WO2019026995A1 - Medical device - Google Patents

Abstract

The present invention provides a medical device or the like comprising an elongated medical device body, a first manipulation wire and a second manipulation wire respectively inserted along the axial direction of the medical device body, and a flexural manipulation part for flexing a distal end of the medical device body through pulling exerted by the first manipulation wire and the second manipulation wire. At an intermediate part and proximal end part with respect to the axial direction of the medical device body, the first manipulation wire and the second manipulation wire extend separately from and parallel with each other in the circumferential direction of the medical device body. At a distal end part with respect to the axial direction of the medical device body, the first manipulation wire and the second manipulation wire gradually curve and converge toward each other toward the distal end side along the circumferential direction of the medical device body.

Description

Medical equipment

The present invention relates to medical devices.
Priority is claimed on Japanese Patent Application No. 2017-150210, filed on Aug. 2, 2017, Japanese Patent Application No. 2018-015534, filed on Jan. 31, 2018, on Jan. 31, 2018. Priority is claimed based on Japanese Patent Application No. 2018-015535, the content of which is incorporated herein by reference.

As a long medical device such as a catheter or the like capable of bending the distal end, a type having a control line is known (for example, Patent Document 1).

In the catheter of Patent Document 1, a plurality of hollow tubes are disposed around a central lumen, and operation wires are respectively inserted into two opposing hollow tubes through the central lumen. . In the catheter of the same document, the tip of the operation line is fixed to the tip of the catheter. The catheter of the same document is configured to be able to pull the rear end of the operation line. Thereby, the distal end portion of the catheter can be bent by selecting and pulling the operation line.

JP, 2013-48711, A

However, in the catheter of Patent Document 1, when the distal end is further bent after passing through a body cavity such as a curved blood vessel, it can be easily bent in the inward direction of the curve, but is bent in the outward direction. Hateful.
This is because, when pulling the operation line located on the out-course side of the curve and trying to bend the tip of the catheter outward, the catheter in the curved blood vessel is in the direction of shortening the path of the pulled operation line. This is because the catheter is rotated about its axis.

The present invention has been made in view of the above-described problems, and provides a medical device such as a catheter having a structure capable of bending the distal end portion in a desired direction more reliably.

Moreover, in medical devices such as catheters, operability in accordance with various needs is required, and from this viewpoint, the technology of Patent Document 1 still has room for improvement.

The present invention has been made in view of the above problems, and provides a medical device such as a catheter having a structure capable of suitably realizing operability in accordance with various needs.

The present invention relates to a long medical device body,
A first operation line and a second operation line respectively inserted along the axial direction of the medical device body;
A bending operation unit for bending an end portion of the medical device body by pulling the first operation line and the second operation line;
Equipped with
The first operation line and the second operation line are spaced apart from each other in the circumferential direction of the medical device body and extend in parallel at an intermediate portion and a base end portion in the axial direction of the medical device body,
At the distal end portion in the axial direction of the medical device body, the first operation line and the second operation line are curved and joined so as to gradually approach each other in the circumferential direction of the medical device body toward the distal end side It provides medical equipment.

The present invention also relates to a long medical device body,
A first operation line and a second operation line respectively inserted along the axial direction of the medical device body;
A bending operation unit for bending an end portion of the medical device body by pulling the first operation line and the second operation line;
Equipped with
The bending operation unit is
A rotating member rotatably supported, wherein the base end of the first operation line and the base end of the second operation line are fixed;
A pulling direction in which the rotating member is pulled along the first operation line and the second operation line, and a moving mechanism moving the rotating member in a direction opposite to the pulling direction;
An operation receiving unit that operates by receiving user operations;
Equipped with
The motive power of the said operation reception part is transmitted to the said rotation member via the said moving mechanism, and the said rotation member provides the medical instrument which moves to the said pulling direction and the said opposite direction.

According to the present invention, it is possible to bend the tip in a desired direction more reliably. Moreover, according to the present invention, it is possible to preferably realize operability according to various needs.

FIG. 21 is a longitudinal cross-sectional view showing a distal end side portion of a medical device main body of a medical device according to 1-1 and 2-1 embodiments. FIG. 2 is a cross-sectional view of the medical device body taken along the line AA of FIG. 1; FIG. 2 is a cross-sectional view of the medical device body taken along the line BB in FIG. 1; FIG. 2 is a cross-sectional view of the medical device body along the line CC of FIG. 1; FIGS. 5 (a) and 5 (b) are schematic views for explaining the bending operation of the distal end portion of the medical device main body of the medical device according to the 1-1 and 2-1 embodiments. It is a top view which shows the bending operation part of the medical device which concerns on the 1st-1 and the 2nd-1 embodiment, and the portion of the neighborhood of it. FIG. 18 is a side view showing a bending operation portion of a medical device according to the first and second embodiments and a portion in the vicinity thereof. FIG. 8 (a) is an overall view of a medical device according to the 1-1 and 2-1 embodiments, and FIG. 8 (b) is a medical treatment of the medical device according to the 1-1 and 2-1 embodiments. It is a general view of the state where the tip part of an apparatus main part bent to one side. It is a longitudinal cross-sectional view which shows the part by the side of the tip in the medical device main part of the medical device concerning a 1-2 and 2-2 embodiment. FIG. 10 is a cross-sectional view of the medical device body taken along the line AA of FIG. 9; FIGS. 11 (a) and 11 (b) are schematic views for explaining the bending operation of the distal end portion of the medical device main body of the medical device according to the first and second embodiments. It is a longitudinal cross-sectional view which shows the part by the side of the tip in the medical device main part of the medical device concerning a 1-3rd and 2-3rd embodiment. FIG. 13 is a cross-sectional view of the medical device body taken along the line AA of FIG. 12; FIG. 13 is a cross-sectional view of the medical device body taken along the line BB in FIG. 12; FIG. 13 is a cross-sectional view of the medical device body taken along the line CC of FIG. 12; 16 (a), 16 (b), 16 (c) and 16 (d) show the bending operation of the distal end portion of the medical device main body of the medical device according to the first and third embodiments. It is a schematic diagram for demonstrating. FIG. 18 is a side view showing a bending operation portion of a medical device according to the first to third embodiments and a portion in the vicinity thereof. Fig. 18 (a) is an overall view of a medical device according to the first to third embodiments, and Fig. 18 (b) is a medical device for medical devices according to the first to third embodiments. FIG. 18C is an overall view of a state in which the tip of the device body is bent to one side, and FIG. 18C is a view of the tip of the medical device body of the medical device according to the first to third embodiments. It is a general view of the bent state. 19 (a) and 19 (b) are schematic views of the distal end portion of the medical device main body of the medical device according to the 1-4 and 2-4 embodiments, and FIG. 19 (a) is a plan view 19 (b) is a side view. FIGS. 20 (a) and 20 (b) are schematic views of the distal end portion of the medical device main body of the medical device according to the first and second embodiments, wherein FIG. 20 (a) is a plan view FIG. 20 (b) is a side view. It is a top view which shows the bending operation part of the medical device which concerns on 1st-6 and 2-6 embodiment, and the part of the vicinity. It is a top view which shows the bending operation part of the medical device which concerns on 1-7 and 2-7 embodiment, and the part of the vicinity.

Hereinafter, embodiments of the present invention will be described using the drawings. In all the drawings, the same components are denoted by the same reference numerals, and the description will not be repeated.
The various components of the medical device according to the present embodiment do not have to be individually independent, and a plurality of components are formed as one member, and one component is formed of a plurality of members. Allow one component to be part of another component, overlap between part of one component and part of another component, etc.

Terms used in describing the embodiments of the present invention are defined as follows unless otherwise noted.
The terms tip and proximal may be used in the description of the embodiments. The tip portion refers to a predetermined length region including the end (distal end) on the insertion tip side of the medical device in each part of the medical device. Further, the proximal end refers to a predetermined length region including the proximal end (proximal end) of the medical device in each part of the medical device.
Moreover, an axial center means the central axis along the longitudinal direction of the medical device body.
The longitudinal cross section of a medical device means the cross section which cut the medical device along the axial center.
The cross section of a medical device means the cross section which cut the medical device by the plane which intersects perpendicularly to the axis.

Embodiment 1-1
First, the first embodiment will be described with reference to FIGS. 1 to 8B.
FIG. 1 is a cross-sectional view taken along the line AA of FIG.
5 (a) and 5 (b) are schematic diagrams for explaining the bending operation when the distal end portion 11 of the medical device body 10 is viewed in the direction of arrow A in FIG. 4, and FIG. The state before bending is shown, and FIG. 5 (b) shows the state of bending.
In FIG. 7, the housing 86 of the bending operation unit 80 is partially broken to show the internal structure of the housing 86.
In FIG. 8A and FIG. 8B, a midway portion in the longitudinal direction of the medical device main body 10 is broken and omitted. In the medical device body 10 shown in FIGS. 8A and 8B, the rotational phase around the axis of the medical device body 10 differs by 90 degrees between the proximal end portion and the distal end portion of the omitted portion. ing.

As shown in any of FIGS. 1 to 8 (b), the medical device 100 according to the present embodiment is inserted along the longitudinal direction of the long medical device main body 10 and the medical device main body 10. A bending operation unit 80 for bending the distal end portion 11 of the medical device body 10 by pulling the first operation line 41 and the second operation line 42 and the first operation line 41 and the second operation line 42 (FIG. 6, 7) and.
In the intermediate portion 12 and the proximal end portion 13 (FIGS. 6 and 7) in the axial direction of the medical device body 10, the first operation line 41 and the second operation line 42 are separated from each other in the circumferential direction of the medical device body 10. It extends in parallel.
At the tip end portion 11 in the axial direction of the medical device body 10, the first operation line 41 and the second operation line 42 are curved and merged so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the tip side. There is.
Here, that the first operation line 41 and the second operation line 42 join together means that the tip 41 a of the first operation line 41 and the tip 42 a of the second operation line 42 are close to each other. . It is preferable that the tip 41 a of the first operation line 41 and the tip 42 a of the second operation line 42 be close to each other at a distance smaller than the thickness of the resin pipe 20 described later.

According to the present embodiment, by pulling both of the first operation line 41 and the second operation line 42, as shown in FIGS. 5 (a) and 5 (b), the distal end portion of the medical device body 10 11 can be bent. At this time, since the load for pulling the distal end portion 11 of the medical device body 10 by the first operation line 41 and the load for pulling the second operation line 42 can be balanced, the first operation line 41 or the second operation line 42 It is possible to suppress the occurrence of a phenomenon in which the medical device body 10 rotates about an axis in order to make a shortcut.
Therefore, even when the distal end portion 11 is further bent after the medical device main body 10 passes a body cavity such as a curved blood vessel, the distal end portion 11 can be more reliably bent in a desired direction.
As in the case of the present embodiment, when the number of operation lines included in the medical device 100 is two and these operation lines merge, the direction in which the tip 11 can be bent by pulling the operation lines. Is one way.

The medical device 100 is typically a catheter.

The medical device body 10 is provided with a resin tube 20 whose lumen is a lumen 21.
In the case of this embodiment, the resin tube 20 has a hollow tubular inner layer 22 whose lumen is a lumen 21 and a hollow tubular outer layer coaxial with the inner layer 22 and formed around the outer periphery of the inner layer 22. And a layer structure including The inner layer 22 and the outer layer 23 are each made of a resin material. The inner peripheral surface of the outer layer 23 is joined to the outer peripheral surface of the inner layer 22.
The resin material forming the inner layer 22 and the resin material forming the outer layer 23 may be different from each other or may be equal to each other.
If necessary, a hydrophilic coat may be formed on the outer surface of the medical device body 10.
The lumen 21 is continuously formed from the distal end to the proximal end of the medical device body 10 and is open at the distal end and the proximal end of the medical device body 10, respectively.

The medical device body 10 further includes a first hollow tube 31 and a second hollow tube 32 embedded in the resin tube 20. The first operation line 41 is inserted into the first hollow tube 31, and the second operation line 42 is inserted into the second hollow tube 32.
The first hollow tube 31 and the second hollow tube 32 are sub-lumen tubes, respectively, and the lumens of the sub-lumen tubes are sub-lumens. That is, each operation line (the first operation line 41, the second operation line 42) is inserted into the sub-lumen.
The inner diameters of the first hollow tube 31 and the second hollow tube 32 are smaller than the inner diameter of the lumen 21.
Each of the first operation line 41 and the second operation line 42 is formed of a thin line such as metal or resin.

In the case of the present embodiment, since the first hollow tube 31 and the second hollow tube 32 are disposed avoiding the position on the incourse side when the distal end portion 11 of the medical device main body 10 is bent, the distal end portion 11 can be easily bent. In particular, since the first hollow tube 31 and the second hollow tube 32 are separated from the incourse side toward the proximal end side of the distal end portion 11, bending becomes easy.

At the distal end portion 11 of the medical device body 10, the first hollow tube 31 and the second hollow tube 32 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. As a result, the first operation line 41 in the first hollow tube 31 and the second operation line 42 in the second hollow tube 32 gradually approach each other in the circumferential direction of the medical device body 10 toward the tip end side. Curved.
The first hollow tube 31 and the second hollow tube 32 do not cross each other. Further, the first operation line 41 and the second operation line 42 do not intersect with each other.

As described above, the medical device body 10 is embedded in the resin pipe 20 having the lumen 21 and the resin pipe 20, and the first hollow pipe into which the first operation line 41 and the second operation line 42 are respectively inserted. 31 and the second hollow tube 32, and the first hollow tube 31 and the second hollow tube 32 are directed to the distal end side at the distal end portion 11 in the axial direction of the medical device body 10. Therefore, they are curved so as to approach each other in the circumferential direction of the medical device body 10 gradually.

Here, in the axial direction of the medical device body 10, a region where the first operation line 41 and the second operation wire 42 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the tip side is It is referred to as a curved area 15. The base end position 15a of the bending area 15 is a position where the first operation line 41 and the second operation line 42 begin to bend toward each other, and the tip end position 15b of the bending area 15 is a first operation line 41. And the second operation line 42 is in a position where it is curved in the direction of each other.
In the case of the present embodiment, the tip end position 15b of the bending area 15 is a position where the tips 41a and 42a of the first operation line 41 and the second operation line 42 are disposed, or a position near the position.

The tip 41 a of the first operation line 41 protrudes from the tip 31 a of the first hollow tube 31. Similarly, the tip 42 a of the second operation line 42 protrudes from the tip 32 a of the second hollow tube 32.
For example, the tip 41a is located near the tip 31a, and the tip 42a is located near the tip 32a.

The medical device body 10 includes, for example, a blade layer 51 embedded in the resin pipe 20. Thereby, the medical device body 10 is reinforced by the blade layer 51. The blade layer 51 is configured by braiding a plurality of wires. The blade layer 51 is disposed, for example, around the inner layer 22.
The first hollow tube 31 and the second hollow tube 32 are disposed, for example, radially outward of the medical device body 10 (at a position farther from the axial center of the medical device body 10) than the blade layer 51. .

The medical device body 10 further includes a winding wire 52 embedded in the resin tube 20. The winding wire 52 is wound radially outward of the medical device body 10 more than the blade layer 51, the first hollow tube 31 and the second hollow tube 32. The winding wire 52 constrains the first hollow tube 31 and the second hollow tube 32 to the blade layer 51, for example.

In the curved area 15, the first hollow tube 31 and the second hollow tube 32 are disposed along the outer periphery of the blade layer 51 (see FIGS. 3 and 4).
In the curved region 15, the distance between the first hollow tube 31 and the second hollow tube 32 in the circumferential direction of the medical device body 10 is gradually reduced toward the tip end, and the periphery of the medical device body 10 The distance between the first operation line 41 and the second operation line 42 in the direction is gradually reduced toward the tip end side.
The first hollow tube 31 and the second hollow tube 32 are brazed in a curved shape, for example, on the distal end side of the proximal end position 15 a of the curved region 15. The first hollow tube 31 and the second hollow tube 32 may be fixed to at least one of the blade layer 51 or the inner layer 22 at the proximal end position 15 a of the curved region 15, respectively. The distal end is disposed at the proximal end position 15a of the curved region 15, and the first hollow tube 31 and the second hollow tube 32 are not restrained by the winding wire 52 at the distal end side from the proximal end 15a. Good.

In the intermediate portion 12 and the proximal end portion 13 in the axial direction of the medical device body 10, the first operation line 41 and the second operation line 42 are disposed at positions facing each other in the circumferential direction of the medical device body 10.
In the case of the present embodiment, for example, as shown in FIG. 2, in the middle portion 12 of the medical device body 10, the first operation line 41 and the second operation line 42 are based on the axial center of the medical device body 10. In the circumferential direction of the medical device body 10, they face each other 180 degrees. Similarly, at the proximal end 13 of the medical device body 10 and the proximal position 15a of the curved region 15, the first operation line 41 and the second operation line 42 are mutually 180 degrees in the circumferential direction of the medical device body 10. Are facing each other. That is, the phase difference between the first operation line 41 and the second operation line 42 in the circumferential direction of the medical device body 10 is 180 degrees at the proximal end position 15 a of the intermediate portion 12, the proximal end 13 and the curved region 15.
The phase difference between the first operation line 41 and the second operation line 42 in the circumferential direction of the medical device body 10 gradually reduces toward the tip end in the bending area 15, and at the tip position 15 b of the bending area 15, For example, the phase difference is approximately zero. In the case of the present embodiment, the first operation line 41 and the second operation line 42 are each rotated 90 degrees in the circumferential direction of the medical device main body 10 in the bending region 15.
However, the arrangement of the first operation line 41 and the second operation line 42 at positions facing each other in the circumferential direction of the medical device body 10 is not limited to this example, and the first operation line 41 and the second operation It means that the lines 42 are separated from each other by 120 degrees or more in the circumferential direction of the medical device body 10.

Further, in the case of the present embodiment, the first hollow tube 31 and the second hollow tube 32 are the medical device at the intermediate portion 12 of the medical device body 10, the proximal end 13 and the proximal end position 15a of the curved region 15. With the axial center of the main body 10 as a reference, they oppose each other 180 degrees in the circumferential direction of the medical device main body 10. That is, the phase difference between the first hollow tube 31 and the second hollow tube 32 in the circumferential direction of the medical device body 10 is 180 degrees at the base end position 15 a of the intermediate portion 12, the base end 13 and the curved region 15. is there. The phase difference is gradually reduced toward the distal end side in the curved region 15.

A ring-shaped marker 70 made of a radiopaque metallic material is provided at the distal end portion 11 of the medical device body 10.
The marker 70 is disposed coaxially with the lumen 21 and around the lumen 21.
The markers 70 are disposed, for example, around the blade layer 51.

The tip 41 a of the first operation line 41 is fixed to the marker 70 by a first fixing portion 71 which is, for example, a spot-like solder.
Similarly, the tip 42 a of the second operation line 42 is fixed to the marker 70 by a first fixing portion 71 which is, for example, a spot-like solder.
The first fixing portion 71 and the second fixing portion 72 are disposed, for example, at the proximal end of the marker 70.

In the case of this embodiment, the tip 41 a of the first operation line 41 and the tip 42 a of the second operation line 42 are connected to each other. That is, the tips of the first operation line 41 and the second operation line 42 are connected to each other.
In more detail, the 1st fixing | fixed part 71 and the 2nd fixing | fixed part 72 mutually adjacent | abut, and are in contact. That is, the first fixing portion 71 and the second fixing portion 72 are integrated.
In addition, the tip 41 a and the tip 42 a may be fixed to the marker 70 by one fixing portion.

