WO2017010231A1

WO2017010231A1 - Insertion driving apparatus for linear object, medical appliance provided with same, and medical operation training apparatus

Info

Publication number: WO2017010231A1
Application number: PCT/JP2016/068121
Authority: WO
Inventors: 松原　功明; 直樹丸井; 山田　裕之; 藤川　芳夫
Original assignee: 国立大学法人名古屋大学; Ntn株式会社
Priority date: 2015-07-16
Filing date: 2016-06-17
Publication date: 2017-01-19

Abstract

This insertion driving apparatus includes: a pair of driving rollers (5, 6) that together hold a delivery wire (104); a driving unit (207) including at least one motor configured to rotate each of the pair of driving rollers (5, 6); a transfer mechanism (250) that transfers torque of the driving unit (207) to each of the driving rollers (5, 6); a housing body (202); and a cover (210). The rotation axis of the driving roller (5) and the rotation axis of the driving roller (6) are parallel to each other. The driving roller (6) is capable of rotating about the axis of a hinge (211) together with the cover (210). The axis of the hinge (211) is an axis parallel to the rotation axis of the driving roller (5) and different from each of the rotation axis of the driving roller (5) and the rotation axis of the driving roller (6). Thus, an insertion driving apparatus that has excellent design flexibility and improved insertion driving performance for a linear object can be provided.

Description

Linear body insertion drive device, medical device including the same, and medical operation training device

The present invention relates to a linear body insertion drive device, and more specifically, a flexible linear body insertion drive device such as a guide wire or a catheter to be inserted into the body, and a medical device incorporating the same. The present invention relates to a medical operation training apparatus.

As a body insertion type medical device, a linear body such as a guide wire or a catheter to be inserted into a tube such as a blood vessel or a ureter is known. In addition, in order to embolize an aneurysm, a wire having a coil for embolization at its tip is known. The surgeon inserts these thin wire shapes into a human body tube and operates them from the outside of the human body to guide them to the target site. Since the tube in the body is not a straight line but is bent or branched, a skill is required for the guidance operation from the outside. In particular, when an excessive load is applied to a human body tube by these wires during operation, the tube may be damaged.

Japanese Patent Laid-Open No. 10-263089 (Patent Document 1) discloses a catheter with an obstacle sensing function in which a pressure sensor is attached to the tip of a guide wire as an apparatus for preventing damage to a human body tube. Japanese Patent Application Laid-Open No. 2008-064508 (Patent Document 2) discloses a linear body compressive force measuring apparatus using a sensor that detects the degree of curvature of a linear body as another method for preventing damage. ing. In addition, a measuring device that can detect not only a compressive force but also a tensile force is disclosed in the re-published patent WO2011 / 033985 (Patent Document 3).

The medical linear body is used for treatment using a catheter. As an example of a medical instrument used for such treatment, for example, a medical instrument used for coil embolization treatment of a cerebral aneurysm that causes subarachnoid hemorrhage can be mentioned. The platinum coil for coil embolization is connected to the head of the delivery wire. The delivery wire and the child catheter are inserted into the Y connector. The catheter is hollow and the delivery wire is inserted into the hollow portion of the child catheter. In the vicinity of the entrance of the Y connector, each of the two operators operates the delivery wire and the child catheter.

Coil embolization is generally performed according to the following procedure. (1) Insert two catheters (parent catheter and child catheter) and guide wire into the femoral artery. The child catheter is placed in the parent catheter, the guide wire is inserted into the child catheter, and the distal end of the child catheter is guided by the guide wire and placed in the cerebral aneurysm. (2) Pull out the guide wire from the child catheter, and insert a delivery wire with a platinum coil (hereinafter referred to as a coil) at the tip into the child catheter instead of the guide wire. (3) After the coil is placed in the cerebral aneurysm, an electrode is connected to the delivery wire, an electrode is also connected to a needle previously punctured in the human body, and then, between the delivery wire and the human body via these electrodes Apply current. Since the coil and the delivery wire are connected by a material that is electrolyzed, the coil and the delivery wire are separated by energization, and as a result, the coil is placed in the cerebral aneurysm. Thereafter, (4) the delivery wire is withdrawn from the child catheter, and a delivery wire with another coil is inserted into the child catheter. (5) Repeat (3) to (4) until the coil is densely filled into the cerebral aneurysm.

Catheter treatment requires skill, and delicate control is required to operate the catheter and delivery wire. Japanese Patent Laid-Open No. 2000-42116 (Patent Document 4) and Japanese Patent Laid-Open No. 2001-157661 (Patent Document 5) disclose a device proposed for improving the operability of a catheter and a delivery wire in catheter treatment. A device has been proposed.

However, when a master-slave device is used, the required operation is different from the case where a linear body such as a delivery wire or a catheter is manually operated. Therefore, new training is required. In addition, when a master-slave device is used, it is difficult to sense fine changes in the patient's pulsation, blood vessels, and the like. Therefore, it is preferable to manually operate the linear body.

Therefore, an insertion device that is disclosed in Japanese Patent Application Laid-Open No. 2010-94235 (Patent Document 6) and inserts a medical linear body into a body tube, which can be operated by a single operator. Was proposed.

Japanese Patent Laid-Open No. 10-263089 JP 2008-064508 A Republished patent WO2011 / 033985 JP 2000-42116 A Japanese Patent Laid-Open No. 2001-157762 JP 2010-94235 A

A linear body insertion drive device 501 described in Japanese Patent Laid-Open No. 2010-94235 (Patent Document 6) will be described with reference to FIGS. FIG. 25 is a cross-sectional view showing a cross section of the insertion drive device 501 parallel to the linear body. FIG. 26 is a cross-sectional view showing a cross section orthogonal to the linear body of the insertion drive device 501. 27 is a cross-sectional view taken along the line XV-XV in FIG. FIG. 28 is a view of a state in which the lid of the insertion drive device 501 is opened, as viewed from a direction orthogonal to the linear body.

