to the preferred embodiments shown in the accompanying drawings.

FIG. 1 is an overall side view showing an embodiment in which the medical tube of the present invention is applied to an endoscope.
2 is a perspective view showing the distal end portion of the catheter shown in FIG. 1, FIG. 3 is a vertical cross-sectional view taken along the line I-I in FIG. 2, and FIG. 4 is a line II-II in FIG. 5 is a vertical sectional view of FIG.
A cross-sectional view taken along the line III-III in FIGS. 1 and 4, and FIG.
6 is a vertical sectional view of the operation tool shown in FIG. 1, and FIG.
8 is a cross-sectional view taken along the line IV-IV in FIG.
It is a cross-sectional view taken along the line -V. In the following description, the right side in FIGS. 2 to 4 will be referred to as the “proximal end” and the left side will be referred to as the “distal end”.

As shown in FIGS. 1 to 8, the catheter 1A of the present invention has a distal end portion 21 that is bent by a wire operation.
And a flexible tube main body 2 having an intermediate portion 22 that is formed on the proximal end side with respect to the distal end portion 21 and that is not substantially curved by a wire operation, and a traction formed over substantially the entire length of the tube main body 2. Lumens 33 and 34 for storing wires
And the pulling wire 5 housed in the lumens 33, 34 and having its tip fixed in an eccentric position near the tip of the tube body 2.
1, 52, an expandable / contractible expander 6 installed on the outer peripheral surface of the tube main body 2 on the distal end side, and provided on the proximal end side of the tube main body 2 for pulling the pulling wires 51, 52 The operation tool 100 of FIG.

The tube body 2 is composed of a flexible tube, and its constituent materials are, for example, soft polyvinyl chloride, polyethylene, polypropylene, polyurethane, polyamide, polytetrafluoroethylene,
Silicone rubber, ethylene-vinyl acetate copolymer, etc.,
A polymer material having flexibility can be preferably used.

Further, in order that the catheter 1A can be confirmed under X-ray fluoroscopy, it is preferable that the tube body 2 be provided with X-ray contrast. As the method, for example, a method of blending an X-ray opaque substance such as barium sulfate, bismuth oxide, or tungsten into the constituent material of the tube body 2, and a marker formed by such an X-ray opaque substance is used for the tube body. The method of embedding in 2 or adhering to the surface of the tube main body 2 is mentioned.

In order to improve the slidability with respect to the body cavity to be inserted, the outer surface of the tube body 2 is coated with a low friction material such as a hydrophilic polymer or a fluororesin (eg polytetrafluoroethylene). May be.

A distal end portion 21 that is bent or curved by a wire operation described later is formed on the distal end side of the tube body 2, and a proximal end portion 23 of the tube is used for bending operation of the distal end portion 21 and other operations. An operation tool 100 for performing is installed. An intermediate portion 22 is formed between the distal end portion 21 and the proximal end portion 23 of the tube body 2. This intermediate portion 22 is
When the catheter 1A is inserted into a tubular organ such as a blood vessel (hereinafter referred to as "blood vessel"), it has flexibility enough to follow the bending and bending of the blood vessel. It is configured not to bend depending on the operation.

In the state where the pulling wires 51 and 52, which will be described later, are not pulled, the distal end portion 21 of the tube body 2 is
Is a straight line state (shown by a solid line in FIG. 1), and this state is hereinafter referred to as “basic position state”.

Inside the tube body 2, a first lumen 31, a second lumen 32, a third lumen 33 and a fourth lumen 34 are formed over substantially the entire length in the longitudinal direction.

The first lumen 31 and the second lumen 32
Are formed so as to be separated from the central axis of the tube body 2 in opposite directions in the cross section of the tube body 2, and the tips of both lumens 31, 32 are respectively
It is open to the outside of the tube body 2, specifically, the tip surface of the tube body 2.

The first lumen 31 accommodates the optical fiber bundle 7 as an observation tool for observing the blood vessel into which the catheter 1A is inserted. The optical fiber bundle 7 can also be used for medical treatment such as irradiating the inner wall of a blood vessel with laser light.

The optical fiber bundle 7 is, as shown in FIG.
It is composed of a light transmitting fiber (light guide) 71 and a light receiving fiber (image fiber) 72, and these optical fibers are made into a bundle by being hardened with a resin such as epoxy, acryl, silicone rubber or the like.

The light transmitting fiber 71 and the light receiving fiber 72 are, for example, polycarbonate, polymethyl methacrylate, polyethyl methacrylate, polypropyl methacrylate, polyvinyl fluoride, vinylidene fluoride, polytetrafluoroethylene, polystyrene, poly. It is composed of a hard plastic such as methylpentene or ethylene-vinyl acetate copolymer, or an optical fiber made of a hard material such as quartz or multi-component glass.

A lens 73 that collects the reflected light from the observation site is attached to the tip of the optical fiber bundle 7, and this portion is located near the tip opening of the first lumen 31. The optical fiber bundle 7 may be fixedly installed to the first lumen 31, but it can be slid with respect to the lumen 31 and the tip of the optical fiber bundle 7 can be retracted from the tip opening of the lumen 31. It is preferable.

Light emitted from a light source (not shown) on the proximal end side of the operating tool 100 is transmitted through the light transmitting fiber 71,
The observation portion is irradiated with light from its tip, the reflected light is collected by the lens 73 and taken in from the tip of the light-receiving fiber 72, and the image is transmitted through the light-receiving fiber 72, and the image receiving portion on the proximal end side of the operating tool 100. (Not shown).

