WO2021200998A1 - Moyeu de bride, corps long et étroit, et accessoire - Google Patents

Moyeu de bride, corps long et étroit, et accessoire Download PDF

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Publication number
WO2021200998A1
WO2021200998A1 PCT/JP2021/013626 JP2021013626W WO2021200998A1 WO 2021200998 A1 WO2021200998 A1 WO 2021200998A1 JP 2021013626 W JP2021013626 W JP 2021013626W WO 2021200998 A1 WO2021200998 A1 WO 2021200998A1
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WO
WIPO (PCT)
Prior art keywords
wire
flange
holes
hole
pair
Prior art date
Application number
PCT/JP2021/013626
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English (en)
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.)
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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 JP2022512570A priority Critical patent/JPWO2021200998A1/ja
Publication of WO2021200998A1 publication Critical patent/WO2021200998A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • 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
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
    • G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes

Definitions

  • the present invention relates to a flange hub arranged between two elongated elements included in an elongated body, an elongated body provided with the flange hub, and an instrument provided with the elongated body.
  • ERCP endoscopic retrograde cholangiopancreatography
  • a thin tube (cannula) extending from the tip of the endoscope is inserted into the bile duct or the like from the duodenal papilla to inject a contrast medium. It takes an X-ray photograph.
  • a flexible passive tube is usually used, and the operator can operate the tube at any time while checking the X-ray perspective image and the endoscopic camera image. Is inserted into the papilla to reach the desired position.
  • an endoscope in which a movable tube that can be bent by traction of a wire is inserted inside is used. In this case, by manipulating the endoscope and the movable tube, the tube is inserted into the papilla and reached the desired position.
  • the tube 100 it is necessary to bend the tip portion 100a of the tube 100 and insert the tip portion 100a of the tube 100 into the cystic duct 200 while the main body of the tube 100 remains along the common bile duct 203 in front of the bifurcation portion 202.
  • the tube 100 may come into contact with the common bile duct 203, so the tip 100a of the tube 100 is inserted into the cystic duct 200 (desired branch duct). Things that cannot be done can often occur.
  • Patent Document 1 discloses a tube (medical device) capable of bending the tip portion.
  • the tube disclosed in Patent Document 1 includes a first wire (first operating line) and a second wire (first operating line) that are wired so as to approach each other toward the tip end side, and the first wire and the tube are provided. It is possible to bend the tip of the tube (medical device) by pulling the second wire.
  • the first wire and the second wire are inserted into the first hollow tube and the second hollow tube, respectively. Therefore, in the curved region in which the first wire and the second wire are wired so as to approach each other, the first hollow pipe and the second hollow pipe gradually approach each other in the entire length of the region. It is necessary to bend the empty pipe and the second hollow pipe. Further, in the tube of Patent Document 1, in order to maintain the state in which the first wire and the second wire are close to each other in the curved region, the wound wire is laid outward in the radial direction of the first hollow tube and the second hollow tube. It is necessary to wind the pipe and to embed the first hollow pipe and the second hollow pipe in the resin pipe.
  • the present invention has been made in view of the above matters, and an object of the present invention is a flange hub provided on an elongated body having two adjacent elongated elements, based on bending of the elongated element on the tip side.
  • a flange hub that can easily adjust the direction of the wire required to cause the bending of the elongated element on the end side to be larger than the bending of the elongated element, an elongated body having the flange hub, and an instrument having the elongated body. Is to provide.
  • the present invention includes the subjects described in the next section.
  • a flange hub provided on an elongated body
  • the elongated body has the flange hub arranged between two adjacent elongated elements.
  • the flange hub includes a hub body extending in the longitudinal direction of the elongated body, a tip flange protruding annularly from the outer periphery of the tip of the hub body, and a proximal flange protruding annularly from the outer periphery of the proximal end of the hub body.
  • a pair of first through holes extending in the longitudinal direction are formed in the tip flange.
  • a pair of second through holes extending in the longitudinal direction are formed in the base end flange.
  • the pair of first through holes and the pair of second through holes are flange hubs formed so as to satisfy the following conditions 1 and 2.
  • Condition 1 When the slender body is divided into one side and the other side with the first plane extending along the center line of the slender body as a boundary, the shortest distance from the first plane is the first distance.
  • One of the first through holes is formed at a position on the side, and the other first through hole is formed at a position on the other side where the shortest distance from the first plane is the first distance.
  • One of the second through holes is formed at a position on one side where the shortest distance from one plane is the second distance, and at a position on the other side where the shortest distance from the first plane is the second distance.
  • the other second through hole is formed.
  • Condition 2 When the slender body is divided into one side and the other side with a second plane extending along the center line of the slender body and orthogonal to the first plane as a boundary, the pair of first planes.
  • the one through hole and the pair of second through holes are formed on the same side, and the pair of first through holes are formed at positions where the shortest distance from the second plane is the third distance.
  • the pair of second through holes are formed at positions where the shortest distance from the second plane is the fourth distance, and the third distance is longer than the fourth distance.
  • the hub body has a hollow cylindrical shape.
  • Item 2. The flange hub according to Item 1, wherein holes are formed on the tip end side and the base end side of the hub body so as to penetrate the tubular wall of the hub body in the thickness direction.
  • Item 3 A pair of third through holes extending in the longitudinal direction are formed in the tip flange. A pair of fourth through holes extending in the longitudinal direction are formed in the base end flange. Item 2. The flange hub according to Item 1 or 2, wherein the pair of third through holes and the pair of fourth through holes are formed so as to satisfy the following conditions 3 and 4. Condition 3: When the slender body is divided into one side and the other side with the one plane extending along the center line of the slender body as a boundary, which is a plane different from the first plane. One of the third through holes is formed at a position on one side where the shortest distance from the one plane is the fifth distance, and the position on the other side where the shortest distance from the one plane is the fifth distance.
  • the other third through hole is formed, and one of the fourth through holes is formed at a position on one side where the shortest distance from the one plane is the sixth distance, and the fourth through hole is formed from the one plane.
  • the other fourth through hole is formed at a position on the other side where the shortest distance is the sixth distance.
  • Condition 4 When the slender body is divided into one side and the other side with a two plane extending along the center line of the slender body and orthogonal to the one plane as a boundary, the pair of first planes.
  • the three through holes and the pair of fourth through holes are formed on the same side, and the pair of third through holes are formed at positions where the shortest distance from the two planes is the seventh distance.
  • the pair of fourth through holes are formed at positions where the shortest distance from the second plane is the eighth distance, and the seventh distance is longer than the eighth distance.
  • Item 4. The flange hub according to Item 3, wherein a plurality of pairs of the pair of third through holes and the pair of fourth through holes satisfying the conditions 3 and 4 are formed.
  • Item 5 When the one plane is the second plane and the second plane is the first plane, the pair of third through holes and the pair of fourth through holes that satisfy the conditions 3 and 4 are formed. Item 3. The flange hub according to Item 3.
  • Item 6 As the pair of first through holes and the pair of second through holes that satisfy the conditions 1 and 2, a pair of first through holes, a pair of second through holes, and a first set that satisfy the following condition 5. Two sets of a pair of first through holes and a pair of second through holes are provided. As the pair of third through holes and the pair of fourth through holes that satisfy the conditions 3 and 4, the third set of third through holes and the pair of fourth through holes that satisfy the following condition 6 and the first Item 5.
  • the flange hub according to Item 5 wherein four sets of a pair of third through holes and a pair of fourth through holes are provided.
  • Condition 5 The pair of first through holes in the first set and the pair of first through holes in the second set are formed at positions that are line-symmetric with respect to the second plane, and are formed in the first set.
  • the pair of second through holes and the second set of the pair of second through holes are formed at positions that are line-symmetric with respect to the second plane.
  • Condition 6 The pair of third through holes in the third set and the pair of third through holes in the fourth set are formed at positions that are line-symmetric with respect to the first plane, and are formed in the third set.
  • the pair of fourth through holes and the fourth set of the pair of fourth through holes are formed at positions that are line-symmetric with respect to the first plane.
  • Item 7 An elongated body in which the flange hub according to any one of Items 1 to 6 is arranged between two elongated elements adjacent to each other in the longitudinal direction.
  • one of the elongated elements arranged on the distal end side in the longitudinal direction has its base end surface joined to the distal end flange of the flange hub.
  • the other elongated element arranged on the proximal end side in the longitudinal direction has its tip surface joined to the proximal end flange of the flange hub.
  • the pair of first through holes formed in the flange hub communicate with a wire lumen that penetrates one of the elongated elements in the longitudinal direction.
  • the pair of second through holes formed in the flange hub is an elongated body that communicates with a wire lumen that penetrates the other elongated element in the longitudinal direction.
  • the flange hub is the flange hub according to any one of Items 3 to 6.
  • the pair of third through holes formed in the flange hub communicate with a wire lumen that penetrates one of the elongated elements in the longitudinal direction.
  • Item 7. The elongated body according to Item 7, wherein each of the pair of fourth through holes formed in the flange hub communicates with a wire lumen penetrating the other elongated element in the longitudinal direction.
  • the flange hub is the flange hub according to Item 6.
  • the pair of first through holes of the first set formed in the flange hub communicates the one elongated element with the pair of first wire lumens penetrating in the longitudinal direction.
  • the pair of first through holes of the second set formed in the flange hub communicates the one elongated element with the pair of second wire lumens penetrating in the longitudinal direction.
  • the pair of third through holes of the third set formed in the flange hub communicates the one elongated element with the pair of third wire lumens penetrating in the longitudinal direction.
  • the pair of third through holes of the fourth set formed in the flange hub communicates the one elongated element with the pair of fourth wire lumens penetrating in the longitudinal direction.
  • the pair of second through holes in the first set formed in the flange hub communicate with the pair of fifth wire lumens penetrating the other elongated element in the longitudinal direction.
  • the pair of second through holes in the second set formed in the flange hub communicates with the pair of sixth wire lumens penetrating the other elongated element in the longitudinal direction.
  • the pair of fourth through holes of the third set formed in the flange hub communicate with the pair of seventh wire lumens penetrating the other elongated element in the longitudinal direction.
  • the first elongated element, the second elongated element, and the third elongated element are connected in this order from the tip side in the longitudinal direction, and are adjacent to the first elongated element in the longitudinal direction.
  • a first flange hub is arranged between the second elongated element, and a second flange hub is arranged between the second elongated element and the third elongated element that are adjacent to each other in the longitudinal direction.
  • the first and second flange hubs are the flange hubs according to Item 6, respectively, and the second distance of the first flange hub and the seventh distance of the second flange hub coincide with each other.
  • the fourth distance of the first flange hub coincides with the fifth distance of the second flange hub, and the sixth distance of the first flange hub and the third distance of the second flange hub are They match, and the eighth distance of the first flange hub and the first distance of the second flange hub match.
  • the base end surface of the first elongated element is joined to the tip flange of the first flange hub.
  • the tip surface of the second elongated element is joined to the base end flange of the first flange hub.
  • the base end surface of the second elongated element is joined to the tip flange of the second flange hub.
  • the tip surface of the third elongated element is joined to the base end flange of the second flange hub.
  • the pair of first through holes of the first set formed in the first flange hub communicate with the pair of first wire lumens penetrating the first elongated element in the longitudinal direction.
  • the pair of first through holes of the second set formed in the first flange hub communicates with the pair of second wire lumens penetrating the first elongated element in the longitudinal direction.
  • the pair of third through holes of the third set formed in the first flange hub communicate the first elongated element with the pair of third wire lumens penetrating in the longitudinal direction.
  • the pair of third through holes of the fourth set formed in the first flange hub communicate the first elongated element with the pair of fourth wire lumens penetrating in the longitudinal direction.
  • the pair of second through holes of the first set formed in the first flange hub communicate the second elongated element with a pair of fifth wire lumens penetrating in the longitudinal direction.
  • the pair of second through holes of the second set formed in the first flange hub communicate the second elongated element with the pair of sixth wire lumens penetrating in the longitudinal direction.
  • the pair of fourth through holes of the third set formed in the first flange hub communicate with the pair of seventh wire lumens penetrating the second elongated element in the longitudinal direction.
  • the pair of fourth through holes of the fourth set formed in the first flange hub communicate the second elongated element with the pair of eighth wire lumens penetrating in the longitudinal direction.
  • one of the first through holes communicates with one of the seventh wire lumens and the other first through.
  • the hole communicates with one of the eighth wire lumens, Of the pair of first through holes of the second set formed in the second flange hub, one of the first through holes communicates with the other of the other seventh wire lumen, and the other first through hole communicates with the other.
  • One through hole communicates with the other eighth wire lumen, Of the pair of third through holes of the third set formed in the second flange hub, one of the third through holes communicates with one of the fifth wire lumens and the other of the third through holes.
  • the hole communicates with one of the sixth wire lumens.
  • one of the third through holes communicates with the other fifth wire lumen, and the other third through hole communicates with the other.
  • the hole communicates with the other sixth wire lumen and
  • the pair of second through holes of the first set formed in the second flange hub communicate with the pair of ninth wire lumens penetrating the third elongated element in the longitudinal direction.
  • the pair of second through holes of the second set formed in the second flange hub communicates with the pair of tenth wire lumens penetrating the third elongated element in the longitudinal direction.
  • the pair of fourth through holes of the third set formed in the second flange hub communicate with the pair of eleventh wire lumens penetrating the third elongated element in the longitudinal direction.
  • Item 7 wherein the pair of fourth through holes of the fourth set formed in the second flange hub communicate with a pair of twelve wire lumens penetrating the third elongated element in the longitudinal direction. Slender body.
  • Item 11 The slender body according to Item 7 and An instrument equipped with a wire
  • the wire is one wire lumen formed in the other elongated element, one second through hole communicating with the other, between the base end flange and the tip end flange of the flange hub, and the first one.
  • one end of the wire extends from the one wire lumen and the other end of the wire extends from the four wire lumens.
  • the first wire is one wire lumen formed in the other elongated element, one second through hole communicating with the first wire lumen, and one between the base end flange and the tip end flange of the flange hub. After sequentially passing through the first through hole and the two wire lumens formed in the one elongated element communicating with the first through hole, the three wire lumens formed in the one elongated element are bent and communicated with the first elongated element.
  • the second wire includes five wire lumens formed on the other elongated element, one of the third through holes communicating with the fifth wire lumen, and one of the flange hubs between the base end flange and the tip end flange.
  • the first wire includes one fifth wire lumen, one second through hole of the first set communicating with the fifth wire lumen, and the first set between the base end flange and the tip flange of the flange hub. After sequentially passing through one of the first through holes and one of the first wire lumens communicating with the first wire lumen, the other first wire lumen communicating with the other first wire lumen and the other of the first set communicating with the first wire lumen.
