Medical Devices

Abstract

To provide a medical apparatus having a structure in which a tip can be bent more securely to a desired direction.SOLUTION: A medical apparatus 100 comprises: a long medical apparatus body 10; a first operation wire 41 and second operation wire 42 that are individually inserted along the medical apparatus body 10's axial direction; and a bending operation unit for performing bending operation on the medical apparatus body 10's tip 11 by drawing the first operation wire 41 and second operation wire 42. At the medical apparatus body 10's intermediate part 12 and base end part in the axial direction, the first operation wire 41 and second operation wire 42 extend in parallel so that the wires are separated from each other in the medical apparatus body 10's circumferential direction. At the medical apparatus body 10's tip 11 in the axial direction, the first operation wire 41 and second operation wire 42 are gradually curved so that the wires become closer to each other toward the tip side in the medical apparatus body 10's circumferential direction, and join.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to medical devices. [Background technology]

[0002] 2. Description of the Related Art As a long medical device such as a catheter whose tip portion can be bent, a type having an operating wire is known (for example, Patent Document 1).

[0003] In the catheter of Patent Document 1, a plurality of hollow tubes are arranged around a central lumen, and an operating wire is inserted into each of the two hollow tubes facing each other through the central lumen. In the catheter of this document, the tip of the operating wire is fixed to the tip of the catheter. The catheter of this document is configured so that the rear end of the operating wire can be pulled and operated. This makes it possible to bend the tip of the catheter by selecting and pulling the operating wire. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] JP 2013-48711 A Summary of the Invention [Problem to be solved by the invention]

[0005] However, in the catheter of Patent Document 1, when the tip is further bent after passing through a curved body cavity such as a blood vessel, it can be easily bent inwardly of the curve but is difficult to bend outwardly. This is because when attempting to bend the tip of the catheter outward by pulling the operating wire located on the outer side of the curve, the catheter rotates around its axis within the curved blood vessel in a direction that shortens the path of the pulled operating wire.

[0006] The present invention has been made in consideration of the above problems, and provides a medical device such as a catheter having a structure that enables the tip portion to be bent in a desired direction more reliably. [Means for solving the problem]

[0007] The present invention includes a long medical device body and A first operating wire and a second operating wire are respectively inserted along an axial direction of the medical device body; A bending operation unit for bending the tip portion of the medical device body by pulling the first operating wire and the second operating wire; Equipped with At an intermediate portion and a base end portion in an axial direction of the medical device body, the first operating wire and the second operating wire extend in parallel and spaced apart from each other in a circumferential direction of the medical device body, The medical device provides a medical device in which, at the tip portion in the axial direction of the medical device main body, the first operating wire and the second operating wire curve and merge so as to gradually approach each other in the circumferential direction of the medical device main body toward the tip side. Effect of the Invention

[0008] According to the present invention, it is possible to more reliably bend the tip portion in a desired direction. [Brief description of the drawings]

[0009] [Figure 1] 1 is a longitudinal cross-sectional view showing a distal end portion of a medical device body of a medical device according to a first embodiment. FIG. [Diagram 2] 2 is a cross-sectional view of the medical device body taken along line AA in FIG. 1. [Diagram 3] 2 is a cross-sectional view of the medical device body taken along line BB in FIG. 1. [Figure 4] 2 is a cross-sectional view of the medical device body taken along line CC in FIG. 1. [Diagram 5] 5(a) and 5(b) are schematic diagrams for explaining the bending operation of the distal end portion of the medical device body of the medical device according to the first embodiment. [Figure 6] 1 is a plan view showing a bending operation section and a portion in the vicinity thereof of the medical device according to the first embodiment. FIG. [Figure 7] 1 is a side view showing a bending operation portion and a portion in the vicinity thereof of the medical device according to the first embodiment. FIG. [Figure 8] FIG. 8(a) is an overall view of the medical device according to the first embodiment, and FIG. 8(b) is an overall view of the medical device according to the first embodiment with the tip portion of the medical device body bent to one side. [Figure 9] 10 is a longitudinal cross-sectional view showing a distal end portion of a medical device body of a medical device according to a second embodiment. FIG. [Figure 10] 10 is a cross-sectional view of the medical device body taken along line AA in FIG. 9. [Figure 11] 11(a) and 11(b) are schematic diagrams for explaining the bending operation of the distal end portion of the medical device body of the medical device according to the second embodiment. [Figure 12] FIG. 11 is a longitudinal cross-sectional view showing a distal end portion of a medical device body of a medical device according to a third embodiment. [Figure 13] 13 is a cross-sectional view of the medical device body taken along line AA in FIG. 12. [Figure 14] 13 is a cross-sectional view of the medical device body taken along line BB in FIG. 12. [Figure 15] 13 is a cross-sectional view of the medical device body taken along line CC in FIG. 12. [Figure 16] 16(a), 16(b), 16(c) and 16(d) are schematic views for explaining the bending operation of the distal end portion of the medical device body of the medical device according to the third embodiment. [Figure 17] FIG. 11 is a side view showing the bending operation portion and the surrounding area of ​​the medical device according to the third embodiment. [Figure 18] Figure 18(a) is an overall view of the medical device of the third embodiment, Figure 18(b) is an overall view of the medical device of the third embodiment in a state where the tip portion of the medical device body of the medical device is bent to one side, and Figure 18(c) is an overall view of the medical device of the third embodiment in a state where the tip portion of the medical device body of the medical device is bent to the other side. [Figure 19]19(a) and 19(b) are schematic diagrams of the distal end of a medical device body of a medical device according to the fourth embodiment, with FIG. 19(a) being a plan view and FIG. 19(b) being a side view. [Figure 20] 20(a) and 20(b) are schematic diagrams of the distal end of a medical device body of a medical device according to the fifth embodiment, with FIG. 20(a) being a plan view and FIG. 20(b) being a side view. [Figure 21] FIG. 13 is a plan view showing a bending operation section and its surrounding area of ​​a medical device according to a sixth embodiment. [Figure 22] FIG. 13 is a plan view showing a bending operation section and its surrounding area of ​​a medical device according to a seventh embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0010] Hereinafter, an embodiment of the present invention will be described with reference to the drawings. In all the drawings, the same components are denoted by the same reference numerals, and the description thereof will be omitted as appropriate. The various components of the medical device according to this embodiment do not need to be independent entities, and it is permitted that multiple components are formed as a single member, that one component is formed from multiple members, that one component is part of another component, that part of one component overlaps with part of another component, etc.

[0011] Terms used in describing embodiments of the present invention are defined as follows unless otherwise specified. In the description of the embodiments, the terms distal end and proximal end may be used. The distal end refers to a region of a given length including the end (distal end) of the medical device at the insertion tip side of the medical device in each part. The proximal end refers to a region of a given length including the end (proximal end) of the medical device at the base end side of the medical device in each part. The axis means the central axis along the longitudinal direction of the medical device body. A longitudinal section of a medical device refers to a section obtained by cutting the medical device along its axis. The cross section of a medical device refers to a cross section obtained by cutting the medical device along a plane perpendicular to the axis.

[0012] [First embodiment] First, the first embodiment will be described with reference to FIG. 1 to FIG. 8(b). FIG. 1 is a cross-sectional view taken along the line AA in FIG. Figures 5(a) and 5(b) are schematic diagrams for explaining the bending action of the tip portion 11 of the medical device main body 10 when viewed in the direction of arrow A in Figure 4, where Figure 5(a) shows the state before bending and Figure 5(b) shows the bent state. In FIG. 7, the housing 86 of the bending operation unit 80 is partially cut away to show the internal structure of the housing 86. 8(a) and 8(b), a longitudinal intermediate portion of the medical device body 10 is cut away and omitted. In the medical device body 10 shown in Fig. 8(a) and 8(b), the rotation phase around the axis of the medical device body 10 differs by 90 degrees between the portion on the base end side and the portion on the tip end side from the omitted portion.

[0013] As shown in any one of Figures 1 to 8(b), the medical device 100 of this embodiment comprises a long medical device main body 10, a first operating wire 41 and a second operating wire 42 which are respectively inserted along the axial direction of the medical device main body 10, and a bending operation section 80 (Figures 6 and 7) for bending the tip portion 11 of the medical device main body 10 by pulling the first operating wire 41 and the second operating wire 42. In the intermediate portion 12 and the base end portion 13 (FIGS. 6 and 7) in the axial direction of the medical device body 10, the first operating wire 41 and the second operating wire 42 extend in parallel and spaced apart from each other in the circumferential direction of the medical device body 10. At the distal end portion 11 in the axial direction of the medical device body 10, the first operating wire 41 and the second operating wire 42 curve and merge so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. Here, the first operating wire 41 and the second operating wire 42 joining together means that the tip 41a of the first operating wire 41 and the tip 42a of the second operating wire 42 are close to each other. It is preferable that the tip 41a of the first operating wire 41 and the tip 42a of the second operating wire 42 are close to each other at a distance smaller than the wall thickness of the resin pipe 20 described later.

[0014] According to this embodiment, by pulling both the first operating wire 41 and the second operating wire 42, the distal end 11 of the medical device body 10 can be bent as shown in Figures 5(a) and 5(b). At this time, the load of pulling the distal end 11 of the medical device body 10 by the first operating wire 41 and the load of pulling by the second operating wire 42 are balanced, so that it is possible to suppress the occurrence of a phenomenon in which the medical device body 10 rotates around its axis as the first operating wire 41 or the second operating wire 42 tries to take a shortcut. Therefore, even when the distal end portion 11 is to be further bent after the medical device body 10 has passed through a curved body cavity such as a blood vessel, the distal end portion 11 can be bent more reliably in a desired direction. In addition, as in the present embodiment, when the medical device 100 is equipped with two operating lines that join together, the tip portion 11 can be bent in only one direction by pulling the operating line.

[0015] The medical device 100 is typically a catheter.

[0016] The medical device body 10 includes a resin tube 20 having an inner cavity that forms a lumen 21 . In this embodiment, the resin pipe 20 has a layered structure including a hollow tubular inner layer 22 having a lumen 21 as an inner cavity, and a hollow tubular outer layer 23 that is coaxial with the inner layer 22 and formed around the outer periphery of the inner layer 22. The inner layer 22 and the outer layer 23 are each made of a resin material. The inner peripheral surface of the outer layer 23 is joined to the outer peripheral surface of the inner layer 22. The resin material constituting the inner layer 22 and the resin material constituting the outer layer 23 may be different from each other or may be the same as each other. A hydrophilic coating may be formed on the outer surface layer of the medical device body 10, if necessary. The lumen 21 is formed continuously from the distal end to the proximal end of the medical device body 10, and opens at both the distal end and the proximal end of the medical device body 10.

