WO2023112412A1 - Catheter handle and catheter equipped with same - Google Patents

Catheter handle and catheter equipped with same Download PDF

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Publication number
WO2023112412A1
WO2023112412A1 PCT/JP2022/034434 JP2022034434W WO2023112412A1 WO 2023112412 A1 WO2023112412 A1 WO 2023112412A1 JP 2022034434 W JP2022034434 W JP 2022034434W WO 2023112412 A1 WO2023112412 A1 WO 2023112412A1
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WO
WIPO (PCT)
Prior art keywords
engaging portion
handle
slider
catheter
axial direction
Prior art date
Application number
PCT/JP2022/034434
Other languages
French (fr)
Japanese (ja)
Inventor
卓弥 金子
Original Assignee
株式会社カネカ
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 株式会社カネカ filed Critical 株式会社カネカ
Publication of WO2023112412A1 publication Critical patent/WO2023112412A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices

Definitions

  • the present invention relates to a handle used for a catheter and a catheter having the same.
  • a catheter usually consists of a tube for insertion into body cavities such as blood vessels, digestive tracts, and ureters, and a handle provided on the proximal side of the tube.
  • Catheters are known that are constructed such that the distal end of the tube can be bent by operating a handle on the proximal side.
  • Such a catheter has a wire in the lumen of a tube, a distal end of the wire fixed to the distal end of the tube, and a proximal end of the wire connected to a handle that can be manipulated. allows the distal end of the tube to bend.
  • one of the two wires is pulled proximally by manipulating the handle to bend the distal end of the tube to one side.
  • the distal end of the tube can be bent to the other side by pulling the other.
  • a slide assembly configured to translate linearly and a control knob rotatably mounted relative to the housing, the proximal ends of the two control wires being disposed within the housing;
  • the slide assembly is configured to independently manipulate each of the two control wires by linearly translating the control knob, and rotating the control knob in a first rotational direction causes the slide assembly to be displaced distally. to tension one of the two control wires, thereby deflecting the catheter in a first deflection direction and rotating the control knob in a second rotational direction, thereby displacing the sliding assembly proximally.
  • a catheter handle is disclosed that is configured to apply tension to the other of two control wires, thereby deflecting the catheter in a second deflection direction.
  • US Pat. No. 5,300,000 discloses a catheter handle for deflecting a distal portion of a catheter, comprising a first rotating member having a first diameter and to which a first wire is coupled; a second rotatable member having a second diameter and to which a second wire is coupled, the second rotatable member having a center point of the second rotatable member
  • the first and second rotatable members are coupled to the first rotatable member so as to be offset from each other such that rotation of the first rotatable member via the first wire is coupled to the second rotatable member and the second wire.
  • a catheter handle is disclosed that is configured to rotate the to deflect the distal portion of the catheter.
  • an object of the present invention is to provide a catheter handle with a novel structure and a catheter having the same.
  • the present invention includes catheter handles and catheters described below.
  • a handle for manipulating a tube of a catheter a handle body having an axially extending lumen; and a shaft disposed in the lumen of the handle body and extending axially and fixed to the handle body.
  • a slider disposed outside the shaft, having a spirally extending first engaging portion on its outer surface, and displaceable along the shaft in the axial direction; rotating about the axial direction with respect to the handle body; a rotatable knob having a second engaging portion on its inner surface that engages the first engaging portion of the slider; a first portion having a first end and a second end, the first portion including the first end; a second portion including two ends and an intermediate portion between the first and second portions, the first portion and the second portion being disposed within the lumen of the tube and the intermediate portion being within the lumen of the handle body; a linear member disposed; and a reversal guide disposed in the lumen of the handle body and in contact with at least a part of the intermediate portion of the linear member; the linear member is in contact with the reversal guide of the linear member
  • a catheter handle fixed to the slider at a portion closer to the first end than the abutment portion.
  • a fifth engaging portion is provided on the inner surface of the slider, and a sixth engaging portion that engages with the fifth engaging portion is provided on the outer surface of the shaft.
  • the catheter handle according to any one of [1] to [5], at least one of which extends axially.
  • a catheter having a catheter handle according to any one of [1] to [6] and a tube provided on the distal side of the catheter handle.
  • the tube provided on the distal side of the catheter handle can be operated by rotating the rotation knob.
  • FIG. 1 depicts a general view of a catheter with a catheter handle.
  • 2 shows a plan view of the internal structure of a catheter handle provided on the catheter shown in FIG. 1;
  • FIG. Fig. 3 shows a plan view of the internal structure of the catheter handle shown in Fig. 2 with the slider partially cut away along the axial direction;
  • 3 is a plan view of the inner structure of the catheter handle shown in FIG. 2 with the slider and shaft removed;
  • FIG. Figure 3 shows a VV cross-sectional view of the catheter handle shown in Figure 2;
  • a catheter 21 has a catheter handle 1 (hereinafter sometimes referred to as "handle 1") and a tube 22 provided on the distal side of the handle 1. As shown in FIG.
  • the catheter 21 is used for treatment or examination by, for example, inserting the tube 22 into a body cavity such as a patient's blood vessel or gastrointestinal tract.
  • the proximal side of the catheter refers to the direction toward the hand side of the user with respect to the extending direction of the catheter
  • the distal side refers to the direction opposite to the proximal side, that is, the direction to the treatment target side.
  • the tube 22 has a flexible tubular structure, and is made of, for example, polyolefin resin (eg, polyethylene or polypropylene), polyamide resin (eg, nylon), polyester resin (eg, PET), aromatic polyether ketone. Constructed from synthetic resins such as resins (e.g. PEEK), polyether polyamide resins, polyurethane resins, polyimide resins, fluorine resins (e.g. PTFE, PFA, ETFE), and metals such as stainless steel, carbon steel, and nickel-titanium alloys. be able to. A metal material can also be used as a metal wire embedded in a synthetic resin tube.
  • polyolefin resin eg, polyethylene or polypropylene
  • polyamide resin eg, nylon
  • polyester resin eg, PET
  • aromatic polyether ketone Constructed from synthetic resins such as resins (e.g. PEEK), polyether polyamide resins, polyurethane resins, polyimide resins
  • the length of the tube 22 in the axial direction (perpendicular direction) is about several times to several tens of times longer than the length of the handle 1 in the same direction, for example, about 500 mm to 1200 mm.
  • the outer diameter of the tube 22 may be, for example, approximately 0.6 mm to 5 mm.
  • the tube 22 has a lumen, and may be either a single lumen structure having one internal lumen or a multi-lumen structure having a plurality of internal lumens. Tube 22 may have a coaxial structure with multiple coaxial lumens.
  • a wire for manipulating the tube 22 is disposed in the lumen of the tube 22 . Wires are provided, for example, to control bending of the distal end of tube 22 . In this case, the distal end of the wire is preferably fixed to the distal end of tube 22 , eg, the distal third of tube 22 .
  • a lead wire, an optical fiber, an endoscope, or the like may be arranged in the lumen of the tube 22, and a lumen for inserting a guide wire or another treatment tool may be provided. A lumen may be provided for fluid communication.
  • the handle 1 is provided on the proximal side of the tube 22, and the proximal end of the wire placed in the lumen of the tube 22 is connected to the handle 1 when assembled as a catheter.
  • FIG. 2 is a plan view of the internal structure of the catheter handle provided on the catheter shown in FIG. 1, and FIG. 3 is the internal structure of the catheter handle shown in FIG.
  • FIG. 4 shows a plan view with a part cut away
  • FIG. 4 shows a plan view of the internal structure of the catheter handle shown in FIG. 2 with the slider and shaft removed
  • FIG. 2 shows a plan view of the catheter handle in which the handle body and the rotation knob, which serve as a housing for the catheter handle, are cut along the axial direction so that the internal structure can be seen.
  • the cut away portion of the handle body in FIG. 2 is shown in dashed lines.
  • a handle 1 comprises a handle body 2 having a bore extending in the axial direction x, and a shaft disposed in the bore of the handle body 2 and extending in the axial direction x and fixed to the handle body 2.
  • 3 and a first engaging portion 11 which is a bore of the handle body 2 and is disposed outside the shaft 3 and extends in a spiral shape on the outer surface, and is displaceable along the shaft 3 in the axial direction x.
  • a rotary knob 5 which is rotatable about the axial direction x with respect to the handle body 2 and has a second engaging portion 12 which engages with the first engaging portion 11 of the slider 4 on its inner surface.
  • the axial direction x corresponds to the direction in which the rotation axis of the rotary knob 5 extends, and the proximal side and the distal side are defined as one side and the other side with respect to the axial direction x.
  • a radial direction is defined as a direction perpendicular to the axial direction x.
  • the handle body 2 has a bore extending in the axial direction x (see FIG. 4).
  • the lumen of the handle body 2 preferably has a cylindrically formed portion centered on the axial direction x, and the rotary knob 5 is preferably arranged in the cylindrically formed portion of the lumen. .
  • the rotary knob 5 is provided rotatably about the axial direction x with respect to the handle body 2 .
  • the rotation knob 5 is preferably arranged in at least part of the lumen of the handle body 2 and preferably only partly in the lumen of the handle body 2 with respect to the axial direction x.
  • the rotary knob 5 preferably has a bore extending in the axial direction x and forms an internal space of the handle 1 together with the bore of the handle body 2 .
  • the bore of the rotary knob 5 preferably has a cylindrical portion centered on the axial direction x.
  • the lumen of the rotary knob 5 communicates with the lumen of the handle body 2 in the axial direction x, and the lumen of the rotary knob 5 and the lumen of the handle body 2 integrally form the inner space of the handle 1, It is preferable that the shaft 3 and the slider 4 are arranged in the space.
  • the handle body 2 is formed open on at least one of the distal side and the proximal side, and the rotary knob 5 is inserted from the distal side or the distal side of the handle body 2 formed open, and the rotary knob 5 is connected to the handle. It is preferably located in the lumen of body 2 . On the other hand, it is preferable that the rotary knob 5 is inserted into the handle body 2 and formed open on the proximal side or the distal side located in the lumen of the handle body 2 . As a result, the internal space of the handle 1 is integrally formed from the internal cavity of the handle body 2 and the internal cavity of the rotary knob 5 .
  • the distal side of the handle body 2 is formed open, the proximal side of the rotation knob 5 is formed open, and the rotation knob 5 extends from the distal side of the handle body 2 to the lumen of the handle body 2 .
  • the handle 1 has a handle body 2 and a rotating knob 5 exposed to the outside. For example, one hand holds the handle body 2 and the other hand holds the rotating knob 5 and rotates the handle body 2.
  • the handle 1 can be operated by pressing the
  • a shaft 3 is arranged in the bore of the handle body 2 so as to extend in the axial direction x (see FIG. 3).
  • the shaft 3 is fixed to the handle body 2 and provided so as not to rotate or move with respect to the handle body 2 .
  • the shaft 3 may be formed integrally with the handle body 2 .
  • the shaft 3 is preferably arranged at a position that serves as the rotation axis of the rotary knob 5 .
  • the shaft 3 is preferably provided from the lumen of the handle body 2 to the lumen of the rotation knob 5, and may be provided so as to extend distally and/or proximally beyond the handle body 2 and the rotation knob 5. good.
  • a tube 22 is preferably connected to the distal side of the shaft 3 .
  • the connection between the shaft 3 and the tube 22 may be in the interior space of the handle 1, distal to the interior space of the handle 1, or outside the handle 1.
  • the shaft 3 can also be formed integrally with the tube 22 .
  • the shaft 3 may be solid or hollow. It is preferable that the shaft 3 is hollow and the lumen of the shaft 3 communicates with the lumen of the tube 22 . As a result, it is possible to deliver the treatment tool from the proximal side of the catheter 21 to the treatment target part, or inject the medicine or the contrast medium through the lumen of the shaft 3 and the lumen of the tube 22 .
  • Treatment instruments include electrode catheters, ablation catheters, mapping catheters, balloon catheters, microcatheters, forceps, laser probes, fiberscopes, high-frequency treatment instruments, electrohydraulic impact crushing probes, and the like.
  • the shaft 3 preferably has a proximal side opening on the outside of the handle 1 in order to allow insertion of such a treatment instrument.
  • the shaft 3 may have a branched portion, and the branched portion of the shaft 3 may be provided with a switching cock.
  • a switching cock As a result, for example, an insertion port for a treatment instrument and an injection port for a drug or the like can be provided separately.
  • a slider 4 is arranged outside the shaft 3 .
  • the slider 4 is arranged in the inner space of the handle 1 and extends from the inner bore of the handle body 2 to the inner bore of the rotary knob 5 (see FIGS. 2 and 3).
  • the slider 4 is arranged radially outwardly of the shaft 3. Accordingly, the slider 4 is provided with a through hole extending in the axial direction x and passing through the slider 4 in the axial direction x. It is preferable that the shaft 3 is inserted through.
  • the slider 4 is provided so as to be displaceable in the axial direction x along the shaft 3, that is, provided so as to be movable in the internal space of the handle 1 in the axial direction x. Therefore, the length of the slider 4 in the axial direction x is preferably shorter than the length of the shaft 3 in the inner space of the handle 1 in the axial direction x. It is preferably formed shorter than the length.
  • the slider 4 is formed to be displaced in the axial direction x by rotating the rotary knob 5 around the axial direction x.
  • a first engaging portion 11 extending spirally is formed on the outer surface of the slider 4
  • a second engaging portion 12 that engages with the first engaging portion 11 is formed on the inner surface of the rotary knob 5 .
  • the first engaging portion 11 is formed so as to extend spirally on the outer surface of the slider 4, that is, on the outer surface of the slider 4 in the radial direction. Specifically, the first engaging portion 11 is formed on the outer surface of the slider 4 so as to extend spirally around the axial direction x of the handle 1. Preferably, the first engaging portion 11 is formed on the outer surface of the slider 4 formed in a cylindrical shape. It is formed. The first engaging portion 11 may be formed continuously or intermittently. The first engaging portion 11 may be formed in a clockwise spiral shape or a counterclockwise spiral shape from the proximal side to the distal side.
