Biased operating device for medical equipment

Abstract

A medical instrument-use deflection operation device 1A comprises: a first rack member 100 and a second rack member 200 stored in a controller housing 300 so as to be reciprocally displaceable in the longitudinal direction along an extending direction of a first and a second operation wire 31, 32, and also so as to have teeth parts 120, 220 that oppose each other; and a pinion member 400 that is rotatably supported, in a state of engagement with the teeth parts 120, 220 of the rack members 100, 200. A first and a second operation knob 510, 520 that each protrude outward from the controller housing 300 are integrally provided on the rack members 100, 200, respectively.

Description

[Technical field]

[0001] The present invention relates to a deflection control device for a medical device. [Background technology]

[0002] Long, flexible, tubular medical devices such as catheters are inserted into tissues of various internal organs (e.g., the heart) through blood vessels, tracheas, or body cavities, internal luminal parts, etc., to perform the desired medical treatment. In order to facilitate insertion into the body and access to tissues, some of such medical devices are known in which the direction of the distal end inserted into the body can be deflected by an operating unit that is connected to the proximal end of the medical device and placed outside the body (see, for example, Patent Documents 1 and 2, etc.).

[0003] Patent Document 1 describes a deflection mechanism in which a cylindrical control handle is provided at the proximal end of a sheath as a medical device and is coaxial with the sheath, and two pull wires inserted into the sheath are advanced and retreated in opposite directions to deflect the direction of the distal end of the sheath.

[0004] The control handle described in Patent Document 1 has a control knob rotatably supported on the distal end side of the main body, which is the part to be held by hand, and a pair of shuttles that advance and retreat in the front-rear direction (the axial direction of the sheath) by rotation of the control knob are built into the main body, and a pull wire is connected to each shuttle. Each shuttle has a shape extending in the axial direction, has a semi-cylindrical part on its distal end side, and has opposing rack parts on its proximal end side, and a pinion meshes with both rack parts to form a rack-and-pinion. In addition, a male thread is formed on the outer peripheral surface of the semi-cylindrical part on the distal end side of one of the pair of shuttles, and the male thread is screwed into a female thread formed on the inner peripheral surface of a rotary shaft integrated with the control knob to form a screw drive mechanism.

[0005] According to the control handle described in Patent Document 1, when the control knob is rotated, the rotation is converted into linear motion of one shuttle by a screw drive mechanism, and the linear motion of the one shuttle causes linear motion of the other shuttle in the opposite direction via a pinion. In this way, the rotation of the control knob is converted into the movement of the two shuttles in opposite directions, and therefore the two pullwires connected to each shuttle move in opposite directions, deflecting the direction of the distal end of the sheath.

[0006] Patent document 2 also describes a deflection mechanism in which a bending operating section provided at the proximal end of a tubular medical device main body pulls a first operating wire and a second operating wire inserted into the medical device main body, thereby deflecting the direction of the distal end of the medical device main body.

[0007] The bending operating section described in Patent Document 2 is housed in a housing held by hand, which contains an advance / retract member equipped with a rack portion that advances and retreats in the front-to-back direction (the axial direction of the medical device body), and the proximal ends of a first operating wire and a second operating wire are fixed to a rotating member installed on the distal end side of the advance / retract member. Furthermore, the housing rotatably supports a dial operating section which has a pinion at its rotation center that meshes with the rack portion of the advance / retract member, and whose left and right ends respectively protrude to the sides of the housing.

[0008] According to the bending operating portion described in Patent Document 2, by holding the housing with one hand and rotating the dial operating portion in one direction with the other hand, the rotating member retracts together with the advancing / retreating member, and as a result, the first operating wire and the second operating wire are pulled toward the proximal end, thereby deflecting the direction of the distal end of the medical device main body. [Prior art documents] [Patent documents]

[0009] [Patent Document 1] JP 2018-094406 A [Patent Document 2] JP 2019-025211 A Summary of the Invention [Problem to be solved by the invention]

[0010] However, the control handle described in the above Patent Document 1 has the disadvantages of being complex in structure and having a large number of parts. In addition, since the control knob, whose rotation axis is coaxial with the sheath, is rotated to deflect the direction of the distal end of the sheath, the operation direction of the control knob, i.e., the rotation direction, and the deflection direction of the distal end of the sheath are completely different, and therefore, there is a problem that it is difficult to grasp the deflection state (the deflection direction and the degree of deflection) according to the operation, and sufficient operability cannot be obtained. Furthermore, since a screw drive mechanism is used to convert the rotation operation into linear motion, the operation reaction force from the deflected distal end of the sheath is difficult to directly transmit to the control knob that is being manually operated, and effective operating resistance (operation feeling) cannot be obtained, making it difficult to obtain sufficient operability.

[0011] On the other hand, the bending operating part described in Patent Document 2 makes it difficult to grasp the housing and rotate the dial operating part with one hand, and as a result, both hands are occupied in operating the bending operating part, which raises concerns that it may become difficult to perform other operations on the catheter or maintain the catheter position.

