Medical device gripping tool

Abstract

This medical device gripping tool comprises: a gripping part that grips a medical device; a cylindrical operation part that is connected to the base-end side of the gripping part and that has a lumen into which the medical device gripped by the gripping part is inserted, the operation part having an outer circumferential part for an operator to perform a rotation operation, and transmitting rotational force received from the operator by the outer circumferential part to the medical device via the gripping part; and a handle part that is provided to the base-end side of the operation part and that supports the operation part in a state of allowing relative rotation, the handle part having an accommodation section that accommodates a portion of the base-end side of the operation part.

Description

Medical Device Grasping Tool

[0001] The present disclosure relates to a medical device grasper.

[0002] For example, Patent Documents 1 and 2 disclose guidewire gripping devices that are used to grip a guidewire and to facilitate the rotation, advancement, and retraction of the guidewire.

[0003] Patent No. 6885923 Publication JP-A-9-173465

[0004] There are cases where a blood vessel is blocked by a lesion, such as a chronic total occlusion (CTO). One known procedure for treating such a lesion is to penetrate the CTO using a penetrating guidewire. In order to penetrate the CTO with a penetrating guidewire, it is necessary to apply a greater amount of rotation to the penetrating guidewire than during delivery, and it is also necessary to counteract the reaction force from the CTO. In this regard, the guidewire gripping devices described in Patent Documents 1 and 2 do not take into consideration the above-mentioned issues that arise when penetrating a CTO using a penetrating guidewire, and there is room for improvement in terms of operability and safety.

[0005] Such problems are not limited to penetration of a CTO using a penetration guidewire, but are common to all percutaneous procedures using medical devices such as guidewires and catheters. These problems are not limited to the vascular system, but are common to all medical devices inserted into biological lumens, such as the lymphatic system, biliary system, urinary system, respiratory system, digestive system, secretory glands, and reproductive organs.

[0006] The present disclosure has been made to solve at least part of the above-mentioned problems, and can be realized in the following aspects.

[0007] (1) According to one aspect of the present disclosure, there is provided a medical device gripping tool comprising: a gripping portion for gripping the medical device; a cylindrical operating portion connected to a proximal end of the gripping portion and having a lumen into which the medical device gripped by the gripping portion is inserted, the operating portion having an outer periphery for an operator to perform a rotational operation, the outer periphery transmitting rotational force received from the operator to the medical device via the gripping portion; and a handle portion provided on the proximal end of the operating portion for supporting the operating portion in a relatively rotatable state, the handle portion having an accommodation portion for accommodating a portion of the proximal end of the operating portion.

[0008] With this configuration, the surgeon can easily rotate the medical device by gripping the handle and rotating the outer periphery of the control unit with his or her fingers. Therefore, for example, when a penetrating guidewire is used as the medical device to penetrate a CTO, even if the penetrating guidewire receives a reaction force from the CTO, the reaction force can be easily resisted. As a result, the operability and safety of the medical device gripper can be improved.

[0009] (2) In the medical device gripping tool of the above embodiment, the length of the operating section accommodated in the housing may be changeable, and the medical device gripping tool may be switchable between a first state in which a specific portion of the operating section protrudes from the housing of the handle section and a second state in which the specific portion is accommodated in the housing of the handle section. According to this configuration, the medical device gripping tool is switchable between a first state in which a specific portion of the operating section protrudes from the housing of the handle section and a second state in which the specific portion is accommodated in the housing of the handle section. Therefore, by changing the structure of the outer periphery of the specific portion of the operating section and the remaining portion, the surgeon can change the structure of the outer periphery of the operating section to a structure suitable for the surgeon's operation, such as switching to the second state when delivering a medical device and the first state when penetrating a CTO. Examples of the structure of the outer periphery include the outer diameter and the presence or absence of a non-slip coating. As a result, the operability and safety of the medical device gripping tool can be further improved. The surgeon can easily switch between the first state and the second state by sliding the operation unit.

[0010] (3) In the medical device gripping tool of the above embodiment, the handle portion may further include a ratchet mechanism, wherein the ratchet mechanism in an ON state allows relative rotation of the operating portion with respect to the handle portion in a first direction and restricts relative rotation in a second direction opposite to the first direction, and the ratchet mechanism in an OFF state allows relative rotation in both the first direction and the second direction. According to this configuration, the handle portion further includes a ratchet mechanism that, in the ON state, allows relative rotation of the operating portion with respect to the handle portion in the first direction and restricts relative rotation in the second direction opposite to the first direction. Therefore, by turning the ratchet mechanism ON, when the surgeon rotates the medical device in the first direction to penetrate the CTO, the medical device can be prevented from rotating in the second direction due to a reaction force from the CTO. As a result, the operability and safety of the medical device gripping tool can be further improved, and the efficiency of CTO penetration using the medical device can be improved.

[0011] (4) In the medical device gripping tool of the above embodiment, the handle portion may further include a ratchet mechanism, and when the medical device gripping tool is in the first state, the ratchet mechanism may be in an ON state, allowing relative rotation of the operation unit with respect to the handle portion in a first direction and restricting relative rotation in a second direction opposite to the first direction, and when the medical device gripping tool is in the second state, the ratchet mechanism may be in an OFF state, allowing relative rotation in both the first direction and the second direction. With this configuration, when the medical device gripping tool is in the first state for CTO penetration, the ratchet mechanism is in the ON state, so that when the surgeon rotates the medical device in the first direction for CTO penetration, the medical device can be prevented from rotating reversely in the second direction due to a reaction force from the CTO. When the medical device gripping tool is in the second state for delivering the medical device, the ratchet mechanism is in the OFF state, so that rotation in the first and second directions for advancing the medical device to the target branch at the bifurcation of the blood vessel is not hindered. As a result, the operability and safety of the medical device gripping tool can be further improved, and further, the efficiency of CTO penetration using the medical device can be improved.

[0012] (5) In the medical device gripper of the above aspect, the ratchet mechanism may include a first ratchet having teeth arranged on a plane perpendicular to the rotation axis of the operating unit relative to the handle portion, and a second ratchet having teeth arranged on a plane perpendicular to the rotation axis of the operating unit relative to the handle portion, and in the ON state, the teeth of the second ratchet engage with the teeth of the first ratchet to limit the rotation of the operating unit relative to the handle portion in the second direction, and in the OFF state, the teeth of the first ratchet and the teeth of the second ratchet disengage, so that the rotation of the operating unit relative to the handle portion is not limited. According to this configuration, the ratchet mechanism is realized by the first ratchet and the second ratchet, each having teeth arranged on a plane perpendicular to the rotation axis of the operating unit relative to the handle portion, so that the teeth of the first and second ratchets can reliably engage with each other in the ON state and reliably disengage from each other in the OFF state.