The second lumen 32 is open to the tip of the tube body 2, and a fluid can be injected into the blood vessel or a liquid can be sucked from the blood vessel through the opening of the tip. Specifically, the lumen 32 is the catheter 1A.
It is used to administer a drug solution or the like into a blood vessel that has been inserted or placed, or when observing the inside of the blood vessel with an endoscope,
It is used as a flush lumen for ejecting a transparent liquid (for example, physiological saline or glucose solution) for pushing out blood that hinders the visibility.

Further, the first lumen 31 and the second lumen 3
In addition to the above, 2 can also be used as a guide wire, an insertion channel for medical treatment / diagnostic tools, and the like. Examples of the medical treatment / diagnostic tool include forceps, cytodiagnosis brush,
Examples thereof include injection needles, high-frequency waves, ultrasonic waves, probes that emit electro-hydraulic shock waves (for calculus breaking), various sensors, and their leads.

The first lumen 31 and the second lumen 3
It is also possible to form at least one inner surface of 2 with the above-mentioned low friction material (for example, to form a coating layer of the low friction material). By doing so, the sliding resistance of the optical fiber bundle and the medical treatment / diagnostic tool inserted into the lumen is reduced, and the insertion operation, movement, rotation, etc. of these can be smoothly performed.

Third lumen 33 and fourth lumen 34
In the cross section of the tube body 2, they are formed at positions separated from the central axis of the tube body 2 in mutually opposite directions and shifted in phase by about 90 ° with respect to the lumens 31, 32. The tips of both lumens 33, 34 are filled with fillers 81, 82, respectively, whereby the tips of lumens 33, 34 are closed.

Third at the base end portion 23 and the intermediate portion 22
In the lumen 33 and the fourth lumen 34, the anti-shrinkage members 4 each made of a densely wound flat plate coil are housed. The anti-shrink member 4 is bendable by an external force, but has an anti-shrink property that does not substantially shrink in the longitudinal direction, and is an intermediate portion of the tube body 2 associated with the pulling of the wires 51 and 52 described later. This is to prevent the part 22 from contracting.

The tip portion of the anti-shrink member 4 has a boundary portion 24 between the tip portion 21 and the intermediate portion 22 of the tube body 2, respectively.
It is inserted up to the vicinity and is fixed at this boundary portion 24 with adhesive layers 91 and 92. That is, the adhesive layers 91 and 92 are formed on the outer peripheral surface of the tip portion of the anti-shrink member 4, and the anti-shrink member 4 is attached to the lumen 33, 3.
4, the outer peripheral surface of the boundary portion 24 is heated while being covered with, for example, a heat-shrinkable tube (not shown), and the heat-shrinkable tube shrinks to press (tighten) the tube body material to melt or Softens and lumens 33, 34
The inner wall surfaces 330, 340 of the above are deformed so as to slightly project inward, the adhesive layers 91, 92 are melted, and the inner wall surfaces 330, 340 of the lumens 33, 34 become the outer peripheral surface of each anti-shrink member 4. It presses and adheres via the adhesive layers 91 and 92.

The inner wall surface 3 of such lumens 33, 34
Due to the deformation of 30, 340 and the action of the adhesive layers 91, 92, the tip of each anti-shrink member 4 is firmly fixed to the third lumen 33 and the fourth lumen 34. The fixing of the tip of the anti-shrink member 4 is not limited to the above-mentioned method, for example, the adhesive layers 91 and 92 are not provided, and instead, the heat shrink tube is pressed by increasing the heating time ( (Tightening) force to increase the inner wall surface 330 of the lumen 33, 34,
340 against the outer peripheral surface of each anti-shrink member 4 more firmly,
It is also possible to employ a method in which they are brought into close contact with each other, a method in which each anti-shrinkage member 4 is tightened and fixed by caulking with a caulking member, and the like.

The anti-shrinkage members 4 are fixed to the third lumen 33 and the fourth lumen 34 at other places, for example, at the base end 23 of the tube body 2. Note that if there are too many fixing points and fixing areas, the anti-shrinkage member 4 is less likely to bend and hinders the bending of the tube body 2. Therefore, the anti-shrinkage member 4 has about two locations, the tip portion and the base end portion. It is preferably fixed by.

The inner diameters of the third lumen 33 and the fourth lumen 34 are not particularly limited, but the anti-shrinkage member 4
It is preferable that the outer diameter is about 1.0 to 2.0 times,
It is more preferable to set it to about 1.0 to 1.2 times.

When the anti-shrinkage member 4 is a flat coil as shown in the drawing, the constituent material thereof is, for example, stainless steel, carbon steel, tungsten steel, a copper alloy such as copper or brass, aluminum, platinum, Examples include various metal materials such as superelastic alloys such as TiNi-based alloys, and various resin materials such as polytetrafluoroethylene, polyethylene, polypropylene, hard polyvinyl chloride and polyester.

The dimensions such as the thickness of the anti-shrinkage member 4 are
For example, in the case of a flat plate coil made of stainless steel material having a substantially rectangular cross section as shown in the drawing, its thickness (wire material thickness) may vary depending on various conditions such as its constituent material, cross-sectional shape of the tube body 2, dimensions, and constituent material. Is 10 μm to 1 m
m, particularly about 10 to 300 μm is preferable.

Further, in the closely wound flat plate coil constituting the anti-shrinkage member 4, there is no gap between the adjacent flat plates,
A so-called perfect contact state is ideal, but if the adjacent flat plates are in close contact with each other at at least one point, some gap may exist between them. Specifically, if the total of the gaps is 10% or less, more preferably 3% or less with respect to the entire length of the coil, the intermediate portion 22
Deflection of the coil does not substantially occur, and there is no practical problem.

The flat coil of the anti-shrink member 4 is not limited to a single-layer winding, but may be a plurality of layers or a plurality of windings.

