WO2021117724A1 - Medical instrument-use deflection operation device - Google Patents

Medical instrument-use deflection operation device Download PDF

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Publication number
WO2021117724A1
WO2021117724A1 PCT/JP2020/045686 JP2020045686W WO2021117724A1 WO 2021117724 A1 WO2021117724 A1 WO 2021117724A1 JP 2020045686 W JP2020045686 W JP 2020045686W WO 2021117724 A1 WO2021117724 A1 WO 2021117724A1
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WO
WIPO (PCT)
Prior art keywords
rack member
controller housing
deflection
rack
wire
Prior art date
Application number
PCT/JP2020/045686
Other languages
French (fr)
Japanese (ja)
Inventor
篤史 山田
徹 谷
渉 米道
辰也 嶋
Original Assignee
国立大学法人滋賀医科大学
日本ゼオン株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 国立大学法人滋賀医科大学, 日本ゼオン株式会社 filed Critical 国立大学法人滋賀医科大学
Priority to CN202080083661.9A priority Critical patent/CN114786759A/en
Priority to JP2021563972A priority patent/JPWO2021117724A1/ja
Publication of WO2021117724A1 publication Critical patent/WO2021117724A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices

Definitions

  • the present invention relates to a deflection operating device for medical devices.
  • a long, flexible, tubular medical device such as a catheter is inserted into tissues such as various organs (for example, the heart) in the body through blood vessels, trachea, body cavities, internal lumens, etc., for the desired medical treatment. Treatment is being performed.
  • the direction of the distal end to be inserted into the body is connected to the proximal end of the medical device and placed outside the body in order to facilitate insertion into the body and access to tissues.
  • the operation unit can be deflected (see, for example, Patent Documents 1 and 2).
  • Patent Document 1 two pull wires inserted in the sheath are moved forward and backward in opposite directions by a cylindrical control handle coaxial with the sheath provided at the proximal end of the sheath as a medical device. A deflection mechanism that deflects the direction of the distal end of the is described.
  • the control knob is rotatably supported on the distal end side of the main body, which is a portion to be gripped by hand, and the control knob is rotated in the main body in the front-rear direction (axial direction of the sheath).
  • a pair of shuttles that move forward and backward are built in, and pull wires are connected to each shuttle.
  • Each shuttle has an axially extending shape, with a semi-cylindrical portion on its distal end side and a rack portion facing each other on its proximal end side, both racks. Pinions mesh with each other to form a rack and pinion.
  • a male screw threaded surface is formed on the outer peripheral surface of the semi-cylindrical portion on the distal end side of one of the pair of shuttles, and the male screw threaded surface is a rotary shaft integrated with the control knob.
  • a screw drive mechanism is configured by screwing into a female screw threaded surface formed on the inner peripheral surface.
  • Patent Document 2 a bending operation portion provided at a proximal end of a tubular medical device main body pulls a first operation line and a second operation line inserted into the medical device main body to pull the medical device. A deflection mechanism that deflects the direction of the distal end of the body is described.
  • an advancing / retreating member having a rack portion that advances / retreats in the front-rear direction (axial direction of the medical device body) is housed in a housing that is gripped by hand, and the advancing / retreating member is far away.
  • the proximal ends of the first operation line and the second operation line are fixed to the rotating member installed on the position end side, and the housing has a pinion that meshes with the rack portion of the advancing / retreating member at the center of rotation.
  • a dial operation unit whose left and right ends project to the side of the housing is rotatably supported.
  • the control handle described in Patent Document 1 has a drawback that the structure is complicated and the number of parts is large. Further, since the rotation axis rotates the control knob coaxial with the sheath to deflect the direction of the distal end of the sheath, the operation direction of the control knob, that is, the rotation direction and the deflection direction of the distal end of the sheath are different. For this reason, there is a problem that it is difficult to grasp the deflection state (direction of deflection and degree of deflection) according to the operation, and it is not possible to obtain sufficient operability.
  • the present invention has been made in view of the above circumstances, and an object of the present invention is to provide a deflection operating device for a medical device, which is easy to operate with one hand, has a simple configuration, and can obtain sufficient operability. It is said.
  • the present invention is a deflection operation device for a medical device that deflects a movable portion of a medical device via a first operation wire and a second operation wire, and the first operation in the main body and the main body.
  • a support handle portion provided on one end side in the longitudinal direction along the extending direction of the wire and the second operation wire, and the first operation wire and the first operation wire provided on the other end side in the longitudinal direction of the main body portion.
  • a controller housing having a wire insertion portion through which the second operation wire is inserted and a tooth portion that can be reciprocally displaced in the longitudinal direction and that face each other are housed in the controller housing.
  • the controller housing is arranged between the first rack member and the second rack member, and the first rack member and the second rack member, and meshes with the respective teeth of both rack members.
  • a slide guide portion comprising a pinion member rotatably supported in the controller housing and forming a groove-shaped opening along at least one of the first rack member and the second rack member in the controller housing.
  • at least one of the first rack member and the second rack member is integrally provided with an operation knob that projects outward from the controller housing through the opening, and the operation knob is the operation knob.
  • the first rack member and the second rack member are moved in opposite directions by operating an operation knob provided on at least one of the rack members.
  • the movable part of the medical device can be deflected by reciprocating displacement. Therefore, the movable part of the medical device can be deflected with a simpler configuration than before.
  • the reciprocating operation direction of the operation knob is the same direction as the extending direction of the first operation wire and the second operation wire, and the operation knobs are the first and the first. It is integrally provided on at least one of the second rack members. Therefore, the operation direction of the operation knob and the deflection direction of the movable portion of the medical device can be sensuously matched. In addition, it is easy to grasp the deflection state (direction of deflection and degree of deflection) according to the operation of the operation knob, and the operation reaction force from the moving part of the medical device is transmitted to the operation knob that is manually operated, which is effective. A feeling of operation resistance (operation feeling) can be obtained. As a result, sufficient operability can be obtained.
  • the operating device can be easily supported by one hand by abutting the palm of the operator against the support handle portion of the controller housing and hooking the finger on the operating knob. Can be operated and operated.
  • the operating knob is composed of a first operating knob and a second operating knob provided on each of the first rack member and the second rack member, respectively. It is characterized by being.
  • the deflection operation device for medical devices can be moved by operating the operation knob on the side of the first operation knob and the second operation knob corresponding to the deflection direction of the movable portion.
  • the portion can be deflected in a desired direction. Therefore, it is easy to grasp the deflection state according to the operation of the first and second operation knobs, and the operation reaction force from the movable part of the medical device is transmitted to the operation knob on the side where the manual operation is performed, which is effective.
  • a feeling of operation resistance (operation feeling) can be obtained.
  • first and second operation knobs can effectively apply an operating force to each operation knob when manually operating with one hand by performing a pulling operation to displace the first and second operation knobs toward the support handle portion, for example. Compared to the deflection operation of rotating the dial, it is not necessary to operate while re-applying the finger, which also improves the operability. Further, even if the controller housing is turned over 180 ° and the left and right positions of the first and second operation knobs are reversed, each operation knob can be operated in the same manner.
  • the deflection operating device for medical devices is characterized in that the support handle portion has a substantially T-shape together with the main body portion of the controller housing.
  • the medical device deflection operating device according to the present invention can easily grip the medical device deflection operating device via the support handle portion, and the operability can be improved.
  • the deflection operating device for medical devices is the first rack between the rack member on at least one of the first rack member and the second rack member and the controller housing. It is characterized in that an urging means for urging the member and the second rack member at a specific position with respect to the controller housing is interposed.
  • the specific position referred to here may be a neutral position in which the movable part of the medical device extends straight and does not deflect. Further, for example, when the medical device is habitually curved, the movable portion is not always straight in the neutral position, and the neutral position is set according to the shape of the medical device.
  • the deflection operating device for medical devices can automatically hold the first rack member and the second rack member at specific positions by urging means without operating the operation knob. .. Therefore, each rack member can be easily and surely held at the specific position, and the operability can be improved.
  • the operation knob is provided on one of the first rack member and the second rack member, and is provided on the other rack member. Is characterized in that a marking portion for marking the relative position of the rack member on the other side with respect to the controller housing is provided.
  • the deflection operating device for medical devices can grasp the deflection state of the medical device by visually recognizing the relative position of the marking portion with respect to the controller housing.
  • a deflection operating device for a medical device that is easy to operate with one hand, has a simple configuration, and can obtain sufficient operability.
  • FIG. 2 is a sectional view taken along line II-II of FIG. 3 is a sectional view taken along line III-III of FIGS. 1 and 4.
  • FIG. 3 is a sectional view taken along line IV-IV of FIG.
  • It is a deflection operation apparatus for medical devices which concerns on one Embodiment of this invention, and is the top view in the state which the lid body on the surface side of a controller housing is seen through.
  • FIG. 5 is a cross-sectional view taken along the line IX-IX of FIG. It is a top view which shows the 2nd rack member and 2nd operation knob which concerns on one Embodiment of this invention. It is a top view which shows the 1st rack member and 1st operation knob which concerns on one Embodiment of this invention.
  • FIG. 5 is a plan view showing a state in which a movable portion of a catheter is deflected in a direction opposite to the one direction shown in FIG. 11 by a deflection operating device for a medical device according to an embodiment of the present invention.
  • FIG. 5 is a plan view of a deflection operating device for a medical device according to another embodiment of the present invention in a state where the lid of the controller housing is seen through.
  • FIG. 3 is a plan view showing an example in which the arrangement of the operation knob, the indicator, and the coil spring is changed in the other embodiment shown in FIG.
  • FIG. 1 shows a deflection operating device for medical devices (hereinafter, abbreviated as a deflection operating device) 1A according to an embodiment and a catheter 2 in which the direction of the distal end is deflected by the deflection operating device 1A.
  • the catheter 2 constitutes the medical device of the present invention.
  • the medical device of the present invention include, but are not limited to, flexible tubes such as a cannula and a sheath in addition to the catheter as shown in this embodiment.
  • the catheter 2 has a movable portion 20 whose direction can be deflected in the left-right direction at the distal end side, that is, the distal end side (lower side in FIG. 1) to be inserted into the body.
  • the deflection operating device 1A is fixed to the proximal end of the catheter 2 and is placed outside the body during use. The deflection operation device 1A deflects the movable portion 20 via the first operation wire 31 and the second operation wire 32 of the catheter 2, which will be described later.
  • Catheter 2 has a structure as shown in FIGS. 2 to 4. However, the structure of the catheter 2 is not limited to this.
  • FIGS. 1 and 4 are cross-sectional views of the catheter 2
  • FIG. 2 shows a cross section II-II in FIG. 1
  • FIG. 3 shows a cross section III-III in FIGS. 1 and 4.
  • FIG. 4 shows the IV-IV cross section of FIG. 3 which is the distal end of the catheter 2.
  • the catheter 2 has one main lumen 23 and two wire lumens 21, 22, that is, a first wire lumen 21 and a second wire lumen 22.
  • the catheter 2 is composed of a multilayer tube having an inner tube 23A and an outer tube 23B made of a flexible resin, and the main lumen 23 is composed of a hollow inside of the inner tube 23A.
  • the outer tube 23B is provided with a first wire lumen 21 and a second wire lumen 22 at positions opposite to each other by about 180 degrees with respect to the central axis of the catheter 2.
  • the first wire lumen 21 is composed of a hollow inside of the first wire lumen tube 21A embedded in the outer tube 23B.
  • the second wire lumen 22 is composed of a hollow inside of the second wire lumen tube 22A embedded in the outer tube 23B.
  • the wire lumens 21 and 22 extend along the axial direction of the catheter 2.
  • a first operating wire 31 is inserted into the first wire lumen 21 so as to be able to advance and retreat along the axial direction of the catheter 2, and a second operating wire 32 is inserted into the second wire lumen 22 so as to advance and retreat along the axial direction of the catheter 2. It is inserted so that it can move forward and backward along the axial direction of.
  • Each of the operating wires 31 and 32 is composed of a stranded wire or a single wire of a metal such as stainless steel, or a filament of a polymer material.
  • the catheter 2 has an annular pull ring 40 provided at the distal end.
  • the pull ring 40 is made of a metal such as stainless steel.
  • the distal end of the first operating wire 31 and the second operating wire 32 are joined to the inner surface 40a of the pull ring 40 by means such as brazing.
  • the proximal end side ends of the first operating wire 31 and the second operating wire 32 are connected to the deflection operating device 1A according to the present embodiment provided at the proximal end of the catheter 2.
  • the deflection operating device 1A deflects the direction of the movable portion 20 of the catheter 2 in the opposite direction of 180 degrees via the pull ring 40 as shown by arrows ⁇ and ⁇ in FIG. It is configured as follows.
  • the catheter 2 has a main lumen 23 and a blade layer 24 arranged so as to surround the wire lumens 21 and 22.
  • the blade layer 24 is a reinforcing member in which a wire rod such as stainless steel is braided, and the blade layer 24 suppresses twisting of the catheter 2.
  • the catheter 2 has a substantially cylindrical coating resin 50 that covers the distal end and the pull ring 40 at the distal end side thereof.
  • the coating resin 50 keeps the pull ring 40 attached to the distal end of the catheter 2.
  • the coating resin 50 constitutes the tip of the catheter 2, and the tip edge thereof is chamfered in an R shape to form a gentle surface.
  • FIG. 5 is a plan view showing the entire deflection operating device 1A.
  • the lid 300B of the controller housing 300 which will be described later, is seen through and the internal configuration is shown by a solid line.
  • the deflection operation device 1A according to the present embodiment includes a flat controller housing 300 having a cavity inside, and a first rack member 100 and a second rack member housed in the controller housing 300. A 200 and a pinion member 400 arranged between the rack members 100 and 200 are provided.
  • the controller housing 300 is formed in a substantially T shape having a cavity inside, and is integrally provided with a substantially rectangular main body 310 and a proximal end of the main body 310 on one end side in the longitudinal direction.
  • the support handle portion 320 is provided, and the wire insertion portion 330 into which the first operation wire 31 and the second operation wire 32 are respectively inserted into the distal ends on the other end side in the longitudinal direction of the main body portion 310. ..
  • the main body 310 has a longitudinal direction along the extending direction of the operating wires 31 and 32 inserted into the catheter 2. The longitudinal direction referred to below is based on the longitudinal direction of the main body 310.
  • the controller housing 300 has a symmetrical shape with the center line C in the longitudinal direction passing through the center in the width direction of the main body 310 as a symmetrical line. As shown in FIG. 6, the controller housing 300 has three screw fastening portions 301, in which a half-split base 300A and a lid 300B that are substantially bisected in the thickness direction are dispersedly arranged at least in the longitudinal direction. It is configured by being detachably combined by 302 and 303.
  • the base 300A and the lid 300B have substantially the same shape, and are integrally molded with a resin or the like.
  • the base 300A has a base side main body portion 310a and a base side support handle portion 320a that form the main body portion 310 and the support handle portion 320 of the controller housing 300, respectively.
  • the lid 300B has a lid-side main body 310b and a lid-side support handle 320b that form the main body 310 and the support handle 320 of the controller housing 300, respectively.
  • the base 300A has a bottom plate portion 304a and a side wall portion 305a forming an edge of the bottom plate portion 304a, whereby the cross section of the base 300A has a thin dish shape.
  • the lid body 300B has a top plate portion 304b and a side wall portion 305b forming an edge of the top plate portion 304b, and the cross section thereof has a thin dish shape.
  • the controller housing 300 is configured by stacking the side wall portions 305a and 305b of the base 300A and the lid 300B so as to face each other, and as shown in FIG. 7, the side wall portions 305a and 305b of both sides form the controller housing 300 as a whole.
  • the side wall portion 305 is configured.
  • the side wall portion 305 on the first rack member 100 side of the main body portion 310 has a first slide guide portion 306 that forms a groove-shaped opening 306a along the first rack member 100. .. Further, as shown in FIG. 8, the side wall portion 305 on the second rack member 200 side of the main body portion 310 forms a groove-shaped opening 307a along the second rack member 200, and the second slide guide portion 307. Has.
  • each component of the controller housing 300 described below will be described as a component of the controller housing 300 in a state where the base 300A and the lid 300B are combined.
  • the support handle portion 320 of the controller housing 300 includes a substantially rectangular first handle portion 321 and a second handle portion 322 that extend laterally at right angles to the main body portion 310, respectively. Has been done.
  • the support handle portion 320 and the main body portion 310 have a substantially T-shape.