Referring to FIGS. 25 to 28, delivery wire 104 is sandwiched between roller 505 for feeding attached to motor 503 and roller 506 for suppressing pressure applied to delivery wire 104, and is driven by roller 505. The roller 506 is rotatably supported by a fixed portion 507. The fixed portion 507 is supported between the lid 510 and an elastic body 508. The lid 510 has a lever 512 for opening and closing, and the projection 513 of the lever 512 and the projection 514 of the housing main body 502 of the driving device are fitted by the pressure of the elastic body 508 so that the lid 510 can be closed. . The operator can elastically deform the lever 512 to release this fitting and open the lid 510. The Y connector 31 is sandwiched between elastic bodies 515 such as rubber attached to the housing main body 502 and the lid 510 of the delivery wire 104 drive device, and attached to the case. The lid 510 can be opened by a hinge 511, and the delivery wire 104 and the Y connector 31 can be set together by closing the lid 510, and the delivery wire 104 and the Y connector can be opened by opening the lid 510. 31 can be removed as a unit.

The insertion drive device 501 is an inexpensive drive device that can realize the operation of the catheter and the delivery wire 104 by a single operator. However, if only one roller 505 is used to drive the delivery wire 104, a predetermined insertion force can be obtained. There may not be. The roller 505 that drives the delivery wire 104 is rotated by a motor 503 via a speed reducer 509. Since the drive speed of the delivery wire 104 is several mm / s, the rotation speed of the roller 505 is very slow. For example, if the drive speed of the delivery wire 104 is 1 mm / s and the radius of the roller 505 is 10 mm, the rotation speed of the roller 505 is about 1 rpm. Therefore, the motor 503 is rotated at a relatively large reduction ratio, and the driving force viewed from the motor 503 is so small that the insertion force of the delivery wire 104 can be ignored.

Therefore, the reason why the predetermined insertion force cannot be obtained is that the torque of the motor 503 is not insufficient and the frictional force acting between the roller 505 and the delivery wire 104 is smaller than the predetermined insertion force. Therefore, in order to obtain a predetermined insertion force, it is necessary to increase the frictional force between the roller 505 and the delivery wire 104.

The factors that increase the frictional force between two objects include the use of a material / surface property with a high coefficient of friction and the increase of the vertical drag on the contact surface. The coefficient of friction is determined by the material and the surface properties, and it is not possible to make it too high because a sticky material cannot be used in consideration of selection among medical materials. Further, if the normal force of the contact surface is too large, the surface of the delivery wire 104 or the roller 505 is worn or damaged.

Another method is to increase the insertion force by attaching two motors to each of the two

rollers

505 and 506 that sandwich the delivery wire 104. However, if a motor for driving the roller 506 on the lid 510 side is attached to the lid 510, the wiring for passing a current moves not a little when the lid 510 is opened and closed. Since it is supported by the lid 510 via the roller 506 and the roller 506 and is not firmly fixed to the lid 510, there is a possibility that the roller support portion is damaged when the lid is opened and closed. Further, as shown in FIGS. 26 and 27, if the rotating shaft of the roller 505 and the output shaft of the motor 503 are coaxial, and the motor is similarly attached to the lid side, the degree of freedom in designing the motor arrangement position is low.

An object of the present invention is to provide a linear body insertion drive device having a high degree of design freedom and an improved linear body insertion drive force, a medical device equipped with the linear body drive device, and a medical operation training device.

In summary, the present invention is a linear body insertion drive device that inserts or retracts a linear body at a predetermined speed in accordance with an operator's command, and includes a pair of drive rollers that sandwich the linear body, and a pair of drive units A drive unit including at least one motor that rotates each of the rollers, and a transmission mechanism that transmits the rotational force of the drive unit to the drive roller. The rotating shaft of the first driving roller of the pair of driving rollers and the rotating shaft of the second driving roller of the pair of driving rollers are parallel to each other. The second drive roller is rotatable around a first axis that is parallel to the rotation axis of the first drive roller and that is different from the rotation axis of the first drive roller and the rotation axis of the second drive roller.

Preferably, the motor that drives the second drive roller is disposed so that the output shaft coincides with the first shaft.

Preferably, the transmission mechanism includes a transmission unit configured to transmit rotation by interposing a plurality of rotation shafts between the motor driving the second drive roller and the second drive roller, and one of the plurality of rotation shafts of the transmission unit. The first axis matches.

Preferably, the insertion drive device further includes a housing body that supports the rotation shaft of the first drive roller and a lid that supports the rotation shaft of the second drive roller. The lid is attached to the housing main body so as to be rotatable about the first axis.

More preferably, the diameter of the first drive roller is equal to the diameter of the second drive roller. In a state where the lid is closed, the distance between the first shaft and the rotation shaft of the first drive roller is equal to the distance between the first shaft and the rotation shaft of the second drive roller.

More preferably, the insertion drive device further includes an elastic member that is fixed to the lid and applies an urging force that presses the linear body against the rotation shaft that supports the second drive roller.

Preferably, the transmission mechanism includes any one of a belt, a chain, and a gear mechanism for transmitting the rotation of the motor to the first drive roller.

More preferably, the drive unit further includes another motor different from the motor, and the transmission mechanism includes any one of a belt, a chain, and a gear mechanism for transmitting rotation of the other motor to the second drive roller. In addition.

Preferably, the number of motors included in the drive unit is one. The transmission mechanism transmits the rotation of the motor to the first drive roller in the first rotation direction, and transmits the rotation of the motor to the second drive roller in the reverse direction of the first rotation direction.

