WO2021153089A1 - カテーテル - Google Patents

カテーテル Download PDF

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Publication number
WO2021153089A1
WO2021153089A1 PCT/JP2020/047613 JP2020047613W WO2021153089A1 WO 2021153089 A1 WO2021153089 A1 WO 2021153089A1 JP 2020047613 W JP2020047613 W JP 2020047613W WO 2021153089 A1 WO2021153089 A1 WO 2021153089A1
Authority
WO
WIPO (PCT)
Prior art keywords
inner pipe
catheter
tip
tube
tubular member
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/JP2020/047613
Other languages
English (en)
French (fr)
Japanese (ja)
Inventor
原田尚実
桝田多恵子
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Terumo Corp
Original Assignee
Terumo Corp
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 Terumo Corp filed Critical Terumo Corp
Priority to JP2021574535A priority Critical patent/JP7544753B2/ja
Priority to CN202080072892.XA priority patent/CN114616015B/zh
Publication of WO2021153089A1 publication Critical patent/WO2021153089A1/ja
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61M25/0113—Mechanical advancing means, e.g. catheter dispensers
    • 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
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
    • 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
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • 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
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/008—Strength or flexibility characteristics of the catheter tip
    • 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
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0082—Catheter tip comprising a tool
    • 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
    • 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
    • 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
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M2025/0063—Catheters; Hollow probes characterised by structural features having means, e.g. stylets, mandrils, rods or wires to reinforce or adjust temporarily the stiffness, column strength or pushability of catheters which are already inserted into the human body
    • 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
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/008—Strength or flexibility characteristics of the catheter tip
    • A61M2025/0081—Soft tip
    • 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
    • A61M2025/0177—Introducing, guiding, advancing, emplacing or holding catheters having external means for receiving guide wires, wires or stiffening members, e.g. loops, clamps or lateral tubes

Definitions

  • the present invention relates to a catheter.
  • Japanese Patent No. 3921108 discloses a balloon catheter for treating a lesion (stenosis or occlusion) of the fallopian tube.
  • This balloon catheter includes a flexible outer tube, an inner tube arranged in the lumen of the outer tube so as to be movable in the axial direction with respect to the outer tube, and the tip and inner tube of the outer tube. It is provided with a tubular balloon that connects the tips to each other.
  • a salpingoscope endoscope is inserted inside the balloon.
  • a balloon tubular member
  • a lead-out step is performed to spread the lesion part of the fallopian tube.
  • the pressurizing step, the advancing step, the depressurizing step, and the retreating step are sequentially performed.
  • a balloon expanding fluid is supplied to the outer space between the balloon and the outer tube to expand the balloon in the radial direction.
  • the inner tube hub provided at the base end of the inner tube is slid toward the tip of the inner tube, so that the expanded balloon is projected from the tip opening of the outer tube toward the tip together with the oviduct mirror.
  • the protruding end of the balloon is rolled up and protrudes from the tip opening of the outer tube toward the tip, the advancing distance of the balloon is half the advancing distance of the fallopian tube.
  • the advancing step is performed until the tip of the fallopian tube is located just before the protruding end of the balloon.
  • the depressurization step the pressure of the balloon expansion fluid is reduced.
  • the retreat step the salpingoscope is retracted by a predetermined length with respect to the balloon.
  • the derivation step cannot be performed efficiently.
  • the balloon and the fallopian tube mirror are at the same distance at the same time. Since it moves forward only, there is no need to perform a backward process. However, if the user vigorously slides the inner tube hub toward the tip of the inner tube, the inner tube member may unintentionally hit the inner surface of the oviduct.
  • the present invention has been made in consideration of such a problem, and provides a catheter capable of efficiently performing a derivation step and suppressing an inner tube member from unintentionally hitting an inner surface of a living organ.
  • the purpose is.
  • One aspect of the present invention is a catheter comprising a flexible outer tube and an inner tube disposed in the lumen of the outer tube so as to be movable in the axial direction with respect to the outer tube.
  • a tubular member connected to the tip of the inner tube without being fixed to the outer tube, and an inner tube for pushing the inner tube toward the tip of the inner tube with respect to the outer tube.
  • the inner tube feeding mechanism includes a feeding mechanism, the inner tube feeding mechanism has a rotation-operable operating portion, and the tubular member has a lumen into which a linear insertion portion of an endoscope can be inserted, and the tubular member.
  • the member is a catheter that projects in the distal direction from the distal end opening of the outer tube by rotating the operating portion.
  • the tubular member since the tubular member is not fixed to the outer tube, the tubular member and the endoscope can be advanced by the same distance at the same time. Therefore, it is not necessary to retract the endoscope with respect to the tubular member in the derivation process. Further, when the user rotates the operation unit, the tubular member protrudes from the tip opening of the outer tube in the tip direction, so that it is possible to prevent the tubular member from advancing well. Therefore, the derivation step can be efficiently performed, and the inner tube member can be prevented from unintentionally hitting the inner surface of the living organ.
  • FIG. 2 is a plan view of the tip of the tubular member of FIG. 2 as viewed from a direction orthogonal to the axial direction of the inner tube. It is a partially omitted perspective view of the inner pipe feed mechanism of FIG. It is a vertical cross-sectional view of the inner pipe feed mechanism of FIG. It is a vertical sectional view along the VI-VI line of FIG.
  • FIG. 5 is a cross-sectional view taken along the line VII-VII of FIG. It is sectional drawing explanatory drawing of the engagement mechanism of FIG. FIG.
  • FIG. 1 is a first explanatory view of salpingoscopic tuboplasty using the catheter system of FIG.
  • FIG. 2 is a second explanatory view of salpingoscopic tuboplasty using the catheter system of FIG.
  • FIG. 3 is a third explanatory view of salpingoscopic tuboplasty using the catheter system of FIG.
  • FIG. 12 is a plan view of the inner pipe feeding mechanism of FIG. 12 as viewed from the second support portion side. It is an exploded perspective view of the support part shown in FIG. It is a cross-sectional view along the XV-XV line of FIG. It is a vertical sectional view along the XVI-XVI line of FIG.
  • FIG. 5 is a plan view of the tip of the tubular member according to the modified example as viewed from a direction orthogonal to the axial direction of the inner pipe. It is sectional drawing explanatory drawing of the engaging mechanism which concerns on a modification.