[0012] The present invention has been made in consideration of the above circumstances, and aims to provide a deflection operating device for medical equipment that is easy to operate with one hand, has a simple configuration, and provides sufficient operability. [Means for solving the problem]

[0013] The present invention relates to a medical device deflection operation device for deflecting a movable part of a medical device via a first operation wire and a second operation wire, the deflection operation device comprising: a main body; a controller housing having a support handle portion provided on one end side of the main body in a longitudinal direction along an extending direction of the first operation wire and the second operation wire; and a wire insertion portion provided on the other end side of the main body in the longitudinal direction, through which the first operation wire and the second operation wire are inserted; a first rack member and a second rack member housed within the controller housing so as to be reciprocally displaceable in the longitudinal direction and to have teeth portions facing each other; and a controller housing arranged between the first rack member and the second rack member and configured to engage with the teeth portions of both rack members. and a pinion member rotatably supported on a controller housing, wherein the controller housing is provided with a slide guide portion that forms a groove-shaped opening along at least one of the first rack member and the second rack member, and at least one of the first rack member and the second rack member is integrally provided with an operation knob that protrudes outwardly from the controller housing through the opening, and when the operation knob is slidably operated so as to be displaced relatively in the longitudinal direction with respect to the support handle portion, the first rack member and the second rack member are displaced in mutually opposite directions with respect to the pinion member, while displacing the first operation wire and the second operation wire in the deflection operation direction of the movable portion.

[0014] According to the medical device deflection device of the present invention, the first rack member and the second rack member can be reciprocated in opposite directions by operating an operation knob provided on at least one of the rack members, thereby deflecting the movable part of the medical device. Therefore, the movable part of the medical device can be deflected with a simpler configuration than conventional devices.

[0015] Furthermore, according to the deflection operation device for medical equipment of the present invention, the reciprocating operation direction of the operation knob is the same as the extending direction of the first operation wire and the second operation wire, and the operation knob is integrally provided on at least one of the first and second rack members. Therefore, the operation direction of the operation knob and the deflection direction of the movable part of the medical equipment can be made to correspond intuitively. In addition, it is easy to grasp the deflection state (the direction of deflection and the degree of deflection) according to the operation of the operation knob, and an effective sense of operational resistance (operation feeling) can be obtained by transmitting the operational reaction force from the movable part of the medical equipment to the operation knob that is being manually operated. As a result, sufficient operability can be obtained.

[0016] In addition, according to the deflection operating device for medical equipment of the present invention, the operator can easily support and operate the operating device with one hand by pressing the palm of his / her hand against the support handle portion of the controller housing and hooking his / her fingers on the operating knob.

[0017] The deflection operating device for medical equipment according to the present invention is characterized in that the operating knob is composed of a first operating knob and a second operating knob provided on the first rack member and the second rack member, respectively.

[0018] With this configuration, the medical device deflection operation device according to the present invention can deflect the movable part in a desired direction by operating the operation knob corresponding to the deflection direction of the movable part out of the first and second operation knobs. Therefore, it is easy to grasp the deflection state according to the operation of the first and second operation knobs, and an effective operation resistance feeling (operation feeling) can be obtained because the operation reaction force from the movable part of the medical device is transmitted to the operation knob on the side where manual operation is being performed.

[0019] In addition, by performing a pulling operation to displace the first and second operation knobs toward the support handle portion, an operating force can be effectively applied to each operation knob when manually operating with one hand, and compared to a deflection operation such as rotating a dial, for example, there is no need to reposition the finger while operating, which also improves operability. Furthermore, even if the controller housing is turned 180° and the left and right positions of the first and second operation knobs are reversed, each operation knob can be conveniently operated in the same way.

[0020] The deflection device for medical equipment according to the present invention is characterized in that the support handle portion and the main body portion of the controller housing form a substantially T-shape.

[0021] With this configuration, the deflection device for medical equipment according to the present invention can be easily gripped via the support handle portion, thereby improving operability.

[0022] The deflection operation device for medical equipment according to the present invention is characterized in that a biasing means is interposed between at least one of the first rack member and the second rack member and the controller housing, for biasing the first rack member and the second rack member to a specific position relative to the controller housing. The specific position here can be considered to be a neutral position in which the movable part of the medical equipment extends straight and does not deflect. In addition, for example, if the medical equipment is shaped to have a curved shape, the movable part is not necessarily straight in the neutral position, and the neutral position is set according to the shape of the medical equipment.

[0023] With this configuration, the deflection operation device for medical equipment according to the present invention can automatically hold the first rack member and the second rack member in specific positions by the biasing means without operating the operation knob, so that each rack member can be easily and reliably held in its specific position, improving operability.

[0024] The deflection operating device for medical equipment according to the present invention is characterized in that the operating knob is provided on one of the rack members, either the first rack member or the second rack member, and the rack member on the other side is provided with an indication portion indicating the relative position of the rack member on the other side with respect to the controller housing.

[0025] With this configuration, the deflection operation device for medical equipment according to the present invention makes it possible to grasp the deflection state of the medical equipment by visually recognizing the relative position of the marking portion with respect to the controller housing. Effect of the Invention

[0026] According to the present invention, it is possible to provide a deflection operation device for medical equipment that can be easily operated with one hand, has a simple configuration, and provides sufficient operability. [Brief description of the drawings]