  • the support handle portion 320 has a substantially T-shape together with the main body portion 310, but the support handle portion of the present invention has a shape such as a substantially L-shape together with the main body portion 310. It may be of any shape having a surface that can be abutted against the palm, and of any shape having a structure that allows the fingers to be locked, such as a finger insertion ring that can be supported by passing the fingers. There may be.
  • the edge 323 on the proximal end side of the support handle portion 320 includes the support portion 323a to which the palm of the operator is applied.
  • the support portion 323a is formed on a gently curved surface that extends from one end to the other end and has a substantially convex shape toward the proximal end side.
  • the corner portions 323b and 323c continuous at both ends of the support portion 323a are chamfered. Since the support portion 323a is gently curved and the corner portions 323b and 323c are chamfered, it is easy for the operator to put the palm on the support portion 323a without discomfort, whereby the deflection operating device 1A The operability of the is improved.
  • Each end edge on the distal end side of the first handle portion 321 and the second handle portion 322 constituting the support handle portion 320 constitutes finger locking portions 321a and 322a on which the operator's finger is hung, respectively. There is.
  • These finger locking portions 321a and 322a are formed on a gently curved surface having a substantially concave shape toward the proximal end side. Further, the outer corner portions 321b and 322b that are continuous with the finger locking portions 321a and 322a are chamfered.
  • the controller housing 300 has a bulging portion having a thickness larger than that of the main body portion 310 at the transition portion from the support handle portion 320 and the support handle portion 320 to the main body portion 310. It has 325.
  • the thickness of the bulging portion 325 has an appropriate thickness that makes it easy for the operator to grip the support handle portion 320.
  • the finger locking portions 321a and 322a are curved in a concave shape so that the fingers can be easily hooked, and in addition, the support handle portion 320 has an appropriate thickness due to the bulging portion 325. ,
  • the support handle portion 320 is easy to grip.
  • the wire insertion portion 330 has a thin tubular sleeve portion 331 protruding from the distal end of the controller housing 300 and a wire introduction port 332 communicating from the inside of the sleeve portion 331 into the controller housing 300. And a gate portion 333 arranged close to the wire introduction port 332.
  • the gate portion 333 includes a pair of cylindrical portions 333a and 333b provided in the controller housing 300.
  • the end of the catheter 2 on the proximal end side is fixed in the sleeve portion 331 and connected to the controller housing 300.
  • a means such as pressing the catheter 2 into the sleeve portion 331 and then adhering or welding the outer tube 23B to the inner surface of the sleeve portion 331 is adopted.
  • the controller housing 300 is not provided with the sleeve portion 331, but a heat-shrinkable tube or the like is used to cover the boundary positions of the controller housing 300 and the catheter 2 from the controller housing 300 to cover the boundary position. May be integrated with the controller housing 300.
  • the proximal end of the first operating wire 31 and the second operating wire 32 is passed between the sleeve portion 331 and the cylindrical portions 333a and 333b of the wire introduction port 332 and the gate portion 333. , Introduced in the controller housing 300. Then, as will be described later, the first operation wire 31 is fixed to the first rack member 100, and the second operation wire 32 is fixed to the second rack member 200.
  • the cylindrical portions 333a and 333b constituting the gate portion 333 may be composed of rotatable rollers.
  • the controller housing 300 reciprocates inside the controller housing 300 with a first guide portion 351 for guiding the first rack member 100 so as to be reciprocally displaceable in the longitudinal direction and a second rack member 200 in the longitudinal direction. It has a second guide portion 352 that leads to displaceability.
  • the first guide portion 351 is formed by two partition wall portions 341 and 342 provided in the center of the controller housing 300 in the longitudinal direction, the first slide guide portion 306, and the guide wall portion 343 in the support handle portion 320. Has been done.
  • the side wall portion 305 of the controller housing 300 has stopper portions 351a and 351b at locations corresponding to the distal end and the proximal end of the first guide portion 351 respectively.
  • the second guide portion 352 is formed by the partition wall portions 341 and 342, the second slide guide portion 307, and the guide wall portion 344 in the support handle portion 320.
  • the side wall portion 305 of the controller housing 300 has stopper portions 352a and 352b at locations corresponding to the distal end and the proximal end of the second guide portion 352, respectively.
  • the partition wall portion 341 is configured such that the ridge portions 341a and 341b of the base 300A and the lid 300B, respectively, are overlapped with each other.
  • the partition wall portion 342 is configured such that the ridge portions 342a and 342b of the base 300A and the lid 300B, respectively, are overlapped with each other.
  • the base 300A of the controller housing 300 has columnar wire guides 334a and 334b on both sides of the proximal end of the ridge 341a.
  • the wire guides 334a and 334b may be composed of rotatable rollers.
  • the first rack member 100 and the second rack member 200 are housed in the controller housing 300 so as to be reciprocally displaceable in the longitudinal direction of the main body 310 and to have teeth 120 and 220 facing each other. Has been done.
  • FIG. 10B shows the first rack member 100
  • FIG. 10A shows the second rack member 200
  • These rack members 100 and 200 include an elongated rectangular parallelepiped rack main body 110 and 210 and tooth portions 120 and 220 composed of a large number of teeth provided on side surfaces of the rack main bodies 110 and 210 which are facing each other. , Each.
  • These rack members 100 and 200 are installed in the first guide portion 351 and the second guide portion 352, respectively, so that the tooth portions 120 and 220 face each other.
  • the rack main body 110 of the first rack member 100 has a guide piece 112 extending in the longitudinal direction of the rack main body 110 on the outer side surface 111 thereof.
  • the guide piece 112 is in a state of being inserted into the opening 306a of the first slide guide portion 306.
  • the rack body 110 of the first rack member 100 is integrally provided with a first operation knob 510 that projects laterally to the controller housing 300 through the opening 306a.
  • the rack main body 210 of the second rack member 200 has a guide piece 212 extending in the longitudinal direction of the rack main body 210 on the outer side surface 211 thereof.
  • the guide piece 212 is in a state of being inserted into the opening 307a of the second slide guide portion 307.
  • the rack main body 210 of the second rack member 200 is integrally provided with a second operation knob 520 that projects laterally of the controller housing 300 through the opening 307a.
  • the first operation knob 510 and the second operation knob 520 have a rectangular plate shape similar to the first handle portion 321 and the second handle portion 322 constituting the support handle portion 320, respectively, and each rack member. It is integrally molded with 100 and 200.
  • the shape of each operation knob 510 and 520 is arbitrary, and may be, for example, a rod shape, a ring shape, a trigger shape, or the like, and is integrally molded with the rack members 100 and 200.
  • each of the finger locking portions 510a and 520a is configured. These finger locking portions 510a and 520a are formed on a gently curved surface having a substantially concave shape toward the proximal end side. Further, the outer corner portions 510b and 520b that are continuous with the finger locking portions 510a and 520a are chamfered.
  • the finger locking portions 510a and 520a are curved in a concave shape so that the fingers can be easily hooked, the operator can easily hook the fingers on the finger locking portions 510a and 520a, whereby the first operation knob 510 can be easily hooked. And the second operation knob 520 is easy to operate.
  • the finger locking portions 510a and 520a have inner convex portions 510c and 520c having a shape that gently shifts to the first rack member 100 and the second rack member 200, respectively. Is formed. Due to these inner convex portions 510c and 520c, the fingers hung on the finger locking portions 510a and 520a are less likely to come into contact with the main body 310 of the controller housing 300, and the operability of the operation knobs 510 and 520 is not hindered. There is.
  • the first operation knob 510 and the second operation knob 520 are operated by being pulled toward the proximal end side (support handle portion 320 side) by a finger hung on the finger locking portions 510a and 520a.
  • the first rack member 100 is integrally displaced toward the proximal end side, and in synchronization with this, the second rack member 200 is moved to the distal end in the opposite direction. It is designed to be displaced to the side.
  • the second operation knob 520 is pulled toward the proximal end side, the second rack member 200 is integrally displaced toward the proximal end side, and in synchronization with this, the first rack member 100 is far away in the opposite direction. It is designed to be displaced toward the end.
  • the index finger is hung on the finger locking portion 510a of the first operation knob 510
  • the middle finger is hung on the finger locking portion 520a of the second operation knob 520
  • each operation knob 510 and 520 is pulled by each finger. can do.
  • the first rack member 100 has a wire fixing portion 511 on the surface side thereof for fixing the end portion on the proximal end side of the first operating wire 31.
  • the second rack member 200 has a wire fixing portion 521 on the back surface side thereof for fixing the end portion on the proximal end side of the second operation wire 32.
  • the wire fixing portions 511 and 521 have the same structure, and the operation wires 31 and 32 can be fixed to the rack members 100 and 200, respectively, by fastening screws.
  • the wire fixing portion 521 of the second rack member 200 includes a groove 521a formed on the surface of the rack main body 210 and extending in the longitudinal direction, and a thin metal tube 521b fitted in the groove 521a. , And a threaded portion 521c.
  • the threaded portion 521c has a female screw 521d fixed in a recess 210a opened in the outer side surface 211 of the rack main body 210, and a hexagon socket head screw 521e screwed into the female screw 521d.
  • the end of the second operating wire 32 on the proximal end side comes into contact with the outside of the wire guide 334b, is guided by the groove 521a, and is inserted into the metal tube 521b through the groove 521a. Then, by crimping the metal pipe 521b with the bolt 521e screwed into the female screw 521d, the second operation wire 32 is crimped and fixed in the metal pipe 521b. As a result, the end of the proximal end of the second operating wire 32 is fixed to the second rack member 200 together with the metal tube 521b.
  • the wire fixing portion 511 of the first rack member 100 is provided on the back surface side of the rack main body portion 110, and has a groove 511a, a metal tube 511b fitted in the groove 511a, and a female screw 511d. It also has a threaded portion 511c with bolts 511e. The screw portion 511c is fixed in the recess 110a that opens on the outer side surface 111 of the rack main body 110.
  • the end of the first operating wire 31 on the proximal end side comes into contact with the outside of the wire guide 334a and is guided by the groove 511a, and is inserted into the metal tube 511b through the groove 511a. Then, by crimping the metal tube 511b with the bolt 511e screwed into the female screw 511d, the first operation wire 31 is crimped and fixed in the metal tube 511b. As a result, the end of the proximal end of the first operating wire 31 is fixed to the first rack member 100 together with the metal tube 511b.
  • the pinion member 400 is arranged between the partition wall portion 341 and the partition wall portion 342.
  • the pinion member 400 is rotatably attached to the controller housing 300 via the rotation shaft 410 as shown in FIG. 9 in a state of being meshed with the tooth portions 120 and 220 of the first rack member 100 and the second rack member 200. It is supported.
  • the first rack member 100 and the second rack member 200 are centered in the longitudinal direction of the tooth portions 120 and 220 with respect to the pinion member 400 in a state where the positions in the reciprocating displacement direction are aligned with each other.
  • the meshing portion is adjusted so that the portion meshes with the pinion member 400.
  • the first rack member 100 and the second rack member 200 are displaced reciprocally with respect to the pinion member 400 by engaging the tooth portions 120 and 220 with the pinion member 400, respectively. ing.
  • the first operation knob 510 and the second operation knob 520 are slid so as to be displaced relative to the support handle portion 320 in the longitudinal direction. Since the operation knobs 510 and 520 are integrally provided on the first rack member 100 and the second rack member 200, they are operated so as to be displaced in opposite directions together with the rack members 100 and 200, respectively. Displacement. When each of the operation knobs 510 and 520 is operated in this way, the first rack member 100 and the second rack member 200 are displaced in opposite directions with respect to the pinion member 400, and the first rack member in the catheter 2 is displaced. The operation wire 31 and the second operation wire 32 are displaced in the deflection operation direction of the movable portion 20 of the catheter 2.
  • the displacement range of the first rack member 100 is restricted by the stopper portions 351a and 351b provided at the distal end and the proximal end of the first guide portion 351 respectively, so that the first rack member 100 is prevented from being separated from the pinion member 400. It has become. Further, the displacement range of the second rack member 200 is restricted by the stopper portions 352a and 352b provided at the distal end and the proximal end of the second guide portion 352, respectively, and the detachment from the pinion member 400 is suppressed. It has become like.
  • the movable portion 20 of the catheter 2 extends straight and is in a neutral state without deflection. It becomes.
  • the first rack member 100 and the second rack member 200 are positioned at neutral positions in which the positions in the displacement directions are aligned with each other, similarly to the operation knobs 510 and 520.
  • This neutral position refers to a specific position of the present invention.
  • the first rack member 100 When the first operation knob 510 is pulled toward the proximal end side as shown in FIG. 11 from the neutral state shown in FIG. 1, the first rack member 100 is integrally displaced toward the proximal end side, and this At the same time, the second rack member 200 is displaced toward the distal end side in the opposite direction. Then, following such displacements of the rack members 100 and 200, the first operation wire 31 is pulled toward the proximal end side and the second operation wire 32 is pushed toward the distal end side. The pull ring 40 deflects following the movements of the operating wires 31 and 32, and the movable portion 20 of the catheter 2 deflects toward the first operating knob 510, which is the operating side.
  • the second rack member 200 when the second operation knob 520 is pulled toward the proximal end side, the second rack member 200 is integrally displaced toward the proximal end side, and in synchronization with this, the first rack member 200 is displaced toward the proximal end side.
  • the rack member 100 is displaced toward the distal end in the opposite direction.
  • the second operation wire 32 is pulled toward the proximal end side and the first operation wire 31 is pushed toward the distal end side.
  • the pull ring 40 deflects following the movements of the operating wires 31 and 32, and the movable portion 20 of the catheter 2 deflects toward the second operating knob 520, which is the operating side.
  • the operation knobs 510 and 520 By operating the rack members 100 and 200 in opposite directions by the operation knobs 510 and 520 in this way, the direction of the movable portion 20 of the catheter via the operation wires 31 and 32 and the pull ring 40 is changed to the operation knob 510. It is designed to be deflected in a direction corresponding to the operation direction of 520.
  • the first rack member 100 and the second rack member 200 in the controller housing 300 are passed through the first operation knob 510 and the second operation knob 520, respectively.
  • the movable portion 20 of the catheter 2 can be deflected. Therefore, the movable portion 20 of the catheter 2 can be deflected with a simpler configuration than the conventional one.
  • the reciprocating operation direction of the first operation knob 510 and the second operation knob 520 extends from the first operation wire 31 and the second operation wire 32. Since the direction is the same as the direction, the operation direction of each operation knob 510 and 520 and the deflection direction of the movable portion 20 of the catheter 2 can be sensuously matched.
  • the movable portion 20 can be moved in a desired direction. It can be deflected. For example, when it is desired to deflect the movable portion 20 toward the first operation knob 510, it is possible by pulling the first operation knob 510 toward the support handle portion 320 (proximal end side), and the movable portion 20 can be pulled to the second operation knob 510 side. When it is desired to deflect the operation knob 520 toward the operation knob 520, the second operation knob 520 can be pulled toward the support handle portion 320.
  • the deflection state (direction of deflection and degree of deflection) of the movable portion 20 can be roughly grasped.
  • first operation knob 510 and the second operation knob 520 perform a pulling operation to displace the support handle portion 320 side, so that the operation force can be effectively used for manual operation with one hand. As compared with the deflection operation of rotating the dial, for example, it is not necessary to operate while re-applying the finger, which also improves the operability.
  • controller housing is turned over 180 ° and the left and right positions of the first and second operation knobs are reversed, both can be operated in the same manner.
  • the palm of the operator is abutted against the support handle portion 320 of the controller housing 300, and the fingers are placed on the finger locking portions 510a and 520a of the operation knobs 510 and 520. By hanging, the deflection operating device 1A can be easily supported and operated with one hand.
  • the support handle portion 320 has a substantially T-shape together with the main body portion 310 of the controller housing 300. Therefore, the deflection operation device 1A according to the present embodiment can be easily gripped via the support handle portion 320, and therefore the operability can be improved.
  • a ring-shaped operation knob 530 is provided only on the first rack member 100 instead of the first and second operation knobs 510 and 520.
  • the second rack member 200 is provided with an indicator 600 that indicates the relative position of the second rack member 200 with respect to the controller housing 300.
  • the indicator 600 constitutes a marking unit of the present invention.
  • Spring 710 and 720 are interposed.
  • the coil springs 710 and 720 respectively constitute the urging means of the present invention.
  • the deflection operation device 1B according to another embodiment is different from the deflection operation device 1A according to one embodiment described above in these respects. Therefore, in the description of the other embodiments, the same components as those of the one embodiment are designated by the same reference numerals, the description thereof will be omitted, and only the differences from the above-described embodiment will be described.
  • the operation knob 530 has a ring shape that is almost perfectly circular, and is integrally molded in the central portion in the longitudinal direction of the rack main body 110.
