Medical device and deflection operation device for medical equipment

Abstract

In order to make it possible to ensure a large lumen of an elongated member and realize a stable deflection operation of a movable part with a simple configuration, this medical device 1 comprises: an outer tube 20 made of a flexible elongated tubular member; and an inner tube 30 made of a flexible elongated tubular member inserted into the outer tube 20 so as to be slidable in the axial direction with respect to the outer tube 20 and rotatable. The distal end of the outer tube 20 is provided with a sliding restricting part 26 (tip member 25) contacting a distal end 30a of the inserted inner tube 30 to restrict the sliding of the inner tube 30 with respect to the distal side. A recessed groove part 40 recessed in the circumferential direction is formed in one side surface side of the inner tube 30 positioned on a movable part 11, and a connection part 50 smoothly connected in the axial direction is provided on the other side surface side of the inner tube 30 facing the one side surface side of the inner tube 30.

Description

Deflection control device for medical devices and medical equipment

[0001] The present invention relates to a medical device that includes an elongated member inserted into the body and that can deflect a movable part provided at the distal end of the elongated member, and more particularly to a medical device such as an endoscope or catheter that includes an elongated member inserted into the body. The present invention also relates to a deflection device for medical equipment that deflects the movable part of the medical device.

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

[0003] Conventionally, a technique has been known in which a movable section provided at the distal end of an elongated member is deflected by attaching a control wire to the movable section and performing the deflection using a control section provided on the proximal side of the elongated member. For example, Patent Document 1 listed below describes a technique in which the distal end of a steerable catheter is configured with a nodal ring structure, multiple control wires are connected to the most distal nodal ring, and the nodal ring structure is deflected in a desired direction by pulling each of the multiple control wires using the control section.

[0004] Japanese Patent Application Laid-Open No. 2020-137897

[0005] However, when a control wire is provided to deflect the movable portion, the control wire must be extended along the elongated member. For example, a wire lumen must be formed in the elongated member and the movable portion at its distal end to allow the control wire to pass through. The wire lumen is formed, for example, in the wall of the elongated member so as to surround the main lumen. Therefore, increasing the inner diameter of the elongated member necessitates increasing the outer diameter, while maintaining the outer diameter of the elongated member necessitates decreasing the inner diameter. This creates a problem: it is difficult to reduce the diameter of the elongated member or increase the inner diameter of the elongated member to accommodate the insertion of the control wire. Furthermore, providing a control wire increases the number of components and complicates the structure. Furthermore, if the thin control wire breaks, deflection becomes impossible.

[0006] The present invention has been made in consideration of the above problems, and aims to provide a medical device and a deflection operating device for medical equipment that can ensure a large lumen for the elongated member and can achieve stable deflection operation of the movable part with a simple configuration.

[0007] In order to achieve the above-mentioned object, the medical device of the present invention is a medical device whose distal end, provided with a movable part, is inserted into the body, and comprises: an outer tube made of a long, flexible tubular member; and an inner tube made of a long, flexible tubular member that is inserted into the outer tube so as to be axially slidable and rotatable relative to the outer tube; the distal end of the outer tube is provided with a slide regulating part that abuts against the distal end of the inserted inner tube and regulates the sliding of the inner tube toward the distal side; one side of the inner tube located at the movable part is formed with one or more circumferentially recessed grooves; and the other side of the inner tube opposite to the one side of the inner tube is provided with a connecting part that is smoothly connected in the axial direction.

[0008] According to the above configuration, the groove portion is formed biased toward one side of the inner tube, and a connection portion that is smoothly connected in the axial direction is provided on the other side.Therefore, when the inner tube is slid distally relative to the outer tube, the sliding control portion generates axial compressive stress in the inner tube, and the stress is concentrated in the groove portion formed on one side, and as a result, the movable portion in which the groove portion is provided can be deflected toward one side.

[0009] The above configuration is a simple configuration that does not require an operating wire, and allows the inner tube to be slid distally relative to the outer tube to stably deflect the distal end of the medical device, while also ensuring a large lumen for the inner tube, which is made of a long tubular member, allowing the medical device to be made thinner.

[0010] Furthermore, according to the above configuration, the inner tube is configured to be rotatable relative to the outer tube, so that the deflection direction can be appropriately controlled by rotating the inner tube relative to the outer tube and setting one side of the inner tube to face the desired direction.

[0011] In the medical device according to the present invention, the inner tube may have, on one side thereof, the plurality of circumferentially recessed grooves arranged along the axial direction.

[0012] According to the above configuration, the multiple groove portions are arranged biased toward one side of the inner tube, and a connection portion that is smoothly connected in the axial direction is provided on the other side.Therefore, when the inner tube is slid distally relative to the outer tube, the sliding control portion generates axial compressive stress in the inner tube, concentrating the stress on the multiple groove portions arranged on one side, and as a result, the movable portion provided with the multiple groove portions can be deflected more flexibly toward one side.

[0013] In the medical device according to the present invention, in the above configuration, the plurality of recessed groove portions may include partial recessed groove portions in which only a portion of the inner tube in the circumferential direction is recessed.

[0014] According to the above configuration, stress is concentrated in the partial groove portion, and the distal end portion of the medical device can be flexibly deflected toward the side where the partial groove portion is disposed.

[0015] In the medical device according to the present invention, in the above configuration, all of the plurality of groove portions may be partial groove portions.

[0016] According to the above configuration, the entire movable portion having the plurality of recessed grooves formed therein can be deflected uniformly.

[0017] In the medical device of the present invention, in the above-mentioned configuration, the multiple groove portions may include partial groove portions that are recessed in only a portion of the circumference of the inner tube, and full-circumferential groove portions that are recessed around the entire circumference of the inner tube.

[0018] According to the above configuration, the circumferential groove portion, which is easily deformed by stress, reacts quickly, allowing the movable portion to be smoothly deflected.

[0019] In the medical device according to the present invention, in the above configuration, the circumferential groove portions may be periodically arranged with a predetermined number of the partial groove portions sandwiched therebetween.

[0020] According to the above configuration, the partial groove portion and the full-circumferential groove portion can be arranged in a well-balanced manner, thereby improving the deflection properties of the entire movable portion.

[0021] In the medical device according to the present invention, in the above configuration, the plurality of recessed grooves may be arranged at approximately equal intervals along the axial direction.

[0022] According to the above configuration, the entire movable portion can be deflected so as to have approximately the same curvature.

[0023] In the medical device according to the present invention, in the above configuration, an axial groove portion extending in the axial direction so as to connect the plurality of groove portions may be formed on the outer peripheral surface of the inner tube.

[0024] According to the above configuration, the flexibility of the movable part is improved by the axial groove portion, and the responsiveness to the deflection of each of the plurality of groove portions can be improved.

[0025] In the medical device of the present invention, in the above configuration, the groove portions may each be formed by a through slit penetrating the wall of the inner tube, a tubular cylindrical member may be inserted and fixed at a position corresponding to the movable portion of the inner tube, and the inner opening of the through slit may be blocked by the outer surface of the tubular member.

[0026] According to the above configuration, a recessed groove portion can be formed in the inner tube through the simple process of forming a through slit, and the tubular member can prevent the lumen of the inner tube from communicating with the outside.

[0027] In the medical device according to the present invention, in the above configuration, the recessed groove portion may be formed by a bottomed groove in which the tube wall of the inner tube is thinned.

[0028] According to the above configuration, by forming a thin-walled, bottomed groove, it is possible to form a recessed groove portion in the inner tube without penetrating the tube wall of the inner tube.

[0029] In addition, in order to achieve the above-mentioned object, the deflection operating device for medical equipment according to the present invention is a deflection operating device for medical equipment that deflects and operates the movable part of the above-mentioned medical device, and is characterized in that it comprises a controller housing to which the proximal end of the outer tube is connected and fixed, and an operating member to which the proximal end of the inner tube is connected and fixed, and the operating member is configured to be axially slidable and rotatable relative to the controller housing.

[0030] According to the above configuration, by sliding the operating member distally relative to the controller housing, the inner tube can be slid distally relative to the outer tube, thereby deflecting the movable part toward one side. Furthermore, by rotating the operating member relative to the controller housing, the one side of the inner tube can be operated to face a desired direction, thereby appropriately controlling the deflection direction of the movable part.