[0027] [Figure 1] 1 is a plan view showing a deflection device for a medical device according to one embodiment of the present invention and a catheter whose movable part is deflected by the device. [Diagram 2] FIG. 2 is a cross-sectional view taken along line II-II of FIG. [Diagram 3] FIG. 5 is a cross-sectional view taken along line III-III of FIG. 1 and FIG. [Figure 4] FIG. 4 is a cross-sectional view taken along line IV-IV of FIG. [Diagram 5] 1 is a plan view of a deflection operation device for a medical instrument according to one embodiment of the present invention, showing a see-through cover on the front side of a controller housing. FIG. [Figure 6] 1 is a perspective view of a deflection operating device for a medical instrument according to one embodiment of the present invention, showing a state in which a cover body of a controller housing is removed from a base. [Figure 7] FIG. 7 is a view taken along the arrow VII in FIG. 5. [Figure 8] FIG. 8 is a view taken along the arrow VIII in FIG. 5. [Figure 9] IX-IX cross-sectional view of FIG. 5. [Figure 10A] FIG. 4 is a plan view showing a second rack member and a second operation knob according to an embodiment of the present invention. [Figure 10B] FIG. 2 is a plan view showing a first rack member and a first operation knob according to an embodiment of the present invention. [Figure 11] 1 is a plan view showing a state in which a movable part of a catheter is deflected in one direction by a deflection operating device for a medical instrument according to one embodiment of the present invention. FIG. [Figure 12] 12 is a plan view showing a state in which a movable part of a catheter is deflected in a direction opposite to the one direction shown in FIG. 11 by a deflection device for a medical instrument according to one embodiment of the present invention. FIG. [Figure 13] FIG. 13 is a plan view of a deflection operating device for a medical instrument according to another embodiment of the present invention, with a lid of a controller housing seen through; [Figure 14] FIG. 14 is a plan view showing an example in which the arrangement of the operation knob, the indicator, and the coil spring is changed in the alternative embodiment shown in FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0028] Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

[0029] (One embodiment) First, the configuration of one embodiment will be described.

[0030] 1 shows a deflection device for medical equipment (hereinafter, abbreviated as a deflection device) 1A according to one embodiment, and a catheter 2 whose distal end is deflected by the deflection device 1A. The catheter 2 constitutes the medical equipment of the present invention. In addition to the catheter shown in this embodiment, the medical equipment of the present invention may be, for example, a flexible tube such as a cannula or a sheath, but is not limited to these.

[0031] The catheter 2 has a movable part 20 whose orientation can be deflected left and right at the end of the tip side, i.e., the distal end side (lower side in FIG. 1), which is inserted into the body. The deflection control device 1A is fixed to the proximal end of the catheter 2, and is disposed outside the body during use. The deflection control device 1A deflects the movable part 20 via a first control wire 31 and a second control wire 32, which are provided in the catheter 2 and will be described later.

[0032] First, the catheter 2 will be described.

[0033] The catheter 2 has a structure as shown in Figures 2 to 4. However, the structure of the catheter 2 is not limited to this.

[0034] Figures 2 and 3 are cross-sectional views of the catheter 2, with Figure 2 showing a cross section taken along line II-II in Figure 1, and Figure 3 showing a cross section taken along line III-III in Figures 1 and 4. Also, Figure 4 shows a cross section taken along line IV-IV in Figure 3, which is the distal end of the catheter 2.

[0035] 2 to 4, the catheter 2 has one main lumen 23 and two wire lumens 21, 22, i.e., a first wire lumen 21 and a second wire lumen 22. The catheter 2 is composed of a multi-layer tube having an inner tube 23A and an outer tube 23B made of flexible resin, and the main lumen 23 is composed of the hollow interior of the inner tube 23A.

[0036] In the outer tube 23B, a first wire lumen 21 and a second wire lumen 22 are provided at positions that are opposite poles and approximately 180 degrees apart from each other with respect to the central axis of the catheter 2.

[0037] The first wire lumen 21 is formed by the hollow interior of a first wire lumen tube 21A embedded in an outer tube 23B. The second wire lumen 22 is formed by the hollow interior of a second wire lumen tube 22A embedded in an outer tube 23B. Each of the wire lumens 21, 22 extends along the axial direction of the catheter 2.

[0038] A first operating wire 31 is inserted through the first wire lumen 21 so as to be movable back and forth along the axial direction of the catheter 2, and a second operating wire 32 is inserted through the second wire lumen 22 so as to be movable back and forth along the axial direction of the catheter 2. Each of the operating wires 31, 32 is made of, for example, a stranded wire or solid wire of a metal such as stainless steel, or a filament of a polymeric material.

[0039] 3 and 4, the catheter 2 according to this embodiment has an annular pull ring 40 provided at the distal end. The pull ring 40 is made of a metal such as stainless steel.

[0040] The distal end of each of the first operating wire 31 and the second operating wire 32 is joined to the inner surface 40a of the pull ring 40 by means of brazing or the like.

[0041] As described below, the proximal ends of a first operation wire 31 and a second operation wire 32 are connected to a deflection operation device 1A according to this embodiment provided at the proximal end of the catheter 2. The deflection operation device 1A is configured to deflect the orientation of the movable part 20 of the catheter 2 in the opposite direction by 180 degrees via a pull ring 40 as indicated by arrows α and β in FIG. 1 by advancing and retracting the operation wires 31 and 32.

[0042] 2 to 4, the catheter 2 has a braided layer 24 disposed so as to surround the main lumen 23 and each of the wire lumens 21, 22. The braided layer 24 is a reinforcing member formed by braiding wire material such as stainless steel, and this braided layer 24 prevents the catheter 2 from twisting.

[0043] 4, the catheter 2 has a generally cylindrical coating resin 50 at its distal tip which coats the tip and the pull ring 40. The pull ring 40 is attached to the distal end of the catheter 2 by this coating resin 50. The coating resin 50 forms the tip of the catheter 2, and the edge of the tip is chamfered in an R shape to form a gentle surface.

[0044] Next, the deflection operation device 1A according to this embodiment will be described.

[0045] Fig. 5 is a plan view showing the entire deflection operation device 1A. In Fig. 5, the internal configuration is shown by solid lines as seen through a cover 300B of a controller housing 300 described later. As shown in Fig. 5, the deflection operation device 1A according to this embodiment includes a flat controller housing 300 having a cavity therein, a first rack member 100 and a second rack member 200 housed in the controller housing 300, and a pinion member 400 disposed between the rack members 100 and 200.