  • the operation knob 530 is a first rack member, for example, when an index finger or a middle finger is inserted inside the operation knob 530, and the inserted finger is hooked on the operation knob 530 and pulled toward the proximal end side or pushed toward the distal end side.
  • the 100 is reciprocally displaced in the longitudinal direction.
  • the second rack member 200 is reciprocally displaced in the opposite direction to the first rack member 100 in synchronization with the reciprocating displacement of the first rack member 100.
  • the indicator 600 is integrally molded with the rack main body 210 of the second rack member 200, and slightly protrudes from the opening 307a toward the side of the controller housing 300. It is desirable that the indicator 600 is colored in a color different from that of the controller housing 300 so that its position can be accurately recognized visually.
  • the indicator 600 is formed in the central portion in the longitudinal direction of the second rack member 200. Therefore, as shown in FIG. 13, when the first rack member 100 and the second rack member 200 are in the neutral position, the positions of the indicator 600 and the operation knob 530 are configured to be the same in the displacement direction.
  • the two coil springs 710 and 720 have the same configuration, and are both installed in a compressed state on the proximal end side and the distal end side of the first rack member 100 in the first guide portion 351. ..
  • One coil spring 710 is interposed between the stopper portion 351b and the first rack member 100
  • the other coil spring 720 is interposed between the stopper portion 351a and the first rack member 100.
  • the first rack member 100 is urged from both sides by the coil springs 710 and 720 to stop at the neutral position, and the second rack member 200 also stops at the neutral position accordingly.
  • a finger is placed on one operating knob 530 and the coil springs 710 and 720 are reciprocally displaced against the urging force of the coil springs 710 and 720 to reciprocate the first rack member 100 and the second rack member.
  • the movable portion 20 of the catheter 2 can be deflected by displacing the 200 in opposite directions.
  • the deflection operating device 1B by having the coil springs 710 and 720, the first rack member 100 and the second rack member 200 are automatically neutralized without operating the operation knob 530.
  • the operability is improved in that it can be held in a position.
  • the movable portion 20 of the catheter 2 is configured to be straight and unbiased when the first rack member 100 and the second rack member 200 are in the neutral position, for example the catheter 2.
  • the movable portion 20 is not always straight in the neutral position, and the neutral positions of the rack members 100 and 200 are set according to the shape of the catheter 2.
  • the deflection state of the movable portion 20 of the catheter 2 can be grasped by visually recognizing the relative position of the second rack member 200 with respect to the controller housing 300 by the indicator 600. ..
  • the operation knob 530 it is also possible to grasp the deflection state of the movable portion 20 of the catheter 2 from the position relative to the controller housing 300 by the operation knob 530. That is, it can be said that the operation knob 530 has the same function as the indicator 600, and this point can be said for the first operation knob 510 and the second operation knob 520 in the above embodiment.
  • the operation knob 530 is provided on the second rack member 200, and the indicator 600 is provided on the first rack member 100. As such, the operation knob 530 and the indicator 600 may be arranged in reverse.
  • each rack Members 100 and 200 can be held in a neutral position.
  • the rack members 100 and 200 are urged toward the distal end side by the coil springs 710 and 720, respectively, but are held in the neutral position by restraining each other via the pinion member 400. ing.
  • the coil springs 710 and 720 may be installed on the second guide portion 352 side, contrary to FIG. In that case, for example, the coil spring 710 is interposed between the stopper portion 352b and the second rack member 200, and the coil spring 720 is interposed between the stopper portion 352a and the second rack member 200.
  • both the coil springs 710 and 720 may be arranged on the distal end side contrary to FIG. In that case, for example, the coil spring 710 is interposed between the stopper portion 351a and the first rack member 100, and the coil spring 720 is interposed between the stopper portion 352a and the second rack member 200.
  • a catheter is taken as an example of a medical device, but the deflection operating device of the present invention can be applied to other tubular medical devices such as a cannula and a sheath.
  • a movable tip of a tubular medical device such as a catheter, a cannula, or a sheath
  • a tubular medical device such as a catheter, a cannula, or a sheath
  • it is easy to operate with one hand, and it has a simple structure and sufficient operability. It is useful as a deflection operating device for medical equipment that can be used.
  • 1A, 1B Deflection operation device for medical equipment 2 Catheter (medical equipment) 20 Movable part 31 First operation wire 32 Second operation wire 100 First rack member 120, 220 Tooth part 200 Second rack member 300 Controller housing 306, 307 Slide guide parts 306a, 307a Opening 310 Main body of controller housing Part 320 Support handle part 330 Wire insertion part 400 Pinion member 510 First operation knob 520 Second operation knob 530 Operation knob 600 Indicator (marking part) 710, 720 coil springs (biasing means)

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Abstract

A medical instrument-use deflection operation device 1A comprises: a first rack member 100 and a second rack member 200 stored in a controller housing 300 so as to be reciprocally displaceable in the longitudinal direction along an extending direction of a first and a second operation wire 31, 32, and also so as to have teeth parts 120, 220 that oppose each other; and a pinion member 400 that is rotatably supported, in a state of engagement with the teeth parts 120, 220 of the rack members 100, 200. A first and a second operation knob 510, 520 that each protrude outward from the controller housing 300 are integrally provided on the rack members 100, 200, respectively.

Description

医療機器用偏向操作装置Deflection operation device for medical equipment
　本発明は、医療機器用偏向操作装置に関する。 The present invention relates to a deflection operating device for medical devices.
　カテーテル等の可撓性を有する長尺なチューブ状の医療機器を、血管や気管、あるいは体腔、体内管腔部等を通して体内の各種臓器（例えば、心臓）等の組織まで挿入し、目的の医療処置を施すことが行われている。そのような医療機器においては体内への挿入や組織への接近の容易化を図るために、体内に挿入される遠位端の向きを、該医療機器の近位端に接続されて体外に配置される操作部により偏向できるようにしたものが知られている（例えば、特許文献１、２等参照）。 A long, flexible, tubular medical device such as a catheter is inserted into tissues such as various organs (for example, the heart) in the body through blood vessels, trachea, body cavities, internal lumens, etc., for the desired medical treatment. Treatment is being performed. In such a medical device, the direction of the distal end to be inserted into the body is connected to the proximal end of the medical device and placed outside the body in order to facilitate insertion into the body and access to tissues. It is known that the operation unit can be deflected (see, for example, Patent Documents 1 and 2).
　特許文献１には、医療機器としてのシースの近位端に設けたシースと同軸的な円筒状の制御ハンドルにより、シース内に挿通された２本のプルワイアを相互に逆方向に進退させてシースの遠位端の向きを偏向させる偏向機構が記載されている。 In Patent Document 1, two pull wires inserted in the sheath are moved forward and backward in opposite directions by a cylindrical control handle coaxial with the sheath provided at the proximal end of the sheath as a medical device. A deflection mechanism that deflects the direction of the distal end of the is described.
　特許文献１に記載の制御ハンドルは、手で把持する部分である本体の遠位端側に制御ノブが回転可能に支持され、本体内には制御ノブの回転によって前後方向（シースの軸方向）に進退する一対のシャトルが内蔵され、各シャトルにプルワイアがそれぞれ連結されている。各シャトルは軸方向に延在する形状であって、その遠位端側には半円筒状部分を有し、近位端側には相互に対向するラック部分を有しており、双方のラック部分にはピニオンが噛み合ってラック・アンド・ピニオンを構成している。また、一対のシャトルのうちの一方のシャトルの遠位端側の半円筒状部分の外周面には雄ねじ螺刻面が形成され、その雄ねじ螺刻面は、制御ノブと一体の回転式シャフトの内周面に形成されている雌ねじ螺刻面に螺合してねじ駆動機構が構成されている。 In the control handle described in Patent Document 1, the control knob is rotatably supported on the distal end side of the main body, which is a portion to be gripped by hand, and the control knob is rotated in the main body in the front-rear direction (axial direction of the sheath). A pair of shuttles that move forward and backward are built in, and pull wires are connected to each shuttle. Each shuttle has an axially extending shape, with a semi-cylindrical portion on its distal end side and a rack portion facing each other on its proximal end side, both racks. Pinions mesh with each other to form a rack and pinion. Further, a male screw threaded surface is formed on the outer peripheral surface of the semi-cylindrical portion on the distal end side of one of the pair of shuttles, and the male screw threaded surface is a rotary shaft integrated with the control knob. A screw drive mechanism is configured by screwing into a female screw threaded surface formed on the inner peripheral surface.
　特許文献１に記載の制御ハンドルによると、制御ノブを回転させると、その回転はねじ駆動機構によって一方のシャトルの直線運動に変換し、該一方のシャトルの直線運動はピニオンを介して他方のシャトルを逆方向に直線運動させる。このようにして制御ノブの回転が２つのシャトルを相互に逆方向に進退する動きに変換され、したがって各シャトルに連結された２本のプルワイアが相互に逆方向に進退してシースの遠位端の向きが偏向するようになっている。 According to the control handle described in Patent Document 1, when the control knob is rotated, the rotation is converted into the linear motion of one shuttle by the screw drive mechanism, and the linear motion of the one shuttle is converted into the linear motion of the other shuttle via the pinion. Is linearly moved in the opposite direction. In this way, the rotation of the control knob is translated into a movement that moves the two shuttles back and forth in opposite directions, so that the two pullwires connected to each shuttle move back and forth in opposite directions to the distal end of the sheath. The direction of is biased.
　また、特許文献２には、チューブ状の医療機器本体の近位端に設けた屈曲操作部により、医療機器本体中に挿通された第１操作線および第２操作線を牽引して、医療機器本体の遠位端の向きを偏向させる偏向機構が記載されている。 Further, in Patent Document 2, a bending operation portion provided at a proximal end of a tubular medical device main body pulls a first operation line and a second operation line inserted into the medical device main body to pull the medical device. A deflection mechanism that deflects the direction of the distal end of the body is described.
　特許文献２に記載の屈曲操作部は、手で把持する筐体内に、前後方向（医療機器本体の軸方向）に進退するラック部を備えた進退部材が収容されるとともに、この進退部材の遠位端側に設置された回転部材に、第１操作線および第２操作線の近位端が固定されており、さらに筐体には、進退部材のラック部に噛合するピニオンを回転中心に有し、その左右端部が筐体の側方にそれぞれ突出するダイヤル操作部が回転可能に支持されている。 In the bending operation portion described in Patent Document 2, an advancing / retreating member having a rack portion that advances / retreats in the front-rear direction (axial direction of the medical device body) is housed in a housing that is gripped by hand, and the advancing / retreating member is far away. The proximal ends of the first operation line and the second operation line are fixed to the rotating member installed on the position end side, and the housing has a pinion that meshes with the rack portion of the advancing / retreating member at the center of rotation. However, a dial operation unit whose left and right ends project to the side of the housing is rotatably supported.
　特許文献２に記載の屈曲操作部によると、片方の手で筐体を把持し、もう片方の手でダイヤル操作部を一方向に回転させることにより、進退部材とともに回転部材が後退し、これに伴って第１操作線および第２操作線が近位端側に牽引されて医療機器本体の遠位端の向きが偏向するようになっている。 According to the bending operation portion described in Patent Document 2, by grasping the housing with one hand and rotating the dial operation portion in one direction with the other hand, the rotating member retracts together with the advancing / retreating member. Along with this, the first operation line and the second operation line are pulled toward the proximal end side, and the direction of the distal end of the medical device body is deflected.
特開２０１８－０９４４０６号公報JP-A-2018-094406 特開２０１９－０２５２１１号公報Japanese Unexamined Patent Publication No. 2019-025211
　しかしながら上記特許文献１に記載の制御ハンドルは、構造が複雑で部品点数も多いという欠点がある。また、回転軸がシースと同軸的な制御ノブを回転させてシースの遠位端の向きを偏向させる構造であることから、制御ノブの操作方向すなわち回転方向とシースの遠位端の偏向方向がまったく異なり、このため、操作に応じた偏向状態（偏向の向きや偏向の程度）を把握し難く、十分な操作性を得ることができないという問題があった。さらに、回転操作から直線運動への運動変換にねじ駆動機構を採用しているため、偏向されるシース遠位端からの操作反力が手動操作を行っている制御ノブに直接的に伝わりにくく、有効な操作抵抗感（操作フィーリング）が得られないことによっても十分な操作性を得にくいものであった。 However, the control handle described in Patent Document 1 has a drawback that the structure is complicated and the number of parts is large. Further, since the rotation axis rotates the control knob coaxial with the sheath to deflect the direction of the distal end of the sheath, the operation direction of the control knob, that is, the rotation direction and the deflection direction of the distal end of the sheath are different. For this reason, there is a problem that it is difficult to grasp the deflection state (direction of deflection and degree of deflection) according to the operation, and it is not possible to obtain sufficient operability. Furthermore, since a screw drive mechanism is used to convert the motion from rotational to linear motion, the operational reaction force from the distal end of the sheath that is deflected is difficult to be directly transmitted to the control knob that is manually operated. It was difficult to obtain sufficient operability because an effective feeling of operation resistance (operation feeling) could not be obtained.
　一方、特許文献２に記載の屈曲操作部は、筐体の把持とダイヤル操作部の回転操作とを片手で行いにくいため、その屈曲操作部を操作するために両手が塞がってしまい、このため、カテーテルの他の操作やカテーテル姿勢の保持が容易でなくなることが懸念される。 On the other hand, in the bending operation portion described in Patent Document 2, since it is difficult to grip the housing and rotate the dial operation portion with one hand, both hands are blocked in order to operate the bending operation portion. There is concern that other operations of the catheter and maintenance of the catheter posture will not be easy.
　本発明は上記事情に鑑みてなされたものであり、片手による操作が容易であり、しかも簡素な構成を有するとともに十分な操作性を得ることができる医療機器用偏向操作装置を提供することを目的としている。 The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a deflection operating device for a medical device, which is easy to operate with one hand, has a simple configuration, and can obtain sufficient operability. It is said.
　本発明は、第１の操作ワイヤおよび第２の操作ワイヤを介して医療機器の可動部を偏向操作する医療機器用偏向操作装置であって、本体部と、前記本体部において前記第１の操作ワイヤおよび前記第２の操作ワイヤの延在方向に沿った長手方向の一端側に設けられた支持ハンドル部と、前記本体部の前記長手方向の他端側に設けられ前記第１の操作ワイヤおよび前記第２の操作ワイヤが挿通されたワイヤ挿通部と、を有するコントローラハウジングと、前記コントローラハウジング内に、それぞれ前記長手方向に往復変位可能に、かつ、相互に対向する歯部を有するように収納された第１のラック部材および第２のラック部材と、前記第１のラック部材および前記第２のラック部材の間に配置され、両ラック部材の前記各歯部に噛合する状態で前記コントローラハウジングに回転自在に支持されたピニオン部材と、を備え、前記コントローラハウジングに、前記第１のラック部材および前記第２のラック部材のうち少なくとも一方に沿って溝状の開口を形成するスライドガイド部が設けられるとともに、前記第１のラック部材および前記第２のラック部材のうち少なくとも一方に、前記開口を通して前記コントローラハウジングの外方に突出する操作ノブが一体に設けられており、前記操作ノブが前記支持ハンドル部に対し前記長手方向に相対変位するようスライド操作されるとき、前記ピニオン部材に対し前記第１のラック部材および前記第２のラック部材が相互に逆方向に変位しつつ、前記第１の操作ワイヤおよび前記第２の操作ワイヤを前記可動部の偏向操作方向に変位させることを特徴とする。 The present invention is a deflection operation device for a medical device that deflects a movable portion of a medical device via a first operation wire and a second operation wire, and the first operation in the main body and the main body. A support handle portion provided on one end side in the longitudinal direction along the extending direction of the wire and the second operation wire, and the first operation wire and the first operation wire provided on the other end side in the longitudinal direction of the main body portion. A controller housing having a wire insertion portion through which the second operation wire is inserted and a tooth portion that can be reciprocally displaced in the longitudinal direction and that face each other are housed in the controller housing. The controller housing is arranged between the first rack member and the second rack member, and the first rack member and the second rack member, and meshes with the respective teeth of both rack members. A slide guide portion comprising a pinion member rotatably supported in the controller housing and forming a groove-shaped opening along at least one of the first rack member and the second rack member in the controller housing. In addition to being provided, at least one of the first rack member and the second rack member is integrally provided with an operation knob that projects outward from the controller housing through the opening, and the operation knob is the operation knob. When the slide operation is performed so as to relatively displace the support handle portion in the longitudinal direction, the first rack member and the second rack member are displaced in opposite directions to the pinion member, and the first rack member is displaced. The operation wire and the second operation wire are displaced in the deflection operation direction of the movable portion.
