Medical operation rod and shaft sleeve

Abstract

An operation rod 1 comprises a shaft of which the shape can be varied so as to curve in an intersecting direction that intersects the longitudinal direction, and an operation device for receiving an operation of changing the shape of the shaft. The operation device includes: at least one wire material that is inserted into the shaft and provided so as to extend from the base-end part of the shaft, the wire material bending the shaft upon being pulled; a pulley that locks the base-end part of the wire material and winds the wire material; an operation tool having an operation part that is positioned apart from the pulley toward the distal side; and a transmission mechanism that includes a rack and a pinion, the transmission mechanism transmitting, to the pulley, an input applied to the operation part.

Description

Medical operating rods and shaft sleeves

[0001] FIELD OF THE DISCLOSURE The present disclosure relates to medical operating rods and shaft sleeves.

[0002] In medical settings, stylets, catheters, and the like are used as operating rods that can be manipulated by practitioners to change their shape. For example, stylets are used when inserting a tracheal tube into a patient's trachea to secure the airway during general anesthesia, emergency resuscitation, or before artificial respiration.

[0003] The procedure for inserting a tracheal tube requires guiding the tip of the tube through the epiglottis and further into the glottis. The tracheal tube is passed from the mouth to the larynx, where it is passed through the epiglottis and then the glottis. However, the shape of the trachea from the mouth to the glottis of the larynx varies depending on the person and their posture, and is generally curved along the way. Therefore, to facilitate insertion of the tracheal tube into the trachea, a stylet, which is a manipulating rod, is used as a means for maintaining the curve of the tracheal tube (see Patent Document 1).

[0004] Special Publication No. 07-505317

[0005] The stylet described in Patent Document 1 comprises a flexible member (14) and a fixed-length filament (20), and when inserted into a tracheal tube (30), the curved shape of the flexible member (14) can be changed by pulling the collar (18) and handle (16) together while grasping them.

[0006] However, as mentioned above, the stylet of Patent Document 1 is configured to only allow pulling operation. Therefore, while the flexible member can be bent in one direction by pulling, it is difficult to bend the flexible member in the other direction as intended, and the operability is not good. Furthermore, the operating rod of Patent Document 1 needs to be cleaned after each use before the next use, which is time-consuming.

[0007] Therefore, an object of the present disclosure is to provide a medical operating rod that can improve operability. Another object of the present disclosure is to provide a medical operating rod and a shaft sleeve that can reduce the effort required for cleaning.

[0008] A medical operating rod according to a first aspect of the present disclosure comprises a shaft whose shape is variable so as to bend in a direction intersecting the longitudinal direction, and an operating device that accepts operations to change the shape of the shaft, wherein the operating device has at least one wire that is inserted into the shaft and extends from the base end of the shaft and bends the shaft when pulled, a pulley that engages the base end of the wire and winds up the wire, an operating tool having an operating unit located distally from the pulley, and a transmission mechanism including a rack and pinion that transmits input to the operating unit to the pulley.

[0009] This allows the operator to operate the operating portion in the distal and proximal directions with good transmission while holding the operating device. Therefore, the shaft can be deformed more accurately in one or the other of the intersecting directions as intended by the practitioner. Furthermore, since the operating portion is located distally from the pulley, shaking of the operating rod during operation can be suppressed. This improves operability.

[0010] In addition, a medical operating rod according to a second aspect of the present disclosure may be the first aspect, in which the operating device has a proximal portion that supports the base end of a tube into which the shaft is inserted, and the operating portion is provided at a position away from the proximal portion in a first direction along the shaft.

[0011] This allows the tube intubation procedure to be performed stably and easily.

[0012] In addition, a medical operating rod according to a third aspect of the present disclosure may be the first aspect in which the wire has a first wire that is engaged with the pulley and wound up as the pulley rotates in one direction, and a second wire that is engaged with the pulley and wound up as the pulley rotates in the other direction.

[0013] This allows the shaft to be bent in one direction and the other direction in the intersecting direction by operating one operating part in one direction and the other direction, thereby improving operability.

[0014] Furthermore, in a medical operating rod according to a fourth aspect of the present disclosure, in the second aspect, the operating tool has an operating tool body that is rod-shaped and long in the first direction, the operating section is provided in a distal portion of the operating tool body in the first direction, the rack is provided in a proximal portion of the operating tool body in the first direction, the pinion is provided coaxially with the pulley, and the rack and pinion may be meshed.

[0015] This allows the transmission mechanism including the rack and pinion to be realized with a simple configuration that is less prone to failure. Furthermore, since the user's operation of the operating unit is oriented along the first direction, i.e., along the longitudinal direction of the shaft, it is possible to prevent the shaft from shaking in the intersecting direction due to operation of the operating device, and the operating rod can be operated stably.

[0016] A medical operating rod according to a fifth aspect of the present disclosure comprises a shaft whose shape is variable so as to bend in a direction intersecting the longitudinal direction, and an operating device that accepts operations to change the shape of the shaft, the operating device having a proximal portion that supports the base end of a tube into which the shaft is inserted, and the proximal portion is rotatable in a second direction intersecting a first direction along the shaft.

[0017] This allows the proximal portion to rotate, reducing the constraints on the orientation when attaching or detaching the shaft from the operating device, making it possible to easily attach or detach the shaft from the operating device.

[0018] Furthermore, a medical operating rod according to a sixth aspect of the present disclosure may be the fifth aspect, wherein the operating device has an inclined surface on the distal side in the first direction relative to the proximal portion, which inclines toward one side of the second direction as it moves toward the distal side.

[0019] As a result, when the shaft is pulled out from the operating device, the base end of the shaft is guided along the inclined surface, causing the proximal portion to rotate automatically, making it easy to pull out the shaft.

[0020] A medical operating rod according to a seventh aspect of the present disclosure comprises a shaft whose shape is variable so as to bend in a direction intersecting the longitudinal direction, an operating device that accepts operations to change the shape of the shaft, a flexible shaft cover that covers the shaft, and a shaft sleeve having a cover connection portion that detachably connects the proximal portion of the shaft cover to the operating device.

[0021] A shaft sleeve according to an eighth aspect of the present disclosure is a shaft sleeve that covers the shaft of a medical operating rod having a shaft whose shape can be changed to bend in a direction intersecting the longitudinal direction, and an operating device that accepts operations to change the shape of the shaft, and includes a flexible shaft cover that covers the shaft, and a cover connection portion that detachably connects the proximal portion of the shaft cover to the operating device.

[0022] This allows the shaft sleeve to be discarded and replaced with a new one after using the operating rod for treatment, eliminating the need to clean the entire operating rod after each treatment, reducing the amount of work required.

[0023] According to the present disclosure, a medical operating rod with good operability can be provided.

