JP6938339B2 - Basket catheter - Google Patents

Description

The present invention relates to a catheter capable of preferably capturing foreign matter in a basket.

For the treatment of stones occurring in the bile duct and urethra, basket catheters (basket forceps) made by knitting shape memory alloy wires such as SUS stranded wire and Ni-Ti into a basket shape and balloon catheters for removing stones are used. In the basket catheter, in the basket portion for catching foreign matter such as calculus, a plurality of metal wires are bound at two points, a distal end and a proximal side to the distal end, and between the two binding portions. The wire is bent or twisted in a spiral shape to form a basket. The basket catheter reaches the treatment site such as in the bile duct through the forceps opening of the endoscope. The basket portion is housed in, for example, a resin sheath at the time of delivery to the affected portion, and is developed into a basket shape by being exposed from the distal end of the sheath at the time of capturing a foreign substance. After the foreign matter is contained in the basket, the basket catheter is removed from the treatment section to remove the foreign matter. However, the catheter itself may not be removed (incarcerated) from the treated area due to stenosis near the treated area. In such a case, it is possible to temporarily release the foreign substance from the basket, remove only the catheter, and insert a new treatment tool. However, depending on the state of capture, it may not be possible to release the foreign matter from the basket. As a result, the procedure time was lengthened and the invasion to the patient was increased by shifting to the de-inclusion procedure or the surgical procedure. Therefore, a device for preventing incarceration has been developed (Patent Documents 1 to 3).

Patent Document 1 describes a hollow sheath portion that can be inserted into a forceps channel of an endoscope, and a tip recovery that is located on the tip side of the hollow sheath portion and can be expanded in a basket shape or a net shape formed by a large number of wires. In the biological tissue recovery tool composed of the parts, an opening is formed by making the wire spacing of one set of the large number of wires wider than the other wire spacing in the expanded state forming the tip recovery part. It is disclosed to do.

In Patent Document 2, a basket formed in a basket shape by a plurality of elastic wires is connected to the tip of an operation wire that is inserted and retreated in the flexible sheath so as to be movable in the axial direction, and the basket is connected to the flexible sheath. In a basket-type collector for an endoscope in which the basket expands and contracts due to the elasticity of each elastic wire when it is recessed from the tip of the basket, the gap between adjacent elastic wires forming the basket is formed wider than the others at only one place. Is disclosed.

Patent Document 3 describes a long shaft body that is inserted into the lumen of a living body, a first dilated form that is exposed from the shaft body, and a second dilated form that is smaller than the first dilated form. A medical device having a treatment unit that can be transferred to and is disclosed. The treatment unit of this medical device is provided at a plurality of first wires provided in the circumferential direction of the treatment unit and a plurality of treatment portions provided in the circumferential direction of the treatment unit, and is located close to the first wire in the first extended form. Along with the transition from the first expansion form to the second expansion form, a plurality of first wires and a second wire that rotates relatively around the axis of the shaft main body and is separated from the first wire are included.

Japanese Unexamined Patent Publication No. 10-137252 Japanese Unexamined Patent Publication No. 2002-11301 Japanese Unexamined Patent Publication No. 2016-30077

However, as described in Patent Documents 1 and 2, by widening the gap between the adjacent elastic wires in advance, it becomes easier to remove the foreign matter from the basket, but the foreign matter having a relatively small size slips through the gap. Therefore, it was sometimes impossible to capture. Further, in the medical device described in Patent Document 3, even if the first wire and the second wire are separated from each other, the first wires arranged in the circumferential direction are arranged at equal intervals, so that there is a gap in which foreign matter is inserted. It was difficult to predict whether it would fall out of the wire, and it was not suitable for removing foreign matter once it had been taken in. Therefore, an object of the present invention is to provide a basket catheter capable of easily and efficiently performing both a foreign matter catching operation and a foreign matter removing operation in the basket portion.

The basket catheter of the present invention that has solved the above problems has an outer cylinder member having a distal side and a proximal side, an interpolation member arranged in the lumen of the outer cylinder member, and a distance between the interpolation members. A basket catheter having an expandable basket portion formed by three or more elastic wires arranged on the position side and arranged side by side in the circumferential direction of the interpolation member, and having an outer cylinder. It has a position adjusting member located on the distal side of the member, the position adjusting member can rotate in the circumferential direction of the outer cylinder member, and only a part of the elastic wires move with the rotation of the position adjusting member. Has a gist in. In the basket catheter of the present invention, only a part of the elastic wires can be moved by rotating the position adjusting member, and the distance between the part of the elastic wires and the other elastic wires adjacent thereto can be separated. can. Therefore, the captured foreign matter can be easily and efficiently removed from the basket portion, and the occurrence of incarceration can be prevented. Further, by rotating the position adjusting member in the opposite direction, the basket portion can be returned to the original state in which the foreign matter can be captured. Therefore, according to the basket catheter of the present invention, both the capture operation and the removal operation of the foreign matter can be easily and efficiently performed.

In the basket catheter, it is preferable that some elastic wires move in the circumferential direction of the outer cylinder member with the rotation of the position adjusting member.

In the basket catheter, it is preferable that the maximum outer diameter of the position adjusting member is smaller than the maximum inner diameter of the outer cylinder member in the radial direction of the outer cylinder member.

In the basket catheter, it is preferable that the position adjusting member is formed in a cylindrical shape and the interpolation member is arranged in the lumen of the position adjusting member.

In the basket catheter, it is preferable that the interpolation member is formed in a cylindrical shape, the position adjusting member is formed in a rod shape or a cylindrical shape, and the position adjusting member is arranged in the lumen of the interpolation member.

In the basket catheter, the position adjusting member has a groove or slit extending from the distal end toward the proximal side, and a part of the elastic wire is arranged in the groove or slit. preferable.

In the basket catheter, the groove is preferably arranged inside the position adjusting member.

It is preferable that the basket catheter is provided with a plurality of grooves or slits, and the plurality of grooves or the plurality of slits are arranged at equal intervals in the circumferential direction.

In the basket catheter, the position adjusting member preferably has an enlarged diameter portion whose outer diameter increases toward the distal end, and the enlarged diameter portion is provided with a groove or a slit.

In the basket catheter, the position adjusting member has an axially extending portion extending along the long axis direction of the outer cylinder member and a radial direction extending in a direction away from the center of the long axis of the outer cylinder member. It is preferable to have an extending portion.