[0017] The medical device body 10 further includes a first hollow tube 31 and a second hollow tube 32 embedded in the resin tube 20. A first operating wire 41 is inserted into the first hollow tube 31, and a second operating wire 42 is inserted into the second hollow tube 32. The first hollow tube 31 and the second hollow tube 32 are each a sub-lumen tube, and the inner lumens of these sub-lumen tubes are sub-lumens. That is, each operating line (the first operating line 41, the second operating line 42) is inserted into the sub-lumen. The inner diameters of the first hollow tube 31 and the second hollow tube 32 are smaller than the inner diameter of the lumen 21 . The first operating wire 41 and the second operating wire 42 are each made of a thin wire such as metal or resin.

[0018] In the present embodiment, the first hollow tube 31 and the second hollow tube 32 are arranged to avoid positions that would be on the in-course side when the distal end 11 of the medical device body 10 is bent, so that the distal end 11 can be easily bent. In particular, the first hollow tube 31 and the second hollow tube 32 are farther away from the in-course side toward the base end side of the distal end 11, so that bending becomes easier.

[0019] At the distal end portion 11 of the medical device body 10, the first hollow tube 31 and the second hollow tube 32 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. As a result, the first operating wire 41 in the first hollow tube 31 and the second operating wire 42 in the second hollow tube 32 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. The first hollow tube 31 and the second hollow tube 32 do not cross each other. Moreover, the first operating line 41 and the second operating line 42 do not cross each other.

[0020] In this way, the medical device main body 10 is composed of a resin tube 20 having a lumen 21, and a first hollow tube 31 and a second hollow tube 32 embedded in the resin tube 20 and through which a first operating wire 41 and a second operating wire 42 are respectively inserted, and at the tip portion 11 in the axial direction of the medical device main body 10, the first hollow tube 31 and the second hollow tube 32 are curved so as to gradually approach each other in the circumferential direction of the medical device main body 10 toward the tip side.

[0021] In addition, a region in the axial direction of the medical device body 10 where the first operating wire 41 and the second operating wire 42 are curved toward the tip side so as to gradually approach each other in the circumferential direction of the medical device body 10 is referred to as a curved region 15. A base end position 15a of the curved region 15 is a position where the first operating wire 41 and the second operating wire 42 start to curve toward each other, and a tip position 15b of the curved region 15 is a position where the first operating wire 41 and the second operating wire 42 finish bending toward each other. In the case of this embodiment, the tip position 15b of the curved region 15 is the position where the tips 41a, 42a of the first operating wire 41 and the second operating wire 42 are disposed, or a position in the vicinity thereof.

[0022] The tip 41a of the first operating wire 41 protrudes from the tip 31a of the first hollow tube 31. Similarly, the tip 42a of the second operating wire 42 protrudes from the tip 32a of the second hollow tube 32. For example, tip 41a is located near tip 31a, and tip 42a is located near tip 32a.

[0023] The medical device body 10 includes, for example, a braided layer 51 embedded in the resin tube 20. This allows the medical device body 10 to be reinforced by the braided layer 51. The braided layer 51 is formed by braiding a plurality of wires. The braided layer 51 is disposed around the inner layer 22, for example. The first hollow tube 31 and the second hollow tube 32 are disposed, for example, on the radially outer side of the medical device body 10 than the braid layer 51 (at a position farther from the axis of the medical device body 10).

[0024] The medical device body 10 further includes a wound wire 52 embedded in the resin tube 20. The wound wire 52 is wound radially outward of the medical device body 10 relative to the braid layer 51, the first hollow tube 31, and the second hollow tube 32. The wound wire 52 restrains the first hollow tube 31 and the second hollow tube 32 relative to the braid layer 51, for example.

[0025] In the curved region 15, the first hollow tube 31 and the second hollow tube 32 are each disposed along the outer periphery of the braid layer 51 (see FIGS. 3 and 4). In the curved region 15, the distance between the first hollow tube 31 and the second hollow tube 32 in the circumferential direction of the medical device main body 10 gradually decreases toward the tip side, and the distance between the first operating wire 41 and the second operating wire 42 in the circumferential direction of the medical device main body 10 gradually decreases toward the tip side. The first hollow tube 31 and the second hollow tube 32 are each formed into a curved shape, for example, on the distal side of the base end position 15a of the curved region 15. At the base end position 15a of the curved region 15, the first hollow tube 31 and the second hollow tube 32 may each be fixed to at least one of the braid layer 51 or the inner layer 22, or the tip of the winding wire 52 may be disposed at the base end position 15a of the curved region 15, and the first hollow tube 31 and the second hollow tube 32 may not be restrained by the winding wire 52 on the distal side of the base end position 15a.

[0026] At the intermediate portion 12 and the base end portion 13 in the axial direction of the medical device body 10, the first operating wire 41 and the second operating wire 42 are disposed at positions opposing each other in the circumferential direction of the medical device body 10. In the case of this embodiment, for example, as shown in Fig. 2, in the intermediate portion 12 of the medical device body 10, the first operating wire 41 and the second operating wire 42 are opposed to each other by 180 degrees in the circumferential direction of the medical device body 10 with the axial center of the medical device body 10 as a reference. Similarly, in the base end portion 13 of the medical device body 10 and the base end position 15a of the curved region 15, the first operating wire 41 and the second operating wire 42 are opposed to each other by 180 degrees in the circumferential direction of the medical device body 10. That is, in the intermediate portion 12, the base end portion 13, and the base end position 15a of the curved region 15, the phase difference between the first operating wire 41 and the second operating wire 42 in the circumferential direction of the medical device body 10 is 180 degrees. The phase difference between the first operating wire 41 and the second operating wire 42 in the circumferential direction of the medical device body 10 gradually decreases toward the tip side in the curved region 15, and the phase difference is, for example, approximately zero at the tip position 15b of the curved region 15. In the case of this embodiment, the first operating wire 41 and the second operating wire 42 are each rotated 90 degrees in the circumferential direction of the medical device body 10 in the curved region 15. However, the fact that the first operating wire 41 and the second operating wire 42 are arranged in positions opposite each other in the circumferential direction of the medical device main body 10 is not limited to this example, but means that the first operating wire 41 and the second operating wire 42 are spaced apart from each other by more than 120 degrees in the circumferential direction of the medical device main body 10.

[0027] In the present embodiment, the first hollow tube 31 and the second hollow tube 32 are opposed to each other by 180 degrees in the circumferential direction of the medical device body 10 at the intermediate portion 12, the base end portion 13, and the base end position 15a of the curved region 15 of the medical device body 10, with the axial center of the medical device body 10 as a reference. That is, at the intermediate portion 12, the base end portion 13, and the base end position 15a of the curved region 15, the phase difference between the first hollow tube 31 and the second hollow tube 32 in the circumferential direction of the medical device body 10 is 180 degrees. The phase difference gradually decreases in the curved region 15 toward the tip side.

[0028] A ring-shaped marker 70 made of a radiopaque metallic material is provided at the distal end 11 of the medical device body 10. The markers 70 are disposed coaxially with and around the lumen 21 . The markers 70 are arranged, for example, around the periphery of the braid layer 51 .

[0029] The tip 41a of the first operating wire 41 is fixed to the marker 70 by a first fixing portion 71 which is, for example, a spot of solder. Similarly, the tip 42a of the second operating wire 42 is fixed to the marker 70 by a first fixing portion 71, which is, for example, a spot of solder. The first fixing portion 71 and the second fixing portion 72 are disposed, for example, at the end portion on the base end side of the marker 70.

[0030] In this embodiment, the tip 41a of the first operating wire 41 and the tip 42a of the second operating wire 42 are connected to each other. That is, the tips of the first operating wire 41 and the second operating wire 42 are connected to each other. More specifically, the first fixed portion 71 and the second fixed portion 72 are adjacent to each other and in contact with each other. That is, the first fixed portion 71 and the second fixed portion 72 are integrated with each other. The tip 41a and the tip 42a may be fixed to the marker 70 by a single fixing portion.

[0031] Next, the hub 90 provided at the base end of the medical device body 10 will be described with reference to FIGS. Hub 90 has a connecting portion 93 for inserting an injector (syringe) (not shown) from the base end of hub 90. A screw groove is formed on the outer periphery of connecting portion 93 so that the syringe can be detachably fixed. The hub 90 has two blades 92 on its outer periphery, which face each other across the axis of the hub 90 . The base end of the medical device body 10 is inserted and fixed into the tip end of the hub 90. This allows the lumen 21 inside the medical device body 10 and the internal space of the hub 90 to communicate with each other. By rotating the wing portion 92 around the axis of the hub 90, a torque operation can be performed to rotate the entire medical device body 10 about its axis. A housing 86 of the bending operation portion 80, which will be described later, is connected and fixed to the tip side of the hub 90.

[0032] Next, the bending operation section 80 included in the medical instrument 100 will be described with reference to FIGS.

[0033] The medical device 100 includes a bending operation section 80 for bending the tip portion 11 of the medical device body 10 by pulling the first operating wire 41 and the second operating wire 42.

[0034] The bending operating unit 80 is configured to include a rotating member 81 that is rotatably supported on a shaft, to which the first operating wire 41 and the second operating wire 42 are engaged and to which the base end of the first operating wire 41 and the base end of the second operating wire 42 are fixed, and a moving mechanism that moves the rotating member 81 in a pulling direction in which the first operating wire 41 and the second operating wire 42 are pulled, and in the opposite direction to the pulling direction. The rotating member 81 is, for example, a pulley. In this specification, a member being rotatable does not necessarily mean that it can rotate 360 ​​degrees or more, but also means that it can only swing within a predetermined angular range of less than 360 degrees.

[0035] 6, the rotating member 81 has an engagement portion formed in a circular shape centered on the rotation center of the rotating member 81, and the first operating wire 41 and the second operating wire 42 are engaged with this engagement portion. Note that the engagement portion of the rotating member 81 is not limited to a circular shape, and may be an arc shape. In this manner, the rotating member 81 has an engagement portion with which the first operating wire 41 and the second operating wire engage, and the engagement portion is formed in a circular or arc shape centered on the rotation center of the rotating member 81.

[0036] The movement mechanism includes a reciprocating member 82 and a pinion 83 . The advancing and retracting member 82 includes a holding portion 82a that rotatably holds the rotating member 81, and a rod-shaped portion 82b that extends from the holding portion 82a toward the base end side of the medical device body 10. The rod-shaped portion 82b is formed with a rack portion 82c.

