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; a turning operation plate turnably arranged to the case; a circular plate member 34 having a turning cam 34e having a rib shape or groove shape and arranged on a plate surface of the turning operation plate; and follower members 35 and 36 respectively coupled to near end sections of operation wires, movable relative to the case in axial line directions of the operation wires, being arranged while separated to both sides while sandwiching the turning center of the turning operation plate, and being engaged with the turning cam 34e. In response to turning of the turning operation plate, the follower members 35 and 36 being engaged with the turning cam 34e move in opposite directions to each other, and move the operation wires in axial line directions of the operation wires in opposite directions to each other.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 a single-use 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 a long member suitable for insertion into the body and passing through a body lumen are used. The long member is made of a flexible member having a small diameter and a long shape, and is configured so that various treatments, examinations, etc. can be performed by inserting the long member into a body lumen from outside the body and allowing its distal end to reach a desired site 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 a catheter assembly configured such that, by rotating a rocker arm, each of a pair of push-pull cables wound around the handle of a cable driver assembly simultaneously operates in opposite directions while sliding a sliding body proximally and distally, thereby deflecting an end effector disposed at the distal end of a sheath.

[0005] Patent Document 2 describes a configuration in which a wire is pulled proximally by rotation of a rotating member, thereby bending the distal side of a catheter tube. It also describes a suitable configuration in which a wire guide member is provided on the rotating member and the wire is positioned so as to contact the outer edge of the wire guide member, thereby increasing the amount of wire pulling relative to the amount of rotation of the rotating member.

[0006] Patent document 3 describes a configuration in which the distal end of the catheter is deflected and oscillated by utilizing the rotational movement of the rotating knob and winding an operating wire around a protrusion or a rotating shaft on the surface of the rotating knob and pulling it. [Prior art documents] [Patent documents]

[0007] [Patent Document 1] Patent Publication No. 2021-3556 [Patent Document 2] Japanese Patent Publication No. 2020-182526 [Patent Document 3] Patent No. 4283703 Summary of the Invention [Problem to be solved by the invention]

[0008] The technology described in Patent Document 1 requires a space between the rocker arm that performs rotational motion and the sliding member that performs translational motion in order to slide the sliding member, which makes it difficult to miniaturize the operating mechanism. Furthermore, the technology described in Patent Document 1 has the problem that, because the push-pull cable is wound around the handle, wear occurs on the components (particularly wear on the push-pull cable and handle), and the wear is likely to generate fine powder, which can easily damage and break the components. Furthermore, the technology described in Patent Document 1 requires pulling the push-pull cable, which causes wear on the components, and has a configuration in which the push-pull cable is wound and folded back, which increases the operating load and makes it difficult to operate. It also has the problem of requiring a complex combination of multiple parts, such as a tension block to restrict the movement of the proximal end block.

[0009] The technology described in Patent Document 2 uses a rotating member and a wire guide member to pull the wire in the circumferential direction of the rotating member, which causes wear of the members (particularly wear of the wire, wire guide member, etc.), which makes it easy for fine powder to be generated due to wear and makes the members susceptible to damage and breakage.In addition, the technology described in Patent Document 2 also has the problem that, because it is necessary to pull the wire, which causes wear of the members, the operating load increases and makes it difficult to operate.

[0010] The technology described in Patent Document 3 has a configuration in which the operating wire is wound around a protrusion or a rotating shaft, and the pulling direction of the operating wire wound around the protrusion in particular changes significantly as the rotating knob rotates, which causes wear of the components (particularly wear of the operating wire, protrusion, etc.), which makes the components more likely to be damaged or broken due to the wear.In addition, the technology described in Patent Document 3 also has the problem that the operating load increases and operability is poor because the operating wire must be pulled, which involves friction between the components.

[0011] 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]

[0012] 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 rotary operation plate rotatably disposed relative to the case and a rib-shaped or groove-shaped rotary cam provided on a plate surface of the rotary operation plate; a first follower member and a second follower member which are connected to the proximal end portions of the first and second operating wires, respectively, are movable in the axial direction of the first and second operating wires relative to the case, are spaced apart on both sides of the rotation center of the rotary operating plate, and engage with the rotary cam; The first and second follower members engaged with the rotating cam move in opposite directions in response to the rotation of the rotating operation plate, thereby moving the first and second operating wires in opposite directions in the axial direction.

