WO2013161579A1 - Medical treatment instrument - Google Patents

Medical treatment instrument Download PDF

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Publication number
WO2013161579A1
WO2013161579A1 PCT/JP2013/060969 JP2013060969W WO2013161579A1 WO 2013161579 A1 WO2013161579 A1 WO 2013161579A1 JP 2013060969 W JP2013060969 W JP 2013060969W WO 2013161579 A1 WO2013161579 A1 WO 2013161579A1
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WO
WIPO (PCT)
Prior art keywords
medical treatment
insertion tube
expansion
distal end
rotating body
Prior art date
Application number
PCT/JP2013/060969
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French (fr)
Japanese (ja)
Inventor
賢一 雲山
Original Assignee
テルモ株式会社
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Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2013161579A1 publication Critical patent/WO2013161579A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00—Dilators with or without means for introducing media, e.g. remedies

Definitions

  • the present invention relates to a medical treatment instrument provided with an expansion body.
  • a medical treatment instrument such as a balloon catheter provided with an expansion body
  • the medical treatment instrument described in Patent Document 1 includes a long shaft, a balloon as an expansion body provided at the tip of the shaft, and a connector provided at the base end of the shaft and communicating with the inside of the balloon.
  • the balloon is expanded by supplying fluid into the balloon from the connector.
  • the objective of this invention is providing the medical treatment tool which can expand an expansion body, without supplying a fluid.
  • the medical treatment tool of the present invention includes an insertion tube that is inserted into a patient's body, a rotating body that extends in the insertion tube and is provided to be rotatable about the axial direction of the insertion tube, and the insertion
  • An expansion body provided at the distal end of the tube and configured to be expandable in the radial direction of the insertion tube; and a rotational force transmission mechanism for transmitting the rotational force of the rotating body to the expansion body to expand the expansion body. It is characterized by having.
  • the rotational body can be expanded by transmitting the rotational force of the rotational body to the expansion body by a mechanical mechanism called a rotational force transmission mechanism. For this reason, it is not necessary to use a fluid for expanding the expansion body, and the expansion body can be expanded without supplying fluid to the expansion body.
  • the expansion body is provided at a distal end portion of the insertion tube, and a plurality of insertion guide portions that guide the insertion tube are disposed in a circumferential direction of the insertion guide portion. It is preferable that the insertion guide unit is rotatably supported, and a base end is provided with an expansion unit that extends in a radial direction of the insertion guide unit.
  • the expansion body since the expansion body includes the insertion guide portion that guides the insertion tube, the insertion tube can be guided in the insertion direction.
  • the expansion portion of the expansion body is configured such that the distal end is rotatably supported by the insertion guide portion and the base end is expanded, so that the diameter of the expansion portion is reduced toward the distal end during expansion. Become. For this reason, the expansion body can be easily inserted into the body, and the stenosis can be expanded by pushing the expansion body into the stenosis in the body.
  • the insertion guide portion is fixed to a distal end portion of the insertion tube, and the rotating body is configured by a screw-like member having an external thread formed on an outer peripheral surface, and the rotational force transmission mechanism. It is preferable to include a cylindrical member having an inner peripheral surface formed with an internal thread that is screwed with the screw-shaped member, and a link member that connects each of the extended portions and the cylindrical member.
  • the rotational force transmission mechanism has a configuration in which the cylindrical member linked to the expansion portion is screwed to the rotating body. Therefore, when the rotating body is rotated, the cylindrical member is rotated.
  • the extension portion can be expanded by sliding in the axial direction. As described above, since the expansion portion can be expanded by the sliding motion of the cylindrical member along the axis of the rotating body, the rotational force transmitting mechanism can be prevented from projecting in the radial direction of the rotating body. The diameter of the expanded body in a state where the body is not expanded can be reduced.
  • the insertion guide portion is fixed to a distal end portion of the insertion tube, and the insertion guide portion has a distal end that opens to the outside and a proximal end that communicates with the interior of the insertion tube. It is preferable that a conveyance path for conveying the object to be conveyed in the insertion tube is provided.
  • the insertion guide portion is provided with a conveyance path having a distal end opened to the outside and a proximal end communicating with the inside of the insertion tube, fluid can be conveyed from the body to the outside via the conveyance path.
  • fluid can be transported from the outside into the body, or a transported object other than fluid such as a guide wire can be transported.
  • the insertion guide portion is fixed to the distal end portion of the insertion tube and does not rotate with the rotation of the rotating body. Therefore, the conveyance path can be provided at an arbitrary position of the insertion guide portion, and the design flexibility of the conveyance path can be provided. Can be increased.
  • the rotating body is formed of a tubular body and includes an image information acquisition unit that is inserted into and removed from the tubular body.
  • the image information acquisition unit is inserted into the rotating body constituted by the tubular body, the diameter of the insertion tube is reduced as compared with the case where the rotating body and the image information acquisition unit are arranged in parallel in the insertion tube. Can be small. Therefore, the insertion tube can be easily inserted into the body, and the expansion body can be inserted into the stenosis portion in the body while confirming the image information acquired by the image information acquisition unit.
  • the insertion guide portion is fixed to a distal end portion of the rotating body, the rotational force transmitting mechanism is provided in the insertion guide portion, and rotation associated with the rotation of the rotating body is restricted.
  • the expansion body is configured such that the insertion guide portion is fixed to the distal end portion of the rotating body, and the rotational force transmission mechanism is configured such that the cylindrical member linked to the expansion portion of the expansion body is screwed into the screw-shaped member. Therefore, if the rotating body is rotated, the cylindrical member can slide in the axial direction of the rotating body and the expanding portion can be expanded while the expanding body rotates.
  • the expansion portion can be expanded by the sliding movement of the cylindrical member along the axis of the screw-shaped member, it is possible to suppress the rotational force transmission mechanism from protruding in the radial direction of the rotating body, The diameter dimension of the expansion body in a state where the expansion body is not expanded can be reduced. Further, since the expansion body is configured such that the expansion portion expands while the insertion guide portion rotates, it is possible to reliably transmit a force sufficient to push the stenosis portion in the body.
  • the screw-like member is extended into the insertion tube, and a conveyance path whose tip is opened to the outside is provided in the screw-like member.
  • the conveyance path whose tip is open to the outside is provided in the screw-like member, the fluid is conveyed from the body to the outside through the conveyance path, or the fluid is conveyed from the outside to the body. Or a transported object other than a fluid such as a guide wire can be transported.
  • the expansion body is rotated with the rotation of the rotating body because the insertion guide portion is fixed to the tip of the rotating body, whereas the screw-like member is restricted from rotating with the rotation of the rotating body. It is configured to be. For this reason, since it can prevent that a conveyance path rotates with rotation of a rotary body, a to-be-conveyed object can be conveyed reliably.
  • the screw-shaped member is formed of a tubular body and includes an image information acquisition unit that is inserted into and removed from the tubular body.
  • the insertion tube is compared with the case where the screw-shaped member and the image information acquisition unit are arranged in parallel in the insertion tube.
  • the diameter can be reduced. Therefore, the insertion tube can be easily inserted into the body, and the expansion body can be inserted into the stenosis portion in the body while confirming the image information acquired by the image information acquisition unit.
  • the medical treatment tool of the present invention is preferably a sinusitis treatment tool.
  • the medical treatment instrument is a sinusitis treatment instrument.
  • the rotational force of the rotating body is transmitted to the expansion body by the rotational force transmission mechanism, and the expansion body is removed.
  • the expansion body can be expanded without supplying fluid to the expansion body. Therefore, since fluid can be prevented from flowing into the nasal cavity suddenly, the patient's posture can be prevented from changing suddenly or fluid can be prevented from flowing into the airway.
  • the side view of the medical treatment tool which concerns on 1st Embodiment of this invention The side view which shows the medical treatment tool which concerns on 1st Embodiment in partial cross section.
  • the front view of the expansion body of the medical treatment tool which concerns on 1st Embodiment The side view which shows the expansion state of the expansion body which concerns on 1st Embodiment.
  • the side view which shows the medical treatment tool which concerns on 3rd Embodiment of this invention partially cut, and shows it.
  • a medical treatment instrument 1 As shown in FIGS. 1 and 2, a medical treatment instrument 1 according to this embodiment includes an insertion tube 2 to be inserted into a patient's body, a grip portion 3 provided at the proximal end of the insertion tube 2, and an insertion A tubular rotator 4 that extends in the tube 2 and is provided so as to be rotatable about the axial direction of the insertion tube 2 and a rotation that extends in the rotator 4 and is restricted by the rotation of the rotator.
  • the fixed tube 5 that is formed, the expansion body 6 provided at the distal end portion of the insertion tube 2 and configured to be expandable in the radial direction of the insertion tube 2, and the rotational force of the rotation body 4 are transmitted to the expansion body 6.
  • a rotational force transmission mechanism 7 that expands the expansion body 6 and an endoscope 8 as an image information acquisition unit that is inserted into and removed from the rotation body 4 are provided.
  • the insertion tube 2 includes a plurality of tubular bodies 21 to 24, and these tubular bodies 21 to 24 are configured to be rotatable with respect to each other and connected in the axial direction.
  • the insertion tube 2 is configured such that a bending means such as a wire (not shown) is connected to the tubular body 21 on the distal end side, the insertion tube 2 can be bent by the bending means, and the bending position of the insertion tube 2 can be fixed. ing.
  • the outer periphery of the insertion tube 2 is tightly covered with a flexible cylindrical member such as an elastic member, and fluids conveyed between the conveyance path 64 described later are tubular bodies 21 to 24. It is designed not to leak from the gap between them.
  • the tubular body 21 on the distal end side and the tubular body 22 on the proximal end side are each provided with rotating shaft portions 211 and 221 that protrude in the coupling direction from one end edge in the coupling direction (the axial direction of the tubular bodies 21 and 22). ing.
  • Tubular bodies 23 and 24 having different shapes are alternately arranged between the distal end side tubular body 21 and the proximal end side tubular body 22.
  • the tubular body 23 includes a rotating shaft portion 231 that protrudes in the coupling direction from both edges in the coupling direction (the axial direction of the tubular body 23).
  • the tubular body 24 includes a rotation support portion 241 whose end edges on both sides in the connecting direction (the axial direction of the tubular body 24) are retracted, and the rotation support portion 241 causes the rotation shafts of the tubular bodies 21 to 23 to rotate. Portions 211, 221, and 231 are supported. Note that a pair of rotation shaft portions 211, 221, 231 and a rotation support portion 241 are provided at positions symmetrical to each other with respect to the central axis of each tubular body 21-24.
  • the insertion tube 2 as described above can be obtained, for example, by laser processing a stainless steel tubular member.
