medical devices

Abstract

To provide a medical device capable of reducing operation force of an operation part.SOLUTION: A medical device includes: a base unit equipped with a driving source and a connection part connected to the driving source; a bendable unit equipped with a bending part and a linear member configured so as to be connected to the connection part for bending the bending part by being driven by the driving source through the connection part; an operation part; and a deceleration mechanism equipped with an output member driven by the force transmitted from the operation part. The connection part includes a holding part that can transition between a holding state for holding the linear member and a release state in which the holding of the linear member is released, and a switching part that is moved by the output member for switching the holding part between the holding state and the release state. The output member is configured so as to move by a second moving amount smaller than a first moving amount when the operation part moves by the first moving amount.SELECTED DRAWING: Figure 11

Description

[Technical Field]

[0001] The present invention relates to a medical device having a bendable curved portion. [Background technology]

[0002] Patent Document 1 discloses a medical instrument that includes an operated part having a deformation part and an operating part that deforms the deformation part, and the operated part and the operating part are detachable. The operated part is provided with a wire for deforming the deformation part, and a magnet on the operated part is fixed to the wire. The operating part is provided with a wire wound around a pulley, and a magnet on the operating part is fixed to the wire. When the operated part is connected to the operating part, the magnet on the operated part and the magnet on the operating part attract each other, and the operating part and the wire on the operated part are interlocked. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Laid-Open No. 2013-248116 Summary of the Invention [Problem to be solved by the invention]

[0004] However, with the configuration of Patent Document 1, when removing the operated part from the operating part, the user must pull the operated part against the attractive force between the magnet on the operated part side and the magnet on the operating part side, which are attracting each other.

[0005] An object of the present invention is to provide a medical device that can reduce the operating force of an operating section. [Means for solving the problem]

[0006] One aspect of the present invention is a medical device comprising: a base unit including a drive source and a coupling portion connected to the drive source; a bendable unit removably attached to the base unit, the bendable unit including a bendable bending portion and a linear member configured to be connectable to the coupling portion and driven by the drive source via the coupling portion to bend the bending portion; a fixed position where removal of the bendable unit from the base unit is restricted, and a removal position where removal of the bendable unit from the base unit is permitted; an operating unit; and a speed reduction mechanism including an output member driven by a force transmitted from the operating unit, wherein the connecting unit includes a holding unit that can transition between a holding state in which the linear member is held when the bendable unit is attached to the base unit and a release state in which the linear member is released from being held, and a switching unit that is moved by the output member and switches the holding unit between the holding state and the release state, When the operation unit is in the fixed position, the holding unit is in the held state, and when the operation unit is in the detached position, the holding unit is in the released state. When the operation unit is moved from the fixed position to the detached position, the holding unit switches from the held state to the released state. The output member is configured to move by a second movement amount smaller than the first movement amount when the operation portion moves by the first movement amount. [Effects of the Invention]

[0007] According to the present invention, the operating force of the operating unit can be reduced. [Brief explanation of the drawings]

[0008] [Figure 1] Overall view of the healthcare system. [Figure 2] FIG. 1 is a perspective view showing a medical device and a support base. [Figure 3] FIG. 2( a ) is an overall perspective view showing the catheter, and FIG. 2( b ) is an enlarged perspective view showing the catheter. [Figure 4] FIG. 2A is a perspective view showing the catheter unit with the wire cover in the covering position, and FIG. 2B is a perspective view showing the catheter unit with the wire cover in the exposing position. [Figure 5] 1A is a perspective view showing the internal structure of the base unit, FIG. 1B is a side view showing the internal structure of the base unit, and FIG. 1C is a view of the base unit as seen along the attachment / detachment direction DE. [Figure 6]1A is a perspective view showing the drive source, the connecting portion, and the drive wire, FIG. 1B is an enlarged view showing the connecting portion and the drive wire, and FIG. 1C is a perspective view showing the wire drive portion, the connecting device, and the bending drive portion. [Figure 7] FIG. 1A is a cross-sectional view showing the state before the catheter unit is attached to the base unit, and FIG. 1B is a cross-sectional view showing the state after the catheter unit is attached to the base unit. [Figure 8] FIG. 10 is a perspective view showing a connection portion of the base unit to the catheter unit. [Figure 9] FIG. 4 is a perspective view showing a planetary gear mechanism built into the base unit. [Figure 10] FIG. 4 is an exploded perspective view showing the operating unit and the planetary gear mechanism. [Figure 11] FIG. [Figure 12] FIG. 3 is a cross-sectional view of the operation unit and the base unit taken along the rotation axis of the operation unit. [Figure 13] 13A is a cross-sectional view showing the cross section 13A-13A of FIG. 12. [Figure 14] (a) is a cross-sectional view of the catheter unit and the base unit taken along the rotation axis of the control unit, and (b) is a cross-sectional view of the base unit taken in a direction perpendicular to the rotation axis. [Figure 15] 10A and 10B are diagrams illustrating fixing of the drive wire by a connecting portion. [Figure 16] 10A and 10B are diagrams illustrating fixing of the drive wire by a connecting portion. [Figure 17] 10A and 10B are diagrams illustrating fixing of the drive wire by a connecting portion. [Figure 18] 10A and 10B are diagrams illustrating fixing of the drive wire by a connecting portion. [Figure 19] 10A and 10B are diagrams illustrating fixing of the drive wire by a connecting portion. [Figure 20] (a) is a cross-sectional view of the catheter unit, (b) is a perspective view of the button, and (c) is a perspective view of the base unit. [Figure 21] FIG. 1A is a diagram showing the operating unit in a detached position, FIG. 1B is a diagram showing the operating unit in a released position, and FIG. 1C is a diagram showing the operating unit in a fixed position. [Figure 22] FIG. 1A is a cross-sectional view showing the operating unit in a detached position, FIG. 1B is a cross-sectional view showing the operating unit in a released position, and FIG. 1C is a cross-sectional view showing the operating unit in a fixed position. [Figure 23] 1A is a skeleton diagram showing a planetary-type planetary gear mechanism according to the first embodiment, FIG. 1B is a skeleton diagram showing a solar-type planetary gear mechanism according to a modified example of the first embodiment, and FIG. 1C is a skeleton diagram showing a star-type planetary gear mechanism according to another modified example of the first embodiment. [Figure 24] FIG. 10 is a perspective view showing a stepped gear mechanism according to a second embodiment. [Figure 25] FIG. DETAILED DESCRIPTION OF THE INVENTION

[0009] Hereinafter, embodiments of the present disclosure will be described with reference to the drawings.

[0010] [First embodiment] <Medical Systems and Medical Devices> A medical system 1A and a medical device 1 according to the first embodiment will be described with reference to Figures 1 and 2. Figure 1 is an overall view of the medical system 1A. Figure 2 is a perspective view showing the medical device 1 and the support base 2.

[0011] The medical system 1A includes a medical device 1, a support base 2 on which the medical device 1 is attached, and a control unit (control device) 3 that controls the medical device 1. In this embodiment, the medical system 1A includes a monitor 4 as a display device.

[0012] The medical device 1 includes a catheter unit (bendable unit) 100 having a catheter 11 as a bendable body, and a base unit (drive unit, attached unit) 200. The catheter unit 100 is configured to be detachable from the base unit 200.

[0013] In this embodiment, a user of the medical system 1A and the medical device 1 can perform tasks such as observing the interior of the subject, collecting various specimens from the interior of the subject, and performing treatment on the interior of the subject by inserting the catheter 11 into the interior of the subject. In one embodiment, the user can insert the catheter 11 into the interior of a patient. Specifically, by inserting the catheter 11 into the bronchi through the patient's oral cavity or nasal cavity, tasks such as observing, collecting, and resecting lung tissue can be performed.

[0014] The catheter 11 can be used as a guide (sheath) for guiding a medical tool for performing the above-mentioned procedure. Examples of the medical tool include an endoscope, forceps, and an ablation device. The catheter 11 itself may also function as the above-mentioned medical tool, in which case the catheter 11 is not limited to being cylindrical, but may be, for example, cylindrical.

[0015] In this embodiment, the control unit 3 includes a calculation unit 3a and an input unit 3b. The input unit 3b receives commands and inputs for operating the catheter 11. The calculation unit 3a includes a storage for storing programs and various data for controlling the catheter, a random access memory, and a central processing unit for executing the programs. The control unit 3 may also include an output unit for outputting signals for displaying images on the monitor 4.

[0016] 2, in this embodiment, the medical device 1 is electrically connected to the control unit 3 via a cable 5 that connects the base unit 200 of the medical device 1 to the support base 2, and the support base 2. The medical device 1 and the control unit 3 may be directly connected by a cable. Alternatively, the medical device 1 and the control unit 3 may be connected wirelessly.

[0017] The medical device 1 is removably mounted to the support base 2 via the base unit 200. More specifically, the medical device 1 is removably mounted to a moving stage (receiving portion) 2a of the support base 2 via an attachment portion (connecting portion) 200a of the base unit 200. Even when the attachment portion 200a of the medical device 1 is detached from the moving stage 2a, the connection between the medical device 1 and the control unit 3 is maintained so that the medical device 1 can be controlled by the control unit 3. In this embodiment, even when the attachment portion 200a of the medical device 1 is detached from the moving stage 2a, the medical device 1 and the support base 2 are connected by a cable 5.

[0018] The user can manually move the medical device 1 when it is removed from the support base 2 (when the medical device 1 is removed from the moving stage 2a) and insert the catheter 11 into the subject.

[0019] A user can use the medical device 1 with the catheter 11 inserted into the subject and the medical device 1 attached to the support base 2. Specifically, with the medical device 1 attached to the moving stage 2a, the moving stage 2a moves, causing the medical device 1 to move. The catheter 11 then moves in the direction of inserting it into the subject, and in the direction of withdrawing it from the subject. The movement of the moving stage 2a is controlled by the control unit 3.

[0020] The mounting portion 200a of the base unit 200 is equipped with a release switch and a removal switch (not shown). With the mounting portion 200a attached to the moving stage 2a, the user can manually move the medical device 1 along the guide direction of the moving stage 2a while continuing to press the release switch. In other words, the moving stage 2a is equipped with a guide structure that guides the movement of the medical device 1. When the user stops pressing the release switch, the medical device 1 is fixed to the moving stage 2a. On the other hand, when the removal switch is pressed with the mounting portion 200a attached to the moving stage 2a, the user can remove the medical device 1 from the moving stage 2a.

[0021] A single switch may have the functions of both the release switch and the removal switch. If the release switch is provided with a mechanism for switching between a pressed state and a non-pressed state, the user will not need to keep pressing the release switch when manually sliding the medical device 1.

[0022] When the mounting part 200a is attached to the moving stage 2a and the release switch and removal switch are not pressed, the medical device 1 is fixed to the moving stage 2a and moved by the moving stage 2a driven by a motor not shown.

[0023] The medical device 1 includes a wire driving unit (linear member driving unit, line driving unit, main body driving unit) 300 for driving the catheter 11. In this embodiment, the medical device 1 is a robotic catheter device that drives the catheter 11 using the wire driving unit 300 controlled by the control unit 3.

[0024] The control unit 3 controls the wire driving unit 300 to bend the catheter 11. In this embodiment, the wire driving unit 300 is built into the base unit 200. More specifically, the base unit 200 includes a base housing 200f that houses the wire driving unit 300. In other words, the base unit 200 includes the wire driving unit 300. The wire driving unit 300 and the base unit 200 can be collectively referred to as a catheter driving device (base device, main body).

[0025] The end where the tip of the catheter 11 inserted into the subject is located is called the distal end in the extending direction of the catheter 11. The opposite side of the distal end in the extending direction of the catheter 11 is called the proximal end.

[0026] The catheter unit 100 has a proximal end cover 16 that covers the proximal end side of the catheter 11. The proximal end cover 16 has a tool hole 16a. A medical instrument can be inserted into the catheter 11 through the tool hole 16a.

[0027] As described above, in this embodiment, the catheter 11 functions as a guide device for guiding a medical instrument to a desired position inside a subject.

[0028] For example, with an endoscope inserted in the catheter 11, the catheter 11 is inserted to a target position inside the subject. At this time, at least one of manual operation by the user, movement of the moving stage 2a, and driving of the catheter 11 by the wire driving unit 300 is used. After the catheter 11 reaches the target position, the endoscope is pulled out of the catheter 11 through the tool hole 16a. Then, medical instruments are inserted through the tool hole 16a, and various specimens are collected from inside the subject, and treatments on the inside of the subject are performed.

