Deflection operating devices for medical equipment

Abstract

The medical device deflection operation device (1A) of the present invention comprises: a first rack member (100) and a second rack member (200), which are accommodated in a manipulator housing (300) in a manner that they can reciprocate in the length direction along the extension direction of the first and second operation guide wires (31, 32) and have teeth (120, 220) facing each other; and a pinion member (400), which is supported to be rotatable in a state of meshing with the teeth (120, 220) of the rack members (100, 200). The rack members (100, 200) are respectively provided with first and second operation handles (510, 520) in one piece, and the first and second operation handles (510, 520) protrude to the outside of the manipulator housing (300).

Description

Technical Field

[0001] The invention relates to a deflection operating device for medical equipment. Background Art

[0002] A flexible long tubular medical device such as a catheter is inserted into various organs (e.g., heart) and other tissues in the body through a blood vessel, trachea, or body cavity, lumen in the body, etc., to perform a target medical treatment. In order to facilitate insertion into the body and access to tissues, the following technology is known: a manipulation unit connected to the proximal end of the medical device and disposed outside the body can be used to deflect the direction of the distal end inserted into the body (e.g., see Patent Documents 1 and 2, etc.).

[0003] Patent Document 1 describes a deflection mechanism in which a cylindrical control handle coaxial with a sheath provided at the proximal end of a sheath as a medical device advances and retreats two puller wires inserted in the sheath in opposite directions to deflect the direction of the distal end of the sheath.

[0004] In the control handle described in Patent Document 1, a control knob is rotatably supported on the distal end side of a main body as a part held by hand, and a pair of shuttles are built in the main body to move forward and backward in the front-back direction (axial direction of the sheath) by the rotation of the control knob, and a pull wire is connected to each shuttle. Each shuttle is axially extended, has a semi-cylindrical portion on the distal end side, and has rack portions facing each other on the proximal end side, and the two rack portions mesh with a pinion to form a rack and pinion. In addition, an outer thread surface is formed on the outer peripheral surface of the semi-cylindrical portion on the distal end side of one of the pair of shuttles, and the outer thread surface is screwed with an inner thread surface formed on the inner peripheral surface of a rotary shaft integral with the control knob to form a bolt drive mechanism.

[0005] According to the control handle described in Patent Document 1, when the control knob is rotated, the rotation is converted into a linear motion of one shuttle through the screw drive mechanism, and the linear motion of the one shuttle causes the other shuttle to linearly move in the opposite direction via the pinion gear. In this way, the rotation of the control knob is converted into the movement of the two shuttles moving forward and backward in opposite directions, so that the two pull wires connected to the respective shuttles move forward and backward in opposite directions, causing the direction of the distal end of the sheath to deflect.

[0006] Patent Document 2 describes a deflection mechanism in which a first operation wire and a second operation wire inserted in the medical device body are pulled by a bending operation unit provided at the proximal end of a tubular medical device body to deflect the direction of the distal end of the medical device body.

[0007] In the bending operation part described in Patent Document 2, an advance / retract member having a rack portion that advances / retracts in the front-to-rear direction (the axial direction of the medical device body) is housed in a shell that is held by the hand, and the proximal ends of the first and second operation wires are fixed to a rotating member provided on the distal end side of the advance / retract member, and further, a dial operation part is rotatably supported on the shell, the dial operation part having a pinion gear meshing with the rack portion of the advance / retract member at the center of rotation, and the left and right ends of the dial operation part protrude on the sides of the shell, respectively.

[0008] According to the bending operation part described in Patent Document 2, by holding the shell with one hand and rotating the dial operation part in one direction with the other hand, the rotating member and the advance and retreat member are moved backward together, and the first operation wire and the second operation wire are pulled toward the proximal side, thereby deflecting the direction of the distal end of the medical device body.

[0009] Prior art literature

[0010] Patent Literature

[0011] Patent Document 1: Japanese Patent Application Publication No. 2018-094406

[0012] Patent document 2: Japanese Patent Application Publication No. 2019-025211. Summary of the invention

[0013] Problem that the invention aims to solve

[0014] However, the control handle described in the above-mentioned patent document 1 has the disadvantages of complex structure and large number of parts. In addition, since the rotation axis is a structure in which the direction of the distal end of the sheath is deflected by rotating the control knob coaxial with the sheath, the operation direction of the control knob, i.e., the rotation direction, is completely different from the deflection direction of the distal end of the sheath. Therefore, it is difficult to grasp the deflection state (deflection direction, deflection degree) corresponding to the operation, and sufficient operability cannot be obtained. Furthermore, since a screw drive mechanism is used in the motion conversion from the rotation operation to the linear motion, the operation reaction force from the deflected distal end of the sheath is difficult to be directly transmitted to the control knob for manual operation, and an effective operation damping feeling (operation feeling) cannot be obtained, and thus it is difficult to obtain sufficient operability.

[0015] On the other hand, since the bending operation unit described in Patent Document 2 is difficult to grasp the housing and rotate the dial operation unit with one hand, both hands are occupied to operate the bending operation unit, which may make it difficult to perform other operations on the catheter and maintain the catheter posture.

[0016] The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a deflection operation device for medical equipment that is easy to operate with one hand, has a simple structure, and can provide sufficient operability.

