Catheter system and method for operating catheter system

Abstract

A catheter system (10) is provided with: a flexible outer tube body (28); an inner tube body (42) movably provided in the first lumen (341) of the outer tube body (28); a tubular balloon (20) that connects the tip of the outer tube body (28) and the tip of the inner tube body (42) to each other; and an operation section (24) which is provided at the base end of the inner tube body (42) and which advances and retreats the endoscope (22) inserted into the lumen (201) of the balloon (20). The housing (50) of the operation part (24) is provided with a visual recognition part (54) which can visually recognize the front end part (22A) of the endoscope (22) in the housing (50) from the outside.

Description

Technical Field

[0001] The present invention relates to a catheter system and a method of operating a catheter system. Background Art

[0002] Patent document 1 discloses a balloon catheter for treating a diseased part (stenotic part or occluded part) of a fallopian tube. The balloon catheter comprises: an outer tube having flexibility; an inner tube disposed in the inner cavity of the outer tube so as to be movable in the axial direction relative to the outer tube; a tubular balloon connecting the front end of the outer tube and the front end of the inner tube; and an operating part disposed in the middle of the outer tube. An endoscope is inserted into the inner side of the balloon. The user operates the operating part to move the endoscope along the outer tube toward the front end.

[0003] Patent Document 1: Japanese Patent No. 3921112

[0004] In endoscopic tuboplasty using a balloon catheter, a balloon is made to protrude from the front end opening of an outer tube toward the front end direction together with the endoscope and inserted into the fallopian tube orifice of a living body. The front end portion of the outer tube is bent relative to the travel direction of the endoscope, and the fallopian tube orifice is also bent relative to the travel direction. Therefore, if the endoscope is used repeatedly, the front end portion of the endoscope will remain in a state of plastic deformation and bending. There is the following problem: when the endoscope is inserted from the base end of the balloon catheter, the bent front end portion is hooked in the operating portion or exposed to the outside from the operating portion, so that the endoscope cannot be stably moved toward the front end direction. Summary of the invention

[0005] An object of the present invention is to solve the above-mentioned problems.

[0006] (1) A first aspect of the present invention is a catheter system that is inserted into a lumen of a living body and can move along the lumen, wherein the catheter system comprises: an outer tube that is flexible; an inner tube that is movably disposed in the lumen of the outer tube along the axial direction of the outer tube; a tubular balloon that connects the front end portion of the outer tube and the front end portion of the inner tube to each other and expands radially inwardly of the outer tube; and an operating unit that is disposed at the base end of the inner tube and causes an endoscope that passes through the inner tube and is inserted into the lumen of the balloon to move forward and backward along the inner tube, the operating unit comprising: a shell into which the endoscope is inserted; and a delivery component that contacts the endoscope in the shell and causes the endoscope to move relative to the shell along the inner tube, the shell comprising a visual identification unit that can visually identify the front end portion of the endoscope in the shell from the outside.

[0007] According to the catheter system, when the endoscope inserted into the housing of the operation unit is moved toward the inner tube, the user can confirm the front end of the endoscope in the operation unit through the visual recognition unit. Therefore, even if the front end of the endoscope is bent due to repeated use, by confirming the movement of the front end in the operation unit, the risk of damage to the endoscope caused by the front end moving in the wrong direction can be effectively reduced.

[0008] (2) In the catheter system described in (1) above, the housing may include an insertion portion inside thereof through which the endoscope is inserted, and the visual confirmation portion may face the insertion portion inside the housing.

[0009] According to this configuration, the visual recognition unit can effectively confirm the progress of the endoscope in the insertion portion of the operation unit.

[0010] (3) In the catheter system described in (1) or (2) above, the visual confirmation portion may be a transparent portion or a semi-transparent portion of the casing.

[0011] According to this configuration, by providing the transparent portion or the semi-transparent portion on the housing of the operation portion, the visual confirmation portion can be realized easily and at low cost.

[0012] (4) In the catheter system described in (1) or (2) above, the visual confirmation portion may be an opening provided in the housing.

[0013] According to this configuration, by providing the opening portion in the housing of the operation portion, the visual confirmation portion can be realized easily and at low cost.

[0014] (5) In the catheter system described in (1) or (2) above, the visual confirmation portion may be a window portion formed of a transparent or translucent member.

[0015] According to this configuration, by providing the window portion formed of a transparent or translucent member in the housing of the operation portion, the visual recognition portion can be realized easily and at low cost.

[0016] (6) In the catheter system described in (4) or (5) above, the visual confirmation section may be formed along a delivery direction of the endoscope.

[0017] According to this configuration, the visual confirmation unit can confirm the progress of the endoscope inside the operation unit over a wide range in the delivery direction of the endoscope.

[0018] (7) In the catheter system described in any one of (1) to (6) above, the delivery component may include a contact portion, which is disposed inside the shell and opposite to the insertion portion and abuts against the endoscope when the endoscope is delivered toward the inner tube, and the visual recognition portion is arranged opposite to the contact portion.

[0019] According to this configuration, when the user operates the operation unit to deliver the endoscope, the visual recognition unit confirms the contact portion of the delivery member that contacts the endoscope, thereby effectively confirming whether the distal end portion of the endoscope contacts the contact portion in a predetermined state.

[0020] (8) In the catheter system described in (7) above, the delivery component may be composed of a group of rotating bodies arranged in a direction orthogonal to the delivery direction of the endoscope across the insertion portion, the group of rotating bodies clamping the endoscope via the abutment portion for holding, and the operating portion comprising: a housing space provided inside the shell for housing the rotating bodies; and a bulging portion provided in the housing space, opposite to the abutment portion and bulging from the inner surface of the shell toward the abutment portion, the bulging portion comprising: a top portion which protrudes most toward the abutment portion in the insertion portion; and a guide hole which opens at the top portion and passes through the bulging portion for the endoscope to be inserted therethrough.

[0021] According to this structure, when a group of rotating bodies clamping the endoscope are rotated and the endoscope is moved in the delivery direction, the top of the bulging portion protruding toward the abutment portion can prevent the front end of the endoscope from moving in a direction different from the moving direction, and the endoscope can be effectively guided along the moving direction by inserting the guide hole of the bulging portion.

[0022] (9) In the catheter system described in any one of (1) to (8) above, the catheter system may supply an expansion fluid to the space between the outer tube and the inner tube in the inner cavity of the outer tube, expand the balloon with the aid of the expansion fluid and move along the inner cavity toward the front end, and supply perfusion fluid between the inner tube and the endoscope to cause the endoscope to retreat relative to the inner tube and the balloon. The movement of the balloon moving toward the front end, the supply of the perfusion fluid between the inner tube and the endoscope, and the movement of the endoscope retreating relative to the inner tube and the balloon are performed in a state where the space is pressurized in the range of 5 to 7 atmospheres with the aid of the expansion fluid.

[0023] According to this structure, since a pressure of 5 to 7 atmospheres is continuously applied to the endoscope in the space, the front end of the endoscope is prone to bending. However, since the front end of the endoscope in the shell can be visually identified through the visual identification part, the risk of damage caused by the front end being sent in the wrong direction in the operating part can be effectively reduced.