[0031] FIG. 1 is a side view showing the overall configuration of a medical device according to an embodiment of the present invention. FIG. 2 is a perspective view of an outer tube and a tip member constituting the elongated member of a medical device according to an embodiment of the present invention. FIG. 3 is a cross-sectional view of an outer tube and a tip member constituting the elongated member of a medical device according to an embodiment of the present invention. FIG. 4 is a perspective view of an inner tube and a tubular member constituting the elongated member of a medical device according to an embodiment of the present invention, as seen from the connection portion side. FIG. 5 is a perspective view of an inner tube and a tubular member constituting the elongated member of a medical device according to an embodiment of the present invention, as seen from the partial groove portion side. FIG. 6 is a side view of an inner tube and a tubular member constituting the elongated member of a medical device according to an embodiment of the present invention, as seen from the partial groove portion side. FIG. 7 is a side view of an inner tube and a tubular member constituting the elongated member of a medical device according to an embodiment of the present invention, as seen from the connection portion side. FIG. 8 is a side view of an inner tube and a tubular member constituting the elongated member of a medical device according to an embodiment of the present invention, as seen from the connection portion side. FIG. 9 is a side view of an inner tube and a tubular member constituting the elongated member of a medical device according to an embodiment of the present invention, as seen with the partial groove portion on the upper side and the connection portion on the lower side. FIG. 10 is a cross-sectional view of an inner tube and a tubular member constituting the elongated member of a medical device according to an embodiment of the present invention, as seen with the partial groove portion on the upper side and the connection portion on the lower side. 7B is a side view showing the vicinity of a movable portion of an elongated member of a medical device according to an embodiment of the present invention, as viewed from the partial groove portion side of an inner tube. FIG. 7C is a side view showing the vicinity of a movable portion of an elongated member of a medical device according to an embodiment of the present invention, as viewed from the connection portion side. FIG. 7D is a cross-sectional view taken along the line A-A of FIG. 7B. FIG. 7C is a diagram for explaining the deflection operation of a movable portion according to an embodiment of the present invention, as viewed from the connection portion side. FIG. 7D is a diagram for explaining the rotation operation of a movable portion according to an embodiment of the present invention, as viewed from the vicinity of the movable portion when the partial groove portion is on the bottom and the connection portion is on the top. FIG. 7E is a perspective view of a deflection operation device for a medical device according to an embodiment of the present invention. FIG. 7F is a plan view of a deflection operation device for a medical device according to an embodiment of the present invention.1 is a side view of a deflection operation device for a medical device according to an embodiment of the present invention; FIG. 2 is an exploded perspective view of a deflection operation device for a medical device according to an embodiment of the present invention; FIG. 3 is a perspective view showing a state in which a cover body of a deflection operation device for a medical device according to an embodiment of the present invention has been removed; FIG. 4 is a perspective sectional view showing a cross section of a controller housing of a deflection operation device for a medical device according to an embodiment of the present invention; FIG. 5 is a plan view showing a deflection operation device for a medical device according to an embodiment of the present invention when a movable part is straightened, the plan view showing a state in which a cover body of the deflection operation device for a medical device has been removed; FIG. 6 is a side sectional view of a deflection operation device for a medical device according to an embodiment of the present invention when a movable part is deflected, the plan view showing a state in which a cover body of the deflection operation device for a medical device has been removed; FIG. 7 is a side sectional view of a deflection operation device for a medical device according to an embodiment of the present invention when a movable part is deflected; 1 is a side view showing an inner tube constituting an elongated member of a medical device in a first modified example of the present invention, with the through slit on the upper side and the connection part on the lower side; FIG. 2 is a view for explaining the deflection operation of the movable part in the first modified example of the present invention, with the through slit on the upper side and the connection part on the lower side; FIG. 3 is a side view showing the inner tube constituting an elongated member of a medical device in a second modified example of the present invention, with the through slit on the upper side and the connection part on the lower side; FIG. 4 is a side view showing an inner tube constituting an elongated member of a medical device in a second modified example of the present invention, with the through slit on the upper side and the connection part on the lower side; FIG. 5 is a side view showing an inner tube constituting an elongated member of a medical device in a third modified example of the present invention, with the through slit on the upper side and the connection part on the lower side;10 is a side view showing an inner tube constituting an elongated member of a medical device according to a third modified example of the present invention, as viewed from the connecting portion side. FIG. 11 is a side view showing an inner tube constituting an elongated member of a medical device according to a third modified example of the present invention, as viewed from the connecting portion side. FIG. 12 is a side view showing an inner tube constituting an elongated member of a medical device according to a fourth modified example of the present invention, as viewed from the through slit side constituting the partial groove portion. FIG. 13 is a side view showing an inner tube constituting an elongated member of a medical device according to a fourth modified example of the present invention, as viewed from the connecting portion side. FIG. 14 is a side view showing an inner tube constituting an elongated member of a medical device according to a fourth modified example of the present invention, as viewed from the connecting portion side. FIG. 15 is a side view showing an inner tube constituting an elongated member of a medical device according to a fourth modified example of the present invention, as viewed from the connecting portion side. FIG. 16 is a side view showing an inner tube constituting an elongated member of a medical device according to a fourth modified example of the present invention, as viewed from the connecting portion side. 10 is a perspective view showing a modified example of a deflection operating device for a medical device according to a sixth modified example of the present invention, illustrating an inner tube constituting an elongated member of a medical device according to a fifth modified example of the present invention, the inner tube being disposed with a bottomed groove on the upper side and a connecting portion on the lower side.

[0032] Hereinafter, embodiments of the present invention will be described with reference to the drawings. In this specification, the user (practitioner) of a medical device according to the present invention is used as a reference, and the inside of the patient's body is defined as the distal side, and the side of the user's hand is defined as the proximal side. The drawings referred to in this specification are not necessarily to scale with respect to actual dimensions, and some parts are exaggerated or simplified to schematically illustrate the configuration according to the present invention.

[0033] First, an overview of a medical device 1 according to an embodiment of the present invention will be described. Fig. 1 is a side view showing the overall configuration of a medical device 1 according to this embodiment.

[0034] The medical device 1 shown in Fig. 1 includes a deflection control device 100 for medical equipment (hereinafter referred to as the deflection control device 100) and an elongated member 10 whose distal end is deflected by the deflection control device 100. The medical device 1 is configured so that a user can deflectably control a movable part 11 (also referred to as an operated part or a deflecting part) located at the distal end of the elongated member 10 constituting the medical equipment by operating an operating handle part 810 of the deflection control device 100. Medical equipment including the elongated member 10 includes, but is not limited to, an endoscope, a catheter, a cannula, and the like.

[0035] The elongated member 10 is a flexible, long tubular member. The axial length of the elongated member 10 is not particularly limited, and can be set to a length that allows it to reach a desired location inside the body. The radial length (outer diameter) of the elongated member 10 is also not particularly limited, and can be set to a length that allows it to be inserted into a tubular organ or an endoscopic forceps port inside the body.

[0036] The elongated member 10 is composed of an outer tube 20 made of a tubular member that is long in the axial direction, and an inner tube 30 made of a tubular member that is long in the axial direction. The inner tube 30 is inserted into the outer tube 20. The outer tube 20 and the inner tube 30 are not fixed to each other, and while inserted into the outer tube 20, the inner tube 30 is slidable and rotatable relative to the outer tube 20. In FIG. 1, the inner tube 30 inserted into the outer tube 20 is indicated by a dotted line.

[0037] A tip member 25 is attached to the distal end of the outer tube 20 that constitutes the elongated member 10. The tip member 25 is provided with a slide restriction portion 26 that restricts the sliding of the inner tube 30 toward the distal side. When the inner tube 30 is slid toward the distal side in the axial direction relative to the outer tube 20, the distal end 30 a of the inner tube 30 abuts against the slide restriction portion 26 of the tip member 25, so that the distal end 30 a of the inner tube 30 cannot move distally beyond the slide restriction portion 26.

[0038] The elongated member 10 has a movable portion 11 at its distal end (left side in FIG. 1 ) that is inserted into the body, the movable portion 11 being capable of deflecting its direction. The movable portion 11 is configured to include a groove portion 40 and a connection portion 50 provided in the inner tube 30. When the inner tube 30 is slid axially distally relative to the outer tube 20, the movable portion 11 can bend (bend) with the side where the groove portion 40 is located facing inward and the side where the connection portion 50 is located facing outward, thereby allowing the movable portion 11 to be deflected. Furthermore, when the inner tube 30 is rotated relative to the outer tube 20, the groove portion 40 and the connection portion 50 are displaced circumferentially within the outer tube 20, thereby rotating the deflection direction of the movable portion 11.

[0039] The deflection operation device 100 includes a controller housing 200 and an operation member 800 arranged to protrude distally from the controller housing 200. The operation member 800 is configured to be slidable relative to the controller housing 200 in the longitudinal direction (axial direction) of the deflection operation device 100 and to be rotatable relative to the controller housing 200. The controller housing 200 is fixed to an outer tube 20, and the operation member 800 is fixed to an inner tube 30. When the operation member 800 is slid relative to the controller housing 200, the inner tube 30 slides relative to the outer tube 20, and when the operation member 800 is rotated relative to the controller housing 200, the inner tube 30 rotates relative to the outer tube 20.

[0040] Each component of the medical device 1 in this embodiment will be described.

[0041] Fig. 2 is a perspective view of the outer tube 20 and the tip member 25 that constitute the elongated member 10 of the medical device 1 in this embodiment. Fig. 3 is a cross-sectional view of the outer tube 20 and the tip member 25 that constitute the elongated member 10 of the medical device 1 in this embodiment. The proximal side of the outer tube 20 is not shown in Figs. 2 and 3. Fig. 3 also shows an enlarged view of the vicinity of the distal end of the outer tube 20.

[0042] 2, the outer tube 20 is made of a tubular member that is long in the axial direction. A tip member 25 is attached to the distal end of the outer tube 20. The tip member 25 also has an opening 25y on the distal side of the outer tube 20.

[0043] As shown in Fig. 3, the outer tube 20 has a lumen 20t extending along the axial direction, with an outer peripheral surface 20c and an inner peripheral surface 20d formed by a cylindrical wall. The lumen 20t opens at the distal end and the proximal end 20b (see Fig. 14) of the outer tube 20. The inner diameter of the lumen 20t of the outer tube 20 is larger than the outer diameter of the inner tube 30, allowing the inner tube 30 to be inserted into the lumen 20t of the outer tube 20.

[0044] The tip member 25 has approximately the same outer diameter as the outer tube 20, and a through-hole 25h is formed in the tip member 25 in the axial direction, which is in communication with the lumen 20t of the outer tube 20. A sliding restriction portion 26 is provided at the distal end of the tip member 25. The inner peripheral surface of the sliding restriction portion 26 forms an opening 25y that connects the lumen 20t of the outer tube 20 to the outside.

[0045] The opening diameter of opening 25y formed by the inner circumferential surface of sliding restriction portion 26 is set to be smaller than the inner diameter of lumen 20t of outer tube 20 and also smaller than the outer diameter of inner tube 30. In other words, sliding restriction portion 26 has proximal end 26b including a surface that extends radially inward, and forms opening 25y with an opening diameter smaller than the outer diameter of inner tube 30. The opening diameter of opening 25y can be approximately the same as the inner diameter of inner tube 30, for example.

[0046] The method for attaching the tip member 25 to the distal end of the outer tube 20 is not particularly limited. For example, the tip member 25 may be fitted onto or into the distal end of the outer tube 20 and glued or fused thereto, or the tip member 25 and the outer tube 20 may be fused together by insert molding, press working, or the like. In this case, it is preferable that the outer tube 20 and the tip member 25 have approximately the same outer diameter and that the outer peripheral surface 20c of the outer tube 20 and the outer peripheral surface 25c of the tip member 25 are smoothly connected in the axial direction.

[0047] 4A and 4B are perspective views of the inner tube 30 and tubular member 60 that constitute the elongated member 10 of the medical device 1 according to this embodiment. FIG. 4A is a perspective view from the connecting portion 50 side, and FIG. 4B is a perspective view from the partial groove portion 41 side. FIGS. 5A to 5C are side views of the inner tube 30 and tubular member 60 that constitute the elongated member 10 of the medical device 1 according to this embodiment. FIG. 5A is a side view from the partial groove portion 41 side, FIG. 5B is a side view from the connecting portion 50 side, and FIG. 5C is a side view with the partial groove portion 41 on the upper side and the connecting portion 50 on the lower side. FIG. 6 is a cross-sectional view of the inner tube 30 and tubular member 60 that constitute the elongated member 10 of the medical device 1 according to this embodiment, with the partial groove portion 41 on the upper side and the connecting portion 50 on the lower side. 4A, 4B, 5A to 5C, and 6, the proximal side of the inner tube 30 is omitted. In Figures 4A and 4B, the tubular member 60 disposed inside the inner tube 30 is indicated by a dotted line. In addition, Figure 6 also shows an enlarged view of the vicinity of the distal end of the inner tube 30.

[0048] As shown in Figures 4A and 4B, 5A to 5C, and 6, the inner tube 30 is made of a tubular member that is long in the axial direction. As shown in Figure 6, the inner tube 30 has a lumen 30t therein along the axial direction, with an outer peripheral surface 30c and an inner peripheral surface 30d formed by a cylindrical tube wall. The lumen 30t opens at the distal end 30a and the proximal end 30b (see Figure 14) of the inner tube 30. The outer diameter of the inner tube 30 is smaller than the inner diameter of the outer tube 20, allowing the inner tube 30 to be inserted into the lumen 20t of the outer tube 20. The inner diameter of the inner tube 30 is not particularly limited, but is preferably large enough to allow a guidewire or the like to be inserted therethrough.