At the center of each anti-shrink member 4 of the third lumen 33 and the fourth lumen 34, there is formed an inner cavity 41 that penetrates from the base end to the tip of each anti-shrink member 4. Pulling wires 51 and 52 for pulling and bending the distal end portion 21 are inserted into the lumen 41. The pulling wires 51, 52 are exposed from the tip openings of the respective lumens 41 and are inserted into the lumens 33, 34 of the tip portion 21. Then, the tips of the pulling wires 51, 52 are embedded in the filling materials 81, 82, respectively, and thereby fixed in the lumens 33, 34. Further, the tips of the pulling wires 51, 52 are arranged so as not to be exposed on the tip surface of the tube body 2.

The tips of the pulling wires 51, 52 are fixed at positions eccentric from the central axis of the tube body 2, preferably near the outer circumference of the tube body 2, and therefore, the basic position state shown by the solid line in FIG. From the wire 5
When one of the Nos. 1 and 52 is pulled toward the base end side, the tip end portion 21 bends toward the pulled wire side as shown by the alternate long and short dash line in FIG. In this case, since the anti-shrink member 4 is fixed to the tube body 2 at the boundary portion 24 and the base end portion 23, the bending of the intermediate portion 22 due to the pulling of the wires 51 and 52 hardly occurs, and the anti-shrink property is reduced. Only the tip portion 21 where the member 4 does not exist surely bends.

As the pulling wires 51 and 52, those having strength and durability to the extent that disconnection is not caused by frequent pulling operations and having little elongation are preferable, for example, stainless steel, superelastic alloy, Examples thereof include metal wires such as amorphous alloys, polyesters such as aromatic polyamide, polyarylate, and polyethylene terephthalate, high-tensile resin fibers such as polyimide, single wires and fiber bundles such as carbon fibers.

The outer diameters of the pulling wires 51, 52 differ depending on various conditions such as their constituent materials, the cross-sectional shape of the tube body 2, dimensions, and constituent materials.
Is composed of polyarylate twisted yarn or stainless steel single wire, the outer diameter is 30 to 500 μm,
In particular, the thickness is preferably about 50 to 300 μm. Further, this outer diameter is sufficiently smaller than the inner diameter of the anti-shrink member 4, specifically 20 to 500 μm, so that a sufficient amount of fluid for expanding and contracting the expansion body 6 described later can pass therethrough.
It is preferable that it is smaller by about m, more preferably about 50 to 300 μm.

The anti-shrinkage member 4 is not limited to the tightly wound flat plate coil shown in the figure, and may be, for example, a pipe made of a superelastic alloy or a metal pipe which is spirally slit. May be.

Further, the anti-shrinkage member 4 is attached to the lumen 33, 3
4 is replaced with an anti-shrink member made of, for example, a coil or a superelastic alloy pipe.
3 is fixed to the outer peripheral surface and the outer surface of the tip portion 21 is covered with resin or the like so as to prevent a step from being formed between the anti-shrink member and the outer surface of the tip portion 21 to prevent the intermediate portion 22 from being bent by a wire operation. It may be configured to.

As shown in FIG. 4, an expansion body 6 is installed on the outer peripheral surface of the tube body 2 on the distal end side. The expansion body 6 is expandable and contractible by injecting and discharging a fluid, and is made of, for example, a rubber material such as latex rubber or silicone rubber, or polyurethane, soft polyvinyl chloride, polyethylene terephthalate, polyamide, ethylene-acetic acid. A thin film made of a resin material such as a vinyl copolymer is formed into a tubular shape or a bag shape.

The expansion body 6 shown in the figure is designed to be in close contact with the inner wall surface of the blood vessel when expanded, and has a role of fixing the catheter 1A to the blood vessel and the like, and has a field of view in front of the expansion body 6 (on the tip side of the tube body). It has the role of blocking the inflow of blood when it is replaced with a transparent liquid by eliminating the blood that interferes with the above. The use and function of the extension body 6 are not limited to these.

The expander 6 is preferably adapted to expand radially from the center of the tube body 2 when expanded. The cross-sectional shape of the expansion body 6 may be a circle, an ellipse, or the like, but if it is approximated to the cross-sectional shape of a blood vessel to be inserted or indwelled, the adhesion to the blood vessel is good. Is preferable.

Further, the expansion body 6 needs to be fluid-tightly attached to the tube body 2. As the attachment method, for example, a method in which the expansion body 6 is attached to the outer peripheral surface of the tube body 2 by another member (cylindrical or bag-shaped member or the like) at the end portion, bonded, fused, or tied with a thread or the like, or A method of integrally molding with the tube body 2 or two-color molding is possible.

In the present embodiment, most of the expansion body 6 is located on the intermediate portion 22, and the distal end side portion is installed on the outer peripheral surface of the tube body 2 straddling the distal end portion 21.

On the outer peripheral surface of the tube body 2,
A side opening 25 that communicates with the third lumen 33 is formed. The side opening 25 is located inside the expansion body 6, and therefore the third lumen 33 is open to the inside of the expansion body 6 through the side opening 25. Fluid is sent into the expansion body 6 through the third lumen 33 to expand the expansion body 6, and the fluid is discharged to contract the expansion body 6.

The side opening 25 is located at a fixed position of the anti-shrink member 4 in the third lumen 33 (the adhesive layer 9 in the illustrated example).
It is formed closer to the tip side than 1, 92). Therefore, between the third lumen 33 and the side opening 25, the fluid for expanding and contracting the expansion body is passed through the lumen between the pulling wires 51 and 52 of the anti-shrink member 4 and the side opening 25. Can be passed through.

The side opening 25 is preferably provided close to the tip of the anti-shrink member 4, and the expansion body 6 is
It is preferable that the side hole 25 is located near the end portion on the tip end side attached to the tube body 2 and provided on the side of the intermediate portion 22 as much as possible. Thereby, even when the expansion body 6 is in an expanded state, the operating force required for bending the distal end portion 21 (the traction force of the pulling wires 51, 52) can be reduced, and even after the distal end portion 21 is bent. The expansion body 6 can be expanded smoothly and effectively.

