Medical devices

Abstract

To provide a medical device capable of puncturing an object part accurately and injecting a medicine to a target position accurately.SOLUTION: A medical device 10 for puncturing an object part and injecting a medicine includes: holding equipment 40 including a long-sized shaft 41 having a tip part and a base end part, and two holding parts 42 connected to the tip of the shaft 41 so as to get close to or away from each other, each of which is formed with a contact surface 45 that can come in contact with the surface of the object part; and puncture equipment 30, which is a long-sized tube body, and is formed with a sharp needle part 33 at the tip.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] The present invention relates to a medical device for directly injecting a drug into the heart.

Background Art

[0002] As a treatment method for coronary artery stenosis, percutaneous coronary intervention (PCI) using a balloon catheter or a stent is generally performed. However, coronary microvascular dysfunction (CMD) may be a problem as a condition in which, despite angina symptoms, the findings of coronary angiography are judged to be normal. Coronary microvascular dysfunction is a state in which minute blood vessels such as pre-arterioles, arterioles, or capillaries peripheral to the coronary artery are damaged and cannot be treated by percutaneous coronary intervention, and blood flow is not sufficiently supplied to the arteries after these minute blood vessels, causing myocardial ischemia. Coronary microvascular dysfunction is presumed to be caused by occlusion of peripheral blood vessels, inflammation, or fibrosis around the blood vessels.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] For the treatment of coronary microvascular dysfunction, it is believed that directly delivering drugs to the pericardial cavity is effective. However, current methods of accessing the pericardial cavity with devices are highly invasive. For example, pericardial drainage performed in cardiac tamponade can damage the heart. Furthermore, if pericardial fluid is not accumulated in the pericardial cavity, the parietal pericardium adheres closely to the visceral pericardium. Therefore, even if one attempts to puncture only the fibrous pericardium adjacent to the parietal side, there is a higher probability of simultaneously puncturing the visceral pericardium. For example, Patent Document 1 proposes a puncture device that can raise the skin and insert a puncture needle into this raised skin. However, this puncture device also raises the underlying tissue when raising the skin, making it difficult to puncture only the target area.

[0005] The present invention was made to solve the above-mentioned problems and aims to provide a medical device that can accurately puncture a target site and accurately inject a drug into the desired location. [Means for solving the problem]

[0006] The above objective is achieved by the invention described in (1) below.

[0007] (1) The medical device according to the present invention is a medical device for injecting a drug into a target site, comprising: a clamping device having a long shaft having a tip and a base; two clamping parts connected to the tip of the shaft, which can move closer to and further apart from each other, and each having a contact surface formed that can contact the surface of the target site; and a puncture device having a long tube with a sharp needle formed at its tip. The clamping portion is an elongated member in a direction parallel to the tip of the shaft portion, and each of the clamping portions is connected to the tip of the shaft by a plurality of intermediate links, and each of the clamping portions, the plurality of intermediate links, and the tip of the shaft form a parallel link mechanism. do. [Effects of the Invention]

[0008] The medical device described in (1) above can press the target area toward the center of the two clamping parts that are in contact with the surface of the target area, thereby relaxing the target area and forming folds in the target area. As a result, the medical device can insert the puncture instrument into the folds formed by the relaxation of the target area, thus suppressing accidental puncture of the tissue below the target area. Therefore, this medical device can accurately puncture the target area and accurately inject the drug to the desired location.

[0009] before Each clamping portion is an elongated member extending in a direction parallel to the tip of the shaft. Each clamping portion is connected to the tip of the shaft by a plurality of intermediate links, and each clamping portion, the plurality of intermediate links, and the tip of the shaft form a parallel link mechanism. do This allows the medical device to move the two clamping portions in contact with the surface of the target area closer together or further apart while keeping them parallel, by moving the shaft towards the tip or proximal end. Therefore, the medical device can effectively apply force to the target area with the two clamping portions, making it easy to loosen the target area.

[0010] ( 2 ) Above (1 ) In the medical device described, the contact surface may be subjected to a hydrophobic coating or a rough surface treatment. This makes the contact surface less likely to shift from the target area and makes it easier to apply force to the target area.

[0011] ( 3 ) (1) or (2) In the medical device described above, the shaft may have a curved portion that can be shaped to any angle or that is shaped to a predetermined angle. This allows the two clamping portions connected to the tip of the shaft to contact the surface of the target area at an appropriate angle. As a result, the medical device can effectively apply force to the target area with the two clamping portions, making it easy to loosen the target area.

