Catheter handle and catheter equipped with same

Abstract

To provide a catheter handle of a new structure.SOLUTION: A catheter handle 1 includes: a handle body 2; a rotary knob 3 provided so as to rotate with a longitudinal direction as a rotation axis with respect to the handle body 2; a drive gear 5 provided so as to rotate with a longitudinal direction as a rotation axis in conjunction with the rotary knob 3; a follower gear 7 having a first vertical rotation axis vertical to a longitudinal direction, which engages with the drive gear 5; a first pulley 9 having a second vertical rotation axis parallel to the first vertical rotation axis; a first linear member 11 laid annularly over the follower gear 7 and the first pulley 9; and a first wire 17 and a second wire 18 whose distal part is disposed in a lumen of a tube 32, and proximal part is disposed in a lumen of the handle body 2. The proximal part of the first wire 17 and the proximal part of the second wire 18, which are between the follower gear 7 and the first pulley 9 of the annular first linear member 11, are respectively fixed to a part on one side and a part on the other side with respect to the shaft 4.SELECTED DRAWING: Figure 3

Description

[Technical Field]

[0001] The present invention relates to a handle used for a catheter and a catheter equipped with the handle. [Background technology]

[0002] A catheter typically comprises a tube for insertion into a body cavity such as a blood vessel, the digestive tract, or the urinary tract, and a handle provided on the proximal side of the tube. Some catheters are known that are configured so that the distal end of the tube can be bent by manipulating the handle on the proximal side. In such catheters, a wire is disposed within the lumen of the tube, the distal end of the wire is fixed to the distal end of the tube, and the proximal end of the wire is connected to the handle, so that the distal end of the tube can be bent by manipulating the handle. For example, in a catheter having two wires disposed within the lumen of the tube, the distal end of the tube can be bent to one side by pulling one of the two wires proximally, and the distal end of the tube can be bent to the other side by pulling the other wire.

[0003] As an example of such a catheter handle, Patent Document 1 discloses a catheter handle having two control wires whose distal ends are connected to a distal region of a catheter, the catheter handle comprising: a housing; a sliding assembly disposed within the housing and configured to linearly translate within the housing; and a control knob rotatably provided relative to the housing, wherein the proximal ends of the two control wires are disposed within the housing; the sliding assembly is configured to operate each of the two control wires separately by linearly translating the sliding assembly; and wherein rotating the control knob in a first rotational direction causes the sliding assembly to displace distally and apply tension to one of the two control wires, thereby deflecting the catheter in a first deflection direction; and rotating the control knob in a second rotational direction causes the sliding assembly to displace proximally and apply tension to the other of the two control wires, thereby deflecting the catheter in a second deflection direction. Patent Document 2 discloses a catheter handle for deflecting a distal portion of a catheter, the catheter handle comprising a first rotating member having a first diameter and to which a first wire is connected, and a second rotating member having a second diameter smaller than the first diameter and to which a second wire is connected, the second rotating member being connected to the first rotating member such that the center point of the second rotating member is offset from the center point of the first rotating member, and the first and second rotating members being configured such that rotation of the first rotating member via the first wire rotates the second rotating member and the second wire, thereby deflecting the distal portion of the catheter. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] Special Publication No. 2015-523892 [Patent Document 2] Special Publication No. 2018-515215 Summary of the Invention [Problem to be solved by the invention]

[0005] As described above, various catheter handles have been proposed in the past, and an object of the present invention is to provide a catheter handle with a novel structure and a catheter equipped with the same. [Means for solving the problem]

[0006] The catheter handle of the present invention, which has been able to solve the above-mentioned problems, is a handle for manipulating a catheter tube, comprising: a handle body having a lumen extending in the longitudinal direction; a rotation knob rotatable relative to the handle body with the longitudinal direction as a rotation axis; a first linear member disposed in the lumen of the handle body; a first wire having a distal portion disposed in the lumen of the tube and a proximal portion disposed in the lumen of the handle body; a second wire having a distal portion disposed in the lumen of the tube and a proximal portion disposed in the lumen of the handle body; a shaft disposed in the lumen of the handle body, extending in the longitudinal direction, and fixed to the handle body; a drive gear disposed outside the shaft, having a rotation axis extending in the longitudinal direction, and provided rotatable in conjunction with rotation of the rotation knob; and a rotation axis extending perpendicular to the longitudinal direction (hereinafter referred to as the "first perpendicular rotation axis"). the first linear member is annularly arranged between the driven gear and the first pulley, and the proximal portion of the first wire is fixed to a portion of the annular first linear member between the driven gear and the first pulley, on one side of an imaginary plane formed by the extension direction of the shaft and the extension direction of the first vertical rotation axis; and the proximal portion of the second wire is fixed to a portion of the annular first linear member between the driven gear and the first pulley, on the other side of the imaginary plane, and the proximal portion of the second wire is fixed to a portion of the annular first linear member between the driven gear and the first pulley, on the other side of the imaginary plane.

[0007] It is preferable that the catheter handle further has a first fixture attached to a portion of the first annular linear member between the driven gear and the first pulley, on one side of the imaginary plane, and a second fixture attached to a portion of the first annular linear member between the driven gear and the first pulley, on the other side of the imaginary plane, and that the proximal portion of the first wire is fixed to the first fixture and the proximal portion of the second wire is fixed to the second fixture.

[0008] It is preferable that the catheter handle further comprises a second linear member disposed in the lumen of the handle body, a second pulley having a rotation axis parallel to the first vertical rotation axis (hereinafter referred to as the "third vertical rotation axis") and having an abutment portion with which the second linear member abuts around the third vertical rotation axis, and a third pulley disposed proximal or distal to the second pulley, having a rotation axis parallel to the third vertical rotation axis (hereinafter referred to as the "fourth vertical rotation axis") and having an abutment portion with which the second linear member abuts around the fourth vertical rotation axis. In this case, the second linear member is arranged in a ring shape spanning the second pulley and the third pulley, and the first fixing device is preferably attached to a portion of the ring-shaped first linear member between the driven gear and the first pulley on one side of the imaginary plane, and a portion of the ring-shaped second linear member between the second pulley and the third pulley on one side of the imaginary plane, and the second fixing device is preferably attached to a portion of the ring-shaped first linear member between the driven gear and the first pulley on the other side of the imaginary plane, and a portion of the ring-shaped second linear member between the second pulley and the third pulley on the other side of the imaginary plane.