  • the first through hole, between the tip flange of the flange hub and the base end flange sequentially passes through the other second through hole of the first set and the other fifth wire lumen communicating with the first through hole.
  • the second wire includes one of the sixth wire lumens, one of the second through holes of the second set communicating with the sixth wire lumen, and the second set between the base end flange and the tip end flange of the flange hub.
  • the third wire is one of the seventh wire lumen, one of the fourth through holes of the third set communicating with the seventh wire lumen, and the third set between the base end flange and the tip flange of the flange hub. After sequentially passing through one of the third through holes and one of the third wire lumens communicating with the third wire lumen, the other third wire lumen communicating with the third wire lumen, and the other of the third set communicating with the third wire lumen.
  • the third through hole, between the tip flange of the flange hub and the base end flange sequentially passes through the other fourth through hole of the third set and the other eighth wire lumen communicating with the third through hole.
  • the fourth wire includes one of the eighth wire lumens, one of the fourth through holes of the fourth set communicating with the eighth wire lumen, and the fourth set between the base end flange and the tip end flange of the flange hub. After sequentially passing through one of the third through holes and one of the fourth wire lumens communicating with the third through hole, the fourth wire lumen communicating with the other fourth wire lumen and the other of the fourth set communicating with the fourth wire lumen are bent.
  • the third through hole, between the tip flange of the flange hub and the base end flange sequentially passes through the other fourth through hole of the fourth set and the other eighth wire lumen communicating with the fourth through hole.
  • one end of the first wire extends from the one fifth wire lumen and the other end of the first wire extends from the other fifth wire lumen.
  • One end of the second wire extends from the one sixth wire lumen, one end of the second wire extends from the other sixth wire lumen, and one end of the third wire is the one.
  • the other end of the third wire extends from the other seventh wire lumen, and one end of the fourth wire extends from the one eighth wire lumen.
  • the other end of the fourth wire extends from the other eighth wire lumen, and one end and the other end of the first wire are pulled in the longitudinal direction of the elongated body, and the second One end and the other end of the wire can be pulled in the longitudinal direction of the elongated body, one end and the other end of the third wire can be pulled in the longitudinal direction of the elongated body, and the fourth wire can be pulled.
  • Item 14 The slender body according to Item 10 and With the first wire With the second wire With the third wire
  • An instrument equipped with a fourth wire The first wire includes one of the ninth wire lumens, one of the second through holes of the first set formed in the second flange hub communicating with the ninth wire lumen, and the base end flange of the second flange hub. After sequentially passing through the first through hole of one of the first set formed in the second flange hub and the seventh wire lumen of one communicating with the tip flange, the tip flange is bent and then bent.
  • the second wire includes one of the tenth wire lumens, one of the second through holes of the second set formed in the second flange hub communicating with the tenth wire lumen, and the base end flange of the second flange hub.
  • the second set After sequentially passing through the first through hole of one of the second set formed in the second flange hub and the seventh wire lumen of the other communicating with the tip flange, the second set is bent.
  • the third wire includes one eleventh wire lumen, one fourth through hole of the third set formed in the second flange hub communicating with the eleventh wire lumen, and the base end flange of the second flange hub.
  • the tip flange one of the third through holes of the third set formed in the second flange hub, the fifth wire lumen communicating with the third through hole, and the first flange communicating with the fifth wire lumen.
  • the other fifth wire lumen communicating with the through hole
  • the third through hole of one of the fourth set formed in the second flange hub communicating with the through hole
  • the tip flange of the second flange hub It sequentially passes between the base end flange and the other fourth through hole of the third set formed in the second flange hub, and the other eleventh wire lumen communicating with the fourth through hole.
  • the fourth wire includes one of the twelfth wire lumens, one of the fourth through holes of the fourth set formed in the second flange hub communicating with the twelfth wire lumen, and the proximal flange of the second flange hub. And the tip flange, the other third through hole of the third set formed in the second flange hub, the sixth wire lumen communicating with the sixth wire lumen, and the first flange communicating with the sixth wire lumen.
  • the second wire lumen After sequentially passing through one of the first through holes and one of the second wire lumens communicating with the first through hole, the second wire lumen is bent to form the second wire lumen of the other and the first flange hub communicating with the second wire lumen.
  • the second through hole of the other of the second set, the second of the other of the second set formed in the first flange hub between the tip flange and the base end flange of the first flange hub.
  • the other sixth wire lumen communicating with the sixth wire lumen, the other third through hole of the fourth set formed in the second flange hub communicating with the through hole, and the tip flange of the second flange hub.
  • one end of the first wire extends from the one ninth wire lumen and the other end of the first wire extends from the other ninth wire lumen.
  • One end of the second wire extends from the one tenth wire lumen, one end of the second wire extends from the other tenth wire lumen, and one end of the third wire is the one.
  • the other end of the third wire extends from the eleventh wire lumen of the other, and one end of the fourth wire extends from the twelfth wire lumen of the other.
  • the other end of the fourth wire extends from the other twelfth wire lumen.
  • One end and the other end of the first wire are pulled in the longitudinal direction of the elongated body
  • one end and the other end of the second wire are pulled in the longitudinal direction of the elongated body
  • a cylindrical tip tip attached to one slender element arranged on the most tip side among the slender elements constituting the slender body is further provided.
  • a part or the whole of the outer peripheral surface of the tip tip is a tapered surface whose diameter is reduced toward the tip side, and the tubular wall of the tip tip has a through hole extending in the longitudinal direction of the elongated body (hereinafter referred to as a through hole). Tip through hole) is formed, The tip through hole is formed for each of the wire lumens formed in the one elongated element, and the base of the tip tip so that each tip through hole communicates with the corresponding wire lumen.
  • the end face is joined to the tip face of the one elongated element.
  • the wire passed through the two wire lumens formed in the one elongated element sequentially passes through one wire lumen and the one tip through hole communicating with the one wire lumen, and then bends to penetrate the second tip.
  • Item 2 The device according to any one of Items 11 to 14, wherein the hole and the other wire lumen communicating with the hole are sequentially passed through the hole.
  • a plate material attached to one elongated element arranged on the most tip side among the elongated elements constituting the elongated body is further provided.
  • the plate material is formed with through holes extending in the longitudinal direction of the elongated body (hereinafter referred to as plate material through holes).
  • the plate material through hole is formed for each of the wire lumens formed in the one elongated element, and the base end surface of the plate material so that each of the chip through holes communicates with the corresponding wire lumen. Is joined to the tip surface of the one elongated element.
  • the wire passed through the two wire lumens formed in the one elongated element sequentially passes through one wire lumen and the one plate material through hole communicating with the wire lumen, and then bends to penetrate the second plate material.
  • Item 2 The device according to any one of Items 11 to 14, wherein the hole and the other wire lumen communicating with the hole are sequentially passed through the hole.
  • Item 17 The slender body according to Item 7 and With the first wire An instrument equipped with a second wire
  • the first wire is one wire lumen formed in the other elongated element, one second through hole communicating with the first wire lumen, and one between the base end flange and the tip end flange of the flange hub.
  • One end of the one wire that sequentially passes through the first through hole and the two wire lumens formed in the one elongated element communicating with the first through hole and extends from the two wire lumens is the one elongated.
  • the second wire is a three wire lumen formed in the other elongated element, the other second through hole communicating with the third wire lumen, between the base end flange and the tip end flange of the flange hub, and the other.
  • One end of the other wire extending from the four wire lumens sequentially passing through the first through hole and the four wire lumens formed in the one elongated element communicating with the first through hole is the one elongated. It is fixed to the tip of the element and On the proximal end side of the elongated body, the other end of the first wire extends from the one wire lumen and the other end of the second wire extends from the third wire lumen.
  • An instrument capable of pulling the other end of the first wire and the other end of the second wire in the longitudinal direction of the elongated body.
  • the wire is passed through the through hole of the flange hub to adjust the direction of the wire required to cause the bending of the elongated element on the distal end side to be larger than the bending of the elongated element on the proximal end side. It can be realized by the simple work.
  • FIG. 1 It is a perspective view which shows a part of the apparatus which concerns on 1st Embodiment of this invention. It is a perspective view which shows a part of the apparatus which concerns on 1st Embodiment of this invention.
  • (A) is a front view showing a tip flange
  • (B) is a front view showing a base flange.
  • (A) and (B) are perspective views showing the tip portion of an elongated body provided with a tip tip.
  • FIG. 1 It is a perspective view which shows a part of the apparatus which concerns on 2nd Embodiment of this invention.
  • (A) is a front view showing a tip flange
  • (B) is a front view showing a base flange.
  • FIG. 1 It is a perspective view which shows a part of the apparatus which concerns on 3rd Embodiment of this invention.
  • (A) is a front view showing a tip flange
  • (B) is a front view showing a base flange.
  • (A) and (B) are perspective views which show a part of the apparatus which concerns on 4th Embodiment of this invention.
  • FIG. 1 A) and (B) are perspective views which show a part of the apparatus which concerns on 4th Embodiment of this invention.
  • FIG. 1 A) and (B) are perspective views which show a part of the apparatus which concerns on 4th Embodiment of this invention.
  • FIG. 1 A) and (B) are perspective views which show a part of the apparatus which concerns on 4th Embodiment of this invention.
  • FIG. 1 A) and (B) are perspective views which show a part of the apparatus which concerns on 4th Embodiment of this invention.
  • FIG. 1 and 2 are perspective views showing a part of the instrument 1 according to the first embodiment of the present invention.
  • the instrument 1 of the first embodiment includes an elongated body 2 and a wire Y1, and is arranged on the tip end side by simultaneously pulling one end and the other end of the wire Y1 in the longitudinal direction X of the elongated body 2.
  • the bending of the elongated element 4A to be performed can be caused to be larger than the bending of the elongated element 4B arranged on the proximal end side (the two-dot chain line in FIG. 1 shows the state of the instrument 1 before bending, and FIG. 1 The solid line shows the state of the instrument 1 after bending).
  • the instrument 1 can be applied to devices such as surgical tools, endoscopes, devices that use surgical tools and endoscopes in combination, movable catheters, movable needles, robot arm structures, and magic hands.
  • the "longitudinal direction X of the slender body” means “the direction parallel to the center line of the slender body”.
  • the "longitudinal direction X of the elongated body” is appropriately abbreviated as “longitudinal direction X”
  • the "direction Y perpendicular to the longitudinal direction X” is appropriately abbreviated as “direction Y”
  • the "longitudinal direction X and direction” are appropriately abbreviated.
  • the “direction Z perpendicular to Y” is abbreviated as "direction Z" as appropriate.
  • the "tip side of the elongated body in the longitudinal direction X" is appropriately abbreviated as “tip side”
  • base end side of the elongated body in the longitudinal direction X is appropriately abbreviated as “base end side”.
  • the elongated body 2 of the first embodiment is a tube in which a flange hub 5 is arranged between two elongated elements 4A and 4B adjacent to each other in the longitudinal direction X, and the elongated body 2 is formed by the elongated element 4A.
  • the slender element 4B constitutes the main body of the slender body 2.
  • the elongated elements 4A and 4B are cylindrical tubes formed of a flexible material.
  • elastic metals or alloys such as ⁇ titanium having a very high restoring force and nickel titanium which is a shape memory alloy, resin, rubber and the like can be used.
  • ⁇ titanium having a very high restoring force
  • nickel titanium which is a shape memory alloy
  • resin for example, polytetrafluoroethylene (PTFE) can be used.
  • the flange hub 5 is formed of a metal such as stainless steel, a resin, or the like, and includes a hub body 6, a tip flange 7, and a base flange 8.
  • a metal such as stainless steel, a resin, or the like
  • the hub body 6, the tip flange 7, and the base end flange 8 are individually manufactured, and then the tip flange 7 and the base end flange 8 are welded to the hub body 6 (spot welding, etc.). It is joined with.
  • the flange hub 5 may be formed by integrally manufacturing the hub body 6, the tip flange 7, and the base end flange 8. Twice
  • the hub body 6 is a cylindrical body extending in the longitudinal direction X.
  • the inner diameter of the hub body 6 substantially matches the inner diameter of the elongated elements 4A and 4B, and the outer diameter of the hub body 6 is smaller than the outer diameter of the elongated elements 4A and 4B.
  • the tip flange 7 (FIGS. 1 and 2) is an annular body protruding from the tip of the hub body 6 in an annular shape, and the outer diameter of the tip flange 7 substantially coincides with the outer diameters of the elongated elements 4A and 4B.
  • the proximal end surface of one of the elongated elements 4A arranged on the distal end side is joined to the distal end flange 7 of the flange hub 5. This joining is performed, for example, using an adhesive.
  • the base end surface of the elongated element 4A modified with a surface treatment agent is heat-sealed to the tip flange 7. Then, the above-mentioned joining may be performed.
  • the elongated element 4A and the flange hub 5 are formed of metal, the above-mentioned joining may be performed by welding.
  • the base end flange 8 is an annular body protruding from the base end of the hub body 6 in an annular shape, and the outer diameter of the base end flange 8 substantially coincides with the outer diameters of the elongated elements 4A and 4B.
  • the tip surface of the other elongated element 4B arranged on the proximal end side is joined to the proximal flange 8 of the flange hub 5. This joining is performed, for example, using an adhesive.
  • the tip surface of the elongated element 4B modified with a surface treatment agent is heat-sealed to the base end flange 8. Therefore, the above-mentioned joining may be performed. Further, when the elongated element 4B and the flange hub 5 are formed of metal, the above-mentioned joining may be performed by welding.
  • FIG. 3A is a front view showing the tip flange 7
  • FIG. 3B is a front view showing the base flange 8.
  • a pair of first through holes 9A and 9B extending in the longitudinal direction X are formed on the tip flange 7.
  • a pair of second through holes 10A and 10B extending in the longitudinal direction X are formed in the base end flange 8.
  • a pair means "the shortest distances from a predetermined plane extending along the center line of the elongated body 2 are equal”.
  • the "shortest distance from a plane” means "a distance along a straight line perpendicular to a plane”.
  • the pair of first through holes 9A and 9B and the pair of second through holes 10A and 10B are formed so as to satisfy the following conditions 1 and 2.
  • the shortest distance from the first plane XZ is the first distance L1.
  • One first through hole 9A is formed at the position on one side, and the other first through hole 9B is formed at the position on the other side where the shortest distance from the first plane XZ is the first distance L1.
  • One second through hole 10A is formed at a position on one side where the shortest distance from the first plane XZ is the second distance L2, and the position on the other side where the shortest distance from the first plane is the second distance L2.
  • the other second through hole 10B is formed in the first plane (the first plane XZ is a plane extending in the longitudinal direction X and the direction Z along the center line of the elongated body 2).
  • all of the first through holes 9A and 9B and the second through holes 10A and 10B are formed on one side of the second plane XY, so that the first through holes 9A and 9B and the first through holes 9A and 9B are formed.
