Medical Devices

Abstract

To provide a medical care device having a simple and compact constitution and being excellent in operability and convenience.SOLUTION: An operation mechanism is constituted while including: a holdable case being coupled to a long member; an operation member having a turning operation plate turnably arranged to the case; an operation transmission member provided between the turning operation plate and operation wires at a near end side of a long member, moves the operation wires in opposite directions with each other in the axial directions of the operation wires in response to the turning of the turning operation plate, and generates tension to at least one of operation wires; and operation plate contact walls 41 and 42 which are arranged to positions relatively fixed to the case, being brought into slidably contact to an outer peripheral surface of the turning operation plate, and turnably hold the turning operation plate. The operation plate contact walls 41 and 42 include stopper surfaces 41a, 41b, 42a, and 42b which are brought int friction contact to an outer peripheral surface of turning operation plate receiving the tension of at least one operation wire via the operation transmission member, and restricts the turning of the turning operation plate.SELECTED DRAWING: Figure 5

Description

[Technical Field]

[0001] The present invention relates to a medical device that has an elongated member that is inserted into the body and is capable of deflecting an operated portion provided at the distal end of the elongated member, and in particular to a medical device such as an endoscope or catheter that has an elongated member that is inserted into the body. [Background technology]

[0002] In conventional minimally invasive medical procedures, medical devices such as endoscopes and catheters equipped with elongated members suitable for insertion into the body and passing through a body lumen are used. The elongated members are generally made of thin, flexible members, and are configured to enable various treatments, examinations, and the like to be performed by inserting the elongated members into a body lumen from outside the body and allowing their distal ends to reach desired locations inside the body.

[0003] Conventionally, a technique has been known in which a bendable manipulated portion is provided at the distal end of an elongated member, and the manipulated portion inserted into the body can be deflected by manipulation by a surgeon outside the body.

[0004] Patent Document 1 describes an esophageal temperature measurement catheter with a compact handle, with the length from the rotating plate's axis of rotation to the base end of the handle being 2 to 11 cm, allowing the base end of the handle to be pressed against the palm of the hand to fix it, and enabling the tip of the catheter shaft to be deflected with one hand, thereby improving operability.

[0005] Patent document 2 describes a catheter handle for a catheter, which includes a gripping portion, an actuator that can be moved bidirectionally laterally from a neutral position relative to the gripping portion, and an automatic locking mechanism that has a single operating state that generates a sufficient and predetermined force to hold the actuator in any position to which it has been moved, and has no other operating states. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] Japanese Patent Application Publication No. 2018-68744 [Patent Document 2] Patent No. 5944331 Summary of the Invention [Problem to be solved by the invention]

[0007] The technology described in Patent Document 1 achieves a lightweight handle by making the handle body more compact, and after the position of the flexible tip portion of the catheter is fixed, the handle is less likely to move when placed on the patient's body. However, there is a problem in that the direction of the flexible tip portion can easily change if force is applied to the flexible tip portion inside the body or if the handle is operated due to unexpected contact.

[0008] On the other hand, the technology described in Patent Document 2 is provided with an automatic locking mechanism that holds an actuator that deflects the distal end of a catheter at a position set by an operator. The automatic locking mechanism described in Patent Document 2 is configured with washers, bushings, screws, etc., and the screws are tightened so that a predetermined tension is generated in the operating wire, and also includes tensioning members such as Belleville washers and springs, which poses a problem in that it requires a complex combination of multiple parts.

[0009] The present invention has been made in view of the above problems, and has an object to provide a medical device that has a simple and compact configuration and is easy to operate and convenient. [Means for solving the problem]

[0010] In order to achieve the above object, the medical device according to the present invention includes: an elongated member having a bendable operated portion disposed on a distal end side thereof; an operating mechanism coupled to a proximal end side of the elongated member; A medical device comprising: first and second operating wires attached to the elongated member and interposed between the operated portion and the operating mechanism so as to be capable of transmitting operation; The operating mechanism includes: a graspable case connected to the elongated member; an operating member having a rotating operating plate arranged rotatably with respect to the case; an operation transmission member interposed between the rotary operation plate and the first and second operation wires on the proximal end side of the elongated member, which moves the first and second operation wires in opposite axial directions in response to rotation of the rotary operation plate and generates tension in at least one of the operation wires; an operation plate contact wall portion that is provided at a position fixed relatively to the case, that slidably contacts the outer peripheral surface of the rotating operation plate, and that rotatably holds the rotating operation plate; The operation plate contact wall portion is characterized by having a stopper surface that frictionally contacts the outer peripheral surface of the rotating operation plate, which receives tension from at least one of the operating wires via the operation transmission member, to limit the rotation of the rotating operation plate.

[0011] According to the above configuration, in a configuration capable of converting the rotational movement of the rotary operation plate into the forward and backward movement of the first and second operating wires, the positions of the rotary operation plate and the first and second operating wires can be maintained by the stopper surface that is in frictional contact with the outer peripheral surface of the rotary operation plate, and a medical device with excellent operability and convenience can be provided. In particular, the medical device according to the present invention is excellent in operability when bending the operated part arranged on the distal end side of an elongated member that constitutes an endoscope, catheter, etc. in a desired deflection direction and fixing the deflection direction of the operated part.

[0012] In the medical device according to the present invention, the operation member has a pair of handles provided so as to protrude radially on both sides of the rotation center of the rotation operation plate, When rotating the operating member, the rotation restriction state of the rotating operating plate may be released by operating the handle of the first or second operating wire that retracts the proximal end portion proximally in the retracting direction.

[0013] According to the above configuration, by operating the handle of the operating member with one hand, it is easy to release the state in which the positions of the rotating operating plate and the first and second operating wires are maintained and to resume operation.

[0014] In the medical device of the present invention, when the operation of the handle in the retracting direction is released, the stopper surface may come into frictional contact with the outer peripheral surface of the rotating operation plate on the side where the proximal end of the first and second operating wires was retracted proximally, thereby restricting the rotation of the rotating operation plate.

[0015] According to the above configuration, when the operation of the handle operated with one hand in the retracting direction is released, the operating position at that time can be reliably maintained.

[0016] In the medical device according to the present invention, the stopper surface of the operation plate contact wall may be disposed at a position where it is pressed by the rotating operation plate that is subjected to tension from at least one of the operation wires.

[0017] According to the above configuration, when the operation of the handle operated with one hand in the retracting direction is released, the tension of at least one of the operating wires presses the rotating operation plate toward the stopper surface, causing the stopper surface to come into frictional contact with the outer peripheral surface of the rotating operation plate, thereby reliably maintaining the operating position at that time.

[0018] The medical device of the present invention may have a pair of stopper surfaces arranged at symmetrical positions with respect to a plane that includes a rotation axis passing through the rotation center of the rotating operation plate and extends in the axial direction of the first and second operating wires.

[0019] According to the above configuration, a pair of stopper surfaces are provided at positions symmetrical to the rotating operation plate, and even if the rotating operation plate attempts to rotate in either one or the other rotation direction due to tension of at least one of the first and second operating wires, the pair of stopper surfaces can restrict the rotation, thereby reliably maintaining the operating position.

[0020] In the medical device according to the present invention, the outer peripheral surface of the rotating operation plate and the stopper surface of the operation plate contact wall may be inclined with respect to a rotation peripheral surface parallel to the rotation axis of the rotating operation plate.

[0021] According to the above configuration, by inclining the contact surface between the outer peripheral surface of the rotating operation plate and the stopper surface, the direction of force and the contact area at the contact surface can be effectively controlled, and the frictional resistance of the stopper surface against the outer peripheral surface of the rotating operation plate can be increased, thereby enhancing the stopper effect.

[0022] In the medical device according to the present invention, the width in the plate thickness direction of the outer peripheral surface of the rotating operation plate may be equal to the wall surface width of the stopper surface in the same direction.

[0023] According to the above configuration, by increasing the contact area between the outer peripheral surface of the rotating operation plate and the stopper surface, the frictional resistance between the outer peripheral surface of the rotating operation plate and the stopper surface can be increased, thereby improving the stopper effect.

[0024] In the medical device according to the present invention, at least one of the outer circumferential surface of the rotating operation plate and the stopper surface may be processed to have a high coefficient of friction.

