Medical appliance

Abstract

To provide a medical appliance which suppresses an unintended movement of a guide wire to a distal end or a proximal end.SOLUTION: A medical appliance 50 has: a support part 60 which can support a connector 40 holding a guide wire G; a grip appliance 70 which grips the guide wire extending toward a proximal end side along an orthogonal direction orthogonal to an end face 40S of the proximal end side of the connector, from the proximal end of the connector; and an intermediate member 80 which fixes a relative position of the support part and the grip appliance.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present invention relates to medical instruments.

Background Art

[0002] In endovascular treatment using a catheter, first, a guide wire is inserted into a blood vessel, and then a catheter such as a balloon catheter is delivered to the tip with the guide wire as a guide. At this time, a force to advance and retreat in the blood vessel is applied to the guide wire by forces such as the bending of the blood vessel and the pushing and pulling on the catheter. Therefore, it is necessary to fix the guide wire so that it does not move.

[0003] In relation to this, for example, Patent Document 1 below discloses a fixator having a configuration in which a guide wire is placed in a groove.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0005] In the fixator disclosed in Patent Document 1, in the case of a guide wire having a hydrophilic coating on its surface, the gripping force is weak and it is difficult to fix the guide wire. When the gripping force is weak, there is a risk that a catheter inserted into the body along the guide wire, such as a balloon catheter, rubs against the guide wire, causing the guide wire to be deeply inserted into the body or to come out. In particular, when used for blood vessels with severe bending and stenosis, there is a risk that the guide wire will come out by its own rigidity even without contact with other catheters. Furthermore, due to contact with other catheters, there is a risk that the guide wire will move unintentionally to the tip or the base end.

[0006] The present invention has been made in view of the above-described problems, and an object thereof is to provide a medical instrument capable of suppressing unintentional movement of a guide wire to the tip or the base end.

Means for Solving the Problems

[0007] The above object of the present invention is achieved by the following means.

[0008] (1) A support portion capable of supporting a connector portion that holds a guide wire, A gripping instrument that grips the guide wire extending toward the base end along an orthogonal direction orthogonal to the end face on the base end side of the connector portion from the base end of the connector portion, A medical instrument having an intermediate member that fixes the relative positions of the support portion and the gripping instrument.

[0009] (2) The gripping instrument is A groove portion into which the guide wire is inserted, A pair of opposing surfaces in the groove portion, and a gripping portion that is provided in a pair and is movable between a position where the guide wire is gripped and a position where the guide wire is not gripped, The medical instrument according to (1).

[0010] (3) The gripping instrument is The medical instrument according to (2), further having an operation portion capable of switching the gripping portion between a position where the guide wire is gripped and a position where the guide wire is not gripped.

[0011] (4) The gripping instrument is A detection portion that detects the diameter of an object existing in the groove portion, A motor that operates the gripping portion, A control portion that controls the driving of the motor, and has The control unit controls the motor so as to switch between a position where the guide wire of the gripping portion is gripped and a position where it is not gripped, based on the diameter of the object detected by the detection unit, for the medical instrument according to (2).

[0012] (5) The gripping instrument further has a display unit indicating the gripped state and non-gripped state of the guide wire, for the medical instrument according to (4).

[0013] (6) The intermediate member extends to the tip side of the connector portion, a belt provided on the tip side of the intermediate member and having flexibility to be wound around a limb, and an opening provided in the belt and through which the guide wire drawn out from the limb can be inserted, for the medical instrument according to any one of (1) to (5).

[0014] (7) At least a part of the intermediate member has a high bending rigidity portion having a higher bending rigidity than other parts of the intermediate member, for the medical instrument according to any one of (1) to (6).

[0015] (8) At least one of the support portion and the gripping instrument is configured to be slidable with respect to the intermediate member, for the medical instrument according to any one of (1) to (7).

[0016] (9) a support portion capable of supporting a connector portion that holds a guide wire, a gripping instrument that grips the guide wire extending from the proximal end of the connector portion toward the proximal end side, and an intermediate member that fixes the relative positions of the support portion and the gripping instrument so that the guide wire can be stretched linearly between the support portion and the gripping instrument, for a medical instrument. [Effect of the Invention]

[0017] According to the medical instrument configured as described above, the relative positions of the support part and the grasping instrument can be fixed by the intermediate member so that the guide wire is in a taut state. Therefore, it is possible to suppress a force from acting in an unintended direction due to the bending of the guide wire or contact with other catheters, causing the guide wire to move unintentionally at the tip or the base end.

Brief Description of the Drawings

[0018]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

Modes for Carrying Out the Invention

[0019] <First Embodiment> Hereinafter, the first embodiment of the present invention will be described with reference to the attached drawings. Note that the following description does not limit the technical scope or the meaning of terms described in the claims. Also, the dimensional ratios in the drawings are exaggerated for the convenience of explanation and may be different from the actual ratios.