  • the catheter system 12 includes a catheter 10 and a salpingoscope 14 (endoscope) as a medical device.
  • the catheter 10 is used, for example, in tuboplasty for treating a lesion (stenosis, occlusion, etc.) of the fallopian tube.
  • the catheter 10 may be used for treating lesions in biological organs such as blood vessels, bile ducts, trachea, esophagus, urethra, and other organs other than the fallopian tubes.
  • the left side (arrow A direction) in FIG. 1 is referred to as “tip” and the right side (arrow B direction) in FIG. 1 is referred to as "base end”.
  • the catheter 10 is attached to the outer catheter 16, the slider 18 provided on the outer catheter 16, the inner catheter 20 inserted into the outer catheter 16, and the tip of the inner catheter 20. It is provided with a provided tubular member 22.
  • the outer catheter 16 has a long flexible outer tube 24, an outer tube hub 26 provided at the base end of the outer tube 24, and a fixing screw 28 provided on the outer tube hub 26.
  • the total length of the outer tube 24 is preferably set to 100 mm or more and 1500 mm or less, and more preferably 200 mm or more and 1000 mm or less.
  • the outer tube 24 includes an outer tube main body 30 and a tip tip 32 provided at the tip of the outer tube main body 30.
  • the constituent materials of the outer tube main body 30 and the tip tip 32 include polyolefin (for example, polyethylene, polypropylene, polybutene, etc.), olefin elastomer, polyester (for example, polyethylene terephthalate, etc.), polyester elastomer, and soft polyvinyl chloride.
  • Examples thereof include flexible polymer materials such as vinyl, polyurethane, urethane-based elastomers, polyamides, amide-based elastomers, polytetrafluoroethylene, fluororesin elastomers, polyimides, ethylene-vinyl acetate copolymers, and silicone rubbers.
  • flexible polymer materials such as vinyl, polyurethane, urethane-based elastomers, polyamides, amide-based elastomers, polytetrafluoroethylene, fluororesin elastomers, polyimides, ethylene-vinyl acetate copolymers, and silicone rubbers.
  • the outer tube body 30 is a tube body having a first lumen 30a penetrating from the tip end to the base end.
  • the outer tube main body 30 has a substantially constant outer diameter from the tip end to the base end.
  • the tip end side of the outer pipe body 30 is shaped so as to be curved in an arc shape.
  • the outer surface of the tip tip 32 is curved to prevent damage to the catheter 10 and living tissue.
  • the tip tip 32 is formed with a lead-out hole 32a for leading the tubular member 22 toward the tip of the tip tip 32.
  • the outer tube hub 26 is made of hard resin or metal (stainless steel, titanium, titanium alloy, etc.).
  • hard resin include polycarbonate, acrylic resin, polyester, polyolefin, styrene resin, polyamide, polysulfone, polyarylate, polyetherimide and the like.
  • the outer tube hub 26 is formed in a hollow shape with a size that is easy to operate manually.
  • the outer tube hub 26 has a first space 34 communicating with the first lumen 30a of the outer tube 24, and is located inside the outer tube hub 26 on the proximal end side (direction of arrow B) with respect to the first space 34.
  • a first insertion hole 36 through which the catheter 20 is inserted and a lead-out port 38 communicating with the first space 34 are formed.
  • Negative pressure is generated in the lead-out port 38 due to the action of a suction pump (not shown).
  • a suction pump (not shown).
  • the perfusate led out to the distal end side of the catheter 10 via the inner catheter 20 can be drawn into the out-drawing port 38 via between the outer catheter 16 and the inner catheter 20.
  • the perfusate is, for example, saline.
  • the outer pipe hub 26 is provided with a first seal member 42 for preventing the perfusate in the first space 34 from leaking to the outside through the first insertion hole 36.
  • the fixing screw 28 fixes the inner catheter 20 to the outer tube hub 26 by screwing it into the screw hole 44 formed at the base end portion of the outer tube hub 26.
  • Examples of the constituent material of the fixing screw 28 are the same as those of the outer tube hub 26.
  • the slider 18 is provided on the outer peripheral surface of the outer pipe 24 in a state where it can be moved (sliding) in the axial direction of the outer pipe 24.
  • the total length of the slider 18 is shorter than the total length of the outer pipe 24.
  • the slider 18 has a long tubular slider main body 46 and a slider hub 48 provided at a base end portion of the slider main body 46.
  • Each of the slider body 46 and the slider hub 48 is made of the same material as the outer tube hub 26 described above.
  • the slider hub 48 is formed in an annular shape in a size that is easy to operate manually.
  • the tip side of the outer tube 24 in a state where the slider 18 is moved to the most proximal side (direction of arrow B) with respect to the outer tube 24 (a state in which the proximal end of the slider 18 is positioned at the tip of the outer tube hub 26). Is exposed on the tip side of the slider 18 and is curved in an arc shape. In a state where the slider 18 is moved to the most tip side (direction of arrow A) with respect to the outer tube 24, the tip side of the outer tube 24 extends linearly along the shape of the slider main body 46.
  • the inner catheter 20 includes a long inner tube 50 and an inner tube hub 52 provided at the proximal end of the inner tube 50.
  • the total length of the inner pipe 50 is preferably set to 100 mm or more and 1500 mm or less, and more preferably 200 mm or more and 1000 mm or less.
  • the inner tube 50 is made of a relatively hard resin (for example, fluororesin, polycarbonate, polyimide, PEEK resin, etc.) or a metal (for example, stainless steel, titanium, titanium alloy, etc.).
  • the inner tube 50 is a tube body having a second lumen 50a penetrating from the tip end to the base end.
  • the inner pipe 50 inserts the first space 34 and the first insertion hole 36 of the outer pipe hub 26.
  • the inner tube 50 is arranged in the first lumen 30a in a state where it can move in the axial direction and can rotate in the circumferential direction with respect to the outer tube 24.
  • the tip of the inner tube 50 is located in the proximal direction (arrow B direction) with respect to the tip of the outer tube 24.
  • An outer lumen 54 for guiding the perfusate to the first space 34 is provided between the inner pipe 50 and the outer pipe 24.
