Medical internal insertion tubes

Abstract

This invention provides a novel medical internal insertion tube with a structure that allows the tip portion of the proximal tube to be bent in any direction while suppressing the bending deformation of the proximal tube, thereby improving manufacturability while maintaining a good sealing state of the main lumen with a small number of parts. [Solution] The medical internal insertion tube 10 comprises a tip tube 30 having a first sub-blumen 44, a base tube 32 having a second sub-blumen 50, a traction wire 56, a fixing portion 38 to which the tip tube 30 and the base tube 32 are fixed together with the sub-blumen 52 in place, and an exposed portion 55 provided at a position separated from the fixing portion 38 to expose the sub-blumen 52, the sub-blumen 52 including a close sub-blumen 53 and a detached sub-blumen 54, and the traction wire 56 is inserted through the close sub-blumen 53 and exposed at the exposed portion 55, and has an extension portion 62 through which the detached sub-blumen 54 which opens at the base end of the exposed portion 55 is inserted.

Description

Technical Field

[0001] The present invention relates to a medical intracorporeal insertion tube that is inserted into a lumen in the body and whose distal end portion can be bent in a predetermined direction.

Background Art

[0002] Conventionally, for example, medical intracorporeal insertion tubes such as catheters and endoscopes have been used, which are inserted into the lumens of living bodies such as patients' luminal organs, blood vessels, and blood vessels, and whose distal end portions can be bent in a predetermined direction at branch portions in the lumen. For example, International Publication No. 2022 / 097666 (Patent Document 1) discloses a medical intracorporeal insertion tube including a distal end side tube, a proximal end side tube, a tubular wiring assist tool, and a traction wire, wherein the wiring assist tool is removably held by an operating wire between the distal end side tube and the proximal end side tube.

[0003] According to the medical intracorporeal insertion tube described in Patent Document 1, a pair of traction wires held at the distal end portion of the distal end side tube are inserted into a pair of through holes arranged in proximity in the circumferential direction penetrating axially inside the tube wall of the distal end side tube and exposed on the wiring assist tool. In the wiring assist tool, after changing and restricting the extending directions of the respective traction wires so that the pair of traction wires extend in a direction in which they are separated from each other in the circumferential direction, they are inserted into a pair of through holes arranged separately from each other in the circumferential direction penetrating axially inside the tube wall of the proximal end side tube. Then, by applying a traction operating force to the traction wire protruding from the proximal end surface of the proximal end side tube, the distal end portion of the distal end side tube can be bent in an arbitrary direction while suppressing the bending deformation of the proximal end side tube, and the distal end portion of the distal end side tube can be bent with a relatively small bending radius.

Prior Art Documents

Patent Documents

[0004]

Patent Document 1

Summary of the Invention

[0005] However, the medical internal insertion tube disclosed in Patent Document 1 requires the placement of a tubular wiring aid between the tip tube and the base tube to change and restrict the direction of extension of the traction wire exposed from the tip tube, which inherently increases the number of parts. Furthermore, in order to seal the main lumen, which is formed by connecting the inner bore of the tip tube, the wiring aid, and the base tube, it is necessary to bond the parts between the tip tube and the wiring aid and between the wiring aid and the base tube, as well as evaluate the waterproofness of the main lumen and the fixing strength between the wiring aid and the tip / base tubes, making manufacturing complicated. In addition, the multiple traction wires, tip tube, wiring aid, and base tube each need to be assembled separately, which also inherently results in poor manufacturability.

[0006] In view of these circumstances, the problem addressed by the present invention is to provide a novel medical internal insertion tube that can be bent in any direction while suppressing the bending deformation of the proximal tube, and that can improve manufacturability while maintaining a good sealing state of the main lumen with a small number of parts. [Means for solving the problem]

[0007] The following describes preferred embodiments for understanding the present invention. However, each embodiment described below is illustrative and can be combined with others as appropriate. Furthermore, the multiple components described in each embodiment can be recognized and adopted as independently as possible, and can be combined with any component described in another embodiment as appropriate. Thus, the present invention is not limited to the embodiments described below, and various other embodiments can be realized.

[0008] The first embodiment includes a tip-side tube positioned at the tip end, having a first cylindrical wall portion, a first main lumen formed by the inner bore of the first cylindrical wall portion, and a plurality of first sub-lumens arranged at a plurality of locations separated from each other in the circumferential direction of the first cylindrical wall portion, each penetrating the first cylindrical wall portion in the axial direction; a base-side tube positioned at the base end of the tip-side tube, having a second cylindrical wall portion, a second main lumen formed by the inner bore of the second cylindrical wall portion, and a plurality of second sub-lumens arranged at a plurality of locations separated from each other in the circumferential direction of the second cylindrical wall portion, each penetrating the second cylindrical wall portion in the axial direction; a towing wire; and a main lumen formed by the coaxially arranged first main lumen and second main lumen being connected in the axial direction, and a plurality of coaxially arranged first sub-lumens and a plurality of second sub-lumens being connected in the axial direction. The present invention relates to a medical internal insertion tube, comprising: a fixing portion in which the base end surface of the tip tube and the tip surface of the base tube are fixed together in a lumen configuration; and an exposed portion provided at a position spaced apart from the fixing portion on the tip tube side or the base tube side, exposing at least four of the sub-lumines to the outer surface, wherein the at least four sub-lumines include a pair of close sub-lumines arranged in close proximity in the circumferential direction, and a pair of sparse sub-lumines provided at positions spaced apart from the close sub-lumines on one and the other side in the circumferential direction, and the traction wire having a holding portion held on the tip tube side, and a pair of extension portions extending from the holding portion, passing through a pair of close sub-lumines to be exposed in the exposed portion, and further passing through a pair of sparse sub-lumines that open at the base end side of the exposed portion to protrude from the base end side of the base tube.

[0009] In the medical internal insertion tube according to this embodiment, the tip tube located at the tip end and the proximal tube located at the proximal end are integrated at a fixing portion. Furthermore, at the fixing portion, the proximal end surface of the tip tube and the tip surface of the proximal tube are fixed to each other with their respective main lumens and sublumens positioned coaxially. This eliminates the need for a cylindrical connecting part that was required between the tip tube and the proximal tube in conventional structures, thereby reducing the number of parts and lowering costs.

[0010] Furthermore, since the exposed portion is limited to the sub-blumen, compared to conventional structures where the tip-side tube and the base-side tube were connected by a tubular wiring aid, a completely sealed state of the main lumen can be stably ensured along the entire length of the medical internal insertion tube. Moreover, the exposed portion where the sub-blumen is exposed to the outside is provided on the outer surface of the tip-side tube or the base-side tube, which is a portion separated from the fixing portion. As a result, it is not necessary to perform the connection work between the two tubes and the insertion work of the sub-blumen of the traction wire simultaneously, as in conventional structures. Therefore, the work of inserting the pair of extensions of the traction wire exposed by inserting the sub-blumen opening at the tip side of the exposed portion, and then changing their position and inserting them into the sub-blumen opening at the base side of the exposed portion at a position separated in the circumferential direction, can be performed more simply and smoothly, improving manufacturability compared to conventional structures.