  • the second through holes 10A and 10B satisfy the condition 2 "formed on the same side (one side) with the second plane XY as a boundary", but in the present invention, "a pair of first through holes 10A and 10B".
  • the condition 2 "pair" is also obtained.
  • the first through holes 9A and 9B and the pair of second through holes 10A and 10B are formed on the same side (one side or the other side) with the second plane XY as a boundary. ”
  • first through holes 9A and 9B and the second through holes 10A and 10B are formed by press working, laser machining, or etching machining. From the viewpoint of easily forming the first through holes 9A and 9B and the second through holes 10A and 10B, etching processing is preferable, and the first through holes 9A and 9B and the second through holes 10A and 10B are made with high accuracy. From the viewpoint of formation, laser processing is preferable.
  • one first through hole 9A communicates the elongated element 4A with the wire lumen R1 penetrating the elongated element 4A in the longitudinal direction X
  • the other first through hole 9B communicates the elongated element 4A. It communicates with the wire lumen R2 that penetrates in the longitudinal direction X.
  • the wire lumen R1 is at the same position as one of the first through holes 9A, that is, at a position on one side with the first plane XX as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the first distance L1 and the shortest distance from the second plane XY is the third distance L3.
  • the wire lumen R2 is a position similar to the other first through hole 9B, that is, a position on the other side with the first plane XX as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the first distance L1 and the shortest distance from the second plane XY is the third distance L3.
  • one second through hole 10A communicates the elongated element 4B with the wire lumen R3 penetrating the elongated element 4B in the longitudinal direction X
  • the other second through hole 10B communicates the elongated element 4B. It communicates with the wire lumen R4 penetrating in the longitudinal direction X.
  • the wire lumen R3 is at the same position as one of the second through holes 10A, that is, at a position on one side with the first plane XY as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the second distance L2 and the shortest distance from the second plane XY is the fourth distance L4.
  • the wire lumen R4 is a position similar to the other second through hole 10B, that is, a position on the other side with the first plane XX as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the second distance L2 and the shortest distance from the second plane XY is the fourth distance L4.
  • Wire Y1 is formed of metal such as stainless steel, polypropylene, acrylic material, PEEK (polyetheretherketone) resin, and the like.
  • the wire Y1 includes a wire lumen R3 formed in an elongated element 4B, a second through hole 10A communicating with the wire lumen R3, a base end flange 8 and a tip flange 7 of a flange hub 5.
  • the wire lumen R1 formed in one of the first through holes 9A and the elongated element 4A communicating with the first through hole 9A sequentially passes through the wire lumen R1 and extends from the tip of the elongated element 4A, and then bends to form the elongated element 4A.
  • Wire lumen R2 the other first through hole 9B communicating with the wire lumen R2, between the tip flange 7 and the base end flange 8 of the flange hub 5, the other second through hole 10B, and the elongated element 4B communicating with the tip flange 7 It sequentially passes through the formed wire lumen R4.
  • one end of the wire Y1 extends from the wire lumen R3
  • the other end of the wire Y1 extends from the wire lumen R4, and the one end and the other end of the wire Y1 are formed. It is said that the slender body 2 can be towed in the longitudinal direction X. This traction is realized by using a traction machine (not shown) to which one end and the other end of the wire Y1 are connected.
  • 4 (A) and 4 (B) are perspective views showing the tip end portion of the elongated body 2.
  • the tip tip 13 is attached to the slender element 4A arranged on the most tip side among the slender elements 4A and 4B constituting the slender body 2.
  • the tip tip 13 has a cylindrical shape, and a part of the outer peripheral surface of the tip tip 13 is a tapered surface whose diameter is reduced toward the tip side. Further, a through hole 16 (hereinafter, chip through hole 16) extending in the longitudinal direction X is formed in the tubular wall of the tip tip 13.
  • the tubular wall of the tip tip 13 is formed by integrally forming an annular portion 14 forming a base end portion and a substantially truncated cone-shaped tubular portion 15 forming a main body, and is annular.
  • an annular portion 14 forming a base end portion and a substantially truncated cone-shaped tubular portion 15 forming a main body, and is annular.
  • a recess H is formed on the outer peripheral surface of the tubular portion 15, and the range of the outer peripheral surface of the tubular portion 15 excluding the surface of the concave portion H is a tapered surface whose diameter is reduced toward the tip side.
  • the recess H is a cutout of a portion of a range 14a of the annular portion 14 projected in the longitudinal direction X, and a tip through hole 16 is formed in the range 14a of the annular portion 14.
  • the tip through hole 16 is formed for each of the wire lumens R1 and R2 formed in the elongated element 4A arranged on the most tip side, and each tip through hole 16 communicates with the corresponding wire lumen R.
  • the base end surface of the tip tip 13 base end surface of the annular portion 14
  • the wire Y1 passing through the two wire lumens R1 and R2 formed in the elongated element 4A passes through one tip through hole 16 communicating with one wire lumen R1 and then bends to and the other wire lumen R2. It passes through the two chip through holes 16 that communicate with each other.
  • the tip tip 13 is formed of metal or resin, and the base end surface of the tip tip 13 and the tip end surface of the elongated element 4A are joined, for example, by using an adhesive.
  • the tip surface of the elongated element 4A modified with a surface treatment agent is heat-sealed to the base end surface of the tip tip 13. By doing so, the above-mentioned joining may be performed. Further, when the elongated element 4A and the tip tip 13 are formed of metal, the above-mentioned joining may be performed by welding.
  • the recess H may not be formed in the tip tip 13.
  • a part or the whole of the outer peripheral surface of the tip tip 13 is a tapered surface whose diameter is reduced toward the tip side, and a through hole 16 penetrating the tubular wall of the tip tip 13 in the longitudinal direction X is formed.
  • the elongated element 4A on the distal end side is elongated on the proximal end side. It can be bent more toward one side of the direction Z than the element 4B (see FIG. 1). The reason will be described below.
  • the distance between the wire lumen R4 and the second through hole 10B) and the first plane XZ is defined as the second distance L2 (FIG. 3B). Therefore, in the elongated element 4B on the base end side, the bending moment in one side of the direction Y (left side in FIG. 3B) generated by the traction of one end of the wire Y1 and the traction of the other end of the wire Y1 occur.
  • the bending moment toward the other side of the direction Y (right side in FIG. 3B) can be offset.
  • the distance between the passing route (first through hole 9A and wire lumen R1) on one end side of the wire Y1 and the first plane XZ and the passing route on the other end side of the wire Y1 ( The distance between the first through hole 9B and the wire lumen R2) and the first plane XZ is set to the first distance L1 (FIG. 3 (A)). Therefore, also in the elongated element 4A, the bending moment toward one side of the direction Y (left side in FIG. 3A) generated by the traction of one end of the wire Y1 and the direction Y generated by the traction of the other end of the wire Y1 The bending moment to the other side (right side in FIG. 3A) can be offset.
  • the distance between (the wire lumen R3 and the second through hole 10B) and the second plane XY is the fourth distance L4 (FIG. 3 (B)).
  • the distance between (the first through hole 9B and the wire lumen R2) and the second plane XY is a third distance L3 (FIG. 3 (A)) longer than the fourth distance L4. That is, in the elongated element 4A on the distal end side, the distance between the passing route of the wire Y1 and the second plane XY is longer than that in the elongated element 4B on the proximal end side.
  • the bending moment in the direction Z applied to the elongated element 4A to one side can be made larger than the bending moment in the direction Z applied to the elongated element 4B to one side. ..
  • the elongated element 4A on the distal end side can be bent more toward one side of the direction Z than the elongated element 4B on the proximal end side. ..
  • the hardness of the elongated element 4A arranged on the distal end side is preferably lower than the hardness of the elongated element 4B arranged on the proximal end side (that is, the elongated element 4A is preferably softer than the elongated element 4B). By doing so, the bending of the elongated element 4A can be made larger than the bending of the elongated element 4B.
  • the bending of the elongated element 4A can be caused more.
  • the outer diameters of the elongated elements 4A and 4B, the outer diameter of the tip flange 7 and the outer diameter of the base end flange 6 are 1.8 mm
  • the inner diameters of the elongated elements 4A and 4B and the inner diameter of the hub body 5 are 1 mm.
  • the first distance L1 is 0.35 mm
  • the second distance L2 is 0.657 mm
  • the third distance L3 is 0.657 mm
  • the fourth distance L4 is 0.175 mm.
  • the ratio MA: MB of the bending moment MA applied to the elongated element 4A and the bending moment MB applied to the elongated element 4B is 3.75: 1 (3 above). .75 is obtained from the calculation of 0.657 mm (third distance L3) /0.175 mm (fourth distance L4)). And if the hardness of the elongated element 4A is equal to the hardness of the elongated element 4A, it is elongated.
  • the displacement of the tip of the element 4A can be increased by 3.75 times as much as the displacement of the tip of the elongated element 4B, and the hardness of the elongated element 4A is 0.5 times the hardness of the elongated element 4B,
  • the displacement of the tip of the elongated element 4A can be increased 7.5 times as large as the displacement of the tip of the elongated element 4B.
  • the wire lumens R1 and R2 of the slender element 4A, the wire lumens R3 and R4 of the slender element 4B, and the through holes 9A, 9B, 10A and 10B of the flange hub 5 By performing a simple operation of passing the wire Y1, the instrument 1 having the above characteristics (the elongated element 4A on the tip end side is bent more toward one side of the direction Z than the elongated element 4B on the proximal end side). A device that can be used 1) can be obtained.
  • an instrument 1 having the above characteristics an instrument 1 capable of bending the elongated element 4A on the distal end side to one side of the direction Z more than the elongated element 4B on the proximal end side.
  • the distance between the plane along the center line of the elongated body 2 and the wire Y1 is the base end. It is necessary to adjust the direction of the wire Y1 so that the side (elongated element 4B side) is short and the tip side (elongated element 4A side) is long.
  • the through hole The above-mentioned adjustment of the direction of the wire Y1 can be realized by performing a simple operation of passing the wire Y1 through the 9A, 9B, 10A, and 10B.
  • the movement of the elongated elements 4A and 4B possible in the first embodiment is to bend the elongated element 4A on the distal end side to one side of the direction Z more than the elongated element 4B on the proximal end side. It is not limited to. For example, by pulling the other of the one end and the other end of the wire Y1 while fixing the other, both the elongated elements 4A and 4B are bent in one side or the other side in the direction Y. be able to. Further, by adjusting the force for pulling one end and the other end of the wire Y1, the bending of the elongated elements 4A and 4B can be finely adjusted.
  • the instrument 1 of the first embodiment since the wire Y1 is passed through the tip through holes 16 and 16 of the tip tip 13 (see FIG. 4), the bent portion Y1a of the wire Y1 is placed on the tip surface of the elongated element 4A. It is possible to avoid contact. Therefore, it is possible to prevent the elongated element 4A from being damaged by the traction force applied from the bent portion Y1a of the wire Y1.
  • a part or the whole of the outer peripheral surface of the tip tip 13 is formed by a tapered surface whose diameter is reduced toward the tip side (see FIG. 4).
  • the instrument 1 can be smoothly inserted into the body. It is not always necessary that a part or the whole of the outer peripheral surface of the tip tip 13 is a tapered surface, and the entire outer peripheral surface of the tip tip 13 may be a surface extending in the longitudinal direction X.
  • the annular plate member 17 shown in FIG. 5 may be attached to the tip of the elongated element 4A arranged on the most tip side.
  • the hole 17k inside the ring of the plate material 17 constitutes the tip opening of the elongated body 2, and the ring of the plate material 17 is formed with a through hole 18 (hereinafter, plate material through hole 18) extending in the longitudinal direction X.
  • the plate material through hole 18 is formed for each of the wire lumens R1 and R2 formed in the elongated element 4A, and the plate material 17 is formed so that each plate material through hole 18 communicates with the corresponding wire lumen R.
  • the base end surface of the slender element 4A is joined to the tip end surface of the slender element 4A.
  • the wire Y1 passed through the two wire lumens R1 and R2 formed in the elongated element 4A sequentially passes through one wire lumen R1 and one plate material through hole 18 communicating with the wire lumen R1, and then bends. It sequentially passes through the second plate material through hole 18 and the other wire lumen R2 communicating with the through hole 18.
  • the plate material 17 is formed of, for example, metal or resin.
  • the base end surface of the plate member 17 and the tip end surface of the elongated element 4A are joined, for example, by using an adhesive.
  • the tip surface of the elongated element 4A modified with a surface treatment agent is heat-sealed to the base end surface of the plate material 17. Then, the above-mentioned joining may be performed. Further, when the elongated element 4A and the plate member 17 are formed of metal, the above-mentioned joining may be performed by welding.
  • the tip tip 13 and the plate material 17 may be omitted when the strength of the elongated element 4A is high or the traction force of the wire Y1 is weak. In this case, the wire Y1 extends from the wire lumen R1 and then bends into the wire lumen R2.
  • FIG. 6 and 7 are perspective views showing a part of the instrument 20 according to the second embodiment of the present invention (the two-dot chain line in FIG. 6 shows the state of the instrument 20 before bending, and the solid line in FIG. 6 is The state of the instrument 20 after bending).
  • the instrument 20 of the second embodiment includes an elongated body 21, a first wire Y2, and a second wire Y3.
  • the elongated body 21 of the second embodiment is a tube in which a flange hub 22 is arranged between two elongated elements 4C and 4D adjacent to each other in the longitudinal direction X, and the elongated body 21 is formed by the elongated element 4C.
  • the main body of the elongated body 21 is configured by the elongated element 4D (in FIG. 7, for convenience of explanation, the intermediate portion of the elongated element 4C and the portion of the elongated element 4D on the flange hub 22 side are omitted. ing).
  • the flange hub 22 includes a hub body 6, a tip flange 23, and a base flange 24.
  • a hub body 6 Of the two elongated elements 4C and 4D constituting the elongated body 21, one of the elongated elements 4C arranged on the distal end side has its proximal end surface joined to the distal end flange 23 of the flange hub 22 and arranged on the proximal end side.
  • the tip surface of the other elongated element 4D to be formed is joined to the base end flange 24 of the flange hub 22.
  • the above-mentioned joining is performed by, for example, the same method as the "joining of the elongated elements 4A and 4B and the flange of the flange hub 5" shown in the first embodiment.
  • FIG. 8 (A) is a front view showing the tip flange 23
  • FIG. 8 (B) is a front view showing the base end flange 24.
  • a pair of third through holes extending in the longitudinal direction X Holes 25A and 25B are formed.
  • the pair of fourth through holes 26A extending in the longitudinal direction X, 26B is formed.