[0037] The bending operation unit 80 further includes a housing 86 which is the main body of the bending operation unit 80, a dial operation unit 84 which is rotatably supported on the housing 86, a pinion 83 which is integral with the dial operation unit 84, and a guide 85 (e.g., a pair of front and rear guides 85) which is provided on the inner surface of the housing 86 and guides the rod-shaped portion 82b in the longitudinal direction of the rod-shaped portion 82b. The proximal end 13 of the medical device body 10 is guided through the inside of the housing 86 to the proximal end side of the housing 86 and is inserted into and fixed to the distal end of the hub 90 . The rotation axis of the dial operation unit 84 extends in a direction perpendicular to the axial direction of the medical device body 10 within the housing 86 . The pinion 83 is formed integrally with the dial operation unit 84 on one surface side of the dial operation unit 84 , and is disposed coaxially with the rotation axis of the dial operation unit 84 . The gear on the outer periphery of the pinion 83 meshes with the gear of the rack portion 82 c of the advancing and retracting member 82 . At least a portion of the dial operation unit 84 is exposed to the outside of the housing 86, so that an operator operating the medical device 100 can rotate the dial operation unit 84 from outside the housing 86.

[0038] The first operating line 41 and the second operating line 42 are each led out from the medical device body 10 inside the housing 86. The base end of the first operating wire 41 is wound around the rotating member 81 one and a half times, for example, and the base end of the first operating wire 41 is fixed to the rotating member 81 at a first fixed portion 81a (FIG. 6). Similarly, the second operating wire 42 is wound around the rotating member 81, for example, one and a half times, and the base end of the second operating wire 42 is fixed to the rotating member 81 at a second fixed portion 81b (FIG. 6). The winding direction of the first operating wire 41 and the winding direction of the second operating wire 42 are opposite to each other on the rotating member 81. Therefore, the rotation angle of the rotating member 81 is autonomously adjusted to an angle at which the tension of the first operating wire 41 and the tension of the second operating wire 42 are balanced.

[0039] When an operator operating the medical device 100 grasps the housing 86 or the hub 90 and rotates the dial operating unit 84, the pinion 83 integrated with the dial operating unit 84 rotates about its axis, and as a result, the advance / retract member 82 having the rack portion 82c advances (moves toward the tip end of the medical device main body 10) or retreats (moves toward the base end of the medical device main body 10) in the axial direction of the medical device main body 10, relative to the housing 86. In FIG. 6, by rotating the dial operation unit 84 clockwise, the advance / retreat member 82 and the rotation member 81 retract, and both the first operation wire 41 and the second operation wire 42 are pulled toward the base end side of the medical device body 10.

[0040] In this way, the bending operation unit 80 is equipped with an operation receiving unit (dial operation unit 84) that operates in response to operation by the user (operator), and the power of the operation receiving unit is transmitted to the rotating member 81 via the moving mechanism, causing the rotating member 81 to move in the above-mentioned pulling direction and in the opposite direction to the pulling direction.

[0041] More specifically, as described above, the operation receiving unit (dial operation unit 84) is axially supported so as to be rotatable, and the moving mechanism includes a pinion 83 that is integral with and coaxial with the operation receiving unit, and a rack member (advancing and retreating member 82) that advances and retreats in conjunction with the rotation of the pinion 83, and the rotating member 81 is axially supported on the rack member.

[0042] In this manner, by operating the bending operation portion 80, the first operation wire 41 and the second operation wire 42 are pulled at the same time. Here, the first operating line 41 and the second operating line 42 being pulled at the same time means that there is a timing when both the first operating line 41 and the second operating line 42 are pulled, and it is not limited to the timing when the first operating line 41 and the second operating line 42 start to be pulled being the same, nor is it limited to the timing when the first operating line 41 and the second operating line 42 end to be pulled being the same.

[0043] For example, when the tip portion 11 of the medical device main body 10 has a straight shape as shown in Figure 8(a), when the dial operating unit 84 is rotated clockwise in Figure 8(b), both the first operating wire 41 and the second operating wire 42 are pulled toward the base end side of the medical device main body 10, causing the tip portion 11 of the medical device main body 10 to bend in one direction. Furthermore, when the dial operating unit 84 is rotated counterclockwise from the state shown in Figure 8(b), the advance / retract member 82 and the rotating member 81 move forward, and the tension in the first operating wire 41 and the second operating wire 42 is released, allowing the tip portion 11 of the medical device main body 10 to return to a straight state. Thus, in this embodiment, the bending operation unit 80 is configured to receive operation by the user through a rotation mechanism (dial operation unit 84), and convert the force imparted to the rotation mechanism by this operation into forward and backward movement in the axial direction of the medical device main body 10 through a conversion mechanism formed by the pinion 83 and rack (rack portion 82c).

[0044] Next, examples of materials for each part of the medical device 100 will be described. The material of the inner layer 22 may be, for example, a resin material such as polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF), or perfluoroalkoxy fluorine resin (PFA). Materials that can be used for the outer layer 23 include polyimide (PI), polyamide-imide (PAI), polyethylene terephthalate (PET), as well as resin materials such as polyethylene (PE), polyamide (PA), nylon elastomer, polyurethane (PU), ethylene-vinyl acetate resin (EVA), polyvinyl chloride (PVC), or polypropylene (PP). The first hollow tube 31 and the second hollow tube 32 may be made of a resin material such as polytetrafluoroethylene (PTFE), polyvinylidene fluoride (PVDF), or perfluoroalkoxy fluorine resin (PFA). The material of the wire constituting the braid layer 51 is preferably a metal material such as stainless steel or tungsten, but may be a resin material. The material of the wire constituting the winding wire 52 is preferably a metal material such as stainless steel or tungsten, but may be a resin material.

[0045] According to the medical device 100 of the first embodiment as described above, the tip 11 of the medical device main body 10 can be bent by pulling both the first operating wire 41 and the second operating wire 42, and at that time, the load pulling the tip 11 of the medical device main body 10 by the first operating wire 41 and the load pulling by the second operating wire 42 are balanced, so that the occurrence of the phenomenon in which the medical device main body 10 rotates around its axis as the first operating wire 41 or the second operating wire 42 attempts to take a shortcut can be suppressed. Therefore, it is possible to more reliably bend the distal end portion 11 of the medical device body 10 in a desired direction.

[0046] Second Embodiment Next, a medical device 100 according to a second embodiment will be described with reference to Figs. 9 to 11(b). Figures 11(a) and 11(b) are schematic diagrams for explaining the bending action of the tip portion 11 of the medical device main body 10 when viewed in the direction of arrow A in Figure 10, where Figure 11(a) shows the state before bending and Figure 11(b) shows the bent state. The medical device 100 of this embodiment differs from the medical device 100 of the first embodiment described above in the points described below, but in other respects is configured in the same manner as the medical device 100 of the first embodiment described above.

[0047] In this embodiment, a parallel region 16 is formed between the tip (tip position 15b) of the curved region 15 and the tips 41a, 42a of the first operating wire 41 and the second operating wire 42, in which the first operating wire 41 and the second operating wire 42 extend in parallel and close to each other.

[0048] That is, the medical device main body 10 is configured to include a plastic tube 20 having a lumen 21, a first operating wire 41 and a second operating wire 42 are inserted around the lumen 21 of the plastic tube 20, and at the tip (tip position 15b) of the curved region 15 where the first operating wire 41 and the second operating wire 42 are curved so as to gradually approach each other in the circumferential direction of the medical device main body 10 toward the tip side, the first operating wire 41 and the second operating wire 42 are close to each other at a distance smaller than the thickness of the plastic tube 20, and a parallel region 16 is formed between the tip (tip position 15b) of the curved region 15 and the tips 41a, 42a of the first operating wire 41 and the second operating wire 42, in which the first operating wire 41 and the second operating wire 42 extend in parallel and close to each other. In the parallel region 16, the first hollow tube 31 and the second hollow tube 32 extend parallel to each other while abutting or adjacent to each other.

[0049] More specifically, in this embodiment, the medical device 100 further includes an annular member 60 embedded in the resin tube 20 at the distal end of the curved region 15 . The annular member 60 is configured to have higher rigidity than the resin pipe 20 and is formed to have an outer diameter smaller than the wall thickness of the resin pipe 20 (see FIG. 10). A first operating wire 41 and a second operating wire 42 are inserted through the annular member 60. This makes it possible to more reliably suppress fluctuations in the paths of the first operating line 41 and the second operating line .

[0050] More specifically, in the present embodiment, the first hollow tube 31 and the second hollow tube 32 are inserted through the annular member 60 . That is, the medical device main body 10 is configured to include a first hollow tube 31 and a second hollow tube 32 which are embedded in a resin tube 20 and through which a first operating wire 41 and a second operating wire 42 are respectively inserted, and the first hollow tube 31 and the second hollow tube 32 are inserted into an annular member 60, and in the curved region 15, the first hollow tube 31 and the second hollow tube 32 are curved so as to gradually approach each other in the circumferential direction of the medical device main body 10 toward the tip side.

[0051] The material of the annular member 60 is not particularly limited, but the annular member 60 can be made of, for example, a metal or a hard resin.

[0052] In the present embodiment, by pulling both the first operating wire 41 and the second operating wire 42, the tip portion 11 of the medical device main body 10 can be bent as shown in Figures 11(a) and 11(b). At this time, the bending angle in the parallel region 16 is steeper than the bending angle in the curved region 15 .

[0053] As an example, in the axial direction of the medical device main body 10, the distance from the tip (tip position 15b) of the curved region 15 to the tips 41a, 42a of the first operating wire 41 and the second operating wire 42 (distance L2 shown in Figure 9) is longer than the distance from the base end (base end position 15a) of the curved region 15 to the tip (tip position 15b) (distance L1 shown in Figure 9). Such a configuration allows the tip portion 11 to bend more easily. Moreover, bending of the tip portion 11 can be made to occur mainly in the parallel region 16. Therefore, regardless of the bending angle of the tip portion 11, the friction between the first operating wire 41 and the first hollow tube 31 and the friction between the second operating wire 42 and the second hollow tube 32 in the curved region 15 can be kept substantially constant, so that regardless of the bending angle of the tip portion 11, the magnitude of the force required to pull the first operating wire 41 and the second operating wire 42 can be kept substantially constant.