  • laser processing is used, the insertion tube 2 in a state where the tubular bodies 21 to 24 of the insertion tube 2 are connected to each other can be easily obtained simply by cutting the circular tubular member with a laser.
  • the grip portion 3 is connected to an operation dial 31 that rotates the rotating body 4 and a tubular body 21 on the distal end side of the insertion tube 2, and performs a bending operation of the insertion tube 2 and a fixing operation of a bending position of the insertion tube 2. Operating means that do not.
  • the operation dial 31 is provided on the outer periphery of the rotating body 4 and is configured to be rotatable together with the rotating body 4.
  • the rotating body 4 is a tubular body having flexibility, and is composed of a screw-like member having an external thread formed on the outer peripheral surface.
  • the rotating body 4 extends over the grip portion 3, the insertion tube 2, and the expansion body 6.
  • a stopper 41 is provided on the outer periphery of the rotating body 4 so as to be disposed on both sides of a bearing 66 described later, and restricts movement of the rotating body 4 in the axial direction.
  • the fixed tube 5 is made of a flexible material and extends over the grip portion 3, the insertion tube 2, and the expansion body 6, and the distal end reaches the distal end of the expansion body 6. And the endoscope 8 is inserted in this fixed tube 5 so that insertion or extraction is possible.
  • the expansion body 6 is fixed to the distal end portion of the insertion tube 2 and is arranged at equal intervals in the circumferential direction of the insertion guide portion 61. And a plurality of extended portions 62.
  • the expansion body 6 is configured to be non-rotatable with respect to the insertion tube 2 by fixing the insertion guide portion 61 to the distal end portion of the insertion tube 2.
  • the insertion guide 61 is made of stainless steel (for example, all types of SUS such as SUS304, SUS303, SUS316, SUS316L, SUS316J1, SUS316J1L, SUS405, SUS430, SUS434, SUS444, SUS429, SUS430F, SUS302, etc.), a cobalt alloy, and a shape memory alloy. These are made of various metal materials such as pseudoelastic alloys, curable resins, ceramics, and the like, and the tip portion is formed in a streamlined manner.
  • the insertion guide portion 61 includes an opening 63 for accommodating the expansion portion 62, a distal end that opens to the outside, and a proximal end that communicates with the inside of the insertion tube 2, and transports a transported object in the insertion tube 2.
  • a path 64, a support portion 65 that supports the fixed tube 5 in a non-rotatable manner, and a bearing 66 that rotatably supports the rotating body 4 are provided.
  • the extended portion 62 is made of the same material as the insertion guide portion 61 or a material different from the insertion guide portion 61 selected from the above materials, and is curved in accordance with the outer edge of the insertion guide portion 61 from the distal end to the proximal end. It is formed into a shape.
  • the extending portion 62 is configured such that the distal end is rotatably supported by the insertion guide portion 61 and the proximal end is expanded in the radial direction of the insertion guide portion 61 by the rotation.
  • the rotational force transmission mechanism 7 includes a tubular member 71 having an inner peripheral surface formed with a female screw that is screwed with a male screw of the rotating body 4, and a plurality of link members 72 that connect each of the expansion portions 62 and the tubular member 71. And. Each link member 72 has one end connected to the base end of the extension 62 and the other end connected to the tubular member 71.
  • the endoscope 8 includes an imaging unit 81 having an imaging element such as a CCD (Charge Coupled Device) image sensor, and an optical fiber that transmits light toward the distal end of the endoscope 8. And an optical transmission unit 82.
  • the endoscope 8 is configured to be bendable by a bending means such as a wire (not shown) connected to the distal end portion of the endoscope 8.
  • the imaging unit 81 is not limited to this, and a digital video camera using another imaging element such as a CMOS (Complementary Metal Oxide Semiconductor) image sensor, an image fiber that acquires and transmits an image using an optical fiber, It may be an imaging system that performs image transmission using an objective lens and a plurality of relay lens optical systems.
  • CMOS Complementary Metal Oxide Semiconductor
  • the operator inserts the expansion body 6 and the insertion tube 2 of the medical treatment instrument 1 from the nostril in a state where the endoscope 8 is arranged at the distal end of the expansion body 6, and curves the insertion tube 2 while bending the imaging section. While confirming the image information in the nostril acquired by 81, the expansion body 6 is guided to the natural mouth of the sinus narrowed by sinusitis.
  • the distal end portion of the expansion body 6 is formed in a streamline shape, resistance at the time of insertion can be suppressed, and the expansion body 6 does not press the body locally, It is possible to prevent the tissue from being damaged. Further, if the endoscope 8 is inserted in advance to the distal end of the expansion body 6, the insertion tube 2 can be inserted while confirming the state in the insertion path based on the image acquired by the endoscope 8. it can.
  • the operator rotates the operation dial 31 to expand the expansion body 6. That is, when the rotating body 4 is rotated by the rotation operation of the operation dial 31, as shown in FIG. 4, the cylindrical member 71 slides along the rotating body 4 toward the distal end side, and the link member 72 is connected to the extension portion 62. Push up the proximal end. As a result, as shown in FIGS. 4 and 5, the expansion part 62 rotates around the tip, and the base end of the expansion part 62 expands radially in the radial direction of the insertion guide part 61. For this reason, the stenosis part of a natural mouth can be expanded and the stenosis part can be expanded and treated. If the insertion tube 2 is retracted somewhat after the expansion body 6 is contracted, it can be confirmed from the image acquired by the endoscope 8 that the narrowed portion of the natural mouth has expanded.
  • the state in the sinus can be confirmed based on the image acquired by the endoscope 8. If fluid or viscous material such as runny nose stays in the paranasal sinuses, the fluid or viscous material is sucked through the conveyance path 64 of the insertion guide portion 61 and the lumen of the insertion tube 2 and conveyed to the outside. can do. Further, a fluid such as physiological saline can be transported from the outside to the lumen of the insertion tube 2 and the transport path 64 of the insertion guide portion 61, and the sinuses can be washed with the fluid.
  • the expansion body 6 can be expanded by transmitting the rotational force of the rotation body 4 to the expansion body 6 by a mechanical mechanism called the rotation force transmission mechanism 7. For this reason, it is not necessary to use a fluid when expanding the expansion body 6, and the expansion body 6 can be expanded without supplying fluid to the expansion body 6.
  • the expansion body when the expansion body is expanded by supplying a fluid to the expansion body as in the prior art, the expansion body may be overexpanded.
  • the machine Since the expansion body 6 can be expanded by a typical mechanism, overexpansion of the expansion body 6 can be prevented.
  • the expansion body 6 since the expansion body 6 includes the insertion guide portion 61 that guides the insertion tube 2, the insertion tube 2 can be guided in the insertion direction. Furthermore, since the expansion part 62 of the expansion body 6 is configured such that the distal end is rotatably supported by the insertion guide part 61 and the base end is expanded, the diameter of the expansion part 62 decreases toward the distal end during expansion. It becomes the shape. For this reason, the expansion body 6 can be easily inserted into the body, and the stenosis can be expanded by pushing the expansion body into the stenosis in the body.
  • the rotational force transmission mechanism 7 has a configuration in which the cylindrical member 71 linked to the expansion portion 62 is screwed to the outer periphery of the rotating body 4. 71 can slide in the axial direction of the rotating body 4 to expand the expansion portion 62. As described above, since the extending portion 62 can be expanded by the sliding operation of the cylindrical member 71 along the axis of the rotating body 4, it is possible to suppress the rotational force transmission mechanism 7 from projecting in the radial direction of the rotating body 4. It is possible to reduce the diameter of the expansion body 6 when the expansion body 6 is not expanded.
  • the insertion guide 61 is provided with a conveyance path 64 having a distal end opened to the outside and a proximal end communicating with the inside of the insertion tube 2, fluid can be conveyed from the body to the outside via the conveyance path 64. Can carry fluid from the outside into the body.
  • the insertion guide portion 61 is fixed to the distal end portion of the insertion tube 2 and does not rotate with the rotation of the rotating body 4. Therefore, the conveyance path 64 can be provided at an arbitrary position of the insertion guide portion 61. The degree of freedom in designing the path 64 can be increased.
  • the insertion tube 2 is compared with the case where the rotating body 4 and the endoscope 8 are arranged in parallel in the insertion tube 2.
  • the diameter can be reduced. Therefore, the insertion tube 2 can be easily inserted into the body, and the expansion body can be inserted into the narrowed portion of the body while confirming the image information acquired by the endoscope 8.
  • the medical treatment instrument 1 When the medical treatment instrument 1 is a sinusitis treatment instrument, the medical treatment instrument 1 transmits the rotational force of the rotating body 4 to the expansion body by the rotational force transmission mechanism 7 so that the expansion body 6 is transferred. Can be expanded. For this reason, the expansion body 6 can be expanded without supplying fluid to the expansion body 6 in the expansion treatment of the narrowed portion of the natural mouth. Therefore, since fluid can be prevented from flowing into the nasal cavity suddenly, the patient's posture can be prevented from changing suddenly or fluid can be prevented from flowing into the airway.
  • the medical treatment tool 1 of the present embodiment is different from the first embodiment in that the expansion body 6 is fixed to the rotating body 4 and the shape of the fixed tube 5. .
  • the fixed tube 5 is a tubular body made of a flexible member, and is made of a screw-like member having an external thread formed on the outer peripheral surface.
  • the fixed pipe 5 is provided with a conveyance path 52 having a distal end opened to the outside and a proximal end extended into the insertion pipe 2.
  • the expansion body 6 is not fixed to the insertion tube 2 but is fixed to the rotating body 4 and is configured to be rotatable together with the rotating body 4. Specifically, the expansion body 6 is configured such that the insertion guide portion 61 is fixed to the distal end portion of the rotating body 4 and is rotatable together with the rotating body 4.
  • the rotational force transmission mechanism 7 includes a cylindrical member 71 having an inner peripheral surface formed with a female screw that is screwed with a male screw of the fixed tube 5, and a plurality of link members 72 that connect each of the expansion portions 62 and the cylindrical member 71. And.
  • the cylindrical member 71 slides to the distal end side along the fixed tube 5, and the link member 72 is the expansion portion.
  • the base end of 62 is pushed up.
  • the expansion portion 62 rotates around the distal end as a rotation center, and the proximal end expands radially in the radial direction of the insertion guide portion 61. Therefore, it is possible to expand a narrowed part in the body, for example, the natural mouth of the sinus that has been narrowed by sinusitis, and the narrowed part can be expanded.
  • the expansion body 6 has a cylindrical member in which the insertion guide portion 61 is fixed to the distal end portion of the rotating body 4, and the rotational force transmission mechanism 7 is linked to the expansion portion 62 of the expansion body 6.
