JP3595408B2 - Slender medical device guidance device - Google Patents

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention provides an elongated medical device provided with a functional portion such as an ultrasonic vibrator, an endoscopic observation window, a treatment heater, a high-frequency electrode, or a laser emitting end at the tip of an elongated rod or string. The present invention relates to a slender medical device guiding device for guiding the robot to a target site by moving the medical device in the axial direction.
[0002]
[Prior art]
In this type of elongated medical device guiding apparatus, if an electric motor is used as a means for driving the elongated medical device to advance and retreat in the axial direction, the structure becomes complicated and cleaning and disinfection after use is difficult, so that mechanical devices are used. It is desirable to use
[0003]
Therefore, conventionally, a slender medical device has been guided by using a rack and pinion mechanism, a cam and pin mechanism, etc., by advancing and retracting in the axial direction (Japanese Patent Publication No. 4-74014).
[0004]
[Problems to be solved by the invention]
The elongated medical device guiding device as described above needs to have a structure as simple as possible, to be difficult to break down, to be easily disassembled as needed, and to be easy to clean and disinfect. However, the rack and pinion mechanism, the cam pin mechanism, and the like cannot satisfy all of these conditions, and there is a drawback that parts processing is costly and expensive.
[0005]
Therefore, the present invention provides a slender medical device guide that is as simple as possible, hardly breaks down, can be easily disassembled as required, can be easily cleaned and disinfected, and can be manufactured easily at low cost. It is intended to provide a device.
[0006]
[Means for Solving the Problems]
In order to achieve the above object, an elongated medical device guiding device of the present invention includes an elongated medical device holding member that holds an elongated medical device provided with a functional portion at the tip of an elongated rod or string, and the elongated medical device. A main body that supports the holding member so as to be able to advance and retreat in the axial direction of the elongated medical device, and the elongated medical device holding member is provided in a screwed manner with respect to the main body and is rotated to move the elongated medical device holding member in the axial direction of the elongated medical device. An operating ring for moving forward and backward.
[0007]
The operating ring may be rotatable about an axis, and may be combined so as not to move relative to the elongated medical device holding member in the axial direction. A holding member rotation restricting means for restricting rotation with respect to the main body may be provided. Alternatively, the operation ring and the elongated medical device holding member may be integrally formed.
[0008]
Further, rotation amount display means for displaying the rotation amount of the operation ring may be provided, and movement amount display means for displaying the movement amount of the elongated medical device holding member in the axial direction is provided. May be.
[0009]
An elongated medical device guide tube that guides the elongated medical device so as to be able to advance and retreat in the axial direction on the front side of the main body may be connected to the main body. An elongated medical device guide tube guided on the side may be connected to the elongated medical device holding member.
[0010]
Further, the main body may be attached to a forceps channel entrance portion of an endoscope. In this case, the main body may be detachable from the forceps channel entrance portion of the endoscope.
[0011]
Further, the elongated medical device may be detachable from the elongated medical device holding member, and the elongated medical device may be fixed to the elongated medical device holding member so as not to be detachable.
[0012]
The elongated medical device may have flexibility, and the elongated medical device may be rigid and do not bend.
[0013]
BEST MODE FOR CARRYING OUT THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
1 to 3 show an elongated medical device guiding apparatus 10 according to a first embodiment of the present invention. FIG. 1 is a longitudinal sectional view showing a state in which the elongated medical device 1 is retracted, and FIG. FIG. 3 is a longitudinal sectional view of the state in which the medical device 1 is pushed out, and FIG.
[0014]
The elongated medical device 1 is provided with a functional portion 1b such as an ultrasonic vibrator, an endoscopic observation window, a treatment heater, a high-frequency electrode, or a laser emitting end at the tip of an elongated rod-shaped or string-shaped portion 1a. It is configured. The rod-shaped or string-shaped portion 1a may be either flexible or rigid and does not bend.
[0015]
The main body 11 is formed in a two-stage cylindrical shape in which a front half is thin and a rear half is thick, and a female screw portion 11a (for example, a pitch of 1 mm) is formed on an inner peripheral surface of the rear half. Is formed.