  • the pair of first through holes 9A and R9B and the pair of second through holes 10A and 10B are formed so as to satisfy the conditions 1 and 2 shown in the first embodiment.
  • the pair of third through holes 25A and 25B and the pair of fourth through holes 26A and 26B are formed so as to satisfy the following conditions 3 and 4.
  • Condition 3 A plane different from the first plane XZ, when the slender body 21 is divided into one side and the other side with the one plane extending along the center line of the slender body 21 as a boundary.
  • One third through hole 25A is formed at a position on one side where the shortest distance from the one plane is the fifth distance L5, and the shortest distance from the one plane is the fifth distance L5 on the other side.
  • the other third through hole 25B is formed at the position, and one fourth through hole 26A is formed at the position on one side where the shortest distance from the one plane is the sixth distance L6, and the one plane is formed.
  • the other fourth through hole 26B is formed at the position on the other side where the shortest distance from is the sixth distance L6.
  • Condition 4 When the elongated body 21 is divided into one side and the other side with the two planes extending along the center line of the elongated body 21 and orthogonal to the one plane as a boundary, a pair of thirds.
  • the through holes 25A and 25B and the pair of fourth through holes 26A and 26B are formed on the same side, and the pair of third through holes 25A and 25B have the shortest distance from the second plane as the seventh distance L7, respectively.
  • the pair of fourth through holes 26A and 26B are formed at positions where the shortest distance from the second plane is the eighth distance L8, and the seventh distance L7 is the eighth distance L8. Longer than.
  • all of the third through holes 25A and 25B and the fourth through holes 26A and 26B are formed on one side of the second plane (first plane XZ), so that the third through hole 25A , 25B and the fourth through holes 26A and 26B satisfy the condition 4 "formed on the same side (one side) with the second plane (first plane XZ) as a boundary".
  • the present invention there is also a case where "a pair of third through holes 25A and 25B are formed on one side or the other side of the two planes, and a pair of fourth through holes 26A and 26B are formed on the two planes". , Condition 4 "formed on the same side (one side or the other side) with the two planes as a boundary" is satisfied.
  • the third through holes 25A and 25B and the fourth through holes 26A and 26B are formed by press working, laser machining, or etching machining. From the viewpoint of easily forming the third through holes 25A and 25B and the fourth through holes 26A and 26B, etching processing is preferable, and the third through holes 25A and 25B and the fourth through holes 26A and 26B can be made with high accuracy. From the viewpoint of formation, laser processing is preferable.
  • one first through hole 9A communicates the elongated element 4C with the wire lumen R1 penetrating the elongated element 4C in the longitudinal direction X
  • the other first through hole 9B communicates the elongated element 4C. It communicates with the wire lumen R2 that penetrates in the longitudinal direction X.
  • the wire lumen R1 is at the same position as one of the first through holes 9A, that is, at a position on one side with the first plane XX as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the first distance L1 and the shortest distance from the second plane XY is the third distance L3.
  • the wire lumen R2 is a position similar to the other first through hole 9B, that is, a position on the other side with the first plane XX as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the first distance L1 and the shortest distance from the second plane XY is the third distance L3.
  • one second through hole 10A communicates the elongated element 4D with a wire lumen R3 penetrating the elongated element 4D in the longitudinal direction X
  • the other second through hole 10B communicates the elongated element 4D with the elongated element 4D in the longitudinal direction X. It communicates with the penetrating wire lumen R4.
  • the wire lumen R3 is at the same position as one of the second through holes 10A, that is, at a position on one side with the first plane XY as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the second distance L2 and the shortest distance from the second plane XY is the fourth distance L4.
  • the wire lumen R4 is a position similar to the other second through hole 10B, that is, a position on the other side with the first plane XX as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the second distance L2 and the shortest distance from the second plane XY is the fourth distance L4.
  • one third through hole 25A communicates the elongated element 4C with a wire lumen R5 penetrating the elongated element 4C in the longitudinal direction X, and the other third through hole 25B extends the elongated element 4C. It communicates with the wire lumen R6 penetrating in the direction X.
  • the wire lumen R5 is at the same position as one of the third through holes 25A, that is, at a position on one side with the first plane XX as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the seventh distance L7 and the shortest distance from the second plane XY is the fifth distance L5.
  • the wire lumen R6 is at the same position as the other third through hole 25B, that is, at a position on one side with the first plane XX as a boundary and on the other side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the seventh distance L7 and the shortest distance from the second plane XY is the fifth distance L5.
  • one fourth through hole 26A communicates the elongated element 4D with a wire lumen R7 penetrating the elongated element 4D in the longitudinal direction X
  • the other fourth through hole 26B communicates the elongated element 4D with the elongated element 4D in the longitudinal direction X. It communicates with the penetrating wire lumen R8.
  • the wire lumen R7 is at the same position as one of the fourth through holes 26A, that is, at a position on one side with the first plane XX as a boundary and one side with the second plane XY as a boundary, and is a position on the first plane. It is formed at a position where the shortest distance from XZ is the eighth distance L8 and the shortest distance from the second plane XY is the sixth distance L6.
  • the wire lumen R8 is located at the same position as the other fourth through hole 26B, that is, on one side with the first plane XX as the boundary and on the other side with the second plane XY as the boundary. It is formed at a position where the shortest distance from XZ is the eighth distance L8 and the shortest distance from the second plane XY is the sixth distance L6.
  • the first wire Y2 is a wire lumen R3 formed in the elongated element 4D, one second through hole 10A communicating with the wire lumen R3, and one first penetration between the base end flange 24 and the tip flange 23 of the flange hub 22.
  • a wire lumen R2 formed in the elongated element 4C by sequentially passing through the hole 9A and the wire lumen R1 formed in the elongated element 4C communicating with the hole 9A, extending from the tip of the elongated element 4C, and then bending.
  • the other first through hole 9B that communicates, between the tip flange 23 and the base end flange 24 of the flange hub 22, the other second through hole 10B, and the wire lumen R4 formed in the elongated element 4D that communicates with this are sequentially inserted. pass.
  • the second wire Y3 has a wire lumen R7 formed in the elongated element 4D, one fourth through hole 26A communicating with the wire lumen R7, and one third penetration between the base end flange 24 and the tip flange 23 of the flange hub 22.
  • the wire lumen R6 formed in the elongated element 4C by sequentially passing through the hole 25A and the wire lumen R5 formed in the elongated element 4C communicating with the hole 25A, extending from the tip of the elongated element 4C, and then bending.
  • the other third through hole 25B that communicates, between the tip flange 23 and the base end flange 24 of the flange hub 22, the other fourth through hole 26B, and the wire lumen R8 formed in the elongated element 4D that communicates with this are sequentially inserted. pass.
  • one end of the first wire Y2 extends from the wire lumen R3
  • the other end of the first wire Y2 extends from the wire lumen R4
  • the second wire Y3 extends from the wire lumen R7.
  • the other end of the second wire Y3 extends from the wire lumen R8, and one end and the other end of the first wire Y2 are extended in the longitudinal direction of the elongated body 21 by a traction machine (not shown). It is possible to pull to X and to pull one end and the other end of the second wire Y3 in the longitudinal direction X of the elongated body 21.
  • a hole 27 is formed on the tip end side of the hub body 6, and a hole 28 is formed on the base end side of the hub body 6.
  • the holes 27 and 28 each penetrate the tubular wall of the hub body 6 in the thickness direction, and the portion of the first wire Y2 passing between the base end flange 24 and the tip end flange 23 is the hub body 6 It is assumed that the holes 27 and 28 are passed through the holes 27 and 28, and the inside of the hub body 6 is passed between the holes 27 and 28.
  • the elongated element 4C corresponds to the elongated element 4A (FIGS. 1 and 2) of the first embodiment
  • the elongated element 4D corresponds to the elongated element 4B of the first embodiment
  • the flange hub Assuming that 22 corresponds to the flange hub 5 of the first embodiment, the first wire Y2 passes through the elongated body 21 by the same route as the wire Y1 shown in the first embodiment. Therefore, for the same reason as in the first embodiment, by simultaneously pulling one end and the other end of the first wire Y2 in the longitudinal direction X of the elongated body 21, the elongated element 4C on the distal end side is moved to the proximal end side. It can be bent more to one side of direction Z than a certain elongated element 4D.
  • the instrument 20 of the second embodiment by simultaneously pulling one end and the other end of the second wire Y3 in the longitudinal direction X of the elongated body 21, the elongated element 4C on the distal end side is pulled to the proximal end side. It can be bent more in one side of the direction Y than the elongated element 4D in. The reason will be described below.
  • the distance between the passage route (wire lumen R8 and the fourth through hole 26B) and the second plane XY is the sixth distance L6 (FIG. 8 (B)). Therefore, in the elongated element 4D on the base end side, the bending moment in one side (upper side of FIG. 8B) of the direction Z generated by the traction of one end of the second wire Y3 and the other end of the second wire Y3. It is possible to cancel the bending moment to the other side (lower side of FIG. 8B) of the direction Z caused by the traction of.
  • the distance between the passage route (third through hole 25B and wire lumen R6) and the second plane XY is the fifth distance L5 (FIG. 8 (A)). Therefore, even in the elongated element 4C, the bending moment in one side (upper side of FIG. 8A) of the direction Z generated by the traction of one end of the second wire Y3 and the traction of the other end of the second wire Y3 are generated.
  • the bending moment toward the other side of the direction Z (lower side in FIG. 8A) can be offset.
  • the distance between the side passage route (wire lumen R8 and the fourth through hole 26B) and the first plane XZ is the eighth distance L8 (FIG. 8 (B)).
  • the distance between the side passage route (third through hole 25B and wire lumen R6) and the first plane XZ is the seventh distance L7 (FIG. 8 (A)), which is longer than the eighth distance L8. Will be done. That is, in the elongated element 4C on the distal end side, the distance between the passing route of the second wire Y3 and the first plane XZ is longer than that in the elongated element 4D on the proximal end side.
  • the bending moment in the direction Y applied to the elongated element 4C to one side is made larger than the bending moment in the direction Y applied to the elongated element 4D to one side. Can be done.
  • the elongated element 4C on the distal end side is made larger than the elongated element 4D on the proximal end side. , Can be greatly bent to one side of the direction Y.
  • the wire lumens R1 and R2 of the elongated element 4A, the wire lumens R3 and R4 of the elongated element 4B, and the through holes 9A, 9B, 10A and 10B of the flange hub 5 The second wire Y3 is passed through the wire lumens R5 and R6 of the elongated element 4A, the wire lumens R7 and R8 of the elongated element 4B, and the through holes 25A, 25B, 26A and 26B of the flange hub 5 through the first wire Y2.
  • the distance between the first wire Y2 and the second plane XY and the distance between the second wire Y3 and the first plane XZ are set between the elongated elements 4A and 4B.
  • the second embodiment is where it is necessary to adjust the directions of the wires Y2 and Y3 so that the distance between them is short on the base end side (elongated element 4B side) and long on the tip end side (elongated element 4A side).
  • the first wire Y1 is passed through the through holes 9A, 9B, 10A, and 10B
  • the second wire Y3 is passed through the through holes 25A, 25B, 26A, and 26B.
  • the orientation of the wires Y2 and Y3 can be adjusted.
  • the movement of the elongated elements 4A and 4B possible in the second embodiment is to bend the elongated element 4C on the distal end side more in one side of the direction Y than the elongated element 4D on the proximal end side. It is not limited to.
  • both of the elongated elements 4A and 4B are moved to one side or the other side of the direction Y. Can be bent.
  • both of the elongated elements 4A and 4B are moved to one side or the other side of the direction Z.
  • the bending of the elongated elements 4A and 4B can be finely adjusted.
  • the portion of the first wire Y2 passing between the base end flange 24 and the tip end flange 23 is a hole formed in the hub body 6. It is passed through 27, 28 and is assumed to pass inside the hub body 6 between these holes 27, 28. As a result, the first wire Y2 and the second wire Y3 are prevented from coming into contact with each other, so that the wires Y2 and Y3 can be smoothly pulled.
  • the hardness of the elongated element 4C arranged on the tip end side is higher than the hardness of the elongated element 4D arranged on the proximal end side. In this way, the bending of the elongated element 4C can be made larger than the bending of the elongated element 4D.
  • the condition 3 when the one plane shown in the condition 3 is a "plane other than the second plane XY" and the second plane shown in the condition 4 is a "plane other than the first plane XX", the condition 3 And a pair of third through holes 25A, 25B and a pair of fourth through holes 26A, 26B satisfying the condition 4 may be formed in the flange hub 22 (for example, one plane is "the first plane XY and 120 °".
  • the pair of third through holes 25A and 25B that satisfy the conditions 3 and 4 A pair of fourth through holes 26A, 26B may be formed in the flange hub 22).
  • the flange hub 22 may be formed with a plurality of pairs of a pair of third through holes 25A and 25B and a pair of fourth through holes 26A and 26B satisfying the conditions 3 and 4 (for example, one plane).
  • a "plane that intersects the first plane XY at an angle of 120 °" and the second plane is a "plane that intersects the first plane XY at an angle of 210 °".
  • the pair of the third through holes 25A and 25B and the pair of the fourth through holes 26A and 26B, one plane is defined as "a plane intersecting the first plane XY at an angle of 240 °", and the second plane is "the first plane”.
  • the pair of the third through holes 25A and 25B and the pair of the fourth through holes 26A and 26B satisfying the conditions 3 and 4 form a flange hub. 22 may be formed).
  • the slender body 21 is a wire in which each of the first through holes 9A and 9B and the third through holes 25A and 25B penetrates the elongated element 4C in the longitudinal direction X. It communicates with the lumen, and each of the second through holes 10A, 10B and the fourth through holes 26A, 26B communicates with the wire lumen that penetrates the elongated element 4D in the longitudinal direction X. " , 10B and the route composed of the wire lumen R communicating with these, and the route composed of the through holes 25A, 25B, 26A, 26B and the wire lumen R communicating with these, respectively, through the wire Y.
  • each wire Y can be pulled, an instrument capable of bending the elongated element 4C on the distal end side more in a plurality of directions than the elongated element 4D on the proximal end side. It can be obtained (when a plurality of pairs of the third through holes 25A and 25B and the fourth through holes 26A and 26B are formed, the through holes 9A, 9B, 10A and 10B and the wire lumen R communicating with these are formed.
  • a wire Y is passed through a route composed of The part and the other end can be towed).
  • FIG. 9 to 13 are perspective views showing a part of the instrument 30 according to the third embodiment of the present invention (the two-dot chain line in FIG. 9 shows the state of the instrument 30 before bending, and the solid line in FIG. 9 is The state of the instrument 30 after bending is shown).
  • the instrument 30 of the third embodiment includes an elongated body 31 (FIGS. 10 to 13), a first wire Y4, a second wire Y5, a third wire Y6, and a fourth wire Y7 (FIG. 10).