  • 71 has a configuration in which the outer periphery of the fixed tube 5 is screwed. Therefore, when the rotating body 4 is rotated, the cylindrical member 71 slides in the axial direction of the rotating body 4 while the expansion body 6 rotates. Thus, the expansion part 62 can be expanded.
  • the expansion portion 62 can be expanded by the sliding operation of the cylindrical member 71 along the axis of the fixed tube 5, it is possible to prevent the rotational force transmission mechanism 7 from protruding in the radial direction of the rotating body 4. It is possible to reduce the diameter of the expansion body 6 when the expansion body 6 is not expanded.
  • the expansion body 6 is configured such that the expansion portion 62 expands while the insertion guide portion 61 rotates, it is possible to reliably transmit a force sufficient to push the stenosis portion in the body.
  • the conveyance path 52 whose tip is opened to the outside is provided in the fixed tube 5
  • the fluid is conveyed from the inside of the body to the outside through the conveyance path 52, and the fluid is conveyed from the outside to the body.
  • the expansion body 6 rotates with the rotation of the rotation body 4 because the insertion guide portion 61 is fixed to the tip of the rotation body 4, whereas the fixed tube 5 rotates with the rotation of the rotation body 4. Is configured to be restricted from being rotated. For this reason, since it can prevent that the conveyance path 52 rotates with rotation of the rotary body 4, a to-be-conveyed object can be conveyed reliably.
  • the insertion tube 2 is compared with the case where the fixed tube 5 and the endoscope 8 are arranged in parallel in the insertion tube 2.
  • the diameter can be reduced.
  • the insertion tube 2 can be easily inserted into the body, and the expansion body 6 can be inserted into the narrowed portion of the body while confirming image information acquired by the endoscope 8.
  • the medical treatment tool 1 of the present embodiment is different from the first embodiment in that the distal end guide portion 9 is provided.
  • the distal end guide portion 9 is provided at the distal end of the insertion guide portion 61 of the expansion body 6 and guides the expansion body 6.
  • the tip guide portion 9 is formed with an outer diameter smaller than the outer diameter of the insertion guide portion 61 and is reduced in diameter toward the tip.
  • the distal end guide portion 9 having a diameter smaller than that of the insertion guide portion 61 is provided at the distal end of the insertion guide portion 61 of the expansion body 6, so the distal end guide portion 9 is first inserted into the narrowed portion in the body, so Thus, the expansion body 6 can be reliably guided.
  • the present invention is not limited to the above-described embodiment, and modifications, improvements, and the like within the scope that can achieve the object of the present invention are included in the present invention.
  • the distal end portion of the insertion guide portion 61 is formed in a streamline shape in the expansion body 6, but is not limited thereto, and may be formed in an obtuse angle shape.
  • the number and the arrangement interval of the extension parts 62 can be arbitrarily set.
  • the conveyance paths 52 and 64 have been used as fluid conveyance paths, they may be used as conveyance paths for conveying an object to be conveyed such as a guide wire.
  • the insertion tube 2 is made of metal such as stainless steel, but may be made of other members such as resin or other metal as long as it has flexibility.
  • the fixed tube 5 extends over the grip portion 3, the insertion tube 2, and the expansion body 6, but it may be provided at least in the insertion guide portion 61.
  • the medical treatment instrument 1 has been used for observation in the sinuses, dilation of a narrowed portion generated in the natural mouth of the sinuses, and treatment of sinusitis. It may be used for observation and treatment.
  • the present invention can be used for medical treatment tools used for diagnosis and treatment of the paranasal sinuses, as well as other medical treatment tools for diagnosis or treatment that do not involve surgical treatment.

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Abstract

　A medical treatment instrument (1) provided with: an insertion tube (2) to be inserted into the body of a patient; a rotating body (4) that is provided so as to extend into the insertion tube (2) and so as to be rotatable with the axial direction of the insertion tube (2) as the center of rotation; an expanding body (6) that is provided to the tip of the insertion tube (2), and that is formed so as to be expandable in the radial direction of the insertion tube (2); and a rotational force transmission mechanism (7) that transmits rotational force from the rotating body (4) to the expanding body (6) and expands the expanding body (6).

Description

医療用処置具Medical treatment tool
　本発明は、拡張体を備えた医療用処置具に関する。 The present invention relates to a medical treatment instrument provided with an expansion body.
　従来、拡張体を備えたバルーンカテーテル等の医療用処置具が知られている（例えば、特許文献１参照）。
　特許文献１に記載の医療用処置具は、長尺状のシャフトと、シャフトの先端に設けられた拡張体としてのバルーンと、シャフトの基端に設けられ、バルーン内部に連通するコネクタとを備え、コネクタからバルーン内に流体を供給することで、バルーンを拡張するように構成されている。 Conventionally, a medical treatment instrument such as a balloon catheter provided with an expansion body is known (see, for example, Patent Document 1).
The medical treatment instrument described in Patent Document 1 includes a long shaft, a balloon as an expansion body provided at the tip of the shaft, and a connector provided at the base end of the shaft and communicating with the inside of the balloon. The balloon is expanded by supplying fluid into the balloon from the connector.
特開２０１１－２１２３８０号公報JP 2011-212380 A
　しかしながら、特許文献１に記載されたような従来の医療用処置具では、拡張体に流体を供給して当該拡張体を拡張させているため、万が一拡張体が破裂した場合、患者の体内に急激に流体が流れ込んでしまうという問題がある。例えば、副鼻腔炎の治療中にこのような状況に陥ると、鼻腔内に急激に流体が流れ込むことで、患者がむせて患者の体勢が急激に変ったり、流体が気道に流入したりするおそれがある。 However, in the conventional medical treatment instrument as described in Patent Document 1, fluid is supplied to the expansion body to expand the expansion body. Therefore, if the expansion body ruptures, it suddenly enters the patient's body. There is a problem that the fluid flows into. For example, if such a situation occurs during the treatment of sinusitis, fluid may suddenly flow into the nasal cavity, causing the patient's posture to change suddenly and fluid to flow into the airways. There is.
　本発明の目的は、流体を供給せずに拡張体を拡張できる医療用処置具を提供することにある。
　なお、本出願は、２０１２年４月２４日に出願された日本特許出願２０１２－０９８７９２に基づく優先権を主張し、当該日本出願に記載された全ての記載内容を援用するものである。 The objective of this invention is providing the medical treatment tool which can expand an expansion body, without supplying a fluid.
This application claims priority based on Japanese Patent Application No. 2012-087992 filed on April 24, 2012, and incorporates all the contents described in the Japanese application.
　本発明の医療用処置具は、患者の体内に挿入される挿入管と、前記挿入管内に延設され、当該挿入管の軸方向を回転中心として回転自在に設けられた回転体と、前記挿入管の先端部に設けられ、当該挿入管の径方向に拡張自在に構成された拡張体と、前記回転体の回転力を前記拡張体に伝達して当該拡張体を拡張させる回転力伝達機構とを備えていることを特徴とする。 The medical treatment tool of the present invention includes an insertion tube that is inserted into a patient's body, a rotating body that extends in the insertion tube and is provided to be rotatable about the axial direction of the insertion tube, and the insertion An expansion body provided at the distal end of the tube and configured to be expandable in the radial direction of the insertion tube; and a rotational force transmission mechanism for transmitting the rotational force of the rotating body to the expansion body to expand the expansion body. It is characterized by having.
　本発明によれば、回転力伝達機構という機械的な機構により、回転体の回転力を拡張体に伝達して当該拡張体を拡張させることができる。このため、拡張体の拡張にあたって流体を用いる必要がなく、拡張体に流体を供給せずに当該拡張体を拡張することができる。 According to the present invention, the rotational body can be expanded by transmitting the rotational force of the rotational body to the expansion body by a mechanical mechanism called a rotational force transmission mechanism. For this reason, it is not necessary to use a fluid for expanding the expansion body, and the expansion body can be expanded without supplying fluid to the expansion body.
　本発明の医療用処置具において、前記拡張体は、前記挿入管の先端部に設けられ、当該挿入管を案内する挿入案内部と、前記挿入案内部の周方向に複数配置され、先端が前記挿入案内部に回動自在に支持されるとともに、基端が前記挿入案内部の径方向に拡張する拡張部を備えていることが好ましい。 In the medical treatment tool of the present invention, the expansion body is provided at a distal end portion of the insertion tube, and a plurality of insertion guide portions that guide the insertion tube are disposed in a circumferential direction of the insertion guide portion. It is preferable that the insertion guide unit is rotatably supported, and a base end is provided with an expansion unit that extends in a radial direction of the insertion guide unit.
　本発明によれば、拡張体は、挿入管を案内する挿入案内部を備えているため、挿入方向に挿入管を案内することができる。また、拡張体の拡張部は、先端が挿入案内部に回動自在に支持されるとともに、基端が拡張するように構成されているため、拡張時は先端に向かうにしたがって縮径した形状となる。このため、体内に拡張体を容易に挿入することができるとともに、体内の狭窄部に拡張体を押し込むことにより、当該狭窄部を押し広げることができる。 According to the present invention, since the expansion body includes the insertion guide portion that guides the insertion tube, the insertion tube can be guided in the insertion direction. In addition, the expansion portion of the expansion body is configured such that the distal end is rotatably supported by the insertion guide portion and the base end is expanded, so that the diameter of the expansion portion is reduced toward the distal end during expansion. Become. For this reason, the expansion body can be easily inserted into the body, and the stenosis can be expanded by pushing the expansion body into the stenosis in the body.
　本発明の医療用処置具において、前記挿入案内部は、前記挿入管の先端部に固定され、前記回転体は、外周面に雄ねじが形成されたねじ状部材から構成され、前記回転力伝達機構は、内周面に前記ねじ状部材と螺合する雌ねじが形成された筒状部材と、前記拡張部のそれぞれと前記筒状部材とを連結するリンク部材とを備えていることが好ましい。 In the medical treatment instrument of the present invention, the insertion guide portion is fixed to a distal end portion of the insertion tube, and the rotating body is configured by a screw-like member having an external thread formed on an outer peripheral surface, and the rotational force transmission mechanism. It is preferable to include a cylindrical member having an inner peripheral surface formed with an internal thread that is screwed with the screw-shaped member, and a link member that connects each of the extended portions and the cylindrical member.
