Movable long structure and wiring aid

Abstract

The objective is to provide highly assembleable, movable, long-length structures, wiring aids for use in movable, long-length structures, movable, long-length structural equipment, etc. [Solution] The spacer 40 is provided with a cylindrical cylinder 42, a base-side protruding edge 43b, and a tip-side protruding edge 43a. The base-side protruding edge 43b is provided with a proximity restricting portion 45b that restricts the circumferential proximity of a pair of traction wires 50 that are led out from a pair of base-side wire lumens 32 provided in the base-side flexible tube 30 and introduced into a pair of tip-side wire lumens 22 provided in the tip-side flexible tube 20, and a placement recess 44 that is open on the outer diameter and in which the traction wires 50 are placed. The tip-side protruding edge 43a is provided with a separation restricting portion 45a that restricts the circumferential separation of the traction wires 50 and a placement recess 44.

Description

Technical Field

[0001] The present invention relates to, for example, a movable long structure that is inserted into a pipeline such as a luminal organ, a blood vessel, or a blood vessel, and whose tip portion is bent in a predetermined direction at a branch portion or the like, a wiring auxiliary tool used for the movable long structure, a movable long structure device, a medical system, a tool, a manipulator, a robot, a medical robot, an insertion method, a method of operating a robot, and a method of operating a movable long structure.

Background Art

[0002] For example, long medical devices inserted into the body cavity such as catheters and endoscopes are frequently used. Such long medical devices bend the tip portion and insert it into a branch portion or the like, for example, like the medical manipulator described in Patent Document 1.

[0003] The endoscope provided in the manipulator of Patent Document 1 is configured such that the bending portion provided in the middle portion on the tip side bends in four directions of up, down, left, and right to change the direction of the tip portion in the up, down, left, and right directions. However, its structure is complex and the assembly property is low.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0005] Therefore, an object of the present invention is to provide a movable long structure with high assembly property, a wiring auxiliary tool used for the movable long structure, a movable long structure device, a medical system, a tool, a manipulator, a robot, a medical robot, an insertion method, a method of operating a robot, and a method of operating a movable long structure.

Means for Solving the Problems

[0006] This invention has a tip-side tubular body, a base-side tubular body, and a traction operating body. The tip-side tubular body and the base-side tubular body are formed in a flexible, elongated shape and are provided with a pair of flexible traction mechanisms that pass through a pair of longitudinally oriented through holes provided inside the tube walls of the tip-side tubular body and the base-side tubular body. The through holes provided in the base-side tubular body are designated as base-side through holes, and the through holes provided in the tip-side tubular body are designated as tip-side through holes. The circumferential spacing between the pair of base-side through holes is set to be wider than the circumferential spacing between the pair of tip-side through holes. It is characterized by being a movable, elongated structure.

[0007] The towing mechanism may be in the shape of a string or a strip. Furthermore, the pair of towing mechanisms may be separate mechanisms, or a single mechanism may be bent back to form a pair. When towing the pair of towing mechanisms, both mechanisms may be towed, or only one mechanism may be towed.

[0008] The circumferential spacing mentioned above refers to the shorter circumferential distance between a pair of through holes. Therefore, the pair of longitudinally penetrating proximal end holes provided inside the tube wall of the proximal end tubular body, whose circumferential spacing is set to be wider than the circumferential spacing between the pair of longitudinally penetrating proximal end holes provided inside the tube wall of the proximal end tubular body, means that the spacing on the shorter side of the circumferential spacing between the proximal end holes is wider than the spacing on the shorter side of the circumferential spacing between the proximal end holes.

[0009] In one aspect of this invention, the tip-side distance, which is the distance between a virtual tip-side line connecting the centers of a pair of tip-side through holes and a tip-side central line passing through the center of the tip-side tubular body and parallel to the virtual tip-side line, may be set wider than the base-side distance, which is the distance between a virtual base-side line connecting the centers of a pair of base-side through holes and a base-side central line passing through the center of the base-side tubular body and parallel to the virtual base-side line.

[0010] In one aspect of this invention, a wiring aid may be provided between the tip-side tubular body and the base-side tubular body, which is detachably held by the traction operating body.

[0011] The cylindrical body described above may have a circular, elliptical, or polygonal cross-section, and the internal space may be similar in shape to the outer diameter or have a different cross-sectional shape. Furthermore, the internal space of the cylindrical body may be located at the center of the outer shape or offset from the center of the outer shape.

[0012] The proximity restriction section may be provided for each of the aforementioned towing operating bodies, or it may be provided as an integral part of the unit. The above-mentioned separation regulating section may be provided for each of the towing operating bodies, or it may be provided integrally.

[0013] Furthermore, this invention is characterized in that it comprises the above-described movable elongated structure and a traction drive unit for towing a pair of the traction operating bodies, wherein the traction drive unit tow the pair of the traction operating bodies to bend and deform the tubular end section.

[0014] Furthermore, this invention is characterized in that it comprises the above-described movable elongated structure and a traction drive unit for towing a pair of the traction operating bodies, wherein a plurality of the traction drive units are provided, and the pair of traction operating bodies are towed by a predetermined traction drive unit to bend and deform the tubular end section in a desired direction.

[0015] Furthermore, this invention is characterized by being a medical system having the above-mentioned movable elongated structural device, a drive unit that drives the traction drive unit, and a control unit connected to apply a drive signal to the drive unit.

[0016] Furthermore, this invention is characterized by being a medical system comprising the above-described movable elongated structural device, a drive unit that selectively drives at least one of the plurality of traction drive units, and a control unit connected to apply a drive signal to the drive unit.

[0017] Furthermore, this invention is characterized by being a tool that includes the above-described movable elongated structural device, an attachment part for attaching the base end tubular body of the movable elongated structure to the tip of a robot arm, and a connecting part for connecting to a drive mechanism that drives the traction drive unit on the robot arm side.

[0018] Furthermore, this invention is characterized by a robot having the above-mentioned tool, a robot arm with the tool attached to its tip, a traction drive unit and a drive unit for driving the robot arm, and a control unit connected to apply a drive signal to the drive unit.

[0019] Furthermore, this invention is characterized by a manipulator comprising the above-described movable elongated structural device, a main body provided at the base end of the base end tubular body in the movable elongated structure, and an operating part in the main body for operating the traction drive unit.

[0020] Furthermore, this invention is characterized by a robot comprising: an input / output unit connected by wire and / or wirelessly to the above-mentioned movable elongated structural device; an input unit that receives operation signals in real time; a calculation unit that executes a predetermined operation program based on the operation signals; and an output unit that generates a drive signal based on the output from the calculation unit that pulls a predetermined traction operation body by the traction drive unit to deform at least the tip side tubular body in a desired direction by bending and / or extending (stretching).

[0021] The present invention also relates to a medical robot comprising the above-described robot, wherein the output unit provides a drive signal to a drive unit provided outside the robot for mechanically driving the movable elongated structure.

[0022] The present invention also relates to an insertion method, which inserts the above-described movable elongated structure into a pipeline, drives and controls the traction drive unit to bend and deform the distal tubular body, and inserts the distal tubular body into a branched pipeline.

[0023] The present invention also relates to a method of operating a robot. For a robot equipped with the above-described movable elongated structure device, when an input / output unit connected by wire and / or wirelessly receives an operation signal in real time, and an arithmetic unit executes a predetermined operation program based on the received operation signal, the traction operation body is tractioned by the traction drive unit based on the output from the arithmetic unit, so that the distal tubular body is bent and deformed and / or stretched (extended) deformed in a desired direction. According to these inventions, as described above, by bending at least the distal portion of the movable elongated structure toward a branched pipeline, it is possible to easily insert the branched pipeline.

Advantages of the Invention

[0024] According to the present invention, since the distal tubular body, the proximal tubular body, and the traction operation body are provided, it is possible to provide a movable elongated structure with high assembly property, a wiring auxiliary tool used for the movable elongated structure, a movable elongated structure device, a medical system, a tool, a manipulator, a robot, a medical robot, an insertion method, a method of operating a robot, and a method of operating a movable elongated structure.

Brief Description of the Drawings

[0025] [Figure 1] Explanatory drawing of a movable elongated structure. Fig. 1(a) is a perspective view of the movable elongated structure, and Fig. 1(b) is a perspective view of the movable elongated structure showing the distal flexible tube and the proximal flexible tube in a transparent state. [Figure 2]Diagram illustrating a movable elongated structure. Figure 2(a) is a front view of the movable elongated structure, and Figure 2(b) is a cross-sectional view taken along the line AA in Figure 2(a). [Figure 3] Diagram illustrating the movable elongated structure. Figure 3(a) is a cross-sectional view taken along arrow BB in Figure 2(a), Figure 3(b) is a cross-sectional view taken along arrow CC in Figure 2(a), and Figure 3(c) is a front view of the movable elongated structure with the spacer removed. [Figure 4] Diagrams illustrating the spacer. Figure 4(a) is a perspective view showing the front, right side, and top of the spacer; Figure 4(b) is a perspective view showing the front, left side, and bottom of the spacer; Figure 4(c) is a front view of the spacer; and Figure 4(d) is a cross-sectional view taken along the DD arrow in Figure 4(c). [Figure 5] Diagram illustrating a movable elongated structure. Figure 5(a) is an exploded perspective view of the movable elongated structure seen from the base end, Figure 5(b) is an exploded perspective view of the movable elongated structure seen from the tip end, Figure 5(c) is an enlarged view of part a in Figure 5(a), and Figure 5(d) is an enlarged view of part b in Figure 5(b). [Figure 6] A perspective view of a movable, elongated structure with the tip-side flexible tube bent. [Figure 7] Diagram illustrating a movable elongated structure with the tip-side flexible tube bent. Figure 7(a) is a cross-sectional view corresponding to the BB arrow cross-section in Figure 2(a) of the movable elongated structure with the tip-side flexible tube bent, and Figure 7(b) is a cross-sectional view corresponding to the CC arrow cross-section in Figure 2(a). [Figure 8] This diagram illustrates a movable elongated structure with the tip-side flexible tube bent diagonally. Figure 8(a) is a cross-sectional view corresponding to the BB arrow cross-section in Figure 2(a) of the movable elongated structure with the tip-side flexible tube bent diagonally, and Figure 8(b) is a cross-sectional view corresponding to the CC arrow cross-section in Figure 2(a). [Figure 9] An illustrative diagram showing the clinical use of a movable, elongated structure. [Figure 10]An explanatory diagram of another embodiment of a movable elongated structure with the tip-side flexible tube bent. Figure 10(a) is a cross-sectional view of the movable elongated structure of another embodiment corresponding to the cross-sectional view taken along arrow BB in Figure 2(a), Figure 10(b) is a cross-sectional view of the said movable elongated structure corresponding to the cross-sectional view taken along arrow CC in Figure 2(a), Figure 10(c) is a cross-sectional view of the movable elongated structure of yet another embodiment corresponding to the cross-sectional view taken along arrow BB in Figure 2(a), and Figure 10(d) is a cross-sectional view of the said movable elongated structure corresponding to the cross-sectional view taken along arrow CC in Figure 2(a). [Figure 11] Diagram illustrating a different configuration of the movable elongated structure. Figure 11(a) is a perspective view of the movable elongated structure with a different configuration, and Figure 11(b) is a perspective view of the movable elongated structure showing the tip-side flexible tube and the base-side flexible tube in a transparent state. [Figure 12] An explanatory diagram of a movable elongated structure in a different arrangement pattern. Figure 12(a) is a front view of the movable elongated structure, and Figure 12(b) is a cross-sectional view taken along the line AA in Figure 12(a). [Figure 13] Diagram illustrating a spacer in another embodiment. Figure 13(a) is a perspective view showing the front, right side, and top of the spacer in another embodiment, Figure 13(b) is a perspective view showing the front, left side, and top of the spacer, and Figure 13(c) is a top view of the spacer. [Figure 14] Diagram illustrating another embodiment of a movable elongated structure. Figure 14(a) is a front view of the movable elongated structure, Figure 14(b) is a cross-sectional view taken along the EE arrow in Figure 15(a), and Figure 14(c) is a rear view of the movable elongated structure. [Figure 15] Diagram illustrating a movable elongated structure in another embodiment. Figure 15(a) is a cross-sectional view taken along the FF arrow in Figure 14(a), Figure 15(b) is a cross-sectional view taken along the GG arrow in Figure 14(a), and Figure 15(c) is a cross-sectional view taken along the HH arrow in Figure 14(a). [Figure 16] Diagram illustrating a spacer in another embodiment. Figure 16(a) is a perspective view showing the front, right side, and top of the spacer; Figure 16(b) is a perspective view showing the back, right side, and top of the spacer; Figure 16(c) is a front view of the spacer; and Figure 16(d) is a top view of the spacer. [Figure 17]Diagram illustrating a spacer in another embodiment. Figure 17(a) is a perspective view showing the front, right side, and top of the spacer; Figure 17(b) is a perspective view showing the back, right side, and top of the spacer; Figure 17(c) is a front view of the spacer; and Figure 17(d) is a side view of the spacer. [Figure 18] Further diagrams illustrating a movable elongated structure and spacer in another embodiment. Figure 18(a) is a perspective view of the movable elongated structure, Figure 18(b) is a cross-sectional view taken along arrow II in Figure 18(a), and Figure 18(c) is a cross-sectional view taken along arrow JJ in Figure 18(a). [Figure 19] Diagrams illustrating a movable elongated structure and spacer in yet another embodiment. Figure 19(a) is a perspective view of a spacer in yet another embodiment, Figure 19(b) is a side view of the spacer viewed from the tip side, and Figure 19(c) is a side view of the spacer viewed from the base end side. [Figure 20] Further diagrams illustrating another embodiment of the movable elongated structure. Figure 20(a) is a perspective view of the movable elongated structure before assembly, Figure 20(b) is a perspective view of the movable elongated structure in the assembled state, and Figure 20(c) is a perspective view of the movable elongated structure with the traction wire routed. [Figure 21] Further diagrams illustrating another embodiment of the movable elongated structure. Figure 21(a) is a front view of the movable elongated structure before assembly, Figure 21(b) is a front view of the movable elongated structure in the assembled state, and Figure 21(c) is a front view of the movable elongated structure with the towing wires routed. [Figure 22] Diagram illustrating the assembly spacer. Figure 22(a) is an enlarged cross-sectional view of the assembly spacer before assembly, and Figure 22(b) is an enlarged cross-sectional view of the assembly spacer in the assembled state. [Figure 23] Schematic diagrams of retractors in other embodiments. Figure 23(a) is a perspective view of the retractor, and Figure 23(b) is a perspective view of the retractor with the towing wire shown in a transparent state. [Figure 24] Schematic diagrams of retractors in other embodiments. Figure 24(a) is a plan view of the retractor, Figure 24(b) is a cross-section passing through the upper wire lumen, and Figure 24(c) is a plan view of the retractor with the elastic retractor in the open position. [Figure 25] Schematic diagram of a medical device in another embodiment. [Figure 26] Schematic diagram of a remote surgery system in another embodiment. [Figure 27] Schematic diagram of a surgical device in a remote surgery system. Figure 27(a) is a plan view of a surgical device that can be mounted on the robotic arm assembly of the remote surgery system, and Figure 27(b) shows the internal configuration of the surgical device in Figure 27(a). [Figure 28] Diagrams illustrating the remote surgery system. Figure 28(a) is a block diagram showing the connection relationships between each unit, and Figure 28(b) is an operation flow diagram of the remote surgery system. [Figure 29] Figure 29(a) shows the results of a demonstration experiment of a movable elongated structure. Figure 29(b) shows the results of the initial state, Figure 29(b) shows the results of the movable elongated structure in a bent state, and Figure 29(c) shows the results of the movable elongated structure, which mimics a conventional two-way movable elongated structure, in a bent state. [Figure 30] This diagram shows the results of a demonstration experiment comparing the bending radii of a movable, long-length structure. [Modes for carrying out the invention]

[0026] Embodiments of the present invention will be described below with reference to the drawings. In the following description, the same parts and components will be denoted by the same reference numerals. This embodiment includes, for example, the following disclosures.

[0027] [Configuration 1] A movable elongated structure (10,300) having a tip tubular body (20,60), a base tubular body (30), and a traction operating body (50), and equipped with a wiring aid (40) that is detachably held by the traction operating body (50) between the tip tubular body (20,60) and the base tubular body (30).

[0028] As an example, a movable elongated structure (10,300) comprises a flexible end-side tubular body (20,60) having a through hole, a flexible base-side tubular body (30) having a through hole, and a traction operating body (50). Furthermore, between the end-side tubular body (20,60) and the base-side tubular body (30), there is a cylindrical body (42), annular protruding edges (43) projecting radially outward from both ends of the cylindrical body (42), and an operating body placement section (44) having the shape of a recess or notch in which the traction operating body (50) is positioned. The traction operating body (50) is inserted through the through hole of the base-side tubular body (30), the operating body placement section (44) is detachably held by the operating body placement section (44), and the traction operating body (50) is inserted through the through hole of the end-side tubular body (20,60).

[0029] Furthermore, the tip tubular body (20) and the base tubular body (30) are formed in a flexible, elongated shape, and are provided with a pair of flexible traction operating bodies (50) that pass through a pair of through holes provided inside the tube walls of the tip tubular body (20) and the base tubular body (30) along the longitudinal direction (L), and a wiring aid (40) positioned between the tip tubular body (20) and the base tubular body (30) to restrict the direction of the traction operating bodies (50), and the through holes provided in the base tubular body (30) are connected to the base through holes ( 32) and the through hole provided in the tip tubular body (20) is designated as the tip through hole (22), and the circumferential spacing between a pair of base end through holes (32) (the spacing Rf between base end wire lumen 36b and base end wire lumen 35a, or the spacing Rg between base end wire lumen 36a and base end wire lumen 35b) is designated as the circumferential spacing between a pair of tip end through holes (22) (the spacing Ra between tip end wire lumen 23a and tip end wire lumen 23b, or the tip wire - The distance between the lumen 24a and the tip wire lumen 24b is set to be wider than Re), and the wiring aid (40) is provided with a cylindrical body (42) arranged along the longitudinal direction (L), a base-side projection (43b) provided at the base end (LB) of the cylindrical body (42) and projecting radially outward, and a tip-side projection (43a) provided at the tip end (LF) of the cylindrical body (42) and projecting radially outward, and a wire is led out from the base-side through hole (32) to the tip-side through hole (22) A proximity restricting portion (45b) is provided to restrict the proximity of the introduced traction operating body (50) in the circumferential direction, and an operating body placement portion (44) is provided which is open on the outer diameter and in which the traction operating body (50) is placed. Additionally, a separation restricting portion (45a) is provided on the tip side protruding edge portion (43a) to restrict the separation of the traction operating body (50) in the circumferential direction, which is led out from the base end side through hole (32) and introduced into the tip side through hole (22), and an operating body placement portion (44) is provided which is open on the outer diameter and in which the traction operating body (50) is placed.

[0030] The tip-side spacing (X1), which is the distance between the tip-side virtual line (FVL) connecting the centers of the pair of tip-side through holes (22) and the tip-side central line (FCL) passing through the center of the tip-side tubular body (20) and parallel to the tip-side virtual line (FVL), may be set wider than the base-side spacing (X2), which is the distance between the base-side virtual line (BVL) connecting the centers of the pair of base-side through holes (32) and the base-side central line (BCL) passing through the center of the base-side tubular body (30) and parallel to the base-side virtual line (BVL).

[0031] A pair of through-holes (32) on the base end side and a pair of through-holes (22) on the tip end side through-holes (22) through which a pair of traction operating bodies (50) are inserted are formed into a set of through-holes (11), and multiple sets of through-holes (11) may be arranged at different positions in the circumferential direction, and multiple proximity restricting parts (45b) and operating body placement parts (44) may be provided on the base end protruding edge (43b), and multiple spacing restricting parts (45a) and operating body placement parts (44) may be provided on the tip end protruding edge (43a).