[0016]
Reference numeral 12 denotes an elongated medical device holding rod 12 for holding the elongated medical device 1. A through-hole through which the elongated medical device 1 is inserted is formed in the axis thereof, and is disposed inside the elongated medical device holding bar 12 by tightening a tightening ring 13 screwed to the rear end thereof. The O-ring 14 made of a resilient member is crushed and closely adheres to the outer peripheral surface of the rod-shaped or string-shaped portion 1a of the elongated medical device 1.
[0017]
As a result, the elongated medical device 1 is fixed to the elongated medical device holding bar 12 without being damaged, and the elongated medical device 1 can be freely attached to and detached from the elongated medical device holding bar 12.
[0018]
However, the elongated medical device 1 may be irremovably fixed to the elongated medical device holding rod 12. Since the O-ring 14 for tightening and fixing the elongated medical device 1 is resilient, there is no risk of the elongated medical device 1 being damaged, and the tightened portion is in a water-tightly sealed state.
[0019]
The elongated medical device holding rod 12 is provided so as to be able to advance and retreat in the axial direction, has an outer diameter that fits into the front half of the main body 11, and fits into the front half of the main body 11. A keyway 12a is formed in the portion in the axial direction.
[0020]
As shown in FIG. 4 in an enlarged manner, the key groove 12a is provided with a rotation stop pin 15 which is screwed into the main body 11 from the outside and whose tip projects inward. Is engaged with the key groove 12a.
[0021]
Therefore, the elongated medical device holding rod 12 is movable in the axial direction in the main body 11, and cannot rotate around the axis. When the rotation stop pin 15 is tightly tightened to the main body 11, the tip 15a presses the bottom surface of the key groove 12a, and the elongated medical device holding rod 12 is fixed to the main body 11.
[0022]
An operating ring 16 is rotatably fitted around the axis on the outer periphery of the rear half of the elongated medical device holding rod 12. The fitting portion between the elongated medical device holding rod 12 and the operating ring 16 has a step at one place, and a lock nut 17 screwed to the elongated medical device holding bar 12 prevents the operating ring 16 from moving in the axial direction. Because of the restriction, the operating ring 16 is rotatable around the axis with respect to the elongated medical device holding rod 12, and cannot move in the axial direction.
[0023]
A male screw 16a is formed in a large diameter portion on the outer peripheral surface near the distal end portion of the operation ring 16, and is screwed with the female screw 11a of the main body 11, and a large diameter portion near the rear end portion of the operation ring 16 is formed. Is an operation knob 16b for performing an operation of pinching and rotating the operation ring 16 with a fingertip.
[0024]
A hole through which the elongated medical device 1 passes is formed at the center position of the distal end cap 18 screwed to the distal end portion of the main body 11, and the rod-shaped or string-like portion 1 a of the elongated medical device 1 is located on the front side thereof. The base end portion of an elongated medical device guide tube 19 that guides the tube so as to be able to advance and retreat in the axial direction is fixed to a distal end cap 18.
[0025]
Therefore, by unscrewing the screw and removing the tip cap 18 from the main body 11, the elongated medical device guide tube 19 can be removed together, and the elongated medical device guide tube 19 adapted to the size of the elongated medical device 1 to be used can be removed. Can be selected and used.
[0026]
As a whole, the elongated medical device guide tube 19 has a uniform inner diameter having a certain gap with respect to the outer diameter of the rod-shaped or string-shaped portion 1a so that the elongated medical device 1 can be loosely passed therethrough. Although it is a straight hard pipe having a large wall thickness, as shown in an enlarged view in FIG. 5, the distal end portion is formed in a smooth tapered shape that gradually becomes thinner toward the front side.
[0027]
Therefore, in that portion, the external shape of the elongated medical device guide tube 19 is a smoothly tapered shape with the tip side gradually narrowing, and there is no risk of damaging the mucous membrane of the patient to be used.
[0028]
Further, the minimum inner diameter of the distal end of the elongated medical device guide tube 19 is set to such a size that the elongated medical device 1 does not rattle, and the functional portion 1b of the elongated medical device guide tube 19 is connected to the distal end of the elongated medical device guide tube 19. , The tip of the elongated medical device 1 does not fluctuate, and accurate use can be performed. Note that the distal end portion of the elongated medical device guide tube 19 is formed in a similar shape in the second and subsequent embodiments.