Next, the hub 90 provided at the proximal end of the medical device main body 10 will be described using FIGS. 6 and 7.
The hub 90 has a connecting portion 93 for inserting a syringe (not shown) from the proximal end of the hub 90. A screw groove is formed on the outer periphery of the connection portion 93 so that the syringe can be detachably fixed.
On an outer periphery of the hub 90, there are provided two wing portions 92 opposed to each other through the axial center of the hub 90.
The proximal end of the medical device body 10 is inserted and fixed to the distal end of the hub 90. Thereby, the lumen 21 inside the medical device body 10 and the internal space of the hub 90 communicate with each other.
By rotating the wing 92 about the axis of the hub 90, it is possible to perform a torque operation to axially rotate the entire medical device body 10.
A housing 86 of a bending operation unit 80, which will be described later, is connected and fixed to the tip end side of the hub 90.

Next, the bending operation unit 80 provided in the medical device 100 will be described with reference to FIGS. 6 and 7.

The medical device 100 includes a bending operation unit 80 for performing bending operation of the distal end portion 11 of the medical device main body 10 by pulling the first operation line 41 and the second operation line 42.

The bending operation portion 80 is a rotary member 81 rotatably supported, and the first operation line 41 and the second operation line 42 are engaged with each other, and the base end portion of the first operation line 41 and the second end The rotating member 81 to which the base end portion of the operation line 42 is fixed, and the rotating direction of the rotating member 81 are moved in the pulling direction in which the first operation line 41 and the second operation line 42 are pulled, and in the opposite direction to the pulling direction. And a moving mechanism.
The rotating member 81 is, for example, a pulley.
Here, in the present specification, that a member is rotatable includes not only an aspect that can rotate 360 degrees or more, but also an aspect that can only swing in a predetermined angle range less than 360 degrees.

As shown in FIG. 6, the rotating member 81 has an engaging portion formed in a circular shape centered on the rotation center of the rotating member 81, and the first operation line 41 and the second operation are provided at this engaging portion. Line 42 is engaged. The engaging portion of the rotating member 81 is not limited to a circular shape, and may be an arc shape.
Thus, the rotary member 81 has an engagement portion with which the first operation line 41 and the second operation line engage, and the engagement portion has a circular shape or a circle centered on the rotation center of the rotary member 81. It is formed in an arc shape.

The moving mechanism is configured to include an advancing and retracting member 82 and a pinion 83.
The advancing and retracting member 82 includes a holding portion 82a rotatably holding the rotating member 81, and a rod-like portion 82b extending from the holding portion 82a to the proximal end side of the medical device main body 10.
The rod portion 82b is formed with a rack portion 82c.

The bending operation unit 80 is further integrally provided with a case 86 which is a main body of the bending operation unit 80, a dial operation unit 84 rotatably supported with respect to the case 86, and the dial operation unit 84. And a guide 85 (for example, a pair of front and rear guides 85) provided on the inner surface of the housing 86 and guiding the rod portion 82b in the longitudinal direction of the rod portion 82b.
The proximal end portion 13 of the medical device body 10 is guided to the proximal end side of the housing 86 through the inside of the housing 86, and is inserted and fixed to the distal end portion of the hub 90.
The rotation axis of the dial operation unit 84 extends in a direction orthogonal to the axial direction of the medical device body 10 in the housing 86.
The pinion 83 is integrally formed with the dial operating unit 84 on one surface side of the dial operating unit 84, and is disposed coaxially with the rotation axis of the dial operating unit 84.
The outer peripheral gear of the pinion 83 meshes with the gear of the rack portion 82 c of the advancing and retracting member 82.
At least a part of the dial operation unit 84 is exposed to the outside of the housing 86 so that an operator who operates the medical device 100 can perform an operation of rotating the dial operation unit 84 from the outside of the housing 86. It has become.

The first operation line 41 and the second operation line 42 are respectively derived from the medical device body 10 in the housing 86.
The base end of the first operation line 41 is, for example, one and a half turns around the rotating member 81, and the base end of the first operation line 41 is the rotating member at the first fixed portion 81a (FIG. 6) It is fixed to 81.
Similarly, the second operation line 42 is, for example, wound one and a half turns around the rotation member 81, and the base end of the second operation line 42 is the rotation member 81 at the second fixed portion 81b (FIG. 6). It is fixed to
The winding direction of the first operation wire 41 and the winding direction of the second operation wire 42 with respect to the rotating member 81 are opposite to each other. Therefore, the rotation angle of the rotating member 81 is autonomously adjusted to an angle at which the tension of the first operation line 41 and the tension of the second operation line 42 are balanced.

When the operator who operates the medical device 100 grips the housing 86 or the hub 90 and rotates the dial operation unit 84, the pinion 83 integral with the dial operation unit 84 is axially rotated, and in accordance with this, the rack unit An advancing and retracting member 82 having an 82c is advanced (moved to the distal end side of the medical device body 10) or retracted (proximal to the medical device body 10) in the axial direction of the medical device body 10 relative to the housing 86. Moving.
In FIG. 6, by moving the dial operating portion 84 clockwise, the advancing and retracting member 82 and the rotating member 81 are retracted, and both the first operation line 41 and the second operation line 42 are on the proximal end side of the medical device body 10. Towed by.

As described above, the bending operation unit 80 includes the operation receiving unit (dial operating unit 84) that receives and operates the user (operator), and the power of the operation receiving unit is transmitted to the rotating member 81 via the moving mechanism. As a result, the rotating member 81 is moved in the pulling direction and in the direction opposite to the pulling direction.

More specifically, as described above, the operation reception unit (dial operation unit 84) is rotatably supported by a shaft, and the movement mechanism includes a pinion 83 integrally and coaxially provided with the operation reception unit. And a rack member (advancing / retracting member 82) which advances and retracts in conjunction with the rotation of the pinion 83, and the rotating member 81 is pivotally supported by the rack member.

Thus, the first operation line 41 and the second operation line 42 are pulled at once by the operation on the bending operation unit 80.
Here, that the first operation line 41 and the second operation line 42 are pulled at one time means that there is a timing at which both the first operation line 41 and the second operation line 42 are pulled together. The timing at which the first operation line 41 and the second operation line 42 are pulled is not limited to the same timing, and the timing at which the first operation line 41 and the second operation line 42 are pulled and the end timing is the same. It is not limited to becoming.

For example, when the distal end portion 11 of the medical device main body 10 has a linear shape as shown in FIG. 8A, when the dial operation portion 84 is rotated clockwise in FIG. 8B, the first operation line 41 Since both the second operation line 42 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in one direction.
When the dial operating portion 84 is rotated counterclockwise from the state of FIG. 8B, the advancing and retracting member 82 and the rotating member 81 move forward, and the tension of the first operation line 41 and the second operation line 42 is relaxed. The distal end portion 11 of the medical device body 10 is allowed to return to a linear shape.
As described above, in the case of the present embodiment, the bending operation unit 80 receives an operation by the user by the rotation mechanism (dial operation unit 84), and the force applied to the rotation mechanism by this operation is received by the pinion 83 and the rack (rack The conversion mechanism configured by the portion 82c) is configured to convert into the forward and backward movement in the axial direction of the medical device body 10.

Next, an example of the material of each part of the medical device 100 will be described.
As a material of the inner layer 22, resin materials, such as a polytetrafluoroethylene (PTFE), a polyvinylidene fluoride (PVDF), a perfluoro alkoxy fluorine resin (PFA), can be used, for example.
The material of the outer layer 23 is polyimide (PI), polyamide imide (PAI), polyethylene terephthalate (PET), polyethylene (PE), polyamide (PA), nylon elastomer, polyurethane (PU), ethylene-vinyl acetate resin ( Resin materials such as EVA), polyvinyl chloride (PVC) or polypropylene (PP) can be used.
As materials of the first hollow tube 31 and the second hollow tube 32, for example, resin materials such as polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF), perfluoroalkoxy fluorine resin (PFA), etc. may be used. Can.
The material of the wire forming the blade layer 51 is preferably, for example, a metal material such as stainless steel or tungsten, but may be a resin material.
The material of the wire constituting the wound wire 52 is preferably, for example, a metal material such as stainless steel or tungsten, but may be a resin material.

According to the medical device 100 according to the above-described first embodiment, the distal end portion 11 of the medical device body 10 is bent by pulling the first operation line 41 and the second operation line 42. At that time, the load to pull the distal end portion 11 of the medical device main body 10 by the first operation line 41 and the load to pull the second operation line 42 can be balanced, so the first operation line 41 or the second operation It is possible to suppress the occurrence of a phenomenon in which the medical device body 10 rotates about an axis as the line 42 attempts to make a shortcut.
Therefore, it is possible to more reliably bend the distal end portion 11 of the medical device main body 10 in a desired direction.

Embodiment 1-2
Next, the medical device 100 according to the first and second embodiments will be described with reference to FIGS. 9 to 11B.
11 (a) and 11 (b) are schematic diagrams for explaining the bending operation when the distal end portion 11 of the medical device body 10 is viewed in the direction of arrow A in FIG. 10, and FIG. 11 (a) is The state before bending is shown, and FIG. 11 (b) shows the state of bending.
The medical device 100 according to this embodiment is different from the medical device 100 according to the above-described 1-1 embodiment in the points described below, and in the other points, in the above-described 1-1 embodiment. It is comprised similarly to the medical device 100 which concerns.

In the case of the present embodiment, the first operation line 41 and the second operation line are located between the tip of the bending area 15 (tip position 15b) and the tips 41a and 42a of the first operation line 41 and the second operation line 42. A parallel region 16 is formed in which the two 42 and 42 extend close to each other and in parallel.

That is, the medical device main body 10 is configured to include the resin tube 20 having the lumen 21, and the first operation line 41 and the second operation line 42 are inserted around the lumen 21 of the resin tube 20. The first operation at the tip (tip position 15b) of the curved region 15 in which the 1 operation line 41 and the second operation line 42 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the tip side. The line 41 and the second operation line 42 are close to each other at a distance smaller than the thickness of the resin tube 20, and the tip of the curved area 15 (tip position 15b) and the first and second operation lines 41 and 42. Between the tips 41a and 42a, parallel regions 16 in which the first operation line 41 and the second operation line 42 extend close to each other and in parallel are formed.
In the parallel region 16, the first hollow tube 31 and the second hollow tube 32 abut on or in close proximity to each other and extend in parallel.

More specifically, in the case of the present embodiment, the medical device 100 further includes an annular member 60 embedded in the resin pipe 20 at the tip of the curved region 15.
The annular member 60 is configured to have higher rigidity than the resin pipe 20 and is formed to have an outer diameter smaller than the thickness of the resin pipe 20 (see FIG. 10).
The first operation line 41 and the second operation line 42 are inserted into the annular member 60.
Thereby, it is possible to more reliably suppress the fluctuation of the paths of the first operation line 41 and the second operation line 42.

More specifically, in the case of the present embodiment, the first hollow tube 31 and the second hollow tube 32 are inserted into the annular member 60.
That is, the medical device body 10 includes the first hollow tube 31 and the second hollow tube 32 which are embedded in the resin tube 20 and into which the first operation line 41 and the second operation line 42 are respectively inserted. The first hollow tube 31 and the second hollow tube 32 are inserted into the annular member 60, and in the curved region 15, the first hollow tube 31 and the second hollow tube 32 have tips. It curves so that it may mutually approach in the circumferential direction of the medical device main body 10 gradually toward the side.

The material of the annular member 60 is not particularly limited, but the annular member 60 can be made of, for example, metal or hard resin.

Also in the case of the present embodiment, by pulling both of the first operation line 41 and the second operation line 42, as shown in FIGS. 11 (a) and 11 (b), the distal end portion of the medical device body 10 11 can be bent.
At this time, the bending angle in the parallel region 16 is steeper than the bending angle in the curved region 15.

As an example, in the axial direction of the medical device body 10, the tip of the bending region 15 is more than the distance (the distance L1 shown in FIG. 9) from the base end (base position 15a) of the bending region 15 to the tip (tip position 15b). The distance from the tip position 15b to the tips 41a and 42a of the first operation line 41 and the second operation line 42 (the distance L2 shown in FIG. 9) is longer.
By such a configuration, the tip end portion 11 can be more easily bent.
Also, the bending of the tip 11 can occur mainly in the parallel region 16. Therefore, regardless of the bending angle of the distal end portion 11, the friction between the first operation line 41 and the first hollow tube 31 and the friction between the second operation line 42 and the second hollow tube 32 in the curved region 15 are Since the force can be maintained substantially constant, the magnitude of the force required to pull the first operation line 41 and the second operation line 42 can be maintained substantially constant regardless of the bending angle of the distal end portion 11.

As another example, in the axial direction of the medical device body 10, the distance (distance L1 shown in FIG. 9) from the base end (base end position 15a) of the bending region 15 to the tip end (tip end position 15b) is The distance (the distance L2 shown in FIG. 9) from the tip (tip position 15b) of the curved region 15 to the tips 41a and 42a of the first operation line 41 and the second operation line 42 is longer.
With such a configuration, the bendability of the distal end portion 11 can be suppressed to a certain extent.
In addition, since the first operation line 41 and the second operation line 42 in the bending area 15 and the first hollow tube 31 and the second hollow pipe 32 can be gently curved, the first operation line 41 and the first operation line 41 in the bending area 15 can The friction with the first hollow tube 31 and the friction between the second operation line 42 and the second hollow tube 32 can be reduced.
In addition, since the length region in which the first hollow tube 31 and the second hollow tube 32 translate close to each other at the distal end portion 11 of the medical device body 10, that is, the length region having high rigidity becomes short, the medical device Good selectivity (such as good blood vessel selectivity) can be obtained when the distal end portion 11 of the main body 10 is bent to enter the bifurcated body cavity.

The distance L1 and the distance L2 may be the same. In this case, the smoothness of pulling of the first operation line 41 and the second operation line 42 and the good selectivity when the distal end portion 11 of the medical device body 10 is bent to enter the bifurcated body cavity can be balanced. be able to.

Embodiment 1-3
Next, a medical device 100 according to the first to third embodiments will be described with reference to FIGS. 12 to 18C.
16 (a) and 16 (b) are schematic diagrams for explaining the bending operation when the distal end portion 11 of the medical device body 10 is viewed in the direction of arrow A in FIG. 15, and FIG. 16 (a) The state before bending is shown, and FIG. 16 (b) shows the state of bending.
16 (c) and 16 (d) are schematic diagrams for explaining the bending operation when the distal end portion 11 of the medical device body 10 is viewed in the direction of arrow B in FIG. 15, and FIG. 16 (c) The state before bending is shown, and FIG. 16 (d) shows the state of bending.
18 (a), 18 (b) and 18 (c), the midway portion in the longitudinal direction of the medical device main body 10 is broken and omitted. In the medical device body 10 shown in FIGS. 18 (a), 8 (b) and 18 (c), the portion on the proximal side and the portion on the distal side of the omitted portion are around the axis of the medical device body 10. The rotational phase is 90 degrees different.
The medical device 100 according to the present embodiment is different from the medical device 100 according to the above-described first embodiment in the points described below, and in the other points, in the above-described first embodiment. It is comprised similarly to the medical device 100 which concerns.

The medical device 100 according to the present embodiment includes the third operation line 43 and the fourth operation line 44 which are respectively inserted along the axial direction of the medical device main body 10. Similarly to the first operation line 41 and the second operation line 42, the third operation line 43 and the fourth operation line 44 are respectively configured by fine lines such as metal or resin.

The medical device body 10 further includes a third hollow pipe 33 and a fourth hollow pipe 34 embedded in the resin pipe 20. The third operation line 43 is inserted into the third hollow tube 33, and the fourth operation line 44 is inserted into the fourth hollow tube 34.
The third hollow tube 33 and the fourth hollow tube 34 are sublumen tubes similar to the first hollow tube 31 and the second hollow tube 32, and the lumens of these sublumen tubes are sublumens. That is, each operation line (the third operation line 43 and the fourth operation line 44) is inserted into the sub-lumen.
The inner diameters of the third hollow tube 33 and the fourth hollow tube 34 are smaller than the inner diameter of the lumen 21.

In the case of the present embodiment, in the middle portion 12 of the medical device main body 10, the first hollow tube 31 and the third hollow tube 33 are in proximity to or in contact with each other and extend in parallel, and the second middle The empty tube 32 and the fourth hollow tube 34 extend in parallel, in proximity to or in contact with each other (see FIG. 13).
Similarly, also at the proximal end portion of the medical device body 10, the first hollow tube 31 and the third hollow tube 33 extend in parallel, in proximity to or in contact with each other, and the second hollow tube 32 And the fourth hollow tubes 34 extend in parallel in proximity to or in abutment with each other.

In the curved region 15 of the distal end portion 11 of the medical device body 10, the third hollow tube 33 and the fourth hollow tube 34 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. ing. As a result, the third operation line 43 in the third hollow tube 33 and the fourth operation line 44 in the fourth hollow tube 34 gradually approach each other in the circumferential direction of the medical device body 10 toward the tip end side. Curved.
The direction in which the third hollow tube 33 and the third operation line 43 are curved in the curved region 15 is a direction symmetrical to the direction in which the first hollow tube 31 and the first operation line 41 are curved.
Similarly, the direction in which the fourth hollow tube 34 and the fourth operation line 44 are curved in the curved region 15 is in the direction symmetrical to the direction in which the second hollow tube 32 and the second operation line 42 are curved. is there.
The hollow tubes (the first hollow tube 31, the second hollow tube 32, the third hollow tube 33, and the fourth hollow tube 34) do not intersect with other hollow tubes. Further, each operation line (the first operation line 41, the second operation line 42, the third operation line 43, and the fourth operation line 44) does not intersect with other operation lines.

In the parallel region 16, the third operation line 43 and the fourth operation line 44 are close to each other as in the case where the first operation line 41 and the second operation line 42 are close to each other and extend in parallel. Extend in parallel.
Further, in the parallel region 16, the third hollow tube 33 and the third hollow tube 33 are arranged in the same way as the first hollow tube 31 and the second hollow tube 32 are in contact with or close to each other, or in parallel. The four hollow tubes 34 extend in parallel in abutment with or close to each other.
The tip 43 a of the third operation line 43 protrudes from the tip of the third hollow tube 33. Similarly, the tip 44 a of the fourth operation line 44 protrudes from the tip of the fourth hollow tube 34.

The tip 43a of the third operation line 43 is fixed to the marker 70 by a third fixing portion 73 which is, for example, a spot-like solder (FIG. 15).
Similarly, the tip end 44 a of the fourth operation line 44 is fixed to the marker 70 by a fourth fixing portion 74 which is, for example, a spot-like solder.
The third fixing portion 73 and the fourth fixing portion 74 are disposed, for example, at the proximal end of the marker 70.
The region where the third fixing portion 73 and the fourth fixing portion 74 are disposed, and the region where the first fixing portion 71 and the second fixing portion 72 are disposed face each other in the circumferential direction of the medical device main body 10. ing.

In the case of the present embodiment, the tip 43 a of the third operation line 43 and the tip 44 a of the fourth operation line 44 are mutually connected. That is, the tips of the third operation line 43 and the fourth operation line 44 are connected to each other.
More specifically, the third fixing portion 73 and the fourth fixing portion 74 are adjacent to each other and in contact with each other. That is, the third fixed portion 73 and the fourth fixed portion 74 are integrated.
In addition, the tip 43a and the tip 44a may be fixed to the marker 70 by one fixing portion.