[0011] In addition, the pair of extensions of the towing wire are inserted through a pair of proximity sub-brumes positioned close together in the circumferential direction from the holding portion held in the tip tube to the exposed portion, while from the exposed portion to the base end face of the base tube, a pair of separation sub-brumes are inserted, positioned at intervals on one and the other sides in the circumferential direction from the pair of proximity sub-brumes. As a result, the pair of separation sub-brumes, which are widely spaced in the circumferential direction, hardly exert any bending tensile force on the base tube, while the bending tensile force acts favorably on the holding portion of the tip tube where the towing wire's holding portion is held and on the pair of proximity sub-brumes, which are closely spaced in the circumferential direction, allowing the tip tube to bend towards the side where the proximity sub-brumes are provided. This allows the tip portion of the tip tube to be bent in any direction while suppressing the bending deformation of the base tube.

[0012] The second aspect is a medical internal insertion tube as described in the first aspect, wherein the proximal end tube is more rigid than the distal end tube.

[0013] According to the medical internal insertion tube in this embodiment, the medical internal insertion tube can be constructed by including a soft tip tube positioned at the tip and a hard proximal tube positioned at the proximal end. This makes it possible to provide two or more stages of hardness change, thereby improving the design freedom of the flexion posture (deflection).

[0014] A third embodiment is a medical internal insertion tube as described in the first or second embodiment, wherein the exposed portion is provided on the outer surface of the proximal end tube.

[0015] According to the medical internal insertion tube in this embodiment, deformation of the proximal tube due to the operation of the traction wire is suppressed compared to the tip tube, thus suppressing excessive deformation of the exposed portion and advantageously maintaining the operational stability of the medical internal insertion tube. In particular, when used in combination with the second embodiment, since the proximal tube is harder than the tip tube, the reduction in rigidity due to the exposed portion is advantageously suppressed, and the durability of the medical internal insertion tube can be stably ensured.

[0016] The fourth aspect is a medical internal insertion tube described in any one of the first to third aspects, wherein at least one of the sub-brumes is not exposed to the exposed portion.

[0017] According to the medical internal insertion tube in this embodiment, the sub-brumes that are not exposed at the exposed portion are connected axially by the first sub-brume and the second sub-brume, and penetrate the entire length of the medical internal insertion tube in a liquid-tight manner. Therefore, it is possible to use the sub-brumes to achieve medical purposes other than the insertion of traction wires, such as lumens for drug administration or suction lumens.

[0018] The fifth embodiment is a medical internal insertion tube described in any one of the first to fourth embodiments, wherein the exposed portion on which the traction wire is exposed is covered by a sealing resin tube fitted onto the tip-side tube or the proximal-side tube on which the exposed portion is provided, and the sealing resin tube is fused to the tip-side tube or the proximal-side tube in a sealed state on the tip-side and proximal-side sides of the exposed portion.

[0019] According to the medical internal insertion tube in this embodiment, since the exposed portion is covered and sealed with a sealing resin tube, the liquid-tightness of the sub-flumen exposed at the exposed portion can be advantageously ensured.

[0020] The sixth aspect is the medical intracorporeal insertion tube according to any one of the first to fifth aspects, wherein the fixing portion is covered by a fusion tube that is externally inserted and fused across the distal tube and the proximal tube.

[0021] According to the medical intracorporeal insertion tube of this aspect, since the fixing portion is covered by a fusion tube that is externally inserted and fused across the distal tube and the proximal tube, it is possible to advantageously ensure the liquid tightness and the fixing property of the fixing portion. As the fusion tube, a metal or resin tube that exhibits good fusion property to the distal tube and the proximal tube can be advantageously employed.

[0022] The seventh aspect is the medical intracorporeal insertion tube according to any one of the first to sixth aspects, wherein in the exposed portion, the protruding height from the inner hole of the first cylindrical wall portion or the second cylindrical wall portion decreases from both axial ends toward the central portion, so that the sub-lumen is exposed.

[0023] According to the medical intracorporeal insertion tube according to this aspect, in the exposed portion, by machining the cylindrical wall portion such as cutting so that the thickness dimension of the first or second cylindrical wall portion gradually decreases from both axial sides toward the center, the sub-lumen can be exposed. Thereby, while moderating the hardness change in the region extending over the exposed portion and both axial sides thereof, the sub-lumen can be exposed, and compared with a shape in which a sharp hardness change occurs between the exposed portion and both axial sides thereof, it has excellent kink resistance.

[0024] The eighth aspect is the medical intracorporeal insertion tube according to any one of the first to sixth aspects, wherein in the exposed portion, the first cylindrical wall portion or the second cylindrical wall portion is heat-compressed and the outer diameter dimension is made smaller than the outer diameter dimensions of the portions adjacent to both axial sides of the exposed portion, and the sub-lumen is exposed at the end surfaces of the portions adjacent to both axial sides facing the exposed portion.

[0025] According to the medical in-vivo insertion tube according to this aspect, by making the outer diameter dimension at the exposed portion smaller than the outer diameter dimensions of the portions adjacent to both axial sides by heat compression, the end faces facing the exposed portions provided on both axial sides of the exposed portion, that is, the surfaces connecting the outer diameter difference between the exposed portion and the portions on both axial sides of the exposed portion, can expose the sub lumen. In this configuration, the exposed portion has the internal sub lumen disappeared by radially heat-compressing the first or second cylindrical wall portion, and increases the wall thickness dimension of the peripheral wall surrounding the main lumen. Thereby, while improving the rigidity of the exposed portion which is the portion where the traction wire is exposed, the sub lumen can be opened on both sides thereof. Moreover, since it is only necessary to heat-compress a part of the first or second cylindrical wall portion to form the exposed portion and expose the sub lumen on the end faces facing the exposed portions provided on both axial sides of the exposed portion, there is no need to perform cutting processing over the entire axial length of the exposed portion, and compared with the seventh aspect in which the cylindrical wall portion is cut or the like so that the thickness dimension of the first or second cylindrical wall portion gradually decreases from both axial sides toward the center, it is also possible to reduce the cutting portion, and it is also possible to facilitate manufacturing.

[0026] The ninth aspect is the medical in-vivo insertion tube described in any one of the first to sixth aspects, wherein the exposed portion is configured by being connected by a relay tube whose both ends are fused to the inner hole between a pair of separated portions where the first cylindrical wall portion or the second cylindrical wall portion is axially separated.

[0027] According to the medical in-vivo insertion tube according to this aspect, in a pair of separated portions of the first or second cylindrical wall portion, the sub lumen is open, and by connecting the inner hole with a relay tube, the liquid tightness of the main lumen can be maintained. The relay tube may be any as long as it can be fused to the inner hole of the separated first or second cylindrical wall portion, and a metal or resin one can be adopted.

[0028] The tenth embodiment is a medical internal insertion tube as described in any one of the first to ninth embodiments, wherein a pair of proximity sub-blumes includes a first proximity sub-blume provided at the 12 o'clock position in a clockwise direction in the circumferential direction, a pair of separation sub-blumes includes a first separation sub-blume provided at the 3 o'clock and 9 o'clock positions in a clockwise direction in the circumferential direction, the traction wire includes a first traction wire, the holding portion of the first traction wire is held at the tip of the tip-side tube in the 12 o'clock position, and the pair of extensions of the first traction wire, after being inserted through the first proximity sub-blume and exposed at the exposed portion, the extension closer to the 3 o'clock position inserts through the first separation sub-blume provided at the 3 o'clock position, and the extension closer to the 9 o'clock position inserts through the first separation sub-blume provided at the 9 o'clock position, and each protrudes from the base end side of the base-side tube.

[0029] According to the medical internal insertion tube in this embodiment, deformation on the proximal end side is suppressed while the tip end tube can be bent in the 12 o'clock direction on the tip side of the exposed end.