　本発明に係る医療機器用偏向操作装置によれば、第１のラック部材および第２のラック部材を、これらラック部材のうち少なくとも一方に設けられた操作ノブを操作することで相互に逆方向に往復変位させ、医療機器の可動部を偏向操作することができる。このため、従来よりも簡素な構成で医療機器の可動部を偏向操作することができる。 According to the deflection operating device for medical devices according to the present invention, the first rack member and the second rack member are moved in opposite directions by operating an operation knob provided on at least one of the rack members. The movable part of the medical device can be deflected by reciprocating displacement. Therefore, the movable part of the medical device can be deflected with a simpler configuration than before.
　また、本発明に係る医療機器用偏向操作装置によれば、操作ノブの往復操作方向が第１の操作ワイヤおよび第２の操作ワイヤの延在方向と同じ方向であり、操作ノブは第１および第２のラック部材の少なくとも一方に一体に設けられている。このため、操作ノブの操作方向と医療機器の可動部の偏向方向を感覚的に対応させることができる。また、操作ノブの操作に応じた偏向状態（偏向の向きや偏向の程度）を把握しやすいとともに、医療機器の可動部からの操作反力が手動操作を行っている操作ノブに伝わって有効な操作抵抗感（操作フィーリング）を得ることができる。これらの結果、十分な操作性を得ることができる。 Further, according to the deflection operation device for medical devices according to the present invention, the reciprocating operation direction of the operation knob is the same direction as the extending direction of the first operation wire and the second operation wire, and the operation knobs are the first and the first. It is integrally provided on at least one of the second rack members. Therefore, the operation direction of the operation knob and the deflection direction of the movable portion of the medical device can be sensuously matched. In addition, it is easy to grasp the deflection state (direction of deflection and degree of deflection) according to the operation of the operation knob, and the operation reaction force from the moving part of the medical device is transmitted to the operation knob that is manually operated, which is effective. A feeling of operation resistance (operation feeling) can be obtained. As a result, sufficient operability can be obtained.
　また、本発明に係る医療機器用偏向操作装置によれば、コントローラハウジングの支持ハンドル部に操作者の手のひらを突き当てるとともに操作ノブに指を掛けることにより、片手で当該操作装置を容易に支持したり操作したりすることができる。 Further, according to the deflection operating device for medical devices according to the present invention, the operating device can be easily supported by one hand by abutting the palm of the operator against the support handle portion of the controller housing and hooking the finger on the operating knob. Can be operated and operated.
　本発明に係る医療機器用偏向操作装置は、前記操作ノブは、前記第１のラック部材および前記第２のラック部材のそれぞれに設けられた第１の操作ノブおよび第２の操作ノブによって構成されていることを特徴とする。 In the deflection operating device for medical devices according to the present invention, the operating knob is composed of a first operating knob and a second operating knob provided on each of the first rack member and the second rack member, respectively. It is characterized by being.
　この構成により、本発明に係る医療機器用偏向操作装置は、第１の操作ノブおよび第２の操作ノブのうち、可動部の偏向方向に対応する側の操作ノブを操作することで、その可動部を所望の方向に偏向させることができる。このため、第１および第２の操作ノブの操作に応じた偏向状態を把握しやすいとともに、医療機器の可動部からの操作反力が手動操作を行っている側の操作ノブに伝わって有効な操作抵抗感（操作フィーリング）を得ることができる。 With this configuration, the deflection operation device for medical devices according to the present invention can be moved by operating the operation knob on the side of the first operation knob and the second operation knob corresponding to the deflection direction of the movable portion. The portion can be deflected in a desired direction. Therefore, it is easy to grasp the deflection state according to the operation of the first and second operation knobs, and the operation reaction force from the movable part of the medical device is transmitted to the operation knob on the side where the manual operation is performed, which is effective. A feeling of operation resistance (operation feeling) can be obtained.
　また、第１および第２の操作ノブは、支持ハンドル部側に変位させる引き操作を行うことにより、片手で手動操作を行うにあたって操作力を有効に各操作ノブに付与することができるとともに、例えばダイヤルを回転させる偏向操作と比べると、指をかけ直しながら操作する必要がなく、このことからも操作性が向上する。さらに、コントローラハウジングを１８０°裏返して第１および第２の操作ノブの左右位置を反転させても各操作ノブを同じように操作することができるという利便性を有する。 Further, the first and second operation knobs can effectively apply an operating force to each operation knob when manually operating with one hand by performing a pulling operation to displace the first and second operation knobs toward the support handle portion, for example. Compared to the deflection operation of rotating the dial, it is not necessary to operate while re-applying the finger, which also improves the operability. Further, even if the controller housing is turned over 180 ° and the left and right positions of the first and second operation knobs are reversed, each operation knob can be operated in the same manner.
　本発明に係る医療機器用偏向操作装置は、前記支持ハンドル部は、前記コントローラハウジングの前記本体部とともに略Ｔ字形状をなしていることを特徴とする。 The deflection operating device for medical devices according to the present invention is characterized in that the support handle portion has a substantially T-shape together with the main body portion of the controller housing.
　この構成により、本発明に係る医療機器用偏向操作装置は、支持ハンドル部を介して当該医療機器用偏向操作装置を把持しやすく、操作性の向上が図られる。 With this configuration, the medical device deflection operating device according to the present invention can easily grip the medical device deflection operating device via the support handle portion, and the operability can be improved.
　本発明に係る医療機器用偏向操作装置は、前記第１のラック部材および前記第２のラック部材のうちの少なくともいずれか一方側のラック部材と前記コントローラハウジングとの間に、前記第１のラック部材および前記第２のラック部材を前記コントローラハウジングに対する特定位置に付勢する付勢手段が介装されていることを特徴とする。ここでいう特定位置とは、医療機器の可動部が真っ直ぐに延びて偏向しない中立位置が考えられる。また、例えば医療機器が湾曲形状に癖付けされたものである場合には、中立位置で可動部が真っ直ぐであるとは限らず、その医療機器の形状に対応して中立位置は設定される。 The deflection operating device for medical devices according to the present invention is the first rack between the rack member on at least one of the first rack member and the second rack member and the controller housing. It is characterized in that an urging means for urging the member and the second rack member at a specific position with respect to the controller housing is interposed. The specific position referred to here may be a neutral position in which the movable part of the medical device extends straight and does not deflect. Further, for example, when the medical device is habitually curved, the movable portion is not always straight in the neutral position, and the neutral position is set according to the shape of the medical device.
　この構成により、本発明に係る医療機器用偏向操作装置は、操作ノブを操作することなく付勢手段によって自動的に第１のラック部材および第２のラック部材を特定位置に保持することができる。このため、各ラック部材をその特定位置に容易かつ確実に保持することができ、操作性の向上が図られる。 With this configuration, the deflection operating device for medical devices according to the present invention can automatically hold the first rack member and the second rack member at specific positions by urging means without operating the operation knob. .. Therefore, each rack member can be easily and surely held at the specific position, and the operability can be improved.
　本発明に係る医療機器用偏向操作装置は、前記操作ノブは、前記第１のラック部材および前記第２のラック部材のうちのいずれか一方側のラック部材に設けられ、他方側のラック部材には、該他方側のラック部材の前記コントローラハウジングに対する相対位置を標示する標示部が設けられていることを特徴とする。 In the deflection operating device for medical devices according to the present invention, the operation knob is provided on one of the first rack member and the second rack member, and is provided on the other rack member. Is characterized in that a marking portion for marking the relative position of the rack member on the other side with respect to the controller housing is provided.
　この構成により、本発明に係る医療機器用偏向操作装置は、コントローラハウジングに対する標示部の相対位置を目視で認識することにより、医療機器の偏向状態を把握することができる。 With this configuration, the deflection operating device for medical devices according to the present invention can grasp the deflection state of the medical device by visually recognizing the relative position of the marking portion with respect to the controller housing.
　本発明によれば、片手による操作が容易であり、しかも簡素な構成を有するとともに十分な操作性を得ることができる医療機器用偏向操作装置を提供することができる。 According to the present invention, it is possible to provide a deflection operating device for a medical device that is easy to operate with one hand, has a simple configuration, and can obtain sufficient operability.
本発明の一実施形態に係る医療機器用偏向操作装置および該装置によって可動部が偏向操作されるカテーテルを示す平面図である。It is a top view which shows the deflection operation device for medical devices which concerns on one Embodiment of this invention, and the catheter whose movable part is deflected by the device. 図１のII－II断面図である。FIG. 2 is a sectional view taken along line II-II of FIG. 図１および図４のIII－III断面図である。3 is a sectional view taken along line III-III of FIGS. 1 and 4. 図３のIV－IV断面図である。FIG. 3 is a sectional view taken along line IV-IV of FIG. 本発明の一実施形態に係る医療機器用偏向操作装置であって、コントローラハウジングの表面側の蓋体を透視した状態での平面図である。It is a deflection operation apparatus for medical devices which concerns on one Embodiment of this invention, and is the top view in the state which the lid body on the surface side of a controller housing is seen through. 本発明の一実施形態に係る医療機器用偏向操作装置であって、コントローラハウジングの蓋体をベースから取り外した状態を示す斜視図である。It is a deflection operation apparatus for medical devices which concerns on one Embodiment of this invention, and is the perspective view which shows the state which the lid body of the controller housing was removed from the base. 図５のVII矢視図である。It is a VII arrow view of FIG. 図５のVIII矢視図である。It is VIII arrow view of FIG. 図５のIX－IX断面図である。FIG. 5 is a cross-sectional view taken along the line IX-IX of FIG. 本発明の一実施形態に係る第２のラック部材および第２の操作ノブを示す平面図である。It is a top view which shows the 2nd rack member and 2nd operation knob which concerns on one Embodiment of this invention. 本発明の一実施形態に係る第１のラック部材および第１の操作ノブを示す平面図である。It is a top view which shows the 1st rack member and 1st operation knob which concerns on one Embodiment of this invention. 本発明の一実施形態に係る医療機器用偏向操作装置によってカテーテルの可動部を一方向に偏向させた状態を示す平面図である。It is a top view which shows the state which deflected the movable part of a catheter in one direction by the deflection operation apparatus for medical devices which concerns on one Embodiment of this invention. 本発明の一実施形態に係る医療機器用偏向操作装置によってカテーテルの可動部を図１１に示した一方向とは逆の方向に偏向させた状態を示す平面図である。FIG. 5 is a plan view showing a state in which a movable portion of a catheter is deflected in a direction opposite to the one direction shown in FIG. 11 by a deflection operating device for a medical device according to an embodiment of the present invention. 本発明の他の実施形態に係る医療機器用偏向操作装置であって、コントローラハウジングの蓋体を透視した状態での平面図である。FIG. 5 is a plan view of a deflection operating device for a medical device according to another embodiment of the present invention in a state where the lid of the controller housing is seen through. 図１３に示した他の実施形態において、操作ノブ、インジケータおよびコイルスプリングの配置を変更した例を示す平面図である。FIG. 3 is a plan view showing an example in which the arrangement of the operation knob, the indicator, and the coil spring is changed in the other embodiment shown in FIG.
　以下、本発明の実施の形態について、図面を参照しつつ説明する。 Hereinafter, embodiments of the present invention will be described with reference to the drawings.
　（一実施形態）
　まず、一実施形態の構成について説明する。 (One Embodiment)
First, the configuration of one embodiment will be described.
　図１は、一実施形態に係る医療機器用偏向操作装置（以下、偏向操作装置と略称）１Ａおよび該偏向操作装置１Ａによって遠位端の向きが偏向操作されるカテーテル２を示している。カテーテル２は、本発明の医療機器を構成する。本発明の医療機器としては、この実施形態に示すようなカテーテルの他に、例えばカニューレやシース等の可撓性を有するチューブが挙げられるが、これらに限定されない。 FIG. 1 shows a deflection operating device for medical devices (hereinafter, abbreviated as a deflection operating device) 1A according to an embodiment and a catheter 2 in which the direction of the distal end is deflected by the deflection operating device 1A. The catheter 2 constitutes the medical device of the present invention. Examples of the medical device of the present invention include, but are not limited to, flexible tubes such as a cannula and a sheath in addition to the catheter as shown in this embodiment.
　カテーテル２は、体内に挿入される先端側すなわち遠位端側（図１で下側）の端部に、その向きを左右方向に偏向させられる可動部２０を有する。偏向操作装置１Ａは、カテーテル２の近位端に固定され、使用時においては体外に配置される。偏向操作装置１Ａは、カテーテル２が有する後述する第１の操作ワイヤ３１および第２の操作ワイヤ３２を介して可動部２０を偏向操作するものである。 The catheter 2 has a movable portion 20 whose direction can be deflected in the left-right direction at the distal end side, that is, the distal end side (lower side in FIG. 1) to be inserted into the body. The deflection operating device 1A is fixed to the proximal end of the catheter 2 and is placed outside the body during use. The deflection operation device 1A deflects the movable portion 20 via the first operation wire 31 and the second operation wire 32 of the catheter 2, which will be described later.
　先に、カテーテル２を説明する。 First, the catheter 2 will be described.
　カテーテル２は、図２～図４に示すような構造を有する。ただし、カテーテル２の構造はこれに限定されない。 Catheter 2 has a structure as shown in FIGS. 2 to 4. However, the structure of the catheter 2 is not limited to this.
　図２および図３はカテーテル２の横断面図であって、図２は図１におけるII－II断面、図３は図１および図４のIII－III断面を示している。また、図４はカテーテル２の遠位端であって図３のIV－IV断面を示している。 2 and 3 are cross-sectional views of the catheter 2, FIG. 2 shows a cross section II-II in FIG. 1, and FIG. 3 shows a cross section III-III in FIGS. 1 and 4. Further, FIG. 4 shows the IV-IV cross section of FIG. 3 which is the distal end of the catheter 2.
　図２～図４に示すように、カテーテル２は、１つのメインルーメン２３と、２つのワイヤルーメン２１、２２すなわち第１のワイヤルーメン２１および第２のワイヤルーメン２２と、を有する。カテーテル２は、可撓性樹脂からなる内側チューブ２３Ａと外側チューブ２３Ｂとを有する多層チューブで構成されており、メインルーメン２３は、内側チューブ２３Ａの中空内部によって構成されている。 As shown in FIGS. 2 to 4, the catheter 2 has one main lumen 23 and two wire lumens 21, 22, that is, a first wire lumen 21 and a second wire lumen 22. The catheter 2 is composed of a multilayer tube having an inner tube 23A and an outer tube 23B made of a flexible resin, and the main lumen 23 is composed of a hollow inside of the inner tube 23A.
　外側チューブ２３Ｂには、第１のワイヤルーメン２１と第２のワイヤルーメン２２とが、カテーテル２の中心軸に対し相互に約１８０度対極となる位置にそれぞれ設けられている。 The outer tube 23B is provided with a first wire lumen 21 and a second wire lumen 22 at positions opposite to each other by about 180 degrees with respect to the central axis of the catheter 2.
　第１のワイヤルーメン２１は、外側チューブ２３Ｂに埋め込まれた第１のワイヤルーメンチューブ２１Ａの中空内部によって構成されている。また、第２のワイヤルーメン２２は、外側チューブ２３Ｂに埋め込まれた第２のワイヤルーメンチューブ２２Ａの中空内部によって構成されている。各ワイヤルーメン２１、２２は、カテーテル２の軸方向に沿って延びている。 The first wire lumen 21 is composed of a hollow inside of the first wire lumen tube 21A embedded in the outer tube 23B. Further, the second wire lumen 22 is composed of a hollow inside of the second wire lumen tube 22A embedded in the outer tube 23B. The wire lumens 21 and 22 extend along the axial direction of the catheter 2.
　第１のワイヤルーメン２１には、第１の操作ワイヤ３１がカテーテル２の軸方向に沿って進退可能に挿通されており、第２のワイヤルーメン２２には、第２の操作ワイヤ３２がカテーテル２の軸方向に沿って進退可能に挿通されている。各操作ワイヤ３１、３２は、例えばステンレス鋼等の金属の撚り線または単線、あるいは高分子材料のフィラメントで構成されている。 A first operating wire 31 is inserted into the first wire lumen 21 so as to be able to advance and retreat along the axial direction of the catheter 2, and a second operating wire 32 is inserted into the second wire lumen 22 so as to advance and retreat along the axial direction of the catheter 2. It is inserted so that it can move forward and backward along the axial direction of. Each of the operating wires 31 and 32 is composed of a stranded wire or a single wire of a metal such as stainless steel, or a filament of a polymer material.