[0025] According to the above configuration, by increasing the coefficient of friction of at least one of the outer peripheral surface of the rotary operation plate and the stopper surface, the frictional resistance between the outer peripheral surface of the rotary operation plate and the stopper surface can be increased, thereby improving the stopper effect.

[0026] In the medical device according to the present invention, the operating member has a rib-shaped or groove-shaped rotating cam provided on the plate surface of the rotating operation plate, The operation transmission member is configured to include first and second follower members that are movable relative to the case in the axial direction of the first and second operation wires, are arranged spaced apart on both sides of the rotation center of the rotary operation plate, and engage with the rotary cam, The first and second follower members engaged with the rotary cam may move in opposite directions in response to rotation of the rotary operation plate, thereby moving the first and second operating wires in opposite axial directions.

[0027] According to the above configuration, the rotational movement of the rotary operating plate can be converted into the forward and backward movement of the first and second follower members and the first and second operating wires with a simple and compact configuration, and there is no need to significantly bend or fold the first and second operating wires in order to operate them in the axial direction, making it possible to provide a medical device that is easy to operate and convenient.

[0028] The medical device of the present invention may be configured so that the dimensions are set to form a clearance of a predetermined value or more between the outer peripheral surface of the rotating operation plate and the stopper surface, and so that by operating the operating member to move the rotating operation plate in the direction of retraction into the case, the state in which the outer peripheral surface of the rotating operation plate is in frictional contact with the stopper surface is released, thereby allowing the rotating operation plate to rotate.

[0029] According to the above configuration, the outer peripheral surface of the rotating operation plate is in frictional contact with the stopper surface, and by operating the handle to shift the position of the rotating operation plate in the retraction direction, this frictional contact state can be released, and by stopping the handle operation, the stopper surface can again come into frictional contact with the outer peripheral surface of the rotating operation plate, thereby fixing its position. [Brief explanation of the drawings]

[0030] [Figure 1] 1 is a schematic diagram illustrating the configuration of an endoscope, which is an example of a medical device according to the present invention. [Figure 2]1A and 1B are diagrams showing the bending action of the operated part of the elongated member in the medical device of the present invention, in which (a) is a diagram showing the state in which the operated part is extended straight without bending, (b) is a diagram showing the state in which the operated part is bent in one direction in the plane, (c) is a diagram showing the state in which the operated part is bent most in one direction in the plane, (d) is a diagram showing the state in which the operated part is bent in the other direction in the plane, and (e) is a diagram showing the state in which the operated part is bent most in the other direction in the plane. [Figure 3] 1 is a perspective view of operation system components contained in a case of an operation mechanism, as viewed from above, in the first embodiment of the present invention. FIG. [Figure 4] FIG. 2 is a perspective view of the operating system components contained in the case of the operating mechanism, as viewed from below, in the first embodiment of the present invention. [Figure 5] 1 is an exploded perspective view of operation system components contained in a case of an operation mechanism as viewed from above in the first embodiment of the present invention. FIG. [Figure 6] FIG. 2 is an exploded perspective view of the operating system components contained in the case of the operating mechanism, as viewed from below, in the first embodiment of the present invention. [Figure 7] FIG. 2 is a partially exploded perspective view of the operating system components contained in the case of the operating mechanism, as viewed from below, in the first embodiment of the present invention. [Figure 8] FIG. 1 is a partially transparent view schematically illustrating the configuration of an operation mechanism from above in the first embodiment of the present invention, showing an initial state in which handles of operation knobs are in symmetrical positions. [Figure 9] FIG. 2 is a partially see-through view schematically illustrating the configuration of the operation mechanism from above in the first embodiment of the present invention, showing a state in which the operation knob is rotated in one direction. [Figure 10] FIG. 2 is a partially see-through view schematically illustrating the configuration of the operation mechanism from above in the first embodiment of the present invention, showing the state after the operation knob has been rotated in one direction. [Figure 11] FIG. 2 is a partially see-through view schematically illustrating the configuration of the operation mechanism from above in the first embodiment of the present invention, showing a state in which the operation knob is rotated in the other direction. [Figure 12]FIG. 2 is a partially see-through view schematically illustrating the configuration of the operation mechanism from above in the first embodiment of the present invention, showing the state after the operation knob has been rotated in the other direction. [Figure 13] FIG. 10 is a perspective view of operating system components contained in a case of an operating mechanism, as viewed from above, in a second embodiment of the present invention. [Figure 14] FIG. 10 is a perspective view of the operating system components contained in the case of the operating mechanism, as viewed from below, in the second embodiment of the present invention. [Figure 15] FIG. 10 is an exploded perspective view of operating system components contained in a case of an operating mechanism, as viewed from above, in a second embodiment of the present invention. [Figure 16] FIG. 10 is an exploded perspective view of the operating system components contained in the case of the operating mechanism, as viewed from below, in the second embodiment of the present invention. [Figure 17] 14 is a partially see-through view schematically illustrating the disk member and follower member shown in FIG. 13. FIG. [Figure 18] 18 is a cross-sectional view of a portion AA in FIG. 17. [Figure 19] 10A and 10B are partial perspective views schematically illustrating the configuration of the operation mechanism from above in a second embodiment of the present invention, in which (a) is an initial state in which the handles of the operation knobs are in symmetrical positions, (b) is a state in which the operation knob has been rotated in one direction, and (c) is a state in which the operation knob has been rotated in the other direction. [Figure 20] 10A and 10B are diagrams showing derivations of stopper surfaces according to the present invention; DETAILED DESCRIPTION OF THE INVENTION

[0031] Hereinafter, embodiments of the present invention will be described with reference to the drawings. In this specification, the inside of the patient's body is defined as the distal side, and the side of the surgeon who is the user of the medical device according to the present invention is defined as the proximal side, with reference to the surgeon. The drawings referred to in this specification are not necessarily to an accurate scale relative to the actual dimensions, and some parts are exaggerated or simplified to schematically illustrate the configuration according to the present invention.

[0032] The medical device according to the present invention is an endoscope, catheter, or the like, equipped with an elongated member, and configured so that an operator can deflectably operate an operated portion disposed on the distal end side of the elongated member. In the following description, the present invention will be described with reference to an example in which the present invention is applied to a single-use endoscope equipped with a tubular member having a lumen as the elongated member, but the present invention is not limited to the configuration described in the present description.

[0033] (Example of endoscope configuration) FIG. 1 is a schematic diagram showing an endoscope 1, which is an example of a medical device according to this embodiment. FIG. 1 illustrates the schematic configuration of the endoscope 1. The endoscope 1 shown in FIG. 1 includes a long tubular member 2 that forms the shaft of the endoscope 1 and an operation mechanism 3 that allows the surgeon to operate the endoscope 1. When the endoscope 1 is in use, various devices can be connected to the operation mechanism 3, such as a controller equipped with an imaging system that receives video signals from an image sensor disposed at the distal end 2 c of the tubular member 2 and outputs images to a monitor, a suction pump that suctions bodily fluids, etc., and an irrigation water control pump that supplies and suctions irrigation water such as saline or a medicinal solution, but these devices are not shown in FIG. 1 . The present invention does not particularly limit the manner in which these various devices are connected to the operation mechanism 3.

[0034] The tubular member 2 is made of a long, thin, flexible tube and is a component that constitutes the shaft of the endoscope 1, which is inserted into a lumen inside the body from outside the body. When an operator performs treatment or examination inside the body, the operator inserts the tubular member 2 from outside the body into a lumen inside the body, and the distal end 2c of the tubular member 2 can reach a desired site inside the body.

[0035] The tubular member 2 has a tubular structure with one or more internal cavities (lumens or channels) formed along its extending direction. For example, an image sensor, an optical output unit, etc. are disposed at the distal end 2c of the tubular member 2, and wiring for transmitting video signals from the image sensor and optical fibers for transmitting light to the optical output unit are inserted into the internal cavity of the tubular member 2, so that operation can be controlled by various devices connected to the operating mechanism 3. Furthermore, the internal cavity of the tubular member 2 may be configured to allow endoscopic treatment tools such as forceps and snares to be inserted therethrough, or to allow fluids such as irrigation water, body fluids, and contrast agents to be passed through.

[0036] The distal end of the tubular member 2 is provided with an operated portion 2a, which is a movable portion that can be bent by an operator using the operating mechanism 3. In this specification, bending includes curving such as bending in an arch shape.