[0054] As another example, in the axial direction of the medical device main body 10, the distance from the base end (base end position 15a) of the curved region 15 to the tip (tip position 15b) (distance L1 shown in Figure 9) is longer than the distance from the tip (tip position 15b) of the curved region 15 to the tips 41a, 42a of the first operating wire 41 and the second operating wire 42 (distance L2 shown in Figure 9). With this configuration, the flexibility of the tip portion 11 can be suppressed to some extent. In addition, since the curvature of the first operating wire 41 and the second operating wire 42 and the first hollow tube 31 and the second hollow tube 32 in the curved region 15 can be made gentle, friction between the first operating wire 41 and the first hollow tube 31, and friction between the second operating wire 42 and the second hollow tube 32 in the curved region 15 can be reduced. In addition, since the length region in which the first hollow tube 31 and the second hollow tube 32 move close to each other and translate at the tip portion 11 of the medical device main body 10, i.e., the length region with high rigidity, is shortened, good selectivity (good vascular selectivity, etc.) is obtained when bending the tip portion 11 of the medical device main body 10 and entering a branched body cavity.

[0055] The distance L1 and the distance L2 may be the same. In this case, a good balance can be obtained between smooth pulling of the first operating wire 41 and the second operating wire 42 and good selectivity when bending the distal end portion 11 of the medical device main body 10 and entering a branched body cavity.

[0056] Third Embodiment Next, a medical device 100 according to a third embodiment will be described with reference to Figs. 12 to 18(c). Figures 16(a) and 16(b) are schematic diagrams for explaining the bending action of the tip portion 11 of the medical device main body 10 when viewed in the direction of arrow A in Figure 15, where Figure 16(a) shows the state before bending and Figure 16(b) shows the bent state. Figures 16(c) and 16(d) are schematic diagrams for explaining the bending action of the tip portion 11 of the medical device main body 10 when viewed in the direction of arrow B in Figure 15, where Figure 16(c) shows the state before bending and Figure 16(d) shows the bent state. 18(a), 18(b), and 18(c), a longitudinal intermediate portion of the medical device body 10 is cut away and omitted. In the medical device body 10 shown in Fig. 18(a), 18(b), and 18(c), the rotation phase around the axis of the medical device body 10 differs by 90 degrees between the portion on the base end side and the portion on the tip end side of the omitted portion. The medical device 100 of this embodiment differs from the medical device 100 of the second embodiment described above in the points described below, but in other respects is configured in the same manner as the medical device 100 of the second embodiment described above.

[0057] The medical device 100 according to this embodiment includes a third operating wire 43 and a fourth operating wire 44, which are respectively inserted along the axial direction of the medical device body 10. The third operating wire 43 and the fourth operating wire 44, like the first operating wire 41 and the second operating wire 42, are each made of a thin wire such as metal or resin.

[0058] The medical device body 10 further includes a third hollow tube 33 and a fourth hollow tube 34 embedded in the resin tube 20. A third operating wire 43 is inserted into the third hollow tube 33, and a fourth operating wire 44 is inserted into the fourth hollow tube 34. The third hollow tube 33 and the fourth hollow tube 34 are sub-lumen tubes similar to the first hollow tube 31 and the second hollow tube 32, and the inner lumens of these sub-lumen tubes are sub-lumens. That is, each operating line (the third operating line 43, the fourth operating line 44) is inserted into the sub-lumen. The inner diameters of the third hollow tube 33 and the fourth hollow tube 34 are smaller than the inner diameter of the lumen 21 .

[0059] In this embodiment, in the intermediate portion 12 of the medical device main body 10, the first hollow tube 31 and the third hollow tube 33 extend in parallel, close to or abutting each other, and the second hollow tube 32 and the fourth hollow tube 34 extend in parallel, close to or abutting each other (see Figure 13). Similarly, at the base end of the medical device main body 10, the first hollow tube 31 and the third hollow tube 33 extend in parallel, close to or abutting each other, and the second hollow tube 32 and the fourth hollow tube 34 extend in parallel, close to or abutting each other.

[0060] In the curved region 15 of the distal end portion 11 of the medical device body 10, the third hollow tube 33 and the fourth hollow tube 34 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. As a result, the third operating wire 43 in the third hollow tube 33 and the fourth operating wire 44 in the fourth hollow tube 34 are curved so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the distal end side. In the curved region 15, the direction in which the third hollow tube 33 and the third operating wire 43 are curved is symmetrical to the direction in which the first hollow tube 31 and the first operating wire 41 are curved. Similarly, the direction in which the fourth hollow tube 34 and the fourth operating wire 44 are curved in the curved region 15 is symmetrical to the direction in which the second hollow tube 32 and the second operating wire 42 are curved. Each hollow tube (first hollow tube 31, second hollow tube 32, third hollow tube 33, and fourth hollow tube 34) does not intersect with the other hollow tubes. Also, each operating line (first operating line 41, second operating line 42, third operating line 43, and fourth operating line 44) does not intersect with the other operating lines.

[0061] In the parallel region 16, just as the first operating wire 41 and the second operating wire 42 extend in parallel and close to each other, the third operating wire 43 and the fourth operating wire 44 extend in parallel and close to each other. In addition, in the parallel region 16, just as the first hollow tube 31 and the second hollow tube 32 abut or extend in parallel in close proximity to each other, the third hollow tube 33 and the fourth hollow tube 34 abut or extend in parallel in close proximity to each other. A tip 43a of the third operating wire 43 protrudes from the tip of the third hollow tube 33. Similarly, a tip 44a of the fourth operating wire 44 protrudes from the tip of the fourth hollow tube .

[0062] The tip 43a of the third operating wire 43 is fixed to the marker 70 by a third fixing portion 73, which is, for example, a spot of solder (FIG. 15). Similarly, the tip 44a of the fourth operating wire 44 is fixed to the marker 70 by a fourth fixing portion 74 which is, for example, a spot of solder. The third fixing portion 73 and the fourth fixing portion 74 are disposed at the end portion on the base end side of the marker 70, for example. The region in which the third fixing portion 73 and the fourth fixing portion 74 are arranged and the region in which the first fixing portion 71 and the second fixing portion 72 are arranged face each other in the circumferential direction of the medical device body 10.

[0063] In this embodiment, the tip 43a of the third operating wire 43 and the tip 44a of the fourth operating wire 44 are connected to each other. That is, the tips of the third operating wire 43 and the fourth operating wire 44 are connected to each other. More specifically, the third fixed portion 73 and the fourth fixed portion 74 are adjacent to each other and in contact with each other. That is, the third fixed portion 73 and the fourth fixed portion 74 are integrated with each other. In addition, the tip 43a and the tip 44a may be fixed to the marker 70 by a single fixing portion.

[0064] 14, in this embodiment, the medical device 100 includes a first annular member 61 embedded in the resin tube 20 at the tip of the curved region 15, instead of the annular member 60. The first annular member 61 is similar to the annular member 60 in the second embodiment, and the first hollow tube 31 and the second hollow tube 32 are inserted through the first annular member 61. Furthermore, in this embodiment, the medical device 100 includes a second annular member 62 embedded in the resin tube 20 at the tip portion of the curved region 15. The second annular member 62 is similar to the first annular member 61. The third hollow tube 33 and the fourth hollow tube 34 are inserted into the second annular member 62. The first annular member 61 and the second annular member 62 are disposed opposite to each other in the circumferential direction of the medical device body 10.

[0065] In the case of this embodiment, by pulling both the first operating wire 41 and the second operating wire 42, the tip portion 11 of the medical device main body 10 can be bent in one direction, as shown in Figures 16(a) and 16(b). Furthermore, in the case of this embodiment, by pulling both the third operating wire 43 and the fourth operating wire 44, the tip portion 11 of the medical device main body 10 can be bent in the opposite direction to the above-mentioned direction, as shown in Figures 16(c) and 16(d).

[0066] As shown in Figures 17 and 18(a), in this embodiment, the bending operation unit 80 includes a first bending operation unit 180 for performing a bending operation of the tip portion 11 of the medical device main body 10 by pulling the first operating wire 41 and the second operating wire 42, and a second bending operation unit 280 for performing a bending operation of the tip portion 11 of the medical device main body 10 by pulling the third operating wire 43 and the fourth operating wire 44.

[0067] The first bending operation unit 180 includes a first rotating member 181, a first advancing / retreating member 182, a first pinion 183, a first dial operation unit 184, and a first guide 185. The first rotating member 181, the first advancing / retreating member 182, the first pinion 183, the first dial operation unit 184, and the first guide 185 correspond to the rotating member 81, the advancing / retreating member 82, the pinion 83, the dial operation unit 84, and the guide 85, respectively, described in the first embodiment. Therefore, the first advancing / retreating member 182 includes a first holding portion 182a, a first rod-shaped portion 182b, and a first rack portion 182c which correspond to the holding portion 82a, the rod-shaped portion 82b, and the rack portion 82c, respectively. Similar to the first embodiment in which the first operating wire 41 and the second operating wire 42 are wound around and fixed to the rotating member 81, the first operating wire 41 and the second operating wire 42 are wound around and fixed to the first rotating member 181.

[0068] The second bending operation unit 280 includes a second rotating member 281, a second advancing / retreating member 282, a second pinion 283, a second dial operation unit 284, and a second guide 285. The second rotating member 281, the second advancing / retreating member 282, the second pinion 283, the second dial operation unit 284, and the second guide 285 are similar to the first rotating member 181, the first advancing / retreating member 182, the first pinion 183, the first dial operation unit 184, and the first guide 185. The second advancing / retreating member 282 includes a second holding portion 282a, a second rod-shaped portion 282b, and a second rack portion 282c that are similar to the first holding portion 182a, the first rod-shaped portion 182b, and the first rack portion 182c, respectively. Similar to the first operating wire 41 and the second operating wire 42 being wound around and fixed to the first rotating member 181, the third operating wire 43 and the fourth operating wire 44 are wound around and fixed to the second rotating member 281. For example, the second bending operation portion 280 is disposed symmetrically above and below the first bending operation portion 180 in FIG.

[0069] In this embodiment, by rotating the first dial operating part 184 to retract the first advancing / retreating member 182 and the first rotating member 181, the first operating wire 41 and the second operating wire 42 can be pulled, and the tip portion 11 of the medical device main body 10 can be bent in one direction (Figure 18(b)). In addition, by rotating the second dial operating part 284 to retract the second advancing / retreating member 282 and the second rotating member 281, the third operating wire 43 and the fourth operating wire 44 can be pulled, and the tip portion 11 of the medical device main body 10 can be bent in the opposite direction to the above-mentioned one direction (Figure 18 (c)).