[0009] It is preferable that the third vertical rotation axis is an extension of the first vertical rotation axis, and the fourth vertical rotation axis is an extension of the second vertical rotation axis. Also, it is preferable that the gear ratio of the driven gear to the driving gear is greater than 1.

[0010] The present invention also provides a catheter comprising a catheter handle of the present invention and a tube disposed distally of the catheter handle. [Effects of the Invention]

[0011] According to the catheter handle and catheter of the present invention, the tube provided on the distal side of the catheter handle can be operated by rotating the rotation knob. [Brief explanation of the drawings]

[0012] [Figure 1] 1 shows an example of an overall view of a catheter with a catheter handle. [Figure 2] 2 shows an example of the internal structure of a catheter handle provided in the catheter shown in FIG. 1, and is a side view of the internal structure. FIG. [Figure 3] FIG. 3 shows a top view of the internal structure of the catheter handle shown in FIG. 2. [Figure 4] FIG. 3 is a cross-sectional view showing the internal structure of the catheter handle shown in FIG. 2, with a drive gear, a driven gear, and a first pulley partially cut away along the longitudinal direction. [Figure 5] FIG. 3 is an enlarged view of the drive gear and driven gear of the internal structure of the catheter handle shown in FIG. 2. [Figure 6] 6 shows a modified example of the drive gear and driven gear shown in FIG. 5. [Figure 7] 6 shows a modified example of the drive gear and driven gear shown in FIG. 5. [Figure 8] 1 shows another example of an overall view of a catheter with a catheter handle. [Figure 9] 9 shows an example of the internal structure of a catheter handle provided in the catheter shown in FIG. 8, and is a side view of the internal structure. [Figure 10] FIG. 10 shows a top view of the internal structure of the catheter handle shown in FIG. [Figure 11] 2 shows another example of the internal structure of the catheter handle provided in the catheter shown in FIG. 1. [Figure 12] 2 shows another example of the internal structure of the catheter handle provided in the catheter shown in FIG. 1. [Figure 13] 9 shows another example of the internal structure of the catheter handle provided in the catheter shown in FIG. 8. [Figure 14] 9 shows another example of the internal structure of the catheter handle provided in the catheter shown in FIG. 8. DETAILED DESCRIPTION OF THE INVENTION

[0013] The catheter handle of the present invention and a catheter equipped with said handle will be specifically described below based on the following embodiments. However, the present invention is not limited to the following embodiments, and can be implemented with appropriate modifications within the scope of the spirit described above and below, and all such modifications are included within the technical scope of the present invention. For convenience, hatching and component symbols may be omitted in the drawings. In such cases, reference should be made to the specification or other drawings. The dimensions of various components in the drawings may differ from their actual dimensions, as priority is given to helping understand the features of the present invention.

[0014] The entire catheter including a catheter handle will be described with reference to Figures 1 and 8. Figure 1 shows an overall view of a catheter according to one embodiment of the present invention, and Figure 8 shows an overall view of a catheter according to another embodiment of the present invention.

[0015] A catheter 31 according to an embodiment of the present invention has a catheter handle 1 (hereinafter referred to as "handle 1") and a tube 32 provided distal to the handle 1. The catheter 31 is used for treatment or examination, for example, by inserting the tube 32 into a body cavity such as a patient's blood vessel or digestive tract.

[0016] In the present invention, the proximal side of the catheter refers to the direction toward the user's hand relative to the extending direction of the catheter, and the distal side refers to the opposite side of the proximal side, i.e., the direction toward the treatment target side.

[0017] The tube 32 has a flexible tubular structure and can be made of, for example, synthetic resins such as polyolefin resins (e.g., polyethylene and polypropylene), polyamide resins (e.g., nylon), polyester resins (e.g., PET), aromatic polyether ketone resins (e.g., PEEK), polyether polyamide resins, polyurethane resins, polyimide resins, and fluororesins (e.g., PTFE, PFA, and ETFE), or metals such as stainless steel, carbon steel, and nickel-titanium alloys. Metal materials can also be used as metal wires embedded in the synthetic resin tube. The axial length of the tube 32 (near-to-far direction) is several to several tens of times longer than the length of the handle 1 in that direction, and is, for example, approximately 500 mm to 1200 mm. The outer diameter of the tube 32 may be, for example, approximately 0.6 mm to 5 mm, and preferably 0.6 mm to 3 mm.

[0018] The tube 32 has an internal lumen, and may be either a single-lumen structure having one internal lumen or a multi-lumen structure having multiple internal lumen. The tube 32 may also have a coaxial structure having multiple coaxial lumens. A wire for manipulating the tube 32 is disposed in the internal lumen of the tube 32. The wire is disposed, for example, to control the bending of the distal end of the tube 32. In this case, the distal end of the wire is preferably fixed to the distal end of the tube 32, for example, the distal one-third portion of the tube 32. A conducting wire, an optical fiber, an endoscope, etc. may be disposed in the internal lumen of the tube 32. A lumen for inserting a guidewire or another treatment tool, or a lumen for passing a drug, a contrast agent, or any fluid may also be disposed in the internal lumen of the tube 32.

[0019] The handle 1 is provided on the proximal side of the tube 32, and when assembled into a catheter, the proximal end of a wire disposed in the lumen of the tube 32 is connected to the handle 1.

[0020] The catheter handle will be described in detail with reference to Figures 2 to 4, 9, and 10. Figures 2 to 4 show an example of the internal structure of a catheter handle provided in the catheter shown in Figure 1, and Figures 9 and 10 show an example of the internal structure of a catheter handle provided in the catheter shown in Figure 8. Figures 2 and 9 show side views of the internal structure of the catheter handle, Figures 3 and 10 show top views of the internal structure of the catheter handle, and Figure 4 shows a cross-sectional view of the internal structure of the catheter handle shown in Figure 2, in which the drive gear, driven gear, and first pulley have been partially removed along the longitudinal direction. Figures 2 to 4, 9, and 10 show the catheter handle in which the handle body and rotation knob, which form the housing of the catheter handle, have been removed along the axial direction to expose the internal structure. The first wire has been omitted from Figure 4. Figure 5 shows an enlarged view of the drive gear and driven gear of the internal structure of the catheter handle shown in Figure 2.