[0013] According to the above configuration, the rotational movement of the rotary operation plate can be converted into the forward and backward movement of the first and second follower members and the first and second operation wires with a simple and compact configuration, and there is no need to significantly bend or turn back the first and second operation wires in order to operate them in the axial direction, making it possible to provide a medical device that is excellent in operability and convenience. In particular, the medical device according to the present invention is excellent in operability when bending the operated portion located on the distal end side of an elongated member that constitutes an endoscope, catheter, etc. in a desired deflection direction.

[0014] The medical device of the present invention may have the first and second follower members each having a slide portion arranged parallel to each other along the axial direction of the first and second operating wires, and a wire connecting portion connecting the slide portion to the first and second operating wires.

[0015] According to the above configuration, the assembling of the first and second follower members to the case and the assembling of the proximal ends of the first and second operating wires to the first and second follower members can be facilitated, and excellent operability can be achieved with a simple configuration that limits the number of components.

[0016] In the medical device of the present invention, on the surface of the rotating operation plate, the distance between a reference line passing through the rotation center of the rotating operation plate and extending in the movement direction of the first and second follower members and an engagement position where the follower members engage with the rotating cam may be greater than the distance between the reference line and a line extending in the movement direction of the wire connecting portion.

[0017] According to the above configuration, with respect to the radial direction of rotation of the rotating operating plate of the operating member, the transmission position (point of force) of the operating force transmitted from the rotating cam of the operating member to the first and second follower members is located radially outward from the transmission position (point of action) of the acting force that moves the first and second operating wires, so that the amount of movement of the first and second operating wires can be increased while suppressing the operating force.

[0018] The medical device of the present invention may be such that the distance between the tracks along which the wire connection portions of the first and second follower members move is equal to the distance between the first and second operating wires attached to the elongate member.

[0019] According to the above configuration, the operating force can be transmitted in an approximately linear manner from the first and second follower members to the first and second operating wires, making it less likely that loss of operating force will occur and effectively suppressing damage to the first and second operating wires due to interference with other members.

[0020] In the medical device according to the present invention, the rotating cam may be formed linearly on the plate surface of the rotating operation plate.

[0021] According to the above configuration, by operating the operation member to rotate the rotary operation plate, the first and second follower members can be moved by a large amount in the opposite directions to each other via the rotary cam.

[0022] In the medical device according to the present invention, the rotating cam may be formed on the surface of the rotating operation plate in a curved shape that bulges outward in the radial direction relative to the rotation center of the rotating operation plate.

[0023] According to the above configuration, by operating the operating member to rotate the rotating operating plate, the first and second follower members can be moved significantly in opposite directions via the rotating cam, and the operating force (operating torque) can be effectively reduced in the range where the operating angle becomes large.

[0024] The medical device of the present invention may be such that the first and second follower members are spaced apart in a direction intersecting the extension direction of the rib-shaped rotating cam, and have a plurality of convex engagement portions that protrude toward the rotating operation plate on both sides of the rotating cam.

[0025] According to the above configuration, when the rotating operation plate rotates in one or the other rotation direction, the rib-shaped rotating cam presses against one or the other of the convex engagement portions protruding on both sides of the rotating cam, driving the first and second follower members.With a simple and compact configuration, the rotational movement of the rotating operation plate can be converted into the forward and backward movement of the follower members and the first and second operating wires. [Brief explanation of the drawings]

[0026] [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. 4 is a partially see-through view that schematically illustrates the disk member and follower members 35 and 36 shown in FIG. [Figure 8] 8 is a cross-sectional view of a portion AA in FIG. 7. [Figure 9] 1A and 1B are partial perspective views schematically illustrating the configuration of the operation mechanism from above in the first 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 10] 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 11] 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 12] 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 13] 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 14] FIG. 10 is a front view of a follower member according to a second embodiment of the present invention, illustrating a configuration in which the position of the pin is offset with respect to the wire rod connecting portion. [Figure 15] 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 16]1A to 1E are diagrams showing examples of a rotating cam according to the present invention, where (a) to (e) are diagrams showing first to fifth examples of the rotating cam, respectively. [Figure 17] 10A and 10B are diagrams showing variations of the arrangement of the rotating cam and pin according to the present invention; DETAILED DESCRIPTION OF THE INVENTION

[0027] 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.