[0037] Two operating wires 4a, 4b are inserted inside the tubular member 2. The two operating wires 4a, 4b are members interposed between the operated portion 2a and the operating mechanism 3 so as to be able to transmit operation. The two operating wires 4a, 4b have rigidity in the axial direction and have pushability for transmitting force from the proximal end to the distal end. As shown in FIGS. 2(a) to 2(e) described below, the distal ends of the two operating wires 4a, 4b are fixed to positions facing each other in the cross-sectional radial direction of the tubular member 2 (i.e., positions on opposite sides of the central axis of the tubular member 2 in the cross section of the tubular member 2) over part or the entirety of the operated portion 2a. Furthermore, as shown in FIGS. 4 and 14 described below, the proximal ends of the two operating wires 4a, 4b are connected to wire connecting portions 35d, 36d of follower members 35, 36 arranged in the operating mechanism 3, respectively.

[0038] In this way, by arranging the two operating wires 4a, 4b between the operating mechanism 3 and the distal end side of the tubular member 2, the two operating wires 4a, 4b are movable in their respective axial directions in conjunction with the sliding of the follower members 35, 36, and the operated portion 2a can be deflected in a desired direction within a plane including the axial directions of the two opposing operating wires 4a, 4b. Note that, in order to efficiently reflect the bending of the two operating wires 4a, 4b in the bending of the operated portion 2a, the two operating wires 4a, 4b are preferably arranged near the circumferential surface of the tubular member 2 away from the central axis of the tubular member 2. Furthermore, in this embodiment, the two operating wires 4a, 4b are attached by being inserted into the interior (lumen) of the tubular member 2, but the method of attaching the operating wires 4a, 4b is not limited to this, and for example, the operating wires 4a, 4b may be attached by placing them on the outside of the tubular member 2 so as to run along it, and fixing the distal end sides of the operating wires 4a, 4b to the distal end side of the tubular member 2.

[0039] The tubular member 2 is preferably set to dimensions suitable for treatment, examination, etc. within the body, and is not particularly limited, but for example, the cross-sectional diameter dimension can be about 2 to 20 mm, and the axial dimension can be about 20 to 200 cm. The range of the operated portion 2a can be set appropriately depending on the target site for treatment or examination within the body, and is not particularly limited, but for example, it can be in the range of about 2 to 10 cm from the distal end 2c of the tubular member 2.

[0040] The material of the tubular member 2 is preferably a material that gives the tubular member 2 flexibility and is not harmful to the human body, and is not particularly limited, but may be, for example, a biocompatible polymer material such as polyurethane, polyethylene, polypropylene, etc. Furthermore, the operated portion 2a and the intermediate portion 2b (the tubular member 2 proximal to the operated portion 2a) may be made of the same material.

[0041] The operated portion 2a arranged on the distal end side of the tubular member 2 preferably has higher flexibility than the intermediate portion 2b of the tubular member 2. The intermediate portion 2b of the tubular member 2 preferably can flexibly deform to fit the internal lumen, while the operated portion 2a preferably can flexibly bend by manipulation by the surgeon. In particular, when the surgeon performs manipulation using the manipulation mechanism 3, it is preferable that the intermediate portion 2b of the tubular member 2 does not bend in conjunction with the manipulation, and only the operated portion 2a arranged on the distal end side of the tubular member 2 can be deflected in conjunction with the manipulation.

[0042] An operating mechanism 3 is connected to the proximal end of the tubular member 2. The operating mechanism 3 is disposed outside the body when the surgeon performs treatment, examination, etc. inside the body, and is configured with a case (housing) 3a that can be held by the surgeon. In this embodiment, the surgeon can operate an operating knob 31 provided on the operating mechanism 3 while holding the case 3a with one hand.

[0043] The case 3a has a shape and dimensions that allow it to be held by the surgeon. The material of the case 3a is not particularly limited, but is preferably a lightweight and durable material, and may be, for example, a polymer material such as PET.

[0044] As described above, the operation mechanism 3 is capable of being connected to various devices (not shown) and is provided with various ports (e.g., a forceps channel port, a suction port, a water supply port, etc.), cable connectors, etc. FIG. 1 shows, as an example, a forceps channel port 3b, a Y-shaped adapter 3c for simultaneously supplying and suctioning irrigation water, a universal cable 3d, and a cable connector 3e that can be connected to a controller equipped with an imaging system. The various ports, connectors, etc. of the operation mechanism 3 are in communication with the lumen of the tubular member 2 connected to the operation mechanism 3, so that the distal end 2c of the tubular member 2 can be positioned inside the body to perform appropriate treatment, but the present invention is not particularly limited to these configurations.

[0045] (Bending operation of the operated part 2a) The bending operation of the operated portion 2a provided on the distal end side of the tubular member 2 will be described with reference to Figures 2(a) to 2(e). Figures 2(a) to 2(e) are partial enlarged views of the distal end side of the tubular member 2 in the endoscope 1 shown in Figure 1. Figure 2(a) is a diagram showing a state in which the operated portion 2a is extended straight without bending, Figure 2(b) is a diagram showing a state in which the operated portion 2a is bent in one in-plane direction, Figure 2(c) is a diagram showing a state in which the operated portion 2a is bent most in one in-plane direction, Figure 2(d) is a diagram showing a state in which the operated portion 2a is bent in the other in-plane direction, and Figure 2(e) is a diagram showing a state in which the operated portion 2a is bent most in the other in-plane direction.

[0046] Two operating wires 4a, 4b are inserted inside the tubular member 2, and part or all of the two operating wires 4a, 4b are fixed to the operated portion 2a of the tubular member 2. In Figures 2(a) to 2(e), the two operating wires 4a, 4b are fixed at positions facing each other in the cross-sectional radial direction of the tubular member 2, and are illustrated so that the plane including the axial direction of the two opposing operating wires 4a, 4b coincides with the plane of the paper.

[0047] When one operating wire 4a is pushed out distally and the other operating wire 4b is pulled proximally, the operated portion 2a bends toward the side where the operating wire 4b is located (the lower side in FIG. 2(b)), changing the orientation (angle α shown in FIG. 2(b)) of the distal end 2c of the tubular member 2. As shown in FIG. 2(c) as an example, the orientation of the distal end 2c of the tubular member 2 can be bent up to a maximum angle α of 275°.

[0048] Conversely, when one operating wire 4a is pulled proximally and the other operating wire 4b is pushed distally, the operated portion 2a bends toward the side where the operating wire 4a is located (the upper side in FIG. 2(d)), changing the orientation (angle β shown in FIG. 2(d)) of the distal end 2c of the tubular member 2. As an example, as shown in FIG. 2(e), the orientation of the distal end 2c of the tubular member 2 can be bent up to a maximum angle β of 275°.

[0049] (First embodiment) The configuration of the operating mechanism 3 in the first embodiment of the present invention will be described with reference to FIGS. 3 to 7. FIG. 3 is a perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as seen from above, and FIG. 4 is a perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as seen from below. The operating system components are arranged in the case 3a of the operating mechanism 3 in the assembled state shown in FIGS. 3 and 4. FIG. 5 is an exploded perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as seen from above, and FIG. 6 is an exploded perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as seen from below. Furthermore, FIG. 7 is a partially exploded perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as seen from below. For clarity of illustration, only FIG. 4 shows the proximal ends of the two operating wires 4a, 4b, and only FIG. 7 shows the two intermediate wires 50a, 50b.

[0050] In the following explanation, for convenience, the side where the operating knob 31 is located in Figures 3 to 7 will be referred to as the upper side, and the side where the base 37 is located will be referred to as the lower side, but the surgeon can perform operations without being aware of the upper and lower sides.

[0051] The operation mechanism 3 in the first embodiment is configured to include an operation knob 31, a rotation support member 33, a disk member 34, a pair of follower members 35 and 36, and a base portion 37 in a case 3a.

[0052] The operation knob 31 is composed of a pair of handles 31a, 31b and a support member 31c. The pair of handles 31a, 31b are connected or integrally provided at both ends of the support member 31c so as to face each other. The pair of handles 31a, 31b protrude to both sides in the extension direction of the support member 31c at both ends of the support member 31c and have a shape that follows the circumferential direction of the disk member 34.