  • 10 to 13 are the same figures, in FIG. 10, the first wire Y4 is colored to show the passing route of the first wire Y4, and in FIG. 11, the first wire Y4 is shown to show the passing route of the second wire Y5.
  • the second wire Y5 is colored, in FIG. 12, the third wire Y6 is colored to show the passing route of the third wire Y6, and in FIG. 13, the fourth wire Y7 is colored to show the passing route of the fourth wire Y7. ing).
  • the elongated body 31 of the third embodiment is a tube in which a flange hub 32 is arranged between two elongated elements 4E and 4F adjacent to each other in the longitudinal direction X, and the elongated body 31 is formed by the elongated element 4E.
  • the slender element 4F constitutes the main body of the slender body 31.
  • the flange hub 32 includes a hub body 6, a tip flange 33, and a base flange 34.
  • one of the elongated elements 4E arranged on the distal end side has its base end surface joined to the distal end flange 33 of the flange hub 32.
  • the tip surface of the other elongated element 4F arranged on the base end side is joined to the base end flange 34 of the flange hub 32.
  • the above-mentioned joining is performed by, for example, the same method as the "joining of the elongated elements 4A and 4B and the flange of the flange hub 5" shown in the first embodiment.
  • FIG. 14 (A) is a front view showing the tip flange 33
  • FIG. 14 (B) is a front view showing the base end flange 34.
  • the flange hub 32 has a pair of first through holes 9A and R9B and a pair of second through holes 10A and 10B that satisfy the conditions 1 and 2 shown in the first embodiment, and is a first set that satisfies the following condition 5.
  • Two through holes 10A-2 and 10B-2 are provided.
  • the pair of first through holes 9A-1,9B-1 of the first set and the pair of first through holes 9A-2,9B-2 of the second set are lines with respect to the second plane XY.
  • the pair of second through holes 10A-1,10B-1 of the first set and the pair of second through holes 10A-2,10B-2 of the second set which are formed at symmetrical positions, form a second plane. It is formed at a position that is line-symmetric with respect to XY.
  • the flange hub 32 is provided with a pair of third through holes 25A and 25B and a pair of fourth through holes 26A and 26B satisfying the conditions 3 and 4 shown in the second embodiment, and a third through hole 26A and 26B satisfying the following condition 6.
  • Fourth through holes 26A-4 and 26B-4 are provided.
  • the pair of third through holes 25A-3, 25B-3 of the third set and the pair of third through holes 25A-4, 25B-4 of the fourth set are lines with respect to the first plane XZ.
  • the pair of fourth through holes 26A-3, 26B-3 of the third set and the pair of fourth through holes 26A-4, 26B-4 of the fourth set which are formed at symmetrical positions, form a first plane. It is formed at a position that is line-symmetric with respect to XZ.
  • a pair of first through holes 9A-1, 9B-1 of the first set communicate with a pair of first wire lumens R9A, R9B penetrating one elongated element 4E in the longitudinal direction X. ..
  • the pair of first through holes 9A-2, 9B-2 of the second set communicate with the pair of second wire lumens R10A, R10B penetrating one elongated element 4E in the longitudinal direction X. ..
  • the pair of third through holes 25A-3, 25B-3 of the third set communicate with the pair of third wire lumens R11A, R11B penetrating one elongated element 4E in the longitudinal direction X. ..
  • the pair of third through holes 25A-4, 25B-4 of the fourth set communicate with the pair of fourth wire lumens R12A, R12B penetrating one elongated element 4E in the longitudinal direction X. ..
  • the pair of second through holes 10A-1,10B-1 of the first set communicate with the pair of fifth wire lumens R13A, R13B penetrating the other elongated element 4F in the longitudinal direction X. ..
  • the pair of second through holes 10A-2, 10B-2 of the second set communicate with the pair of sixth wire lumens R14A, R14B penetrating the other elongated element 4F in the longitudinal direction X. ..
  • the pair of fourth through holes 26A-3, 26B-3 of the third set communicate with the pair of seventh wire lumens R15A, R15B penetrating the other elongated element 4F in the longitudinal direction X. ..
  • the pair of fourth through holes 26A-4, 26B-4 of the fourth set communicates with the pair of eighth wire lumens R16A, R16B penetrating the other elongated element 4F in the longitudinal direction X. ..
  • the first wire Y4 includes one fifth wire lumen R13A, one second through hole 10A-1 of the first set communicating with the fifth wire lumen R13A, and the base end flange 34 and the tip flange of the flange hub 32. It passes through one of the first through holes 9A-1 of the first set and one of the first wire lumens R9A communicating with the first wire lumen R9A sequentially, extends from the tip of the elongated element 4E, and then bends. The other first wire lumen R9B, the other first through hole 9B-1 of the first set communicating with the first wire lumen R9B, between the tip flange 33 and the base end flange 34 of the flange hub 32, the other second of the first set. It sequentially passes through the through hole 10B-1 and the other fifth wire lumen R13B communicating with the through hole 10B-1.
  • the second wire Y5 includes one sixth wire lumen R14A, one second through hole 10A-2 of the second set communicating with the sixth wire lumen R14A, and the base end flange 34 and the tip flange of the flange hub 32. It passes through one of the first through holes 9A-2 of the second set and the second wire lumen R10A communicating with the first through hole 9A-2 in sequence with 33, extends from the tip of the elongated element 4E, and then bends.
  • the other second wire lumen R10B, the other first through hole 9B-2 of the second set communicating with the second wire lumen R10B, between the tip flange 33 and the base end flange 34 of the flange hub 32, the other second of the second set. It sequentially passes through the through hole 10B-2 and the other sixth wire lumen R14B communicating with the through hole 10B-2.
  • the third wire Y6 includes one seventh wire lumen R15A, one fourth through hole 26A-3 of the third set communicating with the seventh wire lumen R15A, and the base end flange 34 and the tip flange of the flange hub 32. It passes through one of the third through holes 25A-3 of the third set and one of the third wire lumens R11A communicating with the third wire lumen R11A in sequence, extends from the tip of the elongated element 4E, and then bends.
  • the other third wire lumen R11B, the other third through hole 25B-3 of the third set communicating with the third wire lumen R11B, between the tip flange 33 and the base end flange 34 of the flange hub 32, the other fourth of the third set. It sequentially passes through the through hole 26B-3 and the other seventh wire lumen R15B communicating with the through hole 26B-3.
  • the fourth wire Y7 includes one eighth wire lumen R16A, one fourth through hole 26A-4 of the fourth set communicating with the eighth wire lumen R16A, and the base end flange 34 and the tip flange of the flange hub 32. It passes through one of the third through holes 25A-4 of the fourth set and the fourth wire lumen R12A communicating with the third through hole 25A-4 in sequence with 33, extends from the tip of the elongated element 4E, and then bends. The other fourth wire lumen R12B, the other third through hole 25B-4 of the fourth set communicating with the fourth wire lumen R12B, between the tip flange 33 and the base end flange 34 of the flange hub 32, the other fourth of the fourth set. It sequentially passes through the through hole 26B-4 and the other eighth wire lumen R16B communicating with the through hole 26B-4.
  • one end of the first wire Y4 extends from one fifth wire lumen R13A (FIG. 10), and the other end of the first wire Y4 extends from the other fifth wire lumen R13B ( Extending from FIG. 10), one end of the second wire Y5 extends from one sixth wire lumen R14A (FIG. 11), and one end of the second wire Y5 extends from the other sixth wire lumen R14B (FIG. 11). ), One end of the third wire Y6 extends from one seventh wire lumen R15A (FIG. 12), and the other end of the third wire Y6 extends from the other seventh wire lumen R15B (FIG. 12). One end of the fourth wire Y7 extends from one eighth wire lumen R16A (FIG. 13), and the other end of the fourth wire Y7 extends from the other eighth wire lumen R16B (FIG. 13). It is extending.
  • first wire Y4 are towed in the longitudinal direction X of the elongated body 31 by a traction machine (not shown), and one end and the other end of the second wire Y5 are towed in the longitudinal direction of the elongated body 31.
  • Pulling to X pulling one end and the other end of the third wire Y6 in the longitudinal direction X of the elongated body 31, and pulling one end and the other end of the fourth wire Y7 in the longitudinal direction of the elongated body 31. It is possible to pull to X.
  • a hole 27 is formed on the tip end side of the hub body 6 to penetrate the cylinder wall of the hub body 6 in the thickness direction, and the cylinder wall of the hub body 6 is thickened on the base end side of the hub body 6.
  • a hole 28 penetrating in the longitudinal direction is formed.
  • the portion of the first wire Y4 passing between the base end flange 24 and the tip end flange 23 and the portion of the second wire Y5 passing between the base end flange 24 and the tip end flange 23 are the hub main bodies, respectively. It is passed through the holes 27 and 28 formed in No. 6 and passes through the inside of the hub body 6 between the holes 27 and 28 (see FIGS. 10 and 11).
  • the elongated element 4E corresponds to the elongated element 4C (FIGS. 6 and 7) of the second embodiment
  • the elongated element 4F corresponds to the elongated element 4D of the second embodiment
  • the flange hub Assuming that 32 corresponds to the flange hub 22 of the second embodiment, the first wire Y4 (FIG. 10) has the same route as the first wire Y2 (FIGS. 6 and 7) shown in the second embodiment. Then, it passes through the elongated body 31.
  • the elongated element 4E on the distal end side is in the direction Z rather than the elongated element 4F on the proximal end side. It can be greatly bent to one side.
  • the route through which the second wire Y5 (FIG. 11) passes and the route through which the first wire Y4 (FIG. 10) passes are line-symmetric with respect to the second plane XY. Therefore, by simultaneously pulling one end and the other end of the second wire Y5 in the longitudinal direction X of the elongated body 31, the elongated element 4E on the tip end side is in the direction Z rather than the elongated element 4F on the proximal end side. Can be greatly bent to the other side of the.
  • the third wire Y6 (FIG. 12) passes through the elongated body 31 by the same route as the second wire Y3 (FIGS. 6 and 7) shown in the second embodiment. Therefore, by simultaneously pulling one end and the other end of the third wire Y6 in the longitudinal direction X of the elongated body 31, the elongated element 4E on the distal end side is in the direction Y rather than the elongated element 4F on the proximal end side. It can be greatly bent to one side.
  • the route through which the fourth wire Y7 passes (FIG. 13) and the route through which the third wire Y6 (FIG. 12) passes are line-symmetrical with respect to the first plane XZ. Therefore, by simultaneously pulling one end and the other end of the third wire Y6 in the longitudinal direction X of the elongated body 31, the elongated element 4E on the distal end side is in the direction Y rather than the elongated element 4F on the proximal end side. Can be greatly bent to the other side of the.
  • the portions of the wires Y4 and Y5 passing between the base end flange 24 and the tip end flange 23 are passed through the holes 27 and 28 formed in the hub body 6, respectively. Therefore, it is assumed that the holes 27 and 28 pass through the inside of the hub body 6 ((FIGS. 10 and 11). Therefore, the first wire Y4 and the second wire Y5 are respectively connected to the third wire. The Y6 and the fourth wire Y7 can be kept out of contact with each other. Therefore, the first, second, third, and fourth wires Y4, Y5, Y6, and Y7 can be smoothly pulled.
  • the hardness of the elongated element 4E arranged on the tip end side is higher than the hardness of the elongated element 4F arranged on the proximal end side. In this way, the bending of the elongated element 4E can be made larger than the bending of the elongated element 4F.
  • FIGS. 15 to 23 are perspective views showing a part of the instrument 40 according to the fourth embodiment of the present invention.
  • the alternate long and short dash line in FIGS. 15 and 16 shows the state of the instrument 40 before bending
  • the solid line in FIGS. 15 and 16 shows the state of the instrument 40 after bending.
  • 18 (A), 19 (A), 20 (A), and 21 (A) are perspective views of the base end side of the instrument 40 viewed from one side of the direction Y.
  • 18 (B), 19 (B), 20 (B), and 21 (B) are perspective views of the base end side of the instrument 40 viewed from the other side in the direction Y.
  • FIGS. 18 (B), 19 (B), 20 (B), and 21 (B) FIGS.
  • FIG. 18 (A), 19 (A), 20 (A), and 21 (A) are longitudinal.
  • FIG. 18 (A), FIG. 19 (A), FIG. 20 (A), and FIG. Direction Z) is shown in the opposite direction.
  • 22 (A) and 23 (A) are perspective views of the tip end side of the instrument 40 viewed from one side of the direction Y.
  • 22 (B) and 23 (B) are perspective views of the tip side of the instrument 40 viewed from the other side in the direction Y.
  • FIGS. 22 (B) and 23 (B) in order to match one side (tip side) and the other side (base end side) of the longitudinal direction X with FIGS. 22 (A) and 22 (A), FIG.
  • the vertical direction (direction Z) is opposite to that of 22 (A) and FIG. 23 (A).
  • the instrument 40 of the fourth embodiment includes an elongated body 41 (FIG. 17), a first wire Y8, a second wire Y9, a third wire Y10, and a fourth wire Y11 (in FIG. 18).
  • the first wire Y8 is colored to show the passing route of the first wire Y8,
  • the second wire Y9 is colored to show the passing route of the second wire Y9 in FIG. 19, and the third wire Y9 is shown in FIGS. 20 and 22.
  • the third wire Y10 is colored to show the passing route of Y10, and in FIGS. 21 and 23, the fourth wire Y7 is colored to show the passing route of the fourth wire Y11).
  • the first elongated element 4G, the second elongated element 4H, and the third elongated element 4I are connected in this order from the tip side in the longitudinal direction X, and the elongated element 41 is connected in the longitudinal direction.
  • the first flange hub 42 is arranged between the first elongated element 4G adjacent to X and the second elongated element 4H, and the first flange hub 42 is arranged between the second elongated element 4H adjacent to X in the longitudinal direction and the third elongated element 4I.
  • the two-flange hub 43 is arranged (in FIGS. 18 to 21, for convenience of explanation, the intermediate portion of the second elongated element 4H and the portion of the third elongated element 4I on the second flange hub 43 side are shown. Is omitted).
  • the first and second flange hubs 42 and 43 include a hub main body 6, a tip flange 33, and a base end flange 34, as in the flange hub 32 (FIGS. 9 to 14) of the third embodiment. .. That is, the first and second flange hubs 42 and 43 have, respectively, a pair of first through holes 9A-1, 9B-1 and a pair of second through holes 10A-1, shown in FIG. 10B-1, a pair of first through holes 9A-2, 9B-2 in a second set, a pair of second through holes 10A-2, 10B-2, and a pair of third through holes 25A- in a third set.
  • the first set of through holes 9A-1,9B-1,10A-1,10B-1 and the second set of through holes 9A-2,9B-2,10A-2,10B-2 are in the third embodiment.