[0030] The eleventh embodiment is a medical internal insertion tube as described in the tenth embodiment, wherein a pair of proximity sub-blumes includes a second proximity sub-blume provided at the 6 o'clock position in the circumferential direction clockwise, a pair of separation sub-blumes includes second separation sub-blumes provided at the 3 o'clock and 9 o'clock positions in the circumferential direction clockwise, the traction wire includes a second traction wire, the holding portion of the second traction wire is held at the tip of the tip-side tube at the 6 o'clock position, and the pair of extensions of the second traction wire, after being inserted through the second proximity sub-blume and exposed at the exposed portion, the extension closer to the 3 o'clock position inserts through the second separation sub-blume provided at the 3 o'clock position, and the extension closer to the 9 o'clock position inserts through the second separation sub-blume provided at the 9 o'clock position, and each protrudes from the base end side of the base-side tube.

[0031] According to the medical internal insertion tube in this embodiment, by providing a second traction wire in addition to the first traction wire, deformation on the proximal end side of the exposed portion is suppressed, while the tip end tube can also be bent in the 6 o'clock direction on the tip side of the exposed portion.

[0032] The twelfth aspect is a medical internal insertion tube as described in the eleventh aspect, wherein the traction wire includes a third traction wire and a fourth traction wire, the holding portion of the third traction wire is held at the tip of the tip-side tube in the 3 o'clock direction, and the pair of extensions of the third traction wire are exposed at the exposed portion by inserting one of the first separation sub-blumes and one of the second separation sub-blumes, both located in the 3 o'clock direction, respectively, and then the extension exposed from the first separation sub-blume passes through the first proximity sub-blume closer to the 3 o'clock direction and protrudes from the base-side of the base-side tube, while the extension exposed from the second separation sub-blume passes through the second proximity sub-blume closer to the 3 o'clock direction The fourth towing wire is inserted through a man and protrudes from the base end side of the base end tube, the holding portion of the fourth towing wire is held at the tip of the tip end tube in the 9 o'clock direction, and the pair of extensions of the fourth towing wire are inserted through the other first separation sub-blumen and the other second separation sub-blumen, both located in the 9 o'clock direction, and exposed at the exposed portion. The extension exposed from the first separation sub-blumen then passes through the first proximity sub-blumen, which is closer to the 9 o'clock direction, and protrudes from the base end side of the base end tube, while the extension exposed from the second separation sub-blumen passes through the second proximity sub-blumen, which is closer to the 9 o'clock direction, and protrudes from the base end side of the base end tube.

[0033] According to the medical internal insertion tube in this embodiment, by providing third and fourth traction wires in addition to the first and second traction wires, deformation on the proximal end side of the exposed portion is suppressed, while the tip end tube can be bent in the 3 o'clock and 9 o'clock directions on the tip side of the exposed portion. [Effects of the Invention]

[0034] According to the present invention, it is possible to provide a novel medical internal insertion tube with a structure that allows the tip portion of the tip tube to be bent in any direction while suppressing the bending deformation of the proximal tube, and that improves manufacturability while maintaining a good sealing state of the main lumen with a small number of parts. [Brief explanation of the drawing]

[0035] [Figure 1] Front view showing a flexible endoscope equipped with a medical internal insertion tube as a first embodiment of the present invention. [Figure 2] Plan view of the flexible endoscope shown in Figure 1. [Figure 3] Figure 1 is a perspective view showing the main components of a medical internal insertion tube. [Figure 4] Figure 3 is a perspective view showing a medical internal insertion tube with the sealing resin tube removed and the exposed portion exposed. [Figure 5] Front view of a medical internal insertion tube shown in Figure 4. [Figure 6] Figure 3 is a cross-sectional view of a medical internal insertion tube, corresponding to the VI-VI section in Figure 5. [Figure 7] Figure 3 is a cross-sectional view of a medical internal insertion tube, corresponding to the VII-VII section in Figure 5. [Figure 8] Figure 3 is a cross-sectional view of a medical internal insertion tube, corresponding to the VIII-VIII section in Figure 5. [Figure 9] Figure 3 is a cross-sectional view of a medical internal insertion tube, corresponding to the IX-IX section in Figure 5. [Figure 10] Figure 3 is a cross-sectional view of a medical internal insertion tube, corresponding to the XX cross-section in Figure 5. [Figure 11] Figure 3 is a cross-sectional view of a medical internal insertion tube, corresponding to the XI-XI section in Figure 1. [Figure 12] Figure 5 is a front view showing the exposed portion of a medical internal insertion tube, with the traction wires removed. [Figure 13] (a) is a front view showing an enlarged view of the main part of a medical internal insertion tube as a second embodiment of the present invention, (b) is a cross-sectional view showing an enlarged view of the XIII(b)-XIII(b) section in (a), and (c) is a longitudinal cross-sectional view showing the XIII(c)-XIII(c) section in (b). [Figure 14] A cross-sectional view showing the main part of another embodiment of the medical internal insertion tube according to the present invention, corresponding to Figure 6. [Figure 15] A longitudinal cross-sectional view showing a key part of yet another embodiment of the medical internal insertion tube according to the present invention, corresponding to Figure 13(c). [Modes for carrying out the invention]

[0036] Embodiments of the present invention will be described below with reference to the drawings.

[0037] First, Figures 1 and 2 show a flexible endoscope 12 equipped with a medical internal insertion tube 10 as a first embodiment of the present invention. The medical internal insertion tube 10 constitutes the tip portion of the shaft 14 of the flexible endoscope 12 and is flexibly deformable. This allows the flexible endoscope 12 to be inserted into a bent or curved lumen, enabling observation and treatment of lesions located within the lumen. In the following description, as a general rule, the tip side refers to the distal end (left side in Figure 1) during use, and the proximal end side refers to the proximal end (right side in Figure 1) during use. The medical internal insertion tube 10 and the flexible endoscope 12 can be used in any orientation, but in the following description, "up" refers to the upper part in Figure 1, "down" refers to the lower part in Figure 1, "left" refers to the upper part in Figure 2, and "right" refers to the lower part in Figure 2. In addition, for multiple identical components, only some components may be labeled with reference numerals, while others may be omitted.

[0038] More specifically, the flexible endoscope 12 comprises a shaft 14, a tip 16 provided at the end of the shaft 14 (i.e., the end of the medical internal insertion tube 10), and a handpiece 18 connected to the proximal end of the shaft 14. The shaft 14 is, for example, a tube with a roughly circular internal bore running through its entire length, and this internal bore of the shaft 14 constitutes the main lumen 20 of the medical internal insertion tube 10. The tip 16 has an internal bore formed therein that communicates with the main lumen 20 of the shaft 14, and through the main lumen 20 of the shaft 14 and the internal bore of the tip 16, imaging equipment can be brought closer to the lesion, or drug solutions or contrast agents can be discharged into the lumen of the treatment site. Note that the tip 16 does not necessarily have an internal bore.

[0039] Furthermore, although the handpiece 18 employs a known structure and therefore only a brief explanation is given, it has a hollow structure with a housing 22, and a first operating handle 24 and a second operating handle 26 are provided on the outside of the housing 22. The first operating handle 24 and the second operating handle 26 are each provided with a first rotation axis and a second rotation axis (not shown) that protrude into the inside of the housing 22, and a traction wire 56, which will be described later, extending from the medical internal insertion tube 10 toward the proximal end is fixed to these first and second rotation axes. As a result, when using the flexible endoscope 12, the user can operate the first operating handle 24 and / or the second operating handle 26 from the outside to wind up or unwind the traction wire 56, thereby deforming the tip portion of the medical internal insertion tube 10.

