Delivery device and endoscope system

Abstract

This delivery device is provided with: a first outer tube member; an inner tube member inserted into the first outer tube member; a second outer tube member positioned proximal to the first outer tube member and connected to the inner tube member; a traction member inserted into the second outer tube member and connected to the first outer tube member; a first connection member in which a first hole for fixing the traction member to the inside thereof and a second hole configured to allow the inner tube member to move forward and backward therethrough are formed; and a fixing member for fixing the first connection member and the first outer tube member.

Description

[Technical field]

[0001] The present invention relates to a delivery device and an endoscope system. [Background technology]

[0002] A representative example of a delivery device is a stent delivery device used to place in the body a stent for expanding a stricture or blockage (hereinafter referred to as a "stricture, etc.") that occurs in the digestive tract, etc. The stent delivery device is inserted into a treatment tool channel of an endoscope and delivers the stent to the stricture, etc. Then, the stent delivery device places the stent stored in the device in the stricture, etc.

[0003] In the stent delivery device described in Patent Document 1, a distal tube is inserted into a tubular member and is slidably disposed relative to the tubular member. A stent is stored between the tubular member and the distal tube. When a traction member fixed to the tubular member is pulled, the tubular member moves, and the stored stent is placed in a stricture or the like. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Japanese Patent Application Publication No. 2006-271565 Summary of the Invention [Problem to be solved by the invention]

[0005] In the stent delivery device described in Patent Document 1, the tubular member and the traction member are joined at only one point. Therefore, the joining strength between the tubular member and the traction member is not sufficient, and the tubular member and the traction member are easily separated. When the tubular member and the traction member are separated, it becomes difficult to release the stent out of the device, and it becomes difficult to place the stent at the target position.

[0006] In view of the above circumstances, an object of the present invention is to provide a delivery device and an endoscope system that can be reliably placed at a target location. [Means for solving the problem]

[0007] In order to solve the above problems, the present invention proposes the following means. A delivery device according to a first aspect of the present invention includes a first outer tube member, an inner tube member inserted inside the first outer tube member, a second outer tube member located proximal to the first outer tube member and connected to the inner tube member, a traction member inserted inside the second outer tube member and connected to the first outer tube member, a first joint member formed with a first hole for fixing the traction member therein and a second hole configured to allow the inner tube member to advance and retreat, and a joint member between the first joint member and the first outer tube member. and is provided so as to be in close contact with the entire circumference of the outer circumferential surface of the first joint member and the entire circumference of the outer circumferential surface of the first outer tubular member. and a fixing member that fixes the

[0008] An endoscopic system according to a second aspect of the present invention includes a first outer tube member, an inner tube member inserted inside the first outer tube member, a second outer tube member located proximal to the first outer tube member and connected to the inner tube member, a traction member inserted inside the second outer tube member and connected to the first outer tube member, a first joint member having a first hole for fixing the traction member therein and a second hole configured so that the inner tube member is inserted and the inner tube member can advance and retreat, and a joint member between the first joint member and the first outer tube member. and is provided so as to be in close contact with the entire circumference of the outer circumferential surface of the first joint member and the entire circumference of the outer circumferential surface of the first outer tubular member. and a fixing member for fixing the delivery device to the endoscope, and an endoscope having a treatment tool channel configured to allow the delivery device to advance and retreat. Effect of the Invention

[0009] According to the above aspect, the bonding strength of the members constituting the delivery device can be ensured. [Brief description of the drawings]

[0010] [Figure 1] FIG. 1 illustrates an endoscope system. [Diagram 2] 2 is a diagram showing the overall configuration of a delivery device of the endoscope system. FIG. [Diagram 3] FIG. 2 is a diagram showing components constituting the delivery device. [Figure 4] FIG. 4 is a partially cutaway and sectional view of FIG. [Diagram 5] FIG. 4 is a cross-sectional view showing a first joint of the delivery device. [Figure 6] FIG. 6 is a cross-sectional view taken along line C6-C6 of FIG. 5. [Figure 7] FIG. 6 is a cross-sectional view taken along line C7-C7 of FIG. 5. [Figure 8] FIG. 4 is a cross-sectional view showing a second bonding portion of the delivery device. [Figure 9] FIG. 9 is a cross-sectional view taken along line C9-C9 of FIG. 8. [Figure 10] FIG. 9 is a diagram showing a cross section taken along line C10-C10 in FIG. [Figure 11] FIG. 2 is a partial cross-sectional view of a delivery device. [Figure 12] FIG. 2 is a partial cross-sectional view showing the state in which the stent has been released from the delivery device. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0011] An embodiment of the present invention will be described with reference to FIGS.

[0012] [Endoscope system 300] The endoscopic system 300 will be described with reference to Fig. 1. The endoscopic system 300 includes an endoscope 200 and a delivery device 100. The delivery device 100 is inserted into a channel of the endoscope 200.

[0013] [Endoscope 200] The endoscope 200 will be described with reference to FIG. The endoscope 200 is a known side-viewing type flexible endoscope, and includes a long insertion section 210, an operation section 220, and a treatment tool channel 230. The operation section 220 is provided at the proximal end of the insertion section 210. In the following description, the operation section 220 side of the endoscope 200 is referred to as the proximal side. The opposite side of the operation section 220 in the longitudinal axis direction of the insertion section 210 is referred to as the distal side of the endoscope 200. A treatment tool such as the delivery device 100 is inserted through the treatment tool channel 230. The endoscope 200 may be a direct-viewing type flexible endoscope.