　本発明によれば、回転力伝達機構は、拡張部にリンク結合した筒状部材が回転体に螺合する構成を有しているため、回転体を回転させれば、筒状部材が回転体の軸線方向にスライドして拡張部を拡張させることができる。このように、回転体の軸線に沿った筒状部材のスライド動作により拡張部を拡張させることができるので、回転力伝達機構が回転体の径方向に張り出すことを抑制することができ、拡張体が拡張していない状態での拡張体の径寸法を小さくすることができる。 According to the present invention, the rotational force transmission mechanism has a configuration in which the cylindrical member linked to the expansion portion is screwed to the rotating body. Therefore, when the rotating body is rotated, the cylindrical member is rotated. The extension portion can be expanded by sliding in the axial direction. As described above, since the expansion portion can be expanded by the sliding motion of the cylindrical member along the axis of the rotating body, the rotational force transmitting mechanism can be prevented from projecting in the radial direction of the rotating body. The diameter of the expanded body in a state where the body is not expanded can be reduced.
　本発明の医療用処置具において、前記挿入案内部は、前記挿入管の先端部に固定され、当該挿入案内部には、先端が外部に開口するとともに、基端が前記挿入管内部と連通し、前記挿入管内の被搬送物を搬送する搬送路が設けられていることが好ましい。 In the medical treatment instrument of the present invention, the insertion guide portion is fixed to a distal end portion of the insertion tube, and the insertion guide portion has a distal end that opens to the outside and a proximal end that communicates with the interior of the insertion tube. It is preferable that a conveyance path for conveying the object to be conveyed in the insertion tube is provided.
　本発明によれば、先端が外部に開口し、基端が挿入管内部と連通する搬送路が挿入案内部に設けられているため、当該搬送路を介して体内から外部に流体を搬送したり、外部から体内に流体を搬送したり、ガイドワイヤ等の流体以外の被搬送物を搬送したりすることができる。ここで、挿入案内部は、挿入管の先端部に固定され、回転体の回転に伴って回転しないので、挿入案内部の任意の位置に搬送路を設けることができ、搬送路の設計自由度を高めることができる。 According to the present invention, since the insertion guide portion is provided with a conveyance path having a distal end opened to the outside and a proximal end communicating with the inside of the insertion tube, fluid can be conveyed from the body to the outside via the conveyance path. In addition, fluid can be transported from the outside into the body, or a transported object other than fluid such as a guide wire can be transported. Here, the insertion guide portion is fixed to the distal end portion of the insertion tube and does not rotate with the rotation of the rotating body. Therefore, the conveyance path can be provided at an arbitrary position of the insertion guide portion, and the design flexibility of the conveyance path can be provided. Can be increased.
　本発明の医療用処置具において、前記回転体は、管状体により構成され、前記管状体内に挿抜自在に挿入される画像情報取得部を備えていることが好ましい。 In the medical treatment instrument of the present invention, it is preferable that the rotating body is formed of a tubular body and includes an image information acquisition unit that is inserted into and removed from the tubular body.
　本発明によれば、管状体により構成された回転体内に画像情報取得部が挿入されるため、挿入管内に回転体と画像情報取得部とを並設する場合に比べて、挿入管の径を小さくすることができる。このため、体内に挿入管を容易に挿入できるとともに、画像情報取得部により取得された画像情報を確認しつつ、体内の狭窄部に拡張体を挿入することができる。 According to the present invention, since the image information acquisition unit is inserted into the rotating body constituted by the tubular body, the diameter of the insertion tube is reduced as compared with the case where the rotating body and the image information acquisition unit are arranged in parallel in the insertion tube. Can be small. Therefore, the insertion tube can be easily inserted into the body, and the expansion body can be inserted into the stenosis portion in the body while confirming the image information acquired by the image information acquisition unit.
　本発明の医療用処置具において、前記挿入案内部は、前記回転体の先端部に固定され、前記回転力伝達機構は、前記挿入案内部内に設けられ、前記回転体の回転に伴う回転が規制されるとともに、外周面に雄ねじが形成されたねじ状部材と、内周面に前記ねじ状部材と螺合する雌ねじが形成された筒状部材と、前記拡張部のそれぞれと前記筒状部材とを連結するリンク部材とを備えていることが好ましい。 In the medical treatment instrument according to the present invention, the insertion guide portion is fixed to a distal end portion of the rotating body, the rotational force transmitting mechanism is provided in the insertion guide portion, and rotation associated with the rotation of the rotating body is restricted. A threaded member having a male screw formed on the outer peripheral surface, a cylindrical member having a female screw threadedly engaged with the threaded member on the inner peripheral surface, each of the expansion portions, and the cylindrical member, It is preferable to provide the link member which connects.
　本発明によれば、拡張体は、挿入案内部が回転体の先端部に固定され、回転力伝達機構は、拡張体の拡張部にリンク結合した筒状部材がねじ状部材に螺合する構成を有しているため、回転体を回転させれば、拡張体が回転しながら、筒状部材が回転体の軸線方向にスライドして拡張部を拡張させることができる。このように、ねじ状部材の軸線に沿った筒状部材のスライド動作により拡張部を拡張させることができるので、回転力伝達機構が回転体の径方向に張り出すことを抑制することができ、拡張体が拡張していない状態での拡張体の径寸法を小さくすることができる。また、拡張体は、挿入案内部が回転しながら拡張部が拡張するように構成されているため、体内の狭窄部を押し広げるだけの力を確実に伝達することができる。 According to the present invention, the expansion body is configured such that the insertion guide portion is fixed to the distal end portion of the rotating body, and the rotational force transmission mechanism is configured such that the cylindrical member linked to the expansion portion of the expansion body is screwed into the screw-shaped member. Therefore, if the rotating body is rotated, the cylindrical member can slide in the axial direction of the rotating body and the expanding portion can be expanded while the expanding body rotates. Thus, since the expansion portion can be expanded by the sliding movement of the cylindrical member along the axis of the screw-shaped member, it is possible to suppress the rotational force transmission mechanism from protruding in the radial direction of the rotating body, The diameter dimension of the expansion body in a state where the expansion body is not expanded can be reduced. Further, since the expansion body is configured such that the expansion portion expands while the insertion guide portion rotates, it is possible to reliably transmit a force sufficient to push the stenosis portion in the body.
　本発明の医療用処置具において、前記ねじ状部材は、前記挿入管内に延設され、当該ねじ状部材内には、先端が外部に開口する搬送路が設けられていることが好ましい。 In the medical treatment instrument of the present invention, it is preferable that the screw-like member is extended into the insertion tube, and a conveyance path whose tip is opened to the outside is provided in the screw-like member.
　本発明によれば、先端が外部に開口する搬送路がねじ状部材内に設けられているため、当該搬送路を介して体内から外部に流体を搬送したり、外部から体内に流体を搬送したり、ガイドワイヤ等の流体以外の被搬送物を搬送したりすることができる。ここで、拡張体は、挿入案内部が回転体の先端部に固定されているため、回転体の回転に伴って回転するのに対し、ねじ状部材は、回転体の回転に伴う回転が規制されように構成されている。このため、回転体の回転に伴って搬送路が回転することを防止することができるので、被搬送物を確実に搬送することができる。 According to the present invention, since the conveyance path whose tip is open to the outside is provided in the screw-like member, the fluid is conveyed from the body to the outside through the conveyance path, or the fluid is conveyed from the outside to the body. Or a transported object other than a fluid such as a guide wire can be transported. Here, the expansion body is rotated with the rotation of the rotating body because the insertion guide portion is fixed to the tip of the rotating body, whereas the screw-like member is restricted from rotating with the rotation of the rotating body. It is configured to be. For this reason, since it can prevent that a conveyance path rotates with rotation of a rotary body, a to-be-conveyed object can be conveyed reliably.
　本発明の医療用処置具において、前記ねじ状部材は、管状体により構成され、前記管状体内に挿抜自在に挿入される画像情報取得部を備えていることが好ましい。 In the medical treatment instrument of the present invention, it is preferable that the screw-shaped member is formed of a tubular body and includes an image information acquisition unit that is inserted into and removed from the tubular body.
　本発明によれば、管状体により構成されたねじ状部材内に画像情報取得部が挿入されるため、挿入管内にねじ状部材と画像情報取得部とを並設する場合に比べて、挿入管の径を小さくすることができる。このため、体内に挿入管を容易に挿入できるとともに、画像情報取得部により取得された画像情報を確認しつつ、体内の狭窄部に拡張体を挿入することができる。 According to the present invention, since the image information acquisition unit is inserted into the screw-shaped member constituted by the tubular body, the insertion tube is compared with the case where the screw-shaped member and the image information acquisition unit are arranged in parallel in the insertion tube. The diameter can be reduced. Therefore, the insertion tube can be easily inserted into the body, and the expansion body can be inserted into the stenosis portion in the body while confirming the image information acquired by the image information acquisition unit.
　本発明の医療用処置具は、副鼻腔炎治療用処置具であることが好ましい。 The medical treatment tool of the present invention is preferably a sinusitis treatment tool.
　本発明によれば、医療用処置具が副鼻腔炎治療用処置具であるところ、当該医療用処置具では、回転力伝達機構により回転体の回転力を拡張体に伝達して当該拡張体を拡張させることができる。このため、自然口の狭窄部の拡張治療にあたって、拡張体に流体を供給せずに当該拡張体を拡張することができる。従って、鼻腔内に急激に流体が流れ込むことを防止することができるので、患者がむせて患者の体勢が急激に変ったり、流体が気道に流入したりすることを防止することができる。 According to the present invention, the medical treatment instrument is a sinusitis treatment instrument. In the medical treatment instrument, the rotational force of the rotating body is transmitted to the expansion body by the rotational force transmission mechanism, and the expansion body is removed. Can be expanded. For this reason, in the expansion treatment of the narrowed part of the natural mouth, the expansion body can be expanded without supplying fluid to the expansion body. Therefore, since fluid can be prevented from flowing into the nasal cavity suddenly, the patient's posture can be prevented from changing suddenly or fluid can be prevented from flowing into the airway.
本発明の第１実施形態に係る医療用処置具の側面図。The side view of the medical treatment tool which concerns on 1st Embodiment of this invention. 第１実施形態に係る医療用処置具を部分的に断面して示す側面図。The side view which shows the medical treatment tool which concerns on 1st Embodiment in partial cross section. 第１実施形態に係る医療用処置具の拡張体の正面図。The front view of the expansion body of the medical treatment tool which concerns on 1st Embodiment. 第１実施形態に係る拡張体の拡張状態を示す側面図。The side view which shows the expansion state of the expansion body which concerns on 1st Embodiment. 第１実施形態に係る拡張体の拡張状態を示す正面図。The front view which shows the expansion state of the expansion body which concerns on 1st Embodiment. 本発明の第２実施形態に係る医療用処置具を部分的に断面して示す側面図。The side view which shows the medical treatment tool which concerns on 2nd Embodiment of this invention in a partial cross section. 第２実施形態に係る医療用処置具の拡張体の正面図。The front view of the expansion body of the medical treatment tool which concerns on 2nd Embodiment. 本発明の第３実施形態に係る医療用処置具を部分的に断面して示す側面図。The side view which shows the medical treatment tool which concerns on 3rd Embodiment of this invention, partially cut, and shows it.