[0032] At the base end protruding edge (43b), a common proximity restricting portion (45b) may be used to restrict the proximity of adjacent traction operating bodies (50) in the circumferential direction to each other among a pair of traction operating bodies (50) that pass through adjacent through-hole sets (11) in the circumferential direction. At the tip end protruding edge (43a), a common separation restricting portion (45a) may be used to restrict the separation of adjacent traction operating bodies (50) in the circumferential direction to each other among a pair of traction operating bodies (50) that pass through adjacent through-hole sets (11) on opposite sides in the circumferential direction.

[0033] One towing operator (50) and the other towing operator (50) intersect in the circumferential direction, passing through adjacent through-hole sets (11) in the circumferential direction, and the cylindrical body (42) may be provided with a guide portion (46) that guides one towing operator (50) to the outside of the other towing operator (50).

[0034] An elongated intermediate tubular body (60) having intermediate through holes (63, 64, 65, 66) is positioned between the tip-side tubular body (20) and the base-side tubular body (30), and a plurality of pairs of traction operating bodies (50) are provided. At least one pair of the plurality of traction operating bodies (50) is inserted through the tip-side through hole (22), the intermediate through holes (63, 64, 65, 66), and the base-side through hole (32), and at least one pair of the plurality of traction operating bodies (50) may be inserted through the intermediate through holes (63, 64, 65, 66) and the base-side through hole (32).

[0035] The traction operator (50) is a flexible wire, and the tip tubular body (20) and the base tubular body (30) are made of flexible tubes having main lumens (21, 31), and the through holes may be wire lumens formed inside the tube wall through which the wire can be inserted. The wire may be bent back at the tip end (LF) of the tip tubular body (20) to form a pair of traction operating bodies (50).

[0036] [Configuration 2] A wiring aid (40) is configured to be detachably held between the tip tubular body (20, 60) and the base tubular body (30) of a movable elongated structure (10, 300) having a tip tubular body (20, 60), a base tubular body (30), and a traction operating body (50). As an example, the wiring aid (40) comprises an annular projection (43) that protrudes radially outward from both ends of a cylindrical body (42), and an operating body placement section (44) having the shape of a recess or notch in which a traction operating body (50) is placed on the annular projection (43).

[0037] Furthermore, the device is provided with at least one cylindrical body (42) positioned along the longitudinal direction (L) between the flexible, elongated tip-side tubular body (20) and the base-side tubular body (30), which are arranged in series from the tip side (LF) to the base side (LB) along the longitudinal direction (L). At the base-side (LB) end of the cylindrical body (42), it protrudes radially outward, and the circumferential spacing between them is set to be wider than the circumferential spacing between a pair of tip-side through holes (22) that penetrate the longitudinal direction (L) and are provided inside the tube wall of the tip-side tubular body (20). A base-side protruding edge portion (43b) is provided with an operating body arrangement portion (44) where a pair of traction operating bodies (50) are arranged, which are led out from a pair of base-side through holes (32) that penetrate in the longitudinal direction (L) and are provided inside the tube wall of the end-side tubular body (30) and introduced into the tip-side through hole (22). A tip-side protruding edge portion (43a) is provided at the tip-side (LF) end of the cylindrical body (42), which protrudes outward in diameter and is also provided with an operating body arrangement portion (44) where the traction operating bodies (50) are arranged, which are led out from the base-side through holes (32) and introduced into the tip-side through hole (22).

[0038] Furthermore, the base end projection (43b) is provided at the base end (LB) of the cylindrical body (42), and the tip end projection (43a) is provided at the tip end (LF) of the cylindrical body (42). The base end projection (43b) is provided with a proximity restricting portion (45b) that restricts the circumferential proximity of the traction operating body (50), which is led out from the base end through hole (32) and introduced into the tip end through hole (22). The tip end projection (43a) is provided with a separation restricting portion (45a) that restricts the circumferential separation of the traction operating body (50), which is led out from the base end through hole (32) and introduced into the tip end through hole (22). The operating body placement portion (44) may have an open outer diameter.

[0039] A pair of through-holes (32) on the base end side and a pair of through-holes (22) on the tip end side through-holes (22) through which a pair of traction operating bodies (50) are inserted are formed into a set of through-holes (11), and multiple sets of through-holes (11) may be arranged at different positions in the circumferential direction, and multiple proximity restricting parts (45b) and operating body placement parts (44) may be provided on the base end protruding edge (43b), and multiple spacing restricting parts (45a) and operating body placement parts (44) may be provided on the tip end protruding edge (43a).

[0040] At the base end protruding edge (43b), a common proximity restricting portion (45b) may be used to restrict the proximity of adjacent traction operating bodies (50) in the circumferential direction to each other among a pair of traction operating bodies (50) that pass through adjacent through-hole sets (11) in the circumferential direction. At the tip end protruding edge (43a), a common separation restricting portion (45a) may be used to restrict the separation of adjacent traction operating bodies (50) in the circumferential direction to each other among a pair of traction operating bodies (50) that pass through adjacent through-hole sets (11) on opposite sides in the circumferential direction.

[0041] One towing operator (50) and the other towing operator (50) intersect in the circumferential direction, passing through adjacent through-hole sets (11) in the circumferential direction, and the cylindrical body (42) may be provided with a guide portion (46) that guides one towing operator (50) to the outside of the other towing operator (50).

[0042] [Configuration 3] A movable elongated structural device (100,217) is provided, comprising the aforementioned movable elongated structure (10,300) and a traction drive unit (102,221) for towing a pair of traction operating bodies (50), wherein the traction drive unit (102,221) tow the pair of traction operating bodies (50) to bend and deform the tubular end body (20).

[0043] [Structure 4] The movable elongated structure (100,217) is provided with the above-mentioned movable elongated structure (10,300) and a traction drive unit (102,221) for towing a pair of traction operating bodies (50), and a plurality of traction drive units (102,221) are provided, and a pair of traction operating bodies (50) are towed by a predetermined traction drive unit (102,221) to cause the tip side tubular body (20) to bend and / or expand / contract (extend) in a desired direction.

[0044] [Composition 5] A medical system (200) having the above-mentioned movable long-length structural device (100, 217), a drive unit that drives the traction drive unit (102, 221), and a control unit (104, 202) connected to apply a drive signal to the drive unit.

[0045] [Composition 6] A medical system (200) comprising the above-mentioned movable elongated structural device (100, 217), a drive unit that selectively drives at least one of a plurality of traction drive units (102, 221), and a control unit (104, 202) connected to apply a drive signal to the drive unit. An operating unit is provided for selectively operating at least one of the multiple traction drive units (102, 221), and may also be connected to a control unit (104, 202).

[0046] [Composition 7] A tool (217) comprising the above-mentioned movable elongated structural device (100, 217), a mounting part for attaching the base end tubular body (30) of the movable elongated structure (10, 300) to the tip of a robot arm (212), and a connecting part (228) for connecting to a drive mechanism that drives the traction drive unit (102, 221) on the robot arm (212) side.

[0047] [Structure 8] A robot comprising the aforementioned tool (217), a robot arm (212) with the tool (217) attached to its tip, a traction drive unit (102, 221), a drive unit for driving the robot arm (212), and control units (104, 202) connected to apply drive signals to the drive unit.

[0048] [Composition 9] A manipulator (100) comprising the above-mentioned movable elongated structural device (100) and a base end tubular body (30) of the movable elongated structure (10, 300) as the main body, and an operating part on the main body side for operating a traction drive unit (102, 221).

[0049] [Configuration 10] A robot comprising: an input / output unit (210a) connected by wire and / or wirelessly to the above-mentioned movable long structural device (100, 217); an input unit that receives operation signals in real time; a computing unit (CPU) that executes a predetermined operation program based on the operation signals; and an output unit that generates a drive signal based on the output from the computing unit (CPU) to pull a predetermined traction operation body (50) by a traction drive unit (102, 221) to deform at least the tip side tubular body (20) in a desired direction by bending and / or extending (extending).

[0050] [Composition 11] A medical robot equipped with the aforementioned robot, wherein the output unit provides drive signals to an externally located drive unit that mechanically drives a movable elongated structure (10,300). [Composition 12] An insertion method in which the above-mentioned movable elongated structure (10,300) is inserted into a conduit, the traction drive unit (102,221) is driven and controlled to bend and deform the tip-side tubular body (20), and the tip-side tubular body (20) is inserted into the branching conduit. The conduit may be at least one of a tubular organ, a blood vessel, or a blood vessel.

[0051] [Composition 13] A method for operating a robot equipped with the aforementioned movable long structural device (100, 217), wherein an input / output unit (210a) connected by wire and / or wirelessly receives operation signals in real time, and a computing unit (CPU) executes a predetermined operation program based on the received operation signals, and based on the output from the computing unit (CPU), a traction drive unit (102, 221) pulls a traction operation body (50) to bend and / or extend (stretch) the tip tubular body (20) in a desired direction.

[0052] [Composition 14] A method for operating a movable elongated structure (10,300) having a tip tubular body (20), a base tubular body (30), and a traction operating body (50), wherein a wiring aid (40) is provided between the tip tubular body (20) and the base tubular body (30), and the wiring aid (40) is detachably held by the traction operating body (50).

[0053] The tip-side tubular body (20) may be bent and deformed by pulling a pair of the towing operators (50), or multiple pairs of the towing operators (50) may be provided, and the tip-side tubular body (20) may be bent and deformed in a desired direction by pulling a predetermined pair of the towing operators (50) from among the multiple pairs.

[0054] The following examples describe the use of the present invention in a medical device as an example of a treatment tool, but the present invention provides treatment tools that are not limited to medical devices. First, let's explain the figures in detail. For example, Figure 1 shows an explanatory diagram of the movable elongated structure 10. Figure 1(a) shows a perspective view of the movable elongated structure 10, and Figure 1(b) shows a perspective view of the movable elongated structure 10 with the tip-side flexible tube 20 and the base-side flexible tube 30 (hereinafter referred to as flexible tubes 20 and 30) shown in a transparent state.

[0055] Figures 2 and 3 show explanatory diagrams of the movable elongated structure 10. Figure 2(a) shows a front view of the movable elongated structure 10, Figure 2(b) shows a cross-sectional view taken along arrow AA in Figure 2(a), Figure 3(a) shows a cross-sectional view taken along arrow BB in Figure 2(a), Figure 3(b) shows a cross-sectional view taken along arrow CC in Figure 2(a), and Figure 3(c) shows a front view of the movable elongated structure 10 with the spacer 40 removed.

[0056] Figure 4 shows an explanatory diagram of the spacer 40. Figure 4(a) shows perspective views of the front, right side, and top of the spacer 40, Figure 4(b) shows perspective views of the front, left side, and bottom of the spacer 40, Figure 4(c) shows a front view of the spacer 40, and Figure 4(d) shows a cross-sectional view taken along the DD arrow in Figure 4(c).

[0057] Figure 5 shows an explanatory diagram of the movable elongated structure 10. Figure 5(a) shows an exploded perspective view of the movable elongated structure 10 as seen from the base end LB, and Figure 5(b) shows an exploded perspective view of the movable elongated structure 10 as seen from the tip end LF. Figure 5(c) shows an enlarged view of part a in Figure 5(a), and Figure 5(d) shows an enlarged view of part b in Figure 5(b). In Figure 5, the towing wire 50 is shown as a dashed line.

[0058] Figure 6 shows a perspective view of the movable elongated structure 10 with the tip-side flexible tube 20 bent. Figure 7 shows an explanatory diagram of the movable elongated structure 10 with the tip-side flexible tube 20 bent. Figure 7(a) shows a cross-sectional view of the movable elongated structure 10 with the tip-side flexible tube 20 bent, corresponding to the cross-sectional view taken along arrow BB in Figure 2(a), and Figure 7(b) shows an enlarged cross-sectional view corresponding to the cross-sectional view taken along arrow CC in Figure 2(a).

[0059] Figure 8 shows an explanatory diagram of the movable elongated structure 10 with the tip-side flexible tube 20 bent diagonally. Figure 8(a) shows a cross-sectional view of the movable elongated structure 10 with the tip-side flexible tube 20 bent diagonally, corresponding to the cross-sectional view taken along arrow BB in Figure 2(a), and Figure 8(b) shows an enlarged cross-sectional view corresponding to the cross-sectional view taken along arrow CC in Figure 2(a).

[0060] Figure 9 shows an image of the movable elongated structure 10 being used in a clinical setting, and Figure 10 shows explanatory diagrams of the movable elongated structures 10a and 10b with the tip-side flexible tube 20 bent. Figure 10(a) shows a cross-sectional view of the movable elongated structure 10a in the bent state, corresponding to the cross-sectional view taken along arrow BB in Figure 2(a), and Figure 10(b) shows an enlarged cross-sectional view of the movable elongated structure 10a corresponding to the cross-sectional view taken along arrow CC in Figure 2(a). Figure 10(c) shows a cross-sectional view of the movable elongated structure 10b in the bent state, corresponding to the cross-sectional view taken along arrow BB in Figure 2(a), and Figure 10(d) shows an enlarged cross-sectional view of the movable elongated structure 10b corresponding to the cross-sectional view taken along arrow CC in Figure 2(a).

[0061] In the movable elongated structure 10, the longitudinal direction is defined as the longitudinal direction L. In the longitudinal direction L, the side of the tip-side flexible tube 20 relative to the base-side flexible tube 30 is defined as tip-side LF, and the side of the base-side flexible tube 30 relative to the tip-side flexible tube 20 is defined as base-side LB. For the sake of convenience in explaining the movable elongated structure 10, the vertical direction in Figure 1 is defined as the height direction H, the upper direction is defined as the upward direction HU, and the lower direction is defined as the downward direction HD. Furthermore, the direction connecting the upper right and lower left in Figure 1 is defined as the width direction W, the upper right direction is defined as the right-side WR, and the lower left direction is defined as the left-side WL.

[0062] Next, an embodiment of the movable elongated structure 10 will be described in detail with reference to Figures 1 to 5. The movable elongated structure 10 comprises a tip-side flexible tube 20 and a base-side flexible tube 30 arranged along the longitudinal direction L, a spacer 40 positioned between the tip-side flexible tube 20 and the base-side flexible tube 30, and a traction wire 50 inserted into the inside of the tube walls of the flexible tubes 20 and 30. The movable elongated structure 10 is covered on the outside along the longitudinal direction L with an outer cover (not shown). Alternatively, only the outside of the spacer 40 may be covered with an outer cover (not shown).

[0063] The tip-side flexible tube 20 is a cylindrical, flexible tube that is long in the longitudinal direction L, and contains a tip-side main lumen 21 (Figure 3(a): cross-sectional view taken along arrow BB in Figure 2(a)). The tip-side main lumen 21 is a space with a circular cross-section along the longitudinal direction L. Furthermore, as shown in Figure 3(a), the tip-side flexible tube 20 is provided with tip-side wire lumens 23a, 23b, 24a, 24b, 25a, 25b, 26a, 26b (hereinafter collectively referred to as 22) inside the tube wall between the tip-side main lumen 21 and the outer surface.

[0064] The tip wire lumen 22 is a circular cross-sectional space extending in the longitudinal direction L inside the pipe wall, and is formed with a diameter that allows the traction wire 50, which will be described later, to be inserted. The tip-side wire lumen 22 is provided in four directions within the ring-shaped cross-section of the tube wall.

[0065] Specifically, as shown in Figure 3(a), the tube wall has a ring-shaped cross-section and is equipped with wire lumens 23a and 23b (hereinafter collectively referred to as 23) at the tip of the upward HU, wire lumens 24a and 24b (hereinafter collectively referred to as 24) at the tip of the downward HD, wire lumens 25a and 25b (hereinafter collectively referred to as 25) at the tip of the right WR, and wire lumens 26a and 26b (hereinafter collectively referred to as 26) at the tip of the left WL.

[0066] Furthermore, as described above, the four end-side wire lumens 22 provided in the ring-shaped cross-section of the pipe wall are arranged in pairs, spaced at predetermined intervals in the circumferential direction of the circular cross-section, so as to allow a pair of traction wires 50 to pass through them.

[0067] In addition, in the tip wire lumen 22 which is composed of a pair of two through holes, the counterclockwise side is designated as 22a (23a, 24a, 25a, 26a), and the clockwise side is designated as 22b (23b, 24b, 25b, 26b).

[0068] Furthermore, the spacing Ra between the two tip-side wire lumens 22 (22a, 22b) provided in four directions on the ring-shaped cross-section of the tube wall (Ra is exemplified between 23a and 23b in Figure 3(a)) is set to be about half the spacing Rb between adjacent tip-side wire lumens 22 in the circumferential direction (23b and 25a, 25b and 24a, 24b and 26a, 26b and 23a) (Rb is exemplified between 23b and 25a in Figure 3(a)). Alternatively, the two tip-side wire lumens 22 provided in each of the four directions may be integrally formed and shaped into an ellipse.

[0069] As shown in Figures 1, 2, and 5, the tip cap 27 is provided at the end of the tip LF of the tip-side flexible tube 20. The tip cap 27 is provided with a bending recess 28 for forming a bent portion 51 of the towing wire 50, which will be described later. The bending recess 28 is provided in four locations, corresponding to the tip-side wire lumens 22 provided in four directions on the pipe wall, and each recess has two insertion holes for inserting the towing wire 50.

[0070] Furthermore, the tip cap 27 may be provided with a through-hole that penetrates in the longitudinal direction L by an instrument inserted into the main lumen formed by the communication of the tip-side main lumen 21, the internal space 41 (described later), and the base-side main lumen 31 in equipment using the movable elongated structure 10.

[0071] The tip-side flexible tube 20 configured as described above can be made of a flexible tube such as polyamide elastomer, stretched polytetrafluoroethylene, polyurethane, or polytetrafluoroethylene.

[0072] As shown in Figures 1, 2, and 3, the base-side flexible tube 30, like the tip-side flexible tube 20, is a cylindrical flexible tube that is long in the longitudinal direction L, and has a base-side main lumen 31 inside. The base-side main lumen 31 is a space with a circular cross-section along the longitudinal direction L. Furthermore, as shown in Figure 3(b) (cross-sectional view taken along the CC arrow in Figure 2(a)), the proximal flexible tube 30 is provided with proximal wire lumens 33a, 33b, 34a, 34b, 35a, 35b, 36a, 36b (hereinafter collectively referred to as 32) inside the tube wall between the proximal main lumen 31 and the outer surface.

[0073] The base wire lumen 32, like the tip wire lumen 22, is a circular cross-sectional space extending in the longitudinal direction L inside the pipe wall, and is formed with a diameter that allows the traction wire 50, which will be described later, to be inserted. The base-side wire lumen 32, like the tip-side wire lumen 22, is provided in four directions within the ring-shaped cross-section of the tube wall.

[0074] Specifically, as shown in Figure 3(b), the tube wall has a ring-shaped cross-section and is equipped with the following wire lumens: 33a, 33b (hereinafter collectively referred to as 33) on the base side of the upward HU, 34a, 34b (hereinafter collectively referred to as 34) on the base side of the downward HD, 35a, 35b (hereinafter collectively referred to as 35) on the base side of the right WR, and 36a, 36b (hereinafter collectively referred to as 36) on the base side of the left WL.

[0075] Furthermore, as described above, the base-end wire lumens 32 provided in four directions on the ring-shaped cross-section of the pipe wall are each provided in pairs at predetermined intervals in the circumferential direction of the circular cross-section, so as to allow a pair of traction wires 50 to be inserted through them. Alternatively, the two base-end wire lumens 32 provided in each of the four directions may be integrally formed and shaped into an ellipse.

[0076] Furthermore, in the base end wire lumen 32, which is composed of a pair of two through holes, the counterclockwise side is designated as 32a (33a, 34a, 35a, 36a), and the clockwise side is designated as 32b (33b, 34b, 35b, 36b).