[0029] As will be described later, the catheter unit 100 is removably attached to a catheter driving device (base device, main body), more specifically, the base unit 200. After the medical device 1 has been used, the user can remove the catheter unit 100 from the base unit 200 and attach a new catheter unit 100 to the base unit 200, thereby using the medical device 1 again. In other words, the catheter unit 100 can be used as a disposable unit. Here, disposable means that the catheter unit 100 used in a single treatment is discarded after use. This prevents the catheter unit 100 from being reused, and allows the medical device 1 to be kept constantly clean.

[0030] 2, the medical device 1 has an operation unit 400. In this embodiment, the operation unit 400 is provided in the catheter unit 100. The operation unit 400 is operated by a user when fixing the catheter unit 100 to the base unit 200 or removing the catheter unit 100 from the base unit 200.

[0031] By connecting the monitor 4 to the endoscope inserted into the catheter 11, it is possible to display images captured by the endoscope on the monitor 4. Furthermore, by connecting the monitor 4 to the control unit 3, it is possible to display on the monitor 4 the state of the medical device 1 and information related to the control of the medical device 1. For example, it is possible to display on the monitor 4 the position of the catheter 11 inside the subject and information related to the navigation of the catheter 11 inside the subject. The monitor 4, the control unit 3, and the endoscope may be connected by wire or wirelessly. Furthermore, the monitor 4 and the control unit 3 may be connected via the support base 2.

[0032] <Catheter> A catheter 11 as a bendable body will be described using Figures 3(a) and (b). Figures 3(a) and (b) are explanatory views of the catheter 11. Figure 3(a) is a view explaining the entire catheter 11. Figure 3(b) is an enlarged view of the catheter 11.

[0033] The catheter 11 includes a bending section (bending body, catheter main body) 12 and a bending drive section (catheter drive section) 13 configured to bend the bending section 12. The bending drive section 13 is configured to receive a driving force from a wire drive section 300 via a connecting device 21, which will be described later, to bend the bending section 12.

[0034] The catheter 11 is extended along the insertion direction of the catheter 11 into the subject. The extension direction (longitudinal direction) of the catheter 11 is the same as the extension direction (longitudinal direction) of the bending section 12 and the extension directions (longitudinal directions) of the first to ninth driving wires (W11 to W33) described below.

[0035] The bending drive unit 13 includes a plurality of drive wires (drive lines, linear members, linear actuators) connected to the bending portion 12. Specifically, the bending drive unit 13 includes a first drive wire W11, a second drive wire W12, a third drive wire W13, a fourth drive wire W21, a fifth drive wire W22, a sixth drive wire W23, a seventh drive wire W31, an eighth drive wire W32, and a ninth drive wire W33.

[0036] Each of the first to ninth drive wires (W11 to W33) includes a holdable portion (holdable shaft, rod) Wa. Specifically, the first drive wire W11 includes a first holdable portion Wa11. The second drive wire W12 includes a second holdable portion Wa12. The third drive wire W13 includes a third holdable portion Wa13. The fourth drive wire W21 includes a fourth holdable portion Wa21. The fifth drive wire W22 includes a fifth holdable portion Wa22. The sixth drive wire W23 includes a sixth holdable portion Wa23. The seventh drive wire W31 includes a seventh holdable portion Wa31. The eighth drive wire W32 includes an eighth holdable portion Wa32. The ninth drive wire W33 includes a ninth holdable portion Wa33.

[0037] In this embodiment, the first to ninth held portions (Wa11 to Wa33) have the same shape.

[0038] Each of the first to ninth drive wires (W11 to W33) includes a flexible wire body (wire member, line body, linear body) Wb. Here, the wire body Wb is a member that allows an object connected thereto to be pushed or pulled, and has a certain degree of rigidity. On the other hand, it is a member that is deformable from a straight shape so that the bending portion 12 can be bent. The first drive wire W11 includes a first wire body Wb11. The second drive wire W12 includes a second wire body Wb12. The third drive wire W13 includes a third wire body Wb13. The fourth drive wire W21 includes a fourth wire body Wb21. The fifth drive wire W22 includes a fifth wire body Wb22. The sixth drive wire W23 includes a sixth wire body Wb23. The seventh drive wire W31 includes a seventh wire body Wb31. The eighth drive wire W32 includes an eighth wire body Wb32. The ninth drive wire W33 includes a ninth wire body Wb33.

[0039] In this embodiment, the first to third wire bodies (Wb11 to Wb13) have the same shape. The fourth to sixth wire bodies (Wb21 to Wb23) have the same shape. The seventh to ninth wire bodies (Wb31 to Wb33) have the same shape. In this embodiment, the first to ninth wire bodies (Wb11 to Wb33) have the same shape except for their lengths.

[0040] The first to ninth held portions (Wa11 to Wa33) are attached to the proximal ends of the first to ninth wire bodies (Wb11 to Wb33). The first to ninth drive wires (W11 to W33) are inserted into the bending portion 12 via a wire guide 17 and fixed therein.

[0041] In this embodiment, the first to ninth wire bodies (Wb11 to Wb33) are each made of metal. However, the first to ninth wire bodies (Wb11 to Wb33) may also be made of resin. Furthermore, the first to ninth wire bodies (Wb11 to Wb33) may also be made of a material containing metal and resin.

[0042] Any one of the first to ninth drive wires (W11 to W33) can be referred to as a linear member, namely, drive wire W. In this embodiment, the first to ninth drive wires (W11 to W33) have the same shape except for the lengths of the first to ninth wire bodies (Wb11 to Wb33).

[0043] In this embodiment, the bending portion 12 is a flexible tubular member having a passage Ht for inserting a medical instrument.

[0044] The wall surface of the bending portion 12 is provided with a plurality of wire holes for passing through each of the first to ninth drive wires (W11 to W33). Specifically, the wall surface of the bending portion 12 is provided with a first wire hole Hw11, a second wire hole Hw12, and a third wire hole Hw13. The wall surface of the bending portion 12 is further provided with a fourth wire hole Hw21, a fifth wire hole Hw22, and a sixth wire hole Hw23. The wall surface of the bending portion 12 is further provided with a seventh wire hole Hw31, an eighth wire hole Hw32, and a ninth wire hole Hw33. The first to ninth wire holes Hw (Hw11 to Hw33) correspond to the first to ninth drive wires (W11 to W33), respectively. The number after the symbol Hw indicates the number of the corresponding drive wire. For example, the first drive wire W11 is inserted into the first wire hole Hw11.

[0045] Any one of the first to ninth wire holes (Hw11 to Hw33) can be referred to as a wire hole Hw. In this embodiment, the first to ninth wire holes (Hw11 to Hw33) have the same shape.

[0046] The bending portion 12 has an intermediate region 12a and a bending region 12b. The bending region 12b is located at the distal end of the bending portion 12, and a first guide ring J1, a second guide ring J2, and a third guide ring J3 are located in the bending region 12b. The bending region 12b refers to a region where the magnitude and direction of bending of the bending portion 12 can be controlled by moving the first guide ring J1, the second guide ring J2, and the third guide ring J3 using the bending drive unit 13. FIG. 3(b) omits a portion of the bending portion 12 that covers the first to third guide rings (J1 to J3).

[0047] In this embodiment, the bending portion 12 includes a plurality of auxiliary rings (not shown). In the bending region 12b, a first guide ring J1, a second guide ring J2, and a third guide ring J3 are fixed to the wall surface of the bending portion 12. In this embodiment, the plurality of auxiliary rings are disposed between the first guide ring J1 and the second guide ring J2, and between the second guide ring J2 and the third guide ring J3.

[0048] The medical instrument is guided to the tip of the catheter 11 by the passage Ht, the first to third guide rings (J1 to J3), and a plurality of auxiliary rings.

[0049] The first to ninth drive wires (W11 to W33) pass through the intermediate region 12a and are fixed to the first to third guide rings (J1 to J3), respectively. Specifically, the first drive wire W11, the second drive wire W12, and the third drive wire W13 are fixed to the first guide ring J1. The fourth drive wire W21, the fifth drive wire W22, and the sixth drive wire W23 pass through the first guide ring J1 and multiple auxiliary rings and are fixed to the second guide ring J2. The seventh drive wire W31, the eighth drive wire W32, and the ninth drive wire W33 pass through the first guide ring J1, the second guide ring J2, and multiple auxiliary rings and are fixed to the third guide ring J3.

[0050] The medical device 1 can bend the bending section 12 in a direction intersecting the extension direction of the catheter 11 by driving the bending drive section 13 with the wire drive section 300. Specifically, by moving each of the first to ninth drive wires (W11 to W33) in the extension direction of the bending section 12, the bending region 12b of the bending section 12 can be bent in a direction intersecting the extension direction via the first to third guide rings (J1 to J3).

[0051] The user can insert the catheter 11 to a desired portion inside the subject by moving the medical device 1 manually or by using the moving stage 2a and / or by bending the bending portion 12.

[0052] In this embodiment, the first to third guide rings (J1 to J3) are moved by the first to ninth drive wires (W11 to W33) to bend the bending section 12, but this configuration is not limiting. Any one or two of the first to third guide rings (J1 to J3) and the drive wires fixed thereto may be omitted.

[0053] For example, the catheter 11 may have the seventh to ninth drive wires (W31 to W33) and the third guide ring J3, and may omit the first to sixth drive wires (W11 to W23) and the first and second guide rings (J1 to J2). Alternatively, the catheter 11 may have the fourth to ninth drive wires (W21 to W33) and the second and third guide rings (J2 to J3), and may omit the first to third drive wires (W11 to W13) and the first guide ring J1.

[0054] Alternatively, catheter 11 may have a configuration in which one guide ring is driven by two drive wires. In this case, the number of guide rings may be one or more.

[0055] <Catheter unit> The catheter unit 100 will be described using Figures 4(a) and (b). Figures 4(a) and (b) are explanatory diagrams of the catheter unit 100. Figure 4(a) is an explanatory diagram of the catheter unit 100 in a state where a wire cover 14, which will be described later, is in a covered position. Figure 4(b) is an explanatory diagram of the catheter unit 100 in a state where a wire cover 14, which will be described later, is in an exposed position.

[0056] The catheter unit 100 includes a catheter 11 having a bending section 12 and a bending drive section 13, and a proximal end cover 16 that supports the proximal end of the catheter 11. The catheter unit 100 also includes a cover (wire cover) 14 that covers and protects first to ninth drive wires (W11 to W33) that serve as a plurality of drive wires.

[0057] The catheter unit 100 is attachable to and detachable from the base unit 200 along an attachment / detachment direction DE. The direction in which the catheter unit 100 is attached to the base unit 200 and the direction in which the catheter unit 100 is removed from the base unit 200 are parallel to the attachment / detachment direction DE.

[0058] The proximal end cover (frame body, bending portion housing, catheter housing) 16 is a cover that covers a part of the catheter 11. The proximal end cover 16 has a tool hole 16a for inserting a medical instrument into the passage Ht of the bending portion 12.

[0059] The wire cover 14 is provided with a plurality of exposed holes (wire cover holes, cover holes) for passing through the first to ninth drive wires (W11 to W33). The wire cover 14 is provided with a first exposed hole 14a11, a second exposed hole 14a12, a third exposed hole 14a13, a fourth exposed hole 14a21, a fifth exposed hole 14a22, a sixth exposed hole 14a23, a seventh exposed hole 14a31, an eighth exposed hole 14a32, and a ninth exposed hole 14a33. The first to ninth exposed holes (14a11 to 14a33) correspond to the first to ninth drive wires (W11 to W33), respectively. The number after the symbol 14a indicates the number of the corresponding drive wire. For example, the first drive wire W11 is inserted into the first exposed hole 14a11.

[0060] Any one of the first to ninth exposure holes (14a11 to 14a33) can be referred to as exposure hole 14a. In this embodiment, the first to ninth exposure holes (14a11 to 14a33) have the same shape.

[0061] The wire cover 14 can be moved between a covering position (see FIG. 14(a)) where it covers the first to ninth drive wires (W11 to W33) and a cover retracted position (see FIG. 14(b)) where it is retracted from the covering position. The cover retracted position can also be called an exposing position where the first to ninth drive wires (W11 to W33) are exposed.

[0062] The wire cover 14 is located in the covered position before the catheter unit 100 is attached to the base unit 200. When the catheter unit 100 is attached to the base unit 200, the wire cover 14 moves from the covered position to the exposed position along the attachment / detachment direction DE.

[0063] In the present embodiment, the wire cover 14 is moved from the covered position to the exposed position and then remains at the exposed position. Therefore, after the catheter unit 100 is attached to the base unit 200, the wire cover 14 remains at the exposed position even if the catheter unit 100 is removed from the base unit 200.