[0049] A through slit 31 is formed on one side surface of the distal end of the inner tube 30, and a connecting portion 50 is formed on the other side surface. The position where the through slit 31 and the connecting portion 50 are formed functions as a movable portion 11.

[0050] The through slits 31 are slits formed in the circumferential direction and are provided so as to penetrate the tube wall of the inner tube 30 and make cuts in the tube wall. More specifically, as shown in Fig. 6, the through slits 31 penetrate the tube wall of the inner tube 30 and have an outer peripheral opening 31c that opens at the outer peripheral surface 30c and an inner peripheral opening 31d that opens at the inner peripheral surface 30d.

[0051] The through slit 31 is formed partially along the circumferential direction, leaving a portion of the tube wall at the distal end of the inner tube 30. More specifically, the through slit 31 is a slit that is continuous in the circumferential direction except for the connection portion 50, and the through slit 31 terminates at one and the other slit end portions 31 e on either side of the connection portion 50, with no through slit 31 formed at the connection portion 50.

[0052] In this embodiment, a plurality of through slits 31 are formed in the distal end portion of the inner tube 30. Here, as an example, a plurality (10) of through slits 31 are formed, but the number of through slits 31 is not particularly limited, and one or a plurality of through slits 31 may be formed. In addition, the width of the through slits 31 (axial length L1 shown in FIG. 5A ) and the spacing between adjacent through slits 31 (axial length L2 shown in FIG. 5A ) are also not particularly limited, and can be set appropriately based on the axial length of the movable portion 11, the number of through slits 31, etc.

[0053] As an example, the width of the through slits 31 is formed to be uniform along the circumferential direction. Furthermore, the width of each of the plurality of through slits 31 is made approximately the same, and the intervals between adjacent through slits 31 are made equal. This makes it possible to curve the entire movable portion 11 with a uniform and even curvature when the movable portion 11 is deflected.

[0054] The through slit 31 is a slit that is continuous in the circumferential direction except for the connecting portion 50, and has a pair of slit end portions 31e near the connecting portion 50. Here, as an example, the slit end portions 31e are formed to be closed in a substantially U-shape.

[0055] The multiple through slits 31 are formed so that the slit ends 31e are aligned in the axial direction and all open in the same direction. As described above, the through slits 31 are formed in the circumferential direction while leaving a portion of the tube wall at the distal end of the inner tube 30, and the position where this portion of the tube wall remains forms the connection portion 50. In other words, the distal end of the inner tube 30 is circumferentially thinned by the multiple through slits 31, and ring-shaped portions of the tube wall of the inner tube 30 remain between adjacent through slits 31, and the connection portion 50 functions as a spine that connects and supports these ring-shaped tube walls in the axial direction.

[0056] In this way, the distal end of the inner tube 30 has the through slit 31 formed in the tube wall on one side surface and the connection portion 50 formed in the tube wall on the other side surface opposite the through slit 31, resulting in a shape that is asymmetric with respect to the axis of the inner tube 30. The other side surface opposite the through slit 31 refers to a position that is rotated approximately 180° in the circumferential direction from approximately the center of the through slit 31 in the circumferential direction (a position that is approximately the same distance in the circumferential direction from one and the other slit end portions 31e).

[0057] A tubular member 60 is inserted and fixed in a lumen 30t at the distal end of the inner tube 30. The tubular member 60 has a through-hole 60h formed therein along the axial direction, and an outer circumferential surface 60c and an inner circumferential surface 60d are formed by the cylindrical tube wall.

[0058] The tubular member 60 is arranged to cover all of the multiple through slits 31 from the inner circumferential side of the inner tube 30. The outer circumferential surface 60c of the tubular member 60 is arranged to be in close contact with the inner circumferential surface 30d of the inner tube 30, and the inner circumferential openings 31d of the through slits 31 are blocked by the outer circumferential surface 60c of the tubular member 60, as shown in Fig. 6. By arranging the tubular member 60 in this manner, the multiple through slits 31 are blocked by the tubular member 60, and the lumen 30t is open at the distal end 30a and the proximal end 30b (see Fig. 14) of the inner tube 30.

[0059] When the inner peripheral opening 31d of the through slit 31 is closed by the outer peripheral surface 60c of the tubular member 60, a bottomed groove portion 40 is formed along the circumferential direction on the outer peripheral surface 30c of the inner tube 30. The outer peripheral surface 60c of the tubular member 60 forms the bottom surface of the groove portion 40. As described above, the through slit 31 is formed partially along the circumferential direction while the connection portion 50 remains, and the groove portion 40 in this embodiment constitutes a partial groove portion 41 that is formed partially along the circumferential direction while the connection portion 50 remains.

[0060] The method for attaching the tubular member 60 to the distal end of the inner tube 30 is not particularly limited. For example, the tubular member 60 may be inserted into the distal end of the inner tube 30 and glued or fused thereto, or the tubular member 60 and the inner tube 30 may be fused together by insert molding, press working, or the like. In this case, it is preferable that the inner tube 30 and the tubular member 60 have approximately the same inner diameter, and that the inner circumferential surface 30d of the inner tube 30 and the inner circumferential surface 60d of the tubular member 60 are smoothly connected in the axial direction.

[0061] The material of the outer tube 20 is not particularly limited, but it is preferable to select a material that can bend flexibly with the inner tube 30 inserted therein, such as silicone rubber.

[0062] The material of the inner tube 30 is not particularly limited, but it is preferable to select a material that has excellent axial rigidity, which allows a sliding operation performed on the proximal end of the inner tube 30 to be transmitted to the distal end of the inner tube 30, and excellent torque transmission properties, which allows a rotational operation performed on the proximal end of the inner tube 30 to be transmitted to the distal end of the inner tube 30. For example, polyamide or polyether ether ketone (PEEK) can be used. Furthermore, because the inner tube 30 slides and rotates while inserted into the outer tube 20, it is preferable to select a material for the inner tube 30 that has excellent slip properties with respect to the material constituting the outer tube 20. A lubricant or the like that reduces friction may be introduced between the inner tube 30 and the outer tube 20.

[0063] The material of the cylindrical member 60 is not particularly limited, but it is preferable to select a material that flexes flexibly inside the inner tube 30 so as not to impair the flexibility of the movable part 11. It is also preferable to select a material that has excellent adhesiveness and fusion with the material constituting the inner tube 30 so that the cylindrical member 60 is in close contact with the inner circumferential surface 30d of the inner tube 30. Examples of materials that can be used for the cylindrical member 60 include thermosetting elastomers such as silicone rubber and thermoplastic elastomers.

[0064] The configuration of the vicinity of the movable portion 11 of the elongated member 10 will be described. Figures 7A to 7C are side views showing the vicinity of the movable portion 11 of the elongated member 10 of the medical device 1 in this embodiment. Figure 7A is a side view seen from the partial groove portion 41 side of the inner tube 30, Figure 7B is a side view when the partial groove portion 41 is on the upper side and the connection portion 50 is on the lower side, and Figure 7C is a side view seen from the connection portion 50 side. Figure 8 is a cross-sectional view taken along line A-A in Figure 7B. In Figures 7A to 7C, the outer tube 20 is shown in cross section, and the proximal sides of the outer tube 20 and inner tube 30 are not shown.

[0065] As shown in FIGS. 7A to 7C, the elongated member 10 is constructed by inserting an inner tube 30 into an outer tube 20.

[0066] As described above, the inner tube 30 can be inserted into the lumen 20t of the outer tube 20. The inner tube 30 and the outer tube 20 are independent and not fixed to each other, and with the inner tube 30 inserted into the outer tube 20, the inner tube 30 and the outer tube 20 can be displaced relative to each other in the axial direction and can rotate relative to each other in the circumferential direction.

[0067] The inner tube 30 is positioned at a position where it has been pushed to the most distal side of the outer tube 20. More specifically, a tip member 25 is attached to the distal end of the outer tube 20, and the inner tube 30 is positioned so that its distal end 30a abuts against the proximal end 26b of the sliding restriction portion 26 of the tip member 25, as shown in Figures 7A to 7C.

[0068] A plurality of grooves 40 are arranged in the axial direction on the outer peripheral surface 30c of the inner tube 30. In this embodiment, all of the plurality of grooves 40 are partial grooves 41 that are formed partially along the circumferential direction with the connection portions 50 remaining. As a result, as shown in Figures 7A to 7C, a plurality of partial grooves 41 are arranged in the axial direction on one side surface of the inner tube 30, and the connection portions 50 extend in the axial direction on the other side surface of the inner tube 30.

[0069] 8, the partial groove portion 41 is formed by blocking the inner peripheral opening 31d of the through slit 31 with the outer peripheral surface 60c of the tubular member 60. The pair of slit end portions 31e constitute both ends of the partial groove portion 41, and the tube wall of the inner tube 30 remaining between both ends of the partial groove portion 41 constitutes the connection portion 50.

[0070] The range of the connection portion 50 (angle θ in the circumferential direction about the axis C shown in FIG. 8 ) is not particularly limited, but it is preferable that the angle θ be less than 180°. In the example shown in FIG. 8 , the angle θ is set to approximately 90°. The movable portion 11 curves such that one side of the inner tube 30 where the partial groove portion 41 is provided (the position facing the connection portion 50) is the inside, and the other side of the inner tube 30 where the connection portion 50 is provided is the outside. The smaller the range of the connection portion 50 (angle θ) and the larger the range of the partial groove portion 41 (angle 360° - θ in the circumferential direction about the axis C), the more flexibly the movable portion 11 can bend.

[0071] The deflection operation of the movable part 11 will be described with reference to Fig. 9. Fig. 9 is a diagram for explaining the deflection operation of the movable part 11 in this embodiment, and is a side view of the vicinity of the movable part 11 when the partial groove part 41 is on the upper side and the connection part 50 is on the lower side. In Fig. 9, the outer tube 20 is shown in cross section, and the proximal sides of the outer tube 20 and the inner tube 30 are not shown.

[0072] 7A to 7C, the elongated member 10 of the medical device 1 in this embodiment is disposed so that the distal end 30a of the inner tube 30 abuts against the proximal end 26b of the sliding restriction portion 26 of the tip member 25. In this case, the movable portion 11 is in a state in which it extends straight without deflection (hereinafter referred to as the straight state).

[0073] 7A to 7C, when the inner tube 30 is slid distally relative to the outer tube 20 as shown by arrow D11 in Fig. 9, a force acting on the inner tube 30 to move it distally inside the outer tube 20 acts on the inner tube 30. However, because the distal end 30a of the inner tube 30 abuts against the proximal end 26b of the sliding restriction portion 26 of the tip member 25, the force acting on the inner tube 30 to move it distally acts as a force that crushes the inner tube 30 in the axial direction, and a compressive stress is generated in the inner tube 30 in the axial direction.