  • the long insertion portion 15 of the oviduct mirror 14 is inserted into the second lumen 50a of the inner tube 50.
  • the fallopian tube mirror 14 is an endoscope for photographing the inside of the fallopian tube 302 (see FIG. 9).
  • the insertion portion 15 is formed linearly and has flexibility. With the insertion portion 15 of the oviduct mirror 14 inserted into the second lumen 50a of the inner tube 50, the inner lumen 56 (lumen for perfusion) through which the perfusate flows between the inner tube 50 and the insertion portion 15 ) Is formed.
  • the perfusate is, for example, saline.
  • the inner tube hub 52 is made of the same material as the outer tube hub 26.
  • the inner tube hub 52 is formed in a hollow shape.
  • a second space 58 communicating with the second lumen 50a of the inner tube 50 and an oviduct mirror 14 located on the proximal end side of the inner tube hub 52 with respect to the second space 58 are inserted into the inner tube hub 52.
  • a second insertion hole 60 and an introduction port 62 communicating with the second space 58 are formed.
  • the introduction port 62 introduces the perfusion solution supplied from a perfusion pump or the like (not shown) into the second space 58.
  • the inner pipe hub 52 is provided with a second seal member 66 for preventing the perfusate in the second space 58 from leaking to the outside through the second insertion hole 60.
  • the tubular member 22 is a flexible tubular member and has flexibility.
  • the tubular member 22 is connected to the tip of the inner pipe 50 without being fixed to the outer pipe 24.
  • the base end portion of the tubular member 22 is adhered or fused to the tip end portion of the outer surface of the inner tube 50.
  • the base end portion of the tubular member 22 may be adhered or fused to the tip end portion of the inner surface of the inner tube 50.
  • the perfusate flows through the lumen 23 of the tubular member 22.
  • the tubular member 22 is made of a resin material such as urethane or polyester elastomer.
  • the outer diameter of the tubular member 22 is preferably set to 1.2 mm or more and 2.0 mm or less, and more preferably 1.3 mm.
  • the wall thickness of the tubular member 22 is preferably set to 0.2 mm or more and 0.7 mm or less, and more preferably 0.3 mm.
  • a lubricating film is provided on the outer surface of the tubular member 22 in order to reduce frictional resistance.
  • the lubricating film is formed, for example, by coating the outer surface of the tubular member 22 with a hydrophilic polymer.
  • the tubular member 22 has transparency. Therefore, the fallopian tube mirror 14 can photograph the outside of the tubular member 22 through the wall portion of the tubular member 22.
  • a spiral convex portion 70 is formed on the outer peripheral surface of the tubular member 22.
  • the spiral convex portion 70 extends over the entire length of the tubular member 22.
  • the spiral convex portion 70 may be provided only in the portion of the tubular member 22 that protrudes from the tip opening 24a of the outer pipe 24.
  • the tubular member 22 has a tubular main body 72 into which the insertion portion 15 of the oviduct mirror 14 is inserted, and a tip wall portion 74 connected to the tip of the tubular main body 72.
  • the outer peripheral surface of the tip wall portion 74 is tapered in the tip direction.
  • an outflow hole 78 for allowing the perfusate to flow out is formed through the tip wall portion 74.
  • the outflow hole 78 is located on the axis of the tubular member 22.
  • the diameter of the outflow hole 78 is less than 0.6 mm. That is, the diameter of the outflow hole 78 is smaller than the outer diameter of the insertion portion 15.
  • An outer space S communicating with the lead-out hole 32a and the outer lumen 54 is formed between the tubular member 22 and the outer pipe main body 30.
  • the catheter 10 further includes an inner tube feeding mechanism 80, a movement limiting mechanism 82, and an engaging mechanism 84.
  • the inner pipe feeding mechanism 80 is for pushing the inner pipe 50 toward the tip end direction (arrow A direction) of the inner pipe 50 while rotating the inner pipe 50 with respect to the outer pipe 24 in the circumferential direction of the inner pipe 50. That is, the tubular member 22 is rotated in the circumferential direction of the inner pipe 50 by transmitting the pushing force of the inner pipe feeding mechanism 80 from the inner pipe 50 to the tubular member 22, and the tubular member 22 is rotated in the circumferential direction of the outer pipe 24 from the tip opening 24a of the outer pipe 24 to the tip direction. Protruding into.
  • the inner pipe feeding mechanism 80 includes a support portion 86 provided separately from the inner pipe 50, and an engaging convex portion 88 provided on the outer peripheral surface of the inner pipe 50.
  • the support portion 86 includes a square tubular support main body 92 extending in a direction orthogonal to the axial direction of the inner pipe 50, and a first cylinder extending from the support main body 92 in the proximal direction (arrow B direction) of the inner pipe 50.
  • a portion 94 and a second tubular portion 96 extending from the support main body 92 in the direction of the tip of the inner pipe 50 (direction of arrow A) are included.
  • the first cylinder portion 94 and the second cylinder portion 96 are located at the same height position of the support main body 92 (the central portion in the longitudinal direction of the support main body 92).
  • the engaging convex portion 88 extends spirally on the outer peripheral surface of the inner pipe 50.
  • the length of the engaging convex portion 88 along the axial direction of the inner pipe 50 is set to be longer than the maximum protruding length of the tubular member 22 from the tip opening 24a of the outer pipe 24 (for example, a length of 6 cm or more).
  • the engaging convex portion 88 is not limited to the example extending in a spiral shape, and is formed, for example, by arranging annular protrusions extending in the circumferential direction of the inner pipe 50 at equal intervals in the axial direction of the inner pipe 50. You may.
  • the operation unit 89 has a feed roller unit 100 arranged in the support main body 92 so that the user can rotate the operation unit. A part of the feed roller portion 100 is exposed to the outside of the support main body 92.
  • the feed roller portion 100 includes a columnar feed roller main body 104, two first rotating shafts 106 protruding from the center of the feed roller main body 104 on both sides, and a plurality of pressing protrusions provided on the outer peripheral surface of the feed roller main body 104. Includes 108 and.
  • the first rotation axis 106 (first rotation axis Ax1 of the feed roller main body 104) extends in a direction orthogonal to the axis direction of the inner pipe 50. Specifically, each of the two first rotating shafts 106 is rotatably supported by two first bearings 110 provided on the inner surface of the support main body 92.