[0017] Solutions for solving problems

[0018] The present invention is a deflection operation device for medical equipment, which performs deflection operation on the movable part of the medical equipment via a first operation guide wire and a second operation guide wire, and is characterized in that it comprises: a manipulator housing, which comprises: a main body, in which a supporting handle is arranged at one end side of the length direction along the extension direction of the first operation guide wire and the second operation guide wire, and a guide wire insertion portion arranged at the other end side of the length direction of the main body and penetrated by the first operation guide wire and the second operation guide wire; a first rack member and a second rack member, which are accommodated in the manipulator housing in a manner that they can be reciprocated in the length direction and have teeth facing each other; and a pinion member, which is arranged between the first rack member and the second rack member to be movable back and forth in the length direction respectively and have teeth facing each other. The meshing state of the teeth of the two rack members is supported by the manipulator housing in a freely rotatable state, and a sliding guide portion is provided in the manipulator housing, and the sliding guide portion forms a groove-shaped opening along at least one of the first rack member and the second rack member, and an operating handle is integrally provided on at least one of the first rack member and the second rack member, and the operating handle protrudes to the outside of the manipulator housing through the opening. When a sliding operation is performed to cause the operating handle to be relatively displaced relative to the supporting handle portion in the length direction, the first rack member and the second rack member are displaced in opposite directions relative to the pinion member, and the first operating guide wire and the second operating guide wire are displaced in the deflection operation direction of the movable portion.

[0019] According to the medical device deflection operation device of the present invention, by operating at least one operating handle provided in the first rack member and the second rack member, the rack members are reciprocally displaced in opposite directions to each other, thereby deflecting the movable part of the medical device. Therefore, the deflection operation of the movable part of the medical device can be performed with a simpler structure than before.

[0020] In addition, according to the deflection operation device for medical equipment involved in the present invention, the reciprocating operation direction of the operating handle is the same direction as the extension direction of the first operating guide wire and the second operating guide wire, and the operating handle is integrally provided in at least one of the first and second rack members. Therefore, the operating direction of the operating handle can correspond to the deflection direction of the movable part of the medical device in terms of feel. In addition, it is easy to grasp the deflection state (direction of deflection, degree of deflection) corresponding to the operation of the operating handle, and the operating reaction force from the movable part of the medical device is transmitted to the operating handle for manual operation, so that an effective operating damping feeling (operation feeling) can be obtained. As a result, sufficient operability can be obtained.

[0021] Furthermore, according to the yaw operation device for medical equipment according to the present invention, the operator can easily support or operate the operation device with one hand by bringing the operator's palm into contact with the support handle portion of the manipulator housing and placing fingers on the operation knob.

[0022] The yaw operation device for medical equipment according to the present invention is characterized in that the operation handle is composed of a first operation handle and a second operation handle respectively provided on the first rack member and the second rack member.

[0023] With this structure, the deflection operation device for medical equipment according to the present invention can deflect the movable part in a desired direction by operating the operating handle on the side corresponding to the deflection direction of the movable part among the first operating handle and the second operating handle. Therefore, it is easy to grasp the deflection state corresponding to the operation of the first and second operating handles, and the operation reaction force from the movable part of the medical equipment is transmitted to the operating handle on the side for manual operation, so that an effective operation damping feeling (operation feeling) can be obtained.

[0024] In addition, the first and second operating handles can effectively apply operating force to each operating handle when manually operated with one hand by performing a pulling operation to displace the support handle portion, and compared with a tilting operation such as rotating a dial, it is not necessary to reposition the fingers while operating, thereby improving operability. Furthermore, even if the operator housing is flipped 180 degrees to reverse the left and right positions of the first and second operating handles, each operating handle can be operated in the same manner.

[0025] The yaw manipulator for medical equipment according to the present invention is characterized in that the support handle portion forms a substantially T-shape together with the main body portion of the manipulator housing.

[0026] With this structure, the medical device yaw operator according to the present invention can be easily grasped via the support handle portion, and the operability can be improved.

[0027] The deflection operation device for medical equipment according to the present invention is characterized in that a force applying unit is installed between at least one of the first rack member and the second rack member and the manipulator housing, and the force applying unit applies force to the first rack member and the second rack member toward a specific position relative to the manipulator housing. The specific position mentioned here can be considered as a neutral position in which the movable part of the medical equipment extends straight without deflection. In addition, in the case where the medical equipment is given a curved shape, for example, the movable part is not necessarily straight in the neutral position, and the neutral position can be set corresponding to the shape of the medical equipment.

[0028] With this structure, the medical device yaw operation device according to the present invention can automatically hold the first rack member and the second rack member at specific positions by the force applying unit without operating the operation handle. Therefore, each rack member can be easily and reliably held at its specific position, and the operability can be improved.

[0029] The deflection operating device for medical equipment according to the present invention is characterized in that the operating handle is arranged on at least one of the first rack member and the second rack member, and an indicator portion is arranged on the other rack member, and the indicator portion indicates the relative position of the other rack member relative to the manipulator housing.

[0030] With this configuration, the medical device yaw operator according to the present invention can grasp the yaw state of the medical device by visually recognizing the relative position of the indicator portion with respect to the manipulator housing.

[0031] Effects of the Invention

[0032] According to the present invention, it is possible to provide a yaw operation device for medical equipment that is easy to operate with one hand, has a simple structure, and can provide sufficient operability. BRIEF DESCRIPTION OF THE DRAWINGS

[0033] Figure 1 It is a plan view showing a deflection operation device for medical equipment according to one embodiment of the present invention and a catheter whose movable portion is deflected by the deflection operation device.

[0034] Figure 2 for Figure 1 II-II sectional view.

[0035] Figure 3 for Figure 1 and Figure 4 III-III sectional view.

[0036] Figure 4 for Figure 3 IV-IV cross-sectional view.

[0037] Figure 5 This is a plan view of the yaw operator for medical equipment according to one embodiment of the present invention as viewed through a cover on the front surface side of a manipulator housing.

[0038] Figure 6 This is a perspective view showing a state in which a cover of a manipulator case is removed from a base body of the yaw operation device for medical equipment according to one embodiment of the present invention.

[0039] Figure 7 for Figure 5 View from the VII direction.

[0040] Figure 8 for Figure 5 View from the VIII direction.

[0041] Fig. 9 for Figure 5 IX-IX sectional view.

[0042] Fig. 10A It is a plan view showing a second rack member and a second operating handle according to an embodiment of the present invention.

[0043] Fig. 10B It is a plan view showing a first rack member and a first operating handle according to one embodiment of the present invention.