[0024] FIG. 1 is a side view showing the overall configuration when a medical manipulation rod according to the present disclosure is used as a stylet and a tracheal tube is attached to the shaft. FIG. 2 is a side view of the manipulation device. FIG. 3 is a perspective view of the manipulation device. FIG. 4 is a perspective view of the manipulation device, without showing the tracheal tube. FIG. 5 is a perspective view of the manipulation device, without showing the tracheal tube and shaft. FIG. 6 is a side view of the manipulation device, showing the interior with one housing omitted. FIG. 7 is a side view of the other housing of the manipulation device. FIG. 8 is a perspective view showing the transmission mechanism. FIG. 9 is another perspective view of the transmission mechanism. FIG. 10 is a perspective view showing a pulley, pinion, and proximal portion. FIG. 11 is a diagram showing the procedure for attaching a medical tube to the manipulation rod. FIG. 12 is another perspective view of the manipulation device, showing a configuration in which a stopper is provided distal to the proximal portion. Figure 13 is another perspective view of the controller, showing a configuration with a stopper distal to the proximal portion, and not showing the tracheal tube connector. Figure 14 is a side view of the controller, showing a configuration in which the proximal portion rotates. Figure 15 is a side view of the controller, showing a configuration in which the proximal portion rotates, and not showing the tracheal tube connector. Figure 16 is a side view of the controller, showing how the connector is guided by the inclined surface and how the proximal portion rotates when the tracheal tube is pulled out. Figure 17 is yet another perspective view of the controller.

[0025] Hereinafter, a medical operating rod according to an embodiment of the present disclosure will be described with reference to the drawings. Note that the concept of direction used in the following description is used for convenience of explanation and does not limit the orientation of each disclosed configuration to that direction. Furthermore, the medical operating rod described below is merely one embodiment of the present disclosure. Therefore, the present disclosure is not limited to the following embodiment, and additions, deletions, or modifications to the configuration are possible within the scope of the disclosure.

[0026] In the following embodiments, the medical manipulation rod of the present disclosure will be described as being applied to a stylet for assisting in intubation of a tracheal tube, but the application of the manipulation rod of the present disclosure is not limited to this. For example, it can also be suitably applied to a catheter to be inserted into a blood vessel.

[0027] (Embodiment 1) An operating rod 1 according to embodiment 1 has the configuration shown in Figures 1 to 11 as an example. The configuration will be described more specifically below. Note that, hereinafter, the longitudinal direction of the operating rod 1 will be referred to as the first direction (or the front-to-rear direction), the direction intersecting the first direction will be referred to as the second direction (or the up-down direction), and the direction intersecting both the first and second directions will be referred to as the third direction (or the left-to-right direction).

[0028] As shown in FIG. 1 , the operating rod 1 includes a shaft 2 and an operating device 3. The shaft 2 has a variable shape so that it can bend in a transverse direction (second direction) that intersects the longitudinal direction (first direction). For example, the shaft 2 has a first portion that is long and highly rigid, and a second portion that is a variable portion that is shorter and less rigid than the first portion and extends distally from the distal end of the first portion. The shaft 2 also has a lumen therein, and at least one wire is housed in the lumen. This wire is fixed at the distal end of the shaft 2 and extends proximally from the proximal end (base end) of the shaft 2. Pulling this wire causes the second portion of the shaft 2 to bend.

[0029] The controller 3 includes a configuration (support mechanism) for supporting the medical tube 100, an example of which is a tracheal tube, and a configuration (operation mechanism) for accepting a user's operation to deform the medical tube 100. That is, the controller 3 supports the medical tube 100 and accepts a user's operation to change the shape of the shaft 2 inserted through the medical tube 100. For example, when the controller 3 accepts a user's operation, it pulls the wire to deform the shaft 2 in a second direction. Such a controller 3 includes a housing 10 and a transmission mechanism 20. Below, the operation mechanism will be described first, and then the support mechanism will be described.

[0030] [Regarding the Operation Mechanism] The housing 10 of the controller 3 has a housing base end 11, a housing tip end 13 located distal to the housing base end 11, and a housing intermediate portion 12 connecting the housing base end 11 and the housing tip end 13. The housing 10 has the housing base end 11, housing intermediate portion 12, and housing tip end 13 integrated together and can be separated into two, left and right halves. That is, the housing 10 is made up of a left housing 10L and a right housing 10R that can be assembled and disassembled, and the housing 10 having the housing base end 11, housing intermediate portion 12, and housing tip end 13 is configured by assembling the left housing 10L and the right housing 10R.

[0031] The housing base end 11 has, for example, a rectangular parallelepiped shape, and its internal space 11a houses a transmission mechanism 20. The transmission mechanism 20 has a pinion 21 and a rack 22. The pinion 21 is supported in the internal space 11a with its shaft 21a facing in the third direction (left-right direction) and is rotatable in one direction and the other direction around this shaft 21a.

[0032] A pulley 23 around which the first wire L1 and the second wire L2 are wound is also housed in the internal space 11a of the housing base end portion 11. The pulley 23 is integrated with the pinion 21, and the rotation axis of the pulley 23 coincides with the axis 21a of the pinion 21 (see FIGS. 8 and 9).

[0033] The rack 22 has a rectangular parallelepiped shape that is long in the first direction, and has a plurality of teeth aligned in the first direction on its underside. The rack 22 is located above the pinion 21, and meshes with the pinion 21 from above. The rack 22 is connected to an operating tool 24. The operating tool 24 has an operating tool main body 25 that is a rectangular rod that is long in the first direction, and an operating portion 26 provided at the tip of the operating tool main body 25.

[0034] The operating tool body 25 has a space that opens downward, and this space is divided into a plurality of small spaces 25b by a plurality of plate-like ribs 25a that are installed between the left and right side walls of the operating tool body 25. The rack 22 is connected to one of the left and right side walls at the base end portion of the operating tool body 25. The operating part 26 is formed integrally with the operating tool body 25 so as to protrude above the top surface of the operating tool body 25 and form a boss part.

[0035] Such an operating tool 24 is housed in the intermediate housing section 12, and its tip portion is exposed to the outside. That is, the intermediate housing section 12 has a rectangular cross section and is cylindrical overall, and its internal space 12a communicates with the internal space 11a of the base housing section 11 at the rear of the intermediate housing section 12. An opening 12b communicating with the internal space 12a is formed at the tip of the intermediate housing section 12. The operating tool 24 has an operating tool body 25 housed in the internal space 12a of the intermediate housing section 12, and an operating section 26 located distal to the pulley 23 and exposed from the opening 12b.

[0036] The operating unit 26 protrudes further upward than the top surface of the tip of the intermediate housing portion 12, allowing the user to easily place their finger on the operating unit 26 while gripping the housing 10 and operate it in the front-rear direction. When the operating unit 26 is operated, the operating tool 24 can move in the front-rear direction along the internal space 12a. When the operating tool 24 moves in the front-rear direction, the rack 22 also moves in the front-rear direction, and the pinion 21 meshing with the rack 22 rotates around the shaft 21a together with the pulley 23. In this way, the transmission mechanism 20 consisting of the pinion 21 and the rack 22 transmits the user's operation input to the operating unit 26 to the pulley 23.