  • the condition 5 shown is satisfied, and the through holes 25A-3, 25B-3, 26A-3, 26B-3 of the third set and the through holes 25A-4, 25B-4, 26A-4 of the fourth set are satisfied.
  • 26B-4 satisfies the condition 6 shown in the third embodiment.
  • the base end surface of the first elongated element 4G is joined to the tip flange 33 of the first flange hub 42.
  • the tip surface of the second elongated element 4H is joined to the base end flange 34 of the first flange hub 42.
  • the base end surface of the second elongated element 4H is joined to the tip flange 33 of the second flange hub 43.
  • the tip surface of the third elongated element 4I is joined to the base end flange 34 of the second flange hub 43.
  • one through hole formed in the base end flange 34 of the first flange hub 42 and one through hole formed in the tip flange 33 of the second flange hub 43 are formed in a second elongated shape.
  • the base end flange 34 of the first flange hub 42 and the tip flange 33 of the second flange hub 43 have the following features 1 to 4 in order to communicate with one wire lumen formed in the element 4H. Will be done.
  • Feature 1 The second distance L2 (FIG. 14 (B)) at the base end flange 34 of the first flange hub 42 and the seventh distance L7 (FIG. 14 (A)) at the tip flange 33 of the second flange hub 43 are Match.
  • Feature 2 The fourth distance L4 (FIG. 14 (B)) at the base end flange 34 of the first flange hub 42 and the fifth distance L5 (FIG. 14 (A)) at the tip flange 33 of the second flange hub 43 Match.
  • Feature 3 The sixth distance L6 (FIG.
  • the flange hubs 42 and 43 have the same structure.
  • a pair of first through holes 9A-1, 9B-1 formed in the first flange hub 42 is a pair of first through holes 9A-1, 9B-1 that penetrate the first elongated element 4G in the longitudinal direction X. It communicates with one wire lumen R17A and R17B.
  • the pair of first through holes 9A-2, 9B-2 formed in the first flange hub 42 is a pair of first through holes 9A-2, 9B-2 that penetrate the first elongated element 4G in the longitudinal direction X. It communicates with two wire lumens R18A and R18B.
  • a pair of third set of third through holes 25A-3, 25B-3 (FIGS. 22 and 23) formed in the first flange hub 42 is a pair of third through holes 25A-3, 25B-3 (FIGS. 22 and 23) penetrating the first elongated element 4G in the longitudinal direction X. It communicates with three wire lumens R19A and R19B (not shown).
  • a pair of third through holes 25A-4, 25B-4 (FIGS. 22 and 23) formed in the first flange hub 42 is a pair of third through holes 25A-4, 25B-4 (FIGS. 22 and 23) penetrating the first elongated element 4G in the longitudinal direction X.
  • (4) Communicates with wire lumens R20A and R20B (not shown).
  • a pair of second through holes 10A-1,10B-1 formed in the first flange hub 42 is a pair of second through holes 10A-1,10B-1 that penetrate the second elongated element 4H in the longitudinal direction X. It communicates with five wire lumens R21A and R21B.
  • the pair of second through holes 10A-2 and 10B-2 formed in the first flange hub 42 is a pair of second through holes 10A-2 and 10B-2 that penetrate the second elongated element 4H in the longitudinal direction X. It communicates with the six wire lumens R22A and R22B.
  • a pair of a pair of fourth through holes 26A-3, 26B-3 (FIGS. 22 and 23) formed in the first flange hub 42 is a pair of a pair of fourth through holes 26A-3 and 26B-3 (FIGS. 22 and 23) penetrating the second elongated element 4H in the longitudinal direction X. It communicates with the seven wire lumens R23A and R23B (see FIG. 18 for R23A and FIG. 19 for R23B).
  • a pair of fourth set of fourth through holes 26A-4, 26B-4 (FIGS. 22 and 23) formed in the first flange hub 42 is a pair of a pair of first elongated elements 4H penetrating the second elongated element 4H in the longitudinal direction X. It communicates with the eight wire lumens R24A and R24B (see FIG. 18 for R24A and FIG. 19 for R24B).
  • one of the first through holes 9A-1 is one of the first through holes 9A-1.
  • the seventh wire lumen R23A is communicated with, and the other first through hole 9B-1 communicates with one eighth wire lumen R24A.
  • one first through hole 9A-2 is the other first through hole 9A-2. It communicates with the seventh wire lumen R23B, and the other first through hole 9B-2 communicates with the other eighth wire lumen R24B.
  • one of the third through holes 25A-3 is one of the fifth wire lumens R21A (FIG. 20).
  • the other third through hole 25B-3 communicates with one sixth wire lumen R22A (FIG. 21).
  • one third through hole 25A-4 is the other fifth wire lumen R21B (FIG. 20).
  • the other third through hole 25B-4 communicates with the other sixth wire lumen R22B (FIG. 21).
  • a pair of second through holes 10A-1,10B-1 formed in the second flange hub 43 is a pair of first through the third elongated element 4I in the longitudinal direction X. It communicates with nine wire lumens R25A and R25B.
  • the pair of second through holes 10A-2, 10B-2 formed in the second flange hub 43 is a pair of second through holes 10A-2, 10B-2 penetrating the third elongated element 4I in the longitudinal direction X. It communicates with 10 wire lumens R26A and R26B.
  • the pair of fourth through holes 26A-3, 26B-3 of the third set formed in the second flange hub 43 is a pair of first through the third elongated element 4I in the longitudinal direction X. It communicates with the eleven wire lumens R27A and R27B.
  • a pair of fourth set of fourth through holes 26A-4, 26B-4 formed in the second flange hub 43 is a pair of first through the third elongated element 4I in the longitudinal direction X. It communicates with the twelve wire lumens R28A and R28B.
  • the first wire Y8 is a second through hole of one of the first set formed in one of the ninth wire lumen R25A and the second flange hub 43 communicating with the ninth wire lumen R25A. 10A-1, between the base end flange 34 and the tip flange 33 of the second flange hub 43, one of the first through holes 9A-1 of the first set formed in the second flange hub 43, one communicating with the first through hole 9A-1.
  • the first flange hub 42 passes through the fourth through hole 26A-3 (FIGS. 22 and 23) of one of the third set formed in the seventh wire lumen R23A and the first flange hub 42 communicating with the seventh wire lumen R23A. 4th through hole 26A-4 (FIGS.
  • the second wire Y9 is a second through hole of one of the second set formed in one tenth wire lumen R26A and a second flange hub 43 communicating with the tenth wire lumen R26A. 10A-2, between the base end flange 34 and the tip flange 33 of the second flange hub 43, one first through hole 9A-2 of the second set formed in the second flange hub 43, the other communicating with this.
  • the first flange hub 42 passes through the other fourth through hole 26B-3 (FIGS. 22 and 23) of the third set formed in the seventh wire lumen R23B and the first flange hub 42 communicating with the seventh wire lumen R23B.
  • the fourth through hole 26B-4 (FIGS.
  • the third wire Y10 is formed on one eleventh wire lumen R27A and a second flange hub 43 communicating with the eleventh wire lumen R27A. 3. Between the base end flange 34 and the tip flange 33 of the second flange hub 43, one third through hole 25A-3 of the third set formed in the second flange hub 43, and one third through hole 25A-3 communicating with the third through hole 25A-3.
  • the tip of the first elongated element 4G passes sequentially through one of the first through holes 9A-1 of the first set formed in the first flange hub 42 and the first wire lumen R17A communicating with the first through hole 9A-1.
  • the tip flange 33 and the base flange 34 the other second through hole 10B-1 of the first set formed in the first flange hub 42, the other fifth wire lumen R21B communicating with this, and this One of the third through holes 25A-4 (FIG.
  • the fourth wire Y11 is formed on one of the twelfth wire lumens R28A and the second flange hub 43 communicating with the twelfth wire lumen R28A. 4. Between the base end flange 34 and the tip flange 33 of the second flange hub 43, the other third through hole 25B-3 of the third set formed in the second flange hub 43, and the one communicating with the third through hole 25B-3.
  • Six-wire lumen R22A (FIG. 23), one second through hole 10A-2 of the second set formed in the first flange hub 42 communicating with the wire lumen R22A, the base end flange 34 and the tip flange 33 of the first flange hub 42.
  • the tip of the first elongated element 4G passes sequentially through one of the first through holes 9A-2 of the second set formed in the first flange hub 42 and the second wire lumen R18A communicating with the first through hole 9A-2.
  • the other second wire lumen R18B, the other first through hole 9B-2 of the second set, and the first flange hub 42 formed in the first flange hub 42 communicating with the other second wire lumen R18B.
  • the tip flange 33 and the base flange 34 Between the tip flange 33 and the base flange 34, the other second through hole 10B-2 of the second set formed in the first flange hub 42, the other sixth wire lumen R22B communicating with this, and this The other third through hole 25B-4 (FIG.
  • one end of the first wire Y8 extends from one ninth wire lumen R25A (FIG. 18), and the other end of the first wire Y8 extends from the other ninth wire lumen R25B ( Extending from FIG. 18), one end of the second wire Y9 extends from one tenth wire lumen R26A (FIG. 19), and the other end of the second wire Y9 extends from the other tenth wire lumen R26B (FIG. 18). Extending from 19), one end of the third wire Y10 extends from one eleventh wire lumen R27A (FIG.
  • one end of the fourth wire Y11 extends from one twelfth wire lumen R28A (FIG. 21), and the other end of the fourth wire Y11 extends from the other twelfth wire lumen R28B. It extends from (FIG. 21).
  • first wire Y8 are towed in the longitudinal direction X of the elongated body 41 by a traction machine (not shown), and one end and the other end of the second wire Y9 are towed in the longitudinal direction of the elongated body 41.
  • Pulling to X pulling one end and the other end of the third wire Y10 in the longitudinal direction X of the elongated body 41, and pulling one end and the other end of the fourth wire Y11 in the longitudinal direction of the elongated body 41. It is possible to pull to X.
  • the portion of the third wire Y10 passing between the base end flange 24 and the tip flange 23 of the second flange hub 43, and the base end flange 24 and the tip flange 23 of the second flange hub 43 The portions of the fourth wire Y11 passing between the holes 27 and 28 are passed through the holes 27 and 28 formed in the hub body 6 of the second flange hub 43, respectively, and the inside of the hub body 6 is passed between the holes 27 and 28, respectively. (See FIGS. 20 and 21).
  • a pair of third through holes 25A-3, 25B-3 (FIGS. 22 and 23) formed in the first flange hub 42, and a first elongated element communicating with the third through holes 25A-3, 25B-3.
  • 4G third wire lumens R19A, R19B (not shown), a pair of fourth set of third through holes 25A-4, 25B-4 (FIGS.
  • Wire Y is not passed through the fourth wire lumens R20A, R20B (not shown) of the first elongated element 4G communicating with these, but these through holes 25A-3, 25B-3, 25A-4, 25B-4
  • the structure of the first flange hub 42 is made the same as the structure of the second flange hub 43, and the cross section of the first elongated element 4G is changed to the second and third.
  • the cross sections of the elongated elements 4H and 4I can be made the same. Therefore, the flange hubs 42, 43 and the elongated elements 4G, 4H, 4I can be easily manufactured.
  • the appliance 40 according to the fourth embodiment has a "first structure in which a second flange hub 43 is arranged between two elongated elements 4H and 4I" and has a “range on the proximal end side of the first flange hub 42". Is configured, and the "range on the tip side of the second flange hub 43" is configured by the "second structure in which the first flange hub 42 is arranged between the two elongated elements 4G and 4H". Can be regarded as.
  • the elongated element 4H corresponds to the elongated element 4E (FIGS. 9 to 13) of the third embodiment
  • the elongated element 4I corresponds to the elongated element 4F of the third embodiment (FIGS. 9 to 13).
  • the first wire Y8 (FIGS. 18, 22, 23) has the same route as the first wire Y4 (FIGS. 9, 10) shown in the third embodiment. It passes through the first structure (the structure in which the second flange hub 43 is arranged between the two elongated elements 4H and 4I).
  • the elongated element 4H on the distal end side is elongated on the proximal end side. It can be said that it can be bent more toward one side of the direction Z than the element 4I.
  • the second wire Y9 (FIGS. 19, 22, and 23) has the same route as the second wire Y5 (FIGS. 9, 11) shown in the third embodiment, and the first structure (two elongated structures) is taken. It passes through a structure in which the second flange hub 43 is arranged between the elements 4H and 4I). Therefore, in the first structure, by simultaneously pulling one end and the other end of the second wire Y9 in the longitudinal direction X of the elongated body 41, the elongated element 4H on the distal end side is pulled from the elongated element 4H on the proximal end side. It can be said that it can be bent more toward the other side of the direction Z than 4I.
  • the elongated element 4G corresponds to the elongated element 4E (FIGS. 9 to 13) of the third embodiment
  • the elongated element 4H corresponds to the elongated element 4F of the third embodiment (FIGS. 9 to 13).
  • the third wire Y10 (FIGS. 20 and 22) has the same route as the first wire Y4 (FIGS. 9 and 10) shown in the third embodiment, and has a second route. It passes through a structure (a structure in which a first flange hub 42 is arranged between two elongated elements 4G and 4H).
  • the elongated element 4G on the distal end side is pulled from the elongated element 4G on the proximal end side. It can be said that it can be bent more toward one side of the direction Z than 4H.
  • the passage route (wire lumen R27A and the fourth through hole 26A-3) on one end side of the third wire Y10 and the second plane XY
  • the distance between the wires Y10 and the passage route (wire lumen R27B and the fourth through hole 26B-3) on the other end side of the third wire Y10 and the distance between the second plane XY are both the sixth distance L6. (FIG. 14 (B)). Therefore, in the elongated element 4I, the bending moment in one side (upper side of FIG.
  • the elongated element 4G corresponds to the elongated element 4E of the third embodiment (FIGS. 9 to 13)
  • the elongated element 4H corresponds to the elongated element 4F of the third embodiment (FIGS. 9 to 13).
  • the fourth wire Y11 (FIGS. 21 and 23) has the same route as the second wire Y5 (FIGS. 9 and 11) shown in the third embodiment, and has a second structure. It passes through a body (a structure in which a first flange hub 42 is arranged between two elongated elements 4G and 4H).
  • the elongated element 4G on the distal end side is pulled from the elongated element 4G on the proximal end side. It can be said that it can be bent more toward the other side of the direction Z than 4H.
  • the passage route (wire lumen R28A and fourth through hole 26A-4) on one end side of the fourth wire Y11 and the second plane XY The distance between the wire lumen R28B and the passage route (wire lumen R28B and the fourth through hole 26B-4) on the other end side of the fourth wire Y11 and the distance between the second plane XY are both the sixth distance. It is L6 (FIG. 14 (B)). Therefore, in the elongated element 4I, the bending moment in one side (upper side of FIG.