In the basket catheter, the position adjusting member extends in the circumferential direction extending along the outer peripheral direction of the interpolation member on the distal end side of the radial extending portion in the cross section perpendicular to the long axis direction of the outer cylinder member. It is preferable to have an extending portion.

In the basket catheter, it is preferable that the radial extending portion of the position adjusting member faces the distal end surface of the interpolation member.

In the basket catheter, it is preferable that a holding portion for sandwiching a part of the elastic wire is provided on the distal side of the position adjusting member.

According to the basket catheter of the present invention, both the capture operation and the removal operation of the foreign substance can be easily and efficiently performed, so that incarceration can be prevented, the choice of procedure according to the case can be increased, and the minimally invasive treatment can be promoted. The effect is obtained.

A side view (partial cross-sectional view) of the distal side of the basket catheter according to the embodiment of the present invention is shown. A front view of the basket catheter shown in FIG. 1 as viewed from the distal end is shown. A side view (partial cross-sectional view) of the distal side of the basket catheter according to the embodiment of the present invention is shown. A front view of the basket catheter shown in FIG. 3 as viewed from the distal end is shown. A cross-sectional view taken along the line XX of the basket catheter shown in FIG. 1 is shown. A cross-sectional view showing a modified example of the basket catheter shown in FIG. 5 is shown. A cross-sectional view showing another modification of the basket catheter shown in FIG. 5 is shown. A cross-sectional view showing the shape of the distal end of a cylindrical position adjusting member having a groove is shown. A cross-sectional view showing the shape of the distal end of a rod-shaped position adjusting member having a groove is shown. FIG. 6 shows a cross-sectional view showing another shape of the distal end of a cylindrical position adjusting member having a groove. A cross-sectional view showing the shape of the distal end portion of a cylindrical position adjusting member having a slit is shown. A cross-sectional view showing the shape of the distal end portion of a rod-shaped position adjusting member having a slit is shown. A cross-sectional view showing the shape of the distal end portion of a rod-shaped position adjusting member having a slit is shown. A side view showing the slit shape of the position adjusting member is shown. A side view (partial cross-sectional view) of a basket catheter including a position adjusting member having a diameter-expanded portion is shown. A side view (partial cross-sectional view) of a basket catheter including a position adjusting member having an axially extending portion and a radial extending portion is shown. A front view (partial cross-sectional view) of a basket catheter including the position adjusting member shown in FIG. 16 as viewed from the distal side is shown. A front view (partial cross-sectional view) of a basket catheter including a position adjusting member having a circumferential extending portion as viewed from the distal side is shown. A front view (partial cross-sectional view) of a basket catheter including a position adjusting member having a holding portion as viewed from the distal side is shown. A plan view (partial cross-sectional view) of the proximal side of the basket catheter according to the embodiment of the present invention is shown. A plan view (partial cross-sectional view) showing a modification of the proximal side of the basket catheter shown in FIG. 20 is shown.

Hereinafter, the present invention will be described in more detail based on the following embodiments. In addition, it is of course possible to carry out, and all of them are included in the technical scope of the present invention. In each drawing, hatching, member reference numerals, and the like may be omitted for convenience, 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 because priority is given to contributing to the understanding of the features of the present invention.

In the present invention, the basket catheter has a distal side and a proximal side, and is a medical treatment tool having a basket-shaped basket portion for catching foreign substances in the body such as calculus. The basket catheter may be simply referred to as a "catheter" below. The catheter 1 of the present invention has an outer cylinder member 2, an interpolation member 3, a basket portion 10, and a position adjusting member 30. 1 and 3 show a plan view (partial cross-sectional view) of the distal side of the catheter 1 according to the embodiment of the present invention, and FIGS. 2 and 4 show the catheter 1 shown in FIGS. 1 and 3, respectively. Represents a front view when viewed from the distal end. FIG. 1 shows a state before the rotation of the position adjusting member 30, and FIG. 3 shows a state after the rotation of the position adjusting member 30. In addition, in FIG. 2 and FIG. 4, the position adjusting member 30, the interpolating member 2 and the connecting tool 20 are omitted.

In the present invention, the proximal side of the catheter 1 refers to the direction toward the hand side of the user (operator) with respect to the extending direction of the catheter 1, and the direction opposite to the distal side (that is, the treatment). (Direction on the target side). Further, the direction from the proximal side to the distal side of the catheter 1 is referred to as an axial direction.

The basket catheter 1 of the present invention is used for treatment using an endoscope, is placed in the body from the distal side of the forceps opening of the endoscope through the forceps opening of the endoscope, and reaches the treated portion. It is desirable that all materials of catheter 1 be biocompatible. The outer cylinder member 2 has a distal side and a proximal side, and can accommodate the basket portion 10 (basket forceps) in the lumen. By accommodating the basket portion 10 inside, the outer cylinder member 2 accommodates the elastic wire of the basket portion 10 until the catheter 1 is conveyed from the forceps opening of the endoscope through the forceps channel to the vicinity of the foreign matter. Prevents 15 from damaging the forceps opening in the endoscope, the forceps channel, internal tissues other than foreign substances, and the like.

Examples of the outer cylinder member 2 include a resin tube, a single wire or a plurality of wires, a tubular body formed by arranging stranded wires in a specific pattern, a metal pipe, or a combination thereof. The resin tube can be manufactured, for example, by extrusion molding. As the tubular body in which the wire rods are arranged in a specific pattern, a tubular body having a mesh structure by simply intersecting or knitting the wire rods, or a coil in which the wire rod is wound is shown. The type of network structure is not particularly limited, and the number of coil turns and the density are not particularly limited. The network structure and the coil may be formed at a constant density throughout the axial direction, or may be formed at a different density depending on the position in the axial direction. In order to increase the flexibility of the metal tube, a plurality of annular grooves or spiral grooves may be formed on the outer surface of the metal tube. Above all, it is preferable that the groove 32 is formed on the outer surface (particularly the outer peripheral surface) on the distal side of the center in the axial direction of the metal tube.

