Deflection operation device for medical instrument

Abstract

To provide a deflection operation device for a medical instrument that can easily hold and release the deflection direction of a movable part of the medical instrument.SOLUTION: A deflection operation device 100 for a medical instrument includes: a first rack member 300 and a second rack member 400 which are housed within a controller housing 200 so as to be reciprocally displaceable in the longitudinal direction along the extending directions of a first operation wire and a second operation wire, and to have teeth portions 320, 420 that face each other; a pinion member 600 which is rotatably supported in a state of meshing with the teeth portions 320, 420 of the rack members 300, 400; and a restriction member (fixing operation button 700) that includes an engaging portion 800 capable of engaging with the teeth portions 320, 420 of at least one of the first rack member 300 and the second rack member 400. The displacement-restricted state in which the engaging portion 800 of the restriction member engages with the teeth portions 320, 420 and the displaceable state in which the engagement of the engaging portion 800 is released can be switched.SELECTED DRAWING: Figure 6

Description

[Technical field]

[0001] The present invention relates to a deflection device for a medical device for deflecting a movable part of the medical device. [Background technology]

[0002] Long, flexible, tubular medical devices such as catheters and endoscopes are inserted into tissues of various internal organs (e.g., the heart) through blood vessels, tracheas, or body cavities, internal luminal parts, etc., to perform the desired medical treatment. In order to facilitate insertion into the body and access to tissues, it is known that such medical devices can be deflected at the distal end of the medical device inserted into the body by a medical device deflection device that is connected to the proximal end of the medical device and disposed outside the body.

[0003] For example, the following Patent Document 1 describes a deflection operation device for a medical device, which includes a first rack member and a second rack member housed in a controller housing so as to be reciprocally displaceable in the longitudinal direction along the extension direction of the first and second operation wires and to have teeth portions facing each other, and a pinion member supported rotatably in a state of meshing with the teeth portions of each rack member, and in which first and second operation knobs protruding outward from the controller housing are integrally provided on each rack member. In the deflection operation device for a medical device described in Patent Document 1, the first rack member and the second rack member are reciprocally displaced in opposite directions to each other by operating an operation knob provided on at least one of these rack members, so that a movable part of the medical device can be deflected. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] International Publication No. 2021 / 117724 Summary of the Invention [Problem to be solved by the invention]

[0005] When the movable part of the medical device is set to a desired deflection direction, there are cases where the user wants to maintain this deflection direction even after releasing the operating knob.However, in the medical device deflection operating device described in Patent Document 1, when the user releases the operating knob, a force acts on the operating knob in a direction in which the movable part extends straight and returns to a neutral position where it is not deflected, due to the restoring force of the movable part or a biasing means (coil spring) arranged inside the medical device deflection operating device, and there is a problem that the deflection direction cannot be maintained.

[0006] The present invention has been made in consideration of the above problems, and aims to provide a deflection operating device for medical equipment that has excellent one-handed operability and a simple configuration, and that can easily hold and release the deflection direction of the movable part of the medical equipment. [Means for solving the problem]

[0007] In order to achieve the above object, the present invention provides a medical device deflection device that deflects a movable part of a medical device via a first manipulation wire and a second manipulation wire, comprising: a controller housing having a main body, a support handle portion provided on a base end side of the main body in a longitudinal direction along an extension direction of the first operation wire and the second operation wire, and a wire insertion portion provided on a tip end side of the main body in the longitudinal direction and through which the first operation wire and the second operation wire are inserted; a first rack member and a second rack member housed within the controller housing so as to be reciprocally displaceable in the longitudinal direction and have teeth portions facing each other; a pinion member disposed between the first rack member and the second rack member and rotatably supported by the controller housing in a state in which the pinion member meshes with the teeth of both rack members; a regulating member that is slidably supported by the controller housing and has an engaging portion that is engageable with the teeth portion of at least one of the first rack member and the second rack member, the controller housing is provided with a slide guide portion that forms a groove-shaped opening along at least one of the first rack member and the second rack member; an operation knob that protrudes through the opening toward a side of the controller housing is integrally provided on at least one of the first rack member and the second rack member; when the operation knob is slidably operated so as to be displaced relative to the support handle portion in the longitudinal direction, the first rack member and the second rack member are displaced in mutually opposite directions relative to the pinion member, and the first operation wire and the second operation wire are displaced in a deflection operation direction of the movable portion, The regulating member can be slid relative to the controller housing to switch between a displacement restricting state in which the engagement portion engages with the tooth portions of at least one of the first rack member and the second rack member to restrict reciprocating displacement of the first rack member and the second rack member in the longitudinal direction, and a displaceable state in which the engagement portion is disengaged from the tooth portions of the first rack member and the second rack member to allow reciprocating displacement of the first rack member and the second rack member in the longitudinal direction.

[0008] According to the above configuration, in the medical device deflection operating device having excellent one-handed operability and a simple configuration, the restricting member is slidably operated to engage the engagement portion of the restricting member with the teeth of at least one of the first rack member and the second rack member to restrict the reciprocating displacement of the first rack member and the second rack member in the longitudinal direction, thereby making it possible to easily maintain the deflection direction of the movable part of the medical device. Also, the restricting member is slidably operated to release the engagement of the engagement portion of the restricting member with the teeth of at least one of the first rack member and the second rack member, thereby making it possible to easily release the hold of the deflection direction of the movable part of the medical device.

[0009] In the medical instrument deflection operation device according to the present invention, in the above-described configuration, the regulating member may be slidable between the first rack member and the second rack member in a direction approximately perpendicular to the longitudinal direction.

[0010] According to the above configuration, the regulating member is arranged between the first rack member and the second rack member having teeth portions facing each other so as to be slidable in a direction approximately perpendicular to the longitudinal direction, and by controlling the state in which the engaging portion is arranged between the teeth of the teeth portions by the sliding operation of the regulating member, it becomes possible to switch between a displacement-restricted state and a displacement-enabled state.

[0011] In the above-described configuration of the medical equipment deflection operation device according to the present invention, the regulating member is integrally provided with a leg portion disposed between the first rack member and the second rack member and a head portion connected to a base end of the leg portion, The engaging portion is provided on a side surface of the leg portion, The restricting member may be slidable in an extending direction of the leg portion to switch between the displacement restricted state and the displacement permitted state.

[0012] According to the above configuration, by sliding the regulating member which has an integral head and a leg with an engagement portion provided on its side, it is possible to switch between a displacement-restricted state and a displacement-allowed state.

[0013] The medical equipment deflection device according to the present invention has the above-mentioned configuration, and further includes a restricting member insertion hole formed in each of the top plate portion and the bottom plate portion of the controller housing, The leg portions of the regulating member may be inserted and supported in the regulating member insertion holes of the top plate portion and the bottom plate portion, and may be disposed between the first rack member and the second rack member.

[0014] According to the above configuration, the legs of the restricting member are inserted and supported by the top plate and the bottom plate of the controller housing, so that the restricting member can be slidably supported on the controller housing.

[0015] In the above-described configuration, the head of the regulating member is disposed on an outer surface side of the top plate portion of the controller housing, When the regulating member is slid relative to the controller housing to achieve the displacement restricted state, the head of the regulating member may abut and engage with an outer surface of the top plate portion of the controller housing.

[0016] According to the above configuration, the head of the restricting member abuts and engages with the outer surface of the top plate of the controller housing, thereby preventing the restricting member from falling off.

[0017] In the above-described configuration, the medical equipment deflection operation device according to the present invention is configured such that the tip end of the leg portion of the regulating member is disposed on an outer surface side of the bottom plate portion of the controller housing, When the regulating member is slid relative to the controller housing to achieve the displacement regulated state, the tip portions of the legs of the regulating member may be in a state where they protrude from an outer surface of the bottom plate portion of the controller housing.

[0018] According to the above configuration, when the displacement restricted state is set, the tip of the leg of the restricting member protrudes from the outer surface of the bottom plate portion of the controller housing, thereby indicating the displacement restricted state.

[0019] In the above-described configuration, the deflection operating device for medical equipment according to the present invention is provided with a stopper portion extending laterally of the leg portion at the tip portion of the leg portion of the regulating member, When the regulating member is slid relative to the controller housing to attain the displacement restricted state, the anti-detachment portion of the regulating member may abut and engage with an outer surface of a bottom plate portion of the controller housing, or with the first rack member or the second rack member.

[0020] According to the above configuration, the stopper portion of the restricting member abuts and engages with the outer surface of the bottom plate portion of the controller housing, or the first rack member or the second rack member, thereby preventing the restricting member from falling off.

[0021] In the above-mentioned configuration of the medical equipment deflection operation device according to the present invention, the leg portion is composed of a connecting leg portion connected to the head portion and constituting the base end portion of the leg portion, and a plurality of divided leg portions connected to the connecting leg portion and constituting the tip end portion of the leg portion, The split leg portions may be formed symmetrically to one another and configured to be elastically deformable laterally.

[0022] According to the above configuration, the multiple split legs are slidably supported in contact with the inner surface of the regulating member insertion hole formed in the bottom plate portion of the controller housing, so that the regulating member can be maintained in the desired sliding position.

[0023] The medical equipment deflection operation device according to the present invention has the above-mentioned configuration, and further comprises a convex portion forming a convex surface on an inner circumferential surface of the regulating member insertion hole formed in the bottom plate portion, A first recess may be provided on each side of the multiple split leg portions, forming a concave surface that fits into the convex surface of the convex portion when in the displacement restricted state, and a second recess may be provided on each side of the multiple split leg portions, forming a concave surface that fits into the convex surface of the convex portion when in the displaceable state.

[0024] According to the above configuration, when the restricting member is slid relative to the controller housing to attain the displaceable state, the first recess of the restricting member engages with the convex portion formed on the inner surface of the restricting member insertion hole, and when the restricting member is slid relative to the controller housing to attain the displacement restricted state, the second recess of the restricting member engages with the convex portion formed on the inner surface of the restricting member insertion hole. Therefore, the position of the restricting member when in the displacement restricted state and the displaceable state is determined and the restricting member stops sliding at each of the engaged positions, thereby improving the user's operating feel.

[0025] In the medical instrument deflection operation device according to the present invention, in the above-described configuration, the engagement portion may have a plurality of engagement protrusions that engage with the teeth of at least one of the first rack member and the second rack member.

[0026] According to the above configuration, the multiple engaging protrusions engage with the teeth of at least one of the first rack member and the second rack member, thereby more reliably regulating the reciprocating displacement of the first rack member and the second rack member in the longitudinal direction.

[0027] In the above-mentioned configuration of the deflection operating device for medical equipment according to the present invention, the engagement portion may be configured to include a first engagement protrusion that engages with the tooth portion of the first rack member, and a second engagement protrusion that engages with the tooth portion of the second rack member.

[0028] According to the above configuration, the engagement portion of the regulating member engages with the teeth of both the first rack member and the second rack member, thereby more reliably regulating the reciprocating displacement of the first rack member and the second rack member in the longitudinal direction.

[0029] In the deflection operation device for medical equipment according to the present invention, in the above-mentioned configuration, the regulating member may be disposed closer to a base end side in the longitudinal direction than the pinion member.