More preferably, the insertion drive device further includes a first rotation shaft that is rotated by a motor. The transmission mechanism includes a transmission unit that transmits the rotation of the first rotation shaft to the second drive roller. The second drive roller and the transmission unit are configured to be rotatable about the first rotation axis.

In another aspect, the present invention is a medical device in which any one of the linear body insertion driving devices described above is incorporated.

Preferably, the medical device further includes a measuring unit that measures an insertion force and an extraction force that are acting forces in the longitudinal axis direction of the linear body, and a notification unit that notifies the acting force measured by the measuring unit.

In yet another aspect, the present invention is a medical operation training apparatus for simulating a human body, in which any of the medical devices described above is incorporated.

In the present invention, each of the two rollers sandwiching the delivery wire is given a rotational force by one or more motors via the transmission mechanism to provide two drive rollers. As a result, the driving force for inserting the delivery wire can be increased as compared with the case where there is only one driving roller, while the material and the vertical drag of the driving roller remain unchanged. Preferably, the axis of the hinge connecting the drive unit main body on which one roller is supported and the lid on which the other roller is supported is made to coincide with any rotation axis of the transmission mechanism. As a result, the degree of freedom in designing the position of the motor output shaft is increased, the lid can be easily opened, the distance between the two drive rollers and the hinge shaft is always constant, and the positioning of the transmission mechanism is also performed when the lid is closed. Can be omitted, and assembling becomes easy and the assembling time can be shortened.

It is the figure which showed schematic structure of the insertion apparatus 100 which is a medical device to which the insertion drive device 1 which concerns on embodiment of this invention was applied. FIG. 2 is a diagram showing a detailed configuration of an insertion device 100. FIG. 2 is a perspective view schematically showing a configuration of a power transmission mechanism from a motor to a drive roller of the insertion drive device 1. 2 is a top view of the insertion drive device 1. FIG. FIG. 5 is a cross-sectional view taken along the line VV in FIG. 4. FIG. 6 is a cross-sectional view taken along the line VI-VI in FIG. 5. It is the figure which showed the state which the cover opened in sectional drawing of FIG. It is a figure for demonstrating the 1st modification which changed arrangement | positioning of a motor. It is a figure for demonstrating the 2nd modification which changed arrangement | positioning of a motor. It is the schematic which showed 50 A of transmission mechanisms using a chain. It is the schematic which showed the transmission mechanism 50B using only a gearwheel. It is the perspective view which showed typically the structure of the power transmission mechanism from the motor of the insertion drive device 1 of Embodiment 2 to a drive roller. FIG. 10 is a top view of the insertion drive device 1 according to the second embodiment. It is sectional drawing in the XIV-XIV cross section of FIG. FIG. 15 is a cross-sectional view taken along the XV-XV cross section of FIG. It is the figure which showed the state which the cover opened in sectional drawing of FIG. It is the figure which showed the state which the cover of FIG. 16 opened on the state which the cover of FIG. 15 closed about the principal part of the transmission mechanism. In the example shown in FIG. 12, a gear is used instead of a belt for the transmission part. FIG. 10 is a perspective view schematically showing a configuration of a power transmission mechanism of an insertion drive device according to a fourth embodiment. FIG. 15 is a cross-sectional view in a cross section orthogonal to the delivery wire of the insertion drive device of the fourth embodiment, and is a cross-sectional view corresponding to FIG. 14. FIG. 16 is a cross-sectional view in a cross section parallel to the delivery wire of the insertion drive device according to the fourth embodiment, corresponding to FIG. 15. It is the schematic which showed the example of 250 A of transmission mechanisms using a chain. It is the schematic which showed the example of the transmission mechanism 250B which uses only a gearwheel. It is the figure which showed the example of the training apparatus which incorporated the insertion apparatus in the simulator for training. 5 is a cross-sectional view showing a cross section parallel to the linear body of the insertion drive device 501. FIG. 6 is a cross-sectional view showing a cross section orthogonal to the linear body of the insertion drive device 501. FIG. FIG. 26 is a cross-sectional view taken along a line XXVII-XXVII in FIG. 25. It is the figure which looked at the state by which the cover of the insertion drive device 501 was opened from the direction orthogonal to a linear body.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. In the following drawings, the same or corresponding parts are denoted by the same reference numerals, and description thereof will not be repeated.

An example of a minimally invasive surgical operation such as treatment using a catheter is coil embolization treatment. The coil embolization treatment is a treatment for embolizing a coil placed in a cerebral aneurysm to prevent rupture of the cerebral aneurysm that causes subarachnoid hemorrhage.

Referring to FIGS. 1 and 2, an insertion device 100 for inserting a delivery wire 104 used for coil embolization treatment into a blood vessel 132 in the body will be described.

FIG. 1 is a diagram showing a schematic configuration of an insertion device 100 that is a medical device to which an insertion drive device 1 according to an embodiment of the present invention is applied. FIG. 2 is a diagram illustrating a detailed configuration of the insertion device 100.

Referring to FIGS. 1 and 2, insertion device 100 controls insertion drive device 1,

Y connectors

31 and 111, sensor control device 90, speaker 92, display 93, and insertion drive device 1. Control circuit 40, foot switches 41 and 46, and

speed control units

43 and 48.

The delivery wire 104 which is a medical linear body in the present embodiment is inserted into the Y connector 31. A platinum coil 101 for coil-embedding the cerebral aneurysm 133 is connected to the head of the delivery wire 104. The delivery wire 104 is inserted into the Y connector 31 from the first input port 32, passes through the Y connector 31, and is inserted into the child catheter 102 connected to the output port 34.