[0028] 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.

[0029] (Example of medical device 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.

[0030] 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.

[0031] 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.

[0032] 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. Note that the term "bending" in this specification includes curving in the shape of an arch.

[0033] 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 over part or the entirety of the operated portion 2a at 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). Furthermore, as shown in FIGS. 4 and 11 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.

[0034] 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.

[0035] 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.

[0036] 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.

[0037] 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.

[0038] 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.

[0039] 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.

[0040] 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.

[0041] (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.

[0042] 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.

[0043] 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°.

[0044] 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°.

[0045] (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 6. 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 viewed 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 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. 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 viewed 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 viewed from below. For clarity of illustration, only the proximal ends of the two operating wires 4a, 4b are shown in FIG. 4.

[0046] In the following explanation, for convenience, the side where the operating knob 31 is located in Figures 3 to 6 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.

[0047] 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.

[0048] 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.

[0049] 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.

[0050] 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 in the center of the flat plate portion 33e, penetrating the upper and lower surfaces of the flat plate portion 33e.

[0051] 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.

[0052] 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.

[0053] 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.

[0054] A rotating cam 34e is provided on the underside of the disc member 34. As an example, the rotating cam 34e is formed in the shape of a rib that protrudes downward from the underside of the disc member 34. In the configuration shown in FIGS. 3 to 6, a linear rotating cam 34e is provided, but this is not limiting 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 35, 36. Furthermore, in the configuration shown in FIGS. 3 to 6, the number of rotating cams 34e is one, but this is not limiting and there may be two or more. Derivative examples of the rotating cam 34e will be described later with reference to FIGS. 16(a) to (e).

[0055] A pair of follower members 35, 36 having the same shape are arranged below the disk member 34. Follower member 35 is configured with a rectangular parallelepiped sliding member 35a, two pins 35b, 35c 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 36 is configured with a rectangular parallelepiped sliding member 36a, two pins 36b, 36c provided on the upper surface of sliding member 36a, and a wire connecting portion 36d provided on the lower surface of sliding member 36a. Sliding members 35a, 36a correspond to the slide portion of the present invention, and pins 35b, 35c, 36b, and 36c correspond to the convex engagement portion of the present invention.

[0056] Two pins 35b, 35c provided on the upper surface of sliding member 35a protrude upward and are spaced apart in the longitudinal direction of sliding member 35a, which is the sliding direction of follower member 35. Two pins 36b, 36c provided on the upper surface of sliding member 36a are similarly spaced apart in the longitudinal direction of sliding member 36a, which is the sliding direction of follower member 36. A rotating cam 34e is disposed between the two pins 35b, 35c and between the two pins 36b, 36c, thereby realizing a cam follower structure, which will be described later.

[0057] Wire connector 35d provided on the underside of sliding member 35a is provided so as to protrude downward and is connected to the proximal end of operating wire 4a by any connecting method. Similarly, wire connector 36d provided on the underside of sliding member 36a is provided so as to protrude downward and is connected to the proximal end of operating wire 4b by any connecting method. The distance between the paths along which wire connectors 35d, 36d move may be designed to be equivalent to the distance between operating wires 4a, 4b inserted and attached within tubular member 2. When these distances are equivalent, operating force is transmitted from follower members 35, 36 to operating wires 4a, 4b in a substantially linear manner, which reduces operating force loss and suppresses damage to operating wires 4a, 4b (such as damage due to interference with other members).

[0058] In this embodiment, the wire connecting portion 35d is provided at a position almost opposite (almost directly behind) the two pins 35b and 35c across the sliding member 35a, and the wire connecting portion 36d is provided at a position almost opposite (almost directly behind) the two pins 36b and 36c across the sliding member 36a.

[0059] 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.

[0060] 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.

[0061] 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, wire insertion holes 37f and 37g are 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 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 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.