As shown in FIG. 14, in the case of the present embodiment, the medical device 100 is provided with a first annular member 61 embedded in the resin pipe 20 at the tip of the curved region 15 instead of the annular member 60. The first annular member 61 is the same as the annular member 60 in the first and second embodiments, and the first hollow tube 31 and the second hollow tube 32 are inserted into the first annular member 61.
Furthermore, in the case of the present embodiment, the medical device 100 includes the second annular member 62 embedded in the resin pipe 20 at the tip end of the curved region 15. The second annular member 62 is similar to the first annular member 61. The third hollow tube 33 and the fourth hollow tube 34 are inserted into the second annular member 62.
The first annular member 61 and the second annular member 62 are disposed to face each other in the circumferential direction of the medical device body 10.

Also in the case of the present embodiment, by pulling both of the first operation line 41 and the second operation line 42, as shown in FIGS. 16 (a) and 16 (b), the tip of the medical device body 10 11 can be bent in one direction.
Furthermore, in the case of the present embodiment, by pulling both of the third operation line 43 and the fourth operation line 44, as shown in FIGS. 16 (c) and 16 (d), The tip 11 can be bent in the opposite direction to the one direction.

As shown in FIGS. 17 and 18A, in the case of the present embodiment, the bending operation unit 80 bends the distal end portion 11 of the medical device body 10 by pulling the first operation line 41 and the second operation line 42. A first bending operation unit 180 for performing the second operation, and a second bending operation unit 280 for performing a bending operation of the distal end portion 11 of the medical device body 10 by pulling the third operation line 43 and the fourth operation line 44; Have.

The first bending operation unit 180 includes a first rotating member 181, a first advancing and retracting member 182, a first pinion 183, a first dial operating unit 184, and a first guide 185. The first rotating member 181, the first advancing and retracting member 182, the first pinion 183, the first dial operating portion 184, and the first guide 185 are the rotating member 81, the advancing and retracting member 82, and the pinion 83 described in the 1-1 embodiment. It corresponds to the dial operation unit 84 and the guide 85, respectively.
Therefore, the first advancing and retracting member 182 includes the first holding portion 182a, the first rod-shaped portion 182b, and the first rack portion 182c, which correspond to the holding portion 82a, the rod-shaped portion 82b, and the rack portion 82c, respectively.
In the same manner as the first operation line 41 and the second operation line 42 are wound and fixed to the rotation member 81 in the 1-1st embodiment, the first operation line 41 is provided to the first rotation member 181. The second operation line 42 is wound and fixed.

The second bending operation unit 280 includes a second rotating member 281, a second advancing and retracting member 282, a second pinion 283, a second dial operating unit 284 and a second guide 285. The second rotating member 281, the second advancing and retracting member 282, the second pinion 283, the second dial operating portion 284 and the second guide 285 are a first rotating member 181, a first advancing and retracting member 182, a first pinion 183, a first dial The same as the operation unit 184 and the first guide 185.
The second advancing and retracting member 282 includes a second holding portion 282a, a second rod-like portion 282b and a second rack portion 282c similar to the first holding portion 182a, the first rod-like portion 182b and the first rack portion 182c.
Similar to the first operation line 41 and the second operation line 42 being wound and fixed to the first rotation member 181, the second operation member 43 has a third operation line 43 and a fourth operation line. 44 are wound and fixed.
For example, the second bending operation unit 280 is vertically symmetrical with respect to the first bending operation unit 180 in FIG.

In the case of the present embodiment, by rotating the first dial operating unit 184 and retracting the first advancing and retracting member 182 and the first rotating member 181, the first operation line 41 and the second operation line 42 are pulled, and medical treatment is performed. The tip 11 of the device body 10 can be bent in one direction (FIG. 18 (b)).
In addition, the third operation line 43 and the fourth operation line 44 are pulled by rotating the second dial operation unit 284 and retracting the second advancing and retracting member 282 and the second rotating member 281, thereby The tip 11 can be bent in the opposite direction to the one direction (FIG. 18C).

As described above, in the case of the present embodiment, the medical device 100 pulls the third operation line 43 and the fourth operation line 44, thereby pulling the first operation line 41 and the second operation line 42, thereby leading the medical device 100. A second bending operation unit 280 for bending the distal end portion 11 of the medical device main body 10 in a direction different from the bending direction of the portion 11 is provided.
At an intermediate portion 12 and a proximal end portion in the axial direction of the medical device body 10, the third operation line 43 and the fourth operation line 44 are separated from each other in the circumferential direction of the medical device body 10 and extend in parallel, At the distal end portion 11 in the axial direction of the medical device body 10, the third operation line 43 and the fourth operation line 44 curve and merge so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side There is.

In addition, the third operation line 43 and the fourth operation line 44 are pulled at once by the operation on the second bending operation unit 280.

The second bending operation unit 280 is a second rotating member 281 rotatably supported and is a base of the third operation line 43 while the third operation line 43 and the fourth operation line 44 are engaged. A second rotation member 281 to which the end and the base end of the fourth operation line 44 are fixed, and a second pulling direction in which the second rotation member 281 is pulled by the third operation line 43 and the fourth operation line 44; And a second moving mechanism configured to move in a direction opposite to the second pulling direction.

The second rotation member 281 has a second engagement portion with which the third operation line 43 and the fourth operation line 44 are engaged, and the second engagement portion is centered on the rotation center of the second rotation member 281. It is formed in a circular shape or an arc shape.

The second bending operation unit 280 includes a second operation receiving unit (second dial operating unit 284) that operates by receiving the user's operation, and the power of the second operation receiving unit performs a second rotation via the second moving mechanism. By being transmitted to the member 281, the second rotating member 281 moves in the second pulling direction and the opposite direction to the second pulling direction.

The second operation reception unit (second dial operation unit 284) is rotatably supported by a shaft, and the second movement mechanism is a second pinion 283 integrally provided coaxially with the second operation reception unit; And a second rack member (second advancing and retracting member 282) which moves in tandem with the rotation of the second pinion 283. The second rotating member 281 is pivotally supported by the second rack member.

Embodiment 1-4
Next, a medical device 100 according to the first to fourth embodiments will be described using FIGS. 19 (a) and 19 (b).
The medical device 100 according to this embodiment is different from the medical device 100 according to the above-described 1-1 embodiment in the points described below, and in the other points, in the above-described 1-1 embodiment. It is comprised similarly to the medical device 100 which concerns.

In the case of the present embodiment, an area between the first operation line 41 and the second operation line 42 or an axial center of the medical device body 10 in the circumferential direction of the distal end portion 11 of the medical device body 10 In a region located on the opposite side of the region, a flexible portion 110 in which the flexibility of the medical device body 10 is locally high is formed.
As a result, the flexibility of the distal end portion 11 is improved, so that the tension acting on the first operation line 41 and the second operation line 42 at the time of bending operation can be reduced. Therefore, it is possible to further suppress the occurrence of the phenomenon that the medical device body 10 rotates about the axis with the first operation line 41 or the second operation line 42 trying to be a shortcut.

More specifically, as shown in FIG. 19B, in the circumferential direction of the distal end portion 11 of the medical device body 10, the region between the first operation line 41 and the second operation line 42, and the medical device body 10 The bendable portion 110 is formed on both sides of the axial center of the region on the opposite side of the region.
Thereby, the flexibility of the tip portion 11 is further improved.

The flexible portion 110 is configured to include a notch shape portion 111 formed on the outer surface side of the medical device body 10.
The notch shape part 111 can be made into the shape which turned in the shape of an arc, for example, as shown in FIG.19 (b).
Thereby, the tip end portion 11 can be bent more sharply.

[Fifth embodiment]
Next, a medical device 100 according to the first to fifth embodiments will be described with reference to FIGS. 20 (a) and 20 (b).
The medical device 100 according to this embodiment is different from the medical device 100 according to the above-described 1-1 embodiment in the points described below, and in the other points, in the above-described 1-1 embodiment. It is comprised similarly to the medical device 100 which concerns.

In the case of the present embodiment, an area between the first operation line 41 and the second operation line 42 or an axial center of the medical device body 10 in the circumferential direction of the distal end portion 11 of the medical device body 10 In a region located on the opposite side of the region, a flexible portion 110 in which the flexibility of the medical device body 10 is locally high is formed.
As a result, the flexibility of the distal end portion 11 is improved, so that the tension acting on the first operation line 41 and the second operation line 42 at the time of bending operation can be reduced. Therefore, it is possible to further suppress the occurrence of the phenomenon that the medical device body 10 rotates about the axis with the first operation line 41 or the second operation line 42 trying to be a shortcut.

More specifically, as shown in FIG. 20 (b), in the region between the first operation line 41 and the second operation line 42 in the circumferential direction of the distal end portion 11 of the medical device body 10, the flexible portion 110 In the area located on the opposite side of the axial center of the medical device main body 10, the bendable portion 110 is not formed.
However, in the circumferential direction of the distal end portion 11 of the medical device body 10, the flexible portion 110 sandwiches the region between the first operation line 41 and the second operation line 42 and the axial center of the medical device body 10 It may be formed on both sides of the area opposite to the area concerned.

The flexible portion 110 is configured to include a notch shape portion 111 formed on the outer surface side of the medical device body 10.
In the case of the present embodiment, the medical device body 10 has a plurality of cutout portions 111 arranged adjacent to each other in the axial direction of the medical device body 10. These notch shaped portions 111 are elongated in the circumferential direction of the medical device body 10, and have a wedge-shaped cross section.
In the case of the present embodiment, the distal end portion 11 of the medical device main body 10 is easily bent in the initial stage of bending, but when reaching a certain bending angle, further bending is caused by contact between the wedge-shaped inclined surfaces. It becomes difficult (the rigidity increases when reaching a certain bending angle).
For this reason, when the distal end portion 11 of the medical device body 10 is pushed into the body cavity, the resistance to deformation in the axial direction is improved, and the blood vessel selectivity of the medical device 100 is improved.

Embodiment 1-6
Next, the first to sixth embodiments will be described with reference to FIG.
The medical device 100 according to the present embodiment is different from the medical device 100 according to the first to third embodiments in the points described below, and the medical treatment according to the first to third embodiments in the other points. It is configured in the same manner as the device 100.

In the case of the present embodiment, as described below, the configuration of the bending operation unit 80 is different from that of the above-described first to third embodiments.
In the case of the present embodiment, the bending operation unit 80 includes the housing 86, the first rotation member 181, the second rotation member 281, the dial operation unit 194 (third rotation member), the first rotation member 181, and the dial A first connection wire 192 interconnecting the operation unit 194 and a second connection wire 193 interconnecting the second rotating member 281 and the dial operation unit 194 are provided.

Each of the first rotating member 181 and the second rotating member 281 is, for example, a pulley.
The rotation axis of the first rotation member 181 extends, for example, in the direction orthogonal to the axial direction (left and right direction in FIG. 21) of the medical device body 10 in the housing 86.
The rotation axis of the first rotation member 181 is rotatable around the axis of the rotation axis, and is relative to the housing 86 in the axial center direction (horizontal direction in FIG. 21) of the medical device body 10 in the housing 86. It is held movably by the case 86. For example, the rotation shaft of the first rotation member 181 is pivotally supported by a long hole (not shown) formed in the housing 86.
Similarly, the rotation axis of the second rotation member 281 extends, for example, in a direction orthogonal to the axial direction of the medical device body 10 in the housing 86. The rotation axis of the second rotation member 281 is rotatable about the axis of the rotation axis, and movable relative to the housing 86 in the axial direction of the medical device body 10 in the housing 86. It is held by the body 86.
As an example, the rotation axis of the first rotation member 181 and the rotation axis of the second rotation member 281 are parallel to each other. However, these rotation axes may not be parallel to each other.

The first operation line 41, the second operation line 42, the third operation line 43 and the fourth operation line 44 are respectively derived from the medical device main body 10 in the housing 86.
The base end portion of the first operation line 41 is, for example, wound one and a half around the first rotating member 181, and the base end of the first operation line 41 is fixed to the first rotating member 181. Similarly, for example, the second operation line 42 is wound one and a half turns around the first rotation member 181, and the base end of the second operation line 42 is fixed to the first rotation member 181. The winding direction of the first operation wire 41 and the winding direction of the second operation wire 42 with respect to the first rotating member 181 are opposite to each other. Therefore, the rotation angle of the first rotation member 181 is autonomously adjusted to an angle at which the tension of the first operation line 41 and the tension of the second operation line 42 are balanced.
The base end of the third operation line 43 is, for example, wound one and a half around the second rotation member 281, and the base end of the third operation line 43 is fixed to the second rotation member 281. Similarly, for example, the fourth operation line 44 is wound one and a half turns around the second rotation member 281, and the base end of the fourth operation line 44 is fixed to the second rotation member 281. The winding direction of the third operation line 43 and the winding direction of the fourth operation line 44 with respect to the second rotating member 281 are opposite to each other. Therefore, the rotation angle of the second rotation member 281 is autonomously adjusted to an angle at which the tension of the third operation line 43 and the tension of the fourth operation line 44 are balanced.

The dial operation unit 194 is rotatably supported with respect to the housing 86. The rotation axis of the dial operation unit 194 extends in a direction orthogonal to the axial direction of the medical device body 10 in the housing 86.
As an example, the rotation axis of the dial operation unit 194 is parallel to the rotation axis of the first rotation member 181 and the rotation axis of the second rotation member 281. However, the rotation axis of the dial operation unit 194 may not be parallel to the rotation axis of the first rotation member 181 and the rotation axis of the second rotation member 281.
At least a portion of the dial operation unit 194 is exposed to the outside of the housing 86 so that an operator who operates the medical device 100 can perform an operation of rotating the dial operation unit 194 from the outside of the housing 86. It has become.

The dial operation unit 194 includes, for example, a main body portion formed in a disk shape, and a winding portion 191 fixed to one surface side of the main body portion.
The winding unit 191 is, for example, a cylindrical bobbin. The winding unit 191 is disposed coaxially with the rotation axis of the dial operation unit 194.

The tip of the first connection wire 192 is connected to the rotation axis of the first rotation member 181. The proximal end of the first connection wire 192 is, for example, wound one and a half turns around the winding unit 191, and the base end of the first connection wire 192 is fixed to the winding unit 191 at the first connection portion 195. It is done.
Similarly, the tip of the second connection wire 193 is connected to the rotation axis of the second rotation member 281. The proximal end portion of the second connection wire 193 is, for example, wound one and a half turns around the winding portion 191, and the proximal end of the second connection wire 193 is fixed to the winding portion 191 at the second connection portion 196. It is done.
The winding direction of the first connection wire 192 and the winding direction of the second connection wire 193 with respect to the winding unit 191 are opposite to each other.

In the case of the present embodiment, the first connection wire 192 or the second connection wire 193 is selectively selected by the operator who operates the medical device 100 holding the housing 86 or the hub 90 and rotating the dial operation unit 194. The first rotating member 181 or the second rotating member 281 is selectively pulled to the proximal end side.
That is, when the operation to rotate the dial operation unit 194 clockwise in FIG. 21 is performed, the first connecting member 192 is pulled to the proximal end side since the first connecting wire 192 is wound around the winding unit 191. Ru. Thus, since both the first operation line 41 and the second operation line 42 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in one direction.
In addition, when the operation to rotate the dial operation unit 194 in the counterclockwise direction in FIG. 21 is performed, the second connection wire 193 is wound around the winding unit 191, so the second rotating member 281 is pulled toward the base end. Be done. Therefore, since both the third operation line 43 and the fourth operation line 44 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in the opposite direction to the one direction.
That is, an operation of pulling both of the first operation line 41 and the second operation line 42 and an operation of pulling both the third operation line 43 and the fourth operation line 44 by an operation on one dial operation unit 194 ,It can be performed.

As described above, the medical device 100 according to the present embodiment includes the third operation line 43 and the fourth operation line 44 respectively inserted along the axial direction of the medical device body 10, and the axial direction of the medical device body 10 The third operation line 43 and the fourth operation line 44 are spaced apart from each other and extend in parallel in the circumferential direction of the medical device body 10 in the middle portion 12 and the proximal end portion 13 in FIG. In the distal end portion 11 in the direction, the third operation line 43 and the fourth operation line 44 are curved and joined so as to approach each other in the circumferential direction of the medical device main body 10 gradually toward the tip side.
Then, the third operation line 43 and the fourth operation line 44 are pulled by the operation on the bending operation unit 80, and the bending of the distal end portion 11 of the medical device body 10 by the pulling of the first operation line 41 and the second operation line 42 It is possible to bend the tip 11 of the medical device body 10 in a direction different from the direction.

More specifically, the bending operation unit 80 includes a first rotating member 181, a second rotating member 281, and a third rotating member (dial operating unit 194) rotatably supported. The rotation shaft of the second rotation member 281 is connected to the first connection portion 195 of the third rotation member, and the rotation shaft of the second rotation member 281 is connected to the second connection portion 196 of the third rotation member.
In addition, the base end of the first operation line 41 and the base end of the second operation line 42 are fixed to the first rotation member 181, and the second rotation member 281 has the third operation line 43. The proximal end and the proximal end of the fourth operation line 44 are fixed.
Then, as the third rotating member rotates in one direction, the first rotating member 181 is pulled, and the first operation line 41 and the second operation line 42 are pulled, so that the distal end portion 11 of the medical device body 10 Is bent, and the third rotating member is rotated in the opposite direction to the one direction, whereby the second rotating member 281 is pulled, and the third operation line 43 and the fourth operation line 44 are pulled, and the medical device The distal end portion 11 of the main body 10 is bent in a direction (for example, the opposite direction) different from the bending direction of the distal end portion 11 of the medical device main body 10 due to the pulling of the first operation line 41 and the second operation line 42.

In the first to sixth embodiments, the rotation shaft of the first rotation member 181 is connected to the third rotation member (dial operation unit 194) via the wire (first connection wire 192), and the second rotation Although the example in which the rotation shaft of the member 281 is connected to the third rotation member via the wire (second connection wire 193) has been described, the present invention is not limited to this example.
For example, the rotation axis of the first rotation member 181 is directly supported by the first connection portion of the third rotation member, and the rotation axis of the second rotation member 281 is the second connection portion of the third rotation member. It may be directly supported by In this case, the third connecting member does not have to include the winding unit 191 described above.

Embodiment 1-7
Next, the first to seventh embodiments will be described with reference to FIG.
The medical device 100 according to the present embodiment is different from the medical device 100 according to the above-described first embodiment in the points described below, and the medical treatment according to the above-described first embodiment in the other points. It is configured in the same manner as the device 100.

In the case of the present embodiment, as described below, the configuration of the bending operation unit 80 is different from that of the above-described first to sixth embodiments.
In the case of the present embodiment, the bending operation unit 80 does not include the winding unit 191, the first connection wire 192, and the second connection wire 193 shown in FIG. Instead, the bending operation unit 80 includes a pinion 197, a first rack member 198, a second rack member 199, and a guide 200 shown in FIG.

The pinion 197 is integrally formed with the dial operating unit 194 on one surface of the disk-shaped dial operating unit 194, and is disposed coaxially with the rotation axis of the dial operating unit 194.

The first rack member 198 is a rod-like member extending in the axial direction of the medical device body 10 in the housing 86. A first rotating member 181 is rotatably supported at the tip of the first rack member 198. On one side of the first rack member 198, a rack is formed that meshes with the gear on the outer periphery of the pinion 197.
The bending operation unit 80 includes, for example, a pair of front and rear guides 200 provided corresponding to the first rack member 198. The first rack member 198 is guided by the guides 200 linearly rectilinearly in the axial direction of the medical device body 10 in the housing 86.