[0024] (10) A second aspect of the present invention is a method for operating a catheter system, wherein the catheter system is inserted into a lumen of a biological body and can move along the lumen, wherein the catheter system comprises: an outer tube, which is flexible; an inner tube, which is movably disposed in the inner lumen of the outer tube along the axial direction of the outer tube; a tubular balloon, which connects the front end portion of the outer tube and the front end portion of the inner tube to each other and expands radially inwardly of the outer tube; and an operating unit, which is disposed at the base end of the inner tube and causes an endoscope inserted into the inner lumen of the balloon through the inner tube to move forward and backward along the inner tube, the operating unit comprising: a shell, into which the endoscope is inserted; and a delivery component, which contacts the endoscope in the shell and causes the endoscope to move relative to the shell along the inner tube, the shell comprising a visual identification unit that can visually identify the front end portion of the endoscope in the shell from the outside, The operation method includes the following steps: an insertion step, in which the front end portion of the outer tube is inserted into the lumen and moves toward the front end direction, and the front end portion of the endoscope is moved to the front end portion of the balloon by the operation unit; a pressurization step, in which an expansion fluid is supplied to a space between the outer tube and the inner tube in the inner lumen of the outer tube, and the space is pressurized in the range of 5 to 7 atmospheres, thereby expanding the front end portion of the balloon; an advancement step, in which the front end portion of the balloon is moved toward the front end direction in the lumen while the space is pressurized in the range of 5 to 7 atmospheres; a supply step, in which a perfusion fluid is supplied between the balloon and the endoscope while the space is further pressurized in the range of 5 to 7 atmospheres; and a retreat step, in which the operation unit is operated while the perfusion fluid is supplied, thereby retreating the endoscope relative to the inner tube.

[0025] According to the operating method of the catheter system, a pressure of 5 to 7 atmospheres is continuously applied to the endoscope from the pressurization process to the forward process and the supply process, so the front end of the endoscope is prone to bending. However, since the user can confirm the front end of the endoscope in the operating part through the visual recognition part, the user can effectively avoid the risk of the front end moving in the wrong direction and damaging the endoscope by confirming the moving condition of the front end.

[0026] According to the present invention, in the catheter system, when the endoscope inserted into the housing of the operation unit is moved toward the inner tube, the user can effectively confirm the front end of the endoscope in the housing through the visual recognition unit. Therefore, even if the front end of the endoscope is bent due to repeated use, the user can confirm the movement of the front end in the housing of the operation unit, thereby effectively reducing the risk of damage to the endoscope caused by the front end moving in the wrong direction. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] Figure 1 It is a schematic structural diagram of a catheter system according to an embodiment of the present invention.

[0028] Figure 2 yes Figure 1 A cross-sectional view of a portion of the catheter system is omitted.

[0029] Figure 3 yes Figure 1 An enlarged front view of the operating part of the catheter system.

[0030] Figure 4 It is along Figure 3 Cross-sectional view of line IV-IV.

[0031] Figure 5 yes Figure 3 An enlarged cross-sectional view of the operating portion.

[0032] Figure 6 It is used Figure 1 First illustration of the catheter system for endoscopic tuboplasty.

[0033] Figure 7 yes Figure 6 A second illustration of endoscopic fallopian tube surgery is shown.

[0034] Figure 8 yes Figure 7 A third illustrative diagram of endoscopic fallopian tube surgery is shown.

[0035] Fig. 9 yes Figure 8 A fourth illustrative diagram of endoscopic fallopian tube surgery is shown.

[0036] Fig.10 yes Fig. 9 A fifth illustrative diagram of endoscopic fallopian tube surgery is shown.

[0037] Fig.11 yes Fig.10 A sixth illustrative diagram of endoscopic fallopian tube surgery is shown.

[0038] Fig.12 It is an enlarged front view of a catheter system having an operating portion according to a first modification.

[0039] Fig.13 It is along Fig.12 Cross-sectional view along line XIII-XIII.

[0040] Fig.14 It is an enlarged front view of a catheter system having an operating portion according to a second modification.

[0041] Fig.15 It is along Fig.14 Cross-sectional view of line XV-XV.

[0042] Fig.16 It is an enlarged front view showing the operation portion having a window.

[0043] Explanation of the reference numerals: 10, 120, 140…catheter system; 12…catheter; 14…outer tube; 18…inner tube; 20…balloon; 22…endoscope; 24, 124, 144…operating unit; 28…outer tube body; 42…inner tube body; 44…inner tube seat; 50…housing; 52…delivery component; 54, 122, 142, 150…visual recognition unit. DETAILED DESCRIPTION

[0044] like Figure 1 As shown in FIG. 1 , the catheter system 10 of this embodiment is inserted into a lumen of a living body and can move along the lumen. The catheter system 10 is used, for example, for endoscopic tuboplasty to treat a lesion 204 (a stenotic portion or an occluded portion, etc.) of a fallopian tube 202 as a lumen (see FIG. 1 ). Figure 6 In addition, the catheter system 10 can also be used to treat lesions in organs other than fallopian tubes, such as blood vessels, bile ducts, trachea, esophagus, urethra, and other organs. Figure 1 The left side of the catheter system 10 (the direction of arrow X1) is referred to as the "front end direction". Figure 1 The right side of the catheter system 10 (the direction of arrow X2) is referred to as the "base end direction".

[0045] The catheter system 10 includes a catheter 12. The catheter 12 includes an outer tube 14, a slider 16, an inner tube 18, a balloon 20, an operation unit 24 for operating an endoscope 22 inserted into the inner tube 18, and a handle 26. Therefore, the catheter 12 is a balloon catheter.

[0046] like Figure 2As shown in FIG. 1 , the outer tube 14 includes: a flexible outer tube body 28, an outer tube seat 30, and a fixing screw 32. The outer tube body 28 includes a tube body 34 and a front end component 36 (front end tip). As the constituent materials of the tube body 34 and the front end component 36, for example, polyolefin, polyester, elastomer resin, flexible polymer material, soft polyvinyl chloride, polyurethane, polyamide, fluororesin, etc. can be cited. The outer tube 14 is an outer conduit.

[0047] The tube body 34 has a first lumen 341. The first lumen 341 penetrates the entire axial length of the tube body 34. The front end of the tube body 34 is formed into a shape curved in an arc in the axial direction of the tube body 34. The tube body 34 has a substantially constant outer diameter throughout the entire axial length.

[0048] The front end member 36 is provided at the front end portion of the tube body 34. The outer peripheral surface of the front end member 36 is in contact with the fallopian tube opening 202a (see Figure 6 ) is bent accordingly. The front end member 36 has a balloon outlet hole 38. The balloon outlet hole 38 includes the front end opening 281 of the outer tube body 28. The balloon 20 passes through the balloon outlet hole 38 and is introduced in a front end direction (arrow X1 direction) beyond the front end member 36.

[0049] The outer tube base 30 is fixed to the base end of the outer tube body 28. For example, a hard resin or a metal material can be used as a constituent material of the outer tube base 30. Examples of the hard resin constituting the outer tube base 30 include polycarbonate, acrylic resin, polyester, polyolefin, styrene resin, polyamide, polysulfone, polyarylate, and polyetherimide. Examples of the metal material constituting the outer tube base 30 include stainless steel, titanium, and titanium alloys.

[0050] The outer tube seat 30 is formed in a hollow shape. The outer tube seat 30 is formed in a size that is easy for the user to operate. The outer tube seat 30 has a first space 301, a first insertion hole 302, and a first introduction port 303. The first space 301 is connected to the first inner cavity 341 of the outer tube body 28 (tube body 34). The first insertion hole 302 is located in the arrow X2 direction of the first space 301. The inner tube 18 is inserted into the first insertion hole 302. The first introduction port 303 introduces the expansion fluid into the first space 301.

[0051] The expansion fluid expands the balloon 20 radially inwardly of the outer tube body 28. The expansion fluid is, for example, physiological saline. Alternatively, the expansion fluid may be sterile water. A first sealing member 40 is provided in the first space 301 of the outer tube seat 30. The first sealing member 40 prevents the expansion fluid in the first space 301 from leaking out from the first insertion hole 302 to the outside.