[0013] (6) In the medical device gripping tool of the above embodiment, the operating unit may have a first operating unit corresponding to the specific portion and a second operating unit corresponding to the remaining portion, and the outer diameter of the first operating unit may be smaller than the outer diameter of the second operating unit. According to this configuration, the outer diameter of the first operating unit corresponding to the specific portion of the operating unit is smaller than the outer diameter of the second operating unit. Therefore, when the medical device gripping tool is in the first state for CTO penetration, the surgeon can apply more rotation to the medical device by operating the first operating unit with a relatively small outer diameter. In other words, with the first operating unit, the finger movement required to rotate the medical device by a certain angle can be made smaller than when using the second operating unit. When the medical device gripping tool is in the second state for delivering the medical device, the surgeon can apply more precise manipulation to the medical device by operating the second operating unit with a relatively large outer diameter. As a result, the operability and safety of the medical device gripping tool can be further improved, and the efficiency of CTO penetration using the medical device can be further improved.

[0014] (7) In the medical device gripping tool of the above aspect, the operating unit may have a first operating unit corresponding to the specific portion and a second operating unit corresponding to the remaining portion, and the second operating unit may be located closer to the distal end than the first operating unit. (8) In the medical device gripping tool of the above aspect, the operating unit may have a first operating unit corresponding to the specific portion and a second operating unit corresponding to the remaining portion, and the second operating unit may be provided adjacent to the gripping unit and the first operating unit, respectively, between the gripping unit and the first operating unit. (9) In the medical device gripping tool of the above aspect, the switching unit may be configured to maintain a current state between the first state and the second state by a concave-convex engagement structure between the switching unit and the operating unit, and when the switching unit is operated, the concave-convex engagement structure is released, thereby enabling switching between the first state and the second state. (10) In the medical device gripping tool of the above form, the operating portion has a shaft, and the outer surface of the shaft is provided with a distal groove portion which is a recess and a proximal groove portion which is a recess provided at a position away from the distal groove portion toward the proximal end, and the switching portion may have a knob protruding from the outer surface of the handle portion and an engaging portion for engaging with either the distal groove portion or the proximal groove portion.

[0015] The present disclosure can be realized in various forms, for example, in the form of a medical device gripping tool and a method for manufacturing the same.

[0016] 1 is an explanatory diagram illustrating the external configuration of a medical device gripping tool. FIG. 1 is an explanatory diagram illustrating the external configuration of a medical device gripping tool. FIG. 1 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool in a second state. FIG. 1 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool in a first state. FIG. 2 is an explanatory diagram illustrating the configuration of a ratchet mechanism and a switching unit. FIG. 3 is a diagram illustrating the ratchet mechanism in an ON state. FIG. 4 is a diagram illustrating the state of the heart during a CTO penetration procedure. FIG. 5 is a diagram illustrating the state of an operator's hand during a CTO penetration procedure. FIG. 6 is a diagram illustrating the state of an operator's hand during a CTO penetration procedure. FIG. 7 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool of a second embodiment with the ratchet mechanism in an ON state. FIG. 8 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool of a second embodiment with the ratchet mechanism in an OFF state. FIG. 9 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool of a third embodiment. FIG. 10 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool of a fourth embodiment. FIG. 10 is an explanatory diagram illustrating a cross-sectional configuration of a medical device gripping tool according to a fifth embodiment.

[0017] 1A and 1B are explanatory diagrams illustrating the external configuration of a medical device gripping tool 1. FIG. 1A shows the medical device gripping tool 1 in a second state. FIG. 1B shows the medical device gripping tool 1 in a first state. The medical device gripping tool 1 is attached to the proximal end of a medical device 2 and is used to facilitate the rotation, advancement, and retraction of the medical device 2. The medical device gripping tool of this embodiment is set to the second state shown in FIG. 1A when delivering the medical device 2 to a lesion, and to the first state shown in FIG. 1B when treating the lesion, thereby improving operability and safety and further improving the efficiency of the procedure. Details will be described later.

[0018] In this embodiment, the opening of a CTO using a penetrating guidewire 2 will be described as an example of a specific application scenario for explaining the medical device holding tool 1. In this case, the medical device holding tool 1 holds the penetrating guidewire 2 as a medical device and assists the surgeon in manipulating the penetrating guidewire 2. The penetrating guidewire 2 is a device for opening a blood vessel by penetrating a lesion that blocks the blood vessel, such as a CTO. Any device, such as a delivery guidewire or a catheter, can be used as the medical device 2. The medical device holding tool 1 can be used in all percutaneous procedures using the medical device 2, in addition to opening a CTO.

[0019] For ease of explanation, Figure 1 includes some parts in which the relative size ratios of the components are different from the actual ones. Some of the components are exaggerated. Figure 1 illustrates mutually orthogonal X, Y, and Z axes. The X axis corresponds to the longitudinal direction of the medical device holding tool 1, the Y axis corresponds to the height direction of the medical device holding tool 1, and the Z axis corresponds to the width direction of the medical device holding tool 1. The left side of Figure 1 is referred to as the "distal side" of the medical device holding tool 1 and each component, and the right side of Figure 1 is referred to as the "proximal side" of the medical device holding tool 1 and each component. The left side of Figure 1 is the -X axis direction. The right side of Figure 1 is the +X axis direction. Of the longitudinal ends of the medical device holding tool 1 and each component, the end located on the distal side is referred to as the "distal end," and the other end located on the proximal side is referred to as the "proximal end." The longitudinal direction of the medical device holding tool 1 and each component is the X axis direction. The tip and its vicinity are referred to as the "tip portion," and the base and its vicinity are referred to as the "base end portion." The tip side is inserted into the living body, and the base side is operated by an operator such as a doctor. These points are also common to Figure 2 and subsequent figures.

[0020] As shown in FIGS. 1A and 1B , the medical device gripping tool 1 includes a gripping section 10, an operating section 20, and a handle section 30. The gripping section 10, the operating section 20, and the handle section 30 each have a lumen therein for inserting a penetration guidewire 2. Therefore, during a procedure, the surgeon inserts the penetration guidewire 2 into the medical device gripping tool 1 and attaches the medical device gripping tool 1 to the proximal end of the penetration guidewire 2. The surgeon can switch the medical device gripping tool 1 from the second state shown in FIG. 1A to the first state shown in FIG. 1B by pressing down the switching section 50 provided on the handle section 30 and pulling either the gripping section 10 or the operating section 20 in the longitudinal direction. Pulling in the longitudinal direction refers to moving the medical device gripping tool in the −X-axis direction. Conversely, the surgeon can switch the medical device gripping tool 1 from the first state to the second state by pressing either the gripping part 10 or the operating part 20 in the longitudinal direction while pressing down the switching part 50. Pressing in the longitudinal direction means moving in the +X-axis direction.