[0020] Hereinafter, with reference to FIG. 1, the configuration of the medical long body 1 including the medical instrument 50 according to the first embodiment will be described. FIG. 1 is a schematic view showing the medical long body 1 including the medical instrument 50 according to the first embodiment of the present invention.

[0021] In the description of the first embodiment, the side of the medical long body 1 inserted into the living body (the left side in FIG. 1) is referred to as the distal end side, and the side of the medical long body 1 where the medical instrument 50 is disposed is referred to as the proximal end side. Note that the distal end portion means a certain range including the distal end (the foremost end) and its periphery, and the proximal end portion means a certain range including the proximal end (the most proximal end) and its periphery. Also, in the drawings, the direction in which the guide wire G extends is denoted as the X direction, the vertical direction is denoted as the Z direction, and the direction orthogonal to the X direction and the Z direction is denoted as the Y direction.

[0022] The medical long body 1 is a catheter for guiding the guide wire G and the balloon catheter 90 to the target site.

[0023] In the present embodiment, the balloon catheter 90 has a shaft 91 and a balloon 92. The balloon catheter 90 is of a so-called rapid exchange type provided with an opening 91H through which the guide wire G is led out closer to the distal end side of the shaft 91. Here, the length L2 along the X direction from the distal end of the balloon catheter 90 to the opening 91H is referred to as the guide wire lumen length.

[0024] As shown in FIG. 1, the medical long body 1 has a shaft 10 extending in the X direction, a distal end member 20 disposed on the distal end side of the shaft 10, a hub 30 disposed on the proximal end side of the shaft 10, a connector portion 40 for holding the guide wire G, and a medical instrument 50 capable of gripping the guide wire G.

[0025] The shaft 10 has flexibility and extends in the X direction. The inner diameter of the shaft 10 is configured to be larger than the outer diameter of the guide wire G and the outer diameter of the balloon catheter 90 in the contracted state.

[0026] The material constituting the shaft 10 is not particularly limited, but fluororesins such as polytetrafluoroethylene (PTFE), ethylene-tetrafluoroethylene copolymer (ETFE), perfluoroalkoxy fluororesin (PFA), olefin resins such as polyethylene and polypropylene, or mixtures thereof, polyurethane, polyester, polyamide, polyether nylon resin, mixtures of olefin resins and ethylene-vinyl acetate copolymer, etc. can be used.

[0027] The tip member 20 is formed of a material that is more flexible than the shaft 10. The tip member 20, also referred to as the tip chip, has functions of suppressing damage to a living body lumen such as a blood vessel, facilitating insertion into a branched blood vessel following a previously inserted guide wire, and further improving the insertability into a stenosis formed in a blood vessel.

[0028] The tip member 20 can be formed of, for example, a flexible resin material. However, the material of the tip member 20 is not particularly limited as long as it can be fixed to the shaft 10.

[0029] The hub 30 is connected to the proximal end of the shaft 10. Further, the hub 30 is configured to be connectable to the connector portion 40.

[0030] The material constituting the hub 30 is not particularly limited, but polyolefins such as polyethylene and polypropylene, thermoplastic resins such as polycarbonate, polyamide, polysulfone, and polyarylate can be preferably used.

[0031] The connector portion 40 has a port 41 through which a contrast agent or a priming liquid can flow, a valve body 42 disposed inside the connector portion 40, and an opener 43 for operating the opening and closing of the valve body 42. The connector portion 40 is a so-called Y-connector.

[0032] Hereinafter, the configuration of the medical instrument 50 according to the first embodiment will be described in detail.

[0033] The medical instrument 50 is an instrument for holding the guide wire G in a stretched state and suppressing the unintentional movement of the guide wire G to the tip or the base end due to the bending of the guide wire G or the force acting in an unintended direction by contact with other catheters.

[0034] As shown in FIGS. 1 to 5, the medical instrument 50 has a support portion 60 capable of supporting the connector portion 40, a gripping instrument 70 for gripping the guide wire G, and an intermediate member 80 for fixing the relative positions of the support portion 60 and the gripping instrument 70.

[0035] As shown in FIG. 1, the support portion 60 fixes and supports the connector portion 40 and fixes the intermediate member 80 so as to be slidable in the X direction. As shown in the cross-sectional view taken along line A-A in FIG. 1, the support portion 60 has an extending portion 61 extending in the Z direction and a C-shaped C portion 62 provided above the extending portion 61.