[0053] The lower surface side of the central portion of the support member 31c is connected to the upper surface central portion 34d of the disc member 34 through a rotation through-hole 33f of the rotation support member 33. The method of connecting the support member 31c and the disc member 34 is not particularly limited, and for example, the support member 31c and the disc member 34 may be bonded with an adhesive, or the support member 31c and the disc member 34 may be engaged and fixed. The support member 31c is connected so as to pass through the center (rotation center) of the disc member 34, and the support member 31c and the disc member 34 are configured to be rotatable integrally with the rotation support member 33.

[0054] The rotation support member 33 is fixed to the case 3a and has a configuration in which four side walls 33a, 33b, 33c, and 33d surrounding the sides are connected or integrated with a flat plate portion 33e extending to the upper surfaces of the four side walls 33a, 33b, 33c, and 33d. A substantially circular rotation through-hole 33f is provided on the distal side of the flat plate portion 33e, penetrating the upper and lower surfaces of the flat plate portion 33e.

[0055] The disk member 34 is formed in a disk shape. As described above, the upper surface central portion 34d of the disk member 34 is connected to the lower surface side of the central portion of the support member 31c through the rotation through-hole 33f of the rotation support member 33.

[0056] The disk member 34 is connected to the lower surface of the central portion of the support member 31c in a state where it is inserted into the rotation through-hole 33f from the underside of the rotation support member 33. The disk member 34 is disposed inside the rotation through-hole 33f, and the support member 31c and the disk member 34 are rotatable integrally with respect to the rotation support member 33. It is preferable that the movement of the operation knob 31 and the disk member 34 in the rotation axis direction be restricted so that the disk member 34 is always positioned inside the rotation through-hole 33f.

[0057] With this configuration, the operation knob 31 and the disk member 34 are rotatable integrally with respect to the rotation support member 33. Since the rotation support member 33 is fixed to the case 3a, the operation knob 31 and the disk member 34 are rotatable relative to the rotation support member 33 and the case 3a. The disk member 34 corresponds to the operation member of the present invention and is configured to include a rotation operation plate of the present invention.

[0058] An intermediate wire fixing portion 34e for fixing one end of the intermediate wires 50a, 50b is provided on the lower surface of the disk member 34. As an example, the intermediate wire fixing portion 34e is linear and passes through the center of the disk member 34, and is formed in the shape of a rib that protrudes downward from the lower surface of the disk member 34.

[0059] As described above, the disc member 34 is disposed on the distal side below the rotation support member 33, while a pair of follower members 35, 36 having the same shape are disposed on the proximal side. The follower member 35 is configured to include a rectangular parallelepiped sliding member 35a and a wire connecting portion 35d provided on the underside of the sliding member 35a. Similarly, the follower member 36 is configured to include a rectangular parallelepiped sliding member 36a and a wire connecting portion 36d provided on the underside of the sliding member 36a.

[0060] As shown in Figure 7, one end of each of the intermediate wires 50a and 50b is fixed to the intermediate wire fixing portion 34e using, for example, fixing devices 51a and 51b, and the other end of each of the two intermediate wires 50a and 50b is connected to the sliding members 35a and 36a using, for example, fixing devices 52a and 52b. The two intermediate wires 50a and 50b have rigidity in the axial direction and have pushability that transmits force from the proximal end to the distal end. When the intermediate wire fixing portion 34e rotates due to the rotation of the disc member 34, the intermediate wires 50a and 50b are moved forward and backward by the intermediate wire fixing portion 34e, and the follower members 35 and 36 are moved forward and backward accordingly. As will be described later, operating wires 4a, 4b are connected to the follower members 35, 36, and movement of the follower members 35, 36 in opposite directions enables deflection of the operated portion 2a located on the distal end side of the tubular member 2. The intermediate wires 50a, 50b and the follower members 35, 36 correspond to the operation transmission member of the present invention.

[0061] Wire connecting portion 35d provided on the underside of sliding member 35a is provided so as to protrude downward. Wire connecting portion 35d is connected to the proximal end side of operating wire 4a by any connecting method. Similarly, wire connecting portion 36d provided on the underside of sliding member 36a is provided so as to protrude downward. Wire connecting portion 36d is connected to the proximal end side of operating wire 4b by any connecting method.

[0062] The base 37 is generally composed of a bottom plate 37c and a pair of support walls 37a, 37b extending upward along the longitudinal direction at both widthwise (short-side) ends of the bottom plate 37c. In this embodiment, the longitudinal dimension of the support walls 37a, 37b of the base 37 (the longitudinal outer dimension of the base 37) is equal to the dimension between the inner surfaces of the side walls 33a, 33b of the rotation support member 33 (the longitudinal inner dimension of the rotation support member 33), and the dimension between the outer surfaces of the support walls 37a, 37b of the base 37 (the widthwise outer dimension of the base 37) is equal to the dimension between the inner surfaces of the side walls 33c, 33d of the rotation support member 33 (the widthwise inner dimension of the rotation support member 33). Thus, the base 37 is fitted and fixed to the lower inside of the rotation support member 33.

[0063] The bottom plate portion 37c is provided with a pair of sliding holes 37d1, 37e1 that penetrate the upper and lower surfaces. Sliding surfaces 37d2, 37e2 are provided on the upper surfaces of the sliding holes 37d1, 37e1 along the longitudinal direction around the sliding holes 37d1, 37e1. The widthwise dimensions of the sliding holes 37d1, 37e1 are smaller than the widthwise dimensions of the sliding members 35a, 36a, so that the sliding members 35a, 36a do not pass through the sliding holes 37d1, 37e1. The sliding members 35a, 36a are placed on the sliding surfaces 37d2, 37e2 so as to be slidable in the sliding direction (the longitudinal direction of the base portion 37). At this time, the wire connecting portions 35d and 36d provided on the lower surface side of the sliding members 35a and 36a are exposed on the lower surface side of the base portion 37 through the sliding holes 37d1 and 37e1, respectively.

[0064] 4, the proximal ends of the operating wires 4a and 4b are connected to the wire connecting portions 35d and 36d of the follower members 35 and 36, respectively, which are exposed on the underside of the base 37. In this embodiment, a wire insertion groove 37h is provided on the distal side of the underside of the base 37, and the operating wires 4a and 4b are inserted into the tubular member 2 through the wire insertion groove 37h and extend toward the distal end of the tubular member 2. As the sliding members 35a and 36a move in the sliding direction, the proximal ends of the operating wires 4a and 4b connected to the sliding members 35a and 36a, respectively, move forward and backward, and the operating wires 4a and 4b move in the axial direction, thereby enabling the operated portion 2a provided on the distal end of the tubular member 2 to be deflected.

[0065] 5, operation plate contact walls 41, 42 are provided on the inner side of each of support walls 37a, 37b of base 37 at positions facing the outer peripheral surface of disc member 34. Operation plate contact walls 41, 42 each have two stopper surfaces 41a, 41b and stopper surfaces 42a, 42b formed to conform to the outer peripheral surface of disc member 34. The stopper surfaces 41a, 41b, 42a, 42b are in frictional contact with the outer peripheral surface of disc member 34, thereby limiting the rotation of disc member 34. It is sufficient that stopper surfaces 41a, 41b, 42a, 42b are disposed in positions where they are pressed by disc member 34 under tension from operating wires 4a, 4b. For example, a configuration may be adopted in which only distal stopper surfaces 41a, 42a are provided. Furthermore, by arranging the stopper surfaces 41a, 41b, 42a, and 42b at positions symmetrical on the left and right (i.e., positions symmetrical on a plane including the rotation axis passing through the rotation center of the disc member 34 and the axial directions of the first and second operating wires), it becomes possible to reliably restrict the rotation of the disc member 34 regardless of whether it rotates in one direction or the other.

[0066] The dimensions are set so that a clearance of a predetermined value or more is formed between the outer peripheral surface of disc member 34 and stopper surfaces 41a, 41b, 42a, and 42b. The presence of this clearance allows disc member 34 to be moved slightly in the direction of retraction into case 3a. During the rotation operation, the surgeon operates operation knob 31 to slightly move disc member 34, separating the outer peripheral surface of disc member 34 from stopper surfaces 41a, 41b, 42a, and 42b, thereby placing disc member 34 in a rotatable state.