[0037] As shown in Figure 10, the pulley 23 has a circumferential groove 23a around which the first wire L1 and the second wire L2 are wound. A notch 23b is formed in a portion of the pulley 23 in the circumferential direction, and the circumferential groove 23a is missing at this notch 23b. The pulley 23 also has a through hole 23c formed along its diameter. One opening of this through hole 23c is located in the groove 23a, and the other opening is located in the notch 23b.

[0038] A proximal portion 30 is provided in front of the pulley 23 (see also Figures 5 and 6). The proximal portion 30 includes a cylindrical portion 31 that serves as a shaft fixing portion for fixing the shaft 2, and a rotation shaft 33. Specifically, the proximal portion 30 includes the cylindrical portion 31 oriented along its axis in the first direction, a flange 32 provided at the base end of the cylindrical portion 31, and the rotation shaft 33 provided at the base end of the cylindrical portion 31. The flange 32 has a roughly square plate shape and is provided to cover the base end of the cylindrical portion 31. However, an opening is formed in the center of the flange 32, and this opening communicates with the internal space 31a of the cylindrical portion 31. The rotation shaft 33 is cylindrical and is provided to protrude to the left and right from the base end of the cylindrical portion 31. The proximal portion 30 is rotatable within a predetermined angular range via the rotation shaft 33.

[0039] An opening 11b that communicates between the outside and the internal space 11a is formed in the front portion of the housing base end 11 of the controller 3. A bearing portion 11c is formed in the housing base end 11 near the opening 11b. The rotation shaft 33 of the proximal portion 30 described above is rotatably supported by this bearing portion 11c. At this time, the proximal portion 30 is in a state in which the front portion of the cylindrical portion 31 protrudes forward (outside) from the opening 11b. A slit 34 that extends along the first direction from the tip surface of the cylindrical portion 31 to the base end surface of the flange 32 is formed in the upper portion of the proximal portion 30.

[0040] The manner in which the wires are connected to the pulley 23 will now be described. The base end portion of the first wire L1 is passed through the internal space 31a of the proximal portion 30 via the slit 34, wound around the pulley 23 in a first direction, and then passed through the through-hole 23c of the pulley 23 from one opening to the other. Similarly, the base end portion of the second wire L2 is passed through the internal space 31a of the proximal portion 30, wound around the pulley 23 in a second direction, and then passed through the through-hole 23c from one opening to the other. The base ends of the first wire L1 and the second wire L2, which exit from the other opening of the through-hole 23c, are then inserted into a tubular fixture 27 and fixed therein with an adhesive. The fixture 27 is inserted into the through-hole 23c from the other opening, thereby locking the first wire L1 and the second wire L2 to the pulley 23. The insertion length of the fixture 27 into the through hole 23c can be changed depending on the tightening of the screw (not shown), and the tension applied to the first wire L1 and the second wire L2 can be adjusted.

[0041] In the case of the operating device 3 of this embodiment, when the operating unit 26 is operated backward, the pulley 23 rotates in a first direction, causing a pushing force to act on the second wire L2, and when the operating unit 26 is operated forward, the pulley 23 rotates in a second direction, causing a pushing force to act on the first wire L1. To prevent bending of the wires when such a pushing force acts, tubular sleeves 35 may be fitted over each of the first wire L1 and the second wire L2 between the proximal portion 30 and the pulley 23. In other words, the first wire L1 is inserted through one sleeve 35, and the second wire L2 is inserted through another sleeve 35.

[0042] Such a sleeve 35 is provided to cover at least a portion of the wire rods L1, L2 distal to the pulley 23. For example, it is provided in a range including at least the proximal end position of the proximal portion 30. As shown in FIG. 10 , the extension direction of each wire rod L1, L2 is bent at the proximal end position of the proximal portion 30. Therefore, by inserting the sleeve 35 in a range including this position, the sliding resistance of the wire rods L1, L2 at this position can be reduced and kinking at this position can be effectively prevented. Furthermore, the sleeve 35 may be provided in a range distal to the proximal portion 30 in addition to, or instead of, the range near the proximal end position of the proximal portion 30. This reduces the sliding resistance of the wire rods L1, L2 distal to the proximal portion 30 and effectively prevents kinking of the wire rods L1, L2 when the shaft 2 is bent.

[0043] The material of the sleeve 35 is not particularly limited, but for example, a metal coil tube or a PTFE (polytetrafluoroethylene) tube can be suitably used. When such a tube is used, the sliding resistance of the wires L1 and L2 can be suitably reduced. Furthermore, when a metal coil tube is used, it is even more effective in preventing kinking of the wires L1 and L2.

[0044] [Support Mechanism] Next, a support mechanism for the medical tubing 100 using the controller 3 will be described. The controller 3 comprises a proximal section 30 and a distal section 40. As described above, the proximal section 30 has a cylindrical section 31, and the base end of the medical tubing 100 is supported on this cylindrical section 31 via a shaft sleeve 50, which will be described later. The distal section 40 is provided at the housing tip section 13 of the housing 10 of the controller 3.

[0045] The distal portion 40 will be described in further detail. As shown in Figures 3 to 5, the housing tip portion 13 of the controller 3 has a notch on its underside, and includes a distal portion 40 that extends forward and downward from the front underside of the housing intermediate portion 12 and is bifurcated to sandwich an internal space 41, and an inclined surface 13a provided on the base end side of the distal portion 40. The left-right width of the distal portion 40 is sized to allow contact with the flange 104 of the medical tubing 100. The distal portion 40 forms a portion that is gripped by the user.

[0046] An inclined surface 13a is formed at the base end of the housing distal portion 13. This inclined surface 13a continues from the underside of the housing intermediate portion 12 and extends downward as it extends forward, reaching the underside of the distal portion 40. In other words, the inclined surface 13a is located distal to the proximal portion 30 in the first direction. A recessed space 10a is formed in the lower center of the housing 10, and is defined by the front surface of the housing proximal end portion 11, the underside of the housing intermediate portion 12, and the rear surface of the housing distal portion 13. This recessed space 10a is open downward and to the left and right of the housing 10, allowing the connection state of the medical tubing 100 to be visually observed from the left and right directions.

[0047] The proximal portion 30 and the distal portion 40 are positioned front to back with the recessed space 10a sandwiched between them. Furthermore, when the cylindrical portion 31 of the proximal portion 30 is oriented along the first direction, its internal space 31a and the internal space 41 of the distal portion 40 are positioned coaxially with the recessed space 10a sandwiched between them. Therefore, when the shaft 2 is supported by the proximal portion 30 and the distal portion 40, the base end of the shaft 2 (e.g., the connector 102) is housed in the recessed space 10a.

[0048] As shown in Figure 5, the base end of the shaft 2 is connected to the proximal portion 30. For example, the base end of the shaft 2 is fitted into and connected to the cylindrical portion 31 of the proximal portion 30. At this time, as described above, the first wire L1 and the second wire L2 extending from the inner cavity of the shaft 2 are wound around and locked onto the pulley 23 (see Figure 10). In addition, a shaft sleeve 50 is placed over the shaft 2. The shaft sleeve 50 has a flexible shaft cover 51 that covers the shaft 2 and a cover connection portion 52 that detachably connects the proximal portion of the shaft cover 51 to the operating device 3 (see also Figure 11).