[0070] Thus, in this embodiment, the medical device 100 is equipped with a second bending operating section 280 for performing a bending operation of the tip portion 11 of the medical device main body 10 in a direction different from the bending direction of the tip portion 11 of the medical device main body 10 by pulling the first operating wire 41 and the second operating wire 42, by pulling the third operating wire 43 and the fourth operating wire 44. At the intermediate portion 12 and base end portion in the axial direction of the medical device body 10, the third operating wire 43 and the fourth operating wire 44 extend in parallel and spaced apart from each other in the circumferential direction of the medical device body 10, and at the tip portion 11 in the axial direction of the medical device body 10, the third operating wire 43 and the fourth operating wire 44 curve and merge so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the tip side.

[0071] Furthermore, by operating the second bending operation portion 280, the third operation wire 43 and the fourth operation wire 44 are pulled at the same time.

[0072] The second bending operating unit 280 is configured to include a second rotating member 281 that is rotatably supported on a shaft, and to which the third operating wire 43 and the fourth operating wire 44 are engaged and to which the base end of the third operating wire 43 and the base end of the fourth operating wire 44 are fixed, and a second moving mechanism that moves the second rotating member 281 in a second pulling direction that pulls the third operating wire 43 and the fourth operating wire 44, and in the opposite direction to the second pulling direction.

[0073] The second rotating member 281 has a second engagement portion with which the third operating wire 43 and the fourth operating wire 44 engage, and the second engagement portion is formed in a circular or arc shape centered on the rotation center of the second rotating member 281.

[0074] The second bending operation unit 280 is equipped with a second operation receiving unit (second dial operation unit 284) that operates in response to receiving operation from the user, and the power of the second operation receiving unit is transmitted to the second rotating member 281 via the second moving mechanism, causing the second rotating member 281 to move in the second pulling direction and the opposite direction to the second pulling direction.

[0075] The second operation receiving portion (second dial operation portion 284) is axially supported so as to be rotatable, and the second moving mechanism includes a second pinion 283 integral with and coaxially arranged with the second operation receiving portion, and a second rack member (second advancing / retreating member 282) which advances and retreats in conjunction with the rotation of the second pinion 283, and a second rotating member 281 is axially supported on the second rack member.

[0076] [Fourth embodiment] Next, a medical device 100 according to a fourth embodiment will be described with reference to Figs. 19(a) and 19(b). The medical device 100 of this embodiment differs from the medical device 100 of the first embodiment described above in the points described below, but in other respects is configured in the same manner as the medical device 100 of the first embodiment described above.

[0077] In this embodiment, in the circumferential direction of the tip portion 11 of the medical device main body 10, an easily-bendable portion 110 in which the flexibility of the medical device main body 10 is locally high is formed in the region between the first operating wire 41 and the second operating wire 42, or in the region located on the opposite side of the axis of the medical device main body 10. This improves the bendability of the distal end portion 11, thereby reducing the tension acting on the first operating wire 41 and the second operating wire 42 during bending. This further reduces the occurrence of the phenomenon in which the medical device body 10 rotates around its axis as the first operating wire 41 or the second operating wire 42 tries to take a shortcut.

[0078] More specifically, as shown in Figure 19(b), in the circumferential direction of the tip portion 11 of the medical device main body 10, an easily bendable portion 110 is formed in both the region between the first operating wire 41 and the second operating wire 42 and the region located on the opposite side of the region with the axis of the medical device main body 10 in between. This further improves the flexibility of the tip portion 11.

[0079] The easily bendable portion 110 is configured to include a notch-shaped portion 111 formed on the outer surface side of the medical device body 10. The cutout portion 111 may be, for example, an arc-shaped cutout as shown in FIG. 19(b). This allows the tip portion 11 to be bent more sharply.

[0080] Fifth embodiment Next, a medical device 100 according to a fifth embodiment will be described with reference to Figs. 20(a) and 20(b). The medical device 100 of this embodiment differs from the medical device 100 of the first embodiment described above in the points described below, but in other respects is configured in the same manner as the medical device 100 of the first embodiment described above.

[0081] In this embodiment, in the circumferential direction of the tip portion 11 of the medical device main body 10, an easily-bendable portion 110 in which the flexibility of the medical device main body 10 is locally high is formed in the region between the first operating wire 41 and the second operating wire 42, or in the region located on the opposite side of the axis of the medical device main body 10. This improves the bendability of the distal end portion 11, thereby reducing the tension acting on the first operating wire 41 and the second operating wire 42 during bending. This further reduces the occurrence of the phenomenon in which the medical device body 10 rotates around its axis as the first operating wire 41 or the second operating wire 42 tries to take a shortcut.

[0082] More specifically, as shown in Figure 20(b), in the circumferential direction of the tip portion 11 of the medical device main body 10, an easily bendable portion 110 is formed in the region between the first operating wire 41 and the second operating wire 42, and no easily bendable portion 110 is formed in the region located on the opposite side of the said region across the axis of the medical device main body 10. However, the easily bendable portion 110 may be formed in both the region between the first operating wire 41 and the second operating wire 42, and the region located on the opposite side of the region, sandwiched between the axis of the medical device main body 10, in the circumferential direction of the tip portion 11 of the medical device main body 10.

[0083] The easily bendable portion 110 is configured to include a notch-shaped portion 111 formed on the outer surface side of the medical device body 10. In this embodiment, the medical device body 10 has a plurality of cutout portions 111 arranged adjacent to each other in the axial direction of the medical device body 10. These cutout portions 111 are elongated in the circumferential direction of the medical device body 10 and have a wedge-shaped cross-sectional shape. In this embodiment, the tip 11 of the medical device body 10 bends easily in the initial stage of bending, but once a certain bending angle is reached, the wedge-shaped inclined surfaces come into contact with each other, making it difficult to bend further (rigidity increases once a certain bending angle is reached). Therefore, the distal end portion 11 of the medical device body 10 has good resistance to deformation against axial compression when it is pushed into a body cavity, and the blood vessel selectivity of the medical device 100 is good.

[0084] Sixth Embodiment Next, a sixth embodiment will be described with reference to FIG. The medical device 100 of this embodiment differs from the medical device 100 of the third embodiment described above in the respects described below, but is otherwise configured in the same manner as the medical device 100 of the third embodiment described above.

[0085] In this embodiment, the configuration of the bending operation portion 80 is different from that of the third embodiment described above, as will be described below. In this embodiment, the bending operation unit 80 includes a housing 86, a first rotating member 181, a second rotating member 281, a dial operation unit 194 (third rotating member), a first connecting wire 192 connecting the first rotating member 181 and the dial operation unit 194 to each other, and a second connecting wire 193 connecting the second rotating member 281 and the dial operation unit 194 to each other.

[0086] Each of the first rotating member 181 and the second rotating member 281 is, for example, a pulley. The rotation axis of the first rotation member 181 extends, for example, in a direction perpendicular to the axial direction of the medical device body 10 in the housing 86 (the left-right direction in FIG. 21). The rotation shaft of the first rotating member 181 is held by the housing 86 so as to be rotatable around the axis of the rotation shaft and to be movable relative to the housing 86 in the axial direction of the medical device main body 10 inside the housing 86 (left and right direction in FIG. 21). For example, the rotation shaft of the first rotating member 181 is supported by an elongated hole (not shown) formed in the housing 86. Similarly, the rotation axis of the second rotating member 281 extends, for example, in a direction perpendicular to the axial direction of the medical device body 10 in the housing 86. The rotation axis of the second rotating member 281 is held by the housing 86 so as to be rotatable around the axis of the rotation axis and to be movable relative to the housing 86 in the axial direction of the medical device body 10 in the housing 86. As an example, the rotation axis of the first rotating member 181 and the rotation axis of the second rotating member 281 are parallel to each other. However, these rotation axes do not have to be parallel to each other.

[0087] The first operating line 41, the second operating line 42, the third operating line 43 and the fourth operating line 44 are each led out from the medical device body 10 within the housing 86. The base end of the first operating wire 41 is wound around the first rotating member 181 by, for example, one and a half turns, and the base end of the first operating wire 41 is fixed to the first rotating member 181. Similarly, the second operating wire 42 is wound around the first rotating member 181 by, for example, one and a half turns, and the base end of the second operating wire 42 is fixed to the first rotating member 181. The winding direction of the first operating wire 41 and the winding direction of the second operating wire 42 around the first rotating member 181 are opposite to each other. For this reason, the rotation angle of the first rotating member 181 is autonomously adjusted to an angle at which the tension of the first operating wire 41 and the tension of the second operating wire 42 are balanced. The base end of the third operating wire 43 is wound around the second rotating member 281 by, for example, one and a half turns, and the base end of the third operating wire 43 is fixed to the second rotating member 281. Similarly, the fourth operating wire 44 is wound around the second rotating member 281 by, for example, one and a half turns, and the base end of the fourth operating wire 44 is fixed to the second rotating member 281. The winding direction of the third operating wire 43 and the winding direction of the fourth operating wire 44 around the second rotating member 281 are opposite to each other. For this reason, the rotation angle of the second rotating member 281 is autonomously adjusted to an angle at which the tension of the third operating wire 43 and the tension of the fourth operating wire 44 are balanced.

[0088] The dial operation unit 194 is rotatably supported relative to the housing 86. The rotation axis of the dial operation unit 194 extends in a direction perpendicular to the axial direction of the medical device body 10 within the housing 86. As an example, the rotation axis of the dial operation unit 194 is parallel to the rotation axis of the first rotating member 181 and the rotation axis of the second rotating member 281. However, the rotation axis of the dial operation unit 194 does not have to be parallel to the rotation axis of the first rotating member 181 and the rotation axis of the second rotating member 281. At least a portion of the dial operation unit 194 is exposed to the outside of the housing 86, so that an operator operating the medical device 100 can rotate the dial operation unit 194 from outside the housing 86.

[0089] The dial operation unit 194 includes, for example, a main body formed in a disk shape, and a winding unit 191 fixed to one surface side of the main body. The winding unit 191 is, for example, a cylindrical bobbin. The winding unit 191 is disposed coaxially with the rotation axis of the dial operation unit 194.

[0090] A tip end of first connecting wire 192 is connected to a rotation shaft of first rotating member 181. A base end of first connecting wire 192 is wound around winding portion 191 one and a half times, for example, and the base end of first connecting wire 192 is fixed to winding portion 191 at first connecting portion 195. Similarly, the tip of second connecting wire 193 is connected to the rotation shaft of second rotating member 281. The base end of second connecting wire 193 is wound around winding portion 191 one and a half times, for example, and the base end of second connecting wire 193 is fixed to winding portion 191 at second connecting portion 196. The winding direction of the first connecting wire 192 and the winding direction of the second connecting wire 193 around the winding portion 191 are opposite to each other.