The outer cylinder member 2 is preferably made of resin or metal. Examples of the resin constituting the outer cylinder member 2 include polyamide-based resin, polyester-based resin, polyurethane-based resin, polyolefin-based resin, fluorine-based resin, vinyl chloride-based resin, silicone-based resin, and natural rubber. Only one of these may be used, or two or more thereof may be used in combination. Of these, polyamide-based resins, polyester-based resins, polyurethane-based resins, polyolefin-based resins, and fluorine-based resins are preferably used. Examples of the metal constituting the outer cylinder member 2 include stainless steel such as SUS304 and SUS316, platinum, nickel, cobalt, chromium, titanium, tungsten, gold, Ni-Ti alloy, Co-Cr alloy, or these. Combinations can be mentioned. In particular, the wire made of Ni—Ti alloy is excellent in shape memory and high elasticity. Further, the wire rod may be a fiber material such as the above-mentioned metal, polyarylate fiber, aramid fiber, ultra-high molecular weight polyethylene fiber, PBO fiber, carbon fiber and the like. The fiber material may be monofilament or multifilament. Further, a tubular body made of resin on which a reinforcing material such as a metal wire is arranged may be used as the outer cylinder member 2.

The interpolation member 3 is arranged in the lumen of the outer cylinder member 2. The interpolation member 3 is connected to the handle 50 provided on the proximal side and the basket portion 10 on the distal side, and transmits the operation on the hand side to the distal side.

The interpolation member 3 is preferably made of the same resin or metal as the outer cylinder member 2. The material of the interpolation member 3 may be the same as or different from the material of the outer cylinder member 2. Similar to the outer cylinder member 2, the interpolation member 3 is a tubular body, a metal pipe, or a combination thereof formed by arranging a resin tube, a single wire or a plurality of wires, and a stranded wire in a specific pattern. Can be used.

It is preferable that the interpolation member 3 is formed in a solid state, or that a plurality of wire rods are bound or twisted. As a result, the outer diameter of the interpolation member 3 can be reduced, so that the position adjusting member 30 and the connecting member 40, which will be described later, can be easily accommodated in the outer cylinder member 2. The elastic wire 15 forming the basket portion 10 is prepared in a long length, the basket portion 10 is formed in the distal portion of the elastic wire 15, and the proximal portion of the basket portion 10 is inside the second binding portion (described later). It can be the insertion member 3. The proximal portion of the wire can be bound or twisted to form the interpolating member 3.

It is preferable that the interpolation member 3 is formed in a hollow shape. As a result, an auxiliary treatment tool for removing foreign matter captured by the basket portion 10 can be arranged in the interpolation member 3. Other assistive devices can be used to observe intraluminal or foreign bodies and remove captured foreign bodies, such as preventing incarceration, increasing case-specific procedure options, and promoting minimally invasive treatment. The effect is obtained. For example, when removing stones in the bile duct by using an endoscope together, the catheter 1 inserted into the bile duct from an endoscope placed in the duodenum because the endoscope cannot be inserted into the bile duct. Therefore, by inserting an auxiliary treatment tool, which is an additional treatment tool, the efficiency of the treatment can be increased and the minimal invasiveness of the treatment can be promoted. Auxiliary treatment tools include balloon catheters, microcatheter, forceps, laser probes, fiberscopes, electrohydraulic impact crushing probes or guide wires.

As the hollow interpolation member 3, a hollow body formed by spirally winding one or a plurality of wire rods may be used. The interpolation member 3 is preferably a hollow body in a part in the perspective direction, and may be a hollow body in the entire axial direction. The hollow body formed by spirally winding a plurality of wires can also be formed as a hollow body without a core by twisting the plurality of wires. The hollow body is preferably a multi-layer hollow body in which a plurality of hollow bodies are stacked. The multi-layer hollow body can be formed, for example, by winding a wire rod around a core material to form a coil, and further winding a wire rod around the coil to form a coil. With such a hollow body, the torque on the hand side can be easily transmitted to the basket portion 10, and the operation of capturing foreign matter can be easily performed.

Although not shown, the interpolation member 3 may further have a metal tube connected to the proximal end of the hollow coil body. By providing the metal tube, the elongation rate of the interpolation member 3 in the axial direction can be suppressed. When the hollow body is formed in a coil shape, an extension resistance member extending along the perspective direction is arranged inside or outside the hollow coil body, and one end and the other end of the extension resistance member are hollow. It can be fixed to the coil body. As a result, it is possible to suppress the hollow coil body from extending in the axial direction.

The outer cylinder member 2 and the interpolation member 3 may be composed of a single layer or may be composed of a plurality of layers. Further, a part of the outer cylinder member 2 may be composed of a single layer in the axial direction, and the other part may be composed of a plurality of layers, and the same applies to the interpolation member 3.

In order to protect the outer cylinder member 2 and the inner cylinder member 3 from fluids such as a contrast medium and a chemical solution, a coating agent may be applied to the outer surface and the inner surface of the outer cylinder member 2 and the inner cylinder member 3. Further, in order to improve the slidability of the guide wire with respect to the interpolation member 3, a lubricant may be applied to the inner surface of the interpolation member 3. Further, in order to improve the slidability of the insertion member 3 with respect to the outer cylinder member 2, a lubricant may be applied to the inner surface of the outer cylinder member 2 and the outer surface of the insertion member 3.

The basket portion 10 is provided to capture foreign matter in the body. As shown in FIGS. 1 and 3, the basket portion 10 is arranged on the distal side of the interpolation member 3, and is formed by three or more elastic wires 15 arranged side by side in the circumferential direction of the interpolation member 3. It is extensible. The three or more elastic wires 15 are bound by the first binding portion and the second binding portion proximal to the first binding portion, respectively. The elastic wire 15 is given a curved shape or a bent shape, and is formed in a basket shape. As a result, a catching portion 16 for catching foreign matter is formed between the two binding portions. By exposing the distal side of the basket portion 10 from the second binding portion from the outer cylinder member 2, the elastic wire 15 expands outward in the radial direction, and the catching portion 16 can catch foreign matter. The shape of the elastic wire 15 may be a shape that passes on the same plane, or may be a shape such as a spiral shape in which the entire wire is not on the same plane.

The elastic wire 15 is a linear member having elasticity, and is preferably composed of a shape memory alloy or a shape memory resin. The elastic wire 15 is a single wire or twist made of, for example, stainless steel such as SUS304 or SUS316, platinum, nickel, cobalt, chromium, titanium, tungsten, aluminum, gold, silver, Ni—Ti alloy, Co—Cr alloy or the like. It may be a metal wire rod. Of these, a metal wire made of a Ni—Ti alloy is preferred. The number of elastic wires 15 is not particularly limited, but may be, for example, 3 or more, 4 or more, 5 or more, 6 or more, 8 or more, 10 or more, or 20 or less, 15 or less. Permissible.