[0021] As shown in FIG. 1B , in the first state, the operating unit 20 includes a “first operating unit” and a “second operating unit,” and the length of the operating unit 20 is longer than in the second state. As shown in the figure, the outer diameter of the first operating unit is smaller than the outer diameter of the second operating unit. As shown in FIG. 1A , in the second state, the operating unit 20 includes only the “second operating unit,” and the length of the operating unit 20 is shorter than in the first state. As shown in the figure, in the second state, the first operating unit is housed inside the handle portion 30. The interior of the handle portion 30 refers to the housing portions 310 and 320. In this embodiment, the first operating unit corresponds to a “specific portion of the operating unit 20.” As such, the length of the operating unit 20 changes between the first state and the second state, and the length of the medical device gripping tool 1 also changes accordingly. That is, the length of the medical device gripping tool 1 in the first state is longer than the length of the medical device gripping tool 1 in the second state.

[0022] Fig. 2 is an explanatory diagram illustrating the cross-sectional configuration of the medical device gripping tool 1 in the second state. An enlarged view of the vicinity of the gripping portion 10 is shown in a speech bubble at the bottom of Fig. 2. Fig. 3 is an explanatory diagram illustrating the cross-sectional configuration of the medical device gripping tool 1 in the first state. An enlarged view of the vicinity of the switching portion 50 is shown in a speech bubble at the bottom of Fig. 3.

[0023] The gripping portion 10 is a member that grips and fixes the penetration guidewire 2. The gripping portion 10 is disposed at the tip of the medical device gripping tool 1, in other words, at the most distal end of the medical device gripping tool 1. The gripping portion 10 has a substantially cylindrical shape. Specifically, the outer shape of the tip end of the gripping portion 10 is tapered, and the outer shape of the base end is cylindrical with a pair of wings extending in the ±Y-axis directions. As shown in the balloon in the lower part of Figure 2, a lumen is formed inside the gripping portion 10, connecting the tip opening 10a and the base opening 10b.

[0024] A recess 11 is formed on the inside of the grip portion 10. An internal thread 12 and a protrusion 14 are formed on the inner circumferential surface of the grip portion 10. The recess 11 is located inside the portion of the grip portion 10 whose outer shape is cylindrical, in other words, on the proximal end side of the grip portion 10. A distal portion of the second shaft 22 of the operation unit 20 and the gripping claws 13 are housed in the recess 11. The internal thread 12 is a thread formed on the inner circumferential surface of the grip portion 10 and is located on the distal end side of the recess 11. When the internal thread 12 is threadedly engaged with the external thread 222 formed on the distal end of the second shaft 22, the inner circumferential surface of the grip portion 10 compresses the claws 132 of the gripping claws 13 in the central axial direction, in other words, toward the penetration guidewire 2. The protrusion 14 is located inside the portion whose outer shape is tapered, in other words, near the center of the grip portion 10. The raised portion 14 is a portion of the inner circumferential surface of the grip portion 10 that rises toward the center. Between the raised portion 14 and the internal thread portion 12, a cone-shaped wall portion 110 is formed, with the diameter of the inner circumferential surface of the grip portion 10 expanding from the distal end toward the proximal end.

[0025] The gripping portion 10 further has gripping claws 13 for gripping the penetration guidewire 2. The gripping claws 13 have a body 131 and multiple claws 132. In the illustrated example, the gripping claws 13 have four claws 132. The body 131 is a cylindrical portion located on the base end side of the gripping claws 13. Each claw 132 is located on the distal end side of the gripping claws 13 and is connected to the body 131 on the distal side of the body 131. The claws 132 are portions that can move toward the center when compressed from the outside. The claws 132 move toward the center by elastic deformation. The claws 132 have a thick distal end portion 132a at the distal end of the curved plate. The distal end portion 132a has a distal wall portion 130a at its distal end that faces the wall portion 110, which is part of the inner circumferential surface of the gripping portion 10. The distal wall portion 130a is a surface whose diameter increases from the distal end toward the proximal end. The distal portion 132a has a proximal wall portion 130b on its proximal end side that faces the wall portion 220 of the second shaft 22. The proximal wall portion 130b is a surface whose diameter decreases from the distal end toward the proximal end.

[0026] When fixing the penetration guidewire 2 inserted into the medical device gripping tool 1, the surgeon rotates the gripping portion 10 around the central axis to thread the inner screw portion 12 and the outer screw portion 222 of the operating portion 20. This causes the gripping portion 10 to move toward the proximal end, and the gripping claws 13 are pushed toward the proximal end by the wall portion 110 of the gripping portion 10. The direction in which the gripping portion 10 moves is indicated by the white arrow in the speech bubble in the lower part of Figure 2. When the gripping claws 13 move toward the proximal end and the proximal end wall portion 130b of the claw portion 132 abuts against the wall portion 220 of the second shaft 22, the gripping claws 13 cannot move further toward the proximal end. Therefore, the distal ends 132a of the multiple claws 132 are pushed toward the center by the wall portion 110 of the gripping portion 10. As a result, the tip portions 132a of the multiple claw portions 132 can support and fix the penetrating guidewire 2. To release the fixation of the penetrating guidewire 2, the surgeon simply rotates the gripping portion 10 in the opposite direction. When moving the penetrating guidewire 2 back and forth within the medical device gripping tool 1, the surgeon releases the fixation of the penetrating guidewire 2. When manipulating the penetrating guidewire 2 using the medical device gripping tool 1, the surgeon fixes the penetrating guidewire 2.

[0027] The operating section 20 is a member that transmits an operation by the surgeon to the penetration guidewire 2. The operating section 20 is connected to the proximal end side of the gripping section 10 and is disposed closer to the proximal end than the gripping section 10. The operating section 20 is generally long and tubular. As shown in FIGS. 2 and 3 , the operating section 20 has a first shaft 21 and a second shaft 22.

[0028] The first shaft 21 is a cylindrical member (tubular body) having an elongated outer shape. A penetration guidewire 2 is inserted into a lumen 21L within the first shaft 21. A distal portion of the first shaft 21 is inserted into the lumen of the second shaft 22 and is fixed to the second shaft 22, for example, with an adhesive. A proximal portion of the first shaft 21 is housed in the housings 310 and 320 of the handle section 30. The outer circumferential surface of the first shaft 21 is provided with two grooves 211 and 212, which are annularly recessed in the outer circumferential surface of the shaft. The distal recess is also referred to as the distal groove 211, and the proximal recess is also referred to as the proximal groove 212. As shown in FIG. 2 , in the second state of the medical device gripping tool 1, the distal groove 211 engages with the engaging portion 52 of the switching section 50, thereby fixing the first shaft 21 of the operating section 20 to the handle section 30 in the longitudinal direction of the medical device gripping tool 1. 3 , in the first state of the medical device gripping tool 1, the proximal groove 212 engages with the engaging portion 52 of the switching unit 50, thereby fixing the first shaft 21 of the operating unit 20 to the handle portion 30 in the longitudinal direction of the medical device gripping tool 1. In other words, when the medical device gripping tool 1 is in either the second state or the first state, the relative movement of the operating unit 20 with respect to the handle portion 30 in the longitudinal direction of the medical device gripping tool 1 is restricted. The second state is a state in which the distal groove 211 engages with the engaging portion 52 of the switching unit 50. The first state is a state in which the proximal groove 212 engages with the engaging portion 52 of the switching unit 50. However, in the circumferential direction of the medical device gripping tool 1, the relative rotation of the operating unit 20 with respect to the handle portion 30 is not restricted. As shown in the speech bubble in the lower part of Figure 3, when knob 51 of switching unit 50 is pressed down, grooves 211 and 212 disengage from engaging portion 52, making it possible to switch between the first state and the second state.