[0030] According to the above configuration, by arranging the regulating member on the longitudinal base end side of the pinion member located approximately in the center of the deflection operating device for medical equipment, the deflection operation of the movable part of the medical equipment and the sliding operation of the regulating member can be performed with one hand while gripping the support handle part, thereby providing a deflection operating device for medical equipment with excellent operability with one hand. [Brief description of the drawings]

[0031] [Figure 1] 1 is a plan view showing an overall configuration of a medical device including a deflection operating device for a medical instrument according to an embodiment of the present invention. [Diagram 2] 2 is a cross-sectional view taken along line AA in FIG. 1. [Diagram 3] 1A and 1B are diagrams showing the vicinity of the distal end of a tubular member in an embodiment of the present invention, where (a) is a perspective view showing the vicinity of the distal end of the tubular member, and (b) is a see-through view for explaining the inside of the tubular member. [Figure 4] 11A to 11C are diagrams illustrating a bending operation of a movable part of a tubular member in an embodiment of the present invention. [Diagram 5] 1 is a perspective view of a deflection operating device for a medical instrument according to an embodiment of the present invention. [Figure 6] 1 is an exploded perspective view of a deflection operating device for a medical instrument according to an embodiment of the present invention with a cover removed. [Figure 7] 1 is a plan view showing an internal configuration of a deflection operation device for a medical instrument according to an embodiment of the present invention. [Figure 8] 1A and 1B are plan views showing a first rack member and a second rack member included in a deflection operating device for a medical instrument in an embodiment of the present invention, where (a) is a diagram showing the second rack member and the second operating knob, and (b) is a diagram showing the first rack member and the first operating knob. [Figure 9] 1 is a plan view showing an internal configuration of a deflection operation device for a medical instrument in an embodiment of the present invention when a first operation knob is pulled. FIG. [Figure 10] 2 is a plan view showing the internal configuration when a second operation knob is pulled in the deflection operation device for medical equipment in the embodiment of the present invention. FIG. [Figure 11] 3 is a perspective view of a fixed operation button included in a deflection operation device according to an embodiment of the present invention. FIG. [Figure 12] 11. FIG. 14 is a first side view of a fixed operation button included in the medical equipment deflection operation device in the embodiment of the present invention, as viewed from the negative Y-axis direction (P1 in FIG. 11) in the coordinate axes shown in FIG. [Figure 13] 11. FIG. 14 is a second side view of the fixed operation button included in the medical equipment deflection operation device in the embodiment of the present invention, as viewed from the positive X-axis direction (P2 in FIG. 11) in the coordinate axes shown in FIG. [Figure 14]11. FIG. 14 is a third side view of the fixed operation button included in the deflection operation device for medical equipment in the embodiment of the present invention, as viewed from the Y-axis positive direction (P3 in FIG. 11) in the coordinate axes shown in FIG. [Figure 15] 11. FIG. 14 is a fourth side view of the fixed operation button included in the medical equipment deflection operation device in the embodiment of the present invention, as viewed from the negative X-axis direction (P4 in FIG. 11) in the coordinate axes shown in FIG. [Figure 16] FIG. 2 is a perspective view showing a displacement restricted state of the deflection operating device for a medical instrument according to the embodiment of the present invention. [Figure 17] 1 is a plan view showing a displacement restriction state of a deflection operation device for a medical instrument according to an embodiment of the present invention. FIG. [Figure 18] 18 is a cross-sectional view of FIG. 17 taken along line B-B. [Figure 19] 19 is an enlarged view of the vicinity of a fixed operation button in FIG. 18. [Figure 20] 18 is a cross-sectional view taken along CC in FIG. 17 . [Figure 21] 21 is an enlarged view of the vicinity of a fixed operation button in FIG. 20. [Figure 22] FIG. 18 is a cross-sectional view taken along line DD of FIG. [Diagram 23] 1 is a perspective view showing a deflection operating device for a medical instrument in an embodiment of the present invention in a displaceable state. FIG. [Figure 24] 1 is a plan view showing a deflection operating device for a medical instrument in an embodiment of the present invention in a displaceable state. FIG. [Diagram 25] 25 is a cross-sectional view of FIG. 24 . [Figure 26] 26 is an enlarged view of the vicinity of a fixed operation button in FIG. 25. [Figure 27] 25 is a cross-sectional view of FIG. 24 . [Figure 28] 28 is an enlarged view of the vicinity of a fixed operation button in FIG. 27. [Figure 29] This is a cross-sectional view of FIG. [Diagram 30] FIG. 13 is a plan view showing a modified example of the deflection operation device for a medical instrument in the embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0032] Hereinafter, an embodiment of the present invention will be described with reference to the drawings. In this specification, the inside of the patient's body is defined as the distal side, and the hand side of the user is defined as the proximal side, based on the user (practitioner) of the medical device provided with the deflection operation device for medical equipment according to the present invention. The drawings referred to in this specification are not necessarily accurate to scale with respect to the actual dimensions, and are partially exaggerated or simplified to show the configuration according to the present invention in a schematic manner.

[0033] First, the overall configuration of a medical device 1, which is a medical device including a deflection operation device 100 for medical equipment (hereinafter, referred to as a deflection operation device 100) in an embodiment of the present invention will be described. Fig. 1 is a plan view showing the overall configuration of a medical device 1 including a deflection operation device 100 in an embodiment of the present invention.

[0034] The medical device 1 shown in Fig. 1 has a deflection operation device 100 and a long tubular member 10 whose distal end is deflected by the deflection operation device 100. The deflection operation device 100 in this embodiment is configured so that a user can operate a movable part 20 (also referred to as an operated part or a deflection part) located at the distal end of the tubular member 10 constituting the medical device 1 in a deflectable manner by operating a first operation knob 510 and a second operation knob 520. The type of medical device 1 including the tubular member 10 as a medical instrument is not particularly limited, and examples thereof include an endoscope, a catheter, and a cannula.

[0035] The tubular member 10 is made of a long, flexible tube member, and has a movable part 20 at the end of the tip side, i.e., the distal side (left side in FIG. 1) that is inserted into the body, that can deflect the direction in the left and right directions. The axial length of the tubular member 10 is not particularly limited, and can be set to a length that can reach a desired part in the body. The radial length of the tubular member 10 is also not particularly limited, and can be set to a length that can be inserted into a tubular organ or an endoscope forceps port in the body. The material of the tubular member 10 is preferably a material that is flexible so that the tubular member 10 can be flexibly deformed when inserted into the body and is not harmful to the human body, and for example, a polymeric material having biocompatibility, such as polyurethane, polyethylene, polypropylene, or a fluororesin such as polytetrafluoroethylene, can be used.

[0036] A tip chip 50 is attached to the distal end 10a of the tubular member 10, and a proximal end 10b of the tubular member 10 is connected to the distal end (sleeve portion 231) of the deflection operation device 100 (see, for example, FIG. 7). As described later, a first operation wire W1 and a second operation wire W2 are attached to the distal end of the tubular member 10 so as to enable deflection operation by the deflection operation device 100 (see, for example, FIGS. 3(a) and (b)).

[0037] The deflection operation device 100 is an apparatus for operation by the user of the medical device 1, and is placed outside the body during use. The deflection operation device 100 is configured to be able to deflect the movable part 20 of the tubular member 10 by displacing the first operation wire W1 and the second operation wire W2 attached to the distal end of the tubular member 10 in the axial direction.

[0038] The tubular member 10, the first operating wire W1 and the second operating wire W2 will be described with reference to Fig. 2. Fig. 2 is a cross-sectional view taken along line AA of Fig. 1.

[0039] A movable part 20 that can be deflected using a deflection operation device 100 is provided at the distal end of the tubular member 10. By operating the bending (curving) operation of the movable part 20 with the deflection operation device 100, the distal end of the tubular member 10 can be deflected in a desired deflection operation direction.

[0040] The tubular member 10 has a tubular structure with a lumen formed along its extension direction, as shown in the cross-sectional view of Fig. 2. A main lumen 11 is formed along the axial direction of the tubular member 10 at approximately the center of the cross section of the tubular member 10. The main lumen 11 is formed so as to open at each of the distal end 10a and the proximal end 10b of the tubular member 10.

[0041] Wire lumens 11a, 11b, 12a, and 12b for inserting the first operating wire W1 and the second operating wire W2 are formed in the tube wall between the outer circumferential surface of the tubular member 10 and the main lumen 11. As shown in Fig. 2 as an example, a pair of wire lumens 11a, 11b and a pair of wire lumens 12a, 12b, that is, a total of four wire lumens 11a, 11b, 12a, and 12b, are formed in the tubular member 10. Like the main lumen 11, each of the wire lumens 11a, 11b, 12a, and 12b is formed so as to open at the distal end 10a and the proximal end 10b of the tubular member 10.

[0042] As described below, a first operating wire W1 is inserted through the pair of wire lumens 11a, 11b, and a second operating wire W2 is inserted through the pair of wire lumens 12a, 12b. The pair of wire lumens 11a, 11b and the pair of wire lumens 12a, 12b are provided at positions that are opposite poles at approximately 180 degrees from each other with respect to the central axis of the tubular member 10.

[0043] In order to reinforce the tubular member 10 and prevent twisting of the tubular member 10, the tubular member 10 may be provided with a braided layer having a reinforcing member formed of braided wires such as stainless steel. The tubular member 10 may have a plurality of lumens other than the lumen for the wire, or may be a multi-layer tube.

[0044] The configuration of the vicinity of the distal end 10a of the tubular member 10 will be described with reference to Figures 3(a), (b) and 4. Figure 3 shows the vicinity of the distal end 10a of the tubular member 10 in an embodiment of the present invention, where (a) is a perspective view that typically shows the vicinity of the distal end 10a of the tubular member 10, and (b) is a see-through view for explaining the inside of the tubular member 10. Note that the main lumen 11 is omitted in Figure 3(b). Figure 4 is a view for explaining the bending operation of the movable part 20 of the tubular member 10 in an embodiment of the present invention.

[0045] The distal end 10a of the tubular member 10 is provided with a tip 50 made of, for example, metal. The tip 50 protects the distal end 10a of the tubular member 10 and reduces the insertion resistance of the tubular member 10 into the body by forming it into a tapered shape. The tip 50 is fixed to the distal end 10a of the tubular member 10.

[0046] A through hole 55a is provided along the central axis of the distal tip 50. The through hole 55a communicates with the main lumen 11 of the tubular member 10, and the main lumen 11 of the tubular member 10 communicates with the outside via this through hole 55a.

[0047] The distal tip 50 has a pair of recesses 56, 57 formed on its proximal side surface. The recess 56 has wire insertion holes 56a, 56b formed therein. Similarly, the recess 57 has wire insertion holes 57a, 57b formed therein. The wire insertion holes 56a, 56b, 57a, 57b are provided so as to correspond to the opening positions of the wire lumens 11a, 11b, 12a, 12b that open at the distal end 10a of the tubular member 10, respectively, and the first operating wire W1 and the second operating wire W2 that are inserted through the wire lumens 11a, 11b, 12a, 12b are inserted through the wire insertion holes 56a, 56b, 57a, 57b, respectively.

[0048] 2 and 3(b), a single operation wire (first operation wire W1) is inserted through the wire lumens 11a and 11b, and a single operation wire (second operation wire W2) is inserted through the wire lumens 12a and 12b. The first operation wire W1 and the second operation wire W2 are made of a metal (stainless steel or the like) having a flexibility sufficient to bend in accordance with the curvature of the tubular member 10 including the movable part 20.

[0049] The first operation wire W1 inserted through the wire lumens 11a and 11b is inserted through the wire insertion holes 56a and 56b of the distal tip 50 provided in correspondence with the wire lumens 11a and 11b. The first operation wire W1 is folded back at a folded back intermediate portion W1c, which corresponds to a position approximately halfway along the axial direction of the wire, in the recess 56 of the distal tip 50. The operation wire W1a on one end side based on the folded back intermediate portion W1c is inserted through the wire lumen 11a through the wire insertion hole 56a, and the operation wire W1b on the other end side is inserted through the wire lumen 11b through the wire insertion hole 56b. When the operation wire W1a and the operation wire W1b are pulled proximally, the folded back intermediate portion W1c is configured to engage with the distal tip 50 by the pulling force.