[0036] A hole portion 61H is provided in the extending portion 61 to which the intermediate member 80 is slidably fixed. In the state where the user is using, the intermediate member 80 is fixed so that it cannot move unintentionally with respect to the support portion 60. On the other hand, when the user wants to move the intermediate member 80 with respect to the support portion 60, a desired force can be applied to move the fixed position of the intermediate member 80 with respect to the support portion 60. According to this configuration, the distance L1 between the support portion 60 and the gripping instrument 70 can be adjusted to be longer than the guide wire lumen length L2 of the balloon catheter 90.

[0037] The C-shaped portion 62 biases a force inwardly in a C shape, whereby the support portion 60 supports the connector portion 40. Note that the configuration in which the support portion 60 supports the connector portion 40 is not limited to the configuration described above.

[0038] The gripping instrument 70 is configured to be able to switch between a gripping release state in which the guide wire G shown in FIGS. 2 and 3 is released from gripping and a gripping state in which the guide wire G shown in FIGS. 4 and 5 is gripped. In the first embodiment, the gripping instrument 70 manually switches between the gripping state and the gripping release state. The gripping instrument 70 grips the guide wire G extending toward the proximal end along the orthogonal direction (X direction in FIG. 1) orthogonal to the end face 40S on the proximal end side of the connector portion 40.

[0039] As shown in FIGS. 2 to 5, the gripping instrument 70 includes an operation portion 71 that can be operated by a user, a first link portion 72 to which the operation portion 71 is connected, a second link portion 73 connected to the first link portion 72, a moving portion 74 pushed out by the second link portion 73, a gripping portion 75 provided at the tip of the moving portion 74, and a biasing member 76 disposed on the outer periphery of the moving portion 74.

[0040] The first link portion 72 is disposed so as to be rotatable about a shaft with respect to a shaft member 78 disposed in a hole portion 72H of the first link portion 72. The shaft member 78 is fixed so as not to move.

[0041] On the other hand, the first link portion 72 and the second link portion 73 are disposed so as to be rotatable about a shaft with respect to a shaft member 79. The shaft member 79 is not fixed and can move freely within the range in which the first link portion 72 and the second link portion 73 can move.

[0042] Further, the second link portion 73 is disposed so as to be rotatable about a shaft with respect to a shaft member 95. The shaft member 95 is fixed to a fixing member 96, and the shaft member 95 is configured to be movable only in the Y direction.

[0043] The gripping portion 75 is movable between a position where it does not grip the guide wire G shown in FIGS. 2 and 3 and a position where it grips the guide wire G shown in FIGS. 4 and 5. The gripping portion 75 is made of a relatively soft material.

[0044] The biasing member 76 biases the fixing member 96 toward the left and is provided to form the groove portion 77 in the normal state.

[0045] In the gripping instrument 70 configured as described above, in a state where the operation portion 71 is lifted upward, as shown in FIGS. 2 and 3, a groove portion 77 into which the guide wire G is inserted is provided.

[0046] In the non-gripping state shown in FIG. 2, the right side of the operation portion 71 is lifted upward, the shaft member 79 is lifted upward, and the first link portion 72 is rotated counterclockwise about the shaft member 78. Along with this, the second link portion 73 is rotated clockwise about the shaft member 79, and as a result, the shaft member 95 slides to the left. As a result, due to the biasing force of the biasing member 76, the gripping portion 75 connected to the moving portion 74 moves to the left side in FIGS. 2 and 3, and the groove portion 77 is formed.

[0047] On the other hand, in the gripping state shown in FIGS. 4 and 5, the operation portion 71 is tilted so that the extending direction is the Y direction. At this time, the first link portion 72 and the second link portion 73 are arranged in the Y direction, and the shaft member 95 slides to the right. As a result, the gripping portion 75 connected to the moving portion 74 moves to the right side in FIGS. 4 and 5, and the guide wire G is gripped.

[0048] For the operation portion 71, the first link portion 72, the second link portion 73, and the moving portion 74, for example, a known plastic material can be used.

[0049] The gripping portion 75 can be made of, for example, a known rubber material. According to this configuration, when gripping the guide wire G, it deforms according to the outer shape of the guide wire G, so that it can grip the guide wire G so as to wrap it, increasing the contact area and enabling suitable gripping. Further, it is preferable to use a material with a large coefficient of friction on one surface of the gripping portion 75 and the groove portion 77 that faces the gripping portion 75 and comes into contact in the gripping state. According to this configuration, the frictional force generated between the gripping portion 75 and the guide wire G becomes large, enabling suitable gripping.

[0050] The intermediate member 80 fixes the relative positions of the support portion 60 and the gripping instrument 70. More specifically, the intermediate member 80 fixes the relative positions of the support portion 60 and the gripping instrument 70 so that the guide wire G can be stretched linearly. For this reason, the relative positions of the support portion 60 and the gripping instrument 70 can be fixed by the intermediate member 80 so that the guide wire G is in a stretched state. Therefore, it is possible to suppress the force acting in an unintended direction due to the bending of the guide wire G or contact with other catheters, causing the guide wire G to move unintentionally to the tip or the base end.