[0067] On the other hand, when the surgeon stops the rotation operation and releases the operation knob 31, the follower members 35, 36, which receive the tension of the operation wires 4a, 4b, push the disk member 34 distally, and frictional contact occurs between the outer circumferential surface of the disk member 34 and the stopper surfaces 41a, 41b, 42a, 42b (particularly the stopper surfaces 41a, 42a located on the distal side). As a result, the rotational movement of the disk member 34 is restricted, and the bent state of the operated portion 2a can be fixed and maintained.

[0068] Furthermore, at least one of the outer peripheral surface of the disc member 34 and the stopper surfaces 41a, 41b, 42a, and 42b may be processed to have a high coefficient of friction. For example, one or both of the outer peripheral surface of the disc member 34 and the stopper surfaces 41a, 41b, 42a, and 42b may be roughened, or an adhesive substance may be attached thereto. Furthermore, the outer peripheral surface of the disc member 34 may be toothed. This increases the frictional resistance between the outer peripheral surface of the disc member 34 and the stopper surfaces 41a, 41b, 42a, and 42b, thereby improving the stopper effect.

[0069] The operation of converting rotational motion into forward and backward motion and the restriction of rotation of the disc member 34 by the stopper surfaces 41a and 41b will be specifically described below with reference to FIGS. 8 to 12. FIGS. 8 to 12 are partial perspective views schematically illustrating the configuration of the operation mechanism 3 shown in FIGS. 3 to 7, viewed from below. FIG. 8 is a diagram schematically illustrating an initial state in which the handles 31a and 31b of the operation knob 31 are positioned symmetrically. FIG. 9 is a diagram schematically illustrating a state in which the operation knob 31 is being rotated in one direction. FIG. 10 is a diagram schematically illustrating a state in which the operator has stopped rotating the operation in one direction and released his / her hands from the handles 31a and 31b. FIG. 11 is a diagram schematically illustrating a state in which the operation knob 31 is being rotated in the other direction. FIG. 12 is a diagram schematically illustrating a state in which the operator has stopped rotating the operation in the other direction and released his / her hands from the handles 31a and 31b. Although not shown, the two operating wires 4a and 4b connected to the follower members 35 and 36 extend downward in the drawing.

[0070] When the surgeon releases the handles 31a, 31b without performing any operation, the tension in the operating wires 4a, 4b acts on the follower members 35, 36, pulling them distally. In this case, a force acts on the disc member 34 from the follower members 35, 36 via the intermediate wires 50a, 50b, pushing the disc member 34 distally. This force causes the outer peripheral surface of the disc member 34 to be pressed into frictional contact with the stopper surfaces 41a, 42a located on the distal side, restricting the rotation of the disc member 34.

[0071] When the surgeon slightly retracts the handles 31a and 31b proximally, the outer peripheral surface of the disc member 34 moves away from the stopper surfaces 41a and 42a, the restriction on the rotation of the disc member 34 is released, and the disc member 34 can be easily rotated. In this state, the surgeon can rotate the disc member 34 using the handles 31a and 31b to perform a deflection operation on the operated portion 2a.

[0072] 8, when the handles 31a and 31b of the operating knob 31 are positioned symmetrically, the pair of follower members 35 and 36 are also positioned symmetrically. At this time, the operated portion 2a located on the distal end side of the tubular member 2 is in a straight, unbent state as shown in FIG.

[0073] As shown in Fig. 9, when the surgeon rotates the handles 31a and 31b in one direction while slightly pulling them proximally, the disc member 34 also rotates in the same direction (for example, the direction of arrow R1 in Fig. 9). More specifically, as shown in the enlarged view at the bottom right of Fig. 9, the outer peripheral surface of the disc member 34 is separated from the stopper surfaces 41a, 41b, 42a, and 42b, allowing the disc member 34 to rotate easily.

[0074] The rotation of the disk member 34 is transmitted to the follower members 35 and 36 via the intermediate wires 50a and 50b, causing the follower member 35 to move in one direction (for example, the direction of arrow L11 in FIG. 9) and the follower member 36 to move in the opposite direction (the direction of arrow L12 in FIG. 9). Then, the operating wires 4a and 4b connected to the follower members 35 and 36 also move in the axial direction in conjunction with each other, and the operated portion 2a located on the distal end side of the tubular member 2 becomes bent in the direction shown in FIG. 2(b).

[0075] When the surgeon operates the handles 31a, 31b to the position shown in Fig. 9 and then releases the handles 31a, 31b, the outer peripheral surface of the disc member 34 is pressed into the stopper surfaces 41a, 42a by the tension of the operating wires 4a, 4b, as shown in Fig. 10, thereby restricting the rotation of the disc member 34. More specifically, as shown in the enlarged view at the bottom right of Fig. 10, the outer peripheral surface of the disc member 34 is in frictional contact with the stopper surfaces 41a, 41b, thereby restricting the rotation of the disc member 34. As a result, the operated portion 2a arranged on the distal end side of the tubular member 2 is fixed in a state bent in the direction shown in Fig. 2(b).

[0076] The same occurs when the surgeon rotates the handles 31a, 31b in the opposite direction. As shown in Fig. 11, when the surgeon rotates the handles 31a, 31b in the other direction while slightly retracting them proximally, the disc member 34 also rotates in the same direction in conjunction with the handles 31a, 31b (for example, the direction of arrow R2 in Fig. 11). The rotation of the disc member 34 is transmitted to the follower members 35, 36 via the intermediate wires 50a, 50b, causing the follower member 35 to move in one direction (for example, the direction of arrow L21 in Fig. 11) and the follower member 36 to move in the opposite direction (for example, the direction of arrow L22 in Fig. 11). Then, the operating wires 4a, 4b connected to the follower members 35, 36 also move in the axial direction in conjunction with the handles 31a, 31b, causing the operated portion 2a located on the distal end side of the tubular member 2 to be bent in the direction shown in Fig. 2(d).

[0077] When the surgeon operates the handles 31a, 31b to the position shown in Fig. 11 and then releases the handles 31a, 31b, the outer peripheral surface of the disk member 34 is pressed into the stopper surfaces 41a, 42a by the tension of the operating wires 4a, 4b, as shown in Fig. 12, thereby restricting the rotation of the disk member 34. As a result, the operated portion 2a arranged on the distal end side of the tubular member 2 is fixed in a state bent in the direction shown in Fig. 2(d).

[0078] As described above, in this embodiment, when the surgeon releases the operation of the handles 31a and 31b, the disc member 34 comes into frictional contact with the stopper surfaces 41a, 41b, 42a, and 42b (particularly the distal stopper surfaces 41a and 42a), restricting the rotation of the disc member 34. This allows the operation position at the time the surgeon releases the operation of the handles 31a and 31b to be reliably maintained. Furthermore, when the surgeon slightly moves the handles 31a and 31b to move the disc member 34 away from the stopper surfaces 41a, 41b, 42a, and 42b, the restriction on the rotation of the disc member 34 is released. In this state, the surgeon can operate the handles 31a and 31b to rotate the disc member 34 and easily bend the operated portion 2a in the desired direction.

[0079] Furthermore, in the operating mechanism 3 according to the present invention, the rotation restriction state of the disc member 34 can be released by operating the handle 31a, 31b, which is the one that is operated to retract the proximal side of the two operating wires 4a, 4b, in the retracting direction.

[0080] Specifically, when retracting the operating wire 4a to bend the operated part 2a, as shown in Figure 9, by operating the handle 31a on the side to which the operating wire 4a is connected (the follower member 35 side) to retract it, the disc member 34 can be moved proximally to release the rotation restriction, and the operated part 2a can be deflected in the desired direction.

[0081] On the other hand, when the operating wire 4b is pulled in to bend the operated portion 2a, the handle 31b on the side to which the operating wire 4b is connected (the follower member 36 side) is pulled in, as shown in Fig. 11, thereby moving the disc member 34 proximally to release the restriction on rotation and deflecting the operated portion 2a in the desired direction. In addition, simply by stopping the operation of the handles 31a, 31b, the operating position is fixed and the operated portion 2a is maintained in the desired bent state.

[0082] In this way, with the operating mechanism 3 according to the present invention, the bending operation of the operated part 2a and maintaining the bent state can be performed by operating the handles 31a and 31b with one hand, and it is extremely easy to operate.