In the catching portion 16, the elastic wire 15 may be formed in a straight line or in a curved shape. Further, it is preferable that the elastic wire 15 has a bent portion (bent portion) in the catching portion 16. At the bent portion, the elastic wire 15 may be curved or bent. By forming the catching portion 16 in this way, it becomes easy to catch the foreign matter.

In the catching portion 16, the elastic wire 15 may be made of different materials on the distal side and the proximal side of the basket portion 10 with respect to the maximum diameter portion 13. For example, it is preferable that the elastic wire 15 arranged proximal to the maximum diameter portion 13 has a lower hardness than the elastic wire 15 arranged distal to the maximum diameter portion 13. As a result, the elastic wire 15 arranged proximal to the maximum diameter portion 13 is easily deformed, so that some elastic wires 15 moved by the position adjusting member 30 and other elastic wires 15 adjacent to the elastic wire 15 are deformed. The distance can be preferably separated.

The basket portion 10 may have different numbers of elastic wires 15 on the proximal side and the distal side with the maximum diameter portion 13 interposed therebetween. For example, the number of elastic wires 15 on the distal side of the maximum diameter portion 13 is larger than that on the proximal side. You can do a lot. By forming the basket portion 10 in this way, both the foreign matter catching operation and the foreign matter removing operation can be easily and efficiently performed.

In the basket portion 10, three or more elastic wires 15 are bound in the first binding portion. In the first binding portion, the elastic wires 15 may or may not be in contact with each other. For example, the elastic wire 15 may be bound by the tip 11 at the first binding portion. A plurality of elastic wires 15 may be bound by a method such as heat welding, silver brazing, adhesion, or caulking. Further, these elastic wires 15 may be bound by forming a knot using a plurality of elastic wires 15.

Although not shown, the tip tip 11 preferably has a wire insertion hole into which the distal ends of the plurality of elastic wires 15 are inserted. The tip tip 11 may have a plurality of such wire insertion holes.

Examples of the material constituting the tip tip 11 include a resin, a metal, or a combination thereof constituting the outer cylinder member 2. The metal constituting the tip 11 is preferably stainless steel or a Ni—Ti alloy.

Although not shown, the tip tip 11 may be provided with a treatment tool insertion passage through which an auxiliary treatment tool, which is a treatment tool different from the basket catheter 1, is inserted. The treatment tool insertion passage preferably extends along the long axis direction of the interpolation member 3. By providing the treatment tool insertion passage in the tip tip 11, the distal end of the assistive treatment tool can be easily arranged on the distal side of the distal end of the catheter 1.

In the radial direction of the interpolation member 3, the outer diameter of the tip tip 11 is preferably larger than the inner diameter of the outer cylinder member 2. Even if the elastic wire 15 is housed in the outer cylinder member 2, the tip end 11 is prevented from being caught by the distal end of the outer cylinder member 2 and the basket portion 10 is prevented from being excessively moved to the proximal side of the outer cylinder member 2. .. Further, since the elastic wire 15 can be immediately exposed from the outer cylinder member 2 when performing the procedure after the accommodation, the procedure can be performed efficiently.

As shown in FIGS. 1 to 4, in the basket portion 10, three or more elastic wires 15 are bound at the second binding portion. In the second binding portion, the elastic wires 15 may or may not be in contact with each other. For example, the elastic wire 15 may be bound by the connector 20 at the second binding portion. In the second binding portion, it is preferable that three or more elastic wires 15 and the interpolation member 3 are connected by the connector 20. The connector 20 can be formed in a cylindrical shape such as a cylindrical shape or a polygonal tubular shape. The connector 20 can be made of, for example, the same material as the tip 11 and the outer cylinder member 2. Since the connector 20 is housed in the outer cylinder member 2 together with the elastic wire 15, the outer diameter of the connector 20 needs to be smaller than the inner diameter of the outer cylinder member 2. Further, a plurality of elastic wires 15 and connecting tools 20 may be bound to each other at a second binding portion by a method such as heat welding, silver brazing, adhesion, or caulking.

When the interpolation member 3 is formed in a hollow shape, the connector 20 is also formed in a ring-shaped or cylindrical hollow shape, for example, and the elastic wire 15 is fixed to the peripheral wall of the connector 20. preferable. The connector 20 may have a plurality of wire insertion passages into which the proximal end of the elastic wire 15 is inserted from the distal side. In that case, it is preferable that a plurality of wire insertion passages are arranged side by side in the circumferential direction. The wire insertion passages are preferably arranged side by side at equal intervals, but may be arranged unevenly. By connecting the interpolation member 3 and the three or more elastic wires 15 via the tubular connecting tool 20, an auxiliary treatment tool inserted into the lumen of the interpolation member 3 can be used in combination.

The position adjusting member 30 is arranged on the distal side of the outer cylinder member 2, is rotatable in the circumferential direction of the outer cylinder member 2, and only a part of the elastic wires 15 can rotate the position adjusting member 30. Move with. 1 to 4 show a basket catheter 1 having six elastic wires 15 (15a to 15f). When the position adjusting member 30 shown in FIGS. 1 to 2 is rotated, a part of the elastic wire 15 (elastic wire 15d) moves with the rotation as shown in FIGS. The distance between the 15 (15d) and the other elastic wire 15 (15e) adjacent thereto can be separated. Such a state is called an open state. The rotation of the position adjusting member 30 means the rotation of the position adjusting member 30 about the major axis direction.

By rotating the position adjusting member 30 in the opposite direction, the shape of the basket portion 10 can be returned from the open state (FIGS. 3 to 4) to the original state (FIGS. 1 to 2). Since such an operation is possible, when it becomes necessary to remove the captured foreign matter from the basket portion 10, the position adjusting member 30 can be rotated to open the shape of the basket portion 10. The stones inside the basket portion 10 are easily released, and the occurrence of incarceration can be prevented. Further, since only a part of the elastic wires 15 are moved by the position adjusting member 30 and the other elastic wires 15 are not moved, the foreign matter captured by the position adjusting member 30 can be dropped from the gap. In addition, some elastic wires 15 can be moved with less force. Therefore, according to the basket catheter 1 of the present invention, both the capture operation and the removal operation of the foreign matter can be easily and efficiently performed.