[0091] In this embodiment, when an operator operating the medical device 100 grasps the housing 86 or the hub 90 and rotates the dial operating unit 194, the first connecting wire 192 or the second connecting wire 193 is selectively wound around the winding unit 191, and the first rotating member 181 or the second rotating member 281 is selectively pulled toward the base end. 21, the first connecting wire 192 is wound around the winding portion 191, and the first rotating member 181 is pulled toward the base end. Therefore, both the first operating wire 41 and the second operating wire 42 are pulled toward the base end of the medical device body 10, and the distal end portion 11 of the medical device body 10 is bent in one direction. 21, the second connecting wire 193 is wound around the winding portion 191, and the second rotating member 281 is pulled toward the base end. Therefore, both the third operating wire 43 and the fourth operating wire 44 are pulled toward the base end of the medical device body 10, and the tip portion 11 of the medical device body 10 is bent in the opposite direction to the one direction. In other words, by operating a single dial operation unit 194, an operation of pulling both the first operation line 41 and the second operation line 42, and an operation of pulling both the third operation line 43 and the fourth operation line 44 can be performed.

[0092] In this manner, the medical device 100 of this embodiment comprises a third operating wire 43 and a fourth operating wire 44, each of which is inserted along the axial direction of the medical device body 10, and at the intermediate portion 12 and the base end portion 13 in the axial direction of the medical device body 10, the third operating wire 43 and the fourth operating wire 44 extend in parallel and spaced apart from each other in the circumferential direction of the medical device body 10, and at the tip portion 11 in the axial direction of the medical device body 10, the third operating wire 43 and the fourth operating wire 44 curve and merge so as to gradually approach each other in the circumferential direction of the medical device body 10 toward the tip side. Furthermore, by operating the bending operating section 80, the third operating wire 43 and the fourth operating wire 44 can be pulled, and the tip portion 11 of the medical device main body 10 can be bent in a direction different from the direction of bending of the tip portion 11 of the medical device main body 10 by pulling the first operating wire 41 and the second operating wire 42.

[0093] More specifically, the bending operation unit 80 comprises a first rotating member 181, a second rotating member 281 and a third rotating member (dial operation unit 194), each of which is rotatably supported on a shaft, and the rotating shaft of the first rotating member 181 is connected to a first connecting portion 195 of the third rotating member, and the rotating shaft of the second rotating member 281 is connected to a second connecting portion 196 of the third rotating member. In addition, the base end of the first operating wire 41 and the base end of the second operating wire 42 are fixed to the first rotating member 181, and the base end of the third operating wire 43 and the base end of the fourth operating wire 44 are fixed to the second rotating member 281. Then, as the third rotating member rotates in one direction, the first rotating member 181 is pulled, and the first operating wire 41 and the second operating wire 42 are pulled, causing the tip portion 11 of the medical device main body 10 to bend, and as the third rotating member rotates in the opposite direction to the above-mentioned one direction, the second rotating member 281 is pulled, and the third operating wire 43 and the fourth operating wire 44 are pulled, causing the tip portion 11 of the medical device main body 10 to bend in a direction different from the direction of bending of the tip portion 11 of the medical device main body 10 due to the pulling of the first operating wire 41 and the second operating wire 42 (for example, the opposite direction).

[0094] In the sixth embodiment, an example is described in which the rotation axis of the first rotating member 181 is connected to the third rotating member (dial operation unit 194) via a wire (first connecting wire 192) and the rotation axis of the second rotating member 281 is connected to the third rotating member via a wire (second connecting wire 193). However, the present invention is not limited to this example. For example, the rotation shaft of the first rotating member 181 may be directly supported by the first connecting portion of the third rotating member, and the rotation shaft of the second rotating member 281 may be directly supported by the second connecting portion of the third rotating member. In this case, the third connecting member does not need to include the above-mentioned winding portion 191.

[0095] Seventh embodiment Next, a seventh embodiment will be described with reference to FIG. The medical device 100 of this embodiment differs from the medical device 100 of the sixth embodiment described above in the points described below, but is otherwise configured in the same manner as the medical device 100 of the sixth embodiment described above.

[0096] In this embodiment, as described below, the configuration of the bending operation portion 80 is different from that of the sixth embodiment. In this embodiment, the bending operation unit 80 does not include the winding unit 191, the first connecting wire 192, and the second connecting wire 193 shown in Fig. 21. Instead, the bending operation unit 80 includes a pinion 197, a first rack member 198, a second rack member 199, and a guide 200 shown in Fig. 22.

[0097] The pinion 197 is formed integrally with the dial operation unit 194 on one surface of the disk-shaped dial operation unit 194 , and is disposed coaxially with the rotation axis of the dial operation unit 194 .

[0098] The first rack member 198 is a rod-shaped member extending in the axial direction of the medical device body 10 inside the housing 86. The first rotating member 181 is rotatably supported at the tip of the first rack member 198. A rack that meshes with a gear on the outer periphery of the pinion 197 is formed on one side of the first rack member 198. The bending operation section 80 includes, for example, a pair of front and rear guides 200 provided corresponding to the first rack member 198. By these guides 200, the first rack member 198 is guided so as to be able to advance and retreat linearly in the axial direction of the medical device body 10 within the housing 86.

[0099] Similarly, the second rack member 199 is a rod-shaped member extending in the axial direction of the medical device body 10 inside the housing 86. A second rotating member 281 is rotatably supported at the tip of the second rack member 199. A rack that meshes with a gear on the outer periphery of the pinion 197 is formed on one side of the second rack member 199. The bending operation section 80 includes, for example, a pair of front and rear guides 200 provided corresponding to the second rack member 199. By these guides 200, the second rack member 199 is guided so as to be able to advance and retreat linearly in the axial direction of the medical device body 10 within the housing 86.

[0100] In this embodiment, the manner in which the first operating line 41 and the second operating line 42 are engaged with and fixed to the first rotating member 181, and the manner in which the third operating line 43 and the fourth operating line 44 are engaged with and fixed to the second rotating member 281 are similar to the sixth embodiment. For this reason, the rotation angle of the first rotating member 181 is autonomously adjusted to an angle at which the tension of the first operating wire 41 and the tension of the second operating wire 42 are balanced, and the rotation angle of the second rotating member 281 is autonomously adjusted to an angle at which the tension of the third operating wire 43 and the tension of the fourth operating wire 44 are balanced.

[0101] In this embodiment, an operator operating the medical device 100 grasps the housing 86 or the hub 90 and rotates the dial operating unit 194, whereby the first rack member 198 or the second rack member 199, which are respectively engaged with the pinion 197, selectively moves toward the base end. 22, the first rack member 198 moves (retreats) toward the base end, and the first rotating member 181 is pulled toward the base end. Therefore, both the first operating wire 41 and the second operating wire 42 are pulled toward the base end of the medical device body 10, and the distal end portion 11 of the medical device body 10 is bent in one direction. 22, the second rack member 199 moves (retreats) toward the base end, and the second rotating member 281 is pulled toward the base end. Therefore, both the third operating wire 43 and the fourth operating wire 44 are pulled toward the base end of the medical device body 10, and the tip portion 11 of the medical device body 10 is bent in the opposite direction to the one direction. In addition, when the first rack member 198 moves toward the base end, the second rack member 199 moves toward the tip end, and when the second rack member 199 moves toward the base end, the first rack member 198 moves toward the tip end.

[0102] Thus, in this embodiment, the bending operation unit 80 includes a first rotating member 181, a second rotating member 281, and a third rotating member (dial operation unit 194), which are each rotatably supported on a shaft, a pinion 197 which is integral with and coaxial with the third rotating member, a first rack member 198 to which the rotating shaft of the first rotating member 181 is connected and which advances and retreats in conjunction with the rotation of the pinion 197, and a second rack member 199 to which the rotating shaft of the second rotating member 281 is connected and which always advances and retreats in the direction opposite to the advancement and retreat direction of the first rack member 198 in conjunction with the rotation of the pinion 197. The base end of the first operating wire 41 and the base end of the second operating wire 42 are fixed to the first rotating member 181, and the base end of the third operating wire 43 and the base end of the fourth operating wire 44 are fixed to the second rotating member 281. When the third rotating member (dial operating unit 194) rotates in one direction, the first rotating member 181 is pulled via the first rack member 198, and the first operating wire 41 and the second operating wire 42 are pulled, causing the tip portion 11 of the medical device main body 10 to bend. In addition, when the third rotating member rotates in the opposite direction to the above-mentioned one direction, the second rotating member 281 is pulled via the second rack member 199, and the third operating wire 43 and the fourth operating wire 44 are pulled, so that the tip portion 11 of the medical device main body 10 is bent in a direction different from the direction in which the tip portion 11 of the medical device main body 10 is bent due to the pulling of the first operating wire 41 and the second operating wire 42.

[0103] Although the embodiments have been described above with reference to the drawings, these are merely examples of the present invention, and various configurations other than those described above can also be adopted.

[0104] In the above first embodiment, an example was described in which the rotation mechanism of the bending operation unit 80 was the dial operation unit 84, but the rotation mechanism of the bending operation unit 80 may be something other than the dial operation unit 84 (for example, a rotary lever, etc.). In addition, in the above first embodiment, an example was described in which the conversion mechanism of the bending operation unit 80 is configured to include a rack (rack portion 82c) and a pinion 83, but the bending operation unit 80 may be configured to include other conversion mechanisms (for example, a cam, a link mechanism, or a pin and a grooved guide, etc.). The same applies to the other embodiments.

[0105] In addition, in each of the above embodiments, the first operating wire 41 and the second operating wire 42 are configured by separate thin wires, but the first operating wire 41 and the second operating wire 42 may each be configured by a portion of a single thin wire. In other words, the single thin wire may be folded back at the tips 41a, 42a. Similarly, although an example in which the third operating wire 43 and the fourth operating wire 44 are configured by separate thin wires has been described above, the third operating wire 43 and the fourth operating wire 44 may each be configured by a portion of a single thin wire. In other words, the single thin wire may be folded back at the tips 43a, 44a.