As the fluid for expanding and contracting the expansion body 6, a gas such as air, CO ₂ gas, O ₂ gas, or a liquid such as physiological saline or a liquid containing the above-mentioned X-ray contrast agent can be mentioned. To be

FIG. 6 is a vertical sectional view showing the structure of the operating tool 100, FIG. 7 is a horizontal sectional view taken along the line IV-IV of FIG. 6, and FIG.
FIG. 7 is a transverse sectional view taken along the line VV of FIG. 6.

The operation tool 100 is provided on the operation tool body 130, which is mounted on the proximal end side of the tube body 2 and has an internal space 101 which fluid-tightly communicates with the third lumen 33. The third connector 11 which is an opening for communicating the outside of the tool body 130 with the internal space 101
2 and a reel 105 which is a pulling tool that is fluid-tightly connected to the operating tool body 130 and pulls the pulling wires 51 and 52 in the tube body proximal direction.

The operation tool main body 130 includes the manifold section 12.
0 and a first housing 10 having a connector portion 121
2 and a second housing 103 having a shape that is substantially symmetrical to the first housing 102 except for the manifold portion 120 and the connector portion 121 are joined together. Then, these first housing 102 and second housing 1
An interior space 101 is defined between the interior space 03 and the interior space 03.

A tubular manifold portion 120 is formed on the front end side of the first housing 102. Also, the first
The base end side of the housing 102 is branched into three parts, and each branch part is formed hollow and has an opening that opens to the outside.
0, the second connector 111, and the third connector 112 constitute a connector portion 121.

Manifold section 120 and connector section 1
Except for 21, the first housing 102 is on the front side (upper side in FIG. 7) of the paper in FIG.
It is located on the inner side (the lower side in FIG. 7) of the drawing and is joined to each other on a plane that is substantially parallel to the central axis of the operating tool 100. on the other hand,
As shown in FIG. 8, the first connector 110 and the second connector 110
In the connector 111, the first housing 102 is shown in FIG.
It projects to the middle lower side (the back side of the paper surface in FIG. 6), and is joined to the second housing 103 at a surface 102A that is substantially perpendicular to the central axis of the operating tool 100 at the tip end side of this protruding portion.

Although not shown, the third connector 112 is also provided.
Also in the manifold section 120, the first housing 102 projects downward in FIG. 8 (back side in FIG. 6), as in the first connector 110 and the second connector 111, and is located at the center of the operation tool 100. The first housing 102 and the second housing 103 are joined to each other on a surface substantially perpendicular to the axis.

The base end portion 23 of the tube body 2 is inserted into the manifold portion 120 and fixed in a fluid-tight manner. As a result, the internal space 101 of the operation tool body 130 is
It is in fluid-tight communication with the lumen 33.

A shaft hole 131 for projecting a shaft body 107 of the reel 105, which will be described later, to the outside of the operating tool body 130 is formed in an intermediate portion between the manifold portion 120 and the connector portion 121. Although the shaft hole 131 is formed on the first housing 102 side in the illustrated example,
It may be formed on the second housing 103 side.

Then, the reel 1 is attached to the operation tool main body 130.
05 and an operation lever 106 which is a reel operation unit, is installed.

The reel 105 includes a reel body 105A for winding the pulling wires 51, 52 and the wires 51, 5
A fixing portion 105B for fixing the base end portion of the reel 2 and the reel unit 1
The shaft 107 is fixed to the center of rotation of 05A, and is rotatably inserted into a shaft hole 131 formed in the operation tool body 130. The shaft 107 rotates about the shaft 107.

Specifically, the reel body 105A is a disk-shaped member, and the pulling wire 51,
A groove 105C through which 52 is inserted is formed. Third lumen 33 and fourth lumen 34 at the base end of the tube body 2
The pulling wires 51 and 52 exposed in the internal space 101 of the operation tool body 130 from the opening of the above are divided into upper and lower parts in FIG. 6, and are respectively wound around the reel body 105A in the opposite grooves 105C in opposite directions.

Incidentally, guide members for covering the grooves 105C may be provided on both sides of the reel body 105A in order to prevent the wires 51, 52 from coming off the grooves 105C (not shown). The cross-sectional shape of the groove 105C is
The shape is not limited to the quadrangle as shown, but may be, for example, a V shape or an arc shape.

A fixing portion 105B for fixing the base ends of the pulling wires 51, 52 to the reel 105 is provided on the base end side of the reel body 105A. The fixing portion 105B in the present embodiment has a tension adjusting means for fixing the base ends of the wires 51, 52 so that the tension of the wires 51, 52 can be adjusted, and is composed of two fixing screws respectively screwed to the reel body 105A. It is configured. And this fixing screw,
The base ends of the wires 51 and 52 wound around the reel body 105A are fixed, and by rotating this fixing screw, the corresponding wires 51 and 52 are wound or unwound to adjust the tension. It

In the state shown in FIGS. 6 and 7, the tip portion 21 of the tube body 2 is in the basic position state.

The shaft body 107 protrudes from the operation tool main body 130 through the shaft hole 131, and the shaft body 107 is projected in this protruding portion.
A lever fitting hole 107A penetrating in the radial direction is formed.