[0074] As described above, the inner tube 30 has an asymmetrical shape in which the plurality of partial grooves 41 are arranged in the axial direction on one side surface and the connection portion 50 is provided on the other side surface. The axial compressive stress generated in the inner tube 30 is concentrated on the one side surface on which the plurality of partial grooves 41 are provided, and the plurality of partial grooves 41 are compressed in the axial direction, deforming the through slit 31 so as to narrow in the axial direction. As a result, the movable portion 11 is in a deflected state (hereinafter referred to as a deflected state) in which the one side surface on which the plurality of partial grooves 41 are provided is the inner side and the other side surface on which the connection portion 50 is provided is the outer side, as shown by arrow D12 in Figure 9.

[0075] In the above-described deflected state, when the inner tube 30 is slid proximally relative to the outer tube 20 as shown by arrow D21 in Fig. 9, the axial compressive stress generated in the inner tube 30 decreases, and the partial grooves 41 are deformed to return to their original state. As a result, the deflection angle of the movable part 11 decreases, and the movable part 11 returns to its straight, undeflected state as shown by arrow D22 in Fig. 9.

[0076] When the inner tube 30 is slid distally relative to the outer tube 20, the movable part 11 is deflected, and the greater the amount of distal displacement of the inner tube 30 relative to the outer tube 20, the greater the deflection angle of the movable part 11. Furthermore, when the movable part 11 is in a deflected state, when the inner tube 30 is slid proximally relative to the outer tube 20, the deflection angle of the movable part 11 becomes smaller, and the smaller the amount of distal displacement of the inner tube 30 relative to the outer tube 20, the smaller the deflection angle of the movable part 11 becomes.

[0077] In this way, the movable part 11 can be deflected by sliding the inner tube 30 axially relative to the outer tube 20, and the movable part 11 can be deflected to the desired angle by adjusting the amount of axial displacement of the inner tube 30 relative to the outer tube 20.

[0078] The pivoting operation of the movable part 11 will be described with reference to Fig. 10. Fig. 10 is a diagram for explaining the pivoting operation of the movable part 11 in this embodiment, and is a side view of the vicinity of the movable part 11 when the partial groove part 41 is on the lower side and the connection part 50 is on the upper side. In Fig. 10, the outer tube 20 is shown in cross section, and the proximal sides of the outer tube 20 and the inner tube 30 are not shown.

[0079] In the elongated member 10 of the medical device 1 in this embodiment, the outer tube 20 and the inner tube 30 are not fixed to each other, and the inner tube 30 is able to rotate around the axis C inside the outer tube 20. When the inner tube 30 is rotated inside the outer tube 20, the orientation of the side surface of the inner tube 30 relative to the outer tube 20, i.e., the orientation (circumferential position) of the plurality of partial grooves 41 and the connection portion 50 provided on the inner tube 30, can be changed. This makes it possible to change the deflection direction of the movable portion 11, which deflects so as to curve with one side surface on which the plurality of partial grooves 41 are provided facing inward and the other side surface on which the connection portion 50 is provided facing outward.

[0080] The inner tube 30 is designed to be able to rotate inside the outer tube 20 whether the movable part 11 is in a straight state or a deflected state. For example, when the movable part 11 is in a deflected state in which it is deflected in a specific direction, rotating the inner tube 30 relative to the outer tube 20 as shown by arrow D31 in Fig. 10 changes the circumferential positions of the multiple partial groove parts 41 and the connection part 50 provided in the inner tube 30 relative to the outer tube 20. As a result, as shown by arrow D32 in Fig. 10, the movable part 11 changes its deflection direction while maintaining the deflection angle, with the elongated member 10 proximal to the movable part 11 as the axis.

[0081] It is also possible to rotate the inner tube 30 relative to the outer tube 20 while sliding the inner tube 30 in the axial direction relative to the outer tube 20. In this case, the deflection angle of the movable part 11 can be changed by adjusting the amount of axial displacement of the inner tube 30 relative to the outer tube 20, and at the same time, the deflection direction of the movable part 11 can be changed by adjusting the amount of rotation of the inner tube 30 relative to the outer tube 20.

[0082] Next, the deflection manipulation device 100 of this embodiment will be described. As described above, the elongated member 10 is configured to include an outer tube 20 and an inner tube 30, and the movable part 11 can be deflected by sliding and rotating the inner tube 30 relative to the outer tube 20. The deflection manipulation device 100 of this embodiment is used to deflect the movable part 11 located at the distal end of the elongated member 10, and is configured to slide and rotate the inner tube 30 relative to the outer tube 20.

[0083] The configuration of a deflection manipulation device 100 according to an embodiment of the present invention will be described with reference to FIGS.

[0084] Fig. 11 is a perspective view of the deflection manipulation device 100 in this embodiment. Fig. 12 is a plan view of the deflection manipulation device 100 in this embodiment. Fig. 13 is a side view of the deflection manipulation device 100 in this embodiment. Fig. 14 is an exploded perspective view of the deflection manipulation device 100 in this embodiment. In Figs. 11 to 14, the distal side of the outer tube 20 and the distal side of the inner tube 30 are not shown.

[0085] 11 to 13, the deflection operation device 100 has an overall shape that is elongated in the longitudinal direction. The deflection operation device 100 includes a controller housing 200 composed of a cover 300 and a base 400, an outer tube fixing member 500 that fixes the outer tube 20, an operation member 800 integrally provided with an operation handle portion 810, and a connection member 900 that is inserted into an insertion hole 220 provided at the proximal end of the controller housing 200. The controller housing 200 forms the housing of the deflection operation device 100. As will be described later, the inner tube 30 inserted into the outer tube 20 is fixed to the operation member 800 inside the controller housing 200. The longitudinal direction of the deflection manipulation device 100 means the direction connecting the distal end where the outer tube 20 and the inner tube 30 are inserted into the deflection manipulation device 100 and the proximal end where the connecting member 900 is inserted, and coincides with the axial direction of the inner tube 30 inserted into the deflection manipulation device 100.

[0086] 13 , the controller housing 200 is curved in an arch shape toward the proximal side to make it easier for the user to grip, and the base 400 is formed with a curved portion 201 on which the user can hook their fingers when gripping the controller housing 200. The operating member 800 is configured to be slidable and rotatable in the longitudinal direction relative to the controller housing 200, and an operating handle portion 810 of the operating member 800 is disposed on the distal side of the controller housing 200. A user can grip the controller housing 200 by, for example, placing their index finger on the curved portion 201 and using their thumb to move or rotate the operating handle portion 810 in the longitudinal direction relative to the controller housing 200.

[0087] The deflection operation device 100 is configured to deflect the movable part 11 provided at the distal end of the elongated member 10 when the user grips the controller housing 200 and moves the operation handle part 810 distally in the longitudinal direction relative to the controller housing 200. In addition, the user can change the deflection direction of the movable part 11 by rotating the operation handle part 810.

[0088] Each member constituting the deflection operation device 100 will be described in more detail with reference to FIG.

[0089] As shown in the exploded perspective view of Fig. 14, the deflection operation device 100 is composed of a cover body 300, a base 400, an outer tube fixing member 500, an expansion member 600, an operation member 800, and a connection member 900. The deflection operation device 100 can be assembled by combining these members. Each member is not particularly limited, but can be made of a polymer material, for example.

[0090] The cover 300 and the base 400 are formed in a generally semi-cylindrical shape and can be stacked on top of each other. When the cover 300 and the base 400 are stacked on top of each other, a space for accommodating the operating member 800 is formed between the cover 300 and the base 400. When the deflection operation device 100 is assembled, the cover 300 and the base 400 are fixed to each other with screws or the like to form a controller housing 200, which is the case for the deflection operation device 100.

[0091] A marker groove 315 is formed on the outer surface of the proximal side of the cover 300. This marker groove 315 is used as a reference marker for grasping the amount of rotation when the operating member 800 is rotated. A similar marker groove 815 is also formed in the operating handle portion 810 of the operating member 800, and the position of this marker groove 815 can be set in the deflection direction of the movable portion 11. By using the marker groove 315 of the cover 300 as a reference, the user can visually and easily grasp the position of the marker groove 815 of the operating handle portion 810, thereby easily grasping the deflection direction of the movable portion 11.

[0092] As shown in Fig. 14, a guide groove 410 having a substantially semicircular cross section and extending in the longitudinal direction is provided on the inner surface on the distal side of the base 400. Although not shown in Fig. 14, a similar guide groove is also provided on the inner surface on the distal side of the cover 300, and when the cover 300 and the base 400 are placed one on top of the other, a cylindrical space 210 (see Fig. 16) is formed that can accommodate the proximal end of the operating member 800. The operating member 800 is slidable and rotatable in the longitudinal direction within this cylindrical space 210.

[0093] Additionally, the guide groove 410 is formed with an engagement recess 450 that is recessed radially outward from the inner surface of the guide groove 410. The engagement recess 450 has a shape that allows the engagement protrusion 550 of the outer tube fixing member 500 to be inserted therein, and by inserting the engagement protrusion 550 into the engagement recess 450, the outer tube fixing member 500 can be fixed to the base 400 (controller housing 200).

[0094] 14 , a connecting member insertion groove 420 having a substantially semicircular cross section and extending in the longitudinal direction is provided on the inner surface of the proximal side of the base 400, and a blade member insertion groove 430 is formed on the inner circumferential surface of the connecting member insertion groove 420. A similar connecting member insertion groove 320 is also provided on the inner surface of the distal side of the cover 300, and although not shown in FIG. 14 , a similar blade member insertion groove is also provided on the inner circumferential surface of the connecting member insertion groove 320. When the cover 300 and the base 400 are overlapped on top of each other, an insertion hole 220 is formed through which the connecting member 900 can be inserted, and the pair of blade members 910 of the connecting member 900 can be inserted into the blade member insertion groove 430 of the base 400 and the blade member insertion groove of the cover 300, thereby fixing the connecting member 900 to the controller housing 200.

[0095] 14, the outer tube fixing member 500 is composed of a tubular member extending in the longitudinal direction. The outer tube fixing member 500 has a through-hole 500h formed therein along the axial direction, which is open at a distal end 500a and a proximal end 500b. The inner and outer diameters of the outer tube fixing member 500 are approximately the same as those of the outer tube 20, so that the inner tube 30 can be inserted through the through-hole 500h of the outer tube fixing member 500.

[0096] The proximal end 20b of the outer tube 20 is fixed to the distal end 500a of the outer tube fixing member 500. Note that the method of attaching the proximal end 20b of the outer tube 20 to the distal end 500a of the outer tube fixing member 500 is not particularly limited. For example, the distal end 500a of the outer tube fixing member 500 may be fitted externally or internally to the proximal end 20b of the outer tube 20 and glued or fused thereto, or the outer tube fixing member 500 and the outer tube 20 may be fused together by insert molding, press working, or the like. In this case, it is preferable that the outer tube 20 and the outer tube fixing member 500 have approximately the same inner and outer diameters so as to be smoothly connected in the axial direction.