[0106] In addition, in each of the above embodiments, an example has been described in which the base end of the first operating wire 41 and the base end of the second operating wire 42 are individually fixed to the bending operating section 80, but the base end of the first operating wire 41 and the base end of the second operating wire 42 may be connected to each other and looped in the bending operating section 80 (for example, looped at the portion engaged with the rotating member 81). Similarly, although an example has been described above in which the base end of the third operating wire 43 and the base end of the fourth operating wire 44 are individually fixed to the second bending operating section 280, the base end of the third operating wire 43 and the base end of the fourth operating wire 44 may be connected to each other and looped at the second bending operating section 280 (for example, looped at the portion engaged with the second rotating member 281).

[0107] In the above third embodiment (Figures 17, 18(a), 18(b), and 18(c)), an example has been described in which the first dial operation unit 184 and the second dial operation unit 284 are arranged to overlap each other in a direction perpendicular to their plate surfaces, and the rotation axis of the first dial operation unit 184 and the rotation axis of the second dial operation unit 284 are arranged coaxially with each other, but the present invention is not limited to this example. For example, the rotation axis of the first dial operation unit 184 and the rotation axis of the second dial operation unit 284 do not have to be arranged coaxially with each other. For example, the first dial operation unit 184 and the second dial operation unit 284 may be arranged at different positions from each other in the axial direction of the medical device main body 10.

[0108] Furthermore, the above-described embodiments can be combined as appropriate without departing from the spirit and scope of the present invention.

[0109] The present embodiment encompasses the following technical ideas. (1) A long medical device body, A first operating wire and a second operating wire are respectively inserted along an axial direction of the medical device body; A bending operation unit for bending the tip portion of the medical device body by pulling the first operating wire and the second operating wire; Equipped with At an intermediate portion and a base end portion in an axial direction of the medical device body, the first operating wire and the second operating wire extend in parallel and spaced apart from each other in a circumferential direction of the medical device body, A medical device in which, at the axial tip portion of the medical device body, the first operating wire and the second operating wire curve and merge so as to gradually approach each other in the circumferential direction of the medical device body toward the tip side. (2) A medical device as described in (1), in which the first operating wire and the second operating wire are pulled simultaneously by operating the bending operating portion. (3) A medical device described in (1) or (2), in which the tips of the first operating wire and the second operating wire are connected to each other. (4) A medical device described in any one of (1) to (3), wherein the first operating wire and the second operating wire are arranged in positions opposing each other in the circumferential direction of the medical device body at the intermediate portion and base end portion in the axial direction of the medical device body. (5) The medical device body includes a resin tube having a lumen, and a first hollow tube and a second hollow tube embedded in the resin tube and through which the first operating wire and the second operating wire are inserted, respectively; A medical device described in any one of (1) to (4), wherein at a tip portion in the axial direction of the medical device body, the first hollow tube and the second hollow tube are curved so as to gradually approach each other in the circumferential direction of the medical device body toward the tip side. (6) The bending operation unit is a rotating member that is rotatably supported by a shaft, the rotating member to which the first operating wire and the second operating wire are engaged and to which a base end portion of the first operating wire and a base end portion of the second operating wire are fixed; a moving mechanism that moves the rotating member in a pulling direction in which the first operating wire and the second operating wire are pulled, and in a direction opposite to the pulling direction; The medical device according to any one of (1) to (5), comprising: (7) A medical device described in any one of (1) to (6), in which an easily-bent portion in which the flexibility of the medical device body is locally high is formed in the region between the first operating wire and the second operating wire in the circumferential direction of the tip portion of the medical device body, or in the region located on the opposite side of the axis of the medical device body. (8) The medical device according to (7), wherein the easily bendable portion includes a cutout portion formed on the outer surface of the medical device body. (9) The medical device body includes a resin tube having a lumen, The first operating wire and the second operating wire are inserted around the lumen of the resin tube, At a tip of a curved region in which the first operating wire and the second operating wire are curved so as to gradually approach each other in the circumferential direction of the medical device main body toward the tip side, the first operating wire and the second operating wire are close to each other at a distance smaller than the thickness of the resin tube, A medical device described in any one of (1) to (8), wherein a parallel region is formed between the tip of the curved region and the tips of the first operating wire and the second operating wire, in which the first operating wire and the second operating wire extend in parallel and close to each other. (10) A medical device as described in (9), wherein in the axial direction of the medical device body, the distance from the tip of the curved region to the tips of the first operating wire and the second operating wire is longer than the distance from the base end of the curved region to the tip. (11) A medical device as described in (9), wherein the distance from the base end to the tip of the curved region in the axial direction of the medical device body is longer than the distance from the tip of the curved region to the tips of the first operating wire and the second operating wire. (12) The medical device further includes an annular member embedded in the resin tube at a tip end of the curved region, The annular member is configured to have higher rigidity than the resin pipe and is formed to have an outer diameter smaller than a wall thickness of the resin pipe, A medical device described in any one of (9) to (11), wherein the first operating wire and the second operating wire are inserted into the annular member. (13) The medical device body includes a first hollow tube and a second hollow tube that are embedded in the resin tube and through which the first operating wire and the second operating wire are inserted, respectively; The first hollow tube and the second hollow tube are inserted into the annular member, The medical device according to (12), wherein in the curved region, the first hollow tube and the second hollow tube are curved so as to gradually approach each other in the circumferential direction of the medical device body toward the tip side. (14) A third operating wire and a fourth operating wire respectively inserted along the axial direction of the medical device body; A second bending operation unit for bending the tip portion of the medical device body in a direction different from the bending direction of the tip portion of the medical device body by pulling the first operating wire and the second operating wire, by pulling the third operating wire and the fourth operating wire; Equipped with At an intermediate portion and a base end portion in an axial direction of the medical device body, the third operating wire and the fourth operating wire extend in parallel and spaced apart from each other in a circumferential direction of the medical device body, A medical device described in any one of (1) to (13), wherein at the tip portion in the axial direction of the medical device main body, the third operating wire and the fourth operating wire curve and merge so as to gradually approach each other in the circumferential direction of the medical device main body toward the tip side. (15) A medical device as described in (14), in which the third operating wire and the fourth operating wire are pulled simultaneously by operating the second bending operating section. (16) The rotating member has an engagement portion with which the first operating wire and the second operating wire are engaged, The medical device according to (6), wherein the engagement portion is formed in a circular or arc shape centered on the center of rotation of the rotating member. (17) The bending operation unit includes an operation receiving unit that receives an operation from a user and operates in response to the operation, The medical device according to (6) or (16), wherein the power of the operation receiving unit is transmitted to the rotating member via the moving mechanism, so that the rotating member moves in the pulling direction and the opposite direction. (18) The operation receiving unit is supported by a shaft so as to be rotatable, The moving mechanism includes: A pinion provided integrally and coaxially with the operation receiving portion; A rack member that advances and retreats in conjunction with the rotation of the pinion; Equipped with The medical device according to (17), wherein the rotating member is axially supported by the rack member. (19) The second bending operation unit is a second rotating member that is rotatably supported by a shaft, the third operating wire and the fourth operating wire are engaged with the second rotating member, and a base end portion of the third operating wire and a base end portion of the fourth operating wire are fixed to the second rotating member; A second moving mechanism that moves the second rotating member in a second pulling direction in which the third operating wire and the fourth operating wire are pulled, and in a direction opposite to the second pulling direction; The medical device according to (14) or (15), (20) The second rotating member has a second engagement portion with which the third operating wire and the fourth operating wire are engaged, The medical device according to (19), wherein the second engagement portion is formed in a circular or arc shape centered on the rotation center of the second rotating member. (21) The second bending operation unit includes a second operation receiving unit that receives an operation from a user and operates in response to the operation, The medical device according to (19) or (20), wherein the power of the second operation receiving portion is transmitted to the second rotating member via the second moving mechanism, thereby causing the second rotating member to move in the second pulling direction and in a direction opposite to the second pulling direction. (22) The second operation receiving portion is pivotally supported so as to be rotatable, The second moving mechanism is A second pinion provided integrally and coaxially with the second operation receiving portion; A second rack member that advances and retreats in conjunction with the rotation of the second pinion; Equipped with The medical device according to (21), wherein the second rotating member is journalled to the second rack member. (23) A third operating wire and a fourth operating wire are respectively inserted along the axial direction of the medical device body, At an intermediate portion and a base end portion in an axial direction of the medical device body, the third operating wire and the fourth operating wire extend in parallel and spaced apart from each other in a circumferential direction of the medical device body, At a distal end portion in an axial direction of the medical device main body, the third operating wire and the fourth operating wire are curved toward the distal end side so as to gradually approach each other in a circumferential direction of the medical device main body and merge with each other, A medical device described in any one of (1) to (13), in which the third operating wire and the fourth operating wire can be pulled by operating the bending operating section, thereby bending the tip portion of the medical device main body in a direction different from the direction of bending of the tip portion of the medical device main body by pulling the first operating wire and the second operating wire. (24) The bending operation unit is The device includes a first rotating member, a second rotating member, and a third rotating member, each of which is rotatably supported by a shaft; a rotation shaft of the first rotation member is connected to a first connection portion of the third rotation member, a rotation shaft of the second rotation member is connected to a second connection portion of the third rotation member, A base end portion of the first operating wire and a base end portion of the second operating wire are fixed to the first rotating member, a base end portion of the third operating wire and a base end portion of the fourth operating wire are fixed to the second rotating member, When the third rotating member rotates in one direction, the first rotating member is pulled, and the first operating wire and the second operating wire are pulled, so that the distal end portion of the medical device body is bent, The medical device described in (23), wherein the third rotating member rotates in the opposite direction to the one direction, thereby pulling the second rotating member and pulling the third operating wire and the fourth operating wire, so that the tip of the medical device main body is bent in a direction different from the direction of bending of the tip of the medical device main body due to the pulling of the first operating wire and the second operating wire. (25) The bending operation unit is a first rotating member, a second rotating member, and a third rotating member, each of which is rotatably supported; a pinion provided integrally and coaxially with the third rotating member; a first rack member to which a rotation shaft of the first rotating member is connected and which advances and retreats in conjunction with the rotation of the pinion; a second rack member to which a rotation shaft of the second rotating member is connected and which always advances and retreats in a direction opposite to the advance and retreat direction of the first rack member in conjunction with rotation of the pinion; Equipped with A base end portion of the first operating wire and a base end portion of the second operating wire are fixed to the first rotating member, a base end portion of the third operating wire and a base end portion of the fourth operating wire are fixed to the second rotating member, When the third rotating member rotates in one direction, the first rotating member is pulled via the first rack member, and the first operating wire and the second operating wire are pulled, so that the distal end portion of the medical device body is bent, The medical device described in (23), wherein, as the third rotating member rotates in the opposite direction to the one direction, the second rotating member is pulled via the second rack member and the third operating wire and the fourth operating wire are pulled, so that the tip of the medical device main body is bent in a direction different from the direction of bending of the tip of the medical device main body due to the pulling of the first operating wire and the second operating wire. [Explanation of symbols]