[0062] The positions of the rotating cam 34e of the disk member 34 and the pins 35b, 35c, 36b, and 36c of the follower members 35 and 36 will be described below with reference to Figures 7 and 8. Figure 7 is a partial see-through view that schematically illustrates the disk member 34 and follower members 35 and 36 shown in Figure 3. In Figure 7, only the rotating cam 34e and the pins 35b, 35c, 36b, and 36c are shown in solid lines, and the other parts are shown in dotted lines. Figure 8 is a partial cross-sectional view taken along the line AA of Figure 7, and is a diagram for explaining the positions of the rotating cam 34e and the pins 35b, 35c, 36b, and 36c.

[0063] In the assembled state, as shown in Figures 7 and 8, a cam follower structure is realized in which a rib-shaped rotating cam 34e is arranged between the two pins 35b, 35c of the follower member 35 and between the two pins 36b, 36c of the follower member 36.

[0064] The follower members 35, 36 are arranged to be spaced apart on either side of the rotation center of the disc member 34 and engage with the rotating cam 34e. The follower members 35, 36 are spaced apart in a direction intersecting the extension direction of the rib-shaped rotating cam 34e and each have a plurality of pins 35b, 35c and pins 36b, 36c that protrude toward the disc member 34 so as to sandwich the rotating cam 34e.

[0065] When the disk member 34 rotates, the side surface of the rotating cam 34e abuts against the side surface of one of the two pins 35b, 35c in the follower member 35, and the side surface of the rotating cam 34e abuts against the side surface of one of the two pins 36b, 36c in the follower member 36. When the disk member 34 rotates further, the rotating cam 34e drives the abutting pin, thereby moving the follower members 35, 36 back and forth in the sliding direction.

[0066] The operation of converting rotational motion into forward and backward motion will be described with reference to Figures 9(a) to 9(c). Figures 9(a) to 9(c) are partial perspective views schematically illustrating the configuration of the operation mechanism 3 shown in Figures 3 to 6 from above, with (a) showing an initial state in which the handles 31a and 31b of the operation knob 31 are positioned symmetrically, (b) showing a state in which the operation knob 31 has been rotated in one direction, and (c) showing a state in which the operation knob 31 has been rotated in the other direction. Note that for clarity of illustration, only the rotating cam 34e and pins 35b, 35c, 36b, and 36c of the disk member 34 and follower members 35 and 36 are shown in solid lines.

[0067] 9(a), 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.

[0068] As shown in FIG. 9(b), when the surgeon rotates the handles 31a, 31b of the operation knob 31 in one direction, the disc member 34 also rotates in the same direction in conjunction with the rotation (for example, the direction of arrow R1 in FIG. 9(b)). As the rotation occurs, the rib-shaped rotating cam 34e comes into contact with the side surface of the pin 35b of the follower member 35 and the side surface of the pin 36c of the follower member 36. As the disc member 34 continues to rotate, the pin 35b is pushed and moved by the rotating cam 34e, causing the follower member 35 to move in one direction (for example, the direction of arrow L11 in FIG. 9(b)). Meanwhile, the pin 36c is pushed and moved by the rotating cam 34e, causing the follower member 36 to move in the opposite direction (for example, the direction of arrow L12 in FIG. 9(b)). Then, the operating wires 4a, 4b connected to the follower members 35, 36 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).

[0069] The same applies when the surgeon rotates the handles 31a and 31b in the opposite direction. As shown in FIG. 9(c), when the surgeon rotates the handles 31a and 31b of the operation knob 31 in the other direction, the disc member 34 also rotates in the same direction (for example, the direction of arrow R2 in FIG. 9(c)). Accompanying this rotation, the rib-shaped rotating cam 34e abuts against the side surfaces of the pins 35c of the follower member 35 and the pins 36b of the follower member 36. As the disc member 34 continues to rotate, the pins 35c are pushed and moved by the rotating cam 34e, causing the follower member 35 to move in one direction (for example, the direction of arrow L21 in FIG. 9(c)). Meanwhile, the pins 36b are pushed and moved by the rotating cam 34e, causing the follower member 36 to move in the opposite direction (for example, the direction of arrow L22 in FIG. 9(c)). Then, the operating wires 4a, 4b connected to the follower members 35, 36 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).