In the insertion device 100, a platinum coil 101 for coil-embedding the cerebral aneurysm 133 is connected to the head of the delivery wire 104. The catheter through which the delivery wire 104 is inserted is a double-tube catheter in which the parent catheter 103 is an outer tube and the child catheter 102 is an inner tube. The child catheter 102 is hollow, and the delivery wire 104 is inserted into the hollow portion of the child catheter 102. The delivery wire 104 is inserted into the Y connector 31, and the child catheter 102 is inserted into the Y connector 111.

Each of the Y connector 111 and the Y connector 31 has three connection ports. One is a connection port of the catheter, the other is a port for inserting a linear body such as a catheter or a delivery wire, and the other is an input port 112 and an input port 33 for physiological saline or medicine.

The parent catheter 103 is inserted into the blood vessel 132 of the human body 131, and the distal end reaches the vicinity of the carotid artery. The child catheter 102 is inserted into the parent catheter 103 and advanced from the distal end of the parent catheter 103 into the cerebral aneurysm 133. The coil 101 is pushed out from the child catheter 102 that has reached the inside of the cerebral aneurysm 133, and the thin and soft coil 101 is packed in the cerebral aneurysm 133. Thereby, the rupture of the cerebral aneurysm 133 is prevented.

The insertion device 100 includes an insertion drive device 1 that moves the delivery wire 104 in the longitudinal axis direction. The insertion drive device 1 includes two

drive rollers

5 and 6. The delivery wire 104 is sandwiched between the rotating surface of the driving roller 5 and the rotating surface of the driving roller 6, and moves in the longitudinal axis direction in response to the rotation of the driving

rollers

5 and 6. The movement of the delivery wire 104 in the longitudinal axis direction by the insertion driving device 1 is controlled by the control circuit 40.

The foot switches 41 and 46 are connected to the control circuit 40 by

wirings

42 and 47, respectively, and the

speed control units

43 and 48 are connected to the control circuit 40 by

wirings

44 and 49, respectively.

Each of the

speed controllers

43 and 48 is provided with a volume switch capable of adjusting the moving speed at which the insertion drive device 1 moves the delivery wire 104.

The insertion speed or the withdrawal speed of the delivery wire 104 can be increased or decreased by operating the volume switch provided in the

speed control units

43 and 48. An operator who performs coil embolization treatment alone holds the Y connector 111 with his left hand when the child catheter 102 is inserted into the Y connector 111. When this operator wants to increase or decrease the insertion speed of the delivery wire 104, he operates the volume switch of the speed control unit 43 with the right hand. When the operator wants to increase or decrease the pulling speed of the delivery wire 104, he operates the volume switch of the speed control unit 48 with the right hand. Thereby, the moving speed of the delivery wire 104 in the longitudinal axis direction can be controlled.

In the Y connector 31, an insertion force sensor 60 is incorporated. The insertion force sensor 60 measures the compressive force in the longitudinal direction (that is, the insertion force of the delivery wire 104) and the pulling force acting on the delivery wire 104 by detecting the degree of curvature of the delivery wire 104. The measurement of the compressive force acting on the delivery wire 104 is necessary in order to prevent the human body from being damaged by applying an excessive compressive force (insertion force) to the linear body introduced into the body. The display 93 notifies the operator of the acting force measured by the insertion force sensor 60.

[Embodiment 1]
FIG. 3 is a perspective view schematically showing a configuration of a power transmission mechanism from the motor of the insertion drive device 1 to the drive roller.

Referring to FIG. 3, delivery wire 104 is sandwiched between two drive rollers, drive roller 5 and drive roller 6. The insertion drive device 1 rotates a motor to a pair of

drive rollers

5 and 6, a motor 3 that rotates the pair of

drive rollers

5 and 6, and one of the pair of

drive rollers

5 and 6. A transmission mechanism 50 that transmits in the first rotation direction and transmits the rotation of the motor 3 in the reverse direction of the first rotation direction to the other of the pair of

drive rollers

5 and 6 is provided.

Since the transmission mechanism 50 transmits the rotation of the motor 3 to the two

rollers

5 and 6, the delivery wire 104 drives the wire as compared with the conventional system in which the delivery wire is driven by the feed roller and the restraining roller. The power can be increased.

The rotation of the motor 3 is transmitted to the rotary shaft 4 via the speed reducer 9. The driving

rollers

5 and 6 rotate following the rotation of the rotating shaft 4 rotated by the motor 3. The transmission mechanism 50 includes transmission units 51 to 53. The transmission unit 52 transmits the rotation of the rotary shaft 4 to the drive roller 6.

The two

drive rollers

5 and 6 are arranged so that their axes are parallel to each other, and are connected to the motor 3 via transmission units 51 to 53 which are similarly arranged so that their axes are parallel. The transmission unit 51 includes a belt 51A, a driving pulley 51B, and a driven pulley 51C. The transmission unit 51 transmits the rotation of the motor 3 to the transmission unit 53. The transmission unit 52 includes a belt 52A, a driving pulley 52B, and a driven pulley 52C. The transmission unit 52 transmits the rotation of the motor 3 to the driving roller 6.

In order to drive the delivery wire 104 in one direction, the driving roller 5 and the driving roller 6 must rotate in the opposite directions. For this reason, the transmission part 53 is arranged between the transmission part 51 and the drive roller 5. Transmission unit 53 includes a gear 53A and a gear 53B. With this configuration, the transmission mechanism 50 can apply the rotational force of one motor 3 to the two

drive rollers

5 and 6. Therefore, the insertion driving device 1 can increase the driving force as compared with the case where the delivery wire is driven by one roller shown in FIGS.

The driving roller 6 and the transmission unit 52 are configured to be rotatable about a common shaft 58. As will be described later, the drive roller 6 and the transmission unit 52 are attached to the lid of the insertion drive device 1. The shaft 58 corresponds to a “first shaft” recited in the claims.