[0044] Fig.11 It is a plan view showing a state in which the movable portion of the catheter is deflected in one direction by the medical device deflection operation device according to one embodiment of the present invention.

[0045] Fig.12 To illustrate the movement of the active portion of the catheter toward the deflection direction of the medical device according to one embodiment of the present invention. Fig.11 A top view of a state in which the deflection is in the opposite direction is shown.

[0046] Fig.13 This is a plan view of a yaw operator for medical equipment according to another embodiment of the present invention, as viewed through a cover of a manipulator housing.

[0047] Fig.14 To show in Fig.13 In another embodiment shown, it is a plan view of an example in which the arrangement of the operating handle, the indicator, and the coil spring is changed. DETAILED DESCRIPTION

[0048] Hereinafter, embodiments of the present invention will be described with reference to the drawings.

[0049] (One embodiment)

[0050] First, the structure of one embodiment will be described.

[0051] Figure 1 A deflection manipulator for medical equipment (hereinafter referred to as the deflection manipulator) 1A according to an embodiment and a catheter 2 whose distal end is deflected by the deflection manipulator 1A are shown. The catheter 2 constitutes the medical equipment of the present invention. As the medical equipment of the present invention, in addition to the catheter shown in this embodiment, flexible tubes such as cannulas and sheaths can be cited, but are not limited thereto.

[0052] The catheter 2 is inserted into the body at the front end side, i.e., the distal end side ( Figure 1The end portion (lower side in the middle) of the catheter 2 has a movable portion 20 that can be deflected in the left and right direction. The deflection operation device 1A is fixed to the proximal end of the catheter 2 and is arranged outside the body when in use. The deflection operation device 1A deflects the movable portion 20 via a first operation guide wire 31 and a second operation guide wire 32 that are described later and are provided in the catheter 2.

[0053] First, the catheter 2 will be described.

[0054] The catheter 2 has Figure 2 to Figure 4 However, the structure of the catheter 2 is not limited thereto.

[0055] Figure 2 and Figure 3 is a cross-sectional view of the catheter 2, Figure 2 Show Figure 1 Middle II-II section, Figure 3 Show Figure 1 and Figure 4 In addition, Figure 4 The distal end of the catheter 2 is shown Figure 3 IV-IV section of.

[0056] like Figure 2 to Figure 4 As shown, the catheter 2 has a main cavity 23, two guidewire cavities 21, 22, namely a first guidewire cavity 21 and a second guidewire cavity 22. The catheter 2 is composed of a multilayer tube having an inner tube 23A and an outer tube 23B made of flexible resin, and the main cavity 23 is composed of the hollow interior of the inner tube 23A.

[0057] In the outer tube 23B, the first guidewire cavity 21 and the second guidewire cavity 22 are respectively disposed at opposite ends of about 180 degrees relative to the central axis of the catheter 2 .

[0058] The first guidewire cavity 21 is formed by the hollow interior of the first guidewire cavity tube 21A buried in the outer tube 23B. In addition, the second guidewire cavity 22 is formed by the hollow interior of the second guidewire cavity tube 22A buried in the outer tube 23B. Each guidewire cavity 21, 22 extends along the axial direction of the catheter 2.

[0059] A first operating guide wire 31 is inserted into the first guide wire cavity 21 so as to be able to advance and retreat along the axial direction of the catheter 2, and a second operating guide wire 32 is inserted into the second guide wire cavity 22 so as to be able to advance and retreat along the axial direction of the catheter 2. Each operating guide wire 31, 32 is made of a twisted wire or a single wire of a metal such as stainless steel, or a wire of a polymer material.

[0060] In addition, if Figure 3 and Figure 4 As shown, the catheter 2 according to this embodiment has a circular ring-shaped pull ring 40 provided at the distal end. The pull ring 40 is made of metal such as stainless steel.

[0061] The distal end portions of the first operation wire 31 and the second operation wire 32 are respectively joined to the inner surface 40 a of the pull ring 40 by brazing or the like.

[0062] In the deflection manipulator 1A according to the present embodiment, which is disposed at the proximal end of the catheter 2, the proximal ends of the first and second operation wires 31 and 32 are connected, respectively, as described later. The deflection manipulator 1A is configured to move the operation wires 31 and 32 forward and backward, thereby Figure 1 As shown by arrows α and β, the direction of the movable portion 20 of the catheter 2 is deflected 180 degrees to the opposite direction via the pull ring 40.

[0063] like Figure 2 to Figure 4 As shown, the catheter 2 has a blade layer 24 disposed so as to surround the main lumen 23 and the guidewire lumens 21 and 22. The blade layer 24 is a reinforcing member braided with wires such as stainless steel, and the blade layer 24 suppresses the catheter 2 from being twisted.

[0064] like Figure 4 As shown, the catheter 2 has a substantially cylindrical covering resin 50 at the distal end of the distal end thereof, which covers the distal end and the pull ring 40. The pull ring 40 is attached to the distal end of the catheter 2 by the covering resin 50. The covering resin 50 constitutes the distal end of the catheter 2, and the distal end edge is chamfered in an R shape to form a gentle surface.

[0065] Next, the yaw operation device 1A according to the present embodiment will be described.

[0066] Figure 5 FIG. 2 is a plan view showing the entire yaw operation device 1A. Figure 5 In the figure, the internal structure is shown by solid lines when viewed through the cover 300B of the manipulator housing 300 described later. Figure 5 As shown, the yaw operation device 1A according to this embodiment includes a flat manipulator case 300 having a cavity therein, a first rack member 100 and a second rack member 200 accommodated in the manipulator case 300 , and a pinion member 400 disposed between the rack members 100 and 200 .

[0067] The manipulator housing 300 is formed in a substantially T-shape with a hollow inside, and comprises: a substantially rectangular main body 310, a support handle 320 integrally provided at the proximal end, and a guide wire insertion portion 330 through which the first operating guide wire 31 and the second operating guide wire 32 are inserted at the distal end, respectively. The proximal end is one end side in the length direction of the main body 310, and the distal end is the other end side in the length direction of the main body 310. In the main body 310, the direction along the extension direction of each operating guide wire 31, 32 inserted in the catheter 2 is the length direction. The length direction described below refers to the direction based on the length direction of the main body 310.