[0051] As shown in FIG. 1, the intermediate member 80 has a high bending rigidity portion 81 with higher bending rigidity compared to other portions of the intermediate member 80.

[0052] In the present embodiment, the high bending rigidity portion 81 has a cylindrical shape like other portions of the intermediate member 80 and is made of a material with higher rigidity than other portions of the intermediate member 80. As shown in FIG. 1, the high bending rigidity portion 81 is provided at the connection location of the gripping instrument 70 provided on the proximal end side.

[0053] The material constituting the intermediate member 80 is not particularly limited, and a known plastic material can be used.

[0054] Next, the usage method of the medical instrument 50 according to the first embodiment will be described.

[0055] First, the user inserts the guide wire G into a predetermined position within the blood vessel. Then, the user places the guide wire G protruding from the limb (e.g., the wrist) into the groove portion 77 of the non-gripping instrument 70 in a non-gripped state.

[0056] Then, the user tilts the operation unit 71 downward and grips the guide wire G with the gripping portion 75. In this state, the user inserts the balloon catheter 90 from the proximal end side of the guide wire G and moves it toward the distal end side.

[0057] When the distal end of the balloon catheter 90 reaches the gripping instrument 70, the user lifts the operation unit 71 upward to make it non-gripping, and then delivers the balloon catheter 90 along the guide wire G to the distal end. While the gripping instrument 70 is in the non-gripping state, to prevent the guide wire G from moving due to an unintended force, the user tightens the valve body 42 using the opener 43 or fixes the guide wire with their own finger. When the portion of the opening 91H of the balloon catheter 90 passes through the gripping portion 75 and only the guide wire G is within the moving range of the gripping portion 75, the user tilts the operation unit 71 downward again to make the gripping instrument 70 in a gripping state, and the gripping instrument 70 grips the guide wire G. With the gripping instrument 70 gripping the guide wire G, the user delivers the balloon catheter 90 to a predetermined position.

[0058] After performing a predetermined treatment at the lesion site, the user withdraws the balloon catheter 90. At this time, the user withdraws the balloon catheter 90 along the guide wire G and operates while suppressing the friction with the guide wire G, thereby minimizing the unintended movement of the guide wire G. When the portion of the opening 91H of the balloon catheter 90 reaches the tip of the moving range of the gripping portion 75, the user lifts the operation unit 71 upward to make it non-gripping, and then removes the balloon catheter 90 along the guide wire G to the proximal end.

[0059] Here, for example, when the distance L1 between the support portion 60 and the gripping instrument 70 is shorter than the guide wire lumen length L2 of the balloon catheter 90, during the removal of the balloon catheter 90 toward the proximal end side, the guide wire G does not become exposed between the support portion 60 and the gripping instrument 70. For this reason, when removing the balloon catheter 90 toward the proximal end side, the guide wire G cannot be gripped between the support portion 60 and the gripping instrument 70, and the operability deteriorates.

[0060] On the other hand, in the medical instrument 50 according to the first embodiment, as shown in FIG. 1, since the distance L1 between the support portion 60 and the gripping instrument 70 can be configured to be longer than the guide wire lumen length L2 of the balloon catheter 90, the guide wire G becomes exposed on the distal end side of the balloon catheter 90 while the portion of the opening 91H of the balloon catheter 90 is on the way to reach the tip of the gripping instrument 70. For this reason, even when the gripping by the gripping instrument 70 is released, the user can grip the exposed guide wire G, so that the operability is improved. Note that the distance L1 between the support portion 60 and the gripping instrument 70 is preferably longer than the width of the finger for gripping by at least the guide wire lumen length L2 of the balloon catheter 90, and according to the balloon catheter 90, the distance L1 between the support portion 60 and the gripping instrument 70 is preferably in the range of 20 to 500 mm.

[0061] Then, when the distal end of the balloon catheter 90 passes through the proximal end of the gripping instrument 70 and only the guide wire G remains on the gripping instrument 70, the user tilts the operation portion 71 downward again to bring the gripping instrument 70 into a gripping state, and the gripping instrument 70 grips the guide wire G. Then, the user removes the balloon catheter 90 from the guide wire G.