[0014] The insertion section 210 has a tip hard section 211, a bending section 212, and a flexible tube section 213. The tip hard section 211 is provided at the tip section of the insertion section 210. The bending section 212 is attached to the proximal side of the tip hard section 211, and is configured to be capable of being bent. The flexible tube section 213 is attached to the proximal side of the bending section 212.

[0015] An imaging unit 216 is provided in an exposed state on the side surface of the tip rigid portion 211. The imaging unit 216 has a light guide 215 and a CCD.

[0016] The elevator 214 is provided on the tip rigid portion 211. A proximal end of the elevator 214 is rotatably supported by the tip rigid portion 211. A elevator operation wire (not shown) is fixed to the tip of the elevator 214. The elevator operation wire (not shown) passes through the insertion portion 210 and extends to the proximal side.

[0017] The bending section 212 is configured to be freely bent in the up-down direction and the left-right direction. The bending section 212 has a tip of an operation wire fixed to the distal side of the bending section 212. The operation wire extends to the operation section 220 through the insertion section 210. The up-down direction is the up-down direction in the field of view of the endoscope among the orthogonal directions in which the insertion section 210 bends in a direction intersecting the axis from a state in which the insertion section 210 extends straight. The left-right direction is the left-right direction in the field of view of the endoscope among the orthogonal directions in which the insertion section 210 bends in a direction intersecting the axis from a state in which the insertion section 210 extends straight. The bending direction of the bending section 212 is not limited to the up-down direction and the left-right direction, and can also be freely bent in a direction intersecting the axis of the insertion section 210.

[0018] A distal end 231 of the treatment tool channel 230 opens to a side surface of the tip hard portion 211. A proximal end of the treatment tool channel 230 extends to the operation section 220.

[0019] A knob 223 for operating the operation wire and a switch 224 for operating the imaging unit 216 are provided at the proximal end of the operation section 220. The user can bend the bending section 212 in a desired direction by operating the knob 223.

[0020] A forceps port 222 communicating with the treatment tool channel 230 is provided distal to the operation section 220. A user can insert an endoscopic treatment tool such as the delivery device 100 from the forceps port 222. A forceps plug 225 is attached to the forceps port 222 to prevent leakage of bodily fluids.

[0021] [Delivery device 100] The delivery device 100 will be described with reference to Fig. 2 to Fig. 11. As shown in Fig. 2, the delivery device 100 has an elongated shape as a whole. The delivery device 100 includes a first outer tubular member 1, an inner tubular member 2, a traction member 3, a second outer tubular member 4, a tip 5, a stent 6, a first joint portion 8, and a second joint portion 9.

[0022] The first outer tube member 1 is a long cylindrical member that can be inserted through the treatment tool channel 230 of the endoscope 200. The first outer tube member 1 is made of resin or the like and has flexibility. The first outer tube member 1 may be a tube made of resin or the like, or may be a coil sheath. As shown in FIG. 3 and FIG. 4, the first outer tube member 1 has a first end 1a on the distal side of the delivery device 100 and a second end 1b on the proximal side of the delivery device 100. The first outer tube member 1 is formed with a first opening 11 and a second opening 12. The first opening 11 opens at the first end 1a. The second opening 12 opens at the second end 1b. The first opening 11 and the second opening 12 communicate with the internal space (lumen) 13 of the first outer tube member 1. The first opening 11 and the second opening 12 are approximately circular openings through which the inner tube member 2 can be inserted. The first outer tube member 1 has a stent storage area E1 that stores a stent 6. The stent storage region E1 is a region between the first outer tubular member 1 and the inner tubular member 2 for storing a stent 6.

[0023] The inner tube member 2 is a long cylindrical member that can be inserted into the treatment tool channel 230 of the endoscope 200. The inner tube member 2 is made of resin or the like and has flexibility. The inner tube member 2 may be a tube made of resin or the like, or may be a coil sheath. As shown in FIG. 3 and FIG. 4, the inner tube member 2 has a first end 2a on the distal side of the delivery device 100 and a second end 2b on the proximal side of the delivery device 100. The inner tube member 2 is formed with a first opening 21 and a second opening 22. The first opening 21 opens at the first end 2a. The second opening 22 opens at the second end 2b. The first opening 21 and the second opening 22 communicate with the lumen (guidewire lumen) 23 of the inner tube member 2. The first opening 21 and the second opening 22 are approximately circular openings through which the guidewire G can be inserted. The inner tube member 2 is inserted into the inside of the first outer tube member 1. Specifically, the inner cylinder member 2 passes through the first opening 11 and the second opening 12 and is inserted into the lumen 13 of the first outer cylinder member 1 so as to be relatively movable. The outer diameter of the inner cylinder member 2 is smaller than the inner diameter of the lumen 13 of the first outer cylinder member 1.