The part of the elastic wires 15 that move with the rotation of the position adjusting member 30 may not be all of the elastic wires 15 of the catheter 1. Although FIGS. 3 to 4 show an example in which one elastic wire 15d moves, a plurality of elastic wires 15 may move. Further, the remaining elastic wires 15 that do not move even if the position adjusting member 30 rotates may be singular or plural.

It is preferable that some elastic wires 15 move in the circumferential direction of the outer cylinder member 2 with the rotation of the position adjusting member 30, only some elastic wires 15 move in the circumferential direction of the outer cylinder member 2, and the remaining elasticity. It is more preferable that the wire 15 does not move in the axial direction or the circumferential direction of the outer cylinder member 2. This makes it easier to form an open state of the basket portion 10.

The position adjusting member 30 is preferably formed in a rod shape or a cylindrical shape. In that case, the position adjusting member 30 extends along the perspective direction. By forming the position adjusting member 30 in a substantially rotationally symmetric shape in this way, the shape becomes more compact, and it is possible to prevent the delivery of the catheter 1 and the expansion and contraction of the basket portion 10 from being hindered. Above all, the cylindrical position adjusting member 30 is more preferable because the interpolation member 3 and other treatment tools can be inserted into the lumen thereof.

The cross-sectional shape of the position adjusting member 30 in the direction perpendicular to the perspective direction can be a circular shape, an elliptical shape, a polygonal shape, or a combination thereof, but the slidability with the outer cylinder member 2 or the interpolating member 3 It is preferable that the shape is circular in order to improve the quality.

Regardless of the displacement of the elastic wire 15 in the circumferential direction, it is preferable that the length of the basket portion 10 arranged proximal to the distal end of the outer cylinder member 2 does not change and is constant. By setting the length of the basket portion 10 in this way, it becomes easy to perform both operations of capturing and removing foreign matter.

It is preferable that the maximum outer diameter of the position adjusting member 30 is smaller than the maximum inner diameter of the outer cylinder member 2 in the radial direction of the outer cylinder member 2. In that case, it is preferable that the position adjusting member 30 can move along the perspective direction. By setting the length of the position adjusting member 30 in the radial direction in this way, the position adjusting member 30 can be accommodated in the outer cylinder member 2, so that the position adjusting member is used when the basket portion 10 is delivered to the affected portion. It is possible to prevent 30 from coming into contact with the inner wall of the living body.

The position of the position adjusting member 30 in the perspective direction of the catheter 1 is not particularly limited, but it is preferable that the distal end of the position adjusting member 30 is arranged proximal to the maximum diameter portion 13 of the basket portion 10. As a result, it is possible to prevent the position adjusting member 30 from coming into contact with the elastic wire 15 and hindering the operation of removing foreign matter.

The catheter 1 may be provided with a mechanism for preventing the distal end of the position adjusting member 30 from moving to the distal side beyond the maximum diameter portion 13 of the basket portion 10. When the position adjusting member 30 moves to the distal side beyond the maximum diameter portion 13, the open state is not maintained and the distance between some elastic wires 15 and the other elastic wires 15 that move with the rotation of the position adjusting member 30 is This is because it becomes smaller. Therefore, it is preferable that the movement width of the connecting member (described later) connected to the position adjusting member 30 in the axial direction is controlled. For example, it is preferable that the handle is provided with a latch that limits the movement of the position adjusting member in the perspective direction. The position adjusting member 30 can be connected to the connecting member at any place such as inside the handle 50 or inside the outer cylinder member 2, but the position adjusting member 30 and the connecting member may be integrated. In that case, the proximal side of the position adjusting member 30 can be referred to as a connecting member.

When transporting the catheter 1, the distal end of the position adjusting member 30 is located proximal to the distal end of the interpolation member 3 so as not to come into contact with the inner wall of the forceps channel of the endoscope or the inner wall of the living body. It is preferably arranged. This makes it possible to prevent the elastic wire 15 provided on the distal side of the interpolation member 3 from interfering with the position adjusting member 30. Further, in order to smoothly engage with the elastic wire 15 and rotate the position adjusting member 30, when the position adjusting member 30 is rotated, the distal end of the position adjusting member 30 is moved from the maximum diameter portion 13 of the basket portion 10. Is preferably located on the proximal side and on the distal side of the proximal end of the basket portion 10.

The position adjusting member 30 is preferably made of resin or metal, and can be made of, for example, the same material as the outer cylinder member 2. That is, the position adjusting member 30 is preferably a metal tube or a resin tube.

The position adjusting member 30 preferably has a higher bending rigidity than the elastic wire 15, and more preferably, the distal end portion of the position adjusting member 30 has a higher bending rigidity than the elastic wire 15. By setting the elasticity in this way, the elastic wire 15 is more easily deformed when the position adjusting member 30 and the elastic wire 15 come into contact with each other. Therefore, a part of the elastic wire 15 can be moved by simply rotating the position adjusting member 30 lightly. Can be made to.

FIG. 5 is a cross-sectional view taken along the line XX of the basket catheter 1 shown in FIG. As shown in FIG. 5, it is preferable that the position adjusting member 30 is formed in a cylindrical shape and the interpolation member 3 is arranged in the lumen of the position adjusting member 30. In that case, it is preferable that the interpolation member 3 is formed in a hollow shape. By arranging the position adjusting member 30 in this way, the clearance between the interpolation member 3 and the outer cylinder member 2 can be effectively utilized. Further, if the interpolation member 3 is formed in a hollow shape, another treatment tool can be inserted into the lumen of the interpolation member 3 even if the position adjusting member 30 is provided in the catheter 1. Here, the fact that the interpolation member 3 is arranged in the lumen of the position adjusting member 30 includes a mode in which at least a part of the interpolation member 3 is arranged and a mode in which all of the interpolation member 3 is arranged.

6 to 7 are cross-sectional views showing a modified example of the catheter 1 shown in FIG. It is preferable that the interpolation member 3 is formed in a cylindrical shape and the position adjusting member 30 is arranged in the lumen of the interpolation member 3. In that case, the position adjusting member 30 may be formed in a rod shape as shown in FIG. 6 or may be formed in a cylindrical shape as shown in FIG. 7. By arranging the position adjusting member 30 in the lumen of the cylindrical interpolation member 3 in this way, the lumen of the interpolation member 3 can be effectively utilized. Here, the fact that the position adjusting member 30 is arranged in the lumen of the interpolation member 3 includes a mode in which a part of the position adjusting member 30 is arranged and a mode in which the entire position adjusting member 30 is arranged.