[0062] As described above, the medical instrument 50 according to the first embodiment includes a support portion 60 capable of supporting a connector portion 40 that holds a guide wire G, a gripping instrument 70 that grips the guide wire G extending toward the proximal end along an orthogonal direction orthogonal to the end face 40S on the proximal end side of the connector portion 40 from the proximal end of the connector portion 40, and an intermediate member 80 that fixes the relative positions of the support portion 60 and the gripping instrument 70. According to the medical instrument 50 configured in this way, the relative positions of the support portion 60 and the gripping instrument 70 can be fixed by the intermediate member 80 so that the guide wire G is in a taut state. For this reason, it is possible to suppress a force from acting in an unintended direction due to the bending of the guide wire G or contact with other catheter devices, and to prevent the guide wire G from unintentionally moving to the tip or the proximal end.

[0063] Further, the gripping instrument 70 includes a groove portion 77 into which the guide wire G is inserted, and a gripping portion 75 that is provided on at least one of the opposing surfaces in the groove portion 77 and is movable between a position where the guide wire is gripped and a position where it is not gripped. According to the medical instrument 50 configured in this way, the guide wire G can be guided to the gripping portion 75 simply by inserting the guide wire G along the groove portion 77, improving the convenience of the procedure. Furthermore, since the gripping portion 75 is movable between a position where the guide wire G is gripped and a position where it is not gripped, the guide wire G can be easily guided into the groove portion 77 by setting it to the non-gripping position when inserting the guide wire G.

[0064] Further, the gripping instrument 70 further includes an operation portion 71 capable of switching the gripping portion 75 between a position where the guide wire G is gripped and a position where it is not gripped. According to the medical instrument 50 configured in this way, the user can easily operate the gripping state and non-gripping state of the guide wire G by operating the operation portion 71. Also, in order to confirm the gripping state and non-gripping state of the gripping portion 75, it is only necessary to check the operation portion 71, so the gripping state and non-gripping state can be easily grasped.

[0065] Further, at least a part of the intermediate member 80 has a high bending rigidity portion 81 with a higher bending rigidity compared to other parts of the intermediate member 80. According to the medical instrument 50 configured in this way, by providing the high bending rigidity portion 81, it is possible to prevent the intermediate member 80 itself from bending and becoming unable to grip the guide wire G in a stretched state.

[0066] Also, the support portion 60 is configured to be slidable with respect to the intermediate member 80. According to the medical instrument 50 configured in this way, since the distance L1 between the support portion 60 and the gripping instrument 70 is configured to be longer than the guide wire lumen length L2 of the balloon catheter 90, the guide wire G becomes exposed on the distal end side of the balloon catheter 90 on the way to the site of the opening 91H of the balloon catheter 90 reaching the distal end of the gripping instrument 70. For this reason, even when the gripping by the gripping instrument 70 is released, the user can grip the exposed guide wire G, so the operability is improved.

[0067] Also, as described above, the medical instrument 50 according to the first embodiment includes a support portion 60 that can support a connector portion 40 that holds the guide wire G, a gripping instrument 70 that grips the guide wire G extending from the proximal end of the connector portion 40 toward the proximal end side, and an intermediate member 80 that fixes the relative positions of the support portion 60 and the gripping instrument 70 so that the guide wire G can be stretched linearly between the support portion 60 and the gripping instrument 70. According to the medical instrument 50 configured in this way, the intermediate member 80 can fix the relative positions of the support portion 60 and the gripping instrument 70 so that the guide wire G is in a stretched state. For this reason, it is possible to suppress the guide wire G from moving unintentionally to the distal end or the proximal end due to the bending of the guide wire G or contact with other catheters, and a force acting in an unintended direction.

[0068] <Second Embodiment> Next, with reference to FIGS. 6 to 8, the configuration of the medical instrument 150 according to the second embodiment will be described.

[0069] FIG. 6 is a block diagram of a medical instrument 150 according to the second embodiment. FIG. 7 is a plan view showing a state where the gripping device 170 of the medical instrument 150 according to the second embodiment is released from gripping. FIG. 8 is a plan view showing a state where the gripping device 170 of the medical instrument 150 according to the second embodiment is in a gripping state.

[0070] Parts common to the first embodiment will not be described, and only the features unique to the second embodiment will be described. Note that the same members as those in the first embodiment described above are denoted by the same reference numerals and described, and redundant descriptions are omitted. The second embodiment is different from the first embodiment in that it can automatically switch between the gripping state and the non-gripping state.

[0071] The medical instrument 150 according to the second embodiment grips the guide wire G in a state where the guide wire G is stretched, thereby suppressing the force acting in an unintended direction due to the bending of the guide wire G or contact with other catheters, and suppressing the unintended movement of the guide wire G to the tip or the base end.

[0072] As shown in FIGS. 6 to 8, the medical instrument 150 includes a support portion (not shown) that can support the connector portion 40, a gripping device 170 that grips the guide wire G, and an intermediate member 80 that fixes the relative positions of the support portion and the gripping device 170. Since the configurations of the support portion and the intermediate member are the same as those of the medical instrument 50 according to the first embodiment described above, the description thereof is omitted.