[0040] Furthermore, as shown in Figure 2, the handpiece 18 is equipped with a substantially cylindrical external connection part 28 that protrudes outward (to the left in this embodiment), and the inner bore of the external connection part 28 and the internal space of the housing 22 are in mutual communication. Through the inner bore of this external connection part 28, electrical wiring etc. extending from the imaging device can be extended to an external monitor etc., and therapeutic drugs or contrast agents can be delivered to the main lumen 20 of the shaft 14 through an external tube etc. (not shown) connected to the external connection part 28.

[0041] The medical internal insertion tube 10, which constitutes the tip portion of the shaft 14, is composed of two tubes connected to each other in the axial direction (the axial direction of the shaft 14, and the left-right direction in Figure 1), as shown in Figures 3 to 11. It comprises a tip-side tube 30 positioned at the tip end and a base-side tube 32 positioned closer to the base end than the tip-side tube 30. In other words, the medical internal insertion tube 10 has a fixing portion 38 to which the base end surface 34 of the tip-side tube 30 and the tip surface 36 of the base-side tube 32 are fixed. The base end of the tip-side tube 30 and the tip of the base-side tube 32 have approximately equal outer diameters, and at the fixing portion 38, the outer circumferential surface of the tip-side tube 30 and the outer circumferential surface of the base-side tube 32 are continuous in the axial direction without approximately any steps. The method of fixing the base end surface 34 of the tip-side tube 30 and the tip surface 36 of the base-side tube 32 is not limited, and known fixing methods such as adhesive bonding and welding can be used.

[0042] Furthermore, the tip tip 16 described above is provided at the tip of the tip tube 30, and the handpiece 18 described above is connected to the proximal end of the proximal tube 32. It should be noted that the configuration is not limited to the proximal end of the proximal tube 32 being directly connected to the handpiece 18; the proximal tube 32 may be connected to the handpiece 18 via one or more different tubes connected in the axial direction.

[0043] Both the tip tube 30 and the base tube 32 are made of synthetic resin. In this embodiment, the tip tube 30 and the base tube 32 have different hardnesses, with the base tube 32 being made of a harder material than the tip tube 30.

[0044] As shown in Figures 9 and 11, the tip tube 30 is a substantially cylindrical member having substantially constant inner and outer diameters along its substantially entire length in the axial direction (left-right direction in Figure 1), and comprises a first cylindrical wall portion 40 and a first main lumen 42 formed by the inner bore of the first cylindrical wall portion 40. The tip tube 30 also comprises a plurality of first sub-lumens 44 arranged at multiple locations spaced apart from each other in the circumferential direction of the first cylindrical wall portion 40 in the radially intermediate portion of the first cylindrical wall portion 40. These first main lumens 42 and each first sub-lumen 44 penetrate the first cylindrical wall portion 40 in the axial direction. In this embodiment, 12 first sub-lumens 44 are provided and are arranged at substantially equal intervals in the circumferential direction of the first cylindrical wall portion 40.

[0045] Figures 9 and 11 show configurations in which a pair of first sub-blumes 44, 44 are arranged on both the upper and lower sides of the tip tube 30, separated from each other in the left-right direction (circumferential direction), and a pair of first sub-blumes 44, 44 are arranged on both the left-right sides of the tip tube 30, separated from each other in the upper and lower direction (circumferential direction). In the following description, in the cross-sections shown in Figures 6 to 11, the upper direction may be referred to as the 12 o'clock direction, the right direction as the 3 o'clock direction, the lower direction as the 6 o'clock direction, and the left direction as the 9 o'clock direction, in a clockwise direction in the circumferential direction. That is, as shown in Figures 9 and 11, a pair of first sub-blumes 44, 44 are arranged on the tip tube 30, separated from each other in the circumferential direction in the 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock directions, respectively.

[0046] As shown in Figures 10 and 12, the base tube 32 has a substantially constant inner diameter over its substantially entire length in the axial direction (left-right direction in Figure 1), while having a portion in the axial middle section where the outer diameter is smaller compared to the other axial sections. The base tube 32 is a substantially cylindrical member as a whole and comprises a second cylindrical wall portion 46 and a second main lumen 48 formed by the inner bore of the second cylindrical wall portion 46. The base tube 32 also comprises a plurality of second sub-lumens 50 arranged at multiple locations in the radial middle section of the second cylindrical wall portion 46 that are spaced apart from each other in the circumferential direction of the second cylindrical wall portion 46. These second main lumens 48 and each second sub-lumen 50 penetrate the second cylindrical wall portion 46 in the axial direction. In this embodiment, 12 second sub-lumens 50 are provided and are arranged at substantially equal intervals in the circumferential direction of the second cylindrical wall portion 46. In particular, as shown in Figure 10, similar to the tip tube 30, a pair of second sub-blumes 50, 50 are arranged circumferentially at intervals from each other in the 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock directions of the base tube 32.

[0047] As shown in Figures 9 and 10, the base end face 34 of the tip tube 30 and the tip face 36 of the base tube 32 have approximately equal inner diameters. Similarly, the first sub-lumens 44 of the tip tube 30 and the second sub-lumens 50 of the base tube 32 have approximately equal inner diameters. When the base end face 34 of the tip tube 30 and the tip face 36 of the base tube 32 are fixed together, the first main lumen 42 and the second main lumen 48 are aligned to communicate in the axial direction, and the first sub-lumens 44 and the second sub-lumens 50 are aligned to communicate in the axial direction.

[0048] As a result, when the base end surface 34 of the tip tube 30 and the tip surface 36 of the base tube 32 are fixed together, the coaxially arranged first main lumen 42 and second main lumen 48 are connected in the axial direction, forming the main lumen 20 in the aforementioned medical internal insertion tube 10 (shaft 14). In addition, each coaxially arranged first sub-lumen 44 and each second sub-lumen 50 are connected in the axial direction to form a plurality of sub-lumens 52. Therefore, in this embodiment, the medical internal insertion tube 10 is configured with one main lumen 20 that penetrates the central portion in the axial direction, and a plurality (12) of sub-lumens 52 that are spaced apart from each other in the circumferential direction and penetrate in the axial direction on the outer circumference side of the main lumen 20.

[0049] In particular, in this embodiment, a pair of sub-blumes 52, 52 are arranged circumferentially at a distance from each other in the 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock directions of the medical internal insertion tube 10, and the medical internal insertion tube 10 contains a total of four pairs of sub-blumes 52, 52 arranged in the 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock directions. In other words, as shown by the dashed line in Figure 11, the medical internal insertion tube 10 is provided with a pair of proximity sub-blumes 53 (particularly the first proximity sub-blume 53a) arranged relatively close in the circumferential direction at the top (12 o'clock direction), and a pair of separation sub-blumes 54 (particularly the first separation sub-blume 54a) are provided at positions separated from the proximity sub-blume 53 (first proximity sub-blume 53a) on one side (clockwise) and the other side (counterclockwise) in the circumferential direction. In other words, the first separation sub-blumen 54a consists of one sub-blumen 52 located to the right (3 o'clock direction) and one sub-blumen 52 located to the left (9 o'clock direction).

[0050] Similarly, the medical internal insertion tube 10 is provided with a pair of proximity sub-blumes 53 (particularly the second proximity sub-blume 53b) arranged relatively close together in the circumferential direction at the bottom (6 o'clock direction), and a pair of separation sub-blumes 54 (particularly the second separation sub-blume 54b) provided at positions separated from the proximity sub-blume 53 (second proximity sub-blume 53b) on one side (clockwise) and the other side (counterclockwise) in the circumferential direction. That is, the second separation sub-blume 54b consists of one sub-blume 52 located to the right (3 o'clock direction) and one sub-blume 52 located to the left (9 o'clock direction).