[0021] A handle 1 according to an embodiment of the present invention comprises a handle body 2 having an inner cavity extending in a longitudinal direction x, a rotation knob 3 rotatable relative to the handle body 2 with the longitudinal direction x as its rotation axis, and a shaft 4 disposed in the inner cavity of the handle body 2, extending in the longitudinal direction x, and fixed to the handle body 2. In the handle 1, the longitudinal direction x corresponds to the direction in which the rotation axis of the rotation knob 3 extends, and the proximal side and the distal side are defined as one side and the other side relative to the longitudinal direction x. Furthermore, the radial direction is defined as the direction perpendicular to the longitudinal direction x. In the handle 1 shown in the drawings, the right side of the drawing corresponds to the proximal side, and the left side of the drawing corresponds to the distal side.

[0022] The handle body 2 has an inner cavity extending in the longitudinal direction x. The inner cavity of the handle body 2 is preferably formed in a shape that is long in the longitudinal direction x, and preferably has a portion formed in a cylindrical (columnar) or polygonal prism shape with the longitudinal direction x as its axis.

[0023] The rotation knob 3 is provided to be rotatable relative to the handle body 2 with the longitudinal direction x as the rotation axis. The handle body 2 is preferably open on at least one of the distal and proximal sides, and the rotation knob 3 is disposed on the distal or proximal side of the open handle body 2. In the handle 1 shown in Figures 2 to 4, the distal side of the handle body 2 is open, and the rotation knob 3 is disposed on the distal side of the handle body 2. In the handle 1 shown in Figures 9 and 10, the proximal side of the handle body 2 is open, and the rotation knob 3 is disposed on the proximal side of the handle body 2. In the handle 1, the handle body 2 and the rotation knob 3 are exposed to the outside, and the handle 1 can be operated, for example, by holding the handle body 2 with one hand and holding the rotation knob 3 with the other hand and rotating it relative to the handle body 2. A portion of the rotation knob 3 may be disposed in the inner cavity of the handle body 2.

[0024] The shaft 4 is disposed in the lumen of the handle body 2 so as to extend in the longitudinal direction x. The shaft 4 is fixed to the handle body 2 so as not to rotate or move relative to the handle body 2. The shaft 4 may be formed integrally with the handle body 2. The shaft 4 is preferably disposed at a position that serves as the rotation axis of the rotation knob 3. The shaft 4 is preferably disposed from the handle body 2 to the rotation knob 3 in the longitudinal direction x, and may be disposed so as to extend distally and / or proximally beyond the handle body 2 and the rotation knob 3. Therefore, it is preferable that the rotation knob 3 has a lumen extending in the longitudinal direction x, and the shaft 4 is disposed in this lumen.

[0025] A tube 32 is preferably connected to the distal side of the shaft 4. The connection between the shaft 4 and the tube 32 may be located within the interior space of the handle 1, may be located distal to the interior space of the handle 1, or may be located outside the handle 1. The shaft 4 may be formed integrally with the tube 32.

[0026] The shaft 4 may be solid or hollow. Preferably, the shaft 4 is hollow and its lumen is connected to the lumen of the tube 32. This allows a treatment tool to be delivered to a treatment target area or a drug or contrast agent to be injected from the proximal side of the catheter 31 through the lumen of the shaft 4 and the lumen of the tube 32. Examples of treatment tools include electrode catheters, ablation catheters, mapping catheters, balloon catheters, microcatheters, forceps, laser probes, fiberscopes, high-frequency treatment tools, and electrohydraulic impact fragmentation probes. To allow for the insertion of such treatment tools, the shaft 4 preferably has a proximal opening outside the handle 1. The shaft 4 may have a branch, and a switch cock may be provided at the branch. This allows, for example, separate insertion ports for treatment tools and injection ports for drugs or the like to be provided.

[0027] Inside the handle 1, a drive gear 5 having a rotation axis extending in the longitudinal direction x is provided outside the shaft 4. The drive gear 5 has an engagement portion that engages with a driven gear 7, which will be described later. The drive gear 5 is provided so as to be rotatable in conjunction with the rotation of the rotary knob 3, and by rotating the rotary knob 3, the drive gear 5 can rotate around the longitudinal direction x as its rotation axis, i.e., around the shaft 4 as its rotation axis.

[0028] In the handle 1 shown in the drawings, the drive gear 5 is joined to the rotatable knob 3, thereby allowing the drive gear 5 to rotate around the longitudinal direction x as an axis of rotation in conjunction with the rotation of the rotatable knob 3. Specifically, the drive gear 5 includes a tubular member 6 extending in the longitudinal direction x. The shaft 4 is inserted into the inner cavity of the tubular member 6, and the drive gear 5 is rotatable relative to the shaft 4 around the longitudinal direction x as an axis of rotation. The tubular member 6 is disposed in the inner cavity of the rotatable knob 3 with the shaft 4 inserted into the inner cavity of the tubular member 6, and the tubular member 6 is non-rotatably attached to the rotatable knob 3. This allows the drive gear 5 to rotate together with the rotatable knob 3. The drive gear 5 may be formed integrally with the rotatable knob 3. Although not shown in the drawings, another gear may be provided between the rotatable knob 3 and the drive gear 5, and the drive gear 5 may be configured to rotate in conjunction with the rotation of the rotatable knob 3 via the other gear.

[0029] The handle 1 is provided with a driven gear 7 having a rotation axis extending perpendicular to the longitudinal direction x and having an engagement portion that engages with the drive gear 5. The drive gear 5 and the driven gear 7 are formed so that teeth provided on the engagement portion of the drive gear 5 and teeth provided on the engagement portion of the driven gear 7 engage with each other. By providing the drive gear 5 and the driven gear 7 in this manner, it is possible to convert rotational movement of the drive gear 5 about its rotation axis in the longitudinal direction x into rotational movement of the driven gear 7 about its rotation axis in the direction perpendicular to the longitudinal direction x. The rotational axis of the driven gear 7 is preferably formed so that the shaft 4 exists on its extension. Hereinafter, the rotational axis of the driven gear 7 will be referred to as the "first vertical rotation axis Q1."