[0083] (Second embodiment) The configuration of the operating mechanism 3 according to the second embodiment of the present invention will be described with reference to FIGS. 13 to 16. FIG. 13 is a perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as viewed from above, and FIG. 14 is a perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as viewed from below. The operating system components are arranged in the case 3a of the operating mechanism 3 in the assembled state shown in FIGS. 13 and 14. FIG. 15 is an exploded perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as viewed from above, and FIG. 16 is an exploded perspective view of the operating system components contained in the case 3a of the operating mechanism 3 shown in FIG. 1, as viewed from below. For clarity of illustration, only FIG. 14 shows the proximal sides of the two operating wires 4a, 4b. Note that components that are substantially the same as the operating system components shown in FIGS. 3 to 7 are designated by the same reference numerals, and their description may be omitted or simplified below.

[0084] The operation mechanism 3 in the second embodiment is configured to include an operation knob 31, a rotation support member 33, a disk member 34z, a pair of follower members 35z and 36z, and a base portion 37z in a case 3a.

[0085] The operation knob 31 and the rotation support member 33 can be substantially the same as those in the first embodiment described above.

[0086] The disc member 34z is formed in a disc shape. Similar to the disc member 34 in the first embodiment described above, a central portion 34d of the upper surface of the disc member 34z is connected to the lower surface of the central portion of the support member 31c through a rotation through-hole 33f of the rotation support member 33. The disc member 34z is disposed inside the rotation through-hole 33f, and the support member 31c and the disc member 34z are rotatable integrally with respect to the rotation support member 33. It is preferable that movement of the operation knob 31 and the disc member 34z in the rotation axis direction be restricted so that the disc member 34z is always positioned inside the rotation through-hole 33f.

[0087] With this configuration, the operation knob 31 and the disk member 34z are rotatable integrally with respect to the rotation support member 33. Since the rotation support member 33 is fixed to the case 3a, the operation knob 31 and the disk member 34z are rotatable relative to the rotation support member 33 and the case 3a. The disk member 34z corresponds to the operation member of the present invention and is configured to include a rotation operation plate of the present invention.

[0088] A rotating cam 34ze is provided on the underside of the disc member 34z. As an example, the rotating cam 34ze is formed in the shape of a rib protruding downward from the underside of the disc member 34z. In the configuration shown in FIGS. 13 to 16, a linear rotating cam 34ze is provided, but this is not limited thereto and any shape may be used as long as it converts the rotational movement of the operation knob 31 into the forward and backward movement of the follower members 35z and 36z. Furthermore, the rotating cam 34ze may be groove-shaped, and the number of rotating cams 34ze is not particularly limited.

[0089] A pair of follower members 35z and 36z having the same shape are disposed below the disk member 34z. Follower member 35z includes a rectangular parallelepiped sliding member 35a, two pins 35zb and 35zc provided on the upper surface of sliding member 35a, and a wire connecting portion 35d provided on the lower surface of sliding member 35a. Similarly, follower member 36z includes a rectangular parallelepiped sliding member 36a, two pins 36zb and 36zc provided on the upper surface of sliding member 36a, and a wire connecting portion 36d provided on the lower surface of sliding member 36a.

[0090] Two pins 35zb, 35zc provided on the upper surface of the sliding member 35a protrude upward and are spaced apart in the longitudinal direction of the sliding member 35a, which is the sliding direction of the follower member 35z. Two pins 36zb, 36zc provided on the upper surface of the sliding member 36a are similarly spaced apart in the longitudinal direction of the sliding member 36a, which is the sliding direction of the follower member 36z. A rotating cam 34ze is disposed between the two pins 35zb, 35zc and between the two pins 36zb, 36zc, thereby realizing a cam follower structure, which will be described later. The rotating cam 34ze and the follower members 35z, 36z correspond to the operation transmission member of the present invention.

[0091] The wire connecting portion 35d provided on the lower surface of the sliding member 35a is provided so as to protrude downward. The wire connecting portion 35d is connected to the proximal side of the operating wire 4a by any connecting method. Similarly, the wire connecting portion 36d provided on the lower surface of the sliding member 36a is provided so as to protrude downward. The wire connecting portion 36d is connected to the proximal side of the operating wire 4b by any connecting method. In this embodiment, the wire connecting portion 35d is provided at a position almost opposite (almost directly behind) the two pins 35zb and 35zc across the sliding member 35a, and the wire connecting portion 36d is provided at a position almost opposite (almost directly behind) the two pins 36zb and 36zc across the sliding member 36a. However, this position is not limited to this, and the positions of the two pins 35zb and 35zc may be shifted widthwise outward from the connection position with the operating wire 4a at the wire connection portion 35d, and similarly, the positions of the two pins 36zb and 36zc may be shifted widthwise outward from the connection position with the operating wire 4b at the wire connection portion 36d.

[0092] The base 37z is generally composed of a bottom plate 37c and a pair of support walls 37a, 37b extending upward along the longitudinal direction at both widthwise (short-side) ends of the bottom plate 37c. In this embodiment, the longitudinal dimension of the support walls 37a, 37b of the base 37z (the longitudinal outer dimension of the base 37z) is equal to the dimension between the inner surfaces of the side walls 33a, 33b of the rotation support member 33 (the longitudinal inner dimension of the rotation support member 33), and the dimension between the outer surfaces of the support walls 37a, 37b of the base 37z (the widthwise outer dimension of the base 37z) is equal to the dimension between the inner surfaces of the side walls 33c, 33d of the rotation support member 33 (the widthwise inner dimension of the rotation support member 33). Thus, the base 37z is fitted and fixed to the lower inside of the rotation support member 33.

[0093] The bottom plate portion 37c is provided with a pair of sliding holes 37d1, 37e1 penetrating the upper and lower surfaces. Sliding surfaces 37d2, 37e2 are provided on the upper surfaces of the sliding holes 37d1, 37e1 along the longitudinal direction around the sliding holes 37d1, 37e1. The widthwise dimensions of the sliding holes 37d1, 37e1 are smaller than the widthwise dimensions of the sliding members 35a, 36a, so that the sliding members 35a, 36a do not pass through the sliding holes 37d1, 37e1. The sliding members 35a, 36a are placed on the sliding surfaces 37d2, 37e2 so as to be slidable in the sliding direction (the longitudinal direction of the base portion 37z). At this time, the wire connecting portions 35d and 36d provided on the lower surface sides of the sliding members 35a and 36a are exposed on the lower surface side of the base portion 37z through the sliding holes 37d1 and 37e1, respectively.

[0094] 14, the proximal sides of the operating wires 4a and 4b are connected to the wire connecting portions 35d and 36d of the follower members 35z and 36z exposed on the underside of the base 37z. In this embodiment, wire insertion holes 37f and 37g are provided on the distal sides of the underside of the base 37z, and the operating wires 4a and 4b are inserted into the tubular member 2 through the wire insertion holes 37f and 37g, respectively, and extend toward the distal end of the tubular member 2. As the sliding members 35a and 36a move in the sliding direction, the proximal sides of the operating wires 4a and 4b connected to the sliding members 35a and 36a, respectively, move forward and backward, and the operating wires 4a and 4b move in the axial direction, thereby enabling the operated portion 2a provided on the distal end of the tubular member 2 to be deflected. However, instead of the wire insertion holes 37f and 37g, a wire insertion groove 37h through which the operating wires 4a and 4b can be inserted may be provided as in the first embodiment described above.

[0095] 15, operation plate contact walls 41 and 42 are provided on the inner sides of the support walls 37a and 37b of the base 37z at positions facing the outer peripheral surface of the disc member 34z. The operation plate contact walls 41 and 42 each have two stopper surfaces 41a and 41b and stopper surfaces 42a and 42b formed to conform to the outer peripheral surface of the disc member 34z. The stopper surfaces 41a, 41b, 42a, and 42b are in frictional contact with the outer peripheral surface of the disc member 34z, thereby limiting the rotation of the disc member 34z. Note that a configuration in which only the distal stopper surfaces 41a and 42a are provided may also be used.