  • the second engaging portion 12 is formed on the inner surface of the rotary knob 5, that is, on the radially inner surface of the rotary knob 5 so as to be able to engage with the first engaging portion 11 (see FIGS. 3 and 4). reference).
  • the second engaging portion 12 is formed to extend spirally on the inner surface of the rotary knob 5 , and more specifically, is formed to extend spirally about the axial direction x of the handle 1 .
  • the second engaging portion 12 is preferably formed on the inner surface of the cylindrical rotary knob 5 .
  • the second engaging portion 12 may be formed continuously or intermittently.
  • the rotary knob 5 is rotated about the axial direction x.
  • the slider 4 can be moved in the axial direction x in the interior space of the handle 1 . That is, the rotational movement of the rotary knob 5 about the axial direction x is converted into parallel movement of the slider 4 in the axial direction x by the spirally formed first engaging portion 11 and the second engaging portion 12. be able to.
  • the first engaging portion 11 and the second engaging portion 12 may be formed so as to extend continuously or intermittently in a spiral shape for one or more turns, or may be formed so as to extend less than one turn. At least one of the first engaging portion 11 and the second engaging portion 12 is preferably formed so as to extend continuously or intermittently in a spiral shape so as to extend one or more turns, and is formed so as to extend two or more turns. More preferably, it is formed so as to extend three or more turns. On the other hand, the other of the first engaging portion 11 and the second engaging portion 12 may be formed continuously or intermittently so as to extend less than one turn in a spiral shape.
  • the first engaging portion 11 provided on the slider 4 is formed so as to extend spirally for one or more turns, and the second engaging portion 12 provided on the rotary knob 5 is formed in a spiral manner. It is formed so as to extend less than one round in a shape.
  • the first engaging portion 11 and the second engaging portion 12 can be formed by combining projections and grooves. That is, it is preferable that one of the first engaging portion 11 and the second engaging portion 12 is a protrusion and the other is a groove.
  • the groove is preferably formed so as to extend continuously in a spiral shape.
  • the groove may be a bottomed groove or a through groove, but from the point of ensuring the strength of the slider 4 or the rotary knob 5, the groove is preferably a bottomed groove.
  • the convex portion may be provided in a spiral shape extending continuously or may be provided in a spiral shape extending intermittently. good too.
  • the first engaging portion 11 provided on the slider 4 is formed as a protrusion (projection)
  • the second engaging portion 12 provided on the rotary knob 5 is formed as a groove.
  • a linear member 7 is provided that bends on the proximal side and has both ends extending distally (see FIG. 3). Both ends of the linear member 7 extending distally are arranged in the lumen of the tube 22 .
  • the linear member 7 has a first end as one end and a second end as the other end.
  • the portion including the second portion 7B is defined as the intermediate portion 7C, and the portion between the first portion 7A and the second portion 7B is defined.
  • the first end and the second end are defined as one end and the other end when the linear member 7 is straightened.
  • the linear member 7 is bent at the intermediate portion 7C so that at least a portion of the intermediate portion 7C including the bent portion is arranged in the lumen of the handle body 2, and at least a portion of the first portion 7A and the second portion 7B are arranged. It is placed in the lumen of tube 22 .
  • the linear member 7 serves as a wire for controlling the tube 22 with the first portion 7A and the second portion 7B.
  • the distal end of the first portion 7A, i.e. the portion near and including the first end, and the distal end of the second portion 7B, i.e. the portion near and including the second end, are connected to the distal end of the tube 22. It is preferably fixed. In this case, by operating the handle 1 and pulling the first portion 7A proximally, the distal end of the tube 22 can be bent in one direction, and the second portion 7B can be pulled proximally. allows the distal end of tube 22 to bend to the other side.
  • the distal end of the first portion 7A can be defined, for example, as a portion within 100 mm proximally from the first end of the first portion 7A
  • the distal end of the second portion 7B can be defined, for example, as the second It can be defined as the portion within 100 mm proximally from the second end of portion 7B
  • the distal end of tube 22 can be defined, for example, as a portion within 100 mm proximally from the distal end of tube 22 .
  • the linear member 7 extends outward from the lumen of the shaft 3 or tube 22 in the interior space of the handle 1 , and the intermediate portion 7C of the linear member 7 extends from the lumen of the rotary knob 5 to the interior of the handle body 2 . It preferably extends through the cavity.
  • the linear member 7 is preferably arranged in a bore of the slider 4, that is, a through hole extending in the axial direction x.
  • a gap extending in the axial direction x (a gap penetrating the slider 4 in the axial direction x) is formed between the inner surface of the through hole of the slider 4 and the shaft 3, and the linear member 7 is arranged in the gap. is preferred.
  • a reversal guide 8 for guiding bending of the intermediate portion 7C of the linear member 7 is provided in the lumen of the handle body 2, and at least a part of the intermediate portion 7C of the linear member 7 contacts the reversal guide 8. in contact with
  • the reversing guide 8 is fixed to the handle body 2 and provided so as not to rotate or move with respect to the handle body 2 .
  • the reversing guide 8 may be formed integrally with the handle body 2 .
  • the reversing guide 8 is provided at a position overlapping the slider 4 with respect to the axial direction x, or provided on the proximal side of the slider 4 . More preferably, it is provided closer to the proximal side than the slider 4 when the slider 4 is located at the most proximal side.
  • the reverse guide 8 is provided with a guide passage for making a U-turn of the linear member 7 to the distal side, and the linear member 7 abuts against the guide passage.
  • the guide passage is preferably formed in a U shape or an arc shape (for example, a semicircular shape) that protrudes toward the proximal side in plan view along the axial direction x.
  • the guide passage is preferably formed as a tubular passage, and the intermediate portion 7C of the linear member 7 is preferably inserted through the lumen of the tubular passage.
  • the linear member 7 has a portion on the first end side (the first portion 7A side) of the reversing guide 8 and a portion on the second end side (the second portion 7B side) of the reversing guide 8. Interlockingly, it is displaceable in the axial direction x. Since the portion of the linear member 7 closer to the first end than the reversing guide 8 is connected to the portion closer to the second end than the reversing guide 8 via the portion in contact with the reversing guide 8, the linear member 7 is connected to the second end of the reversing guide 8.
  • the portion on the second end side of the reversing guide 8 can be displaced to the distal side, and the portion on the first end side of the reversing guide 8 is displaced to the distal side.
  • the portion closer to the second end than the reversing guide 8 can be displaced to the proximal side.
  • the first part 7A and the second part 7B may all be arranged in the tube 22, or only a part thereof may be arranged in the tube 22.
  • the intermediate portion 7C may be entirely arranged in the inner space of the handle 1, or only a part thereof may be arranged in the inner space of the handle 1.
  • the intermediate portion 7C is connected to the first portion 7A, the second portion 7B, and the inner space of the handle 1 by the connecting portion 10. It preferably extends from 22 to the inner space of the handle 1, more specifically, the inner lumen of the rotary knob 5, and regardless of the displacement of the linear member 7 in the axial direction x, the first portion 7A and the second portion 7B is preferably located in the bore of the rotary knob 5.
  • the first portion 7A and the second portion 7B may extend across the lumen of the handle body 2 .
  • the intermediate portion 7 ⁇ /b>C preferably includes all of the portion of the linear member 7 that abuts on the reversing guide 8 when the linear member 7 is displaced in the axial direction x. In other words, it is preferable that the intermediate portion 7C of the linear member 7 is in contact with the reversing guide 8 . In addition, it is preferable that a part of the intermediate portion 7C be located in the inner cavity of the rotary knob 5 regardless of the displacement of the linear member 7 in the axial direction x.
  • the linear member 7 is fixed to the slider 4 at a portion closer to the first end than the contact portion of the linear member 7 with the reversing guide 8 .
  • the linear member 7 is fixed to the slider 4 with a fixture 9 provided on the slider 4 .
  • the slider 4 is displaced in the axial direction x.
  • the portion of the linear member 7 closer to the second end than the reversing guide 8 can be displaced in the opposite axial direction x.
  • the portion of the linear member 7 closer to the first end than the reversing guide 8 is displaced to the proximal side accordingly, and the reversing guide 8 of the linear member 7 displaces to the proximal side.
  • the portion on the second end side is displaced distally.
  • the portion of the linear member 7 closer to the first end than the reversing guide 8 is displaced distally accordingly, and the portion of the linear member 7 closer to the second end than the reversing guide 8 is displaced.
  • the portion is displaced proximally.
  • the first portion 7A and the second portion 7B of the linear member 7 placed in the lumen of the tube 22 can be pulled proximally or pushed distally.
  • You can control the bending of the For example, rotating the rotary knob 5 clockwise as viewed from the proximal side bends the distal end of the tube 22 in one direction, and rotating the rotary knob 5 counterclockwise viewed from the proximal side bends the tube.
  • the distal end of 22 can be bent in the other direction.
  • the linear member 7 is preferably fixed to the inner surface of the slider 4.
  • a fixture 9 for the linear member 7 is installed on the inner surface of the slider 4 , and the linear member 7 is fixed to this fixture 9 . etc., may be directly fixed.
  • the fixture 9 may be omitted.
  • Methods for fixing the linear member 7 to the inner surface of the fixture 9 or the slider 4 include adhesion with an adhesive, welding, fitting, caulking, screwing, and the like.
  • the fixing portion of the linear member 7 to the slider 4 is closer than the point where the linear member 7 extends from the lumen of the shaft 3 or the tube 22 to the outside when the slider 4 is positioned on the most distal side. It is preferably located on the posterior side. In other words, in the state where the slider 4 is positioned on the most distal side, the linear member 7 extends from the lumen of the shaft 3 or the tube 22 to the outside at a position distal to the portion fixed to the slider 4. Extending is preferred.
  • the linear member 7 is fixed to the slider 4 at a portion closer to the first end than the contact portion with the reversing guide 8 when the slider 4 is located on the most proximal side.
  • the linear member 7 can be fixed to the slider at the portion on the first end side from the contact portion with the reversing guide 8 . It will be fixed to 4.
  • the linear member 7 is not fixed to the slider 4 at the portion closer to the second end than the contact portion with the reversing guide 8.
  • the portion closer to the second end than the contact portion with the reversing guide 8 is not fixed to the slider 4 .
  • metal wires such as stainless steel, carbon steel, and nickel-titanium alloys, polyamide resins (eg, nylon), polyolefin resins (eg, polyethylene and polypropylene), polyester resins (eg, PET), aromatic Resin wires (i.e., fiber materials ) can be used. These metal wires and resin wires may have a monofilament structure or a multifilament structure.
  • the linear member 7 may be covered with a cylindrical body made of coiled metal or synthetic resin.
  • the diameter (diameter) of the linear member 7 can be, for example, about 100 ⁇ m to 1500 ⁇ m.
  • the first portion 7A, the second portion 7B and the intermediate portion 7C of the linear member 7 may be made of the same material or may be made of different materials.
  • the intermediate portion 7C is preferably made of a material different from that of the first portion 7A and the second portion 7B.
  • the intermediate portion 7C is preferably made of a flexible material so that it can be bent at the reversing guide 8 with a relatively small bending radius.
  • the first portion 7A and the second portion 7B are arranged in the lumen of the tube 22, and the movement of the linear member 7 in the axial direction x in the handle 1 is caused to move through the first portion 7A and the second portion 7B.
  • the tube 22 Since it is required that the tube 22 be properly transmitted to the distal end of the tube 22, it is preferably made of a material having relatively high rigidity, and flexibility is not required as much as that of the intermediate portion 7C. Therefore, it is preferable that the intermediate portion 7C has less bending rigidity than the first portion 7A and the second portion 7B. Moreover, it is preferable that the first portion 7A and the second portion 7B have greater axial rigidity than the intermediate portion 7C. For example, it is preferable that the intermediate portion 7C is made of a resin wire, and the first portion 7A and the second portion 7B are made of a metal wire.
  • the joining of the intermediate portion 7C and the first portion 7A and the joining of the intermediate portion 7C and the second portion 7B in the connecting portion 10 are , adhesion, welding, crimping, or the like.
  • the intermediate portion 7C is made of a rope. This makes it easier to smoothly bend the intermediate portion 7C by the reversing guide 8 while ensuring the strength of the intermediate portion 7C.
  • the rope may be a fiber rope made of fibrous material or a wire rope made of metal material, but is preferably a fiber rope. This makes it easier for the intermediate portion 7C to bend smoothly.
  • the fiber rope is preferably composed of a high-strength fiber material in order to prevent breakage, and is preferably composed of so-called super fiber.
  • super fibers examples include aramid fibers, ultra-high molecular weight polyethylene fibers, polyarylate fibers, ultra-high strength polyvinyl alcohol fibers, polyparaphenylenebenzobisoxazole (PBO) fibers, polyphenylene sulfide (PPS) fibers, and the like.
  • the super fiber preferably has, for example, a tensile strength of 1 GPa or more, preferably 2 GPa or more, and an elastic modulus of 25 GPa or more, preferably 50 GPa or more.
  • the handle 1 is provided with a third engaging portion 13 on the outer surface of the slider 4 in order to prevent the slider 4 from rotating together with the rotation knob 5 when the rotation knob 5 is rotated about the axial direction x.
  • a fourth engaging portion 14 that engages with the third engaging portion 13 is provided on the inner surface of the handle body 2, and at least one of the third engaging portion 13 and the fourth engaging portion 14 extends in the axial direction x. is preferably formed. As a result, the slider 4 can be displaced along the axial direction x without rotating around the axial direction x.