  • the plurality of pressing protrusions 108 are arranged at equal intervals in the circumferential direction of the feed roller main body 104. Each pressing protrusion 108 extends over the entire width of the feed roller main body 104. The pressing protrusion 108 contacts (engages) with the engaging convex portion 88 provided on the outer peripheral surface of the inner pipe 50.
  • the pressing protrusion 108 presses the engaging convex portion 88 toward the tip of the inner pipe 50 by rotating the feed roller main body 104.
  • the pushing force in the direction of arrow A acts on the inner pipe 50 by rotating the feed roller portion 100.
  • the pressing protrusion 108 also functions as a non-slip portion for the user's fingers.
  • a support roller portion 102 is provided on the side opposite to the feed roller portion 100 with respect to the inner pipe 50. That is, the inner pipe 50 is sandwiched between the feed roller portion 100 and the support roller portion 102.
  • the support roller portion 102 includes a columnar support roller main body 112 and two second rotating shafts 114 protruding from the center of the support roller main body 112 on both sides.
  • the outer peripheral surface of the support roller body 112 is recessed in an arc shape.
  • the outer peripheral surface of the support roller main body 112 is in contact with the engaging convex portion 88 provided on the inner pipe 50.
  • the second rotation axis 114 (second rotation axis Ax2 of the support roller main body 112) extends in a direction orthogonal to the axis direction of the inner pipe 50 (parallel to the first rotation axis Ax1).
  • the second rotating shaft 114 is rotatably supported by two second bearings 116 provided on the inner surface of the support main body 92.
  • the power conversion mechanism 90 is supported so as to be inserted into each of the two spiral grooves 118 and the two spiral grooves 118 provided on the outer peripheral surface of the inner pipe 50. It has two insertion protrusions 120 provided in the portion 86.
  • the length of the spiral groove 118 along the axial direction of the inner pipe 50 is the same as the length of the engaging convex portion 88 along the axial direction of the inner pipe 50.
  • the groove width of the spiral groove 118 can be set as appropriate.
  • the two spiral grooves 118 have the same spiral winding direction.
  • Each insertion protrusion 120 projects radially inward from the inner peripheral surface of the second tubular portion 96 in a columnar shape.
  • the two insertion protrusions 120 are located so as to face each other with the inner tube 50 in between.
  • Each insertion protrusion 120 is in contact with the groove side surface of the spiral groove 118 (see FIG. 7). That is, the insertion protrusion 120 presses the groove side surface of the spiral groove 118 when the inner tube 50 moves toward the tip end direction (arrow A direction) of the inner tube 50 against the support portion 86.
  • the movement limiting mechanism 82 includes two bulging portions 122 provided at the tip end portion of the inner pipe 50 and a stopper portion 124 provided on the inner surface of the outer pipe main body 30.
  • Each bulging portion 122 is formed by bulging a part of the inner pipe 50 outward in the radial direction.
  • the bulging end of each bulging portion 122 (the radial outer end of the inner pipe 50) is not in contact with the inner surface of the outer pipe main body 30.
  • the two bulging portions 122 are provided at positions displaced by 180 ° in the circumferential direction of the inner pipe 50.
  • a gap through which the perfusate can flow is formed between the two bulging portions 122 and the inner surface of the outer pipe body 30.
  • the number, position, size, and shape of the bulging portions 122 can be set as appropriate. Three or more bulging portions 122 may be provided in the circumferential direction of the inner pipe 50. The bulging portion 122 may extend in an annular shape. In this case, the perfusate circulates in the gap between the bulge 122 and the inner surface of the outer tube body 30. The bulging portion 122 may be provided separately from the inner pipe 50.
  • the stopper portion 124 is formed by a step provided on the inner surface of the outer pipe main body 30.
  • the wall thickness of the portion of the outer pipe body 30 on the tip side of the stopper portion 124 is thicker than the wall thickness of the portion of the outer pipe body 30 on the proximal end side of the stopper portion 124.
  • the stopper portion 124 extends in an annular shape.
  • the stopper portion 124 is a surface that points in the proximal direction of the outer pipe 24.
  • the distance between the bulging portion 122 and the stopper portion 124 is set according to the maximum protruding length of the tubular member 22 from the tip opening 24a of the outer pipe 24.
  • the distance between the bulging portion 122 and the stopper portion 124 is preferably set so that the maximum protruding length of the tubular member 22 is 4 cm or more and 12 cm or less, and the maximum protruding length of the tubular member 22 is 5 cm or more. It is more preferably set to be 11 cm or less, and further preferably set so that the maximum protruding length of the tubular member 22 is 6 cm.
  • the engaging mechanism 84 has two recesses 126 formed on the inner surface of the inner tube 50.
  • the recess 126 is located at the base end of the inner pipe 50.
  • Each recess 126 does not open to the base end surface of the inner pipe 50. That is, the recess 126 has a U-shaped or quadrangular cross section along the axial direction of the inner pipe 50.
  • Each of the two protrusions 128 protruding radially outward from the insertion portion 15 is inserted into each recess 126.
  • the two recesses 126 are located 180 ° apart in the circumferential direction of the inner pipe 50.
  • the perfusate supplied from the introduction port 62 of the inner pipe hub 52 to the second space 58 flows in the direction of the tip of the inner pipe 50 (direction of arrow A) through the gap between the two protrusions 128.
  • Lubricant is applied to at least one of the pressing portion 126a and the surface 128a of the protruding portion 128.
  • the frictional resistance between the pressing portion 126a and the surface 128a of the protruding portion 128 can be reduced, so that the insertion portion 15 can be effectively suppressed from rotating together with the inner pipe 50.
  • the tip of the fallopian tube mirror 14 is located immediately before the outflow hole 78 (see FIG. 2).
  • the number, position, size and shape of the recesses 126 can be appropriately set.
  • the user inserts the catheter 10 transcervically to the uterine cavity 300 and brings the tip of the outer tube 24 closer to the fallopian tube ostium 302a of the fallopian tube 302. (Insert process). At this time, the user confirms the fallopian tube opening 302a from the photographed image of the fallopian tube mirror 14.
  • a lead-out step is performed in which the tubular member 22 is led out toward the tip of the outer tube 24 to spread the lesion portion 304 of the oviduct 302.