[0068] The manipulator housing 300 has a symmetrical shape with a center line C in the longitudinal direction passing through the center in the width direction of the main body 310 as a symmetry line. Figure 6 As shown, the manipulator housing 300 is composed of a base 300A and a cover 300B which are roughly divided into two halves in the thickness direction and can be detachably combined by three screw fastening parts 301, 302, and 303 distributed at least in the length direction. The base 300A and the cover 300B have roughly the same shape and are integrally molded by resin or the like.

[0069] like Figure 6 As shown, the base 300A includes a base body side body portion 310a and a base body side support handle portion 320, which respectively constitute the main body portion 310 and the support handle portion 320 of the manipulator housing 300. In addition, similarly, the cover 300B includes a cover body side body portion 310b and a cover body side support handle portion 320, which respectively constitute the main body portion 310 and the support handle portion 320 of the manipulator housing 300.

[0070] like Figure 6 As shown in FIG. 1 , the base 300A includes a bottom plate portion 304a and a side wall portion 305a forming the edge of the bottom plate portion 304a, and thus the cross section of the base 300A is thin and disc-shaped. In addition, the cover 300B includes a top plate portion 304b and a side wall portion 305b forming the edge of the top plate portion 304b, and its cross section is thin and disc-shaped. The manipulator housing 300 is configured such that the side walls 305a and 305b of the base 300A and the cover 300B overlap each other, as shown in FIG. Figure 7 As shown, the side wall portion 305 as the entire manipulator housing 300 is formed by the two side wall portions 305a and 305b.

[0071] like Figure 7 As shown, the side wall portion 305 on the first rack member 100 side of the main body portion 310 has a first sliding guide portion 306, and the first sliding guide portion 306 forms a groove-shaped opening 306a along the first rack member 100. Figure 8As shown, the side wall portion 305 on the second rack member 200 side of the main body portion 310 has a second slide guide portion 307 that forms a groove-shaped opening 307 a along the second rack member 200 .

[0072] Unless otherwise specified, each component included in the manipulator housing 300 described below will be described as a component of the manipulator housing 300 in a state where the base body 300A and the cover body 300B are combined.

[0073] like Figure 5 As shown, the support handle 320 of the manipulator housing 300 includes a substantially rectangular first handle 321 and a second handle 322 extending laterally and perpendicular to the main body 310. The support handle 320 and the main body 310 form a substantially T-shape.

[0074] In addition, in the present embodiment, the supporting handle portion 320 is roughly T-shaped together with the main body portion 310, but as the supporting handle portion of the present invention, it can also be any shape with a surface that can contact the palm, such as a shape that is roughly L-shaped together with the main body portion 310. In addition, it can also be any shape with a structure that can hold the fingers, such as a ring for inserting fingers that can be supported by passing the fingers through.

[0075] like Figure 5 As shown, the edge 323 on the proximal side of the support handle portion 320 includes a support portion 323a that contacts the palm of the operator. The support portion 323a is formed into a gently curved surface that is generally convex toward the proximal side from one end to the other end. In addition, each corner portion 323b and 323c that is continuous at both ends of the support portion 323a is chamfered. Since the support portion 323a is gently curved and each corner portion 323b and 323c is chamfered, it is easy for the operator to make the palm contact the support portion 323a in a coordinated manner, thereby seeking to improve the operability of the deflection operation device 1A.

[0076] The distal ends of the first handle portion 321 and the second handle portion 322 constituting the support handle portion 320 respectively constitute finger locking portions 321a and 322a for the operator's fingers to rest on. These finger locking portions 321a and 322a are formed as gently curved surfaces that are generally concave toward the proximal end. In addition, the corner portions 321b and 322b on the outer sides of the finger locking portions 321a and 322a are chamfered.

[0077] In addition, if Figure 7 and Figure 8As shown, the manipulator housing 300 has an expansion portion 325 formed to be thicker than the main body 310 at the support handle portion 320 and at the transition portion between the support handle portion 320 and the main body 310. The thickness of the expansion portion 325 is an appropriate thickness for the operator to easily grip the support handle portion 320. In the support handle portion 320, each finger locking portion 321a, 322a is curved into a concave shape so that the fingers can be easily placed thereon. In addition, the support handle portion 320 has an appropriate thickness due to the expansion portion 325, so that the support handle portion 320 is easy to grip.

[0078] like Figure 5 and Fig. 9 As shown, the guide wire insertion portion 330 includes: a tubular sleeve portion 331 protruding from the distal end of the manipulator housing 300, a guide wire introduction port 332 communicating from the sleeve portion 331 to the manipulator housing 300, and a gate portion 333 disposed adjacent to the guide wire introduction port 332. The gate portion 333 includes a pair of cylindrical portions 333a and 333b disposed in the manipulator housing 300.

[0079] The proximal end of the catheter 2 is fixed in the sleeve 331 and connected to the manipulator housing 300. When the catheter 2 is fixed in the sleeve 331, for example, the outer tube 23B may be bonded or welded to the inner surface of the sleeve 331 after the catheter 2 is pressed into the sleeve 331. In addition, when forming the guide wire insertion portion, the sleeve 331 may not be provided in the manipulator housing 300, and the manipulator housing 300 and the boundary position from the manipulator housing 300 to the catheter 2 may be covered with a heat shrink tube or the like, so that the cover is integrated with the manipulator housing 300.

[0080] The proximal ends of the first operating guide wire 31 and the second operating guide wire 32 are introduced into the manipulator housing 300 from the sleeve portion 331 through the guide wire introduction port 332 and between the cylindrical portions 333a and 333b of the gate portion 333. Then, as described later, the first operating guide wire 31 is fixed to the first rack member 100, and the second operating guide wire 32 is fixed to the second rack member 200. In addition, the cylindrical portions 333a and 333b constituting the gate portion 333 may also be constituted by freely rotatable rollers.