[0110] 10 Medical device body 11 Tip 12 Middle section 13 Proximal end 15 Curved Area 15a Proximal position 15b Tip position 16 parallel regions 20 Plastic pipe 21 Lumens 22 Inner layer 23 Outer layer 31 1st hollow tube 31a Tip 32 2nd hollow tube 32a Tip 33 Third hollow tube 34 4th hollow tube 41 1st operation line 41a Tip 42 2nd operation line 42a Tip 43 3rd operation line 43a Tip 44 4th operation line 44a Tip 51 Braid Layer 52 turns of wire 60 Annular member 61 First annular member 62 Second annular member 70 Markers 71 1st fixed part 72 Second fixed part 73 Third fixed part 74 4th fixed part 80 Bending operation section 81 Rotating members 81a 1st fixed part 81b 2nd fixed part 82 Moving parts (moving mechanism) 82a Holding part 82b Rod-shaped part 82c Rack section 83 Pinion (moving mechanism) 84 Dial operation section 85 Guide 86 Case 90 Hub 92 Wings 93 Connecting part 100 Medical Equipment 110 Easy bending part 111 Notched portion 180 1st bending operation section 181 First rotating member 182 First moving member (moving mechanism) 182a 1st holding part 182b 1st bar part 182c 1st Rack Section 183 First pinion (moving mechanism) 184 First dial operation section 185 First Guide 191 Winding section 192 First connecting wire 193 Second connecting wire 194 Dial operation unit (third rotating member) 195 1st connection site 196 Second connection site 197 Pinion 198 First rack member 199 Second rack member 200 Guide 280 2nd bending operation section 281 Second rotating member 282 Second moving member (moving mechanism) 282a 2nd holding part 282b Second rod-shaped part 282c 2nd Rack Section 283 Second pinion (moving mechanism) 284 Second dial operation section 285 2nd Guide

Claims

1. A long medical device body and A first operating wire and a second operating wire are respectively inserted along an axial direction of the medical device body; A bending operation unit for bending the distal end portion of the medical device body by pulling the first operating wire and the second operating wire; Equipped with At an intermediate portion and a base end portion in an axial direction of the medical device body, the first operating wire and the second operating wire extend in parallel and spaced apart from each other in a circumferential direction of the medical device body, A ring-shaped marker is provided at the tip of the medical device body, a distal end portion in an axial direction of the medical device main body, and a proximal end portion of the marker and a vicinity of the proximal end portion thereof constitute a curved region in which a most distal portion including a tip of the first operating wire and a most distal portion including a tip of the second operating wire are curved and joined so as to gradually approach each other in a circumferential direction of the medical device main body toward the distal side, At an end portion on the base end side of the marker, a tip end of the first operating wire and a tip end of the second operating wire are fixed to the marker via respective fixing portions, and the fixing portion of the first operating wire and the fixing portion of the second operating wire are adjacent to each other in the circumferential direction and in contact with each other, A medical device in which the tip position of the curved region is a position where the tip of the first operating wire and the tip of the second operating wire are located.

2. The medical device according to claim 1 , wherein the first operating wire and the second operating wire are pulled simultaneously by operating the bending operating portion.

3. The medical device according to claim 1 or 2, wherein the first operating wire and the second operating wire are arranged in positions opposing each other in the circumferential direction of the medical device body at the axial intermediate portion and base end portion of the medical device body.

4. the medical device body includes a resin tube having a lumen, and a first hollow tube and a second hollow tube that are embedded in the resin tube and through which the first operating wire and the second operating wire are inserted, A medical device as described in any one of claims 1 to 3, wherein at a tip portion in the axial direction of the medical device body, the first hollow tube and the second hollow tube are curved so as to gradually approach each other in the circumferential direction of the medical device body toward the tip side.

5. The bending operation unit is a rotating member that is rotatably supported by a shaft, the rotating member having the first operating wire and the second operating wire engaged therewith and a base end portion of the first operating wire and a base end portion of the second operating wire fixed thereto; a moving mechanism that moves the rotating member in a pulling direction in which the first operating wire and the second operating wire are pulled and in a direction opposite to the pulling direction; The medical device according to any one of claims 1 to 4, comprising:

6. A medical device as described in any one of claims 1 to 5, wherein a bendable portion in which the flexibility of the medical device body is locally high is formed in a region between the first operating wire and the second operating wire in the circumferential direction of the tip portion of the medical device body, or in a region located on the opposite side of the axis of the medical device body.

7. The medical device according to claim 6 , wherein the easily bendable portion includes a notch-shaped portion formed on an outer surface side of the medical device body.

8. A third operating wire and a fourth operating wire are respectively inserted along the axial direction of the medical device body; A second bending operation unit for bending the distal end portion of the medical device body in a direction different from the bending direction of the distal end portion of the medical device body by pulling the third operating wire and the fourth operating wire, Equipped with At an intermediate portion and a base end portion in an axial direction of the medical device body, the third operating wire and the fourth operating wire extend in parallel and spaced apart from each other in a circumferential direction of the medical device body, A medical device as described in any one of claims 1 to 7, wherein at the tip portion in the axial direction of the medical device main body, the third operating wire and the fourth operating wire curve and merge so as to gradually approach each other in the circumferential direction of the medical device main body toward the tip side.

9. The medical device according to claim 8 , wherein the third operating wire and the fourth operating wire are pulled simultaneously by operating the second bending operating portion.

10. the rotating member has an engagement portion with which the first operating wire and the second operating wire are engaged, The medical device according to claim 5 , wherein the engagement portion is formed in a circular or arc shape centered on the center of rotation of the rotating member.

11. The bending operation unit includes an operation reception unit that receives an operation from a user and operates in response to the operation, The medical device according to claim 5 or 10, wherein the rotating member moves in the pulling direction and the opposite direction by transmitting power of the operation receiving unit to the rotating member via the moving mechanism.

12. The operation receiving unit is supported by a shaft so as to be rotatable, The moving mechanism includes: A pinion provided integrally and coaxially with the operation receiving portion; A rack member that advances and retreats in conjunction with the rotation of the pinion; Equipped with The medical device according to claim 11 , wherein the rotating member is journalled on the rack member.

13. The second bending operation unit is a second rotating member that is rotatably supported by a shaft, the third operating wire and the fourth operating wire are engaged with the second rotating member, and a base end portion of the third operating wire and a base end portion of the fourth operating wire are fixed to the second rotating member; a second moving mechanism that moves the second rotating member in a second pulling direction in which the third operating wire and the fourth operating wire are pulled, and in a direction opposite to the second pulling direction; The medical device according to claim 8 or 9, comprising:

14. the second rotating member has a second engagement portion with which the third operating wire and the fourth operating wire are engaged, The medical device according to claim 13 , wherein the second engagement portion is formed in a circular or arc shape centered on the rotation center of the second rotating member.

15. The second bending operation unit includes a second operation receiving unit that receives an operation from a user and operates in response to the operation, The medical device according to claim 13 or 14, wherein the power of the second operation receiving portion is transmitted to the second rotating member via the second moving mechanism, thereby causing the second rotating member to move in the second pulling direction and in a direction opposite to the second pulling direction.

16. The second operation receiving portion is pivotally supported so as to be rotatable, The second moving mechanism is a second pinion provided integrally and coaxially with the second operation receiving portion; a second rack member that advances and retreats in conjunction with the rotation of the second pinion; Equipped with The medical device according to claim 15 , wherein the second rotating member is journalled on the second rack member.

17. a third operating wire and a fourth operating wire respectively inserted along an axial direction of the medical device body; At an intermediate portion and a base end portion in an axial direction of the medical device body, the third operating wire and the fourth operating wire extend in parallel and spaced apart from each other in a circumferential direction of the medical device body, At a distal end portion in an axial direction of the medical device main body, the third operating wire and the fourth operating wire are curved toward the distal end side so as to gradually approach each other in a circumferential direction of the medical device main body and merge with each other, A medical device as described in any one of claims 1 to 7, wherein by operating the bending operating section, the third operating wire and the fourth operating wire can be pulled, and the tip portion of the medical device main body can be bent in a direction different from the direction of bending of the tip portion of the medical device main body by pulling the first operating wire and the second operating wire.

18. The bending operation unit is The device includes a first rotating member, a second rotating member, and a third rotating member, each of which is rotatably supported by a shaft; a rotation shaft of the first rotation member is connected to a first connection portion of the third rotation member, a rotation shaft of the second rotation member is connected to a second connection portion of the third rotation member, A base end portion of the first operating wire and a base end portion of the second operating wire are fixed to the first rotating member, A base end portion of the third operating wire and a base end portion of the fourth operating wire are fixed to the second rotating member, When the third rotating member rotates in one direction, the first rotating member is pulled, and the first operating wire and the second operating wire are pulled, so that the distal end portion of the medical device body is bent, The medical device described in claim 17, wherein the third rotating member rotates in an opposite direction to the one direction, thereby pulling the second rotating member and pulling the third operating wire and the fourth operating wire, so that the tip of the medical device main body is bent in a direction different from the direction of bending of the tip of the medical device main body due to pulling of the first operating wire and the second operating wire.

19. The bending operation unit is a first rotating member, a second rotating member, and a third rotating member, each of which is rotatably supported; a pinion provided integrally and coaxially with the third rotating member; a first rack member to which a rotation shaft of the first rotating member is connected and which advances and retreats in conjunction with the rotation of the pinion; a second rack member to which a rotation shaft of the second rotating member is connected and which always advances and retreats in a direction opposite to the advancement and retreat direction of the first rack member in conjunction with rotation of the pinion; Equipped with A base end portion of the first operating wire and a base end portion of the second operating wire are fixed to the first rotating member, A base end portion of the third operating wire and a base end portion of the fourth operating wire are fixed to the second rotating member, When the third rotating member rotates in one direction, the first rotating member is pulled via the first rack member, and the first operating wire and the second operating wire are pulled, so that the distal end portion of the medical device body is bent, The medical device described in claim 17, wherein when the third rotating member rotates in the opposite direction to the one direction, the second rotating member is pulled via the second rack member and the third operating wire and the fourth operating wire are pulled, so that the tip of the medical device main body is bent in a direction different from the direction of bending of the tip of the medical device main body due to the pulling of the first operating wire and the second operating wire.

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