[0064] However, the wire cover 14 may be configured to move from the covered position to the exposed position and then return to the covered position. For example, the catheter unit 100 may be provided with a biasing member that biases the wire cover 14 from the exposed position toward the covered position. In this case, after the catheter unit 100 is attached to the base unit 200, when the catheter unit 100 is removed from the base unit 200, the wire cover 14 is moved from the exposed position to the covered position.

[0065] When the wire cover 14 is in the exposed position, the first to ninth held portions (Wa11 to Wa33) of the first to ninth drive wires (W11 to W33) are exposed. As a result, the bending drive portion 13 is allowed to be connected to a connecting device 21, which will be described later. When the wire cover 14 is in the exposed position, the first to ninth held portions (Wa11 to Wa33) of the first to ninth drive wires (W11 to W33) protrude from the first to ninth exposed holes (14a11 to 14a33). More specifically, the first to ninth held portions (Wa11 to Wa33) protrude from the first to ninth exposed holes (14a11 to 14a33) in the attachment direction Da, which will be described later.

[0066] As shown in FIG. 4(b), each of the first to ninth driving wires (W11 to W33) is arranged along a circle (imaginary circle) having a predetermined radius.

[0067] In this embodiment, the catheter unit 100 has a key shaft (key, catheter side key) 15. In this embodiment, the key shaft 15 extends in the attachment / detachment direction DE. The wire cover 14 is provided with a shaft hole 14b through which the key shaft 15 passes. The key shaft 15 is engageable with a key receiving portion 22, which will be described later. By engaging the key shaft 15 with the key receiving portion 22, movement of the catheter unit 100 relative to the base unit 200 is limited within a predetermined range in the circumferential direction of a circle (imaginary circle) on which the first to ninth drive wires (W11 to W33) are arranged.

[0068] In this embodiment, when viewed in the attachment / detachment direction DE, the first to ninth drive wires (W11 to W33) are arranged outside the key shaft 15 so as to surround the key shaft 15. In other words, the key shaft 15 is arranged inside a circle (a virtual circle) in which the first to ninth drive wires (W11 to W33) are arranged. Therefore, the key shaft 15 and the first to ninth drive wires (W11 to W33) can be arranged in a space-saving manner.

[0069] In this embodiment, the catheter unit 100 includes an operating section 400. The operating section 400 is configured to be movable (rotatable) relative to the proximal end cover 16 and the bending drive section 13. The operating section 400 is rotatable around a rotation axis 400r. The rotation axis 400r of the operating section 400 extends in the attachment / detachment direction DE.

[0070] With the catheter unit 100 attached to the base unit 200, the operation unit 400 is configured to be movable (rotatable) relative to the base unit 200. More specifically, the operation unit 400 is configured to be movable (rotatable) relative to the base housing 200f, the wire driving unit 300, and the connecting device 21, which will be described later.

[0071] <Base unit> The base unit 200 and the wire driving section 300 will be described using Figures 5(a) to (c). Figures 5(a) to (c) are explanatory diagrams of the base unit 200 and the wire driving section 300. Figure 5(a) is a perspective view showing the internal structure of the base unit 200. Figure 5(b) is a side view showing the internal structure of the base unit 200. Figure 5(c) is a view of the base unit 200 as seen along the attachment / detachment direction DE.

[0072] As described above, the medical device 1 includes the base unit 200 and the wire driving unit 300. In this embodiment, the wire driving unit 300 is housed in the base housing 200f and provided inside the base unit 200. In other words, the base unit 200 includes the wire driving unit 300.

[0073] The wire driving unit 300 has multiple driving sources (motors, actuators). In this embodiment, the wire driving unit 300 includes a first driving source M11, a second driving source M12, a third driving source M13, a fourth driving source M21, a fifth driving source M22, a sixth driving source M23, a seventh driving source M31, an eighth driving source M32, and a ninth driving source M33.

[0074] Any one of the first to ninth driving sources (M11 to M33) can be referred to as driving source M. In this embodiment, the first to ninth driving sources (M11 to M33) have the same configuration.

[0075] The base unit 200 includes a coupling device 21. The coupling device 21 is housed in a base housing 200f. The coupling device 21 is connected to the wire driving unit 300. The coupling device 21 has a plurality of coupling portions. In this embodiment, the coupling device 21 includes a first coupling portion 21c11, a second coupling portion 21c12, a third coupling portion 21c13, a fourth coupling portion 21c21, a fifth coupling portion 21c22, a sixth coupling portion 21c23, a seventh coupling portion 21c31, an eighth coupling portion 21c32, and a ninth coupling portion 21c33.

[0076] Any one of the first to ninth connecting portions (21c11 to 21c33) can be called a connecting portion 21c. In this embodiment, the first to ninth connecting portions (21c11 to 21c33) have the same configuration.

[0077] Each of the multiple connecting portions is connected to a corresponding one of the multiple driving sources and driven by the corresponding one of the multiple driving sources. Specifically, the first connecting portion 21c11 is connected to and driven by the first driving source M11. The second connecting portion 21c12 is connected to and driven by the second driving source M12. The third connecting portion 21c13 is connected to and driven by the third driving source M13. The fourth connecting portion 21c21 is connected to and driven by the fourth driving source M21. The fifth connecting portion 21c22 is connected to and driven by the fifth driving source M22. The sixth connecting portion 21c23 is connected to and driven by the sixth driving source M23. The seventh connecting portion 21c31 is connected to and driven by a seventh driving source M31. The eighth connecting portion 21c32 is connected to and driven by an eighth driving source M32. The ninth connecting portion 21c33 is connected to and driven by a ninth driving source M33.

[0078] As will be described later, a bending drive unit 13 including first to ninth drive wires (W11 to W33) is connected to the connection device 21. The bending drive unit 13 receives the driving force of the wire drive unit 300 via the connection device 21 and bends the bending portion 12.

[0079] The drive wire W is connected to the connecting portion 21c via the hold portion Wa. Each of the multiple drive wires is connected to each of the multiple connecting portions. Specifically, the first hold portion Wa11 of the first drive wire W11 is connected to the first connecting portion 21c11. The second hold portion Wa12 of the second drive wire W12 is connected to the second connecting portion 21c12. The third hold portion Wa13 of the third drive wire W13 is connected to the third connecting portion 21c13. The fourth hold portion Wa21 of the fourth drive wire W21 is connected to the fourth connecting portion 21c21. The fifth hold portion Wa22 of the fifth drive wire W22 is connected to the fifth connecting portion 21c22. The sixth hold portion Wa23 of the sixth drive wire W23 is connected to the sixth connecting portion 21c23. The seventh held portion Wa31 of the seventh drive wire W31 is connected to the seventh connecting portion 21c31. The eighth held portion Wa32 of the eighth drive wire W32 is connected to the eighth connecting portion 21c32. The ninth held portion Wa33 of the ninth drive wire W33 is connected to the ninth connecting portion 21c33.

[0080] The base unit 200 has a base frame 25. The base frame 25 is provided with a plurality of insertion holes for passing the first to ninth drive wires (W11 to W33). The base frame 25 is provided with a first insertion hole 25a11, a second insertion hole 25a12, a third insertion hole 25a13, a fourth insertion hole 25a21, a fifth insertion hole 25a22, a sixth insertion hole 25a23, a seventh insertion hole 25a31, an eighth insertion hole 25a32, and a ninth insertion hole 25a33. The first to ninth insertion holes (25a11 to 25a33) correspond to the first to ninth drive wires (W11 to W33), respectively. The number after the symbol 25a indicates the number of the corresponding drive wire. For example, the first drive wire W11 is inserted into the first insertion hole 25a11.

[0081] Any one of the first to ninth insertion holes (25a11 to 25a33) can be referred to as an insertion hole 25a. In this embodiment, the first to ninth insertion holes (25a11 to 25a33) have the same shape.

[0082] The base frame 25 is provided with an attachment opening 25b into which the wire cover 14 is inserted. First to ninth insertion holes (25a11 to 25a33) are arranged at the bottom of the attachment opening 25b.

[0083] The base unit 200 further includes a motor frame 200b, a first bearing frame 200c, a second bearing frame 200d, and a third bearing frame 200e. The motor frame 200b, the first bearing frame 200c, the second bearing frame 200d, and the third bearing frame 200e are connected to each other.

[0084] The base frame 25 has a key receiving portion (key hole, base side key, main body side key) 22 that receives the key shaft 15. The engagement between the key shaft 15 and the key receiving portion 22 prevents the catheter unit 100 from being attached to the base unit 200 in the wrong phase.

[0085] By engaging the key shaft 15 with the key receiving portion 22, the movement of the catheter unit 100 relative to the base unit 200 is limited within a predetermined range in the circumferential direction of the circle (imaginary circle) on which each of the first to ninth drive wires (W11 to W33) is arranged.

[0086] As a result, the first to ninth drive wires (W11 to W33) are engaged with the corresponding first to ninth insertion holes (25a11 to 25a33) and the corresponding first to ninth connecting portions (21c11 to 21c33), respectively. In other words, the drive wire W is prevented from engaging with an insertion hole 25a other than the corresponding insertion hole 25a and a connecting portion 21c other than the corresponding connecting portion 21c.

[0087] The user can correctly connect each of the first to ninth drive wires (W11 to W33) to each of the first to ninth connecting portions (21c11 to 21c33) by engaging the key shaft 15 with the key receiving portion 22. Therefore, the user can easily attach the catheter unit 100 to the base unit 200.

[0088] In this embodiment, the key shaft 15 has a protrusion that protrudes in a direction intersecting the attachment / detachment direction DE, and the key receiving portion 22 has a recess into which the protrusion is inserted. The position at which the protrusion and the recess engage in the circumferential direction is the position at which the drive wire W engages with the corresponding insertion hole 25a and the corresponding connecting portion 21c.

[0089] The key shaft 15 may be disposed in either the base unit 200 or the catheter unit 100, and the key receiving portion 22 may be disposed in the other. For example, the key shaft 15 may be disposed on the base unit 200 side, and the key receiving portion 22 may be disposed on the catheter unit 100 side.

[0090] <Connection between motor and drive wire> The connection between the wire driving unit 300, the connecting device 21, and the bending driving unit 13 will be described using Figures 6(a) to 6(c). Figures 6(a) to 6(c) are explanatory diagrams of the wire driving unit 300, the connecting device 21, and the bending driving unit 13. Figure 6(a) is a perspective view of the driving source M, the connecting unit 21c, and the driving wire W. Figure 6(b) is an enlarged view of the connecting unit 21c and the driving wire W. Figure 6(c) is a perspective view showing the connection between the wire driving unit 300, the connecting device 21, and the bending driving unit 13.

[0091] In this embodiment, the first to ninth drive wires (W11 to W33) are connected to the first to ninth connecting portions (21c11 to 21c33) in the same configuration. Also, the first to ninth connecting portions (21c11 to 21c33) are connected to the first to ninth drive sources (M11 to M33) in the same configuration. Therefore, the following description will be given of the configuration in which one drive wire W, one connecting portion 21c, and one drive source M are connected.

[0092] As shown in Fig. 6(a), the driving source M has an output shaft Ma and a motor body Mb that rotates the output shaft Ma in a rotation direction Rm. A spiral groove is provided on the surface of the output shaft Ma. The output shaft Ma has a so-called screw shape. The motor body Mb is fixed to a motor frame 200b.

[0093] The connecting portion 21c has a tractor 21ct connected to the output shaft Ma and a tractor support shaft 21cs that supports the tractor 21ct. The tractor support shaft 21cs is connected to a connecting base 21cb.

[0094] The connecting portion 21c has a leaf spring 21ch as a holding portion for holding the held portion Wa of the drive wire W. The drive wire W passes through an insertion hole 25a and engages with the connecting portion 21c. More specifically, the held portion Wa engages with the leaf spring 21ch. As will be described later, the leaf spring 21ch can be in a state where it clamps and fixes and holds the held portion Wa (fixed state), or in a state where it releases its hold on the held portion Wa (released state).

[0095] The connecting portion 21c has a pressing member 21cp as a switching portion. The pressing member 21cp has a gear portion 21cg as a cam gear that meshes with teeth 29g (see FIG. 10) of a planetary carrier 53 (described later), and a cam 21cc as a cam portion (pressing portion) that presses the leaf spring 21ch. The cam 21cc rotates integrally with the gear portion 21cg.

[0096] As will be described later, the cam 21cc can move relative to the leaf spring 21ch. The movement of the cam 21cc switches the leaf spring 21ch between a fixed state (holding state) and a released state.