[0024] The first outer cylindrical member 1 has a stent storage area E1 for storing the stent 6. The stent storage area E1 is an area for storing the stent 6 between the first outer cylindrical member 1 and the inner cylindrical member 2. The stent storage area E1 is an area for storing the stent 6 inserted on the outside of the inner cylindrical member 2 in the lumen 13 of the first outer cylindrical member 1. The stent storage area E1 is an area extending from the first end 1a of the first outer cylindrical member 1 to the proximal side by at least the length of the stent 6.

[0025] The second outer tube member 4 is a long cylindrical member that can be inserted into the treatment tool channel 230 of the endoscope 200. The second outer tube member 4 is made of resin or the like and has flexibility. The second outer tube member 4 may be a tube made of resin or the like, or may be a coil sheath. As shown in FIG. 3 and FIG. 4, the second outer tube member 4 has a first end 4a on the distal side of the delivery device 100 and a second end 4b on the proximal side of the delivery device 100. The second outer tube member 4 is provided on the proximal side of the delivery device 100 than the first outer tube member 1. The second outer tube member 4 has a first opening 41 and a second opening 42 formed therein. The first opening 41 opens to the first end 4a. The second opening 42 opens to the second end 4b. The first opening 41 and the second opening 42 communicate with an internal space (lumen) 43 of the second outer tube member 4. The first opening 41 and the second opening 42 are substantially circular openings through which the pulling member 3 can be inserted. A first end 4a of the second outer cylindrical member 4 is connected to a second end 2b of the inner cylindrical member 2 by a second joint 9.

[0026] The towing member 3 is a long member that can be inserted into the treatment tool channel 230 of the endoscope 200. The towing member 3 is made of metal such as NiTi, resin, or the like, and is a flexible wire. As shown in FIG. 3 and FIG. 4, the towing member 3 is inserted into the inside of the second outer tube member 4. Specifically, the towing member 3 passes through the first opening 41 and the second opening 42 and is inserted into the internal space (lumen) 43 of the second outer tube member 4 so as to be relatively movable. The outer diameter of the towing member 3 inserted into the internal space (lumen) 43 of the second outer tube member 4 is smaller than the inner diameter of the lumen 43 of the second outer tube member 4. The distal end portion 31 of the towing member 3 is connected to the proximal end portion 14 of the first outer tube member 1 by the first joint portion 8. At least the distal end portion 31 of the towing member 3 may have a rough surface by a technique such as sandblasting. The surgeon can tow the towing member 3 to tow the first outer tube member 1 to the proximal side.

[0027] The tip 5 has a substantially conical shape. A through hole 51 extending in the axial direction is formed in the tip 5. As shown in FIG. 3 and FIG. 4, the tip 5 has a distal end 52 and a proximal end 53, and is connected to the inner tube member 2 at the proximal end 53. The distal end 52 has a smaller diameter than the proximal end 53. The through hole 51 communicates with the guidewire lumen 23 of the inner tube member 2 via the first opening 21. Therefore, when the guidewire G is inserted into the through hole 51 of the tip 5, the guidewire G can be advanced into the guidewire lumen 23 of the inner tube member 2.

[0028] The guidewire is a tool used when inserting the delivery device 100 into a lumen. For example, the surgeon inserts the proximal end of the guidewire G protruding from the forceps plug 225 of the endoscope 200 into the through hole 51 of the tip 5 of the delivery device 100. The guidewire G enters the guidewire lumen 23 of the inner cylindrical member 2 from the through hole 51. The surgeon pushes in the delivery device 100 while holding the guidewire G, thereby advancing the delivery device 100 along the guidewire G.

[0029] The stent 6 is a cylindrical self-expanding stent. The stent 6 is formed by weaving wires. As shown in FIG. 3 and FIG. 4, the stent 6 is housed in the stent storage area E1 of the first outer tubular member 1. Specifically, the inner tubular member 2 is passed through the inside of the stent 6, and the stent 6 in a reduced diameter state is housed in the gap between the inner tubular member 2 and the first outer tubular member 1. The stent 6 is engaged with an engagement portion (not shown) formed on the outer circumferential surface of the inner tubular member 2. As a result, the stent 6 is positioned relative to the inner tubular member 2 in the reduced diameter state, and does not move relative to the inner tubular member 2 in the longitudinal direction. When the traction member 3 is pulled proximally, the first outer tubular member 1 moves proximally of the delivery device 100, and the stent 6 is released from the delivery device 100. The stent 6 may be a laser-cut type stent formed by cutting a metal tube with a laser. The stent 6 may be a covered stent in which the inner or outer peripheral surface of the inner cylindrical member 2 is covered with a resin film.

[0030] The wires forming the stent 6 are made of a superelastic alloy mainly made of NiTi. The superelastic alloy mainly made of NiTi is not permanently deformed when braided, and the braided shape is memorized by applying heat treatment in the braided state.

[0031] Although the example in which the stent 6 is a self-expanding stent has been described, the stent 6 is not limited to a self-expanding stent. The stent 6 may be a non-self-expanding stent, and examples thereof include a stent made of a CoCr-based alloy, and a biodegradable stent made of polylactic acid, polyglycolic acid, and copolymers thereof. The stent 6 may be a stent that expands with a fluid. Examples of a stent that expands with a fluid include a non-self-expanding stent that is expanded by another treatment tool such as a balloon.