　また、図３および図４に示すように、本実施形態に係るカテーテル２は、遠位端に設けられた円環状のプルリング４０を有する。プルリング４０は、例えばステンレス鋼等の金属で構成されている。 Further, as shown in FIGS. 3 and 4, the catheter 2 according to the present embodiment has an annular pull ring 40 provided at the distal end. The pull ring 40 is made of a metal such as stainless steel.
　第１の操作ワイヤ３１および第２の操作ワイヤ３２は、その遠位端側の端部が、プルリング４０の内面４０ａにろう付け等の手段でそれぞれ接合されている。 The distal end of the first operating wire 31 and the second operating wire 32 are joined to the inner surface 40a of the pull ring 40 by means such as brazing.
　カテーテル２の近位端に設けられた本実施形態に係る偏向操作装置１Ａには、後述するように第１の操作ワイヤ３１および第２の操作ワイヤ３２の近位端側の端部がそれぞれ接続されている。偏向操作装置１Ａは、これら操作ワイヤ３１、３２を進退させることにより、図１の矢印α、βのようにプルリング４０を介してカテーテル２の可動部２０の向きを１８０度の反対方向に偏向させるように構成されている。 As will be described later, the proximal end side ends of the first operating wire 31 and the second operating wire 32 are connected to the deflection operating device 1A according to the present embodiment provided at the proximal end of the catheter 2. Has been done. By advancing and retreating these operating wires 31 and 32, the deflection operating device 1A deflects the direction of the movable portion 20 of the catheter 2 in the opposite direction of 180 degrees via the pull ring 40 as shown by arrows α and β in FIG. It is configured as follows.
　図２～図４に示すように、カテーテル２は、メインルーメン２３および各ワイヤルーメン２１、２２を囲むようにして配設されたブレード層２４を有する。ブレード層２４は、ステンレス等の線材が編組されてなる補強部材であり、このブレード層２４によってカテーテル２の捩れが抑えられるようになっている。 As shown in FIGS. 2 to 4, the catheter 2 has a main lumen 23 and a blade layer 24 arranged so as to surround the wire lumens 21 and 22. The blade layer 24 is a reinforcing member in which a wire rod such as stainless steel is braided, and the blade layer 24 suppresses twisting of the catheter 2.
　図４に示すように、カテーテル２は、その遠位端側の先端に、該先端およびプルリング４０を被覆する略円筒状の被覆樹脂５０を有する。この被覆樹脂５０により、プルリング４０はカテーテル２の遠位端に装着された状態となっている。被覆樹脂５０はカテーテル２の先端部を構成しており、その先端縁部はＲ状に面取りされてなだらかな面に形成されている。 As shown in FIG. 4, the catheter 2 has a substantially cylindrical coating resin 50 that covers the distal end and the pull ring 40 at the distal end side thereof. The coating resin 50 keeps the pull ring 40 attached to the distal end of the catheter 2. The coating resin 50 constitutes the tip of the catheter 2, and the tip edge thereof is chamfered in an R shape to form a gentle surface.
　次に、本実施形態に係る偏向操作装置１Ａについて説明する。 Next, the deflection operation device 1A according to the present embodiment will be described.
　図５は偏向操作装置１Ａの全体を示す平面図である。図５では、後述するコントローラハウジング３００の蓋体３００Ｂを透視して内部構成を実線で示した状態としている。図５に示すように本実施形態に係る偏向操作装置１Ａは、内部に空洞を有する扁平状のコントローラハウジング３００と、コントローラハウジング３００内に収納された第１のラック部材１００および第２のラック部材２００と、これらラック部材１００、２００の間に配置されたピニオン部材４００と、を備えている。 FIG. 5 is a plan view showing the entire deflection operating device 1A. In FIG. 5, the lid 300B of the controller housing 300, which will be described later, is seen through and the internal configuration is shown by a solid line. As shown in FIG. 5, the deflection operation device 1A according to the present embodiment includes a flat controller housing 300 having a cavity inside, and a first rack member 100 and a second rack member housed in the controller housing 300. A 200 and a pinion member 400 arranged between the rack members 100 and 200 are provided.
　コントローラハウジング３００は、内部に空洞を有する略Ｔ字状に形成されたものであって、略長方形状の本体部３１０と、本体部３１０の長手方向の一端側である近位端に一体に設けられた支持ハンドル部３２０と、本体部３１０の長手方向の他端側である遠位端に第１の操作ワイヤ３１および第２の操作ワイヤ３２がそれぞれ挿通されるワイヤ挿通部３３０と、を有する。本体部３１０は、カテーテル２内に挿通されている各操作ワイヤ３１、３２の延在方向に沿った方向が長手方向となっている。以下でいう長手方向は、この本体部３１０の長手方向に基づくものとする。 The controller housing 300 is formed in a substantially T shape having a cavity inside, and is integrally provided with a substantially rectangular main body 310 and a proximal end of the main body 310 on one end side in the longitudinal direction. The support handle portion 320 is provided, and the wire insertion portion 330 into which the first operation wire 31 and the second operation wire 32 are respectively inserted into the distal ends on the other end side in the longitudinal direction of the main body portion 310. .. The main body 310 has a longitudinal direction along the extending direction of the operating wires 31 and 32 inserted into the catheter 2. The longitudinal direction referred to below is based on the longitudinal direction of the main body 310.
　コントローラハウジング３００は、本体部３１０の幅方向中央を通る長手方向の中心線Ｃを対称線とした対称形状を有する。コントローラハウジング３００は、図６に示すように、厚さ方向に略二等分される半割状のベース３００Ａおよび蓋体３００Ｂが、少なくとも長手方向に分散配置された３箇所のねじ締結部３０１、３０２、３０３により着脱可能に組み合わされて構成される。ベース３００Ａと蓋体３００Ｂとはほぼ同一形状であり、それぞれ樹脂等によって一体成形されたものである。 The controller housing 300 has a symmetrical shape with the center line C in the longitudinal direction passing through the center in the width direction of the main body 310 as a symmetrical line. As shown in FIG. 6, the controller housing 300 has three screw fastening portions 301, in which a half-split base 300A and a lid 300B that are substantially bisected in the thickness direction are dispersedly arranged at least in the longitudinal direction. It is configured by being detachably combined by 302 and 303. The base 300A and the lid 300B have substantially the same shape, and are integrally molded with a resin or the like.
　図６に示すように、ベース３００Ａは、コントローラハウジング３００の本体部３１０および支持ハンドル部３２０をそれぞれ構成するベース側本体部３１０ａおよびベース側支持ハンドル部３２０ａを有する。またこれと同様に、蓋体３００Ｂは、コントローラハウジング３００の本体部３１０および支持ハンドル部３２０をそれぞれ構成する蓋体側本体部３１０ｂおよび蓋体側支持ハンドル部３２０ｂを有する。 As shown in FIG. 6, the base 300A has a base side main body portion 310a and a base side support handle portion 320a that form the main body portion 310 and the support handle portion 320 of the controller housing 300, respectively. Similarly, the lid 300B has a lid-side main body 310b and a lid-side support handle 320b that form the main body 310 and the support handle 320 of the controller housing 300, respectively.
　図６に示すように、ベース３００Ａは、底板部３０４ａと、底板部３０４ａの縁を形成する側壁部３０５ａと、を有し、これによりベース３００Ａの断面は薄い皿状になっている。また、蓋体３００Ｂは、天板部３０４ｂと、天板部３０４ｂの縁を形成する側壁部３０５ｂと、を有し、その断面は薄い皿状になっている。コントローラハウジング３００は、ベース３００Ａおよび蓋体３００Ｂの各側壁部３０５ａ、３０５ｂを相互に対向させて重ねて構成され、図７に示すように、両者の側壁部３０５ａ、３０５ｂによりコントローラハウジング３００全体としての側壁部３０５が構成される。 As shown in FIG. 6, the base 300A has a bottom plate portion 304a and a side wall portion 305a forming an edge of the bottom plate portion 304a, whereby the cross section of the base 300A has a thin dish shape. Further, the lid body 300B has a top plate portion 304b and a side wall portion 305b forming an edge of the top plate portion 304b, and the cross section thereof has a thin dish shape. The controller housing 300 is configured by stacking the side wall portions 305a and 305b of the base 300A and the lid 300B so as to face each other, and as shown in FIG. 7, the side wall portions 305a and 305b of both sides form the controller housing 300 as a whole. The side wall portion 305 is configured.
　図７に示すように、本体部３１０における第１のラック部材１００側の側壁部３０５は、第１のラック部材１００に沿って溝状の開口３０６ａを形成する第１のスライドガイド部３０６を有する。また、図８に示すように、本体部３１０における第２のラック部材２００側の側壁部３０５は、第２のラック部材２００に沿って溝状の開口３０７ａを形成する第２のスライドガイド部３０７を有する。 As shown in FIG. 7, the side wall portion 305 on the first rack member 100 side of the main body portion 310 has a first slide guide portion 306 that forms a groove-shaped opening 306a along the first rack member 100. .. Further, as shown in FIG. 8, the side wall portion 305 on the second rack member 200 side of the main body portion 310 forms a groove-shaped opening 307a along the second rack member 200, and the second slide guide portion 307. Has.
　以下に説明するコントローラハウジング３００が有する各構成要素は、特に説明がない限り、ベース３００Ａと蓋体３００Ｂとを合体させた状態でのコントローラハウジング３００の構成要素として説明する。 Unless otherwise specified, each component of the controller housing 300 described below will be described as a component of the controller housing 300 in a state where the base 300A and the lid 300B are combined.
　図５に示すように、コントローラハウジング３００の支持ハンドル部３２０は、本体部３１０に直交してそれぞれ側方に延びる略矩形状の第１のハンドル部３２１および第２のハンドル部３２２を含んで構成されている。支持ハンドル部３２０は、本体部３１０とともに略Ｔ字形状をなしている。 As shown in FIG. 5, the support handle portion 320 of the controller housing 300 includes a substantially rectangular first handle portion 321 and a second handle portion 322 that extend laterally at right angles to the main body portion 310, respectively. Has been done. The support handle portion 320 and the main body portion 310 have a substantially T-shape.
　なお、本実施形態では支持ハンドル部３２０は、本体部３１０とともに略Ｔ字形状をなすものであるが、本発明の支持ハンドル部としては、本体部３１０とともに略Ｌ字形状をなす形状等の、手のひらに突き当て可能な面を有する任意の形状であってよく、また、手指を通すことによって支持できるような手指挿通用の輪などの手指の係止を可能にする構造を有する任意の形状であってもよい。 In the present embodiment, the support handle portion 320 has a substantially T-shape together with the main body portion 310, but the support handle portion of the present invention has a shape such as a substantially L-shape together with the main body portion 310. It may be of any shape having a surface that can be abutted against the palm, and of any shape having a structure that allows the fingers to be locked, such as a finger insertion ring that can be supported by passing the fingers. There may be.
　図５に示すように、支持ハンドル部３２０の近位端側の端縁３２３は、操作者の手のひらが当てられる支持部３２３ａを含んでいる。この支持部３２３ａは、その一端から他端にわたり、近位端側に向けて略凸形状となるなだらかな湾曲面に形成されている。また、支持部３２３ａの両端に連続する各角部３２３ｂ、３２３ｃは、面取り加工されている。支持部３２３ａがなだらかに湾曲しており、かつ、各角部３２３ｂ、３２３ｃが面取り加工されているため、操作者は支持部３２３ａに手のひらを違和感なく当てやすくなっており、これにより偏向操作装置１Ａの操作性の向上が図られている。 As shown in FIG. 5, the edge 323 on the proximal end side of the support handle portion 320 includes the support portion 323a to which the palm of the operator is applied. The support portion 323a is formed on a gently curved surface that extends from one end to the other end and has a substantially convex shape toward the proximal end side. Further, the corner portions 323b and 323c continuous at both ends of the support portion 323a are chamfered. Since the support portion 323a is gently curved and the corner portions 323b and 323c are chamfered, it is easy for the operator to put the palm on the support portion 323a without discomfort, whereby the deflection operating device 1A The operability of the is improved.
　支持ハンドル部３２０を構成する第１のハンドル部３２１および第２のハンドル部３２２の遠位端側の各端縁は、それぞれ操作者の指が掛けられる指係止部３２１ａ、３２２ａを構成している。これら指係止部３２１ａ、３２２ａは、近位端側に向けて略凹形状となるなだらかな湾曲面に形成されている。また、各指係止部３２１ａ、３２２ａにそれぞれ連続する外側の各角部３２１ｂ、３２２ｂは面取り加工されている。 Each end edge on the distal end side of the first handle portion 321 and the second handle portion 322 constituting the support handle portion 320 constitutes finger locking portions 321a and 322a on which the operator's finger is hung, respectively. There is. These finger locking portions 321a and 322a are formed on a gently curved surface having a substantially concave shape toward the proximal end side. Further, the outer corner portions 321b and 322b that are continuous with the finger locking portions 321a and 322a are chamfered.
　また、図７および図８に示すように、コントローラハウジング３００は、支持ハンドル部３２０および支持ハンドル部３２０から本体部３１０への移行部分に、本体部３１０より厚さが大きく形成された膨出部３２５を有する。この膨出部３２５の厚さは、操作者が支持ハンドル部３２０を握りやすい適宜厚さを有する。支持ハンドル部３２０においては、各指係止部３２１ａ、３２２ａは指が掛かりやすいように凹形状に湾曲しており、これに加えて支持ハンドル部３２０が膨出部３２５により適宜厚さを有するため、支持ハンドル部３２０を握りやすくなっている。 Further, as shown in FIGS. 7 and 8, the controller housing 300 has a bulging portion having a thickness larger than that of the main body portion 310 at the transition portion from the support handle portion 320 and the support handle portion 320 to the main body portion 310. It has 325. The thickness of the bulging portion 325 has an appropriate thickness that makes it easy for the operator to grip the support handle portion 320. In the support handle portion 320, the finger locking portions 321a and 322a are curved in a concave shape so that the fingers can be easily hooked, and in addition, the support handle portion 320 has an appropriate thickness due to the bulging portion 325. , The support handle portion 320 is easy to grip.
　図５および図９に示すように、ワイヤ挿通部３３０は、コントローラハウジング３００の遠位端から突出する細い管状のスリーブ部３３１と、スリーブ部３３１内からコントローラハウジング３００内に連通するワイヤ導入口３３２と、ワイヤ導入口３３２に近接配置されたゲート部３３３と、を有する。ゲート部３３３は、コントローラハウジング３００に設けられた一対の円柱部３３３ａ、３３３ｂを含んでいる。 As shown in FIGS. 5 and 9, the wire insertion portion 330 has a thin tubular sleeve portion 331 protruding from the distal end of the controller housing 300 and a wire introduction port 332 communicating from the inside of the sleeve portion 331 into the controller housing 300. And a gate portion 333 arranged close to the wire introduction port 332. The gate portion 333 includes a pair of cylindrical portions 333a and 333b provided in the controller housing 300.
　カテーテル２は、その近位端側の端部がスリーブ部３３１内に固定されてコントローラハウジング３００に接続されている。スリーブ部３３１内へのカテーテル２の固定は、例えば、カテーテル２をスリーブ部３３１内に圧入した上で外側チューブ２３Ｂをスリーブ部３３１の内面に接着あるいは溶着するなどの手段が採られる。なお、ワイヤ挿通部の形成にあたっては、コントローラハウジング３００にスリーブ部３３１を設けずに、熱収縮チューブ等を用いて、コントローラハウジング３００およびコントローラハウジング３００からカテーテル２の境界位置を被覆して、その被覆をコントローラハウジング３００と一体化させてもよい。 The end of the catheter 2 on the proximal end side is fixed in the sleeve portion 331 and connected to the controller housing 300. For fixing the catheter 2 into the sleeve portion 331, for example, a means such as pressing the catheter 2 into the sleeve portion 331 and then adhering or welding the outer tube 23B to the inner surface of the sleeve portion 331 is adopted. In forming the wire insertion portion, the controller housing 300 is not provided with the sleeve portion 331, but a heat-shrinkable tube or the like is used to cover the boundary positions of the controller housing 300 and the catheter 2 from the controller housing 300 to cover the boundary position. May be integrated with the controller housing 300.