[0030] The types of the drive gear 5 and the driven gear 7 are not particularly limited as long as they can be arranged so that their rotation axes intersect perpendicularly. Examples of combinations of the drive gear 5 and the driven gear 7 (more specifically, the combination of the engaging portion of the drive gear 5 and the engaging portion of the driven gear 7) include a combination in which the drive gear 5 is a bevel gear and the driven gear 7 is a bevel gear, a combination in which the drive gear 5 is a spur gear and the driven gear 7 is a crown gear, and a combination in which the drive gear 5 is a crown gear and the driven gear 7 is a spur gear. The gears may be straight gears whose teeth extend parallel to the rotation axis, helical gears whose teeth extend obliquely to the rotation axis, or spiral gears whose teeth are curved. For example, bevel gears may be helical bevel gears, and helical bevel gears are included in the bevel gear category. Spur gears whose teeth do not extend parallel to the rotation axis are also included in the category of spur gears. Figures 5 to 7 show examples of the configuration of the drive gear 5 and the driven gear 7. Figure 5 shows an example in which the drive gear 5 is a bevel gear and the driven gear 7 is a bevel gear, Figure 6 shows an example in which the drive gear 5 is a spur gear and the driven gear 7 is a crown gear, and Figure 7 shows an example in which the drive gear 5 is a crown gear and the driven gear 7 is a spur gear.

[0031] Although the gear ratio of the driven gear 7 to the drive gear 5 is not particularly limited, it is preferable that the gear ratio of the driven gear 7 to the drive gear 5 be greater than 1, since this enables more precise control when the rotary knob 3 is rotated. In other words, it is preferable that the number of rotations of the driven gear 7 per one rotation of the drive gear 5 is less than 1. The gear ratio of the driven gear 7 to the drive gear 5 is more preferably 1.2 or greater, and even more preferably 1.5 or greater. There is no particular upper limit to the gear ratio of the driven gear 7 to the drive gear 5, and it may be, for example, 6.0 or less, 5.0 or less, or 4.0 or less. The gear ratio can be calculated by dividing the number of teeth of the driven gear 7 by the number of teeth of the drive gear 5. Note that, because it is easy to set the gear ratio, the combination of the drive gear 5 and the driven gear 7 is preferably a combination of the drive gear 5 being a bevel gear and the driven gear 7 being a bevel gear, or a combination of the drive gear 5 being a spur gear and the driven gear 7 being a crown gear.

[0032] The driven gear 7 is preferably disposed in the inner cavity of the handle body 2. For example, it is preferable that a first shaft member 8 is provided at a position corresponding to the first vertical rotation axis Q1 of the driven gear 7, and that the first shaft member 8 is fixed to the inner surface of the handle body 2 and / or the shaft 4 in the inner cavity of the handle body 2. In this case, the driven gear 7 is provided rotatable relative to the first shaft member 8. Alternatively, the driven gear 7 may have a shaft portion that rotates integrally with the driven gear 7, and a fitting portion (e.g., a recess) for the shaft portion of the driven gear 7 may be provided on the inner surface of the handle body 2 and / or the shaft 4, and the shaft portion of the driven gear 7 may be fitted into the fitting portion.

[0033] The handle 1 is provided with a first pulley 9, the first pulley 9 having a rotation axis parallel to the first vertical rotation axis Q1, located proximally or distally of the driven gear 7. When the rotation knob 3 is located distally of the handle body 2, as in the handle 1 shown in Figures 2 to 4, the first pulley 9 is preferably located proximally of the driven gear 7. On the other hand, when the rotation knob 3 is located proximally of the handle body 2, as in the handle 1 shown in Figures 9 and 10, the first pulley 9 is preferably located distally of the driven gear 7. The first pulley 9 is preferably located at a position overlapping with the driven gear 7 when viewed from the distal or proximal side of the handle 1. Hereinafter, the rotation axis of the first pulley 9 will be referred to as the "second vertical rotation axis Q2."

[0034] The first pulley 9 is a member that is rotatable about the second vertical rotation axis Q2. It is preferable that the shaft 4 exists on the extension of the second vertical rotation axis Q2. The first pulley 9 is preferably formed in a cylindrical shape with the second vertical rotation axis Q2 as its axis, and more preferably in a disk shape with a short height (for example, a length of 1 / 2 or less of the diameter of the cylindrical circle).

[0035] The first pulley 9 is preferably disposed in the inner cavity of the handle body 2. For example, it is preferable that the second shaft member 10 is provided at a position that corresponds to the second vertical rotation axis Q2 of the first pulley 9, and that the second shaft member 10 is fixed to the inner surface of the handle body 2 and / or the shaft 4 in the inner cavity of the handle body 2. In this case, the first pulley 9 is provided rotatable relative to the second shaft member 10. Alternatively, the first pulley 9 may have a shaft portion that rotates integrally with the first pulley 9, and a fitting portion (e.g., a recess) for the shaft portion of the first pulley 9 may be provided on the inner surface of the handle body 2 and / or the shaft 4, and the shaft portion of the first pulley 9 may be fitted into the fitting portion.

[0036] A first linear member 11 is disposed in the inner cavity of the handle body 2, and is provided in an annular shape, spanning the driven gear 7 and the first pulley 9. Therefore, the driven gear 7 has an abutment portion 7A with which the first linear member 11 abuts around the first vertical rotation axis Q1, and the first pulley 9 has an abutment portion with which the first linear member 11 abuts around the second vertical rotation axis Q2. The first linear member 11 is preferably spanned between the driven gear 7 and the first pulley 9 so as to extend in the longitudinal direction x between them. Furthermore, the first linear member 11 is preferably spanned between the driven gear 7 and the first pulley 9 under tension.

[0037] In the driven gear 7, the abutment portion 7A is preferably formed at a position offset from the engagement portion that engages with the drive gear 5 in the extension direction of the first vertical rotation axis Q1. In the driven gear 7, the engagement portion is preferably formed closer to the shaft 4 than the abutment portion 7A, which prevents the first linear member 11 from being caught in the engagement portion of the drive gear 5 or the engagement portion of the driven gear 7 when the drive gear 5 and the driven gear 7 rotate. In particular, when the engagement portion of the driven gear 7 is a bevel gear or a crown gear, it is preferable that the engagement portion of the driven gear 7 be located closer to the shaft 4 than the abutment portion 7A.