[0097] The connecting portion 21c is supported by a first bearing B1, a second bearing B2, and a third bearing B3. The first bearing B1 is supported by a first bearing frame 200c of the base unit 200. The second bearing B2 is supported by a second bearing frame 200d of the base unit 200. The third bearing B3 is supported by a third bearing frame 200e of the base unit 200. Therefore, when the output shaft Ma rotates in the rotation direction Rm, the connecting portion 21c is restricted from rotating around the output shaft Ma. The first bearing B1, the second bearing B2, and the third bearing B3 are provided for each of the first to ninth connecting portions (21c11 to 21c33).

[0098] Because the rotation of the connecting portion 21c around the output shaft Ma is restricted, when the output shaft Ma rotates, a force along the rotational axis direction of the output shaft Ma acts on the tractor 21ct due to the spiral groove of the output shaft Ma. As a result, the connecting portion 21c moves along the rotational axis direction of the output shaft Ma (direction Dc). The movement of the connecting portion 21c moves the drive wire W, and the bending portion 12 bends. At this time, by switching the rotation direction of the drive source M, the connecting portion 21c can drive the drive wire W in either a direction that presses the drive wire W or a direction that pulls the drive wire W.

[0099] In other words, the output shaft Ma and the tractor 21ct constitute a so-called feed screw that converts the rotational motion transmitted from the drive source M into linear motion using a screw. In this embodiment, the output shaft Ma and the tractor 21ct are slide screws, but they may also be ball screws.

[0100] As shown in FIG. 6(c), by attaching the catheter unit 100 to the base unit 200, the first to ninth driving wires (W11 to W33) are respectively connected to the first to ninth connecting portions (21c11 to 21c33).

[0101] The control unit 3 can control each of the first to ninth drive sources (M11 to M33) independently of one another. That is, any of the first to ninth drive sources (M11 to M33) can operate or stop independently, regardless of whether the other drive sources are stopped or not. In other words, the control unit 3 can control each of the first to ninth drive wires (W11 to W33) independently of one another. As a result, each of the first to third guide rings (J1 to J3) is controlled independently of one another, and the bending region 12b of the bending portion 12 can be bent in any direction.

[0102] <Attaching the catheter unit> The operation of attaching the catheter unit 100 to the base unit 200 will be described using Figures 7(a) and (b). Figures 7(a) and (b) are explanatory views of attaching the catheter unit 100. Figure 7(a) is a view of the catheter unit 100 before it is attached to the base unit 200. Figure 7(b) is a view of the catheter unit 100 after it has been attached to the base unit 200.

[0103] In this embodiment, the attachment / detachment direction DE of the catheter unit 100 is the same as the direction of the rotation axis 400r of the operation section 400. Of the attachment / detachment directions DE, the direction in which the catheter unit 100 is attached to the base unit 200 is called the attachment direction Da. Of the attachment / detachment directions DE, the direction in which the catheter unit 100 is removed from the base unit 200 (the opposite direction to the attachment direction Da) is called the removal direction Dd.

[0104] 7(a), before the catheter unit 100 is attached to the base unit 200, the wire cover 14 is located in the cover position. At this time, the wire cover 14 covers the first to ninth drive wires (W11 to W33) so that the first to ninth held portions (Wa11 to Wa33) do not protrude from the first to ninth exposure holes (14a11 to 14a33) of the wire cover 14. Therefore, before the catheter unit 100 is attached to the base unit 200, the first to ninth drive wires (W11 to W33) can be protected.

[0105] When the catheter unit 100 is attached to the base unit 200, the key shaft 15 is engaged with the key receiver 22. The key shaft 15 protrudes from the wire cover 14. In this embodiment, when the key shaft 15 reaches the entrance of the key receiver 22, the wire cover 14 does not engage with the attachment opening 25b. In other words, when the phase of the catheter unit 100 relative to the base unit 200 is such that the key shaft 15 and the key receiver 22 cannot engage with each other, the wire cover 14 does not engage with the attachment opening 25b and remains positioned in the covered position. Therefore, even when the catheter unit 100 is moved so that the key shaft 15 and the key receiver 22 engage with each other, the first to ninth drive wires (W11 to W33) are protected.

[0106] When the key shaft 15 and the key receiving portion 22 engage and the catheter unit 100 is moved in the attachment direction Da relative to the base unit 200, the catheter unit 100 is attached to the base unit 200. Attaching the catheter unit 100 to the base unit 200 moves the wire cover 14 to the exposed position. In this embodiment, the wire cover 14 moves from the covered position to the exposed position by abutting against the base frame 25 (see FIG. 7(b)).

[0107] More specifically, when the catheter unit 100 is attached, the wire cover 14 comes into contact with the base frame 25 and stops. In this state, by moving the catheter unit 100 in the attachment direction Da, the wire cover 14 moves relative to the other portions of the catheter unit 100. As a result, the wire cover 14 moves from the covered position to the exposed position.

[0108] While the wire cover 14 moves from the covered position to the exposed position, the held portion Wa of the drive wire W protrudes from the exposed hole 14a of the wire cover 14 and is inserted into the insertion hole 25a. Then, the held portion Wa engages with the leaf spring 21ch of the connecting portion 21c (see FIG. 6(b)).

[0109] When the catheter unit 100 is simply attached to the base unit 200, it can be removed by moving the catheter unit 100 in the removal direction Dd relative to the base unit 200. Furthermore, as will be described later, when the catheter unit 100 is simply attached to the base unit 200, the drive wire W and the connecting portion 21c are released from their fixed state.

[0110] With the catheter unit 100 attached to the base unit 200, operating the operation unit 400 prevents the catheter unit 100 from being removed from the base unit 200. Furthermore, with the catheter unit 100 attached to the base unit 200, operating the operation unit 400 fixes the bending drive unit 13 to the connecting device 21, and connects the bending drive unit 13 to the wire drive unit 300 via the connecting device 21.

[0111] <Planetary gear mechanism> Next, the planetary gear mechanism 50 provided in the base unit 200 will be described with reference to Figs. 8 to 13. Fig. 8 is a perspective view showing a connection portion of the base unit 200 to the catheter unit 100. Fig. 9 is a perspective view showing the planetary gear mechanism 50 built into the base unit 200. Note that Fig. 9 shows the base housing 200f with a portion cut away. Fig. 10 is an exploded perspective view showing the operation unit 400 and the planetary gear mechanism 50. Fig. 11 is an exploded perspective view showing the planetary gear mechanism 50. Fig. 12 is a cross-sectional view of the operation unit 400 and the base unit 200 taken along the rotation axis 400r of the operation unit 400. Fig. 13 is a cross-sectional view showing the 13A-13A cross section of Fig. 12.

[0112] As shown in FIGS. 8 to 12, the base unit 200 has a planetary gear mechanism 50 disposed near the base frame 25. The planetary gear mechanism 50 has a sun gear 51, an internal gear 52, a planetary carrier 53, and a plurality of (eight in this embodiment) planetary gears 54. The sun gear 51 and the planetary carrier 53 are configured to be rotatable about the rotation axis 400r of the operation section 400 when the catheter unit 100 is attached to the base unit 200. The sun gear 51 and the planetary carrier 53 are rotatably supported by, for example, the base frame 25 or the base housing 200f, but are not limited thereto and may be supported by other members of the base unit 200.

[0113] The sun gear 51 has a gear portion 51a and a pair of protrusions 51b, 51b that can engage with a pair of engagement portions 400j provided on the operation unit 400. The protrusions 51b, 51b extend along the attachment / detachment direction DE, which is parallel to the axial direction of the rotation shaft 400r. As shown in FIGS. 8 and 9, most of the planetary gear mechanism 50 is covered by the base housing 200f, with only the protrusions 51b, 51b of the sun gear 51 exposed to the outside. This prevents the user from touching the gear portion of the planetary gear mechanism 50 and prevents dust and debris from entering the planetary gear mechanism 50, thereby reducing damage to the planetary gear mechanism 50. This also improves user safety.

[0114] The internal gear 52 is integrally provided on the inner circumferential surface of the base housing 200f (see FIG. 11) and is fixed to the base housing 200f. The planetary carrier 53 has a plurality of shaft portions 53a (eight in this embodiment) that rotatably support a plurality of planetary gears 54, and a plurality of toothed portions 29g formed on the inner circumferential surface 53b. The plurality of shaft portions 53a each extend parallel to the rotation axis 400r. The plurality of toothed portions 29g serving as output gears are disposed downstream of the sun gear 51, the internal gear 52, and the planetary gears 54 in the installation direction Da within the installation / removal direction DE.

[0115] When the catheter unit 100 is attached to the base unit 200, the protrusion 51b of the sun gear 51 engages with the engagement portion 400j of the operation unit 400. As a result, when the operation unit 400 rotates, the rotation of the operation unit 400 is transmitted to the sun gear 51. The sun gear 51 is concentric with the operation unit 400 and rotates integrally therewith.

[0116] As shown in FIGS. 12 and 13 , the gear portion 51a of the sun gear 51 meshes with each planetary gear 54, and each planetary gear 54 meshes with an internal gear 52 fixed to the base housing 200f. Therefore, the rotation of the sun gear 51 is decelerated and output to the planetary carrier 53 via the planetary gears 54. That is, the sun gear 51 is an input member (input portion) that receives the rotation of the operating unit 400 and rotates, the internal gear 52 is a fixed member, and the planetary carrier 53 is an output member (output portion) that outputs the transmitted rotation to the pressing member 21cp. A force applied to the operating unit 400 by the user is received by the sun gear 51 and transmitted from the sun gear 51 to the planetary carrier 53 via the planetary gears 54. The internal gear 52 is fixed to the base unit 200 so that its position within the base unit 200 does not change. Furthermore, in this embodiment, eight planetary gears 54 are provided, and therefore the eight planetary gears 54 share the load, allowing the planetary gear mechanism 50 to be configured compactly and to have a long life.

[0117] For example, when the operating unit 400 is rotated by a user in the direction of arrow Q1 (see FIG. 10), the sun gear 51 also rotates in the direction of arrow Q2, as shown in FIG. 13. The planetary gear 54, which meshes with the sun gear 51 and the internal gear 52, rotates (spins) in the direction of arrow Q3 around the shaft portion 53a, while rotating (revolves) in the direction of arrow Q4 around the rotation axis 400r. As a result, the planetary carrier 53, which supports the planetary gear 54, also rotates in the direction of arrow Q4 around the rotation axis 400r. The directions of arrows Q1, Q2, and Q4 are the same rotation direction around the rotation axis 400r. The direction of arrow Q3 is the opposite rotation direction to the directions of arrows Q1, Q2, and Q4.

[0118] In this way, the planetary carrier 53 rotates in conjunction with the operating unit 400, and the planetary gear mechanism 50 decelerates the rotation of the operating unit 400 operated by the user and transmits it to the planetary carrier 53. In other words, the planetary gear mechanism 50 decelerates the rotation transmitted from the operating unit 400 so that when the operating unit 400 rotates by a first rotation angle, the planetary carrier 53 rotates by a second rotation angle that is smaller than the first rotation angle. More specifically, the rotation of the operating unit 400 is transmitted to the sun gear 51 at the same rotation, and the rotation of the sun gear 51 is transmitted to the planetary carrier 53 at a predetermined reduction ratio. This reduction ratio is calculated as (z1 + z2) / z1, where z1 and z2 are the numbers of teeth of the gear portion 51a of the sun gear 51 and the internal gear 52, respectively.

[0119] <Fixing and releasing the bending drive unit> Next, using Figures 14(a)(b), 15, 16, 17, 18, and 19, we will explain the configuration for fixing the bending drive unit 13 to the connecting device 21 and the configuration for releasing the fixing of the bending drive unit 13 by the connecting device 21.

[0120] Figures 14(a) and 14(b) are diagrams illustrating the connection between the catheter unit 100 and the base unit 200. Figure 14(a) is a cross-sectional view of the catheter unit 100 and the base unit 200 taken along the rotation axis 400r. Figure 14(b) is a cross-sectional view of the base unit 200 taken at the connecting portion 21c in a direction perpendicular to the rotation axis 400r. Figures 15, 16, 17, 18, and 19 are diagrams illustrating the fixation of the driving wire W by the connecting portion 21c.

[0121] As described above, the planetary gear mechanism 50 decelerates the rotation of the operating unit 400 operated by the user and transmits the rotation to the planetary carrier 53. As shown in FIGS. 14(a) and 14(b) and 15, the teeth 29g provided on the inner circumferential surface 53b of the planetary carrier 53 mesh with the gear portion 21cg of the pressing member 21cp. When the gear portion 21cg is rotated by the teeth 29g, the cam 21cc of the pressing member 21cp presses the leaf spring 21ch, and the leaf spring 21ch (connecting portion 21c) is switched between a fixed state and a released state.