  • the distance between the passing route (wire lumen R28B and the fourth through hole 26B-4) and the first plane XZ is the short eighth distance L8 (FIG. 14 (B)). Therefore, in the elongated element 4I, the bending moment in the direction Y caused by the traction of one end and the other end of the fourth wire Y11 can be suppressed to a small value.
  • the instrument 40 of the fourth embodiment by simultaneously pulling one end and the other end of the first wire Y8 in the longitudinal direction X, the elongated element 4H on the distal end side is moved to the proximal end side. It can be bent more toward one side of the direction Z than a certain elongated element 4I, and by simultaneously pulling one end and the other end of the second wire Y9 in the longitudinal direction X, the elongated element 4H on the tip side can be bent. , It can be bent more toward the other side of the direction Z than the elongated element 4I on the base end side, and by simultaneously pulling one end and the other end of the third wire Y10 in the longitudinal direction X, it can be bent toward the tip side.
  • a slender element 4G can be bent more in one side of the direction Z than the slender elements 4H and 4I on the base end side, and one end and the other end of the fourth wire Y11 are simultaneously pulled in the longitudinal direction X. By doing so, the elongated element 4G on the distal end side can be bent more toward the other side in the direction Z than the elongated elements 4H and 4I on the proximal end side.
  • the instrument 40 of the fourth embodiment has the above-mentioned characteristics, so that one end and the other end of the first wire Y8 and one end and the other end of the third wire Y10 are simultaneously placed in the longitudinal direction X.
  • the range on the tip side of the second flange hub 43 elongated element 4H, first flange hub 42, elongated element 4G
  • the range on the tip side of the second flange hub 43 can be greatly bent to one side of the direction Z (upper side of FIG. 15). reference).
  • the range on the tip side of the second flange hub 43 (Elongated element 4H, first flange hub 42, elongated element 4G) can be greatly bent to the other side in the direction Z (see the lower side of FIG. 15).
  • one end and the other end of the first wire Y8 and one end and the other end of the fourth wire Y11 are simultaneously pulled in the longitudinal direction X, and the second wire
  • the range on the tip side of the second flange hub 43. (Elongated element 4G, first flange hub 42, elongated element 4H) can be bent in an S shape (the S-shaped bending shown on the upper side of FIG. 16 is one end and the other end of the first wire Y8.
  • the hardness of the elongated element 4G is higher than the hardness of the elongated element 4H, and the hardness of the elongated element 4H is higher than the hardness of the elongated element 4I.
  • the bending of the elongated element 4G is caused more than the bending of the elongated element 4H, and the bending of the elongated element 4H is caused larger than the bending of the elongated element 4I. Can be done.
  • the instruments 20, 30, and 40 of the second to fourth embodiments form an elongated body as in the instrument 1 of the first embodiment (FIG. 1).
  • the tip tip 13 or the plate member 17 may be attached to the tip of one slender element 4 arranged on the most tip side of the plurality of slender elements 4 (FIGS. 6 and 9 show the second and third embodiments).
  • FIGS. 15 and 16 show an example in which the plate member 17 is provided on the instrument 40 of the third embodiment).
  • the tip through hole 16 of the tip tip 13 is each of the wire lumens R formed in the one elongated element 4.
  • the base end surface of the tip tip 13 is joined to the tip surface of the one elongated element 4 so that each tip through hole 16 communicates with the corresponding wire lumen R.
  • the wire Y passed through the two wire lumens R and R formed in the one elongated element 4 sequentially passes through one wire lumen R and one tip through hole 16 communicating with the wire lumen R, and then bends. Then, it sequentially passes through the second tip through hole 16 and the other wire lumen R communicating with the second tip through hole 16.
  • the plate material through hole 18 of the plate material 17 is each of the wire lumens R formed in the one elongated element 4.
  • the base end surface of the plate material 17 is joined to the tip surface of the above-mentioned one elongated element 4 so that each plate material through hole 18 communicates with the corresponding wire lumen R.
  • the wire Y passed through the two wire lumens R formed in the one elongated element 4 sequentially passes through one wire lumen R and one plate material through hole 18 communicating with the wire lumen R, and then bends.
  • the second plate material through hole 18, and the other wire lumen R communicating with the through hole 18 are sequentially passed through.
  • the members constituting the elongated body 31 are connected to each other by applying a preload by pulling the wires Y4, Y5, Y6, and Y7 to the elongated body 31. It may be joined.
  • the base end surface of the tip tip 13 or the base end surface of the plate material 17 is joined to the tip surface of the elongated element 4E without any gap without using an agent, heat fusion, or welding, and the proximal end surface of the elongated element 4E is joined to the flange hub 32. It can be joined to the tip flange 33 without a gap, and the base end flange 34 of the flange hub 32 can be joined to the tip surface of the elongated element 4F without a gap.
  • the force for pulling one end and the other end of the wires Y4, Y5, Y6, Y7 is a force required to cause the above-mentioned preload and bending of the elongated body 31.
  • the wires Y4, Y5, Y6, Y7 can be pulled.
  • the above preload can be performed by the force of aN included in the traction force, and the elongated element 4E on the tip side can be bent in one side of the direction Z by the force of bN included in the traction force of the wire Y4.
  • the members constituting the elongated body 41 are joined to each other by applying the preload by the traction of the wires Y8, Y9, Y10, Y11 to the elongated body 31. You may.
  • the route (FIG. 21) to be used becomes axisymmetric with respect to the first plane XZ.
  • the route through which the third wire Y10 passes (FIG. 22) and the fourth wire Y11
  • the passing route (FIG. 23) is line-symmetric with respect to the second plane XY. Therefore, by performing the above preloading, the base end surface of the tip tip 13 or the base end surface of the plate material 17 is joined to the tip surface of the elongated element 4G without a gap without using an adhesive, heat fusion, or welding.
  • the base end surface of the elongated element 4G is joined to the tip flange 33 of the first flange hub 42 without a gap, and the base end flange 34 of the first flange hub 42 is joined to the tip surface of the elongated element 4H without a gap.
  • the base end surface can be joined to the tip flange 34 of the second flange hub 43 without a gap, and the base end flange 34 of the second flange hub 43 can be joined to the tip surface of the elongated element 4I without a gap.
  • the force for pulling one end and the other end of the wires Y8, Y9, Y10, Y11 is a force required to cause the above-mentioned preload and bending of the elongated body 41. Is adjusted to.
  • the flange hubs 22, 32, 42, 43 of the second, third, and fourth embodiments (FIGS. 6, FIG. 9, FIG. 16 and the like).
  • a hole 27 is formed on the tip end side of the hub body 6 to penetrate the tubular wall of the hub body 6 in the thickness direction, and the tubular wall of the hub body 6 is formed in the thickness direction on the base end side of the hub body 6.
  • a through hole 28 may be formed.
  • the wire Y1 (FIGS. 1 and 2) is passed through the holes 27 and 28 of the hub body 6, and the wire Y1 passes through the inside of the hub body 6 between the holes 27 and 28. In this way, the exposed range of the wire Y1 can be suppressed to a small size, so that it is possible to prevent the wire Y1 from being damaged by contact with another object.
  • the holes 27 and 28 are not necessarily formed in the hub main body 6 of the flange hubs 22, 32, 42 and 43 (FIGS. 6, FIG. 9, FIG. 17, etc.) of the second, third and fourth embodiments. You may.
  • the flange hub 22 (FIG. 6) of the second embodiment the portions of the first and second wires Y2 and Y3 that pass between the base end flange 24 and the tip end flange 23 are the hub main body 6, respectively. It is supposed to pass outside.
  • the first, second, third, and fourth wires Y4, Y5 passing between the base end flange 34 and the tip end flange 33.
  • Y6 and Y7 are assumed to pass outside the hub body 6, respectively.
  • the first, second, third, and fourth wires Y8, Y9 which pass between the base end flange 34 and the tip end flange 33, It is assumed that the portions Y10 and Y11 each pass through the outside of the hub body 6.
  • one wire provided in the instruments 1, 20, 30, and 40 (FIGS. 1, FIG. 6, FIG. 9, FIG. 15, and FIG. 16) is attached to the tip side.
  • An example was shown in which one end and the other end of the one wire can be towed by extending the wire and then bending the wire to the base end side.
  • One end of the two wires may be extended and fixed to the tip of the elongated element or the base end flange of the flange hub by welding, fastening, or the like so that the other end of the two wires can be towed.
  • the appliances 1, 20, 30, 40 (FIGS. 1, FIG. 6, FIG. 9, FIG. 15, FIG. 16) of the first to fourth embodiments are changed as follows.
  • the instrument 1 of the first embodiment includes an elongated body 2 (FIGS. 1 and 2), a first wire, and a second wire (the first wire and the second wire are wire Y1 (FIG. 2). It is provided in place of 1)).
  • the first wire includes a wire lumen R3 formed in the elongated element 4B, one second through hole 10A communicating with the wire lumen R3, and one first through hole between the base end flange 8 and the tip flange 7 of the flange hub 5.
  • one end of the first wire extending from the wire lumen R1 is fixed to the tip of the elongated element 4A by sequentially passing through the two wire lumens R1 formed on the elongated element 4A communicating with the 9A.
  • the second wire is a wire lumen R4 formed in the elongated element 4B, the other second through hole 10B communicating with the wire lumen R4, between the base end flange 8 and the tip flange 7 of the flange hub 5, and the other first through hole.
  • one end of the second wire extending from the wire lumen R2 is sequentially passed through the wire lumen R2 formed in the elongated element 4A communicating with the elongated element 4A, and is fixed to the tip of the elongated element 4A by welding, fastening, or the like. ..
  • the other end of the first wire extends from the wire lumen R3
  • the other end of the second wire extends from the wire lumen R4, and the other end of the first wire.
  • the other end of the second wire and the other end of the second wire can be pulled in the longitudinal direction X of the elongated body 2, respectively.
  • the instrument 20 of the second embodiment includes an elongated body 21 (FIGS. 6 and 7), a first wire, a second wire, a third wire, and a fourth wire (first wire). And the second wire is provided in place of the wire Y2 (FIG. 6 etc.), and the third wire and the fourth wire are provided in place of the wire Y3 (FIG. 6 etc.).
  • the first wire includes a wire lumen R3 formed in the elongated element 4D, one second through hole 10A communicating with the wire lumen R3, and one first through hole between the base end flange 24 and the tip flange 23 of the flange hub 22.
  • one end of the first wire extending from the wire lumen R1 is fixed to the tip of the elongated element 4C by sequentially passing through the wire lumen R1 formed on the elongated element 4C communicating with the wire lumen R1.
  • the second wire includes a wire lumen R4 formed in the elongated element 4D, the other second through hole 10B communicating with the wire lumen R4, between the base end flange 24 of the flange hub 22 and the tip flange 23, and the other first through hole.
  • one end of a second wire extending from the wire lumen R2 is fixed to the tip of the elongated element 4C by sequentially passing through the second wire lumen R2 formed on the elongated element 4C communicating with the 9B.
  • the third wire includes a wire lumen R7 formed in the elongated element 4D, one fourth through hole 26A communicating with the wire lumen R7, and one third through hole between the base end flange 24 and the tip flange 23 of the flange hub 22. 25A, one end of a third wire extending from the wire lumen R5 is fixed to the tip of the elongated element 4C by sequentially passing through the wire lumen R5 formed on the elongated element 4C communicating with the wire lumen R5.
  • the fourth wire includes a wire lumen R8 formed in the elongated element 4D, the other fourth through hole 26B communicating with the wire lumen R8, between the base end flange 24 and the tip flange 23 of the flange hub 22, and the other third through hole. 25B, one end of a fourth wire extending from the wire lumen R6 is fixed to the tip of the elongated element 4C by sequentially passing through the wire lumen R6 formed on the elongated element 4C communicating with the wire lumen R6.
  • the other end of the first wire extends from the wire lumen R3, the other end of the second wire extends from the wire lumen R4, and the other end of the third wire is the wire.
  • the other end of the fourth wire extends from the wire lumen R8 to extend the other end of the first wire, the other end of the second wire, the other end of the third wire, and the second The other ends of the four wires can be pulled in the longitudinal direction X of the elongated body 21, respectively.
  • a route composed of the through holes 9A and 10A and the wire lumen R communicating with the through holes 9A and 10A may be formed.
  • a wire Y is passed through a route composed of a set of 25B and 26B and a wire lumen R communicating with the set of 25B and 26B, one end of each wire Y is fixed to the tip of an elongated element 4C, and each wire Y is fixed. The other end of the wire can be towed.
  • the device 30 of the third embodiment includes an elongated body 31 (FIGS. 10 to 13), a first wire, a second wire, a third wire, a fourth wire, a fifth wire, and a sixth wire.
  • the seventh wire and the eighth wire are provided (the first wire and the second wire are provided in place of the wire Y4 (FIG. 9, etc.), and the third wire and the fourth wire are the wires Y5.
  • the fifth wire and the sixth wire are provided in place of the wire Y6 (FIG. 9 etc.), and the seventh wire and the eighth wire are provided in place of the wire Y7 (FIG. 6 etc.). Will be provided instead).
  • the first wire includes one fifth wire lumen R13A, one second through hole 10A-1 of the first set communicating with the fifth wire lumen R13A, and the first set between the base end flange 34 and the tip flange 33 of the flange hub 32.
  • One end of the first wire that sequentially passes through one first through hole 9A-1 and one first wire lumen R9A communicating with the first wire lumen R9A and extends from the first wire lumen R9A is formed by an elongated element 4E. It is fixed to the tip.
  • the second wire is the other fifth wire lumen R13B, the other second through hole 10B-1 of the first set communicating with the fifth wire lumen R13B, and the first set between the base end flange 34 and the tip flange 33 of the flange hub 32.
  • One end of the second wire that sequentially passes through the other first through hole 9B-1 and the other first wire lumen R9B communicating with the first wire lumen R9B and extends from the first wire lumen R9B is formed by the elongated element 4E. It is fixed to the tip.
  • the third wire includes one sixth wire lumen R14A, one second through hole 10A-2 of the second set communicating with the sixth wire lumen R14A, and the second set between the base end flange 34 and the tip flange 33 of the flange hub 32.
  • One end of the third wire Y5 that sequentially passes through one first through hole 9A-2 and one second wire lumen R10A communicating with the first through hole 9A-2 and extends from the second wire lumen R10A is the tip of the elongated element 4E. Is fixed to.
  • the fourth wire is the other sixth wire lumen R14B, the other second through hole 10B-2 of the second set communicating with the sixth wire lumen R14B, and the second set between the base end flange 34 and the tip flange 33 of the flange hub 32.