[0032] The first joint portion 8 has a first joint member 81 and a fixing member 82. The first joint portion 8 connects and fixes the first outer tubular member 1 and the pulling member 3 to each other.

[0033] The first joining member 81 is a tubular member that can be inserted through the treatment tool channel 230 of the endoscope 200. The first joining member 81 is made of resin or the like and has flexibility. The entire first joining member 81 or the surface of the first joining member 81 is made of the same resin as the surface of the first outer tubular member 1. However, the material of the entire first joining member 81 or the surface of the first joining member 81 is not limited to this. As shown in FIG. 5, the first joining member 81 has a first end 81a on the distal side of the delivery device 100 and a second end 81b on the proximal side of the delivery device 100. As shown in FIG. 7, the first joining member 81 is a multi-lumen tube in which a first hole 811 and a second hole 812 are formed. The first end 81a of the first joining member 81 contacts the second end 1b of the first outer tubular member 1. The end face of the first end 81a of the first joining member 81 and the end face of the second end 1b of the first outer tubular member 1 contact each other.

[0034] The distal end 31 of the towing member 3 is inserted into the first hole 811, and the distal end 31 is fixed inside the first hole 811. Specifically, the distal end 31 is inserted into the first hole 811 and then fixed to the first hole 811 by an adhesive. At this time, the surface of the towing member 3 is roughened, so that the joining strength can be improved. In other words, if the surface roughness of the towing member 3 is large, the joining strength is improved. Note that the first hole 811 and the towing member 3 may be fixed by a frictional force generated between the inner surface of the first hole 811 and the outer surface of the towing member 3. The inner diameter of the first hole 811 is approximately equal to the outer diameter of the towing member 3.

[0035] 5 and 7, the inner tube member 2 is inserted into the second hole 812. The inner tube member 2 is inserted into the second hole 812 so as to be relatively movable. The inner diameter of the second hole 812 is larger than the outer diameter of the inner tube member 2. In this embodiment, the inner diameter of the second hole 812 is larger than the inner diameter of the first hole 811, but is not limited thereto. That is, the inner diameter of the second hole 812 may be smaller than the inner diameter of the first hole 811.

[0036] The fixing member 82 is a tubular member that can be inserted into the treatment tool channel 230 of the endoscope 200. The fixing member 82 is made of resin or the like and has flexibility. The fixing member 82 is provided so as to cover the first outer tube member 1 and the first joint member 81. Specifically, the fixing member 82 is disposed radially outward of the first outer tube member 1 and the first joint member 81, covers the entire circumference of the first outer tube member 1 and the entire circumference of the first joint member 81, and is provided so as to be in close contact with the first outer tube member 1 and the first joint member 81. The fixing member 82 covers the entire circumference of the second end 1b of the first outer tube member 1 and the first end 81a of the first joint member 81. The fixing member 82 fixes the first outer tube member 1 and the first joint member 81.

[0037] The entire fixing member 82 or the surface of the fixing member 82 is desirably formed of the same material as the surface of the first outer tube member 1. The entire fixing member 82 or the surface of the fixing member 82 is desirably formed of the same resin as the surface of the first joining member 81. That is, it is desirably that the surface of the first joining member 81, the surface of the fixing member 82, and the surface of the first outer tube member 1 are formed of the same material, particularly the same resin. In the present invention, this resin may have thermal fusion properties. By forming the surface of the first joining member 81, the surface of the fixing member 82, and the surface of the first outer tube member 1 from a resin having thermal fusion properties, these members can be easily thermally fused. Therefore, compared to bonding based on the elasticity of each member, it is possible to bond more firmly. However, the material of the fixing member 82 or the surface of the fixing member 82 is not limited to this.

[0038] The structure in which the first outer tube member 1 and the pulling member 3 are connected and fixed by the first joint portion 8 will be described. The distal end portion 31 of the pulling member 3 is fixed inside the first hole 811 of the first joint member 81. The end face of the first end 81a of the first joint member 81 and the end face of the second end 1b of the first outer tube member are butted against each other. That is, the end face of the first end 81a of the first joint member 81 and the end face of the second end 1b of the first outer tube member are in contact with each other. A fixing member 82 is provided so as to cover both the first joint member 81 and the first outer tube member 1. The fixing member 82 covers the entire circumference of the second end 1b of the first outer tube member 1 and the first end 81a of the first joint member 81 and is in close contact with each other.

[0039] With the above structure, the first joint portion 8 connects and fixes the first outer tube member 1 and the towing member 3. Therefore, a larger joint area can be secured compared to when the first outer tube member 1 and the towing member 3 are connected and fixed at only one point. The first joint portion 8 has a structure in which the fixing member 82 covers the entire circumference of the first outer tube member 1 and the first joint member 81. Therefore, a larger joint area can be secured compared to when a part of the outer circumferential surface of a tubular member such as the first outer tube member 1 is joined to a part of the inner circumferential surface of the fixing member 82.

[0040] The second joint portion 9 has a second joint member 91. The second joint portion 9 connects and fixes the inner tubular member 2 and the second outer tubular member 4 together.