The reel 105 is preferably made of a material having a proper strength (rigidity), a low friction material and an excellent wear resistance. Examples of such a material include various metals such as stainless steel, copper alloys, aluminum, aluminum alloys, polyethylene (especially medium to high density), polystyrene, polyethylene terephthalate, polyester such as polybutylene terephthalate,
Acrylic resin, acrylonitrile-butadiene-styrene copolymer, aromatic or aliphatic polyamide, polyacetal, melamine resin, phenol resin, polyether ether ketone, polysulfone, polyphenylene sulfide, polyimide, polyacetal, various resins such as fluororesin, alumina Various ceramics such as

When the reel 105 is made of the above-mentioned material, when the reel 105 rotates, the outer surface of the shaft 107 slides on the inner surface of the shaft hole 131 and the reel body 105A slides on the pulling wires 51, 52. Is preferable, durability is improved, and generation of abrasion powder is prevented, which is preferable.

As shown in the figure, the structure in which the pulling tool (reel 105) is housed in the internal space 101 of the operating tool main body 130 provides a flow path for the fluid for expanding and contracting the expansion body 6. Also, it can serve as a space for housing and installing the tow tool, and the operating tool 100 can be made smaller and lighter.

A ring-shaped first seal member 113 is provided on the outer periphery of the shaft body 107 between the upper surface of the reel unit 105A and the upper inner surface of the first housing 102. The first seal member 113 is provided on the reel 105.
The reel body 105A when rotating and not rotating.
The upper surface of the first housing 102 and the inner surface of the upper portion of the first housing 102, the fluid entering from the shaft hole 131 is blocked, and the fluid leaks from the internal space 101 to the outside through the shaft hole 131. It also has a role of keeping (sealing) the inner space 101 of the tool body 130 fluid-tight.

As the constituent material of the first seal member 113, for example, natural rubber, isoprene rubber, butadiene rubber, styrene-butadiene rubber, butadiene-acrylonitrile rubber, chloroprene rubber, nitrile rubber, butyl rubber, ethylene-propylene rubber, acrylic is used. Various rubbers such as system rubbers, urethane rubbers, hydrin rubbers, silicone rubbers, fluororubbers or blends thereof, polyurethane elastomers, polyester elastomers,
Polyamide elastomer, polystyrene elastomer,
Examples thereof include elastic materials such as various thermoplastic elastomers such as fluorine-based elastomers, and further mainly resin materials having high flexibility such as soft polyvinyl chloride. Further, the various rubbers are not limited to vulcanized rubbers, and may be viscoelastic materials such as unvulcanized or semi-vulcanized rubbers (vulcanization coefficient is less than 100%).

The installation position of the first seal member 113 is not limited to that shown in the figure, and for example, the shaft hole 131 and the shaft body 1 may be installed.
It may be installed between 07 and.

One end of the operating lever 106 is fitted in the lever fitting hole 107A. In this case, when the operation lever 106 is fitted into the lever fitting hole 107A, the sliding surface (lower surface) of the operation lever 106 is changed to the second housing 103.
7 is locked and pressure-bonded to the upper surface of the protrusion protruding around the shaft hole 131, and the reaction force causes the reel 105 to slightly move upward in FIG. 7 and stop. As a result, the first seal member 113 is attached to the upper surface of the reel unit 105A and the second housing 1A.
It is sandwiched between the upper inner surface of 03 and the inner surface and compressed, and adheres to those surfaces.

In the case of this embodiment, the first seal member 1
13 also has a braking function for braking the rotation of the reel 105. That is, when the first seal member 113 is compressed by being sandwiched between the upper surface of the reel body 105A and the upper inner surface of the second housing 103, and comes into close contact with those surfaces,
The frictional force produces a braking force when the reel 105 rotates.

As shown in FIG. 7, the operating lever 10
The distance L between the upper surface of the reel body 105A and the inner surface of the upper portion of the second housing 103 in the state of being fitted in the lever fitting hole 107A of 6 also depends on the materials of the first seal member 113, the second housing 103 and the operation lever 106. According to the first
The thickness of the seal member 113 in its natural state (the state in which an external force such as a compression force is not applied) is preferably about 50 to 99%, more preferably about 75 to 96%. More preferably, it is 79 to 96%. This is because an appropriate braking force can be obtained in such a range.

The operating lever 106 has a bent portion 106A which is bent in an L shape in the middle thereof and extends vertically in FIG. The operation lever 106 is mainly composed of the bent portion 106A.
Put your hand on and rotate. Therefore, the bent portion 106A
As an anti-slip means, it is preferable that minute irregularities or a coating layer of the elastic or viscoelastic material is formed on the outer surface of the. Further, such slip prevention means may be provided on the upper surface of the operation lever 106.

The operation lever 106 is preferably made of the same material as the reel 105 described above. As a result, when the operation lever 106 is rotated,
The operation lever 106 slides smoothly with respect to the operation tool body 130, and wear is suppressed.

Further, the operating tool 100 has a rotation angle regulating means for regulating the rotation angle range of the reel 105. In the present embodiment, the rotation angle restricting means includes, as shown in FIG. 1, the bent portion 106A of the operation lever 106,
It is composed of contact portions 132 and 133 on the outer surface of the operation tool body 130, with which the bent portion 106A abuts. When the operation lever 106 is rotated, the operation lever 106A is moved from the basic position shown by the solid line in FIG.
When rotated, the bent portion 106A comes into contact with the contact portion 132 and stops, and conversely, when the operation lever 106 is rotated from the basic position state to the tip side by, for example, 45 °, the bent portion 106A contacts the contact portion 133. Stop in contact. As a result, the rotation angle range (maximum rotation angle) of the operation lever 106 is regulated by 45 ° left and right around the basic position state, and the pulling wire 51,
It is possible to prevent breakage due to excessive pulling of 52 and damage to the optical fiber bundle 6 and the like due to excessive bending of the tip portion 21 of the tube body 2.

In such an operating tool 100, a single first
The reel 105 is braked by the seal member 113,
Further, the rotation angle range of the reel 105 is also regulated without installing a dedicated member or the like, and the contact portions 132 and 133 formed on the outer surface of the bending portion 106A for rotating the reel 105 and the operation tool body 130. Because it is done using and,
The braking function can be obtained and the rotation angle range can be restricted with an extremely simple configuration.