  • One end of the third wire Y5 extending sequentially from the other first through hole 9B-2 and the other second wire lumen R10B communicating with the second wire lumen R10B is the tip of the elongated element 4E. Is fixed to.
  • the fifth wire is one of the seventh wire lumen R15A, one of the fourth through holes 26A-3 of the third set communicating with the seventh wire lumen R15A, and the third set between the base end flange 34 and the tip flange 33 of the flange hub 32.
  • the sixth wire is the other seventh wire lumen R15B, the other fourth through hole 26B-3 of the third set communicating with the seventh wire lumen R15B, and the third set between the base end flange 34 and the tip flange 33 of the flange hub 32.
  • One end of the sixth wire extending from the wire lumen R11B after sequentially passing through the other third through hole 25B-3 and the other third wire lumen R11B communicating with the third through hole 25B-3 is fixed to the tip of the elongated element 4E.
  • the seventh wire Y7 is formed between one eighth wire lumen R16A, one fourth through hole 26A-4 of the fourth set communicating with the eighth wire lumen R16A, and a fourth wire between the base end flange 34 and the tip flange 33 of the flange hub 32.
  • One end of the fourth wire extending from the fourth wire lumen R12A after sequentially passing through one of the third through holes 25A-4 of the set and the fourth wire lumen R12A communicating with the third through hole 25A-4 is the tip of the elongated element 4E. Is fixed to.
  • the eighth wire Y7 is formed between the other eighth wire lumen R16B, the other fourth through hole 26B-4 of the fourth set communicating with the eighth wire lumen R16B, the base end flange 34 of the flange hub 32, and the tip flange 33.
  • One end of the eighth wire extending sequentially from the other third through hole 25B-4 of the set and the other fourth wire lumen R12B communicating with the fourth wire lumen R12B is the tip of the elongated element 4E. Is fixed to.
  • the other end of the first wire extends from one fifth wire lumen R13A and the other end of the second wire extends from the other fifth wire lumen R13B.
  • the other end of the three wires extends from one sixth wire lumen R14A, the other end of the fourth wire extends from the other sixth wire lumen R14B, and the other end of the fifth wire is one of the first. It extends from the seventh wire lumen R15A, the other end of the sixth wire extends from the other seventh wire lumen R15B, the other end of the seventh wire extends from one eighth wire lumen R16A, and the second The other end of the eight wires extends from the other eighth wire lumen R16B.
  • the other end of the first wire, the other end of the second wire, the other end of the third wire, the other end of the fourth wire, the other end of the fifth wire, the other end of the sixth wire, the first The other end of the seventh wire and the other end of the eighth wire can be pulled in the longitudinal direction X of the elongated body 31, respectively.
  • the instrument 40 of the fourth embodiment includes an elongated body 41 (FIG. 17), a first wire, a second wire, a third wire, a fourth wire, a fifth wire, a sixth wire, and a seventh wire.
  • the wire and the eighth wire are provided (the first wire and the second wire are provided in place of the wire Y8 (FIG. 15 and the like), and the third wire and the fourth wire are the wires Y9 (FIG. 15 and the like).
  • the fifth wire and the sixth wire are provided in place of the wire Y10 (FIG. 15 etc.)
  • the seventh wire and the eighth wire are provided in place of the wire Y11 (FIG. 15 etc.). Will be).
  • the first wire includes one ninth wire lumen R25A, one second through hole 10A-1 of the first set formed in the second flange hub 43 communicating with the ninth wire lumen R25A, and the base end flange 34 of the second flange hub 43.
  • One end of the first wire that sequentially passes through one of the fourth through holes 26A-3 of the third set formed in the hub 42 and extends from the fourth through hole 26A-3 is the first flange hub 42. It is fixed to the base end flange 34 of.
  • the second wire includes the other ninth wire lumen R25B, the other second through hole 10B-1 of the first set formed in the second flange hub 43 communicating with the ninth wire lumen R25B, and the base end flange 34 of the second flange hub 43.
  • One end of a second wire that sequentially passes through one of the fourth through holes 26A-4 of the fourth set formed in the hub 42 and extends from the fourth through hole 26A-4 is the first flange hub 42. It is fixed to the base end flange 34 of.
  • the third wire includes one tenth wire lumen R26A, one second through hole 10A-2 of the second set formed in the second flange hub 43 communicating with the tenth wire lumen R26A, and the base end flange 34 of the second flange hub 43.
  • One end of a third wire that sequentially passes through the other fourth through hole 26B-3 of the third set formed in the hub 42 and extends from the fourth through hole 26B-3 is the base of the first flange 42.
  • the fourth wire is the other tenth wire lumen R26B, the other second through hole 10B-2 of the second set formed in the second flange hub 43 communicating with the tenth wire lumen R26B, and the base end flange 34 of the second flange hub 43.
  • One end of a fourth wire that sequentially passes through the other fourth through hole 26B-4 of the fourth set formed in the hub 42 and extends from the fourth through hole 26B-4 is the base of the first flange 42.
  • the fifth wire includes one eleventh wire lumen R27A, one fourth through hole 26A-3 of the third set formed in the second flange hub 43 communicating with the eleventh wire lumen R27A, and the base end flange of the second flange hub 43. Between 34 and the tip flange 33, one third through hole 25A-3 of the third set formed in the second flange hub 43, one fifth wire lumen R21A communicating with this, and the first communicating with this.
  • One end of the fifth wire extending from the first wire lumen R17A, which sequentially passes through one of the first through holes 9A-1 of the set and one of the first wire lumens R17A communicating with the first through hole 9A-1, is a first elongated element. It is fixed to the tip of 4G.
  • the sixth wire is the other eleventh wire lumen R27B, the third set of the other fourth through hole 26B-3 formed in the second flange hub 43 communicating with the eleventh wire lumen R27B, and the base end flange of the second flange hub 43.
  • One end of a sixth wire extending from the first wire lumen R17B after sequentially passing through a set of the other first through hole 9B-1 and the other first wire flange R17B communicating with the first through hole 9B-1 is the first. It is fixed to the tip of the elongated element 4G.
  • the seventh wire includes one twelfth wire lumen R28A, one fourth through hole 26A-4 of the fourth set formed in the second flange hub 43 communicating with the twelfth wire lumen R28A, and the base end flange of the second flange hub 43.
  • the other third through hole 25B-3 of the third set formed in the second flange hub 43 the sixth wire lumen R22A communicating with this, and the first communicating with this.
  • the eighth wire is the other twelfth wire lumen R28B, the other fourth through hole 26B-4 of the fourth set formed in the second flange hub 43 communicating with the twelfth wire lumen R28B, and the base end flange of the second flange hub 43.
  • the other end of the first wire extends from one ninth wire lumen R25A
  • the other end of the second wire extends from the other ninth wire lumen R25B
  • the second wire The other end of the three wires extends from one tenth wire lumen R26A
  • the other end of the fourth wire extends from the other tenth wire lumen R26B
  • the other end of the fifth wire is one of the first. It extends from the eleventh wire lumen R27A
  • the other end of the sixth wire extends from the other eleventh wire lumen R27B
  • the other end of the seventh wire extends from one of the twelfth wire lumens R28A.
  • the other end of the eighth wire extends from the other twelfth wire lumen R28B. And the other end of the first wire, the other end of the second wire, the other end of the third wire, the other end of the fourth wire, the other end of the fifth wire, the other end of the sixth wire, the first The other end of the seventh wire and the other end of the eighth wire can be pulled in the longitudinal direction X of the elongated body 41, respectively.
  • the cavity 40 of the elongated element 4A, the cavity 60 of the hub body 6, and the cavity 40 of the elongated element 4B communicate with each other to form the elongated body 2.
  • the main lumens 40, 60, 40 are composed.
  • the cavity 40 of the elongated element 4C, the cavity 60 of the hub body 6, and the cavity 40 of the elongated element 4D communicate with each other to form the elongated body 21.
  • the main lumens 40, 60, 40 are composed.
  • the cavity 40 of the elongated element 4E FIG.
  • the main lumens 40, 60, 40 of the elongated body 31 are constructed. Further, in the instrument 40 of the fourth embodiment (FIGS. 15 to 23), the cavity 40 of the elongated element 4G (FIG. 22), the cavity 60 of the hub body 6 of the first flange hub 42 (FIG. 22), and the elongated element 4H 40 (FIG. 18), the cavity 60 (FIG. 18) of the hub body 6 of the second flange hub 43, and the cavity 40 (FIG. 18) of the elongated element 4I communicate with each other to form an elongated body 41 (FIG. 17).
  • Main lumens 40, 60, 40, 60, 40 are configured.
  • the elongated bodies 2, 21, 31, 41 are longitudinal in addition to bending by pulling the wire Y. It is possible to move forward and backward in direction X and rotate around the center line.
  • a guide wire (not shown), a cautery needle, a loop-shaped snare, a small forceps, or other therapeutic device can be inserted into the main lumens of the elongated bodies 2, 21, 31, and 41.
  • the above guide wire is formed of a wire and is used as a guide for guiding the elongated bodies 2, 21, 31, and 41 into a desired lumen.
  • the guide wire is inserted into the main lumen of the slender body 2,21,31,41 so that the base end portion extends from the base end of the slender body 2,21,31,41, and the base end portion of the guide wire is inserted.
  • the guide wire can be moved back and forth in the longitudinal direction X of the elongated bodies 2, 21, 31, and 41, and the guide wire can be rotated around the center line thereof.
  • the tips of the slender bodies 2,21,31,41 are located at the bifurcation of the lumen.
  • the guide wire inserted into the main lumen is advanced in the longitudinal direction X so that the tip of the guide wire extends from the tip opening of the elongated bodies 2, 21, 31, and 41, and the guide wire is rotated.
  • the tip of the guide wire can be inserted into the branch pipe (the above-mentioned "tip opening of elongated bodies 2, 21, 31, 41" is "elongated”.
  • the tip opening of one elongated element 4 arranged on the most advanced side “the tip opening 13k of the tip tip 13 (FIG. 4) ”, Alternatively, it is composed of "hole 16k of plate 17 (FIG. 5)").
  • the tip of the guide wire By adding a bending habit to the tip of the guide wire before inserting it into the main lumen, the tip of the guide wire has a habit when the tip of the guide wire is extended from the tip opening of the elongated bodies 2, 21, 31, and 41. Since the tip of the guide wire bends in the attached direction, the tip of the guide wire may be easily inserted into the branch pipe. Further, it is preferable that the guide wire is composed of a wire having a torque coil structure. In this way, the tip of the guide wire can be reliably rotated by the rotation operation with respect to the base end of the guide wire. As a result, the direction of the tip of the guide wire can be reliably adjusted to the desired direction, so that the tip of the guide wire can be reliably inserted into the desired lumen. Therefore, the tips of the elongated bodies 2, 21, 31, and 41 can be reliably inserted into the desired lumen by the guide with the guide wire.
  • the elongated bodies 2, 21, 31, 41 can be easily moved into the desired lumen. If you can proceed to, you do not need to use a guide wire.
  • therapeutic devices such as cautery needles, looped snares and small forceps are used to remove tumors in the lumen.
  • the treatment device With the slender bodies 2, 21, 31, 41 placed in the range photographed by the endoscopic camera, insert these treatment devices into the main lumen and make the tip of the treatment device slender.
  • the surgical field is confirmed with an endoscopic camera by extending from 2,21,31,41 and allowing the treatment device to function as a flexible surgical arm that bends along the elongated body 2,21,31,41.
  • the tip of the elongated body 2,21,31,41 is inserted into the lumen by the guide of the guide wire, after the guide wire is pulled out from the main lumen of the elongated body 2,21,31,41.
  • the guide wire is inserted into the main lumen while the guide wire is still inserted into the main lumen.
  • the elongated bodies 2, 21, 31, and 41 are tubes in which the elongated elements 4, 4 which are pipe bodies are connected to each other by flange hubs 22, 32, 42, and 43.
  • the slender body of the present invention may be one in which slender elements that are not tubular bodies (slender elements that do not have a cavity 40) are connected by flange hubs 22, 32, 42, and 43.
  • the hub body 6 of the flange hubs 22, 32, 42, 43 may not have the cavity 60.

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Abstract

L'invention concerne un moyeu de bride disposé sur un corps long et étroit comprenant deux éléments longs et étroits adjacents, le moyeu de bride permettant de régler, au moyen d'une opération simple, l'orientation d'un fil requis pour rendre la courbure des éléments longs et étroits plus grande du côté d'une extrémité distale que du côté d'une extrémité de base. Dans ce moyeu de bride, des premiers trous traversants (9A, 9B) sont formés dans une bride d'extrémité distale (23), et des seconds trous traversants (10A, 10B) sont formés dans une bride d'extrémité de base (24). Les premiers trous traversants (9A, 9B) sont formés au niveau de positions pour lesquelles la distance la plus courte depuis un second plan XY est une troisième distance L3, et les seconds trous traversants (10A, 10B) sont formés au niveau de positions pour lesquelles la distance la plus courte depuis le deuxième plan XY est une quatrième distance L4, la troisième distance L3 étant supérieure à la quatrième distance L4.
PCT/JP2021/013626 2020-03-30 2021-03-30 Moyeu de bride, corps long et étroit, et accessoire WO2021200998A1 (fr)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080262422A1 (en) * 2007-04-18 2008-10-23 Nmt Medical, Inc. Flexible Catheter System
US20130297012A1 (en) * 2012-05-04 2013-11-07 St. Jude Medical, Cardiology Division, Inc. Delivery system deflection mechanism
CN205698858U (zh) * 2016-04-08 2016-11-23 上海庆之医疗科技有限公司 导管
WO2019026995A1 (fr) * 2017-08-02 2019-02-07 住友ベークライト株式会社 Dispositif médical
WO2019027013A1 (fr) * 2017-08-02 2019-02-07 住友ベークライト株式会社 Dispositif médical
WO2019203061A1 (fr) * 2018-04-16 2019-10-24 国立大学法人滋賀医科大学 Cathéter mobile

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080262422A1 (en) * 2007-04-18 2008-10-23 Nmt Medical, Inc. Flexible Catheter System
US20130297012A1 (en) * 2012-05-04 2013-11-07 St. Jude Medical, Cardiology Division, Inc. Delivery system deflection mechanism
CN205698858U (zh) * 2016-04-08 2016-11-23 上海庆之医疗科技有限公司 导管
WO2019026995A1 (fr) * 2017-08-02 2019-02-07 住友ベークライト株式会社 Dispositif médical
WO2019027013A1 (fr) * 2017-08-02 2019-02-07 住友ベークライト株式会社 Dispositif médical
WO2019203061A1 (fr) * 2018-04-16 2019-10-24 国立大学法人滋賀医科大学 Cathéter mobile

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