[0041] The second joint member 91 is a tubular member that can be inserted through the treatment tool channel 230 of the endoscope 200. The second joint member 91 is made of resin or the like and has flexibility. As shown in FIGS. 8 to 10 , the second joint member 91 has a first end 91a on the distal side of the delivery device 100 and a second end 91b on the proximal side of the delivery device 100. The second joint member 91 connects and fixes the inner tube member 2 and the second outer tube member 4. The second joint member 91 is a multi-lumen tube having a first hole 911 and a second hole 912.

[0042] The first end 4a of the second outer tube member 4 is inserted into the first hole 911, and the first end 4a of the second outer tube member 4 is fixed inside the first hole 911. The pulling member 3 is inserted into the first hole 911. The pulling member 3 is inserted into the first hole 911 so as to be relatively movable. As shown in FIGS. 8 to 10, the inner diameter of the first hole 911 differs between the first end 91a and the second end 91b of the second joining member 91. Specifically, in the first hole 911, the inner diameter of the second end 91b is larger than the inner diameter of the first end 91a. The inner diameter of the first hole 911 at the second end 91b is approximately equal to the outer diameter of the second outer tube member 4.

[0043] The second end 2b of the inner tube member 2 is inserted into the second hole 912, and the second end 2b of the inner tube member 2 is fixed inside the second hole 912. The second hole 912 is configured to allow a guide wire G to be inserted therethrough. The guide wire G can be inserted into the second hole 912 so as to be relatively movable. The inner diameter of the second hole 912 differs between the first end 91a and the second end 91b of the second joining member 91. Specifically, in the second hole 912, the inner diameter of the second end 91b is smaller than the inner diameter of the first end 91a. The inner diameter of the second hole 912 at the first end 91a is approximately equal to the outer diameter of the inner tube member 2.

[0044] A structure in which the inner tube member 2 and the second outer tube member 4 are connected and fixed by the second joint member 9 will be described. A first end 4a of the second outer tube member 4 is fixed inside a first hole 911 of the second joint member 91. A second end 2b of the inner tube member 2 is fixed inside a second hole 912 of the second joint member 91.

[0045] With the above structure, the second joint portion 9 connects and fixes the inner tube member 2 and the second outer tube member 4. Therefore, a larger joint area can be secured compared to the case where the inner tube member and the second joint member are connected and fixed at only one point. Furthermore, the second joint portion 9 has a structure in which the first hole 911 of the second joint member 91 covers the entire circumference of the second outer tube member 4, and the second hole 912 of the second joint member 91 covers the entire circumference of the inner tube member 2. Therefore, a larger joint area can be secured compared to the case where a part of the outer circumferential surface of the second outer tube member 4 is joined to a part of the inner circumferential surface of the cylindrical member.

[0046] As described above, the inner diameter of the first hole 911 and the inner diameter of the second hole 912 of the second joining member 91 are 1b are different from each other. The inner diameter of the first hole 911 at the second end 91b is a diameter that allows the second outer tube member 4 to be inserted. The inner diameter of the first hole 911 at the first end 91a is small enough to allow the traction member 3, which has an outer diameter smaller than that of the second outer tube member 4, to be inserted. Similarly, the inner diameter of the second hole 912 at the first end 91a is a diameter that allows the inner tube member 2 to be inserted, and the inner diameter of the second hole 912 at the second end 91b is small enough to allow the guide wire G, which has an outer diameter smaller than that of the inner tube member 2, to be inserted. Therefore, the outer diameter of the second joining member 91 can be made smaller than when the diameters of the first hole 911 and the second hole 912 are uniform between the first end 91a and the second end 91b.

[0047] The above-described delivery device 100 in use will be described with reference to FIG. 11. The distal end of the delivery device 100 protrudes from the distal end 231 of the treatment instrument channel 230 of the endoscope 200 during use. In particular, when the distal end of the delivery device 100 is disposed near the placement position of the stent 6, the entire stent storage region E1 provided in the delivery device 100 protrudes from the distal end 231 of the treatment instrument channel 230. In this state, the first joint member 81 and the fixing member 82 are disposed inside the treatment instrument channel 230. Similarly, the second joint member 91 is also disposed inside the treatment instrument channel 230. Meanwhile, the second opening 42 of the second outer tube member 4 is disposed outside the forceps port 222 on the proximal side of the treatment instrument channel 230.

[0048] After the surgeon or his / her assistant determines the placement position of the stent 6, the surgeon or his / her assistant next pulls the traction member 3 proximally. With the position of the second outer tube member 4 relative to the forceps plug 225 fixed, the traction member 3 is pulled proximally. The traction member 3 is fixed to the first outer tube member 1 by the first joint member 81 and the fixing member 82. The inner tube member 2 is inserted into the lumen 13 so as to be movable forward and backward relative to the first outer tube member 1. Therefore, when the traction member 3 is pulled proximally, the first outer tube member 1, the first joint member 81, and the fixing member 82 move backward with the movement of the traction member 3, and the inner tube member 2 does not move backward. The inner tube member 2 is connected to the second outer tube member 4, and the position of the second outer tube member 4 relative to the treatment instrument channel 230 is maintained. Therefore, the position of the inner tube member 2 is maintained, and the position of the stent storage region E1 is unlikely to deviate from the target position where it is placed. In this state, when the first outer cylindrical member 1 is retracted relative to the inner cylindrical member 2, the stent 6 is exposed to the outside. When the stent 6 is exposed to the outside from the stent storage region E1, it expands in diameter, and becomes larger than the outer diameter of the tip 5. When the towing member 3 is then pulled further proximally, the first joint 8 comes into contact with the second joint 9. When the towing member 3 is continued to be pulled with the first joint 8 at the second joint 9, the inner cylindrical member 2 and the tip 5 are retracted. Because the stent 6 has expanded in diameter to be larger than the outer diameter of the tip 5, the delivery device 100 can be retracted without the stent 6 being retracted.