Similarly, the second rack member 199 is a rod-like member extending in the axial center direction of the medical device body 10 in the housing 86. A second rotating member 281 is rotatably supported at the tip of the second rack member 199. On one side surface of the second rack member 199, a rack engaged with the gear on the outer periphery of the pinion 197 is formed.
The bending operation unit 80 includes, for example, a pair of front and rear guides 200 provided corresponding to the second rack member 199. The second rack member 199 is guided by the guides 200 linearly rectilinearly in the axial direction of the medical device body 10 in the housing 86.

Also in the case of the present embodiment, the manner in which the first operation line 41 and the second operation line 42 are engaged and fixed with respect to the first rotating member 181, and the third operation line 43 and the fourth operation with respect to the second rotating member 281. The manner of engagement and fixation of the wire 44 is the same as in the first to sixth embodiments.
Therefore, the rotation angle of the first rotating member 181 is autonomously adjusted to an angle at which the tension of the first operation line 41 and the tension of the second operation line 42 are balanced, and the second rotation The rotation angle of the member 281 is autonomously adjusted to an angle at which the tension of the third operation line 43 and the tension of the fourth operation line 44 are balanced.

In the case of the present embodiment, the first rack member 198 or the first rack member 198 or the first mesh member meshing with the pinion 197 when the operator who operates the medical device 100 grips the housing 86 or the hub 90 and rotates the dial operation unit 194. The two rack members 199 selectively move to the proximal side.
That is, when the operation for rotating the dial operation portion 194 clockwise in FIG. 22 is performed, the first rack member 198 moves (retracts) to the base end side, so the first rotating member 181 is pulled to the base end side. Be done. Thus, since both the first operation line 41 and the second operation line 42 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in one direction.
In addition, when the operation to rotate the dial operation unit 194 in the counterclockwise direction in FIG. 22 is performed, the second rack member 199 moves (retracts) to the base end side, so the second rotating member 281 moves to the base end side. Towed. Therefore, since both the third operation line 43 and the fourth operation line 44 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in the opposite direction to the one direction.
When the first rack member 198 moves to the base end side, the second rack member 199 moves to the tip end side, and when the second rack member 199 moves to the base end side, the first rack member 198 moves to the tip side.

As described above, in the case of the present embodiment, the bending operation unit 80 includes the first rotation member 181, the second rotation member 281, and the third rotation member (dial operation unit 194), which are rotatably supported. A pinion 197 integrally provided coaxially with the three rotation members, a first rack member 198 connected to the rotation shaft of the first rotation member 181 and interlocked with the rotation of the pinion 197, and a second rotation member A second rack member 199 is connected to the rotary shaft 281 and interlocked with the rotation of the pinion 197 to always advance and retract in a direction opposite to the advancing and retracting direction of the first rack member 198.
The base end of the first operation line 41 and the base end of the second operation line 42 are fixed to the first rotation member 181, and the base end of the third operation line 43 is connected to the second rotation member 281. And the proximal end of the fourth operation line 44 are fixed.
As the third rotating member (dial operating unit 194) rotates in one direction, the first rotating member 181 is pulled through the first rack member 198, and the first operation line 41 and the second operation line 42 The distal end portion 11 of the medical device body 10 is bent by being pulled.
Further, as the third rotating member rotates in the opposite direction to the one direction, the second rotating member 281 is pulled through the second rack member 199, and the third operation line 43 and the fourth operation line 44 By being pulled, the distal end portion 11 of the medical device body 10 bends in a direction different from the bending direction of the distal end portion 11 of the medical device body 10 due to the pulling of the first operation line 41 and the second operation line 42.

As mentioned above, although each embodiment was described with reference to drawings, these are illustrations of the present invention and can also adopt various composition except the above.

In the above first embodiment, although the example in which the rotation mechanism of the bending operation unit 80 is the dial operation unit 84 has been described, the rotation mechanism of the bending operation unit 80 is other than the dial operation unit 84 (for example, a rotary lever Etc.).
Also, in the above-described first embodiment, although the example in which the conversion mechanism of the bending operation unit 80 is configured to include the rack (rack portion 82c) and the pinion 83 has been described, the bending operation unit 80 A conversion mechanism (e.g., a cam, a link mechanism, or a pin and a grooved guide) may be configured.
The same applies to the other embodiments.

In each of the above embodiments, an example in which the first operation line 41 and the second operation line 42 are configured by separate thin lines has been described, but the first operation line 41 and the second operation line 42 are one. It may be configured by each part of the thin line of. That is, the one thin line may be folded back at the tips 41a and 42a.
Similarly, although the example in which the third operation line 43 and the fourth operation line 44 are configured by separate thin lines has been described above, the third operation line 43 and the fourth operation line 44 are one thin line. It may be constituted by a part of each. That is, the one thin line may be folded back at the tips 43a and 44a.

In each of the above-described embodiments, an example has been described in which the base end of the first operation line 41 and the base end of the second operation line 42 are individually fixed to the bending operation unit 80, but the first operation The proximal end of the line 41 and the proximal end of the second operation line 42 may be connected to each other to form a loop (for example, a loop at a portion engaged with the rotation member 81) in the bending operation unit 80.
Similarly, although the example in which the base end of the third operation line 43 and the base end of the fourth operation line 44 are individually fixed to the second bending operation unit 280 has been described above, the third operation line is described. The proximal end of the third operation line 44 and the proximal end of the fourth operation line 44 may be interconnected to form a loop (for example, a loop at a portion engaged with the second rotation member 281) in the second bending operation unit 280 .

In the above first to third embodiments (FIG. 17, FIG. 18 (a), FIG. 18 (b) and FIG. 18 (c)), the first dial operating unit 184 and the second dial operating unit 284 have their plates An example has been described in which the rotary shaft of the first dial operating unit 184 and the rotary shaft of the second dial operating unit 284 are arranged coaxially with each other in the direction orthogonal to the plane. The invention is not limited to this example.
For example, the rotation axis of the first dial operation unit 184 and the rotation axis of the second dial operation unit 284 may not be arranged coaxially with each other. For example, the first dial operation unit 184 and the second dial operation unit 284 may be disposed at mutually different positions in the axial direction of the medical device main body 10.

Embodiment 2-1
First, the second embodiment will be described with reference to FIGS. 1 to 8B.
FIG. 1 is a cross-sectional view taken along the line AA of FIG.
5 (a) and 5 (b) are schematic diagrams for explaining the bending operation when the distal end portion 11 of the medical device body 10 is viewed in the direction of arrow A in FIG. 4, and FIG. The state before bending is shown, and FIG. 5 (b) shows the state of bending.
In FIG. 7, the housing 86 of the bending operation unit 80 is partially broken to show the internal structure of the housing 86.
In FIG. 8A and FIG. 8B, a midway portion in the longitudinal direction of the medical device main body 10 is broken and omitted. In the medical device body 10 shown in FIGS. 8A and 8B, the rotational phase around the axis of the medical device body 10 differs by 90 degrees between the proximal end portion and the distal end portion of the omitted portion. ing.

As shown in any of FIGS. 1 to 8 (b), the medical device 100 according to the present embodiment is inserted along the longitudinal direction of the long medical device main body 10 and the medical device main body 10. A bending operation unit 80 for bending the distal end portion 11 of the medical device body 10 by pulling the first operation line 41 and the second operation line 42 and the first operation line 41 and the second operation line 42 (FIG. 6, 7) and.
The bending operation unit 80 is a rotating member 81 rotatably supported, and the rotating member 81 to which the base end of the first operation line 41 and the base end of the second operation line 42 are fixed; A movement mechanism for moving the rotating member 81 in the pulling direction in which the first operation line 41 and the second operation line 42 are pulled and in the direction opposite to the pulling direction, and an operation receiving unit For example, the dial operation unit 84). The power of the operation reception unit is transmitted to the rotating member 81 via the moving mechanism, so that the rotating member 81 moves in the pulling direction and the opposite direction to the pulling direction.

According to the present embodiment, when the user performs an operation of moving the rotating member 81 in the pulling direction with respect to the operation receiving unit, the first operation line 41 and the second operation line fixed to the rotating member 81, respectively. 42 and both can be towed.
As a result, operability according to various needs can be suitably realized within the range corresponding to the arrangement of the operation lines (in the present embodiment, the first operation line 41 and the second operation line 42).

In the case of the present embodiment, by pulling both of the first operation line 41 and the second operation line 42, as shown in FIGS. 5 (a) and 5 (b), the distal end portion 11 of the medical device body 10 is obtained. Can be bent. At this time, since the load for pulling the distal end portion 11 of the medical device body 10 by the first operation line 41 and the load for pulling the second operation line 42 can be balanced, the first operation line 41 or the second operation line 42 It is possible to suppress the occurrence of a phenomenon in which the medical device body 10 rotates about an axis in order to make a shortcut.
Therefore, even when the distal end portion 11 is further bent after the medical device main body 10 passes a body cavity such as a curved blood vessel, the distal end portion 11 can be more reliably bent in a desired direction.

More specifically, in the case of the present embodiment, the first operation line 41 and the second operation line 42 are medical in the intermediate portion 12 and the proximal end portion 13 (FIGS. 6 and 7) in the axial direction of the medical device body 10. In the circumferential direction of the device body 10, they extend parallel to each other while being separated from each other.
At the tip end portion 11 in the axial direction of the medical device body 10, the first operation line 41 and the second operation line 42 are curved and merged so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the tip side. There is.
Here, that the first operation line 41 and the second operation line 42 join together means that the tip 41 a of the first operation line 41 and the tip 42 a of the second operation line 42 are close to each other. . It is preferable that the tip 41 a of the first operation line 41 and the tip 42 a of the second operation line 42 be close to each other at a distance smaller than the thickness of the resin pipe 20 described later.

As in the case of the present embodiment, when the number of operation lines included in the medical device 100 is two and these operation lines merge, the direction in which the tip 11 can be bent by pulling the operation lines. Is one way.

Here, in the catheter of Patent Document 1, when the distal end is further bent after passing through a body cavity such as a curved blood vessel, it can be easily bent in the inward direction of the curve, but is bent in the outward direction. It is hard to do it.
This is because, when pulling the operation line located on the out-course side of the curve and trying to bend the tip of the catheter outward, the catheter in the curved blood vessel is in the direction of shortening the path of the pulled operation line. This is because the catheter is rotated about its axis.
On the other hand, according to the present embodiment, as described above, it is possible to more reliably bend the tip 11 in a desired direction.

The medical device 100 is typically a catheter.

The medical device body 10 is provided with a resin tube 20 whose lumen is a lumen 21.
In the case of this embodiment, the resin tube 20 has a hollow tubular inner layer 22 whose lumen is a lumen 21 and a hollow tubular outer layer coaxial with the inner layer 22 and formed around the outer periphery of the inner layer 22. And a layer structure including The inner layer 22 and the outer layer 23 are each made of a resin material. The inner peripheral surface of the outer layer 23 is joined to the outer peripheral surface of the inner layer 22.
The resin material forming the inner layer 22 and the resin material forming the outer layer 23 may be different from each other or may be equal to each other.
If necessary, a hydrophilic coat may be formed on the outer surface of the medical device body 10.
The lumen 21 is continuously formed from the distal end to the proximal end of the medical device body 10 and is open at the distal end and the proximal end of the medical device body 10, respectively.

The medical device body 10 further includes a first hollow tube 31 and a second hollow tube 32 embedded in the resin tube 20. The first operation line 41 is inserted into the first hollow tube 31, and the second operation line 42 is inserted into the second hollow tube 32.
The first hollow tube 31 and the second hollow tube 32 are sub-lumen tubes, respectively, and the lumens of the sub-lumen tubes are sub-lumens. That is, each operation line (the first operation line 41, the second operation line 42) is inserted into the sub-lumen.
The inner diameters of the first hollow tube 31 and the second hollow tube 32 are smaller than the inner diameter of the lumen 21.
Each of the first operation line 41 and the second operation line 42 is formed of a thin line such as metal or resin.

In the case of the present embodiment, since the first hollow tube 31 and the second hollow tube 32 are disposed avoiding the position on the incourse side when the distal end portion 11 of the medical device main body 10 is bent, the distal end portion 11 can be easily bent. In particular, since the first hollow tube 31 and the second hollow tube 32 are separated from the incourse side toward the proximal end side of the distal end portion 11, bending becomes easy.

At the distal end portion 11 of the medical device body 10, the first hollow tube 31 and the second hollow tube 32 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. As a result, the first operation line 41 in the first hollow tube 31 and the second operation line 42 in the second hollow tube 32 gradually approach each other in the circumferential direction of the medical device body 10 toward the tip end side. Curved.
The first hollow tube 31 and the second hollow tube 32 do not cross each other. Further, the first operation line 41 and the second operation line 42 do not intersect with each other.

As described above, the medical device body 10 is embedded in the resin pipe 20 having the lumen 21 and the resin pipe 20, and the first hollow pipe into which the first operation line 41 and the second operation line 42 are respectively inserted. 31 and the second hollow tube 32, and the first hollow tube 31 and the second hollow tube 32 are directed to the distal end side at the distal end portion 11 in the axial direction of the medical device body 10. Therefore, they are curved so as to approach each other in the circumferential direction of the medical device body 10 gradually.

Here, in the axial direction of the medical device body 10, a region where the first operation line 41 and the second operation wire 42 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the tip side is It is referred to as a curved area 15. The base end position 15a of the bending area 15 is a position where the first operation line 41 and the second operation line 42 begin to bend toward each other, and the tip end position 15b of the bending area 15 is a first operation line 41. And the second operation line 42 is in a position where it is curved in the direction of each other.
In the case of the present embodiment, the tip end position 15b of the bending area 15 is a position where the tips 41a and 42a of the first operation line 41 and the second operation line 42 are disposed, or a position near the position.

The tip 41 a of the first operation line 41 protrudes from the tip 31 a of the first hollow tube 31. Similarly, the tip 42 a of the second operation line 42 protrudes from the tip 32 a of the second hollow tube 32.
For example, the tip 41a is located near the tip 31a, and the tip 42a is located near the tip 32a.

The medical device body 10 includes, for example, a blade layer 51 embedded in the resin pipe 20. Thereby, the medical device body 10 is reinforced by the blade layer 51. The blade layer 51 is configured by braiding a plurality of wires. The blade layer 51 is disposed, for example, around the inner layer 22.
The first hollow tube 31 and the second hollow tube 32 are disposed, for example, radially outward of the medical device body 10 (at a position farther from the axial center of the medical device body 10) than the blade layer 51. .

The medical device body 10 further includes a winding wire 52 embedded in the resin tube 20. The winding wire 52 is wound radially outward of the medical device body 10 more than the blade layer 51, the first hollow tube 31 and the second hollow tube 32. The winding wire 52 constrains the first hollow tube 31 and the second hollow tube 32 to the blade layer 51, for example.

In the curved area 15, the first hollow tube 31 and the second hollow tube 32 are disposed along the outer periphery of the blade layer 51 (see FIGS. 3 and 4).
In the curved region 15, the distance between the first hollow tube 31 and the second hollow tube 32 in the circumferential direction of the medical device body 10 is gradually reduced toward the tip end, and the periphery of the medical device body 10 The distance between the first operation line 41 and the second operation line 42 in the direction is gradually reduced toward the tip end side.
The first hollow tube 31 and the second hollow tube 32 are brazed in a curved shape, for example, on the distal end side of the proximal end position 15 a of the curved region 15. The first hollow tube 31 and the second hollow tube 32 may be fixed to at least one of the blade layer 51 or the inner layer 22 at the proximal end position 15 a of the curved region 15, respectively. The distal end is disposed at the proximal end position 15a of the curved region 15, and the first hollow tube 31 and the second hollow tube 32 are not restrained by the winding wire 52 at the distal end side from the proximal end 15a. Good.

In the intermediate portion 12 and the proximal end portion 13 in the axial direction of the medical device body 10, the first operation line 41 and the second operation line 42 are disposed at positions facing each other in the circumferential direction of the medical device body 10.
In the case of the present embodiment, for example, as shown in FIG. 2, in the middle portion 12 of the medical device body 10, the first operation line 41 and the second operation line 42 are based on the axial center of the medical device body 10. In the circumferential direction of the medical device body 10, they face each other 180 degrees. Similarly, at the proximal end 13 of the medical device body 10 and the proximal position 15a of the curved region 15, the first operation line 41 and the second operation line 42 are mutually 180 degrees in the circumferential direction of the medical device body 10. Are facing each other. That is, the phase difference between the first operation line 41 and the second operation line 42 in the circumferential direction of the medical device body 10 is 180 degrees at the proximal end position 15 a of the intermediate portion 12, the proximal end 13 and the curved region 15.
The phase difference between the first operation line 41 and the second operation line 42 in the circumferential direction of the medical device body 10 gradually reduces toward the tip end in the bending area 15, and at the tip position 15 b of the bending area 15, For example, the phase difference is approximately zero. In the case of the present embodiment, the first operation line 41 and the second operation line 42 are each rotated 90 degrees in the circumferential direction of the medical device main body 10 in the bending region 15.
However, the arrangement of the first operation line 41 and the second operation line 42 at positions facing each other in the circumferential direction of the medical device body 10 is not limited to this example, and the first operation line 41 and the second operation It means that the lines 42 are separated from each other by 120 degrees or more in the circumferential direction of the medical device body 10.

Further, in the case of the present embodiment, the first hollow tube 31 and the second hollow tube 32 are the medical device at the intermediate portion 12 of the medical device body 10, the proximal end 13 and the proximal end position 15a of the curved region 15. With the axial center of the main body 10 as a reference, they oppose each other 180 degrees in the circumferential direction of the medical device main body 10. That is, the phase difference between the first hollow tube 31 and the second hollow tube 32 in the circumferential direction of the medical device body 10 is 180 degrees at the base end position 15 a of the intermediate portion 12, the base end 13 and the curved region 15. is there. The phase difference is gradually reduced toward the distal end side in the curved region 15.

A ring-shaped marker 70 made of a radiopaque metallic material is provided at the distal end portion 11 of the medical device body 10.
The marker 70 is disposed coaxially with the lumen 21 and around the lumen 21.
The markers 70 are disposed, for example, around the blade layer 51.

The tip 41 a of the first operation line 41 is fixed to the marker 70 by a first fixing portion 71 which is, for example, a spot-like solder.
Similarly, the tip 42 a of the second operation line 42 is fixed to the marker 70 by a first fixing portion 71 which is, for example, a spot-like solder.
The first fixing portion 71 and the second fixing portion 72 are disposed, for example, at the proximal end of the marker 70.

In the case of this embodiment, the tip 41 a of the first operation line 41 and the tip 42 a of the second operation line 42 are connected to each other. That is, the tips of the first operation line 41 and the second operation line 42 are connected to each other.
In more detail, the 1st fixing | fixed part 71 and the 2nd fixing | fixed part 72 mutually adjacent | abut, and are in contact. That is, the first fixing portion 71 and the second fixing portion 72 are integrated.
In addition, the tip 41 a and the tip 42 a may be fixed to the marker 70 by one fixing portion.