[0029]
FIG. 6 is an enlarged right side view of the first embodiment, and FIG. 7 is an enlarged left side view. Numerals indicating the axial distance are displayed every 10 mm. In addition, linear indices B and C parallel to the axial direction are displayed on both the main body 11 and the operation ring 16.
[0030]
Therefore, when the operation ring 16 is rotated one turn, the operation ring 16 advances and retreats by 1 mm in the axial direction with respect to the main body 11, so that the amount of advance and retreat can be read from the scale A. Further, the positional relationship between the index B and the index C The rotation angle of the operation ring 16 can be read from the. The screw pitch of the threaded portion between the main body 11 and the operation ring 16 and the interval between the scales A and the like may be appropriately selected according to the purpose of use and the like.
[0031]
In the elongated medical device guiding apparatus of the embodiment configured as described above, the main body 11 is gripped with a hand or an arm-shaped surgical instrument fixing device (not shown) or the like, and the operation knob 16b is pinched with a fingertip to operate the operation ring. By rotating the operation ring 16, the operating ring 16 is moved in the axial direction while being rotated by screwing with the main body 11, and the elongated medical device holding rod 12 for holding the elongated medical device 1 is moved in the axial direction along with the operation ring 16. However, the elongated medical device holding rod 12 does not rotate due to the engagement between the detent pin 15 and the key groove 12a.
[0032]
Then, since the elongated medical device 1 is held by the elongated medical device holding rod 12, it is driven forward and backward in the axial direction according to the rotation amount of the operating ring 16, and the amount of advance and retreat is accurately determined from the scale A and the indexes B and C. Can be confirmed.
[0033]
When cleaning and disinfecting is performed after use, all parts can be easily disassembled, except that it is difficult to separate the elongated medical device holding rod 12 and the operation ring 16, and the inside is reliably cleaned. Disinfection can be performed.
[0034]
FIGS. 8 and 9 show an elongated medical device guiding device 10 according to the second and third embodiments of the present invention. In the second embodiment shown in FIG. 8, a rigid elongated medical device guide tube 19 is bent in the middle, and in the third embodiment shown in FIG. 9, the elongated medical device guide tube 19 is flexible. It is formed of a tube having properties. All other parts are the same as in the first embodiment.
[0035]
FIGS. 10 and 11 show an elongated medical device guiding apparatus 10 according to a fourth embodiment of the present invention, in which a connection ring 21 to which a base end of an elongated medical device guide tube 19 is fixed is held. The elongated medical device guide tube 19 is connected to and fixed to the distal end of the elongated medical device holding bar 12 by being screwed into the distal end of the rod 12. FIG. 10 shows a state in which the elongated medical device 1 is most retracted, and FIG. 11 shows a state in which the elongated medical device 1 is pushed out to the most distal end.
[0036]
With such a configuration, the elongated medical device guide tube 19 is advanced and retracted in the axial direction together with the elongated medical device 1 so that the waist is strengthened. Therefore, the rod-shaped or string-shaped portion 1a of the elongated medical device 1 is soft and the This is effective when you need to push. By attaching and detaching the connecting ring 21 to and from the elongated medical device holding rod 12, the elongated medical device guide tube 19 can be exchanged similarly to the first embodiment.
[0040]
FIG. 14 shows an elongated medical device guiding device 10 of the present invention attached to an inlet portion 53 of a forceps channel 52 that is inserted through an insertion tube 51 of an endoscope 50. The entrance portion 53 of the forceps channel 52 is located below the operation portion 54 of the endoscope 50, and the main body 11 of the elongated medical device guiding device 10 is detachably attached thereto via the connection base 25. .
[0041]
FIG. 15 is an enlarged cross-sectional view thereof, showing the distal end cap 18 of the elongated medical device guiding device 10 similar to that of the first embodiment, and the entrance portion 53 of the forceps channel 52 instead of the elongated medical device guide tube 19. A short elongated medical device guide tube 18a to be inserted into the protruding luer base 55 is integrally formed.