[0052] The fixing screw 32 is threadedly engaged with the outer tube seat 30. The user fixes the inner tube 18 to the outer tube seat 30 by tightening the fixing screw 32. The user allows the inner tube 18 to move relative to the outer tube seat 30 by loosening the fixing screw 32.

[0053] The slider 16 is mounted on the outer tube 14. The slider 16 slides on the outer peripheral surface of the tube body 34 along the axial direction of the outer tube body 28. The total length of the slider 16 in the axial direction is shorter than the total length of the outer tube body 28 in the axial direction. The slider 16 has a slider body 161 and a slider seat 162. The slider body 161 is a tubular member. The slider seat 162 is fixed to the base end of the slider body 161. The slider seat 162 is formed in a cylindrical shape.

[0054] In a state where the slider 16 is moved to the maximum in the direction of the arrow X1 relative to the tube 34 (initial state of the slider 16), the front end of the tube 34 extends linearly along the shape of the slider main body 161. Conversely to the above, if the slider 16 is moved in the direction of the arrow X2 relative to the tube 34, the front end of the tube 34 is exposed in the direction of the arrow X1 more than the slider 16. At this time, the front end of the tube 34 is bent in an arc shape. Before the catheter system 10 is used, the catheter system 10 is stored in a state where the front end of the tube 34 is bent.

[0055] The inner tube 18 includes an inner tube body 42 and an inner tube seat 44. The inner tube body 42 is made of relatively hard resin or metal. The inner tube body 42 has a second lumen 421 extending throughout the entire length of the inner tube body 42 in the axial direction. The inner tube 18 is an inner conduit.

[0056] The inner tube body 42 is movably disposed in the first inner cavity 341 of the tube body 34 along the axial direction of the outer tube body 28. The inner tube body 42 is inserted through the outer tube seat 30. The front end of the inner tube body 42 is arranged closer to the arrow X2 direction than the front end of the tube body 34. An outer lumen Sa for the expansion fluid to flow is provided between the outer peripheral surface of the inner tube body 42 and the inner peripheral surface of the tube body 34.

[0057] The insertion portion 221 of the endoscope 22 is inserted into the second lumen 421 of the inner tube body 42. When the insertion portion 221 is inserted into the second lumen 421 of the inner tube body 42, an inner lumen Sb for flowing perfusion fluid is provided between the inner tube body 42 and the insertion portion 221.

[0058] The inner tube seat 44 is fixed to the base end of the inner tube body 42. The inner tube seat 44 is formed in a hollow shape. The inner tube seat 44 has a second space 441, a second insertion hole 442, and a second introduction port 443. The second space 441 is connected to the second inner cavity 421 of the inner tube body 42. The second insertion hole 442 is located in the arrow X2 direction of the second space 441. The insertion portion 221 of the endoscope 22 is inserted into the second insertion hole 442. The second introduction port 443 introduces the perfusate into the second space 441.

[0059] The perfusion liquid is, for example, physiological saline. A second sealing member 46 is provided in the second space 441 of the inner tube seat 44. The second sealing member 46 prevents the perfusion liquid in the second space 441 from leaking out from the second insertion hole 442 to the outside.

[0060] The balloon 20 is a tubular member that connects the front end of the outer tube body 28 and the front end of the inner tube body 42. The balloon 20 is expanded radially inward of the outer tube body 28 by the expansion fluid. In other words, the balloon 20 is formed to be elastically deformable in the radial direction. The balloon 20 is preferably made of polyolefin, polyester, elastomer resin, a flexible polymer material, soft polyvinyl chloride, polyurethane, polyamide, polyisoprene, polyester, fluororesin, etc.

[0061] One end of the balloon 20 is bonded to the front end of the outer tube body 28 by an adhesive (not shown). Alternatively, one end of the balloon 20 may be welded to the front end of the outer tube body 28. One end of the balloon 20 is sandwiched between the front end of the tube 34 and the front end member 36.

[0062] The other end of the balloon 20 is fixed to the outer peripheral surface of the front end of the inner tube body 42 by the balloon fixing member 48. In addition, the other end of the balloon 20 may also be bonded to the front end of the inner peripheral surface of the inner tube body 42 by an adhesive. The other end of the balloon 20 may also be welded to the front end of the inner peripheral surface of the inner tube body 42.

[0063] The balloon 20 has an inner cavity 201 into which the insertion portion 221 of the endoscope 22 can be inserted. Between the outer peripheral surface of the balloon 20 and the inner peripheral surface of the tube body 34, a bag-shaped outer space Sc with a closed front end is provided.

[0064] When the balloon 20 is expanded radially inward, a pushing force (pushing force in the distal direction) is transmitted from the inner tube body 42 to the balloon 20, whereby the balloon 20 protrudes in the distal direction from the distal end opening 281 of the outer tube body 28 (see Figure 8 At this time, the front end of the balloon 20 is rolled up in a manner that the inner surface of the balloon 20 faces outward. That is, the protruding portion of the balloon 20 that protrudes further in the direction of the arrow X1 than the front end opening 281 of the outer tube body 28 includes a portion where the wall of the balloon 20 is double-folded in the radial direction.

[0065] like Figure 2 As shown, the endoscope 22 is an endoscope for observing the fallopian tube 202. The endoscope 22 includes a flexible insertion portion 221. The insertion portion 221 is inserted into the second lumen 421 of the inner tube body 42 and the lumen 201 of the balloon 20.

[0066] The insertion portion 221 includes a light guide, a lens unit, an image guide, and a cover portion, which are not shown in the figure. The light guide guides light from a light source, which is not shown in the figure, connected to the base end of the insertion portion 221 to the front end of the insertion portion 221. The lens unit is an objective lens located at the front end of the insertion portion 221. The image guide guides the image obtained by the lens unit toward the base end of the insertion portion 221. The cover portion is a tube component that protects the light guide, the lens unit, and the image guide. The endoscope 22 is used together with a display portion such as a display and a shooting control device for displaying the captured image (endoscopic image) on the display portion. In addition, in Figure 2 The structure of the insertion portion 221 is simplified and shown in FIG.

[0067] like Figure 1 As shown in FIG. 1 , the operation part 24 is provided outside the base end of the inner tube body 42. The operation part 24 moves the insertion part 221 of the endoscope 22 relative to the inner tube 18 along the axial direction (arrow X direction) of the catheter 12. That is, the operation part 24 moves the endoscope 22 inserted into the inner cavity 201 of the balloon 20 through the inner tube body 42 forward and backward along the inner tube body 42.

[0068] like Figure 3 As shown, the operation unit 24 includes a housing 50 and a delivery member 52 .

[0069] The housing 50 is formed of a resin material and is hollow. The housing 50 includes a housing body 56, a first connection portion 58, a second connection portion 60, and an insertion portion 62 for inserting the endoscope 22. Figure 4 As shown, the housing body 56 is composed of a pair of split bodies 561 and 562. The pair of split bodies 561 and 562 can be split in the width direction (arrow Y direction) orthogonal to the axial direction (arrow X direction) of the inner tube 18. The housing body 56 extends in the up-down direction orthogonal to the axial direction (arrow X direction) of the inner tube 18 and orthogonal to the width direction (arrow Y direction).

[0070] The housing body 56 is rectangular in a plan view. In addition, the housing body 56 is not limited to being rectangular in a plan view. Figure 5 As shown, the housing body 56 has a bottom 641, a pair of side walls 642 (see Figure 4 ), a front wall 643 and a rear wall 644. The bottom 641 is provided at the lower part of the housing body 56. The interior of the housing body 56 is covered by the bottom 641.