[0029] The second shaft 22 is a cylindrical member. The second shaft 22 has a larger outer diameter and an inner diameter than the first shaft 21, and a distal portion of the first shaft 21 is inserted into and fixed in a lumen within the second shaft 22. In other words, the second shaft 22 covers a distal portion of the first shaft 21 that is exposed from the distal end of the handle portion 30. A wall portion 220 and an external thread portion 222 are formed on the outer peripheral surface of the distal end of the second shaft 22. A distal portion of the second shaft 22 is housed in the recess 11 of the grip portion 10.

[0030] As shown in FIG. 3 , in the first state of the medical device holder 1, a portion of the first shaft 21 is exposed to the outside at a position adjacent to the tip of the handle portion 30. At this time, the outer circumferential portion 21c of the first shaft 21 exposed to the outside corresponds to the “first operating portion.” As shown in FIG. 2 , in the second state of the medical device holder 1, as the first shaft 21 is housed in the handle portion 30, a portion of the second shaft 22 is exposed to the outside at a position adjacent to the tip of the handle portion 30. At this time, the outer circumferential portion 22c of the second shaft 22 exposed to the outside corresponds to the “second operating portion.” The first shaft 21 and the second shaft 22 are fixed with, for example, an adhesive. Therefore, when the penetrating guidewire 2 is fixed by the holder 10, when either the first operating portion or the second operating portion is rotated, the rotational force applied by the surgeon is transmitted to the penetrating guidewire 2 via the holder 10, rotating the penetrating guidewire 2.

[0031] The handle portion 30 supports the operating portion 20 in a relatively rotatable state and is a member that enables the surgeon to grasp the medical device gripping tool 1. The handle portion 30 is provided on the proximal end side of the operating portion 20. The handle portion 30 is disposed at the proximal end of the medical device gripping tool 1, in other words, at the proximal-most side of the medical device gripping tool 1. The handle portion 30 is long and tubular overall. As shown in Figures 2 and 3 , the handle portion 30 has a distal housing 31, a proximal housing 32, a ratchet mechanism 40, and a switching portion 50.

[0032] The distal housing 31 is a cylindrical member whose outer and inner diameters both gradually decrease from the base end to the distal end. The distal housing 31 is disposed closer to the distal end than the base end housing 32. A distal housing 31 has a distal housing section 310 formed therein. The distal housing 31 has a space for housing the first shaft 21 and the switching unit 50. A distal opening 30a is formed in the distal surface of the distal housing 31, connecting the distal housing section 310 to the outside. A portion of the proximal end of the first shaft 21 is inserted from the distal opening 30a into the distal housing 310. An engaging section 311 is formed at the proximal end of the distal housing 31 for fixing the distal housing 31 and the base end housing 32. A recess 312 is formed in a portion of the outer peripheral surface of the distal housing 31, and a knob 51 of the switching unit 50 protrudes from a through-hole provided in the center of the recess 312. A through hole provided in the center of the recess 312 is a hole that connects the tip accommodating portion 310 to the outside.

[0033] The base end housing 32 is a cylindrical member having a substantially constant outer diameter. The base end housing 32 is disposed closer to the base end than the distal end housing 31. A base end accommodating section 320 is formed inside the base end housing 32. The base end accommodating section 320 is a space for accommodating the first shaft 21 and the ratchet mechanism 40. An engaging section 321 for fixing the distal end housing 31 and the base end housing 32 is formed at the distal end of the base end housing 32. A base end opening 30b that connects the base end accommodating section 320 to the outside is formed at the proximal end surface of the base end housing 32, and the penetration guidewire 2 inserted into the medical device gripping tool 1 is pulled out to the outside from the base end opening 30b.

[0034] FIG. 4A is an explanatory diagram illustrating the configuration of the ratchet mechanism 40 and the switching unit 50. The switching unit 50 is a member that switches the fixed state of the first shaft 21, thereby enabling switching between a first state and a second state. The switching unit 50 is housed in the tip housing 310 of the tip housing 31. The switching unit 50 has a knob 51 and an engaging unit 52. The knob 51 is a protruding portion provided on the surface opposite the engaging unit 52. As shown in FIGS. 2 and 3 , the upper portion of the knob 51 is exposed to the outside through a through-hole in the recess 312 of the tip housing 31. The engaging unit 52 is a pawl that engages with the grooves 211 and 212 of the first shaft 21. As shown in FIGS. 2 and 3 , the engaging unit 52 engages with the grooves 211 and 212 when the knob 51 is not pressed down. 3, when the knob 51 is pressed down, the engagement portion 52 is separated from the grooves 211 and 212 and does not engage with the grooves 211 and 212. Therefore, when the knob 51 is pressed down, the first shaft 21 is released from the fixed state, and the first shaft 21 can be moved. In other words, when the knob 51 is pressed down, the state can be changed between the first state and the second state.

[0035] The ratchet mechanism 40 is a mechanism for restricting the rotation direction of the operation unit 20 relative to the handle unit 30. The ratchet mechanism 40 is housed in the base end housing portion 320 of the base end housing 32. The ratchet mechanism 40 has a first ratchet 41 and a second ratchet 42.

[0036] As shown in FIG. 4A , the first ratchet 41 includes a shaft body 411 disposed at the distal end, a gear body 412 disposed at the proximal end, and a spring 414 (see FIGS. 2 and 3 ) housed inside the shaft body 411 and the gear body 412. The shaft body 411 is a hollow polygonal column-shaped member and is fixed to the distal housing 31 with, for example, an adhesive, with the first shaft 21 inserted therethrough. As shown in FIGS. 2 and 3 , the proximal end of the shaft body 411 is housed inside the gear body 412. The gear body 412 is a cylindrical member with a bottom and is housed inside the proximal housing 32 with the first shaft 21 inserted therethrough. The inner diameter of the distal end of the gear body 412 is slightly larger than the outer diameter of the proximal end of the shaft body 411, and the distal end of the gear body 412 covers the proximal end of the shaft body 411. The distal end of the gear body 412 is an open end. Therefore, when the gear body 412 attempts to rotate in the circumferential direction, the outer peripheral surface of the shaft body 411 and the inner peripheral surface of the gear body 412 engage with each other, thereby restricting the rotation of the gear body 412 in the circumferential direction. The gear body 412 has sawtooth teeth 413 on the outside of its base end surface, which corresponds to the bottom. In other words, the teeth 413 of the gear body 412 are arranged on a plane perpendicular to the rotation axis O relative to the handle portion 30 of the operation unit 20. The spring 414 is housed inside the shaft body 411 and the gear body 412 and presses the gear body 412 toward the second ratchet 42. The pressing direction of the spring 414 is indicated by the diagonal arrow in FIG. 4A . The base end surface of the gear body 412 engages with the step portion 322 of the base end housing 32, so that even when pressed by the spring 414, it does not move further toward the base end than the position shown in FIG. 3 .