　以下、本発明の各実施形態を図面に基づいて説明する。
　なお、第２実施形態以降において、次の第１実施形態で説明する構成部材と同じ構成部材および同様な機能を有する構成部材には、第１実施形態の構成部材と同じ符号を付し、それらの説明を省略または簡略化する。 Hereinafter, each embodiment of the present invention will be described with reference to the drawings.
In the second and subsequent embodiments, the same constituent members as those described in the first embodiment and constituent members having the same functions are denoted by the same reference numerals as those in the first embodiment. The description of is omitted or simplified.
〔第１実施形態〕
　図１および図２に示すように、本実施形態に係る医療用処置具１は、患者の体内に挿入される挿入管２と、挿入管２の基端に設けられた把持部３と、挿入管２内に延設され、当該挿入管２の軸方向を回転中心として回転自在に設けられた管状の回転体４と、回転体４内に延設され、回転体の回転に伴う回転が規制された固定管５と、挿入管２の先端部に設けられ、当該挿入管２の径方向に拡張自在に構成された拡張体６と、回転体４の回転力を拡張体６に伝達して当該拡張体６を拡張させる回転力伝達機構７と、回転体４内に挿抜自在に挿入される画像情報取得部としての内視鏡８とを備えている。 [First Embodiment]
As shown in FIGS. 1 and 2, a medical treatment instrument 1 according to this embodiment includes an insertion tube 2 to be inserted into a patient's body, a grip portion 3 provided at the proximal end of the insertion tube 2, and an insertion A tubular rotator 4 that extends in the tube 2 and is provided so as to be rotatable about the axial direction of the insertion tube 2 and a rotation that extends in the rotator 4 and is restricted by the rotation of the rotator. The fixed tube 5 that is formed, the expansion body 6 provided at the distal end portion of the insertion tube 2 and configured to be expandable in the radial direction of the insertion tube 2, and the rotational force of the rotation body 4 are transmitted to the expansion body 6. A rotational force transmission mechanism 7 that expands the expansion body 6 and an endoscope 8 as an image information acquisition unit that is inserted into and removed from the rotation body 4 are provided.
　挿入管２は、複数の管状体２１～２４を備え、これら管状体２１～２４が互いに回動自在に、かつ軸方向に連結されて構成される。この挿入管２は、先端側の管状体２１に図示しないワイヤ等の湾曲手段が接続されており、当該湾曲手段により挿入管２を湾曲可能、かつ挿入管２の湾曲位置を固定可能に構成されている。また、挿入管２の外周は、弾性部材等の可撓性を有する筒状部材により密着して覆われており、後述する搬送路６４との間で搬送される流体が、管状体２１～２４間の隙間から漏れ出さないようになっている。 The insertion tube 2 includes a plurality of tubular bodies 21 to 24, and these tubular bodies 21 to 24 are configured to be rotatable with respect to each other and connected in the axial direction. The insertion tube 2 is configured such that a bending means such as a wire (not shown) is connected to the tubular body 21 on the distal end side, the insertion tube 2 can be bent by the bending means, and the bending position of the insertion tube 2 can be fixed. ing. Further, the outer periphery of the insertion tube 2 is tightly covered with a flexible cylindrical member such as an elastic member, and fluids conveyed between the conveyance path 64 described later are tubular bodies 21 to 24. It is designed not to leak from the gap between them.
　先端側の管状体２１および基端側の管状体２２は、それぞれ連結方向（各管状体２１、２２の軸方向）の一方の端縁から連結方向に突出した回動軸部２１１、２２１を備えている。この先端側の管状体２１と基端側の管状体２２との間には、互いに異なる形状を有した管状体２３、２４が交互に配置されている。
　管状体２３は、連結方向（管状体２３の軸方向）の両側の端縁から連結方向に突出した回動軸部２３１を備えている。
　一方、管状体２４は、連結方向（管状体２４の軸方向）の両側の端縁が後退した回動支持部２４１を備え、当該回動支持部２４１により各管状体２１～２３の回動軸部２１１、２２１、２３１が支持される。
　なお、回動軸部２１１、２２１、２３１および回動支持部２４１は、各管状体２１～２４の中心軸に対して互いに対称な位置に一対設けられている。 The tubular body 21 on the distal end side and the tubular body 22 on the proximal end side are each provided with rotating shaft portions 211 and 221 that protrude in the coupling direction from one end edge in the coupling direction (the axial direction of the tubular bodies 21 and 22). ing. Tubular bodies 23 and 24 having different shapes are alternately arranged between the distal end side tubular body 21 and the proximal end side tubular body 22.
The tubular body 23 includes a rotating shaft portion 231 that protrudes in the coupling direction from both edges in the coupling direction (the axial direction of the tubular body 23).
On the other hand, the tubular body 24 includes a rotation support portion 241 whose end edges on both sides in the connecting direction (the axial direction of the tubular body 24) are retracted, and the rotation support portion 241 causes the rotation shafts of the tubular bodies 21 to 23 to rotate. Portions 211, 221, and 231 are supported.
Note that a pair of rotation shaft portions 211, 221, 231 and a rotation support portion 241 are provided at positions symmetrical to each other with respect to the central axis of each tubular body 21-24.
　以上のような挿入管２は、例えば、ステンレス製の円管状部材をレーザー加工することにより得られる。レーザー加工を用いた場合、円管状部材をレーザーで切断するだけで、挿入管２の管状体２１～２４が互いに連結された状態の挿入管２を容易に得ることができる。 The insertion tube 2 as described above can be obtained, for example, by laser processing a stainless steel tubular member. When laser processing is used, the insertion tube 2 in a state where the tubular bodies 21 to 24 of the insertion tube 2 are connected to each other can be easily obtained simply by cutting the circular tubular member with a laser.
　把持部３は、回転体４を回転操作する操作ダイヤル３１と、挿入管２の先端側の管状体２１に接続され、挿入管２の湾曲操作および挿入管２の湾曲位置の固定操作を行う図示しない操作手段とを備えている。操作ダイヤル３１は、回転体４の外周に設けられ、回転体４とともに回転可能に構成されている。 The grip portion 3 is connected to an operation dial 31 that rotates the rotating body 4 and a tubular body 21 on the distal end side of the insertion tube 2, and performs a bending operation of the insertion tube 2 and a fixing operation of a bending position of the insertion tube 2. Operating means that do not. The operation dial 31 is provided on the outer periphery of the rotating body 4 and is configured to be rotatable together with the rotating body 4.
　回転体４は、可撓性を有する管状体であって、外周面に雄ねじが形成されたねじ状部材から構成されている。この回転体４は、把持部３、挿入管２、および拡張体６にわたって延設されている。そして、回転体４の外周には、後述する軸受６６の両側に配置され、回転体４の軸線方向の移動を規制するストッパ４１が設けられている。 The rotating body 4 is a tubular body having flexibility, and is composed of a screw-like member having an external thread formed on the outer peripheral surface. The rotating body 4 extends over the grip portion 3, the insertion tube 2, and the expansion body 6. A stopper 41 is provided on the outer periphery of the rotating body 4 so as to be disposed on both sides of a bearing 66 described later, and restricts movement of the rotating body 4 in the axial direction.
　固定管５は、可撓性を有する材で構成され、把持部３、挿入管２、および拡張体６にわたって延設され、先端が拡張体６の先端まで達している。そして、この固定管５内に内視鏡８が挿抜自在に挿入される。 The fixed tube 5 is made of a flexible material and extends over the grip portion 3, the insertion tube 2, and the expansion body 6, and the distal end reaches the distal end of the expansion body 6. And the endoscope 8 is inserted in this fixed tube 5 so that insertion or extraction is possible.
　拡張体６は、図２および図３に示すように、挿入管２の先端部に固定されて当該挿入管２を案内する挿入案内部６１と、挿入案内部６１の周方向に等間隔に配置された複数の拡張部６２とを備えている。この拡張体６は、挿入案内部６１が挿入管２の先端部に固定されることで、挿入管２に対して回転不能に構成されている。 As shown in FIGS. 2 and 3, the expansion body 6 is fixed to the distal end portion of the insertion tube 2 and is arranged at equal intervals in the circumferential direction of the insertion guide portion 61. And a plurality of extended portions 62. The expansion body 6 is configured to be non-rotatable with respect to the insertion tube 2 by fixing the insertion guide portion 61 to the distal end portion of the insertion tube 2.
　挿入案内部６１は、ステンレス鋼（例えば、ＳＵＳ３０４、ＳＵＳ３０３、ＳＵＳ３１６、ＳＵＳ３１６Ｌ、ＳＵＳ３１６Ｊ１、ＳＵＳ３１６Ｊ１Ｌ、ＳＵＳ４０５、ＳＵＳ４３０、ＳＵＳ４３４、ＳＵＳ４４４、ＳＵＳ４２９、ＳＵＳ４３０Ｆ、ＳＵＳ３０２等ＳＵＳの全品種）、コバルト系合金、形状記憶合金、擬弾性合金などの各種金属材料、及び硬化性樹脂、セラミック等で構成され、先端部が流線形に形成されている。この挿入案内部６１には、拡張部６２を収容する開口６３と、先端が外部に開口するとともに、基端が挿入管２内部と連通し、挿入管２内の被搬送物を搬送するする搬送路６４と、固定管５を回転不能に支持する支持部６５と、回転体４を回転自在に支持する軸受６６とが設けられている。 The insertion guide 61 is made of stainless steel (for example, all types of SUS such as SUS304, SUS303, SUS316, SUS316L, SUS316J1, SUS316J1L, SUS405, SUS430, SUS434, SUS444, SUS429, SUS430F, SUS302, etc.), a cobalt alloy, and a shape memory alloy. These are made of various metal materials such as pseudoelastic alloys, curable resins, ceramics, and the like, and the tip portion is formed in a streamlined manner. The insertion guide portion 61 includes an opening 63 for accommodating the expansion portion 62, a distal end that opens to the outside, and a proximal end that communicates with the inside of the insertion tube 2, and transports a transported object in the insertion tube 2. A path 64, a support portion 65 that supports the fixed tube 5 in a non-rotatable manner, and a bearing 66 that rotatably supports the rotating body 4 are provided.