[0050] The second operation wire W2 inserted through the wire lumens 12a and 12b is inserted through the wire insertion holes 57a and 57b of the distal tip 50 provided in correspondence with the wire lumens 12a and 12b. The second operation wire W2 is folded back at a folded back intermediate portion W2c, which corresponds to a position approximately halfway along the axial direction of the wire, in the recess 57 of the distal tip 50. The operation wire W2a on one end side based on the folded back intermediate portion W2c is inserted through the wire lumen 12a through the wire insertion hole 57a, and the operation wire W2b on the other end side is inserted through the wire lumen 12b through the wire insertion hole 57b. When the operation wire W2a and the operation wire W2b are pulled proximally, the folded back intermediate portion W2c is configured to engage with the distal tip 50 by the pulling force.

[0051] In this way, by adopting a structure in which the wire is folded back at the distal end 10a of the tubular member 10, the number of parts can be reduced, and the number of manufacturing steps can be reduced, and structural restrictions can also be reduced.

[0052] The operation wire W1a on one end side constituting the first operation wire W1 extends along the tubular member 10 while being inserted through the wire lumen 11a, and the proximal end of the operation wire W1a is guided inside the deflection operation device 100. Similarly, the operation wire W1b on the other end side constituting the first operation wire W1 extends along the tubular member 10 while being inserted through the wire lumen 11b, and the proximal end of the operation wire W1b is guided inside the deflection operation device 100. As described later, the proximal end of the operation wire W1a and the proximal end of the operation wire W1b are connected and fixed to the first rack member 300 of the deflection operation device 100. When the first rack member 300 moves proximally, the operation wire W1a and the operation wire W1b are pulled proximally, and the movable part 20 is deflected to the side where the recess 56 of the distal tip 50 is arranged (the direction of the arrow α shown in FIG. 4).

[0053] The operation wire W2a on one end side constituting the second operation wire W2 extends along the tubular member 10 while being inserted through the wire lumen 12a, and the proximal end of the operation wire W2a is guided inside the deflection operation device 100. Similarly, the operation wire W2b on the other end side constituting the second operation wire W2 extends along the tubular member 10 while being inserted through the wire lumen 12b, and the proximal end of the operation wire W2b is guided inside the deflection operation device 100. As described later, the proximal end of the operation wire W2a and the proximal end of the operation wire W2b are connected and fixed to the second rack member 400 of the deflection operation device 100. When the second rack member 400 moves proximally, the operation wire W2a and the operation wire W2b are pulled proximally, and the movable part 20 is deflected to the side where the recessed part 57 of the distal tip 50 is arranged (the direction of the arrow β shown in FIG. 4).

[0054] The configuration of the deflection operation device 100 according to the embodiment of the present invention will be described with reference to Figs. 5 to 10. Fig. 5 is a perspective view of the deflection operation device 100 according to the embodiment of the present invention. Fig. 6 is an exploded perspective view of the deflection operation device 100 according to the embodiment of the present invention with the cover body 200B removed. Fig. 7 is a plan view showing the internal configuration of the deflection operation device 100 according to the embodiment of the present invention. Fig. 8 is a plan view showing the first rack member 300 and the second rack member 400 included in the deflection operation device 100 according to the embodiment of the present invention, (a) showing the second rack member 400 and the second operation knob 520, and (b) showing the first rack member 300 and the first operation knob 510. Fig. 9 is a plan view showing the internal configuration of the deflection operation device 100 according to the embodiment of the present invention when the first operation knob 510 is pulled. Fig. 10 is a plan view showing the internal configuration of the deflection operation device 100 according to the embodiment of the present invention when the second operation knob 520 is pulled.

[0055] In addition, the first operation wire W1 and the second operation wire W2, and the coil springs 255 and 256 are omitted in Fig. 6. Also, Fig. 7, Fig. 9, and Fig. 10 show the internal configuration of the deflection operation device 100 seen through the cover body 200B. In the following description, the side where the head 710 of the fixed operation button 700 is arranged is referred to as the upper side, and the side where the leg part 720 of the fixed operation button 700 is arranged is referred to as the lower side.

[0056] The deflection operation device 100 in this embodiment is generally configured to include a controller housing 200 configured with a base 200A and a cover body 200B, a first rack member 300 and a second rack member 400 housed in the controller housing 200, a pinion member 600 disposed between the first rack member 300 and the second rack member 400, and a fixed operation button 700. Each member constituting the deflection operation device 100 can be produced by molding, for example, resin, and the deflection operation device 100 can be assembled by combining each of these members.

[0057] The controller housing 200 is formed in a substantially T-shape having a cavity therein. As shown in Fig. 5, the controller housing 200 has a main body section 210, a support handle section 220 provided integrally on the longitudinal base end side (proximal side) of the main body section 210, and a sleeve section 231 constituting a wire insertion section 230 through which the first operation wire W1 and the second operation wire W2 are respectively inserted on the longitudinal tip side (distal side) of the main body section 210. The longitudinal direction of the main body section 210 is a direction along the extension direction of the first operation wire W1 and the second operation wire W2 inserted inside the tubular member 10.

[0058] The controller housing 200 has a symmetrical shape with a longitudinal center line C (see FIG. 7) passing through the center of the width direction of the main body 210 as a line of symmetry. As shown in FIGS. 5 and 6, the controller housing 200 is configured by combining a halved base 200A and a lid 200B, which are approximately divided into two equal parts in the thickness direction, in a detachable manner. The base 200A and the lid 200B constituting the controller housing 200 have approximately the same shape, and can be fixed by screwing, bonding with an adhesive, or the like in a state where they are stacked facing each other. The lid 200B constitutes a top plate portion of the controller housing 200 of the present invention, and the base 200A constitutes a bottom plate portion of the controller housing 200 of the present invention.

[0059] As shown in FIG. 6, a first slide guide section 206 and a second slide guide section 207 are formed on both side surfaces of the controller housing 200. An opening is formed on the side surface of the first slide guide section 206 for exposing the first operation knob 510 of the first rack member 300 to the side, and an opening is formed on the side surface of the second slide guide section 207 for exposing the second operation knob 520 of the second rack member 400 to the side. As described later, the first rack member 300 and the second rack member 400 are displaced in the longitudinal direction in conjunction with each other via the pinion member 600. Therefore, even if only one of the first operation knob 510 and the second operation knob 520 is provided, the first rack member 300 and the second rack member 400 can be displaced in a desired direction to perform a deflection operation of the movable section 20.

[0060] 5 and 7, the support handle portion 220 of the controller housing 200 includes a first handle portion 221 and a second handle portion 222, each of which has a substantially rectangular shape and extends laterally perpendicular to the main body portion 210. The support handle portion 220 and the main body portion 210 form a substantially T-shape.

[0061] As shown in FIG. 7, the proximal edge 223 of the support handle portion 220 includes a support portion 223a on which the palm of the user's hand is placed. The support portion 223a is formed into a gently curved surface that is substantially convex from one end to the other end toward the proximal side. In addition, corners 223b, 223c continuing to both ends of the support portion 223a are chamfered. Since the support portion 223a is gently curved and each corner 223b, 223c is chamfered, the user can easily place the palm of the user's hand on the support portion 223a without feeling uncomfortable, thereby improving the operability of the deflection operation device 100.

[0062] As shown in Fig. 7, the distal end edges of the first handle portion 221 and the second handle portion 222 constituting the support handle portion 220 respectively constitute finger locking portions 221a, 222a on which the user's fingers can be hooked. These finger locking portions 221a, 222a are formed into gently curved surfaces that are substantially concave toward the proximal side. In addition, the outer corners 221b, 222b continuing to the finger locking portions 221a, 222a are chamfered.

[0063] In this embodiment, the support handle portion 220 forms an approximately T-shape together with the main body portion 210, but it may have any shape having a surface that can be pressed against the palm, such as an approximately L-shape together with the main body portion 210, and it may also have any shape having a structure that allows fingers to be engaged, such as a finger insertion ring that can be supported by passing the fingers through.

[0064] 7, the wire insertion portion 230 has a thin tubular sleeve portion 231 protruding from the distal end of the controller housing 200, a wire introduction port 232 that communicates from the inside of the sleeve portion 231 to the inside of the controller housing 200, and a gate portion 233 disposed adjacent to the wire introduction port 232. The gate portion 233 includes a pair of cylindrical portions 233a, 233b provided on the controller housing 200. Note that the cylindrical portions 233a, 233b constituting the gate portion 233 may be formed of rotatable rollers.

[0065] The tubular member 10 is connected to the controller housing 200 with its proximal end 10b fixed inside the sleeve portion 231. The means for fixing the tubular member 10 to the sleeve portion 231 is not particularly limited, and for example, a means for press-fitting the proximal end 10b of the tubular member 10 into the sleeve portion 231 and then gluing or welding it to the inner surface of the sleeve portion 231 can be used. Note that, when forming the wire insertion portion 230, the controller housing 200 and the boundary position of the tubular member 10 from the controller housing 200 may be covered using a heat shrink tube or the like without providing the sleeve portion 231 on the controller housing 200, and the cover may be integrated with the controller housing 200.

[0066] The proximal ends of the operation wires W1a, W1b, W2a, and W2b constituting the first operation wire W1 and the second operation wire W2 are passed from the inside of the sleeve portion 231 through the wire introduction port 232 and between the cylindrical portions 233a and 233b of the gate portion 233, and introduced into the controller housing 200. As described later, the proximal ends of the operation wires W1a and W1b constituting the first operation wire W1 are fixed to the first rack member 300, and the proximal ends of the operation wires W2a and W2b constituting the second operation wire W2 are fixed to the second rack member 400.

[0067] As shown in FIG. 7, the controller housing 200 has therein a first guide portion 251 that guides the first rack member 300 so that it can be displaced back and forth in the longitudinal direction, and a second guide portion 252 that guides the second rack member 400 so that it can be displaced back and forth in the longitudinal direction.

[0068] 6 and 7, the first guide portion 251 is formed by two partition walls 241a, 242a extending in the longitudinal direction provided at the center of the controller housing 200, the first slide guide portion 206, and a guide wall portion 243 in the support handle portion 220. The second guide portion 252 is formed by two partition walls 241b, 242b extending in the longitudinal direction provided at the center of the controller housing 200, the second slide guide portion 207, and a guide wall portion 244 in the support handle portion 220.

[0069] 7, a coil spring 255 is disposed on the distal side of the first guide portion 251, and a coil spring 256 is disposed on the distal side of the second guide portion 252. The coil springs 255 and 256 serve to bias the first rack member 300 and the second rack member 400 that have moved to the distal side, respectively, and to return them to a neutral position in which the first rack member 300 and the second rack member 400 are disposed in symmetrical positions. Note that the coil springs may be disposed on the proximal side of the first guide portion 251 and the proximal side of the second guide portion 252, or a configuration may be adopted in which no coil spring is provided.

[0070] As shown in Fig. 6 and Fig. 7, the partition wall portions 241a and 241b form a partition wall on the distal side in the longitudinal direction, and the proximal ends of the partition wall portions 241a and 241b are connected by a curved portion 241c near the center in the longitudinal direction. The partition wall portions 242a and 242b form a partition wall on the proximal side in the longitudinal direction, and the distal ends of the partition wall portions 242a and 242b are connected by a curved portion 242c near the center in the longitudinal direction. The curved portion 241c and the curved portion 242c are provided so as to be spaced apart in the longitudinal direction, and a space in which the pinion member 600 is disposed and a space in which the leg portion 720 of the fixed operation button 700 is disposed are formed between the curved portion 241c and the curved portion 242c.

[0071] In the base 200A and the cover 200B of the controller housing 200, between the curved portion 241c and the curved portion 242c, pivot shaft engagement portions 261, 271 (see Figures 19 and 26 described below) that rotatably support the pivot shaft 602 of the pinion member 600 are formed facing each other above and below.