Next, details of the insertion drive device 1 will be described with reference to FIGS. FIG. 4 is a top view of the insertion drive device 1. FIG. 5 is a cross-sectional view taken along the line VV of FIG. 6 is a cross-sectional view taken along the line VI-VI in FIG. FIG. 7 is a view showing a state in which the lid is opened in the cross-sectional view of FIG. 6.

4 to 6, in addition to the driving

rollers

5 and 6, the transmission mechanism 50 (transmission units 51 to 53), and the motor 3, the insertion driving device 1 further includes a housing body 2 and a lid 10. Including. The housing body 2 supports the rotating shaft of the driving roller 5 and the motor 3. The fixing portion 7 provided on the lid 10 supports the rotation shaft of the driving roller 6. The fixing portion 7 is supported on the lid 10 via an elastic body 8. The lid 10 is attached to the housing body 2 so as to be rotatable about a shaft 58 that is an extension of the rotation shaft of the motor 3.

The delivery wire 104 is sandwiched between the driving roller 5 and the driving roller 6 by closing the lid 10. The driving roller 6 is pressed against the delivery wire 104 and the driving roller 5 with a predetermined force by the elastic body 8. That is, the elastic body 8 is fixed to the lid 10 and applies a biasing force that presses the delivery wire 104 to the rotating shaft that supports the drive roller 6.

As a result, a vertical drag is generated between the drive roller 6 and the delivery wire 104 and between the delivery wire 104 and the drive roller 5, and the delivery wire 104 is driven by the frictional force between each roller and the wire as the motor 3 rotates.

The housing body 2 is provided with a lever 12 for opening and closing. The

protrusions

13 and 14 of the fitting portions provided on the lever 12 and the lid 10 can be fitted by the pressure of the elastic body 8 to close the lid 10. When the lever 12 is elastically deformed and this fitting is released, the lid 10 can be opened. The Y connector 31 is sandwiched between elastic bodies 15 such as rubber attached to the housing body 2 and the lid 10 and attached to the insertion drive device 1. The lever 12 may be provided on the lid 10.

The insertion drive device 1 is configured to be able to open the lid 10 with a hinge 11. The operator can set the delivery wire 104 and the Y connector 31 integrally by closing the lid 10, and can remove the delivery wire 104 and the Y connector 31 while opening the lid 10.

By making the axis of the hinge 11 and the output shaft of the motor 3 coincide with each other, the relative distance between the two

drive rollers

5 and 6 and the shaft of the motor 3 is constant even when the lid 10 is opened and closed. For this reason, since the arrangement correction mechanism of the transmission part when the lid 10 is opened and closed can be omitted, the lid 10 can be opened and closed with a simple configuration. Since the delivery wire 104 and the Y connector 31 can be removed / installed together, the assembly is easy and the assembly time can be shortened as compared with the case where the shaft of the hinge 11 and the output shaft of the motor 3 are not matched.

It should be noted that the same effect can be obtained without necessarily aligning the axis of the motor 3 and the axis of the hinge 11. FIG. 8 is a diagram for explaining a first modified example in which the arrangement of the motor is changed. FIG. 9 is a diagram for explaining a second modification in which the arrangement of the motor is changed.

In the modification shown in FIG. 8, the shaft of the motor 3 is attached to the pulley 51 </ b> C of the transmission unit 51. In the modification shown in FIG. 9, the shaft of the motor 3 is attached to the gear 53 </ b> A of the transmission unit 53. Even if it deform | transforms like these, if the axis | shaft 58 is made to correspond with the axis | shaft of the hinge 11, the same effect will be acquired.

In the configuration shown in FIGS. 3 to 7, the transmission unit 53 for reversing the rotational direction of the shaft is a gear mechanism, but it may be replaced by a belt or chain that has been marked (crossed). Also, the

transmission units

51 and 52 may use chains instead of belts.

That is, the transmission mechanism 50 may be configured to include any one of a belt, a chain, and a gear mechanism for transmitting the rotation of the motor 3 to the drive roller 5. Further, the transmission mechanism 50 may be configured to further include any one of a belt, a chain, and a gear mechanism for transmitting the rotation of the motor 3 to the drive roller 6 so as to reverse the rotation of the drive roller 5. .

FIG. 10 is a schematic view showing an example of a transmission mechanism 50A using a chain. The transmission mechanism 50A shown in FIG. 10 includes a chain 51D, chain wheels (sprockets) 51E and 51F, a chain 52D, and

chain wheels

52E and 52F. Even in such a configuration, the same effect can be obtained by making the axis of the hinge 11 coincide with the axes of the chain wheel 51E and the chain wheel 52E.

FIG. 11 is a schematic view showing an example of a transmission mechanism 50B using only gears. The transmission mechanism 50B shown in FIG. 11 includes gears 53A to 53F. Even in such a configuration, the same effect can be obtained by matching the axis of the hinge 11 with the axis of the gear 53D.

Note that the motor 3 may be disposed at any of the positions described with reference to FIGS. 3, 8, and 9 in both cases of FIGS. 10 and 11.
[Embodiment 2]
FIG. 12 is a perspective view schematically showing a configuration of a power transmission mechanism from the motor to the drive roller of the insertion drive device 1 according to the second embodiment.

Referring to FIG. 12, delivery wire 104 is sandwiched between two drive rollers, drive roller 5 and drive roller 6.

The rotation of the drive unit 207 including the two

motors

203 and 204 is transmitted to the

drive rollers

5 and 6 by the transmission mechanism 250. The transmission mechanism 250 includes a transmission unit 251 that transmits the rotation of the motor 203 to the driving roller 5, and a transmission unit 252 that transmits the rotation of the motor 204 to the driving roller 6. The

motors

203 and 204 are given drive signals by the wiring pairs 203P and 204P, respectively.