　第１の操作ワイヤ３１および第２の操作ワイヤ３２は、その近位端側の端部が、スリーブ部３３１内からワイヤ導入口３３２およびゲート部３３３の円柱部３３３ａ、３３３ｂの間を通されて、コントローラハウジング３００内に導入される。そして、後述するように第１の操作ワイヤ３１は第１のラック部材１００に固定され、第２の操作ワイヤ３２は第２のラック部材２００に固定される。なお、ゲート部３３３を構成する円柱部３３３ａ、３３３ｂは、回転自在なローラで構成されていてもよい。 The proximal end of the first operating wire 31 and the second operating wire 32 is passed between the sleeve portion 331 and the cylindrical portions 333a and 333b of the wire introduction port 332 and the gate portion 333. , Introduced in the controller housing 300. Then, as will be described later, the first operation wire 31 is fixed to the first rack member 100, and the second operation wire 32 is fixed to the second rack member 200. The cylindrical portions 333a and 333b constituting the gate portion 333 may be composed of rotatable rollers.
　図５に示すように、コントローラハウジング３００は、その内部に、第１のラック部材１００を長手方向へ往復変位可能に導く第１のガイド部３５１と、第２のラック部材２００を長手方向へ往復変位可能に導く第２のガイド部３５２と、を有する。 As shown in FIG. 5, the controller housing 300 reciprocates inside the controller housing 300 with a first guide portion 351 for guiding the first rack member 100 so as to be reciprocally displaceable in the longitudinal direction and a second rack member 200 in the longitudinal direction. It has a second guide portion 352 that leads to displaceability.
　第１のガイド部３５１は、コントローラハウジング３００の中心に設けられた長手方向に延びる２つの仕切り壁部３４１、３４２、第１のスライドガイド部３０６および支持ハンドル部３２０内のガイド壁部３４３により形成されている。コントローラハウジング３００の側壁部３０５は、第１のガイド部３５１の遠位端および近位端に対応する箇所に、ストッパ部３５１ａ、３５１ｂをそれぞれ有する。 The first guide portion 351 is formed by two partition wall portions 341 and 342 provided in the center of the controller housing 300 in the longitudinal direction, the first slide guide portion 306, and the guide wall portion 343 in the support handle portion 320. Has been done. The side wall portion 305 of the controller housing 300 has stopper portions 351a and 351b at locations corresponding to the distal end and the proximal end of the first guide portion 351 respectively.
　第２のガイド部３５２は、仕切り壁部３４１、３４２、第２のスライドガイド部３０７および支持ハンドル部３２０内のガイド壁部３４４により形成されている。コントローラハウジング３００の側壁部３０５は、第２のガイド部３５２の遠位端および近位端に対応する箇所に、ストッパ部３５２ａ、３５２ｂをそれぞれ有する。 The second guide portion 352 is formed by the partition wall portions 341 and 342, the second slide guide portion 307, and the guide wall portion 344 in the support handle portion 320. The side wall portion 305 of the controller housing 300 has stopper portions 352a and 352b at locations corresponding to the distal end and the proximal end of the second guide portion 352, respectively.
　仕切り壁部３４１は、図６に示すようにベース３００Ａおよび蓋体３００Ｂがそれぞれ有する凸条部３４１ａ、３４１ｂが相互に重ねられて構成される。また、仕切り壁部３４２は、図６に示すようにベース３００Ａおよび蓋体３００Ｂがそれぞれ有する凸条部３４２ａ、３４２ｂが相互に重ねられて構成される。 As shown in FIG. 6, the partition wall portion 341 is configured such that the ridge portions 341a and 341b of the base 300A and the lid 300B, respectively, are overlapped with each other. Further, as shown in FIG. 6, the partition wall portion 342 is configured such that the ridge portions 342a and 342b of the base 300A and the lid 300B, respectively, are overlapped with each other.
　図６に示すように、コントローラハウジング３００のベース３００Ａは、凸条部３４１ａの近位端の両側に、円柱状のワイヤガイド３３４ａ、３３４ｂを有する。ワイヤガイド３３４ａ、３３４ｂは、回転自在なローラで構成されていてもよい。 As shown in FIG. 6, the base 300A of the controller housing 300 has columnar wire guides 334a and 334b on both sides of the proximal end of the ridge 341a. The wire guides 334a and 334b may be composed of rotatable rollers.
　第１のラック部材１００および第２のラック部材２００は、コントローラハウジング３００内に、それぞれ本体部３１０の長手方向に往復変位可能に、かつ、相互に対向する歯部１２０、２２０を有するように収納されている。 The first rack member 100 and the second rack member 200 are housed in the controller housing 300 so as to be reciprocally displaceable in the longitudinal direction of the main body 310 and to have teeth 120 and 220 facing each other. Has been done.
　図１０Ｂは第１のラック部材１００を示し、図１０Ａは第２のラック部材２００を示している。これらラック部材１００、２００は、細長い直方体状のラック本体部１１０、２１０と、ラック本体部１１０、２１０の相互の対向面である側面にそれぞれ設けられた多数の歯からなる歯部１２０、２２０と、をそれぞれ有する。これらラック部材１００、２００は、歯部１２０、２２０が相互に対向するようにして、第１のガイド部３５１および第２のガイド部３５２にそれぞれ設置されている。 FIG. 10B shows the first rack member 100, and FIG. 10A shows the second rack member 200. These rack members 100 and 200 include an elongated rectangular parallelepiped rack main body 110 and 210 and tooth portions 120 and 220 composed of a large number of teeth provided on side surfaces of the rack main bodies 110 and 210 which are facing each other. , Each. These rack members 100 and 200 are installed in the first guide portion 351 and the second guide portion 352, respectively, so that the tooth portions 120 and 220 face each other.
　図１０Ｂに示すように、第１のラック部材１００のラック本体部１１０は、その外側の側面１１１に、ラック本体部１１０の長手方向に延びるガイド片１１２を有する。このガイド片１１２は、第１のスライドガイド部３０６の開口３０６ａに挿入された状態となっている。そして第１のラック部材１００のラック本体部１１０には、開口３０６ａを通してコントローラハウジング３００の側方に突出する第１の操作ノブ５１０が一体に設けられている。 As shown in FIG. 10B, the rack main body 110 of the first rack member 100 has a guide piece 112 extending in the longitudinal direction of the rack main body 110 on the outer side surface 111 thereof. The guide piece 112 is in a state of being inserted into the opening 306a of the first slide guide portion 306. The rack body 110 of the first rack member 100 is integrally provided with a first operation knob 510 that projects laterally to the controller housing 300 through the opening 306a.
　図１０Ａに示すように、第２のラック部材２００のラック本体部２１０は、その外側の側面２１１に、ラック本体部２１０の長手方向に延びるガイド片２１２を有する。このガイド片２１２は、第２のスライドガイド部３０７の開口３０７ａに挿入された状態となっている。そして第２のラック部材２００のラック本体部２１０には、開口３０７ａを通してコントローラハウジング３００の側方に突出する第２の操作ノブ５２０が一体に設けられている。 As shown in FIG. 10A, the rack main body 210 of the second rack member 200 has a guide piece 212 extending in the longitudinal direction of the rack main body 210 on the outer side surface 211 thereof. The guide piece 212 is in a state of being inserted into the opening 307a of the second slide guide portion 307. The rack main body 210 of the second rack member 200 is integrally provided with a second operation knob 520 that projects laterally of the controller housing 300 through the opening 307a.
　第１の操作ノブ５１０および第２の操作ノブ５２０は、それぞれ支持ハンドル部３２０を構成する第１のハンドル部３２１および第２のハンドル部３２２と相似した矩形の板形状を有し、各ラック部材１００、２００と一体成形されている。なお、各操作ノブ５１０、５２０の形状は任意であり、例えば、棒状、リング状、引き金状等であってもよく、各ラック部材１００、２００と一体成形される。 The first operation knob 510 and the second operation knob 520 have a rectangular plate shape similar to the first handle portion 321 and the second handle portion 322 constituting the support handle portion 320, respectively, and each rack member. It is integrally molded with 100 and 200. The shape of each operation knob 510 and 520 is arbitrary, and may be, for example, a rod shape, a ring shape, a trigger shape, or the like, and is integrally molded with the rack members 100 and 200.
　図１０Ａおよび図１０Ｂに示すように、第１の操作ノブ５１０および第２の操作ノブ５２０の遠位端側（図１０Ａおよび図１０Ｂで左側）の各端縁は、操作者の指が掛けられる指係止部５１０ａ、５２０ａをそれぞれ構成している。これら指係止部５１０ａ、５２０ａは、近位端側に向けて略凹形状となるなだらかな湾曲面に形成されている。また、各指係止部５１０ａ、５２０ａにそれぞれ連続する外側の各角部５１０ｂ、５２０ｂは面取り加工されている。各指係止部５１０ａ、５２０ａは、指が掛かりやすいように凹形状に湾曲しているため、操作者が各指係止部５１０ａ、５２０ａに指を掛けやすく、これにより第１の操作ノブ５１０および第２の操作ノブ５２０を操作しやすくなっている。 As shown in FIGS. 10A and 10B, the operator's finger is hung on each edge of the first operation knob 510 and the second operation knob 520 on the distal end side (left side in FIGS. 10A and 10B). Each of the finger locking portions 510a and 520a is configured. These finger locking portions 510a and 520a are formed on a gently curved surface having a substantially concave shape toward the proximal end side. Further, the outer corner portions 510b and 520b that are continuous with the finger locking portions 510a and 520a are chamfered. Since the finger locking portions 510a and 520a are curved in a concave shape so that the fingers can be easily hooked, the operator can easily hook the fingers on the finger locking portions 510a and 520a, whereby the first operation knob 510 can be easily hooked. And the second operation knob 520 is easy to operate.
　また、図１０Ａおよび図１０Ｂに示すように、各指係止部５１０ａ、５２０ａには、第１のラック部材１００および第２のラック部材２００にそれぞれなだらかに移行する形状の内側凸部５１０ｃ、５２０ｃが形成されている。これら内側凸部５１０ｃ、５２０ｃにより、各指係止部５１０ａ、５２０ａに掛けた指がコントローラハウジング３００の本体部３１０に接触しにくく、各操作ノブ５１０、５２０の操作性が阻害されないようになっている。 Further, as shown in FIGS. 10A and 10B, the finger locking portions 510a and 520a have inner convex portions 510c and 520c having a shape that gently shifts to the first rack member 100 and the second rack member 200, respectively. Is formed. Due to these inner convex portions 510c and 520c, the fingers hung on the finger locking portions 510a and 520a are less likely to come into contact with the main body 310 of the controller housing 300, and the operability of the operation knobs 510 and 520 is not hindered. There is.
　第１の操作ノブ５１０および第２の操作ノブ５２０は、指係止部５１０ａ、５２０ａに掛けた指で近位端側（支持ハンドル部３２０側）に引かれることにより操作される。第１の操作ノブ５１０を近位端側に引くと第１のラック部材１００が一体的に近位端側に変位し、これと同期して第２のラック部材２００が逆方向の遠位端側に変位するようになっている。また、第２の操作ノブ５２０を近位端側に引くと第２のラック部材２００が一体的に近位端側に変位し、これと同期して第１のラック部材１００が逆方向の遠位端側に変位するようになっている。 The first operation knob 510 and the second operation knob 520 are operated by being pulled toward the proximal end side (support handle portion 320 side) by a finger hung on the finger locking portions 510a and 520a. When the first operation knob 510 is pulled toward the proximal end side, the first rack member 100 is integrally displaced toward the proximal end side, and in synchronization with this, the second rack member 200 is moved to the distal end in the opposite direction. It is designed to be displaced to the side. Further, when the second operation knob 520 is pulled toward the proximal end side, the second rack member 200 is integrally displaced toward the proximal end side, and in synchronization with this, the first rack member 100 is far away in the opposite direction. It is designed to be displaced toward the end.
　例えば、第１の操作ノブ５１０の指係止部５１０ａに人差し指を掛け、第２の操作ノブ５２０の指係止部５２０ａに中指を掛けて、それぞれの指により各操作ノブ５１０、５２０を引き操作することができる。 For example, the index finger is hung on the finger locking portion 510a of the first operation knob 510, the middle finger is hung on the finger locking portion 520a of the second operation knob 520, and each operation knob 510 and 520 is pulled by each finger. can do.
　図１０Ｂに示すように、第１のラック部材１００は、その表面側に、第１の操作ワイヤ３１の近位端側の端部を固定するワイヤ固定部５１１を有する。また、図１０Ａに示すように、第２のラック部材２００は、その裏面側に、第２の操作ワイヤ３２の近位端側の端部を固定するワイヤ固定部５２１を有する。 As shown in FIG. 10B, the first rack member 100 has a wire fixing portion 511 on the surface side thereof for fixing the end portion on the proximal end side of the first operating wire 31. Further, as shown in FIG. 10A, the second rack member 200 has a wire fixing portion 521 on the back surface side thereof for fixing the end portion on the proximal end side of the second operation wire 32.
　各ワイヤ固定部５１１、５２１は同一構造であって、ねじ締結により各操作ワイヤ３１、３２をそれぞれ各ラック部材１００、２００に固定可能となっている。 The wire fixing portions 511 and 521 have the same structure, and the operation wires 31 and 32 can be fixed to the rack members 100 and 200, respectively, by fastening screws.
　図１０Ａに示すように、第２のラック部材２００のワイヤ固定部５２１は、ラック本体部２１０の表面に形成された長手方向に延びる溝５２１ａと、この溝５２１ａに嵌め込まれた細い金属管５２１ｂと、ねじ部５２１ｃと、を有する。ねじ部５２１ｃは、ラック本体部２１０の外側の側面２１１に開口する凹所２１０ａ内に固定された雌ねじ５２１ｄと、雌ねじ５２１ｄにねじ込まれる六角穴付きのボルト５２１ｅと、を有する。 As shown in FIG. 10A, the wire fixing portion 521 of the second rack member 200 includes a groove 521a formed on the surface of the rack main body 210 and extending in the longitudinal direction, and a thin metal tube 521b fitted in the groove 521a. , And a threaded portion 521c. The threaded portion 521c has a female screw 521d fixed in a recess 210a opened in the outer side surface 211 of the rack main body 210, and a hexagon socket head screw 521e screwed into the female screw 521d.
　第２の操作ワイヤ３２の近位端側の端部は、ワイヤガイド３３４ｂの外側に接触して溝５２１ａにガイドされ、溝５２１ａを通して金属管５２１ｂ内に挿入される。そして、雌ねじ５２１ｄにねじ込んだボルト５２１ｅで金属管５２１ｂをかしめることにより、金属管５２１ｂ内に第２の操作ワイヤ３２が圧着されて固定される。これにより第２の操作ワイヤ３２の近位端の端部は、金属管５２１ｂとともに第２のラック部材２００に固定される。 The end of the second operating wire 32 on the proximal end side comes into contact with the outside of the wire guide 334b, is guided by the groove 521a, and is inserted into the metal tube 521b through the groove 521a. Then, by crimping the metal pipe 521b with the bolt 521e screwed into the female screw 521d, the second operation wire 32 is crimped and fixed in the metal pipe 521b. As a result, the end of the proximal end of the second operating wire 32 is fixed to the second rack member 200 together with the metal tube 521b.
　図１０Ｂに示すように、第１のラック部材１００のワイヤ固定部５１１は、ラック本体部１１０の裏面側に設けられており、溝５１１ａと、溝５１１ａに嵌め込まれた金属管５１１ｂと、雌ねじ５１１ｄおよびボルト５１１ｅによるねじ部５１１ｃと、を有する。ねじ部５１１ｃは、ラック本体部１１０の外側の側面１１１に開口する凹所１１０ａ内に固定されている。 As shown in FIG. 10B, the wire fixing portion 511 of the first rack member 100 is provided on the back surface side of the rack main body portion 110, and has a groove 511a, a metal tube 511b fitted in the groove 511a, and a female screw 511d. It also has a threaded portion 511c with bolts 511e. The screw portion 511c is fixed in the recess 110a that opens on the outer side surface 111 of the rack main body 110.
　第１の操作ワイヤ３１の近位端側の端部は、ワイヤガイド３３４ａの外側に接触して溝５１１ａにガイドされ、溝５１１ａを通して金属管５１１ｂ内に挿入される。そして、雌ねじ５１１ｄにねじ込んだボルト５１１ｅで金属管５１１ｂをかしめることにより、金属管５１１ｂ内に第１の操作ワイヤ３１が圧着されて固定される。これにより第１の操作ワイヤ３１の近位端の端部は、金属管５１１ｂとともに第１のラック部材１００に固定されている。 The end of the first operating wire 31 on the proximal end side comes into contact with the outside of the wire guide 334a and is guided by the groove 511a, and is inserted into the metal tube 511b through the groove 511a. Then, by crimping the metal tube 511b with the bolt 511e screwed into the female screw 511d, the first operation wire 31 is crimped and fixed in the metal tube 511b. As a result, the end of the proximal end of the first operating wire 31 is fixed to the first rack member 100 together with the metal tube 511b.