  • the third engaging portion 13 and the fourth engaging portion 14 can be formed by combining projections and grooves. That is, it is preferable that one of the third engaging portion 13 and the fourth engaging portion 14 is a protrusion and the other is a groove.
  • the third engaging portion 13 provided on the outer surface of the slider 4 is formed as a protrusion
  • the fourth engaging portion 14 provided on the inner surface of the handle body 2 is formed as a groove.
  • the third engaging portion 13 or the fourth engaging portion 14 formed as a groove is preferably formed so as to extend in the axial direction x, and more preferably formed so as to extend continuously in the axial direction x. preferable.
  • the groove may be a bottomed groove or a through groove, but from the point of ensuring the strength of the slider 4 or the handle body 2, the groove is preferably a bottomed groove.
  • the third engaging portion 13 or the fourth engaging portion 14 formed as a convex portion may or may not be formed to extend in the axial direction x.
  • the protrusion formed as the third engaging portion 13 on the outer surface of the slider 4 The portion is preferably arranged on the proximal side of the first engaging portion 11 in the slider 4 .
  • At least part of the groove formed as the fourth engaging portion 14 on the inner surface of the handle body 2 is preferably arranged distally of the reversing guide 8 .
  • the groove is formed on the slider 4 in the axial direction x relative to the first engaging portion 11. It may be formed at an overlapping position, or may be formed closer to the proximal side than the first engaging portion 11 . In this case, it is preferable that at least a portion of the convex portion formed as the fourth engaging portion 14 on the inner surface of the handle body 2 is arranged on the distal side of the reversing guide 8 .
  • a sixth engaging portion 16 that engages with the fifth engaging portion 15 is provided on the outer surface of the shaft 3, and at least one of the fifth engaging portion 15 and the sixth engaging portion 16 extends in the axial direction x. It may be formed as Even if the fifth engaging portion 15 and the sixth engaging portion 16 are provided in this manner, the slider 4 can be displaced along the axial direction x without rotating around the axial direction x.
  • the fifth engaging portion 15 and the sixth engaging portion 16 can be formed by combining projections and grooves. That is, it is preferable that one of the fifth engaging portion 15 and the sixth engaging portion 16 is a protrusion and the other is a groove.
  • the fifth engaging portion 15 provided on the inner surface of the slider 4 is formed as a groove
  • the sixth engaging portion 16 provided on the outer surface of the shaft 3 is formed as a convex portion.
  • the fifth engaging portion 15 or the sixth engaging portion 16 formed as a groove is preferably formed so as to extend in the axial direction x, and more preferably formed so as to extend continuously in the axial direction x. preferable.
  • the groove may be a bottomed groove or a through groove, but from the point of ensuring the strength of the slider 4 or the shaft 3, the groove is preferably a bottomed groove.
  • the fifth engaging portion 15 or the sixth engaging portion 16 formed as a convex portion may or may not be formed to extend in the axial direction x.
  • the inner surface of the slider 4 is formed as the fifth engaging portion 15.
  • the groove may be formed on the slider 4 at a position overlapping the first engaging portion 11 in the axial direction x, or may be formed on the proximal side or distal side of the first engaging portion 11 . It is preferable that at least a portion of the convex portion formed as the sixth engaging portion 16 on the outer surface of the shaft 3 is arranged on the distal side of the reversing guide 8 .
  • the convex portion when a convex portion is formed as the fifth engaging portion 15 on the inner surface of the slider 4 , the convex portion is axially aligned with the first engaging portion 11 on the slider 4 . It may be arranged at a position overlapping x, and may be arranged on the proximal side or the distal side of the first engaging portion 11 . In this case, it is preferable that at least a part of the groove formed as the sixth engaging portion 16 on the outer surface of the shaft 3 is arranged on the distal side of the reversing guide 8 .
  • the handle 1 When the handle 1 is provided with the third engaging portion 13 and the fourth engaging portion 14, the fifth engaging portion 15 and the sixth engaging portion 16 may not be provided. Conversely, when the handle 1 is provided with the fifth engaging portion 15 and the sixth engaging portion 16, the third engaging portion 13 and the fourth engaging portion 14 may not be provided. In either case, when rotating the rotary knob 5 about the axial direction x, the slider 4 can be displaced along the axial direction x without rotating about the axial direction x. Of course, the handle 1 may be provided with the third engaging portion 13 and the fourth engaging portion 14 , and further provided with the fifth engaging portion 15 and the sixth engaging portion 16 .
  • the catheter handle of the present invention can displace the first portion and the second portion of the linear member to the distal side or the proximal side in the lumen of the tube. , but not limited to controlling the bending of the distal end of the tube.
  • the first portion and/or the second portion of the linear member may be moved in and out of the distal end of the tube by manipulating the catheter handle.
  • the distal end of the first portion is attached to the distal end of the second portion of the linear member and operating the catheter handle.
  • a treatment tool such as a knife or a snare
  • the distal end of the first portion is Alternatively, the treatment instrument attached to the distal end of the second portion may be removable from the distal end of the tube.

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Abstract

A catheter handle (1) equipped with: a handle body (2); a shaft (3) that is disposed in a lumen of the handle body (2) and fixed to the handle body (2); a slider (4) that is disposed on the outside of the shaft (3), has a spirally extending first engaging part (11) on the outer surface, and is provided so as to be displaceable in the axial direction along the shaft (3); a rotary knob (5) that is provided so as to be capable of rotating relative to the handle body (2) and has a second engaging part (12), which engages with the first engaging part (11), on the inner surface; a linear member (7) having a first portion (7A), a second portion (7B), and a middle portion (7C) between the first and second portions, the first portion (7A) and the second portion (7B) being disposed in a lumen of a tube (22), and the middle portion (7C) being disposed in the lumen of the handle body (2); and a reversing guide (8) that is in contact with the middle portion (7C) of the linear member (7). The linear member (7) is fixed to the slider (4) on the first-portion (7A) side from the portion in contact with the reversing guide (8).

Description

カテーテルハンドルおよびそれを備えたカテーテルCatheter handle and catheter with same
　本発明は、カテーテルに用いられるハンドルと、それを備えたカテーテルに関するものである。 The present invention relates to a handle used for a catheter and a catheter having the same.
　カテーテルは、通常、血管や消化管や尿管などの体腔に挿入するためのチューブと、チューブの近位側に設けられたハンドルとから構成されている。カテーテルには、手元側のハンドルを操作してチューブの遠位端部を屈曲できるように構成されたものが知られている。このようなカテーテルは、チューブの内腔にワイヤが配され、ワイヤの遠位端部がチューブの遠位端部に固定され、ワイヤの近位端部がハンドルに接続され、ハンドルを操作することによりチューブの遠位端部を屈曲できるようになっている。例えば、チューブの内腔にワイヤが２本配されたカテーテルでは、ハンドルを操作することにより、２本のワイヤの一方を近位側に引っ張ることでチューブの遠位端部を一方側に屈曲させ、他方を引っ張ることでチューブの遠位端部を他方側に屈曲させることができる。 A catheter usually consists of a tube for insertion into body cavities such as blood vessels, digestive tracts, and ureters, and a handle provided on the proximal side of the tube. Catheters are known that are constructed such that the distal end of the tube can be bent by operating a handle on the proximal side. Such a catheter has a wire in the lumen of a tube, a distal end of the wire fixed to the distal end of the tube, and a proximal end of the wire connected to a handle that can be manipulated. allows the distal end of the tube to bend. For example, in a catheter having two wires arranged in the lumen of a tube, one of the two wires is pulled proximally by manipulating the handle to bend the distal end of the tube to one side. , the distal end of the tube can be bent to the other side by pulling the other.
　このようなカテーテルハンドルとして、例えば特許文献１には、先端部がカテーテルの先端領域に結合された２つの制御ワイヤを備えたカテーテルハンドルであって、ハウジングと、ハウジング内に配置され、ハウジング内で直線的に並進するように構成された摺動アセンブリと、ハウジングに対して回転自在に設けられた制御ノブを有し、前記２つの制御ワイヤの基端部がハウジング内に配置され、摺動アセンブリを直線的に並進させることによって摺動アセンブリが２つの制御ワイヤのそれぞれを別個に操作するように構成され、制御ノブを第１の回転方向へ回転させることによって、摺動アセンブリが先端側へ変位して２つの制御ワイヤの一方に張力をかけ、それによりカテーテルが第１の偏向方向に偏向し、制御ノブを第２の回転方向へ回転させることによって、摺動アセンブリが基端側へ変位して２つの制御ワイヤの他方に張力をかけ、それによりカテーテルが第２偏向方向に偏向するように構成されたカテーテルハンドルが開示されている。特許文献２には、カテーテルの遠位部分を偏向させるカテーテルハンドルであって、第１の直径を有し、第１のワイヤが連結される第１の回転部材と、前記第１の直径より小さい第２の直径を有し、第２のワイヤが連結される第２の回転部材とを有し、第２の回転部材は、第２の回転部材の中心点が第１の回転部材の中心点からずれるように、第１の回転部材に連結され、第１および第２の回転部材は、第１のワイヤを介した第１の回転部材の回転が、第２の回転部材および第２のワイヤを回転させて、カテーテルの遠位部分を偏向させるように構成されたカテーテルハンドルが開示されている。 As such a catheter handle, for example, US Pat. a slide assembly configured to translate linearly and a control knob rotatably mounted relative to the housing, the proximal ends of the two control wires being disposed within the housing; The slide assembly is configured to independently manipulate each of the two control wires by linearly translating the control knob, and rotating the control knob in a first rotational direction causes the slide assembly to be displaced distally. to tension one of the two control wires, thereby deflecting the catheter in a first deflection direction and rotating the control knob in a second rotational direction, thereby displacing the sliding assembly proximally. A catheter handle is disclosed that is configured to apply tension to the other of two control wires, thereby deflecting the catheter in a second deflection direction. US Pat. No. 5,300,000 discloses a catheter handle for deflecting a distal portion of a catheter, comprising a first rotating member having a first diameter and to which a first wire is coupled; a second rotatable member having a second diameter and to which a second wire is coupled, the second rotatable member having a center point of the second rotatable member The first and second rotatable members are coupled to the first rotatable member so as to be offset from each other such that rotation of the first rotatable member via the first wire is coupled to the second rotatable member and the second wire. A catheter handle is disclosed that is configured to rotate the to deflect the distal portion of the catheter.
特表２０１５－５２３８９２号公報Japanese Patent Publication No. 2015-523892 特表２０１８－５１５２１５号公報Japanese Patent Publication No. 2018-515215
　上記のように、従来様々なカテーテルハンドルが提案されており、本発明の目的は、新規の構造のカテーテルハンドルとそれを備えたカテーテルを提供することにある。 As described above, various catheter handles have been proposed in the past, and an object of the present invention is to provide a catheter handle with a novel structure and a catheter having the same.
　本発明は、下記のカテーテルハンドルおよびカテーテルを含む。
［１］カテーテルのチューブを操作するためのハンドルであって；軸方向に延びる内腔を有するハンドル本体と；ハンドル本体の内腔に配置され、軸方向に延び、ハンドル本体に固定されたシャフトと；シャフトの外側に配置され、らせん状に延びる第１係合部を外面に有し、シャフトに沿って軸方向に変位可能に設けられたスライダーと；ハンドル本体に対して軸方向を中心として回転可能に設けられ、スライダーの第１係合部に係合する第２係合部を内面に有する回転ノブと；第１端と第２端を有し、第１端を含む第１部分と第２端を含む第２部分と第１部分と第２部分の間の中間部分とを有し、第１部分と第２部分がチューブの内腔に配置され、中間部分がハンドル本体の内腔に配置された線状部材と；ハンドル本体の内腔に配置され、線状部材の中間部分の少なくとも一部が当接した反転ガイドとを備え；線状部材が、線状部材の反転ガイドとの当接部分より第１端側の部分で、スライダーに固定されているカテーテルハンドル。
［２］線状部材において、中間部分は、第１部分と第２部分とは異なる材料から構成されている［１］に記載のカテーテルハンドル。
［３］中間部分はロープから構成されている［１］または［２］に記載のカテーテルハンドル。
［４］第１係合部と第２係合部は、一方が凸部であり他方が溝である［１］～［３］のいずれかに記載のカテーテルハンドル。
［５］スライダーの外面に第３係合部が設けられ、ハンドル本体の内面に第３係合部に係合する第４係合部が設けられ、第３係合部と第４係合部の少なくとも一方が軸方向に延びるように形成されている［１］～［４］のいずれかに記載のカテーテルハンドル。
［６］スライダーの内面に第５係合部が設けられ、シャフトの外面に第５係合部に係合する第６係合部が設けられ、第５係合部と第６係合部の少なくとも一方が軸方向に延びるように形成されている［１］～［５］のいずれかに記載のカテーテルハンドル。
［７］［１］～［６］のいずれかに記載のカテーテルハンドルと、カテーテルハンドルの遠位側に設けられたチューブとを有するカテーテル。 The present invention includes catheter handles and catheters described below.
[1] A handle for manipulating a tube of a catheter; a handle body having an axially extending lumen; and a shaft disposed in the lumen of the handle body and extending axially and fixed to the handle body. a slider disposed outside the shaft, having a spirally extending first engaging portion on its outer surface, and displaceable along the shaft in the axial direction; rotating about the axial direction with respect to the handle body; a rotatable knob having a second engaging portion on its inner surface that engages the first engaging portion of the slider; a first portion having a first end and a second end, the first portion including the first end; a second portion including two ends and an intermediate portion between the first and second portions, the first portion and the second portion being disposed within the lumen of the tube and the intermediate portion being within the lumen of the handle body; a linear member disposed; and a reversal guide disposed in the lumen of the handle body and in contact with at least a part of the intermediate portion of the linear member; the linear member is in contact with the reversal guide of the linear member A catheter handle fixed to the slider at a portion closer to the first end than the abutment portion.