[0046] The controller housing 300 is formed in a generally T-shape having a cavity therein, and has a generally rectangular main body 310, a support handle portion 320 integrally provided at a proximal end, which is one end side in the longitudinal direction of the main body 310, and a wire insertion portion 330, through which the first operation wire 31 and the second operation wire 32 are inserted, at a distal end, which is the other end side in the longitudinal direction of the main body 310. The longitudinal direction of the main body 310 is the direction along the extension direction of the operation wires 31, 32 inserted in the catheter 2. The longitudinal direction referred to below is based on the longitudinal direction of the main body 310.

[0047] Controller housing 300 has a symmetrical shape with a longitudinal center line C passing through the widthwise center of main body 310 as a line of symmetry. As shown in Fig. 6, controller housing 300 is configured by detachably combining half-split base 300A and lid 300B, which are roughly divided into two in the thickness direction, with screw fastening parts 301, 302, 303 at least at three locations distributed in the longitudinal direction. Base 300A and lid 300B have roughly the same shape, and are integrally molded from resin or the like.

[0048] 6, base 300A has base-side main body portion 310a and base-side support handle portion 320a which respectively constitute main body portion 310 and support handle portion 320 of controller housing 300. Similarly, lid 300B has lid-side main body portion 310b and lid-side support handle portion 320b which respectively constitute main body portion 310 and support handle portion 320 of controller housing 300.

[0049] As shown in Fig. 6, the base 300A has a bottom plate portion 304a and a side wall portion 305a that forms the edge of the bottom plate portion 304a, so that the cross section of the base 300A is in the shape of a thin dish. The lid body 300B has a top plate portion 304b and a side wall portion 305b that forms the edge of the top plate portion 304b, so that the cross section of the base 300A is in the shape of a thin dish. The controller housing 300 is configured by stacking the side walls 305a, 305b of the base 300A and the lid body 300B so that they face each other, and as shown in Fig. 7, the side walls 305a, 305b of the two constitute the side wall portion 305 of the controller housing 300 as a whole.

[0050] 7, side wall 305 of main body 310 on the first rack member 100 side has a first slide guide portion 306 that forms a groove-shaped opening 306a along the first rack member 100. Also, as shown in FIG. 8, side wall 305 of main body 310 on the second rack member 200 side has a second slide guide portion 307 that forms a groove-shaped opening 307a along the second rack member 200.

[0051] Unless otherwise specified, each component of controller housing 300 described below will be described as a component of controller housing 300 in a state in which base 300A and lid 300B are combined.

[0052] 5, the support handle portion 320 of the controller housing 300 includes a first handle portion 321 and a second handle portion 322, each of which has a substantially rectangular shape and extends laterally perpendicular to the main body portion 310. The support handle portion 320 and the main body portion 310 form a substantially T-shape.

[0053] In this embodiment, the support handle portion 320 forms an approximately T-shape together with the main body portion 310, but the support handle portion of the present invention may be of any shape having a surface that can be pressed against the palm, such as a shape that forms an approximately L-shape together with the main body portion 310, and may also be of any shape having a structure that allows fingers to be engaged, such as a finger insertion ring that can be supported by passing the fingers through.

[0054] As shown in FIG. 5, the edge 323 on the proximal end side of the support handle portion 320 includes a support portion 323a on which the palm of the operator's hand is placed. The support portion 323a is formed into a gently curved surface that is substantially convex from one end to the other end toward the proximal end side. In addition, each of the corners 323b, 323c continuing to both ends of the support portion 323a is chamfered. Since the support portion 323a is gently curved and each of the corners 323b, 323c is chamfered, the operator can easily place his / her palm on the support portion 323a without feeling uncomfortable, which improves the operability of the deflection operation device 1A.

[0055] The distal end edges of the first handle portion 321 and the second handle portion 322 constituting the support handle portion 320 respectively constitute finger locking portions 321a, 322a on which the operator's fingers are hooked. These finger locking portions 321a, 322a are formed into gently curved surfaces that are substantially concave toward the proximal end. In addition, the outer corners 321b, 322b that are continuous with the finger locking portions 321a, 322a are chamfered.

[0056] 7 and 8, controller housing 300 has support handle portion 320 and bulging portion 325 formed to be thicker than main body portion 310 at the transition portion from support handle portion 320 to main body portion 310. The thickness of bulging portion 325 is an appropriate thickness that allows an operator to easily grip support handle portion 320. In support handle portion 320, finger locking portions 321a, 322a are curved in a concave shape so that fingers can be easily hooked thereon, and in addition, support handle portion 320 has an appropriate thickness due to bulging portion 325, making support handle portion 320 easy to grip.

[0057] 5 and 9, wire insertion portion 330 has a thin tubular sleeve portion 331 protruding from the distal end of controller housing 300, a wire introduction port 332 that communicates from inside sleeve portion 331 to the inside of controller housing 300, and a gate portion 333 disposed adjacent to wire introduction port 332. Gate portion 333 includes a pair of cylindrical portions 333a, 333b provided on controller housing 300.

[0058] The catheter 2 has a proximal end fixed inside the sleeve portion 331 and is connected to the controller housing 300. The catheter 2 is fixed inside the sleeve portion 331 by, for example, press-fitting the catheter 2 into the sleeve portion 331 and then gluing or welding the outer tube 23B to the inner surface of the sleeve portion 331. Note that, when forming the wire insertion portion, instead of providing the sleeve portion 331 in the controller housing 300, a heat shrink tube or the like may be used to cover the boundary position between the controller housing 300 and the catheter 2, and the cover may be integrated with the controller housing 300.