[0012] ( 4 ) Above (1)~(3 In a medical device as described in any one of the above, the shaft may have a shaft lumen that movably accommodates the puncture instrument. This allows the medical device to easily puncture a puncture instrument into a fold of the target site that is loosely formed near the tip of the shaft, by moving the puncture instrument within the shaft lumen.

[0013] ( 5 ) Above (1)~( 4 In the medical device described in any one of the above, the two clamping portions may be arranged to surround the outer circumference of the tip of the shaft when in close proximity. This allows the medical device to smoothly insert and remove the tip of the clamping device having the clamping portions from an outer cylinder for transporting it to the vicinity of the target position. [Brief explanation of the drawing]

[0014] [Figure 1] This is a plan view showing a medical device according to an embodiment. [Figure 2] This diagram shows the area near the tip of a medical device; (A) is a plan view, and (B) is a front view seen from the tip side. [Figure 3] This is a schematic diagram showing the usage status of medical devices. [Figure 4] This diagram shows the tip of a medical device positioned near the heart; (A) is a plan view, and (B) is a cross-sectional view along line AA in Figure 4(A). [Figure 5] This diagram shows the clamping portion of a medical device deployed near the heart; (A) is a plan view, and (B) is a cross-sectional view along line BB in Figure 5(A). [Figure 6] This figure shows the fibrous pericardium being stretched by the clamping portion of a medical device; (A) is a plan view, and (B) is a cross-sectional view along the CC line in Figure 6(A). [Figure 7] This figure shows the state in which the fibrous pericardium is relaxed by the clamping portion of a medical device; (A) is a plan view, and (B) is a cross-sectional view along the DD line in Figure 7(A). [Figure 8]It is a diagram showing a state where a puncture instrument is punctured into the fibrotic pericardium relaxed by the clamping part of a medical device, (A) is a plan view, (B) is a cross-sectional view taken along line E-E of FIG. 8(A), and (C) is a cross-sectional view taken along line F-F of FIG. 8(A). [Figure 9] It is a cross-sectional view showing a first modification of the medical device according to the embodiment. [Figure 10] It is a cross-sectional view showing a second modification of the medical device according to the embodiment. [Figure 11] It is a plan view showing a third modification of the medical device according to the embodiment. [Figure 12] It is a diagram showing a third modification of the medical device according to the embodiment, (A) is a front view in a state where the clamping part is deployed, and (B) is a front view in a state where the clamping part is contracted. [Figure 13] It is a plan view showing a fourth modification of the medical device according to the embodiment.

Mode for Carrying Out the Invention

[0015] Hereinafter, embodiments of the present invention will be described with reference to the drawings. Note that the dimensions in the drawings may be exaggerated for convenience of explanation and may be different from the actual dimensions. In this specification and the drawings, components having substantially the same functional configuration are denoted by the same reference numerals, and redundant description is omitted. In this specification, the side inserted into the living body of the device is referred to as the "tip side", and the side operated by the operator is referred to as the "base end side".

[0016] As shown in FIG. 3, the medical device 10 according to the present embodiment is inserted into the thoracic cavity (body cavity) from the incision formed by incising the chest, and a drug for improving coronary microvascular dysfunction is directly injected into the pericardial cavity 103 of the heart 100. In the present embodiment, the drug includes, in addition to drugs having a therapeutic effect, cells, exosomes, nucleic acid drugs, and the like. The drug may be any of a liquid, solid, or gas containing a gel.

[0017] As shown in Figures 1 and 2, the medical device 10 includes a long outer cylinder 20, a long clamping instrument 40 that can be inserted into the outer cylinder 20 and can grasp tissue, and a long puncture instrument 30 that can be inserted into the outer cylinder 20.

[0018] The outer tube 20 is a tubular body with a lumen 21 through which the clamping instrument 40 and the puncture instrument 30 pass. The outer tube 20 is inserted from an incision made in the chest to near the heart 100 and provides the lumen 21 as an access passage to allow the clamping instrument 40 and the puncture instrument 30 to reach the fibrous pericardium 101.

[0019] The puncture device 30 has a puncture shaft 32 in which a needle lumen 31 for delivering the drug is formed, and a hub 35 fixed to the proximal end of the puncture shaft 32.