The two

drive rollers

5 and 6 are arranged so that the axes thereof are parallel to each other, and are connected to the motor 203 and the motor 204 via the transmission unit 251 and the transmission unit 252 that are similarly arranged so that the axes are parallel to each other. ing.

In the example shown in FIG. 12, the transmission unit 251 includes a belt 251A, a driving pulley 251B, and a driven pulley 251C. The transmission unit 252 includes a belt 252A, a driving pulley 252B, and a driven pulley 252C. That is, the driving roller 5 is driven by the motor 203 via the transmission unit 251, and the driving roller 6 is driven by the motor 204 via the transmission unit 252. The delivery wire is moved in the insertion direction or the pulling direction by controlling the motor 203 and the motor 204 so that the driving roller 5 and the driving roller 6 rotate in the opposite directions.

With the configuration shown in FIG. 12, the rotational force of the two motors can be applied to the two rollers, compared with the case where the delivery wire is driven by the feeding roller and the restraining roller shown in FIGS. , Driving force increases.

The driving roller 6 and the transmission unit 252 are configured to be rotatable about a common shaft 258. As will be described later, the drive roller 6 and the transmission unit 252 are attached to the lid of the insertion drive device 1. The shaft 258 corresponds to the “first shaft” recited in the claims.

Next, details of the insertion drive device 1 will be described with reference to FIGS. FIG. 13 is a top view of the insertion driving apparatus 1 according to the second embodiment. 14 is a cross-sectional view taken along the line XIV-XIV in FIG. FIG. 15 is a cross-sectional view taken along the line XV-XV in FIG. 16 is a view showing a state in which the lid is opened in the cross-sectional view of FIG.

Referring to FIGS. 13 to 15, in addition to drive

rollers

5 and 6, transmission mechanism 250 (transmission units 251 and 252) and

motors

203 and 204, insertion drive device 1 further includes housing body 202, And a lid 210. The housing body 202 supports the rotation shaft of the drive roller 5 and the

motors

203 and 204. The lid 210 supports the rotation shaft of the drive roller 6. The driving roller 6 is supported on the lid 210 via an elastic body 208. The lid 210 is attached to the housing main body 202 so as to be rotatable about a shaft 258 on the extension of the rotation shaft of the motor 204.

As shown in FIG. 15, the delivery wire 104 is sandwiched between the driving roller 5 and the driving roller 6 by closing the lid 210. The driving roller 6 is pressed against the delivery wire 104 and the driving roller 5 by a predetermined force by the elastic body 208. That is, the elastic body 208 is fixed to the lid 210 and applies an urging force that presses the delivery wire 104 to the rotating shaft that supports the drive roller 6.

As a result, vertical drag is generated between the drive roller 6 and the delivery wire 104 and between the delivery wire 104 and the drive roller 5. In this state, when the

motors

203 and 204 are rotated in the reverse direction, the delivery wire 104 is driven by the frictional force between each roller and the wire.

The housing body 202 is provided with a lever 212 for operating opening and closing. The

protrusions

213 and 214 of the fitting portions provided on the lever 212 and the lid 210 can be fitted by the pressure of the elastic body 208 to close the lid 210. When the lever 212 is elastically deformed to release this fitting, the lid 210 can be opened as shown in FIG. The Y connector 31 is sandwiched between elastic bodies 215 such as rubber attached to the housing main body 202 and the lid 210 and attached to the insertion driving device 1. Note that the lever 212 may be provided on the lid 210.

The insertion drive device 1 is configured such that the lid 210 can be opened with a hinge 211. The operator can set the delivery wire 104 and the Y connector 31 integrally by closing the lid 210, and can remove the delivery wire 104 and the Y connector 31 as they are integrated by opening the lid 210.

28 is configured such that the lid 510 rotates around an axis (hinge 511) parallel to the insertion direction of the delivery wire 104. The conventional insertion drive device shown in FIG. On the other hand, in the present embodiment, the central axis of rotation of the lid 210 is a direction intersecting with the insertion direction of the delivery wire 104 and is a direction parallel to the rotation axis of the

drive rollers

5 and 6.

FIG. 17 is a diagram showing the main part of the transmission mechanism, in which the cover of FIG. 15 is closed and the cover of FIG. 16 is opened.

Referring to FIG. 17, when the lid 210 is closed, the rotation axis of the drive roller 5 and the rotation axis of the drive roller 6 are both on the axis 161 orthogonal to the axis 163 through which the delivery wire 104 passes. The rotation axis of the motor 204 is on the axis 163. This indicates that the distance between the rotating shaft of the motor 204 and the rotating shaft of the driving roller 5 is equal to the distance between the rotating shaft of the motor 204 and the rotating shaft of the driving roller 6.

When the lid 210 is opened, the driving roller 6 and the transmission unit 252 (the belt 252A, the

pulleys

252B, and 252C) rotate about the shaft 258 in the direction indicated by the angle θ in FIG. The center O1 of the driving roller 6 moves to the position of the center O2 when the lid is opened.

The axis of the hinge 211 and the input shaft of the transmission unit 252 (the output shaft of the motor 204) both coincide with each other at the shaft 258. Thus, even when the lid 210 is opened and closed, the relative distance between the rotation center axis of the two drive rollers 6 and the axis of the hinge 211 is constant, and is equal to the distance between the rotation center axis of the drive roller 5 and the hinge 211. For this reason, the lid 210 can be easily opened and closed while the motor 204 is fixed. In the design example shown in FIG. 17, the

motors

203 and 204 are arranged such that the rotation shafts are arranged on a shaft 162 parallel to the shaft 161. This is advantageous in that the belt and pulley can be shared by the two motors. In addition, if it does not stick to commonality, since the installation position of the motor 203 is relatively free, the degree of design freedom increases.