[0038] The driven gear 7 is preferably formed in a cylindrical shape with the first vertical rotation axis Q1 as its axis at the portion where the abutment portion 7A is formed, and a groove is preferably formed on the circumferential surface of the cylindrical shape, and this groove serves as the abutment portion 7A of the first linear member 11. As described above, the first pulley 9 is preferably formed in a cylindrical or disc shape with the second vertical rotation axis Q2 as its axis, and a groove is preferably formed on the circumferential surface of the cylindrical or disc shape, and this groove serves as the abutment portion of the first linear member 11.

[0039] The first linear member 11, which is looped between the driven gear 7 and the first pulley 9, can move while rotating between the driven gear 7 and the first pulley 9 by rotating the rotary knob 3. That is, by rotating the rotary knob 3, the drive gear 5 rotates about its rotation axis in the longitudinal direction x, and the driven gear 7 engaged with the drive gear 5 rotates about the first vertical rotation axis Q1. The first linear member 11 abuts against the abutment portion 7A of the driven gear 7, and moves together with the abutment portion 7A of the driven gear 7 as the driven gear 7 rotates. Because the first linear member 11 is looped between the driven gear 7 and the first pulley 9, when the first linear member 11 moves together with the abutment portion 7A of the driven gear 7, the first linear member 11 moves together with the abutment portion of the first pulley 9 at the abutment portion of the first pulley 9 accordingly. As a result, the first linear member 11, which is looped between the driven gear 7 and the first pulley 9, can move between the driven gear 7 and the first pulley 9 while rotating.

[0040] A first wire 17 and a second wire 18 are disposed in the lumen of the handle body 2. The distal portions of the first wire 17 and the second wire 18 are disposed in the lumen of the tube 32 and the proximal portions thereof are disposed in the lumen of the handle body 2. The distal end of the first wire 17 is preferably fixed to the distal end of the tube 32, and the distal end of the second wire 18 is preferably fixed to the distal end of the tube 32. In this case, by operating the handle 1 to pull the first wire 17 proximally, the distal end of the tube 32 can be bent in one direction, and by operating the handle 1 to pull the second wire 18 proximally, the distal end of the tube 32 can be bent in the other direction. The distal end of the first wire 17 can be defined, for example, as the portion within 100 mm proximally of the distal end of the first wire 17, and the distal end of the second wire 18 can be defined, for example, as the portion within 100 mm proximally of the distal end of the second wire 18. The distal end of the tube 32 can be defined as, for example, the portion within 100 mm proximal to the distal end of the tube 32 .

[0041] The proximal portions of the first wire 17 and the second wire 18 preferably extend from the lumen of the shaft 4 or the tube 32 to the outside thereof within the lumen of the handle body 2, and more preferably extend from the lumen of the shaft 4 or the tube 32 to the outside thereof distal to the midpoint between the first vertical rotation axis Q1 of the driven gear 7 and the second vertical rotation axis Q2 of the first pulley 9. When the driven gear 7 is disposed distal to the first pulley 9 as shown in Figures 2 and 3, the proximal portions of the first wire 17 and the second wire 18 preferably extend from the lumen of the shaft 4 or the tube 32 to the outside thereof proximal to the drive gear 5. On the other hand, when the first pulley 9 is positioned distal to the driven gear 7 as shown in Figures 9 and 10, the proximal portions of the first wire 17 and the second wire 18 may extend outward from the inner cavity of the shaft 4 or the tube 32 proximal to the second vertical rotation axis Q2 of the first pulley 9, or may extend outward from the inner cavity of the shaft 4 or the tube 32 distal to the second vertical rotation axis Q2 of the first pulley 9.

[0042] In the lumen of the handle body 2, the proximal portion of the first wire 17 and the proximal portion of the second wire 18 are each fixed to the first linear member 11. More specifically, in the lumen of the handle body 2, when an imaginary plane is imagined to be formed by the extension direction of the shaft 4 and the extension direction of the first vertical rotation axis Q1, the proximal portion of the first wire 17 is fixed to a portion of the annular first linear member 11 between the driven gear 7 and the first pulley 9, on one side of the imaginary plane, and the proximal portion of the second wire 18 is fixed to a portion of the annular first linear member 11 between the driven gear 7 and the first pulley 9, on the other side of the imaginary plane. For example, in a state in which the first linear member 11 can be seen in a ring shape as shown in Figures 3 and 10, the proximal portion of the first wire 17 is fixed to a part of the first linear member 11 on one side of the shaft 4, and the proximal portion of the second wire 18 is fixed to a part of the first linear member 11 on the other side of the shaft 4.

[0043] The proximal portion of the first wire 17 and the proximal portion of the second wire 18 may be fixed directly to the first linear member 11, or as shown in the drawings, the proximal portion of the first wire 17 may be fixed to a first fixture 19 attached to the first linear member 11, and the proximal portion of the second wire 18 may be fixed to a second fixture 20 attached to the first linear member 11. Methods for fixing the first wire 17 and the second wire 18 to the first linear member 11, the first wire 17 to the first fixture 19, the second wire 18 to the second fixture 20, and the first fixture 19 and the second fixture 20 to the first linear member 11 include bonding with an adhesive, welding, tying, fitting, crimping, screwing, etc.

[0044] The handle 1 configured as described above can pull the first wire 17 proximally or the second wire 18 proximally by rotating the rotation knob 3. When the rotation knob 3 is rotated, the first linear member 11 moves while rotating between the driven gear 7 and the first pulley 9. As a result, when one portion of the first linear member 11 moves proximally relative to the shaft 4, the other portion moves distally relative to the shaft 4, and conversely, when one portion moves distally relative to the shaft 4, the other portion moves proximally relative to the shaft 4. Therefore, when the rotation knob 3 is rotated in one direction (counterclockwise as viewed from the proximal side in FIGS. 2 and 3, and clockwise as viewed from the proximal side in FIGS. 9 and 10), one portion of the first linear member 11 moves proximally relative to the shaft 4, and the first wire 17 fixed to that portion can be pulled proximally, and when the rotation knob 3 is rotated in the other direction (clockwise as viewed from the proximal side in FIGS. 2 and 3, and counterclockwise as viewed from the proximal side in FIGS. 9 and 10), the other portion of the first linear member 11 moves proximally relative to the shaft 4, and the second wire 18 fixed to that portion can be pulled proximally. As a result, for example, it is possible to control the bending of the distal end of the tube 32.