[0097] An engaging protrusion 550 is integrally formed on the proximal end of the outer tube fixing member 500. The engaging protrusion 550 can be formed, for example, by a flat plate member extending in the longitudinal direction and erected substantially perpendicularly from the outer peripheral surface of the outer tube fixing member 500. The engaging protrusion 550 has a shape that allows it to be inserted into the engaging recess 450 of the base 400, and as described above, by inserting the engaging protrusion 550 into the engaging recess 450, the outer tube fixing member 500 can be fixed to the base 400 (controller housing 200).

[0098] The expansion member 600 is a member that is attached to the proximal end 30b of the inner tube 30. The expansion member 600 serves to easily fix the inner tube 30 to the operating member 800. Here, as shown in Fig. 14, the expansion member 600 is composed of a tubular member that can be fitted onto the proximal end of the inner tube 30, and has rounded rectangular flat plate members attached to both longitudinal ends.

[0099] 14, the operating member 800 is made up of an operating handle portion 810, a cylindrical portion 820, a connecting portion 830, a half member 841, and a half member 842. The operating handle portion 810, the cylindrical portion 820, the connecting portion 830, and the half member 841 are integrally provided.

[0100] The operating handle portion 810 and the cylindrical portion 820 are cylindrical with a through-hole 800h formed therein along the axial direction. The cylindrical portion 820 is cylindrical, while the operating handle portion 810 provided on the distal side of the cylindrical portion 820 is tapered so that its outer diameter increases toward the distal side. In addition, a marker groove 815 is formed on the proximal side of the operating handle portion 810, and the position of this marker groove 815 can be set in the deflection direction of the movable portion 11.

[0101] A plurality of fine slits 810A are formed in the axial direction over the entire outer circumferential surface on the distal side of the operating handle portion 810. The operating handle portion 810 is a member that the user directly touches when performing a deflection operation of the movable portion 11, and by providing the slits 810A on the outer circumferential surface of the operating handle portion 810, slippage of the operating handle portion 810 during operation can be reduced.

[0102] The inner diameter of the through-hole 800h formed inside the operating handle portion 810 and the cylindrical portion 820 is set to be larger than the outer diameter of the outer tube fixing member 500. This allows the outer tube fixing member 500 to be inserted through the through-hole 800h of the operating handle portion 810 and the cylindrical portion 820.

[0103] A connecting portion 830 is provided on the proximal side of the tubular portion 820, extending from the proximal end 820b of the tubular portion 820 toward the proximal side. The connecting portion 830 is configured as an elongated rod-shaped member extending in the longitudinal direction. The longitudinal length of the connecting portion 830 (the longitudinal distance between the proximal end 820b of the tubular portion 820 and the distal end 840a of the inner tube fixing portion 840) is not particularly limited, but as will be described later, the longitudinal length of the connecting portion 830 is the maximum distance over which the inner tube 30 slides axially relative to the outer tube 20, and therefore it is preferable that the longitudinal length of the connecting portion 830 be set to a length that allows the movable portion 11 to be sufficiently deflected. Furthermore, the width of the connecting portion 830 is not particularly limited, but as will be described later, the rotation of the operating member 800 is restricted when the side surfaces 830a and 830b of the connecting portion 830 abut against the engaging protrusions 550 of the outer tube fixing member 500, respectively. Therefore, it is preferable to make the connecting portion 830 thinner and increase the rotation range of the operating member 800, while also taking into consideration the balance with the strength of the connecting portion 830.

[0104] When the half-split members 841 and 842 are stacked on top of each other, they form a cylindrical shape and constitute the inner tube fixing part 840. The half-split members 841 and 842 have a shape that fits the expansion member 600 attached to the proximal end 30b of the inner tube 30, and are fixed together with the expansion member 600 by adhesive or the like while sandwiching the expansion member 600. At this time, when fixing the inner tube fixing part 840 to the expansion member 600, care is taken not to block the opening at the proximal end 30b of the inner tube 30. By fixing the expansion member 600 to the inner tube fixing part 840 in this way, the inner tube 30 and the operating member 800 can be fixed together.

[0105] 14 , the connecting member 900 is composed of a long, thin tubular member. The connecting member 900 has a gently curved shape to match the bow-shaped curve of the controller housing 200. The outer diameter of the connecting member 900 is set smaller than the inner diameter of the inner tube 30, so that the distal end 900a of the connecting member 900 can be inserted into the lumen 30t of the inner tube 30 from the proximal end 30b of the inner tube 30. The connecting member 900 serves to extend the lumen 30t of the inner tube 30 and guide it to the outside of the controller housing 200.

[0106] The proximal end of the connecting member 900 is provided with a pair of wing members 910 and an engaging portion 920. The pair of wing members 910 are provided distally of the engaging portion 920.

[0107] The pair of blade members 910 can be configured, for example, by flat plate members extending in the longitudinal direction and erected approximately perpendicularly from the outer circumferential surface of the connecting member 900. The pair of blade members 910 have a shape that allows them to be inserted into the blade member insertion grooves 430 formed in each of the cover body 300 and the base 400, and as described above, by inserting the pair of blade members 910 into the blade member insertion grooves 430, the connecting member 900 can be fixed to the controller housing 200.

[0108] The engaging portion 920 is configured by a protruding member that protrudes laterally so as to expand the proximal end surface of the connecting member 900. The engaging portion 920 is disposed outside the controller housing 200 when the deflection operation device 100 is assembled, and functions as an engaging portion with a connector or the like that is connected to the proximal side of the connecting member 900.

[0109] Next, the internal configuration of the deflection manipulation device 100 of this embodiment when assembled will be described with reference to Figures 15 and 16. Figure 15 is a perspective view showing a state in which the cover 300 of the deflection manipulation device 100 of this embodiment has been removed. Figure 16 is a perspective cross-sectional view showing a cross section of the controller housing 200 of the deflection manipulation device 100 of this embodiment. In Figures 15 and 16, the distal side of the outer tube 20 and the distal side of the inner tube 30 are not shown.

[0110] The deflection manipulation device 100 can be fabricated by assembling the components shown in Fig. 14. An example of a method for assembling the deflection manipulation device 100 will be described below.

[0111] 7A to 7C, the elongated member 10 is prepared in a state in which the inner tube 30 is inserted into the outer tube 20 and the movable part 11 is capable of deflection. On the proximal side of the elongated member 10, the lengths of the outer tube 20 and the inner tube 30 are adjusted so that the proximal end 30b of the inner tube 30 is positioned more proximal than the proximal end 20b of the outer tube 20, i.e., the inner tube 30 protrudes from the proximal end 20b of the outer tube 20.

[0112] First, the proximal end 30b of the inner tube 30 is inserted into a through-hole 800h formed in the operating handle portion 810 and the tubular portion 820 of the operating member 800 from the operating handle portion 810 side. Because the inner diameter of the through-hole 800h of the operating member 800 is larger than the outer diameter of the outer tube 20, the operating member 800 can be advanced distally to a position where it is fitted onto the outer tube 20.

[0113] Next, the proximal end 30b of the inner tube 30 is inserted into the distal end 500a of the outer tube fixing member 500, and the outer tube fixing member 500 is advanced distally. Then, the distal end 500a of the outer tube fixing member 500 is fixed to the proximal end 20b of the outer tube 20. This fixes the outer tube 20 and the outer tube fixing member 500.

[0114] Next, the expansion member 600 is attached to the proximal end of the inner tube 30 and fixed by adhesive or the like. Then, the operating member 800 is advanced proximally, and the position of the operating member 800 is adjusted so that the half member 841 of the operating member 800 overlaps the expansion member 600. With the half member 841 positioned so that it fits into the expansion member 600, the expansion member 600 is sandwiched between the half members 841 and 842 and fixed by adhesive or the like. In this way, the inner tube 30 and the operating member 800 are fixed.

[0115] It is preferable to fix the inner tube 30 to the operating member 800 after determining the orientation of one side surface (the side where the partial groove portion 41 is provided) and the other side surface (the side where the connection portion 50 is provided) of the inner tube 30 based on the marker groove 815 of the operating member 800, thereby making it possible to grasp the deflection direction of the movable part 11 by the marker groove 815. For example, if the inner tube 30 is fixed to the operating member 800 so that the orientation of one side surface (the side where the partial groove portion 41 is provided) of the inner tube 30 matches the orientation of the marker groove 815 of the operating member 800, sliding the operating member 800 distally will make it possible to deflect the movable part 11 in the direction in which the marker groove 815 exists.

[0116] Through the steps up to this point, the outer tube 20 and the outer tube fixing member 500 are connected to each other, and the inner tube 30 and the operating member 800 are connected to each other. However, since the inner tube 30 is slidable and rotatable relative to the outer tube 20 while inserted into the outer tube 20, the inner tube 30 and the operating member 800 are slidable and rotatable relative to the outer tube 20 and the outer tube fixing member 500.

[0117] With the operating member 800 connected as described above, the operating member 800 is placed in the guide groove 410 of the base 400. At this time, the engaging protrusion 550 of the outer tube fixing member 500 is adjusted so that it faces the base 400, and the engaging protrusion 550 is inserted into the engaging recess 450 formed in the guide groove 410. As a result, with the operating member 800 placed in the guide groove 410 of the base 400, the engaging protrusion 550 fits into the engaging recess 450, and the outer tube fixing member 500 is fixed to the base 400.

[0118] Next, the distal end 900a of the connecting member 900 is inserted into the lumen 30t from the proximal end 30b of the inner tube 30, and the connecting member 900 is placed in the connecting member insertion groove 420 of the base 400. At this time, one of the blade members 910 of the connecting member 900 is inserted into the blade member insertion groove 430. As a result, with the operating member 800 placed in the connecting member insertion groove 420 of the base 400, the blade member 910 fits into the blade member insertion groove 430, and the connecting member 900 is fixed to the base 400. Note that although the connecting member 900 is inserted into the lumen 30t of the inner tube 30, it is not fixed to the inner tube 30, and the inner tube 30 and the connecting member 900 are slidable relative to each other. This state is illustrated in Figures 15 and 16.

[0119] Finally, the lid 300 is placed on the base 400 and the lid 300 and base 400 are fixed together with screws or the like, thereby completing the assembly of the deflection operation device 100.

[0120] The above-described method for assembling the deflection manipulation device 100 is merely an example, and is not limited thereto. For example, in the above-described method for assembling the deflection manipulation device 100, the deflection manipulation device 100 is assembled after the movable part 11 is brought into a state in which deflection manipulation is possible as shown in Figures 7A to 7C, but the deflection manipulation device 100 may be assembled first, and then the configurations of the distal end part of the outer tube 20 and the distal end part of the inner tube 30 may be adjusted as appropriate.