Next, the hub 90 provided at the proximal end of the medical device main body 10 will be described using FIGS. 6 and 7.
The hub 90 has a connecting portion 93 for inserting a syringe (not shown) from the proximal end of the hub 90. A screw groove is formed on the outer periphery of the connection portion 93 so that the syringe can be detachably fixed.
On an outer periphery of the hub 90, there are provided two wing portions 92 opposed to each other through the axial center of the hub 90.
The proximal end of the medical device body 10 is inserted and fixed to the distal end of the hub 90. Thereby, the lumen 21 inside the medical device body 10 and the internal space of the hub 90 communicate with each other.
By rotating the wing 92 about the axis of the hub 90, it is possible to perform a torque operation to axially rotate the entire medical device body 10.
A housing 86 of a bending operation unit 80, which will be described later, is connected and fixed to the tip end side of the hub 90.

Next, the bending operation unit 80 provided in the medical device 100 will be described with reference to FIGS. 6 and 7.

The medical device 100 includes a bending operation unit 80 for performing bending operation of the distal end portion 11 of the medical device main body 10 by pulling the first operation line 41 and the second operation line 42.

The bending operation portion 80 is a rotary member 81 rotatably supported, and the first operation line 41 and the second operation line 42 are engaged with each other, and the base end portion of the first operation line 41 and the second end The rotating member 81 to which the base end portion of the operation line 42 is fixed, and the rotating direction of the rotating member 81 are moved in the pulling direction in which the first operation line 41 and the second operation line 42 are pulled, and in the opposite direction to the pulling direction. And a moving mechanism.
The rotating member 81 is, for example, a pulley.
Here, in the present specification, that a member is rotatable includes not only an aspect that can rotate 360 degrees or more, but also an aspect that can only swing in a predetermined angle range less than 360 degrees.

As shown in FIG. 6, the rotating member 81 has an engaging portion formed in a circular shape centered on the rotation center of the rotating member 81, and the first operation line 41 and the second operation are provided at this engaging portion. Line 42 is engaged. The engaging portion of the rotating member 81 is not limited to a circular shape, and may be an arc shape.
Thus, the rotary member 81 has an engagement portion with which the first operation line 41 and the second operation line engage, and the engagement portion has a circular shape or a circle centered on the rotation center of the rotary member 81. It is formed in an arc shape.

The moving mechanism is configured to include an advancing and retracting member 82 and a pinion 83.
The advancing and retracting member 82 includes a holding portion 82a rotatably holding the rotating member 81, and a rod-like portion 82b extending from the holding portion 82a to the proximal end side of the medical device main body 10.
The rod portion 82b is formed with a rack portion 82c.

The bending operation unit 80 is further integrally provided with a case 86 which is a main body of the bending operation unit 80, a dial operation unit 84 rotatably supported with respect to the case 86, and the dial operation unit 84. And a guide 85 (for example, a pair of front and rear guides 85) provided on the inner surface of the housing 86 and guiding the rod portion 82b in the longitudinal direction of the rod portion 82b.
The proximal end portion 13 of the medical device body 10 is guided to the proximal end side of the housing 86 through the inside of the housing 86, and is inserted and fixed to the distal end portion of the hub 90.
The rotation axis of the dial operation unit 84 extends in a direction orthogonal to the axial direction of the medical device body 10 in the housing 86.
The pinion 83 is integrally formed with the dial operating unit 84 on one surface side of the dial operating unit 84, and is disposed coaxially with the rotation axis of the dial operating unit 84.
The outer peripheral gear of the pinion 83 meshes with the gear of the rack portion 82 c of the advancing and retracting member 82.
At least a part of the dial operation unit 84 is exposed to the outside of the housing 86 so that an operator who operates the medical device 100 can perform an operation of rotating the dial operation unit 84 from the outside of the housing 86. It has become.

In the housing 86, the whole of the rotating member 81 is accommodated. That is, the bending operation unit 80 includes a housing 86, and the entire rotation member 81 is accommodated in the housing 86.

The first operation line 41 and the second operation line 42 are respectively derived from the medical device body 10 in the housing 86.
The base end of the first operation line 41 is, for example, one and a half turns around the rotating member 81, and the base end of the first operation line 41 is the rotating member at the first fixed portion 81a (FIG. 6) It is fixed to 81.
Similarly, the second operation line 42 is, for example, wound one and a half turns around the rotation member 81, and the base end of the second operation line 42 is the rotation member 81 at the second fixed portion 81b (FIG. 6). It is fixed to
The winding direction of the first operation wire 41 and the winding direction of the second operation wire 42 with respect to the rotating member 81 are opposite to each other. Therefore, the rotation angle of the rotating member 81 is autonomously adjusted to an angle at which the tension of the first operation line 41 and the tension of the second operation line 42 are balanced.

When the operator who operates the medical device 100 grips the housing 86 or the hub 90 and rotates the dial operation unit 84, the pinion 83 integral with the dial operation unit 84 is axially rotated, and in accordance with this, the rack unit An advancing and retracting member 82 having an 82c is advanced (moved to the distal end side of the medical device body 10) or retracted (proximal to the medical device body 10) in the axial direction of the medical device body 10 relative to the housing 86. Moving.
In FIG. 6, by moving the dial operating portion 84 clockwise, the advancing and retracting member 82 and the rotating member 81 are retracted, and both the first operation line 41 and the second operation line 42 are on the proximal end side of the medical device body 10. Towed by.

As described above, the operation reception unit (dial operation unit 84) is rotatably supported by a shaft, and the movement mechanism is interlocked with the rotation of the pinion 83 and the rotation of the pinion 83 integrally and coaxially with the operation reception unit. And a rack member (advancing member 82) to be advanced and retracted, and the rotating member 81 is pivotally supported by the rack member.

Thus, the first operation line 41 and the second operation line 42 are pulled at once by the operation on the bending operation unit 80.
Here, that the first operation line 41 and the second operation line 42 are pulled at one time means that there is a timing at which both the first operation line 41 and the second operation line 42 are pulled together. The timing at which the first operation line 41 and the second operation line 42 are pulled is not limited to the same timing, and the timing at which the first operation line 41 and the second operation line 42 are pulled and the end timing is the same. It is not limited to becoming.

For example, when the distal end portion 11 of the medical device main body 10 has a linear shape as shown in FIG. 8A, when the dial operation portion 84 is rotated clockwise in FIG. 8B, the first operation line 41 Since both the second operation line 42 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in one direction.
When the dial operating portion 84 is rotated counterclockwise from the state of FIG. 8B, the advancing and retracting member 82 and the rotating member 81 move forward, and the tension of the first operation line 41 and the second operation line 42 is relaxed. The distal end portion 11 of the medical device body 10 is allowed to return to a linear shape.
As described above, in the case of the present embodiment, the bending operation unit 80 receives an operation by the user by the rotation mechanism (dial operation unit 84), and the force applied to the rotation mechanism by this operation is received by the pinion 83 and the rack (rack The conversion mechanism configured by the portion 82c) is configured to convert into the forward and backward movement in the axial direction of the medical device body 10.

Next, an example of the material of each part of the medical device 100 will be described.
As a material of the inner layer 22, resin materials, such as a polytetrafluoroethylene (PTFE), a polyvinylidene fluoride (PVDF), a perfluoro alkoxy fluorine resin (PFA), can be used, for example.
The material of the outer layer 23 is polyimide (PI), polyamide imide (PAI), polyethylene terephthalate (PET), polyethylene (PE), polyamide (PA), nylon elastomer, polyurethane (PU), ethylene-vinyl acetate resin ( Resin materials such as EVA), polyvinyl chloride (PVC) or polypropylene (PP) can be used.
As materials of the first hollow tube 31 and the second hollow tube 32, for example, resin materials such as polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF), perfluoroalkoxy fluorine resin (PFA), etc. may be used. Can.
The material of the wire forming the blade layer 51 is preferably, for example, a metal material such as stainless steel or tungsten, but may be a resin material.
The material of the wire constituting the wound wire 52 is preferably, for example, a metal material such as stainless steel or tungsten, but may be a resin material.

According to the medical device 100 according to the above-described Embodiment 2-1, bending the distal end portion 11 of the medical device body 10 by pulling both of the first operation line 41 and the second operation line 42 At that time, the load to pull the distal end portion 11 of the medical device main body 10 by the first operation line 41 and the load to pull the second operation line 42 can be balanced, so the first operation line 41 or the second operation It is possible to suppress the occurrence of a phenomenon in which the medical device body 10 rotates about an axis as the line 42 attempts to make a shortcut.
Therefore, it is possible to more reliably bend the distal end portion 11 of the medical device main body 10 in a desired direction.

Embodiment 2-2
Next, a medical device 100 according to the second embodiment will be described with reference to FIGS. 9 to 11B.
11 (a) and 11 (b) are schematic diagrams for explaining the bending operation when the distal end portion 11 of the medical device body 10 is viewed in the direction of arrow A in FIG. 10, and FIG. 11 (a) is The state before bending is shown, and FIG. 11 (b) shows the state of bending.
The medical device 100 according to the present embodiment is different from the medical device 100 according to the above-described second embodiment in the points described below, and in the other points, in the above-described second embodiment. It is comprised similarly to the medical device 100 which concerns.

In the case of the present embodiment, the first operation line 41 and the second operation line are located between the tip of the bending area 15 (tip position 15b) and the tips 41a and 42a of the first operation line 41 and the second operation line 42. A parallel region 16 is formed in which the two 42 and 42 extend close to each other and in parallel.

That is, the medical device main body 10 is configured to include the resin tube 20 having the lumen 21, and the first operation line 41 and the second operation line 42 are inserted around the lumen 21 of the resin tube 20. The first operation at the tip (tip position 15b) of the curved region 15 in which the 1 operation line 41 and the second operation line 42 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the tip side. The line 41 and the second operation line 42 are close to each other at a distance smaller than the thickness of the resin tube 20, and the tip of the curved area 15 (tip position 15b) and the first and second operation lines 41 and 42. Between the tips 41a and 42a, parallel regions 16 in which the first operation line 41 and the second operation line 42 extend close to each other and in parallel are formed.
In the parallel region 16, the first hollow tube 31 and the second hollow tube 32 abut on or in close proximity to each other and extend in parallel.

More specifically, in the case of the present embodiment, the medical device 100 further includes an annular member 60 embedded in the resin pipe 20 at the tip of the curved region 15.
The annular member 60 is configured to have higher rigidity than the resin pipe 20 and is formed to have an outer diameter smaller than the thickness of the resin pipe 20 (see FIG. 10).
The first operation line 41 and the second operation line 42 are inserted into the annular member 60.
Thereby, it is possible to more reliably suppress the fluctuation of the paths of the first operation line 41 and the second operation line 42.

More specifically, in the case of the present embodiment, the first hollow tube 31 and the second hollow tube 32 are inserted into the annular member 60.
That is, the medical device body 10 includes the first hollow tube 31 and the second hollow tube 32 which are embedded in the resin tube 20 and into which the first operation line 41 and the second operation line 42 are respectively inserted. The first hollow tube 31 and the second hollow tube 32 are inserted into the annular member 60, and in the curved region 15, the first hollow tube 31 and the second hollow tube 32 have tips. It curves so that it may mutually approach in the circumferential direction of the medical device main body 10 gradually toward the side.

The material of the annular member 60 is not particularly limited, but the annular member 60 can be made of, for example, metal or hard resin.

Also in the case of the present embodiment, by pulling both of the first operation line 41 and the second operation line 42, as shown in FIGS. 11 (a) and 11 (b), the distal end portion of the medical device body 10 11 can be bent.
At this time, the bending angle in the parallel region 16 is steeper than the bending angle in the curved region 15.

As an example, in the axial direction of the medical device body 10, the tip of the bending region 15 is more than the distance (the distance L1 shown in FIG. 9) from the base end (base position 15a) of the bending region 15 to the tip (tip position 15b). The distance from the tip position 15b to the tips 41a and 42a of the first operation line 41 and the second operation line 42 (the distance L2 shown in FIG. 9) is longer.
By such a configuration, the tip end portion 11 can be more easily bent.
Also, the bending of the tip 11 can occur mainly in the parallel region 16. Therefore, regardless of the bending angle of the distal end portion 11, the friction between the first operation line 41 and the first hollow tube 31 and the friction between the second operation line 42 and the second hollow tube 32 in the curved region 15 are Since the force can be maintained substantially constant, the magnitude of the force required to pull the first operation line 41 and the second operation line 42 can be maintained substantially constant regardless of the bending angle of the distal end portion 11.

As another example, in the axial direction of the medical device body 10, the distance (distance L1 shown in FIG. 9) from the base end (base end position 15a) of the bending region 15 to the tip end (tip end position 15b) is The distance (the distance L2 shown in FIG. 9) from the tip (tip position 15b) of the curved region 15 to the tips 41a and 42a of the first operation line 41 and the second operation line 42 is longer.
With such a configuration, the bendability of the distal end portion 11 can be suppressed to a certain extent.
In addition, since the first operation line 41 and the second operation line 42 in the bending area 15 and the first hollow tube 31 and the second hollow pipe 32 can be gently curved, the first operation line 41 and the first operation line 41 in the bending area 15 can The friction with the first hollow tube 31 and the friction between the second operation line 42 and the second hollow tube 32 can be reduced.
In addition, since the length region in which the first hollow tube 31 and the second hollow tube 32 translate close to each other at the distal end portion 11 of the medical device body 10, that is, the length region having high rigidity becomes short, the medical device Good selectivity (such as good blood vessel selectivity) can be obtained when the distal end portion 11 of the main body 10 is bent to enter the bifurcated body cavity.

The distance L1 and the distance L2 may be the same. In this case, the smoothness of pulling of the first operation line 41 and the second operation line 42 and the good selectivity when the distal end portion 11 of the medical device body 10 is bent to enter the bifurcated body cavity can be balanced. be able to.

Embodiment 2-3
Next, a medical device 100 according to the second and third embodiments will be described with reference to FIGS. 12 to 18C.
16 (a) and 16 (b) are schematic diagrams for explaining the bending operation when the distal end portion 11 of the medical device body 10 is viewed in the direction of arrow A in FIG. 15, and FIG. 16 (a) The state before bending is shown, and FIG. 16 (b) shows the state of bending.
16 (c) and 16 (d) are schematic diagrams for explaining the bending operation when the distal end portion 11 of the medical device body 10 is viewed in the direction of arrow B in FIG. 15, and FIG. 16 (c) The state before bending is shown, and FIG. 16 (d) shows the state of bending.
18 (a), 18 (b) and 18 (c), the midway portion in the longitudinal direction of the medical device main body 10 is broken and omitted. In the medical device body 10 shown in FIGS. 18 (a), 8 (b) and 18 (c), the portion on the proximal side and the portion on the distal side of the omitted portion are around the axis of the medical device body 10. The rotational phase is 90 degrees different.
The medical device 100 according to this embodiment is different from the medical device 100 according to the above-described second embodiment in the points described below, and in the other points, in the above-described second embodiment. It is comprised similarly to the medical device 100 which concerns.

The medical device 100 according to the present embodiment includes the third operation line 43 and the fourth operation line 44 which are respectively inserted along the axial direction of the medical device main body 10. Similarly to the first operation line 41 and the second operation line 42, the third operation line 43 and the fourth operation line 44 are respectively configured by fine lines such as metal or resin.

The medical device body 10 further includes a third hollow pipe 33 and a fourth hollow pipe 34 embedded in the resin pipe 20. The third operation line 43 is inserted into the third hollow tube 33, and the fourth operation line 44 is inserted into the fourth hollow tube 34.
The third hollow tube 33 and the fourth hollow tube 34 are sublumen tubes similar to the first hollow tube 31 and the second hollow tube 32, and the lumens of these sublumen tubes are sublumens. That is, each operation line (the third operation line 43 and the fourth operation line 44) is inserted into the sub-lumen.
The inner diameters of the third hollow tube 33 and the fourth hollow tube 34 are smaller than the inner diameter of the lumen 21.

In the case of the present embodiment, in the middle portion 12 of the medical device main body 10, the first hollow tube 31 and the third hollow tube 33 are in proximity to or in contact with each other and extend in parallel, and the second middle The empty tube 32 and the fourth hollow tube 34 extend in parallel, in proximity to or in contact with each other (see FIG. 13).
Similarly, also at the proximal end portion of the medical device body 10, the first hollow tube 31 and the third hollow tube 33 extend in parallel, in proximity to or in contact with each other, and the second hollow tube 32 And the fourth hollow tubes 34 extend in parallel in proximity to or in abutment with each other.

In the curved region 15 of the distal end portion 11 of the medical device body 10, the third hollow tube 33 and the fourth hollow tube 34 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. ing. As a result, the third operation line 43 in the third hollow tube 33 and the fourth operation line 44 in the fourth hollow tube 34 gradually approach each other in the circumferential direction of the medical device body 10 toward the tip end side. Curved.
The direction in which the third hollow tube 33 and the third operation line 43 are curved in the curved region 15 is a direction symmetrical to the direction in which the first hollow tube 31 and the first operation line 41 are curved.
Similarly, the direction in which the fourth hollow tube 34 and the fourth operation line 44 are curved in the curved region 15 is in the direction symmetrical to the direction in which the second hollow tube 32 and the second operation line 42 are curved. is there.
The hollow tubes (the first hollow tube 31, the second hollow tube 32, the third hollow tube 33, and the fourth hollow tube 34) do not intersect with other hollow tubes. Further, each operation line (the first operation line 41, the second operation line 42, the third operation line 43, and the fourth operation line 44) does not intersect with other operation lines.

In the parallel region 16, the third operation line 43 and the fourth operation line 44 are close to each other as in the case where the first operation line 41 and the second operation line 42 are close to each other and extend in parallel. Extend in parallel.
Further, in the parallel region 16, the third hollow tube 33 and the third hollow tube 33 are arranged in the same way as the first hollow tube 31 and the second hollow tube 32 are in contact with or close to each other, or in parallel. The four hollow tubes 34 extend in parallel in abutment with or close to each other.
The tip 43 a of the third operation line 43 protrudes from the tip of the third hollow tube 33. Similarly, the tip 44 a of the fourth operation line 44 protrudes from the tip of the fourth hollow tube 34.

The tip 43a of the third operation line 43 is fixed to the marker 70 by a third fixing portion 73 which is, for example, a spot-like solder (FIG. 15).
Similarly, the tip end 44 a of the fourth operation line 44 is fixed to the marker 70 by a fourth fixing portion 74 which is, for example, a spot-like solder.
The third fixing portion 73 and the fourth fixing portion 74 are disposed, for example, at the proximal end of the marker 70.
The region where the third fixing portion 73 and the fourth fixing portion 74 are disposed, and the region where the first fixing portion 71 and the second fixing portion 72 are disposed face each other in the circumferential direction of the medical device main body 10. ing.

In the case of the present embodiment, the tip 43 a of the third operation line 43 and the tip 44 a of the fourth operation line 44 are mutually connected. That is, the tips of the third operation line 43 and the fourth operation line 44 are connected to each other.
More specifically, the third fixing portion 73 and the fourth fixing portion 74 are adjacent to each other and in contact with each other. That is, the third fixed portion 73 and the fourth fixed portion 74 are integrated.
In addition, the tip 43a and the tip 44a may be fixed to the marker 70 by one fixing portion.