The first connector 110 is a so-called luer taper connector having a tapered inner surface whose inner diameter gradually decreases toward the tip, and can liquid-tightly connect a three-way stopcock (not shown), the tip of a syringe, or the like. This first connector 1
The distal end of the inner lumen of 10 and the proximal end of the second lumen 32 of the tube body 2 are fluid-tightly connected by the first connection tube 115.

For example, the tip of a syringe can be connected to the first connector 110, and the liquid in the syringe can be supplied into the second lumen 32 via the connector 110 and the tube 115. In addition, from the first connector 110, for example, forceps, cytodiagnosis brush, injection needle, clip device,
It is also possible to insert a guide wire, high-frequency, ultrasonic waves, electro-hydraulic shock waves, probes that emit laser light, tubes for cleaning and suction, and various medical treatment instruments such as a measure.

The base end portion of the second lumen 32 and the first connecting tube 115 are preferably connected so that their inner surfaces are stepless. Similarly, the narrow portion 110A of the first connector 110 is connected. Inner diameter of and the first connected to it
It is preferable that the inner diameter of the connection tube 115 is the same and the inner surfaces thereof are steplessly connected. Thereby, for example, a medical treatment instrument such as a guide wire can be smoothly inserted or removed without being caught, and furthermore, the medical treatment instrument can be inserted not only from the connector 110 but also from the distal end portion 21 of the tube body 2. Or it can be removed smoothly.

The second connector 111 is a connector for inserting a fiberscope, and the distal end of the inner cavity of the connector 111 and the proximal end of the first lumen 31 of the tube body 2 are connected by the second connecting tube 116. Fluid-tightly connected. Then, the optical fiber bundle 6 in the first lumen 31 passes through the tube 116, and the second connector 111
Has been inserted into the lumen.

A hollow optical fiber fixing member 117 made of an elastic material such as silicone rubber is fitted in the inner cavity of the second connector 111. Further, at the base end of the connector 111, the hollow valve cap 11
8 is screwed.

As shown in FIG. 6, when the optical fiber bundle 7 is inserted into the optical fiber fixing member 117 and the valve cap 118, the valve cap 118 is rotated and its tip is screwed into the connector 111. The tip end surface of the valve cap 118 presses the optical fiber fixing member 117, the optical fiber fixing member 117 is deformed, the hollow portion of the optical fiber fixing member 117 is closed, and the optical fiber fixing member 117 is brought into close contact with the optical fiber bundle 7. Thereby, the optical fiber bundle 7 inserted through the hollow portion is fixed so as not to move in the axial direction. Such fixing of the optical fiber bundle 7 is performed after the axial position of the optical fiber bundle 7 is adjusted as desired.

The flow passage from the second lumen 32 to the first connector 110 and the flow passage from the first lumen 31 to the second connector 110 respectively communicate with the internal space 101 of the operation tool body 130. Are absent and the fluid flow between them is blocked.

Like the first connector 110, the third connector 112 is a so-called luer taper connector having a tapered inner surface in which the inner diameter gradually decreases toward the tip, and the three-way stopcock (not shown) or the tip of a syringe is fluid-tight. Can be connected to. The inner cavity of the third connector 112 fluid-tightly communicates with the third lumen 33 of the tube body 2 through the internal space 101 of the operation tool body 130.

Therefore, the tip of the syringe filled with the fluid for expanding and contracting the expansion body 6 is attached to the third connector 11.
2 and the fluid in the syringe can be supplied into the third lumen 33 via the connector 112 and the internal space 101. At this time, as described above, the internal space 1
01 and the lumens 31 and 32 are shut off from each other, and the fluid is blocked by the first lumen 31 and the second lumen 32.
Never leak out.

A second seal member 114 is provided between the first housing 102 and the second housing 103 along the joint surface between them. This second seal member 1
14 is the first housing 102 and the third housing 1
It has a role of preventing the fluid from leaking from the internal space 101 of the operating tool 100 and preventing the fluid from entering the internal space 101 from the outside of the operating tool 100 by closely contacting with each of the joint surfaces of 03.

Specifically, as shown in FIG. 7, grooves 102a and 103a are provided on the joint surfaces of the first housing 102 and the second housing 103 so as to face each other. Second ring-shaped inside 103a
The seal member 114 is stored and installed.

The second seal member 114 is arranged in the first connector 110 and the second connector 111 as shown in FIG. That is, the first housing 102
The second housing 103 of the first housing 102 so as to bypass the first connection tube 115 and the second connection tube 116 inserted in the first housing 102.
A groove 102a is formed along the joint surface with. Then, a groove 103a is formed in the second housing 103 at a position facing the groove 102a (not shown), and the second seal member 114 is installed between the grooves 102a and 103a.

Although not shown, the third connector 112 is also provided.
Also in the manifold portion 120, the second seal member 114 bypasses the proximal end portion 23 of the tube body 2 and the inner cavity of the third connector 112, similarly to the arrangement in the first connector 110 and the second connector 111. First housing 102 and second housing 103
Are arranged along the joint surface of.

As the constituent material of the second seal member 114, the same materials as those of the above-mentioned first seal member 113 can be mentioned.

The operation tool 100 is assembled by, for example, the first
The shaft member 107 of the reel 105 in which the seal member 113 is previously inserted in the shaft member 107 is inserted into the shaft hole 131 from the inside of the first housing 102, and then one end of the operation lever 4 is moved to the outside of the first housing 102. After fitting in the exposed lever insertion hole and fixing with an adhesive or the like, the wires 51, 52
Is wound around the reel 105, the fixing and the tension are adjusted appropriately, and the first connection tube 115 is connected to the first connector 110.
After the second connection tube 116 is attached to the second connector 111, the second seal member 114 is inserted into the groove 102a, and the second seal member 11 is inserted into the grooves 102a and 103a.
This can be performed by joining the first housing 102 and the second housing 103 with an adhesive or the like while sandwiching 4 therebetween, and the assembly can be performed very easily.