[0121] The controller housing 200 is formed by stacking the cover 300 and the base 400. A cylindrical space 210 is formed inside the controller housing 200, as shown in FIG.

[0122] The proximal end portion (cylindrical portion 820, connecting portion 830, and inner tube fixing portion 840) of the operating member 800 is housed in the cylindrical space 210. Because the operating member 800 is not fixed to the controller housing 200, it is slidable in the longitudinal direction relative to the controller housing 200 inside the cylindrical space 210 and is rotatable relative to the controller housing 200.

[0123] The operating member 800 and the inner tube 30 are fixed at an inner tube fixing portion 840, and the inner tube 30 moves integrally with the operating member 800. When the operating member 800 is slid longitudinally relative to the controller housing 200, the inner tube 30 also slides longitudinally (axially) relative to the controller housing 200 in conjunction with the operating member 800. When the operating member 800 is rotated relative to the controller housing 200, the inner tube 30 also rotates relative to the controller housing 200 in conjunction with the operating member 800.

[0124] 16 , the outer tube fixing member 500 is inserted into the cylindrical portion 820 of the operating member 800, and the inner tube 30 is inserted into the outer tube fixing member 500. In other words, the outer tube fixing member 500 is disposed in the gap formed between the inner circumferential surface of the cylindrical portion 820 of the operating member 800 and the outer circumferential surface 30 c of the inner tube 30.

[0125] The engaging protrusions 550 of the outer tube fixing member 500 fit into the engaging recesses 450 of the base 400, and the engaging recesses 450 and the engaging protrusions 550 engage with each other. This fixes the outer tube fixing member 500 to the controller housing 200.

[0126] The proximal end 20b of the outer tube 20 is fixed to the distal end 500a of the outer tube fixing member 500. The outer tube fixing member 500 is fixed to the controller housing 200. With this configuration, the outer tube 20 is connected and fixed to the controller housing 200 via the outer tube fixing member 500. The connecting member 900 is also fixed to the controller housing 200 by being sandwiched between the cover 300 and the base 400.

[0127] In this way, in the deflection operation device 100, the outer tube 20, outer tube fixing member 500, connecting member 900, and controller housing 200 are integrated, and when a user grasps the controller housing 200, the positions of the outer tube 20, outer tube fixing member 500, connecting member 900, and controller housing 200 are fixed relative to the grasping hand.

[0128] Meanwhile, the inner tube 30 and the operating member 800 are connected and fixed to each other, but are not fixed to any of the outer tube 20, outer tube fixing member 500, connecting member 900, or controller housing 200. When a user grips the controller housing 200 and slides the operating member 800 in the longitudinal direction relative to the controller housing 200, the inner tube 30 can be slid in the axial direction relative to the outer tube 20. Furthermore, when a user grips the controller housing 200 and rotates the operating member 800 relative to the controller housing 200, the inner tube 30 can be rotated relative to the outer tube 20.

[0129] In the deflection operation device 100 of this embodiment, when the operation member 800 is slid most distally, the distal end 840a of the inner tube fixing portion 840 abuts against the engaging protrusion 550 of the outer tube fixing member 500, restricting further sliding of the operation member 800 toward the distal side. When the operation member 800 is slid most proximally, the proximal end 820b of the tubular portion 820 abuts against the engaging protrusion 550 of the outer tube fixing member 500, restricting further sliding of the operation member 800 toward the proximal side. Furthermore, by making the outer diameter of the operation handle portion 810 larger than the cylindrical space 210 within the controller housing 200, the operation handle portion 810 does not enter the cylindrical space 210, restricting further sliding of the operation member 800 toward the proximal side. In this way, the range of longitudinal sliding of the operation member 800 can be defined. The range of longitudinal sliding of the operating member 800 can be appropriately set by adjusting the axial length of the connecting portion 830 of the operating member 800 or the axial length of the connecting portion 830 of the operating member 800.

[0130] Furthermore, in the deflection operation device 100 of this embodiment, the rotation of the operation member 800 is restricted by the side surfaces 830a, 830b of the connecting portion 830 coming into contact with the engaging protrusion 550 of the outer tube fixing member 500. For this reason, by making the width of the connecting portion 830 as narrow as possible while also taking into consideration the strength of the connecting portion 830, the rotation range of the operation member 800 can be increased, and the rotation range can also be made to be nearly the entire circumference (360°).

[0131] Next, a deflection operation of the movable part 11 of the elongated member 10 using the deflection operation device 100 of this embodiment will be described with reference to Figures 17 to 20. Figure 17 is a diagram showing the deflection operation device 100 of this embodiment when the movable part 11 is straightened (when the movable part 11 is in a straight state), and is a plan view showing a state in which the cover 300 of the deflection operation device 100 is removed. Figure 18 is a side cross-sectional view of the deflection operation device 100 of this embodiment when the movable part 11 is straightened (when the movable part 11 is in a straight state). Figure 19 is a diagram showing the deflection operation device 100 of this embodiment when the movable part 11 is deflected, and is a plan view showing a state in which the cover 300 of the deflection operation device 100 is removed. Figure 20 is a side cross-sectional view of the deflection operation device 100 of this embodiment when the movable part 11 is deflected.

[0132] 17 to 20, the distal side of the elongated member 10 including the movable part 11 is not shown. However, in the following description, it is assumed that the orientation of one side surface of the inner tube 30 on which the partial groove portion 41 is provided matches the orientation of the marker groove 815 of the operating member 800, and that when the operating member 800 is slid distally, the movable part 11 can be deflected in the direction in which the marker groove 815 exists.

[0133] 17 and 18 shows the deflection manipulation device 100 in a state in which the manipulation member 800 has been slid to the most proximal side. In this state, at the distal end of the elongated member 10, the distal end 30a of the inner tube 30 is disposed so as to abut against the proximal end 26b of the sliding restriction portion 26 of the tip member 25, as shown in FIGS. 7A to 7C, and the movable portion 11 is in a straight state in which it extends straight without being deflected.

[0134] The operating member 800 can be slid from the most proximal position to the distal position relative to the controller housing 200 as shown by arrow D41 in FIGS.

[0135] When a user grips the controller housing 200 and slides the operating member 800 distally, the inner tube 30 fixed to the operating member 800 slides distally along the longitudinal direction (axial direction) relative to the outer tube 20 fixed to the controller housing 200. This allows the inner tube 30 to slide distally relative to the outer tube 20, as indicated by arrow D11 in FIG. 9 . As a result, as indicated by arrow D12 in FIG. 9 , the movable part 11 can be deflected so as to curve with one side surface on which the multiple partial grooves 41 are provided facing inward and the other side surface on which the connection part 50 is provided facing outward. Here, the inner tube 30 is fixed to the operating member 800 so that the orientation of the one side surface of the inner tube 30 on which the partial grooves 41 are provided matches the orientation of the marker grooves 815 on the operating member 800. The user can determine the deflection direction of the movable part 11 from the position of the marker grooves 815.

[0136] The deflection operation device 100 shown in Figures 19 and 20 is in a state in which the operation member 800 has been slid to the most distal side, and the movable part 11 is in the deflected state as shown in Figure 9. In this state, the operation member 800 can be slid to the proximal side relative to the controller housing 200, as shown by arrow D51 in Figures 19 and 20.

[0137] When the user grips the controller housing 200 and slides the operating member 800 proximally, the inner tube 30 fixed to the operating member 800 slides proximally along the longitudinal direction (axial direction) relative to the outer tube 20 fixed to the controller housing 200. This allows the inner tube 30 to slide proximally relative to the outer tube 20, as shown by arrow D21 in Fig. 9. As a result, the deflection angle of the movable part 11 decreases, as shown by arrow D22 in Fig. 9, and the movable part 11 returns to a straight state in which it is extended straight without deflection, as shown by arrow D22 in Fig. 9.

[0138] When the operating member 800 is slid distally relative to the controller housing 200, the inner tube 30 can be slid distally relative to the outer tube 20, and the movable part 11 can be deflected.

[0139] The greater the distal displacement of the operating member 800 relative to the controller housing 200, the greater the distal displacement of the inner tube 30 relative to the outer tube 20, and the greater the deflection angle of the movable part 11.

[0140] When the operating member 800 is slid proximally relative to the controller housing 200, the inner tube 30 can be slid proximally relative to the outer tube 20, thereby reducing the deflection angle of the movable part 11. As the amount of distal displacement of the operating member 800 relative to the controller housing 200 decreases, the amount of distal displacement of the inner tube 30 relative to the outer tube 20 decreases, and the deflection angle of the movable part 11 becomes smaller.

[0141] In this way, the movable part 11 can be deflected by sliding the operating member 800 relative to the controller housing 200 and sliding the inner tube 30 axially relative to the outer tube 20, and the movable part 11 can be deflected to a desired angle by adjusting the amount of axial displacement of the operating member 800 relative to the controller housing 200.

[0142] Furthermore, the operating member 800 can be rotated relative to the controller housing 200 as shown by the arrow D61 in FIGS. 17 to 20, regardless of whether the movable portion 11 is in a straight or deflected state.

[0143] When the operating member 800 is rotated relative to the controller housing 200, the inner tube 30 fixed to the operating member 800 rotates inside the outer tube 20 fixed to the controller housing 200. This makes it possible to change the orientation of the side surface of the inner tube 30 relative to the outer tube 20, i.e., the orientation of the multiple partial groove portions 41 and the connection portion 50 provided on the inner tube 30, and to change the deflection direction of the movable portion 11. The user can deflect the movable portion 11 in the desired direction by rotating the operating member 800 while checking the position of the marker grooves 815 of the operating member 800.

[0144] It should be noted that the operating member 800 may be rotated relative to the controller housing 200 while sliding relative to the controller housing 200. In this case, the deflection angle of the movable part 11 can be changed by adjusting the amount of longitudinal (axial) displacement of the operating member 800 relative to the controller housing 200, and at the same time, the deflection direction of the movable part 11 can be changed by adjusting the amount of rotation of the operating member 800 relative to the controller housing 200.

[0145] Modifications of the medical device 1 in the above-described embodiment will be described below.

[0146] First, a first modified example will be described. Figures 21A to 21C are side views showing the inner tube 30 constituting the elongated member 10 of the medical device 1 according to the first modified example of the present invention. Figure 21A is a side view seen from the side of the through slit 31 constituting the partial groove portion 41, Figure 21B is a side view seen from the side of the connecting portion 50, and Figure 21C is a side view when the through slit 31 is on the upper side and the connecting portion 50 is on the lower side. Figure 22 is a diagram for explaining the deflection operation of the movable portion 11 according to the first modified example of the present invention, and is a side view of the vicinity of the movable portion 11 when the through slit 31 is on the upper side and the connecting portion 50 is on the lower side. The proximal side of the inner tube 30 is not shown in Figures 21A to 21C. In Figure 22, the outer tube 20 is shown in cross section, and the proximal sides of the outer tube 20 and the inner tube 30 are not shown.