[0072] As described later, recessed grooves 260, 270 (see FIGS. 19 and 26) extending along the longitudinal direction are formed in the base 200A and the cover 200B of the controller housing 200 so as to face each other above and below, respectively, and the pinion member 600 may be supported so as to be movable along the longitudinal direction and rotatable with its rotating shaft member 602 fitted into the groove formed by the recessed groove members 260, 270. In this case, the rotating shaft member engaging portions 261, 271 which fix the longitudinal position of the rotating shaft member 602 of the pinion member 600 are formed, for example, on the proximal side of the recessed groove members 260, 270.

[0073] 6, an upper insertion hole 280 and a lower insertion hole 290, through which the leg portion 720 of the fixed operation button 700 can be inserted, are formed vertically opposite each other between the curved portion 241c and the curved portion 242c in the base 200A and the cover body 200B of the controller housing 200. The upper insertion hole 280 and the lower insertion hole 290 form the restricting member insertion hole of the present invention.

[0074] The upper through-hole 280 and the lower through-hole 290 have a shape that fits the shape of the leg 720 of the fixed operation button 700, and are formed to penetrate the lid body 200B and the base 200A, respectively. That is, the upper through-hole 280 is a through-hole formed in the lid body 200B that constitutes the top plate portion of the controller housing 200, and the lower through-hole 290 is a through-hole formed in the base 200A that constitutes the bottom plate portion of the controller housing 200. In this embodiment, the upper through-hole 280 and the lower through-hole 290 are formed between the curved portion 241c and the curved portion 242c, closer to the pinion member 600, and the fixed operation button 700 is inserted and supported by the upper through-hole 280 and the lower through-hole 290 closer to the pinion member 600.

[0075] The operation wires W1a, W1b, W2a, and W2b constituting the first operation wire W1 and the second operation wire W2 are introduced into the controller housing 200 from the proximal end 10b of the tubular member 10, and as shown in FIG. 7, are branched at cylindrical wire guides 234a and 234b and are guided to the first guide section 251 and the second guide section 252, respectively. The wire guides 234a and 234b may be formed of rotatable rollers. The proximal end of the first operation wire W1 (operation wires W1a and W1b) guided to the first guide section 251 is connected to the first rack member 300. The proximal end of the second operation wire W2 (operation wires W2a and W2b) guided to the second guide section 252 is connected to the second rack member 400.

[0076] The first rack member 300 and the second rack member 400 are housed within the controller housing 200 so as to be reciprocally displaceable in the longitudinal direction of the main body portion 210, and so that the tooth portions 320, 420 face each other.

[0077] 6 and 7, the first rack member 300 and the second rack member 400 each have an elongated rectangular parallelepiped rack main body 310, 410 and teeth portions 320, 420 consisting of a large number of teeth provided on the side surfaces, which are the opposing surfaces of the rack main bodies 310, 410. The first rack member 300 and the second rack member 400 are installed in the first guide portion 251 and the second guide portion 252, respectively, with the teeth portions 320, 420 facing each other.

[0078] 8(b), rack main body 310 of first rack member 300 has, on its outer side surface 311, a guide piece 312 extending in the longitudinal direction of rack main body 310. This guide piece 312 is inserted into an opening formed in the side surface of first slide guide portion 206. A first operation knob 510 is integrally provided on rack main body 310 of first rack member 300, which protrudes to the side of controller housing 200 through this opening.

[0079] 8(a), the rack main body 410 of the second rack member 400 has a guide piece 412 extending in the longitudinal direction of the rack main body 410 on its outer side surface 411. This guide piece 412 is inserted into an opening formed in the side surface of the second slide guide portion 207. A second operation knob 520 is integrally provided on the rack main body 410 of the second rack member 400, which protrudes to the side of the controller housing 200 through this opening.

[0080] The first operation knob 510 and the second operation knob 520 have a rectangular plate shape similar to the first handle portion 221 and the second handle portion 222 constituting the support handle portion 220, respectively, and are formed integrally with the first rack member 300 and the second rack member 400, respectively. The first operation knob 510 and the second operation knob 520 may have any shape, for example, a rod shape, a ring shape, a trigger shape, etc. The first operation knob 510 and the second operation knob 520 may be formed separately from the first rack member 300 and the second rack member 400, and then fixed to the first rack member 300 and the second rack member 400, respectively.

[0081] As shown in FIG. 8(a) and FIG. 8(b), the distal side (left side in FIG. 8(a) and FIG. 8(b)) edges of the first operation knob 510 and the second operation knob 520 respectively constitute finger locks 510a, 520a on which the user's fingers can be hooked. These finger locks 510a, 520a are formed into gently curved surfaces that are approximately concave toward the proximal side. In addition, the outer corners 510b, 520b that are continuous with the finger locks 510a, 520a are chamfered. Each finger lock 510a, 520a is curved into a concave shape so that the user can easily hook the finger, making it easy for the user to hook the finger on each finger lock 510a, 520a, which makes it easy to operate the first operation knob 510 and the second operation knob 520.

[0082] 8(a) and 8(b), finger locking portions 510a, 520a are formed with inner convex portions 510c, 520c having shapes that smoothly transition to the first rack member 300 and the second rack member 400, respectively. These inner convex portions 510c, 520c make it difficult for fingers hooked on the finger locking portions 510a, 520a to come into contact with the main body portion 210 of the controller housing 200, and thus the operability of the first operation knob 510 and the second operation knob 520 is not hindered.

[0083] The first operation knob 510 and the second operation knob 520 are operated by pulling them proximally (towards the support handle section 220) with fingers hooked on the finger locking sections 510a, 520a. When the first operation knob 510 is pulled proximally, the first rack member 300 is displaced integrally to the proximal side, and in sync with this, the second rack member 400 is displaced distally in the opposite direction. When the second operation knob 520 is pulled proximally, the second rack member 400 is displaced integrally to the proximal side, and in sync with this, the first rack member 300 is displaced distally in the opposite direction. Since the first rack member 300 and the second rack member 400 are displaced in the longitudinal direction in conjunction with each other via the pinion member 600, it is also possible to provide only one of the first operating knob 510 and the second operating knob 520 and displace the first operating knob 510 and the second operating knob 520 in the longitudinal direction by pushing and pulling this operating knob in the longitudinal direction.

[0084] For example, a user can place his / her index finger on finger stop portion 510a of first operation knob 510 and his / her middle finger on finger stop portion 520a of second operation knob 520, and use each finger to pull first operation knob 510 and second operation knob 520, respectively.

[0085] As shown in Fig. 8(b), the first rack member 300 has a wire fixing portion 511 for fixing the proximal end portion of the first operation wire W1 (operation wires W1a, W1b) on its back surface side. Also, as shown in Fig. 8(a), the second rack member 400 has a wire fixing portion 521 for fixing the proximal end portion of the second operation wire W2 (operation wires W2a, W2b) on its front surface side.

[0086] The wire fixing portions 511, 521 have the same structure, and the first operation wire W1 and the second operation wire W2 can be fixed to the first rack member 300 and the second rack member 400, respectively, by screw fastening.

[0087] 8(a), the wire fixing portion 521 of the second rack member 400 has a groove 521a extending in the longitudinal direction formed on the surface of the rack main body 410, a thin metal tube 521b fitted into this groove 521a, and a threaded portion 521c. The threaded portion 521c has a female thread 521d fixed in a recess 410a opening into the outer side surface 411 of the rack main body 410, and a hexagonal socket bolt 521e screwed into the female thread 521d.

[0088] As described above, the second operation wire W2 is folded back at the recess 57 of the distal tip 50, and the operation wires W2a and W2b constituting the second operation wire W2 are guided to the inside of the deflection operation device 100. The proximal ends of these operation wires W2a and W2b come into contact with the outside of the wire guide 234b, are guided to the groove 521a, and are inserted into the metal tube 521b through the groove 521a. Then, the proximal ends of the operation wires W2a and W2b are crimped and fixed in a bundled state in the metal tube 521b by crimping the metal tube 521b with the bolt 521e screwed into the female thread 521d. The operation wires W2a and W2b protruding to the proximal side of the metal tube 521b are appropriately cut off. As a result, the proximal end of the second operation wire W2 (the proximal ends of both the operation wires W2a and W2b) can be fixed to the second rack member 400 together with the metal tube 521b. In addition, the tension of the operation wires W2a, W2b can be finely adjusted by loosening the bolt 521e and moving the metal tube 521b and the operation wires W2a, W2b in the longitudinal direction.

[0089] 8(b), the wire fixing portion 511 of the first rack member 300 is provided on the back side of the rack main body 310, and has a groove 511a, a metal tube 511b fitted into the groove 511a, and a threaded portion 511c formed by a female thread 511d and a bolt 511e. The threaded portion 511c is fixed in a recess 310a that opens into the outer side surface 311 of the rack main body 310.

[0090] As described above, the first operation wire W1 is folded back at the recess 56 of the distal tip 50, and the operation wires W1a and W1b constituting the first operation wire W1 are guided to the inside of the deflection operation device 100. The proximal ends of these operation wires W1a and W1b come into contact with the outside of the wire guide 234a and are guided to the groove 511a, and are inserted into the metal tube 511b through the groove 511a. Then, the proximal ends of the operation wires W1a and W1b are crimped and fixed in a bundled state in the metal tube 511b by crimping the metal tube 511b with the bolt 511e screwed into the female thread 511d. The operation wires W1a and W1b protruding to the proximal side of the metal tube 511b are appropriately cut off. As a result, the proximal end of the first operation wire W1 (the proximal ends of both the operation wires W1a and W1b) can be fixed to the first rack member 300 together with the metal tube 511b. In addition, the tension of the operation wires W1a, W1b can be finely adjusted by loosening the bolt 511e and moving the metal tube 511b and the operation wires W1a, W1b in the longitudinal direction.

[0091] The pinion member 600 is disposed between the curved portion 241c and the curved portion 242c. The pinion member 600 is configured with a gear portion 601 that meshes with each of the tooth portions 320, 420, and a rotating shaft member 602 that is located approximately at the center of the gear portion 601 and serves as a rotating shaft of the pinion member 600, as shown in Fig. 6 and Fig. 7.

[0092] The rotating shaft member 602 of the pinion member 600 is rotatably supported by the controller housing 200 in a state where it is fitted into the rotating shaft member engagement portions 261, 271 formed on the base 200A and the cover body 200B of the controller housing 200, respectively. This allows the pinion member 600 to rotate in a state where the gear portion 601 is engaged with the respective tooth portions 320, 420 of the first rack member 300 and the second rack member 400. Furthermore, the rotating shaft member 602 of the pinion member 600 may be movable in the longitudinal direction between the curved portion 241c and the curved portion 242c along the groove formed by the recessed groove portion 260 of the controller housing 200, with both ends of the rotating shaft member 602 fitted into the recessed groove portion 260 of the controller housing 200, respectively, before use of the medical device 1. In this case, the rotating shaft 602 of the pinion member 600 is rotatably engaged and supported by the rotating shaft engagement portions 261, 271 formed on the base 200A and the cover body 200B of the controller housing 200 when the medical device 1 is in use.

[0093] The meshing points of the first rack member 300 and the second rack member 400 are adjusted relative to the pinion member 600 so that the longitudinal center portions of the tooth portions 320, 420 mesh with the pinion member 600 while their positions in the reciprocating displacement direction are aligned with each other.

[0094] The first rack member 300 and the second rack member 400 are reciprocatingly displaced in opposite directions relative to the pinion member 600 by having the respective tooth portions 320, 420 mesh with the pinion member 600. The displacement range of the first rack member 300 is restricted by the first guide portion 251, so that separation of the first rack member 300 from the pinion member 600 is suppressed. The displacement range of the second rack member 400 is restricted by the second guide portion 252, so that separation of the second rack member 400 from the pinion member 600 is suppressed.

[0095] 9, when the first operation knob 510 is pulled proximally, the first rack member 300 is displaced integrally to the proximal side. At this time, the gear portion 601 meshes with the tooth portion 320, causing the pinion member 600 to rotate. The rotation of the pinion member 600 is transmitted to the second rack member 400 via the meshing of the gear portion 601 with the tooth portion 420, and the second rack member 400 is displaced in the opposite direction, to the distal side.