[0122] More specifically, the multiple tooth portions 29g provided on the planet carrier 53 have the function of switching between a state in which each of the first to ninth connecting portions (21c11 to 21c33) fixes each of the first to ninth driving wires (W11 to W33) and a state in which each of the first to ninth driving wires (W11 to W33) is released. Each of the multiple tooth portions (action portion, switching gear portion) 29g provided on the planet carrier 53 engages with the gear portion 21cg of the pressing member 21cp of each of the first to ninth connecting portions (21c11 to 21c33).

[0123] Specifically, in this embodiment, the plurality of tooth portions provided on the planet carrier 53 include a first tooth portion 29g11, a second tooth portion 29g12, a third tooth portion 29g13, a fourth tooth portion 29g21, a fifth tooth portion 29g22, a sixth tooth portion 29g23, a seventh tooth portion 29g31, an eighth tooth portion 29g32, and a ninth tooth portion 29g33. The first to ninth tooth portions (29g11 to 29g33) are formed with gaps between each other.

[0124] The first tooth portion 29g11 meshes with the gear portion 21cg of the first linking portion 21c11. The second tooth portion 29g12 meshes with the gear portion 21cg of the second linking portion 21c12. The third tooth portion 29g13 meshes with the gear portion 21cg of the third linking portion 21c13. The fourth tooth portion 29g21 meshes with the gear portion 21cg of the fourth linking portion 21c21. The fifth tooth portion 29g22 meshes with the gear portion 21cg of the fifth linking portion 21c22. The sixth tooth portion 29g23 meshes with the gear portion 21cg of the sixth linking portion 21c23. The seventh tooth portion 29g31 meshes with the gear portion 21cg of the seventh linking portion 21c31. The eighth tooth portion 29g32 meshes with the gear portion 21cg of the eighth connecting portion 21c32. The ninth tooth portion 29g33 meshes with the gear portion 21cg of the ninth connecting portion 21c33.

[0125] Any one of the first to ninth tooth portions (29g11 to 29g33) can be referred to as tooth portion 29g. In this embodiment, the first to ninth tooth portions (29g11 to 29g33) have the same configuration.

[0126] In this embodiment, the first to ninth drive wires (W11 to W33) are connected to the first to ninth coupling portions (21c11 to 21c33) in the same configuration. Also, the first to ninth coupling portions (21c11 to 21c33) are connected to the first to ninth tooth portions (29g11 to 29g33) in the same configuration. Therefore, the following description will be given of the configuration in which one drive wire W, one coupling portion 21c, and one tooth portion 29g are connected.

[0127] In each of the first to ninth connecting portions (21c11 to 21c33), the gear portion 21cg is moved by the tooth portion 29g, whereby the pressing member 21cp rotates and the cam 21cc moves between the pressing position and a retracted position retracted from the pressing position.

[0128] By rotating the operating unit 400, the planet carrier 53 rotates via the sun gear 51 and the planet gear 54 of the planetary gear mechanism 50. The rotation of the planet carrier 53 causes the first to ninth connecting portions (21c11 to 21c33) to operate. In other words, by rotating one operating unit 400, the first to ninth connecting portions (21c11 to 21c33) can be operated.

[0129] The operating section 400 can move between a fixed position (locked position) and a detached position when the catheter unit 100 is attached to the base unit 200. As will be described later, the operating section 400 can also move to a released position when the catheter unit 100 is attached to the base unit 200. The released position is located between the fixed position and the detached position in the circumferential direction of the operating section 400. The catheter unit 100 is attached to the base unit 200 when the operating section 400 is located at the detached position.

[0130] When the catheter unit 100 is attached to the base unit 200, the drive wire W is released from being fixed (locked) to the connecting portion 21c. This state is called the released state of the connecting portion 21c. The state in which the drive wire W is fixed (locked) to the connecting portion 21c is called the fixed state of the connecting portion 21c. In other words, the state of the connecting portion 21c when the leaf spring 21ch is in the fixed state (held state) is called the fixed state (held state), and the state of the connecting portion 21c when the leaf spring 21ch is in the released state is called the released state.

[0131] The operation of fixing the drive wire W to the connecting portion 21c will be described with reference to Figures 15, 16, 17, 18, and 19. In this embodiment, each tooth portion 29g of the planetary carrier 53 has three teeth Za1, Za2, and Za3, and the gear portion 21cg of each pressing member 21cp has four teeth Zb1, Zb2, Zb3, and Zb4.

[0132] After the catheter unit 100 is attached to the base unit 200 and before the operation section 400 is operated, the catheter unit 100 can be removed from the base unit 200. Hereinafter, the state in which the catheter unit 100 can be removed from the base unit 200 will be referred to as the removable state.

[0133] Fig. 15 is a diagram showing the state of the planet carrier 53 and the connecting portion 21c in a detachable state. Fig. 15 is a diagram showing the planet carrier 53 and the connecting portion 21c in a state in which the operating portion 400 is in the detachment position.

[0134] The leaf spring 21ch of the connecting portion 21c has a fixed portion 21cha fixed to the connecting base 21cb and a pressed portion 21chb that abuts against the cam 21cc of the pressing member 21cp. The leaf spring 21ch has a first portion 21chd1 and a second portion 21chd2. When the catheter unit 100 is attached to the base unit 200, the held portion Wa is inserted between the first portion 21chd1 and the second portion chd2.

[0135] The cam 21cc has a holding surface 21cca and a pressing surface 21ccb. In the direction of the radius of rotation of the pressing member 21cp, the holding surface 21cca is located closer to the rotation center 21cpc of the pressing member 21cp than the pressing surface 21ccb.

[0136] 15, in the removable state (when the operating unit 400 is in the removable position), the leaf spring 21ch is held in a position where the pressed portion 21chb abuts against the holding surface 21cca. Also, the tooth Za1 of the planetary carrier 53 and the tooth Zb1 of the gear portion 21cg are stationary with a clearance La between them.

[0137] In terms of the rotation direction of the operating unit 400, the direction in which the operating unit 400 moves from the detached position toward the unlocked position and the locked position is called the locking direction (locking direction), and the direction in which the operating unit 400 moves from the locked position toward the unlocked position and the operating unit 400 toward the detached position is called the unlocking direction. The operating unit 400 rotates from the unlocked position in the unlocking direction to move to the detached position. The operating unit 400 rotates from the unlocked position in the locking direction to move to the locked position.

[0138] When the catheter unit 100 is attached to the base unit 200 and the operation section 400 is in the detached position, the connecting section 21c is in the released state, and the fixation of the drive wire W by the connecting section 21c is released.

[0139] When connecting portion 21c is in the released state, cam 21cc is located in a retracted position retracted from a pressing position (described later). At this time, fixation of held portion Wa by leaf spring 21ch is released. The force with which first portion 21chd1 and second portion 21chd2 fasten held portion Wa when connecting portion 21c is in the released state is smaller than the force with which first portion 21chd1 and second portion 21chd2 fasten held portion Wa when connecting portion 21c is in the fixed state.

[0140] When the connecting portion 21c is in the released state, if the catheter unit is moved in the removal direction Dd relative to the base unit 200, the held portion Wa can be pulled out from between the first portion 21chd1 and the second portion 21chd2.

[0141] When the connecting portion 21c is in the released state, it is preferable that the first portion 21chd1 and the second portion 21chd2 do not generate a force tightening the held portion Wa (the force is zero). When the connecting portion 21c is in the released state, it is preferable that a gap is generated between at least one of the first portion 21chd1 and the second portion 21chd2 and the held portion Wa.

[0142] Fig. 16 is a diagram showing the state of the planet carrier 53 and the connecting portion 21c when the operating unit 400 is rotated in the locking direction from the detached position. Fig. 16 is a diagram showing the state of the planet carrier 53 and the connecting portion 21c when the operating unit 400 is in the released position.

[0143] When the operating unit 400 is rotated in the locking direction while it is in the removal position (FIG. 15), the planetary carrier 53 rotates clockwise, and the operating unit 400 is then positioned in the release position.

[0144] Even when the operating section 400 is rotated, the key shaft 15 and the key receiving section 22 are engaged, so the entire catheter unit 100 (excluding the operating section 400) is restricted from rotating relative to the base unit 200. In other words, the operating section 400 can rotate relative to the entire catheter unit 100 (excluding the operating section 400) and the base unit 200 when they are stationary.

[0145] As the planetary carrier 53 rotates clockwise, the clearance between the tooth Za1 of the planetary carrier 53 and the tooth Zb1 of the gear portion 21cg decreases from the clearance La to the clearance Lb.

[0146] The tooth Zb2 of the gear portion 21cg is disposed at a position with a clearance Lz between it and the tooth tip circle (dotted line) of the tooth portion 29g of the planetary carrier 53. Therefore, the planetary carrier 53 can rotate without interfering with the tooth Zb2. Meanwhile, the coupling portion 21c is maintained in the same state (released state) as shown in FIG.

[0147] When the operating unit 400 is further rotated in the locking direction from the state shown in Fig. 16, the planetary carrier 53 further rotates clockwise. The state of the planetary carrier 53 and the connecting portion 21c at this time is shown in Fig. 17.

[0148] Figure 17 is a diagram showing the state of the planetary carrier 53 and the connecting portion 21c when the operating unit 400 is rotated in the locking direction from the release position. As shown in Figure 17, when the operating unit 400 is rotated in the locking direction from the release position, the tooth Za1 of the planetary carrier 53 comes into contact with the tooth Zb1 of the gear portion 21cg. Meanwhile, the connecting portion 21c is in the same state as shown in Figures 15 and 16 and is maintained in the released state.

[0149] Fig. 18 is a diagram showing a state in which the pressing member 21cp is rotated as a result of the operation unit 400 being rotated in the locking direction. As shown in Fig. 18, when the operation unit 400 is further rotated in the locking direction from the state in Fig. 17, the planetary carrier 53 further rotates clockwise.

[0150] 17 to the state shown in FIG. 18, the planetary carrier 53 rotates the gear portion 21cg clockwise. When the gear portion 21cg rotates, the holding surface 21cca moves away from the pressed portion 21chb, and the pressing surface 21ccb moves closer to the pressed portion 21chb. Then, the first portion 21chd1 and the second portion 21chd2 start to sandwich the held portion Wa.

[0151] Then, while the corner 21ccb1 arranged at the end of the pressing surface 21ccb presses the pressed portion 21chb, the tooth Za3 of the planetary carrier 53 moves to a position away from the tooth Zb3 of the gear portion 21cg. At this time, the held portion Wa is sandwiched between the first portion 21chd1 and the second portion 21chd2.

[0152] When the tooth Za3 of the planetary carrier 53 separates from the tooth Zb3 of the gear portion 21cg, the transmission of the driving force from the planetary carrier 53 to the gear portion 21cg ends. At this time, the corner portion 21ccb1 of the cam 21cc receives a reaction force from the leaf spring 21ch.

[0153] The reaction force of the leaf spring 21ch acting on the corner 21ccb1 in the direction of the rotation radius of the pressing member 21cp acts at a position away from the rotation center 21cpc of the pressing member 21cp, causing the pressing member 21cp to rotate clockwise. At this time, the pressing member 21cp rotates in the same direction as the direction in which it is rotated by the planetary carrier 53, which rotates clockwise.

[0154] 19 is a diagram showing the state of the planet carrier 53 and the connecting portion 21c when the operating portion 400 is in the fixed position. As shown in Fig. 19, the pressing member 21cp receives the reaction force of the leaf spring 21ch and further rotates from the state shown in Fig. 18.

[0155] As shown in Figure 19, the pressing member 21cp stops with the pressing surface 21ccb of the cam 21cc and the pressed portion 21chb of the leaf spring 21ch in surface contact. In other words, the pressing surface 21ccb and the surface of the pressed portion 21chb are aligned on the same plane. At this time, the connecting portion 21c is in a fixed state. When the connecting portion 21c is in a fixed state, the cam 21cc of the pressing member 21cp is located in the pressing position, and the pressing surface 21ccb presses the pressed portion 21chb.

[0156] When the connecting portion 21c is in the fixed state, the held portion Wa is sandwiched between the first portion 21chd1 and the second portion 21chd2. That is, the cam 21cc presses the leaf spring 21ch, and the held portion Wa is tightened by the leaf spring 21ch. As a result, the held portion Wa is fixed by the leaf spring 21ch.