[Embodiment 3]
FIG. 18 is an example in which a gear is used instead of a belt for the transmission unit in the example shown in FIG. Specifically, the insertion drive device according to the third embodiment shown in FIG. 18 includes a transmission unit 351 instead of the transmission unit 251 in the configuration shown in FIG. The transmission unit 351 includes a drive-side gear 351A and a driven-side gear 351B that meshes with the gear 351A.

The gear 351A is attached to the rotating shaft of the motor 203. The gear 351 </ b> B is attached to the rotation shaft of the drive roller 5.

Also in the configuration shown in FIG. 18, the lid can be easily opened and closed by matching the input shaft of the transmission unit 252 and the axis of the hinge for opening and closing the lid of the driving device with the shaft 258, and the delivery wire 104 And Y connector can be removed and installed together. Therefore, as compared with the case where the hinge shaft and the rotation shaft of the transmission portion 252 do not coincide with each other, the assembly is easy and the assembly time can be shortened. Further, the lid 210 can be easily opened and closed while the motor 204 is fixed, and the installation position of the motor 203 is relatively free, so that the degree of freedom in design increases.

[Embodiment 4]
FIG. 19 is a perspective view schematically showing the configuration of the power transmission mechanism of the insertion drive device of the fourth embodiment. FIG. 20 is a cross-sectional view in a cross section orthogonal to the delivery wire of the insertion drive device of the fourth embodiment, and is a cross-sectional view corresponding to FIG. FIG. 21 is a cross-sectional view in a cross section parallel to the delivery wire of the insertion drive device of the fourth embodiment, and is a cross-sectional view corresponding to FIG.

In the insertion drive device of the fourth embodiment shown in FIGS. 19 to 21, a transmission unit 253 is added to the second embodiment shown in FIGS. 12, 14, and 15. Transmission unit 253 includes

gears

253A and 253B.

The gear 253A is attached to the output shaft of the motor 204. The gear 253 </ b> B is attached to the input shaft of the transmission unit 252. The

transmission units

252 and 253 are configured such that the rotation shaft of the gear 253B, which is the output shaft of the transmission unit 253, the input shaft of the transmission unit 252 and the rotation shaft of the hinge 211 coincide with each other.

In this way, the rotation axis (rotation axis of the pulley 252B) that does not coincide with the rotation axis of the drive roller 6 of the transmission unit 252 that transmits the rotational force from the motor 204 to the drive roller 6 coincides with the rotation axis of the hinge 211. Yes. If this condition is satisfied, the lid can be opened and closed with the motor 204 fixed even if the output shaft of the motor 204 and the rotation axis of the hinge 211 do not necessarily coincide. Further, since the installation position of the motor 203 is relatively free, the degree of freedom in design increases.

[Modification]
In the configuration of the fourth embodiment, the transmission unit 253 is a gear mechanism. However, the transmission unit 253 may be replaced by a belt or a chain that has been brushed (crossed). Also, the

transmission units

251 and 252 may use chains instead of belts. In the second and third embodiments, a chain or a gear may be applied.

That is, the transmission mechanism 250 shown in FIG. 12 may be configured to include any one of a belt, a chain, and a gear mechanism for transmitting the rotation of the motor 203 to the drive roller 5. Further, the transmission mechanism 250 may be configured to further include any one of a belt, a chain, and a gear mechanism for transmitting the rotation of the motor 204 to the drive roller 6.

FIG. 22 is a schematic view showing an example of a transmission mechanism 250A using a chain. The transmission mechanism 250A illustrated in FIG. 22 includes a chain 251D, chain wheels (sprockets) 251E and 251F, a chain 252D, and

chain wheels

252E and 252F. Even in such a configuration, the same effect can be obtained by matching the axis of the hinge 211 with the axis of the chain wheel 252E.

FIG. 23 is a schematic diagram showing an example of a transmission mechanism 250B using only gears. A transmission mechanism 250B illustrated in FIG. 23 includes

gears

251G, 251H, and 251J, and gears 252G, 252H, 252J, and 252k. Even in such a configuration, the same effect can be obtained by matching the axis of the hinge 211 with the axis of the gear 252H.

Further, the drive unit 207 may not include two motors. For example, the transmission mechanism may be modified so that the motor 204 is eliminated as in the first embodiment and the rotation of the motor 203 is transmitted not only to the driving roller 5 but also to the driving roller 6. Specifically, in FIG. 23, the gear 252k may be disposed so as to mesh with both the gear 251H and the gear 252H, and the motor 204 may be removed.

In addition, the insertion device 100 shown in the above embodiment can be incorporated in a training simulator for simulating a human body. FIG. 24 is a diagram illustrating an example of a training device in which an insertion device is incorporated in a training simulator.

Referring to FIG. 24, the training device 400 includes an insertion drive device 1, a guide wire (linear body) 104, a catheter 103, a simulator 432, a cable 428, an operation device 94, a speaker 92, and a display. Instrument 93.

The catheter 103 is connected to the insertion driving device 1 and the delivery wire 104 that has passed through the insertion driving device 1 is inserted. Any of the insertion drive devices 1 described with reference to FIGS. 3 to 23 can be used.

An operator holding the delivery wire 104 drives the insertion drive device 1 with the operating device 94 to advance the delivery wire 104 into the simulator 231 or pull it out of the simulator 431, and compresses or pulls the delivery wire 104. When a force is applied, the compressive force or tensile force is displayed by the indicator 93 which is a “notification unit”.

The simulator 431 simulates a human body and displays an equivalent to a fluoroscopic image of a human body tube. An operator who is training a medical device operates the delivery wire 104 with the operation device 94 while viewing the display image of the simulator 431. The simulator 431 changes the insertion resistance and the extraction resistance with respect to the inserted delivery wire 104. The resistance force during operation, that is, the measured compressive force and tensile force acting on the delivery wire 104 are displayed on the display 93 and also transmitted to the simulator 431 via the cable 428. The simulator 431 changes the insertion resistance and the withdrawal resistance of the delivery wire 104 based on the transmitted compressive force and tensile force. A warning sound is output from the speaker 92 when the compressive force and tensile force acting on the delivery wire 104 exceed a predetermined threshold.