[0096] Furthermore, the second rack member 400 displaced toward the distal side is biased by the coil spring 256. When the operation of pulling the first operation knob 510 toward the proximal side is stopped and the hand is released from the first operation knob 510, the second rack member 400 is displaced toward the proximal side by the action of the coil spring 256, and the first rack member 300 is displaced toward the distal side in the opposite direction via the meshing of the pinion member 600, so that the first rack member 300 and the second rack member 400 return to their left-right symmetrical neutral positions.

[0097] 10, when the second operation knob 520 is pulled proximally, the second rack member 400 is displaced integrally to the proximal side. At this time, the gear portion 601 meshes with the tooth portion 420, causing the pinion member 600 to rotate. The rotation of the pinion member 600 is transmitted to the first rack member 300 via the meshing of the gear portion 601 with the tooth portion 320, and the first rack member 300 is displaced in the opposite direction, to the distal side.

[0098] Furthermore, the first rack member 300 displaced toward the distal side is biased by the coil spring 255. When the operation of pulling the second operation knob 520 toward the proximal side is stopped and the hand is released from the second operation knob 520, the first rack member 300 is displaced toward the proximal side by the action of the coil spring 255, and the second rack member 400 is displaced toward the distal side in the opposite direction via the meshing of the pinion member 600, so that the first rack member 300 and the second rack member 400 return to their left-right symmetrical neutral positions.

[0099] As described above, in the deflection operation device 100 in this embodiment, the first operation knob 510 and the second operation knob 520 can be slid so as to be displaced relative to the controller housing 200 in the longitudinal direction. The first operation knob 510 and the second operation knob 520 are provided integrally with the first rack member 300 and the second rack member 400, respectively, and are operated so as to be displaced in mutually opposite directions together with the first rack member 300 and the second rack member 400, respectively. When the first operation knob 510 and the second operation knob 520 are operated in this manner, the first rack member 300 and the second rack member 400 are displaced in mutually opposite directions relative to the pinion member 600, while the first operation wire W1 and the second operation wire W2 in the tubular member 10 are displaced in the deflection operation direction of the movable part 20 of the tubular member 10.

[0100] Hereinafter, the fixed operation button 700 will be described with reference to Figs. 11 to 15. Fig. 11 is a perspective view of the fixed operation button 700 included in the deflection operation device 100 in the embodiment of the present invention. Figs. 12 to 15 are first to fourth side views of the fixed operation button 700 included in the deflection operation device 100 in the embodiment of the present invention. Fig. 12 is a side view seen from the Y-axis negative direction (P1 in Fig. 11) in the coordinate axes shown in Fig. 11. Fig. 13 is a side view seen from the X-axis positive direction (P2 in Fig. 11) in the coordinate axes shown in Fig. 11. Fig. 14 is a side view seen from the Y-axis positive direction (P3 in Fig. 11) in the coordinate axes shown in Fig. 11. Fig. 15 is a side view seen from the X-axis negative direction (P4 in Fig. 11) in the coordinate axes shown in Fig. 11.

[0101] The fixed operation button 700 is slidably supported on the controller housing 200 of the deflection operation device 100. As shown in Fig. 7, for example, the fixed operation button 700 is disposed adjacent to the proximal side of the pinion member 600 and at a position spaced apart from the pinion member 600 without contacting the pinion member 600. The fixed operation button 700 constitutes a regulating member of the present invention.

[0102] The fixed operation button 700 has a head 710 disposed on the upper side of the lid 200B of the controller housing 200, and a leg 720 inserted into an upper insertion hole 280 and a lower insertion hole 290 formed in the lid 200B and the base 200A, respectively. The head 710 and the leg 720 are integrally formed. Hereinafter, the side of the leg 720 closer to the head 710 may be referred to as the base side or upper side, and the side farther from the head 710 may be referred to as the tip side or lower side. In the coordinate axes shown in FIG. 11, the positive direction of the Z axis is the base side and the upper side, and the negative direction of the Z axis is the tip side and the lower side.

[0103] The fixed operation button 700 is slidable in the extension direction of the leg portion 720 with the leg portion 720 inserted through the upper insertion hole 280 and the lower insertion hole 290. As described below, by sliding the fixed operation button 700 in the extension direction of the leg portion 720, it is possible to perform a switching operation between a displacement restricted state in which the reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction is restricted, and a displacement permitted state in which the reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction is permitted.

[0104] The head 710 is set to be larger than the opening of the upper through-hole 280. This prevents the head 710, which is disposed on the upper side of the lid 200B, from passing through the upper through-hole 280. By setting the head 710 so as not to pass through the upper through-hole 280, the fixed operation button 700, which is slidable in the extending direction of the leg 720, is restricted from sliding downwards more than in a state where the head 710 is in contact with the lid 200B. The shape of the head 710 is not particularly limited, but may be formed into a disk shape.

[0105] 6, a circular rib 282 is formed on the upper surface of the lid body 200B so as to surround the opening of the upper insertion hole 280. When the fixed operation button 700 is slid downward, the disk-shaped head 710 moves downward and fits into the rib 282 on the upper surface of the lid body 200B to come into contact with and engage with the upper surface of the lid body 200B, thereby restricting the fixed operation button 700 from sliding downward.

[0106] Head 710 is connected to the base end of leg 720, and leg 720 extends downward from the bottom surface of head 710. Leg 720 can be inserted into upper insertion hole 280 and lower insertion hole 290, and is configured to be slidable in the extending direction (up and down direction) while being supported by upper insertion hole 280 and lower insertion hole 290.

[0107] The length of the leg 720 in the extension direction (vertical direction) may be set, for example, to be approximately equal to or greater than the thickness of the controller housing 200, so that when the fixed operation button 700 slides in the vertical direction, the leg 720 is inserted into both the upper insertion hole 280 and the lower insertion hole 290. The shape of the leg 720 is not particularly limited, but may be, for example, a cylindrical or prismatic shape extending in the extension direction (vertical direction).

[0108] The leg 720 is composed of a base end connected to the underside of the head 710 and a tip end connected to the base end. In this embodiment, the leg 720 is generally formed in a rectangular column shape, and the tip end is bifurcated. More specifically, as shown in Figs. 11 to 15, the leg 720 is composed of a connecting leg 730 that is connected to the head 710 and constitutes the base end of the leg 720, and two split leg parts 740 and 750 that are connected to the connecting leg 730 and constitute the tip end of the leg 720.

[0109] The leg portion 720 is disposed between the first rack member 300 and the second rack member 400, and has an engagement portion 800 that can engage with the teeth portions 320, 420 of at least one of the first rack member 300 and the second rack member 400. For example, by disposing the fixed operation button 700 on a longitudinal center line C (see FIG. 7) that passes through the center in the width direction of the main body portion 210, the leg portion 720 can be disposed between the first rack member 300 and the second rack member 400.

[0110] The shape of the engaging portion 800 is not particularly limited as long as it can engage with the toothed portions 320, 420, but may be a shape that fits the teeth of the toothed portions 320, 420. The engaging portion 800 is configured, for example, with engaging protrusions 810, 820 that mesh with the teeth of the toothed portions 320, 420. In this case, the number of engaging protrusions 810, 820 is not particularly limited, but a plurality of engaging protrusions 810, 820 may be arranged side by side and engaged with a plurality of teeth of the toothed portion 320 or toothed portion 420 to improve the engaging force.

[0111] As shown in Figs. 11 to 15, the engagement portion 800 can be provided, for example, on the connecting leg portion 730 constituting the base end portion of the leg portion 720. The engagement portion 800 is provided at a position where, when the fixed operation button 700 is slid downward, it is engaged with the teeth portion 320 or the teeth portion 420, and when the fixed operation button 700 is slid upward, it is disengaged from the teeth portion 320 and the teeth portion 420. In a state where the engagement portion 800 is engaged with the teeth portion 320 or the teeth portion 420 (displacement restricted state), the displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction is restricted by the engagement portion 800. On the other hand, in a state where the engagement portion 800 is disengaged from the teeth portion 320 and the teeth portion 420 (displaceable state), the first rack member 300 and the second rack member 400 can freely reciprocate in the longitudinal direction.

[0112] As shown in FIGS. 11 to 15, the engagement portion 800 can be configured by an engagement protrusion 810 provided on one surface (opposing the teeth portion 320 of the first rack member 300) of the connecting leg portion 730, and an engagement protrusion 820 provided on the other surface (opposing the teeth portion 420 of the second rack member 400) of the connecting leg portion 730. In this embodiment, two engagement protrusions 810 and two engagement protrusions 820 are provided on one surface and the other surface of the connecting leg portion 730, respectively. With this, by sliding the fixed operation button 700 in the vertical direction, the engagement portion 800 can be brought into a state in which it is engaged with at least one of the teeth portion 320 and the teeth portion 420, and it becomes possible to restrict the longitudinal displacement of both the first rack member 300 and the second rack member 400.

[0113] The engaging portion 800 may be provided only on the surface of the connecting leg portion 730 that faces either the tooth portion 320 or the tooth portion 420. In this case, by engaging the engaging portion 800 with either the tooth portion 320 or the tooth portion 420, it becomes possible to restrict the displacement of both the first rack member 300 and the second rack member 400 in the longitudinal direction.

[0114] Two split legs 740, 750 are integrally formed below the connecting leg 730 so as to extend from the tip of the connecting leg 730. The two split legs 740, 750 extend axially (downward) facing each other and are formed symmetrically to each other. Note that the leg 720 may not be split, or may have three or more split legs.

[0115] A pair of recesses 741a, 741b and a pair of recesses 742a, 742b are formed on the side surface of the split leg 740 at different positions in the extension direction of the leg 720. The pair of recesses 741a, 741b are arranged on the base end side (upper side), and the pair of recesses 742a, 742b are arranged on the tip side (lower side). The pair of recesses 741a, 741b are provided symmetrically with respect to the center of the split leg 740 in the extension direction, and the pair of recesses 742a, 742b are similarly provided symmetrically with respect to the center of the split leg 740 in the extension direction.

[0116] A pair of recesses 751a, 751b and a pair of recesses 752a, 752b are also formed on the side surface of split leg 750 at different positions in the extension direction of leg 720. The pair of recesses 751a, 751b are arranged on the base end side (upper side), and the pair of recesses 752a, 752b are arranged on the tip side (lower side). The pair of recesses 751a, 751b are provided symmetrically with respect to the center of split leg 750 in the extension direction, and the pair of recesses 752a, 752b are similarly provided symmetrically with respect to the center of split leg 750 in the extension direction.

[0117] The two split legs 740, 750 are configured to be elastically deformable laterally. As shown in Fig. 13 and Fig. 15, the distance between the two split legs 740, 750 at the tip end is slightly larger than the distance between the two split legs at the base end, and the tip end is slightly open. With this shape, the tip ends of the two split legs 740, 750 spread out laterally and come into contact with the inner circumferential surface of the lower insertion hole 290, and as described later, when the fixed operation button 700 is slid, the recesses 741a, 741b, 742a, 742b, 751a, 751b, 752a, 752b of the two split legs 740, 750 can be fitted into the protrusions 295 (see Fig. 19 and Fig. 26) on the inner circumferential surface of the lower insertion hole 290 by the elasticity of the split legs 740, 750. In addition, the distance between the base end and tip end of the two split legs 740, 750 may be approximately the same, and the two split legs 740, 750 may extend downwardly so as to be approximately parallel to each other, and the split legs 740, 750 may not be provided with recesses 741a, 741b, 742a, 742b, 751a, 751b, 752a, 752b.