[0081] like Figure 5 As shown, the manipulator housing 300 has a first guide portion 351 inside which guides the first rack member 100 so as to be reciprocally movable in the longitudinal direction, and a second guide portion 352 which guides the second rack member 200 so as to be reciprocally movable in the longitudinal direction.

[0082] The first guide portion 351 is formed by two partition walls 341 and 342 provided at the center of the manipulator housing 300 and extending in the longitudinal direction, the first slide guide 306, and a guide wall 343 in the support handle 320. The side wall 305 of the manipulator housing 300 has stopper portions 351a and 351b at locations corresponding to the distal end and the proximal end of the first guide portion 351, respectively.

[0083] The second guide 352 is formed by the partition walls 341, 342, the second slide guide 307, and the guide wall 344 in the support handle 320. The side wall 305 of the manipulator housing 300 has stoppers 352a, 352b at locations corresponding to the distal end and the proximal end of the second guide 352, respectively.

[0084] like Figure 6 As shown in FIG. 1 , the partition wall 341 is formed by overlapping the convex strips 341a and 341b respectively provided on the base 300A and the cover 300B. Figure 6 As shown, the partition wall portion 342 is configured such that convex stripes 342 a and 342 b respectively provided on the base body 300A and the cover body 300B overlap with each other.

[0085] like Figure 6 As shown, the base 300A of the manipulator housing 300 has cylindrical guide wire guides 334a, 334b ​​on both sides of the proximal end of the convex strip 341a. The guide wire guides 334a, 334b ​​may also be formed by freely rotatable rollers.

[0086] The first rack member 100 and the second rack member 200 are housed in the manipulator housing 300 so as to be reciprocally movable in the longitudinal direction of the main body 310 and to have teeth 120 and 220 facing each other.

[0087] Fig. 10B A first rack member 100 is shown, Fig. 10A The second rack member 200 is shown. The rack members 100 and 200 respectively have a rack main body 110 and 210 in an elongated rectangular shape, and tooth portions 120 and 220 each formed of a plurality of teeth provided on the side surfaces of the rack main body 110 and 210 that are facing each other. The rack members 100 and 200 are respectively provided in the first guide portion 351 and the second guide portion 352 so that the tooth portions 120 and 220 face each other.

[0088] like Fig. 10BAs shown, the rack body 110 of the first rack member 100 has a guide piece 112 extending in the length direction of the rack body 110 on the outer side surface 111 thereof. The guide piece 112 is inserted into the opening 306a of the first sliding guide 306. In addition, the rack body 110 of the first rack member 100 is integrally provided with a first operating handle 510 protruding to the side of the manipulator housing 300 through the opening 306a.

[0089] like Fig. 10A As shown, the rack body 210 of the second rack member 200 has a guide piece 212 extending in the length direction of the rack body 210 on the outer side surface 211 thereof. The guide piece 212 is inserted into the opening 307a of the second sliding guide 307. In addition, the rack body 210 of the second rack member 200 is integrally provided with a second operating handle 520 protruding to the side of the manipulator housing 300 through the opening 307a.

[0090] The first operating handle 510 and the second operating handle 520 respectively have a rectangular plate shape similar to the first handle portion 321 and the second handle portion 322 constituting the support handle portion 320, and are integrally formed with each rack member 100, 200. In addition, the shape of each operating handle 510, 520 is arbitrary, for example, it can be a rod shape, a ring shape, a hook shape, etc., and is integrally formed with each rack member 100, 200.

[0091] like Fig. 10A and Fig. 10B As shown, the distal ends of the first operating handle 510 and the second operating handle 520 ( Fig. 10A and Fig. 10B Each end edge (on the left side in the figure) constitutes a finger locking portion 510a, 520a for the operator's finger to rest on. These finger locking portions 510a, 520a are formed into a gently curved surface that is roughly concave toward the proximal side. In addition, each corner portion 510b, 520b on the outer side of each finger locking portion 510a, 520a is chamfered. Each finger locking portion 510a, 520a is bent into a concave shape in a manner that makes it easy for the operator to rest his finger on each finger locking portion 510a, 520a, thereby making it easy to operate the first operating handle 510 and the second operating handle 520.

[0092] In addition, if Fig. 10A and Fig. 10BAs shown, each finger locking portion 510a, 520a is formed with inner convex portions 510c, 520c of a shape that smoothly transitions to the first rack member 100 and the second rack member 200. Due to these inner convex portions 510c, 520c, the fingers resting on each finger locking portion 510a, 520a are unlikely to come into contact with the main body 310 of the manipulator housing 300, and the operability of each operating handle 510, 520 is not hindered.

[0093] The first operating handle 510 and the second operating handle 520 are operated by pulling the fingers resting on the finger locking portions 510a and 520a toward the proximal side (the support handle portion 320 side). When the first operating handle 510 is pulled toward the proximal side, the first rack member 100 is displaced toward the proximal side as a whole, and synchronously, the second rack member 200 is displaced toward the distal side in the opposite direction. In addition, when the second operating handle 520 is pulled toward the proximal side, the second rack member 200 is displaced toward the proximal side as a whole, and synchronously, the second rack member 100 is displaced toward the distal side in the opposite direction.

[0094] For example, the index finger can be placed on the finger locking portion 510a of the first operating handle 510, and the middle finger can be placed on the finger locking portion 520a of the second operating handle 520, and the operating handles 510 and 520 can be pulled by the respective fingers.

[0095] like Fig. 10B As shown in FIG. 1 , the first rack member 100 has a guide wire fixing portion 511 on its surface side for fixing the end portion of the proximal end side of the first operation guide wire 31. Fig. 10A As shown, the second rack member 200 has a wire fixing portion 521 on the back side thereof for fixing the proximal end portion of the second operation wire 32 .