  • the user rotates the feed roller portion 100 of the inner pipe feed mechanism 80 with the fixing screw 28 loosened.
  • a pushing force in the direction of arrow A acts on the engaging convex portion 88 provided on the outer peripheral surface of the inner pipe 50 from the pressing protrusion 108 of the feed roller portion 100.
  • the insertion protrusion 120 presses the groove side surface of the spiral groove 118, so that the pushing force is converted into a rotational force (see FIGS. 4 and 7). Therefore, the inner pipe 50 moves in the tip direction (arrow A direction) of the inner pipe 50 while rotating in the circumferential direction of the inner pipe 50 with respect to the outer pipe 24.
  • the pushing force of the inner pipe feeding mechanism 80 is transmitted from the inner pipe 50 to the tubular member 22, so that the tubular member 22 advances (advances) while rotating in the circumferential direction of the inner pipe 50 with respect to the outer pipe 24.
  • the tubular member 22 and the fallopian tube mirror 14 project toward the tip of the outer tube 24 from the tip opening 24a of the outer tube 24 while the tip of the insertion portion 15 is positioned immediately before the outflow hole 78 of the tubular member 22.
  • the user can change the forward speed of the tubular member 22 by adjusting the rotational speed of the feed roller portion 100. Therefore, the user can advance the tubular member 22 at an appropriate speed.
  • the perfusate is supplied to the introduction port 62 and the fluid in the outlet port 38 is sucked (perfusion solution supply step). Then, the perfusate supplied to the introduction port 62 flows through the second space 58, the inner lumen 56, and the lumen 23 of the tubular member 22, and flows out from the outflow hole 78 to the outside of the tubular member 22 (inside the oviduct 302). do.
  • the perfusate that has flowed out into the oviduct 302 is sucked into the outer space S through the lead-out hole 32a while contacting the outer surface of the tubular member 22.
  • the perfusate guided to the outer space S is discharged to the outside through the outer lumen 54, the first space 34, and the outlet port 38. As a result, the outer surface of the tubular member 22 becomes wet with the perfusate. In this perfusate supply step, it is not necessary to suck the fluid in the outlet port 38.
  • the user determines whether or not the tubular member 22 has reached the lesion portion 304 based on the captured image of the salpingoscope 14. Then, as shown in FIG. 11, when the tubular member 22 reaches the lesion portion 304, the lesion portion 304 is expanded by the tubular member 22. At this time, since the tubular member 22 moves forward while rotating, the lesion portion 304 can be effectively expanded. Further, the tubular member 22 can more effectively spread the lesion portion 304 by the action of the spiral convex portion 70. This improves the stenosis or obstruction of the oviduct 302.
  • the user After expanding the lesion 304, the user removes the catheter 10 (removal step). Before removing the catheter 10, physiological saline is injected through the introduction port 62, then the fallopian tube mirror 14 is inserted, and the catheter 10 is removed while observing the inside of the fallopian tube 302 with the fallopian tube mirror 14. May be good. This completes the salpingoscopic tuboplasty.
  • the catheter 10 according to the present embodiment has the following effects.
  • the catheter 10 has a flexible tubular member 22 connected to the tip of the inner tube 50 without being fixed to the outer tube 24, and the inner tube 50 to the outer tube 24 at the tip of the inner tube 50. It is provided with an inner pipe feeding mechanism 80 for pushing in a direction.
  • the inner tube feeding mechanism 80 has a rotation-operable operating portion 89, and the tubular member 22 has a lumen 23 into which the linear insertion portion 15 of the oviduct mirror 14 can be inserted.
  • the tubular member 22 projects in the tip direction from the tip opening 24a of the outer tube 24 by rotating the operation portion 89.
  • the tubular member 22 since the tubular member 22 is not fixed to the outer tube 24, the tubular member 22 and the fallopian tube mirror 14 can be advanced by the same distance at the same time. Therefore, in the derivation step, it is not necessary to retract the fallopian tube mirror 14 with respect to the tubular member 22. Further, when the user rotates the operation unit 89, the tubular member 22 protrudes from the tip opening 24a of the outer tube 24 in the tip direction, so that the tubular member 22 can be prevented from moving forward vigorously. Therefore, the derivation step can be efficiently performed, and the tubular member 22 can be prevented from unintentionally hitting the inner surface of the oviduct 302.
  • the inner pipe feeding mechanism 80 is formed so as to push the inner pipe 50 toward the tip end of the inner pipe 50 while rotating the inner pipe 50 in the circumferential direction by rotating the operation unit 89.
  • the tubular member 22 projects from the tip opening 24a of the outer tube 24 toward the tip while rotating in the circumferential direction of the inner tube 50 by transmitting the pushing force of the inner tube feeding mechanism 80 from the inner tube 50 to the tubular member 22. do.
  • the tubular member 22 projects in the distal direction from the tip opening 24a of the outer tube 24 while rotating in the circumferential direction of the inner tube 50, so that the tubular member 22 causes the lesion portion 304 (stenosis or obstruction). ) Can be effectively expanded.
  • the operation unit 89 includes a feed roller unit 100 for applying a pushing force in the tip direction of the inner pipe 50 to the inner pipe 50, and the inner pipe feeding mechanism 80 has a pushing force acting on the inner pipe 50 from the feed roller unit 100. It has a power conversion mechanism 90 that converts the inner pipe 50 into a rotational force in the circumferential direction.
  • the user can rotate the inner pipe 50 by the action of the power conversion mechanism 90 by rotating the feed roller unit 100 to apply a pushing force to the inner pipe 50. Therefore, the user can advance the inner pipe 50 and the tubular member 22 while rotating them in the circumferential direction of the inner pipe 50 by a simple operation.
  • the inner pipe feed mechanism 80 has a support portion 86 provided separately from the inner pipe 50, and the feed roller portion 100 is a first rotation axis Ax1 extending in a direction orthogonal to the axial direction of the inner pipe 50. It is provided on the support portion 86 so that it can rotate around, and the pushing force acts on the inner pipe 50 by rotating the feed roller portion 100.
  • the configuration of the inner pipe feed mechanism 80 can be simplified.