[0051] In this embodiment, the medical internal insertion tube 10 is provided with an exposed portion 55 that exposes the sub-blumen 52 to its outer surface at a position spaced apart from the fixing portion 38 towards the tip tube 30 or the proximal tube 32. In this embodiment, the exposed portion 55 is provided at a position spaced apart from the fixing portion 38 towards the proximal tube 32, i.e., on the outer surface of the proximal tube 32. In particular, in this embodiment, the exposed portion 55 is provided relatively close to the fixing portion 38 on the proximal tube 32. This exposed portion 55 is formed by reducing the outer diameter of the proximal tube 32 (second tube wall portion 46), so that the outer diameter of the proximal tube 32 is smaller at the position where the exposed portion 55 is formed compared to other parts.

[0052] The exposed portion 55 is formed with a predetermined axial dimension (left-right dimension in Figure 1), and in the longitudinal middle portion of the exposed portion 55, a region with the smallest outer diameter is provided over the predetermined axial dimension. In short, in the base end tube 32, the outer diameter is approximately constant in the portions adjacent to the exposed portion 55 on both axial sides, while the outer diameter is smallest in the axial middle portion of the exposed portion 55, and the axial ends of the exposed portion 55 are formed as a tapered shape in which the outer diameter gradually increases as it moves axially outward. The outer diameter of the exposed portion 55 is smaller than the diameter of circle C (shown as a dashed line in Figure 10) that virtually connects the outer peripheral ends of each second sub-blumen 50, so that each second sub-blumen 50 is exposed on the outer surface of the exposed portion 55. In other words, in this embodiment, in the exposed portion 55, the protrusion height from the inner hole (second main lumen 48) of the second cylindrical wall portion 46 decreases from both ends in the axial direction toward the center, thereby exposing each second sub-lumen 50 (each sub-lumen 52).

[0053] In the medical internal insertion tube 10, a traction wire 56 is inserted through a sub-blumen 52, which is composed of a first sub-blumen 44 and a second sub-blumen 50. In this embodiment, the traction wire 56 is inserted through eight of the twelve sub-blumens 52. In particular, in this embodiment, as also shown in Figure 11, the traction wire 56 is folded back at the tip surface 58 of the tip-side tube 30 and inserted through a pair of first sub-blumens 44, 44 provided in the tip-side tube 30 in the 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock directions. That is, in this embodiment, a total of four traction wires 56 are provided in the 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock directions. Of these four traction wires 56, the traction wire 56 above (in the 12 o'clock direction) is the first traction wire 56a, and the traction wire 56 below (in the 6 o'clock direction) is the second traction wire 56b. Furthermore, the towing wire 56 on the right (3 o'clock direction) is the third towing wire 56c, and the towing wire 56 on the left (9 o'clock direction) is the fourth towing wire 56d.

[0054] Furthermore, the folded portions of each towing wire 56 (first to fourth towing wires 56a to 56d) are held on the tip surface 58 of the tip tube 30, and these folded portions of the first to fourth towing wires 56a to 56d constitute a holding portion 60 that is held on the tip tube 30 side. In short, each towing wire 56 has a holding portion 60 that is held on the tip tube 30 side. Note that a rigid plate member (not shown) having through holes at the positions of the first main lumen 42 and each first sub-lumen 44 may be superimposed on the tip surface 58 of the tip tube 30, thereby improving the strength of the tip surface 58 of the tip tube 30 and allowing the holding portion 60 of each towing wire 56 to be held on the plate member.

[0055] As described above, each towing wire 56 has a holding portion 60 at its tip, and the portion of each towing wire 56 extending from the holding portion 60 toward the base end is inserted into each sub-blumen 52. Since each sub-blumen 52 is exposed to the outside at the exposed portion 55 in the middle of its length, each towing wire 56 is also exposed to the outside in the middle of its length. Each towing wire 56 extending toward the base end inside each sub-blumen 52 extends beyond the base end tube 32 and is connected to the first rotation axis of the first operating handle 24 and the second rotation axis of the second operating handle 26 within the handpiece 18 connected to the base end of the base end tube 32. In short, each towing wire 56 has a pair of extension portions 62, 62 extending toward the base end from both ends of the holding portion 60. In particular, as a specific example, the first towing wire 56a is held in the holding portion 60, and a pair of extensions 62, 62 extending from both ends of the holding portion 60 toward the base end are inserted into a pair of proximity sub-blumes 53 (first proximity sub-blume 53a) and exposed in the exposed portion 55. Each of these extensions 62 is then inserted into a pair of sub-blumes 52, 52 that open at the base end side of the exposed portion 55 and protrudes from the base end side of the base end tube 32.

[0056] More specifically, the first traction wire 56a is held at the tip surface 58 of the tip tube 30 in the 12 o'clock direction (upward), and each extension 62 of the first traction wire 56a is inserted into the first proximity sub-blumen 53a and exposed at the exposed portion 55, and then bent in the circumferential direction at the exposed portion 55, as shown in Figures 6-8, the extension 62 closer to the 3 o'clock direction (right) is inserted into the first separation sub-blumen 54a provided in the 3 o'clock direction, and the extension 62 closer to the 9 o'clock direction (left) is inserted into the first separation sub-blumen 54a provided in the 9 o'clock direction, so that each extension 62 protrudes from the base end side of the base tube 32.

[0057] Similarly, the second traction wire 56b is held at the 6 o'clock direction (downward) on the tip surface 58 of the tip tube 30. Each extension 62 of the second traction wire 56b is inserted into the second proximity sub-blumen 53b and exposed at the exposed portion 55. At the exposed portion 55, it is bent circumferentially, and as shown in Figures 6-8, the extension 62 closer to the 3 o'clock direction (right) is inserted into the second separation sub-blumen 54b located at the 3 o'clock direction, and the extension 62 closer to the 9 o'clock direction (left) is inserted into the second separation sub-blumen 54b located at the 9 o'clock direction, so that each extension 62 protrudes from the base end of the base tube 32.

[0058] Furthermore, the third traction wire 56c is held at the tip surface 58 of the tip tube 30 in the 3 o'clock direction (to the right), and each extension 62 of the third traction wire 56c is inserted into the first and second separation sub-blumes 54a and 54b in the 3 o'clock direction and exposed at the exposed portion 55, and then bent in the circumferential direction at the exposed portion, as shown in Figures 6 to 8, the extension 62 closer to the 12 o'clock direction (up) is inserted into the first proximity sub-blume 53a on the side closer to the 3 o'clock direction, and the extension 62 closer to the 6 o'clock direction (down) is inserted into the second proximity sub-blume 53b on the side closer to the 3 o'clock direction, so that each extension 62 protrudes from the base end side of the base tube 32.

[0059] Furthermore, the fourth traction wire 56d is held at the tip surface 58 of the tip tube 30 in the 9 o'clock direction (left), and each extension 62 of the fourth traction wire 56d is inserted into the first and second separation sub-blumes 54a and 54b in the 9 o'clock direction and exposed at the exposed portion 55, and then bent in the circumferential direction at the exposed portion, as shown in Figures 6 to 8, the extension 62 closer to the 12 o'clock direction (up) is inserted into the first proximity sub-blume 53a on the side closer to the 9 o'clock direction, and the extension 62 closer to the 6 o'clock direction (down) is inserted into the second proximity sub-blume 53b on the side closer to the 9 o'clock direction, so that each extension 62 protrudes from the base end side of the base tube 32.