[0096] During the rotation operation, the surgeon operates the operation knob 31 to slightly move the disc member 34z, separating the outer circumferential surface of the disc member 34z from the stopper surfaces 41a, 41b, 42a, and 42b, thereby making the disc member 34z rotatable. On the other hand, when the surgeon stops the rotation operation and releases the operation knob 31, the follower members 35z and 36z, which receive the tension of the operation wires 4a and 4b, push the disc member 34z distally, causing frictional contact between the outer circumferential surface of the disc member 34z and the stopper surfaces 41a, 41b, 42a, and 42b (particularly the stopper surfaces 41a and 42a located on the distal side). As a result, the rotational movement of the disc member 34z is restricted, and the bent state of the operated portion 2a can be fixed and maintained.

[0097] The following describes the arrangement of the rotating cam 34ze of the disk member 34z and the pins 35zb, 35zc, 36zb, and 36zc of the follower members 35z and 36z with reference to Figures 17 and 18. Figure 17 is a partially see-through view that schematically illustrates the disk member 34z and follower members 35z and 36z shown in Figure 13. In Figure 17, only the rotating cam 34ze and the pins 35zb, 35zc, 36zb, and 36zc are indicated by solid lines, and the other parts are indicated by dotted lines. Figure 18 is a partial cross-sectional view taken along the line AA of Figure 17, and is a diagram for explaining the arrangement of the rotating cam 34ze and the pins 35zb, 35zc, 36zb, and 36zc.

[0098] In the assembled state, as shown in Figures 17 and 18, a cam follower structure is realized in which a rib-shaped pivoting cam 34ze is disposed between the two pins 35zb and 35zc of the follower member 35z and between the two pins 36zb and 36zc of the follower member 36z. The follower members 35z and 36z are disposed spaced apart on both sides of the rotation center of the disc member 34z and engage with the pivoting cam 34ze. When the disc member 34z rotates, a side surface of the pivoting cam 34ze abuts against a side surface of one of the two pins 35zb and 35zc of the follower member 35z, and a side surface of the pivoting cam 34ze abuts against a side surface of one of the two pins 36zb and 36zc of the follower member 36z. When the disk member 34z rotates further, the rotary cam 34ze drives the pin with which it abuts, thereby moving the follower members 35z and 36z back and forth in the sliding direction.

[0099] The operation of converting rotational motion into forward and backward motion will be described with reference to Figures 19(a) to (c). Figures 19(a) to (c) are partial perspective views schematically illustrating the configuration of the operation mechanism 3 shown in Figures 13 to 16 from above, with (a) schematically illustrating the initial state in which the handles 31a and 31b of the operation knob 31 are positioned symmetrically, (b) illustrating the state in which the operation knob 31 has been rotated in one direction, and (c) illustrating the state in which the operation knob 31 has been rotated in the other direction. Note that, for clarity of illustration, only the rotating cam 34ze and pins 35zb, 35zc, 36zb, and 36zc of the disk member 34z and follower members 35z and 36z are represented by solid lines.

[0100] 19(a), when the handles 31a and 31b of the operating knob 31 are positioned symmetrically, the pair of follower members 35z and 36z are also positioned symmetrically. At this time, the operated portion 2a located on the distal end side of the tubular member 2 is in a straight, unbent state, as shown in FIG.

[0101] As shown in FIG. 19(b), when the surgeon rotates the handles 31a and 31b of the operation knob 31 in one direction, the disc member 34z also rotates in the same direction (for example, the direction of arrow R3 in FIG. 19(b)). Accompanying this rotation, the rib-shaped rotating cam 34ze abuts against the side surfaces of the pin 35zb of the follower member 35z and the pin 36zc of the follower member 36z. As the disc member 34z continues to rotate, the pin 35zb is pushed and moved by the rotating cam 34ze, causing the follower member 35z to move in one direction (for example, the direction of arrow L31 in FIG. 19(b)). Meanwhile, the pin 36zc is pushed and moved by the rotating cam 34ze, causing the follower member 36z to move in the opposite direction (for example, the direction of arrow L32 in FIG. 19(b)). Then, the operating wires 4a and 4b connected to the follower members 35z and 36z also move in the axial direction in unison, and the operated portion 2a located on the distal end side of the tubular member 2 becomes bent in the direction shown in Figure 2(b).

[0102] The same occurs when the surgeon rotates the handles 31a and 31b in the opposite direction. As shown in FIG. 19(c), when the surgeon rotates the handles 31a and 31b of the operation knob 31 in the other direction, the disc member 34z also rotates in the same direction (for example, the direction of arrow R4 in FIG. 19(c)). Accompanying this rotation, the rib-shaped rotating cam 34ze abuts against the side surfaces of the pin 35zc of the follower member 35z and the pin 36zb of the follower member 36z. As the disc member 34z continues to rotate, the pin 35zc is pushed and moved by the rotating cam 34ze, causing the follower member 35z to move in one direction (for example, the direction of arrow L41 in FIG. 19(c)). Meanwhile, the pin 36zb is pushed and moved by the rotating cam 34ze, causing the follower member 36z to move in the opposite direction (for example, the direction of arrow L42 in FIG. 19(c)). Then, the operating wires 4a and 4b connected to the follower members 35z and 36z also move in the axial direction in unison, and the operated portion 2a located on the distal end side of the tubular member 2 becomes bent in the direction shown in Figure 2(d).

[0103] In this manner, in this embodiment, the rotational motion of the disk member 34z is converted into the advancing and retreating motion of the follower members 35z and 36z via the rotary cam 34ze and the pins 35zb, 35zc, 36zb, and 36zc, so that the follower members 35z and 36z move in opposite directions. When the follower members 35z and 36z move back and forth, the operating wires 4a and 4b connected to the follower members 35z and 36z also move back and forth in the axial direction in conjunction with the movement of the follower members 35z and 36z, thereby enabling deflection of the operated portion 2a located on the distal end side of the tubular member 2.

[0104] In this embodiment, as in the first embodiment described above, the disc member 34z comes into frictional contact with the stopper surfaces 41a, 41b, 42a, and 42b, thereby restricting the rotation of the disc member 34z. That is, when the surgeon releases the operation of the handles 31a and 31b, the disc member 34z comes into frictional contact with the stopper surfaces 41a, 41b, 42a, and 42b (particularly the distal stopper surfaces 41a and 42a), thereby restricting the rotation of the disc member 34z. This makes it possible to reliably maintain the operating position at the time the surgeon releases the operation of the handles 31a and 31b.

[0105] Furthermore, when the surgeon moves the handles 31a and 31b slightly to move the disc member 34z away from the stopper surfaces 41a, 41b, 42a, and 42b, the restriction on the rotation of the disc member 34z is released. In this state, the surgeon can operate the handles 31a and 31b to rotate the disc member 34z, and can easily bend the operated portion 2a in the desired direction.

[0106] (Example of derivative) Derivative examples of the stopper surfaces 41a, 41b, 42a, and 42b will be described below. Fig. 20 is a perspective view showing a derivative example of the stopper surfaces 41a, 41b, 42a, and 42b according to the present invention. Fig. 20 shows a derivative example based on the configuration of the second embodiment, but this derivative example can be applied to both the first and second embodiments described above.

[0107] 20 illustrates the operation knob 31, the disk member 34z, the pair of follower members 35z and 36z, and the base 37z as an assembled state of the operation system components contained in the case 3a of the operation mechanism 3. Note that the rotation support member 33 is not illustrated. Also, an enlarged view of the vicinity of the stopper surface 42a of the operation plate contact wall portion 42 is illustrated in the lower right of FIG.

[0108] As shown in Fig. 20, the stopper surface 42a may be formed so as to be inclined with respect to the rotational circumferential surface parallel to the rotation axis of the disc member 34z. For example, the outer circumferential surface of the disc member 34z may be formed in a tapered shape with a diameter decreasing downward, so that the angle between the stopper surface 42a and the rotational circumferential surface (angle θ shown in Fig. 20) is greater than zero. Furthermore, the outer circumferential surface of the disc member 34z may also be formed in a tapered shape in accordance with the inclination of the stopper surface 42a.

[0109] In this way, in the first and second embodiments described above, by inclining the contact surface between the outer peripheral surface of the disc member 34, 34z and the stopper surface 42a (and the stopper surfaces 41a, 41b, 42b not shown in FIG. 20), the direction of force and the contact area at the contact surface can be effectively controlled, and the frictional resistance of the stopper surfaces 41a, 41b, 42a, 42b against the outer peripheral surface of the disc member 34, 34z can be increased, thereby enhancing the stopper effect.