[0157] In this embodiment, the first portion 21chd1 and the second portion 21chd2 of the leaf spring 21ch press the held portion Wa at positions spaced apart from each other. Furthermore, a bent portion 21chc connecting the first portion 21chd1 and the second portion 21chd2 is disposed between the first portion 21chd1 and the second portion 21chd2. The bent portion 21chc is disposed with a gap G from the held portion Wa. This allows the held portion Wa to be stably fixed by the first portion 21chd1 and the second portion 21chd2.

[0158] The material of the leaf spring 21ch can be resin or metal, but it is preferable to use metal.

[0159] When the connecting portion 21c is in the fixed state, the held portion Wa is restricted from being pulled out from between the first portion 21chd1 and the second portion 21chd2.

[0160] The tooth Za3 of the planet carrier 53 and the tooth Zb4 of the gear portion 21cg are stopped at a position where a clearance Lc is created between them. The surface of the tip of this tooth Za3 is inclined away from the rotation axis (rotation axis 400r) of the planet carrier 53 toward downstream in the release direction with respect to a cylindrical surface that is in contact with the tip surfaces of the other teeth Za1 and Za2 and is centered on the rotation axis. As a result, when the planet carrier 53 is rotated in the release direction from the state shown in FIG. 19 as described below, the tooth Za3 of the planet carrier 53 can reach the tooth Zb4 beyond the tooth Zb3 of the gear portion 21cg without prying on it.

[0161] To release the connection between the drive wire W and the connecting portion 21c, the operating portion 400, which is located in the fixed position, is rotated in the release direction. At this time, the planetary carrier 53 rotates counterclockwise from the state shown in Fig. 19. When the planetary carrier 53 rotates counterclockwise, the tooth Za3 of the planetary carrier 53 abuts against the tooth Zb4 of the gear portion 21cg, causing the pressing member 21cp to rotate counterclockwise.

[0162] By further rotating the planetary carrier 53 counterclockwise, the fixation of the drive wire W by the connecting portion 21c is released. The operations of the planetary carrier 53 and the pressing member 21cp at this time are the reverse of the operations described above. In other words, the fixation of the drive wire W by the connecting portion 21c is released by the reverse operation of the operation performed when the drive wire W is fixed by the connecting portion 21c.

[0163] The above operation is performed for each of the first to ninth connecting parts (21c11 to 21c33). That is, in the process of moving the operating part 400 from the detached position to the fixed position, the movement (rotation) of the operating part 400 causes the first to ninth connecting parts (21c11 to 21c33) to change from the released state to the fixed state. In the process of moving the operating part 400 from the fixed position to the detached position, the movement (rotation) of the operating part 400 causes the first to ninth connecting parts (21c11 to 21c33) to change from the fixed state to the released state. That is, by operating one operating part 400, the user can switch between the released state and the fixed state of multiple connecting parts.

[0164] That is, each of the multiple connecting parts is provided with an operating part for switching between the released state and the fixed state, and the user does not need to operate this. Therefore, the user can easily attach and detach the catheter unit 100 to and from the base unit 200. Furthermore, the medical device 1 can be simplified.

[0165] The state in which the first to ninth drive wires (W11 to W33) are fixed by the first to ninth connecting portions (21c11 to 21c33), respectively, is called a first state. The state in which the first to ninth drive wires (W11 to W33) are released from the first to ninth connecting portions (21c11 to 21c33), respectively, is called a second state.

[0166] The first state and the second state are switched in conjunction with the movement of the operating unit 400. That is, the first state and the second state are switched in conjunction with the movement of the operating unit 400 between the detached position and the fixed position.

[0167] The planetary carrier 53 of the planetary gear mechanism 50 is configured to interlock with the operating unit 400. In this embodiment, the sun gear 51, the internal gear 52, and the planet gears 54 of the planetary gear mechanism 50 function as transmission members for interlocking the operating unit 400 and the planetary carrier 53. The planetary gear mechanism 50 functions as an interlocking unit that interlocks with the operating unit 400 so that the first state and the second state are switched in conjunction with the movement of the operating unit 400.

[0168] Specifically, with the catheter unit 100 attached to the base unit 200, the planetary carrier 53 of the planetary gear mechanism 50 moves a part of the leaf spring 21ch (pressed portion 21chb) relative to the held portion Wa in conjunction with the movement of the operation portion 400. The movement of the pressed portion 21chb switches the connecting portion 21c between a fixed state and a released state.

[0169] <Moving the control panel> Next, the movement of the operation unit 400 will be described with reference to FIGS. 20(a) to 20(c), 21(a) to 21(c), and 22(a) to 22(c).

[0170] In this embodiment, the operation section 400 is configured to be movable between a detached position, a released position, and a fixed position when the catheter unit 100 is attached to the base unit 200. The released position is located between the detached position and the fixed position.

[0171] In this embodiment, the operation unit 400 is switched between the first state and the second state in conjunction with the movement of the operation unit 400 between the release position and the fixed position.

[0172] In this embodiment, the operation unit 400 can move between the detachment position and the fixed position by moving in a direction different from the attachment / detachment direction DE. The operation unit 400 moves between the detachment position and the fixed position by moving in a direction intersecting (preferably perpendicular to) the attachment / detachment direction DE. In this embodiment, the operation unit 400 moves between the detachment position and the fixed position by rotating around a rotation axis 400r extending in the attachment / detachment direction DE. Therefore, the operability when the user operates the operation unit 400 is good.

[0173] Figures 20(a) to (c) are explanatory diagrams of the catheter unit 100 and the base unit 200. Figure 20(a) is a cross-sectional view of the catheter unit 100. Figure 20(b) is a perspective view of the button 41. Figure 20(c) is a perspective view of the base unit 200.

[0174] Figures 21(a) to (c) are diagrams illustrating the operation of the operating unit 400. Figure 21(a) is a diagram illustrating a state in which the operating unit 400 is in a detached position. Figure 21(b) is a diagram illustrating a state in which the operating unit 400 is in a released position. Figure 21(c) is a diagram illustrating a state in which the operating unit 400 is in a fixed position.

[0175] Figures 22(a) to (c) are cross-sectional views illustrating the operation of the operating unit 400. Figure 22(a) is a cross-sectional view showing the operating unit 400 in a state where it is in the detached position. Figure 22(b) is a cross-sectional view showing the operating unit 400 in a state where it is in the released position. Figure 22(c) is a cross-sectional view showing the operating unit 400 in a state where it is in the fixed position.

[0176] When the operation portion 400 is in the fixed position, the connection portions 21c are in a fixed state, and the held portions Wa of the drive wires W are fixed to the corresponding connection portions 21c (see FIG. 19).

[0177] When the operating unit 400 is in the released position, the connecting unit 21c is in the released state, and the lock between the held portion Wa of the driving wire W and the connecting unit 21c is released (see FIG. 16). In this state, the driving wire W is disconnected from the wire driving unit 300. Therefore, when the catheter 11 receives an external force, the bending section 12 can bend freely without receiving resistance from the wire driving unit 300.

[0178] When the operating section 400 is in the detachment position, the catheter unit 100 is allowed to be detached from the base unit 200. Furthermore, with the operating section 400 in the detachment position, the catheter unit 100 can be attached to the base unit 200. When the operating section 400 is in the detachment position, the connecting section 21c is in the released state, and the lock between the held section Wa of the drive wire W and the connecting section 21c is released (see FIG. 15).

[0179] As shown in FIG. 20(a), the catheter unit 100 has an operation part biasing spring 43 that biases the operation part 400, a button 41 as a moving member, and a button spring 42 that biases the button 41.

[0180] In this embodiment, the operation portion biasing spring 43 is a compression spring. The operation portion 400 is biased by the operation portion biasing spring 43 in a direction Dh toward the proximal end cover 16.

[0181] In this embodiment, the button 41 and the button spring 42 are provided on the operation unit 400. When the operation unit 400 moves to the detached position, the released position, or the fixed position, the button 41 and the button spring 42 move together with the operation unit 400.

[0182] The button 41 is configured to be movable relative to the operating unit 400 in a direction intersecting the direction of the rotation axis 400r of the operating unit 400. The button 41 is biased by a button spring 42 toward the outside of the catheter unit 100 (in a direction away from the rotation axis 400r).

[0183] As will be described later, the button 41 restricts the operation unit 400 from moving from the release position to the detachment position. In addition, by moving the button 41 relative to the operation unit 400, the operation unit 400 is allowed to move from the release position to the detachment position.

[0184] The button 41 has a button protrusion (regulated portion) 41a. The button protrusion 41a has a slope 41a1 and a regulated surface 41a2.

[0185] The base unit 200 includes a base frame 25. The base frame 25 includes a lock shaft 26. The lock shaft 26 includes a lock protrusion (restriction portion) 26a.

[0186] In this embodiment, there are provided a plurality of (two in this embodiment) lock shafts 26. All of the lock shafts 26 may be provided with the lock protrusions 26a, or only some of the lock shafts 26 may be provided with the lock protrusions 26a.

[0187] On the other hand, as shown in Fig. 10 and Figs. 21(a) to (c), a lock groove 400a that engages with the lock shaft 26 is provided on the inside of the operating part 400. The lock groove 400a extends in a direction different from the attachment / detachment direction DE. In this embodiment, it extends in the rotation direction of the operating part 400. It can also be said that the lock groove 400a extends in a direction intersecting (perpendicular to) the attachment / detachment direction DE.

[0188] When a plurality of lock shafts 26 are provided, the lock groove 400a is provided for each of the plurality of lock shafts 26.

[0189] As shown in FIG. 21(a), when the catheter unit 100 is attached to the base unit 200, the lock shaft 26 engages with the lock groove 400a through the entrance 400a1 of the lock groove 400a.

[0190] At this time, the operation unit 400 is in the detachment position, and the connecting portion 21c is in the released state (see FIG. 15). Therefore, the first to ninth connecting portions (21c11 to 21c33) are released from the fixation of the first to ninth driving wires (W11 to W33), respectively. Also, as shown in FIG. 22(a), the button protrusion 41a and the lock protrusion 26a face each other.

[0191] When the operating unit 400 is rotated in the locking direction R1 while it is in the detached position, the inclined surface 41a1 of the button protrusion 41a comes into contact with the inclined surface 26a1 of the locking protrusion 26a. The button 41 moves toward the inside of the operating unit 400 (toward the rotation shaft 400r) against the biasing force of the button spring 42. Then, the button protrusion 41a moves over the locking protrusion 26a, and the operating unit 400 moves to the unlocked position (see FIG. 22(b)).

[0192] At this time, the connecting portion 21c is in a released state (see FIG. 16). Therefore, the first to ninth connecting portions (21c11 to 21c33) are no longer fixed to the first to ninth driving wires (W11 to W33), respectively.

[0193] In this embodiment, the operation unit 400 is allowed to be moved from the detached position to the released position without operating the button 41. In other words, the user does not need to operate the button 41 when moving the operation unit 400 from the detached position to the released position.

[0194] When the operating unit 400 is rotated in the locking direction R1 while it is in the release position, the operating unit 400 moves to the locking position. With the operating unit 400 in the locking position, the positioning portion 400a2 of the lock groove 400a is located at a position corresponding to the locking shaft 26. The operating unit 400 is biased by the operating unit biasing spring 43 in the direction Dh toward the proximal end cover 16. As a result, the positioning portion 400a2 engages with the locking shaft 26.

[0195] In the process of the operation portion 400 moving from the release position to the fixed position, the held portion Wa of the drive wire W is fixed to the connecting portion 21c as described above.

[0196] When the operation unit is in the fixed position, the connecting portion 21c is in a fixed state (see FIG. 14). Therefore, the first to ninth drive wires (W11 to W33) are fixed to the first to ninth connecting portions (21c11 to 21c33), respectively. In this state, the drive force from the wire drive unit 300 can be transmitted to the bending drive unit 13. In other words, the drive force from each of the first to ninth drive sources (M11 to M33) can be transmitted to each of the first to ninth drive wires (W11 to W33) via the first to ninth connecting portions (21c11 to 21c33).

[0197] When the operating section 400 is in the release position, a wall 400a3 forming the lock groove 400a is located upstream of the lock shaft 26 in the removal direction Dd of the catheter unit 100. When the operating section 400 is in the fixed position, the positioning section 400a2 is located upstream of the lock shaft 26 in the removal direction Dd. As a result, when the operating section 400 is in the release position or the fixed position, removal of the catheter unit 100 from the base unit 200 is restricted. On the other hand, when the operating section 400 is in the removal position, an entrance 400a1 of the lock groove 400a is located upstream of the lock shaft 26 in the removal direction Dd. As a result, removal of the catheter unit 100 from the base unit 200 is permitted.