[2] The catheter handle according to [1], wherein the intermediate portion of the linear member is made of a material different from that of the first portion and the second portion.
[3] The catheter handle according to [1] or [2], wherein the intermediate portion is composed of a rope.
[4] The catheter handle according to any one of [1] to [3], wherein one of the first engaging portion and the second engaging portion is a protrusion and the other is a groove.
[5] A third engaging portion is provided on the outer surface of the slider, and a fourth engaging portion that engages with the third engaging portion is provided on the inner surface of the handle body. The catheter handle according to any one of [1] to [4], wherein at least one of is formed to extend axially.
[6] A fifth engaging portion is provided on the inner surface of the slider, and a sixth engaging portion that engages with the fifth engaging portion is provided on the outer surface of the shaft. The catheter handle according to any one of [1] to [5], at least one of which extends axially.
[7] A catheter having a catheter handle according to any one of [1] to [6] and a tube provided on the distal side of the catheter handle.
　本発明のカーテルハンドルおよびカテーテルによれば、回転ノブを回転させる操作により、カテーテルハンドルの遠位側に設けられたチューブを操作することができる。 According to the catheter handle and catheter of the present invention, the tube provided on the distal side of the catheter handle can be operated by rotating the rotation knob.
カテーテルハンドルを備えたカテーテルの全体図を表す。FIG. 1 depicts a general view of a catheter with a catheter handle. 図１に示したカテーテルに設けられたカテーテルハンドルの内部構造の平面図を表す。2 shows a plan view of the internal structure of a catheter handle provided on the catheter shown in FIG. 1; FIG. 図２に示したカテーテルハンドルの内部構造であって、スライダーを軸方向に沿って一部切除した平面図を表す。Fig. 3 shows a plan view of the internal structure of the catheter handle shown in Fig. 2 with the slider partially cut away along the axial direction; 図２に示したカテーテルハンドルの内部構造からスライダーとシャフトを除いた平面図を表す。3 is a plan view of the inner structure of the catheter handle shown in FIG. 2 with the slider and shaft removed; FIG. 図２に示したカテーテルハンドルのＶ－Ｖ断面図を表す。Figure 3 shows a VV cross-sectional view of the catheter handle shown in Figure 2;
　以下、下記実施の形態に基づき本発明のカテーテルハンドルと当該ハンドルを備えたカテーテルを具体的に説明するが、本発明はもとより下記実施の形態によって制限を受けるものではなく、前・後記の趣旨に適合し得る範囲で適当に変更を加えて実施することも勿論可能であり、それらはいずれも本発明の技術的範囲に包含される。なお、各図面において、便宜上、ハッチングや部材符号等を省略する場合もあるが、かかる場合、明細書や他の図面を参照するものとする。また、図面における種々部材の寸法は、本発明の特徴の理解に資することを優先しているため、実際の寸法とは異なる場合がある。 Hereinafter, the catheter handle of the present invention and the catheter equipped with the handle will be specifically described based on the following embodiments. Of course, it is possible to make appropriate modifications within the scope of adaptation, and all of them are included in the technical scope of the present invention. In each drawing, for the sake of convenience, hatching, member symbols, etc. may be omitted, but in such cases, the specification and other drawings shall be referred to. In addition, the dimensions of various members in the drawings may differ from the actual dimensions, since priority is given to helping to understand the features of the present invention.
　図１を参照して、カテーテルハンドルを備えたカテーテルの全体を説明する。本発明の実施の形態に係るカテーテル２１は、カテーテルハンドル１（以下、「ハンドル１」と称する場合がある）と、ハンドル１の遠位側に設けられたチューブ２２とを有する。カテーテル２１は、例えば、チューブ２２を患者の血管や消化管などの体腔に挿入して、治療や検査に用いられる。 The entire catheter with a catheter handle will be described with reference to FIG. A catheter 21 according to an embodiment of the present invention has a catheter handle 1 (hereinafter sometimes referred to as "handle 1") and a tube 22 provided on the distal side of the handle 1. As shown in FIG. The catheter 21 is used for treatment or examination by, for example, inserting the tube 22 into a body cavity such as a patient's blood vessel or gastrointestinal tract.
　本発明において、カテーテルの近位側とは、カテーテルの延在方向に対して使用者の手元側の方向を指し、遠位側とは近位側の反対方向、すなわち処置対象側の方向を指す。 In the present invention, the proximal side of the catheter refers to the direction toward the hand side of the user with respect to the extending direction of the catheter, and the distal side refers to the direction opposite to the proximal side, that is, the direction to the treatment target side. .
　チューブ２２は、可撓性を有する管状構造を有しており、例えば、ポリオレフィン樹脂（例えば、ポリエチレンやポリプロピレン）、ポリアミド樹脂（例えば、ナイロン）、ポリエステル樹脂（例えば、ＰＥＴ）、芳香族ポリエーテルケトン樹脂（例えば、ＰＥＥＫ）、ポリエーテルポリアミド樹脂、ポリウレタン樹脂、ポリイミド樹脂、フッ素樹脂（例えば、ＰＴＦＥ、ＰＦＡ、ＥＴＦＥ）等の合成樹脂や、ステンレス鋼、炭素鋼、ニッケルチタン合金等の金属から構成することができる。金属材料は、合成樹脂チューブ内に埋め込まれた金属線材としても用いることができる。チューブ２２の軸方向（遠近方向）の長さは、ハンドル１の同方向の長さの数倍から数十倍程度長くなっており、例えば、５００ｍｍ～１２００ｍｍ程度である。チューブ２２の外径は、例えば、０．６ｍｍ～５ｍｍ程度とすればよい。 The tube 22 has a flexible tubular structure, and is made of, for example, polyolefin resin (eg, polyethylene or polypropylene), polyamide resin (eg, nylon), polyester resin (eg, PET), aromatic polyether ketone. Constructed from synthetic resins such as resins (e.g. PEEK), polyether polyamide resins, polyurethane resins, polyimide resins, fluorine resins (e.g. PTFE, PFA, ETFE), and metals such as stainless steel, carbon steel, and nickel-titanium alloys. be able to. A metal material can also be used as a metal wire embedded in a synthetic resin tube. The length of the tube 22 in the axial direction (perpendicular direction) is about several times to several tens of times longer than the length of the handle 1 in the same direction, for example, about 500 mm to 1200 mm. The outer diameter of the tube 22 may be, for example, approximately 0.6 mm to 5 mm.
　チューブ２２は内腔を有しており、内部に１つの内腔を有するシングルルーメン構造であっても、複数の内腔を有するマルチルーメン構造のいずれであってもよい。チューブ２２は、複数の同軸の内腔が設けられたコアキシャル構造を有するものであってもよい。チューブ２２の内腔には、チューブ２２を操作するためのワイヤが配置される。ワイヤは、例えばチューブ２２の遠位端部の曲がりを制御するために設けられる。この場合、ワイヤの遠位端部はチューブ２２の遠位端部、例えばチューブ２２の遠位側１／３の部分に固定されることが好ましい。チューブ２２の内腔には、導線、光ファイバ、内視鏡などが配置されてもよく、ガイドワイヤや別の処置具を挿通するための内腔が設けられたり、薬剤や造影剤、任意の流体を流通させるための内腔が設けられてもよい。 The tube 22 has a lumen, and may be either a single lumen structure having one internal lumen or a multi-lumen structure having a plurality of internal lumens. Tube 22 may have a coaxial structure with multiple coaxial lumens. A wire for manipulating the tube 22 is disposed in the lumen of the tube 22 . Wires are provided, for example, to control bending of the distal end of tube 22 . In this case, the distal end of the wire is preferably fixed to the distal end of tube 22 , eg, the distal third of tube 22 . A lead wire, an optical fiber, an endoscope, or the like may be arranged in the lumen of the tube 22, and a lumen for inserting a guide wire or another treatment tool may be provided. A lumen may be provided for fluid communication.
　ハンドル１はチューブ２２の近位側に設けられ、カテーテルとして組み立てた際には、チューブ２２の内腔に配されたワイヤの近位端部がハンドル１に接続される。 The handle 1 is provided on the proximal side of the tube 22, and the proximal end of the wire placed in the lumen of the tube 22 is connected to the handle 1 when assembled as a catheter.
　カテーテルハンドルの詳細について、図２～図５を参照して説明する。図２は、図１に示したカテーテルに設けられたカテーテルハンドルの内部構造の平面図を表し、図３は、図２に示したカテーテルハンドルの内部構造であって、スライダーを軸方向に沿って一部切除した平面図を表し、図４は、図２に示したカテーテルハンドルの内部構造からスライダーとシャフトを除いた平面図を表し、図５は、図２に示したカテーテルハンドルのＶ－Ｖ断面図を表す。図２では、カテーテルハンドルのハウジングとなるハンドル本体と回転ノブを軸方向に沿って切除し、内部構造が見えるようにしたカテーテルハンドルの平面図が示されている。図５では、図２においてハンドル本体の切除された部分が点線で示されている。 The details of the catheter handle will be explained with reference to FIGS. 2 to 5. 2 is a plan view of the internal structure of the catheter handle provided on the catheter shown in FIG. 1, and FIG. 3 is the internal structure of the catheter handle shown in FIG. FIG. 4 shows a plan view with a part cut away, FIG. 4 shows a plan view of the internal structure of the catheter handle shown in FIG. 2 with the slider and shaft removed, and FIG. Represents a cross-sectional view. FIG. 2 shows a plan view of the catheter handle in which the handle body and the rotation knob, which serve as a housing for the catheter handle, are cut along the axial direction so that the internal structure can be seen. In FIG. 5, the cut away portion of the handle body in FIG. 2 is shown in dashed lines.
　本発明の実施の形態に係るハンドル１は、軸方向ｘに延びる内腔を有するハンドル本体２と、ハンドル本体２の内腔に配置され、軸方向ｘに延び、ハンドル本体２に固定されたシャフト３と、ハンドル本体２の内腔であってシャフト３の外側に配置され、らせん状に延びる第１係合部１１を外面に有し、シャフト３に沿って軸方向ｘに変位可能に設けられたスライダー４と、ハンドル本体２に対して軸方向ｘを中心として回転可能に設けられ、スライダー４の第１係合部１１に係合する第２係合部１２を内面に有する回転ノブ５とを有する。ハンドル１において、軸方向ｘとは、回転ノブ５の回転軸が延びる方向に相当し、軸方向ｘに対する一方側と他方側として、近位側と遠位側が定められる。また、軸方向ｘに対する直交方向として径方向が定められる。 A handle 1 according to an embodiment of the present invention comprises a handle body 2 having a bore extending in the axial direction x, and a shaft disposed in the bore of the handle body 2 and extending in the axial direction x and fixed to the handle body 2. 3 and a first engaging portion 11 which is a bore of the handle body 2 and is disposed outside the shaft 3 and extends in a spiral shape on the outer surface, and is displaceable along the shaft 3 in the axial direction x. and a rotary knob 5 which is rotatable about the axial direction x with respect to the handle body 2 and has a second engaging portion 12 which engages with the first engaging portion 11 of the slider 4 on its inner surface. have In the handle 1, the axial direction x corresponds to the direction in which the rotation axis of the rotary knob 5 extends, and the proximal side and the distal side are defined as one side and the other side with respect to the axial direction x. A radial direction is defined as a direction perpendicular to the axial direction x.
　ハンドル本体２は、軸方向ｘに延びる内腔を有する（図４を参照）。ハンドル本体２の内腔は、軸方向ｘを中心とした円筒状に形成された部分を有することが好ましく、当該内腔の円筒状に形成された部分に回転ノブ５が配置されることが好ましい。回転ノブ５は、ハンドル本体２に対して、軸方向ｘを中心に回転可能に設けられる。回転ノブ５は、ハンドル本体２の内腔の少なくとも一部に配置されることが好ましく、軸方向ｘに対する一部のみが、ハンドル本体２の内腔に配置されることが好ましい。 The handle body 2 has a bore extending in the axial direction x (see FIG. 4). The lumen of the handle body 2 preferably has a cylindrically formed portion centered on the axial direction x, and the rotary knob 5 is preferably arranged in the cylindrically formed portion of the lumen. . The rotary knob 5 is provided rotatably about the axial direction x with respect to the handle body 2 . The rotation knob 5 is preferably arranged in at least part of the lumen of the handle body 2 and preferably only partly in the lumen of the handle body 2 with respect to the axial direction x.
　回転ノブ５は、軸方向ｘに延びる内腔を有し、ハンドル本体２の内腔とともに、ハンドル１の内部空間を形成することが好ましい。回転ノブ５の内腔は、軸方向ｘを中心とした円筒状に形成された部分を有することが好ましい。回転ノブ５の内腔はハンドル本体２の内腔と軸方向ｘに連通し、回転ノブ５の内腔とハンドル本体２の内腔とが一体的にハンドル１の内部空間を形成し、当該内部空間にシャフト３やスライダー４が配置されることが好ましい。 The rotary knob 5 preferably has a bore extending in the axial direction x and forms an internal space of the handle 1 together with the bore of the handle body 2 . The bore of the rotary knob 5 preferably has a cylindrical portion centered on the axial direction x. The lumen of the rotary knob 5 communicates with the lumen of the handle body 2 in the axial direction x, and the lumen of the rotary knob 5 and the lumen of the handle body 2 integrally form the inner space of the handle 1, It is preferable that the shaft 3 and the slider 4 are arranged in the space.