[0020] The puncture shaft 32 has a sharp needle portion 33 at its tip. The hub 35 is fixed to the proximal end of the puncture shaft 32 and has a port 34 that communicates with the needle lumen 31. A syringe or the like can be connected to the port 34 to supply medication to be delivered to the pericardial cavity 103 into the needle lumen 31.

[0021] The clamping device 40 includes a long shaft 41, two clamping parts 42 connected to the tip of the shaft 41, a moving mechanism 43 that movably connects the two clamping parts 42 to the shaft 41, and a biasing part 44 that biases the clamping parts 42. In this embodiment, the cross-sectional shape of the shaft 41 is rectangular, but it is not particularly limited and may be circular, elliptical, or the like.

[0022] The two clamping portions 42 are elongated members having a predetermined length along the extending direction of the tip of the shaft 41 and are arranged parallel to the tip of the shaft 41. The two clamping portions 42 are capable of contacting the outer surface of the fibrous pericardium 101 to be contacted and are movable so as to move closer to and further apart from each other. On the side of the two clamping portions 42 opposite to the side to which the moving mechanism 43 is connected, a contact surface 45 is formed that can contact the outer surface of the fibrous pericardium 101 to be contacted. That is, the two contact surfaces 45 are oriented in the same direction. It is preferable that the contact surfaces 45 are coated with a hydrophobic coating or have a rough surface finish so as not to slip against the outer surface of the fibrous pericardium 101 that they contact. Therefore, it is preferable that the contact surfaces 45 are more hydrophobic or have a rougher surface than the other surfaces of the clamping portion 42.

[0023] The moving mechanism 43 has a structure that combines, for example, two parallel link mechanisms, and can move relatively closer to and further apart from the two clamping parts 42 while maintaining their parallel state on the same plane. Each parallel link mechanism is formed by the tip of the shaft 41, two intermediate links 46 formed parallel and of the same length, and one clamping part 42 parallel to the tip of the shaft 41. One end of each of the two intermediate links 46 forming the parallel link mechanism is rotatably connected to a first fulcrum 47 and a second fulcrum 48 located at a distance L apart in the axial direction of the tip of the shaft 41, and the other end is rotatably connected to a position at a distance L apart from the same clamping part 42. The two clamping parts 42 are then positioned on opposite sides of the shaft 41. Therefore, the two clamping parts 42 can move relatively closer to and further apart from the shaft 41 while maintaining a parallel state.

[0024] The biasing member 44 is a member that biases the clamping member 42 to hold the shaft 41 in a predetermined position. The biasing member 44 is, for example, an elastically deformable, bent, elongated member, and both ends are fixed to two intermediate links 46 that extend from the second support point 48 to the separate clamping members 42. As a result, the two intermediate links 46 that extend from the second support point 48 to the separate clamping members 42 are held in a state where the side connected to the clamping member 42 is tilted slightly towards the tip side of the second support point 48. As a result, in a natural state where no external force is acting, the two clamping members 42 are in an expanded state that is relatively separated from the tip of the shaft 41. The form of the biasing member 44 is not particularly limited. For example, the biasing member 44 may be a coil spring or a leaf spring. Alternatively, the biasing member 44 may be fixed to two intermediate links 46 connected to the first support point 47. Furthermore, the biasing portion 44 may be fixed to the two clamping portions 42. Also, the biasing portion 44 may be fixed to the intermediate link 46 and the shaft 41. Furthermore, the biasing portion 44 may be fixed to the clamping portions 42 and the shaft 41. Also, the biasing portion 44 may not be provided at all.

[0025] Next, the method of using the medical device 10 according to this embodiment will be described.

[0026] First, as shown in Figure 4, the surgeon prepares the clamping device 40 and outer cylinder 20 by elastically deforming the biasing part 44 and bringing the two clamping parts 42 close to the shaft 41, thereby housing them in the lumen 21 of the outer cylinder 20. Next, the surgeon inserts the outer cylinder 20, with the two clamping parts 42 housed in the lumen 21, into the thoracic cavity through an incision made in the chest. While observing the inside of the thoracic cavity with an endoscope inserted into the thoracic cavity through a separate incision made in the chest, the surgeon guides the tip of the outer cylinder 20 to near the pericardium of the heart 100. The pericardium consists of a fibrous pericardium and a serous pericardium located inside the fibrous pericardium. The serous pericardium consists of a fibrous pericardium 101 and a visceral pericardium 102 located inside the fibrous pericardium 101. A cavity called the pericardial cavity 103 exists between the fibrous pericardium 101 and the visceral pericardium 102.