[0059] The proximal ends of the first operation wire 31 and the second operation wire 32 are passed from inside the sleeve portion 331 through the wire introduction port 332 and between the cylindrical portions 333a, 333b of the gate portion 333, and introduced into the controller housing 300. Then, as described below, the first operation wire 31 is fixed to the first rack member 100, and the second operation wire 32 is fixed to the second rack member 200. Note that the cylindrical portions 333a, 333b constituting the gate portion 333 may be formed of rotatable rollers.

[0060] As shown in FIG. 5, the controller housing 300 has therein a first guide portion 351 that guides the first rack member 100 so that it can be displaced back and forth in the longitudinal direction, and a second guide portion 352 that guides the second rack member 200 so that it can be displaced back and forth in the longitudinal direction.

[0061] First guide portion 351 is formed by two partition walls 341, 342 extending in the longitudinal direction provided at the center of controller housing 300, first slide guide portion 306, and guide wall portion 343 within support handle portion 320. Side wall portion 305 of controller housing 300 has stopper portions 351a, 351b at positions corresponding to the distal end and proximal end of first guide portion 351, respectively.

[0062] The second guide portion 352 is formed by the partition walls 341, 342, the second slide guide portion 307, and a guide wall portion 344 in the support handle portion 320. The side wall portion 305 of the controller housing 300 has stopper portions 352a, 352b at positions corresponding to the distal end and proximal end of the second guide portion 352, respectively.

[0063] The partition wall 341 is formed by overlapping the protruding portions 341a and 341b of the base 300A and the lid 300B, respectively, as shown in Fig. 6. The partition wall 342 is formed by overlapping the protruding portions 342a and 342b of the base 300A and the lid 300B, respectively, as shown in Fig. 6.

[0064] 6, base 300A of controller housing 300 has cylindrical wire guides 334a, 334b ​​on both sides of the proximal end of protruding strip portion 341a. Wire guides 334a, 334b ​​may be formed of rotatable rollers.

[0065] The first rack member 100 and the second rack member 200 are housed within the controller housing 300 so as to be reciprocally displaceable in the longitudinal direction of the main body portion 310 and have teeth portions 120, 220 opposed to each other.

[0066] Fig. 10B shows a first rack member 100, and Fig. 10A shows a second rack member 200. These rack members 100, 200 respectively have elongated rectangular parallelepiped rack main bodies 110, 210 and teeth sections 120, 220 consisting of a large number of teeth provided on the side surfaces of the rack main bodies 110, 210 that face each other. These rack members 100, 200 are respectively installed on a first guide section 351 and a second guide section 352 such that the tooth sections 120, 220 face each other.

[0067] 10B, rack main body 110 of first rack member 100 has, on its outer side surface 111, a guide piece 112 extending in the longitudinal direction of rack main body 110. This guide piece 112 is inserted into opening 306a of first slide guide portion 306. A first operation knob 510 is integrally provided on rack main body 110 of first rack member 100, protruding to the side of controller housing 300 through opening 306a.

[0068] 10A, rack main body 210 of second rack member 200 has, on its outer side surface 211, a guide piece 212 extending in the longitudinal direction of rack main body 210. This guide piece 212 is inserted into opening 307a of second slide guide portion 307. A second operation knob 520 is integrally provided on rack main body 210 of second rack member 200, protruding to the side of controller housing 300 through opening 307a.

[0069] The first operation knob 510 and the second operation knob 520 have a rectangular plate shape similar to the first handle portion 321 and the second handle portion 322 constituting the support handle portion 320, respectively, and are molded integrally with the respective rack members 100, 200. The shape of each of the operation knobs 510, 520 is arbitrary and may be, for example, rod-shaped, ring-shaped, trigger-shaped, or the like, and are molded integrally with the respective rack members 100, 200.

[0070] As shown in Fig. 10A and Fig. 10B, the distal end edges (left side in Fig. 10A and Fig. 10B) of the first operation knob 510 and the second operation knob 520 respectively constitute finger locks 510a, 520a on which the operator's fingers can be hooked. These finger locks 510a, 520a are formed into gently curved surfaces that are approximately concave toward the proximal end. In addition, the outer corners 510b, 520b that are continuous with the finger locks 510a, 520a are chamfered. Each finger lock 510a, 520a is curved into a concave shape so that the operator can easily hook the finger on each finger lock 510a, 520a, which makes it easy to operate the first operation knob 510 and the second operation knob 520.

[0071] 10A and 10B, finger locking portions 510a, 520a are formed with inner convex portions 510c, 520c having shapes that smoothly transition to first rack member 100 and second rack member 200, respectively. These inner convex portions 510c, 520c make it difficult for fingers hooked on each finger locking portion 510a, 520a to come into contact with main body portion 310 of controller housing 300, and the operability of each operation knob 510, 520 is not hindered.

[0072] The first operation knob 510 and the second operation knob 520 are operated by pulling them toward the proximal end (the support handle portion 320 side) with fingers hooked on the finger locking portions 510a, 520a. When the first operation knob 510 is pulled toward the proximal end, the first rack member 100 is displaced integrally toward the proximal end, and in synchronization with this, the second rack member 200 is displaced toward the distal end in the opposite direction. When the second operation knob 520 is pulled toward the proximal end, the second rack member 200 is displaced integrally toward the proximal end, and in synchronization with this, the first rack member 100 is displaced toward the distal end in the opposite direction.

[0073] For example, a user can hook an index finger on finger stop 510a of first operation knob 510 and a middle finger on finger stop 520a of second operation knob 520, and pull and operate each of operation knobs 510, 520 with each finger.

[0074] As shown in Fig. 10B, the first rack member 100 has, on its front surface side, a wire fixing part 511 for fixing the end part on the proximal end side of the first operating wire 31. Also, as shown in Fig. 10A, the second rack member 200 has, on its back surface side, a wire fixing part 521 for fixing the end part on the proximal end side of the second operating wire 32.