[0096] The guide wire fixing portions 511 and 521 have the same structure, and can fix the operation wires 31 and 32 to the rack members 100 and 200 respectively by screwing.

[0097] like Fig. 10A As shown, the guide wire fixing portion 521 of the second rack member 200 includes: a groove 521a formed on the surface of the rack body 210 and extending in the length direction, a thin metal tube 521b embedded in the groove 521a, and a threaded portion 521c. The threaded portion 521c includes: an internal thread 521d, which is fixed in a concave portion 210a opened on the side surface 211 of the outer side of the rack body 210; and a hexagon socket head bolt 521e, which is screwed into the internal thread 521d.

[0098] The end of the proximal side of the second operating guide wire 32 contacts the outside of the guide wire guide 334b ​​and is guided to the groove 521a, and is inserted into the metal pipe 521b through the groove 521a. Then, the metal pipe 521b is tightened with a bolt 521e screwed into the internal thread 521d, so that the second operating guide wire 32 is crimped and fixed in the metal pipe 521b. Thus, the proximal end of the second operating guide wire 32 is fixed to the second rack member 200 together with the metal pipe 521b.

[0099] like Fig. 10B As shown, the guide wire fixing portion 511 of the first rack member 100 is arranged on the back side of the rack body 110, and the guide wire fixing portion 511 has: a groove 511a, a metal pipe 511b embedded in the groove 511a, and a threaded portion 511c formed by an internal thread 511d and a bolt 511e. The threaded portion 511c is fixed in a concave portion 110a opened on the side surface 111 of the outer side of the rack body 110.

[0100] The end of the proximal side of the first operating guide wire 31 contacts the outer side of the guide wire guide 334a and is guided to the groove 511a, and is inserted into the metal pipe 511b through the groove 511a. Then, the metal pipe 511b is tightened with a bolt 511e screwed into the internal thread 511d, so that the first operating guide wire 31 is crimped and fixed in the metal pipe 511b. As a result, the proximal end of the first operating guide wire 31 is fixed to the first rack member 100 together with the metal pipe 511b.

[0101] like Figure 5 As shown, the pinion member 400 is disposed between the partition wall portion 341 and the partition wall portion 342. Fig. 9 As shown, the pinion member 400 is rotatably supported by the manipulator housing 300 via a rotation shaft 410 in a state of being meshed with the tooth portions 120 and 220 of the first rack member 100 and the second rack member 200 .

[0102] like Figure 1 As shown, the first rack member 100 and the second rack member 200 are aligned with each other in the reciprocating displacement direction relative to the pinion member 400, and the meshing position is adjusted so that the longitudinal center of each tooth portion 120, 220 meshes with the pinion member 400.

[0103] As the teeth 120 , 220 are respectively engaged with the pinion member 400 , the first rack member 100 and the second rack member 200 are reciprocally displaced in opposite directions relative to the pinion member 400 .

[0104] In the deflection operation device 1A according to the present embodiment having the above-mentioned structure, a sliding operation is performed to displace the first operation handle 510 and the second operation handle 520 relative to the support handle portion 320 in the longitudinal direction. Since the operation handles 510 and 520 are respectively provided integrally with the first rack member 100 and the second rack member 200, they are respectively operated in a manner of being displaced in opposite directions with the rack members 100 and 200. When the operation handles 510 and 520 are operated in this way, the first rack member 100 and the second rack member 200 are displaced in opposite directions with respect to the pinion member 400, and the first operation guide wire 31 and the second operation guide wire 32 in the catheter 2 are displaced in the deflection operation direction of the movable portion 20 of the catheter 2.

[0105] The first rack member 100 is limited in displacement range by the stopper portions 351a and 351b respectively provided at the distal end and the proximal end of the first guide portion 351, thereby preventing the first rack member 100 from being disengaged from the pinion member 400. In addition, the second rack member 200 is limited in displacement range by the stopper portions 352a and 352b respectively provided at the distal end and the proximal end of the second guide portion 352, thereby preventing the first rack member 100 from being disengaged from the pinion member 400.

[0106] like Figure 1 As shown in the figure, when the positions of the first operating handle 510 and the second operating handle 520 in the displacement direction are consistent with each other, the movable portion 20 of the catheter 2 extends straight and is in a neutral state without deflection. At this time, the first rack member 100 and the second rack member 200 are positioned at a neutral position where the positions of the displacement directions are consistent with each other, similarly to the operating handles 510 and 520. This neutral position is called a specific position of the present invention.

[0107] like Fig.11 As shown, when the first operating handle 510 is moved from Figure 1 When the neutral state shown is pulled toward the proximal side, the first rack member 100 is displaced toward the proximal side as a whole, and synchronously, the second rack member 200 is displaced toward the distal side in the opposite direction. Then, following the displacement of each rack member 100, 200, the first operating guide wire 31 is pulled toward the proximal side, and the second operating guide wire 32 is pushed toward the distal side. The pull ring 40 deflects following the movement of each operating guide wire 31, 32, and the movable portion 20 of the catheter 2 deflects toward the first operating handle 510 side as the operating side.

[0108] On the other hand, Fig.12As shown, when the second operating handle 520 is pulled toward the proximal side, the second rack member 200 is displaced toward the proximal side as a whole, and synchronously, the first rack member 100 is displaced toward the opposite distal side. Then, following the displacement of each rack member 100, 200, the second operating guide wire 32 is pulled toward the proximal side, and the first operating guide wire 31 is pushed toward the distal side. The pull ring 40 deflects following the movement of each operating guide wire 31, 32, and the movable portion 20 of the catheter 2 deflects toward the second operating handle 520 side as the operating side.

[0109] By operating the rack members 100 and 200 in opposite directions through the operating knobs 510 and 520 , the movable portion 20 of the catheter is deflected in a direction corresponding to the operating direction of the operating knobs 510 and 520 via the operating wires 31 and 32 and the pull ring 40 .