As shown in FIG. 14, in the case of the present embodiment, the medical device 100 is provided with a first annular member 61 embedded in the resin pipe 20 at the tip of the curved region 15 instead of the annular member 60. The first annular member 61 is the same as the annular member 60 in the 2-2nd embodiment, and the first hollow tube 31 and the second hollow tube 32 are inserted into the first annular member 61.
Furthermore, in the case of the present embodiment, the medical device 100 includes the second annular member 62 embedded in the resin pipe 20 at the tip end of the curved region 15. The second annular member 62 is similar to the first annular member 61. The third hollow tube 33 and the fourth hollow tube 34 are inserted into the second annular member 62.
The first annular member 61 and the second annular member 62 are disposed to face each other in the circumferential direction of the medical device body 10.

Also in the case of the present embodiment, by pulling both of the first operation line 41 and the second operation line 42, as shown in FIGS. 16 (a) and 16 (b), the tip of the medical device body 10 11 can be bent in one direction.
Furthermore, in the case of the present embodiment, by pulling both of the third operation line 43 and the fourth operation line 44, as shown in FIGS. 16 (c) and 16 (d), The tip 11 can be bent in the opposite direction to the one direction.

As shown in FIGS. 17 and 18A, in the case of the present embodiment, the bending operation unit 80 bends the distal end portion 11 of the medical device body 10 by pulling the first operation line 41 and the second operation line 42. A first bending operation unit 180 for performing the second operation, and a second bending operation unit 280 for performing a bending operation of the distal end portion 11 of the medical device body 10 by pulling the third operation line 43 and the fourth operation line 44; Have.

The first bending operation unit 180 includes a first rotating member 181, a first advancing and retracting member 182, a first pinion 183, a first dial operating unit 184, and a first guide 185. The first rotating member 181, the first advancing and retracting member 182, the first pinion 183, the first dial operating portion 184, and the first guide 185 are the rotating member 81, the advancing and retracting member 82, and the pinion 83 described in the 2-1th embodiment. It corresponds to the dial operation unit 84 and the guide 85, respectively.
Therefore, the first advancing and retracting member 182 includes the first holding portion 182a, the first rod-shaped portion 182b, and the first rack portion 182c, which correspond to the holding portion 82a, the rod-shaped portion 82b, and the rack portion 82c, respectively.
In the same manner as the first operation line 41 and the second operation line 42 are wound and fixed to the rotation member 81 in the 2-1 embodiment, the first operation line 41 is provided to the first rotation member 181. The second operation line 42 is wound and fixed.

The second bending operation unit 280 includes a second rotating member 281, a second advancing and retracting member 282, a second pinion 283, a second dial operating unit 284 and a second guide 285. The second rotating member 281, the second advancing and retracting member 282, the second pinion 283, the second dial operating portion 284 and the second guide 285 are a first rotating member 181, a first advancing and retracting member 182, a first pinion 183, a first dial The same as the operation unit 184 and the first guide 185.
The second advancing and retracting member 282 includes a second holding portion 282a, a second rod-like portion 282b and a second rack portion 282c similar to the first holding portion 182a, the first rod-like portion 182b and the first rack portion 182c.
Similar to the first operation line 41 and the second operation line 42 being wound and fixed to the first rotation member 181, the second operation member 43 has a third operation line 43 and a fourth operation line. 44 are wound and fixed.
For example, the second bending operation unit 280 is vertically symmetrical with respect to the first bending operation unit 180 in FIG.

In the case of the present embodiment, by rotating the first dial operating unit 184 and retracting the first advancing and retracting member 182 and the first rotating member 181, the first operation line 41 and the second operation line 42 are pulled, and medical treatment is performed. The tip 11 of the device body 10 can be bent in one direction (FIG. 18 (b)).
In addition, the third operation line 43 and the fourth operation line 44 are pulled by rotating the second dial operation unit 284 and retracting the second advancing and retracting member 282 and the second rotating member 281, thereby The tip 11 can be bent in the opposite direction to the one direction (FIG. 18C).

As described above, in the case of the present embodiment, the medical device 100 pulls the third operation line 43 and the fourth operation line 44, thereby pulling the first operation line 41 and the second operation line 42, thereby leading the medical device 100. A second bending operation unit 280 for bending the distal end portion 11 of the medical device main body 10 in a direction different from the bending direction of the portion 11 is provided.
At an intermediate portion 12 and a proximal end portion in the axial direction of the medical device body 10, the third operation line 43 and the fourth operation line 44 are separated from each other in the circumferential direction of the medical device body 10 and extend in parallel, At the distal end portion 11 in the axial direction of the medical device body 10, the third operation line 43 and the fourth operation line 44 curve and merge so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side There is.

In addition, the third operation line 43 and the fourth operation line 44 are pulled at once by the operation on the second bending operation unit 280.

The second bending operation unit 280 is the second rotating member 281 rotatably supported, and the base end of the third operation line 43 and the base end of the fourth operation line 44 are fixed. A second rotating member 281, a second moving mechanism for moving the second rotating member 281 in a second pulling direction in which the third operation line 43 and the fourth operation line 44 are pulled and in a direction opposite to the second pulling direction; And a second operation receiving unit (second dial operation unit 284) that operates in response to an operation. Then, the power of the second operation reception unit is transmitted to the second rotating member 281 via the second moving mechanism, whereby the second rotating member 281 moves in the second pulling direction and the direction opposite to the second pulling direction. It is supposed to be.
In the case of the present embodiment, the second pulling direction is the same as the pulling direction.
More specifically, the third operation line 43 and the fourth operation line 44 are engaged with the second rotating member 281 and the base end of the third operation line 43 and the base end of the fourth operation line 44 And are fixed.

As described above, the bending operation unit 80 includes the housing 86. The entire rotating member (first rotating member 181) and the entire second rotating member 281 are accommodated in the housing 86.

The second rotation member 281 has a second engagement portion with which the third operation line 43 and the fourth operation line 44 are engaged, and the second engagement portion is centered on the rotation center of the second rotation member 281. It is formed in a circular shape or an arc shape.

The second operation reception unit (second dial operation unit 284) is rotatably supported by a shaft, and the second movement mechanism is a second pinion 283 integrally provided coaxially with the second operation reception unit; And a second rack member (second advancing and retracting member 282) which moves in tandem with the rotation of the second pinion 283. The second rotating member 281 is pivotally supported by the second rack member.

Embodiment 2-4
Next, a medical device 100 according to the second to fourth embodiments will be described with reference to FIGS. 19 (a) and 19 (b).
The medical device 100 according to the present embodiment is different from the medical device 100 according to the above-described second embodiment in the points described below, and in the other points, in the above-described second embodiment. It is comprised similarly to the medical device 100 which concerns.

In the case of the present embodiment, an area between the first operation line 41 and the second operation line 42 or an axial center of the medical device body 10 in the circumferential direction of the distal end portion 11 of the medical device body 10 In a region located on the opposite side of the region, a flexible portion 110 in which the flexibility of the medical device body 10 is locally high is formed.
As a result, the flexibility of the distal end portion 11 is improved, so that the tension acting on the first operation line 41 and the second operation line 42 at the time of bending operation can be reduced. Therefore, it is possible to further suppress the occurrence of the phenomenon that the medical device body 10 rotates about the axis with the first operation line 41 or the second operation line 42 trying to be a shortcut.

More specifically, as shown in FIG. 19B, in the circumferential direction of the distal end portion 11 of the medical device body 10, the region between the first operation line 41 and the second operation line 42, and the medical device body 10 The bendable portion 110 is formed on both sides of the axial center of the region on the opposite side of the region.
Thereby, the flexibility of the tip portion 11 is further improved.

The flexible portion 110 is configured to include a notch shape portion 111 formed on the outer surface side of the medical device body 10.
The notch shape part 111 can be made into the shape which turned in the shape of an arc, for example, as shown in FIG.19 (b).
Thereby, the tip end portion 11 can be bent more sharply.

[Second embodiment]
Next, a medical device 100 according to the second to fifth embodiments will be described with reference to FIGS. 20 (a) and 20 (b).
The medical device 100 according to the present embodiment is different from the medical device 100 according to the above-described second embodiment in the points described below, and in the other points, in the above-described second embodiment. It is comprised similarly to the medical device 100 which concerns.

In the case of the present embodiment, an area between the first operation line 41 and the second operation line 42 or an axial center of the medical device body 10 in the circumferential direction of the distal end portion 11 of the medical device body 10 In a region located on the opposite side of the region, a flexible portion 110 in which the flexibility of the medical device body 10 is locally high is formed.
As a result, the flexibility of the distal end portion 11 is improved, so that the tension acting on the first operation line 41 and the second operation line 42 at the time of bending operation can be reduced. Therefore, it is possible to further suppress the occurrence of the phenomenon that the medical device body 10 rotates about the axis with the first operation line 41 or the second operation line 42 trying to be a shortcut.

More specifically, as shown in FIG. 20 (b), in the region between the first operation line 41 and the second operation line 42 in the circumferential direction of the distal end portion 11 of the medical device body 10, the flexible portion 110 In the area located on the opposite side of the axial center of the medical device main body 10, the bendable portion 110 is not formed.
However, in the circumferential direction of the distal end portion 11 of the medical device body 10, the flexible portion 110 sandwiches the region between the first operation line 41 and the second operation line 42 and the axial center of the medical device body 10 It may be formed on both sides of the area opposite to the area concerned.

The flexible portion 110 is configured to include a notch shape portion 111 formed on the outer surface side of the medical device body 10.
In the case of the present embodiment, the medical device body 10 has a plurality of cutout portions 111 arranged adjacent to each other in the axial direction of the medical device body 10. These notch shaped portions 111 are elongated in the circumferential direction of the medical device body 10, and have a wedge-shaped cross section.
In the case of the present embodiment, the distal end portion 11 of the medical device main body 10 is easily bent in the initial stage of bending, but when reaching a certain bending angle, further bending is caused by contact between the wedge-shaped inclined surfaces. It becomes difficult (the rigidity increases when reaching a certain bending angle).
For this reason, when the distal end portion 11 of the medical device body 10 is pushed into the body cavity, the resistance to deformation in the axial direction is improved, and the blood vessel selectivity of the medical device 100 is improved.

[2-6 embodiment]
Next, a second embodiment is described with reference to FIG.
The medical device 100 according to the present embodiment is different from the medical device 100 according to the above-described second and third embodiments in the points described below, and the medical treatment according to the above-described second and third embodiments in the other points. It is configured in the same manner as the device 100.

In the case of the present embodiment, as described below, the configuration of the bending operation unit 80 is different from that of the above second to third embodiments.
In the case of this embodiment, the bending operation unit 80 includes the housing 86, the first rotating member 181 (rotating member), the second rotating member 281, the dial operating unit 194 (third rotating member), and the first rotation. A first connecting wire 192 connecting the member 181 and the dial operating portion 194 to each other, and a second connecting wire 193 connecting the second rotating member 281 and the dial operating portion 194 to each other There is.

Each of the first rotating member 181 and the second rotating member 281 is, for example, a pulley.
The rotation axis of the first rotation member 181 extends, for example, in the direction orthogonal to the axial direction (left and right direction in FIG. 21) of the medical device body 10 in the housing 86.
The rotation axis of the first rotation member 181 is rotatable around the axis of the rotation axis, and is relative to the housing 86 in the axial center direction (horizontal direction in FIG. 21) of the medical device body 10 in the housing 86. It is held movably by the case 86. For example, the rotation shaft of the first rotation member 181 is pivotally supported by a long hole (not shown) formed in the housing 86.
Similarly, the rotation axis of the second rotation member 281 extends, for example, in a direction orthogonal to the axial direction of the medical device body 10 in the housing 86. The rotation axis of the second rotation member 281 is rotatable about the axis of the rotation axis, and movable relative to the housing 86 in the axial direction of the medical device body 10 in the housing 86. It is held by the body 86.
As an example, the rotation axis of the first rotation member 181 and the rotation axis of the second rotation member 281 are parallel to each other. However, these rotation axes may not be parallel to each other.

The first operation line 41, the second operation line 42, the third operation line 43 and the fourth operation line 44 are respectively derived from the medical device main body 10 in the housing 86.
The base end portion of the first operation line 41 is, for example, wound one and a half around the first rotating member 181, and the base end of the first operation line 41 is fixed to the first rotating member 181. Similarly, for example, the second operation line 42 is wound one and a half turns around the first rotation member 181, and the base end of the second operation line 42 is fixed to the first rotation member 181. The winding direction of the first operation wire 41 and the winding direction of the second operation wire 42 with respect to the first rotating member 181 are opposite to each other. Therefore, the rotation angle of the first rotation member 181 is autonomously adjusted to an angle at which the tension of the first operation line 41 and the tension of the second operation line 42 are balanced.
The base end of the third operation line 43 is, for example, wound one and a half around the second rotation member 281, and the base end of the third operation line 43 is fixed to the second rotation member 281. Similarly, for example, the fourth operation line 44 is wound one and a half turns around the second rotation member 281, and the base end of the fourth operation line 44 is fixed to the second rotation member 281. The winding direction of the third operation line 43 and the winding direction of the fourth operation line 44 with respect to the second rotating member 281 are opposite to each other. Therefore, the rotation angle of the second rotation member 281 is autonomously adjusted to an angle at which the tension of the third operation line 43 and the tension of the fourth operation line 44 are balanced.

The dial operation unit 194 is rotatably supported with respect to the housing 86. The rotation axis of the dial operation unit 194 extends in a direction orthogonal to the axial direction of the medical device body 10 in the housing 86.
As an example, the rotation axis of the dial operation unit 194 is parallel to the rotation axis of the first rotation member 181 and the rotation axis of the second rotation member 281. However, the rotation axis of the dial operation unit 194 may not be parallel to the rotation axis of the first rotation member 181 and the rotation axis of the second rotation member 281.
At least a portion of the dial operation unit 194 is exposed to the outside of the housing 86 so that an operator who operates the medical device 100 can perform an operation of rotating the dial operation unit 194 from the outside of the housing 86. It has become.

The dial operation unit 194 includes, for example, a main body portion formed in a disk shape, and a winding portion 191 fixed to one surface side of the main body portion.
The winding unit 191 is, for example, a cylindrical bobbin. The winding unit 191 is disposed coaxially with the rotation axis of the dial operation unit 194.

The tip of the first connection wire 192 is connected to the rotation axis of the first rotation member 181. The proximal end of the first connection wire 192 is, for example, wound one and a half turns around the winding unit 191, and the base end of the first connection wire 192 is fixed to the winding unit 191 at the first connection portion 195. It is done.
Similarly, the tip of the second connection wire 193 is connected to the rotation axis of the second rotation member 281. The proximal end portion of the second connection wire 193 is, for example, wound one and a half turns around the winding portion 191, and the proximal end of the second connection wire 193 is fixed to the winding portion 191 at the second connection portion 196. It is done.
The winding direction of the first connection wire 192 and the winding direction of the second connection wire 193 with respect to the winding unit 191 are opposite to each other.

In the case of the present embodiment, the first connection wire 192 or the second connection wire 193 is selectively selected by the operator who operates the medical device 100 holding the housing 86 or the hub 90 and rotating the dial operation unit 194. The first rotating member 181 or the second rotating member 281 is selectively pulled to the proximal end side.
That is, when the operation to rotate the dial operation unit 194 clockwise in FIG. 21 is performed, the first connecting member 192 is pulled to the proximal end side since the first connecting wire 192 is wound around the winding unit 191. Ru. Thus, since both the first operation line 41 and the second operation line 42 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in one direction.
In addition, when the operation to rotate the dial operation unit 194 in the counterclockwise direction in FIG. 21 is performed, the second connection wire 193 is wound around the winding unit 191, so the second rotating member 281 is pulled toward the base end. Be done. Therefore, since both the third operation line 43 and the fourth operation line 44 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in the opposite direction to the one direction.
That is, an operation of pulling both of the first operation line 41 and the second operation line 42 and an operation of pulling both the third operation line 43 and the fourth operation line 44 by an operation on one dial operation unit 194 ,It can be performed.

As described above, the medical device 100 according to the present embodiment includes the third operation line 43 and the fourth operation line 44 respectively inserted along the axial direction of the medical device main body 10, and the operation on the bending operation unit 80 is performed. , The third operation line 43 and the fourth operation line 44, and the medical device body in a direction different from the bending direction of the distal end portion 11 of the medical device body 10 by the pulling of the first operation line 41 and the second operation line 42. It is possible to bend the tip 11 of ten.

More specifically, the bending operation unit 80 includes, in addition to the rotation member (first rotation member 181), a second rotation member 281 and a third rotation member (dial operation portion 194) which are rotatably supported. Further, the rotation shaft of the rotation member is connected to the first connection portion 195 of the third rotation member, and the rotation shaft of the second rotation member 281 is connected to the second connection portion 196 of the third rotation member. There is.
Further, the base end of the first operation line 41 and the base end of the second operation line 42 are fixed to the rotating member, and the second end of the third operation line 43 is fixed to the second rotating member 281. And the proximal end of the fourth operation line 44 are fixed.
Then, as the third rotating member rotates in one direction, the rotating member is pulled, and the first operation line 41 and the second operation line 42 are pulled, and the tip portion 11 of the medical device body 10 is bent. When the third rotating member is rotated in the opposite direction to the one direction, the second rotating member 281 is pulled, and the third operation line 43 and the fourth operation line 44 are pulled, so that the medical device body 10 is The distal end portion 11 bends in a direction (for example, an opposite direction) different from the bending direction of the distal end portion 11 of the medical device body 10 due to the pulling of the first operation line 41 and the second operation line 42.

In the second embodiment, the rotation shaft of the rotation member (first rotation member 181) is connected to the third rotation member (dial operation unit 194) via a wire (first connection wire 192). Although the example in which the rotation axis of the second rotation member 281 is connected to the third rotation member via the wire (second connection wire 193) has been described, the present invention is not limited to this example.
For example, the rotation shaft of the rotation member is directly supported by the first connection portion of the third rotation member, and the rotation shaft of the second rotation member 281 is the second connection portion of the third rotation member. It may be supported directly. In this case, the third connecting member does not have to include the winding unit 191 described above.

[2-7 Embodiment]
Next, the second to seventh embodiments will be described using FIG.
The medical device 100 according to the present embodiment is different from the medical device 100 according to the above-described second embodiment in the points described below, and the medical treatment according to the second embodiment in the other points. It is configured in the same manner as the device 100.

In the case of the present embodiment, as will be described below, the configuration of the bending operation unit 80 is different from that of the above-described second embodiment.
In the case of the present embodiment, the bending operation unit 80 does not include the winding unit 191, the first connection wire 192, and the second connection wire 193 shown in FIG. Instead, the bending operation unit 80 includes a pinion 197, a first rack member 198, a second rack member 199, and a guide 200 shown in FIG.

The pinion 197 is integrally formed with the dial operating unit 194 on one surface of the disk-shaped dial operating unit 194, and is disposed coaxially with the rotation axis of the dial operating unit 194.

The first rack member 198 is a rod-like member extending in the axial direction of the medical device body 10 in the housing 86. A first rotating member 181 (rotating member) is rotatably supported at the tip of the first rack member 198. On one side of the first rack member 198, a rack is formed that meshes with the gear on the outer periphery of the pinion 197.
The bending operation unit 80 includes, for example, a pair of front and rear guides 200 provided corresponding to the first rack member 198. The first rack member 198 is guided by the guides 200 linearly rectilinearly in the axial direction of the medical device body 10 in the housing 86.

Similarly, the second rack member 199 is a rod-like member extending in the axial center direction of the medical device body 10 in the housing 86. A second rotating member 281 is rotatably supported at the tip of the second rack member 199. On one side surface of the second rack member 199, a rack engaged with the gear on the outer periphery of the pinion 197 is formed.
The bending operation unit 80 includes, for example, a pair of front and rear guides 200 provided corresponding to the second rack member 199. The second rack member 199 is guided by the guides 200 linearly rectilinearly in the axial direction of the medical device body 10 in the housing 86.