[0077] Furthermore, the spacing Rc (in Figure 3(b), Rc is shown as an example between 33a and 33b) between the two proximal wire lumens 32 (32a, 32b) provided in four directions on the ring-shaped cross-section of the tube wall is set to approximately half the spacing Rd (in Figure 3(b), Rd is shown as an example between 33b and 35a) between adjacent proximal wire lumens 32 (33b and 35a, 35b and 34a, 34b and 36a, 36b and 33a) in the circumferential direction.

[0078] The proximal flexible tube 30, configured as described above, can be made of a flexible tube such as polyamide elastomer, stretched polytetrafluoroethylene, polyurethane, or polytetrafluoroethylene, similar to the tip flexible tube 20. The tip flexible tube 20 and the proximal flexible tube 30 may be made of the same material or different materials.

[0079] As shown in Figures 4 and 5, the spacer 40 comprises a cylinder 42 having an internal space 41 with a circular cross-section that penetrates in the longitudinal direction L, and protruding edges 43 (43a, 43b) provided at both ends of the cylinder 42 in the longitudinal direction L. The internal space 41 is formed with the same diameter as the main lumens 21 and 31 described above. The cylinder 42 is formed with a diameter that is positioned inside the diameter of the traction wire 50 that is inserted through the tip-side wire lumen 22 provided in the tip-side flexible tube 20 and the base-side wire lumen 32 provided in the base-side flexible tube 30.

[0080] The protruding edges 43 (43a, 43b) are formed with an outer diameter that protrudes outward from the outer diameter of the cylinder 42, and are provided with placement recesses 44 for positioning the traction wire 50 at locations corresponding to the tip-side wire lumen 22 and the base-side wire lumen 33 (hereinafter referred to as wire lumens 22 and 32). The protruding edges 43 are formed with an outer diameter equivalent to the outer diameter of the tip-side flexible tube 20 and the base-side flexible tube 30.

[0081] The arrangement recess 44 is a recess for arranging two traction wires 50 that are inserted into two wire lumens 22 and 32, and is formed with a width and depth corresponding to the two wire lumens 22 and 32. Of the protruding edges 43 provided on both sides of the cylinder 42 in the longitudinal direction L, the tip side LF is designated as the tip side protruding edge 43a, and the base side LB is designated as the base side protruding edge 43b.

[0082] Furthermore, the space between the multiple arrangement recesses 44 provided in the circumferential direction on the tip-side protruding edge portion 43a is designated as a spacing restriction portion 45a. More specifically, the spacing restriction portions 45a provided on both sides of the arrangement recess 44 restrict the circumferential separation of the traction wires 50 arranged in the same arrangement recess 44 on the tip-side protruding edge portion 43a.

[0083] Specifically, the separation of the traction wires 50, which are placed in the arrangement recesses 44 provided in four directions on the tip-side protruding edge portion 43a, in the circumferential direction is restricted by the separation restricting portions 45a located on both sides of the arrangement recesses 44 on the tip-side protruding edge portion 43a.

[0084] Furthermore, the area between the multiple arrangement recesses 44 provided in the circumferential direction on the base end protruding edge portion 43b is designated as a proximity restriction portion 45b. More specifically, the proximity restriction portion 45b between the arrangement recesses 44 prevents the traction wires 50, which are arranged in adjacent arrangement recesses 44 in the circumferential direction on the base end protruding edge portion 43b, from approaching each other in the circumferential direction.

[0085] Specifically, the distance between the upper HU placement recess 44 and the right WR placement recess 44 is restricted by the spacing restriction portion 45a between the upper HU placement recess 44 and the right WR placement recess 44, preventing the traction wire 50 located in the upper HU placement recess 44 of the base end protruding edge portion 43b from being in close proximity to the traction wire 50 located in the upper HU placement recess 44 of the right WR.

[0086] Similarly, the distance between the right WR placement recess 44 and the downward HD placement recess 44 is restricted by the separation restriction section 45a between the right WR placement recess 44 and the downward HD placement recess 44. The distance between the left WL placement recess 44 and the downward HD placement recess 44 is restricted by the separation restriction section 45a between the downward HD placement recess 44 and the left WL placement recess 44. The distance between the upward HU placement recess 44 and the upward HU placement recess 44 is restricted by the separation restriction section 45a between the left WL placement recess 44 and the upward HU placement recess 44.

[0087] Furthermore, the cylinder 42 is provided with a guide projection 46 at its longitudinal end L that guides the traction wire 50 radially outward. The guide projection 46 is provided at the end in the longitudinal direction L at a position corresponding to the arrangement recess 44 of the protruding edge 43, with a corresponding width, and is formed to have a trapezoidal vertical cross-sectional shape, with the protruding height gradually increasing from the end in the longitudinal direction L toward the center in the longitudinal direction L of the cylinder 42 (see Figure 4(d)).

[0088] The guide projections 46 are provided at both ends in the longitudinal direction L, at positions that are radially opposite to each other among the arrangement recesses 44 provided in four directions, and are provided so that the opposing directions are perpendicular between the tip-side guide projection 46a of the tip-side LF and the base-side guide projection 46b of the base-side LB.

[0089] Specifically, the tip-side guide projection 46a of the tip-side LF is provided in the upper direction HU and the lower direction HD so as to be opposite to the height direction H, and the base-side guide projection 46b of the base-side LB is provided in the right side WR and the left side WL so as to be opposite to the width direction W.

[0090] The spacer 40 configured as described above can be made of, for example, a metal material such as stainless steel, an elastic material such as polytetrafluoroethylene, an elastic material such as a spring, or a resin material.

[0091] Furthermore, the spacer 40 may be formed as an integral part of the cylinder 42 and the protruding edge 43, or it may be formed as a separate part and assembled. If the cylinder 42 and the protruding edge 43 are formed as separate parts, they may be made of the same material or different materials.

[0092] The towing wire 50 is a flexible wire and, as shown in Figures 1 and 2, is formed to be at least twice the length L in the longitudinal direction of the movable elongated structure 10. The towing wire 50 consists of a bent return portion 51 positioned in the bent recess 28 of the tip cap 27, and two towing portions 52 located on the base end side LB from the bent return portion 51.

[0093] As described above, the towing wire 50, which is bent back at the bending return section 51 and has a pair of towing sections 52, is provided in four sections corresponding to the wire lumens 22 and 32 provided in four directions. Specifically, there are towing sections 53a and 53b (hereinafter collectively referred to as 53) located generally upward HU, towing sections 54a and 54b (hereinafter collectively referred to as 54) located generally downward HD, towing sections 55a and 55b (hereinafter collectively referred to as 55) located generally on the right WR, and towing sections 56a and 56b (hereinafter collectively referred to as 56) located generally on the left WL.

[0094] In each of the towing sections 53, 54, 55, and 56, one side of the portion corresponding to the towing section 52 (the counterclockwise side in the inserted state) is designated as towing section 53a, 54a, 55a, and 56a, while the other side (the clockwise side in the inserted state) is designated as towing section 53b, 54b, 55b, and 56b. The towing wire 50 can be made of metal materials such as stainless steel, or nylon, fluorocarbon, etc.

[0095] The assembly of the movable elongated structure 10, in which each element is configured as described above, will be explained below. First, the tip-side flexible tube 20, spacer 40, and base-side flexible tube 30 are arranged in series along the longitudinal direction L, from the tip-side LF towards the base-side LB.

[0096] At this time, as shown in Figures 1, 2, and 5, the tip-side wire lumens 22 (23, 24, 25, 26), the four-directional arrangement recesses 44, and the base-side wire lumens 32 (33, 34, 35, 36) are arranged to communicate in the longitudinal direction L. Then, the towing portion 52 (Figure 1) of the towing wire 50, which has been bent back near the middle of its length to form a bent portion 51, is inserted into the tip-side wire lumen 22, the arrangement recess 44, and the base-side wire lumen 32.

[0097] Specifically, first, the traction portion 53a of the traction portion 53 is inserted from the tip side LF into the tip side wire lumen 23a of the left WL in the tip side wire lumen 23 (Figure 3(a)), and the traction portion 53b is inserted into the tip side wire lumen 23b of the right side WR, thereby leading out the traction portion 53 from the base end LB of the tip side wire lumen 23, and the bend return portion 51 is positioned in the bend recess 28 of the upward direction HU.

[0098] The traction portion 53, which is led out from the base end LB of the tip wire lumen 23, is placed in the upper HU arrangement recess 44 of the tip protruding edge 43a, extends diagonally downward toward the base end LB along the cylinder 42, and is placed in the upper HU of the widthwise arrangement recess 44 of the base protruding edge 43b.

[0099] Specifically, the traction portion 53a, which is led out from the tip wire lumen 23a, is positioned on the left WL in the upper HU arrangement recess 44 at the tip edge portion 43a, extends downward HD along the cylinder 42 toward the left WL, and is positioned on the upper HU of the left WL arrangement recess 44 at the base edge portion 43b. It is then inserted into the base wire lumen 36b of the upper HU in the base wire lumen 36 of the left WL of the base flexible tube 30, and is led out from the base LB.

[0100] The traction portion 53b, which is led out from the tip wire lumen 23b, is positioned in the right WR in the upper HU arrangement recess 44 at the tip edge portion 43a, extends downward HD along the cylinder 42 toward the right WR, and is positioned in the upper HU of the right WR arrangement recess 44 at the base edge portion 43b. It is then inserted into the base wire lumen 35a of the upper HU in the base wire lumen 35 of the right WR in the base flexible tube 30, and is led out from the base LB.

[0101] As shown in Figures 2 and 3, the tip wire lumen 22 of the tip flexible tube 20 through which the traction portion 52 is inserted and the base wire lumen 32 of the base flexible tube 30 form a pair of through-holes 11. The tip wire lumen 23a of the tip flexible tube 20 and the base wire lumen 36b of the base flexible tube 30 form a pair of through-holes 11a through which the traction portion 53a is inserted, and the tip wire lumen 23b and the base wire lumen 35a form a pair of through-holes 11b through which the traction portion 53b is inserted.

[0102] Then, as shown in Figure 3(b), a through-hole assembly 11a is formed, and the line passing through the center of the base-side wire lumen 36b through which the traction portion 53 is inserted and the center of the base-side wire lumen 35a that constitutes the through-hole assembly 11b and through which the traction portion 53 is inserted is defined as the base-side virtual line BVL. A line passing through the center of the base-side flexible tube 30 and parallel to the base-side virtual line BVL is defined as the base-side central line BCL, and the distance between the base-side central line BCL and the base-side virtual line BVL is defined as the base-side distance X2.

[0103] As shown in Figure 3(a), the line passing through the center of the tip-side wire lumen 23a through which the traction portion 53 is inserted, and the line passing through the center of the tip-side wire lumen 23b through which the traction portion 53 is inserted, constitutes the through-hole assembly 11a and is defined as the tip-side virtual line FVL. The line passing through the center of the tip-side flexible tube 20 and parallel to the tip-side virtual line FVL is defined as the tip-side central line FCL. The distance between the tip-side central line FCL and the tip-side virtual line FVL is defined as the tip-side spacing X1. In this case, the tip-side spacing X1 is wider than the base-side spacing X2.

[0104] Next, as shown in Figures 1 and 3(a), the traction portion 54a of the traction portion 54 is inserted from the tip side LF into the tip side wire lumen 24a of the right side WR in the tip side wire lumen 24, and the traction portion 54b is inserted into the tip side wire lumen 24b of the left side WL, thereby leading out the traction portion 54 from the base end side LB of the tip side wire lumen 24, and the bent return portion 51 is positioned in the downward bending recess 28 of HD.

[0105] The traction portion 54, which is led out from the base end LB of the tip wire lumen 24, is placed in the downward HD arrangement recess 44 of the tip protruding edge 43a, extends diagonally upward toward the base end LB along the cylinder 42, and is placed in the downward HD of the widthwise arrangement recess 44 of the base protruding edge 43b.

[0106] Specifically, the traction portion 54a, which is led out from the tip wire lumen 24a, is positioned in the right WR in the downward HD arrangement recess 44 at the tip protruding edge portion 43a, extends upward HU along the cylinder 42 toward the right WR, and is positioned in the downward HD of the right WR arrangement recess 44 at the base end protruding edge portion 43b. It is then inserted into the base end wire lumen 35b of the downward HD in the base end wire lumen 35 of the right WR in the base end flexible tube 30, and is led out from the base end LB.

[0107] The traction portion 54b, which is led out from the tip wire lumen 24b, is positioned on the left WL in the downward HD arrangement recess 44 at the tip protruding edge 43a, extends upward HU and toward the left WL along the cylinder 42, and is positioned on the downward HD of the left WL arrangement recess 44 at the base end protruding edge 43b. It is then inserted into the base wire lumen 36a of the downward HD in the base wire lumen 36 of the left WL of the base flexible tube 30, and is led out from the base LB.

[0108] Furthermore, the tip-side wire lumen 24a of the tip-side flexible tube 20 and the base-side wire lumen 35b of the base-side flexible tube 30 are through-hole sets 11c through which the traction portion 54a is inserted, and the tip-side wire lumen 24b and the base-side wire lumen 36a are through-hole sets 11d through which the traction portion 54b is inserted (see Figures 3(a) and (b)).

[0109] The distance (X2) between the base-side virtual line (BVL) passing through the center of the base-side wire lumen 35b through which the traction portion 54 is inserted and the center of the base-side wire lumen 36a through which the traction portion 54 is inserted and the base-side virtual line (BVL) passing through the center of the base-side flexible tube 30 is wider than the distance (X1) between the tip-side virtual line (FVL) passing through the center of the tip-side wire lumen 24a through which the traction portion 54 is inserted and the center of the tip-side wire lumen 24b through which the traction portion 54 is inserted and the base-side virtual line (FVL) passing through the center of the tip-side flexible tube 20.

[0110] Next, as shown in Figure 3(a), the traction portion 55a of the traction portion 55 is inserted from the tip side LF into the tip side wire lumen 25a in the upward direction HU of the tip side wire lumen 25, and the traction portion 55b is inserted into the tip side wire lumen 25b in the downward direction HD, thereby leading out the traction portion 55 from the base end side LB of the tip side wire lumen 25, and the bent return portion 51 is positioned in the bent recess 28 of the right side WR.

[0111] The traction portion 55, which is led out from the base end LB of the tip wire lumen 25, is placed in the arrangement recess 44 of the right WR of the tip edge portion 43a, extends diagonally along the cylinder 42 toward the center in the width direction toward the base end LB, and is placed in the right WR of the arrangement recess 44 in the height direction H of the base edge portion 43b.

[0112] Specifically, as shown in Figures 1, 3, and 5, the traction portion 55a, which is led out from the tip-side wire lumen 25a, is positioned in the upward HU in the right-side WR arrangement recess 44 at the tip-side protruding edge 43a, extends toward the left-side WL and upward HU, and is positioned in the right-side WR of the upward HU arrangement recess 44 at the base-side protruding edge 43b. It is then inserted through the base-side wire lumen 33b of the right-side WR in the base-side wire lumen 33 of the upward HU in the base-side flexible tube 30, and is led out from the base-side LB.

[0113] Furthermore, the traction portion 55a, which is positioned in the upward direction HU of the arrangement recess 44 for the right WR at the tip-side protruding edge portion 43a, extends toward the left WL and upward direction HU, and is positioned on the right WR of the arrangement recess 44 for the upward direction HU at the base-side protruding edge portion 43b, is positioned across the tip-side guide projection 46a of the right WR provided on the tip-side LF and the base-side guide projection 46b of the upward direction HU provided on the base-side LB, and is spaced apart from the outer surface of the cylinder 42 between the tip-side guide projection 46a and the base-side guide projection 46b.

[0114] The traction portion 55b, which is led out from the tip wire lumen 25b, is positioned in the downward HD in the right WR arrangement recess 44 at the tip edge portion 43a, extends toward the left WL and downward HD, and is positioned in the right WR of the downward HD arrangement recess 44 at the base edge portion 43b. It is then inserted into the base wire lumen 34a of the right WR in the base wire lumen 34 of the downward HD in the base flexible tube 30, and is led out from the base LB.

[0115] Furthermore, the traction portion 55b, which is positioned upward HU in the arrangement recess 44 for the right WR at the tip-side protruding edge portion 43a, extends toward the left WL and downward HD, and is positioned on the right WR in the arrangement recess 44 for the downward HD at the base-side protruding edge portion 43b, is positioned across the tip-side guide projection 46a of the right WR provided on the tip-side LF and the base-side guide projection 46b of the downward HD provided on the base-side LB, and is spaced apart from the outer surface of the cylinder 42 between the tip-side guide projection 46a and the base-side guide projection 46b.

[0116] Furthermore, the tip-side wire lumen 25a of the tip-side flexible tube 20 and the base-side wire lumen 33b of the base-side flexible tube 30 are through-hole sets 11e through which the traction portion 55a is inserted, and the tip-side wire lumen 25b and the base-side wire lumen 34a are through-hole sets 11f through which the traction portion 55b is inserted (see Figures 3(a) and (b)).

[0117] The distance (X2) between the base-side virtual line (BVL) passing through the center of the base-side wire lumen 33b through which the traction portion 55 is inserted and the center of the base-side wire lumen 34a through which the traction portion 55 is inserted and the base-side virtual line (BVL) passing through the center of the base-side flexible tube 30 is wider than the distance (X1) between the tip-side virtual line (FVL) passing through the center of the tip-side wire lumen 25a through which the traction portion 55 is inserted and the center of the tip-side wire lumen 25b through which the traction portion 55 is inserted and the base-side virtual line (FVL) passing through the center of the tip-side flexible tube 20.

[0118] Next, the traction portion 56a of the traction portion 56 is inserted from the tip side LF into the tip side wire lumen 26a in the downward HD direction of the tip side wire lumen 26, and the traction portion 56b is inserted into the tip side wire lumen 26b in the upward HU direction, thereby leading out the traction portion 56 from the base end side LB of the tip side wire lumen 26, and the bent return portion 51 is positioned in the bent recess 28 of the left side WL.

[0119] The traction portion 56, which is led out from the base end LB of the tip wire lumen 26, is placed in the arrangement recess 44 on the left side WL of the tip edge portion 43a, extends diagonally towards the center in the width direction toward the base end LB along the cylinder 42, and is placed in the left side WL of the arrangement recess 44 in the height direction H of the base edge portion 43b.

[0120] Specifically, as shown in Figures 1 and 5(a), the traction portion 56a, which is led out from the tip-side wire lumen 26a, is positioned in the downward HD direction in the left WL arrangement recess 44 at the tip-side protruding edge 43a, extends toward the right WR and downward HD direction, and is positioned in the left WL direction in the downward HD arrangement recess 44 at the base-side protruding edge 43b. It is then inserted through the base-side wire lumen 34b of the left WL direction in the base-side wire lumen 34 of the downward HD direction in the base-side flexible tube 30, and is led out from the base-side LB direction.

[0121] Furthermore, the traction portion 56a, which is positioned in the downward direction HD in the arrangement recess 44 of the left WL at the tip-side protruding edge portion 43a, extends toward the right WR and downward direction HD, and is positioned on the left WL of the arrangement recess 44 of the downward direction HD at the base-side protruding edge portion 43b, is positioned across the tip-side guide projection 46a of the left WL provided on the tip-side LF and the base-side guide projection 46b of the downward direction HD provided on the base-side LB, and is spaced apart from the outer surface of the cylinder 42 between the tip-side guide projection 46a and the base-side guide projection 46b.

[0122] The traction portion 56b, which is led out from the tip wire lumen 26b, is positioned in the upward direction HU in the arrangement recess 44 of the left WL at the tip edge portion 43a, extends toward the right WR and upward direction HU, and is positioned in the left WL of the arrangement recess 44 of the upward direction HU at the base edge portion 43b. It is then inserted into the base wire lumen 33a of the left WL in the base wire lumen 33 of the upward direction HU at the base flexible tube 30, and is led out from the base LB.