Without providing the second seal member 114,
The first housing 102 and the second housing 103 may be fluid-tightly joined by joining the first housing 102 and the second housing 103 with each other with no gaps. However, by interposing the seal member as shown in the figure, the internal space 101 of the operation tool 100 can be reliably kept fluid-tight with respect to the outside.

FIG. 9 is a partially enlarged transverse sectional view showing another embodiment of the present invention. Hereinafter, the configuration of the catheter 1B of the present invention will be described based on this figure, but the description of the same items as the catheter 1 will be omitted.

The catheter 1B has substantially the same structure as the catheter 1, but the structure of the third lumen 33 and the anti-shrink member 4 housed in the lumen 33 and the arrangement of the expander 6 are slightly different. .

A side port 43 is formed near the tip of the anti-shrink member (flat plate coil) 4 of the catheter 1B. On the other hand, the side opening 25 of the tube body 2 is located on the base end side of the adhesive layer 91 and near the side opening 43.

Further, the entire extension body 6 has an intermediate portion 22.
On the base end side of the boundary 24.

With such a structure, when the above-mentioned fluid is injected from the third connector 112, this fluid will flow into the inner cavity of the third connector 112, the internal space 101 of the operating tool 100, and the anti-shrink member 4. Through the lumen, the side opening 43 of the anti-shrink member 4 and the side opening 25 of the tube body 2, the expansion body 6
When reaching the inside, the expansion body 6 expands on the base end side of the boundary portion 24. In this way, compared with the catheter 1A, the expansion of the expandable body 6 and the bending of the distal end portion 21 are not interfered with each other, so that the operating force required for bending the distal end portion 21 is reduced, and further, the distal end portion is reduced. Even when 21 is bent, the expansion body 6 can be expanded more smoothly and the operability is improved.

The side holes 25 are formed by opening a part of the anti-shrink member 4 by laser processing (for example, YAG laser), electric discharge processing, chemical etching, cutting processing, and the like, and by using them in combination. You can

FIG. 10 is a partially enlarged transverse sectional view showing another embodiment of the present invention. Hereinafter, the configuration of the catheter 1C of the present invention will be described based on this figure, but the description of the same items as those of the catheter 1B will be omitted.

The catheter 1C has substantially the same structure as the catheter 1B, but the structure of the anti-shrink member 4 housed in the third lumen 33 is slightly different.

The anti-shrinkage member 4 is composed of a tightly wound flat plate coil. And, in this flat plate coil, a gap 44 is formed between adjacent flat plates in some places. This gap 44 is usually formed in the manufacture of the flat coil.
This is caused by the fact that the flat cross section of the flat plate forming the coil does not have a perfect rectangular shape, and a portion where adjacent flat plates do not adhere to each other is formed.

Therefore, if the above-mentioned fluid is injected from the third connector 112, this fluid will flow into the third connector 112.
Through the internal space 101 of the operation tool 100 and the internal cavity of the anti-shrinkage member 4, and enters between the anti-shrinkage member 4 and the inner surface of the third lumen 33 through the gap 44, and further the side opening It passes through 25 and reaches the inside of the expansion body 6. Therefore, unlike the catheter 1B, the expansion member 6 can be expanded and contracted by sending the fluid into the expansion member 6 and discharging it from the expansion member 6 without providing the side opening in the anti-shrink member 4. You can

In this embodiment, it is preferable to use gas such as air as the fluid. By doing so, since the fluid can pass through the relatively narrow gap 44 of the flat coil, the expansion body 6 can be expanded and contracted quickly and satisfactorily.

The area of the gap 44 is not particularly limited,
For example, the total area of the gaps 44 formed in the entire anti-shrinkage member 4 is preferably about 0.1 to ⁵ mm ² , more preferably about 0.5 to ² mm ² .

The catheter tube of the present invention has been described above based on the illustrated embodiment, but the present invention is not limited to this. For example, the first connector 110, the second
The connector 111 and the third connector 112 may have a structure integrated with the second housing 103, or
At least one of them may be formed separately from the first housing 102 and the second housing 103 and fitted into the first housing 102 or the second housing 103.

In the illustrated example, the side opening 25 is provided in the third lumen 33, but it may be provided in the fourth lumen 34, or the third lumen 33 and the fourth lumen 34.
May be provided in both. Further, the side opening 43 may be provided on either or both of the two anti-shrink members 4 depending on the arrangement of the side opening 25.

Furthermore, for example, a two-way stopcock may be built in the third connector 112 so that the injected fluid does not leak.

Further, the pulling tool for pulling the pulling wire is not limited to the one shown in the figure, and any pulling wire can be pulled by a plunger sliding axially in the cylinder. Good.

[0121]

As described above, according to the catheter of the present invention, the lumen for accommodating the member for the tip bending mechanism and the lumen for injecting / discharging the fluid to / from the expandable body have a simple structure. Can be the same lumen. Therefore, the number of lumens of the tube body can be minimized, and the diameter of the catheter can be efficiently reduced.

When an anti-shrink member, particularly an anti-shrink member made of a flat plate coil, is provided, the tube body is made thin and at the same time the tube body is prevented from shrinking or bending due to the pulling of the pulling wire. With a simple structure, only the tip of the tube body can be reliably bent.

When the lumen has an anti-shrink member and the anti-shrink member is provided with a side opening or a gap, the expander can be arranged on the proximal side of the bent main body of the tube body. The operating force required for bending is reduced, and the expander expands smoothly even when the tip of the tube body is bent, so that operability is improved.