[0070] As described above, in this embodiment, the rotational movement of the disk member 34 is converted into the advance / retract movement of the follower members 35, 36 via the rotary cam 34e and the pins 35b, 35c, 36b, 36c, so that the follower members 35, 36 move in opposite directions. When the follower members 35, 36 move forward / retractably, the operating wires 4a, 4b connected to the follower members 35, 36 also move forward / retractably in the axial direction in conjunction with the movement of the follower members 35, 36, so that the operated portion 2a located on the distal end side of the tubular member 2 can be deflected.

[0071] (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. 10 to 13. FIG. 10 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. 11 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. 10 and 11. FIG. 12 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. 13 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. 11 shows the proximal ends 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 6 are designated by the same reference numerals, and their description may be omitted or simplified below.

[0072] The operation mechanism 3 in the second embodiment is configured to include an operation knob 31, a rotation support member 33, a disk member 34, a pair of follower members 35z and 36z, and a base portion 37z in a case 3a.

[0073] The operation knob 31, the rotation support member 33, and the disk member 34 can be substantially the same as those in the first embodiment described above.

[0074] A pair of follower members 35z and 36z having the same shape are disposed below the disk member 34. Follower member 35z is configured to include a rectangular parallelepiped sliding member (slide portion) 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 is configured to include a rectangular parallelepiped sliding member (slide portion) 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.

[0075] Two pins 35zb, 35zc provided on the upper surface of the sliding member 35a are provided at positions spaced apart in the longitudinal direction of the sliding member 35a, which is the sliding direction of the follower member 35z, so as to protrude upward. Similarly, two pins 36zb, 36zc provided on the upper surface of the sliding member 36a are provided at positions spaced apart in the longitudinal direction of the sliding member 36a, which is the sliding direction of the follower member 36z.

[0076] FIG. 14 is a front view of the follower member 35z in this embodiment, illustrating a configuration in which the positions of the pins 35zb, 35zc, 36zb, and 36zc are offset relative to the wire connecting portions 35d and 36d. In the first embodiment described above, the two pins 35b and 35c are located almost directly behind the wire connecting portions 35d and 36d, sandwiching the sliding member 35a therebetween. In contrast, in this embodiment, the two pins 35zb and 35zc are provided at positions shifted outward in the width direction from the positions almost directly behind the wire connecting portion 35d, as shown in FIG. 14. More specifically, in this embodiment, the arrangement position P1 of the two pins 35zb and 35zc is shifted outward in the width direction from the connection position P2 of the wire connecting portion 35d with the operating wire 4a, and the offset distance D1 between these positions is set to a value greater than zero. The follower member 36z has the same shape as the follower member 35z, and the two pins 36zb and 36zc are also provided at positions shifted from the wire connecting portion 36d.

[0077] The base portion 37z is generally composed of a pair of support walls 37a, 37b and a bottom plate portion 37c, and is adapted to be fitted and fixed to the lower inner side of the rotation support member 33, similar to the first embodiment described above.

[0078] 12 , operation plate contact wall portions 41, 42 are provided on the inner side of each of the support wall portions 37a, 37b of the base portion 37z at positions facing the outer circumferential surface of the disc member 34. The operation plate contact wall portions 41, 42 have two stopper surfaces 41a, 41b and stopper surfaces 42a, 42b, respectively, which are formed to have a shape that follows the outer circumferential surface of the disc member 34. The stopper surfaces 41a, 41b, 42a, 42b are in frictional contact with the outer circumferential surface of the disc member 34, thereby limiting the rotation of the disc member 34.