[0123] Furthermore, the traction portion 56b, which is positioned downward HD in the arrangement recess 44 of the left WL at the tip-side protruding edge portion 43a, extends toward the right WR and upward HU, and is positioned on the left WL of the arrangement recess 44 of the upward HU at the base-side protruding edge portion 43b, is positioned across the tip-side guide projection 46a of the left WL provided on the tip-side LF and the base-side guide projection 46b of the upward HU provided on the base-side LB, and is spaced apart from the outer surface of the cylinder 42 between the tip-side guide projection 46a and the base-side guide projection 46b.

[0124] Furthermore, the tip-side wire lumen 26a of the tip-side flexible tube 20 and the base-side wire lumen 34b of the base-side flexible tube 30 are configured as through-hole sets 11g through which the traction portion 56a is inserted, and the tip-side wire lumen 26b and the base-side wire lumen 33a are configured as through-hole sets 11h through which the traction portion 56b is inserted (see Figures 3(a) and (b)).

[0125] The distance (X2) between the base side virtual line (BVL) passing through the center of the base end wire lumen 34b through which the traction portion 56 is inserted and the center of the base end wire lumen 33a through which the traction portion 56 is inserted and the base end virtual line (BVL) passing through the center of the base end central line (BCL) passing through the center of the base end flexible tube 30 is wider than the distance (X1) between the tip side virtual line (FVL) passing through the center of the tip end wire lumen 26a through which the traction portion 56 is inserted and the center of the tip end wire lumen 26b through which the traction portion 56 is inserted and the base end virtual line (FVL) passing through the center of the tip end flexible tube 20.

[0126] Furthermore, in the spacer 40 of the movable elongated structure 10 assembled as described above, the traction portion 55 and the traction portion 56 extend diagonally across the tip-side guide projection 46a of the tip-side LF and the base-side guide projection 46b of the base-side LB, and are positioned radially outward from the cylinder 42. As a result, they are positioned beyond the radially outward of the traction portion 53 and the traction portion 54, which extend diagonally along the cylinder 42.

[0127] As described above, when the towing wire 50 is inserted through the wire lumens 22 and 32 and positioned, the two towing portions 52 are positioned in the positioning recesses 44 of the spacer 40. Specifically, as shown in Figure 5(d), the traction portions 53a and 53b are positioned in the upper HU positioning recess 44 of the tip-side protruding edge portion 43a, the traction portions 54a and 54b are positioned in the lower HD positioning recess 44, the traction portions 55a and 55b are positioned in the right WR positioning recess 44, and the traction portions 56a and 56b are positioned in the left WL positioning recess 44.

[0128] Then, as shown in Figure 5(c), the traction portions 56b and 55a are positioned in the upper HU positioning recess 44 of the base end protruding edge portion 43b, the traction portions 56a and 55b are positioned in the lower HD positioning recess 44, the traction portions 53b and 54a are positioned in the right WR positioning recess 44, and the traction portions 53a and 54b are positioned in the left WL positioning recess 44.

[0129] In the above explanation, the towing sections 53, 54, 55, and 56 were inserted in that order, but the insertion order is not limited, and they can be inserted in any order. Alternatively, the wire may be inserted in this order from the base end LB toward the tip end LF through the base end wire lumen 32, the placement recess 44, and the tip end wire lumen 22, then bent back at the bending recess 28 of the tip end LF to form a bent return portion 51, and the tip end wire lumen 22, the placement recess 44, and the base end wire lumen 32 may be inserted in this order.

[0130] Furthermore, the traction wire 50 may be inserted through the tip-side wire lumen 22 of the tip-side flexible tube 20 and the base-side wire lumen 32 of the base-side flexible tube 30, which are arranged along the longitudinal direction L. Then, the traction wire 50 between the tip-side flexible tube 20 and the base-side flexible tube 30 may be loosened, a spacer 40 may be placed between the tip-side flexible tube 20 and the base-side flexible tube 30, and the loosened traction wire 50 may be placed in the placement recess 44 for assembly.

[0131] The movable elongated structure 10 configured in this way has the following characteristics compared to conventionally used bidirectional movable nephroureteroscopes and movable bile duct catheters. The movable elongated structure 10 can be formed with an outer diameter (1.8~3.2 mm) that is thinner at its narrowest point than a nephroureteroscope and wider at its widest point than a movable bile duct catheter.

[0132] Furthermore, the tip-side flexible tube 20 and proximal-side flexible tube 30 that constitute the movable elongated structure 10 can be made of flexible tubing, and can be freely moved and bent in all four directions (all directions) up to approximately 270 degrees, which is the same maximum bending angle as that of a nephroureteroscope.

[0133] Furthermore, as shown in Figures 6 to 8, the movable elongated structure 10 configured in this way can be smoothly bent in the longitudinal direction L by pulling the traction wire 50 to the base end LB. Specifically, the tip-side flexible tube 20 can be bent upwards (HU) by pulling the traction portion 53 through which the tip-side wire lumen 23 in the upward direction (HU) is inserted toward the base end (LB), and the tip-side flexible tube 20 can be bent downwards (HD) by pulling the traction portion 54 through which the tip-side wire lumen 24 in the downward direction (HD) is inserted toward the base end (LB).

[0134] Furthermore, by pulling the traction portion 55 through which the tip wire lumen 25 of the right WR is inserted in the tip-side flexible tube 20 toward the base end LB, the tip-side flexible tube 20 can be bent toward the right WR, and by pulling the traction portion 56 through which the tip wire lumen 26 of the left WL is inserted toward the base end LB, the tip-side flexible tube 20 can be bent toward the left WL.

[0135] More specifically, as shown in Figure 7, the traction portion 53a of the traction portion 53, which is inserted through the tip-side wire lumen 23a (Figure 7(a)) of the upward HU in the tip-side flexible tube 20, is inserted through the base-side wire lumen 36b (Figure 7(b)) of the upward HU in the base-side wire lumen 36 of the left-side WL in the base-side flexible tube 30, and the traction portion 53b is inserted through the base-side wire lumen 35a of the upward HU in the base-side wire lumen 35 of the right-side WR.

[0136] In the width direction W, the circumferential spacing Rf between the base end wire lumens 35a and 36b, which are in the upward direction HU of the base end wire lumens 35 and 36, is wider than the circumferential spacing Ra between the tip end wire lumens 23a and 23b of the tip end wire lumen 23, and the tip end wire lumens 23a and 23b are located in the upward direction HU relative to the base end wire lumens 35a and 36b.

[0137] Therefore, when the traction portion 53 is pulled towards the base end LB, as shown in Figure 7(a), in the base end wire lumens 35a and 36b, which have a wide circumferential spacing, there is almost no tensile force acting on the base end flexible tube 30 in the bending direction. In the tip end flexible tube 20, the traction portion 53, which is inserted into the tip end wire lumen 23 positioned upward HU, acts eccentrically upward HU, causing the tip end flexible tube 20 to bend upward HU.

[0138] Similarly, in the tip-side flexible tube 20, the traction portion 54a of the traction portion 54 through which the tip-side wire lumen 24 of the downward HD is inserted is inserted into the base-side wire lumen 35b of the downward HD of the base-side wire lumen 35 of the right-side WR in the base-side flexible tube 30, as shown in Figure 7(b), and the traction portion 54b is inserted into the base-side wire lumen 36a of the downward HD of the base-side wire lumen 36 of the left-side WL.

[0139] In the width direction W, the circumferential distance Rg between the proximal wire lumens 35b and 36a, which is in the downward HD direction, is wider than the circumferential distance Re between the tip wire lumen 24a and tip wire lumen 24b of the tip wire lumen 24, and the tip wire lumens 24a and 24b are located in the downward HD direction relative to the proximal wire lumens 35b and 36a.

[0140] Therefore, when the traction portion 54 is pulled towards the base end LB, the base end wire lumens 35b and 36a, which have a wide circumferential spacing, hardly exert any tensile force in the bending direction on the base end flexible tube 30. Instead, the traction portion 54, which is inserted into the tip end wire lumen 24 positioned downward HD in the tip end flexible tube 20, exerts an eccentric tensile force downward HD, allowing the tip end flexible tube 20 to be bent downward HD.

[0141] Furthermore, in the tip-side flexible tube 20, the traction portion 55a of the traction portion 55 through which the tip-side wire lumen 25 of the right-side WR is inserted, in the base-side flexible tube 30, the base-side wire lumen 33b of the right-side WR of the base-side wire lumen 33 of the upward-direction HU, and the traction portion 55b is inserted into the base-side wire lumen 34a of the right-side WR of the base-side wire lumen 34 of the downward-direction HD.

[0142] In the height direction H, the circumferential spacing between the proximal wire lumens 33b and 34a, which are the right WRs of the proximal wire lumens 33 and 34, is wider than the circumferential spacing between the tip wire lumens 25a and 25b of the tip wire lumen 25, and the tip wire lumens 25a and 25b are located to the right WR relative to the proximal wire lumens 33b and 34a.

[0143] Therefore, when the traction portion 55 is pulled towards the base end LB, as shown in Figure 7(a), in the base end wire lumens 33b and 34a, which have a wide circumferential spacing, there is almost no tensile force acting on the base end flexible tube 30 in the bending direction. In the tip end flexible tube 20, the traction portion 55, which is inserted into the tip end wire lumen 25 located on the right WR, acts eccentrically on the right WR, allowing the tip end flexible tube 20 to be bent towards the right WR.

[0144] Furthermore, in the tip-side flexible tube 20, the traction portion 56a of the traction portion 56 through which the tip-side wire lumen 26 of the left WL is inserted is inserted in the base-side wire lumen 34b of the left WL of the base-side wire lumen 34 of the downward HD in the base-side flexible tube 30, and as shown in Figure 7(b), the traction portion 56b is inserted into the base-side wire lumen 33a of the left WL of the base-side wire lumen 33 of the upward HU.

[0145] In the height direction H, the circumferential spacing between the proximal wire lumens 33a and 34b, which are the left WL of the proximal wire lumens 33 and 34, is wider than the circumferential spacing between the tip wire lumen 26a and tip wire lumen 26b of the tip wire lumen 26, and the tip wire lumens 26a and 26b are located on the left WL relative to the proximal wire lumens 33a and 34b.

[0146] Therefore, when the traction portion 56 is pulled towards the base end LB, the base end wire lumens 33a and 34b, which have a wide circumferential spacing, hardly exert any tensile force in the bending direction on the base end flexible tube 30. Instead, the traction portion 56, which is inserted into the tip end wire lumen 26 located on the left WL, exerts an eccentric tensile force on the left WL of the tip end flexible tube 20, allowing the tip end flexible tube 20 to be bent towards the left WL.

[0147] Furthermore, as described in detail above and as shown in Figure 7(a), in a movable elongated structure 10 in which the tip-side flexible tube 20 can be bent upward HU by pulling the traction portion 53 toward the base end LB, the tip-side flexible tube 20 can be bent downward HD by pulling the traction portion 54, the tip-side flexible tube 20 can be bent to the right WR by pulling the traction portion 55, and the tip-side flexible tube 20 can be bent to the left WL by pulling the traction portion 56, as shown in Figure 8, the tip-side flexible tube 20 can be bent in an oblique direction intersecting the height direction H and the width direction W by pulling the traction wire 50.

[0148] Specifically, when the traction section 53 that bends the tip-side flexible tube 20 upward HU and the traction section 55 that bends it to the right WR are pulled toward the base end LB with the same traction force (Figure 8(a)), the tip-side flexible tube 20 can be bent upward HU and to the right WR at a 45-degree angle to the upper right when viewed from the longitudinal direction L.

[0149] Furthermore, if the traction force of the traction section 55 is increased compared to the traction section 53, the force bending to the right WR will increase, causing it to bend diagonally upward to the right, approaching the right WR direction. Conversely, if the traction force of the traction section 53 is increased compared to the traction section 55, the force bending upward to the HU will increase, causing it to bend diagonally upward to the right, approaching the upward HU direction.

[0150] Furthermore, when the traction portion 53 that bends the tip-side flexible tube 20 upward HU and the traction portion 56 that bends it to the left WL are pulled toward the base end LB with the same traction force (as shown in Figure 8(a)), the tip-side flexible tube 20 can be bent upward HU and to the left WL at a 45-degree angle to the left and upward when viewed from the longitudinal direction L.

[0151] Furthermore, if the traction force of the traction section 56 is increased compared to the traction section 53, the force bending to the left WL will increase, causing it to bend diagonally upward to the left, approaching the left WL direction. Conversely, if the traction force of the traction section 53 is increased compared to the traction section 56, the force bending upward to the HU will increase, causing it to bend diagonally upward to the left, approaching the upward HU direction.

[0152] Conversely, if the traction section 54 that bends the tip-side flexible tube 20 downwards (HD) and the traction section 55 that bends it to the right (WR) are pulled toward the base end (LB) with the same traction force, the tip-side flexible tube 20 can be bent downwards (HD) and to the right (WR) at a 45-degree angle to the right when viewed from the longitudinal direction L.

[0153] Furthermore, if the traction force of the traction section 55 is increased compared to the traction section 54, the force bending to the right WR will increase, causing it to bend diagonally downward to the right, approaching the right WR direction. Conversely, if the traction force of the traction section 54 is increased compared to the traction section 55, the force bending downward to the HD will increase, causing it to bend diagonally downward to the right, approaching the downward HD direction.

[0154] Furthermore, by pulling the tip-side flexible tube 20 toward the base end LB with the same pulling force on the pulling portion 54 that bends it downwards in the HD direction and the pulling portion 56 that bends it toward the left WL direction, the tip-side flexible tube 20 can be bent downwards in the HD direction and toward the left WL direction at a 45-degree angle to the left when viewed from the longitudinal direction L.

[0155] Furthermore, if the traction force of the traction part 56 is increased compared to the traction part 54, the force bending to the left WL will increase, causing it to bend diagonally downward to the left, approaching the left WL direction. Conversely, if the traction force of the traction part 54 is increased compared to the traction part 56, the force bending downward to HD will increase, causing it to bend diagonally downward to the left, approaching the downward HD direction.

[0156] Furthermore, when the traction sections 53, 54, 55, and 56 are pulled with the same traction force, the flexible tubes 20 and 30 are compressed in the longitudinal direction L, and the length of the movable elongated structure 10 can be shortened in the longitudinal direction L.

[0157] As described above, the movable elongated structure 10 can be bent or shortened relative to the base flexible tube 30 in a desired direction by pulling with one or a combination of the four traction wires 50, as shown in Figure 6.

[0158] However, as described above, the traction wire 50 positioned in the arrangement recess 44 of the spacer 40 extends in an oblique direction intersecting the longitudinal direction L. When pulled, a circumferential force acts due to the circumferential component of the traction force, but its movement is restricted by the restricting portion 45 (45a, 45b), which is the edge of the arrangement recess 44 in the protruding edge portion 43. Therefore, it is possible to prevent circumferential force from acting on the tip-side wire lumen 22 and the base-side wire lumen 32 through which the traction wire 50 is inserted.

[0159] Furthermore, in the movable elongated structure 10, which can bend the tip-side flexible tube 20 in a desired direction by pulling the traction wire 50, the placement recess 44 for positioning the traction wire 50 at the protruding edge 43 of the spacer 40 is a recess with an open outer diameter. As shown in Figure 3(c), when the traction wire 50 is slackened between the tip-side flexible tube 20 and the base-side flexible tube 30, the traction wire 50 comes out of the placement recess 44, and the spacer 40 can be removed from between the tip-side flexible tube 20 and the base-side flexible tube 30. Therefore, for example, it can be easily replaced with spacers 40a with different lengths in the longitudinal direction L, or spacers with different deformability due to their material.

[0160] As described above, the device comprises a long, flexible tip-side flexible tube 20 and a base-side flexible tube 30 arranged in series along the longitudinal direction L from the tip-side LF to the base-side flexible tube LB, a pair of flexible traction wires 50 through which a pair of wire lumens 22 and 32 are inserted along the longitudinal direction L and provided inside the tube walls of the flexible tubes 20 and 30, and a spacer 40 positioned between the tip-side flexible tube 20 and the base-side flexible tube 30 to restrict the direction of the traction wires 50, wherein the circumferential spacing between the pair of base-side wire lumens 32 provided in the base-side flexible tube 30 is set to be wider than the circumferential spacing between the pair of tip-side wire lumens 22 provided in the tip-side flexible tube 20 through which the same traction wires 50 are inserted, and the spacer 40 comprises a cylindrical cylinder 42 arranged along the longitudinal direction L, and a base-side protruding edge 43b provided at the base-side LB end of the cylinder 42 that protrudes radially outward. The movable elongated structure 10 is provided with a tip-side protruding edge portion 43a located at the end of the tip-side LF of the cylinder 42, which protrudes radially outward, and a proximity restricting portion 45b located at the base-side protruding edge portion 43b that restricts the circumferential proximity of the traction wire 50, which is led out from the base-side wire lumen 32 and introduced into the tip-side wire lumen 22, and a positioning recess 44 located with an open radial side where the traction wire 50 is placed. The movable elongated structure 10 is provided with a distance restricting portion 45a located at the tip-side protruding edge portion 43a that restricts the circumferential distance of the traction wire 50, which is led out from the base-side wire lumen 32 and introduced into the tip-side wire lumen 22, and a positioning recess 44 located with an open radial side where the traction wire 50 is placed. Since the spacer 40 is configured to be removable from between the tip-side flexible tube 20 and the base-side flexible tube 30, the assembly of the movable elongated structure 10 is improved, as well as its usability and versatility.

[0161] More specifically, by allowing the spacer 40 to be removed from between the tip-side flexible tube 20 and the base-side flexible tube 30, the ease of assembly of the movable elongated structure 10 is improved, and the spacer 40 can be replaced with one that suits the application and specifications of the movable elongated structure 10. Furthermore, when disposing of the movable long structure 10, the spacer 40 can be removed and disposed of separately.

[0162] Furthermore, a spacer 40 is provided between a long, flexible tip-side flexible tube 20 and a base-side flexible tube 30, which are arranged in series along the longitudinal direction L from the tip-side LF to the base-side flexible tube LB. The spacer 40 includes a cylindrical cylinder 42 arranged along the longitudinal direction L, a base-side protruding edge 43b provided at the base-side LB end of the cylinder 42 and projecting radially outward, and a tip-side protruding edge 43a provided at the tip-side LF end of the cylinder 42 and projecting radially outward. The base-side protruding edge 43b is provided with a proximity restricting portion 45b that restricts the circumferential proximity of the towing wire 50, which is led out from the base-side wire lumen 32 and introduced into the tip-side wire lumen 22, and the radially outward side is open and the towing wire 50 is positioned there. A spacing recess 44 is provided, and the tip-side protruding edge 43a is provided with a spacing restricting portion 45a that restricts the circumferential spacing of the traction wire 50 that is led out from the base-side wire lumen 32 and introduced into the tip-side wire lumen 22, and a spacing recess 44 that is open on the outer diameter side and into which the traction wire 50 is placed. The spacer 40 restricts the direction in which a pair of flexible traction wires 50 that pass through a pair of wire lumens 22, 32 provided inside the tube walls of the flexible tubes 20, 30 along the longitudinal direction L extend, so that the traction wire 50 led out from the base-side wire lumen 32 provided in the base-side flexible tube 30 can be smoothly introduced into the tip-side wire lumen 22.

[0163] Furthermore, the circumferential spacing (Rf, Rg) between a pair of base-side wire lumens 32 is set wider than the circumferential spacing (Ra, Re) between a pair of tip-side wire lumens 22 through which the same traction wire 50 is inserted. Furthermore, the distance (X2) between the base-side virtual line BVL, which passes through the centers of the base-side wire lumens 32 through which the traction portion 52 is inserted, and the base-side central line BCL, which passes through the center of the base-side flexible tube 30 and is parallel to the base-side virtual line BVL, is greater than the distance (X2) between the base-side virtual line FVL, which passes through the centers of the tip-side wire lumens 22 through which the traction portion 52 is inserted, and the tip-side central line FCL, which passes through the center of the tip-side flexible tube 20 and is parallel to the tip-side virtual line FVL, resulting in a wider distance X1 between the tip-side virtual line FVL, which passes through the centers of the tip-side wire lumens 22 through which the traction portion 52 is inserted, and the tip-side central line FCL, which passes through the center of the tip-side flexible tube 20 and is parallel to the tip-side virtual line FVL.