As shown in FIGS. 8 to 15, the position adjusting member 30 has a groove 32 or a slit 33 extending from the distal end toward the proximal side, and a part of the groove 32 or the slit 33 is formed. It is preferable that the elastic wire 15 is arranged. When the elastic wire 15 to be moved in the circumferential direction is caught in the groove 32 or the slit 33, a part of the elastic wire 15 is easily moved with the rotation of the position adjusting member 30. Here, the slit 33 penetrates the position adjusting member 30 along the radial direction, and the groove 32 does not penetrate the position adjusting member 30 along the radial direction.

The groove 32 or the slit 33 is preferably formed along the extending direction of the elastic wire 15, and more preferably extends from the distal end of the position adjusting member 30 toward the proximal side. As a result, the elastic wire 15 is caught in the groove 32 or the slit 33 before the position adjusting member 30 is rotated, so that the elastic wire 15 can be prevented from being freely positioned.

The groove 32 or the slit 33 may extend linearly along the perspective direction, and may extend linearly from the distal end toward the proximal side, or may extend in a curved shape or a combination of straight lines and curves. May be good. Further, the groove 32 or the slit 33 may have a meandering shape or a sawtooth shape. When the elastic wire 15 is formed in a spiral shape, it is preferable that the slit 33 of the position adjusting member 30 extends linearly along the perspective direction. Since the elastic wire 15 is easily caught in the slit 33, the elastic wire 15 can be easily moved in the circumferential direction.

The groove 32 or the slit 33 may be provided one or more. In order to facilitate the formation of the open state of the basket portion 10, it is preferable that the position adjusting member 30 is provided with a plurality of slits 33 or grooves 32. In that case, the plurality of slits 33 or the plurality of grooves 32 are preferably arranged at equal intervals in the circumferential direction. That is, it is preferable that the plurality of slits 33 or the plurality of grooves 32 are arranged rotationally symmetrically with respect to the major axis direction of the position adjusting member 30. The elastic wire 15 arranged in rotation symmetry can be easily arranged in the groove 32 or the slit 33. Here, the number of the grooves 32 or the slits 33 counts the number of the grooves 32 or the slits 33 appearing on the outer peripheral surface (the surface excluding the distal end surface and the proximal end surface) of the position adjusting member 30.

The number of grooves 32 or slits 33 is less than the total number of elastic wires 15. As a result, a part of the elastic wires 15 can be moved with the rotation of the position adjusting member 30, and the remaining elastic wires 15 are less likely to move.

A specific configuration example of the position adjusting member 30 described above will be described with reference to FIGS. 8 to 15. 8 to 13 show a cross-sectional view of the position adjusting member 30 in a direction perpendicular to the long axis direction, and FIG. 14 shows a side view showing the shape of the slit 33 of the position adjusting member 30. Reference numeral 15 is a side view of the basket catheter 1 including the position adjusting member 30 having the enlarged diameter portion 34.

In FIG. 8, the position adjusting member 30 is formed in a cylindrical shape, the groove 32 is arranged on the outside (outer peripheral surface) of the position adjusting member 30, and in FIG. 9, the position adjusting member 30 is formed in a rod shape. An example is shown in which the groove 32 is arranged on the outside (outer peripheral surface) of the position adjusting member 30. As described above, the position adjusting member 30 provided with the groove 32 on the outer peripheral surface can be easily manufactured by laser processing or the like.

As another embodiment, it is preferable that the position adjusting member 30 is formed in a cylindrical shape as shown in FIG. 10, and the groove 32 is arranged inside (inner peripheral surface) of the position adjusting member 30. Since the elastic wire 15 is provided with elasticity so as to expand its diameter naturally, the elastic wire 15 can be easily accommodated in the groove 32 arranged inside the position adjusting member 30, and the elastic wire 15 becomes the position adjusting member 30. It is firmly fixed to.

It is preferable that one or a plurality of elastic wires 15 are arranged in each groove 32, but it is preferable that one elastic wire 15 is arranged in order to prevent the elastic wire 15 from being excessively deformed. Therefore, the width of the groove 32 is preferably a size equal to or larger than the outer diameter of the elastic wire 15, more preferably 1.1 times or more, still more preferably 1.2 times or more. In order to prevent the elastic wire 15 from falling out of the groove 32, the width of the groove 32 is preferably 3 times or less the outer diameter of the elastic wire 15.

The width of the groove 32 may be constant or different in the perspective direction, but in order to facilitate the arrangement of the elastic wire 15 in the groove 32, the width of the groove 32 is preferably constant in the perspective direction. ..

From the viewpoint of preventing the elastic wire 15 from falling out of the groove 32 when the position adjusting member 30 is rotated, the depth of the groove 32 in the radial direction of the position adjusting member 30 is 0.8 of the outer diameter of the elastic wire 15. The size is preferably twice or more, more preferably the outer diameter or more, further preferably 1.25 times or more the outer diameter, and four times or less or three times or less. It is also acceptable to set the size.

As yet another embodiment, as shown in FIG. 11, the position adjusting member 30 may be formed in a cylindrical shape, and the slit 33 may be arranged at the distal end portion. Further, as shown in FIG. 12, the position adjusting member 30 may be formed in a rod shape, and the slit 33 may be arranged.

When a plurality of slits 33 are provided in the position adjusting member 30, the slits 33 are provided in one region (first region) when the outer peripheral surface of the position adjusting member 30 is divided into two equal parts in the circumferential direction as shown in FIG. The other region (second region) may not be provided with the slit 33. As a result, it is possible to suppress the movement of the elastic wire 15 arranged in the vicinity of the second region while moving the elastic wire 15 arranged in the vicinity of the first region. Here, the example of the slit 33 has been described, but in the case of the groove 32 as well, the slit 33 may be provided in the first region and not in the second region.

The width of the slit 33 can be set in the same manner as the width of the groove 32, but in order to make it difficult for the elastic wire 15 to come off after hooking the elastic wire 15 in the slit 33, as shown in FIG. It is preferable that the width is larger at the proximal end than at the distal end. In order to facilitate the effect of preventing the elastic wire 15 from coming off, the width of the slit 33 at the distal end is preferably 1.2 times or more the width of the slit 33 at the proximal end, and more preferably 1. It is 5.5 times or more, more preferably 2 times or more. In FIG. 14, the width of the slit 33 changes stepwise in the middle of the perspective direction, but the width of the slit 33 may gradually change.