　ハンドル本体２は、遠位側と近位側の少なくとも一方がオープンに形成され、オープンに形成されたハンドル本体２の遠位側または遠位側から回転ノブ５が挿入され、回転ノブ５がハンドル本体２の内腔に配置されることが好ましい。一方、回転ノブ５は、ハンドル本体２に挿入され、ハンドル本体２の内腔に位置する近位側または遠位側がオープンに形成されることが好ましい。これにより、ハンドル本体２の内腔と回転ノブ５の内腔とから一体的にハンドル１の内部空間が形成される。図面に示したハンドル１では、ハンドル本体２の遠位側がオープンに形成され、回転ノブ５の近位側がオープンに形成され、回転ノブ５がハンドル本体２の遠位側からハンドル本体２の内腔に挿入されている。ハンドル１は、ハンドル本体２と回転ノブ５が外側に露出しており、例えば、一方の手でハンドル本体２を持って、もう一方の手で回転ノブ５を持ってハンドル本体２に対して回転させることにより、ハンドル１を操作することができる。 The handle body 2 is formed open on at least one of the distal side and the proximal side, and the rotary knob 5 is inserted from the distal side or the distal side of the handle body 2 formed open, and the rotary knob 5 is connected to the handle. It is preferably located in the lumen of body 2 . On the other hand, it is preferable that the rotary knob 5 is inserted into the handle body 2 and formed open on the proximal side or the distal side located in the lumen of the handle body 2 . As a result, the internal space of the handle 1 is integrally formed from the internal cavity of the handle body 2 and the internal cavity of the rotary knob 5 . In the handle 1 shown in the drawings, the distal side of the handle body 2 is formed open, the proximal side of the rotation knob 5 is formed open, and the rotation knob 5 extends from the distal side of the handle body 2 to the lumen of the handle body 2 . is inserted in the The handle 1 has a handle body 2 and a rotating knob 5 exposed to the outside. For example, one hand holds the handle body 2 and the other hand holds the rotating knob 5 and rotates the handle body 2. The handle 1 can be operated by pressing the
　ハンドル本体２の内腔には、シャフト３が軸方向ｘに延びるように配置される（図３を参照）。シャフト３はハンドル本体２に固定され、ハンドル本体２に対して回転したり移動しないように設けられる。シャフト３はハンドル本体２と一体的に形成されてもよい。シャフト３は、回転ノブ５の回転軸となる位置に配置されることが好ましい。シャフト３は、ハンドル本体２の内腔から回転ノブ５の内腔にかけて設けられることが好ましく、ハンドル本体２と回転ノブ５よりも遠位側および／または近位側に延びるように設けられてもよい。 A shaft 3 is arranged in the bore of the handle body 2 so as to extend in the axial direction x (see FIG. 3). The shaft 3 is fixed to the handle body 2 and provided so as not to rotate or move with respect to the handle body 2 . The shaft 3 may be formed integrally with the handle body 2 . The shaft 3 is preferably arranged at a position that serves as the rotation axis of the rotary knob 5 . The shaft 3 is preferably provided from the lumen of the handle body 2 to the lumen of the rotation knob 5, and may be provided so as to extend distally and/or proximally beyond the handle body 2 and the rotation knob 5. good.
　シャフト３の遠位側にはチューブ２２が接続されることが好ましい。シャフト３とチューブ２２の接続部は、ハンドル１の内部空間にあってもよく、ハンドル１の内部空間よりも遠位側にあってもよく、ハンドル１の外側にあってもよい。シャフト３はチューブ２２と一体的に形成することもできる。 A tube 22 is preferably connected to the distal side of the shaft 3 . The connection between the shaft 3 and the tube 22 may be in the interior space of the handle 1, distal to the interior space of the handle 1, or outside the handle 1. The shaft 3 can also be formed integrally with the tube 22 .
　シャフト３は、中実状に形成されてもよく、中空状に形成されてもよい。なお、シャフト３は中空状に形成され、シャフト３の内腔がチューブ２２の内腔と連通していることが好ましい。これにより、シャフト３の内腔およびチューブ２２の内腔を通して、カテーテル２１の手元側から処置対象部に処置具を送達したり、薬剤や造影剤を注入することができる。処置具としては、電極カテーテル、アブレーションカテーテル、マッピングカテーテル、バルーンカテーテル、マイクロカテーテル、鉗子、レーザープローブ、ファイバースコープ、高周波処置具、電気水圧衝撃破砕プローブ等が挙げられる。シャフト３は、このような処置具の挿入を可能とするために、シャフト３はハンドル１の外側に近位側開口を有することが好ましい。シャフト３は分岐部を有していてもよく、シャフト３の分岐部に切り替えコックが設けられていてもよい。これにより、例えば、処置具の挿入口と薬剤等の注入口とを分けて設けることができる。 The shaft 3 may be solid or hollow. It is preferable that the shaft 3 is hollow and the lumen of the shaft 3 communicates with the lumen of the tube 22 . As a result, it is possible to deliver the treatment tool from the proximal side of the catheter 21 to the treatment target part, or inject the medicine or the contrast medium through the lumen of the shaft 3 and the lumen of the tube 22 . Treatment instruments include electrode catheters, ablation catheters, mapping catheters, balloon catheters, microcatheters, forceps, laser probes, fiberscopes, high-frequency treatment instruments, electrohydraulic impact crushing probes, and the like. The shaft 3 preferably has a proximal side opening on the outside of the handle 1 in order to allow insertion of such a treatment instrument. The shaft 3 may have a branched portion, and the branched portion of the shaft 3 may be provided with a switching cock. As a result, for example, an insertion port for a treatment instrument and an injection port for a drug or the like can be provided separately.
　シャフト３の外側には、スライダー４が配置されている。スライダー４はハンドル１の内部空間に配置され、ハンドル本体２の内腔から回転ノブ５の内腔にかけて配置されている（図２および図３を参照）。スライダー４は、シャフト３に対して径方向の外側に配置されており、従って、スライダー４には、軸方向ｘに延び、スライダー４を軸方向ｘに貫通する貫通穴が設けられ、この貫通穴にシャフト３が挿通されていることが好ましい。 A slider 4 is arranged outside the shaft 3 . The slider 4 is arranged in the inner space of the handle 1 and extends from the inner bore of the handle body 2 to the inner bore of the rotary knob 5 (see FIGS. 2 and 3). The slider 4 is arranged radially outwardly of the shaft 3. Accordingly, the slider 4 is provided with a through hole extending in the axial direction x and passing through the slider 4 in the axial direction x. It is preferable that the shaft 3 is inserted through.
　スライダー４は、シャフト３に沿って軸方向ｘに変位可能に設けられており、すなわち、ハンドル１の内部空間を軸方向ｘに移動可能に設けられている。従って、スライダー４は、軸方向ｘの長さが、ハンドル１の内部空間におけるシャフト３の軸方向ｘの長さよりも短く形成されていることが好ましく、またハンドル１の内部空間の軸方向ｘの長さよりも短く形成されていることが好ましい。 The slider 4 is provided so as to be displaceable in the axial direction x along the shaft 3, that is, provided so as to be movable in the internal space of the handle 1 in the axial direction x. Therefore, the length of the slider 4 in the axial direction x is preferably shorter than the length of the shaft 3 in the inner space of the handle 1 in the axial direction x. It is preferably formed shorter than the length.
　スライダー４は、回転ノブ５を軸方向ｘを中心として回転させることにより、軸方向ｘに変位するように形成されている。そのために、スライダー４の外面にらせん状に延びる第１係合部１１が形成され、回転ノブ５の内面に第１係合部１１に係合する第２係合部１２が形成されている。 The slider 4 is formed to be displaced in the axial direction x by rotating the rotary knob 5 around the axial direction x. For this purpose, a first engaging portion 11 extending spirally is formed on the outer surface of the slider 4 , and a second engaging portion 12 that engages with the first engaging portion 11 is formed on the inner surface of the rotary knob 5 .
　第１係合部１１は、スライダー４の外面、すなわちスライダー４の径方向の外方側の面に、らせん状に延びるように形成される。詳細には、第１係合部１１は、ハンドル１の軸方向ｘを軸としたらせん状に延びるようにスライダー４の外面に形成され、好ましくは、円筒状に形成されたスライダー４の外面に形成される。第１係合部１１は、連続的に形成されても、断続的に形成されてもよい。第１係合部１１は、近位側から遠位側に向かって、右回りのらせん状に形成されてもよく、左回りのらせん状に形成されてもよい。 The first engaging portion 11 is formed so as to extend spirally on the outer surface of the slider 4, that is, on the outer surface of the slider 4 in the radial direction. Specifically, the first engaging portion 11 is formed on the outer surface of the slider 4 so as to extend spirally around the axial direction x of the handle 1. Preferably, the first engaging portion 11 is formed on the outer surface of the slider 4 formed in a cylindrical shape. It is formed. The first engaging portion 11 may be formed continuously or intermittently. The first engaging portion 11 may be formed in a clockwise spiral shape or a counterclockwise spiral shape from the proximal side to the distal side.
　第２係合部１２は、回転ノブ５の内面、すなわち回転ノブ５の径方向の内方側の面に、第１係合部１１に係合可能に形成される（図３および図４を参照）。第２係合部１２は、回転ノブ５の内面にらせん状に延びるように形成され、詳細には、ハンドル１の軸方向ｘを軸としたらせん状に延びるように形成される。第２係合部１２は、好ましくは、円筒状に形成された回転ノブ５の内面に形成される。第２係合部１２は、連続的に形成されても、断続的に形成されてもよい。 The second engaging portion 12 is formed on the inner surface of the rotary knob 5, that is, on the radially inner surface of the rotary knob 5 so as to be able to engage with the first engaging portion 11 (see FIGS. 3 and 4). reference). The second engaging portion 12 is formed to extend spirally on the inner surface of the rotary knob 5 , and more specifically, is formed to extend spirally about the axial direction x of the handle 1 . The second engaging portion 12 is preferably formed on the inner surface of the cylindrical rotary knob 5 . The second engaging portion 12 may be formed continuously or intermittently.
　上記のようにスライダー４の外面に第１係合部１１が形成され、回転ノブ５の内面に第２係合部１２が形成されることにより、回転ノブ５を軸方向ｘを中心として回転させることにより、スライダー４をハンドル１の内部空間において軸方向ｘに移動させることができる。すなわち、らせん状に形成された第１係合部１１と第２係合部１２によって、回転ノブ５の軸方向ｘを中心とした回転移動をスライダー４の軸方向ｘの平行移動へと変換させることができる。 By forming the first engaging portion 11 on the outer surface of the slider 4 and forming the second engaging portion 12 on the inner surface of the rotary knob 5 as described above, the rotary knob 5 is rotated about the axial direction x. As a result, the slider 4 can be moved in the axial direction x in the interior space of the handle 1 . That is, the rotational movement of the rotary knob 5 about the axial direction x is converted into parallel movement of the slider 4 in the axial direction x by the spirally formed first engaging portion 11 and the second engaging portion 12. be able to.
　第１係合部１１と第２係合部１２は、連続的または断続的にらせん状に１周以上延びるように形成されてもよく、１周未満となるように形成されてもよい。なお、第１係合部１１と第２係合部１２の少なくとも一方は、連続的または断続的にらせん状に１周以上延びるように形成されることが好ましく、２周以上延びるように形成されることがより好ましく、３周以上延びるように形成されることがさらに好ましい。一方、第１係合部１１と第２係合部１２の他方は、連続的または断続的にらせん状に１周未満となるように形成されてもよく、例えば、らせん状に半周のみ延びるように設けられてもよい。図面に示したハンドル１では、スライダー４に設けられた第１係合部１１が、らせん状に１周以上延びるように形成され、回転ノブ５に設けられた第２係合部１２が、らせん状に１周未満延びるように形成されている。 The first engaging portion 11 and the second engaging portion 12 may be formed so as to extend continuously or intermittently in a spiral shape for one or more turns, or may be formed so as to extend less than one turn. At least one of the first engaging portion 11 and the second engaging portion 12 is preferably formed so as to extend continuously or intermittently in a spiral shape so as to extend one or more turns, and is formed so as to extend two or more turns. More preferably, it is formed so as to extend three or more turns. On the other hand, the other of the first engaging portion 11 and the second engaging portion 12 may be formed continuously or intermittently so as to extend less than one turn in a spiral shape. may be provided in In the handle 1 shown in the drawings, the first engaging portion 11 provided on the slider 4 is formed so as to extend spirally for one or more turns, and the second engaging portion 12 provided on the rotary knob 5 is formed in a spiral manner. It is formed so as to extend less than one round in a shape.
　第１係合部１１と第２係合部１２は、凸部と溝の組み合わせにより形成することができる。すなわち、第１係合部１１と第２係合部１２は、一方が凸部であり他方が溝であることが好ましい。なお、溝として第１係合部１１または第２係合部１２が形成される場合、溝はらせん状に連続的に延びるように形成されることが好ましい。溝は、有底溝であってもよく、貫通溝であってもよいが、スライダー４または回転ノブ５の強度を確保する点から、溝は有底溝であることが好ましい。一方、凸部として第１係合部１１または第２係合部１２が形成される場合は、凸部は連続的に延びるらせん状に設けられても、断続的に延びるらせん状に設けられてもよい。図面では、スライダー４に設けられた第１係合部１１が凸部（凸条）として形成され、回転ノブ５に設けられた第２係合部１２が溝として形成されている。 The first engaging portion 11 and the second engaging portion 12 can be formed by combining projections and grooves. That is, it is preferable that one of the first engaging portion 11 and the second engaging portion 12 is a protrusion and the other is a groove. In addition, when the first engaging portion 11 or the second engaging portion 12 is formed as a groove, the groove is preferably formed so as to extend continuously in a spiral shape. The groove may be a bottomed groove or a through groove, but from the point of ensuring the strength of the slider 4 or the rotary knob 5, the groove is preferably a bottomed groove. On the other hand, when the first engaging portion 11 or the second engaging portion 12 is formed as a convex portion, the convex portion may be provided in a spiral shape extending continuously or may be provided in a spiral shape extending intermittently. good too. In the drawing, the first engaging portion 11 provided on the slider 4 is formed as a protrusion (projection), and the second engaging portion 12 provided on the rotary knob 5 is formed as a groove.