　拡張部６２は、挿入案内部６１と同様の材料、若しくは上記材料の中から選択される挿入案内部６１とは異なる材料で構成され、先端から基端にかけて挿入案内部６１の外縁に合わせた湾曲形状に形成されている。この拡張部６２は、先端が挿入案内部６１に回動自在に支持されるとともに、当該回動により、基端が挿入案内部６１の径方向に拡張するように構成されている。 The extended portion 62 is made of the same material as the insertion guide portion 61 or a material different from the insertion guide portion 61 selected from the above materials, and is curved in accordance with the outer edge of the insertion guide portion 61 from the distal end to the proximal end. It is formed into a shape. The extending portion 62 is configured such that the distal end is rotatably supported by the insertion guide portion 61 and the proximal end is expanded in the radial direction of the insertion guide portion 61 by the rotation.
　回転力伝達機構７は、内周面に回転体４の雄ねじと螺合する雌ねじが形成された筒状部材７１と、拡張部６２のそれぞれと筒状部材７１とを連結する複数のリンク部材７２とを備えている。各リンク部材７２は、一端が拡張部６２の基端に連結され、他端が筒状部材７１に連結されている。 The rotational force transmission mechanism 7 includes a tubular member 71 having an inner peripheral surface formed with a female screw that is screwed with a male screw of the rotating body 4, and a plurality of link members 72 that connect each of the expansion portions 62 and the tubular member 71. And. Each link member 72 has one end connected to the base end of the extension 62 and the other end connected to the tubular member 71.
　内視鏡８は、図３に示すように、ＣＣＤ（Charge Coupled Device）イメージセンサ等の撮像素子を有する撮像部８１と、当該内視鏡８の先端部に向けて光を伝送する光ファイバー等の光伝送部８２とを備えている。この内視鏡８は、当該内視鏡８の先端部に接続された図示しないワイヤ等の湾曲手段により、湾曲可能に構成されている。また、撮像部８１はこれに限らず、ＣＭОＳ（Complementary Metal Oxide Semiconductor）イメージセンサ等の他の撮像素子を用いたデジタルビデオカメラ、光ファイバーを利用して画像の取得および画像の伝送を行なうイメージファイバ、対物レンズおよび複数のリレーレンズ光学系によって画像伝送を行なう撮像システムであってもよい。 As shown in FIG. 3, the endoscope 8 includes an imaging unit 81 having an imaging element such as a CCD (Charge Coupled Device) image sensor, and an optical fiber that transmits light toward the distal end of the endoscope 8. And an optical transmission unit 82. The endoscope 8 is configured to be bendable by a bending means such as a wire (not shown) connected to the distal end portion of the endoscope 8. The imaging unit 81 is not limited to this, and a digital video camera using another imaging element such as a CMOS (Complementary Metal Oxide Semiconductor) image sensor, an image fiber that acquires and transmits an image using an optical fiber, It may be an imaging system that performs image transmission using an objective lens and a plurality of relay lens optical systems.
　次に、医療用処置具１の使用例として、当該医療用処置具１を用いて副鼻腔炎の治療を行う手順を説明する。
　先ず、操作者は、拡張体６の先端に内視鏡８を配置した状態で鼻孔から医療用処置具１の拡張体６および挿入管２を挿入し、挿入管２を湾曲させつつ、撮像部８１により取得される鼻孔内の画像情報を確認しながら副鼻腔炎によって狭窄した副鼻腔の自然口に拡張体６を導く。 Next, as a usage example of the medical treatment instrument 1, a procedure for treating sinusitis using the medical treatment instrument 1 will be described.
First, the operator inserts the expansion body 6 and the insertion tube 2 of the medical treatment instrument 1 from the nostril in a state where the endoscope 8 is arranged at the distal end of the expansion body 6, and curves the insertion tube 2 while bending the imaging section. While confirming the image information in the nostril acquired by 81, the expansion body 6 is guided to the natural mouth of the sinus narrowed by sinusitis.
　ここで、拡張体６は、先端部が流線形に形成されているため、挿入時の抵抗を抑制することができるとともに、拡張体６が体内を局部的に押圧することがなく、鼻腔内の組織を傷めてしまうことを防止することができる。また、内視鏡８を予め拡張体６の先端まで挿入しておけば、内視鏡８により取得される画像に基づいて、挿入経路内の様子を確認しながら挿入管２を挿入することができる。 Here, since the distal end portion of the expansion body 6 is formed in a streamline shape, resistance at the time of insertion can be suppressed, and the expansion body 6 does not press the body locally, It is possible to prevent the tissue from being damaged. Further, if the endoscope 8 is inserted in advance to the distal end of the expansion body 6, the insertion tube 2 can be inserted while confirming the state in the insertion path based on the image acquired by the endoscope 8. it can.
　拡張体６が自然口の狭窄部に導かれると、操作者は、操作ダイヤル３１を回転操作して拡張体６を拡張させる。すなわち、操作ダイヤル３１の回転操作によって回転体４が回転されると、図４に示すように、筒状部材７１が回転体４に沿って先端側にスライドし、リンク部材７２が拡張部６２の基端を押し上げる。これにより、拡張部６２は、図４および図５に示すように、先端を回転中心として回動し、当該拡張部６２の基端が挿入案内部６１の径方向に放射状に拡張する。このため、自然口の狭窄部を拡張することができ、当該狭窄部を拡張治療することができる。なお、拡張体６を収縮させた後、挿入管２を幾分後退させれば、内視鏡８で取得される画像により、自然口の狭窄部が拡張したことを確認することができる。 When the expansion body 6 is guided to the narrowed portion of the natural mouth, the operator rotates the operation dial 31 to expand the expansion body 6. That is, when the rotating body 4 is rotated by the rotation operation of the operation dial 31, as shown in FIG. 4, the cylindrical member 71 slides along the rotating body 4 toward the distal end side, and the link member 72 is connected to the extension portion 62. Push up the proximal end. As a result, as shown in FIGS. 4 and 5, the expansion part 62 rotates around the tip, and the base end of the expansion part 62 expands radially in the radial direction of the insertion guide part 61. For this reason, the stenosis part of a natural mouth can be expanded and the stenosis part can be expanded and treated. If the insertion tube 2 is retracted somewhat after the expansion body 6 is contracted, it can be confirmed from the image acquired by the endoscope 8 that the narrowed portion of the natural mouth has expanded.
　その後、操作者が、拡張した自然口から副鼻腔内に挿入管２を挿入すれば、内視鏡８で取得される画像に基づいて、副鼻腔内の状態を確認することができる。そして、副鼻腔内に鼻水等の流体や粘性物が留まっている場合は、挿入案内部６１の搬送路６４および挿入管２の内腔を介して、流体や粘性物を吸引し、外部に搬送することができる。また、外部から挿入管２の内腔および挿入案内部６１の搬送路６４に生理食塩水等の流体を搬送して、当該流体で副鼻腔内を洗浄することもできる。 Thereafter, if the operator inserts the insertion tube 2 into the sinus from the expanded natural mouth, the state in the sinus can be confirmed based on the image acquired by the endoscope 8. If fluid or viscous material such as runny nose stays in the paranasal sinuses, the fluid or viscous material is sucked through the conveyance path 64 of the insertion guide portion 61 and the lumen of the insertion tube 2 and conveyed to the outside. can do. Further, a fluid such as physiological saline can be transported from the outside to the lumen of the insertion tube 2 and the transport path 64 of the insertion guide portion 61, and the sinuses can be washed with the fluid.
　本実施形態によれば、次のような効果がある。
　すなわち、医療用処置具１において、回転力伝達機構７という機械的な機構により、回転体４の回転力を拡張体６に伝達して当該拡張体６を拡張させることができる。このため、拡張体６の拡張にあたって流体を用いる必要がなく、拡張体６に流体を供給せずに当該拡張体６を拡張することができる。
　ここで、従来のように、拡張体に流体を供給して当該拡張体を拡張させる場合は、拡張体が過拡張するおそれがあるが、本実施形態の医療用処置具１によれば、機械的な機構により拡張体６を拡張させることができるので、拡張体６の過拡張を防止することができる。 According to this embodiment, there are the following effects.
That is, in the medical treatment instrument 1, the expansion body 6 can be expanded by transmitting the rotational force of the rotation body 4 to the expansion body 6 by a mechanical mechanism called the rotation force transmission mechanism 7. For this reason, it is not necessary to use a fluid when expanding the expansion body 6, and the expansion body 6 can be expanded without supplying fluid to the expansion body 6.
Here, when the expansion body is expanded by supplying a fluid to the expansion body as in the prior art, the expansion body may be overexpanded. However, according to the medical treatment tool 1 of the present embodiment, the machine Since the expansion body 6 can be expanded by a typical mechanism, overexpansion of the expansion body 6 can be prevented.
　また、拡張体６は、挿入管２を案内する挿入案内部６１を備えているため、挿入方向に挿入管２を案内することができる。さらに、拡張体６の拡張部６２は、先端が挿入案内部６１に回動自在に支持されるとともに、基端が拡張するように構成されているため、拡張時は先端に向かうにしたがって縮径した形状となる。このため、体内に拡張体６を容易に挿入することができるとともに、体内の狭窄部に拡張体を押し込むことにより、当該狭窄部を押し広げることができる。 Moreover, since the expansion body 6 includes the insertion guide portion 61 that guides the insertion tube 2, the insertion tube 2 can be guided in the insertion direction. Furthermore, since the expansion part 62 of the expansion body 6 is configured such that the distal end is rotatably supported by the insertion guide part 61 and the base end is expanded, the diameter of the expansion part 62 decreases toward the distal end during expansion. It becomes the shape. For this reason, the expansion body 6 can be easily inserted into the body, and the stenosis can be expanded by pushing the expansion body into the stenosis in the body.
　また、回転力伝達機構７は、拡張部６２にリンク結合した筒状部材７１が回転体４の外周に螺合する構成を有しているため、回転体４を回転させれば、筒状部材７１が回転体４の軸線方向にスライドして拡張部６２を拡張させることができる。このように、回転体４の軸線に沿った筒状部材７１のスライド動作により拡張部６２を拡張させることができるので、回転力伝達機構７が回転体４の径方向に張り出すことを抑制することができ、拡張体６が拡張していない状態での拡張体６の径寸法を小さくすることができる。 In addition, the rotational force transmission mechanism 7 has a configuration in which the cylindrical member 71 linked to the expansion portion 62 is screwed to the outer periphery of the rotating body 4. 71 can slide in the axial direction of the rotating body 4 to expand the expansion portion 62. As described above, since the extending portion 62 can be expanded by the sliding operation of the cylindrical member 71 along the axis of the rotating body 4, it is possible to suppress the rotational force transmission mechanism 7 from projecting in the radial direction of the rotating body 4. It is possible to reduce the diameter of the expansion body 6 when the expansion body 6 is not expanded.