[0049] The shaft cover 51 has a long, bag-like shape with a closed distal end and can accommodate almost the entire shaft 2. The thickness of such a shaft cover 51 is, for example, 0.05 mm to 0.3 mm, and more preferably 0.1 mm to 2.0 mm. The color may be colorless and transparent, colored and transparent, or opaque. Examples of materials include polyurethane (PU), polyvinyl chloride (PVC), polypropylene (PP), polyethylene (PE), various elastomers, and various silicone rubbers. However, the configuration and material of the shaft cover 51 are not limited to these.

[0050] As shown in Figures 2, 4, and 6, the cover connecting portion 52 is cylindrical and detachably attached to the operating device. Specifically, the cover connecting portion 52 has a base end 53, a flange 54, and a tip end 55. The base end 53 is cylindrical and has an inner diameter that engages with the outer diameter of the cylindrical portion 31 of the proximal portion 30. Therefore, the base end 53 can be press-fitted onto the cylindrical portion 31 of the proximal portion 30 with little force, making it detachable. In addition, a groove 53a that is recessed forward and extends in the left-right direction is formed on the base end surface of the base end 53 (see Figure 6). Therefore, when the base end 53 is fitted onto the cylindrical portion 31, the rotation shaft 33 of the proximal portion 30 fits into the groove 53a of the base end 53 from behind. This engagement between the groove 53a and the rotation shaft 33 suppresses rotation of the shaft sleeve 50 around its axis, thereby suppressing rotation of the medical tubing 100.

[0051] The tip portion 55 is located distal to the base end portion 53, with the flange 54 sandwiched therebetween. The tip portion 55 is cylindrical and has a tapered outer circumferential surface such that the outer diameter gradually decreases toward the distal side. That is, as shown in FIG. 4 , the outer circumferential surface of the tip portion 55 forms a truncated cone surface 55a. The base end of the shaft cover 51 is connected to the base end portion 53 by adhesive, thermal welding, or the like. The distal end (the most distal portion) of the tip portion 55 forms a truncated cone surface 55b that is even more inclined than the truncated cone surface 55a.

[0052] In the operating rod 1 according to this embodiment, the shaft 2 is covered with the above-described shaft sleeve 50, and then the medical tube 100 is attached. As shown in FIG. 1 , the medical tube 100 has a tube 101 and a connector 102. The tube 101 is a tubular member that forms the main body of the medical tube 100, and is configured with a length, diameter, material, and the like according to the intended use. When the medical tube 100 is a tracheal tube, the length of the tube 101 is shorter than the length of the shaft 2.

[0053] 3, the connector 102 has an integrally formed base end portion 103, a flange 104, and a tip end portion 105. The base end portion 103 is cylindrical and is fitted onto and connected to the cover connection portion 52 of the shaft sleeve 50. The tip end portion 55 of the cover connection portion 52 has a truncated conical surface 55a, so that the base end portion 103 of the connector 102 is stably connected to this truncated conical surface 55a.

[0054] A plate-shaped flange 104 is provided on the distal side of the base end portion 103. The flange 104 is configured to protrude from the outer surface of the base end portion 103 in the radially expanding direction. Meanwhile, as shown in Figure 2, a step portion 12c is formed in the lower part (above the recessed space 10a) of the housing intermediate portion 12 of the controller 3. The flange 104 is configured to abut against this step portion 12c, and the step portion 12c prevents (restricts) the connector 102 from moving proximally beyond the position where the flange 104 abuts.

[0055] The flange 104 has a generally vertically elongated shape, and as shown in FIG. 3 , the left and right portions of the disc member are cut out to form a vertically elongated shape (e.g., an oval shape). Therefore, the flange 104 can abut against the upper step 12c, but the left and right protrusions are small, so that the user does not feel uncomfortable when holding the controller 3. Therefore, when viewed along the first direction, the left and right edges 104a, 104a of the flange 104 are flush with the left and right side surfaces of the housing 10 of the controller 3 or are located inward from the left and right side surfaces. In other words, the left and right width dimensions of the flange 104 are equal to or smaller than the width dimension of the housing 10.

[0056] A tip portion 105 of the connector is provided on the distal side of the flange 104. The tip portion 105 has a cylindrical shape and is fitted into the tube 101 to be connected.

[0057] [Attachment and Detachment of Medical Tubing] The manner in which the medical tubing 100 is attached to and detached from the above-described operating rod 1 will be described with reference to FIG. 11 . First, the housing 10 of the operating rod 1 is disassembled into a left housing 10L and a right housing 10R. For example, the operating tool 24, rack 22, pulley 23, pinion 21, proximal portion 30, shaft 2, first wire L1, and second wire L2 are assembled to the left housing 10L. Then, the right housing 10R is connected to the left housing 10L. This completes the assembly of the above-described parts into the housing 10 (see "State (A)" in FIG. 11 ). The procedure for connecting the base ends of the first wire L1 and second wire L2 extending from within the shaft 2 to the pulley 23 has already been described.

[0058] Next, the shaft 2 of the operating rod 1 in state (A) is covered with the shaft sleeve 50. That is, the tip of the shaft 2 is inserted into the inner cavity of the cover connecting portion 52 of the shaft sleeve 50, and the cover connecting portion 52 is moved to the base end of the shaft 2, thereby covering the entire shaft 2 with the shaft cover 51. Then, the cover connecting portion 52 is fitted onto the proximal portion 30 of the operating device 3 and connected (see "state (B)" in FIG. 11 ).

[0059] As already explained, the proximal portion 30 is rotatable about the rotation axis 33, and specifically, the distal end is rotatable in the second direction, i.e., the vertical direction. Therefore, when the shaft sleeve 50 is fitted onto the shaft 2, by rotating the proximal portion 30 so that it faces downward, interference with the housing 10 (particularly the housing tip portion 13) can be avoided, improving workability.

[0060] Next, the medical tubing 100 is fitted onto the shaft 2 covered with the shaft sleeve 50. That is, the tip of the shaft 2 is inserted into the lumen of the connector 102 of the medical tubing 100, and the connector 102 is moved to the proximal end of the shaft 2 and fitted onto the tip end 55 of the cover connection portion 52 of the shaft sleeve 50. As a result, the shaft 2 covered with the shaft sleeve 50 is inserted into the medical tubing 100, and a predetermined distance is exposed from the distal end of the medical tubing 100 (see "State (C)" in Figure 11).

[0061] Since the shaft 2 is connected to the proximal portion 30, it can rotate in the second direction around the rotation axis 33. Therefore, when fitting the medical tubing 100, the shaft 2 can be rotated and moved away from the housing 10, thereby improving workability.

[0062] After medical tubing 100 is fitted onto shaft 2, medical tubing 100 (and shaft 2) is rotated upward around rotation axis 33, and the middle portion of tubing 101 is housed in internal space 41 of distal support portion 40. This completes the attachment of medical tubing 100 to operating rod 1.