[0118] As shown in Figs. 11 to 15, the split leg parts 740 and 750 are provided at their tip parts with stopper parts 743 and 753, respectively. The stopper parts 743 and 753 have a cross section larger than that of the split leg parts 740 and 750, respectively, and spread out laterally at the tip parts of the split leg parts 740 and 750, respectively, to form a substantially T-shape together with the split leg parts 740 and 750. When the leg part 720 is inserted into the upper insertion hole 280 and the lower insertion hole 290, the stopper parts 743 and 753 are disposed below the base 200A of the controller housing 200. When the fixed operation button 700 is slid upward, the stopper parts 743 and 753 move upward and come into contact with the lower surface of the base 200A or the first rack member 300 and the second rack member 400, thereby restricting the fixed operation button 700 from sliding upward.

[0119] In this manner, the leg parts 720 of the fixed operation button 700 are inserted into the upper insertion hole 280 and the lower insertion hole 290. Furthermore, the head part 710 and the retaining parts 743, 753 restrict sliding in the vertical direction, and the fixed operation button 700 is disposed so as to be slidable in the extending direction of the leg parts 720 (vertical direction) between the position where the head part 710 contacts the cover body 200B and the positions where the retaining parts 743, 753 contact the base 200A or the first rack member 300 and the second rack member 400.

[0120] In addition, by operating the fixed operation button 700 in the vertical direction relative to the controller housing 200, the position of the engagement portion 800 provided on the fixed operation button 700 can be moved in the vertical direction, making it possible to switch between a state in which the engagement portion 800 engages with the tooth portion 320 or the tooth portion 420 (displacement restricted state) and a state in which the engagement portion 800 has separated from the tooth portion 320 and the tooth portion 420 and the engagement is released (displaceable state).

[0121] Hereinafter, the switching operation between the displacement restricted state and the displacement permitted state by the fixed operation button 700 will be described in more detail with reference to FIGS.

[0122] 16 to 22 show the displacement restricted state of the deflection operation device 100 in the embodiment of the present invention. Fig. 16 and Fig. 17 are a perspective view and a plan view, respectively, showing the displacement restricted state of the deflection operation device 100 in the embodiment of the present invention. Fig. 18 is a BB cross-sectional view of Fig. 17, and Fig. 19 is an enlarged view of the vicinity of the fixed operation button 700 in Fig. 18. Fig. 20 is a CC cross-sectional view of Fig. 17, and Fig. 21 is an enlarged view of the vicinity of the fixed operation button 700 in Fig. 20. Fig. 22 is a DD cross-sectional view of Fig. 17.

[0123] 23 to 29 show the deflection operation device 100 in the embodiment of the present invention in a displaceable state. Fig. 23 and Fig. 24 are a perspective view and a plan view, respectively, showing the deflection operation device 100 in the embodiment of the present invention in a displaceable state. Fig. 25 is an E-E sectional view of Fig. 24, and Fig. 26 is an enlarged view of the vicinity of the fixed operation button 700 in Fig. 25. Fig. 27 is an F-F sectional view of Fig. 24, and Fig. 28 is an enlarged view of the vicinity of the fixed operation button 700 in Fig. 27. Fig. 29 is a G-G sectional view of Fig. 24.

[0124] In the deflection operation device 100 of this embodiment, the user can operate the fixed operation button 700 to hold the deflection direction of the movable part 20 located at the distal end of the tubular member 10, or release the hold on the deflection direction to freely deflect the movable part 20.

[0125] The fixed operation button 700 is provided so as to be vertically slidable with respect to the controller housing 200 with the leg portion 720 inserted through the upper insertion hole 280 and the lower insertion hole 290, as shown in, for example, FIG. 19 and FIG. 26. The user can set the deflection operation device 100 to a displacement restricted state and fix and hold the deflection direction of the movable portion 20 by performing an operation of pressing downward the head portion 710 of the fixed operation button 700 arranged on the upper side of the lid body 200B. The user can also set the deflection operation device 100 to a displaceable state and freely deflect the movable portion 20 using the first operation knob 510 or the second operation knob 520 by performing an operation of pressing upward the tip portion (retaining portions 743, 753) of the fixed operation button 700 or an operation of pulling upward the head portion 710 of the fixed operation button 700.

[0126] In the deflection operation device 100 of this embodiment, by moving the fixed operation button 700 downward as shown in Fig. 16 to Fig. 22, the first rack member 300 and the second rack member 400 cannot be displaced in the longitudinal direction, and the deflection direction of the movable part 20 is fixed and maintained. The user operates the first operation knob 510 or the second operation knob 520 to set the movable part 20 in a desired deflection direction, and for example, performs an operation of pressing the head part 710 of the fixed operation button 700 downward to move the fixed operation button 700 downward, thereby maintaining the desired deflection of the movable part 20.

[0127] 20 and 21, when the fixed operation button 700 is moved downward, an engagement portion 800 provided on a connecting leg portion 730 configured at the base end of the leg portion 720 moves downward and engages with the teeth of the toothed portion 320 of the first rack member 300 and the teeth of the toothed portion 420 of the second rack member 400. More specifically, the engagement portion 800 is composed of engagement protrusions 810, 820, and the engagement protrusion 810 provided on the surface of the first rack member 300 facing the toothed portion 320 is arranged so as to fit between the teeth of the toothed portion 320, and the engagement protrusion 820 provided on the surface of the second rack member 400 facing the toothed portion 420 is arranged so as to fit between the teeth of the toothed portion 420.

[0128] The fixed operation button 700 has its leg portion 720 inserted into the upper insertion hole 280 and the lower insertion hole 290, and the leg portion 720 contacts the inner peripheral surface of each of the upper insertion hole 280 and the lower insertion hole 290 to fix the position in the longitudinal direction. For this reason, even if a force for displacing the first rack member 300 in the longitudinal direction is applied by operating the first operation knob 510, for example, the engagement protrusion 810 engages with the tooth portion 320, so that the first rack member 300 cannot be displaced in the longitudinal direction. Similarly, even if a force for displacing the second rack member 400 in the longitudinal direction is applied by operating the second operation knob 520, for example, the engagement protrusion 820 engages with the tooth portion 420, so that the second rack member 400 cannot be displaced in the longitudinal direction. In other words, the engaging protrusion 810 engages with the tooth portion 320 and functions as a stopper that regulates the longitudinal displacement of the first rack member 300, and the engaging protrusion 820 engages with the tooth portion 420 and functions as a stopper that regulates the longitudinal displacement of the second rack member 400.

[0129] Furthermore, the fixed operation button 700 is slidable in the up-down direction relative to the controller housing 200, and the sliding direction (up-down direction) is approximately perpendicular to the longitudinal direction which is the displacement direction of the first rack member 300 and the second rack member 400. As a result, even if a force is applied to the first rack member 300 or the second rack member 400 to displace them in the longitudinal direction, the action of this force will not cause the fixed operation button 700 to slide in the up-down direction, and the displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction can be reliably restricted by the engagement protrusions 810, 820.

[0130] The head 710 of the fixed operation button 700 is set to be larger than the opening of the upper through-hole 280, and even if the user strongly presses the fixed operation button 700 downward, the head 710 abuts and engages with the upper surface of the cover body 200B, and remains on the outer surface (upper surface) of the cover body 200B without passing through the upper through-hole 280, thereby restricting the downward sliding of the fixed operation button 700. This makes it possible to prevent the fixed operation button 700 from passing through the upper through-hole 280 and the lower through-hole 290 and falling off from the lower surface of the base 200A.

[0131] As described above, the split leg 740 of the fixed operation button 700 has a pair of recesses 741a, 741b and a pair of recesses 742a, 742b formed at different positions in the extension direction, and the split leg 750 of the fixed operation button 700 has a pair of recesses 751a, 751b and a pair of recesses 752a, 752b formed at different positions in the extension direction. Meanwhile, the inner circumferential surface of the lower through-hole 290 is formed with a convex portion 295 having a convex surface shaped corresponding to these recesses 741a, 741b, 742a, 742b, 751a, 751b, 752a, 752b.

[0132] FIG. 22 shows a cross section passing through the recess 741b of the split leg 740 and the recess 751a of the split leg 750. A protrusion 295 is formed on the inner peripheral surface of the lower insertion hole 290 so as to face the recess 741b and the recess 751a. When the fixed operation button 700 is slid downward to a displacement restricted state in which the engagement protrusions 810 and 820 are respectively disposed between the teeth of the teeth 320 and 402, as shown in FIG. 22, the recess 741b and the recess 751a provided on the elastically deformable split leg 740 and 750 are fitted into the corresponding protrusion 295. Although not shown, the other recesses 741a and 751b are also fitted into the corresponding protrusions 295 in the same manner. As a result, the fixed operation button 700 is positioned by sliding to a stop at the position where the engagement protrusions 810, 820 engage with the teeth portions 320, 402, and the user can understand from the feeling of the recesses 741a, 741b, 751a, 751b fitting into the protrusions 295 that he or she has moved the fixed operation button 700 downward to a position where the displacement is restricted.

[0133] 23 to 29, in the deflection operation device 100 of this embodiment, by moving the fixed operation button 700 upward, the first rack member 300 and the second rack member 400 become capable of reciprocating displacement, and the deflection operation of the movable part 20 can be freely performed by operating the first operation knob 510 or the second operation knob 520. The user can move the fixed operation button 700 upward by pressing the tip part (retaining parts 743, 753) of the fixed operation button 700 upward or by pulling the head part 710 of the fixed operation button 700 upward.

[0134] When the fixed operation button 700 is moved upward, as shown in Fig. 27 and Fig. 28, the engagement portion 800 provided on the connecting leg portion 730 configured at the base end of the leg portion 720 moves upward and becomes separated from the teeth portion 320 of the first rack member 300 and the teeth portion 420 of the second rack member 400. More specifically, the engagement protrusions 810, 820 configuring the engagement portion 800 become disposed above the teeth portion 320 and the teeth portion 420. As a result, the engagement between the engagement protrusion 810 and the teeth portion 320 and the engagement between the engagement protrusion 820 and the teeth portion 420 are released, and the first rack member 300 and the second rack member 400 can move back and forth in the longitudinal direction without being hindered by the engagement portion 800.

[0135] The fixed operation button 700 has anti-slip portions 743, 753 at the tips of the legs 720, and even if the user strongly pushes the fixed operation button 700 upward (strongly pulls it upward), the anti-slip portions 743, 753 abut and engage with the upper surface of the base 200A, or the first rack member 300 or the second rack member 400, so that the fixed operation button 700 does not pass through the lower through-hole 290 and remains on the lower surface side of the base 200A, thereby restricting the fixed operation button 700 from sliding upward. This makes it possible to prevent the fixed operation button 700 from passing through the lower through-hole 290 and the upper through-hole 280 and falling off from the upper surface of the cover body 200B.

[0136] 29 shows a cross section passing through the recess 742b of the split leg 740 and the recess 752a of the split leg 750. When the fixed operation button 700 is slid upward to a displaceable state in which the engagement protrusions 810, 820 are separated from the teeth 320, 402, as shown in FIG 29, the recesses 742b and 752a provided on the elastically deformable split legs 740, 750 are adapted to fit into the corresponding protrusions 295, respectively. Although not shown, the other recesses 742a, 752b are adapted to fit into the corresponding protrusions 295 in the same manner. As a result, the fixed operation button 700 is positioned by sliding to a stop at a position where the engagement protrusions 810, 820 are disengaged from the teeth portions 320, 402, and the user can understand from the feeling of the recesses 742a, 742b, 752a, 752b fitting into the protrusions 295 that the fixed operation button 700 has been moved upward to a position where it can be displaced.

[0137] As described above, the deflection operation device 100 is configured to be able to deflect the movable part 20 located at the distal end of the tubular member 10 constituting the medical device 1 in a desired direction by operating the first operation knob 510 or the second operation knob 520. Furthermore, the deflection operation device 100 can freely switch between a displacement restriction state that restricts the reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction and a displacement enabling state that enables the reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction by sliding the fixed operation button 700 in the up and down direction, and can easily hold and release the deflection direction of the movable part 20.