[0027] Next, the surgeon grasps the proximal end of the clamping instrument 40 located outside the body and the proximal end of the outer cylinder 20, and moves the outer cylinder 20 toward the proximal end relative to the clamping instrument 40. As a result, as shown in Figure 5, the tip of the clamping instrument 40, including the clamping portion 42, protrudes toward the tip from the outer cylinder 20. As a result, the biasing portion 44 returns to its original shape due to its own restoring force, and each intermediate link 46 rotates around the first fulcrum 47 or the second fulcrum 48, causing the two clamping portions 42 to move toward the proximal end relative to the shaft 41 and become separated from each other in an expanded state.

[0028] Next, the surgeon operates the clamping device 40 to press the contact surface 45 of the clamping portion 42 against the fibrous pericardium 101. This fixes the clamping portion 42 to the fibrous pericardium 101. In this state, when the surgeon moves the shaft 41 of the clamping device 40 toward the tip relative to the outer cylinder 20, the shaft 41 moves toward the tip while the clamping portion 42, whose movement toward the tip is restricted by the contact surface 45 contacting the fibrous pericardium 101, moves toward the tip. As a result, as shown in Figure 6, each intermediate link 46 rotates around the first fulcrum 47 or the second fulcrum 48, the biasing portion 44 deforms elastically, and the two clamping portions 42 connected to the shaft 41 by the intermediate links 46 forming the movement mechanism 43 move toward each other. Therefore, the two clamping portions 42 are in an expanded state, further apart from each other than in the deployed state. As a result, the fibrous pericardium 101, fixed to the two clamping portions 42, is stretched by the two clamping portions 42. This action is effective, for example, when the fibrous pericardium 101 is curved or already wrinkled, but it is not required.

[0029] With the clamping portion 42 fixed to the fibrous pericardium 101, when the surgeon moves the shaft 41 of the clamping device 40 towards the proximal end relative to the outer cylinder 20, the shaft 41 moves towards the proximal end while the clamping portion 42, whose movement towards the proximal end is restricted by the contact surface 45 contacting the fibrous pericardium 101, moves towards the proximal end. As a result, as shown in Figure 7, each intermediate link 46 rotates around the first fulcrum 47 or the second fulcrum 48, the biasing portion 44 deforms elastically, and the two clamping portions 42 connected to the shaft 41 by the movement mechanism 43 move toward each other. Therefore, the two clamping portions 42 are in a close proximity state, closer to each other than in the deployed state. As a result, a portion of the fibrous pericardium 101 fixed to the two clamping parts 42 loosens considerably away from the visceral pericardium 102, which is in contact with the inner surface opposite to the outer surface in contact with the clamping parts 42, and forms folds, thus widening the pericardial cavity 103 between the fibrous pericardium 101 and the visceral pericardium 102. However, if the fibrous pericardium 101 is tightly clamped by the two clamping parts 42 with the clamping device 40 and pressed against the visceral pericardium 102 below, sufficient space will not be formed in the pericardial cavity 103. For this reason, when clamping the fibrous pericardium 101, the surgeon needs to ensure that the two clamping parts 42 do not close completely (see Figure 7(B)), or lift the fibrous pericardium 101 clamped by the two clamping parts 42 away from the visceral pericardium 102 to secure space in the pericardial cavity 103. The fibrous pericardium 101, sandwiched between the two clamping portions 42, appears straight and roughly the same size as the clamping portions 42 when viewed from above, and has a mountain-like shape when viewed from the side, with the center being the most raised and becoming lower towards the ends of the clamping portions 42.

[0030] Next, the surgeon inserts the puncture instrument 30 into the lumen 21 of the outer cannula 20 from the proximal end of the outer cannula 20, and as shown in Figure 8, the needle portion 33 at the tip of the puncture instrument 30 protrudes from the tip opening of the outer cannula 20 and punctures the fibrous pericardium 101. When the surgeon performs the puncture, he aims for the pericardial cavity 103, which is the space between the lower visceral pericardium 102 and the upper fibrous pericardium 101. If the two clamping portions 42 are not completely closed, as shown in Figure 8(B), the surgeon punctures the raised portion of the fibrous pericardium 101 that is being held between the clamping portions 42. Also, if the surgeon is lifting the fibrous pericardium 101 held by the two clamping portions 42 away from the visceral pericardium 102, the surgeon punctures the portion of the fibrous pericardium 101 that is away from the visceral pericardium 102 with the proximal end of the clamping portion 42. At this time, the pericardial cavity 103 between the fibrous pericardium 101 and the visceral pericardium 102 is widened by the two clamping portions 42, so the operator can puncture only the fibrous pericardium 101 without piercing the visceral pericardium 102 with the needle portion 33. Therefore, the operator can accurately deliver the drug-releasing tip opening of the needle portion 33 to the pericardial cavity 103 without damaging the visceral pericardium 102.