[0060] As shown in Figure 3, the exposed portion 55 where the first to fourth traction wires 56a to 56d, which are routed as described above, are exposed is covered by a tube 64, which is a sealing resin tube fitted onto the base end tube 32. Furthermore, this tube 64 covers the fixing portion 38 where the base end surface 34 of the tip end tube 30 and the tip surface 36 of the base end tube 32 are fixed together, and the fusion tube that is fitted onto and fused across the tip end tube 30 and the base end tube 32 is made up of the tube 64. In other words, in this embodiment, the sealing resin tube and the fusion tube are made up of the same tube 64. This tube 64 is fused in a sealed state on the tip side and the base end side of the exposed portion 55, with the tip portion of the tube 64 fused to the tip end tube 30 and the base portion of the tube 64 fused to the portion of the base end tube 32 on the base end side of the exposed portion 55.

[0061] The specific manufacturing method for the medical internal insertion tube 10 described above is not limited, but as a specific example, as shown in Figure 12, the base end surface 34 of the tip tube 30 and the tip surface 36 of the base tube 32 are overlapped and fixed together to form a shaft 14. Then, the first traction wire 56a is inserted from the opening at the tip of the exposed portion 55 on one side of the first proximity sub-blumen 53a and protrudes from the tip side of the tip tube 30, and this first traction wire 56a is folded back to the base end to form a holding portion 60. The first traction wire 56a that has been folded back to the base end is inserted into the other side of the first proximity sub-blumen 53a on the tip tube 30 and extends to the base end, protruding from the opening at the tip of the exposed portion 55. As a result, each extension 62 of the first traction wire 56a protrudes from the tip-side opening of the exposed portion 55 toward the base end, and these are inserted through the base-side opening of the exposed portion 55 of the first separation sub-blumen 54a, protruding toward the base end of the base-side tube 32, and connected to the first rotation axis of the first operating handle 24 of the handpiece 18.

[0062] Similarly, the second traction wire 56b is inserted through the tip-side opening of the exposed portion 55, folded back beyond the tip-side tube 30, inserted through the base-side opening of the exposed portion 55, protruding from the base-side tube 32, and connected to the first rotation axis of the first operating handle 24 of the handpiece 18. Similarly, the third and fourth traction wires 56c and 56d are inserted through the tip-side opening of the exposed portion 55, folded back beyond the tip-side tube 30, inserted through the base-side opening of the exposed portion 55, protruding from the base-side tube 32, and connected to the second rotation axis of the second operating handle 26 of the handpiece 18. For example, the handpiece 18 may be divisible into multiple components, and the handpiece 18 may be formed by connecting the first to fourth traction wires 56a to 56d to the respective rotation axes of the first and second operating handles 24 and 26, and then assembling the multiple components. The tip 16 and handpiece 18 can be fixed to the shaft 14 at any time. This completes the medical internal insertion tube 10 and the flexible endoscope 12 equipped with the medical internal insertion tube 10.

[0063] In the medical internal insertion tube 10 with the structure described above, the first traction wire 56a is wound up as the first rotation axis rotates when the first operating handle 24 of the flexible endoscope 12 is rotated to one side in the circumferential direction around the first rotation axis (for example, clockwise in Figure 1). Here, the tip tube 30 of the medical internal insertion tube 10 is more flexible than the proximal tube 32, and the first traction wire 56a is positioned upward (at the 12 o'clock position) in the tip tube 30. As shown by the dashed line in Figure 1, only the tip tube 30 of the medical internal insertion tube 10 is bent upward. In particular, each extension 62 of the first towing wire 56a is located on both the left and right sides of the base tube 32. The force exerted when winding the first towing wire 56a does not affect the upward bending deformation, or cancels out on both the left and right sides. As a result, the deformation of the base tube 32 is efficiently suppressed, and only the tip tube 30 can be deformed. Similarly, by rotating the first operating handle 24 to the other side in the circumferential direction around the first rotation axis (for example, counterclockwise in Figure 1), the second towing wire 56b is wound up as the first rotation axis rotates. Since the second towing wire 56b is positioned downward (at the 6 o'clock position) in the tip tube 30, as shown by the dashed line in Figure 1, the deformation of the base tube 32 is efficiently suppressed, and only the tip tube 30 can be deformed downward.

[0064] Furthermore, by rotating the second operating handle 26 of the flexible endoscope 12 in one direction circumferentially around the second rotation axis (for example, clockwise in Figure 1), the third traction wire 56c is wound up in conjunction with the rotation of the second rotation axis. Since the third traction wire 56c is positioned to the right (3 o'clock direction) in the tip tube 30, as shown by the dashed line in Figure 2, deformation of the proximal tube 32 is efficiently suppressed while only the tip tube 30 is deformed to the right. In addition, by rotating the second operating handle 26 in the other direction circumferentially around the second rotation axis (for example, counterclockwise in Figure 1), the fourth traction wire 56d is wound up in conjunction with the rotation of the second rotation axis. Since the fourth traction wire 56d is positioned to the left (9 o'clock direction) in the tip tube 30, as shown by the dashed line in Figure 2, deformation of the proximal tube 32 is efficiently suppressed while only the tip tube 30 is deformed to the left.

[0065] Furthermore, the first operating handle 24 and the second operating handle 26 can be operated simultaneously. For example, by rotating both the first operating handle 24 and the second operating handle 26 to one side in the circumferential direction around their respective axes of rotation, the tip tube 30 can be deformed in the upper right direction. In particular, by making the amount of circumferential rotation of the first operating handle 24 and the second operating handle 26 different, it is possible to bend the tip tube 30 in the 1 o'clock or 2 o'clock direction in a clockwise direction, and the direction of bending deformation of the tip tube 30 can be precisely set. By employing this operating method, the tip tube 30 can be deformed over its entire 360° circumference in the clockwise circumferential direction.

[0066] In particular, in the medical internal insertion tube 10 of this embodiment, the exposed portion 55 that exposes each sub-lumen 52 to the outer surface is provided at a position away from the fixing portion 38 of the tip-side tube 30 and the proximal-side tube 32 on the proximal-side tube 32 side. This makes it possible to insert each traction wire 56 through each sub-lumen 52 through the exposed portion 55, and since no other members are provided between the tip-side tube 30 and the proximal-side tube 32, the work efficiency in assembly work is improved. Furthermore, since the first main lumen 42 in the tip-side tube 30 and the second main lumen 48 in the proximal-side tube 32 are directly connected without the need for other members, leakage when, for example, a drug solution or contrast agent is flowed within the main lumen 20 can be effectively prevented.

[0067] Furthermore, the base tube 32 is made harder than the tip tube 30. This allows deformation of the base tube 32 to be suppressed when the first operating handle 24 and / or the second operating handle 26 are operated, so that only the tip tube 30 is deformed.

[0068] Furthermore, the exposed portion 55 is provided on the outer surface of the base-side tube 32. This allows for stable deformation of the tip-side tube 30. In other words, in this embodiment, each towing wire 56 is bent in the circumferential direction at the exposed portion 55, making it easier to deform the tip side of the exposed portion 55 compared to the base side. If the exposed portion 55 were provided on the flexible tip-side tube 30, there would be a risk that each towing wire 56 would dig into the flexible tip-side tube 30 when the tip side of the exposed portion 55 is deformed by the pulling of each towing wire 56, potentially causing excessive deformation of the tip side beyond the exposed portion 55. In contrast, in this embodiment, since the exposed portion 55 is provided on the relatively rigid base-side tube 32, the risk of each towing wire 56 digging into the base-side tube 32 is reduced when the pulling of each towing wire 56, thereby suppressing excessive deformation of the tip side beyond the exposed portion 55.