[0063] Here, medical tubing 100 attached to operating rod 1 can rotate via rotation shaft 33, but the position can be stabilized by placing the underside of medical tubing 100 on a finger. Note that operating device 3 may be provided with a rotation restriction unit that restricts the rotation of medical tubing 100. For example, rotation may be restricted by sizing the inner surface of distal portion 40 so that it comes into contact with and interferes with the outer surface of medical tubing 100, or by providing convex or concave portions on the outer surface of rotation shaft 33 and the inner surface of housing 10 that houses rotation shaft 33, so that resistance is felt when rotating rotation shaft 33.

[0064] When operating the operating rod 1 in this manner, the user grips the housing tip portion 13 of the housing 10 with their fingers and operates the operation unit 26 with their fingertips. For example, the user grips the left and right side walls of the housing tip portion 13 with their thumb and middle finger and operates the operation unit 26 with their index finger. Furthermore, the medical tubing 100 is supported with their ring finger and little finger, and the operation unit 26 is operated with their index finger. As shown in FIG. 5 , the operation unit 26 of the operating rod 1 is located away from the proximal portion 30 and toward the distal portion 40 in the first direction, more specifically, between the proximal portion 30 and the distal portion 40. Therefore, for a user gripping the middle portion of the housing 10 as described above, operation of the operation unit 26 is easy and stable.

[0065] Next, to remove the medical tubing 100 from the operating rod 1, grasp the portion of the medical tubing 100 exposed distally beyond the housing 10 with one hand, and while grasping the housing 10 with the other hand, pull the medical tubing 100 straight out in the longitudinal direction of the tube 101 without rotating the medical tubing 100 relative to the housing 10. As the medical tubing 100 is being pulled out, the flange 104 abuts against the inclined surface 13a, causing the operating device 3 to naturally rotate upward via the rotation axis 33. Thereafter, by further pulling the medical tubing 100 in the longitudinal direction of the tube 101, it is completely removed from the shaft sleeve 50 and the operating device 3.

[0066] As another method for removing the medical tubing 100 from the operating rod 1, the medical tubing 100 may be rotated relative to the housing 10 and pulled in a direction that separates the tubing 101 from the operating device 3. In this way, the connector 102 comes out of the cover connecting portion 52, and the medical tubing 100 can be completely removed from the shaft sleeve 50 and the operating device 3.

[0067] In this way, the operating rod 1 of this embodiment can easily separate the operating rod 1 and the medical tube 100 by simply pulling the medical tube 100 in the longitudinal direction of the tube 101, by utilizing the inclined surface 13a formed on the housing 10.

[0068] The operating rod 1 of the first embodiment includes a detachable shaft sleeve 50. Therefore, after using the operating rod 1 in the intubation procedure of the medical tube 100, the operating rod 1 can be reused simply by replacing the shaft sleeve 50 with a new one. In other words, the effort of cleaning the entire operating rod 1 after each use can be eliminated. The shaft sleeve according to the present disclosure exhibits the desirable effect of facilitating the reuse of the operating rod as described above, but the operating rod combined with the shaft sleeve of the present disclosure to exhibit this effect is not limited to the operating rod having the configuration described in the present specification, and may be an operating rod with another configuration.

[0069] However, the operating rod 1 does not have to be provided with the shaft sleeve 50. In this case, the proximal portion 30 of the operating rod 1 may be configured to be connectable to the medical tube 100.

[0070] Second Embodiment An operating rod 1A according to a second embodiment has the configuration shown in FIGS. 12 and 13 as an example.

[0071] The operating rod 1A according to the present embodiment has the same configuration as the operating rod 1 according to the first embodiment, but is provided with a stopper 66 midway along the longitudinal direction of the shaft 2, which locks the base end of the medical tubing 100. This stopper 66 is cylindrical and is press-fit onto the shaft 2 within the recessed space 10a of the housing 10. The stopper 66 does not move relative to the shaft 2 in response to changes in the posture of the operating rod 1A, but is movable along the shaft 2 when a predetermined force is applied by the user. Such a stopper 66 is made of an elastic material such as rubber.

[0072] The operating rod 1A of the present embodiment also includes a shaft sleeve 60 similar to the shaft sleeve 50 of the operating rod 1 according to the first embodiment. The shaft sleeve 60 includes a shaft cover 61 and a cover connecting portion 62. Of these, the shaft cover 61 has the same configuration as the shaft cover 51 of the first embodiment. On the other hand, the cover connecting portion 62 has a flange 64 and a tip portion 65, but does not include a configuration corresponding to the base end portion 53 of the cover connecting portion 52 of the first embodiment. That is, the cover connecting portion 62 has a structure that engages with a stopper 66, and is detachably connected to the operating device 3.

[0073] In addition to having the same functions as the operating rod 1 of embodiment 1, this operating rod 1A also has the function of being able to accommodate medical tubing 100 of various lengths and appropriately support these medical tubing 100. That is, in the case of operating rod 1A, the user sets stopper 66 to an appropriate position on shaft 2 depending on the length of the medical tubing 100 being used. For example, if the medical tubing 100 is long, the user sets stopper 66 to a more proximal position, and if the medical tubing 100 is short, the user sets stopper 66 to a more distal position.

[0074] Next, the shaft sleeve 60 is placed over the shaft 2 so that the cover connecting portion 62 fits into the stopper 66. Note that one of the matching concave and convex portions is provided on the stopper 66 and the other is provided on the cover connecting portion 62 so that the stopper 66 and the cover connecting portion 62 can engage with each other. Then, the shaft 2 is passed through the lumen of the medical tubing 100 so that the connector 102 fits over the cover connecting portion 62 of the shaft sleeve 60, and the tubing 101 is housed in the internal space 41 of the distal portion 40. This completes the attachment of the medical tubing 100 to the operating rod 1A, and the medical tubing 101 is supported at an appropriate position according to its length.

[0075] (Embodiment 3) An operating rod 1B according to embodiment 3 has, as an example, the configuration shown in Figures 14 to 16. Note that in Figure 15, the connector 102 of the medical tubing 100 is not shown.

[0076] The operating rod 1B according to this embodiment has a configuration similar to that of the operating rod 1 according to embodiment 1, except that the transmission mechanism 20 composed of the pinion 21 and rack 22, the pulley 23, and the shaft sleeve 50 are omitted. Differences between the operating rod 1B and the operating rod 1 will be described in detail below.

[0077] 15, the operating rod 1B has a transmission unit 70 connected to the rear of the operating tool 24. The transmission unit 70 is housed within the housing base end 11, is a member extending rearward and downward from the rear lower surface of the operating tool 24, and has a locking portion 71 facing the proximal side of the proximal portion 30. This locking portion 71 locks the base end of a wire L3 extending proximally from the base end of the proximal portion 30. In the operating rod 1B, for example, one wire L3 is passed through the lumen of the shaft 2.

[0078] With this configuration, when the operating part 26 of the operating rod 1B is operated forward, the wire L3 is pushed out and the tip portion of the shaft 2 is bent downward, and when the operating part 26 is operated backward, the wire L3 is pulled and the tip portion of the shaft 2 is bent upward. In other words, by operating the operating part 26 back and forth by the user, the tip portion of the shaft 2 can be displaced in both directions in the second direction.