[0075] The wire fixing portions 511, 521 have the same structure, and the operation wires 31, 32 can be fixed to the rack members 100, 200, respectively, by screw fastening.

[0076] 10A, wire fixing portion 521 of second rack member 200 has groove 521a extending in the longitudinal direction formed on the surface of rack main body 210, thin metal tube 521b fitted into groove 521a, and threaded portion 521c. Threaded portion 521c has female thread 521d fixed in recess 210a opening into outer side surface 211 of rack main body 210, and hexagon socket bolt 521e screwed into female thread 521d.

[0077] The proximal end of the second operation wire 32 comes into contact with the outside of the wire guide 334b, is guided by the groove 521a, and is inserted into the metal tube 521b through the groove 521a. The second operation wire 32 is crimped and fixed in the metal tube 521b by crimping the metal tube 521b with a bolt 521e screwed into the female thread 521d. As a result, the proximal end of the second operation wire 32 is fixed to the second rack member 200 together with the metal tube 521b.

[0078] 10B, the wire fixing portion 511 of the first rack member 100 is provided on the back side of the rack main body 110, and has a groove 511a, a metal tube 511b fitted into the groove 511a, and a threaded portion 511c formed by a female thread 511d and a bolt 511e. The threaded portion 511c is fixed in a recess 110a that opens into the outer side surface 111 of the rack main body 110.

[0079] The proximal end of the first operation wire 31 comes into contact with the outside of the wire guide 334a and is guided into the groove 511a, through which it is inserted into the metal tube 511b. The first operation wire 31 is crimped and fixed in the metal tube 511b by crimping the metal tube 511b with a bolt 511e screwed into the female thread 511d. As a result, the proximal end of the first operation wire 31 is fixed to the first rack member 100 together with the metal tube 511b.

[0080] 5, the pinion member 400 is disposed between the partition wall portion 341 and the partition wall portion 342. The pinion member 400 is rotatably supported by the controller housing 300 via a rotating shaft 410 as shown in FIG. 9 in a state in which the pinion member 400 meshes with the tooth portions 120, 220 of the first rack member 100 and the second rack member 200.

[0081] As shown in FIG. 1, the first rack member 100 and the second rack member 200 have their meshing points adjusted relative to the pinion member 400 so that the longitudinal center portions of the tooth portions 120, 220 mesh with the pinion member 400 while their positions in the reciprocating displacement direction are aligned with each other.

[0082] The first rack member 100 and the second rack member 200 are reciprocally displaced in mutually opposite directions relative to the pinion member 400 by the respective tooth portions 120, 220 meshing with the pinion member 400.

[0083] In the deflection operation device 1A according to this embodiment having the above configuration, the first operation knob 510 and the second operation knob 520 are slid so as to be displaced relative to the support handle part 320 in the longitudinal direction. Since the operation knobs 510, 520 are integrally provided on the first rack member 100 and the second rack member 200, respectively, they are operated so as to be displaced in mutually opposite directions together with the rack members 100, 200. When the operation knobs 510, 520 are operated in this manner, the first rack member 100 and the second rack member 200 are displaced in mutually opposite directions relative to the pinion member 400, while the first operation wire 31 and the second operation wire 32 in the catheter 2 are displaced in the deflection operation direction of the movable part 20 of the catheter 2.

[0084] The displacement range of the first rack member 100 is restricted by stopper portions 351a, 351b provided respectively at the distal end and the proximal end of the first guide portion 351, so as to prevent the first rack member 100 from coming off the pinion member 400. In addition, the displacement range of the second rack member 200 is restricted by stopper portions 352a, 352b provided respectively at the distal end and the proximal end of the second guide portion 352, so as to prevent the second rack member 200 from coming off the pinion member 400.

[0085] 1, when the positions of the first operating knob 510 and the second operating knob 520 in the displacement direction are aligned with each other, the movable part 20 of the catheter 2 extends straight and is in a neutral state without deflection. At this time, the first rack member 100 and the second rack member 200 are positioned in a neutral position where the positions of the displacement direction are aligned with each other, similar to the respective operating knobs 510, 520. This neutral position is referred to as a specific position of the present invention.

[0086] When the first operation knob 510 is pulled toward the proximal end from the neutral state shown in Fig. 1 as shown in Fig. 11, the first rack member 100 is displaced integrally toward the proximal end, and in synchronization with this, the second rack member 200 is displaced toward the distal end in the opposite direction. Following this displacement of the rack members 100, 200, the first operation wire 31 is pulled toward the proximal end, and the second operation wire 32 is pushed toward the distal end. The pull ring 40 is deflected following the movement of the operation wires 31, 32, and the movable part 20 of the catheter 2 is deflected toward the first operation knob 510, which is the operation side.

[0087] 12, when the second operation knob 520 is pulled toward the proximal end, the second rack member 200 is displaced integrally toward the proximal end, and in synchronization with this, the first rack member 100 is displaced toward the distal end in the opposite direction. Following this displacement of the rack members 100, 200, the second operation wire 32 is pulled toward the proximal end, and the first operation wire 31 is pushed toward the distal end. The pull ring 40 is deflected following the movement of the operation wires 31, 32, and the movable part 20 of the catheter 2 is deflected toward the second operation knob 520, which is the operation side.

[0088] In this manner, by operating each rack member 100, 200 in opposite directions using each operating knob 510, 520, the orientation of the movable part 20 of the catheter is deflected in a direction corresponding to the operating direction of each operating knob 510, 520 via each operating wire 31, 32 and pull ring 40.