[0079] When the surgeon operates the operation knob 31 to rotate the disc member 34, a predetermined clearance is generated between the outer peripheral surface of the disc member 34 and the stopper surfaces 41a, 41b, 42a, and 42b, so that the outer peripheral surface of the disc member 34 and the stopper surfaces 41a, 41b, 42a, and 42b hardly come into contact with each other. On the other hand, when the surgeon releases the operation knob 31, the disc member 34 is pulled distally by the tension of the operation wires 4a and 4b, and frictional contact occurs between the outer peripheral surface of the disc member 34 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 34 is restricted, and the bent state of the operated portion 2a can be fixed and maintained. However, the present invention does not particularly limit the configuration of the operation plate contact wall portions 41, 42 and the stopper surfaces 41 a, 41 b, 42 a, 42 b. Also, as in the first embodiment described above, in this embodiment, it is not necessarily required to provide the operation plate contact wall portions 41, 42 and the stopper surfaces 41 a, 41 b, 42 a, 42 b.

[0080] In this embodiment, a wire insertion groove 37h is provided on the distal side of the underside of the base 37z. The operating wires 4a, 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. However, instead of the wire insertion groove 37h, wire insertion holes 37f, 37g through which the operating wires 4a, 4b can be inserted, as in the first embodiment described above, may be provided.

[0081] Hereinafter, a configuration in which the position of the pin is offset with respect to the wire connecting portion will be described with reference to Figures 15(a) to (c). Figures 15(a) to (c) are partial transparent views that schematically illustrate the configuration of the operation mechanism 3 shown in Figures 10 to 13 from above, with (a) schematically illustrating the initial state in which the handles 31a and 31b of the operation knob 31 are in symmetrical positions, (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.

[0082] 15(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.

[0083] In the follower member 35z according to this embodiment, the positions of the two pins 35zb and 35zc are provided outward in the width direction from the connection position of the wire connecting portion 35d with the operating wire 4a. Also, in the follower member 36z according to this embodiment, the positions of the two pins 36zb and 36zc are provided outward in the width direction by an offset distance D1 from the connection position of the wire connecting portion 36d with the operating wire 4b.

[0084] Specifically, when a reference line L1 is considered on the plate surface of the disc member 34, passing through the rotation center O of the disc member 34 and extending in the movement direction of the follower member 36z, and an imaginary line L2 is considered, passing through the connection position of the wire connection portion 36d with the operating wire 4a and extending in the movement direction of the wire connection portion 36d, a distance D2 between the reference line L1 and the engagement position where the follower member 36z engages with the turning cam 34e is set to be larger than a distance D3 between the reference line L1 and the imaginary line L2. The follower member 35z has a similar configuration.

[0085] As shown in FIG. 15(b), when the surgeon rotates the handles 31a and 31b of the operation knob 31 in one direction, the disc member 34 also rotates in the same direction (for example, the direction of arrow R3 in FIG. 15(b)). Accompanying this rotation, the rib-shaped rotating cam 34e 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 34 continues to rotate, the pin 35zb is pushed and moved by the rotating cam 34e, causing the follower member 35z to move in one direction (for example, the direction of arrow L31 in FIG. 15(b)). Meanwhile, the pin 36zc is pushed and moved by the rotating cam 34e, causing the follower member 36z to move in the opposite direction (for example, the direction of arrow L32 in FIG. 15(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).

[0086] As shown in FIG. 15(c), when the surgeon rotates the handles 31a and 31b of the operation knob 31 in the other direction, the disc member 34 also rotates in the same direction (for example, the direction of arrow R4 in FIG. 15(c)). Accompanying this rotation, the rib-shaped rotating cam 34e 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 34 continues to rotate, the pin 35zc is pushed and moved by the rotating cam 34e, causing the follower member 35z to move in one direction (for example, the direction of arrow L41 in FIG. 15(c)). Meanwhile, the pin 36zb is pushed and moved by the rotating cam 34e, causing the follower member 36z to move in the opposite direction (for example, the direction of arrow L42 in FIG. 15(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).

[0087] As described above, in this embodiment, the rotational movement of the disk member 34 is converted into the advancing and retreating movement of the follower members 35z and 36z via the rotary cam 34e 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.