[0198] When the operating unit 400 is rotated in the release direction R2 while it is in the fixed position, the operating unit 400 is positioned at the release position. In the process of the operating unit 400 moving from the fixed position to the release position, the held portion Wa of the driving wire W is released from the connecting portion 21c as described above.

[0199] When the operating unit 400 is positioned at the release position, the regulated surface 41a2 of the button protrusion 41a abuts against the regulated surface 26a2 of the lock protrusion 26a (see FIG. 22(b)). In this state, rotation of the operating unit 400 in the release direction R2 is restricted. In addition, removal of the catheter unit 100 from the base unit 200 is restricted.

[0200] When the operating unit 400 is in the release position, the user can press the button 41 toward the inside of the operating unit 400, causing the regulated surface 41a2 to separate from the regulating surface 26a2 and the button protrusion 41a to climb over the lock protrusion 26a. As a result, the operating unit 400 is allowed to rotate in the release direction R2, and the operating unit 400 can be moved from the release position to the detachment position.

[0201] When the operating section 400 is positioned at the detachment position, the connecting section 21c is released. Therefore, when the catheter unit 100 is detached from or attached to the base unit 200, the load acting on the drive wire W (for example, the resistance received by the connecting section 21c) can be reduced. This allows the user to easily attach and detach the catheter unit 100.

[0202] When the operation section 400 is located in the release position, the catheter unit 100 is restricted from being removed from the base unit 200, and the connecting section 21c is in the release state. As described above, when the connecting section 21c is in the release state, the connection between the driving wire W and the wire driving section 300 is cut off, and the bending section 12 can be bent freely without receiving resistance from the wire driving section 300.

[0203] With the catheter 11 inserted inside the subject, the user can stop driving the catheter 11 by the wire driving unit 300 by positioning the operating unit 400 in the release position. Furthermore, because removal of the catheter unit 100 from the base unit 200 is restricted, the user can hold the base unit 200 and pull out the catheter 11 from inside the subject.

[0204] Furthermore, in the configuration of this embodiment, the operation unit 400 is restricted from moving from the release position to the detachment position unless the button 41 is operated. Therefore, when the user moves the operation unit 400 from the fixed position to the release position, it is possible to prevent the operation unit 400 from being moved to the detachment position by mistake.

[0205] In this embodiment, there is one locking protrusion 26a and one button 41. However, the medical device 1 may have a plurality of locking protrusions 26a and buttons 41.

[0206] (Advantages of this embodiment) As described above, the rotation of the operating unit 400 is transmitted to the gear portion 21cg of the pressing member 21cp via the planetary gear mechanism 50 so that the state of the leaf spring 21ch can be switched between the fixed state and the released state. When the pressing member 21cp rotates, the leaf spring 21ch (connecting portion 21c) can be switched between the fixed state and the released state.

[0207] According to this embodiment, the rotation of the operating unit 400 is decelerated by the planetary gear mechanism 50 and transmitted to the gear portion 21cg of the pressing member 21cp. In other words, the planetary gear mechanism 50 is a speed reduction mechanism that decelerates and transmits the rotation of the operating unit 400. According to this embodiment, the rotation angle of the planetary carrier 53 is smaller than the rotation angles of the operating unit 400 and the sun gear 51. Therefore, when operating the operating unit 400 from the detached position to the fixed position, it is necessary to rotate the operating unit 400 against the biasing force of the leaf spring 21ch, but this reduces the force required by the user to operate the operating unit 400, thereby improving operability.

[0208] Furthermore, when the gear portion 21cg of the pressing member 21cp and the tooth portion 29g of the planetary carrier 53 are engaged, a reaction force acts on the pressing member 21cp due to the elastic force of the elastically deformed leaf spring 21ch when it returns to its original position. This reaction force is transmitted to the operating unit 400 via the gear trains of the planetary gear mechanism 50, but is attenuated as the gear trains of the planetary gear mechanism 50 rotate and is not transmitted directly, thereby improving the operability of the operating unit 400.

[0209] Furthermore, the space inside the planetary gear mechanism 50 in the radial direction accommodates a part of the base frame 25, the first to ninth connecting portions (21c11 to 21c33), and the key shaft 15 and bending drive portion 13 of the catheter unit 100. The sun gear 51 and planet carrier 53 of the planetary gear mechanism 50 are configured to rotate concentrically with the operation portion 400. This results in good space efficiency, and the size of the device can be prevented from increasing even when the planetary gear mechanism 50 is provided.

[0210] Furthermore, by adjusting the reduction ratio of the planetary gear mechanism 50, the amount of rotation of the operating unit 400 and the operating force applied by the user to the operating unit 400 can be set as desired. For example, the reduction ratio of the planetary gear mechanism 50 is set to 1.5 to 3.0. Preferably, the reduction ratio of the planetary gear mechanism 50 is set to 2.4 so that the planet carrier 53 rotates approximately 50° when the operating unit 400 rotates approximately 120° between the detached position and the locked position. Rotating the operating unit 400 by 120° is an appropriate operating range that can be performed with a single action by the user, and further, by setting the reduction ratio to approximately 2.4, a large operating force is not required to transition the coupling portion 21c between the released state and the locked state.

[0211] (Variation) As a modification of the first embodiment, a configuration for decelerating the rotation of the operating unit 400 using another planetary gear mechanism will be described with reference to Figures 23(a) to 23(c). Figure 23(a) is a skeleton diagram showing the planetary type planetary gear mechanism 50 described in Figures 8 to 13. Figure 23(b) is a skeleton diagram showing a solar type planetary gear mechanism 150. Figure 23(c) is a skeleton diagram showing a star type planetary gear mechanism 250.

[0212] As shown in FIG. 23(b), a solar-type planetary gear mechanism 150, which is a modification of the first embodiment, has a sun gear 151, an internal gear 152, and a planet carrier 153 that rotatably supports multiple planet gears 154. In the solar-type planetary gear mechanism 150, rotation of the operation unit 400 (see FIG. 2) is input to the internal gear 152. The sun gear 151 is fixed to the base unit 200. The internal gear 152 meshes with the multiple planet gears 154, and the planet carrier 153 rotates in the same direction as the internal gear 152. In other words, the internal gear 152 is an input member (input unit) that rotates when the rotation of the operation unit 400 is input, the sun gear 151 is a fixed member, and the planet carrier 153 is an output member (output unit) that outputs the transmitted rotation to the pressing member 21cp. The force applied to the operating part 400 by the user is received by the internal gear 152 and transmitted from the internal gear 152 to the planetary gear 154. The sun gear 151 is fixed to the base unit 200 so that its position within the base unit 200 does not change. According to the solar type planetary gear mechanism 150, the rotation angle of the planetary carrier 153 is smaller than the rotation angle of the operating unit 400 and the internal gear 152.

[0213] 23(c), a star-type planetary gear mechanism 250, which is another modified example of the first embodiment, includes a sun gear 251, an internal gear 252, and a planet carrier 253 that rotatably supports a plurality of planet gears 254. In the star-type planetary gear mechanism 250, rotation of the operation unit 400 (see FIG. 2) is input to the sun gear 251. The planet carrier 253 is fixed to the base unit 200. The sun gear 251 meshes with the plurality of planet gears 254, and the internal gear 252 meshes with the plurality of planet gears 254, thereby rotating in the opposite direction to the sun gear 251. In other words, the sun gear 251 is an input member (input unit) that rotates when the rotation of the operation unit 400 is input, the planet carrier 253 is a fixed member, and the internal gear 252 is an output member (output unit) that outputs the transmitted rotation to the pressing member 21cp. A force applied by a user to the operating unit 400 is received by the sun gear 251 and transmitted from the sun gear 251 to the internal gear 252 via the planet gear 254. The planet carrier 253 is fixed relative to the base unit 200 so that its position within the base unit 200 does not change. According to the star-type planetary gear mechanism 250, the rotation angle of the internal gear 252 is smaller than the rotation angle of the operating unit 400 and the sun gear 251.

[0214] The planetary-type planetary gear mechanism 50 and the solar-type planetary gear mechanism 150 output rotation input from the operating unit 400 as rotation in the same direction, while the star-type planetary gear mechanism 250 outputs rotation input from the operating unit 400 as rotation in the opposite direction. In either case, these planetary gear mechanisms 50, 150, and 250, which function as reduction mechanisms, reduce the rotation of the operating unit 400 and transmit it to the gear portion 21cg of the pressing member 21cp, thereby reducing the operating force of the operating unit 400. Note that when the gears constituting the planetary-type, solar-type, and star-type planetary gear mechanisms all have the same number of teeth, the planetary-type planetary gear mechanism is preferred because it can achieve the largest reduction ratio.

[0215] [Second embodiment] Next, a medical device according to a second embodiment will be described with reference to Figures 24 and 25. This embodiment differs from the first embodiment in that a stepped gear mechanism 350 is used instead of the planetary gear mechanism 50. Hereinafter, elements with the same reference numerals as those in the first embodiment will be considered to have substantially the same configurations and functions as those described in the first embodiment, and differences from the first embodiment will be mainly described.

[0216] FIG. 24 is a perspective view showing the stepped gear mechanism 350. FIG. 25 is an exploded perspective view showing the stepped gear mechanism 350. As shown in FIGS. 24 and 25, the base unit 200 (see FIG. 8) has a stepped gear mechanism 350 arranged near the base frame 25. The stepped gear mechanism 350 has an input gear 351, multiple (two in this embodiment) stepped gears 354, 354, and an output gear 353 as an output member (output section). The input gear 351 and the output gear 353 are configured to be rotatable around a rotation axis 400r of the operation section 400 when the catheter unit 100 is attached to the base unit 200. The input gear 351 and the output gear 353 are rotatably supported by, for example, the base frame 25 or the base housing 200f, but are not limited thereto and may be supported by other members of the base unit 200. The stepped gears 354, 354 are rotatably supported by the base frame 25.

[0217] The input gear 351 has a gear portion 351a and a pair of protrusions 351b, 351b that can engage with a pair of engagement portions 400j (see FIG. 10) provided on the operating unit 400. The protrusions 351b, 351b extend along the attachment / detachment direction DE that is parallel to the axial direction of the rotation shaft 400r. The output gear 353 has a gear portion 353a and multiple teeth 29g (see FIG. 15) formed on its inner circumferential surface 353b. The multiple teeth 29g are disposed downstream of the input gear 351 and the gear portion 353a in the attachment direction Da of the attachment / detachment direction DE.

[0218] Each stage gear 354 has a first gear portion 354a that meshes with the gear portion 351a of the input gear 351 and a second gear portion 354b that meshes with the gear portion 353a of the output gear 353, and these first gear portion 354a and second gear portion 354b rotate together. The first gear portion 354a has a first number of teeth, and the second gear portion 354b has a second number of teeth that is less than the first number of teeth.

[0219] When the catheter unit 100 is attached to the base unit 200, the protrusion 351b of the input gear 351 engages with the engagement portion 400j of the operation unit 400. As a result, when the operation unit 400 rotates, the rotation of the operation unit 400 is transmitted to the input gear 351 serving as an input member (input unit). A gear portion 351a serving as an input gear portion of the input gear 351 meshes with a first gear portion 354a of the stepped gear 354, and therefore the rotation of the input gear 351 is transmitted to the stepped gear 354. Furthermore, a second gear portion 354b of the stepped gear 354 meshes with a gear portion 353a serving as an output gear portion of the output gear 353, and therefore the rotation of the stepped gear 354 is transmitted to the output gear 353. A force applied to the operation unit 400 by the user is received by the input gear 351 and transmitted from the input gear 351 to the output gear 353 via the stepped gear 354. According to this embodiment, the rotation angle of the output gear 353 is smaller than the rotation angle of the operation unit 400 and the input gear 351 .

[0220] At this time, because the number of teeth (second number of teeth) of the second gear portion 354b of the stepped gear 354 is smaller than the number of teeth (first number of teeth) of the first gear portion 354a, the rotation of the input gear 351 is reduced in speed by the stepped gear 354 and transmitted to the output gear 353. A tooth portion 29g provided on an inner circumferential surface 353b of the output gear 353 meshes with a gear portion 21cg of the pressing member 21cp. As the gear portion 21cg rotates due to the tooth portion 29g, the cam 21cc of the pressing member 21cp presses the leaf spring 21ch, and the leaf spring 21ch (connecting portion 21c) is switched between a fixed state (holding state) and a released state.