[0164] Therefore, by pulling a pair of traction wires 50 inserted through the base-side wire lumen 32, which has a wide spacing in the circumferential direction and a narrow base-side spacing X2, the tip-side flexible tube 20, which has a narrow spacing in the circumferential direction and a wide tip-side wire lumen 22 with a wide tip-side spacing X1, can be bent.

[0165] Furthermore, the wire lumens 22 and 32 are provided inside the tube walls of the flexible tubes 20 and 30, and in the spacer 40, a recessed area 44 is provided in the protruding edge 43 that is located at the end of the cylindrical cylinder 42 and extends outward. As a result, the traction wire 50 does not protrude into the internal space 41 of the spacer 40, and the main lumens 21 and 31 can be effectively utilized.

[0166] Furthermore, since the arrangement recess 44 provided on the protruding edge 43 at the end of the cylindrical cylinder 42, which protrudes radially outward, is open radially outward, after inserting the traction wire 50 through the wire lumens 22 and 32, a spacer 40 can be placed between the base end flexible tube 30 and the tip end flexible tube 20, and the traction wire 50 can be placed in the arrangement recess 44, thereby improving the ease of assembly of the movable long structure 10.

[0167] Specifically, as shown in Figures 5(c) and 5(d), the separation restricting portions 45a on both sides of the arrangement recess 44 for the upward HU at the tip-side protruding edge portion 43a restrict the separation of the traction portions 53a and 53b that are inserted into the tip-side wire lumens 23a and 23b.

[0168] Similarly, at the tip-side protruding edge 43a, the separation restricting portions 45a on both sides of the downward HD arrangement recess 44 restrict the separation of the traction portions 54a, 54b inserted through the tip-side wire lumens 24a, 24b; at the tip-side protruding edge 43a, the separation restricting portions 45a on both sides of the right-side WR arrangement recess 44 restrict the separation of the traction portions 55a, 55b inserted through the tip-side wire lumens 25a, 25b; and at the tip-side protruding edge 43a, the separation restricting portions 45a on both sides of the left-side WL arrangement recess 44 restrict the separation of the traction portions 56a, 56b inserted through the tip-side wire lumens 26a, 26b.

[0169] Furthermore, at the base end protruding edge portion 43b, the proximity of the traction portion 53b inserted through the base end wire lumen 35a of the upper HU of the base end wire lumen 35 of the right WR and the traction portion 53a inserted through the base end wire lumen 36b of the upper HU of the base end wire lumen 36 of the left WL is restricted by the proximity restricting portion 45b between the arrangement recess 44 of the upper HU and the arrangement recess 44 of the right WR, and between the arrangement recess 44 of the upper HU and the arrangement recess 44 of the left WL.

[0170] Furthermore, at the protruding edge portion 43b, the proximity of the traction portion 54a inserted through the protruding wire lumen 35b of the downward HD of the protruding wire lumen 35 of the right WR and the traction portion 54b inserted through the protruding wire lumen 36a of the downward HD of the protruding wire lumen 36 of the left WL is restricted by the proximity restricting portion 45b between the arrangement recess 44 of the downward HD and the arrangement recess 44 of the right WR, and between the arrangement recess 44 of the downward HD and the arrangement recess 44 of the left WL.

[0171] Similarly, at the base end protruding edge portion 43b, the proximity of the traction portion 55a inserted through the base end wire lumen 33b of the right WR of the base end wire lumen 35 of the upward HU and the traction portion 55b inserted through the base end wire lumen 34a of the right WR of the base end wire lumen 36 of the downward HD is restricted by the proximity restricting portion 45b between the arrangement recess 44 of the right WR and the arrangement recess 44 of the upward HU, and between the arrangement recess 44 of the right WR and the arrangement recess 44 of the downward HD.

[0172] Furthermore, at the base end protruding edge portion 43b, the proximity of the traction portion 56b inserted through the base end wire lumen 33a of the left WL of the base end wire lumen 36 of the upward HU and the traction portion 56a inserted through the base end wire lumen 34b of the left WL of the base end wire lumen 34 of the downward HD is restricted by the proximity restricting portion 45b between the arrangement recess 44 of the left WL and the arrangement recess 44 of the upward HU, and between the arrangement recess 44 of the left WL and the arrangement recess 44 of the downward HD.

[0173] Furthermore, as shown in Figures 3(a) and 3(b), a pair of base-side wire lumens 32 and a pair of tip-side wire lumens 22 through which a pair of traction wires 50 are inserted form a through-hole set 11, and multiple through-hole sets 11 are arranged at different positions in the circumferential direction, and multiple proximity restricting portions 45b and arrangement recesses 44 are provided on the base-side protruding edge portion 43b, and multiple spacing restricting portions 45a and arrangement recesses 44 are provided on the tip-side protruding edge portion 43a, so that the tip portion of the movable elongated structure 10 can be bent in a bending direction corresponding to the number of sets.

[0174] More specifically, multiple through-hole sets 11 are arranged at different positions in the circumferential direction, and multiple proximity restricting portions 45b and placement recesses 44 are provided on the base-side protruding edge portion 43b, while multiple spacing restricting portions 45a and placement recesses 44 are provided on the tip-side protruding edge portion 43a. By pulling at least one pair of the multiple traction wires 50 inserted through each wire lumen 22, 32, the tip portion of the movable elongated structure 10 can be bent in a bending direction corresponding to the traction wire 50 being pulled.

[0175] Furthermore, at the base end protruding edge portion 43b, a common proximity restricting portion 45b restricts the proximity of circumferentially adjacent traction wires 50 that pass through circumferentially adjacent through-hole sets 11, and at the tip end protruding edge portion 43a, a common separation restricting portion 45a shared with the opposite side of the traction wire 50 restricts the separation of circumferentially adjacent traction wires 50 that pass through circumferentially adjacent through-hole sets 11, so that the orientation of multiple pairs of traction wires 50 can be restricted by a spacer 40 with a simple structure.

[0176] More specifically, at the base end protruding edge portion 43b, the proximity of two adjacent towing wires 50 in the circumferential direction to each other can be restricted by a common proximity restricting portion 45b. In other words, the proximity restricting portion 45b can be shared by two adjacent towing wires 50 in the circumferential direction towing wires 50 in the circumferential direction towing wires 50 in the circumferential direction. Therefore, the proximity restricting portion 45b can be shared by two adjacent towing wires 50 in the circumferential direction, resulting in a simpler structure compared to the case where a proximity restricting portion 45b is provided for each towing wire 50.

[0177] Furthermore, at the tip-side protruding edge portion 43a, the separation restricting portion 45a can restrict the separation of two adjacent towing wires 50 in the circumferential direction, specifically those towing wires 50 that pass through adjacent through-hole sets 11 in the circumferential direction. In other words, the separation restricting portion 45a can be used for both towing wires 50 passing through adjacent through-hole sets 11 on opposite sides in the circumferential direction. Therefore, the separation of different pairs of adjacent towing wires 50 in the circumferential direction can be restricted with a simpler structure compared to the case where a separation restricting portion 45a is provided for each towing wire 50.

[0178] As described above, the proximity restricting portion 45b and the separation restricting portion 45a function as restricting portions 45 for different pairs of traction wires 50 adjacent to each other in the circumferential direction, and therefore can be constructed with a simple structure. Furthermore, the base end protruding edge portion 43b and the tip end protruding edge portion 43a can be further simplified by placing both different pairs of traction wires 50 adjacent to each other in the circumferential direction into the arrangement recess 44.

[0179] As a specific example, as shown in Figures 3(a) and (b), we will explain below using a through-hole assembly 11a consisting of a tip-side wire lumen 23a and a base-side wire lumen 36b through which the traction portion 53a is inserted, and a through-hole assembly 11h consisting of a tip-side wire lumen 26b and a base-side wire lumen 33a through which the traction portion 56b is inserted.

[0180] At the base end protruding edge portion 43b, a common proximity restricting portion 45b can restrict the proximity of circumferentially adjacent traction portions 53a and 56b among a pair of traction portions 53 and 56 that pass through circumferentially adjacent through-hole sets 11a and 11h. In other words, the proximity restricting portion 45b can be used by the circumferentially adjacent traction portions 53a and 56b of the pair of traction portions 53 and 56 that pass through the circumferentially adjacent through-hole sets 11a and 11h.

[0181] Therefore, compared to the case where proximity restricting sections 45b are provided for each towing section 53a, 56b, the proximity of towing sections 53a, 56b in towing sections 53 and 56 of towing sections 56 of circumferentially adjacent through-hole sets 11a, 11h can be restricted with a simpler structure.

[0182] Furthermore, at the tip-side protruding edge portion 43a, the separation of the traction portions 53a and 53b of the pair of traction portions 53 that pass through adjacent through-hole sets 11a and 11b in the circumferential direction can be restricted by the separation restricting portions 45a of the right WR and left WL of the upper HU arrangement recess 44.

[0183] Furthermore, at the tip-side protruding edge portion 43a, the separation of the traction portions 55a and 55b of the pair of traction portions 55 that pass through adjacent through-hole sets 11e and 11f in the circumferential direction can be restricted by the separation restricting portion 45a in the upper direction HU and lower direction HD of the arrangement recess 44 of the right-side WR.

[0184] In other words, the spacing restricting portion 45a between the arrangement recess 44 of the upward HU and the arrangement recess 44 of the right-side WR can be shared by the circumferentially adjacent traction portions 53b and 55a of the pair of traction portions 53 and 55 through which the circumferentially adjacent through-hole sets 11b and 11e are inserted.

[0185] Therefore, compared to the case where a spacing restriction section 45a is provided for each towing section 53b, 55a, the towing sections 53b, 55a of the towing sections 53 and 55 of the towing sections 53 and 55 of the towing sections 11a, 11h adjacent to each other in the circumferential direction can be restricted with a simpler structure.

[0186] Furthermore, since one towing wire 50 and the other towing wire 50 that pass through adjacent through-hole sets 11 in the circumferential direction intersect in the circumferential direction, and the cylinder 42 is provided with a guide projection 46 that guides one towing wire 50 to the outside of the other towing wire 50, multiple pairs of towing wires 50 can smoothly pull a predetermined towing wire 50 without interfering with each other, and the tip portion of the movable elongated structure 10 can be bent.

[0187] More specifically, a guide projection 46 is provided on the cylinder 42 to guide one of the two towing wires 50, which are inserted through a set of circumferentially adjacent through holes 11 that intersect in the circumferential direction, to the outside of the other towing wire 50. This prevents one towing wire 50 from overpassing the other towing wire 50 and interfering with it. Therefore, multiple pairs of towing wires 50 can smoothly pull the predetermined towing wire 50 without interfering with each other, allowing the tip portion of the movable elongated structure 10 to bend.

[0188] Furthermore, since the towing wire 50 is a flexible wire, and the flexible tubes 20 and 30 are made of flexible tubes having main lumens 21 and 31, and the wire lumens 22 and 32 are formed inside the tube walls and are wire lumens through which the wire can be inserted, by pulling the towing wire 50 made of flexible wire, at least the tip portion of the movable elongated structure 10 made of tubes having main lumens 21 and 31 can be bent, and instruments, chemicals, etc. can be inserted into the main lumens 21 and 31 of the movable elongated structure 10, which can be bent at least at the tip portion, to perform a predetermined procedure.

[0189] Furthermore, since the wire is bent back at the tip LF of the tip-side flexible tube 20 to form a pair of traction wires 50, a single wire can be used to form a pair of traction wires 50, thus enabling the construction of a simple, movable, long-length structure 10.

[0190] Furthermore, the conduit can be easily inserted to a predetermined location even if it is at least one of the tubular organs, blood vessels, or blood vessels that have a narrow and complex branching structure. Specifically, bidirectional movable and flexible ureteroscopes are used clinically. However, as shown in Figure 9, the kidney has a three-dimensional shape, and it has become clear that there are areas that cannot be reached with bidirectional movable and flexible endoscopes. For example, in the upper minor calyces of the kidney, which have a three-dimensional shape, various internal surfaces can be accessed by a combination of bidirectional movable and flexible endoscopes and axial rotation, but in the middle and lower minor calyces, there are internal surfaces that cannot be accessed. In contrast, as illustrated in Figure 9(a), the movable elongated structure 10, which moves in four directions (all directions), can be bent in all directions by two directions (up and down) (two directions in the drawing of Figure 9(a)) and two directions (two directions in the drawing of Figure 9(b)) and combinations thereof.

[0191] Furthermore, because multiple traction wires 50 are routed in a crisscross pattern using spacers 40, even if the proximal flexible tube 30 bends along the path as shown in Figure 9, the deterioration of the movable bending performance of the tip-side flexible tube 20 is minimal. As a result, all inner surfaces of the upper, middle, and lower renal calyces can be freely accessed. Thus, because the movable elongated structure 10 is movable in four directions (all directions), its tip can reach a desired location in three-dimensional tubular organs such as kidneys, blood vessels, and vascular structures.

[0192] In the above-described movable elongated structure 10, four towing wires 50 (53, 54, 55, 56) are provided and configured to bend the tip-side flexible tube 20 in a desired direction. However, the configuration is not limited to the above, and the towing wires 50 may be arranged according to the direction of bending.

[0193] Specifically, as shown in Figures 10(a) and 10(b), for example, in the case of a movable elongated structure 10a that bends the tip-side flexible tube 20 in one direction upward HU, it is equipped only with the traction portion 53 of the aforementioned movable elongated structure 10, and the base-side protruding edge portion 43b is provided with an arrangement recess 44a that can accommodate only one traction portion 53a, 53b on the right WR and one on the left WL.

[0194] Then, the traction portion 53 is inserted through the tip-side wire lumen 23 (23a, 23b) of the tip-side flexible tube 20, the traction portion 53 is positioned in the upper HU-position recess 44 of the tip-side protruding edge portion 43a, and the traction portions 53a and 53b are positioned in the position recess 44a of the base-side protruding edge portion 43b, respectively.

[0195] Furthermore, the traction portion 53 is inserted through the base end wire lumens 35 and 36 of the base end flexible tube 30. Note that the tip end wire lumens 22 other than the tip end wire lumens 23 in the tip end flexible tube 20 and the base end wire lumens 32 other than the base end wire lumens 35 and 36 in the base end flexible tube 30 may or may not be provided.

[0196] In the movable elongated structure 10a configured in this way, the tip wire lumen 23 is spaced more closely together in the circumferential direction than the base wire lumens 35 and 36 through which the traction portion 53 is inserted. Since the traction portion 53 is inserted through the tip wire lumen 23, which is positioned upward HU above the base wire lumens 35 and 36, when the traction portion 53 is pulled towards the base LB, the tip flexible tube 20 can be bent upward HU as shown in Figure 10(a).

[0197] Furthermore, as shown in Figures 10(c) and 10(d), in the case of a movable elongated structure 10b in which the tip-side flexible tube 20 is bent in two directions, upward HU and downward HD, the movable elongated structure 10 is provided with the traction parts 53 and 54 described above.

[0198] Then, the traction portion 53 is inserted through the tip-side wire lumen 23 of the tip-side flexible tube 20, the traction portion 53 is positioned in the upper HU arrangement recess 44 of the tip-side protruding edge portion 43a, and the traction portions 53a and 53b are positioned in the upper HU of the width direction W arrangement recess 44 of the base-side protruding edge portion 43b, respectively. Furthermore, the traction portion 53 is inserted through the proximal wire lumens 35a and 36b of the proximal flexible tube 30.

[0199] Furthermore, the traction portion 54 is inserted through the tip-side wire lumen 24 of the tip-side flexible tube 20, the traction portion 54 is positioned in the downward HD arrangement recess 44 of the base-side wire lumen 34a, and the traction portions 54a and 54b are positioned in the downward HD of the widthwise arrangement recess 44 of the base-side wire lumen 34b, respectively. Then, the traction portion 54 is inserted through the base-side wire lumen 35b and base-side wire lumen 36a of the base-side flexible tube 30.

[0200] In the movable elongated structure 10b configured in this way, as shown in Figures 10(c) and 10(d), the tip wire lumen 24 has a narrower circumferential spacing than the base wire lumens 35a and 36b through which the traction portion 53 is inserted, and the traction portion 53 is inserted into the tip wire lumen 23 which is located upward HU from the base wire lumens 35a and 36b. The traction portion 54 is inserted into the tip wire lumen 24 which has a narrower circumferential spacing than the base wire lumens 35b and 36a through which the traction portion 54 is inserted, and is located downward HD from the base wire lumens 35b and 36a. Therefore, when the traction portion 53 is pulled towards the base LB, the tip flexible tube 20 can be bent upward HU as shown in Figure 10(c), and when the traction portion 53 is pulled towards the base LB, the tip flexible tube 20 can be bent downward HD.

[0201] Regarding the movable elongated structure 10 using the spacer 40, in the above description, the traction wire 50 was extended diagonally through the spacer 40 and inserted into the wire lumens 23 and 33. However, as shown in Figures 11 and 12, it may also be positioned with the wire extended straight through the spacer 40.

[0202] Figure 11 shows an explanatory diagram of the movable elongated structure 10 in a different arrangement pattern. Figure 11(a) shows a perspective view of the movable elongated structure 10 in a different arrangement pattern, and Figure 11(b) shows a perspective view of the movable elongated structure 10 with the tip-side flexible tube 20 and the base-side flexible tube 30 shown in a transparent state.

[0203] Figure 12 shows an explanatory diagram of the movable elongated structure 10 in a different arrangement pattern. Figure 12(a) shows a front view of the movable elongated structure 10, and Figure 12(b) shows a cross-sectional view taken along arrow AA in Figure 12(a).

[0204] The movable elongated structure 10 of the arrangement pattern has a traction wire 50 that is bent back near the center of its length to form a bent portion 51. The traction portion 52 (53-56) of the traction wire 50 is inserted along the longitudinal direction L into the four-way arranged tip-side wire lumens 22, arrangement recesses 44, and base-side wire lumens 32.

[0205] For example, the traction portion 53a of the traction portion 53 is inserted from the tip side LF into the tip side wire lumen 23a of the left side WL in the tip side wire lumen 23, and the traction portion 53b is inserted into the tip side wire lumen 23b of the right side WR, thereby leading out the traction portion 53 from the base side LB of the tip side wire lumen 23, and the bend return portion 51 is positioned in the bend recess 28 of the upward direction HU. The other traction portions 54, 55, and 56 are routed in the same manner.

[0206] The traction portion 53, which is led out from the base end LB of the tip-side wire lumen 23, is positioned in the upward HU of the tip-side protruding edge 43a and the base-side protruding edge 43b, and is inserted through the base-side wire lumen 33 of the upward HU in the base-side flexible tube 30, and led out from the base end LB.

[0207] Thus, the movable elongated structure 10, in which the traction portion 52 is inserted straight along the longitudinal direction L into the wire lumens 23 and 33, as described above, has a reduced effect in suppressing the bending effect that occurs in the base-side flexible tube 30 when the traction wire 50 is pulled, compared to the movable elongated structure 10 in which the traction wire 50 is positioned by extending it diagonally in the spacer 40. However, it allows the tip-side flexible tube 20 to be bent in a desired direction relative to the base-side flexible tube 30, and the movable elongated structure 10 can be shortened (compressed) without bending by pulling all four sets of traction wires 50, or by pulling two sets of traction wires 50 that are facing each other in the radial direction.

[0208] Furthermore, regarding the spacer 40 in the movable elongated structure 10 described above, guide projections 46 are provided on both the tip side LF and the base side LB, but as shown in Figure 13, guide projections 46 may be provided on only one side in the longitudinal direction L.