  • the inner pipe feed mechanism 80 has an engaging convex portion 88 provided on the outer peripheral surface of the inner pipe 50, and the feed roller portion 100 includes a pressing protrusion 108 that engages with the engaging convex portion 88.
  • the configuration of the inner pipe feed mechanism 80 can be further simplified.
  • the power conversion mechanism 90 has a spiral groove 118 provided on the outer peripheral surface of the inner pipe 50 and an insertion protrusion 120 provided in the support portion 86 so as to be inserted into the spiral groove 118. It is in contact with the groove side surface of the spiral groove 118.
  • a spiral convex portion 70 is formed on the outer peripheral surface of the tubular member 22.
  • the lesion portion 304 can be spread more effectively by the tubular member 22.
  • the tip of the outer peripheral surface of the tubular member 22 (the outer peripheral surface of the tip wall portion 74) is tapered in diameter toward the tip.
  • the lesion portion 304 can be expanded more effectively by the tubular member 22.
  • the inner tube 50 has a second lumen 50a into which the insertion portion 15 is inserted, the inner tube 50 is rotatable in the circumferential direction with respect to the insertion portion 15, and the inner tube 50 is inserted into the inner tube 50 from the insertion portion 15.
  • a pressing portion 126a for pressing the protruding portion 128 projecting outward in the radial direction in the tip direction is provided.
  • the insertion portion 15 can be advanced together when the inner pipe 50 is advanced. Therefore, it is possible to prevent the insertion portion 15 from being displaced in the axial direction of the inner pipe 50 with respect to the tubular member 22 during the advancing step.
  • the catheter 10 includes a movement limiting mechanism 82 that limits the amount of protrusion of the tubular member 22 from the tip opening 24a of the outer tube 24.
  • the inner pipe feeding mechanism 130 includes a support portion 132 provided separately from the inner pipe 50, and a plurality of engaging protrusions 133 spirally arranged on the outer peripheral surface of the inner pipe 50.
  • the operation unit 134 which is arranged in the support portion 132 to apply a rotational force in the circumferential direction to the inner pipe 50, and the rotational force applied from the operation unit 134 to the inner pipe 50 are pushed in the tip direction of the inner pipe 50. It has a power conversion mechanism 136 that converts it into force.
  • the support portion 132 is fixed to the outer pipe hub 26 (see FIG. 1). As shown in FIGS. 12 to 14, the support portion 132 rotatably supports the inner pipe 50.
  • the support portion 132 is provided on the first support portion 140 in which the accommodating recess 138 in which a part of the operation portion 134 is accommodated is formed, and on the first connection surface 142 in which the accommodating recess 138 in the first support portion 140 is open. It has a second support portion 144 and the like.
  • the first support portion 140 extends in a direction orthogonal to the extending direction of the inner pipe 50.
  • the accommodating recess 138 is formed in a rectangular shape in a plan view from the second support portion 144 side (see FIG. 14).
  • the accommodating recess 138 has a cross section formed in an arc shape (semicircular shape) along a direction orthogonal to the axial direction of the inner pipe 50 (see FIG. 15). That is, the bottom surface 138a forming the accommodating recess 138 is curved so as to be recessed in an arc shape.
  • the first support portion 140 has a first wall portion 146 located in the proximal direction (arrow B direction) of the inner pipe 50 with respect to the accommodating recess 138 and a tip direction (arrow A) of the inner pipe 50 with respect to the accommodating recess 138. It has a second wall portion 148 adjacent to the direction).
  • the inner surface 146a (the surface on the accommodating recess 138 side) of the first wall portion 146 is recessed toward the outer surface 146b (the surface opposite to the accommodating recess 138) of the first wall portion 146.
  • the first lateral recess 150 is formed.
  • the first lateral recess 150 is formed in a triangular shape in a plan view from the second support portion 144 side.
  • a first contact surface 152 inclined from one end side to the other end side in the longitudinal direction of the first support portion 140 toward the outer surface 146b side is formed.
  • the first contact surface 152 is inclined with respect to the axial direction of the inner pipe 50 and is inclined with respect to the surface orthogonal to the axial direction of the inner pipe 50.
  • the first wall portion 146 is formed with a first notched portion 154 cut out in an arc shape so as to open into the first connecting surface 142.
  • the first notch 154 communicates with the first lateral recess 150.
  • the second lateral recess 156 recessed toward the inner surface 148b (the surface on the accommodating recess 138 side) of the second wall portion 148 is formed. It is formed.
  • the second lateral recess 156 is formed in a triangular shape in a plan view from the second support portion 144 side.
  • a second contact surface 158 inclined from one end side to the other end side in the longitudinal direction of the first support portion 140 toward the inner surface 148b side is formed.
  • the second contact surface 158 extends parallel to the first contact surface 152.
  • the second wall portion 148 is formed with a second notch portion 160 cut out in an arc shape so as to open into the first connection surface 142.
  • the second notch 160 communicates with the second lateral recess 156.
  • the second support portion 144 is formed in a square ring shape.
  • the second support portion 144 has a second connection surface 162 that contacts the first connection surface 142 of the first support portion 140.
  • the second support portion 144 is formed with a through hole 164 communicating with the accommodating recess 138.
  • the second support portion 144 has a third wall portion 166 located in the proximal direction (arrow B direction) of the inner pipe 50 with respect to the through hole 164 and a tip direction (arrow A) of the inner pipe 50 with respect to the through hole 164. It has a fourth wall portion 168 located in the direction).
  • the third wall portion 166 is formed with a third notch portion 170 cut out in an arc shape so as to open into the second connection surface 162.
  • the first notch 154 and the third notch 170 communicate with each other to form one first hole 171.
  • An inner pipe 50 is inserted through the first hole 171.
  • the fourth wall portion 168 is formed with a fourth cutout portion 176 cut out in an arc shape so as to open into the second connecting surface 162.
  • the second notch 160 and the fourth notch 176 communicate with each other to form one second hole 177.
  • An inner pipe 50 is inserted through the second hole 177.
  • the inner surface 168a (the surface on the through hole 164 side) of the fourth wall portion 168 has a fourth lateral recess 178 recessed toward the outer surface 168b (the surface opposite to the through hole 164) of the fourth wall portion 168. It is formed.
  • each engaging protrusion 133 protrudes radially outward from the outer peripheral surface of the inner pipe 50.