[0037] The second ratchet 42 is a cylindrical member with a bottom, and has sawtooth teeth 423 on the outside of the tip surface corresponding to the bottom. In other words, the teeth 423 of the second ratchet 42 are arranged on a plane perpendicular to the rotation axis O relative to the handle portion 30 of the operation unit 20. The second ratchet 42 is fixed to the first shaft 21 with the first shaft 21 inserted inside. As shown in FIG. 2 , when the medical device gripping tool 1 is in the second state, the second ratchet 42 is positioned away from the first ratchet 41. As shown in FIG. 3 , when the medical device gripping tool 1 is in the first state, the second ratchet 42 is positioned adjacent to the first ratchet 41. When the first and second ratchets 41, 42 are positioned away from each other, this state is also referred to as "the ratchet mechanism 40 is in the OFF state," and when the first and second ratchets 41, 42 are positioned adjacent to each other, this state is also referred to as "the ratchet mechanism 40 is in the ON state." That is, when the medical device gripping tool 1 is in the second state (FIG. 2), the ratchet mechanism 40 is in the OFF state. When the medical device gripping tool 1 is in the first state (FIG. 3), the ratchet mechanism 40 is in the ON state.

[0038] FIG. 4B is a diagram showing the ratchet mechanism 40 in the ON state. As shown in FIG. 4B , when the ratchet mechanism 40 is in the ON state, the teeth 413 of the gear body 412 of the first ratchet 41 engage with the teeth 423 of the second ratchet 42. Then, the wall portions 413 a of the sawtooth teeth 413 engage with the wall portions 423 a of the teeth 423, restricting relative rotation of the operating unit 20 with respect to the handle unit 30 in the second direction D2. The manner in which relative rotation is restricted is indicated by the dashed arrow in FIG. 4B . When the ratchet mechanism 40 is in the ON state, relative rotation in the first direction D1, which is opposite to the second direction D2, is not restricted. In other words, when the ratchet mechanism 40 is in the ON state, relative rotation in the first direction D1 is permitted. This is because the walls 413 a and 423 a of the teeth 413 and 423 are not present on the side of rotation in the first direction D1. The gear body 412 of the first ratchet 41 is pushed toward the second ratchet 42 by the spring 414, so that the first ratchet 41 and the second ratchet 42 are prevented from coming apart as the operating part 20 rotates in the first direction D1 or the second direction D2.

[0039] When the ratchet mechanism 40 is in the OFF state, the teeth 413 of the gear body 412 of the first ratchet 41 are separated from the teeth 423 of the second ratchet 42. Therefore, when the ratchet mechanism 40 is in the OFF state, the relative rotation of the operating unit 20 with respect to the handle unit 30 is not restricted in both the first direction D1 and the second direction D2.

[0040] The grip portion 10, the operating portion 20, and the handle portion 30 can be made of a known resin material. The grip portion 10, the operating portion 20, and the handle portion 30 can be made of the same material or different materials. The grip claw 13 can be made of a known metal material.

[0041] FIG. 5 is a diagram showing the state of the heart during a CTO penetration procedure. In this embodiment, a case where a CTO 99 in a left coronary artery 94 of a heart 90 is opened is illustrated. In FIG. 5 , for the sake of distinction, the penetration guidewire 2 is depicted by a solid line and the guiding catheter 3 is depicted by a dashed line. The surgeon can perform the procedure, for example, by following the steps a1 to a5 below. (a1) The surgeon inserts a workhorse wire from the forearm or thigh and delivers it to the entrance of the left coronary artery 94. The workhorse wire is a guidewire used for delivery. (a2) The surgeon inserts the workhorse wire from the distal end of the guiding catheter 3 and delivers the guiding catheter 3 along the workhorse wire to the entrance of the left coronary artery 94. (a3) ​​The surgeon removes the workhorse wire and inserts the penetration guidewire 2 from the proximal end of the guiding catheter 3. The surgeon delivers the penetrating guidewire 2 to the entrance of the left coronary artery 94 by pushing the penetrating guidewire 2 along the guiding catheter 3. (a4) The surgeon further pushes the penetrating guidewire 2 into the left coronary artery 94 and delivers the penetrating guidewire 2 to a branch of the left coronary artery 94 where the CTO 99 is located. (a5) The surgeon uses the penetrating guidewire 2 to penetrate the CTO 99.

[0042] 6A and 6B are diagrams showing the state of the surgeon's hands during the CTO penetration procedure. FIG. 6A illustrates the operation in the second state, and FIG. 6B illustrates the operation in the first state. In step a4, for example, when an operation is required to push the penetrating guidewire 2 in the intended direction at a branching portion of a blood vessel or to push the penetrating guidewire 2 through a sharply curved portion of a blood vessel, the surgeon attaches the medical device gripping tool 1 to the penetrating guidewire 2, places the medical device gripping tool 1 in the second state shown in FIG. 6A , and operates the second operating unit. The outer diameter Φ2 of the second operating unit operated at this time is relatively larger than the outer diameter Φ1 of the first operating unit. This allows the surgeon to perform delicate rotational operations, in other words, highly accurate rotational operations, on the penetrating guidewire 2, facilitating delivery operations that require sharp curves or complex blood vessel selection. Pushing the penetrating guidewire 2 through a sharply curved portion of a blood vessel is, in other words, a delicate operation of the penetrating guidewire 2. In the second state, the relative rotation of the operating portion 20 with respect to the handle portion 30 is not restricted, so the surgeon can rotate the penetration guide wire 2 in both the first direction D1 and the second direction D2, and therefore blood vessel selection is not hindered.

[0043] In step a5, the surgeon places the medical device gripper 1 in the first state shown in FIG. 6B and operates the first operating part. The outer diameter Φ1 of the operated first operating part is relatively smaller than the outer diameter Φ2 of the second operating part. This allows the surgeon to apply more rotation to the penetration guidewire 2. In other words, the finger movement required to rotate the penetration guidewire 2 by a certain angle can be made smaller, making it easier to penetrate even a hard CTO 99. In the first state, the relative rotation of the operating part 20 in the second direction D2 with respect to the handle part 30 is limited. Therefore, even if the surgeon receives a reaction force from the CTO 99 when rotating the operating part 20 in the first direction D1, the penetration guidewire 2 is prevented from rotating in the second direction D2, which could cause damage to the body cavity.