[0073] The gripping device 170 according to the second embodiment is configured to be able to switch between a gripping release state in which the gripping of the guide wire G shown in FIG. 7 is released and a gripping state in which the guide wire G shown in FIG. 8 is gripped. In the second embodiment, the gripping device 170 automatically switches between the gripping state and the gripping release state.

[0074] As shown in FIGS. 6 to 8, the gripping device 170 includes a gripping portion 110, a motor 120 that operates the gripping portion 110, a detection portion 130 that detects the diameter of an object existing in the groove portion 177, a biasing member 140 provided on the side of the gripping portion 110 in the Y direction, a control portion 160 that controls the driving of the motor 120, and a display portion 180 that indicates a gripping state and a non-gripping state.

[0075] The gripping portion 110 is composed of a pair of gripping portions 111 and 112. As shown in FIG. 7, the gripping portion 111 includes a first roller 111A provided on the tip side in the X direction, a second roller 111B provided on the base end side in the X direction, and a pedestal portion 111C that rotatably fixes the first roller 111A and the second roller 111B. The pedestal portion 111C has a trapezoidal shape.

[0076] As shown in FIG. 7, the gripping portion 112 includes a first roller 112A provided on the tip side in the X direction, a second roller 112B provided on the base end side in the X direction, and a pedestal portion 112C that rotatably fixes the first roller 112A and the second roller 112B. The pedestal portion 112C has a trapezoidal shape.

[0077] The motor 120 has a motor shaft 121. As shown in FIGS. 7 and 8, the motor shaft 121 has a substantially rectangular shape. A known motor can be used as the motor 120, for example, a stepping motor can be used.

[0078] In the non-gripping state shown in FIG. 7, the motor 120 rotates the motor shaft 121 so that the long side of the motor shaft 121 is in the Y direction. As a result, the first roller 111A of the gripping portion 111 and the first roller 112A of the gripping portion 112, and the second roller 111B of the gripping portion 111 and the second roller 112B of the gripping portion 112 are separated from each other, and the groove portion 177 shown in FIG. 7 is formed.

[0079] On the one hand, in the gripping state shown in FIG. 8, the motor 120 rotates the motor shaft 121 so that the long side of the motor shaft 121 is in the X direction. As a result, the first roller 111A of the gripping portion 111 and the first roller 112A of the gripping portion 112, as well as the second roller 111B of the gripping portion 111 and the second roller 112B of the gripping portion 112, approach each other to grip the guide wire G.

[0080] The detection unit 130 can detect the diameter of an object existing in the groove portion 177. As shown in FIGS. 7 and 8, the detection unit 130 is disposed at four locations: the left side of the first roller 111A, the right side of the second roller 111B, the left side of the first roller 112A, and the right side of the second roller 112B. Specifically, it can detect the diameters of the guide wire G and the balloon catheter 90 existing in the groove portion 177. Hereinafter, among the detection units 130, the detection units located on the left side of the first roller 111A and the left side of the first roller 112A are referred to as the tip-side detection units 131, and the detection units located on the right side of the second roller 111B and the right side of the second roller 112B are referred to as the base-end side detection units 132.

[0081] The detection unit 130 is not particularly limited, but for example, an illuminance sensor can be used. The illuminance sensor emits infrared light and measures the illuminance of the infrared light reflected from an object existing in the groove portion 177. The infrared light reflected from an object existing in the groove portion 177 is detected to have a large illuminance when the diameter of the object is large and a small illuminance when the diameter of the object is small. Since the thresholds for delimiting "large", "medium", and "small" illuminance depend on the diameter and color of the device, it is preferably obtained experimentally.

[0082] The biasing member 140 biases the gripping portion 111 downward in FIG. 7 and biases the gripping portion 112 upward in FIG. 7 so that the gripping portion 111 and the gripping portion 112 approach each other.

[0083] The control unit 160 drives the motor 120 based on the diameter of the object detected by the detection unit 130 to control the motor shaft 121 in the state of FIG. 7 or FIG. 8. The control unit 160 is a known CPU.

[0084] The display unit 180 can indicate the gripped state and non-gripped state of the guide wire G. As the display unit 180, for example, a known display or the like can be used.

[0085] Next, a method of using the medical instrument 150 according to the second embodiment will be described.

[0086] First, the user inserts the guide wire G to a predetermined position within the blood vessel. At this time, with nothing placed in the gripping instrument 170, the illuminance of the distal end side detection unit 131 and the proximal end side detection unit 132 is "zero", and at this time, the control unit 160 controls the gripping instrument 170 to be in a non-gripped state.