[0071] like Figure 4 As shown, a pair of side walls 642 are separately arranged along the width direction (arrow Y direction) of the shell body 56. The side wall 642 is formed to be parallel to the up-down direction of the shell body 56. A pair of side walls 642 are respectively provided on each split body 561, 562. A first axial hole 661 and a second axial hole 662 are provided on the inner surface of each side wall 642. The first axial hole 661 and the second axial hole 662 are arranged opposite to the split bodies 561, 562. The first axial hole 661 and the second axial hole 662 are circular and recessed outward in the width direction relative to the inner surface of the side wall 642. The first axial hole 661 and the second axial hole 662 are separately arranged in parallel along the up-down direction of the shell body 56. The first axial hole 661 is arranged above the second axial hole 662.

[0072] like Figure 5 As shown, the front wall 643 is arranged on the front end side of the housing body 56. The front wall 643 extends in the up-down direction of the housing body 56. The first connection portion 58 is provided in the central portion of the front wall 643. The rear wall 644 is arranged on the base end side of the housing body 56. The rear wall 644 extends in the up-down direction of the housing body 56. The second connection portion 60 is provided in the central portion of the rear wall 644.

[0073] In addition, the housing body 56 has a storage space 68 and an opening 70. The storage space 68 is a space surrounded by a bottom 641, a pair of side walls 642, a front wall 643, and a rear wall 644, and is formed to store the delivery member 52. The opening 70 is provided at the upper portion of the housing body 56 and opens at the upper portion of the storage space 68. The storage space 68 is communicated with the outside through the opening 70.

[0074] The first connection portion 58 is formed in an annular shape and protrudes from the front wall 643 toward the front end direction (arrow X1 direction). A first mounting hole 581 is provided at the center of the first connection portion 58. The first mounting hole 581 extends along the axial direction of the inner tube 18 (arrow X direction). The first mounting hole 581 penetrates from the front end of the first connection portion 58 to the inside of the housing body 56. The first fitting 72 is connected to the first mounting hole 581.

[0075] The first fitting 72 is formed in a cylindrical shape. The first fitting 72 includes a first main body 721, a first end 722, and a first bulging portion 723. The first main body 721 is inserted into the first mounting hole 581 and retained. The first end 722 is arranged in the front end direction (arrow X1 direction) of the first main body 721. The first end 722 is formed to have a larger diameter than the first main body 721. The first end 722 abuts against the end of the first connecting portion 58. The front end of the first end 722 is connected to the base end of the inner tube seat 44.

[0076] The first bulge 723 is arranged in the base end direction of the first main body 721 (arrow X2 direction). The first bulge 723 is arranged in the storage space 68. The first bulge 723 is formed into a roughly conical shape. The front end of the first bulge 723 is formed with the maximum diameter, and the first bulge 723 has a first guide surface 74 that gradually decreases in diameter toward the base end direction. The front end of the first bulge 723 has a vertical plane that is orthogonal to the axis of the first accessory 72, and is retained by abutting the inner surface of the front wall 643 with the annular surface. The base end of the first bulge 723 has a top 761. The top 761 is the smallest diameter at the first bulge 723, and is arranged most adjacent to the abutting portions 941 and 942 of the delivery component 52 described later. The top 761 has a surface that is orthogonal to the axis of the first accessory 72.

[0077] The first accessory 72 has a first guide hole 78 through which the endoscope 22 can be inserted. The first guide hole 78 is arranged at the center of the first accessory 72 and extends along the axial direction (arrow X direction). The first guide hole 78 penetrates from the top 761 (base end) of the first accessory 72 to the front end. The first guide hole 78 is tapered from the base end toward the front end. When the endoscope 22 is inserted into the first guide hole 78, the endoscope 22 is inserted from the base end of the first guide hole 78 toward the front end direction (arrow X1 direction).

[0078] The second connection portion 60 is formed in an annular shape and protrudes from the rear wall 644 toward the base end direction (arrow X2 direction). The first connection portion 58 and the second connection portion 60 are arranged on the axis of the inner tube 18. A second mounting hole 601 is provided at the center of the second connection portion 60. The second mounting hole 601 extends along the axis direction of the inner tube 18 (arrow X direction). The second mounting hole 601 penetrates from the front end of the second connection portion 60 to the inside of the housing body 56. The second fitting 79 is connected to the second mounting hole 601.

[0079] The second accessory 79 is formed in a cylindrical shape. The second accessory 79 includes a second main body 801, a second end 802, and a second bulging portion 803. The second main body 801 is inserted into the second mounting hole 601 and retained. The second end 802 is arranged in the base end direction of the second main body 801. The second end 802 is formed to have a larger diameter than the second main body 801. The second end 802 abuts against the end of the second connecting portion 60. The front end of the handle portion 26 is inserted into the inside of the base end of the second end 802.

[0080] The second bulge 803 is arranged in the front end direction (arrow X1 direction) of the second main body 801. The second bulge 803 is arranged in the storage space 68. That is, in the storage space 68, the first bulge 723 of the first accessory 72 is opposite to the second bulge 803. The second bulge 803 is formed in a substantially conical shape. The base end of the second bulge 803 is formed with the maximum diameter, and the second bulge 803 has a second guide surface 82 that gradually decreases in diameter toward the front end direction (arrow X1 direction). The base end of the second bulge 803 has a vertical plane orthogonal to the axis of the second accessory 79, and is held by the vertical plane abutting against the inner surface of the rear wall 644. The front end of the second bulge 803 has a top 762. The top 762 is the smallest diameter at the second bulge 803, and is arranged most adjacent to the abutment parts 941 and 942 of the delivery member 52 described later. The top 762 has a surface orthogonal to the axis of the second accessory 79.

[0081] The second accessory 79 has an insertion hole 83 into which the front end of the handle 26 is inserted, and a second guide hole 84 through which the endoscope 22 can be inserted. The insertion hole 83 opens at the base end of the second accessory 79. The second guide hole 84 is arranged at the center of the second accessory 79 and extends along the axial direction (arrow X direction). The second guide hole 84 passes through from the front end of the insertion hole 83 to the front end (top 762) of the second accessory 79. The second guide hole 84 is formed, for example, with a substantially constant diameter along the axial direction of the second accessory 79. When the endoscope 22 is inserted into the second guide hole 84, the endoscope 22 is inserted from the base end of the second guide hole 84 toward the front end direction (arrow X1 direction).

[0082] The insertion portion 62 is provided in the housing space 68. The insertion portion 62 is disposed between the base end of the first guide hole 78 and the front end of the second guide hole 84 in the housing space 68. The insertion portion 62 is a space through which the endoscope 22 can be inserted along the axial direction of the housing 50.

[0083] The delivery member 52 is provided inside the housing 50. The delivery member 52 includes a first rotating body 861 and a second rotating body 862. The first rotating body 861 and the second rotating body 862 are arranged side by side along the up-down direction of the housing body 56. The first rotating body 861 and the second rotating body 862 are opposite to each other across the insertion portion 62. The first rotating body 861 and the second rotating body 862 are of the same shape. In addition, the first rotating body 861 and the second rotating body 862 are not limited to being formed of the same shape. The first rotating body 861 and the second rotating body 862 may also be of different shapes.