[0110] Next, the operation of this embodiment will be described.

[0111] According to the yaw operation device 1A according to the present embodiment, the movable portion 20 of the catheter 2 can be yawed by reciprocating the first rack member 100 and the second rack member 200 in the manipulator housing 300 via the first operation knob 510 and the second operation knob 520, respectively. Therefore, the movable portion 20 of the catheter 2 can be yawed with a simpler structure than in the past.

[0112] In addition, according to the deflection operation device 1A involved in this embodiment, the reciprocating operation direction of the first operating handle 510 and the second operating handle 520 is the same direction as the extension direction of the first operating guide wire 31 and the second operating guide wire 32, so that the operation direction of each operating handle 510, 520 can correspond to the deflection direction of the movable part 20 of the catheter 2 in terms of feel.

[0113] That is, by operating the operating handle (510 or 520) on the side corresponding to the deflection direction of the movable part 20 among the first operating handle 510 and the second operating handle 520, the movable part 20 can be deflected in a desired direction. For example, by pulling the first operating handle 510 toward the support handle part 320 (proximal end side), the movable part 20 can be deflected toward the first operating handle 510 side, and by pulling the second operating handle 520 toward the support handle part 320 side, the movable part 20 can be deflected toward the second operating handle 520 side. If the relative positions of the operating handles 510 and 520 with respect to the manipulator housing 300 are visually recognized in combination with such operations, the deflection state (deflection direction, deflection degree) of the movable part 20 can be roughly grasped.

[0114] Therefore, it is easy to grasp the deflection state of the movable portion 20 of the catheter 2 corresponding to the operation of each operating knob 510, 520, and the operating reaction force from the movable portion 20 is directly transmitted to the operating knob (510 or 520) on the side of the pulling operation, so that an effective operating damping feeling (operation feeling) can be obtained. As a result, sufficient operability can be obtained.

[0115] In addition, the first operating handle 510 and the second operating handle 520 can effectively apply operating force to each operating handle 510, 520 when manually operating with one hand by performing a pulling operation to displace the support handle portion 320 sideways, and compared with a deflection operation such as rotating a dial, there is no need to reposition the fingers while operating, thereby improving operability.

[0116] Furthermore, there is a convenience that even if the operation device housing is turned over 180 degrees to reverse the left and right positions of the first and second operation handles, both can be operated in the same manner.

[0117] Furthermore, according to the yaw operation device 1A of the present embodiment, the operator can easily support or operate the yaw operation device 1A with one hand by bringing the palm of the operator into contact with the support handle portion 320 of the manipulator housing 300 and placing fingers on the finger locking portions 510 a and 520 a of the operation knobs 510 and 520 .

[0118] In the yaw operation device 1A according to the present embodiment, the support handle 320 forms a substantially T-shape together with the main body 310 of the manipulator housing 300. Therefore, the yaw operation device 1A according to the present embodiment is easy to hold via the support handle 320, thereby improving operability.

[0119] (Another embodiment)

[0120] Next, through Fig.13 A yaw operation device 1B according to another embodiment of the present invention will be described.

[0121] In the yaw operation device 1B, in the yaw operation device 1A of the above-mentioned embodiment, an annular operation handle 530 is provided only on the first rack member 100 instead of the first and second operation handles 510 and 520, and an indicator 600 is provided on the second rack member 200, and the indicator 600 indicates the relative position of the second rack member 200 with respect to the manipulator housing 300. The indicator 600 constitutes the indicating portion of the present invention. In addition, in the yaw operation device 1B, two coil springs 710 and 720 are installed between the first rack member 100 and the manipulator housing 300, and the two coil springs 710 and 720 urge the first rack member 100 and the second rack member 200 toward the neutral position of the manipulator housing 300. The coil springs 710 and 720 respectively constitute the urging means of the present invention.

[0122] The yaw operation device 1B according to another embodiment is different from the yaw operation device 1A according to the above-mentioned embodiment in these respects. Therefore, in the description of another embodiment, the same components as those of the above-mentioned embodiment are denoted by the same reference numerals, and their description is omitted, and only the differences from the above-mentioned embodiment are described.

[0123] The operating handle 530 has a substantially circular ring shape and is integrally formed in the longitudinal center of the rack body 110. By inserting, for example, an index finger or a middle finger into the operating handle 530, placing the inserted finger on the operating handle 530 and pulling it toward the proximal end or pushing it toward the distal end, the first rack member 100 is reciprocated in the longitudinal direction. In addition, in synchronization with the reciprocating movement of the first rack member 100, the second rack member 200 is reciprocated in the opposite direction to the first rack member 100.

[0124] The indicator 600 is integrally formed with the rack body 210 of the second rack member 200 and slightly protrudes from the opening 307a to the side of the manipulator housing 300. The indicator 600 is preferably colored in a color different from that of the manipulator housing 300 and capable of visually identifying its position accurately.

[0125] The indicator 600 is formed at the longitudinal center of the second rack member 200. Fig.13 As shown, when the first rack member 100 and the second rack member 200 are in the neutral position, the positions of the indicator 600 and the operating handle 530 are at the same position in the displacement direction.

[0126] The two coil springs 710 and 720 have the same structure and are respectively arranged in a compressed state on the proximal side and the distal side of the first rack member 100 in the first guide portion 351. One coil spring 710 is installed between the stopper portion 351b and the first rack member 100, and the other coil spring 720 is installed between the stopper portion 351a and the first rack member 100. The first rack member 100 is stopped at the neutral position by the coil springs 710 and 720 applying force from both sides, and the second rack member 200 is also stopped at the neutral position.

[0127] exist Fig.13 In the deflection operation device 1B shown, a finger is placed on an operation handle 530 to overcome the force of the coil springs 710 and 720 and move the operation handle 530 back and forth, so that the first rack member 100 and the second rack member 200 can be displaced in opposite directions to deflect the movable portion 20 of the catheter 2.