[0045] It is preferable that the fixed portion of the first wire 17 to the first linear member 11 is always located on one side of the shaft 4 (i.e., the virtual plane described above) regardless of the rotation of the rotary knob 3. It is preferable that the fixed portion of the second wire 18 to the first linear member 11 is always located on the other side of the shaft 4 (i.e., the virtual plane described above) regardless of the rotation of the rotary knob 3. When the first wire 17 is fixed to the first fixture 19, it is preferable that the first fixture 19 is always located on one side of the shaft 4 (i.e., the virtual plane described above) regardless of the rotation of the rotary knob 3. When the second wire 18 is fixed to the second fixture 20, it is preferable that the second fixture 20 is always located on the other side of the shaft 4 (i.e., the virtual plane described above) regardless of the rotation of the rotary knob 3. Note that, from the viewpoint of ease of control of the first linear member 11, it is preferable that the first wire 17 is fixed to the first fixture 19 and the second wire 18 is fixed to the second fixture 20. By attaching the first fastener 19 and the second fastener 20 to the first linear member 11, even if the rotation knob 3 continues to be turned in one direction or the other, the first fastener 19 or the second fastener 20 gets caught on the driven gear 7 or the first pulley 9, preventing the rotation knob 3 from rotating any further in one direction or the other. Therefore, the proximal portions of the first fastener 19 and the first wire 17 are always located on one side of the shaft 4, and the proximal portions of the second fastener 20 and the second wire 18 are always located on the other side of the shaft 4.

[0046] The first linear member 11, the first wire 17, and the second wire 18 may be made of metal wires such as stainless steel, carbon steel, or nickel-titanium alloy, or resin wires (i.e., fiber materials) made of synthetic resins such as polyamide resins (e.g., nylon), polyolefin resins (e.g., polyethylene or polypropylene), polyester resins (e.g., PET), aromatic polyether ketone resins (e.g., PEEK), polyimide resins, aromatic polyamide resins (e.g., aramid), or fluororesins (e.g., PTFE, PFA, FEP, ETFE). These metal wires and resin wires may have a monofilament structure or a multifilament structure. The first linear member 11, the first wire 17, and the second wire 18 may be covered by a cylindrical body made of a coil-shaped metal or synthetic resin. The diameters of the first linear member 11, the first wire 17, and the second wire 18 may be, for example, approximately 100 μm to 1500 μm.

[0047] The first linear member 11 is preferably made of a rope. This ensures the strength of the first linear member 11 while facilitating smooth bending of the first linear member 11 at the abutting portion 7A of the driven gear 7 or the abutting portion of the first pulley 9. The rope may be a fiber rope made of a fiber material or a wire rope made of a metal material, but a fiber rope is preferable. This allows the first linear member 11 to bend smoothly. The fiber rope is preferably made of a high-strength fiber material to prevent breakage, and is preferably made of so-called super fiber. Examples of super fiber include aramid fiber, ultra-high molecular weight polyethylene fiber, polyarylate fiber, ultra-high strength polyvinyl alcohol fiber, polyparaphenylene benzobisoxazole (PBO) fiber, and polyphenylene sulfide (PPS) fiber. The super fiber preferably has a tensile strength of 1 GPa or more, preferably 2 GPa or more, and an elastic modulus of 25 GPa or more, preferably 50 GPa or more.

[0048] 11 to 14, in order to ensure that the first fixture 19 and the second fixture 20 are stably fixed to the first linear member 11 and that the first wire 17 fixed to the first fixture 19 and the second wire 18 fixed to the second fixture 20 are stably pulled proximally, it is preferable that the handle 1 further includes a second pulley 12 and a third pulley 14 having rotation axes parallel to the first vertical rotation axis Q1, that a second linear member 16 is provided that spans the second pulley 12 and the third pulley 14 in an annular shape, and that the first fixture 19 and the second fixture 20 are attached so as to straddle the first linear member 11 and the second linear member 16, respectively. Figures 11 and 12 show other examples of the internal structure of the catheter handle provided in the catheter shown in Figure 1, and Figures 11 and 12 show different examples of the structure. Figures 13 and 14 show other examples of the internal structure of the catheter handle provided in the catheter shown in Figure 8, and Figures 13 and 14 show different examples of the structure. The handle 1 shown in Figures 11 to 14 will be described in detail below. Note that in the following, explanations of parts that overlap with those described above will be omitted.

[0049] The handle 1 preferably further includes a second pulley 12 having a rotation axis (hereinafter referred to as the "third vertical rotation axis Q3") parallel to the first vertical rotation axis Q1, and a third pulley 14 having a rotation axis (hereinafter referred to as the "fourth vertical rotation axis Q4") parallel to the third vertical rotation axis Q3, located proximal or distal to the second pulley 12. In FIGS. 11 and 12, the third pulley 14 is disposed proximal to the second pulley 12, while in FIGS. 13 and 14, the third pulley 14 is disposed distal to the second pulley 12. When the first pulley 9 is disposed proximal to the driven gear 7 as shown in FIGS. 11 and 12, the third pulley 14 is disposed proximal to the second pulley 12. When the first pulley 9 is disposed distal to the driven gear 7 as shown in FIGS. 13 and 14, the third pulley 14 is disposed distal to the second pulley 12.

[0050] The second pulley 12 is a member rotatable about the third vertical rotation axis Q3, and the third pulley 14 is a member rotatable about the fourth vertical rotation axis Q4. It is preferable that the shaft 4 exists on the extensions of the third vertical rotation axis Q3 and the fourth vertical rotation axis Q4. The second pulley 12 and the third pulley 14 are preferably formed in a cylindrical shape with the third vertical rotation axis Q3 or the fourth vertical rotation axis Q4 as their axis, and more preferably formed in a disk shape with a short height (for example, a length equal to or less than half the diameter of the cylindrical circle).

[0051] The second pulley 12 and the third pulley 14 are preferably arranged in positions where they overlap each other when viewed from the distal or proximal side of the handle 1. In addition, the second pulley 12 and the third pulley 14 are preferably arranged on the opposite side of the shaft 4 from the driven gear 7 and the first pulley 9.