　ハンドル１の内部空間には、近位側で屈曲し、両端が遠位側に延びる線状部材７が設けられる（図３を参照）。遠位側に延びた線状部材７の両端はチューブ２２の内腔に配置される。これについて詳しく説明すると、線状部材７は、一方側の端として第１端を、他方側の端として第２端を有し、第１端を含む部分が第１部分７Ａ、第２端を含む部分が第２部分７Ｂ、第１部分７Ａと第２部分７Ｂの間の部分が中間部分７Ｃと規定される。第１端と第２端は、線状部材７をまっすぐに延ばしたときの一方端と他方端として規定される。そして、線状部材７を中間部分７Ｃで屈曲させ、屈曲部を含む中間部分７Ｃの少なくとも一部がハンドル本体２の内腔に配置され、第１部分７Ａと第２部分７Ｂの少なくとも一部がチューブ２２の内腔に配置される。 In the internal space of the handle 1, a linear member 7 is provided that bends on the proximal side and has both ends extending distally (see FIG. 3). Both ends of the linear member 7 extending distally are arranged in the lumen of the tube 22 . To explain this in detail, the linear member 7 has a first end as one end and a second end as the other end. The portion including the second portion 7B is defined as the intermediate portion 7C, and the portion between the first portion 7A and the second portion 7B is defined. The first end and the second end are defined as one end and the other end when the linear member 7 is straightened. Then, the linear member 7 is bent at the intermediate portion 7C so that at least a portion of the intermediate portion 7C including the bent portion is arranged in the lumen of the handle body 2, and at least a portion of the first portion 7A and the second portion 7B are arranged. It is placed in the lumen of tube 22 .
　線状部材７は、第１部分７Ａと第２部分７Ｂがチューブ２２を制御するためのワイヤとなる。第１部分７Ａの遠位端部、すなわち第１端を含むその近傍部分と、第２部分７Ｂの遠位端部、すなわち第２端を含むその近傍部分は、チューブ２２の遠位端部に固定されることが好ましい。この場合、ハンドル１を操作して、第１部分７Ａを近位側に引っ張ることにより、チューブ２２の遠位端部を一方向に曲げることができ、第２部分７Ｂを近位側に引っ張ることにより、チューブ２２の遠位端部を他方側に曲げることができる。第１部分７Ａの遠位端部は、例えば第１部分７Ａの第１端から近位側に１００ｍｍ以内の部分として規定することができ、第２部分７Ｂの遠位端部は、例えば第２部分７Ｂの第２端から近位側に１００ｍｍ以内の部分として規定することができる。チューブ２２の遠位端部は、例えばチューブ２２の遠位端から近位側に１００ｍｍ以内の部分として規定することができる。 The linear member 7 serves as a wire for controlling the tube 22 with the first portion 7A and the second portion 7B. The distal end of the first portion 7A, i.e. the portion near and including the first end, and the distal end of the second portion 7B, i.e. the portion near and including the second end, are connected to the distal end of the tube 22. It is preferably fixed. In this case, by operating the handle 1 and pulling the first portion 7A proximally, the distal end of the tube 22 can be bent in one direction, and the second portion 7B can be pulled proximally. allows the distal end of tube 22 to bend to the other side. The distal end of the first portion 7A can be defined, for example, as a portion within 100 mm proximally from the first end of the first portion 7A, and the distal end of the second portion 7B can be defined, for example, as the second It can be defined as the portion within 100 mm proximally from the second end of portion 7B. The distal end of tube 22 can be defined, for example, as a portion within 100 mm proximally from the distal end of tube 22 .
　線状部材７は、ハンドル１の内部空間で、シャフト３またはチューブ２２の内腔からその外側に延出し、線状部材７の中間部分７Ｃが、回転ノブ５の内腔からハンドル本体２の内腔にかけて延在することが好ましい。 The linear member 7 extends outward from the lumen of the shaft 3 or tube 22 in the interior space of the handle 1 , and the intermediate portion 7C of the linear member 7 extends from the lumen of the rotary knob 5 to the interior of the handle body 2 . It preferably extends through the cavity.
　線状部材７は、スライダー４の内腔すなわち軸方向ｘに延びる貫通穴に配置されることが好ましい。例えば、スライダー４の貫通穴の内面とシャフト３との間に軸方向ｘに延びる隙間（スライダー４を軸方向ｘに貫通する隙間）が形成され、当該隙間に線状部材７が配置されることが好ましい。 The linear member 7 is preferably arranged in a bore of the slider 4, that is, a through hole extending in the axial direction x. For example, a gap extending in the axial direction x (a gap penetrating the slider 4 in the axial direction x) is formed between the inner surface of the through hole of the slider 4 and the shaft 3, and the linear member 7 is arranged in the gap. is preferred.
　ハンドル本体２の内腔には、線状部材７の中間部分７Ｃでの屈曲をガイドするための反転ガイド８が設けられ、線状部材７の中間部分７Ｃの少なくとも一部が反転ガイド８に当接している。反転ガイド８は、ハンドル本体２に固定され、ハンドル本体２に対して回転したり移動したりしないように設けられる。反転ガイド８はハンドル本体２と一体的に形成されてもよい。 A reversal guide 8 for guiding bending of the intermediate portion 7C of the linear member 7 is provided in the lumen of the handle body 2, and at least a part of the intermediate portion 7C of the linear member 7 contacts the reversal guide 8. in contact with The reversing guide 8 is fixed to the handle body 2 and provided so as not to rotate or move with respect to the handle body 2 . The reversing guide 8 may be formed integrally with the handle body 2 .
　反転ガイド８は、軸方向ｘに対して、スライダー４と重なる位置に設けられるか、スライダー４よりも近位側に設けられることが好ましい。より好ましくは、スライダー４が最も近位側に位置する状態で、スライダー４よりも近位側に設けられる。 It is preferable that the reversing guide 8 is provided at a position overlapping the slider 4 with respect to the axial direction x, or provided on the proximal side of the slider 4 . More preferably, it is provided closer to the proximal side than the slider 4 when the slider 4 is located at the most proximal side.
　反転ガイド８には、線状部材７を遠位側にＵターンさせるガイド通路が設けられ、当該ガイド通路に線状部材７が当接する。ガイド通路は、軸方向ｘに沿った平面視で、近位側に凸となるＵ字状または弧状（例えば、半円状）に形成されることが好ましい。ガイド通路は管状通路として形成されることが好ましく、線状部材７の中間部分７Ｃが、管状通路の内腔に挿通されることが好ましい。 The reverse guide 8 is provided with a guide passage for making a U-turn of the linear member 7 to the distal side, and the linear member 7 abuts against the guide passage. The guide passage is preferably formed in a U shape or an arc shape (for example, a semicircular shape) that protrudes toward the proximal side in plan view along the axial direction x. The guide passage is preferably formed as a tubular passage, and the intermediate portion 7C of the linear member 7 is preferably inserted through the lumen of the tubular passage.
　線状部材７は、ハンドル１の内部空間において、反転ガイド８より第１端側（第１部分７Ａ側）の部分と反転ガイド８より第２端側（第２部分７Ｂ側）の部分とが連動して、軸方向ｘに変位可能となっている。線状部材７は、反転ガイド８より第１端側の部分が反転ガイド８と当接している部分を介して反転ガイド８より第２端側の部分と繋がっているため、反転ガイド８より第１端側の部分が近位側に変位することにより、反転ガイド８より第２端側の部分が遠位側に変位することができ、反転ガイド８より第１端側の部分が遠位側に変位することにより、反転ガイド８より第２端側の部分が近位側に変位することができる。 In the interior space of the handle 1, the linear member 7 has a portion on the first end side (the first portion 7A side) of the reversing guide 8 and a portion on the second end side (the second portion 7B side) of the reversing guide 8. Interlockingly, it is displaceable in the axial direction x. Since the portion of the linear member 7 closer to the first end than the reversing guide 8 is connected to the portion closer to the second end than the reversing guide 8 via the portion in contact with the reversing guide 8, the linear member 7 is connected to the second end of the reversing guide 8. By displacing the portion on the one end side to the proximal side, the portion on the second end side of the reversing guide 8 can be displaced to the distal side, and the portion on the first end side of the reversing guide 8 is displaced to the distal side. By displacing to , the portion closer to the second end than the reversing guide 8 can be displaced to the proximal side.
　第１部分７Ａと第２部分７Ｂは全部がチューブ２２に配置されてもよく、一部のみがチューブ２２に配置されてもよい。中間部分７Ｃは、全部がハンドル１の内部空間に配置されてもよく、一部のみがハンドル１の内部空間に配置されてもよい。図３では、中間部分７Ｃが第１部分７Ａと第２部分７Ｂとハンドル１の内部空間で連結部１０で接続されているが、このように、第１部分７Ａと第２部分７Ｂは、チューブ２２からハンドル１の内部空間、具体的には回転ノブ５の内腔にかけて延びていることが好ましく、線状部材７の軸方向ｘへの変位に関わらず、第１部分７Ａと第２部分７Ｂの一部が回転ノブ５の内腔に位置することが好ましい。第１部分７Ａと第２部分７Ｂは、ハンドル本体２の内腔にかけて延びていてもよい。中間部分７Ｃは、線状部材７のうち、線状部材７の軸方向ｘの変位によって反転ガイド８に当接する部分を全て含むことが好ましい。換言すれば、反転ガイド８に当接するのは、線状部材７のうち中間部分７Ｃであることが好ましい。また、中間部分７Ｃは、線状部材７の軸方向ｘの変位に関わらず、一部が回転ノブ５の内腔に位置することが好ましい。 The first part 7A and the second part 7B may all be arranged in the tube 22, or only a part thereof may be arranged in the tube 22. The intermediate portion 7C may be entirely arranged in the inner space of the handle 1, or only a part thereof may be arranged in the inner space of the handle 1. In FIG. 3, the intermediate portion 7C is connected to the first portion 7A, the second portion 7B, and the inner space of the handle 1 by the connecting portion 10. It preferably extends from 22 to the inner space of the handle 1, more specifically, the inner lumen of the rotary knob 5, and regardless of the displacement of the linear member 7 in the axial direction x, the first portion 7A and the second portion 7B is preferably located in the bore of the rotary knob 5. The first portion 7A and the second portion 7B may extend across the lumen of the handle body 2 . The intermediate portion 7</b>C preferably includes all of the portion of the linear member 7 that abuts on the reversing guide 8 when the linear member 7 is displaced in the axial direction x. In other words, it is preferable that the intermediate portion 7C of the linear member 7 is in contact with the reversing guide 8 . In addition, it is preferable that a part of the intermediate portion 7C be located in the inner cavity of the rotary knob 5 regardless of the displacement of the linear member 7 in the axial direction x.
　線状部材７は、線状部材７の反転ガイド８との当接部分より第１端側の部分で、スライダー４に固定されている。図３では、スライダー４に設けられた固定具９で、線状部材７がスライダー４に固定されている。これにより、回転ノブ５を軸方向ｘを中心として回転させると、スライダー４が軸方向ｘに変位し、それに合わせて線状部材７の反転ガイド８より第１端側の部分を軸方向ｘに変位させることができるとともに、線状部材７の反転ガイド８より第２端側の部分をそれとは反対の軸方向ｘに変位させることができる。具体的には、スライダー４が近位側に変位すると、それに合わせて線状部材７の反転ガイド８より第１端側の部分が近位側に変位し、線状部材７の反転ガイド８より第２端側の部分が遠位側に変位する。スライダー４が遠位側に変位すると、それに合わせて線状部材７の反転ガイド８より第１端側の部分が遠位側に変位し、線状部材７の反転ガイド８より第２端側の部分が近位側に変位する。これにより、チューブ２２の内腔に配置された線状部材７の第１部分７Ａと第２部分７Ｂを近位側に引いたり遠位側に押し込むことができ、例えばチューブ２２の遠位端部の曲がりを制御したりすることができる。例えば、回転ノブ５を手元側から見て右回りに回転させることにより、チューブ２２の遠位端部を一方向に曲げ、回転ノブ５を手元側から見て左回りに回転させることにより、チューブ２２の遠位端部を他方向に曲げることができる。 The linear member 7 is fixed to the slider 4 at a portion closer to the first end than the contact portion of the linear member 7 with the reversing guide 8 . In FIG. 3 , the linear member 7 is fixed to the slider 4 with a fixture 9 provided on the slider 4 . As a result, when the rotary knob 5 is rotated about the axial direction x, the slider 4 is displaced in the axial direction x. In addition, the portion of the linear member 7 closer to the second end than the reversing guide 8 can be displaced in the opposite axial direction x. Specifically, when the slider 4 is displaced to the proximal side, the portion of the linear member 7 closer to the first end than the reversing guide 8 is displaced to the proximal side accordingly, and the reversing guide 8 of the linear member 7 displaces to the proximal side. The portion on the second end side is displaced distally. When the slider 4 is displaced distally, the portion of the linear member 7 closer to the first end than the reversing guide 8 is displaced distally accordingly, and the portion of the linear member 7 closer to the second end than the reversing guide 8 is displaced. The portion is displaced proximally. As a result, the first portion 7A and the second portion 7B of the linear member 7 placed in the lumen of the tube 22 can be pulled proximally or pushed distally. You can control the bending of the For example, rotating the rotary knob 5 clockwise as viewed from the proximal side bends the distal end of the tube 22 in one direction, and rotating the rotary knob 5 counterclockwise viewed from the proximal side bends the tube. The distal end of 22 can be bent in the other direction.