[Brief description of drawings]

FIG. 1 is an overall side view showing an embodiment when the catheter of the present invention is applied to an endoscope.

FIG. 2 is a perspective view showing a distal end portion of the catheter tube shown in FIG.

3 is a vertical cross-sectional view taken along the line I-I in FIG.

FIG. 4 is a vertical sectional view taken along line II-II in FIG.

5 is a cross-sectional view taken along the line III-III in FIG.

6 is a vertical cross-sectional view of the operation tool shown in FIG.

7 is a cross-sectional view taken along the line IV-IV in FIG.

8 is a cross-sectional view taken along the line VV in FIG.

FIG. 9 is a vertical cross-sectional view of the distal end portion of the catheter tube showing the second embodiment of the present invention.

FIG. 10 is a vertical cross-sectional view of the distal end portion of the catheter tube showing the third embodiment of the present invention.

[Explanation of symbols]

 1A, 1B, 1C Catheter 2 Tube main body 21 Tip part 22 Intermediate part 23 Base end part 24 Boundary part 31 First lumen 32 Second lumen 33 Third lumen 330 Inner wall surface 34 Fourth lumen 340 Inner wall surface 4 Anti-shrink member 41 Lumen 43 Side port 44 Gap 51, 52 Traction wire 6 Expander 91, 92 Adhesive layer 100 Operation tool 101 Internal space 102 First housing 103 Second housing 105 Reel 106 Lever 107 Shaft 110 First connector 111 Second connector 112 3rd connector 113 1st airtight ring 114 2nd airtight ring 115 1st connection tube 116 2nd connection tube 121 Connector part

Claims (9)

[Claims] 1. A flexible tube body having a distal end portion that is bent by a wire operation and an intermediate portion that is formed on the proximal end side of the distal end portion and that is not substantially curved by a wire operation, and the tube body. A lumen for accommodating at least one pulling wire formed over substantially the entire length of the tube; A catheter having an expandable / contractible expandable body installed on the outer peripheral surface on the distal end side of the main body, and an operating tool provided on the proximal end side of the tube main body for pulling the pulling wire. The operation tool is mounted on the proximal end side of the tube body,
An operation tool main body having an internal space that fluid-tightly communicates with the lumen, an opening provided in the operation tool main body for communicating the outside of the operation tool main body with the internal space, and a fluid-tight seal to the operation tool main body. And a pulling tool that pulls the pulling wire in the proximal direction of the tube body, and the lumen is opened into the expansion body, and the fluid for expanding / contracting the expansion body is A catheter which is infused and discharged through the lumen containing the puller wire. 2. The catheter according to claim 1, wherein an anti-shrink member having an anti-shrink property in a longitudinal direction is fixed in the lumen at the intermediate portion of the tube body. 3. The anti-shrink member has an inner cavity penetrating from a proximal end to a distal end thereof, and the traction wire is housed in the inner cavity, and a space between the anti-shrink member and the traction wire is provided. The catheter of claim 2, wherein the catheter is configured to pass the fluid. 4. The catheter according to claim 2, wherein the anti-shrink member is a tightly wound coil. 5. The expansion body is provided on a boundary portion between the distal end portion and the intermediate portion of the tube main body, the tube main body being closer to the distal end than the distal end of the anti-shrink member, the lumen. The catheter according to any one of claims 2 to 4, further comprising at least one side port that communicates with the dilator. 6. The expansion body is provided in the intermediate portion of the tube body, and a part of the anti-shrink member is filled with fluid to the expansion body.
At least one side port for allowing discharge is provided, and at least one side port for communicating the lumen and the dilation body is provided at the intermediate portion of the tube body. The catheter according to any one of claims 2 to 4, wherein: 7. The tube main body has a second lumen that opens to the outside of the tube main body, the operating tool is disposed in the internal space of the operating tool main body, and one end thereof is the A connection pipe that fluid-tightly connects to a second lumen; and a second opening that is formed in the operation tool body and connects the outside of the operation tool body and the internal space to each other; The other end of the pipe is fluid-tightly connected to the second opening, whereby the second lumen communicates with the outside of the operation tool body through the connection pipe without communicating with the internal space. The catheter according to any one of claims 1 to 6, characterized in that: 8. A flexible tube body having a distal end portion that is bent by a wire operation and an intermediate portion that is formed on a proximal end side of the distal end portion and that is not substantially curved by a wire operation, and the tube main body. A pair of lumens for storing the pulling wires which are formed over substantially the entire length of the tube main body and are spaced apart from each other in the opposite direction from the central axis of the tube main body; A pair of pulling wires fixed in an eccentric position in the vicinity, an expandable / contractible expander installed on the outer peripheral surface of the distal end side of the tube body, and a pair of paired puller wires provided on the proximal end side of the tube body. A catheter having an operating tool for pulling the pulling wire of, wherein the operating tool is attached to a proximal end side of the tube body,
An operation tool body having an internal space that fluid-tightly communicates with at least one of the pair of lumens, an opening provided in the operation tool body, for communicating the outside of the operation tool body with the internal space, and the operation. A fluid-tightly connected to a tool main body, and has a traction tool that pulls the traction wire housed in the lumen communicating with the internal space in the proximal direction of the tube main body, and the internal space of the operating tool. At least one of the pair of lumens communicating with each other is open to the inside of the expandable body, and a fluid for expanding / contracting the expandable body is injected / exhausted through the lumen. 9. The inner space of the operation tool communicates with both of the pair of wire-holding lumens in a fluid-tight manner, and the pair of pulling wires are independent by the pulling tool in the tube body proximal direction. 9. The catheter according to claim 8, wherein the catheter is retracted.