　図５に示すように、ピニオン部材４００は、仕切り壁部３４１と仕切り壁部３４２との間に配置されている。ピニオン部材４００は、第１のラック部材１００および第２のラック部材２００の各歯部１２０、２２０に噛合する状態で、図９に示すように回転軸４１０を介してコントローラハウジング３００に回転自在に支持されている。 As shown in FIG. 5, the pinion member 400 is arranged between the partition wall portion 341 and the partition wall portion 342. The pinion member 400 is rotatably attached to the controller housing 300 via the rotation shaft 410 as shown in FIG. 9 in a state of being meshed with the tooth portions 120 and 220 of the first rack member 100 and the second rack member 200. It is supported.
　図１に示すように、第１のラック部材１００および第２のラック部材２００は、ピニオン部材４００に対し、往復変位方向の位置が相互に揃った状態で各歯部１２０、２２０の長手方向中央部がピニオン部材４００に噛合するように噛合箇所が調整されている。 As shown in FIG. 1, the first rack member 100 and the second rack member 200 are centered in the longitudinal direction of the tooth portions 120 and 220 with respect to the pinion member 400 in a state where the positions in the reciprocating displacement direction are aligned with each other. The meshing portion is adjusted so that the portion meshes with the pinion member 400.
　第１のラック部材１００および第２のラック部材２００は、各歯部１２０、２２０がピニオン部材４００にそれぞれ噛合していることにより、ピニオン部材４００に対し相互に逆方向に往復変位するようになっている。 The first rack member 100 and the second rack member 200 are displaced reciprocally with respect to the pinion member 400 by engaging the tooth portions 120 and 220 with the pinion member 400, respectively. ing.
　上記構成を備えた本実施形態に係る偏向操作装置１Ａでは、第１の操作ノブ５１０および第２の操作ノブ５２０が、支持ハンドル部３２０に対し長手方向に相対変位するようスライド操作される。各操作ノブ５１０、５２０は、第１のラック部材１００および第２のラック部材２００にそれぞれ一体に設けられているため、それぞれ各ラック部材１００、２００とともに相互に逆方向に変位するように操作される。このように各操作ノブ５１０、５２０が操作されるとき、ピニオン部材４００に対し第１のラック部材１００および第２のラック部材２００が相互に逆方向に変位しつつ、カテーテル２内の第１の操作ワイヤ３１および第２の操作ワイヤ３２がカテーテル２の可動部２０の偏向操作方向に変位するようになっている。 In the deflection operation device 1A according to the present embodiment having the above configuration, the first operation knob 510 and the second operation knob 520 are slid so as to be displaced relative to the support handle portion 320 in the longitudinal direction. Since the operation knobs 510 and 520 are integrally provided on the first rack member 100 and the second rack member 200, they are operated so as to be displaced in opposite directions together with the rack members 100 and 200, respectively. Displacement. When each of the operation knobs 510 and 520 is operated in this way, the first rack member 100 and the second rack member 200 are displaced in opposite directions with respect to the pinion member 400, and the first rack member in the catheter 2 is displaced. The operation wire 31 and the second operation wire 32 are displaced in the deflection operation direction of the movable portion 20 of the catheter 2.
　第１のラック部材１００は、第１のガイド部３５１の遠位端および近位端にそれぞれ設けられたストッパ部３５１ａ、３５１ｂによって変位範囲が規制され、ピニオン部材４００からの離脱が抑えられるようになっている。また、第２のラック部材２００は、第２のガイド部３５２の遠位端および近位端にそれぞれ設けられたストッパ部３５２ａ、３５２ｂによって変位範囲が規制され、ピニオン部材４００からの離脱が抑えられるようになっている。 The displacement range of the first rack member 100 is restricted by the stopper portions 351a and 351b provided at the distal end and the proximal end of the first guide portion 351 respectively, so that the first rack member 100 is prevented from being separated from the pinion member 400. It has become. Further, the displacement range of the second rack member 200 is restricted by the stopper portions 352a and 352b provided at the distal end and the proximal end of the second guide portion 352, respectively, and the detachment from the pinion member 400 is suppressed. It has become like.
　図１に示すように、第１の操作ノブ５１０および第２の操作ノブ５２０の変位方向の位置が相互に揃った状態のとき、カテーテル２の可動部２０は真っ直ぐに延び、偏向なしの中立状態となる。このとき、第１のラック部材１００および第２のラック部材２００は、各操作ノブ５１０、５２０と同様に変位方向の位置が相互に揃った中立位置に位置付けられる。この中立位置は、本発明の特定位置をいう。 As shown in FIG. 1, when the positions of the first operation knob 510 and the second operation knob 520 in the displacement direction are aligned with each other, the movable portion 20 of the catheter 2 extends straight and is in a neutral state without deflection. It becomes. At this time, the first rack member 100 and the second rack member 200 are positioned at neutral positions in which the positions in the displacement directions are aligned with each other, similarly to the operation knobs 510 and 520. This neutral position refers to a specific position of the present invention.
　図１に示す中立状態から、図１１に示すように、第１の操作ノブ５１０を近位端側に引くと、第１のラック部材１００が一体的に近位端側に変位し、これと同期して第２のラック部材２００が逆方向の遠位端側に変位する。そしてこのような各ラック部材１００、２００の変位に追従して、第１の操作ワイヤ３１が近位端側に引き込まれるとともに第２の操作ワイヤ３２が遠位端側に押し込まれる。プルリング４０は各操作ワイヤ３１、３２の動きに追従して偏向し、カテーテル２の可動部２０は、操作側である第１の操作ノブ５１０側に偏向する。 When the first operation knob 510 is pulled toward the proximal end side as shown in FIG. 11 from the neutral state shown in FIG. 1, the first rack member 100 is integrally displaced toward the proximal end side, and this At the same time, the second rack member 200 is displaced toward the distal end side in the opposite direction. Then, following such displacements of the rack members 100 and 200, the first operation wire 31 is pulled toward the proximal end side and the second operation wire 32 is pushed toward the distal end side. The pull ring 40 deflects following the movements of the operating wires 31 and 32, and the movable portion 20 of the catheter 2 deflects toward the first operating knob 510, which is the operating side.
　一方、図１２に示すように、第２の操作ノブ５２０を近位端側に引くと、第２のラック部材２００が一体的に近位端側に変位し、これと同期して第１のラック部材１００が逆方向の遠位端側に変位する。そしてこのような各ラック部材１００、２００の変位に追従して、第２の操作ワイヤ３２が近位端側に引き込まれるとともに第１の操作ワイヤ３１が遠位端側に押し込まれる。プルリング４０は各操作ワイヤ３１、３２の動きに追従して偏向し、カテーテル２の可動部２０は、操作側である第２の操作ノブ５２０側に偏向する。 On the other hand, as shown in FIG. 12, when the second operation knob 520 is pulled toward the proximal end side, the second rack member 200 is integrally displaced toward the proximal end side, and in synchronization with this, the first rack member 200 is displaced toward the proximal end side. The rack member 100 is displaced toward the distal end in the opposite direction. Then, following such displacements of the rack members 100 and 200, the second operation wire 32 is pulled toward the proximal end side and the first operation wire 31 is pushed toward the distal end side. The pull ring 40 deflects following the movements of the operating wires 31 and 32, and the movable portion 20 of the catheter 2 deflects toward the second operating knob 520, which is the operating side.
　このように各操作ノブ５１０、５２０によって各ラック部材１００、２００を相反する方向に操作することにより、各操作ワイヤ３１、３２およびプルリング４０を介してカテーテルの可動部２０の向きが各操作ノブ５１０、５２０の操作方向に応じた方向に偏向するようになっている。 By operating the rack members 100 and 200 in opposite directions by the operation knobs 510 and 520 in this way, the direction of the movable portion 20 of the catheter via the operation wires 31 and 32 and the pull ring 40 is changed to the operation knob 510. It is designed to be deflected in a direction corresponding to the operation direction of 520.
　次に、本実施形態の作用を説明する。 Next, the operation of this embodiment will be described.
　本実施形態に係る偏向操作装置１Ａによれば、コントローラハウジング３００内の第１のラック部材１００および第２のラック部材２００を、それぞれ第１の操作ノブ５１０および第２の操作ノブ５２０を介して往復変位させることにより、カテーテル２の可動部２０を偏向操作することができる。このため、従来よりも簡素な構成でカテーテル２の可動部２０を偏向操作することができる。 According to the deflection operation device 1A according to the present embodiment, the first rack member 100 and the second rack member 200 in the controller housing 300 are passed through the first operation knob 510 and the second operation knob 520, respectively. By reciprocating the displacement, the movable portion 20 of the catheter 2 can be deflected. Therefore, the movable portion 20 of the catheter 2 can be deflected with a simpler configuration than the conventional one.
　また、本実施形態に係る偏向操作装置１Ａによれば、第１の操作ノブ５１０および第２の操作ノブ５２０の往復操作方向が、第１の操作ワイヤ３１および第２の操作ワイヤ３２の延在方向と同じ方向であるため、各操作ノブ５１０、５２０の操作方向とカテーテル２の可動部２０の偏向方向を感覚的に対応させることができる。 Further, according to the deflection operation device 1A according to the present embodiment, the reciprocating operation direction of the first operation knob 510 and the second operation knob 520 extends from the first operation wire 31 and the second operation wire 32. Since the direction is the same as the direction, the operation direction of each operation knob 510 and 520 and the deflection direction of the movable portion 20 of the catheter 2 can be sensuously matched.
　すなわち、第１の操作ノブ５１０および第２の操作ノブ５２０のうち、可動部２０の偏向方向に対応する側の操作ノブ（５１０または５２０）を操作することで、可動部２０を所望の方向に偏向させることができる。例えば、可動部２０を第１の操作ノブ５１０側に偏向させたいときには、第１の操作ノブ５１０を支持ハンドル部３２０（近位端側）に引くことにより可能であり、可動部２０を第２の操作ノブ５２０側に偏向させたいときには、第２の操作ノブ５２０を支持ハンドル部３２０側に引くことにより可能である。このような操作とあいまって各操作ノブ５１０、５２０のコントローラハウジング３００に対する相対位置を目視で認識すれば、可動部２０の偏向状態（偏向の向きや偏向の程度）を概ね把握することができる。 That is, by operating the operation knob (510 or 520) on the side of the first operation knob 510 and the second operation knob 520 corresponding to the deflection direction of the movable portion 20, the movable portion 20 can be moved in a desired direction. It can be deflected. For example, when it is desired to deflect the movable portion 20 toward the first operation knob 510, it is possible by pulling the first operation knob 510 toward the support handle portion 320 (proximal end side), and the movable portion 20 can be pulled to the second operation knob 510 side. When it is desired to deflect the operation knob 520 toward the operation knob 520, the second operation knob 520 can be pulled toward the support handle portion 320. If the relative positions of the operation knobs 510 and 520 with respect to the controller housing 300 are visually recognized in combination with such an operation, the deflection state (direction of deflection and degree of deflection) of the movable portion 20 can be roughly grasped.
　このため、各操作ノブ５１０、５２０の操作に応じたカテーテル２の可動部２０の偏向状態を把握しやすいとともに、可動部２０からの操作反力が、引き操作している側の操作ノブ（５１０または５２０）に直接伝わるので、有効な操作抵抗感（操作フィーリング）を得ることができる。これらの結果、十分な操作性を得ることができる。 Therefore, it is easy to grasp the deflection state of the movable portion 20 of the catheter 2 in response to the operation of each of the operation knobs 510 and 520, and the operation reaction force from the movable portion 20 is the operation knob (510) on the pulling operation side. Or, since it is directly transmitted to 520), an effective feeling of operation resistance (operation feeling) can be obtained. As a result, sufficient operability can be obtained.
　また、第１の操作ノブ５１０および第２の操作ノブ５２０は、支持ハンドル部３２０側に変位させる引き操作を行うことにより、片手で手動操作を行うにあたって操作力を有効に各操作ノブ５１０、５２０に付与することができるとともに、例えばダイヤルを回転させる偏向操作と比べると、指をかけ直しながら操作する必要がなく、このことからも操作性の向上が図られている。 Further, the first operation knob 510 and the second operation knob 520 perform a pulling operation to displace the support handle portion 320 side, so that the operation force can be effectively used for manual operation with one hand. As compared with the deflection operation of rotating the dial, for example, it is not necessary to operate while re-applying the finger, which also improves the operability.
　さらに、コントローラハウジングを１８０°裏返して第１および第２の操作ノブの左右位置を反転させても両者を同じように操作することができるという利便性を有する。 Further, even if the controller housing is turned over 180 ° and the left and right positions of the first and second operation knobs are reversed, both can be operated in the same manner.
　また、本実施形態に係る偏向操作装置１Ａによれば、コントローラハウジング３００の支持ハンドル部３２０に操作者の手のひらを突き当てるとともに各操作ノブ５１０、５２０の各指係止部５１０ａ、５２０ａに指を掛けることにより、片手で偏向操作装置１Ａを容易に支持したり操作したりすることができる。 Further, according to the deflection operation device 1A according to the present embodiment, the palm of the operator is abutted against the support handle portion 320 of the controller housing 300, and the fingers are placed on the finger locking portions 510a and 520a of the operation knobs 510 and 520. By hanging, the deflection operating device 1A can be easily supported and operated with one hand.
　また、本実施形態に係る偏向操作装置１Ａは、支持ハンドル部３２０は、コントローラハウジング３００の本体部３１０とともに略Ｔ字形状をなしている。このため、本実施形態に係る偏向操作装置１Ａは、支持ハンドル部３２０を介して把持しやすく、そのため操作性の向上が図られるようになっている。 Further, in the deflection operation device 1A according to the present embodiment, the support handle portion 320 has a substantially T-shape together with the main body portion 310 of the controller housing 300. Therefore, the deflection operation device 1A according to the present embodiment can be easily gripped via the support handle portion 320, and therefore the operability can be improved.
　（他の実施形態）
　次に、図１３により、本発明の他の実施形態に係る偏向操作装置１Ｂを説明する。 (Other embodiments)
Next, the deflection operation device 1B according to another embodiment of the present invention will be described with reference to FIG.
　偏向操作装置１Ｂは、上述の一実施形態の偏向操作装置１Ａにおいて、第１および第２の操作ノブ５１０、５２０に代えてリング状の操作ノブ５３０が第１のラック部材１００のみに設けられ、第２のラック部材２００には、該第２のラック部材２００のコントローラハウジング３００に対する相対位置を標示するインジケータ６００が設けられている。インジケータ６００は、本発明の標示部を構成する。また、偏向操作装置１Ｂでは、第１のラック部材１００とコントローラハウジング３００との間に、第１のラック部材１００および第２のラック部材２００をコントローラハウジング３００に対する中立位置に付勢する２つのコイルスプリング７１０、７２０が介装されている。コイルスプリング７１０、７２０は、それぞれ本発明の付勢手段を構成する。 In the deflection operation device 1B, in the deflection operation device 1A of the above-described embodiment, a ring-shaped operation knob 530 is provided only on the first rack member 100 instead of the first and second operation knobs 510 and 520. The second rack member 200 is provided with an indicator 600 that indicates the relative position of the second rack member 200 with respect to the controller housing 300. The indicator 600 constitutes a marking unit of the present invention. Further, in the deflection operating device 1B, two coils for urging the first rack member 100 and the second rack member 200 in a neutral position with respect to the controller housing 300 between the first rack member 100 and the controller housing 300. Spring 710 and 720 are interposed. The coil springs 710 and 720 respectively constitute the urging means of the present invention.
　他の実施形態に係る偏向操作装置１Ｂは、これらの点で上述した一実施形態に係る偏向操作装置１Ａと相違する。したがって他の実施形態の説明では一実施形態と同一構成要素には同一の符号を付してそれらの説明は省略し、上記一実施形態との相違点のみを説明する。 The deflection operation device 1B according to another embodiment is different from the deflection operation device 1A according to one embodiment described above in these respects. Therefore, in the description of the other embodiments, the same components as those of the one embodiment are designated by the same reference numerals, the description thereof will be omitted, and only the differences from the above-described embodiment will be described.
　操作ノブ５３０は、ほぼ真円状のリング形状を有し、ラック本体部１１０の長手方向中央部に一体成形されている。操作ノブ５３０は、例えば人差し指や中指がその内部に挿入され、挿入された指を操作ノブ５３０に引っ掛けて近位端側に引いたり遠位端側に押したりすることで、第１のラック部材１００が長手方向に往復変位するようになっている。そして第１のラック部材１００の往復変位と同期して第２のラック部材２００が第１のラック部材１００と逆方向に往復変位するようになっている。 The operation knob 530 has a ring shape that is almost perfectly circular, and is integrally molded in the central portion in the longitudinal direction of the rack main body 110. The operation knob 530 is a first rack member, for example, when an index finger or a middle finger is inserted inside the operation knob 530, and the inserted finger is hooked on the operation knob 530 and pulled toward the proximal end side or pushed toward the distal end side. The 100 is reciprocally displaced in the longitudinal direction. Then, the second rack member 200 is reciprocally displaced in the opposite direction to the first rack member 100 in synchronization with the reciprocating displacement of the first rack member 100.