[0079] The housing base end 11 of the operating rod 1B also has a connector housing 72. Specifically, a recess with a circular cross section that opens toward the front recessed space 10a is formed in the front portion of the housing base end 11, and this recess forms the connector housing 72. At least a portion of the proximal portion 30 is located in the connector housing 72, and the connector 102 of the medical tubing 100 is fitted onto the outside of the proximal portion 30 within the connector housing 72 to be connected. At this time, the connector 102 is fitted into the connector housing 72.

[0080] With this configuration, the proximal portion of medical tubing 100 is supported by proximal section 30 and connector housing 72 relative to operating rod 1B, and the middle portion of tubing 101 is housed in internal space 41 of distal section 40. Note that proximal section 30 may be press-fitted into connector 102 of medical tubing 100, and in addition to this, or instead, connector housing 72 may be press-fitted into connector 102. This allows for more stable support of medical tubing 100 relative to operating rod 1B.

[0081] 15 , a sloped surface 72a that slopes downward as it extends forward is formed on the lower part of connector accommodating portion 72. This sloped surface 72a extends from a position midway along the depth dimension of connector accommodating portion 72 in the first direction (e.g., about halfway along the depth dimension) to the open end of connector accommodating portion 72, widening the opening of connector accommodating portion 72 in side view. Thus, connector accommodating portion 72 includes an expanded diameter portion 73 having sloped surface 72a and a constant diameter portion 74 that is proximal to expanded diameter portion 73.

[0082] This configuration makes it difficult for the medical tubing 100 to come off the operating rod 1B during the intubation procedure, and easy to remove after the intubation procedure is completed. That is, as shown in Figure 14, when the medical tubing 100 is properly attached to the operating rod 1B, the connector 102 is fitted onto the proximal portion 30 and also fitted into the fixed diameter portion 74 deep within the connector housing 72, thereby restricting rotation of the medical tubing 100 in the second direction. Therefore, the medical tubing 100 is difficult to detach from the distal portion 40.

[0083] In contrast, for example, after completing an intubation procedure, if the medical tubing 100 is slightly pulled forward from the operating device 3, the connector 102 will move out of the fixed diameter portion 74 and into the expanded diameter portion 73. This allows the connector 102 to rotate downward about the rotation axis 33, allowing the tubing 101 to be detached from the distal portion 40. Therefore, when it is desired to intentionally remove the medical tubing 100, the configuration allows for easy removal.

[0084] The operating rod 1B can be operated, for example, in the following manner. For example, the user holds the housing tip portion 13 between the thumb and middle finger, pinching it from the left and right. Then, the index finger is placed on the operating portion 26 from above and operated in a first direction (forward and backward). At this time, the area between the thumb and index finger (interdigital space) is placed against the medical tubing 100 from below at the middle portion of the housing 10 in the first direction. In this way, when operating the operating rod 1B, the user can grasp the operating rod 1B and the medical tubing 100 from the left and right and from above and below, allowing for stable operation.

[0085] Note that the same operation mode as that of the operating rod 1B can be achieved in the case of the operating rod 1 and operating rod 1A described above. The connector accommodating portion 72 described for the operating rod 1B can also be applied to the operating rod 1 and operating rod 1A. In the operating rod 1A, the shaft sleeve 60 is connected to the operating device 3 by being fixed to the stopper 66, but the shaft sleeve 60 may be directly fixed to the shaft 2 and connected to the operating device 3. Alternatively, the shaft sleeve 60 may be assembled to the medical tubing 100, and the shaft sleeve 60 may be connected to the operating device 3 by connecting the medical tubing 100 to the operating device 3.

[0086] (Embodiment 4) An operating rod 1C according to embodiment 4 has the configuration shown in Figures 17A and 17B as an example. Hereinafter, the differences between the operating rod 1C and the operating rod 1 described above will be described.

[0087] The operating rod 1C includes a shaft sleeve 80 having a shaft cover 81 and a cover connecting portion 82. Of these, the shaft cover 81 has the same configuration as the shaft cover 51 of the operating rod 1. On the other hand, the cover connecting portion 82 has a different configuration from the cover connecting portion 52 of the operating rod 1, and has a base end portion 83 and a tip end portion 84 that are coaxially aligned. The base end portion 83 has a function of connecting to a proximal portion 85 of the operating device 3, and is configured, for example, in a male threaded shape. That is, the base end portion 83 is cylindrical, and a thread 83a is formed on the outer circumferential surface thereof, running along the outer circumferential surface.

[0088] The distal end portion 84 functions to connect to the connector 102 of the medical tubing 100 and is configured with multiple ribs 84a on the outer circumferential surface of the cylindrical member. The ribs 84a extend along the axial direction and protrude in the radial expansion direction, with multiple ribs (six in the example of FIG. 17A ) provided circumferentially. The distal end portion 84 is made of a soft material such as rubber, and the ribs 84a in particular are made of a material that is elastic and relatively easily deformed. The end surface of each rib 84a in the radial expansion direction is inclined so that the distal portion is closer to the axis of the distal end portion 84 than the proximal portion. The connector 102 is fitted onto the distal end portion 84. The proximal end portion 83 is made of the same material as the distal end portion 84, and the proximal end portion 83 and the distal end portion 84 are integrally configured as a single part. However, this is not limited thereto, and the proximal end portion 83 and the distal end portion 84 may be made of different materials (for example, the proximal end portion 83 may be made of a harder material than the distal end portion 84).

[0089] The operator 3 of the operating rod 1C has a proximal portion 85. This proximal portion 85 has a different configuration from the proximal portion 30 of the operator 3 of the operating rod 1, and has a female-threaded configuration. That is, the proximal portion 85 is a member having a cylindrical internal space, and a thread 85a is formed on the inner circumferential surface thereof, running along the inner circumferential surface. A thread 83a on the base end portion 83 of the cover connecting portion 82 is threadedly engaged with the thread 85a on this proximal portion 85. Then, as shown in FIG. 17B , the threads 83a, 85a are threadedly engaged with each other, and the shaft sleeve 80 is connected to the operator 3.

[0090] In this type of operating rod 1C, the distal end portion 84 has multiple ribs 84a with inclined end surfaces as described above, and is made of a soft material. Therefore, various medical tubing 100 with different dimensions can be appropriately attached and stably held. Furthermore, the base end portion 83 and the proximal portion 85 are configured to be threaded together. Therefore, the operation (rotation operation) for separating the proximal end portion 83 and the proximal portion 85 is different from the operation (pulling operation) for separating the distal end portion 84 and the connector 102, which prevents the shaft sleeve 80 from unintentionally coming loose when removing the medical tubing 100.

[0091] (Operations and Effects) From the above description of the embodiments, the following technical concepts are disclosed.