[0147] As in the first modified example, the through slit 31 of the inner tube 30 may be formed so that the slit end 31e closes in an approximately V-shape as shown in Figures 21B and 21C, and further, may be formed so that the width is greatest at approximately the circumferential center of the through slit 31 (the position opposite the connection portion 50).

[0148] When the movable portion 11 is deflected, the inner tube 30 bends with one side surface on which the partial groove portion 41 is provided facing inward and the other side surface on which the connection portion 50 is provided facing outward. By forming the through slits 31 so that the width is greatest at approximately the circumferential center as in the first modified example, the inner tube 30 has a shape that makes it easy to bend inward, allowing the movable portion 11 to be deflected more flexibly. Note that all of the multiple through slits 31 may be the through slits 31 whose width is greatest at approximately the circumferential center, or only some of the multiple through slits 31 may be the through slits 31 whose width is greatest at approximately the circumferential center.

[0149] Next, a second modified example will be described. Figures 23A to 23C are side views showing the inner tube 30 constituting the elongated member 10 of the medical device 1 in the second modified example of the present invention. Figure 23A is a side view seen from the side of the through slit 31 constituting the partial groove portion 41, Figure 23B is a side view seen from the side of the connecting portion 50, and Figure 23C is a side view when the through slit 31 is on the upper side and the connecting portion 50 is on the lower side. The proximal side of the inner tube 30 is not shown in Figures 23A to 23C.

[0150] 5A and 5B, all of the through slits 31 formed in the inner tube 30 are formed partially along the circumferential direction, leaving a portion of the tube wall of the inner tube 30. In contrast to this, as in the second modified example, a full-circumferential through slit 32 that is open around the entire circumferential direction without leaving a portion of the tube wall may be formed in the inner tube 30.

[0151] When axial compressive stress is generated in the inner tube 30, the full-circumference through slits 32 do not generate resistance due to the connection portion 50, and respond quickly to the compressive stress and deform, compared to the through slits 31 (hereinafter referred to as partial through slits 31) that form the connection portion 50 by leaving a portion of the tube wall of the inner tube 30. As a result, when axial compressive stress acts on the inner tube 30, the full-circumference through slits 32 deform first, triggering deformation of the inner tube 30, followed by deformation of the partial through slits 31, making it possible to bend the inner tube 30 reliably.

[0152] In the movable part 11, the partial through slit 31 forms a partial groove portion 41 that is recessed in only a portion of the circumferential direction of the inner tube 30, and the full-circumferential through slit 32 forms a full-circumferential groove portion that is recessed around the entire circumference of the inner tube 30.

[0153] Since the inner tube 30 needs to have a connection portion 50, even when forming the full-circumferential through slits 32, it is preferable to form partial through slits 31 that leave a portion of the tube wall as the connection portion 50. That is, it is preferable that the multiple grooves 40 formed in the movable portion 11 include both partial grooves 41 that are recessed only in a portion of the circumferential direction of the inner tube 30 and full-circumferential grooves that are recessed around the entire circumference of the inner tube 30. The number and positions of the full-circumferential through slits 32 are not particularly limited. For example, as shown in Figures 23A to 23C, the full-circumferential through slits 32 may be periodically and balanced with respect to the partial through slits 31, such as by arranging two partial through slits 31 between adjacent full-circumferential through slits 32. This allows the full-circumferential through slits 32 to be periodically arranged with a predetermined number of partial through slits 41 sandwiched therebetween, thereby improving the deflection of the entire movable portion 11.

[0154] Next, a third modified example will be described. Figures 24A to 24C are side views showing the inner tube 30 constituting the elongated member 10 of the medical device 1 in the third modified example of the present invention. Figure 24A is a side view seen from the side of the through slit 31 constituting the partial groove portion 41, Figure 24B is a side view seen from the side of the connecting portion 50, and Figure 24C is a side view when the through slit 31 is on the upper side and the connecting portion 50 is on the lower side. The proximal side of the inner tube 30 is not shown in Figures 24A to 24C.

[0155] As in the third modified example, a plurality of through slits 31 may be formed in the inner tube 30, and an axial through slit 33 may be formed in the approximate circumferential center of the plurality of through slits 31 (at a position facing the connection portion 50) along the axial direction so as to cross the plurality of through slits 31. By forming the axial through slit 33, one side of the inner tube 30 (the side facing the connection portion 50) can deform more flexibly.

[0156] In the movable part 11, the partial through slits 31 form partial groove portions 41 in which only a portion of the circumferential direction of the inner tube 30 is recessed, and the axial through slits 33 form axial groove portions that extend in the axial direction so as to connect the multiple partial groove portions 41. By forming the axial groove portions, the movable part 11 can be deflected more flexibly.

[0157] Next, a fourth modified example will be described. Figures 25A to 25C are side views showing the inner tube 30 constituting the elongated member 10 of the medical device 1 in the fourth modified example of the present invention. Figure 25A is a side view seen from the side of the through slit 31 constituting the partial groove portion 41, Figure 25B is a side view seen from the side of the connecting portion 50, and Figure 25C is a side view when the through slit 31 is on the upper side and the connecting portion 50 is on the lower side. Figure 26 is a diagram for explaining the deflection operation of the movable portion 11 in the fourth modified example of the present invention, and is a side view of the vicinity of the movable portion 11 when the partial groove portion 41 is on the upper side and the connecting portion 50 is on the lower side. In Figures 25A to 25C, the proximal side of the inner tube 30 is omitted. In Figure 26, the outer tube 20 is shown in cross section, and the proximal sides of the outer tube 20 and the inner tube 30 are omitted.

[0158] In the above-described embodiment, a plurality of through slits 31 are formed in the inner tube 30. However, as in a fourth modified example, a single through slit 31 may be formed in the inner tube 30 as shown in Figures 25A to 25C. The axial width (length) of the single through slit 31 is not particularly limited, but for example, as shown in Figures 25A to 25C, a single through slit 31 may be formed so as to extend over the entire movable portion 11. This makes it easier for the inner tube 30 to bend inward, allowing the movable portion 11 to be deflected more flexibly.

[0159] Next, a fifth modified example will be described. Figures 27A and 27B are views showing the inner tube 30 constituting the elongated member 10 of the medical device 1 in the fifth modified example of the present invention. Figure 27A is a side view in which the bottomed groove 35 is on the upper side and the connecting portion 50 is on the lower side, and Figure 27B is a cross-sectional view in which the bottomed groove 35 is on the upper side and the connecting portion 50 is on the lower side. The proximal side of the inner tube 30 is not shown in Figures 27A and 27B. Figure 27B also shows an enlarged view of the vicinity of the distal end of the inner tube 30.

[0160] In the above-described embodiment, a through slit 31 is formed penetrating the tube wall of the inner tube 30, and the cylindrical member 60 is inserted into the inner tube 30 to close the inner peripheral opening 31d of the through slit 31 with the outer peripheral surface 60c of the cylindrical member 60, thereby forming the recessed groove portion 40. However, as in the fifth modified example, instead of the through slit 31, a bottomed groove 35 may be formed in which the tube wall of the inner tube 30 is thinned, as shown in Figures 27A and 27B.

[0161] 27B, the bottomed groove 35 has an outer peripheral opening 35c that opens at the outer peripheral surface 30c of the inner tube 30, and has a groove bottom 35d formed by a thick portion of the tube wall of the inner tube 30. The bottomed groove 35 also has a bottomed groove end 35e, and a connection portion 50 is formed on the tube wall of the other side of the inner tube 30 that faces the bottomed groove 35.

[0162] By forming the bottomed groove 35 by thinning the inner tube 30, the recessed groove portion 40 can be formed in the inner tube 30 without penetrating the tube wall of the inner tube 30. Furthermore, since there is no need to insert the cylindrical member 60 into the inner tube 30, the number of steps required to fabricate the movable part 11 can be reduced, and the number of parts required to configure the movable part 11 can also be reduced.

[0163] Next, a sixth modified example will be described. Fig. 28 is a perspective view showing a deflection manipulation device 100 according to the sixth modified example of the present invention. In Fig. 28, the distal side of the outer tube 20 and the distal side of the inner tube 30 are not shown.

[0164] The deflection operation device 100 may be configured so as to allow the inner tube 30 to slide and rotate relative to the outer tube 20. In the above-described deflection operation device 100, for example, as shown in Fig. 16 , the outer tube 20 is fixed to the controller housing 200 inside the controller housing 200 by engaging and fixing an engaging protrusion 550 of an outer tube fixing member 500 connected and fixed to the outer tube 20 with an engaging recess 450 of the base 400. Alternatively, as in a sixth modified example, the outer tube 20 may be fixed to the controller housing 200 outside the controller housing 200 using an outer tube support member 250.

[0165] The outer tube support member 250 is composed of a flange portion 251 , a support portion 252 , and a fixing portion 253 .

[0166] The flange portion 251 is fixed to the distal end of the controller housing 200. The flange portion 251 can be configured, for example, by a disk member having a through-hole formed in approximately the center thereof, through which the proximal end portion of the elongated member 10 passes.

[0167] The support portion 252 is fixed to the flange portion 251 and is disposed so as to protrude toward the distal side. The support portion 252 can be configured, for example, by a plurality of rod-shaped members extending toward the distal side in a direction substantially perpendicular to the disk member of the flange portion 251.

[0168] The fixing portion 253 is fixed to the support portion 252 and is disposed on the distal side of the controller housing 200. The fixing portion 253 is also coupled and fixed to the outer peripheral surface 20c of the outer tube 20. The fixing portion 253 can be configured, for example, by a circular plate member having a through hole formed in the approximate center thereof, the through hole having a diameter approximately the same as the outer diameter of the outer tube 20, and the inner peripheral surface of the through hole of the fixing portion 253 is fixed by adhesive or the like to the outer peripheral surface 20c of the outer tube 20 inserted through the through hole. In this case, it is not necessary to engage and fix the engaging protrusion 550 of the outer tube fixing member 500 with the engaging recess 450 of the base 400.

[0169] In the deflection operation device 100 of the sixth modified example, the outer tube 20 is connected and fixed to the controller housing 200 via the outer tube support member 250, so that by sliding and rotating the operating member 800 to which the inner tube 30 is connected and fixed, the inner tube 30 can be rotated and slid relative to the outer tube 20, thereby performing deflection operations on the movable part 11.

[0170] By appropriately setting the length of the support portion 252, the operating member 800, which has been slid distally, can be restricted from sliding further distally by the fixing portion 253. The user can visually grasp the deflection state of the movable portion 11, for example, by checking the longitudinal (axial) position of the operating member 800 between the flange portion 251 and the fixing portion 253. Furthermore, because there is no need to provide the engaging protrusion 550 on the outer tube fixing member 500, the operating member 800 can be rotated relative to the controller housing 200 without being restricted by the engaging protrusion 550.