[0044] In steps a1 to a3, the surgeon performs the operations without attaching the medical device gripping tool 1 to the work horse wire or the penetrating guide wire 2. In steps a1 to a3, the surgeon may perform the operations by attaching the medical device gripping tool 1 to the work horse wire or the penetrating guide wire 2. In steps a3 to a5, the surgeon may also use another device to suppress kinking of the penetrating guide wire 2. Examples of other devices to suppress kinking of the penetrating guide wire 2 include a short catheter and a protective shaft. In the medical device gripping tool 1 of the above embodiment, the protruding portion 14 is provided on the inside of the gripping portion 10 provided at the tip, so that when a protective shaft is inserted through the tip opening 10a, the proximal end of the protective shaft can be supported by the protruding portion 14.

[0045] 6A and 6B , in the second state, the second operating unit is positioned adjacent to the handle portion 30, while in the first state, the first operating unit is positioned adjacent to the handle portion 30. Therefore, the surgeon does not need to move the position of the hand holding the medical device gripping tool 1 when operating the medical device gripping tool 1 in the second state for precise delivery of the penetration guidewire 2 and when operating the medical device gripping tool 1 in the first state for penetration of the CTO 99. This improves the operability of the medical device gripping tool 1 and the efficiency of the procedure. Because the shape of the medical device gripping tool 1 changes at a glance between the first and second states, the surgeon can easily distinguish between the states and prevent misuse.

[0046] As described above, with the medical device gripping tool 1 of the first embodiment, the surgeon can easily rotate the medical device by gripping the handle portion 30 with his or her hand and rotating the outer periphery of the operation portion 20 with his or her fingers. Therefore, for example, when penetrating a CTO 99 using the penetrating guidewire 2 as a medical device, even if the penetrating guidewire 2 receives a reaction force from the CTO 99, the reaction force can be easily resisted. As a result, the operability and safety of the medical device gripping tool 1 can be improved.

[0047] The medical device gripping tool 1 of the first embodiment is configured to be switchable between a first state in which a specific portion of the operating unit 20 protrudes from the housing portion 310, 320 of the handle portion 30 and a second state in which the specific portion is housed in the housing portion 310, 320 of the handle portion 30. Therefore, by changing the structure of the outer peripheries 21c, 22c of the specific portion of the operating unit 20 and the remaining portion, the surgeon can change the structure of the outer peripheries 21c, 22c of the operating unit 20 to a structure suitable for the surgeon's operation, such as switching to the second state when delivering the penetrating guidewire 2 as a medical device and the first state when penetrating the CTO 99. In the above embodiment, the structure of the outer peripheries 21c, 22c may be, for example, the outer diameter or the presence or absence of a non-slip coating. As a result, the operability and safety of the medical device gripping tool 1 can be further improved. The surgeon can easily switch between the first state and the second state by sliding the operating unit 20.

[0048] Furthermore, according to the medical device gripping tool 1 of the first embodiment, the handle portion 30 further includes a ratchet mechanism 40 that, when in the ON state, allows relative rotation of the operation unit 20 with respect to the handle portion 30 in a first direction D1 and restricts relative rotation in a second direction D2 opposite to the first direction D1 ( FIGS. 4A and 4B ). Therefore, by turning the ratchet mechanism 40 ON, when the surgeon rotates the penetration guidewire 2 in the first direction D1 to penetrate the CTO, the penetration guidewire 2 is prevented from rotating in the second direction D2 due to a reaction force from the CTO 99. As a result, the operability and safety of the medical device gripping tool 1 can be further improved, and the efficiency of CTO penetration using the penetration guidewire 2 can be improved.

[0049] Furthermore, according to the medical device grasping tool 1 of the first embodiment, the ratchet mechanism 40 is in the ON state when the medical device grasping tool 1 is in the first state for CTO penetration, and therefore, when the surgeon rotates the penetration guidewire 2 in the first direction D1 to penetrate the CTO, the counter-rotation of the penetration guidewire 2 in the second direction D2 due to the reaction force from the CTO 99 can be prevented. When the medical device grasping tool 1 is in the second state for delivering the penetration guidewire 2, the ratchet mechanism 40 is in the OFF state, and therefore, rotation of the penetration guidewire 2 in the first and second directions D1 and D2 to advance the penetration guidewire 2 to the target branch at the bifurcation of the blood vessel can be unimpeded. As a result, the operability and safety of the medical device grasping tool 1 can be further improved, and further, the efficiency of CTO penetration using the penetration guidewire 2 can be improved.

[0050] Furthermore, according to the first embodiment of the medical device gripping tool 1, the ratchet mechanism 40 is realized by a first ratchet 41 and a second ratchet 42, each having teeth 413, 423 arranged on a plane perpendicular to the rotation axis O relative to the handle portion 30 of the operating portion 20, so that in the ON state the teeth 413, 423 of the first and second ratchets 41, 42 are reliably engaged with each other, and in the OFF state the teeth 413, 423 of the first and second ratchets 41, 42 can be reliably released.

[0051] Furthermore, according to the medical device holder 1 of the first embodiment, the outer diameter Φ1 of the first operating portion corresponding to a specific portion of the operating unit 20 is smaller than the outer diameter Φ2 of the second operating portion. The outer diameter Φ1 of the first operating portion can also be considered the outer diameter of the outer periphery 21c of the first shaft 21. The outer diameter Φ2 of the second operating portion can also be considered the outer diameter of the outer periphery 22c of the second shaft 22. Therefore, when the medical device holder 1 is in the first state for CTO penetration, the surgeon can apply more rotation to the penetration guidewire 2 by operating the first operating portion, which has a relatively small outer diameter. In other words, with the first operating portion, the finger movement required to rotate the penetration guidewire 2 by a certain angle can be made smaller than when using the second operating portion. When the medical device holder 1 is in the second state for delivering the penetration guidewire 2, the surgeon can apply more precise manipulation to the penetration guidewire 2 by operating the second operating portion, which has a relatively large outer diameter. As a result, the operability and safety of the medical device holder 1 can be further improved, and furthermore, the efficiency of CTO penetration using the penetration guide wire 2 can be further improved.

[0052] <Second embodiment> Figure 7 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool 1A of the second embodiment when the ratchet mechanism 40A is in the ON state. Figure 8 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool 1A of the second embodiment when the ratchet mechanism 40A is in the OFF state. The medical device gripping tool 1A of the second embodiment does not have an extension / retraction mechanism. The medical device gripping tool 1A has the same configuration as the first embodiment, except that it has an operation unit 20A instead of the operation unit 20, a handle unit 30A instead of the handle unit 30, a ratchet mechanism 40A instead of the ratchet mechanism 40, and a fixing unit 50A instead of the switching unit 50.

[0053] The operation unit 20A has a first shaft 21A instead of the first shaft 21. The first shaft 21A differs from the first embodiment only in that it does not have a distal groove 211. The handle unit 30A has a distal housing 31A instead of the distal housing 31, and a proximal housing 32A instead of the proximal housing 32. The distal housing 31A differs from the first embodiment only in that it does not have a recess 312. The proximal housing 32A has a cutout in addition to the configuration described in the first embodiment. The cutout is a linear cutout provided on the side surface of the proximal housing 32A in the +Y axis direction, and is a cutout that communicates between the proximal accommodating unit 320 and the outside.