[0049] Until the stent 6 is completely expanded, the first outer cylindrical member 1 can be advanced relative to the inner cylindrical member 2 to reduce the diameter of the stent 6 and re-contain it (recapture) between the first outer cylindrical member 1 and the inner cylindrical member 2. Recapture is useful when resetting the placement position, etc.

[0050] The dimensions of each member constituting delivery device 100 in the longitudinal direction of delivery device 100 will be described with reference to FIGS.

[0051] The length of the stent storage area E1 in the longitudinal direction is referred to as length D1. The length from the second end 81b of the first joint member 81 to the first end 91a of the second joint member 91 in the initial state in which the stent 6 is stored in the stent storage area E1 and the stent 6 can be placed is referred to as length D2. The length D2 is longer than the length D1. The length D2 is the length when the first outer tube member 1 is farthest from the second joint portion 9 on the distal side. The length D2 is the length of the part of the inner tube member 2 exposed in the treatment instrument channel 230. With the above structure, even if the pulling member 3 is pulled proximally until the stent 6 is released from the delivery device 100, the first joint member 81 and the second joint member 91 do not come into contact with each other. Therefore, it is possible to prevent a situation in which the first outer tube member 1 does not sufficiently retract because the first joint member 81 cannot be pulled proximally of the delivery device 100, the stent 6 is not completely exposed from the stent storage area E1, and the stent 6 cannot be released. In the region of length D2, the members constituting the delivery device 100, i.e., the inner tube member 2 and the traction member 3, are unlikely to come into contact with the inside of the treatment instrument channel 230. Therefore, when the delivery device 100 moves forward or backward relative to the treatment instrument channel 230, it is unlikely to be affected by the frictional force against the inner surface of the treatment instrument channel 230.

[0052] The second joint member 91 is inserted into the treatment instrument channel 230. Therefore, the second joint member 91 is disposed distal to the forceps port 222. In the initial state, that is, in a state in which the first end 1a and the stent storage region E1 of the first outer tubular member 1 protrude from the distal end of the treatment instrument channel 230 and the second end 1b is located within the distal end portion 231, the length D4 from the first end 91a of the second joint member 91 to the forceps port 222 of the endoscope 200 is longer than the length D3 from the first end 1a of the first outer tubular member 1 to the first end 91a of the second joint member 91. Similarly, the length D5 from the first end 91a of the second joint member 91 to the second end 4b of the second outer tubular member 4 is longer than the length D3. The length D4 is the insertion length of the second outer tubular member 4 inserted into the treatment instrument channel 230.

[0053] When the stent 6 is placed, the position of the second outer tubular member 4 relative to the treatment tool channel 230 is maintained, and the lengths D2 and D3 change. Here, the members that move when the delivery device 100 releases the stent 6 are referred to as moving members. Specifically, the moving members are the first joint member 81, the first joint portion 8, and the traction member 3. The lengths D2 and D3 change depending on the degree of movement of the moving members. The length D3 is a length at which the first end 81a of the first joint portion 8 is not exposed from the distal end portion 231 of the treatment tool channel 230 even when the traction member 3 is pushed out to the most distal side. For example, in the case of the delivery device 100 for the bile duct, the length D3 is 20 cm. The length D3 is longer than the total length of the length of the first outer tubular member 1 and the maximum value of the length D2.

[0054] As described above, the length D4 is longer than the length D3. That is, in the delivery device 100, the length D3 of the portion that advances and retreats within the long treatment tool channel 230 is shorter than the length D4 of the portion that is held in position. As a result, it is possible to reduce the influence of friction that occurs between the delivery device 100 and the treatment tool channel 230 during the placement operation of the stent 6. Therefore, the delivery device 100 is less likely to shift position, and the stent 6 can be placed at a desired position.

[0055] As described above, the length D5 is longer than the length D3. That is, in the delivery device 100, the length D3 of the portion advancing and retracting in the long treatment instrument channel 230 is at its maximum length (maximum value of the length D3) is shorter than the length D5. As a result, it is possible to reduce the influence of friction generated between the delivery device 100 and the treatment instrument channel 230 during the placement operation of the stent 6. Therefore, the delivery device 100 is less likely to shift position relative to the treatment instrument channel 230, and the stent 6 can be placed at a desired position.

[0056] Since the lengths D3, D4, and D5 have the above-mentioned relationship, the region (D4, D5 region) where the moving member does not appear outside from the distal end of the delivery device 100 is larger than the region (D3 region) where the moving member appears outside from the distal end of the delivery device 100. Therefore, when the delivery device 100 releases the stent 6, the effect of the frictional force generated between the delivery device 100 and the treatment tool channel 230 can be suppressed.