Also in the case of the present embodiment, the manner in which the first operation line 41 and the second operation line 42 are engaged and fixed with respect to the first rotating member 181, and the third operation line 43 and the fourth operation with respect to the second rotating member 281. The manner of engagement and fixation of the wire 44 is the same as in the second embodiment.
Therefore, the rotation angle of the first rotating member 181 is autonomously adjusted to an angle at which the tension of the first operation line 41 and the tension of the second operation line 42 are balanced, and the second rotation The rotation angle of the member 281 is autonomously adjusted to an angle at which the tension of the third operation line 43 and the tension of the fourth operation line 44 are balanced.

In the case of the present embodiment, the first rack member 198 or the first rack member 198 or the first mesh member meshing with the pinion 197 when the operator who operates the medical device 100 grips the housing 86 or the hub 90 and rotates the dial operation unit 194. The two rack members 199 selectively move to the proximal side.
That is, when the operation for rotating the dial operation portion 194 clockwise in FIG. 22 is performed, the first rack member 198 moves (retracts) to the base end side, so the first rotating member 181 is pulled to the base end side. Be done. Thus, since both the first operation line 41 and the second operation line 42 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in one direction.
In addition, when the operation to rotate the dial operation unit 194 in the counterclockwise direction in FIG. 22 is performed, the second rack member 199 moves (retracts) to the base end side, so the second rotating member 281 moves to the base end side. Towed. Therefore, since both the third operation line 43 and the fourth operation line 44 are pulled to the proximal end side of the medical device body 10, the distal end portion 11 of the medical device body 10 bends in the opposite direction to the one direction.
When the first rack member 198 moves to the base end side, the second rack member 199 moves to the tip end side, and when the second rack member 199 moves to the base end side, the first rack member 198 moves to the tip side.

As described above, in the case of the present embodiment, the bending operation unit 80 includes the second rotating member 281 and the third rotating member (the dial that are rotatably supported in addition to the rotating member (the first rotating member 181)). First rack member connected to the operation unit 194), the pinion 197 integrally and coaxially provided with the third rotation member, and the rotation shaft of the first rotation member 181 and advancing and retracting in conjunction with the rotation of the pinion 197 198 and a second rack member 199 to which the rotation shaft of the second rotation member 281 is connected and which always moves in the direction opposite to the advancing / retracting direction of the first rack member 198 in conjunction with the rotation of the pinion 197 ing.
The base end of the first operation line 41 and the base end of the second operation line 42 are fixed to the rotation member (first rotation member 181), and the third operation line is connected to the second rotation member 281. The proximal end portion 43 and the proximal end portion of the fourth operation line 44 are fixed.
As the third rotating member (dial operating unit 194) rotates in one direction, the first rotating member 181 is pulled through the first rack member 198, and the first operation line 41 and the second operation line 42 The distal end portion 11 of the medical device body 10 is bent by being pulled.
Further, as the third rotating member rotates in the opposite direction to the one direction, the second rotating member 281 is pulled through the second rack member 199, and the third operation line 43 and the fourth operation line 44 By being pulled, the distal end portion 11 of the medical device body 10 bends in a direction different from the bending direction of the distal end portion 11 of the medical device body 10 due to the pulling of the first operation line 41 and the second operation line 42.

As mentioned above, although each embodiment was described with reference to drawings, these are illustrations of the present invention and can also adopt various composition except the above.

In the above-described second embodiment, although the example in which the rotation mechanism of the bending operation unit 80 is the dial operation unit 84 has been described, the rotation mechanism of the bending operation unit 80 is other than the dial operation unit 84 (for example, a rotary lever Etc.).
In the above-described second embodiment, although an example in which the conversion mechanism of the bending operation unit 80 includes the rack (the rack portion 82c) and the pinion 83 has been described, the bending operation unit 80 is not limited thereto. A conversion mechanism (e.g., a cam, a link mechanism, or a pin and a grooved guide) may be configured.
The same applies to the other embodiments.

In each of the above embodiments, an example in which the first operation line 41 and the second operation line 42 are configured by separate thin lines has been described, but the first operation line 41 and the second operation line 42 are one. It may be configured by each part of the thin line of. That is, the one thin line may be folded back at the tips 41a and 42a.
Similarly, although the example in which the third operation line 43 and the fourth operation line 44 are configured by separate thin lines has been described above, the third operation line 43 and the fourth operation line 44 are one thin line. It may be constituted by a part of each. That is, the one thin line may be folded back at the tips 43a and 44a.

In each of the above-described embodiments, an example has been described in which the base end of the first operation line 41 and the base end of the second operation line 42 are individually fixed to the bending operation unit 80, but the first operation The proximal end of the line 41 and the proximal end of the second operation line 42 may be connected to each other to form a loop (for example, a loop at a portion engaged with the rotation member 81) in the bending operation unit 80.
Similarly, although the example in which the base end of the third operation line 43 and the base end of the fourth operation line 44 are individually fixed to the second bending operation unit 280 has been described above, the third operation line is described. The proximal end of the third operation line 44 and the proximal end of the fourth operation line 44 may be interconnected to form a loop (for example, a loop at a portion engaged with the second rotation member 281) in the second bending operation unit 280 .

In the above-described second to third embodiments (FIG. 17, FIG. 18 (a), FIG. 18 (b), FIG. 18 (c)), the first dial operating unit 184 and the second dial operating unit 284 have their plates An example has been described in which the rotary shaft of the first dial operating unit 184 and the rotary shaft of the second dial operating unit 284 are arranged coaxially with each other in the direction orthogonal to the plane. The invention is not limited to this example.
For example, the rotation axis of the first dial operation unit 184 and the rotation axis of the second dial operation unit 284 may not be arranged coaxially with each other. For example, the first dial operation unit 184 and the second dial operation unit 284 may be disposed at mutually different positions in the axial direction of the medical device main body 10.

Further, in the above-described 2-1 embodiment, an example in which the number of operation lines included in the medical device 100 is two and the operation lines are joined will be described, and in the above-described 2-3 embodiment The example in which the number of operation lines included in the device 100 is four and two operation lines merge is described.
However, the present invention is not limited to this example, and the medical device 100 has a configuration in which two operation lines extend in parallel from their distal ends to their proximal ends, and the operation lines do not merge. It may be In this case, the two operation lines are disposed at mutually opposing positions in the circumferential direction of the medical device main body 10. In this case, for example, in a state where the medical device 100 is intruded into a body cavity using a technique called over-the-wire, the medical device body 10 is made rigid by pulling two operation lines, and the medical device The main body 10 can be held in a bent shape along the bend of the body cavity. When the two operation lines extend in parallel from their distal end to the proximal end, the medical device 100 may be an active catheter capable of bending the distal end portion 11 by the operation lines. Alternatively, the operation line may be of the type used to stiffen the medical device body 10. In the case where the medical device 100 is an active catheter, the medical device body 10 attempts to shorten its operation line by bending the distal end portion 11 while the medical device body 10 is rigidized as described above. It is possible to suppress the occurrence of the phenomenon of rotation. Also in this case, when the number of operation lines is four, the pair of operation lines are disposed at mutually opposing positions in the circumferential direction of the medical device body 10, and the other pair of operation lines are also They are disposed at mutually opposing positions in the circumferential direction of the medical device body 10. Then, by pulling two or four operation lines at once, the medical device main body 10 can be made rigid to retain its shape, or the distal end portion 11 can be bent in that state.

Further, the above-described embodiments can be combined as appropriate without departing from the spirit of the present invention.

The present embodiment includes the following technical ideas.
(1) A long medical device body,
A first operation line and a second operation line respectively inserted along the axial direction of the medical device body;
A bending operation unit for bending an end portion of the medical device body by pulling the first operation line and the second operation line;
Equipped with
The first operation line and the second operation line are spaced apart from each other in the circumferential direction of the medical device body and extend in parallel at an intermediate portion and a base end portion in the axial direction of the medical device body,
At the distal end portion in the axial direction of the medical device body, the first operation line and the second operation line are curved and joined so as to gradually approach each other in the circumferential direction of the medical device body toward the distal end side Medical equipment.
(2) The medical device according to (1), wherein the first operation line and the second operation line are pulled at once by an operation on the bending operation unit.
(3) The medical device according to (1) or (2), in which tips of the first operation line and the second operation line are connected to each other.
(4) The first operation line and the second operation line are disposed at positions opposed to each other in the circumferential direction of the medical device body at an intermediate portion and a base end portion in the axial direction of the medical device body ((4) The medical device according to any one of 1) to 3).
(5) The medical device main body includes a resin tube having a lumen, and a first hollow tube and a second hollow tube which are embedded in the resin tube and in which the first operation line and the second operation line are respectively inserted. And a hollow tube, comprising
At the distal end portion in the axial direction of the medical device body, the first hollow tube and the second hollow tube are curved so as to gradually approach each other in the circumferential direction of the medical device body toward the distal end side The medical device according to any one of (1) to (4).
(6) The bending operation unit
A rotary member rotatably supported, wherein the first operation line and the second operation line are engaged, and a base end of the first operation line and a base end of the second operation line A rotating member to which the part is fixed,
A pulling direction in which the rotating member is pulled along the first operation line and the second operation line, and a moving mechanism moving the rotating member in a direction opposite to the pulling direction;
The medical device according to any one of (1) to (5), comprising:
(7) In the circumferential direction of the distal end portion of the medical device body, an area between the first operation line and the second operation line or an opposite of the area with the axial center of the medical device body interposed therebetween. The medical device according to any one of (1) to (6), wherein a flexible portion locally high in flexibility of the medical device body is formed in a region located on the side.
(8) The medical device according to (7), wherein the flexible portion includes a notch-shaped portion formed on the outer surface side of the medical device body.
(9) The medical device body is configured to include a resin tube having a lumen,
The first operation line and the second operation line are inserted around the lumen of the resin pipe,
The first operation line and the second operation line are provided at the tip of a curved region where the first operation line and the second operation line are curved so as to gradually approach each other in the circumferential direction of the medical device body toward the tip side. The two operation lines are close to each other at a distance smaller than the thickness of the resin tube,
The first operation line and the second operation line extend in parallel close to each other between the end of the curved area and the ends of the first operation line and the second operation line. The medical device according to any one of (1) to (8), wherein parallel regions are formed.
(10) In the axial direction of the medical device body, the distance from the tip of the curved area to the tips of the first operation line and the second operation line rather than the distance from the proximal end to the tip of the curved area The medical device described in (9) is long.
(11) In the axial direction of the medical device body, the distance from the proximal end to the distal end of the curved region is the distance from the distal end of the curved region to the tips of the first operation line and the second operation line Also the medical device described in (9).
(12) The medical device further includes an annular member embedded in the resin pipe at the tip of the curved region,
The annular member is configured to have higher rigidity than the resin pipe, and is formed to have an outer diameter smaller than a thickness of the resin pipe,
The medical instrument according to any one of (9) to (11), wherein the first operation line and the second operation line are inserted into the annular member.
(13) The medical device body includes a first hollow tube and a second hollow tube which are embedded in the resin tube and into which the first operation line and the second operation line are respectively inserted. Has been
The first hollow tube and the second hollow tube are inserted into the annular member,
In the curved region, the medical device according to (12), wherein the first hollow tube and the second hollow tube are curved so as to gradually approach each other in the circumferential direction of the medical device main body toward the distal end side. machine.
(14) A third operation line and a fourth operation line respectively inserted along the axial direction of the medical device body,
The medical device body in a direction different from the bending direction of the distal end portion of the medical device body by the pulling of the first operation line and the second operation line by the pulling of the third operation line and the fourth operation line A second bending operation portion for performing bending operation of the tip portion of the
Equipped with
The third operation line and the fourth operation line are spaced apart from each other in the circumferential direction of the medical device body and extend in parallel at an intermediate portion and a base end portion in the axial direction of the medical device body,
The third operation line and the fourth operation line are curved and merged so as to gradually approach each other in the circumferential direction of the medical device body in the axial direction of the medical device body in the axial direction. The medical device according to any one of (1) to (13).
(15) The medical device according to (14), wherein the third operation line and the fourth operation line are pulled at once by an operation on the second bending operation unit.
(16) The rotating member has an engagement portion with which the first operation line and the second operation line are engaged,
The medical instrument according to (6), wherein the engagement portion is formed in a circular shape or a circular arc shape centering on the rotation center of the rotation member.
(17) The bending operation unit includes an operation receiving unit that receives a user's operation and operates.
The medical instrument according to (6) or (16), wherein the rotating member moves in the pulling direction and the opposite direction by transmitting the power of the operation receiving unit to the rotating member via the moving mechanism.
(18) The operation receiving unit is pivotally supported to be rotatable.
The movement mechanism is
A pinion integrally provided coaxially with the operation receiving unit;
A rack member which advances and retracts in conjunction with the rotation of the pinion;
Equipped with
The medical device according to (17), wherein the rotating member is pivotally supported by the rack member.
(19) The second bending operation unit
A second rotary member rotatably supported, wherein the third operation line and the fourth operation line are engaged, and a proximal end portion of the third operation line and the fourth operation line A second rotating member to which the proximal end is fixed;
A second pulling direction in which the second rotating member is pulled to pull the third operating line and the fourth operating line, and a second moving mechanism moving the second rotating member in a direction opposite to the second pulling direction;
The medical device according to (14) or (15), which is configured to include:
(20) The second rotation member has a second engagement portion with which the third operation line and the fourth operation line are engaged,
The medical instrument according to (19), wherein the second engagement portion is formed in a circular shape or a circular arc shape centered on the rotation center of the second rotation member.
(21) The second bending operation unit includes a second operation receiving unit that receives a user's operation and operates.
The power of the second operation receiving unit is transmitted to the second rotating member via the second moving mechanism, whereby the second rotating member is in the second pulling direction and in the direction opposite to the second pulling direction. The medical device according to (19) or (20) moving.
(22) The second operation receiving unit is pivotally supported to be rotatable.
The second moving mechanism is
A second pinion integrally and coaxially provided with the second operation receiving unit;
A second rack member which advances and retracts in conjunction with the rotation of the second pinion;
Equipped with
The medical device according to (21), wherein the second rotating member is pivotally supported by the second rack member.
(23) A third operation line and a fourth operation line respectively inserted along the axial direction of the medical device main body,
The third operation line and the fourth operation line are spaced apart from each other in the circumferential direction of the medical device body and extend in parallel at an intermediate portion and a base end portion in the axial direction of the medical device body,
The third operation line and the fourth operation line are curved and merged so as to gradually approach each other in the circumferential direction of the medical device main body toward the distal end side at the distal end portion in the axial direction of the medical device main body ,
The third operation line and the fourth operation line are pulled by an operation on the bending operation unit, and the direction of bending of the distal end portion of the medical device main body by the pulling of the first operation line and the second operation line is The medical device according to any one of (1) to (13), wherein the tip of the medical device body can be bent in different directions.
(24) The bending operation unit
And a first rotating member, a second rotating member, and a third rotating member rotatably supported.
The rotation shaft of the first rotation member is coupled to a first connection portion of the third rotation member,
The rotation shaft of the second rotation member is coupled to a second connection portion of the third rotation member,
The base end of the first operation line and the base end of the second operation line are fixed to the first rotating member,
The base end of the third operation line and the base end of the fourth operation line are fixed to the second rotating member,
By rotating the third rotating member in one direction, the first rotating member is pulled, and the first operation line and the second operation line are pulled, and the tip of the medical device main body is bent. And
By rotating the third rotating member in the opposite direction to the one direction, the second rotating member is pulled, and the third operation line and the fourth operation line are pulled, so that the medical device main body The medical device according to (23), wherein the distal end portion is bent in a direction different from the bending direction of the distal end portion of the medical device body due to the pulling of the first operation line and the second operation line.
(25) The bending operation unit
A first rotation member, a second rotation member and a third rotation member rotatably supported respectively;
A pinion integrally provided coaxially with the third rotating member;
A first rack member connected to the rotation shaft of the first rotation member and interlocked with the rotation of the pinion;
A second rack member to which a rotation shaft of the second rotation member is connected and which moves and retracts in a direction reverse to the advancing and retracting direction of the first rack member in synchronization with the rotation of the pinion;
Equipped with
The base end of the first operation line and the base end of the second operation line are fixed to the first rotating member,
The base end of the third operation line and the base end of the fourth operation line are fixed to the second rotating member,
By rotating the third rotating member in one direction, the first rotating member is pulled through the first rack member, and the first operation line and the second operation line are pulled, The tip of the medical device body bends,
As the third rotating member rotates in the opposite direction to the one direction, the second rotating member is pulled through the second rack member, and the third operation line and the fourth operation line are pulled. And the tip of the medical device body is bent in a direction different from the bending direction of the tip of the medical device body due to the pulling of the first operation line and the second operation line (23). Medical equipment.