[0069] In this embodiment, the exposed portion 55 is covered by a tube 64, the tip of the tube 64 is fused to the tip tube 30 in a sealed state, and the proximal end of the tube 64 is fused to the portion of the proximal tube 32 that is further proximal than the exposed portion 55 in a sealed state. As a result, even when the medical internal insertion tube 10 (shaft 14 in the flexible endoscope 12) is inserted into a lumen in the body, it is possible to prevent bodily fluids such as blood from entering the medical internal insertion tube 10 through the exposed portion 55.

[0070] In particular, this tube 64 also functions as a fusion tube that is externally fitted and fused to the fixing portion 38, spanning both the tip and proximal ends. This prevents blood and other substances from entering the main lumen 20 through the fixing portion 38 when the medical internal insertion tube 10 (shaft 14 in the flexible endoscope 12) is inserted into a lumen inside the body. Furthermore, when a liquid such as a drug solution or contrast agent is flowed through the main lumen 20, it prevents the liquid inside the main lumen 20 from leaking out through the fixing portion 38.

[0071] Furthermore, in the exposed portion 55, the protrusion height from the second main lumen 48 in the second cylindrical wall portion 46 decreases from both ends in the axial direction toward the center, thereby exposing each sub-lumen 52. This makes the hardness change associated with forming the exposed portion 55 in the base end tube 32 more gradual, suppressing abrupt changes in hardness at the formation location of the exposed portion 55 in the base end tube 32. Compared to cases where the exposed portion is formed in a shape that causes abrupt changes in hardness, the kink resistance of the base end tube 32 can be improved. The exposed portion 55 with such a shape can be formed, for example, by machining the base end tube (second cylindrical wall portion) whose outer diameter is substantially constant along its entire length.

[0072] Next, Figures 13(a) to 13(c) show the main parts of a medical internal insertion tube 70 as a second embodiment of the present invention. In the second embodiment, the only difference from the first embodiment is the shape of the proximal end tube 72, and more specifically, the only difference is the shape of the exposed portion 74 provided on the proximal end tube 72. Therefore, the medical internal insertion tube 70 of this embodiment also constitutes the tip portion of the shaft 14 of the flexible endoscope 12, and, as in the first embodiment, each traction wire 56 is inserted through each sub-blumen 52. In Figure 13, the illustration of each traction wire 56 and tube 64, which have the same configuration as in Embodiment 1, is omitted in the medical internal insertion tube 70. Furthermore, for components and parts that are substantially the same as in Embodiment 1, the same reference numerals as in Embodiment 1 are used in the figure, and detailed explanations are omitted.

[0073] In this embodiment, the base tube 72 has an outer diameter that is substantially constant along its entire length (left-right direction in Figure 13(a)), and the exposed portion 74 is formed by heating and compressing the middle portion in the length direction to reduce its outer diameter. As a result, the outer diameter of the exposed portion 74 in the base tube 72 is smaller than that of the portions adjacent to it on both sides in the axial direction. That is, annular stepped surfaces 76, 76 are formed on both sides in the axial direction of the exposed portion 74 as end faces facing the exposed portion 74 of the adjacent portions on both sides in the axial direction. Immediately after heating and compressing the base tube 72, the openings of each second sub-blumen 50 at each stepped surface 76 are closed by the molten resin, but each second sub-blumen 50 can be opened at each stepped surface 76 by cutting each stepped surface 76. As a result, each sub-blumen 52 (second sub-blumen 50) is exposed at the end faces (each stepped surface 76) adjacent to the exposed portion 74 on both axial sides, and each towing wire 56 can be inserted through each sub-blumen 52 via the exposed portion 74, thereby achieving the same effects as in the first embodiment. In this embodiment, since each second sub-blumen 50 can be opened at each stepped surface 76 by cutting each stepped surface 76, the cutting area can be reduced compared to the case where cutting is performed over substantially the entire axial length of the exposed portion 55 as in the first embodiment, thereby simplifying manufacturing. In addition, in the exposed portion 74, the middle portion of the base end tube 72 in the longitudinal direction is heated and compressed to remove the internal second sub-blumen 50, thereby increasing the wall thickness of the peripheral wall surrounding the main lumen 20. This improves the rigidity of the exposed portion 74 while opening the second sub-blumen 50 on both sides. The annular stepped surfaces 76 on both axial sides of the exposed portion 74 may be the end faces of the portions adjacent to the exposed portion 74 on both axial sides, that is, surfaces connecting the difference in outer diameter between the exposed portion 74 and the portions on both axial sides of the exposed portion, and may be machined in a tapered shape as in the first embodiment.

[0074] Although embodiments of the present invention have been described in detail above, the present invention is not limited by its specific description.

[0075] In the above embodiment, four traction wires 56 are provided, and by pulling each traction wire 56 toward the base end, the tip tube 30 can be bent and deformed in the up and down and left and right directions. However, the embodiment is not limited to this. For example, if it is desired to bend the tip tube in only a specific direction, fewer than four traction wires may be used. As shown in the medical internal insertion tube 80 in Figure 14, two traction wires 56 may be provided, and the extensions 62 of each of these traction wires 56 may be inserted into sub-brumes 52 in the 3 o'clock direction (right) and the 6 o'clock direction (down) on the tip side of the exposed portion 55. In this case, by pulling each traction wire 56 toward the base end, the tip tube 30 can be bent to the right and / or downwards.

[0076] Furthermore, in this case, since the traction wire 56 is not inserted through the three sub-brumes 52a in the upper left, each of these sub-brumes 52a does not need to be exposed to the outer surface in the exposed portion 55. And, since the sub-brumes 52a that are not exposed in the exposed portion 55 are liquid-tight along the entire length of the shaft 14 of the flexible endoscope 12, each of these sub-brumes 52a can be used separately from the main lumen 20 as a lumen for flowing drug solutions or contrast agents. Also, in the above embodiment, the main lumen 20 was a single hole shape, but for example, one or more lumens may be provided within the main lumen, and for example, a lumen for inserting imaging equipment and a lumen for flowing drug solutions or contrast agents may be provided separately within the main lumen.

[0077] Furthermore, the medical internal insertion tube according to the present invention only needs to be able to bend the tip tube in at least one direction, and may only be provided with a single traction wire having two extensions. In that case, each extension should be inserted into a pair of proximity sub-brumes on the tip side of the exposed portion, and be bent circumferentially at the exposed portion to be inserted into a pair of separation sub-brumes on the proximal end side of the exposed portion. Therefore, at the exposed portion, it is sufficient that these pair of proximity sub-brumes and pair of separation sub-brumes are exposed on the outer surface, and at least four sub-brumes should be exposed on the outer surface at the exposed portion.