  • Each engaging protrusion 133 is formed in a quadrangular pyramid shape.
  • Each engaging protrusion 133 can pass from the third side recess 172 to the first side recess 150 and from the fourth side recess 178 to the second side recess 156 when the inner pipe 50 rotates. It is formed to the size possible. The position, size, shape, and number of the engaging protrusions 133 can be appropriately set.
  • the operation unit 134 has a rotary roller unit 184 that rotates around a rotation axis Ax (see FIG. 15) extending in the axial direction of the inner pipe 50.
  • the rotary roller portion 184 is arranged in the accommodating recess 138 so that the user can perform a rotational operation. That is, a part of the rotating roller portion 184 is exposed to the outside of the support portion 132.
  • the rotary roller portion 184 includes an annular rotary roller body 186, a plurality of inner protrusions 188 provided on the inner peripheral surface of the rotary roller body 186, and a plurality of outer protrusions 190 provided on the outer peripheral surface of the rotary roller body 186. And include.
  • the inner pipe 50 is inserted through the inner hole 189 of the rotating roller main body 186.
  • the plurality of inner protrusions 188 are arranged at equal intervals in the circumferential direction of the rotating roller main body 186.
  • Each inner protrusion 188 extends over the entire width of the rotating roller body 186 (see FIG. 16).
  • the inner protrusion 188 contacts (engages) with the engagement protrusion 133 provided on the outer peripheral surface of the inner pipe 50.
  • the inner protrusion 188 is inserted into the gap between the engaging protrusions 133 adjacent to each other in the circumferential direction of the inner pipe 50.
  • the inner protrusion 188 contacts the engagement protrusion 133 from the circumferential direction of the inner pipe 50.
  • the inner protrusion 188 presses the engagement protrusion 133 in the circumferential direction of the inner pipe 50 by rotating the rotating roller portion 184. That is, the rotational force applied to the rotary roller portion 184 by the user acts on the inner pipe 50 by rotating the rotary roller portion 184.
  • the plurality of outer protrusions 190 are provided at equal intervals in the circumferential direction of the rotating roller main body 186. Each outer protrusion 190 extends over the entire width of the rotating roller body 186 (see FIGS. 12 and 16). The outer protrusion 190 functions as a non-slip portion for the user's fingers.
  • the power conversion mechanism 136 has a first contact surface 152 and a second contact surface 158 provided on the support portion 132.
  • the first contact surface 152 and the second contact surface 158 come into contact with the plurality of engaging protrusions 133 from the base end direction (arrow B direction) of the inner pipe 50.
  • the plurality of engaging protrusions 133 come into contact with the first contact surface 152 and the second contact surface 158 and are pressed in the tip direction (arrow A direction) of the inner pipe 50.
  • the inner pipe feeding mechanism 130 has the same effect as the inner pipe feeding mechanism 80 described above. Further, the operation unit 134 includes a rotary roller unit 184 for applying a rotational force in the circumferential direction to the inner pipe 50.
  • the inner pipe feeding mechanism 130 has a power conversion mechanism 136 that converts the rotational force acting on the inner pipe 50 from the rotary roller portion 184 into a pushing force in the tip direction of the inner pipe 50.
  • the user rotates the rotating roller portion 184 to apply a rotational force in the circumferential direction to the inner pipe 50, and by the action of the power conversion mechanism 136, the tip direction (arrow) of the inner pipe 50.
  • the inner tube 50 can be moved in the A direction). Therefore, the user can move the inner pipe 50 and the tubular member 22 forward while rotating with respect to the outer pipe 24 by a simple operation.
  • the rotating roller portion 184 is provided so as to rotate around the rotating axis Ax extending in the axial direction of the inner pipe 50, and the rotational force acts on the inner pipe 50 by rotating the rotating roller portion 184.
  • the configuration of the inner pipe feed mechanism 130 can be simplified.
  • the inner pipe feeding mechanism 130 has a plurality of engaging protrusions 133 spirally arranged on the outer peripheral surface of the inner pipe 50.
  • the rotary roller portion 184 has an inner hole 189 through which the inner tube 50 is inserted, and the inner surface forming the inner hole 189 is an inner protrusion that contacts a plurality of engaging protrusions 133 from the circumferential direction of the inner tube 50. 188 is provided.
  • the rotational force of the rotating roller portion 184 can be efficiently transmitted to the inner pipe 50.
  • the inner pipe feeding mechanism 130 has a support portion 132 provided separately from the inner pipe 50, and the power conversion mechanism 136 has the base end direction of the inner pipe 50 with respect to the plurality of engaging protrusions 133 (arrow B).
  • the first contact surface 152 and the second contact surface 158 provided on the support portion 132 so as to come into contact with each other from the direction) are included.
  • the engaging projection 133 is pushed from the first contact surface 152 and the second contact surface 158 toward the tip of the inner pipe 50. Since the pressure acts, the inner tube 50 can be moved toward the tip end with respect to the outer tube 24.
  • the catheter 10 may have the tubular member 192 shown in FIG. 17 instead of the tubular member 22 described above.
  • the tubular member 192 includes a tubular main body portion 72 and a tip wall portion 194.
  • the tip wall portion 194 has a substantially constant outer diameter from the tubular main body portion 72 to the tip of the tubular member 192.
  • the tip corner portion 194a of the tip wall portion 194 is formed in an R shape.
  • the tubular member 192 can prevent the oviduct 302 (living organ) from being damaged.
  • the catheter 10 may include the engagement mechanism 195 shown in FIG. 18 instead of the engagement mechanism 84 described above.
  • the engaging mechanism 195 has two recesses 196 formed on the inner surface of the base end portion of the inner pipe 50 so as to open to the base end surface of the inner pipe 50, and the base end direction of the inner pipe 50. Includes the base end wall portion 198 mounted in the recess 196 from (direction of arrow B).
  • a locking hole 202 into which the locking projection 200 provided on the base end wall portion 198 is fitted is formed on the surface forming the recess 196.
  • the base end wall portion 198 is provided with a pressing portion 198a that presses the surface 128a of the protruding portion 128 that points in the base end direction in the tip direction (arrow A direction).
  • the base end wall portion 198 is removable from the inner pipe 50.