　また、先端が外部に開口し、基端が挿入管２内部と連通する搬送路６４が挿入案内部６１に設けられているため、当該搬送路６４を介して体内から外部に流体を搬送したり、外部から体内に流体を搬送したりすることができる。ここで、挿入案内部６１は、挿入管２の先端部に固定され、回転体４の回転に伴って回転しないので、挿入案内部６１の任意の位置に搬送路６４を設けることができ、搬送路６４の設計自由度を高めることができる。 In addition, since the insertion guide 61 is provided with a conveyance path 64 having a distal end opened to the outside and a proximal end communicating with the inside of the insertion tube 2, fluid can be conveyed from the body to the outside via the conveyance path 64. Can carry fluid from the outside into the body. Here, the insertion guide portion 61 is fixed to the distal end portion of the insertion tube 2 and does not rotate with the rotation of the rotating body 4. Therefore, the conveyance path 64 can be provided at an arbitrary position of the insertion guide portion 61. The degree of freedom in designing the path 64 can be increased.
　また、管状体により構成された回転体４内に内視鏡８が挿入されるため、挿入管２内に回転体４と内視鏡８とを並設する場合に比べて、挿入管２の径を小さくすることができる。このため、体内に挿入管２を容易に挿入できるとともに、内視鏡８により取得された画像情報を確認しつつ、体内の狭窄部に拡張体を挿入することができる。 In addition, since the endoscope 8 is inserted into the rotating body 4 formed of a tubular body, the insertion tube 2 is compared with the case where the rotating body 4 and the endoscope 8 are arranged in parallel in the insertion tube 2. The diameter can be reduced. Therefore, the insertion tube 2 can be easily inserted into the body, and the expansion body can be inserted into the narrowed portion of the body while confirming the image information acquired by the endoscope 8.
　また、医療用処置具１が副鼻腔炎治療用処置具である場合、医療用処置具１では、回転力伝達機構７により回転体４の回転力を拡張体に伝達して当該拡張体６を拡張させることができる。このため、自然口の狭窄部の拡張治療にあたって、拡張体６に流体を供給せずに当該拡張体６を拡張することができる。従って、鼻腔内に急激に流体が流れ込むことを防止することができるので、患者がむせて患者の体勢が急激に変ったり、流体が気道に流入したりすることを防止することができる。 When the medical treatment instrument 1 is a sinusitis treatment instrument, the medical treatment instrument 1 transmits the rotational force of the rotating body 4 to the expansion body by the rotational force transmission mechanism 7 so that the expansion body 6 is transferred. Can be expanded. For this reason, the expansion body 6 can be expanded without supplying fluid to the expansion body 6 in the expansion treatment of the narrowed portion of the natural mouth. Therefore, since fluid can be prevented from flowing into the nasal cavity suddenly, the patient's posture can be prevented from changing suddenly or fluid can be prevented from flowing into the airway.
〔第２実施形態〕
　次に、本発明の第２実施形態を図６および図７に基づいて説明する。
　本実施形態の医療用処置具１は、図６および図７に示すように、拡張体６が回転体４に固定されている点、および固定管５の形状が、第１実施形態と相違する。 [Second Embodiment]
Next, a second embodiment of the present invention will be described with reference to FIGS.
As shown in FIGS. 6 and 7, the medical treatment tool 1 of the present embodiment is different from the first embodiment in that the expansion body 6 is fixed to the rotating body 4 and the shape of the fixed tube 5. .
　固定管５は、可撓性を有する部材で構成された管状体であって、外周面に雄ねじが形成されたねじ状部材から構成されている。この固定管５には、内視鏡８用の挿入路５１とは別に、先端が外部に開口し、基端が挿入管２内に延設された搬送路５２が設けられている。 The fixed tube 5 is a tubular body made of a flexible member, and is made of a screw-like member having an external thread formed on the outer peripheral surface. In addition to the insertion path 51 for the endoscope 8, the fixed pipe 5 is provided with a conveyance path 52 having a distal end opened to the outside and a proximal end extended into the insertion pipe 2.
　拡張体６は、挿入管２には固定されずに回転体４に固定され、回転体４とともに回動自在に構成されている。具体的に、拡張体６は、挿入案内部６１が回転体４の先端部に固定され、回転体４とともに回動自在に構成されている。 The expansion body 6 is not fixed to the insertion tube 2 but is fixed to the rotating body 4 and is configured to be rotatable together with the rotating body 4. Specifically, the expansion body 6 is configured such that the insertion guide portion 61 is fixed to the distal end portion of the rotating body 4 and is rotatable together with the rotating body 4.
　回転力伝達機構７は、内周面に固定管５の雄ねじと螺合する雌ねじが形成された筒状部材７１と、拡張部６２のそれぞれと筒状部材７１とを連結する複数のリンク部材７２とを備えている。 The rotational force transmission mechanism 7 includes a cylindrical member 71 having an inner peripheral surface formed with a female screw that is screwed with a male screw of the fixed tube 5, and a plurality of link members 72 that connect each of the expansion portions 62 and the cylindrical member 71. And.
　以上のような医療用処置具１では、操作ダイヤル３１の回転操作によって回転体４が回転されると、筒状部材７１が固定管５に沿って先端側にスライドし、リンク部材７２が拡張部６２の基端を押し上げる。これにより、拡張部６２は、先端を回転中心として回動し、基端が挿入案内部６１の径方向に放射状に拡張する。従って、体内の狭窄部、例えば、副鼻腔炎によって狭窄した副鼻腔の自然口を拡張することができ、当該狭窄部を拡張治療することができる。 In the medical treatment instrument 1 as described above, when the rotating body 4 is rotated by the rotation operation of the operation dial 31, the cylindrical member 71 slides to the distal end side along the fixed tube 5, and the link member 72 is the expansion portion. The base end of 62 is pushed up. As a result, the expansion portion 62 rotates around the distal end as a rotation center, and the proximal end expands radially in the radial direction of the insertion guide portion 61. Therefore, it is possible to expand a narrowed part in the body, for example, the natural mouth of the sinus that has been narrowed by sinusitis, and the narrowed part can be expanded.
　本実施形態によれば、第１実施形態の効果に加えて、次のような効果がある。
　すなわち、医療用処置具１において、拡張体６は、挿入案内部６１が回転体４の先端部に固定され、回転力伝達機構７は、拡張体６の拡張部６２にリンク結合した筒状部材７１が固定管５の外周に螺合する構成を有しているため、回転体４を回転させれば、拡張体６が回転しながら、筒状部材７１が回転体４の軸線方向にスライドして拡張部６２を拡張させることができる。このように、固定管５の軸線に沿った筒状部材７１のスライド動作により拡張部６２を拡張させることができるので、回転力伝達機構７が回転体４の径方向に張り出すことを抑制することができ、拡張体６が拡張していない状態での拡張体６の径寸法を小さくすることができる。また、拡張体６は、挿入案内部６１が回転しながら拡張部６２が拡張するように構成されているため、体内の狭窄部を押し広げるだけの力を確実に伝達することができる。 According to the present embodiment, in addition to the effects of the first embodiment, there are the following effects.
That is, in the medical treatment instrument 1, the expansion body 6 has a cylindrical member in which the insertion guide portion 61 is fixed to the distal end portion of the rotating body 4, and the rotational force transmission mechanism 7 is linked to the expansion portion 62 of the expansion body 6. 71 has a configuration in which the outer periphery of the fixed tube 5 is screwed. Therefore, when the rotating body 4 is rotated, the cylindrical member 71 slides in the axial direction of the rotating body 4 while the expansion body 6 rotates. Thus, the expansion part 62 can be expanded. As described above, since the expansion portion 62 can be expanded by the sliding operation of the cylindrical member 71 along the axis of the fixed tube 5, it is possible to prevent the rotational force transmission mechanism 7 from protruding in the radial direction of the rotating body 4. It is possible to reduce the diameter of the expansion body 6 when the expansion body 6 is not expanded. In addition, since the expansion body 6 is configured such that the expansion portion 62 expands while the insertion guide portion 61 rotates, it is possible to reliably transmit a force sufficient to push the stenosis portion in the body.
　また、先端が外部に開口する搬送路５２が固定管５内に設けられているため、当該搬送路５２を介して体内から外部に流体を搬送したり、外部から体内に流体を搬送したりすることができる。ここで、拡張体６は、挿入案内部６１が回転体４の先端部に固定されているため、回転体４の回転に伴って回転するのに対し、固定管５は、回転体４の回転に伴う回転が規制されように構成されている。このため、回転体４の回転に伴って搬送路５２が回転することを防止することができるので、被搬送物を確実に搬送することができる。 In addition, since the conveyance path 52 whose tip is opened to the outside is provided in the fixed tube 5, the fluid is conveyed from the inside of the body to the outside through the conveyance path 52, and the fluid is conveyed from the outside to the body. be able to. Here, the expansion body 6 rotates with the rotation of the rotation body 4 because the insertion guide portion 61 is fixed to the tip of the rotation body 4, whereas the fixed tube 5 rotates with the rotation of the rotation body 4. Is configured to be restricted from being rotated. For this reason, since it can prevent that the conveyance path 52 rotates with rotation of the rotary body 4, a to-be-conveyed object can be conveyed reliably.
　また、管状体により構成された固定管５内に内視鏡８が挿入されるため、挿入管２内に固定管５と内視鏡８とを並設する場合に比べて、挿入管２の径を小さくすることができる。このため、体内に挿入管２を容易に挿入できるとともに、内視鏡８により取得された画像情報を確認しつつ、体内の狭窄部に拡張体６を挿入することができる。 In addition, since the endoscope 8 is inserted into the fixed tube 5 formed of a tubular body, the insertion tube 2 is compared with the case where the fixed tube 5 and the endoscope 8 are arranged in parallel in the insertion tube 2. The diameter can be reduced. For this reason, the insertion tube 2 can be easily inserted into the body, and the expansion body 6 can be inserted into the narrowed portion of the body while confirming image information acquired by the endoscope 8.
〔第３実施形態〕
　次に、本発明の第３実施形態を図８に基づいて説明する。
　本実施形態の医療用処置具１は、図８に示すように、先端案内部９を備える点が、第１実施形態と相違する。 [Third Embodiment]
Next, a third embodiment of the present invention will be described with reference to FIG.
As shown in FIG. 8, the medical treatment tool 1 of the present embodiment is different from the first embodiment in that the distal end guide portion 9 is provided.