[0209] Figure 13 shows an explanatory diagram of spacer 40e. Figure 13(a) shows perspective views of the front, right side, and top of spacer 40e, Figure 13(b) shows perspective views of the front, left side, and top of spacer 40e, and Figure 13(c) shows a top view of spacer 40e.

[0210] As shown in Figure 13, the spacer 40e is provided with a guide projection 46 only on the tip side LF. Furthermore, while the spacer 40 described above had guide projections 46 facing each other in the circumferential direction, the spacer 40e has a guide projection 46 only on the left side WL, which is one side in the width direction W.

[0211] Furthermore, among the arrangement recesses 44 of the base end protruding edge portion 43b that do not have the guide projection portion 46, the arrangement recesses 44e located in the upper direction HU, the right side WR, and the left side WL are formed in a roughly W shape with the outer diameter open when viewed from the longitudinal direction L, so as to accommodate the two traction wires 50 respectively. In other words, the arrangement recesses 44e are provided corresponding to each traction wire 50, and the side walls of the arrangement recesses 44e function as restricting portions 45a and 45b for each traction wire 50.

[0212] A movable long structure 10e using the spacer 40e configured in this way will be explained with reference to Figures 14 and 15. Figures 14 and 15 are explanatory diagrams of the movable elongated structure 10e. Figure 14(a) shows a front view of the movable elongated structure 10e, Figure 14(b) shows a cross-sectional view taken along the EE arrow in Figure 15(a), Figure 14(c) shows a rear view of the movable elongated structure 10e, Figure 15(a) shows a cross-sectional view taken along the FF arrow in Figure 14(a), Figure 15(b) shows a cross-sectional view taken along the GG arrow in Figure 14(a), and Figure 15(c) shows a cross-sectional view taken along the HH arrow in Figure 14(a).

[0213] Unlike the above-described movable elongated structure 10, which has a spacer 40 between the tip-side flexible tube 20 and the base-side flexible tube 30, the movable elongated structure 10e shown in Figures 14 and 15 has an intermediate tube 60 between the tip-side flexible tube 20 and the base-side flexible tube 30, a spacer 40 between the base-side flexible tube 30 and the intermediate tube 60, and the above-described spacer 40e between the tip-side flexible tube 20 and the intermediate tube 60.

[0214] The intermediate tube 60, like the tip-side flexible tube 20 and the base-side flexible tube 30, is a cylindrical flexible tube that is long in the longitudinal direction L and has a main lumen 61 inside. The intermediate tube 60 also has two intermediate wire lumens 63, 64, 65, and 66 each in the four directions: upward HU, downward HD, right WR, and left WL inside the tube wall.

[0215] The intermediate tube 60 can be made of a flexible tube such as polyamide elastomer, stretched polytetrafluoroethylene, polyurethane, or polytetrafluoroethylene, similar to the tip-side flexible tube 20 and the base-side flexible tube 30. The intermediate tube 60 may be made of the same material as the tip-side flexible tube 20 and the base-side flexible tube 30, or it may be made of a different material.

[0216] Then, the traction portion 54b that passes through the tip wire lumen 23a of the left WL in the tip wire lumen 23 of the upward HU in the tip flexible tube 20 passes through the intermediate wire lumen 66a of the downward HD in the intermediate wire lumen 66 provided in the left WL of the intermediate tube 60, and passes through the base wire lumen 34b of the left WL of the base wire lumen 34 provided in the downward HD in the base flexible tube 30.

[0217] Then, the traction portion 54a, which passes through the tip wire lumen 23b of the right WR in the tip wire lumen 23 of the upward HU in the tip flexible tube 20, passes through the intermediate wire lumen 65a of the upward HU in the intermediate wire lumen 65 provided in the right WR of the intermediate tube 60, and passes through the base wire lumen 33b of the right WR of the base wire lumen 33 provided in the upward HU of the base flexible tube 30.

[0218] Furthermore, the traction portion 53b that passes through the tip wire lumen 24a of the right WR in the tip wire lumen 24 of the downward HD in the tip flexible tube 20 passes through the intermediate wire lumen 65b of the downward HD in the intermediate wire lumen 65 provided in the right WR of the intermediate tube 60, and passes through the base wire lumen 34a of the right WR of the base wire lumen 34 provided in the downward HD in the base flexible tube 30.

[0219] Then, the traction portion 53a that passes through the tip wire lumen 24b of the left WL in the tip wire lumen 24 of the downward HD in the tip flexible tube 20 passes through the intermediate wire lumen 66b of the upward HU in the intermediate wire lumen 66 provided in the left WL of the intermediate tube 60, and passes through the base wire lumen 33a of the left WL of the base wire lumen 34 provided in the upward HU of the base flexible tube 30.

[0220] In contrast, the traction portions 55 and 56 are not inserted through the tip-side wire lumens 25 and 26 in the width direction W of the tip-side flexible tube 20. Instead, the traction portion 55a is inserted through the intermediate wire lumen 63a on the left side WL of the intermediate wire lumen 63 provided in the upward direction HU of the intermediate tube 60, and is inserted through the base-side wire lumen 36b on the upward direction HU of the base-side wire lumen 36 provided in the left side WL of the base-side flexible tube 30.

[0221] Then, the traction portion 55b is inserted through the intermediate wire lumen 63b of the right WR of the intermediate wire lumen 63 provided in the upper HU of the intermediate tube 60, and is inserted through the base end wire lumen 35a of the upper HU of the base end wire lumen 35 provided in the right WR of the base end flexible tube 30.

[0222] Furthermore, the traction portion 56a is inserted through the intermediate wire lumen 64a of the right WR of the intermediate wire lumen 64 provided in the downward HD of the intermediate tube 60, and is inserted through the base end wire lumen 35b of the downward HD of the base end wire lumen 35 provided in the right WR of the base end flexible tube 30.

[0223] Then, the traction portion 56b is inserted through the intermediate wire lumen 64b on the left WL of the intermediate wire lumen 64 provided in the downward HD of the intermediate tube 60, and is inserted through the base end wire lumen 36a on the downward HD of the base end wire lumen 36 provided in the left WL of the base end flexible tube 30.

[0224] Furthermore, the traction portions 55 and 56, which are not inserted through the tip-side wire lumen 23 of the tip-side flexible tube 20 but are inserted through the intermediate wire lumen 63 of the intermediate tube 60 and the base-side wire lumen 33 of the base-side flexible tube 30, are bent back at a recessed portion 51 formed by the placement recess 44e of the protruding edge 43 of the spacer 40e placed between the tip-side flexible tube 20 and the intermediate tube 60.

[0225] Furthermore, in the spacer 40e positioned between the tip-side flexible tube 20 and the intermediate tube 60 of the movable long structure 10e, the traction portion 53a and the traction portion 54b intersect on the front side shown in Figure 14(a), but are routed so that the traction portion 53b and the traction portion 54a do not intersect on the rear side shown in Figure 14(c).

[0226] In the movable elongated structure 10e configured in this way, the traction sections 53 and 54 are inserted through the tip-side flexible tube 20, the intermediate tube 60, and the base-side flexible tube 30, while the traction sections 55 and 56 are inserted through the intermediate tube 60 and the base-side flexible tube 30.

[0227] Therefore, the spacer 40 positioned between the base-side flexible tube 30 and the intermediate tube 60 has four traction sections 53, 54, 55, and 56, while the spacer 40e positioned between the tip-side flexible tube 20 and the intermediate tube 60 has two traction sections 53 and 54. Therefore, a spacer 40e is used that minimizes the intersection of the towing wires 50 and has a guide projection 46 provided only on the tip side LF.

[0228] As described above, in the movable elongated structure 10e, in which the traction portions 53 and 54 are inserted through the tip-side flexible tube 20, the intermediate tube 60, and the base-side flexible tube 30, and the traction portions 55 and 56 are inserted through the intermediate tube 60 and the base-side flexible tube 30, the tip-side flexible tube 20 can be bent either upward HU or downward HD relative to the intermediate tube 60 by pulling either the traction portion 53 or the traction portion 54, which are inserted through the tip-side flexible tube 20, the intermediate tube 60, and the base-side flexible tube 30, towards the base-side LB.

[0229] In contrast, by pulling either the traction portion 55 or traction portion 56, which are inserted into the intermediate tube 60 and the base-side flexible tube 30, towards the base-side LB, the intermediate tube 60 can be bent either upward (HU) or downward (HD) relative to the base-side flexible tube 30. At this time, if the traction portions 53 and 54 are not being pulled, the tip-side flexible tube 20 will not bend relative to the intermediate tube 60, but will instead bend in accordance with the intermediate tube 60, which bends upward (HU) or downward (HD) relative to the base-side flexible tube 30. In other words, the movable elongated structure 10e can be bent with virtually no interference between the tip-side flexible tube 20 and the intermediate tube 60.

[0230] As described above, an elongated intermediate tube 60 having intermediate wire lumens 63, 64, 65, and 66 is positioned between the tip-side flexible tube 20 and the base-side flexible tube 30, and multiple pairs of towing wires 50 are provided. At least one pair of the multiple pairs of towing wires 50 is inserted through the tip-side wire lumen 22, the intermediate wire lumens 63, 64, 65, and 66 and the base-side wire lumen 32, and at least one pair of the multiple pairs of towing wires 50 is inserted through the intermediate wire lumens 63, 64, 65, and 66 and the base-side wire lumen 32. Therefore, a movable elongated structure 10e can be constructed in which the intermediate tube 60 and the tip-side flexible tube 20 can be bent.

[0231] More specifically, of the multiple pairs of towing wires 50, towing wires 55 and 56 are inserted through the intermediate wire lumens 63 and 64 and the base wire lumens 35 and 36, while the other towing wires 53 and 54 of the multiple pairs of towing wires 50 are inserted through the tip wire lumens 23 and 24, the intermediate wire lumens 65 and 66, and the base wire lumens 33 and 34. Therefore, by pulling the towing wires 55 and 56 inserted through the intermediate wire lumens 63 and 64 and the base wire lumens 35 and 36, the intermediate tube 60 in the middle section of the movable long structure 10e can be bent, and by pulling the towing wires 53 and 54 inserted through the tip wire lumens 23 and 24, the intermediate wire lumens 65 and 66, and the base wire lumens 33 and 34, the tip flexible tube 20, which is the tip section of the movable long structure 10e, can be bent.

[0232] Thus, with the above configuration, the intermediate tube 60 in the middle portion of the movable elongated structure 10e and the tip-side flexible tube 20, which is the tip portion of the movable elongated structure 10e, can be bent with virtually no interference.

[0233] Although the guide projections 46 provided on the spacers 40 and 40e described above are formed in a trapezoidal shape in vertical cross-section, gradually protruding from the ends in the longitudinal direction L toward the center, the guide projections 46g may also be formed in a smooth shape, as shown in Figure 16.

[0234] Figure 16 shows an explanatory diagram of a spacer 40g having a guide projection 46g. Figure 16(a) shows perspective views of the front, right side, and top of the spacer 40g, Figure 16(b) shows perspective views of the back, right side, and top of the spacer 40g, Figure 16(c) shows a front view of the spacer 40g, and Figure 16(d) shows a top view of the spacer 40g.

[0235] The guide projection 46g on the spacer 40g gradually increases in height and width from the end in the longitudinal direction L towards the center in the longitudinal direction L. It is formed in a roughly hexagonal shape when viewed from the front, with the height gradually decreasing and the width gradually narrowing from the point where the width is widest.

[0236] The guide projection 46g formed in the shape described above has gentler corners compared to the guide projection 46 provided on the spacer 40 or spacer 40e described above, and can reduce stress concentration on the traction wire 50 that straddles the guide projection 46.

[0237] Furthermore, although the spacer 40 described above has a concave arrangement recess 44 with an open radially outer side at the protruding edge portion 43, a spacer 40i may also have an arrangement recess 44i having a compression support portion 441 as shown in Figure 17.

[0238] Figure 17 shows an explanatory diagram of a spacer 40i having a compression support portion 441 in a placement recess 44i. Figure 17(a) shows perspective views of the front, right side, and top of the spacer 40i; Figure 17(b) shows perspective views of the rear, right side, and top of the spacer 40i; Figure 17(c) shows a front view of the spacer 40i; and Figure 17(d) shows a side view of the spacer 40i.

[0239] The protruding edge portion 43i of the spacer 40i is provided with recesses 44i arranged in four directions at equal intervals in the circumferential direction, and a compression support portion 441 is placed in each of the arrangement recesses 44i. The arrangement recess 44i is formed in a roughly bean-shaped recess, with arc recesses for the traction wire 50 arranged at predetermined intervals in the circumferential direction, and the spaces between them being convex outward in diameter.

[0240] The compression support portion 441 is formed so as to protrude circumferentially from both sides of the arrangement recess 44i, on the radially outer side of the roughly bean-shaped arrangement recess 44i described above, with a gap that allows the traction wire 50 to pass through radially.

[0241] A movable elongated structure 10 having a spacer 40i having the arrangement recess 44i configured in this way, placed between the tip-side flexible tube 20 and the base-side flexible tube 30, can achieve the same effects as the movable elongated structure 10 with the spacer 40 arranged as described above, and can also achieve the following effects.

[0242] When the towing wire 50 is pulled to bend the flexible tubes 20 and 30, a compressive force acts on the flexible tubes 20 and 30. This compressive force also acts on the spacer 40i placed between the flexible tubes 20 and 30.

[0243] In spacer 40i, if the outer diameter open portion of the placement recess 44i becomes large, the flexible tubes 20 and 30, under compressive force, may become lodged in the outer diameter open portion of the placement recess 44i, potentially preventing the desired bending deformation. In contrast, spacer 40i is provided with a compression support portion 441 that protrudes outward from the placement recess 44i, thereby supporting the aforementioned compressive force and enabling the desired bending deformation.

[0244] Furthermore, the spacer 40i functions as an anti-extraction part in which the compression support part 441 prevents the traction wire 50 from coming out of the placement recess 44i, thereby preventing the traction wire 50 placed in the placement recess 44i from moving radially outward from the placement recess 44i and coming out unintentionally due to the compression support part 441.

[0245] In addition, although not shown, the spacer 40i having a placement recess 44i equipped with a compression support portion 441 may have three placement recesses 44i in the circumferential direction of the protruding edge portion 43i. Specifically, as shown in Figures 18 and 19, a movable elongated structure 10j using a spacer 40j with three arrangement recesses 44j provided on the protruding edge 43j will be described together with Figures 18 and 19.

[0246] Figures 18 and 19 show explanatory diagrams of the movable elongated structure 10j and the spacer 40j. Figure 18(a) shows a perspective view of the movable elongated structure 10j, Figure 18(b) shows a cross-sectional view taken along arrow II in Figure 18(a), Figure 18(c) shows a cross-sectional view taken along arrow JJ in Figure 18(a), Figure 19(a) shows a perspective view of the spacer 40j, Figure 19(b) shows a side view of the spacer 40j viewed from the tip side LF, and Figure 19(c) shows a side view of the spacer 40j viewed from the base side LB.

[0247] The movable elongated structure 10j shown in Figures 18 and 19, similar to the movable elongated structure 10 described above, has a tip-side flexible tube 20j, a spacer 40j, and a base-side flexible tube 30j arranged from the tip-side LF to the base-side LB, and a traction wire 50 is routed through it. Note that components similar to those in the movable elongated structure 10 described above are denoted by the same reference numerals, and their descriptions are omitted.

[0248] The spacer 40j used in the movable long structure 10j has three bean-shaped placement recesses 44j in the circumferential direction, similar to the placement recesses 44i of the spacer 40i shown in Figure 17, and each placement recess 44j is provided with a compression support portion 441. Therefore, three traction wires 50 (53, 54, 55) are routed in the movable long structure 10j.

[0249] However, in the above-described arrangement recess 44i, the protruding edge portion 43i of the distal-end side LF and the protruding edge portion 43i of the proximal-end side LB were formed in the same shape. In contrast, the arrangement recess 44j has different shapes for the arrangement recess 44ja and the compression support portion 441a provided on the distal-end side protruding edge portion 43ja of the distal-end side LF and the arrangement recess 44jb and the compression support portion 44lb provided on the proximal-end side protruding edge portion 43jb of the proximal-end side LB.

[0250] Specifically, although the circumferential positions of the arrangement recess 44ja in the distal-end side protruding edge portion 43ja and the arrangement recess 44jb in the proximal-end side protruding edge portion 43jb coincide, the arrangement recess 44jb provided in the proximal-end side protruding edge portion 43jb is formed to have a longer circumferential length than the arrangement recess 44ja provided in the distal-end side protruding edge portion 43ja. Therefore, the protruding length of the compression support portion 441b is also formed to be longer than that of the compression support portion 441a.

[0251] Specifically, the arrangement recess 44ja provided in the distal-end side protruding edge portion 43ja has a length at which two traction wires 50 are arranged at an appropriate interval. In contrast, the arrangement recess 44jb provided in the proximal-end side protruding edge portion 43jb is formed to have a circumferential length such that the intervals between the traction wires 50 arranged on both sides of the arrangement recess 44jb are the same as the intervals between the traction wires 50 arranged in adjacent arrangement recesses 44jb. Therefore, the traction portions 52 of the respective traction wires 50 arranged in the arrangement recesses 44jb arranged in three directions in the circumferential direction are arranged at intervals of 60 degrees in the circumferential cross-section.

[0252] The distal-end side wire lumen 22 of the distal-end side flexible tube 20j and the proximal-end side wire lumen 32 of the proximal-end side flexible tube 30j that constitute the movable long-structured body 10j using the spacer 40j configured as described above have different arrangements. Specifically, as shown in FIG. 18(b), the distal-end side wire lumens 22(23, 24, 25) provided in the distal-end side flexible tube 20j are arranged in two each in three directions in the circumferential cross-section.

[0253] Of the tip-side wire lumens 22 arranged in three directions, the upward direction HU is defined as the tip-side wire lumen 23. Of the two tip-side wire lumens 23, the counterclockwise side is defined as the tip-side wire lumen 23a, and the clockwise side is defined as the tip-side wire lumen 23b.

[0254] Similarly, the tip-side wire lumens 22 arranged on the right side WR are defined as the tip-side wire lumens 24. Of the two tip-side wire lumens 24, the counterclockwise side is defined as the tip-side wire lumen 24a, and the clockwise side is defined as the tip-side wire lumen 24b. The tip-side wire lumens 22 arranged on the left side WL and in the downward direction HD are defined as the tip-side wire lumens 25. Of the two tip-side wire lumens 25, the counterclockwise side is defined as the tip-side wire lumen 25a, and the clockwise side is defined as the tip-side wire lumen 25b.

[0255] In contrast, the base-side wire lumens 32 provided in the base-side flexible tube 30j are arranged in six directions at equal intervals in the circumferential direction of the cross-section as shown in Fig. 18(c). Therefore, the base-side wire lumen 32 in the upward direction HU among the six base-side wire lumens 32 is defined as the base-side wire lumen 32a, and in clockwise order, from the base-side wire lumen 32b to the base-side wire lumen 32f.

[0256] The movable long structure 10j using the spacer 40j configured as described above is assembled as follows. Attach the pulling wire 50 formed with the bent-back portion 51 by bending from the bent recess 28 of the tip cap 27 provided at the tip of the tip-side flexible tube 20j, and insert the pulling portion 52 into the tip-side wire lumen 22.

[0257] Then, place the pulling portion 52 led out from the tip-side wire lumen 22 to the base side LB in the placement recess 44ja of the tip-side protruding edge portion 43ja in the spacer 40j, stretch it in the diagonal direction and place it in the placement recess 44jb of the base-side protruding edge portion 43jb, insert it into the base-side wire lumen 32 of the base-side flexible tube 30j, and lead it out from the base side LB.

[0258] Specifically, the traction portion 53 is inserted through the tip-side wire lumen 23 (23a, 23b) of the tip-side flexible tube 20j from the tip-side LF and led out from the base-side LB, and positioned in the arrangement recess 44ja of the upward-direction HU at the tip-side protruding edge portion 43ja.