　インジケータ６００は、第２のラック部材２００のラック本体部２１０に一体成形され、上記開口３０７ａからコントローラハウジング３００の側方に僅かに突出している。インジケータ６００は、コントローラハウジング３００とは異なる色であって目視で適確にその位置が認識できる色に着色されていることが望ましい。 The indicator 600 is integrally molded with the rack main body 210 of the second rack member 200, and slightly protrudes from the opening 307a toward the side of the controller housing 300. It is desirable that the indicator 600 is colored in a color different from that of the controller housing 300 so that its position can be accurately recognized visually.
　インジケータ６００は、第２のラック部材２００の長手方向中央部に形成されている。したがって、図１３に示すように第１のラック部材１００および第２のラック部材２００が中立位置にあるとき、インジケータ６００および操作ノブ５３０の位置が変位方向で同じ位置となるよう構成されている。 The indicator 600 is formed in the central portion in the longitudinal direction of the second rack member 200. Therefore, as shown in FIG. 13, when the first rack member 100 and the second rack member 200 are in the neutral position, the positions of the indicator 600 and the operation knob 530 are configured to be the same in the displacement direction.
　２つのコイルスプリング７１０、７２０は同じ構成のものであって、いずれも圧縮状態で第１のガイド部３５１における第１のラック部材１００の近位端側および遠位端側にそれぞれ設置されている。一方のコイルスプリング７１０は、ストッパ部３５１ｂと第１のラック部材１００との間に介装され、他方のコイルスプリング７２０は、ストッパ部３５１ａと第１のラック部材１００との間に介装されている。第１のラック部材１００はコイルスプリング７１０、７２０で両側から付勢されることにより中立位置に停止し、これに伴って第２のラック部材２００も中立位置に停止するようになっている。 The two coil springs 710 and 720 have the same configuration, and are both installed in a compressed state on the proximal end side and the distal end side of the first rack member 100 in the first guide portion 351. .. One coil spring 710 is interposed between the stopper portion 351b and the first rack member 100, and the other coil spring 720 is interposed between the stopper portion 351a and the first rack member 100. There is. The first rack member 100 is urged from both sides by the coil springs 710 and 720 to stop at the neutral position, and the second rack member 200 also stops at the neutral position accordingly.
　図１３に示す偏向操作装置１Ｂは、１つの操作ノブ５３０に指を掛け、コイルスプリング７１０、７２０の付勢力に抗して往復変位させることにより、第１のラック部材１００および第２のラック部材２００を相互に逆方向に変位させてカテーテル２の可動部２０を偏向させることができるようになっている。 In the deflection operating device 1B shown in FIG. 13, a finger is placed on one operating knob 530 and the coil springs 710 and 720 are reciprocally displaced against the urging force of the coil springs 710 and 720 to reciprocate the first rack member 100 and the second rack member. The movable portion 20 of the catheter 2 can be deflected by displacing the 200 in opposite directions.
　他の実施形態に係る偏向操作装置１Ｂによれば、コイルスプリング７１０、７２０を有することにより、操作ノブ５３０を操作することなく自動的に第１のラック部材１００および第２のラック部材２００を中立位置に保持することができる点で、操作性の向上が図られている。 According to the deflection operating device 1B according to another embodiment, by having the coil springs 710 and 720, the first rack member 100 and the second rack member 200 are automatically neutralized without operating the operation knob 530. The operability is improved in that it can be held in a position.
　この実施形態では、第１のラック部材１００および第２のラック部材２００が中立位置にあるとき、カテーテル２の可動部２０は真っ直ぐで偏向なしとなるように構成されているが、例えばカテーテル２が湾曲形状に癖付けされたものである場合には、中立位置で可動部２０が真っ直ぐであるとは限らず、そのカテーテル２の形状に対応して各ラック部材１００、２００の中立位置は設定される。 In this embodiment, the movable portion 20 of the catheter 2 is configured to be straight and unbiased when the first rack member 100 and the second rack member 200 are in the neutral position, for example the catheter 2. In the case of a curved shape, the movable portion 20 is not always straight in the neutral position, and the neutral positions of the rack members 100 and 200 are set according to the shape of the catheter 2. To.
　また、偏向操作装置１Ｂによれば、インジケータ６００によってコントローラハウジング３００に対する第２のラック部材２００の相対位置を目視して認識することにより、カテーテル２の可動部２０の偏向状態を把握することができる。なお、操作ノブ５３０によっても、コントローラハウジング３００に対する相対位置からカテーテル２の可動部２０の偏向状態を把握することは勿論可能である。すなわち操作ノブ５３０がインジケータ６００と同様の機能を有しているといえ、この点は、上記一実施形態における第１の操作ノブ５１０および第２の操作ノブ５２０についても同様にいえることである。 Further, according to the deflection operating device 1B, the deflection state of the movable portion 20 of the catheter 2 can be grasped by visually recognizing the relative position of the second rack member 200 with respect to the controller housing 300 by the indicator 600. .. Of course, it is also possible to grasp the deflection state of the movable portion 20 of the catheter 2 from the position relative to the controller housing 300 by the operation knob 530. That is, it can be said that the operation knob 530 has the same function as the indicator 600, and this point can be said for the first operation knob 510 and the second operation knob 520 in the above embodiment.
　なお、他の実施形態に係る偏向操作装置１Ｂにあっては、図１４に示すように、操作ノブ５３０が第２のラック部材２００に設けられ、インジケータ６００が第１のラック部材１００に設けられるといったように、操作ノブ５３０およびインジケータ６００を逆配置にしてもよい。 In the deflection operation device 1B according to another embodiment, as shown in FIG. 14, the operation knob 530 is provided on the second rack member 200, and the indicator 600 is provided on the first rack member 100. As such, the operation knob 530 and the indicator 600 may be arranged in reverse.
　また、図１４に示すように、コイルスプリング７２０を第２のラック部材２００とストッパ部３５２ｂとの間に移し、２つのコイルスプリング７１０、７２０双方を近位端側に配置しても、各ラック部材１００、２００を中立位置に保持することができる。この場合、各ラック部材１００、２００は、それぞれコイルスプリング７１０、７２０により遠位端側に付勢されるが、ピニオン部材４００を介して互いに拘束し合うことで中立位置に保持されるようになっている。 Further, as shown in FIG. 14, even if the coil spring 720 is moved between the second rack member 200 and the stopper portion 352b and both the two coil springs 710 and 720 are arranged on the proximal end side, each rack Members 100 and 200 can be held in a neutral position. In this case, the rack members 100 and 200 are urged toward the distal end side by the coil springs 710 and 720, respectively, but are held in the neutral position by restraining each other via the pinion member 400. ing.
　また、他の実施形態においては、図１３とは逆に、コイルスプリング７１０、７２０を第２のガイド部３５２側に設置してもよい。その場合、例えば、コイルスプリング７１０がストッパ部３５２ｂと第２のラック部材２００との間に介装され、コイルスプリング７２０がストッパ部３５２ａと第２のラック部材２００との間に介装される。 Further, in another embodiment, the coil springs 710 and 720 may be installed on the second guide portion 352 side, contrary to FIG. In that case, for example, the coil spring 710 is interposed between the stopper portion 352b and the second rack member 200, and the coil spring 720 is interposed between the stopper portion 352a and the second rack member 200.
　また、コイルスプリング７１０、７２０の双方を図１４とは逆に遠位端側に配置してもよい。その場合、例えば、コイルスプリング７１０がストッパ部３５１ａと第１のラック部材１００との間に介装され、コイルスプリング７２０がストッパ部３５２ａと第２のラック部材２００との間に介装される。 Further, both the coil springs 710 and 720 may be arranged on the distal end side contrary to FIG. In that case, for example, the coil spring 710 is interposed between the stopper portion 351a and the first rack member 100, and the coil spring 720 is interposed between the stopper portion 352a and the second rack member 200.
　また、上記各実施形態では、医療機器としてカテーテルを例にしたが、本発明の偏向操作装置は、カニューレやシース等の他のチューブ状の医療機器に適用することができる。 Further, in each of the above embodiments, a catheter is taken as an example of a medical device, but the deflection operating device of the present invention can be applied to other tubular medical devices such as a cannula and a sheath.
　本発明は、例えばカテーテル、カニューレ、シース等のチューブ状の医療機器の先端可動部を偏向操作するにあたり、片手による操作が容易であり、しかも簡素な構成を有するとともに十分な操作性を得ることができる医療機器用偏向操作装置として有用である。 According to the present invention, for example, when a movable tip of a tubular medical device such as a catheter, a cannula, or a sheath is deflected, it is easy to operate with one hand, and it has a simple structure and sufficient operability. It is useful as a deflection operating device for medical equipment that can be used.
１Ａ、１Ｂ　医療機器用偏向操作装置
２　カテーテル（医療機器）
２０　可動部
３１　第１の操作ワイヤ
３２　第２の操作ワイヤ
１００　第１のラック部材
１２０、２２０　歯部
２００　第２のラック部材
３００　コントローラハウジング
３０６、３０７　スライドガイド部
３０６ａ、３０７ａ　開口
３１０　コントローラハウジングの本体部
３２０　支持ハンドル部
３３０　ワイヤ挿通部
４００　ピニオン部材
５１０　第１の操作ノブ
５２０　第２の操作ノブ
５３０　操作ノブ
６００　インジケータ（標示部）
７１０、７２０　コイルスプリング（付勢手段）
  1A, 1B Deflection operation device for medical equipment 2 Catheter (medical equipment)
20 Movable part 31 First operation wire 32 Second operation wire 100 First rack member 120, 220 Tooth part 200 Second rack member 300 Controller housing 306, 307 Slide guide parts 306a, 307a Opening 310 Main body of controller housing Part 320 Support handle part 330 Wire insertion part 400 Pinion member 510 First operation knob 520 Second operation knob 530 Operation knob 600 Indicator (marking part)
710, 720 coil springs (biasing means)

Claims (5)

  1. 　第１の操作ワイヤおよび第２の操作ワイヤを介して医療機器の可動部を偏向操作する医療機器用偏向操作装置であって、
    　本体部と、前記本体部において前記第１の操作ワイヤおよび前記第２の操作ワイヤの延在方向に沿った長手方向の一端側に設けられた支持ハンドル部と、前記本体部の前記長手方向の他端側に設けられ前記第１の操作ワイヤおよび前記第２の操作ワイヤが挿通されたワイヤ挿通部と、を有するコントローラハウジングと、
    　前記コントローラハウジング内に、それぞれ前記長手方向に往復変位可能に、かつ、相互に対向する歯部を有するように収納された第１のラック部材および第２のラック部材と、
    　前記第１のラック部材および前記第２のラック部材の間に配置され、両ラック部材の前記各歯部に噛合する状態で前記コントローラハウジングに回転自在に支持されたピニオン部材と、を備え、
    　前記コントローラハウジングに、前記第１のラック部材および前記第２のラック部材のうち少なくとも一方に沿って溝状の開口を形成するスライドガイド部が設けられるとともに、
    　前記第１のラック部材および前記第２のラック部材のうち少なくとも一方に、前記開口を通して前記コントローラハウジングの外方に突出する操作ノブが一体に設けられており、
    　前記操作ノブが前記支持ハンドル部に対し前記長手方向に相対変位するようスライド操作されるとき、前記ピニオン部材に対し前記第１のラック部材および前記第２のラック部材が相互に逆方向に変位しつつ、前記第１の操作ワイヤおよび前記第２の操作ワイヤを前記可動部の偏向操作方向に変位させることを特徴とする医療機器用偏向操作装置。     A deflection operation device for a medical device that deflects a moving part of a medical device via a first operation wire and a second operation wire.
    A main body portion, a support handle portion provided on one end side of the main body portion in the longitudinal direction along the extending direction of the first operation wire and the second operation wire, and the longitudinal direction of the main body portion. A controller housing provided on the other end side and having a wire insertion portion through which the first operation wire and the second operation wire are inserted.
    A first rack member and a second rack member housed in the controller housing so as to be reciprocally displaceable in the longitudinal direction and having tooth portions facing each other.
    A pinion member arranged between the first rack member and the second rack member and rotatably supported by the controller housing in a state of being meshed with each tooth portion of both rack members is provided.
    The controller housing is provided with a slide guide portion that forms a groove-shaped opening along at least one of the first rack member and the second rack member.
    At least one of the first rack member and the second rack member is integrally provided with an operation knob that projects outward from the controller housing through the opening.
    When the operation knob is slid so as to be displaced relative to the support handle portion in the longitudinal direction, the first rack member and the second rack member are displaced in opposite directions with respect to the pinion member. A deflection operation device for a medical device, wherein the first operation wire and the second operation wire are displaced in the deflection operation direction of the movable portion.
  2. 　前記操作ノブは、前記第１のラック部材および前記第２のラック部材のそれぞれに設けられた第１の操作ノブおよび第２の操作ノブによって構成されていることを特徴とする請求項１に記載の医療機器用偏向操作装置。 The first aspect of the present invention, wherein the operation knob is composed of a first operation knob and a second operation knob provided on the first rack member and the second rack member, respectively. Deflection operation device for medical equipment.
  3. 　前記支持ハンドル部は、前記コントローラハウジングの前記本体部とともに略Ｔ字形状をなしていることを特徴とする請求項１または２に記載の医療機器用偏向操作装置。 The deflection operating device for a medical device according to claim 1 or 2, wherein the support handle portion has a substantially T-shape together with the main body portion of the controller housing.
  4. 　前記第１のラック部材および前記第２のラック部材のうちの少なくともいずれか一方側のラック部材と前記コントローラハウジングとの間に、前記第１のラック部材および前記第２のラック部材を前記コントローラハウジングに対する特定位置に付勢する付勢手段が介装されていることを特徴とする請求項１ないし３のいずれか一項に記載の医療機器用偏向操作装置。 Between the rack member on at least one of the first rack member and the second rack member and the controller housing, the first rack member and the second rack member are placed in the controller housing. The deflection operating device for a medical device according to any one of claims 1 to 3, wherein an urging means for urging a specific position is interposed.
  5. 　前記操作ノブは、前記第１のラック部材および前記第２のラック部材のうちのいずれか一方側のラック部材に設けられ、他方側のラック部材には、該他方側のラック部材の前記コントローラハウジングに対する相対位置を標示する標示部が設けられていることを特徴とする請求項１に記載の医療機器用偏向操作装置。
          The operation knob is provided on one of the first rack member and the second rack member, and the other rack member has the controller housing of the other rack member. The deflection operating device for a medical device according to claim 1, wherein a marking unit for marking a relative position with respect to the relative position is provided.
PCT/JP2020/045686 2019-12-12 2020-12-08 Medical instrument-use deflection operation device WO2021117724A1 (en)

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CN202080083661.9A CN114786759A (en) 2019-12-12 2020-12-08 Deflection operation device for medical equipment
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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH11262530A (en) * 1997-12-01 1999-09-28 Cordis Webster Inc Catheter with irrigatable tip
JP2007181689A (en) * 2005-12-30 2007-07-19 Biosense Webster Inc Dual-lever bi-directional handle
US20150105809A1 (en) * 2013-10-10 2015-04-16 Medtronic Vascular, Inc. Catheter pull wire actuation mechanism
US20190314609A1 (en) * 2018-04-13 2019-10-17 Merit Medical Systems, Inc. Steerable drainage devices

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9101269B2 (en) * 2011-12-15 2015-08-11 Biosense Webster (Israel), Ltd. Self-holding medical device control handle with cam actuated clutch mechanism
JP5535260B2 (en) * 2012-03-19 2014-07-02 日本ライフライン株式会社 Catheter handle

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH11262530A (en) * 1997-12-01 1999-09-28 Cordis Webster Inc Catheter with irrigatable tip
JP2007181689A (en) * 2005-12-30 2007-07-19 Biosense Webster Inc Dual-lever bi-directional handle
US20150105809A1 (en) * 2013-10-10 2015-04-16 Medtronic Vascular, Inc. Catheter pull wire actuation mechanism
US20190314609A1 (en) * 2018-04-13 2019-10-17 Merit Medical Systems, Inc. Steerable drainage devices

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