[0054] The ratchet mechanism 40A has a second ratchet 42A instead of the second ratchet 42. The second ratchet 42A is not fixed to the first shaft 21A and is slidable on the outer circumferential surface of the first shaft 21A along the longitudinal direction of the first shaft 21A. A handle 421 is also attached to the second ratchet 42A. The handle 421 protrudes outward from a notch in the base housing 32A. The surgeon can switch the ratchet mechanism 40A between an ON state ( FIG. 7 ) and an OFF state ( FIG. 8 ) by grasping the handle 421 and moving it along the notch in the base housing 32A.

[0055] The fixing portion 50A fixes the first shaft 21A by engaging the engaging portion 52 with the proximal groove 212 of the first shaft 21A. The fixing portion 50A and the proximal groove 212 may be omitted, and the first shaft 21A and the handle portion 30A may be fixed together with an adhesive or the like.

[0056] As described above, the configuration of the medical device gripping tool 1A can be modified in various ways, and it may be configured without an extension / retraction mechanism, in other words, without switching between the first state and the second state. The medical device gripping tool 1A of this second embodiment can also achieve the same effects as the first embodiment. According to the medical device gripping tool 1A of the second embodiment, the configuration of the medical device gripping tool 1A can be simplified, and the surgeon can operate either the first or second operation unit, whichever is more suitable for the surgeon's operation. This improves the operability and safety of the medical device gripping tool and also improves the efficiency of CTO penetration using the penetration guidewire 2.

[0057] 9 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool 1B of the third embodiment. Like the second embodiment, the medical device gripping tool 1B of the third embodiment does not have an extension / retraction mechanism, and the structures of the first and second operating parts are different from those of the second embodiment. The medical device gripping tool 1B of the third embodiment has an operating part 20B instead of the operating part 20A in the configuration described in the second embodiment.

[0058] The operating unit 20B includes the first shaft 21A described in the second embodiment. The operating unit 20B further includes a second shaft 22B instead of the second shaft 22 and a non-slip surface 25. The second shaft 22B is longer than the second shaft 22 described in the first embodiment and covers the entire first shaft 21A exposed from the tip of the handle portion 30A. The non-slip surface 25 is provided on a portion of the outer circumferential surface of the second shaft 22B near the base end. In the illustrated example, the non-slip surface 25 is provided on approximately half of the outer circumferential surface of the second shaft 22B near the base end. The non-slip surface 25 may be a coating made of a resin with a high friction coefficient, or an uneven surface formed on the outer circumferential surface. In the third embodiment, the outer circumferential surface 22c of the second shaft 22B that is not covered by the non-slip surface 25 corresponds to the "second operating unit," and the outer circumferential surface 25c of the non-slip surface 25 corresponds to the "first operating unit." Since the anti-slip member 25 is sufficiently thin, in this embodiment, the first operating portion and the second operating portion can be considered to have the same outer diameter. For convenience of explanation, the anti-slip member 25 is depicted in Figure 9 as being thicker than it actually is.

[0059] In this way, the configuration of the medical device gripping tool 1B can be modified in various ways, and the medical device gripping tool 1B of the third embodiment may not have an extension mechanism and the first and second operating parts may have the same outer diameter. The medical device gripping tool 1B of the third embodiment can also achieve the same effects as the first and second embodiments.

[0060] <Fourth embodiment> Figure 10 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool 1C of the fourth embodiment. The medical device gripping tool 1C of the fourth embodiment does not have the ratchet mechanism 40 in the configuration described in the first embodiment. The medical device gripping tool 1C can be used by switching between a first state shown in Figure 10 and a second state as shown in Figure 2. Because the medical device gripping tool 1C does not have the ratchet mechanism 40, the rotation direction of the operating portion 20 is not limited even in the first state.

[0061] As described above, the configuration of the medical device gripping tool 1C can be modified in various ways, and it may be configured without the ratchet mechanism 40. The medical device gripping tool 1C of this fourth embodiment can also achieve the same effects as the first embodiment. According to the medical device gripping tool 1C of the fourth embodiment, the configuration of the medical device gripping tool 1C can be simplified, and rotation can be applied in both the first direction D1 and the second direction D2 when penetrating the CTO, thereby improving the degree of freedom of the procedure.

[0062] 11 is an explanatory diagram illustrating the cross-sectional configuration of a medical device gripping tool 1D of the fifth embodiment. The medical device gripping tool 1D of the fifth embodiment does not have both an extension / retraction mechanism and a ratchet mechanism 40. In the configuration described in the first embodiment, the medical device gripping tool 1D does not have the ratchet mechanism 40, and has an operating part 20D instead of the operating part 20, a handle part 30D instead of the handle part 30, and a fixing part 50D instead of the switching part 50.

[0063] The operating unit 20D has a first shaft 21D instead of the first shaft 21. The first shaft 21D differs from the first embodiment only in that it does not have a distal groove 211. The handle unit 30D has a distal housing 31D instead of the distal housing 31. The distal housing 31D differs from the first embodiment only in that it does not have a recess 312. The fixing unit 50D fixes the first shaft 21D by engaging an engaging portion 52 with a proximal groove 212 of the first shaft 21D. The fixing unit 50D and the proximal groove 212 may be omitted, and the first shaft 21D and the handle unit 30D may be fixed with an adhesive or the like.

[0064] As described above, the configuration of the medical device grasping tool 1D can be modified in various ways, and it may be configured without both the telescopic mechanism and the ratchet mechanism 40. The medical device grasping tool 1D of this fifth embodiment can also achieve the same effects as the first embodiment. According to the medical device grasping tool 1D of the fifth embodiment, the configuration of the medical device grasping tool 1D can be simplified, and rotation can be applied in both the first direction D1 and the second direction D2 when penetrating the CTO, thereby improving the degree of freedom of the procedure.

[0065] <Modifications of this embodiment> The present disclosure is not limited to the above-described embodiment, and can be implemented in various forms without departing from the gist thereof. For example, the following modifications are also possible.

[0066] [Modification 1] In the above first to fifth embodiments, one example of the configuration of the medical device holders 1, 1A to 1D is shown. The configuration of the medical device holders 1, 1A to 1D can be modified in various ways.

[0067] For example, the medical device gripping tool 1 may omit some of the above-described components, or may include additional components not described above. For example, the outer shapes of the gripping portion 10 and the handle portion 30 may be modified to be more suitable for operation by the surgeon. For example, the outer peripheral surface of the handle portion 30 may be provided with a non-slip surface to facilitate gripping by the surgeon. The non-slip surface can be achieved by a coating, unevenness, or the like. For example, the distal housing 31 and the proximal housing 32 may be integrally formed.