[0092] The operating rod according to technical concept 1 comprises a shaft whose shape can be changed to bend in a direction intersecting the longitudinal direction, and an operating device that accepts operations to change the shape of the shaft. The operating device has at least one wire that is inserted into the shaft and extends from the base end of the shaft and bends the shaft when pulled, a pulley that engages the base end of the wire and winds up the wire, an operating tool having an operating unit located distally from the pulley, and a transmission mechanism including a rack and pinion that transmits input to the operating unit to the pulley.

[0093] This allows the operating unit to be operated with good transmission in the distal and proximal directions while holding the operating device. In other words, without a transmission mechanism including a rack and pinion, the transmission of the operating force when deforming the shaft in a specific direction (e.g., the direction opposite to the bending direction shown in Figure 3 of Patent Document 1) is poor. Furthermore, the actual deformation of the shaft does not match the user's intended operation, resulting in poor operability. In contrast, the operating rod disclosed herein is equipped with the above-described transmission mechanism. Therefore, the shaft can be deformed in one or the other of the intersecting directions more accurately according to the practitioner's intention.

[0094] Furthermore, since the operating unit is located distally from the pulley (i.e., close to the tip of the shaft), shaking of the operating rod during operation can be suppressed. Conversely, if the operating unit is operated at a position far away from the tip of the shaft, even if the shaking of the hand during operation is small, it may be amplified as it travels along the shaft, causing significant shaking of the shaft tip. In contrast, the present disclosure allows operation at a position closer to the tip of the shaft, thereby reducing the impact of shaking of the hand during operation on shaking of the shaft tip. Furthermore, since the deforming tip of the shaft is located closer to the operating hand, it is easy to grasp visually and allows operation in a natural posture. Therefore, for example, it is easy to hold and operate the operating device with one hand while operating another tool with the other hand.

[0095] In order for the medical rod according to the present disclosure to achieve the aforementioned effect of improved operability, it is sufficient to have at least the configuration described in Technical Concept 1. Therefore, it should be noted that the configurations according to the other technical concepts described below and further configurations are optional configurations that may or may not be added to the operating rod of Technical Concept 1, that is, they are not required configurations. Furthermore, the configurations included in any one of the technical concepts described below are required configurations only to achieve the corresponding effect described therein. Therefore, it should be noted that the configurations according to any other technical concept are not required to achieve the effect described therein.

[0096] An operating rod according to technical idea 2 may be configured such that, in technical idea 1, the operating device has a proximal portion that supports the base end of the tube into which the shaft is inserted, and the operating portion is located at a position away from the proximal portion in a first direction along the shaft.

[0097] This allows the operating rod to be operated while stably supporting the tube, allowing for stable and easy tube intubation procedures. In other words, because the tube is stably supported by the proximal portion, the user can perform the intubation procedure by grasping only the operating device. The proximal portion may have a tubular portion that is inserted into the base end of the tube, and the outer surface of this tubular portion may be configured to engage with the inner surface of the base end of the tube. Furthermore, since the operating portion is located distal to the proximal portion, the tube can be advanced without changing the grip position relative to the operating device during operation, resulting in good operability.

[0098] The operating rod according to Technical Idea 3 may be the same as Technical Idea 1, in which the wire has a first wire that is engaged with the pulley and wound up as the pulley rotates in one direction, and a second wire that is engaged with the pulley and wound up as the pulley rotates in the other direction.

[0099] The operating rod according to Technical Idea 4 may be such that, in Technical Idea 2, the operating tool has an operating tool body that is rod-shaped and long in the first direction, the operating section is provided at a distal portion of the operating tool body in the first direction, the rack is provided at a proximal portion of the operating tool body in the first direction, the pinion is provided coaxially with the pulley, and the rack and pinion are meshed with each other.

[0100] An operating rod according to technical idea 5 is similar to technical idea 1 in that the operating device has a proximal portion that supports the base end of the tube into which the shaft is inserted, and a distal portion that is located away from the proximal portion in a first direction distal to the proximal portion and supports an intermediate portion of the shaft, and the operating portion may be positioned in a direction that approaches the distal portion relative to the proximal portion in the first direction.

[0101] As a result, the proximal portion supports the base end of the shaft, and the distal portion also supports the middle portion in the longitudinal direction. Therefore, the shaft can be stably supported, improving operability. Furthermore, by providing the operating unit spaced apart from the proximal portion in the first direction, the operating unit can be positioned closer to the shaft while avoiding interference with the proximal portion. Therefore, operability is further improved.

[0102] An operating rod according to Technical Concept 6 is based on Technical Concept 5, and the operating portion may be located between the proximal portion and the distal portion. This allows the position at which the user's operating force acts on the operating portion to be located between the proximal portion and the distal portion, thereby improving the stability of operation.

[0103] The operating rod according to technical concept 7 comprises a shaft whose shape can be changed to bend in a direction intersecting the longitudinal direction, and an operating device that accepts operations to change the shape of the shaft, the operating device having a proximal portion that supports the base end of a tube into which the shaft is inserted, and the proximal portion is rotatable in a second direction intersecting a first direction along the shaft.

[0104] An operating rod according to technical idea 8 may be the same as technical idea 7, in which the operating device has an inclined surface on the distal side in the first direction relative to the proximal portion, which slopes toward one side of the second direction as it moves toward the distal side.

[0105] The operating rod according to technical concept 9 comprises a shaft whose shape can be changed so as to bend in a direction intersecting the longitudinal direction, and an operating device that accepts operations to change the shape of the shaft, the operating device having a proximal portion that supports the base end of a tube into which the shaft is inserted, and a distal portion that is positioned away from the proximal portion in a first direction and supports an intermediate portion of the shaft, and the proximal portion is rotatable in a second direction intersecting the first direction.

[0106] This allows the shaft to be stably supported at the proximal and distal portions. Furthermore, in a configuration in which the shaft is supported at the proximal and distal portions, the proximal portion is rotatable, so the shaft can be easily attached to and detached from the operating device while avoiding interference with the distal portion.

[0107] An operating rod according to Technical Concept 10 is Technical Concept 9, wherein the operating device has a recessed space between the proximal portion and the distal portion, the recessed space opening toward one side in the second direction and accommodating the base end of the shaft, and a wall surface defining the distal side of the recessed space may form an inclined surface that slopes toward one side in the second direction as it approaches the distal side. As a result, when the shaft is pulled out of the operating device, the base end of the shaft is guided along the inclined surface, causing the proximal portion to automatically rotate. This makes it easy to pull out the shaft.

[0108] The operating rod according to technical concept 11 may include a shaft whose shape can be changed to bend in a direction intersecting the longitudinal direction, an operating device that accepts operations to change the shape of the shaft, a flexible shaft cover that covers the shaft, and a shaft sleeve having a cover connection portion that detachably connects the proximal portion of the shaft cover to the operating device.

[0109] This allows the shaft sleeve to be discarded and replaced with a new one after one treatment using the operating rod, making it possible to perform the next treatment. In other words, there is no need to wash the entire operating rod every time a treatment is performed, improving usability.

[0110] The operating rod according to Technical Concept 12 is based on Technical Concept 11, and the cover connection portion may be cylindrical and have a truncated cone shape such that the outer diameter of the distal end decreases toward the distal side.