[0128] According to the yaw operation device 1B according to another embodiment, the coil springs 710 and 720 are provided, so that the first rack member 100 and the second rack member 200 can be automatically held in the neutral position without operating the operation handle 530 , thereby improving operability.

[0129] In the present embodiment, when the first rack member 100 and the second rack member 200 are in the neutral position, the movable portion 20 of the catheter 2 is configured to be straight and non-deflected. However, in the case where the catheter 2 is given a curved shape, for example, the movable portion 20 is not necessarily straight in the neutral position, and the neutral position of each rack member 100, 200 may be set corresponding to the shape of the catheter 2.

[0130] Furthermore, according to the deflection operation device 1B, the deflection state of the movable portion 20 of the catheter 2 can be grasped by visually recognizing the relative position of the second rack member 200 with respect to the manipulator housing 300 through the indicator 600. In addition, of course, the deflection state of the movable portion 20 of the catheter 2 can also be grasped by the relative position of the operating knob 530 with respect to the manipulator housing 300. That is, it can be said that the operating knob 530 has the same function as the indicator 600, and this point is also the same for the first operating knob 510 and the second operating knob 520 in the above-mentioned embodiment.

[0131] In addition, if Fig.14 As shown, in a yaw operation device 1B according to another embodiment, the operation handle 530 and the indicator 600 may be arranged in reverse as follows: the operation handle 530 is provided on the second rack member 200 , and the indicator 600 is provided on the first rack member 100 .

[0132] In addition, if Fig.14As shown, even if the coil spring 720 is moved between the second rack member 200 and the stopper portion 352b, the two coil springs 710, 720 are arranged on the proximal side, and each rack member 100, 200 can be maintained in the neutral position. In this case, each rack member 100, 200 is urged on the distal side by the coil springs 710, 720, but is maintained in the neutral position by being restrained by each other via the pinion member 400.

[0133] In addition, in another embodiment, it is also possible to Fig.13 On the contrary, the coil springs 710 and 720 are arranged on the side of the second guide portion 352. In this case, for example, the coil spring 710 is installed between the stopper portion 352b and the second rack member 200, and the coil spring 720 is installed between the stopper portion 352a and the second rack member 200.

[0134] In addition, you can also Fig.14 On the contrary, both the coil springs 710 and 720 are arranged on the distal end side. In this case, for example, the coil spring 710 is installed between the stopper portion 351a and the first rack member 100, and the coil spring 720 is installed between the stopper portion 352a and the second rack member 200.

[0135] Furthermore, in each of the above-mentioned embodiments, a catheter is taken as an example of a medical device, but the deflection operation device of the present invention can be applied to other tubular medical devices such as a cannula and a sheath.

[0136] Industrial Applicability

[0137] The present invention is useful as a deflection operation device for medical equipment that can be easily operated with one hand when deflecting a distal movable portion of a tubular medical equipment such as a catheter, cannula, or sheath, has a simple structure, and can provide sufficient operability.

[0138] Description of Reference Numerals

[0139] 1A, 1B: Deflection operating devices for medical equipment

[0140] 2: Catheter (medical device)

[0141] 20: Activities Department

[0142] 31: First operation guidewire

[0143] 32: Second operating guide wire

[0144] 100: First rack member

[0145] 120, 220: Tooth

[0146] 200: Second rack member

[0147] 300: Manipulator housing

[0148] 306, 307: Sliding guide

[0149] 306a, 307a: Open

[0150] 310: Main body of manipulator housing

[0151] 320: Support handle

[0152] 330: Guidewire insertion

[0153] 400: Pinion component

[0154] 510: First operating handle

[0155] 520: Second operating handle

[0156] 530: Operating handle

[0157] 600: indicator (indicator)

[0158] 710, 720: Coil spring (force applying unit)

Claims

1. A deflection operation device for medical equipment, which performs deflection operation on a movable part of the medical equipment via a first operation guide wire and a second operation guide wire, characterized in that: have: A manipulator housing, comprising: a main body, a support handle provided at one end of the main body in a length direction along the extending direction of the first operating guide wire and the second operating guide wire, and a guide wire insertion portion provided at the other end of the main body in the length direction and inserted by the first operating guide wire and the second operating guide wire; A first rack member and a second rack member are housed in the manipulator housing in a manner that they are respectively movable back and forth in the length direction and have teeth facing each other; as well as a pinion member disposed between the first rack member and the second rack member and rotatably supported by the manipulator housing in a state of being meshed with the respective teeth of the two rack members; The manipulator housing is provided with a slide guide portion, the slide guide portion forming a groove-shaped opening along at least one of the first rack member and the second rack member, and An operating handle is integrally provided on at least one of the first rack member and the second rack member, the operating handle protrudes to the outside of the manipulator housing through the opening, and the end edge of the operating handle on the distal end side constitutes a finger locking portion. The support handle portion and the main body portion of the manipulator housing are substantially T-shaped. The support handle portion is used to be contacted by the palm of the operator during the sliding operation, and the finger locking portion is used to be placed by the operator's finger during the sliding operation. When a sliding operation is performed to displace the operating handle relative to the support handle portion in the length direction, the first rack member and the second rack member are displaced in opposite directions relative to the pinion member, and the first operating guide wire and the second operating guide wire are displaced in the deflection operation direction of the movable portion.

2. The deflection operation device for medical equipment according to claim 1, characterized in that: The operating handle is composed of a first operating handle and a second operating handle provided on the first rack member and the second rack member, respectively.

3. The deflection operation device for medical equipment according to claim 1 or 2, characterized in that: A force applying unit is installed between at least one of the first rack member and the second rack member and the manipulator housing, and the force applying unit applies force to the first rack member and the second rack member toward a specific position relative to the manipulator housing.

4. The deflection operation device for medical equipment according to claim 1, characterized in that: The operating handle is provided on at least one of the first rack member and the second rack member, and an indicator portion is provided on the other rack member, the indicator portion indicating a relative position of the other rack member with respect to the manipulator housing.

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