[0087] Then, the user places the guide wire G protruding from the limb (for example, the wrist) in the groove portion 177 of the non-gripped gripping instrument 170. As a result, the distal end side detection unit 131 and the proximal end side detection unit 132 detect the diameter of the guide wire G disposed in the groove portion 177, transmit the detected signal to the control unit 160, and the control unit 160 controls the gripping instrument 170 to be in a gripped state. At this time, the illuminance of the distal end side detection unit 131 and the proximal end side detection unit 132 is "small".

[0088] Then, in this state, the user moves the balloon catheter 90 from the proximal end side to the distal end side. When the distal end of the balloon catheter 90 reaches the proximal end side detection unit 132 of the gripping instrument 170, the proximal end side detection unit 132 detects the diameter of the balloon catheter 90, transmits the detected signal to the control unit 160, and the control unit 160 controls the gripping instrument 170 to be in a non-gripped state. At this time, the illuminance of the distal end side detection unit 131 is "small", and the illuminance of the proximal end side detection unit 132 is "medium".

[0089] Then, in this state, the user delivers the balloon catheter 90 to the tip along the guide wire G. When the balloon catheter 90 reaches the distal end side detection unit 131, the illuminance of the distal end side detection unit 131 and the proximal end side detection unit 132 is "medium".

[0090] Then, when the portion of the opening 91H of the balloon catheter 90 passes through the tip of the grasping instrument 70 and only the guide wire G remains on the grasping instrument 170, the tip-side detection unit 131 and the base-side detection unit 132 detect the diameter of the guide wire G disposed in the groove portion 177, transmit the detected signal to the control unit 160, and the control unit 160 controls the grasping instrument 170 to be in a grasping state. At this time, the illuminance of the tip-side detection unit 131 and the base-side detection unit 132 is "low". Then, the user delivers the balloon catheter 90 to a predetermined position while the grasping instrument 170 holds the guide wire G.

[0091] Then, after the user performs a predetermined treatment at the lesion site, the user withdraws the balloon catheter 90. Then, when the portion of the opening 91H of the balloon catheter 90 reaches the tip of the grasping instrument 170, the tip-side detection unit 131 detects the diameter of the balloon catheter 90, transmits the detected signal to the control unit 160, and the control unit 160 controls the grasping instrument 170 to be in a non-grasping state. At this time, the illuminance of the tip-side detection unit 131 is "medium", and the illuminance of the base-side detection unit 132 is "low". In this state, the user removes the balloon catheter 90 along the guide wire G to the base end.

[0092] Then, when the tip of the balloon catheter 90 passes through the base end of the grasping instrument 170 and only the guide wire G remains, the tip-side detection unit 131 and the base-side detection unit 132 detect the diameter of the guide wire G disposed in the groove portion 177, transmit the detected signal to the control unit 160, and the control unit 160 controls the grasping instrument 170 to be in a grasping state. At this time, the illuminance of the tip-side detection unit 131 and the base-side detection unit 132 is "low". Then, the user removes the balloon catheter 90 from the guide wire G.

[0093] As described above, the gripping device 170 of the medical instrument 150 according to the second embodiment includes a detection unit 130 that detects the diameter of an object existing in the groove portion 177, a motor 120 that operates the gripping portion 110, and a control unit 160 that controls the driving of the motor 120. The control unit 160 controls the motor 120 to switch between a position where the guide wire G of the gripping portion 110 is gripped and a position where it is not gripped based on the diameter of the object detected by the detection unit 130. According to the medical instrument 150 configured in this way, since the gripping state and the non-gripping state of the guide wire G can be automatically switched, the operator does not need to switch the gripping state and the non-gripping state, and the gripping state and the non-gripping state of the guide wire G can be switched at a suitable timing.

[0094] Further, the gripping device 170 of the medical instrument 150 according to the second embodiment further includes a display unit 180 that indicates the gripping state / non-gripping state of the guide wire G. According to the medical instrument 150 configured in this way, the user can easily grasp the gripping state / non-gripping state of the guide wire G by checking the display unit 180.

[0095] <Modification Example 1> Next, with reference to FIG. 9, the configuration of the medical instrument 250 according to Modification Example 1 will be described. FIG. 9 is a schematic diagram showing the medical instrument 250 according to Modification Example 1.

[0096] As shown in FIG. 9, the medical instrument 250 according to Modification Example 1 includes a support portion 260 that can support the connector portion 40, a gripping device 270 that grips the guide wire G, an intermediate member 280 that fixes the relative positions of the support portion 260 and the gripping device 270, and a belt body 290 provided on the tip side of the intermediate member 280.

[0097] The gripping device 270 can use the gripping device 70 according to the first embodiment or the gripping device 170 according to the second embodiment described above, and further, as shown in FIG. 9, it may have a small length along the X direction.