[0111] As a result, when the operating rod is used as a stylet and the shaft is inserted into a tracheal tube, the distal end, which is shaped like a truncated cone at the cover connection part, fits inside various tracheal tubes with different inner diameters, making it possible to use a single operating rod for intubation procedures using various tracheal tubes with different inner diameters.

[0112] The operating rod according to Technical Concept 13 may be any one of the technical concepts described above, and may have a cylindrical stopper that is press-fitted onto the shaft and locks the base end of the tracheal tube. This allows various tracheal tubes of different lengths to be locked by the stopper, whose position on the shaft is appropriately adjusted. Therefore, one operating rod can be used for intubation procedures using various tracheal tubes of different lengths.

[0113] (Other) For example, the cover connection portion has a cylindrical shape that covers the proximal portion, and its distal end has a truncated cone shape (see FIG. 4). Meanwhile, the portion of the cover connection portion proximal to the distal end has a tapered outer circumferential surface that is less inclined than the distal end, and the distal end has a truncated cone surface with an outer diameter slightly smaller than the base end. As a result, when the tube (or connector) is fitted onto the cover connection portion, the cover connection portion is press-fitted onto the tube (or connector), generating an appropriate frictional force (sliding resistance) between the contact surfaces of the two.

[0114] Therefore, for example, when the operating device is rotated to change the orientation around the shaft's axis, the tube does not spin freely relative to the shaft but rather follows and turns smoothly, resulting in good operability. Furthermore, the tube and operating rod are pushed and pulled toward a desired position inside the patient's body, and the presence of the above-mentioned frictional force improves the tube's ability to follow the shaft during a pulling operation. In addition to the sliding resistance between the tube and the cover connection portion, the ability of the tube to follow the shaft during a pulling operation can also be improved by appropriately setting the sliding resistance at the contact point between the distal portion and the shaft.

[0115] Furthermore, sliding resistance also occurs between the outer surface of the shaft and the inner surface of the tube, and if this sliding resistance is increased to improve compliance during the pulling operation, it may become difficult to pull the tube out of the shaft after the intubation procedure is completed.In contrast, if the outer surface of the main body of the cover connection part is tapered, the frictional force generated can be easily adjusted by setting the inclined surface, and difficulty in pulling out can be avoided.

[0116] However, the above-described configuration of the cover connecting portion is merely an example and is not limiting. For example, the cover connecting portion may not have a configuration that is press-fitted into the tube (or connector), but may instead have a flange that abuts against the proximal end surface of the tube (or connector). Even with such a configuration, operational stability is ensured when advancing the operating rod distally. Furthermore, the above-described configuration and effects of the cover connecting portion also apply to the proximal portion and the stopper shown in Technical Concept 13.

[0117] Furthermore, the stopper of Technical Concept 13 may have an adjustable fixed position relative to the operating device. For example, in the case of a stopper fitted onto the shaft as shown in Figures 12 and 13, the stopper may be configured so that its fixed position in the axial direction relative to the shaft is adjustable. Specifically, at least a part or the entire part of the stopper that comes into contact with the shaft is made of an elastic material such as rubber, and is configured so that a predetermined sliding resistance occurs between the contact surfaces of the stopper and the shaft.

[0118] This allows the user to change the position of the stopper relative to the shaft. Furthermore, by making the sliding resistance between the stopper and the shaft greater than the sliding resistance between the shaft and the tube, the stopper can be prevented from moving when the tube is removed from the shaft, and the stopper can be maintained in the desired position. Furthermore, if the outer peripheral surface of the stopper is tapered, as in the cover connection portion described above, the sliding resistance increases depending on the insertion length of the stopper relative to the tube. In this case, if the sliding resistance becomes excessively large, it becomes difficult to remove the tube from the shaft. Therefore, to prevent the sliding resistance from becoming excessively large, the stopper may be provided with a flange extending in the radial direction from the outer peripheral surface, so that the base end surface of the tube contacts the flange, thereby restricting the insertion length from becoming excessively long.

[0119] The present disclosure can be suitably applied to operating rods and shaft sleeves for medical use.

[0120] REFERENCE SIGNS LIST 1, 1A, 1B, 1C Operating rod 2 Shaft 3 Operating device 10 Housing 10a Recessed space 13a Inclined surface 20 Transmission mechanism 21 Pinion 22 Rack 23 Pulley 24 Operating tool 25 Operating tool body 26 Operating section 30 Proximal section 40 Distal section 50 Shaft sleeve 51 Shaft cover 52 Cover connection section L1, L2, L3 Wire rod

Claims

1. A medical operating rod comprising: a shaft whose shape can be changed so that it can be bent in a direction intersecting the longitudinal direction; and an operating device that accepts operations to change the shape of the shaft, wherein the operating device has: at least one wire that is inserted inside the shaft and extends from the base end of the shaft and bends the shaft when pulled; a pulley that engages the base end of the wire and winds it up; an operating tool having an operating unit located distally from the pulley; and a transmission mechanism including a rack and pinion that transmits input to the operating unit to the pulley.

2. A medical operating rod as described in claim 1, wherein the operating device has a proximal portion that supports the base end of a tube into which the shaft is inserted, and the operating portion is provided at a position away from the proximal portion in a first direction along the shaft.

3. A medical operating rod as described in claim 1, wherein the wire comprises a first wire that is engaged with the pulley and wound up as the pulley rotates in one direction, and a second wire that is engaged with the pulley and wound up as the pulley rotates in the other direction.

4. A medical operating rod as described in claim 2, wherein the operating tool has an operating tool body that is rod-shaped and long in the first direction, the operating section is provided on a distal portion of the operating tool body in the first direction, the rack is provided on a proximal portion of the operating tool body in the first direction, the pinion is provided coaxially with the pulley, and the rack and pinion are engaged with each other.

5. A medical operating rod comprising: a shaft whose shape can be changed so as to bend in a direction intersecting the longitudinal direction; and an operating device that accepts operations to change the shape of the shaft, wherein the operating device has a proximal portion that supports the base end of a tube into which the shaft is inserted, and the proximal portion is rotatable in a second direction intersecting a first direction along the shaft.

6. A medical operating rod according to claim 5, wherein the operating device has an inclined surface on the distal side in the first direction relative to the proximal portion, which inclines toward one side in the second direction as it moves toward the distal side.

7. A medical operating rod comprising: a shaft whose shape is variable so as to bend in a direction intersecting the longitudinal direction; an operating device that accepts operations to change the shape of the shaft; and a shaft sleeve having a flexible shaft cover that covers the shaft and a cover connection portion that detachably connects a proximal portion of the shaft cover to the operating device.

8. A shaft sleeve for covering the shaft of a medical operating rod having a shaft whose shape is variable so as to bend in a direction intersecting the longitudinal direction, and an operating device that accepts operations to change the shape of the shaft, the shaft sleeve comprising: a flexible shaft cover that covers the shaft; and a cover connection portion that detachably connects a proximal portion of the shaft cover to the operating device.

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