[0138] When the fixed operation button 700 is slid downward to place the deflection operation device 100 in a displacement restricted state, the engagement portion 800 of the fixed operation button 700 engages with at least one of the teeth portion 320 of the first rack member 300 and the teeth portion 420 of the second rack member 400, and the reciprocating displacement in the longitudinal direction of the first rack member 300 and the second rack member 400 is restricted. As a result, the deflection direction of the movable portion 20, which is deflected via the first operation wire W1 and the second operation wire W2, is fixed and held, and the movable portion 20 can be fixed and held in a desired deflection direction.

[0139] Furthermore, when the fixed operation button 700 is slid upward to set the deflection operation device 100 in a displaceable state, the engagement portion 800 of the fixed operation button 700 is released from the teeth portion 320 of the first rack member 300 and the teeth portion 420 of the second rack member 400, and the first rack member 300 and the second rack member 400 are placed in a state in which they can be displaced back and forth in the longitudinal direction. This makes it possible to deflect the movable portion 20 with the first operation knob 510 and the second operation knob 520, and set the movable portion 20 in a desired deflection direction.

[0140] The user can visually determine whether the deflection operation device 100 is in a displacement restricted state or a displacement enabled state by visually checking the state of the head 710. The state in which the head 710 is pressed downward and in contact with the upper surface of the lid 200B indicates a displacement restricted state in which the deflection operation direction of the movable part 20 is maintained, while the state in which the head 710 protrudes upward from the upper surface of the lid 200B indicates a displacement enabled state in which the deflection operation of the movable part 20 can be performed.

[0141] Furthermore, the user may visually recognize whether the deflection operation device 100 is in the displacement restricted state or the displaceable state by visually checking the state of the tip side of the leg 720 (for example, the retaining parts 743, 753). Even when the deflection operation device 100 is viewed from below, it becomes possible to visually recognize whether the deflection operation device 100 is in the displacement restricted state or the displaceable state based on the state of the tip side of the leg 720. The state in which the retaining parts 743, 753 are pushed upward and in contact with the lower surface of the base 200A indicates a displacement restricted state in which the deflection operation direction of the movable part 20 is maintained, while the state in which the retaining parts 743, 753 protrude downward from the lower surface of the base 200A indicates a displaceable state in which the deflection operation of the movable part 20 can be performed. Furthermore, the tip side of leg 720 (eg, retaining portions 743, 753) may be colored so that the state of the tip side of leg 720 (eg, the protruding state of retaining portions 743, 753) can be easily visually grasped.

[0142] Additionally, grooves 260, 270 extending along the longitudinal direction may be formed vertically opposite each other in base 200A and cover 200B of controller housing 200. As shown in Fig. 19 and Fig. 26, shaft stoppers 262, 272 protruding from the bottom surface of groove 260 are provided on the proximal sides of grooves 260, 270 at vertically opposing positions, respectively.

[0143] Before the medical device 1 is used, the rotating shaft 602 of the pinion member 600 can move along the recessed grooves 260 and 270, and this allows the first operation wire W1 and the second operation wire W2 to be in a slackened state. When the medical device 1 is used, the rotating shaft 602 of the pinion member 600 is moved proximally beyond the shaft stoppers 262 and 272 by pulling both of the first operation knobs 510 and 520 proximally, and the rotating shaft 602 is placed in the rotating shaft member engaging parts 261 and 271 located proximally of the shaft stoppers 262 and 272. This allows the rotating shaft 602 to be rotatably engaged with the rotating shaft member engaging parts 261 and 271 and fixed in position so as not to move in the longitudinal direction, thereby providing tension to the first operation wire W1 and the second operation wire W2 and allowing the movable part 20 to be deflected.

[0144] Next, a modified example of the deflection operation device 100 in this embodiment will be described with reference to Fig. 30. Fig. 30 is a plan view showing a modified example of the deflection operation device 100 in the embodiment of the present invention.

[0145] From the viewpoint of user operability, the fixed operation button 700 is preferably arranged on the longitudinal base end side (proximal side) of the pinion member 600 located at the approximate center of the deflection operation device 100, although not particularly limited thereto. In the above-mentioned deflection operation device 100, the fixed operation button 700 is arranged at a position between the curved portion 241c and the curved portion 242c and adjacent to the proximal side of the pinion member 600, but it may be arranged at a position closer to the support handle part 220 on the longitudinal base end side (proximal side), as shown in FIG. 30, for example. This allows the fixed operation button 700 to be arranged within the reach of the fingers of the hand of the user gripping the support handle part 220, thereby further improving operability with one hand.

[0146] 30, an upper insertion hole 280 and a lower insertion hole 290 are formed in a position close to the support handle portion 220, and the fixed operation button 700 is disposed so as to be vertically slidable at this position. Note that the fixed operation button 700 is preferably disposed between the first rack member 300 and the second rack member 400 so that the engagement portion 800 can engage with the teeth portions 320, 420.

[0147] In the deflection operation device 100 shown in FIG. 30 , by sliding the fixed operation button 700, a switching operation can be performed between a displacement restriction state in which the engagement portion 800 of the fixed operation button 700 engages with at least one of the teeth portion 320 of the first rack member 300 and the teeth portion 420 of the second rack member 400 to restrict the reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction and a displacement permitted state in which the engagement of the engagement portion 800 with the teeth portion 320 of the first rack member 300 and the second rack member 400 is released to allow the first rack member 300 and the second rack member 400 to be displaced reciprocatingly in the longitudinal direction, thereby making it possible to easily hold and release the deflection direction of the movable portion 20.

[0148] The operation of the deflection operation device 100 in the above-described embodiment will be described below.

[0149] The deflection operation device 100 in the above-described embodiment deflects the movable part 20 of the medical device 1 via the first operation wire W1 and the second operation wire W2, and includes a controller housing 200, a first rack member 300, a second rack member 400, a pinion member 600, and a fixed operation button 700 which is a regulating member.

[0150] The controller housing 200 has a main body portion 210, a support handle portion 220 provided on the longitudinal base end side of the main body portion 210 along the extension direction of the first operating wire W1 and the second operating wire W2, and a wire insertion portion 230 provided on the longitudinal tip side of the main body portion 210 and through which the first operating wire W1 and the second operating wire W2 are inserted.

[0151] The first rack member 300 and the second rack member 400 are housed within the controller housing 200 so as to be reciprocally displaceable in the longitudinal direction, and so as to have teeth portions 320, 420 opposed to each other.

[0152] The pinion member 600 is disposed between the first rack member 300 and the second rack member 400, and is rotatably supported by the controller housing 200 in a state in which it meshes with the respective tooth portions 320, 420 of the first rack member 300 and the second rack member 400.

[0153] The fixed operation button 700 is slidably supported by the controller housing 200, and has an engagement portion 800 that can engage with the teeth portions 320, 420 of at least one of the first rack member 300 and the second rack member 400.

[0154] The controller housing 200 is provided with a slide guide portion (first slide guide portion 206 or second slide guide portion 207) that forms a groove-shaped opening along at least one of the first rack member 300 and the second rack member 400, and at least one of the first rack member 300 and the second rack member 400 is integrally provided with an operation knob (first operation knob 510 or second operation knob 520) that protrudes to the side of the controller housing 200 through the opening.

[0155] When the first operating knob 510 or the second operating knob 520 is slid so as to be displaced longitudinally relative to the support handle portion 220, the first rack member 300 and the second rack member 400 are displaced in opposite directions relative to the pinion member 600, thereby displacing the first operating wire W1 and the second operating wire W2 in the deflection operating direction of the movable portion 20.

[0156] Furthermore, the deflection operation device 100 can be switched between a displacement restriction state in which the engagement portion 800 engages with the tooth portions 320, 420 of at least one of the first rack member 300 and the second rack member 400 to restrict reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction by sliding the fixed operation button 700 relative to the controller housing 200, and a displacement permitted state in which the engagement portion 800 is disengaged from the tooth portions 320, 420 of the first rack member 300 and the second rack member 400 to allow reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction.

[0157] According to the above configuration, in the deflection operation device 100 having excellent one-handed operability and a simple configuration, the fixed operation button 700 is slid to engage the engagement portion 800 of the fixed operation button 700 with at least one of the teeth portions 320, 420 of the first rack member 300 and the second rack member 400 to restrict the reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction, thereby making it possible to easily hold the deflection direction of the movable portion 20 of the medical equipment (medical device 1). Also, by sliding the fixed operation button 700 to release the engagement of the engagement portion 800 of the fixed operation button 700 with at least one of the teeth portions 320, 420 of the first rack member 300 and the second rack member 400, it becomes possible to easily release the hold of the deflection direction of the movable portion 20 of the medical equipment (medical device 1).

[0158] In the deflection operation device 100 in the above-described embodiment, the fixed operation button 700 may be slidable between the first rack member 300 and the second rack member 400 in a direction approximately perpendicular to the longitudinal direction.

[0159] According to the above configuration, the fixed operation button 700 is arranged between the first rack member 300 and the second rack member 400 having mutually opposing tooth portions 320, 420 so as to be slidable in a direction approximately perpendicular to the longitudinal direction, and by controlling the state in which the engagement portion 800 is arranged between the teeth of the tooth portions 320, 420 by the sliding operation of the fixed operation button 700, it becomes possible to switch between a displacement-restricted state and a displacement-allowed state.

[0160] In the above-described embodiment, the deflection operation device 100 is configured such that the fixed operation button 700 is integrally provided with a leg 720 arranged between the first rack member 300 and the second rack member 400 and a head 710 connected to the base end of the leg 720, and an engagement portion 800 is provided on the side of the leg 720, and the fixed operation button 700 may be slid in the extension direction of the leg 720 to switch between a displacement-restricted state and a displacement-allowed state.

[0161] According to the above configuration, by sliding the fixed operation button 700 which is integrally formed with the head portion 710 and the leg portion 720 having the engagement portion 800 provided on the side thereof, it is possible to switch between the displacement restricted state and the displacement permitted state.

[0162] In the deflection operation device 100 in the above-described embodiment, an upper insertion hole 280 and a lower insertion hole 290, which are regulating member insertion holes, are formed in the cover body 200B constituting the top plate portion of the controller housing 200, and in the base 200A constituting the bottom plate portion, respectively, and the leg portion 720 of the fixed operation button 700 may be inserted and supported in the upper insertion hole 280 and the lower insertion hole 290 of the cover body 200B and the base 200A of the controller housing 200, respectively, and be positioned between the first rack member 300 and the second rack member 400.

[0163] According to the above configuration, the leg parts 720 of the fixed operation button 700 are inserted into and supported by the cover body 200B and the base 200A of the controller housing 200, so that the fixed operation button 700 can be supported relative to the controller housing 200 so as to be slidable therewith.

[0164] In the deflection operation device 100 in the above-described embodiment, the head 710 of the fixed operation button 700 is arranged on the outer surface (top surface) of the cover body 200B of the controller housing 200, and when the fixed operation button 700 is slid relative to the controller housing 200 to enter a displacement restricted state, the head 710 of the fixed operation button 700 may abut and engage with the outer surface (top surface) of the cover body 200B of the controller housing 200.

[0165] According to the above configuration, the head 710 of the fixed operation button 700 abuts and engages with the outer surface (top surface) of the cover body 200B of the controller housing 200, thereby preventing the fixed operation button 700 from falling off.

[0166] In the deflection operation device 100 in the above-described embodiment, the tip of the leg 720 of the fixed operation button 700 is positioned on the outer surface (bottom surface) of the base 200A of the controller housing 200, and when the fixed operation button 700 is slid relative to the controller housing 200 to enter a displacement restricted state, the tip of the leg 720 of the fixed operation button 700 may protrude from the outer surface (bottom surface) of the base 200A of the controller housing 200.