[0110] The width of the outer peripheral surface of the disk members 34, 34z in the thickness direction may be set to be equal to the wall width of the stopper surfaces 41a, 41b, 42a, 42b in the same direction, to maximize the contact area.

[0111] The operation of the present invention will be described below.

[0112] The medical device (endoscope 1, catheter, etc.) according to the present invention comprises a long member (tubular member 2) having a bendable operated portion 2a arranged at the distal end, an operating mechanism 3 connected to the proximal end of the long member, and operating wires 4a, 4b attached to the long member and interposed between the operated portion 2a and the operating mechanism 3 so as to be able to transmit operation. The operating mechanism 3 is composed of a graspable case 3a connected to the elongated member, an operating member (disk member 34, 34z) having a rotary operating plate arranged rotatably relative to the case 3a, an operation transmission member (rotating cam 34ze, follower member 35, 36, 35z, 36z, intermediate wire member 50a, 50b) interposed between the rotary operating plate and the operating wires 4a, 4b at the proximal end side of the elongated member, which moves the operating wires 4a, 4b in opposite axial directions in response to the rotation of the rotary operating plate and generates tension in at least one of the operating wires 4a, 4b, and an operating plate contact wall portion 41, 42 which is provided at a fixed position relative to the case 3a, comes into slidable contact with the outer peripheral surface of the rotary operating plate, and rotatably holds the rotary operating plate. The operation plate contact wall portions 41, 42 have stopper surfaces 41a, 41b, 42a, 42b that come into frictional contact with the outer peripheral surface of the rotating operation plate, which receives tension from at least one of the operating wires 4a, 4b via the operation transmission member (rotating cam 34ze, follower members 35, 36, 35z, 36z, intermediate wires 50a, 50b), thereby limiting the rotation of the rotating operation plate.

[0113] According to the above configuration, in a configuration capable of converting the rotational movement of the rotary operation plate into the advancement and retreat movement of the operating wires 4a, 4b, the positions of the rotary operation plate and the operating wires 4a, 4b can be maintained by the stopper surfaces 41a, 41b, 42a, 42b that are in frictional contact with the outer peripheral surface of the rotary operation plate, and a medical device 1 having excellent operability and convenience can be provided with a simple and compact configuration. In particular, the medical device 1 according to the present invention is excellent in operability when bending an operated part arranged on the distal end side of an elongated member constituting an endoscope, catheter, etc. in a desired deflection direction to fix the deflection direction of the operated part.

[0114] The above-described embodiments have been described to facilitate understanding of the present invention, and are not intended to limit the present invention. Therefore, each element disclosed in the above-described embodiments is intended to include all design modifications and equivalents that fall within the technical scope of the present invention. [Explanation of symbols]

[0115] 1 Endoscope (medical device) 2 Tubular members (long members) 2a Operated part 2b middle part 2c Distal end 3 Operating mechanism 3a Case 3b Forceps Channel Port 3c Y-shaped adapter 3d universal cable 3e cable connector 4a, 4b operating wire 31 Control knob 31a, 31b handle 31c Support member 33 Rotation support member 33a, 33b, 33c, 33d side wall section 33e Flat plate part 33f Rotating through hole 34, 34z Disc member (operating member) 34d Top center 34e Intermediate wire fixing part 34ze rotary cam 35, 36, 35z, 36z Follower parts 35a, 36a sliding members 35b, 35c, 35zb, 35zc, 36b, 36c, 36zb, 36zc pin 35d, 36d Wire connection part 37, 37z base 37a, 37b Support wall section 37c Bottom plate part 37d1, 37e1 sliding hole 37d2, 37e2 sliding surface 37f, 37g Wire insertion holes 37h Wire insertion groove 41, 42 Operation panel contact wall 41a, 41b, 42a, 42b Stopper surfaces 50a, 50b intermediate wire 51a, 51b, 52a, 52b Fixtures

Claims

1. an elongated member having a bendable operated portion disposed on a distal end side thereof; an operating mechanism coupled to a proximal end side of the elongated member; a first operating wire and a second operating wire attached to the elongated member and interposed between the operated portion and the operating mechanism so as to be capable of transmitting operation; The operating mechanism includes: a graspable case connected to the elongated member; an operating member having a rotating operating plate arranged rotatably relative to the case; an operation transmission member interposed between the rotary operation plate and the first and second operation wires on the proximal end side of the elongated member, which moves the first and second operation wires in opposite axial directions in response to rotation of the rotary operation plate and generates tension in at least one of the operation wires; an operation plate contact wall portion that is provided at a position fixed relatively to the case, that slidably contacts the outer peripheral surface of the rotating operation plate, and that rotatably holds the rotating operation plate; the operation plate contact wall portion has a stopper surface that frictionally contacts the outer peripheral surface of the rotary operation plate that receives tension from the at least one operation wire via the operation transmission member to limit the rotation of the rotary operation plate, The operating member has a rib-shaped or groove-shaped rotary cam provided on the plate surface of the rotary operation plate, the operation transmission member is configured to include first and second follower members that are movable relative to the case in the axial direction of the first and second operation wires, are arranged spaced apart on both sides of the rotation center of the rotary operation plate, and engage with the rotary cam; A medical device characterized in that the first and second follower members engaged with the rotating cam move in opposite directions in response to rotation of the rotating operating plate, thereby moving the first and second operating wires in opposite directions in the axial direction.

2. A long member having a bendable operated portion disposed at a distal end thereof; an operating mechanism coupled to a proximal end side of the elongated member; a first operating wire and a second operating wire attached to the elongated member and interposed between the operated portion and the operating mechanism so as to be capable of transmitting operation; The operating mechanism includes: a graspable case connected to the elongated member; an operating member having a rotating operating plate arranged rotatably relative to the case; an operation transmission member interposed between the rotary operation plate and the first and second operation wires on the proximal end side of the elongated member, which moves the first and second operation wires in opposite axial directions in response to rotation of the rotary operation plate and generates tension in at least one of the operation wires; an operation plate contact wall portion that is provided at a position fixed relatively to the case, that slidably contacts the outer peripheral surface of the rotating operation plate, and that rotatably holds the rotating operation plate; the operation plate contact wall portion has a stopper surface that frictionally contacts the outer peripheral surface of the rotary operation plate that receives tension from the at least one operation wire via the operation transmission member to limit the rotation of the rotary operation plate, A medical device characterized in that the dimensions are set so that a clearance of a predetermined value or more is formed between the outer peripheral surface of the rotating operation plate and the stopper surface, and by operating the operating member to move the rotating operation plate in the direction of retraction into the case, the state in which the outer peripheral surface of the rotating operation plate is in frictional contact with the stopper surface is released, thereby allowing the rotating operation plate to rotate.

3. The operating member has a pair of handles provided so as to protrude radially on both sides of the rotation center of the rotating operation plate, A medical device as described in claim 1 or 2, characterized in that when the operating member is rotated, the rotation restriction state of the rotating operating plate can be released by operating the handle of the first or second operating wire that is operated to retract proximally in the retracting direction.

4. The medical device described in claim 3, characterized in that when the operation of the handle in the retracting direction is released, the stopper surface comes into frictional contact with the outer peripheral surface of the rotating operation plate on the side of the first and second operating wires that was retracted proximally, thereby restricting the rotation of the rotating operation plate.

5. A medical device as described in any one of claims 1 to 4, characterized in that the stopper surface of the operating plate contact wall portion is positioned at a position where it is pressed by the rotating operating plate which is under tension from at least one of the operating wires.

6. A medical device described in any one of claims 1 to 5, characterized in that a pair of stopper surfaces are arranged at positions symmetrical with respect to a plane that includes a rotation axis passing through the rotation center of the rotating operation plate and extends in the axial direction of the first and second operating wires.

7. A medical device according to any one of claims 1 to 6, characterized in that the outer peripheral surface of the rotating operation plate and the stopper surface of the operation plate contact wall portion are inclined with respect to the rotational peripheral surface parallel to the rotation axis of the rotating operation plate.

8. 8. The medical device according to claim 1, wherein the width of the outer peripheral surface of the rotating operation plate in the plate thickness direction is equal to the wall width of the stopper surface in the same direction.

9. 9. The medical device according to claim 1, wherein at least one of the outer peripheral surface of the rotating operation plate and the stopper surface is processed to have a high coefficient of friction.

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