As shown in FIG. 15, the position adjusting member 30 preferably has a diameter-expanded portion 34 whose outer diameter increases toward the distal end. In that case, it is preferable that the enlarged diameter portion 34 is provided with the groove 32 or the slit 33. By providing the enlarged diameter portion 34, the width of the groove 32 or the slit 33 expands toward the distal side, so that the elastic wire 15 can be easily arranged.

The outer diameter of the enlarged diameter portion 34 may be formed larger than the outer diameter of the proximal end of the position adjusting member 30, but in order to facilitate the arrangement of the elastic wire 15 in the groove 32 or the slit 33, the position The outer diameter of the proximal end of the adjusting member 30 is preferably 1.2 times or more, and more preferably 1.5 times or more. In the embodiment shown in FIG. 15, the position adjusting member 30 is made of a material having spring elasticity, and the position adjusting member 30 is smaller than the inner diameter of the interpolation member 3 when housed in the interpolation member 3. In a state of being discharged to the outside of the interpolation member 3 or the outer cylinder member 2, it is preferable that the maximum diameter is larger than the outer diameter of the interpolation member 3 or the outer cylinder member 2. As a result, the position adjusting member 30 does not interfere with the elastic wire 15 in the retracted state, and the elastic wire 15 is likely to be hooked on the groove 32 or the slit 33 in the released state.

The shape of the enlarged diameter portion 34 is not particularly limited, but when the position adjusting member 30 is viewed from the side surface, the distal end may be located radially outward of the proximal end in the entire circumferential direction. The distal end may be part of the circumferential direction and may be located radially outward of the proximal end. More specifically, the enlarged diameter portion 34 may have a cone shape in which the inner diameter increases toward the distal end.

In order to improve the catching of the elastic wire 15 on the enlarged diameter portion 34, the enlarged diameter portion 34 preferably has a size of 5% or more of the total length of the basket portion 10 in the perspective direction, and more preferably 10 % Or more, more preferably 15% or more. On the other hand, if the diameter-expanded portion 34 is excessively long, the basket portion 10 may hinder the operation of capturing and removing foreign matter. Therefore, in the perspective direction, the diameter-expanded portion 34 is 50% of the total length of the basket portion 10. The size is preferably the following, more preferably 40% or less, still more preferably 30% or less.

Hereinafter, still another embodiment of the position adjusting member 30 will be described with reference to FIGS. 16 to 19. In order to facilitate understanding of the shape of the position adjusting member 30, FIGS. 17 to 19 omit the illustration of the tip end 11, the elastic wire 15, and the connector 20. 16 to 17 are a side view and a front view (partial cross-sectional view) of the catheter 1 including the rod-shaped position adjusting member 30, respectively. As shown in FIGS. 16 to 17, the position adjusting member 30 is separated from the axially extending portion 35 extending along the major axis direction of the outer cylinder member 2 and the center of the major axis of the outer cylinder member 2. It is preferable to have a radial extending portion 36 extending in the direction. Since the position adjusting member 30 has the axially extending portion 35 in this way, the position adjusting member 30 can be easily arranged in the lumen of the outer cylinder member 2. Further, a part of the elastic wires 15 can also be moved by rotating the position adjusting member 30 after bringing the elastic wires 15 into contact with the radial extending portion 36 of the position adjusting member 30.

The radial extending portion 36 may extend linearly along the radial direction as long as it extends in a direction away from the center of the long axis of the outer cylinder member 2, and may be curved or straight and curved. It may extend to the combined shape.

As shown in FIG. 16, it is preferable that the radial extending portion 36 of the position adjusting member 30 faces the distal end surface of the interpolation member 3. When the position adjusting member 30 is formed in this way, the radial extending portion 36 and the elastic wire 15 are substantially perpendicular to each other, and the elastic wire 15 can be easily hooked by the radial extending portion 36. Therefore, the basket portion 10 is opened. It becomes easy to form into a state.

FIG. 18 is a front view (partial cross-sectional view) showing a modified example of the position adjusting member 30 shown in FIG. As shown in FIG. 18, the position adjusting member 30 extends along the outer peripheral direction of the interpolation member 3 on the distal end side of the radial extending portion 36 in the cross section perpendicular to the long axis direction of the outer cylinder member 2. It is preferable to have a circumferentially extending portion 37. Since the circumferential extending portion 37 makes it easy to hook the elastic wire 15 in the vicinity of the second binding portion, it becomes easy to form the basket portion 10 in the open state. In the position adjusting member 30, it is preferable that the axial extending portion 35, the radial extending portion 36, and the circumferential extending portion 37 are arranged in this order from the proximal side.

FIG. 19 is a front view (partial cross-sectional view) showing a modified example of the position adjusting member 30 shown in FIG. As shown in FIG. 19, the position adjusting member 30 formed in a cylindrical shape may have an axial extending portion 35, a radial extending portion 36, and a circumferential extending portion 37. For example, the axial extending portion 35 is a tubular body, and the radial extending portion 36 extending in the radial direction from the outer peripheral surface of the tubular body is provided, and the radial direction of the radial extending portion 36 is provided. It is preferable that a circumferential extending portion 37 extending from the outer end along the circumferential direction is formed.

As shown in FIG. 19, it is preferable that a holding portion 38 for sandwiching a part of the elastic wire 15 is provided on the distal side of the position adjusting member 30. By sandwiching a part of the elastic wires 15 between the holding portions 38, it is possible to prevent the elastic wires 15 from coming off from the position adjusting member 30 when the position adjusting member 30 is rotated, and to prevent the elastic wires 15 from returning to their original distances. can. In FIG. 19, the sandwiching portion 38 is formed by the outer peripheral surface of the position adjusting member 30 and the radial extending portion 36, but the present invention is not limited to this aspect.

Next, a configuration example on the proximal side of the catheter 1 will be described with reference to FIGS. 20 to 21. In order to rotate or move the position adjusting member 30 in the axial direction (longitudinal direction), it is preferable that the operating member 54 is connected to the proximal side of the position adjusting member 30. The operating member 54 is not particularly limited as long as it is a mechanism for axially moving the connecting member 40 in the perspective direction, and may be a button, a rotary handle, a rotary knob, or the like in addition to the slide lever.