[0167] According to the above configuration, when the displacement restricted state is set, the tip of the leg 720 of the fixed operation button 700 protrudes from the outer surface (lower surface) of the base 200A of the controller housing 200, thereby indicating the displacement restricted state.

[0168] In the deflection operation device 100 in the above-described embodiment, the tip of the leg 720 of the fixed operation button 700 is provided with anti-removal portions 743, 753 that extend to the side of the leg 720, and when the fixed operation button 700 is slid relative to the controller housing 200 to enter a displacement-restricted state, the anti-removal portions 743, 753 of the fixed operation button 700 may abut and engage with the outer surface (lower surface) of the base 200A of the controller housing 200, or the first rack member 300 or the second rack member 400.

[0169] According to the above configuration, the anti-detachment portions 743, 753 of the fixed operation button 700 abut and engage with the outer surface (lower surface) of the base 200A of the controller housing 200, or the first rack member 300 or the second rack member 400, thereby preventing the fixed operation button 700 from falling off.

[0170] In the above-described embodiment, the deflection operation device 100 has a leg 720 of a fixed operation button 700 which is configured by a connecting leg 730 connected to a head 710 and constituting a base end of the leg 720, and a plurality of split legs 740, 750 connected to the connecting leg 730 and constituting a tip end of the leg 720, and the multiple split legs 740, 750 may be formed symmetrically to each other and configured to be elastically deformable laterally.

[0171] According to the above configuration, the multiple split leg portions 740, 750 come into contact with the inner circumferential surface of the lower insertion hole 290 formed in the base 200A of the controller housing 200, and can hold the fixed operation button 700 in a desired sliding position.

[0172] In the deflection operation device 100 in the above-described embodiment, a convex portion 295 forming a convex surface is provided on the inner surface of the lower insertion hole 290 formed in the base 200A, and a first concave portion (concave portions 741a, 741b, 751a, 751b) forming a concave surface that fits into the convex surface of the convex portion 295 when in a displacement-restricted state, and a second concave portion (concave portions 742a, 742b, 752a, 752b) forming a concave surface that fits into the convex surface of the convex portion 295 when in a displacement-enabled state may be provided on the side surfaces of the multiple split leg portions 740, 750.

[0173] According to the above configuration, when the fixed operation button 700 is slid relative to the controller housing 200 to set the displacement restricted state, the first recess (recess 741a, 741b, 751a, 751b) of the fixed operation button 700 fits into the convex portion 295 formed on the inner surface of the lower insertion hole 290, and when the fixed operation button 700 is slid relative to the controller housing 200 to set the displacement permitted state, the second recess (recess 742a, 742b, 752a, 752b) of the fixed operation button 700 fits into the convex portion 295 formed on the inner surface of the lower insertion hole 290. Therefore, the position of the fixed operation button 700 when set to the displacement restricted state and the displacement permitted state is determined, and the fixed operation button 700 stops sliding at each fitting position, thereby improving the operability for the user.

[0174] In the deflection operation device 100 in the above-described embodiment, the engagement portion 800 may have a plurality of engagement protrusions 810 , 820 that engage with the teeth 320 , 420 of at least one of the first rack member 300 and the second rack member 400 .

[0175] According to the above configuration, the multiple engaging protrusions 810, 820 engage with the tooth portions 320, 420 of at least one of the first rack member 300 and the second rack member 400, thereby more reliably regulating the reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction.

[0176] In the deflection operation device 100 in the above-described embodiment, the engagement portion 800 may be configured to include a first engagement protrusion (engagement protrusion 810) that engages with the teeth portion 320 of the first rack member 300, and a second engagement protrusion (engagement protrusion 820) that engages with the teeth portion 420 of the second rack member 400.

[0177] According to the above configuration, the engagement portion 800 of the fixed operation button 700 engages with the tooth portions 320, 420 of both the first rack member 300 and the second rack member 400, thereby more reliably restricting the reciprocating displacement of the first rack member 300 and the second rack member 400 in the longitudinal direction.

[0178] In the deflection operation device 100 in the above-described embodiment, in the above-described configuration, the fixed operation button 700 may be disposed closer to the base end side than the pinion member 600 in the longitudinal direction.

[0179] According to the above configuration, by arranging the fixed operation button 700 on the longitudinal base end side of the pinion member 600, which is located approximately in the center of the deflection operation device 100, the deflection operation of the movable part 20 of the medical equipment (medical device 1) and the sliding operation of the fixed operation button 700 can be performed with one hand while gripping the support handle part 220, thereby providing a deflection operation device 100 with excellent operability with one hand.

[0180] The above-described embodiment is described for facilitating understanding of the present invention, and is not described for limiting the present invention. Therefore, each element disclosed in the above-described embodiment is intended to include all design modifications and equivalents that fall within the technical scope of the present invention. [Explanation of symbols]

[0181] 1 Medical devices 10 Tubular member 10a Distal end 10b Proximal end 11 Main Lumens 11a, 11b, 12a, 12b Lumens for wires 20 Moving parts 50 Tip 55a through hole 56, 57 Recess 56a, 56b, 57a, 57b Wire insertion holes 100 Deflection operation device (Deflection operation device for medical equipment) 200 Controller Housing 200A base 200B Lid body 206 First slide guide part 207 Second slide guide part 210 Main body 220 Support handle part 221 First handle part 221a, 222a Finger locking part 221b, 222b, 223b, 223c corner 222 Second handle part 223 Edge 223a Support part 230 Wire insertion part 231 Sleeve section 232 Wire inlet 233 Gate 233a, 233b Cylinder section 234a, 234b Wire guide 241a, 241b, 242a, 242b Partition wall 241c, 242c curved section 243, 244 Guide wall 251 First guide section 252 Second guide section 255, 256 coil spring 260, 270 Concave groove part 261, 271 Rotating shaft member engagement portion 262, 272 Shaft stop part 280 Upper insertion hole 282 Ribs 290 Lower insertion hole 295 Convex 300 First rack member 310, 410 Rack body 310a, 410a recess 311, 411 Side 312, 412 Guide piece 320, 420 teeth 400 Second rack member 510 First operation knob 510a, 520a finger locking part 510b, 520b corner 510c, 520c inner convex part 511, 521 Wire fixing part 511a, 521a groove 511b, 521b metal tube 511c, 521c threaded part 511d, 521d female thread 511e, 521e bolts 520 Second operation knob 600 Pinion member 601 Gear section 602 Rotating shaft material 700 Fixed operation button 710 Head 720 Legs 730 Connecting legs 740, 750 split legs 741a, 741b, 742a, 742b, 751a, 751b, 752a, 752b Recesses 743, 753 Retaining part 800 Engagement part 810, 820 Engagement protrusion W1 First operating wire W1a, W1b, W2a, W2b Control wires W1c, W2c folded middle part W2 Second operating wire

Claims

1. A deflection operation device for a medical device that deflects a movable part of the medical device via a first operation wire and a second operation wire, a controller housing having a main body, a support handle portion provided on a base end side of the main body in a longitudinal direction along an extension direction of the first operation wire and the second operation wire, and a wire insertion portion provided on a tip end side of the main body in the longitudinal direction and through which the first operation wire and the second operation wire are inserted; a first rack member and a second rack member housed within the controller housing so as to be reciprocally displaceable in the longitudinal direction and have teeth portions facing each other; a pinion member disposed between the first rack member and the second rack member and rotatably supported by the controller housing in a state in which the pinion member meshes with the teeth of both rack members; a regulating member that is slidably supported by the controller housing and has an engaging portion that is engageable with the teeth portion of at least one of the first rack member and the second rack member, a slide guide portion that forms a groove-shaped opening along at least one of the first rack member and the second rack member is provided on the controller housing; an operation knob is integrally provided on at least one of the first rack member and the second rack member and protrudes to a side of the controller housing through the opening, when the operation knob is slidably operated so as to be displaced relative to the support handle portion in the longitudinal direction, the first rack member and the second rack member are displaced in mutually opposite directions relative to the pinion member, and the first operation wire and the second operation wire are displaced in a deflection operation direction of the movable portion, a deflection operating device for a medical instrument, characterized in that the regulating member can be slid relative to the controller housing to switch between a displacement restricting state in which the engagement portion engages with the tooth portions of at least one of the first rack member and the second rack member to restrict reciprocating displacement of the first rack member and the second rack member in the longitudinal direction, and a displaceable state in which the engagement portion is disengaged from the tooth portions of the first rack member and the second rack member to allow reciprocating displacement of the first rack member and the second rack member in the longitudinal direction.

2. 2. The deflection operating device for medical equipment according to claim 1, wherein the regulating member is slidable between the first rack member and the second rack member in a direction substantially perpendicular to the longitudinal direction.

3. the regulating member is integrally configured to include a leg portion disposed between the first rack member and the second rack member and a head portion connected to a base end of the leg portion, The engaging portion is provided on a side surface of the leg portion, 3. The deflection operating device for medical equipment according to claim 2, characterized in that the restricting member can be slid in the extending direction of the leg portion to switch between the displacement restricted state and the displacement permitted state.

4. a restricting member insertion hole is formed in each of a top plate portion and a bottom plate portion of the controller housing, A deflection operating device for medical equipment as described in claim 3, characterized in that the leg portions of the regulating member are inserted and supported in the regulating member insertion holes of each of the top plate portion and the bottom plate portion and are positioned between the first rack member and the second rack member.

5. the head of the regulating member is disposed on an outer surface side of the top plate portion of the controller housing, A deflection operating device for medical equipment as described in claim 4, characterized in that when the regulating member is slid relative to the controller housing to achieve the displacement regulating state, the head of the regulating member abuts and engages with the outer surface of the top plate portion of the controller housing.

6. a tip end of the leg of the regulating member is disposed on an outer surface side of the bottom plate portion of the controller housing, A deflection operating device for medical equipment as described in claim 5, characterized in that when the regulating member is slid relative to the controller housing to achieve the displacement regulating state, the tip portion of the leg of the regulating member protrudes from the outer surface of the bottom plate portion of the controller housing.

7. a stopper portion extending laterally of the leg portion is provided at the tip portion of the leg portion of the restricting member, A deflection operating device for medical equipment as described in claim 6, characterized in that when the regulating member is slid relative to the controller housing to achieve the displacement regulating state, the anti-detachment portion of the regulating member abuts and engages with the outer surface of the bottom plate portion of the controller housing, or with the first rack member or the second rack member.

8. the leg portion is composed of a connecting leg portion connected to the head portion and constituting the base end portion of the leg portion, and a plurality of divided leg portions connected to the connecting leg portion and constituting the tip end portion of the leg portion, 8. The deflection operating device for medical equipment according to claim 7, wherein the plurality of split leg portions are formed symmetrically to one another and are configured to be elastically deformable laterally.

9. A convex portion forming a convex surface is provided on an inner peripheral surface of the regulating member insertion hole formed in the bottom plate portion, A deflection operating device for medical equipment as described in claim 8, characterized in that a first recess is provided on each side of the multiple split leg portions, the first recess forming a concave surface that fits into the convex surface of the convex portion when in the displacement restricted state, and a second recess forming a concave surface that fits into the convex surface of the convex portion when in the displaceable state.

10. A deflection operating device for medical equipment as described in any one of claims 1 to 9, characterized in that the engagement portion has a plurality of engagement protrusions that engage with the tooth portions of at least one of the first rack member and the second rack member.

11. A deflection operating device for medical equipment as described in any one of claims 1 to 9, characterized in that the engagement portion is configured to include a first engagement protrusion that engages with the tooth portion of the first rack member, and a second engagement protrusion that engages with the tooth portion of the second rack member.

12. 10. The deflection operating device for medical equipment according to claim 1, wherein the regulating member is disposed on a base end side in the longitudinal direction relative to the pinion member.

Images