[0031] Next, the operator connects a syringe or similar device to the port 34 (see Figure 1) of the hub 35 of the puncture device 30 and injects the drug into the pericardial cavity 103 via the needle lumen 31. This allows the drug to act effectively on the tissue and improve coronary microvascular dysfunction.

[0032] Next, the surgeon removes the puncture instrument 30 from the fibrous pericardium 101. Subsequently, the surgeon moves the contact surface 45 of the clamping portion 42 away from the fibrous pericardium 101 and moves the outer cylinder 20 toward the tip of the clamping instrument 40, or moves the clamping instrument 40 toward the proximal end of the outer cylinder 20. As a result, the moving mechanism 43 contacts the edge of the tip opening of the outer cylinder 20 and receives force, causing the moving mechanism 43 to bend and fold. Consequently, each intermediate link 46 rotates around the first fulcrum 47 or the second fulcrum 48, the biasing portion 44 deforms elastically, and the two clamping portions 42 connected to the shaft 41 by the moving mechanism 43 move toward each other. As a result, the tip of the clamping instrument 40, including the two clamping portions 42, is housed inside the outer cylinder 20. After this, the surgeon removes the clamping instrument 40 and the outer cylinder 20 from the body, completing the procedure using the medical device 10.

[0033] As described above, the medical device 10 according to this embodiment is a medical device 10 for puncturing a target site (fibrous pericardium 101) and injecting a drug, and comprises a clamping instrument 40 having a long shaft 41 having a tip and a base, two clamping parts 42 connected to the tip of the shaft 41 and capable of moving closer to and further apart from each other, each having a contact surface 45 that can simultaneously contact the surface of the target site, and a puncture instrument 30 having a long tube body with a sharp needle part 33 formed at its tip. As a result, the medical device 10 can bring the two clamping parts 42 that are in contact with the surface of the target site closer together, press the target site toward the vicinity of the center of the two clamping parts 42, and loosen the target site to form folds in the target site. Therefore, the medical device 10 can puncture the puncture instrument 30 into the folds of the loosened target site, thus suppressing accidental puncture of the tissue below the target site. Therefore, this medical device 10 can accurately puncture the target site and accurately inject the drug into the desired location (pericardial cavity 103) beyond the target site (fibrous pericardium 101). Furthermore, in addition to the effect of accurately injecting the drug, this medical device 10 also has the effect of introducing a drug delivery device (for example, a catheter for injecting the drug or a device for guiding the catheter) used to supply the drug to the pericardial cavity 103 into the pericardial cavity 103.

[0034] Each clamping portion 42 is an elongated member in a direction parallel to the tip of the shaft 41. Each clamping portion 42 is connected to the tip of the shaft 41 by a plurality of intermediate links 46. Each clamping portion 42, the plurality of intermediate links 46, and the tip of the shaft 41 form a parallel link mechanism. As a result, the medical device 10 can move the two clamping portions 42 in contact with the surface of the target area closer together or further apart while maintaining parallelity by moving the shaft 41 toward the tip or proximal end.

[0035] The contact surface 45 may be coated with a hydrophobic coating or have a roughened surface. This makes the contact surface 45 less likely to slip from the target area and makes it easier to apply force to the target area. Therefore, the medical device 10 can effectively apply force to the target area with its two clamping parts 42, making it easy to loosen the target area.

[0036] It should be noted that the present invention is not limited to the embodiments described above, and various modifications can be made by those skilled in the art within the technical framework of the present invention. For example, the target area that the clamping portion 42 contacts is not particularly limited as long as it is a membranous tissue that, when subjected to force from two points on its surface in a direction toward each other, can slacken and form folds so as to separate from the adjacent tissue on the opposite side of the surface receiving the force, and does not have to be tissue of the heart 100.