[0052] The second pulley 12 is preferably disposed in the inner cavity of the handle body 2. For example, it is preferable that a third shaft member 13 is provided at a position corresponding to the third vertical rotation axis Q3 of the second pulley 12, and that the third shaft member 13 is fixed to the inner surface of the handle body 2 and / or the shaft 4 in the inner cavity of the handle body 2. In this case, the second pulley 12 is provided rotatable relative to the third shaft member 13. Alternatively, the second pulley 12 may have a shaft portion that rotates integrally with the second pulley 12, and a fitting portion (e.g., a recess) for the shaft portion of the second pulley 12 may be provided on the inner surface of the handle body 2 and / or the shaft 4, and the shaft portion of the second pulley 12 may be fitted into the fitting portion.

[0053] The third pulley 14 is preferably disposed in the inner cavity of the handle body 2. For example, it is preferable that a fourth shaft member 15 is provided at a position corresponding to the fourth vertical rotation axis Q4 of the third pulley 14, and that the fourth shaft member 15 is fixed to the inner surface of the handle body 2 and / or the shaft 4 in the inner cavity of the handle body 2. In this case, the third pulley 14 is provided rotatable relative to the fourth shaft member 15. Alternatively, the third pulley 14 may have a shaft portion that rotates integrally with the third pulley 14, and a fitting portion (e.g., a recess) for the shaft portion of the third pulley 14 may be provided on the inner surface of the handle body 2 and / or the shaft 4, and the shaft portion of the second pulley 12 may be fitted into this fitting portion.

[0054] The third vertical rotation axis Q3 of the second pulley 12 may be an extension of the first vertical rotation axis Q1 of the driven gear 7, or may be located closer to or closer to the first vertical rotation axis Q1 of the driven gear 7. The fourth vertical rotation axis Q4 of the third pulley 14 may be an extension of the second vertical rotation axis Q2 of the first pulley 9, or may be located closer to or closer to the second vertical rotation axis Q2 of the first pulley 9.

[0055] A second linear member 16 is disposed within the bore of the handle body 2, and is provided in an annular shape, spanning the second pulley 12 and the third pulley 14. Accordingly, the second pulley 12 has an abutment portion with which the second linear member 16 abuts around the third vertical rotation axis Q3, and the fourth pulley has an abutment portion with which the second linear member 16 abuts around the fourth vertical rotation axis Q4. The second pulley 12 and the third pulley 14 are preferably formed in a cylindrical or disc shape, with grooves formed on their circumferential surfaces, and the grooves serve as abutment portions for the second linear member 16. The second linear member 16 is preferably spanned between the second pulley 12 and the third pulley 14 so as to extend in the longitudinal direction x between them. Moreover, the second linear member 16 is preferably stretched between the second pulley 12 and the third pulley 14 in a tensioned state.

[0056] After the second pulley 12, the third pulley 14, and the second linear member 16 are provided as described above, it is preferable that the first fixing device 19 and the second fixing device 20 are attached so as to straddle the first linear member 11 and the second linear member 16, respectively. Specifically, assuming an imaginary plane formed by the extension direction of the shaft 4 and the extension direction of the first vertical rotation axis Q1, it is preferable that the first fixture 19 be attached to a portion of the annular first linear member 11 between the driven gear 7 and the first pulley 9 on one side of the imaginary plane and a portion of the annular second linear member 16 between the second pulley 12 and the third pulley 14 on one side of the imaginary plane, and the second fixture 20 be attached to a portion of the annular first linear member 11 between the driven gear 7 and the first pulley 9 on the other side of the imaginary plane and a portion of the annular second linear member 16 between the second pulley 12 and the third pulley 14 on the other side of the imaginary plane. This allows the first fixture 19 and the second fixture 20 to be stably fixed to the first linear member 11 and the second linear member 16. In this manner, it is preferable that the proximal portion of first wire 17 and the proximal portion of second wire 18 are fixed to first fixture 19 and second fixture 20, respectively, attached to first linear member 11 and second linear member 16. For the method of fixing first fixture 19 and second fixture 20 to second linear member 16, refer to the above description of the method of fixing first fixture 19 and second fixture 20 to first linear member 11.

[0057] In the handle 1 configured as described above, by rotating the rotary knob 3, the second linear member 16 can move while rotating in conjunction with the first linear member 11 between the second pulley 12 and the third pulley 14. That is, when the rotary knob 3 is rotated, the first linear member 11 moves while rotating between the driven gear 7 and the first pulley 9, and further, the first fastener 19 and the second fastener 20 are fixed to the first linear member 11 and the second linear member 16, respectively, so that the second linear member 16 can move while rotating between the second pulley 12 and the third pulley 14. As a result, when the rotary knob 3 is rotated, the first wire 17 fixed to the first fastener 19 and the second wire 18 fixed to the second fastener 20 are stably pulled proximally.

[0058] In one embodiment, as shown in FIGS. 11 and 13, the third vertical rotation axis Q3 of the second pulley 12 is preferably located on an extension of the first vertical rotation axis Q1 of the driven gear 7, and the fourth vertical rotation axis Q4 of the third pulley 14 is preferably located on an extension of the second vertical rotation axis Q2 of the first pulley 9. In this case, the first shaft member 8 of the driven gear 7 and the third shaft member 13 of the second pulley 12 can be made to be a common member, and the first shaft member 8 and the third shaft member 13 can be constructed from a single member. Furthermore, the second shaft member 10 of the first pulley 9 and the fourth shaft member 15 of the third pulley 14 can be made to be a common member, and the second shaft member 10 and the fourth shaft member 15 can be constructed from a single member. This reduces the number of parts in the handle 1, making it easier to manufacture the handle 1.

[0059] 12 , it is also preferable that the first pulley 9 is disposed proximal to the driven gear 7, and the third vertical rotation axis Q3 of the second pulley 12 is disposed proximal to the first vertical rotation axis Q1 of the driven gear 7. In this case, the second pulley 12 disposed proximal to the driven gear 7 prevents the first fastener 19 and the second fastener 20 from moving proximally to the second pulley 12, preventing the first fastener 19 and the second fastener 20 from becoming entangled in the driven gear 7. This prevents damage to the driven gear 7 and the first fastener 19 and the second fastener 20.

[0060] In the above case, the proximal portions of the first wire 17 and the second wire 18 preferably extend outward from the lumen of the shaft 4 or the tube 32 proximal to the drive gear 5 and distal to the third vertical rotation axis Q3 of the second pulley 12. With the handle 1 configured in this manner, even when the rotation knob 3 is rotated to move the first fastener 19 from its most distal position to the proximal side, the first wire 17 can be smoothly pulled proximally, and even when the rotation knob 3 is rotated to move the second fastener 20 from its most distal position to the proximal side, the second wire 18 can be smoothly pulled proximally.