　線状部材７は、スライダー４の内面に固定されることが好ましい。図３では、スライダー４の内面に線状部材７の固定具９が設置され、この固定具９に線状部材７が固定されているが、線状部材７は、スライダー４の内面に接着剤等で直接固定されてもよい。スライダー４の内面に線状部材７を直接固定する場合は、固定具９はなくてもよい。線状部材７の固定具９またはスライダー４の内面への固定方法としては、接着剤による接着、溶着、嵌合、カシメ、ネジ止め等が挙げられる。 The linear member 7 is preferably fixed to the inner surface of the slider 4. In FIG. 3, a fixture 9 for the linear member 7 is installed on the inner surface of the slider 4 , and the linear member 7 is fixed to this fixture 9 . etc., may be directly fixed. When the linear member 7 is directly fixed to the inner surface of the slider 4, the fixture 9 may be omitted. Methods for fixing the linear member 7 to the inner surface of the fixture 9 or the slider 4 include adhesion with an adhesive, welding, fitting, caulking, screwing, and the like.
　線状部材７のスライダー４への固定部は、スライダー４が最も遠位側に位置する状態で、線状部材７がシャフト３またはチューブ２２の内腔からその外側に延出する地点よりも近位側に位置することが好ましい。換言すれば、線状部材７は、スライダー４が最も遠位側に位置する状態において、スライダー４への固定部よりも遠位側の位置で、シャフト３またはチューブ２２の内腔からその外側に延出することが好ましい。 The fixing portion of the linear member 7 to the slider 4 is closer than the point where the linear member 7 extends from the lumen of the shaft 3 or the tube 22 to the outside when the slider 4 is positioned on the most distal side. It is preferably located on the posterior side. In other words, in the state where the slider 4 is positioned on the most distal side, the linear member 7 extends from the lumen of the shaft 3 or the tube 22 to the outside at a position distal to the portion fixed to the slider 4. Extending is preferred.
　線状部材７は、スライダー４が最も近位側に位置する状態で、反転ガイド８との当接部分より第１端側の部分が、スライダー４に固定されている。このように線状部材７をスライダー４に固定することで、スライダー４の軸方向ｘの変位に関わらず、線状部材７が反転ガイド８との当接部分より第１端側の部分でスライダー４に固定されることとなる。一方、線状部材７は、反転ガイド８との当接部分より第２端側の部分でスライダー４に固定されないことが好ましく、詳細には、線状部材７は、スライダー４が最も近位側に位置する状態で、反転ガイド８との当接部分より第２端側の部分が、スライダー４に固定されないことが好ましい。 The linear member 7 is fixed to the slider 4 at a portion closer to the first end than the contact portion with the reversing guide 8 when the slider 4 is located on the most proximal side. By fixing the linear member 7 to the slider 4 in this way, regardless of the displacement of the slider 4 in the axial direction x, the linear member 7 can be fixed to the slider at the portion on the first end side from the contact portion with the reversing guide 8 . It will be fixed to 4. On the other hand, it is preferable that the linear member 7 is not fixed to the slider 4 at the portion closer to the second end than the contact portion with the reversing guide 8. , it is preferable that the portion closer to the second end than the contact portion with the reversing guide 8 is not fixed to the slider 4 .
　線状部材７としては、ステンレス鋼、炭素鋼、ニッケルチタン合金等の金属線材や、ポリアミド樹脂（例えば、ナイロン）、ポリオレフィン樹脂（例えば、ポリエチレンやポリプロピレン）、ポリエステル樹脂（例えば、ＰＥＴ）、芳香族ポリエーテルケトン樹脂（例えば、ＰＥＥＫ）、ポリイミド樹脂、芳香族ポリアミド樹脂（例えば、アラミド）、フッ素樹脂（例えば、ＰＴＦＥ、ＰＦＡ、ＦＥＰ、ＥＴＦＥ）等の合成樹脂から形成された樹脂線材（すなわち繊維材料）を用いることができる。これらの金属線材や樹脂線材は、モノフィラメント構造を有していてもよく、マルチフィラメント構造を有していてもよい。線状部材７は、コイル状の金属や合成樹脂によって形成された筒体によって被覆されていてもよい。線状部材７の径（直径）としては、例えば、１００μｍ～１５００μｍ程度とすることができる。 As the linear member 7, metal wires such as stainless steel, carbon steel, and nickel-titanium alloys, polyamide resins (eg, nylon), polyolefin resins (eg, polyethylene and polypropylene), polyester resins (eg, PET), aromatic Resin wires (i.e., fiber materials ) can be used. These metal wires and resin wires may have a monofilament structure or a multifilament structure. The linear member 7 may be covered with a cylindrical body made of coiled metal or synthetic resin. The diameter (diameter) of the linear member 7 can be, for example, about 100 μm to 1500 μm.
　線状部材７の第１部分７Ａと第２部分７Ｂと中間部分７Ｃは、同じ材料から構成されてもよく、異なる材料から構成されてもよい。なお、中間部分７Ｃは、第１部分７Ａと第２部分７Ｂとは異なる材料から構成されていることが好ましい。中間部分７Ｃは反転ガイド８で比較的小さい屈曲半径で屈曲させることができるように、曲げやすい材料から構成されることが好ましい。一方、第１部分７Ａと第２部分７Ｂは、チューブ２２の内腔に配置され、ハンドル１での線状部材７の軸方向ｘの動きが、第１部分７Ａと第２部分７Ｂを介してチューブ２２の遠位端部まで好適に伝わることが求められることから、比較的剛性の高い材料から構成されることが好ましく、中間部分７Ｃよりも屈曲性は求められない。従って、中間部分７Ｃは、第１部分７Ａと第２部分７Ｂよりも曲げ剛性が小さいことが好ましい。また、第１部分７Ａと第２部分７Ｂは、中間部分７Ｃよりも軸剛性が大きいことが好ましい。例えば、中間部分７Ｃは樹脂線材から構成され、第１部分７Ａと第２部分７Ｂは金属線材から構成されることが好ましい。 The first portion 7A, the second portion 7B and the intermediate portion 7C of the linear member 7 may be made of the same material or may be made of different materials. The intermediate portion 7C is preferably made of a material different from that of the first portion 7A and the second portion 7B. The intermediate portion 7C is preferably made of a flexible material so that it can be bent at the reversing guide 8 with a relatively small bending radius. On the other hand, the first portion 7A and the second portion 7B are arranged in the lumen of the tube 22, and the movement of the linear member 7 in the axial direction x in the handle 1 is caused to move through the first portion 7A and the second portion 7B. Since it is required that the tube 22 be properly transmitted to the distal end of the tube 22, it is preferably made of a material having relatively high rigidity, and flexibility is not required as much as that of the intermediate portion 7C. Therefore, it is preferable that the intermediate portion 7C has less bending rigidity than the first portion 7A and the second portion 7B. Moreover, it is preferable that the first portion 7A and the second portion 7B have greater axial rigidity than the intermediate portion 7C. For example, it is preferable that the intermediate portion 7C is made of a resin wire, and the first portion 7A and the second portion 7B are made of a metal wire.
　中間部分７Ｃが、第１部分７Ａと第２部分７Ｂとは異なる材料から構成される場合、連結部１０における中間部分７Ｃと第１部分７Ａの接合および中間部分７Ｃと第２部分７Ｂの接合は、接着、溶着、かしめ等により行うことができる。 When the intermediate portion 7C is made of a material different from that of the first portion 7A and the second portion 7B, the joining of the intermediate portion 7C and the first portion 7A and the joining of the intermediate portion 7C and the second portion 7B in the connecting portion 10 are , adhesion, welding, crimping, or the like.
　中間部分７Ｃはロープから構成されていることが好ましい。これにより、中間部分７Ｃの強度を確保しつつ、中間部分７Ｃを反転ガイド８でスムーズに屈曲させやすくなる。ロープは、繊維材料から構成されたファイバーロープであっても、金属材料から構成されたワイヤーロープであってもよいが、ファイバーロープであることが好ましい。これにより中間部分７Ｃがスムーズに屈曲しやすくなる。ファイバーロープは、破断を防止する点から高強度の繊維材料から構成されることが好ましく、いわゆるスーパー繊維から構成されることが好ましい。スーパー繊維としては、例えば、アラミド繊維、超高分子量ポリエチレン繊維、ポリアリレート繊維、超高強力ポリビニルアルコール繊維、ポリパラフェニレンベンゾビスオキサゾール（ＰＢＯ）繊維、ポリフェニレンサルファイド（ＰＰＳ）繊維等が挙げられる。スーパー繊維は、例えば、引張強度が１ＧＰａ以上、好ましくは２ＧＰａ以上であり、弾性率が２５ＧＰａ以上、好ましくは５０ＧＰａ以上であることが好ましい。 It is preferable that the intermediate portion 7C is made of a rope. This makes it easier to smoothly bend the intermediate portion 7C by the reversing guide 8 while ensuring the strength of the intermediate portion 7C. The rope may be a fiber rope made of fibrous material or a wire rope made of metal material, but is preferably a fiber rope. This makes it easier for the intermediate portion 7C to bend smoothly. The fiber rope is preferably composed of a high-strength fiber material in order to prevent breakage, and is preferably composed of so-called super fiber. Examples of super fibers include aramid fibers, ultra-high molecular weight polyethylene fibers, polyarylate fibers, ultra-high strength polyvinyl alcohol fibers, polyparaphenylenebenzobisoxazole (PBO) fibers, polyphenylene sulfide (PPS) fibers, and the like. The super fiber preferably has, for example, a tensile strength of 1 GPa or more, preferably 2 GPa or more, and an elastic modulus of 25 GPa or more, preferably 50 GPa or more.
　ハンドル１は、回転ノブ５を軸方向ｘを中心として回転させた際に、スライダー４が回転ノブ５とともに回転しないようにするために、スライダー４の外面に第３係合部１３が設けられ、ハンドル本体２の内面に第３係合部１３と係合する第４係合部１４が設けられ、第３係合部１３と第４係合部１４の少なくとも一方が軸方向ｘに延びるように形成されていることが好ましい。これにより、スライダー４が軸方向ｘを中心に回転することなく、スライダー４を軸方向ｘに沿って変位させることができる。 The handle 1 is provided with a third engaging portion 13 on the outer surface of the slider 4 in order to prevent the slider 4 from rotating together with the rotation knob 5 when the rotation knob 5 is rotated about the axial direction x. A fourth engaging portion 14 that engages with the third engaging portion 13 is provided on the inner surface of the handle body 2, and at least one of the third engaging portion 13 and the fourth engaging portion 14 extends in the axial direction x. is preferably formed. As a result, the slider 4 can be displaced along the axial direction x without rotating around the axial direction x.
　第３係合部１３と第４係合部１４は、凸部と溝の組み合わせにより形成することができる。すなわち、第３係合部１３と第４係合部１４は、一方が凸部であり他方が溝であることが好ましい。図面に示したハンドル１では、スライダー４の外面に設けられた第３係合部１３が凸部として形成され、ハンドル本体２の内面に設けられた第４係合部１４が溝として形成されている。 The third engaging portion 13 and the fourth engaging portion 14 can be formed by combining projections and grooves. That is, it is preferable that one of the third engaging portion 13 and the fourth engaging portion 14 is a protrusion and the other is a groove. In the handle 1 shown in the drawings, the third engaging portion 13 provided on the outer surface of the slider 4 is formed as a protrusion, and the fourth engaging portion 14 provided on the inner surface of the handle body 2 is formed as a groove. there is
　溝として形成される第３係合部１３または第４係合部１４は、軸方向ｘに延びるように形成されることが好ましく、軸方向ｘに連続的に延びるように形成されることがより好ましい。溝は、有底溝であってもよく、貫通溝であってもよいが、スライダー４またはハンドル本体２の強度を確保する点から、溝は有底溝であることが好ましい。一方、凸部として形成される第３係合部１３または第４係合部１４は、軸方向ｘに延びるように形成されてもよく、そうでなくてもよい。 The third engaging portion 13 or the fourth engaging portion 14 formed as a groove is preferably formed so as to extend in the axial direction x, and more preferably formed so as to extend continuously in the axial direction x. preferable. The groove may be a bottomed groove or a through groove, but from the point of ensuring the strength of the slider 4 or the handle body 2, the groove is preferably a bottomed groove. On the other hand, the third engaging portion 13 or the fourth engaging portion 14 formed as a convex portion may or may not be formed to extend in the axial direction x.
　図面に示されるように、第３係合部１３が凸部として形成され、第４係合部１４が溝として形成される場合、スライダー４の外面に第３係合部１３として形成された凸部は、スライダー４において、第１係合部１１よりも近位側に配置されることが好ましい。ハンドル本体２の内面に第４係合部１４として形成された溝の少なくとも一部は、反転ガイド８よりも遠位側に配置されることが好ましい。 As shown in the drawings, when the third engaging portion 13 is formed as a protrusion and the fourth engaging portion 14 is formed as a groove, the protrusion formed as the third engaging portion 13 on the outer surface of the slider 4 The portion is preferably arranged on the proximal side of the first engaging portion 11 in the slider 4 . At least part of the groove formed as the fourth engaging portion 14 on the inner surface of the handle body 2 is preferably arranged distally of the reversing guide 8 .
　なお、図面には示されていないが、スライダー４の外面に第３係合部１３として溝が形成される場合は、当該溝は、スライダー４において、第１係合部１１と軸方向ｘに重なる位置に形成されてもよく、第１係合部１１よりも近位側に形成されてもよい。この場合、ハンドル本体２の内面に第４係合部１４として形成された凸部は、少なくとも一部が、反転ガイド８よりも遠位側に配置されることが好ましい。 Although not shown in the drawings, when a groove is formed on the outer surface of the slider 4 as the third engaging portion 13, the groove is formed on the slider 4 in the axial direction x relative to the first engaging portion 11. It may be formed at an overlapping position, or may be formed closer to the proximal side than the first engaging portion 11 . In this case, it is preferable that at least a portion of the convex portion formed as the fourth engaging portion 14 on the inner surface of the handle body 2 is arranged on the distal side of the reversing guide 8 .