[0098] The intermediate member 280 extends to the distal end side of the connector portion 40, and a belt body 290 is fixed to the bifurcated distal end of the intermediate member 280.

[0099] The belt body 290 has flexibility and is wound around a limb W (for example, a wrist). The belt body 290 has an opening 291, and a guide wire G drawn out from the limb can be inserted through the opening 291.

[0100] According to the configuration of the medical instrument 250 according to the first modification in this way, since the medical instrument 250 can be fixed to the limb by the belt body 290, it is possible to suppress changes in the relative positions of the limb, the support portion 260, and the gripping instrument 270, and it is possible to grip the guide wire G in a more stable state with the wire taut.

[0101] As described above, the configurations of the medical instruments 50, 150, and 250 according to the present invention have been described through the first embodiment, the second embodiment, and the modifications. However, the present invention is not limited to the configurations described in the embodiments, and can be appropriately changed based on the description in the claims.

[0102] For example, in the gripping instrument 370 shown in FIG. 10, a configuration may be adopted in which components other than the gripping portion 375 are covered with a cover C and only the gripping portion 375 to which blood adheres is replaced and used.

[0103] Also, in the first embodiment described above, the high bending rigidity portion 81 is made of a high-rigidity material, but it may be configured in a shape that is less likely to deform in the Y direction. For example, it may be configured in a flat shape in the Y direction.

[0104] Also, in the first embodiment described above, the support portion 60 is configured to be slidable with respect to the intermediate member 80. However, the gripping instrument may be configured to be slidable with respect to the intermediate member, and further, both the support portion and the gripping instrument may be configured to be slidable with respect to the intermediate member.

[0105] In the first embodiment described above, the support portion 60 fixes and supports the connector portion 40 and also fixes the intermediate member 80 so as to be slidable in the X direction. However, a configuration in which the intermediate member is like a rail and the gripping instrument side is slid may also be adopted.

[0106] In the first embodiment described above, one gripping portion 75 is provided, and the gripping portion 75 is gripped by being pressed against the opposite vertical wall. However, two gripping portions may be provided to sandwich the guide wire.

Explanation of Reference Numerals

[0107] 40 Connector portion 40S End face on the proximal end side of the connector portion 50, 150, 250 Medical instruments 60, 260 Support portions 70, 170, 270, 370 Gripping instruments 71 Operation portion 75, 110, 111, 112, 375 Gripping portions 77, 177 Groove portions 80, 280 Intermediate members 81 High bending rigidity portion 90 Balloon catheter 120 Motor 130 Detection portion 160 Control portion 180 Display portion 290 Belt 291 Opening G Guide wire

Claims

1. A support portion capable of supporting a connector portion that holds a guide wire, A gripping device that grips the guide wire extending toward the proximal end along an orthogonal direction orthogonal to the end face on the proximal end side of the connector portion from the proximal end of the connector portion, A medical instrument having an intermediate member that fixes the relative positions of the support portion and the gripping device.

2. The gripping device, A groove portion into which the guide wire is inserted, A gripping portion provided on at least one of the opposing surfaces in the groove portion and movable between a position where the guide wire is gripped and a position where it is not gripped, the medical instrument according to claim 1.

3. The gripping device, The medical instrument according to claim 2, further having an operating portion capable of switching the gripping portion between a position where the guide wire is gripped and a position where it is not gripped.

4. The gripping device, A detection portion that detects the diameter of an object present in the groove portion, A motor that operates the gripping portion, A control portion that controls the driving of the motor, and The control portion controls the motor so as to switch between a position where the gripping portion grips the guide wire and a position where it does not grip based on the diameter of the object detected by the detection portion, the medical instrument according to claim 2.

5. The medical instrument according to claim 4, wherein the gripping device further has a display portion indicating a gripped state and a non-gripped state of the guide wire.

6. The intermediate member extends to the distal end side of the connector portion, A belt body provided on the distal end side of the intermediate member and having flexibility to be wound around a limb, An opening provided in the belt body through which the guide wire drawn out from the limb can be inserted, the medical instrument according to claim 1 or 2.

7. The medical instrument according to claim 1 or 2, wherein at least a part of the intermediate member has a high bending rigidity portion having a higher bending rigidity than other parts of the intermediate member.

8. The medical instrument according to claim 1 or 2, wherein at least one of the support portion and the gripping device is configured to be slidable with respect to the intermediate member.

9. A support portion capable of supporting a connector portion that holds a guide wire, A gripping device that grips the guide wire extending toward the proximal end from the proximal end of the connector portion, A medical instrument having an intermediate member that fixes the relative positions of the support portion and the grasping instrument so that the guide wire can be stretched linearly between the support portion and the grasping instrument.

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