[0078] Furthermore, in the present invention, the exposed portion 92 may be configured to include a relay tube 94, as in the medical internal insertion tube 90 shown in Figure 15. Specifically, in the embodiment shown in Figure 15, the base end tube 96 (second cylindrical wall portion 46) is configured to include a pair of axially separated separation portions 98, 98, and the inner bore 100 of each separation portion 98, which are separated from each other in the axial direction, are connected by a substantially cylindrical relay tube 94. In this embodiment, both ends of the relay tube 94 are inserted into the inner bore 100 of each separation portion 98 and fused together. As a result, the inner bore 100 of each separation portion 98 is in communication through the inner bore 102 of the relay tube 94, and the main lumen 20 is formed. In this embodiment, since each second sub-lumen 50 in the exposed portion 92 opens to the axial end face 106 of each separation portion 98, each traction wire 56 can be inserted into each sub-lumen 52 through the exposed portion 92, and the same effects as in the above embodiment can be achieved. The relay tube 94 may be made of a rigid material such as metal or synthetic resin.

[0079] Furthermore, in the above embodiment, the exposed portion 55 was provided on the base end side of the fixing portion 38, i.e., on the base end tube 32, but the exposed portion may be provided on the tip end tube instead of, or in addition to, the base end tube. In short, multiple exposed portions may be provided in the axial direction, for example, multiple exposed portions may be provided on either the base end tube or the tip end tube, or exposed portions may be provided on both the base end tube and the tip end tube.

[0080] Furthermore, in the above embodiment, each towing wire 56 was folded back at the tip of the tip-side tube 30 to form a holding portion 60, which was held on the tip surface 58 of the tip-side tube 30, but the embodiment is not limited to this. The holding portion formed by folding back each towing wire may be fixed to a member other than the tip-side tube, for example, a tip or the like. Note that each towing wire 56 for bending the tip side of the tip-side tube 30 in a specific direction is not limited to the example where it is folded back at the tip to form a holding portion 60. For example, the towing wire 56 may be composed of two wires each held in a holding portion 60 held on the tip side of the tip-side tube 30, and the two wires may pass through a pair of first / second proximity sub-blumes 53a, 53b and first / second separation sub-blumes 54a, 54b to form a pair of extensions 62 protruding from the base side of the base-side tube 32.

[0081] Furthermore, in the above embodiment, the hardness of the tip tube 30 and the base tube 32 were different, with the base tube 32 being harder than the tip tube 30. However, the embodiment is not limited to this, and for example, the hardness of the tip tube and the base tube may be the same. In that case, for example, the tip tube and the base tube can be obtained by cutting a straight resin tube to a predetermined length.

[0082] In the above embodiment, an example was shown in which the medical internal insertion tube 10 according to the present invention was applied to a flexible endoscope 12. However, the present invention is not limited to this embodiment, and the medical internal insertion tube according to the present invention may be applied to catheters, etc., which can be inserted into internal lumens such as those of the circulatory system, respiratory system, or digestive system to perform treatment or insert other medical devices. [Explanation of Symbols]

[0083] 10. Medical internal insertion tube (first embodiment) 12 Flexible endoscopes 14 shafts 16 Tips 18 Handpieces 20 main lumens 22 Housing 24. First operating handle 26. Second operating handle 28 External connection section 30. Tip tube 32 Proximal end tube 34 (Proximal end face of the tip tube) 36 (Proximal end tube) tip surface 38 Fixing part 40 First cylinder wall part 42 1st Main Lumen 44 First Sub-Blumen 46 Second cylinder wall part 48 Second main lumen 50 Second Sub-Blumen 52 Subblemen 52a (Sub-bloom that is not exposed in the exposed area) 53 Proximity Sub-Blumen 53a First Proximity Sub-Blumen 53b Second Proximity Sub-Blumen 54 Separation Subblemen 54a First Separation Subblemen 54b Second Separation Subblemen 55 Exposed part 56 Towing wire 56a First towing wire 56b Second towing wire 56c Third towing wire 56d Fourth towing wire 58 (Tip side of the tip tube) 60 Holding part 62 Extension part 64 Tubes (Sealing resin tubes, fusion tubes) 70 Medical internal insertion tube (second embodiment) 72 Proximal end tube 74 Exposed part 76 Step surface 80 Medical internal insertion tubes (Figure 14) 90 Medical internal insertion tubes (Figure 15) 92 Exposed part 94 Relay tube 96 Proximal end tube 98 Separation part 100,102 Internal bore 104 Second Main Lumen 106 Axial end face

Claims

1. A tip-side tube positioned at the tip end, having a first cylindrical wall portion, a first main lumen formed by the internal bore of the first cylindrical wall portion, and a plurality of first sub-lumens arranged at a plurality of mutually separated locations in the circumferential direction of the first cylindrical wall portion, each penetrating the first cylindrical wall portion in the axial direction, A proximal tube having a second cylindrical wall portion, a second main lumen formed by the internal bore of the second cylindrical wall portion, and a plurality of second sub-lumens arranged at a plurality of mutually separated locations in the circumferential direction of the second cylindrical wall portion, each penetrating the second cylindrical wall portion in the axial direction, and positioned on the proximal end side of the tip-side tube, Towing wire and The first main lumen and the second main lumen, which are arranged coaxially, are connected in the axial direction to form a main lumen, and the plurality of first sub-lumens and the plurality of second sub-lumens, which are arranged coaxially, are connected in the axial direction to form a plurality of sub-lumens, and the base end face of the tip tube and the tip face of the base tube are fixed to a fixing portion, It comprises an exposed portion provided at a position separated from the fixing portion from the tip-side tube or the base-side tube, which exposes at least four of the sub-lumines to the outer surface, The at least four sub-blumes include a pair of close sub-blumes arranged in close proximity in the circumferential direction, and a pair of spaced sub-blumes provided at positions spaced apart from the close sub-blumes on one and the other side in the circumferential direction. The towing wire has a holding portion held on the tip side tube, and a pair of extending portions that extend from the holding portion, pass through a pair of proximity sub-brumes to be exposed to the exposed portion, and further pass through a pair of separation sub-brumes that open at the base end of the exposed portion to protrude from the base end side of the base end tube. Medical internal insertion tube.

2. The medical internal insertion tube according to claim 1, wherein the proximal end tube is more rigid than the distal end tube.

3. The medical internal insertion tube according to claim 1 or claim 2, wherein the exposed portion is provided on the outer surface of the proximal end tube.

4. A medical internal insertion tube according to claim 1 or 2, wherein at least one of the sub-blumes is not exposed to the exposed portion.

5. The exposed portion of the towing wire is covered by a sealing resin tube fitted onto the tip-side tube or the base-side tube on which the exposed portion is provided. The medical internal insertion tube according to claim 1 or claim 2, wherein the sealing resin tube is fused in a sealed state to the tip-side tube or the base-side tube at the tip-side and base-side ends of the exposed portion.

6. The medical internal insertion tube according to claim 1 or 2, wherein the fixing portion is covered by a fusion tube that is externally fitted and fused over the tip-side tube and the proximal-side tube.

7. In the exposed portion, the sub-blumen is exposed as the protrusion height of the first cylindrical wall portion or the second cylindrical wall portion from the inner hole decreases from both ends in the axial direction toward the center. The medical internal insertion tube according to claim 1 or claim 2.

8. In the exposed portion, the first cylindrical wall portion or the second cylindrical wall portion is heated and compressed so that its outer diameter is smaller than the outer diameter of the portions adjacent to the axial side of the exposed portion, and the sub-blumen is exposed at the end faces of the portions adjacent to the axial side facing the exposed portion, as described in claim 1 or claim 2.

9. The medical internal insertion tube according to claim 1 or claim 2, wherein the exposed portion is configured such that the first cylindrical wall portion or the second cylindrical wall portion is separated in the axial direction by a relay tube whose ends are fused to the inner bore between a pair of separated portions.

Images