  • the inner pipe hub 52 is formed to be detachable from the inner pipe 50. Further, the inner pipe hub 52 may be omitted.
  • Such an engaging mechanism 195 has the same effect as the above-mentioned engaging mechanism 84. Further, since the proximal wall portion 198 is removable from the inner tube 50, the fallopian tube mirror 14 can be attached to the catheter 10 when the catheter 10 is used. That is, the catheter 10 can be used as a disposable item and the salpingoscope 14 can be used as a reused item.
  • the inner pipe feeding mechanism (80, 130) for pushing the inner pipe toward the tip of the inner pipe is provided, and the inner pipe feeding mechanism has an operation unit (89, 134) that can be rotated and operated.
  • the tubular member has a lumen (23) into which the linear insertion portion (15) of the endoscope (14) can be inserted, and the tubular member is formed by rotating the operation portion of the outer tube.
  • a catheter that projects in the distal direction from the distal opening (24a).
  • the inner tube feeding mechanism is formed so as to push the inner tube toward the tip of the inner tube while rotating the inner tube in the circumferential direction of the inner tube by rotating the operation unit. Even if the tubular member projects from the tip opening of the outer tube toward the tip while rotating in the circumferential direction of the inner tube by transmitting the pushing force of the inner tube feeding mechanism from the inner tube to the tubular member. good.
  • the operating portion includes a feed roller portion (100) for applying a pushing force in the tip direction of the inner tube to the inner tube, and the inner tube feeding mechanism is described from the feed roller portion. It may have a power conversion mechanism (90) that converts the pushing force acting on the inner pipe into a rotational force in the circumferential direction of the inner pipe.
  • the inner tube feeding mechanism has a support portion (86) provided separately from the inner tube, and the feeding roller portion extends in a direction orthogonal to the axial direction of the inner tube.
  • the support portion is provided so as to be rotatable around the rotation axis (Ax1), and the pushing force may act on the inner pipe by rotating the feed roller portion.
  • the inner tube feeding mechanism has an engaging convex portion (88) provided on the outer peripheral surface of the inner tube, and the feeding roller portion is a pressing protrusion that engages with the engaging convex portion. (108) may be included.
  • the power conversion mechanism includes a spiral groove (118) provided on the outer peripheral surface of the inner tube and an insertion protrusion (120) provided in the support portion so as to be inserted into the spiral groove. , And the insertion protrusion may come into contact with the groove side surface of the spiral groove.
  • the operating portion includes a rotating roller portion (184) for applying a rotational force in the circumferential direction to the inner tube, and the inner tube feeding mechanism acts on the inner tube from the rotating roller portion. It may have a power conversion mechanism (136) that converts the rotational force into a pushing force in the tip direction of the inner pipe.
  • the rotating roller portion is provided so as to rotate around a rotating axis (Ax) extending in the axial direction of the inner tube, and the rotational force is applied by the rotation of the rotating roller portion. It may act on the inner tube.
  • the inner tube feeding mechanism has a plurality of engaging protrusions (133) spirally arranged on the outer peripheral surface of the inner tube, and the inner tube is inserted into the rotating roller portion.
  • An inner protrusion (188) having an inner hole (189) and forming the inner hole may be provided with an inner protrusion (188) that contacts the plurality of engaging protrusions from the circumferential direction of the inner pipe.
  • the inner tube feeding mechanism has a support portion (132) provided separately from the inner tube, and the power conversion mechanism has the inner tube for the plurality of engaging protrusions.
  • the contact surface (152, 158) provided on the support portion may be included so as to make contact from the proximal end direction of the support portion.
  • a spiral convex portion (70) may be provided on the outer peripheral surface of the tubular member.
  • the inner tube has a lumen (50a) into which the insertion portion is inserted, the inner tube is rotatable in the circumferential direction with respect to the insertion portion, and the inner tube has a cavity (50a) into which the insertion portion is inserted.
  • Pressing portions (126a, 198a) for pressing the protruding portion (128) protruding outward in the radial direction from the insertion portion in the tip direction may be provided.
  • the tip of the outer peripheral surface of the tubular member may be tapered in diameter toward the tip.
  • the tip corner portion (194a) of the tubular member may be formed in an R shape.
  • the catheter may be provided with a movement limiting mechanism (82) that limits the amount of protrusion of the tubular member from the tip opening of the outer tube.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH05200120A (ja) * 1991-10-18 1993-08-10 Imagyn Medical Inc 外翻カテーテルおよび外翻カテーテルに細長い器具を位置決めする方法
US5935098A (en) * 1996-12-23 1999-08-10 Conceptus, Inc. Apparatus and method for accessing and manipulating the uterus
JP2004283588A (ja) * 2003-03-20 2004-10-14 Medtronic Vascular Inc 血管内装置用制御ハンドル
WO2010110043A1 (ja) * 2009-03-25 2010-09-30 テルモ株式会社 バルーンカテーテルおよびバルーンカテーテル組立体
JP2012010880A (ja) * 2010-06-30 2012-01-19 Terumo Corp 医療用装置
JP2018186900A (ja) * 2017-04-28 2018-11-29 株式会社北里コーポレーション 卵管狭窄部改善具

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007185379A (ja) * 2006-01-13 2007-07-26 Olympus Medical Systems Corp 回転自走式内視鏡
JP4493608B2 (ja) * 2006-03-06 2010-06-30 テルモ株式会社 アテレクトミーカテーテル

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH05200120A (ja) * 1991-10-18 1993-08-10 Imagyn Medical Inc 外翻カテーテルおよび外翻カテーテルに細長い器具を位置決めする方法
US5935098A (en) * 1996-12-23 1999-08-10 Conceptus, Inc. Apparatus and method for accessing and manipulating the uterus
JP2004283588A (ja) * 2003-03-20 2004-10-14 Medtronic Vascular Inc 血管内装置用制御ハンドル
WO2010110043A1 (ja) * 2009-03-25 2010-09-30 テルモ株式会社 バルーンカテーテルおよびバルーンカテーテル組立体
JP2012010880A (ja) * 2010-06-30 2012-01-19 Terumo Corp 医療用装置
JP2018186900A (ja) * 2017-04-28 2018-11-29 株式会社北里コーポレーション 卵管狭窄部改善具

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