With the configuration as described above, the operation of the skilled operator can be quantified, and the procedure of the less experienced operator can be improved early. Further, the operator's operation can be recorded together with the fluoroscopic image as a record during the operation.

If the method proposed this time is used, the delivery wire insertion force can be increased. Also, if the position of the motor 204 is determined, the motor 203 is relatively free to be placed and the degree of freedom in design is increased, and the lid can be opened and closed and the delivery wire and the Y connector can be easily removed / installed.

The embodiment disclosed this time should be considered as illustrative in all points and not restrictive. The scope of the present invention is shown not by the above description of the embodiments but by the scope of claims, and is intended to include all modifications within the meaning and scope equivalent to the scope of claims.

1,501 Insertion drive, 2,202,502 Housing body, 3,203,204,503 Motor, 4 Rotating shaft, 5,6,505,506 Roller, 7,507 Fixing part, 8, 15, 208, 215, 508, 515 elastic body, 9,509 speed reducer, 10, 210, 510 lid, 11, 211, 511 hinge, 12, 212, 512 lever, 13, 14, 213, 214 protrusion, 31, 111 connector, 32 , 33, 112 input port, 34 output port, 40 control circuit, 41, 46 foot switch, 42, 44, 47, 49 wiring, 43, 48 speed control unit, 50, 50A, 50B, 250, 250A, 250B transmission mechanism , 51, 52, 53, 251, 252, 253, 351, transmission unit, 51A, 52A, 251A, 25 A belt, 51B, 51C, 52B, 52C, 251B, 251C, 252B, 252C pulley, 51D, 52D, 251D, 252D chain, 51E, 52E, 52F, 252E, 252F chain wheel, 53A, 53B, 53D, 53F, 251G , 251H, 251J, 252G, 252H, 252J, 252k, 253A, 253B, 351A, 351B gear, 58, 161, 162, 163, 258 shaft, 60 insertion force sensor, 90 sensor controller, 92 speaker, 93 display, 94 operation device, 100 insertion device, 101 coil, 102 child catheter, 103 parent catheter, 104 delivery wire, 131 human body, 132 blood vessel, 133 cerebral aneurysm, 203P, 204P wiring pair, 207 drive unit, 23 , 431 simulator, 400 training devices, 428 cables, 513 and 514 protrusions.

Claims

A linear body insertion drive device for inserting or retracting a linear body at a predetermined speed according to an operator's command,
A pair of drive rollers for sandwiching the linear body;
A drive unit including at least one motor for rotating each of the pair of drive rollers;
A transmission mechanism that transmits the rotational force of the drive unit to the drive roller;
The rotating shaft of the first driving roller of the pair of driving rollers and the rotating shaft of the second driving roller of the pair of driving rollers are parallel to each other,
The second drive roller is rotatable about a first axis that is parallel to the rotation axis of the first drive roller and different from the rotation axis of the first drive roller and the rotation axis of the second drive roller. The linear body insertion drive device.
The linear body insertion drive device according to claim 1, wherein the motor for driving the second drive roller is disposed so that an output shaft thereof coincides with the first shaft.
The transmission mechanism is
A transmission unit that transmits rotation by interposing a plurality of rotation shafts between the motor that drives the second drive roller and the second drive roller;
2. The linear body insertion drive device according to claim 1, wherein one of the plurality of rotating shafts of the transmission unit and the first shaft coincide with each other.
A housing body that supports a rotation shaft of the first drive roller;
A lid that supports the rotation shaft of the second drive roller;
The linear body insertion drive device according to claim 1, wherein the lid is attached to the housing main body so as to be rotatable about the first axis.
The diameter of the first driving roller and the diameter of the second driving roller are equal,
The distance between the first shaft and the rotation shaft of the first drive roller and the distance between the first shaft and the rotation shaft of the second drive roller are equal when the lid is closed. Item 5. The linear body insertion drive device according to Item 4.
The linear body insertion drive device according to claim 4, further comprising an elastic member that is fixed to the lid and applies an urging force that presses the linear body against a rotating shaft that supports the second drive roller.
The transmission mechanism is
The linear body insertion drive device according to claim 1, comprising any one of a belt, a chain, and a gear mechanism for transmitting rotation of the motor to the first drive roller.
The drive unit further includes another motor different from the motor,
The transmission mechanism is
The linear body insertion drive apparatus according to claim 7, further comprising any one of a belt, a chain, and a gear mechanism for transmitting rotation of the other motor to the second drive roller.
The number of motors included in the drive unit is one,
The transmission mechanism transmits rotation of the motor to the first drive roller in a first rotation direction, and transmits rotation of the motor to the second drive roller in a direction reverse to the first rotation direction. The linear body insertion drive device described in 1.
The insertion drive device further includes a first rotation shaft that is rotated by the motor,
The transmission mechanism includes a transmission unit that transmits rotation of the first rotation shaft to the second drive roller;
The linear body insertion drive device according to claim 9, wherein the second drive roller and the transmission unit are configured to be rotatable about the first rotation shaft.
A medical device in which the linear body insertion drive device according to any one of claims 1 to 10 is incorporated.
A measuring unit for measuring an insertion force and a pulling force, which are acting forces in the longitudinal axis direction of the linear body,
The medical device according to claim 11, further comprising: a notification unit that notifies the acting force measured by the measurement unit.
A medical operation training apparatus for simulating a human body, in which the medical device according to claim 11 or 12 is incorporated.