[0259] Then, the traction portion 53 is extended diagonally along the cylinder 42 toward the base end LB and positioned in the arrangement recess 44jb at the base end protruding edge portion 43jb, and is inserted from the tip end LF into the base end wire lumens 32e and 32b of the base end flexible tube 30j and led out from the base end LB.

[0260] Furthermore, the traction portion 54 is inserted through the tip-side wire lumen 24 (24a, 24b) of the tip-side flexible tube 20j from the tip-side LF and led out from the base-side LB, and positioned in the arrangement recess 44ja of the right-side WR at the tip-side protruding edge portion 43ja.

[0261] Then, the traction portion 54 is extended diagonally along the cylinder 42 toward the base end LB and positioned in the arrangement recess 44jb at the base end protruding edge portion 43jb, and is inserted from the tip end LF into the base end wire lumens 32a and 32d of the base end flexible tube 30j and led out from the base end LB.

[0262] Similarly, the traction portion 55 is inserted through the tip wire lumen 25 (25a, 25b) of the tip flexible tube 20j from the tip side LF and led out from the base side LB, and positioned in the left side WL and downward HD arrangement recess 44ja of the tip protruding edge portion 43ja.

[0263] Then, the traction portion 55 is extended diagonally along the cylinder 42 toward the base end LB and positioned in the arrangement recess 44jb at the base end protruding edge portion 43jb, and is inserted from the tip end LF into the base end wire lumens 32c and 32f of the base end flexible tube 30j and led out from the base end LB.

[0264] In other words, in the base-end flexible tube 30j, each traction portion 52 is positioned on the base-end wire lumen 32 at an opposing position. The movable elongated structure 10j configured in this way has the same effect as the movable elongated structure 10 described above, and can be shortened (compressed) without bending by pulling all three towing wires 50 (53, 54, 55).

[0265] Next, different embodiments of the movable elongated structure 10k and spacer 40k will be described below. In the spacer 40 described above, protruding edges 43 are provided on both sides of the longitudinal direction L of the cylinder 42 having an internal space 41. However, as shown in Figures 20 to 22, the assembly spacer 40k may also be constructed using only the cylinder 42k.

[0266] Figure 20 shows an explanatory diagram of the movable long structure 10k. Figure 20(a) shows a perspective view of the movable long structure 10k before assembly, Figure 20(b) shows a perspective view of the movable long structure 10k in the assembled state, and Figure 20(c) shows a perspective view of the movable long structure 10k with the traction wire 50 routed.

[0267] Figure 21 shows an explanatory diagram of the movable long structure 10k. Figure 21(a) shows a front view of the movable long structure 10k before assembly, Figure 21(b) shows a front view of the movable long structure 10k in the assembled state, and Figure 21(c) shows a front view of the movable long structure 10k with the traction wire 50 routed.

[0268] Figure 22 shows an explanatory diagram of the assembly spacer 40k. Figure 22(a) shows an enlarged cross-sectional view of the part including the assembly spacer 40k before assembly, and Figure 22(b) shows an enlarged cross-sectional view of the part including the assembly spacer 40k in the assembled state. In the following descriptions of the movable elongated structure 10k and the assembled spacer 40k, the same components as those described above in the descriptions of the movable elongated structure 10 and the spacer 40 will be denoted by the same reference numerals and their descriptions will be omitted.

[0269] The assembled spacer 40k is composed of a cylindrical cylinder 42k having a guiding convex portion 46 at the same position as the guiding convex portion 46 provided in the cylinder 42 of the spacer 40. In addition, mounting portions 421 for mounting a flange portion 43k described later are provided on both end sides in the longitudinal direction L of the guiding convex portion 46 of the cylinder 42k.

[0270] When the cylinder 42k configured as described above is used, a tip-side flexible tube 20k and a base-end-side flexible tube 30k having flange portions 43k at opposite end portions are used. Specifically, the flexible tubes 20k and 30k are tubes having main lumens 21 and 31 inside and having flexibility in the form of a long cylinder in the longitudinal direction L, and have flange portions 43k at end portions facing each other in the longitudinal direction L.

[0271] As shown in Fig. 20(a), the flange portion 43k is a disk made of a hard resin having a main through-hole 431 provided in the main lumens 21 and 31 at the center, corresponding to the wire lumens 22 and 32, and having a wire arrangement hole 44k formed of a through-hole. The main through-hole 431 is formed with a diameter into which the mounting portion 421 of the above-described cylinder 42k is fitted.

[0272] The tip-side flexible tube 20k, the base-end-side flexible tube 30k, and the assembled spacer 40k composed of the cylinder 42k configured as described above are assembled to form a movable long structure 10k. Specifically, as shown in Figs. 20(a), 21(a), and 22(a), the tip-side flexible tube 20k, the assembled spacer 40k, and the base-end-side flexible tube 30k are arranged in this order from the tip side LF to the base end side LB in the longitudinal direction L. At this time, the tip-side flexible tube 20k is arranged so that the flange portion 43k becomes the base-end side LB, and the base-end-side flexible tube 30k is arranged so that the flange portion 43k becomes the tip side LF.

[0273] In addition, the assembled spacer 40k is arranged so that the guiding convex portion 46 is in a desired direction in the circumferential direction. Then, as shown in Figures 20(b), 21(b), and 22(b), the mounting portion 421 of the cylinder 42k that constitutes the assembly spacer 40k is inserted into the main through hole 431 of the protruding edge portion 43k and fitted into place, thereby assembling the tip-side flexible tube 20k, the assembly spacer 40k, and the base-side flexible tube 30k.

[0274] As shown in Figures 20(c) and 21(c), a traction wire 50 is inserted through the wire lumens 22 and 32 of the assembled tip-side flexible tube 20k and base-side flexible tube 30k to form a movable long structure 10k. At this time, the traction wire 50 is passed through the wire placement hole 44k provided in the protruding edge portion 43k at the ends of the tip-side flexible tube 20k and the base-side flexible tube 30k.

[0275] Furthermore, the routing of the traction wire 50 in the assembly spacer 40k may be done in the same way as the movable long structure 10 described above, by routing the traction wire 50 so that it extends diagonally, or it may be routed straight along the longitudinal direction L, as shown in Figures 11 and 12.

[0276] The assembly spacer 40k and the movable elongated structure 10k using the assembly spacer 40k, configured in this manner, consist of a cylinder 42k that is assembled with a protruding edge portion 43k provided at the end of the tip-side flexible tube 20k and the base-side flexible tube 30k. Therefore, they have the same effect as the integrated spacer 40 and the movable elongated structure 10 equipped with the spacer 40.

[0277] Furthermore, compared to the movable long structure 10, in which the tip-side flexible tube 20, spacer 40, and base-side flexible tube 30 are arranged along the longitudinal direction L and assembled by routing the traction wire 50, the tip-side flexible tube 20k, assembly spacer 40k, and base-side flexible tube 30k can be assembled by fitting the mounting portion 421 of the cylinder 42k into the main through hole 431 of the protruding edge portion 43k provided at the ends of the flexible tubes 20k and 30k, thereby improving the ease of assembly compared to the movable long structure 10 described above.

[0278] Furthermore, as shown in Figures 23 and 24, the retractor 300 may be constructed using a movable elongated structure 10e. Figure 23 shows a schematic diagram of the retractor 300. Figure 23(a) shows a perspective view of the retractor 300, and Figure 23(b) shows a perspective view of the retractor 300 with the towing wire 50 shown in a transparent state.

[0279] Figure 24 shows a schematic diagram of the retractor 300. Figure 24(a) shows a plan view of the retractor 300, Figure 24(b) shows a cross-section passing through the upper wire lumen, and Figure 24(c) shows a plan view of the retractor 300 with the elastic retractor 301 in the open position.

[0280] The retractor 300 utilizes the movable elongated structure 10e described above, and instead of the tip-side flexible tube 20 in the movable elongated structure 10e, it is equipped with an elastic retractor 301 on the tip-side LF of the spacer 40e. Specifically, the movable elongated structure 10e shown in Figures 14 and 15 is used in an orientation where the width direction W is the height direction H.

[0281] In the retractor 300, the spacer 40e is formed to have a shorter longitudinal length L of the cylinder 42 than the spacer 40e on the tip side LF of the movable long structure 10e, but the other configurations are the same. Also, the routing of the towing wire 50 is the same as that of the movable long structure 10e, so the explanation is omitted.

[0282] Two elastic retractors 301 are fixed to the front end LF of the spacer 40e, with the two retractors positioned opposite each other in the width direction W. The elastic retractor 301 consists of an elastic body 302 extending toward the tip side LF and a plurality of plate portions 303 protruding outward from the elastic body 302 in the width direction W.

[0283] The elastic body 302 is a rectangular plate having a predetermined thickness that is longer in the longitudinal direction L than in the height direction H, and the plate portion 303 is a rectangular plate having a predetermined thickness that is longer in the height direction H than in the width direction W. Multiple plate portions 303 are arranged at predetermined intervals in the longitudinal direction L, and are integrally formed with the elastic body 302. They are formed in a substantially rectangular parallelepiped shape, longer in the height direction H than in the width direction W, and longer in the longitudinal direction L than in the height direction H.

[0284] Multiple plate sections 303 are arranged at predetermined intervals in the longitudinal direction L, and each plate section 303 has an insertion hole 304 formed therein, which corresponds to the tip-side wire lumens 22 (23, 24) of the tip-side flexible tube 20 in the movable elongated structure 10e, through which the traction wire 50 (54, 53) is inserted.

[0285] The elastic retractor 301 configured in this way is positioned such that, at the tip side LF of the spacer 40e, it faces opposite each other at a predetermined distance in the width direction W, that is, the direction in which the plate portion 303 protrudes from the elastic body 302 faces outward in the width direction W. Then, the traction portion 53 is inserted through the insertion hole 304 of the elastic retractor 301 on the left side WL, and the traction portion 54 is inserted through the insertion hole 304 of the elastic retractor 301 on the right side WR.

[0286] With the retractor 300 configured in this way, the intermediate tube 60 can be bent in the width direction W, as shown by the arrow in Figure 23(a), by pulling the traction sections 55 and 56, which are positioned in the height direction H at the base end LB, toward the base end LB.

[0287] Specifically, the intermediate tube 60 can be bent to the left WL by pulling the traction portion 56, which is inserted through the left wire lumens 34b and 36a of the left wire lumen WL in the proximal wire lumens 34 and 36, toward the proximal LB.

[0288] Conversely, the intermediate tube 60 can be bent towards the right WR by pulling the traction portion 55, which is inserted through the right wire lumens 34a and 36b of the right wire lumen 34 and 36, towards the base LB. Then, by releasing the tension on the traction sections 55 and 56, the bending caused by the tension on the traction sections 55 and 56 is relieved by the elastic force of the intermediate tube 60.

[0289] Then, by pulling the traction portions 53 and 54 that are inserted through the base end wire lumens 33 and 35 in the width direction W at the base end LB, the elastic retractor 301 can be opened. Specifically, by pulling the traction portion 53 inserted through the insertion hole 304 of the elastic retractor 301 on the left side of the WL, the elastic retractor 301 on the left side of the WL can be bent outward in the width direction W, as shown by the arrow in Figure 23(a), without bending the intermediate tube 60.

[0290] Conversely, by pulling the traction portion 54 inserted through the insertion hole 304 of the elastic retractor 301 of the right WR, the elastic retractor 301 of the right WR can be bent outward in the width direction W without bending the intermediate tube 60, as shown by the arrow in Figure 23(a).

[0291] Therefore, when the traction portion 53 and the traction portion 54 are pulled simultaneously, as shown in Figure 24(c), the elastic retractors 301 on both sides in the width direction W are bent outward in the width direction W, allowing the retractor 300 to be used as a wound retractor to open a predetermined area. Furthermore, by releasing the traction on the traction section 53 and / or the traction section 54, the bending of the traction section 53 and / or the traction section 54 due to traction is relieved by the elastic force of the elastic retractor 301 (302).

[0292] In the following, a manipulator 100, which is a medical device in another embodiment using the movable elongated structure 10 of the present invention, as shown in Figure 25, will be described. Figure 25 is a schematic diagram of the manipulator 100, which is a medical device in another embodiment using the movable elongated structure 10 of the present invention.

[0293] The manipulator 100 is a medical device for inserting into a conduit with branching pathways, such as a blood vessel, and performing a predetermined procedure after its tip reaches a predetermined location. It comprises a manipulator body 101 having a grip for the operator to grasp, and a movable elongated structure 10 extending from the tip of the manipulator body 101 to the tip side LF.

[0294] The manipulator body 101 includes a traction drive unit 102 that pulls the traction portion 52 (not shown) of the traction wire 50 (not shown) extending from the base end LB of the movable elongated structure 10, an operating handle 103 (103a, 103b) that manually controls the bending direction of the movable elongated structure 10 by pulling the traction portion 52 with the traction drive unit 102, and a control unit 104 that controls how the traction drive unit 102 pulls the eight traction portions 52 by manually operating the operating handle 103.

[0295] The traction drive unit 102 and the control unit 104 are located inside the manipulator body 101, while the operating handle 103 is located outside the manipulator body 101. The operating handle 103 includes an up-down operating handle 103a for bending the movable elongated structure 10 in the height direction H, and a width-direction operating handle 103b for bending it in the width direction.

[0296] The operator can manually operate the vertical control handle 103a to bend the tip end LF of the movable elongated structure 10 either upward HU or downward HD in the height direction H, and can also bend it to a desired amount depending on the amount of operation of the vertical control handle 103a.

[0297] Furthermore, the operator can manually operate the widthwise operating handle 103b to bend the movable elongated structure 10 to the right or left in the widthwise direction, and can bend it to a desired amount depending on the amount of operation of the widthwise operating handle 103b.

[0298] The operator can then manually operate both the vertical operating handle 103a and the horizontal operating handle 103b simultaneously or sequentially to bend the tip LF of the movable elongated structure 10 in an oblique direction that intersects the height direction H and the width direction, and can also bend it in a desired bending direction depending on the amount of operation of the vertical operating handle 103a and the horizontal operating handle 103b.

[0299] In the description of the manipulator 100 above, a movable long structure 10 was used, but instead of the movable long structure 10, any of the movable long structures 10a to 10e, 10j, or 10k described above may be used. In this case, it is advisable to provide a traction drive unit 102 corresponding to the bending direction, i.e., the number of traction wires 50 (tow section 52), and an operating handle 103 corresponding to the bending direction. Furthermore, if necessary, the operating handles 103a and 103b may be provided in a separate unit and connected to the manipulator body 101 by wire or wireless connection.

[0300] Next, a remote surgery system 200 in one embodiment of the present invention will be described with reference to Figures 26 and 27. Figure 26 shows a schematic diagram of the remote surgery system 200 in another embodiment, and Figure 27 shows a schematic diagram of the tool 217 in the remote surgery system 200. More specifically, Figure 27(a) shows a plan view of the tool 217 that can be loaded into the robot arm assembly of the remote surgery system 200, and Figure 27(b) shows the internal structure of the tool 217.

[0301] The remote surgery system 200 includes a surgeon console 201 which serves as the station for each of the two operators D (D1, D2), a master control unit 202 operated by operator D, a viewing / core cart 240, and a patient-side cart 210 which is the patient-side cart.

[0302] The surgeon console 201 includes a viewer 201a on which an image of the surgical site is displayed to operator D. When using the surgeon console 201, operators D1 and / or D2 typically sit in the chair of the surgeon console, aligning both of their eyes with the viewer 201a, and holding the master control unit 202 in one hand.

[0303] The remote surgery system 200 can be operated by two operators simultaneously, but it can also be operated by a single operator. When two operators operate simultaneously, coordinated operation between the two is possible, which has the advantage of shortening the overall surgery time for patients. The system may also include three or more surgical consoles 201 and master control units 202, depending on the needs.

[0304] The robot on the patient-side cart 210 is positioned adjacent to the patient. During use, the patient-side cart 210 is positioned near the patient requiring surgery. The robot on the patient-side cart 210 is fixed during surgical procedures but is equipped with casters on the base 211 to allow for movement. The surgeon's console 201 is used in the same operating room as the patient-side cart, but may be positioned remotely from the patient-side cart 210.

[0305] The patient-side cart 210 includes four robotic arm assemblies 212, although the number of robotic arm assemblies 212 is arbitrary. Each robotic arm assembly 212 is connected to and controlled by a drive unit 213 that enables three-dimensional movement.

[0306] The display unit 214 displays image data related to the surgery. The drive unit 213 is controlled by the master control unit 202 of the surgeon console 201. The movement of the tool 217 of the robot arm assembly 212 is controlled by the operation of the master control unit 202.

[0307] One of the four robotic arm assemblies 212a is equipped with an image acquisition device 215, such as an endoscope. The remote end of the image acquisition device 215 includes a viewing camera 216. The elongated, shaft-shaped image acquisition device 215 allows the viewing camera 216 to be inserted through the surgical entry port of the patient (not shown).

[0308] The image acquisition device 215 is operablely connected to the viewer 201a of the surgeon console 201 in order to display the images acquired by its viewing camera 216. Each of the other robotic arm assemblies 212 is a linkage device that supports and includes a tool 217, which is a detachable surgical instrument.

[0309] The tool 217 includes an elongated, movable elongated structure 10 that can be inserted through the patient's surgical entry port. The movement of the movable elongated structure 10 is controlled by the master control unit 202 of the surgeon console 201. The movable elongated structure 10 utilizes the movable elongated structure 10 of the embodiment described above.

[0310] Figure 27 shows a representative configuration of a tool 217 that can be loaded into the robotic arm assembly 212 of the remote surgery system 200 shown in Figure 26. A tool 217 mounted on another robotic arm assembly 212 may have a similar configuration, or it may be a surgical device with a different configuration.

[0311] The tool 217 shown in Figure 27(a) comprises a movable elongated structure 10 having a traction wire 50, a surgical device 221 for driving, controlling, and monitoring the tool 217, and a connector 228 for connecting to a robot. The surgical device 221 constitutes a traction drive unit that drives the traction wire 50 within the movable elongated structure 10.

[0312] As shown in Figure 27(b), which illustrates the internal configuration of tool 217, the medical system consists of a surgical device 221 that drives tool 217, which is directly connected to the robotic arm assembly 212 in Figure 26, via a shaft 225, and a patient-side cart 210 that controls the surgical device 221.

[0313] The movable elongated structure 10 has a base-end tubular body 30 connected to the shaft 225, a wiring aid 40, and a tip-end tubular body 20 which is an end effector. As described in the above embodiment, the movable elongated structure 10 has a bending structure, which increases the degree of freedom of the operating angle of the tip-end tubular body 20 and improves the accuracy of robot control.

[0314] The surgical device 221 of tool 217 has a control circuit 231 that controls signals within the surgical device and a signal interface 232 with the robot on the patient-side cart 210. The control circuit 231 is configured to control a drive mechanism (not shown) that drives a predetermined traction wire of the movable elongated structure 10 based on a control signal from the robot 210.

[0315] As also explained in Figure 28, the robot on the patient-side cart 210 is connected to the surgical device 221 via a signal interface 232 and a connector 228 by wire and / or wirelessly. Inside the robot on the patient-side cart 210, there is an input unit that receives operation signals from the master control unit 202, a calculation unit CPU that executes a predetermined operation program based on the operation signals, and an output unit that generates drive signals to drive the movable elongated structure 10 of the tool 217 via the surgical device 221 based on the output from the calculation unit. The input unit and the output unit constitute an input / output unit 210a (I / O). Figure 28 is an explanatory diagram of the remote surgery system 200, where Figure 28(a) is a block diagram showing the connection relationships with each unit, and Figure 28(b) is an operation flow diagram of the remote surgery system 200.

[0316] The visual core cart 240 has functions related to the image acquisition equipment. When the remote surgery system 200 is started for surgery, the surgeon operates the master control unit 202 of the surgeon console 201, and if there are two surgeons, they also operate the master control unit 202 of the surgeon console 201 (step S1), and the commands generated by the operation are sent to the visual core cart 240 (step S2). Next, the visual core cart 240 interprets the signals and moves the desired robotic arm assembly 212 to the patient's surgical area (step S3).