[0088] In particular, in this embodiment, the positions of the pins 35zb, 35zc, 36zb, and 36zc are offset with respect to the wire connecting portions 35d and 36d, so that the rotation radius of the pins 35zb, 35zc, 36zb, and 36zc (points receiving force from the rotating cam 34e) during rotational movement is larger than the rotation radius of the wire connecting portions 35d and 36d (points at which a force acting to move the operating wires 4a and 4b acts). In this way, when the rotation radius of the pins 35zb, 35zc, 36zb, and 36zc is made larger than the rotation radius of the wire connecting portions 35d and 36d, the transmission position (point of force) of the operating force transmitted from the rotating cam 34e to the follower members 35z and 36z is located radially outward of the transmission position (point of action) of the acting force that moves the operating wires 4a and 4b. As a result, the amount of movement of the wire connection portions 35d, 36d in the sliding direction can be increased in response to the torque acting on the pins 35zb, 35zc, 36zb, 36zc, and the axial movement distance of the operating wires 4a, 4b can be efficiently increased while reducing the operating force.

[0089] (Example of derivative) Derivative examples of the rotating cam 34e will be described below. Figures 16(a) to 16(e) are diagrams showing first to fifth examples of the rotating cam 34e according to the present invention. Figures 16(a) to 16(e) show derivative examples relating to the shape of the rotating cam 34e provided on the underside of the disc member 34. These derivative examples can be applied to both the first and second embodiments described above.

[0090] In the first and second embodiments described above, one linear rotating cam 34e is provided on the lower surface of the disc member 34. This rotating cam 34e is shown in Figure 16(a). When the linear rotating cam 34e is used, the follower members 35 and 36 can be moved by a large distance in opposite directions via the rotating cam 34e.

[0091] As shown in Figure 16(b), a curved rotating cam 34e may be provided. The curved shape of the rotating cam 34e is not particularly limited as long as it is an arc equidistant from the rotation center, but it is preferable that the rotating cam 34e be formed in a curved shape that bulges outward in the radial direction from the rotation center of the disc member 34. By using this shape, the follower members 35, 36 can be moved significantly in opposite directions to each other via the rotating cam 34e, and the operating force (operating torque) can be effectively reduced in a range where the operating angle is large, thereby improving operability.

[0092] 16(c), two linear rotary cams 34e1 and 34e2 may be provided. In this case, in the initial state in which the handles 31a and 31b of the operation knob 31 are in symmetrical positions, either of the rotary cams 34e1 and 34e2 may be disposed between the pins 35b and 35c of the follower member 35, and either of the rotary cams 34e1 and 34e2 may be disposed between the pins 36b and 36c of the follower member 36.

[0093] As shown in Figure 16(d), two curved rotating cams 34e1, 34e2 may be provided. In this case, too, in the initial state in which handles 31a, 31b of operation knob 31 are in symmetrical positions, either of the rotating cams 34e1, 34e2 may be disposed between pins 35b, 35c of follower member 35, and either of the rotating cams 34e1, 34e2 may be disposed between pins 36b, 36c of follower member 36. Both of the rotating cams 34e1, 34e2 shown in Figure 16(d) are formed in a curved shape that bulges outward in the radial direction with respect to the rotation center of disc member 34, and this makes it possible to effectively reduce the operating force (operating torque) in a range where the operating angle becomes large.

[0094] As shown in FIG. 16(e), two rotating cams 34e1 and 34e2 may be provided. The rotating cams 34e1 and 34e2 shown in FIG. 16(e) have a shape similar to that of the single linear rotating cam 34e shown in FIG. 16(a), with the central portion removed and only both ends remaining. In the rotating cam 34e1 shown in FIG. 16(a), the contact area of ​​the pins 35b, 35c, 36b, and 36c is limited, and they do not contact the central portion of the rotating cam 34e. Therefore, the rotating cams 34e1 and 34e2 shown in FIG. 16(e) achieve the same operation as the rotating cam 34e shown in FIG. 16(a). Note that even if the rotating cam 34e has any other shape, it may be shaped in consideration of the contact area, as in the example shown in FIG. 16(e).

[0095] Fig. 17 is a diagram showing a modified example of the arrangement of the rotary cam and pin according to the present invention, which is a partial cross-sectional view taken along the line AA in Fig. 7 and is expressed in the same manner as Fig. 8.