[0037] Furthermore, as shown in the first modified example in Figure 9, the shaft 41 may have a curved portion 49 that can be shaped to any angle. The curved portion 49 is formed from, for example, a plastically deformable material. The operator can deform the curved portion 49 as needed to curve it to any angle. This allows the two clamping portions 42 connected to the tip of the shaft 41 to contact the surface of the target area at an appropriate angle. As a result, the medical device 10 can effectively apply force to the target area with the two clamping portions 42, making it easy to relax the target area. The curved portion 49 may be pre-shaped and curved at a predetermined angle. In this case, the curved portion 49 does not need to be made from a plastically deformable material.

[0038] Furthermore, as shown in the second modified example in Figure 10, the shaft 41 may have a shaft lumen 50 that movably accommodates the puncture instrument 30. The shaft lumen 50 is open to the outside at the tip and proximal end of the shaft 41. The shaft 41 is curved so as to fold back towards the space between the two clamping portions 42 on the tip side of the moving mechanism 43. Therefore, the operator can insert the puncture instrument 30 from the proximal end of the shaft 41 into the shaft lumen 50 and make it protrude from the tip of the shaft 41. The medical device 10 can then easily puncture the needle portion 33 of the puncture instrument 30 into the folds of the target site that are loosened near the tip of the shaft 41 by the clamping portions 42, using the puncture instrument 30 moving through the shaft lumen 50.

[0039] Furthermore, as shown in the third modified example in Figures 11 and 12, the two clamping portions 42 may be positioned close together to surround the outer circumference of the tip of the shaft 41. The two clamping portions 42, when close together as shown in Figure 12(B), form a single cylinder. This allows the medical device 10 to smoothly insert and remove the tip of the clamping device having the clamping portions 42 from the outer cylinder 20 for transporting it to the vicinity of the target position. The shaft 41 has a shaft lumen 50 that movably accommodates the puncture instrument 30, and the shaft lumen 50 is open to the outside at the proximal end of the shaft 41 and also opens to the outside towards the space between the two clamping portions 42 at a side opening 51 located on the side of the shaft 41 closer to the proximal end than the tip. Therefore, the operator can extend the puncture instrument 30, inserted into the shaft lumen 50 from the proximal end of the shaft 41, through the side opening 51 on the side of the shaft 41. Furthermore, the medical device 10 allows the needle portion 33 of the puncture instrument 30 to easily puncture the folds of the target area, which are formed to slacken near the tip of the shaft 41 by the clamping portion 42, using the puncture instrument 30 that moves within the shaft lumen 50.

[0040] Furthermore, as shown in the fourth modified example in Figure 13, the moving mechanism 43 does not have to be a parallel link mechanism. The clamping portion 42 may be divided into multiple sections in the axial direction. Also, each clamping portion 42 may be connected to the shaft 41 by a single intermediate link 46, rather than being connected to the shaft 41 by multiple intermediate links 46.

[0041] Furthermore, each of the configurations described herein may be combined as appropriate. [Explanation of symbols]

[0042] 10 Medical Devices 20 Outer cylinder 21 Lumen 30 Puncture device 31 Needle lumen 32 puncture shafts 33 Needle section 34 ports 35 Hub 40 Clamping device 41 shaft 42 Clamping part 43 Moving mechanism 44. Encouraging part 45 Contact surface 46 Intermediate Links 47. First support point 48 Second support point 49 Curved section 50 shaft lumen 51 Side opening 100 hearts 101 Fibrous pericardium (target site) 102 Visceral pericardium 103 Pericardial cavity

Claims

1. A medical device for puncturing a target site and injecting a drug, A clamping device comprising: a long shaft having a tip and a base; and two clamping parts connected to the tip of the shaft, which can move closer to and further apart from each other, and each having a contact surface formed that can contact the surface of the target part; A puncture device comprising a long tubular body with a sharp needle portion formed at its tip, The clamping portion is an elongated member in a direction parallel to the tip of the shaft portion. Each of the aforementioned clamping portions is connected to the tip of the shaft by a plurality of intermediate links, Each of the clamping portions, the plurality of intermediate links, and the tip of the shaft form a parallel link mechanism in this medical device.

2. The medical device according to claim 1, wherein the contact surface is subjected to a hydrophobic coating or roughening process.

3. The medical device according to claim 1 or 2, wherein the shaft has a curved portion that can be shaped to any angle or is shaped to a predetermined angle.

4. The medical device according to claim 1 or 2, wherein the shaft has a shaft lumen that movably houses the puncture instrument.

5. The medical device according to claim 1 or 2, wherein the two clamping portions are arranged in close proximity to surround the outer circumference of the tip of the shaft.

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