[0057] According to the delivery device 100 of the embodiment, the traction member 3 is fixed inside the first hole 911. 8 The first joining member 81 and the first outer tube member 1, from which the end face of the pulling member 3 is formed, are fixed by a fixing member 82. That is, the pulling member 3 is fixed to the first outer tube member 1 by the first joining member 81 and the fixing member 82. By fixing the pulling member 3 inside the first hole 911, a wide joining area between the pulling member 3 and the first hole 911 can be secured. As a result, a wider joining area can be secured compared to a case in which the end face of the pulling member and the end face of the joining member are fixed at only one point, and the joining strength can be increased.

[0058] According to the delivery device 100 of the embodiment, the first outer tube member 1 and the first joining member 81 are fixed to the fixing member 82. That is, the fixing member 82 tightly contacts and covers the entire circumference of the first outer tube member 1 and the first joining member 81. Therefore, a wider joining area can be ensured.

[0059] According to the delivery device 100 of the embodiment, the first outer tube member 1 and the first joint member 81 are connected at their end faces on the radially inner side of the fixing member 82. As a result, the inner diameter of the delivery device 100 can be secured, and the inner diameter of the second hole 812 through which the inner tube member 2 is inserted so as to be capable of advancing and retracting can be secured wide. As a result, when the pulling member 3 is pulled, the first outer tube member 1 can be smoothly pulled relative to the inner tube member 2. In addition, since the inner diameter of the second hole 812 can be secured wide, a wide advancement and retraction path for the guidewire can be secured. Therefore, the guidewire G can be smoothly advanced and retracted.

[0060] According to the delivery device 100 of the embodiment, the fixing member 82, the first outer tube member 1, and the first joining member 81 are formed from the same material, and therefore can be joined together by thermal fusion, making them easy to join.

[0061] According to the delivery device 100 of the embodiment, the diameter of the first hole 911 is large enough to fix the traction member therein, and the diameter of the second hole 912 is large enough to insert the inner tube member 2 so that it can advance and retreat. Therefore, while the traction member is fixed by the first hole 911, the inner tube member 2 can easily advance and retreat.

[0062] According to the delivery device 100 of the embodiment, the second joint member 91 is a member that connects the inner tube member 2 and the second outer tube member 4. As a result, a larger joint area can be secured compared to the case where the inner tube member 2 and the second outer tube member 4 are joined at only one location.

[0063] According to the delivery device 100 of the embodiment, the stent 6 is released from the stent storage area E1 by pulling the towing member. The first hole 911 of the second joint member 91 has a size that allows the towing member to advance and retreat freely. Therefore, a path for the towing member to advance and retreat can be secured while joining the inner tube member 2 and the second outer tube member 4. As a result, the advance and retreat path for the towing member is secured while suppressing the outer diameter dimension of the delivery device 100, and the towing member can advance and retreat smoothly, resulting in excellent operability.

[0064] According to the delivery device 100 according to the embodiment, the entire delivery device 100 is advanced and retracted along the guidewire. The guidewire is provided so as to be able to advance and retract freely relative to the inner tube member 2. Therefore, the inner tube member 2 and the second outer tube member 4 are reliably joined over a wide joining area, while a wide path for the guidewire G to advance and retract can be secured.

[0065] According to the delivery device 100 of the embodiment, the inner diameter of the first hole 911 at the first end 91a may be a diameter large enough to insert the traction member 3, but the inner diameter of the first hole 911 at the second end 91b must be a diameter large enough to insert and fix the second outer tube member 4. That is, the diameter of the first hole 911 at the second end 91b is larger than the diameter of the first hole 911 at the first end 91a. The inner diameter of the second hole 912 at the first end 91a must be a diameter large enough to insert and fix the inner tube member 2, but the inner diameter of the second hole 912 at the second end 91b must be a diameter large enough to insert the guide wire G. As a result, the outer diameter of the second joint member 91 can be made thin. As a result of the second joint portion 9 being made thin, the second joint portion 9 is less likely to come into contact with the treatment instrument channel 230 when the delivery device 100 moves forward and backward within the treatment instrument channel 230, and the forward and backward movement of the delivery device 100 can be performed smoothly. In particular, when the endoscope insertion portion is curved, it is possible to prevent the treatment instrument channel 230 and the second joint portion 9 from coming into contact with each other and providing resistance to the advancement and retreat of the treatment instrument channel 230 and the second joint portion 9.

[0066] As long as desired mechanical properties are satisfied, there is no particular limitation on the materials of the first outer tube member 1, the inner tube member 2, the traction member 3, the second outer tube member 4, the first bonding member 81, the fixing member 82, and the second bonding member 91. In the case of a delivery device used under X-ray fluoroscopy, a radiopaque metallic marker (e.g., medical radiopaque metals and alloys such as platinum, tungsten, and iridium) may be added, or a radiopaque material (e.g., barium sulfate, etc.) may be mixed in.