[0096] In the first and second embodiments described above, the rotating cam 34e is formed in a rib shape, but as shown in Fig. 17, the rotating cam 34m may be formed in a groove shape. In this case, it is preferable to provide only one pin in each of the follower members 35 and 36 at a position facing the groove-shaped rotating cam 34m. Although Fig. 17 shows only the pin 35m provided in the follower member 35, a similar pin is also provided in the follower member 36.

[0097] In the assembled state, a pin (pin 35m shown in FIG. 17) provided on each of the follower members 35, 36 is disposed in a groove-shaped rotating cam 34m. When the disc member 34 rotates, the groove surface of the rotating cam 34m abuts against the side surface of the pin provided on the follower members 35, 36. When the disc member 34 rotates further, the rotating cam 34m drives the abutting pin, thereby moving the follower members 35, 36 back and forth in the sliding direction.

[0098] The operation of the present invention will be described below.

[0099] 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 operation mechanism 3 includes a grippable case 3a connected to the elongated member, a rotary operation plate rotatably arranged relative to the case 3a, an operation member (disk member 34) having ribbed or grooved rotary cams 34e and 34m provided on the plate surface of the rotary operation plate, and follower members 35, 35z, 36, and 36z connected to the proximal ends of the operation wires 4a and 4b, respectively, movable in the axial direction of the operation wires 4a and 4b relative to the case 3a, and arranged spaced apart on both sides of the rotation center of the rotary operation plate, and engaging with the rotary cams 34e and 34m. The follower members 35, 35z, 36, and 36z engaging with the rotary cams 34e and 34m move in opposite directions in response to rotation of the rotary operation plate, thereby moving the operation wires 4a and 4b in opposite directions in the axial direction.

[0100] According to the above configuration, the rotational movement of the rotary operation plate can be converted into the forward and backward movement of the follower members 35, 35z, 36, 36z and the operating wires 4a, 4b with a simple and compact configuration, and there is no need to significantly bend or fold back the operating wires 4a, 4b in order to operate them in the axial direction, making it possible to provide a medical device 1 that is excellent in operability and convenience. In particular, the medical device 1 according to the present invention is excellent in operability when bending an operated portion located on the distal end side of a tubular member that constitutes an endoscope, catheter, or the like in a desired deflection direction.

[0101] 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]

[0102] 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 Disc member (operating member) 34d Top center 34e, 34e1, 34e2, 34m rotary cam 35, 35z, 36, 36z Follower parts 35a, 36a Sliding member (slide portion) 35b, 35c, 35m, 35zb, 35zc, 36b, 36c, 36zb, 36zc Pin (convex engagement part) 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

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 rotary operation plate rotatably disposed relative to the case, and a rib-shaped or groove-shaped rotary cam provided on a plate surface perpendicular to a rotary axis of the rotary operation plate; a first follower member and a second follower member which are connected to the proximal end portions of the first and second operating wires, respectively, are movable in the axial direction of the first and second operating wires relative to the case, are spaced apart on both sides of the rotation center of the rotary operating 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. The medical device of claim 1, characterized in that the first and second follower members have respective slide portions arranged parallel to each other along the axial direction of the first and second operating lines, and respective wire connection portions connecting the slide portions to the first and second operating lines.

3. The medical device described in claim 2, characterized in that on the plate surface of the rotating operation plate, the distance between a reference line passing through the rotation center of the rotating operation plate and extending in the movement direction of the first and second follower members and an engagement position where the follower members engage with the rotating cam is greater than the distance between the reference line and a line extending in the movement direction of the wire connection portion.

4. A medical device as described in claim 2 or 3, characterized in that the distance between the tracks along which the wire connection portions of each of the first and second follower members move is equivalent to the distance between the first and second operating wires attached to the elongate member.

5. 5. The medical device according to claim 1, wherein the rotary cam is formed linearly on the surface of the rotary operation plate.

6. The medical device according to any one of claims 1 to 4, characterized in that the rotating cam is formed on the surface of the rotating operation plate in a curved shape that bulges radially outward relative to the rotation center of the rotating operation plate.

7. A medical device as described in any one of claims 1 to 6, characterized in that the first and second follower members are spaced apart in a direction intersecting the extension direction of the rib-shaped rotating cam, and have multiple convex engagement portions that protrude toward the rotating operation plate on both sides of the rotating cam.

Images