[0084] The first rotating body 861 includes a roller body 88 and a shaft 90. The roller body 88 is formed in a circular ring shape. The shaft 90 is fixed to the center of the roller body 88. Figure 4As shown, the shaft 90 extends in the width direction (arrow Y direction) of the housing body 56. Both ends of the shaft 90 are inserted into the first shaft hole 661 of the housing body 56. The first rotating body 861 is rotatably supported inside the housing body 56 via the shaft 90. The upper part of the roller body 88 is exposed above the housing 50 via the opening 70. By moving the upper part of the roller body 88 around the circumference of the roller body 88, the first rotating body 861 can be rotated.

[0085] The roller body 88 includes: a first tooth portion 921 and a second tooth portion 922, an abutting portion 941 that abuts against the endoscope 22, and a fitting portion 96. The first tooth portion 921 and the second tooth portion 922 are arranged on the outer periphery of the roller body 88. The first tooth portion 921 and the second tooth portion 922 are arranged along the circumference of the roller body 88. The first tooth portion 921 is arranged on one side in the width direction of the roller body 88. The second tooth portion 922 is arranged on the other side in the width direction of the roller body 88. The first tooth portion 921 and the second tooth portion 922 are separated from each other and arranged side by side in the axial direction of the shaft 90. The first tooth portion 921 and the second tooth portion 922 each have a plurality of meshing teeth, and the number of meshing teeth and the pitch in the circumferential direction are the same. In the width direction of the roller body 88, the width of the first tooth portion 921 is greater than the width of the second tooth portion 922. In addition, the width of the first tooth portion 921 and the width of the second tooth portion 922 may be set to be the same, or the width of the first tooth portion 921 may be smaller than the width of the second tooth portion 922 .

[0086] The fitting portion 96 and the contact portion 941 are provided between the first tooth portion 921 and the second tooth portion 922 in the width direction of the roller body 88 .

[0087] The abutment portion 941 is an annular groove that is recessed radially inward. The abutment portion 941 is disposed at the center of the roller body 88 in the width direction. The cross section of the abutment portion 941 is formed in a semicircular shape. The cross-sectional shape of the abutment portion 941 is formed corresponding to the cross-sectional shape of the endoscope 22. The abutment portion 941 is opposite to the first bulging portion 723 and the second bulging portion 803. The first bulging portion 723 bulges from the front wall 643 of the housing 50 toward the abutment portion 941. The second bulging portion 803 bulges from the rear wall 644 of the housing 50 toward the abutment portion 941.

[0088] The fitting portion 96 includes an annular recess 981 and an annular protrusion 982 arranged in parallel along the width direction of the roller body 88. In the width direction (arrow Y direction) of the roller body 88, the annular recess 981 is arranged between the first tooth portion 921 and the abutment portion 941. The annular recess 981 is formed to be more recessed radially inward than the abutment portion 941. In the width direction of the roller body 88, the annular protrusion 982 is arranged between the second tooth portion 922 and the abutment portion 941. The annular protrusion 982 is formed to be more protruding radially outward than the abutment portion 941. The annular protrusion 982 is more protruding radially outward than the first tooth portion 921 and the second tooth portion 922.

[0089] The second rotating body 862 is arranged below the first rotating body 861. The second rotating body 862 is opposite to the bottom 641 of the shell body 56. The second rotating body 862 is covered by the shell body 56. Both ends of the shaft 90 in the second rotating body 862 are inserted into the second shaft hole 662 of the shell body 56. The first tooth portion 921 of the second rotating body 862 is arranged on the other side of the width direction of the roller body 88 and meshes with the second tooth portion 922 of the first rotating body 861. The second tooth portion 922 of the second rotating body 862 is arranged on one side of the width direction of the roller body 88 and meshes with the first tooth portion 921 of the first rotating body 861. That is, in the width direction of the delivery component 52, the first rotating body 861 and the second rotating body 862 are arranged differently from each other. The user can rotate the second rotating body 862 in the opposite direction to the first rotating body 861 by rotating the first rotating body 861. In addition, as Figure 3 As shown, the first rotating body 861 of the operating part 24 is not limited to the case where the first rotating body 861 is arranged at the top and the second rotating body 862 is arranged at the bottom. For example, when the catheter system 10 is used, by rotating the operating part 24 relative to the central axis of the first accessory 72, the first rotating body 861 and the second rotating body 862 can also be arranged in the left-right direction intersecting the up-down direction for use. In the following description, the case where the first rotating body 861 is arranged at the top and the second rotating body 862 is arranged at the bottom is described.

[0090] The abutment portion 942 of the second rotating body 862 faces the abutment portion 941 of the first rotating body 861. The outer peripheral surface of the endoscope 22 is held by being sandwiched between the abutment portion 942 of the second rotating body 862 and the abutment portion 941 of the first rotating body 861. The endoscope 22 can be sent toward the inner tube body 42 by rotating the first rotating body 861 and the second rotating body 862.

[0091] The annular convex portion 982 of the second rotating body 862 is fitted into the annular concave portion 981 of the first rotating body 861. The annular concave portion 981 of the second rotating body 862 is fitted into the annular convex portion 982 of the first rotating body 861. The annular convex portion 982 is fitted into the annular concave portion 981. The abutting portion 941 of the first rotating body 861 and the abutting portion 942 of the second rotating body 862 are opposite to each other.

[0092] like Figure 5 As shown, in the housing space 68 of the housing body 56, the outer periphery of the first rotating body 861 is opposite to the first guide surface 74 of the first bulging portion 723. The outer periphery of the first rotating body 861 is opposite to the second guide surface 82 of the second bulging portion 803. The outer periphery of the second rotating body 862 is opposite to the first guide surface 74 of the first bulging portion 723. The outer periphery of the second rotating body 862 is opposite to the second guide surface 82 of the second bulging portion 803. The outer periphery of the first rotating body 861 is separated from the first guide surface 74 and the second guide surface 82. The outer periphery of the second rotating body 862 is separated from the first guide surface 74 and the second guide surface 82. The gap between the outer periphery of the first rotating body 861 and the first bulging portion 723 is substantially the same as the gap between the outer periphery of the first rotating body 861 and the second bulging portion 803. The gap between the outer periphery of the second rotating body 862 and the first bulging portion 723 is substantially the same as the gap between the outer periphery of the second rotating body 862 and the second bulging portion 803.

[0093] like Figure 3 As shown, the visual recognition portion 54 is provided in the shell body 56, and the front end portion 22A of the endoscope 22 in the storage space 68 can be visually recognized from the outside. The visual recognition portion 54 has a transparent portion 100 throughout the entire shell body 56. That is, the entire shell body 56 is the transparent portion 100. The visual recognition portion 54 is opposite to the insertion portion 62 and the abutment portions 941, 942. In addition, the visual recognition portion 54 is not limited to the case where it is provided throughout the entire shell body 56. The visual recognition portion 54 is provided in the range of at least the front end portion 22A (abutment portions 941, 942) of the endoscope 22 in the shell body 56. The transparent portion 100 can be colorless and transparent, or can be colored and transparent. The visual recognition portion 54 is not limited to the case where it has a transparent portion 100. The visual recognition portion 54 can also have a translucent portion. The visual recognition portion 54 can be a structure that allows the front end portion 22A of the endoscope 22 to be visually recognized from the outside of the shell body 56.

[0094] like Figure 1 As shown, the handle 26 includes a tubular member 102 and a protective tube 104. The tubular member 102 is formed in a tubular shape. The front end of the tubular member 102 is connected to the base end of the second connection portion 60 in the operation portion 24. The protective tube 104 is fixed to the base end of the tubular member 102.

[0095] Next, endoscopic fallopian tube surgery using the catheter system 10 will be described.