　回転ノブ５を軸方向ｘを中心として回転させた際に、スライダー４が回転ノブ５とともに回転しないようにするために、図５に示すように、スライダー４の内面に第５係合部１５が設けられ、シャフト３の外面に第５係合部１５と係合する第６係合部１６が設けられ、第５係合部１５と第６係合部１６の少なくとも一方が軸方向ｘに延びるように形成されていてもよい。このように第５係合部１５と第６係合部１６を設けても、スライダー４が軸方向ｘを中心に回転することなく、スライダー４を軸方向ｘに沿って変位させることができる。 In order to prevent the slider 4 from rotating together with the rotary knob 5 when the rotary knob 5 is rotated about the axial direction x, as shown in FIG. A sixth engaging portion 16 that engages with the fifth engaging portion 15 is provided on the outer surface of the shaft 3, and at least one of the fifth engaging portion 15 and the sixth engaging portion 16 extends in the axial direction x. It may be formed as Even if the fifth engaging portion 15 and the sixth engaging portion 16 are provided in this manner, the slider 4 can be displaced along the axial direction x without rotating around the axial direction x.
　第５係合部１５と第６係合部１６は、凸部と溝の組み合わせにより形成することができる。すなわち、第５係合部１５と第６係合部１６は、一方が凸部であり他方が溝であることが好ましい。図５では、スライダー４の内面に設けられた第５係合部１５が溝として形成され、シャフト３の外面に設けられた第６係合部１６が凸部として形成されている。 The fifth engaging portion 15 and the sixth engaging portion 16 can be formed by combining projections and grooves. That is, it is preferable that one of the fifth engaging portion 15 and the sixth engaging portion 16 is a protrusion and the other is a groove. In FIG. 5, the fifth engaging portion 15 provided on the inner surface of the slider 4 is formed as a groove, and the sixth engaging portion 16 provided on the outer surface of the shaft 3 is formed as a convex portion.
　溝として形成される第５係合部１５または第６係合部１６は、軸方向ｘに延びるように形成されることが好ましく、軸方向ｘに連続的に延びるように形成されることがより好ましい。溝は、有底溝であってもよく、貫通溝であってもよいが、スライダー４またはシャフト３の強度を確保する点から、溝は有底溝であることが好ましい。一方、凸部として形成される第５係合部１５または第６係合部１６は、軸方向ｘに延びるように形成されてもよく、そうでなくてもよい。 The fifth engaging portion 15 or the sixth engaging portion 16 formed as a groove is preferably formed so as to extend in the axial direction x, and more preferably formed so as to extend continuously in the axial direction x. preferable. The groove may be a bottomed groove or a through groove, but from the point of ensuring the strength of the slider 4 or the shaft 3, the groove is preferably a bottomed groove. On the other hand, the fifth engaging portion 15 or the sixth engaging portion 16 formed as a convex portion may or may not be formed to extend in the axial direction x.
　図５に示されるように、第５係合部１５が溝として形成され、第６係合部１６が凸部として形成される場合、スライダー４の内面に第５係合部１５として形成された溝は、スライダー４において、第１係合部１１と軸方向ｘに重なる位置に形成されてもよく、第１係合部１１よりも近位側または遠位側に形成されてもよい。シャフト３の外面に第６係合部１６として形成された凸部は、少なくとも一部が、反転ガイド８よりも遠位側に配置されることが好ましい。 As shown in FIG. 5, when the fifth engaging portion 15 is formed as a groove and the sixth engaging portion 16 is formed as a convex portion, the inner surface of the slider 4 is formed as the fifth engaging portion 15. The groove may be formed on the slider 4 at a position overlapping the first engaging portion 11 in the axial direction x, or may be formed on the proximal side or distal side of the first engaging portion 11 . It is preferable that at least a portion of the convex portion formed as the sixth engaging portion 16 on the outer surface of the shaft 3 is arranged on the distal side of the reversing guide 8 .
　なお、図面には示されていないが、スライダー４の内面に第５係合部１５として凸部が形成される場合は、当該凸部は、スライダー４において、第１係合部１１と軸方向ｘに重なる位置に配置されてもよく、第１係合部１１よりも近位側または遠位側に配置されてもよい。この場合、シャフト３の外面に第６係合部１６として形成された溝の少なくとも一部は、反転ガイド８よりも遠位側に配置されることが好ましい。 Although not shown in the drawings, when a convex portion is formed as the fifth engaging portion 15 on the inner surface of the slider 4 , the convex portion is axially aligned with the first engaging portion 11 on the slider 4 . It may be arranged at a position overlapping x, and may be arranged on the proximal side or the distal side of the first engaging portion 11 . In this case, it is preferable that at least a part of the groove formed as the sixth engaging portion 16 on the outer surface of the shaft 3 is arranged on the distal side of the reversing guide 8 .
　ハンドル１に第３係合部１３と第４係合部１４が設けられる場合、第５係合部１５と第６係合部１６は設けられなくてもよい。逆に、ハンドル１に第５係合部１５と第６係合部１６が設けられる場合、第３係合部１３と第４係合部１４は設けられなくてもよい。いずれの場合も、回転ノブ５を軸方向ｘを中心として回転させた際に、スライダー４が軸方向ｘを中心に回転することなく、スライダー４を軸方向ｘに沿って変位させることができる。もちろん、ハンドル１に、第３係合部１３と第４係合部１４が設けられ、さらに第５係合部１５と第６係合部１６が設けられてもよい。 When the handle 1 is provided with the third engaging portion 13 and the fourth engaging portion 14, the fifth engaging portion 15 and the sixth engaging portion 16 may not be provided. Conversely, when the handle 1 is provided with the fifth engaging portion 15 and the sixth engaging portion 16, the third engaging portion 13 and the fourth engaging portion 14 may not be provided. In either case, when rotating the rotary knob 5 about the axial direction x, the slider 4 can be displaced along the axial direction x without rotating about the axial direction x. Of course, the handle 1 may be provided with the third engaging portion 13 and the fourth engaging portion 14 , and further provided with the fifth engaging portion 15 and the sixth engaging portion 16 .
　以上、本発明のカテーテルハンドルについて説明したが、本発明のカテーテルハンドルは、チューブの内腔で線状部材の第１部分と第２部分を遠位側または近位側に変位させるものであれば、チューブの遠位端部の曲がりを制御するものに限定されない。例えば、カテーテルハンドルを操作することによって、線状部材の第１部分および／または第２部分をチューブの遠位端から出し入れできるものであってもよい。あるいは、線状部材の第１部分の遠位端部や第２部分の遠位端部にナイフやスネアなどの処置具を取り付け、カテーテルハンドルを操作することによって、第１部分の遠位端部や第２部分の遠位端部に取り付けた処置具がチューブの遠位端から出し入れできるものであってもよい。 Although the catheter handle of the present invention has been described above, the catheter handle of the present invention can displace the first portion and the second portion of the linear member to the distal side or the proximal side in the lumen of the tube. , but not limited to controlling the bending of the distal end of the tube. For example, the first portion and/or the second portion of the linear member may be moved in and out of the distal end of the tube by manipulating the catheter handle. Alternatively, by attaching a treatment tool such as a knife or a snare to the distal end of the first portion or the distal end of the second portion of the linear member and operating the catheter handle, the distal end of the first portion is Alternatively, the treatment instrument attached to the distal end of the second portion may be removable from the distal end of the tube.
　本願は、２０２１年１２月１３日に出願された日本国特許出願第２０２１－２０１９７７号に基づく優先権の利益を主張するものである。２０２１年１２月１３日に出願された日本国特許出願第２０２１－２０１９７７号の明細書の全内容が、本願に参考のため援用される。 This application claims the benefit of priority based on Japanese Patent Application No. 2021-201977 filed on December 13, 2021. The entire contents of the specification of Japanese Patent Application No. 2021-201977 filed on December 13, 2021 are incorporated herein by reference.
　１：カテーテルハンドル
　２：ハンドル本体
　３：シャフト
　４：スライダー
　５：回転ノブ
　７：線状部材、７Ａ：第１部分、７Ｂ：第２部分、７Ｃ：中間部分
　８：反転ガイド
　９：固定具
　１０：連結部
　１１：第１係合部
　１２：第２係合部
　１３：第３係合部
　１４：第４係合部
　１５：第５係合部
　１６：第６係合部
　２１：カテーテル
　２２：チューブ 1: Catheter Handle 2: Handle Body 3: Shaft 4: Slider 5: Rotation Knob 7: Linear Member, 7A: First Part, 7B: Second Part, 7C: Intermediate Part 8: Reversing Guide 9: Fixture 10: Connection Part 11: First Engagement Part 12: Second Engagement Part 13: Third Engagement Part 14: Fourth Engagement Part 15: Fifth Engagement Part 16: Sixth Engagement Part 21: Catheter 22: Tube

Claims (7)

  1. 　カテーテルのチューブを操作するためのハンドルであって、
    　軸方向に延びる内腔を有するハンドル本体と、
    　前記ハンドル本体の内腔に配置され、前記軸方向に延び、前記ハンドル本体に固定されたシャフトと、
    　前記シャフトの外側に配置され、らせん状に延びる第１係合部を外面に有し、前記シャフトに沿って前記軸方向に変位可能に設けられたスライダーと、
    　前記ハンドル本体に対して前記軸方向を中心として回転可能に設けられ、前記スライダーの前記第１係合部に係合する第２係合部を内面に有する回転ノブと、
    　第１端と第２端を有し、前記第１端を含む第１部分と前記第２端を含む第２部分と前記第１部分と前記第２部分の間の中間部分とを有し、前記第１部分と前記第２部分が前記チューブの内腔に配置され、前記中間部分が前記ハンドル本体の内腔に配置された線状部材と、
    　前記ハンドル本体の内腔に配置され、前記線状部材の前記中間部分の少なくとも一部が当接した反転ガイドと、を備え、
    　前記線状部材は、前記線状部材の前記反転ガイドとの当接部分より前記第１端側の部分で、前記スライダーに固定されているカテーテルハンドル。     A handle for manipulating the tube of the catheter,
    a handle body having an axially extending bore;
    a shaft disposed in the lumen of the handle body, extending in the axial direction and fixed to the handle body;
    a slider disposed outside the shaft, having a spirally extending first engaging portion on an outer surface thereof, and displaceable in the axial direction along the shaft;
    a rotary knob that is rotatable about the axial direction with respect to the handle body and has a second engaging portion that engages with the first engaging portion of the slider on an inner surface thereof;
    having a first end and a second end, a first portion including said first end, a second portion including said second end, and an intermediate portion between said first portion and said second portion; a linear member in which the first portion and the second portion are arranged in the lumen of the tube, and the intermediate portion is arranged in the lumen of the handle body;
    a reversal guide disposed in the lumen of the handle body and in contact with at least a portion of the intermediate portion of the linear member;
    The linear member is a catheter handle fixed to the slider at a portion closer to the first end than the contact portion of the linear member with the reversing guide.
  2. 　前記線状部材において、前記中間部分は、前記第１部分と前記第２部分とは異なる材料から構成されている請求項１に記載のカテーテルハンドル。 The catheter handle according to claim 1, wherein in the linear member, the intermediate portion is made of a material different from that of the first portion and the second portion.
  3. 　前記中間部分はロープから構成されている請求項１に記載のカテーテルハンドル。 The catheter handle according to claim 1, wherein said intermediate portion is constructed of a rope.
  4. 　前記第１係合部と前記第２係合部は、一方が凸部であり他方が溝である請求項１に記載のカテーテルハンドル。 The catheter handle according to claim 1, wherein one of the first engaging portion and the second engaging portion is a protrusion and the other is a groove.
  5. 　前記スライダーの外面に第３係合部が設けられ、前記ハンドル本体の内面に前記第３係合部に係合する第４係合部が設けられ、前記第３係合部と前記第４係合部の少なくとも一方が前記軸方向に延びるように形成されている請求項１に記載のカテーテルハンドル。 A third engaging portion is provided on the outer surface of the slider, and a fourth engaging portion that engages with the third engaging portion is provided on the inner surface of the handle body. 2. A catheter handle according to claim 1, wherein at least one of the joints is formed to extend in the axial direction.
  6. 　前記スライダーの内面に第５係合部が設けられ、前記シャフトの外面に前記第５係合部に係合する第６係合部が設けられ、前記第５係合部と前記第６係合部の少なくとも一方が前記軸方向に延びるように形成されている請求項１に記載のカテーテルハンドル。 A fifth engaging portion is provided on the inner surface of the slider, and a sixth engaging portion that engages with the fifth engaging portion is provided on the outer surface of the shaft, and the fifth engaging portion and the sixth engaging portion are provided. 2. A catheter handle according to claim 1, wherein at least one of the sections is formed to extend in said axial direction.
  7. 　請求項１～６のいずれか一項に記載のカテーテルハンドルと、
    　前記カテーテルハンドルの遠位側に設けられたチューブとを有するカテーテル。     a catheter handle according to any one of claims 1 to 6;
    and a tube distal to the catheter handle.
PCT/JP2022/034434 2021-12-13 2022-09-14 Catheter handle and catheter equipped with same WO2023112412A1 (en)

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2018506333A (en) * 2015-01-21 2018-03-08 メドトロニック ヴァスキュラー インコーポレイテッド Guide catheter with operating mechanism
US20180304044A1 (en) * 2014-09-01 2018-10-25 Clph, Llc Steerable catheters and methods for making them

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20180304044A1 (en) * 2014-09-01 2018-10-25 Clph, Llc Steerable catheters and methods for making them
JP2018506333A (en) * 2015-01-21 2018-03-08 メドトロニック ヴァスキュラー インコーポレイテッド Guide catheter with operating mechanism

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