[0171] The first to sixth modified examples described above can be combined as appropriate. For example, some or all of the through slits 31 (partial through slits 31), the full circumferential through slits 32, and the axial through slits 33 in the first to fourth modified examples may be formed by the bottomed grooves 35 in the fifth modified example.

[0172] The operation of the medical device 1 and the deflection operation device 100 in the above-described embodiment will be described below.

[0173] The medical device 1 in the above-described embodiment has a distal end provided with a movable part 11 that is inserted into the body, and comprises an outer tube 20 made of a long, flexible tubular member, and an inner tube 30 made of a long, flexible tubular member that is inserted into the outer tube 20 so as to be axially slidable and rotatable relative to the outer tube 20.

[0174] A slide restricting portion 26 is provided at the distal end of the outer tube 20, which abuts against the distal end 30a of the inserted inner tube 30 to restrict sliding of the inner tube 30 distally. One side surface of the inner tube 30 located at the movable portion 11 is formed with one or more circumferentially recessed grooves 40. A connecting portion 50 that is smoothly connected in the axial direction is provided on the other side surface of the inner tube 30 opposite to the one side surface of the inner tube 30.

[0175] According to the above configuration, the groove portion 40 is formed biased toward one side of the inner tube 30, and the connection portion 50, which is smoothly connected in the axial direction, is provided on the other side.Therefore, when the inner tube 30 is slid distally relative to the outer tube 20, the sliding control portion 26 generates axial compressive stress in the inner tube 30, and the stress is concentrated in the groove portion 40 formed on one side.As a result, the movable portion 11, in which the groove portion 40 is provided, can be deflected toward one side.

[0176] The above configuration is a simple configuration that does not require an operating wire, and allows the inner tube 30 to slide distally relative to the outer tube 20, thereby stably deflecting the distal end of the medical device 1. It also allows the lumen 30t of the inner tube 30, which is made of a long tubular member, to be large, allowing the diameter of the medical device 1 to be reduced.

[0177] Furthermore, according to the above configuration, the inner tube 30 is configured to be rotatable relative to the outer tube 20, so the deflection direction can be appropriately controlled by rotating the inner tube 30 relative to the outer tube 20 and setting one side of the inner tube 30 to face the desired direction.

[0178] In the medical device 1 in the above-described embodiment, a plurality of grooves 40 recessed in the circumferential direction may be arranged along the axial direction on one side surface of the inner tube 30 .

[0179] According to the above configuration, the multiple groove portions 40 are arranged biased toward one side of the inner tube 30, and the connection portion 50, which is smoothly connected in the axial direction, is provided on the other side. Therefore, when the inner tube 30 is slid distally relative to the outer tube 20, the sliding control portion 26 generates axial compressive stress in the inner tube 30, and the stress is concentrated on the multiple groove portions 40 arranged on one side. As a result, the movable portion 11, which has the multiple groove portions 40 provided thereon, can be deflected more flexibly toward one side.

[0180] In the medical device 1 in the above-described embodiment, the plurality of groove portions 40 may include partial groove portions 41 in which only a portion of the inner tube 30 in the circumferential direction is recessed.

[0181] According to the above configuration, stress is concentrated in the partial groove portion 41 , and the distal end portion of the medical device 1 can be flexibly deflected toward the side where the partial groove portion 41 is disposed.

[0182] In the medical device 1 in the above-described embodiment, all of the plurality of groove portions 40 may be partial groove portions 41 .

[0183] According to the above configuration, the entire movable portion 11 having the plurality of recessed grooves 40 formed therein can be deflected uniformly.

[0184] In the medical device 1 in the above-described embodiment, the multiple groove portions 40 may include partial groove portions 41 that are recessed in only a portion of the circumference of the inner tube 30, and full-circumferential groove portions that are recessed around the entire circumference of the inner tube 30. The full-circumferential groove portions can be configured by full-circumferential through slits 32 formed in the inner tube 30.

[0185] According to the above-described configuration, the circumferential groove portion, which is easily deformed by stress, reacts quickly, and the movable portion 11 can be smoothly deflected.

[0186] In the medical device 1 in the above-described embodiment, the circumferential groove portions may be periodically arranged with a predetermined number of partial groove portions 41 sandwiched therebetween.

[0187] According to the above configuration, the partial groove portion 41 and the full-circumferential groove portion are arranged in a well-balanced manner, thereby improving the deflection properties of the entire movable portion 11 .

[0188] In the medical device 1 in the above-described embodiment, the plurality of grooves 40 may be arranged at approximately equal intervals along the axial direction.

[0189] According to the above configuration, the entire movable portion 11 can be deflected so as to have approximately the same curvature.

[0190] In the medical device 1 in the above-described embodiment, an axial groove portion extending in the axial direction so as to connect the plurality of groove portions 40 may be formed on the outer peripheral surface 30c of the inner tube 30. The axial groove portion can be constituted by an axial through slit 33 formed in the inner tube 30.

[0191] According to the above configuration, the flexibility of the movable part 11 is improved by the axial grooves, and the responsiveness to the deflection of each of the plurality of grooves 40 can be improved.

[0192] In the medical device 1 in the above-described embodiment, the groove portions 40 are each formed by a through slit 31 penetrating the tubular wall of the inner tube 30, and a tubular cylindrical member 60 is inserted and fixed at a position corresponding to the movable portion 11 of the inner tube 30, and the inner opening 31d of the through slit 31 may be blocked by the outer surface of the cylindrical member 60.

[0193] According to the above configuration, the groove portion 40 can be formed in the inner tube 30 through a simple process of forming the through slit 31, and the tubular member 60 can prevent the lumen 30t of the inner tube 30 from communicating with the outside.

[0194] In the medical device 1 in the above-described embodiment, the recessed groove portion 40 may be formed by a bottomed groove 35 in which the tube wall of the inner tube 30 is thinned.

[0195] According to the above configuration, by forming the thin-walled bottomed groove 35 , the recessed groove portion 40 can be formed in the inner tube 30 without penetrating the tube wall of the inner tube 30 .

[0196] In addition, the deflection operating device 100 in the above-described embodiment is used to deflect the movable part 11 of the medical device 1, and is equipped with a controller housing 200 to which the proximal end 30b of the outer tube 20 is connected and fixed, and an operating member 800 to which the proximal end 30b of the inner tube 30 is connected and fixed, and the operating member 800 is configured to be axially slidable and rotatable relative to the controller housing 200.

[0197] According to the above configuration, by sliding the operating member 800 distally relative to the controller housing 200, the inner tube 30 can be slid distally relative to the outer tube 20, thereby deflecting the movable part 11 toward one side. Furthermore, by rotating the operating member 800 relative to the controller housing 200, the one side of the inner tube 30 can be operated to face a desired direction, thereby appropriately controlling the deflection direction of the movable part 11.

[0198] The above-described embodiments are described to facilitate understanding of the present invention, and are not described to limit the present invention. Therefore, each element disclosed in the above-described embodiments is intended to include all design modifications and equivalents that fall within the technical scope of the present invention.

[0199] REFERENCE SIGNS LIST 1 medical device 10 elongated member 11 movable part 20 outer tube 20b, 26b, 30b, 500b, 820b proximal end 20c, 25c, 30c, 60c outer peripheral surface 20d, 30d, 60d inner peripheral surface 20t, 30t lumen 25 distal end member 25h, 60h, 500h, 800h through hole 25y opening 26 sliding restriction part 30 inner tube 30a, 500a, 840a, 900a distal end 31 through slit (partial through slit) 31c, 35c outer peripheral opening 31d inner peripheral opening 31e slit end 32 full circumferential through slit 33 axial through slit 35 bottomed groove 35d groove bottom 35e bottomed groove end 40 Groove portion 41 Partial groove portion 50 Connection portion 60 Cylindrical member 100 Deflection operation device for medical equipment (deflection operation device) 200 Controller housing 201 Curved portion 210 Cylindrical space 220 Insertion hole 250 Outer tube support member 251 Flange portion 252 Support portion 253 Fixing portion 300 Cover body 315, 815 Marker groove 320, 420 Connection member insertion groove 400 Base 410 Guide groove 430 Blade member insertion groove 450 Engaging recess 500 Outer tube fixing member 550 Engaging protrusion 600 Expansion member 800 Operation member 810 Operation handle portion 810A Slit 820 Cylindrical portion 830 Connection portion 830a, 830b Side surface 840 Inner tube fixing portion 841, 842 Half member 900 Connection member 910 Blade member 920 Engagement portion

Claims

1. A medical device having a distal end provided with a movable part that is inserted into the body, comprising: an outer tube made of a long, flexible tubular member; and an inner tube made of a long, flexible tubular member that is inserted into the outer tube so as to be axially slidable and rotatable relative to the outer tube, wherein the distal end of the outer tube is provided with a sliding restriction part that abuts against the distal end of the inserted inner tube and restricts sliding of the inner tube toward the distal side, one or more circumferentially recessed grooves are formed on one side of the inner tube that is located at the movable part, and a connecting part that is smoothly connected in the axial direction is provided on the other side of the inner tube that faces the one side of the inner tube.

2. The medical device according to claim 1, wherein the plurality of circumferentially recessed grooves are arranged along the axial direction on one side of the inner tube.

3. The medical device according to claim 2, wherein the plurality of grooves include partial grooves in which only a portion of the inner tube in the circumferential direction is recessed.

4. The medical device according to claim 3, wherein all of said plurality of groove portions are said partial groove portions.

5. A medical device as described in claim 2, characterized in that the plurality of grooves include partial grooves that are recessed in only a portion of the circumference of the inner tube, and full-circumferential grooves that are recessed around the entire circumference of the inner tube.

6. The medical device according to claim 5, wherein the circumferential grooves are periodically arranged with a predetermined number of partial grooves sandwiched between them.

7. A medical device according to any one of claims 2 to 6, characterized in that the plurality of grooves are arranged at approximately equal intervals along the axial direction.

8. A medical device according to any one of claims 2 to 6, characterized in that an axial groove portion extending in the axial direction so as to connect the plurality of groove portions is formed on the outer peripheral surface of the inner tube.

9. A medical device according to any one of claims 1 to 6, characterized in that the recessed grooves are each formed by a through slit penetrating the wall of the inner tube, a tubular cylindrical member is inserted and fixed at a position of the inner tube corresponding to the movable part, and the inner opening of the through slit is blocked by the outer surface of the cylindrical member.

10. A medical device according to any one of claims 1 to 6, wherein the recessed groove is formed by a bottomed groove in which the wall of the inner tube is thinned.

11. A deflection operating device for medical equipment that deflects and operates a movable part of a medical device described in any one of claims 1 to 6, comprising: a controller housing to which the proximal end of the outer tube is connected and fixed; and an operating member to which the proximal end of the inner tube is connected and fixed, wherein the operating member is configured to be axially slidable and rotatable relative to the controller housing.

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