As the material of the operating member 54, for example, a synthetic resin such as ABS or polycarbonate, or a foamed plastic such as a polyurethane foam can be used.

The position adjusting member 30 and the operating member 54 are preferably connected via a connecting member 40. The connecting member 40 can be a linear body, a tubular body, or a rod-shaped body extending in the perspective direction. 20 to 21 show an example in which a tubular body extending in the perspective direction is used as the connecting member 40.

In order to improve the operability of the outer cylinder member 2 and the inner cylinder member 3, it is preferable that a handle 50 having a hollow portion 55 is provided on the proximal side of the outer cylinder member 2 or the inner cylinder member 3. In FIGS. 20 to 21, the handle 50 includes a first handle 51 and a second handle 52, the first handle 51 is connected to the proximal end side of the interpolation member 3, and the second handle 52 is outside. It is connected to the proximal end side of the tubular member 2. The first handle 51 and the second handle 52 are preferably formed in a cylindrical shape so that the proximal end side of the interpolation member 3 and the outer cylinder member 2 can be inserted.

As the material of the handle 50, the same material as that of the operating member 54 can be used.

The lumen of the first handle 51 may communicate with the lumen of the interpolation member 3. The lumen of the first handle 51 may function as a passage for a drug, a fluid in the living body cavity, or the like, in addition to the insertion passage for the guide wire. Further, the lumen of the second handle 52, which is the lumen of the outer cylinder member 2 and communicates with the outside of the interpolation member 3, may function as a passage for a drug, a fluid in the living body cavity, or the like.

The insertion member 3 and the first handle 51, and the outer cylinder member 2 and the second handle 52 can be joined by using a conventionally known joining means such as an adhesive or heat welding. The first handle 51 is arranged proximal to the second handle 52. An annular resistance member 53 may be provided at the proximal end of the second handle 52, for example. As a result, the position of the second handle 52 with respect to the first handle 51 can be prevented from being unintentionally displaced, so that the relative positions of the outer cylinder member 2 and the interpolation member 3 can be fixed.

The operating member 54 is preferably in contact with the elastic member 56 arranged in the hollow portion 55 of the handle 50. As a result, the position adjusting member 30 can be easily slid by operating the operating member 54. In FIG. 20, the second handle 52 is provided with the hollow portion 55, and in FIG. 21, the first handle 51 is provided with the hollow portion 55.

In FIG. 20, the slide lever as the operating member 54 comes into contact with the spring member as the elastic member 56 arranged in the hollow portion 55 provided in the second handle 52 connected to the outer cylinder member 2. There is. In FIG. 21, the slide lever as the operating member 54 comes into contact with the spring member as the elastic member 56 arranged in the hollow portion 55 provided in the first handle 51 connected to the interpolation member 3. ing.

It is preferable that the operating member 54 is in contact with the proximal end of the spring member. As a result, when the slide lever is pushed to the distal side, that is, when the spring member is urged, the connecting member 40 moves to the distal side, so that the position adjusting member 30 connected to the connecting member 40 is moved. It can be slid toward the distal end of the basket portion 10. On the other hand, when the hand is released from the slide lever, the urging of the spring member is released, and as a result of the connecting member 40 being placed in the latest position, the position adjusting member 30 connected to the connecting member 40 is also proximal to the basket portion 10. Placed on the side. By providing the operating member 54 and the elastic member 56 on the handle 50 in this way, the position adjusting member 30 can be easily slid by operating in only one direction.

As the elastic member 56, a spring member such as a coil spring, a leaf spring, or a mainspring, or a rubber member can be used.

1: Basket catheter 2: Outer cylinder member 3: Interpolation member 10: Basket part 11: Tip tip 13: Maximum diameter part 15, 15a, 15b, 15c, 15d, 15e, 15f: Elastic wire 16: Capture part 20: Connection Tool 30: Position adjusting member 32: Groove 33: Slit 34: Enlarged portion 35: Axial extending portion 36: Radiating extending portion 37: Circumferential extending portion 38: Holding portion 40: Connecting member 50: Handle 51 : 1st handle 52: 2nd handle 53: Resistance member 54: Operating member 55: Hollow portion 56: Elastic member

Claims (8)

An outer cylinder member having a distal side and a proximal side,
An interpolation member arranged in the lumen of the outer cylinder member and
A basket having an expandable basket portion arranged on the distal side of the interpolation member and formed by three or more elastic wires arranged side by side in the circumferential direction of the interpolation member. It ’s a catheter,
It has a position adjusting member arranged on the distal side of the outer cylinder member, and has a position adjusting member.
The position adjusting member includes an axially extending portion extending along the long axis direction of the outer cylinder member and a radial extending portion extending in a direction away from the center of the long axis of the outer cylinder member. With a part,
A basket catheter characterized in that the position adjusting member is rotatable in the circumferential direction of the outer cylinder member, and only a part of the elastic wires move with the rotation of the position adjusting member. The basket catheter according to claim 1, wherein the partial elastic wire moves in the circumferential direction of the outer cylinder member with the rotation of the position adjusting member. In the radial direction of the outer cylinder member
The basket catheter according to claim 1 or 2, wherein the maximum outer diameter of the position adjusting member is smaller than the maximum inner diameter of the outer cylinder member. The position adjusting member is formed in a cylindrical shape and has a tubular shape.
The basket catheter according to any one of claims 1 to 3, wherein the interpolation member is arranged in the lumen of the position adjusting member. The interpolation member is formed in a cylindrical shape.
The basket catheter according to any one of claims 1 to 3, wherein the position adjusting member is formed in a rod shape or a cylindrical shape, and the position adjusting member is arranged in a lumen of the interpolation member. The position adjusting member extends in the circumferential direction extending along the outer peripheral direction of the interpolation member on the tip side of the radial extending portion in a cross section perpendicular to the long axis direction of the outer cylinder member. The basket catheter according to any one of claims 1 to 5, which has an interpolated portion. The basket catheter according to any one of claims 1 to 6, wherein the position adjusting member is a basket catheter whose radial extending portion faces the distal end surface of the interpolation member. The basket catheter according to any one of claims 1 to 7 , wherein a holding portion for sandwiching the part of the elastic wire is provided on the distal side of the position adjusting member.

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