[0061] 14 , it is also preferable that the first pulley 9 is disposed distally of the driven gear 7, and the third vertical rotation axis Q3 of the second pulley 12 is disposed distally of the first vertical rotation axis Q1 of the driven gear 7. In this case, the second pulley 12 disposed distally of the driven gear 7 prevents the first fastener 19 and the second fastener 20 from moving distally of the second pulley 12, preventing the first fastener 19 and the second fastener 20 from becoming entangled in the driven gear 7. This prevents damage to the driven gear 7 and the first fastener 19 and the second fastener 20.

[0062] 9, 10, 13, and 14, when the first pulley 9 is positioned distal to the driven gear 7, the proximal portions of the first wire 17 and the second wire 18 preferably extend from the lumen of the shaft 4 or the tube 32 distal to the second vertical rotation axis Q2 of the first pulley 9 (or further distal to the third vertical rotation axis Q4 of the second pulley 14). The handle 1 configured in this manner can smoothly pull the first wire 17 proximally even when the rotation knob 3 is rotated to move the first fastener 19 from its most distal position to the proximal side, and can smoothly pull the second wire 18 proximally even when the rotation knob 3 is rotated to move the second fastener 20 from its most distal position to the proximal side.

[0063] The catheter handle of the present invention has been described above, but the catheter handle of the present invention is not limited to one that controls the bending of the distal end of the tube, as long as it displaces the first wire and the second wire distally or proximally within the lumen of the tube. For example, the catheter handle may be one that allows the first wire and / or the second wire to be inserted and removed from the distal end of the tube by operating the catheter handle. Alternatively, the catheter handle may be one in which a treatment tool such as a knife or snare is attached to the distal end of the first wire or the distal end of the second wire, and the treatment tool attached to the distal end of the first wire or the distal end of the second wire can be inserted and removed from the distal end of the tube by operating the catheter handle. [Explanation of symbols]

[0064] 1: Catheter handle 2: Handle body 3: Rotary knob 4: Shaft 5: Drive gear 6: Cylindrical member 7: driven gear, 7A: contact part 8:First shaft member 9: First pulley 10:Second shaft member 11: First linear member 12: Second pulley 13:Third shaft member 14: 3rd pulley 15: 4th shaft member 16: Second linear member 17: First wire 18: Second wire 19:First fixture 20:Second fixture Q1: First vertical rotation axis Q2: 2nd vertical rotation axis Q3: 3rd vertical rotation axis Q4: 4th vertical rotation axis 31: Catheter 32: Tube

Claims

1. A handle for manipulating a catheter tube, a handle body having a longitudinally extending lumen; a rotation knob provided rotatably with respect to the handle body with the longitudinal direction as a rotation axis; a first linear member disposed in an inner cavity of the handle body; a first wire having a distal portion disposed within the lumen of the tube and a proximal portion disposed within the lumen of the handle body; a second wire having a distal portion disposed within the lumen of the tube and a proximal portion disposed within the lumen of the handle body; a shaft disposed within a lumen of the handle body, extending in the longitudinal direction, and fixed to the handle body; a drive gear disposed outside the shaft, having a rotation axis extending in the longitudinal direction, and rotatable in conjunction with rotation of the rotary knob; a driven gear having a rotation axis (hereinafter referred to as a "first vertical rotation axis") extending in a direction perpendicular to the longitudinal direction, the driven gear having an engagement portion that engages with the drive gear and an abutment portion that the first linear member abuts around the first vertical rotation axis; a first pulley that is disposed proximal or distal to the driven gear, has a rotation axis (hereinafter referred to as a "second vertical rotation axis") that is parallel to the first vertical rotation axis, and has an abutment portion around the second vertical rotation axis with which the first linear member abuts; the first linear member is provided in an annular shape and extends between the driven gear and the first pulley, a proximal portion of the first wire is fixed to a portion of the annular first linear member between the driven gear and the first pulley, the proximal portion being on one side of an imaginary plane formed by an extension direction of the shaft and an extension direction of the first vertical rotation axis; A catheter handle in which the proximal portion of the second wire is fixed to the portion of the annular first linear member between the driven gear and the first pulley, on the other side of the imaginary plane.

2. a first fixture attached to a portion of the annular first linear member between the driven gear and the first pulley, the portion being on the one side with respect to the imaginary plane; a second fixture attached to a portion of the annular first linear member between the driven gear and the first pulley, the second fixture being attached to the other side of the imaginary plane; a proximal portion of the first wire is fixed to the first fixture; The catheter handle of claim 1 , wherein a proximal portion of the second wire is fixed to the second fixture.

3. a second linear member disposed in the inner cavity of the handle body; a second pulley having a rotation axis (hereinafter referred to as a "third vertical rotation axis") parallel to the first vertical rotation axis and having an abutment portion around the third vertical rotation axis with which the second linear member abuts; a third pulley that is disposed proximally or distally of the second pulley, has a rotation axis (hereinafter referred to as a "fourth vertical rotation axis") parallel to the third vertical rotation axis, and has an abutment portion around the fourth vertical rotation axis with which the second linear member abuts; the second linear member is provided in a circular shape and spans the second pulley and the third pulley, the first fixing device is attached to a portion of the annular first linear member between the driven gear and the first pulley, the portion being on the one side of the imaginary plane, and to a portion of the annular second linear member between the second pulley and the third pulley, the portion being on the one side of the imaginary plane, 3. The catheter handle according to claim 2, wherein the second fixing device is attached to a portion of the first annular linear member between the driven gear and the first pulley, the portion being on the other side of the imaginary plane, and a portion of the second annular linear member between the second pulley and the third pulley, the portion being on the other side of the imaginary plane.

4. the third vertical rotation axis is on an extension of the first vertical rotation axis, 4. The catheter handle according to claim 3, wherein the fourth vertical axis of rotation is an extension of the second vertical axis of rotation.

5. 5. The catheter handle according to claim 1, wherein the gear ratio of the driven gear to the drive gear is greater than 1.

6. A catheter handle according to any one of claims 1 to 5; and a tube disposed distal to the catheter handle.

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