[0317] Next, the movable elongated structure 10 of the tool 217 attached to the selected robotic arm assembly 212 is inserted into the patient through the elongated pipe (step S4). After reaching a predetermined location by bending the tubular end 20, a predetermined procedure is performed (step S5) to complete the surgery on the living tissue.

[0318] In the description of the remote surgery system 200 and tool 217 above, a movable elongated structure 10 was used, but instead of the movable elongated structure 10, any of the above-mentioned movable elongated structures 10a to 10e, 10j, or 10k may be used. In this case, it is advisable to provide a traction drive unit 102 corresponding to the bending direction, i.e., the number of traction wires 50 (traction section 52), and an operating handle 103 corresponding to the bending direction.

[0319] The aforementioned manipulator 100, retractor 300, tool 217, and remote surgery system 200 equipped with tool 217 are equipped with a movable elongated structure 10, and in addition to the effects of the movable elongated structure 10 described above, they can also achieve the effects obtained from each of their respective configurations.

[0320] The demonstration experiments conducted on the movable elongated structures 10 (10a, 10b, 10e, 10j, 10k) configured in this way and used in manipulators 100, retractors 300, etc., will be described below with reference to Figures 29 and 30.

[0321] First, as shown in Figure 29, the bending performance of the movable long structure 10, which is movable in four directions (all directions), was confirmed compared to a conventional bidirectional movable long structure. Figure 29(a) shows the initial state, Figure 29(b) shows the movable long structure 10 in a bent state, and Figure 29(c) shows a movable long structure that mimics a conventional bidirectional movable long structure in a bent state. In Figures 29(b) and (c), the right-hand diagram illustrates the routing of the traction portion 52 of the spacer 40 in the movable long structure 10.

[0322] In this demonstration experiment, in order to mimic a conventional bidirectional movable elongated structure, the traction portion 52 was arranged linearly in the spacer 40 of the movable elongated structure 10 to create a bidirectional movable structure, and the bending shape was compared with that of the movable elongated structure 10. The movable elongated structure 10 shown in Figure 29(b) was designed with an outer diameter of 3.2 mm for the tip-side flexible tube 20 and the base-side flexible tube 30, a tip-side spacing X1 of 1.157 mm, and a base-side spacing X2 of 0.32 mm. When a pair of traction wires 50 were pulled, the movable elongated structure 10 showed a displacement of approximately 20 mm at the tip end of the base-side flexible tube 30, whereas in Figure 29(b) only a displacement of approximately 5 mm occurred. This confirmed that when the tip end of the tip-side flexible tube 20 is flexibly bent so that the orientation of the tip end is the same, the deformation of the base-side flexible tube 30 reduces the distance deviated from the horizontal by 75%.

[0323] As a result, the traction of the traction wire 50 has little effect on the deformation of the base-side flexible tube 30 in the movable long structure 10, and even when the base-side flexible tube 30 is deformed by complex paths or external forces, the deterioration of the movable bending performance of the tip-side flexible tube 20 is reduced. From these results, it was confirmed that the deterioration of the bending performance of the tip-side flexible tube 20 can be reduced by routing the traction wire 50.

[0324] Next, as shown in Figure 30, the bending radius of the movable elongated structure 10 was compared with that of a conventional bidirectional movable elongated structure. Figure 30(a) shows the structure when bent at 90 degrees, and Figure 30(b) shows the structure when bent at 275 degrees. The upper part of each figure shows a conventional two-way movable elongated structure, and the lower part shows the movable elongated structure 10 of the present invention.

[0325] The movable elongated structure 10 shown in the lower part of Figure 30 can be bent in four directions (all directions), and it was confirmed that, compared to the conventional two-directional movable elongated structure shown in the upper part of Figure 30, the bending radius is approximately 13% smaller at the same degree of bending.

[0326] Furthermore, while conventional bidirectional movable long structures use one traction wire 50 to bend in one direction, the movable long structure 10, which uses a loop-shaped traction wire 50, requires the equivalent (synonymous) of pulling two traction wires 50 to bend in one direction. As a result, the traction force acting on the traction wire 50 is approximately half that of a conventional bidirectional movable long structure, allowing the use of thinner traction wires 50 that are more prone to breakage compared to conventional bidirectional movable long structures. In addition, because the traction force acting on the traction wire 50 is approximately halved, the force that contacts the inner surface of the tip-side wire lumen 22 of the tip-side flexible tube 20 and the inner surface of the base-side wire lumen 32 of the base-side flexible tube 30 when the traction wire 50 is bent is also approximately halved, confirming that softer tubes can be used for the tip-side flexible tube 20 and the base-side flexible tube 30.

[0327] In the correspondence between the configuration of the present invention and the embodiments described above, the longitudinal direction of the present invention corresponds to the longitudinal direction L, and similarly, The tip side corresponds to the tip side LF, The proximal end corresponds to the proximal end LB. The tubular body at the tip corresponds to the flexible tubes 20, 20j, and 20k at the tip. The tubular body at the proximal end corresponds to the flexible tubes 30, 30j, and 30k at the proximal end. The cylindrical body corresponds to cylinders 42 and 42k. The wiring aid is compatible with spacers 40, 40a, 40e, 40g, 40i, 40j and assembly spacer 40k. The proximal end protrusions correspond to the proximal end protrusions 43b and 43jb. The tip side protrusions correspond to tip side protrusions 43a and 43ja. The through-hole at the tip corresponds to the tip wire lumen 22. The base end through hole corresponds to the base end wire lumen 32. The towing mechanism corresponds to the towing wire 50. The leading-side virtual line corresponds to the leading-side virtual line FVL. The center line on the tip side corresponds to the center line FCL on the tip side. The tip-side spacing corresponds to the tip-side spacing X1. The proximal virtual line corresponds to the proximal virtual line BVL. The proximal center line corresponds to the proximal center line BCL. The base-side spacing corresponds to the base-side spacing X2. The proximity restriction section corresponds to the proximity restriction section 45b, The operating mechanism placement section corresponds to the placement recesses 44, 44a, 44e, 44i, 44j, 44ja, and 44jb. The separation control section corresponds to the separation control section 45a, The through-hole sets correspond to through-hole sets 11, 11a, 11b, 11c, 11d, 11e, 11f, 11g, and 11h. The induction section corresponds to induction protrusions 46, 46g, The intermediate tubular body corresponds to the intermediate tube 60. The intermediate through-holes correspond to intermediate wire lumens 63, 64, 65, and 66. The main lumen corresponds to 21 and 31 lumens. The movable long structure corresponds to movable long structures 10, 10a, 10b, 10e, 10j, and 10k. The traction drive unit corresponds to the traction drive unit 102 and the drive device 213. The movable, long-length structural device is compatible with the Manipulator 100 and Retractor 300. The control unit corresponds to control unit 104 and master control unit 202. The medical system is compatible with the remote surgery system 200. The robot arm corresponds to the robot arm assembly 212. The connection part corresponds to connector 228. The tool is compatible with tool 217. The manipulator is compatible with manipulator 100. The input / output unit is compatible with input / output unit 210a. The arithmetic unit corresponds to the arithmetic unit CPU, While robots and medical robots are compatible with the patient-side cart 210, the embodiment is not limited to the one described above.

[0328] Although a towing wire 50 was used as the towing mechanism, it may also be in the form of a strip. Furthermore, although a pair of towing sections 53 were formed by bending a single towing wire 50 at the bending section 51, a pair may be formed using separate towing wires 50. When towing a pair of separately formed towing wires 50, one towing wire 50 may be towed, or both towing wires 50 may be towed. In addition, even when both towing wires 50 are towed, each towing wire 50 may be towed with a different towing force.

[0329] The flexible tubes 20 and 30 use a circular ring-shaped tube with main lumens 21 and 31 inside, but they may also be tubular bodies with an elliptical ring-shaped or polygonal ring-shaped cross-section, and the main lumens 21 and 31 may be similar in shape to the outer diameter of the above-described cross-sectional shape, or they may have a different cross-sectional shape. Furthermore, the main lumens 21 and 31 in the flexible tubes 20 and 30 may be positioned offset from the center of the flexible tubes 20 and 30.

[0330] Furthermore, the flexible tubes 20 and 30 may be constructed as a spine structure in which rigid bodies having a main lumen inside are connected via rotational joints and elastic bodies. Alternatively, the remote surgery system 200 may be configured using a retractor 300 instead of the movable elongated structure 10 in tool 217. [Explanation of symbols]

[0331] 10, 10a, 10b, 10e, 10j, 10k… Movable long-length structure 11,11a,11b,11c,11d,11e,11f,11g,11h,...Through hole set 20, 20j, 20k... Flexible tube at the tip 21…Main lumen at the tip 22… Wire lumen at the tip 30,30j,30k…Proximal flexible tube 31…Main lumen at the base 32…Proximal wire lumen 40, 40a, 40e, 40g, 40i, 40j… Spacers 40k... Assembly spacer 42,42k... cylinder 43,43i,43j,43k...Protrusion 43a, 43ja… Protruding edge portion at the tip 43b, 43jb…Proximal side protruding edge 44, 44a, 44e, 44i, 44j, 44ja, 44jb… Placement recess 45a...Separation regulation part 45b... Proximity control section 46,46g...Inductive protrusion 50... Towing wire 60...Intermediate tube 62…Intermediate wire lumens 100... Manipulator 102...Towing drive unit 200... Remote surgery system 202…Master control unit 210...Patient-side cart 210a... Input / Output Unit 212...Robot arm assembly 213... Drive unit 228… Connector 217...Tools 300... Retractor 302...Elastic body CPU... Processing Unit X1...Distance at the tip X2…Proximal distance BCL... Centerline on the proximal end BVL…Proximal virtual line FCL... Center line at the tip FVL…Virtual line at the tip L...longest direction LF... Tip side LB...Proximal side

Claims

1. The device has a tip-side tubular body, a base-side tubular body, and a traction operating body, and a wiring aid is provided between the tip-side tubular body and the base-side tubular body, which is detachably held by the traction operating body. A movable, elongated structure.

2. The tip-side tubular body and the base-side tubular body are formed in a flexible, elongated shape, A pair of flexible traction operating bodies that pass through a pair of longitudinally oriented through holes provided inside the tube walls of the tip-side tubular body and the base-side tubular body, A wiring aid is provided, which is positioned between the tip-side tubular body and the base-side tubular body and restricts the direction of the traction operating body. The through hole provided in the base end tubular body is designated as the base end through hole, and the through hole provided in the tip end tubular body is designated as the tip end through hole. The circumferential spacing between the pair of base-side through holes is set to be wider than the circumferential spacing between the pair of tip-side through holes. The aforementioned wiring aid is At least one cylindrical body is provided, arranged along the longitudinal direction, The cylindrical body has a base-side protruding edge portion that is positioned at the base end and protrudes radially outward, The cylindrical body is provided with a tip-side protruding edge portion that is positioned at the tip end and protrudes outward in the diameter, The base end protruding edge is provided with an operating body arrangement portion on which the traction operating body, which is led out from the base end through hole and introduced into the tip end through hole, is arranged. The tip-side protruding edge is provided with an operating body arrangement portion on which the traction operating body, which is led out from the base-side through hole and introduced into the tip-side through hole, is arranged. The movable elongated structure according to claim 1.

3. The distance between the virtual line connecting the centers of the pair of end-side through holes and the central line passing through the center of the end-side tubular body and parallel to the virtual line is the end-side distance. The base end spacing is set wider than the base end spacing, which is the distance between the base end virtual line connecting the centers of the pair of base end through holes and the base end central line passing through the center of the base end tubular body and parallel to the base end virtual line. The movable elongated structure according to claim 2.

4. The aforementioned base-side protruding edge is provided at the base-side end of the cylindrical body, The aforementioned tip-side protruding edge portion is provided at the tip end of the cylindrical body, The base end protruding edge is provided with a proximity restricting portion that restricts the circumferential proximity of the traction operating body, which is led out from the base end through hole and introduced into the tip end through hole, The tip side protruding edge is provided with a spacing restricting portion that restricts the circumferential spacing of the traction operating body, which is led out from the base end side through hole and introduced into the tip side through hole. The operating body arrangement section is open on the outer diameter The movable elongated structure according to claim 2 or claim 3.

5. The base end protrusion and the tip end protrusion are integrally formed with the cylindrical body. The movable elongated structure according to claim 4.

6. At least one of the base end protruding edge and the tip end protruding edge is constructed separately from the cylindrical body and is configured to be assembled. The movable elongated structure according to claim 4.

7. A pair of base-side through holes and a pair of tip-side through holes through which the pair of traction operating bodies are inserted are formed into a set of through holes. Multiple sets of these through-holes are arranged at different positions in the circumferential direction. Multiple proximity restricting portions and operating body placement portions are provided on the protruding base edge portion, Multiple separation restricting portions and operating body placement portions are provided on the tip side protruding edge portion. A movable elongated structure according to any one of claims 4 to 6.

8. In the base end protruding edge portion, a common proximity restricting portion restricts the proximity of adjacent traction operating bodies in the circumferential direction to each other among a pair of traction operating bodies that pass through the circumferentially adjacent through-hole set. At the tip side protruding edge portion, the separation of a pair of traction operating bodies that pass through adjacent through-hole sets in the circumferential direction is restricted by a separation restricting portion common to the traction operating body that passes through an adjacent through-hole set on the opposite side in the circumferential direction. The movable elongated structure according to claim 7.

9. One of the traction operating bodies and the other of the traction operating bodies intersect in the circumferential direction, passing through the set of through holes that are adjacent to each other in the circumferential direction. The cylindrical body is provided with a guide portion that guides one of the traction operating bodies to the outside of the other traction operating body. The movable elongated structure according to claim 7 or claim 8.

10. An elongated intermediate tubular body having an intermediate through-hole is positioned between the aforementioned tip-side tubular body and the aforementioned base-side tubular body. Multiple pairs of the aforementioned traction operating bodies are provided, At least one of the multiple pairs of traction operating bodies is inserted through the tip-side through hole, the intermediate through hole, and the base-side through hole. At least one of the multiple pairs of traction operating bodies is inserted through the intermediate through hole and the base end through hole. A movable elongated structure according to any one of claims 7 to 9.

11. The aforementioned traction mechanism is a flexible wire, The aforementioned tip-side tubular body and the aforementioned base-side tubular body are composed of flexible tubes having a main lumen. The through-hole is a wire lumen formed inside the tube wall through which the wire can be inserted. A movable elongated structure according to any one of claims 2 to 10.

12. The wire was bent back at the tip end of the tubular end to form a pair of traction operating bodies. The movable elongated structure according to claim 11.

13. A movable elongated structure as described in any one of claims 1 to 12, It is equipped with a traction drive unit that pulls a pair of the aforementioned traction operating bodies, The traction drive unit pulls the pair of traction operating bodies to bend and deform the tubular end section. A movable, long-length structural device.

14. A movable elongated structure as described in any one of claims 7 to 10, It is equipped with a traction drive unit that pulls a pair of the aforementioned traction operating bodies, Multiple traction drive units are provided. The pair of traction operators are pulled by a predetermined traction drive unit to cause the tip-side tubular body to bend and / or expand / contract (extend) in a desired direction. A movable, long-length structural device.

15. A movable elongated structural device as described in claim 13 or claim 14, A drive unit that drives the traction drive unit, It comprises a control unit connected to the drive unit to apply a drive signal. Healthcare system.

16. A movable, elongated structural device as described in claim 14, A drive unit that selectively drives at least one of the multiple traction drive units, It comprises a control unit connected to apply a drive signal to the drive unit. Healthcare system.

17. An operating unit is provided for selectively operating the drive of at least one of the multiple traction drive units, and is connected to the control unit. The medical system according to claim 16.

18. A movable elongated structural device as described in claim 13 or claim 14, The movable elongated structure includes a mounting portion for attaching the base end tubular body to the tip of a robot arm, The robot arm is provided with a connection part that connects to a drive mechanism that drives the traction drive unit. tool.

19. The tool described in claim 18, A robotic arm with the aforementioned tool attached to its tip The traction drive unit and the drive unit that drives the robot arm, It comprises a control unit connected to apply a drive signal to the drive unit. robot.

20. A movable elongated structural device as described in claim 13 or claim 14, The main body portion provided at the base end of the base end tubular body in the movable elongated structure, The main body is equipped with an operating section for operating the traction drive unit. manipulator.

21. An input / output unit connected by wire and / or wirelessly to a movable elongated structural device as described in claim 13 or claim 14, An input unit that receives control signals in real time, A calculation unit that executes a predetermined operation program based on the aforementioned operation signal, The system comprises an output unit that generates a drive signal based on the output from the calculation unit, which causes the traction drive unit to pull a predetermined traction operating body, thereby causing at least the tip-side tubular body to bend and / or expand / contract (extend) in a desired direction. robot.

22. The robot comprises the robot described in claim 21, The output unit provides a drive signal to an externally located drive unit that mechanically drives the movable elongated structure. Medical robot.

23. A movable elongated structure described in any of claims 1 to 12 is inserted into the conduit, The traction drive unit that pulls the pair of traction operating bodies is driven and controlled to bend and deform the tip-side tubular body, and the tip-side tubular body is inserted into the branching conduit. Method of insertion.

24. A movable, elongated structure having a tip-side tubular body, a base-side tubular body, and a traction mechanism, with a wiring aid detachably held by the traction mechanism between the tip-side tubular body and the base-side tubular body, is inserted into the conduit. The traction drive unit is driven and controlled to bend and deform the tubular end section, and the tubular end section is inserted into the branching conduit. Method of insertion.

25. The conduit is at least one of a tubular organ, a blood vessel, and a blood vessel. The insertion method according to claim 23 or claim 24.

26. A robot equipped with a movable elongated structural device as described in claim 13 or claim 14, wherein a wired and / or wirelessly connected input / output unit receives operation signals in real time. When the arithmetic unit executes a predetermined operation program based on the received operation signal, Based on the output from the calculation unit, the traction drive unit pulls the traction operator to deform the tip-side tubular body by bending and / or extending (stretching) in the desired direction. How to operate the robot.

27. A wiring aid is removed from a movable elongated structure having a tip-side tubular body, a base-side tubular body, and a traction operating body, the wiring aid being detachably held between the tip-side tubular body and the base-side tubular body by the traction operating body. Operation method for a movable, long-length structure.

28. The pair of traction operators are pulled to bend and deform the tubular end section. A method for operating a movable elongated structure according to claim 27.

29. Multiple pairs of the aforementioned towing operation bodies are provided, The towing mechanism pulls a predetermined pair of the towing mechanisms from among multiple pairs of towing mechanisms to bend and deform the tubular end section in a desired direction. A method for operating a movable elongated structure according to claim 27.

30. A movable elongated structure having a tip-side tubular body, a base-side tubular body, and a traction operating body, configured to be removable and holdable between the tip-side tubular body and the base-side tubular body. Wiring aids.

31. At least one cylindrical body is provided, which is arranged in series along the longitudinal direction from the tip end to the base end, between the flexible, elongated tip end tubular body and the base end tubular body, and which is arranged along the longitudinal direction. At the base end of the cylindrical body, there is a base edge portion that protrudes radially outward, and the circumferential spacing is set wider than the circumferential spacing between the pair of longitudinally penetrating through holes provided inside the tube wall of the tip-side tubular body. This base edge portion is provided with an operating body arrangement section where a pair of traction operating bodies are led out from the pair of longitudinally penetrating through holes provided inside the tube wall of the base-side tubular body and introduced into the tip-side through holes. At the tip end of the cylindrical body, there is a tip edge portion that protrudes radially outward, and is provided with an operating body arrangement section where the traction operating bodies are led out from the base through holes and introduced into the tip-side through holes. Wiring aid according to claim 30.

Images