[0096] Endoscopic fallopian tube formation has a preparation step of preparing the catheter system 10. In the preparation step, the fixing screw 32 is tightened in a state where the inner tube body 42 is completely pulled relative to the outer tube body 28 in the direction of the arrow X2. Thus, the inner tube body 42 is fixed to the outer tube body 28. By bringing the slider 16 to the initial state, the front end portion of the tube body 34 extends straightly by means of the slider body 161.

[0097] Next, in the insertion process, the catheter 12 is inserted into the uterine fundus 200 through the cervical canal. Figure 6 As shown, the slider 16 is pulled back relative to the outer tube body 28 toward the base end direction (arrow X2 direction) of the outer tube body 28. As a result, the front end of the tube body 34 is exposed from the slider 16 and bent. At this time, the front end opening 281 of the outer tube body 28 is located near the fallopian tube orifice 202a.

[0098] In the insertion process, the endoscope 22 is inserted into the second lumen 421 of the inner tube body 42 through the protective tube portion 104 of the handle portion 26. After the front end portion of the endoscope 22 is inserted into the tubular member 102 of the handle portion 26, the user moves the endoscope 22 toward the front end direction (arrow X1 direction). The front end portion 22A of the endoscope 22 is inserted into the storage space 68 of the operation portion 24 from the second guide hole 84 of the second connection portion 60.

[0099] like Figure 5 As shown, by rotating the first rotating body 861 of the operation portion 24 clockwise, the second rotating body 862 rotates counterclockwise in the opposite direction to the first rotating body 861, and the front end portion 22A of the endoscope 22 is inserted and clamped between the abutting portions 941 and 942 in the insertion portion 62 along with the rotation of the first rotating body 861 and the second rotating body 862. By further rotating the first rotating body 861, the endoscope 22 clamped by the abutting portions 941 and 942 is sent out in the front end direction (travel direction, arrow X1 direction).

[0100] In the insertion process, after the distal end portion 22A of the endoscope 22 is sent out from the abutment portions 941, 942 into the storage space 68, it passes through the first guide hole 78 of the first fitting 72 and moves toward the second lumen 421 of the inner tube body 42. By further operating the first rotating body 861 of the operating portion 24, the endoscope 22 is moved forward along the second lumen 421 of the inner tube body 42, and the distal end portion 22A of the endoscope 22 moves to the distal end portion of the balloon 20.

[0101] Then, in the confirmation step, the user moves the endoscope 22 forward so that the front end of the endoscope 22 is located at the front end of the outer tube body 28 (the front end opening of the balloon outlet hole 38), thereby confirming the fallopian tube orifice 202a using the image of the endoscope 22. Next, the fixing screw 32 is loosened to release the fixation of the inner tube body 42 relative to the outer tube 14.

[0102] Next, the balloon is led out. Figure 7 As shown, in the pressurizing process of the balloon lead-out process, the first introduction port 303 is supplied with an expansion fluid for pressurization. The expansion fluid is supplied from the first introduction port 303 through the outer lumen Sa to the outer space Sc of the balloon 20 between the outer tube body 28 and the inner tube body 42 in the inner cavity of the outer tube body 28. In the pressurizing process, the outer space Sc is pressurized in the range of 5 to 7 atmospheres by the expansion fluid. More preferably, the outer space Sc is pressurized to 6 atmospheres.

[0103] The balloon 20 is elastically deformed by being pressed radially inward by the expansion fluid supplied to the outer space Sc. That is, the portion of the balloon 20 located radially outward of the insertion portion 221 is in close contact with the outer peripheral surface of the insertion portion 221. The inner surfaces of the portion of the balloon 20 located closer to the arrow X1 direction than the front end of the insertion portion 221 are in contact with each other.

[0104] After that, the user loosens the fixing screw 32 and operates the inner tube seat 44 in a state where the outer space Sc is pressurized by the expansion fluid, so that the inner tube body 42 moves forward relative to the outer tube body 28 (advancing step). In this advancing step, the outer space Sc is continuously pressurized by the expansion fluid in the range of 5 to 7 atmospheres. Figure 8 As shown, the balloon 20 pushed in the distal direction (arrow X1 direction) by the inner tube body 42 advances relative to the outer tube body 28. That is, the balloon 20 is transmitted from the inner tube body 42 to the balloon 20 by the pushing force, and protrudes from the distal end opening 281 of the outer tube body 28 in the arrow X1 direction together with the insertion portion 221.

[0105] In the advancement process, one end of the balloon 20 is fixed to the front end of the outer tube body 28. Therefore, when the balloon 20 is advanced, the balloon 20 is rolled up at the front end (protruding end) of the balloon 20. That is, the inner surface of the balloon 20 faces outward at the front end of the balloon 20.

[0106] Next, the user determines whether the endoscope 22 has reached the front end of the balloon 20 based on the endoscopic image. Fig. 9As shown, the perfusion liquid is supplied to the second introduction port 443 (supplying process). As a result, the perfusion liquid flows between the balloon 20 and the insertion portion 221 of the endoscope 22 via the inner lumen Sb. The balloon 20 is separated radially outward relative to the insertion portion 221 by the perfusion liquid. In the perfusion liquid supplying process, the perfusion liquid is supplied while the outer space Sc of the balloon 20 is continuously pressurized in the range of 5 to 7 atmospheres.

[0107] Next, the user Fig.10 As shown, the endoscope 22 is retracted a predetermined distance (retraction process). In the retraction process, the user rotates the first rotating body 861 of the operating portion 24 counterclockwise. Along with the rotation of the first rotating body 861, the second rotating body 862 rotates clockwise, and the insertion portion 221 of the endoscope 22 clamped by the abutment portions 941 and 942 is retracted toward the base end direction (arrow X2 direction). In the retraction process, the endoscope 22 is retracted while the outer space Sc of the balloon 20 is continuously pressurized in the range of 5 to 7 atmospheres. Afterwards, the above-mentioned pressurization process and forward process are performed again.

[0108] That is, in endoscopic fallopian tube formation surgery using the catheter system 10, while the space is pressurized in the range of 5 to 7 atmospheres using an expansion fluid, the balloon 20 is moved in the front end direction (forward motion) in the balloon extraction process, the perfusion fluid is supplied between the inner tube body 42 and the endoscope 22 in the supply process, and the endoscope 22 is retracted relative to the inner tube body 42 and the balloon 20 in the retraction process.

[0109] like Fig.10 As shown, in the advancing step, the front end of the balloon 20 advances and contacts the lesion 204. Then, by continuing the advancing step, as shown in FIG. Fig.11 When the balloon 20 completely passes through the lesion 204, the lesion 204 is expanded by the balloon 20. That is, the stenosis or occlusion of the fallopian tube 202 is improved.

[0110] After the lesion 204 is expanded radially outward by the balloon 20, the catheter 12 and the endoscope 22 are pulled out from the uterus (pulling process). In the pulling process, the balloon 20 can be pulled back by pulling the inner tube body 42 while injecting the perfusion fluid through the second introduction port 443, and the endoscope 22 can be operated to be located at the front end of the balloon 20. In this way, the catheter 12 and the endoscope 22 can be pulled out from the uterus while observing the inside of the fallopian tube 202 with the endoscope 22. After the pulling process, the endoscopic fallopian tube formation is completed.

[0111] This embodiment has the following effects.

[0112] like Figure 1As shown, a catheter system 10 comprises: an outer tube body 28, an inner tube body 42, and a balloon 20 that connects the front end of the outer tube body 28 and the front end of the inner tube body 42 and expands radially inwardly of the outer tube body 28, wherein the catheter system 10 comprises an operating unit 24 for moving an endoscope 22 inserted through the inner tube body 42 and into the inner cavity 201 of the balloon 20 forward and backward. Figure 3 As shown, the operation unit 24 includes a delivery member 52 for moving the endoscope 22 relative to the housing 50 along the inner tube body 42 , and the housing 50 is provided with a visual recognition unit 54 for visually recognizing the distal end portion 22A of the endoscope 22 from the outside.