[0221] As described above, according to this embodiment, the rotation of the operating unit 400 is decelerated by the stepped gear mechanism 350 and transmitted to the gear portion 21cg of the pressing member 21cp so that the state of the leaf spring 21ch can be switched between the locked state and the unlocked state. In other words, the stepped gear mechanism 350 is a speed reduction mechanism that decelerates and transmits the rotation of the operating unit 400. Therefore, when operating the operating unit 400 from the detached position to the locked position, the operating unit 400 must be rotated against the biasing force of the leaf spring 21ch. However, this reduces the force required by the user to operate the operating unit 400, thereby improving operability. Furthermore, the stepped gear mechanism 350 can be configured with a small number of parts, resulting in reduced cost, compactness, and high durability.

[0222] Here, the numbers of teeth of the first gear portion 354a and the second gear portion 354b of the stepped gear 354 are z3 and z4, respectively, the number of teeth (third number of teeth) of the gear portion 351a of the input gear 351 is z5, and the number of teeth (fourth number of teeth) of the gear portion 353a of the output gear 353 is z6. In this case, the reduction ratio of the stepped gear mechanism 350 is calculated as (z3 / z5)×(z6 / z4). By adjusting the reduction ratio of the stepped gear mechanism 350, the amount of rotation of the operating unit 400 and the operating force of the operating unit 400 by the user can be set arbitrarily. For example, in this embodiment, z3 = 12, z4 = 6, z5 = 56, and z6 = 50, and the reduction ratio of the stepped gear mechanism 350 is 1.79.

[0223] In order to increase the reduction ratio of the stepped gear mechanism 350, it is preferable to select gears in which the number of teeth of the first gear portion 354a and the second gear portion 354b of the stepped gear 354 are small and the reduction ratio (z3 / z4) of the stepped gear 354 is large. In this embodiment, the reduction ratio (z3 / z4) of the stepped gear 354 is 2. Therefore, if the gear ratio (z6 / z5) between the gear portion 351a of the input gear 351 and the gear portion 353a of the output gear 353 is 0.5 or more, the stepped gear mechanism 350 can decelerate the rotation of the operating unit 400. In other words, the ratio (z6 / z5) of the number of teeth of the gear portion 353a to the number of teeth of the gear portion 351a should be larger than the ratio (z4 / z3) of the number of teeth of the second gear portion 354b to the number of teeth of the first gear portion 354a.

[0224] (Other embodiments) In all of the above-described embodiments, the operating unit 400 is configured to be rotatable about the rotation axis 400r, but this is not limiting. For example, the operating unit 400 may be configured to transition the coupling portion 21c between the fixed state and the released state by linearly moving parallel to the rotation axis 400r (attachment / detachment direction DE). When the operating unit 400 is configured to linearly move, the pressing member 21cp, which is linked to the linear movement (movement) of the operating unit 400, is preferably configured to linearly move as well, and the speed reduction mechanism provided between the operating unit 400 and the pressing member 21cp is preferably a linear-movement type. Furthermore, when transmitting the rotational or linear movement of the operating unit 400 to the gear unit 21cg via the speed reduction mechanism, a motion conversion mechanism that converts rotational and linear movement may be appropriately provided. Examples of motion conversion mechanisms that convert rotational to linear movement include a ball screw, a rack and pinion, and a timing belt. Examples of motion conversion mechanisms that convert linear movement to rotation include a slider crank and a rack and pinion.

[0225] In any case, the speed reduction mechanisms, such as the planetary gear mechanisms 50, 150, 250 and stepped gear mechanism 350, reduce the speed of the movement (including rotation and linear movement) input from the operating unit 400 and transmit it to the pressing member 21cp. The speed reduction mechanism has an output member that is driven by the force transmitted from the operating unit 400 and configured to move the pressing member 21cpp. The output member can be said to be a transmission member that transmits the force transmitted from the operating unit 400 to the pressing member 21cp. When the operating unit 400 moves by a first movement amount, the output member moves by a second movement amount that is smaller than the first movement amount, thereby moving the pressing member 21cp. The speed reduction mechanism reduces the speed of the movement of the operating unit 400 and transmits it to the pressing member 21cp so as to switch the connecting portion 21c between a held state and a released state. More specifically, in a configuration in which the operating unit 400 and the output member rotate, when the operating unit 400 rotates a first rotation angle as a first movement amount, the output member rotates a second rotation angle as a second movement amount that is smaller than the first rotation angle. In a configuration in which the operating unit 400 and the output member move linearly, when the operating unit 400 moves a first movement amount in the linear direction, the output member moves a second movement amount that is smaller than the first movement amount. In this relationship of movement amounts, it can be said that the speed reduction mechanism slows down the movement of the operating unit 400 and transmits it to the output member. Note that, due to the action of the speed reduction mechanism, the movement speed of the output member becomes slower relative to the movement speed of the operating unit 400, and conversely, the force output by the output member becomes larger relative to the force received by the operating unit 400 from the user. For example, the torque output by the output member becomes larger relative to the torque required to move the operating unit 400. In any of the above-described embodiments, when the operation unit 400 moves by a first movement amount, the input member moves by the first movement amount. For example, when the operation unit 400 rotates by a first rotation angle as the first movement amount, the input member moves by the first rotation angle.

[0226] In addition, in all of the above-described embodiments, the operation section 400 is provided in the catheter unit 100, but this is not limiting. For example, the operation section 400 may be provided in the base unit 200.

[0227] In addition, in all of the above-described embodiments, the operation unit 400 and the input member (input unit) are configured as separate bodies, but this is not limiting. For example, the operation unit 400 may be provided on the base unit 200, and the input member (input unit) may be formed integrally with the operation unit 400.

[0228] Furthermore, as described above, the pressing member 21cp is moved by the output member. In all of the above-described embodiments, the pressing member 21cp is moved directly by the output member, but this is not limiting. In other words, a transmission member may be provided between the output member and the pressing member 21cp, and the output member may move the pressing member 21cp via the transmission member.

[0229] Furthermore, the first embodiment has been described using the planetary gear mechanisms 50, 150, and 250, and the second embodiment has been described using the stepped gear mechanism 350, as examples of the speed reduction mechanism that reduces the rotation input from the operating unit 400 and transmits it to the pressing member 21cp. However, this is not limiting. For example, the speed reduction mechanism may be a parallel-axis gear reducer combining spur gears, a helical reducer combining helical gears, a bevel gear reducer combining bevel gears, or a worm reducer combining a worm gear and a worm wheel. Furthermore, the speed reduction mechanism is not limited to a combination of gears; a belt pulley may also be used. Furthermore, the speed reduction mechanism may be a direct-acting reducer that uses a fluid and a piston, etc., instead of a rotating member.

[0230] In the first embodiment, the rotation of the operating unit 400 is reduced by the planetary gear mechanism 50 having eight planetary gears 54, but this is not limiting. For example, the number of planetary gears 54 may be one to seven, or nine or more. In addition, the present invention is not limited to a single-pinion planetary gear mechanism, and a double-pinion planetary gear mechanism may be applied. Furthermore, each gear of the planetary gear mechanism 50 may be replaced by a roller, and a planetary roller mechanism may be applied in which the rotation of each roller is controlled by frictional force.

[0231] In the second embodiment, the rotation of the operating unit 400 is reduced by the stepped gear mechanism 350 having a pair of stepped gears 354, but this is not limiting. The stepped gear mechanism 350 may also reduce the rotation of the operating unit 400 by combining multiple stepped gears in series.

[0232] In addition, in each of the above-described embodiments, the object to be operated is described as a bendable catheter 11. However, the object to be operated is not limited to this, and may include an articulated robot, etc. An example of such an articulated robot is a medical robot arm equipped with a surgical instrument (forceps, sharp blade, etc.) at its tip. [Explanation of symbols]

[0233] 12: Curved portion / 21c: Connecting portion / 21cc: Cam portion (cam) / 21cg: Cam gear (gear portion) / 21ch: Holding portion (plate spring) / 21cp: Switching portion (pressure member) / 29g: Output gear (tooth portion) / 50, 150, 250: Reduction mechanism (planetary gear mechanism) / 51: Input portion (sun gear) / 52: Fixed portion (internal gear) / 53, 153: Output portion (planetary carrier) / 54: Planetary gear / 152: Input portion (internal gear) / 151: Fixed portion (sun gear) / 100 : Bendable unit (catheter unit) / 200: Base unit / 251: Input part (sun gear) / 252: Output member (internal gear) / 253: Fixed member (planet carrier) / 350: Reduction mechanism (step gear mechanism) / 351: Input part (input gear) / 351a: Input gear part (gear part) / 353a: Output gear part (gear part) / 354: Step gear / 354a: First gear part / 354b: Second gear part / 400: Operation part / M: Drive source / W: Linear member (drive wire)

Claims

1. A driving source; a base unit having a coupling portion connected to the drive source; a bendable unit that is detachably attached to the base unit, the bendable unit including a bendable bending portion and a linear member that is configured to be connectable to the connecting portion and that is driven by the drive source via the connecting portion to bend the bending portion; an operation unit that is movable between a fixed position where removal of the bendable unit from the base unit is restricted and a removal position where removal of the bendable unit from the base unit is permitted; a reduction mechanism including an output member driven by the force transmitted from the operation unit, the connecting portion includes a holding portion that can transition between a holding state in which the linear member is held when the bendable unit is attached to the base unit and a release state in which the holding of the linear member is released, and a switching portion that is moved by the output member and switches the holding portion between the holding state and the release state, When the operation unit is in the fixed position, the holding unit is in the holding state, When the operation unit is in the detachment position, the holding unit is in the released state, and when the operation unit is moved from the fixed position toward the detachment position, the holding unit switches from the held state to the released state; the output member is configured to move by a second movement amount smaller than the first movement amount when the operation unit moves by the first movement amount; A medical device characterized by:

2. The operation unit is configured to be rotatable, the output member is configured to rotate by a second rotation angle as the second movement amount which is smaller than the first rotation angle when the operation unit rotates by a first rotation angle as the first movement amount, The medical device of claim 1 .

3. The operating unit is rotatable around a rotation axis extending along the attachment / detachment direction of the bendable unit relative to the base unit. The medical device of claim 2 .

4. the reduction mechanism is a planetary gear mechanism including an input section that rotates upon receiving rotation of the operation section, the output member, a fixed member that is fixed to the base unit, and a plurality of planetary gears, The output member is configured to output the rotation transmitted from the input portion to the switching portion.

4. The medical device according to claim 2 or 3.

5. the input portion is a sun gear, the output member is a planet carrier that rotatably and revolvably supports the plurality of planet gears that mesh with the sun gear, the fixed member is an internal gear that meshes with the plurality of planetary gears; The medical device of claim 4 .

6. the input portion is an internal gear, the output member is a planetary carrier that rotatably and revolvably supports the plurality of planetary gears that mesh with the internal gear, the fixed member is a sun gear that meshes with the plurality of planetary gears; The medical device of claim 4 .

7. the input is a sun gear; the output member is an internal gear that meshes with the plurality of planetary gears, the fixed member is a planet carrier that supports the plurality of planet gears rotatably and revolvably; The medical device of claim 4 .

8. the reduction mechanism includes an input unit that rotates upon receiving rotation of the operation unit, the output member, and stepped gears that mesh with the input unit and the output member, respectively; the output member is configured to output the rotation transmitted from the input portion to the switching portion, The stepped gear includes a first gear portion having a first number of teeth and meshing with the input portion, and a second gear portion having a second number of teeth less than the first number of teeth and meshing with the output member.

4. The medical device according to claim 2 or 3.

9. the input portion includes an input gear portion having a third number of teeth and meshing with the first gear portion, the output member includes an output gear portion having a fourth number of teeth and meshing with the second gear portion, a ratio of the fourth number of teeth to the third number of teeth is greater than a ratio of the second number of teeth to the first number of teeth; The medical device of claim 8 .

10. the input unit engages with the operation unit and rotates coaxially with the operation unit.

9. The medical device according to any one of claims 4 to 8.

11. the switching portion includes a cam portion that rotates to switch the holding portion between the holding state and the release state, and a cam gear that rotates integrally with the cam portion, The output member includes an output gear that meshes with the cam gear.

11. The medical device according to any one of claims 4 to 10.

12. The operation unit is provided on the bendable unit, the speed reducing mechanism is provided in the base unit, and is moved by the operation unit in a state where the bendable unit is attached to the base unit.

12. A medical device according to any one of claims 1 to 11.

13. The holding portion is a leaf spring that clamps and holds the linear member in the held state.

13. The medical device according to any one of claims 1 to 12.

14. The base unit includes a plurality of the connecting portions, When the operation unit is moved from the fixed position toward the detached position, the holding unit of each of the plurality of connecting units switches from the holding state to the release state.

14. A medical device according to any one of claims 1 to 13.

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