[0068] For example, the medical device gripping tool 1 may be configured to be switchable between the first state and the second state without operating the switching unit 50. In this case, the switching unit 50 and the distal groove 211 and the proximal groove 212 of the first shaft 21 may be omitted. In this case, the surgeon can quickly switch the medical device gripping tool 1 to the first state by pulling either the gripping unit 10 or the operating unit 20 in the longitudinal direction, and can quickly switch the medical device gripping tool 1 to the second state by pushing either the gripping unit 10 or the operating unit 20 in the longitudinal direction.

[0069] For example, the configuration of the ratchet mechanism 40 is merely an example, and various modifications are possible. For example, the teeth 413, 423 of the first and second ratchets 41, 42 do not have to be arranged on a plane perpendicular to the rotation axis O of the handle portion 30 of the operation unit 20. In this case, the first and second ratchets 41, 42 may be realized by sawtooth teeth arranged in the circumferential direction and pawls that catch on the teeth, as in a typical ratchet mechanism. For example, the shaft 411 and the spring 414 may be omitted, and the shaft 411 may be used to restrict rotation of the first ratchet 41, and the spring 414 may be used to press the first ratchet 41, by other means.

[0070] For example, the configuration of the switching unit 50 is one example, and various modifications are possible. In the above embodiment, the engaging portion 52 (protrusion) of the switching unit 50 is engaged with the grooves 211, 212 formed in the first shaft 21. This protrusion-relationship may be reversed. Specifically, a configuration may be adopted in which a protrusion is formed on the first shaft 21 and engaged with the groove of the switching unit 50 to fix the first shaft 21.

[0071] [Modification 2] The configurations of the medical device holders 1, 1A to 1D of the first to fifth embodiments and the configuration of the medical device holders 1, 1A to 1D of modification 1 may be combined as appropriate.

[0072] This aspect has been described above based on embodiments and modifications. The above-described embodiments of the aspect are intended to facilitate understanding of this aspect and are not intended to limit this aspect. This aspect may be modified or improved without departing from the spirit and scope of the claims, and equivalents thereof are included in this aspect. If a technical feature is not described as essential in this specification, it may be deleted as appropriate.

Claims

1. A medical device gripping device, A gripping part for grasping medical devices, A cylindrical operating section connected to the base end of the gripping section, having a lumen into which the medical device gripped by the gripping section is inserted, having an outer circumference for the operator to perform a rotational operation, and transmitting the rotational force received by the operator from the outer circumference to the medical device via the gripping section, A handle portion provided on the base end side of the operating portion and supporting the operating portion in a state where it can rotate relative to it, the handle portion having a housing portion that accommodates a part of the base end side of the operating portion, A medical device gripping device equipped with the following features.

2. A medical device gripping device according to claim 1, The length of the operating section housed in the aforementioned housing is adjustable. The aforementioned medical device gripping device is A specific part of the operating section is in a first state in which it protrudes from the housing of the handle section, A medical device gripping device in which the aforementioned specific part is switchable between a second state in which it is housed in the housing portion of the handle portion and a second state.

3. A medical device gripping device according to claim 1, The handle portion further has a ratchet mechanism, In the ON state, the ratchet mechanism allows relative rotation of the operating part with respect to the handle part in a first direction, and restricts relative rotation in a second direction opposite to the first direction. A medical device gripping device wherein the ratchet mechanism in the OFF state allows both relative rotation in the first direction and relative rotation in the second direction.

4. A medical device gripping device according to claim 2, The handle portion further has a ratchet mechanism, When the medical device gripping device is in the first state, the ratchet mechanism is turned ON, and the ratchet mechanism allows relative rotation of the operating part with respect to the handle part in the first direction, and restricts relative rotation in the second direction opposite to the first direction. A medical device gripping device wherein, when the medical device gripping device is in the second state, the ratchet mechanism is in the OFF state, and the ratchet mechanism allows both relative rotation in the first direction and relative rotation in the second direction.

5. A medical device gripping device according to claim 3, The ratchet mechanism is, The operating unit comprises a first ratchet having teeth arranged on a plane perpendicular to the axis of rotation relative to the handle portion, and a second ratchet having teeth arranged on a plane perpendicular to the axis of rotation relative to the handle portion of the operating unit. When the ON state is activated, the teeth of the second ratchet engage with the teeth of the first ratchet, thereby restricting the relative rotation of the operating part with respect to the handle in the second direction. A medical device gripping device in which, when in the OFF state, the teeth of the first ratchet and the teeth of the second ratchet separate, thereby not restricting the relative rotation of the operating part with respect to the handle part.

6. A medical device gripping device according to any one of claims 1 to 5, The operating unit has a first operating unit corresponding to the specific portion and a second operating unit corresponding to the remaining portion. A medical device gripping device wherein the outer diameter of the first operating part is smaller than the outer diameter of the second operating part.

7. A medical device gripping device according to any one of claims 1 to 5, The operating unit has a first operating unit corresponding to the specific portion and a second operating unit corresponding to the remaining portion. The second operating section is located closer to the tip than the first operating section, and is a medical device gripping device.

8. A medical device gripping device according to any one of claims 1 to 5, The operating unit has a first operating unit corresponding to the specific portion and a second operating unit corresponding to the remaining portion. The second operating section is provided between the gripping section and the first operating section, adjacent to the gripping section and the first operating section, respectively, in a medical device gripping device.

9. A medical device gripping device according to claim 2, further, A medical device gripping device comprising a switching unit that maintains the current state of the first state and the second state through a recessed engagement structure with the operating unit, and which enables switching between the first state and the second state when the switching unit is operated, thereby releasing the recessed engagement structure.

10. A medical device gripping device according to claim 9, The operating section has a shaft, The outer circumferential surface of the shaft is provided with a tip groove, which is a recess, and a base groove, which is a recess located away from the tip groove towards the base end. The switching portion comprises a knob protruding from the outer circumferential surface of the handle portion and an engaging portion for engaging with either the tip groove portion or the base groove portion, wherein the switching portion is a medical device gripping device.

11. A medical device gripping device according to claim 8, The tip of the second operating part is housed inside the gripping part. A medical device gripping device wherein the second operating part and the gripping part move longitudinally in accordance with the movement of the first operating part when one of them is moved longitudinally.

12. A medical device gripping device according to claim 8, A medical device gripping device wherein the outer diameter of the second operating portion is smaller than the outer diameter of the gripping portion and larger than the outer diameter of the first operating portion.

13. A medical device gripping device according to claim 10, The handle portion is a cylindrical tip housing whose outer diameter gradually decreases from the base end to the tip end, and has a tip housing in which a recess is formed in a part of the outer surface. The knob protrudes from a through hole provided in the center of the recess on the outer circumferential surface of the handle portion, and is a medical device gripping device.

14. A medical device gripping device according to any one of claims 1 to 5, The aforementioned medical device is a guide wire, a medical device gripping device.