[0113] Thus, when the endoscope 22 inserted into the housing 50 is advanced toward the inner tube body 42 by the delivery member 52, the user can confirm the advancement status of the front end portion 22A of the endoscope 22 in the housing 50 through the visual recognition unit 54. Figure 5 As shown in the double-dashed line shape of , when the front end portion 22A is moved in a different direction instead of the predetermined direction, the user stops the moving action of the endoscope 22, temporarily pulls the endoscope 22 from the operation portion 24 in the proximal direction, and then inserts the front end portion 22A into the insertion portion 62 of the operation portion 24 again. That is, even if the front end portion 22A of the endoscope 22 is bent due to repeated use, the risk of damage to the endoscope 22 caused by the front end portion 22A moving in the wrong direction can be effectively reduced by confirming the moving condition of the front end portion 22A in the operation portion 24.

[0114] like Figure 5 As shown, the housing 50 has an insertion portion 62 for inserting the endoscope 22, and the visual recognition portion 54 is disposed opposite to the insertion portion 62 in the housing 50. Thus, the user can effectively confirm the movement of the endoscope 22 in the insertion portion 62 in the housing 50 through the visual recognition portion 54.

[0115] like Figure 3 As shown, since the visual recognition portion 54 is the transparent portion 100 (translucent portion) of the housing 50 , the visual recognition portion 54 can be easily realized at a low cost compared to a structure in which the transparent portion 100 (translucent portion) is provided separately from the housing 50 .

[0116] like Figure 4As shown, the delivery member 52 is provided inside the housing 50, and includes abutment portions 941, 942 that abut against the endoscope 22 when the endoscope 22 is delivered toward the inner tube body 42. The visual recognition portion 54 is arranged opposite to the abutment portions 941, 942 of the delivery member 52. Thus, when the user operates the delivery member 52 to deliver the endoscope 22 toward the inner tube 18, the abutment portions 941, 942 of the delivery member 52 that abut against the endoscope 22 are confirmed by the visual recognition portion 54, thereby being able to effectively confirm whether the front end portion 22A of the endoscope 22 abuts against the abutment portions 941, 942 in a predetermined state.

[0117] like Figure 5 As shown, the delivery member 52 is composed of a first rotating body 861 and a second rotating body 862, and the first rotating body 861 and the second rotating body 862 hold the endoscope 22 by sandwiching the endoscope 22 via the contact parts 941 and 942. The first rotating body 861 and the second rotating body 862 are formed of, for example, a resin material or an elastic material. The operation portion 24 includes a first bulging portion 723 and a second bulging portion 803 which are provided inside the housing 50 and bulge from the inner surface of the housing 50 toward the contact parts 941 and 942. The first bulging portion 723 and the second bulging portion 803 include: a top portion 761 and a bulging portion 803 which are most protruding toward the contact parts 941 and 942 in the insertion portion 62, and a first guide hole 78 and a second guide hole 84 which are opened at the top portion 761 and 762 and penetrate the first bulging portion 723 and the second bulging portion 803 and allow the endoscope 22 to be inserted.

[0118] Thus, when the first rotating body 861 and the second rotating body 862 are rotated and the endoscope 22 is moved in the delivery direction, the top 761 of the first bulging portion 723 protruding toward the abutting portions 941 and 942 can effectively prevent the front end portion 22A of the endoscope 22 from moving in a direction different from the moving direction (arrow X1 direction). The so-called direction different from the moving direction specifically refers to the direction along the outer periphery of the first rotating body 861 or the second rotating body 862, the base end direction of the storage space 68 (arrow X2 direction), etc. By inserting the endoscope 22 into the first guide hole 78 of the first bulging portion 723, the endoscope 22 is effectively guided in the moving direction. In addition, the delivery component 52 is not limited to the case where it is composed of a group of rotating bodies. The delivery component 52 can be composed of a single rotating body or a movable body that slides along the axial direction.

[0119] The catheter system 10 performs the operation of advancing the balloon 20 in the distal direction (arrow X1 direction), supplying the perfusate between the inner tube body 42 and the endoscope 22, and retreating the endoscope 22 relative to the inner tube body 42 and the balloon 20 while the outer space Sc is pressurized with the expansion fluid in the range of 5 to 7 atmospheres. Thus, since the pressure of 5 to 7 atmospheres is continuously applied to the endoscope 22 in the outer space Sc, the distal end portion 22A of the endoscope 22 tends to bend easily. However, since the distal end portion 22A of the endoscope 22 in the housing 50 can be visually recognized via the visual recognition portion 54, the risk of damage to the endoscope 22 caused by the distal end portion 22A being sent out in the wrong direction in the operation portion 24 can be effectively reduced.

[0120] In the operation method of the catheter system 10, the balloon leading-out step includes: a pressurizing step of supplying a dilating fluid to the outer space Sc between the outer tube body 28 and the inner tube body 42 in the inner cavity of the outer tube body 28 and pressurizing the outer space Sc in the range of 5 to 7 atmospheres, thereby dilating the front end of the balloon 20; and an advancing step of advancing the front end of the balloon 20 in the fallopian tube 202 in the state where the outer space Sc is pressurized in the range of 5 to 7 atmospheres. The operation method of the catheter system 10 further includes: a supplying step of supplying a perfusion fluid between the balloon 20 and the endoscope 22 in the state where the outer space Sc is pressurized in the range of 5 to 7 atmospheres; and a retreating step of retreating the endoscope 22 relative to the inner tube body 42 by operating the operating unit 24 in the state where the perfusion fluid is supplied.

[0121] When operating the catheter system 10, the front end portion 22A of the endoscope 22 is easily bent due to the continuous application of 5 to 7 atmospheres of pressure to the endoscope 22 from the pressurization process of the balloon delivery process to the advancing process and the supply process. However, since the user can confirm the front end portion 22A of the endoscope 22 in the operating portion 24 through the visual recognition unit 54, the risk of the front end portion 22A moving in the wrong direction and causing damage to the endoscope 22 can be effectively avoided by confirming the progress of the front end portion 22A.

[0122] Fig.12 The catheter system 120 of the first modified example shown includes an operation unit 124 having a visual confirmation unit 122 .

[0123] The operation part 124 includes a delivery member 128 having a first rotating body 1261 and a second rotating body 1262. The first rotating body 1261 and the second rotating body 1262 are formed in the same shape. The first rotating body 1261 and the second rotating body 1262 include a roller body 130 and a shaft 90. The roller body 130 is formed in an annular shape. The outer periphery of the roller body 130 has annular outer peripheral surfaces 1321 and 1322.

[0124] The first rotating body 1261 and the second rotating body 1262 are arranged side by side in the vertical direction in the housing body 56. Fig.13 As shown, the outer circumferential surface 1321 of the first rotating body 1261 contacts the outer circumferential surface 1322 of the second rotating body 1262. Thus, the user rotates the first rotating body 1261 to rotate the second rotating body 1262 in the opposite direction to the first rotating body 1261. The visual recognition unit 122 is provided on the housing body 56.

[0125] During endoscopic tuboplasty using the catheter system 120, when the user operates the delivery component 128 to move the front end portion 22A of the endoscope 22 toward the inner tube body 42, the user can effectively confirm the movement status of the front end portion 22A of the endoscope 22 through the visual recognition portion 122 having the transparent portion 100.