The present embodiment includes the following technical ideas.
<1> Long medical device body,
A first operation line and a second operation line respectively inserted along the axial direction of the medical device body;
A bending operation unit for bending an end portion of the medical device body by pulling the first operation line and the second operation line;
Equipped with
The bending operation unit is
A rotating member rotatably supported, wherein the base end of the first operation line and the base end of the second operation line are fixed;
A pulling direction in which the rotating member is pulled along the first operation line and the second operation line, and a moving mechanism moving the rotating member in a direction opposite to the pulling direction;
An operation receiving unit that operates by receiving user operations;
Equipped with
A medical instrument in which the rotating member moves in the pulling direction and the opposite direction by transmitting the power of the operation receiving unit to the rotating member via the moving mechanism.
<2> The bending operation unit includes a housing,
The medical device according to <1>, wherein the entire rotation member is accommodated in the housing.
<3> The rotating member has an engagement portion with which the first operation line and the second operation line are engaged,
The medical instrument according to <1> or <2>, wherein the engagement portion is formed in a circular shape or a circular arc shape centered on the rotation center of the rotation member.
<4> The operation receiving unit is pivotally supported to be rotatable.
The movement mechanism is
A pinion integrally provided coaxially with the operation receiving unit;
A rack member which advances and retracts in conjunction with the rotation of the pinion;
Equipped with
The medical device according to any one of <1> to <3>, wherein the rotating member is pivotally supported by the rack member.
<5> A third operation line and a fourth operation line respectively inserted along the axial direction of the medical device body,
The medical device body in a direction different from the bending direction of the distal end portion of the medical device body by the pulling of the first operation line and the second operation line by the pulling of the third operation line and the fourth operation line A second bending operation portion for performing bending operation of the tip portion of the
Equipped with
The second bending operation unit is
A second rotating member rotatably supported, wherein a base end of the third operation line and a base end of the fourth operation line are fixed;
A second pulling direction in which the second rotating member is pulled to pull the third operating line and the fourth operating line, and a second moving mechanism moving the second rotating member in a direction opposite to the second pulling direction;
A second operation receiving unit configured to receive a user operation and operate;
Equipped with
The power of the second operation receiving unit is transmitted to the second rotating member via the second moving mechanism, whereby the second rotating member is in the second pulling direction and in the direction opposite to the second pulling direction. The medical device according to any one of <1> to <4>, which moves.
<6> The bending operation unit includes a housing,
The medical instrument according to <5>, wherein the whole of the rotating member and the whole of the second rotating member are accommodated in the housing.
<7> The second rotating member has a second engagement portion with which the third operation line and the fourth operation line are engaged,
The medical instrument according to <5> or <6>, wherein the second engagement portion is formed in a circular shape or a circular arc shape centering on the rotation center of the second rotation member.
<8> The second operation receiving unit is pivotally supported to be rotatable.
The second moving mechanism is
A second pinion integrally and coaxially provided with the second operation receiving unit;
A second rack member which advances and retracts in conjunction with the rotation of the second pinion;
Equipped with
The medical device according to any one of <5> to <7>, wherein the second rotating member is pivotally supported by the second rack member.
<9> A third operation line and a fourth operation line respectively inserted along the axial direction of the medical device main body,
The third operation line and the fourth operation line are pulled by an operation on the bending operation unit, and the direction of bending of the distal end portion of the medical device main body by the pulling of the first operation line and the second operation line is The medical device according to <1>, wherein the tip of the medical device body can be bent in different directions.
<10> The bending operation unit
It further comprises a second rotating member and a third rotating member which are each rotatably supported.
The rotation shaft of the rotation member is coupled to a first connection portion of the third rotation member,
The rotation shaft of the second rotation member is coupled to a second connection portion of the third rotation member,
The proximal end portion of the first operation line and the proximal end portion of the second operation line are fixed to the rotating member,
The base end of the third operation line and the base end of the fourth operation line are fixed to the second rotating member,
By rotating the third rotating member in one direction, the rotating member is pulled, and the first operation line and the second operation line are pulled to bend the tip of the medical device body.
By rotating the third rotating member in the opposite direction to the one direction, the second rotating member is pulled, and the third operation line and the fourth operation line are pulled, so that the medical device main body The medical device according to <9>, wherein the distal end portion is bent in a direction different from the bending direction of the distal end portion of the medical device body due to the pulling of the first operation line and the second operation line.
<11> The bending operation unit is
Second and third rotating members rotatably supported respectively;
A pinion integrally provided coaxially with the third rotating member;
A first rack member connected to the rotation shaft of the rotation member and interlocked with the rotation of the pinion;
A second rack member to which a rotation shaft of the second rotation member is connected and which moves and retracts in a direction reverse to the advancing and retracting direction of the first rack member in synchronization with the rotation of the pinion;
Equipped with
The proximal end portion of the first operation line and the proximal end portion of the second operation line are fixed to the rotating member,
The base end of the third operation line and the base end of the fourth operation line are fixed to the second rotating member,
By rotating the third rotating member in one direction, the rotating member is pulled through the first rack member, and the first operation line and the second operation line are pulled, thereby the medical device The tip of the body is bent,
As the third rotating member rotates in the opposite direction to the one direction, the second rotating member is pulled through the second rack member, and the third operation line and the fourth operation line are pulled. And the tip of the medical device body is bent in a direction different from the bending direction of the tip of the medical device body due to the pulling of the first operation line and the second operation line. Medical equipment.

DESCRIPTION OF SYMBOLS 10 medical device main body 11 tip part 12 middle part 13 base end part 15 bending area 15a base end position 15b tip position 16 parallel area 20 resin tube 21 lumens 22 inner layer 23 outer layer 31 first hollow tube 31a tip 32 second hollow tube 32a tip 33 third hollow tube 34 fourth hollow tube 41 first operation line 41a tip 42 second operation line 42a tip 43 third operation line 43a tip 44 fourth operation line 44a tip 51 blade layer 52 winding wire 60 Annular member 61 first annular member 62 second annular member 70 marker 71 first fixing portion 72 second fixing portion 73 third fixing portion 74 fourth fixing portion 80 bending operation portion 81 rotating member 81 a first fixing portion 81 b second fixing Part 82 Advancement / retraction member (moving mechanism)
82a holding portion 82b rod portion 82c rack portion 83 pinion (moving mechanism)
84 dial operation part 85 guide 86 housing 90 hub 92 wing part 93 connection part 100 medical instrument 110 bendable part 111 notch shape part 180 first bending operation part 181 first rotating member 182 first advancing and retracting member (moving mechanism)
182a first holding portion 182b first rod-shaped portion 182c first rack portion 183 first pinion (moving mechanism)
184 first dial operation unit 185 first guide 191 winding unit 192 first connection wire 193 second connection wire 194 dial operation unit (third rotating member)
195 1st connection part 196 2nd connection part 197 pinion 198 1st rack member 199 2nd rack member 200 guide 280 2nd bending operation part 281 2nd rotation member 282 2nd advance and withdrawal member (movement mechanism)
282a second holding portion 282b second rod-shaped portion 282c second rack portion 283 second pinion (moving mechanism)
284 Second dial operating unit 285 Second guide

Claims (36)

1. Long medical device body,
   A first operation line and a second operation line respectively inserted along the axial direction of the medical device body;
   A bending operation unit for bending an end portion of the medical device body by pulling the first operation line and the second operation line;
   Equipped with
   The first operation line and the second operation line are spaced apart from each other in the circumferential direction of the medical device body and extend in parallel at an intermediate portion and a base end portion in the axial direction of the medical device body,
   At the distal end portion in the axial direction of the medical device body, the first operation line and the second operation line are curved and joined so as to gradually approach each other in the circumferential direction of the medical device body toward the distal end side Medical equipment.
2. The medical device according to claim 1, wherein the first operation line and the second operation line are pulled at one time by an operation on the bending operation unit.
3. The medical device according to claim 1, wherein tips of the first operation line and the second operation line are connected to each other.
4. In the middle portion and the base end portion in the axial direction of the medical device body, the first operation line and the second operation line are disposed at positions facing each other in the circumferential direction of the medical device body. The medical device according to any one of 3.
5. The medical device main body includes a resin tube having a lumen, and a first hollow tube and a second hollow tube which are embedded in the resin tube and through which the first operation line and the second operation line are respectively inserted. And is composed, and
   At the distal end portion in the axial direction of the medical device body, the first hollow tube and the second hollow tube are curved so as to gradually approach each other in the circumferential direction of the medical device body toward the distal end side The medical device according to any one of claims 1 to 4.
6. The bending operation unit is
   A rotary member rotatably supported, wherein the first operation line and the second operation line are engaged, and a base end of the first operation line and a base end of the second operation line A rotating member to which the part is fixed,
   A pulling direction in which the rotating member is pulled along the first operation line and the second operation line, and a moving mechanism moving the rotating member in a direction opposite to the pulling direction;
   The medical device according to any one of claims 1 to 5, comprising:
7. In the circumferential direction of the distal end portion of the medical device body, a region between the first operation line and the second operation line, or a position opposite to the region with the axial center of the medical device body interposed therebetween The medical device according to any one of claims 1 to 6, wherein a flexible portion locally high in flexibility of the medical device body is formed in the region where
8. The medical device according to claim 7, wherein the flexible portion includes a cutout shape portion formed on the outer surface side of the medical device body.
9. The medical device body includes a resin tube having a lumen,
   The first operation line and the second operation line are inserted around the lumen of the resin pipe,
   The first operation line and the second operation line are provided at the tip of a curved region where the first operation line and the second operation line are curved so as to gradually approach each other in the circumferential direction of the medical device body toward the tip side. The two operation lines are close to each other at a distance smaller than the thickness of the resin tube,
   The first operation line and the second operation line extend in parallel close to each other between the end of the curved area and the ends of the first operation line and the second operation line. 9. A medical device according to any one of the preceding claims, wherein parallel regions are formed.
10. The distance from the tip of the curved area to the tips of the first operation line and the second operation line is longer than the distance from the proximal end to the tip of the curved area in the axial direction of the medical device body Item 9. The medical device according to item 9.
11. In the axial direction of the medical device body, the distance from the proximal end to the distal end of the curved region is longer than the distance from the distal end of the curved region to the distal ends of the first operation line and the second operation line Item 9. The medical device according to item 9.
12. The medical device further comprises an annular member embedded in the resin pipe at the tip of the curved region,
    The annular member is configured to have higher rigidity than the resin pipe, and is formed to have an outer diameter smaller than a thickness of the resin pipe,
    The medical instrument according to any one of claims 9 to 11, wherein the first operation line and the second operation line are inserted into the annular member.
13. The medical device main body includes a first hollow tube and a second hollow tube which are embedded in the resin pipe and into which the first operation line and the second operation line are respectively inserted. ,
    The first hollow tube and the second hollow tube are inserted into the annular member,
    The medical device according to claim 12, wherein in the curved region, the first hollow tube and the second hollow tube are curved so as to gradually approach each other in the circumferential direction of the medical device main body toward the distal end side. machine.
14. A third operation line and a fourth operation line respectively inserted along an axial direction of the medical device body;
    The medical device body in a direction different from the bending direction of the distal end portion of the medical device body by the pulling of the first operation line and the second operation line by the pulling of the third operation line and the fourth operation line A second bending operation portion for performing bending operation of the tip portion of the
    Equipped with
    The third operation line and the fourth operation line are spaced apart from each other in the circumferential direction of the medical device body and extend in parallel at an intermediate portion and a base end portion in the axial direction of the medical device body,
    The third operation line and the fourth operation line are curved and merged so as to gradually approach each other in the circumferential direction of the medical device body in the axial direction of the medical device body in the axial direction. The medical device according to any one of claims 1 to 13.
15. The medical device according to claim 14, wherein the third operation line and the fourth operation line are pulled at once by an operation on the second bending operation unit.
16. The rotating member has an engagement portion with which the first operation line and the second operation line are engaged,
    The medical instrument according to claim 6, wherein the engaging portion is formed in a circular shape or an arc shape centered on the rotation center of the rotating member.
17. The bending operation unit includes an operation receiving unit that receives a user's operation and operates.
    The medical instrument according to claim 6 or 16, wherein the rotating member moves in the pulling direction and the opposite direction by transmitting the power of the operation receiving unit to the rotating member via the moving mechanism.
18. The operation receiving unit is pivotally supported rotatably.
    The movement mechanism is
    A pinion integrally provided coaxially with the operation receiving unit;
    A rack member which advances and retracts in conjunction with the rotation of the pinion;
    Equipped with
    The medical device according to claim 17, wherein the rotating member is pivotally supported by the rack member.
19. The second bending operation unit is
    A second rotary member rotatably supported, wherein the third operation line and the fourth operation line are engaged, and a proximal end portion of the third operation line and the fourth operation line A second rotating member to which the proximal end is fixed;
    A second pulling direction in which the second rotating member is pulled to pull the third operating line and the fourth operating line, and a second moving mechanism moving the second rotating member in a direction opposite to the second pulling direction;
    The medical device according to claim 14 or 15, comprising:
20. The second rotation member has a second engagement portion with which the third operation line and the fourth operation line are engaged,
    20. The medical device according to claim 19, wherein the second engagement portion is formed in a circular shape or an arc shape centered on the rotation center of the second rotation member.
21. The second bending operation unit includes a second operation receiving unit that receives a user's operation and operates.
    The power of the second operation receiving unit is transmitted to the second rotating member via the second moving mechanism, whereby the second rotating member is in the second pulling direction and in the direction opposite to the second pulling direction. 21. The medical device according to claim 19 or 20, which moves.
22. The second operation receiving unit is pivotally supported to be rotatable.
    The second moving mechanism is
    A second pinion integrally and coaxially provided with the second operation receiving unit;
    A second rack member which advances and retracts in conjunction with the rotation of the second pinion;
    Equipped with
    22. The medical device according to claim 21, wherein the second rotating member is pivotally supported by the second rack member.
23. And a third operation line and a fourth operation line respectively inserted along the axial direction of the medical device body,
    The third operation line and the fourth operation line are spaced apart from each other in the circumferential direction of the medical device body and extend in parallel at an intermediate portion and a base end portion in the axial direction of the medical device body,
    The third operation line and the fourth operation line are curved and merged so as to gradually approach each other in the circumferential direction of the medical device main body toward the distal end side at the distal end portion in the axial direction of the medical device main body ,
    The third operation line and the fourth operation line are pulled by an operation on the bending operation unit, and the direction of bending of the distal end portion of the medical device main body by the pulling of the first operation line and the second operation line is The medical device according to any one of claims 1 to 13, wherein the distal end portion of the medical device body can be bent in different directions.
24. The bending operation unit is
    And a first rotating member, a second rotating member, and a third rotating member rotatably supported.
    The rotation shaft of the first rotation member is coupled to a first connection portion of the third rotation member,
    The rotation shaft of the second rotation member is coupled to a second connection portion of the third rotation member,
    The base end of the first operation line and the base end of the second operation line are fixed to the first rotating member,
    The base end of the third operation line and the base end of the fourth operation line are fixed to the second rotating member,
    By rotating the third rotating member in one direction, the first rotating member is pulled, and the first operation line and the second operation line are pulled, and the tip of the medical device main body is bent. And
    By rotating the third rotating member in the opposite direction to the one direction, the second rotating member is pulled, and the third operation line and the fourth operation line are pulled, so that the medical device main body The medical device according to claim 23, wherein the distal end portion is bent in a direction different from the bending direction of the distal end portion of the medical device body due to the pulling of the first operation line and the second operation line.
25. The bending operation unit is
    A first rotation member, a second rotation member and a third rotation member rotatably supported respectively;
    A pinion integrally provided coaxially with the third rotating member;
    A first rack member connected to the rotation shaft of the first rotation member and interlocked with the rotation of the pinion;
    A second rack member to which a rotation shaft of the second rotation member is connected and which moves and retracts in a direction reverse to the advancing and retracting direction of the first rack member in synchronization with the rotation of the pinion;
    Equipped with
    The base end of the first operation line and the base end of the second operation line are fixed to the first rotating member,
    The base end of the third operation line and the base end of the fourth operation line are fixed to the second rotating member,
    By rotating the third rotating member in one direction, the first rotating member is pulled through the first rack member, and the first operation line and the second operation line are pulled, The tip of the medical device body bends,
    As the third rotating member rotates in the opposite direction to the one direction, the second rotating member is pulled through the second rack member, and the third operation line and the fourth operation line are pulled. The tip end portion of the medical device main body is bent in a direction different from the bending direction of the tip end portion of the medical device main body by the pulling of the first operation line and the second operation line. Medical equipment.
26. Long medical device body,
    A first operation line and a second operation line respectively inserted along the axial direction of the medical device body;
    A bending operation unit for bending an end portion of the medical device body by pulling the first operation line and the second operation line;
    Equipped with
    The bending operation unit is
    A rotating member rotatably supported, wherein the base end of the first operation line and the base end of the second operation line are fixed;
    A pulling direction in which the rotating member is pulled along the first operation line and the second operation line, and a moving mechanism moving the rotating member in a direction opposite to the pulling direction;
    An operation receiving unit that operates by receiving user operations;
    Equipped with
    A medical instrument in which the rotating member moves in the pulling direction and the opposite direction by transmitting the power of the operation receiving unit to the rotating member via the moving mechanism.
27. The bending operation unit includes a housing.
    The medical device according to claim 26, wherein the entire rotation member is accommodated in the housing.
28. The rotating member has an engagement portion with which the first operation line and the second operation line are engaged,
    28. The medical device according to claim 26, wherein the engaging portion is formed in a circular shape or an arc shape centered on the rotation center of the rotating member.
29. The operation receiving unit is pivotally supported rotatably.
    The movement mechanism is
    A pinion integrally provided coaxially with the operation receiving unit;
    A rack member which advances and retracts in conjunction with the rotation of the pinion;
    Equipped with
    The medical device according to any one of claims 26 to 28, wherein the rotating member is pivotally supported by the rack member.
30. A third operation line and a fourth operation line respectively inserted along an axial direction of the medical device body;
    The medical device body in a direction different from the bending direction of the distal end portion of the medical device body by the pulling of the first operation line and the second operation line by the pulling of the third operation line and the fourth operation line A second bending operation portion for performing bending operation of the tip portion of the
    Equipped with
    The second bending operation unit is
    A second rotating member rotatably supported, wherein a base end of the third operation line and a base end of the fourth operation line are fixed;
    A second pulling direction in which the second rotating member is pulled to pull the third operating line and the fourth operating line, and a second moving mechanism moving the second rotating member in a direction opposite to the second pulling direction;
    A second operation receiving unit configured to receive a user operation and operate;
    Equipped with
    The power of the second operation receiving unit is transmitted to the second rotating member via the second moving mechanism, whereby the second rotating member is in the second pulling direction and in the direction opposite to the second pulling direction. The medical device according to any one of claims 26 to 29, which moves.
31. The bending operation unit includes a housing.
    31. The medical device according to claim 30, wherein the whole of the rotating member and the whole of the second rotating member are accommodated in the housing.
32. The second rotation member has a second engagement portion with which the third operation line and the fourth operation line are engaged,
    32. The medical device according to claim 30, wherein the second engagement portion is formed in a circular shape or a circular arc shape centered on the rotation center of the second rotating member.
33. The second operation receiving unit is pivotally supported to be rotatable.
    The second moving mechanism is
    A second pinion integrally and coaxially provided with the second operation receiving unit;
    A second rack member which advances and retracts in conjunction with the rotation of the second pinion;
    Equipped with
    The medical device according to any one of claims 30 to 32, wherein the second rotating member is pivotally supported by the second rack member.
34. And a third operation line and a fourth operation line respectively inserted along the axial direction of the medical device body,
    The third operation line and the fourth operation line are pulled by an operation on the bending operation unit, and the direction of bending of the distal end portion of the medical device main body by the pulling of the first operation line and the second operation line is The medical device according to claim 26, which is capable of bending the distal end portion of the medical device body in different directions.
35. The bending operation unit is
    It further comprises a second rotating member and a third rotating member which are each rotatably supported.
    The rotation shaft of the rotation member is coupled to a first connection portion of the third rotation member,
    The rotation shaft of the second rotation member is coupled to a second connection portion of the third rotation member,
    The proximal end portion of the first operation line and the proximal end portion of the second operation line are fixed to the rotating member,
    The base end of the third operation line and the base end of the fourth operation line are fixed to the second rotating member,
    By rotating the third rotating member in one direction, the rotating member is pulled, and the first operation line and the second operation line are pulled to bend the tip of the medical device body.
    By rotating the third rotating member in the opposite direction to the one direction, the second rotating member is pulled, and the third operation line and the fourth operation line are pulled, so that the medical device main body The medical device according to claim 34, wherein the distal end portion is bent in a direction different from the bending direction of the distal end portion of the medical device body due to the pulling of the first operation line and the second operation line.
36. The bending operation unit is
    Second and third rotating members rotatably supported respectively;
    A pinion integrally provided coaxially with the third rotating member;
    A first rack member connected to the rotation shaft of the rotation member and interlocked with the rotation of the pinion;
    A second rack member to which a rotation shaft of the second rotation member is connected and which moves and retracts in a direction reverse to the advancing and retracting direction of the first rack member in synchronization with the rotation of the pinion;
    Equipped with
    The proximal end portion of the first operation line and the proximal end portion of the second operation line are fixed to the rotating member,
    The base end of the third operation line and the base end of the fourth operation line are fixed to the second rotating member,
    By rotating the third rotating member in one direction, the rotating member is pulled through the first rack member, and the first operation line and the second operation line are pulled, thereby the medical device The tip of the body is bent,
    As the third rotating member rotates in the opposite direction to the one direction, the second rotating member is pulled through the second rack member, and the third operation line and the fourth operation line are pulled. The tip portion of the medical device body is bent in a direction different from the bending direction of the tip portion of the medical device body due to the pulling of the first operation line and the second operation line. Medical equipment.

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