[0067] Although the first embodiment has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment, and design modifications and the like within the scope of the present invention are also included. In addition, the components shown in the above embodiment and the modified examples shown below can be appropriately combined to form a configuration. [Industrial Applicability]

[0068] The present invention can be applied to a delivery device for delivering a medical instrument into the body. [Explanation of symbols]

[0069] 1...First outer cylinder member 1a...first end 1b...Second end 2...Inner cylinder member 2a...first end 2b...Second end 3. Traction member 4... Second outer cylinder member 4a...first end 4b...Second end 6. Stent 8...First joint 9...Second joint 13, 43... Internal space (lumens) 81... First joining member 81a...first end 81b...Second end 82... Fixing member 91... Second joining member 91a...first end 91b...Second end 100 Delivery Device 300 Endoscope system 230...Treatment tool channel 811...first hole 812...Second hole 911...first hole 912...Second hole E1: Stent storage area

Claims

1. A first outer cylinder member; an inner cylindrical member inserted into the first outer cylindrical member; a second outer tubular member located proximal to the first outer tubular member and connected to the inner tubular member; a pulling member that is inserted into the second outer tube member and connected to the first outer tube member; A first joining member having a first hole for fixing the pulling member therein and a second hole configured to allow the inner tube member to advance and retreat; a fixing member disposed radially outward of the first joining member and the first outer tubular member, and provided so as to be in close contact with an entire circumference of an outer circumferential surface of the first joining member and an entire circumference of an outer circumferential surface of the first outer tubular member, and fixing the first joining member and the first outer tubular member; A delivery device comprising:

2. The first outer tubular member and the first joining member are disposed so as to be in contact with each other at a radially inner side of the fixing member. The delivery device of claim 1 .

3. a surface of the fixing member, a surface of the first outer tubular member, and a surface of the first joining member are formed of the same resin having thermal fusion properties; The fixing member, the first outer cylinder member, and the first joining member are fixed to each other by thermal fusion. The delivery device of claim 1 .

4. A diameter of the first hole of the first joining member is smaller than a diameter of the second hole of the first joining member. The delivery device of claim 1 .

5. a second joining member having a first hole configured to fix the second outer cylindrical member therein and a second hole configured to fix the inner cylindrical member therein; The delivery device of claim 1 .

6. The first hole of the second joint member is configured so that the pulling member can be inserted therethrough and the pulling member can advance and retreat. A delivery device according to claim 5.

7. The second hole of the second joint member has a size through which a guide wire that guides the delivery device is inserted and which allows the guide wire to advance and retreat. A delivery device according to claim 5.

8. the second joint member having a first end distal to the delivery device and a second end proximal to the delivery device; The diameter of the first hole is larger at the second end than at the first end, The diameter of the second hole is larger at the first end than at the second end. A delivery device according to claim 5.

9. The delivery device further includes a second joint member that is disposed proximal to the delivery device relative to the first joint member and that fixes the second outer cylindrical member and the inner cylindrical member. The delivery device of claim 1 .

10. the first outer tubular member has a stent storage region in which a stent is stored, the first joint member having a second end proximal to the delivery device; the second joint member having a first end distal to the delivery device; In the longitudinal direction of the delivery device, a length from the second end of the first joint member to the first end of the second joint member is longer than a length of the stent storage region.

10. A delivery device according to claim 9.

11. the first barrel member having a first end distal to the delivery device; the second joint member having a first end distal to the delivery device; the second barrel member having a second end proximal to the delivery device; In a longitudinal direction of the delivery device, a length from the first end of the second joint member to the second end of the second outer tubular member is longer than a length from the first end of the first outer tubular member to the first end of the second joint member.

10. A delivery device according to claim 9.

12. a stent that is stored between the first outer tubular member and the inner tubular member and that is released in response to proximal movement of the traction member relative to the second outer tubular member. The delivery device of claim 1 .

13. A first outer cylinder member; an inner cylindrical member that is inserted through the inside of the first outer cylindrical member; a second outer tube member located proximal to the first outer tube member and connected to the inner tube member; a traction member inserted through the inside of the second outer tube member and connected to the first outer tube member; A first joining member having a first hole for fixing the towing member therein and a second hole configured so that the inner tube member can be inserted therethrough and the inner tube member can advance and retreat; a fixing member disposed radially outward of the first joining member and the first outer tubular member, and provided so as to be in close contact with an entire circumference of an outer circumferential surface of the first joining member and an entire circumference of an outer circumferential surface of the first outer tubular member, and fixing the first joining member and the first outer tubular member; A delivery device comprising: an endoscope having a treatment tool channel configured so that the delivery device can be advanced and retreated; An endoscope system comprising:

14. The endoscopic system according to claim 13 , further comprising a second joint member arranged proximal to the delivery device relative to the first joint member and fixing the second outer tube member and the inner tube member.

15. The delivery device further includes a stent that is stored between the first outer tubular member and the inner tubular member and that is released upon proximal movement of the traction member relative to the second outer tubular member. The endoscope system according to claim 14.

16. The first joint member has a stent storage area in which the stent is stored, The first joint member and the second joint member are configured to be positioned inside the treatment instrument channel in a state in which the entire stent storage region protrudes from the distal side of the endoscope in the treatment instrument channel. The endoscope system of claim 15.

17. the first barrel member having a first end distal to the delivery device; the second joint member having a first end distal to the delivery device; The first joint member has a stent storage area in which the stent is stored, In a state in which the entire stent storage region of the treatment instrument channel protrudes from the distal side of the endoscope, a length from the first end of the second joint member to a forceps port of the endoscope in a longitudinal direction of the delivery device is longer than a length from the first end of the first outer tube member to the first end of the second joint member. The endoscope system of claim 15.

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