[0089] Next, the operation of this embodiment will be described.

[0090] According to the deflection operation device 1A of this embodiment, the movable part 20 of the catheter 2 can be deflected by reciprocatingly displacing the first rack member 100 and the second rack member 200 in the controller housing 300 via the first operation knob 510 and the second operation knob 520, respectively. Therefore, the movable part 20 of the catheter 2 can be deflected with a simpler configuration than conventional devices.

[0091] Furthermore, according to the deflection operation device 1A of this embodiment, the reciprocating operation direction of the first operating knob 510 and the second operating knob 520 is the same as the extension direction of the first operating wire 31 and the second operating wire 32, so that the operation direction of each operating knob 510, 520 and the deflection direction of the movable part 20 of the catheter 2 can be intuitively matched.

[0092] That is, the movable part 20 can be deflected in a desired direction by operating the operation knob (510 or 520) of the first operation knob 510 or the second operation knob 520, which corresponds to the deflection direction of the movable part 20. For example, when it is desired to deflect the movable part 20 toward the first operation knob 510, it is possible to do so by pulling the first operation knob 510 toward the support handle part 320 (the proximal end side), and when it is desired to deflect the movable part 20 toward the second operation knob 520, it is possible to do so by pulling the second operation knob 520 toward the support handle part 320. By visually recognizing the relative positions of the operation knobs 510 and 520 with respect to the controller housing 300 in conjunction with such an operation, it is possible to roughly grasp the deflection state (the direction of deflection and the degree of deflection) of the movable part 20.

[0093] This makes it easy to grasp the deflection state of the movable part 20 of the catheter 2 in response to the operation of each of the operation knobs 510, 520, and since the operation reaction force from the movable part 20 is directly transmitted to the operation knob (510 or 520) on the side being pulled, an effective sense of operation resistance (operation feeling) can be obtained. As a result, sufficient operability can be obtained.

[0094] In addition, by performing a pulling operation to displace the first operating knob 510 and the second operating knob 520 toward the support handle portion 320, an operating force can be effectively applied to each operating knob 510, 520 when performing manual operation with one hand, and compared to a deflection operation such as rotating a dial, there is no need to reposition the finger while operating, which also improves operability.

[0095] Furthermore, even if the controller housing is turned over 180 degrees and the left and right positions of the first and second operation knobs are reversed, both can be conveniently operated in the same way.

[0096] Furthermore, according to the deflection operation device 1A of this embodiment, the operator can easily support and operate the deflection operation device 1A with one hand by placing the palm of his / her hand against the support handle portion 320 of the controller housing 300 and hooking his / her fingers on each finger engagement portion 510a, 520a of each operation knob 510, 520.

[0097] Moreover, in the deflection operation device 1A according to this embodiment, the support handle part 320 forms a substantially T-shape together with the main body part 310 of the controller housing 300. Therefore, the deflection operation device 1A according to this embodiment can be easily gripped via the support handle part 320, and thus operability is improved.

[0098] (Other embodiments) Next, a deflection operation device 1B according to another embodiment of the present invention will be described with reference to FIG.

[0099] In the deflection operation device 1B, instead of the first and second operation knobs 510, 520 in the deflection operation device 1A of the above-mentioned embodiment, a ring-shaped operation knob 530 is provided only on the first rack member 100, and an indicator 600 is provided on the second rack member 200 for indicating the relative position of the second rack member 200 with respect to the controller housing 300. The indicator 600 constitutes the indication unit of the present invention. In addition, in the deflection operation device 1B, two coil springs 710, 720 are interposed between the first rack member 100 and the controller housing 300 to bias the first rack member 100 and the second rack member 200 to a neutral position with respect to the controller housing 300. The coil springs 710, 720 each constitute the biasing means of the present invention.

[0100] The deflection operation device 1B according to the other embodiment differs from the deflection operation device 1A according to the above-mentioned embodiment in these respects. Therefore, in the description of the other embodiment, the same components as those in the first embodiment are given the same reference numerals, and the description of those components is omitted, and only the differences from the above-mentioned embodiment will be described.

[0101] The operation knob 530 has a substantially circular ring shape, and is integrally molded in the longitudinal center of the rack main body 110. For example, an index finger or a middle finger is inserted into the operation knob 530, and the first rack member 100 is displaced reciprocally in the longitudinal direction by hooking the inserted finger on the operation knob 530 and pulling it toward the proximal end or pushing it toward the distal end. In synchronization with the reciprocating displacement of the first rack member 100, the second rack member 200 is displaced reciprocally in the opposite direction to the first rack member 100.

[0102] Indicator 600 is integrally molded with rack main body 210 of second rack member 200, and protrudes slightly from opening 307a to the side of controller housing 300. It is desirable that indicator 600 is colored a different color from controller housing 300 so that its position can be accurately recognized visually.

[0103] The indicator 600 is formed in the center in the longitudinal direction of the second rack member 200. Therefore, when the first rack member 100 and the second rack member 200 are in the neutral position as shown in Fig. 13, the indicator 600 and the operation knob 530 are configured to be in the same position in the displacement direction.

[0104] The two coil springs 710, 720 have the same configuration and are both installed in a compressed state on the proximal end side and the distal end side of the first rack member 100 in the first guide portion 351. One coil spring 710 is interposed between the stopper portion 351b and the first rack member 100, and the other coil spring 720 is interposed between the stopper portion 351a and the first rack member 100. The first rack member 100 is biased from both sides by the coil springs 710, 720 to stop at a neutral position, and the second rack member 200 also stops at the neutral position accordingly.