　具体的に、先端案内部９は、拡張体６の挿入案内部６１の先端に設けられ、拡張体６を案内する。この先端案内部９は、外径が挿入案内部６１の外径よりも小さく形成されるとともに、先端に向かうにしたがって縮径している。 Specifically, the distal end guide portion 9 is provided at the distal end of the insertion guide portion 61 of the expansion body 6 and guides the expansion body 6. The tip guide portion 9 is formed with an outer diameter smaller than the outer diameter of the insertion guide portion 61 and is reduced in diameter toward the tip.
　本実施形態によれば、第１実施形態の効果に加えて、次のような効果がある。
　すなわち、拡張体６の挿入案内部６１の先端に挿入案内部６１よりも小径の先端案内部９が設けられているため、体内の狭窄部に先ず先端案内部９を挿入することで、狭窄部内に拡張体６を確実に案内することができる。 According to the present embodiment, in addition to the effects of the first embodiment, there are the following effects.
That is, since the distal end guide portion 9 having a diameter smaller than that of the insertion guide portion 61 is provided at the distal end of the insertion guide portion 61 of the expansion body 6, the distal end guide portion 9 is first inserted into the narrowed portion in the body, so Thus, the expansion body 6 can be reliably guided.
　なお、本発明は前述の実施形態に限定されるものではなく、本発明の目的を達成できる範囲での変形、改良等は本発明に含まれるものである。
　例えば、前記各実施形態において、拡張体６は、挿入案内部６１の先端部が流線形に形成されていたが、これに限らず、鈍角形状に形成されてもよい。また、拡張部６２の数や配置間隔は、任意に設定することができる。さらに、搬送路５２、６４は、流体搬送路として用いられていたが、ガイドワイヤ等の被搬送物を搬送する搬送路として用いてもよい。 It should be noted that the present invention is not limited to the above-described embodiment, and modifications, improvements, and the like within the scope that can achieve the object of the present invention are included in the present invention.
For example, in each of the above-described embodiments, the distal end portion of the insertion guide portion 61 is formed in a streamline shape in the expansion body 6, but is not limited thereto, and may be formed in an obtuse angle shape. Further, the number and the arrangement interval of the extension parts 62 can be arbitrarily set. Furthermore, although the conveyance paths 52 and 64 have been used as fluid conveyance paths, they may be used as conveyance paths for conveying an object to be conveyed such as a guide wire.
　前記各実施形態において、挿入管２は、ステンレス等の金属により構成されていたが、可撓性を有するものであれば、樹脂やその他の金属等の他の部材で構成してもよい。 In each of the above embodiments, the insertion tube 2 is made of metal such as stainless steel, but may be made of other members such as resin or other metal as long as it has flexibility.
　前記第２実施形態において、固定管５は、把持部３、挿入管２、および拡張体６にわたって延設されていたが、少なくとも挿入案内部６１内に設けられていればよい。 In the second embodiment, the fixed tube 5 extends over the grip portion 3, the insertion tube 2, and the expansion body 6, but it may be provided at least in the insertion guide portion 61.
　前記各実施形態において、医療用処置具１は、副鼻腔内の観察や副鼻腔の自然口に生じた狭窄部の拡張、副鼻腔炎の治療に用いられていたが、体内の他の部位の観察や治療に用いてもよい。 In each of the above-described embodiments, the medical treatment instrument 1 has been used for observation in the sinuses, dilation of a narrowed portion generated in the natural mouth of the sinuses, and treatment of sinusitis. It may be used for observation and treatment.
　本発明は、副鼻腔の診察や治療に用いる医療用処置具の他、外科的処置を伴わない他の診察用または治療用の医療用処置具に利用できる。 The present invention can be used for medical treatment tools used for diagnosis and treatment of the paranasal sinuses, as well as other medical treatment tools for diagnosis or treatment that do not involve surgical treatment.
　１　　　医療用処置具
　２　　　挿入管
　４　　　回転体（ねじ状部材）
　５　　　固定管（ねじ状部材）
　６　　　拡張体
　７　　　回転力伝達機構
　８　　　内視鏡（画像情報取得部）
　５２　　搬送路
　６１　　挿入案内部
　６２　　拡張部
　６４　　搬送路
　７１　　筒状部材
　７２　　リンク部材 DESCRIPTION OF SYMBOLS 1 Medical treatment tool 2 Insertion tube 4 Rotating body (screw-shaped member)
5 Fixed tube (threaded member)
6 Expansion body 7 Rotational force transmission mechanism 8 Endoscope (image information acquisition unit)
52 Conveyance path 61 Insertion guide part 62 Expansion part 64 Conveyance path 71 Cylindrical member 72 Link member

Claims (9)

  1. 　患者の体内に挿入される挿入管と、
    　前記挿入管内に延設され、当該挿入管の軸方向を回転中心として回転自在に設けられた回転体と、
    　前記挿入管の先端部に設けられ、当該挿入管の径方向に拡張自在に構成された拡張体と、
    　前記回転体の回転力を前記拡張体に伝達して当該拡張体を拡張させる回転力伝達機構とを備えていることを特徴とする医療用処置具。     An insertion tube inserted into the patient's body;
    A rotating body that extends in the insertion tube and is rotatably provided with the axial direction of the insertion tube as a rotation center;
    An expansion body provided at the distal end of the insertion tube and configured to be expandable in the radial direction of the insertion tube;
    A medical treatment instrument comprising: a rotational force transmission mechanism that transmits a rotational force of the rotating body to the expansion body to expand the expansion body.
  2. 　請求項１に記載の医療用処置具において、
    　前記拡張体は、
    　前記挿入管の先端部に設けられ、当該挿入管を案内する挿入案内部と、
    　前記挿入案内部の周方向に複数配置され、先端が前記挿入案内部に回動自在に支持されるとともに、基端が前記挿入案内部の径方向に拡張する拡張部を備えていることを特徴とする医療用処置具。     The medical treatment tool according to claim 1, wherein
    The extension is
    An insertion guide provided at the distal end of the insertion tube and guiding the insertion tube;
    A plurality of the guides are arranged in the circumferential direction of the insertion guide part, the distal end is rotatably supported by the insertion guide part, and the base end is provided with an expansion part that extends in the radial direction of the insertion guide part. Medical treatment tool.
  3. 　請求項２に記載の医療用処置具において、
    　前記挿入案内部は、前記挿入管の先端部に固定され、
    　前記回転体は、外周面に雄ねじが形成されたねじ状部材から構成され、
    　前記回転力伝達機構は、
    　内周面に前記ねじ状部材と螺合する雌ねじが形成された筒状部材と、
    　前記拡張部のそれぞれと前記筒状部材とを連結するリンク部材とを備えていることを特徴とする医療用処置具。     The medical treatment tool according to claim 2,
    The insertion guide is fixed to a distal end of the insertion tube;
    The rotating body is composed of a screw-like member having a male screw formed on the outer peripheral surface,
    The rotational force transmission mechanism is
    A cylindrical member in which an internal thread is formed on the inner peripheral surface to be screwed with the threaded member;
    A medical treatment instrument comprising a link member that connects each of the expansion portions and the tubular member.
  4. 　請求項２に記載の医療用処置具において、
    　前記挿入案内部は、前記挿入管の先端部に固定され、
    　当該挿入案内部には、先端が外部に開口するとともに、基端が前記挿入管内部と連通し、前記挿入管内の被搬送物を搬送する搬送路が設けられていることを特徴とする医療用処置具。     The medical treatment tool according to claim 2,
    The insertion guide is fixed to a distal end of the insertion tube;
    The insertion guide portion has a distal end that opens to the outside, a proximal end that communicates with the inside of the insertion tube, and is provided with a conveyance path that conveys the object to be conveyed in the insertion tube. Treatment tool.
  5. 　請求項１に記載の医療用処置具において、
    　前記回転体は、管状体により構成され、
    　前記管状体内に挿抜自在に挿入される画像情報取得部を備えていることを特徴とする医療用処置具。     The medical treatment tool according to claim 1, wherein
    The rotating body is constituted by a tubular body,
    A medical treatment instrument comprising an image information acquisition unit that is inserted into the tubular body so as to be freely inserted and removed.
  6. 　請求項２に記載の医療用処置具において、
    　前記挿入案内部は、前記回転体の先端部に固定され、
    　前記回転力伝達機構は、
    　前記挿入案内部内に設けられ、前記回転体の回転に伴う回転が規制されるとともに、外周面に雄ねじが形成されたねじ状部材と、
    　内周面に前記ねじ状部材と螺合する雌ねじが形成された筒状部材と、
    　前記拡張部のそれぞれと前記筒状部材とを連結するリンク部材とを備えていることを特徴とする医療用処置具。     The medical treatment tool according to claim 2,
    The insertion guide portion is fixed to a tip portion of the rotating body,
    The rotational force transmission mechanism is
    A screw-like member provided in the insertion guide, the rotation associated with the rotation of the rotating body is restricted, and an external thread is formed on the outer peripheral surface;
    A cylindrical member in which an internal thread is formed on the inner peripheral surface to be screwed with the threaded member;
    A medical treatment instrument comprising a link member that connects each of the expansion portions and the tubular member.
  7. 　請求項６に記載の医療用処置具において、
    　前記ねじ状部材は、前記挿入管内に延設され、当該ねじ状部材内には、先端が外部に開口する搬送路が設けられていることを特徴とする医療用処置具。     The medical treatment tool according to claim 6,
    The medical treatment instrument, wherein the screw-shaped member extends into the insertion tube, and a conveyance path having a distal end opened to the outside is provided in the screw-shaped member.
  8. 　請求項６に記載の医療用処置具において、
    　前記ねじ状部材は、管状体により構成され、
    　前記管状体内に挿抜自在に挿入される画像情報取得部を備えていることを特徴とする医療用処置具。     The medical treatment tool according to claim 6,
    The screw-like member is constituted by a tubular body,
    A medical treatment instrument comprising an image information acquisition unit that is inserted into the tubular body so as to be freely inserted and removed.
  9. 　請求項１に記載の医療用処置具において、
    　前記医療用処置具は、副鼻腔炎治療用処置具であることを特徴とする医療用処置具。     The medical treatment tool according to claim 1, wherein
    The medical treatment instrument is a sinusitis treatment instrument.
PCT/JP2013/060969 2012-04-24 2013-04-11 Medical treatment instrument WO2013161579A1 (en)

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Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2008513125A (en) * 2004-09-17 2008-05-01 アクラレント インコーポレイテッド Devices and methods for dilating and modifying sinuses and other intranasal or paranasal cavities

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2008513125A (en) * 2004-09-17 2008-05-01 アクラレント インコーポレイテッド Devices and methods for dilating and modifying sinuses and other intranasal or paranasal cavities

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