[0126] Fig.14 The catheter system 140 of the second modified example shown in FIG. 1 includes an operation unit 144 having a visual recognition unit 142. The visual recognition unit 142 is provided on a side wall 642 of the housing body 56. The visual recognition unit 142 is an opening 146 opened on the side wall 642. Fig.15 As shown in FIG. 1 , the openings 146 are provided in the pair of partitions 561 and 562. The openings 146 penetrate the side wall 642 in the width direction (arrow Y direction) of the housing 50. Fig.14 As shown, the opening 146 opens at a position opposite to the insertion portion 62. The opening 146 is formed into a strip along the travel direction of the endoscope 22. For example, both ends of the opening 146 are opened to a position where the tops 761 and 762 of the first and second bulges 723 and 803 can be visually identified. In addition, the opening 146 only needs to open at a position opposite to the insertion portion 62, and is not limited to being formed into a strip shape along the travel direction of the endoscope 22. In addition, the opening 146 is not limited to being respectively provided in a pair of split bodies 561 and 562. The opening 146 can also be provided in either of the pair of split bodies 561 and 562.

[0127] During endoscopic tuboplasty using the catheter system 140 , when the user operates the delivery component 52 to move the front end portion 22A of the endoscope 22 toward the inner tube body 42 , the user can effectively confirm the progress of the front end portion 22A of the endoscope 22 through the opening portion 146 serving as the visual identification portion 142 .

[0128] The second modification example exerts the following effects.

[0129] like Fig.14 As shown, by providing the visual confirmation portion 142 as the opening portion 146 provided in the side wall 642 of the housing body 56 , the visual confirmation portion 142 can be easily realized at low cost.

[0130] By forming the visual confirmation portion 142 along the delivery direction (arrow X direction) of the endoscope 22 , the movement of the endoscope 22 in the housing 50 can be confirmed by the visual confirmation portion 142 over a wide range in the delivery direction of the endoscope 22 .

[0131] exist Fig.14 In the second modification shown in FIG. 1 , the structure in which the delivery member 52 has the first tooth portion 921 and the second tooth portion 922 is described, but the present invention is not limited to this structure. Fig.12 As shown, the delivery member 128 may not include the first tooth portion 921 and the second tooth portion 922 and the outer peripheral surfaces 1321 and 1322 of the first rotating body 1261 and the second rotating body 1262 may be in contact with each other.

[0132] In addition, the visual recognition portion 142 is not limited to the open opening portion 146. Fig.16 As shown, the visual recognition unit 150 may be a window 154 formed by a transparent or translucent cover member 152 and closing the opening 146. Through the window 154, the user can check the travel status of the front end portion 22A of the endoscope 22 in the housing 50. By providing the window 154 formed by the transparent or translucent cover member 152 in the housing 50 of the operation unit 144, the visual recognition unit 150 can be easily and inexpensively implemented.

[0133] In addition, the present invention is not limited to the above disclosure, and various structures can be adopted without departing from the gist of the present invention.

Claims

1. A catheter system, inserted into a lumen of a biological body and capable of traveling along the lumen, characterized in that: have: an outer tube, which is flexible; An inner tube, which is movably disposed in the inner cavity of the outer tube along the axial direction of the outer tube; a tubular balloon that connects the front end portion of the outer tube and the front end portion of the inner tube to each other and expands radially inwardly of the outer tube; and an operating unit, which is provided at the base end of the inner tube and causes the endoscope inserted through the inner tube and into the inner cavity of the balloon to move forward and backward along the inner tube, The operating unit has: a housing into which the endoscope is inserted; and a delivery member that contacts the endoscope in the housing and moves the endoscope along the inner tube relative to the housing, The housing includes a visual confirmation portion that allows a distal end portion of the endoscope in the housing to be visually confirmed from the outside.

2. The catheter system according to claim 1, characterized in that The housing has an insertion portion inside for the endoscope to be inserted therethrough. The visual recognition portion faces the insertion portion in the housing.

3. The catheter system according to claim 1 or 2, characterized in that: The visual recognition portion is a transparent portion or a semi-transparent portion of the housing.

4. The catheter system according to claim 1, characterized in that The visual recognition portion is an opening portion provided in the housing.

5. The catheter system according to claim 1, characterized in that The visual recognition portion is a window portion formed of a transparent or translucent member.

6. The catheter system according to claim 4 or 5, characterized in that The visual confirmation portion is formed along a delivery direction of the endoscope.

7. The catheter system according to claim 2, characterized in that The delivery member includes a contact portion, which is provided inside the housing and faces the insertion portion and contacts the endoscope when the endoscope is delivered toward the inner tube. The visual recognition portion is arranged to face the contact portion.

8. The catheter system according to claim 7, characterized in that The delivery member is composed of a group of rotating bodies arranged in a direction perpendicular to the delivery direction of the endoscope via the insertion portion. The set of rotating bodies holds the endoscope by sandwiching it via the abutment portion. The operating unit has: a receiving space, which is disposed inside the housing and receives the rotating body; and a bulging portion, which is disposed in the accommodating space, is opposite to the abutting portion and bulges from the inner surface of the shell toward the abutting portion, The bulging portion comprises: a top portion that protrudes most toward the abutment portion within the insertion portion; and A guide hole is opened at the top portion and penetrates the bulging portion to allow the endoscope to be inserted therethrough.

9. The catheter system according to claim 1, characterized in that The catheter system supplies an expansion fluid to the space between the outer tube and the inner tube in the inner cavity of the outer tube, expands the balloon with the expansion fluid and moves along the inner cavity toward the front end, and supplies a perfusion fluid between the inner tube and the endoscope to cause the endoscope to retreat relative to the inner tube and the balloon. The movement of the balloon moving toward the distal end, the supply of the perfusion fluid between the inner tube and the endoscope, and the retreat of the endoscope relative to the inner tube and the balloon are performed while the space is pressurized in the range of 5 to 7 atmospheres by the expansion fluid.

10. A method for operating a catheter system, wherein the catheter system is inserted into a lumen of a biological body and can move along the lumen, characterized in that: The catheter system comprises: an outer tube, which is flexible; An inner tube, which is movably disposed in the inner cavity of the outer tube along the axial direction of the outer tube; a tubular balloon that connects the front end portion of the outer tube and the front end portion of the inner tube to each other and expands radially inwardly of the outer tube; and an operating unit, which is provided at the base end of the inner tube and causes the endoscope inserted through the inner tube and into the inner cavity of the balloon to move forward and backward along the inner tube, The operating unit has: a housing into which the endoscope is inserted; and a delivery member that contacts the endoscope in the housing and moves the endoscope along the inner tube relative to the housing, The housing includes a visual recognition portion that allows the distal end portion of the endoscope in the housing to be visually recognized from the outside. The operation method has the following steps: an inserting step of inserting the front end portion of the outer tube into the lumen and advancing it toward the front end direction, and advancing the front end portion of the endoscope to the front end portion of the balloon through the operating unit; A pressurizing step of supplying an expansion fluid to a space between the outer tube and the inner tube in the inner cavity of the outer tube and pressurizing the space in a range of 5 to 7 atmospheres, thereby expanding the front end of the balloon; A forwarding step of moving the front end of the balloon toward the front end direction in the lumen while the space is pressurized in a range of 5 to 7 atmospheres; a supplying step of supplying a perfusion fluid between the balloon and the endoscope while the space is further pressurized in a range of 5 to 7 atmospheres; as well as The retreat step is to operate the operation portion while the perfusion fluid is being supplied, thereby retreating the endoscope relative to the inner tube.

Images