[0105] The deflection operation device 1B shown in FIG. 13 is designed so that by hooking a finger on one operation knob 530 and displacing it back and forth against the biasing force of coil springs 710, 720, the first rack member 100 and the second rack member 200 can be displaced in opposite directions to each other to deflect the movable part 20 of the catheter 2.

[0106] According to the deflection operation device 1B of another embodiment, by having the coil springs 710, 720, the first rack member 100 and the second rack member 200 can be automatically held in the neutral position without operating the operation knob 530, thereby improving operability.

[0107] In this embodiment, when the first rack member 100 and the second rack member 200 are in the neutral position, the movable part 20 of the catheter 2 is configured to be straight and undeflected. However, for example, if the catheter 2 is pre-shaped to have a curved shape, the movable part 20 is not necessarily straight in the neutral position, and the neutral positions of each rack member 100, 200 are set in accordance with the shape of the catheter 2.

[0108] Furthermore, according to the deflection operation device 1B, the relative position of the second rack member 200 with respect to the controller housing 300 can be visually recognized by the indicator 600, thereby making it possible to grasp the deflection state of the movable part 20 of the catheter 2. It is of course possible to grasp the deflection state of the movable part 20 of the catheter 2 from the relative position with respect to the controller housing 300 by the operation knob 530 as well. In other words, it can be said that the operation knob 530 has the same function as the indicator 600, and this point can also be said to be similar to the first operation knob 510 and the second operation knob 520 in the above embodiment.

[0109] In addition, in a deflection operation device 1B according to another embodiment, the operation knob 530 and the indicator 600 may be arranged in reverse, such that the operation knob 530 is provided on the second rack member 200 and the indicator 600 is provided on the first rack member 100, as shown in FIG. 14.

[0110] 14, even if the coil spring 720 is moved between the second rack member 200 and the stopper portion 352b and both of the coil springs 710, 720 are disposed on the proximal end side, the rack members 100, 200 can be held in the neutral position. In this case, the rack members 100, 200 are biased toward the distal end side by the coil springs 710, 720, respectively, but are held in the neutral position by being restrained by each other via the pinion member 400.

[0111] 13, the coil springs 710 and 720 may be installed on the second guide portion 352 side. In that case, for example, the coil spring 710 is interposed between the stopper portion 352b and the second rack member 200, and the coil spring 720 is interposed between the stopper portion 352a and the second rack member 200.

[0112] In addition, both of the coil springs 710 and 720 may be disposed on the distal end side, opposite to that in Fig. 14. In that case, for example, the coil spring 710 is interposed between the stopper portion 351a and the first rack member 100, and the coil spring 720 is interposed between the stopper portion 352a and the second rack member 200.

[0113] Furthermore, in each of the above embodiments, a catheter is used as an example of a medical device, but the deflection device of the present invention can be applied to other tubular medical devices such as a cannula or a sheath. [Industrial Applicability]

[0114] The present invention is useful as a deflection device for medical instruments that can be easily operated with one hand when deflecting the tip movable part of a tubular medical instrument such as a catheter, cannula, or sheath, and that has a simple configuration and sufficient operability. [Explanation of symbols]

[0115] 1A, 1B Deflection control device for medical equipment 2. Catheter (medical device) 20 Moving parts 31 First operating wire 32 Second operating wire 100 First rack member 120, 220 teeth 200 Second rack member 300 Controller Housing 306, 307 Slide guide part 306a, 307a opening 310 Main body of controller housing 320 Support handle part 330 Wire insertion part 400 Pinion member 510 First control knob 520 Second Control Knob 530 Operation knob 600 Indicator (Sign) 710, 720 Coil spring (biasing means)

Claims

1. A deflection operation device for a medical device that deflects a movable part of the medical device via a first operation wire and a second operation wire, a controller housing having a main body, a support handle portion provided on one end of the main body in a longitudinal direction along an extension direction of the first operation wire and the second operation wire, and a wire insertion portion provided on the other end of the main body in the longitudinal direction and through which the first operation wire and the second operation wire are inserted; a first rack member and a second rack member housed within the controller housing so as to be reciprocally displaceable in the longitudinal direction and have teeth portions facing each other; a pinion member disposed between the first rack member and the second rack member and rotatably supported on the controller housing in a state of meshing with the teeth of both rack members, a slide guide portion that forms a groove-shaped opening along at least one of the first rack member and the second rack member is provided on the controller housing; an operation knob is integrally provided on at least one of the first rack member and the second rack member and protrudes outwardly from the controller housing through the opening, and an edge on a distal end side of the operation knob constitutes a finger locking portion; The support handle portion and the main body portion of the controller housing form a substantially T-shape, the support handle portion is for an operator's palm to rest against when the device is slid, and the finger lock portion is for the operator's finger to be hooked on when the device is slid, A deflection operating device for medical equipment, characterized in that when the operating knob is slid so as to be displaced relative to the support handle portion in the longitudinal direction, the first rack member and the second rack member are displaced in opposite directions relative to the pinion member, while the first operating wire and the second operating wire are displaced in the deflection operating direction of the movable part.

2. 2. The deflection operating device for medical equipment according to claim 1, wherein the operating knob is composed of a first operating knob and a second operating knob provided on the first rack member and the second rack member, respectively.

3. The deflection operating device for medical equipment according to claim 1 or 2, characterized in that a biasing means is interposed between at least one of the first rack member and the second rack member and the controller housing, for biasing the first rack member and the second rack member to a specific position relative to the controller housing.

4. The deflection operating device for medical equipment as described in claim 1, characterized in that the operating knob is provided on one of the rack members of the first rack member and the second rack member, and the rack member on the other side is provided with an indication portion indicating the relative position of the rack member on the other side with respect to the controller housing.

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