[0042]
The connection cap 25, which is pressed against the tip cap 18 in the axial direction by a pressing nut 26 and is rotatably provided around the axis, can be luer-engaged with the luer cap 55. . Note that the elongated medical device guiding device of each embodiment other than the first embodiment may be similarly configured.
[0043]
【The invention's effect】
According to the present invention, the structure in which the operating ring for driving the elongated medical device holding member to advance and retreat in the axial direction of the elongated medical device is simply provided by screwing to the main body, and the amount of movement of the elongated medical device in the axial direction is reduced. Since it can be controlled, the structure is simple and it is hard to break down, it can be easily disassembled as needed, it can be made easy to clean and disinfect, etc. It can be manufactured at lower cost.
[Brief description of the drawings]
FIG. 1 is a longitudinal sectional view of a slender medical device according to a first embodiment of the present invention in a retracted state.
FIG. 2 is a longitudinal cross-sectional view of the elongated medical device according to the first embodiment of the present invention in a state of being sent out.
FIG. 3 is an external view of the elongated medical device according to the first embodiment of the present invention in a state in which the medical device is being delivered.
FIG. 4 is a sectional view taken along line IV-IV of the first embodiment of the present invention.
FIG. 5 is an enlarged sectional view of a distal end portion according to the first embodiment of the present invention.
FIG. 6 is a right side view of the first embodiment of the present invention.
FIG. 7 is a left side view of the first embodiment of the present invention.
FIG. 8 is an external view of a second embodiment of the present invention.
FIG. 9 is an external view of a third embodiment of the present invention.
FIG. 10 is a longitudinal sectional view of a slender medical device according to a fourth embodiment of the present invention in a retracted state.
FIG. 11 is a vertical cross-sectional view of a fourth embodiment of the present invention in a state where an elongated medical device has been delivered.
FIG. 12 is an external view of a fifth embodiment of the present invention.
FIG. 13 is a longitudinal sectional view of a slender medical device according to a fifth embodiment of the present invention in a retracted state.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Slender medical tool 11 Main body 12 Holding member 16 Operation ring

Claims (11)

An elongated medical device holding member that holds an elongated medical device provided with a functional portion at the tip of an elongated rod or string,
A body that supports the elongated medical device holding member so as to be able to advance and retreat in the axial direction of the elongated medical device,
Holding member rotation restricting means for restricting rotation of the elongated medical device holding member with respect to the main body,
A rotatably axially screwed in the axis direction with respect to the body is provided so as not to be moved relative to the elongate medical device retaining member, Ri by the rotation-operating the elongate medical device An operating ring for moving the holding member forward and backward in the axial direction of the elongated medical device. The operation ring rotation amount rotation amount display means elongated medical device guidance system according to claim 1 Symbol mounting is provided with for displaying. The elongated medical device guiding device according to claim 1 or 2, further comprising a movement amount display means for displaying an amount of movement of the elongated medical device holding member in the axial direction. The elongated medical device guiding device according to any one of claims 1 to 3 , wherein an elongated medical device guide tube for guiding the elongated medical device forward and backward in the axial direction ahead of the main body is connected to the main body. The elongated medical device guide according to any one of claims 1 to 3 , wherein an elongated medical device guide tube that guides the elongated medical device in the main body and on the front side of the main body is connected to the elongated medical device holding member. apparatus. The elongated medical device guiding device according to any one of claims 1 to 5 , wherein the main body is attached to a forceps channel entrance portion of an endoscope. 7. The device for guiding an elongated medical device according to claim 6 , wherein the main body is detachable from a forceps channel entrance portion of the endoscope. The elongated medical device guiding device according to any one of claims 1 to 7 , wherein the elongated medical device is detachable from the elongated medical device holding member. The elongated medical device guiding device according to any one of claims 1 to 7 , wherein the elongated medical device is fixed to the elongated medical device holding member so as not to be detachable. The elongated medical device guiding device according to any one of claims 1 to 9 , wherein the elongated medical device has flexibility. The elongated medical device guiding device according to any one of claims 1 to 9 , wherein the elongated medical device is rigid and does not bend.

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